Iyini inqubo ye-Mitrofanoff? Ake sixoxe ngayo kalula.

Ngezinye izikhathi kufanele sibhekane nezinkinga zempilo esingenakuzicabanga. Ikakhulukazi uma kukhulunywa ngezinkinga zesinyi, kunzima kakhulu ukungakwazi ukuchama ngendlela evamile. Ukuphila nezimo ezinjalo kuyinselele enkulu kokubili enganeni kanye nomuntu omdala. Ukuze sisize abantu abanjalo, namuhla sikhuluma ngokuhlinzwa okukhethekile okwenziwa ukuze kube lula ukuphila kwabo. Lokhu kubizwa ngokuthi iMitrofanoff Procedure. Nakuba igama lingavamile kancane, izinzuzo zalokhu zibaluleke kakhulu.

Kalula nje, kuyini lokhu kuhlinzwa kweMitrofanoff?

Ukuhlinzwa kwe-Mitrofanoff kuyindlela yokuhlinzwa edala umgodi omncane (obizwa ngokuthi i-stoma ) esiswini ukuze umchamo uphume esinyeni. Lena inqubo ekhethekile kakhulu ngoba odokotela abahlinzayo basebenzisa ingxenye yomzimba wakho ukudala lo mgodi. Leyo yi -appendix yakho.

Cabanga nje, usebenzisa i-scrotum yakho, udala indlela encane efana nethubhu esuka kwesinyeni sakho iye esiswini sakho. Bese kuthi, uma udinga ukuchama, ungafaka i-catheter , ithubhu eliguquguqukayo, ngaleli thuba (stoma) ukuze ukhiphe isinyeni sakho.

Le nqubo yaqala ukwethulwa ngo-1976 nguprofesa ogama lakhe linguPaul Mitrofanoff. Yingakho yaqanjwa igama layo. Ibizwa nangokuthi 'i-appendicovesicostomy'.

Ake siqale siqonde kancane ngalezi zingxenye zomzimba wethu.

Ukuze uqonde ngokugcwele lokhu kuhlinzwa, kuyasiza ukuba nombono omncane wokuthi uhlelo lomchamo lomzimba wethu kanye ne-ureter zisebenza kanjani.

• Isinye: Lesi sikhwama esinemisipha esibukeka njengebhaluni. Umchamo owenziwa yizinso zethu ngokuhlunga igazi ugeleza ngamapayipi amabili amancane (ama-ureter) bese uqoqana kulesi sinye. Uma sesigcwele, sizwa isidingo sokuchama. Ngemuva kwalokho, umchamo uphuma emzimbeni nge-urethra.
• Isithasiselo: Lena yingxenye yesimiso sethu sokugaya ukudla. Iyithubhu elincane elitholakala ohlangothini olungezansi kwesokudla lwesisu sakho, elixhunywe engxenyeni yokuqala yamathumbu akho amakhulu. Odokotela abasazi ukuthi linamuphi omunye umsebenzi. Kodwa singaphila impilo enempilo ngaphandle kwalo. Abantu abaningi bayalisusa ngokuhlinzwa uma bethola i-appendicitis. Ngakho-ke, akukho nkinga ngokulisebenzisa kwezinye izindlela eziwusizo.

Cabanga nje uma ungenayo i-appendix, okusho ukuthi yasuswa ekuhlinzweni kwangaphambilini, ubungenzani? Kukhona nesixazululo salokho futhi. Uma kunjalo, udokotela ohlinzayo uzosusa i-appendix emathunjini akho amancane.Bathatha ingxenye encane bese benza le ndlela. Ibizwa ngokuthi indlela ye-Monti noma ye-Monti-Yang.

Kwenzekani ngempela ngesikhathi sokuhlinza i-Mitrofanoff?

Lokhu kukuvumela ukuthi ukhiphe isisu sakho ngokwakho ngokufaka i-catheter ngembobo esiswini sakho (stoma). Lokhu kubizwa ngokuthi i-self-catheterization .

Usuku lonke, ngezikhathi ezithile (ngokuvamile njalo emahoreni angu-3-4), kuzodingeka wenze okulandelayo:

1. Ipayipi eliguquguqukayo (i-catheter) lifakwa ngembobo (stoma) esiswini bese liqondiswa endleleni eya kwesinye.

2. Wonke umchamo uthululwa endlini yangasese noma esitsheni esiseduze nepayipi.

3. Uma isinyi singasenalutho nhlobo, i-catheter iyasuswa. Imbobo (stoma) iyavaleka ngokuzenzakalelayo. Akukho ukuvuza komchamo kusuka lapho.

Le ndlela ilula, ayibuhlungu kakhulu, futhi ikhululekile kubantu abaningi kunokufaka i-catheter nge-urethra evamile.

Ubani odinga lokhu kuhlinzwa?

Ukuhlinzwa kwe-Mitrofanoff kungadingeka kokubili ezinganeni nakubantu abadala. Sizobheka kokubili ngokwehlukana.

Kungani ingane idinga ukuhlinzwa kwe-Mitrofanoff?

Abanye abantwana bazalwa benobuthakathaka obuthile ohlelweni lwabo lwezinzwa. Lokhu kubangela ukuthi bangakwazi ukulawula imisipha yesinye. Lokhu kubizwa ngokuthi i-neurogenic bladder . Futhi, izingane ezinezinkinga zesistimu yomchamo ezizalwa nazo zingadinga lolu kuhlinzwa.

Izizathu ezivamile zokuthi kungani izingane zidinga lokhu kuhlinzwa yilezi:

• I-Spine Bifida: Ubuthakathaka bomgogodla obukhona lapho kuzalwa.
• Ukuphuma kwesinye noma ukukhishwa kwe-cloacal: Ukuvezwa kwesinye ngaphandle ngenxa yokwakheka okungaphelele kodonga lwesisu ngesikhathi sokuzalwa.
• I-Cerebral Palsy: Isimo esithinta ukunyakaza komzimba kanye nokulawulwa kwemisipha ngenxa yomonakalo ebuchosheni.
• I-Sacral agenesis: Ukungabikho kwengxenye ephansi yomgogodla okuzelwe nayo.
• Ukulimala komgogodla.

Kungani umuntu omdala edinga ukuhlinzwa kwe-Mitrofanoff?

Abantu abadala bangase bangakwazi ukulawula isinyi sabo ngezizathu ezahlukene.

• Izimo zomdlavuza: Izimo ezifana nomdlavuza wesinye, umdlavuza we-prostate, noma umdlavuza we-colorectal.
• Ukungakwazi ukulawula umchamo: Ukungakwazi ukuzibamba kakhulu komchamo.
• Ukuvuvukala kwesinye (i-Cystitis).
• Izifo zesimiso sezinzwa: Isinyi esibangelwa yizinzwa esibangelwa yizimo ezifana ne-multiple sclerosis noma isifo sikaParkinson.
• Ukulimala komgogodla, ukukhubazeka, noma izimila zomgogodla.
• Isifo sohlangothi.

Kwenzekani ngaphambi, ngesikhathi nangemva kokuhlinzwa?

Kuvamile ukuzizwa wesaba kancane uma ukhuluma ngokuhlinzwa okukhulu okunje. Kodwa ukwazi kahle ukuthi lezi zinto zenzeka kanjani kungasiza ekunciphiseni lokho kwesaba.

Ngaphambi kwenqubo

Ukuze unciphise ingozi yokutheleleka ngesikhathi sokuhlinzwa, amathumbu akho kufanele abe angenalutho ngangokunokwenzeka. Lokhu kudinga ukulandela imiyalelo kadokotela wakho ngqo. Lokhu kungafaka:

• Ukuzila ukudla ngosuku olwandulela ukuhlinzwa.
• Ukuphuza isiphuzo esikhethekile ukuze kuhlanzwe amathumbu ngokuphelele (ukuhlanza amathumbu).

Ngesikhathi senqubo

Lokhu kuhlinzwa kwenziwa ngaphansi kwe-anesthesia ejwayelekile . Lokhu kusho ukuthi ngeke uzwe lutho ngesikhathi sokuhlinzwa, futhi uzobe ulele ngokuphelele.

Udokotela ohlinzayo ulandela lezi zinyathelo:

1. Kuzokwenziwa isilonda esiswini sakho.

2. I-appendix ihlukaniswe nomathumbu amakhulu.

3. Uhlangothi olulodwa lwayo luxhunywe embotsheni encane eyenziwe esinyeni, kanti olunye uhlangothi luxhunywe embotsheni encane (stoma) eyenziwe esikhumbeni sesisu.

4. Kwakhiwa isakhiwo esifana nevalvu lapho i-ureter ixhuma khona nesinye ukuvimbela umchamo ukuthi ungagelezi emuva. Le valve iyaqina futhi ivaleke lapho isinye sigcwala, ivimbele umchamo ukuthi uvuzane ngendlela edaliwe.

5. Ukuze kukusize ukhiphe umchamo kuze kube yilapho isinye sakho siphola, kufakwa ipayipi lesikhashana (ipayipi elingaphezulu kwesisu) ngqo esinyeni sakho. Lokhu kuqoqa umchamo esikhwameni esingaphandle komzimba wakho.

6. Ngezinye izikhathi, amapayipi amancane (ama-ureteral stents) angafakwa kumapayipi athwala umchamo usuka ezinso uye kwesinye (ama-ureters). Lokhu akudingekile kuwo wonke umuntu.

7. Ekugcineni, ukusika okuyinhloko okwenziwe ngenxa yokuhlinzwa kuvalwa ngezithungo ezincibilikayo.

Ngemva kwenqubo

Ngemva kokuhlinzwa, kuzodingeka uhlale esibhedlela cishe isonto lonke. Phakathi nalesi sikhathi:

• Ngeke uvunyelwe ukudla izinsuku eziningana. Kunalokho, uzonikezwa uketshezi lwe-IV ukuze unike amathumbu akho isikhathi sokuphulukiswa.
• Osukwini lokuqala noma ezimbili, kuzodingeka ulale embhedeni. Uzokwazi ukugoqa nokunyakaza imilenze yakho, kodwa ngeke uvunyelwe ukuvuka uhlale phansi.
• Uma ubuyela ekhaya, i-catheter kanye ne-'suprapubic' tube yesikhashana kuzofakwa ngaphakathi kwendlela entsha eyenziwe (umhubhe we-Mitrofanoff) ukuze ingavaleki. Le catheter kuzodingeka ishiywe endaweni yayo cishe amasonto amane.
• Uma lawo 'ma-stents e-ureteral' efakwa, kuzodingeka kwenziwe enye inqubo encane ukuze asuswe cishe emavikini ayi-6-8.
• Ngosuku ozofundiswa ngalo ukuzihlikihla, udokotela uzokhipha womabili amapayipi esikhashana ehhovisi. Lokhu akudingi ukuhlinzwa okunye.

Yiziphi izinzuzo nezingozi zalokhu kuhlinzwa?

Njenganoma iyiphi inqubo yezokwelapha, kunezinzuzo kanye nezingozi ezithile.

Ukululama nokuphila ngemva kokuhlinzwa

Emasontweni ambalwa okuqala ngemva kokuhlinzwa, ungase ubhekane nalokhu:

• Igazi elincane emchameni (i-hematuria).
• Ukufinyela okubuhlungu kwemisipha yesinye (ukuqaqamba kwesinyi).

Udokotela wakho uzokunikeza imithi yokuqeda izinhlungu kanye nemithi yokuphumula imisipha yalokhu.

Ngemva kwamasonto acishe abe yi-6, kuzodingeka ubone udokotela wakho ukuze ufunde ukuthi ungayifaka kanjani i-catheter ngokwakho (ukuzithutha ngokwakho).

Kodwa-ke, kufanele uhlale unake ukusebenza kohlelo lwakho lomchamo. Kufanele wenze ukuhlolwa okulandelayo minyaka yonke:

• Ukuhlolwa kwegazi ukuhlola izinga lama-electrolyte egazini kanye nokusebenza kwezinso.
• I-Cystoscopy (ukuhlolwa kwengaphakathi lesinye).
• Ukuhlolwa kwe-ultrasound kwezinso kanye nesinye.
• Ukuhlolwa kwe-X-ray kwezinso, esinyeni kanye ne-urethra.

Isikhathi sokubona udokotela ngokushesha

Uma uhlangabezana nanoma yiziphi zalezi zimpawu, kufanele ushayele udokotela wakho ucingo ngokushesha :

• Ukungakwazi ukukhipha ngokuphelele isinye.
• Ukopha ngokweqile, ukuvuvukala, noma ukuklwebheka.
• Isicanucanu nokuhlanza.
• Ubuhlungu obukhulu.
• Izimpawu zokutheleleka, njengokukhipha okunuka kabi noma umkhuhlane.

Uyini umehluko phakathi kweMitrofanoff ne-Urostomy?

Zombili lezi zindlela zihilela ukudlulisa umchamo ngembobo esiswini. Kodwa-ke, nge -urostomy , kwakhiwa indlela yokudlula esinyeni bese kukhishwa umchamo ngqo ezinso. Abanye abantu abane-urostomy kufanele bagqoke isikhwama sokuqoqa umchamo ngaso sonke isikhathi. Lokhu kusho ukuthi abakwazi ukulawula ukuhamba komchamo wabo. Kodwa-ke, nge-Mitrofanoff, unenkululeko eyengeziwe ngoba ungakhipha umchamo esinyeni sakho kuphela nge-catheter uma udinga ukwenza kanjalo.

Ingabe lokhu kuhlinzwa kungunaphakade?

Lokhu kungaguqulwa. Okusho ukuthi, umhubhe ungasuswa ngokuhlinzwa. Kodwa-ke, i-appendix ayixhunywanga emathunjini, njengoba ingeyona into ebalulekile. Ngemva kokususwa kwe-Mitrofanoff, kungadingeka ukuthi uchame ngendlela evamile nge-urethra, noma kungadingeka ukuthi ufake i-catheter kuyo ukuze ukhiphe isinye sakho, noma kungadingeka ukuthi wenze i-urostomy. Lokhu kuyinto okufanele uyixoxe nodokotela wakho.