Mhlawumbe wena noma othile omaziyo utshelwe udokotela ukuthi badinga ukuhlinzwa okubizwa ngokuthi 'i-proctocolectomy'. Kuvamile ukuzizwa wesaba futhi wethukile kancane uma uzwa leli gama. Cishe unemibuzo eminingi ekhanda lakho, njengokuthi "Kuyini lokhu kuhlinzwa? Kungani ngikudinga lokhu? Impilo yami izoba njani ngemva kwalokhu?" Ungakhathazeki. Ake sixoxe ngakho konke lokhu ngendlela elula kakhulu, isinyathelo ngesinyathelo, njengoba nje ubungakhuluma nomngane.
Kalula nje, kuyini i-Proctocolectomy?
I-proctocolectomy inqubo yokuhlinzwa esusa ingxenye noma wonke amathumbu akho amakhulu (ikholoni) kanye ne-rectum.
Manje ake sichaze lokhu kakhudlwana. Uhlelo lwethu lokugaya ukudla lunengxenye ebizwa ngokuthi i-large intestine. Ihlanganisa izingxenye ezintathu: i-colon, i-rectum, kanye ne-anus. Cabanga ngayo njengepayipi elide.
- Ikholoni: Lena yingxenye enkulu kakhulu yale payipi. Yilapho imfucuza eseleyo ngemva kokugaya ukudla esikudlayo imuncwa khona futhi iguqulwe ibe uhlobo oluqinile, olubizwa ngokuthi indle.
- I-Rectum: Lena yingxenye emfushane yamathumbu amakhulu egcina indle okwesikhashana ngaphambi kokuba iphume emzimbeni.
- Indunu: Lena yimbobo lapho indle iphuma khona emzimbeni.
Ekuhlinzeni nge-proctocolectomy, igama elithi "procto" libhekisela ku-rectum kanti elithi "colectomy" libhekisela ekususweni kwe-colon. Ngakho-ke , i-proctocolectomy iwukuhlinzwa okususa kokubili i-colon kanye ne-rectum. Ngezinye izikhathi, uma kususwa i-colon kuphela, kubizwa ngokuthi i-colectomy. Uma kususwa i-rectum kuphela, kubizwa ngokuthi i-proctectomy. Uyawuqonda umehluko?
Kungani udinga ukwenza lolu hlobo lokuhlinzwa?
Odokotela batusa ukuhlinzwa okukhulu kanje kuphela uma kunesizathu esibucayi. Lokhu kuhlinzwa kuvame ukwenziwa uma isimo esiku-colon noma i-rectum sivimbela i-colon noma i-rectum ukuthi isebenze kahle, noma uma isimo sisongela ukuphila.
Nazi ezinye zezizathu eziyinhloko:
- Izifo Zamathumbu Ezivuvukalayo (IBD): Lezi yizimo ezibangela ukuvuvukala isikhathi eside kanye nezilonda emathunjini. I-Ulcerative Colitis kanye neSifo sikaCrohn yizibonelo eziyinhloko. Abanye abantu kufanele basuswe izingxenye zamathumbu abo ezigulayo uma zingenakukwazi ukulawulwa ngemithi.
- Umdlavuza we-Coloral kanye nezimo ezingaphambi komdlavuza: Lapho amangqamuzana anomdlavuza ekhula ku-colon noma i-rectum, noma lapho kuvela ama-polyp angase abe umdlavuza (izimo ezifana ne -Familial Adenomatous Polyposis ), ukwelashwa okungcono kakhulu ukususa ngokuphelele izindawo ezigulayo.
- Ezinye izizathu:
- I-Ischemia yenzeka lapho ukugeleza kwegazi emathunjini kulahleka futhi izicubu ziyafa.
- Izimo ze-Diverticulitis eziyinkimbinkimbi.
- Ukulimala okubuhlungu emathunjini ngenxa yengozi enkulu.
- Ukuqunjelwa okukhulu okungelapheki ngemithi.
Into ebaluleke kakhulu ukuthi lokhu kuhlinzwa kwenziwa ukuze kusindiswe impilo yakho futhi kukunikeze impilo engcono nekhululekile.
Uphuma kanjani endlini yangasese ngemva kokuhlinzwa?
Lona ngumbuzo omkhulu engqondweni yawo wonke umuntu. Ngemva kokususwa kwe-colon kanye ne-rectum, indlela evamile yokuphuma kwendle iyanyamalala. Uzikhipha kanjani indle?
Impendulo yalokhu incike ohlotsheni lwe-proctocolectomy olwenzayo. Udokotela wakho uzonquma uhlobo lokuhlinzwa olukulungele kangcono ngokusekelwe esimweni sakho sezokwelapha kanye nesizathu sokuhlinzwa. Ake sibheke izinhlobo.
Yiziphi izinhlobo zokuhlinzwa kwe-proctocolectomy?
Kunezindlela eziningana zokwenza lokhu kuhlinzwa. Udokotela wakho uzokhetha indlela engcono kakhulu kuwe.
| Uhlobo lokuhlinzwa | Incazelo elula yalokho okwenzekayo |
|---|---|
| I-Proctocolectomy nge-Ileostomy (nge-ileostomy) | Kule nqubo, ikholoni kanye ne-rectum kususwa ngokuphelele. Bese kuthi ingxenye yokugcina yamathumbu amancane, ebizwa ngokuthi i-ileum , ikhishwe ngesikhumba sesisu bese kwakheka imbobo (stoma). Indle iphuma ngale mbobo. Kufakwa isikhwama ngaphandle kwayo. Abanye abantu kufanele bayigqoke unomphela, kanti abanye okwesikhashana kuphela. |
| Ukuhlinzwa Kwe-Proctocolectomy Okubuyiselayo Ngesikhwama Sase-Ileoanal (Ukuhlinzwa kokufaka esikhundleni) | Kule nqubo, ikholoni kanye ne-rectum nakho kuyasuswa, kodwa i-anus ishiywa iphelele. Okulandelayo, kwakheka isikhwama sangaphakathi kusukela ekugcineni kwamathumbu amancane (ileum). Lesi sikhwama, njenge-rectum yokuqala, sisiza ukubamba indle isikhashana. Lesi sikhwama sibe sesixhunywa kwi-anus (ileoanal anastomosis).Lokhu kukuvumela ukuthi ukhululeke ngendlela evamile. Lokhu kungenziwa ngokuhlinzwa okukodwa noma okubili. |
| I-Proctocolectomy Engaphansi (ukususa ingxenye) | Lokhu kuhilela ukushiya ingxenye yekholoni noma i-rectum. Isibonelo, inqubo kaHartmann isusa kuphela ingxenye yokugcina yekholoni (i-sigmoid colon) kanye ne-rectum. Uma lokhu kwenziwa, izingxenye ezisele eziphilile zekholoni zingaxhunyaniswa kabusha (i-anastomosis) , ukuze ukwazi ukuhamba kwamathumbu okuvamile. Ngezinye izikhathi i -colostomy yesikhashana (ukuvulwa kwekholoni) ingafakwa kuze kube yilapho inxeba liphola. |
Yini okufanele uyenze ngaphambi kokuhlinzwa?
Uma kungesona ukuhlinzwa okuphuthumayo, uzoba nesikhathi esanele sokulungiselela.
- Emasontweni ambalwa kusengaphambili: Khuluma nodokotela wakho mayelana nokuhlinzwa, izinhlobo zako, izingozi, kanye nezinzuzo. Buza noma yimiphi imibuzo onayo.
- Emasontweni amabili ngaphambi: Uma uthatha imithi yokunciphisa igazi, udokotela wakho uzokweluleka ukuthi uyeke noma uyinciphise. Futhi, zama ukugcina amathumbu akho ephilile ngokudla i-fiber eningi nokuphuza amanzi amaningi phakathi nalesi sikhathi.
- Amahora angama-24 ngaphambi: Ngosuku olungaphambi kokuhlinzwa, uzonikezwa isilungiselelo samathumbu ukuze uhlanze amathumbu akho ngokuphelele. Uzovunyelwa kuphela ukuphuza uketshezi olucacile, njengamanzi nesobho, ngalolo suku. Unganikwa futhi ama-antibiotic ukuvimbela ukutheleleka ngemva kokuhlinzwa.
Kwenzekani ngesikhathi sokuhlinzwa?
Uma uya esibhedlela, uzofakwa ingubo yokuhlinzwa. I-catheter ye-IV izofakwa emthanjeni wakho bese unikezwa usawoti kanye nanoma yimiphi imithi edingekayo. Uzobe usuyiswa egumbini lokuhlinzwa.
Udokotela wezinzwa uzokufaka ngaphansi kwe-anesthesia ejwayelekile. Ngeke uzwe lutho ngesikhathi sokuhlinzwa. Uzoxhunywa emshinini (i-ventilator) ukuze ukusize uphefumule.
Ukuhlinzwa Okuvulekile? Ukuhlinzwa kwe-Laparoscopic?
Namuhla, ukuhlinzwa okuningi kwe-proctocolectomy kwenziwa nge-laparoscopically . Lokhu kusho ukuthi esikhundleni sokwenza i-incision enkulu esiswini, ukuhlinzwa kwenziwa ngezimbobo ezimbalwa ezincane, lapho kufakwa khona ikhamera nezinsimbi ezincane kakhulu zokuhlinza. Le ndlela ivumela ukululama okusheshayo, ubuhlungu obuncane, kanye nezibazi ezincane. Kodwa-ke, le ndlela ayifanele wonke umuntu. Ezimweni eziyinkimbinkimbi noma eziphuthumayo, ukuhlinzwa okuvulekile kwendabuko kuyadingeka.
Ngesikhathi sokuhlinzwa, udokotela ohlinzayo ususa ngokucophelela ikholoni eligulayo kanye ne-rectum. Ngemuva kwalokho, njengoba kuxoxwe ngakho ekuqaleni, kwenziwa i-ileostomy/colostomy noma amathumbu aphinde axhumane (i-anastomosis).
Kwenzekani ngemva kokuhlinzwa?
Ngemva kokuhlinzwa, kuzodingeka uhlale esibhedlela cishe isonto lonke. Phakathi nalesi sikhathi, uzoqala kancane kancane ukudla okumanzi bese kancane kancane uqala ukudla okuqinile.
Uma une-ostomy (ileostomy/colostomy), umhlengikazi we-Wound Ostomy Continence Nurse (WOCN) uzokusiza. Bazokufundisa konke okudingeka ukwazi mayelana nokusebenzisa isikhwama se-ostomy nokugcina i-stoma yakho (ukuvula esiswini sakho) ihlanzekile. Ngisho noma kuyi-ostomy yesikhashana, kuzothatha izinyanga eziningana ngaphambi kokuba uxoxe ngezinyathelo ezilandelayo (ukuyisusa noma ukudala isikhwama sangaphakathi) nodokotela wakho.
Yiziphi izingozi nezinkinga ezihlobene nalokhu kuhlinzwa?
Njenganoma yikuphi ukuhlinzwa, kunezingozi ezithile ezihilelekile, kodwa lezi azivamile.
| Uhlobo lwenkinga | Izinto ezingenzeka |
|---|---|
| Izingozi ezivamile zokuhlinzwa | Ukusabela ekubulaweni yizinzwa, ukulimala kwezitho ezizungezile, ukopha ngokweqile, kanye nokutheleleka. |
| Izinkinga eziphathelene nokuhlinzwa | - Ukuvaleka kwamathumbu: Izicubu zezibazi ngenxa yokuhlinzwa zingabangela ukuthi amathumbu avaleke. - Ukulimala kwemizwa: Ukuhlinzwa kwendunu kungalimaza imizwa ehilelekile ekusebenzeni kocansi noma ekuchameni. Lokhu kuvame ukuphola ngokuhamba kwesikhathi. |
| Izinkinga Ezihlobene Ne-Ostomy (Ileostomy/Colostomy) | - Ukungezwani nesikhumba: Isikhumba esizungeze i-stoma singaba bomvu futhi sibe buhlungu ngenxa yokuthinta indle. - Izinguquko ku-stoma: I-stoma ingase ingene ngaphakathi kusukela ezingeni lesikhumba (ukuhoxa) noma iphume kakhulu (ukwehla). - I- Phantom Rectum: Ngisho noma i-rectum isusiwe, abanye abantu bangase bazizwe benesifiso sokuzikhulula. Lokhu kuzoncipha ngokuhamba kwesikhathi. |
| Izinkinga Ezihlobene Nesikhwama Sangaphakathi | - I-Pouchitis: Ukuvuvukala kwengaphakathi lesikhwama esisanda kudalwa. Lokhu kwelashwa ngama-antibiotic. - Ukuvuza kwe-anastomotic: Ukuvuza endaweni lapho kuxhunywa khona amathumbu. Lesi yisimo esingavamile kodwa esibucayi. - Ubunzima besikhashana bokulawula ukuhamba kwamathumbu: Ezigabeni zokuqala, kungaba nzima ukulawula ukuhamba kwamathumbu ngenxa yemisipha ebuthakathaka yendunu. Lokhu kuzothuthuka ngokuzivocavoca nesikhathi. |
Kunjani ukunakekelwa ngemva kokuhlinzwa?
Kungathatha izinyanga eziningana ukuthi ululame ngokuphelele. Phakathi nalesi sikhathi, kubaluleke kakhulu ukulandela imiyalelo kadokotela wakho ngokucophelela.
- Ukunakekelwa kwenxeba: Udokotela noma umhlengikazi uzokufundisa indlela yokuhlanza inxeba nokushintsha ibhandeji.
- Ukunakekelwa kwe-Ostomy: Uzofunda ukuthi ungathulula kanjani isikhwama se-ostomy izikhathi eziningana ngosuku futhi ugcine isikhumba esizungeze i-stoma sihlanzekile.
- Ukudla: Ngemva kokufika ekhaya uvela esibhedlela, kancane kancane faka ukudla okuqinile. Esikhundleni sokudla ukudla okuningi ngesikhathi esisodwa, yidla kancane izikhathi eziningana ngosuku. Hlafuna ukudla kwakho kahle.
- Ukumanzisa: Lokhu kubaluleke kakhulu. Njengoba ingxenye enkulu yekholoni yakho isusiwe, umzimba wakho uzomunca amanzi amancane. Ngakho-ke kubalulekile ukuphuza amanzi amaningi noketshezi usuku lonke.
Uzobona nini udokotela
Ngemva kokubuya ekhaya evela ekuhlinzweni, uma unezinye zezimpawu ezilandelayo , shayela udokotela wakho ngokushesha noma uye eMnyangweni Wezimo Eziphuthumayo (ETU) wesibhedlela esiseduze.
- Izimpawu zokuvaleka kwamathumbu zifaka phakathi ukuqunjelwa, ubuhlungu besisu, ukuqunjelwa kanye nesicanucanu.
- Izimpawu zesimo esithathelwanayo njengobuhlungu obukhulu besisu, ukuvuvukala, ukuphuma kobomvu esilondeni, kanye nomkhuhlane.
Ukuhlinzwa kwe-proctocolectomy kuyindlela enkulu yokuhlinzwa. Kodwa kungakusiza ukuthi uthole impumuzo esimweni sesikhathi eside futhi kuthuthukise ikhwalithi yempilo yakho. Ngobuchwepheshe banamuhla, izikhwama ze-ostomy zingenziwa zingabonakali futhi zikhululekile kakhulu. Khuluma nodokotela wakho ngezinketho zakho bese wenza isinqumo esikulungele wena.
Umlayezo Wokuya Nawe Ekhaya
- I-proctocolectomy iwukuhlinzwa okusindisa impilo okususa ikholoni kanye ne-rectum. Ivame ukwenziwa ezimweni ezimbi kakhulu njenge-IBD kanye nomdlavuza.
- Indlela yokukhipha amathumbu ngemva kokuhlinzwa izohluka. Kunezinketho ezifana ne-ileostomy (isikhwama sangaphandle) noma isikhwama sangaphakathi (isikhwama sangaphakathi).
- Khuluma nodokotela wakho ngokukhululekile ngohlobo lokuhlinzwa olukufanele futhi uthole yonke imibuzo yakho iphendulwa.
- Kuthatha isikhathi ukululama ngemva kokuhlinzwa. Phakathi nalesi sikhathi, landela imiyalelo kadokotela wakho ngokucophelela, ikakhulukazi mayelana nokudla nokuphuza uketshezi.
- Nakuba ukuhlala ne-ostomy kungase kubonakale kuyinselele ekuqaleni, ngokuqeqeshwa nokusekelwa okufanele, kungaba yingxenye yokuphila okuvamile.
- Uma uhlangabezana nanoma yiziphi izimpawu ezingavamile (ubuhlungu obukhulu, umkhuhlane, isicanucanu) ngemva kokuhlinzwa, funa iseluleko sezokwelapha ngokushesha.
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