Uma udokotela wakho ekutshela ukuthi udinga ukuhlinzwa kwamathumbu amakhulu, kuvamile ukuzizwa ukwesaba okukhulu nokukhathazeka. Uma uzwa igama elifana nelithi "proctocolectomy," kungabonakala kuyinkimbinkimbi nakakhulu. Kodwa ungakhathazeki. Lokhu ukuhlinzwa okusindisa impilo okungakusiza uphile impilo engcono ngokunciphisa izimpawu zakho zamanje. Sizoxoxa ngakho konke ngendlela elula ongayiqonda.
Kuyini ngempela i-Proctocolectomy?
Kalula nje, i-proctocolectomy ukususwa ngokuhlinzwa kwekholoni lakho kanye nengxenye yokugcina ye-rectum yakho.
Ake sichaze lokhu kakhudlwana. Amathumbu amakhulu ayingxenye ende efana nepayipi yesistimu yethu yokugaya ukudla. Anezingxenye ezintathu eziyinhloko:
1. Ikholoni: Lena yingxenye enkulu kunazo zonke. Imunca amanzi avela emikhiqizweni elahliwe ekudleni esikudlayo bese iwaguqula abe yisimo esiqinile, esibizwa ngokuthi indle.
2. I-Rectum: Lena yingxenye emfushane ye-rectum elandela i-colon. Yilapho indle igcinwa khona okwesikhashana ngaphambi kokuba ikhishwe.
3. Indunu: Imbobo lapho indle iphuma khona emzimbeni.
Ngakho-ke, ekuhlinzweni kwe-proctocolectomy, kokubili ikholoni kanye ne-rectum kuyasuswa, noma ingxenye yakho. Igama elithi "Procto" lisho i-rectum. Igama elithi "Colectomy" lisho ukususwa kwekholoni.
Kungani udinga ukwenza lolu hlobo lokuhlinzwa?
Kunezizathu eziningana zokuthi kungani ukuhlinzwa okukhulu kangaka kungenziwa. Isizathu esiyinhloko ukuthi isifo esisemathunjini sivimbela leyo ngxenye yomzimba ukuthi isebenze kahle noma ukuthi lesi sifo sisongela ukuphila.
| Isimo sezokwelapha | Incazelo elula |
|---|---|
| Izifo Zamathumbu Ezivuvukalayo | Uma ingaphakathi lamathumbu lilimele njalo futhi livuvukala ngenxa yezimo ezifana ne -Ulcerative Colitis nesifo sikaCrohn , kungase kudingeke ukuhlinzwa uma lesi simo singenakulawuleka ngemithi. |
| Umdlavuza we-Colorectal kanye nezimo ezingaphambi komdlavuza | Ukuvimbela ukusabalala kwamangqamuzana omdlavuza wamathumbu amakhulu noma ezimweni ezifana ne -Familial Adenomatous Polyposis (FAP) , okuyisimo esidluliselwa ngofuzo esibangela amakhulu ama-polyp angase abe nomdlavuza. |
| Ezinye izizathu | Izinkinga ezifana nokufa kwezicubu zamathumbu ngenxa yokulahlekelwa igazi (ischemia), ukuqunjelwa okukhulu, ukulimala okukhulu kwamathumbu, noma i-diverticulitis . |
Uzikhipha kanjani indle ngemva kokuhlinzwa?
Lona ngumbuzo omkhulu abantu abaningi abanawo. Uma kususwa ikholoni kanye ne-rectum, indlela evamile yokuphuma kwendle iyalahleka. Uzikhipha kanjani indle? Impendulo yalokhu incike ohlotsheni lwe-proctocolectomy olwenzile. Udokotela wakho uzonquma indlela efanele kakhulu ngokusekelwe esimweni sakho sezokwelapha.
Kunezindlela eziningana eziyinhloko:
1. Inqubo ye-Ileostomy
Lokhu kuhilela ukuxhuma ingxenye yokugcina yamathumbu akho amancane, ebizwa ngokuthi i-ileum, nomgodi omncane (stoma) owenziwe esikhumbeni sesisu sakho. Isikhwama se-ostomy sibe sesinamathiselwa emgodleni ukuze kuqoqwe indle. Lokhu kungaba okuhlala njalo noma okwesikhashana . Okwesikhashana kwenziwa kuphela kuze kube yilapho umzimba wakho uphulukiswa. Lokhu kungashintshwa kamuva ngokuhlinzwa okunye.
2. Isikhwama se-Ileoanal (ukudalwa kwesikhwama sangaphakathi)
Lena inqubo ethakazelisa kakhulu. Ibizwa nangokuthi i-Restorative Proctocolectomy. Kuthathwa ingxenye yamathumbu akho amancane (ileum) bese kudalwa isikhwama esincane kuyo. Cabanga ngayo njengengxenye entsha yomzimba wakho engabamba indle yakho okwesikhashana, njenge-rectum yakho. Ngemuva kwalokho, isikhwama siphinde sixhunywe kwi-anus yakho. Ngemva kwale nqubo, uzokwazi ukuya endlini yangasese bese ukhipha indle ngokujwayelekile ngemva kwesikhashana. Inqubo evame kakhulu yalokhu ibizwa ngokuthi i-J-pouch .
3. I-Proctocolectomy Engaphansi Kwesamba (ukusindisa ingxenye)
Kulokhu, ingxenye yamathumbu amakhulu iyashiywa. Uma kungenzeka ukwenza kanjalo, ingxenye esele yamathumbu ingaxhunyaniswa kabusha ne-anus noma ingxenye esele ye-rectum (anastomosis). Kodwa-ke, ngezinye izikhathi, kungadingeka kwenziwe imbobo yesikhashana esiswini bese kufakwa isikhwama sendle (colostomy) kuze kube yilapho indawo yokuxhumana iphola.
Into ebaluleke kakhulu ukuthi udokotela wakho uzoxoxa nawe ngokuthi iyiphi kulezi zindlela engcono kakhulu kuwe. Ngakho-ke, xoxa nganoma yimiphi imibuzo noma ukukhathazeka onakho nodokotela wakho.
Kwenzekani ngaphambi, ngesikhathi, nangemva kokuhlinzwa
Ngaphambi kokuhlinzwa
Uma kungesona ukuhlinzwa okuphuthumayo, uzoba nesikhathi sokulungiselela.
- Emasontweni ambalwa ngaphambi: Udokotela wakho uzokuchazela ngokuhlinzwa, izingozi zako, kanye nezinketho zakho.
- Emasontweni amabili ngaphambi: Uma uthatha imithi yokunciphisa igazi, uzotshelwa ukuthi uyeke noma uyinciphise. Uzokwelulekwa ukuthi udle ukudla okune-fiber ephezulu futhi uphuze amanzi amaningi.
- Amahora angama-24 ngaphambi: Uzonikezwa isilungiselelo samathumbu ukuze uhlanze amathumbu akho ngokuphelele. Uzotshelwa nokuthi udle uketshezi kuphela losuku. Unganikwa futhi ama-antibiotic ukuvimbela ukutheleleka ngemva kokuhlinzwa.
Ngesikhathi sokuhlinzwa
Uzolaliswa ngaphansi kwe-anesthesia, ngakho ngeke uzwe lutho. Ukuhlinzwa kungenziwa ngezindlela ezimbili eziyinhloko:
- Ukuhlinzwa Okuvulekile: Indlela yendabuko, eyenziwa ngokusikwa okukhulu esiswini.
- Ukuhlinzwa kwe-Laparoscopic: Okwaziwa nangokuthi ukuhlinzwa "kwe-keyhole", lokhu kwenziwa ngokwenza izimbobo ezimbalwa ezincane esiswini bese kufakwa ikhamera namathuluzi abucayi kuzo. Le ndlela iholela ekupholeni okusheshayo kanye nobuhlungu obuncane.
Udokotela ohlinzayo ube esesusa ngokucophelela ingxenye yamathumbu egulayo bese enza izinqubo ezidingekayo (ileostomy, pouch, noma re-connect) njengoba kuxoxwe ngakho ekuqaleni.
Ngemva kokuhlinzwa
Kuzodingeka uhlale esibhedlela cishe isonto. Phakathi nalesi sikhathi, uzoshintsha kancane kancane usuke ekudleni okumanzi uye ekudleni okuqinile. Uma une-ostomy (isikhwama), umhlengikazi oqeqeshwe ngokukhethekile (WOCN - Wound Ostomy Continence Nurse) uzokufundisa ukuthi ungayisebenzisa kanjani futhi agcine isikhumba sakho sihlanzekile.
Yiziphi izinkinga ezingaba khona?
Njenganoma yikuphi ukuhlinzwa, kunezingozi nezinkinga ezithile ezingase zenzeke, kodwa isikhathi esiningi lokhu kungokwesikhashana.
| Uhlobo lwenkinga | Incazelo |
|---|---|
| Izinkinga ezivamile zokuhlinzwa | Ukusabela ekubulaweni yizinzwa, ukopha kwangaphakathi, izifo, ukuvaleka kwamathumbu, njll. |
| Izinkinga ezihlobene ne-ostomy (isikhwama) | Ukutheleleka kwesikhumba okuzungeze i-stoma, okuhlasela noma okuphuma ku-stoma.Isimo esibizwa ngokuthi i-phantom rectum singaba khona. Lona umuzwa wokuthi kufanele ukhululeke ngisho noma i-rectum isusiwe. Lokhu kuzoncipha ngokuhamba kwesikhathi. |
| Izinkinga ezihlobene nesikhwama se-Ileoanal (isikhwama sangaphakathi) | I-Pouchitis , ukuvuza kwe-anastomotic, kanye nokungakwazi ukuzibamba indle kusenesikhathi. Eziningi zalezi zingelapheka. |
Yiziphi izimo eziphuthumayo ezidinga ukubona udokotela?
Uma ubuyela ekhaya ngemva kokuhlinzwa, uma unezinye zezimpawu ezilandelayo, shayela udokotela wakho ngokushesha noma uye e -Emergency Treatment Unit (ETU) yesibhedlela.
- Ukuqunjelwa, ubuhlungu besisu, isicanucanu, kanye nokuqunjelwa (lokhu kungaba izimpawu zokuvaleka kwamathumbu).
- Ubuhlungu obukhulu besisu, umkhuhlane, ukuphuma kobomvu emsikweni (lezi yizimpawu zokutheleleka).
Ungakhohlwa, uma uzizwa ungento engavamile, ungayinaki. Kuphephile ukufuna iseluleko sezokwelapha.
Umlayezo Wokuya Nawe Ekhaya
- Nakuba i-proctocolectomy iwukuhlinzwa okukhulu, ingalapha izimo ezisongela ukuphila futhi ikuvumele ukuthi uphile impilo ekhululekile.
- Kunezindlela ezahlukene zokuzikhulula ngemva kokuhlinzwa. Abanye abantu kufanele baphile nesikhwama se-ostomy, kanti abanye banezinye izinketho ezibavumela ukuthi bakhululeke ngendlela evamile. Udokotela wakho uzonquma ukuthi yini engcono kakhulu kuwe.
- Kuthatha isikhathi ukuphulukiswa. Ungabuyela empilweni evamile ezinyangeni ezimbalwa. Kubaluleke kakhulu ukuba nesineke nokulandela imiyalelo kadokotela wakho phakathi nalesi sikhathi.
- Zizwe ukhululekile ukuxoxa ngazo zonke izinto ozesabayo, ukungabaza, kanye nemibuzo nodokotela wakho. Kuzokunika amandla amakhulu engqondo.
- Nakuba ukuhlala nesikhwama se-ostomy kungaba yinselele ekuqaleni, uma usujwayele, ungaqhubeka nokusebenza ngendlela evamile. Kunezindlela eziningi ezitholakalayo namuhla zokusiza ngalokhu.
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