Mitundu yosiyanasiyana ya opaleshoni imagwiritsidwa ntchito pochizira matenda opatsirana (IBD) . Mtundu umodzi wa opaleshoni umene nthawi zina amagwiritsidwa ntchito ndi kuchotsa kachilombo (komwe kumatchedwa proctectomy) ndi anus. Pamene zonsezi zichotsedwa, njira ina idzafunika kuti chitsime chichoke m'thupi. Ngati nthendayi yonse imachotsedwanso (yotchedwa colectomy ), panthawi imodzimodzimodzi ndi proctectomy kapena kale, leodiomy idzafunika.
Kwa anthu omwe ali ndi matenda a Crohn's and ulcerative colitis, mtundu wa ileostomy wotchedwa lekiniosis umakhala wotsiriza. Apa ndi pamene gawo la matumbo aang'ono amabweretsa kupyolera mimba, kunja kwa thupi, kupanga chomwe chimatchedwa stoma. Chikwama cha ostomy chimavala pa stoma kuti asonkhanitse chitseko ndipo amachotsedwa kangapo patsiku pakafunika.
Kuchita opaleshoni ya prostitectomy ingagwiritsidwenso ntchito pochiza khansa yapakhungu koma nkhaniyi idzakambilana za opaleshoniyo monga ikugwiritsira ntchito IBD komanso mogwirizana ndi kuchotsa anus. Pambuyo pake, kachilomboka kamatulutsidwa pa opaleshoni ya j-poch (ileoanal pouch anastomosis, kapena IPAA) , yomwe imachitika kwa odwala omwe ali ndi zilonda zam'mimba. Kwa odwalawa, nyerere imasiyidwa m'malo ndipo gawo lomalizira la m'mimba mwachinyama imapangidwira kukhala chimango chomwe chimagwira chitsime, monga chigamulocho chimagwira.
Pamene anus imachotsedwanso, dera limenelo la thupi limatsekedwa opaleshoni.
Anthu ena mumzinda wa IBD amanena za izi ngati kukhala ndi "Bayi Barbie" -yomwe imatchedwa chifukwa chakuti anthu ena amawakumbutsa pansi pa chidole, chomwe (mwachiwonekere) chiribe choyimira kuti chichotse pansi.
Proctectomy ndi opaleshoni yayikulu, osati chifukwa chachitidwa ndi mankhwala osokoneza bongo komanso zonse zomwe zimayenda nazo.
Pambuyo pa proctectomy ndi anus kuchotsedwa kwa IBD, ileostomy ndi yosatha. Icho chingakhale chinthu chovuta kukumana nacho pa zifukwa zambiri.
Komabe, ndikofunika kuzindikira kuti izi zingakhale opaleshoni yopulumutsa moyo kwa anthu ena omwe ali ndi IBD ndipo adzasintha kwambiri moyo wawo kwa ena ambiri. Anthu omwe ali ndi matenda a IBD omwe ali ndi kachilombo koyambitsa matendawa amatha kupirira ululu ndipo amakhala ndi madokotala ambiri omwe amawagwiritsa ntchito kuti athetse mavuto monga zibambo komanso fistula . Pambuyo pa opaleshoni ya proctectomy, anthu omwe ali ndi IBD amamva bwino ndikupeza kuti moyo wawo uli bwino.
Chifukwa Chake Wina Angakhale Wofunika Kwake Rectum ndi Anus Anachotsedwa
Zomwe zikuchitika tsopano zikuika chiwerengero cha odwala ndi Crohn's disease omwe amafunikira opaleshoni ya proctectomy monga pakati pa 12 peresenti ndi 20 peresenti. Anthu omwe ali ndi matenda a Crohn angafunikire kuchitidwa opaleshoniyi chifukwa matenda a Crohn amakhudza madera ozungulira anus, omwe amatchedwa perianal.
Matenda a Crohn nthawi zina amachititsa mavuto monga fistula kapena abscesses pafupi ndi anus. Mavutowa akhoza kukhala ovuta kuchiza ndi kuchiritsa ndipo sangabweretse mavuto komanso kuchepa kwa moyo. Nthaŵi zina, kugwiritsa ntchito leostomy kwa nthawi yochepetsera kukhala m'mimba kapena kuika mchere kungathandize, koma ngati zinthuzi sizigwira ntchito, proctectomy ikhoza kutonthozedwa.
Odwala omwe ali ndi ulcerative colitis omwe safuna kuchita opaleshoni ya j-pouch kapena sangathe kuchitidwa opaleshoni chifukwa cha mavuto m'dera la perianal, proctocolectomy ndi ileostomy yosatha ndiyotheka. Kwa anthu ochepa omwe ali ndi zilonda zam'mimba, ululuwu umakhalabe ndi kutupa, ndipo kuchotsa izo kumapereka mpata wabwino wopititsa patsogolo moyo wabwino.
Kwa odwala ena, ndipo izi ndizosowa, chiopsezo cha khansa ya m'magazi ndichochotsanso kuti kuchotsa chigamulocho ndi njira yabwino yochepetsera chiopsezocho.
Opaleshoni ya Proctectomy
Kuchita opaleshoni ya prostitectomy ndi opaleshoni yaikulu ndipo pali njira zosiyanasiyana zomwe zingagwiritsidwe ntchito.
Wachipatala wamkulu amene akuchita opaleshoniyo adzasankha momwe opaleshoniyo idzachitikire, ndipo odwala adzafuna kukambirana pazomwe amachitira opaleshoni isanakwane. Gulu lililonse lochita opaleshoni ndi chipatala lidzakhala ndi njira yabwino yothetsera opaleshoniyo ndi kusankha momwe adokotala angakhalire kuchipatala pambuyo pake ndi oyang'anira pambuyo.
Nthawi zonse, opaleshoniyi imapangidwa pansi pa anesthesia ndipo imafuna kuti chipatala chikhalepo kwa masiku angapo. Utsogoleri wa ululu udzakhala mbali yofunikira ya kuchiritsa onse kuchipatala ndi kunyumba. Monga ma opaleshoni ambiri, kudzuka ndi kuchoka pabedi ndikuyenda mwamsanga pamene ogwira ntchito kuchipatala akuyamikira ndi kofunika kuti machiritso ayambe.
Pambuyo pa opaleshoni ya proctectomy, odwala amapita kunyumba ndi ileostomy yatsopano, ngati wina sali pambali pa opaleshoniyo. Namwino wothandizira odwala amathandizira kumvetsetsa momwe angasamalire stoma yatsopano ndi momwe mungasinthire chida cha ostomy. Padzakhalanso nsonga pansi pomwe anus yatsekedwa, ndipo dera limenelo liyenera kusamalidwa ndi kusamalidwa kwapadera kwa nthawi mpaka itachiritsidwa. Gulu la opaleshoni lidzapereka malangizo pazinthu zina zomwe wodwala atatulutsidwa kuchipatala.
Kusintha kwa Zakudya
Odwala angakhale pamtumbo (osati kudya zakudya) mpaka matumbo aang'ono "amadzuka" kuchokera ku opaleshoni ndikuyamba kuimba phokoso limene katswiri wa zaumoyo angamve kupyolera mu stethoscope pamimba. Gawo lotsatira nthawi zambiri kumadya zakumwa zoyera monga gelatin ndi msuzi, ndipo pang'onopang'ono kuwonjezera mitundu yambiri ya zakudya mpaka mutadya chakudya cholimba kachiwiri.
Odwala nthawi zambiri amapita kunyumba pa zakudya zomwe zasinthidwa kwa milungu ingapo mpaka ochita opaleshoni achikulire akuti chakudya choyenera chingayambirenso. Pambuyo pake, pakhoza kukhala zakudya zochepa zomwe dokotala ndi opaleshoni amalimbikitsa kuti zipewe (zinthu monga mapulogalamu kapena mtedza) chifukwa mtundu uliwonse wa opaleshoni ya m'mimba uli ndi chiopsezo chakumapeto. Izi zowopsya zimakhala zosiyana kwambiri ndi munthu, kotero zakudya zimakambidwa bwino ndi dokotalayo ndi ena a gulu la thanzi.
Zovuta Zopangika za Proctectomy
Mabala a Perianal: Mavuto ambiri omwe amagwiritsidwa ntchito pochita opaleshoni ya Crohn ndizokhala ndi chilonda chosagwedezeka m'dera la perianal. Nthaŵi zina, anthu omwe ali ndi matenda a Crohn omwe amafunikira proctectomy amadwala kwambiri ndipo akhoza kukhala osauka kwambiri kuposa iwowo ndi madokotala awo omwe angafune opaleshoni yoyamba.
Kukhala ndi ziphuphu kapena fistula m'dera la perianal ndichinthu chowopsa chifukwa chokhala ndi mavuto m'madera omwewo atatha opaleshoni. Zakudya zoperewera kapena mavitamini, kukhala wosuta, ndi kunenepa kwambiri kungathandizenso kuti zilonda zichiritsidwe musanapite opaleshoni. Nthawi zambiri mabala osachiritsika amachiritsidwa moyenera ndi njira zothandizira mabala koma pazochitika zingapo, opaleshoni ina ingafunike.
Ntchito yokhudzana ndi kugonana : Zokhudzana ndi ntchito za kugonana zimayambanso ndi opaleshoni yotereyi. Mwamwayi, kutsekemera kwa erectile kwa amuna pambuyo pa proctectomy ndi kotsika, ndipo akuyenera kukhala pakati pa awiri ndi anayi peresenti. Ngakhale nkhani yabwino kwambiri ndi yakuti kafukufuku wina wamtsogolo wa nthawi yayitali anasonyeza kuti 90 peresenti ya anthu omwe anali opaleshoni ya prostitectomy amakhutira ndi thanzi lawo la kugonana.
Odwala ena amafotokoza kuti ntchito yogonana ndi yoipa kwambiri, ndipo chiwerengerochi chiyenera kukhala pakati pa 25 ndi 30 peresenti. Odwala omwe amapeza kuti kugonana si zomwe akufuna kuti azikhala akufuna kukambirana nkhaniyi ndi dokotala wa opaleshoni ndi / kapena gastroenterologist. Thandizo liripo pazokhudzana ndi thanzi labwino komanso chidutswa chofunikira kwambiri kuti zithetse vuto lanu ndikuziyika kwa gulu lanu la thanzi.
Mankhwala: Odwala ena akhoza kudera nkhaŵa ndi momwe mankhwala omwe akugwiritsidwira panopo angakhudzire kupumula. Kafukufuku wina adawonetsa kuti anthu omwe ali ndi matenda a Crohn omwe akulandira mankhwala a biologic alibe vuto lalikulu lokhala ndi vuto ndi machiritso a machiritso kusiyana ndi omwe sakutenga mankhwala a biologic panthawiyo.
Mawu Ochokera
Kuchita opaleshoni ya prostitectomy ndizovuta kwa anthu ambiri omwe ali ndi IBD. Kukhala ndi opaleshoni imeneyi kumatanthawuza ostomy yosatha, ndipo ngakhale odwala ambiri amamva bwino ndikusangalala ndi moyo pambuyo pa opaleshoni ya ostomy, mwachibadwa kukhala ndi nkhawa.
Kuyankhula za opaleshoni ndi opaleshoni wamkulu ndi gastroenterologist nthawi zambiri kumathandiza kuika zinthu zambiri zoopsa pamalingaliro. Uthenga wabwino ndi wakuti anthu ambiri omwe ali ndi IBD omwe ali ndi opaleshoni ya proctectomy amachiritsa bwino ndikupitiriza kukhala omasuka ndikusangalala ndi moyo wawo.
> Zotsatira:
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