Mitundu Yambiri ya Opaleshoni ya Colectomy yomwe Ikhoza Kuchitidwa Kwa Matenda Okula
Mwachidule, kuchitidwa opaleshoni kuchotsa zonse kapena gawo la coloni (matumbo akulu) amatchedwa colectomy. Komabe, pali mitundu yosiyanasiyana ya opaleshoni ya colectomy. Anthu omwe ali ndi matenda opatsirana (IBD) akhoza kuchitidwa opaleshoni ya colectomy kuti adziwe matenda awo, koma mtundu wa opaleshoni umachitidwa, ndi kuchuluka kwa chiwonongekocho chichotsedwa, chidzakhala chosiyana chifukwa cha mtundu wanji wa matendawa, ndi momwe Kuwonongeka kwakukulu kumatumbo akulu.
Kuchita opaleshoni ya Colectomy kawirikawiri imayikidwa mu imodzi mwa magulu angapo, malinga ndi kuchuluka kwake kwa coloni kuchotsedwa, kapena ngati yonseyo itachotsedwa.
Komabe, ziyenera kudziwika kuti sikuti opaleshoni iliyonse yopangidwa ndi IBD idzagwera chimodzi mwa izi: pali kusiyana. Musanachite opaleshoni kuchotsa gawo kapena colon yanu yonse, lankhulani ndi timu yanu yopaleshoni yokhudza opaleshoni yeniyeni yomwe muli nayo. Gwiritsani ntchito ndondomeko ili m'munsiyi kuti mudzidziwe ndi zina mwaziganizo, kuti mudziwe nokha kumvetsetsa opaleshoni yomwe ikuchitidwa pa vuto lanu.
Proctocolectomy
Mu mtundu uwu wa opaleshoni ya colectomy, khola imachotsedwa, pamodzi ndi rectum . "Procto" amatanthauza "rectum." Kagawo kameneka ndi mbali ya thupi lomwe liri kumapeto kwa koloni limene limagwiritsidwa ntchito kuti likhale ndi chitseko lisanathe kuchotsedwa ku thupi kudzera mu anus . Pamodzi ndi colon ndi rectum atachotsedwa, thupi lidzasowa njira yatsopano yotaya chidutswa.
Kwa anthu ambiri omwe ali ndi IBD (Crohn's disease kapena ulcerative colitis), proctocolectomy imatanthauzanso kulengedwa kwa ileostomy . Analoostomy ndi pamene chiwalo cha m'mimba chimabweretsa kupyolera mu mimba. Chophimba chimachoka mthupi kudzera mu stoma, ndipo chimasonkhanitsidwa mu chipangizo cha ostomy chimene chimabedwa kunja kwa thupi.
The ileostomy ikhoza kukhala yosatha kapena ikhoza kukhala yochepa.
J-Pouch Surgery
Mtundu umodzi wa opaleshoni umene umachitika nthawi imodzi kapena nthawi zina proctocolectomy ndi thumba la leal-anal anastomosis (IPAA) . Kuchita opaleshoni imeneyi kumatchedwa kuti opaleshoni ya j-pouch (ngakhale zikwama zina zimapangidwanso mu "S" kapena "W" mawonekedwe). Pa opaleshoni imeneyi, gawo lomalizira la m'mimba mwachinyamatayo (terminal leamu), limagwirizanitsidwa palimodzi mwa "J" ndipo amatha kugwira chikhomo kwa nthawi, akutumikira monga rectum. J-poch imagwirizanitsidwa ndi anus pa opaleshoni ina, kawirikawiri patapita nthawi ndi ileostomy yaifupi. Pambuyo pochita opaleshoni kuti athe kugwirizanitsa matumbo aang'ono ndi anus, chitseko chikhoza kuchotsedwanso kudzera mu anus (pansi). Kuchita opaleshoniyi kumachitidwa kwa odwala matenda a zilonda zam'mimba, koma m'madera ena apadera angathe kuthandizira anthu omwe ali ndi matenda a Crohn .
Ileoanal Anastomosis
Mtundu wina wa opaleshoni womwe umachitidwa kuti ubwezeretse mphamvu yosunthira sitima kudzera mu anus umatchedwa leoanal anastomosis (kukoka). Mu opaleshoniyi, atatha kuchotsedwa ndi colon ndi rectum, katumbo kakang'ono kamagwirizanitsa ndi anus. Nthaŵi zambiri nthawi yodikira pakati pa opaleshoni ya colectomy ndi opaleshoni, pamene wodwala ali ndi ileostomy yaifupi kuti athe kuchiritsidwa.
Palibe thumba lopangidwa kuchokera m'mimba yaing'ono. Kuchita opaleshoniyi kunkachitidwa kawirikawiri kwa anthu omwe ali ndi zilonda zam'mimba zisanafike zaka za 1980, isanachitike kuti opaleshoni yowonjezereka ikhale yoyenera. Nthawi zina amachitanso anthu omwe ali ndi matenda a Crohn omwe alibe matenda m'mimba mwawo.
Colectomy Yonse
Colectomy yeniyeni imatanthawuza kuti zonsezi zimachotsedwa. Mawuwa akhoza kukhala osokoneza poyerekeza ndi proctocolectomy chifukwa mu colectomy wathunthu, rectum yatsala m'malo. Colectomy yochuluka ndi ena kapena onse omwe amachoka kumalo omwe amachokapo akhoza kuchitika nthawi zina za ulcerative colitis kapena matenda a Crohn.
Cholectomy chonse chifunikanso kulengedwa kwa ileostomy (ndi stoma, pomwe thumba lavala kunja kwa thupi kuti lisonkhanitse chovala). The ileostomy ingakhale yosatha, koma nthawi zina zingakhale zazing'ono. Kuchita opaleshoni yowonjezereka, monga opaleshoni ya j-poch kapena opaleshoni yopyolera, ingakhoze kuchitidwa kuti "abwererenso" matumbo ang'onoting'onoting'ono kumtunda ndi kubwezeretsa ileostomy yaifupi. Pambuyo pochita opaleshoni kuti agwirizane m'mimba mwaching'ono ndi rectum, chitseko chikhoza kuchotsedwanso kudzera mu anus (pansi).
Chosankha Colectomy
Colectomy yachepa ndi pamene gawo la colon lichotsedwa, ndipo nthawi zina limatchedwa colectomy. Mu opaleshoni iyi, mbali iliyonse ya colon ingachotsedwe. Cholectomy yochepa ikhoza kuchitidwa kwa anthu ena omwe ali ndi matenda a Crohn, ndipo amatha kupiranso khansa ya colon kapena diverticulitis . Pambuyo pa gawo la coloni lomwe liri ndi matenda akuchotsedwera, koloni yathanzi kumbali zonse imagwirizana. Rolostomy , komwe mbali ya coloni imabweretsamo kupyolera mimba kuti chotupa chichotsedwe mu thumba la pamimba, nthawi zambiri sichifunika.
Colectomy yazing'ono sizingachitike kwa anthu omwe ali ndi zilonda zam'mimba, chifukwa nthendayi imabwereranso mu gawo labwino lomwe limakhalapo. Mu matenda a Crohn, palinso kachilombo ka matendawa kubwereranso mumtunda, ndipo opaleshoni yowonjezera imafunika nthawi zina.
Chigamulo chochotseratu chigawo cha anthu omwe ali ndi matenda a Crohn ndi chisankho chodziwika bwino, ndikuganizira momwe matendawa alili m'tchire, ndi zaka komanso wathanzi.
Hemicolectomy
Mu opaleshoni ya hemicolectomy, mwina theka kapena lamanzere la coloni imachotsedwa. M'chilungamo cha hemicolectomy, cecum , kukwera kolon , ndi gawo la phulusa losunthirapo amachotsedwa, pamodzi ndi zowonjezereka , zomwe zikuphatikizidwa ndi colon. Kumanzere kwa hemicolectomy, kutsika kwa colon , ndi mbali ina ya phulusa yowonongeka imachotsedwa. Njirayi ingapangidwe pofuna kuthana ndi matenda a Crohn, matenda a khansa, kapena khansa yamtunda. Kawirikawiri, zigawo zathanzi za coloni zimagwirizana palimodzi ndipo ostomy safunikira.
Chitsime:
Munthu B, Khaikin M. "Ntchito Yokonzanso Matenda a Crohn's." Chipatala cha Clinol Chikulire Chokwanira . 2007 Nov; 20 (4): 314-321. lembani: 10.1055 / s-2007-991031. 22 Dec 2015.