Mitundu Yambiri ya Njira Zogwiritsira Ntchito
Gastrectomy ndi njira yopaleshoni imene imachotsa, m'mimba mwake, gawo la m'mimba. Pali mitundu yambiri ya kugonana, yomwe imasiyana mosiyana ndi ziwalo za m'mimba ndi zozungulira zomwe zimachotsedwa panthawiyi.
The Esophagus, Stomach, ndi Duodenum
Kuti mumvetse bwino mitundu yosiyanasiyana ya njira ya kugonana, ndikofunika kumvetsetsa momwe zimakhalira m'mimba komanso m'mimba.
Anthu ambiri amamvetsa mimba ndi momwe zimagwirira ntchito, koma sadziwika bwino ndi ziwalo ndi zobvala zozungulira.
Munthu akamadya chakudya, chimbudzi chimayamba ndi kuluma koyamba. Manyowa amathandiza kuluma kapena kudula chakudya m'zidutswa zing'onozing'ono, kenako kutafuna kumapangitsa kuti chakudyacho chikhale chodabwitsa kwambiri. Salava imakhala ndi mavitamini a m'mimba omwe amayamba kuyambitsa zakudya, koma mano amachititsa ntchito zambiri pakadali pano. Kudula, malingana ndi kutalika kwake komanso momwe zimakhalira bwino, kungatenge mpweya wolimba ndikuupanga kukhala phala wabwino. Chakudya chikafunidwa bwino, kumeza kumayambitsa chakudya kuchokera pakamwa mpaka m'khosi. Mphepete imatsogolera chakudya ku mimba.
Mankhwalawa ndi chubu yomwe imagwirizanitsa kummimba mpaka m'mimba, ndipo imalola kuti nyama izizifuna kuti pang'onopang'ono zilowe m'mimba. Pakati pa mimba ndi m'mimba ndi mitsempha yotsegulira yomwe imatha kutseguka ndi kutseka, kulola chakudya kuti chilowe m'mimba, koma chimalepheretsa kuchoka pamwamba pa mimba.
Mimba imapanga asidi ku chakudya, ndipo imapangitsa kuti chakudyacho chipitirize kugwira ntchito. Mimba itatha kumaliza gawo lake la chimbudzi, pirmonic sphincter, minofu pansi pa mimba, imatsegula ndi kutsekera kuti chakudya chiloĊµe m'mimba pang'ono ndikulowa m'mimba yoyamba ya m'mimba.
Gawo ili la m'mimba mwaching'ono limatchedwa duodenum.
Mitundu ya Gastrectomy
Mitundu yosiyana ya kudzipangidwira ndi izi:
- Gastrectomy yochepa: Iyi ndi njira yowonongeka yomwe m'munsi mwa mimba imachotsedwa.
- Zojambulajambulazi: Njirayi opaleshoni imachotsa mbali ya kumanzere ya m'mimba.
- Kuthamanga kwapopogogastomy : Njira yopaleshoni yomwe pamwamba pa mimba, mtima wamphongo sphincter, ndi gawo la mimba imachotsedwa.
- Chidziwitso chonse : Mimba yonse imachotsedwa mu njira yopaleshoniyi. Zigawo za mayendedwe ndi duodenum zingachotsedwe.
Zifukwa za Gastrectomy
Pali zifukwa zingapo zomwe zimapangidwira. Chikhalidwe cha vutoli chidzatsimikizira mtundu wa kugonana komwe ukuchitidwa, ndipo minofu yambiri iyenera kuchotsedwa. Kawirikawiri, pochiza matenda opatsirana, amayesetsa kuchepetsa kuchuluka kwa matenda omwe achotsedwa, kusunga minofu yabwino kwambiri momwe ingathere pochotsa minofu yoipa.
Kunenepa kwambiri
M'mbuyomu, opaleshoni ya opaleshoni inkachitidwa pofuna kuchiza matenda kapena chikhalidwe chokhudza mimba. Kulemera kwa thupi kunkaonedwa kuti ndi mbali imodzi, kapena vuto linalake, pambuyo pochiritsira matenda ena.
M'zaka zaposachedwapa, kugwiritsira ntchito mankhwala ogwiritsira ntchito kogwiritsira ntchito kugwiritsidwa ntchito monga opaleshoni yachipatala, yomwe ndi njira yopaleshoni yopangira kunenepa kwambiri.
Kwa anthu ochepa kwambiri, kuchepa kukula kwa mimba kungachititse kuti kuchepa kwakukulu kuwonjezereke kwa thupi. Mosiyana ndi opaleshoni ya kulemera kwa thupi, odwala matenda opatsirana pogonana ali pangozi yochepa ya kusowa kwa zakudya m'thupi chifukwa cha kuchepa kwa zakudya zopatsa thanzi, komabe amatha kutaya mapiritsi owonjezera.
Mosiyana ndi mitundu ina ya zozizwitsa zomwe zimayesetsa kusunga minofu yathanzi ngati n'zotheka, pamene chovala chamanja chimagwiritsidwa ntchito pofuna kulemera kwake, pali ziwalo zathanzi zomwe zimachotsedwa kuti zichepetse mphamvu za wodwalayo.
Zimenezi zimapangitsa wodwala kumverera kuti ali ndi chakudya chochepa kwambiri, ndipo amachititsa kulemera kwake.
Zilonda: Zilonda zapeptic , kapena zilonda zomwe zimapanga m'mimba, mitsempha kapena duodenum, zimayambitsa ululu ndi magazi. Kwa odwala ena, pamakhala magazi ochepa koma osasinthasintha omwe angayambe kuperewera kwa magazi. Kwa ena, kutuluka kwa magazi ndiko mwadzidzidzi komanso kofunika, kufunika kuti tipeze chidwi. Zilonda zimayamba kupezeka pamene wodwalayo akufuna kufufuza kuti amve ululu m'mimba. Esophagogroduodenoscopy (EGD) , yomwe imadziwikanso ngati Wopambana GI, imakhala ikuchitidwa kuti dokotala aone mkati mwa mimba kotero kuti matenda angapangidwe.
Chidziwitso chaching'ono sizodziwika kuti choyamba chithandizo cha zilonda. Malingana ndi mtundu wa zilonda, mankhwala akhoza kukhala mzere woyamba wa mankhwala, kenako ndi njira zina zothandizira kusiya magazi monga jekeseni wa epinephrine, kapena njira yowonjezera yomwe imagwiritsa ntchito kutentha kuti asiye magazi. Ndi pamene mankhwala awa amalephera kuchiza zilonda zamtunduwu kapena kulephera kuimitsa kutuluka kwa magazi kumene kugonana kwake kumaganiziridwa.
Mimba
Matenda opatsirana khansa komanso osakhala ndi khansa akhoza kuchitika mmimba. Zomwe zimachitika, komanso njira zochepetsera zochotsa zotupazo sizingapambane kapena sizikuwoneka kuti zitsogolere, zotsatirazi zimaganiziridwa. Kuchuluka kwake, kukula kwake, ndi malo a chotupacho (s) kudzakuthandizani kuzindikira gawo lina la mimba, liwu, ndi duodenum liyenera kuchotsedwa.
Kusuta
Ngakhale zilonda zam'mimba zimayambitsa magazi m'mimba, pali mitundu ina ya mavuto omwe angayambitsenso magazi. Chimodzi mwa zofala kwambiri ndi vuto limene mitsuko ya magazi imakhala pamwamba pa minofu mkati mwa minofu ya dongosolo la m'mimba, lotchedwa angioectasia. Zomwe zimatchedwanso malingaliro amtunduwu, kapena AVMs, mtundu uwu wamadzi wambiri wodetsa magazi ukhoza kuyambitsa magazi.
Pamaso pa Gastrectomy
Musanayambe kugonana, wodwalayo adzafunika kudya kapena kumwa kwa maola asanu ndi limodzi kapena oposa pokonzekera opaleshoni. Choyenera, chakudya chonse ndi madzimadzi adzayenera kuchoka m'mimba kuti zichitike, kotero wodwala sangadye chakudya chamadzulo tsiku lisanayambe opaleshoni. Kwa odwala omwe ali ndi pang'onopang'ono, kuyamwa zakumwa kungakhale chinthu chokhacho chomwe chimatengedwa pakamwa tsiku lisanachitike kuti chitukuko chikhale chokwanira.
Pa Gastrectomy
Njira yowonongeka imayamba ndi anesthesia ambiri, kuti atsimikizire kuti wodwalayo sakukumana ndi ululu ndipo amakhalabe wosadziwa panthawi ya opaleshoni. Mmodzi wodwala atakhala pansi, wakhala akulowetsedwa ndikuikidwa pa mpweya wabwino, opaleshoni ikhoza kuyamba.
Ndondomeko ya kugonana imatha kuchita chimodzi mwa njira ziwiri: miyambo ya chikhalidwe yomwe imapangidwira pamimba, kapena njira yatsopano yosasinthika yomwe imawoneka kuti ikuphatikizidwa, ndipo opaleshoni amagwiritsa ntchito kakang'ono kamera imaphatikizidwa mu imodzi mwa zofunikila kuti muwone opaleshoni pa khungu.
Pamene zidazo zilipo, chigawo chofunikira cha mmimba chimadulidwa ndikuchotsedwa pamodzi. Kuti muwonongeke, komwe mimba yonse imachotsedwa, mimba imagwirizanitsidwa ndi duodenum. Ngati chigawo cha m'mimba chikuchotsedwa m'mphepete mwachitsulo chikhoza kubwezeretsedwa pamodzi kuti chikhale chonse, koma chaching'ono, m'mimba.
Dokotalayo akamaliza ntchitoyi, zidazo zimachotsedwa, ziwalozo zimatsekedwa, ndipo anesthesia imaletsedwa kotero wodwala akhoza kudzuka. Pomwe wodwalayo ayamba kudzuka, chubu la kupuma lingachotsedwe kuti wodwalayo ayambe kupuma yekha popanda mpweya wabwino.
Kubwezeretsanso Pambuyo pa Gastrectomy
Njira yothetsera vutoli pambuyo poyendetsa khungu nthawi zambiri imayang'anitsitsa pang'onopang'ono kubwezeretsa zakudya mkati mwa zakudya. Momwemo, zakudya zidzalekerera ndi mimba yatsopano yomwe yasintha kumene, koma odwala ambiri amafunika kubwerera mofulumira ku chakudya chawo chachilendo ndipo panthawiyi angathe kuzindikira kuti sangathe kulekerera zakudya zina zomwe amakonda. Odwala ambiri amayamba ndi zakudya zopatsa thanzi ndipo zimavuta kuti azidya zakudya monga momwe angathe. Odwala omwe ali ndi manja apamwamba a kulemera kwa thupi amakhala ndi dongosolo lokhwima lomwe amadya ndi opaleshoni yawo kuti awonjezere kulemera kwawo.
Kwa odwala ena, pangakhale phukusi lotchedwa chupastric tube yomwe imayikidwa pa opaleshoni. Thubuyi imayikidwa m'mphuno, kummero, ndi mmimba. Izi zimathandiza antchito kuchotsa chilichonse chamadzimadzi chomwe chingamange, chomwe chingathandize kuchepetsa kunyowa ndi kupewa kusanza. Izi chubu zimachotsedwa pamene wodwalayo ali bwino mokwanira kuti azilekerera chakudya ndi madzi.
Kuchita opaleshoni ndi opaleshoni yowopsa kwambiri ndipo odwala ambiri amafunika mankhwala ena opweteka panthawi yomwe amachira. Kusinkhasinkha kwa m'mimba nthawi zambiri kumakhala kosavuta, ndipo kungakhumudwitse ndi tsiku losavuta tsiku ndi tsiku monga kupopera ndi kutsokomola. Panthawi yochira, zochitika za m'mimba, kaya ndizovuta kwambiri kapena zochepa zazing'ono, ziyenera kumangidwa ndi dzanja kapena mtolo panthawi yopuma komanso kutsokomola kuti zisawonongeke.
Zowopsa za Kugonana
Kuphatikiza pa ngozi za anesthesia komanso ngozi zambiri za opaleshoni , njira yowonongeka ili ndi zoopsa zina zomwe muyenera kuziganizira pamene opaleshoni ikulimbikitsidwa. Zowopsazi ziyenera kulemedwa potsata chiopsezo chosayendetsa. Mwachitsanzo, wodwalayo amene wauzidwa kuti amafunika kupatsa chidziwitso chochepa chifukwa cha zilonda zamagazi ayenera kuyembekezera kuti ali ndi zilonda zomwe zimapitirizabe kutuluka paziopsezo zomwe zilipo pamene akuchitidwa opaleshoni kuti athetse vutoli. Zina mwazoopsazi ndizo:
- Kupuma: Monga ma opaleshoni ambiri, nthawi zonse amapezeka magazi. Odwalawa ali opatsirana kwambiri pa odwala opaleshoni omwe akuchitidwa opaleshoni chifukwa cha magazi m'magazi.
- Kutenga: N'zotheka kuti kachilombo kawopsa kakadzachitika pambuyo pa njirayi, m'maganizo a m'mimba kapena m'thupi mwawo.
- Kuthamanga: Pali mwayi woti mzere wokhala ndi mimba kumene mimba imatsitsidwira pamodzi idzatuluka. Izi zikhoza kukhala zovuta kwambiri pamene kutuluka kwa asidi ndi m'mimba mulibe chifukwa chowopsa kwambiri, koma kutuluka kwa zinthu izi m'mimba kudzakhumudwitsa kwambiri minofu yomwe ili pafupi.
- Kusokonezeka ndi Kusinkhasinkha: Izi ndizovuta kwambiri pamene kugwiritsidwa ntchito kwa opaleshoni kumatseguka ndipo kungalole kuti m'mimba zichoke kuti zichoke mthupi. Nthawi zambiri amalephera kubwezeretsa malingaliro pamene akuvutika maganizo, monga panthawi yopuma.
- Kuchepetsa Kutentha: Odwala ena amakumana ndi zovuta zowonjezera chitsulo ndi zakudya zina pamapeto pake ndikufuna kuwonjezera.
- Kuperewera kwa Iron Iron Anemia: Chifukwa cha kuchepetsa kuyamwa kwa chitsulo, odwala ena amayamba kuchepa. Iron ndi chinthu chofunikira kwambiri cha magazi, popanda chitsulo thupi silingathe kupanga maselo a magazi ndipo zotsatira zake pa nthawi ndi kuchepa kwa magazi.
- Kulimbitsa thupi: Kanthu kakang'ono kamene kamakhala kofiira chifukwa cha zilonda zam'chipatala, vutoli likhoza kulemetsa kudya popanda "kumangiriza" pakati pa mmimba ndi mmimba.
- Mphuno ndi Kutupa
- Matenda a Kutaya: Kutsika kwa mphamvu yakukuta shuga / chakudya chophweka kungawononge chakudya "kutaya" kuchokera m'mimba kupita ku duodenum mofulumira, kumayambitsa kupunduka, kutsegula m'mimba, kumva kutaya, kutentha kozizira, kunyoza, ndi kubwezera.
Mawu Ochokera
Ndondomeko ya opaleshoniyi ndi opaleshoni yaikulu, koma nthawi zambiri imakhala yopambana kwambiri pochiza matenda oopsa kwambiri. Ikuonanso kuti ndi opaleshoni yotetezeka kwambiri. Ndondomeko ikhoza kubweretsa chipatala kwa sabata kapena kupitirira, koma odwala ambiri potsiriza amatha kubwerera ku moyo wawo wokhazikika-komanso zakudya zomwe amakonda - pambuyo potsatira.
> Chitsime:
> Gastrectomy. MedlinePlus. Idapezeka mu October, 2017. https://medlineplus.gov/ency/article/002945.htm