Zininzi iintlobo ezahlukeneyo zokuhlinzwa ezisebenzisayo ukunyanga izifo zesibindi (IBD) . Olunye uhlobo lotyando oluthile olusetyenzisiweyo lusetyenziswe ukususwa kwe- rectum (ebizwa ngokuba yi-proctectomy) kunye ne-anus. Xa zombini ezo zakhiwo zisuswe, enye indlela iya kufuneka kwi-stool ukushiya umzimba. Ukuba zonke iikholoni zisusiwe (ezibizwa ngokuba yi- colectomy ), mhlawumbi ngexesha elifanayo njengeproctectomy okanye ngaphambi, i-ileostomy iya kufuneka.
Kubantu abanesifo sikaCrohn kunye ne-ulcerative colitis, uhlobo lwe-ileostomy olubizwa ngokuba yi-ileostomy yokuphela yinto eyenziwa ngokuqhelekileyo. Yilona xa inxalenye yesisu esincinci iziswa ngesisu, ngaphandle komzimba, ukwenza into ebizwa ngokuba yi-stoma. Isikhumba se-ostomy sigqitywe kwi-stoma ukuqokelela isitulo kwaye sichithwa ngamaxesha amaninzi ngosuku xa kufuneka.
I-Proctectomy yokuhlinzwa ingasetyenziselwa ukunyanga umhlaza wesibeleko kodwa eli nqaku liza kuxubusha uphando njengoko lusebenza kwi-IBD kwaye ngokubambisana nokususwa kwe-anus. I-rectum, okanye ininzi ye-rectum, iphinda isuswe ngexesha lotyando lwe-j-pouch (i-ileoanal pouch anastomosis, okanye i-IPAA) , eyenziwa kuphela kwizigulane ezinezilonda zesilonda. Ezi zi gulane, i-anus ishiywe kwindawo kunye nesigaba sokugqibela samathumbu amancinci senziwa kwisakhiwo esithatha isitulo, njengengqungquthela.
Xa i-anus iphinda isuswe, loo ndawo yomzimba iyavalwa ngokuvakalayo.
Abanye abantu kwicandelo le-IBD babhekisela kule nto njengokuba "neBarbie butt" -kubizwa ngokuba kubantu abathile ubakhumbuza ngezantsi kwedolli, leyo (ngokucacileyo) ayinaso isakhiwo sokukhupha isitulo.
I-proctectomy yindlela yokuhlinzwa enkulu, kwaye kungekhona nje ngokuba yenziwe phantsi kwe-anesthetic jikelele kunye nayo yonke into ehamba nayo.
Emva kweproctectomy kunye ne-anus ukususwa kwi-IBD, i-ileostomy isigxina. Le nto ingaba nzima ukujamelana nezizathu ezininzi.
Nangona kunjalo, kubalulekile ukuphawula ukuba oku kungenza uphando olusindisa ubomi kwabanye abantu abane-IBD kwaye luya kuphucula kakhulu umgangatho wobomi kwabanye abaninzi. Abantu abane-IBD abanesi sifo kwindawo yabo ye-rectum kunye ne-anus (indawo ye- perianal ) banokujamelana neentlungu kwaye banokungenelela ngoncedo lwezonyango kunye nokuqeshwa kwabagqirha ukulawula iingxaki ezifana ne- abscesses kunye ne- fistula . Emva kokuhlinzwa kwe-proctectomy, abantu abane-IBD baziva bebhetele ngakumbi kwaye bafumana umgangatho wobomi uphuculo.
Isizathu sokuba umntu afune iRectum kunye no-Anus
Uqikelelo olukhoyo lubeka ipesenteji yezigulane ngesifo sikaCrohn esidinga ukuhlinzwa kweproctectomy njengama-12 ekhulwini kunye nama-20 ekhulwini. Abantu abanesifo sikaCrohn bangadinga ukuhlinzwa ngenxa yokuba isifo sikaCrohn sichaphazela indawo ejikeleze i-anus, ebizwa ngokuba yi-perianal.
Isifo sikaCrohn ngezinye izihlandlo sinokubangela iingxaki ezifana ne-fistula okanye i-abscesses kufuphi ne-anus. Ezi ngxaki zinokuba nzima ukulawula nokuphulukisa kwaye zingabangela ukuba zibuhlungu nje kodwa zinciphise emgangathweni wobomi. Kwezinye iimeko, ukusebenzisa i-elaostomy ngexesha elithile lokuphepha ukuhlala kwisigxina okanye ukufaka imida kungakunceda, kodwa xa ezi zinto zingasebenzi, i-proctectomy inokucetyiswa.
Kwizigulane ezine-ulcerative colitis ezingenakufuna ukuhlinzwa okanye zingakwazi ukuhlinzwa ngenxa yeengxaki kwi-perianal ndawo, i-proctocolectomy kunye ne-eliostomy esisigxina nayo ikhetho. Kwabancinci abantu abane-ulcerative colitis, i-rectum isaqhubeka nokuvuvukala, kwaye ukususa kwayo kuya kunika ithuba elihle lokuphucula umgangatho wobomi.
Kwezinye izigulane, kwaye le nto inqabile, umngcipheko wesifo somhlaza wukuthi ukususa i-rectum kuthathwa njengeyona ndlela ingcono yokunciphisa umngcipheko.
I-Proctectomy Surgery
Utyando lwe-Proctectomy lugqirha olukhulu kwaye kukho iindlela ezahlukeneyo ezinokusetyenziswa.
Ugqirha ogqithisileyo ozalisa utyando uza kuthatha isigqibo malunga nendlela oya kutyunjwa ngayo, kwaye izigulane ziya kufuna ukuthetha malunga neenkcukacha zokuqeshwa kwabangaphambi kokuhlinzwa. Iqela ngalinye lokugqeba kunye nesibhedlele liya kuba neendlela ezikhethiweyo zokugqiba utyando kunye nokuthatha isigqibo malunga nokuba izigulane ziza kuhlala nini esibhedlele emva koko kunye nokulawulwa kwezilondolozo.
Kuzo zonke iimeko, le ntsebenzo yenziwa phantsi kwe-anesthesia jikelele kwaye iya kufuna ukuhlala esibhedlele okungenani iintsuku ezimbalwa. Ulawulo lwezinhlungu luya kuba yingxenye ebalulekileyo yokubuyisela kokubili esibhedlele nasekhaya. Njengokuba kuninzi uphando, ukunyuka nokuphuma ebhedeni nokuhamba ngokukhawuleza xa abasebenzi basebhedlele becebisa kubalulekile ekuphiliseni.
Emva kokuhlinzwa kwe-proctectomy, izigulane ziya kubuyela ekhaya nge-ileostomy entsha, ukuba enye yayingekho kwindawo ngaphambi kokuhlinzwa. Umongikazi we- enterostomal unyango uya kunceda ekuqondeni indlela yokunyamekela i-stoma entsha kunye nendlela yokutshintsha i-ostomy device. Kuya kubakho ukukhangela endaweni ephantsi apho i-anus ivaliwe khona, kwaye loo ndawo ingadinga ukunakekelwa okhethekileyo kunye nokucoca kwithuba de liphilise ngokupheleleyo. Iqela eligqityiweyo liya kunika imiyalelo nakweyiphi enye ingxaki ngaphambi kokuba isiguli sikhululwe esibhedlele.
Utshintsho kwiDiet
Izigulane zingabikho ekuphumleni kwesibilini (kungadli ukutya) de i-intestine encinci "ivuke" kwindlela yokuhlinzwa kwaye iqala ukwenza ingxolo ukuba uchwepheshe wezempilo uyakuva nge stethoscope esiswini. Isinyathelo esilandelayo ngokuqhelekileyo sidla i-liquids ecacileyo ezifana ne-gelatin kunye nomhluzi, kwaye ngokuthe kancinci ukongeza iintlobo zokutya de uze udla ukutya kokutya okuqinileyo kwakhona.
Izigulane zivame ukubuyela ekhaya ngokutya okutshintshiweyo kwiiveki ezimbalwa de ukuba ugqirha ogqithisileyo uthi ukutya okuqhelekileyo kunokuqalisa kwakhona. Emva koko, kunokutya okumbalwa ukuba ugqirha kunye nodokotela wesifo segastroenterologist banconywe kugwenywe (izinto ezifana ne-popcorn okanye i-nut) kuba naluphina uhlobo lokuhlinzwa esiswini lubeka umngcipheko wexesha elizayo olunezithintelo . Lo mngcipheko wokukhutshwa uya kuhluka kakhulu kumntu kumntu, ngoko kukutya kukuxubusha ngokugqithiseleyo nodokotela ogqirha kunye namanye amalungu eqela lezempilo.
Iingxaki zeNgxaki zeProctectomy
Amanxeba angamaPeriya: Inkxalabo eqhelekileyo yokuhlinzwa kwe-proctectomy kwisifo sikaCrohn kukuba yilonda elingenakunqandwa kwiindawo zendawo. Kwezinye iimeko, abantu abanesifo sikaCrohn abadinga i-proctectomy baye bagula kakhulu kwaye banokuba besimweni esinyameko kunokuba bona kunye noogqirha babo bafuna ngaphambi kokuhlinzwa.
Ukuba ama-abscesses okanye i-fistula kwindawo ye-perianal yinto ebangela ingozi yokuba neengxaki kule ndawo emva kokuhlinzwa. Ukungondleki kwesondlo okanye ukungaphumeleli kwevithamini, ukutshaya, kunye nokugqithisa kunokuba negalelo ekuphileni amanxeba ngokuphilisa emva kokuhlinzwa. Kwimeko amaninzi isilonda esingenagxothwa siphathwa ngokufanelekileyo ngamacandelo okunyamekela ngamanxeba kodwa kwincinci yamatyala, omnye uvavanyo lungafuneka.
Umsebenzi wesondo: Ukukhathazeka malunga nomsebenzi wesondo kuyaqhelekileyo nangolu hlobo lotyando. Ngethamsanqa, i-erectile dysfunction kumadoda emva kwe-proctectomy iphantsi, kwaye iqikelelwe ukuba iphakathi kwamabini amabini anesine. Ngona iindaba ezilungileyo kukuba olunye uphando olulandelayo lwexesha elide lubonisa ukuba abantu abangama-90 ekhulwini abanesifo se-proctectomy banelisekile ngempilo yabo yesondo.
Ezinye izigulane zixela ukuba umsebenzi wesini ubi kakhulu, kwaye izinga liqikelelwe libe phakathi kwama-25 ne-30 ekhulwini. Izigulane ezifumana ukuba umsebenzi wesondo awuyiyo into abayathanda ukuba yiyo iya kufuna ukujongana nesi sihloko kunye nodokotela ogqirha kunye / okanye i-gastroenterologist. Uncedo lufumaneka kwimicimbi enxulumene nempilo yezesondo kunye neyona nto ibaluleke kakhulu ekufumaneni iingxaki ezijongene nazo kukuzisa ingqalelo kwiqela lakho lononophelo lwezempilo.
Amachiza: Ezinye izigulane ziyakhathazeka malunga nendlela amayeza athatyathwayo angakuchaphazela ukubuyiswa. Olunye uphando lubonise ukuba abantu abanesifo sikaCrohn abafumana unyango lwe-biologic abanalo mngcipheko ophezulu wokuba neengxaki zokuphilisa isilonda kunokuba abo bangathathi unyango lwe-biologic ngelo xesha.
ILizwi
Utyando lwe-Proctectomy luyinto enzima kubantu abaninzi abane-IBD. Ukuba le ntsebenzo ithetha u-ostomy osigxina, kwaye nangona ezininzi izigulane ziziva zibhetele kwaye zizonwabele ubomi emva kokuhlinzwa ostomy, kuyinto engokwemvelo ukuba nexhala.
Ukuthetha malunga nokuhlinzwa kunye nodokotela ogqithisileyo kunye ne-gastroenterologist ngokuqhelekileyo kunceda ekubeka izinto ezininzi ezinobungozi ngombono. Iindaba ezilungileyo kukuba uninzi lwabantu abane-IBD abane-proctectomy yokuhlinzwa bonyanga kakuhle kwaye baqhubeka beziva bebhetele kwaye banandipha ubomi babo ngakumbi.
> Imithombo:
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> Kunitake H, Hodin R, Shellito PC, et al. "Ukwelashwa kwexesha elide kunye ne-infliximab kwizigulane ezineesifo sikaCrohn kunye nesifo sezilonda zesilonda asinxulumene nezinga elongeziweyo leengxaki zokusebenza emva koko." J Gourrointest Surg . 2008 Oct; 12 (10): 1730-6; ingxoxo 1736-7.
> Genua JC kunye neVivas DA. "Ulawulo lweeNxeba zePheranal Nonhealing." Klinikhi Colon Rectal Surg . 2007 Nov; 20: 322-328.
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