Iintlobo ezahlukeneyo zeNkqubo zeGastrectomy
I-gastrectomy yinkqubo yokuqhawula isisusa, ubuncinci, inxalenye yesisu. Kukho iintlobo ezininzi ze-gastrectomy, ezihluke kwiimeko ezingakanani zesisu kunye nezizungezo ezizungezile zisuswe ngexesha lenkqubo.
I-Esophagus, isisu, ne-Duodenum
Ukuqonda kangcono iintlobo ezahlukeneyo zeenkqubo zokuziphatha, kubalulekile ukuqonda ukuma kwesisu kunye nezicubu ezijikelezayo.
Uninzi lwabantu luyiqonda isisu kunye nendlela olusebenza ngayo, kodwa aluqondanga kangangoko nezitho kunye nezicubu ezijikelezayo.
Xa umntu esidla ukutya, inkqubo yokugaya igxobhozo iqala ngomlingo wokuqala. Amazinyo anceda ukuluma okanye ukukrazula ukutya kwiincinci ezincinci, kwaye ukuhlafuna ngokuqhubekayo kukuphelisa ukutya ukuya kwiindawo eziphathekayo eziphathekayo. I-saliva iqulethe i-enzyme yokugaya eqala ukutyhila ukutya, kodwa amazinyo enza uninzi lomsebenzi kweli nqanaba kwinkqubo. Ukuhlafuna, ngokuxhomekeke kwithuba elide kwaye lenziwa kakuhle kangakanani, lithatha i-steak ekhuni kwaye iguqule ibe yincinci enhle. Xa ukutya kuhlolwe kakuhle, ukugwinya kugxotha ukutya ukusuka emlonyeni ukuya emqaleni. Umqala uqondisa ukutya kwisitopu.
I- esophagus iyisibhubhu edibanisa umqala emlonyeni, kwaye ivumela ukutya okufunyenwe ukunyuka ukuya kwisisu emva kwesigxina ngasinye. Phakathi kwendawo yesisu kunye nesisu ngumsizi wesiphincter onokuvula nokuvala, ukuvumela ukutya ukuba kungene kwisisu, kodwa ukukhusela ukuba ungashiyi phezulu kwesisu.
Isisu songeza i-asidi ekudleni, kwaye sishukumisa ukutya ukuze kuqhubeke inkqubo yokugaya. Emva kwesisu sesigqiba isabelo sayo senkqubo yokugaya, i-pyloric sphincter, i-muscle ephantsi kwesisu, ivula kwaye ivale ukuvumela ukutya ukuba kuqhutywe kancinci kwisisu kwaye kube yintlungu yokuqala yamathumbu amancinci.
Le nxalenye yamathumbu amancinci kuthiwa yi-duodenum.
Iintlobo zeGastrectomy
Iintlobo ezahlukeneyo zesigxina sendlela zilandelayo:
- I-gastrectomy ekhethekileyo: Le nkqubo yendlela yokwenza isigxina apho inxalenye yesisu isusiwe.
- I-Sleeve gastrectomy: Le nkqubo ikhupha isalathisi sesisu.
- I-Esophagogastomyomy : Inkqubo yokuhlinzwa apho isisu sesisu, isifo se-cardiac sphincter, kunye nenxalenye yesigxina isuswe.
- I-gastrectomy iyonke: Ubungakanani besisu sisusiwe kule nkqubo yokucubungula. Iingxenye ze-esophagus ne duodenum zingasuswa.
Izizathu zeGastrectomy
Kukho izizathu ezininzi zokubangela ukuba i-gastrectomy ingenziwa. Ubume beengxaki buya kululela uhlobo lwegastrectomy eyenziwa, kwaye kufuneka zikhutshwe kangakanani izicubu. Ngokuqhelekileyo, xa unyanga izifo zesondlo, kwenziwa umgudu wokunciphisa inani lezicubu ezisuswe, kugcinwa izicubu ezintle njengoko kunokwenzeka xa ususa izicubu ezimbi.
Ukunyanya
Kwixesha elidlulileyo, uphando lwe-gastrectomy lwaluqhutyelwa ukunyanga isifo okanye imeko echaphazela isisu. Ukulahlekelwa kwesisindo bekubhekwa njengesiphumo esisecaleni, okanye kwintlanzi, emva kokunyangwa kwesinye isifo.
Kwiminyaka yakutshanje, i-gastrectomy isetyenziswe njengophando lwe-bariatric, yinkqubo yokuhlinzwa eyenziwa ukunyanyisa ukukhuluphala.
Kuba abantu abagqithisileyo, ukunciphisa ubungakanani besisu kunokukhokelela ekunciphiseni okubonakalayo kwinqanaba lomzimba. Ngokungafani nokuhlinzwa okwehlisa umzimba, izigulane ze-gastrectomy zezigulane zisesichengeni esincinci sokungondleki ngenxa yokungabikho kokutya okunciphisa izondlo, kodwa ziyakwazi ukuchitha amaninzi amaninzi.
Ngokungafani nezinye iindidi zesigxina somzimba esifuna ukugcina izicubu ezinempilo kangangoko kunokwenzeka, xa i-sleeve gastrectomy eyenziwa ngenjongo yokulahleka kwesisindo, kukho izicubu ezinempilo ezikhutshweyo ukwenzela ukunciphisa kakhulu umthamo wesigulane sokutya.
Oku kukhokelela kwisigulane nesigulo esipheleleyo ngokutya okuncinci, kwaye ke kukhokelela ekulahlekeni kwesisindo.
Ulcers: Izilonda zamapeptic , okanye izilonda ezenza isisu, isophagus okanye i-duodenum, kunokubangela ubuhlungu obukhulu kunye nokuphuma kwegazi. Kwezinye izigulane, kukho ukulahlekelwa okuncinci kwegazi okungabangela i-anemia eqhubekayo. Kwabanye, ukuphuma kwegazi kubakho ngokukhawuleza kwaye kuphuthumayo, okufuna ukuba ingqalelo ngokukhawuleza. Izilonda zihlala zixilongwa xa isigulane sifuna ukuxilongwa kwiintlungu zesisu. I- esophagogroduodenoscopy (EGD) , eyaziwa njenge-Upper GI, iqhutshwa ngokuvumela ukuba ugqirha abone ngaphakathi ngaphakathi kwesisu ukuze i-diagnostic ingenziwa.
I-gastrectomy ayifuni ukukhetha kuqala unyango lwezilonda. Ngokuxhomekeka kuhlobo lwesilonda, amayeza anokuba ngumgca wokuqala wonyango, elandelwa ngamanye amanyathelo okuyeka ukuphuma kwegazi njengenjoza ye-epinephrine, okanye inkqubo yokuqhelisa esebenzisa ubushushu ukuyeka ukulahleka kwegazi. Yilapho ezi ntlobo zonyango zihluleka ukuphilisa izilonda okanye ukuhluleka ukuyeka ukuphuma kwamanzi okuqhelekileyo ukuba kuqwalaselwe.
Izidumbu
Izicubu ezinomhlaza kwaye ezingenayo umdlavuza zingenzeka kwisisu. Xa zenzeke, kwaye iindlela ezincinci zokususa izicubu aziphumelelanga okanye akunakwenzeka ukukhokelela kwisiphumo esifunekayo, isicatshulwa singagqalwa. Isixa, ubukhulu, kunye nendawo ye-tumor (s) ziya kunceda ukuba isiphi isahlulo sesisu, isisu kunye ne-duodenum kufuneka zisuswe.
Ukuhlamba
Nangona izilonda ze-peptic ziyinto eqhelekileyo yokuphaphaka esiswini, kukho nezinye iintlobo zeengxaki ezingakhokelela ekuphumeni kwegazi. Enye yezona zinto zixhaphakileyo yinto apho umkhumbi wegazi uphantsi kwimizimba ephakathi kweethambo zesistim sokutya, esibizwa nge-angioectasia. Eyaziwa nangokuthi i-malteration, okanye i-AVMs, olu hlobo lwesitya esingaqhelekanga lunokuphuma igazi.
Ngaphambi kweGastrectomy
Ngaphambi kwenkqubo yokugulisa, isigulane kufuneka sidye ukutya okanye siphuze iinyanga ezintandathu okanye ngaphezulu ukulungiselela utyando. Eyona ndlela, zonke ukutya kunye nocwilisi kuya kufuneka ukuba ziphume ngesisu ngenxa yenkqubo, ngoko ke isigulane asiyi kudla emva kwesidlo ngosuku ngaphambi kokuhlinzwa. Kwizigulane ezineenkqubo zokugonya ezicothayo, ukucoca i-liquids kungenjalo kuphela into eyenziwa ngomlomo ngosuku ngaphambi kokuba inkqubo ikhulise amathuba okuba isisu sisinanto ngokupheleleyo.
Ngexesha leGastrectomy
Inkqubo yokuguqulwa komzimba iqala nge- anesthesia jikelele, ukuqinisekisa ukuba isiguli asiyi kubuhlungu kwaye sihlala singenasiphako ngexesha lotyando. Xa isigulane sitsalwa, senziwe nge-intubated kwaye sifakwe kwi-ventilator, utyando luyaqala.
Inkqubo yokuguqulwa komzimba ingenziwa ngenye yeendlela ezimbini: inkqubo yendabuko apho kukho ukukhutshwa okukhulu kwisisu, okanye intsha engumngcipheko omtsha apho kubandakanywa khona izinto ezincinci ezibandakanya ukukhangela kwisisu esiswini, kwaye ugqirha usetyenziswa elincinci ikhamera ifakwe kwenye yezinto ezibonwayo ukubukela ukuhlinzwa kwi-monitor.
Emva kokuba izixhobo zikhoyo, icandelo elifunekayo yesisu liyanqunyulwa kwaye libuye libuyele ndawonye. Ukuze isalathisi esipheleleyo, apho isisu sisuswe khona, i-esophag ixhunyiwe kwi-duodenum. Ukuba icandelo lesisu lisusiwe iimijelo zinokugqitywa kunye kunye ukwenza konke, kodwa kuncinci, isisu.
Emva kokuba ugqirha ugqiba inkqubo, izixhobo ziyakususwa, ukugqitywa (s) kuvaliwe, kwaye i-anesthesia igqityiwe ukuze isiguli singavuswa. Xa isiguli siqala ukuvuka, ityhufumla yokuphefumula ingasuswa ukuze isiguli siqale ukuphefumula singenayo i-ventilator.
Ukubuyisela emva kweGastrectomy
Inkqubo yokubuyiselwa emva kokuba i-gastrectomy ivame ukugxila ekutheni ukutya okunciphisa ngokukhawuleza kukutya. Ngokufanelekileyo, ukutya kuya kunyamezela kakuhle ngesisu esisandul 'ukutshintsha, kodwa izigulane ezininzi kufuneka zibuyele ngokukhawuleza ekudleni kwazo kwaye ngexesha le nkqubo zingafumanisa ukuba azikwazi ukunyamezela ezinye zokutya ezizithandayo. Uninzi lwezigulane ziza kuqala ngokutya okucokisekileyo kunye nokuqhubela phambili kunzima ukutya ukutya njengoko kunako. Izigulane ezine-sleeve gastrectomy yokulahleka kwesisindo ziya kuba nesicwangciso esiqinileyo sokutya esinikwe ngabagqirha babo ukuze banciphise ukulahleka kwabo.
Kwezinye izigulane, kunokubakho ityhubhu ebizwa ngokuba yi-nasogastric tube yangeniswa ngexesha lotyando. Le bhubhu ifakwe kwimpumlo, phantsi komqala, ibe kwisisu. Oku kuvumela abasebenzi ukuba basuse nayiphi na isisu esiswini esinokuyakha, esinokukunceda ukunciphisa isicupunu kunye nokukhusela ukuhlanza. Le bhubhu isuswe xa isigulane sikwanele ukunyamezela kokutya kunye namanzi.
I-gastrectomy yindlela yokuhlinzwa ngokugqithiseleyo kwaye izigulane ezininzi ziza kufuna uhlobo oluthile lwezonyango zentlungu ngexesha lokubuyisela inkqubo. Izibilini zesisu zisoloko zithenda, kwaye ziyakucasulwa yimini elula ukuya kwimihla efana nokukrazula nokukhwehlela. Ngexesha lokubuyiselwa, ukubandakanywa kwesisu, nokuba ngaba yinto eninzi yendabuko okanye i-laparoscopic incisions, kufuneka ibhekiswe ngesandla okanye umqubu ngexesha lokukrazula nokukhwehlela ukukunceda ukukhusela iingxaki.
Izingozi zeGastrectomy
Ukongeza kwimingcipheko ye-anesthesia kunye neengozi eziqhelekileyo zokuhlinzwa , inkqubo yegastrectomy ineengozi ezongezelelweyo ezifuneka ziqwalaselwe xa unyango lucebisa. Ezi ngozi kufuneka zilinganwe nomngcipheko wokungaqhubeki. Ngokomzekelo, isigulane esitsheliweyo ukuba sidinga isicatshulwa esincinane ngenxa yezilonda zamachiza kufuneka siqikelele umngcipheko wokuba nezilonda eziqhubekayo ziphuma kwiingozi ezikhoyo xa utyunjwa ukulungisa ingxaki. Ezinye zezo ngozi zibandakanya:
- Ukuhlamba: Njengamathuba amaninzi okuhlinzwa, kunokuhlala kusengozini yokukhupha. Lo mngcipheko uphezulu kwizigulane zokugulisa ezenza utyando ngenxa yokuphuma kwindlela yokugaya.
- Usulelo: Kungenzeka ukuba usulelo luya kwenzeka emva kwenkqubo, kwimibilini yesisu okanye kwindlela yokugaya.
- Ukuhamba: Kukhona ithuba lokuba umgca we-suture apho isisu sityhunyiwe khona kunye siya kuvuza. Oku kungabangela inkxalabo enzulu njengoko ukuphazamiseka kweziqu ze-asidi kunye nesisu kungekhona nje ukuba kubangele ukusuleleka kwintsholongwane, kodwa ukuphazamiseka kwezi zinto kwisisu kuya kubacaphukisa kakhulu izicubu ezikufuphi.
- Ukuguqulwa kwezinto kunye nokuHlola: Le ngxaki enzulu kakhulu apho kuqhutywe izigulane kunye nokuvumela ukuba amalungu omzimba azame ukuphuma emzimbeni ngokusebenzisa izigqibo. Iyakwazi ukuthintelwa ngokukhupha iingcamango xa zixinzelelekile, njengokuba zixuba.
- Ukunciphisa Ukunciphisa: Ezinye izigulane zinzima ukuthoba isinyithi kunye nezinye izondlo ekudleni kwazo emva kwenkqubo kwaye ziya kufuna ukuxhaswa.
- Ukunqongophala kwe-Iron anemia: Ngenxa yokunciphisa ukutsalwa kwesinyithi, ezinye izigulane zinegazi. Insimbi iyimfuneko ebalulekileyo yokwakha igazi, ngaphandle kwesinyithi umzimba awukwazi ukwakha iiseli zegazi kunye nomphumo ngenxa yexesha i-anemia.
- Ukubethelwa: Ukunciphisa isisu ngenxa yesikhumba esicatshulwa kwisayithi yokuqhawulwa, le ngxaki ingenza kube nzima ukugwinya ukutya ngaphandle kokuba "kubambelele" phakathi komqala kunye nesisu.
- Isihlunu kunye nokuvuthwa
- I-Syndrome yokuLahla: Ukunciphisa amandla okugaya ushukela / i-carbohydrate elula kunokukhokelela ekutheni "ukulahla" ukutya ukusuka esiswini kuya kwi-duodenum ngokukhawuleza, okukhokelela ekutyumeni, ehudo, evelele, ekhukhulayo, ekhanda, kunye nokuqhaqha.
ILizwi
Inkqubo yokuguqulwa komzimba yindlela enkulu yokuhlinzwa, kodwa ngokuqhelekileyo yimpumelelo kakhulu ekuphatheni izifo ezininzi ezinzulu zokugaya. Kwakhona kuthathwa njengophelo olukhuselekileyo. Inkqubo inokubangela ukuhlala kwesibhedlele kwiveki okanye ngaphezulu, kodwa ezininzi izigulane ziyakwazi ukubuyela ekudleni kwazo kunye nokutya okuthandayo-emva kwenkqubo.
> Umthombo:
> Gastrectomy. MedlinePlus. Kufinyelelwe ngoOktobha, 2017. https://medlineplus.gov/ency/article/002945.htm