Ukuguqulwa, ukuphulukiswa, ukutheleleka, nokuningi
Cishe uzwe ukuthi amakolonoscopies amakhulu kangakanani ekuvimbeleni umdlavuza wekoloni . I-American Cancer Society incoma ukuthi ukuqala eneminyaka engama-50, bonke abesilisa nabesifazane engozini enkulu yomdlavuza wekoloni kufanele bathole i-colonoscopy njalo eminyakeni eyishumi (noma enye yezinqubo ezilandelayo njalo eminyakeni emihlanu: i-CT colonography, sigmoidoscopy eguquguqukayo, noma i-bluum ehlukile kabili enema).
Ungase ukwazi ukwazi ukuthi i-colonoscopy iyingozi kangakanani. Kunezinkinga ezimbalwa ezingenzeka, futhi abanye abantu basengozini enkulu kunazo zonke kunabanye, kodwa izindaba ezinhle ukuthi bonke abavamile. Funda kabanzi mayelana nezingozi nokuthi unganciphisa kanjani.
Izinhlekelele zeColonoscopy
Izingozi zeColonoscopy zihlanganisa ukuphuma kwegazi okukhulu, ukuphazamiseka kwamathumbu emathunjini (ukupheka umgodi emathunjini), ukutheleleka, ukusabela okubi kumabhayisikili, kanye nesifo sofuba. Kodwa-ke, lezi zinkinga azikho okwenzekayo futhi azifani kakhulu ne-colonoscopies ezingafaki ukususwa kwe- polyp . Izingozi zifaka:
- I-Perforation
- Ukuphuza
- I-Postpolypectomy syndrome
- Ukutheleleka
- Ukubhekana ne-anesthesia (iningi lezinhliziyo ezinzima kanye nezinkinga zokuphefumula)
- Izinkinga ze-colonoscopy prep
- Imiphumela engalungile yamanga
- Izinkinga ezingavamile kakhulu (njengokuhlukana kwengubo, i- diverticulitis , ne-gas explosion)
- Ukufa
Indlela Ukubhekana Nezimo Ezinzima Kwenzeka Kanjani
Nakuba izimpawu ezincane ezifana nokuqhaqhabalaza kuvamile, cishe abantu abangamaphesenti angu-1.6 kuphela abathola inkinga ye-colonoscopy engathà sina ngokwanele ukuze bavakashele noma bavakashele esibhedlela.
Khumbula ukuthi lokhu kufaka kokubili labo abanezintambo ezisuswe kanye nalabo abangenalo, labo abanezimo zezokwelapha ezidinga ikolonoscopy, nalabo asebekhulile noma abagulayo. Izingqinamba ezingamaphesenti angama-85 ezihlobene nokususwa kwe-polyp.
Hlola ngokucophelela inkinga ngayinye ekhona.
I-Perforation: Ukuguqulwa kwesinye kwesinye ukwesaba okukhulu ngesikhathi se-colonoscopy. Lokhu kungenzeka uma i-colonoscope ihlukana phakathi kwendwangu yamathumbu futhi ingena emgodini we-peritoneal ngenxa yemishini, ngenxa ye-barotrauma, noma inqubo yokususa i-polyp. Ingozi ihluka kusuka ezingaphansi kwamaphesenti angu-0.01 kulabo abanama-colonoscopy yokuhlola kuphela kuya kumaphesenti angu-0.3 kulabo abane-polyp esusiwe, benengozi enkulu yamaphesenti angu-0.05.
Ukweqa: Ukuphuma kwegazi okuncane nokuhamba kwesikhathi okuvamile kuvame ukulandela i-colonoscopy. Kodwa ingozi yokuphuma kwegazi, kodwa, yi-2.6 kwengu-1 000 kulabo abane-colonoscopy yedwa, kuze kufike ku-9.8 kwabayishumi kulabo abanesipuni. Ingozi ikhulu kakhulu kulabo abanezintambo ezincane ezisuswe, kulabo abanokulungiswa kwamathumba amancane, nalabo abathatha igazi elincane kakhulu iCoumadin ( warfarin ).
I-Postpolypectomy syndrome: I- Postpolypectomy syndrome yingozi yokushisa emathunjini ahlobene ne-cautery esetshenziswa lapho i-polyp isuswa. Kubizwa nangokuthi i-postpolypectomy electrocoagulation syndrome. Izigaba ezivela ku-100,000 kuya ku-100 000 kuya kwesinye kubantu abayi-1 000 (amaphesenti angu-0.003 kuya kumaphesenti angu-0.1.) Izimpawu, eziqala ngezinsuku eziyisihlanu emva kwenqubo, zifaka ubuhlungu, umkhuhlane, kanye nokubalwa kwamangqamuzana egazi elimhlophe .
Ukutheleleka: I- bacterium yangasese (amabhaktheriya egameni legazi) livela kumaphesenti angama-25 abantu, kodwa lokhu okungaqabukeli kubangela izinkinga. Labo abanezinkinga ze-valve senhliziyo (isibonelo, ngenxa yokukhononda kwenhliziyo) kufanele bathathe ama-antibiotic okuvimbela ngaphambi kwenqubo. Ingozi yokutheleleka okujulile njenge-peritonitis (ukutheleleka emgodini wesisu) ayivamile.
Ukuphendulela kwe-Anesthhesia: I-sedation enikeziwe nge-colonoscopies, ngezinye izikhathi ebizwa ngokuthi " ukulala kwe-twilight ," iphephile kakhulu ngokuphathelene ne-anesthesia ejulile, kodwa ingabangela izinkinga ezithile. Izingozi ezivame ukwedlula zonke ziyi-cardiopulmonary futhi zihlanganisa i-hypoxia (ukungabi khona kwe-oxygen egazini), i-aspiration pneumonia, ne-arrhythmias yenhliziyo. Ukusabela okwe-allergen kumithi yokwelapha kungase kwenzeke. Ingozi enkulu yezinkinga ze-cardiopulmonary iphakathi kwabantu abayisishiyagalolunye kwabayishumi.
Ukuncintisana KwamaColonoscopy Prep: Nakuba i-colonoscopy prep ayijabulisi, abantu abaningi bayayivumela kakhulu. Izinkinga zingase zenzeke kulabo abanemibandela enjenge-congestive heart failure kanye nesifo sezinso.
Amanga Okungamanga: Okungahambi kahle kwamanga lapho isifo sikhona kodwa ukuhlolwa kokuhlola kungaphumeleli ukuthola lesi sifo. Uma umdlavuza we-polyp noma we-colon ukhona, kodwa ungatholakali ku-colonoscopy, lokhu kungabhekwa njengamanga amanga. Amanani angamanga amanga ahluka kakhulu, kuye ngokuthi kwenzeka kanjani udokotela owenza inqubo kanye nendlela esetshenziselwa ukubika. Ingozi enkulu yomphumela omubi wamanga (uma othile eba nomdlavuza wekoloni naphezu kokuhlolwa kokuhlolwa komdlavuza wekoloni eminyakeni emithathu eyandulele) uphakathi kuka-3.5% namaphesenti angu-7.
Kunzima kakhulu ukubhekana nezinkinga : Kunezinkinga ezimbalwa ezingavamile kakhulu eziye zabikwa emva kwe-colonoscopy. Eminye yalezi zibandakanya ukuqubuka kwesipelingi kanye ne-diverticulitis. Ukuqhuma kwegesi, okungase kubangele ukuhlanganiswa kwe-hydrogen ne-methane ehlangene ne-oksijini kanye ne-electrocautery, nakho kuyinto engavamile kakhulu.
Ukufa: Ingozi yokufa ehlobene ne-colonoscopy iphansi kakhulu, kulinganiselwa phakathi kwamaphesenti angu -007 no -03. Ucwaningo ngo-2010 lwathola ukuthi kubantu abangaphezu kuka-371,000 abawela i-colonoscopy, kwakukhona ukufa kwabangu-128 kunoma iyiphi imbangela. Ngokucabangela ukuthi i-colonoscopies ivame ukuqhutshwa kubantu asebekhulile nalabo abanezinye izimo zezokwelapha, le nombolo iphansi kakhulu.
Yini Okukhulisa Ingozi Yakho Yezinkinga
Izibalo zinikeza umbono wengozi ejwayelekile yezinkinga, kodwa ingozi yomuntu ngamunye ingahluka kuye ngezici eziningi. Ezinye izinto eziveza ingozi yakho zihlanganisa:
- Ukususwa kwe- polyp : Uma izinhlayiya zitholakala futhi zisusiwe ngesikhathi se-colonoscopy, kunengozi enkulu yokukhwabanisa nokuphuma kwegazi, uma kuqhathaniswa ne-colonoscopy eyenziwa yedwa futhi kungatholakali ama-polyps.
- Ubudala obudala
- Ezinye izimo zezokwelapha: "Izimo ze-Comorbid" ezifana nesifo senhliziyo zandisa ingozi yezinkinga.
- Ukusetshenziswa kwegazi elimhlophe: I- aspirin ehlukile, engenzi ukwanda kwegazi, kodwa iyanciphisa ingozi yezinkinga ezihlobene nenhliziyo.
Nciphise Izingozi zeColonoscopy
I- colonoscopy prep efanele izosiza ukuqinisekisa ukuthi udokotela wakho unombono ocacile ngenkathi uhamba nge-colon yakho. Ezinye izindlela zokunciphisa ingozi yezinkinga zihlanganisa:
- Khetha i-doc efanele: Khetha i- gastroenterologist eqinisekiswe yibhodi ukwenza inqubo, ngokumelene nodokotela wakho womndeni.
- Qaphela: Qinisekisa ukuthi ulandela izikhombisi-ndlela ngqo ngesikhathi sakho se-colonoscopy prep.
- Cela ukusekela: Qinisekisa ukuthi i- anesthhesiologist enolwazi oluzobhekana nalo luzobe lukhona ngesikhathi senqubo uma kwenzeka unomthelela omubi kulolu daba.
- Yiba nekhethelo mayelana nendawo: Khetha umtholampilo noma isibhedlela esenza inombolo enkulu yalezi zinqubo. Ucwaningo lubonisa ukuthi izakhiwo ezenza inani elikhulu lamakholonoscopies zinenani eliphansi lokucindezeleka kunelabo abenza izinqubo ezimbalwa.
- Yenza inqubo noma eseduze nesibhedlela: Uma kwenzeka isilwane se-perforation, ufuna ukukwazi ukulungiswa ngaso leso sikhathi.
- Buza ngokucindezela kwesisu: Buza udokotela wakho uma ehlela ukufaka ingcindezi esiswini ngesikhathi se-colonoscopy. Ucwaningo olwanyatheliswa ku- Gastroenterology Nursing lwathola ukuthi izingozi ze-colonoscopy, ubude, nokungahleleki zingancishiswa uma udokotela esebenzisa izindlela ezithile zokucindezela esiswini ngesikhathi senqubo.
Okwenza Ukuhlolwa Kwegciwane Le-Colon Kugcine Ukuphila
Ngemuva kokubukeza izinkinga ezikhona ze-colonoscopy, kubalulekile ukucindezela ukuthi i-colonoscopy ingasindisa ngokucacile izimpilo. Yize kube khona ukuphikisana mayelana nokusebenza komdlavuza webele kanye nokuhlolwa komdlavuza we-prostate , ukuhlolwa komdlavuza we- colon kwenza umehluko futhi kubangele izinga lokunciphisa ukufa lokubulawa komdlavuza wekoloni. Noma kunjalo, umdlavuza wekoloni usalokhu kungumphumela wesithathu oholela ekufeni okuhlobene nomdlavuza emadodeni.
Ukuhlolwa komdlavuza weColon kuyingqayizivele yokuthi kungasetshenziswa kokubili ukuvimbela nokutholakala kokuqala. Uma izimpande zitholakele futhi zisusiwe esiteji esinqanda, i-colonoscopy ingaba nendima yokuvimbela. Lapho kuqala ukwelashwa, i-colonoscopy ingaba yindlela yokuthola okokuqala.
Ukulinganisa Izingozi Nezinzuzo
Ingabe kufanele uthole ikholonoscopy ? Impendulo yabantu abaningi ngubobo ngoba izinzuzo ezingase zibe ngaphezu kwezingozi. Ama-Colonoscopies aphakathi kwamathuluzi aphumelele kakhulu atholakalayo ekuvimbeleni umdlavuza. Kodwa-ke, khuluma nodokotela wakho mayelana nezinkinga zakho ezithile uma kwenzeka unengozi enkulu yezinkinga kunomuntu ojwayelekile.
> Imithombo:
> I-American Society Ye-Endoscopy Yamathumbu. Izinkinga zeColonoscopy. 2011. http://www.asge.org/assets/0/71542/71544/56321364-c4d8-4742-8158-55b6bef2a568.pdf
> Ranasinghe, I., Przynski, C., Searfoss, R., et al. Ukwahlukahluka kobuciko beColonoscopy Phakathi kweziNsiza: Ukuthuthukiswa koHlelo lwe-Post-Colonoscopy-Isilinganiso Esihambelanayo Sokuvakashela Izibhedlela ezingakahlelwe. I-Gastroenterology . 2016. 150 (1): 103-113.
> Reumkens, A., Rondagh, E., Bakker, C., Winkens, B., Masclee, A., no S. Sanduleanu. Izinkinga zePost-Colonoscopy: Ukubuyekezwa Okuhlelekile, Amathrendi Esikhathi, Nokuhlaziywa Kwezinguquko Ezihlobene Nezibalo. I-American Journal ye-Gastroenterology . 2016. 111 (8): 1092-101.
> Stock, C., Ihle, P., Sieg, A., Schubert, I., Hoffmeister, M., no H. Brenner. Izenzakalo ezimbi ezidinga ukwelashwa esibhedlela phakathi kwezinsuku ezingama-30 Emva kokuhlolwa kwezilonda eziphuthumayo kanye nama-colonoscopies okuyi-Nonscreening. I-Endoscopy yamathumbu . 2013. 77 (3): 419-29.