Izinhlobo eziningi zokuhlinza zisetshenziselwa ukwelapha isifo sofuba esiswini (IBD) . Uhlobo olulodwa lokuhlinzeka ngezinye izikhathi ukususwa kwe- rectum (okubizwa ngokuthi i-proctectomy) ne-anus. Uma zombili lezo zakhiwo zisuswa, enye indlela izodingeka ukuze isitembu sishiye umzimba. Uma yonke ikholoni isusiwe (okuthiwa i- colectomy ), noma ngesikhathi esisodwa njenge-proctectomy noma ngaphambili, i-ileostomy iyodingeka.
Kubantu abane-Crohn's and ulcerative colitis, uhlobo lwe-ileostomy olubizwa nge-ileostomy yokuphela yilokho okwenziwe ngokujwayelekile. Lapha lapho ingxenye yamathumbu amancane ehliswa esiswini, ngaphandle komzimba, ukwakha okuthiwa i-stoma. Isikhwama se-ostomy sigqokwe phezu kwe-stoma ukuqoqa isitopu futhi sichithwa izikhathi eziningana ngosuku uma sidingeka.
Ukwelashwa kwe-proctectomy kungasetshenziselwa ukwelapha umdlavuza we-rectal kodwa lesi sihloko sizoxoxa ngokuhlinzwa njengoba kusebenza ku-IBD futhi ngokubambisana nokususwa kwe-anus. I-rectum, noma ingxenye enkulu ye-rectum, isuswe ngesikhathi sokuhlinzwa kwe-j-pouch (i-ileoanal poch anastomosis, noma i-IPAA) , ejwayelekile eyenziwa kuphela kwiziguli ezine-colcer ulcerative. Kulezi ziguli, i-anus ishiywe endaweni futhi isigaba sokugcina samathumbu amancane senziwe isakhiwo esibamba isitokisi, njenge-rectum.
Lapho i-anus isusiwe futhi, leyo ndawo yomzimba ivalwe ngokuhlinzwa.
Abanye abantu emphakathini we-IBD babhekisela kulokhu njengokuthi "i-Barbie butt" -kubizwa ngokuthi ngoba kwabanye abantu kubakhumbuza ngezansi, kanti (okusobala) ayinaso isakhiwo sokuphuma esitokisini.
I-proctectomy iyinkimbinkimbi enkulu, hhayi ngenxa nje yokuthi yenziwe ngaphansi kokuhlinzekwa komzimba jikelele nakho konke okuhamba nayo.
Ngemuva kwe-proctectomy ne-anus ekususweni kwe-IBD, i-ileostomy ingunaphakade. Lokho kungaba umqondo onzima ukubhekana nezizathu eziningi.
Noma kunjalo, kubalulekile ukuqaphela ukuthi lokhu kungaba ukuhlinzwa okusindisa ukuphila kwabanye abantu abane-IBD futhi kuzokwenza ngcono kakhulu izinga lempilo kwabanye abaningi. Abantu abane-IBD abanesifo endaweni yabo ye-rectum kanye ne-anus (indawo ye- perianal ) bangabhekana nobuhlungu futhi banokungenelela okuningi kwezokwelapha kanye nokuqashwa kwabadokotela ukuphatha izinkinga ezifana ne- abscesses ne- fistula . Emva kokuhlinzwa kwe-proctectomy, abantu abane-IBD bavame ukuzizwa bengcono futhi bathole izinga labo lokuphila liphuthukisiwe.
Okwenza Umuntu Angadinga I-Rectum Ne-Anus Isusiwe
Izilinganiso zamanje zibeka iphesenti yeziguli ezine-Crohn's disease ezidinga ukuhlinzekwa kwe-proctectomy njengephakathi kuka-12% namaphesenti angu-20. Abantu abanesifo sikaCrohn kungadingeka ukuthi babe nokuhlinzwa ngoba isifo sikaCrohn sithinta indawo esungeze i-anus, okuthiwa indawo ye-perianal.
Isifo sikaCrohn ngezinye izikhathi singabangela izinkinga ezifana ne-fistula noma ama-abscesses eduze kwe-anus. Lezi zinkinga kungaba nzima ukuphatha nokuphulukisa futhi kungabangeli ubuhlungu kuphela kodwa futhi kunciphise izinga lokuphila. Kwezinye izimo, ukusebenzisa i-ileostomy isikhathi esithile sokugwema ukuba nesibalo endaweni noma ukufaka amanzi kungasiza, kodwa uma lezi zinto zingasebenzi, i-proctectomy inganconywa.
Kulezi ziguli ezine-ulcerative colitis ezingafuni ukuhlinzwa noma ukukwazi ukuhlinzwa ngenxa yezinkinga endaweni ye-perianal, i-proctocolectomy ne ileostomy engunaphakade nayo iyindlela yokukhetha. Kwabancane abantu abane-ulcerative colitis, i-rectum isaqhubeka nokuvuvukala, futhi ukususa kuyoba nethuba elihle lokuthuthukisa ikhwalithi yokuphila.
Kwezinye iziguli, futhi lokhu kungavamile, ingozi yomdlavuza we-rectal ingukuthi ukususa i-rectum kubhekwa njengendlela engcono yokunciphisa leyo ngozi.
I-Proctectomy Surgery
Ukuhlinzwa kwe-Proctectomy kuyindlela enkulu yokuhlinzeka futhi kunezindlela ezehlukene ezingasetshenziswa.
Udokotela ohlinzayo oqedile ukuhlinzwa uyokhipha isinqumo mayelana nokuthi ukuhlinzwa kuyokwenziwa kanjani, futhi iziguli zizofuna ukukhuluma ngemininingwane yokuqokwa kwangaphambi kokuhlinzwa. Wonke amaqembu okuhlinzeka kanye nesibhedlela azoba nendlela ekhethwayo yokuqeda ukuhlinzwa futhi anqume ukuthi iziguli zizohlala isikhathi esingakanani esibhedlela nasemuva kokuphathwa kwe-carecare.
Kuzo zonke izimo, lokhu kuhlinzwa kwenziwa ngaphansi kwe-anesthesia jikelele futhi kuzodinga ukuhlala esibhedlela okungenani izinsuku ezimbalwa. Ukuphathwa kobuhlungu kuyoba yingxenye ebalulekile yokutakula kokubili esibhedlela nasekhaya. Njengokuhlinzwa okuningi, ukuvuka nokuphuma embhedeni nokuhamba ngokushesha abasebenzi basebhedlela batusa kubalulekile ekuphulukiseni.
Ngemuva kokuhlinzwa kwe-proctectomy, iziguli zizobuyela ekhaya nge-ileostomy entsha, uma engekho endaweni ngaphambi kokuhlinzwa. Umhlengikazi we-inferostomal therapy uyosiza ekuqondeni indlela yokunakekela isisu esisha nokuthi ungashintsha kanjani uhlelo lokusebenza lwe-ostomy. Kuzophinde kube nokugxila endaweni ezansi lapho i-anus ivaliwe khona, futhi leyo ndawo ingadinga ukunakekelwa okukhethekile nokuhlanza okwesikhashana ize ipholisiswe ngokugcwele. Ithimba elihlinzayo lizonikeza imiyalo kunoma yiziphi ezinye izinto ezikhathazayo ngaphambi kokuba isiguli sikhululwe esibhedlela.
Izinguquko ekudleni
Iziguli zingase zibe nokuphumula kwesibilini (ukungadli ukudla) kuze kube yilapho intombazane encane "ivuka" ngokuhlinzwa futhi iqala ukwenza umsindo umqeqeshi wezezempilo angayizwa nge-stethoscope esiswini. Isinyathelo esilandelayo ngokuvamile sidla iziphuzo ezicacile ezifana ne-gelatin nomhluzi, futhi kancane kancane uneza izinhlobo eziningi zokudla uze udle ukudla okuqinile futhi.
Iziguli zivame ukubuyela ekhaya ngokudla okuguquguqukayo amasonto ambalwa kuze kube yilapho udokotela ohlinzayo ekhuluma ukuthi ukudla okuvamile kungabuyekezwa. Emva kwalokho, kungase kube nokudla okuncane ukuthi udokotela ohlinzayo nodokotela we- gastroenterologist bagwemeke (izinto ezifana ne-popcorn noma amantongomane) ngoba noma yiluphi uhlobo lokuhlinzwa kwesisu lubeka ingozi ngokuhamba kwesikhathi ibe nesithintelo semathumba . Le ngozi yokuvimbela izokuhluka kakhulu komuntu nomuntu, ngakho ukudla kuxoxwa kahle nodokotela ohlinzayo namanye amalungu eqembu lezempilo.
Izinkinga ezingenzeka zeProctectomy
Amanxeba angama-perian: Ukuhlukumeza okuvamile kakhulu kwe-proctectomy ukuhlinzeka ngesifo sikaCrohn kungukuthi unesilonda esingavaliwe endaweni yangasese. Kwezinye izimo, abantu abanesifo sikaCrohn abadinga i-proctectomy baye bathola kahle futhi bangase babe nesimo esingokomzimba kunabo futhi odokotela bazo bafuna ngaphambi kokuhlinzwa.
Ukuba ne-abscesses noma i-fistula endaweni ye-perianal futhi kuyisici esiyingozi yokuba nezinkinga kule ndawo ngemva kokuhlinzwa. Ukungondleki okuncane kakhulu noma ukungabi namandla e-vitamin, ukubhema, nokukhuluphala kungaphinde kube nomthelela ekwenzeni izilonda ziphulukise kahle ngemva kokuhlinzwa. Ezimweni eziningi isilonda esingenalo ukuphulukiswa siyaphathwa ngokuhambisana namasu okunakekelwa kwezilonda kepha ngamancane amacala, olunye ukuhlinzwa kungadingeka.
Umsebenzi wocansi : Ukukhathazeka ngomsebenzi wezocansi nakho kuvamile ngalolu hlobo lokuhlinzwa. Ngenhlanhla, ukungasebenzi kahle kwe-erectile kumadoda ngemva kwe-proctectomy kuphansi, futhi kulinganiselwa ukuthi kube phakathi kwamaphesenti amabili nezine. Ngisho nezindaba ezingcono kakhulu ukuthi isifundo esisodwa esilandelayo sokulandelela isikhathi eside sabonisa ukuthi amaphesenti angu-90 abantu ababenokuhlinza nge-proctectomy banelisekile ngezempilo zabo zobulili.
Ezinye iziguli zibika ukuthi umsebenzi wezocansi ubi kakhulu, kanti izinga lilinganiswa ukuthi liphakathi kwamaphesenti angu-25 no-30. Iziguli ezithola ukuthi umsebenzi wezocansi akuyona into engathanda ukuba nazo zizofuna ukubhekana nalesi sihloko nodokotela ohlinzayo kanye / noma isifo se-gastroenterologist. Usizo luyatholakala ezindabeni ezihlobene nempilo yezocansi kanye nengxenye ebaluleke kakhulu ekutholeni ukukhathazeka okukhulunywe ngayo ukuletha ukunakekelwa kwethimba lakho lezempilo.
Imithi: Ezinye iziguli zingase zikhathazeke ngokuthi imithi ekhona manje ethinta kanjani ukutakula. Ucwaningo olulodwa lwabonisa ukuthi abantu abanesifo sikaCrohn abathola ukwelashwa kwe-biologic abanalo ingozi enkulu yokubhekana nezinkinga nokuphulukiswa kwesilonda kunelabo abangathathi ukwelashwa kwe-biologic ngaleso sikhathi.
Izwi elivela
Ukuhlinzeka nge-proctectomy kuyinkinga enzima kubantu abaningi abane-IBD okumele babhekane nabo. Ukuba nokuhlinzwa kusho i-ostomy ehlala njalo, kanti nakuba iziguli eziningi zizwa zingcono futhi zijabulela ukuphila ngemva kokuhlinzwa kwe-ostomy, kungokwemvelo ukuthi kube nokukhathazeka.
Ukukhuluma ngokuhlinzwa ngokuhlinzeka ngogqirha ohlinzayo kanye nesifo se-gastroenterologist kuvame ukufaka izinto eziningi zobungozi ngokubheka. Izindaba ezinhle ukuthi iningi labantu abane-IBD abane-proctectomy ukuhlinzwa baphulukise kahle futhi baqhubeke bezwa kangcono futhi bajabulele izimpilo zabo ngaphezulu.
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