Opaleshoni ya anti-reflux

Opaleshoni ya anti-reflux ndichithandizo cha acid reflux, yotchedwanso GERD (gastroesophageal Reflux matenda). GERD ndimkhalidwe womwe chakudya kapena asidi m'mimba amabwerera kuchokera m'mimba mwanu kupita m'mimba. Mimbayi ndi chubu kuchokera pakamwa panu mpaka m'mimba.

Reflux nthawi zambiri imachitika ngati minofu yomwe pamimba imakumana ndimimba siyitsekera mokwanira. Hernia yobereka imatha kukulitsa zizindikiritso za GERD. Zimachitika pamene m'mimba mwadutsira pachitseko ichi m'chifuwa.

Zizindikiro za Reflux kapena kutentha pa chifuwa zikuyaka m'mimba zomwe zimamvekanso kummero kapena pachifuwa, kuphulika kapena kutulutsa kwa gasi, kapena vuto kumeza chakudya kapena madzi.

Njira zodziwika bwino zamtunduwu zimatchedwa kugwiritsa ntchito ndalama. Pochita opaleshoniyi, dokotalayo:

• Choyamba konzani chophukacho, ngati wina alipo. Izi zimaphatikizapo kumangiriza kutseguka kwa diaphragm yanu ndikumangirira kuti m'mimba musakwere m'mwamba kudzera potseguka pakhoma la minofu. Madokotala ena amaika mauna pamalo omwe akonzedwa kuti akhale otetezeka.
• Lembani kumtunda kwa mimba yanu kumapeto kwa mimba yanu ndi zokopa. Zomangazo zimapanikizika kumapeto kwa kholingo, zomwe zimathandiza kupewa asidi wam'mimba ndi chakudya kuti chisakwere kuchokera m'mimba kupita kummero.

Opaleshoni imachitika mukakhala kuti mukudwala anesthesia, chifukwa chake mukugona komanso osamva ululu. Nthawi zambiri opaleshoni imatenga maola awiri kapena atatu. Dokotala wanu angasankhe njira zosiyanasiyana.

KUKONZEKETSA

• Dokotala wanu azipanga 1 yodula yayikulu m'mimba mwanu.
• Chubu chimatha kulowetsedwa m'mimba mwanu kudzera m'mimba kuti khoma lam'mimba likhale m'malo. Chubu ichi adzachotsedwa pafupifupi sabata.

KUKONZETSA LAPAROSCOPIC

• Dokotala wanu amapanga mabala atatu mpaka asanu m'mimba mwanu. Thubhu yocheperako yokhala ndi kamera yaying'ono kumapeto imalowetsedwa kudzera mwa kudulidwa uku.
• Zida zopangira opaleshoni zimayikidwa kudzera pazidutsazo. Lapaloscope yolumikizidwa ndi zowonera makanema m'chipinda chogwiritsira ntchito.
• Dokotala wanu amakonza nyumbayo kwinaku akuyang'ana mkati mwa mimba yanu poyang'anira.
• Dokotalayo angafunikire kusintha njira yotsegulira pakagwa mavuto.

MALANGIZO OTHANDIZA

• Iyi ndi njira yatsopano yomwe ingachitike popanda kudula. Kamera yapadera yomwe ili ndi chida chosinthira (endoscope) imadutsa mkamwa mwanu mpaka mummero.
• Pogwiritsa ntchito chida ichi, adokotala amaika tating'ono tating'ono pomwe pakhosi limakumana ndi m'mimba. Zithunzi izi zimathandiza kupewa chakudya kapena asidi m'mimba kuti asayimire kumbuyo.

Asanaganizidwe za opareshoni, wothandizira zaumoyo wanu adzakuyesani:

• Mankhwala monga H2 blockers kapena PPIs (proton pump inhibitors)
• Zosintha m'moyo

Kuchita opaleshoni kuti muchepetse kutentha kwa mtima kapena zizindikiro za Reflux kungalimbikitsidwe ngati:

• Zizindikiro zanu sizikhala bwino mukamagwiritsa ntchito mankhwala.
• Simukufuna kupitiriza kumwa mankhwalawa.
• Muli ndi mavuto owopsa m'mimba mwanu, monga zipsera kapena kupindika, zilonda zam'mimba, kapena magazi.
• Muli ndi matenda a reflux omwe amayambitsa chibayo, chifuwa chachikulu, kapena kuwuma.

Opaleshoni ya anti-reflux imagwiritsidwanso ntchito kuthana ndi vuto pomwe gawo lina la m'mimba mwanu likugwera pachifuwa kapena kupindika. Izi zimatchedwa hernia wa para-esophageal.

Zowopsa za anesthesia iliyonse ndi opaleshoni yonse ndi:

• Zomwe zimachitika ndi mankhwala
• Mavuto opumira
• Kukhetsa magazi, magazi kuundana, kapena matenda

Zowopsa za opaleshoniyi ndi izi:

• Kuwonongeka kwa m'mimba, kum'mero, chiwindi, kapena m'matumbo ang'ono. Izi ndizosowa kwambiri.
• Kutupa kwa gasi. Apa ndipamene mimba imadzaza ndi mpweya kapena chakudya ndipo mumalephera kuthetsa vutoli mwakuboola kapena kusanza. Zizindikirozi pang'onopang'ono zimakhala zabwino kwa anthu ambiri.
• Zowawa komanso zovuta mukameza. Izi zimatchedwa dysphagia. Kwa anthu ambiri, izi zimatha miyezi itatu yoyambirira atachitidwa opaleshoni.
• Kubwereranso kwa hernia wobereka kapena Reflux.

Mungafunike mayeso otsatirawa:

• Kuyezetsa magazi (kuwerengera kwathunthu magazi, ma electrolyte, kapena kuyesa kwa chiwindi).
• Esophageal manometry (kuyeza zovuta m'mimba) kapena kuwunika kwa pH (kuti muwone kuchuluka kwa asidi m'mimba akubwerera m'mimba mwanu).
• Pamwamba endoscopy. Pafupifupi anthu onse omwe ali ndi anti-reflux opaleshoniyi adayesedwa kale. Ngati simunayesedwepo, muyenera kutero.
• X-ray ya kum'mero.

Nthawi zonse uzani omwe amakupatsani ngati:

• Mutha kukhala ndi pakati.
• Mukumwa mankhwala aliwonse, kapena zowonjezera kapena zitsamba zomwe mwagula popanda mankhwala.

Musanachite opaleshoni yanu:

• Mungafunike kusiya kumwa aspirin, ibuprofen (Advil, Motrin), vitamini E, clopidogrel (Plavix), warfarin (Coumadin), ndi mankhwala ena aliwonse kapena zowonjezera zomwe zimakhudza magazi kugundana masiku angapo asanachite opareshoni. Funsani dokotala wanu zomwe muyenera kuchita.
• Funsani omwe amakupatsani mankhwala omwe muyenera kumwa patsiku la opareshoni yanu.

Patsiku la opareshoni yanu:

• Tsatirani malangizo a omwe amakupatsani za nthawi yosiya kudya ndi kumwa.
• Tengani mankhwala omwe dokotala adakuwuzani kuti mumwe pang'ono pokha madzi.
• Tsatirani malangizo osamba musanachite opaleshoni.

Wothandizira anu adzakuuzani nthawi yoti mufike kuchipatala. Onetsetsani kuti mwafika nthawi.

Anthu ambiri omwe achita opaleshoni ya laparoscopic amatha kuchoka kuchipatala pasanathe masiku 1 kapena 3 chitachitika. Mungafunike kukhala mchipatala masiku awiri kapena asanu ndi awiri ngati mwachitidwa opareshoni. Anthu ambiri amatha kubwerera kuzinthu zachilendo m'masabata 4 mpaka 6.

Kutentha pa chifuwa ndi zizindikiro zina ziyenera kusintha pambuyo pa opaleshoni. Anthu ena amafunikirabe kumwa mankhwala akumwa pa chifuwa pambuyo pa opaleshoni.

Mungafunike kuchitidwa opaleshoni ina mtsogolomo mukadzakhala ndi zidziwitso zatsopano za Reflux kapena mavuto akumeza. Izi zitha kuchitika ngati mimba idakulungidwa pamimba mwamphamvu, kukulunga kumasuka, kapena nthenda yatsopano yoberekera ikayamba.

Kupeza ndalama; Kuphatikiza ndalama kwa Nissen; Belsey (Mark IV) kugwiritsa ntchito ndalama; Kugwiritsa ntchito ndalama zamagulu; Thal fundoplication; Kukonza nthenda ya Hiatal; Endoluminal fundoplication; Reflux ya gastroesophageal - opaleshoni; GERD - opaleshoni; Reflux - opaleshoni; Hernia hernia - opaleshoni

• Opaleshoni ya anti-reflux - kutulutsa
• Reflux ya gastroesophageal - kutulutsa
• Kutentha pa chifuwa - zomwe mungafunse dokotala wanu
• Chisamaliro cha bala la opaleshoni - chotseguka

• Kukonza nthenda ya Hiatal - mndandanda
• Chithandizo cha Hiatal - x-ray

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Mazer LM, Azagury DE. Kuwongolera maopareshoni am'magazi a reflux am'mimba. Mu: Cameron AM, Cameron JL, olemba., Eds. Chithandizo Chamakono Cha Opaleshoni. Wolemba 13. Philadelphia, PA: Elsevier; 2020: 8-15.

Richter JE, Friedenberg FK. Matenda a reflux am'mimba. Mu: Feldman M, Friedman LS, Brandt LJ, olemba. Sleisenger ndi Fordtran's Mimba ndi Matenda a Chiwindi: Pathophysiology / Diagnosis / Management. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016: chap 44.

Yates RB, Oelschlager BK, Pellegrini CA. (Adasankhidwa) Matenda a reflux a gastroesophageal ndi hernia wobereka. Mu: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Buku Lopanga Opaleshoni. Wolemba 20th. Philadelphia, PA: Elsevier; 2017: mutu 42.