Opaleshoni ya Matenda a Crohn: Colectomies

Zamkati

• Momwe Colectomies Amagwirira Ntchito
• Anastomosis ndi Colostomy
• Mabokosi a Colostomy
• Zoganizira za Opaleshoni
• Chifukwa Chiyani Muyenera Kutenga Colectomy?

Pamene mankhwala ndi kusintha kwa moyo kwalephera kuthandiza anthu omwe ali ndi matenda a Crohn kupeza mpumulo, nthawi zambiri opaleshoni ndi gawo lotsatira. Crohn's & Colitis Foundation of America (CCFA) inanena kuti magawo awiri mwa atatu mpaka atatu mwa anayi a anthu onse omwe ali ndi matenda a Crohn adzafunika kuchitidwa opaleshoni.

Matenda a Crohn amapezeka pamene chitetezo chamthupi chanu chimayamba kulimbana ndi matupi ake, ndikupangitsa kutupa kwa m'mimba. Izi zimapangitsa kuti pakhale zovuta zosiyanasiyana komanso zopweteka, kuphatikiza kutsegula m'mimba pafupipafupi, kupweteka m'mimba, komanso matenda. Ngakhale kulibe mankhwala odziwika a matenda a Crohn, anthu ambiri pamapeto pake amakhululukidwa kwazaka zambiri, nthawi zambiri kudzera mumankhwala kapena opaleshoni yotchedwa colectomy.

Maopareshoni angapo amapezeka kwa anthu omwe ali ndi matenda a Crohn, ndipo ma colectomies ndi ena mwa ovuta kwambiri. Pakati pa colectomy, dondolo limagawidwanso m'magawo osiyanasiyana. Ngati zingatheke, dotolo wanu adzajowina ileamu ndi rectum kuti mulole kupitiliza kudutsa zinyalala osavala thumba lakunja.

Momwe Colectomies Amagwirira Ntchito

Colectomies amachitidwa kwa anthu omwe ali ndi matenda a Crohn, khansa ya m'matumbo, diverticulitis, ndi zina. Poyambirira, ndondomekoyi inkachitika popanga chotupa m'mimba kuti chotse kholalo. Kuchita opaleshoniyi nthawi zambiri kumachitika pogwiritsa ntchito laparoscopy ndikugwiritsa ntchito tinthu tating'onoting'ono tambiri. Izi zimachepetsa nthawi yakuchiritsa ndikuchepetsa mavuto azovuta.

Kukhazikitsanso koloni kumatanthauza kuchotsa gawo lanu ndikukhazikitsanso magawo otsala kuti abwezeretse matumbo. Nthawi zambiri, kolectomy pang'ono, yomwe imakhudza kuchotsa gawo lomwe lakhudzidwa, imachitika. Ngati mukuganiza za colectomy, mungafunikire kusankha pakati pa anastomosis, yomwe ndi yolumikiza magawo awiri amatumbo anu kuti azitha kugwira ntchito yamatumbo, ndi colostomy, yomwe ndi opaleshoni yomwe m'matumbo mwanu mumabweretsedwa m'mimba mwanu. kukhuthulira m'thumba. Pali zabwino ndi zoyipa kwa onse, zomwe zingapangitse chisankho kukhala chovuta kwambiri.

Anastomosis ndi Colostomy

Anastomosis imakhala ndi zoopsa zina. Makamaka, pamakhala chiopsezo cha kuwonongeka kwa sutures, komwe kumatha kuyambitsa matenda ndikupangitsa kuti sepsis. Ikhozanso kupha nthawi zina. Ngakhale colostomy ndi yotetezeka, imakhala ndi zoopsa zake. Colostomy imatulutsa ndowe zomwe zimayenera kutulutsidwa pamanja. Anthu ena omwe ali ndi colectomy amatha kulandira colostomy ndi kuthirira, komwe kumapanga kapu pamwamba pa stoma, kapena kutuluka, kusunga zinyalala mkati. Ayenera kuthirira kamodzi patsiku, pogwiritsa ntchito malaya othirira.

Mabokosi a Colostomy

Ngati muli ndi colostomy yachikhalidwe, mudzakhala ndi thumba. Izi ziyenera kutulutsidwa kapena kusinthidwa mosiyanasiyana tsiku lonse. Matumba amakono a colostomy ali ndi fungo locheperako ndipo ndi osabereka kuposa akale, amakulolani kuti mukhale moyo wabwinobwino osadandaula za ena kudziwa za matenda anu. Madokotala ambiri m'malo mwake amapereka thumba la kolo-anal, lotchedwa ileoanal thumba, lomwe limapangidwa pogwiritsa ntchito matumbo anu apansi.

Zoganizira za Opaleshoni

Pambuyo pa opaleshoni, muyenera poyamba kukhala ndi zakudya zochepa kuti muchepetse nkhawa m'matumbo. Malinga ndi CCFA, pafupifupi 20% ya odwala amawonetsa kuzindikiranso pambuyo pazaka ziwiri, 30% amawonetsa kuzindikiranso pambuyo pazaka zitatu, ndipo mpaka 80% amawonetsa kuzindikiranso kwa zaka 20. Sikubwereza konse komwe kumatanthauza kuti mufunika kuchitidwanso opaleshoni ina.

Infliximab (Remicade) itha kulembedwa kuti ipewe kubwereza kuzizindikiro. Infliximab ndi chotchinga chotupa chotchedwa necrosis factor (TNF) chomwe chimathandiza kuti chitetezo cha mthupi chisamagwire bwino ntchito. Zatsimikizira kuti zikuyenda bwino.

Mavuto akabwereranso pambuyo pochitidwa opaleshoni, nthawi zambiri amakhala mdera lina lamatumbo. Izi zitha kufuna maopaleshoni owonjezera.

Chifukwa Chiyani Muyenera Kutenga Colectomy?

Ndi kubwereza kwakukulu kotereku, mwina mungadabwe chifukwa chake muyenera kupeza colectomy konse. Kwa anthu ambiri omwe ali ndi matenda a Crohn omwe amadwala matenda opatsirana pogonana, zizindikilo zawo zimakhala zovuta kwambiri kotero kuti mankhwala samathandiza kapena atha kukhala ndi zotupa kapena fistula zomwe zimafunikira chidwi nthawi yomweyo. Kwa anthu ena, chisankho chokhala ndi colectomy chimapangidwa patapita nthawi yayitali ndikuganizira mozama za izi.

Ngakhale kuchotsedwa kwa coloni yanu yonse kapena gawo lanu kumathandizadi kukuwonetsani zakanthawi kochepa, kuchitidwa opaleshoni sikuchiza matenda a Crohn. Palibe mankhwala a matenda a Crohn panthawiyi. Pali kuthekera kokha kochepetsera ndikuwongolera zizindikilo. Kwa anthu ena, mankhwala a matenda a Crohn adzakhala njira yamoyo. Kwa ena, colectomy imatha kubweretsa kukhululukidwa kwanthawi yayitali, ngakhale kubwereza kumatheka nthawi zonse.Ngati colectomy imapatsa ngakhale mpumulo wocheperako pambuyo pazaka zopweteka zaka, zingakhale zabwino kwa anthu ena.