Utyando lwe-anti-reflux

Utyando lwe-anti-reflux lunyango lwe-asidi ye-asidi, ekwabizwa ngokuba yi-GERD (isifo se-gastroesophageal reflux). I-GERD yimeko apho ukutya okanye isisu esiswini sibuya esiswini sakho siye kwi-esophagus. I-esophagus yityhubhu ukusuka emlonyeni wakho ukuya esiswini.

I-Reflux ihlala isenzeka ukuba izihlunu apho isisu sidibana khona nesisu asivaleli ngokwaneleyo ngokwaneleyo. I-hernia yokuzalwa inokwenza iimpawu ze-GERD zibi ngakumbi. Kwenzeka xa isisu siqhuma kulo vulo esifubeni sakho.

Iimpawu ze-Reflux okanye ukutsha kwentliziyo kuyatsha esiswini ukuze uve nasemqaleni okanye esifubeni, ukuqhuma okanye amaqamza erhasi, okanye ingxaki yokuginya ukutya okanye ulwelo.

Inkqubo eqhelekileyo yolu hlobo ibizwa ngokuba yingxowa-mali. Kolu tyando, ugqirha wakho wotyando uya:

• Okokuqala lungisa i-hernia yokubeleka, ukuba ukhona. Oku kubandakanya ukuqinisa ukuvulwa kwidayaphragm yakho ngemithungo yokugcina isisu sakho ukuba singangxami siye phezulu ngokuvula kudonga lwezihlunu. Abanye oogqirha bafaka isiqwenga semingxuma kwindawo elungisiweyo ukuyenza ikhuseleke ngakumbi.
• Gquba inxalenye ephezulu yesisu sakho malunga nokuphela kwesisu sakho. Izibonda zenza uxinzelelo ekupheleni kwesisu sakho, esinceda ukukhusela i-asidi yesisu kunye nokutya ekuphumeni ukusuka esiswini ukuya kwi-esophagus.

Utyando lwenziwa ngelixa uphantsi kweanesthesia ngokubanzi, ngenxa yoko ulele kwaye awunazintlungu. Ugqirha luhlala luthabatha iiyure ezi-2 ukuya kwezi-3. Ugqirha wakho unokukhetha kwiindlela ezahlukeneyo.

UKULUNGISWA OKUVULIWEYO

• Ugqirha wakho uza kwenza i-1 enkulu yokusika esiswini sakho.
• Umbhobho unokufakwa kwisisu sakho ngesisu ukugcina udonga lwesisu endaweni. Le tube izakukhutshwa malunga neveki.

UKULUNGISWA KWELAPAROSCOPIC

• Ugqirha wakho uza kwenza i-3 ukuya kwi-5 ukusika okuncinci esiswini sakho. Ityhubhu ebhityileyo enekhamera encinci esiphelweni ifakwe kwelinye lala macandelo.
• Izixhobo zoqhaqho zifakwa ngakwamanye amanxeba. I-laparoscope iqhagamshelwe kwisibekeli sevidiyo kwigumbi lokusebenza.
• Ugqirha wakho uyalungisa ngelixa ejonga ngaphakathi kwesisu sakho esweni.
• Ugqirha kufuneka atshintshele kwinkqubo evulekileyo xa kukho iingxaki.

ISICWANGCISO SONYAKA SOKUGQIBELA

• Le yinkqubo entsha enokwenziwa ngaphandle kokusika. Ikhamera ekhethekileyo kwisixhobo esiguquguqukayo (i-endoscope) sidluliswa ngomlomo wakho nakwi-esophagus yakho.
• Usebenzisa esi sixhobo, ugqirha uya kubeka iziqwengana ezincinci kwindawo apho umqala udibana khona nesisu. Ezi kliphu zinceda ukukhusela ukutya okanye iasidi yesisu ekuxhaseni.

Ngaphambi kokuba utyando luqwalaselwe, umboneleli wakho wezempilo uya kuzama:

• Amayeza anje nge-H2 blockers okanye ii-PPIs (proton pump inhibitors)
• Utshintsho kwindlela yokuphila

Utyando lokunyanga isitshisa okanye iimpawu ze-reflux kunokucetyiswa xa:

• Iimpawu zakho azibi ngcono xa usebenzisa amayeza.
• Awufuni ukuqhubeka uthatha la mayeza.
• Unengxaki ezinzima ngakumbi kwi-esophagus yakho, njengokuqhekeka okanye ukunciphisa, izilonda, okanye ukuphuma kwegazi.
• Unesifo se-reflux esibangela i-pneumonia yokuphefumla, ukukhwehlela okungapheliyo, okanye ukuphakama.

Utyando oluchasene ne-reflux lukwasetyenziselwa ukunyanga ingxaki apho inxenye yesisu sakho iyabambeka esifubeni sakho okanye ijijekile. Oku kubizwa ngokuba yi-para-esophageal hernia.

Umngcipheko wayo nayiphi na i-anesthesia kunye notyando ngokubanzi zezi:

• Impendulo kumayeza
• Iingxaki zokuphefumla
• Ukopha, amahlwili egazi, okanye usulelo

Iingozi zolu tyando zezi:

• Ukonakala kwesisu, umqala, isibindi, okanye amathumbu amancinci. Oku kunqabile kakhulu.
• Ukuqunjelwa kwegesi. Kulapho isisu sigcwalisa umoya okanye ukutya kwaye awukwazi ukukhulula uxinzelelo ngokugquma okanye ukugabha. Ezi mpawu zihamba kancinci kubantu abaninzi.
• Intlungu kunye nobunzima xa uginya. Oku kubizwa ngokuba yi-dysphagia. Kwinkoliso yabantu, oku kuyaphela ngeenyanga ezintathu zokuqala emva kotyando.
• Ukubuya kwe-hernia yokuzalwa okanye i-reflux.

Unokufuna ezi mvavanyo zilandelayo:

• Uvavanyo lwegazi (ukubala okupheleleyo kwegazi, ii-electrolyte, okanye iimvavanyo zesibindi).
• I-Esophageal manometry (ukulinganisa uxinzelelo kwi-esophagus) okanye ukubeka iliso kwi-pH (ukubona ukuba isisu esiswini sibuyela kangakanani kwisifo sakho).
• Endoscopy ephezulu. Phantse bonke abantu abanolu tyando lwe-anti-reflux sele benalo olu vavanyo. Ukuba awukwenzi olu vavanyo, kuya kufuneka uyenze.
• I-X-ray ye-esophagus.

Soloko uxelela umboneleli wakho ukuba:

• Unokukhulelwa.
• Uthatha nawaphi na amayeza, okanye izongezo okanye amayeza owathengileyo ngaphandle kommiselo.

Ngaphambi kotyando lwakho:

• Kuya kufuneka uyeke ukuthatha i-aspirin, ibuprofen (Advil, Motrin), ivithamin E, clopidogrel (Plavix), warfarin (Coumadin), kunye nezinye iziyobisi okanye izongezo ezichaphazela ukujija kwegazi kwiintsuku ezininzi ngaphambi kotyando. Buza ugqirha wakho otyandayo ukuba ufanele wenze ntoni.
• Buza umboneleli wakho ukuba zeziphi iziyobisi omele uzithathe ngosuku lotyando lwakho.

Ngomhla wotyando lwakho:

• Landela imiyalelo yomboneleli wakho malunga nexesha lokuyeka ukutya nokusela.
• Thatha amayeza ugqirha wakho akuxelele ukuba uwathabathe ngesiphuzo esincinci samanzi.
• Landela imiyalelo yokuhlamba ngaphambi kotyando.

Umboneleli wakho uya kukuxelela ukuba ufike nini esibhedlele. Qiniseka ukuba ufika ngexesha.

Uninzi lwabantu abanotyando lwe-laparoscopic banokusishiya isibhedlele ngaphakathi kweentsuku ezi-1 ukuya kwezi-3 emva kwenkqubo. Unokufuna ukuhlala esibhedlele kweentsuku ezi-2 ukuya kwezi-6 ukuba utyando luvulekile. Uninzi lwabantu lunokubuyela kwimisebenzi yesiqhelo kwiiveki ezi-4 ukuya kwezi-6.

Isitshisa kunye nezinye iimpawu kufuneka ziphuculwe emva kotyando. Abanye abantu kusafuneka bathathe amachiza okuba nesitshisa emva kotyando.

Unokufuna olunye utyando kwixa elizayo ukuba uphuhlisa iimpawu ezintsha ze-reflux okanye iingxaki zokuginya. Oku kunokwenzeka ukuba isisu sisongelwe ngokuqinileyo emqolo, isongelo siyakhulula, okanye i-hernia entsha yokubeleka iyavela.

Ukuxhasa ngemali Inkxaso mali yeNissen; Belsey (UMark IV) inkxaso-mali; Inkxaso mali yeqela; Inkxaso mali yeThal; Ukulungiswa kweHernatal hernia; Endoluminal fundoplication; I-reflux ye-Gastroesophageal - utyando; GERD - utyando; Reflux - utyando; IHernatal hernia - utyando

• Utyando lwe-anti-reflux-ukukhutshwa
• I-reflux ye-Gastroesophageal-ukukhutshwa
• Isitshisa - yintoni ekufuneka uyibuze kugqirha
• Unonophelo lwenxeba lotyando - luvulekile

• Ukulungiswa kweHernatal hernia- uthotho
• IHernatal hernia - i-x-reyi

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IMazer LM, iAzagury DE. Ulawulo lotyando lwesifo se-reflux sesisu. Ku: ICameron AM, uCameron JL, ii-eds. Unyango lwangoku lonyango. Umhla we-13. IPhiladelphia, PA: Elsevier; 2020: 8-15.

URichter JE, uFriedenberg FK. Isifo se-reflux sesifo se-Gastroesophageal. Ku: UFeldman M, uFriedman LS, uBrandt LJ, ii-eds. Sleisenger kunye neFordtran's Amathumbu kunye nezifo zesibindi: iPathophysiology / Diagnosis / Management. Ngomhla we-10. IPhiladelphia, PA: Elsevier Saunders; I-2016: isahluko 44.

IYates RB, iOelschlager BK, iPellegrini CA. Isifo se-Gastroesophageal Reflux kunye ne-hernia ye-hiatal. Ku: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, ii-eds. Incwadi yeSabiston yoNyango. Umhla we-20. IPhiladelphia, PA: Elsevier; Ngo-2017: isahluko 42.