I-Colovesical Fistula

Umxholo

• Iimpawu
• Oonobangela kunye noxilongo
• Izinketho zonyango
• Ugqirha
• Ukuchacha
• Imbonakalo

Ushwankathelo

I-foloula ye-colovesical yimeko. Kukunxibelelana okuvulekileyo phakathi kwekholoni (amathumbu amakhulu) kunye nesinyi. Oku kunokuvumela into yelindle ukusuka kwikholoni ukuba ingene kwisinyi, ibangele usulelo olubuhlungu kunye nezinye iingxaki.

Ikholoni, enceda ifom yesitulo ukuba ikhutshwe ngetekeni, ihleli ngaphezulu kwesinyi. I-bladder igcina umchamo ngaphambi kokuba ukhutshwe nge-urethra. Udonga olungqindilili lweethishu luhlulahlula ikholoni kunye nesinyi. Utyando okanye olunye ukonzakala kweli candelo lomzimba kunokubangela ukuba i-fistula yenze. Xa kuvulwa ukuvulwa, iziphumo ziyi-colovesical fistula, ekwabizwa ngokuba yi-vesicocolic fistula.

Iyanyangeka i-fistula ecolovesical. Nangona kunjalo, ngenxa yokuba ingaqhelekanga, kukho ulwazi olunomda malunga nendlela efanelekileyo yokulawula le meko ibuhlungu.

Iimpawu

Unokukwazi ukuba une-fistula emhlophe ukuba uphuhlisa enye yayo kubandakanya:

• IPneumaturia. Le yenye yeempawu eziqhelekileyo. Kwenzeka xa igesi ephuma kwikholoni ixubana nomchamo. Ungabona amaqamza kumchamo wakho.
• Fecaluria. Olu phawu lwenzeka xa unemixube yelindle kumchamo. Uya kubona umbala omdaka okanye ubumnyama kumchamo wakho.
• IDysuria. Olu phawu lubangela uvakalelo olubuhlungu okanye oluvuthayo xa uchama, kunye nosulelo oluphindaphindeneyo lomchamo (UTI). Ingakhula ukusuka nakuphi na ukucaphuka kwesinyi, kodwa phantse isiqingatha seemeko ezinqabileyo ze-fistula ezikhoyo nge-dysuria.

• Oonobangela kunye noxilongo

  Ingaphezulu kwesiqingatha seemeko ze-fistula ezi-colovesical ziziphumo zesifo esiphambukayo.

  
  

  Ezinye izizathu ezibangelwa yifistula zibandakanya:

  • umhlaza ongathandabuzekiyo
  • isifo sesisu sokuvuvukala, ngakumbi isifo sikaCrohn
  • utyando olubandakanya ikholoni okanye isinyi
  • i-radiotherapy (uhlobo lonyango lomhlaza)
  • umhlaza kwamanye amalungu angqongileyo

  Ukuchonga i-colovesical fistula kunokwenziwa nge-cystography, uhlobo lovavanyo lokucinga. Ngexesha lenkqubo, ugqirha ufaka ityhubhu ecekeceke, eguqukayo kunye nekhamera kwelinye icala kwisinyi sakho. Ikhamera ihambisa imifanekiso yodonga lwesinyi kwikhompyuter, ukuze ugqirha wakho abone ukuba kukho i-fistula.

  Enye inkqubo eluncedo yokucinga yimifanekiso ye-barium. Oku kunokunceda ekuchongeni iingxaki kwikholoni. Ngexesha lenkqubo, ugqirha wakho ufaka inani elincinci lolwelo oluqukethe i-barium yesinyithi kwi-rectum yakho ngetyhubhu encinci. Ingubo yolwelo lwe-barium inxiba ngaphakathi kwi-rectum, ivumela ikhamera ekhethekileyo ye-X-ray ukuba ibone izicwili ezithambileyo kwikholoni ngokweenkcukacha ezinkulu kune-X-ray esemgangathweni.

  
  

  Imifanekiso ye-fistula, kunye novavanyo lomzimba, isampuli yomchamo, kunye nokuphononongwa kwezinye iimpawu, kunokunceda ugqirha wakho afumane isifo se-fistula.

  Izinketho zonyango

  Unyango olukhethiweyo lwe-foloula ye-colovesical luqhaqho.

  Unyango lwe-Conservative lunokuzama ukuba i-fistula incinci ngokwaneleyo, ayibangelwa bububi, kwaye ikwisigulana esineempawu ezilinganiselweyo. Oogqirha banokucebisa unyango olulondolozayo xa isigulana sinezinye izifo ezinzima kakhulu, utyando aluthathwa ngokuba lukhuselekile, okanye xa umhlaza uqhubekile kwaye ungasebenzi. Unyango olulondolozayo lunokubandakanya:

  • ukondliwa ngemithambo yakho ukuze amathumbu akho angasebenzi kwaye aphumle
  • Iintsholongwane kunye namayeza e-steroid
  • une-catheter efakwe esinyini ukukhupha ulwelo olunokuthi lungene kulo ukusuka kwikholoni

  Injongo yonyango olulondolozayo kukuba i-fistula ivalwe kwaye iphilise yodwa. Nangona kunjalo, utyando lusenokuba yimfuneko kwiimeko apho i-fistula ayiziphilisi yodwa.

  
  

  Ngenxa yokuba i-colovesical fistula yinkxalabo ye-diverticulitis, qiniseka ukuba ulandela imiyalelo yakho ugqirha ekunyangeni isifo se-diverticular. Ngamanye amaxesha, amayeza anele ukumisa ukuqhubela phambili kwale meko.

  Ugqirha

  Xa unyango olulondolozayo lungafanelekanga okanye lusebenza kakuhle, uyakufuna utyando. Umsebenzi ungasusa okanye ulungise i-fistula kwaye unqande ukutshintshana kolwelo phakathi kwesinyi kunye nekholoni.

  Uhlobo lotyando olufunekayo ukunyanga i-colovesical fistula ixhomekeke kwi-etiology (unobangela), ubungqongqo, kunye nendawo ye-fistula. Ngokwesiqhelo, kwezi meko, oogqirha basebenzisa uhlobo lotyando olubizwa ngokuba yi-sigmoid colectomy. Olu tyando lubandakanya ukususwa kwenxalenye yekholoni esezantsi.Inkqubo ikwabandakanya ukususwa kwefistula uqobo, kunye nokufakwa kwesikhumba kunye nesinyi.

  Umsebenzi ungenziwa ngotyando oluvulekileyo. Oogqirha banokwenza ukusikwa okukhulu esiswini, okanye bangene kwi-laparoscopically, ebandakanya izixhobo ezizodwa, ezincinci zoqhaqho kunye neendlela ezimbalwa ezincinci. Utyando lwe-laparoscopic lusetyenziswa rhoqo kule nkqubo kuba yenza ukubuyela ngokukhawuleza kunye nokunciphisa umngcipheko wokudibana. Kwisifundo esinye, ixesha eliqhelekileyo lotyando lwe-laparoscopic ukulungisa i-foloula yecolovesical yayingaphaya kweeyure ezimbini.

  Ukulungiswa kotyando ngayo nayiphi na indlela kubandakanya:

  • ilele etafileni yotyando ineenyawo ezinxungupheleyo (eyaziwa njengendawo ye-lithotomy)
  • I-anesthesia ngokubanzi
  • uqhaqho lotyando oluvulekileyo okanye ukusikwa kwe-laparoscopic
  • Ukwahlulwa kwekholoni kunye nesinyi, ezihanjiswa kude kude ukuqhubeka nenkqubo
  • Ukususwa kotyando lwefistula (inkqubo eyaziwa ngokuba yi resection)
  • ukulungiswa kwazo naziphi na iziphene okanye ukwenzakala kwesinyi kunye / okanye ikholoni
  • ukufuduselwa kwikholoni kunye nesinyi kwizikhundla zazo ezifanelekileyo
  • Ukubekwa kwesiqwenga esikhethekileyo phakathi kwekholoni kunye nesinyi ukunceda ukuthintela i-fistula yexesha elizayo ukuba ingenzeki
  • Ukuvalwa kwazo zonke iindlela ezisikiweyo

  Ukuchacha

  Uphononongo lwase-Australia lokulungiswa kwe-fistula ye-laparoscopic colovesical fistula yafumanisa ukuba isibhedlele esiqhelekileyo sihlala emva kotyando iintsuku ezintandathu. Kwiintsuku ezimbini, umsebenzi oqhelekileyo wamathumbu ubuyile. Uhlolisiso olwenziweyo lwendoda eneminyaka engama-58 eyathi yenziwa utyando oluvulelekileyo ukuze inyange i-fistula ebumbekayo yafumanisa ukuba ibiziva ukuba iphilile kwiintsuku ezimbini emva kotyando. Wagqitha umchamo ocacileyo kwiintsuku ezimbini kamva, naye.

  Ugqirha wakho uya kukunika amayeza okubulala iintsholongwane ngaphandle kohlobo lotyando okanye lotyando olwenzayo.

  Kuya kufuneka uvuke kwaye uhambe ngosuku emva kotyando lwakho. Ukuba bekukho iingxaki, nangona kunjalo, unokucetyiswa ukuba uhlale ebhedini usuku olongezelelweyo okanye ezimbini. Ukuba utyando lube yimpumelelo, kuya kufuneka ukwazi ukuqhubeka nemisebenzi yesiqhelo, njengokuhamba ngezinyuko kunye nokuqhuba, kwiveki enye okanye ezimbini. Njengalo naluphi na utyando kwindawo esiswini, kuya kufuneka uphephe ukuphakamisa nantoni na enzima iiveki ezimbalwa. Qiniseka ukuba uthetha nogqirha wakho malunga nayiphi na imiqobo kwimisebenzi yakho.

  Uya kuthi unikwe ukutya okucacileyo okungamanzi ngosuku lokuqala okanye emva kotyando. Emva koko uya kunyuka uye kukutya okuthambileyo, emva koko uye kukutya okuqhelekileyo. Ukuba unesifo esahlukileyo, unokucetyiswa ukuba utye ukutya okunesondlo esiphezulu. Iinkcukacha zokutya kwakho ziya kuxhomekeka kweminye imiba yezempilo. Ukuba utyebe kakhulu, uya kucetyiswa ukuba ulandele isicwangciso sokunciphisa umzimba kubandakanya utshintsho kwindlela yokutya kunye nokuzilolonga rhoqo.

  Ukuba uqaphela ukuvulwa kokuqunjelwa, ukuqhina okubalulekileyo, ukopha kwi-rectum yakho, okanye umchamo obala umbala, tsalela ugqirha wakho. Ubuhlungu abuhambelani nokuphilisa kunye neempawu zosulelo kwiindawo ezinje ngobubomvu, ukufudumala, okanye amanzi amdaka emva kotyando kufuneka axelwe.

  Imbonakalo

  Nangona kubuhlungu, i-colovesical fistula inokunyangwa ngempumelelo. Kuyafana nezizathu ezingunobangela, ezinje ngezifo eziguqukayo. Nangona ungadinga ukutshintsha indlela otya ngayo kunye nendlela ophila ngayo, ezi meko kunye nonyango lwabo akufuneki zibangele naziphi na iingxaki zexesha elide.