Utyando lwezifo zikaCrohn: IiColectomies

Umxholo

• Isebenza njani iColectomies
• Anastomosis kunye neColostomy
• Iibhegi zeColostomy
• Ukuqwalaselwa emva koPhando
• Kutheni ufumana iColectomy?

Xa amayeza kunye notshintsho kwindlela yokuphila zisilela ukunceda abantu abanesifo sikaCrohn ukuba bafumane isiqabu, utyando kuhlala linyathelo elilandelayo. ICrohn's & Colitis Foundation yaseMelika (CCFA) inika ingxelo yokuba isibini kwisithathu ukuya kwisithathu kwisine sabo bonke abantu abanesifo sikaCrohn ekugqibeleni baya kufuna utyando.

Isifo sikaCrohn senzeka xa amajoni akho omzimba aqala ukuhlasela izicwili zawo, ebangela ukudumba kwamathumbu emathunjini. Oku kudala iintlobo ezahlukeneyo zokungonwabi kunye neempawu ezibuhlungu, kubandakanya urhudo rhoqo, iintlungu zesisu, kunye nosulelo. Nangona kungekho nonyango eyaziwayo yesifo sikaCrohn, abantu abaninzi ekugqibeleni bangena ekuxolelweni iminyaka emininzi, ngokuqhelekileyo ngamayeza okanye ngotyando olubizwa ngokuba yi-colectomy.

Utyando oluninzi luyafumaneka kubantu abanesifo sikaCrohn, kwaye ii-colectomies zezona ziphambili. Ngexesha le-colectomy, ikholoni iphinde yahlulwa-hlulwa yaya kumaqondo ahlukeneyo. Ukuba kunokwenzeka, ugqirha wakho uya kujoyina ileum kunye ne-rectum ukukuvumela ukuba uqhubeke nokudlula inkunkuma ngaphandle kokunxiba ibhegi yangaphandle.

Isebenza njani iColectomies

Iicolectomies zenziwa kubantu abanesifo sikaCrohn, umhlaza wekolon, i-diverticulitis, kunye nezinye iimeko. Ekuqaleni, le nkqubo yayisenziwa ngokwenza isisu esiswini ukususa ikholoni. Utyando ngoku lwenziwa rhoqo kusetyenziswa i-laparoscopy kwaye kusetyenziswa iindlela ezininzi ezincinci. Oku kunciphisa ixesha lokuphilisa kwaye kunciphise umngcipheko weengxaki.

Ukwahlula kwakhona ikholoni kubandakanya ukususa icandelo lekholoni kunye nokufaka kwakhona kumacandelo aseleyo ukubuyisela ukusebenza kwamathumbu. Ngokwesiqhelo, i-colectomy eyinxalenye, ebandakanya ukususa indawo echaphazelekayo kwikholoni, iyenziwa. Ukuba ucinga i-colectomy, kuya kufuneka ukhethe phakathi kwe-anastomosis, ebopha amacandelo amabini emathunjini akho ukugcina ukusebenza kwamathumbu, kunye ne-colostomy, olwenziwa ngotyando apho isisu sakho esikhulu siziswa sisisu sakho. ukukhupha engxoweni. Kukho okuhle kunye nokubi kuzo zombini, ezinokwenza isigqibo sibe nzima kakhulu.

Anastomosis kunye neColostomy

I-anastomosis ineengozi ezithile. Ngokuyinhloko, kukho umngcipheko wokuqhekeka kwee-sutures, ezinokubangela ukusuleleka kunye nokukhokelela kwi-sepsis. Inokubulala nakwimeko ezinqabileyo. Nangona icolostomy ikhuselekile, inemingcipheko yayo. I-colostomy idala ukuphuma kwelindle ekufuneka likhutshiwe ngesandla. Abantu abathile abane-colectomy banokulungela i-colostomy kunye nokunkcenkceshela, okwenza i-cap phezu kwe-stoma, okanye ukuphuma, ukugcina inkunkuma ngaphakathi. Kufuneka bayinkcenkceshele kube kanye ngemini, basebenzise umkhono wokunkcenkceshela.

Iibhegi zeColostomy

Ukuba une-colostomy yemveli, uya kuba nengxowa eqhotyoshelweyo. Oku kufuneka kuchithwe okanye kutshintshwe amaxesha ngamaxesha emini. Iipaji zanamhlanje ze-colostomy zinevumba elincinci kwaye ziyinyumba ngakumbi kunangaphambili, zikuvumela ukuba uphile ubomi obuqhelekileyo ngaphandle kokukhathalela abanye abantu abaziyo ngemeko yakho. Oogqirha abaninzi endaweni yoko baya kuphakamisa isikhwama se-colo-anal, esibizwa ngokuba sisingxobo se-ileoanal, esakhiwa kusetyenziswa amathumbu akho asezantsi.

Ukuqwalaselwa emva koPhando

Emva kotyando, kufuneka kuqala ugcine ukutya okusezantsi-fiber ukunciphisa uxinzelelo kwinkqubo yakho yokwetyisa. Ngokwe-CCFA, malunga neepesenti ezingama-20 zezigulana zibonisa ukuphindeka kweempawu emva kweminyaka emibini, iipesenti ezingama-30 zibonisa ukuphindeka kweempawu emva kweminyaka emithathu, kwaye ukuya kuthi ga kwiipesenti ezingama-80 zibonisa ukuphindeka kweempawu kwiminyaka engama-20. Ayizizo zonke izinto eziphindaphindayo ezithetha ukuba uya kufuna olunye utyando.

I-infliximab (i-Remicade) inokumiselwa ukuthintela ukuphindaphinda kweempawu. I-infliximab sisicwili se-tumor necrosis factor (TNF) esisebenza ukuthintela amajoni omzimba ekusebenzeni kakubi. Kubonakalise ukuba yimpumelelo.

Xa iingxaki zibuya emva kotyando, zihlala kwindawo eyahlukileyo yamathumbu. Oku kunokufuna utyando olongezelelekileyo.

Kutheni ufumana iColectomy?

Ngezinga eliphezulu lokuphindaphinda, unokuzibuza ukuba kutheni kufanele ufumane i-colectomy kwaphela. Kubantu abaninzi abanesifo sikaCrohn abangena kwi-colectomies, iimpawu zabo zinokuba nzima kangangokuba amayeza awancedi okanye banokuba ne-perforations okanye i-fistula efuna ingqwalaselo kwangoko. Kwabanye abantu, isigqibo sokuba ne-colectomy senziwa emva kwexesha elide lokucingisisa malunga nayo.

Ngelixa ukususwa kwayo yonke okanye inxenye yekholoni yakho ngokuqinisekileyo kunokunceda iimpawu zakho zexesha elifutshane, utyando alunyangi isifo sikaCrohn. Akukho nonyango yesifo sikaCrohn ngeli xesha. Kukho kuphela ithuba lokunciphisa nokulawula iimpawu. Kwabanye abantu, amayeza esi sifo sikaCrohn aya kuba yindlela yokuphila. Kwabanye, i-colectomy inokukhokelela ekuxolelweni kwexesha elide, nangona ukuphindaphinda kuhlala kunokwenzeka.Ukuba i-colectomy ibonelela ngesixa esincinci sonyango emva kweminyaka yeempawu ezibuhlungu, kunokuba kulungele abanye abantu.