Muzituluka opaleshoni. Mitundu ya ntchito, zizindikiro, kukonzekera ndi khalidwe

M'badwo uliwonse wa moyo anthu kuzichita mungoli ake. Pofuna kukhala mu nthawi kulikonse, munthu masiku ano ali kugona zochepa, kusiya chakudya kapena chamasana snacking mothamanga. Izi zonse zoyipa alili m'mimba. Kulephera kuthana kwa dokotala complicates zinthu. Ngati mankhwala sangathe kulimbana ndi vutoli, m'pofunika kuti amachita miyeso kwambiri. kukhwimitsa ndi chapamimba opaleshoni.

Kodi m'mimba nanga ntchito zake

M'mimba - thupi zapadera monga dzenje minofu thumba kulandira ndi chimbudzi. Ili pansi pa ulamuliro wa kholingo. mbali m'munsi mwa sphincter pyloric zipita duodenum ndi. Chopanda kanthu m'mimba ali buku mu osiyanasiyana malita 0.5. Pambuyo chakudya ndi incremented kuti okwanira 1, koma akhoza kulimbana kudya ndipo anatambasula mpaka malita 4.

Kuwonjezera kasungidwe chakudya analandira mu ntchito m'mimba monga:

• Machining misa chakudya;
• kayendedwe ka chakudya mu gawo lotsatira la intestine ya;
• Zotsatira mankhwala pa chakudya michere chapamimba;
• zinthu kusankha zimene zimachititsa mayamwidwe vitamini B12;
• mayamwidwe zakudya;
• disinfection chakudya acid amathiridwa misa;
• ulimi wa mahomoni.

Kuti bwino kugwira ntchito zake, thupi ziyenera kukhala wathanzi. nthawi zofunika kulabadira kusintha kakomedwe, kutentha, ululu ndi nseru, kupewa opaleshoni m'mimba.

matenda wamba a m'mimba

Nthawi zambiri, madokotala kuchiza aakulu gastritis, duodenitis, kukokoloka, chilonda ndi khansa zotupa. Aliyense matenda m'njira ina oopsa ndipo zimafunika oyenerera mankhwala. Wodwala anyamule mankhwala dokotala ndi mtima wonse kutsatira malangizo onse, asalole kukaona unit opaleshoni.

Mitundu ya ntchito. resection

Mu yochizira matenda, matenda a m'mimba ntchito mitundu yambiri ya popanga munthu opaleshoni. Izi resection, gastrectomy, gastroenterostomy, vagotomy. Aliyense ntchito ali zizindikiro zake ndi contraindications, ndipo amafuna luso enieni dokotala wa.

Gastrectomy anatchula kuchotsa mbali zina za limba, kenako kuchepetsa esophageal chubu mosalekeza. Chotero opaleshoni chapamimba analamula kuti zotupa khansa, zilonda kapena mkulu-mlingo wa kunenepa. opaleshoni kumafuna matenda mabuku mosabisa mtima kukonzekera. Komanso, nkotheka chitukuko cha mavuto postoperative.

Malinga zovuta matenda, adokotala amasankha mtundu wa resection. Zimenezi zingakhale:

• Complete kuchotsa mimba.
• Kuchotsa mbali ya chiwalo pafupi ndi kum'mero, ie, proximal resection.
• Chiwalo kuchotsa gawo m'munsi kuti duodenum, ndiko wapotalikira resection.
• Wamanja kuchotsa kunenepa.

anagwira ntchito proximal ndi wapotalikira nthawi zambiri. Gastrectomy mu nkhani iyi ikukhudza chitsa suturing thupi ku mmero (proximal) kapena intestine yaing'ono (wapotalikira). resection amenewa zimakhala katswiri kwa maola oposa 2.

Resection wa chapamimba chilonda

Nthawi zambiri, zilonda zam'mimba angathe kuchiritsidwa pa outpatient maziko. Koma nthawi zina mankhwala suchokera. Opaleshoni zilonda akapatsidwa milandu zotsatirazi:

• Mu cicatricial kuchepetsa wa sphincter pyloric (pyloric stenosis).
• Mu kafalitsidwe wa matenda kunja m'mimba (peneratsiya).
• Pamene perforation (kudzera-dzenje maonekedwe).
• Zilonda kupanga pamene akuthamanga ndi chachikulu ndi kuya kwambiri kuwonongeka minofu.

Komanso, opaleshoni chapamimba ingaperekedwe ngati wodwalayo anayamba magazi, omwe sangathe kulimbana ndi mankhwala. Chifukwa resection mwina kupereka musabise pafupipafupi.

Resection kwa zotupa khansa

Gastroenterologists ndi oncologists nthawi zambiri zinkakambidwa odwala ndi zotupa khansa. khansa ya mmimba imatengedwa mawonekedwe ambiri a khansa. Opaleshoni kwa khansa ya mmimba kungafune alibe tsankho resection, ndi kuchotsa wathunthu wa limba. Opaleshoni imeneyi imatchedwa gastrectomy. Yokhala, mtundu wa resection, koma mpheto ndi zovuta zambiri, ndi kungasokoneze wodwala kwambiri kutchulidwa.

Pamene gastrectomy amachotsa osati m'mimba, koma awiri England ndi lymph mfundo. Complete kuchotsa kum'mero chapamimba akusonyeza kugwirizana ndi jejunum lapansi. Amapanga pawiri (anastomosis) akugwirizira DIL matumbo msoko.

Pambuyo pa opaleshoni, mankhwala ndi processing makina a chakudya si opangidwa. Izi zimafuna potsatira kwambiri zakudya ndipo ngakhale yogawa chakudya tsiku lonse. Zina ayenera kukhala laling'ono, menyu kwathunthu inathetsedwa mafuta zovuta ndi zovuta kugaya chakudya.

Pa zonse njira gastrectomy laparoscopic phindu lochepa. Ntchito miyambo lotseguka njira, imene ang'ambe thupilo waukulu anachita. Pa kuchira pambuyo opaleshoni ya mtima amafuna masabata angapo. Pambuyo kudzuka ku ochititsa dzanzi wodwala safuna kumwa kapena kudya. Anapereka catheter mkodzo ndi chubu nasogastric, nthawi zina amapezeka mpweya kudzera amabisa.

Madzi mtima akuyamba kupereka pokhapokha maonekedwe a phokoso matumbo. Ngati thupi zambiri sagwirizana madzi, ndiye yambani kumupatsa zakudya zofewa.

Resection kwa kunenepa

Ndi digiri yapamwamba ya kunenepa zina zotchulidwa kotenga resection. Nthawi zina ndondomeko amatchedwa thumba kuchotsa. Opaleshoni amadula kwambiri m'mimba, koma lofotokozabe mavavu thupi. Izi amachepetsa buku thupi, koma maganizo chimbudzi. M'mimba yaitali ofanana ndi minofu thumba, zikuwoneka ngati chubu yopapatiza amene buku ndi pafupifupi 150 ml. Pali kuchepetsa kwakukulu kulemera ndi kuchepetsa njala zichotsedwa m'deralo ambabala timadzi udindo mukumvera. Kotenga resection amalola kutaya 60% onenepa, pamene m'mimba aikidwa matupi akunja monga zibaluni kapena bandeji. Njira amachitira kunenepa angagwiritsidwe ntchito pa msinkhu uliwonse.

gastroenterostomy

Mu ena zikuonetsa kuti agwire resection za m'mimba si zotheka. Zimenezi zikugwira ntchito kwa odwala achikulire ofooka, zochitika za stenosis cicatricial chifukwa cha amayaka ndipo milandu inoperable khansa ya mmimba. odwala amenewa anagwira gastroenterostomy. Pa ntchito ndi M'mimbamo kupanga anastomosis pakati pa mimba ndi intestine yaing'ono.

Opaleshoni kumathandiza tichepetse m'mimba, imathandizira pa gulu la chakudya ndi kubwezeretsa patency. Komabe, limapereka kwambiri matendawo, choncho kokha anachita pamene palibe chithandizo chosiyanasiyana.

vagotomy

njira ina chithandizo cha zilonda muzituluka ndi vagotomy. Opaleshoni imeneyi yokhudza kung'ambika kwa mitsempha vagus. Chifukwa cha mpheto imayima zikhumbo mitsempha imene ulimi wa madzi chapamimba zimatengera. Mu acidity chapamimba yafupika, chifukwa mu chilonda machiritso imayamba.

Kwa nthawi yoyamba mu unit opaleshoni Yaponyedwa kwa wodwala kwa vagotomy mu 1911. chilengezo anapangidwa pa Berlin Zopangira Congress. Kuyambira 1946, ntchito ya anaikidwa pa mtsinje.

Kuyambira mu 1993, chiwerengero cha vagotomy mwadzidzidzi utachepa kuyambira mankhwala kukhala ambiri ankadya kuti ndigwire yopanga acid.

mtengo wa opareshoni

Mtengo wa mpheto chomwecho mu maiko osiyanasiyana ndipo ngakhale kumadera m'dziko akhoza zimasiyana kwambiri. Izi zidalira pa zovuta za matenda, matenda malo, dokotala kapena Choyenereza oncologist ndi zipangizo luso chipatala. mfundo zonse tatsimikiza pa mokambilana ndi akatswiri. Nthawi zambiri mu mtengo ntchito zikuphatikizapo m'chipatala, ochititsa dzanzi ndi chisamaliro pambuyo ntchito.

M'zaka zaposachedwapa, anthu amene ali ndi mavuto aakulu ndi kunenepa, madokotala amachita kuthandiza. Kuthana ndi kulemera owonjezera chizathandiza ntchito kwa gastrectomy kotenga. mtengo wake ambiri Russia ndi pafupifupi 140 000 rubles.