Kugonjetsedwa kwa impso: zizindikiro, opaleshoni, kukonzanso

Njira yokhayo yothandizira kupweteka kwa impso ndiyo opaleshoni yomwe nthawi zina matenda amatha kusintha. Pa nthawi yomweyo, madokotala amakono amagwiritsa ntchito njira zomwe zimateteza ziwalo, makamaka impso resection imachitika mmalo mwa nephrectomy, mwazinthu zina, gawo lowonongeka ndilokhalitsa.

Thupi ili ndi chiyani?

Impso ndi mtundu wa fyuluta yomwe imathandiza kuyeretsa magazi. Magazi ochulukira amatha kupyola mu tsiku. Ndi chifukwa chake izi zikuyeretsedwanso kuzinthu zosiyanasiyana zochokera ku metabolism.

Munthu wathanzi aliyense ali ndi impso ziwiri, zomwe zimakhala zosiyana kwambiri pansi pa chithunzithunzi. Thupi ili, atatha kuyeretsa magazi, limatulutsa mkodzo, umene, kudzera m'machubu yapadera, imalowa m'chikhodzodzo. M'menemo, mankhwalawa akugwira ntchito yofunika kwambiri amasonkhanitsa kuti ugule. Thupi limatha kugwira ntchito bwino ndi impso imodzi.

Zisonyezo za ntchito

Kuwongolera koteroko, monga impso resection, imaperekedwa kwa mavuto ambiri omwe amafuna chithandizo mu njira yogwiritsira ntchito. Koma amayamba kuchotsa mbali ya thupi pokhapokha ngati sichiwonongeke, chifukwa pokhapokha mliriyo wabwezeretsedwa pambuyo pa matenda. Kawirikawiri, resection imagwiritsidwa ntchito pamene chifuwa chimapezeka pa impso kapena chotupa chomwe chingasokoneze kukhala chovulaza.

Kuphatikiza apo, pali zizindikiro zambiri, zomwe zimatsogolera madokotala ambiri pokhazikitsa opaleshoni yotere:

• Kukula msanga mu maphunziro osasangalatsa.
• Malo amtundu wowonongeka sali oposa 4 cm.
• Mng'onoting'ono waukulu wa kuwonongeka koopsa kwa ziphuphu.
• Urolithiasis.
• Tsitsi pa impso.
• Chiwonongeko cha thupi.
• Zochitika pa zamoyo mu impso.
• Kuopsa kwa impso kulephera.
• Kuwonongeka kwa mbali ya impso chifukwa cha kupsyinjika.

Mu maonekedwe opweteka, resection ya limba imayang'aniridwa mosamala kwambiri, chifukwa ngati dokotala amasiya matupi ndi zizindikilo zobwereranso panthawi ya opaleshoni, chotupacho chiyamba kuyamba kukonzanso. Kawirikawiri madokotala ochita opaleshoni amaopseza ndi kuchotsa kwathunthu impso kuti asathenso kubwezeretsa mapangidwe ndi ma metastasis.

Kutsutsa kwa impso: njira zazikulu

Pochiza chiwalo ichi, madokotala amagwiritsa ntchito opaleshoni yotseguka kapena laparoscopic. Pachiyambi choyamba, kusakanikirana ndi zina za impso kumapezeka kudula m'dera la lumbar. Koma nthawi zambiri laparoscopic resection wa impso amachita. Kufufuza za njira iyi ya chithandizo, nthawi zambiri imakhala yabwino. Opaleshoniyi imakulolani kuti mupewe zilonda zazikulu pa thupi la wodwalayo. Panthawiyi, makina opangidwa ndi microsurgical ndi kamera ya televizioni amalowetsedwa pogwiritsira ntchito chubu lapadera (catheter).

Kusankha mtundu wa opaleshoni kumadalira kupezeka mu chipatala cha zipangizo zoyenera ndi ziyeneretso za madokotala opaleshoni. Inde, madokotala ambiri amasankha laparoscopy, chifukwa pambuyo pake wodwalayo akupitiriza mwamsanga kusintha.

Contraindications kuti kuchotsa mbali ya impso

Kugonjetsedwa kwa chotupa cha impso sikuchitika ngati munthuyo ali ndi vuto lalikulu kapena ali ndi co-morbidity zomwe zimapangitsa kuti pakhale vuto loti likhale ndi mavuto pamene akuchitidwa opaleshoni.

Kufufuza koyambirira musanagwiritse ntchito resection

Musanayambe kusokoneza gawo la impso, wodwalayo ayenera kuyesedwa kaye ndi wodwalayo. Kukonzekera kugwirizanitsa ntchito kumaphatikizapo kafukufuku wambiri, kufufuza kwazitsulo ndi mayeso a ma laboratory:

• Mafilimu a chiwalo chosiyanitsa.
• Ultrasound, MRI ndi CT.
• Kuchulukitsa kwachitsulo ndi angiography.

Kuwonjezera apo, asanayambe opaleshoni, wodwalayo ayenera kukhala masabata angapo kuchipatala. Koma asanalowe kuchipatala, wodwalayo ayenera kutenga chifuwa cha X-ray ndikupatsirana magazi pamatenda awa: matenda a chiwindi, chiwindi, HIV. Mu chipatala, munthu amafufuzidwa ndi munthu wodwala minofu komanso wothandizira, ndipo enema imachitidwa madzulo madzulo asanayambe kugwiritsidwa ntchito.

Ntchito

Kugonjetsedwa kwa impso kumachitika ndi anesthesia wamba. Chinthu choyamba chimene madokotala amachita ndikumuthandiza wodwalayo ndi zingwe kupita ku tebulo la opaleshoni. Pogwiritsa ntchito chiwalo chogwiritsidwa ntchito, dokotala amachititsa kuti thupi lake lizikhala ndi chotupa. Kutalika kwa mbeu yotereyi ndi pafupifupi masentimita 10-12. Pamene chisokonezo cha impso chowonongeka chikuchitidwa ndi njira ya laparoscopic, kutalika kwa mankhwalawa sikudutsa 3-4 cm.

Panthawi ya opaleshoni yochizira opaleshoni, dokotala akuyandikira gulu lovulala lija ndi wosanjikiza, kenaka amathyola mwendo wa impso ndi chipangizo chapadera chopangidwa ndi mawonekedwe a zotanuka. Pamene laparoscopic imathandizira, dokotalayo akuyang'ana momwe zipangizo zikuyendera pazithunzi.

Kuwombera pa nthawi ya opaleshoni kumagwiritsidwa ntchito kuchepetsa kuthamanga kwa magazi pamene kuchotsa limba ndi scalpel - izi zimachitidwa ndi dokotala pazowonongeka za impso. Matenda ovulala a dokotala amasangalatsidwa ngati mphete, motero amapeza ziphuphu ziwiri zofanana. Kenako amawasuntha ndi kuwasokera pamodzi.

Kenaka, kumalo ochotsedwamo gawo la impso, madzi amayamba kuyendetsa madzi omwe amachotsedwa ku limba pambuyo pa opaleshoni. Pambuyo pa kuikidwa kwake, kutengeka thupi kumagwedezeka.

Zovuta

Ngakhale kusokonezeka kwa gawo lomwe lakhudzidwa ndi chiwalocho ndi ntchito yabwino kwambiri, m'malo momaliza kuchotsa impso, koma ngakhale zitatha kukhala ndi zotsatira zoyipa, zomwe zimakhala zochitidwa opaleshoni iliyonse. Mwachitsanzo, kuwonongeka kwakukulu kwa ubongo wa ubongo kapena matenda a myocardial infarction akhoza kuchitika.

Popeza nthawi zambiri magulu otsiriza a matendawa amapezeka nthawi zambiri anthu okalamba omwe ali ndi matenda osiyanasiyana a khansa komanso khansa ya panthawi inayake, panthawi ya opaleshoni ali ndi matenda ambiri omwe amachititsa kuti matendawa asokonezeke, makamaka matenda a mtima.

Dokotala wothandizira amafunika kukhala ndi chidziwitso chochulukirapo pakubweranso, chifukwa ndi kofunikira osati kungoyembekezera zochitikazo, komanso kuti awachenjeze panthawi yake.

Kubwezeretsa pambuyo pa impso resection

Pambuyo pa opaleshoni, nthawi yowonzanso nthawi yayitali imafunika, yomwe ikhoza kutha chaka chimodzi. Kawirikawiri odwala amadandaula ndi ululu pambuyo pa impso resection, yomwe ingathe kuthetsedweratu ndi kuyang'anira mankhwala opweteka. Pofuna kupewa chitukuko cha zotsatira zotsatira za opaleshoni, muyenera kutsatira malangizo ena:

• Imwani madzi ambiri.
• Kuti ayesedwe pambuyo pa resection miyezi itatu iliyonse.
• Chotsani zochitika zolimbitsa thupi, monga masiku oyambirira atatha kutuluka wodwalayo akumva kusweka ndi kutopa kwakukulu. Ndikofunika kuti mupumule mokwanira.
• Peŵani mikwingwirima ndi zovuta zamanjenje.
• Afunseni dokotala za zofunikira za zakudya. Ndipotu, pambali iliyonse, malingaliro awo, chirichonse chidzadalira kukula kwa matenda, msinkhu ndi zovuta za ntchitoyi.
• Ndikoyenera kupewa kupewa kuchotsa gawo la impso pakuyankhula ndi odwala ndi hypothermia, chifukwa thupi nthawi imeneyi silikutetezedwa ku matenda.
• Pambuyo pa opaleshoni, munthu ayenera kufufuza momwe ziwalo zimakhalira.

Kugwirizana ndi zakudya pambuyo pa opaleshoni

Ndikofunika kutsatira ndondomeko yoyenera panthawi ya kukonzanso. M'masiku oyambirira mutatha kusakanizidwa ndi limba, munthu amaperekedwa ndi zakudya zamkati. Patatha masiku angapo wodwalayo amayamba kudya yekha. Ndibwino kuti mutatha opaleshoniyi mudye chakudya chokonzekera mwatsopano, pamene chiyenera kukhala chophweka, ndi michele ndi mavitamini.

Panthawi yochira, wodwalayo ndi bwino kuchepetsa katundu pachiwindi ndi impso. Ndibwino kuti mugwiritse ntchito impso mmalo mwa tiyi nthawi zonse, koma ntchito yake iyenera kugwirizanitsidwa ndi dokotala. Ndibwino kumwa zakumwa zopangidwa kuchokera ku cranberries ndi cranberries, komanso tei ya bearberry kapena dandelion root.

Pambuyo pa resection ya impso iyenera kuwonjezedwa ku zakudya za mazira, kirimu wowawasa, uchi ndi zosiyanasiyana. Ndi zofunika kuphika nyama ndi nsomba, osati mwachangu. Koma kusintha zizoloŵezi n'kofunika pang'onopang'ono, ngakhale kuti zowonjezereka zambiri zimagwiritsidwa ntchito mwamsanga pambuyo pa opaleshoni.

Mwa zina, wodwalayo ayenera kusiya kusuta, saliti, zokometsera ndi mafuta. N'kosaloledwa kudya zakudya zomwe zili ndi zoteteza, maswiti, soda ndi zakumwa zoledzeretsa. Kuchokera ku rich broths ndi marinades, ndibwino kukana nthawi ya kukonzanso.