Gastrectomy

Ntchito zambiri kumachitidwa matenda a duodenum ndi m'mimba ndi gastrectomy.

Maziko a ntchito ndi excision mbali matenda a limba. Choncho kupitiriza kubwezeretsa (umphumphu) m'mimba anastomosis imagwiridwa pakati pa jejunum ndi duodenum kapena m'mimba chitsa.

Opaleshoni alowererepo akhale ndi njira ziwiri zofunika kwambiri.

Pamene ntchito njira yoyamba (Billroth I) Gastrectomy imagwiridwa ndi anthu okwana excision antrum ake pyloric ndi m'madipatimenti. Mu nkhani iyi, imposition wa anastomosis imagwiridwa pakati pa mmunsi mwa thupi ndi chitsa cha duodenum pa mfundo ya "kutha kuthetsa".

Gastrectomy mwa njira zingatipangitse vuto ndithu oopsa, akuwonetseredwa mu kusowa zikayamba wa anastomosis pa mphambano za mfundo zitatu m'deralo. Kuthetsa izo, pali zambiri Mabaibulo osiyanasiyana. Amagwiritsidwa ntchito Gaberera kusinthidwa II. Ndi opareshoni iyi, pambuyo excision 2 \ 3 yolimbikitsa ndi chapamimba zokolola luminal kuchepetsa pogwiritsa ntchito crimping matabwa kuti m'lifupi ndi wofanana ndi M'lifupi mwa lumen wa duodenum ndi.

Gastrectomy ndi Billroth II njira ikuchitika ndi mwamphamvu chitsa suturing thupi. Kubwezeretsa kupitiriza wa kapepalako m'mimba Pankhaniyi kubala anakuta kumbuyo kapena kutsogolo gastroenteroanastomosis.

Kusankha njira excision ikuchitika kutenga nkhani mtundu wa kudwala, kutanthauzira ake ndi excised m'mimba kukula.

Pali wachibale ndipo mtheradi zikuonetsa kwa opaleshoni kuti excision.

Mtheradi ankaona malignancies, kobwereza chilonda magazi, amaganiziridwa chotupa chija alibe zilonda ndi pyloric stenosis.

Kuti adziwe wachibale monga unhealed kwa zilonda nthawi yaitali mu duodenum ndi m'mimba, komanso perforated chilonda pa maziko a chikhalidwe chabwino wodwalayo, amene analandira mwa maola asanu oyamba pambuyo perforation lapansi.

Mu kukhalapo kwa chotupa chija ndi chironda chachikulu ntchito imagwiridwa ntchito njira yapadera.

Choncho, pamene chironda chachikulu kuti m'pofunika kuti excise 2/3 kapena 3/4 ya m'mimba ndi thupi pyloric. Choncho, ndi kupewedwa kumwa. Pa nkhani ya akuluakulu pamwamba pa zilonda wamng'ono kupindika ntchito subtotal gastrectomy. Pambuyo pa zimenezi excision 4/5 limba (pafupifupi 80%).

Zakudya pambuyo resection chapamimba ikukhudza malire a chakudya pa nthawi. Choncho, odwala akulimbikitsidwa osati magilamu 250 msuzi kapena galasi kumwa. Pa nkhomaliro mungathe kudya zosaposa awiri chakudya. Kudya tsiku lonse tikulimbikitsidwa pafupipafupi (maulendo osachepera asanu kapena asanu). Kuwonjezera chiwerengero cha analandira analimbikitsa mapuloteni (120 g), kuchepetsa kuchuluka kwa chakudya (300 g). Nthawi zina zikhoza kwathunthu lilibe zakudya zotsekemera ndi zakumwa. Iwo amaloledwa kugwiritsa ntchito mmalo shuga. Kuonjezera kuchuluka kwa mapuloteni analimbikitsa yophika nyama, nsomba, calcined kapena tchizi grated, scrambled dzira azungu.

Iwo m'pofunika kuti monga mu zakudya ndi zakudya mankhwala olemera ndi masamba mafuta. Mu nkhani ya tolerability osauka, makamaka mu mawonekedwe ufulu ndi kuchuluka awo okha magalamu 70-80 patsiku. Pankhani ya tsankho kwa mkaka mu maonekedwe ake free, yekha m'gulu zikuchokera mbale kapena m'malo ndi mankhwala ena.

The zakudya komanso kwenikweni monga kukonzekera okhala chitsulo ndi multivitamin.

Pa nkhani ya kuchepetsa kulemera kwa wodwalayo ali ololedwa kuwonjezera phindu mphamvu ya chakudya ndi 10-15% poyerekeza ponseponse thupi.