Inqubo yokusebenza ukunciphisa isisu, kanjani futhi kungani kwenziwa. Ukubopha nge-gastric

Akuwona wonke umuntu obhekene nokukhuluphala akwazi ukukhipha i-kilos ngokweqile ngokwakhe. Ngisho neseluleko sabachwepheshe bezokwelapha ekulahlekelweni kwesisindo kwezinye izimo abanamandla. Nokho, ukukhuluphala akuyona nje iphutha langaphandle elibi. Ngokuvamile kuba umthombo wokuthuthukiswa kwezifo eziningi. Kulokhu, ukulahlekelwa isisindo kubalulekile. Futhi ukukhululwa kwangempela kweziguli kuyindlela yokunciphisa isisu.

Ulwazi jikelele

Ngokuvamile, imbangela yokukhuluphala ikhona emtongeni omkhulu wesisu. Ihlukaniswa ngenxa yokungondleki nokungahambisani nokudla. Wonke umuntu uyazi ukuthi odokotela bancoma ukuthi badle ukudla okuyingxenye - izikhathi ezingu-5-6 ngosuku. Ngaphezu kwalokho, kubalulekile ukukhumbula inani lezinxenye. Kumele kube njengokuthi kufanelane nesundu.

Ngeshwa, iningi labantu lizinaki ngokuphelele lezi zeluleko. Badla ngokungavamile, ngokuvamile ngemva komsebenzi, kusihlwa. Futhi ngesikhathi esifanayo badla ingxenye izikhathi 2-3 ngaphezu kokunconywa. Yiqiniso, ezimweni ezinjalo, ivolumu yesisu iyanda. Umzimba othunyelwe udinga ukudla okwengeziwe. Futhi ama-khalori ashintshwe ngokushesha ashintsha zibe amaphilisi engeziwe.

Ungashintsha isimo ngokwakho ngaphandle kokusebenzisa ukungenelela ngokushesha. Ukuze wenze lokhu, udinga ukuqala ukudla ngokufanele, kancane kancane ugodle isisu kuya ezingxenyeni ezincane. Ngokuhamba kwesikhathi, kuzoba mncane. Ngaphezu kwalokho, kukhona isethi esikhethekile yokuzivocavoca okuhlose ukulwa nokukhuluphala ngokweqile.

Ehlelwe ngendlela ehlukile ngokuphelele yokuphila, ngeshwa, ayitholakali kuzo zonke iziguli ezihluphekile ngokweqile. Futhi abantu abanjalo banento eyodwa - ukucabanga ngomsebenzi wokunciphisa isisu.

Izinhlobo zokungenelela kokuhlinzwa

Odokotela baye bathuthukisa ubuchwepheshe obuningi ukuze banciphise umthamo wesisu:

• I-gastroplasty efana;
• Ukuhlinzeka nge-bypass;
• Ukumiswa;
• Ukuhamba nge-banding;
• Ukulinganisa.

Lezi zenzo zihluke kakhulu kumasu. Ngaphezu kwalokho, banezinkomba zabo nokuphikisana kwazo. Kodwa okuyisisekelo salokhu kungenelela kuyodwa - ukunciphisa kakhulu isisu, ukunciphisa umuzwa wendlala nokuvikela isiguli ekudleni ngokweqile.

Ngakho-ke, ake sibone ukuthi imisebenzi yokunciphisa isisu isenzeka kanjani.

Gastroplasty ebonakalayo

Ukusebenza kuyinkambiso ethandwa kakhulu ekwakheni i-ventricle encane. Yini esekelwe ngesisekelo sayo? Ukunciphisa okunjalo kumthamo wesisu kusekelwe ekuhlukaneni komzimba zibe izingxenye ezingalingani ezimbili. Wonke ama-receiver receptors asezindaweni ezingenhla, ehlukaniswa ngendandatho ekhethekile yokusekela. Le ngxenye inesayizi encane futhi cishe i-20 ml.

Ngesikhathi sokudla, i-ventricle encane igcwala ngokushesha. Ama-receptors atholakale kulesi sigaba adlulisela ulwazi lobuchopho ngolwazi lwe-saturation yezinto eziphilayo. Ngakho-ke, umuntu uvikelekile ngokugcwele ekudleni ngokweqile. Ngemuva kwemizuzu embalwa, ukudla kuyingxenye enkulu yesisu. Esikhathini esizayo, kusetshenzwa futhi kudlule indlela evamile.

Imisebenzi enjalo iyanconywa iziguli ezinomthamo womzimba womzimba owedlula u-35 kg.

Ukungenelela kokuhlinzwa kungenziwa ngezindlela ezimbili:

1. I-incision ejwayelekile, ubude bayo buyi-7-8 cm. I- suture yezithokozi isetshenziswa kamuva .
2. Indlela ye-Laparoscopic. Ukusebenza okuyinkimbinkimbi kakhulu, kusukela ekubukeni kokubukwa kwekhono lobuchwepheshe, kusho ukugqama. Ithuthukisa umphumela wokuzithokozisa, kunciphisa isikhathi sokutakula. Lokhu kulula kakhulu iziguli.

Kodwa-ke, kukhona okungahambisani nanoma yi-gastroplasty eqondile. Akukona neze kunconywa kubantu abasebenzisa izinsizi zabo "zaedat." Ngoba iziguli ezinjalo zingase zibe nokucindezeleka.

Ukusebenza kunikeza imiphumela emihle kakhulu. Iziguli zilawula ukuqeda cishe u-60% wesisindo esiningi. Imiphumela emihle ibonakala ezinyangeni eziyisithupha zokuqala, ngemuva kokungenelela.

Kungakanani umsebenzi wokunciphisa isisu? Intengo yomcimbi ihlukahluka kuye ngokuthi isikhungo sezokwelapha esizobanjwa ngaso. Ngokwesilinganiso, izindleko ze-gastroplasty eqondile yi-ruble 102,000.

Ukwenza ukuxhuma

Abantu abakhuluphele kakhulu, njalo bezwa umuzwa olamandla kakhulu. Ukugulisa isisu kuvumela iziguli ukuba zibalekele emfuleni "wolf", ngakho-ke, ngokudla ngokweqile.

Ukusebenza lokhu kusho ukuthini? Phakathi nokuhlinzwa, udokotela wenza i-ventricle encane. Ixhumeke ngokuqondile emathunjini amancane. Ngalokhu kusebenza, ingxenye enkulu yesisu ayifakiwe kwinkqubo yokugaya ukudla, kodwa zonke izitho zigcinwa.

Izinzuzo eziyinhloko zokungenelela okunjalo:

1. Ngokuphawulekayo, ukulahlekelwa isisindo, kuyilapho kuhlelekile. Kungenzeka ukuthi ulahle u-65-75% wesisindo esiningi.
2. Abantu ababhekene nohlobo lwesifo sikashukela sohlobo lwesibili 2 ezikhathini eziningi balahla ukuxhomeka kwezidakamizwa.
3. Ukwenza ngcono isimo sesiguli, ogama lakwa-anamnesis abakhona: i-hypertension, i-asthma, ukuhluleka ukuphefumula, ukushona kwenhliziyo, izifo zomgogodla, ukugula okuhlangene.
4. Imiphumela ephumelele igcinwa. Ukuzuza isisindo akunakwenzeka. Ngakho-ke, imisebenzi ephindaphindiwe ayinqabile kakhulu.

Kodwa-ke, ungakhohlwa ukuthi ukuhlinzwa kwesisu esiswini kuyindlela yokuhlinza. Ngakho-ke, njalo kukhona ingozi yezimo ezinzima.

Imiphumela engavumelekile ukuthi iziguli zingabhekana nazo zilandelayo:

• Ukuphuza;
• Amacici egazi ezitsheni;
• Izinkinga zamapulmonary (pneumonia);
• Ama-ulcers ekuhlanganiseni kwamathumbu amancane nesisu (kungenzeka ukuthi u-1-3%, ngisho nabokubhema, ubungozi bokukhuphuka komhlabathi kuphezulu kakhulu);
• Ukungabi namavithamini namaminerali (kuvela kubantu abangahambisani nemithi kadokotela).

Iziguli emva kokugwema izidakamizwa ezikhethekile eziphakanyisiwe ukusetshenziswa kuzo zonke izimpilo zabo:

• Izidakamizwa ezinezinsimbi;
• Ukulungiswa kwe-calcium;
• Ama-multivitamini.

Lokhu kuyindlela ephumelelayo futhi ethandwayo yokunciphisa isisu. Intengo yale nqubo iphakathi kwama-ruble angu-130 000-200 000 futhi yenziwa emitholampilo eminingi.

Ukulalelwa kwesisu

Lokhu kusebenza kungokwesigaba sobuchwepheshe obusha. Usebenze iminyaka engu-10. Lokhu kungenelela okuhlinzekwayo kwaziwa ngokuthi ukukhipha noma ukuvuselela. Iyini igama lomsebenzi wokunciphisa isisu ngolimi lwabachwepheshe? Lokhu kungenelela kokuhlinzwa kukhonjiswe ngokuthi gastrectomy longitudinal .

Ukusebenza kuhilela ukukhipha ingxenye enkulu yelungu, kodwa ngesikhathi esifanayo ukugcina zonke izivalo zokuphila ezidingekayo ngenqubo yokugaya ngokuphelele. Ukumelana kuvumela kusuka esiswini esikhulu ukwenza ithubhu encane, ivolumu yayo engaba ngu-100-120 ml.

Izinkomba zokusebenza okunjalo zilandelayo:

• Izicubu;
• Isilonda se-Peptic;
• Le carcinoma;
• Izifo ze-duodenum.

Ukulahleka kwesisindo emva kokuhlinzwa, ngokusho odokotela, kungenxa yezici ezilandelayo zokusebenza:

1. Ingxenye yesisu eyenza i-hormone ghrelin (inikeza umuzwa wendlala) isusiwe. Lokhu kuqeda ingozi yokudla ngokweqile.
2. Ukudla ngokushesha kudlula esiswini bese kungena emathunjini. Ngenxa yalokho, isiguli ngokushesha siyaqaphela ukuthi unelisekile. Akafuni ukuqhubeka nokudla.

Ukusebenza okunjalo akukhuthazwa abantu abahlukunyezwayo. Kungcono ukuthi lezi ziguli zicabangele ukukhetha kokugubha.

Uma sikhuluma ngemiphumela emibi engaba khona, ke akukho izingozi ezinjengokuphuma kwegazi, ukungahambisani kwamalungu, akukho dokotela ohlinzayo ongakwazi ukukhipha. Ngaphezu kwalokho, umphumela ongathandeki kakhulu ohlotshaniswa nokungahambisani nesikhathi esizayo nokudla okunempilo kungase kube nesisu. Kulokhu, udokotela angancoma ukusebenza kwesibili. Kodwa manje sikhuluma ngokuzikhandla.

Ukuhlinzwa okunjalo okunciphisa isisu kuvunyelwe abantu beminyaka yonke. Zingenziwa ngabantu ababili asebekhulile kanye nentsha.

Izindleko zokuthengiswa kwemikhiqizo i-ruble engaba ngu-200 000 eMoscow kanye nama-ruble angu-240 000-261,000 eSt. Petersburg.

Okuyinhloko ye-banding

Lokhu kusebenza kahle, okungokwesigaba esilula nesiphephile. Ukuboshwa kwe-gastric kusho ukuhlukaniswa komzimba zibe izingxenye ezimbili ezingafani. Inqubo yenziwa ngokufaka indandatho ekhethekile. Ngakho esifundeni esiphezulu sesitho esikhulu sakha i-ventricle encane.

Lokhu kungenelela kunconywa kubantu abano-index yabo eningi abangaphezu kuka-35, kodwa angadluli uphawu lwama-50.

Ukuboshwa kwe-gastric kunqunyelwe iziguli ezinokukhushulwa kwazo eziye zaholela ezinkingeni zempilo ezijulile, njenge:

• Isifo sikashukela;
• Ama-veicic veins of extremities;
• I-hypertension;
• Ukungabi nalutho ngenxa yokukhuluphala (okwenziwe ama-ovaries we-polycystic);
• Izifo zomgogodla, izifo ezihlangene (i-arthrosis, i-arthritis).

Inqubo iphumelela kakhulu futhi inikeza imiphumela emihle kakhulu. Ngaphezu kwalokho, ukugembula kungavamile ukuholela emibikweni.

Kodwa ukuhlinzwa okunjalo kunokuphikisana. Ukukhishwa kwe-banding akukwenziwa ezimweni ezilandelayo:

• Ukukhulelwa;
• Izifo zamaphaphu, inhliziyo;
• Ulcer, igastritis eerosive;
• Izifo zesifo;
• I-cirrhosis yesibindi;
• Izifo zengqondo;
• Ukuzivikela okunamandla;
• Izifo zendalo ezizimele (isifo samathambo, i-lupus erythematosus, i-scleroderma);
• Ubunjalo emzimbeni wesifo esivela ngumlingiswa ongapheli (isb.

Isiguli esiye sabanjwa ngokubambisana siyodinga ukujwayela izincomo ezintsha ekudleni. Futhi lokhu akulula ngokwanele.

Odokotela batusa ukugcina imithetho enjalo kuyo yonke impilo yabo yamuva:

1. Yidla ukudla okuncane, izikhathi ezingaba ngu-5-6 ngosuku.
2. Ingxenye yokuqala kumele ihlolwe (ngokufaka okungenani ukunyakaza okungama-30), futhi kuphela lapho igwinya. Emva kwalokhu, kufanele kube khona isikhashana okwesikhashana. Lokhu kuzoqinisekisa ukuthi ukudlula kokudla okugwinya kungena esiswini nge-bandage.
3. Ukuphuza ngesikhathi sokudla kuvinjelwe. Ungadla ihora elilodwa lemishini ngaphambi kokudla noma imizuzu engu-30 ngemuva kokudla.
4. Kusukela eziphuzweni ezinamakhalori amnandi, i-ayisikhilimu, ushokoledi kuzodingeka zishiywe ngokuphelele. Uma kungenjalo, ukungenelela kokuhlinzwa ngeke kuhlinzeke umphumela oyifunayo.

Namuhla, ukuhlinzwa okunjalo kwenziwa nge-laparoscopic indlela. Ngenxa yalendlela, ukungenelela kokuhlinzwa akudingi i-anesthesia ejwayelekile, umthwalo enhliziyweni unciphise kakhulu. Ngaphezu kwalokho, ukubhekwa okuncane okungadluli 1.5 cm kuhlala emzimbeni.

Enye yezinzuzo zokufaka amabhande ngekhono ukukhulula futhi uqinise indandatho. Ngakho-ke, isiguli sinethuba lokulawula inqubo yokulahlekelwa isisindo.

Iyini izindleko zokuhlinzwa okunjalo ukuze unciphise isisu? Inani lentengo ePetersburg liyi-170,000 ruble.

Ukufaka i-cylinder

Uma sicabangela yonke imisebenzi yokunciphisa esiswini, khona-ke kulula kakhulu kubo ukuvula ibhaluni. Le ndlela, empeleni, ayiyona inqubo yokungenela. Lesi yisenzakalo esikhethekile, okusikhumbuza i-gastroscopy evamile.

Kuyini ukukhwabanisa? Isiguli sifakwe ngaphakathi esiswini nge probe ngokusebenzisa umlomo womlomo, ngendlela ibhaluni ekhethekile efakwe esithombeni. Ekubukeni, kufana ne-bubble enezindonga ezincane. I-can ingagcwaliswa ngamanzi (cishe 600-700 ml). Ngenqubo yokwehla kwamandla emali, igcwalisa ingxenye yesisu. Ngenxa yalokho, kukhona indawo encane yokudla emzimbeni.

Ibhaluni isesiswini sezinyanga ezingaba ngu-4-6. Ngemuva kwalesi sikhathi, kufanele ukuthi isuswe. Inqubo yenziwa futhi ngokusebenzisa i-endoscope engabandakanyi ukusikeka.

Ukubeka ibhaluni kukuvumela ukuba ulahle u-30% wesisindo esiningi. Izindleko zenkambiso yizinkulungwane ezingu-55 000-65 000.

Ukusebenza kuphi ukunciphisa isisu

Ukuhlinzeka okunjalo okuhlinzayo manje kwenziwa cishe cishe yonke imitholampilo. Uma udokotela ebona ukuthi ukusebenza kahle kangakanani, ngokuqinisekile uyosikhuthaza isibhedlela lapho uzosizwa khona.

Uma wena ngokwakho ukhetha umtholampilo, qiniseka ukuthi ufunda imibono yeziguli, ube nesithakazelo kwezobuchwepheshe bokuqhuba. Ngaphezu kwalokho, cacisa ukuthi udokotela ohlinzayo usebenza kanjani ezandleni ozakwala ngazo.

Umbono weziguli

Ingabe ukuphuma kwesisu kuhlinzeka imiphumela emihle kakhulu? Impendulo yesiguli ibonisa ukuthi cishe zonke izimo kungenzeka ukufezekisa ukulahlekelwa kwesisindo esifisa. Abantu bathi bayakwazi ukulahlekelwa kuze kube ngu-65 kg. Okuthandwa kakhulu yizixazululo ezilandelayo: ukuxhuma, ukubamba iqhaza.

Kodwa-ke, ukusebenza kunecala elihlukile. Iziguli eziye zathola ukungenelela okunjalo zibhekana nesidingo sokulandela ngokuqinile ukudla okusimisiwe.

Isiphetho

Ngaphambi kokuthatha isinqumo kumcimbi onjalo, qiniseka ukuthi ulinganisa zonke izinzuzo nezingozi. Mhlawumbe usakwazi ukuzilawula futhi, ngaphandle kokusizwa udokotela ohlinzayo, ukunciphisa ukudla kwakho? Uma ungayitholi, ke uthemba ochwepheshe bakho bezempilo kuphela!