Nephrectomy ngokwengxenye: inkomba, ukusebenza, ukuvuselelwa

Okuwukuphela ukwelashwa okuphumelelayo izinso izimila - eyohlinzwa, ngesikhathi okususa izicubu pathologically ezishintshwe. Kulesi odokotela yesimanje esetshenziswa amasu ukuze kulondolozwe izitho, ikakhulukazi, esikhundleni nephrectomy wenziwa nephrectomy ngokwengxenye, ngamanye amagama, kuphela ingxenye lilimele ngesikhathi excised.

Kuyini lokhu umzimba?

Sezinso - uhlobo ukuhlunga osiza ekuhlanzeni igazi. Ngalo usuku sihamba semali igazi. Kuyinto lokhu yokugcina okwengeziwe kuhlanzwe ahlukahlukene by-imikhiqizo ye-umzimba.

Wonke umuntu enempilo has nezinso zombili, okuyinto cishe afanako ngezansi diaphragm. Lokhu umzimba ngemva uhlanzekile igazi ukhiqiza umchamo, okuyinto Amapayipi ekhethekile ku esinyeni. Iqoqa umkhiqizo imfucuza echama. Umzimba uyakwazi ngendlela evamile nge sezinso eyodwa kuphela.

Izinkomba esinyathelweni

ukuphazamiseka okunjalo nephrectomy ngokwengxenye, lomisiwe izinkinga eziningi ezidinga ukwelashwa nge ukuhlinzwa. Kodwa asesebenzisa ukususwa emzimbeni kuphela esehlulwe akuphelele, ngoba kuphela kuleli cala, kuqinisekiswa ukululama ephelele isiguli ngemva kokuba ukugula. Ngokuvamile yakhetha resection, lapho nginesimila ku izinso kutholakala noma izimila ezingase sikhiqize ku ebulalayo.

Ngaphezu kwalokho, kukhona izinkomba ezimbalwa ukuthi odokotela abaningi esiholwa ukuqokwa operation ezifana:

• Ukwanda okusheshayo izimila ingozi.
• INSIMU izicubu ezonakele ingeqi 4 cm.
• ingozi Ephakeme ukonakala abulalayo kwezicubu.
• Urolithiasis.
• Simila phezu izinso.
• Isifo sofuba umonakalo isitho.
• inqubo Oncologic e nezinso.
• Ubungozi ukwehluleka kwezinso.
• Ukulimala izinso ngenxa ukulimala.

Lapho komdlavuza isitho resection abazenzi ngokunembile kakhulu, ngoba uma udokotela ngesikhathi ukuhlinzwa ikhefu izicubu nge ubufakazi ukonakala, isimila kabusha isiqalo ukuthuthukisa. Ngokuvamile, odokotela abahlinzayo ezimweni ezinjalo azibona engozini futhi lususwe izinso, ukugwema kabusha okwenziwe ukwakheka kanye Ukudlulela.

nephrectomy ngokwengxenye: izindlela eziyinhloko

Ekwelapheni umzimba, odokotela ziye zanquma ukuvula noma ukuhlinzwa laparoscopic. Esimweni sokuqala, excision we ingxenye izinso kwenzeka ngokusebenzisa imbobo esifundeni lumbar. Kodwa kaningi kwenziwe laparoscopic nephrectomy esinqunyiwe. Izibuyekezo lokhu indlela yokwelashwa ngokuvamile omuhle. Lo msebenzi ikuvumela ukuba ugweme amanxeba omkhulu emzimbeni wesiguli. Phakathi kuba imbobo encane, lapho ngokusebenzisa tube ekhethekile nezimo (ipayipi) yethulwa amathuluzi microsurgical nekhamera ithelevishini.

Khetha uhlobo ukuhlinzwa kuncike ukutholakala esibhedlela imishini kanye ziqu nodokotela. Yiqiniso, odokotela abaningi bathanda laparoscopic, ngoba ngemva kwalokho isiguli iba ngcono.

Izimo ukususwa izinso

Resection yesimila izinso kungentiwa, uma umuntu usesimweni esibucayi noma has comorbidities ukuthi kwandisa ingozi yokungenwa yezinkinga phakathi nokuhlinzwa.

Nokuhlola kokuqala phambi resection

Ngaphambi afeze excision wesabelo abathintekayo izinso, isiguli kufanele kuqala qiniseka ukuhlola obulala izinzwa. Ukulungiselela resection iyona inhlolovo jikelele, ukufunda Luhlolo wezinsimbi futhi laboratory:

• Radiography umzimba nge-ejenti ukuze kuvele umehluko.
• Ultrasound, i-MRI kanye CT.
• perfusion kwezinso futhi angiography.

Yonke enye into ngaphambi kokuba sihlinzwe isiguli kuyodingeka ichithe ama esibhedlela amasonto amaningana. Kodwa ngaphambi kokuba bangene ekhaya isikhungo sokwelapha isiguli kufanele wenze esifubeni X-ray kanye nokuhlolwa kwegazi ngoba lezi zifo ezilandelayo: isifo sokusha kwesibindi, ugcunsula kanye negciwane lesandulela ngculaza. Umuntu uhlola obulala izinzwa esibhedlela futhi wemithi yangaphakathi, futhi kusihlwa phambi resection wenziwa ukukhiqizwa enema.

ukusebenza

nephrectomy ngokwengxenye kwenziwa ngaphansi izinzwa jikelele. Into yokuqala odokotela silungise ezizibeni isiguli etafuleni yokusebenza, futhi uhlangothi enempilo buyela roller. Ngo excision ezivamile ethintekile udokotela isitho nommese wenza imbobo arcuate emzimbeni wesiguli. Ubude anemifantu ezinjalo cishe 10-12 cm. Lapho excision ingxenye ezilimele wenziwa laparoscopically izinso, ubude imbobo lingaphansi kuka 3-4 cm.

Phakathi evamile izingqimba ukuhlinzwa udokotela esondela isitho ethintekile whereupon umlenze izibopho izinso idivayisi ekhethekile kwakhiwa njengenhlangano isakhiwo nokunwebeka. ukuhlinzwa Laparoscopic udokotela ohlinzayo ihlola inqubekelaphambili zomculo esikrinini qapha.

Isiqeshana phakathi nokuhlinzwa isetshenziswa ukunciphisa igazi ngalapho ngesikhathi kwenzeka ekususeni umzimba nge nommese - isenzo udokotela okuchitha ingxenye ezilimele izinso. Izicubu abathintekayo is excised odokotela njengoba nhlonhlo, kanjalo ukuthola ichopho amabili alinganayo. Bona wabe eseshintsha unyawo lwabo futhi crosslinked nomunye.

Yibe usubeka ukususwa izinso fed amanzi ukulawula labelwe emva kokuhlinzwa we uketshezi emzimbeni. Ngemuva ayifake sutured imbobo emzimbeni.

yezinkinga

Nakuba excision wengxenye ethintekile somzimba ukusebenza kahle, kunokuba nokususwa ngokuphelele izinso, kodwa ngisho nangemva kungase kube nemiphumela engemihle ayisibonelo sokuba aphinde ahlinzwe. Ngokwesibonelo, kungase kubangele acute ingozi cerebrovascular noma isilethikusebenza.

Njengoba ezikhathini eziningi ekupheleni-esiteji isifo itshe izinso zivame kakhulu kubantu abadala abane-zonke izinhlobo izimila kanye nomdlavuza esiteji ezithile ke ngesikhathi ukusebenza, sebenalo eziningi comorbidities, ikakhulukazi zenhliziyo.

udokotela Operating kudinga okuhlangenwe nakho okukhulu alulame okwalandela, njengoba kubalulekile hhayi kuphela ukunikeza ukubukeka zinkinga, kodwa futhi ngesikhathi ebaxwayisa.

Ukuvuselelwa ngemva nephrectomy esinqunyiwe

Ngemva kokuhlinzwa, inkathi yokutakula eside liyadingeka, engahlala isikhathi esingangonyaka. Kaningi, iziguli esekhala ubuhlungu emva nephrectomy ngokwengxenye, ezingasetshenziswa kuphela kuyoqedwa ethula amaphilisi ezinhlungu. Ukuvimbela ukuthuthukiswa imiphumela engemihle ngemuva kokuhlinzwa kufanele ulandele abanye izincomo:

• Phuza amanzi amaningi.
• Obuqinisekisiwe ngemva resection njalo ngemva kwezinyanga ezintathu.
• Ukuphungula kokuvivinya umzimba, njengoba ezinsukwini zakuqala emva osenyameni isiguli azizwa ukukhathala ukukhathala ezinzima. Udinga phumula.
• Gwema kubangela ukucindezeleka kwemizwa.
• Xhumana nodokotela mayelana nezici amandla. Ngempela, esimweni ngasinye nezincomo zayo, konke kulele ekutheni kobukhulu isifo, ubudala nokuba yinkimbinkimbi ukusebenza.
• Kufanele kugwenywe emva ukususwa izinso ukuxhumana nabantu abagulayo hypothermia ngoba umzimba ngalesi sikhathi okungavikelwe ezifweni.
• Ngemva kokuhlinzwa, umuntu kufanele aqaphe isimo amalunga omzimba.

Ukudla emva kokuhlinzwa

Kubalulekile ngesikhathi nokuvuselelwa Gcila etidzingweni umsoco ofanele. Ezinsukwini zokuqala ngemva kokuba isidumbu excision kwamandla indoda ihlinzekwa ngemithambo yegazi. Ngemva kwezinsuku ezimbalwa, isiguli siqala ukudla ngokuzimela. Ngilusizo emuva kokuhlinzwa ezinjalo, sebenzisa ukudla asanda walungisa, ngaleyo ndlela-ke kufanele kube kalula digestible, ne izakhi mkhondo namavithamini.

Esikhathini esiyiminyaka ekululameni kwesiguli kungcono ukunciphisa umthwalo phezu isibindi kanye nezinso. Kunconywa ukuphuza itiye esikhundleni izinso evamile, kodwa isicelo yayo kubalulekile uvumelana udokotela. Enye ewusizo ukuphuza izithelo iziphuzo ezenziwe kusukela cranberry kanye cranberry kanye itiye bearberry noma dandelion impande.

Ngemva nephrectomy esinqunyiwe kufanele ukungezwa ekudleni amaqanda, ukhilimu omuncu, uju kanye nemifino enhlobonhlobo. Inyama kanye nenhlanzi, kuyinto efiselekayo ubilise, kodwa musa Fry. Kodwa ukushintsha yokudla udinga kancane, nakuba iningi imikhawulo sisetshenziswa ngokushesha ngemva kokuhlinzwa.

Ngaphezu kwalokho, isiguli ngeke alahle ukudla ngibhema okunosawoti, okubabayo nanamafutha. It kungavunyelwe ukusebenzisa imikhiqizo equkethe nezivimbelakuvunda, amaswidi, iziphuzo ezinesoda kanye nophuzo oludakayo. Kusukela umhluzi ecebile kanye marinades kangcono, futhi, ukunikeza ngesikhathi ukuvuselelwa.