Gastrectomy

Umsebenzi ezininzi eziqhele kwenziwa zezifo duodenum kunye isisu gastrectomy.

Isiseko tyando Ukusikwa yinxalenye zizifo welungu. Ngaloo ukuqhubeka nokubuyiselwa (ingqibelelo) anastomosis zesisu lwenziwa phakathi jejunum kunye duodenum okanye isisu isiphunzi.

ungenelelo Surgical kunokwenziwa ngeendlela ezimbini ezingundoqo.

Xa usebenzisa indlela lokuqala (Billroth I) Gastrectomy lwenziwa yi Ukusikwa iyonke antrum yayo pyloric kunye namasebe. Kulo mzekelo, nokubekwa anastomosis lwenziwa phakathi inxalenye esezantsi lomzimba kuthiwe isiphunzi le duodenum kumgaqo 'ukufika ekugcineni ".

Gastrectomy le ndlela kungabangela kakhulu kwingxaki eyingozi, wabonakaliswa ukunqongophala yengxinano le anastomosis apho kudibana amalungu amathathu ndawo. Ukuze ukubusiphula, kukho iinguqulelo ezininzi ezahlukeneyo. Adla ngokusetyenziswa Gaberera ukuguqulwa II. Kunye nalo msebenzi, emva Ukusikwa 2 \ 3 ngokuhlanganisa esiswini imveliso luminal valiweyo ngayo ngokusebenzisa crimping beentanda ukuze ububanzi balo babulingana nobubanzi le mithambo le duodenum.

Gastrectomy method Billroth II ikhutshwa phandle ngokuqinileyo isiphunzi umzimba suturing. Ukubuyisela ukuqhubeka iphecana zesisu kulo mzekelo ukuvelisa gastroenteroanastomosis sommandla angasemva okanye ngaphambili.

Ukhetho Indlela Ukusikwa lwenziwa kuthathelwa ingqalelo uhlobo ngezifo, kwasendaweni yayo kunye nobungakanani nesisu excised.

Kukho ezibonisa lwezizalwane ngokupheleleyo ukuba utyando ukuze Ukusikwa.

Absolute ingqalelo ezinezigulo, nezolo isilonda ukopha, asolwa yobubi angakwazi izilonda kunye stenosis pyloric.

Izinto ezibonisa isihlobo ziquka unhealed kuba nezilonda ixesha elide kwi duodenum kunye nesisu, kwakunye isilonda tubing kwisiqalo yemeko elungileyo isigulane, nemali leyo efumaneka sele ngaphakathi kweeyure ezintandathu zokuqala emva kokuba perforation.

Phambi yobubi kunye nokusebenza Peptic isilonda olwenziwa ngokusebenzisa indlela ekhethekileyo.

Ngoko, xa isilonda Peptic kuyacetyiswa ukuba ukubhengeza 2/3 okanye 3/4 ye esiswini ngomzimba pyloric. Ngaloo ndlela, kuyathintelwa likakade. Kwimeko amagosa aphezulu nangezilonda ugobile engaphantsi isicelo gastrectomy losuku. Xa oku kwenziwe Ukusikwa 4/5 ilungu (80%).

Diet emva resection esiswini kubandakanya ukumiselwa ukudla ngexesha. Ngenxa yoko, izigulane siyaleza ngaphezulu kwe 250 grams isuphu okanye iglasi yokusela. Emini uyakwazi ningadli ngaphezu izidlo ezimbini. Ukutya yonke imini kuyacetyiswa rhoqo (ubuncinane izihlandlo ezihlanu okanye ezintandathu). Ukwandisa inani kwiproteni efunyenweyo kucetyiswa (120 g), zinciphisa inani wekhabohayidreyiti (300 g). Kwezinye iimeko ukuba ngokupheleleyo ngaphandle ukutya okunamafutha kunye neziselo. Uvunyelwe ukusebenzisa ethutyana iswekile. Ukwandisa inani protein ekucetyiswa nyama iphekiweyo, intlanzi, calcined okanye itshizi ya, begilana iqanda abelungu.

Uyacetyiswa ukuba afake idayethi zokutya iimveliso ahlanganiswe ngeoli yemifuno. Kwimeko tolerability ihlwempu, ingakumbi ifomu okhululekileyo imali yabo kuphela 70-80 grams ngemini. Kwimeko sokucalulana ukuba ubisi kwimo yaso simahla, wawuquka kuphela kuhlanganiselo izitya okanye kufakwe ezinye izinto.

Yokudla kwakhona ukuba ziquka amalungiselelo eziqulathe zentsimbi kunye afikelelekayo.

Kwimeko lokuncitshiswa ubunzima isigulane ukuba ukwandisa ixabiso amandla lokutya nge 10-15% xa kuthelekiswa eqhelekileyo nokomzimba.