Matenda osiyanasiyana a ndulu nthawi zambiri amaphatikizidwa ndi kupanga miyala yolimba kapena miyala yomwe imalepheretsa kufalikira kwa bile ndi chimbudzi. Matendawa amatchedwa cholecystitis ndipo amatanthauza kuchotsa kwathunthu thupi, cholecystectomy. Laparoscopy ya gallbladder ndi, mpaka lero, njira yowonjezera yowonjezera komanso yopita patsogolo. Ntchitoyi ndi yothandiza komanso yotetezeka kwa wodwalayo.
Kodi ndulu imachotsedwa bwanji ndi laparoscopy?
Mtundu uwu wa cholecystectomy umachitidwa pansi pa anesthesia (endotracheal). Atangogona tulo kwa wodwalayo kupyolera pamimba, pulojekiti imalowetsedwa mmimba. Ndi chithandizo chake, madzi owonjezera ndi magetsi amachotsedwa, kusanza kosasintha kumapewa. Komanso, gulu la madokotala limagwirizanitsa munthu ndi mpweya wabwino wamapapu, kenako mukhoza kupitiriza ntchitoyo.
Choyamba, dokotalayu akupanga mazithunzi ang'onoang'ono 4 m'mimba mwa m'mimba. Kupyolera mwa imodzi mwa iwo, mpweya wapadera wouluka umayambitsidwa, kulola kuti ziphuphu zifalikire mofulumira ndikufutukula ziwalo, zomwe zimapangitsa kuyang'ana kumapeto.
Pachimake chilichonse, zipangizo zamakono zopangira opaleshoni zimaphatikizidwa kuti zimakhala zovuta zokwanira kuti zisawononge ndulu, koma nthawi yomweyo zimakhala zosavuta, choncho pamene mukugwira ntchito monga dokotala, chiopsezo cha ziwalo zoyandikana ndizochepa. Komanso pamimba pamimba makamera owonetsera makompyuta amalowetsedwa, okonzedwa ndi flashlight, chomwe chithunzi chake chimawonekera kwa opaleshoni ya opaleshoniyo.
Chifukwa cha cholecystectomy, m'pofunika kuchotsa kaye chikhodzodzo (holedoch) ndi mitsempha, motero amaikidwa mosamala (zolemba) zopangidwa ndi chitsulo. Pambuyo pake, katswiri amachititsa zomwe zimagwiritsidwa ntchito ndipo amasamala mosamala mitsempha yambiri ya mitsempha. Kuchotsedwa kwa gallbladder ndizeng'onoting'ono ndi panthawi imodzimodziyo cauterization (coagulation) ya madera a magazi, osakanizidwa ndi matenda osinthika. Chiwalocho chimachotsedwa kupyolera pang'onopang'ono kakang'ono pafupi ndi nsalu.
Pambuyo pa cholecystectomy, mimba ya m'mimba imatsukidwa ndi mankhwala a antiseptic, ndipo ziphuphu zimasulidwa kapena kusindikizidwa. Nthawi zina mumodzi mwa iwo kwa masiku 1-2 akuika ngalande yaing'ono.
Kukonzekera laparoscopy wa gallbladder
Pafupifupi masiku khumi asanayambe opaleshoni, aspirin ndi zina zotchedwa antiticoagulants, vitamini E ndi zitsulo zomwe zimakhalapo, mankhwala osagwiritsidwa ntchito ndi mankhwala oletsa kutupa amasiya.
Madzulo kumapeto kwa njirayi, enema yoyeretsa imachitidwa, kenako iyenera kukhala yophweka kudya, koma isanakwane 6 koloko. Kuyambira pakati pausiku, amaletsedwa kumwa madzi ndikudya. M'maŵa chisanafike cholecystectomy, enema imabwerezedwa.
Patapita nthawi yochotsa ndulu ndi laparoscopy
Akachitidwa opaleshoni, wodwalayo amasamukira ku ward, kumene amadzuka mkati mwa ora limodzi. Pa maola 4-6 otsatira wodwalayo adzayenera kutsatira mpumulo wogona, koma patatha nthawi yomwe mungathe kukhala, kuyenda, kumwa madzi oyera opanda mpweya.
Pamene pali kunyowa ndi kupweteka mu nthawi ya postoperative ya kuchotsa ndulu, njira ya laparoscopy imagwiritsa ntchito Cerukal ndi mankhwala opweteka, nthawizina - gulu lachidakwa. Komanso, pofuna kupewa matenda, maantibayotiki ndi ololedwa.
Kuchokera tsiku lachiwiri pambuyo pa cholecystectomy amaloledwa kudya chakudya chochepa - nkhuku yofooka, nyama yofiira, nyemba, tchizi kapena yogurt.
Kutuluka kumapangidwa tsiku la 3-7, malingana ndi moyo wa wodwalayo, kusakaniza kwa zida zowonongeka.
Kubwezeretsa kunyumba pambuyo pa laparoscopy ya gallbladder
Kubwezeretsa kwa wodwalayo kumaphatikizapo kusunga zakudya № 5 pa Pevzner, kulepheretsa kuchita zinthu zolimbitsa thupi. Munthu akatha kusankha cholecystectomy sangathe kunyamula zolemera, kuchita ntchito yovuta, ngakhale kuzungulira nyumba.
Ndibwino kuti muvale zovala zofewa ndi chiuno chovala kwambiri kuti chovalacho chisakwiyitse ndipo sichikuchotsa malo. Tsiku ndi tsiku ndikofunika kukonza mapulani ndi kukonzekera kosankhidwa ndi dokotala wa opaleshoni, komanso kuwamangiriza ndi pulasitiki pa silika.
Pambuyo masiku 8-10, nthawi yobwezeretsa imathera, ngati sutures ikugwirizana bwino, ndipo palibe mavuto.