Ukusebenza esiswini. Izinhlobo zokusebenza, izinkomba, ukulungiselela nokuziphatha

Esizukulwaneni ngasinye sabantu, impilo ibeka isigqi sayo. Ukuze ufike lapho ngesikhathi, umuntu wanamuhla kufanele alale kancane, wenqaba ukudla kwasekuseni noma kwasemini, ube ne-snack egijima. Konke lokhu kuthinta kabi isimo sesisu. Ukuhambela udokotela isikhathi esedlule kuyinkimbinkimbi. Uma ukwelashwa kwezidakamizwa kungakwazi ukubhekana nale nkinga, umuntu kufanele asebenzise izinyathelo eziqine kakhulu. Izinyathelo ezinjalo zisebenza ngaphakathi esiswini.

Iyini isisu nokuthi yimiphi imisebenzi yayo

Isisu yisitho esikhethekile ngesimo se-muscular sac, engenzelwe ukuthola nokugaya ukudla. Lesi sitho sitholakala ngaphansi kwesigcawu. Ingxenye yayo engezansi idlula nge-sphincter yemifula ibe yi-duodenum. Isisu esingenalutho sinomthamo ngaphakathi kwama-0.5 amalitha. Ngemuva kokudla, landa ku-1 litre, kepha lingakwazi ukumelana nokudla ngokweqile futhi lithele ku-4 amalitha.

Ngaphezu kokugcina ukudla, imisebenzi yesisu ihlanganisa:

• Ukucubungula imishini yesisindo sokudla;
• Ukukhuthazwa kokudla kwesigaba esilandelayo samathumbu;
• Umphumela wamakhemikhali ekudleni ngama-enzyme of juice esiswini;
• Ukunikezwa kwezakhi ezikhuthaza ukungena kwe-vitamin B12;
• Ukwamukela izakhi;
• Ukukhipha ukushiswa kwesisindo sokudla nge-hydrochloric acid;
• Ukukhiqizwa kwamahomoni.

Ukuze usebenze kahle, umzimba kufanele ube nempilo. Kubalulekile ukunaka izinguquko ukunambitheka, ukuguquka kwenhliziyo, ubuhlungu kanye ne-nausea ngesikhathi sokugwema ukuhlinzwa kwesisu.

Izifo ezivamile zesisu

Ngokuvamile, odokotela baphathwa nge-gastritis engapheli, i-duodenitis, ukuguguleka kwamanzi, izilonda kanye nama-neoplasms oncological. Isifo ngasinye siba yingozi nakakhulu futhi sidinga ukwelashwa okufanelekayo. Isiguli kufanele sigcwalise ngokugcwele umshwalense kadokotela futhi silandele zonke izincomo ukuze kungadingeki ukuba uvakashele iyunithi yokusebenza.

Izinhlobo zokusebenza. Ukumiswa

Ezokwelapha, ngezifo zesisu, kunezinhlobo eziningana zokungenelela kokuhlinzwa ezisetshenziswayo. Lona ukubuyisana, i-gastrectomy, i-gastroenterostomy, i-vagotomy. Umsebenzi ngamunye unezinkomba zawo kanye nokuphikisana kwawo futhi udinga ukuthi udokotela ohlinzayo abe neziqu ezithile.

Ukuhlushwa kwesisu kubizwa ngokuthi ukususwa kwengxenye ethile yelungu nokubuyiselwa okulandelayo kokuqhutshwa kwe-tube esophageal. Ukusebenza okufanayo esiswini kunqunywe ngamagciwane, izilonda noma izinga eliphakeme lokukhuluphala. Ukusebenza kudinga ukuxilongwa okuphelele nokulungiswa okuthile kwesiguli. Ngaphezu kwalokho, ukuthuthukiswa kwezinkinga ze-postoperative kungenzeka.

Kuncike ebuchosheni besifo, udokotela ukhetha uhlobo lokuvuselela. Kungaba:

• Ukususwa ngokuphelele kwesisu.
• Ukususwa kwengxenye yelungu eduze kwesigcawu, okungukuthi, ukubuyisana okuqhubekayo.
• Ukususwa komkhakha wezitho ezingezansi phambi kwe-duodenum, okungukuthi, ukuthengiswa kwe-distal.
• Ukususwa kwemikhono yokukhuluphala.

Ngokuvamile, ukuhlinzwa okuphambene nokusabalalisa kwenziwa. Ukulalelwa kwesisu kulokhu kuhilela ukugxilisa isisindo somzimba esihlokweni (proximal) noma emathunjini amancane (distal). Imiphakamiso efanayo ifakwe ochwepheshe ngaphezu kwamahora amabili.

Ukumelana nesilonda sesisu

Ngokuvamile, isilonda esiswini singelapheka ngaphandle. Kodwa ngezinye izikhathi ukuphathwa kwezidakamizwa akunikezi umphumela. Ukusebenza kwesilonda kunqunywe kumacala alandelayo:

• Ngokunciphisa i-pyloric sphincter (i-pyloric stenosis).
• Ngokusakazwa kwe-pathology ngaphezu kwesisu (ukukhulelwa).
• Uma i-perforating (ukubukeka komgogodla).
• Ngendlela ephakeme yezilonda ezinamasayizi amakhulu kanye nokujula okukhulu komzimba wesisindo.

Ngaphezu kwalokho, ukuhlinzeka ngesisu kungenziwa uma ngabe isiguli sinegazi elingenakwelashwa ngokwemithi. Isizathu sokuthengiswa komzimba singasetshenziswa ngokuphindaphindiwe kwesifo.

Ukuhlushwa kwezicubu zomdlavuza

I-Gastroenterologists kanye ne-oncologists bavame ukuphathwa yiziguli ezinezinambuzane zomdlavuza. Umdlavuza we-gastric ubhekwa njengendlela ejwayelekile kakhulu yomdlavuza. Ukusebenza ngomdlavuza wesisu kungadinga ukuthengiswa kokukhetha, kodwa ukususwa okuphelele kwesitho. Lo msebenzi ubizwa ngokuthi i-gastrectomy. Ngokuhlelekile, lokhu kuyindlela yokuvuselela, kodwa ukuxhaphazwa kuyinkimbinkimbi, futhi umthelela omubi ngesiguli ubizwa kakhulu.

Lapho i-gastrectomy isuswe, hhayi kuphela isisu, kodwa futhi i-omentum emibili, ne-lymph nodes. Ukususwa okuphelele kwesisu kuveza ukuxhuma okuqondile kwe- jejunum. Ukuhlanganiswa okufakelwayo (i-anastomosis) kwenziwa nge-suture yamathumbu emathunjini amabili.

Ngemuva kokusebenza, ukusetshenziselwa kokudla kwamakhemikhali kanye nemishini akukwenziwa. Lokhu kudinga ukunamathela ngokuqinile ekudleni nokusabalalisa okufanayo okufanayo usuku lonke. Izingxenye kufanele zibe ezincane, kusukela kumenyu eziqedile ngokuphelele amafutha anamanzi nokudla okugaya.

Nge-gastrectomy ephelele, indlela ye-laparoscopic cishe ayisetshenzisiwe. Inqubo evamile yokuvuleka isetshenziswa, lapho kunqunywa khona ukusika okukhulu. Isiguli sidinga amasonto ambalwa ukuze alulame kusukela ekuhlinzekeni. Ngemuva kokuvusa kusuka ku-anesthesia, isiguli asiphuzi noma sidle. Ubeka umcengezi we-urinary kanye ne- nasogastric tube, ngezinye izikhathi ukuphefumula kwenzeka nge-mask.

Isiguli siqala ukunikeza amanzi kuphela emva kokuvela kwemisindo ye-peristaltic. Uma umzimba ngokujwayelekile uphendukela ketshezi, qala ukunikeza ukudla okulula.

Ukumelana nokukhuluphala

Ngesilinganiso esiphakeme sokukhuluphala, kwezinye izimo, ukuthengiswa kwe-longitudinal kunqunywe. Ngezinye izikhathi inqubo ibizwa ngokuthi ukususwa kwemikhono. Ukuhlinzwa kunciphisa isisu esisodwa, kodwa kugcina ama-valve engokwenyama. Ngenxa yalokho, ivolumu yelungu inciphisa, kodwa inqubo yokugaya ingaphazanyiswa. Isisu asibukeli njengesikhwama semisipha, sibonakala njengethubhu elincanyana, umthamo wayo cishe ngo-150 ml. Kukhona ukwehla okuphawulekayo kwesisindo nokunciphisa umuzwa wendlala, njengoba indawo ekhiqiza i-hormone ephethe lo mzwa isusiwe. Ukwehlukaniswa kwe-Longitudinal kukuvumela ukuba ulahlekelwe u-60% wesisindo esiningi, kuyilapho esiswini kungabeki izinto zangaphandle, njengebhalethi noma ibhande. Le ndlela yokwelapha ukukhuluphala ingasetshenziswa kunoma yisiphi isikhathi.

I-Gastroenterostomy

Ngezinye izinkomba, ukuthengiswa kwesisu akunakwenzeka. Lokhu kusebenza kubantu asebekhulile, iziguli ezinobuthakathaka, amacala we-cicatricial stenosis ngenxa yokushisa kwesisu nezinkinga ezingenakwenzeka zezifo ezingokwemvelo. Iziguli ezinjalo zithola i-gastroenterostomy. Ngesikhathi sokusebenza, i-ankle isakhiwe phakathi kwesiguli sesisu nomathumbu omncane.

Ukusebenza kusiza ukukhulula isisu, ukusheshisa ukuphuma kokudla nokubuyisela i-patency. Kodwa-ke, linikeza izinkinga eziningi, ngakho-ke kwenziwa ngaphandle kokunye ukhetho lwezokwelapha.

Vagotomy

Enye indlela yokwelapha isilonda esiswini is vagotomy. Lokhu kungukusebenza okubandakanya ukuhlukaniswa kwe-vagus nerve. Ngenxa yokuxhaphaza, izimo zesibindi ziyeka, lapho ukukhiqizwa kwesiphuzo esiswini kuncike khona. Okuqukethwe kwesisu kunciphisa i-asidi, okuholela ekuphulukisweni kwezilonda.

Ngokokuqala ngqa ku-unit unit, isiguli sanikezwa ukuba sifeze i-vagotomy ngo-1911. Umbiko ngalokhu wenziwa eBrother Surgical Congress. Kusukela ngo-1946, ukusebenza kuye kwasakazwa.

Kusukela ngo-1993, inani lama-vagotomi liye lahla kakhulu, njengoba izidakamizwa ezivimbela ukukhiqizwa kwe-asidi zisetshenziswa kakhulu.

Izindleko zokusebenza

Izindleko zokuphathwa okufanayo emazweni ahlukene, ngisho nasezindaweni zezwe elilodwa zingahluka ngokuphawulekayo. Konke kuncike ebuchosheni besifo, indawo ye-pathology, isitifiketi somhlinza ohlinzayo noma oncologist, kanye nemishini yobuchwepheshe emtholampilo. Yonke imibuzo ixazululwa ngesikhathi kuxoxisana nabachwepheshe. Ngokuvamile, izindleko zokuhlinzwa zihlanganisa ukuhlala esibhedlela, i-anesthesia nokunakekelwa kokuthunyelwe.

Eminyakeni yamuva, abantu abanezinkinga ezinkulu ngokukhuluphala, bacela usizo lwabahlinzayo. Ukuze ubhekane nesisindo esiningi ngokweqile ukusebenza kwe-longitudinal ukuthengiswa kwesisu kuvumela. Izindleko zayo ezivamile eRussia cishe ngama-ruble angu-140,000.