Ni iki cyitwa kubaka neobladder? Intego, Uburyo & Gukira

Kubaka neobladder ni uburyo bwo kubaga bukora uruhara rushya rukozwe mu gice cy'urura rwawe iyo uruhara rwawe rwa mbere rugomba gukurwaho. Ubu bwoko bw'ububabare butangaje buguha ubushobozi bwo kongera kunyara bisanzwe, akenshi bikagufasha kugumana igenzura n'icyubahiro nyuma yo gukuraho uruhara kubera kanseri cyangwa izindi ndwara zikomeye.

Bitekereze nk'inzira umuganga wawe akoresha akugarurira ikintu cyegereye icyo wari ufite mbere. Nubwo ari kubaga gukomeye, ibihumbi by'abantu bagiye banyuramo ubu buryo neza kandi bagaruka mu buzima bwuzuye, bukora.

Ni iki cyitwa kubaka neobladder?

Kubaka neobladder bikubiyemo gukoresha igice cy'urura rwawe ruto kugirango ukore uruhara rushya ruhuza neza n'umuyoboro wawe. Umuganga wawe ahindura neza iyi nyama y'urura ikaba igikapu gishobora kubika inkari kandi kikagufasha kunyara unyuze mu cyuho cyawe gisanzwe.

Ubu buryo kandi bwitwa neobladder ya orthotopic, bisobanura gusa ko uruhara rushya ruri ahantu hamwe n'urwawe rwa mbere. Intego ni ukugarura imikorere isanzwe yo kunyara uko bishoboka nyuma yo gukuraho uruhara rwawe.

Uruhara rwawe rushya ntizakora neza nk'urwa mbere, ariko abantu benshi basanga bashobora kunyara bisanzwe ku manywa kandi bakagera ku igenzura ryiza uko igihe kigenda. Inyama z'urura zihinduka mu nshingano zayo nshya, nubwo bishobora gutwara amezi menshi kugirango byose bishyire mu murongo mwiza.

Kuki kubaka neobladder bikorwa?

Ubu bwoko bwo kubaga bukunze gukorwa nyuma ya cystectomy ikaze, ari ukurwaho rwose uruhara rwawe kubera kanseri y'uruhara. Iyo kanseri yaguye mu rukuta rw'imitsi y'uruhara rwawe, gukuraho urugingo rwose akenshi bitanga amahirwe meza yo gukira.

Muganga wawe ashobora no kugusaba gukora iyi nzira kubera izindi ndwara zikomeye zisaba gukuraho uruhago. Izi zirimo kwangirika gukabije kw'uruhago kubera imirasire, ubumuga bumwe bwo kuvuka, cyangwa ibikomere bikomeye byangije uruhago ku buryo budashobora gusanwa.

Icyemezo cyo gukora isubukurwa ry'uruhago rushya gishingiye ku bintu bitandukanye bijyanye n'ubuzima bwawe n'imyubakire y'umubiri wawe. Umuganga ubaga azasuzuma neza niba uri umukandida mwiza ashingiye ku mikorere y'impyiko zawe, uko imitsi yawe imeze, n'ubuzima bwawe muri rusange.

Ni iki gikorerwa isubukurwa ry'uruhago rushya?

Ubusanzwe kubaga bifata amasaha 4 kugeza kuri 6 kandi bikorwa hakoreshejwe imiti rusange yo gutuma utumva. Umuganga ubaga azakora icyuho mu nda yawe kugira ngo agere ku ruhago rwawe n'izindi ngingo zikikije, hanyuma akureho uruhago rwawe yitonze arinda ibice by'ingenzi bikikije.

Ibi nibyo bibaho mu ntambwe z'ingenzi z'iyi nzira:

1. Umuganga ubaga akuraho santimetero zigera kuri 60 z'urwungano rwawe rutoya, akenshi akura mu gice cya ileum
2. Urwungano rwasigaye rurasubizwa hamwe kugira ngo urwungano rwawe rwo mu gifu rukomeze gukora neza
3. Igice cy'urwungano cyakuweho gihindurwa neza kikaba nk'umufuka w'umuzingi
4. Uru ruhago rushya ruhuzwa n'imitsi yawe (imiyoboro iva mu mpyiko zawe)
5. Uwo mufuka uhuzwa n'imitsi yawe, bigatuma wihagarika mu buryo busanzwe

Umuganga ubaga ashobora kandi gushyiraho imiyoboro y'agateganyo yitwa stents mu miyoboro yawe kugira ngo ifashe gukira, hamwe na kateter kugira ngo ivane inkari mu gihe uruhago rwawe rushya rukira. Izi zikurwaho nyuma y'ibyumweru bike igihe cyose ibintu bikora neza.

Ni gute witegura isubukurwa ry'uruhago rushya?

Kutegura iyi operasiyo bikubiyemo intambwe nyinshi z'ingenzi kugira ngo zemeze umusaruro mwiza ushoboka. Itsinda ryawe ry'abaganga rizagufasha mu byo usabwa byose, ariko gutegura mbere bituma ugabanya umunabi kandi bigashyigikira imikoreshereze yawe.

Muganga wawe ashobora kugusaba gukora izi ntambwe zo kwitegura:

• Reka kunywa itabi byibuze mu byumweru 2 mbere yo kubagwa kugira ngo wongere ubuzima
• Kora imyiteguro y'amara ukoresheje imiti idasanzwe yo kuyamesa iminsi 1-2 mbere
• Teganya umuntu uzakujyana mu rugo akagumana nawe mu minsi mike ya mbere
• Kura polish y'inzara n'imitako mbere yo kugera mu bitaro
• Fata imiti yanditswe na muganga yo kurwanya indwara kugira ngo wirinde kwandura
• Kurikiza amabwiriza yo kwirinda kurya, ubusanzwe ntukarya cyangwa unywe ikintu icyo aricyo cyose nyuma ya saa sita z'ijoro mbere yo kubagwa

Itsinda ryawe ry'ubuvuzi rizareba kandi imiti ufata kandi rishobora kugusaba guhagarika imiti imwe n'imwe ituma amaraso atinda cyangwa ibyongera imbaraga. Ntuzatinye kubaza ibibazo ku kintu icyo aricyo cyose utumva - iyi ni intambwe ikomeye, kandi kumva ufite amakuru bifasha abantu benshi kumva bafite icyizere.

Ni gute usoma ibizamini by'imikorere ya neobladder yawe?

Nyuma yo kubagwa, itsinda ryawe ry'ubuvuzi rizakurikirana uko uruhago rwawe rushya rukora neza binyuze mu bizamini bitandukanye no kubona. Kumva ibi bipimo birashobora kugufasha gukurikirana iterambere ryawe no kumenya icyo witegura mugihe cyo gukira.

Abaganga bawe bazasuzuma ubusanzwe ibipimo byingenzi byinshi:

• Urugero rw'inkari zisohoka - rugomba kwiyongera buhoro buhoro kugera kuri litiro 1-2 ku munsi
• Inkari zisigara nyuma yo kwihagarika - byaba byiza hasigara munsi ya 100ml
• Urugero rwa creatinine - rugomba kuguma ruhamye, rukerekana imikorere myiza y'impyiko
• Ubwuzuzanye bwa electrolyte - cyane cyane urugero rwa chloride, rushobora kugirwaho ingaruka
• Urugero rwo kwifata - ubushobozi bwo gufata inkari ku manywa na nijoro

Gukira neza ubusanzwe birerekana iterambere rihamye muri izi nzego mu mezi 3-6. Ubushobozi bushya bw'uruhago rwawe buzagenda bwiyongera buhoro buhoro, kandi imbaraga zawe zizongera uko imyenda yorohera kandi ukiga uburyo bushya bwo gusukura neza.

Ni gute wakongera imikorere ya neobladder yawe?

Kubaho neza ufite neobladder bisaba kwiga imigenzo n'uburyo bushya. Inkuru nziza ni uko abantu benshi bamenyera neza kandi bashobora gusubira mu bikorwa byabo bisanzwe bafite impinduka zimwe.

Ubu buryo burashobora kugufasha kugera ku mikorere myiza ishoboka:

• Kumenyera gusohora inkari mu gihe giteganijwe buri masaha 2-3 ku manywa
• Kwigira uburyo bukwiye bwo gusohora inkari, harimo kuruhuka no gufata igihe cyawe
• Gukora imyitozo yo mu gice cyo hasi cy'umubiri kugirango ukomeze imitsi ishyigikira
• Kuguma ufite amazi ahagije unywa ibirahure 6-8 by'amazi buri munsi
• Kwimuka ibintu bitera ububabare bwa nyababyeyi nk'isukari, inzoga, n'ibiryo biryoshye mbere na mbere
• Koresha uburyo bwa Valsalva (gushyira imbaraga gake) kugirango bifashe gusohora inkari neza

Abantu benshi basanga kubyuka rimwe cyangwa kabiri nijoro kugirango basohore inkari birinda impanuka kandi bigatuma nyababyeyi yabo nshya ikora neza. Ibi biroroha hamwe no kumenyera, kandi abantu benshi bagira gahunda ikora neza kubuzima bwabo.

Ni izihe mpamvu zishobora gutera ibibazo bya neobladder?

Nubwo kubaka neobladder muri rusange bigenda neza, ibintu bimwe na bimwe bishobora kongera ibyago byo kugira ibibazo cyangwa bikagira ingaruka ku buryo nyababyeyi yawe nshya ikora neza. Kubisobanukirwa bifasha wowe n'umuganga wawe gufata ibyemezo byiza byo kwita ku buzima bwawe.

Impamvu nyinshi zishobora kugira uruhare ku musaruro wawe wo kubagwa:

• Ubukure bwo hejuru (imyaka irenga 70) bushobora kugira ingaruka ku gukira no kugira ubuzima bwiza
• Ubuvuzi bwa radiyo bwakozwe mbere mu gice cyo hasi cy'umubiri bushobora kugira ingaruka ku gukira kw'imitsi
• Ibibazo by'imikorere y'impyiko bishobora kugira ingaruka ku bushobozi bwawe bwo gukora ubu buryo
• Indwara yo mu gifu irimo kubyimba irashobora kugorana gukoresha imitsi yo mu mara
• Umunyinya wongera cyane ibibazo byo kwandura no gukira
• Indwara ya diyabete irashobora gutinda gukira no kongera ibyago byo kwandura

Itsinda ry’abaganga bazakora isuzuma ryimbitse ry’ibi bintu mbere yo kugusaba kubaka neobladder. Rimwe na rimwe, uburyo bwo kubaga bushobora kuba bwiza bitewe n'uko ubuzima bwawe bumeze, kandi ibyo ni byiza rwose.

Ese kubaka neobladder biruta izindi nzira?

Kubaka neobladder bitanga inyungu ikomeye yo kugufasha kunyara bisanzwe binyuze mu mwobo wawe w'umubiri, abantu benshi babona ko ari ngombwa mu buryo bwo mu mutwe no mu buryo bw'ingirakamaro. Ariko, ntibisobanura ko ari wo mwanzuro mwiza kuri buri wese.

Ugereranije n'izindi nzira zo gusimbuza uruhago, neobladder isanzwe itanga ubuzima bwiza ku bantu babishoboye. Ntabwo uzagomba gukoresha agafuka ko hanze cyangwa gukoresha catheter binyuze mu mwobo wo mu nda yawe.

Ariko, izindi nzira nka ileal conduit cyangwa continent cutaneous diversion zishobora kuba amahitamo meza niba ufite indwara zimwe na zimwe cyangwa imiterere y'umubiri ituma kubaka neobladder bigira ingaruka nyinshi. Umuganga uzakubaga azagufasha gusobanukirwa uburyo butanga ubuzima bwiza kandi bufite akamaro ku buzima bwawe bwihariye.

Ni izihe ngaruka zishobora guterwa no kubaka neobladder?

Kimwe n'ubundi bwoko bwose bwo kubaga bukomeye, kubaka neobladder bifite ibyago bimwe na bimwe ugomba gusobanukirwa mbere yo gufata umwanzuro wawe. Ingaruka nyinshi zirashobora gucungwa, kandi ibibazo bikomeye ntibisanzwe mu matsinda y'abaganga bafite uburambe.

Ingaruka zisanzwe zishobora kubaho zirimo:

• Kutagira ubushobozi bwo kunyara, cyane cyane nijoro, bigira ingaruka ku 10-30% by'abarwayi
• Kutagira ubusa bwuzuye bisaba gukoresha catheter rimwe na rimwe
• Indwara z'inkari, zishobora kwiyongera mu ntangiriro
• Impinduka za metabolike bitewe no guhura kw'inkari n'ibice by'amara
• Kugabanuka cyangwa kugabanuka ku ngingo zihuza
• Ibibazo by'impyiko niba inkari zisubiye inyuma muri ureters

Ibikomere bitajyenda neza ariko bikomeye bishobora kwibandaho ni ukuva amaraso menshi, indwara zikomeye, cyangwa ibibazo byo gukira kw'ibikomere. Itsinda ry'abaganga bakubaga bazagukurikiranira hafi kandi bakemure ibibazo byose vuba na bwangu nibigaragara.

Ibikomere bidasanzwe bishobora kwibandaho kuva amaraso menshi, guhagarika urugendo rw'amara, cyangwa ibibazo bikomeye bya metabolike. Nubwo ibi byumvikana biteye inkeke, bibaho mu buryo butarenze 5% by'ibihe kandi mubisanzwe birashoboka kubikemura hakoreshejwe ubuvuzi bukwiye.

Ni ryari nkwiriye kubona umuganga ku bijyanye n'ibibazo bya neobladder?

Nyuma yo kubaka neobladder yawe, ni ngombwa kugumana mu buryo bwa hafi n'itsinda ryawe ry'ubuvuzi kandi ukamenya igihe cyo gushaka ubufasha bw'inyongera. Ibibazo byinshi birashobora gukemurwa vuba iyo byakemuwe hakiri kare.

Vugana n'umuganga wawe vuba na bwangu niba ubona:

• Ubukana burenze 101°F (38.3°C) cyangwa guhinda umushyitsi
• Urubavu rukabije cyangwa kubyimba
• Kutabasha rwose kunyara cyangwa gutwika cyane
• Amara mu nkari arenze ibara ry'umutuku woroshye
• Isesemi no kuruka bituma utabasha kurya cyangwa kunywa
• Ibimenyetso byo kumira amazi nk'izunguruka cyangwa umunwa wumye

Ugomba kandi kuvugana niba ubona impinduka zitunguranye mu buryo unyaramo, kuvuza amazi bidahagarara birushaho kuba bibi aho kuba byiza, cyangwa ibimenyetso byose bikubabaza. Itsinda ryawe ry'ubuvuzi riteganya izi telefoni kandi ryakemura ibibazo bito mbere yuko biba binini.

Ibikoresho bibazwa kenshi ku bijyanye no kubaka neobladder

Q1: Ese kubaka neobladder ni byiza ku barwayi ba kanseri y'umuyoboro w'inkari?

Yego, kubaka neobladder akenshi ni uburyo bwiza ku barwayi ba kanseri y'umuyoboro w'inkari bakeneye gukurwaho umuyoboro w'inkari. Bituma ugumana imibereho isanzwe nyuma yo kuvurwa kanseri mugihe ugikora gukuraho kanseri neza nkuko cystectomy ibigeraho.

Ubu buryo ntibuvangira imiti ivura kanseri kandi bushobora no guteza imbere imibereho yawe mu gihe cyo gukira. Abantu benshi barwaye kanseri bakwiriye kubagwa muri ubu buryo bavuga ko bishimiye cyane icyemezo bafashe.

Ikibazo cya 2: Ese kubaka neobladder biteza ibibazo by'impyiko?

Kubaka neobladder ubwabyo ntibisanzwe guteza ibibazo by'impyiko, ariko bisaba gukurikiranira hafi imikorere y'impyiko. Uburyo umubiri wawe mushya uhuza n'impyiko bigomba gukora neza kugira ngo birinde ko inkari zisubira inyuma.

Itsinda ryawe ry'abaganga rizasuzuma imikorere y'impyiko yawe buri gihe hakoreshejwe ibizamini by'amaraso n'amashusho. Abantu benshi bagumana imikorere isanzwe y'impyiko nyuma yo kubagwa muri ubu buryo iyo ubuvuzi bukurikiranwa neza.

Ikibazo cya 3: Ese nshobora kubaho ubuzima busanzwe mfite neobladder?

Yego, abantu benshi bafite neobladders basubira mu buzima busanzwe, bufite imbaraga. Urashobora gukora, gukora imyitozo ngororamubiri, kugenda, no kwitabira ibikorwa byinshi wari usanzwe ukora mbere yo kubagwa, nubwo ushobora gukenera gukora impinduka zimwe.

Itandukaniro rikuru ni uko uzakenera kunyara ku gihe aho gutegereza ko wumva ubishaka, kandi ushobora gukenera kubyuka rimwe cyangwa kabiri nijoro. Abantu benshi basanga izi mpinduka nto zikwiriye cyane ubushobozi bwo kunyara bisanzwe.

Ikibazo cya 4: Bifata igihe kingana iki kugira ngo ukire nyuma yo kubagwa neobladder?

Gukira by'ibanze bisanzwe bifata ibyumweru 6-8, ariko kwiga gukoresha neobladder yawe neza akenshi bifata amezi 3-6. Muri iki gihe, umubiri wawe mushya w'inkari ugenda wiyongera buhoro buhoro kandi ugakura ubushobozi bwo kuyobora no kuyisukura neza.

Abantu benshi basubira mu kazi no gukora ibikorwa byoroheje mu byumweru 6-8, mugihe gukira neza harimo imikorere myiza y'umubiri w'inkari bishobora gufata umwaka. Buri wese akira ku muvuduko we, rero ntugacike intege niba igihe cyawe gitandukanye.

Ikibazo cya 5: Ese nzagomba gukoresha catheter mu neobladder yanjye?

Abantu benshi bafite neobladders ntibasaba gukoresha catheterization buri gihe, ibyo bikaba ari kimwe mu byiza by'iyi nzira. Ariko, hari abantu bashobora gukenera gukoresha catheterization rimwe na rimwe niba bagira ikibazo cyo gusohora inkari zose.

Itsinda ryawe ry'ubuvuzi rizakwigisha uko wakoresha catheter niba bibaye ngombwa, ariko abantu benshi ntibazigera babikenera. Intego ni uko wajya wihagarika bisanzwe nta tuyobe cyangwa ibikoresho byo hanze.