Chii chinonzi Neobladder Reconstruction? Chinangwa, Maitiro & Kupora

Neobladder reconstruction inzira yekuvhiya inogadzira itsva bladder kubva muchikamu cheura rako kana yako yekutanga bladder ichida kubviswa. Kuvhiya uku kunoshamisa kunokupa kugona kuita weti zvakajairika zvakare, kazhinji zvichikubvumira kuti uchengetedze kutonga uye rukudzo mushure mekubviswa kwebladder nekuda kwekenza kana mamwe mamiriro akakomba.

Funga nezvazvo senzira yechiremba wako yekukupa chimwe chinhu chiri pedyo nezvawaive nacho kare. Kunyange zvazvo iri kuvhiya kukuru, zviuru zvevanhu vakabudirira kuita iyi nzira uye vakadzokera kuhupenyu hunozadzisa, hunoshingaira.

Chii chinonzi neobladder reconstruction?

Neobladder reconstruction inosanganisira kushandisa chikamu cheura rako diki kugadzira itsva bladder inobatanidza zvakananga kune yako urethra. Chiremba wako anonyatso shandura iyi tishu yeura kuita homwe inogona kuchengeta weti uye kukubvumira kuti uite weti kuburikidza nekuvhura kwako kwakajairika.

Iyi nzira inonziwo orthotopic neobladder, izvo zvinongoreva kuti itsva bladder inogara munzvimbo imwechete neyako yekutanga. Chinangwa ndechekuvandudza basa reurinary rakajairika sezvinobvira mushure mekubviswa kwebladder yako.

Yako itsva bladder haishande chaizvo seyekutanga yako, asi vanhu vazhinji vanowana kuti vanogona kuita weti zvakajairika masikati uye vachiwana kutonga kwakanaka nekufamba kwenguva. Iyo tishu yeura inojairana nebasa rayo idzva, kunyangwe zvingatora mwedzi yakati wandei kuti zvese zvigadzirise mune tsika inonakidza.

Nei neobladder reconstruction ichiitwa?

Kuvhiya uku kunowanzoitwa mushure me radical cystectomy, iyo iri kubviswa kwakakwana kwebladder yako nekuda kwekenza yebladder. Kana kenza yapararira mumadziro emuscle ebladder yako, kubvisa nhengo yese kazhinji kunopa mukana wakanakisa wekurapa.

Chiremba wako angakurudzirawo maitiro aya kune mamwe mamiriro akakomba anoda kubviswa kweguvhu. Izvi zvinogona kusanganisira kukuvadzwa kwakanyanya kwemwaranzi kuguvhu, zvimwe zvikanganiso zvekuzvarwa, kana trauma yakakura yakakuvadza guvhu zvisingagadzirisike.

Sarudzo yekupinda mukuvakwazve kwe neobladder inoenderana nezvinhu zvakawanda pamusoro pehutano hwako uye anatomy. Chiremba wako achanyatsoongorora kana uri munhu akakodzera zvichienderana nebasa remapapu ako, mamiriro e urethra yako, uye hutano hwako hwese.

Ndeapi maitiro ekuvakwazve kwe neobladder?

Kuvhiyiwa kunowanzo tora maawa 4 kusvika ku6 uye kunoitwa pasi peanesthesia yakajairika. Chiremba wako achaita incision mudumbu rako kuti asvike kuguvhu rako nenhengo dzakapoteredza, wobva abvisa guvhu rako zvakanyatsonaka uchichengetedza zvivakwa zvakakosha zviri pedyo.

Hezvino zvinoitika panguva yematanho makuru emaitiro:

1. Chiremba wako anobvisa anenge masendimita makumi maviri nemana ematumbo ako madiki, kazhinji kubva muchikamu cheileum
2. Matumbo akasara anobatanidzwa zvakare kuitira kuti hurongwa hwako hwekugaya huchienderera mberi nekushanda zvakajairika
3. Chikamu chematumbo chakabviswa chinonyatso shandurwa kuita bhegi remhando yepasi rose
4. Guvhu idzva iri rinobatanidzwa kune ureters yako (machubhu kubva kumapapu ako)
5. Iro bhegi rinobva raisirwa ku urethra yako, zvichikubvumira kuti weti zvakasikwa

Chiremba wako anogonawo kuisa machubhu enguva pfupi anonzi stents mu ureters yako kuti abatsire kupora, pamwe chete ne catheter yekudhonza weti apo guvhu rako idzva rinopora. Izvi zvinowanzo bviswa mushure memavhiki mashoma kana zvese zvichishanda nemazvo.

Maitiro ekugadzirira kuvakwazve kwe neobladder yako?

Kugadzirira kuvhiyiwa uku kunosanganisira matanho akati wandei akakosha kuti ave nechokwadi chekubuda kwakanaka. Chikwata chako chekurapa chichakutungamira kuburikidza nechinhu chimwe nechimwe, asi kuronga mberi kunobatsira kuderedza kushushikana uye kunotsigira kupora kwako.

Chiremba wako anogona kukukumbira kuti upedze matanho aya ekugadzirira:

• Regai kusvuta kwemavhiki angangoita 2 vasati vavhiwa kuti uvandudze kupora
• Pedzisa kugadzirira ura nemishonga yekuchenesa yakakosha mazuva 1-2 asati aitwa
• Ronga kuti mumwe munhu akutyire kumba uye agare newe kwemazuva mashoma ekutanga
• Bvisa polish yezvipikiri nezvishongo usati wasvika kuchipatara
• Tora mishonga inorwisa mabhakitiriya yakarairwa kudzivirira hutachiona
• Tevedza mirairo yekutsanya, kazhinji hapana chikafu kana chinwiwa mushure mepakati peusiku vasati vavhiwa

Vashandi vehutano vako vachaongororawo mishonga yako uye vanogona kukukumbira kuti umise mamwe ma thinners eropa kana zvinowedzera. Usazeza kubvunza mibvunzo pamusoro pechero chinhu chausinganzwisisi - iri idanho guru, uye kunzwa wakaziviswa kunobatsira vanhu vazhinji kuti vanzwe vakavimbika.

Maitiro ekuverenga bvunzo dzako dzekushanda kwe neobladder?

Mushure mekuvhiyiwa kwako, timu yako yezvokurapa ichatarisa kuti ura hwako hutsva huri kushanda zvakanaka sei kuburikidza nemiedzo yakasiyana-siyana uye zviongororo. Kunzwisisa zviyero izvi kunogona kukubatsira kutevera kufambira mberi kwako uye kuziva zvekutarisira panguva yekupora.

Vanachiremba vako vanowanzoongorora zviratidzo zvakakosha:

• Urine output volume - inofanira kuwedzera zvishoma nezvishoma kusvika 1-2 litres pazuva
• Residual urine mushure mekuita weti - zvakanaka zvishoma pane 100ml yasara
• Creatinine mazinga - anofanira kugara akagadzikana, achiratidza basa rakanaka reitsvo
• Electrolyte balance - kunyanya chloride mazinga, ayo anogona kukanganiswa
• Continence rates - kugona kubata weti masikati neusiku

Kupora kwakajairika kunowanzo ratidza kuvandudzwa kwakagadzikana munzvimbo idzi pamusoro pemwedzi 3-6. Kugona kwako kutsva kwebladder kuchawedzera zvishoma nezvishoma, uye kutonga kwako kuchavandudzika sezvo matishu achichinjika uye iwe uchidzidza nzira itsva dzekuzora zvakakwana.

Maitiro ekuvandudza basa rako re neobladder?

Kurarama zvakanaka ne neobladder kunoda kudzidza tsika itsva nemaitiro. Mashoko akanaka ndeokuti vanhu vazhinji vanojaira zvakanaka uye vanogona kudzokera kuzviitiko zvavo zvenguva dzose nekugadzirisa kumwe.

Nzira idzi dzinogona kukubatsira kuti uwane basa rakanaka:

• Dzidzira kubvisa weti panguva yakanangana maawa 2-3 masikati
• Dzidza nzira dzakakodzera dzekubvisa weti, kusanganisira kuzorora uye kutora nguva yako
• Ita maekisesa e pelvic floor kusimbisa tsandanyama dzinotsigira
• Gara uine mvura yakawanda nemagirazi 6-8 emvura zuva rega rega
• Dzivisa zvinotsamwisa bladder zvakaita secaffeine, doro, uye chikafu chinonhuwira pakutanga
• Shandisa iyo Valsalva maneuver (kunyatsosunda) kubatsira kubvisa zvakakwana

Vanhu vazhinji vanowana kuti kumuka kamwe kana kaviri usiku kuti vanyare kunodzivirira tsaona uye kunochengeta bladder yavo itsva iine hutano. Izvi zvinova nyore nekudzidzira, uye vanhu vazhinji vanogadzira tsika inoshanda zvakanaka kune mararamiro avo.

Ndezvipi zvinhu zvine njodzi yematambudziko e neobladder?

Nepo neobladder reconstruction ichiwanzo kubudirira, zvimwe zvinhu zvinogona kuwedzera njodzi yematambudziko kana kukanganisa kuti bladder yako itsva inoshanda sei. Kunzwisisa izvi kunokubatsira iwe nachiremba wako kuti uite zvisarudzo zvakanaka zvekuchengetwa kwako.

Zvimwe zvinhu zvinogona kukanganisa mhedzisiro yako yekuvhiya:

• Zera repamusoro (rinopfuura 70) rinogona kukanganisa kupora uye mitengo yekuchengeta
• Kurapa kwemwaranzi yapfuura kune pelvis kunogona kukanganisa kupora kwetishu
• Matambudziko ebasa reitsvo anogona kukanganisa kukodzera kwako kweiyi nzira
• Inflammatory bowel disease inogona kuomesa kushandisa tishu yemukati
• Kusvuta kunowedzera zvakanyanya hutachiona uye matambudziko ekupora
• Diabetes inogona kunonotsa kupora uye kuwedzera njodzi yehutachiona

Chikwata chako chekuvhiya chichanyatsoongorora zvinhu izvi usati wapa zano rekugadzirisa neobladder. Dzimwe nguva nzira dzimwe dzingave dzakakodzera zvichienderana nemamiriro ako emunhu, uye izvo zvakanaka.

Ko kuvakwazve neobladder kuri nani pane dzimwe sarudzo here?

Kuvakwazve neobladder kunopa mukana wakakura wekukubvumira kuti wotsveta zvakajairika kuburikidza nemukana wako wechisikigo, izvo vanhu vazhinji vanoona zvakakosha mupfungwa uye mukuita. Zvisinei, hazvifaniri kuva sarudzo yakanakisisa kune munhu wose.

Kana ichienzaniswa nedzimwe sarudzo dzekutsiva dumbu, neobladder inowanzoita kuti vanhu vakodzera vave nehupenyu huri nani. Haufaniri kutarisira bhegi rekunze kana kuita catheterization kuburikidza nemukana mudumbu rako.

Zvisinei, mamwe maitiro akadai seileal conduit kana continent cutaneous diversion angave sarudzo dziri nani kana uine mamwe mamiriro ehutano kana anatomy inoita kuti kuvakwazve neobladder kuve nenjodzi yakawanda. Chiremba wako achakubatsira kunzwisisa kuti ndeipi sarudzo inopa chiyero chakanakisa chekuchengeteka uye basa remamiriro ako chaiwo.

Ndezvipi zvipingamupinyi zvinogona kuitika zvekugadzirisa neobladder?

Kufanana nekumwe kuvhiyiwa kukuru, kuvakwazve neobladder kunotakura njodzi dzaunofanira kunzwisisa usati waita sarudzo yako. Zvipingamupinyi zvakawanda zvinogoneka, uye matambudziko akakomba haawanzoitiki nemapoka ekuvhiya ane ruzivo.

Zvipingamupinyi zvakajairika zvinogona kuitika zvinosanganisira:

• Kusagadzikana kwemvura, kunyanya usiku, kuchikanganisa 10-30% yevanhu
• Kusazara kwemvura kunoda catheterization dzimwe nguva
• Zvirwere zvemugwagwa wemvura, izvo zvinogona kuve zvakanyanya kazhinji pakutanga
• Kuchinja kwemetabolic nekuda kwekubata weti netishu yemukati
• Zvirambidzo kana kudzikira panzvimbo dzekubatanidza
• Matambudziko eitsvo kana weti ikadzokera kumashure muureters

Zvisingawanzoitiki asi zvakanyanya kukomba zvinogona kusanganisira magwamba eropa, zvirwere zvakakomba, kana matambudziko ekupora kwemaronda. Chikwata chako chekuvhiya chichakutarisa zvakanyanya uye chichagadzirisa chero matambudziko nekukurumidza kana akamuka.

Matambudziko asingawanzoitiki anogona kusanganisira kubuda ropa kwakanyanya, kuvharika kwematumbu, kana matambudziko makuru emetabolic. Kunyangwe izvi zvichinzwa zvichinetesa, zvinowanika muzviitiko zvisingasviki 5% uye zvinowanzo manejwa nekuchengetwa kwakakodzera kwekurapa.

Ndingatarisira riini chiremba nezve zvinonetsa zve neobladder?

Mushure mekuvakwa patsva kwe neobladder yako, zvakakosha kuti urambe uchiwirirana nechikwata chako chekurapa uye uzive kuti ungatsvaga rubatsiro rwakawedzerwa rini. Nyaya zhinji dzinogona kugadziriswa nekukurumidza kana dzichigadziriswa pakutanga.

Bata chiremba wako nekukurumidza kana uine:

• Fivha inodarika 101°F (38.3°C) kana kutonhora
• Kurwadziwa kwakanyanya mudumbu kana kuzvimba
• Kusagona kukwana kuita weti kana kupisa kwakanyanya
• Ropa mumvura inodarika pinki yakajeka
• Nyemba nekutsvuka kunodzivirira kudya kana kunwa
• Zviratidzo zvekushaya mvura mumuviri senge dzungu kana muromo wakaoma

Unofanirwawo kubata kana ukaona shanduko dzemutsika dzako dzekuyera, kubuda nguva dzose kuri kuipa pane kuvandudza, kana chero zviratidzo zvinokunetsa. Chikwata chako chehutano chinotarisira mafoni aya uye chinoda kugadzirisa matambudziko madiki vasati vava makuru.

Mibvunzo inowanzo bvunzwa nezve kuvakwa patsva kwe neobladder

Q1: Kuvakwa patsva kwe neobladder kwakanakira varwere vane gomarara rebladder here?

Hongu, kuvakwa patsva kwe neobladder kazhinji isarudzo yakanaka kune varwere vane gomarara rebladder vanoda kubviswa bladder yavo. Zvinokutendera kuti uchengetedze mararamiro akajairika mushure mekurapwa kwegomarara uchiri kupa kubviswa kwegomarara kwakakwana kunowanikwa ne cystectomy.

Maitiro acho haavhiringidzi kurapwa kwekenza uye anogona kuvandudza mhando yehupenyu hwako panguva yekupora. Vazhinji varwere vane kenza avo vakakodzera kuvhiyiwa uku vanoshuma kugutsikana kukuru nekusarudza kwavo.

Q2: Kuvakwazve kwe neobladder kunokonzera matambudziko eitsvo here?

Kuvakwazve kweNeobladder pachayo kazhinji hakukonzere matambudziko eitsvo, asi kunoda kunyatso tarisa kushanda kweitsvo. Kubatana pakati pechitsva chako chetsvo nemitsvo kunoda kushanda nemazvo kudzivirira kuwedzera weti.

Chikwata chako chekurapa chichaongorora kushanda kweitsvo yako nguva dzose kuburikidza nemiedzo yeropa uye mifananidzo. Vanhu vazhinji vanochengetedza kushanda kwakajairika kweitsvo mushure mekuvhiyiwa uku kana kutarisirwa kwakakodzera kwakachengetedzwa.

Q3: Ndingararama hupenyu hwakajairika ne neobladder here?

Hongu, vanhu vazhinji vane neobladders vanodzoka kuhupenyu hwakajairika, hunoshingaira. Unogona kushanda, kurovedza muviri, kufamba, uye kutora chikamu muzviitiko zvakawanda zvaunofarira usati wavhiyiwa, kunyangwe iwe uchigona kuita zvimwe zvigadziriso.

Musiyano mukuru ndewekuti iwe uchada kuita weti pane chirongwa pane kumirira kukurudzira, uye unogona kuda kumuka kamwe kana kaviri usiku. Vanhu vazhinji vanowana shanduko idzi diki dzakakodzera kukwanisa kuita weti zvakajairika.

Q4: Zvinotora nguva yakareba sei kupora kubva mukuvhiyiwa kwe neobladder?

Kupora kwekutanga kunowanzo tora 6-8 mavhiki, asi kudzidza kushandisa neobladder yako zvinobudirira kazhinji zvinotora 3-6 mwedzi. Munguva iyi, chitsva chako chetsvo chinowedzera zvishoma nezvishoma uye unovandudza kutonga kuri nani uye nzira dzekuzora.

Vanhu vazhinji vanodzoka kubasa uye zviitiko zvakareruka mukati me6-8 mavhiki, nepo kupora kwakazara kusanganisira kushanda kwakanyanya kwechitsvo kunogona kutora kusvika gore. Munhu wese anopora pamwero wavo, saka usaora mwoyo kana nguva yako yakasiyana.

Q5: Ndichada kuisa catheter yechitsvo changu here?

Vanhu vazhinji vane neobladders havadi kuisa catheter nguva dzose, chimwe chezvinhu zvikuru zvakanakira nzira iyi. Zvisinei, vamwe vanhu vangada kuisa catheter dzimwe nguva kana vachinetseka kubvisa zvachose.

Vashandi vehutano vako vachakudzidzisa kuisa catheter kana zvichidikanwa, asi vanhu vazhinji havazombodi. Chinangwa ndechekuti iwe wotsvaga zvakajairika pasina chero machubhu kana zvishandiso zvekunze.