Gastrectomy

Imisebenzi ngokuvamile lwenziwa yezifo duodenum futhi isisu gastrectomy.

Ngesisekelo msebenzi excision okuyingxenye onesifo isitho. Ngakho embili sokubuyiselwa (ubuqotho) anastomosis emathunjini wenziwa phakathi jejunum kanye duodenum noma isisu isiqu.

kokungenela Steel ingenziwa izindlela ezimbili eziyisisekelo.

Uma usebenzisa indlela yokuqala (Billroth mina) Gastrectomy wenziwa excision Imininingwane antrum yayo pyloric neminyango. Kulokhu, ukunqunywa anastomosis wenziwa phakathi engxenyeni engezansi yomzimba futhi libheka isiphunzi salesi duodenum isimiso "ukuqeda ukuqeda".

Gastrectomy ngale ndlela kungaholela ngempela inkinga eyingozi, ebonakaliswa yokuntuleka yobunzima we anastomosis eslphambanweni emalungeni ezintathu endaweni. Ukuqeda ke, kukhona izinguqulo eziningi ezahlukene. Evame ukusetshenziswa Gaberera ukuguqulwa II. Nge lo msebenzi, ngemva excision 2 \ 3 ukugqugquzela kanye esiswini umkhiqizo luminal olugcwele ke esebenzisa crimping ezivuzayo ukuze ububanzi ilingana ububanzi mafutha anciphisa isikhala esingaphakathi we duodenum.

Gastrectomy nge Billroth II indlela Kwenziwa uvalwe isiqu suturing umzimba. Ukubuyisela ngokuqhubeka pheshana emathunjini kulokhu ukukhiqiza Imbondela gastroenteroanastomosis ezingemuva noma ngaphambili.

Kukhethwa indlela excision Kwenziwa ikhumbula uhlobo zokugula, kwasendaweni yayo futhi excised usayizi esiswini.

Kukhona izinkomba isihlobo kanye ngokuphelele ukuhlinzwa ukuze excision.

Ingabe Ohulumeni Banalo Lonke kubhekwe komdlavuza, yansukuzonke isilonda ukopha, esolwa umdlavuza ukonakala izilonda futhi stenosis pyloric.

Ukuze izinkomba isihlobo zihlanganisa unhealed okwesikhathi eside izilonda isikhathi ku duodenum nasesiswini, kanye isilonda perforated on isizinda yesimo esihle isiguli, eyamukelwa emahoreni zokuqala eziyisithupha emva perforation.

Ephambi kwezinduna umdlavuza kanye isilonda operation peptic wenziwa usebenzisa isu elikhethekile.

Ngakho, lapho peptic isilonda kungcono mkhuba 2/3 noma 3/4 isisu nge umzimba pyloric. Ngakho, it is kuvinjelwe kokushelela. Endabeni izikhulu phezulu ezincane ugobile izilonda isicelo gastrectomy subtotal. Uma lokhu sekwenziwe 4/5 isitho excision (cishe 80%).

Ukudla ngemuva resection esiswini kuhilela komkhawulo ukudla kudliwa ngesikhathi. Ngakho, iziguli Kunconywa hhayi ngaphezulu kuka-250 amagremu isobho noma ingilazi ukuphuza. Ngezinye kwasemini nawe ungadla akukho kuka ukudla ezimbili. Ukudla usuku lonke Kunconywa njalo (okungenani izikhathi ezinhlanu noma eziyisithupha). Ukwandisa inani wathola amaprotheni Kunconywa (120 g), nokukhawulela inani carbohydrate (300 g). Kwezinye izimo kungase ngaphandle ngokuphelele ukudla okunoshukela neziphuzo. It is uvunyelwe ukusebenzisa ushukela esikhundleni. Ukwandisa inani amaprotheni Kunconywa inyama abilisiwe, inhlanzi, calcined noma ushizi ogayiwe, ngiyocasha amaqanda qanda.

Kungcono ukukufaka ekudleni kanye wezokudla imikhiqizo ahlanganiswe ezitshalo. Endabeni ka tolerability abampofu, ikakhulukazi ngesimo mahhala futhi lemali yabo kukhawulwe 70-80 amagremu ngosuku. Endabeni ukungabekezelelani ukuze ubisi injalo khulula, kuphela kufakwe Ukwakheka izitsha noma esikhundleni ngeminye imikhiqizo.

Ukudla futhi ngempela zihlanganisa amalungiselelo equkethe yensimbi kanye multivitamin.

Endabeni nokuncipha isisindo isiguli ovunyelwe kwandiswe inzuzo amandla ukudla by 10-15% uma kuqhathaniswa kuyinsakavukela bokuphila.