Gastrectomy

The anowanzodanwa akaita mabasa zvirwere duodenum uye mudumbu ndiro gastrectomy.

Hwaro kushanda ndiko excision kurwara chikamu nenyere. Saka chamazuva kudzorerwa (kuperera) gastrointestinal anastomosis rinoitwa pakati jejunum uye duodenum kana mudumbu chigutsa.

Kuvhiya kupindira anogona chinoitwa dzinokosha nzira mbiri.

Kana uchishandisa nzira yokutanga (Billroth I) Gastrectomy rinoitwa nevanhu zvachose excision wayo pyloric antrum uye madhipatimendi. Panyaya iyi, iyo nokuiswa anastomosis rinoitwa pakati yepazasi chikamu muviri uye chigutsa ari duodenum panheyo "rutivi".

Gastrectomy nenzira iyi zvinogona pakava ngozi, richiratidzwa kwokushayiwa tightness of anastomosis panguva mhesano mapfundo matatu nzvimbo. Kuhupedza, kune shanduro dzakasiyana-siyana. Yaiwanzoshandiswa Gaberera nadzurudzo II. With mashandiro ichi, mushure excision 2 \ 3 kuunganidza uye gastric zvibereko luminal kuderedza nayo achishandisa crimping vazvo kuti yakafara akaenzana upamhi lumen yacho duodenum.

Gastrectomy pamwe Billroth II nzira iri kuitwa zvakasimba chigutsa suturing muviri. Kunotangazve chamazuva ose nemudumbu mune iyi kubudisa kuifukidza shure kana mberi gastroenteroanastomosis.

Pakusarudza nzira excision rinoitwa kufungisisa mhando zvokurwara, ayo localization uye excised dumbu kukura.

Kune hama uye mhedziso zvairatidza kuti kuvhiyiwa excision.

Mhedziso vaiona malignancies, idzokororo urikanwi ropa, vakafungira malignancy degeneration nemaronda uye pyloric stenosis.

Nokuti hama zvairatidza zvinosanganisira unhealed kwenguva refu nemaronda ari duodenum uye dumbu, uyewo Perforated urikanwi iri pakanyorwa ezvinhu omurwere, iyo vakagamuchira mukati maawa matanhatu okutanga mushure perforation zvakanaka.

In pamberi malignancy uye peptic urikanwi oparesheni rinoitwa kushandisa chaiyo nzira.

Saka, kana peptic urikanwi zvinokurudzirwa kuti excise 2/3 kana 3/4 mudumbu pamwe pyloric muviri. Saka, zviri kudziviswa wava kusvutazve. Kana ari pamusoro vakuru vaduku curvature nemaronda rikashandiswa subtotal gastrectomy. Kana izvi zvaitwa excision 4/5 nhengo (anenge 80%).

Diet pashure gastric resection hunosanganisira kukamurwa zvokudya panguva. Nokudaro, varwere vanenge varumbidzwa asingapfuuri 250 magiramu pakati mumuto kana kunwa girazi. At kwemasikati unogona kudya hakuna kupfuura kudya maviri. Kudya yose zuva inokurudzirwa kakawanda (kanenge kashanu kana katanhatu). Kuwedzera uwandu akagamuchira rakarumbidza mapuroteni (120 g), Kuderedza uwandu makabhohaidhiretsi (300 g). Muzvimwe zviitiko inogona kunze zvachose sugary zvokudya nokumwa. Zvinonzi akabvumira kushandisa shuga Sevamiririri. Kuwedzera uwandu mapuroteni yakarumbidza yakabikwa, hove, calcined kana grated chizi, scrambled zai nevachena.

Zvinokurudzirwa kuti zvinyorwe zvokudya uye Mishonga zvigadzirwa vafumiswa pamwe muriwo anonhuwirira. Kana murombo tolerability, kunyanya mune vakasununguka chimiro uye mari yavo shoma 70-80 magiramu pazuva. Kana asingashiviriri kuti mukaka zvayo yakasununguka chimiro, izvozvo chete vanobatanidzwa Zvinoumba ndiro kana kutsiviwa nedzimwe zvigadzirwa.

Zvokudya uyewo hayo zvinosanganisira kugadzirira ane simbi uye multivitamin.

Kana zvinoderedza uremu murwere anobvumirwa kuwedzera simba kukosha zvokudya 10-15% kufananidzwa vasiri ndozvakajairwa.