Kufutisa uye kuvhiyiwa kwebariatric: izvo zvaunoda kuziva
Kufutisa chirwere chisingaperi, chakakomba uye chinopedza simba. Kuwedzeredza uremu hwemuviri kunokonzeresa shanduko huru yemuviri neyepfungwa, uye kazhinji inokanganisa zvakanyanya hupenyu hweavo vanobatwa
Simba uye chishuwo chekufamba chinodzikira nekirogiramu yega yega inowedzerwa kumuviri, izvo zvakare nekuda kwekunetseka mukuita mafambiro.
Uye saka, kunyangwe kufamba kana kutamba nevana vako kunogona kuve kwakaoma nekuda kwekudikitira kukuru, kupfupika kwekufema uye kurwadziwa.
Uye handizvo chete: sezvakaratidzwa neongororo dzakawanda, yakanyatsobatana nezvirwere zvakadai seshuga, chirwere chemwoyo, hypertension uye kenza.
Nhau dzakanaka, zvisinei, ndedzekuti kufutisa kunogonawo kurapwa nekuvhiyiwa kwebariatric.
Chinhu chakakosha kuvimba nenzvimbo dzine ruzivo rwakasimba uye hunyanzvi chaihwo mumunda.
Ngozi dzekufutisa
Kufutisa haisi chirwere chete pachayo, sezvava kuzivikanwa zvino, asi zvakare inogona kukurudzira kutanga kwezvimwe zvirwere.
Huremu hwakawandisa hunoremedza majoini uye spinal column, zvichiita kuti zvirwere zvikuru zve osteo-articular system munguva refu.
Mukuwedzera, inokanganisa kurara, zvichitungamirira kune inonzi 'obstructive sleep apnea syndrome', inoratidzirwa ne-micro-awakenings yakawanda iyo munhu asingazivi, asi izvo zvinotungamirira kuneta kukuru nokukurumidza apo munhu anomuka mangwanani.
Nekuda kwekufutisa, hosha dzakakomba dzemetabolism dzinokura zvakare dzinogara dzisingaperi uye dzakaoma kugadzirisa nekurapa
Hypertension, chirwere chemwoyo uye chirwere cheshuga mellitus ndezvimwe zvezvirwere zvakakosha zvinofarirwa uye zvinowedzerwa nekufutisa.
Chekupedzisira, avo vanorwara nekufutisa kwakanyanya vane njodzi yakawedzera yekuva neoplasms (colon, zamu), gastro-oesophageal reflux (inosanganiswa ne30% yevarwere), urological, dermatological uye. psychiatric matambudziko.
Kana kudya uye zvinodhaka hazvina kukwana: kuvhiyiwa kwebariatric
Kuvhiyiwa kweBariatric kana kuvhiyiwa kufutisa ikozvino kunopa mukana wekuwana kudzikiswa kwehuremu muvarwere vane morbid kufutisa inopesana nemishonga, pharmacological, uye yekudya marapirwo.
Kudzikira uremu kunowanikwa nerudzi urwu rwekuvhiya kunounza shanduko huru muhupenyu hwevarwere.
Pamusoro pekusimudzira kuvandudzwa kwakakosha mukuona kwechifananidzo chako, nezvose zvakabatana zvepfungwa zvinobatsira, zvinoderedza njodzi yekukudziridza uye kuwedzera hukama hwepathologies.
Kunyanya panyaya yevarwere vane chirwere cheshuga, kuvhiyiwa kwakaratidzwa mune zvidzidzo zvakawanda kuti kunoshanda kupfuura kurapwa kwechiremba chete.
Ichi ndicho chikonzero, muhupo hwekufutisa kana kuoma, mhinduro chete yekurapa ndeyekuvhiyiwa kwebariatric.
Kufutisa, apo kuvhiyiwa kwebariatric kunoratidzwa
Zvinoenderana nemirairo yeAmerican Metabolic and Bariatric Surgery Society neItaly Society of Obesity Surgery, kuvhiyiwa kwebariatric kunongoratidzwa kana murwere achinge aratidza kufutisa kwakanyanya, kureva iyo fomu yekufutisa ine body mass index (BMI kana BMI)> 40 kana kana iri pakati pe30 ne39 uye inosanganiswa neinenge 1 yakakura-yakabatana nehutachiona hwehutachiona: arterial hypertension, chirwere cheshuga mellitus, apnoea yekurara, majoini pathologies, nezvimwe.
Zera revarwere vanokodzera kuvhiyiwa rinobva pamakore gumi nemasere kusvika makumi matanhatu nemasere.
Kuvhiya kunogona kutariswa chete kune varwere vane BMI pakati pe30 ne35 uye muvarwere vanopfuura makore makumi matanhatu nemashanu kana ikatenderwa neboka rakasarudzika rakasiyana siyana, rinoumbwa neakasiyana hunyanzvi manhamba (anaesthetist, chiremba anovhiya, internist) uyo, mushure mekuziva kuvapo kwehupenyu hwakaderedzwa nekuda kwekufutisa uye kuvapo kwezvinokonzeresa comorbidities, kuongorora njodzi-yebhenefiti reshiyo yekuvhiya uye kupa kuenderera mberi kwekuvhiya.
Contraindications pakuvhiya ndeiyi: kutadza kusimba kwemoyo, kusagadzikana kweangina, chirwere chepulmonary chirwere, kenza mukurapa kunoshanda, portal hypertension, kudhakwa nezvinodhaka, kusaziva.
Iyo preoperative nzira
Zvinokosha zvikuru, mukuona kwekuvhiyiwa kwebariatric, ndiyo pre-operative kosi, iyo yakakosha kuti udzidze murwere kuitira kuti akwanise kusarudza nzira yekuvhiya yakakodzera kwazvo, kuziva mamiriro ake ehutano, kuongorora chirwere. zvinogoneka kuvapo zvisizvo pathologies uye kumugadzirira nenzira yakanakisisa inobvira.
Munguva ye pre-operative course, murwere anoongororwa nenyanzvi dzakawanda dzine ruzivo mumunda wekuvhiya bariatric.
Kutenda kukubatana kwenhamba dzakasiyana idzi preoperatively uye postoperative kuti kuvhiyiwa kwebariatric kunowana kwainobva kubudirira.
Chikwata chemultidisciplinary chinoongorora murwere ari mumiriri wekuvhiyiwa kwebariatric chine:
- chiremba anovhiya;
- anesthetist;
- cardiologist;
- psychologist;
- chiremba.
Ongororo dzepfungwa dzinogona kuona zvinhu zvinopokana zvachose pakuvhiyiwa: psychosis, kusanganisira schizophrenia, kupindwa muropa nezvinodhaka, kudhakwa kwechokwadi, mhirizhonga yepabonde yapfuura, kusagadzikana muhukama hwevaviri kana muchato, uye kuedza kuzviuraya kwekare zvinhu zvinodzivirira kuvhiyiwa.
Kuongororwa kwezvokudya kunoshanda kujekesa nguva uye nzira yekutanga kwehutano hwekufutisa, maitiro ayo nekufamba kwenguva, nguva yenguva yekuregererwa, kuonekwa uye kuoma kwekudzoka zvakare.
Chimwezve chinhu ndechekuzivikanwa kwekusangana kwekusagadzikana kwekudya, uye kunyanya kudya-kudya, kupesvedzera kusarudzwa kwekuvhiya.
Zvichienderana nemigumisiro yenguva dzose yekuongorora ropa uye kushandiswa kwekuongorora kwakaitwa (gastroscopy, manometry, abdominal ultrasound, polysomnography) kumwe kuongororwa nedzimwe nyanzvi, dzakadai se endocrinologist, gastroenterologist / hepatologist, pulmonologist, psychiatrist, inogonawo kudiwa.
Kupindirana kwenhamba dzakasiyana dzehunyanzvi kunokosha pakuongororwa kwakaringana kwemurwere, kusimbiswa kwechiratidzo chekuvhiya uye kusarudzwa kweiyo inonyanya kushanda yekuongorora-yekurapa nzira, tichifunga kuti nzvimbo yega yega inokwanisa ine imwechete inorambidza, yakasanganiswa kana malabsorptive. kupindira mumukwende wayo.
Mune varwere vane gastro-oesophageal reflux zviratidzo kana kuvapo kweosophagitis, an oesophageal manometry inoitwawo pa gastroscopy kuongorora kumanikidzwa kwevhavha pakati peguro uye mudumbu (LES kana pasi pesophageal sphincter).
Kuongororwa uku kwakakosha pasarudzo yekuvhiyiwa kuitira kurapa gastric acid reflux.
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