Kuwanda Kwehuremu uye Kuvhiyiwa Kwedumbu: Kukosha Kwazvo, Vanokodzera Kuwedzerwa Uye Maitiro Anofambira Mberi Sei?
Kukanganisa kweObesiti paUtano uye Mhedzisiro Dzayo Pasi Pose
Obesiti haisi kungova dambudziko rekunaka kwechitarisiko chete; iri pakati pezvikonzero zvikuru zvekufa zvinokonzerwa nezvirwere zvinodzivirirwa pasi rose. Kunyanya mushure mekushandiswa kwefodya kunotungamira kugomarara remapapu, obesiti iri pakati pezvikonzero zvikuru zvekufa pasi rose. Nekuda kwechimiro chayo chekuva chirwere chinoramba chiripo uye chine mativi akawanda, inotungamira mukukura kwezvirwere zvakakomba zvakaita sekurwara kwemwoyo nemitsipa yeropa, chirwere chechirwere chechipiri chechirwere cheshuga uye kushungurudzika, uye inoderedza zvakanyanya kunaka kweupenyu hwemunhu.
Sangano reUtano Pasi Pose (WHO) rinotsanangura obesiti sechirwere chinoratidzwa nekuwanda kwe mafuta mumuviri kupfuura mwero wakajairika uye kuungana kwakawandisa kwemafuta, izvo zvinogona kukonzera matambudziko mazhinji epanyama, epfungwa uye ehupenyu munharaunda. Zvirwere zvinowanzobatana neobesiti zvinosanganisira mhando dzegomarara, metabolic syndrome, high blood pressure, hope apnoea uye matambudziko emapfupa nemajoini.
Zvikonzero zveObesiti uye Maitiro eKurapa
Kusashanda muviri uye tsika dzekudya dzisina hutano ndizvo zvikuru zvinowedzera njodzi yeobesiti. Kunyange zvazvo kurudziro dzekuchinja maitiro dzichisanganisira kudya kwakarongeka uye maekisesaizi, izvi hazviwanzoita nyore kutevedzera kune vanhu vakawanda. Nekuda kwekushaya kugona kutevedzera kurapwa, kuderera kwehuremu kunogona kugumira uye hutano hunogona kuramba huchiderera.
Mazuvano mune dzimwe nzira dzekurapa dzakagadzirwa, uye mukati mezviitiko zveobesiti yakanyanya, nzira dzekuvhiya dzinobudirira mukuderedza huremu dzave kutora nzvimbo huru. Pakati padzo, kuvhiyiwa kwekuderedza dumbu (tupu mudziyo) kunonyanya kuzivikanwa nekubudirira kwadzo uye kuchengetedzeka.
Chii chinonzi Kuvhiyiwa kweTupu Mudziyo (Sleeve Gastrectomy)?
Kuvhiyiwa kwetupu mudziyo inzira inobvisa chikamu chedumbu chinodarika 75-80% nechirapa. Dumbu rinoramba rava diki uye rakatetepa semudziyo. Izvi zvinoita kuti munhu azadzikane nekudya kushoma uye huwandu hwekalori hunoderera zvakanyanya. Nzira iyi haingobatsiri kuderedza huremu chete; inobatsirawo mukuvandudza zvirwere zvakawanda zvinobva paobesiti.
Kuvhiyiwa kwetupu mudziyo kunogona kuvandudza kana kuderedza matambudziko anotevera ane chekuita neobesiti:
Chirwere cheshuga chechipiri (Type 2 diabetes)
High blood pressure
Hope apnoea
Chirwere chemafuta mudumbu (fatty liver disease)
Polycystic ovary syndrome (PCOS)
Chirwere che reflux
Matambudziko emajoini
Ndiani Akakodzera Kuvhiyiwa kweTupu Mudziyo?
Oparesheni iyi inonyanya kukurudzirwa kune vane body mass index (BMI) 40 kana kupfuura, kana BMI iri pamusoro pe35 uye vane mamwe matambudziko ehutano. Mumamiriro anowanzozivikanwa se "morbid obesity" kana "super obesity", nzira dzekuvhiya dzinopa mhinduro dzakachengeteka uye dzinoshanda. Zvakare, kune avo vakatadza kuderedza huremu nekudya uye maekisesaizi uye vane matambudziko akakomba ane chekuita neobesiti, kuvhiyiwa kwetupu mudziyo kunogona kuitwa.
Vazhinji vevanhu vanenge vaita oparesheni iyi vanogona kurasikirwa ne50-80% yehuremu hwavo hwakawandisa mukati megore rekutanga. Zvidzidzo zvinoratidza kuti njodzi dzekuvhiya dzakaderera uye kuti kuvandudzwa kwezvirwere zvakaita sechirwere cheshuga kwakakwira.
Maitiro eKurapa neKuvhiya Pasi Pose
Ongororo dzenguva refu pamusoro pekuvhiya kweobesiti (semuenzaniso Swedish Obesity Study, SOS) dzakaratidza kuti bariatric surgery inobatsira pakuderedza huremu kwenguva refu uye zvinobudirira. Nzira dzekuvhiya dzave kutambirwa munyika dzakawanda seimwe yenzira huru dzekurapa obesiti. Nekufambira mberi kwetekinoroji, oparesheni zhinji dzinoitwa nenzira yakavharwa (laparoscopic); izvi zvinoderedza nguva yekupora uye njodzi dzekuwedzera matambudziko.
Oparesheni Inoitwa Sei?
Kuvhiyiwa kwetupu mudziyo kunowanzoitwa nenzira ye laparoscopy, kureva kuti inopinda zvishoma muviri. Kuburikidza nekubvarura diki mudumbu, dumbu rinopatsanurwa nezvishandiso zvemishonga zvinonzi stapler uye chikamu chinodiwa chinobviswa. Dumbu rinogadzirwazve kuva diki uye rakatetepa. Nekuderedzwa kukuru kwehukuru hwedumbu, huwandu hwedumbu hunoderera uye mamwe mahomoni anokonzeresa nzara (akaita seghrelin) haachabudiswe; izvi zvinobatsira kudzora nzara uye kuderedza kupinda kwekalori.
Nguva yekupora inowanzo kukurumidza. Vazhinji vevarwere vanomuka mushure memazuva mashoma uye vanodzokera kuhupenyu hwavo hwemazuva ose mukati memavhiki mashoma.
Kuderera kweHuremu uye Kuvandudzwa kweUtano Mushure meOparesheni
Mhedzisiro yakanaka inowanzoonekwa mushure mekuvhiyiwa kwetupu mudziyo inosanganisira:
Kurasikirwa nehuremu hwakawandisa mukati megore rekutanga
Kuderedzwa kana kupedza zvirwere zvakabatana neobesiti zvakaita sechirwere cheshuga chechipiri, high blood pressure uye hope apnoea
Kuvandudzwa kwemafuta eropa akaita sekolesterol
Kuderedzwa kwekurwadziwa mumajoini edumbu nemakumbo
Kuwedzera kwekunaka kweupenyu uye kugona kufamba
Kuderera kwehuremu kunogara kwenguva refu kunowanikwa zvakanyanya kupfuura nzira dzisiri dzekuvhiya. Kunyange zvazvo mwero wekuderera kwehuremu uchisiyana pakati pevanhu, zvidzidzo zvakasiyana zvinoratidza kuti vazhinji vevarwere vanorasikirwa ne50-80% yehuremu hwavo hwakawandisa mukati megore rekutanga.
Njodzi uye Kuchengetedzeka kweOparesheni
Senge chero oparesheni, kuvhiyiwa kwetupu mudziyo kunogona kuva nenjodzi. Asi mwero wekuoma kwezvinetso wakaderera zvikuru nemaitiro azvino uye matambudziko mazhinji anenge ari madiki kana epakati. Matambudziko akakomba haawanzoitika, uye kuchengetedzeka kunowedzerwa nekuongororwa kwakadzama uye kutarisirwa nechikwata chehunyanzvi. Nguva yekugara muchipatara inowanzo pfupi; vazhinji vevarwere vanobuda muchipatara mukati memazuva 3-4.
Kuchinja kweKudya uye Maitiro eHupenyu
Kuti kuderedzwa kwehuremu kuenderere mberi mushure mekuvhiyiwa, zvakakosha kutevedzera mitemo yekudya. Mumavhiki ekutanga, zvinwiwa chete ndizvo zvinotenderwa, zvichiteverwa nekudya kwakapwanyika uyezve zvokudya zvakaoma. Nekuda kwekuderedzwa kwehukuru hwedumbu, munhu anozadzikane nekukurumidza; zvinokurudzirwa kupa nguva pakati pezvinwiwa nezvokudya kuti dumbu risakuvadzwe. Zvakare, zvinogona kudikanwa kuti munhu atore mapuroteni, mavhitamini uye maminerari. Maekisesaizi anofambiswa nachiremba anobatsira mukuderedza huremu uye kudzivirira kuderera kwemhasuru uye kusuruvara kweganda.
Mari yeKuvhiyiwa kweTupu Mudziyo
Mutengo wekuvhiyiwa kwetupu mudziyo unosiyana zvichienderana neruzivo rwechikwata chekuvhiyiwa, zvivako zvechipatara uye zvishandiso zvinoshandiswa. Kuti uwane mutengo wakanyatsojeka, kuongororwa nachiremba kunodiwa. Kuti uwane ruzivo rwakazara, zvakanakisisa kubvunza chiremba kana nzvimbo yehutano.
Mukupedzisa, kuvhiyiwa kwetupu mudziyo inzira inoshanda uye yemazuva ano yekurwisa obesiti, inotarisira kuvandudza kunaka kweupenyu uye kuderedza matambudziko ehutano anouya neobesiti. Mushure mekuongororwa kwakazara nechikwata chehunyanzvi, zvinokurudzirwa kugadzira chirongwa chakakodzera kune zvaunoda.
Mibvunzo Inonyanya Kubvunzwa
1. Chii chinonzi kuvhiyiwa kwetupu mudziyo uye chinoitwa sei?
Kuvhiyiwa kwetupu mudziyo inzira yekuvhiya inoderedza hukuru hwedumbu kuitira kuti munhu adye zvishoma uye arase huremu. Nenzira ye laparoscopy (yakavharwa), chikamu chikuru chedumbu chinobviswa uye dumbu rinoramba riri semudziyo.
2. Ndiani akakodzera kuvhiyiwa kwetupu mudziyo?
Kazhinji, vanhu vane body mass index 40 kana kupfuura, kana 35 uye pamusoro uye vane mamwe matambudziko ehutano, ndivo vakakodzera oparesheni. Kuongororwa nachiremba kunodiwa kuti pave nechisarudzo chekupedzisira.
3. Kuderera kwehuremu kunotarisirwa mushure mekuvhiyiwa kwetupu mudziyo?
Kunyange zvazvo paine misiyano pakati pevanhu, vazhinji vevarwere vanorasikirwa ne50-80% yehuremu hwavo hwakawandisa mukati megore rekutanga. Mwero wekuderera kwehuremu unoenderana nezera, murume kana mukadzi, metabolism uye maitiro ehupenyu.
4. Pane ngozi yekudzokera kuhuremu hwekare mushure mekuvhiyiwa?
Kuchinja maitiro ehupenyu uye kutevedzera zano rechiremba kunobatsira kuchengetedza huremu hutsva. Kana tsika dzisina kunaka dzekudya dzikadzoka, huremu hunogona kuwedzera zvakare.
5. Njodzi dzekuvhiyiwa kwetupu mudziyo ndedzipi?
Nekufambira mberi kwetekinoroji, mwero wekuoma kwezvinetso wakaderera; vazhinji vevarwere vanopora pasina matambudziko. Muzviitiko zvisingawanzoitika, matambudziko akaita sekubuda ropa, kubuda mvura kana utachiona anogona kuitika.
6. Kuvhiyiwa kwetupu mudziyo kunobatsira here pazvirwere zvakaita sechirwere cheshuga uye high blood pressure?
Kune varwere vakawanda, kunyanya vane chirwere cheshuga chechipiri uye high blood pressure, zvirwere izvi zvinogona kuvandudzwa zvakanyanya kana kupedza zvachose mushure mekuvhiyiwa.
7. Kudya mushure mekuvhiya kunofanira kuva kwakaita sei?
Pakatanga, kudya kunoitwa nezvinwiwa; nekufamba kwenguva, munhu anopiwa chikafu chakapwanyika uyezve anopinda muchikafu chakaoma. Chirongwa chekudya kwako chichagadzirwa nachiremba wako pamwe nemunyanzvi wezvekudya.
8. Kurovedza muviri kunodiwa here mushure mekuvhiya?
Kuti kuderedza uremu kutsigire uye kudzivirira kurasikirwa nemhasuru, kurovedza muviri kunokurudzirwa. Chiremba wako achakutungamira pamusoro penguva yakakodzera uye mhando dzekurovedza muviri dzakakodzera.
9. Kunzwa nzara kunoderera here mushure mekuvhiya?
Hongu, nekuti chikamu chikuru chegastrin chinogadzirwa mudumbu chinobviswa, vazhinji vevarwere vanonzwa nzara zvishoma.
10. Kuvhiya kwechubhu mudumbu kunotora nguva yakareba sei?
Kuvhiya kunowanzotora awa imwe kusvika mbiri, asi zvinoenderana nemamiriro ehutano hwemurwere uye ruzivo rwemuvhiyi, nguva inogona kusiyana.
11. Munhu anogona kubuda muchipatara riini uye kudzokera kuhupenyu hwakajairika?
Vazhinji vevarwere vanobuda muchipatara mukati memazuva matatu kana mana mushure mekuvhiya, uye vanogona kudzokera kuhupenyu hwavo hwemazuva ose mukati memavhiki mashoma.
12. Mushure mekuvhiya, zvinodikanwa here kutora mavhitaminzi nemaminerari?
Kazhinji hongu. Chiremba wako achakurudzira mavhitaminzi nemaminerari akakodzera zvaunoda.
13. Mari yekuvhiya inotarwa sei?
Mutengo wekuvhiya unoenderana nenzvimbo inoitirwa, ruzivo rwechikwata cheutano, nzira inoshandiswa uye zvishandiso zvemishonga. Kuti uwane ruzivo rwakajeka, zvinodikanwa kubvunza chiremba.
14. Kuvhiya kwechubhu mudumbu igadziriso inogara here?
Kurasikirwa kweuremu kunowanikwa nekubatsirwa kwekuvhiya kunowanzogara, asi kuti budiriro irambe iripo, zvinodikanwa kuramba uchitevedzera mararamiro ane hutano.
15. Pane matambudziko akaita sekurasikirwa nebvudzi kana kusununguka kweganda mushure mekuvhiya here?
Kana kurasikirwa kweuremu kukaitika nekukurumidza, dzimwe nguva munhu anogona kurasikirwa nebvudzi kwechinguvana kana kuti ganda rikasununguka. Kudya kwakaringana uye kurovedza muviri kunobatsira panguva iyi.
Zvinyorwa
Sangano reHutano Pasi Pose (WHO): Chinyorwa chekuwandisa uremu
Sangano reAmerica reMetabolic uye Bariatric Surgery (ASMBS)
Chidzidzo cheSwedish Obese Subjects (SOS) – New England Journal of Medicine
Centers for Disease Control and Prevention (CDC): Zvinyorwa zvekuwandisa uremu kwevakuru
The Lancet, "Kuwanda kwevanhu vane uremu hwakawandisa pasi rose, mudunhu, uye munyika", 2022
National Institutes of Health (NIH): Mirayiridzo yeBariatric Surgery