Ukukhuluphala Nokuhlinzwa Kwamathumbu Esiswini: Kungani Kubalulekile, Kubhekiswe Kubani Futhi Inqubo Iqhubeka Kanjani?
Umthelela Wokukhuluphala Empilweni Kanye Nemiphumela Yomhlaba Wonke
Ukukhuluphala akuyona inkinga yobuhle kuphela; kuyimbangela enkulu yokulahlekelwa ukuphila ngenxa yezifo ezingavinjelwa emhlabeni wonke. Ikakhulukazi ngemva komdlavuza wamaphaphu obangelwa ukusebenzisa ugwayi, ukukhuluphala sekuyimbangela ehamba phambili yokufa emhlabeni jikelele. Ngenxa yokuba yisifo esingapheli futhi esinemigudu eminingi, kwandisa amathuba okuthuthuka kwezifo ezinzima ezifana nezifo zenhliziyo nemithambo yegazi, isifo sikashukela sohlobo lwesibili kanye nokudangala, futhi kuthinta kabi izinga lempilo yomuntu.
Inhlangano Yezempilo Yomhlaba (WHO) ichaza ukukhuluphala njengenkinga yezempilo lapho amazinga amafutha emzimbeni ekhuphuka kakhulu adlule imingcele enempilo, okuholela ezinkingeni eziningi zomzimba, ezingokwengqondo nezokuxhumana nabantu. Phakathi kwezifo ezihambisana nokukhuluphala, kuvame ukubonakala izinhlobo zomdlavuza, isifo se-metabolic syndrome, umfutho wegazi ophezulu, i-sleep apnea kanye nezinkinga zamalunga.
Izimbangela Zokukhuluphala Kanye Nendlela Yokwelapha
Ukuphila impilo yokunganyakazi kanye nemikhuba yokudla okungelona elinempilo kubalulekile ekwandiseni ingozi yokukhuluphala. Yize kunconywa izinhlelo zokudla kanye nokuzivocavoca ngokusebenzisa izindlela zokwelapha eziguqula ukuziphatha, le nqubo ayihlali isikhathi eside kubantu abaningi. Ngenxa yobunzima bokulandela ukwelashwa, ukwehla kwesisindo kungahlala kunganele futhi impilo ingase ibe zimbi kakhulu.
Kwezokwelapha zesimanje sekuthuthukiswe izindlela ezahlukene zokwelapha, kanti ezimweni zokukhuluphala okukhulu izindlela zokuhlinzwa ezisebenza kahle ekwehliseni isisindo ziya ngokuya zibalulekile. Phakathi kwazo, ukuhlinzwa kwesitsha sesisu (sleeve gastrectomy) kugqama ngenxa yezinga eliphezulu lempumelelo nokuphepha kwalo.
Kuyini Ukuhlinzwa Kwe-Tube Stomach (Sleeve Gastrectomy)?
Ukuhlinzwa kwe-tube stomach kuwukususwa kwesilinganiso esingu-75-80% sesisu ngendlela yokuhlinzwa. Ingxenye esele yesisu iba yinde futhi ibe yisimo sethumbu. Lokhu kwenza umuntu azizwe egcwele ngokushesha ngemithamo emincane yokudla futhi inani lamakhalori athathwayo lehle kakhulu. Le ndlela ayigcini ngokusekela ukwehla kwesisindo kuphela; iphinde inikele ekuthuthukiseni izinkinga eziningi ezihambisana nokukhuluphala.
Ukuhlinzwa kwe-tube stomach kungathuthukisa noma kwehlise izinkinga ezilandelayo ezihambisana nokukhuluphala:
Isifo sikashukela sohlobo lwesibili
Umfutho wegazi ophezulu
I-sleep apnea
Isifo samafutha esibindi
I-Polycystic Ovary Syndrome (PCOS)
Isifo se-reflux
Izinkinga zamalunga
Ubani Ofanele Ukuhlinzwa Kwe-Tube Stomach?
Lo msebenzi unconywa ikakhulukazi kubantu abanesisindo somzimba (BMI) esingu-40 nangaphezulu noma labo abanesisindo esingu-35 nangaphezulu abanezinkinga ezihambisana nempilo. Ezimweni ezibizwa ngokuthi "morbid obesity" noma "super obesity", izindlela zokuhlinzwa zinikeza izixazululo ezisebenzayo nezivikelekile. Futhi, abantu abahlulekile ukwehlisa isisindo ngendlela yokudla nokuzivocavoca, abanezinkinga ezinzima ezihambisana nokukhuluphala, bangahlinzwa i-tube stomach.
Iningi labaguli abahlinzwe i-tube stomach bangalahlekelwa cishe u-50-80% wesisindo sabo esingaphezulu onyakeni wokuqala. Izifundo zibonisa ukuthi amazinga ezinkinga ezihlobene nokuhlinzwa aphansi, kanti izinga lokuthuthuka kwezifo ezingapheli ezifana nesifo sikashukela liphezulu.
Indlela Yokwelapha Ngokuhlinzwa Emhlabeni Wonke
Ucwaningo lwesikhathi eside mayelana nokuhlinzwa kokukhuluphala (njenge-Swedish Obesity Study, SOS) lukhombisile ukuthi i-bariatric surgery inikeza ukwehla kwesisindo okuzinzile nokusebenzayo. Izindlela zokuhlinzwa zamukelwa njengokunye kwezinketho eziyisisekelo ekwelapheni ukukhuluphala emazweni amaningi. Ngenxa yentuthuko yezobuchwepheshe, iningi lokuhlinzwa lenziwa ngendlela evaliwe (laparoscopic); lokhu kufushane isikhathi sokululama futhi kwehlisa ingozi yezinkinga.
Ukuhlinzwa Kwenzeka Kanjani?
Ukuhlinzwa kwe-tube stomach kuvame ukwenziwa ngendlela ye-laparoscopic okusho ukuthi kuyindlela encane yokuhlinzwa. Kwenziwa ukusikwa okuncane esiswini bese isisu sihlukaniswa ngamathuluzi akhethekile ezokwelapha abizwa nge-stapler bese ingxenye efiselekayo isuswa. Isisu sibunjwa kabusha sibe yithumbu elincane nelide. Ngenxa yokuncishiswa okukhulu kwesisu, umthamo wesisu uyancipha futhi ingxenye yamahomoni abhekele ukuzwa indlala (njenge-ghrelin) ayikhiqizwa; lokhu kusiza ekulawuleni indlala kanye nokuthatha amakhalori.
Inqubo yokululama ivamise ukuba sheshayo. Iningi labaguli bangakwazi ukuhamba ezinsukwini ezimbalwa emva kokuhlinzwa futhi babuyele empilweni yansuku zonke emasontweni ambalwa.
Ukwehla Kwesisindo Kanye Nokuthuthuka Kwezempilo Ngemva Kokuhlinzwa
Imiphumela emihle evame ukubonakala ngemva kokuhlinzwa kwe-tube stomach yile:
Ukulahlekelwa iningi lesisindo esingaphezulu onyakeni wokuqala
Ukuncipha noma ukuphela kwezifo ezihambisana nokukhuluphala ezifana nesifo sikashukela sohlobo lwesibili, umfutho wegazi ophezulu kanye ne-sleep apnea
Ukuthuthuka kwamafutha egazini afana ne-cholesterol
Ukuncipha kobuhlungu emalungeni amadolo nemilenze
Ukukhuphuka kwekhwalithi yokuphila kanye namandla okunyakaza
Ukwehla kwesisindo okuqhubekayo kutholakala ngezinga eliphezulu uma kuqhathaniswa nezindlela zokwelapha ezingezona ezokuhlinzwa. Izinga lokwehla kwesisindo lingahluka kumuntu nomuntu, kodwa izifundo eziningi zikhombisa ukuthi iningi labaguli abahlinziwe bangalahlekelwa u-50-80% wesisindo esingaphezulu onyakeni wokuqala.
Izingozi Nokuphepha Kokuhlinzwa
Njengazo zonke izindlela zokuhlinzwa, i-tube stomach nayo inezingozi ezithile. Izinga lezingqinamba liphansi kakhulu ngezindlela zokuhlinzwa zesimanje futhi iningi lazo lithambile noma liphakathi nendawo. Izinkinga ezinzima zivame ukuba yivelakancane, kodwa ukuhlolwa ngokuningiliziwe ngaphambi kokuhlinzwa kanye nokuqapha ithimba lochwepheshe kwandisa ukuphepha. Isikhathi sokuhlala esibhedlela ngemva kokuhlinzwa sivame ukuba sifushane; iningi labaguli lingakhululwa ezinsukwini ezingu-3-4.
Izinguquko Ekudleni Nasekuphileni
Ukuze ukwehla kwesisindo okuqhubekayo kuqhubeke ngemva kokuhlinzwa, kubalulekile ukulandela imithetho yokudla okunempilo. Ezinsukwini zokuqala kudliwa ukudla oketshezi, bese kuthi ngokuhamba kwesikhathi kudliwe okuxutshwe kube püre bese kuthi ekugcineni kudliwe ukudla okuqinile. Njengoba umthamo wesisu unciphile, umuntu uzizwa egcwele ngokushesha; kunconywa ukuthi kube nesikhathi sokulinda phakathi kokudla oketshezi nokudla okuqinile ukuze kuvikelwe isisu. Futhi, kungadingeka ukwesekwa kwephrotheni, amavithamini namaminerali. Kulesi sikhathi, ukuzivocavoca okuqondiswa udokotela kusiza ekwehliseni isisindo futhi kuvikele ukulahlekelwa kwemisipha kanye nokuxega kwesikhumba.
Mayelana Nezindleko Zokuhlinzwa Kwe-Tube Stomach
Izindleko zokuhlinzwa kwe-tube stomach ziyahlukahluka kuye ngolwazi lwethimba lohlinzo, amathuba esikhungo kanye nezinto ezizosebenziswa kwezokwelapha. Ukuze kutholakale inani lokugcina, ukuhlolwa kodokotela kuyadingeka. Ukuze uthole ulwazi oluningiliziwe, kungcono ukuxhumana nesikhungo sezempilo noma udokotela ochwepheshe.
Ekugcineni, ukuhlinzwa kwe-tube stomach kuyindlela yesimanje nephumelelayo ekuqedeni ukukhuluphala, okuhloswe ngayo ukukhuphula izinga lempilo nokunciphisa izinkinga ezihambisana nakho. Ngemuva kokuhlolwa okuphelele ngaphansi kokuqondiswa kwethimba lezempilo elichwepheshe, kunconywa ukuthi kwenziwe uhlelo olufanele izidingo zomuntu ngamunye.
Imibuzo Evame Ukubuzwa
1. Kuyini ukuhlinzwa kwe-tube stomach futhi kwenziwa kanjani?
Ukuhlinzwa kwe-tube stomach kuwuhlinzo olunciphisa umthamo wesisu ukuze umuntu adle kancane futhi wehlise isisindo. Ngokusebenzisa indlela ye-laparoscopic (evaliwe), ingxenye enkulu yesisu isuswa bese isisu sishiywa sibe yithumbu elincane.
2. Ubani ofanele ukuhlinzwa kwe-tube stomach?
Ngokuvamile abantu abanesisindo somzimba (BMI) esingu-40 nangaphezulu noma abangaphezu kuka-35 abanezinkinga ezihambisana nempilo bafanele ukuhlinzwa. Ukuze kuthathwe isinqumo esiqondile, ukuhlolwa kodokotela kuyadingeka.
3. Kulindeleke ukwehla kwesisindo okungakanani ngemva kokuhlinzwa kwe-tube stomach?
Nakuba umehluko ungavela kumuntu nomuntu, iningi labaguli lingalahlekelwa u-50-80% wesisindo sabo esingaphezulu onyakeni wokuqala. Izinga lokwehla kwesisindo lixhomeke ebudaleni, ubulili, isivinini sokushisa komzimba kanye nendlela yokuphila yomuntu.
4. Ingabe kunengozi yokubuyela esisindweni sangaphambili ngemva kokuhlinzwa?
Izinguquko ekuphileni nasekudleni kanye nokulandela izincomo zikadokotela kusiza ekugcineni isisindo. Uma imikhuba yokudla engalungile ibuyela, ukukhuluphala kungabuya futhi.
5. Iyini ingozi yezinkinga zokuhlinzwa kwe-tube stomach?
Ngenxa yezindlela ezithuthukile, amazinga ezinkinga aphansi; iningi labaguli liphila kahle ngemva kokuhlinzwa. Ezimweni ezingavamile, kungavela izinkinga ezifana nokuvuza, ukopha noma ukutheleleka.
6. Ingabe ukuhlinzwa kwe-tube stomach kuyasiza ezifweni ezifana nesifo sikashukela kanye nomfutho wegazi ophezulu?
Kubantu abaningi, ikakhulukazi abanesifo sikashukela sohlobo lwesibili noma umfutho wegazi ophezulu, izifo ezihambisana nokukhuluphala zingathuthuka kakhulu noma kwezinye izikhathi ziphele ngokuphelele ngemva kokuhlinzwa.
7. Ukudla ngemva kokuhlinzwa kufanele kube njani?
Isigaba sokuqala kudliwa ukudla oketshezi; ngokuhamba kwesikhathi kudliwe okuxovwe bese kuthi ekugcineni kudliwe ukudla okuqinile. Uhlelo lwakho lokudla lomuntu siqu luhlelwa udokotela kanye nodokotela wezokudla.
8. Ingabe ukuzivocavoca kuyadingeka ngemva kokuhlinzwa?
Ukuze kusekelwe ukwehla kwesisindo futhi kugwenywe ukulahleka kwemisipha, kunconywa ukuzivocavoca. Udokotela wakho uzokweluleka ngesikhathi esifanele kanye nohlobo lokuzivocavoca olufanele.
9. Ingabe umuzwa wokulamba uyancipha ngemva kokuhlinzwa?
Yebo, ngoba ingxenye enkulu yesisu ekhiqiza i-hormone yokulamba ebizwa nge-ghrelin iyasuswa, eziningi ezigulini umuzwa wokulamba uyancipha kakhulu.
10. Ukuhlinzwa kwesitsha sesisu kuthatha isikhathi esingakanani?
Ukusebenza kuvamise ukuthatha amahora angu-1-2, kodwa inqubo ingahluka ngokuya ngesimo sezempilo sesiguli kanye nesipiliyoni sikadokotela ohlinzayo.
11. Kungaba nini ukuphuma esibhedlela nokubuyela empilweni evamile?
Iningi lezifo liphumelela ukuphuma esibhedlela phakathi kwezinsuku ezi-3-4 ngemva kokuhlinzwa, futhi zingabuyela ezimpilweni zazo zansuku zonke phakathi namaviki ambalwa.
12. Ngabe kudingeka ukwesekwa ngamavithamini namaminerali ngemva kokuhlinzwa?
Imvamisa yebo. Udokotela wakho uzoncoma amavithamini namaminerali afanele izidingo zakho.
13. Imali yokuhlinzwa inqunywa ngani?
Izindleko zokuhlinzwa ziya ngokuthi kwenziwa kuphi, isipiliyoni sethimba lezempilo, ubuchwepheshe obusetshenzisiwe kanye nemishini yezokwelapha esetshenziswayo. Ulwazi oluqondile lutholakala ngokubonisana nodokotela.
14. Ingabe ukuhlinzwa kwesitsha sesisu kuyisixazululo esihlala njalo?
Ukwehla kwesisindo okutholakala ngokuhlinzwa kuvamise ukuba njalo, kodwa ukuqhubeka kwempumelelo kudinga ukuqhubeka kwemikhuba yokuphila enempilo.
15. Ingabe kunezinkinga ezifana nokulahleka kwezinwele noma ukuxega kwesikhumba ngemva kokuhlinzwa?
Uma ukwehla kwesisindo kwenzeka ngokushesha, kwesinye isikhathi kungaba nokulahleka kwezinwele okwesikhashana noma ukuxega kwesikhumba. Ukudla okunempilo nokuzivocavoca kunomthelela omuhle kulesi sigaba.
Imithombo
Inhlangano Yezempilo Yomhlaba (WHO): Imininingwane nge-Obesity kanye nokukhuluphala ngokweqile
Inhlangano YaseMelika Yezokwelapha Nokuhlinzwa Kwe-Metabolic (ASMBS)
Ucwaningo LwaseSweden Lwabaguli Abakhuluphele (SOS) – New England Journal of Medicine
Izikhungo Zokulawulwa Nokuvimbela Izifo (CDC): Imininingwane Yabantu Abakhuluphele
The Lancet, "Ukusabalala komhlaba wonke, kwesifunda, nezwe kokukhuluphala ngokweqile", 2022
Izikhungo Zikazwelonke Zempilo (NIH): Imihlahlandlela Yokuhlinzwa Kwe-Bariatric