Sawubona futhi wamukelekile, msebenzisi we-inthanethi, kubhulogi yezempilo yokugaya ukudla lapho siya khona ngqo ekuhlaziyweni kwenkinga ye-inguinal fat hernia, eyaziwa nangokuthi i-inguinal hernia, uhlobo lwe-hernia oluvela lapho izicubu zamafutha ezingaphambi kwe-peritoneal ziphuma endaweni ebuthakathaka emisipheni yesisu.
Lokhu kungabangela ukungakhululeki nobuhlungu, futhi ezimweni ezimbi kakhulu kungadinga ukwelashwa ngokuhlinzwa noma ngokwelashwa. Kulesi sihloko, sizohlola izimbangela, izimpawu (ezibhalwe ngabantu, zabantu) , kanye nezinketho zokwelapha ama-hernia e-inguinal, sigxile ohlotsheni oluthile olwaziwa ngokuthi i-hernia ye-inguinal enamafutha.
I-Hernia Enamafutha E-Inguinal
I-hernia enamafutha inguinal yisimo esivamile esenzeka lapho izicubu ezinamafutha ziphuma endaweni ebuthakathaka odongeni lwesisu, ngokuvamile endaweni ye-groin. Lesi simo singadala ukungakhululeki, futhi kwezinye izimo, izinkinga uma singelashwa kahle futhi ngokushesha.
Kubalulekile ukuthi abathandi bezempilo kanye nomphakathi jikelele baqonde izimpawu kanye nokwelashwa kwama-hernias e-inguinal ukuze kuthuthukiswe ukutholakala kusenesikhathi kanye nenhlalakahle. Ukwaziswa kungathuthukisa ikhwalithi yokuphila futhi kuvimbele izinkinga ezinkulu esikhathini esizayo.
Isingeniso
Uma kukhulunywa ngokuthola intengo engcono kakhulu kanye nohlu oluphelele lwezinsizakalo ze-hernia ye-inguinal, kubalulekile ukuqonda ukubaluleka kokufuna ukunakekelwa kwezokwelapha okufanele kanye nokwelashwa.
I-hernia ye-inguinal iyisimo esivamile sezokwelapha esihilela ukuphuma kwezicubu endaweni ebuthakathaka emisipheni yesisu, okuvame ukuholela ekuvuvukeni noma ekuvuvukeni okubonakalayo. Kuyimbangela yokungakhululeki okukhulu kubantu abaningi futhi, uma ingelashwa, ingaholela ngisho nasezinkingeni ezinkulu.
Kumhlahlandlela olandelayo ophelele, sizohlola izimbangela, izici eziyingozi, izimpawu, ukuxilongwa, kanye nezinketho zokwelapha ama-hernias e-inguinal, sicacise ukubaluleka kokubhekana nalesi simo ngosizo lochwepheshe bezokwelapha kanye nezinsizakalo zezempilo zomphakathi noma zangasese ezitholakalayo.
Thola ukukhethwa okubanzi kwemikhiqizo namamodeli ngokuthunyelwa kwamahhala ngamapulatifomu athembekile, bese usebenzisa leli thuba ukubhekana nenkinga ye-hernia ye-inguinal ngokushesha nangokuthembekile.
Kungakhathaliseki ukuthi ufuna ulwazi ngokuzikhandla noma njengamanje ubhekene nezinselele ze-hernia ye-inguinal, lo mhlahlandlela uhlose ukukuhlomisa ngolwazi nezinsiza ezidingekayo ukuze wenze izinqumo ezinolwazi mayelana nokunakekelwa kwempilo yakho.
Namuhla, njengoba siqaphela kakhulu izimo zezokwelapha ezifana ne-inguinal hernias, kubalulekile ukugqamisa izingozi nezinkinga ezingaba khona ezihlobene nalesi simo, kuyilapho sigcizelela umthelela omuhle wokungenelela okufika ngesikhathi nangokuphumelelayo.
Ngokuqonda izimbangela nezimpawu, abantu bangathatha izinyathelo zokuthatha isinyathelo ukuze babhekane nezinkinga zabo zezempilo futhi bahlole izinketho zokwelapha ezitholakalayo ngesiqondiso esivela kochwepheshe bezempilo.
Lo mhlahlandlela uwumthombo owusizo wokukhulisa ulwazi ngezici ezahlukene ze-hernias ye-inguinal, ohlanganisa ulwazi olubalulekile olunika abantu amandla okubeka phambili inhlalakahle yabo futhi bafune izixazululo ezifanele kakhulu zezidingo zabo ezithile zezempilo.
Izimbangela
Izimbangela ze-inguinal hernias zivame ukuhlotshaniswa nokuhlanganiswa kokucindezela okukhulu esiswini kanye nephuzu elibuthakathaka elikhona odongeni lwesisu.
Lokhu kungaba ngenxa yezici ezahlukahlukene, njengokuphakamisa izinto ezisindayo, ukukhwehlela okuqhubekayo, ukuzikhandla lapho ukhipha indle noma uchama , noma ngisho nobuthakathaka obungokwemvelo bodonga lwesisu.
Kwezinye izimo, ubuthakathaka bezicubu zesisu kanye nokukhula kwe-hernia ye-inguinal kungabangelwa yizici ezithile eziyingozi, njengobudala, izimo zokuzalwa, noma umlando wokuhlinzwa kwesisu.
Ukuxhumana okuyinkimbinkimbi kwalezi zici kungabangela ukuthi izicubu, ngokuvamile ingxenye yamathumbu, ziphume endaweni ebuthaka, okuholela ekwakhekeni kwe-hernia ye-inguinal.
Ngaphezu kwalokho, izimbangela ze-inguinal hernias zingaba nezinhlobo eziningi, futhi azibandakanyi nje ukuzikhandla ngokomzimba kanye nobuthakathaka bemisipha, kodwa futhi nezinye izinkinga zempilo eziyisisekelo ezifaka isandla ekuthuthukisweni kwalesi simo.
Kubalulekile ukuqaphela indima yokuphila kokungahlali phansi , ukukhuluphala ngokweqile, isifo samaphaphu esingamahlalakhona (i-COPD), kanye nezimo ezibangela ukunqwabelana koketshezi esiswini (i-ascites) njengezinto ezingase zandise ingozi yokuthola i-hernia ye-inguinal.
Ngokubhekana nalezi zimbangela kanye nezici eziyingozi, abantu bangathatha izinyathelo zokunciphisa ingcindezi engaba khona emisipheni yabo yesisu futhi banciphise amathuba okuba ne-hernia ye-inguinal fat preperitoneal.
Izici zobungozi
Kunezici eziningana ezingabangela ukuthi umuntu athambekele ekuhlushweni yi-inguinal hernias. Isibonelo, amadoda anamathuba amaningi okuthola i-inguinal hernias kunabesifazane, okubangelwa ukwakheka kwemvelo komzimba wabesilisa, ikakhulukazi ukuba khona komsele we-inguinal.
Ngakolunye uhlangothi, ukuguga kuyisici esibalulekile esiyingozi , njengoba ubuthakathaka obuqhubekayo bezicubu zesisu nemisipha ngokuhamba kwesikhathi kwandisa amathuba okuthuthukisa i-hernia ye-inguinal.
Ngaphezu kwalokho, izici ezifana nomlando womndeni we-inguinal hernias, ukuzalwa ngaphambi kwesikhathi kanye nesisindo esiphansi sokuzalwa , kanye nezimo ezibangela ukucindezeleka okukhulu esiswini, njengokuqunjelwa okungapheli, kungandisa ingozi yokuthola i-inguinal hernia.
Ngokuqonda nokubhekana nalezi zici eziyingozi, abantu bangenza izinqumo ezinolwazi ukuze banciphise ukuthambekela kwabo kulesi simo.
Izimpawu
Ukuvezwa kwe- hernia ye-inguinal kuvame ukubonakala ngezimpawu eziningana ezihlukile. Isibonakaliso esivelele se-hernia ye-inguinal ukuba khona kokuvuvukala noma ukuvuvukala endaweni ye-groin noma i-inguinal canal.
Lokhu kuvuvukala okuphawulekayo kungase kubonakale kakhulu ngesikhathi semisebenzi ekhulisa ingcindezi yangaphakathi kwesisu, njengokuma, ukukhwehlela, noma ukuphakamisa izinto ezisindayo , futhi kungase kuhambisane nomuzwa wokusinda noma ukungakhululeki endaweni ethintekile.
Kwezinye izimo, abantu bangase babe nomuzwa obuhlungu noma oshisayo embotsheni , kanye nomuzwa wokuhudula noma wokugcwala okungahambisani nokuvuvuka okubonakalayo.
Kubalulekile ukuqaphela lezi zimpawu nokufuna ukuhlolwa kwezokwelapha okusheshayo ukuqinisekisa ukuxilongwa okunembile kanye nokwelashwa okufanele nokufika ngesikhathi kwalesi simo.
Ngaphezu kwalokho, izimpawu ezithile, njengobuhlungu bendawo noma ukungakhululeki embotsheni, ikakhulukazi lapho ugoba, ukhwehlela, noma wenza imisebenzi yomzimba, kungase kube uphawu lwe-hernia ye-inguinal.
Ukuba khona kwezinkinga zokuhamba kwamathumbu, njengokuqunjelwa noma ukungakhululeki ngesikhathi sokuzikhulula, kanye nomuzwa wokucindezeleka esiswini, kuyizimpawu ezengeziwe ezingase zibonise ukuba khona kwe-hernia ye-inguinal.
Kwezinye izimo, ama-hernia e-inguinal angaholela esimweni esaziwa ngokuthi ukuklinywa , lapho izicubu eziphumayo zibanjwa khona futhi igazi lazo liyaphazamiseka, okubangela ubuhlungu obukhulu, isicanucanu nokuhlanza.
Ukuqaphela lezi zimpawu nokufuna usizo lwezokwelapha lwendawo, ngokwendawo okuyo emhlabeni wonke , ukunakekelwa ngesikhathi kubalulekile ukuvimbela ukuqhubeka kwe-hernia kanye nokuqala kwezinkinga ezingaba yingozi.
Iqhubu endaweni yesisu
Uphawu olubalulekile lwe-hernia ye-inguinal ukuba khona kweqhubu endaweni ye-groin, okungase kusuke esiswini esingezansi kuye e-groin. Lokhu kuqhubu kuvela ezicutshini ezingaphansi, njengengxenye yamathumbu , eziphuma endaweni ebuthaka yodonga lwesisu.
Kubalulekile ukuqaphela ukuthi ukuvuvukala kungase kubonakale kakhulu ngesikhathi semisebenzi ekhulisa ukucindezeleka kwesisu futhi kungase kuhlotshaniswe namazinga ahlukahlukene okungakhululeki noma umuzwa wokusinda.
Nakuba abanye abantu bengase babone ukuvuvuka okubonakalayo, abanye bangase babe nomuzwa wokugcwala noma ukucindezeleka endaweni yesisu ngaphandle kokubonakala okucacile.
Kungakhathaliseki ukuthi ivele kanjani, ukuba khona kweqhubu endaweni yesisu kufanele kuholele ekuhlolweni okuphelele kwezokwelapha ukuze kutholakale indlela efanele yokwelashwa kwayo.
Kwezinye izimo, ukuqubuka okuhlobene ne-hernia ye-inguinal kungashintshwa, okusho ukuthi kungaphonswa kancane esiswini, noma kunganyamalala lapho umuntu elele ngomhlane.
Kodwa-ke, kubalulekile ukuqapha lapho uzama ukuphatha iqhubu, njengoba kubalulekile ukuthi uchwepheshe wezempilo ahlole isimo ukuze avimbele ingozi yezinkinga.
I-hernia evalelwe noma engabuyiselwa emuva, ebonakala ngokungakwazi ukuhoxisa iqhubu, ingabangela izinkinga ezinkulu futhi idinga ukunakekelwa okuphuthumayo kwezokwelapha.
Ukuqonda uhlobo lokuvuvukala nokuqaphela izimpawu ezihambisana nakho kubalulekile ekubhekaneni ngempumelelo ne-hernia ye-inguinal nokuvimbela imiphumela yayo emibi.
Ubuhlungu noma ukungaphatheki kahle
Ubuhlungu noma ukungakhululeki endaweni yesisu kuyisibonakaliso esibalulekile esingahambisana ne-hernia ye-inguinal. Lokhu kungakhululeki kungahluka ngobukhulu futhi kube kubi kakhulu ngezenzo ezithile, njengokuphakamisa izinto ezisindayo, ukuzikhandla, noma ukuma isikhathi eside.
Kungabonakala futhi njengomuzwa obuthakathaka, obuhlungu noma ocindezelayo embotsheni, ikakhulukazi ngesikhathi semisebenzi ekhulisa ukucindezeleka kwangaphakathi kwesisu. Kwezinye izimo, ubuhlungu bungavela embotsheni kuya e-pubis noma e-scrotum , futhi bungahlotshaniswa nezinye izimpawu, njengokuzwa ukushisa noma ukusinda.
Ukuqonda uhlobo oluhlanganisiwe lobuhlungu kanye nobudlelwano balo nemisebenzi yomzimba noma ukuba khona kweqhubu kubalulekile ekuhlukaniseni nasekubhekaneni nemiphumela ethile ye-hernia ye-inguinal.
Ukufuna iseluleko sezokwelapha kanye nokuhlolwa kungasiza ekuphatheni ngempumelelo ukungakhululeki okuhambisana nakho futhi kwakheke uhlelo lokwelashwa olufanele oluhambisana nezidingo zomuntu ngamunye.
Ukuxilongwa
Ukuxilongwa kwe-hernia ye-inguinal kuvame ukuhilela ukuhlolwa okuphelele komlando wezokwelapha womuntu, ukuhlolwa ngokomzimba ngokucophelela, futhi, kwezinye izimo, ukuhlolwa kokuxilonga ukuqinisekisa ukuba khona nokuhlola izici ze-hernia.
Ngesikhathi sokuhlolwa ngokomzimba, uchwepheshe wezempilo angahlola ngokucophelela indawo ethintekile, ikakhulukazi indawo ye-inguinal , ukuthola noma yiziphi izimpawu ezibonakalayo noma ezizwakalayo ze-hernia, njengeqhubu noma ukuvuvukala.
Ngaphezu kwalokho, umuntu angacelwa ukuba enze imisebenzi ethile, njengokukhwehlela noma ukuzikhandla, ukuze uchwepheshe wezempilo akwazi ukubona ngokucacile ukuphuma kwe-hernia.
Ukuhlolwa kwezithombe zokuxilonga, njenge -ultrasound noma i-magnetic resonance imaging (MRI), kunganconywa ukuze kunikezwe ulwazi oluningiliziwe mayelana nosayizi nendawo ye-hernia, ikakhulukazi uma ukuxilongwa kungasekelwe ekuhlolweni ngokomzimba kuphela.
Ngaphezu kwalokho, ezimweni lapho ukuxilongwa kuhambisana nezimpawu ezingavamile noma ingozi engaba khona yezinkinga, kungadingeka ukwenza izivivinyo ezengeziwe, njenge- barium swallow noma i-upper endoscopy , ukuhlola ukubandakanyeka kwezinye izakhiwo nokukhipha ezinye izimbangela zezimpawu.
Umphumela walezi zindlela zokuxilonga uvumela umhlinzeki wezempilo ukuthi athole ukuxilongwa okunembile, anqume uhlobo lwe-hernia ye-inguinal, futhi akhe uhlelo lokwelapha olusebenzayo oluhambisana nezidingo zezempilo zomuntu kanye nokucatshangelwa kwakhe.
Ukwelapha
Ukwelashwa kwe-hernia ye-inguinal kuvame ukuhilela ukubhekana nendlela eyisisekelo yokuphuma kwe-hernia, futhi kungase kuhilele kokubili izinyathelo zokulondoloza kanye nokungenelela kokuhlinzwa , kuye ngohlobo kanye nobunzima be-hernia.
Ukwelashwa okulondolozayo kunganconywa kuma-hernia angenazimpawu noma angabonisi izimpawu eziningi, okungase kuhlanganise nokwenza izinguquko zendlela yokuphila njengokugwema ukuphakamisa izinto ezisindayo, ukulawula ukuqunjelwa, nokugqoka izingubo zokusekela ukuze kuncishiswe ukungakhululeki nokuvimbela ukuqhubeka kwe-hernia.
Kodwa-ke, kubalulekile ukuqaphela ukuthi yize izinyathelo zokulondoloza zingasiza ekunciphiseni izimpawu ezithile, aziyilungisi ngempumelelo i-hernia, futhi ukwelashwa okuqondile kwe-hernia ye-inguinal kuvame ukuhilela ukulungiswa kokuhlinzwa ukuze kuqiniswe udonga lwesisu olubuthakathaka futhi kuvinjelwe ukuphuma kwezicubu.
Ukungenelela kokuhlinzwa kwe-inguinal hernias kungenziwa kusetshenziswa izindlela ezahlukene, njengokuhlinzwa okuvulekile kanye namasu e-laparoscopic , anikeza izinzuzo ezihlukile futhi angakhethwa ngokusekelwe esimweni sempilo yomuntu kanye nezici ze-hernia.
- El ukwelashwa okuvulekile kokuhlinzwa Ukulungiswa kwe-hernia kuhilela ukwenza i-incision eduze kwendawo ye-hernia bese kusunduzwa izicubu ezivelelayo zibuyele esiswini, kulandelwe ukufakwa kwe-mesh yokuhlinzwa ukuze kuqiniswe indawo ebuthaka.
- Ngakolunye uhlangothi, ukulungiswa kwe-laparoscopic Ukulungiswa kwe-Hernia kuyindlela engangenisi kakhulu esebenzisa ukusikwa okuncane kanye namathuluzi akhethekile ukuze kube lula ukubekwa kabusha kwezicubu ze-herniated kanye nokubekwa kwe-mesh ngengozi encishisiwe yezinkinga kanye nesikhathi esifushane sokululama.
Kungakhathaliseki ukuthi iyiphi indlela ethile, umgomo oyinhloko wokulungisa i-hernia yokuhlinzwa ukuqinisa ngempumelelo indawo ebuthaka yodonga lwesisu, ukunciphisa ingozi ye-hernia ephindaphindayo, nokubuyisela induduzo nokusebenza komuntu.
Ngokubhekana nama-hernias ngohlelo lokwelapha oluphelele nolwenzelwe umuntu ngamunye, abantu banganciphisa ingozi yezinkinga, banciphise izimpawu ezihambisanayo, futhi bakhuthaze ukululama okusheshayo nokuqhubekayo okusekela inhlalakahle yabo yesikhathi eside kanye nekhwalithi yokuphila.
Ukulungiswa kokuhlinzwa
Ukulungiswa kwe-hernia ye-inguinal ngokuhlinzwa kuyisici esiyisisekelo sokwelashwa, okuhloswe ngaso ukubhekana nobuthakathaka obuyisisekelo bodonga lwesisu nokuvimbela ukuphuma kwezicubu.
Kungaba ukulungiswa kwe-hernia evulekile, okwenziwa ngokusika okukodwa okukhulu eduze kwendawo ye-hernia , noma ukulungiswa kwe-hernia nge-laparoscopic, okubonakala ngokusetshenziswa kwezimbobo eziningana ezincane kanye nosizo lwe-laparoscope, ithubhu elincane elinekhamera enamathiselwe ukuqondisa inqubo yokuhlinzwa.
Ngesikhathi sokulungiswa kokuhlinzwa, izicubu eziphumayo ziyabekwa kabusha, bese kubekwa i-mesh yokwenziwa phezu kwendawo ebuthaka ukuze kunikezwe ukwesekwa okwengeziwe nokuvimbela ukuphinda kwe-hernia.
Ukukhethwa kwendlela ethile yokuhlinzwa kunqunywa ngokusekelwe esimweni sempilo yomuntu, izici ze-hernia, kanye nobuchwepheshe bukadokotela ohlinzayo, ngenhloso efanayo yokubhekana ngempumelelo ne-hernia nokukhuthaza ukululama okwanelisayo nokuqhubekayo.
Ngaphezu kwezici zobuchwepheshe zokungenelela kokuhlinzwa, ukulungiselela kanye nokunakekelwa ngemva kokuhlinzwa okuhlobene nokulungiswa kwe-hernia kuyizinto ezibalulekile ezifaka isandla empumelelweni iyonke kanye nomphumela wokungenelela.
Lokhu kuhlanganisa ukuhlolwa okuphelele kwangaphambi kokuhlinzwa ukuze kuthuthukiswe isimo sempilo yomuntu, ukuqapha noma yiziphi izimo zezokwelapha eziyisisekelo, kanye nokusebenzisa izinyathelo zokunciphisa ingozi yezinkinga zokuhlinzwa.
Ngaphezu kwalokho, ukunakekelwa ngemva kokuhlinzwa kuhilela ukunamathela eziqondisweni ezithile zokunakekelwa kwenxeba, ukuguqulwa komsebenzi, kanye nokuqapha noma yiziphi izimpawu ezingaba khona zezinkinga ukuqinisekisa ukululama okubushelelezi nokungenazinkinga ngemva kokulungiswa kokuhlinzwa kwe-hernia ye-inguinal.
Ukunikezwa kwemithi yokulawula ubuhlungu
Kwezinye izimo, ukuphatha ubuhlungu kanye nokungakhululeki okuhambisana ne-hernia ye-inguinal, ikakhulukazi esikhathini sangaphambi noma ngemva kokuhlinzwa, kungase kuhilele ukusetshenziswa kwemithi efanele yobuhlungu enqunywe futhi iqashwe ochwepheshe bezempilo ezibhedlela zomphakathi noma ezizimele noma emitholampilo yezempilo ukuze kuthuthukiswe ukuhamba ngesikhathi sokululama kwezicubu.
Isiphetho
Endabeni yokubeka isikhathi sokugcina ohlwini lwezinto eziza kuqala, i-hernia enamafutha e-inguinal yisimo, yize singase sibonakale sincane, esidinga ukunakwa nokunakekelwa . Ukuqonda izimpawu zayo, izimbangela, kanye nezinketho zokwelapha kubalulekile ekugcineni impilo enhle nokuvimbela izinkinga.
Uma usola ukuthi wena noma othile oseduze nawe kungenzeka ukuthi unalesi simo, ungangabazi ukubonisana nochwepheshe wezempilo. Yabelana ngalesi sihloko ezinkundleni zakho zokuxhumana ukuze usize ekuqwashiseni ngale ndaba ebalulekile futhi unikele empilweni yomphakathi wakho.
UDkt. Jorge Delgado, Udokotela Ohlinzayo. I-Fatty Inguinal Hernia.