Ostomie kɔrɔtɔlenw: Stoma Ischemique nɛrɛma walima bulama, Prolapse jugumanba, ani Ileostomie dehydratation high-output¶

Banakɔtaa (colostomie, ileostomie, walima urostomie) bɛ na ni jiribolo kɛnɛman walima banakɔtaa laban ye kɔnɔbara kogo fɛ walasa nɔgɔ ka se ka lankolonya ka don kɛnɛma foroko kɔnɔ. Ikomi tiɲɛ na, stoma ye banakɔtaa kɔnɔna ɲɛgɛnɛsira nɔgɔlen ye min jiginna a kɔnɔna na ka taa kɛnɛma, a farikolo kɔkanna lakanani tɛ a la, wa a bɛ a jigi da pewu mesenteric arteries nafamaw kan minnu bɛ siri ka tɛmɛ tunnel sirilen dɔ fɛ kɔnɔbara fasa kɔnɔ. Ni stoma kɛra bulama jɛman ye, bulama dibiman walima nɛrɛmuguma, ka funu fo ka a bugɔ ni plastiki wafer bololanɛgɛ ye, ka teleskɔpi bɔ kɔnɔbara la ni dimi juguman ye, walima ka ji jilama min ka ca ni mililitiri 1500 fo 2000 ye tile kɔnɔ, aw bɛ aw ka sigida wele kɔrɔtɔko nimɔrɔw walima ka opereli kɔrɔtɔlen dɔ ɲini joona. Walasa ka kɔnɔbara ni jiko kɔrɔtɔko minnu bɛ tali kɛ ɲɔgɔn na, aw ye sɛbɛn ɲɛ banakɔtaa datuguli, kirinni min bɛ sɔgɔsɔgɔ, ani kɔnɔboli, . ischemie acute mésentérique ani banakɔtaa sɔgɔsɔgɔninjɛ, ani dumuni baga, kɔnɔboli jugumanba, ani farikolojidɛsɛ.

Ni aw bɛ stoma kulɛri ni a funteni sɛgɛsɛgɛcogo dɔn, waati min na aw bɛ farikolo barikalan wafer tigɛ joona, ka tabali sukaro jalen granulated kɛ cogo min na walasa ka stoma prolapsed edematous dɔgɔya ni osmosis ye ka a to a dalen bɛ a la, ani mun na ji jɛlen min bɛ jolidɛsɛ juguya juguya ileostomie min bɛ bɔ kosɛbɛ, o bɛ se ka banakɔtaa ni banabagatɔ ka ɲɛnamaya bɛɛ kisi.

Aw bɛ o kɛ sisan¶

1. Aw bɛ sɔgɔsɔgɔninjɛ kulɛri lajɛ joona ni aw ye a bɔ walima ka a lajɛ foroko jɛlen dɔ kɔnɔ. Stoma kɛnɛman ye sogo bilenman jɛman ye walima roso-pinki juguman, a ɲiginnen don, a bɛ manamana, ani a ka suma (a ni aw ɲɛda kɔnɔna bɛ kelen ye). Ni sɔgɔsɔgɔninjɛ kɛra bilen jɛman ye, bulu nɛrɛmuguma, prune dibiman, bulama, walima nɛrɛmuguma jɛman, walima ni a bɛ nɛnɛ ani ka ja/a bɛ sɔgɔsɔgɔ ka se bolokɔni gansan ma, a joli siraw bɛ tigɛ (stoma ischemia walima necrosis). Aw bɛ aw ka sigida kɔrɔtɔko nimɔrɔ wele (911 Ameriki/Kanada, 112 UE, 999 Angletɛri) walasa ka opereli jateminɛ teliya la.
2. Ni stoma bɛ funu walima ka telescope kɛ kɛnɛma (prolapse), aw bɛ wafer gɛlɛn bɔ walima ka barika da tigɛ ka bonya joona. Aw kana wafer convex gɛlɛn, plastique locking flange, walima fari barika tigɛlen sirilen to abada stoma fununen walima prolapse lamini na. Plastiki bololanɛgɛ gɛlɛn bɛ kɛ i n’a fɔ tourniquet min bɛ banakɔtaa da lamini, ka jolisiraw ni joli siraw sɔgɔ miniti damadɔ kɔnɔ. Aw bɛ wafer bɛɛ bɔ kɔnɔbara la (walima aw bɛ a wuli ka taa foroko belebeleba dɔ la min bɛ se ka ji bɔ a yɔrɔ kelen na, ni dingɛ tigɛlen don ka tɛmɛ milimɛtɛrɛ 3 fo 6 kan ka tɛmɛ stoma fununen kan).
3. Ni sɔgɔsɔgɔninjɛ min ma gɛlɛya, min ɲɛ ye bulama ye, aw bɛ banabagatɔ bila ka a da a kɔ kan ka a da ni tabali sukaro jalen ye min falen don sɔgɔsɔgɔninjɛ la. Ni banakɔtaa yɔrɔ jan dɔ bɔra ka bɔ sɔgɔsɔgɔninjɛ la, ni dimi juguman tɛ a la walima ni a ɲɛ ye nɛrɛ ye, aw bɛ banabagatɔ da ka a gɛnɛgɛnɛw kɔrɔta dɔɔni walasa ka kɔnɔbara kɔnɔna tansiyɔn jigin, aw bɛ finimugu nɛnɛman dɔ da walima jisumamugu min sirilen don finimugu la dɔɔni dɔɔni foroko kan miniti 10 kɔnɔ, walima ka sukaro finman jalen gansan (tabali sukaro)** taji **½ fo 1 kɛ ka a ɲɛsin ɲɛgɛnɛsira ɲiginnen ma min bɛ kɛnɛ kan miniti 15 fo miniti 20. Sukaro min falen don, o bɛ ji sama ka bɔ banakɔtaa kogo fununen na ni osmosis ye (Desai osmotic reduction maneuver), ka stoma dɔgɔya walasa a ka teli ka segin ka don kɔnɔ a yɛrɛ ma.
4. Ni ileostomi bɔli tɛmɛna mililitiri 1500 fo 2000 kan (litiri 1,5 fo litiri 2) lɛri 24 kɔnɔ, aw bɛ ji gansan, te, walima jiriden duman min dabila ka sɔrɔ ka wuli joona ka taa ji la min bɛ wele ko Oral Rehydration Solution (ORS). Banabagatɔ min kɔnɔbara fitini walima ileostomie ka surun, aw bɛ ji gansan min ni soda sukaro ye tiɲɛ na a bɛ soja ni ji caman bɔ ka don ostomi foroko kɔnɔ, ka hypovolémie shock ni sugunɛbaralabana teliya. Sip Diɲɛ kɛnɛyatɔn (OMS) ka ORS min ka osmolarity dɔgɔyalen don walima aw bɛ so kɔnɔ St. Mark’s electrolyte solution (kɔgɔ, bikaribonati ani sukaro hakɛ tigitigi bɛ min na ji litiri 1 kɔnɔ) min.
5. Aw bɛ a lajɛ ni kɔnɔbara basigilen don pewu ka fara kɔnɔdimi ni fɔɔnɔ kan. Ni ileostomi ma ji walima gazi zeru bɔ fo lɛri lɛrɛ 4 fo lɛri 6 (walima ni kolotuguda tɛ foyi bɔ fo lɛri 24 fo lɛri 48 kɔnɔbara basigilen jugumanba kɛrɛfɛ, kɔnɔbara sirilen fununen, kɔnɔboli, walima fɔɔnɔ kasa nɔgɔlen), aw bɛ wafer bɔ, aw bɛ a kɛ banabagatɔ bɛ lafiɲɛ jisuma na walima ni a bɛ a gɛnɛgɛnɛ ni a disi la, ka taa kɛnɛyaso la. Aw kana kɔnɔbolifura ta abada ni aw bɛ siga la ko a bɛ kɔnɔboli datugu.
6. Aw bɛ joli bɔli kunbɛn ni tansiyɔn nɔgɔman ye, walima aw bɛ taa dɔgɔtɔrɔso la walasa ka kɔnɔbara basigilen joli bɔ. Joli bilenman jɛman dɔ bɔli ni aw bɛ kɔnɔbara ko, o tɛ kojugu ye nka ni joli bɛ bɔ walima ni a bɛ foroko fa joona (kɛrɛnkɛrɛnnenya la banabagatɔw la minnu bɛ ni sugunɛbilenni ye ani parastomal varices), aw bɛ nɛnɛmadalan walima gazi min sutura oksimetazɔlini nugulafura la, aw bɛ o digi ka ɲɛ joli bɔyɔrɔ la ani ka kɔrɔtɔko baarakɛlaw wele.

Desizɔn jiri : ostomie kɔrɔtɔko sɛgɛsɛgɛli¶

flowchart TD
    A["Ostomie Kɔrɔtɔko (Ileostomie, Colostomie, walima Urostomie) ."] --> B{"Aw bɛ stoma kulɛri ni a cogoya sɛgɛsɛgɛ"}
    B -->|"Dugukolonɔn, bulama dibiman, slate gris, nɛnɛ walima jalen"| C["STOMA ISCHEMIE ACUTE / NECROSE: Aw bɛ wafer sirilen bɔ joona"]
    C --> D["Aw bɛ banabagatɔ ka NPO mara (foyi tɛ da la) ani ka EMS wele walasa ka opereli sɛgɛsɛgɛli kɛ joona"]
    B -->|"Stoma telescope ka bɔ santimɛtɛrɛ 5 fo 20 (Prolapse) ."| E{"Banakɔtaa min bɔra a la, o ye pinɛ ye/a bɛ sumaya walima a bɛ dibi/dimi?"}
    E -->|"Kɔnɔnatumu dibiman/nɛrɛma, kɔnɔdimi gɛlɛn, walima dimi jugumanba"| C
    E -->|"Sogo bilenman/pinki, a ka nɔgɔn, wa dimi tɛ a la"| F["Aw bɛ wafer/flange sirilen bɔ o yɔrɔnin bɛɛ walasa ring kana se ka basi sɔgɔ"]
    F --> G["Aw bɛ banabagatɔ da a kɔ kan + ka tabali sukaro finman jalen kɛ stoma kan miniti 20 kɔnɔ"]
    B -->|"Ji bɔli > mililitiri 1500 ka se mililitiri 2000 ma tile kɔnɔ + sugunɛ ɲɛnamini/dibi"| H["STOMA JIGISƐN MIN BƐ SƆRƆ kosɛbɛ: Aw bɛ ji gansan ni minfɛn sukaromaw dabila"]
    H --> I["Aw bɛ St. Mark’s walima OMS ka da kɔnɔ farikolojidɛsɛ fura min; aw bɛ taa ER la ni ɲɛnamini, kirinni, walima oliguric"]
    B -->|"Zero bɔli fo lɛri 4 fo lɛri 6 (ileostomie) + kirinni/fɔɔnɔ"| J["STOMA OBSTRUCTION ACUTE: Aw bɛ wafer (wafer) kɛ min ka bon, aw kana foyi min ni fɔɔnɔ bɛ aw la, aw kana kɔnɔboli furaw kɛ"]
    J --> K["Aw bɛ a lajɛ ka aw ko ni funteni ye ani ka aw jɔ gɛnɛgɛnɛ na ka se disi ma; aw bɛ taa ER la walasa ka katetɛri decompression nɔgɔman kɛ"]

Stoma kulɛri ɲɛminɛbaga : ka ɲɛgɛnɛsira kɛnɛmanw ni joli siraw sɔgɔsɔgɔninjɛ ni jolilabanaw faranfasi¶

Sabula banakɔtaa ɲɛgɛnɛsiralabanaw tɛ ni fari kɛnɛma keratini ye (stratum corneum), a ka kapilɛri dilan bɛ ye ɲɛkisɛ fɛ. Stoma kulɛri lajɛ ye fɛɛrɛ teliyalen ye min bɛ se ka mesenteric joli bolicogo jateminɛ.

Mun na kɔnɔbara basigilen bɛ kɛ¶

Ni operelikɛla ye ileostomie walima colostomie da, u bɛ banakɔtaa jiribolo walima a laban dɔ lajɛ ka fara a joli-sira-funu-yɔrɔ kan min bɛ i n’a fɔ ventilateur, ka a sama ka tɛmɛ da dɔ fɛ min dabɔra opereli fɛ (trephine) kɔnɔbara basigilen farikolo, fascia ani fari la. Joli min bɛ kɛ joli sira fɛ ka taa stoma la, o bɛ se ka dɛsɛ kun naani de kosɔn:

1. Opereli kɔfɛ mesenteriki tansiyɔn walima joli siraw sɔgɔsɔgɔli daminɛ na (lɛrɛ 24 fo lɛri 72 fɔlɔ opereli kɔfɛ): Ni mesenteri kurulen don kojugu, ka a firifiri (volvulus), walima a bɛ digidigi opereli kɔfɛ kɔnɔbara kogo fununi fɛ, walima ni tansiyɔn dɔgɔyara (hypotension) ani joli-sira-funu-fura bɛ kɔngɔ bila splanchnic arteries la, stoma yɔrɔjan kuncɛ bɛ perfusion bɔnɛ.
2. Masina sɔgɔli ni wafer da wulilen fitinin ye: Sɔgɔsɔgɔninjɛ bɛ funu a yɛrɛ la dɔgɔkun 6 fo dɔgɔkun 8 fɔlɔ kɔnɔ opereli kɔfɛ, wa a bɛ funu fana waati dɔɔni kɔnɔbara basigilen, kɔnɔboli, walima banakɔtaa datugucogo waatiw la. Ni banabagatɔ tora ka farikolojidɛsɛbanakisɛ dɔ kɛ min tigɛra ka kɔn, o min ka dɔgɔn sisan ka tɛmɛ stoma cɛmancɛ kan, o la, hidrokoloyi walima plastiki ɲɔgɔndan bololanɛgɛ gɛlɛn bɛ tigɛ ka don stoma da la i n’a fɔ lastikuw.
3. Parastomal hernia min bɛ kaso la: Banakɔtaa bɔgɔlan dɔ bɛ sɔgɔsɔgɔ stoma kɛrɛ fɛ ka tɛmɛ fascial da fɛ ka don farikolo jukɔrɔ tulu la ka sɔrɔ ka siri ka kink.
4. Tromboembolisme systémique walima ischemie non-occlusive mesenterique : Kɔfɛ, dusukun tantanni kuruw, dusukun tantanni jugumanba, walima aorte dissection bɛ se ka mesenterique sanfɛla walima duguma joli datugu (aw ye sɛbɛn ɲɛ). sɔgɔsɔgɔninjɛ jugumanba (ischemie mésentérique).).

Sanfɛla (fascia sanfɛ) ni a jugumanba (fascia duguma) sɔgɔsɔgɔninjɛ¶

Ni kɔrɔtɔko operelikɛlaw ye sɔgɔsɔgɔninjɛ dibiman walima nɛrɛmuguma jateminɛ, farikolo dan min nafa ka bon kosɛbɛ, o ye anterior rectus fascia (fasa fiyɛli gɛlɛn min sigilen bɛ santimɛtɛrɛ 2 fo santimɛtɛrɛ 0,8 fo 1,5 kɔnɔbara fari jukɔrɔ):

• Superficial mucosal ischemia (min bɛ datugu fascia sanfɛ): Kɔnɔbara fan min bɛ bɔ kɔnɔbara kɔkan, o dɔrɔn de bɛ kɛ dibi ye walima dibi don, ka sɔrɔ banakɔtaa jugumanba min bɛ farikolo yɔrɔ kɔnɔ, o bɛ to pinki ye. Nin bana ninnu ka teli ka kɛnɛma salen sɔgɔsɔgɔ ani ka kɛnɛya ni kɔlɔsili ɲuman ye (hali n’a y’a sɔrɔ u ka teli ka kɛ kɔfɛ sɔgɔsɔgɔninjɛ walima u dɔgɔyali).
• Necrosis transmural jugumanba (a bɛ taa fascia duguma ka don kɔnɔbara la): Ni kulɛri jɛman, bulama walima nɛrɛmuguma bɛ taa ka taa a fɛ ka tɛmɛ fascial hakɛ kan kɔnɔbara kogo kɔnɔ, banakɔtaa kogo salen min bɛ kɔnɔbara kɔnɔ, o bɛna teliya ka don kɔnɔbara la ka nɔgɔ bɔn ka taa kɔnɔbara la (fecal peritonitis), o bɛ kɛ sababu ye ka kɔrɔtɔko kɛ laparotomie ani stoma lajɛ.

Test-tube ("glass tube") yeelen sɛgɛsɛgɛli min bɛ kɛ ER kɔnɔ¶

Kɔrɔtɔko yɔrɔ la, dɔgɔtɔrɔw bɛ tulu kɛ nɔgɔya la galasi joli lajɛlan jɛlen dɔ la (Vacutainer), pikirijikɛlan plastiki jɛlen dɔ, walima denmisɛnw ka anoscope/otoscope speculum, aw bɛ a don santimɛtɛrɛ 3 fo santimɛtɛrɛ 5 fo ka se santimɛtɛrɛ 1,2 fo 2 ma stoma lumen kɔnɔ, ka sɛbɛnnikɛlan yeelen jɛman dɔ yeelen tubabu kɛrɛ fɛ. Ni kɔnɔnatumuw kɛra pinki jɛman ye santimɛtɛrɛ 1 ka jigin jiribolo la, ischemie bɛ kɛ sanfɛla la. Ni ɲɛgɛnɛsira tora ka kɛ nɛrɛmuguma ye, ka kɛ nɛrɛmuguma ye, walima ka kɛ bulama ye kɔnɔbara kogo fasa hakɛ jukɔrɔ, banabagatɔ bɛ taa ni a ye joona opereli yɔrɔ la. Aw kana gilasi tubabufura walima fɛn nɔgɔlenw don stoma kɔnɔ abada so kɔnɔ; kɔnɔna sɛgɛsɛgɛli to dɔgɔtɔrɔ kɔrɔtɔlenw bolo.

Stoma prolapse ani du kɔnɔ tabali sukaro (osmotique réduction) manɛwɛrɛ¶

Stoma prolapse bɛ kɛ ni banakɔtaa yɔrɔ dafalen dɔ bɛ intussusceptes (telescopes insides) ka sɔgɔsɔgɔ ka taa kɛnɛma ka tɛmɛ stoma da fɛ, ka jɛngɛ kɔnɔbara kɔkan i n’a fɔ waraba jiribolo min janya bɛ bɔ santimɛtɛrɛ 5 la ka se santimɛtɛrɛ 25 ma yɔrɔ o yɔrɔ. Kɛrɛnkɛrɛnnenya la, kɔnɔboli ka teli ka kɛ loop colostomies la (kɛrɛnkɛrɛnnenya la transverse loop colostomies, yɔrɔ min na bolokɔni yɔrɔjan "inactive" bɛ telescope kɛ kɛnɛma) ani ileostomie labanw na ni kɔnɔbara tansiyɔn wulila ka bɔ sɔgɔsɔgɔ la, ka girinya kɔrɔta, ka kasi denyɛrɛniw na, walima ni fasa ye.

Mun na stoma min bɔra a la, o bɛ siri farikolo kɔkan¶

Ni banakɔtaa santimɛtɛrɛ 10 fo 15 (santimɛtɛrɛ 4 fo santimɛtɛrɛ 6) bɛ bɔ ka tɛmɛ fasabolo fitinin fɛ kɔnɔbara kogo la, farikolojidɛsɛ sirilen ni plastiki ostomi wafer bɛ mesenteric veins minnu tansiyɔn ka dɔgɔn, olu digidigi ka sɔrɔ tansiyɔnba joli siraw bɛ taa a fɛ ka joli bɔn banakɔtaa bɔlen na. Ji bɛ wuli joona ka don ɲɛgɛnɛsiraw la (kɔrɔbɔli cɛmancɛ). Miniti 30 fo miniti 60 kɔnɔ, banakɔtaa min bɔra, o bɛ funu fo ka se a girinya hakɛ siɲɛ fila walima saba ma, ka fasa kojugu ani ka kɛ bɔgɔ ye walasa ka segin ka tɛmɛ kɔnɔbara kogo dingɛ fɛ. Ni a ma dɔgɔya, funu bɛ laban ka joli siraw sɔgɔsɔgɔ, ka ɲɛgɛnɛsira pinki ɲuman wuli ka kɛ opereli kɔrɔtɔlen ye min bɛ kɛ ni gangreni ye, min bɛ sɔgɔsɔgɔ.

So dɔgɔyali senfɛ-senfɛ ni Desai granulated tabali sukaro fɛɛrɛ ye¶

Ni sɔgɔsɔgɔninjɛ min bɔra, o ye pinki walima bilen ye, a ka suma, a ka nɔgɔn, wa a tɛ kɔnɔdimi juguman bila mɔgɔ la, aw bɛ se ka dɔgɔtɔrɔso osmotiki furakɛli sariyalen kɛ so kɔnɔ ka aw to furakɛli jateminɛ labɛn:

1. Aw bɛ wafer min bɛ sɔgɔsɔgɔ walima ka foroko fila da wuli joona. Ni plastiki flansɛ walima hidrokolodi dingɛ bɛ ka sɔgɔsɔgɔ banakɔtaa bɔlen da la, aw bɛ wafer bɔ fari la dɔɔni dɔɔni walasa stoma basigilen kana sɔgɔsɔgɔ.
2. Aw bɛ banabagatɔ da a kɔ kan (supine). Aw bɛ barajuru dɔ bila u gɛnɛgɛnɛw kɔrɔ walasa kɔnɔbara fasaw ka lafiya ani girinya ka banakɔtaa samali dabila ka taa duguma.
3. Aw bɛ tabali sukaro jalen finman granulé (sucrose) ni bolomafara ye stoma kɛnɛ bɛɛ kan.
4. Aw bɛ sukaro finman jalen gansan **½ fo 1 ( garamu 100 fo 200) kɛ banakɔtaa bɔlen ɲɛda ɲiginnen ni fununen kan walasa a ka datugu pewu. (Aw aw kana sukaro mugu kɛ, ɲɔmugu bɛ min na, wa aw kana sukaro wuli ji la fɔlɔ; a ka kan ka kɛ kristalɛ jalenw ye.)
5. Osmose physics bɛ baara kɛ cogo min na: Banakɔtaa fununen ye fɛn ye min bɛ se ka don a la, a bɛ fa ni hypotonic edema fluid ye. Sukaro kristali jalenw bɛ osmotique gradient (osmotique hypertonique) kɛ kosɛbɛ ɲɛgɛnɛsira la, ka ji minɛlen sama joona ka bɔ banakɔtaa kogo fununen na ka don sukaro dacogo la.
6. Aw bɛ miniti 15 fo miniti 20 makɔnɔ ka banabagatɔ to a ka kɛ fla ye. Sukaro finman jalen bɛ wuli ka kɛ siro jɛlen ye ni ji bɛ bɔ stoma kogo la. Miniti 15 fo miniti 20 kɔnɔ, banakɔtaa min sirilen don, min fununen don, o bɛ ye ka fiɲɛ bɔ ani ka dɔgɔya ni kɛmɛsarada la 30 fo 50 ye a cɛmancɛ la.
7. A to a yɛrɛ ka dɔgɔya walima ka a bilasirali kɛ ni bolokɔni fla ye.
8. A ka ca a la, ni kirinni bɛ dɔgɔya dɔrɔn ani ni banabagatɔ ye ninakili bɔ ka a to a dalen bɛ a la, banakɔtaa min bɔra a la, o bɛ segin ka segin kɔnɔbara kɔnɔ ka ɲɛ a yɛrɛ ma.
9. Ni aw ka operelikɛla walima aw ka ostomi dɔgɔtɔrɔso y’a fɔ aw ye ka tɛmɛ, aw bɛ se ka bolokɔni flakɛlen dɔ da ni gansan ye, min bɛ kɛ ni tulu ye min bɛ se ka ji la, ka a da nɔgɔya la ka a da sɔgɔsɔgɔninjɛ fiɲɛ bɔlen yɔrɔ jan na ani ka kɔnɔna ɲɛminɛcogo nɔgɔman kɛ ka a sɔrɔ banabagatɔ bɛ ninakili bɔ. Aw kana a gɛrɛ ni fanga ye abada, aw kana aw bolokɔni don banakɔtaa kogo la abada, ka a jɔ joona ni aw ye a yɛrɛ tanga walima ni dimi bɛ aw la.
10. Aw bɛ foroko kelen kɛ min ka bon, min bɛ se ka wuli, ji bɛ se ka bɔ min na, a dɔgɔyalen kɔfɛ. Aw bɛ sukaro siro ko ni pɔnpeji sumalen ye, ka a lamini fari gosi ka a ja, ka foroko kelen nɔgɔlen dɔ kɛ a la min tigɛlen don walasa a ka bɛn kɔnɔbara ma ni milimɛtɛrɛ 2 fo 3 (insi 0,1) ye. Aw bɛ taa aw ka operelikɛla fɛ walima Joginda, Ostomie ani Continence (WOC) dɔgɔtɔrɔso baarakɛla fɛ.

Ileostomie farikolojidɛsɛ min bɛ bɔ kosɛbɛ: mun na ji jɛlen bɛ a juguya¶

Ikomi banakɔtaa belebele (kolonɔn) bɛ ji ni natiri mililitiri 1000 fo 1500 (litiri 1 fo 1,5) minɛ kokura don o don, banabagatɔ min ka kolostomi bɛ a la, a ka ca a la, o bɛ banakɔtaa bɔ min bɛ kɛ tilayɔrɔ ye walima min dilannen don, ni farikolojidɛsɛ farati ka dɔgɔn. O ni banabagatɔ min ni ileostomie (walima jejunostomy / banakɔtaa surun) bɛ a la, o ye kolotuguda bɛɛ tɛmɛ walima k’a bɔ.

Ileostomie bɔli hakɛ normal ni farati¶

• Ileostomie kɔgɔlen bɔli cogoya la: mililitiri 500 fo 1200 (litiri 0,5 ka se litiri 1,2) lɛri 24 kɔnɔ, ni o bɛ kɛ ni wosomugu ye walima ni a bɛ kɛ ni ɲinmugu ye (aw bɛ foroko basigilen lankolonya siɲɛ 4 fo siɲɛ 6 tile kɔnɔ).
• Stoma (HOS) hakɛ min bɛ bɔ kosɛbɛ: A bɔli ka tɛmɛ mililitiri 1500 kan sanga 24 kɔnɔ tile fila kɔnɔ, walima ka tɛmɛ mililitiri 2000 kan (litiri 2) sanga 24 kɔnɔ** (ka ji foroko dafalen lankolonya sanga 1 fo lɛri 2 o lɛri 2, walima siɲɛ 8 fo 12+ tile kɔnɔ).

Jejuno-ileal sodium-glucose cotransport trap (Mun na ji jɛlen bɛ kɔgɔ bɔ) .¶

Ileostomi jilama ji litiri kelen kelen bɛɛ kɔnɔ, soja** milimoli **90 fo 120 ɲɔgɔn bɛ sɔrɔ a la, ka fara potasiyɔmu, manje ani bikarbonati kan.

A tɛ i n’a fɔ kolotuguda, banakɔtaa sanfɛla (jejunum) bɛ ni selilu ni ɲɔgɔn cɛ ɲɔgɔndan sirilenw ye minnu bɛ "bɔ" minnu tɛ se ka ji minɛ fo ni soja ni sukaro bɛ taa ɲɔgɔn fɛ ni baara ye ka tɛmɛ burusi-dankan na SGLT1 (Sodium-Glucose Linked Transporter 1) furakisɛ fɛ, o min bɛ soja hakɛ de wajibiya min ka dɔgɔn 60 fo 90 mmol/L kɔnɔbara basigilen kɔnɔ.

• Min bɛ kɛ ni ileostomi banabagatɔ ye ji gansan min, te barikama, kafe, dumunikɛminɛnw soda, walima jagokɛla ka farikoloɲɛnajɛ minfɛnw: Ji gansan natiri bɛ miligaramu 0 min/L, ani farikoloɲɛnajɛ minfɛn minnu bɛ kɛ ka caya (i n’a fɔ Gatorade walima Powerade) natirili miligaramu 18 fo 20 dɔrɔn bɛ sɔrɔ sukaro doni caman kɛrɛfɛ. Ni nin ji min natirili ka dɔgɔn, o donna ɲɛgɛnɛsira la, natiri bɛ teliya ka jɛnsɛn ka bɔ banabagatɔ joli la ka don kɔnɔbara la walasa ka osmotic gradient (osmotic gradient) kɛ kelen ye, ani ji hakɛ bɛɛ faralen farikolo yɛrɛ ka sodium leached kan, o bɛ bɔn ka ɲɛ ka don ileostomy foroko kɔnɔ miniti 20 o kɔfɛ. Ni minnɔgɔ bɛ banabagatɔ la ka taa a fɛ ani ni a bɛ ji jɛlen min, a farikolojidɛsɛ bɛ teliya ka taa a fɛ (secretory net fluid loss).
• Min bɛ kɛ ni u ye jiriden ji duman min, soda basigilen, walima balodɛsɛ jilama minnu bɛ kɛ: Sukaro min ka ca ni joli ye, o bɛ ji hakɛ caman sama ka bɔ joli la ka don banakɔtaa la ni osmosis ye (osmotic diarrhea), ka stoma bɔli siɲɛ fila lɛrɛ kelen kɔnɔ.

Marka senuma ka furaji walima OMS Oral Rehydration Solution ɲagami cogo so kɔnɔ¶

Walasa ka ileostomi ji bɔli caman kɔsegin so kɔnɔ, laadilikanw minnu bɔra British Society of Gastroenterology (BSG), ESPEN ani St. Mark’s Hospital Intestinal Failure Unit fɛ, olu b’a jira ko ji gansanw (ji gansan, te, kafe) ka kan ka dan mililitiri 500 fo 1000 ma tile kɔnɔ ani ka bɔnɛw bila sodiyɔmu caman nɔ na glucose-électrolyte Oral Rehydration Solution (75 fo 90 mmol/L soja):

1. Jagokɛyɔrɔ OMS Reduced-Osmolarity Oral Rehydration Salts: Aw bɛ WHO ORS pake jɔnjɔn kelen (walima Dioralyte fanga fila foroko fila ɲagami i n’a fɔ stoma ekipu dɔ y’a jira cogo min na, walima CeraLyte 70/90, DripDrop, walima Pedialyte Sport) ka ji sanuman hakɛ tigitigi kofɔlen kɛ (a ka ca a la litiri 1 [33,8 jila onsi]).
2. Waliju. Mark ka Electrolyte Mix (Dɔgɔtɔrɔso Formula officiel min bɛ kɛ ji litiri 1 [Amerika tasaw 4,2] la):
3. Glucose mugu hakɛ teyin 6 (garamu 20) (walima tabali sukaro teaspoon 6 ni glucose/dextrose mugu saniyalen tɛ sɔrɔ, hali ni glucose mugu de ka fisa walasa ka osmolarity ɲuman sɔrɔ)
4. Tabali kɔgɔ (kuloridi sodiyɔmu) kutu ɲɛ 1 hakɛ ( garamu 3,5 )
5. ** Bikarbonati (bikarbonati sodiyɔmu)** (walima sitɛrɛti trisodiyɔmu) te kuuru ½ ( garamu 2,5 ) .
6. Aw bɛ a wuli pewu ji nɛnɛ litiri 1 (1000 mL) la. Aw bɛ a min dɔɔni dɔɔni tile bɛɛ kɔnɔ (aw y’a nɛnɛ walima ka limoni/lime dajilama dɔ fara a kan min tɛ sukaro ye, o bɛ kɔgɔ daji muɲu nɔgɔya kosɛbɛ).
7. Aw bɛ fɛn gɛlɛnw ni jimafɛnw fara ɲɔgɔn kan dumunikɛtuma na: Aw kana jimafɛnw min miniti 30 ka kɔn dumuni gɛlɛnw ɲɛ, dumuni gɛlɛnw dunni waati, walima miniti 30 dumuni gɛlɛnw dunni kɔfɛ, o la dumuni gɛlɛnw ka taa dɔɔni dɔɔni banakɔtaa fitini kɔnɔ. Aw bɛ dumuni sirilenw dun minnu falen don amidon na, minnu bɛ ileostomi bɔli mɔ: tiga finman, pasta gansan, pɔmitɛri tobilen, buru finman, bananku, manje nɔgɔlen, pɔmutɛri ani marifa.

Stoma balili jugumanba (dumuni boloci walima masin balili) .¶

Ikomi ileostomi bɛ tɛmɛ da fitinin dɔ fɛ kɔnɔbara fasa kogo la, dumuni minnu bɛ kɛ ni fiɲɛ ye, minnu ma ɲimi ka ɲɛ (popo, ɲɛgɛn, seleri juru, coco, jiriden jalenw, nɔnɔ, walima citrus pith) olu bɛ se ka ɲɔgɔn sɔrɔ ka kɛ fɛn gɛlɛn ye kɔnɔbara fascia kɔfɛ yɛrɛ (dumuni bolus obstruction). Nɔrɔli, tigɛli (volvulus), walima parastomal hernia fana bɛ se ka banakɔtaa kink kɔnɔna na.

Ka stoma balili yɔrɔ dɔ ni a dafalen dɔn¶

• Stoma yɔrɔ dɔ balili: Stoma bɛ paste normale thick tɛmɛni dabila ka bɔ ji kasa juguman na, ji bɛ min na degun kɔrɔ ka fara girin mankanba kan, kɔnɔbara basigilen misɛnninw, ani stoma dome funun ni ŋɛɲɛ bɛ min na.
• Stoma datugulen pewu: Nnabana zeru ni gazi zeru bɛ don foroko kɔnɔ fo lɛrɛ 4 fo lɛri 6 ileostomie la (walima lɛri 24 fo lɛri 48 ni dimi ye kolotuguda la). Kɔnɔbara bɛ bonya, dimi jugumanba jikuruw bɛ kɛ miniti damadɔ o miniti damadɔ, kɔnɔbara bɛ funu, banabagatɔ bɛ fɔɔnɔ daminɛ ka bɔ bilisi bilenman walima ji jɛman dibiman na.

So kɔnɔ fɛɛrɛ lakananenw dumuni-bolus fitini nɔgɔman na (ni banabagatɔ TƐ fɔɔnɔ) .¶

1. Aw bɛ sisan wafer bɔ ka foroko dɔ kɛ min da ka bon walasa ka stoma funu sɔrɔ.
2. Aw bɛ dumuni gɛlɛnw bɛɛ dunni dabila joona. Ni banabagatɔ tɛ fɔɔnɔ, a bɛ se ka farikolojidɛsɛ fura min da kɔnɔ. Ni kɔnɔboli walima fɔɔnɔ bɛ a la, aw bɛ u to da la (NPO).
3. Aw bɛ aw su jisuma na miniti 15 fo miniti 20 walima aw bɛ finimugu sumalen dɔ bila kɔnɔbara fan bɛɛ la walasa ka kɔnɔbara fasaw lafiya.
4. Aw bɛ gɛnɛgɛnɛ ni disi jɔli kɛ ani ka peristomal massage nɔgɔman kɛ: Aw bɛ aw da kɛrɛ fɛ ni gɛnɛgɛnɛw sama ka taa disi fan fɛ, walima aw bɛ aw lamaga dɔɔni dɔɔni aw bolow ni gɛnɛgɛnɛw kan ka aw to kɔnɔbara lamini na walasa ka dumunikɛminɛn dɔ bɔ fascia kɔfɛ.
5. AW kana kɔnɔbara basigilen ta abada ileostomie balili kama. Kɔnɔbolifura bɛ peristalsis fariman bila masin da tugulen na, o bɛ kɛ sababu ye ka banakɔtaa sɔgɔ ani ka farikolojidɛsɛ jugumanba bila a la.
6. Aw bɛ taa kɛnɛyaso la ni bɔli ma daminɛ tuguni lɛri 4 fo lɛri 6 kɔnɔ walima ni fɔɔnɔ daminɛna. Dɔgɔtɔrɔw bɛna sɔgɔsɔgɔninjɛ sɛgɛsɛgɛli nɔgɔman kɛ nizɛrikan na ani ka **14-Fransɛkan walima 16-Fransɛkan bilenman katetɛri tululen dɔ don kɔnɔbara la santimɛtɛrɛ damadɔ kɔnɔ walasa ka dumuni bololanɛgɛ jigin ni saline normale sumalen ye.

Parastoma hernie (banakisɛfagalan) sɔgɔli, joli bɔli, ani farikolo yɔrɔw farali¶

Parastoma hernie (hernie parastomale) bilali kaso la ni bulge reducible ye¶

Ostomi banabagatɔ kɛmɛsarada la, fo ka se 30 fo 50 ma, a laban bɛ parastomal hernia sɔrɔ, o ye kuru ye fari jukɔrɔ sɔgɔsɔgɔninjɛ kɛrɛfɛ yɔrɔ min na banakɔtaa bɔgɔlan wɛrɛ bɛ gɛrɛ sɔgɔsɔgɔninjɛ kɛrɛfɛ ka tɛmɛ farikolo da wulilen fɛ.

• Bɔli min tɛ bɔ kɛnɛ kan min bɛ se ka dɔgɔya: Bugun bɛ bɔ ni a jɔlen don walima ni a bɛ sɔgɔsɔgɔ, a bɛ nɔgɔya ani dimi tɛ a la, a bɛ kɛ fla ye ni a dalen bɛ a la, ani stoma bɛ to pinki ye ni bɔli bɛ kɛ cogo la.
• Strangulated / incarcerated parastomal hernia (Operence Emergency): Kurukuru min bɛ stoma kɛrɛ fɛ, o bɛ kɛ fara ye, a bɛ gɛlɛya, a bɛ sɔgɔsɔgɔ, wa a tɛ se ka kɛ fla ye ni a dalen don; fari min bɛ kurukuru sanfɛ, o bɛ kɛ bilen ye walima ka kɛ bulama ye; stoma bɛ kɛ bulama ye min bɛ kɛ bulama ye walima a bɛ bɔli dabila; ani banabagatɔ bɛ kɔnɔdimi jugumanba sɔrɔ ani fɔɔnɔ. Aw bɛ wafer bɔ joona, ka da a kan, aw kana dimi kuru gɛrɛntɛ ka taa kɔnɔna na, ani ka kɔrɔtɔko baarakɛlaw wele.

Joli bɔli kɔnɔbara la : ɲɛgɛnɛsira sɔgɔli ni dawolo-tansiyɔn jiginni parastoma varices¶

• Muko misɛnniw bɔli: Ni aw bɛ a ko ni fanga ye bɔrɔ caman cili waati walima ni wafer da sirilen ye ka stoma magaya, o ka teli ka kɛ sababu ye ka joli bilenman jɛman bila gaze kan. Ni aw ye gaze nɛnɛman ni ɲiginnen digi dɔɔni dɔɔni o yɔrɔ la miniti 2 fo miniti 3, o bɛ a jɔ pewu.
• Parastomal variceal hemorrhage (Life-Threatening): Banabagatɔ minnu bɛ ni sugunɛbilenni walima dawolo tansiyɔn bɛ u la, dawolo jolisira minnu bɛ tansiyɔnba la, olu bɛ kɛ joli siraw ye minnu falen don sɔgɔsɔgɔninjɛ ni kɔnɔbara fari bɛ ɲɔgɔn sɔrɔ yɔrɔ min na yɛrɛ (caput medusae, a ka ca a la a bɛ ye i n’a fɔ halo bulu-buluman peristomal fari kan). Nin kirinni ninnu bɛ se ka kari u yɛrɛ ma ka joli dibiman walima joli bilenman jɛman mililitiri kɛmɛ caman kɛ ka don ostomi foroko kɔnɔ miniti damadɔ kɔnɔ, o bɛ na ni joli bɔli ye.
• Dɛmɛ fɔlɔ teliya la: Aw bɛ foroko bɔ, ka sɔgɔsɔgɔninjɛ yɔrɔ sɔrɔ fari ni sɔgɔsɔgɔninjɛ dancɛ la, ka gaze sterili kelen min dabɔ (walima gazi min ɲiginnen don ni ɔkisimɛtazɔlini 0,05% nugulafura ye min tɛ sɔrɔ dɔgɔtɔrɔso la) digi ka ɲɛsin joli bɔyɔrɔ ma ni bolokɔni kelen ye ka aw to 911/112/999 weleli la. Aw bɛ banabagatɔ to a ka kɛ fla ye ni a senw kɔrɔtalen don (aw ye sɛbɛn ɲɛ dumunikɛminɛnw kɔnɔnatumuw ni cirose joli bɔli).

Mucocutaneous farali ani stoma kɔsegin¶

Dɔgɔkun 2 fo dɔgɔkun 4 fɔlɔ opereli kɔfɛ, sɔgɔsɔgɔninjɛ da min bɛ kɔnɔbara fari la, olu bɛ se ka sama ka bɔ ɲɔgɔn na (mucocutaneous separation), walima stoma bɛ se ka jigin fari hakɛ jukɔrɔ (retraction).

• Fara danfara: Farati min man dun ka bɔ fari sanfɛla la, o bɛ ɲɛnabɔ WOC dɔgɔtɔrɔso baarakɛla fɛ ni kalisiyɔmu alginate walima hidrofibre mugu min bɛ minɛ. Nka ni sɔgɔsɔgɔninjɛ bɔra pewu degere 360 ​​lamini na ka jigin farikolojidɛsɛ jukɔrɔ ka don kɔnɔbara la, banakɔtaa bɛ bɔn kɔnɔbara la ka ɲɛ (kɔnɔnabana). Ni aw ye dingɛ juguman lankolon ye, kɔnɔdimi jugumanba ni farigan bɛ min na, aw bɛ anpulu wele joona.

Sigidaw ka kɔrɔtɔko nimɔrɔw ani baaradaw ka sariyaw¶

• Etazini ni Kanada: Aw bɛ 911 wele ni kɔnɔbara basigilen/bilen ye, ni aw bɛ kɔnɔbara basigilen bila kaso la, ni kɔnɔbara basigilen don kosɛbɛ, walima ni farikolojidɛsɛ jugumanba bɛ aw la ni sinkɔrɔkɛrɛdimi ye. Joginda, kolotugudaw ani kɔnɔbara basigilen furakɛli jɛkulu (WOCN) ani Ameriki kolosinsinnanw ka tɔnba (ASCRS) bɛ sɔn ka waferw bɔli teliya la, ka sɔgɔsɔgɔninjɛ dɔgɔya ni sucrose granulé ye, ani ka ji segin fura da la ileostomie minnu bɛ bɔ kosɛbɛ.
• Repibliki Uni: Aw bɛ 999 wele ni kɔnɔbara basigilen jugumanba, sɔgɔsɔgɔninjɛ jugumanba, walima sɔgɔsɔgɔninjɛ jugumanba don, walima aw bɛ 111 / aw ka NHS Stoma Care Nurse Specialist wele walasa ka teliya la tile kelen dɔgɔtɔrɔso sɛgɛsɛgɛli kɛ ni kɔnɔboli ye walima ni a bɔli ka ca. British Society of Gastroenterology (BSG) ani St Mark’s Hospital ka laadilikanw bɛ St Mark ka elektrɔli jilama ni hypotonic ji dantigɛcogo kɛ sariya ye stomaw la minnu bɛ bɔ kosɛbɛ.
• Erɔpu jamanaw ka tɔnba: Aw ye 112 wele. Erɔpu jamanaw ka balodɛsɛ ni farikolojidɛsɛ furakɛli jɛkulu (ESPEN) ani Erɔpu tɔnba min bɛ wele ko Crohn’s and Colitis Organization (ECCO) ka laadilikanw bɛ ORS isotoniki/sodiyɔmu caman sɔrɔ joona (90 mmol/L sodium), loperamide/antisecretory titration daminɛ joona dɔgɔtɔrɔw ka kɔlɔsili kɔnɔ, ani opereli teliya la seginnkanni ni kɔnɔbara basigilen walima a datugulen don.
• Ɔsitarali ni Zelande kura: Aw bɛ 000 wele Ɔsitarali walima 111 Nuwɛlika. Australian Association of Stomal Therapy Nurses (AASTN) ka sariyaw bɛ sinsin minɛnw bonya teliya kan sɔgɔsɔgɔninjɛ/prolapsed stomas ani teliya la joli seginni na walasa ka ileostomie min bɛ bɔ kosɛbɛ ni oliguria ye.
• Endi ni Azi Pasifiki: Aw bɛ 112 wele Ɛndujamana na, 995 Singapuri, 119 Zapɔn ni Kore Dugu, walima 999 Mali ni Hong Kong. Aw ye an ka lisi dafalen lajɛ diɲɛ kɔnɔ kɔrɔtɔko nimɔrɔw.

Ɲininkali minnu bɛ kɛ tuma caman na¶

Mun na ni aw ye tabali sukaro finman gansan bɔn stoma min bɔra a la, o b’a to a bɛ dɔgɔya?¶

Stoma yɔrɔ min bɛ bɔ kɛnɛ kan, o ye banakɔtaa kɔnɔna ɲɛgɛnɛsira ye, o min bɛ kɛ i n’a fɔ barika min bɛ se ka don a kɔnɔ. Ni stoma dɔ bɔra kɔnɔbara la, joli siraw sɔgɔsɔgɔli bɛ ji tɛmɛnen minɛ farikolo yɔrɔ kɔnɔ, o bɛ a to a bɛ funu kojugu fo a tɛ se ka segin ka tɛmɛ farikolo da la. Ni aw ye ɲɛgɛnɛsira ɲiginnenw datugu ni sukaro kristali jalenw ye minnu dilannen don ni girinya ye, o bɛ kɛ sababu ye ka ji sirilen sama joona ka bɔ banakɔtaa kogo fununen na ka don sukaro la, ka farikolojidɛsɛ bɔ a la miniti 15 fo miniti 20 kɔnɔ walasa a ka se ka wuli ka segin a kɔnɔ cogo nɔgɔman na k’a sɔrɔ a dalen bɛ a la.

Mun na ileostomi bɛ mɔgɔ min na, o tɛ se ka ji gansan caman min dɔrɔn k’a sɔrɔ a ka bɔrɔ bɛ fa ji bɔli la?¶

A tɛ i n’a fɔ kolotuguda kɛnɛman, banakɔtaa sanfɛla tɛ se ka ji jɛlen minɛ a yɛrɛ ma; a farikolokisɛw bɛ natirili hakɛ caman de wajibiya (milimɔli 60 fo 90 litiri kelen kɔnɔ) ka fara sukaro hakɛ dɔ kan walasa ka ji sama ka tɛmɛ banakɔtaa kogo kan ka don joli la. Ni ileostomi banabagatɔ ye ji gansan min, te walima farikoloɲɛnajɛ minfɛnw na, soja bɛ bɔ u joli la tiɲɛ na ka taa kɔnɔbara la walasa ka kɔgɔ hakɛ kɛ kelen ye, ka ji min min sisan, ani u yɛrɛ ka kɔgɔ fila bɛɛ ko ka bɔ ostomi foroko kɔnɔ ka ɲɛ ani ka farikolojidɛsɛ juguya.

Ne bɛ se ka danfara don cogo di biɲɛ/dumuni nɔgɔli nɔgɔman ni joli lakika walima stoma min bɛ ka sa?¶

Ni aw ye biɲɛ bilenman, jelatɛni bilenman, dumuni kalali bilenman, likɔri walima nɛgɛfura dun, o bɛ to ka banakɔtaa walima ji min bɛ ostomi foroko kɔnɔ ka kɛ bilen ye walima ka kɛ nɛrɛmuguma ye, o bɛ se ka kɛ i n’a fɔ mɔgɔ bɛ mɔgɔ jalaki. Nka, dumuni ni nɛgɛ bɛ bɔli dɔrɔn de kulɛri foroko kɔnɔ; u tɛ stoma ɲɛnama yɛrɛ kulɛri Changer abada. Aw bɛ sɔgɔsɔgɔninjɛ ɲɛda ko nɔgɔya la ni farikolojidɛsɛ ye: sɔgɔsɔgɔninjɛ kɛnɛman bɛna kɛ hali bi sogo jɛman ye min ɲɛ ye bulama ye, a bɛ mɔ, a bɛ mɔ ani a ka suma, k’a sɔrɔ sɔgɔsɔgɔninjɛ min bɛ sɔgɔsɔgɔ, o bɛna kɛ ni farikolo yɔrɔ ye min ɲɛ ye bulama ye, a ɲɛ ye bulama ye, walima a ɲɛ ye nɛrɛmuguma ye banakɔtaa kogo yɛrɛ la.

Mun na furabuluw bɛ bɔ tuma dɔw la u bɛɛ lajɛlen na ileostomi foroko kɔnɔ, ani furakisɛ jumɛnw farati ka bon?¶

Ikomi ileostomi bɛ banakɔtaa bɛɛ bɔ walima ka tɛmɛ a fɛ ani ka kɔnɔbara tɛmɛni waati surunya, furakisɛ minnu bɛ bɔ ka mɛn (ER, XR, SR, XL) ani minnu bɛ kɛ kɔnɔbara la, olu ka teli ka tɛmɛ ka ɲɛ ka don ostomi foroko kɔnɔ u ma wuli pewu, o bɛ kɛ sababu ye ka fura faratilenw bɔli walima furakɛli dɛsɛ. Aw kana furakisɛw ta abada minnu bɛ bɔ waati jan kɔnɔ walima minnu bɛ kɛ kɔnɔbara la ni ileostomie ye fo ni furakɛlikɛla dɔ ye u saniya kɛrɛnkɛrɛnnenya la (aw bɛ furakisɛw, jilamaw walima furakisɛw ɲini minnu bɛ bɔ joona), ani ka kɔnɔboli furaw ta abada, minnu bɛ se ka kɛ sababu ye ka elekitoroliti dɔgɔyali bila mɔgɔ ka ɲɛnamaya farati la.

Yala a bɛnnen don ni stoma kura yɛrɛ bɛ a bonya Changé kalo fila fɔlɔ kɔnɔ opereli kɔfɛ wa?¶

Awɔ. Opereli kɔfɛ dɔrɔn, kɔnɔbara bɛɛ bɛ funu opereli tali fɛ, wa a cɛmancɛ bɛ dɔgɔya dɔɔni dɔɔni dɔgɔkun 6 fo dɔgɔkun 8 fɔlɔ kɔnɔ fo ka se a hakɛ basigilen ma. O kalo fila fɔlɔw kɔnɔ, aw ka kan ka kɔnɔbara cɛmancɛ suman ni sumanikɛlan ye wafer caman cili bɛɛ la walasa a da kana bonya kojugu (o bɛ peristoma fari bila dumunikɛminɛnw na minnu bɛ sɔgɔsɔgɔ) walima ka gɛlɛya kojugu (o bɛ se ka stoma sɔgɔ ni a fununen don waati dɔɔni).

Sosow ani ɲɛmɔgɔyaso ka bilasiralikan¶

• Jogin, Ostomi ani Continence Nurses Society (WOCN, Etazuni): WOCN Society ka kɛnɛyako laadilikan: Banabagatɔ baliku furakɛli ni nɔgɔ walima sugunɛ ostomi ye (Triage of stoma ischemia, mucocutaneous separation, prolapse, and peristomal varices).
• Amerika ka kolosinsinnanw ni kɔnɔbara operelikɛlaw ka tɔn (ASCRS, Etazuni): Kɛnɛyaso baarakɛcogo laadilikanw ka ɲɛsin kolotuguda opereli ma (Sɔgɔsɔgɔninjɛ sanfɛla ni ɲɛda duguma, sɔgɔsɔgɔninjɛ sɔgɔsɔgɔninjɛ, ani kɔnɔbara balili jateminɛ).
• British Society of Gastroenterology (BSG) & St. Mark’s Hospital Intestinal Failure Unit (Royaume-Uni): Banabagatɔ minnu ka banakɔtaa ka surun ani minnu bɛ bɔ kosɛbɛ, olu furakɛcogo laadilikanw (Nightingale J et al., Gut: jejunal sodium-glucose cotransport physiology, hypotonic fluid restriction, and St. Mark’s electrolyte solution furakɛlicogo).
• Erɔpu jamana ka balodɛsɛ ni farikolojidɛsɛ furakɛli jɛkulu (ESPEN, Erɔpu): ESPEN ka laadilikan min ɲɛsinnen bɛ balocogo ɲuman ma banakɔtaa jugumanba ni banakɔtaa basigilen na (Ileostomie ji min bɛ bɔ kosɛbɛ ani manje/potasiyɔmu lakununni sariyaw).
• Myers JO & Rothenberger DA / Desai DC (Kɔnɔbara ni ɲɛgɛnɛsira banaw / Amerika ka opereli gafe): Sɔgɔsɔgɔninjɛ minnu bɛ bɔ sɔgɔsɔgɔninjɛ la, olu dɔgɔyali osmotique fɛ ni sukaro granulée topicale ye.

Gafe minnu bɛ tali kɛ o ko la¶

• Banakɔtaa datugulen, sɔgɔsɔgɔninjɛ min bɛ sɔgɔsɔgɔ, ani volvulus kɔrɔtɔko taamasiɲɛw
• Mesenteric ischemia acute, banakɔtaa sɔgɔsɔgɔninjɛ, ani kɔnɔbara basigilen dunni kɔfɛ
• Dumuni baga, kɔnɔboli jugumanba, ani farikolojidɛsɛ
• Esophageal varices kari, cirose joli bɔli, ani sugunɛbilenni
• Kɔnɔbara bɔli ani kɔnɔbara da wulilen joginda ladonni