Kirurgjia e gastrektomis\u00eb s\u00eb m\u00ebng\u00ebs, e njohur zakonisht si gastrektomia e m\u00ebng\u00ebs, synon t\u00eb zvog\u00ebloj\u00eb v\u00ebllimin e stomakut. Kjo \u00ebsht\u00eb arsyeja pse emri tjet\u00ebr i saj \u00ebsht\u00eb zvog\u00eblimi i stomakut. Megjithat\u00eb, ky mekaniz\u00ebm i njohur dhe m\u00eb i zakonsh\u00ebm q\u00eb mendohet se \u00ebsht\u00eb ky nuk mund t\u00eb shpjegoj\u00eb vet\u00ebm humbjen e pesh\u00ebs dhe p\u00ebrmir\u00ebsimin e diabetit t\u00eb tipit 2.<\/p>\n\n\n\n
Duhet t\u00eb ket\u00eb mekanizma t\u00eb tjer\u00eb. Si rezultat i studimeve \u00ebsht\u00eb zbuluar se ulja e oreksit, pra t\u00eb ngr\u00ebnit m\u00eb pak, mb\u00ebshtetet nga hormoni grelin i sekretuar nga hyrja, pra pjesa fundus e stomakut. N\u00eb fakt, kur stomaku \u00ebsht\u00eb bosh, rritet sekretimi i grelin\u00ebs, i cili rrit oreksin, k\u00ebshtu q\u00eb personi ndihet i uritur. Nd\u00ebrkoh\u00eb zvog\u00eblohet sekretimi i hormoneve si GLP-1 (glukagon si peptidi 1), CCK (kolecistokinina), PYY (peptidi YY), q\u00eb jep ndjenj\u00ebn e ngopjes, pra ndal oreksin. Kur hahet vakti dhe stomaku \u00ebsht\u00eb plot, zvog\u00eblohet sekretimi i grelin\u00ebs, rritet sekretimi i hormoneve si GLP-1, CCK, PPY, ulet oreksi dhe personi ndihet i ngopur. N\u00eb fakt, me operacionin e m\u00ebng\u00ebs gastrike, gjendja hormonale e stomakut arrihet me mbushjen dhe shtrirjen e shpejt\u00eb t\u00eb stomakut dhe ulet d\u00ebshira e personit p\u00ebr t\u00eb ngr\u00ebn\u00eb.<\/p>\n\n\n\n
Si do t\u00eb ushqehem pas operacionit? A do t\u00eb jem n\u00eb gjendje t\u00eb ha dhe t\u00eb pi gjith\u00e7ka?<\/p>\n\n\n\n
Kandidat\u00ebt q\u00eb vendosin t’i n\u00ebnshtrohen operacionit t\u00eb m\u00ebng\u00ebs s\u00eb stomakut shpesh pyesin n\u00ebse do t\u00eb jen\u00eb n\u00eb gjendje t\u00eb han\u00eb ushqimet q\u00eb hanin dhe i p\u00eblqejn\u00eb pas operacionit.<\/p>\n\n\n\n
Pacient\u00ebt q\u00eb i n\u00ebnshtrohen operacionit t\u00eb m\u00ebng\u00ebs s\u00eb stomakut ushqehen me nj\u00eb diet\u00eb t\u00eb ve\u00e7ant\u00eb pas operacionit. Kjo diet\u00eb p\u00ebrb\u00ebhet nga ushqime t\u00eb l\u00ebngshme p\u00ebr tre jav\u00ebt e para, ushqime t\u00eb pure p\u00ebr jav\u00ebn e kat\u00ebrt dhe ushqime normale nga java e pest\u00eb. Ekzistojn\u00eb dy rregulla kryesore n\u00eb t\u00eb ushqyerit. E para \u00ebsht\u00eb t\u00eb shmangni t\u00eb gjitha pijet e gazuara, e dyta \u00ebsht\u00eb t\u00eb b\u00ebni dallimin midis t\u00eb ngurta dhe t\u00eb l\u00ebngshme, dometh\u00ebn\u00eb t\u00eb ndaloni pirjen e l\u00ebngjeve 30 minuta para ngr\u00ebnies dhe t\u00eb filloni t\u00eb pini l\u00ebngje 30 minuta pas ngr\u00ebnies. Nj\u00eb pik\u00eb tjet\u00ebr e r\u00ebnd\u00ebsishme \u00ebsht\u00eb marrja e mjaftueshme e l\u00ebngjeve. Nevoja ditore p\u00ebr uj\u00eb duhet t\u00eb llogaritet n\u00eb baz\u00eb t\u00eb 30-35 ml p\u00ebr kilogram. P\u00ebr shembull, nj\u00eb pacient 100 kg duhet t\u00eb konsumoj\u00eb t\u00eb pakt\u00ebn 3 litra l\u00ebngje n\u00eb dit\u00eb. Ne mund t\u00eb kuptojm\u00eb marrjen e pamjaftueshme t\u00eb l\u00ebngjeve nga goja e that\u00eb dhe sasi t\u00eb vogla t\u00eb urin\u00ebs s\u00eb err\u00ebt. P\u00ebr m\u00eb tep\u00ebr, kur pim\u00eb m\u00eb pak uj\u00eb, p\u00ebrjetojm\u00eb lodhje pa asnj\u00eb arsye. N\u00eb k\u00ebt\u00eb rast, n\u00ebse nuk mund t\u00eb merrni uj\u00eb t\u00eb mjaftuesh\u00ebm nga goja, duhet t\u00eb vendosni nj\u00eb serum n\u00eb spital. Kur korrigjohet deficiti i l\u00ebngjeve, p\u00ebrmir\u00ebsohet edhe lodhja. P\u00ebrve\u00e7 k\u00ebsaj, uji i pijsh\u00ebm konsumon gjithashtu kalori af\u00ebrsisht 30 kalori kur nj\u00eb got\u00eb uj\u00eb ekskretohet p\u00ebrmes veshkave.<\/p>\n\n\n\n
\u00c7far\u00eb mund t\u00eb ndodh\u00eb me ne pas operacionit?<\/p>\n\n\n\n
Gj\u00ebja m\u00eb e frikshme n\u00eb 24 or\u00ebt e para pas operacionit \u00ebsht\u00eb nj\u00eb mpiksje nga venat e vi\u00e7it n\u00eb mushk\u00ebri. Ne e quajm\u00eb k\u00ebt\u00eb emboli pulmonare. P\u00ebr t\u00eb parandaluar q\u00eb kjo situat\u00eb t\u00eb ndodh\u00eb, ne veshim \u00e7orape kompresioni dhe b\u00ebjm\u00eb nj\u00eb injeksion t\u00eb vog\u00ebl t\u00eb ngjash\u00ebm me insulin\u00ebn p\u00ebr hollimin e gjakut p\u00ebrpara operacionit. Nj\u00eb nd\u00ebrlikim tjet\u00ebr m\u00eb i zakonsh\u00ebm midis dit\u00ebs s\u00eb dyt\u00eb dhe t\u00eb shtat\u00eb \u00ebsht\u00eb rrjedhja. Rrjedhja \u00ebsht\u00eb rrjedhja e l\u00ebngut gastrik n\u00eb bark nga skaji i jasht\u00ebm i sapokrijuar i stomakut t\u00eb tkurrur. Meqen\u00ebse l\u00ebngu i stomakut \u00ebsht\u00eb shum\u00eb acid, ai ka nj\u00eb efekt djeg\u00ebs. Nj\u00eb sekret i mrekulluesh\u00ebm mbron stomakun nga shp\u00ebrb\u00ebrja e murit t\u00eb tij t\u00eb brendsh\u00ebm. Megjithat\u00eb, ky acid ka nj\u00eb efekt djeg\u00ebs n\u00eb bark. P\u00ebrve\u00e7 k\u00ebsaj, infeksioni i shkaktuar nga bakteret e shtuara n\u00eb k\u00ebt\u00eb mjedis p\u00ebrkeq\u00ebson gjendjen e pacientit. P\u00ebr fat t\u00eb mir\u00eb, ne nuk hasim shum\u00eb shpesh rrjedhje. Nj\u00eb norm\u00eb prej 0-1% jepet n\u00eb seri t\u00eb ndryshme.<\/p>\n\n\n\n
Si mund ta di n\u00ebse \u00ebsht\u00eb e paligjshme?<\/p>\n\n\n\n
Kur ka rrjedhje, shfaqen ethe p\u00ebr shkak t\u00eb infeksionit dhe dhimbje barku n\u00eb shpin\u00eb, dhe paralelisht me infeksionin dhe temperatur\u00ebn, rrahjet e zemr\u00ebs rriten n\u00eb mbi 100 rrahje n\u00eb minut\u00eb. Kjo situat\u00eb mund t’ju ndodh\u00eb n\u00eb sht\u00ebpi brenda 1 muaji pas daljes nga spitali n\u00eb dit\u00ebn e 3-t\u00eb ose t\u00eb 4-t\u00eb. N\u00eb nj\u00eb rast t\u00eb till\u00eb, \u00ebsht\u00eb thelb\u00ebsore q\u00eb t\u00eb kontaktoni kirurgun tuaj. Kjo situat\u00eb nuk \u00ebsht\u00eb e mundur t\u00eb humbas\u00eb n\u00ebse pacient\u00ebt ndiqen nga af\u00ebr. P\u00ebr k\u00ebt\u00eb arsye, ne i kushtojm\u00eb shum\u00eb r\u00ebnd\u00ebsi kontrollit t\u00eb dit\u00ebs s\u00eb 7-t\u00eb dhe ndjekim nga af\u00ebr pacient\u00ebt tan\u00eb p\u00ebrmes Whatsapp p\u00ebr 3 jav\u00eb deri n\u00eb muajin e par\u00eb, q\u00eb \u00ebsht\u00eb dita e par\u00eb e kontrollit.<\/p>\n\n\n\n
Si trajtohet nj\u00eb rrjedhje?<\/p>\n\n\n\n
\u00cbsht\u00eb e rrezikshme t\u00eb mos humbas\u00ebsh rrjedhjen, por t\u00eb humbas\u00ebsh rrjedhjen dhe t\u00eb mos b\u00ebsh nj\u00eb diagnoz\u00eb, duke e l\u00ebn\u00eb pacientin vet\u00ebm me fatin e tij. Prandaj, diagnoza p\u00ebrb\u00ebn 50% t\u00eb trajtimit. P\u00ebr t\u00eb vendosur nj\u00eb diagnoz\u00eb, ne i b\u00ebjm\u00eb pacient\u00ebt tan\u00eb t\u00eb pin\u00eb l\u00ebng radiopak dhe t\u00eb b\u00ebjn\u00eb nj\u00eb tomografi abdominale. Pas vendosjes s\u00eb diagnoz\u00ebs, ndalojm\u00eb ushqyerjen me goj\u00eb dhe vendosim nj\u00eb tub, pra nj\u00eb drenazh, n\u00eb zon\u00ebn ku grumbullohet inflamacioni, n\u00ebn drejtimin e tomografis\u00eb ose ekografis\u00eb. Ne fillojm\u00eb nj\u00ebkoh\u00ebsisht antibiotik\u00ebt me spekt\u00ebr t\u00eb gjer\u00eb dhe sigurojm\u00eb ushqim intravenoz. Nd\u00ebrkoh\u00eb, injektimi i botoksit mund t\u00eb b\u00ebhet n\u00eb muskujt pilorik p\u00ebr t\u00eb ulur presionin n\u00eb daljen e stomakut p\u00ebr t\u00eb leht\u00ebsuar mbylljen. N\u00ebse nuk mbyllet brenda 30 dit\u00ebve, vendosim stenta metalike t\u00eb veshura me plastik\u00eb q\u00eb shtrihen nga ezofag deri n\u00eb duoden dhe nd\u00ebrpresin kontaktin e stomakut me ushqimin.<\/p>\n\n\n\n
N\u00ebse \u00ebsht\u00eb e nevojshme, e \u00e7ojm\u00eb n\u00eb reanimacion. Q\u00ebllimi yn\u00eb k\u00ebtu \u00ebsht\u00eb t\u00eb parandalojm\u00eb q\u00eb infeksioni t\u00eb p\u00ebrparoj\u00eb dhe organe t\u00eb tilla si mushk\u00ebrit\u00eb, veshkat, m\u00ebl\u00e7ia dhe zemra t\u00eb mos funksionojn\u00eb. Me nj\u00eb trajtim kaq efektiv, rrjedhja mbyllet n\u00eb 6-8 jav\u00eb dhe stenti hiqet me metod\u00eb endoskopike. Mund t\u00eb provohen metoda t\u00eb tilla si vendosja endoskopike e qepjeve t\u00eb brendshme ose vendosja e kap\u00ebseve. Riparimi kirurgjik i zon\u00ebs ku shfaqet fistula nuk do t\u00eb jap\u00eb rezultate t\u00eb suksesshme. Prandaj, q\u00ebllimi i trajtimit kirurgjik \u00ebsht\u00eb ulja e presionit intragastrik dhe shnd\u00ebrrimi n\u00eb bypass gastrik kryhet me kirurgji revizioni.N\u00ebse ende nuk mbyllet, i gjith\u00eb stomaku mund t\u00eb hiqet kirurgjik dhe t\u00eb z\u00ebvend\u00ebsohet me nj\u00eb stomak nga zorra e holl\u00eb. Megjithat\u00eb, n\u00ebse mund t\u00eb krijojm\u00eb nj\u00eb fistul\u00eb t\u00eb kontrolluar n\u00eb p\u00ebrputhje me parimet baz\u00eb kirurgjikale, rrjedha e rrjedhjes mund t\u00eb ulet dhe t\u00eb mbyllet me kalimin e koh\u00ebs pa pasur nevoj\u00eb p\u00ebr procedura shum\u00eb t\u00eb komplikuara.<\/p>\n\n\n\n
A do t\u00eb jet\u00eb i mir\u00eb operacioni i gastrektomis\u00eb me m\u00ebng\u00eb p\u00ebr diabetin tim?<\/p>\n\n\n\n
P\u00ebrve\u00e7 efekteve t\u00eb dobishme t\u00eb humbjes s\u00eb pesh\u00ebs, mund t\u00eb themi se diabeti i tipit 2 zgjidhet plot\u00ebsisht me rreth 50%, me heqjen e fundusit duke ulur hormonin ghrelin dhe duke rritur hormonin GLP-1, dhe nevoja p\u00ebr mjekim zvog\u00eblohet n\u00eb. pacient\u00ebt e mbetur. Megjithat\u00eb, n\u00eb rastet e diabetit tip 2 t\u00eb kombinuar me obezitetin morbid, mbi 85% arrihen rezultate t\u00eb suksesshme n\u00eb trajtimin e diabetit t\u00eb tipit 2 me bypass gastrik dhe teknika t\u00eb tjera t\u00eb trajtimit kirurgjik metabolik.<\/p>\n","protected":false},"excerpt":{"rendered":"
Kirurgjia e gastrektomis\u00eb s\u00eb m\u00ebng\u00ebs, e njohur zakonisht si gastrektomia e m\u00ebng\u00ebs, synon t\u00eb zvog\u00ebloj\u00eb v\u00ebllimin e stomakut. Kjo \u00ebsht\u00eb arsyeja pse emri tjet\u00ebr i saj \u00ebsht\u00eb zvog\u00eblimi i stomakut. Megjithat\u00eb, ky mekaniz\u00ebm i njohur dhe m\u00eb i zakonsh\u00ebm q\u00eb mendohet se \u00ebsht\u00eb ky nuk mund t\u00eb shpjegoj\u00eb vet\u00ebm humbjen e pesh\u00ebs dhe p\u00ebrmir\u00ebsimin e […]<\/p>\n","protected":false},"author":1,"featured_media":28168,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[117],"tags":[],"class_list":["post-29164","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized-sq"],"_links":{"self":[{"href":"https:\/\/drburakkavlakoglu.com\/sq\/wp-json\/wp\/v2\/posts\/29164","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/drburakkavlakoglu.com\/sq\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/drburakkavlakoglu.com\/sq\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/drburakkavlakoglu.com\/sq\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/drburakkavlakoglu.com\/sq\/wp-json\/wp\/v2\/comments?post=29164"}],"version-history":[{"count":0,"href":"https:\/\/drburakkavlakoglu.com\/sq\/wp-json\/wp\/v2\/posts\/29164\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/drburakkavlakoglu.com\/sq\/wp-json\/wp\/v2\/media\/28168"}],"wp:attachment":[{"href":"https:\/\/drburakkavlakoglu.com\/sq\/wp-json\/wp\/v2\/media?parent=29164"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/drburakkavlakoglu.com\/sq\/wp-json\/wp\/v2\/categories?post=29164"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/drburakkavlakoglu.com\/sq\/wp-json\/wp\/v2\/tags?post=29164"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}