{"id":37,"date":"2011-12-16T16:53:40","date_gmt":"2011-12-16T16:53:40","guid":{"rendered":"http:\/\/lkksb.lv\/?page_id=37"},"modified":"2020-04-24T17:44:53","modified_gmt":"2020-04-24T14:44:53","slug":"operacijas-iespejas","status":"publish","type":"page","link":"https:\/\/lkksb.lv\/?page_id=37","title":{"rendered":"Oper\u0101cijas iesp\u0113jas"},"content":{"rendered":"\n<h3 class=\"wp-block-heading\">\u010c\u016blain\u0101 kol\u012bta pacientiem<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Pacientiem ar \u010cK, \u012bpa\u0161i ja ilgtermi\u0146a medikamentoz\u0101 \u0101rst\u0113\u0161ana ir nav devusi gaid\u012bto rezult\u0101tu, vai ja rodas neatliekamas komplik\u0101cijas (piem\u0113ram, toksisks jeb fulminants kol\u012bts, kad resn\u0101 zarna strauji papla\u0161in\u0101s, dz\u012bv\u012bbu apdraudo\u0161i asins izpl\u016bdumi un zarnu perfor\u0101cija) vai resn\u0101s zarnas displ\u0101zija (zarnu g\u013cot\u0101das \u0161\u016bnu izmai\u0146as, kas ir agr\u012bna zarnu v\u0113\u017ea paz\u012bme), var b\u016bt nepiecie\u0161ama \u0137irur\u0123iska pal\u012bdz\u012bba \u2013 parasti oper\u0101cija, lai izgrieztu resn\u0101s zarnas (kolektomija).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u010cK oper\u0101cijas m\u0113r\u0137is ir iz\u0101rst\u0113t slim\u012bbu, vienlaikus p\u0113c iesp\u0113jas maz\u0101k mainot norm\u0101las fiziolo\u0123iskas funkcijas un pacienta dz\u012bvesveidu.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">T\u0101l\u0101k ir nor\u0101d\u012btas bie\u017e\u0101k sastopam\u0101s \u0137irur\u0123isk\u0101s proced\u016bras.<\/p>\n\n\n\n<ul class=\"postli wp-block-list\"><li><strong>Tot\u0101la proktokolektomija ar ileostomu:<\/strong> iz\u0146em visu resno zarnu, k\u0101 ar\u012b taisno zarnu un an\u0101lo kan\u0101lu. Tad tievo zarnu galu izvada cauri atverei v\u0113dera sien\u0101, izveidojot stomu jeb ileostomu. Lai sav\u0101ktu gremo\u0161anas atkritumus, stomai pievieno main\u0101mu, \u0101r\u0113ju maisu.<\/li><li><strong>Da\u013c\u0113ji tot\u0101la kolektomija un l\u012bkumain\u0101s zarnas maisa an\u0101la anastomoze (IPAA jeb maisa oper\u0101cija):<\/strong> iz\u0146em visu resno un taisno zarnu, bet saglab\u0101 an\u0101lo atveri. Tad ar tievo zarnu galu izveido maisu, ko pievieno pie an\u0101l\u0101s atveres. Bie\u017ei izveido \u012bslaic\u012bgu stomu, lai novirz\u012btu gremo\u0161anas atkritumu pl\u016bsmu un sadzied\u0113tu maisu. Oper\u0101cijas izv\u0113le ir balst\u012bta uz katras proced\u016bras ieguvumu un risku izv\u0113rt\u0113jumu katram pacientam, tostarp, oper\u0101cijas iemeslu, pacienta vecumu, saist\u012bt\u0101s saslim\u0161anas un \u013caundab\u012bga veidojuma esam\u012bbu.<\/li><\/ul>\n\n\n\n<h3 class=\"wp-block-heading\">Krona slim\u012bbas pacientiem<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Oper\u0101cija parasti tiek veikta tiem KS pacientiem, kuriem ir komplik\u0101cijas, piem\u0113ram, obstrukcija, strikt\u016bra, abscess vai fistula vai, ja slim\u012bbai nav atbildes reakcija uz medikamentozo terapiju. Kopum\u0101 \u0137irurgs cen\u0161as iz\u0146emt p\u0113c iesp\u0113jas maz\u0101k zarnu, jo \u0137irur\u0123isk\u0101 oper\u0101cija ne\u0101rst\u0113 slim\u012bbu tikai t\u0101s izrais\u012bt\u0101s sekas un komplik\u0101cijas. Bie\u017e\u0101k sastopam\u0101s proced\u016bras ir nor\u0101d\u012btas t\u0101l\u0101k.<\/p>\n\n\n\n<ul class=\"postli wp-block-list\"><li><strong>Rezekcija un anastomoze:<\/strong> \u0161o proced\u016bru lieto pacientiem ar strikt\u016br\u0101m un smagu vai penetr\u0113jo\u0161u zarnu iekaisumu vai kam ir perfor\u0113jusi zarna. Tiek iz\u0146emta slim\u012bbas skart\u0101 zarnas da\u013ca, un vesel\u012bgie gali tiek savienoti atk\u0101rtoti (anastomoze). Tom\u0113r slim\u012bba bie\u017ei atk\u0101rtojas anastomozes vietas tuvum\u0101.<\/li><li><strong>Strikt\u016bru plastija:<\/strong> \u0161o proced\u016bru var veikt pacientiem ar cie\u0161iem, parastiem zarnu sa\u0161aurin\u0101jumiem (strikt\u016br\u0101m), kuriem nav atbildes reakcijas uz medikamentozu \u0101rst\u0113\u0161anu; proced\u016bras laik\u0101 atver sa\u0161aurin\u0101to re\u0123ionu un maina t\u0101 formu, neiz\u0146emot nevienu zarnu da\u013cu.<\/li><li><strong>Perian\u0101la dren\u0101\u017ea:<\/strong> pacientiem ar perian\u0101lu slim\u012bbu, lai dren\u0113tu sepsi, bie\u017ei nepiecie\u0161ama oper\u0101cija. Bie\u017ei griezuma viet\u0101 atst\u0101j tievu materi\u0101la gabalu (drenu), lai veicin\u0101tu strutu dren\u0101\u017eu, kam\u0113r uzs\u0101k medikamentozu terapiju un antibiotikas.<\/li><\/ul>\n","protected":false},"excerpt":{"rendered":"<p>\u010c\u016blain\u0101 kol\u012bta pacientiem Pacientiem ar \u010cK, \u012bpa\u0161i ja ilgtermi\u0146a medikamentoz\u0101 \u0101rst\u0113\u0161ana ir nav devusi gaid\u012bto rezult\u0101tu, vai ja rodas neatliekamas komplik\u0101cijas (piem\u0113ram, toksisks jeb fulminants kol\u012bts, kad resn\u0101 zarna strauji papla\u0161in\u0101s, dz\u012bv\u012bbu apdraudo\u0161i asins izpl\u016bdumi un zarnu perfor\u0101cija) vai resn\u0101s [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":9,"menu_order":15,"comment_status":"closed","ping_status":"open","template":"","meta":{"_themeisle_gutenberg_block_has_review":false,"footnotes":""},"class_list":["post-37","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/lkksb.lv\/index.php?rest_route=\/wp\/v2\/pages\/37","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/lkksb.lv\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/lkksb.lv\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/lkksb.lv\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/lkksb.lv\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=37"}],"version-history":[{"count":8,"href":"https:\/\/lkksb.lv\/index.php?rest_route=\/wp\/v2\/pages\/37\/revisions"}],"predecessor-version":[{"id":1556,"href":"https:\/\/lkksb.lv\/index.php?rest_route=\/wp\/v2\/pages\/37\/revisions\/1556"}],"up":[{"embeddable":true,"href":"https:\/\/lkksb.lv\/index.php?rest_route=\/wp\/v2\/pages\/9"}],"wp:attachment":[{"href":"https:\/\/lkksb.lv\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=37"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}