I-interlocutor yethu - udokotela ohlinzayo ohlonishwayo uJaroslav Susak, MD kanye noprofesa, wenza ngempumelelo ukusebenza kwesibindi namaphakethe, adinga ubuchwepheshe obuhle.
Jaroslav Mikhailovich , yiziphi izinkinga eziyinkimbinkimbi kakhulu, futhi uzibhekana kanjani nazo?
Ukukhubazeka okukhulu kakhulu - i-pancreatitis enzima. Ukwelashwa okungenakuqhathaniswa nodokotela kungaholela ekushintsheni okungenakuguqulwa nokufa. I-pathologies yesibindi, i-bile ducts kanye ne-pancreas ihlale isongela kakhulu empilweni yesiguli, futhi ukusebenza kulezi zitho kudinga ulwazi kanye namakhono akhethekile. Udokotela ohlinzayo ohlonishwayo uJaroslav Susak usebenza ngendlela kaProfesa Zemskov, ososayensi onethalente nodokotela ohlinzayo, owayenenhlanhla yokufunda. Futhi waba nesipiliyoni esiwusizo kakhulu esikhungweni se-European Center for Surgery esibindi. Ngaphambili esibhedlela sosizo lokuqala, lapho ngisebenza khona ngonyaka wesithathu, kwakukhona iminyango ezine yokuhlinzeka yonke indawo. Kamuva, ngenxa yokuhlelwa kabusha, kwabe sekusemandleni ethu ukuthuthukisa ulwazi olutholakale futhi wethule izindlela zokuqhubeka. Isibonelo, singenza i-hemo-ne-lymphosorption (ukuhlanzwa kwegazi ne-lymph) ngehora, mahhala, kuziguli ezimbi. Inkambiso enzima kangaka ivame ukutholela isiguli futhi ngokuqinisekile imbuyisela ekuphileni.
Udokotela ohlinzayo ohlonishwayo uJaroslav Susak, wathi ngokucindezeleka okunamandla kunengozi empilweni yesiguli. Ubhekana kaningi kangakanani nalesi sifo?
Alas, kaningi. Ezimweni eziningi, i-ambulensi isinikeza iziguli kithi, ngoba sithole isipiliyoni esikhulu sokunakekelwa kweziguli kule nkinga, kanti izinga layo liphakeme kakhulu. Unyaka esibhedlela uthola iziguli eziyizinkulungwane eziyinkulungwane, okuyizinkulungwane ezingu-130-150 ezimbi kakhulu. I-pancreatitis enhle ingabonakala njengengcindezi ye-cholelithiasis, imbangela yayo yesibili ingumuthi wokudla utshwala, okwenza umonakalo onamandla onobuthi esibindi nesibindi, endaweni yesithathu yokulimala. Ngezimbangela ezivamile zokuphefumula okunamandla nakho kungabizwa ngokuthi ukwephulwa kwe-hormonal sphere, izifo ze-parathyroid, ukuphazamiseka kwesifo sikashukela, isifo sikashukela.
I-Yaroslav, cishe, ayikwazi ukubhekwa njengeminye izimo eziyingozi zeziguli ezilethwe i-ambulensi?
Ngezimo ezilula zingabhekana ngokuthula kwezinye izibhedlela. Ngokuvamile, samukela iziguli nazo zonke izifo zokwelapha: i-appendicitis ejulile, i-cholecystitis, i-percerated ulcer ulcer, i-jaundice yokuhlinzwa, ne-peritonitis njengengcindezi yabo, kanye nezimo eziphuthumayo emdlalweni we-pancreatic.
I-Yaroslav, egumbini lokulinda, iziguli zifika ngokushesha ekamelweni lokusebenza?
Hhayi ngaso sonke isikhathi. Konke kuncike ekuxilongweni nesimo sesiguli. Kwenzeka ukuthi isiguli sidinga ukulungele ukusebenza, ukubamba ukwelashwa okusekelayo. Uma umuntu enesifo esibuhlungu noma egazini elimangalisayo, lapho wonke umuntu enquma imizuzu, siyamyisa ngokushesha etafuleni lokusebenza. Amacala ayingozi kakhulu uma sibhekene nemiphumela ye-cholelithiasis. Ukuhamba ngezinyawo ze-bile, itshe libaphazamisa, okuholela ekugxileni, ekuguleni kwe-stenosis, ekucindezelweni okwandayo kumaphakethe nokuvuvukala kwawo. Kulokhu, isiguli sibhekene nobuhlungu obunzima, isimo sakhe sihlahloka kakhulu. Ukulondoloza abagulayo, sisusa leli tshe. Uma uthola amatshe, ungasebenzisi izindlela ezingabazeki futhi ulinde ukuthuthukiswa kwe-pancreatitis, ngoba uzoqala ngokushesha. Ngikholelwa ukuthi amatshe ahlale ekhombisa ukuhlinzwa.
Udokotela ohlinzayo ohloniphekile uJaroslav Susak, futhi empeleni abanye abantu bakholelwa ukuthi ukuhlinzwa ngeke kubalondoloze ekuvuseleleni kwamatshe?
Kulungile, ngani? Ukususa i-gallbladder (i-reservoir, lapho kwakhiwa khona amatshe), ngaleyo ndlela sixazulula le nkinga: i-bile ishesha ukungena emathunjini futhi izimo zokubunjwa kwamatshe azivuki. Emva kokusebenza, uma kwenziwa kahle, isiguli kumele sinamathele emikhawulweni ethile izinyanga ezine, bese iphila ngaphandle kokuthatha imithi. Kuyingozi kakhulu uma i-gallbladder isendaweni, kodwa ayisebenzi. Ngenxa yokulimala kwe-bile, kutholakala ukutheleleka okungapheli, okuholela ekubhubhiseni kwamadayipi, bese kuhlaselwa i-pancreatitis.
Jaroslav, futhi kwenzekani ngemva kokususwa kwe-pancreas?
I-gland isuswe esithombeni esibi. Ngemuva kokusebenza (kodwa hhayi esikhundleni sayo!) Sisebenzisa izidakamizwa ezandisa kakhulu isikhathi sokuphila seziguli.
Kukhona izinganekwane mayelana nalesi sidakamizwa. Awuxoshwa? Ngisebenzisa i- "Ukraina", eyakhiwa e-Austria yi-Novitsky yase-Ukraine ngo-1972, iminyaka eminingi. I-analogue yakhe, imithi yethu yasekhaya "Amitazin", eyabhalwa nguDkt. Potopalsky, yabonakala ekuqaleni - ngo-1959. "I-Ukraina" iphumelela ngezicubu ezihlukahlukene, ikakhulukazi lezo ezingaphenduli i-chemotherapy (lezi zihlanganisa izicubu ze-pancreatic, i-melanoma, ne-ovarian tumors). Leli khambi liphawuleka ngokuthi akuphatheli kuphela ukubonakaliswa kwendawo, kodwa isifo sezinto eziphilayo. Iphazamisa amangqamuzana abulalayo kuphela futhi ijwayele ukuvimbela ukuzivikela. Kungaba ukunyanyisa ukusho ukuthi "i-Ukraina" iyakwazi ukwelapha zonke iziguli ezenzakalelayo, kodwa kwandisa amathuba akhe okusinda. Lokhu kuyindlela yokwelapha ephumelelayo, okuthuthukisa ikhwalithi nokulinda kwempilo yesiguli ngemuva kokuhlinzwa.
Udokotela ohlinzayo ohlonishwayo uJaroslav Susak, ufuna ukusho ukuthi ukususwa kwe-tumor - hhayi okwamanje?
Kulungile. Ukusebenza akusona isikhathi sokukhohlwa ngenkinga ngokukodwa. Ngomkhuba wami kwakukhona icala lapho sisebenza owesifazane, bese siphathwa nge "Ukraine". Ngemva kwesikhashana isiguli sethu sigxilile ngokuphepha futhi sazala ingane enempilo. Kumele kukhunjulwe ukuthi umdlavuza awubonakali ngaphandle kwesizathu: zikhona njalo izici eziholela ekuthuthukiseni umdlavuza. Ukusebenza akukwazi ukuqeda ngokuphelele lo muntu okhethekile wenyama yakhe. Akusilo ithemba elikhulu ... Ukuxazulula inkinga enzima kangaka ngokusizwa kuphela nge-scalpel akunakwenzeka.
Isifo siyisikhumbuzo esibi kakhulu sokuthi umuntu kufanele anakekele empilweni yakhe. Kwenzeke kaningi ukuthi ngemva kokuba isisu sisuswe endaweni eyodwa, emva kwesikhathi sasivela kwenye. Kungani?
Kodwa yilokho esikudingayo ukusebenza. Ngiphinde ngibuyele ezigulini: "Khumbula ukuthi emva kokuhlinzwa akudingeki nje kuphela uqhubeke nokwelashwa, kodwa futhi uguqule kakhulu indlela yakho yokuphila."
I-Yaroslav, kodwa uma umuntu engashintshi?
Uhlala ekhetha - nendlela yokwelashwa, nezinqumo, noma ukulwa naye noma cha. Kodwa azikho izindinganiso ezifanelwe ngokuphelele kubo bonke abantu, futhi asikwazi ukuqinisekisa ukuthi izindlela noma izindlela ezafika komunye nazo ziyothinta omunye. Bonke abantu bahlukile: isiguli esisodwa siyabona inqubo yokwelashwa njengomsebenzi futhi sigcwalise ngokugcwele yonke imiyalelo kadokotela, kanti enye iya ekuguleni kwakhe futhi ayilwa. Yiqiniso, bayoba namathuba ahlukene nokubikezela.
Uzizwa kanjani ngemithandazo yezempilo, uvakashele izinto ezingcwele? Bangakwazi ukuletha ukuphulukiswa? Ukholo njalo kusiza ekususeni noma yisiphi isifo. Kwezinye iziguli, ukuguqulwa kwezicubu kwenzeka ngokuzenzekelayo. Kodwa lezi zinkimbinkimbi. Isici sengqondo sibaluleke kakhulu, angikuphikisana. Kuyaziwa nangokuthi iziguli, ezithandazela ngobuqotho, ziyabuyela ngokushesha. Kodwa-ke, isifo esibi kufanele siphathwe ngezindlela ezinzulu. Uma ngibona isiguli esinenkinga noma enye inkinga enkulu, ngeke ngimbize esontweni futhi ngithembele kuNkulunkulu. Kodwa angathandaza ukuze aqiniswe ngokomoya: ngaso sonke isikhathi usekela kakhulu. Kumele kukhunjulwe: uma uboniswa ukusebenza, ukuhlehlisa ukuhlehlisa kuyingozi nje.
Jaroslav Susak , uke wazi ukuthi labo abanethemba baphuthuma ngokushesha?
Udokotela kufanele ahlale ekhumbula isikhathi sakhe. Ngifundisa abafundi bami ukuba bacabangele uhlobo lwesiguli, ukwamukela kwakhe. Umuntu ngamunye udinga ukukhuluma ngezindlela ezehlukene, ecabangela indlela aphatha ngayo ukugula kwakhe.
Yiqiniso, uma sinenkinga elula, isibonelo, ukufakwa kwesifiso, ngakho-ke singase sihlabelele ngalokhu, okuyinto ezimweni eziningi kubonakala ngokuqonda. Nakuba nginitshela ukuthi: wonke umuntu ojwayelekile uyamesaba udokotela ohlinzayo kanye nokungenelela kokuhlinzwa. Kungase kungabi khona ukwesaba abantu okwanele, abangazi lutho, nalabo abangenalutho lokulahlekelwa. Isibonelo, uma umuntu ekhonza isigwebo ezindaweni zokulahla inkululeko, ubona ukuhlinzwa nokuphathwa, cishe njengendawo yokubhuka. Wonke umuntu unesibalo sakhe sokwesaba, kepha uma uhlala enhle ngaso sonke isikhathi, lokhu kuphethwe ukuhlukumeza kwenkinga. Kubalulekile ukubona ukuhlinzwa nokuphathwa esibhedlela njengenqubo yemvelo, hhayi njengento engavamile. Zama ukuthatha kalula futhi uzisebenzele kanzima. Ngakho umzimba wethu uhlelwe, ukuthi ngezinye izikhathi uhluleka, njenganoma iyiphi indlela. Uma ufuna ukumsiza, kufanele uqinisekise lokhu ngezenzo zakho - ngaleyo ndlela uzokwandisa impilo yakho. Kodwa ukuwela ekucindezelekeni, ngokuphambene nalokho, kwandisa isimo, kungabe uzilimaza kuphela.
Mhlawumbe zonke iziguli , ukufika kudokotela ohlinzayo ofanelekayo u-Yaroslav Susak, ucabanga: Futhi kungani ngingenalo ... "Wonke umuntu uqhubeka nalesi nkulumo. Jaroslav, yini "hhayi" ocabanga ukuthi iyona efanele kakhulu?
Okokuqala - i-appendicitis enzima. Ngokuvamile kwenzeka kubantu abadla okungalungile. Kodwa ukuphuma nge-cirrhosis yesibindi kungabangela ukuphuza ngokweqile, isibindi se-hepatitis. Isilonda sokuqhamuka kwesisu noma i-duodenum kungenxa yokungalungi ekudleni, impilo engalungile, ukucindezeleka. Isifo se-bile siyisidlo esingajwayelekile ngaso sonke isikhathi, ukudla okunamafutha, inqwaba yezidlo ezinamakha. Ukuhlonipha kubaluleke kakhulu. Uma othile emndenini wakho ehlushwa yilesi sifo noma leso sifo, kungenzeka ukuthi unomkhuba kuwo. Lokhu ukukhanya okuyisixwayiso, isixwayiso sokuthi udinga ukuba uqaphe futhi unamathele ekulinganiseni kukho konke.
Jaroslav, kungenzeka yini ukugwema izimo ezicindezelayo ngokulandela imithetho?
Kunzima ukusho into entsha lapha. E-Ukraine, akekho ohilelekile ekuvimbeleni, njengoba, isibonelo, kwakunezikhathi zaseSoviet. Uhlelo lwezempilo lweSoviet, ngokuhlolwa kwalo okuvimbela, ukuhlolwa kwezokwelapha, odokotela besifunda, benza umsebenzi omuhle. Kwabhujiswa, kodwa ngesikhathi esifanayo abazange bashintshe noma yini. Ngikholelwa ukuthi lowo owenze lokhu wenza isono esikhulu. Uhlelo lwe-Semashko lusabhekwa njengelinye lamahle kakhulu emhlabeni. Namuhla, ukuhlolwa kokuvimbela kungavamile. Ngenxa yalokho, lesi sifo sitholakale kakade esiteji lapho kudingwa ukuhlinzwa okudingekayo. Yebo, uma i-ambulensi ilawula ukusigulisa isiguli, futhi singamlondoloza.
Namuhla, iningi labantu lihlanganyela ngokuzikhandla ekuziphatheni, kuhle, ulwazi ngemithi lungatholakala kwi-Inthanethi, kuboniswe emakethe. Ecabanga ukuthi lokhu kuyindaba yakhe, umuntu uqala ukuthatha izidakamizwa akudingeki! Ngisho nodokotela akakwazi ukuphulukisa ngokwakhe, ngoba angeke abe nomgomo: umbono wangaphandle ubaluleke kakhulu. Yini esingayisho ngesiguli esiphathwa ngokungahleliwe!
Udokotela ohlinzayo ohloniphekile uJaroslav Susak, ungaba yini icala ngokuzikhandla, okukhumbula kakhulu?
Ngaleso sikhathi ngasebenza esibhedlela. Ebusuku, owesifazane wakhononda ngesisu esisemkhulu. Izinsuku ezintathu wayekhathazeka ubuhlungu, nezihlobo ezinesihawu (emndenini babeyizidokotela) zamnika iziguli zokuphuza. I-anaesthetized kahle ... Njengoba sekuvele etafuleni lokusebenza, isiguli sasine-ulcer perforating ulcer. I-Peritonitis yaqala. Owesifazane waba nemisebenzi emithathu, kwaba kathathu ekunakekeleni okukhulu. Sivele sishaye izandla zethu.
Ngenhlanhla , isiguli sagcinwa. Ngemva konyaka, sasebenza emtholampilo wakhe, sibeka inetha elikhethekile, kanti uthisha osetha umhlalaphansi uhlala ngokuthula. Sekudlule iminyaka eyisithupha, lo wesifazane ufika kithi ukuze athole iseluleko, alandele yonke imiyalelo yezokwelapha ngokucophelela. Ngicabanga ukuthi akayena ozozibulala.
Udokotela ohlinzayo ohlonishwayo u-Yaroslav Susak unendodakazi nezingane. Uthanda umsebenzi wakhe futhi uyaziqhenya ngokuthi umsebenzi wakhe ukusiza abantu.