Izinhlobo ze-Pneumonectomy nezizathu zokuhlinzwa
I-pneumonectomy uhlobo lokuhlinzwa komdlavuza wamaphaphu lapho wonke amaphaphu asuswa njengokwelashwa umdlavuza wamaphaphu. I-pneumonectomy nayo yenziwa ngezikhathi ezithile kwezinye izimo, ezifana nesifo sofuba, i-COPD eqinile, noma ukuhlukumezeka okuphazamisa imikhumbi yegazi emikhulu eduze kwamaphaphu.
(Okunye ukuhlinza okwenziwe ngomdlavuza wamaphaphu kubandakanya ukuguqulwa komgqa kanye ne- lobectomy .)
Izinhlobo ze-Pneumonectomy
Kunezinqubo ezimbili zokuhlinzekela eziyinhloko ngaphansi kwesihloko se-pneumonectomy:
- I-Pneumonectomy ejwayelekile : Nge-pneumonectomy ejwayelekile, i-lung lungile (eliqukethe ama-lobes angu-3) noma i-lungs yangakwesokunxele (equkethe 2 lobes) isusiwe.
- I-pneumonectomy eyengeziwe : Ku-pneumonectomy engavamile, enye yamaphaphu isusiwe kanye nengxenye yecalafragm , i-membrane efaka isikhumba esifubeni ( pleura ), futhi ingxenye yesikhumba esinezinhliziyo (i-pericardium). Le nqubo ivame ukuyenzelwa i- mesothelioma , uhlobo lomdlavuza oqala emgodini ojikeleze amaphaphu.
Kwenziwe Nini?
Uhlobo lokuhlinzekwa komdlavuza wamaphaphu udokotela wakho uncoma ukuthi luzoxhomeka ezintweni eziningana, kuhlanganise:
- Indawo yesikhumba sakho.
- Ubukhulu besisu sakho.
- Kungakhathaliseki ukuthi ubuhlungu bakho buye basakazeka yini kumathissi aseduze.
- Isimo sakho sezempilo jikelele.
- Amaphaphu akho asebenza kanjani kahle ngaphambi kokuhlinzwa.
I-pneumonectomy ivame ukwenza njengokwelashwa komdlavuza ongasona omncane wesifo samaphaphu , lapho inqubo encane engavumayo, njenge- lobectomy , ayikwazi ukususa sonke isisu.
Lokhu kungenzeka uma i-tumor ikhulu, uma isakaze ngaphezu kwe-lobe eyodwa, noma uma ikhona endaweni ephakathi yamaphaphu.
Ngenxa yokuthi i-pneumonectomy ihilela ukukhipha wonke amaphaphu, inqubo ivame ukugcinwa kulabo bantu abanomsebenzi okwanele wamaphaphu futhi bazokwazi ukubekezelela ukuhlala nephuphu elilodwa kuphela.
Lokho kusho ukuthi abantu abaningi baye baphila ukuphila okusebenzayo kulandela i-pneumonectomy.
Ukulungiselela i-Pneumonectomy
Lapho ulungiselela i-pneumonectomy yakho ngomdlavuza wamaphaphu, uzovakashela udokotela wakho futhi ube nokuhlolwa okunezinyathelo ezenziwe ukuze kuqinisekiswe ukuthi inqubo iphumelele ngangokunokwenzeka. Njengoba ukuhlinzwa akuyona ukwelashwa okujwayelekile komdlavuza wamaphaphu osakaze ngaphezu kwamapayipi, udokotela wakho uzotusa izivivinyo ukulawula noma yikuphi ukusabalalisa ( metastasis ) yomdlavuza.
Lokhu kungabandakanya ukuskena kwethambo ukuze kubheke ukusakazeka komdlavuza oswini , ukuskena kobuchopho ukuze kulawulwe ama- metastases obuchopho , kanye neskena lesisu ukuze kulawulwe izidakamizwa zesibindi kanye ne- metastase ye-adrenal .
Ukuhlolwa kuzokwenziwe ukuze uqiniseke ukuthi uzokwazi ukubekezelela ukuhlala nephaphu elilodwa kuphela. Izivivinyo zomsebenzi wepulmonary zizohlola amaphaphu akho anempilo futhi zithole ikhono layo lokuletha oksijeni okwanele emzimbeni wakho wedwa. Udokotela wakho angase futhi ancoma ukuhlolwa ukuze aqiniseke ukuthi inhliziyo yakho isebenza kahle njengoba ukuhlinzwa kungeza ukucindezeleka enhliziyweni. Umlando oqaphile, ukuhlolwa ngokomzimba kanye nomsebenzi webhu kuzokwenziwa ukuqinisekisa ukuthi unempilo ngangokunokwenzeka.
Emva kokuba udokotela wakho efunde imiphumela yezivivinyo zakho, uzoxoxa ngokucophelela ngezinzuzo nezingozi zokuhlinzwa. Kuyasiza kakhulu ukuletha uhlu lwemibuzo nawe ukuze uqiniseke ukuthi yikuphi ukukhathazeka ongakunaki.
Uma kukhona noma yimiphi imithi engakhuphula ukuphuma kwegazi, njengeCoumadin (warfarin).
i-aspirin, noma imishanguzo elwa nokuvuvukala njenge-Advil (ibuprofen), udokotela wakho uzokutusa ukuyeka lokhu isikhathi esithile ngaphambi kokuhlinzwa kwakho. Qinisekisa ukuthi uvumele udokotela wakho wazi uma usebenzisa noma yiziphi izindlela zokwelapha zamakhemikhali noma izithako zokudla okunempilo, ngoba ezinye zazo zingancipha igazi lakho.
Uma ubhema, udokotela wakho uzakutusa kakhulu ukuthi uyeke ngokushesha ngangokunokwenzeka ngaphambi kokuhlinzwa kwakho. Ucwaningo luye lwabonisa ukuthi ukuhlinzwa komdlavuza wamaphaphu kuphumelela futhi kunezinkinga ezimbalwa uma abantu beyeka ukubhema kusengaphambili .
Ngobusuku ngaphambi kokuhlinzwa, udokotela wakho uzokutusa ukuba "ugijime" - okungukuthi, ungadli noma uphuze noma yini (ngisho namanzi) okungenani amahora angu-8.
Ngomuso kokuhlinzwa kwakho, umhlengikazi uzokubuza imibuzo eminingana bese ufaka i-IV (umugqa ohambisayo) engalweni yakho. Uyophinde afane nawe nabaqaphi ukuze ukucindezeleka kwegazi lakho, izinga lokushaya kwenhliziyo, namazinga e-oksijeni kungalandelwa kulo lonke ukuhlinzwa. Udokotela wakho ohlinzayo uzovakashela futhi axoxe ngenqubo futhi akucele ukuthi usayine ifomu lokuvuma . I-anesthesiologist izovakashela futhi ukukhuluma nge- anesthesia oyonikezwayo , bese ubuza nganoma yiziphi izinkinga wena noma amalungu omndeni wakho oye wazibonela nge-anesthesia esikhathini esidlule. Abasebenzi begumbi lokusebenza bazoqondisa umndeni wakho endaweni yokulinda, lapho abasebenzi abahlinzekwa khona bangabagcina babuyekezwe ngokuqhubekayo kwakho futhi ukhulume nabo lapho ukuhlinzwa kwakho kuphelile.
Ngesikhathi se-Pneumonectomy
Ekamelweni lokusebenza, uzonikezwa ukuhlinzekwa komzimba okujwayelekile ukuze ulale, futhi i-endotracheal tube izofakwa emlonyeni wakho ukuvumela i- ventilator ikuphefumule ngesikhathi sokuhlinzwa.
Ukuqubuka okude kuyokwenziwa eceleni kwakho ngokulandela ijika lezimbambo zakho. Udokotela ohlinzayo uzosakaza izimbambo zakho futhi angasusa ingxenye yembambo ukuze athole amaphaphu akho.
Uma amaphaphu akho evuliwe ngokwanele, ithimba elihlinzayo lizowela iphaphu lakho eliqukethe umdlavuza. Imithambo yegazi emikhulu (i-arteries kanye nemivilini) ehamba emapapheni yakho izoboshwa, futhi i- bronchus eholela emaphashini iyoboshwa futhi igodliwe.
Ngemuva kokuphulukiswa kwamaphaphu, udokotela ohlinzayo uzohlola ngokucophelela ukuze aqiniseke ukuthi konke ukuphuma kwegazi kulawulwa, futhi uzovala lezo zinto.
Isikhala esisele lapho iphaphu lakho lizobe lizogcwaliswa kancane kancane nge-fluid.
Ngemuva kwe-Pneumonectomy
Uma ukuhlinzwa kwakho kuqediwe, uzosuswa ekamelweni lokutakula lapho uzobe uhlolisise khona amahora ambalwa. Kwezinye izimo, ungase uthathwe ngqo kwiyunithi yokunakekelwa okujulile (i-ICU). Ngemva kokululama, abantu abaningi basebenzisa izinsuku zokuqala eziningana ku-ICU. Ngosuku lokuqala, ukuphefumula kwakho kungasizwa nge-ventilator.
Njengoba lokhu kungabangela ukukhathazeka okuthile, uzonikezwa imithi egcina ulele kakhulu kuze kube yilapho ithubhu isuswa.
Uma isitsha se-ventilator sisusiwe futhi ulala kancane, isazi sokuphefumula sizokucela ukuba ukhwehlele, futhi sizokusiza ekusebenziseni i-spirometer yokukhuthaza. Lona idivayisi oyifumayo ukuze usebenzise amaphaphu akho, futhi usize ukugcina amabhasi amancane emoyeni akho avulekele.
Uma ukwazi, abahlengikazi bazokusiza ukuba uhlale, bese kukukhuthaza ukuvuka uphinde uhambe ngosizo. Ngeke uzizwe sengathi usebenza, kodwa ukwandisa umsebenzi wakho kuzokusiza ukuthi uphinde uphinde uthole amandla akho ngokushesha, futhi unciphise ingozi yokuthuthukisa ama- blood clots . Iningi labantu lichitha okungenani izinsuku ezingu-6 kuya kwezingu-10 esibhedlela ngemuva kokuhlinzwa.
Abanye abantu babuyela emsebenzini emva kwamasonto angu-8, kodwa udokotela wakho uzokunika imikhawulo ekhethekile, njengokugwema ukuphakamisa okunzima. Kuzophinde kuthathe isikhathi sokuba iphalenda yakho isele, futhi ukuphefumula kungaqhubeka izinyanga ezimbalwa emva kokuhlinzwa.
Nini Ukubiza Udokotela Wakho
Uma ukhishwa esibhedlela, uzonikezwa imiyalo ngokucophelela ukuthi ungayinakekela kanjani ekhaya nokuthi uzokulandela nini nodokotela wakho. Phakathi kwama-aphoyintimenti, kufanele ubize udokotela wakho uma unamanye izimpawu noma imibuzo ephathelene nawe. Shayela udokotela wakho ngokushesha lapho uhlakulela umkhuhlane, unesihlungu esifubeni esihluke kulokho obekuhlangenwe nakho, ube nokuphefumula okuncane, ube nokuphuma noma ukubomvu eduze kwe-incision yakho, noma uma uthuthukisa noma yikuphi ubuhlungu emanzini akho (kungenzeka ama-clots wegazi).
Izinkinga
Ngenxa yokuthi i-pneumonectomy iyinkambiso enkulu yezokwelapha, izinkinga ze-pneumonectomy azivamile. Udokotela wakho uzoxoxa ngalokhu nawe ngaphambi kokuhlinzwa kwakho. Ezinye izinkinga ezingase zibandakanye:
- Isidingo sokuphefumula isikhathi eside ngemva kokuhlinzwa
- Izifo, njenge-pneumonia
- Ukuphuza
- I-fistula ye-bronchopleural - uxhumano phakathi kwe-bronchus eyanqunywa kanye nendawo phakathi kwe-pleura
- Izinkinga zenhliziyo, ezifana nesifo senhliziyo noma izilinganiso ezingavamile zenhliziyo
- Isibungu
- Ama-blood clots emilenzeni (inhlanzi ejulile ye-vein) noma ehamba emaphashini akho ( embolism embolism )
- I-Empyema - i-pus esikhaleni phakathi kwezingqimba (i-pleura) efaka emaphashini
- Izinkinga ezihlobene ne-anesthesia
- Izinkinga zezinso noma ukwehluleka kwezinso
- I-postpneumonectomy syndrome - izimpawu ezibangelwa izitho ezifubeni ezigcwalisa isikhala esishiye singekho emaphashini asusiwe
- Ubuhlungu obungapheli ekukhungeni kwakho noma lapho izimbambo zakho zinqunywe khona
Isibikezelo
Isibikezelo esilandelayo ngemuva kwe-pneumonectomy sincike ezintweni eziningi. Ezinye zazo zibandakanya ukuthi yikuphi ukuphuza okususwe (ukuchazwa kahle kungcono kwe-pneumonectomy kwesokunxele kune-pneumonectomy efanele), isiteleka somdlavuza , ubulili (abesifazane bavame ukwenza kangcono kunamadoda), uhlobo lomdlavuza wamaphaphu , nokuthi unempilo kangakanani jikelele ngaphambi kokuhlinzwa. Ukuphindaphindiwe komdlavuza emaphashini akuvamile ngemva kwe-pneumonectomy, kodwa ngezinye izikhathi umdlavuza wamaphaphu ungaphinda ufike ezindaweni ezikude zomzimba.
Imithombo:
I-American Cancer Society. Umhlahlandlela oningiliziwe: I-Cancer Lung - I-Cell-Non-Small. Ukuhlinzwa. Kubuyekezwe 05/16/16. http://www.cancer.org/cancer/lungcancer-non-smallcell/detailedguide/non-sall-cell-lung-cancer-treating-surgery
U-Erhunmwunsee, uL. and M. Onaitis. Ukuyeka ukubhema nokuphumelela kokuhlinzwa komdlavuza wamaphaphu. Imibiko yamanje ye-Oncology . 2009. 11 (4): 269-74.