Inqubo Yokuhlinzekela Iziguli ze-COPD ezinezigqila ezinkulu
Uma unesifo se-chronic obstructive pulmonary noma i- COPD , ungase ube engozini yokuthuthukisa i-bullae enwetshiwe, enezingqimba ezincane, izikhala ezigcwele umoya endaweni yamaphaphu. I-bullae yimbangela yokuvimbela ngaphakathi kwe-tubon bronchiole noma i-bronchus. I-bullae enkulu idala ukucindezela okukhulu phezu kwesisekelo, izicubu zamaphaphu enempilo, okwenza lokho kuncishise ukugeleza kwegazi nokuphefumula emaphashini.
Lokhu kubangela ukuqhuma kwe- dyspnea noma ukuphefumula.
Uma i-bullae ikhula kakhulu (ngokuvamile ikhulu kunamentimitha eyodwa), udokotela wakho angase ancoma i-bullectomy ukuba aphathe futhi akusize uphefumule kangcono. Le nqubo yokuhlinza isusa i-bullae enwetshiwe, ivumela ama-sacs emoyeni enempilo emaphashini ukuba akhulise kahle. Lokhu kuzokwenza kube lula ukuphefumula.
Kudingeka nini i-Bullectomy?
Inqubo kucatshangwa noma kunini lapho kubonakala khona i-bullae egcwele umoya emoyeni x-ray noma CT scan. Iningi leziguli ezibhekwa njengokuhlinzwa kunezimpawu ezifaka:
- ukuphelelwa umoya
- ubuhlungu
- iphaphu eliphelile
Ezinye izimpawu, nakuba zingavamile, zifaka ukuphuma kwegazi nokutheleleka ku-bullae. Ezinye iziguli azikho izimpawu kodwa zingadinga ukuhlinzeka uma i-bullae ihlanganisa ingxenye engaphezu kwesigamu sesigxobo se-pleural-indawo egcwala amanzi ophakathi kwamabhungane ensimbi ajikeleze amaphaphu.
Uma udokotela wakho esolwa udinga i-bullectomy, uzohlola umsebenzi wakho wamaphaphu ngokusebenzisa ukuhlolwa okulodwa noma ngaphezulu ngaphambi kokuhlinzwa.
Ukuhlolwa okuvamile okulethwe ngaphambi kwe-bullectomy kufaka:
- i-x-ray yesifuba
- isifo se- CT scan
- izivivinyo zomsebenzi wamapulmoni
- ukuskena kwe-ventilation / perfusion noma i- VQ scan
- amaphaphu angiography
Iziguli ezine-bullae encane, i-hypercapnia, i-cor pulmonate, noma i-FEV1 engaphansi kwezingamaphesenti angu-40 ezibikezelwe azikhethwa ukuhlinzwa.
Ngaphambi kokuhlinzwa kuboniswa, udokotela wakho angase azame ukuphatha i-bullae yakho ekhulisiwe ngaphandle kwayo.
Uma ungabonakali, ukuyeka ukubhema kungenzeka kube ngokwanele ukuphatha lesi simo. Uma usenayo izimpawu ngemuva kokuyeka ukubhema, imithi, nokukhathazeka njengama-bronchodilators, i-glucocorticoids enganyanyisiwe, ukugoma, ukuphefumula okwenziwe nge-oksijeni noma ukuvuselelwa kwepulmasi kungasiza. Uma lezi zingasebenzi, ukuhlinzwa ngokuvamile kuvame ukusebenza.
I-Bullectomy Yenzani?
Udokotela wakho ohlinzayo angenza i-bullectomy ngenye yezindlela ezimbili. Enye yi-thoracotomy, lapho ukucubungula okungu-4 kuya ku-6-intshi kwenziwa ngaphansi kwe-armpit yakho. Udokotela ohlinzayo wabe esefaka ithubhu elikhanyayo elibizwa ngokuthi i-thoracoscope namathuluzi okuhlinzeka ngamathengisi ukuze asuse i-bullae.
Okunye okukhethwa kukho yi-thoracoscopy yevidiyo. Ngokufanayo ne-thoracotomy yendabuko, i-video thoracotomy ihilela isikrini sevidiyo futhi idonsa ukuthi iqondisa udokotela ohlinzayo. Kubandakanya ukubhekwa okuncane ezinhlangothini zesifuba. Uma i-bullae isusiwe, udokotela wakho ohlinzayo uzovala lokho okushiwo.
Kungakhathaliseki indlela ye-bullectomy udokotela wakho ohlinzayo ukhetha, ukuhlinzwa kwenziwa ngaphansi kwe-anesthesia jikelele. Lokhu kusho ukuthi uzodinga ukuzila ukudla ngaphambi kokuhlinzwa. Qiniseka ukuthi ulandela yonke imiyalelo kadokotela wakho.
Ukubuyiswa okuvela ku-bullectomy kungathatha amasonto ambalwa uze uphinde uthole amandla akho futhi ukwazi ukubuyela emsebenzini.
Ngalesi sikhathi, kufanele uxhumane nodokotela wakho uma uhlangabezana nalokhu:
- ukuphuma
- ukutheleleka ku-incision
- ukushisa okuphezulu
- izibonakaliso zokuphendula okweqile kubandakanya ukubomvu, ukuvuvukala nokukhathazeka ngokuphefumula
- ubuhlungu
Umthombo
- > Krishnamohan P, Shen KR, i-Wigle DA, et al. I-Bullectomy ye-giant lung bullae ephawulekayo noma eyinkimbinkimbi. U-Ann Thorac Surg 2014; 97: 425-31.