Iintlobo zePneumonectomy kunye nezizathu zoBuloyiko
I-pneumonectomy uhlobo lwe-operesheni yomhlaza wamaphaphu apho kususwe umphunga wonke njengonyango lomhlaza wemiphunga. I-pneumonectomy iyenziwa ngezinye iimeko kwezinye iimeko, ezifana nesifo sofuba, i-COPD eninzi, okanye i-trauma ephazamisa imithwalo yegazi emikhulu kufuphi nemipopu.
(Olunye uphando olwenzelwe umhlaza womphunga luquka ukuthengiswa kwemida kunye ne- lobectomy .)
Iintlobo zePneumonectomy
Kukho iinkqubo ezimbini zokupasa eziphambili phantsi kwesihloko se-pneumonectomy:
- I-Pneumonectomy ephezulu : Nge-pneumonectomy efanelekileyo, mhlawumbi umphunga welungelo (oqulethe i-lobes 3) okanye umphunga wekhohlo (oqukethe i-lobes 2) ususwe.
- I-pneumonectomy eyongezelelekileyo : Kwi-pneumonectomy eyongezelelweyo, enye yemiphunga isuswa kunye nenxalenye yesithintelo , isalathisi esibandakanye isigxina sesifuba ( pleura ), kunye nenxalenye yembumba yokudibanisa intliziyo (i-pericardium). Le nkqubo ininzi iyenzeka kwimethliyolioma , uhlobo lomhlaza oqala kumbindi ojikeleze iimpompo.
Yenza nini?
Uhlobo lomhlaza wesifo somphunga ugqirha ugunyazisa luya kuxhomekeka kwizinto eziliqela, kuquka:
- Indawo yakho yokudlala.
- Ubungakanani besisu sakho.
- Ingakhathaliseki ukuba isifo sakho sisifo sifikelele kumathambo asondeleyo.
- Ubume bakho bempilo.
- Impompo yakho isebenza kakuhle ngaphambi kokuhlinzwa.
I-pneumonectomy yenziwa ngokuqhelekileyo njengonyango lomhlaza wesifo somhlaza wamangqamuzana , xa inkqubo encinane yokungena, njenge- lobectomy , ayikwazi ukususa i-tumor.
Oku kunokwenzeka ukuba i-tumor ikhulu, ukuba isasazeka ngaphaya kwe-lobe enye, okanye ukuba ikhona kwindawo ephakathi yemiphunga.
Ngenxa yokuba i-pneumonectomy iquka ukususwa kwempompo yonke, le nkqubo igcinwa kulabo bantu abanomsebenzi okhethekileyo wamaphaphu kwaye baya kukwazi ukunyamezela ukuhlala nomphunga omnye kuphela.
Oko kwathiwa, abaninzi abantu baye bahlala ubomi obusebenzayo emva kwe-pneumonectomy.
Ukulungiselela iPneumonectomy
Xa ulungiselela ukunyuka kwepneumonectomy yomdlavuza wamaphaphu, uya kutyelela ugqirha wakho kwaye unemivavanyo emininzi eyenziwe ukuqinisekisa ukuba inkqubo iyaphumelela ngangokunokwenzeka. Ekubeni utyando alukho unyango oluqhelekileyo lomhlaza wemiphunga oye wanda ngaphaya kwemiphunga, ugqirha wakho uya kuncomela iimvavanyo ukulawula nayiphi na isasazeka ( metastasis ) yomhlaza.
Ezi zingabandakanya ukukhangela kwithebhu ukujonga ukusasazeka komhlaza kwisithambo , ukukhangela ingqondo ukulawula ubuchopho be-metastase , kunye neskripthi esiswini ukuze ulawule i- metastase yesibindi kunye ne- adrenal metastases .
Uvavanyo luya kwenziwa ukwenzela ukuba uqiniseke ukuba uya kukwazi ukunyamezela ukuhlala nomphunga omnye kuphela. Iimvavanyo zomsebenzi wePulmonary ziza kuhlola imiphunga yakho enempilo kwaye iqinisekise ukukwazi ukuhambisa i-oksijeni eyaneleyo emzimbeni wakho yedwa. Ugqirha wakho unokuphinda ukhuthaze iimvavanyo ukuqinisekisa ukuba intliziyo yakho isebenza kakuhle ekubeni utyando lunokunyusa uxinzelelo entliziyweni. Umlando oqapheleyo, uvavanyo lomzimba kunye nomsebenzi webhu uya kwenziwa ukwenzela ukuba uqiniseke ukuba unempilo enokwenzeka.
Emva kokuba ugqirha wakho ufunde iziphumo zeemvavanyo zakho, uya kuxoxa ngokucophelela ngeenzuzo kunye neengozi zokuhlinzwa. Kunceda kakhulu ukuzisa uluhlu lwemibuzo kunye nawe ukuqinisekisa ukuba kukho na ukukhathazeka ongenakukujongelwa.
Ukuba ukhona nawaphi na amayeza anokunyusa igazi, njengeCoumadin (warfarin).
i-aspirin, okanye imishanguzo echasayo efana ne-Advil (ibuprofen), ugqirha wakho uya kucetyiswa ukuba ayeke ukuyeka le ixesha ngaphambi kokuhlinzwa kwakho. Qinisekisa ukuvumela ugqirha wakho ukuba uyazi ukuba usebenzisa naziphi na izilwanyana zamachiza okanye izongezelelo zondlo, kuba ezinye zezi zinto zinganciphisa igazi lakho.
Ukuba utshaya, ugqirha wakho uya kuncomela ukuba uhambe ngokukhawuleza ngaphambi kokuhlinzwa kwakho. Ucwaningo luye lwabonisa ukuba ukuhlinzwa komhlaza wamaphaphu kuphumelele kwaye kunemingcipheko encinane xa abantu beyeka ukutshaya ngaphambili .
Ngobusuku ngaphambi kokuhlinzwa, ugqirha wakho uya kukuphakamisa ukuba "ukhawuleze" - oko kukuthi, ungadli okanye ungasiphuli nantoni (nokuba ngamanzi) ubuncinane ubuncinane iiyure eziyi-8.
Ngomso wokuhlinzwa kwakho, umongikazi uza kukubuza imibuzo emininzi kwaye abeke i-IV (umgca wokubamba) entengeni yakho. Uya kulungelelana nawe kunye nabagadi beenyawo ukwenzela ukuba uxinzelelo lwegazi, izinga leentliziyo, kunye namazinga oksijini libekwe iliso kulo lonke uphando. Ugqirha wakho uza kubuya kwakhona axoxe ngenkqubo kwaye akucele ukuba usayine ifomu yokuvuma . I-anesthesiologist iya kutyelela ukuthetha nge- anesthesia uya kunikwa, kwaye ubuze malunga naziphi na iingxaki wena okanye amalungu omndeni wakho oye wazifumana nge-aneshesia esikhathini esidlulileyo. Abasebenzi begumbi lokusebenza baya kubakhokela intsapho yakho kwindawo yokulinda, apho abasebenzi abagqatsayo banokuzigcina zihlaziywa kwinkqubela yakho kwaye uthethe nabo xa utyando lwakho lwenziwe.
Ngexesha lePneumonectomy
Kulo gumbi lokusebenza, uya kunikwa i- anesthetic jikelele ukuze ulale, kwaye i-tube endotracheal iya kufakwa emlonyeni wakho ukuvumela i- ventilator ukuba iphefumle ngexesha lotyando.
Ukutsalwa okude kuya kwenziwa ngasecaleni lakho emva kwekhefu lembambo zakho. Ugqirha uya kufaka iimbambo zakho kwaye angasusa inxalenye yembambo ukuze afumane umphunga wakho.
Xa umphunga wakho ubonakaliswe ngokwaneleyo, iqela lotyando liya kuphala umphunga wakho onomdlavuza. Imithambo yegazi emikhulu (iirrire kunye nemithanjeni) ehamba kwimpompo iya kubotshelwa, kunye ne- bronchus ekhokelela kwimpompo iya kubotshelwa kwaye igqitywe.
Emva kokuba umpu wakho ususwe, ugqirha uya kuhlola ngokucophelela ukuqinisekisa ukuba ukuphuma kwegazi kulawulwa, kwaye uya kuvala loo nto.
Isikhundla esisele apho umphunga wakho ubuye uya kuzaliswa ngokuthe ngcembe.
Emva kwePneumonectomy
Xa utyando lwakho luphelile, uya kuthathwa kwigumbi lokubuyisela apho uza kujongwa ngokude kwiiyure eziliqela. Kwezinye iimeko, unokuthi uthathe ngqo kwiyunithi yonyango enzulu (ICU). Ukulandela ukubuyiswa, abaninzi abantu bachitha iintsuku zokuqala kwi-ICU. Ngosuku lokuqala, ukuphefumla kwakho kunokuncediswa ngomoya.
Ekubeni oku kunokubangela uxhalaba oluthile, uya kunikwa imishanguzo egcina ulele kakhulu kwaze kwasuswa ityhubhu.
Xa i-ventilator isuswe kwaye ulala phantsi, umphefumli wokuphefumula uza kukucela ukuba ukhwehle, kwaye uyakukunceda ekusebenziseni i-spirometer yokukhuthaza. Esi sixhobo ophefumlayo ukuze usebenzise imiphunga yakho, kwaye uncede ukugcina iipoksi zomoya ezincinci kwimiphepha yakho evulekile.
Xa unako, abahlengikazi banokukunceda uhlale, kwaye kukukhuthaza ukuba uvuke kwaye uhambe ngoncedo. Unokuba ungathi usebenze, kodwa ukwandisa umsebenzi wakho kuya kukunceda uvuselele amandla akho ngokukhawuleza, kwaye unciphise umngcipheko wokuphuhlisa ama- blood clots . Uninzi lwabantu luchitha ubuncinane iintsuku ezi-6 ukuya kwi-10 esibhedlele emva kokuhlinzwa.
Abanye abantu babuyela emsebenzini emva kweeveki eziyi-8, kodwa ugqirha wakho uza kukunika izithintelo ezikhethekileyo, njengokuphepha konke ukuphakamisa okunzima. Kuza kuthatha ixesha lokuba umphunga wakho usele uthabathe, kwaye ukuphefumula okufutshane kunokuqhubeka kunye neenyanga eziliqela emva kokuhlinzwa.
Nini ukubiza uDokotela wakho
Xa ukhishwa esibhedlele, uya kunikwa imiyalelo ngokucophelela malunga nokuzinyamekela ekhaya kwaye nini ukulandelelana nodokotela wakho. Phakathi kokuqeshwa, kufuneka ubizele ugqirha ukuba unempawu okanye iimbuzo ezikukhathazayo. Shayela ugqirha wakho ngokukhawuleza ukuba uhlakulela umkhuhlane, intlungu yesifuba eyahlukileyo kwizinto oye wahlangabezana nazo, ube ngumphefumlo omncinci, unokuphuma okanye ubole ngokukhawuleza kwakho, okanye ukuba uvelise nayiphi na intlungu emathole akho (okunokwenzeka iifutha zegazi).
Iingxaki
Ngenxa yokuba i-pneumonectomy yinkqubo enkulu yonyango, iingxaki ze-pneumonectomy aziqhelekanga. Ugqirha wakho uza kuxubusha oku kunye nawe phambi kokuhlinzwa kwakho. Ezinye iingxaki ezinokuba nazo zingabandakanya:
- Isidingo sokuphefumula ixesha elide emva kokuhlinzwa
- Izifo, njenge-pneumonia
- Ukuhlamba
- I-frontupleural fistula - uxhumano phakathi kwe-bronchus echithwe kunye nendawo phakathi kwe-pleura
- Iingxaki zeentliziyo, ezifana nesifo senhliziyo okanye izitho zentliziyo ezingavamile
- Stroke
- Igazi livale emilenzeni (inzulu ye-vein thrombosis) okanye uhamba kwimipuphu yakho (i- pulmonary embolism )
- I-Empyema - pus kwi-space phakathi kweembrane (i-pleura) yokufaka imiphunga
- Iingxaki ezinxulumene ne-anesthesia
- Iingxaki zeengxaki okanye ukungaphumeleli kwezintso
- I-Postpneumonectomy syndrome - iimpawu ezibangelwa ziziko kwisifuba ukuzalisa isikhala esishiye singabikho kwisithuba se-lung
- Intlungu eqhubekayo kwi-incision yakho okanye apho izimbambo zakho zahlulwa khona
Prognosis
Isalathiso esilandelayo emva kwe-pneumonectomy incike kwiimeko ezininzi. Ezinye zazo zibandakanya ukuba yiyiphi imiphunga isuswe (i-prognosis ibhetele kwi-pneumonectomy ekhohlo kune-right pneumonectomy), isigaba somdlavuza , ubulili (abafazi bathanda ukwenza okungcono kunamadoda), uhlobo lomhlaza womphunga kunye nendlela ophilileyo ngayo jikelele phambi kokuhlinzwa. Ukuphindaphinda komhlaza empompe akuqhelekanga emva kwe-pneumonectomy, kodwa ngamanye amaxesha umdlavuza wamaphaphu unokubuyela kwimimandla ekude yomzimba.
Imithombo:
American Cancer Society. Isikhokelo esinqununu: I-Cancer ye-Lung - I-Cell-Non-Small Cell. Ukuhlinzwa. Ukuhlaziywa 05/16/16. http://www.cancer.org/cancer/lungcancer-non-smallcell/detailedguide/non-sall-cell-lung-cancer-reating-surgery
Erhunmwunsee, L. noMnu Onaitis. Ukuyeka ukutshaya kunye nokuphumelela komhlaza womphunga. Imibiko yeOncology yamanje . 2009. 11 (4): 269-74.