Ugqirha wakho usenokuba ucebise i-pleurectomy njengendlela yokucanda ukuphinda usebenze ngokuphindaphindiweyo, i-pneumothoraces, okanye i-mesothelioma. Yiyiphi le ndlela yokuhlinzwa? Ziziphi iingozi kunye neengxaki ezinokwenzeka, kwaye yintoni na ukuchazwa?
I-pleurectomy yinkqubo yokucwangcisa eyenziweyo ukususa inxalenye ye- pleura , iimbambo ezijikeleze imiphunga.
Imiphunga ijikelezwe zimbini zeemfesane; i- parietal pleura ngaphandle, kufuphi nomdonga wesifuba, kunye ne- pleceral pleura ngaphakathi, kufuphi nemipopho. Phakathi kwe-pleura kuluhlu lwesigxina . Ngokuqhelekileyo, kukho umncinci wesikhewu kule ndawo (phantse ezimbini ukuya kweyesithathu).
Izizathu zePleurectomy
Ngaphandle kwe-pleurectomy ye-mesothelioma (apho i-pleura ngokwayo ingathinteka ngumhlaza), i-pleurectomy ivame ukucetyiswa emva kokuba enye unyango ihlulekile. Umzekelo, ukuba umntu uyaqhubeka nokuhlakulela umthamo okanye umoya kwisithuba senkcenkceshe nangona utyalwa yi-thoracentesis.)
Kukho izizathu ezimbalwa ezenza ukuba ugqirha wakho angancoma i-pleurectomy:
- Unyango lwama-mesothelioma - Uphawu oluqhelekileyo lwe-pleurectomy ukuphatha i-mesothelioma embi . Lo mhlaza, odla ngokubhekiselele kwimfucumfucu ye-asbestos, inokuvela kwi-linings pleings (i-mesothelioma yesinelo) kunye neengxube zenhliziyo nesisu. Xa i-pleurectomy isetyenziselwa ukuphatha i-mesothelioma, ihlala idibaniswe nenkqubo ebizwa ngokuba yi-decortication (i-pleurectomy decortication.) Ezi nkqubo azibandakanyi nje ukukhutshwa kwelungu kodwa nje nayiphi na i-tumor esondeleyo ekhoyo kwisifuba esifubeni. Olunye uphando olwenzelwe i-mesothelioma luyi-pneumonectomy eyongeziweyo, into engenayo. Naphezu kwezinga eliphezulu leengxaki ze-pneumonectomy, ukusinda kubonakala kufana phakathi kwe-pleurectomy decortication kunye ne-pneumonectomy engaphezulu
- Ukunyangwa kwexesha eliqhelekileyo lokunyanzeliswa kwesigxina okanye ukuchithwa okubi kakubi - I-pleurectomy inokuthi yenzelwe abantu abaphikelelayo okanye abaphindaphindiweyo xa kuqhubeka ezinye iinkqubo (njenge- pleurodesis ) ukukhusela kunye nokukhusela ukwakhiwa kwamanzi phakathi kweendlela ze-pleura. Kwi-pleurodesis, ikhemikhali ifakwa phakathi kweemibini ezimbini zomphunga ngenzame yokukhanda ezi zihlulo ndawonye. Ngamanye amaxesha ukuchithwa kwesigxina "kudibanisa" kuthetha ukuba kukho indawo ehlukeneyo apho amanzi angakha khona. Oku kunokukwenza ukuba ufake i-stent okanye i-pleurodesis engasebenzi. Ngokususa i-pleura ngokupheleleyo, ukwakheka kwe-fluid kunokuthintela.
- Unyango lweempembelelo ezimbi ezimbi-I-Pleurectomy isetyenziswe ngendlela efanayo ukuphathwa kakubi kwesilingo . Ukusetyenziswa kwamangqumbo angalungile kukusetyenziswa kwamalungu omhlaza apho amangqamuzana omhlaza. Zingasuka kumdlavuza oyintloko wamaphaphu , okanye ngenxa yeemastastas ezivela kwezinye i-kansa ezifana nomhlaza wesifuba . Ngelixa unyango lweempembelelo ezinobungozi obuqhelekileyo ludla ngokuphindaphindiweyo, ukulawula ukwakhiwa kwe-fluid kunokuphucula ukuphefumula nokunciphisa intlungu.
- Unyango lwe-pneumothorax - Ukuba uthe wabandezeleka nge-pneumothoraces ezimbini okanye ngaphezulu (amaphuphu aphelile) i-pleurectomy ingenziwa ukwenzela ukuthintela ukuphindaphinda kwakhona.
Inkqubo
I-pleurectomy idlalwa phantsi kwe-anesthesia jikelele kwindawo yokusebenza.
Kwi-pleurectomy, i-incision isenziwa ngasemva kwaye iyafana nemiphunga (i-thoracotomy. Izishuzi ezongezelelweyo zingasuswa ukuba ugqirha wakho usebenza kwi-mesothelioma. Ngaphambi kokuba i-incision ivalwe, iibhulo zamanzi zifakwe eziza kususwa kamva xa ukuphuma kwegazi kunye nokukhupha kubuncinane. Isibhengezo sivaliwe, ngokuqhelekileyo kunye ne-sutures eza kutshabalalisa ngokwazo.
Iingozi kunye neengxaki
Ingozi ye-pleurectomy iyafana neyezinye iindlela ezininzi zokuhlinzwa kwaye ziquka:
- Umngcipheko we-anesthesia (i-anesthetic jikelele ngokuqhelekileyo isetyenziselwa i-pleurectomy)
- Ukuhlamba
- Sulelo
- Ukulimala kwimiphophu kunye nezinye izitho kwisigubungelo sesifuba
- Ukuphazamiseka komoya okuqhubekayo (ngamanye amaxesha kunokuba nzima ukususa ityhubhu yesifuba elandela i-pleurectomy ngenxa yokuvuza komoya okuqhubekayo)
Iingxaki zingabandakanywa ukususwa ngokwaneleyo kwezicubu zesilumko ukuze i-effusion effusion okanye ipneumothorax ibuyele. Izicathulo zomzimba (ukuxhamla) zingakhula kwisifuba kunye nentlungu engapheliyo ingenzeka kwabanye abantu.
Nge-mesothelioma, izingozi zihlala zixhomekeke kumlinganiselo womhlaza kunye nokukwazi ukuba ugqirha ukufikelela kunye nokususa izicubu zomhlaza.
Emva kokuPiliswa
Uphulo lokuphefumula luvame ukubandakanyeka ngexesha lakho lokuphucula, kukunceda uphefumle kwaye uphume ebhedini ngokukhawuleza ukunciphisa umngcipheko we-pneumonia, i-blood clots kunye nezinye iingxaki. Ukulungiswa kwepulmonary kunokucetyiswa phantsi komgca kunye nokuphucula ukuphefumla.
Prognosis
Ngokubanzi, i-pleurectomy iyakunyamezela kakuhle. Kubantu abanesifo se-mesothelioma esichengileyo, ngokuqhelekileyo kukho unyango oluthile , olubhekiselele ukuba lwenziwe ukunciphisa iimpawu kunye nokuphucula induduzo kodwa aluphilisi eso sifo.
I-pleurectomy kubantu abane-mesothelioma inokuphucula ixesha lokuphila, kwaye iphucule iimpawu zokuphefumula.
U mzekelo
Emva kokuba uKen efumaniswe ukuba une-mesothelioma, ugqirha wakhe wancoma ukuba abe ne-pleurectomy kunye neyokuhlobisa ukususa i-tumor kwi-pleura kunye nesigubungelo esiphezulu sayo.
> Imithombo:
> Cao, C. et al. Ukuphononongwa ngokuchanekileyo kunye nokuhlaziywa kweemeta zonyango olwenziwe ngonyango lwe-mesothelioma enesilonda. Cancer Lung . 2014. 83 (2): 240-5.
> Hasegawa, S. I-pneumonectomy eyongezelelweyo okanye i-pleurectomy / i-decortication ye-mesothelioma engamanga. I-General Thoracic and Surgery Cardiovascular . 2014. 62 (9): 516-21.
> Vlahu, T., kunye noW.Vigneswaran. I-Pleurectomy ne-Decortication. Iingxelo zeMicrosoft Medicine . 2017. 5 (11): 246.