Izimpawu zePleurodesis, iNkqubo, kunye neengxaki
I-Pleurodesis yindlela eyenziwa ngamanye amaxesha kubantu abanomdlavuza wamaphaphu kunye nezinye iimeko. Yintoni le nkqubo ifaka kunye kwaye ingahle ikhuthazwe nini?
I-Pleurodesis - Inkcazo
I-Pleurodesis yinkqubo eyenzelwe ukufumana iziqendu zombini zepayipi ( i-pleura ) ukunamathela kunye. Oku kusebenza ukutshabalalisa isikhala phakathi kweziqendu ( umgca wecala ) ukwenzela ukuba umbane (amanzi, igazi, okanye ipus) ayinakukwazi ukwakha phakathi kweziqendu.
Kukho ngokuphindwe kathathu ukuya kumane amathisipuni amachiza phakathi kwamaphandle (parietal) nangaphakathi (visceral). Xa kuqhutyelwa i-pleural effusion, ngenxa yezinto ezibini ezinobungozi kunye nezibi, le mveliso yetshezi iyakha kwaye isikhala sendawo sinokubamba ezinye iilitha ezininzi zamanzi.
Ngaphambi kokuba kucetyiswe i-pleurodesis, oogqirha bafuna ukubona kuqala ukuba i-effusion effusion (okanye i-pneumothorax) iya kuphinda ibuye kwakhona. Ukuba sisisigxina esisodwa, ukwenza i-thoracentesis ukususa umkhuhlane kubakho konke okufunekayo. Ngelishwa, i-effusion ye-pleural effusion (kunye ne-pneumothoraces) kwaye ngokugqithiseleyo ukuchithwa kwesicengceko esibuhlungu kudla ngokuphindaphindiweyo.
Inkqubo yePleurodesis
Kwi-pleurodesis, i-chemicals ijojowe phakathi kwembini yamacwecwe enqabileyo. Ezi ziikhemikhali zenza ukuvuvukala okubangela ukuba kunqabile. Oku kukhwela kunye nokubamba iimbumba zombini kunye ukuze umbane okanye umoya ungabi nako ukwakha nokuqokelela kwindawo.
Ingqungquthela yangaphakathi yegama elibizwa ngokuba yi-plecer visureal pleura, kwaye i-membrane yangaphandle yecala libizwa ngokuba yi-parietal pleura. Ngokuxhomekeka kwiimeko eziphantsi, inqubo inokuthi yenziwe nge-incision encinci (i-thoracoscopy yocetywayo yevidiyo okanye i-VATS) okanye i-thoracotomy (ukuvulelwa kwemiphunga evulekile.)
Kukho iintlobo ezimbini ze-pleurodesis, ezisoloko zisetyenziswa kunye:
- I-pleurodesis yamatshini ibangela ukuvuvukala kunye nokuqhawulwa ngokucoca i-parietal (ngaphandle) i-pleura nge-gauze.
- I-pleurodesis yamachiza iquka ukujoba i-chemicals (esoloko i-talc) phakathi kweembrane zesikhalazo ukudala ukuvuvukala kunye nokuqhwala (fibrosis.)
Izizathu zokuba iPleurodesis ingenziwa
Kukho iimeko ezininzi apho i-pleurodesis enokuthi yenziwe, leyo leyo ibangelwa kwiimeko zonyango ezifana nomhlaza wemiphunga, i-mesothelioma, i-cystic fibrosis kunye nezinye izifo.
- Ukuxhatshazwa kwamangcwaba okubi - Abantu abanomdlavuza wamaphaphu , umdlavuza webele , okanye i- metastase kumpompo kwenye i- kansela bangaphuhlisa ukuxhatshazwa kwamangqungquthela embi, ukuchithwa kwesigxina esineengqamuzana zomhlaza. Xa oku kunjalo kukho iikhotho ezimbini. Omnye ukwenza i-thoracentesis kwaye ubeke i-stent eyohlala ishenxisa umbane kwindawo yokuxhamla kwelinye inxalenye yomzimba (i-catheter ye-pleural catheter okanye i-cathterter ye-pleural). Enye i-pleurodesis.
- Ukutshatyalaliswa kwenyameko ngokuphindaphindiweyo
- I-pneumothorax eqhubekayo - i- pneumothorax ligama elisetyenziselwa ukuchaza imiphunga epholileyo. Ukuba i-pneumothorax ivela kwaye ityhubhu yesifuba ifakwa, i-pneumothorax ihlala isombulula. Ukuba i-pneumothorax iqhubeka (ukuqhuma komoya okuqhubekayo,) okanye ihamba kwaye iphinde iphinde ibuyele, unyango olongezelelweyo ukuxazulula i-pneumothorax okanye ukuthintela ukuphindaphinda.
- Pneumothorax ephindaphindiweyo
Ngaphambi kwePleurodesis - Ukulungiselela
Ngaphambi kokuba i-pleurodesis yenziwe, oogqirha bajonga izinto ezininzi.
Okubaluleke kakhulu, kubalulekile ukuba kususwe iziphumo zesiphumo esiphuthumayo ekuphuculeni iimpawu (ukunciphisa ukuphefumula okufutshane) kulabo abanomdlavuza. Ukutshatyalaliswa kwesigxina okungabangela iimpawu ezinjengeentlungu zesifuba okanye ukuphefumula okukufutshane kwesi sihlandlo ngokuqhelekileyo kushiywe yodwa. Ukongezelela oku, amanye amagqirha ancomela inkqubo kuphela ukuba ulindelekileyo lobomi bukhulu kuneenyanga enye.
Ngakolunye uhlangothi, i-pneumothoraces ngokukhawuleza ingenzeka kubantu abancinci kwaye banempilo.
Kule meko, inqubo ingenziwa ukuze kuthinte enye i-pneumothorax ukuba ingabikho kwixesha elizayo.
Iingxaki
Ngokubanzi, inkqubo ye-pleurodesis iyakunyamezela. Kwipesenti ethile yabantu, inkqubo iya kuba yinkcitho kwaye ingakumbi yonyango kunye nencati yokuhlala ukucima umbane, okanye i- pleurectomy (ukususwa kwesigxina) kuya kufuneka. Enye inkxalabo, kuba abantu abanokuba nompompo wokutshintshwa kwemiphunga ngexesha elizayo, kukuba i-pleurodesis yangaphambili ingenza le nkqubo ibe nzima.
Kulabo abanemfesane ecaleni ngenxa yeemeko ezincinci, okanye abanama-pneumothoraces aphindaphindiweyo (amaninzi ahlobene nelifa,) i-pleurodesis inokuqinisekisa ukuba enye i-effusion okanye i-pneumothorax ayiyi kuvela xa uncedo lwezonyango olungekho.
Umzekelo: Umdlavuza kaPrince wamaphaphu wawubangela ukuqhuma komnxeba ngokuphindaphindiweyo, ngoko ugqirha wakhe wancoma ukuba unenqubo ebizwa ngokuba yi-pleurodesis.
> Imithombo:
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> Dugan, K., Laxmanan, B., Murgu, S., no-D. Hogarth. Ukulawulwa koMoya oPheleleyo wokuvuza. Esifubeni . Ngo-2017 uMar 3. (i-Epub ngaphambi kokuprinta).
> Fortin, M., no-A. Tremblay. Iingxabano eziphambili: ukuhlala ecatheter cationter vs pleurodesis ukwenzela ukunyanzeliswa kwesigxina. Umbhalo Wezifo Zesifo . 2015. 7 (6): 1052-7.
> Lenker, A., Mayer, D., noS. Bernard. Amanyathelo okujongana nokuphathwa kakubi kwamanzi. I-Clinical Journal ye-Oncology Nursing . 2015. 19 (5): 501-504.
> UTomas, J., no-A. Musani. Imiphumo emibi yomsindo: ukuhlaziywa. Iiklinikhi kwiMpilo yamayeza . 2013. 34 (3): 459-71.