Ngaba ukunyaniseka kuya kuzaliswa iziphumo ezilungileyo ezivela kwiNkqubo zoLwandle?
Ukuba uceba ukuhlinzwa ngokukhawuleza kungekudala, usenokucinga, kwaye mhlawumbi ukhathazekile, malunga nazo zonke izinto ezingahambi kakuhle. Ezi zibizwa ngokuba "iingxaki." Nangona iingxaki ezinokuvela kwi-operesheni ngokwazo, ngokucwangciswa okufutshane, kunye nokuziphatha kakuhle kakhulu kwezempilo, unokukwazi ukucacisa ezininzi ezi zinto ezingabalulekanga.
Iingxaki ezinxulumene nokuhlinzwa ngokutsha zivame ukuqhubeka ngokuphindaphindiweyo kwizigulane ezithwala kakhulu.
I-conundrum eyimfesane kukuba abantu abangaphezu kwamandla amaninzi kwaye banamaxesha amaninzi ngokuqhelekileyo abo bafuna ukuhlinzwa ngokugqithiseleyo.
Iintlobo zeeNkathazo zoPhephelo olusemva koBugqirha
Ziziphi iingxaki ozimele uzikhathalele malunga nokuba ungaphezu komzimba okanye ukhuluphele, kwaye uceba ukufumana ukuhlinzwa ngokukhawuleza?
Omkhulu uqinisekisa ukuba ugqirha wakho ufumene ngokuchanekileyo. Oku kungenxa yokuba ukufumana i-MRI echanekileyo okanye enye ifilimu yokuxilonga ingabangela ingxaki ngakumbi kwizigulane ezigqithiseleyo kunokuba zinobunzima obuphilileyo. Iifilimu ezingalunganga zingakhokelela ekuxilongweni okuphosakeleyo kunye nenkqubo yokuhlinzwa engalunganga eyenziwa. Kungakhokelela ekubeni utyando ngephakamiso engafanelekanga, ngokunjalo.
Kwaye kunye nezicubu ezongezelelweyo ukuhamba ngeendlela, kunokuba nzima ukuba ugqirha wakho afikelele kwindawo echanekileyo yomqolo wakho womgudu. Kuyafana nokubeka isixhobo sokugqitywa apho kufuneka sihambe khona.
Uninzi lweengxaki zonyango lunokwenzeka, ngokunjalo.
Ezi ziquka intlungu ye-vein thrombosis, i-pulmary embolism, intsholongwane, i-pneumonia, iingxaki zentliziyo, ukulimala kwentsholongwane kunye nokuvuvukala kwe-post. Iingxaki ezinxulumene ne-anesthesia, umzekelo ukulala kwe-apnea, nazo zinokwenzeka.
I-Anesthesia, kwakunye neyeza ezibuhlungu ezisebenza kwi- system central neervous zinganciphisa imisipha evule i-pharynx, eyona isakhiwo apho umoya uhamba ngexesha lokuphefumla.
Le meko enzima kakhulu ingongezelela kwiingxaki zokuphefumla ezinxulumene nokukhuluphala. Kungenzeka nokuba kubulawe.
I-Hypoxia-hypoventilation inokuphelisa amandla akho okuphefumula; kubakho kwi-10% yabantu abagqithisileyo, kwaye kunokubangela isidingo sokonyango olongezelelweyo lwe-oxygen ngexesha okanye emva kokuhlinzwa.
Ukumiswa kwenkqubo kuyenye enye ingozi. Xa umntu ogqithisileyo etafileni yokunyanga, unokuhlawulela ekukhethweni phakathi kokufikelela kwisayithi yokuhlinzwa okanye ukwenza enye imeko yezobuganga ibe nzima. Ngokomzekelo, ukubeka ingcinezelo yengcinezelo yegazi ngexesha lotyando kunokubangela iingxaki ezingakumbi kubasebenzi bezonyango abakhona.
Njengoko iingxaki ezinxulumene nolwasemdeni zixhala , ukuxhamla umgudu kukukhathazeka ngokukodwa ngabagqirha; ukuphelelwa kwe-back back failed . I-American Academy ye-Neurosurgeons ithi ekugqithweni okwenziweyo ukuphucula intlungu ephantsi, izinga lokungaphumeleli kwezigulane ezigqithisileyo ziphezulu kunezinye izigulane.
Ngoluhlu olufana nalokhu, akumangalisi ukuba oogqirha baxelela izigulane zabo ezigqithiseleyo ukuba zinciphise isisindo ngaphambi kokuba inkqubo! Ucwaningo lwango-2017 olupapashwe kwiphepha le- Surgical Neurology International lincoma ngokubhekiselele kwiinkqubo ezilahlekileyo zokulahleka kokunciphisa umzimba - kubandakanywa uphando lwe-bariatric
Enyanisweni, abanye oogqirha abaya kuvuma ukusebenza kwizigulane ezigqithisileyo.
Kutheni i-Overweight and Obese Surgery Surgery Izigulane ezininzi zisengozini yeZithuba zokuSebenza zoPhulo?
Ukukunyusela ukucinga ngeso lengqondo kunye nokuhamba kwezixhobo zokuqhawulwa kwindawo efanelekileyo ngqo emva kwakho akuzona kuphela iingxaki zokuhlinzwa kwangaphambili. Ezinye izimo zempilo zinokubeka emngciphekweni ophezulu, ngokunjalo.
Ukuhlaziywa kuka-2016 kwonyango lwezonyango olupapashwe kwi- Global Spine Journal lafumanisa ukuba iimeko "zokudibanisa", oko kukuthi, izifo ezongezelelweyo ezenzeka ngokukhawuleza ngokunyanya, mhlawumbi zibe negalelo kwiinkalo eziphezulu zeengxaki zokusebenza.
Kuyaziwa kakuhle ukuba ukukhuluphala kunxulumene ne-metabolic, i-cardiovascular kunye nezinye iingxaki ezifana nesifo sikashukela nesifo senhliziyo. Ubukho beemeko ezinokubambisana zingenza utyando lwakho lube nzima kakhulu ugqirha ukuba agqibe ngaphandle kwesiganeko.
Akunjalo nje kuphela, kodwa isifundo safumanisa nokuba ukugqithisa ngokungazinzi-kungaphakathi kunye nokwalo-kuphakamisa umngcipheko wezithuba zobungqina bokuhlinzwa.
Abaphandi abavela kwi-University of Thomas Jefferson. Ngokutsho kwezinto zokuphrinta, bafumanisa ukuba umngcipheko weengxaki zonyango ukwandisa ngokumalunga nesantya sokunyanya. Ngamanye amazwi, i-index ye-mass body index (BMI) ephezulu, ithuba elikhulu lokuba uya kuba neengxaki ezinxulumene nokuhlinzwa kwakho kwangemva.
I-BMI, okanye i-index index mass, ingumlinganiselo wesisindo somzimba ngokuphakama kwakho. I-BMI engama-30 okanye ngaphezu kwayo ibonisa ukukhuluphala, kwaye umntu ono-BMI oneminyaka engama-40 okanye ngaphezulu ukhangeleka kakhulu.
Abaphandi bakaTomas Jefferson bafumene ukuba izigulane zonyango ezazinesisindo esinempilo zinezinga le-complication ye-14 ekhulwini. Kodwa kwizigulane ezigqithisileyo, izinga liye laya kuma-36 ekhulwini.
Iinzuzo zeNtsholongwane yokuChiza
Ukuba i-BMI yakho ingama-30 okanye ngaphezulu, ukwenza utyando emva kwakho kungabangela ingozi engaphezulu komthetho ugqirha wakho. Ngokufanayo, iingcali ezininzi zincoma ukuba izigulane ezigqithisileyo zingavunyelwa ukuhlinzwa ngenxa yesimo sabo.
Utyando olusisigxina lomlingo (MIS) lubangela ubuncipheko obuncinane beengxaki kunokuba luhlobo lwendabuko, kwaye lunokukhetha.
Uphononongo olwenziwa ngo-2008 olubandakanya izigulane ezingama-58 alukwazanga ukuchonga ingozi eyongeziweyo yezixazululo kwizigulane ze-MIS ezigqithiseleyo okanye zikhulu kakhulu.
Kwizigulane ezininzi ze-MIS, intlungu elandela inkqubo ayifanele. Esi sizathu esinye isizathu sokuba izigulane ze-MIS ngokubanzi ziphinde ziqalise umsebenzi kunye neminye imisebenzi ngokukhawuleza kunabo abanokuhlinzwa ngokusemthethweni.
I-American Academy ye-Neurosurgeons ibonisa ukuba ukuphazamiseka kwezicubu ezincinci . I-MIS isebenzisa i- fluoroscopy evumela ukuba kwenziwe izinto ezincinci kakhulu, kunye nokuhamba kakuhle kwezinto zokusebenza.
ILizwi
Ukulahlekelwa kwesisindo sinokuba isicwangciso sakho sesinye se-intanethi yokubuyiselwa ngempumelelo. Ukulahlekelwa isisindo ngaphambi kokuhlinzwa kwakho kunokuncedisa ukunciphisa ezinye zeengxaki ezixutyushwa ngasentla ezifana nokufumana ukuchongwa okufanelekileyo kunye nocwangco, ukubeka indawo ekhuselekileyo, ukuhamba ngokuchanekileyo kwisixhobo sokugqithisa, ukugcina ukhuselekile ngexesha le-anesthesia, equka ukunciphisa ingozi yokulala, kunye nokuninzi.
Oko kwathiwa, njengokuba kukho nantoni na yokuhlinzwa, ukuzama ukunakekelwa kokungabonakali kuqala kungaba yinto efanelekileyo. Oku kuya kuthetha ukuthatha iiseshoni zonyango ezonyango ezigxininisa ukusetyenziswa kwembuyiselo kunye nokuqiniswa komxholo.
Nangona ukugqithisa okanye ukugqithisela kubambelela kwinkqubo yokuzilolonga kunzima, kuya kuba yinto enomdla kakhulu ukubeka umgudu. Kwabaninzi abantu, inkqubo yokulolonga ngokufanelekileyo ibalulekileyo ekukhuseleni ukuhlinzwa ngokusemgangathweni. I-American Family Physician ibikela ukuba iiprogram-ezilawulwa kwiprogram yokunyanzeliswa ekhaya ekhaya ngenxa yeentlungu ezisezantsi ziyakunceda ukunciphisa imfuno yakho yezinye iinkonzo zonyango, okwenza indlela yonyango efanelekileyo.
Ukuba ukwenza uqeqesho kukubonakalisa kunzima, ungabuza umculi wakho malunga nokuzivocavoca kwamanzi , okuba lula ukuba amalunga.
> Umthombo:
> Casazza, B., MD Ukuxilongwa kunye nokunyangwa kobuhlungu obubuyisekayo obuphantsi. WaseMerika ugqirha. Feb. 2012. http://www.aafp.org/afp/2012/0215/p343.html
> Epstein, N., Ubungozi obuninzi kunye neengxaki zokuhlinzwa okwenziwe ngumthunzi kwizigulana ezigqithisileyo. Uphulo lwe-Neurol Int. Epreli 2017. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4868585/
> Jackson, K., et. al. Iimiphumo zobukhulu bezonyango kwi-Spine Surgery: Uhlolo lokuHlola lweNcwadi. I-Global Spine J. NgoJuni 2016. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4868585/
> Inkcazo yokushicilelwa. Thomas Jefferson University. "Ubunzima bubophelele kwiNgcipheko ephezulu yeengxaki kwi-Spinal Surgery." ScienceDaily. Oktobha 2006. https://www.sciencedaily.com/releases/2006/10/061010022634.htm
> UMcCormick, uP. Lumbar Izifo ezithintekayo: Ukuqwalasela izigulane ezithandekayo AANS Bulletin 2008 Umqulu 17 Inkcazo 2.