Inkqubo yokutyikitya ye-COPD izigulane ezine-bullae enkulu
Ukuba unesifo esingasasigxina se-pulmonary disease okanye i- COPD , usenokuba ngumngcipheko wokuphuhlisa i-bullae, eyindawo egciniweyo, iindawo ezizaliswe ngomoya kwindawo yokuphuphuma kwemiphunga. I-Bullae yimbangela yokukhupha ngaphakathi kwe-bronchiole tubes okanye i-bronchus. I-bullae enkulu idala ukunyanzeliswa okukhulu kwi-underlying, izifo zamaphaphu ezempilo, okuye zinciphisa ukuhamba kwegazi kunye ne-oxygen emiphakeni.
Oku kubangela ukunyuka kwe- dyspnea okanye ukuphefumula okufutshane.
Ukuba i-bullae ikhula kakhulu (ngokuqhelekileyo inkulu ngaphezu kweyentimenti enye), ugqirha wakho unokucebisa ukuba i-bullectomy ukubaphatha nokukunceda uphefumule ngakumbi. Le nkqubo yokukhupha isusa i-bullae enwetshiwe, ivumele i-sac air air inemiphunga ukuba ikhulise kakuhle. Oku kuya kwenza kube lula ukuphefumla.
Kufuneka ntoni i-Bullectomy?
Inkqubo ithatyathwa xa kuninzi i-bullae egcwele umoya efunyenwe kwi-x-ray okanye i-CT scan. Uninzi lwezigulane ezithathwa ngokuba unyango lunemiqondiso kuquka:
- ukuqhawukelwa ngumphefumlo
- intlungu
- umphunga ophule
Ezinye iimpawu, nangona zinqabile, zibandakanya ukuphuma kwegazi kunye nokusuleleka kwi-bullae. Ezinye izigulane azikho iimpawu kodwa zingadinga ukuhlinzwa ukuba i-bullae ibandakanya ngaphezulu kwesigamu sesigxina se-pleural-indawo egcwele amanzi ephakathi kweembrane zecala ezijikeleze imiphunga.
Ukuba ugqirha wakho ugxeka ukuba ufuna i-bullectomy, uya kuhlola umsebenzi wakho wemiphunga ngomvavanyo omnye okanye ngaphezulu phambi kokuhlinzwa.
Iimvavanyo eziqhelekileyo eziyalelwe phambi kwe-bullectomy ziquka:
- x-ray esifubeni
- i- CT scan
- iimvavanyo zepmonta
- i-ventilation / perfusion scan okanye i- VQ scan
- engumphunga wengqondo
Izigulane ezinomncinci we-bullae, i-hypercapnia, i-cor pulmonate, okanye i-FEV1 ngaphantsi kwama-40 ekhulwini anikezelweyo abaviwa ngabaviwa.
Ngaphambi kokuba utyando luboniswe, ugqirha wakho unokuzama ukulawula ibhola yakho eyongeziweyo ngaphandle kwayo.
Ukuba ungaziqhelani, ukuyeka ukutshaya kunokwanela ukulawula imeko. Ukuba usenayo impawu emva kokuyeka ukutshaya, unyango kunye nokunyamekela ezifana ne-bronchodilators, inhaled glucocorticoids, ukugonywa, i-oxygen eyongezelelweyo okanye ukuvuselelwa kwepmonta kunokunceda. Ukuba aba asebenzi, utyando luqhelekileyo kwikota elilandelayo.
I-Bullectomy eyenziwa njani?
Ugqirha wakho angenza i-bullectomy ngeendlela ezimbini. Enye i-thoracotomy, apho ukuchithwa kwe-4- kuya kwe-6 intshi kwenziwe ngaphantsi kwe-armpit yakho. Udokotela ogqirha ke ufaka ityhuthi ekhanyayo ebizwa ngokuba yi-thoracoscope kunye nezixhobo zokucoca ngeekathetha ukuze zisuse i-bullae.
Enye indlela i-thoracoscopy yevidiyo. Efana ne-thoracotomy yendabuko, i-thoracotomy yevidiyo iquka i-screen yesikrini kunye ne-console ekhokela ugqirha. Iquka ukuboniswa okuncinci kwiphepha lesifuba. Emva kokuba i-bullae isuswe, ugqirha wakho uza kuvalwa izigqibo.
Kungakhathaliseki indlela ye-bullectomy ugqirha wakho ukhetha, umsebenzi uwenziwa phantsi kwe-anesthesia jikelele. Oku kuthetha ukuba kuya kufuneka ukhawuleze ngaphambi kokuhlinzwa. Qiniseka ukuba ulandele yonke imiyalelo yengcali yakho.
Ukubuyisela kwi-bullectomy kungathatha iiveki ezimbalwa uze uphinde ufumane amandla akho kwaye uyakwazi ukubuyela emsebenzini.
Ngeli xesha, kufuneka uqhagamshelane nogqirha wakho xa ufumana:
- kuphuma
- ukusuleleka kwi-incision
- bushushu obuphezulu
- iimpawu zempendulo ebonakalayo ebandakanya ubomvu, ukuvuvukala nokuphefumula ukuphefumula
- intlungu
Umthombo
- > Krishnamohan P, Shen KR, iWigle DA, et al. I-Bullectomy ye-bullae ephawulekayo okanye eyinkimbinkimbi ye-lung bullae. U-Ann Thorac Surgery 2014; 97: 425-31.