Musaope 'kutenthedwa ndi magetsi'! Tiyeni tiphunzire za Electrosurgery.

Kodi munamvapo munthu akunena kuti, “Mafunde anasiya kutuluka magazi ” panthawi ya opaleshoni? Kapena munawonapo dokotala akuyika chipangizo chaching'ono pamalopo kuti achotse chinthu monga molu kapena chotupa? Njira yochiritsira iyi, yomwe imamveka yowopsa pang'ono mukamva dzinalo, imatchedwa `Electrosurgery` mu sayansi ya zamankhwala. Ngakhale dzinali lingamveke ngati lalikulu, kwenikweni ndi njira yogwiritsidwa ntchito kwambiri komanso yotetezeka mu opaleshoni padziko lonse lapansi. Chifukwa chake, tiyeni tikambirane za izi molondola komanso mosavuta lero.

Mwachidule, kodi Electrosurgery ndi chiyani?

Kuchiza ndi electrosurgery ndi njira yochitira opaleshoni yomwe imagwiritsa ntchito mphamvu yamagetsi yothamanga kwambiri kudula minofu, kuwononga minofu yosafunikira, kapena kuyimitsa kutuluka magazi (coagulation). Pankhaniyi, magetsi opangidwa ndi makina otchedwa ``Electrosurgical Unit (ESU)`` amatumizidwa ku chipangizo chaching'ono chonga cholembera (electrode) chomwe dokotala amagwiritsa ntchito. Magetsi ochokera ku chipangizochi akamalunjika kumalo omwe akuchiritsidwa, kutentha kumapangidwa pamene magetsi akudutsa mu minofu.

Kutentha komwe kumachitika mwanjira imeneyi kumawononga minofu yosafunikira. Koma kuwonongeka kumeneku ndiko komwe kumatithandiza. Pogwiritsa ntchito njira iyi, titha kuchotsa zotupa zosafunikira ndi ziphuphu pakhungu. Imagwiritsidwanso ntchito kutseka mitsempha yaying'ono yamagazi yomwe imadulidwa panthawi ya opaleshoni ndikuletsa kutuluka kwa magazi. Nthawi zina imachitika ngati chithandizo chokha, ndipo nthawi zina imachitika limodzi ndi mankhwala ena.

Kodi mitundu ikuluikulu ya opaleshoni yamagetsi ndi iti?

Pali mitundu ingapo ya njira iyi yopangidwira zosowa zosiyanasiyana. Tiyeni tiwone zomwe zili.

Kodi electrocautery ndi yosiyana ndi ina?

Inde, ` electrocautery` ndi njira yosiyana pang'ono. Mu opaleshoni yamagetsi, magetsi amadutsa mwachindunji m'minofu ya thupi. Koma mu opaleshoni yamagetsi , magetsi amadutsa kokha m'nsonga ya chida. Choncho nsonga ya chida imatentha. Kenako, nsonga yotenthedwayo ikakhudza minofu, kutentha kwachindunji kumawononga minofu kapena kuyimitsa kutuluka kwa magazi. Mwachidule, nthawi imodzi, magetsi amadutsa m'minofu, ndipo inayo, chida chotenthedwa chimagwiritsidwa ntchito.

Kodi njira iyi imagwiritsidwa ntchito pa matenda amtundu wanji?

Opaleshoni yamagetsi ndi chinthu chomwe chimagwiritsidwa ntchito m'magawo ambiri azachipatala.

• Matenda a khungu: Akatswiri a khungu nthawi zambiri amagwiritsa ntchito njira imeneyi. Ndi yothandiza kwambiri pochotsa zilonda zosavulaza monga ziphuphu ndi zizindikiro za khungu . Imagwiritsidwanso ntchito pochiza mitundu ina ya khansa ya pakhungu . Mwachitsanzo, mu njira ya ED&C (Electrodessication & Curettage), dokotalayo amayamba kaye wachotsa chotupa cha khansa kenako amagwiritsa ntchito opaleshoni yamagetsi kuti awononge maselo otsala a khansa .
• Maopaleshoni ena: Izi ndizofunikira kwambiri pa opaleshoni zina, makamaka zomwe zimaphatikizapo endoscopy (mayeso pogwiritsa ntchito kamera kuti ayang'ane mkati mwa thupi), kuchotsa minofu yosafunikira (monga zotupa zazing'ono) kapena kuchepetsa kutuluka kwa magazi .

Kodi chimachitika ndi chiyani panthawi ya chithandizo?

Choyamba, mudzapatsidwa mankhwala oletsa dzanzi kuti muchepetse dzanzi pamalo omwe mukulandira chithandizo, kapena mungapatsidwe mankhwala oletsa dzanzi kwathunthu. Zomwe zimachitika pambuyo pake zimadalira ngati muli ndi `monopolar` kapena `bipolar`.

Opaleshoni ya Monopolar Electrosurgery

Iyi ndiyo njira yomwe imagwiritsidwa ntchito kwambiri. “Mono” imatanthauza “chimodzi.” Apa, nsonga imodzi yokha ya electrode imayikidwa pa thupi lanu.

1. Magetsi ochokera ku makina a ESU amabwera ku electrode yogwira ntchito (chipangizo chonga cholembera chomwe chili m'manja mwa dokotala).

2. Magetsi awa amadutsa m'maselo a thupi lanu ndikutentha dera limenelo.

3. Kenako magetsi amadutsa m'thupi lonse n'kupita ku "grounding pad" (dispersive electrode) yomwe imalumikizidwa pa ntchafu yanu kapena kwina kulikonse.

4. Pomaliza, magetsi ochokera ku grounding pad amabwerera ku makina a ESU, ndikumaliza ntchito yozungulira.

Opaleshoni ya Bipolar Electrosurgery

“Bi” amatanthauza “ziwiri.” Apa, nsonga ziwiri za ma electrode zimayikidwa pa thupi lanu. Tangoganizani kuti dokotalayo akugwira minofu yomwe ikuchiritsidwa ndi chipangizo chonga forceps.

1. Magetsi amalowa mu minofu kuchokera mbali imodzi ya electrode (electrode yogwira ntchito).

2. Magetsiwo amayenda mtunda waufupi kwambiri kudzera mu minofu kenako nkupita mbali ina ya electrode (electrode yobwerera).

3. Kuchokera pamenepo, magetsi amabwerera ku makina a ESU, ndikumaliza kuzungulira.

Kodi ubwino wa njira iyi ndi wotani?

Kudula ndi electrosurgery ndi njira yomwe ili ndi ubwino wambiri kuposa kungodula ndi scalpel.

• Chithandizo cholunjika: Palibe kuwonongeka kochepa kwa minofu yathanzi yozungulira.
• Kuchepa kwa zipsera: Kuchuluka kwa zipsera zomwe zimachitika chifukwa chochotsa minofu kumachepa.
• Liwiro: Kuwonongeka kwa minofu (ablation) kungachitike mwachangu.
• Kuletsa kutuluka magazi : Kutuluka magazi kumatha kutha msanga kwambiri, zomwe zimachepetsa nthawi yomwe imagwiritsidwa ntchito pochita opaleshoni.

Kodi pali zotsatirapo kapena zoopsa zilizonse?

Njira imeneyi ndi yotetezeka kwambiri ikachitidwa ndi dokotala wodziwa bwino ntchito. Komabe, monga momwe zimakhalira ndi njira ina iliyonse yachipatala, pali zoopsa zina zomwe zingachitike. Komabe, madokotala amachita chilichonse kuti achepetse zoopsazi.

• Kupsa: Ngati mphamvu yamagetsi ikuoneka yokwera kwambiri, kutentha kungachitike. Pofuna kupewa izi, madokotala nthawi zonse amayamba ndi mphamvu yotsika kwambiri .
• Kugwedezeka kwamagetsi: Ngati cholumikizira cha pansi sichinalumikizidwe bwino, mutha kugwidwa ndi magetsi. Komabe, mwayi woti izi zichitike ndi wochepa kwambiri, chifukwa chilichonse chimawunikidwa bwino musanalandire chithandizo.
• Matenda: Matenda amatha kuchitika ngati zipangizo zomwe zagwiritsidwa ntchito sizinayeretsedwe bwino. Komanso, majeremusi amatha kufalikira kudzera mu utsi womwe umapangidwa minofu ikatenthedwa. Pachifukwa ichi, madokotala amagwiritsa ntchito zida zoyeretsedwera zokha ndipo amachita chithandizochi m'zipinda zomwe zili ndi makina opumira utsi.
• Kutuluka magazi:Nthawi zina, kuwonongeka kwa minofu kungayambitse kutuluka magazi ambiri kuposa momwe amayembekezera, koma dokotala amatha kuwongolera mwa kusintha makonda pa makina a ESU.
• Kusintha kwa mtundu wa khungu: Pambuyo pa opaleshoni yamagetsi, khungu likhoza kukhala loyera kwambiri pamalo omwe mwalandira chithandizo (hypopigmentation). Dokotala wanu adzakufotokozerani pasadakhale ngati pali chiopsezo cha izi kuchokera ku chithandizocho.
• Mavuto ndi zipangizo zoyikidwa: Monga tanenera kale, njira ya Monopolar makamaka ingasokoneze magwiridwe antchito a zipangizo zamagetsi monga pacemakers ndi defibrillators. Ngati muli ndi chipangizo chotere, muyenera kudziwitsa dokotala wanu musanachite opaleshoni. Kenako adzasankha njira yotetezeka kwambiri kwa inu.

Zitenga nthawi yayitali bwanji kuti munthu achire?

Izi zimadalira mtundu wa chithandizocho.

• Ngati chinthu chonga chipolopolo kapena chotupa pamwamba pa khungu chachotsedwa, zimatenga pafupifupi sabata imodzi kuti bala lipole.
• Ngati ndi chilonda chozama kwambiri, chingatenge milungu iwiri kapena inayi kapena kuposerapo.

Dokotala adzakufotokozerani nthawi yochira malinga ndi vuto lanu.

Kodi muyenera kupita kwa dokotala liti?

Mukalandira chithandizo, ngati bala lanu likutuluka magazi ndipo silinasiye kutuluka magazi pambuyo pa mphindi 20 za kupanikizika kosalekeza, imbani dokotala wanu nthawi yomweyo. Ngati kutuluka magazi kuli kwakukulu, pitani ku Dipatimenti Yothandiza Pangozi (ETU) ya chipatala chapafupi.

Komanso, ngati bala likuoneka kuti likutupa, pali ululu wambiri, kapena ngati mukuona kuti silikuchira monga momwe mukuyembekezerera, musazengereze kulankhula ndi dokotala wanu.