Kana iwe kana mumwe munhu waunoziva achiti anofanira kuvhiyiwa chipfuva, unotya zvishoma, handiti? Patinonzwa izwi rekuti "kuvhiyiwa chipfuva," tinofunga nezvekucheka kukuru, mazuva mashoma muchipatara, uye kurwadziwa kwakawanda. Kutya ikoko kwakakodzera. Asi ikozvino, sainzi yezvekurapa yafambira mberi zvakanyanya. Nhasi, tichataura nezvenzira yekuvhiyiwa chipfuva isingade kucheka kukuru kwakadaro, asi kucheka kudiki. Izvi zvinonzi VATS. Mabhenefiti kuvarwere, nguva yekupora, nezvimwe zvinhu zvakawanda zvakasiyana nekuvhiyiwa kwechinyakare. Ngatitaurei nezveizvi zvakadzama .
Zvichitaurwa zviri nyore, chii chinonzi VATS?
Zita rakazara reVATS ndiVideo-assisted thoracic surgery . MuchiSinhala, zvinoreva "video-assisted thoracic surgery." Kunyange zvazvo zita racho ringanzwika serakaoma, zvinoitika mukuita uku zviri nyore kwazvo.
Funga nezvazvo, kazhinji kana uchivhiya chipfuva, unofanirwa kuita kucheka kukuru munzvimbo yechipfuva, nepambabvu kuti usvike nhengo dzakadai semapapu kana moyo. Izvi zvinonzi `(Thoracotomy)`. Asi munzira yeVATS, hauite kucheka kukuru kudaro. Pane kudaro, unongogadzira maburi madiki mashoma, angangoita inchi imwe kana hafu, pakati pembabvu.
Zvadaro, chubhu diki ine kamera yakabatanidzwa pairi (thoracoscope) inopfuudzwa nepaburi rimwe remaburi aya ichipinda muchipfuva. Kamera iyi inokudza zvese zviri mukati mechipfuva, kusanganisira nhengo nematishu, uye inoiratidza zvakajeka pavhidhiyo. Iye zvino chiremba anogona kuona vhidhiyo iyi uye kuisa zvishandiso zvekuvhiya zvine hungwaru kuburikidza nemamwe maburi madiki kuti aite kuvhiya uku nemazvo. Zvakafanana nemutambo wevhidhiyo, asi basa rakaoma uye rine mutoro.
Uku kuvhiyiwa kusinganyanyi kupindira mumuviri, zvichireva kuti kunosanganisira kucheka kushoma. Izvi zvinoreva kuti murwere haarwadziwi zvakanyanya, haabudi ropa rakawanda, uye haawani nguva yekupora.
Ndeapi marudzi ezvirwere anorapwa nekuvhiyiwa kweVATS?
Kuvhiyiwa kweVATS kunoshandiswa kuongorora nekurapa zvirwere zvakawanda zvepachipfuva. Kunonyanya kufarirwa nekenza yemapapu . Kunoshandiswawo kune kenza yakapararira mumapapu ichibva kune dzimwe nzvimbo.
Kuwedzera kune chikonzero chikuru ichi, kuvhiyiwa kweVATS kunobatsira kune zvimwe zvirwere zvakawanda. Ngationei kuti ndezvipi.
| Dambudziko rehutano | Tsananguro iri nyore |
|---|---|
| Kenza yesophagus kana thymus | Kubvisa kenza inobuda mupaipi yechikafu (esophagus) kana mugland rethymus riri pamusoro pechipfuva. |
| Kubuda kweropa muropa | Kuungana kwakaita semvura mukati me pleura, membrane yakakomberedza mapapu. Kuvhiyiwa uku kunoitwa kubvisa mvura iyi uye kuwana chikonzero. |
| Zvirwere zvemapapu nezvirwere | Kurapa zvirwere zvakaita seCOPD uye hutachiona hwemapapu hwakakomba. |
| Kubuda kwemvura mumoyo (pericardial effusion) | Kuunganidzwa kwemvura mubhegi rakatenderedza moyo. Kubvisa izvi. |
| Kudikitira zvakanyanya (Hyperhidrosis) | Kudzora tsinga dzinokonzera kudikitira kwakanyanya muzvanza nedzimwe nhengo dzemuviri. |
| Myasthenia gravis | Kubvisa thymus gland inokonzera chirwere chinopedza simba retsandanyama. |
Mhando dzekuvhiyiwa kweVATS
Vanachiremba vanoshandisa tekinoroji yeVATS kuita maoparesheni akasiyana-siyana, anosanganisira:
- Kubviswa kwemapapu eVATS: Izvi zvinosanganisira kubvisa chikamu chemapapu chine chirwere.
- Kubviswa kwechidimbu chemapapu: Kubviswa kwechidimbu chidiki chenyama yemapapu chakaita sekoni.
- Kubviswa kwepaburi repaburi: Kubviswa kwepaburi repaburi repaburi zvachose.
- Kubviswa kwemapapu zvachose: Kubviswa kwemapapu rimwe chete.
- Kubviswa kwepombi yechikafu nekuda kwechikonzero chakadai sekenza.
- Thymectomy: Kubviswa kwe thymus gland ine chirwere.
- `Kushongedza`:Kubvisa mavanga ane utachiona uye mavanga akakomberedza mapapu uye kubvumira mapapu kuti akure zvakanaka zvakare.
- Kuvhiyiwa kwekuderedza huwandu hwemapapu (LVRS): Mumamiriro ezvinhu akadai seCOPD, zvikamu zvemapapu zvakakuvara zvinobviswa, zvichiita kuti zvikamu zvine hutano zvishande zvakanaka.
Ndinofanira kugadzirira sei kuvhiyiwa uku?
Kufanana nekuvhiyiwa kupi zvako, uku kunoda kugadzirira nokungwarira. Chinhu chakakosha ndechekutevedzera mirairo yachiremba wako nemazvo. Unowanzo kumbirwa kuita zvinhu zvakaita se:
- Kutsanya: Uchakurudzirwa kurega kudya kana kunwa kwemaawa mashoma usati wavhiyiwa.
- Kumisa Mishonga: Ungakumbirwa kuti urege kutora mimwe mishonga, kunyanya mishonga inobvisa ropa, mavhitamini, uye mishonga yeAyurvedic, usati wavhiyiwa. Kurukura izvi nachiremba wako.
- Kurega kusvuta: Kana uri munhu anosvuta, zvakakosha kuti urege zvachose, mavhiki mashoma usati wavhiyiwa. Kusvuta kunogona kukonzera matambudziko panguva yekunzwa kurwadziwa uye kunonoka kupora mushure mekuvhiyiwa.
Uchafanirawo kuongororwa kakawanda kuti uone kana muviri wako wakasimba usati wavhiyiwa.
- Kuongororwa kweropa: Kuongororwa kweropa kwakadai sekuongororwa kweropa rose (CBC).
- Kuongororwa kwemoyo: Kuongororwa kweEKG kana kuti `Kuongororwa kwekumanikidzwa kwekurovedza muviri`.
- Miedzo yekufungidzira yakaita seye chest X-ray kana CT scan / PET scan.
- Kuongororwa kwebasa remapapu: Ona kuti mapapu ako ari kushanda zvakanaka sei.
- X-ray yekumedza endoscopy yepamusoro kana kuti barium.
Chii chinoitika panguva yekuvhiyiwa?
Usazvidya mwoyo nezvazvo. Kana waendeswa kuchipatara, unotanga wapihwa mushonga weanesthesia. Izvi zvinoreva kuti uchange wakarara zvachose uye hauzonzwi chero chinhu. Hauzonzwi kurwadziwa kana kusagadzikana kusvika kuvhiyiwa kwapera.
Chikwata chekuvhiya chinozotevera matanho aya:
1. Uchatendeutswa woiswa padivi rakatarisana nepachaitwa kuvhiyiwa.
2. Kuchekwa kudiki kwakati wandei (kazhinji 2-4) kunochekwa muchipfuva, chinenge inch imwe chete, pakati pembabvu. Dzimwe nguva kune nzira ye "uniport VATS - U-VATS", iyo inoitwa neburi rimwe chete.
3. Kamera (thoracoscope) inopinzwa nepaburi rimwe chete uye mukati mechipfuva munoonekwa pachiratidziro chevhidhiyo.
4. Zvishandiso zvekuvhiya zvakakosha zvinopinzwa kuburikidza nemamwe maburi uye, uchitarisa mifananidzo iri pavhidhiyo, nyama ine chirwere kana chikamu chenhengo chinofanira kubviswa chinobviswa nokungwarira.
5. Mushure mekuvhiyiwa, chubhu yechipfuva inoiswa kwenguva pfupi kuti ibudise mweya kana mvura yakawandisa inogona kunge ichiungana muchipfuva.
6. Pakupedzisira, maburi madiki anovharwa nemasitichi anonyungudika kana kuti staples.
Mune zvimwe zvipatara zvepamusoro, kuvhiyiwa uku kunotoitwa uchishandisa 'robhoti tekinoroji'. Ikoko, chiremba anoita kuvhiyiwa uku achitarisa pakombiyuta uye achidzora ruoko rwerobhoti. Kuvhiyiwa kweVATS kwekenza yemapapu kunowanzo tora maawa maviri kusvika matatu.
Ndezvipi zvakanakira uye njodzi dzekuvhiyiwa uku?
Chinonyanya kukosha ndechekuti VATS inobatsira zvikuru kupfuura kuvhiyiwa kwechivanhu kwakavhurika pachipfuva (`Thoracotomy`). Zvisinei, kufanana nekuvhiyiwa kupi zvako, haina njodzi dzayo.
Ngatitarisei izvi zviviri zvakasiyana.
| Mabhenefiti | Njodzi |
|---|---|
| Nguva pfupi yekurara muchipatara: Unogona kudzokera kumba mumazuva 1-2. | Kusashanda zvakanaka kwemoyo (Arrhythmias). |
| Marwadzo mashoma uye mavanga: Sezvo pasina cheko guru, kurwadziwa kushoma uye mavanga acho madikiwo. | Kugwamba kweropa uye kurohwa. |
| Kukurumidza kupora kwekushanda kwekufema: Mapapu anopora nekukurumidza. | Kudonha kwemapapu (`Pneumothorax`) kana kutadza kwemapapu kuputira mweya zvakanaka (`Atelectasis`). |
| Njodzi shoma yekutapukirwa: Maronda acho madiki, saka pane njodzi shoma yekutapukirwa. | Kubuda ropa mukati uye kubuda ropa rakawanda. |
| Kurumidza kudzokera kuhupenyu hwemazuva ese: Unogona kuenda kubasa nekukurumidza wowana basa. | Zvirwere zvekufema zvakaita sepneumonia. |
| - | Kukuvadzwa kwenhengo dzakapoteredza, tsinga, kana mitsipa yeropa. |
Chii chinoitika mushure mekuvhiyiwa uye zvinotora nguva yakareba sei kuti munhu apore?
Mushure mekuvhiyiwa, nyama yakabviswa inotumirwa kurabhoritari kuti inoongororwa. Izvi zvinonzi `Biopsy` . `Pathologist` anoongorora nyama yacho achishandisa maikorosikopu kuti aone kana paine masero ekenza, zviratidzo zvehutachiona, kana zvimwe zvirwere. Kurapwa kwako kuchaongororwa zvichibva pane mushumo iwoyo.
Mushure mekuvhiyiwa, uchapihwa mishonga yekudzora marwadzo. Zvakare, vanamukoti nenyanzvi dzekurapa muviri vachakukurudzira kuti uite maekisesaizi ekufema zvakadzama . Kufamba-famba kwakakoshawo kuti upore nekukurumidza.
Usati waenda kumba, chiremba achabvisa chubhu yechipfuva.
Nguva yekupora inosiyana kubva pamunhu nemunhu uye zvichienderana nerudzi rwekuvhiyiwa kwakaitwa. Mamwe mavhiyiwa anogona kutora mavhiki maviri chete kuti apore, nepo mamwe anogona kutora mavhiki masere.
Gadzirisa zvinhu izvi mushure mekunge waenda kumba:
- Chinja mapfekero eganda nguva nenguva sezvakarairwa nachiremba wako.
- Usatyaira kana kusimudza zvinhu zvinorema kusvika chiremba akuudza kuti udaro.
- Famba zvishoma katatu pazuva kudzivirira ropa kuungana mumakumbo ako.
- Inwa mishonga inonyaradza marwadzo nemishonga inorwisa mabhakitiriya yakanyorwa nachiremba panguva chaiyo.
- Iva nechokwadi chekuenda kukiriniki pazuva rawakapihwa rekuongororwazve.
Ndinofanira kufonera chiremba rini?
Kana ukaona zviratidzo zvakaita seizvi mushure mekudzokera kumba, unofanira kufonera chiremba wako nekukasika .
- Kana uchinzwa kurwadziwa kwakanyanya pachipfuva .
- Kana uchinzwa kuoma kufema .
- Kana ukaona zviratidzo zvehutachiona . Semuenzaniso:
- Kutsvuka, kuzvimba, kana kubuda kweyero kwakakomberedza nzvimbo yakachekwa.
- Kupindwa nechando.
Usaregeredza zviratidzo izvi. Zvakakosha kutsvaga kurapwa nekukurumidza.
Mukupedzisa, VATS ibudiriro huru munyaya dzekuvhiyiwa kwechipfuva. Kune munhu ari kurwisana nechirwere chakaita sekenza, zvinomuzorodza zvikuru kukwanisa kupora nekukurumidza mushure mekuvhiyiwa, kurwadziwa kushoma, uye kudzokera kuhupenyu hwake hwemazuva ese nekukurumidza. Kana wakarongerwa kuvhiyiwa kwerudzi urwu, usatya, taura nachiremba wako nezvazvo zvizere, uye bvunza mibvunzo yese yaunayo.
Mharidzo Yekuenda Nayo Kumba
- VATS inzira yekuvhiya yemazuva ano inoitwa pasina kuchekwa kukuru pachipfuva, uchishandisa kamera nepakati pemaburi madiki.
- Marwadzo, kugara muchipatara, uye nguva yekupora zvishoma pane kuvhiyiwa kwechipfuva kwakavhurika kwechinyakare.
- Nzira iyi inoshandiswa kurapa zvirwere zvakawanda zvepachipfuva, kusanganisira kenza yemapapu.
- Sekunge kune dzimwe njodzi dzekuvhiyiwa, pane dzimwe njodzi, saka kurukurai nachiremba wenyu zvakanaka musati mavhiyiwa.
- Kuti munhu apore nekukurumidza uye zvinobudirira, zvakakosha kutevedzera mirayiridzo yekurapa nekungwarira usati wavhiyiwa uye mushure mekuvhiyiwa.
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