Ngaba nawe unengxaki yokuphefumla imihla ngemihla ngenxa ye-emphysema enzima? Ngaba uziva utyhafile nasemva kokwenza imisebenzi emincinci? Nasemva kokusela amayeza nokuya kwiinkqubo zokubuyisela impilo, ubunzima bakho bokuphefumla abunciphi? Ukuba kunjalo, mhlawumbi ugqirha wakho angathetha nawe ngotyando olukhethekileyo. Yiloo nto sithetha ngayo namhlanje. Oku kubizwa ngokuba yiLung Volume Reduction Surgery, okanye i-LVRS ngamafutshane.
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Ngamafutshane, yintoni utyando lwe-LVRS?
Cinga ngemiphunga yakho njengee-sponge ezimbini. Xa i-emphysema inzima, amaqamza omoya ayenzeka kwezinye iindawo zesi siponge, nto leyo ebangela ukuba zidumbe. Ezi ndawo zonakeleyo azisakwazi ukuphefumla, kwaye azikwazi ukufunxa ioksijini egazini. Ayipheleli apho, kodwa ezi ndawo zidumbileyo nezingenamsebenzi zikwavimba iindawo eziphilileyo zemiphunga, nto leyo ebangela ukuba zingakwazi ukusebenza kakuhle.
Utyando lwe-LVRS lubandakanya ukusika nokususa ezo ndawo zomphunga ezonakeleyo, ezidumbileyo, nezingasebenziyo.
Oko kukuthi, ubukhulu bemiphunga buyancitshiswa. Kwenzeka ntoni xa usenza oku? Iindawo ezisele eziphilileyo zemiphunga ziyavunyelwa ukuba zande kwaye zisebenze ngokufanelekileyo. Emva koko, ioksijini esemoyeni ophefumlayo inokungena ngokufanelekileyo egazini ize ithunyelwe emzimbeni wonke.
Into ebalulekileyo kukuba olu tyando aluyinyangi ngokupheleleyo i-emphysema. Kwaye alunakuqinisekiswa ukuba luya kwandisa ubomi bakho. Injongo ephambili yolu tyando kukunciphisa ubunzima bokuphefumla nokuphucula umgangatho wobomi bakho.
Ngubani onokwenza olu tyando? Akwenzeki na ukuba wonke umntu enze olu tyando?
Hayi, olu tyando alufanelekanga kuye wonke umntu. Izifundo zifumanise ukuba olu tyando lusebenza kakuhle kuphela kwizigulana ezihlangabezana neemfuno ezithile. Ugqirha wakho uza kukuxilonga ngononophelo ukuze abone ukuba ungumntu ofanelekileyo na kule nkqubo. Ezi mpawu zihlala ziqwalaselwa:
- Ukuba ungaphantsi kweminyaka engama-75 ubudala.
- Ukuba nokuphelelwa ngumphefumlo kakhulu (ukuphelelwa ngamandla) okuqhubeka nangona amayeza kunye nokuvuselelwa kwemiphunga.
- Umonakalo kwimiphunga kufuneka ube kwiindawo eziphezulu kakhulu. Oku kuthetha ukuba yonke eminye imiphunga kufuneka ibe kwimeko entle.
- Ubungqina bokuba imiphunga ifumile kakhulu kwaye umoya ubambeke kakhulu.
- Kufuneka ukuba uyeke ngokupheleleyo ukutshaya ubuncinane iinyanga ezi-4. Olu tyando aluyi kwenziwa kumntu oqhubeka nokutshaya.
- Yiba nakho ngokwasemzimbeni nangokwengqondo ukuthatha inxaxheba kwinkqubo yokuvuselela imiphunga kangangeeveki ezi-6 ukuya kwezili-10 ngaphambi kotyando kunye neeveki ezili-10 ukuya kwezili-12 emva kotyando.
Ziziphi iindlela zotyando?
Kukho iindlela ezimbini eziphambili zokususa iindawo ezonakeleyo zomphunga. Ugqirha wakho uya kugqiba ukuba yeyiphi indlela efanelekileyo kuwe ngokwemeko yakho.
| Indlela yotyando | Icacisiwe ngokulula |
|---|---|
| I-Thoracoscopy | Oku kuquka ukwenza imingxunya emincinci emi-3 okanye emi-5 phakathi kweembambo endaweni yokusikwa okukhulu esifubeni. Ikhamera (i-videoscope) ifakwa nge-incision enye ukujonga imiphunga, kwaye izixhobo zotyando zifakwa ngezinye izigxunya ukususa iindawo ezonakeleyo. Le ndlela ikwabizwa ngokuba yi-VATS (Video-Assisted Thoracic Surgery) . Ekubeni kungekho sigxunya sikhulu, ixesha lokuchacha linokuba likhawuleza kancinci. |
| I-Sternotomy | Olu lutyando oluvulelekileyo. Olu tyando lwenziwa ngokusika isifuba ngobude phakathi kwesifuba nokuvula isifuba. Inzuzo yale ndlela kukuba imiphunga yomibini inokufikelelwa lula ngokusikwa kube kanye. |
Ukongeza, kwezinye iimeko, kukho indlela ebizwa ngokuba yiBronchoscopic Lung Volume Reduction (BLR), equka ukufaka iivalvu ezincinci emiphungeni kusetyenziswa i-bronchoscope ukuvumela umoya ukuba uphume kwiindawo ezonakeleyo, ngaphandle kotyando. Kodwa loo nto yingongoma eyahlukileyo.
Zeziphi iimvavanyo ezenziwayo ngaphambi kotyando?
Ukuze afumanise ukuba ungumntu ofanelekileyo na kolu tyando, ugqirha wakho uza kukucela ukuba wenze uvavanyo oluninzi. Ungakhathazeki, zonke ezi vavanyo zenzelwe ukhuseleko lwakho nokufumana iziphumo ezilungileyo kolu tyando.
- Uvavanyo lweMifanekiso: Ii-X-ray zesifuba kunye nee-CT scans ezikumgangatho ophezulu zinokubonisa ukuba ungakanani umoya ovaleleke emiphungeni kwaye apho umonakalo omkhulu ukhoyo khona.
- Uvavanyo lweMisebenzi yeMiphunga (ii-PFT): Ezi zisetyenziselwa ukulinganisa indlela imiphunga yakho esebenza ngayo. Zijonga izinto ezifana nexabiso lakho le-FEV1 ukuze ziqikelele ukuba uza kufumana inzuzo engakanani ngotyando.
- Uvavanyo Lokuzilolonga: Izinto ezifana novavanyo lokuhamba ngemizuzu emithandathu zilinganisa ukuba ungazilolonga umgama ongakanani.
- Uvavanyo lokuSasazwa kweMiphunga (i-DLCO): Olu vavanyo luvavanya indlela imiphunga yakho efunxa ngayo ioksijini egazini lakho.
- Uvavanyo lwentliziyo: Izinto ezifana ne-EKG, i-echocardiogram, kunye novavanyo loxinzelelo zenziwa ukuqinisekisa ukuba intliziyo yakho isebenza kakuhle.
- Ezinye iimvavanyo: Izinto ezifana ne-V/Q scan kunye novavanyo lwegesi yegazi emithanjeni zibonelela ngolwazi oluthe kratya malunga nenkqubo yokuphefumla.
Iingenelo kunye neengozi zotyando
Njengalo naluphi na utyando, olu lunezibonelelo kunye neengozi. Kubalulekile ukuthetha ngokukhululekileyo ngale nto nogqirha wakho kwaye ufumane ukuqonda okuhle.
Zithini iingenelo?
- Umgangatho wobomi uphucuke kakhulu.
- Ukuncipha kokuphelelwa ngumphefumlo.
- Ukusebenza kakuhle kwemiphunga.
- Ukwanda kwamandla okwenza umthambo.
- Inkqubo yokuphefumla elula.
Zithini iingozi?
Lonke utyando lunemingcipheko, kwaye oogqirha benza konke okusemandleni abo ukunciphisa loo mingcipheko.
- Iimpendulo ezingalunganga kwi-anesthesia.
- Umphunga owileyo (i-pneumothorax).
- Ukuvuza komoya okuvela kwizititshi.
- Iimeko ezisulelayo ezifana ne-pneumonia.
- Uhlaselo lwentliziyo (i-myocardial infarction).
Olu lutyando olunzima. Ngokwezibalo, umngcipheko wokufa ngenxa yolu tyando uphakathi kwe-3% kunye ne-5%. Yiyo loo nto ukukhetha isigulana esifanelekileyo kubaluleke kakhulu.
Kuthatha ixesha elingakanani ukuchacha?
Emva kotyando, kuya kufuneka uhlale esibhedlele iintsuku ezi-3 ukuya kwezi-7. Emva kokuba ubuyele ekhaya, uya kucelwa ukuba uqalise inkqubo yokuvuselela imiphunga kwakhona kwiiveki ezimbalwa zokuqala. Oku kubaluleke kakhulu kuba olu qheliselo noqeqesho lubalulekile ukuze ufumane okuninzi kotyando lwakho.
Ukukhululeka kokuphefumla okuza notyando kudla ngokuthatha iminyaka emibini ukuya kwemihlanu. Kungoko ke, kubaluleke kakhulu ukuyeka ngokupheleleyo ukutshaya nokulandela imiyalelo kagqirha ngeli xesha.
Ndifanele ndimbone nini ugqirha?
Ukuba kukho naziphi na kwezi mpawu zilandelayo emva kotyando, kufuneka uye kwiYunithi yoNyango oluNgxamisekileyo (ETU) yesibhedlele ngoko nangoko .
- Ifiva.
- Intlungu ebuhlungu esifubeni.
- Ubunzima obukhulu bokuphefumla.
- Ukutshintsha kombala oluhlaza okwesibhakabhaka kolusu, imilebe, okanye iinzipho (i-cyanosis).
Umyalezo Wokuya Ekhaya
- I-LVRS lutyando olwenziwa kuphela kwiqela elithile lezigulana ezine-emphysema enzima.
- Ukuba uceba ukwenza olu tyando, kubalulekile ukuyeka ngokupheleleyo ukutshaya.
- Olu asilotyando lokunyanga, injongo yalo ephambili kukunciphisa ubunzima bokuphefumla nokuphucula umgangatho wobomi.
- Iziphumo zotyando zihlala iminyaka eliqela, kwaye ukuvuselelwa kwemiphunga kubaluleke kakhulu ukuze zisebenze kakuhle.
- Ngaphambi kokuba wenze nasiphi na isigqibo, xoxa nogqirha wakho ngezinto ezilungileyo, iingxaki kunye neengozi zolu tyando ukuze ufumane ukuqonda okucacileyo.
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