Kujwayelekile ukuthi noma ubani azizwe esaba kakhulu futhi ethukile lapho ezwa ukuthi unomdlavuza, ikakhulukazi uma ezwa ukuthi ususakazekele kwezinye izingxenye zomzimba. Kodwa-ke, kwisayensi yezokwelapha ethuthukisiwe yanamuhla, kunezindlela zokwelapha ezinamandla ezingasiza ekwandiseni impilo nokulawula izimpawu ngisho nasezimweni ezinjalo. Namuhla, sizokhuluma ngokuhlinzwa okukhethekile okunjalo. Lokhu kubizwa ngokuthi ukuhlinzwa kwe-Debulking.
Kalula nje, kuyini ukuhlinzwa kwe-Debulking?
Cabanga nje ukuthi ingadi inokhula oluningi. Senzani? Sikhipha ukhula oluningi ngangokunokwenzeka, akunjalo? Khona-ke imithi emihle nemivini inethuba lokukhula kahle futhi. Ukuhlinzwa kokususa amaphutha, noma ukuhlinzwa kwe-`(Cytoreduction)`, kuyinto efana naleyo.
Kalula nje, lokhu kuhilela ukususa ngokuhlinzwa umdlavuza omningi ngangokunokwenzeka uma ususakazeke emzimbeni wonke. Ngezinye izikhathi kungase kungenzeki ukususa umdlavuza ngokuphelele. Kodwa ukususa omningi ngangokunokwenzeka kwenza kube lula ngezinye izindlela zokwelapha, njenge-chemotherapy, ukulawula noma yimaphi amangqamuzana omdlavuza asele.
Lokhu kunezinhloso eziningana eziyinhloko:
- Kusiza ekwandiseni isikhathi sokuphila.
- Ukunciphisa ukusabalala komdlavuza.
- Ukuqeda izimpawu ezifana nokucindezeleka nobuhlungu obubangelwa izimila zomdlavuza ezithweni ezizungezile.
- Kwezinye izimo, lokhu kuhlinzwa kungasiza ngisho nokwelapha ngokuphelele izifo ezifana nomdlavuza wesibeletho.
Yiziphi izinhlobo zezimo lokhu kuhlinzwa okwenziwa kakhulu kuzo?
Ukuhlinzwa kokususa ama-bulking kuvame ukusetshenziswa kakhulu kumdlavuza osusakazekele esiswini (ngaphakathi kwesisu) kanye nasesinqeni. Odokotela bangase bacabangele lokhu kuhlinzwa ezimweni ezilandelayo:
| Isimo sezokwelapha | Isingeniso esifushane |
|---|---|
| Umdlavuza Wesibeletho | Lokhu kuhlinzwa kuvame ukwenziwa lapho umdlavuza wesibeletho se-epithelial, ovela emaseli angaphansi kwengqimba engaphandle yesibeletho, ususakazekile. |
| Umdlavuza Wesisu | Isetshenziselwa umdlavuza osakazekela e -peritoneum , ulwelwesi oluzungezile izitho esiswini, njengesibindi nesisu. |
| I-Mesothelioma ye-Peritoneal | Lokhu kuhlinzwa kwenziwa futhi kulesi simo somdlavuza, esingabangelwa yizici ezifana nokuhogela i-asbestos. |
| I-Pseudomyxoma Peritonei | Lesi yisimo lapho umdlavuza osesithanjeni usakazeka khona ulwelwesi esiswini sonke. Kwenziwa ukuhlinzwa ukuze kususwe ulwelwesi. |
Kwenzekani ngaphambi kokuhlinzwa?
Njengoba lokhu kuwukuhlinzwa okukhulu, kudingeka kube nokulungiselela okuhle kusengaphambili.
Ingxoxo nodokotela
Udokotela wakho womdlavuza ohlinzayo uzochaza konke ngokucacile.
- Ukwelashwa Kwangaphambi Kokuhlinzwa: Ngezinye izikhathi ukwelashwa kwe-neoadjuvant, njengokwelashwa ngamakhemikhali, kunganikezwa ngaphambi kokuhlinzwa ukuze kuncishiswe umdlavuza.
- Uhlobo lokuhlinzwa: Udokotela uzonquma ukuthi lokhu kuzokwenziwa "njengokuhlinzwa kwe-laparoscopic", okusho ukuthi ikhamera ifakwa ngokusikwa okuncane, noma "njenge-laparotomy", okusho ukuthi isisu siyavuleka.
- Izitho zomzimba ezisusiwe: Ezimweni zomdlavuza wesibeletho, ama-ovari, amashubhu esibeletho, isibeletho, kanye nomlomo wesibeletho ngokuvamile kuyasuswa. Kuye ngokuthi umdlavuza ususakazeke kangakanani, ingxenye yamathumbu amancane noma ikholoni nayo ingadinga ukususwa.
- Isikhathi sokuhlinzwa: Lokhu ukuhlinzwa okukhulu okuthatha amahora amaningana, kodwa isikhathi singase sihluke kuye ngesimo sakho.
Ukuhlolwa okudingekayo
Kuzokwenziwa izivivinyo eziningana ukuze kubonakale ukuthi umzimba wakho uyakufanelekela yini ukuhlinzwa.
- Ukuhlolwa kwegazi: Amazinga kashukela egazini, inani eliphelele legazi (i-CBC), ukuhlolwa kokusebenza kwezinso nesibindi.
- Ukuhlolwa kwezithombe: Izinto ezifana ne-chest X-ray, i-CT scan, i-MRI scan, kanye ne-PET scan zingenziwa.
Ukuhlangana nodokotela wezinzwa
Udokotela wezinzwa uzokubuza imibuzo embalwa ngaphambi kokuhlinzwa. Isibonelo, uzobuza ngesipiliyoni sakho sangaphambilini nge-anesthesia, imithi oyiphuzayo, amavithamini owaphuzayo, noma yiziphi ezinye izimo zezokwelapha onazo, kanye nesimo samazinyo akho.
Kufanele uzilungiselele kanjani ukuhlinzwa?
- Gwema ukubhema:Uma usebenzisa noma yiluphi uhlobo lwe-nicotine, okuhlanganisa ugwayi kanye nogwayi kagesi, yeka ngokushesha. I-nicotine ingaphazamisa ukujikeleza kwegazi futhi ilibazise ukuphola kwenxeba ngemva kokuhlinzwa.
- Ukuzila Ukudla: Uzokwaziswa ukuthi uyeke ukudla noma ukuphuza amahora amaningana ngaphambi kokuhlinzwa. Landela le miyalelo ngokucophelela.
- Hlela ukuhlala kwakho esibhedlela: Kuzodingeka uhlale esibhedlela izinsuku ezimbalwa (ngokuvamile ezingu-3-7) ngemva kwalokhu kuhlinzwa. Kuzoba usizo ukuhlela imisebenzi yakho yasekhaya kanye nomsebenzi kusenesikhathi ngaleso sikhathi.
- Umuntu ozokusiza uma usufikile ekhaya: Kuhle ukuba nomuntu ozokusiza ezinsukwini zokuqala ngemuva kokufika ekhaya.
Kwenzekani ngesikhathi sokuhlinzwa?
Ngemva kokunikezwa i-anesthesia, uzobe ulele ngokuphelele. Ngeke uzwe ubuhlungu. Udokotela ohlinzayo uzokwenza ukusika okukodwa noma ngaphezulu esiswini sakho futhi asuse ngokucophelela isimila somdlavuza nanoma yisiphi izicubu esisakazekile. Kwezinye izimo, ukwelashwa okukhethekile okubizwa ngokuthi ``Hyperthermic Intraperitoneal Chemotherapy (HIPEC)``, lapho imithi ye-chemotherapy eshisayo ifakwa khona emgodini wesisu ngesikhathi sokuhlinzwa, kungenziwa. Ekugcineni, ukusika kuzothungwa, bese kufakwa ipayipi ``drain``` ukuze kukhishwe noma yiluphi uketshezi oluqongelele emzimbeni wakho.
Kwenzekani ngemva kokuhlinzwa?
Uzoqashwa ngabasebenzi bezokwelapha egumbini lokululama uze uvuke ekuhlinzweni kwe-anesthesia. Phakathi nezinsuku ezimbalwa ozobe usesibhedlela, bazokunikeza imithi yezinhlungu, bahlanze inxeba lakho, njll. Bazoqala ngokukunika amanzi amancane okuphuza, bese bekwazisa ukudla okumanzi.
Okubalulekile: Uzofundiswa izivivinyo ezikhethekile esibhedlela. Izivivinyo zemilenze zisiza ekuvimbeleni ukuqhekeka kwegazi (i-deep vein thrombosis). Ukuphefumula okujulile nokukhwehlela kusiza ekuhlanzeni amaphaphu futhi kunciphise ingozi yokutheleleka njenge-pneumonia. Lokhu kubalulekile.
Yimiphi imiphumela emibi kanye nezinkinga ezingaba khona?
Njenganoma yikuphi ukuhlinzwa okukhulu, lokhu kungaba nemiphumela emibi kanye nezinkinga.
- Imiphumela emibi evamile: ukuphuma kwegazi esilondeni, ukukhathala okukhulu, ukulahlekelwa yisifiso sokudla, ubuhlungu, kanye nobunzima bokukhipha indle.
- Izinkinga ezingaba khona: ukuqhekeka kwegazi, ukutheleleka kwenxeba, i-lymphedema, kanye ne-ileus yesikhashana.
Asikho isidingo sokwesaba ngoba abasebenzi bezokwelapha bahlala beqaphela lezi zinto.
Kuthatha isikhathi esingakanani ukululama?
Kungathatha izinyanga eziningana ukuze ululame ngokugcwele. Kujwayelekile kakhulu ukuzizwa ukhathele kakhulu kunokujwayelekile ngemva kokuhlinzwa.Umzimba wakho usebenzisa amandla amaningi ukuze welapheke. Ngakho-ke thola ukuphumula okwanele. Kufanele ugweme ukuphakamisa isisindo esingaphezu kwamakhilogremu angu-4-5 ngemva kokuhlinzwa. Udokotela wakho uzokutshela ukuthi kufanele uhlale isikhathi esingakanani ungakwenzi lokho.
Kunini lapho kufanele ufune khona iseluleko sezokwelapha ngokushesha?
Uma uhlangabezana nalezi zimpawu ezilandelayo ngemuva kokubuyela ekhaya, kufanele uthathe isinyathelo ngokushesha .
| Isimo Esiphuthumayo - iya ku-ETU ngokushesha! | |
|---|---|
| Izimpawu Zokuqhekeka Kwegazi | - Ubunzima bokuphefumula - Ukukhwehlela ngegazi - Ubuhlungu esifubeni noma emhlane ongaphezulu - Ukuvuvukala, ukubomvu, noma ukufudumala uma kuthintwa emlenzeni owodwa |
| Shayela udokotela wakho ngokushesha. | |
| Izimpawu Zokutheleleka | - Ukuthuthumela komzimba, umuzwa wokuba manzi nokubanda. - Umkhuhlane (ongaphezu kwama-degree Celsius angu-38 / 100.4 Fahrenheit) |
Khumbula, ihlule legazi emlenzeni (i-deep vein thrombosis) lingaqhekeka bese lihlala emthanjeni emaphashini (i-pulmonary embolism). Lesi yisimo esiphuthumayo esisongela impilo. Ngakho-ke qaphela kakhulu lezi zimpawu.
Umlayezo Wokuya Nawe Ekhaya
- Ukuhlinzwa kokususa ama-bulking kuyindlela enkulu yokuhlinzwa esusa umdlavuza omningi ngangokunokwenzeka osusakazeke emzimbeni wonke.
- Lokhu kungalawula izimpawu, kwandise isikhathi sokusinda, futhi kwandise impumelelo yezinye izindlela zokwelapha umdlavuza.
- Njengoba lokhu kuwukuhlinzwa okukhulu, kuzothatha izinyanga eziningana ukululama. Kuvamile ukuzizwa ukhathele phakathi nalesi sikhathi.
- Landela imiyalelo kadokotela wakho ngokucophelela ngemva kokuhlinzwa, ikakhulukazi mayelana nokuzivocavoca umzimba nokugwema ukuphakamisa izinto ezisindayo.
- Uma uba nezimpawu zokuqhekeka kwegazi noma ukutheleleka, funa iseluleko sezokwelapha ngokushesha ngaphandle kokulibala.
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