Ingabe nawe unenkinga yokuphefumula usuku nosuku ngenxa ye-emphysema enzima? Ingabe uzizwa uphelelwa amandla ngisho nangemva kokwenza imisebenzi emincane? Ngisho nangemva kokuthatha imithi nokuya ezinhlelweni zokuvuselela, ubunzima bakho bokuphefumula abunciphi? Uma kunjalo, mhlawumbe udokotela wakho angakhuluma nawe ngokuhlinzwa okukhethekile. Yilokho esikhuluma ngakho namuhla. Lokhu kubizwa ngokuthi i-Lung Volume Reduction Surgery, noma i-LVRS ngamafuphi.
Kalula nje, kuyini ukuhlinzwa kwe-LVRS?
Cabanga ngamaphaphu akho njengeziponji ezimbili. Uma i-emphysema inzima, kwakheka amabhamuza omoya kwezinye izingxenye zalesi siponji, okubangela ukuba zivuvuke. Lezi zindawo ezonakele azisakwazi ukuphefumula, futhi azikwazi ukumunca umoya-mpilo egazini. Akukhona lokho kuphela, kodwa lezi zindawo ezivuvukele, ezingenamsebenzi nazo zivimba izingxenye ezinempilo zamaphaphu, okwenza angakwazi ukusebenza kahle.
Ukuhlinzwa kwe-LVRS kuhilela ukusika nokususa lezo zingxenye zamaphaphu ezonakele, ezivuvukile, nezingenamsebenzi.
Okusho ukuthi, ubukhulu bamaphaphu buyancishiswa. Kwenzekani uma wenza lokhu? Izingxenye ezisele zamaphaphu ezinempilo ziyavunyelwa ukuthi zikhule futhi zisebenze kahle. Ngemuva kwalokho, umoya-mpilo osemoyeni owuphefumulayo ungamuncwa kahle egazini bese uthunyelwa emzimbeni wonke.
Into ebalulekile ukuthi lokhu kuhlinzwa akuyilaphi ngokuphelele i-emphysema. Futhi akuqinisekisiwe ukuthi kuzokwandisa impilo yakho. Umgomo oyinhloko walokhu kuhlinzwa ukunciphisa ubunzima bokuphefumula nokuthuthukisa ikhwalithi yokuphila kwakho.
Ubani ongenza lokhu kuhlinzwa? Akwenzeki yini kuwo wonke umuntu?
Cha, lokhu kuhlinzwa akufanele wonke umuntu. Ucwaningo luthole ukuthi lokhu kuhlinzwa kusebenza kahle kakhulu ezigulini ezihlangabezana nezindinganiso ezithile. Udokotela wakho uzokuxilonga ngokucophelela ukuze anqume ukuthi ungumuntu ofanele yini kule nqubo. Lezi zindinganiso zivame ukucatshangelwa:
- Ukuba ngaphansi kweminyaka engama-75 ubudala.
- Ukuba nokuphefumula okunzima (ukuphelelwa umoya) okuqhubekayo naphezu kokwelashwa kanye nokuvuselelwa kwamaphaphu.
- Umonakalo emaphashini kufanele ube sezingxenyeni ezingaphezulu, okusho ukuthi amanye amaphaphu kufanele abe sesimweni esihle.
- Ubufakazi bokuthi amaphaphu agcwele ngokweqile kanye nokubanjwa komoya.
- Kumelwe ukuthi usuyeke ngokuphelele ukubhema okungenani izinyanga ezine. Lokhu kuhlinzwa ngeke kwenziwe kumuntu oqhubeka nokubhema.
- Yiba nekhono ngokomzimba nangokwengqondo lokubamba iqhaza ohlelweni lokuvuselelwa kwamaphaphu amasonto ayi-6-10 ngaphambi kokuhlinzwa kanye namasonto ayi-10-12 ngemuva kokuhlinzwa.
Yiziphi izindlela zokuhlinzwa?
Kunezindlela ezimbili eziyinhloko zokususa izingxenye zamaphaphu ezonakele. Udokotela wakho ohlinzayo uzonquma ukuthi iyiphi indlela engcono kakhulu kuwe ngokusekelwe esimweni sakho.
| Indlela yokuhlinzwa | Kuchazwe kalula |
|---|---|
| I-Thoracoscopy | Lokhu kuhilela ukwenza imicu emincane emi-3 noma emi-5 phakathi kwezimbambo esikhundleni sokusika okukhulu esifubeni. Ikhamera (i-videoscope) ifakwa ngokusika okukodwa ukuze kubhekwe amaphaphu, bese kufakwa amathuluzi okuhlinza ngezinye izicucu ukuze kususwe izingxenye ezonakele. Le ndlela ibizwa nangokuthi i-VATS (Video-Assisted Thoracic Surgery) . Njengoba kungekho ukusika okukhulu, isikhathi sokululama singase sisheshe kancane. |
| Ukuhlinzwa kwe-Sternotomy | Lokhu ukuhlinzwa okuvulekile. Ukuhlinzwa kwenziwa ngokusika ithambo lesifuba ngobude phakathi kwesifuba bese kuvulwa isifuba. Inzuzo yale ndlela ukuthi womabili amaphaphu angafinyelelwa kalula ngokusika okukodwa. |
Ngaphezu kwalokho, kwezinye izimo, kukhona indlela ebizwa ngokuthi i-Bronchoscopic Lung Volume Reduction (BLR), ehilela ukufaka ama-valve amancane emaphashini kusetshenziswa i-bronchoscope ukuvumela umoya ukuthi uphume ezindaweni ezonakele, ngaphandle kokuhlinzwa. Kodwa leso yisihloko esihlukile.
Yiziphi izivivinyo ezenziwa ngaphambi kokuhlinzwa?
Ukuze anqume ukuthi ungumuntu ofanele yini kulokhu kuhlinzwa, udokotela wakho uzokucela ukuthi uhlolwe kaningana. Ungakhathazeki, zonke lezi zivivinyo zenzelwe ukuphepha kwakho nokuthola imiphumela emihle kakhulu kulokhu kuhlinzwa.
- Ukuhlolwa Kwezithombe: Ama-X-ray esifubeni kanye nokuskena kwe-CT okunekhwalithi ephezulu kungabonisa ukuthi kungakanani umoya ovaleleke emaphashini nokuthi umonakalo omkhulu ukuphi.
- Ukuhlolwa Kokusebenza Kwephaphu (ama-PFT): Lokhu kusetshenziselwa ukukala ukuthi amaphaphu akho asebenza kahle kangakanani. Kubheka izinto ezifana nenani lakho le-FEV1 ukuze kubikezelwe ukuthi uzothola inzuzo engakanani ngokuhlinzwa.
- Izivivinyo Zokuzivocavoca: Izinto ezifana nokuhlolwa kokuhamba ngezinyawo kwemizuzu eyisithupha zilinganisa ukuthi ungavivinya umzimba isikhathi esingakanani.
- Ukuhlolwa Kokusabalalisa Amaphaphu (i-DLCO): Lokhu kuhlola ukuthi amaphaphu akho amunca kahle kangakanani umoya-mpilo egazini lakho.
- Ukuhlolwa Kwenhliziyo: Izinto ezifana ne-EKG, i-echocardiogram, kanye nokuhlolwa kokucindezeleka zenziwa ukuqinisekisa ukuthi inhliziyo yakho isebenza kahle.
- Ezinye izivivinyo: Izinto ezifana nokuskena kwe-V/Q kanye nokuhlolwa kwegesi yegazi emithanjeni kunikeza ulwazi olwengeziwe mayelana nohlelo lokuphefumula.
Izinzuzo nezingozi zokuhlinzwa
Njenganoma yikuphi ukuhlinzwa, lokhu kunezinzuzo nezingozi. Kubalulekile ukukhuluma ngokukhululekile ngalokhu nodokotela wakho futhi uthole ukuqonda okuhle.
Yiziphi izinzuzo?
- Izinga lempilo lithuthuke kakhulu.
- Ukuncipha kokuphefumula.
- Ukusebenza kwamaphaphu okuthuthukisiwe.
- Ikhono lokuzivocavoca elikhuphukile.
- Inqubo yokuphefumula elula.
Ziyini izingozi?
Ukuhlinzwa ngakunye kunezingozi, futhi odokotela benza konke okusemandleni abo ukuze bazinciphise.
- Ukusabela okubi ekubulaweni yizinzwa.
- Amaphaphu awile (i-pneumothorax).
- Ukuvuza komoya okuvela ezithungweni.
- Izimo ezithathelwanayo njenge-pneumonia.
- Ukuhlaselwa yinhliziyo (i-myocardial infarction).
Lokhu ukuhlinzwa okungathi sína. Ngokwezibalo, ingozi yokufa ngenxa yalokhu kuhlinzwa iphakathi kuka-3% no-5%. Yingakho ukukhetha isiguli esifanele kubaluleke kakhulu.
Kuthatha isikhathi esingakanani ukululama?
Ngemva kokuhlinzwa, kuzodingeka uhlale esibhedlela izinsuku ezi-3 kuya kweziyi-7. Ngemva kokuya ekhaya, uzocelwa ukuthi uqale uhlelo lokuvuselela amaphaphu futhi phakathi kwamasonto ambalwa okuqala. Lokhu kubaluleke kakhulu ngoba lokhu kuzivocavoca nokuqeqeshwa kubalulekile ukuze uthole okuningi ekuhlinzweni kwakho.
Ukukhululeka kokuphefumula okuhambisana nokuhlinzwa kuvame ukuhlala iminyaka emibili kuya kwemihlanu. Ngakho-ke, kubaluleke kakhulu ukuyeka ngokuphelele ukubhema nokulandela imiyalelo kadokotela phakathi nalesi sikhathi.
Kufanele ngimbone nini udokotela?
Uma kuvela noma yiziphi izimpawu ezilandelayo ngemuva kokuhlinzwa, kufanele uye e-Emergency Treatment Unit (ETU) yesibhedlela ngokushesha .
- Imfiva.
- Ubuhlungu obukhulu esifubeni.
- Ubunzima obukhulu bokuphefumula.
- Ukushintsha kombala wesikhumba, izindebe, noma izinzipho (i-cyanosis).
Umlayezo Wokuya Nawe Ekhaya
- I-LVRS ukuhlinzwa okwenziwa kuphela eqenjini elithile leziguli ezine-emphysema enzima.
- Uma uhlela ukwenza lokhu kuhlinzwa, kubalulekile ukuyeka ngokuphelele ukubhema.
- Lokhu akusilo ukuhlinzwa okwelaphayo, umgomo wakho oyinhloko ukunciphisa ubunzima bokuphefumula nokuthuthukisa ikhwalithi yokuphila.
- Imiphumela yokuhlinzwa ihlala iminyaka eminingana, futhi ukuvuselelwa kwamaphaphu kubaluleke kakhulu ukuze kusebenze kahle.
- Ngaphambi kokwenza noma yisiphi isinqumo, xoxa nodokotela wakho ngezinzuzo, ububi, kanye nezingozi zalokhu kuhlinzwa ukuze uthole ukuqonda okucacile.
👩🏽⚕️ Imibuzo eyengeziwe (ama-FAQ)
💬 Kuyini Ukuvuvukala Kwemilenze / Ukuvuvukala Kwezingqimba?
Lokhu akugcini nje ngokuba imilenze yakho iqine njengoba ukhuluphala/ukhula! 'Ukuvuvukala Kwemilenze' yisimo lapho omunye wemilenze yakho (kodwa ngokuvamile yomibili imilenze), amaqakala kanye nezinyawo kuba kukhulu ngendlela engavamile ngenxa yokuqongelela koketshezi (i-Edema) ngaphansi kwesikhumba, okwenza kube nzima ukugqoka izicathulo/ukuhamba. Uma ucindezela le ndawo evuvukele ngomunwe wakho, izokwehla njengomgodi isikhashana (i-Pitting edema). Lokhu kuyisibonakaliso somonakalo omkhulu, obulalayo 'enhliziyweni noma ezinso' zomzimba!
💬 Yiziphi izimbangela eziyinhloko ezibulalayo zokuvuvukala kwezinyawo nemilenze (Ukuvuvukala Kwemilenze)?
Kunezimbangela ezi-4 eziyinhloko zalokhu: 1) 'Ukwehluleka Kwenhliziyo' - Lapho inhliziyo ingakwazi ukupompa igazi/ibuthakathaka (njengalapho ubhajwe endizeni), lelo gazi liyanqwabelana emilenzeni ngenxa yamandla adonsela phansi kanye nokuvuvukala. 2) 'Ukwehluleka Kwezinso/Isifo Sokusha Kwezinso' - Lapho izinso zingakwazi ukukhiqiza umchamo/izinso zilahlekelwa amaprotheni futhi zigcwale amanzi. 3) Imiphumela emibi yamaphilisi athile omfutho wegazi kanye nemithi yomdlavuza webele. 4) I-Liver Cirrhosis - Kulesi simo, isisu sonke sigcwala amanzi futhi sikhule njengebhaluni.
💬 Uma umlenze uvuvukala, yiziphi 'izimo ezisongela ukuphila/eziphuthumayo' lapho kufanele uye esibhedlela/emnyangweni wezimo eziphuthumayo ngokushesha, ngaphandle kokufaka uwoyela/ibhalsamu nje?
Kuvamile ukuba nemilenze evuvukile ngesikhathi sokukhulelwa kanye nokuvuvukala ngemva kokuma isikhathi eside (Ukuvuvukala kwemilenze okuncane - gcina imilenze yakho iphakeme). Kodwa lena ingozi enkulu! Kanye nemilenze evuvukile, 1) 'Uma umlenze owodwa kuphela (uhlangothi olulodwa kuphela) uvuvukile, ubomvu futhi uvutha (Ukufudumala/Ubomvu/Ubuhlungu Obukhulu - I-DVT/ihlule legazi)', 2) Uma ngokuzumayo uba nobunzima bokuphefumula kanye nokuqina kwesifuba kanye nokukhwehlela/ukuhlanza (I-Pulmonary Embolism / Ukwehluleka Kwenhliziyo), ungafa ngemizuzu embalwa, udinga ukuya esibhedlela ngokushesha!
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