Ukuhlinzwa Kwamathambo Emhlathini (Ukuhlinzwa Kwamalunga E-Mandibular): Okudingeka Ukwazi

Uma udokotela wakho ekutshela ukuthi udinga ukuhlinzwa ingxenye yomhlathi wakho ongezansi, ungase uzizwe ukwesaba okukhulu nokushaqeka. Uma uzwa ngalokhu kuhlinzwa okubizwa ngokuthi 'i-mandibulectomy', ungase ube nemibuzo eminingi engqondweni yakho. Kuvamile ukuba nemibuzo efana nokuthi, "Ingabe ubuso bami buzoshintsha?", "Ingabe ngizokwazi ukukhuluma nokudla futhi?" Kodwa ungakhathazeki. Kulesi sihloko, sizoxoxa ngalokhu kuhlinzwa, ukuthi kwenziwa kanjani, ukuthi kwenzeka kanjani, nokuthi yini ongayilindela ngemva kokuhlinzwa ngendlela elula neqondakalayo.

Kalula nje, kuyini i-mandibulectomy?

Kalula nje, i-mandibulectomy ukususwa ngokuhlinzwa kwengxenye noma yonke ithambo lakho lomhlathi elingezansi (i-mandible). Lokhu ngezinye izikhathi kubizwa ngokuthi 'ukususwa kwe-mandibular resection'.

Odokotela bavame ukunquma ukwenza lolu hlobo lokuhlinzwa uma kukhona isimila somdlavuza ethanjeni lomhlathi, uma kukhona ukutheleleka okukhulu, noma uma ithambo lomhlathi lonakaliswe yisimo esithile sezokwelapha. Umgomo oyinhloko ukususa ngokuphelele ingxenye egulayo nokuvimbela isifo ukuthi singasabalali.

Yiziphi izinhlobo eziyinhloko zalokhu kuhlinzwa?

Ukuhlinzwa kwe-Mandibulectomy kungahlukaniswa ngezinhlobo ezimbili eziyinhloko. Kuya ngokuthi kukhishwe ithambo lomhlathi elingakanani. Ake sibheke ukuthi yiziphi lezo zinhlobo ezimbili.

Utholaphi amathambo okwakha kabusha?

Ku-segmental mandibulectomy, odokotela abahlinzayo bathatha amathambo, izicubu, isikhumba, kanye nemithambo yegazi (imithambo yegazi kanye nemithambo yegazi) kusuka kwenye ingxenye yomzimba wakho ukuze bakhe kabusha umhlathi wakho. Lokhu kubizwa ngokuthi "ukuvuselelwa kwe-free-flap." Cabanga ngakho njengokuthatha indwangu bese uyilungisa ukuze ulungise ingxenye edabukile yengubo yakho.

Izindawo lapho amathambo nezicubu zivame ukuthathwa khona ngenxa yalokhu yilezi:

• Umlenze ongezansi: Ngokuvamile, kuthathwa ingxenye yethambo le-fibula.
• I-blade yehlombe: Kwezinye izimo, ingxenye ye-blade yehlombe ingasuswa.
• Ithanga: Ingxenye yethambo lethanga nayo ingathathwa ngale njongo.

Ngezinye izikhathi, amapuleti ensimbi noma izingcezu zamathambo ezivela komunye umnikeli zingasetshenziswa. Ithimba lakho lezokwelapha lizokuchazela lokhu.

Kukuziphi izimo lapho lokhu kuhlinzwa kuyadingeka khona?

Udokotela uzosebenzisa lolu hlobo lokuhlinzwa ngezizathu eziningana eziqondile kakhulu. Phakathi kwazo, izizathu eziyinhloko yilezi.

• Umdlavuza womlomo: Uma umdlavuza owakheka emlonyeni, olimini, ezinsinini, noma esihlathini, ususakazekele emhlathini.
• Umdlavuza we-Oropharyngeal: Uma umdlavuza oqala engxenyeni ephakathi yomphimbo usakazekela ethanjeni lomhlathi.
• Ukutheleleka Kwamathambo (i-Osteomyelitis): Uma unesifo esibi kakhulu sebhaktheriya esisakazekele ethanjeni lomhlathi futhi esingasabeli ekwelashweni.
• I-Osteonecrosis yomhlathi: Uma ithambo lomhlathi lifa ngenxa yokusetshenziswa kwemithi ethile (ikakhulukazi ama-bisphosphonates) noma ukwelashwa ngemisebe.
• Izingozi ezinkulu: Uma umhlathi uphukile waba yizicucu engozini enkulu futhi wonakele kakhulu ukuba ungalungiswa nganoma iyiphi enye indlela.

Kwenzekani ngaphambi kokuhlinzwa?

Kukhona isikhathi sokulungiselela ngaphambi kokuhlinzwa, lapho ithimba lezokwelapha lithola ukuqonda okugcwele ngesimo sakho.

• Ukuhlolwa: I-CT scan ukuze kulinganiswe ngokunembile usayizi kanye nokusabalala kwesimila noma indawo eyonakele ethanjeni lakho lomhlathiUkuhlolwa okufana nalokhu kuyenziwa. Uma kwenziwa ukuhlinzwa kokwakha kabusha, kwenziwa nokuhlolwa okukhethekile ukuhlola impilo yemithambo yegazi endaweni yomnikeli.
• Ukuhlangana nethimba lezokwelapha: Lokhu kuhlinzwa kwenziwa yithimba lodokotela elihlanganisa imikhakha eyahlukene. Leli thimba lingafaka phakathi udokotela ohlinzayo wekhanda nentamo, udokotela ohlinzayo olungisa kabusha, kanye nodokotela ohlinzayo womlomo. Bazoxoxa nawe ngokuningiliziwe ngalokhu kuhlinzwa.
• Izinto Okufanele Uziyeke: Uzokwaziswa ukuthi ugweme izinto ezingase zandise ukopha noma ziphazamise inqubo yokuphulukiswa ngesikhathi sokuhlinzwa.
• Utshwala
• Izibulala-zinhlungu ezifana ne -aspirin ne-ibuprofen
• Ukubhema (ugwayi) - Lokhu kuyingozi kakhulu enkambisweni yokuphulukiswa.
• Eminye imithi ye-Ayurvedic noma ye-herbal

Okubalulekile: Qiniseka ukuthi utshela udokotela wakho nganoma yimiphi imithi oyithathayo njengamanje, ngisho namavithamini.

Kwenzekani ngesikhathi sokuhlinzwa?

Lokhu ukuhlinzwa okuyinkimbinkimbi okuzothatha amahora amaningana. Kodwa awunalutho okufanele ukhathazeke ngalo. Uzoba ngaphansi kwe-anesthesia ejwayelekile kuyo yonke inqubo, ngakho-ke uzobe ulele kahle.

Ekuhlinzweni kwe-Marginal Mandibulectomy...

1. Udokotela ohlinzayo uzokwenza i-incision ngaphakathi kwesihlathi sakho.

2. Isimila noma ingxenye yomhlathi enesifo iyasuswa, kanye nenani elincane lezicubu ezinempilo ezizungezile.

3. Izimbobo zivaliwe futhi ziyathungwa.

Ekuhlinzweni kwe-Segmental Mandibulectomy...

Lena inqubo ende kancane. Amaqembu amabili okuhlinzwa angasebenza ngesikhathi esisodwa. Ngesikhathi iqembu elilodwa lenza ukuhlinzwa kwenqulu, elinye iqembu lilungiselela indawo yokunikela.

1. Okokuqala, umhlathi onesifo uyasuswa kanye nezicubu ezizungezile.

2. Izingxenye ezisusiwe zithunyelwa elabhorethri ukuze zihlolwe ukuze kubonakale ukuthi amangqamuzana omdlavuza akhona noma ukuthi asakazekile yini.

3. Kuhlolwa futhi ukuthi umdlavuza ususakazekele yini kuma-lymph node entanyeni.

4. Ithimba elihlinzayo elihlukile lithatha izingxenye zamathambo, isikhumba, kanye nemithambo yegazi ezidingekayo endaweni yokufakelwa kwamathambo (isb., umlenze).

5. Ithambo elikhishwe lakhiwe ngendlela yokuthi lifane ncamashi nengxenye ekhishwe emhlathini.

6. Ukuze kuhlinzekwe ngegazi ezicutshini ezithathiwe, leyo mithambo yegazi ixhunywe kahle kakhulu emithanjeni yegazi entanyeni yakho.

7. Ingxenye entsha yomhlathi inamathele emhlathini kusetshenziswa amapuleti ensimbi akhethekile nezikulufo, futhi ukusikwa kuyavalwa futhi kuthungwe.

Izinto ezengeziwe okufanele zenziwe ngokuhlinzwa

Ngemva kokuhlinzwa, ungase udinge ukwelashwa okwengeziwe ukuze ugcine amazinyo akho nomhlathi wakho endaweni efanele futhi wenze ukuphefumula kube lula.

• Ama-arch bars nama-rubber bands: Lokhu kufakwa emlonyeni ukuze amazinyo nomhlathi kuhlale kuqondile.
• Ukuhlinzwa kwe-Tracheostomy:Ezinsukwini ezimbalwa zokuqala ngemva kokuhlinzwa, kufakwa ipayipi ngaphambili kwentamo ku-windpipe (trachea) ukuze kube lula ukuphefumula ngoba umphimbo uzovuvukala. Lokhu kungokwesikhashana.
• Ipayipi lokuphakela: Njengoba kunzima ukudla ngomlomo, ipayipi lifakwa ngekhala liye esiswini ukuze linikeze ukudla okunomsoco okudingekayo futhi linikeze ukudla okumanzi.

Kwenzekani ngemva kokuhlinzwa?

Isikhathi sokululama sidinga ukubekezela okuncane.

• Ukuhlala esibhedlela: Kuye ngohlobo lokuhlinzwa olwenzayo, kungadingeka uhlale esibhedlela noma kuphi kusukela ezinsukwini ezimbili kuya emavikini amabili. Ukuhlinzwa okuhlukaniswe ngezigaba ngokuvamile kudinga ukuhlala isikhathi eside.
• Uma ubuyela ekhaya: Ngemva kokubuyela ekhaya, kubaluleke kakhulu ukulandela imiyalelo enikezwe udokotela wakho ngqo. Uzofundiswa ukuthi ungagcina kanjani izimbobo zakho zihlanzekile nokuthi udle kanjani. Ungase ube nepayipi lokuncelisa lapho ubuyela ekhaya, noma ungase utshelwe ukuthi udle ukudla okumanzi kuphela. Thatha noma yimiphi imithi yobuhlungu oyinikwa ngesikhathi.
• Ezinye izindlela zokwelapha: Ngesikhathi sokululama kwakho, ungase udinge usizo kuchwepheshe wezokukhuluma kanye nochwepheshe wezokwelapha ngokomzimba ukuze akusize ufunde ukugwinya nokukhuluma futhi. Uma uhlinzwe ngenxa yomdlavuza, udokotela wakho angase futhi akuncomele ukwelashwa ngemisebe noma i-chemotherapy ukuze kubulawe noma yimaphi amangqamuzana omdlavuza asele.

Kuthatha isikhathi esingakanani ukululama ngokuphelele?

Kunzima ukusho isikhathi esiqondile salokhu. Kuyahlukahluka kuye ngomuntu nomuntu futhi kuye ngohlobo lokuhlinzwa.

• Ukululama ngemva kokuhlinzwa kwe-mandibulectomy okungaphelele kuyashesha.
• Ukululama ngemva kokuhlinzwa kwe-segmental mandibulectomy kanye nokwakhiwa kabusha kungathatha izinyanga. Kuthatha isikhathi ukufunda kabusha indlela yokugwinya, ukudla, nokukhuluma.
• Kungathatha amasonto ambalwa ukubuyela emsebenzini. Kungase kudingeke ulinde isikhathi eside ukuze uqale imisebenzi enzima njengokuzivocavoca umzimba. Ithimba lakho lezokwelapha lizokunikeza isimiso esikusebenzelayo.

Yiziphi izimpawu ezidinga ukuvakashelwa kudokotela ngokushesha?

Uma uba nanoma yiziphi zalezi zimpawu ngesikhathi usekhaya ngemva kokuhlinzwa, funa iseluleko sezokwelapha ngokushesha. Uma kudingeka, iya eMnyangweni Wezimo Eziphuthumayo (ETU) wesibhedlela.