Cabanga uma umuntu eba nomdlavuza womlomo, noma ukutheleleka okukhulu ethanjeni lomhlathi ongezansi... ngezinye izikhathi ingxenye enesifo kufanele isuswe ngokuphelele ngokuhlinzwa. Ngakho-ke, kulesi sihloko namuhla, sizokhuluma ngokuhlinzwa okubaluleke kakhulu okwenziwa esimweni esinjalo. Nakuba lesi kuyisihloko esiyinkimbinkimbi kancane, ake sixoxe ngaso kalula ngangokunokwenzeka.
Kuyini i-mandibulectomy?
Kalula nje, i-mandibulectomy ukususwa kwengxenye noma yonke ithambo lomhlathi/ithambo lomhlathi elingezansi. Odokotela bavame ukwenza lokhu kuhlinzwa ukuze basuse isimila esinomdlavuza noma enye ingxenye yomhlathi egulayo. Lokhu kubizwa nangokuthi ukususwa kwethambo lomhlathi .
Yiziphi izinhlobo eziyinhloko zalokhu kuhlinzwa?
Lokhu kuhlinzwa kungahlukaniswa ngezinhlobo ezimbili eziyinhloko. Ake sibone ukuthi ziyini.
| Uhlobo lokuhlinzwa | Incazelo elula |
|---|---|
| Ukuhlinzwa Kwe-Mandibulectomy Okuyingxenye (Ukuhlinzwa Kwe-Marginal Mandibulectomy) | Lokhu kuhilela ukususa ingxenye encane yomhlathi wakho ongezansi. Lokhu kuvame ukuqeda isidingo sokuhlinzwa okuvuselelayo. |
| Ukuhlinzwa Kwe-Mandibulectomy Engxenyeni Yesisu | Kule nqubo, ingxenye enkulu yomhlathi ongezansi iyasuswa. Ngakho-ke, umhlathi kumele wakhiwe kabusha. Ukuze benze lokhu, odokotela abahlinzayo bathatha amathambo, imithambo yegazi, kanye nezicubu ezivela kwenye ingxenye yomzimba wakho (isb., umlenze, ihlombe) ukuze baphinde bakhe umhlathi. Le nqubo ibizwa nangokuthi i-free-flap reconstruction . |
Ulitholaphi ithambo lokuvuselela umhlathi wakho?
Ekuhlinzweni kwe-mandibulectomy okuhlukaniswe ngezigaba, sithi izingcezu zamathambo ezidingekayo ukwakha kabusha umhlathi zithathwe kwezinye izingxenye zomzimba. Izindlela ezivame kakhulu ezisetshenziswa kulokhu yilezi:
- Umlenze ongezansi
- Ihlombe lehlombe
- Inqulu
Kwezinye izimo, amapuleti ensimbi noma ngisho nethambo elivela kumuntu onikelayo lingasetshenziswa ngale njongo.
Ubani odinga lokhu kuhlinzwa?
Kunezimo eziningana lapho udokotela wakho angase ancome lolu hlobo lokuhlinzwa.
- Uma unomdlavuza womlomo .
- Uma unomdlavuza engxenyeni ephakathi yomphimbo (umdlavuza we-oropharyngeal) .
- Uma kukhona ukutheleleka okukhulu kwethambo lomhlathi (i-osteomyelitis) .
- Uma imithi ethile (ukwelashwa nge-bisphosphonate) ibangela ukulahlekelwa okukhulu kwamathambo emhlathini (i-osteonecrosis yomhlathi) .
- Uma kukhona ukulimala okukhulu kakhulu emhlathini ongezansi.
Into ebaluleke kakhulu ukuthi ithimba lakho lezokwelapha lizonquma ukuthi yikuphi ukwelashwa okungcono kakhulu kuwe kulesi simo. Ngakho-ke, kubaluleke kakhulu ukukhuluma nabo ngokukhululekile nokuxazulula imibuzo yakho nokukhathazeka kwakho.
Kwenzekani ngaphambi kokuhlinzwa?
Ngaphambi kokwenza lolu hlobo lokuhlinzwa, ithimba lakho lezokwelapha lizokwenza izivivinyo eziningana, okuhlanganisa ne-CT scan, ukuze kuhlolwe kangcono ubukhulu nesimo sesimila emhlathini wakho.
Uma udinga ukuhlinzwa kokulungisa umhlathi, kungase kwenziwe izivivinyo ezengeziwe ukuhlola impilo yemithambo yegazi endaweni yomnikeli.
Futhi, udokotela wakho uzokweluleka ukuthi ugweme izinto ezilandelayo ngaphambi kokuhlinzwa, njengoba lokhu kungandisa ukopha ngesikhathi sokuhlinzwa futhi kulibazise ukuphola kwenxeba ngemva kwalokho.
- Utshwala
- Izibulala-zinhlungu ezifana ne -aspirin ne-ibuprofen
- Ukubhema
- Ezinye izithasiselo zemithi
Kwenzekani ngesikhathi sokuhlinzwa?
Ukuhlinzwa kwe-mandibulectomy kuyindlela ende ethatha amahora amaningana. Kwenziwa ngenkathi ulele ngaphansi kwe-anesthesia ejwayelekile .
Ekuhlinzweni kwe-Marginal Mandibulectomy...
1. Udokotela ohlinzayo uzokwenza i-incision ngaphakathi kwesihlathi sakho.
2. Ingxenye yomdlavuza yomhlathi ongezansi kanye nezicubu ezizungezile kuyasuswa.
3. Izimbobo zithungwa zivaliwe.
Ekuhlinzweni kwe-Segmental Mandibulectomy...
Lena inqubo eyinkimbinkimbi kakhulu.
1. Okokuqala, umdlavuza womhlathi kanye nezicubu ezizungezile kuyasuswa.
2. Izingxenye ezisusiwe zithunyelwa ukuze kuhlolwe i-biopsy ukuze kuhlolwe ukuthi kusekhona yini amangqamuzana omdlavuza.
3. Kuhlolwa futhi ukuze kubonakale ukuthi umdlavuza ususakazekele yini kuma-lymph node.
4. Bese kuthi ucezu lwethambo, izicubu, kanye nesikhumba luthathwe endaweni ethile (njengomlenze, ihlombe, njll.).
5. Ithambo elikhishiwe libunjwe ngendlela yokuthi lilingane nengxenye yomhlathi esusiwe.
6. Imithambo yegazi (imithambo yegazi nemithambo yegazi) evela endaweni eqoqiwe ixhunywe emithanjeni yegazi ekhanda nasentanyeni. Lokhu kwenziwa ngokucophelela okukhulu.
7. Ekugcineni, umhlathi omusha uqiniswe ngamapuleti nezikulufo, futhi ukusikwa kuvaliwe.
Ngemva kokuhlinzwa, ungase udinge ezinye zalezi zinto:
- Imigoqo ye-arch kanye nama-rubber bands ngaphakathi emlonyeni ukuze amazinyo nomhlathi kuhambisane kahle.
- Ishubhu le-tracheostomy elizokusiza uphefumule.
- Ipayipi lokuncelisa liyipayipi elidluliselwa lisuka ekhaleni liye esiswini ukuze linikeze ukudla okunempilo.
Kwenzekani ngemva kokuhlinzwa?
Kuye ngohlobo lokuhlinzwa olwenzile, kungadingeka uhlale esibhedlela izinsuku ezimbili kuya kwamasonto amabili. Ngemva kokubuyela ekhaya, kufanele ulandele imiyalelo kadokotela wakho mayelana nokugcina izimbobo zakho zihlanzekile nokudla . Ekuqaleni, kungadingeka udle ukudla okumanzi noma ngepayipi lokuncelisa. Futhi khuluma nodokotela wakho mayelana nendlela yokuphatha ubuhlungu bakho.
Ngesikhathi senqubo yokuphulukiswa, ungadinga ukwelashwa kokukhuluma kanye nokwelashwa ngokomzimba. Uma ube nomdlavuza, ukwelashwa ngemisebe noma ngamakhemikhali nakho kunganconywa ukubulala noma yimaphi amangqamuzana omdlavuza asele.
Yiziphi izimpawu ezidinga usizo lwezokwelapha ngokushesha?
Kubaluleke kakhulu ukufuna iseluleko sezokwelapha ngokushesha uma uhlangabezana nanoma yiziphi izimpawu eziyisixwayiso ngemva kokubuyela ekhaya uvela ekuhlinzweni. Qaphela lezi zimpawu ezilandelayo.
| Isici okufanele usiqaphele |
|---|
| Umkhuhlane ongaphezu kuka-100.5 Fahrenheit (38.05 Celsius) |
| Ikhanda elibuhlungu kakhulu |
| Ubuhlungu obukhulu obungapheli naphezu kokuthatha imithi yokubulala izinhlungu |
| Ubunzima bokuphefumula (ukuphelelwa umoya) |
| Ukuvuvukala okukhulu (i-angioedema) endaweni yokuhlinzwa noma kwenye indawo |
| Isicanucanu noma ukuhlanza |
| Isimo esifana nokuqubuka kwesikhumba |
Uma ubona into efana nale, yazisa udokotela wakho ngokushesha. Uma kwenzeka isimo esiphuthumayo, iya eMnyangweni Wezimo Eziphuthumayo (ETU) wesibhedlela esiseduze.
Umlayezo Wokuya Nawe Ekhaya
- I-Mandibulectomy iwukuhlinzwa okukhulu okusetshenziselwa izimo ezibucayi njengomdlavuza womlomo kanye nezifo ezinzima.
- Kulokhu, kususwa ingxenye encane noma enkulu yomhlathi, futhi ngezinye izikhathi umhlathi wakhiwa kabusha kusetshenziswa ithambo elithathwe kwenye indawo emzimbeni.
- Inqubo yokuphulukiswa ithatha isikhathi futhi idinga ukwesekwa yithimba lezokwelapha, okuhlanganisa odokotela kanye nabelaphi bezokukhuluma.
- Kubaluleke kakhulu ukulandela yonke imiyalelo udokotela wakho akunika yona ngaphambi nangemva kokuhlinzwa.
- Uma ubona noma yiziphi izimpawu eziyisixwayiso ngemva kokuhlinzwa, ungalibali futhi funa iseluleko sezokwelapha ngokushesha.
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