Uma wena noma othile omaziyo ethi udinga ukuhlinzwa esifubeni, uyesaba kancane, akunjalo? Uma sizwa igama elithi "ukuhlinzwa esifubeni," sicabanga ngokusikwa okukhulu, izinsuku ezimbalwa esibhedlela, kanye nobuhlungu obukhulu. Lokho kwesaba empeleni kuyafaneleka. Kodwa manje, isayensi yezokwelapha isithuthuke kakhulu. Namuhla, sizokhuluma ngendlela yokuhlinzwa esifubeni engadingi ukusikwa okukhulu kangaka, kodwa ukusikwa okuncane. Lokhu kubizwa ngokuthi i-VATS. Izinzuzo ezigulini, isikhathi sokululama, nezinye izinto eziningi zihlukile ekuhlinzweni kwendabuko. Ake sixoxe ngalokhu ngokuningiliziwe .
Kalula nje, iyini i-VATS?
Igama eliphelele le-VATS lithi ukuhlinzwa kwesifuba okusizwa yividiyo . NgesiSinhala, lisho "ukuhlinzwa kwesifuba okusizwa yividiyo." Nakuba igama lingase lizwakale liyinkimbinkimbi, okwenzekayo kule nqubo kulula kakhulu.
Cabanga ngakho, ngokuvamile uma wenza ukuhlinzwa kwesifuba, kufanele wenze ukusika okukhulu endaweni yesifuba, ngokusebenzisa izimbambo ukuze ufinyelele izitho ezifana namaphaphu noma inhliziyo. Lokhu kubizwa ngokuthi `(i-Thoracotomy)`. Kodwa endleleni ye-VATS, awenzi ukusika okukhulu kangaka. Kunalokho, wenza nje izimbobo ezimbalwa ezincane, cishe isentimitha noma ingxenye, phakathi kwezimbambo.
Ngemuva kwalokho, ipayipi elincane elinekhamera enamathiselwe kulo (i-thoracoscope) lidlula kwenye yalezi zimbobo liye esifubeni. Le khamera ikhulisa konke okungaphakathi kwesifuba, okuhlanganisa izitho nezicubu, futhi ikubonisa ngokucacile kusikrini sevidiyo. Manje udokotela ohlinzayo angabuka le vidiyo futhi afake amathuluzi okuhlinza abucayi ngezinye izimbobo ezincane ukuze enze ukuhlinzwa ngokunemba okukhulu. Kufana nomdlalo wevidiyo, kodwa umsebenzi oyinkimbinkimbi kakhulu futhi onesibopho.
Lolu uhlobo lokuhlinzwa okungadingi ukungenelela okukhulu, okusho ukuthi luhilela ukusikwa okuncane. Lokhu kusho ukuthi isiguli sizwa ubuhlungu obuncane, ukopha, kanye nesikhathi sokululama.
Yiziphi izinhlobo zezifo eziphathwa ngokuhlinzwa kwe-VATS?
Ukuhlinzwa kwe-VATS kusetshenziselwa ukuxilonga nokwelapha izifo eziningi zesifuba. Kuthandwa kakhulu umdlavuza wamaphaphu . Kusetshenziswa futhi kumdlavuza osakazeke emaphashini osuvele usakazekele kwezinye izindawo.
Ngaphezu kwalesi sizathu esiyinhloko, ukuhlinzwa kwe-VATS kuyasiza kwezinye izifo eziningi. Ake sibone ukuthi ziyini.
| Isimo sezokwelapha | Incazelo elula |
|---|---|
| Umdlavuza we-esophagus noma i-thymus | Ukususa umdlavuza okhula emgudwini wokudla (umphimbo) noma endlaleni ye-thymus esifubeni esingaphezulu. |
| Ukuphuma kwe-Pleural | Ukuqongelela okufana noketshezi ngaphakathi kwe-pleura, ulwelwesi oluzungeze amaphaphu. Lokhu kuhlinzwa kwenziwa ukuze kususwe lolu ketshezi futhi kutholakale imbangela. |
| Ukutheleleka kanye nezifo zamaphaphu | Ukwelapha izimo ezifana ne-COPD kanye nokutheleleka okukhulu kwamaphaphu. |
| Ukuphuma kwegazi enhliziyweni (ukunqwabelana koketshezi oluzungeze inhliziyo) | Ukuqongelela koketshezi esikhwameni esizungeze inhliziyo. Ukususa lokhu. |
| Ukujuluka ngokweqile (i-Hyperhidrosis) | Ukulawula imizwa ebangela ukujuluka ngokweqile ezintendeni zezandla nakwezinye izingxenye zomzimba. |
| I-Myasthenia gravis | Ukususa i-thymus gland ehilelekile esifweni esibuthakathaka semisipha. |
Izinhlobo zokuhlinzwa kwe-VATS
Odokotela abahlinzayo basebenzisa ubuchwepheshe be-VATS ukwenza izinhlobo ezahlukene zokuhlinzwa, okuhlanganisa:
- Ukususwa kwamaphaphu kwe-VATS: Lokhu kuhilela ukususa ingxenye yamaphaphu enesifo.
- Ukususwa kwe-wedge resection: Ukususwa kwengxenye encane yezicubu zamaphaphu emise okwekhoni.
- Ukususwa kwe-Lobectomy: Ukususwa okuphelele kwengxenye eyodwa yamaphaphu.
- Ukususwa kwephaphu: Ukususwa okuphelele kwephaphu elilodwa.
- Ukususwa kwe-Esophagectomy: Ukususwa kwepayipi lokudla ngenxa yesizathu esinjengomdlavuza.
- I-Thymectomy: Ukususwa kwe -thymus gland enesifo.
- `Ukuhlobisa`:Ukususa ulwelwesi olunegciwane kanye nezibazi eziye zakheka nxazonke zamaphaphu nokuvumela amaphaphu ukuthi akhule kahle futhi.
- Ukuhlinzwa kokunciphisa umthamo wamaphaphu (LVRS): Ezimweni ezifana ne-COPD, izingxenye zamaphaphu ezonakele ziyasuswa, okuvumela izingxenye eziphilile ukuthi zisebenze kahle.
Ngingakulungiselela kanjani lokhu kuhlinzwa?
Njenganoma yikuphi ukuhlinzwa, lokhu kudinga ukulungiselela ngokucophelela. Into ebaluleke kakhulu ukulandela imiyalelo kadokotela wakho ngqo. Ngokuvamile uzocelwa ukuba wenze izinto ezinjengalezi:
- Ukuzila Ukudla: Uzokwaziswa ukuthi uyeke ukudla noma ukuphuza amahora ambalwa ngaphambi kokuhlinzwa.
- Ukuyeka Imithi: Ungase ucelwe ukuthi uyeke ukuthatha imithi ethile, ikakhulukazi imithi yokunciphisa igazi, amavithamini, kanye nemithi ye-Ayurvedic, ngaphambi kokuhlinzwa. Xoxa ngalokhu nodokotela wakho.
- Ukuyeka ukubhema: Uma ubhema, kubalulekile ukuyeka ngokuphelele, okungenani amasonto ambalwa ngaphambi kokuhlinzwa. Ukubhema kungabangela izinkinga ngesikhathi sokubulala izinzwa futhi kubambezele ukululama ngemva kokuhlinzwa.
Kuzodingeka futhi uhlolwe kaningana ukuze uhlole ukufaneleka komzimba wakho ngaphambi kokuhlinzwa.
- Ukuhlolwa kwegazi: Ukuhlolwa okufana nokubalwa kwegazi okuphelele (i-CBC).
- Ukuhlolwa kwenhliziyo: I-EKG noma `ukuhlolwa kokucindezeleka kokuzivocavoca`.
- Ukuhlolwa kwezithombe njenge-X-ray yesifuba noma i-CT scan / i-PET scan.
- Ukuhlolwa kokusebenza kwamaphaphu: Bona ukuthi amaphaphu akho asebenza kahle kangakanani.
- I-endoscopy ephezulu noma i-X-ray yokugwinya i-barium.
Kwenzekani ngesikhathi sokuhlinzwa?
Ungakhathazeki ngalokhu. Ngemva kokuyiswa egumbini lokuhlinza, uzoqale unikezwe i-anesthesia ejwayelekile. Lokhu kusho ukuthi uzobe ulele ngokuphelele futhi ngeke uzwe lutho. Ngeke uzwe ubuhlungu noma ukungakhululeki kuze kube yilapho ukuhlinzwa sekuphelile.
Ithimba lokuhlinzwa libe selilandela lezi zinyathelo:
1. Uzophendulwa bese ubekwa ohlangothini oluphambene nohlangothi lapho kuzokwenziwa khona ukuhlinzwa.
2. Kwenziwa izimbobo eziningana ezincane (ngokuvamile ezingu-2-4) esifubeni, cishe nge-intshi eyodwa, phakathi kwezimbambo. Ngezinye izikhathi kukhona nendlela ethi "uniport VATS - U-VATS", eyenziwa ngembobo eyodwa.
3. Ikhamera (i-thoracoscope) ifakwa ngembobo eyodwa bese ingaphakathi lesifuba libukwa esikrinini sevidiyo.
4. Izinsimbi zokuhlinza ezikhethekile zifakwa ngezinye izimbobo futhi, ngenkathi ubheka izithombe ezibonwe kuvidiyo, izicubu ezigulayo noma ingxenye yesitho okufanele isuswe isuswa ngokucophelela okukhulu.
5. Ngemva kokuhlinzwa, ithubhu lesifuba libekwa okwesikhashana ukuze kukhishwe noma yimuphi umoya noma uketshezi oluningi olungase luqongeleleke esifubeni.
6. Ekugcineni, imivimbo emincane ivalwa ngezithungo noma izinti ezincibilikayo.
Kwezinye izibhedlela ezithuthukile, lokhu kuhlinzwa kwenziwa ngisho kusetshenziswa 'ubuchwepheshe berobhothi'. Lapho, udokotela wenza ukuhlinzwa ngenkathi ebuka isikrini sekhompyutha futhi elawula ingalo yerobhothi. Ukuhlinzwa kwe-VATS komdlavuza wamaphaphu kuvame ukuthatha cishe amahora amabili kuya kwamathathu.
Yiziphi izinzuzo nezingozi zalokhu kuhlinzwa?
Okubaluleke kakhulu, i-VATS inenzuzo kakhulu kunokuhlinzwa kwesifuba okuvulekile kwendabuko (`i-Thoracotomy`). Kodwa-ke, njenganoma yikuphi ukuhlinzwa, ayinazo izingozi zayo.
Ake sibheke lezi ezimbili ngokwehlukana.
| Izinzuzo | Izingozi |
|---|---|
| Isikhathi esifushane sokulaliswa esibhedlela: Ngokuvamile ungaya ekhaya ezinsukwini ezingu-1-2. | Ukuphazamiseka kwenhliziyo (i-Arrhythmias). |
| Ubuhlungu obuncane kanye nezibazi: Njengoba kungekho ukusikwa okukhulu, ubuhlungu buncane kakhulu kanti nezibazi nazo zincane. | Amahlule egazi kanye nokushaya. |
| Ukululama okusheshayo komsebenzi wokuphefumula: Amaphaphu alulama ngokushesha. | Ukuwa kwamaphaphu (`Pneumothorax`) noma ukwehluleka kwamasaka omoya emaphashini ukufutha kahle (`Atelectasis`). |
| Ingozi encane yokutheleleka: Ukusikwa kuncane, ngakho-ke kunengozi encane yokutheleleka. | Ukopha kwangaphakathi nokopha ngokweqile. |
| Buyela ngokushesha empilweni evamile: Ungaya emsebenzini ngokushesha uthole umsebenzi. | Izifo zokuphefumula ezifana ne-pneumonia. |
| - | Ukulimala kwezitho ezizungezile, imizwa, noma imithambo yegazi. |
Kwenzekani ngemva kokuhlinzwa futhi kuthatha isikhathi esingakanani ukululama?
Ngemva kokuhlinzwa, izicubu ezisusiwe zithunyelwa elabhorethri ukuze zihlolwe. Lokhu kubizwa ngokuthi 'i-Biopsy' . 'Isazi Sezifo' sihlola izicubu ngaphansi kwesibonakhulu ukuze sibone ukuthi kukhona yini amangqamuzana omdlavuza, izimpawu zokutheleleka, noma ezinye izimo. Ukwelashwa kwakho okuqhubekayo kuzonqunywa ngokusekelwe kulowo mbiko.
Ngemva kokuhlinzwa, uzonikezwa imithi yokulawula ubuhlungu. Futhi, abahlengikazi kanye nodokotela be-physiotherapists bazokukhuthaza ukuthi wenze izivivinyo zokuphefumula okujulile . Ukuhamba nakho kubaluleke kakhulu ukuze ululame ngokushesha.
Ngaphambi kokuba uye ekhaya, udokotela uzokhipha ipayipi lesifuba.
Isikhathi sokululama siyahlukahluka kumuntu nomuntu futhi kuye ngohlobo lokuhlinzwa okwenziwayo. Okunye ukuhlinzwa kungathatha amasonto amabili nje kuphela ukululama, kanti okunye kungathatha amasonto ayisishiyagalombili.
Nakekela lezi zinto ngemva kokubuyela ekhaya:
- Shintsha ama-dressing lapho usika njalo njengoba udokotela wakho ekuyalile.
- Ungashayeli noma uphakamise izinto ezisindayo kuze kube yilapho udokotela ekuyala.
- Hamba kancane okungenani kathathu ngosuku ukuze uvimbele ukuqhekeka kwegazi emilenzeni yakho.
- Phuza imithi yokubulala izinzwa ebhalwe ngudokotela kanye nama-antibiotic ngesikhathi esifanele.
- Qiniseka ukuthi uya emtholampilo ngosuku olunikeziwe lokuhlolwa kabusha.
Kufanele ngimshayele nini udokotela?
Uma uba nezimpawu ezinjengalezi ngemva kokubuyela ekhaya, kufanele ushayele udokotela wakho ucingo ngokushesha .
- Uma uzwa ubuhlungu obukhulu esifubeni .
- Uma uzizwa unenkinga yokuphefumula .
- Uma ubona izimpawu zokutheleleka . Isibonelo:
- Ubomvu, ukuvuvukala, noma uketshezi oluphuzi oluzungeze indawo yokusikwa.
- Imfiva.
Ungazinaki lezi zimpawu. Kubaluleke kakhulu ukufuna ukwelashwa ngokushesha.
Ekuphetheni, i-VATS iyintuthuko enkulu emkhakheni wokuhlinzwa kwesifuba. Kumuntu obhekene nesifo esifana nomdlavuza, kuyimpumuzo enkulu ukukwazi ukululama ngokushesha ngemva kokuhlinzwa, ukuzwa ubuhlungu obuncane, nokubuyela empilweni yakhe evamile ngokushesha. Uma uhlelelwe lolu hlobo lokuhlinzwa, ungesabi, khuluma nodokotela wakho ngakho ngokuphelele, bese ubuza yonke imibuzo onayo.
Umlayezo Wokuya Nawe Ekhaya
- I-VATS iyindlela yokuhlinzwa yesimanje eyenziwa ngaphandle kokusikwa okukhulu esifubeni, kusetshenziswa ikhamera edlula ezimbotsheni ezincane.
- Ubuhlungu, ukulaliswa esibhedlela, kanye nesikhathi sokululama kuncane kakhulu kunokuhlinzwa kwesifuba okuvulekile okuvamile.
- Le ndlela isetshenziswa ekwelapheni izifo eziningi zesifuba, okuhlanganisa nomdlavuza wamaphaphu.
- Njengakuzo zonke izinhlobo zokuhlinzwa, kunezingozi ezithile, ngakho xoxa ngazo ngokucophelela nodokotela wakho ngaphambi kokuhlinzwa.
- Ukuze ululame ngokushesha nangokuphumelelayo, kubalulekile ukulandela imiyalelo yezokwelapha ngokucophelela ngaphambi nangemva kokuhlinzwa.
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