Utyando lwemiphunga

Utyando lwemiphunga lutyando olwenziwa ukulungisa okanye ukususa izicwili zemiphunga. Kukho utyando lwemiphunga oluqhelekileyo, kubandakanya:

• I-Biopsy yokukhula okungaziwayo
• I-Lobectomy, ukususa i-lobes enye okanye ezingaphezulu zemiphunga
• Ukufakelwa kwemiphunga
• IPneumonectomy, ukususa umphunga
• Ugqirha ukuthintela ukwakhiwa okanye ukubuya kolwelo esifubeni (pleurodesis)
• Ugqirha lokususa usulelo esifubeni (empyema)
• Utyando lokususa igazi kwisifuba, ngakumbi emva koxinzelelo
• Utyando lokususa izicwili ezincinci ezifana neebhaluni (ii-blebs) ezibangela ukuwa kwemiphunga (pneumothorax)
• Ukudityaniswa komtshato, ukususa inxenye yelobe emiphungeni

I-thoracotomy yinqumle yokuhlinzwa eyenziwa ngugqirha ukuze avule udonga lwesifuba.

Uya kuba ne-anesthesia ngokubanzi ngaphambi kotyando. Uya kulala kwaye ungakwazi kuva iintlungu. Iindlela ezimbini eziqhelekileyo zokwenza utyando kwimiphunga yakho yi-thoracotomy kunye nevidiyo encediswa ngoqhaqho lwe-thoracoscopic (VATS). Utyando lweerobhothi lunokusetyenziswa.

Utyando lwemiphunga usebenzisa i-thoracotomy lubizwa ngokuba luvulo oluvulekileyo. Kolu tyando:

• Uya kulala ngecala lakho kwitafile yokusebenza. Ingalo yakho iya kubekwa ngaphezu kwentloko yakho.
• Ugqirha wakho uza kusika phakathi kweembambo ezimbini. Ukusikwa kuya kusuka ngaphambili kodonga lwesifuba ukuya ngasemva kwakho, kudlula nje ngaphantsi kwekhwapha. Ezi zibambo ziya kwahlulwa okanye ubambo lususwe.
• Umphunga wakho kweli cala uza kuthambeka ukuze umoya ungangeni kwaye uphume kuwo ngexesha lotyando. Oku kwenza ukuba kube lula kugqirha ukuba asebenze emiphungeni.
• Ugqirha wakho usenokungazi ukuba ungakanani umphunga wakho ekufuneka ususwe de kube kuvulwe isifuba sakho kwaye nemiphunga ibonakala.
• Ugqirha wakho ususa i-lymph node kule ndawo.
• Emva kotyando, enye okanye ngaphezulu kweetyhubhu zokuhambisa amanzi ziya kufakwa kwindawo yakho yesifuba ukukhupha ulwelo olwakhayo. Ezi tyhubhu zibizwa ngokuba ziityhubhu zesifuba.
• Emva kotyando emiphungeni yakho, ugqirha wakho uya kuvala iimbambo, izihlunu, kunye nolusu ngemisonto.
• Utyando oluvulekileyo lwemiphunga lungathabatha iiyure ezi-2 ukuya kwezi-6.

Uncedo lwevidiyo yokuncedisa utyando lwe-thoracoscopic:

• Ugqirha wakho uza kwenza utyando oluncinci oluncinci phezu kodonga lwesifuba. Ividiyocope (ityhubhu enekhamera encinci esiphelweni) kunye nezinye izixhobo ezincinci ziya kugqitywa koku kusika.
• Emva koko ugqirha wakho ususa inxenye okanye yonke imiphunga, akhuphe ulwelo okanye igazi elakhekileyo, okanye enze ezinye iinkqubo.
• Ityhubhu enye okanye ezingaphezulu ziya kufakwa esifubeni ukukhupha ulwelo olwakhayo.
• Le nkqubo ikhokelela kwiintlungu ezingaphantsi kakhulu kunye nokubuyela kwimeko yesiqhelo ngokukhawuleza kunokuhlinzwa kotyando.

I-Thoracotomy okanye i-video yokuncedisa utyando lwe-thoracoscopic lunokwenziwa:

• Susa umhlaza (njengomhlaza wemiphunga) okanye i-biopsy ukukhula okungaziwayo
• Phatha ukonzakala okubangela ukuwa kwethishu yemiphunga (pneumothorax okanye hemothorax)
• Nyanga umphefumlo owileyo ngokusisigxina (atelectasis)
• Susa izicwili zemiphunga ezigulayo okanye ezonakeleyo kwi-emphysema okanye kwi-bronchiectasis
• Susa igazi okanye amahlwili egazi (hemothorax)
• Susa amathumba, anje ngedolo le-pulmonary nodule
• Fakela izicubu zemiphunga eziwile (Oku kunokuba ngenxa yesifo esifana nesifo esinganyangekiyo semiphunga, okanye ukwenzakala.)
• Susa usulelo kwisifuba (empyema)
• Misa ukwakhiwa kolwelo kwisifuba (pleurodesis)
• Susa i-clot yegazi kwi-pulmonary artery (pulmonary embolism)
• Nyanga iingxaki zesifo sephepha

Unyango lwe-thoracoscopic oluncediswa ngevidiyo lungasetyenziselwa ukunyanga uninzi lwezi meko. Ngamanye amaxesha, utyando lwevidiyo alunakwenzeka, kwaye ugqirha wotyando kungafuneka atshintshele kuqhaqho oluvulekileyo.

Iingozi zolu tyando zibandakanya:

• Ukusilela kwemiphunga ukwandisa
• Ukwenzakala kwimiphunga okanye kwimithambo yegazi
• Ufuna ityhubhu yesifuba emva kotyando
• Intlungu
• Ukuvuza kwexesha elide
• Ukuphindaphindwa kokwakhiwa kolwelo kwisifuba
• Ukopha
• Usulelo
• Ukuphazamiseka kwesingqisho sentliziyo
• Umonakalo kwidaphaphm, esophagus, okanye trachea
• Ukufa

Uya kuba notyelelo oluninzi kunye nomboneleli wakho wezempilo kwaye uye kuvavanyo lonyango ngaphambi kotyando lwakho. Umboneleli wakho uya:

• Yenza uvavanyo olupheleleyo lomzimba
• Qiniseka ukuba ezinye iimeko zonyango onokuba nazo, ezinjengesifo seswekile, uxinzelelo lwegazi oluphezulu, okanye iingxaki zentliziyo okanye zemiphunga ziphantsi kolawulo
• Yenza uvavanyo ukuze uqiniseke ukuba uya kuba nakho ukunyamezela ukususwa kwethishu yemiphunga, ukuba kukho imfuneko

Ukuba uyatshaya, kuya kufuneka uyeke ukutshaya kwiiveki ezimbalwa ngaphambi kotyando. Cela uncedo kumboneleli wakho.

Soloko uxelela umboneleli wakho:

• Zeziphi iziyobisi, iivithamini, amayeza, kunye nezinye izongezo ozithathayo, kwanezo uzithengileyo ngaphandle kommiselo
• Ukuba ubusele utywala obuninzi, ngaphezu kwesiselo esinye okanye ezi-2 ngosuku

Ngexesha leveki ngaphambi kotyando lwakho:

• Unokucelwa ukuba uyeke ukuthatha iziyobisi ezenza kube nzima kwigazi lakho ukuba lijiye. Ezinye zezi aspirin, ibuprofen (Advil, Motrin), vitamin E, warfarin (Coumadin), clopidogrel (Plavix), okanye ticlopidine (Ticlid).
• Buza umboneleli wakho ukuba zeziphi iziyobisi omele uzithathe ngosuku lotyando lwakho.
• Lungiselela ikhaya lakho ukubuya kwakho esibhedlele.

Ngomhla wotyando lwakho:

• Musa ukutya okanye usele nantoni na emva kobusuku ezinzulwini zobusuku ngaphambi kotyando lwakho.
• Thatha amayeza ugqirha wakho amiselweyo ngeesips ezincinci zamanzi.
• Umboneleli wakho uya kukuxelela ukuba ufike nini esibhedlele.

Uninzi lwabantu luhlala esibhedlele iintsuku ezi-5 ukuya kwezi-7 emva kokuvula i-thoracotomy. Ukuhlala esibhedlele kunyango oluncedwayo lwe-thoracoscopic luhlala lufutshane. Unokuchitha ixesha kwigumbi lokunyamekela (ICU) emva kotyando.

Ngexesha lokuhlala kwakho esibhedlele, uya:

• Celwa ukuba uhlale ecaleni kwebhedi kwaye uhambe ngokukhawuleza emva kotyando.
• Yiba neetyhubhu ezivela ecaleni kwesifuba sakho ukukhupha ulwelo kunye nomoya.
• Nxiba isitokhwe esikhethekileyo ezinyaweni nasezinyaweni ukukhusela amahlwili egazi.
• Fumana iifotsholo ukunqanda amahlwili egazi.
• Fumana amayeza eentlungu nge-IV (ityhubhu engena kwimithambo yakho) okanye ngomlomo ngeepilisi. Unokufumana iyeza lakho leentlungu ngomatshini okhethekileyo onika idosi yeyeza lonyango xa ucofa iqhosha. Oku kukuvumela ukuba ulawule ukuba lingakanani iyeza lentlungu olifumanayo. Unokuba ne-epidural ibekwe. Le yicatheter esemqolo ehambisa iyeza lentlungu ukuze ibambe imithambo-luvo kwindawo yotyando.
• Celwa ukuba wenze ukuphefumla okunzulu okuninzi ukukunceda ukukhusela inyumoniya kunye nosulelo. Imithambo yokuphefumla nzulu ikwanceda ukufuthisa imiphunga ebityandwa. Iityhubhu zakho zesifuba ziya kuhlala zikwindawo de umphunga wakho ube ugcwele umoya.

Isiphumo sixhomekeke:

• Uhlobo lwengxaki yokuphathwa
• Zingaphi izicubu zemiphunga (ukuba zikhona) ezisusiweyo
• Impilo yakho iyonke ngaphambi kotyando

Thoracotomy; Ukususwa kwamathambo emiphunga; Inyumoniya; I-Lobectomy; Umkhuhlane wemiphunga; Thoracoscopy; Unyango lwe-thoracoscopic; IVATS

• Ukhuseleko kwigumbi lokuhlambela kubantu abadala
• Indlela yokuphefumla xa unomoya omfutshane
• Utyando lwemiphunga - ukukhupha
• Ukhuseleko lweoksijini
• Umsele wamanzi angasemva
• Ukuthintela ukuwa
• Unonophelo lwenxeba lotyando - luvulekile
• Ukuhamba neengxaki zokuphefumla
• Sebenzisa ioksijini ekhaya
• Sebenzisa ioksijini ekhaya-yintoni oza kuyibuza ugqirha wakho

• I-pulmonary lobectomy - uthotho

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I-Feller-Kopman DJ, i-Decamp MM. Ungenelelo kunye neendlela zotyando kwizifo zemiphunga. Ku: IGoldman L, iSchafer AI, ii-eds. Amayeza eGoldman-Cecil. Ngomhla wama-26. IPhiladelphia, PA: Elsevier; 2020: isahl. 93.

I-Lumb A, uThomas C. Utyando lwePulmonary. Ku: Lumb A, Thomas C, eds. INunn kunye neLumb's Applied Respiratory Physiology. Umhla we-9. IPhiladelphia, PA: Elsevier; 2021: isahluko 33.

U-Putnam JB. Umlenze, udonga lwesifuba, i-pleura, kunye ne-mediastinum. Ku: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, ii-eds. Incwadi yeSabiston yoNyango. Umhla we-20. IPhiladelphia, PA: Elsevier Saunders; Ngo-2017: isahluko 57.