Thoracotomy: yintoni na, iintlobo kunye nokubonakaliswa

Umxholo

• Iindidi ze-thoracotomy
• Iziphumo ebezingalindelekanga ezinokwenzeka

I-Thoracotomy yinkqubo yoqhaqho lwezonyango equka ukuvula isifuba kwaye inokwenzeka kwimimandla eyahlukeneyo yesifuba, ukubonelela ngendlela ethe ngqo yokufikelela kwilungu elichaphazelekayo kunye nobubanzi obaneleyo ukuvumela intsimi elungileyo yokusebenza, ukunqanda ukonakala komzimba.

Kukho iintlobo ezahlukeneyo ze-thoracotomy, ekufuneka yenziwe ngokuxhomekeke kwilungu ekufuneka lifikelelwe kunye nenkqubo ekufuneka yenziwe, kwaye inokusetyenziselwa ukuhlalutya okanye ukususa amalungu okanye izakhiwo ezonzakeleyo, ukulawula ukopha, ukunyanga i-embolism yegesi, ukwenza ukuxilongwa kwentliziyo, phakathi kwabanye.

Iindidi ze-thoracotomy

Kukho iintlobo ezi-4 ezahlukeneyo ze-thoracotomy, ezihambelana nommandla apho kwenziwa khona i-incision:

• I-posterolateral thoracotomy: le yeyona nkqubo iqhelekileyo, kwaye indlela esetyenziswa ngokubanzi ukufikelela kwimiphunga, ukususa umphunga okanye isahlulo semiphunga ngenxa yomhlaza, umzekelo. Ngexesha lotyando, kusikwa kusikwe ecaleni kwesifuba ngasemva, phakathi kweembambo, kunye neembambo zahluliwe, kwaye kungafuneka kususwe enye yazo ukujonga umphunga.
• I-thoracotomy ephakathi: Kule hlobo lwe-thoracotomy, i-incision yenziwa kunye ne-sternum, ukuze kuvulwe ukufikelela esifubeni. Inkqubo isetyenziswa ngokubanzi xa kufuneka kwenziwe utyando lwentliziyo.
• I-Axillary thoracotomy: Kolu hlobo lwe-thoracotomy, kuqatywa imbeleko kwingingqi ye-armpit, edla ngokusetyenziselwa ukunyanga i-pneumothorax, equlathe ubukho bomoya kwindawo yomlomo, phakathi komphunga nodonga lwesifuba.
• I-anterolateral thoracotomy: Le nkqubo isetyenziswa ngokubanzi kwiimeko zongxamiseko, apho kusikwa khona ngaphambili kwesifuba, esinokuba yimfuneko emva koxinzelelo esifubeni okanye ukuvumela ukufikelela ngqo entliziyweni emva kokubanjwa kwentliziyo.

Iziphumo ebezingalindelekanga ezinokwenzeka

Ezinye zeengxaki ezinokuthi zenzeke emva kokwenza i-thoracotomy zi:

• Umoya emva kotyando;
• Ukuvuza komoya, kufuna ukusetyenziswa kwexesha elide kwityhubhu yesifuba emva kwenkqubo;
• Usulelo;
• Ukopha;
• Ukuqulunqwa kwamahlwili egazi;
• Iingxaki ezibangelwa yi-anesthesia jikelele;
• Isifo sentliziyo okanye arrhythmias;
• Utshintsho lweentambo zamagama;
• I-Bronchopleural fistula;

Ukongeza, kwezinye iimeko, indawo apho kwenziwa khona i-thoracotomy inokubangela iintlungu ixesha elide emva kotyando. Kwezi meko, okanye ukuba umntu ufumanisa ukungalunganga ngexesha lokubuyisela kwimeko yesiqhelo, ugqirha kufuneka aziswe.