UTshintsho lwemiphunga-Iintlobo, Inkqubo, Iindleko eIndiya, imingcipheko, ukuBuyisa kunye neeNzuzo

Yintoni iLung Transplant?

Uqhaqho-fakelo lwemiphunga yinkqubo yotyando ebandakanya ukutshintshwa komphunga onesifo okanye owonakeleyo ngomphunga osempilweni ovela kumnikeli. Olu tyando lunzima ngokwesiqhelo lwenziwa kwizigulana ezithwaxwa ziimeko ezinzima zemiphunga ezingenakulawulwa ngolunye unyango. Eyona njongo iphambili yofakelo lwemiphunga kukuphucula umgangatho wobomi kunye nokwandisa ubomi babantu abanesifo semiphunga sokugqibela. 

Ufakelo lwemiphunga luhlala luqwalaselwa kwizigulane ezineemeko ezifana isifo esinganyangekiyo semiphunga (COPD), pulmonary fibrosis, icystic fibrosis, kunye ne-pulmonary hypertension. Ezi zifo zinokuphazamisa kakhulu ukusebenza kwemiphunga, okukhokelela kwiimpawu ezibuthathaka ezifana nokuphefumla, ukukhohlela okungapheliyo, kunye nokunciphisa ukunyamezela umthambo. Kwiimeko ezininzi, abaguli banokufumanisa ukuba iimpawu zabo zinciphisa kakhulu imisebenzi yabo yemihla ngemihla kunye nomgangatho wobomi bonke.

Inkqubo yofakelo lwemiphunga ngokwayo ibandakanya amanyathelo abalulekileyo aliqela. Okokuqala, isigulane sivavanywa ukugqiba ukufaneleka kwabo kwi-transplant. Olu vavanyo lubandakanya imbali yonyango olucokisekileyo, uvavanyo lomzimba, kunye neemvavanyo ezahlukeneyo zokuvavanya ukusebenza kwemiphunga kunye nempilo iyonke. Ukuba isigulana sithathwa njengomgqatswa ofanelekileyo, babekwa kuluhlu lokulinda lomphunga womxhasi. 

Nje ukuba kufumaneke umphunga womnikeli ohambelanayo, isigulana singeniswa esibhedlele ukwenzela utyando lofakelo. Ngethuba lenkqubo, ugqirha wotyando uyawususa umphunga onesifo kwaye uwufake endaweni yawo ngomphunga womnikeli. Utyando luhlala luhlala iiyure ezininzi kwaye lufuna ukuba isigulane sibe phantsi kwe-anesthesia jikelele. Emva kokutshintshwa, isigulane siya kubekwa esweni ngokusondeleyo kwiyunithi yokunyamekela kakhulu (ICU) iintsuku eziliqela ukuqinisekisa ukubuyiswa okufanelekileyo kunye nokusebenza komphunga omtsha.

Kutheni le nto uTshintsho lwemiphunga lwenziwa?

Ufakelo lwemiphunga lwenziwa xa ezinye iindlela zonyango ziye zasilela ukunika isiqabu ngokwaneleyo kwiimpawu okanye xa umsebenzi wemiphunga uye wehla ukuya kwinqanaba elibalulekileyo. Izigulane zinokufumana uluhlu lweempawu ezikhokelela kwisincomo sofakelo lwemiphunga. Ezi mpawu zinokubandakanya:

• Ukuphefumla kakhulu, naxa uphumle
• Ukhohlokhohlo olungapheliyo olungaphucukanga ngamayeza
• Usulelo lokuphefumla rhoqo
• Ukukhathala nobuthathaka
• Ubunzima bokwenza imisebenzi yemihla ngemihla, njengokuhamba okanye ukunyuka izitebhisi

Isigqibo sokuqhubeka noqhaqho-fakelo lwemiphunga ngokuqhelekileyo senziwa xa ukusebenza kwemiphunga yesigulana kuwela ngaphantsi komqobo othile, okukholisa ukulinganiswa ngovavanyo olubizwa ngokuba ngumthamo wokuphelelwa ngamandla (FEV1). Olu vavanyo luvavanya ukuba ungakanani na umoya umntu anokuwukhupha ngenkani ngomzuzwana omnye. Ukuncipha kakhulu kwe-FEV1 kubonisa ukuba imiphunga ayisebenzi ngokwaneleyo, kwaye uqhaqho-fakelo lunokuba yimfuneko.

Ukongeza ekusebenzeni kwemiphunga, ezinye izinto ziyaqwalaselwa xa kumiselwa imfuno yofakelo lwemiphunga. Ezi ziquka impilo yonke yesigulana, ubukho bezinye iimeko zonyango, kunye nokukwazi kwabo ukubambelela kukhathalelo emva kokutshintshwa, okubalulekileyo kwimpumelelo yenkqubo. 

Iimpawu zoTshintsho lweLung

Ayisiso sonke isigulana esinesifo semiphunga esinelungelo loqhaqho-fakelo lwemiphunga. Iimeko ezininzi zeklinikhi kunye neziphumo zovavanyo zinceda ukufumanisa ukuba isigulana siyayifanelekela na le nkqubo yokusindisa ubomi. Ezi zilandelayo zezinye zezalathisi eziphambili zofakelo lwemiphunga:

1. ISifo Semiphunga Yenqanaba Lokuphela: Izigulane ezinezifo zemiphunga zokugqibela, ezifana neCOPD, i-pulmonary fibrosis, okanye i-cystic fibrosis, zihlala ziqwalaselwa ukutshintshwa kwemiphunga xa imeko yabo iqhubela phambili ukuya kwindawo apho ezinye iindlela zonyango zingasasebenzi.
2. Ukonakaliswa okumandundu kokuSebenza: Ukwehla okubonakalayo kokusebenza kwemiphunga, okuboniswa ngokuqhelekileyo yi-FEV1 engaphantsi kwe-30% yexabiso eliqikelelweyo, sisalathisi esinamandla sokungenela uqhaqho-fakelo lwemiphunga. Eli nqanaba lokukhubazeka lihlala lihambelana neempawu ezinzima kunye nokunciphisa umgangatho wobomi.
3. Ukuxhomekeka kwi-Oxygen: Izigulane ezifuna i-oksijeni eyongezelelweyo ukugcina amanqanaba e-oksijini eyaneleyo egazini labo, ngakumbi abo bangakwazi ukwenza imisebenzi yemihla ngemihla ngaphandle kwayo, banokuba ngabaviwa bokufakelwa kwemiphunga.
4. Uxinzelelo lwegazi lwemiphunga: Le meko, ebonakaliswe luxinzelelo lwegazi oluphezulu kwimiphunga, inokukhokelela ekuphelelweni kwentliziyo kwaye luphawu oluqhelekileyo lokufakelwa kwemiphunga, ngakumbi kwizigulane ezine-idiopathic pulmonary arterial hypertension.
5. Usulelo oluQhoboshekileyo lokuphefumla: Izigulana ezinezifo ezingapheliyo zemiphunga ezifumana izifo rhoqo kunye nezinzima zokuphefumla ezikhokelela kumonakalo ongakumbi wemiphunga nazo zinokuqwalaselwa kufakelo lofakelo.
6. Ubudala kunye nempilo iyonke:  Ngelixa kungekho mda ungqongqo wokufakelwa kwemiphunga, abaviwa bahlala bephakathi kweminyaka eyi-18 kunye ne-65 kwaye basempilweni entle ngokwasemzimbeni, ngokufuthi beqwalaselwe ukuya kuthi ga kwi-70 okanye ngaphaya ngokusekelwe kwizinto ezizimeleyo. Ukongeza, izigulana kufuneka zibe nempilo entle iyonke, ngaphandle kokugula okubalulekileyo okunokuthi kube nzima utyando okanye ukuchacha.
7. Imiba yezengqondo: Impilo yengqondo nengokweemvakalelo yesigulana nayo iyavavanywa. Abaviwa kufuneka babonise ukukwazi ukuthobela ukunakekelwa emva kokutshintshwa, kubandakanywa ukuthatha amayeza e-immunosuppressive kunye nokuya kuqeshwa olulandelayo.

Isishwankathelo, isigqibo sokucebisa ukufakelwa kwemiphunga sisekelwe kwindibaniselwano yeziphumo zeklinikhi, ubunzima besifo semiphunga, kunye nempilo yonke yesigulane kunye nokukwazi ukubambelela kukhathalelo lwasemva kotyando. Imeko nganye ivavanywa ngabanye, kwaye iqela leengcali ezininzi zonyango lisebenza kunye ukumisela eyona ndlela ilungileyo yokwenza isigulane ngasinye.

Iintlobo zoTshintsho lwemiphunga

Uqhaqho-fakelo lwemiphunga lungahlelwa ngokweendidi ezahlukeneyo ngokusekwe kwinani lemiphunga efakelweyo kunye nomthombo womphunga onikelayo. Iindidi ezimbini eziphambili zofakelo lwemiphunga zezi:

1. UTshintsho lwemiphunga enye: Le nkqubo ibandakanya ukufakelwa komphunga omnye kulowo ungasekhoyo. Ihlala isenziwa kwizigulana ezinesifo semiphunga kwicala elinye, apho omnye umphunga uchatshazelwa kakhulu ngelixa omnye uhlala usempilweni noko.
2. Ukufakelwa kwemiphunga emibini: Kule nkqubo, yomibini imiphunga itshintshwa yimiphunga esempilweni evela kumnikeli oswelekileyo. Uqhaqho-fakelo lwemiphunga ephindwe kabini ngokuqhelekileyo luyacetyiswa kwizigulana ezinesifo semiphunga samazwe amabini, esifana ne-cystic fibrosis okanye i-pulmonary fibrosis eqatha, apho yomibini imiphunga isengozini kakhulu.

Kwezinye iimeko, ukufakela imiphunga yomxhasi ophilayo nako kunokuqwalaselwa, nangona oku kungaqhelekanga. Kuqhaqho lofakelo lwemiphunga yomnikeli ophilayo, inxenye yomphunga osuka kumnikeli ophilayo ukhutshelwa kumamkeli. Oku kudla ngokufuna abanikeli ababini abaphilayo, ngamnye enikela nge-lobe, ukuxhasa ngokwaneleyo ukuphefumla kommkeli. Le ndlela intsonkothe ​​ngakumbi kwaye ifuna ukuthelekisa ngononophelo kunye novavanyo lwabo bobabini onikelayo kunye nomamkeli.

Contraindications for Lung Transplant

Ngelixa ukufakelwa kwemiphunga kunokusindisa ubomi kwizigulana ezininzi ezinezifo ezinzima zemiphunga, iimeko ezithile okanye izinto ezithile zinokwenza isigulana singayifanelanga le nkqubo. Ukuqonda ezi contraindications kubalulekile kuzo zombini izigulana kunye nababoneleli ngezempilo.

1. Usulelo olusebenzayo: Izigulane ezinosulelo olusebenzayo, ezifana isifo sofuba okanye nzima pneumonia, usenokungakufanelekeli uqhaqho-fakelo lwemiphunga. Ukunyanzeliswa kwe-immune efunekayo emva kokutshintshwa kunokunyusa ezi zifo.
2. Ububi: Imbali yee-cancer ezithile, ngakumbi ezo zingekaxoki, zinokusithintela isigulana ekubeni sifumane uqhaqho-fakelo lwemiphunga. Oku kungenxa yokwanda komngcipheko wokuphinda ubuyele komhlaza xa amajoni omzimba ecinezelwe.
3. Izigulo eziMandundu: Izigulana ezineminye imiba ebalulekileyo yezempilo, njengesifo senhliziyo esiphezulu, isifo sesibindi, okanye ukungaphumeleli kwezintso, zisenokungabi ngabaviwa abafanelekileyo. Uxinzelelo lotyando kunye nokubuyisela kunokuba luninzi kubantu abaneengxaki ezininzi zempilo.
4. Ukuhlukunyezwa kwesiyobisi: Ukusetyenziswa kakubi kweziyobisi okusebenzayo, kubandakanywa ukutshaya, utywala, okanye ukusebenzisa iziyobisi, kunokukhupha isigulana. Ukuzinikela kwindlela yokuphila esempilweni kubalulekile kwimpumelelo yoqhaqho-fakelo lwemiphunga.
5. Ukungahambelani noNyango: Izigulane ezinembali yokungalandeli iingcebiso zonyango okanye izicwangciso zonyango zingathathwa njengezingafanelekanga. Ukubambelela kukhathalelo emva kokutshintshwa kubalulekile kwimpumelelo yenkqubo.
6. Imiba yezengqondo: Imiba yempilo yengqondo, ukunqongophala kwenkxaso yoluntu, okanye iimeko zokuhlala ezingazinzanga zinokuchaphazela amandla esigulane okumelana neemfuno zofakelo lwemiphunga. Inkqubo yenkxaso ezinzileyo ibalulekile ekubuyiseni kwakhona.
7. Iingqwalasela zobudala: Ngelixa ubudala bodwa bungachasananga ngokungqongqo, abaguli abadala banokujongana nemingcipheko eyongezelelweyo. Imeko nganye ivavanywa ngabanye, ngokuqwalasela impilo yonke kunye nesimo sokusebenza.
8. Ubukhulu: Kakhulu ukunyanya kunokwenza utyando lube nzima kunye nokuchacha. Isalathiso sobunzima bomzimba (BMI) ngaphezu komda othile sinokukhokelela ekungafanelekiyo, njengoko sinokunyusa umngcipheko weengxaki.
9. Ukusebenza kakubi kwemiphunga:  Izigulana ezinokungasebenzi kakuhle kwemiphunga nazo ezineminye imiba yempilo eqatha ethintela ukuxilongwa kwazo zonke, okanye ekungalindelekanga ukuba zixhamle kakhulu kuqhaqho-fakelo ngenxa yobuthathaka obugqithisileyo, abanakujongwa njengabaviwa abafanelekileyo.
10. Ufakelo lwangaphambili: Izigulana eziye zenziwa uqhaqho-fakelo lwemiphunga ngaphambili zinokujongana nemingcipheko eyongezelelweyo kunye neengxaki, okwenza uqhaqho-fakelo lwesibini lube nzima ngakumbi kwaye lunqabile ukuba luphumelele.

Ukuqonda ezi zithintelo kunokunceda abaguli kunye neentsapho zabo ukuba babe neengxoxo ezinolwazi kunye namaqela abo okhathalelo lwempilo malunga nokufakelwa kwemiphunga.

ULungiselela njani uTshintsho lwemiphunga

Ukulungiselela uqhaqho-fakelo lwemiphunga kubandakanya amanyathelo abalulekileyo aliqela ukuqinisekisa esona siphumo sifanelekileyo. Nantsi into enokuthi izigulane zilindele xa kukhokelela kwinkqubo.

1. UVavanyo oluBanzi: Ngaphambi kokufakwa kuluhlu lofakelo, izigulane zivavanywa ngokucokisekileyo. Oku kubandakanya imbali yonyango, iimvavanyo zomzimba, kunye neemvavanyo ezahlukeneyo zokuvavanya ukusebenza kwemiphunga kunye nempilo yonke.
2. UVavanyo lwangaphambili loTshintsho: Izigulana kusenokwenzeka ukuba zingene kuthotho lweemvavanyo, eziquka:
   1. Iimvavanyo zokuSebenza kwemiphunga: Ukulinganisa umthamo wemiphunga kunye nomsebenzi.
   2. Izifundo zokufanekisa: Njenge isifuba X-reyi or CT scans ukubona ukwakheka kwemiphunga.
   3. Uvavanyo lweGazi: Ukujonga usulelo, ukusebenza kwamalungu, kunye nokuhambelana kohlobo lwegazi.
3. UVavanyo lweNtliziyo: Ukuvavanya impilo yentliziyo, kubandakanywa i qeebloyi okanye uvavanyo loxinzelelo.
   Ukuguqulwa kwendlela yokuphila: Izigulane zinokucetyiswa ukuba zitshintshe indlela yokuphila, njengokuyeka ukutshaya, ukuphucula ukutya kunye nokwandisa umthambo. Olu tshintsho lunokuphucula impilo yonke kunye nokuphucula iziphumo zokutshintshwa.
4. Imfundo kunye neeNgcebiso: Izigulana kufuneka zizimase iiseshini ezifundisayo malunga nenkqubo yoqhaqho-fakelo, kubandakanywa nokuba yintoni onokuyilindela phambi, ngexesha, nasemva kotyando. Ukucetyiswa kusenokuba luncedo ukujongana nayo nayiphi na inkxalabo ngokwasemoyeni okanye ngokwasengqondweni. Ukunxibelelana namaqela enkxaso kwizigulane zoqhaqho-fakelo lwemiphunga kunye neentsapho zazo kunokubonelela ngenkxaso nokuqondana koontanga.
5. Inkqubo yoNkxaso: Ukuseka inkqubo yenkxaso eyomeleleyo kubalulekile. Abaguli bafanele bachonge amalungu entsapho okanye abahlobo abanokubanceda xa bechacha baze banikele inkxaso ngokweemvakalelo.
6. Iingqwalasela zezeMali: Ukuqonda iindleko ezinxulumene nokufakelwa kwemiphunga, kubandakanywa utyando, ukulaliswa esibhedlele, kunye nokunyamekela emva kokuhlinzwa, kubalulekile. Izigulane kufuneka zixoxe ngeendlela zemali kunye neqela labo lezempilo kunye nababoneleli be-inshurensi.
7. Imiyalelo yokuSebenza kwangaphambili: Njengoko umhla wotyando usondela, izigulana ziya kufumana imiyalelo ethile, enokubandakanya:
   1. Ukuphepha amayeza athile, ngakumbi ancitshisi igazi.
   2. Ukuzila ukutya ngaphambi kwenkqubo.
   3. Ukulungiselela isithuthi ukuya nokubuya esibhedlele.
8. UQhagamshelwano oluNgxamisekileyo: Izigulane kufuneka ziqinisekise ukuba zinendlela ethembekileyo yokuqhagamshelwana nazo xa kukho umphunga womxhasi. Oku kusenokuquka ukugcina ifowuni kufutshane yaye ukulungele ukuya esibhedlele ngokukhawuleza.

Ngokulandela la manyathelo okulungiselela, izigulane zinokunceda ukuqinisekisa ukuba zilungele inkqubo yokufakelwa kwemiphunga, ukwandisa amathuba okuba nesiphumo esiyimpumelelo.

UTshintsho lwemiphunga: Inkqubo yeNyathelo ngeNyathelo

Ukuqonda inkqubo yofakelo lwemiphunga kunokunceda ukunciphisa unxunguphalo nokulungiselela izigulane ukuba zilindele ntoni na. Nantsi isishwankathelo senyathelo ngenyathelo lenkqubo.

1. Ukulinda uMnikelo weMiphu: Sakuba sifakwe isigulana kuluhlu lofakelo, banokulinda umphunga ofanelekileyo. Ixesha lokulinda linokwahluka ngokusekelwe kwizinto ezifana nodidi lwegazi, ubukhulu, kunye nokungxamiseka kwemfuneko.
2. Ukufumana umnxeba: Xa umphunga womnikeli ufumaneka, iziko lofakelo lofakelo liya kuqhagamshelana nesigulane. Kubalulekile ukuba ulungele ukuya esibhedlele ngokukhawuleza.
3. ULungiselelo lwaPhambi kokuSebenza: Ekufikeni esibhedlele, izigulane ziya kuvavanywa kokugqibela, kubandakanywa novavanyo lwegazi kunye nezifundo zokucinga. Umgca we-intravenous (IV) uya kufakwa kumayeza kunye nolwelo.
4. Ukubulawa: Ngaphambi kokuba utyando luqale, izigulane ziya kufumana i-anesthesia jikelele, ziqinisekisa ukuba azikho zingqondweni kwaye azinantlungu ngexesha lenkqubo.
5. Inkqubo yoTyando: Ugqirha wotyando uya kwenza i-incision esifubeni, ngokuqhelekileyo ngethambo lesifuba okanye icala lesifuba. Umphunga owonakeleyo uya kususwa, kwaye umphunga womnikeli uya kufakwa ngononophelo kwindawo yesifuba. Ugqirha wotyando uya kudibanisa umphunga omtsha kwindlela yomoya kunye nemithambo yegazi.
6. Ukubeka iliso: Emva kotyando, izigulane ziya kuhanjiswa kwiyunithi yokhathalelo olunzulu (ICU) ukuze zijongwe ngokusondeleyo. Abasebenzi bezonyango baya kugcina iliso elibukhali kwiimpawu ezibalulekileyo kunye nokusebenza kwemiphunga.
7. Ukubuyisela: Izigulane ziya kutshintsha ngokuthe ngcembe ukusuka kwi-ICU ukuya kwigumbi lesibhedlele eliqhelekileyo njengoko imeko yabo izinzile. Ukuchacha kunokuthatha iintsuku ezininzi ukuya kwiiveki, apho izigulana ziya kuqalisa ukuvuselelwa kwemiphunga ukuze zomeleze imiphunga yazo kunye nokuphucula ukuphefumla.
8. Isicwangciso sokukhupha: Nje ukuba izigulane zizinzile kwaye zikwazi ukulawula ukhathalelo lwazo, ziya kukhutshwa esibhedlele. Baya kufumana imiyalelo ecacileyo malunga namayeza, ukuqeshwa okulandelayo, kunye nokutshintsha indlela yokuphila.
9. Ukhathalelo Lwexesha elide: Emva kokukhutshwa, izigulane ziya kufuna ukutyelelwa rhoqo ukujonga ukusebenza kwemiphunga kunye nokuqinisekisa ukuba umzimba uyawamkela umphunga omtsha. Amayeza e-immunosuppressive aya kumiselwa ukukhusela ukugatywa komphunga womxhasi. Ukubambelela kula mayeza bubomi bonke kwaye kubalulekile ekuthinteleni ukulahlwa kunye nokulawula iziphumo ebezingalindelekanga zexesha elide ezinokubakho.
10. Uhlengahlengiso kwindlela yokuphila: Izigulana kuya kufuneka zenze utshintsho oluqhubekayo kwindlela yokuphila, kubandakanywa nokuphepha usulelo, ukugcina ukutya okunempilo, kunye nokubambelela kwiirejimeni zamayeza. Amaqela enkxaso kunye neengcebiso zinokuba luncedo ngeli xesha lohlengahlengiso. Ukuqonda ukuba i-immunosuppressants inokunyusa umngcipheko kwezinye iimeko (umzekelo, isifo seswekile, osteoporosis) kunye nokufuna ukubeka iliso ngononophelo kubalulekile kwimpilo yexesha elide.

Ngokuqonda inkqubo yofakelo lwemiphunga, izigulana zinokuziva zixhotyisiwe kwaye zilungele uhambo lwazo oluya kwimpilo engcono yemiphunga.

Imingcipheko kunye neeNgxaki zoTshintsho lwemiphunga

Njengalo naluphi na utyando olukhulu, uqhaqho-fakelo lwemiphunga luza neengozi kunye neengxaki ezinokubakho. Kubalulekile ukuba izigulane zizazi ezi zinto ukuze zenze izigqibo ezinolwazi ngempilo yazo.

1. Uyala: Umzimba usenokuwubona umphunga omtsha njengowasemzini kwaye uzame ukuwugatya. Lo ngumngcipheko oqhelekileyo kwaye ulawulwa ngamayeza e-immunosuppressive.
2. Usulelo: Emva kofakelo lwemiphunga, izigulane zisengozini enkulu yosulelo ngenxa yeziyobisi ezikhusela umzimba. Usulelo oluqhelekileyo lubandakanya inyumoniya kunye nosulelo lokuphefumla.
3. Ukuhlamba: Iinkqubo zotyando zinokukhokelela ekuphumeni kwegazi, okunokufuna uncedo olongezelelweyo okanye utofelo-gazi.
4. Amahlwili: Kukho umngcipheko wokuba amahlwili egazi enze imilenze (i-vein thrombosis enzulu) okanye imiphunga (i-pulmonary embolism), enokuba yingozi.
5. Iingxaki zemiphunga: Imiba efana ne-bronchial anastomotic stricture (ukuncipha kwendlela yomoya) okanye ukungasebenzi kakuhle kwe-primary graft (ukungasebenzi kakuhle komphunga omtsha) kunokwenzeka.
6. Ukonakala Kwezintso: Ukusetyenziswa kwexesha elide kwamayeza e-immunosuppressive kunokukhokelela kwiingxaki zezintso, ezifuna ukubeka iliso kunye nokulawulwa.
7. Umngcipheko woMhlaza: Izigulana ezityhutyha uqhaqho-fakelo lwemiphunga zisemngciphekweni omkhulu wokuba nee-cancer ezithile ngenxa ye-immunosuppression.
8. Imiba yentliziyo: Kusenokubakho umngcipheko wokuba nesifo sentliziyo kunye noxinzelelo lwegazi emva kofakelo lwemiphunga.
9. Isifo seGastroesophageal Reflux (GERD): Ezinye izigulana zinokuba namava e-GERD, enokuthi ibe nefuthe elibi kwimpilo yomphunga kwaye ibe negalelo kwiingxaki ezinjengokwaliwa okungapheliyo. Ifuna ulawulo olucokisekileyo.
10. Iziphumo zengqondo: Impembelelo yeemvakalelo yokutshintshwa kwemiphunga inokukhokelela kuxhalaba, ukudakumba, okanye eminye imiba yempilo yengqondo. Inkxaso kunye neengcebiso zibalulekile ekumelaneni nazo.

Nangona le mingcipheko inokuvakala ngokumalunga, kubalulekile ukukhumbula ukuba izigulane ezininzi zifumana iziphumo eziyimpumelelo kunye nokuphucula umgangatho wobomi emva kokutshintshwa kwemiphunga. Ukunyamekela okulandelwa rhoqo kunye nokuthobela iingcebiso zonyango kunokunciphisa kakhulu le mingcipheko.

Ukuchacha emva koTshintsho lweLung

Inkqubo yokubuyisela emva kokufakelwa kwemiphunga ibalulekile kwimpumelelo yenkqubo kunye nempilo yonke yesigulane. Umda wexesha lokuchacha unokwahluka kakhulu ukusuka kumntu ukuya komnye, kodwa kukho izigaba eziqhelekileyo ezinokulindela uninzi lwezigulana.

• Ukhathalelo olukhawulezileyo lwasemva kokusebenza - Emva kotyando lofakelo lwemiphunga, izigulane ziqhele ukusiwa kwiYunithi yoNonophelo olunzulu (ICU) ukuze zijongwe ngokusondeleyo. Esi sigaba sokuqala sithatha malunga neentsuku ezi-1 ukuya kwezi-3. Ngeli xesha, ababoneleli bezempilo baya kubeka iliso kwiimpawu ezibalulekileyo, ukusebenza kwemiphunga, kunye naziphi na iimpawu zeengxaki. Izigulana zisenokuba kwii-ventilator okwethutyana ukunceda ukuphefumla.
• Ukuhlala esibhedlele - Ukulandela i-ICU, izigulane zihlala zichitha malunga neeveki ezi-1 ukuya kwezi-2 esibhedlele. Ngeli xesha, baya kuqalisa unyango lomzimba ukuze bafumane amandla kunye nokuhamba. Iqela lezonyango liya kuqalisa kwakhona isigulane kumayeza e-immunosuppressive ukukhusela ukulahlwa kwamalungu. Uvavanyo lwarhoqo luya kuqhutywa ukujonga ukusebenza kwemiphunga kunye nokuchacha ngokupheleleyo.
• Ukubuyiselwa kweKhaya - Nje ukuba ukhululwe, ukuchacha kuyaqhubeka ekhaya. Iiveki ezimbalwa zokuqala zibalulekile, kwaye izigulane kufuneka zilindele ukuba zilula. Uninzi lwezigulana zinokubuyela kwimisebenzi elula kwiiveki ezi-4 ukuya kwezi-6, kodwa ukuchacha ngokupheleleyo kunokuthatha iinyanga ezi-3 ukuya kwezi-6. Ukuqeshwa okulandelwa rhoqo kubalulekile ukujonga ukusebenza kwemiphunga kunye nokulungelelanisa amayeza njengoko kufuneka.

Iingcebiso zoTshintsho lwemiphunga emva kokunyanyekelwa

1. Ukubambelela kunyango: Kubalulekile ukuthatha amayeza e-immunosuppressive njengoko kumiselwe ukuthintela ukulahlwa.
2. Ukuhlolwa rhoqo: Yiya kuzo zonke iimvavanyo zokulandelela ukusebenza kwemiphunga kunye novavanyo lwempilo ngokubanzi.
3. Indlela yokuphila esempilweni: Yamkela indlela yokutya elungeleleneyo, yenza umthambo omncinane, kwaye ukuphephe ukutshaya notywala.
4. Uthintelo loSulelo: Ziqhelise ucoceko kwaye uphephe iindawo ezixineneyo ukunciphisa umngcipheko wosulelo.
5. Inkxaso yoMvakalelo: Funa inkxaso kusapho, abahlobo, okanye iinkonzo zokucebisa ukuze umelane nemiba yokuchacha ngokweemvakalelo.

Ukuqalisa kwakhona Imisebenzi eqhelekileyo

Izigulana zinokuphinda ziqalise ngokuthe ngcembe imisebenzi yesiqhelo, kuquka umsebenzi kunye nobudlelwane boluntu, ngokuqhelekileyo phakathi kwe-3 ukuya kwiinyanga ezi-6 emva kokutshintshwa. Nangona kunjalo, imidlalo enempembelelo ephezulu okanye imisebenzi eyenza umngcipheko wokulimala kufuneka igwenywe ubuncinane unyaka. Soloko udibana nababoneleli bezempilo phambi kokuba wenze utshintsho olubalulekileyo kumanqanaba omsebenzi.

Iinzuzo zoTshintsho lwemiphunga

Ufakelo lwemiphunga lunokuphucula kakhulu umgangatho wobomi kwizigulana ezithwaxwa zizifo ezinzima zemiphunga. Nazi ezinye iingenelo eziphambili:

1. Uphuculo lwemiphunga: Ukutshintshwa okuphumelelayo kwemiphunga kunokubuyisela umsebenzi wemiphunga oqhelekileyo okanye osondeleyo, ovumela izigulane ukuba ziphefumle lula kwaye zibandakanyeke kwimisebenzi yemihla ngemihla ngaphandle kwemida ebekwe yimeko yabo yangaphambili.
2. Umgangatho woBomi owongeziweyo: Izigulana ezininzi zixela ukuphucuka okukhulu kumgangatho wabo bonke wobomi emva kokutshintshwa. Banokuyonwabela imisebenzi ebikade inzima okanye ebingenakwenzeka ngaphambili, njengokuhamba, ukwenza umthambo, nokuchitha ixesha nentsapho nabahlobo.
3. Ukwandiswa kokulindeleka koBomi: Ngelixa uqhaqho-fakelo lwemiphunga aluqinisekisi unyango, lunokwandisa kakhulu ixesha lokuphila kwizigulana ezinesifo semiphunga sokugqibela. Izigulana ezininzi ziphila iminyaka eliqela emva kolu nyango, ezinye ziphila ubomi obulungileyo.
4. Ukuncipha kweempawu: Izigulana zihlala zifumana ukuncipha kweempawu ezifana nokuphefumla kancinci, ukukhohlela okungapheliyo, kunye nokudinwa, nto leyo enokuphucula kakhulu ukusebenza kwabo kwemihla ngemihla kunye nokuba sempilweni ngokweemvakalelo.
5. Okuzuzwayo ngokwasengqondweni: Ukukhululeka kwizifo ezingapheliyo kunokukhokelela ekuphuculeni impilo yengqondo, ukunciphisa ukuxhalaba kunye nokudakumba okuhambelana nesifo esibi semiphunga.

UTshintsho lweLung vs. Iindlela ezizezinye zoLawulo lweSifo seMiphunga esikwinqanaba lokuGqibela

Kubantu abaphethwe sisifo esiqatha, esisekupheleni kwesifo semiphunga, uqhaqho-fakelo lwemiphunga lubonelela ngamathuba okuphucula kakhulu ubomi kunye nokwandisa ubomi bobomi ngokutshintsha imiphunga enesigulo ngemiphunga ephilileyo. Nangona kunjalo, ayizizo zonke izigulana ezingabaviwa bokutshintshwa, kwaye uluhlu lweendlela zokulawula ezizezinye zisetyenziselwa ukulawula iimpawu, ukwandisa ukusebenza kwemiphunga eseleyo, okanye ukubonelela ngoncedo oluxhasayo. Ukhetho lonyango luxhomekeke kwisifo esithile semiphunga, ubuqatha baso, impilo yesigulana iyonke, kunye nezinto esizikhethayo.

Ukuqonda ezi ndlela zahlukeneyo kubalulekile kwizigulane kunye neentsapho zazo.

Lithini Iindleko zoTshintsho lwemiphunga eIndiya?

Iindleko zofakelo lwemiphunga eIndiya ziqhele ukusuka kwi- ₹ 1,00,000 ukuya kwi- ₹2,50,000. Eli xabiso linokwahluka ngokusekelwe kwizinto ezininzi:

• Isibhedlele: Izibhedlele ezohlukeneyo zineendlela ezahlukeneyo zokubeka amaxabiso. Amaziko adumileyo afana nezibhedlele ze-Apollo anokubonelela ngokhathalelo olubanzi kunye nezixhobo eziphambili, ezinokuchaphazela iindleko zizonke.
• Indawo: Isixeko kunye nommandla apho utshintshelo lwenziwa khona kunokuchaphazela iindleko ngenxa yomahluko kwiindleko zokuphila kunye namaxabiso ezempilo.
• Uhlobo lwegumbi: Ukukhethwa kwegumbi (iwadi jikelele, igumbi labucala, njl. njl.) kunokuchaphazela kakhulu ixabiso elipheleleyo.
• Iingxaki: Naziphi na iingxaki ezinokuvela ngexesha okanye emva kotyando zinokukhokelela kwiindleko ezongezelelweyo.

Kwizibhedlele zeApollo, sibeka phambili unxibelelwano oluselubala kunye nezicwangciso zokhathalelo lomntu. Izibhedlele zeApollo sesona sibhedlele sibalaseleyo sofakelo lwemiphunga eIndiya ngenxa yobungcali bethu obuthembekileyo, amaziko ahambele phambili, kunye nokuzinikela kwiziphumo zesigulana. Sikhuthaza abo baza kuba ngabaguli abafuna a uqhaqho-fakelo lwemiphunga eIndiya ukuqhagamshelana nathi ngokuthe ngqo ngolwazi oluthe kratya malunga neendleko zofakelo kunye noncedo ngesicwangciso semali.

Ngezibhedlele zeApollo, ufumana ukufikelela kubuchwephesha obuthembekileyo, ukhathalelo olupheleleyo lwasemva, kunye nexabiso elibalaseleyo, okusenza ukuba sibe lolona khetho lukhethekileyo uqhaqho-fakelo lwemiphunga eIndiya.

Imibuzo Ebuzwa Rhoqo malunga noTshintsho lweLung

1. Loluphi utshintsho kwidayethi ekufuneka ndilwenzile phambi koTshintsho lweLung?
   Phambi koTshintsho lwemiphunga, kubalulekile ukugcina a ukutya elungeleleneyo zizityebi kwiziqhamo, imifuno, iiproteni ezibhityileyo, kunye nokutya okuziinkozo. Kuphephe ukutya okugayiweyo, ityuwa eninzi, neswekile. Ukuhlala u-hydrated nako kubalulekile. Dibana nengcali yezondlo ukuze ufumane iingcebiso ezizezakho.
2. Ndingatya ngokuqhelekileyo emva koTshintsho lwemiphunga?
   Emva koTshintsho lweLung, unokubuyela ngokuthe ngcembe ekutyeni okuqhelekileyo, kodwa kubalulekile ukugxila ekutyeni okuxineneyo kwezondlo. Kuphephe ukutya okukrwada okanye okungaphekwanga ngokwaneleyo ukunciphisa umngcipheko wosulelo. Ukulandelela rhoqo kunye ne-dietitian kunokunceda ukulungelelanisa ukutya kwakho kwiimfuno zakho zokubuyisela.
3. Izigulana ezisele zikhulile kufuneka zilungiselele njani uTshintsho lwemiphunga?
   Izigulana esele zikhulile ezithathela ingqalelo uTshintsho lwemiphunga kufuneka zenze uhlolo olucokisekileyo ukuvavanya impilo yazo iyonke. Kubalulekile ukulawula iimeko zempilo ezikhoyo kwaye ulandele indlela yokuphila enempilo. Ukuzibandakanya kumsebenzi womzimba omncinci kunye nokutya okunokulinganisela kunokuphucula iziphumo.
4. Ngaba ukukhulelwa kukhuselekile emva koTshintsho lweLung?
   Ukukhulelwa emva koTshintsho lwemiphunga kunokwenzeka kodwa kufuna ukucwangciswa ngononophelo kunye nolawulo lwezonyango. Kubalulekile ukuxoxa ngezicwangciso zakho neqela lakho lezempilo ukuqinisekisa ukuba nobabini kunye nosana nihlala nisempilweni ngexesha lonke lokukhulelwa.
5. Zeziphi izinto ekufuneka ziqwalaselwe kwizigulana zabantwana abafuna uTshintsho lweLung?
   Izigulana zabantwana ezenziwa kuTshintsho lweLung zifuna ukhathalelo olulodwa olulungiselelwe iminyaka yabo kunye nophuhliso. Inkqubo yovavanyo iyafana, kodwa indlela yotyando kunye nokhathalelo emva kokuhlinzwa inokwahluka. Inkxaso yosapho ibalulekile ngexesha lokuchacha.
6. Ukutyeba kukuchaphazela njani ukufaneleka kweLung Transplant?
   Ukutyeba ngokugqithiseleyo kunokwenza kube nzima ukufaneleka koTshintsho lwemiphunga. Ubunzima obugqithisileyo bunokunyusa imingcipheko yotyando kunye nokuchaphazela ukubuyiswa. Ukunciphisa umzimba ngokutya kunye nokuzilolonga kudla ngokucetyiswa ngaphambi kokuqwalasela ukutshintshwa.
7. Ngaba izigulana ezinesifo seswekile zingenza iLung Transplant?
   Ewe, abaguli abanesifo seswekile banoTshintsho lweLung, kodwa isifo seswekile sabo kufuneka silawulwe kakuhle. Isifo seswekile esingalawulwayo sinokukhokelela kwiingxaki ngexesha nasemva kotyando, ngoko ke kubalulekile ukusebenza ngokusondeleyo nababoneleli bezempilo ukuzinzisa amanqanaba eswekile yegazi.
8. Kuthekani ukuba ndinoxinzelelo lwegazi phambi koTshintsho lwemiphunga yam?
   Ukuba noxinzelelo lwegazi akukwenzi uvumeleke ngokuzenzekelayo ukuba ufumane uTshintsho lwemiphunga. Nangona kunjalo, kufuneka ilawulwe kakuhle phambi kotyando. Ukubekwa esweni rhoqo kunye nohlengahlengiso lwamayeza lunokuba yimfuneko ukuze kuqinisekiswe impilo entle.
9. Imbali yokutshaya ichaphazela njani ukutyunjwa kweLung Transplant?
   Imbali yokutshaya inokuchaphazela ukufaneleka kweLung Transplant. Ngokuqhelekileyo izigulane kufuneka ziyeke ukutshaya kangangexesha elithile ngaphambi kokuba ziqwalaselwe utyando. Oku kunceda ukuphucula impilo yonke yemiphunga kwaye kunciphisa umngcipheko weengxaki.
10. Yeyiphi imingcipheko yoTshintsho lweLung kwizigulana ezinembali yesifo sentliziyo?
    Izigulane ezinembali yesifo senhliziyo zinokujongana nemingcipheko eyongezelelweyo ngexesha loTshintsho lweLung. Uvavanyo olunzulu lwe-cardiovascular luyimfuneko ukuvavanya impilo yentliziyo kunye nokugqiba ukuba isigulane singumviwa ofanelekileyo wenkqubo.
11. Lide kangakanani ixesha lokubuyisela uTshintsho lwemiphunga?
    Ixesha lokubuyisela uTshintsho lweLung linokwahluka, kodwa uninzi lwezigulana zinokulindela ukuchitha iinyanga ezi-3 ukuya kwezi-6 zichacha ngokupheleleyo. Ukulandelela rhoqo kunye nokubambelela kwiirejimeni zamayeza kubalulekile ngeli xesha.
12. Loluphi utshintsho kwindlela yokuphila ekufuneka ndiyenze emva koTshintsho lweLung?
    Emva koTshintsho lweLung, kubalulekile ukuba uphile ngendlela esempilweni, kuquka ukutya okunesondlo, ukuzilolonga rhoqo, kunye nokunqanda ukutshaya notywala. Ukuhlala uphaphile malunga nosulelo kunye nokuya kwidinga lokulandelelanisa nako kubalulekile.
13. Ndingahamba emva koTshintsho lweLung?
    Ukuhamba emva koTshintsho lweLung kunokwenzeka, kodwa kufuna ukucwangciswa ngononophelo. Thetha neqela lakho lezempilo phambi kokuba wenze amalungiselelo okuhamba, kwaye uqinisekise ukuba uyafikelela kukhathalelo lwezonyango kwindawo oya kuyo.
14. Zeziphi iimpawu zokulahlwa kwelungu emva koTshintsho lweLung?
    Iimpawu zokulahlwa kwelungu zingabandakanya ukuphefumula okufutshane, ukunciphisa ukusebenza kwemiphunga, umkhuhlane, kunye nokudinwa. Kubalulekile ukuba uxele naziphi na iimpawu ezingaqhelekanga kumboneleli wakho wezempilo ngoko nangoko ukuze zihlolwe ngokukhawuleza.
15. Kukangaphi apho kufuneka ndibonane nogqirha wam emva koTshintsho lweLung?
    Emva koTshintsho lweLung, izigulana zihlala zifuna ukulandelwa rhoqo kunyaka wokuqala, rhoqo emva kweeveki ezimbalwa. Njengoko ixesha lihamba kwaye ukuba ukuchacha kuzinzile, olu tyelelo lunokuncipha rhoqo.
16. Iyintoni indima yamayeza okhuselo lomzimba emva koTshintsho lweLung?
    Amayeza e-Immunosuppressive abaluleke kakhulu emva koTshintsho lweLung ukukhusela umzimba ekwaleni umphunga omtsha. Izigulane kufuneka zithathe la mayeza njengoko kumiselwe kwaye ziye kuhlolo lwarhoqo ukujonga iziphumo zawo.
17. Ndingathatha inxaxheba kwimidlalo emva koTshintsho lweLung?
    Ukuthatha inxaxheba kwimidlalo emva koTshintsho lweLung lunokwenzeka, kodwa kufuneka kuthethwe ngononophelo. Imisebenzi enempembelelo ephantsi iyacetyiswa ngokubanzi ekuqaleni, ngokunyuka kancinci kancinci njengoko kucetyiswe liqela lakho lezempilo.
18. Kufuneka ndenze ntoni xa ndifumana iziphumo ebezingalindelekanga kumayeza am?
    Ukuba ufumana iziphumo ebezingalindelekanga kumayeza akho emva koTshintsho lweLung, qhagamshelana nomboneleli wakho wezempilo ngoko nangoko. Basenokuhlengahlengisa idosi yakho okanye bakutshintshele kwelinye iyeza ukuze balawule iziphumo ebezingalindelekanga ngokufanelekileyo.
19. Unjani umgangatho wokhathalelo lweLung Transplant eIndiya xa uthelekisa namanye amazwe?
    Umgangatho wokunakekelwa kweLung Transplant e-Indiya ihambelana namazwe amaninzi aseNtshona, kunye namaqela onyango anamava kunye nezixhobo eziphambili. Ukongezelela, iindleko zenkqubo ziphantsi kakhulu eIndiya, okwenza kube yinto ekhangayo kwizigulane ezininzi.
20. Zeziphi izibonelelo zenkxaso ezifumanekayo kwizigulane zoTshintsho lweLung?
    Izigulane zoTshintsho lweLung zinokufikelela kwizibonelelo ezahlukeneyo zenkxaso, kubandakanywa iinkonzo zokucebisa, amaqela enkxaso, kunye nezixhobo zemfundo. Izibhedlele ezifana ne-Apollo zibonelela ngenkxaso ebanzi ukunceda izigulana zikwazi ukuhamba ngendlela yazo.
21. Lithini izinga lempumelelo yotyando lofakelo lwemiphunga?
    Izinga lempumelelo yotyando lofakelo lwemiphunga luxhomekeke kwizinto ezifana nempilo yesigulana, ubudala, kunye nonobangela wokusilela kwemiphunga. Ngokomyinge, izinga lokusinda lonyaka omnye limalunga nama-1–85%, kwaye izinga lokusinda leminyaka emi-90 limalunga nama-5–50%. Ukubambelela ekulandeleni unyango kunye namayeza adlala indima enkulu kwimpumelelo yexesha elide.
22. Lithini izinga lokusinda eliqhelekileyo emva koTshintsho lweLung?
    Amazinga okusinda emva kofakelo lwemiphunga ahluka ngokwesigulane kunye nemeko. Uninzi lwezigulana ziphila ubuncinci iminyaka emi-5 emva kotyando, kwaye ezinye ziphila ngaphezulu kweminyaka eyi-10. Ulandelelwano lwezonyango oluqhubekayo, indlela yokuphila enempilo, kunye nolawulo olusebenzayo losulelo kunokuphucula kakhulu amathuba okusinda.
23. Ngaba kukho umda weminyaka yokufaneleka kofakelo-fakelo lwemiphunga?
    Akukho mda ungqongqo weminyaka yobudala, kodwa uninzi lwamaziko ofakelo lotshintsho luthatha abaviwa ukuya kuthi ga kwiminyaka engama-65-70 ubudala. Nangona kunjalo, ubudala bebhayoloji kunye nemeko yempilo iyonke ibaluleke ngakumbi kunexesha lokulandelelana kweziganeko. Imeko nganye ivavanywa ngokuzimeleyo ukuze kuqinisekiswe esona siphumo sifanelekileyo.

isiphelo

I-Lung Transplantation yinkqubo yokuguqula ubomi enokuthi iphucule kakhulu umgangatho wobomi kwizigulane ezinezifo ezinzima zemiphunga. Ukuqonda inkqubo yokubuyisela, izibonelelo, kunye neendleko ezinokubakho kubalulekile kuye nabani na ocinga ngolu khetho. Ukuba wena okanye umntu omthandayo niphonononga ukuba kunokwenzeka uTshintsho lweLung, kubalulekile ukuthetha nogqirha onokunika isikhokelo nenkxaso yobuqu.