I-Open Thoracotomy - Iindleko, Iimpawu, Ukulungiselela, Iingozi, kunye nokuBuyisa

Utyando lwe-open thoracotomy luyindlela yotyando equka ukwenza umngxuma omkhulu eludongeni lwesifuba ukuze kufikelelwe kwisifuba. Le ndlela ivumela oogqirha ukuba babone kwaye basebenze amalungu angaphakathi kwesifuba, kuquka imiphunga, intliziyo, kunye nemithambo yegazi emikhulu. Injongo ephambili yotyando lwe-open thoracotomy kukuxilonga nokunyanga iimeko ezahlukeneyo ezichaphazela ezi zakhiwo zibalulekileyo.

Ngexesha lenkqubo, ugqirha wenza utyando ecaleni kwesifuba, phakathi kweembambo, nto leyo enokufuna ukuba iimbambo zisasazeke okanye zisuswe okwethutyana ukuze kungeneke ngokwaneleyo. Utyando lwesifuba oluvulekileyo ludla ngokwenziwa phantsi kwe-anesthesia jikelele, ukuqinisekisa ukuba isigulana asikho zingqondweni ngokupheleleyo kwaye asinazintlungu kulo lonke utyando.

Le nkqubo idla ngokusetyenziselwa ukulawula iimeko ezinzima zesifuba. Idla ngokusetyenziselwa ukunyanga umhlaza wemiphunga, ukususa iithumba, ukulungisa imithambo yegazi eyonakeleyo, okanye ukulungisa usulelo olunzima esifubeni. Ukongeza, i-thoracotomy evulekileyo inokufuneka kwiimeko zokulimala, ezifana nezo zibangelwa ziingozi zemoto okanye ukuwa, apho kufuneka ukufikelela ngokukhawuleza kwisifuba ukulawula ukopha okanye ukulungisa ukwenzakala.

Iingenelo ze-Open Thoracotomy

Utyando lwe-thoracotomy oluvulekileyo lubonelela ngophuculo oluphambili lwempilo kunye neziphumo zomgangatho wobomi kwizigulana ezineengxaki ezahlukeneyo zesifuba.

• Ukufikelela ngqo kwi-Thracic Organs: Le nkqubo ivumela oogqirha ukuba bafikelele ngqo kwimiphunga, intliziyo, kunye nezinye izakhiwo zesifuba, nto leyo evumela unyango olupheleleyo lweemeko ezinzima.
• Ukususwa kweTumor okuSebenzayo: Utyando lwesifuba oluvulekileyo lunokuvumela ukufikelela ngokuthe ngqo ngakumbi kwiithumba ezintsonkothileyo okanye ezinkulu, nangona iindlela ezingaphantsi kakhulu zinokubonelela ngeziphumo ezifanayo ze-oncologic kwiimeko zokuqala.
• Umsebenzi oPhuculweyo wokuPhefumla: Ukunyanga izifo zemiphunga okanye ukuvaleka kwayo kunokunceda izigulane ziphefumle lula kwaye kuphucule ukusebenza kwemiphunga.
• Umgangatho woBomi owongeziweyo: Izigulane ezininzi ziphinda zibuyele kwinqanaba lomsebenzi kwaye azibonakali iimpawu emva kokuchacha.

Iimpawu: Kutheni kwenziwa i-Open Thoracotomy

Utyando lwe-open thoracotomy ludla ngokucetyiswa xa iinkqubo ezingangenisi kakhulu, ezifana notyando lwe-thoracoscopic (olwaziwa ngokuba lutyando lwe-video-assisted thoracoscopic okanye i-VATS), zingafanelekanga okanye ziye zasilela ukunika iziphumo ezifanelekileyo. Kukho iimpawu kunye neemeko ezininzi ezinokukhokelela kwisigqibo sokwenza i-open thoracotomy.

Izigulana zinokuba neentlungu zesifuba ezingapheliyo, ubunzima bokuphefumla, okanye ukwehla kobunzima obungachazwanga, oku kunokubonisa iingxaki ezisisiseko ezifana nomhlaza wemiphunga okanye usulelo olunzima olufana ne-pneumonia okanye i-empyema. Kwiimeko zokonzakala, izigulana zinokuba neempawu ezifana neentlungu zesifuba eziqatha, ubunzima bokuphefumla, okanye iimpawu zokothuka, ezifuna utyando olukhawulezileyo.

Utyando lwethoracotomy oluvulekileyo lunokusetyenziswa nakwizigulane ezine-pleural effusion, apho ulwelo luqokelelana kwindawo ye-pleural ejikeleze imiphunga, nto leyo ebangela ingxaki yokuphefumla. Ukuba ulwelo alunakukhutshelwa ngokwaneleyo ngeendlela ezingangenisi kakhulu, kunokufuneka i-open thoracotomy ukuze kususwe ulwelo kwaye kulungiswe unobangela oyintloko.

Ngamafutshane, i-open thoracotomy yenziwa xa kukho imfuneko yokufikelela ngqo kwi-thoracic cavity ukuze kuchongwe okanye kunyangwe izifo ezinzulu ezingenakulawulwa ngeendlela ezingafunekiyo.

Iimeko ezininzi zeklinikhi kunye neziphumo zokuxilongwa zingenza isigulana sibe ngumntu oza kuhlinzwa isifuba esivulekileyo. Ezi mpawu zihlala zivela kwizifundo zemifanekiso, uvavanyo lomzimba, kunye nemeko yempilo yesigulana iyonke. Nazi ezinye zeempawu eziqhelekileyo zenkqubo:

• Umhlaza wemiphunga: Izigulana ezifunyaniswe zinomhlaza wemiphunga zinokufuna i-open thoracotomy ukuze zisuswe i-tumor reseption, ingakumbi ukuba i-tumor inkulu okanye ikwindawo eyenza kube nzima ukuyisusa kusetyenziswa iindlela ezingeyongozi kangako.
• Umonzakalo: Utyando lwesifuba oluvulekileyo ludla ngokuboniswa kwiimeko zokulimala kakhulu esifubeni, njengokuqhekeka kwembambo, ukuqhekeka kwemiphunga, okanye ukwenzakala okukhulu kwemithambo yegazi. Kwezi meko, ukufikelela ngokukhawuleza kwindawo yesifuba kubalulekile ukulawula ukopha nokulungisa izakhiwo ezonakeleyo.
• I-Pleural Effusion: Xa isigulane sibonakala sinomoya omkhulu wokukhupha i-pleural ongenakukwazi ukukhutshelwa ngokwaneleyo nge-thoracentesis okanye ukufakwa kwetyhubhu yesifuba, kunokufuneka i-thoracotomy evulekileyo ukuze kususwe ulwelo kwaye kulungiswe unobangela oyintloko, njengosulelo okanye isifo somhlaza.
• Usulelo: Usulelo olunzima esifubeni, olufana nokuphuma kwegazi okanye amathumba emiphungeni, lunokufuna i-thoracotomy evulekileyo ukuze kukhutshwe amanzi emzimbeni kunye nokususwa kokungcola. Oku kuyinyani ngakumbi xa usulelo lungaphenduli kwii-antibiotics okanye iindlela zokukhupha amanzi ezingaphantsi kokungenelela.
• Ukuzalwa Okungaqhelekanga: Kwezinye iimeko, izigulana ezineziphene zentliziyo ezizalwa nazo okanye ezinye iingxaki zesifuba zinokufuna i-open thoracotomy ukuze kulungiswe utyando.
• Iinkqubo zentliziyo: Ezinye iindlela zotyando lwentliziyo zinokufuna indlela yokususwa kwemithambo yegazi, nangona uninzi, olufana nokulungiswa kwevalvu, ukutshintshwa kwevalvu, kunye nokufakelwa kwemithambo yegazi yentliziyo (i-CABG), lwenziwa nge-sternotomy. Kwiimeko ezithile, i-thoracotomy ingasetyenziselwa iindlela ezingaphantsi kakhulu okanye ezikhethekileyo.
• Uvuko: Kwimeko apho kufuneka kuchongwe isifo esiqinisekileyo, i-open thoracotomy inokwenziwa ukuze kufunyanwe iisampulu zezicubu kwimiphunga okanye kwi-mediastinum ukuze kuhlalutywe ngakumbi.

Ukuqukumbela, isigqibo sokuqhubeka notyando lwe-thoracotomy oluvulekileyo sisekelwe kudibaniso lweempawu zonyango, iziphumo zokuxilonga, kunye nesidingo sokufikelela ngqo kwi-thoracic cavity ukuze kunyangwe ngempumelelo imeko engaphantsi. Le nkqubo idlala indima ebalulekileyo ekulawuleni izifo ezahlukeneyo ze-thoracic kunye nokwenzakala, inika oogqirha ithuba lokufikelela ngokufanelekileyo ekwenzeni amanyathelo okusindisa ubomi.

Izithintelo ze-Open Thoracotomy

Utyando lwe-thoracotomy oluvulekileyo luyindlela ebalulekileyo yotyando equka ukwenza i-incision eludongeni lwesifuba ukuze kufikelelwe kwi-thoracic cavity. Nangona inokusindisa ubomi, iimeko ezithile okanye izinto zinokwenza isigulana singafaneleki kolu tyando. Ukuqonda ezi zithintelo kubalulekile kwizigulana nakubaboneleli bezempilo.

• Isifo Semiphunga Esibi: Izigulane ezinesifo esingapheliyo sokuvaleka kwemiphunga (COPD) esiqhubekekayo okanye isifo sombefu esiqatha zisenokungayinyamezeli kakuhle le nkqubo. Uxinzelelo lotyando kunye ne-anesthesia lunokwandisa iingxaki zokuphefumla.
• Ukungazinzi kwentliziyo nemithambo yegazi: Abantu abanesifo sentliziyo esibalulekileyo, esifana nesifo semithambo yegazi yentliziyo okanye ukusilela kwentliziyo, banokujamelana neengozi ezinkulu ngexesha lotyando. Uxinzelelo entliziyweni ngexesha nasemva kwenkqubo lunokubangela iingxaki.
• Iziphazamiso zeCoagulation: Izigulane ezineengxaki zokopha okanye abo bathatha unyango lwe-anticoagulant basenokungafaneleki. Umngcipheko wokopha kakhulu ngexesha nasemva kotyando unokuba yingozi ebomini.
• Ubukhulu: Ukutyeba kakhulu kunokwenza indlela yotyando ibe nzima kwaye konyuse umngcipheko weengxaki emva kotyando, ezifana nosulelo kunye nokuphola okulibazisekileyo.
• Usulelo: Usulelo olusebenzayo, ingakumbi esifubeni, lunokuba yingozi enkulu. Utyando xa kukho usulelo lunokukhokelela kwiingxaki ezingaphezulu kunye nemiphumo emibi.
• Impilo Embi xa iyonke: Izigulane ezineengxaki ezininzi okanye ezo zibuthathaka zisenokungakwazi ukumelana noxinzelelo lotyando. Uvavanyo olupheleleyo lwempilo iyonke lubalulekile ngaphambi kokuba uqhubeke.
• Utyando Lwangaphambili Lwesifuba: Izigulana ezikhe zenziwa utyando lwesifuba ngaphambili zinokuba nezicwili ezibangela ukuba inkqubo ibe nzima, nto leyo eyenza ukuba i-open thoracotomy ingacebisi kangako.
• Ukwala kwesigulana: Ukuba isigulane asifuni ukwenza olu tyando okanye asiqondi iingozi kunye neenzuzo zalo, kusenokungavumelekanga ukuqhubeka nalo.
• Ubudala obuPhezulu: Ayikokuguga ngokwako kodwa yimpilo iyonke kunye nobuthathaka obubalulekileyo. Izigulane ezindala ezinezinye iingxaki zempilo ezinzulu zinokujongana nemingcipheko ephezulu, ngoko ke ukuhlolwa kwempilo ngokupheleleyo kubalulekile ngaphambi kotyando.
• Ukunqongophala kweNkxaso: Izigulane ezingenazo iinkqubo zokuxhasa ezaneleyo zokuchacha zisenokungabi ngabona bafanelekileyo, njengoko unyango emva kotyando lubalulekile kwiziphumo eziphumelelayo.

Ungayilungiselela njani i-Open Thoracotomy?

Ukulungiselela i-open thoracotomy kubalulekile ukuqinisekisa iziphumo ezilungileyo. Nazi amanyathelo kunye nezinto ekufuneka ziqwalaselwe zizigulana ngaphambi kokuba zingene kule nkqubo:

• Uthethwano lwaPhambi kweNkqubo: Izigulana ziza kudibana neqela lazo lotyando ukuze zixoxe ngale nkqubo, kuquka iingozi zayo, iingenelo zayo, kunye noko kufuneka kulindelwe. Eli lithuba lokubuza imibuzo nokucacisa naziphi na iinkxalabo.
• Uphononongo lweMbali yezoNyango: Kuza kujongwa ngokucokisekileyo imbali yezonyango zesigulana. Oku kuquka ukuxoxa ngazo naziphi na iindlela zotyando zangaphambili, amayeza akhoyo ngoku, ii-allergies, kunye neemeko zempilo ezikhoyo.
• Uvavanyo loMzimba: Uvavanyo olupheleleyo lomzimba luya kunceda ukuvavanya impilo yesigulana iyonke kunye nokuchonga naziphi na iingxaki ezinokuthi zichaphazele utyando.
• Uvavanyo lweempawu: Izigulana zingenza iimvavanyo ezininzi, kuquka:
  • I-X-ray yesifuba: Ukuvavanya impilo yemiphunga nokuchonga naziphi na izinto ezingaqhelekanga.
  • I-CT scan: Ukubonelela ngemifanekiso eneenkcukacha zesifuba kunye nokunceda ukucwangcisa indlela yotyando.
  • Iimvavanyo zoMsebenzi wePulmonary: Ukuvavanya umthamo wemiphunga kunye nomsebenzi.
  • Uvavanyo lweGazi: Ukujonga ukuba akukho anemia, usulelo, kunye nokusebenza kwamalungu omzimba ngokubanzi.
• Ulawulo lwamayeza: Izigulana kusenokufuneka zilungise amayeza azo ngaphambi kotyando. Oku kuquka ukuyeka ukusebenzisa amayeza okunciphisa igazi okanye amanye amayeza anokunyusa umngcipheko wokopha. Kubalulekile ukulandela imiyalelo kagqirha wotyando malunga nolawulo lwamayeza.
• Imiyalelo yokuzila ukutya: Izigulana zihlala ziyalelwa ukuba zingatyi okanye zingaseli kangangexesha elithile ngaphambi kotyando, ngokuqhelekileyo ziqale ngobusuku bangaphambi kotyando. Oku kubalulekile ukunciphisa umngcipheko wokufunxa ngexesha lotyando.
• Ukuyeka Ukutshaya: Ukuba isigulane siyatshaya, siya kukhuthazwa ukuba siyeke okanye ubuncinane sinciphise ukutshaya ngaphambi kokuba kwenziwe olu tyando. Ukutshaya kunokuphazamisa ukuphiliswa kwaye kwandise umngcipheko weengxaki.
• Ukulungiselela iNkxaso: Izigulane kufuneka zilungiselele umntu oza kuzikhapha ukuya esibhedlele aze azincede ngokuzithutha zibuyele ekhaya emva kwenkqubo. Ukuba nenkxaso ngexesha lokuchacha kubalulekile.
• Ucwangciso lwasemva kotyando: Kubalulekile ukuxoxa ngononophelo emva kotyando, kuquka ulawulo lweentlungu, imiqathango yokusebenza komzimba, kunye nokulandela amaxesha okudibana nogqirha. Ukuqonda into onokuyilindela kunokunciphisa ixhala.
• Ukulungiselela ngokweemvakalelo: Kuqhelekile ukuba nexhala ngaphambi kotyando. Izigulana kufuneka zicinge ngokuxoxa ngeemvakalelo zazo nababoneleli bezempilo okanye zifune inkxaso kusapho nakubahlobo.

Amanyathelo eNkqubo yeThoracotomy evulekileyo

Ukuqonda inkqubo yenyathelo ngenyathelo yotyando oluvulekileyo kunokunceda ukucacisa indlela olusebenza ngayo olu tyando kwaye kunciphise ixhala. Nantsi into edla ngokwenzeka ngaphambi, ngexesha, nasemva kotyando:

Ngaphambi kweNkqubo:

• Ukufika esibhedlele: Izigulana ziza kufika esibhedlele ngomhla wotyando. Ziza kubhalisa kwaye zinokuthathwa zisiwe kwindawo yangaphambi kotyando.
• UVavanyo lwangaphambili: Abahlengikazi baza kuthatha iimpawu ezibalulekileyo, bahlole imbali yezonyango, baze baqalise utyando lwe-intravenous (IV) ukuze bafumane amayeza kunye nolwelo.
• Uthethwano lwe-Aneesthesia: I-anesthesiologist iya kudibana nesigulana ukuze sixoxe ngeendlela zokuthomalalisa iintlungu kunye nokujongana nayo nayiphi na inkxalabo.
• Ukumakisha iNdawo yoCando: Ugqirha uza kuphawula indawo apho kuza kunqunyulwa khona ukuqinisekisa ukuchaneka.

Ngexesha leNkqubo:

• Ulawulo lokuthomalalisa: Xa sele ekwigumbi lotyando, isigulana siya kufumana i-anesthesia jikelele, ukuqinisekisa ukuba asizi nto kwaye asinazintlungu ngexesha lotyando.
• Ukusika: Ugqirha uza kwenza umngxuma omkhulu ecaleni kwesifuba, ngokuqhelekileyo phakathi kweembambo, ukuze afikelele emngxunyeni wesifuba.
• Ukufikelela kwiMiphunga okanye kwiNtliziyo: Ngokuxhomekeke kwisizathu sotyando, ugqirha wotyando unokufuna ukususa inxalenye yomphunga, ukulungisa ivalvu yentliziyo, okanye ukulungisa ezinye iingxaki zesifuba.
• Ungenelelo ngotyando: Inkqubo ethile iya kwahluka ngokuxhomekeke kwisifo. Oku kunokubandakanya ukususa iithumba, ukukhupha ulwelo, okanye ukulungisa izicubu ezonakeleyo.
• Ukuvalwa: Xa utyando lugqityiwe, ugqirha uza kuvala isilonda esebenzisa i-sutures okanye i-staples. Ityhubhu yesifuba ingafakwa ukunceda ekukhupheni naluphi na ulwelo okanye umoya onokuqokelelana.

Emva kweNkqubo:

• Igumbi lokubuyisela: Izigulana ziza kusiwa kwindawo yokuchacha apho ziza kubekwa esweni xa zivuka emva kokusebenzisa i-anesthesia. Iimpawu ezibalulekileyo ziya kujongwa ngokusondeleyo.
• Ulawulo lweentlungu: Ukunciphisa iintlungu kuya kunikwa ngamayeza, kwaye izigulana ziya kukhuthazwa ukuba zichaze nayiphi na ingxaki.
• Ulawulo lweThubhu yeSifuba: Ukuba kufakwe ityhubhu yesifuba, iya kuhlolwa ukuba ayikhuphi amanzi kwaye inokuhlala apho kangangeentsuku ezininzi.
• UkuHlanganisa ngokuthe ngcembe: Izigulana ziya kukhuthazwa ukuba ziqale ukushukuma ngokukhawuleza nje ukuba zizinzile. Oku kunceda ukuthintela iingxaki ezifana nokuqhekeka kwegazi kwaye kukhuthaza ukusebenza kakuhle kwemiphunga.
• Ukuhlala esibhedlele: Ubude bokuhlala buyahluka ngokuxhomekeke ekuchacheni komntu kodwa ngokuqhelekileyo buqala kwiintsuku ezimbalwa ukuya kwiveki.

Ukubuyiselwa Emva kwe-Open Thoracotomy

Ukuchacha emva kotyando oluvulekileyo lwesifuba yinkqubo ebalulekileyo efuna umonde kunye nokunamathela kwiingcebiso zonyango. Ixesha elilindelekileyo lokuchacha linokwahluka ngokusekwe kwiimeko zempilo zomntu ngamnye, ubungakanani botyando, kunye nazo naziphi na iingxaki ezinokuvela. Ngokubanzi, izigulana zinokulindela ukuhlala esibhedlele malunga neentsuku ezi-5 ukuya kwezi-7 emva kotyando, kuxhomekeke kwinkqubela yazo yokuchacha. Kwiimeko ezithile, izigulana zinokufumana utshintsho oluhlala ixesha elide ekusebenzeni kwemiphunga okanye ukuphinda kwesimo esingundoqo, kuxhomekeke kwisifo esinyangiweyo.

Ixesha elilindelekileyo lokuBuyisa kwakhona:

• IVeki yokuqala: Izigulana ziya kuva iintlungu kunye nokungonwabi, nto leyo enokulawulwa ngamayeza amiselweyo. Ukuzilolonga ukuphefumla kunye nokuqalisa kwangethuba kuyakhuthazwa ukuthintela iingxaki ezifana ne-pneumonia.
• Iiveki 2-4: Izigulane ezininzi zinokunyusa kancinci kancinci amanqanaba azo okusebenza. Imisebenzi elula efana nokuhamba ingaqaliswa, kodwa ukuphakamisa izinto ezinzima kunye nokuzilolonga okunzima kufuneka kuphetshwe.
• Iiveki 4-6: Ngeli xesha, uninzi lwezigulane lunokubuyela kwimisebenzi elula okanye kwimisebenzi yemihla ngemihla. Nangona kunjalo, ukuchacha ngokupheleleyo kungathatha ukuya kuthi ga kwiinyanga ezi-3, ingakumbi kwabo benza utyando olukhulu.

Iingcebiso zoLondolozo lwasemva:

• Ulawulo lweentlungu: Landela imiyalelo kagqirha wakho malunga namayeza eentlungu. Kubalulekile ukulawula iintlungu ngokufanelekileyo ukuze kube lula ukwenza umthambo wokuphefumla.
• Imithambo yokuphefumla: Ukuphefumla nzulu kunye nokuzilolonga ukukhohlela kubalulekile ukuthintela iingxaki zemiphunga. Sebenzisa i-spirometer yokukhuthaza ukuba ikhona.
• Ukhathalelo lwamanxeba: Gcina indawo yotyando icocekile kwaye yomile. Jonga iimpawu zosulelo, njengokunyuka kobomvu, ukudumba, okanye ukukhupha.
• Ukutya: Ukutya okunesondlo okutyebileyo kwiproteni kunokunceda ekubuyiseleni impilo. Hlala unamanzi emzimbeni kwaye ucinge ngokutya okuncinci rhoqo ukuze kube lula ukugaya ukutya.
• Ukuqeshwa kolandelo: Yiya kulo lonke utyelelo lokulandelela olucwangcisiweyo ukujonga ukuchacha kwakho kunye nokujongana nayo nayiphi na inkxalabo.

Imisebenzi Eqhelekileyo Ingaphinda Iqalise Nini?

Uninzi lwezigulana lunokubuyela kwimisebenzi eqhelekileyo kwiiveki ezi-6 ukuya kwezili-12, kodwa oku kuyahluka. Nxibelelana nomboneleli wakho wezempilo ukuze ufumane iingcebiso ezihambelana nenkqubela yakho yokuchacha.

Iingozi kunye neengxaki ze-Open Thoracotomy

Njengayo nayiphi na inkqubo yotyando, i-open thoracotomy ineengozi. Nangona izigulane ezininzi zenza utyando ngaphandle kweengxaki, kubalulekile ukuqaphela iingozi eziqhelekileyo nezingaqhelekanga.

Imingcipheko eqhelekileyo:

• nantlungu: Iintlungu emva kotyando kulindeleke kwaye zinokulawulwa ngamayeza.
• Usulelo: Kukho umngcipheko wokosuleleka kwindawo yokusika okanye ngaphakathi kwimiphunga. Ii-antibiotics zinganikwa ukunciphisa lo mngcipheko.
• Ukuhlamba: Ukopha okuthile kuyinto eqhelekileyo, kodwa ukopha kakhulu kunokufuna amanyathelo ongezelelweyo.
• Iingxaki zokuphefumla: Izigulana zinokuba nengxaki yokuphefumla okanye i-pneumonia, ingakumbi ukuba zineengxaki zemiphunga esele zikhona.
• Amahlwili egazi: Kukho umngcipheko wokuba negazi eliqhekekileyo emilenzeni, nto leyo enokubangela iingxaki ezingakumbi ukuba ziya emiphungeni.

Imingcipheko enqabileyo:

• Iingxaki ze-Anesthesia: Nangona kunqabile, ezinye izigulana zinokuba neempendulo ezingalunganga kwi-anesthesia, kuquka neempendulo ze-allergy okanye iingxaki zokuphefumla.
• Ukwenzakala kwilungu: Kukho umngcipheko omncinci wokwenzakala kwamalungu angqongileyo, njengentliziyo, imiphunga, okanye imithambo yegazi emikhulu.
• Ubuhlungu obungapheliyo: Ezinye izigulana zisenokuva iintlungu eziqhubekayo kwindawo yokusikwa, eyaziwa ngokuba yi-post-thoracotomy pain syndrome.
• Pneumothorax: Le yimeko engaqhelekanga kodwa imbi kakhulu apho umoya uvuza kwindawo ephakathi kwemiphunga nodonga lwesifuba, nto leyo ebangela ukuba imiphunga iwe.
• Utshintsho kumsebenzi wemiphunga wexesha elide: Kwezinye iimeko, izigulana zinokufumana utshintsho kwindlela esebenza ngayo imiphunga, ingakumbi ukuba inxenye enkulu yezicubu zemiphunga isusiwe.
• Iziphumo zexesha elide: Ezinye izigulana zinokuphinda zibuyele kwimeko yazo (ezifana nokubuyela umva kwethumba okanye usulelo olungapheliyo) okanye utshintsho oluqhubekayo ekusebenzeni kwemiphunga, kuxhomekeke kwisifo esinyangiweyo.

Ukuqukumbela, nangona i-open thoracotomy ibaluleke kakhulu kwiimeko ezahlukeneyo zesifuba, ukuqonda izithintelo, amanyathelo okulungiselela, iinkcukacha zenkqubo, kunye neengozi ezinokubakho kunokunika amandla izigulana ukuba zenze izigqibo ezinolwazi malunga nempilo yazo. Soloko unxibelelana neengcali zempilo ukuqinisekisa iziphumo ezilungileyo.

Utyando lweThoracoscopic oluVulekileyo vs. oluncediswa yiVidiyo (VATS)

Nangona utyando lwe-open thoracotomy luyindlela yendabuko, utyando lwe-thoracoscopic oluncediswa yividiyo (i-VATS) lukhetho olungenakungenelela kakhulu. Nantsi intengiselwano yeenkqubo ezimbini:

Ixabiso le-Open Thoracotomy eIndiya

Ixabiso eliqhelekileyo lotyando lwesifuba oluvulekileyo eIndiya liqala kwi-₹1,00,000 ukuya kwi-₹3,00,000. Iindleko ziyahluka ngokuxhomekeke kwisibhedlele, isixeko, kunye nobunzima. Izigulana kufuneka zibonane nesibhedlele sazo ukuze zifumane uqikelelo olukhethekileyo.

Imibuzo Ebuzwa Rhoqo Malunga ne-Open Thoracotomy

Ndifanele nditye ntoni emva kokuhlinzwa kwesifuba? 

Emva kotyando, gxila ekutyeni okunesondlo okutyebileyo kwiproteni, iivithamini, kunye neeminerali ukunceda ekupholeni. Ukutya okufana nenyama engenamafutha, intlanzi, amaqanda, ubisi, iziqhamo kunye nemifuno kuyanceda. Hlala unamanzi emzimbeni kwaye ucinge ngokutya okuncinci, rhoqo ukuze uphephe ukungonwabi.

Ndizakuhlala ixesha elingakanani esibhedlele? 

Uninzi lwezigulane zihlala esibhedlele malunga neentsuku ezi-5 ukuya kwezi-7 emva kokuhlinzwa kwesifuba. Ixesha lakho elichanekileyo linokwahluka ngokuxhomekeke kwinkqubela yakho yokuchacha kunye nazo naziphi na iingxaki ezinokuvela.

Ndingaqhuba emva kotyando? 

Ngokwesiqhelo kuyacetyiswa ukuba ungaqhubi imoto ubuncinane iiveki ezi-4 ukuya kwezi-6 emva kotyando, okanye ude ugqirha wakho akunike imvume. Oku kukuqinisekisa ukuba ungasabela ngokukhawuleza xa kuvela imeko engxamisekileyo ngaphandle kwentlungu okanye ukungonwabi.

Zeziphi izinto endinokuzenza ngexesha lokuchacha? 

Imisebenzi elula efana nokuhamba iyakhuthazwa ukukhuthaza ukujikeleza kwegazi nokusebenza kwemiphunga. Nangona kunjalo, kuphephe ukuphakamisa izinto ezisindayo, ukuzilolonga okunzima, kunye nayo nayiphi na imisebenzi ecinezela isifuba sakho ubuncinane iiveki ezi-6.

Ndingayilawula njani intlungu emva kotyando? 

Landela isicwangciso solawulo lweentlungu sikagqirha wakho, esinokubandakanya amayeza amiselweyo. Sebenzisa iipakethi zomkhenkce kwindawo yotyando ukunceda ukunciphisa ukudumba nokungonwabi kwaye uziqhelise ukuphefumla nzulu ukuze uthomalalise iintlungu.

Ndingabuyela nini emsebenzini? 

Ixesha lokubuyela emsebenzini liyahluka. Uninzi lwezigulana lunokuphinda luqalise umsebenzi olula kwiiveki ezi-6 ukuya kwezili-12 kodwa qhagamshelana nomboneleli wakho wezempilo ukuze akunike iingcebiso ezisekelwe ekuchacheni kwakho.

Zeziphi iimpawu zosulelo endifanele ndizijonge? 

Jonga indawo otyandwe kuyo ukuze ubone ukuba kukho ukubomvu okwandileyo, ukudumba, ubushushu, okanye ukukhupha ulwelo. Umkhuhlane, ukubanda, okanye iintlungu eziya zisiba mandundu nazo zinokubonisa usulelo. Nxibelelana nogqirha wakho ukuba ubona naziphi na kwezi mpawu.

Ndingahlamba emva kotyando? 

Ungazihlamba emva kokuba ugqirha wakho ekunike imvume, ngesiqhelo emva kweentsuku ezimbalwa emva kotyando. Kuphephe ukumanzisa inxeba emanzini lide liphole ngokupheleleyo.

Ndingenza ntoni xa ndinengxaki yokuphefumla? 

Ukuba unengxaki yokuphefumla, nxibelelana nomboneleli wakho wezempilo ngoko nangoko. Kubalulekile ukujongana nayo nayiphi na ingxaki yokuphefumla ngokukhawuleza, kuba ingabonisa iingxaki.

Ngaba kukho naziphi na izithintelo zokutya emva kotyando? 

Nangona kungekho miqathango ingqongqo yokutya, kungcono ukuphepha ukutya okunzima nokunamafutha okunokubangela ukungakhululeki. Gxila ekutyeni okunesondlo ukuze uxhase ukuphiliswa.

Ndingakuxhasa njani ukuchacha kwam? 

Yenza umthambo olula, landela icebiso likagqirha wakho, gcina ukutya okunempilo, kwaye uhlale unamanzi aneleyo emzimbeni. Inkxaso yeemvakalelo evela kusapho nakubahlobo inokukunceda ekuchacheni kwakho.

Kuthekani ukuba ndinemeko esele ikhona? 

Yazisa umboneleli wakho wezempilo malunga nazo naziphi na iimeko ezikhoyo, njengoko zinokuchaphazela ukuchacha kwakho. Iqela lakho lezonyango liza kulungelelanisa isicwangciso sakho sokhathalelo ngokufanelekileyo.

Ndingahamba emva kotyando? 

Kucetyiswa ukuba ungahambi umgama omde kangangeeveki ezi-6 emva kotyando. Xoxa ngezicwangciso zakho zokuhamba nogqirha wakho ukuqinisekisa ukuba zikhuselekile kuwe.

Ndingenza ntoni xa ndiziva ndixhalabile malunga nokuchacha? 

Kuqhelekile ukuba nexhala emva kotyando. Cinga ngokuxoxa ngeemvakalelo zakho nomboneleli wakho wezempilo okanye ingcali yezempilo yengqondo. Amaqela enkxaso nawo anokuba luncedo.

Kukangaphi apho ndiya kufuna idinga lokulandelisa? 

Amadinga okulandela emva kotyando adla ngokucwangciswa rhoqo emva kweeveki ezimbalwa kwiinyanga ezimbalwa zokuqala emva kotyando. Ugqirha wakho uya kujonga indlela ochacha ngayo aze alungise isicwangciso sakho sokhathalelo njengoko kufuneka.

Ndingangena na kwi-physiotherapy? 

Ewe, unyango lomzimba lunokuba luncedo ekuchacheni kwakho. Ugqirha wakho unokucebisa inkqubo eyenzelwe wena ukunceda ekubuyiseleni amandla kunye nokuhambahamba.

Kuthekani ukuba ndinabantwana? 

Ukuba unabantwana, lungiselela uncedo ngexesha lokuchacha kwakho. Nciphisa imisebenzi yomzimba nabo ude uzive unamandla kwaye uxelele usapho lwakho ngeemfuno zakho.

Ngaba kuqhelekile ukuziva udiniwe emva kotyando? 

Ewe, ukudinwa kuqhelekile emva kotyando. Umzimba wakho uyaphola, kwaye kubalulekile ukuphumla nokuzinika ixesha lokuphola ngokupheleleyo.

Ndingenza ntoni xa ndifumana iintlungu esifubeni? 

Ukuba uva iintlungu esifubeni, nxibelelana nomboneleli wakho wezempilo ngoko nangoko. Nangona ukungonwabi okuthile kuyinto eqhelekileyo, iintlungu ezinzima okanye eziya zisiba mandundu kufuneka zihlolwe.

Ndingalilungiselela njani ikhaya lam ukuba lichache? 

Lungisa ikhaya lakho ngokuqinisekisa ukufikelela lula kwizinto ezibalulekileyo, ukususa iingozi ezinokubangela ukukhubeka, kunye nokulungiselela uncedo ngemisebenzi yemihla ngemihla. Indawo yokuchacha ekhululekileyo inokukunceda kwinkqubo yakho yokuchacha.

isiphelo

Utyando lwe-open thoracotomy luyindlela ebalulekileyo yotyando enokuphucula kakhulu iziphumo zempilo kwizigulana ezineemeko ezahlukeneyo zesifuba. Ukuqonda inkqubo yokuchacha, iingenelo, kunye nezinye iindlela ezinokubakho kunokunika amandla izigulana ukuba zenze izigqibo ezinolwazi malunga nonyango lwazo. Soloko unxibelelana neengcali zonyango ukuze uxoxe ngemeko yakho ethile kwaye uqinisekise iziphumo ezilungileyo.