Ukuhlobisa i-Empyema - Izindleko, Izinkomba, Ukulungiselela, Izingozi, Nokululama

Ukuhlobisa i-empyema inqubo yokuhlinzwa ehloselwe ukwelapha isimo esaziwa ngokuthi i-empyema, okuwukuqongelela kobomvu esikhaleni se-pleural—indawo ephakathi kwamaphaphu nodonga lwesifuba. Lesi simo sivame ukuvela njengenkinga ye-pneumonia, amathumba emaphashini, noma ukulimala kwesifuba, okuholela ekuthelelekeni nasekuvuvukeni. Umgomo oyinhloko wokuhlobisa i-empyema ukususa ungqimba olujiyile lwezicubu ("isikhumba") olwakheka nxazonke zamaphaphu ngenxa yokutheleleka, okuvumela amaphaphu ukuthi akhule ngokugcwele futhi asebenze kahle futhi.

Ngesikhathi senqubo yokuhlobisa, udokotela ohlinzayo usika udonga lwesifuba ukuze afinyelele isikhala se-pleural. Udokotela ohlinzayo ube esesusa ngokucophelela izinto ezithelelekile kanye nezicubu ezinemicu ezivele zakhiwe. Lokhu akusizi nje kuphela ukususa ukutheleleka kodwa futhi kubuyisela ikhono lamaphaphu lokukhula nokufinyela, okubalulekile ekuphefumuleni okuvamile. Le nqubo ingenziwa kusetshenziswa ukuhlinzwa okuvulekile kwendabuko noma amasu angangenisi kakhulu, kuye ngesimo sesiguli kanye nobuchwepheshe bukadokotela ohlinzayo.

Ukuhlobisa i-empyema kuvame ukwenziwa lapho ezinye izindlela zokwelapha, njengemithi elwa namagciwane noma ukukhipha uketshezi lwe-pleural, zehlulekile ukuxazulula ukutheleleka. Ngokubhekana nezinkinga eziyisisekelo ezibangela i-empyema, le nqubo ingathuthukisa kakhulu ikhwalithi yokuphila kwesiguli kanye nomsebenzi wokuphefumula.
 

Kungani kwenziwa i-Decortication ye-Empyema?

Ukuhlobisa i-empyema kuyanconywa lapho isiguli sibonisa izimpawu ze-empyema ezingathuthuki ngokwelashwa okulondolozayo. Izimpawu ezivamile zifaka phakathi ukukhwehlela okuqhubekayo, ubuhlungu besifuba, umkhuhlane, ubunzima bokuphefumula, kanye nokukhathala. Lezi zimpawu zingathinta kakhulu impilo yansuku zonke yesiguli kanye nenhlalakahle iyonke.

I-Empyema ivame ukukhula njengenkinga ye-pneumonia, lapho ukutheleleka kusakazekela khona endaweni ye-pleural, okuholela ekuqongeleleni kobomvu. Ezinye izimbangela zingafaka phakathi amathumba emaphashini, isifo sofuba, noma izinkinga zangemva kokuhlinzwa. Lapho umzimba uzama ukulwa nokutheleleka, kungaholela ekwakhekeni kwengqimba ejiyile, enemicu ezungeze amaphaphu, evimbela ukunyakaza kwawo futhi ingabangela izinkinga ezengeziwe.
 

Ukuhlobisa ngokuvamile kunconywa uma:

• Ukwelashwa Okulondolozayo Kuyehluleka: Uma ama-antibiotic kanye nezinqubo zokukhipha amanzi emzimbeni, njenge-thoracentesis noma ukufakwa kwepayipi lesifuba, kungaxazululi ngokwanele ukutheleleka noma uma i-empyema iphinde ivele, ukungenelela kokuhlinzwa kungadingeka.
• I-Empyema Engapheli: Iziguli ezine-empyema engapheli, lapho ukutheleleka kuqhubeke isikhathi eside, zingase zibe ne-pleural peel ejiyile edinga ukususwa ngokuhlinzwa ukuze kubuyiselwe ukusebenza kwamaphaphu.
• Izimpawu ezinzima: Iziguli ezibhekene nokucindezeleka okukhulu kokuphefumula noma ukukhubazeka okukhulu ekusebenzeni kwamaphaphu zingazuza ngokuhlobisa ukuze kuncishiswe izimpawu futhi kuthuthukiswe ikhwalithi yokuphila kwazo.
• Imiphumela yesithombe: Ama-X-ray esifubeni noma ama-CT scan angase aveze ukuthi kukhona i-empyema etholakala endaweni ethile, okubonisa ukuthi ubomvu buvaleleke emaphaketheni ngaphakathi kwesikhala se-pleural. Lokhu kungadinga ukuhlinzwa ukuze kususwe ukutheleleka ngempumelelo.

Ngokwenza ukuhlanza i-empyema, abahlinzeki bezempilo bahlose ukuqeda umthombo wokutheleleka, ukubuyisela ukusebenza kwamaphaphu, futhi ekugcineni bathuthukise impilo nenhlalakahle yesiguli iyonke.
 

Izinkomba zokuhlotshiswa kwe-Empyema

Izimo eziningana zezokwelapha kanye nokutholakele kokuxilonga kungabonisa isidingo sokuhlanza i-empyema. Ukuqonda lezi zinkomba kubalulekile kokubili ezigulini kanye nabahlinzeki bezempilo ekunqumeni inkambo efanele yesenzo. Nazi izinkomba eziyinhloko zale nqubo yokuhlinzwa:

• I-Empyema Eqhubekayo Noma Ephindaphindayo: Uma isiguli sitholakale sinesifo sokukhipha indle esingaphenduli ekwelashweni ngama-antibiotic noma ekwelashweni kokukhipha amanzi emzimbeni, kungase kudingeke ukuthi kukhishwe indle. Lokhu kuyiqiniso ikakhulukazi ezigulini ezithola izigameko eziphindaphindayo zokukhipha indle naphezu kokwelashwa.
• Izimpawu Ezingamahlalakhona: Iziguli ezinezimpawu ezingamahlalakhona ezihlobene nokuphelelwa ngamandla, njengokukhwehlela okuqhubekayo, ubuhlungu besifuba, kanye nobunzima bokuphefumula, zingase zibe ngabantu abazohlolwa. Lezi zimpawu zingathinta kakhulu ikhwalithi yokuphila kwesiguli futhi zingase zibonise ukuthi ukutheleleka akukapheli.
• Imiphumela Yezithombe: Ukuthwebula izithombe, njenge-X-ray yesifuba noma i-CT scans, kungaveza ukuthi kukhona i-pleural peel ejiyile noma i-loculated empyema. Lokhu okutholakele kusikisela ukuthi ukutheleleka akukhona nje kuphela ukuthi kukhona kodwa futhi kuyinkimbinkimbi ngokwakhiwa kwezicubu ze-fibrous ezivimbela ukwanda kwamaphaphu.
• Ukwehluleka Kwezindlela Zokungenelela Ezingezona Ezokuhlinzwa: Uma ukungenelela okungekona ukuhlinzwa, njengokugeleza kwepayipi lesifuba noma i-thoracentesis, kwehlulekile ukukhipha i-empyema ngokwanele noma uma uketshezi luphinde luqongelela, ukuhlobisa kungase kudingeke ukuze kususwe izicubu ezine-fibrous futhi kuvumele ukusebenza kahle kwamaphaphu.
• Ukucindezeleka Okukhulu Kokuphefumula: Iziguli ezibhekene nokucindezeleka okukhulu kokuphefumula ngenxa yokuphelelwa ngamandla zingadinga ukuhlinzwa okuphuthumayo. Ukuhlobisa kungasiza ekunciphiseni izimpawu nokuthuthukisa ukusebenza kwamaphaphu, kunikeze isiguli impumuzo.
• Izimo eziyisisekelo: Izimo ezithile zempilo eziyisisekelo, njengokucindezela amasosha omzimba noma izifo zamaphaphu ezingamahlalakhona, zingandisa ingozi yokuthola i-empyema futhi zenze ukwelashwa kwayo kube nzima. Ezimweni ezinjalo, ukuhlanza kungacatshangwa ukuvimbela izinkinga ezengeziwe nokuthuthukisa impilo yesiguli iyonke.

Ngokubona lezi zinkomba, abahlinzeki bezempilo bangenza izinqumo ezinolwazi mayelana nesidingo sokuhlanza i-empyema, baqinisekise ukuthi iziguli zithola ukunakekelwa okufika ngesikhathi nangokufanele.
 

Izinhlobo Zokuhlobisa I-Empyema

Nakuba kungekho izinhlobo ezichazwe ngokusemthethweni zokuhlanza i-empyema, inqubo ingafinyelelwa ngezindlela ezahlukene ngokusekelwe esimweni esithile sesiguli kanye nolwazi lukadokotela ohlinzayo. Izindlela ezimbili eziyinhloko ezisetshenziswa ekuhlanzeni i-empyema yilezi:

• Ukuhlobisa Okuvulekile: Le ndlela yendabuko ihilela ukwenza ukusika okukhulu odongeni lwesifuba ukuze kufinyelelwe esikhaleni se-pleural ngqo. Udokotela ohlinzayo ususa izinto ezithelelekile kanye nezicubu ezinemicu ezizungeze amaphaphu. Ukuhlobisa okuvulekile kuvumela umbono ophelele we-pleural cavity futhi kuvame ukusetshenziswa ezimweni eziyinkimbinkimbi lapho kudingeka khona ukususwa okukhulu kwezicubu.
• Ukuhlobisa i-Thoracoscopic Surgery (VATS) ngosizo lwevidiyo: Le ndlela engangenisi kakhulu isebenzisa ukusikwa okuncane kanye nekhamera ukuqondisa udokotela ohlinzayo ekususeni izicubu ezinegciwane. Ukuhlanza i-VATS kuvame ukuholela ebuhlungwini obuncane ngemva kokuhlinzwa, izikhathi ezimfushane zokululama, kanye nezibazi ezincishisiwe uma kuqhathaniswa nokuhlanza okuvulekile. Ngokuvamile kuyathandwa ezigulini ezinezifo ezincane noma lapho udokotela ohlinzayo enolwazi ngale ndlela.

Zombili lezi zindlela zihlose ukufeza umgomo ofanayo: ukususa izicubu ezinemicu kanye nobomvu esikhaleni se-pleural, okuvumela iphaphu ukuthi liphinde lande futhi lisebenze kahle. Ukukhetha indlela yokwelapha kuncike ezicini ezahlukahlukene, okuhlanganisa ubukhulu be-empyema, impilo yesiguli iyonke, kanye nokukhetha kukadokotela ohlinzayo.

Ekuphetheni, ukuhlanza i-empyema kuyindlela ebalulekile yokuhlinzwa ebhekana nezinkinga ezivela ekubulaleni i-empyema, ukubuyisela ukusebenza kwamaphaphu nokuthuthukisa ikhwalithi yokuphila kweziguli. Ukuqonda inqubo, izinkomba zayo, kanye nezindlela ezahlukene kunganika iziguli amandla okwenza izinqumo ezinolwazi mayelana nezinketho zazo zokwelapha.
 

Contraindications for Decortication for Empyema

Ukuhlobisa i-empyema inqubo yokuhlinzwa ehlose ukususa ulwelwesi lwe-pleural olujiyile olungavela ngenxa yokutheleleka noma ukuvuvukala endaweni ye-pleural. Nakuba le nqubo ingasindisa impilo futhi ithuthukise kakhulu ikhwalithi yokuphila kweziguli eziningi, kunezimo ezithile nezici ezingenza isiguli singafaneleki ukuhlobisa i-empyema. Ukuqonda lezi ziphazamiso kubalulekile kokubili ezigulini nakubahlinzeki bezempilo.

• I-Comorbidities Enzima: Iziguli ezinezinkinga zempilo ezibalulekile, njengesifo senhliziyo esibi, isifo sikashukela esingalawuleki, noma isifo samaphaphu esithuthukile, zingase zingakubekezeleli ukucindezeleka kokuhlinzwa. Lezi zimo zingandisa ingozi yezinkinga ngesikhathi nangemva kwenqubo.
• Umsebenzi Ongemuhle We-Pulmonary: Abantu abanenkinga yokusebenza kwamaphaphu, njengoba kuboniswe ukuhlolwa kokusebenza kwamaphaphu, bangase bangabi ngabantu abafanele ukuhlanza amaphaphu. Ukuhlinzwa kungaphazamisa kakhulu ukusebenza kokuphefumula, okuholela ezinkingeni ezifana nokwehluleka kokuphefumula.
• Ukutheleleka Okungalawulwa: Uma isiguli sinesifo esisebenzayo, esingalawuleki esisakazeke ngale kwesikhala se-pleural, ukwenza ukuhlanza kungase kungafaneleki. Ukuba khona kokutheleleka okusemzimbeni kungenza kube nzima ukululama futhi kwandise ingozi ye-sepsis.
• Ububi: Iziguli ezinezimila ezinobungozi ezaziwayo esikhaleni se-pleural noma ezakhiweni ezizungezile zingase zingazuzi ekuhlobiseni. Ezimweni ezinjalo, kungase kudingeke ukuthi kugxilwe ekunakekelweni kobuhlungu kunokungenelela kokuhlinzwa.
• Ukunamathela noma i-Fibrosis: Ukunamathela okukhulu noma i-fibrosis esikhaleni se-pleural kungenza inqubo ibe nzima. Uma i-pleura ijiyile kakhulu noma inamathela ezakhiweni ezizungezile, kungaba nzima ukwenza ukuhlanza ngokuphephile.
• Okuthandwayo Kwesiguli: Ezinye iziguli zingase zikhethe ukungahlinzwa ngenxa yezinkolelo zazo, ukwesaba inqubo, noma ukukhathazeka ngokululama. Imvume enolwazi ibalulekile, futhi ukuzimela kwesiguli kumele kuhlonishwe.
• Ukucatshangelwa kweminyaka: Nakuba ubudala bodwa bungeyona into ephikisanayo ngokuqinile, iziguli esezikhulile zingase zibe nengozi enkulu yezinkinga. Ukuhlolwa okuphelele kwempilo yazo iyonke kanye nesimo sazo sokusebenza kuyadingeka ngaphambi kokuba ziqhubeke.
• Ukukhuluphala: Ukukhuluphala ngokweqile kungenza kube nzima ukufinyelela kokuhlinzwa futhi kwandise ingozi yezinkinga zangemva kokuhlinzwa, njengokutheleleka kwamanxeba nezinkinga zokuphefumula.
• Izinkinga ze-Coagulation: Iziguli ezinezinkinga zokopha noma labo abasebenzisa ukwelashwa okuvimbela ukuphuma kwegazi bangase babhekane nezingozi ezengeziwe ngesikhathi sokuhlinzwa. Ukuphathwa ngokucophelela kwalezi zimo kubalulekile ngaphambi kokucabangela ukuhlanza.

Ngokubona lezi ziphazamiso, abahlinzeki bezempilo bangahlola kangcono izingozi nezinzuzo zokuhlobisa i-empyema, baqinisekise ukuthi iziguli zithola ukunakekelwa okufanele kakhulu okufanelana nezimo zazo.
 

Indlela Yokulungiselela Ukuhlobisa I-Empyema

Ukulungiselela ukuhlanza i-empyema kuhilela izinyathelo eziningana ezibalulekile ukuqinisekisa umphumela omuhle kakhulu. Iziguli kufanele zibe nolwazi oluphelele futhi zihlanganyele ngenkuthalo ekulungiseleleni kwazo kwangaphambi kwenqubo. Nakhu ongakulindela:

• Ukubonisana Ngaphambi Kwenqubo: Iziguli zizoba nokubonisana okuningiliziwe nodokotela wazo ohlinzayo. Leli yithuba lokuxoxa ngenqubo, izinzuzo zayo, izingozi, nokuthi yini okufanele uyilindele ngesikhathi sokululama. Iziguli kufanele zizizwe zikhululekile ukubuza imibuzo nokuveza noma yikuphi ukukhathazeka.
• Ukubuyekezwa Komlando Wezokwelapha: Kuzobuyekezwa umlando wezokwelapha wesiguli ngokuphelele. Lokhu kuhlanganisa nokuxoxa nganoma yikuphi ukuhlinzwa kwangaphambilini, imithi yamanje, ukungezwani komzimba, kanye nezimo zempilo ezikhona. Kubalulekile ukunikeza ulwazi oluphelele nolunembile.
• Ukuhlolwa Komzimba: Kuzohlolwa umzimba ngokuphelele ukuze kuhlolwe impilo yesiguli iyonke kanye nokufaneleka kwaso ukuhlinzwa. Lokhu kungafaka phakathi ukuhlola izimpawu ezibalulekile, ukusebenza kwamaphaphu, kanye nesimo somzimba jikelele.
• Ukuhlolwa kokuxilonga: Iziguli zingase zenze izivivinyo eziningana ukuze zihlole isimo sazo sempilo kanye nobukhulu be-empyema. Izivivinyo ezivamile zifaka:
  • I-X-ray yesifuba noma i-CT Scan: Lezi zifundo ze-imaging zisiza ukubona ngeso lengqondo isikhala se-pleural nokuhlola ubukhulu be-empyema.
  • Ukuhlolwa Kwegazi: Ukuhlolwa kwegazi okuvamile kuzohlola ukutheleleka, ukusebenza kwesibindi nezinso, kanye nekhono lokujiya kwegazi.
  • Ukuhlolwa Kokusebenza Kwamaphaphu: Lokhu kuhlolwa kulinganisa amandla kanye nokusebenza kwamaphaphu, okusiza ekunqumeni ukuthi isiguli singakubekezelela yini ukuhlinzwa.
• Ukuphathwa Kwemithi: Iziguli kungadingeka zilungise imithi yazo ngaphambi kwenqubo. Lokhu kuhlanganisa ukuyeka imithi yokunciphisa igazi noma eminye imithi engandisa ingozi yokopha. Kubalulekile ukulandela imiyalelo kadokotela ohlinzayo mayelana nokuphathwa kwemithi.
• Imiyalelo yokuzila ukudla: Iziguli ngokuvamile zizoyalwa ukuba zizile ukudla isikhathi esithile ngaphambi kokuhlinzwa, ngokuvamile kusukela ngobusuku obandulele. Lokhu kusho ukuthi akuvunyelwe ukudla noma ukuphuza, okuhlanganisa namanzi, ukuze kuncishiswe ingozi yokufutha ngesikhathi sokuhlinzwa.
• Ukuhlela ezokuthutha: Njengoba ukuhlanza ngokuvamile kwenziwa ngaphansi kwe-anesthesia ejwayelekile, iziguli zizodinga umuntu ozozihambisa ekhaya ngemoto ngemva kwenqubo. Kubalulekile ukuhlela ukuba umuntu omdala onokwethenjelwa asize.
• Ukuhlelwa Kokunakekelwa Kwangemva Kokuhlinzwa: Iziguli kufanele zixoxe ngokunakekelwa kwangemva kokuhlinzwa nethimba lazo lezokunakekelwa kwempilo. Lokhu kuhlanganisa ukuqonda ukuphathwa kobuhlungu, ukunakekelwa kwamanxeba, kanye nokuhlolwa kokulandela. Ukuba nohlelo kunganciphisa ukukhathazeka futhi kuqinisekise ukululama okubushelelezi.
• Ukuguqulwa kwendlela yokuphila: Iziguli zingase zelulekwe ukuthi zenze izinguquko ezithile zendlela yokuphila eziholela ekuhlinzweni, njengokuyeka ukubhema noma ukuthuthukisa ukudla okunomsoco, ukuze zithuthukise impilo yazo iyonke kanye namathuba okululama.

Ngokulandela lezi zinyathelo zokulungiselela, iziguli zingasiza ekuqinisekiseni ukuthi zilungele ukuhlanza i-empyema, okuholela ekuhlangenwe nakho kokuhlinzwa okuphumelelayo kanye nokululama.
 

Ukuhlobisa i-Empyema: Inqubo Yesinyathelo Ngesinyathelo

Ukuqonda inqubo yesinyathelo ngesinyathelo yokuhlanza i-empyema kungasiza ekunciphiseni ukukhathazeka nokulungiselela iziguli lokho ezingakulindela. Nansi incazelo yenqubo:

• Ukulungiselela Ngaphambi Kokusebenza: Ngosuku lokuhlinzwa, iziguli zizofika esibhedlela noma esikhungweni sokuhlinzwa. Zizohlola, futhi umhlengikazi uzobuyekeza umlando wazo wezokwelapha futhi aqinisekise inqubo. Kuzobekwa umugqa we-intravenous (IV) ukuze unikeze imithi kanye noketshezi.
• Ukuphathwa Kwezinzwa: Ngaphambi kokuba inqubo iqale, udokotela wezinzwa uzohlangana nesiguli ukuze kuxoxwe ngezinketho zokuhlinzwa kwezinzwa. Iningi leziguli lizothola i-anesthesia ejwayelekile, okusho ukuthi lizobe lilele futhi lingazi ngesikhathi sokuhlinzwa. Udokotela wezinzwa uzoqapha izimpawu ezibalulekile zesiguli kuyo yonke inqubo.
• Isikhundla: Uma isiguli sesingaphansi kwe-anesthesia, sizobekwa etafuleni lokuhlinzwa, ngokuvamile silale ngohlangothi lwaso. Lesi simo senza udokotela ohlinzayo afinyelele kangcono ohlangothini oluthintekile lwesifuba.
• Ukusikwa: Udokotela ohlinzayo uzokwenza i-incision odongeni lwesifuba, ngokuvamile phakathi kwezimbambo, ukuze afinyelele isikhala se-pleural. Ubukhulu nendawo ye-incision kungahluka kuye ngokuthi i-empyema ingakanani kanye nokukhetha kukadokotela ohlinzayo.
• Ukuhlola Isikhala Se-Pleural: Ngemva kokusikwa, udokotela ohlinzayo uzohlola ngokucophelela isikhala se-pleural. Uzohlola ubukhulu be-empyema, afune i-pleura ejiyile kanye nanoma yiluphi uketshezi olunegciwane oludinga ukukhishwa amanzi.
• Ukuhlobisa: Umgomo oyinhloko wenqubo ukususa i-pleura ejiyile (ukuhlobisa). Udokotela ohlinzayo uzohlukanisa ngokucophelela i-pleura nezicubu zamaphaphu ezingaphansi, okungase kuhilele ukusebenzisa amathuluzi akhethekile. Lesi sinyathelo sibalulekile ukuze iphaphu likhule ngokugcwele futhi lisebenze kahle ngemva kwenqubo.
• Ukubekwa kweDrain: Ngemva kokuhlobisa, udokotela ohlinzayo angabeka ipayipi lesifuba ukusiza ukukhipha noma yiluphi uketshezi olusele nomoya esikhaleni se-pleural. Leli payipi lizohlala endaweni yalo izinsuku eziningana ukuze kube lula ukuphulukiswa nokuvimbela ukunqwabelana koketshezi.
• Ukuvalwa: Uma inqubo isiqediwe, udokotela ohlinzayo uzovala indawo yokusikwa esebenzisa i-sutures noma ama-staple. Kuzofakwa ibhandeji elihlanzekile ukuvikela indawo yokuhlinza.
• Igumbi Lokubuyisela: Ngemva kokuhlinzwa, iziguli zizoyiswa egumbini lokululama, lapho zizoqashwa khona njengoba zivuka ngemva kokuhlinzwa. Izimpawu ezibalulekile zizohlolwa njalo, futhi kuzoqalwa ukuphathwa kobuhlungu.
• Ukuhlala Esibhedlela: Iningi leziguli lizohlala esibhedlela izinsuku ezimbalwa ngemva kwenqubo. Phakathi nalesi sikhathi, abahlinzeki bezempilo bazoqapha ukululama, baphathe ubuhlungu, futhi baqinisekise ukuthi ithubhu lesifuba lisebenza kahle.
• Imiyalelo yokukhipha: Uma isiguli sesizinzile futhi ipayipi lesifuba selisusiwe, sizothola imiyalelo yokukhishwa. Lokhu kuzofaka ulwazi mayelana nokunakekelwa kwenxeba, imikhawulo yemisebenzi, kanye nokuqokwa kokulandelela.

Ngokuqonda inqubo yesinyathelo ngesinyathelo yokuhlanza i-empyema, iziguli zingazizwa zilungele futhi zinolwazi oluthe xaxa mayelana nokuhlangenwe nakho kwazo kokuhlinzwa.
 

Izingozi Nezinkinga Zokuhlotshiswa Kwe-Empyema

Njenganoma iyiphi inqubo yokuhlinzwa, ukuhlanza i-empyema kunezingozi ezithile kanye nezinkinga ezingaba khona. Nakuba iziguli eziningi zenza inqubo ngaphandle kwezinkinga, kubalulekile ukuqaphela izingozi ezivamile nezingavamile. Nasi umbono ocacile:
 

• Izingozi Ezivamile:
  • Ubuhlungu: Ubuhlungu obuvela ngemva kokuhlinzwa buvamile futhi ngokuvamile bungaphathwa ngemithi. Iziguli kufanele zixhumane nethimba lazo lezempilo mayelana namazinga azo obuhlungu.
  • Ukutheleleka: Kukhona ingozi yokutheleleka endaweni yokuhlinzwa noma endaweni ye-pleural. Ama-antibiotic angase anikezwe ukunciphisa le ngozi.
  • Ukopha: Kulindeleke ukuthi kopha okuthile, kodwa ukopha ngokweqile kungadinga ukungenelela okwengeziwe. Odokotela abahlinzayo bathatha izinyathelo zokuphepha ukuze banciphise le ngozi.
  • Izinkinga Zokuphefumula: Iziguli zingase zibe nobunzima besikhashana bokuphefumula ngemva kokuhlinzwa, ikakhulukazi uma zazinezinkinga zamaphaphu ezazikhona. Ukuzivocavoca ukuphefumula kanye nokwelashwa ngokomzimba kungasiza ekuthuthukiseni ukusebenza kwamaphaphu.
     
• Izingozi Ezivamile Ezincane:
  • I-Pneumothorax: Lokhu kwenzeka lapho umoya uvuza ungene esikhaleni se-pleural, okungase kubangele ukuwohloka kwamaphaphu. Kungadinga ukwelashwa okwengeziwe, njengokufakwa kwepayipi lesifuba.
  • Ukwakheka kwe-Fistula: Ezimweni ezingavamile, ukuxhumana okungavamile (i-fistula) kungavela phakathi kwesikhala se-pleural nezakhiwo ezizungezile, okuholela ezinkingeni.
  • Izinkinga Zokubulala Izinzwa: Nakuba zingavamile, izinkinga ezivela ekubulaleni izinzwa zingaba khona, okuhlanganisa ukusabela kokungezwani komzimba noma izinkinga zokuphefumula. Udokotela onolwazi lokubulala izinzwa uzoqapha iziguli eduze.
  • Izibazi noma i-Fibrosis: Ezinye iziguli zingase zibe nezibazi esikhaleni se-pleural, okungathinta ukusebenza kwamaphaphu futhi kungadinga ukwelashwa okwengeziwe.
     
• Izingozi Ezingavamile:
  • Ukulimala Kwezitho: Kunobungozi obuncane bokulimala kwezitho ezizungezile, njengephaphu, inhliziyo, noma i-diaphragm, ngesikhathi senqubo. Odokotela abahlinzayo bayaqikelela kakhulu ukugwema lokhu.
  • Ukwehla Kokusebenza Kwamaphaphu Kwesikhathi Eside: Kwezinye izimo, iziguli zingase zibhekane nokwehla kokusebenza kwamaphaphu ngemva kokuhlinzwa, ikakhulukazi uma zazinesifo esibalulekile samaphaphu esasikhona ngaphambili.

Nakuba izingozi ezihlobene nokususwa kwe-empyema kubalulekile ukuzicabangela, iziguli eziningi zithola ukuthuthuka okukhulu ezimpawini zazo kanye nekhwalithi yokuphila ngemva kwenqubo. Ukuxhumana okuvulekile nabahlinzeki bezempilo kungasiza ekuxazululeni izinkinga nokuqinisekisa ukuthi iziguli zinolwazi oluhle ngohambo lwazo lokuhlinzwa.
 

Ukululama Ngemva Kokuhlotshiswa Kwe-Empyema

Ukululama ekuhlanzweni kwe-empyema kuyisigaba esibalulekile esithinta kakhulu umphumela ojwayelekile wenqubo. Isikhathi esilindelekile sokululama singahluka kuye ngesiguli, kodwa ngokuvamile, iziguli zingalindela ukuhlala esibhedlela cishe izinsuku ezi-5 kuya kweziyi-7 ngemuva kokuhlinzwa. Phakathi nalesi sikhathi, abahlinzeki bezempilo bazoqapha izimpawu ezibalulekile, baphathe ubuhlungu, futhi baqinisekise ukuthi amaphaphu asebenza kahle.

Uma seziphumile esibhedlela, iziguli zivame ukuqhubeka nokululama kwazo ekhaya. Amasonto ambalwa okuqala abalulekile ekwelapheni, futhi iziguli zelulekwa ukuba ziphumule. Iningi labantu lingalindela ukubuyela emisebenzini elula zingakapheli amasonto amabili kuya kwamane, kuyilapho imisebenzi enzima kakhulu, njengokuphakamisa izinto ezisindayo noma ukuzivocavoca ngamandla, kufanele igwenywe okungenani amasonto ayi-6 kuya kwayi-8.
 

Amathiphu okunakekela ngemuva ahlanganisa:

• Ukulawula Ubuhlungu: Landela uhlelo olumisiwe lokulawula ubuhlungu. Izidambisi zezinhlungu ezingaphezu kwe-counter zinganconywa, kodwa njalo thintana nodokotela wakho ngaphambi kokuthatha noma yimuphi umuthi.
• Ukunakekelwa Kwenxeba: Gcina indawo yokuhlinzwa ihlanzekile futhi yomile. Landela imiyalelo kadokotela wakho mayelana nokushintsha kwezingubo zokugqoka kanye nezimpawu zokutheleleka okufanele uziqaphele, njengokwanda kokubomvu, ukuvuvukala, noma ukuphuma kwamanzi.
• Izivivinyo Zokuphefumula: Zivocavoce ngokuphefumula okujulile njengoba kuyalelwe ngumhlinzeki wakho wezempilo. Lokhu kusiza ukwandisa amaphaphu nokuvimbela izinkinga ezifana ne-pneumonia.
• Ukudla: Gcina ukudla okunomsoco okucebile ngamaprotheni, amavithamini, kanye namaminerali ukuze kusekelwe ekwelapheni. Ukuhlala unamanzi emzimbeni nakho kubalulekile.
• Ama-aphoyintimenti Okulandelela: Yiba khona kuzo zonke izikhathi zokulandelela ezihleliwe ukuze uqaphe inqubekela phambili yokululama futhi ubhekane nanoma yiziphi izinkinga.
• Imikhawulo yomsebenzi: Gwema imisebenzi engacindezela isifuba, njengokuphakamisa izinto ezisindayo noma ezemidlalo ezithinta kakhulu, kuze kube yilapho udokotela wakho evuma.

Ngokulandela lezi ziqondiso, iziguli zingenza inqubo yokululama ibe lula futhi kancane kancane zibuyele emisebenzini yazo evamile.
 

Izinzuzo Zokuhlobisa I-Empyema

Ukuhlobisa i-empyema kunikeza ukuthuthukiswa okuningana kwezempilo okubalulekile kanye nemiphumela yekhwalithi yempilo. Umgomo oyinhloko walolu hlelo lokuhlinzwa ukususa ungqimba lwe-pleural olujiyile oluvimbela ukwanda kwamaphaphu, okuvumela ukusebenza kangcono kwamaphaphu. Nazi ezinye zezinzuzo ezibalulekile:

• Umsebenzi Wephaphu Othuthukisiwe: Ngokususa ungqimba olunemicu oluzungeze amaphaphu, ukuhlobisa kuvumela amaphaphu ukuthi akhule ngokugcwele, kuthuthukiswe ukusebenza kokuphefumula. Iziguli zivame ukubhekana nokwehla okukhulu kokuphelelwa umoya kanye nokwanda kwamandla emaphaphu jikelele.
• Ukunciphisa Izinhlungu: Iziguli eziningi zibika ukwehla kobuhlungu besifuba ngemva kwenqubo. Ukususwa kwezicubu ze-pleural ezithelelekile kunciphisa ingcindezi emaphashini nasezindaweni ezizungezile, okuholela ekululameni okukhululekile.
• Ingozi Encishisiwe Yezinkinga: Ukuhlobisa kungasiza ekuvimbeleni izinkinga ezengeziwe ezihambisana nokuphelelwa ngamandla, njengokutheleleka okungapheli noma ukwakheka kwamathumba emaphashini. Ngokubhekana nenkinga eyisisekelo, iziguli zingagwema izinkinga zempilo ezinkulu esikhathini esizayo.
• Ikhwalithi Yempilo Ethuthukisiwe: Njengoba ukusebenza kwamaphaphu kuthuthukisiwe kanye nobuhlungu bunciphile, iziguli zivame ukuthola ukuthi izinga lazo lokuphila lithuthuka kakhulu. Zingakwazi ukwenza imisebenzi yansuku zonke kalula futhi zijabulele indlela yokuphila esebenzayo.
• Ukuhlala Okufushane Esibhedlela: Uma kuqhathaniswa nezinye izindlela zokwelapha i-empyema, ukuhlanza kungaholela ekuhlaleni esibhedlela isikhathi esifushane kanye nesikhathi sokululama okusheshayo, okuvumela iziguli ukuthi zibuyele empilweni yazo evamile ngokushesha.

Sekukonke, ukuhlobisa i-empyema kuyindlela yokuhlinzwa ewusizo engaholela ekuthuthukisweni okukhulu kwempilo kanye nekhwalithi engcono yempilo yeziguli ezihlushwa yilesi simo.
 

Ukuhlobisa i-Empyema vs. Ukuhlinzwa Kwe-Thoracoscopic Okusizwa Yividiyo (VAT)

Nakuba ukuhlanza kuyindlela evamile yokwelapha i-empyema, enye indlela i-Video-Assisted Thoracoscopic Surgery (VATS). Zombili lezi zinqubo zihlose ukwelapha i-empyema, kodwa ziyahlukahluka ngendlela kanye nobuchwepheshe. Nasi ukuqhathanisa kokubili:

Isici	Ukuhlobisa i-Empyema	Ukuhlinzwa Kwethoracoscopic Okusizwa Ngevidiyo (i-VATS)
Indlela Yokuhlinza	Ukuhlinzwa okuvulekile	Ukuhlasela okuncane
Isikhathi sokubuyisela	Isikhathi eside (izinsuku ezingu-5-7 esibhedlela)	Kufushane (izinsuku ezingu-2-4 esibhedlela)
Izinga Lobuhlungu	Ubuhlungu obukhulu ngemva kokuhlinzwa	Ubuhlungu obuphansi ngemuva kokuhlinzwa
Ukwehla	Ukusika okukhulu	Izimbobo ezincane
Izinkinga	Ingozi ephezulu yezinkinga	Ingozi ephansi yezinkinga
Izinkomba	ukuphelelwa ngamandla okukhulu okune-pleura ejiyile	I-empyema yesigaba sokuqala noma amacala angemabi kakhulu

 

Izindleko Zokuhlobisa I-Empyema eNdiya

Izindleko zokuhlobisa i-empyema eNdiya zivame ukusuka ku-₹1,00,000 kuya ku-₹2,50,000. Le ntengo ingahluka ngokuya ngesibhedlela, ubuchwepheshe bukadokotela ohlinzayo, kanye nesimo sesiguli esithile. Ukuze uthole isilinganiso esiqondile, xhumana nathi namuhla.
 

Imibuzo Evame Ukubuzwa Mayelana Nokuhlobisa I-Empyema

Yini okufanele ngiyidle ngaphambi nangemva kokuhlinzwa? 

Ngaphambi kokuhlinzwa, gxila ekudleni okulinganiselayo okucebile ngezithelo, imifino, kanye namaprotheni angenamafutha. Ngemva kokuhlinzwa, gcina ukudla okufanayo, kodwa beka phambili ukudla okunamaprotheni amaningi ukuze kusize ekwelapheni. Hlala unamanzi futhi ugweme ukudla okunzima, okunamafutha okungase kuphazamise isisu sakho.

Ngizohlala isikhathi esingakanani esibhedlela? 

Iningi leziguli lihlala esibhedlela cishe izinsuku ezi-5 kuya kweziyi-7 ngemva kokuhlanza. Ukuhlala kwakho okuqondile kungahluka kuye ngentuthuko yakho yokululama kanye nanoma yiziphi izinkinga ezingase zivele.

Ngingakwazi yini ukuthatha imithi yami evamile ngaphambi kokuhlinzwa? 

Xhumana nodokotela wakho mayelana nemithi yakho evamile. Eminye imithi kungadingeka imiswe noma ilungiswe ngaphambi kokuhlinzwa, ikakhulukazi imithi yokunciphisa igazi noma imithi ethinta umfutho wegazi.

Yiziphi izimpawu zokutheleleka okufanele ngizibheke? 

Qaphela ukwanda kokubomvu, ukuvuvukala, noma ukuphuma kwegazi endaweni yokuhlinzwa, umkhuhlane, ukubanda, noma ubuhlungu obuqhubekayo. Uma ubona noma yiziphi zalezi zimpawu, xhumana nomhlinzeki wakho wezempilo ngokushesha.

Ngingabuyela nini emsebenzini? 

Iningi leziguli lingabuyela emsebenzini olula zingakapheli amasonto amabili kuya kwamane ngemva kokuhlinzwa. Kodwa-ke, uma umsebenzi wakho uhilela ukuphakamisa okunzima noma umsebenzi onzima, kungadingeka ulinde amasonto ayisithupha kuya kwayisishiyagalombili noma kuze kube yilapho udokotela wakho evuma.

Ingabe ikhona imingcele ekusebenzeni komzimba ngemva kokuhlinzwa? 

Yebo, gwema ukuphakamisa izinto ezisindayo, ukuzivocavoca okunzima, kanye nemisebenzi enomthelela omkhulu okungenani amasonto ayi-6 kuya kwayi-8 ngemuva kokuhlinzwa. Ukuhamba kancane kanye nemisebenzi elula kuyakhuthazwa ukuze kukhuthazwe ukujikeleza kwegazi kanye nokuphulukiswa.

Ngingabulawula kanjani ubuhlungu ngemva kokuhlinzwa? 

Landela uhlelo lokulawula ubuhlungu lukadokotela wakho, olungafaka phakathi imithi ebhalwe ngudokotela noma imithi yokunciphisa ubuhlungu etholakala ngaphandle kwemithi kadokotela. Sebenzisa amaphakethe eqhwa endaweni yokuhlinzwa ukuze unciphise ukuvuvukala nokungakhululeki.

Yini okufanele ngiyenze uma ngiphelelwa umoya ngemva kokuhlinzwa? 

Uma ubhekene nokuphelelwa umoya, xhumana nomhlinzeki wakho wezempilo ngokushesha. Kungaba uphawu lwenkinga okudingeka ixazululwe.

Ngingakwazi ukushayela ngemva kokuhlinzwa? 

Ngokuvamile kuyalulekwa ukuthi ugweme ukushayela okungenani amasonto amabili ngemva kokuhlinzwa noma kuze kube yilapho ungasasebenzisi imithi yobuhlungu engaphazamisa ikhono lakho lokushayela ngokuphepha.

Ingabe kuphephile ngeziguli esezikhulile ukwenza le nqubo? 

Yebo, iziguli esezikhulile zingahlotshiswa ngokuphephile ukuze zihlinzwe, kodwa zingadinga ukuhlolwa okwengeziwe kwangaphambi kokuhlinzwa kanye nokunakekelwa kwangemva kokuhlinzwa ukuqinisekisa ukululama okubushelelezi.

Iyini inqubo evamile yokukhishwa esibhedlela? 

Ngaphambi kokuphuma esibhedlela, ithimba lakho lezokunakekelwa kwempilo lizoqinisekisa ukuthi uzinzile, linikeze imiyalelo yokunakekelwa ekhaya, futhi lihlele ama-aphoyintimenti okulandelela. Uzothola nolwazi mayelana nokuphatha ubuhlungu nokubona izimpawu zezinkinga.

Kuyoze kube nini ngidinga ukuthatha ama-antibiotic ngemva kokuhlinzwa? 

Isikhathi sokwelashwa ngama-antibiotic siyahlukahluka kuye ngesimo sakho kanye nokuba khona kokutheleleka. Udokotela wakho uzokunikeza isiqondiso sokuthi kufanele uqhubeke isikhathi esingakanani uthatha ama-antibiotic.

Ingabe izingane zingahlotshiswa ukuze zikhiphe isisu? 

Yebo, izingane zingenza le nqubo uma kudingeka. Iziguli zezingane zingadinga ukunakekelwa okukhethekile kanye nokubhekwa ngesikhathi nangemva kokuhlinzwa.

Yiziphi izingozi ezihlobene nokuhlobisa? 

Izingozi zifaka phakathi ukopha, ukutheleleka, kanye nezinkinga ezihlobene nokubulala izinzwa. Xoxa ngalezi zingozi nomhlinzeki wakho wezempilo ukuze uqonde ukuthi zisebenza kanjani esimweni sakho esithile.

Ingabe ngizodinga ukwelashwa ngokomzimba ngemva kokuhlinzwa? 

Ezinye iziguli zingase zizuze ekwelashweni ngokomzimba ukuze kuthuthukiswe ukusebenza kwamaphaphu kanye nokululama okuphelele. Udokotela wakho uzohlola izidingo zakho futhi akuthumelele uma kudingeka.

Ngingakusekela kanjani ukululama kwami ​​ekhaya? 

Gxila ekudleni okunomsoco, hlala unamanzi emzimbeni, landela imiyalelo kadokotela wakho, futhi wenze imisebenzi elula njengoba kufanele. Ukuphumula nakho kubalulekile ekwelapheni.

Kuthiwani uma nginesimo esivele sikhona? 

Yazisa umhlinzeki wakho wezempilo nganoma yiziphi izimo ezikhona kakade, njengoba zingase zithinte ukuhlinzwa kwakho kanye nokululama kwakho. Ithimba lakho lezokwelapha lizolungisa ukunakekelwa kwakho ngokufanele.

Kufanele ngihlele nini isikhathi sami sokulandelela? 

Ama-aphoyintimenti okulandelela ngokuvamile ahlelwa zingakapheli isonto elilodwa kuya kwamabili ngemva kokuhlinzwa. Udokotela wakho uzokunikeza imiyalelo ethile yokuthi uzobuya nini ukuze ahlolwe.

Ngingakwazi yini ukuthatha izithasiselo zemithi ngaphambi noma ngemva kokuhlinzwa? 

Xhumana nodokotela wakho ngaphambi kokuthatha noma yiziphi izithasiselo zamakhambi, njengoba ezinye zingase zithinteke nemithi noma zithinte ukululama kwakho.

Yini okufanele ngiyenze uma nginenkinga ngesikhathi sokululama? 

Uma unenkinga noma uhlangabezana nezimpawu ezingavamile ngesikhathi sokululama kwakho, ungangabazi ukuxhumana nomhlinzeki wakho wezempilo ukuze uthole isiqondiso nokusekelwa.
 

Isiphetho

Ukuhlobisa i-empyema kuyinqubo ebalulekile yokuhlinzwa engaholela ekusebenzeni kahle kwamaphaphu, ekunciphiseni ubuhlungu, kanye nekhwalithi yokuphila ethuthukisiwe yeziguli. Ukuqonda inqubo yokululama, izinzuzo, kanye nezingozi ezingaba khona kubalulekile ekwenzeni izinqumo ezinolwazi mayelana nempilo yakho. Uma wena noma othandekayo wakho nicabangela le nqubo, kubalulekile ukukhuluma nochwepheshe wezokwelapha onganikeza iseluleko kanye nokusekelwa komuntu siqu okufanela izidingo zakho ezithile.