I-Open Thoracotomy - Izindleko, Izinkomba, Ukulungiselela, Izingozi, Nokululama

Ukuhlinzwa kwe-thoracotomy evulekile inqubo yokuhlinzwa ehilela ukwenza ukusika okukhulu odongeni lwesifuba ukuze kufinyelelwe emgodini wesifuba. Le ndlela ivumela odokotela abahlinzayo ukuba babone futhi bahlinze izitho ezisesifubeni, okuhlanganisa amaphaphu, inhliziyo, kanye nemithambo yegazi emikhulu. Inhloso eyinhloko yokuhlinzwa kwe-thoracotomy evulekile ukuxilonga nokwelapha izimo ezahlukahlukene ezithinta lezi zakhiwo ezibalulekile.

Ngesikhathi senqubo, udokotela ohlinzayo uvame ukwenza i-incision eceleni kwesifuba, phakathi kwezimbambo, okungadinga ukuthi izimbambo zihlukaniswe noma zisuswe okwesikhashana ukuze kutholakale ukufinyelela okwanele. Ukuhlinzwa kwe-thoracotomy okuvulekile kuvame ukwenziwa ngaphansi kwe-anesthesia ejwayelekile, okuqinisekisa ukuthi isiguli asizwa nhlobo futhi asinabuhlungu phakathi nokuhlinzwa.

Le nqubo ivame ukusetshenziselwa ukuphatha izimo ezibucayi zesifuba. Ivame ukusetshenziselwa ukwelapha umdlavuza wamaphaphu, ukususa izimila, ukulungisa imithambo yegazi eyonakele, noma ukubhekana nokutheleleka okukhulu esifubeni. Ngaphezu kwalokho, i-thoracotomy evulekile ingadingeka ezimweni zokulimala, njengalezo ezibangelwa izingozi zezimoto noma ukuwa, lapho ukufinyelela ngokushesha emgodini wesifuba kudingeka khona ukulawula ukopha noma ukulungisa ukulimala.

 

Izinzuzo ze-Open Thoracotomy

Ukuhlinzwa kwesifuba okuvulekile kunikeza ukuthuthukiswa okuningana kwezempilo okubalulekile kanye nemiphumela yekhwalithi yempilo yeziguli ezinezimo ezahlukahlukene zesifuba.

• Ukufinyelela Okuqondile Ezithweni Zesifuba: Le nqubo ivumela odokotela abahlinzayo ukuthi bafinyelele ngqo emaphashini, enhliziyweni, nakwezinye izakhiwo zesifuba, okwenza kube nokwelashwa okuphelele kwezimo eziyinkimbinkimbi.
• Ukususwa Kwesimila Okuphumelelayo: Ukuhlinzwa kwesifuba okuvulekile kungavumela ukufinyelela okuqondile kakhulu ezinhlamvini eziyinkimbinkimbi noma ezinkulu, yize izindlela ezingangenisi kakhulu zinganikeza imiphumela efanayo yomdlavuza ezimweni zesigaba sokuqala.
• Umsebenzi Othuthukisiwe Wokuphefumula: Ukwelapha izifo zamaphaphu noma ukuvaleka kwawo kungasiza iziguli ukuba ziphefumule kalula futhi kuthuthukise ukusebenza kwamaphaphu.
• Ikhwalithi Yempilo Ethuthukisiwe: Iziguli eziningi ziphinde zibuyele ezingeni lomsebenzi futhi zithole izimpawu ezimbalwa ngemva kokululama.

 

Izinkomba: Kungani Kuqhutshwa I-Open Thoracotomy

Ukuhlinzwa kwe-thoracotomy evulekile kuvame ukunconywa lapho izinqubo ezingadingi ukungenelela okukhulu, njengokuhlinzwa kwe-thoracoscopic (okwaziwa nangokuthi ukuhlinzwa kwe-thoracoscopic okusizwa ngevidiyo noma i-VATS), zingafaneleki noma zehlulekile ukunikeza imiphumela eyanele. Kunezimpawu nezimo eziningana ezingaholela esinqumweni sokwenza i-thoracotomy evulekile.

Iziguli zingase zibe nobuhlungu besifuba obuqhubekayo, ubunzima bokuphefumula, noma ukwehla kwesisindo okungachazeki, okungabonisa izinkinga eziyisisekelo njengomdlavuza wamaphaphu noma izifo ezinzima njenge-pneumonia noma i-empyema. Ezimweni zokulimala, iziguli zingase zibe nezimpawu ezifana nobuhlungu besifuba obukhulu, ubunzima bokuphefumula, noma izimpawu zokushaqeka, okudinga ukungenelela kokuhlinzwa okusheshayo.

Ukuhlinzwa kwe-thoracotomy evulekile kungabuye kuboniswe ezigulini ezine-pleural effusion, lapho uketshezi luqongelela khona endaweni ye-pleural ezungeze amaphaphu, okubangela ukucindezeleka kokuphefumula. Uma uketshezi lungakwazi ukukhipha amanzi ngokwanele ngezindlela ezingangenisi kakhulu, kungadingeka i-thoracotomy evulekile ukuze kususwe uketshezi futhi kulungiswe imbangela eyinhloko.

Ngamafuphi, i-thoracotomy evulekile yenziwa lapho kunesidingo sokufinyelela ngqo emgodini wesifuba ukuze kutholakale noma kwelashwe izimo zezokwelapha ezingathi sína ezingenakukwazi ukuphathwa ngamasu angangenisi kakhulu.

Izimo eziningana zezokwelapha kanye nokutholakele kokuxilonga kungenza isiguli sibe yilungu le-thoracotomy evulekile. Lezi zimpawu zivame ukuvela ezifundweni zezithombe, ukuhlolwa ngokomzimba, kanye nesimo sempilo sesiguli sonke. Nazi ezinye zezimpawu ezivamile zenqubo:

• Umdlavuza wamaphaphu: Iziguli ezitholakale zinomdlavuza wamaphaphu zingadinga i-thoracotomy evulekile ukuze kukhishwe isimila, ikakhulukazi uma isimila sikhulu noma sisendaweni eyenza kube nzima ukusisusa kusetshenziswa amasu angangenisi kakhulu.
• Ukuhlukumezeka: Ukuhlinzwa kwesifuba okuvulekile kuvame ukukhonjiswa ezimweni zokulimala okukhulu kwesifuba, njengokuphuka kwezimbambo, ukuqhekeka kwamaphaphu, noma ukulimala okukhulu kwemithambo yegazi. Kulezi zimo, ukufinyelela ngokushesha emgodini wesifuba kubalulekile ukulawula ukopha nokulungisa izakhiwo ezonakele.
• I-Pleural Effusion: Uma isiguli siveza ukuphuma okukhulu kwe-pleural okungenakukwazi ukukhishwa ngokwanele nge-thoracentesis noma ukufakwa kwepayipi lesifuba, kungadingeka i-thoracotomy evulekile ukuze kususwe uketshezi futhi kulungiswe imbangela eyinhloko, njengokutheleleka noma umdlavuza.
• Amagciwane: Ukutheleleka okukhulu esifubeni, njenge-empyema noma amathumba emaphaphu, kungadinga i-thoracotomy evulekile ukuze kukhishwe amanzi emzimbeni futhi kukhishwe ukungcola. Lokhu kuyiqiniso ikakhulukazi lapho ukutheleleka kungaphenduli kuma-antibiotic noma amasu okukhipha amanzi emzimbeni angangeni kakhulu.
• I-Congenital Anomalies: Kwezinye izimo, iziguli ezinezinkinga zenhliziyo ezizalwa nazo noma ezinye izinkinga zesifuba zingadinga i-thoracotomy evulekile ukuze kulungiswe ukuhlinzwa.
• Izinqubo Zenhliziyo: Ukuhlinzwa okuthile kwenhliziyo kungadinga indlela yokuhlinzwa nge-thoracotomy, yize iningi, njengokulungiswa kwe-valve, ukushintshwa kwe-valve, kanye ne-coronary artery bypass grafting (CABG), kwenziwa nge-sternotomy. Ezimweni ezithile, i-thoracotomy ingasetshenziswa ezindleleni ezingangenisi kakhulu noma ezikhethekile.
• Isidumbu: Ezimweni lapho kudingeka khona ukuxilongwa okuqondile, i-thoracotomy evulekile ingenziwa ukuze kutholakale amasampula ezicubu emaphashini noma e-mediastinum ukuze kuhlaziywe kabanzi.

Ekuphetheni, isinqumo sokuqhubeka nokuhlinzwa kwesifuba esivulekile sisekelwe ekuhlanganisweni kwezimpawu zomtholampilo, okutholakele ekuxilongweni, kanye nesidingo sokufinyelela ngqo emgodini wesifuba ukuze kwelashwe ngempumelelo isimo esiyisisekelo. Le nqubo idlala indima ebalulekile ekuphatheni izifo ezahlukahlukene zesifuba kanye nokulimala, inikeza odokotela abahlinzayo ukufinyelela okudingekayo ukuze benze ukungenelela okusindisa impilo.

 

Izimo zokungasebenzi kahle kwe-Open Thoracotomy

Ukuhlinzwa kwe-thoracotomy evulekile kuyindlela ebalulekile yokuhlinzwa ehilela ukwenza i-incision odongeni lwesifuba ukuze kufinyelelwe emgodini wesifuba. Nakuba kungasindisa impilo, izimo noma izici ezithile zingenza isiguli singafaneleki kulolu hlinzeko. Ukuqonda lezi ziphazamiso kubalulekile kokubili ezigulini nakubahlinzeki bezempilo.

• Isifo Esibi Sokuphefumula: Iziguli ezinesifo esingapheli sokuvimbela amaphaphu esithuthukile (i-COPD) noma i-asthma enzima zingase zingayibekezeleli kahle inqubo. Ukucindezeleka kokuhlinzwa kanye ne-anesthesia kungenza izinkinga zokuphefumula zibe zimbi kakhulu.
• Ukungazinzi Kwemithambo Yenhliziyo: Abantu abanesifo senhliziyo esibucayi, njengesifo semithambo yenhliziyo esibi noma ukwehluleka kwenhliziyo, bangase babhekane nezingozi ezengeziwe ngesikhathi sokuhlinzwa. Ukucindezeleka enhliziyweni ngesikhathi nangemva kwenqubo kungaholela ezinkingeni.
• Izinkinga ze-Coagulation: Iziguli ezinezinkinga zokopha noma labo abasebenzisa ukwelashwa okuvimbela ukugabha kwegazi kungenzeka bangabi yibo abafanelekayo. Ingozi yokopha ngokweqile ngesikhathi nangemva kokuhlinzwa ingaba yingozi empilweni.
• Ukukhuluphala: Ukukhuluphala ngokweqile kungenza kube nzima ukuhlinzwa futhi kwandise ingozi yezinkinga zangemva kokuhlinzwa, njengokutheleleka kanye nokuphulukiswa okulibazisekile.
• ukutheleleka: Ukutheleleka okusebenzayo, ikakhulukazi esifubeni, kungaba yingozi enkulu. Ukuhlinzwa lapho kukhona ukutheleleka kungaholela ezinkingeni ezengeziwe kanye nemiphumela emibi.
• Impilo Empofu Seyonke: Iziguli ezinezinkinga eziningi ezihambisana nalesi sifo noma lezo ezibuthakathaka zingase zingabi namandla okumelana nokucindezeleka kokuhlinzwa. Ukuhlolwa okuphelele kwempilo iyonke kubalulekile ngaphambi kokuqhubeka.
• Ukuhlinzwa Kwesifuba Kwangaphambilini: Iziguli ezike zahlinzwa esifubeni ngaphambilini zingase zibe nezicubu ezibomvu ezenza inqubo ibe nzima, okwenza i-thoracotomy evulekile ingatuseki.
• Ukwenqaba Kwesiguli: Uma isiguli singathandi ukwenza inqubo noma singaziqondi izingozi nezinzuzo, kungase kungavunyelwe ukuqhubeka.
• Iminyaka Ethuthukile: Akuyona iminyaka ngokwayo kodwa impilo iyonke kanye nobuthakathaka okubaluleke kakhulu. Iziguli ezindala ezinezinye izinkinga ezinkulu zempilo zingase zibhekane nezingozi ezinkulu, ngakho-ke ukuhlolwa okuphelele kwempilo kubalulekile ngaphambi kokuhlinzwa.
• Ukushoda Kosekelo: Iziguli ezingenazo izinhlelo zokusekela ezanele zokululama zingase zingabi yizo ezifanelekile, njengoba ukunakekelwa ngemva kokuhlinzwa kubalulekile ukuze kube nemiphumela ephumelelayo.

 

Ungayilungiselela Kanjani I-Open Thoracotomy?

Ukulungiselela i-open thoracotomy kubalulekile ukuqinisekisa imiphumela emihle kakhulu. Nazi izinyathelo kanye nezinto okufanele uzicabangele ngaphambi kokwenza le nqubo:

• Ukubonisana Ngaphambi Kwenqubo: Iziguli zizohlangana nethimba lazo lokuhlinzwa ukuze zixoxe ngenqubo, okuhlanganisa izingozi zayo, izinzuzo, kanye nokuthi yini okufanele uyilindele. Leli yithuba lokubuza imibuzo nokucacisa noma yikuphi ukukhathazeka.
• Ukubuyekezwa Komlando Wezokwelapha: Kuzobuyekezwa umlando wezokwelapha wesiguli ngokucophelela. Lokhu kuhlanganisa nokuxoxa nganoma yikuphi ukuhlinzwa kwangaphambilini, imithi yamanje, ukungezwani komzimba, kanye nezimo zempilo ezikhona.
• Ukuhlolwa Komzimba: Ukuhlolwa okuphelele ngokomzimba kuzosiza ekuhloleni impilo yesiguli iyonke futhi kutholakale noma yiziphi izinkinga ezingase zithinte ukuhlinzwa.
• Ukuhlolwa kokuxilonga: Iziguli zingase zenze izivivinyo eziningana, okuhlanganisa:
  • I-X-ray yesifuba: Ukuhlola impilo yamaphaphu nokubona noma yikuphi ukukhubazeka.
  • I-CT scan: Ukunikeza izithombe ezinemininingwane zesifuba nokusiza ukuhlela indlela yokuhlinzwa.
  • Ukuhlolwa Komsebenzi Wamaphaphu: Ukuhlola umthamo wamaphaphu nokusebenza.
  • Ukuhlolwa Kwegazi: Ukuhlola i-anemia, ukutheleleka, kanye nokusebenza kwezitho zomzimba wonke.
• Ukuphathwa Kwemithi: Iziguli kungadingeka zilungise imithi yazo ngaphambi kokuhlinzwa. 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 zingadli noma ziphuze isikhathi esithile ngaphambi kokuhlinzwa, ngokuvamile kusukela ngobusuku obandulele. Lokhu kubalulekile ukunciphisa ingozi yokufutha ngesikhathi sokubulala izinzwa.
• Ukuyeka Ukubhema: Uma isiguli sibhema, sizokhuthazwa ukuba siyeke noma okungenani sinciphise ukubhema ngaphambi kwenqubo. Ukubhema kungaphazamisa ukuphulukiswa futhi kwandise ingozi yezinkinga.
• Ukuhlela ukusekela: Iziguli kufanele zihlele ukuthi othile aziphelezele ziye esibhedlela futhi azisize ngokuzithutha ziye ekhaya ngemva kwenqubo. Ukuthola ukwesekwa ngesikhathi sokululama kubalulekile.
• Ukuhlela Ngemva Kokuhlinzwa: Kubalulekile ukuxoxa ngokunakekelwa ngemva kokuhlinzwa, okuhlanganisa ukuphathwa kobuhlungu, imikhawulo yokusebenza ngokomzimba, kanye nokuqokwa kokulandelela. Ukuqonda ukuthi yini ongayilindela kunganciphisa ukukhathazeka.
• Ukulungiselela Kwemizwa: Kuvamile ukuzizwa ukhathazekile ngaphambi kokuhlinzwa. Iziguli kufanele zicabangele ukuxoxa ngemizwa yazo nabahlinzeki bezempilo noma ukufuna ukwesekwa emndenini nakubangane.

 

Izinyathelo Zenqubo Yokuhlinza Isifuba Ezivulekile

Ukuqonda inqubo yesinyathelo ngesinyathelo yokuhlinzwa kwesifuba okuvulekile kungasiza ekuchazeni imfihlo yenqubo futhi kunciphise ukukhathazeka okuthile. Nakhu okwenzekayo ngokuvamile ngaphambi, ngesikhathi, nangemva kokuhlinzwa:

 

Ngaphambi Kwenqubo:

• Ukufika Esibhedlela: Iziguli zizofika esibhedlela ngosuku lokuhlinzwa. Zizohlola futhi zingase ziyiswe endaweni yangaphambi kokuhlinzwa.
• Ukuhlola Ngaphambi Kokuhlinzwa: Abahlengikazi bazothatha izimpawu ezibalulekile, babukeze umlando wezokwelapha, bese beqala umugqa we-IV (i-intravenous) wemithi noketshezi.
• Ukubonisana Ngezinzwa: Udokotela obulala izinzwa uzohlangana nesiguli ukuze baxoxe ngezinketho zokubulala izinzwa futhi babhekane nanoma yikuphi ukukhathazeka.
• Ukumaka Indawo Yokuhlinzwa: Udokotela ohlinzayo uzomaka indawo lapho kuzokwenziwa khona ukusika ukuze aqinisekise ukuthi kunembile.

 

Ngesikhathi Senqubo:

• Ukuphathwa Kwezinzwa: Uma sesisegumbini lokuhlinza, isiguli sizothola i-anesthesia ejwayelekile, okuqinisekisa ukuthi asizwakali futhi asinabuhlungu ngesikhathi sokuhlinzwa.
• Ukusikwa: Udokotela ohlinzayo uzokwenza ukusika okukhulu eceleni kwesifuba, ngokuvamile phakathi kwezimbambo, ukuze afinyelele emgodini wesifuba.
• Ukufinyelela Amaphaphu noma Inhliziyo: Kuye ngesizathu sokuhlinzwa, udokotela ohlinzayo angadinga ukususa ingxenye yamaphaphu, ukulungisa i-valve yenhliziyo, noma ukulungisa ezinye izinkinga zesifuba.
• Ukungenelela Ngokuhlinzwa: Inqubo ethile izohluka ngokuya ngokutholakala kwesifo. Lokhu kungase kuhilele ukususa izimila, ukukhipha uketshezi, noma ukulungisa izicubu ezonakele.
• Ukuvalwa: Uma ukuhlinzwa sekuqediwe, udokotela ohlinzayo uzovala inxeba esebenzisa i-sutures noma ama-staple. Ipayipi lesifuba lingabekwa ukusiza ukukhipha noma yiluphi uketshezi noma umoya ongase uqongeleleke.

 

Ngemva Kwenqubo:

• Igumbi Lokubuyisela: Iziguli zizothuthelwa endaweni yokululama lapho zizoqashwa khona njengoba zivuka ngemva kokubulala izinzwa. Izimpawu ezibalulekile zizoqashelwa eduze.
• Ukulawula Ubuhlungu: Ukuqeda ubuhlungu kuzonikezwa ngemithi, futhi iziguli zizokhuthazwa ukuthi zikhulume nganoma yikuphi ukungakhululeki.
• Ukuphathwa Kwepayipi Lesifuba: Uma kufakwe ipayipi lesifuba, lizoqashwa ukuze likhiphe amanzi futhi lingase lihlale endaweni yalo izinsuku eziningana.
• Ukugqugquzela Kancane Kancane: Iziguli zizokhuthazwa ukuba ziqale ukunyakaza ngokushesha nje lapho sezizinzile. Lokhu kusiza ukuvimbela izinkinga ezifana nokuqhekeka kwegazi futhi kukhuthaze ukusebenza kwamaphaphu.
• Ukuhlala Esibhedlela: Ubude bokuhlala buzohluka ngokuya ngokululama komuntu kodwa ngokuvamile busukela ezinsukwini ezimbalwa kuya esontweni.

 

Ukululama Ngemva Kokuhlinzwa Kwesifuba Okuvulekile

Ukululama ekuhlinzweni kwesifuba okuvulekile kuyinqubo ebalulekile edinga isineke nokunamathela ekwelulekweni kwezokwelapha. Isikhathi esilindelekile sokululama singahluka ngokuya ngezimo zempilo zomuntu ngamunye, ubukhulu bokuhlinzwa, kanye nanoma yiziphi izinkinga ezingase zivele. Ngokuvamile, iziguli zingalindela ukuhlala esibhedlela cishe izinsuku ezi-5 kuya kweziyi-7 ngemva kokuhlinzwa, kuye ngentuthuko yazo yokululama. Ezimweni ezithile, iziguli zingase zithole izinguquko zesikhathi eside ekusebenzeni kwamaphaphu noma ukuphinda kwesimo esiyisisekelo, kuye ngesifo eselashwe ngaso.

 

Umugqa Wesikhathi Wokuthola Okulindelekile:

• Iviki Lokuqala: Iziguli zizothola ubuhlungu nokungakhululeki, okungalawulwa ngemithi enqunywe udokotela. Ukuzivocavoca ukuphefumula kanye nokuqala kokwelashwa kuyakhuthazwa ukuze kuvinjelwe izinkinga ezifana ne-pneumonia.
• Amaviki 2-4: Iziguli eziningi zingakhuphula kancane kancane amazinga azo okusebenza. Imisebenzi elula njengokuhamba ingaqaliswa, kodwa ukuphakamisa okunzima nokuzivocavoca okunzima kufanele kugwenywe.
• Amaviki 4-6: Ngalesi sikhathi, iziguli eziningi zingabuyela emsebenzini olula noma emisebenzini yansuku zonke. Kodwa-ke, ukululama okuphelele kungathatha izinyanga ezifika kwezi-3, ikakhulukazi kulabo abanokuhlinzwa okukhulu.

 

Amathiphu okunakekela ngemuva:

• Ukulawula Ubuhlungu: Landela imiyalelo kadokotela wakho mayelana nemithi yobuhlungu. Kubalulekile ukuphatha ubuhlungu ngempumelelo ukuze kube lula ukuvivinya umzimba ngokuphefumula.
• Izivivinyo Zokuphefumula: Ukuphefumula okujulile kanye nokuzivocavoca ukukhwehlela kubalulekile ukuvimbela izinkinga zamaphaphu. Sebenzisa i-spirometer yokukhuthaza uma ikhona.
• Ukunakekelwa Kwenxeba: Gcina indawo yokuhlinza ihlanzekile futhi yomile. Bheka izimpawu zokutheleleka, njengokukhuphuka ububomvu, ukuvuvukala, noma ukuphuma.
• Ukudla: Ukudla okunomsoco okucebile ngamaprotheni kungasiza ekululameni. Hlala unamanzi futhi ucabangele ukudla okuncane, okuvamile ukuze unciphise ukugaya ukudla.
• Ama-aphoyintimenti Okulandelela: Yiya kukho konke ukuvakasha kokulandelela okuhleliwe ukuze uhlole ukululama kwakho futhi ubhekane nanoma yikuphi ukukhathazeka.

 

Imisebenzi Ejwayelekile Ingaqhubeka Nini?

Iningi leziguli lingabuyela emisebenzini evamile zingakapheli amasonto ayi-6 kuya kwayi-12, kodwa lokhu kuyahlukahluka. Xhumana nomhlinzeki wakho wezempilo ukuze uthole iseluleko esiqondene nawe ngokusekelwe entuthukweni yakho yokululama.

 

Izingozi Nezinkinga Zokuhlinzwa Kwesifuba Esivulekile

Njenganoma iyiphi inqubo yokuhlinzwa, i-thoracotomy evulekile inezingozi. Nakuba iziguli eziningi zihlinzwa ngaphandle kwezinkinga, kubalulekile ukuqaphela izingozi ezivamile nezingavamile.

 

Izingozi Ezivamile:

• Pain: Ubuhlungu obuvela ngemva kokuhlinzwa bulindelekile futhi bungaphathwa ngemithi.
• ukutheleleka: Kukhona ingozi yokutheleleka endaweni yokusika noma ngaphakathi kwamaphaphu. Ama-antibiotic angase anikezwe ukunciphisa le ngozi.
• Ukuphuza: Ukopha okuthile kuyinto evamile, kodwa ukopha ngokweqile kungadinga ukungenelela okwengeziwe.
• Izinkinga Zokuphefumula: Iziguli zingase zibe nenkinga yokuphefumula noma i-pneumonia, ikakhulukazi uma zinezinkinga zamaphaphu ezikhona kakade.
• Amahlule Egazi: Kukhona ingozi yokuba namahlule egazi emilenzeni, okungaholela ezinkingeni ezinkulu uma ziya emaphashini.

 

Izingozi Ezingavamile:

• Izinkinga ze-Anesthesia: Nakuba kungavamile, ezinye iziguli zingase zibe nokusabela okungekuhle ekubulaweni yizinzwa, okuhlanganisa ukusabela kokungezwani komzimba noma izinkinga zokuphefumula.
• Ukulimala kwesitho: Kukhona ingozi encane yokulimala kwezitho ezizungezile, njengenhliziyo, amaphaphu, noma imithambo yegazi emikhulu.
• Ubuhlungu obungapheli: Ezinye iziguli zingase zizwe ubuhlungu obuqhubekayo endaweni yokusikwa, okwaziwa ngokuthi i-post-thoracotomy pain syndrome.
• I-Pneumothorax: Lesi yisimo esingavamile kodwa esibi lapho umoya uvuza khona esikhaleni esiphakathi kwamaphaphu nodonga lwesifuba, okubangela ukuwohloka kwamaphaphu.
• Izinguquko Zomsebenzi Wesikhathi Eside Wemaphaphu: Kwezinye izimo, iziguli zingase zizwe izinguquko ekusebenzeni kwamaphaphu, ikakhulukazi uma ingxenye enkulu yezicubu zamaphaphu isusiwe.
• Imiphumela Yesikhathi Eside: Ezinye iziguli zingase ziphinde zibhekane nezimo eziyisisekelo (njengokubuyela emuva kwesimila noma ukutheleleka okungapheli) noma izinguquko eziqhubekayo ekusebenzeni kwamaphaphu, kuye ngesifo eselashwe.

Ekuphetheni, nakuba i-open thoracotomy iyinqubo ebalulekile yezimo ezahlukahlukene zesifuba, ukuqonda izithiyo, izinyathelo zokulungiselela, imininingwane yenqubo, kanye nezingozi ezingaba khona kunganika iziguli amandla okwenza izinqumo ezinolwazi mayelana nempilo yazo. Njalo xhumana nochwepheshe bezempilo ukuqinisekisa imiphumela emihle kakhulu.

 

Ukuhlinzwa Kwe-Open Thoracotomy vs. Ukuhlinzwa Kwe-Thoracoscopic Okusizwa Yividiyo (VAT)

Nakuba i-open thoracotomy iyindlela yendabuko, ukuhlinzwa kwe-thoracoscopic okusizwa ngevidiyo (i-VAT) kuyindlela ehlukile engenasidingo. Nasi ukuqhathanisa izinqubo ezimbili:

 

Izindleko ze-Open Thoracotomy eNdiya

Izindleko ezimaphakathi zokuhlinzwa kwesifuba okuvulekile eNdiya zisukela ku-₹1,00,000 kuya ku-₹3,00,000. Izindleko ziyahlukahluka kuye ngesibhedlela, idolobha, kanye nobunzima. Iziguli kufanele zithintane nesibhedlela sazo sokwelapha ukuze zithole izilinganiso eziqondene nawe.

 

Imibuzo Evame Ukubuzwa Mayelana Nokuvuleka Kwethambo Lokubeletha

Yini okufanele ngiyidle ngemva kokuhlinzwa kwesifuba okuvulekile? 

Ngemva kokuhlinzwa, gxila ekudleni okunempilo okucebile ngamaprotheni, amavithamini, kanye namaminerali ukuze kusize ukululama. Ukudla okufana nenyama engenamafutha amaningi, inhlanzi, amaqanda, ubisi, izithelo, kanye nemifino kuyazuzisa. Hlala unamanzi futhi ucabangele ukudla okuncane, okuvamile ukuze ugweme ukungakhululeki.

Ngizohlala isikhathi esingakanani esibhedlela? 

Iningi leziguli lihlala esibhedlela cishe izinsuku ezi-5 kuya kweziyi-7 ngemva kokuhlinzwa kwesifuba okuvulekile. Ubude besikhathi sakho esiqondile bungahluka ngokuya ngentuthuko yakho yokululama kanye nanoma yiziphi izinkinga ezingase zivele.

Ngingakwazi ukushayela ngemva kokuhlinzwa? 

Ngokuvamile kuyalulekwa ukuthi ugweme ukushayela okungenani amasonto amane kuya kwayisithupha ngemva kokuhlinzwa, noma kuze kube yilapho udokotela wakho ekunike imvume. Lokhu kwenzelwa ukuqinisekisa ukuthi ungasabela ngokushesha uma kwenzeka isimo esiphuthumayo ngaphandle kobuhlungu noma ukungakhululeki.

Yimiphi imisebenzi engingayenza ngesikhathi sokululama? 

Imisebenzi elula njengokuhamba iyakhuthazwa ukukhuthaza ukujikeleza kwegazi nokusebenza kwamaphaphu. Kodwa-ke, gwema ukuphakamisa okunzima, ukuzivocavoca okunzima, nanoma yimiphi imisebenzi ecindezela isifuba sakho okungenani amasonto ayisithupha.

Ngingabulawula kanjani ubuhlungu ngemva kokuhlinzwa? 

Landela uhlelo lokulawula ubuhlungu lukadokotela wakho, olungafaka phakathi imithi ebhalwe ngudokotela. Sebenzisa amaphakethe eqhwa endaweni yokuhlinzwa ukuze unciphise ukuvuvukala nokungakhululeki futhi uzijwayeze ukuzivocavoca okujulile ukuze unciphise ubuhlungu.

Ngingabuyela nini emsebenzini? 

Isikhathi sokubuyela emsebenzini siyahlukahluka. Iziguli eziningi zingaqala kabusha umsebenzi olula zingakapheli amasonto ayi-6 kuya kwayi-12 kodwa xhumana nomhlinzeki wakho wezempilo ukuze uthole iseluleko esiqondene nawe ngokusekelwe ekululameni kwakho.

Yiziphi izimpawu zokutheleleka okufanele ngiziqaphele? 

Qaphela indawo yakho yokuhlinzwa ukuze uthole ukubomvu okwenyukayo, ukuvuvukala, ukufudumala, noma ukuphuma koketshezi. Umkhuhlane, ukubanda, noma ubuhlungu obuqhubekayo nakho kungabonisa ukutheleleka. Xhumana nodokotela wakho uma ubona noma yiziphi zalezi zimpawu.

Ngingakwazi yini ukugeza ngemva kokuhlinzwa? 

Ngokuvamile ungageza ngemva kokuba udokotela wakho ekunike imvume, ngokuvamile ezinsukwini ezimbalwa ngemva kokuhlinzwa. Gwema ukucwilisa inxeba emanzini kuze kube yilapho selipholile ngokuphelele.

Yini okufanele ngiyenze uma nginenkinga yokuphefumula? 

Uma unenkinga yokuphefumula, xhumana nomhlinzeki wakho wezempilo ngokushesha. Kubalulekile ukuxazulula noma yiziphi izinkinga zokuphefumula ngokushesha, njengoba zingase zibonise izinkinga.

Ingabe ikhona imikhawulo yokudla ngemva kokuhlinzwa? 

Nakuba kungekho mingcele eqinile yokudla, kungcono ukugwema ukudla okunzima nokunamafutha okungase kubangele ukungakhululeki. Gxila ekudleni okunempilo ukuze usekele ukuphulukiswa.

Ngingakusekela kanjani ukululama kwami? 

Yenza umsebenzi womzimba olula, landela iseluleko sikadokotela wakho, gcina ukudla okunempilo, futhi uhlale unamanzi emzimbeni. Ukusekelwa ngokomzwelo okuvela emndenini nakubangani nakho kungakusiza ekululameni kwakho.

Kuthiwani uma nginesimo esivele sikhona? 

Yazisa umhlinzeki wakho wezempilo nganoma yiziphi izimo ezikhona kakade, njengoba zingase zithinte ukululama kwakho. Ithimba lakho lezokwelapha lizolungisa uhlelo lwakho lokunakekelwa ngokufanele.

Ngingakwazi ukuhamba ngemva kokuhlinzwa? 

Kunconywa ukugwema ukuhamba ibanga elide okungenani amasonto ayisithupha ngemuva kokuhlinzwa. Xoxa ngezinhlelo zakho zokuhamba nodokotela wakho ukuqinisekisa ukuthi kuphephile kuwe.

Yini okufanele ngiyenze uma ngizizwa ngikhathazekile ngokululama? 

Kuvamile ukuzizwa ukhathazekile ngemva kokuhlinzwa. Cabanga ngokuxoxa ngemizwa yakho nomhlinzeki wakho wezempilo noma uchwepheshe wezempilo yengqondo. Amaqembu okusekelana nawo angaba usizo.

Kukangaki ngidinga ama-aphoyintimenti okulandelela? 

Ama-aphoyintimenti okulandelela ngokuvamile ahlelwa njalo emavikini ambalwa ezinyangeni ezimbalwa zokuqala ngemva kokuhlinzwa. Udokotela wakho uzoqapha ukululama kwakho futhi alungise uhlelo lwakho lokunakekelwa njengoba kudingeka.

Ngingakwazi yini ukuhlanganyela ekwelashweni ngokomzimba? 

Yebo, ukwelashwa ngokomzimba kungaba usizo ekululameni kwakho. Udokotela wakho angase ancome uhlelo oluklanyelwe wena ukuze lusize ekubuyiseni amandla nokuhamba.

Kuthiwani uma nginezingane? 

Uma unezingane, hlela usizo ngesikhathi sokululama kwakho. Nciphisa imisebenzi yomzimba nazo uze uzizwe unamandla futhi uxoxe ngezidingo zakho nomndeni wakho.

Ingabe kungokwemvelo ukuzizwa ukhathele ngemva kokuhlinzwa? 

Yebo, ukukhathala kuvamile ngemva kokuhlinzwa. Umzimba wakho uyalulama, futhi kubalulekile ukuphumula nokuzinika isikhathi sokululama ngokugcwele.

Yini okufanele ngiyenze uma ngizwa ubuhlungu esifubeni? 

Uma uzwa ubuhlungu besifuba, xhumana nomhlinzeki wakho wezempilo ngokushesha. Nakuba ukungakhululeki okuthile kuyinto evamile, ubuhlungu obukhulu noma obuqhubeka bukhula kufanele buhlolwe.

Ngingalilungiselela kanjani ikhaya lami ukuthi lilulame? 

Lungisa ikhaya lakho ngokuqinisekisa ukufinyelela okulula ezintweni ezibalulekile, ukususa izingozi ezikukhubekisayo, nokuhlela usizo ngemisebenzi yansuku zonke. Indawo yokululama ekhululekile ingasiza enkambisweni yakho yokululama.

 

Isiphetho

Ukuhlinzwa kwe-open thoracotomy kuyindlela ebalulekile yokuhlinzwa engathuthukisa kakhulu imiphumela yezempilo yeziguli ezinezimo ezahlukahlukene zesifuba. Ukuqonda inqubo yokululama, izinzuzo, kanye nezinye izindlela ezingaba khona kunganika iziguli amandla okwenza izinqumo ezinolwazi mayelana nokunakekelwa kwazo. Njalo xhumana nochwepheshe wezokwelapha ukuze uxoxe ngesimo sakho esithile futhi uqinisekise umphumela ongcono kakhulu.