25 lakh+
Iziguli Ezijabule
Abanolwazi futhi
odokotela abanekhono
17
Izikhungo Zokunakekela Ezempilo
Isikhungo Sokudluliswa Okuphezulu kakhulu
Ngokuhlinzwa Okuyinkimbinkimbi
Ukuhlinzwa kwe-bullectomy kususa amasaka agcwele umoya amaningi emaphashini abizwa ngokuthi i-bullae. Lezi zikhala zomoya ezingavamile zinganwetshwa zibe amasentimitha angu-20 ububanzi futhi zifaka ingcindezi eyingozi ezicutshini zamaphaphu ezinempilo.
Iziguli zidinga lokhu kuhlinzwa ngemuva kokuthi lezi zikhwama zomoya zidale kanzima ubunzima bokuphefumula. Odokotela abahlinzayo bakhomba i-bullae enkulu kunesentimitha elingu-1 futhi benza inqubo yokuvimbela ukuwa kwamaphaphu.
Ukuhlinzwa kudinga ukunakekelwa okucophelelayo kwangemva kokuhlinzwa, kodwa kunikeza usizo olubaluleke kakhulu ezigulini ezinezimbotshana zazo ezingaphenduli kahle ekwelashweni okujwayelekile.
CARE Izibhedlela uyaphumelela ekuhlinzeni i-bullectomy ngokusebenzisa:
Odokotela Abahlinza Kakhulu Be-Bullectomy eNdiya
Izibhedlela ze-CARE zinikeza izinketho zokuhlinzwa ezithuthukisiwe ze-bullectomy:
Amakheli okwelashwa kwe-bullectomy ye-CARE:
Izinketho zokuhlinzwa ze-CARE zifaka:
I-bullectomy idinga ukuhlolwa okuphelele kwezokwelapha. Udokotela wakho uzosebenzisa izivivinyo ezimbalwa ezihlanganisa isifuba se-CT scan, ama-X-ray, nokuhlolwa kokusebenza kwamaphaphu ukuze abone ukuthi uyafaneleka yini.
Odokotela basebenzisa izindlela ezimbili eziyinhloko:
Udokotela ohlinzayo ususa i-bullae ngokusebenzisa amasu okugxilisa futhi ngezinye izikhathi wengeza ukuqinisa ukuvimbela ukuvuza komoya.
Cishe uzohlala esibhedlela izinsuku ezingama-3-7. Amashubhu esifuba ahlala kuze kuphole ukuvuza komoya. Ukuthola kwakho ngokugcwele kungase kuthathe amaviki ambalwa njengoba ubuyela kancane emisebenzini yakho evamile. Khumbula ukugwema ukuhamba ngendiza izinyanga ezi-3 ngemuva kokuhlinzwa.
Ukuvuza komoya kuhlala isikhathi eside ezigulini eziningi. Ezinye izingozi zihlanganisa:
Izinkampani zomshwalense zivame ukumboza i-bullectomy lapho i-bullous emphysema enkulu idala izinkinga ezinkulu zokuphefumula (i-FEV1 ngaphansi kuka-50% ebikezelwe).
Ukuhlangana nodokotela abahlinza isifuba abambalwa kukusiza ukuthi ufunde mayelana necala lakho elithile kanye nokukhetha kokwelashwa.
Ukuhlinzwa kwe-bullectomy kunikeza ithemba langempela ezigulini ezilwa ne-bullae enkulu emaphashini azo. Inqubo isusa amasaka omoya ayingozi futhi yenza izicubu zamaphaphu ezinempilo zisebenze kahle futhi. Iziguli ziphefumula kangcono futhi zingakwazi ukuzivocavoca kalula iminyaka eminingana ngemva kokuhlinzwa kwazo.
Izibhedlela ze-CARE zihamba phambili kule nqubo ekhethekile e-Hyderabad. Ithimba labo elinamakhono lisebenzisa izindlela ezithuthukisiwe ze-VATS eziholela ezibazini ezincane kanye nokululama ngokushesha. Amacala ayinkimbinkimbi angase adinge izindlela zendabuko, ezinikezwa isibhedlela ngobuchwepheshe.
Izibhedlela ze-CARE zinikeza ukuhlolwa okuningiliziwe, ukunakekelwa kokuhlinzwa kochwepheshe, nokusekelwa okuqhubekayo kuyo yonke inqubo. Le ndlela yokubambisana isiza ukufeza umphumela omuhle kakhulu esigulini ngasinye esiye sabhekana nale nqubo yokuthuthukisa impilo.
Izibhedlela Zokuhlinza I-Bullectomy eNdiya
Ukuhlinzwa kwe-bullectomy kususa amasaka amakhulu omoya (bullae) emaphashini. Lawa ma-bulla yizikhala ezingavamile ezinkulu kunesentimitha elingu-1 ezikhula lapho amasaka omoya wamaphaphu ephuka. Odokotela basusa la ma-bulla ukuze basize izicubu zamaphaphu ezinempilo zisebenze kangcono.
Odokotela basikisela i-bullectomy ezigulini ezine:
Ukuhlinzwa kuba semqoka uma i-bullae ithatha ngaphezu kuka-30% wesikhala samaphaphu.
Amakhandidethi ahamba phambili ngokuvamile yilaba:
I-Bullectomy inezinga eliphansi lenkinga. Ucwaningo lubonisa ukuthi kuphela i-1-10% yeziguli ezibhekana nezinkinga ezimweni ezingavamile. Izindlela zesimanje ezifana ne-VATS zenza inqubo iphephe nakakhulu.
Iziguli ziba nokungakhululeki okuthile ngemva kokuhlinzwa. Imithi yezinhlungu isiza ekulawuleni lokhu kuphatheka kabi, futhi iziguli eziningi ziyayeka ukudinga imithi yokusiza izinhlungu njengoba isimo siba ngcono ngokuhamba kwesikhathi.
Isikhathi sokuhlinzwa ngokuvamile sisukela emaminithini angama-30 kuye kwangama-80. Ubude besikhathi buncike endleleni yokuhlinzwa, isimo sesiguli, kanye nobunzima becala.
I-VATS yenza i-bullectomy ihlasele kancane ngokusika okuncane (3-4 cm). I-thoracotomy yendabuko evulekile isebenzisa izimbobo ezinkulu (15-20 cm) ezimweni eziyinkimbinkimbi.
Izingozi ezingenzeka ezihlobene nokuhlinzwa kwe-bullectomy zihlanganisa:
Ukuhlala esibhedlela kuthatha izinsuku ezingu-3-7. Odokotela basusa amashubhu esifubeni uma ukuvuza komoya sekupholile, okuvame ukuthatha izinsuku ezi-5. Iziguli zidinga amasonto ambalwa ukuze zilulame ngokugcwele. Bangakwazi ukubuyela emisebenzini yabo yansuku zonke isinyathelo ngesinyathelo kodwa kufanele bathole imvume kadokotela ngaphambi kokushayela noma ukubuyela emsebenzini.
Izinzuzo zihlala iminyaka emihlanu ezigulini eziningi. Ukuthuthukiswa kokusebenza kwamaphaphu kufinyelela umvuthwandaba phakathi nonyaka wokuqala bese kugcina uzinzo esikhathini esithile ngokusekelwe esimweni. Iziguli eziyeka ukubhema zibonisa imiphumela engcono kunalezo ezilokhu zibhema. Ngokuvamile, iziguli ezine-bulla ku-lobes ephezulu zithola imiphumela engcono kakhulu.
Ukuhlinzwa kudinga i-anesthesia jikelele. Ithimba labahlinzayo lisebenzisa ishubhu le-double-lumen endotracheal elinika amandla umoya wephaphu elilodwa. Le nqubo ivumela odokotela abahlinzayo ukuba bahlinze iphaphu elilodwa kuyilapho elinye iphaphu liqhubeka nokusebenza. Ama-anesthetic asebenza isikhathi esifushane asiza iziguli zisheshe zivuke.
Iziguli ezihlangabezana nalokhu okulandelayo ngokuvamile azinconywa ukuba zenze inqubo: