Marudzi ePneumonectomy & Zvikonzero zveUkuvhiya
Chirwere chepneumonectomy rudzi rwemapapu emapapu emapapu umo chirwere chose chakabviswa sechirapa yemukenza wemapapu. Pneumonectomy inowanzoitwawo dzimwe nguva kune dzimwe mamiriro ezvinhu, zvakadai sechirwere chetachiona, COPD yakakomba, kana kushungurudzika kunokanganisa mishonga yakanyanya yeropa pedyo nemapapu.
(Mamwe mavhivhi akaitwa pamukenza wemapapu anosanganisira wedge resection uye lobectomy .)
Mhando dzePneumonectomy
Pane zviviri zvekuvhiya zvinotangira pasi pemusoro wepneumonectomy:
- Pneumonectomy yakasimba : Nepneumonectomy yakafanana, kana mapapu akanaka (ane 3 lobes) kana kuruboshwe (rine 2 lobes) rinobviswa.
- Extrapleural pneumonectomy : Mune pneumonectomy yakawanda, imwe yemapapu inobviswa pamwe chete nechikamu chechidimbu , chidimbu chinoputira chifuva chepfu ( pleura ), uye chikamu chemuviri unodzika mwoyo (pericardium). Iyi nzira inowanzoitirwa mesothelioma , mararamiro ekenza inotanga mumakamuri akapoteredza mapapu.
Rinoitwa Rini?
Rudzi rwemapapu emapapu emapurini chirwere chako chinokurudzira chichabva pane zvimwe zvinhu, kusanganisira:
- Nzvimbo yemarara yako.
- Ukuru hwemuviri wako.
- Zvichida kana kwete maronda ako akapararira kumatumbu ari pedyo.
- Mamiriro ako ehutano hwehutano.
- Mipapu yako inoshanda sei zvisati zvaitika kuvhiyiwa.
Chirwere chepneumonectomy chinonyanya kuitwa sechirwere chekenza isiri duku yemapapu emapapu , kana chirongwa chiduku chisingaoneki, chakadai selobectomy , hachibvise dumbu rose.
Izvi zvinogona kuitika kana bundu racho rakakura, kana rakapararira kupfuura rimwe rabe, kana kuti iri munzvimbo yepakati pemapapu.
Nokuti pneumonectomy inosanganisira kubviswa kwepapu rose, iyo nzira inowanzochengeterwa vanhu avo vane mapapiro akakwana basa uye vachakwanisa kurambidza kurarama nemapapu rimwe chete.
Izvozvo zvakati, vanhu vazhinji vakaenda kunorarama hupenyu hunoita hutevera pneumonectomy.
Kugadzirira Pneumonectomy
Mukugadzira pneumonectomy yako yemukenza wemapapu, iwe uchashanyira chiremba wako uye uine miedzo yakawanda inoitwa kuti uone kuti nzira yacho yakabudirira sezvinobvira. Kubvira pakuvhiyiwa haisi yekurapa kwemapapu emapapu ayo akapararira kupfuura mapapu, chiremba wako achakurudzira miedzo kuti atonge kunze kwekupararira ( metastasis ) yekenza.
Izvi zvinogona kusanganisira kupona kwepfupa kuti utsvake kupararira kwekenza kune pfupa , kuongorora kuropi kuti utonge kunze kweuropi metastases , uye chirwere chemuviri kuti chibvise kunze kwechiropa chemasastases uye adrenal metastases .
Miedzo ichazoitwa kuitira kuti uve nechokwadi chokuti uchakwanisa kutsungirira kurarama nemapapu rimwe chete. Pulmonary function tests ichaongorora mapapu ako ane hutano uye ichwanise kukwanisa kwayo kupa oxygen yakakwana mumuviri wako ndoga. Chiremba wako anogonawo kukurudzira miedzo kuti ave nechokwadi chekuti mwoyo wako uri kushanda zvakanaka sezvo chirwere chinogona kuwedzera kushushikana kumwoyo. Nhoroondo yakanyatsocherechedza, kuongorora muviri uye nebasa rebasa zvichaitwa kuitira kuti uve nechokwadi chokuti iwe une utano sezvinobvira.
Mushure mekunge chiremba wako akadzidza mhinduro dzekuedza kwako, achabvunzurudza zvakanakisisa zvikomborero uye ngozi dzekuvhiya. Zvinobatsira zvikuru kuunza mutsara wemibvunzo pamwe newe kuti uone kuti pane zvinetso zvako zvausina kukanganwa.
Kana iwe uri pane chero mishonga inogona kuwedzera kubuda ropa, zvakadai seCoumadin (warfarin).
aspirin, kana anti-inflammatory medication efana Advil (ibuprofen), chiremba wako achakurudzira kuregera izvi kwechinguva nguva isati yavhiyiwa. Iva nechokwadi chekutendera chiremba wako kuziva kana uri kushandisa chero mishonga yemishonga kana utachiona hwekudya, sezvo mamwe eaya anogona kuderedza ropa rako zvakare.
Kana iwe utsi, chiremba wako anokurudzira zvakasimba kuti iwe urege nokukurumidza sezvinobvira musati mavhiyiwa. Dzidzo dzakaratidza kuti kurapwa kwekenza yemapapu kunobudirira zvikuru uye kune zvinetso zvishomanana kana vanhu vachirega kusvuta vasati vamboita .
Usiku humwe usati wavhiyiwa, chiremba wako achakurudzira kuti iwe "kutsanya" - kureva, usadya kana kunwa chinhu (kunyange mvura) kwemaawa masere.
Pamangwanani ekuvhiyiwa kwako, mukoti anokubvunza mibvunzo yakawanda uye apa IV (intravenous line) mumaoko ako. Iye achakufananidza iwe nevanotarisa kuitira kuti ropa rako riwedzere, kutengesa kwemoyo, uye oksijeni mazinga anogona kuongororwa mukuvhiya kwose. Chiremba wako achakushanyira zvakare kuzokurukura nzira yacho uye kukukumbira kuti usayine fomu yemvumo . Anesthesiologist ichashanyirawo kutaura pamusoro peanesthesia iwe uchapiwa, uye kubvunza pamusoro pezvinetso zvako iwe kana vemhuri yako wakambonzwa neanesthesia munguva yakapfuura. Vashandi vekugadzira vachabatsira mhuri yako kuenda kunzvimbo yekumirira, apo vashandi vanogadzira vanogona kuvadzidzisa kuti vavandudzire pakufambira mberi kwenyu uye vataure navo kana chirwere chako chaitwa.
Panguva yePneumonectomy
Muimba yekushanda, iwe uchapiwa hutano hwekuita kuti iwe ure, uye endotracheal tube ichaiswa mumuromo wako kuitira kuti mhepo inoputira kukufemera iwe panguva yekuvhiyiwa.
Iko kusanganisa kwenguva refu kuchaitwa pamwe chete necheperi kwako zvichienderana nekukwirira kwembambo dzako. Chiremba wacho achaparadzira nhengo dzako uye anogona kubvisa chikamu chebvu kuti awane mapapu ako.
Apo mapapu ako anonyatsobudiswa pachena, boka rekuvhiya richaputsa mapapu ako ane kenza. Mishonga yakanyanya yeropa (arrion uye veins) kuenda kumapapu ako ichasungwa, uye bronchus inotungamirira kumapapu ichasungirirwa uye ichavharwa.
Mushure mokunge mapapu ako abviswa, chiremba anovhiya achanyatsotarisa kuti ave nechokwadi chokuti zvose zvinobuda ropa zvinodzorwa, uye zvichazovhara zvinyorwa.
Nzvimbo yakasara apo mapapu ako ainge aita zvishoma nezvishoma kuzadza nemvura.
Pashure pePneumonectomy
Apo kuvhiyiwa kwako kwapera, iwe uchaendeswa kunzvimbo yekudzikinura uko iwe uchanyatsocherechedza maawa akawanda. Mune zvimwe zviitiko, unogona kutorwa zvakananga kumubatanidzwa wechipatara (ICU). Kutevera kuregererwa, vanhu vazhinji vanopedza mazuva ekutanga muma ICU. Kwezuva rokutanga, kufema kwako kunogona kubatsirwa nefini.
Sezvo izvi zvinogona kukonzera kushungurudzika, iwe uchapiwa mishonga inokuchengetedza iwe kusvikira wakanyarara.
Apo ventilator inobviswa uye iwe unenge usisina kurara, mushandi wekupora anokukumbira kuti ufukidze, uye ichakubatsira iwe mukushandiswa kwekukurudzira spirometer. Ichi chigadziro chaunofema kuti uite mapapu ako, uye kubatsira kuchengetedza mabhazi maduku mumhepo mumapapu ako akazaruka.
Kana iwe uchikwanisa, vanoyamwisa vachakubatsira iwe kugara, nekukukurudzira kuti usimuke uye famba uchibatsira. Iwe unganzwa usingafungi sekushanda, asi kuwedzera basa rako kuchakubatsira kuti uwanezve simba rako nekukurumidza, uye kuderedza dambudziko rekuwedzera ropa . Vanhu vazhinji vanopedza mazuva masere kusvika ku10 muchipatara mushure mekuvhiyiwa.
Vamwe vanhu vanodzokera kubasa mushure memasvondo masere, asi chiremba wenyu achakupai zvipingamupinyi zvakakosha, zvakadai sekudzivisa chero kukwira kunorema. Ichatorawo nguva yekuti mapfupa ako asara kutora, uye kufema kwepfufu kunogona kuramba kwemwedzi inoverengeka mushure mekuvhiyiwa.
Nguva Yekudaidza Chiremba Wako
Paunosunungurwa kubva kuchipatara, iwe uchapiwa mirayiridzo yakajeka yekuzvitarisira iwe pamba uye nguva yekutevera nechiremba wako. Pakati pekugadza, unofanira kudana chiremba wako kana une zviratidzo kana mibvunzo inokutambudza. Dana chiremba wako pakarepo kana iwe ukava nefivha, uine marwadzo epfupa akasiyana nezvakange uchinetseka, uwedzere kufema, uine kubuda ropa kana kubwinya pedyo nekukanganiswa kwako, kana kuti iwe uchitanga marwadzo mumakana ako (zvichiita ropa clots).
Matambudziko
Nemhaka yekuti pneumonectomy ndiyo nzira huru yekurapa, zvinetso zvepneumonectomy hazvishamisi. Chiremba wako achakurukurirana aya nemwi musati mavhiyiwa. Zvimwe zvinogona kuitika zvinogona kusanganisira:
- Chido chekufemerwa kwenguva refu mushure mekuvhiyiwa
- Zvirwere, zvakadai sepineumonia
- Bleeding
- Bronchopleural fistula - kuwirirana pakati pebronchus iyo yakatemwa uye nzvimbo pakati pezwi
- Zvinetso zvemwoyo, zvakadai sekurwadziwa kwepfungwa kana kusagadzikana kwemoyo
- Stroke
- Ropa rinovhara mumakumbo (yakadzika mutsara thrombosis) kana kuenda kumapapu ako ( pulmonary embolism )
- Empyema - pus mukati pakati pe membrane (pleura) kuisa mapapu
- Matambudziko akaenzana neanesthesia
- Zvinetso zvepoyi kana kusagadzikana kwepso
- Postpneumonectomy syndrome - zviratidzo zvinokonzerwa nhengo mubhokisi dzinozadza nzvimbo yakasara isina kubva pamapapu akabviswa
- Kurwirwa kunopfurikidza mukupinda kwako kana kuti nharo dzako dzakagurwa
Prognosis
Izvo zvinotevera zvinotevera pneumonectomy zvinoenderana nezvimwe zvinhu. Zvimwe zveizvi zvinosanganisira mapapu ari kubviswa (zvinoreva kuti zviri nani kune pneumonectomy yakasara pane yakarurama pneumonectomy), danho rekenza , hutano (vakadzi vanowanzoita zviri nani kudarika varume), rudzi rwekenza yemapapu , uye mararamiro aunoita mukuru pamberi pokuvhiyiwa. Kudzokorora kwekenza mumapapu hakusiwo mushure mekunge pneumonectomy, asi dzimwe nguva kenza yemapapu inogona kudzokera kune nzvimbo dziri kure dzomuviri.
Sources:
American Cancer Society. Detailed Guide: Chirwere Chirwere - Chechidiki-Chema. Surgery. Updated 05/16/16. http://www.cancer.org/cancer/lungcancer-non-smallcell/detailedguide/non-small-cell-lung-cancer-treating-surgery
Erhunmwunsee, L. naM. Onaitis. Kupera kusvuta uye kubudirira kwemapirini emapapu emapapu. Ikozvino Incology Reports . 2009. 11 (4): 269-74.