Nzira Dzakawanda Dzinosanganisira Kubatsira
Kana iwe wakamboonekwa uine kuvhiringidzika kwepabonde yepamusoro (OSA) , ungave uchifarira kudzidza pamusoro pekuvhiya kusarudzwa kuti uite chirwere chacho . Kune huwandu hwekuvhiya hunogona kuchinja hutachiona hwehutano hwakanaka uye hunovandudza kupona kwepnea uye kunononoka , iyo inowanzova uvulopalatopharyngoplasty (UPPP). Asi ndeapi mamwe maitiro ekurapa aripo?
Dzidza pamusoro pemitemo yakasiyana-siyana pamwe chete inozivikanwa se pharyngoplasty, uye njodzi dzinobatana nemararamiro aya.
Ndeipi Iyo Yakanyatsogadzirwa Nenzira?
Kuvhiyiwa kwepalati kunosanganisira boka remitambo iyo inowanzoitwa pasi peanesthesia yakawanda muimba yekushandisa. Mhando dzakasiyana-siyana dzakanyatsotarisa dzinosanganisira kuvhiyiwa kunotevera:
- Uvulopalatopharyngoplasty (UPPP) kana palatopharyngoplasty
- Expansion sphincter pharyngoplasty
- Lateral pharyngoplasty
- Uvulopalatal flap
- Palatal kufambira mberi pharyngoplasty
- Z-palatoplasty
- Relocation pharyngoplasty
Kuvhiyiwa kwepalate kunobatanidza ne tonsillectomy mune varwere vakawanda vane matoni asina kumbobviswa. Kuvhiyiwa kwepalate (kana pasina tonsillectomy) inonyanya kushandiswa kugadzirisa kuvharwa kwemahope obstructive, uye maitiro anogona kuitwa oga kana kuti pamwe chete ne hypopharyngeal nzira. Iyi nzira inosanganisira kusanganiswa kwemashupu ekubvisa uye kugadzirisa mafungiro echinangwa chekuwedzera huwandu hwemigwagwa asi pasina kuchinja mabasa akadai sekufema, kutaura, uye kumedza.
Zvimwe zvikamu zvehutano hwemunhu zvinosanganisira zvinotevera:
UPPP yakatanga kurondedzerwa mukurapwa kwemaitiro ekudzivirira kubata hope muna 1982, uye kwemakore akawanda ndiyo ndiyo nzira yaive yakawanikwa. Iyo nzira inosanganisira kubviswa kwekuvhuvhuta uye chikamu chemafuta akareruka, nekudzokorora kwechikamu chinosara chezoro rakanyorova uye mativi ehuro kunowanzoitwa nekucheka zvivakwa pamwechete zvakananga. Zvichienzaniswa nedzimwe nzira, UPPP inowanzobatanidza mamwe maviri ekubviswa kubva pameso akaoma. Kana iyo yevula isina kubviswa, iyi nzira inonzi palatopharyngoplasty.
- Kuwedzerwa sphincter pharyngoplasty kunosanganisira anenge asingatauri kutorwa, asi humwe hutachiona hunogadziriswa. Mune nzira iyi, mutsara unonyatsochera tonsil (palatopharyngeus muscle) inosunungurwa kubva kune rumwe rutivi rwehuro uye yakaiswa mberi uye pashure. Izvi zvinokwevera maruva akareba mberi, nechinangwa chekuzarura nzvimbo iyo shure kwekanyoro kaviri yekufema. Muboka rakasarudzwa revarwere, nzira iyi yakaratidza mhinduro dzakanaka kupfuura UPPP mumutambo we randomized kuenzanisa iviri.
- Lateral pharyngoplasty inogona kuitika chete apo varwere vane toni. Inosanganisira zvimwe zvinoshandiswa kubva mumuviri, asiwo zvakanyanya kudzokorora zvinyoro zvishoma (denga remuromo) pamwe chete ne lateral pharyngeal tishu (kurutivi rwehuro). Iyi nzira inowanikwa-inobatanidzwa kupfuura UPPP, asi inoratidzwawo mhinduro dzakanaka pakati peboka rakasarudzwa revarwere mukuenzanisa kusinganzwisisiki kuenzanisa maviri.
- Uvulopalatal flap inoshandiswa kune varwere vane micheka yakanaka. Nzira yacho inosanganisira kusina kubviswa kwemuviri weshumba yakadzika; panzvimbo pacho, chidimbu chemuromo (mucosa) pane chikamu chemafuta akanyorobviswa chinobviswa kuti zvibviswe kudonha kwemafupa akanaka. Nokubudirira, inoita kuti chipfuva chinononoka chipfupi pasina kubvisa tsvina, nokuti kutapudza kwemasumbu kunotarisirwa kuti kuve kuchikanganisa kuvhara.
- Palatal progression pharyngoplasty inobata muromo nekubvisa imwe pfupa padenga remuromo (hard palate) munzvimbo inoenda kumashure, iyo inosangana nekanyoro. Mushure mokubviswa kwepafupa, chirwere chinotapira chinodonhedzwa mberi uye chigadziriswa panzvimbo.
- Z-palatoplasty inoda chikamu chikamu chikamu chinotapira mukati uye chinokwevera hafu imwe mberi uye mberi. Izvi zvinogona kunyanya kubudirira kune varwere vane ruvara pamakona ehuro, izvo zvinogona kuitika mushure mokunge tonsillectomy kana kuti imwe yapfuura imwe nzira yakanyorova. Z-palatoplasty inobatanidza nehuwandu hwakaoma nekumedza pashure pekuvhiyiwa kupfuura mamwe maitiro emarata.
- Kutsiva pharyngoplasty kunosanganisira zviduku zvishoma zvekusunungura nekucheka pamwe misumbu iri kurutivi rwehuro neimwe nzira.
Iyo nzira yekuvhiya iyo yakakodzera iwe pachako inoda kuongorora kwakanyatsoongorora muviri, uye kukurukura naye, chiremba wako.
Ngozi dzePatate Process
Sezvakaita chero nzira ipi zvayo yokuvhiya, pane zvipimo zvinofanira kuonekwa. Marwadzo anowanzoitika sechikamu chekuvhiyiwa kwakanyanya. Zvimwe zvezvimwe zvinetso zvakanyanya zvinosanganisira zvinotevera:
- Bleeding
Kuvhiyiwa kwose kunoisa njodzi yokubuda ropa, asi yakawanda yehutano iyi inosanganiswa ne tonsillectomy. Kuongororwa kwakawanda kwekubuda ropa kune ngozi pashure pokunge tonsillectomy iri 2 kusvika ku4 muzana.
- Kurwara
Utachiona hunogoneka asi husingaiti.
- Dambudziko kukumedza
Iyo muromo inokosha mukumedza nokuti inoratidza chisimbiso pakati pemusana wemuromo uye kumashure kwemhino. Mushure mokuvhiyiwa kwenzanga, zvinokwanisika kuva nezvikafu, kunyanya zvinwiwa, zvinouya kumashure kwemhino kana dzimwe nguva kuburikidza nemhuno. Izvi zvinowanzoitika mumavhiki maviri ekutanga mushure mekugadzirisa, asi kusangana uku hakusi kusingagumi kana kukosha.
- Kuchinja mukutaura
Muromo unokosha pakubudisa mitauro. Kunyange zvazvo kuchinja kusinganzwisisiki mumutauro (kunoratidzwa kuburikidza nehuwandu hwekuongorora sarudzo) kunogona kuitika, kushanduka kwenguva refu kwekutaura kwakanyanya kudarika.
- Kunyorera kumusoro kwehuro
Zvinokwanisika kuti kusakanganiswa kuporesa kunogona kuita kuparara kunopisa nzvimbo iri shure kwechinguva chiduku.
Kana iwe uchida kukurukura nezvesarudzo dzokuvhiya kubata chirwere chekurara, iwe unofanira kutanga nokutaura nehope yako nyanzvi . Kana kushandiswa kwakanaka kwemazamu kune chisarudzo chinoenderana nemamiriro ako ezvinhu, kutumira kune chiremba wezvechirwere kunogona kuva danho rokutanga kuti uongorore kurapwa kwakakosha kwakakodzera iwe.
Sources:
Cahali MB. "Pakupedzisira Pharyngoplasty: A New Treatment for Obstructive Hope Apnea-Hypopnea Syndrome." Laryngoscope . 2003 Nov; 113 (11): 1961-8.
Friedman M, Ibrahim HZ, Vidyasagar R, Pomeranz J, naJoseph NJ. "Z-Palatoplasty (ZPP): A Technique yevarwere Vasina zvipo." Otolaryngol Head Neck Surg . 2004 Jul; 131 (1): 89-100.
Fujita S, Conway W, Zorick F, uye Roth T. "Kurongedzwa Kuvhiya kweAnatomic Zvisina Kuipa Mukudzivirira Kurara KweApnea Syndrome: Uvulopalatopharyngoplasty." Otolaryngol Head Neck Surg . 1981 Nov-Dec; 89 (6): 923-34.
Kezirian EJ, Maselli J, Vittinghoff E, Goldberg AN, uye Auerbach AD. "Kudzivisa Kuberekwa kweApnea Surgery Ita Maitiro muUnited States: 2000 kusvika muna 2006." Otolaryngol Head Neck Surg . 2010 Sep; 143 (3): 441-7.
Kezirian EJ, Weaver EM, Yueh B, Deyo RA, Khuri SF, Daley J, naHenderson W. "Kuitika Kwezvinetso Zvikuru Pashure peUvulopalatopharyngoplasty." Laryngoscope . 2004 Mar; 114 (3): 450-3.
Kezirian EJ, Weaver EM, Yueh B, Khuri SF, Daley J, uye Henderson WG. "Zvinokonzerwa Nengozi Nokuda Kwezvinetso Zvikuru Pashure peUvulopalatopharyngoplasty." Arch Otolaryngol Head Neck Surg . 2006 Oct; 132 (10): 1091-8.
Li HY, naLee LA. "Kutarisa Pharyngoplasty yeAvstructive Sleep Apnea." Laryngoscope . 2009 Dec; 119 (12): 2472-7.
Pang KP, uye Woodson BT. "Kuwedzerwa Sphincter Pharyngoplasty: Mutsva Mutsva weKurapwa Kwekudzivirira Apnea Yokurara." Otolaryngol Head Neck Surg . 2007 Jul; 137 (1): 110-4.
Powell N, Riley R, Guilleminault C, naTroell R. "A Reversible Uvulopalatal Flap yekunyora uye Kurara Apnea Syndrome." Kurara . 1996; 19: 593-9.
Sher AE, Schechtman KB, uye Piccirillo JF. "Kubudirira kwekutsvaga kwekushandura kweKwenga Kwemhepo muVanhu Vakawanda Vasina Kudzivisa Kurara Apnea Syndrome." Kurara . 1996 Feb; 19 (2): 156-77.
Woodson BT, Robinson S, uye Lim HJ. "Transpalatal Advancement Pharyngoplasty Migumisiro Inofananidzwa neUvulopalatopharyngoplasty." Otolaryngol Head Neck Surg. 2005 Aug; 133 (2): 211-7.
Woodson BT, uye Toohill RJ. "Transpalatal Inokurudzira Pharyngoplasty yeChipatapata Chokurara Apnea." Laryngoscope . 1993 Mar; 103 (3): 269-76.