Kukonzekera Anu Mediastinoscopy ndi Zimene Mukuyembekeza
Pakati pa mapapu ( mediastinum ), mediastinoscopy ndi njira yomwe chubu (mediastinoscope) imayikidwa kupyolera mu khoma la mchifuwa .Vuto la mediastinamu liri ndi mtima, chifuwa , trachea , lymph nodes , ndi mitsempha ya mwazi. Potsatira njirayi, madokotala amatha kuyang'ana zotupa kapena ziwalo zowonjezereka za m'kati mwa mthupi komanso kutenga zitsanzo (biopsies) kuti ayang'ane khansa kapena zinthu zina.
Nchifukwa chiyani chochita cha Mediastinoscopy?
Kachilombo kameneka kamalimbikitsidwa nthawi zambiri ngati njira yothandizira kudziwa msinkhu wa khansa ya m'mapapo - kuona ngati, kutali ndi zigawo ziti zomwe khansa ingafalikire. Kumvetsetsa molondola za siteji ya kansa ya m'mapapo ndi kofunika kwambiri pakuthandizira madokotala njira zoyenera zothandizira. Mankhwala amtundu wina amatha kupangidwanso kuti azindikire zina, monga sarcoidosis ndi masymphma.
Mediastinoscopy vs Njira Zina
Malinga ndi mayesero omwe amachititsa kuti khansa ya m'mapapo iwonongeke, njira zina zitha kusintha m'malo mwa anthu ena. Chiyeso chofala kwambiri chomwe chimagwiritsidwa ntchito ngati njira yotsatirira njirayi ndi PET kufufuza. Kufufuza kwa PET kumawoneka m'mapapu anu pogwiritsa ntchito kanthana kake ka CT koma kumadalira njira yosiyana. Mosiyana ndi kanema ka CT yomwe imayang'ana kusintha kwa mapangidwe, mapepala a PET amayang'ana kusintha kwa ntchito. Khansa yomwe ikukulirakulira nthawi zambiri imawoneka pa PET yowunikira, pamene chiwombankhanga (chomwe chingayang'ane ngati khansara pa CT) chidzawoneka ngati chikukula.
Kodi Mpangidwe wa Mediastinoscopy Ndi liti?
Nthawi zambiri odwala amakhulupirira kuti munthu ali ndi maselo am'kati mwa mediastinum omwe ali abwino. Kukhalapo kwa maseŵera a m'mimba kumathandiza kwambiri pakukhazikitsa khansa ya m'mapapo, ndipo popeza kukhala ndi malo olondola ndi kofunika pa chithandizo, akhoza kuthandizira kwambiri kusankha mankhwala othandiza kwambiri.
Zolemba zamakono zimagwiritsidwa ntchito mochuluka kuposa kale. Monga tanenera pamwambapa, kujambulira PET nthawi zina kumapereka chidziwitso chofanana koma ndi phunziro lochepa kwambiri. Kuphatikizidwa kwa bronchoscopy ndi endobronchial ultrasound (ndi biopsy ngati kuli kofunikira) kungakhalenso nthawi zina m'malo mofunika kuchita mediastinoscopy.
Kukonzekera Zomwe Mumakhulupirira
Musanayambe kukonza njira yanu, dokotala wanu adzakuuzani za kuopsa kwa ndondomekoyi, ndi zomwe angayembekezere kuphunzira pomuyesa. Ngati muli ndi mankhwala alionse monga magazi owopsa a Coumadin (warfarin), aspirin, kapena mankhwala otsutsa-kutupa monga ibuprofen, amakulimbikitsani kuti muzisiye izi kwa nthawi yisanachitike. Ndikofunika kuti dokotala adziwe ngati mukugwiritsa ntchito mankhwala aliwonse a zitsamba kapena zakudya zowonjezereka chifukwa zina mwa izi zingakulepheretseni kuika magazi. Musanayambe ndondomekoyi, mudzafunsidwa kuti "muthamangire," ndiko kuti, musadye kapena kumwa chirichonse (ngakhale madzi) kwa maola angapo.
Pakati pa Mediastinoscopy Yanu
Mukafika kuchipatala, dokotala adzakufunsani mafunso angapo ndikuyika IV ((intravenous line) m'dzanja lanu. Adzakuyenerani ndi mawonekere kuti mtima wanu uchepetse komanso kuthamanga kwa magazi kukuyang'aniridwa nthawi zonse.
Dokotala yemwe akuyendetserako amachezera ndi inu kuti akambirane mayesero ndi zoopsa zake, ndikukupemphani kuti mulembe fomu yoyenera. Katswiri wa zamagetsi amakufunsani mafunso okhudza mbiri yanu ya anesthesia, mavuto omwe abanja lanu ali nawo ndi anesthesia, ndipo kambiranani za anesthesia omwe mupatsidwa.
Mu chipinda chogwiritsira ntchito mudzapatsidwa mankhwala osokoneza bongo , ndipo mutatha kugona, chubu idzaikidwa pamtima panu kuti ikuthandizeni kupuma. Dokotala wanu amachititsa kachipangizo kakang'ono pamwamba pa chifuwa chanu (sternum) ndi kuyika mediastinoscope, chubu chopanda kuwala.
Adzayang'anitsitsa mediastinum yanu ndi kutenga biopsies kumadera aliwonse omwe akuwoneka achilendo. Pambuyo pochotsa mediastinoscope, zolemba zochepa kapena steri-strips (matepi a tepi) zidzagwiritsidwa ntchito kutseka incision.
Kodi Mungayang'ane Chiyani Pambuyo Pomwe Mumakhulupirira Zomwe Mumakhulupirira?
Mukadzuka mu chipinda chochezera mudzagona chifukwa cha anesthesia. Mukhoza kukhala ndi vuto linalake, ndipo zimakhala zosavuta kuti mukhale ndi mantha komanso pakhosi lopweteka kuchokera mu chubu. Malo osungirako antchito akuyang'anirani inu kwa maola ochuluka musanalole kuti mubwerere kuchipatala chanu kapena kubwerera kwanu. Ngati mupita kunyumba potsatira ndondomekoyi, mudzafunsidwa kuti wina akuyendetseni, chifukwa zotsatira za anesthesia zingathe kukhala maola angapo.
Zovuta Zilipo
Zovuta zazikulu sizodziwika pambuyo pa mediastinoscopy, koma zingaphatikizepo:
- Kutsekemera - Nthawi zina, opaleshoni yowonjezera ikhoza kuyenera kuteteza magazi.
- Pneumothorax - A pneumothorax ndi "mpweya wothamanga" kapena "mapaipi otayika." Izi zikachitika, thumba la chifuwa nthawi zambiri liyenera kuti lisalowe m'malo mpaka mpweya utatsimikizika.
- Kupitirizabe kuopseza kumachitika ngati mitsempha yamagetsi iwonongeka panthawiyi.
- Matenda - Matenda amatha kuchitika, ndipo amapezeka nthawi zambiri ngati zinyama zimatengedwa nthawi yamkati.
- Mavuto okhudzana ndi anesthesia.
- Aphonia - Aphonia amatanthawuza kulephera kulankhula kapena kupanga phokoso (izi kawirikawiri zimakhala zochepa ndipo zimachoka palokha.)
Zotsatira za Mediastinoscopy Yanu
Pambuyo pa mediastinoscopy, dokotala wanu adzakhazikitsa msonkhano kuti akambirane zotsatira. Ngati biopsy imatengedwa nthawi yanu, zingatenge masiku angapo kuti labu liziyang'ana minofu ndi kutumiza zotsatira kwa dokotala wanu.
Ndi khansara yamapapu, zotsatira za wanu mediastinoscopy zingapereke chidziwitso chofunikira pozindikira siteji ya khansa yanu. Kudziwa malo oyenerera a khansa yanu ndi imodzi mwa njira zofunika kwambiri pakusankha ndondomeko ya mankhwala yomwe idzagwiritse ntchito bwino kwambiri pakhungu lanu.
Kodi Muyenera Kuitanira Dokotala Wanu Nthawi Yanji?
Muyenera kutchula dokotala wanu ndi zizindikiro kapena zodandaula zomwe mukutsatira ndondomeko yanu. Ndikofunika kutchula dokotala nthawi yomweyo ngati mukudwala ululu, kupuma kupuma kapena kukhala ndi malungo (nthawi zambiri kuposa 100.5 F, koma funsani dokotala zomwe angakulimbikitseni).
Pansi pa Mediastinoscopy
Kuyeza khansara yamapapu n'kofunika kwambiri pakusankha mankhwala opambana. Zilonda zam'mimba mkati mwa mediastinum, komabe zingakhale zovuta kuzifufuza. Ngakhale kuti PET imafufuza ndi endobronchial ultrasound m'malo mwa zosowa za mediastinoscopies, ndondomekoyi imagwiritsidwanso kawirikawiri pa ntchito yoyamba ya khansara yamapapo. Ngati muli ndi mediastinoscopy, lankhulani ndi dokotala wanu za njira zomwe zingatheke. Kukhala wothandizira nokha mu chisamaliro chanu cha khansa kungakuthandizeni kuti mukhale ndi mphamvu zambiri, ndipo nthawi zina mukhoza kuthandizira zotsatira zanu.
> Zotsatira:
> National Institute of Health. Medline Plus. Zojambulajambula ndi zovuta. Kusinthidwa 06/05/17. https://medlineplus.gov/ency/article/003864.htm
> Velez-Cubian, F., Toosi, K., Glover, J., Pancholy, B., ndi E. Hong. Aphonia Yachidule Pambuyo pa Mediastinoscopy. Annals of Surgery Opera . 2017. 103 (6): e549-e550.