Kumvetsetsa Njira za Laparotomy ndi Laparoscopy

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Laparotomy ndi Laparoscopy

Laparotomy ndi mankhwala omwe amachitidwa opaleshoni pamimba pogwiritsa ntchito chikhomodzinso chokwanira, osati njira yowonongeka. Dzina lina la opaleshoni iyi yowonjezereka ndizokhazikitsidwa.

Laparotomy amagwiritsira ntchito incision kukula kwathunthu ndipo njira yochepa yosawonongera ya njirayi imatchedwa laparoscopy ndipo imagwiritsa ntchito zingapo zing'onozing'ono.

Mchitidwe wamakhalidwe - laparotomy - nthawi zambiri amatchedwa njira yotseguka, chifukwa choti mankhwalawa amachititsa kuti dokotalayo aganizire ziwalo, mitsempha ya mitsempha, ndi ziphuphu m'mimba. Laparotomy amagwiritsa ntchito zipangizo za laparoscopic kuphatikizapo kamera yomwe imapangidwira pang'onopang'ono kuti dokotalayo aone ngati zipangizo zamakono ndi zipangizo zopangira opaleshoni.

Chisankho chotsatira ndondomeko yotseguka kapena laparoscopically chimakhala ndi dokotalayo ndipo, ngati chili chonse, akuyembekeza kuti apeze pa opaleshoni. Ngati opaleshoni ikuchitika ngati mwadzidzidzi, dokotalayo akhoza kuchita laparotomy ndi laparoscopic laparotomy chifukwa zimapereka maonekedwe akuluakulu ndipo zingakhale zofulumira kusiyana ndi njira yochepetsera. Pakangotha ​​mphindi zochepa, njira yotseguka imakhala yofulumira kwambiri pa nthawi yoyamba ya opaleshoni.

Nthawi zambiri njira yotseguka imasungidwa nthawi yomwe imakhala yofunika kwambiri, wodwalayo sakhala wosakhazikika kapena pamene njirayo imafuna kutengeka kwakukulu, monga opaleshoni yomwe imafuna kuti chigawo chachikulu cha m'mimba chikhale chowoneka ndi chofikira.

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Laparotomy yofufuza ndi Laparoscopy yofufuza

Laparotomy yofufuzira ndi dzina lopatsidwa opaleshoni yotsegula m'mimba yogwiritsidwa ntchito kufufuza ziwalo ndi ziphuphu za mimba pamene matenda asanapangidwe. Ngati chitsimikizo cha vuto la m'mimba sichiri chowonekera, kuyang'ana pamimba pamimba kungathandize.

M'mbuyomu, kufufuza kotchedwa laparotomy kunkachitika kawirikawiri chifukwa cha "ululu m'mimba wosadziwika," pamene mayesero sanathe kupeza chifukwa cha ululu. Idachitiranso pa zifukwa zambiri, kuphatikizapo zoopsa, kuyembekezera khansa kapena zinthu zina zomwe mayesero sangathe kuzipeza.

Masiku ano, njira yochepa yosavomerezeka imagwiritsidwa ntchito mobwerezabwereza kuposa njirayi. Pamene ndondomekoyi yachitidwa ndi njira zowonongeka, imatchedwa laparoscopy

Kuchita opaleshoni, mwachizoloŵezi, sikunali kozolowereka kusiyana ndi kale lomwe chifukwa cha kupititsa patsogolo mafano a thupi pogwiritsa ntchito Magnetic Resonance Imagine (MRI), Computer Tomography (CT Scans) ndi njira zina. Nthawi zambiri timatha kuzindikira zinthu popanda kuyang'ana ndi kuwona opaleshoni, ndipo mavuto ambiri amatha kuchiritsidwa ndi mankhwala m'malo mozengereza.

Nthaŵi zina, dokotalayo amatha kupeza chifukwa cha vuto la m'mimba ndi kutsiriza njira yopenda popanda mankhwala ena. Zotsatirazi zikhoza kukambidwa pamene wodwalayo ali maso komanso atcheru, ndipo ndondomeko ya mankhwala imapangidwa. Mwachitsanzo, ngati mzimayi atapezeka kuti ali ndi mazira oopsa kwambiri pa laparotomy, dokotalayo angasankhe kukambirana momwe angapangidwire ndi wodwalayo asanayambe kupita kuchipatala.

Pakati pa laparotomy yowonongeka, zitsanzo za minofu zingathenso kutengedwa mu ndondomeko yotchedwa biopsy . Izi zimachitidwa kuti athandizidwe ndi matenda a m'mimba monga minofu ingathe kufufuzidwa ndi makina osakanikirana ndipo vutoli lingapezedwe mwanjira imeneyo.

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Zifukwa Za Laparotomy Kapena Laparoscopy

Zifukwa Za Laparotomy

Laparotomy ndi dzina lenileni la opaleshoni yomwe imachitidwa pamimba. Mawu akuti laparotomy akuyesedwa nthawi zambiri amagwiritsidwa ntchito pofotokoza njira yomwe ikugwiritsidwa ntchito pofuna kudziwa momwe matenda aliri. Mwachitsanzo, ngati wodwala ali ndi ululu m'mimba ndipo chitsimikizo cha ululu umenewo sichimveka bwino, dokotalayo adzayang'anira laparotomy.

Zifukwa Zambiri Zopangira Laparotomy:

Utumbo Wambiri ndi Wamng'ono : Kutsegula m'mimba, kutsekemera kwa m'mimba, khansa,

Chiwindi : Kutupa, kuthamanga kwa chiwindi, kutambasula kwa chiwindi, kusowa kwa kupsa.

Njira Yamakono-Impso, Ureters ndi Chikhodzodzo : Mitsempha ngati miyala ya impso, khansara, kupwetekedwa mtima

Mchitidwe Wobereka Wamwamuna : Endometriosis, khansa, ectopic pregnancy, kutupa

Gallbladder : Kawirikawiri amagwiritsa ntchito njira yochepetsetsa yochepa, nthawi zambiri imatha kuchotsedwa pogwiritsa ntchito njira yotseguka

Malonda : Kutupa, kutambasula kwaperesa, kupasuka

Pancreas : Kutupa kwa zikondamoyo, khansara

Madandaulo a m'mimba ambiri : Matenda monga abscess , khansa, kupwetekedwa mtima, kutupa kwa matenda, kudziwa momwe polojekiti ikuyendera, kugwirizana ndi njira zapitazo

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Opaleshoni Yowopsa ya Laparotomy

Laparotomy ingakhoze kuchitidwa mofulumira, kutanthauza kuti wodwala akukumana ndi chiopsezo chowopsya ndipo laparoscopy ikufunika kuti azindikire mtundu wa vuto, kuti athetse vutoli kapena onse. Vuto likhoza kukhala lokha kuchokera kumudzi wosadziwika, kuwonongeka kwa limba kapena ngakhale kutuluka kwa magazi komwe sikungatheke ngakhale kuti chifukwa chake chikudziwika.

Ndondomeko yomwe imachitika kawirikawiri pambuyo povulazidwa kwambiri chifukwa cha kupweteka kwa m'mimba ndizomwe zimakhala zovuta kwambiri. Apa ndi pamene kachilombo kakang'ono kamapangidwira mimba ndipo m'mimba mwa mimba mumatuluka ndi madzi. Ngati kutuluka kwa thupi kumatuluka m'thupi ndi magazi ambiri, laparotomy ingasonyezedwe. DPL sichidziŵa kuti ndi chitsimikizo chotani koma imasonyeza kuti magazi amapezeka. Laparotomy idzazindikira kuti chovulaza ndi dokotalayo angathe kukonzanso vutoli.

Zoopsa, monga ngozi ya galimoto kapena kuvulala koopsa (kugwa kapena kugunda kwa mfuti) ndi chifukwa chobweretsera mavuto a m'mimba omwe ayenera kupezeka kapena kuchiritsidwa ndi laparotomy. Pazifukwa izi zingakhale zoonekeratu kuti pali zilonda zazikulu za m'mimba, komabe ziwalo, zotengera ndi zida zogwirira ntchito sizingakhale zomveka bwino. Pazochitikazi, dokotalayo amatha kuganiza mozama za kuvulala ndikuzindikira kuti vutoli, ndipo nthawi zambiri, amachitiranso vutoli.

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Laparotomy: Ngozi ndi Mavuto

Kuphatikiza pa zoopsa zonse za opaleshoni ndi zoopsa za anesthesia , laparoscopy ndi laparotomy zimapangitsa zoopsa zawo. Zowopsa zimasiyana malinga ndi vuto lalikulu kapena matenda omwe amachititsa kuti pakhale ndondomeko yofunikira, koma zoopsa zenizenizi ndi izi:

• Kutenga
• Chosowa chosadziwika
• Kutsegula kuchokera ku malo opaleshoni

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Pulogalamu ya Laparotomy ndi Laparoscopy

Laparotomy kapena laparoscopy imayamba ndi kayendetsedwe ka anesthesia. Pamene anesthesia ikatha, khungu la mimba limakonzedwa ndi njira yothetsera antibacterial pofuna kuteteza matenda pa malo opaleshoni.

Dokotala wa opaleshoniyo adzapanga incision. Ngati ululu uli m'munsimu pamimba pazowonjezereka, incision idzaikidwa kudera limenelo.

Ngati njira yowonongeka yopangidwira yopangidwira yopangidwa ndi laparoscopy ikukonzekera, zingapo zing'onozing'ono zosapitirira kuposa inchi yaitali zidzapangidwa, ngati laparotomy ikukonzekera, kutengeka kwakukulu kumapangidwa.

Ngati chitsulo chachikulucho chikagwiritsidwa ntchito, chikhoza kukhala chimbudzi cha pakatikati, chomwe chimayikidwa pakati pa fupa la pubic ndi pansi pa sternum, ndi kutengeka kwapakati, komwe kumaikidwa pamzere.

Nthaŵi zina, mankhwalawa angakhale ochepa kumayambiriro kwa opaleshoniyo ndipo kenako amawunikira kuti athe kukwaniritsa njira zothandizira. Nthawi zina njira yowonongeka imakhala yotseguka ngati dokotalayo akusowa malo ambiri kuti awone ngati nkhaniyo ndi ntchito yake.

Katemera akadzapangidwa, ziwalo ndi ziphuphu zidzayendera chifukwa cha zizindikiro za matenda, matenda kapena kutupa. Zizindikiro zimatha kutengedwa ndi matenda osiyanasiyana ngati pakufunika. Nthawi zina, mimba ya m'mimba ikhoza "kutsukidwa," kumene mchere umayikidwa m'mimba, kenako amasonkhanitsidwa kuti apitirize kuphunzira.

Pamene ziwalo ndi ziphuphu za mimba zatsimikiziridwa, "kuyang'ana ndikuwona" gawo la ndondomeko lapitirira; Komabe, nthawi zambiri, njira yowonjezera idzachitidwa. Mwachitsanzo, laparotomy imachitidwa pofuna kupeza chitsime cha kupweteka kwa m'mimba, ndipo zowonjezereka zowonjezera zimapezeka, njira yothandizira pulogalamuyo imatha kuphatikizidwa ndi laparotomy.

Chombocho chikhoza kutsekedwa m'njira zosiyanasiyana. Zowonongeka kwakukulu nthawi zambiri zimatsekedwa ndi sutures kapena zakudya, zing'onozing'ono zimatha kutsekedwa ndi mapepala othandizira otchedwa steri-strips kapena glue opaleshoni. Chombocho chimaphatikizidwa ndi bandage yopanda ntchito. Anesthesia imayimitsidwa ndipo mankhwala amapatsidwa kuti amutse wodwalayo, amene amatengedwa kupita ku malo ochira.

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Kuchokera ku Laparotomy

Kupulumuka kwa njira ya laparotomy kumasiyana kwambiri kuchokera kwa wodwala mpaka wodwala. Izi ndi chifukwa cha mavuto ambiri omwe opanga opaleshoni amafunikira. Kawirikawiri, ndondomeko yosavuta yomwe ndi laparotomy ndipo palibe njira yowonjezerapo imafuna masabata awiri kapena 6 a nthawi yopuma asanabwerere kuntchito zoyenera. Izi zikhoza kuwonjezereka kwambiri ndi njira zomwe ziyenera kuchitika pambuyo pofufuza.

Odwala omwe ali ndi laparotomiya komanso amakhala ndi vuto lalikulu (wodwalayo yemwe anali pangozi ya galimoto ndi mafupa osweka ndi kutuluka kwa magazi kumene kumafuna laparotomy) akhoza kutenga nthawi yayitali kuchiritsa opaleshoni. Thupi limagwira ntchito kuti lichiritse maulendo angapo kamodzi, kotero nthawi yonse ya machiritso imatambasulidwa. Mavuto ena omwe amachititsa kuti laparotomy ikhale yofunikira akhoza kuchepetsa machiritso. Wodwala amene ali ndi khansa angakhale ndi vuto lovuta kwambiri pamene chithandizo cha khansa chingayambe kupezeka. N'chimodzimodzinso pakakhala opaleshoni yowonjezereka ndi laparotomy.

Atatulutsidwa kuchipatala kuti akabwezere kunyumba, nkofunika kuti chisamaliro chapadera chichotsedwe kuti chiteteze matenda komanso chisamalire bwino. Matenda ndi chimodzi mwa mavuto omwe amachitidwa opaleshoni imeneyi, kotero kudziwa momwe angadziwire zizindikiro za matenda ndikofunika. Sungani kuti musamalidwe ngati mukukwera kuchoka kumakhala kapena zinthu zina zomwe zimawonjezera mphamvu ya m'mimba kuti musamve kupweteka, kuchepetsa komanso kuchepetsa chiopsezo cha chosowa chosadziwika.

_Zotsatira:

> Kufufuza m'mimba. National Institutes of Health. 2006. http://www.nlm.nih.gov/medlineplus/ency/article/002928.htm