Cholinga:
Kumanga khoma la chifuwa n'kofunika ngati pali vuto mu thoracic kapena pachifuwa. Chomwe chimayambitsa chifuwa cha mpanda ndi chifuwa kapena chosasunthika. Kutha kwachangu kwapakati pafupipafupi ndiko njira yopaleshoni yomwe imapangidwira mkati mwa sternum (yomwe imadziwikanso monga bere), pambuyo pake sternum imagawidwa kapena kupasuka.
Njirayi imapereka mwayi wokhudzana ndi mtima ndi mapapo kwa opaleshoni.
Etiology:
Mafelemu a mchifuwa amagawidwa m'magulu awiri: anapeza ndi congenital .
Kupezeka:
- Zovuta
- Kutupa
- Kutenga
- Mafunde
Congenital:
- Poland Syndrome
- Pectus Excavatum
- Pectus Carinatum
Zolinga:
Zolinga za zomangamanga ndizo:
- Chotsani minofu yosafunika, yochokera ku khoma la chifuwa
- Bweretsani bata ndi makonzedwe ku khoma la chifuwa
- Chotsani malo aliwonse omwe afa (malo osayera ndi malo opanda kanthu omwe amachotsa atachotsa mbali ya mapapo kapena mapapo onse)
- Perekani chingwe cholimba pa khoma la chifuwa
- Pezani zotsatira zabwino
Anatomy:
Khoma la chifuwa liri ndi zigawo zitatu:
- Chingwe chakunja: Minofu yofewa, yomwe ili ndi khungu, mafuta ochepa kwambiri, ndi minofu
- Chigawo chapakati: Mfupa, yomwe imaphatikizapo nthiti, karoti, ndi sternum
- Mzere wosanjikiza: Malo osasunthika, omwe ndi malo (masentimita) pakati pa mafupa ndi mapapo
Chimodzi, ziwiri, kapena zigawo zitatu ziyenera kumangidwanso malinga ndi vuto.
Zotsatira zowonongeka zimayambira ndi zida zakuya kwambiri ndipo zimangopitirirabe - phokoso lachonde, kenako chigoba chofewa, ndipo pamapeto pake zimakhala zofewa.
Kuwonjezera pamenepo, mtundu wamangidwe wodalirika udzadalira malo olakwika pa khoma la chifuwa.
Kumangidwanso kwa Gawo la mkati:
- Cholinga cha kubwezeretsa mkati mwake, chomwe chimadziwika kuti parietal cavity, ndicho kupeza chingwe chopanda mphamvu.
- Izi zimachitidwa podzaza malo okufa kuti asadzazidwe ndi madzi ndi / kapena pus.
- Malo owonongeka amadzazidwa ndi kugwiritsidwa ntchito kwa minofu (yomwe imadziwikanso kuti ziphuphu za m'madera ena) m'derali kapena kuti omentum :
- Latissimus dorsi flap
- Serratus anterior flap
- Pectoralis yaikulu flap
- Rectus abdominis
- Chigoba cha omental
Kumangidwanso kwa Pakati Pakati:
- Chigoba chophatikizidwa chimaonedwa kuti ndi chigawo chapakati
- Izi zimatetezedwa kuti ziziteteza ziwalo zofunika (mtima, mapapo, etc.) ndi kupanga kupuma koyenera
- Ngati nthiti zinayi zowonongeka kapena zowonjezereka zachotsedwa kapena vuto lili lalikulu kuposa masentimita asanu, chigobacho chiyenera kumangidwanso
- Ntchito yomangidwanso ikuchitika ndi zotsatirazi:
Kubwezeretsedwa kwa alloplastiki:
- Minga yolimbikitsidwa ndi methyl methacrylate
- Matenda a mafupa
Kumangidwanso kokhazikika:
- Latissimus dorsi flap
- Serratus anterior flap
- Pectoralis yaikulu flap
- Rectus abdominis
- Chigoba cha omental
Kumangidwanso kwa Zowonjezera:
- Minofu yofewa (khungu, minofu yapansi) imatengedwa kuti ili kunja
- Chilema cha minofu yofewa ikhoza kukhala makulidwe ang'onoang'ono (mwangozi wodwala) kapena ikhoza kukhala makulidwe okwanira (kuyapa kwambiri)
Mabala amtundu wambiri amamangidwanso ndi:
- Kugawidwa kwa khungu khungu kapena
- Chiwonongeko cha dzikoli
Zilonda zowonjezera zonse zimangidwanso ndi:
- Chiwonongeko cha dzikoli
- Kuwombera kwaulere nthawi zambiri
Zotsatira:
Din AM, Evans GRD. Chipilala Chophimba Pachifuwa. Mu McCarthy JG, Galiano RD, Boutros SG, eds. Chithandizo Chamakono mu Opaleshoni Yapulasitiki. Philadelphia: Saunders Elsevier, 2006.
Janis JE. Chipilala Chophimba Pachifuwa. Mu Janis JE (ed). Zofunikira za Surgery Pulasitiki. St. Louis: Quality Medical Publishing inc., 2007.
Kusintha RR. Kumangidwanso Kwambiri. Ku Thorne CHM, Beasely RW, Aston SJ, Bartlett SP, Gurtner GC, Spear S, eds. Grabb ndi Smith's Plastic Surgery, 6th ed. Philadelphia: Lippincott, wa 2007.
Pectus Carinatum Medline Plus.
Inapezeka pa April 2, 2011.
Pomerantz J, Hoffman W. Chest Wall Defects. Mu Kryger, ZB, Sisco M (eds.). Opaleshoni Yapulasitiki Yothandiza. Austin, Texas: Landes Bioscience, 2007.
http://www.microsurgeon.org/. Inapezeka pa April 2, 2011.