Opaleshoni Yapulasitiki Kuti Kubwezeretsanso Chizindikiro
Mtsinje wa TRAM (transverse rectus abdominus myocutaneous) ndi njira yomwe imagwiritsira ntchito minofu, mafuta ndi khungu kuchokera pamimba kuti mupange kachilombo ka mimba pambuyo poyambitsa matenda . Ndondomekoyi imatenga dzina lakelo kuchokera kumtundu wa rectus abdominus minofu mumimba. Pali njira ziwiri zomwe mungagwiritsire ntchito TRAM - monga mfulu (yosamalidwa), komanso ngati pedicle. Chifuwa chanu chokonzedwanso sichingawonekere ndikumverera chimodzimodzi ndi chifuwa chanu chachibadwa, ndipo mudzafunikira opaleshoni yowonjezera kuti mupange msomali ndi areola.
Kubwezeretsedwa kwa TRAM Flap
Panthawi yomanga nyumba ya TRAM, khungu, mafuta, ndi minofu zidzasunthira kuchoka pa mimba mpaka pachifuwa chanu, ndipo zimagwiritsidwa ntchito popanga chifuwa. Amayi ambiri ali ndi minofu yokwanira m'mimba mwawo kuti apange chifuwa chatsopano. Koma ngati mulibe minofu yokwanira, imatha kukhazikika kuti izitha kukula kwa chifuwa chatsopano. Njira ziwiri amagwiritsira ntchito kusuntha minofu yanu kuchokera kumimba yanu mpaka pachifuwa chanu.
Njira Zowonjezera ndi za Pedicle Flap
- Chipangizo cha Pedicle - Njira imeneyi sikutanthauza kudula chikopa cha khungu, mafuta, mitsempha ya magazi, ndi minofu yaulere kuchokera kumimba mwako. Chombo cha pedicle chidzasunthira kupyola mumtambo pansi pa khungu lanu mpaka kumalo anu.
- Chilakolako chaulere - Dokotala wanu akudula chigawo cha khungu, mafuta, mitsempha ya mitsempha, ndi minofu yaulere kuchokera kumalo mwako. Gawo ili lidzasamutsira kumalo anu m'chifuwa ndikugwirizananso ndi magazi anu pogwiritsira ntchito microsurgery (mofanana ndi ndondomeko ya DIEP ). Izi zidzatenga nthawi yambiri kusiyana ndi njira ya pedicle, koma opaleshoni ambiri amaganiza kuti zimapanga mawere ambiri.
Ubwino wa TRAM Flap
Kubwezeretsa chifuwa cha TB kumamva kwambiri ngati chifuwa chachibadwa kwa aliyense amene akukukhudzani: Zidzakhala zotentha ndi zofewa chifukwa zidzasindikizidwa bwino ndi mafuta okwanira kuti azisakaniza ndi kutuluka ngati chifuwa chanu choyambirira. Chifukwa minofu ya m'mimba ndi mafuta zimaphatikizidwa mu chifuwa chanu chatsopano, mumakhalanso ndi mimba, zomwe zimapangitsa kuti mimba yanu ikhale yopanda phokoso.
Kuipa kwa TRAM Flap
Chifuwa chanu chatsopano sichidzakhala ndi nkhawa chifukwa mitsempha yomwe ili mu chifuwa chanu choyambirira yachotsedwa. Njira yothandizira TRAM imatenga nthawi yochulukirapo pochita opaleshoni ndi kuchiritsa kusiyana ndi kukhazikitsa malo. Zowopsa zina zimagwirizanitsidwa ndi katemera wa TRAM - mimba ya m'mimba ndi mimba ya m'mimba (chifukwa minofu yomwe imathandiza mimba yasuntha). Ndondomeko ya TRAM ili ndi chiwerengero cha 5% cholephera kutero pamene chovalacho chikhoza kufa, ndipo chiyenera kuchotsedwa kwathunthu. Chombo cha pedicle, chomwe sichichotsedwa ku magazi ake, sichikhoza kuchepa.
Simunali Wotsatila Ngati:
- ndinu olemera kwambiri kapena olemera kwambiri - muli pangozi yaikulu ya mimba ya m'mimba pambuyo pa TRAM, popeza muli ndi minofu yochepa kuti musamalire mimba yanu
- ndinu woonda kwambiri - simudzakhala ndi minofu yokwanira ya m'mimba
- mumasuta - zilonda zanu za m'mimba zimatenga nthawi yaitali kuti zichiritse, ndipo minofu yanu ya mafuta imatha kukhala minofu yambiri
Kubwezeretsedwa kwa M'thupi Tsopano kapena Patapita nthawi
Kubwezeretsa m'mimba kungatheke panthawi yomwe akudwala matendawa. Ngati mukufuna chithandizo cha ma radiation kumalo osokonezeka kapena chifuwa, muyenera kuchedwa. Komabe, ndibwino kuyembekezera: Kuchita mwambo wisanachitike chithandizo kumatha kulepheretsa kuti wodwalayo atha kukuchitirani bwino.
Ngati mukuganiza za kumangidwanso, ndi bwino kulankhula ndi opaleshoni yanu ya pulasitiki musanayambe kugonana. Izi zimakupatsani mwayi wokhala ndi miyeso ndi zithunzi zomwe zimatengedwa m'mawere anu achilengedwe , kotero kuti chifuwa chanu chokonzedwanso chikhoza kubweretsedwanso molondola. Dokotala wanu opaleshoni ya pulasitiki angakupatseni zosankha zambiri, ndipo akhoza kuthandiza kuteteza khungu ndi kupewa zipsera zosafunikira ngati mutayambana naye.
Zimene Tingayembekezere Panthawi Yokonzanso Matenda a TRAM Flap
Simudzakhala maso pamene mukudwala matenda osokoneza bongo kapena kubwezeretsanso, kotero mutha kukhala ndi sedationous intravenous kapena anesthesia . Lankhulani ndi dokotala wanu opaleshoni ndi wodwalayo wamagetsi omwe angakuthandizeni kwambiri. Ngati mwachitidwa opaleshoni musanayambe kukumana ndi vutoli, funsani ngati mutha kuyesedwa. Ngati mukudwala matenda osokoneza bongo komanso kumanganso nthawi imodzi (kubwezeretsa mwamsanga), dokotala wanu opaleshoni amachotsa chifuwa chanu poyamba, kuteteza khungu lenileni kuti likhale labwino.
Kukonzekera kwa TRAM Flap Kubwezeretsedwa kwa M'thupi
Dokotala wanu opaleshoni adzagwiritsa ntchito khungu pokonzekera mosamala kuti pakhale khungu lanu. Mphuno yachitsulo idzagwedezeka kudutsa mimba yanu, pamwamba pa rectus abdominus minofu yanu. Kuphulika kumeneku kudzakhala khungu la khungu lomwe limatseketsa incision pachifuwa chanu chokonzedwanso. Pamene chokopa chotseka chidzatsekedwa, chidzakhala mzere womwe umadutsa mimba yanu kuchokera ku mchiuno mpaka kumapeto.
Kusuntha Minofu ndi Khungu
Pazizindikiro za khungu, dokotala wanu wa opaleshoni ya pulasitiki amachititsa kuti thupi liziyenda bwino, ndikumeta khungu ndi minofu. Chombo chidzapangidwa pansi pa khungu lanu kuti chikhomocho chikhotsedwe. Mphunoyi imatha kudutsa mumsewuwu kupita ku mastectomy incision. Tawonani kuti fanizoli likuwonetsera zaulere - khungu, mafuta, mitsempha ya mitsempha, ndi minofu zadulidwa.
Kupanga Chiberekero Chatsopano
Mphuno yamkati ya m'mimba (yomwe imagwirizanitsidwa ndi minofu) idzaikidwa kuti idzaze khungu limene linatayika panthawi yachisoni. Ngati muli ndi phokoso la pedicle, dokotala wanu opaleshoni ya pulasitiki adzatseka makina a khungu kuti apange chifuwa chatsopano. Ndipo ngati mukukhala ndi ufulu womasuka, dotolo wanu amagwiritsa ntchito microsurgery kuti agwiritse ntchito mitsempha ya magazi poyamba, kenako atseke pakhungu.
Kuchokera ku TRAM Flap Kubwezeretsa Mimba
Muyenera kukhala mu chipatala masiku 4 mpaka 7 pamene mukuyamba kuchiritsidwa kuchokera ku opaleshoni yokonzanso mawere. Ngati muli ndi madakiteriya opanga opaleshoni , mudzaphunziranso zomwe mungasunge ndikusunga mauthenga a madzi. Lembani ululu ngati mulipo kuti mutha kuchiritsidwa. Musabwererenso kuti mugwire ntchito - konzani kuti mukhale ovuta kwa masabata atatu kapena asanu kuti mupeze. Onetsetsani kuti muli ndi winawake pafupi kuti akuthandizeni ndikuyendetsa chilichonse. Komanso, onetsetsani kuti mupite ku malo omwe mukutsatira kuti dokotala wanu azitha kuyang'anitsitsa zomwe mukuchita komanso kuvala kwanu, ndi kuchotsani zotupa zanu. Onani kuti fanizoli likuwonetsa phula la TRAM yodzazidwa ndi nkhono yokonzanso ndi isola.
TRAM Flap Yophatikiza Kachiwiri
Chombo cha TRAM chingagwiritsidwe ntchito pakamanganso mawere pambuyo, kapena, ndi matenda owirikiza awiri . Muyenera kukhala ndi minofu yokwanira ya mabere awiri. Khungu lanu la m'mimba limagawidwa m'magawo awiri, ndipo limagwiritsidwa ntchito kutsegula mastectomy incision. Njirayi iwiri ya TRAM idzatenga katatu ngati TRAM imodzi, komanso nthawi yobwezeretsa iwiri iwiri. Mwinamwake mukumva wofooka ndikukumva kuwawa kwa masabata angapo pambuyo pake.
Kuganizira Kwambiri za TRAM Flap
- Dongosolo limodzi - dokotala wanu akhoza kuchotsa minofu ya m'mimba nthawi imodzi yokha. Ngati mukusowa kubwezeretsa m'mawa, muyenera kusankha njira yosiyana.
- Nsalu ya Bikini - ululu wako wa m'mimba udzakhala wotalika kwambiri. Ngati simukuvala bikinis, sivuta. Koma ngati simukufuna chiwopsezo kuchokera ku chiuno kuti mupite pamimba, TRAM si yanu.
- Kuthamanga kwina - mimba yanu yamimba imatha kutambasulidwa kapena kusuntha pakati pa TRAM. Dokotala wanu angakhoze kupanga kanema yatsopano kwa inu.
- Zikuwoneka bwino, zimakhala bwino - chifuwa chanu chatsopano chidzamva ngati chinthu chenicheni kwa wokondedwa wanu (kutentha, kusintha, zofewa) koma simudzakhalanso ndi zofanana kuchokera pachifuwa chanu choyambirira. Mitsempha yathyoledwa, kotero kutentha kwa m'mawere kumatayika.
Zotsatira
Pezani Opaleshoni Yapulasitiki / Yowonongeka M'dera Lanu
Zotsatira:
American Cancer Society. Kubwezeretsa Amtabata Pambuyo pa Mastectomy. Mitundu ya Kumangidwanso kwa Amabere. Zosinthidwa: 09/06/2007.
Dr. Susan Love Research Foundation. Kubwezeretsa mimba. Zasinthidwa: April 21, 2008.