Njira Yopangira Opaleshoni ya Odwala a COPD Ali ndi Bullae Yaikulu
Ngati muli ndi matenda osokoneza bongo kapena COPD , mungakhale pa chiopsezo chokulitsa bullae, yomwe ili ndi mipanda yokhala ndi mipiringidzo, malo odzaza mpweya m'mapapo. Bullae ndi zotsatira za chitetezo mu bronchiole tubes kapena bronchus. Mphungu yamphongo imayambitsa kupanikizika kwakukulu pazomwe zimayambira, mapepala a mapapu abwino, omwe amachititsa kuchepetsa magazi ndi mpweya m'mapapo.
Izi zimayambitsa kupweteka kwa dyspnea kapena kupuma pang'ono.
Ngati bullae ikukula kwambiri (kawirikawiri yaikulu kuposa mamita imodzi), dokotala wanu angapangire bullectomy kuti awachitire ndikuthandizani kupuma bwino. Njira yopaleshoniyi imachotsa bullae yowonjezera, yomwe imathandiza kuti mapapu abwino a m'mapapo apitirire bwino. Izi zidzapangitsa kuti kupuma kukhale kophweka.
Kodi Bullectomy Ndi Yotani?
Ndondomekoyi imalingaliridwa nthawi iliyonse pamene bullae yodzazidwa ndi mpweya imapezeka pa chifuwa x-ray kapena CT scan. Odwala ambiri omwe amaonedwa ngati opaleshoni ali ndi zizindikiro kuphatikizapo:
- kupuma pang'ono
- ululu
- mapapu akugwa
Zizindikiro zina, ngakhale zosawerengeka, zimaphatikizapo kutuluka magazi ndi matenda mu bullae. Odwala ena alibe zizindikiro koma angafunikire opaleshoni ngati bullae ikuphatikizapo theka la chonde-malo odzaza madzi omwe ali pakati pa mapepala omwe amateteza mapapo.
Ngati dokotala akudandaula kuti mukufunikira bullectomy, adzayang'ana mapapu anu pogwiritsa ntchito mayesero amodzi kapena angapo musanayambe opaleshoni.
Mayesero ovomerezeka omwe amalamulidwa musanayambe bullectomy ndi awa:
- chifuwa x-ray
- chifuwa cha CT
- mayesero a ntchito ya pulmonary
- kupanikizira mpweya / phulusa kapena VQ kuwunika
- mapaipi angiography
Odwala omwe ali ndi bullae yaing'ono, hypercapnia, cor pulmonate, kapena FEV1 osachepera 40 peresenti ya omwe akulosera sali oyenera opaleshoni.
Asanachitike opaleshoni, dokotala angayesetse kuyendetsa bullae yowonjezera popanda.
Ngati muli osakaniza, kusiya kusuta kungakhale kokwanira kuti muyambe kusamalira. Ngati muli ndi zizindikiro pambuyo posiya kusuta fodya, mankhwala, ndi kusamalira monga bronchodilators, kutsekemera glucocorticoids, katemera, mpweya wochulukitsa kapena kukonzanso mapulitsi kungathandize. Ngati izi sizikugwira ntchito, opaleshoni nthawi zambiri ndizochita zotsatirazi.
Bullectomy Yachita Bwanji?
Dokotala wanu angathe kuchita bullectomy mwa njira imodzi. Imodzi ndi mankhwala a thoracotomy, komwe makina a 4 mpaka 6-inch amapangidwa pansi pa chifuwa chanu. Dokotala wa opaleshoni ndiye amapanga chubu chowoneka chotchedwa thoracoscope ndi zipangizo zopangira opaleshoni kudzera mwa catheters kuti achotse bullae.
Chotsatira china ndi kanema kavidiyo. Mofananamo ndi thoracotomy yachikhalidwe, mavidiyo a thoracotomy amawonetsera kanema ndi kanthano komwe amatsogolera dokotala wa opaleshoni. Zimaphatikizapo zochepa zazing'ono pambali pa chifuwa. Pamene bullae imachotsedwa, dokotala wanu akutseketsa zomwe zikuchitika.
Mosasamala kanthu za njira ya bullectomy dokotala wanu opaleshoni amasankha, opaleshoni imachitidwa pansi pa anesthesia. Izi zikutanthauza kuti mufunika kudya msanga musanachite opaleshoni. Onetsetsani kutsatira malangizo onse a dokotala wanu.
Kubwezeretsa kwa bullectomy kungatenge milungu ingapo mpaka mutabwereranso mphamvu ndipo mutha kubwerera kuntchito.
Panthawiyi, muyenera kuonana ndi dokotala mukakumana:
- magazi
- matenda mu incision
- kutentha kwakukulu
- Zizindikiro zowonongeka monga kuphwanya, kutupa komanso vuto lopuma
- ululu
Kuchokera
- > Krishnamohan P, Shen KR, Wigle DA, et al. Bullectomy kwa zizindikiro zovuta kapena zovuta zazikulu zamapapu bullae. Chikulire cha Ann Thorac 2014; 97: 425-31.