Dokotala wanu mwina adalimbikitsa pleurectomy ngati njira yopaleshoni yafupipafupi yowonjezereka, pneumothoraces, kapena mesothelioma. Kodi ntchitoyi ndi yotani makamaka? Kodi ndi zoopsa zotani ndipo zingatheke bwanji, ndipo ndizomwe zili zotani?
A pleurectomy ndi njira yopaleshoni yomwe imachotsedwa kuchotsa mbali ya pleura , yomwe imayang'ana mapapu.
Mapapu akuzunguliridwa ndi ziwalo ziwiri zofufuzira; phokoso la parietal kunja, pafupi ndi khoma la chifuwa, ndi visceral pleura mkati, pafupi ndi mapapo. Pakati pa pleura imagwirizanitsa pempho lachisomo . Kawirikawiri, pali madontho amadzimadzi mu malo awa (pafupifupi ma teaspoon awiri kapena atatu) omwe amamatira ndi kumathandiza kupaka mapaipi m'mapapo panthawi yopuma.
Zifukwa za Pleurectomy
Zina kusiyana ndi pleurectomy kwa mesothelioma (momwe pleuractomy imakhudzidwa ndi khansa), pleurectomy nthawi zambiri amalimbikitsidwa pambuyo mankhwala ena alephera. Mwachitsanzo, ngati munthu akupitiriza kukhala ndi madzi kapena mpweya mu malo ozizira ngakhale kuti ali ndi thoracentesis.)
Pali zifukwa zingapo zomwe dokotala angakulimbikitsireni pleurectomy:
- Kuchiza kwa mesothelioma - Chizindikiro chofala kwambiri cha pleurectomy ndi kuchiza mesothelioma yovulaza . Khansara iyi, yomwe nthawi zambiri imayanjanitsidwa ndi chiwonongeko cha asibesitosi, ikhoza kutuluka kuchokera ku zilembo zofufuzira (pleural mesothelioma) komanso ziwalo za mtima ndi mimba. Pamene pleurectomy imagwiritsidwa ntchito pochizira mesothelioma, nthawi zambiri imakhala pamodzi ndi njira yotchedwa decortication (pleurectomy decortication). Njirazi sizikutanthauza kuchotsa phokoso lokha koma la chotupa chilichonse chomwe chilipo pachifuwa. Njira ina yopaleshoni ya mesothelioma ndi pneumonectomy yowonjezereka, njira yowonjezereka. Ngakhale kuti chiwerengero chachikulu chokhala ndi vuto la pneumonectomy ndi chokwanira kwambiri, kupulumuka kumakhala kofanana pakati pa pleurectomy decortication ndi extrapleural pneumonectomy
- Kuchiza kwachidziwitso chodziwika bwino kapena kupwetekedwa kwachisokonezo - A pleurectomy angapangidwenso kwa anthu omwe amapitirizabe kapena kupitilira mobwerezabwereza phokoso pamene njira zina (monga pleurodesis ) zimalephera kuteteza ndi kuteteza madzi omwe amamanga pakati pa zigawo zomveka. Mu chiphalalasi, mankhwala amagawanika pakati pa zigawo ziwiri za mapapu pofuna kuyesa zigawo izi palimodzi. Nthaŵi zina kugwiritsira ntchito phokoso ndi "multiloculated" kumatanthauza kuti pali malo osiyanasiyana omwe madzi amatha kumanga. Izi zingapangitse kuti kuika kwa stent kapena pleurodesis kusagwire ntchito. Mwa kuchotsa phokosolo lonse, kumangirira kwa madzi kumatha kutetezedwa.
- Kuchiza kwa mankhwala osokoneza bongo - Pleurectomy imagwiritsidwanso ntchito mofananamo pofuna kuthana ndi mankhwala osokoneza bongo . Zowopsya zofufuzira zowopsya ndizochonderera kwambiri zomwe maselo a khansa alipo. Angatuluke ku khansara yamaphunziro oyambirira, kapena chifukwa cha metastases kuchokera kwa khansa zina monga khansa ya m'mawere . Pamene chithandizo cha mankhwala osokoneza bongo amachititsa kuti munthu asamangokhalira kupweteka, kulamulira kumanga madzi kumatha kuchepetsa kupuma komanso kuchepetsa kupweteka.
- Kuchiza kwa pneumothorax watsopano - Ngati mwakhala mukuvutika ndi mapiritsi awiri (mapaipi omwe agwa) pleurectomy ikhoza kupewedwanso kubwereza kachiwiri.
The Procedure
A pleurectomy kawirikawiri amachitidwa ndi anesthesia ambiri mu chipinda chogwiritsira ntchito.
Mu pleurectomy, mankhwalawa amatengedwera kumbuyo ndi kufanana ndi mapapo (thoracotomy.) Pambuyo popeza dokotala wodwala ndiye mosamala amachotsapo ndi kuchotsa zigawo za pempho. Matenda ena akhoza kuchotsedwa ngati dokotala akugwira ntchito kwa mesothelioma. Asanayambe kutsekedwa, miphika yamagazi imayikidwa yomwe idzachotsedwa pakapita nthawi pamene kutuluka ndi kutuluka kuli kochepa. Chombocho chimatsekedwa, nthawi zambiri ndi sutures zomwe zidzasungunuka pazokha.
Mavuto ndi Zovuta
Kuopsa kwa pleurectomy ndi kofanana ndi njira zina zochitira opaleshoni ndikuphatikizapo:
- Ngozi ya anesthesia (mankhwala amadzimadzi ambiri amagwiritsidwa ntchito pa pleurectomy)
- Kusuta
- Kutenga
- Kuwonongeka kwa mapapo ndi ziwalo zina mu chifuwa
- Kuthamanga kwa mpweya kumakhala kovuta (nthawi zina zimakhala zovuta kuchotsa chifuwa cha chifuwa potsatira pleurectomy chifukwa cha mpweya wotsikirapo)
Mavuto angaphatikizepo kuchotseratu minofu yodandaula kuti pasakhale phokoso lopweteka kapena pneumothorax. Zosakaniza (kumatira) zingapangidwe mu chifuwa ndi kupweteka kosayembekezereka kumachitika kwa anthu ena.
Ndi mesothelioma, zoopsa nthawi zambiri zimadalira kukula kwa khansara komanso kuthekera kwa dokotalayo kuti athe kupeza ndi kuchotsa minofu ya khansa.
Pambuyo pa Opaleshoni
Mankhwala opatsirana kumaphatikizapo nthawi yonse ya kuchira, kukuthandizani kuti mupume mwamphamvu ndikukweranso pabedi mwamsanga kuti muchepetse chiopsezo chanu cha chibayo, mazira a magazi, ndi mavuto ena. Kukonzekera kwapulisi kumalimbikitsidwa pansi pa mzere komanso kupititsa patsogolo kupuma.
Kuthamangitsani
Kawirikawiri, pleurectomy imalekerera bwino. Kwa anthu omwe ali ndi mesothelioma yovuta, nthawi zambiri amatha kupweteka , kutanthauza kuti amachitika kuti achepetse zizindikiro ndikuwongolera chitonthozo koma samachiza matenda.
A pleurectomy kwa anthu omwe ali ndi mesothelioma amatha kukhala ndi chiyembekezo chokhala ndi moyo, komanso kusintha zizindikiro za mpweya wochepa.
Zitsanzo
Ken akapezeka kuti ali ndi mesothelioma, adokotala anamuuza kuti akhale ndi mankhwala enaake ochotsera chotupacho kuti achotse chotupacho muchisomo chake komanso pafupi ndi chifuwa chake.
> Zotsatira:
> Cao, C. et al. Kuwongolera mwatsatanetsatane ndi kufotokoza kafukufuku wa chithandizo cha opaleshoni kwa mesothelioma yonyoza. Khansa Yam'mimba . 2014. 83 (2): 240-5.
> Hasegawa, S. Zozizwitsa za pneumonectomy kapena pleurectomy / zokongoletsera za mesothelioma. General Thoracic ndi Opaleshoni ya Mtima . 2014. 62 (9): 516-21.
> Vlahu, T., ndi W. Vigneswaran. Pleurectomy ndi Decortication. Annals of Translational Medicine . 2017. 5 (11): 246.