Kuvhiyiwa kwemapapu

Kuvhiyiwa kwemapapu kuvhiya kunoitwa kugadzirisa kana kubvisa materu emapapu. Kune zvakawanda zvakajairika zvekuvhiya kwemapapu, kusanganisira:

• Biopsy yekukura kusingazivikanwe
• Lobectomy, kubvisa rimwe kana akawanda mapofu emapapu
• Kugadzira mapapu
• Pneumonectomy, kubvisa mapapu
• Kuvhiya kudzivirira kuvakwa kana kudzoka kwemvura kuchipfuva (pleurodesis)
• Kuvhiya kubvisa hutachiona muchipfuva (empyema)
• Kuvhiya kubvisa ropa muchipfuva mhango, kunyanya mushure mekukuvara
• Kuvhiya kubvisa madiki mabhaluni-akafanana matishu (blebs) ayo anokonzera mapapu kudonha (pneumothorax)
• Wedge resection, kubvisa chikamu chemuhomba mupapu

Iyo thoracotomy kucheka kwekuvhiya kunoitwa nachiremba anovhura rusvingo rwechipfuva.

Iwe unenge uine general anesthesia usati wavhiyiwa. Iwe unenge wakarara uye usingakwanise kunzwa kurwadziwa. Nzira mbiri dzakajairika dzekuvhiya pamapapu ako ndeye thoracotomy uye vhidhiyo-inobatsira kuvhiya thoracoscopic (VATS). Robotic kuvhiya inogona zvakare kushandiswa.

Kuvhiya kwemapapu uchishandisa thoracotomy kunonzi kuvhiya kwakavhurika. Mukuvhiya uku:

• Iwe ucharara parutivi rwako patafura inoshanda. Ruoko rwako ruchaiswa pamusoro pemusoro wako.
• Chiremba wako achaita kucheka kwekuvhiya pakati pembabvu mbiri. Iyo yekucheka inoenda kubva kumberi kweako chipfuva madziro kumusana kwako, ichipfuura ichingove pasi pehapwa. Mbabvu idzi dzinozopatsanurwa kana mbabvu inogona kubviswa.
• Mapapu ako kudivi rino anozopeputswa kuitira kuti mweya usapinda mukati nekubuda mauri panguva yekuvhiyiwa. Izvi zvinoita kuti zvive nyore kuti chiremba anovhiya pamapapu.
• Chiremba wako anogona kunge asingazive kuti yakawanda yemapapu ako inoda kubviswa kusvikira chipfuva chako chavhurika uye mapapu achionekwa.
• Chiremba wako anovhiya anogona zvakare kubvisa lymph node munzvimbo ino.
• Mushure mekuvhiyiwa, rimwe chete kana anopfuura machubhu emvura anoiswa munzvimbo yako yechifuva kuti ubudise zvinwiwa zvinovaka. Machubhu aya anonzi machubhu echifuva.
• Mushure mekuvhiyiwa pamapapu ako, chiremba wako anovhara mbabvu, mhasuru, uye ganda nemasuture.
• Kuvhura kwemapapu kunogona kutora kubva kumaawa maviri kusvika kumatanhatu.

Vhidhiyo-yakabatsirwa thoracoscopic kuvhiyiwa:

• Chiremba wako achaita zvidimbu zvidiki zvekuvhiya pamusoro pechifuva chako. Vhidhiyocope (chubhu ine kamera diki pamagumo) uye zvimwe zvishandiso zvidiki zvichapfuudzwa kuburikidza nekucheka uku.
• Ipapo, chiremba wako anovhiya anogona kubvisa chikamu kana mapapu ako ese, kubvisa mvura kana ropa rakavaka, kana kuita mamwe maitiro.
• Rimwe kana akawanda machubhu anozoiswa mubhokisi rako kuti ubudise zvinwiwa zvinovaka.
• Maitiro aya anotungamira pakurwadziwa kushoma uye nekukurumidza kupora pane kuvhura kwemapapu.

Thoracotomy kana vhidhiyo-yakabatsirwa thoracoscopic kuvhiya kunogona kuitwa ku:

• Bvisa kenza (senge kenza yemapapu) kana biopsy kukura kusingazivikanwe
• Rapa kukuvara kunokonzera mapapu tishu kudonha (pneumothorax kana hemothorax)
• Bata zvachose rakapunzika mapapu tishu (atelectasis)
• Bvisa tishu remapapu iro rinorwara kana kukuvara kubva emphysema kana bronchiectasis
• Bvisa ropa kana ropa clots (hemothorax)
• Bvisa mamota, senge wega pulmonary nodule
• Fufutira mapapu emapapu akadonha (Izvi zvinogona kunge zvichikonzerwa nechirwere chakadai sechirwere chisingaperi chisingadziviriri chemapapu, kana kukuvara.
• Bvisa hutachiona muchipfuva (empyema)
• Mira fluid buildup mubhokisi chest (pleurodesis)
• Bvisa ropa rinogwamba kubva mupurmonary arteri (pulmonary embolism)
• Rapa matambudziko etibhii

Vhidhiyo-yakabatsirwa thoracoscopic kuvhiya inogona kushandiswa kurapa mazhinji eaya mamiriro. Mune zvimwe zviitiko, kuvhiyiwa kwevhidhiyo kunogona kusakwanisika, uye chiremba anovhiya angafanirwa kuchinjira kuvhiya yakavhurika.

Ngozi dzekuvhiya uku dzinosanganisira:

• Kukundikana kwemapapu kuwedzera
• Kukuvadza kumapapu kana mitsipa yeropa
• Chinodiwa chechipfuva chubhu mushure mekuvhiyiwa
• Kurwadziwa
• Yakareba mhepo inodonha
• Yakadzokororwa fluid kuvaka mukati mechipfuva mhango
• Kubuda ropa
• Utachiona
• Kukanganiswa kwemoyo mutinhimira
• Kukuvadza kune diaphragm, esophagus, kana trachea
• Rufu

Iwe uchave nekushanya kwakati wandei nemupi wako wekuchengeta hutano uye kuenda kunovhenekwa kurapwa usati wavhiyiwa Wako mupi acha:

• Ita bvunzo yakakwana yemuviri
• Ita shuwa kuti mamwe marapirwo aungave uine, akadai seshuga, kuwedzerwa kweropa, kana matambudziko emoyo kana mapapu ari pasi pesimba
• Ita bvunzo kuti uve nechokwadi chekuti unozokwanisa kushivirira kubviswa kwemapapu ako emapapu, kana zvichidikanwa

Kana iwe uchisvuta, iwe unofanirwa kurega kuputa vhiki dzinoverengeka usati wavhiyiwa. Kumbira mupiki wako kuti akubatsire.

Nguva dzose udza mupi wako:

• Ndeapi madhiragi, mavitamini, mahebhu, uye zvimwe zvinowedzera zvauri kutora, kunyangwe izvo zvawakatenga usina mushonga
• Kana iwe wanga uchinwa doro rakawanda, zvinopfuura 1 kana 2 zvinwiwa pazuva

Pakati pevhiki usati wavhiyiwa:

• Iwe unogona kukumbirwa kumira kutora zvinodhaka izvo zvinoita kuti zviomere iro ropa rako kugwamba. Mamwe acho maaspirin, ibuprofen (Advil, Motrin), vitamini E, warfarin (Coumadin), clopidogrel (Plavix), kana ticlopidine (Ticlid).
• Kumbira mupi wako kuti ndeapi madhiragi aunofanirwa kutora pazuva rekuvhiyiwa kwako.
• Gadzirira imba yako kudzoka kwako kubva kuchipatara.

Pazuva rekuvhiyiwa kwako:

• Usadya kana kunwa chero chinhu pakati pehusiku husiku usati waitwa oparesheni.
• Tora mishonga yaunorayirwa nachiremba uine sips diki yemvura.
• Mupiki wako anokuudza iwe kuti usvike nguvai kuchipatara.

Vanhu vazhinji vanogara muchipatara kwemazuva mashanu kusvika kumanomwe mushure mekuvhura thoracotomy. Kugara muchipatara kweiyo vhidhiyo-yakabatsirwa thoracoscopic kuvhiyiwa kazhinji kazhinji ipfupi. Unogona kupedza nguva uri munzvimbo yevanotarisirwa zvakanyanya (ICU) mushure mekuvhiyiwa.

Panguva yekugara kwako muchipatara, ucha:

• Kumbira kugara padivi pemubhedha uye ufambe nekukurumidza mushure mekuvhiyiwa.
• Iva nehubhu (s) ichibuda nerutivi rwechifuva chako kuti ubudise zvinwiwa nemhepo.
• Pfeka masokisi akakosha pamakumbo ako nemakumbo ekudzivirira kuwanda kweropa.
• Gamuchira pfuti kudzivirira kudzivirira ropa.
• Gamuchira mishonga inorwadza kuburikidza neIV (chubhu inopinda mutsinga dzako) kana nemuromo nemapiritsi. Iwe unogona kugamuchira mushonga wako wekurwadziwa kuburikidza nemuchina wakasarudzika uyo unokupa iwe muyero wemushonga wekurwadziwa kana iwe ukabaya bhatani. Izvi zvinokutendera iwe kudzora kuti marwadzo mangani emishonga iwe aunowana. Iwe unogona zvakare kuve nechirwere chakaiswa. Iyi ndiyo katheta mumashure iyo inopa mushonga wekurwadza kuti igwese tsinga kunzvimbo yekuvhiya.
• Kumbira kuita yakawanda yekufema kwakadzika kubatsira kudzivirira mabayo uye hutachiona. Kufema kwakadzika kurovedza muviri kunobatsira zvakare kufutisa mapapu akavhiyiwa. Yako chipfuva chubhu (s) icharamba iri munzvimbo kusvikira mapapu ako azere mweya.

Mhedzisiro yacho inoenderana ne:

• Rudzi rwechinetso chiri kurapwa
• Yakawanda sei mapapu emapapu (kana paine) anobviswa
• Hutano hwako hwese usati wavhiyiwa

Thoracotomy; Lung tishu kubviswa; Pneumonectomy; Lobectomy; Lung biopsy; Thoracoscopy; Vhidhiyo-yakabatsirwa thoracoscopic kuvhiyiwa; VATS

• Kuchengetedzwa kwekugezera kwevakuru
• Nzira yekufema kana iwe uchinge uchinge uchishaya mweya wekufema
• Kuvhiyiwa kwemapapu - kubuda
• Okisijeni chengetedzo
• Postural abudise
• Kudzivirira kudonha
• Kuchengeta ronda rekuvhiya - rakavhurika
• Kufamba nematambudziko ekufema
• Kushandisa oxygen kumba
• Uchishandisa oxygen kumba - chii chekubvunza chiremba wako

• Pulmonary lobectomy - akateedzana

Alfille PH, Wiener-Kronish JP, Bagchi A. Kuongorora kwekutanga. Mune: Broaddus VC, Mason RJ, Ernst JD, et al, eds. Murray naNadel Chinyorwa cheKufema Kwemishonga. 6th ed. Philadelphia, PA: Elsevier Saunders; 2016: chitsiko 27.

Feller-Kopman DJ, Anodzikisa MM. Kupindira uye nzira dzekuvhiya kuchirwere chemapapu. Mune: Goldman L, Schafer AI, eds. Goldman-Cecil Mushonga. 26th ed. Philadelphia, PA: Elsevier; 2020: chits. 93.

Chiuno A, Thomas C. Kuvhiya kwepulmonary. Mune: Lumb A, Thomas C, eds. Nunn naLumb's Yakafemerwa Kufema Physiology. 9th ed. Philadelphia, PA: Elsevier; 2021: chits. 33.

Putnam JB. Mapapu, madziro echipfuva, pleura, uye mediastinum. Mu: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Chinyorwa Chekuvhiya. 20th ed. Philadelphia, PA: Elsevier Saunders; 2017: chits. 57.