Tsarin maganin ƙwayar cuta shine wata hanya mai mahimmanci wanda zai iya damar likitocin likita don samun damar shiga cikin kwakwalwa lokacin aikin tiyata. An sanya wani shinge a cikin kirji, kuma ana iya samun damar zuwa gabobin ɓangaren katako ta hanyar katsewa ta hanyar cire wani ɓangare na haƙarƙari. Anyi hanya a cikin ɗakin aiki a karkashin ƙwayar cuta.
Dalilai na Guda Ɗaya
Za a iya yin maganin ƙwayar cuta don dalilai da yawa, ba kawai kawar da ciwon daji ba.
Ana buɗewa da kuma fallasa ƙwaƙwalwar ƙwaƙwalwar katako da matsakaici (yankin tsakanin huhu) zai iya ba wa likitocin damar shiga cikin zuciya, huhu, esophagus, ɓangare na sama (thoracic) ko kuma aorta, da kuma gaban (sashi na baya) na kashin baya. Wasu alamomi sun haɗa da:
- Yin aikin tiyata na huhu
- Magungunan ciwon daji na asibiti
- Zuciyar zuciya / aortic
- Ciwon daji
- Tsarin pneumothorax mai tsanani (rududun huhu)
- Gudanarwa na COPD
- Tarin fuka
- Biopsy da kuma kimantawar wani taro mediastinal unknown
- Hoto zuwa ga kashin baya
- Tsarin maganin magungunan ƙwayar cuta (gaggawa) - Wannan hanya ne a cikin ɗakin gaggawa don bala'in gaggawa irin na kirji
Tsarin hanyoyin
Akwai nau'i daban-daban na ƙwayoyin maganin da za a iya yi, dangane da nuni ga tiyata da yanayin da ake bi. Wadannan sun haɗa da:
- Tsarin ƙwaƙwalwar ƙwayar cuta - Wannan ita ce hanyar da ta fi dacewa da kuma hanyar da ake amfani da shi na samun dama ga huhu don cire ƙwayar huhu ko wani ɓangare daga cikin huhu don kula da ciwon huhu na huhu . An sanya shinge tare da gefen kirji zuwa ga baya tsakanin haƙarƙarin. Ƙunƙunƙun ƙwalƙwarar suna yada bambance (haƙarƙiri za a iya cirewa) don ganin kullun. Yan likitoci zasu iya cire huhu ( pneumonectomy ), lobe na daya daga cikin huhu ( lobectomy ), ko ƙananan ƙwayar ƙwayar cuta.
- Magungunan Median thoracotomy - A cikin kwakwalwa na kwakwalwa, likitocin likitoci suna yin karkatawa ta hanyar sternum (ƙirjin ƙirjin) don samun damar shiga kirji. Wannan hanya ana yin amfani da shi don yin aiki a zuciya.
- Axillary thoracotomy - A cikin maganin maganin ƙwayar cuta, likitocin yara suna samun dama ga kirji ta hanyar haɗuwa a kusa da tsaka. Anyi amfani da wannan ne don maganin pneumothorax (rududun huhu), amma kuma ana iya yin shi don ƙwayar zuciya da huhu.
- Tsarin maganin gargajiya - Wannan hanya hanya ce ta gaggawa wadda ta shafi karkatarwa a gaban katako. Ana iya yin aiki bayan babban ciwo na kirji, ko don ba da izinin shiga kai tsaye a zuciya bayan an kama shi.
Shiryawa da Shiri
Kafin samun cike da ƙwayoyi za ku sami tarihin mai kyau da kuma aikin jiki, kuma yana iya samun nazarin don dubawa a kan zuciyarku da aikin huhu. Idan ana amfani da ƙwayar ƙwayar ka don ciwon huhu na huhu, zai iya zama mahimmancin samun ra'ayi na biyu . Nazarin ya nuna cewa mutanen da ke da wadannan magungunan da aka yi a cibiyoyin ciwon daji wadanda suka yi girma a cikin wadannan hanyoyin na iya samun sakamako mafi kyau. Ga wasu mutane, hanya mara izuwa wanda aka sani da tiyata mai amfani da video-assisted thoracoscopic tiyata (VATS) za'a iya amfani dasu maimakon maimakon maganin ƙwayoyi, amma wannan ba samuwa a duk asibitoci.
Hanyar
An yi amfani da ƙwayoyin maganin ƙwayoyin cuta a ƙarƙashin ƙwayar cuta a cikin ɗakin aiki. An yi doguwar tsawo a gefe ɗaya daga cikin kirji, kuma an raba raƙuman don samun damar shiga kirji. A yayin aikin, alamu masu muhimmanci suna kulawa da hankali don tabbatar da cewa kuna jurewa hanya sosai. Lokacin da aka kammala tiyata, an sanya ɗakin kwakwalwa a cikin kwandon kwakwalwa kuma ya bar a cikin wuri na tsawon lokaci.
Matsaloli na yiwuwa
Wasu mutane sun shiga cikin ƙwayayye ba tare da fuskantar matsalolin ba, yayin da wasu zasu haɗu da ɗaya ko fiye. Yana da muhimmanci a yi magana da dan likitan ku da kyau game da aikin da kuka yi da kuma abin da za ku yi tsammani. Lalle ne, waɗanda suka fi lafiya a gaba ɗaya kafin wannan hanya zasu iya zama mafi sauki fiye da waɗanda suke fama da ƙarin damuwa na likita. Kuma kamar yadda aka tilasta yin aiki, shan taba yana iya ƙara haɗarin damuwa mai tsanani.
Wasu yiwuwar illa da rikice-rikicen ƙwayoyin maganin ƙwayar cuta na iya haɗa da:
- Dogaro da bukatar taimako na ventilatory bayan tiyata
- Rashin iska mai tsayi yana haifar da buƙatar buƙatar katako bayan an tilastawa
- Kamuwa da cuta
- Bleeding
- Ruwan jini - Rawan jini mai yaduwa (jini clots) da almarin jini (jini wanda ya karya da kuma tafiya zuwa ga huhu) yana da mahimmanci da mawuyacin wahala na tiyata
- Abubuwan da ke faruwa na maganin rigakafi
- Ciwon zuciya ko arrhythmias
- Hanyoyin murya ko ɓarna
- Bronchopleural fistula - Wannan ƙari ne wanda wata hanya ta ɓarna ta kasance a tsakanin ƙwayar daji da kuma sararin samaniya tsakanin membranes (pleura) da rufin huhu
- Ciwo na postpneumonectomy ko ciwo na ciwon maganin ciwon maganin ciwon maganin ciwo - Cutar a yankin yankin ƙwayar cuta na iya zama wani lokaci na tsawon lokaci bayan tiyata
Tambayoyi don Tambayi Kafin
Ka yi la'akari da tambayar likitanka tambayoyi masu zuwa, da kuma rubuta wasu tambayoyi da za ka iya.
- Wanene zai yi aikin tiyata?
- Nawa daga cikin wadannan hanyoyin da kuka yi?
- Mene ne wasu matsalolin da zan iya tsammanin?
- Yaya tsawon lokaci za a yi?
- Har yaushe zan iya zama a asibitin bayan tiyata?
- Yaya sauri zan iya komawa aiki?
- Kuna bayar da shawarar cewa ina da gyaran kwalliya bayan aikin tiyata?
- Menene zan iya tsammanin a tsawon dogon lokaci - ka ce, shekara daya daga yanzu ko shekaru 3 daga yanzu?
- Wa ya kamata in kira idan na fuskanci matsaloli bayan dawo gida?
Misalan: likitan likitan Jim ya gaya masa cewa zai yi wani maganin ƙwayar cuta don samun damar yin amfani da huhu ya kuma yi masa aikin jinya don cutar ciwon huhu.
Sources:
Bendixen, M., Jorgensen, O., Kronborg, C., Andersen, C. da P. Licht. Jin zafi da kuma rayuwa na rayuwa bayan lobectomy ta hanyar bidiyo da aka taimaka wa magungunan thoracoscopic ko anterolateralthoracotomy don ciwon ciwon huhu na farko. Lancet Oncology . 2016 17 (6): 836-44.
Fernandez, R., Kosinski, A., Burfeind, W. et al. Ƙungiyar Tsirarrun likitoci masu ƙwayar cutar ciwon huhu da ƙwayar cutar ciwon huhu. Annals na Thoracic Tiyata . 2016 Mayu 19. (Epub gaba da bugu).
Sengupta, S. Bayanin maganin rikice-rikicen kwayoyin halitta bayan thoracotomy. Littafin Indiya na Anesthesia . 2015. 59 (9): 618-26.
Jami'ar Michigan Healthcare System. Ana shirya don ƙwayar ka. Http://surgery.med.umich.edu/thoracic/pdf/preparingforyourthoracotomy.pdf