Laryngectomy

Laryngectomy ndi opaleshoni yochotsa zonse kapena gawo la kholingo (mawu amawu).

Laryngectomy ndi opaleshoni yayikulu yomwe imachitika mchipatala. Musanachite opareshoni mudzalandira ochititsa dzanzi. Mudzakhala mukugona komanso opanda ululu.

Kuchuluka kwa kholingo kumachotsa kholingo lonse. Gawo lina la pharynx yanu lingathenso kutulutsidwa. Pharynx wanu ndimphira yolumikizana ndi mamina pakati pamphongo ndi pamimba.

• Dokotalayo adzadula m'khosi mwanu kuti atsegule malowo. Amasamalidwa kuti asunge mitsempha yayikulu ndi zina zofunika.
• Mphuno ndi minofu pozungulira pake zidzachotsedwa. Ma lymph node amathanso kuchotsedwa.
• Dokotalayo adzatsegula khola lanu ndikubowo pakhosi panu. Trachea yanu iphatikizidwa ndi dzenje ili. Dzenje limatchedwa stoma. Pambuyo pa opaleshoni mudzapuma kudzera mu stoma yanu. Sichidzachotsedwa.
• Mimba, minofu, ndi khungu lanu zidzatsekedwa ndi zokopa kapena matupi. Mutha kukhala ndi machubu ochokera pachilonda chanu kwakanthawi mutachitidwa opaleshoni.

Dokotalayo amathanso kupanga kupindika kwa tracheoesophageal (TEP).

• TEP ndi kabowo kakang'ono pamphepete mwanu (trachea) ndi chubu chomwe chimasunthira chakudya kuchokera kukhosi kwanu kupita kumimba kwanu (kum'mero).
• Dokotala wanu adzaika kachigawo kakang'ono kopangidwa ndi anthu (prosthesis) kutsegulira uku. Prosthesis ikuthandizani kuti muzitha kulankhula mukachotsa bokosilo.

Pali maopaleshoni ochulukirapo ochepa ochotsera kholingo.

• Mayina a njirazi ndi endoscopic (kapena transoral resection), ofukula pang'ono laryngectomy, yopingasa kapena supraglottic pang'ono laryngectomy, ndi supracricoid pang'ono laryngectomy.
• Njirazi zitha kugwira ntchito kwa anthu ena. Kuchita opaleshoni komwe muli nako kumadalira kuchuluka kwa khansa yanu komanso khansa yomwe muli nayo.

Kuchita opaleshoniyo kumatha kutenga maola 5 mpaka 9.

Nthawi zambiri, laryngectomy imachitika pofuna kuchiza khansa yam'mero. Zimathandizidwanso kuchiza:

• Zowopsa zazikulu, monga kuwombera mfuti kapena kuvulala kwina.
• Kuwonongeka kwakukulu kwa kholingo kuchokera kuchipatala. Izi zimatchedwa radiation necrosis.

Zowopsa za opaleshoni iliyonse ndi izi:

• Thupi lawo siligwirizana ndi mankhwala
• Mavuto opumira
• Mavuto amtima
• Magazi
• Matenda

Zowopsa za opaleshoniyi ndi izi:

• Hematoma (magazi ambiri kunja kwa mitsempha)
• Matenda opweteka
• Fistula (kulumikizana kwa minofu komwe kumapangidwa pakati pa pharynx ndi khungu lomwe nthawi zambiri silimakhalapo)
• Kutsegula kwa stoma kumatha kukhala kocheperako kapena kothina. Izi zimatchedwa stomal stenosis.
• Akuyenda mozungulira kupindika kwa tracheoesophageal (TEP) ndi prosthesis
• Kuwonongeka kwa madera ena am'mero ​​kapena trachea
• Mavuto kumeza ndi kudya
• Mavuto kulankhula

Mukapatsidwa opareshoni mukayesedwa kuchipatala. Zina mwa izi ndi izi:

• Kuyezetsa thupi kwathunthu komanso kuyesa magazi. Kafukufuku woyeserera atha kuchitidwa.
• Kuchezera ndi odziwa kulankhula komanso wothandizira kumeza kuti akonzekere zosintha atachitidwa opaleshoni.
• Upangiri wathanzi.
• Kuleka kusuta - uphungu. Ngati mumasuta ndipo simunasiye.

Nthawi zonse uzani wothandizira zaumoyo wanu:

• Ngati muli ndi pakati kapena mutha kukhala ndi pakati
• Ndi mankhwala ati omwe mukumwa, ngakhale mankhwala, zowonjezera, kapena zitsamba zomwe mwagula popanda mankhwala
• Ngati mwakhala mukumwa mowa wambiri, kuposa 1 kapena 2 zakumwa patsiku

M'masiku asanachitike opaleshoni yanu:

• Mutha kupemphedwa kusiya kumwa aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), clopidogrel (Plavix), warfarin (Coumadin), ndi mankhwala ena aliwonse omwe amalepheretsa magazi anu kugwirana.
• Funsani mankhwala omwe muyenera kumwa patsiku la opareshoni yanu.

Patsiku la opareshoni yanu:

• Mudzafunsidwa kuti musamwe kapena kudya kalikonse pakati pausiku usiku usanachitike opaleshoni yanu.
• Tengani mankhwala omwe wothandizirayo adakuwuzani kuti mumwe pang'ono pokha madzi.
• Mudzauzidwa nthawi yobwera kuchipatala.

Muyenera kukhala mchipatala masiku angapo mutachitidwa opaleshoni.

Pambuyo pa ndondomekoyi, mudzakhala groggy ndipo simudzatha kuyankhula. Chigoba cha oxygen chidzakhala pa stoma yanu. Ndikofunika kuti mutu wanu ukhale wokweza, mupumule kwambiri, ndikusuntha miyendo yanu nthawi ndi nthawi kuti musinthe magazi. Kusunga magazi kumachepetsa chiopsezo chanu chotenga magazi.

Mutha kugwiritsa ntchito ma compress ofunda kuti muchepetse ululu mozungulira momwe mumapangira. Mupeza mankhwala opweteka.

Mukalandira zakudya kudzera mu IV (chubu chomwe chimalowa mumtsempha) ndi ma feed feed. Kudyetsa ma chubu kumaperekedwa kudzera mu chubu chomwe chimadutsa mphuno mwanu ndikulowa m'mimba mwanu.

Mutha kuloledwa kumeza chakudya pakangotha ​​masiku awiri kapena atatu mutachitidwa opaleshoni. Komabe, zimakhala zachilendo kudikirira masiku 5 mpaka 7 pambuyo pa opaleshoni yanu kuti muyambe kudya pakamwa panu. Mutha kukhala ndi kafukufuku wameza, momwe x-ray imatengedwa mukamamwa zakumwa zosiyana. Izi zachitika kuti muwonetsetse kuti palibe kutayikira musanayambe kudya.

Kukhetsa kwanu kumatha kuchotsedwa masiku awiri kapena atatu. Muphunzitsidwa momwe mungasamalire chubu lanu laryngectomy ndi stoma. Muphunzira kusamba mosamala. Muyenera kusamala kuti musalole madzi kulowa mu stoma yanu.

Kukhazikika pakulankhula ndi othandizira kulankhula kudzakuthandizani kuzindikira momwe mungalankhulire.

Muyenera kupewa kunyamula zolemetsa kapena kuchita zovuta kwa milungu isanu ndi umodzi. Mutha kuyambiranso ntchito zanu zabwinobwino.

Tsatirani ndi omwe amakupatsani zomwe mwauzidwa.

Mabala anu amatenga pafupifupi masabata awiri kapena atatu kuti achiritse. Mutha kuyembekezera kuchira kwathunthu pafupifupi mwezi umodzi. Nthawi zambiri, kuchotsa kholingo kumachotsa khansa yonse kapena zinthu zovulala. Anthu amaphunzira momwe angasinthire moyo wawo ndikukhala opanda mawu awo. Mungafunike mankhwala ena, monga radiotherapy kapena chemotherapy.

Laryngectomy wathunthu; Laryngectomy pang'ono

• Kumeza mavuto

Lorenz RR, Couch INE, Burkey BB. Mutu ndi khosi. Mu: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Buku Lopanga Opaleshoni. Wolemba 20th. Philadelphia, PA: Elsevier Saunders; 2017: mutu 33.

Wolemba MR. Khansara ya mutu ndi khosi. Mu: Goldman L, Schafer AI, olemba. Mankhwala a Goldman-Cecil. Wolemba 25. Philadelphia, PA: Elsevier Saunders; 2016: chap 190.

Rassekh H, Haughey BH. Chiwerengero cha Laryngectomy ndi laryngopharyngectomy. Mu: Flint PW, Haughey BH, Lund V, et al, olemba. Cummings Otolaryngology: Opaleshoni ya Mutu ndi Khosi. Lachisanu ndi chimodzi. Philadelphia, PA: Elsevier Saunders; 2015: chap 110.