Uvulopalatopharyngoplasty (UPPP)

Uvulopalatopharyngoplasty (UPPP) ndi opareshoni yotsegulira mayendedwe apamwamba potulutsa minofu yambiri pakhosi. Zitha kuchitidwa kuti muchepetse tulo tating'onoting'ono tating'onoting'ono (OSA) kapena kuponyera mwamphamvu.

UPPP imachotsa minofu yofewa kumbuyo kwa mmero. Izi zikuphatikiza:

• Uvula yense kapena gawo lake (kansalu kofewa komwe kamakhala pansi pakamwa).
• Mbali zam'kamwa ndi zofewa m'mbali mwa mmero.
• Tonsil ndi adenoids, ngati akadalipo.

Dokotala wanu angalimbikitse opaleshoniyi ngati muli ndi vuto lolepheretsa kugona mokwanira (OSA).

• Yesani kusintha kwamachitidwe koyamba, monga kuchepa thupi kapena kusintha magonedwe anu.
• Akatswiri ambiri amalimbikitsa kuyesa kugwiritsa ntchito CPAP, zingwe zokulitsa m'mphuno, kapena chida pakamwa kuti muchiritse OSA poyamba.

Dokotala wanu angalimbikitse opaleshoniyi kuti athetse kusuta kwambiri, ngakhale mulibe OSA. Musanaganize za opaleshoniyi:

• Onani ngati kuchepa thupi kumakuthandizani kuti muzitha kuyamwa.
• Ganizirani zakufunika kwanu kwa inu kuti muzisinkhasinkha. Kuchita opaleshoniyi sikugwira ntchito kwa aliyense.
• Onetsetsani kuti inshuwaransi yanu izilipira opaleshoniyi. Ngati mulibe OSA, inshuwaransi yanu siyingaphimbe opaleshoniyo.

Nthawi zina, UPPP imachitika limodzi ndi maopaleshoni ena owopsa kuti athetse OSA kwambiri.

Zowopsa za anesthesia ndi opaleshoni yonse ndi izi:

• Zomwe zimachitika chifukwa cha mankhwala kapena mavuto ampweya
• Kukhetsa magazi, magazi kuundana, kapena matenda

Zowopsa za opaleshoniyi ndi izi:

• Kuwonongeka kwa minofu yapakhosi ndi m'kamwa kofewa. Mutha kukhala ndi mavuto ena osungira zakumwa kuti zisatuluke m'mphuno mukamamwa (wotchedwa velopharyngeal insufficiency). Nthawi zambiri, izi zimangokhala zoyipa kwakanthawi.
• Nkhungu pakhosi.
• Kulankhula kumasintha.
• Kutaya madzi m'thupi.

Onetsetsani kuuza dokotala kapena namwino kuti:

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

M'masiku asanachitike opareshoni:

• Mutha kufunsidwa kuti musiye kumwa zochotsa magazi monga aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), clopidogrel (Plavix), warfarin (Coumadin).
• Funsani dokotala wanu mankhwala omwe muyenera kumwa patsiku la opareshoni yanu.
• Ngati mumasuta, yesetsani kusiya. Kusuta kumatha kuchepetsa kuchira. Funsani omwe akukuthandizani kuti akuthandizeni kusiya.
• Lolani wothandizira wanu adziwe za chimfine, chimfine, malungo, kuphulika kwa herpes, kapena matenda ena omwe mungakhale nawo musanachite opareshoni. Mukadwala, opareshoni yanu imafunika kuimitsidwa kaye.

Patsiku la opaleshoniyi:

• Muyenera kuti mudzafunsidwa kuti musamwe kapena kudya chilichonse kwa maola angapo opaleshoniyo isanakwane.
• Tengani mankhwala aliwonse omwe adakuuzani kuti mumwe ndi madzi pang'ono.
• Tsatirani malangizo pa nthawi yobwera kuchipatala. Onetsetsani kuti mwafika nthawi.

Kuchita opaleshoniyi nthawi zambiri kumafuna kugona usiku wonse kuchipatala kuti muwonetsetse kuti mumeza. Kuchita opaleshoni ya UPPP kumatha kukhala kopweteka komanso kuchira kwathunthu kumatenga masabata awiri kapena atatu.

• Khosi lanu lidzakhala lowawa kwa milungu ingapo. Mupeza mankhwala opweteka amadzimadzi kuti muchepetse kupweteka.
• Mutha kukhala ndi zotchinga kumbuyo kwanu. Izi zidzasungunuka kapena dokotala wanu adzawachotsa paulendo woyamba wotsatira.
• Idyani zakudya zofewa zokha ndi zakumwa kwa milungu iwiri yoyambirira mutachitidwa opaleshoni. Pewani zakudya zosapatsa thanzi kapena zakudya zomwe ndi zovuta kutafuna.
• Muyenera kutsuka mkamwa mukatha kudya ndi madzi amchere kwa masiku 7 kapena 10 oyamba.
• Pewani kunyamula kapena kupondereza kwa milungu iwiri yoyambirira. Mutha kuyenda ndikuyenda pang'ono pambuyo pa maola 24.
• Mudzakhala ndi ulendo wotsatira ndi dokotala wanu masabata awiri kapena atatu mutatha opaleshoni.

Mphuno yogona imayamba bwino kwa pafupifupi theka la anthu omwe achita opaleshoniyi. Popita nthawi, phindu limatha kwa anthu ambiri.

Kafukufuku wina akuwonetsa kuti opareshoni amayenera okha anthu omwe ali ndi zovuta pakamwa lofewa.

Opaleshoni ya m'kamwa; Njira zopangira uvulopalatal; UPPP; Laser-assisted uvulopalaplasty; Kutalika kwa palatoplasty; Kulephera kwa Velopharyngeal - UPPP; Kulepheretsa kugona tulo - uvulopalaplasty; OSA - uvulopalaplasty

Katsantonis GP. Classic uvulopalatopharyngoplasty. Mu: Friedman M, Jacobowitz O, olemba. Kugona Tulo ndi Kuputa. Wachiwiri ed. Philadelphia, PA: Elsevier; 2020: chap 32.

Qaseem A, Holty JE, Owens DK, et al; Clinical Guidelines Committee ya American College of Physicians. Kusamalira matenda obanika kutulo mwa akulu: malangizo achipatala ochokera ku American College of Physicians. Ann Intern Med. 2013; 159 (7): 471-483. PMID: 24061345 www.ncbi.nlm.nih.gov/pubmed/24061345. (Adasankhidwa)

Wakefield TL, Lam DJ, Ishman SL. Matenda obanika kutulo komanso kusowa tulo. 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.