Thoracotomy: ndi chiyani, mitundu ndi zisonyezo

Zamkati

• Mitundu ya thoracotomy
• Zotsatira zoyipa

Thoracotomy ndi njira yochitira opaleshoni yomwe imakhala yotsegula pachifuwa ndipo imatha kuchitika m'malo osiyanasiyana pachifuwa, kuti ipereke njira yolunjika kwambiri yolumikizira limba lomwe lakhudzidwa ndi mulifupi wokwanira kulola gawo logwirira ntchito, kupewa kuwonongeka kwa ziwalo.

Pali mitundu yosiyanasiyana ya thoracotomy, yomwe imayenera kuchitidwa kutengera ndi chiwalo chomwe chingapezeke ndi njira yomwe ikuyenera kuchitidwa, ndipo chitha kugwiritsidwa ntchito kupenda kapena kuchotsa ziwalo kapena nyumba zomwe zavulala, kuwongolera kutaya magazi, kuthandizira kuphatikizika kwa gasi, kuchita kutikita minofu ya mtima, pakati pa ena.

Mitundu ya thoracotomy

Pali mitundu 4 yosiyanasiyana ya thoracotomy, yomwe imakhudzana ndi dera lomwe amapangidwira:

• Zojambula zakale: iyi ndiyo njira yofala kwambiri, ndipo njira yomwe imagwiritsidwa ntchito kufikira mapapu, kuchotsa mapapo kapena gawo lamapapo chifukwa cha khansa, mwachitsanzo. Pochita opaleshoniyi, amang'amba mbali yapachifuwa kumbuyo, pakati pa nthiti, ndipo nthitizi zalekanitsidwa, ndipo kungakhale kofunikira kuchotsa umodzi kuti muwone mapapo.
• Thoracotomy yapakatikati: Mu mtundu uwu wa thoracotomy, kutumbidwa kumapangidwa motsatira sternum, kuti athe kutsegula pachifuwa. Njirayi imagwiritsidwa ntchito nthawi zambiri opaleshoni yamtima ikachitika.
• Axillary thoracotomy: Mu mtundu uwu wa thoracotomy, chimbudzi chimapangidwa m'dera lamakhwapa, lomwe limagwiritsidwa ntchito kwambiri pochizira pneumothorax, yomwe imakhalapo ndi mpweya pakhosi, pakati pa mapapo ndi chifuwa.
• Anterolateral thoracotomy: Njirayi imagwiritsidwa ntchito nthawi zambiri pakagwa mwadzidzidzi, pomwe pamangoyambika chifuwa, chomwe chingakhale chofunikira pambuyo povulala pachifuwa kapena kuloleza kufikira pamtima mutamangidwa mtima.

Zotsatira zoyipa

Zina mwa zovuta zomwe zingachitike mutachita thoracotomy ndi izi:

• Mpweya pambuyo opaleshoni;
• Kutulutsa mpweya, komwe kumafuna kuti chubu lachifuwa ligwiritse ntchito nthawi yayitali;
• Matenda;
• Magazi;
• Mapangidwe magazi kuundana;
• Zovuta zomwe zimadza chifukwa cha anesthesia wamba;
• Matenda a mtima kapena arrhythmias;
• Kusintha kwa zingwe zamawu;
• Bronchopleural fistula;

Kuphatikiza apo, nthawi zina, dera lomwe thoracotomy idachitidwira limatha kupweteketsa mtima kwanthawi yayitali atachitidwa opaleshoni. Zikatero, kapena ngati munthuyo wazindikira kuti ali ndi vuto pakachira, dokotala ayenera kudziwitsidwa.