ʻOki kino o ka puʻu

Hana ʻia ka ʻoki kino no ka hoʻoponopono ʻana a wehe ʻana paha i nā aʻa māmā. Nui a hewahewa nā ʻōkuhi lung, e like me:

• Biopsy o kahi ulu ʻike ʻole ʻia
• Lobectomy, e hemo i hoʻokahi a i ʻole nā ​​lobes o kahi akemāmā
• Ke kuʻi ʻōpū
• Pneumonectomy, e hemo i kahi akemāmā
• Ke ʻoki kino e pale ai i ke kūkulu ʻana a i ʻole hoʻihoʻi o ka wai i ka umauma (pleurodesis)
• ʻO keʻoki e wehe i kahi maʻi i ka lua o ka umauma (empyema)
• ʻO ke ʻoki kino e hemo ai ke koko i ka hakahaka o ka umauma, keu hoʻi ma hope o ka ʻeha
• Ke ʻoki ʻana e hemo i nā ʻupena like me ka balloon liʻiliʻi (blbs) i kumu e hāneʻe ai ka māmā (pneumothorax)
• ʻO ke kū hou ʻana o ka wedge, e hemo i kahi ʻāpana o ka ʻula i loko o ka akemāmā

ʻO ka thoracotomy kahi ʻoki ʻoki a kahi kauka nāna e wehe ai ka paia o ka umauma.

E loaʻa iā ʻoe ka maʻi anesthesia āpau ma mua o ke kahakaha ʻana. E hiamoe ʻoe a hiki ʻole ke ʻeha. ʻElua ala maʻamau e hana ai i ke kahakaha ma kāu mau māmā ʻo ka thoracotomy a me ke kōkua ʻo thacacoscopic i kōkua ʻia e ka wikiō (VATS). Hiki ke hoʻohana ʻia ke keʻoki Robotic.

ʻO ke kīkō o ka maʻi e hoʻohana ana i ka thoracotomy i kapa ʻia he ʻoki wehe. I kēia ʻoki kino:

• E moe ʻoe ma kou ʻaoʻao ma ka papa hana. E kau ʻia kou lima ma luna o kou poʻo.
• E ʻokiʻoki kāu kaukipoki ma waena o nā iwi ʻelua. E hele ka ʻoki mai mua o kou paia umauma a i kou kua, e hele wale ana ma lalo o ka ʻelima. E hoʻokaʻawale ʻia kēia mau iwi ʻaoʻao a hemo paha i kahi iwi ʻaoʻao.
• E hoʻopau ʻia kou māmā ma kēia ʻaoʻao i mea e holo ʻole ai ka ea i waho a i waho i ka wā o ke ʻoki. ʻOi aku ka maʻalahi o kēia no ka hana ʻana a ke kauka.
• ʻAʻole maopopo paha i kāu kaukukuna ka nui o kāu mau māmā e hemo a hiki i ka hāmama ʻana o kou umauma a ʻike ʻia ka māmā.
• Hiki i kāu kauka lāʻau ke wehe i nā lymph node ma kēia wahi.
• Ma hope o ke kahakaha ʻana, e hoʻokomo ʻia i hoʻokahi a ʻoi aʻe nā paipu hoʻoheheʻe i loko o kou umauma e ninini i nā wai e kūkulu ana. Kapa ʻia kēia mau paipu nā paipu umauma.
• Ma hope o ke kahakaha ʻana o kou māmā, e pani ana kāu kauka lāʻau i nā iwi ʻaoʻao, nā mākala, a me ka ʻili me nā sutures.
• Lawe ʻia ke kahakaha māmā mai 2 a 6 mau hola.

ʻOki kino wikiō-kōkua:

• E ʻokiʻoki kāu kaukipoki i nā ʻoki ʻoki liʻiliʻi ma luna o ka paia o kou umauma. E hele ʻia kahi pahu wikiō (kahi paipu me kahi kāmela liʻiliʻi ma ka hopena) a me nā mea hana liʻiliʻi ʻē aʻe ma o kēia mau ʻoki.
• A laila, hiki i kāu kauka lāʻau ke hoʻoneʻe i kahi ʻāpana a i ʻole o kou māmā āpau, hoʻokahe i ka wai a i ʻole ke koko i kūkulu ʻia, a i ʻole hana i nā hana ʻē aʻe.
• E hoʻokomo ʻia i hoʻokahi a ʻoi aʻe nā paipu i loko o kou umauma e hoʻokahe i nā wai e kūkulu ana.
• ʻO kēia kaʻina e alakaʻi ai i ka liʻiliʻi o ka ʻeha a me ka hoʻihoʻi wikiwiki ʻana ma mua o ke kahamaha hāmama.

Hana ʻia ʻo Thoracotomy a i ʻole kōkua wikiō iā:

• Wehe i ka maʻi ʻaʻai (e like me ka maʻi ʻaʻaʻa) a i ʻole biopsy kahi ulu ʻike ʻole ʻia
• E mālama i nā hōʻeha e kumu i ka hāʻule o nā kiko o ka maʻi (pneumothorax a i ʻole hemothorax)
• E mālama mau i nāʻiʻo māmā (atelectasis)
• Wehe i nāʻiʻo puʻupaʻa i maʻi a ʻino ʻia mai ka emphysema a i ʻole ka bronchiectasis
• Wehe i ke koko a i ʻole ke koko clots (hemothorax)
• Wehe i nā tumors, e like me ka nodule pulmonary mehameha
• Inflate lung tissue that has felled (ʻO kēia paha ma muli o ka maʻi e like me ka maʻi pulmonary obstructive maʻi, a i ʻole kahi ʻeha.)
• Wehe i ka maʻi i loko o ka umauma lua (empyema)
• Kū i ka paʻa ʻana o ka wai i ka lua o ka umauma (pleurodesis)
• Wehe i kahi koko koko mai ke aʻa pulmonary (pulmonary embolism)
• E mālama i nā pilikia o ka maʻi kō

Hiki ke hoʻohana ʻia i ka ʻoki ʻana i ke kokua wikiō e kōkua i ka hapa nui o kēia mau ʻano. I kekahi mau hihia, hiki ʻole paha ke ʻoki wikiō, a pono paha i ke kaukipō e hoʻololi i kahi ʻoki hamama.

ʻO nā pōʻino o kēia ʻoki ʻana:

• Hoʻonui ʻole ʻia o ka hū
• ʻO ka ʻeha i nā ake māmā a i ʻole nā ​​kīʻaha koko
• Pono no kahi pahu pahu ma hope o ke kahakaha
• ʻEha
• Hoʻolaha lewa hoʻolōʻihi
• ʻO ka paʻa ʻana o ka wai i ka lua o ka umauma
• Kahena
• Maʻi kīnā
• Nā haunaele puʻuwai puʻuwai
• Ka hōʻino i ka diaphragm, esophagus, a i ʻole trachea
• Make

E kipa pinepine ʻia ʻoe me kāu mea mālama ola a hele i nā hoʻokolohua olakino ma mua o kāu ʻoki ʻana. E hāʻawi kāu mea hoʻolako:

• Hana i kahi hōʻike kino piha
• E ʻike pono i nā kūlana olakino ʻē aʻe i loaʻa iā ʻoe, e like me ka maʻi diabetes, ke koko kiʻekiʻe, a i ʻole ka pilikia o ka puʻuwai a i ʻole nā ​​mumū e kaohi ʻia
• Hana i nā hoʻokolohua e ʻike pono hiki iā ʻoe ke hoʻomanawanui i ka hemo ʻana o kāu mau kiko māmā, inā pono

Inā ʻoe he puhipaka, pono ʻoe e haʻalele i ka puhipaka ʻana i mau pule ma mua o kou ʻoki ʻana. E noi i kāu mea hāʻawi mai i kōkua.

E haʻi mau i kāu mea hāʻawi:

• ʻO nā lāʻau, nā wikamina, nā mea kanu, a me nā mea hoʻopili ʻē aʻe āu e lawe nei, ʻo nā mea āu i kūʻai ai me ka ʻole o ka lāʻau
• Inā inu nui ʻoe i ka waiʻona, ʻoi aku ma mua o 1 a 2 paha inu i ka lā

I loko o ka pule ma mua o kou ʻoki kino:

• E noi ʻia paha ʻoe e haʻalele i ka lawe ʻana i nā lāʻau i paʻakikī i kou koko ke naue. ʻO kekahi o kēia mau aspirin, ibuprofen (Advil, Motrin), wikamina E, warfarin (Coumadin), clopidogrel (Plavix), a i ʻole ticlopidine (Ticlid).
• E nīnau i kāu mea hāʻawi i nā lāʻau e pono ai e lawe i ka lā o kou ʻoki ʻana.
• E hoʻomākaukau i kou home no kāu hoʻi mai ka haukapila.

I ka lā o kou ʻoki kino:

• Mai ʻai a inu paha i kekahi mea ma hope o ke aumoe i ka pō ma mua o kou ʻoki ʻana.
• E lawe i nā lāʻau i kau ʻia e kāu kauka me ka wai liʻiliʻi o ka wai.
• E haʻi aku kāu mea lawelawe iā ʻoe i ka wā e hōʻea ai i ka haukapila.

Noho ka hapa nui o ka poʻe i ka haukapila no 5 a 7 mau lā ma hope o ka wehe ʻana o ka thoracotomy. Noho ka haukapila no kahi ʻoki wikiō i kōkua ʻia me ke wikiō e ʻoi aku ka pōkole. Hiki iā ʻoe ke hoʻolilo i ka manawa i ke keʻena mālama mālama (ICU) ma hope o kekahi ʻoki.

I kou noho ma ka haukapila, e:

• Noi ʻia e noho ma ka ʻaoʻao o ka moe a hele wawe ma hope o ke kaha ʻana.
• E hele mai ka Tube mai ka ʻaoʻao o kou umauma e hoʻokahe i nā wai a me ka ea.
• E komo i nā stocking kūikawā i kou mau wāwae a me kou mau wāwae e pale ai i ke koko koko.
• Loaʻa nā kī ʻana i mea e pale aku ai ke kahe o ke koko.
• Loaʻa i nā lāʻau ʻeha ma o ka IV (kahi paipu e hele i loko o kou mau uaua) a i ʻole me ka waha me nā huaale. Hiki paha iā ʻoe ke loaʻa i kāu lāʻau ʻeha ma o kahi mīkini kūikawā e hāʻawi iā ʻoe i ka lāʻau o ka ʻehaʻeha ke kūʻē ʻoe i kahi pihi. ʻAe kēia iā ʻoe e kaohi i ka nui o ka lāʻau ʻeha e loaʻa iā ʻoe. Hiki paha iā ʻoe ke kau i kahi epidural. ʻO kēia kahi catheter ma ka hope e hāʻawi i ka lāʻau ʻeha e hōʻino i nā ʻalolo i kahi ʻoki.
• Noi ʻia ʻoe e hana i ka hanu hohonu e kōkua ai i ka pale ʻana i ka niumonia a me ka maʻi. Kōkua nā hana hanu hohonu i ka hoʻoulu ʻana i ka hanu i hana ʻia. E noho mau kāu mau pahu umauma ma kahi a hiki i ka wā i piha pono ai kou māmā.

Pili ka hopena i:

• Ke ʻano o ka pilikia e mālama ʻia ana
• Ehia mau kiko o ka māmā (inā loaʻa) e hemo
• ʻO kou olakino holoʻokoʻa ma mua o ke kahakaha ʻana

Thoracotomy; Wehe i nā ʻaʻa o ka naʻau; Pneumonectomy; Lobectomy; ʻO ka biopsy lung; Thoracoscopy; ʻOki kino wikiō i kōkua ʻia me ke kōkua wikiō; Nā VATS

• Ka palekana i ka lumipaku no nā mākua
• Pehea e hanu ai inā pōkole ʻoe o ka hanu
• ʻOki kino - hoʻokuʻu
• Ka palekana o oxygen
• Kahe hoʻoheheʻe hope
• Pāleʻa ka pale ʻana
• Mālama ʻeha ʻeha - wehe
• ʻO ka huakaʻi me nā pilikia hanu
• Ke hoʻohana nei i ka oxygen ma ka home
• Ke hoʻohana nei i ka oxygen ma ka home - he aha e nīnau aku ai i kāu kauka

• Pulmonary lobectomy - moʻo

Alfille PH, Wiener-Kronish JP, Bagchi A. He loiloi mua. I: Broaddus VC, Mason RJ, Ernst JD, et al, eds. ʻO Murray a me Nadel's Textbook of Respiratory Medicine. ʻElua huaʻōlelo Piladelapia, PA: Elsevier Saunders; 2016: chap 27.

ʻO Feller-Kopman DJ, Decamp MM. Hoʻopili a me nā ʻoki poepoe i ka maʻi maʻi. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 26th ed. Piladelapia, PA: Elsevier; 2020: chap 93.

Lumb A, ʻO Thomas C. Kaukana pulmonary. I: Lumb A, Thomas C, hua. ʻO Nunn lāua ʻo Lumb's Applied Respiratory Physiology. 9th ed. Piladelapia, PA: Elsevier; 2021: chap 33.

Putnam JB. Lū, pā umauma, pleura, a me mediastinum. I: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. ʻO Sabiston Textbook of Surgery. 20 ouk. Piladelapia, PA: Elsevier Saunders; 2017: chap 57.