ʻOki ʻoki

ʻO ka dissection ʻāʻī kahi ʻoki e nānā a hemo i nā lymph node i ka ʻāʻī.

ʻO ka dissection neck kahi hana nui i hana ʻia e wehe i nā lymph node i loaʻa i ka maʻi ʻaʻai. Hana ʻia ia i ka haukapila. Ma mua o ke kaha ʻana, e loaʻa iā ʻoe ka anesthesia laulā. E hiamoe kēia a ʻaʻole hiki iā ʻoe ke ʻeha.

ʻO ka nui o nā kiko a me nā helu o nā lymph node i lawe ʻia e pili i ka laha ʻana o ka maʻi ʻaʻai. Aia he 3 ʻano nui o ka ʻoki dissection ʻāʻī:

• Dissection ʻāʻī Radical. Lawe ʻia nā mea āpau ma ka ʻaoʻao o ka ʻāʻī mai ka iwi ā i ka iwi iwi. Hoʻoneʻe ʻia ka mākala, nā aʻalolo, ka aʻa salivary, a me nā kīʻaha koko nui ma kēia wahi.
• Hoʻololi ʻia ka dissection ʻāʻoki radical. ʻO kēia ka ʻano maʻamau o ka dissection ʻāʻī. Wehe ʻia nā puka lymph āpau. Lawe ʻia ka liʻiliʻi o ka ʻāʻī liʻiliʻi ma mua o ka dissection radical. Hiki i kēia ʻoki ke hoʻokoe i nā aʻalolo i ka ʻāʻī a, i kekahi manawa, nā kīʻaha koko a i ʻole nāʻiʻo.
• Dissection ʻāʻī koho. Inā ʻaʻole i pālahalaha nui ka maʻi ʻaʻai, pono e hemo ka liʻiliʻi o nā pūnana lymph. Hiki ke hoʻōla ʻia ka mākala, nā aʻa, a me nā kīʻaha koko ma ka ʻāʻī.

Hāpai ka ʻōnaehana lymph i nā hunaola keokeo a puni ke kino e hakakā i ka maʻi. Hiki i nā hunaola maʻi ʻaʻai i ka waha a i ʻole ka ʻāʻī ke hele i loko o ka wai lymph a paʻa i nā pūnana lymph. Lawe ʻia nā lymph node e pale aku i ka maʻi ʻaʻai mai ka hoʻolaha ʻana i nā ʻāpana ʻē aʻe o ke kino a e hoʻoholo inā pono hou kahi lāʻau.

Koi paha kāu kauka i kēia kaʻina hana inā:

• Loaʻa ʻoe i ka maʻi ʻaʻai o ka waha, elelo, gland thyroid, a i ʻole nā ​​wahi ʻē aʻe o ka puʻu a me ka ʻāʻī.
• Ua pālahalaha ka maʻi ʻaʻai i nā lymph node.
• Hiki i ka maʻi ʻaʻai ke hoʻolaha aku i nā ʻāpana ʻē aʻe o ke kino.

Nā pilikia no ka anesthesia a me ke kahakaha ʻana ma:

• Nā hopena āpau i nā lāʻau
• Nā pilikia hanu
• Kahena
• Maʻi kīnā

ʻO nā pilikia ʻē aʻe no kēia ʻoki kino:

• Numbness i loko o ka ʻili a me ka pepeiao ma ka ʻaoʻao o ke ʻoki, ʻo ia mau paha
• Hoʻopōʻino i nā aʻa o ka pāpālina, lehelehe, a me ke alelo
• Hāpai nā pilikia i ka poʻohiwi a me ka lima
• Holo ʻāʻī kaupalena
• Kahe ʻana i ka poʻohiwi ma ka ʻaoʻao o ke ʻoki
• Pilikia i ke kamaʻilio ʻana a me ka ale ʻana paha
• ʻAha helehelena

E haʻi mau i kāu mea mālama ola:

• Inā ʻoe a hāpai paha.
• He aha nā lāʻau āu e lawe nei, me nā mea āu i kūʻai ai me ka ʻole o ka lāʻau. Hoʻopili kēia i nā huaora, nā mea kanu, a me nā mea hoʻohui.
• Inā inu nui ʻoe i ka waiʻona, ʻoi aku ma mua o 1 a 2 paha inu i ka lā.

I nā lā ma mua o kou ʻoki kino:

• E noi paha iā ʻoe e haʻalele i ka lawe ʻana i ka aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), clopidogrel (Plavix), warfarin (Coumadin), a me nā lāʻau ʻē aʻe paʻakikī i kou koko ke ʻū.
• E nīnau i kāu mea hāʻawi i nā lāʻau e pono ai ʻoe e lawe i ka lā o kou ʻoki ʻana.
• E haʻi ʻia ʻoe i ka wā e hōʻea ai i ka haukapila.

I ka lā o kou ʻoki kino:

• E noi ʻia ʻoe ʻaʻole e inu a ʻai paha i kekahi mea ma hope o ke aumoe i ka pō ma mua o kou ʻoki kino ʻana.
• E lawe i nā lāʻau i ʻae ʻia me kahi wai liʻiliʻi.

Lawe ʻia ʻoe i ka lumi hoʻāla e ala aʻe ma hope o ke kahakaha ʻana.

• E hoʻāla ʻia ke poʻo o kou wahi moe i kahi kihi iki.
• E loaʻa ʻoe i kahi paipu i kahi aa (IV) no nā wai a me nā meaʻai. ʻAʻole hiki iā ʻoe ke ʻai a inu paha no 24 mau hola mua.
• E loaʻa iā ʻoe ka lāʻau ʻeha a me nā antibiotic.
• E loaʻa nā ʻauwai i kou ʻāʻī.

E kōkua nā kahu maʻi iā ʻoe e hele i waho o kahi moe a neʻe iki i ka lā o ke ʻoki. Hiki paha iā ʻoe ke hoʻomaka i ka hoʻōla kino ʻoiai ʻoe ma ka haukapila a ma hope o kou hoʻi ʻana i ka home.

Hele ka hapa nui o ka poʻe i ka home mai ka haukapila i 2 a 3 mau lā. Pono ʻoe e ʻike i kāu mea hoʻolako no kahi kipa ukali ma 7 a 10 mau lā.

ʻO ka manawa hoʻōla e pili ana i ka nui o nā kiko i lawe ʻia.

Dissection ʻāʻī Radical; Hoʻololi ʻia ka dissection ʻāʻī radical; Hoʻokaʻawale ʻāʻī koho. Lawe ʻia ka lymph node - ʻāʻī; Ka maʻi ʻaʻai o ke poʻo a me ka ʻāʻī - hoʻokae ʻāʻī; Maʻi ʻaʻai waha - dissection ʻāʻī; Ka maʻi ʻaʻai puʻu - dissection o ka ʻāʻī; ʻO ka maʻi ʻaʻai maʻi squamous - dissection neck

ʻO Callender GG, Udelsman R. ʻO ke kaʻina hana i ka maʻi ʻaʻai thyroid. I: Cameron JL, Cameron AM, eds. ʻO ke kaʻoki lāʻau lapaʻau o kēia manawa. 12th ed. Piladelapia, PA: Elsevier; 2017: 782-786.

Robbins KT, Samant S, Ronen O. Hoʻokaʻawale ʻāʻī. I: Flint PW, Haughey BH, Lund V, et al, eds. Cummings Otolaryngology: Ke poʻo poʻo a me ka ʻāʻī. ʻElua huaʻōlelo Piladelapia, PA: Elsevier Saunders; 2015: chap 119.