Kunenqwaba yokuhlolwa namaskeni okuzodingeka ube nawo ngaphambi kokuba uqale ukwelashwa komdlavuza. Kubalulekile ukuthi ithimba lakho lezokwelapha lenze lokhu kuhlola ukuze lihlole ukuthi izitho zakho ezibalulekile zomzimba zisebenza kanjani njengamanje (zisebenza). Lokhu kwaziwa ngokuthi ukuhlolwa kokusebenza kwesitho 'sesisekelo' namaskena. Izitho zakho ezibalulekile zifaka inhliziyo, izinso namaphaphu.
Iningi ukwelashwa komdlavuza kungabangela ezihlukahlukene okuqhamuka uma udla imishanguzo. Eminye yale miphumela engemihle inamandla okubangela ukulimala kwesikhashana noma isikhathi eside kwezinye zezitho zakho ezibalulekile zomzimba. Ikakhulukazi abanye imiphumela emibi yokwelashwa ngamakhemikhali kungadala ukulimala ezithweni ezahlukene zomzimba. Ukuhlolwa nokuskena okuzodingeka kuncike ohlotsheni lokwelashwa komdlavuza olunikezwayo.
Eziningi zalezi ziskena zizophindwa phakathi nangemuva kokwelashwa ukuze kuqinisekiswe ukuthi ukwelashwa azizilimazi lezi zitho ezibalulekile. Uma ukwelashwa kuzithikameza izitho, ukwelashwa ngezinye izikhathi kungase kulungiswe noma ngezinye izikhathi kushintshwe. Lokhu okokuzama ukuqinisekisa ukuthi izitho ezibalulekile azithinteki unomphela.
Ukuhlolwa kokusebenza kwenhliziyo (inhliziyo).
Ezinye zokwelapha ngamakhemikhali zaziwa ngokubangela ukulimala kwenhliziyo nokuthi isebenza kanjani. Kubalulekile ukuthi odokotela bazi ukuthi inhliziyo yakho isebenza kanjani ngaphambi kokuthi uqale ukwelashwa. Uma usuvele unenhliziyo engasebenzi ngendlela efanele, lokhu kungase kunqume uhlobo lokwelapha ngamakhemikhali onganikezwa.
Uma ukusebenza kwenhliziyo kwehlela ezingeni elithile ngesikhathi sokwelashwa, umthamo wokwelapha ungase wehle noma umiswe. I-Chemotherapy esetshenziswa kwezinye izindlela zokwelapha ze-lymphoma ezingadala umonakalo njengokuthi i-doxorubicin (adriamycin), i-daunorubicin futhi i-epirubicin, zaziwa ngokuthi ama-anthracycline.
Yiziphi izinhlobo zokuhlolwa kokusebenza kwenhliziyo?
I-Electrocardiogram (ECG)
I-electrocardiogram (ECG) ukuhlolwa okusiza ukuthola izinkinga ngemisipha yenhliziyo, ama-valve, noma isigqi. I-ECG isivivinyo esingenabuhlungu esihlola ukusebenza kwenhliziyo yakho ngaphandle kokuhlasela. Irekhoda ukusebenza kukagesi kwenhliziyo njengemigqa ephepheni.
Lokhu kuhlolwa kwenziwa ehhovisi likadokotela noma esibhedlela. Abahlengikazi noma ochwepheshe bezokwelapha bavame ukwenza i-ECG. Udokotela ube esebuyekeza umphumela wokuhlolwa.
Ngaphambi kokuba wenze i-ECG tshela ithimba lakho lezempilo mayelana nayo yonke imithi oyiphuzayo. Buza ukuthi kufanele yini uyiphuze ngosuku lokuhlolwa ngoba eminye imithi ingaba nomthelela emiphumeleni.
- Ngokuvamile awudingi ukukhawulela ukudla noma isiphuzo sakho ngaphambi kwe-ECG yakho.
- Kuzodingeka ukhiphe izingubo zakho kusukela okhalweni kuya phezulu ngesikhathi se-ECG yakho.
- I-ECG ithatha imizuzu emi-5 ukuya kweyi-10 ukuqeda. Ngesikhathi se-ECG, umhlengikazi noma uchwepheshe wezokwelapha uzobeka izitika ezibizwa ngokuthi umkhondo noma ama-electrode esifubeni sakho nasezithweni (ezingalweni nasemilenzeni). Bese, bazoxhuma izintambo kubo. Le mikhondo iqoqa imininingwane mayelana nokusebenza kukagesi kwenhliziyo yakho. Uzodinga ukuhlala unganyakazi ngesikhathi sokuhlolwa.
- Ngemva kokuhlolwa, ungabuyela emisebenzini yakho evamile, kuhlanganise nokushayela.
I-Echocardiogram (i-echo)
An i-echocardiogram (i-echo) kuwukuhlola okusiza ekutholeni izinkinga ngemisipha yenhliziyo, amavalvu, noma isigqi. I-echo iyi-ultrasound yenhliziyo yakho. I-Ultrasound isebenzisa amaza omsindo wemvamisa ephezulu ukuthatha isithombe sezitho ezingaphakathi emzimbeni. Ithuluzi elinjenge-wand elibizwa ngokuthi i-transducer lithumela amaza omsindo. Bese, amaza omsindo "echo" emuva. Ukuhlolwa akubuhlungu futhi akuhlaseli.
- I-echo yenziwa ehhovisi likadokotela noma esibhedlela. Izazi ze-Sonographer, eziqeqeshwe ngokukhethekile ukusebenzisa imishini ye-ultrasound, ngokuvamile zenza i-echo. Udokotela ube esebuyekeza imiphumela yokuhlolwa.
- Ngaphambi kokuba ube ne-echo yakho, tshela ithimba lakho lezempilo mayelana nayo yonke imithi oyiphuzayo. Buza ukuthi kufanele yini uyiphuze ngosuku lokuhlolwa ngoba eminye imithi ingaba nomthelela emiphumeleni.
- Ngokuvamile awudingi ukukhawulela ukudla noma isiphuzo sakho ngaphambi kwe-echo yakho.
- Uzodinga ukukhipha izingubo zakho kusukela okhalweni phezulu ngesikhathi se-echo yakho.
- I-echo ithatha cishe imizuzu engama-30 ukuya ehoreni elingu-1 ukuqeda. Ngesikhathi se-echo, uzolala ngohlangothi lwakho etafuleni futhi ucelwe ukuthi uhlale unganyakazi. Uchwepheshe we-ultrasound uzofaka ijeli elincane esifubeni sakho. Bese bazohambisa i-transducer efana ne-wand esifubeni sakho ukuze benze izithombe zenhliziyo yakho.
- Ngemva kokuhlolwa, ungabuyela emisebenzini yakho evamile, kuhlanganise nokushayela.
Ukuskena kwe-Multigated Acquisition (MUGA).
Kwaziwa nangokuthi 'i-cardiac blood pooling' imaging noma 'i-gated blood pool scan'. Iskena se-multigated acquisition (MUGA) sidala izithombe zevidiyo zamagumbi aphansi enhliziyo ukuhlola ukuthi ampompa igazi ngendlela efanele yini. Ibonisa noma yikuphi ukungahambi kahle ngobukhulu bamagumbi enhliziyo kanye nokuhamba kwegazi enhliziyweni.
Odokotela futhi ngezinye izikhathi basebenzisa izikena ze-MUGA njengokunakekelwa kokulandelela ukuze bathole imiphumela engemihle yenhliziyo yesikhathi eside, noma imiphumela yakamuva. Imiphumela ephuzile ingase yenzeke eminyakeni engaphezu kwemi-5 ngemva kokwelashwa. Abasinde kumdlavuza abangase badinge ukulandelwa kwe-MUGA scan bahlanganisa:
- Abantu abaye belashwa ngemisebe esifubeni.
- Abantu abake baba nomnkantsha wamathambo/ukufakelwa kwe-stem cell noma izinhlobo ezithile ze-chemotherapy.
Iskena se-MUGA senziwa emnyangweni we-radiology esibhedlela noma esikhungweni sokuthwebula seziguli ezingaphandle.
- Ungase ungakwazi ukudla noma ukuphuza amahora angu-4 kuya kwangu-6 ngaphambi kokuhlolwa.
- Ungase futhi ucelwe ukuthi ugweme i-caffeine nogwayi kuze kube amahora angu-24 ngaphambi kokuhlolwa.
- Iziyalezo uzonikezwa ngaphambi kokuhlolwa kwakho. Letha uhlu olugcwele lwayo yonke imithi oyisebenzisayo.
- Uma ufika ukuze uthole iskena sakho se-MUGA, kungase kudingeke ukuthi ukhiphe izingubo zakho kusukela okhalweni uye phezulu. Lokhu kubandakanya ubucwebe noma izinto zensimbi ezingase ziphazamise ukuskena.
- Ukuskena kungase kuthathe amahora angu-3 ukuqeda. Isikhathi sincike ekutheni zingaki izithombe ezidingekayo.
- Uchwepheshe uzobeka izitika ezibizwa ngokuthi ama-electrode esifubeni sakho ukuze aqaphe ukusebenza kukagesi wenhliziyo yakho ngesikhathi sokuhlolwa.
- Inani elincane le-radioactive material lizojovwa emthanjeni osengalweni yakho. I-radioactive material ibizwa ngokuthi i-tracer.
- Uchwepheshe uzothatha inani elincane legazi engalweni yakho futhi alixube ne-tracer.
- Khona-ke uchwepheshe uzobuyisela ingxube emzimbeni wakho ngomugqa we-intravenous (IV) ofakwe ngqo emithanjeni.
Umkhondo ufana nodayi. Ibophezela kumangqamuzana egazi abomvu, athwala umoya-mpilo kuwo wonke umzimba wakho. Ikhombisa indlela igazi elihamba ngayo enhliziyweni yakho. Ngeke ukwazi ukuzwa i-tracer ihamba emzimbeni wakho.
Uchwepheshe uzokucela ukuthi ulale unganyakazi etafuleni futhi ubeke ikhamera ekhethekile ngaphezu kwesifuba sakho. Ikhamera icishe ibe ngamafidi angu-3 ububanzi futhi isebenzisa imisebe ye-gamma ukulandelela umkhondo. Njengoba i-tracer ihamba phakathi kwegazi lakho, ikhamera izothatha izithombe ukuze ibone ukuthi igazi limpompa kahle kangakanani emzimbeni wakho. Izithombe zizothathwa ekubukeni okuningi, futhi ngasinye sithatha cishe imizuzu emi-5.
Ungacelwa ukuthi uzivocavoce phakathi kwezithombe. Lokhu kusiza udokotela abone ukuthi inhliziyo yakho isabela kanjani ekucindezelekeni kokuzivocavoca. Uchwepheshe angase futhi akucele ukuthi uthathe i-nitro-glycerine ukuze uvule imithambo yegazi futhi ubone ukuthi inhliziyo yakho isabela kanjani emuthini.
Ungalindela ukubuyela emisebenzini yakho evamile ngokushesha ngemva kokuhlolwa. Phuza uketshezi oluningi futhi uchame njalo izinsuku ezingu-1 kuya kwezi-2 ngemva kokuskena ukuze usize umkhondo ukuthi uphume emzimbeni wakho.
Ukuhlolwa komsebenzi wokuphefumula
Kukhona ezinye izindlela zokwelapha ngamakhemikhali ezisetshenziswa ekwelashweni kwe-lymphoma ezingathinta ukusebenza kwamaphaphu akho futhi zithinte ukuphefumula. I-Bleomycin i-chemotherapy evamile esetshenziswa ekwelapheni i-Hodgkin lymphoma. Ukuhlolwa okuyisisekelo kwenziwa ukuze kubonakale ukuthi umsebenzi wakho wokuphefumula unjani ngaphambi kokwelashwa, futhi ngesikhathi sokwelashwa futhi kaningi ngemva kokwelashwa.
Uma umsebenzi wakho wokuphefumula wehla, lesi sidakamizwa singase simiswe. Kukhona izinhlolo eziningi zemitholampilo okwamanje ezibheka ukumisa lesi sidakamizwa ngemuva kwemijikelezo emi-2-3 uma iziguli zinokuxola okuphelele. Lokhu kwenzelwa ukunciphisa ubungozi bezinkinga zokuphefumula.
Kuyini ukuhlola ukusebenza kokuphefumula (kwamaphaphu)?
Ukuhlolwa kokusebenza kwamaphaphu yiqembu lokuhlola elikala ukuthi amaphaphu asebenza kahle kangakanani. Bakala ukuthi ungakanani umoya amaphaphu akho angawubamba nokuthi ungawukhipha kahle kangakanani umoya emaphashini akho.
- I-Spirometry ikala ukuthi ungakanani umoya ongawuphefumula emaphashini akho nokuthi ungakwenza ngokushesha kangakanani.
- I-Lung plethysmography ikala ukuthi ungakanani umoya emaphashini akho ngemva kokudonsa umoya kakhulu nokuthi ungakanani umoya osele emaphashini akho ngemva kokuphefumula kwakho okuningi ngangokunokwenzeka.
- Ukuhlola ukusabalala kwamaphaphu kulinganisa ukuthi umoya-mpilo uhamba kahle kangakanani usuka emaphashini akho uye egazini lakho.
Ukuhlolwa kokusebenza kwamaphaphu ngokuvamile kwenziwa emnyangweni okhethekile wesibhedlela ngumelaphi wokuphefumula oqeqeshiwe.
Tshela ithimba lakho lezempilo mayelana nayo yonke imithi kadokotela kanye nengekho incwadi oyiphuzayo. Ngokuvamile utshelwa ukuthi ungabhemi amahora ama-4 kuya kwayisi-6 ngaphambi kokuba uhlolwe ukusebenza kwamaphaphu.
Gqoka izingubo ezixegayo ukuze ukwazi ukuphefumula kahle. Gwema ukudla ukudla okunzima ngaphambi kokuhlolwa kokusebenza kwamaphaphu - kungenza kube nzima ukuthi uphefumule kakhulu.
Ukuhlolwa kwe-Spirometry
Ukuhlolwa kwe-Spirometry kungenye yokuhlola ukusebenza kwamaphaphu okujwayelekile okusetshenziselwa ukunquma kokubili umthamo womoya amaphaphu angawuhogela futhi awukhiphe, kanye nezinga lapho umoya ungahogela khona futhi ukhishwe. Idivayisi esetshenzisiwe ibizwa ngokuthi i-spirometer, futhi ama-spirometer amaningi esimanje axhunywe kukhompuyutha ehlanganisa ngokushesha idatha kusuka ekuhlolweni.
Uzocelwa ukuthi uphefumule usebenzisa ishubhu elide elinomlomo wekhadibhodi. Ishubhu elide lixhunywe kukhompyutha ekala inani lomoya owuphefumulayo ngokuhamba kwesikhathi.
Uzocelwa kuqala ukuthi uphefumule kahle ngomlomo. Uyobe usucelwa ukuthi udonse umoya omkhulu ongakwazi ukuwuphefumula bese uwukhipha ngamandla, ngokushesha, nangesikhathi eside ngangokunokwenzeka.
Ukuhlolwa kwe-plethysmography yamaphaphu
Lokhu kuhlola kunquma:
- Isamba somthamo wamaphaphu. Lona umthamo womoya emaphashini ngemva kokuphefumulelwa okukhulu.
- I-Functional Residual Capacity (FRC). I-FRC iyivolumu yomoya emaphashini ekupheleni kokuphelelwa yisikhathi kokuphumula okuthulile
- Ivolumu eyinsalela okuwumthamo womoya oshiywe emaphashini ngemva kokuphelelwa yisikhathi okukhulu.
Ngesikhathi sokuhlolwa uzocelwa ukuthi uhlale ebhokisini elivaliwe elifana nebhokisi locingo. Kunomlomo ngaphakathi kwebhokisi okuzodingeka uwuphefumule ngaphakathi nangaphandle ngesikhathi sokuhlolwa.
Umsebenzisi uzokutshela ukuthi uphefumula kanjani ngaphakathi nangaphandle komlomo ngenkathi kuthathwa izilinganiso. I-shutter ngaphakathi kwe-mouthpiece izovuleka futhi ivalwe ukuvumela ukufundwa okuhlukahlukene ukuba kuthathwe. Kuye ngokuhlolwa okudingekayo, kungase kudingeke uphefumule amanye amagesi (angenayo nangenabungozi) kanye nomoya. Ukuhlolwa okuphelele ngokuvamile akuthathi ngaphezu kwemizuzu emi-4-5.
Yazisa udokotela uma uthatha noma yimiphi imithi, ikakhulukazi uma ihlobene nobunzima bokuphefumula, njengoba kungase kudingeke uyeke ukuyiphuza ngaphambi kokuhlolwa. Uma ungenwa umkhuhlane noma esinye isifo esingase sikuvimbele ukuba uphefumule kahle, kungase kudingeke ukuthi uhlele kabusha ukuhlolwa ukuze uthole ukuthi usungcono nini.
Ungagqoki noma yiziphi izimpahla ezingase zikuvimbele ukuthi uphefumule ngaphakathi futhi uphume ngokugcwele futhi ugweme ukudla ukudla okukhulu phakathi namahora amabili okuhlolwa, noma ukuphuza utshwala (phakathi kwamahora amane) noma ukubhema (lingakapheli ihora) lokuhlolwa. Akufanele futhi wenze noma yikuphi ukuvivinya umzimba okukhandlayo emizuzwini engama-30 ngaphambi kokuhlolwa.
Ukuhlola ukusabalala kwamaphaphu
Ikala ukuthi i-oksijini ihamba kahle kangakanani isuka emaphashini akho iye egazini lakho.
Ngesikhathi sokuhlolwa kokusabalala kwamaphaphu, uphefumula inani elincane legesi ye-carbon monoxide ngomlomo weshubhu. Ngemva kokubamba umoya wakho cishe imizuzwana eyi-10, bese ukhipha igesi.
Lo moya uqoqwa ku-tube futhi uhlolwe.
Akufanele ubheme noma uphuze utshwala esikhathini esingamahora ama-4 ngaphambi kokuhlolwa. Gqoka izingubo ezingakufanelanga ukuze ukwazi ukuphefumula kahle ngesikhathi sokuhlolwa.
Yazisa udokotela wakho ukuthi yimiphi imithi oyiphuzayo nokuthi uyeke yini ukuyiphuza ngaphambi kokuhlolwa.
Ukuhlolwa kokusebenza kwezinso (izinso).
Kukhona imithi yokwelapha ngamakhemikhali engathinta ukusebenza kwezinso zakho. Kubalulekile ukuhlola ukusebenza kwezinso zakho ngaphambi kokuba kuqale ukwelashwa, ngesikhathi sokwelashwa nangezinye izikhathi ngemva kokwelashwa. Ukusebenza kwakho kwezinso kungagadwa ngokuhlolwa kwegazi ngaphambi komjikelezo ngamunye we-chemotherapy. Lezi zivivinyo ezilandelayo zithola ukubukeka okunembe kakhudlwana kokuthi izinso zakho zisebenza kahle kangakanani.
Uma ukusebenza kwezinso zakho kwehla ngesikhathi sokwelashwa, umthamo wakho wokwelashwa ungase wehliswe, ubambezeleke noma umiswe konke ndawonye. Lokhu kwenzelwa ukuvimbela ukulimala okwengeziwe ezinso zakho. Ama-chemotherapies avamile asetshenziswa ku-lymphoma futhi angabangela umonakalo ahlanganisa; ifosfamide, imethotrexatei-carboplatin, i-radiotherapy nangaphambi kwe- ukufakelwa kwe-stem cell.
Yiziphi ezinye zezivivinyo zokusebenza kwezinso ezisetshenziswayo?
Ukuskena kwezinso (izinso).
Iskena sezinso wukuhlolwa kwesithombe esibheka izinso.
Iwuhlobo lokuhlolwa kwesithombe senuzi. Lokhu kusho ukuthi inani elincane lento ekhipha imisebe isetshenziswa ngesikhathi sokuskena. I-radioactive matter (i-radioactive tracer) imuncwa izicubu zezinso ezivamile. I-tracer enemisebe ithumela imisebe ye-gamma. Lezi zithathwa yisithwebuli ukuze zithathe izithombe.
Lapho ubhukha iskena, uchwepheshe uzokunikeza noma yimiphi imiyalelo efanele yokulungiselela.
Eminye imiyalelo ingafaka:
- Ngokuvamile iziguli kudingeka ziphuze izingilazi zamanzi ezingu-2 phakathi nehora elingu-1 lokuhlolwa.
- I-tracer enemisebe ijovwa emthanjeni osengalweni yakho. Ngemuva kokuphathwa kwama-radiotracers, ukuskena kuzokwenzeka.
- Ubude besikhathi sokuskena buzohluka ngobude kuye ngombuzo womtholampilo okukhulunywa ngawo. Isikhathi sokuskena ngokuvamile sithatha ihora.
- Ungaqalisa kabusha umsebenzi ojwayelekile ngemva kokuskena.
- Khulisa uketshezi olumumatha ukuze usize ukukhipha umkhondo.
I-Renal ultrasound
I-renal ultrasound ukuhlolwa okungahlaseli okusebenzisa amaza e-ultrasound ukukhiqiza izithombe zezinso zakho.
Lezi zithombe zingasiza udokotela wakho ukuthi ahlole indawo, ubukhulu, nokuma kwezinso zakho kanye nokugeleza kwegazi ezinso zakho. I-ultrasound yezinso ngokuvamile ihlanganisa esinyeni sakho.
I-Ultrasound isebenzisa amaza omsindo wemvamisa ephezulu athunyelwa i-transducer ecindezelwe esikhumbeni sakho. Amagagasi omsindo ahamba emzimbeni wakho, egxuma izitho abuyele ku-transducer. Lawa ma-echoes ayarekhodwa futhi aguqulwe ngokwedijithali abe ividiyo noma izithombe zezicubu nezitho ezikhethelwe ukuhlolwa.
Iziyalezo mayelana nendlela yokulungiselela nokuthi yini ongayilindela uzonikezwa ngaphambi kokuqokwa kwakho.
Olunye ulwazi olubalulekile luhlanganisa;
- Ukuphuza izingilazi ezi-3 zamanzi okungenani ihora elilodwa ngaphambi kokuhlolwa futhi ungasikhiphi esinyeni sakho
- Uzobe ulele ubheke phansi etafuleni lokuhlolwa okungenzeka ungakhululeki
- Faka ijeli elibandayo esikhumbeni sakho endaweni ohlolwayo
- I-transducer izohlikihlwa endaweni ehlolwayo
- Inqubo ayinabuhlungu
- Ungabuyela emisebenzini evamile ngemva kwenqubo
