Uvulopalatopharyngoplasty (UPPP)

Uvulopalatopharyngoplasty (UPPP) ke ho buuoa ho bula li-airways tse kaholimo ka ho ntša lisele tse eketsehileng mmetsong. E ka etsoa ho phekola ho koaleha moea ka nakoana borokong (OSA) kapa ho tsubella hampe haholo.

UPPP e tlosa lisele tse bonolo mokokotlong oa 'metso. Sena se kenyelletsa:

• Tsohle kapa karolo ea uvula (lesela le bonolo la lisele tse leketlileng ka morao molomong).
• Likarolo tsa mahalapa a bonolo le lisele tse mahlakoreng a 'metso.
• Lithone le li-adenoids, haeba li ntse li le teng.

Ngaka ea hau e ka 'na ea khothaletsa ho buuoa haeba u e-na le bothata ba ho koaleha moea ka nakoana borokong.

• Leka liphetoho tsa bophelo pele, joalo ka ho theola boima ba 'mele kapa ho fetola boemo ba hau ba ho robala.
• Litsebi tse ngata li khothaletsa ho leka ho sebelisa CPAP, marapo a holisang nko, kapa sesebelisoa sa molomo ho phekola OSA pele.

Ngaka ea hau e ka khothaletsa ho buuoa hona ho phekola ho tsubella ho matla, leha o sena OSA. Pele o nka qeto ka ts'ebetso ena:

• Bona hore na ho theola boima ba 'mele ho u thusa ho honotha.
• Nahana kamoo ho leng bohlokoa ho uena ho phekola ho tsuba. Ho buuoa ha ho sebetse ho bohle.
• Etsa bonnete ba hore inshorense ea hau e tla lefella ts'ebetso ena. Haeba u sena OSA, inshorense ea hau e kanna ea se koahele opereishene.

Ka linako tse ling, UPPP e etsoa hammoho le liopereishene tse ling tse hlaselang ho phekola OSA e matla le ho feta.

Likotsi tsa anesthesia le ho buuoa ka kakaretso ke:

• Liketso tsa meriana kapa mathata a ho hema
• Ho tsoa mali, ho koala mali kapa tšoaetso

Likotsi tsa ts'ebetso ena ke:

• Tšenyo ea mesifa ea 'metso le mahalapa a bonolo. U kanna ua ba le mathata a mang a ho boloka mokelikeli hore o se ke oa nyoloha ka nko ea hau ha u noa (e bitsoang velopharyngeal insufficiency). Hangata, sena ke litlamorao tsa nakoana feela.
• Mucus qoqothong.
• Phetoho ea puo.
• Ho felloa ke metsi 'meleng.

Etsa bonnete ba hore o bolella ngaka kapa mooki oa hau:

• Haeba u imme kapa u ka ima
• Ke lithethefatsi life tseo u li sebelisang, ho kenyelletsa lithethefatsi, litlatsetso, kapa litlama tseo u li rekileng ntle le lengolo la ngaka
• Haeba u kile oa noa joala bo bongata, ho noa lino tse fetang tse 1 kapa tse peli ka letsatsi

Nakong ea matsatsi a pele ho ts'ebetso:

• U ka kopuoa ho emisa ho noa mali a kang aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), clopidogrel (Plavix), warfarin (Coumadin).
• Botsa ngaka ea hau hore na ke lithethefatsi life tseo u lokelang ho li noa ka letsatsi la ts'ebetso ea hau.
• Haeba u tsuba, leka ho emisa. Ho tsuba ho ka lieha ho fola. Botsa mofani oa hau thuso ea ho tlohela.
• Lumella mofani oa hau hore a tsebe ka serame, feberu, feberu, ho tsoa ha herpes kapa bokuli bo bong boo u ka bang le bona pele u etsoa opereishene. Haeba u kula, ho ka hlokahala hore opereishene ea hao e chechisoe.

Letsatsing la ho buuoa:

• Mohlomong u tla botsoa hore u se ke ua noa kapa ua ja letho ka lihora tse 'maloa pele u buuoa.
• Nka lithethefatsi leha e le life tseo ngaka ea hao e u boleletseng hore u li noe ka ho noa metsi hanyane.
• Latela litaelo tsa hore na u fihle sepetlele neng. Etsa bonnete ba hore o fihla ka nako.

Ts'ebetso ena hangata e hloka ho lula sepetlele bosiu bo le bong ho netefatsa hore o ka metsa. Ho buuoa ka UPPP ho ka ba bohloko mme ho fola ka botlalo ho nka libeke tse 2 kapa tse 3.

• 'Metso oa hau o tla ba bohloko haholo ho fihlela libeke tse' maloa. U tla fumana meriana ea bohloko ea mokelikeli ho kokobetsa bohloko.
• U kanna oa ba le lithuko ka morao molaleng oa hau. Tsena li tla qhala kapa ngaka ea hau e tla li tlosa leetong la pele la ho latela.
• Ja lijo tse bonolo le maro feela libekeng tse 2 tse qalang kamora ho buuoa. Qoba lijo tse sa lomosoang kapa lijo tseo ho leng thata ho li hlafuna.
• U tla hloka ho hlatsoa molomo oa hau kamora ho ja ka tharollo ea metsi a letsoai matsatsing a 7 ho isa ho a 10 a pele.
• Qoba ho phahamisa boima kapa ho thellela libeke tse 2 tse qalang. U ka tsamaea le ho etsa lintho tse bobebe kamora lihora tse 24.
• U tla etela hape le ngaka ea hau libeke tse 2 kapa tse 3 kamora ho buuoa.

Ho koaleha moea ka nakoana borokong ho ntlafala qalong bakeng sa hoo e ka bang halofo ea batho ba buuoang sena. Ha nako e ntse e tsamaea, molemo ona oa fela ho batho ba bangata.

Liphuputso tse ling li bontša hore ho buuoa ho loketse feela batho ba nang le bothata ba mahalapa a bonolo.

Ho buuoa ka mahalapa; Tsamaiso ea likhahla tsa uvulopalatal; UPPP; Laser-thusa uvulopalaplasty; Radiofrequency palatoplasty; Ho hloka matla ha Velopharyngeal - UPPP; Ho thibela ho phomola ha boroko - uvulopalaplasty; OSA - uvulopalaplasty

Katsantonis GP. Uvulopalatopharyngoplasty ea khale. Ka: Friedman M, Jacobowitz O, bahlophisi. Ho robala ka boroko le ho tsuba. Lekhetlo la bobeli. Philadelphia, PA: Elsevier; 2020: khaolo ea 32.

Qaseem A, Holty JE, Owens DK, et al; Komiti ea Tataiso ea Bongaka ea Koleji ea Amerika ea Lingaka. Tsamaiso ea ho koaleha moea ka nakoana borokong ho batho ba baholo: litataiso tsa litloaelo tsa bongaka tse tsoang American College of Physicians. Ann Intern Med. 2013; 159 (7): 471-483. PMID: 24061345 www.ncbi.nlm.nih.gov/pubmed/24061345.

Wakefield TL, Lam DJ, Ishman SL. Ho phomola ha boroko le mathata a ho robala. Ka: Flint PW, Haughey BH, Lund V, et al, eds. Cummings Otolaryngology: Ho Buuoa Hlooho le Nko. La 6th. Philadelphia, PA: Elsevier Saunders; 2015: khaolo ea 18.