Ngati dokotala wanu atakuuzani kuti muli ndi matenda a magazi mungadabwe kuti, " Ndiye n'chifukwa chiyani ndulu yanga ndi yaikulu?" " Kodi nsomba yanga imakhudzana bwanji ndi magazi anga?" Kapena ngakhale " Kodi mpeni ndi chiyani?" Izi ndizo mafunso abwino kwambiri. Tiyeni tiyambe ndi ntchito ya ntchentche, kenaka kambiranani chifukwa chake phala likukula mitsempha ya myeloproliferative, ndipo potsirizira pake ayang'anenso njira zothandizira mankhwala a splenomegaly (kutambasula kwa mpeni).
Spleen Basics
Nkhumba ndi chiwalo chochepa (pafupi kukula kwa chibonga) chomwe chimakhala kumbali ya kumanzere kwa mimba pansi pa nthiti. Nkhumbayo imapangidwa ndi mitundu iwiri ya minofu (1) zamkati zofiira zomwe zimasungira maselo ofiira a magazi ndi (2) mapira oyera omwe ali mbali ya chitetezo cha mthupi. M'magazi ofiira, maselo ofiira a m'magazi akale kapena osasokonezeka (monga maselo a sickle) achotsedwa pamasamba. Mapira ofiira amathandizanso thupi kutsegula matenda, makamaka matenda ena a bakiteriya. Masamba oyera amathandiza kuti apange ma lymphocytes, mtundu wa selo loyera la magazi, zomwe zimathandiza kupanga ma antibodies kuti atenge matenda kapena katemera. Ngakhale izi ndizo ntchito zazikuluzikulu kamodzi kamene mumabadwira, musanabereke, nthata ndiyo yaikulu yopanga maselo a magazi ( hematopoiesis ). Chakumapeto kwa mimba ndi atabereka, fupa la fupa limatengera izi.
Chifukwa chake Mbalame Yayamba Kukulitsidwa
Mu polycythemia vera maselo ofiira ambiri amagazi amapangidwa, zomwe zimapangitsa kuchuluka kwa maselo ofiira ofiira omwe amafunika kuti azisakanizidwa ndi ntchentche, zomwe zimayambitsa splenomegaly.
Mu myelofibrosis oyambirira , mafupa awonongeka ndi fibrosis, zomwe zimapangitsa kuti zovuta kupanga maselo a magazi. Pachifukwa ichi, nthendayi ikulonjeze kuti ikhale yopangira maselo a magazi kunja kwa mafupa. Izi zingachitenso ku chiwindi nthawi zambiri.
Zizindikiro Za Kukhala ndi Spleen Yowonjezeka
Anthu ambiri omwe ali ndi nthenda yotambasula sangadziwe, makamaka ngati nthendayo imakula pang'ono.
Ena anganene kuti "chidzalo" m'mimba. Pamene nthendayo ikukula kwambiri, imatha kupitirira m'mimba, yomwe ingakupangitseni kumva kumverera, monga mutangodya chakudya chokwanira mukangodya pang'ono.
Mphuno ndi yovuta ndipo nthawi zambiri imatetezedwa ndi nkhwangwa. Pamene ikufutukula sikutetezedwanso ndi kuvulazidwa, makamaka kuwonongeka kwa ngozi ya galimoto kapena kuwonetsa masewera (monga mpira kapena hockey). Kutupa kwa nthenda yotambasula kungayambitse magazi ambiri.
Kodi Mmene Mungayambitsire Mbalame?
Ngati nthata yanu imakula mokhazikika, mankhwala sangafunike. Dokotala wanu angayang'ane kuchuluka kwa magazi anu ndi kukula kwa ndulu yanu mosamala. Ngati mankhwala akufunika pali magulu akuluakulu atatu: mankhwala ochizira, splenectomy, ndi radiotherapy.
Choyamba ndi chithandizo chamankhwala. Kawirikawiri, izi ndi mankhwala omwe amayenera kuchepetsa kupanga maselo a magazi. Imodzi mwa mankhwala omwe amagwiritsidwa ntchito kuchepetsa kukula kwa nthata mu misoproliferative neoplasms ndi hydroxyurea. Hydroxyurea ndi mankhwala am'thupi omwe amatengedwa tsiku ndi tsiku. Kawirikawiri imayambira pa mlingo wochepa ndipo imakula kwambiri mpaka kufunikira kwenikweni (kawirikawiri mlingo wapadera wa hemoglobin, maselo oyera a magazi, kapena mapulateletsiti).
Njira zina zoyamaliramo mankhwala monga busulfan, melphalan, alpha interferon, thalidomide, kapena lenalidomide. Prednisone ingaperekedwe ndi thalidomide kapena lenalidomide. Njira zamachiritso zachiwiri zimaphatikizapo zida zowonjezereka (zomwe zimatchedwanso 2CDA), daunorubicin, decitabine, kapena 5-azacytidine. Dokotala wanu adzasankha mankhwala anu pogwiritsa ntchito matenda anu, mavuto ena azachipatala ndi zotsatira za mankhwala.
Chisankho chachiwiri ndi mankhwala a splenectomy kapena kuchotsa opaleshoni. Choopsa kwambiri chochotsa nthendayi ndizomwe zingathe kupha matenda aakulu. Ngati simunayambe kale, muyenera kulandira katemera wapadera kuti muteteze ku matenda a pneumococcal ndi matenda a meningococcal musanafike splenectomy.
Penguyo ikachotsedwa, mumayikidwa penicillin kawiri tsiku lililonse kuti muteteze matendawa. Kuonjezerapo, malungo (oposa 100.4F) ndiwadzidzidzi omwe amafunika kuchipatala mwamsanga.
Njira yachitatu ya chithandizo ndi radiotherapy (yotchedwanso mankhwala a radiation). Mafunde akugwiritsidwa ntchito pa ntchentche yomwe ingathandize kuchepetsa kukula kwake. Zotsatirazi ndizokhalitsa kuti splenic radiotherapy imatengedwa kuti imatha kupweteka , yochizira pofuna kuchepetsa zizindikiro kuti zikhale ndi moyo wabwino. Izi zikhoza kukhala njira yabwino kwa anthu omwe sali otchuka ku splenectomy.
Pali zinthu zambiri zomwe muyenera kuziganizira posankha ngati mungapange bwanji splenomegaly mu polycythemia vera kapena myelofibrosis. Onetsetsani kuti mukambirane ndi dokotala wanu madalitso komanso zotsatirapo za mankhwalawa.
> Zotsatira:
> Mesa RA. Momwe ndimachitira ndi matenda a splenomegaly odwala omwe ali ndi myelofibrosis. Magazi. 2009; 113: 5394-5400.
> Vannucchi AM. Momwe ndimachitira polycythemia vera. Magazi. 2014; 124: 3212-3220.