Splenectomy Ndi Opaleshoni Yowononga Matenda

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Kodi Splenectomy Ndi Chiyani?

Splenectomy ndi kuchotsa opaleshoni ya mpeni . Pali mitundu iwiri ya splenectomies - njira yotseguka yotseguka , pogwiritsa ntchito kukula kwathunthu, ndi njira ya laparoscopic, yomwe imagwiritsa ntchito zingapo zing'onozing'ono. Opaleshoni ya laparoscopic nthawi zambiri imatchedwa opaleshoni yochepa kwambiri.

Ndondomeko ya laparoscopic ndiyo njira yowonjezera ya splenectomy ndipo imagwiritsidwa ntchito ngati chotheka ndi dotoloyo. Ndondomekoyi imagwiritsa ntchito zingapo zing'onozing'ono ndipo nthawi zambiri imatchedwa opaleshoni yochepa. Chifukwa cha kukula kwake, njira ya laparoscopic imachepetsa kupweteka kwabwino komanso chiopsezo cha matenda .

Osati odwala onse a anatomy kapena matumbo amalola njira yothetsera; muzochitikazi, njira yotsegula imagwiritsidwa ntchito. Amagwiritsidwanso ntchito pamene nthata ikuchotsedwa chifukwa cha matenda otchedwa splenomegaly, kapena kutambasula kwa mpeni. Ichi ndi chifukwa chakuti nthata ikhoza kukhala yayikulu kwambiri kuti isachotsedwe kudzera mu zochitika zapang'ono kwambiri za laparoscopic.

Nthaŵi zina, njirayi ingayambe ngati opaleshoni ya laparoscopic koma dokotalayo angasankhe kupitiriza opaleshoniyo ndi kutsegula koyera ngati nthata itapezeka kuti yakula kwambiri.

Pa opaleshoni yowonjezereka, monga pambuyo pa kuwonongeka kwa galimoto pamene nthata yaphulika, mwambo wotseguka wotseguka ukhoza kugwiritsidwa ntchito kulola dokotalayo kuti awonetsere chovulala ndikuyamba opaleshoni mofulumira.

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Kodi Spleen Surgery ndi Yotani?

Kuchita opaleshoni ya splenectomy, kapena opaleshoni yakuchotsa makola, sikutheka kupezeka pazidzidzidzi. Nthaŵi zambiri splenectomy imachitidwa mwamsanga , kapena kuti ipulumutse moyo wa wodwala, nthata yawonongeka ndi vuto. Nthendayi imakhala ndi mitsempha yambiri, imakhala ndi mitsempha yambiri ya magazi komanso magazi ambiri, ndipo imatuluka mosavuta. Ngati kutaya magazi sikungayambe kuyendetsedwa ndi njira zina, ziyenera kuchotsedwa opaleshoni, kapena wodwala akhoza kuwukha magazi. Ngozi ya galimoto ndi yowonongeka ya chiwonongeko kwa nthata.

Kutuluka mofulumira, pamene nthata imaphulika mwadzidzidzi popanda chifukwa chodziwika bwino, ndi yosavuta koma imathandizanso kuchitidwa opaleshoni yowopsa .

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Zizindikiro Za Splenectomy?

Splenectomy, opaleshoni yochotsa nthata, ikhoza kuwonetsedwa m'mabuku otsatirawa:

• Magazi amatha
• Hypersplenism : Ichi ndi chikhalidwe chomwe nthendayi imakhala yopanda mphamvu ndikuwononga maselo abwino a magazi.
• Splenomegaly : Kukulitsa kwa mpeni
• Khansa
• Matenda oopsa : Ichi ndi chikhalidwe chomwe chimbudzi chachikulu chomwe chimatsogolera kuchiwindi chimakhala ndi kuthamanga kwa magazi. Zikhoza kuyambitsa matenda osiyanasiyana a chiwindi, kuphatikizapo cirrhosis ndi khansa.
• Matenda a chiwindi a chiwindi : Izi ndi matenda aakulu a chiwindi, pamene minofu yowonongeka imalowetsedwa ndi minofu yowopsya ngati kuwonongeka kwachitika. Magazi samayenda momasuka kudzera mu chiwindi, kuchititsa kuopsa kwa pathupi.
• Lymphoma : Mtundu uwu wa khansara ukhoza kupangitsa kufalikira kwa nthenda (splenomegaly).
• Idiopathic thrombocytopenia purpura (ITP)
• Kuchepetsa magazi m'thupi : Matenda oterewa , omwe maselo osasunthika ali ndi mawonekedwe ozungulira ndipo amaonongeka pamene akuyenda kudzera mu nthata, amatha kuchiritsidwa ndi splenectomy.
• Hemolytic anemia : Mitundu ina ya magazi a hemolytic anemia, momwe ma maselo ofiira amawonongeka msanga ndi thupi, akhoza kusintha ndi kuchotsa mphala.

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Matenda a Splenectomy

Kuphatikiza pa zoopsa zonse zomwe zimachitika ndi opaleshoni ndi anesthesia , opaleshoni kuchotsa mpeni ali ndi mavuto ake omwe angathe. Mphuno ndi chiwalo chachikulu kwambiri, kutanthauza kuti imakhala ndi mitsempha yambiri ya mitsempha. Izi zimapangitsa mpeni kukhala wokonzeka kuwukha magazi zikawonongeka kapena kugwiritsidwa ntchito. Ngati nthendayi yowonongeka kwambiri ndipo imatuluka magazi musanayambe opaleshoni, kutuluka kwa magazi kungapitirizebe opaleshoni mpaka opaleshoniyo atha kupeza chitsime cha kutuluka magazi ndi kuchiletsa.

Mphuno imakhala kumbuyo kwa mimba, pansi pa mitsempha ya mthunzi ndi kupuma pafupi ndi ziphuphu ndi matumbo. Chifukwa cha kuyandikana ndi ziwalo zina ndi ziwalo zina, pali chiopsezo chochepa kuti akhoza kuwonongeka panthawiyi.

Kuopsa kwa kachilombo koyambitsa matenda ndiko kochepa kwambiri ndi njirayi kusiyana ndi opaleshoni yeniyeni, osati chifukwa cha opaleshoni yokha, koma chifukwa nthendayi imathandiza kuthetsa matenda. Katundu akachotsedwa, chitetezo cha mthupi sichigwira ntchito komanso chimachitidwa opaleshoniyo isanakwane.

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Splenectomy: Njira ya Laparoscopic

Splenectomy ingakhoze kuchitidwa laparoscopically kapena kugwiritsa ntchito njira yotseguka ndi incision full size. Ngakhale kuti opaleshoni zambiri zimachotsa nthata yonse, n'zotheka kukhala ndi splenectomy yokha, njira yomwe mbali imodzi ya chiwalo imachotsedwa.

Kuchita opaleshoni kumayamba ndi kayendedwe ka anesthesia . Pomwe wodwalayo sakudziwa, opaleshoniyo imayamba, makamaka poyambitsa makina asanu aang'ono oposa 2 mpaka 3 sentimita kutalika kwa nthiti kumanzere. Kamera kakang'ono yotchedwa laparoscope imalowetsedwa mu imodzi mwa zochitikazo. Zomwe zimagwiritsidwa ntchito zikugwiritsidwa ntchito pophatikiza zipangizo zopangira opaleshoni komanso ntchito yeniyeni ya opaleshoni. Pa opaleshoni, dokotalayo amawona malo akugwiritsidwa ntchito ndi kamera, chifukwa zomwe zimawoneka kuti ndizochepa kwambiri kuti dokotalayo aone opaleshoniyo mwachindunji.

Nthendayi imakhala ndi mitsempha yambiri ya magazi, kotero dokotalayo amapeza mitsempha ya mitsempha yomwe imatsogolera ndi kuchokera pamphuno ndipo imayika zojambulazo kuti zisaimitse magazi kuti asatuluke mpaka kumphepete. Nthendayi imachotsedwa ku ziwalo zina za thupi. Pamene ili mfulu, nthata imayikidwa mu thumba lopanda kanthu kotero kuti ikhoza kutulutsidwa kunja kwa thupi kupyolera mu chimodzi mwa zochitikazo. Ngati ndi kotheka, incision ikhoza kukulirakulira kuti ikulole thumba lidutse. Izi zimachitika kotero kuti palibe ziwalo za mpeni zomwe zimatha kusiya ndi kukhalabe m'mimba, momwe zingayambitse matenda aakulu.

Katundu atachotsedwa ndipo dotoloyo sapeza zizindikiro za kutuluka mwazi, zidazo zimachotsedwa ndipo zofunikila zimatsekedwa. Zomwe zimagwiritsidwa ntchito zingakhale zotsekedwa ndi ululu wopangira opaleshoni, ster-strips (zing'onozing'ono zomangira bandage), kapena zochepetsetsa, zakuya kapena sutures .

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Splenectomy: Open Procedure

Njira yotseguka ya splenectomy ili yofanana kwambiri ndi njira ya laparoscopic ndi kusiyana kwakukulu kwakukulu - incision yomwe imagwiritsidwa ntchito ndi pafupifupi masentimita 4 kapena asanu m'litali, ndipo dokotalayo amatha kuyang'ana mu incision kuti awone njira yonseyo.

Njirayi ndi yothandiza makamaka pamtundu wa splenomegaly, kapena kutambasula kwa mpeni, zomwe zingapangitse kuti mphulupuluyo ikhale yayikulu kwambiri kuti ichotsedwe kudzera m'maganizo ang'onoang'ono omwe amagwiritsidwa ntchito pang'onopang'ono. Ngati nthendayi yavutika kwambiri, njira yotseguka ingagwiritsidwe ntchito kuti dokotalayo apitirize kuona malo ndi magazi kuti aziwoneka mofulumira kusiyana ndi njira ya laparoscopic.

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Kuchokera Pambuyo pa Opaleshoni ya Splenecotomy

Kupeza opaleshoni ya splenectomy kumasiyanasiyana kwambiri kuchokera kwa wodwala mpaka wodwala, makamaka chifukwa pali zifukwa zosiyana zokhala ndi splenectomy. Mosasamala chifukwa cha opaleshoni yanu, mukadzuka kuchokera ku opaleshoni yanu, mudzamva ululu kumbali yanu ya kumanzere m'mimba mwanu. Mudzakhalanso ndi chubu, yotchedwa chupastric tube (NG), yomwe imalowa m'mphuno mwanu, pansi pamimba ndi m'mimba mwako. Thubu iyi imalepheretsa kumanga mimba ya asidi, kuchepetsanso kusuta ndi kusanza mukamatsatira. Thumba imachotsedwa tsiku limodzi kapena awiri pambuyo pa opaleshoni.

Wodwala wodwala amatha kupita kunyumba kuchokera kuchipatala maola 48 mpaka 72 atatha opaleshoni ngati splenectomy ikuchitidwa mosiyana kwambiri. Njira yotseguka ingafune kukhala motalika, nthawi zambiri mpaka sabata, musanayambe kumasulidwa. Odwala ambiri amatha kuyambiranso ntchito zawo zachizolowezi masabata 4 mpaka 6 pambuyo pa opaleshoni. Komabe, wodwala amene akufuna splenectomy pambuyo pake atatha kupwetekedwa amatha kupita kuchipatala nthawi yaitali chifukwa cha kuvulala kwina kulikonse komwe kungakhaleko. Nthawi zina, kuwonongeka kwa mpeni kungakhale kochepetsetsa kwambiri.

Nthendayi imakhala yotuluka m'magazi mukamavulala kotero mungafunike kuika magazi pambuyo pa ndondomekoyi. Izi zidzadalira kuchuluka kwa magazi omwe anataya kale, panthawi ndi pambuyo pake ndikuchitidwa ngati pakufunika. Popanda kuikidwa magazi, wodwalayo amene amayamba kutuluka magazi angakhale wofooka kapenanso ngakhale wamutu, chifukwa cha kutaya magazi.

Ndikofunika kwambiri kuti mukhale okhudzidwa ndi chisamaliro chanu, monga chilonda chanu chingathe kutenga kachilomboka pakatha opaleshoniyi. Zomwe mukufunira ziyenera kuyang'anitsidwa ngati zizindikiro za matenda tsiku ndi tsiku kapena nthawi zambiri.

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Pambuyo pa Splenectomy

Pambuyo pa splenectomy, mudzakhala ovuta kudwala ndipo thupi lanu silingamenyane nawo mosavuta. Muyenera kuyesetsa kupeza chithandizo chamankhwala pa zinthu zomwe simunayambe mwachitsatira kuti mupeze chithandizo cham'mbuyo, monga zilonda zamoto, malungo , sinus ndi matenda ena akumutu, ndi matenda ena onse.

Dokotala wanu angakulimbikitseni kuti mulandire chithandizo kuti muteteze chibayo ndipo mukhoza kupereka zowonjezera katemera, monga katemera wa meningitis. Kukaniza kwa matendawa kungapite patsogolo mkati mwa zaka ziwiri za opaleshoni yanu, koma nkokayikitsa kuti idzabwereranso kumagulu opangira ntchito.

Ngati mukuwona dokotala watsopano kapena akuchiritsidwa ndi vuto losagwirizana, onetsetsani kuti dokotala adziwe kuti mulibe nthata.

Kusamalidwa Pogwiritsa Ntchito Opaleshoni

_Zotsatira:

_{Pambuyo Pambuyo Yanu Yachotsedwa: Zimene Mukuyenera Kudziwa Kuti Mudziteteze. American Family Physician. http://www.aafp.org/afp/20010201/508ph.html}

_{Congenital Spherocytic Anemia. MedLine Plus http://www.nlm.nih.gov/medlineplus/ency/article/000530.htm}

_{Malonda Kuchotsa. MedLine Plus http://www.nlm.nih.gov/medlineplus/ency/article/002944.htm}

_{Splenectomy. National Institutes of Health. [link ulr = http: //www.ncbi.nlm.nih.gov/books/bv.fcgi? rid = chiyero.section.3057] http://www.ncbi.nlm.nih.gov/books/bv. fcgi? rid = chifukwatu.3057}