Uma udokotela wakho etshela ukuthi unesifo segazi ungase uzibuze, " Pho kungani ipeni lami likhulu kangaka?" " Iphika lami lihlobene kanjani negazi lami?" Noma ngisho " Kuyini i-spleen?" Lezi yizo zonke imibuzo ezinhle kakhulu. Ake siqale ngomsebenzi wephethini, bese uxoxa ngokuthi kungani i-spleen yandisa ama-myeloproliferative neoplasms, futhi ekugcineni ubuyekeze izinketho zokwelapha ze-splenomegaly (ukukhuliswa kwe-spleen).
Ama-Basics Basics
I-spleen iyisitho esincane (mayelana nobukhulu besibindi sakho) esihlala ngakwesobunxele kwesisu esisingaphansi kwesibhamu. I-spleen yenziwe ngezinhlobo ezimbili zezicubu (1) i-pulp ebomvu ehlunga amangqamuzana egazi abomvu futhi (2) i-pulp emhlophe eyingxenye yesistimu yomzimba. Emaspini obomvu, amangqamuzana egazi abomvu asebekhulile noma angasetshenziswanga (njengama-sickle cells) asusiwe ekusakazweni. I-pulp ebomvu ibuye isisiza umzimba ukuhlunga izifo, ikakhulukazi ukutheleleka kwamagciwane. I-pulp elimhlophe lisiza ukukhiqiza i-lymphocytes, uhlobo lwe-white cell cell, olusiza ukwenza ama-antibodies ukuba afinyeleleke noma ekuphenduleni ukugoma. Nakuba lezi ziyimisebenzi emikhulu yelwane uma uzalwa, ngaphambi kokubeletha, i-spleen ngumkhiqizi omkhulu wamangqamuzana egazi ( hematopoiesis ). Ngasekupheleni kokukhulelwa nangemva kokubeletha, umnkantsha wamathambo uthatha lo mkhiqizo.
Okwenza I-Spleen Ikhushulwe
E- polycythemia vera inomboro ephindaphindiwe yamaseli abomvu ayenziwa, okwenza kube nenani elikhudlwana lamaseli abomvu abomvu okudingeka ahlungwe yi-spleen, eholele ku-splenomegaly.
E- myelofibrosis eyinhloko , umnyoba wethambo unobungozi yi-fibrosis, okwenze kube nzima kakhulu ukukhiqiza amaseli egazi. Kulesi simo, i-spleen ingahle ikhulise ukusekela ukukhiqizwa kwamangqamuzana egazi ngaphandle kwamarrow. Lokhu kungase kwenzeke nesibindi ngokuvamile ngezinga eliphansi.
Izimpawu Zokuba ne-Spleen Ekhulisiwe
Abantu abaningi abane-spleen ekhulisiwe bangase bangazi, ikakhulukazi uma i-spleen isanda kakhulu.
Abanye bangase babike "ukugcwala" esiswini. Uma uhlangothi lukhuliswa kakhulu, lungacindezela esiswini, okungase kukunikeze umuzwa wokuzwa ugcwele, njengokuthi udle ukudla okuphelele uma udla kuphela inani elincane.
I-spleen iyinkimbinkimbi futhi ivame ukuvikelwa yi-ribcage. Njengoba ikhulisa, ayisekho ivikelwe futhi ijwayele ukulimala, ikakhulukazi ukuhlukunyezwa kusuka engozini yemoto noma imidlalo yokuxhumana (njengebhola noma iHockey). Ukuhlukunyezwa kwipeni ekhulisiwe kungabangela ukuphuma okukhulu kwegazi.
I-Splenomegaly Ingasetshenziswa Kanjani?
Uma i-spleen yakho ikhuliswa ngobumnene kuphela, ukwelashwa kungase kungadingeki. Udokotela wakho cishe uzoqapha ukubala kwegazi lakho nobukhulu besitezi sakho eduze. Uma ukwelashwa kuyadingeka kunezigaba ezintathu ezinkulu: ukwelashwa kwezokwelapha, i-splenectomy, ne-radiotherapy.
Okokuqala yi-therapy yezokwelapha. Ngokuvamile, lezi ziyimithi ehlose ukunciphisa ukukhiqizwa kwegazi. Omunye wemithi ejwayelekile ejwayele ukunciphisa usayizi we-spleen kuma-neoplasms we-myeloproliferative yi-hydroxyurea. I-Hydroxyurea imithi yomlomo ethathwa nsuku zonke. Ngokuvamile kuqalwe ngomthamo ophansi futhi wenyuka kuze kube yilapho umfutho oyifunayo (ngokuvamile izinga elithile le-hemoglobin, amaseli egazi amhlophe, noma amaplatelet).
Ezinye izindlela zokwelapha zokuqala zihlanganisa ibhasi, i-melphalan, i-alpha interferon, i-thalidomide, noma i-lenalidomide. I-Prednisone inganikezwa nge-thalidomide noma i-lenalidomide. Imithi yokwelashwa yesibili ifaka phakathi i-cladribine (ebizwa nangokuthi i-2CDA), i-daunorubicin, i-decitabine, noma i-5-azacytidine. Udokotela wakho uzokhetha ukwelashwa kwakho ngokususelwa ekuxilongweni okuqondile, ezinye izinkinga zezokwelapha nemiphumela emibi yokwelashwa.
Ukhetho lwesibili ukwelashwa yi- splenectomy noma ukususwa kokuhlinzwa kwesipere. Ingozi ebaluleke kunazo zonke yokususa i-pengu yilezi zifo ezingasongela impilo. Uma ungakafiki kakade, kufanele uthole imithi ethile yokuvikela imithi yokuvikela i-pneumococcal kanye ne-meningococcal ngaphambi kwe-splenectomy.
Uma isilwane sisusiwe, cishe uzobekwa ku-penicillin kabili nsuku zonke ukuvimbela lezi zifo. Ukwengeza, imfiva (enkulu kunama-100.4F) iyisimo esiphuthumayo esidinga ukwelashwa ngokushesha.
Inketho yesithathu yokwelapha i-radiotherapy (ebizwa nangokuthi i-radiation therapy). I-radiation ihloswe ngengubo engasiza ukusihlehlisa usayizi. Le miphumela yesikhashana i-radiotherapy ye-splenic ibhekwa njenge- palliative , ukwelashwa okuhloswe ukunciphisa izimpawu zokuthuthukisa izinga lokuphila. Lokhu kungase kube inketho enhle kubantu abangewona abakhethiweyo abakhulu be-splenectomy.
Kunezinto eziningi okufanele uzicabangele uma unquma ukuthi noma ukwelapha kanjani i-splenomegaly kuyi-polycythemia vera noma i-myelofibrosis eyinhloko. Qinisekisa ukuthi uxoxe nodokotela wakho izinzuzo kanye nemiphumela emibi yezokwelapha.
> Imithombo:
> Mesa RA. Indlela engiphatha ngayo i-splenomegaly ephawulekayo kuziguli ezine-myelofibrosis. Igazi. 2009; 113: 5394-5400.
> I-vannucchi AM. Indlela engiphatha ngayo i-polycythemia vera. Igazi. 2014; 124: 3212-3220.