I-Splenectomy Ingabe Ukuhlinza Ukususwa Kwamapulangwe

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Kuyini Splenectomy?

I-splenectomy iyisusa sokukhishwa kwesipere . Kunezinhlobo ezimbili ze-splenectomies - indlela evulekile yendabuko, esebenzisa ukukhishwa okujwayelekile kwesayizi, nendlela yokusebenzisa i-laparoscopic, esebenzisa ukucubungula okuncane kakhulu. Ukuhlinzeka nge-laparoscopic kuvame ukubizwa ngokuthi ukuhlinzwa okuncane okungavamile.

Inqubo ye-laparoscopic yindlela ejwayelekile kakhulu yezinqubo ezimbili ze-splenectomy futhi isetshenziswa kakhulu uma kungenzeka ngudokotela ohlinzayo. Le nqubo isebenzisa ukucubungula okuncane okuncane futhi ngokuvamile ibizwa ngokuthi ukuhlinzwa okuncane okungavamile. Ngenxa yobukhulu be-incision, indlela ye-laparoscopic inciphisa kokubili ubuhlungu bokutakula kanye nobungozi bokutheleleka .

Akuwona wonke ama-patient anatomy noma izimo zamaphere avumela inqubo ye-laparoscopic; Kulezo zimo, indlela evulekile isetshenziswa. Ibuye isetshenziswe lapho isilwane sisuswa ngenxa yesimo esibizwa ngokuthi i-splenomegaly, noma ukukhuliswa kwesipere. Lokhu kungenxa yokuthi i-spleen ingaba mkhulu kakhulu ukuba ingasuswa ngokusebenzisa ukucubungula okuncane kakhulu kwe-laparoscopic.

Kwezinye izimo, inqubo ingase iqale njengophenyo lwe-laparoscopic kodwa udokotela ohlinzayo angakhetha ukuqhubeka nokuhlinzeka nge-incision evulekile uma i-spleen itholakala ukuthi yanda kakhulu.

Phakathi nokuhlinzwa okuphuthumayo, njengokungathi ngemuva kokushayiswa kwemoto lapho uphaphu luqhekekile, ukucubungula okuvamile kwendabuko kungasetshenziswa ukuvumela udokotela ohlinzayo ukuba acabange ngokulimala futhi aqale ukuhlinzwa ngokushesha.

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Ngabe I-Surgery Surgery iphuthumayo?

I-splenectomy, noma ukuhlinzwa kwe-spleen, kungenakuvinjelwa ezimweni eziphuthumayo. Ezimweni eziningi lapho i-splenectomy eyenziwa ngokuphuthumayo , noma ukusindisa impilo yesiguli, i-pengu yonakaliswe ukuhlukunyezwa. I-spleen i-vascular kakhulu, enezimbangela zegazi eziningi kanye negazi elikhulu, futhi liphuma kalula. Uma ukuphuma kwegazi kungenakulawulwa ezinye izindlela, kufanele kususwe ngokuhlinzwa, noma isiguli singase siphele igazi. Ingozi yemoto iyimbangela evamile yokuhlukumezeka ku-spleen.

Ukuphuka okungajwayelekile, uma uhlangothi luqhuma ngokungalindelekile ngenxa yesizathu esicacile, luyinto engavamile kodwa futhi luba nesidingo sokuhlinzwa okuphuthumayo .

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Izinkomba Ze-Splenectomy?

I-splenectomy, ukuhlinzekwa ukukhipha ubhedu, kungaboniswa emacaleni alandelayo:

• Ama-clots egazi
• I-Hypersplenism : Lesi yisimo lapho isilwane singasebenzi khona futhi sichitha amaseli egazi aphilile.
• I-Splenomegaly : Ukwandiswa kwengubo
• I-Cancer
• I-portal yomshuwalense : Lesi yisimo lapho isitsha esikhulu segazi esiholela esibindi sinegazi eliphezulu kakhulu. Kungabangelwa izimo eziningi zesibindi eziningi, kuhlanganise ne-cirrhosis nomdlavuza.
• I-cirrhosis yesibindi : Lesi sifo esingelapheki sesibindi lapho izicubu ezonakalisiwe zishintshwa khona nezicubu ezibomvu njengoba umonakalo usuyenziwe. Igazi aligeli ngokukhululekile ngesibindi, okwenza kube nomfutho wegazi ophezulu.
• I-Lymphoma : Lolu hlobo lomdlavuza lungabangela ukwandiswa kwe-spleen (splenomegaly).
• Idiopathic thrombocytopenia purpura (i-ITP)
• I-anemia ye-spherocytic : Loluhlobo lwe-anemia, lapho amangqamuzana egazi abuthakathaka aphephile futhi awonakele njengoba ehamba ngepeni, angelashwa nge-splenectomy.
• I-anemia ye-Hemolytic : Ezinye izinhlobo ze-anemia ye-hemolytic, isimo lapho amangqamuzana egazi abomvu abhujiswa khona ngaphambi kwesikhathi ngomzimba, angathuthukiswa ngokususwa kwesipere.

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Izinkinga ze-Splenectomy

Ngaphandle kwezingozi ezijwayelekile ezihlobene nokuhlinzwa kanye nokuhlinzekwa kwezinzwa , ukuhlinzeka ukususa ipeni kunezinkinga zayo ezikhona. I-spleen iyisitho esinamandla kakhulu, okusho ukuthi sinemithwalo eminingi yegazi. Lokhu kwenza i-spleen ikwazi ukuphuma uma ilimazekile noma isebenza. Uma uhlangothi lulimale kakhulu futhi lungelapha ngaphambi kokuhlinzwa, ukuphuma kwegazi kungase kuqhubeke phakathi nokuhlinzwa kuze kube yilapho udokotela ohlinzayo ekwazi ukuthola umthombo wokugaya nokuwulawula.

I-spleen isiswini ngemuva kwesisu, ngaphansi kwesisipha somzimba futhi siphumule eduze kwe-pancreas kanye namathumbu. Ngenxa yokusondela kwezinye izitho nezakhiwo, kunengozi encane yokuthi zingalimala ngesikhathi senqubo.

Ingozi yokutheleleka ihamba kancane nale nqubo kunokuhlinzwa okujwayelekile, hhayi ngenxa yenqubo yokuhlinza ngokwayo, kodwa ngoba ipeni inendima ekulwa nokutheleleka. Uma isilwane sisusiwe, isimiso somzimba sokuzivikela asisebenzi futhi senze ngaphambi kokuhlinzwa.

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I-Splenectomy: Inqubo Ye-Laparoscopic

I-splenectomy ingenziwa i- laparoscopically noma isebenzise indlela evulekile ngokukhipha ukukhanya okugcwele. Nakuba iningi lezinhlinzeko lisusa lonke i-spleen, kungenzeka ukuba ne-splenectomy eyingxenye, inqubo lapho kuphela ingxenye yesitho isusiwe.

Ukuhlinzwa kuqala ngokuphathwa kwe- anesthesia . Uma isiguli singenalutho, ukuhlinzwa kuqala, ngokuvamile ngokufakwa kwezicucu ezincane ezincane eziphakathi kuka 2 kuya ku-3 cm ubude ngaphansi kwezimbambo ngakwesokunxele. Ikhamera encane ebizwa ngokuthi i-laparoscope efakwe kwenye yezinto ezifakiwe. Okunye okusetshenziselwa ukusetshenziselwa okusetshenziselwa ukufakwa kwezikhali zokuhlinzeka kanye nokusebenza kwangempela kwalokhu kuhlinzwa. Ngesikhathi sokuhlinzwa, udokotela ohlinzayo ubheka isikhala esisebenza ngekhamera, njengoba okushiwo ukuthi kuncane kakhulu ukuvumela udokotela ohlinzayo ukuba abuke ukuhlinzwa ngokuqondile.

I-spleen inemithambo eminingi yegazi, ngakho-ke udokotela ohlinzayo uthola imithwalo yegazi eholela ku-spleen futhi ibeka iziqeshana kuzo ukuyeka unomphela igazi kusukela ekugeleza kuze kube ku-spleen. I-spleen iyasuswa kwezinye izakhiwo zomzimba. Uma kungenalutho, uhlangothi lufakwa esikhwameni esisinyumba ukuze lukhishwe emzimbeni ngenye yezingxoxo. Uma kunesidingo, ukufakwa komzimba kunganciphisa kancane ukuze kuvunyelwe isikhwama. Lokhu kwenziwa ngakho-ke ayikho izingcezu ze-spleen ezikwazi ukuhlukana futhi zihlale emgodini wesisu, lapho zingabangela ukutheleleka okukhulu.

Uma isela selususiwe futhi udokotela ohlinzayo engatholakali izimpawu zokuphuma kwegazi, izinsimbi zisusiwe futhi ukucubungula kuvaliwe. Lokhu okufakwe kungenziwa kuvaliwe nge-glue yokuhlinza, i-ster-strips (amabhande amancane okubopha amabhande), noma okuncane kakhulu, okuyisisekelo noma ama- sutures .

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I-Splenectomy: Indlela Yokuvula

Inqubo evulekile ye-splenectomy ifana kakhulu nenqubo ye-laparoscopic ngenye umehluko oyinhloko - ukushiswa okusetshenzisiwe kusetshenziswa cishe ngamasentimitha angu-4 kuya kwangu-5 ubude, kanti udokotela ohlinzayo uyakwazi ukubuka ukungena ukubona inqubo yonke.

Le ndlela isebenza ngokukhethekile ezimweni ze-splenomegaly, noma ukukhuliswa kwe-spleen, okungenza ukuthi ubude bukhulu bungasuswa ngezinkomba ezincane ezisetshenziselwa inqubo encane yokuhlasela. Uma uhlangothi luye lwahlukunyezwa kakhulu, inqubo evulekile ingasetshenziswa futhi ukuvumela udokotela ohlinzayo ukuba abuke kangcono indawo nokuphuma kwegazi ukuze alawulwe masinyane kunendlela yokwenza i-laparoscopic.

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Ukwamukela Ngemva Kokuhlinzwa Kwe-Splenecotomy

Ukwamukela emva kokuhlinzwa kwe-splenectomy kuyahlukahluka kakhulu kusuka kwesiguli kuya kwesineke, ikakhulukazi ngoba kunezizathu ezihlukahlukene kakhulu zokuba ne-splenectomy. Kungakhathaliseki isizathu sokuhlinzwa kwakho, uma uvuka kusuka ekuhlinzekeni kwakho, uzozizwa ubuhlungu ohlangothini lwakho lwesobunxele endaweni yesisu sakho. Uyothola futhi ithubhu, ebizwa ngokuthi i-nasogastric tube (NG), engena ekhaleni lakho, phansi phansi isisu sakho nasesisu sakho. Le tube itvimbela ukwakheka kwesisu esiswini, ukunciphisa isicanucanu nokuhlanza ngemuva kwenqubo yakho. Ithebhu ngokuvamile isuswe ngosuku noma amabili emva kokuhlinzwa.

Isiguli esiphezulu siyakwazi ukubuyela ekhaya esibhedlela kusukela emahoreni ama-48 kuya kwangu-72 emva kokuhlinzwa uma i-splenectomy yenziwa i-laparoscopically. Inqubo evulekile ingadinga ukuhlala isikhathi eside, kaningi kuze kube ngesonto, ngaphambi kokukhishwa. Iziguli eziningi ziyakwazi ukuqhuba imisebenzi yazo evamile emasontweni amane kuya ku-6 emva kokuhlinzwa. Kodwa-ke, isiguli esidinga i-splenectomy ngemuva kokuthi uhlangothi lube nesifo esibuhlungu lungase lubekwe esibhedlela isikhathi eside kuncike kunoma yikuphi ukulimala okungeziwe okungenzeka kube khona. Kwezinye izimo, umonakalo ophikweni ungase ube yincane kunazo zonke zokulimala.

I-spleen ijwayele ukuphuma uma ilimazekile ukuze udinga ukumpontshelwa igazi ngemuva kwenqubo. Lokhu kuzoxhomeka enani legazi elahlekile ngaphambi, ngesikhathi nangemva kwenqubo futhi kwenziwa kuphela uma kudingeka. Ngaphandle kokumpontshelwa, isiguli esiye sabona ukuphuma kwegazi singase sibe nomuzwa obuthakathaka noma ngisho nekhanda, ngenxa yokulahlekelwa igazi.

Kubaluleke kakhulu ukuthi ukhuthele ngokunakekelwa kwe-incision , njengoba isilonda sakho singenwe kalula ngemuva kwalokhu kuhlinzwa. Ukubheka kwakho kufanele kuhlolwe ngezibonakaliso zokutheleleka nsuku zonke noma kaningi.

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Ngemuva kwe-Splenectomy

Ngemuva kwe-splenectomy, uzobe ujwayele ukutheleleka futhi umzimba wakho ngeke ulwa nabo kalula. Uzodinga ukukhuthaza ngokufuna ukunakekelwa kwezempilo ngezimo ongase ungakaze uzifune ngokushesha ukwelashwa esikhathini esedlule, njenge-throat, umkhuhlane , isono kanye nokutheleleka kwezindlebe, nezinye izifo ezivamile.

Udokotela wakho uzotusa ukuthi uthola umgomo wokuvimbela i-pneumonia futhi angase akhombise imishanguzo eyengeziwe, njengomuthi wokugoma we-meningitis. Ukumelana nokutheleleka kwakho kungase kuthuthuke kungakapheli iminyaka emibili yokuhlinzwa kwakho, kodwa akunakwenzeka ukuthi kuyoke ibuyele kumazinga oku-preoperative.

Uma ubona udokotela omusha noma ukwelashwa ngenkinga engavumelani, qiniseka ukuthi uvumele udokotela azi ukuthi awunayo i-spleen.

Ukunakekelwa kwe-Incision Ngemuva kokuhlinzwa

_Imithombo:

_{Ngemuva kokuthi i-Spleen Yakho Isusiwe: Okudingayo Ukuze Uzivikele Ukuzivikela. I-American Family Physician. http://www.aafp.org/afp/20010201/508ph.html}

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

_{Ukususwa kwamapulangwe. I-MedLine Plus http://www.nlm.nih.gov/medlineplus/article/002944.htm}

_{Splenectomy. Izikhungo zezempilo zikazwelonke. [link ulr = http: //www.ncbi.nlm.nih.gov/books/bv.fcgi? rid = = gg.section.3057] http://www.ncbi.nlm.nih.gov/books/bv. fcgi? rid = up.section.3057}