Ungase ungacabangi ngesipelingi sakho okuningi, kodwa bekukufunele wena. Uma ungenayo, kunezinto ezithile okufanele wazi ukuthi uzigcine uphephile ezifweni.
Iyini Inyoka Yakho?
Ngokuvamile, i-spleen yakho, isakhiwo esingamasentimitha angu-4 esitholakala ngakwesobunxele sezintambo zakho zomhlanga, ingxenye yesistimu yakho yegazi kanye nesistimu yomzimba. Kuyasiza ukugcina umyalelo wamaseli akho abomvu wegazi namaseli amhlophe egazi.
Ngamanye amazwi, isebenza njengesihlungi segazi. Kususa amangqamuzana asebomvu egazi obomvu bese ihlala endaweni yokugcinwa kwamanye amaseli wegazi obomvu ukuze ikhulule esimweni esiphuthumayo, futhi iyasiza ukubuyisela kabusha insimbi.
Olunye umsebenzi: i-spleen yakho ingenza ama-antibodies akhiphe amabhaktheriya nanoma yimaphi amanye amangqamuzana agqoke kuma-antibodies. Le ngxenye yokugcina isiza ukugcina imizimba yethu ikhululekile kuma-pathogens.
Ngokusobala, uma singenalo isitho, sisengozini kakhulu kubhaktheriya, ikakhulukazi uhlobo oluthile lwebhaktheriya oluthiwa amabhaktheriya ahlanganiswe ngoba ane-carbohydrate ekhethekile (i-polysaccharide) ehambisana nabo. Ungayilahleka kanjani isitha sakho, noma kunjalo?
Ubani Obeka Ipeni Labo?
Kunezizathu ezintathu eziyinhloko zokuthi kungani abantu bengenayo ipeni yabo:
- Ingozi noma ukuhlukunyezwa
- I-auto-splenectomy ye-Sickle Cell Disease
- Ukwelashwa kwesinye isifo
I-Trauma: Isizathu esivamile kakhulu sokuthi isilwane sakho sisuswe ngokuhlinzwa sikhathazekile. Lokhu ngokuvamile ngenxa yengozi yemoto nezithuthuthu kanye nokuwa, ukulwa, nokulimala kwezemidlalo.
I-spleen yilona isisulu esilimele kakhulu ekuhlukunyezweni kwesisu esisodwa (1 koku-4 amacala okulimala okunjalo kuthinta uhlangothi). Ezimweni zemoto, ukulimala okunjalo kungase kuhlotshaniswe nokubekwa okungalungile nokusetshenziswa kwesibhakela. Kukhona futhi izigameko zokugwaza nezibhamu ezingahle zilimaze ubhedu kodwa lokhu kungavamile.
Akuwona wonke umonakalo ophikweni oludinga ukuhlinzwa. Odokotela abahlinzayo bavame ukubukela ukuze babone indlela umuntu kanye nokulimala okuqhubeka ngayo, uma kungeyona esiphuthumayo, ngaphambi kokunquma ukuya ekuhlinzekeni.
Isilonda Sokugula : I- Autosplenectomy iyakwenzeka ngesifo se-sickle cell. E-US, abantu abayi-100,000 bane-cellle ye-sickle. Emhlabeni wonke, ngaphezu kwezigidi. Kunezinhlobo ezahlukene zeSille Cell. Ukungafani kulezi zinhlobo kuxhomeke ekutheni izakhi zokuguqula izakhi zikhona. Ukulahlekelwa kwe-spleen kwenzeka kakhulu kunhlobo oluvame kakhulu lweselula yeSickle: isifo se-Hemoglobin SS. Isifo se-Hemoglobin SS sibangelwa ukuthi sibe namakhophi amabili we-hemoglobin S gene mutation efanayo. Ngalolu hlobo, abantu ngokuvamile balahlekelwa ipeni yabo ngenqubo ebizwa ngokuthi "i-autosplenectomy." Kube khona amacala angavamile kwezinye izifo ezibangela inqubo efanayo.
Ukwelashwa kwesinye isifo, njengesifo esizimele: Abanye baye baxoshwa ukuze baphathe ukugula, ikakhulukazi ukugula okuzenzakalelayo. I-splenectomy isetshenziselwa ukwelapha isifo esisodwa esingavamile ikakhulukazi -immune thrombocytopenic purpura (ITP). Kulesi sifo, isimiso somzimba samasosha omzimba ngeshwa ukuhlasela amaplatelets. Lokhu kusho ukuthi imizimba yethu ayinayo eyodwa yamathuluzi abayidingayo ukuvala ukuyeka ukuyeka igazi.
Labo abathintekayo amasistimu omzimba bahamba ngokungafani nalokhu kungaba nemivimbo futhi baphume kalula. Bangase babe nezindawo ezibomvu emilenzeni yabo. Lesi sifo singasuka sodwa, kodwa abanye badinga imithi. Uma ingasuki futhi imithi ayanele, ngezinye izikhathi ukususa i-spleen kungenelela okusiza.
Kukhona ezinye izifo ezingase ziphathwe nge-splenectomy. Ngezinye izikhathi i-splenectomy iyadingeka ngoba umuntu une-anemia (isibalo esincane se-cell cell) ngenxa yokubhujiswa kwamaseli abo abomvu egazi. Lokhu kungenziwa ngenxa yezifo eziningana ezifana ne-inherited spherocytosis noma i-autoimmune i-hemolytic anemia (AIHA).
I-splenectomy ngezinye izikhathi, kodwa hhayi ngaso sonke isikhathi, yeka ukwehlukana kwamaseli abomvu uma imithi noma ezinye izifo zingasebenzi.
Kunezinye izizathu ze-splenectomy kanye. Nakuba kungavamile kakhulu, abanye baye babhekana nezinkinga ze-sphalaectomies ukuphatha i-thalassemia kanye ne-thrombocytopenic purpura ye-thrombocytopenic purpura (TTP). Ngezinye izikhathi izifo ezincane zenziwa ngenxa yokuthi i-spleen yayikhulu kakhulu kwesinye isifo . Kanti futhi kwenziwa ngezikhathi ezithile ukuze kutholakale ukuxilongwa kwe-Hodgkin's lymphoma ukuze kunqume ukwelashwa okungcono komdlavuza.
Abantu abangaba ngu-22,000 balahlekelwa isilwane ngokuhlinzwa njalo ngonyaka e-US
Kuyini Ukuhlinzwa?
Ukuhlinzwa ukukhipha iphleen yakho kubizwa ngokuthi i- splenectomy . E-US, kuvame ukwenza nge-laproscopically (ngekhamera kanye nokucubungula okuncane kakhulu). Uma uphilile, ungashiya esibhedlela ngosuku olufanayo futhi uphinde utholakale ngokugcwele emavikini amabili.
Indlela Yokuzivikela Ezifweni Ngaphambi Kokuhlinzwa
Abantu abangenayo i-spleens cishe banokugula kusuka kwezinye izinhlobo zamabhaktheriya, ikakhulukazi amabhaktheriya ahlanganisiwe (amabhaktheriya anomzimba we-carbohydrates cover). Kumelwe ugonywe ngaphambi kokuhlinzwa, uma kuhlinzekwa ukuhlinzwa. Izifo eziningi ze-splenectomi zenziwa njengeziphuthumayo ngemuva kokuhlukumezeka nokuhlelwa okuthuthukile kangako njalo.
Uma kunokwenzeka, kufanele ube nemigomo emivikini amabili ngaphambi kokuhlinzwa okuhleliwe. Uma ube nokuhlinzwa okuphuthumayo futhi awuzange ugonywe kusengaphambili (noma ukugonywa akuzange kwenziwe ngaphambi kokuhlinzwa ngesinye isizathu), kufanele ugonywe ngemuva kwalokho. Imishanguzo kufanele inikezwe amasonto amabili noma ngaphezulu ngemuva kokuhlinzwa, kodwa ungalinde isikhathi eside kakhulu.
Yimiphi imithi okufanele uyenze?
Kukhona izinto ezine okufanele uthole imithi ngokumelene:
- I-Neisseria meningitidis
- I-Haemophilus influenzae
- Streptococcus pneumoniae
- Umkhuhlane
Kumelwe futhi ugonywe kuzo zonke izifo owazovame ukugonywa ngazo, njengokusungula isisulu, ama-mumps, i-rubella, i-varicella, ne-tetanus. Kumele ukhulume nodokotela wakho noma omunye ochwepheshe wezokwelapha mayelana nokuthi udinga ukuphinda uvuselelwe yini noma udinga inguqulo ehlukile yenye yale migomo.
I-Neisseria meningitidis (N. meningitidis): Lena yi-bacteria engabangela i-meningitis kanye / noma i-sepsis. Umuthi wokugoma oyinhloko uphezulu. Okushoyo; ivikela ngezinhlobo ezine ze-N. meningitidis (i-Serogroups A, C, W-135, no-Y). Ishiya B ivuliwe uma ingabanjwanga ngqo. I-Serogroup X ayitholakali kancane futhi ayinayo umgomo okhona.
H. i-influenzae hlobo b (Hib): Lezi zinambuzane zazivame ukuba imbangela enkulu ye-bacteria meningitis ezinganeni ezingaphansi kwe-5 kuze kube yilapho umuthi wokugoma uqala ukusetshenziswa. Iphinde ibangele ukukhuphuka komkhuhlane kanye nokuphuza komphimbo kanye nokutheleleka okungaba yingozi. Ngokuyinhloko ukutheleleka ezinganeni, kodwa noma ubani ongenawo udoti kufanele agonywe.
I-Streptococcus pneumoniae (Strep pneumo): Kunezinhlobo eziningi ze-Strep pneumo, njengoba ivame ukubizwa. Yikuphi ukucindezeleka okuvikelwe ngokumelene nomgomo owutholayo. I-PCV 7 ivikela ngezinkinga ezingu-7; I-PCV 13 ngokumelene no-13; Umuthi wokugoma we-polysaccharide u-PPSV23 uvikelekile ngokumelene no-23 kodwa impendulo yegciwane lengculazi yayingenamandla futhi evikelekile.
Umkhuhlane: Uzodinga ukuthola umgomo wokugonywa unyaka nonyaka. Ukukuvikela ekungeneni kwe-bacteria yesibili, njengalabo abangela i-pneumonia, esengozini uma ugula ngophuhlane. Abaningi ababulawa yi-influenza nabo bafa ngenxa yokutheleleka kwama-bacteria okuhlasela lapho amasosha omzimba amaphaphu ephuzwa futhi ephelelwa umkhuhlane.
Zikhona Izinengozi Zokukhathazeka Ngokuthi Uhamba Ngani?
Uma uhamba ungase uhlangane nezimbungulu ongenakukunye. Ungase futhi uhlale endaweni ethile enezimbungulu ezihlukile kunezinye izindawo. Kukhona ukutheleleka okunye okungenzeka ukuthi usengozini enkulu. Uma uhamba eNtshonalanga Afrika, qiniseka ukuthi uzogonywa ngokumelene nokuqeda i-meningococcal meningitis nokuthi imishanguzo isesikhathini. (Ukuvikelwa komgomo akuhlali njalo uma nje singathanda). Ngokufanayo, imithi yokugoma i-pneumococcal ayihlanganisi yonke imithwalo futhi ungase uvezwe ohlangothini oluhlukile uma uhamba.
Futhi ungase ube engozini enkulu yokubhekana nesifo esibucayi se- malaria uma ungenayo i-spleen. Qinisekisa ukuthi une-malaria prophylaxis uma uhamba lapho ungase usengozini futhi uqaphele ngokucophelela ukugwema umiyane .
Ngokufanayo, uma uhlala noma uhambo oluya ezindaweni lapho iBabesia itholakele khona, uzobe usengozini enkulu uma ungenayo ipeni. Lokhu kuzoba ikakhulukazi eNantucket noma Emvinini WaseMivini eMassachusetts, kodwa futhi iBlock Island iphuma eRhode Island naseShelter Island, Fire Island, naseMpumalanga Long Island-yonke ingxenye yeNew York State. I-parasite nayo ingenzeka nakwezinye izingxenye zalezi zindawo nakwezinye izindawo zeNyakatho NaseMiddle Midwest, kuhlanganise naseNew Jersey, eWisconsin naseMinnesota. Kunezimo ezingavamile (futhi ezingathí sina) ezivela eYurophu. AbaseBabesia bangase basakazwe ngegazi lokumpontshelwa igazi.
Futhi, abanye abangenayo isitha bangase babe nethuba lokuba nesifo se-vein deep or other clot lapho behamba ngezindiza ezindiza noma ukugibela. Uma uzohamba, xoxa nodokotela wakho noma omunye ochwepheshe bezempilo ngalesi sifo nanoma yiziphi izingozi ongabhekana nazo.
Ezinye izinkathazo
Kufanele ukhulume nodokotela wakho noma ochwepheshe bezokwelapha mayelana nendlela yokusingatha impilo yakho ngosuku nosuku.
Abanye abantu abangenayo isitezi, ikakhulukazi izingane, bathatha ama-antibiotic athile nsuku zonke ngesicelo sikadokotela wabo. Izinzuzo nokuqeda lokhu kufanele kuxoxwe nodokotela wakho noma omunye ochwepheshe bezempilo. Ukuthatha ama-antibiotics njalo kungaba nemiphumela engalindelekile . Ungakwazi ukuhlakulela ukumelana nama-antibiotic noma uthole izifo ezenzeka lapho amabhaktheriya ethu ajwayelekile asuswa futhi engashiywa angahlosiwe, ngakho-ke kubalulekile ukukhuluma nochwepheshe wezokwelapha ngalokhu.
Abanye baphatha ama-antibiotic nabo abathatha ngokushesha uma behlakulela umkhuhlane noma begula. Bese befuna usizo lwezokwelapha ngokushesha. Ukwelapha okusheshayo kungasiza ekuvimbeleni ukutheleleka ukuba kungabi yisifo sokubulala.
Enye ingozi yokutheleleka okukhulu isuka kubhaktheriya okuthiwa i-Capnocytophagia. Yimbangela engavamile yezifo kubantu abanezinhlanzi kepha kungaba yisifo esingathí sina kakhulu kumuntu ongenawo uhlangothi. Ngokuvamile ngenxa yokulunywa inja, nakuba ngezinye izikhathi ikati lihlaba futhi. Izimpawu ziqala ngokuvamile ngosuku olulodwa, ngakho kufanele uzilungiselele uma inja iluma ukufuna ukunakekelwa kwezokwelapha (futhi ingathatha ama-antibiotic afana ne-penicillin namanye ama-antibiotic avamile angaphatha isifo).
Abantu Benzani Ngesikhathi Eside?
Ososayensi babuke emuva emasotheni alahlekelwa yiwo eMpini Yezwe II. Bathola ukuthi kwabasebenzi baseMelika abangu-740 bathola ukuthi abaningi baphila impilo ende. Kodwa-ke, sekuye kwanda ukushona ngenxa ye-pneumonia (mhlawumbe iStrep pneumo infections) kanye nesifo se-ischemic (ukuhlasela kwenhliziyo, mhlawumbe ngenxa yokuthi ukususa ama-spleens kuthinteka ohlelweni lwayo lwegazi futhi kubangele ukuthi bagqoke ngaphezulu, okuyinto ebonakalayo engezona ezithathelwanayo) .
Kuthiwani Uma Unenkinga Enkulu?
Ukuba ne-spleen enkulu ibizwa ngokuthi i-splenomegaly. Kuyinto into udokotela noma omunye ochwepheshe wezokwelapha okufanele ahlole.
Kunezizathu eziningi zokuthi kungani u-spleen angase abe mkhulu. Enye yezinto ezivame kakhulu yi-mono (i-mononucleosis ebangelwa i-EBV, i- Epstein Barr Virus).
Kukhona labo abanezinhlanzi ezinkulu ngenxa yezimo zegazi abazalelwa ngazo, njenge-thalassemia noma i-sarcoid. Abanye banesifo esikhulu ngenxa ye-lymphoma noma i-leukemia (umdlavuza wegazi) noma i-hemolytic anemia (lapho amaseli abomvu abhujiswa). Abanye bahlakulela ekubeni nesifo sesibindi (njenge-portal hypertension).
Ungaba Naphezu Kwedlule Elilodwa?
Empeleni, yebo. Abanye abantu banamaphere angaphezu kweyodwa. Abanye bazalwa nge-polysplenia (noma ama-multiple spleens) angahle ahlobene nezinye izimo zokubeletha (noma izinkinga zezokwelapha ekuzalweni). Ezinye ziphelela kancane kancane ngepleen yazo zihlukanisiwe nokunye; lokhu ngokuvamile "yindwangu yokufinyelela" okubangelwa ukuhlukumezeka (okufaka kusuka ekuhlinzekeni, ngisho nase-splenectomy).
> Imithombo:
> I-Robinette CD, i-Fraumeni JF. I-Splenectomy nokufa okulandelwayo kuma-veterans empini ka-1939-45. I-Lancet. 1977; 2 (8029): 127-9.
> Watters JM, Sambasivan CN, Zink K, et al. I-splenectomy iholela esimweni esingaqhubekayo se-hypercoagulable ngemva kokuhlukunyezwa. Am J Surg. 2010; 199 (5): 646-51.
> CDC. Ukugonywa kwe-Asplenia.
> Halpert B, u-Alden ZA. Ama-accessory angena noma emsila we-pancreas: inhlolovo yezingu-2 700 ezengeziwe. I-Arch Pathol. 1964; 77: 652-654.