Ukuba ugqirha wakho uxelele ukuba unesifo segazi ongase uzibuze, " Kutheni kutheni ipeyini yam inkulu kangaka?" " Ingaba iphiri lami lithetha ntoni ngegazi lam?" Okanye " Nantoni na?" Leyo yonke imibuzo ebalulekileyo. Masiqale ngomsebenzi wepeni, ngoko nixubushe ukuba kutheni i-spleen ikwandisa kwi-myeloproliferative neoplasms, kwaye ekugqibeleni ihlolisise ukhetho lwezokwelapha lwe-splenomegaly (ukwandiswa kwetyeni).
Spleen Basics
I-spleen iyilungu elincinci (malunga nobukhulu bentonga yakho) ehlala kwicala lesobunxele besisu esisingaphantsi kwe-ribcage. Ipeni yenziwe ngeentlobo ezimbini zezicubu (1) i-pulp ebomvu ehlunga iiseli ezibomvu zegazi kunye (2) i-pulp emhlophe eyingxenye yesistim somzimba. Kwi-pulp ebomvu, iintsholongwane zegazi ezibomvu ezindala okanye ezingasetshenziswanga (ezifana neeseli zegulane) zisuswe kwi-circulation. I-pulp ebomvu iyakusiza ukuhlunga umzimba kwi-infections, ngokukodwa ukutheleleka kubaktheriya abathile. I-pulp emhlophe inceda ukuvelisa i-lymphocyte, uhlobo lwe-cell cell egazini, elinceda ukwenza i-antibodies ukusuleleka okanye ukuphendula ukugonywa. Nangona ezi ziyimisebenzi emikhulu yerenti xa uzalwa, ngaphambi kokuzalwa, ipeni ngumvelisi omkhulu weeseli zegazi ( hematopoiesis ). Ekubeni ekupheleni kokukhulelwa kwaye emva kokuzalwa, umongo wethambo uthatha lo mveliso.
Kutheni i-Spleen iphakanyisiwe
Kwi- polycythemia vera inombolo egqithisileyo yeeseli zegazi ezibomvu ziveliswa, kubangele inani elinyukayo leeseli ezibomvu zegazi ezifuneka ukuba zihlanjwe ngepeni, ezikhokelela kwi-splenomegaly.
Kwi- primary myelofibrosis , umongo wethambo uwonakaliswe yi-fibrosis, okwenza kube nzima ukuvelisa iiseli zegazi. Kule meko, i-spleen inokwandisa ukuxhasa imveliso yeeseli yegazi ngaphandle kwethambo lomongo. Oku kunokwenzeka nakwizibindi ngokuqhelekileyo ukuya kwinqanaba elincinci.
Iimpawu zokuba nePenti ekhulisiweyo
Abantu abaninzi abanesipelo esandisiweyo abanokwazi, ingakumbi ukuba ipenti yanda kakhulu.
Abanye bangabika "ukuzaliseka" kwisisu. Xa ipeni ikhulise kakhulu, inokuyicinezela esiswini, esinokukunceda uzive ugcwele, njengokuba udla isidlo esipheleleyo xa udla kuphela umlinganiselo omncinci.
I-spleen iyakhawuleza yaye iqheleke ngokukhuselwa yi-ribcage. Njengoko ikhulisa ingasayi kukhuselwa kwaye ilungele ukulimala, ingakumbi ingozi evela kwingozi yemoto okanye udibaniso lwemidlalo (njengobhola bebhola okanye iHockey). Ixinzelelo kwipen ekhulisiweyo ingabangela ukuphuma kwamanzi.
I-Splenomegaly iyakwenziwa njani?
Ukuba i-spleen yakho yanda nje ngokunyanisekileyo, unyango alufanelekanga. Ugqirha wakho uya kubeka iliso kwiibalo zegazi kunye nobungakanani benteni yakho ngokufutshane. Ukuba unyango luyadingeka kukho iindidi ezintathu ezinkulu: unyango lwezokwelapha, u-splenectomy, kunye ne-radiotherapy.
Iyokuqala yonyango lonyango. Ngokuqhelekileyo, le miyeza ijoliswe ekunciphiseni ukuveliswa kweeseli zegazi. Elinye lamachiza aqhelekileyo asetyenziswe ukunciphisa ubungakanani bepen kwi-myeloproliferative neoplasms yi-hydroxyurea. I-Hydroxyurea yinyango yomlomo ethathwa rhoqo imihla. Ngokuqhelekileyo iqaliswe kwiqondo eliphantsi kwaye liye landa kwaze kwaba yinto efunayo (ngokuqhelekileyo inqanaba elithile le-hemoglobin, iiseli zegazi ezimhlophe, okanye iiplatelets).
Ezinye iindlela zokwelapha zokuqala ziquka i-busulfan, i-melphalan, i-interferon ye-alpha, i-thalidomide, okanye i-lenalidomide. I-Prednisone inokunikezwa nge-thalidomide okanye lenalidomide. Izindlela zokwelapha ezisezantsi ziquka i-cladribine (ebizwa ngokuba yi-2CDA), i-daunorubicin, i-decitabine, okanye i-5-azacytidine. Ugqirha wakho uya kukhetha unyango lwakho olusekelwe kwi-diagnostic yakho ethile, ezinye iingxaki zezokwelapha kunye nemiphumo emibi yonyango.
Ukhetho lwesibini lwenyango luyi- splenectomy okanye ususwe ngophane. Umngcipheko obaluleke kakhulu wokususa ipeni yinto enokubangela ukongela ubomi obunzima. Ukuba ungekho, kufuneka ufumane izitofu ezithile zokukhusela ezikhuselweni ze-pneumococcal kunye ne-meningococcal ngaphambi kokuba u-splenectomy.
Xa ithenda isusiwe, mhlawumbi uza kufakwa kwi-penicillin kabini imihla ngemihla ukukhusela ezi zifo. Ukongeza, umkhuhlane (omkhulu kunama-100.4F) yimeko engxamisekileyo efuna ukunikwa ngonyango.
Inketho yesithathu yonyango i-radiotherapy (ebizwa nangokuthi unyango lwe-radiation). I-radiation ijoliswe kwipenethi enganceda ukuyinciphisa ngobukhulu. Ezi mphulo zisesigxina ukuze i-radiotherapy ye-splenic ithathwa njengento enomdla , unyango olujoliswe ekunciphiseni iimpawu zokuphucula umgangatho wobomi. Oku kunokuba yinto enhle kubantu abangenabo abaviwa abakhulu be-splenectomy.
Kukho izinto ezininzi oza kuziqwalasela xa usenza isigqibo malunga nokuba ungayiphatha njani i-splenomegaly kwi-polycythemia vera okanye i-myelofibrosis ephambili. Qinisekisa ukuba uxoxe nodokotela wakho ngezibonelelo kunye nemiphumo emibi yeziphumo zonyango.
> Imithombo:
> Mesa RA. Indlela endiphatha ngayo i-splenomegaly yezibonakaliso kwizigulane ezine-myelofibrosis. Igazi. 2009: 113: 5394-5400.
> AMannucchi AM. Ndiyiphatha njani i-polycythemia vera. Igazi. 2014; 124: 3212-3220.