Kuchotsa nthenda

Kuchotsa nthata ndi opaleshoni yochotsa ndulu yodwala kapena yowonongeka. Kuchita opaleshoniyi kumatchedwa splenectomy.

Nduluyo ili kumtunda kwamimba, mbali yakumanzere pansi pa nthitiyo. Nthata imathandiza thupi kulimbana ndi majeremusi ndi matenda. Zimathandizanso kusefa magazi.

Nkhumba imachotsedwa pamene muli ndi anesthesia (kugona ndi kupweteka). Dokotalayo amatha kupanga splenectomy yotseguka kapena laparoscopic splenectomy.

Panthawi yochotsa ndulu:

• Dokotalayo amadula (cheka) pakati pamimba kapena mbali yakumanzere ya mimba pansi pa nthiti.
• Nthata imapezeka ndikuchotsedwa.
• Ngati mukulandidwanso khansa, ma lymph node m'mimba amayesedwa. Akhozanso kuchotsedwa.
• Kutsekemera kumatsekedwa pogwiritsa ntchito zokopa kapena zowonjezera.

Pa laparoscopic ndulu kuchotsa:

• Dokotalayo amadula katatu kapena kanayi m'mimba.
• Dokotalayo amalowetsa chida chotchedwa laparoscope kudzera podula kamodzi. Kukula kwake kumakhala ndi kamera kakang'ono ndi kuwala kumapeto, komwe kumalola dokotalayo kuti aone mkati mwa mimba. Zida zina zimalowetsedwa kudzera pakadulidwe kena.
• Mpweya wopanda vuto umaponyedwa m'mimba kuti uwonjezere. Izi zimapatsa chipinda chaopaleshoni kuti agwire ntchito.
• Dokotalayo amagwiritsa ntchito kukula ndi zida zina kuchotsa ndulu.
• Kukula ndi zida zina zimachotsedwa. Zomwe zimapangidwazo zimatsekedwa pogwiritsa ntchito zokopa kapena zofunikira.

Ndi opaleshoni ya laparoscopic, kuchira nthawi zambiri kumakhala kofulumira komanso kosapweteka kwambiri kuposa opaleshoni yotseguka. Lankhulani ndi dokotala wanu wa opaleshoni za mtundu wanji wa opaleshoni womwe ndi woyenera kwa inu kapena mwana wanu.

Zinthu zomwe zingafune kuchotsedwa kwa ndulu ndi monga:

• Kutupa kapena chotupa m'matumba.
• Kuundana kwamagazi (thrombosis) m'mitsempha yamagazi ya ndulu.
• Matenda a chiwindi.
• Matenda kapena zovuta zamagulu amwazi, monga idiopathic thrombocytopenia purpura (ITP), cholowa cholowa m'malo mwa mayi, thalassemia, hemolytic anemia, ndi cholowa cha elliptocytosis. Izi zonse ndizosowa.
• Hypersplenism (nthenda yopitilira muyeso).
• Khansa yamitsempha monga matenda a Hodgkin.
• Khansa ya m'magazi.
• Zotupa zina kapena khansa zomwe zimakhudza ndulu.
• Matenda ochepetsa magazi.
• Splenic artery aneurysm (kawirikawiri).
• Kuvulala kwa ndulu.

Zowopsa za anesthesia ndi opaleshoni yonse ndi izi:

• Zomwe zimachitika ndi mankhwala
• Mavuto opumira
• Kukhetsa magazi, magazi kuundana, matenda

Zowopsa za opaleshoniyi ndi izi:

• Mitsempha yamagazi pamitsempha yapakhomo (mtsempha wofunikira womwe umanyamula magazi kupita ku chiwindi)
• Mapapu atagwa
• Hernia pamalo odulidwa opaleshoniyi
• Kuwonjezeka kwa chiopsezo chotenga kachilombo pambuyo pa splenectomy (ana ali pachiopsezo chachikulu kuposa achikulire omwe ali ndi kachilombo)
• Kuvulaza ziwalo zapafupi, monga kapamba, m'mimba, ndi m'matumbo
• Mafinya kusonkhanitsa pansi pa utoto

Zowopsa ndizofanana ndikuchotsa ndulu zotseguka komanso laparoscopic.

Inu kapena mwana wanu mudzayendera maulendo angapo ndi omwe amakupatsani chithandizo chamankhwala komanso kumuyesa kangapo asanamuchite opaleshoni. Mutha kukhala ndi:

• Kuyezetsa kwathunthu
• Katemera, monga pneumococcal, meningococcal, Haemophilus influenzae, katemera wa chimfine
• Kuyeza kuyezetsa magazi, mayeso apadera ojambula zithunzi, ndi mayeso ena kuti mutsimikizire kuti muli ndi thanzi lokwanira kuchitidwa opaleshoni
• Kuika anthu magazi kuti mulandire ma cell ofiira owonjezera ndi ma platelets, ngati mukufuna

Mukasuta, yesetsani kusiya. Kusuta kumawonjezera chiopsezo chanu pamavuto monga kuchira pang'onopang'ono. Funsani omwe akukuthandizani kuti akuthandizeni kusiya.

Uzani wopezayo:

• Ngati muli, kapena mutha kukhala ndi pakati.
• Ndi mankhwala ati, mavitamini, ndi zina zowonjezera zomwe inu kapena mwana wanu mukumwa, ngakhale zomwe zidagulidwa popanda mankhwala.

Sabata isanachitike opaleshoni:

• Inu kapena mwana wanu mungafunike kusiya kumwa magazi mopepuka. Izi zimaphatikizapo aspirin, ibuprofen (Advil, Motrin), clopidogrel (Plavix), vitamini E, ndi warfarin (Coumadin).
• Funsani dokotalayo kuti ndi mankhwala ati omwe inu ndi mwana wanu muyenera kumwa patsiku la opareshoni.

Patsiku la opareshoni:

• Tsatirani malangizo okhudza nthawi yomwe inu kapena mwana wanu muyenera kusiya kudya kapena kumwa.
• Tengani mankhwala omwe dokotalayo adakuwuzani kapena mwana wanu kuti mumwe pang'ono.
• Fikani kuchipatala nthawi yake.

Inu kapena mwana wanu mudzakhala mchipatala pasanathe sabata. Kukhala kuchipatala kumatha kukhala 1 kapena masiku awiri okha kuchokera pamene laparoscopic splenectomy. Kuchiritsa kumatha kutenga milungu 4 mpaka 6.

Mukapita kunyumba, tsatirani malangizo pa momwe mungadzisamalire nokha kapena mwana wanu.

Zotsatira za opaleshoniyi zimatengera matenda kapena zovulala zomwe inu kapena mwana wanu muli nazo. Anthu omwe alibe kuvulala koopsa kapena mavuto azachipatala nthawi zambiri amachira atachitidwa opaleshoni iyi.

Ndulu ikachotsedwa, munthu amatha kutenga matenda. Lankhulani ndi wothandizira za kupeza katemera wofunikira, makamaka katemera wa chimfine wapachaka. Ana angafunike kumwa maantibayotiki kuti apewe matenda. Akuluakulu ambiri safuna maantibayotiki kwa nthawi yayitali.

Splenectomy; Laparoscopic splenectomy; Kuchotsa ndulu - laparoscopic

• Laparoscopic kuchotsa ndulu mwa akulu - kutulutsa
• Tsegulani kuchotsa kwa ndulu mwa akulu - kutulutsa
• Kuchotsa ndulu - mwana - kutulutsa
• Chisamaliro cha bala la opaleshoni - chotseguka
• Mukakhala ndi nseru ndi kusanza

• Maselo ofiira ofiira, maselo olunjika
• Kuchotsa ndulu - mndandanda

Brandow AM, Camitta BM. Hyposplenism, splenic trauma, ndi splenectomy. Mu: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, olemba. Nelson Textbook of Pediatrics. Wolemba 21. Philadelphia, PA: Elsevier; 2020: chap 514.

Mier F, Hunter JG. Laparoscopic splenectomy. Mu: Cameron JL, Cameron AM, olemba, eds. Chithandizo Chamakono Cha Opaleshoni. Wolemba 12. Philadelphia, PA: Elsevier; 2017: 1505-1509.

Poulose BK, Holzman MD. Ndulu. Mu: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery: Maziko Achilengedwe a Njira Zamakono Zopangira Opaleshoni. Wolemba 20th. Philadelphia, PA: Elsevier; 2017: mutu 56.