Ukususwa kobende

Ukususwa kobende ukuhlinzwa ukususa ubende obugulayo noma obonakele. Lokhu kuhlinzwa kubizwa nge-splenectomy.

Ubende busengxenyeni engenhla yesisu, ohlangothini lwesobunxele ngaphansi kwe-ribcage. Ubende busiza umzimba ukulwa namagciwane nezifo. Kuyasiza nokuhlunga igazi.

Ubende luyasuswa ngenkathi ungaphansi kwe-anesthesia ejwayelekile (ilele futhi ayinazinhlungu). Udokotela ohlinzayo angenza i-splenectomy evulekile noma i-laparoscopic splenectomy.

Ngesikhathi sokususwa kobende okuvulekile:

• Udokotela ohlinzayo usika (ukusika) maphakathi nesisu noma ohlangothini lwesobunxele lwesisu ngaphansi kwezimbambo.
• Ubende buyatholakala futhi bususiwe.
• Uma uphinde welashelwa umdlavuza, kuhlolisiswa ama-lymph node esiswini. Zingasuswa futhi.
• Ukusikeka kuvaliwe kusetshenziswa imithungo noma ukudla okuyisisekelo.

Ngesikhathi kususwa ubende lwe-laparoscopic:

• Udokotela ohlinzayo usika kathathu noma kane esiswini.
• Udokotela ohlinzayo ufaka ithuluzi elibizwa ngokuthi yi-laparoscope ngenye yokusikeka. Ububanzi bunekhamera encane nokukhanya ekugcineni, okuvumela udokotela ohlinzayo ukuthi abone ngaphakathi esiswini. Ezinye izinsimbi zifakwa ngokusebenzisa okunye ukusikeka.
• Igesi engenabungozi ifakwa esiswini ukuyinweba. Lokhu kunikeza igumbi labahlinzayo ukusebenza.
• Udokotela ohlinzayo usebenzisa ubukhulu nezinye izinsimbi ukususa ubende.
• Ububanzi nezinye izinsimbi ziyasuswa. Ukusikeka kuvaliwe kusetshenziswa imithungo noma ukudla okuyisisekelo.

Ngokuhlinzwa kwe-laparoscopic, ukululama kuvame ukushesha futhi kungabi buhlungu kakhulu kunokuhlinzwa okuvulekile. Khuluma nodokotela wakho ohlinzayo mayelana nokuthi yiluphi uhlobo lokuhlinzwa olulungele wena noma ingane yakho.

Izimo ezingadinga ukususwa kwepeni zifaka:

• Ithumba noma i-cyst esibondeni.
• I-clot yegazi (thrombosis) emithanjeni yegazi yobende.
• I-cirrhosis yesibindi.
• Izifo noma ukuphazamiseka kwamaseli egazi, njenge-idiopathic thrombocytopenia purpura (ITP), i-spherocytosis eyifa, i-thalassemia, i-hemolytic anemia, ne-elliptocytosis yefa. Zonke lezi yizimo ezingavamile.
• I-Hypersplenism (ubende obusebenzayo).
• Umdlavuza wohlelo lwe-lymph njengesifo seHodgkin.
• Umdlavuza wegazi.
• Ezinye izicubu noma umdlavuza ezithinta ubende.
• I-sickle cell anemia.
• I-Splenic artery aneurysm (engavamile).
• Ukuhlukumezeka ebunzimeni.

Izingozi ze-anesthesia nokuhlinzwa ngokujwayelekile yilezi:

• Ukusabela emithini
• Izinkinga zokuphefumula
• Ukopha, amahlule egazi, ukutheleleka

Izingozi zalokhu kuhlinzwa zifaka:

• Ukuqina kwegazi emthanjeni we-portal (umthambo obalulekile ohambisa igazi esibindini)
• Iphaphu eliwile
• UHernia esizeni sokuhlinza
• Ingozi eyengeziwe yokutheleleka ngemuva kwe-splenectomy (izingane zisengozini enkulu kunabantu abadala bokutheleleka)
• Ukulimala ezithweni eziseduze, njengamanyikwe, isisu nekholoni
• Ubuthongo iqoqo ngaphansi diaphragm

Izingozi ziyefana ekususweni kobende okuvulekile nokwe-laparoscopic.

Wena noma ingane yakho nizoba nokuvakashelwa okuningi nabahlinzeki bezempilo kanye nokuhlolwa okuningana ngaphambi kokuhlinzwa. Ungahle ube:

• Ukuhlolwa okuphelele ngokomzimba
• Ukugoma, njenge-pneumococcal, meningococcal, Haemophilus influenzae, kanye nemithi yokugomela umkhuhlane
• Ukuhlola ukuhlolwa kwegazi, ukuhlolwa okukhethekile kwe-imaging, nokunye ukuhlola ukuze uqiniseke ukuthi uphilile ngokwanele ukuba uhlinzwe
• Ukumpontshelwa ukuthola amangqamuzana egazi abomvu engeziwe nama-platelets, uma uwadinga

Uma ubhema, kufanele uzame ukuyeka. Ukubhema kwandisa ubungozi bezinkinga ezinjengokuphulukiswa kancane. Cela umhlinzeki wakho akusize uyeke.

Tshela umhlinzeki:

• Uma ukhona, noma kungenzeka ukhulelwe.
• Imiphi imishanguzo, amavithamini, nezinye izithako ozithathayo wena noma ingane yakho, ngisho naleyo ebithengwe ngaphandle kwemithi kadokotela.

Phakathi nesonto ngaphambi kokuhlinzwa:

• Wena noma ingane yakho kungadingeka ukuthi uyeke okwesikhashana ukuthatha izinciphisi zegazi. Lokhu kufaka phakathi i-aspirin, ibuprofen (Advil, Motrin), i-clopidogrel (i-Plavix), i-vitamin E, ne-warfarin (i-Coumadin).
• Buza udokotela ohlinzayo ukuthi yiziphi izidakamizwa wena noma ingane yakho okufanele nizisebenzise ngosuku lokuhlinzwa.

Ngosuku lokuhlinzwa:

• Landela imiyalo yokuthi wena noma ingane yakho kufanele niyeke nini ukudla noma ukuphuza.
• Thatha izidakamizwa udokotela ohlinzayo akutshele zona noma ingane yakho ukuthi uziphuze ngophuzo oluncane lwamanzi.
• Fika esibhedlela ngesikhathi.

Wena noma ingane yakho nizochitha isikhathi esingaphansi kwesonto esibhedlela. Ukuhlala esibhedlela kungaba yizinsuku ezi-1 noma ezi-2 kuphela ngemuva kwe-laparoscopic splenectomy. Ukuphulukiswa kungathatha amasonto amane kuye kwayisithupha.

Ngemuva kokuya ekhaya, landela imiyalo yokuzinakekela wena noma ingane yakho.

Umphumela walokhu kuhlinzwa uncike ekutheni yisiphi isifo noma ukulimala wena noma ingane yakho onakho. Abantu abangenakho okunye ukulimala okunzima noma izinkinga zezokwelapha bavame ukululama ngemuva kwalokhu kuhlinzwa.

Ngemuva kokuthi uswazi selususiwe, umuntu usethubeni lokuba abe nezifo. Khuluma nomhlinzeki ngokuthola imigomo edingekayo, ikakhulukazi umuthi wokugomela umkhuhlane waminyaka yonke. Izingane zingadinga ukuthatha ama-antibiotic ukuvikela izifo. Iningi labantu abadala alidingi ama-antibiotic isikhathi eside.

I-Splenectomy; I-splenectomy ye-Laparoscopic; Ukususwa kobende - i-laparoscopic

• Ukususwa kobende kwe-Laparoscopic kubantu abadala - ukukhipha
• Vula ukususwa kobende kubantu abadala - ukukhipha
• Ukususwa kobende - ukukhishwa kwengane
• Ukunakekelwa kwesilonda sokuhlinzwa - kuvulekile
• Lapho unesicanucanu nokuhlanza

• Amaseli abomvu egazi, ama-target cell
• Ukususwa kobende - uchungechunge

IBrandow AM, iCamitta BM. I-Hyposplenism, ukuhlukumezeka kwe-splenic, ne-splenectomy. Ku: Kliegman RM, St Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Incwadi kaNelson Yezingane. Umhlaka 21. IPhiladelphia, PA: Elsevier; 2020: isahluko 514.

UMier F, uHunter JG. I-splenectomy ye-Laparoscopic. Ku: UCameron JL, uCameron AM, ama-eds. Ukwelashwa Kwamanje. Umhla ka-12. IPhiladelphia, PA: Elsevier; 2017: 1505-1509.

IPoulose BK, iHolzman MD. Ubende. Ku: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. ISabiston Incwadi Yokuhlinzwa: Isisekelo Sebhayoloji Sokuzijwayeza Kwamanje Kokuhlinzwa. Umhla ka-20. IPhiladelphia, PA: Elsevier; 2017: isahluko 56.