Spleen tshem tawm

Spleen tshem tawm yog phais kom tshem tawm tus kab mob uas muaj mob lossis puas lawm. Qhov kev phais mob no hu ua splenectomy.

Tus po yog nyob rau sab saum toj ntawm lub plab, ntawm sab lauj taw rau hauv qab daim duab. Tus po ua rau lub cev tua cov kab mob thiab kab mob. Nws kuj tseem pab lim ntshav.

Tus po pa tawm thaum koj tab tom tso tshuaj loog (tsaug zog thiab tsis hnov ​​mob). Tus kws phais mob yuav ua tau qhib txoj hlab ntsws lossis ua pob txha caj qaum.

Thaum qhib tshem tus po tawm:

• Tus kws phais mob txiav me me (nruab nrab) hauv nruab nrab lub plab lossis sab laug ntawm lub plab qis sab hauv qab ntawm tus tav.
• Tus po yog qhov chaw nyob thiab tshem tawm.
• Yog tias koj tseem tabtom kho tus mob qog noj ntshav, qog ntshav hauv lub plab yog kuaj. Tej zaum lawv tseem yuav raug tshem tawm thiab.
• Qhov nti nruab nrab yog kaw siv cov stitches lossis staples.

Thaum lub sij hawm tshem tawm spleen laparoscopic:

• Tus kws phais mob txiav 3 lossis 4 qhov me me hauv plab.
• Tus kws phais mob ntxig rau ib qho cuab yeej hu ua laparoscope los ntawm ib qho ntawm kev txiav. Qhov kev txiav txim siab muaj lub koob yees duab me me thiab lub teeb ci rau ntawm qhov kawg, uas tso cai rau tus kws phais neeg pom hauv lub plab. Lwm yam twj paj nruag yog ntxig los ntawm lwm qhov kev txiav.
• Cov pa roj tsis huv yuav tso rau hauv plab kom nthuav nws. Qhov no muab cov chav phais neeg ua haujlwm.
• Tus kws phais siv tus ntsuas thiab lwm yam khoom siv los tshem tawm tus po.
• Cov cuab yeej thiab lwm yam twj paj nruag tau muab tshem tawm. Lub incisions raug kaw siv stitches lossis staples.

Nrog kev phais laparoscopic, kev rov ua haujlwm yog feem ntau sai dua thiab tsis mob siab dua li qhib kev phais. Tham nrog koj tus kws phais mob txog hom kev phais twg zoo rau koj lossis koj tus menyuam.

Cov mob uas yuav tsum tau tshem tus po xws li:

• Qog lossis cyst hauv qhov hnoos qeev.
• Cov ntshav txhaws (thrombosis) hauv cov hlab ntshav ntawm tus po.
• Cov mob ua paug rau daim siab.
• Kab mob lossis mob cuam tshuam ntawm cov qe ntshav, xws li idiopathic thrombocytopenia purpura (ITP), kab mob spherocytosis, thalassemia, hemolytic anemia, thiab kab mob elliptocytosis mob. Cov no yog txhua yam mob tsis tshua muaj.
• Cov Hypersplenism (kev tsim tawm ntawm spleen).
• Mob kheesxaws ntawm cov lymph mob xws li mob Hodgkin.
• Mob ntshav siab.
• Lwm cov qog lossis mob qog ntshav uas cuam tshuam rau tus po.
• Sickle cell anemia.
• Splenic artery aneurysm (tsis tshua muaj).
• Kev poob plig rau lub spleen.

Kev phom sij rau kev ua kom loog thiab phais feem ntau yog:

• Kev tshuaj tiv thaiv
• Cov teeb meem ua pa
• Los ntshav, ntshav txhaws, kis kab mob

Kev phom sij rau qhov kev phais mob suav nrog:

• Cov ntshav txhaws hauv lub portal txoj hlab ntsha (ib qho tseem ceeb ntshav uas nqa ntshav mus rau lub siab)
• Lub ntsws ntsws tawg
• Hernia ntawm thaj chaw phais mob
• Ua rau muaj kev pheej hmoo kis mob ntxiv tom qab splenectomy (menyuam yaus yog cov muaj pheej hmoo ntau dua li cov laus rau kev kis mob)
• Kev raug mob rau cov nruab nrog nyob ze, xws li tus txiav, plab, thiab hnyuv tws
• Pus sau hauv qab daim diaphragm

Kev phom sij zoo ib yam rau ob qho tib si qhib thiab laparoscopic spleen tshem tawm.

Koj lossis koj tus menyuam yuav ntsib ntau tus kws kho mob thiab ntau yam kev kuaj uantej yuav phais mob. Koj yuav muaj:

• Kev kuaj mob lub cev tag
• Cov tshuaj txhaj tiv thaiv kab mob, xws li mob ntsws o, mob meningococcal, Haemophilus mob npaws, thiab tshuaj tiv thaiv khaub thuas
• Kev kuaj ntshav cov ntshav, kuaj cov duab tshwj xeeb, thiab lwm yam kev kuaj kom paub tseeb tias koj noj qab haus huv txaus rau kev phais mob
• Hloov ntshav txais ntshav ntxiv rau cov ntshav liab thiab platelets, yog tias koj xav tau

Yog tias koj haus luam yeeb, koj yuav tsum sim tso tseg. Kev haus luam yeeb ua rau koj muaj feem ntau rau teeb meem xws li kho qeeb. Nug koj tus kws kho mob kom pab txiav.

Qhia tus kws khomob:

• Yog tias koj, lossis xeeb tub.
• Cov tshuaj twg, vitamins, thiab lwm yam tshuaj pab koj lossis koj tus menyuam tau noj, txawm tias yog cov yuav los uas tsis muaj daim ntawv xaj tshuaj.

Lub lim tiam ua ntej kev phais mob:

• Koj lossis koj tus menyuam yuav tsum raug txwv tsis pub noj ntshav thinner. Cov no suav nrog cov tshuaj aspirin, ibuprofen (Advil, Motrin), clopidogrel (Plavix), vitamin E, thiab warfarin (Coumadin).
• Nug tus kws phais yuav siv tshuaj uas koj lossis koj tus menyuam tseem noj nyob rau hnub phais.

Hnub ntawm kev phais mob:

• Ua raws li cov lus qhia txog thaum koj lossis koj tus menyuam yuav tsum tsum tsis txhob noj lossis haus.
• Siv cov tshuaj uas tus kws phais mob tau hais kom koj lossis koj tus menyuam nqa nrog cov pas me me.
• Mus txog tsev kho mob kom ncav sijhawm.

Koj lossis koj tus menyuam yuav siv sijhawm tsawg dua li ib asthiv hauv tsev khomob. Nyob hauv tsev kho mob tsuas yog 1 lossis 2 hnub tom qab xoo pob laparoscopic. Kho zoo yuav noj ntev li 4 txog 6 lub lim tiam.

Tom qab mus tsev, ua raws cov lus qhia saib xyuas koj tus kheej lossis koj tus menyuam.

Qhov tshwm sim ntawm qhov kev phais no nyob ntawm seb koj lossis koj tus menyuam muaj mob dab tsi. Cov neeg uas tsis muaj kev raug mob hnyav lossis teebmeem kev kho mob feem ntau yuav rov qab zoo tom qab kev phais mob no.

Tom qab tus po tshem tawm, tus neeg ntxim yuav kis tus kab mob. Tham nrog tus kws kho mob txog kev txhaj tshuaj tiv thaiv kab mob, tshwj xeeb yog cov tshuaj tiv thaiv khaub thuas txhua xyoo. Cov menyuam yaus yuav tsum siv tshuaj tua kab mob tiv thaiv kab mob. Feem ntau cov neeg laus tsis tas yuav siv tshuaj tua kab mob mus sij hawm ntev.

Splenectomy; Laparoscopic splenectomy; Spleen tshem tawm - laparoscopic

• Laparoscopic spleen tshem tawm hauv cov laus - kev tawm mus
• Qhib spleen tshem tawm hauv cov laus - kev tawm mus
• Spleen tshem tawm - menyuam - tawm
• Kev phais mob kho mob - qhib
• Thaum koj xeev siab thiab ntuav

• Mob ntshav liab, phiaj hlwb
• Spleen tshem tawm - series

Brandow AM, Camitta BM. Hyposplenism, mob ntsws splenic, thiab splenectomy. Hauv: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Phau Ntawv ntawm Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020: chap 514.

Mier F, Tus Saib Xyuas JG. Laparoscopic splenectomy. Hauv: Cameron JL, Cameron AM, eds. Kev Kho Mob Tam Sim NoCov. 12th ed. Philadelphia, PA: Elsevier; 2017: 1505-1509.

Poulose BK, Holzman MD. Tus spleen. Hauv: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Phau Ntawv Txog Kev phais mob: Txheej Txheem Qoob Loo ntawm Kev xyaum phais mob niaj hnubCov. 20 tus ed. Philadelphia, PA: Elsevier; 2017: chap 56.