Kana chiremba wako akakuudza kuti iwe une chirwere cheropa iwe ungashamisika, " Zvino nei chidimbu changu chiri chikuru?" " Ndechepi yangu ine chokuita neropa rangu?" Kana kuti " Chii chinonzi spleen?" Izvi zvose mibvunzo yakanaka kwazvo. Ngatitangei nebasa repleen, uye kurukurai kuti nei chirwere chinowedzera myeloproliferative neoplasms, uye pakupedzisira ongorora maitiro ekurapwa kweplenomegaly (kuwedzera kwepleen).
Spleen Basics
Iyo chirwere chikamu chiduku-duku (pamusoro pehukuru hwechibhakera chako) chinogara kuruboshwe rwomukati pasi pebhiriji. Ipleen yakagadzirwa nemhando mbiri dzezvisikwa (1) tsvina yakatsvuka iyo inosvina masero matsvuku eropa uye (2) mapapu machena ari chikamu chemuviri wechirwere chemuviri. Mune mitsara yakatsvuka, mashese akare kana asina kusvibiswa masero matsvuku (zvakadai searele cells) anobviswa kubva pakuparadzirwa. Mipururu yakatsvuka inobatsira muviri kusvina zvirwere, kunyanya zvimwe zvirwere zvebhakitiriya. Mucherepa mutsva unobatsira kubudisa lymphocytes, rudzi rwechichena chemuviri weropa, iyo inobatsira kuita kuti zvirwere zvirwere zvirwere kana kuti kupindura majekiseni. Kunyangwe izvi zviya zvakakosha zvepleen kana iwe wakaberekwa, usati waberekwa, chirwere chacho ndicho chibereko chikuru chemasero eropa ( hematopoiesis ). Kusvikira kumagumo ekudzivirira uye mushure mokuberekwa, marora emapfupa anotora izvi.
Chikonzero nei Spleen Yakawedzerwa
Mu polycythemia vera nhamba yakawandisa yemasero matsvuku eropa anobudiswa, zvichiita kuti kuwedzerwa kuwanda kwemasero matsvuku eropa inoda kuenzaniswa nespleen, zvichiita kuti splenomegaly.
Mukutanga myelofibrosis , bone marora inokuvadzwa ne fibrosis, zvichiita kuti zvive zvakaoma kubudisa masero eropa. Muchiitiko ichi, chirwere chinogona kukura kuti chibatsire kushandiswa kwesero rega ropa kunze kweropa remafu. Izvi zvinogonawo kuitika muchiropa kazhinji kusvika pamwero muduku.
Zviratidzo Zvokuva nePleen Yakakurumbira
Vanhu vazhinji vane chirwere chakawedzerwa vangave vasingazivi, kunyanya kana spleen iri shoma shoma.
Vamwe vangashuma "kuzara" mumimba. Kana chirwere chacho chikawedzera zvakanyanya, chinogona kupfuurira mudumbu, izvo zvinogona kukupa manzwiro ekuzvinzwa zvakakwana, sekunge iwe wakangodya kudya kwakakwana pawakangodya kaduku.
Iyo spleen haina kusimba uye inowanzochengetedzwa ne ribcage. Sezvazvinokurudzira hazvisati zvidzivirirwa uye zvinowanzokuvara, kunyanya kunetseka kubva pangozi yemotokari kana kutambira mitambo (sebhola kana hockey). Kutambudza kune spleen yakawedzerwa kunogona kukonzera kubuda kukuru.
Izvozvo Zvingaita Sei Kuti Chirwere Chigadziriswe?
Kana chirwere chako chinenge chichiwedzera zvishoma, kurapwa kungasazodiwa. Chiremba wako angangotarisa ropa rako uye hukuru hwepleen yako zvakasimba. Kana kurapwa kuchidikanwa pane zvitatu zvakakura zvakasiyana: chirwere cherapi, splenectomy, uye radiotherapy.
Chokutanga ndechekurapa. Muzvizhinji, izvi zvinoshandiswa mishonga inotarirwa kuderedza kushandiswa kwesero reropa. Imwe yemishonga yakajairika inoshandiswa kuderedza spleen ukuru mune myeloproliferative neoplasms is hydroxyurea. Hydroxyurea inorapwa mishonga inotorwa zuva nezuva. Inowanzotanga pamwero wakaderera uye wakawedzera kusvikira zvaidiwa (kazhinji kacho imwe nhamba ye hemoglobin, masero eropa, kana maplatelets).
Mimwe mishonga yokutanga yemishonga inosanganisira busulfan, melphalan, alpha interferon, thalidomide, kana lenalidomide. Prednisone inogona kupiwa ne thalidomide kana lenalidomide. Mutsara wechipiri mushonga unosanganisira cladribine (inonziwo 2CDA), daunorubicin, decitabine, kana 5-azacytidine. Chiremba wako achasarudza chirwere chako chinoenderana nehuwandu hwehutano hwako, mamwe matambudziko ezvoutano uye nemigumisiro yemishonga.
Chisarudzo chechipiri chekurapa ndechokuti splenectomy kana kuporesa kubviswa kwepleen. Chinhu chinonyanya kukosha chokubvisa chirwere chacho ndicho chinokonzerwa nehutachiona hutachiona hwehupenyu. Kana iwe usati watoziva, iwe unofanirwa kugamuchira zvirwere zvakakonzerwa kuti udzivirire kubva pneumococcal uye zvirwere zvemaningococcal vasati vasvika splenectomy.
Kana imwechete iyo yakabviswa, iwe ungangoiswa pa penicillin kaviri zuva rimwe nerimwe kuti udzivirire zvirwere izvi. Uyezve, fivhiri (yakakura kupfuura 100.4F) ndeyekukurumidzira kunoda kurapwa kwenguva pfupi.
Chimwe chechitatu chinoshandiswa kurapa ndeye radiotherapy (inonziwo rayation therapy). Radiation inotarirwa ne spleen iyo inogona kubatsira kuideredza muhukuru. Izvi zvinowanikwa kwenguva pfupi kuitira kuti splenic radiotherapy inofungidzirwa kuti inononoka , kurapa inotarisirwa kuderedza zviratidzo kuvandudza hupenyu hwehupenyu. Izvi zvingava sarudzo yakanaka kune vanhu vasiri ivo vakakodzera kutsvaga splenectomy.
Kune zvinhu zvakawanda zvokufunga nezvazvo kana uchitora kana kuti sei kurapa splenomegaly mu polycythemia vera kana kuti primary myelofibrosis. Iva nechokwadi chekukurukurirana nachiremba wako zvikomborero uye zvinokonzerwa nemigumisiro yemishonga iyi.
> Sources:
> Mesa RA. Maitiro andinoita sei zviratidzo zveplenomegaly kune varwere vane myelofibrosis. Ropa. 2009; 113: 5394-5400.
> Vannucchi AM. Maitiro andinoita sei polycythemia vera. Ropa. 2014; 124: 3212-3220.