Wehe ʻeleʻele

ʻO ka hoʻoneʻe ʻāpala kahi ʻoki e wehe ai i kahi māpala maʻi a i ʻole poino. Kapa ʻia kēia ʻoki lāʻau ʻo splenectomy.

Aia ka iwi i ka ʻaoʻao luna o ka ʻōpū, ma ka ʻaoʻao hema ma lalo o ka iwi ʻaoʻao. Kōkua ka ʻōpala i ke kino i ka hakakā ʻana i nā germat a me nā maʻi. Mālama pū kekahi ia i ke koko.

Wehe ʻia ka spleen ʻoiai ʻoe ma lalo o ka anesthesia āpau (hiamoe a ʻaʻohe ʻeha). Hiki i ke kauka ke hana i kahi splenectomy hāmama a i ʻole laparoscopic splenectomy.

I ka wehe ʻana o ka spleen wehe:

• Hana ke kaukoki i kahi ʻoki (incision) ma ka waena o ka ʻōpū a i ʻole ka ʻaoʻao hema o ka ʻōpū ma lalo pono o nā iwi ʻaoʻao.
• Kuhi ʻia ka ʻōpala a hemo.
• Inā mālama ʻia ʻoe no ka maʻi ʻaʻai, nānā ʻia nā lymph node i loko o ka ʻōpū. Lawe ʻia paha lākou.
• Hoʻopili ʻia ka ʻokiʻoki me ka hoʻohana ʻana i nā humuhumu a i ʻole nā ​​staples.

I ka hemo ʻana o ka sparen laparoscopic:

• Hana ke kaukōkō i nā ʻoki liʻiliʻi he 3 a 4 paha i loko o ka ʻōpū.
• Hoʻokomo ka mea hoʻopuka i kahi mea kani i kapa ʻia he laparoscope ma o kekahi o nā ʻoki. He kāmele liʻiliʻi kā ka laulā a me ka kukui ma ka hopena, e hiki ai i ke kaukipō ke ʻike i loko o ka ʻōpū. Hoʻokomo ʻia nā mea hana ʻē aʻe i loko o nā ʻoki ʻē aʻe.
• Hoʻopili ʻia kahi kinoea kolohe ʻole i loko o ka ʻōpū e hoʻonui ia. Hāʻawi kēia i ka lumi kaukoki e hana.
• Hoʻohana ka mea hoʻopōʻaiapili i ka laulā a me nā mea hana ʻē aʻe e hemo ai i ka palapū.
• Lawe ʻia ka laulā a me nā mea hana ʻē aʻe. Hoʻopili ʻia nā ʻokiʻoki me ka hoʻohana ʻana i nā humuhumu a i ʻole nā ​​staples.

Me ke kahakaha laparoscopic, ʻoi aku ka wikiwiki o ka hoʻōla a ʻoi aku ka ʻeha ma mua o ka ʻoki hāmama. E kamaʻilio me kāu kaukukō e pili ana i ke ʻano o ke kaha ʻoki kūpono iā ʻoe a me kāu keiki.

Nā kūlana e koi ai i ka hoʻoneʻe ʻāpala i:

• Loaʻa i ʻole a cyst paha i loko o ka māū.
• Koko koko (thrombosis) i loko o nā kīʻaha koko o ka spleen.
• Cirrhosis o ke ake.
• Nā maʻi a me nā maʻi o nā hunaola koko, e like me idiopathic thrombositopenia purpura (ITP), herherary spherositosis, thalassemia, hemolytic anemia, a me hereditary elliptocytosis. ʻO nā kūlana laha ʻole kēia.
• Hypersplenism (spleen overactive).
• Ka maʻi ʻaʻai o ka ʻōnaehana lymph e like me ka maʻi Hodgkin.
• Leukemia.
• ʻO nā tumors ʻē aʻe a i ʻole nā ​​maʻi ʻino e hoʻopili i ka lola.
• Anemia maʻi maʻi maʻi.
• Aneurysm artery Splenic (laha ʻole).
• Ka ulia i ka ʻōpala.

Nā pilikia no ka anesthesia a me ke kahakaha ʻana ma:

• Nā hopena i nā lāʻau
• Nā pilikia hanu
• Kahe ʻana o ke kahe, ke koko, maʻi

ʻO nā pōʻino no kēia ʻoki ʻana:

• Koko koko i loko o ka puka vein (kahi mea nui e lawe i ke koko i ke ake)
• Pulupā naha
• ʻO Hernia ma ke kahua ʻoki ʻoki
• Hoʻonui i ka makaʻu no ka maʻi ma hope o splenectomy (ʻoi aku ka kiʻekiʻe o ka makaʻu o nā keiki ma mua o nā mākua no ka maʻi)
• ʻO ka hōʻeha i nā mea kokoke, e like me ka pancreas, ʻōpū, a me ke kolona
• ʻOhi hōʻiliʻili ma lalo o ka diaphragm

Ua like nā pōpilikia no ka wehe wehe ʻana a me ka laparoscopic spleen.

E kipa pinepine ʻoe a me kāu keiki me nā kahu mālama olakino a me nā hoʻokolohua he nui ma mua o ka ʻoki ʻana. Loaʻa iā ʻoe:

• He hōʻike kino piha
• Immunisations, e like me ka pneumococcal, meningococcal, Haemophilus influenzae, a me nā lāʻau lapaʻau flu
• ʻO ka nānā ʻana i nā hoʻokolohua koko, nā hoʻokolohua kiʻi kūikawā, a me nā hoʻokolohua ʻē aʻe e ʻike pono ʻoe i ke olakino e hiki ai ke ʻoki
• Transfusions e loaʻa keu ke koko ʻula a me nā platelet, inā pono ʻoe iā lākou

Inā puhi ʻoe, pono ʻoe e hoʻāʻo. Hoʻonui ka puhi paka ʻana i kou pilikia no nā pilikia e like me ka hoʻōla lohi. E noi i kāu mea nāna e hāʻawi i ke kōkua no ka haʻalele.

E haʻi i ka mea hāʻawi:

• Inā ʻoe, a hāpai paha.
• He aha nā lāʻau, nā wikamina, a me nā mea hoʻopiha ʻē aʻe āu a me kāu keiki e lawe nei, ʻo nā mea i kūʻai ʻia me ka ʻole o ka lāʻau.

I loko o ka pule ma mua o ke kahakaha ʻana:

• Pono ʻoe a me kāu keiki e hōʻoki iki i ka lawe ʻana i nā mea lahilahi o ke koko. Hoʻopili kēia i ka aspirin, ibuprofen (Advil, Motrin), clopidogrel (Plavix), wikamina E, a me warfarin (Coumadin).
• E nīnau i ke kaukipō i nā lāʻau āu e lawe ai a i ʻole paha i kāu keiki i ka lā o ke ʻoki.

I ka lā o ke kaha ʻana:

• E hāhai i nā ʻōkuhi e pili ana i ka wā e haʻalele ai ʻoe a me kāu keiki i ka ʻai a inu paha.
• Lawe i nā lāʻau a ke kauka i haʻi aku ai iā ʻoe a i ʻole paha i kāu keiki e lawe me kahi wahi wai ʻuʻuku.
• E hōʻea i ka haukapila i ka manawa.

ʻO ʻoe a ʻo kāu keiki e noho ma lalo o hoʻokahi pule ma ka haukapila. ʻO ka hale haukapila he 1 a 2 paha mau lā ma hope o ka laparoscopic splenectomy. He 4 a 6 mau pule paha ka hala ʻana o ka hoʻōla.

Ma hope o ka hoʻi ʻana i ka home, e hāhai i nā ʻōkuhi no ka mālama ʻana iā ʻoe iho a i kāu keiki paha.

Pili ka hopena o kēia ʻoki ʻana i ke ʻano o ka maʻi a ʻeha paha āu a ʻo kāu keiki paha. ʻO ka poʻe i loaʻa ʻole nā ​​ʻeha ʻē aʻe a i ʻole nā ​​pilikia olakino e hoʻi hou mai ma hope o kēia ʻoki.

Ma hope o ka hemo ʻana o ka spleen, ʻoi aku paha ka hoʻomohala ʻana o kekahi i nā maʻi. E kamaʻilio me ka mea hoʻolako e pili ana i ka loaʻa ʻana o nā lāʻau āpau e pono ai, ʻo ia hoʻi ka lāʻau āpau o ka maʻi flu. Pono paha nā keiki e lawe i nā lāʻau antibiotic e pale i nā maʻi. ʻO ka hapa nui o nā mākua ʻaʻole pono nā antibiotic i ka wā lōʻihi.

Splenectomy; Laparoscopic splenectomy; Wehe ʻeleʻele - laparoscopic

• Lawe ka laparoscopic spleen i nā mākua - hoʻokuʻu
• Wehe i ka wehe spleen i nā mākua - hoʻokuʻu
• Wehe ʻeleʻele - keiki - hoʻokuʻu
• Mālama ʻeha ʻeha - wehe
• Ke loaʻa ka nausea a me ka luaʻi

• Nā hunaola ʻulaʻula, nā hunaola target
• Wehe ʻeleʻele - moʻo

ʻO Brandow AM, Camitta BM. Hyposplenism, splenic trauma, a me splenectomy. I: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. ʻO Puka Textbook of Pediatrics ʻo Nelson. 21st ed. Piladelapia, PA: Elsevier; 2020: chap 514.

ʻO Mier F, ʻo Hunter JG. Laparoscopic splenectomy. I: Cameron JL, Cameron AM, eds. ʻO ke kaʻoki lāʻau lapaʻau o kēia manawa. 12th ed. Piladelapia, PA: Elsevier; 2017: 1505-1509.

Poulose BK, Holzman MD. ʻO ka ʻōpala. I: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. ʻO Sabiston Textbook of Surgery: Ke kumu kumu olaola o ka hana ʻoki ʻana o kēia ao. 20 ouk. Piladelapia, PA: Elsevier; 2017: chap 56.