ﻋﻼﻗﺔ ﻣﺮﺽ ﺗﻜﺴﺮ ﺻﻔﻴﺤﺎﺕ ﺍﻟﺪﻡ ﺑﻄﺐ ﺍﻻﺳﻨﺎﻥ ﺃﻭ Thrombocytopenia

ﻋﻼﻗﺔ ﻣﺮﺽ ﺗﻜﺴﺮ ﺻﻔﻴﺤﺎﺕ ﺍﻟﺪﻡ ﺑﻄﺐ ﺍﻻﺳﻨﺎﻥ

ﺃﻭ

Thrombocytopenia

ﺍﺫﺍ ﻣﺎ ﻫﺬﺍ ﺍﻟﻤﺮﺽ؟؟

ﻭﻣﺎ ﻋﻼﻗﺘﻪ ﺑﻄﺐ ﺍﻷﺳﻨﺎﻥ ؟؟!!!!

ﻫﻮ ﺣﺎﻟﻪ ﺗﻜﻮﻥ ﻓﻴﻬﺎ ﻋﺪﺩ ﺍﻟﺼﻔﻴﺤﺎﺕ ﺍﻟﺪﻣﻮﻳﻪ platelet

ﻣﻨﻬﺎﺭﺓ ﻭﺗﻌﺎﻧﻲ ﻣﻦ ﻧﻘﺼﺄﻥ ﺷﺪﻳﺪ ﻓﺪ ﺍﻋﺪﺍﺩﻫﺎ decrease

number

_ ﺍﻣﺎ ﻋﻦ ﻋﻼﻗﺘﻪ ﺑﻄﺐ ﺍﻷﺳﻨﺎﻥ ﻫﻮ ﺑﺴﺒﺐ ﺗﻜﺴﺮ

ﺍﻟﺼﻔﻴﺤﺎﺕ ﺍﻟﺪﻣﻮﻳﻪ

ﻫﺬﺍ ﺩﻟﻴﻞ ﺍﻧﻪ ﻻ ﺗﻮﺟﺪ ﺧﺜﺮﺓ ﺩﻣﻮﻳﻪ ﺍﻱ ﺑﻌﺪ ﺍﻟﻘﻠﻊ ﺳﻴﺴﺘﻤﺮ

ﺍﻟﻨﺰﻳﻒ ﻭﻳﺴﺘﻤﺮ ﻭﻳﺴﺘﻤﺮ .......

ﻟﺮﺑﻤﺎ ﺗﺼﻞ ﺑﻨﺎ ﺍﻟﺤﺎﻟﻪ ﺇﻟﻰ ﺣﺎﻟﻪ ﻟﺮﺑﻤﺎ ﺃﺧﻄﺮ ﺇﻻ ﻭﻫﻲ ﺍﻝ

shock ﺃﻭ ﺍﻟﺠﻠﻄﻪ ﺍﻟﺪﻣﺎﻏﻴﺔ ﺑﺴﺒﺐ ﺍﻟﻨﺰﻑ ﺍﻟﻤﺴﺘﻤﺮ

ﺗﻨﺒﻴﻪ

ﻧﺴﺘﻨﺘﺞ ﻣﻦ ﻫﺬﺍ ﺍﻟﻜﻼﻡ ﺍﻧﻪ ﻫﺬﺍ ﺍﻟﺤﺎﻟﻪ ﺧﻄﺮﻩ ﺟﺪﺍ ﺑﻤﻌﻨﻰ

ﺃﺩﻕ ﻻ ﺗﻌﺘﻤﺪ ﻋﻠﻰ ﺍﻟﺨﺒﺮﻩ ﺃﻭ ﺍﻟﻤﻬﺎﺭﺓ ﻭﻟﻜﻦ ﺗﻌﺘﻤﺪ ﺍﻟﻌﻠﻢ

What types of thrombocytopenia

ﻋﻨﺪﻧﺎ ﻧﻮﻋﻴﻦ ﻫﻤﺎ

 ﺍﻷﻭﻟﻲ ﺃﻭ ﻋﺪﻳﻢ ﺍﻟﺴﺒﺐ idopathic

ﻫﺬﺍ ﺍﻟﻨﻮﻉ ﻳﺼﻴﺐ ﺍﻷﺷﺨﺎﺹ ﺑﺪﻭﻥ ﺳﺒﺐ ﻳﻌﻨﻲ ﻳﺠﻲ ﺍﻟﻤﺮﻳﺾ

ﻳﺮﺍﺟﻊ ﺻﺪﻓﻪ ﻳﻜﺘﺸﻒ ﻫﻮ ﺣﺎﻣﻞ ﻫﺬﺍ ﺍﻟﻤﺮﺽ

ﻳﻌﺘﻘﺪ ﺍﻟﺒﻌﺾ ﻫﻨﺎﻟﻚ ﻋﺪﻭﻯ ﻓﺎﻳﺮﻭﺳﻴﻪ ﻫﻲ ﺍﻟﺴﺒﺐ

Viral infection

_ ﺍﻣﺎ ﺍﻷﺧﻄﺮ ﻫﻮ ﺍﻟﻨﻮﻉ ﺍﻟﺜﺎﻧﻮﻱ Secondry

ﻭﻳﺤﺼﻞ ﻧﺘﻴﺠﻪ ﺇﺣﺪﻯ ﻫﺬﺍ ﺍﻷﻣﺮﺍﺽ

_1 Systemic diseases ﺃﻣﺮﺍﺽ ﻋﺎﻣﻪ

_2 Metastatic cancer to bone

ﺍﻟﻲ ﻋﻨﺪﻫﻢ ﺳﺮﻃﺎﻥ ﺍﻟﻌﻈﻢ ﺭﺍﺡ ﺗﺪﻣﺮ ﻧﺨﺎﻉ ﺍﻟﻌﻈﻢ ﻭﻫﻮ ﻣﻮﺿﻊ

ﺻﻨﺎﻋﻪ ﻣﻜﻮﻧﺎﺕ ﺍﻟﺪﻡ ﻟﺬﻟﻚ ﺳﺒﺐ ﻣﻬﻢ

_3 Splenomegaly

ﺗﻌﻤﻠﻖ ﺍﻟﻄﺤﺎﻝ

ﻣﺜﻞ ﻣﺎ ﺗﻌﺮﻓﻮﻥ ﺍﻟﻄﺤﺎﻝ ﻋﻀﻮ ﻣﻬﻢ ﻟﻤﻜﻮﻧﺎﺕ ﺍﻟﺪﻡ ﻭﺻﻨﺎﻋﺔ

ﻟﺬﻟﻚ ﻣﻦ ﻳﺼﻴﺮ ﺑﻴﻪ ﺯﻳﺎﺩﺓ ﺑﺎﻟﺤﺠﻢ

ﻧﺎﺗﺞ ﻋﻦ ﺍﻛﻮ ﺍﺿﻄﺮﺍﺏ ﻟﺬﻟﻚ ﻳﺪﻣﺮ ﺍﻟﺼﻔﻴﺤﺎﺕ ﺍﻟﺪﻣﻮﻳﻪ

_4 Drugs

ﺍﻻﺩﻭﻳﻪ ﻭﻣﻨﻬﺎ ﺍﻷﻫﻢ ﺍﻟﻌﻼﺝ ﺍﻟﻜﻴﻤﻴﺎﺋﻲ

ﻣﺎ ﺍﻟﺴﺒﺐ ؟ !!!!!!!!

ﻷﻥ ﻣﺎﺩﺓ ﺍﻹﺷﻌﺎﻉ ﺗﺪﻣﺮ ﺍﻟﻌﻈﻢ ﻭﺗﺴﻮﻱ ﻧﺨﺮ ﺍﻟﻌﻈﻢ

Osteoporosis

ﻟﺬﻟﻚ ﺗﻘﺘﻞ ﻧﺨﺎﻉ ﺍﻟﻌﻈﻢ ﻭﻫﻮ ﺍﻟﻌﻀﻮ ﺍﻟﺮﺋﻴﺲ ﻟﺒﻨﺎﺀ ﻣﻜﻮﻧﺎﺕ

ﺍﻟﺪﻡ

ﻟﺤﺪ ﺍﻵﻥ ﻟﻢ ﻧﻔﻬﻢ ﻛﻴﻒ ﻳﺘﻢ ﻋﻼﺝ ﻫﻜﺬﺍ ﻣﺮﺿﻰ ﻓﻲ ﻋﻴﺎﺩﺓ

ﻃﺐ ﺍﻷﺳﻨﺎﻥ !!!!!

 ﺍﻟﻌﻼﺝ ﻛﺎﻵﺗﻲ ﻳﺎ ﺩﻛﺘﻮﺭ / ﺓ

ﻗﺒﻞ ﻣﺎ ﺍﺩﺧﻞ ﺑﺎﻟﻌﻼﺝ ﺇﻟﻴﻚ ﺗﺴﺎﺅﻝ ﻣﻬﻢ ﺣﺘﻰ ﺃﺟﺒﺮﻙ ﻭﺗﺬﻛﺮ

ﺩﺍﺋﻤﺎ ﺍﻟﻌﻼﺝ

ﻣﺎﺫﺍ ﻳﺤﺪﺙ ﺇﺫﺍ ﺃﻧﺎ / ﺍﻧﺖ ﻟﻢ ﻧﻬﺘﻢ ﻟﻠﻤﺮﺽ

ﻭﺍﺟﺮﻳﻨﺎ ﺍﻟﻌﻤﻠﻴﺔ

____ ﺍﻟﺠﻮﺍﺏ ﺭﺍﺡ ﺗﺤﺼﻞ ﻫﺪﻳﻪ ﻭﺃﻱ ﻫﺪﻳﻪ؟ !!

ﺗﻔﺘﺢ ﻋﻠﺒﻪ ﺍﻟﻬﺪﻳﻪ ﺗﺠﺪ

_1 ﺯﻳﺎﺩﺓ ﺍﻟﻨﺰﻳﻒ

_2 ﺣﺎﻟﻪ ﻃﻮﺍﺭﺉ ﻟﻠﻤﺴﺘﺸﻔﻰ ﻭﺑﺄﺳﺮﻉ ﻭﻗﺖ ﻣﻤﻜﻦ ﺑﺴﺒﺐ

Stress of patient ﺍﻟﻤﺮﻳﺾ ﺭﺃﺡ ﻳﺨﺎﻑ ﻭﺭﺍﺡ ﻳﺮﺗﻔﻊ

ﻣﺴﺘﻮﻯ ﺍﻟﺘﻮﺗﺮ ﻟﻠﻄﺮﻓﻴﻦ

ﻟﺬﻟﻚ ﺍﻟﻌﻼﺝ

Mangment patient with thrombocytopenia

* ﻛﺎﻵﺗﻲ

_1 ﺍﻛﻮ ﺍﻟﻌﺪﻳﺪ ﻣﻦ ﺍﻟﻄﺮﻕ ﺃﺫﻛﺮ ﺍﻟﻤﻬﻢ ﻓﻘﻂ

ﺃﻭﻷ // ﺑﻌﺪ ﻣﺎ ﻧﻌﺮﻑ ﻫﺬﺍ ﺍﻟﻤﺮﻳﺾ ﻳﺤﻤﻞ ﻫﺬﺍ ﺍﻟﻤﺮﺽ ﻻﺯﻡ

ﻳﻜﻮﻥ ﻭﻳﺎﻧﻪ ﺃﻭ ﺗﺤﺖ ﺇﺷﺮﺍﻑ ﺃﺧﺼﺎﺋﻲ ﺍﻟﺪﻡ ﺃﻭ

Hematologist

ﻃﺒﻘﺎ ﺇﻟﻰ ﻧﻮﻉ ﺍﻟﻌﻤﻠﻴﺔ ﺍﻟﻲ ﺍﻧﺖ ﻃﺎﻟﺒﻪ ‏( ﺟﺮﺍﺣﻪ،ﺣﺸﻮﺓ،

ﺟﺮﺍﺣﻪ ﺭﺋﻴﺴﻴﻪ mjaor/minor ‏)

ﺃﺧﺼﺎﺋﻲ ﺍﻟﺪﻡ ﻳﺮﻓﻊ ﻣﺴﺘﻮﻯ ﺍﻟﺼﻔﻴﺤﺎﺕ ﺍﻟﺪﻣﻮﻳﻪ ﺣﺴﺐ

ﺍﻟﻌﻤﻠﻴﺔ ﺍﻟﻲ ﺍﻧﺖ ﻣﺤﺘﺎﺟﻪ

_ ﻛﻴﻒ ﻧﻌﺮﻑ ﺍﻷﻋﺪﺍﺩ ﺍﻟﺨﺎﺻﻪ ﺑﻜﻞ ﻋﻤﻠﻴﺔ

ﺍﻧﻲ ﺃﻋﻠﻤﻚ ﻛﺎﻵﺗﻲ

_1 ﺍﺫﺍ ﻛﺎﻧﺖ ﻋﻨﺪﻙ ﻋﻤﻠﻴﺔ ﺳﻨﻴﻪ ﻋﺎﺩﻳﻪ ‏( ﺣﺸﻮﺍﺕ ‏) ﻳﻌﻨﻲ

ﺍﻟﻤﺮﻳﺾ

ﻋﻨﺪﻩ ﺁﻟﻢ ﻣﺜﻞ ﺃﻱ ﻣﺮﻳﺾ ﻭﻟﻜﻦ ﻫﻮ ﻣﺼﺎﺏ ﺑﻤﺮﺽ

ﺗﻜﺴﺮ ﺍﻟﺼﻔﻴﺤﺎﺕ

ﻋﺪﺩ ﺍﻟﺼﻔﻴﺤﺎﺕ ﻻﺯﻡ ﻳﻜﻮﻥ 30 ، 000

_2 ﺍﺫﺍ ﻣﺤﺘﺎﺝ ﻗﻠﻊ ﻻﺯﻡ ﻳﻜﻮﻥ 50 ، 000 ﺃﻭ ﺃﻛﺜﺮ

_3 ﺍﺫﺍ ﺗﺤﺘﺎﺝ mjaor Surgery ﻳﻌﻨﻲ ﺗﺴﻮﻱ flab ﻭ

suture ﻭﻣﺎ ﺷﺎﺑﻪ ﻭﺍﻟﻌﻤﻠﻴﺔ ﺗﺴﺘﻐﺮﻕ ﻭﻗﺖ ﻻﺯﻡ ﻳﻜﻮﻥ ﺍﻟﻌﺪﺩ

ﻓﻮﻕ 80 ، 000 ﺇﻟﻰ 100 ،000

ﻳﻌﻨﻲ ﻗﺮﻳﺐ ﻋﻦ ﺍﻟﺤﺪ ﺍﻟﻄﺒﻴﻌﻲ

ﻣﻼﺣﻈﻪ

Normal range of platelet is

150,000