Splenomegaly - ndichiyani? Zizindikiro, zimayambitsa, chithandizo cha splenomegaly

Splenomegaly - ndichiyani? Yankho funso, inu mumatenga pang'ono. Komanso, tikambirana chiyani matenda Izi zikachitika, kodi zizindikiro zake ndi, ndondomeko ya matenda ndi mankhwala.

mwachidule

Splenomegaly - ndichiyani? Zochita matenda, mawu amatchedwa matenda, amene amakhala ndi kukulitsa kwambiri a ndulu ya. Childs, izi zimachitika pamene chifaniziro cha thupi nawo ndondomeko pathological kuchokera kunja. Komabe, tisaiwale kuti kulemera kwa ndulu, ngakhale boma zimaikidwa kwambiri (2 khola) kuposa chiwalo china chilichonse. N'chifukwa chake pakhomo pa zimene kuwonjezeka kwa thupi imatengedwa splenomegaly, nthawi zonse makonzedwe. Choncho, mu mkhalidwe yachibadwa ya ndulu kulemera kwa munthu wamkulu ali pafupi 100-150 ga pa palpation thupi la thanzi sadzakhala upambana masentimita 7 (anayeza diagonally). The matenda a "ndulu splenomegaly" kuika yosowa kwambiri. Izi zimachitika pansi zinthu zotsatirazi:

• ngati kukula thupi kuposa anati phindu;
• Ngati splenic afiira abnormally kwambiri;
• Ngati ndulu ndi bwino zimadziŵika ndi palpation.

Ntchito ya ndulu mu thupi la munthu

Splenomegaly - ndichiyani? Yankho funso takambirana pamwambapa. Ndulu ndi chiwalo chofunika kwa chitetezo cha m'thupi. Monga amadziwika, lili fasoleobraznuyu kutiumba ndi ili mu chapamwamba mbali yakumanzere ya pamimba - kapena m'malo pansipa chifundamtima. Choncho ndulu akuyesetsa pakati pa 9 ndi 11 nthiti. Mu wathanzi wamkulu thupi ankaimira umalemera pafupifupi 150 magalamu. Limafotokoza gawo mu zinthu zonse m'mimba kuyeza pafupifupi 11 masentimita mu njira choimirira.

ndulu

Anapereka thupi chimagwira ntchito zofunika m'thupi la munthu. ntchito kuchotsa zinthu zakunja kapena mabakiteriya kwa makope a, komanso kukhala chitetezo kwa chitetezo cha m'thupi ndi kuchotsa maselo nthenda magazi.

Tikumbukenso kuti ndulu achuluke mu kukula ngakhale kuti amagwira ntchito mwake, poyankha matenda aliwonse. Ichi ndi chifukwa chakuti matenda ena zokhudza maselo a magazi, angathe kuwonjezeka magazi m'thupi. Akatswiri amanena matenda amene bwanji ndulu, nthawi zambiri kutumikira chifukwa cha kukula yake yaikulu. Komabe, matenda "splenomegaly" anaika nthawi zina. Pambuyo kuwonjezeka kwa thupi sikuti kulankhula za chikhalidwe chake nthenda.

Nthenda ndulu kukula

Splenomegaly - ndichiyani? matenda ino pa abnormally ndulu zikuluzikulu. Pankhaniyi, thupi wasonyeza amatha kulemera 500 magalamu, ndi miyeso yake yaikulu - zimasiyana masentimita 11 20. Splenomegaly, zimayambitsa yomwe ife tione pansipa, limodzi ndi thupi magilamu 1000 ndi kutalika kuposa 20 masentimita, amaona yaikulu ndi katundu. Zochizira matenda wodwalayo angafunike adjuvant mankhwala kapena opaleshoni.

Splenomegaly: zimayambitsa matenda

Pali zinthu zambiri zimene zikuyambitsa a chikhalidwe ichi pathological. Iwo ali zosiyanasiyana ndipo nthawi zambiri zimasiyana zotupa zilonda (khansa), kuchulukana (kapena mphamvu kuwonjezeka magazi) ndi matenda ena matenda limba kusalola matenda yotupa ndi matenda maselo magazi.

Taonani zomwe zimakonda ndulu zikuluzikulu, monga zinthu monga:

• khansa magazi (mwachitsanzo, khansa, lymphoma kapena myelofibrosis);
• matenda maselo a magazi m'thupi (monga spherocytosis, thalassemia kapena chikwakwa selo magazi m'thupi);
• chiwindi matenda (mwachitsanzo, aakulu chiwindi C, matenda enaake chifukwa aakulu chiwindi B, ntchito yaitali mowa ndi mafuta m'chiwindi) ;
• matenda yotupa (nyamakazi ndi lupus erythematosus);
• matenda Gaucher (kapena matenda a kagayidwe zamadzimadzi);
• nthenda yotaya magazi ndi occlusion Mitsempha mitsempha (mwachitsanzo, thrombosis splenic mtsempha, congestive kulephera mtima ndipo blockage wa mtsempha zipata);
• idiopathic thrombocytopenic purpura;
• matenda osiyanasiyana (bakiteriya endocarditis, mononucleosis, AIDS, malungo, Leishmania, Mycobacterium, etc. d.).

Splenomegaly: zizindikiro

Monga amadziwika, zopatuka monga splenomegaly, alibe zizindikiro zenizeni. Komabe, ambiri mwa iwo ndi osamveka ululu m'mimba ndi bloating. Zonsezi ndi zizindikiro za splenomegaly ankaona nonspecific. Tikumbukenso kuti anthu ena ndi ndulu kwambiri yatupa Kawirikawiri wa satiety oyambirira ndi zizindikiro chapamimba Reflux.

Chizindikiro chotsiriza cha matenda kumachitika chifukwa chakuti chifukwa kukakamiza zonse m'mimba m'mimba akuyamba kuloza.

Nthawi zina zizindikiro zimene kugwirizana ndi kuwonjezeka kwa thupi, ndi zotsatirazi:

• Thukuta usiku;
• malungo;
• kuwonda;
• ambiri kufooka;
• pallor;
• mabala mosavuta;
• kutopa.

Pamene ndi amene kupita kuchipatala?

Splenomegaly ana ndi akulu amafuna ndi maganizo kuvomerezedwa ndi dokotala wa maso. Komabe, si aliyense amene ali ndi vuto pathological, akudziwa kuti ayenera kutembenukira kwa dokotala aliyense. Pankhani imeneyi tisaiwale kuti kusankha katswiri zimatengera makamaka chimene watumikira kukhala matenda. Choncho, odwala lingakhale kuti panthawiyi, dokotala (dokotala amene imakhazikika mu mankhwala a matenda a m'magazi), Oncology (khansa zotupa katswiri) ndi gastroenterologist (katswiri matenda intestine, kuphatikizapo chiwindi). Pambuyo pa ulendo omaliza kwa dokotala ayenera kuchititsa mankhwala Kupenda zonse kenako perekani mankhwala.

Malinga ndi zimene zimayambitsa matenda kwa anthu ndi matenda kuti kumafunika mwamsanga m'chipatala. Childs, izi zimachitika pamene wodwalayo ululu mumamva m'mimba ndi zizindikiro za magazi ndi matenda, sali pansi chisamaliro kunyumba.

anayendera

Pambuyo mankhwala wodwalayo katswiri mu malo oyamba akuyembekezera bwino. Kuti tichite zimenezi, madokotala amagwiritsa ntchito njira palpation ndi percussion. Ndi njira izi kudziwa kukula kwa ndulu ya. Mu boma yachibadwa za 3% ya anthu ndi thupi mosavuta palpable. Komabe palpable misa mu anasiya pamimba chapamwamba angakhale osiyana kwambiri chifukwa chifukwa ndi ndulu si zikuluzikulu. N'chifukwa chake akatswiri ntchito ndi njira zina matenda.

Ngati splenomegaly pa palpation sanapezeke, koma zizindikiro zonse amasonyeza lilipo, wodwala akhoza kupita ku mayeso wamba magazi. Mu njira ya kafukufuku, akatswiri amanena zikuchokera, mawonekedwe, ndi nambala ya maselo oyera, maselo othandiza magazi kuundana ndi maselo ofiira. zolozerazi mwina Iyeyunso kapena kutsimikizira pamaso pa matenda.

matenda a splenomegaly

Ngati chiwerengero cha akatswiri kusanthula pambuyo kuyendera ndi kuika chikaiko zotsatira, ndiye matenda zolondola anagwira ultrasound, komanso kompyuta ndi kumveka maginito tomography. Njirazi angapereke zithunzi zambiri za ziwalo, motero, molondola kudziwa kupezeka kapena kusapezeka kwa matenda. Iwo ayenera kukumbukira kuti maginito kumveka kulingalira ndiwo kwenikweni pa mtima wa splenic mtsempha thrombosis kapena thrombosis wa zipata za.

Kupatula ena onse, kwa matenda a matenda ntchito phunziro radioisotope. Izi njira yolondola kwambiri okhoza bwino kudziwa mbali ya zimakhala ndulu. Komabe, njira pano zovuta kukhazikitsa ndi okwera mtengo kwambiri.

mitundu matenda

Malinga zifukwa chikhalidwe choterocho pathological chithandizo angakhale osiyana. Tikumbukenso kuti lero zambiri odwala kunena za matenda ili monga "splenomegaly chiwindi." Ngakhale kuti mawu akuti si kwathunthu zoona, koma kwenikweni, kuwonjezera mamembala a ndulu kaŵirikaŵiri limodzi ndi kuwonjezeka mu ziwalo zina za m'kati. Chotero chitsanzo akhoza kwambiri kuvutika alili ndi mankhwala ake.

1. Wongolerani splenomegaly - ndichiyani? Izi kukulitsa a ndulu, amene anauka chifukwa cha zochitika aliyense pathological kuchokera kumbali.
2. Hepatomegaly - ndi mtundu wa kukulitsa a chiwindi, amene pamodzi ndi kuwonjezeka mu ulamuliro tatchulawa.
3. Banti syndrome - kuwonjezeka munthawi yomweyo ndi ndulu, ndi chiwindi.

mankhwala a matenda

Kodi ngati wodwala matenda monga "splenomegaly"? Chithandizo cha limba ayenera kupita kwa wochititsa matenda. Monga amadziwika, matenda ndi chiwonetsero cha matenda ena. Iwo ayenera kukumbukira kuti ndulu zikuluzikulu palibe kufunika kuchitira bola ngati thupi la wodwalayo woterewu hypersplenism kwambiri.

Kawirikawiri limodzi ndi chithandizo cha amabweretsera akatswiri matenda kugwira mndandanda wa miyeso kusintha mkhalidwe wa mtima ndi mankhwala a splenomegaly. njira zimenezi mwina zotsatirazi:

• kuikidwa leukocyte kulemera;
• kupatsidwa zinthu za m'mwazi kuikidwa;
• glucocorticoid mankhwala wodwala (la ogwira ntchito mankhwala "prednisolone" mu kuchuluka kwa 20-40 mg ndi tsiku lililonse kwa miyezi 4-6);
• kuchotsa thupi yatupa kapena splenectomy.

alowererepo opaleshoni

Splenectomy anachita ndi akatswiri m'malo osowa. Monga ulamuliro, opareshoni ngati umalimbana kulimbana matenda akuluakulu. Childs splenectomy anachita pa zinthu zimenezi pathological monga thalassemia, splenic mtsempha occlusion, matenda Gaucher, ndipo khansa. kuchotsa ndi kukula ndulu chisankho opangidwa ndi dokotala aliyense payekha kwa wodwala aliyense. Izo zimatengera zinthu ndi chiopsezo ayenera moyo wodwalayo. Pambuyo pa kuwonongeka amphamvu limba angayambe splenic chophukacho, zimene zikuphatikizapo chiyani ndi kukha magazi mkati. Mwa njira, chifukwa ichi, anthu odwala amene anapezeka ndi "splenomegaly" koletsedwa kuchita masewera ndi ntchito zilizonse.

Kodi likuoneka kuchotsa ndulu ya?

Pakalibe thupi ili, kapena otchedwa asplenia, amapereka chiopsezo apamwamba kwambiri matenda ndi chamoyo ndi ena mavairasi moyo pachiswe, monga izi: Neisseria meningitidis, Hemophilus influenzae ndi Streptococcus pneumoniae. N'chifukwa chake pambuyo machitidwe a splenectomy nthawi zonse katemera onse mabakiteriya izi.

kuchira

Splenomegaly palokha ndi wosachiritsika. Ndipotu, si ndulu poyankha matenda ena aliwonse mu thupi la munthu. Mu magazi m'thupi, wodwalayo Kwalamulidwa chitsulo m'kamwa ndi Arsenic. Ngati zopatuka izi limodzi ndi thrombocytopenia ndi leukopenia, madokotala kuchotsa limba chofuna. Tikumbukenso kuti pambuyo opaleshoni ya mtima yomweyo amalembedwa kuchuluka kwa maselo othandiza magazi kuundana ndi leukocytes, zokha zizindikiro za hemorrhagic diathesis, wodwalayo anawonjezera kwambiri kwa kulemera ndi bwino chikhalidwe chake ambiri. Ngati wachinyamata ndi matenda izi padali Kuchedwa kukula, pambuyo splenectomy, zonsezi zifuma kubwerera mwakale. Ngati pa nthawi ya opaleshoni, wodwalayo palibe zikutha m'mayiko thupi, si akuona kusintha mu ziwalo ndi mafupa, ndiye m'malo mwamsanga chikhululukiro.

kuti adzimvera

Ambiri, monga matenda ndi splenomegaly si koopsa mofanana ndi matenda chimapangitsa. Tikumbukenso kuti panali nthawi zambiri amachita masiku ano zachipatala, ngakhale pamene anawonjezera kwambiri ndulu amabwerera kukula mwake pambuyo kuphatikiza mankhwala a matenda chachikulu. Izi mwina chifukwa chakuti njira yodziwira alipo kulola mofulumira kupeza chifukwa chenicheni cha splenomegaly ndi kuyamba m'ziwawa ake mankhwala.