Muscat isibindi: anatomy, Histology, patomorfologija

Muscat isibindi - phetho ezingamahlalakhona congestive plethora emithambo yegazi yezitho zangaphakathi. Lesi simo sibonakala hhayi kuphela isimiso sokugaya ukudla bungene, kodwa inhliziyo, amaphaphu, izinso kanye nobuchopho.

ngezigaba

Morphologically kunezigaba ezintathu izinguquko ezenzeka esibindini njengoba isifo siqhubeka:

1. Muscat isibindi: ku isizinda okunamafutha amaseli (ophuzi) kubonakala vasodilatation (obomvu amnyama).
2. cystic Emgodini onomthombo: indwangu kuyinto ayazika ngenxa ezicutshini of ukuhluma. Igazi soaks le parenchyma isitho, kanye kokuvela izilonda sclerosis.
3. Senhliziyo isifo sokusha: surface body iba ukubukeka engalingani.

omsakazo

Ukwephula ukugeleza kwegazi emiphumeleni uhlelo portal kwetinhlavu ezinjengokungcoliswa Muscat isibindi. Izimbangela yokujama tsi - kuphula umthetho we ventricular umsebenzi kanye nokuncipha ukubuya emithambo yegazi. Lokhu okubonakalisa congestive ukumelwa inhliziyo, futhi zivame ukuhambisana nesifo senhliziyo nemithambo yayo. ingcindezi Ukwandisa uhlelo emithambo yegazi, kanye ukucinana yokujama tsi igazi imithambo yegazi zithikameze ngempumelelo ukugeleza kwegazi kwezitho zomzimba.

lwezifo

Lesi sifo awahlobene ubulili kanye neminyaka. Kodwa wezibalo iningi ithinta abesilisa senile abadala. Ngokuvamile, kwesidumbu kuphela kungacacisa ukuthi isiguli sine-Muscat isibindi. Necropsy kungenzeka ukunikeza izimpendulo ozithandayo udokotela. Ukuze wenze lokhu, ama-ejensi kungukuthi zibukeke kuphela esikalini, kodwa futhi wathumela i- luhlolo histological.

engcupheni isifo sesibindi kukhona ukungawuvivinyi umzimba, ukudla okungenamsoco, imikhuba emibi, khona isifo senhliziyo emlandweni, kanye yobudala umuntu omdala sika.

umtholampilo

Ezimweni eziningi, izimpawu yinhliziyo yibona esithombeni emitholampilo ye isifo, ukuze isiguli kungenzeka uqaphele ukuthi linezinkinga isibindi. Muscat isibindi, kanye nanoma yimuphi omunye ngokoma kwesibindi, owabonakaliswa ubuhlungu ngakwesokudla quadrant engenhla, jaundice kwesikhumba futhi lwamafinyila ulwelwesi, ukuvuvukala emilenzeni ekupheleni kosuku, ascites (ekuqongeleleni uketshezi ngaphakathi komgodi ongaphakathi kwamathumbu). Kodwa kungcono zonke izimpawu bezimo. Beka ngamaphesenti ayikhulu Kungahlonzwa ngomshini kuphela ngemva kwesidumbu, ngoba noyedwa izindlela zokuthwebula izithombe zokwelapha zanamuhla ayikwazi ukubonisa ukuthi umzimba ufana amakinati. Isibindi palpation kuyinto obukhulu, onqenqemeni is babanjwa futhi protruded kusukela lwaleli costal.

ukuhlola

Ukuze lokwenza ukuxilongwa "ezingamahlalakhona yokwenziwa ukuminyana emithambo yegazi", kumele:

1. Ukuqinisekisa ubukhona yinhliziyo (instrumentally noma behlolwa):

• -X-ray yesifuba (ekhombisa ukuguquka kwenhliziyo, ukuminyana emithambo yegazi emaphashini, noma ukuba khona effusion pleural);
• Doppler Ukuhlola inhliziyo, futhi bakhiphe elezinga eliphansi vena cava (ukuhlonza izimbangela yesifo senhliziyo);
• CT noma i-MRI;
• ECG.

2. Feza ukuhlolwa laboratory yegazi, njenge-chemistry kokusebenza kwesibindi ukuhlolwa :

• igazi bilirubin owandiswayo;
• transaminase ngokulinganisela anda (ALT, AST);
• nesanda phosphatase ane-alikhali;
• wehlise e-albumin futhi ayewukela isikhathi ekunqandeni.

3. Baphendukele ukuhlola wezinsimbi, ukusungula iqiniso ukonakala morphologically kwesibindi. Lezi izifundo zihlanganisa:

• laparocentesis (khulula aspirating uketshezi ngaphakathi komgodi ongaphakathi kwamathumbu) ukunquma izimbangela ascites;
• biopsy inaliti (ukuqinisekisa ukuxilongwa "Muscat isibindi" amaslayidi zingenziwa futhi ukuphila lesiguli).

Imiphumela yaloku kuhlola okungenhla Comparative kuhlanganisa izifo ezifana isifo sokusha oludakayo, umdlavuza, isifo senhliziyo, hemochromatosis, thrombosis ka bakhiphe elezinga eliphansi vena cava kanye nomfutho wegazi ophezulu portal. Ungakhohlwa mayelana izifo ezibangelwa amagciwane isibindi - nokohlobo A, B, C, D, E. Ngaphezu kwalokho, kukhona kungenzeka isifo yisinanakazana.

yezinkinga

Muscat isibindi okubangela isifo sokusha yakhe inhliziyo akazange umphumela ephethwe yisifo senhliziyo. Ezimweni lapho yokwehluleka kwesibindi acute kwaba imbangela yokufa, kukhona ezingavamile futhi ayikwazi kubhekwe Indlela. Ukopha iziyaluyalu - futhi ngempela ezingavamile, nakuba ayengafiki engakaze ibonwe. Abanye ochwepheshe usola ukuthi kukhona ukuhlobana phakathi kwesibindi sokuqina kwesibindi nesenzakalo izimila ebulalayo, kodwa lo mbono engakaze lawo.

ukwelashwa

ukwelashwa kufanele okuhloswe ngalo ukubhekana nesifo ecashile, okusho yokumelwa yinhliziyo. A isifo sokusha ngokwako ayinakho oluthile lokwelapha. Ngaphezu kwalokho, isiguli uyayalwa ukulandela ukudla nge izivimbelo usawoti isifuba ukushintsha oda usuku lwakho ukulala kahle, abe ngaphandle futhi ukuvocavoca umzimba ngokwanele. Lezi manipulations elula kungasiza ukunciphisa umfutho wegazi izitsha ezinkulu, kuhlanganise e vein portal.

therapy okunezimpawu kuyinto isisu (ukunciphisa inani loketshezi esiswini), ne-beta-blocker futhi ACE inhibitors (i-ukuzinza wenhliziyo).

ukwelashwa Steel ngokuvamile hhayi lwenziwa. Lihlobene nokubhekana ubuso nengozi enkulu ukuze isiguli futhi akusho bathethelele uqobo. Ngezinye izikhathi, udokotela angase anqume ukundlula ingxenye vein portal intrahepatic, kodwa lokhu kungaholela ezinzima inhliziyo ukwehluleka ilungelo uhlobo ventricular futhi edema yamaphaphu ngenxa ngokucijile ukwandisa ukubuya emithambo yegazi.