Splenomegaly - kuyini? Izimpawu, izimbangela, ekwelapheni splenomegaly

Splenomegaly - kuyini? Impendulo umbuzo, uthola mncinyane. Ngaphezu kwalokho, sizoxoxa kungani lesi sifo kwenzeka, ziyini izimpawu zaso, inqubo ukuxilongwa kanye nokwelashwa.

Uhlolojikelele

Splenomegaly - kuyini? Ngo umkhuba emtholampilo, leli gama libhekisela sifo, elinesimo ukukhulisa abalulekile ubende. Ngokuvamile, lokhu kwenzeka lapho umfanekiso umzimba ohilelekile inqubo sokugembula kusukela ngaphandle. Nokho, kufanele kuphawulwe ukuthi isisindo ubende, ngisho esimweni esejwayelekile kungaba okukhulu (2-emhlanjini) kunanoma iyiphi enye isitho. Yingakho embundwini lapho ukwanda yomzimba kubhekwa splenomegaly, njalo okunemibandela. Ngakho, usesimweni evamile isisindo ubende omdala imayelana 100-150 g ku palpation umzimba ophilile ngeke sidlule 7 cm (kulinganiswa ngokuphambeneyo). Sitholakele "ubende splenomegaly" sibeke ngempela ezingavamile. Lokhu kwenzeka ngaphansi kwezimo ezilandelayo:

• uma usayizi umzimba idlula ukubaluleka wathi;
• Uma onokuqundeka splenic ngokungavamile okukhulu;
• Uma ubende kusobala selitholakala ngu palpation.

Indima ubende emzimbeni womuntu

Splenomegaly - kuyini? Impendulo umbuzo esixoxe ngazo ngenhla. Ubende iyingxenye ebalulekile izivikeli mzimba. Njengoba yaziwa, it has fasoleobraznuyu ukuma itholakala engxenyeni engenhla kwesokunxele esiswini - noma kunalokho ngezansi diaphragm. Ngakho ubende uzimisele phakathi 9th futhi ubambo 11. Ngokuvamile kumuntu omdala umzimba ophilile womuntu emelelwa ukala mayelana 150 amagremu. Ihlanganisa ingxenye ku-komgodi ongaphakathi kwamathumbu yokulinganisa cishe 11 amasentimitha ohlangothini mpo.

ubende

umzimba Kwethulwa ufeza indima ebalulekile emzimbeni womuntu. Umsebenzi wakhe ukushabalalisa eziphilayo angaphandle noma amagciwane kwegazi, kanye namasosha ngoba izivikeli mzimba futhi ususe ukuqothuka kwezinwele okungavamile kuphelile egazi.

Kufanele kuqashelwe ukuthi ubende kungase kwandise ngobukhulu ngisho nalapho imisebenzi yayo evamile, ekuphenduleni yisiphi isifo. Lokhu kungenxa yokuthi izifo ezithile ezithinta amaseli weengazi, uyakwazi okwandisa ukugeleza kwegazi emzimbeni. Ngokusho kochwepheshe, lesi sifo ezithinta ubende, kaningi ukukhonza imbangela usayizi wakhe omkhulu. Nokho, uphethwe "splenomegaly" ukubeka ezimweni ezingajwayelekile. Ngemva nesanda umzimba akusho ngaso sonke isikhathi khuluma ngesimo sakhe ongaphilile.

Okungavamile usayizi ubende

Splenomegaly - kuyini? Lokhu inkinga itholakala lapho i-ngokungavamile ubende lakhulisiwe. Kulokhu, umzimba kuboniswe lungaba mayelana 500 amagremu, kanye Ubukhulu bayo ngobukhulu - ziyahlukahluka kusuka ngamasentimitha 11 kuya ku-20. Splenomegaly, izimbangela zezinkumbulo esiphila iyohlola ngezansi, ephelezelwa esisindo engaphezu kuka-1000 amagremu kanye nobude obungamamitha angaphezu 20 amasentimitha, kubhekwa omkhulu futhi ezisindayo. Ukuze ekwelapheni lesi sifo isiguli kungase kudingeke ukwelashwa adjuvant noma ukuhlinzwa.

Splenomegaly: izimbangela zezifo

Kukhona ungenye yezimbangela eziningi kulesi simo sokugembula. Ziyakwazi ezihlukahlukene futhi ngokuvamile ziyahlukahluka kusukela ezimileni abulalayo (umdlavuza), ukuminyana (noma ukwanda oluqinile ukugeleza kwegazi) kanye nezifo ezinye izifo isitho kokuziphatha ukuba Izifo ukuvuvukala futhi izifo kwamangqamuzana egazi.

Cabanga yezimbangela ezivame kakhulu ubende elase landile, okuyinto zifaka izimo ezifana nalezi:

• umdlavuza wegazi (isib wegazi, lymphoma noma myelofibrosis);
• izifo kwamangqamuzana egazi (ezifana spherocytosis, thalassemia noma isikela cell anemia);
• isifo sesibindi (isb, ukusha kwesibindi kohlobo C, isifo sokusha ngenxa kwesibindi kohlobo B okungamahlalakhona, ukusetshenziswa isikhathi eside utshwala kanye okunamafutha isibindi) ;
• Izifo ukuvuvukala (rheumatoid arthritis kanye lupus erythematosus);
• isifo Gaucher (noma isifo lipid umzimba);
• normal ukugeleza kwegazi futhi occlusion imithambo yegazi, emithanjeni (isib splenic umthambo thrombosis, congestive senhliziyo futhi ukuvaleka vein portal);
• idiopathic purpura thrombocytopenic;
• izifo eziningi (endocarditis webhaktheriya, mononucleosis, ingculaza, umalaleveva, Leishmania, Mycobacterium, njll d.).

Splenomegaly: izimpawu

Njengoba yaziwa, ukuphambuka ezifana splenomegaly, asinazo izimpawu ezithile. Nokho, ezivame kakhulu phakathi kwabo azicacile ubuhlungu besisu futhi ukuvuvukala. Konke lezizibonakaliso splenomegaly kubhekwe nonspecific. Kufanele kuqashelwe ukuthi abanye abantu ubende kanzima lakhulisiwe ngokuvamile akhononde satiety ekuseni futhi esiswini izimpawu Reflux.

Isibonakaliso lokugcina isifo kwenzeka ngenxa yokuthi ngenxa ingcindezi ngaphakathi komgodi ongaphakathi kwamathumbu isisu iqala bayeke.

Kwezinye izimo, izimpawu ezihlobene nokwanda umzimba, yilezi ezilandelayo:

• ukujuluka ebusuku;
• umkhuhlane;
• kwesisindo;
• ubuthakathaka jikelele;
• pallor;
• nokulimala kalula;
• ukukhathala.

Lapho futhi kubani ukuba afune usizo lwezokwelapha?

Splenomegaly ezinganeni nakubantu abadala kudinga observation esiyisibopho i kudokotela onolwazi oluthé. Nokho, hhayi wonke umuntu has a isimo sokugembula, uyazi ukuthi kufanele baphenduke noma yimuphi udokotela. Kule ndaba kufanele kuphawulwe ukuthi kukhethwa uchwepheshe kuncike ngokuyinhloko yini usekhonze ukuthuthukisa lesi sifo. Ngakho, iziguli zingase ubheke eyisazi (udokotela owelapha ngokukhethekile ekwelapheni izifo igazi), Oncology (umdlavuza izimila Uchwepheshe) kanye gastroenterologist (izifo emathunjini onguchwepheshe, kuhlanganise kwesibindi). Ngemva ekuhambeleni kwethu kokugcina ukuze udokotela kufanele aqhube luhlolo umnyuziki yezokwelapha bese babela ukwelashwa okuphumelelayo.

Kuye izimbangela zesifo kubantu nale Ihlahlubo kungadinga esibhedlela esiphuthumayo. Ngokuvamile, lokhu kwenzeka uma isiguli babulawa ubuhlungu besisu futhi izimpawu ukopha futhi ukutheleleka, awekho ngaphansi ukunakekelwa ekhaya.

ukuhlolwa

Ngemva ukwelashwa isiguli kuchwepheshe kwasekuqaleni ulinde luhlolo. Ukuze wenze lokhu, odokotela basebenzisa izindlela palpation kanye eshaywayo. Ngalezi zindlela zinikeza Usayizi ubende. Esimweni esejwayelekile mayelana 3% wabantu unomzimba kalula palpable. Nokho mass palpable e kwesokunxele esiswini engenhla zingahluka ngempela ngenxa imbangela, futhi ubende akuzona lakhulisiwe. Yingakho ochwepheshe zisebenzisa nezinye izindlela zokuxilonga.

Uma splenomegaly ku palpation alutholakalanga, kodwa zonke izimpawu zibonisa ikhona, isiguli yabelwe kwegazi ezivamile. Ngokuhamba lolu cwaningo, izazi zisanda kuhlola ukwakheka, ukuma, kanye nenombolo wamangqamuzana egazi amhlophe, izinhlayiya zegazi kanye amangqamuzana abomvu egazi. Lezi zinkomba ingase futhi uphike noma uqinisekise khona lesi sifo.

ukuxilongwa splenomegaly

Uma isibalo ochwepheshe ihlaziya emva kuhlolwa futhi ukungabaza ekutheni imiphumela ke uphethwe esinembile eyenziwa ultrasound, kanye computer futhi magnetic resonance tomography. Lezi zindlela anganikeza izithombe ezinemininingwane yezitho zangaphakathi, futhi ngenxa yalokho, ukunquma ngokunembile ukuba khona noma ukungabi yesifo. Kufanele kuqashelwe ukuthi le magnetic resonance imaging siyasebenza ikakhulukazi ngesikhathi ukuzimisela splenic umthambo thrombosis noma thrombosis ingosi.

Ngaphandle kwabo bonke abanye, ukuze kuhlonzwe izifo ezifana usebenzisa cwaningo radioisotope. Le ndlela enembile kakhulu elikwaziyo ukuze kuchazeke kahle ingxenye kwezicubu ubende. Nokho, indlela samanje kunzima nokusebenzisa eqolo.

zinhlobo isifo

Kuye izizathu isimo esinjalo sokugembula yokwelashwa kwakhe kungaba ezahlukene. Kufanele kuqashelwe ukuthi namuhla ngokuvamile kakhulu iziguli elikushoyo ngalokhu uphethwe ngokuthi "isibindi splenomegaly." Nakuba inkulumo ethi aluyona kweqiniso, kodwa empeleni, kweNdikimba ubende uvame ukuhambisana ukwanda ezinye izitho zangaphakathi. iphethini okunjalo kungaba ngokuphawulekayo sibe sibi isimo lesiguli kanye nokwelashwa kwayo.

1. splenomegaly Maphakathi - kuyini? Lokhu kweNdikimba ubende, esadaleka ngenxa yimuphi izenzakalo sokugembula kuthabathela ecaleni.
2. Hepatomegaly - uhlobo ukukhulisa kwesibindi, okuyinto kuhlangene nokwanda igunya oshiwo ngenhla.
3. Banti syndrome - ukukhuphuka kanyekanye futhi ubende, futhi isibindi.

ekwelapheni lesi sifo

Kuthiwani uma isiguli okwatholakala "splenomegaly"? Ukwelashwa isitho kufanele iqondiswe imbangela eyinhloko isifo. Njengoba yaziwa, lesi sifo siwukubonakaliswa omunye isifo. Kufanele kuphawulwe ukuthi ubende lakhulisiwe asikho isidingo aphathe nje umzimba lesiguli akwenzeki ngokuphazima hypersplenism ezinzima.

Ngokuvamile parallel ekwelapheni eyisisekelo Ochwepheshe isifo afeze uchungechunge izinyathelo yokuthuthukisa ngezimo zesiguli futhi ekwelapheni splenomegaly. Izinqubo ezinjalo phakathi okulandelayo:

• ukumpontshelwa leukocyte isisindo;
• ukumpontshelwa platelet;
• ukuphathwa glucocorticoid isiguli (ayabelwe izidakamizwa "prednisolone" e isamba 20-40 mg nsuku zonke izinyanga 4-6);
• kokukhipha umzimba lakhulisiwe nobe splenectomy.

kokungenela kuhlinzwa

Splenectomy eyenziwa ongoti kunalokho ezingavamile. Njengomthetho, ukuhlinzwa okunjalo okuhloswe ngazo ukulwa nezifo ezinkulu. Ngokuvamile splenectomy eyenziwa ngaso izimo zokucabanga okubangelwa isifo ezifana thalassemia, splenic vein occlusion, isifo Gaucher, futhi wegazi. ukususa i-ubende isinqumo lakhulisiwe senziwa udokotela ngayinye esigulini ngasinye. It kuncike isimo futhi ingozi kungenzeka ukuphila kwesiguli. Ngemva ngesikhathi umonakalo eqinile isitho singenzeka ukudabuka splenic, okuyinto Kwakuyohlanganisani i ukopha zangaphakathi. By endleleni, ngenxa yalesi sizathu, uma kuhlinzwa iziguli ezifuna uxilongwe "splenomegaly" akuvumelekile ukuba sihlanganyele emidlalweni futhi iyiphi okhandlayo.

Yini esongela ukususwa ubende?

Ukungabi bikho lokhu umzimba, noma okuthiwa asplenia, inikeza isengozini enkulu nakakhulu inani labantu ebaphethe nge umzimba abanye amagciwane ezisongela ukuphila, okuhlanganisa lokhu okulandelayo: Neisseria meningitidis, Hemophilus influenzae futhi Streptococcus pneumoniae. Yingakho ngemva ekusebenzeni splenectomy kufanele njalo zigonyelwe yonke ala magciwane.

yokutakula

Splenomegaly ngokwayo alelapheki. Phela, kuphela impendulo ubende ukuze isiphi esinye isifo umzimba womuntu. Ngo kwegazi, isiguli ezinqunyiwe yensimbi temlomo na-arsenic. Uma lokhu ukuphambuka kuhambisana thrombocytopenia futhi leukopenia, odokotela ukususa isitho avuvukele. Kufanele kuqashelwe ukuthi emva kokuhlinzwa isiguli ngokushesha ezinophawu ukwanda kwenani zegazi kanye leukocyte, fade izimpawu oluhambisana diathesis, isiguli unezela kakhulu isisindo futhi kuthuthukisa isimo sakhe jikelele. Uma ingane nale Ihlahlubo kwase kudlule isikhathi ekukhuleni, ngemva splenectomy, konke kuza emuva evamile. Uma ngesikhathi ukuhlinzwa, lesi siguli kungekho Ukuwohloka umzimba, futhi ningagcini izinguquko izitho namathambo, khona-ke kunalokho ngokushesha ku ukuthethelelwa.

Kufinyeta

Ngokuvamile, kokutshelwa ngokukhubazeka kwengane kuba splenomegaly ingozi njengoba kuba isifo ecashile. Kufanele kuqashelwe ukuthi kwakukhona Ezimweni eziningi zokwelapha zanamuhla, ngisho nalapho lakhulisiwe kakhulu ubende ubuyela lingakanani evamile ngemva ukwelashwa lesi sifo ecashile. Kokunye, lokhu kubangelwa yokuthi izindlela zokuxilonga ekhona ukuvumela ukuba ngokushesha ukukhomba imbangela splenomegaly kweqiniso futhi uqale ukusebenzisa imithi yayo ngokugcwele.