Hepatomegaly: akakufunsani kusintha chiwindi. Kapangidwe ka ziwalo mkati

Moyo adalinso mosachotsera, matupi zofunika, monga aliyense wa iwo amachita ntchito yeniyeni. Pamene mmodzi sichitha, ena ali akusokoneza, ndipo lonse chamoyo. Choncho, vuto la chiwindi chifukwa kuwonongeka kwa thirakiti m'mimba, kachitidwe magazi ndi excretory, kumene kumakhala akutitsogolera kuti kuchepa chitetezo chokwanira, ndi zambiri mavuto ena m'thupi. Kodi chiwindi anthu, ndi kusintha okhudzidwa pathological mu izo?

Kapangidwe ka ziwalo mkati

Musanayambe kukamba za chiwindi, ganizirani mmene kapangidwe ka ziwalo zathu mkati, zomwe pali kugwirizana pakati pawo. Anthu, pali machitidwe zingapo: magazi, kupuma, minofu ndi mafupa, m'mimba, excretory, mantha kugonana. Aliyense ali ndi dongosolo zovuta. Popeza tikulankhula chiwindi, kupenda matupi chikugwirizana ndi izo, ndipo pafupi nthawi yomweyo za izo. Choncho, chiwindi athu - kooneka ili chabe m'munsimu zakulera kumanja a thupi, mu zonse m'mimba. M'mphepete pansi pa izo nkhawa ya kum'mero, m'mimba, ndulu ndi duodenum. Ndipo zigawo zake kukhudzana ndi impso lamanja ndi England adrenal. Kapamba lagona kumbuyo m'mimba. ndulu The imatengedwa mwa ife ndi thupi ambiri a chiwindi ndi ya ndulu ducts. Komanso, chiwindi misempha abwino, magazi ndi lymph ziwiya.

Kapangidwe ka chiwindi

Hepatomegaly (akakufunsani kusintha chiwindi) zikachitika, pamene miyeso zake wamkulu upambana 12-13 cm. Limba tichipeza anachoka ndi ufulu lobes, ndi dongosolo Claude Quinn ogaŵikana 8 zigawo. Aliyense gawo munthu (gawo) ali okwanira magazi, zhelchevyvedenie maukonde ndi mitsempha yake ulusi. magawo minofu (parenchyma) mawonekedwe elongated maselo (kwa chiwindi matabwa). Parenchyma chinamulowerera ya ndulu capillaries ndi mitsempha ya magazi. Pakati pa wina gawo chimafikira kwa chiwindi lalikulukulu Vienna, ndi pakati pawo - mitsempha, ya ndulu ducts ndi mitsempha ena. Mu kunsi kwa thupi pansi kulingalira, pali awiri lengthwise grooves ndi yopingasa wina. Izi otchedwa chiwindi chipata. Iwo kuphatikiza ya ndulu ducts onse, kupanga wamba, mpaka kufika duodenum ndi. mitsempha kwa chiwindi kupanga - zipata. Kwa izo, ndi kwa mitsempha mu utuluke yofunikayi limba magazi. kusintha akakufunsani zingakhudze onse a zinthu zakumwamba.

chiwindi

Imodzi mwa ntchito zazikulu za chiwindi athu - neutralizing ziphe, poizoni, mitundu yonse ya zinthu mlendo ndi zosafunika. iyo ili nawo onse zikuchitika mu thupi mitundu anthu a kagayidwe, chimbudzi, magazi, mu kupanga mavitamini ambiri ndi mahomoni. Ndi mtundu wa kusungiramo magazi ndi kufufuza zinthu. Zonse wotanganidwa opaleshoni mode, chiwindi poyera yatsoka momwemo njira zosiyanasiyana pathological. Mmodzi wa iwo - hepatomegaly, kusintha akakufunsani mu chiwindi, amene yodziwika ndi kuchuluka kwake. Anatsimikiza mtima palpation ndi ultrasound ndi yopangidwa tomography. The mitundu iwiri chomaliza kulola kusiyanitsa mosaphonyetsa zikuluzikulu chiwindi matenda ofanana ziwalo moyandikana (impso bwino, ndulu, intestine).

Zimayambitsa matenda

Lingaliro ndi akakufunsani kusintha thupi lonse, osati mbali ya izo, monga kudwala focal. Polemba hepatomegaly? kusintha akakufunsani chiwindi anali anamuona pa matenda otsatirawa:

• matenda enaake;
• mtima kulephera;
• chosaopsa ndi zilonda (khansa) zotupa;
• hemangioma;
• parasitic ndipo sanali parasitic cysts;
• matenda helminth;
• abscesses;
• TB, ndi ena opatsirana sifilisnoy kugonjetsedwa;
• kuledzera;
• madzi m'thupi;
• Metastasis kuchokera ku ziwalo loyandikana;
• poizoni ndi matenda a chiwindi;
• adenoma;
• carcinoma;
• hyperplasia.

Nthawi zina pali hepatomegaly wachete, ndiwo chizindikiro concomitant wa chimfine, ena matenda opatsirana, kutupikana.

zizindikiro

Zizindikiro akakufunsani chiwindi kusintha mu magawo oyambirira a matenda ndi kuwonetseredwa kwambiri. Wodwala angachite kusapeza mu lamanja nusu chapamwamba, poipa patapita mafuta ndi zakudya zokometsera, mowa. Komabe, pali odwala amene Samva chilichonse mpaka matenda chifukwa cha hepatomegaly, sapita ku mitundu pachimake, ndipo sizichitika kuwonjezeka kwambiri chiwindi. Zizindikiro zimadalira matenda chachikulu. Common monga:

• ululu mbali lake lamanja, makamaka pamene lakuthwa makina psinjika;
• nseru, mu zina kudutsa mu kusanza;
• kutentha;
• kuchepetsa kudya;
• jaundiced mtundu wa khungu;
• zosasangalatsa fungo ku M'mimbamo m'kamwa;
• nthawizina uko totupa, kuyabwa;
• okwana kudzitsitsa.

zizindikiro zosonyeza hepatomegaly

Staphylococcal, streptococcal ndi matenda pneumococcal zingachititse abscesses (suppuration) mu waukulu anthu prostate ndi chifukwa, kukulitsa chiwindi. Zizindikiro izi zikuphatikiza: ankanjenjemera, tachycardia, thukuta kwambiri, kupweteka kuzimiririka kumanja kwa thupi, ankagwirizana ngakhale tsamba ndi dzanja. Chithandizo mu nkhani iyi yokha opaleshoni. Mu matenda ena wamba - khansa ya chiwindi, amene chaka chilichonse amapha pa milioni miyoyo anthu - hepatomegaly, kuphatikiza mbali pamwamba, limodzi ndi chidwi kuwonda, kufooka, matumbo kukanika, flatulence. Matenda a chiwindi (chifukwa chachikulu ndi uchidakwa) ndi concomitant hepatomegaly yodziwika ndi ululu ufulu nusu chapamwamba, mu malo, matenda oopsa zipata, kukulitsa a ndulu ya. Mu matenda a chiwindi kukulitsa chiwindi komanso limodzi ndi ululu kumanja, ndi kwambiri kumatheka pamene maganizo thupi (mwachitsanzo, panthawi kudya kuyenda), nseru, kufooka ambiri.

diagnostics

Ngati wodwala anadandaula za ululu ufulu nusu chapamwamba, chinthu choyamba dokotala kupanga palpation ndipo mwina oterewa hepatomegaly. Akakufunsani kusintha Chiwindi angathe kuonedwa (kapena kutsutsa) ntchito kafukufuku zina. Mfundo palpation zitha kudziwa malire a thupi kuchuluka, kuchuluka kwa ululu, ndipo amatha osalimba a parenchyma. Ndipo matenda zina akusankhidwa ndi ultrasound, CT, Kujambula, ndipo chiwerengero cha zitsanzo. Njirazi ndi monga:

• Khama la bilirubin, ndi mapuloteni okwana m'mwazi;
• stercobilin mtima m'manyi;
• zitsanzo ndi katundu zhelchevyvodimymi zinthu (bromsulfoftalein, galactose);
• radioisotope maphunziro;
• chiwindi biopsy.

Bilirubin akufotokozera boma ufulu ndi kuchuluka. Munthu akakhala wathanzi alipo yekha kwaulere (0.4-1 mg / DL). Kuvutika anamuona pa matenda a chikasu ndiyo, kutupa ndi kuchulukana kwa tubules kwa chiwindi, mitundu ina ya matenda enaake. Ntchito zitsanzo za anatsimikiza monga otaya mapuloteni-kagayidwe mu chiwindi. Bromsulfoftaleinovaya chitsanzo amalola kuti aone ngati pali kuphwanya zopangitsa excretory (secretory) ntchito. Mu anthu athanzi pa mphindi 45 pambuyo kumayambiriro utoto m'magazi lili zochepa 5%. Chiyambi galactose amalola kuti tifufuza ndi zimam'patsa kagayidwe. biopsy The ikuchitika pansi zinthu zasayansi ndi amaganiziridwa matenda a chiwindi mu siteji zobisika, matenda enaake, khansa, fibrosis, ndi matenda ena. Izo contraindicated mu abscesses, ascites, yaitali obstructive matenda a chikasu ndiyo, syndrome hemorrhagic. radioisotopes Research (oyamba Bengal ananyamuka magazi) kukuchitidwa matenda ambiri chiwindi. Mu anthu athanzi magazi theka Achotsa utoto kwa mphindi 8.

Kudwala a kapamba

chiwindi ndi yogwirizana zopangitsa ena - kapamba. Kudwala limodzi zivute zitani kumabweretsa kusokonezeka kwa ena, kotero nthawi ya matenda, matupi awiri pa yomweyo cheke. kusintha akakufunsani kapamba (chiwindi si nkhawa) tingaone kudzera mwa ultrasound. Palpation si kumatanthauza. Ultrasound Kupenda limasonyeza miyeso, ndi osalimba pachilichonse za minofu echogenicity ndi (anasonyeza phokoso) kuti thupi zofunika, kutenga nawo mbali pa chimbudzi ndi mayamwidwe shuga (insulin katulutsidwe). kusintha akakufunsani ali anati mu kapamba, fibrosis, ndipo mogwirizana ndi zaka. Kupeza kusintha pa ultrasound, wodwala akhoza kunena mayesero zina (chopereka magazi, endoscopy wa duodenum ndi).

chithandizo

Ngati kapamba anaulula kusintha akakufunsani, koma wodwalayo kudandaula ayi, mankhwala si chofunika. Kapena ankachitira hepatomegaly wofatsa. Kawirikawiri, chikhalidwe ichi watsimikiza lokha pambuyo normalization wa mphamvu ndi kutha kwa matenda osadziwika bwino. Pamene chiwindi hepatomegaly kwenikweni chitani chithandizo matenda chachikulu, kuchititsa kudwala. Komanso, wodwalayo kuponyedwa pa zakudya kwambiri kuti amakonda onse menyu yokazinga, zokometsera, mchere, mafuta ndi mowa. Folk mankhwala akuonetsa kumwa infusions wa ananyamuka m'chiuno, chokeberry, madzi mchere, kudya otsika-mafuta kanyumba tchizi ndi uchi. Odwala munthu analimbikitsa yosalekerera kamwedwe, amaletsa zinthu zakuthupi.