tib neeg spleen

Tib neeg lub cev nqaij daim tawv yog tag nrho ntawm kev paub tsis meej. Ib tug ntawm lawv yog tus po.

Zoo li txhua lub cev tsis sib xws, tus po, qhov laj thawj, yuav tsum ua tib zoo "pob" hauv lub cev tom qab cov ntaub so ntswg thiab pob txha. Tab sis qhov tseeb, nws nyob ze rau ntawm qhov chaw thiab yog li ntawd yooj yim raug mob. Tus po tsis muaj lub luag haujlwm tshwj xeeb uas lwm yam kabmob ua tsis tau. Yog, thiab ib tug neeg tuaj yeem ua neej nyob yam tsis muaj nws (ntawm chav kawm, nrog kev hloov hauv kev ua neej). Tab sis nyob rau tib lub sijhawm, tus po tseem muaj nyob rau qee qhov laj thawj hauv txhua tus vertebrates. Thiab nyob rau hauv Suav teb, nws yog respectfully hu ua - "niam thib ob ntawm lub cev."

Tus po yog dab tsi, nws puas tuaj yeem mob, thiab nws kho li cas? Peb teb cov lus nug no thiab lwm yam nrog Tus neeg sib tw ntawm kev kho mob sciences, tus kws kho mob ntawm cov qeb siab tshaj plaws nrog kev tshwj xeeb hauv gastroenterology thiab cardiology Yulia Esipenko.

Dab tsi yog qhov tseem ceeb kom paub txog tib neeg tus po

Tib neeg spleen nyob qhov twg

Tus po yog nyob rau sab laug sab sauv ntawm lub plab kab noj hniav, me ntsis tom qab lub plab, nyob rau theem ntawm 9-11 tav. Ntawd yog, yog tias nws mob siab tshaj qhov qis ntawm cov tav ntawm sab laug, qhov no yuav yog tus po ua rau nws tus kheej hnov.

Saib ntawm qhov chaw ntawm lub cev, tus po yog nyob nruab nrab ntawm lub plab, sab laug raum thiab txoj hnyuv.

Tus neeg spleen zoo li cas thiab nws ua haujlwm li cas?

Outwardly, tib neeg spleen zoo li ib tug flattened taum: ib tug elongated oval duab, liab doog xim (raws li nws yuav tsum tau rau ib tug hematopoietic organ). Tus po yog nyob rau hauv lub parenchymal kab mob: uas yog, tsis muaj kab noj hniav nyob rau hauv (xws li, piv txwv li, nyob rau hauv lub plab), thiab cov ntaub so ntswg ua hauj lwm hu ua parenchyma. Nws zoo li daim txhuam cev, thiab tag nrho cov txheej txheem physiological tshwm sim hauv nws.

Lub "pulp" ntawm tus po yog dawb thiab liab pulp. Thawj tsim cov hlwb B, uas tsim cov tshuaj tiv thaiv kab mob, thiab T hlwb, uas ntes thiab rhuav tshem cov hlwb nrog cov tshuaj tiv thaiv txawv teb chaws. Liab pulp yog xav tau rau cov ntshav rov ua dua tshiab (ua rau cov laus thiab cov erythrocytes tsis zoo, koom nrog kev ua cov hlau), thiab tseem tshem tawm cov kab mob phem nrog kev pab ntawm macrophages thiab granulocytes.⁴ua hauj lwm raws li ib tug reservoir rau leukocytes thiab platelets. Raws li ib tug reservoir, tus spleen muaj txog ib khob ntawm cov ntshav, uas yog raug tshem tawm mus rau hauv lub dav circulatory system thaum xav tau.

Muaj ob qhov chaw ntawm tus po: diaphragmatic thiab visceral. Nyob rau tom kawg yog lub rooj vag ntawm tus po - ib hom chaw nres nkoj. Cov hlab ntsha splenic hla lub rooj vag, los ntawm qhov chaw uas cov ntshav nkag mus rau hauv lub cev, thiab cov hlab ntsha splenic tawm. Nws sau cov ntshav los ntawm tus po, plab, pancreas, thiab ntau dua omentum, tom qab ntawd koom nrog cov leeg mesenteric los tsim cov hlab ntsha portal. Los ntawm no, cov ntshav nrog cov khoom lwj nkag mus rau hauv daim siab rau detoxification, qhov tseeb, qhov kawg ua tiav.

Vim li cas tib neeg plees ua mob

Lub cev no muaj cov hlab ntsha xaus (vim tus neeg tuaj yeem hnov ​​​​mob) uas nyob hauv cov tshuaj ntsiav. Yog li ntawd, tus po tuaj yeem ua mob tsuas yog nrog kev nce hauv ntim, ntxiv rau, sai heev⁵. Qhov no tuaj yeem tshwm sim rau ntau qhov laj thawj.

Kev mob ntawm lub cev yuav tshwm sim, piv txwv li, thaum lub sij hawm los yog tom qab khiav. Vim lub load, cov ntshav ntim tau nce ntau heev, tus po yog ncab, thiab cov kev xav tsis zoo no tshwm sim nyob rau sab laug hypochondrium, paub txog ntau yam (nco txog yam tsawg kawg ntawm kev kawm lub cev). Hauv cov poj niam cev xeeb tub, tus po, nrog rau lwm cov plab hnyuv siab raum, yog "kev tsim txom" los ntawm lub tsev menyuam nyob rau theem tom ntej, uas tuaj yeem ua rau mob.

Feem ntau cov poov tshuaj tshwm nyob rau hauv cov lus xaus ntawm cov kws kho mob: lub cev feem ntau puas thaum sib ntaus sib tua thiab ua phem ua phem. Thiab txawm hais tias tus po yog nyob tom qab cov tav, nws nyob ze ntawm qhov chaw, yog li nws tuaj yeem raug mob tsis yog nrog riam phom, tab sis tsuas yog nrog lub nrig lossis txawm tias thaum ntog.

Muaj ntau qhov laj thawj rau kev mob ntawm tus po nyob rau hauv lub plab mog. Lawv tshwm sim tsis tau tsuas yog los ntawm qhov mob, tab sis kuj los ntawm lwm yam tsos mob. Wb tham txog lawv.

Nws feem ntau lees paub tias ib tug neeg tsuas muaj ib tus po xwb. Tab sis muaj qhov txawv txav ntawm cov ntaub so ntswg loj hlob: outwardly, nws zoo li ntxiv "mini-spleens". Lawv raug hu ua science - accessory spleens.³. Qhov teeb meem yog tias txawm tias lawv qhov me me (feem ntau txog li 2 cm), lawv tuaj yeem ua rau cov hlab ntsha, ua rau tsis zoo rau kev noj qab haus huv.

Kev tshem tawm ntawm tus po

Feem ntau tus po yog immobile vim ligaments tuav nws. Tab sis qee zaum, piv txwv li, tom qab ntau lub cev xeeb tub lossis kev loj hlob ntawm lub cev, lub ligamentous apparatus tsis muaj zog, thiab tus po tuaj yeem hloov thiab txawm tias twist. Volvulus ntawm tus po yog qhov txaus ntshai tshaj plaws ntawm kev hloov pauv, vim tias nws tuaj yeem ua rau thrombosis lossis txawm tias necrosis ntawm cov ntaub so ntswg ntawm lub cev (necrosis).

Ib tug neeg uas muaj tus po spleen hnov ​​mob vim qhov nro ntawm ligaments thiab cuam tshuam ntawm cov txheej txheem circulatory.

Thrombosis ntawm splenic leeg

Tawm tsam keeb kwm ntawm kab mob pancreatic lossis kis kab mob, tom qab raug mob, xws li teeb meem xws li thrombosis ntawm splenic vein tuaj yeem tsim. Tab sis qee zaum cov ntshav txhaws hauv lumen ntawm cov hlab ntsha ntawm lawv tus kheej, tsis muaj teeb meem yav dhau los.

Nrog rau tag nrho cov hlab ntsha, cov ntshav tawm ntawm tus spleen nres, lub cev loj tuaj.

Qhov peculiarity ntawm tus kab mob yog tias thaum xub thawj nws pib mus unnoticed los ntawm ib tug neeg. Tom qab ntawd, muaj qhov mob thiab hnov ​​​​qhov hnyav ntawm sab laug, qee zaum qhov kub thiab txias nce. Qhov no yog li cas cov txheej txheem inflammatory manifests nws tus kheej. Qee lub sij hawm muaj hemorrhagic syndrome: nosebleeds, ntuav nrog ntshav.

Thawj cov tsos mob, koj yuav tsum sab laj nrog kws kho mob: tej zaum koj yuav tsum tau tso tseg cov ntshav kom tsis txhob muaj teeb meem.

Spleen infarction

Tus kab mob no cuam tshuam nrog kev ua txhaum ntawm cov ntshav: thaum lub sijhawm ntev cov ntshav tsis ntws zoo rau hauv ib lossis lwm qhov chaw, nws maj mam tuag. Qhov no tshwm sim vim hais tias cov ceg ntawm cov hlab ntsha splenic tsis txuas nrog ib leeg thiab tsis tuaj yeem pab tsim cov ntshav ntws thaum muaj qhov "ua tsis tiav".

Infarction ntawm tus po tuaj yeem qhia tau tias:

• mob nyob rau hauv sab laug hypochondrium, radiating mus rau sab laug xub pwg (nce los ntawm inhalation);
• txias, kub taub hau subfebrile⁶.

Raws li cov cim qhia, splenic infarction tuaj yeem tsis meej pem nrog mob pancreatitis lossis pyelonephritis. Tab sis qee zaum, lub plawv nres yuav tsis tshwm sim nws tus kheej.

Neoplasms

Lub cyst yog ib qho kab mob txawv txav hauv tus po uas tuaj yeem ua rau los yog kis tau (piv txwv li, tom qab raug mob lossis kab mob parasitic). Yuav muaj ntau yam neoplasms hauv ib lub cev. Cov tsos mob yuav tsis tshwm sim ntev mus txog thaum lub cyst (los yog cysts) loj tuaj. Qhov mob yog nruab nrab. Ntawm lwm cov tsos mob: hnyav nyob rau sab laug hypochondrium, tsis muaj zog, tso zis tsis zoo, hloov quav.

Yog tias tsis muaj teeb meem, thiab lub cyst nws tus kheej tsis loj hlob sai, feem ntau tsis tas yuav kho - tab sis nws yuav tsum tau saib xyuas tsis tu ncua. Hauv cov xwm txheej nyuaj, ntau yam kev xaiv muaj peev xwm ua tau, mus txog rau kev tshem tawm.

Lwm yam neoplasms kuj txawv: benign (piv txwv li, hemangiomas, lipomas) thiab malignant.

Kev qaug zog, tsis muaj kev nyuaj siab, mob thiab hnyav nyob rau sab laug, tsis qab los noj mov thiab poob ceeb thawj - cov tsos mob no yuav tsum tau them sai sai rau thiab mus ntsib kws kho mob tam sim ntawd.

Qeb

Ib kab noj hniav uas muaj cov kua paug hauv tus po. Feem ntau, ib qho abscess tsim los ua ib qho teeb meem ntawm lwm tus kab mob. Qhov ua rau tuaj yeem yog kab mob, raug mob (thaum hematoma pib fester), lossis tus po spleen infarction. Ntxiv nrog rau qhov mob, cov tsos mob tuaj yeem ua npaws, ua daus no, thiab tawm hws.

Tib neeg spleen kho li cas?

Rau txhua qhov kev hloov pauv hauv kev noj qab haus huv, koj yuav tsum sab laj nrog kws kho mob. Txhawm rau pib, mus ntsib tus kws kho mob. Tus kws kho mob yuav tshuaj xyuas, sau ntawv xeem thiab lwm yam kev tshawb fawb, yog tias tsim nyog, xa mus rau tus kws kho mob nqaim. Kev kuaj mob yuav xav tau kev kuaj kuaj, ultrasound, fluoroscopy, xam tomography.

Tom qab tsim kev kuaj mob, tus kws kho mob yuav sau ntawv kho mob. Conservative txoj kev kho, ua ntej ntawm tag nrho cov, muab kev thaj yeeb thiab txias nyob rau hauv lub cheeb tsam ntawm sab laug hypochondrium. Tus so nyob ntawm tus kab mob.

Npaj

Kev siv tshuaj yog hais txog kev kho mob. Cov tshuaj tsuas yog muab los ntawm kws kho mob thiab tsuas yog raws li cov lus qhia.

Piv txwv li, nrog rau kev kuaj mob abscess, broad-spectrum antibacterial tshuaj yog muab ntxiv rau kev phais txoj kev kho mob.

Splenopexy

Thaum tus po tsis muaj teeb meem (nyob rau hauv daim ntawv ntawm caws pliav los yog necrosis), kev ua haujlwm yog ua los txuas lub cev mus rau lub diaphragm. Qhov tseeb, tus po yog sutured kom nws tsis txav ib ncig ntawm lub plab kab noj hniav kom tsis txhob muaj kev pheej hmoo ntawm kev sib tw.

Kev phais

Kev ua haujlwm yog ua tiav yog tias xav tau kev phais nyob rau sab sauv lossis qis ntawm tus po, thiab tib lub sijhawm nws muaj peev xwm cawm tau lub cev. Ib feem ntawm tus po tuaj yeem raug tshem tawm, piv txwv li, nrog cov qog nqaij hlav.

Splenectomy

Qhov no yog lub npe ntawm kev ua haujlwm kom tshem tawm tus po. Indications rau qhov no tej zaum yuav muaj ntau yam kab mob thiab anomalies (piv txwv li, hloov chaw ntawm lub cev uas provoked volvulus thiab necrosis).

Nws muaj peev xwm ua neej nyob tsis muaj tus po: lub luag haujlwm tseem ceeb ntawm lub cev "disassemble" lub siab thiab cov qog ntshav ntawm lawv tus kheej. Tab sis tib lub sijhawm, kev pheej hmoo ntawm kev kis tus kab mob txaus ntshai, xws li meningococcus thiab pneumococcus, nce ntxiv. Yog li ntawd, cov neeg uas tau tshem lawv tus po rau qee qhov laj thawj raug pom zoo kom txhaj tshuaj tiv thaiv ntau yam kab mob, suav nrog mob khaub thuas.⁴.

Lwm Cov Kev Kho Mob rau Spleen

Nyob ntawm qhov qhia tau hais tias, kev kho mob sib txawv yuav xav tau.

Abscesses thiab qee cov hlwv yuav xav tau cov kua dej percutaneous. Los ntawm ib lub qhov me me, tus kws kho mob ntxig lub raj xa dej mus rau hauv lub cev, los ntawm cov ntsiab lus ntawm cov kab noj hniav raug tshem tawm thiab kho nrog tshuaj tua kab mob.

Yog tias kuaj tau mob qog noj ntshav, tus kws kho mob tuaj yeem sau tshuaj khomob thiab / lossis kev kho hluav taws xob. Tab sis tsuas yog nyob rau theem pib. Qib 3 thiab 4 ntawm oncology tsuas yog tshem tawm cov poov xab.

Yuav ua li cas kom koj tus po nyob hauv tsev

Kev tiv thaiv kab mob ntawm tus po muaj xws li cov lus pom zoo rau kev noj qab haus huv. Qhov no yog kev noj zaub mov zoo nrog ntau cov zaub, tshuaj ntsuab thiab txiv hmab txiv ntoo, kev ua neej nyob, tsis muaj tus cwj pwm phem. Tab sis muaj qee cov cai tshwj xeeb uas koj yuav tsum tau ua yog tias koj tsis xav mus ntsib kws kho mob.

• Tsim nyog ib ce muaj zog. Nws yog ib qho tseem ceeb rau kev txav mus los, vim tias txoj kev no koj tuaj yeem zam kev stagnation hauv lub cev. Tab sis nws yog ib qho tseem ceeb kom ua raws li txoj cai kev nyab xeeb - nco ntsoov tias tus po yog qhov tsis zoo, nws yooj yim rau kev puas tsuaj.
• Hnav khaub ncaws raws li huab cua thiab qhov loj me. Tus po tuaj yeem hnov ​​​​mob hnyav rau hypothermia, tab sis qhov no tuaj yeem zam tau los ntawm kev hnav khaub ncaws tsim nyog rau huab cua txias thiab cua. Nyob rau tib lub sijhawm, cov khaub ncaws yuav tsum yog qhov loj me, tsis nruj heev: cov hlua khi thiab cov hlua khi tuaj yeem cuam tshuam cov ntshav ncig.
• Wb tham txog detox. Tus po yuav zoo yog tias koj haus dej ntshiab txaus txhua hnub (xws li dej, tsis yog tshuaj yej, kas fes lossis kua txiv hmab txiv ntoo). Nws tseem yog ib qho tseem ceeb uas yuav tsum tau xyuam xim rau cov khoom noj uas koj noj (qhov sib txawv E-Necks yuav tsum khaws cia kom tsawg). Thiab tsis txhob siv yeeb tshuaj: ib qho "chemistry" cuam tshuam tsis zoo rau lub xeev ntawm tus po thiab nws cov hlab ntsha.

Nrov lus nug thiab lus teb

Yuav ua li cas paub txog thawj cov teeb meem nrog tus po, thiab lwm cov lus nug nrov tau teb Tus neeg sib tw ntawm kev kho mob sciences, tus kws kho mob ntawm cov qeb siab tshaj plaws nrog kev tshwj xeeb hauv gastroenterology thiab cardiology Yuliya Esipenko.

Qhov chaw ntawm:

1. Cov qauv thiab kev ua haujlwm ntawm tus po. Reina E. Mebius, Georg Kraal // Xwm txheeb xyuas kev tiv thaiv kab mob. URL: https://www.nature.com/articles/nri1669
2. Kev txheeb xyuas ntawm Splenic Reservoir Monocytes thiab lawv xa mus rau qhov chaw mob. Filip K. Swirski, Matthias Nahrendorf, Martin Etzrodt, lwm tus // Science. 2009. 325(5940). 612–616 : kuv. URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2803111/
3. Accessory spleen mimicking ib sab xis-sided retroperitoneal qog. TA Britvin, NA Korsakova, DV Undercut // Bulletin of Surgery. 2017. URL: https://cyberleninka.ru/article/n/dobavochnaya-selezyonka-imitiruyuschaya-pravostoronnyuyu-zabryushinnuyu-opuhol/viewer
4. Txheej txheem cej luam ntawm Spleen. Harry S. Jacob // MSD Phau Ntawv Qhia. URL: https://www.msdmanuals.com/en-gb/professional/hematology-and-oncology/spleen-disorders/overview-of-the-spleen
5. Mob plab: kev kuaj mob sib txawv, kev kho tau zoo. HE. Minushkin // RMJ. 2002. No. 15. URL: https://www.rmj.ru/articles/gastroenterologiya/Abdominalynaya_boly_differencialynaya_diagnostika_vozmoghnye_lechebnye_podhody/
6. Kev phais rau cov kab mob ntawm tus po. Kev pab qhia ntawv. AV Bolshov, V.Ya. Khryshchanovich // BSMU Minsk. 2015. URL: http://rep.bsmu.by/bitstream/handle/BSMU/7986/366534-%D0%B1%D1%80..pdf?sequence=1&isAllowed=y