Vim li cas cov qog ntshav qab zib supraclavicular loj tuaj? Yog vim li cas rau txoj kev loj hlob ntawm xws li ib tug pathological phenomenon yuav tau teev nyob rau hauv qab no. Koj tseem yuav kawm txog cov kabmob no yog vim li cas ib tug neeg xav tau lawv, thiab yuav kho lawv li cas thaum mob.
Cov ntaub ntawv tseem ceeb
Supraclavicular lymph nodes, loj ob peb zaug, qhia txog kev ua haujlwm tsis zoo hauv lub cev. Thiab ua ntej qhia koj txog dab tsi cov kab mob provoke xws li pathology, koj yuav tsum paub seb cov kab mob no yog dab tsi.
Lymph nodes yog cov qog me me uas zoo li taum. Raws li koj paub, lawv nyob thoob plaws hauv tib neeg lub cev thiab yog ib feem tseem ceeb ntawm cov kab mob lymphatic, txhawb cov qog thiab cov as-ham, nrog rau tshem tawm cov khoom tsis tsim nyog rau hauv cov hlab ntsha.
Raws li cov kws tshaj lij, cov qog ntshav qab zib supraclavicular thiab tag nrho cov lymphatic system tag nrho yog qhov tseem ceeb tshaj plaws ntawm tib neeg lub cev tiv thaiv kab mob, uas tiv thaiv lub cev los ntawm ntau yam kab mob. Cov qog no lim cov qog, cov kab mob, cov kab mob thiab lwm yam teeb meem, uas yuav raug puas los ntawm cov qe ntshav dawb, lossis yog li ntawd.hu ua lymphocytes.
Lymph nodes tuaj yeem ua ib leeg lossis pab pawg. Lawv qhov ntau thiab tsawg sib txawv los ntawm me me mus rau loj heev. Nyob rau hauv ib lub xeev o, lub supraclavicular lymph node yog hnov nyob rau hauv lub cheeb tsam ntawm lub supraclavicular fossa. Tsis tas li ntawd, cov qog zoo sib xws tuaj yeem pom nyob rau hauv armpits thiab puab tais, tab sis lawv muaj ntau lub npe. Nyob rau hauv lub xeev noj qab haus huv, lymph nodes tsis ua mob. Tsis tas li ntawd xwb, lawv tsis pom qhov muag thiab tsis pom kev kiag li.
Ua rau mob
Vim li cas cov qog ntshav qab zib supraclavicular loj tuaj? Yog vim li cas rau txoj kev loj hlob ntawm xws li ib tug pathology yuav muab zais nyob rau hauv ntau yam teeb meem. Feem ntau, cov qog nqaij hlav ib leeg raug mob thiab o vim muaj ntau yam kev raug mob, nrog rau cov qog lossis kab mob uas tshwm sim ncaj qha rau hauv lawv lossis hauv cov kabmob uas nyob ze. Yog li, nyob ntawm seb cov qog ua paug, nws muaj peev xwm txheeb xyuas lawv qhov ua rau nce.
Piv txwv li, cov qog nqaij hlav supraclavicular ua rau mob vim mob qog lossis mob hauv siab, ntsws, plab, lossis caj dab. Yog li ntawd, nrog xws li pathology, nws yog cov kabmob no uas yuav tsum tau kuaj xyuas ua ntej.
Kab mob ua rau mob qog nqaij hlav
Vim li cas cov qog supraclavicular ua rau mob? Kev loj hlob ntawm cov qog no tuaj yeem tshwm sim ua ke nrog kev mob ntawm lwm cov qog hauv lwm qhov chaw ntawm lub cev. Nyob rau hauv cov ntaub ntawv no, lawv hais txog generalized lymphadenopathy. Cov kab mob pathological no feem ntau tshwm sim los ntawm:
- Mononucleosis, cov tsos mob uas mob caj pas, ua npaws thiab qaug zog.
- kab mob kab mob, nrog rau mob caj pas (vim yog kab mob streptococcus).
- kab mob Lyme (ib kab mob kis los ntawm qee hom zuam).
- kis kab mob - cytomegalovirus.
- kab mob kis, suav nrog rubella, qhua pias, mumps lossis kab mob qhua pias.
- Cancer, suav nrog Hodgkin tus kab mob, leukemia thiab lymphoma.
- Kev mob tshwm sim ntawm kev siv Phenytoin, tshuaj siv los tiv thaiv qaug dab peg.
- Cov tshuaj tiv thaiv tsis zoo los ntawm cov tshuaj tiv thaiv kab mob qog-measles-rubella.
- Acquired Immune Deficiency Syndrome.
- Venereal disease - syphilis.
Metastases rau supraclavicular lymph nodes
Cov tshuaj niaj hnub paub txog cov hauv qab no ntawm kev sib kis cov qog nqaij hlav:
- lymphogenic;
- mixed;
- hematogenous.
Rau lymphogenous metastasis, nkag mus ntawm cov qog hlwb ua ntej mus rau hauv cov hlab ntsha lymphatic, thiab tom qab ntawd mus rau cov qog ntshav nyob ze lossis nyob deb, suav nrog cov supraclavicular sawv daws, yog yam ntxwv. Feem ntau, mob qog noj ntshav epithelial (piv txwv li, melanoma) kis tau li no. Xws li metastasis tau kawm zoo, yog li nws yooj yim heev kom paub txog cov qog ntawm theem ntawm nws qhov pib.
Metastases nyob rau hauv cov qog ntshav saum cov pob txha caj dab feem ntau tshwm sim hauv ntsws lossis mob qog noj ntshav mis, nrog rau cov qog nqaij hlav malignant hauv thaj tsam peritoneal.
Vim txoj kev loj hlobmetastases
Metastases hauv ib lub cev xws li supraclavicular lymph node feem ntau kis vim:
- hnub nyoog yam (tseem pom feem ntau hauv cov laus);
- qhov loj thiab qhov chaw ntawm qhov pib ua kom pom tseeb ntawm neoplasm (cov qog loj ntau zaus ua rau muaj qhov tshwm sim ntawm metastases);
- comorbidities (cov kab mob ntev uas ua rau lub cev tsis muaj zog tiv thaiv);
- kis ntawm cov qog nqaij hlav qog nqaij hlav (kev loj hlob ntawm kev tsim rau hauv phab ntsa ntawm lub cev yog qhov txaus ntshai thiab feem ntau ua rau cov qog nqaij hlav loj hlob mus rau hauv lub lumen ntawm lub cev).
Kev kuaj kab mob
Cov qog ntshav qab zib supraclavicular nyob qhov twg? Qhov chaw ntawm cov qog no hauv lub xeev noj qab haus huv yog qhov nyuaj rau kev txiav txim siab. Yog tias cov kabmob no tau mob, ces lawv tuaj yeem yooj yim palpable hauv supraclavicular fossae.
Kev kuaj mob ntawm cov qog ntshav qog ntshav yuav tsum tsuas yog ua los ntawm tus kws kho mob paub txog. Ua li no, nws tshuaj xyuas qhov chaw supraclavicular los ntawm cov leeg nqaij sternocleidomastoid mus rau acromioclavicular leeg. Nyob rau tib lub sijhawm, thaj tsam ntawm ob txhais ceg ntawm cov leeg sternocleidomastoid yog ua tib zoo xyuas. Hauv cheeb tsam no, palpation yog nqa nrog ib nrab lossis ntiv tes taw.
Nrog rau kev soj ntsuam kom meej thiab sib sib zog nqus ntawm cov subclavian fossae, lawv cov seem sab nraud raug soj ntsuam ntawm cov npoo ntawm cov leeg deltoid. Hauv cov neeg noj qab haus huv, cov qog ntshav qab zib supraclavicular tsis tuaj yeem ua palpable.
Lwm txoj kev kuaj mob
Ib qho mob supraclavicular lymph node ntawm sab laug lossis sab xis tuaj yeem kuaj pompalpation, uas yog, ib txwm soj ntsuam nrog ob txhais tes. Tsis tas li, cov qog no muaj rau kev tshawb fawb hauv cov hauv qab no:
- Ultrasound. Ultrasound soj ntsuam ntawm lub supraclavicular lymph node yog qhov yooj yim tshaj plaws, paub thiab tsis mob txoj kev los xyuas nws qhov txawv txav.
- Computed tomography yog ib txoj kev nyuaj. Tib lub sijhawm, nws tsuas yog siv los ntsuas qhov mob ntawm cov qog ntshav qab zib uas tsis tuaj yeem nkag mus rau cov palpation palpation.
- X-ray kuaj. Txoj kev no yog siv tsawg heev. Raws li txoj cai, cov qog ntshav loj tuaj yeem pom ntawm lub hauv siab x-ray heev los ntawm kev sib tsoo.
- Mediastinoscopy, thoracoscopy thiab laparoscopy.
- Biopsy.
Qhov kawg ntawm kev kuaj mob thiab tshawb nrhiav qhov ua rau cov qog nqaij hlav loj yog qhov tshwm sim ntawm kev kuaj ntshav. Lwm txoj kev tshawb fawb muab cov ntaub ntawv tsuas yog hais txog cov yam ntxwv sab nraud ntawm lub caj pas o. Thiab tsuas yog tom qab kev tshuaj xyuas cov qauv ntawm lub cev hauv lub tshuab kuaj kab mob, nrog rau los ntawm kev soj ntsuam PCR thiab cov kab mob bacteriological, ib tus tuaj yeem hais nrog kev ntseeg siab txog qhov tseeb ua rau qhov loj ntawm cov qog nqaij hlav.
txheej txheem kho
Yuav ua li cas thiaj kho tau cov kab mob supraclavicular lymph node ntawm sab xis lossis sab laug? Kev kho mob ntawm cov qog no muaj nyob rau hauv kev tshem tawm ncaj qha ntawm qhov ua rau nws nce, mob thiab o. Tshwj xeeb, tus kab mob no tau kho nrog tshuaj tua kab mob, thaum kis kab mob tuaj yeem ploj mus ntawm nws tus kheej yam tsis siv tshuaj.
mob hnyav duaIb rooj plaub ntawm o ntawm supraclavicular lymph node yog qog nqaij hlav cancer. Yog tias muaj qee qhov laj thawj me me uas xav tias qhov nce hauv lub cev no cuam tshuam nrog cov kab mob oncological, tom qab ntawd yuav tsum tau ua biopsy thiab, tau kawg, kev kuaj xyuas tiav los ntawm tus kws kho mob paub txog.
Yog li, yog tias cov qog ntshav qab zib loj zuj zus tsis tau ploj mus hauv ib hlis, thiab tib lub sijhawm lawv qhov loj me tsis tau txo qis, ces koj yuav tsum mus ntsib tus kws tshaj lij tam sim. Nws tsis tuaj yeem hais tias cov qog no tuaj yeem o tau ntev ntev tom qab kis tus kab mob. Qhov tshwm sim no tshwj xeeb tshaj yog rau cov menyuam yaus.
Cov Ntaub Ntawv Tshwj Xeeb
Thaum cov qog nqaij hlav loj, suav nrog supraclavicular, nco ntsoov tias:
- Qhov loj ntawm cov qog ntshav ib txwm yog li 1-1.5 cm;
- qhov laj thawj tseem ceeb rau qhov loj ntawm lub cev no yog kab mob hauv zos;
- tus neeg mob laus dua, qhov tshwm sim ntau dua ntawm qhov ua tsis zoo ntawm qhov tshwm sim pathological;
- noj tshuaj tua kab mob yam tsis tau tsim qhov tseeb ntawm kev txhim kho lymphadenopathy yog kev kho mob cuav (thawj qhov kev kuaj mob yuav tsum tau ua, thiab tsuas yog tom qab ntawd cov kev kho mob tsim nyog tau sau tseg);
- yog tias qhov loj ntawm qhov tsis tau txo qis hauv ib hlis, tom qab ntawd nws cov kev kuaj mob histological thiab biopsy tau ua tiav;
- loj ntawm cov qog thiab spleen yuav tsum tau kuaj tam sim;
- nthuav cov qog ntshav nrog rauqhov nce hauv lub cev kub thiab mob hauv thaj tsam ntawm lawv qhov chaw qhia tias muaj kab mob sib kis;
- Ib tus qog nqaij hlav qog nqaij hlav tuaj yeem coj los ntawm caj dab lossis axilla, thiab cov qog ntshav hauv lub puab tsaig tsis haum rau kev kuaj mob;
- aspiration ntawm lub caj pas loj nrog rab koob biopsy tsis nqa cov ntaub ntawv kuaj mob vim nws tsis muab lub tswv yim ntawm kev hloov pauv.
