Lo lus "adenopathy ntawm cov qog ntshav qab zib" yog hais txog cov kab mob pathological uas tshwm sim los ntawm kev hloov pauv hauv cov duab thiab nce qhov loj ntawm ib lossis ib zaug tag nrho pawg ntawm pawg uas yog ib feem ntawm cov hlab ntsha. Feem ntau, tus kab mob tsis tshwm sim ntawm nws tus kheej, tab sis tsim tawm tsam keeb kwm ntawm tus kab mob uas yog qhov ua rau muaj kev cuam tshuam. Nrog rau kev kho mob raws sij hawm, qhov kev mob tshwm sim feem ntau yog qhov zoo. Tsis quav ntsej qhov teeb meem tuaj yeem ua rau muaj teeb meem ua rau tus neeg mob lub neej txaus ntshai.
Kev txhim kho mechanism
Cov kab mob lymphatic zoo ib yam hauv cov qauv rau cov hlab ntsha thiab cov hlab ntsha. Outwardly, nws zoo li cov cag ntoo. Ib qho tshwj xeeb ntawm lymphatic system yog tias nws sib sau ua ke cov kabmob sib txawv rau hauv ib qho tag nrho. Tsis tas li ntawd, nws yog lub luag haujlwm rau tshem tawm cov kua dej ntau dhau, cov tshuaj lom thiab cov kab mob los ntawm cov ntaub so ntswg. Nws kuj tseem koom nrog hauv kev thauj khoom tseem ceeb thiab ntxiv dag zog rau lub cev tiv thaiv kab mob.
Lymph nodes nyob thoob plaws lub cev. Cov pab pawg sib cais yog nyob hauv thaj chaw axillary, caj dab, puab tais. Nyob rau tib lub sijhawm, qhov nce me ntsis hauv cov qog ntshav (tsawg dua 1 cm inch) tsis yog qhov ceeb toom. Ib qho xwm txheej zoo sib xws tuaj yeem tshwm sim hauv tus neeg noj qab haus huv, uas cuam tshuam nrog cov txheej txheem physiological hauv lub cev.
Raws li kev cuam tshuam ntawm ntau yam tsis zoo, qhov loj ntawm cov qog nqaij hlav (1 cm inch lossis ntau dua) tuaj yeem tshwm sim. Nyob rau tib lub sijhawm, thaum palpation, nws tuaj yeem pom cov pawg uas tau hloov pauv loj hauv ib cheeb tsam lossis ob peb zaug ib zaug. Nyob rau hauv thawj rooj plaub, nws yog kev cai los tham txog localized adenopathy ntawm lymph nodes, nyob rau hauv lub thib ob - txog generalized.
Tus kab mob no tshwm sim raws li hauv qab no: ib qho me me ntawm cov ntshav thiab cov kab mob uas nkag mus rau hauv lub cev nkag mus rau hauv cov kua dej lom hauv cov pawg. Hauv qhov no, cov qog ntshav qab zib yuav tsum tau tshem tawm ntawm cov teeb meem sib txuas ua ntej nws nkag mus rau hauv lub hauv paus venous txaj. Cov kab mob, ntawm qhov tod tes, tuaj yeem kis tau rau pawg (raws li txoj cai, qhov no tshwm sim thaum lub cev tiv thaiv tsis muaj zog) thiab nyob twj ywm hauv lawv, ua lawv txoj haujlwm tseem ceeb. Lub sijhawm no, cov qog ntshav qab zib pib loj tuaj, ua rau lub cev tiv thaiv kab mob thiab sim tiv thaiv cov neeg ua haujlwm txawv teb chaws. Feem ntau, cov pawg ua mob. Daim duab kho mob ncaj qha nyob ntawm thaj chaw twg ntawm lub cev raug cuam tshuam.
Raws li International Classification of Diseases (ICD-10), lymphadenopathy tau muab tus lej R59.
Yog vim li cas
Pathology tsis tshua muaj kev ywj pheej. Lymphadenopathy yog ib yam kab mob uas feem ntau tshwm sim tawm tsam keeb kwm yav dhau los ntawm lwm yam kab mob uas tau ua rau muaj kev cuam tshuam.
Qhov laj thawj tseem ceeb ntawm pathology:
- Ntau hom kab mob sib txawv. Feem ntau, cov neeg mob muaj stomatitis, pharyngitis, hniav abscess, HIV, tuberculosis, mononucleosis, toxoplasmosis, thiab STDs yog cov kab mob tseem ceeb. Tsis tshua muaj, kab mob lymphadenopathy yog tshwm sim los ntawm cytomegalovirus, brucellosis, histoplasmosis, plague, tularemia, nas-tom kub taub hau, thiab paracoccidioidomycosis. Feem ntau, pawg nyob rau ntawm caj dab raug cuam tshuam, tsawg dua nyob rau hauv lub puab tsaig, thaj tsam saum lub caj dab. Nyob rau hauv lub xub ntiag ntawm tus kab mob HIV, adenopathy ntawm lymph nodes yog generalized.
- Neoplasms. Tus kab mob no tshwm sim tawm tsam keeb kwm ntawm leukemia, lymphoma, thiab qog nqaij hlav metastasis.
- Pathologies ntawm lub cev: lupus erythematosus, sarcoidosis, kab mob Kawasaki.
- Noj tej yam tshuaj. Kev siv cov tshuaj, cov tshuaj nquag uas yog allopurinol, atenolol, carbamazepine, quinidine, captopril, phenytoin, feem ntau ua rau cov qog ntshav nce ntxiv. Tsis tas li ntawd, pathology tsim tawm tsam keeb kwm yav dhau los ntawm kev noj tshuaj tua kab mob uas koom nrog hauv pawg hauv qab no: penicillins, cephalosporins, sulfonamides.
- Nyob rau hauv cov poj niam, qhov ua rau ntawm tus kab mob yog feem ntau yog lub installation ntawm silicone implants nyob rau hauv lub mammary qog.
Cov kab mob lymphatic ncaj qha rau kev tsim cov tshuaj tiv thaiv kab mob thaum nkag mus raulub cev ntawm ntau tus neeg txawv teb chaws. Tias yog vim li cas nws txoj kev koom tes hauv cov txheej txheem pathological tuaj yeem tshwm sim rau ntau qhov laj thawj, qhov tseem ceeb ntawm cov kab mob inflammatory thiab kis kab mob, nrog rau ntau hom qog.
Tuberculosis, oncological pathologies thiab HIV yog cov kab mob uas ua rau muaj kev hem thawj rau tus neeg mob lub neej. Txawm li cas los xij, feem ntau, adenopathy ntawm cov qog ntshav tau kuaj pom hauv cov neeg mob uas tsis tshua muaj kev hem thawj.
Los ntawm qhov pom ntawm lub tswv yim ntawm kev loj hlob ntawm tus kab mob, nws tsis muaj teeb meem dab tsi ntawm tus neeg sawv cev provoking nkag mus rau hauv lub cev. Qhov no yog vim qhov tseeb tias qhov kev hloov pauv ntawm cov qauv node ib txwm zoo ib yam.
Symptoms
Daim duab kho mob ntawm tus kab mob ncaj qha nyob ntawm nws daim ntawv, tus yam ntxwv ntawm tib neeg lub cev thiab cov kab mob hauv qab. Qee qhov xwm txheej, qhov swb ntawm ib qho ntawm ib qho yuav muaj kev siv zog ntawm kev tshwm sim ntau dua li kev hloov pauv hauv tag nrho pawg pawg.
Muaj ib yam li "reactive lymphadenopathy". Qhov no yog ib qho mob hnyav ntawm tus kab mob, uas muaj qhov cuam tshuam loj heev hauv tus neeg mob tus mob. Nws txhawj xeeb txog kub taub hau, ua daus no, tawm hws ntau, hauv zos hyperemia thiab mob. Yog tias tsis kho, muaj kev ua txhaum ntawm kev ncaj ncees ntawm cov ntaub so ntswg ntawm cov qog nqaij hlav. Nyob rau tib lub sijhawm, cov kab mob inflammatory tau nqa mus thoob plaws hauv lub cev nrog cov ntshav khiav, ua rau muaj kev loj hlob ntawm cov kab mob sepsis.
Ua ntej ntawm tag nrho, nrog lymphadenopathy, muaj qhov nce hauv cov pob loj. Nws yog ib qho tseem ceeb kom nkag siab tias lawv li qubTsis muaj qhov sib txawv ntawm lub cev sib txawv.
Daim duab kho mob thiab qhov mob hnyav ntawm cov tsos mob ntawm cov qog nqaij hlav hauv txhua kis yog txawv. Lawv ncaj qha nyob ntawm seb qhov tsub zuj zuj ntawm thaj chaw twg koom nrog hauv cov txheej txheem pathological. Hom kab mob:
- Cervical lymphadenopathy. Hom kab mob ntau tshaj plaws. Lub knot yog zoo palpable. Nws muaj ib tug bumpy nto thiab ib tug ntom kev ntxhib los mos. Daim tawv nqaij tam sim ntawd saum lub pob caus ua liab thiab nruj. Tus neeg mob xav tias tsis xis nyob, cov tsos mob ntawm kev tsis haum tshuaj yuav tshwm sim. Nodes mob. Yog tias lawv muaj cov ntsiab lus purulent, kub taub hau ntxiv rau cov tsos mob ntawm ncauj tsev menyuam lymphadenopathy. Muaj ntau pawg ntawm cov nodes nyob rau hauv cheeb tsam no. Feem ntau yog mob: parotid, occipital, submandibular. Adenopathy ntawm lymph nodes nyob rau hauv caj dab feem ntau tsim tawm tsam keeb kwm ntawm kis kab mob. Tsawg zaus, nws tshwm sim los ntawm oncology thiab autoimmune pathologies.
- Axillary lymphadenopathy. Tus kab mob yog nrog los ntawm kev nce hauv cov nodes, uas tam sim ntawd tau txais ib daim ntawv cone-puab. Tsis tas li ntawd, cov neeg mob muaj cov tsos mob hauv qab no: kev tsis zoo ntawm kev noj qab haus huv, tawm hws ntau dhau (feem ntau thaum hmo ntuj so), qhov hnyav ntawm lub cev poob qis, ua npaws, ua pob khaus ntawm daim tawv nqaij, redness hauv zos, o ntawm thaj chaw ntawm lub cev. kev sib sau. Nws yog ib qho tseem ceeb kom paub tias adenopathy ntawm axillary lymph nodes yog benign pathology nyob rau hauv feem ntau. Txawm li cas los xij, qee zaum cov neeg mob kuj raug kuaj mob cancer.
- Lymphadenopathy ntawm mediastinum. Feem ntau tshwm sim tom qab mob ntsws. Feem ntau cov tsos mob ntawm adenopathy ntawm cov qog nqaij hlav intrathoracic: mob, hnoos, ua tsis taus pa, poob ntawm daim tawv muag sab sauv, tsis xis nyob thaum zaub mov nkag mus rau hauv txoj hlab pas, kub taub hau, tsis muaj zog, mob taub hau, khaus ntawm daim tawv nqaij. Tus kab mob tuaj yeem ua rau mob hnyav thiab mob hnyav.
- Y Retroperitoneal lymphadenopathy. Ib qho tshwj xeeb ntawm hom kab mob no yog qhov tseeb tias cov qog nqaij hlav loj tuaj yeem tsis tuaj yeem kuaj pom thaum kuaj pom qhov muag. Txhawm rau kuaj xyuas cov kab mob pathology, nws yog ib qho tsim nyog yuav tsum ua x-ray lossis ultrasound kuaj. Cov tsos mob ntawm adenopathy ntawm lymph nodes ntawm lub plab kab noj hniav: tawm hws ntau dhau, tsis muaj zog, nce me ntsis hauv lub cev kub, raws plab. Ntawm palpation, tus kws kho mob pom qhov nce ntawm tus po thiab daim siab.
Thaum cov tsos mob ntawm cov qog nqaij hlav o tshwm sim, koj yuav tsum hu rau tus kws kho mob sai li sai tau. Qhov no yog vim qhov tseeb tias cov kab mob pathogenic kis tau sai heev nrog cov kua dej lom lom nyob hauv pawg.
Diagnosis
Thaum thawj cov cim ceeb toom tshwm sim uas qhia tias lymphadenopathy (axillary, cervical, mediastinal, thiab lwm yam), koj yuav tsum sab laj tus kws kho mob. Yog tias tsim nyog, nws yuav xa koj mus rau kev sab laj nrog cov kws kho mob nqaim (tus kws kho mob, tus kws kho mob oncologist, kws phais mob, kws kho mob, kws kho mob endocrinologist, kws kho mob urologist lossis gynecologist).
Lub luag haujlwm tseem ceeb hauv kev kuaj mob ntawm adenopathy ntawm cov qog nqaij hlav muaj anamnesis. Tus kws kho mob tshwj xeeb yuav tsum muabcov ntaub ntawv hais txog cov tsos mob thiab lawv qhov hnyav, nrog rau tham txog ntu ntawm kev raug mob, kev kis kab mob yav dhau los, nrog rau qhov xwm txheej ntawm kev sib deev. Tom qab ntawd, tus kws kho mob ua qhov kev ntsuam xyuas, thaum lub sijhawm nws ntsuas qhov loj, zoo li, qhov ntom ntom, mob thiab thaj chaw ntawm qhov cuam tshuam los yog pawg pawg.
Raws li cov txiaj ntsig ntawm qhov kev kuaj mob thawj zaug, tus kws tshaj lij tau tshaj tawm kev xa mus rau kev tshuaj ntsuam xyuas, suav nrog:
- kuaj ntshav thiab biochemical kuaj ntshav thiab zis.
- Test Wasserman.
- Kev kuaj mob.
- HIV test.
- YUltrasound.
- X-ray kuaj.
- CT, MRI.
Yog tias muaj qhov tsis txaus ntseeg ntawm tus kab mob malignant, ib qho piv txwv ntawm cov pob txha pob txha biomaterial lossis cov ntsiab lus ntawm cov node raug coj mus rau kev tshawb fawb cytological thiab histological.
kev kho mob zoo
Qhov ntim ntawm cov kev ntsuas kho ncaj qha nyob ntawm lub hnub nyoog ntawm tus neeg mob, daim ntawv ntawm tus kab mob, qhov hnyav ntawm tus neeg mob tus mob. Kev xaiv ntawm kev siv tswv yim rau kev kho mob ntawm adenopathy ntawm cov qog ntshav qab zib yog ua tiav tom qab kev txheeb xyuas cov kab mob hauv qab, uas ua rau muaj kev cuam tshuam.
Yog tias cov khoom sib txuam thiab cov ntaub so ntswg ib puag ncig cuam tshuam los ntawm kev kis kab mob, qhia tshuaj tua kab mob. Ua ntej qhov kev nkag siab zoo ntawm cov kab mob rau qee yam tshuaj raug nthuav tawm, cov kws kho mob tau sau tshuaj tua kab mob uas koom nrog pawg cephalosporins thiab fluoroquinolones. Raws li txoj cai, cov kws tshaj lij pom zoonoj Medakson thiab Levofloxacin. Lub sijhawm kho yog nyob ntawm tus kheej tus yam ntxwv ntawm tus neeg mob txoj kev noj qab haus huv thiab qhov hnyav ntawm tus kab mob.
Cov kab mob kis sai heev thoob plaws lub cev los ntawm cov qog ntshav. Hauv qhov no, kev kho mob hauv zos ntawm tus kab mob yuav tsum tau kho nrog ceev faj. Tag nrho cov nyiaj yuav tsum raug sau los ntawm kws kho mob, tsuas yog nws tuaj yeem ntsuas qhov tsim nyog ntawm lawv siv. Yuav luag txhua qhov xwm txheej, cov kws tshaj lij pom zoo kom siv Vishnevsky cov tshuaj pleev. Tus neeg sawv cev yuav tsum raug siv ncaj qha rau cov qog ntshav qog ntshav.
Yog tias thaum lub sijhawm kuaj ntshav kuaj pom tias cov txheej txheem pathological yog qhov tsis zoo, tus neeg mob tau txais kev khomob khomob. Qhov tshwm sim ntawm tus kab mob no ncaj qha nyob ntawm qhov hnyav ntawm tus kab mob hauv qab.
Raws li kev kho mob ntxiv, cov kws kho mob tau sau cov tshuaj tiv thaiv kab mob. Lawv yog tsim los ntxiv dag zog rau lub cev tiv thaiv thaum lub sij hawm sib ntaus tawm tsam tus kab mob. Glutoxim pom muaj kev ua haujlwm siab hauv kev xyaum.
Surgery
Feem ntau, adenopathy yog kho nrog tshuaj. Kev cuam tshuam kev phais yog pom zoo tsuas yog thaum cov ntsiab lus ntawm cov qog nqaij hlav yog sawv cev los ntawm cov kua dej purulent.
Hauv cov xwm txheej zoo li no, kev txiav txim siab ntawm kev kawm raug ua tiav. Nws yog nqa tawm, raws li txoj cai, siv cov txheej txheem txheej txheem - qhib kev phais. Tom qab tau txais kev nkag mus, tus kws phais tshem tawm cov ntsiab lus purulent, txhim kho cov kua dej, los ntawm txoj kev.uas yuav yog qhov tawm ntawm qhov tso tawm, thiab stitches.
Txoj kev ua neeg
Kev siv cov txheej txheem tsis yog ib txwm siv tsis tas yuav tsum tau nrhiav kev pab kho mob uas tsim nyog. Kev siv lwm txoj kev tso cai, tab sis tsuas yog tom qab tau txais kev pom zoo los ntawm tus kws kho mob tuaj koom. Qhov no yog vim lub fact tias nyob rau hauv tej rooj plaub, tej yam ntuj tso tshuaj muaj peev xwm ua rau tus kab mob no loj zuj zus.
Daim ntawv qhia ua tau zoo tshaj plaws:
- Sib tov cov nyom tshiab dandelion nyom. Moisten ib lub paj rwb swab nyob rau hauv cov kua txiv tso tawm thiab siv tom kawg ncaj qha mus rau cov qog nqaij hlav. Lotion tuaj yeem ua 3 zaug hauv ib hnub.
- Sib tov sib npaug ntawm nettle thiab yarrow. Sib tov cov khoom no thiab ncuav 500 ml ntawm dej. Muab lub thawv rau hluav taws. Boil rau 20 feeb. Cia lub broth txias. Noj peb zaug ib hnub ua ntej noj mov.
- YMix 500 g ntawm goose los yog badger rog nrog boletus (cov nroj tsuag tshuaj). Cov tom kawg yuav tsum tau noj 6 tbsp. l. Kho thaj chaw muaj kev cuam tshuam nrog cov tshuaj pleev uas tshwm sim.
Tus yam ntxwv ntawm tus kabmob hauv menyuam yaus
Txog thaum tus me nyuam muaj 12 xyoos, cov kab mob lymphatic tsis paub qab hau. Nyob rau tib lub sij hawm, nws pib tsim txawm nyob rau hauv lub sij hawm ntawm intrauterine txoj kev loj hlob. Nws yog vim qhov tsis paub tab ntawm lub cev ntawm cov menyuam yaus uas adenopathy ntawm cov qog ntshav tau kuaj pom ntau zaus.
Nyob rau hauv tus menyuam yug tshiab, kev txuam nrog yuav tsum tsis txhob ua palpable. Txwv tsis pub, nws yog txoj cai los tham txog lawv qhov kev nce ntxiv, thiab yog li ntawd, txog qhov muaj tus kab mob pathologic altxheej txheem.
Thawj 12 lub hlis ntawm lub neej yog suav tias yog qhov tseem ceeb. Nyob rau hauv no hais txog, yog tias pom muaj palpable formations, nws yog tsim nyog hu rau ib tug kws kho mob. Thaum lub hnub nyoog no, o ntawm cov pawg nyob tom qab ntawm lub taub hau, hauv puab tais thiab ntawm caj dab feem ntau tshwm sim. Nyob rau hauv ib tug me nyuam, qhov ua rau o ntawm lymph nodes yog feem ntau kis kab mob. Tsis tas li ntawd, adenopathy feem ntau tsim tawm tsam keeb kwm ntawm cov kab mob pathologies thiab kev tiv thaiv kab mob. Hauv kev sib cais, tus kab mob tshwm sim nrog helminthic ntxeem tau thiab muaj kev tsis haum tshuaj. Raws li kev txheeb cais, 10% ntawm cov neeg mob hluas raug kuaj mob qog nqaij hlav.
Yog tias tus menyuam muaj cov qog ntshav hauv lub caj dab loj, qhov ua rau kuj yog cov txheej txheem inflammatory hauv qhov ncauj kab noj hniav, suav nrog banal teething. Yog tias, tom qab thawj lub hlis ntawm lub neej, cov kab mob dav dav tau ua ke nrog dermatitis, ua npaws, raws plab thiab candidiasis, tus kws kho mob xav tias muaj kev tiv thaiv kab mob.
Huab cua
Qhov tshwm sim ntawm pathology ncaj qha nyob ntawm lub sijhawm ntawm kev hu rau tus kws tshaj lij. Cov menyuam yaus hnub nyoog qis dua 12 xyoos nyob rau hauv lub xub ntiag ntawm palpable formations yuav tsum tau qhia tam sim ntawd rau tus kws kho mob kom tsis txhob muaj cov mob hnyav. Cov neeg laus yuav tsum nrhiav kev kho mob raws sij hawm.
Lymphadenopathy nws tus kheej tsis txaus ntshai, kev hem thawj yog kab mob hauv qab. Nws yog ib qho tseem ceeb kom paub tias qhov ua rau ntawm tus kab mob tuaj yeem ua rau tus txheej txheem malignant, tsis quav ntsej uas ua rau tuag.
Nyob hauv kaw
Adenopathy ntawm cov qog ntshav qab zib yog ib yam kab mob uas tsis yogyog ib qho kab mob ywj pheej, tab sis ua haujlwm raws li cov tsos mob ntawm ntau yam mob. Yog tias thawj cov cim ceeb toom tshwm sim, koj yuav tsum sab laj nrog kws kho mob uas yuav xa mus rau kev tshuaj ntsuam xyuas thiab, raws li nws cov txiaj ntsig, kos cov kev kho mob zoo tshaj plaws.
Raws li twb tau hais lawm tias nyob rau hauv kev faib tawm thoob ntiaj teb ntawm cov kab mob (ICD-10) lymphadenopathy tau muab rau tus lej R59.
