Tej zaum tsis muaj leej twg yuav hais tias nyob rau hauv tib neeg lub cev qhov tseem ceeb tshaj plaws yog ob txoj kev sib tshuam - cov hlab ntshav thiab lymphatic. Nrog rau cov hlab ntsha, txhua yam yog qhov tseeb: nws thauj cov pa oxygen thiab carbon dioxide, cov as-ham thiab cov khoom metabolic tawm los ntawm ob lub raum, tawv nqaij, lub ntsws, thiab lwm yam kabmob, nrog rau kev tswj xyuas cua sov hauv cov tsiaj ntshav sov. Yog li, nws yog tsis yooj yim sua kom overestimate nws qhov tseem ceeb nyob rau hauv lub neej ntawm lub cev, tab sis lub lymphatic system tsis muaj tsawg tseem ceeb. Lymph yog cov kua dej ntawm cov ntshav, thiab cov kab ke no yog tsim los ua kom cov qog ntshav qab zib, tswj homeostasis, ntxiv cov ntshav lymphocytes, thiab koom nrog hauv kev tiv thaiv kab mob thiab kev tiv thaiv ntawm tes. Cov kab mob lymphatic muaj cov hlab ntsha thiab cov qog ntshav, uas tau muab faib ua cov qog ntshav hauv cheeb tsam.
Lymphatic system
Qhov tag nrho ntawm cov qauv ntawm cov kab ke no yog sawv cev los ntawm kev sib txuas ntawm cov hlab ntsha (capillaries, trunks, ducts), uas muaj ntau cov ntsaws ruaj ruaj - cheeb tsam, lossis cheeb tsam nodes. Raws li cov kua dej ntws hauv lub cev,lub lymphatic system yog lub luag hauj lwm rau kev noj cov dej, insoluble hais, colloidal thiab tshem tawm cov kev daws los ntawm cov ntaub so ntswg. Nyob rau hauv lub regional lymph nodes, tsub zuj zuj ntawm lymphocytes rhuav tshem cov teeb meem tshuaj, ua ib tug tiv thaiv (tiv thaiv) muaj nuj nqi.
Lymph nodes hauv system
Lymph nodes yog anatomical tsim ntawm cov xim liab, mos thiab elastic thaum soj ntsuam. Feem ntau lub raum-zoo li tus, los ntawm 0.5 mus rau 50 millimeters ntev. Lymph nodes nyob ib leeg los yog nyob rau hauv pawg thiab nyob rau hauv ib qho tseem ceeb anatomical qhov chaw ntawm lub cev. Lawv yog cov yam ntxwv ntawm tus kheej sib txawv, thiab nrog lub hnub nyoog, cov neeg nyob sib ze tuaj yeem sib koom ua ke. Cov nodes uas yog thawj ntawm txoj kev ntawm cov hlab ntsha ntawm lub lymphatic system uas nqa lymphatic los ntawm ib tug tshwj xeeb department los yog lub cev (tej chaw) hu ua regional, los yog regional lymph nodes.
Human lymph nodes
Tus naj npawb ntawm cov "filters" hauv lub cev yog tus kheej, tab sis qhov nruab nrab ntawm lawv yog los ntawm 400 txog 1000. Daim duab hauv qab no yuav pab koj nkag siab qhov twg cov qog ntshav hauv cheeb tsam nyob.
Lymph nodes tau rov tsim dua thoob plaws hauv tib neeg lub neej, hloov lawv cov duab thiab qauv. Nrog lub hnub nyoog, lawv tus lej poob los ntawm 1.5-2 zaug, lawv tuaj yeem sib koom ua ke lossis hloov los ntawm cov ntaub so ntswg adipose. Cov nodes ua impassable rau lymph thiab atrophy. Raws li, theem ntawm lub cev tiv thaiv kab mob thiab kev tiv thaiv tag nrho cov kab mob raug txo.
Kev ua haujlwm ntawm cov qog ntshav qab zib
Dhau li ntawm kev lim, cov khoom siv noLub lymphatic system ua haujlwm hauv qab no:
- ncaj qha tsim ntawm lub cev tiv thaiv kab mob (tsim T-lymphocytes thiab phagocytes);
- tuav dej homeostasis ntawm lub cev;
- tso dej tawm ntawm cov kua nruab nrab;
- koom nrog hauv cov metabolism hauv tseem ceeb ntawm cov protein, rog, carbohydrates.
Hom kab mob qog noj ntshav hauv cheeb tsam
Pab pawg ntawm cov qog ntshav qab zib tau npaj los thaiv txoj hauv kev kis tus kabmob. Cov pab pawg hauv qab no ntawm cov qog ntshav hauv cheeb tsam yog qhov txawv:
- mediastinal (intrathoracic);
- bronchopulmonary;
- luj tshib thiab popliteal;
- splenic;
- paraortal;
- mezzanine.
- iliac;
- inguinal thiab femoral.
Kev nce hauv cov qog ntshav hauv cheeb tsam qhia tau hais tias muaj teeb meem hauv thaj chaw "kev pabcuam", uas yog ib qho ntawm cov cim qhia hauv kev kuaj mob.
Cov qauv ntawm cov qog nqaij hlav
Anatomically, cov qauv no muaj cov qauv lobed. Txhua lub node yog them nrog cov ntaub so ntswg capsule. Cov medulla (sab nraud) thiab cortical (internal) cov khoom yog sib cais los ntawm trabeculae, los yog crossbars.
Lub medulla muaj cov hauv paus hauv qhov uas B-lymphocytes tau txais antigen-dependent maturation thiab sib txawv. Lub cortex muaj feem ntau T-lymphocytes, uas kuj paub tab thiab sib txawv ntawm no. Nyob rau hauv cov qog nqaij hlav, lub cev tiv thaiv kab mob yog tsim rau txawv teb chaws antigens uas cov lymph coj mus rau lub sinusoidal ducts. Qhov saum npoo ntawm cov ducts yog npogcov hlwb macrophage, uas nws txoj haujlwm yog txhawm rau rhuav tshem cov khoom txawv teb chaws.
Muaj ib qho indentation ntawm qhov nkag ntawm cov hlab ntsha lymphatic - lub rooj vag. Los ntawm cov sinuses ntawm cov tshuaj ntsiav - tshwj xeeb qhov nyob nruab nrab ntawm lub capsule thiab crossbars - cov lymph nkag mus rau hauv lub capsules ntawm lub cortical thiab medulla, sau nyob rau hauv lub portal sinus thiab nkag mus rau hauv lub excretory hlab ntsha. Thaum dhau los ntawm cov qauv ntawm cov node, lymph yog lim.
hom qog ntshav qab zib
Peb hom kev tsim no yog qhov txawv txav:
- Teb nrawm, nyob rau hauv qhov chaw ntawm cov tshuaj cortical tsawg dua li ntawm medulla. Lawv puv sai heev.
- Cov qauv tsim lossis cov lus teb qeeb - ntau cortex dua li medulla.
- Intermediate - ob yam tshuaj (cortical thiab hlwb) muaj nyob rau hauv tib tus nqi.
Kev ua tau zoo ntawm kev kho mob qog noj ntshav feem ntau nyob ntawm tus neeg muaj feem ntau ntawm ib lossis lwm hom qog ntshav hauv cheeb tsam hauv tib neeg.
kev ua txhaum cai
Hauv lub cev noj qab haus huv, cov qog ntshav qab zib tsis mob thiab yuav luag tsis pom. Yog hais tias lub regional lymph nodes loj, qhov no qhia tau hais tias ib tug dysfunctional xeev ntawm lub cheeb tsam uas cov qauv no belongs. Qhov loj thiab qhov mob ntawm qhov chaw ntawm cov leeg no yuav qhia tau tias muaj kab mob sib kis (herpes, qhua pias, rubella) lossis kab mob sib txuas (mob caj dab, rheumatism). Cov kab mob sib sib zog nqus ntawm cov qog ntshav hauv cheeb tsam tau pom nroglymphedema, lifangioma, lymphosarcomas, lymphadenitis, tuberculosis, HIV thiab nyob rau hauv lub lig theem ntawm oncological lesions ntawm ntau yam kabmob. Thaum thawj qhov kev txhawj xeeb, koj yuav tsum sab laj nrog kws kho mob. Txhawm rau kuaj xyuas tus mob, qhov kev tshawb fawb tseeb tshaj plaws niaj hnub no yog ultrasound ntawm cov qog ntshav hauv cheeb tsam.
Thaum mus ntsib kws kho mob
Lub pob txha loj yog vim li cas mus ntsib kws kho mob (immunologist, kws kho mob kis mob, tus kws kho mob oncologist). Tab sis tsis txhob ntshai - ntau zaus tus mob no cuam tshuam nrog kev kis kab mob, ntau dua nrog oncology.
- Nrog rau qhov mob purulent hauv cov ntaub so ntswg, microbes los ntawm qhov txhab nkag mus rau cov qog nqaij hlav, ua rau lymphadenitis - cov txheej txheem mob hnyav. Yog hais tias lub purulent node tsis qhib, phlegmon yuav tsim - ib qho teeb meem loj thiab rupture ntawm lymph node.
- Ntau hom kab mob TB ib txwm ua rau cov qog nqaij hlav o, feem ntau hauv caj dab (hu ua "scrofula").
- Nodes tuaj yeem loj thaum kis tus kab mob Bartonella thiab ua rau miv khawb kab mob. Miv yog cov nqa ntawm microbe. Cov pob qij txha thiab cov qhov txhab tsis zoo yuav tsum ceeb toom cov niam txiv.
- Ntau zaus, cov qog ntshav qog ntshav nce ntxiv hauv SARS vim yog lub cev tawm tsam nrog tus kab mob nkag mus. Thaum rov qab los, cov nodes rov qab mus rau qhov qub.
- Nyob hauv cheeb tsam hauv pliaj, qhov nce ntawm cov pob txha feem ntau cuam tshuam nrog kev sib deev kis kab mob (syphilis).
Ntxiv rau kev xa mus rau ultrasound, tus kws kho mob tuaj yeem xa tus neeg mob kom kuaj ntshav kom tiav, immunogram, kuaj kab mob HIV thiab puncture ntawm cov qog ntshav hauv cheeb tsam ntawm thaj tsam cuam tshuam.
Yuav ua li cas ultrasound yuav qhia
Kev kuaj xyuas raws sijhawm thiab ua tau zoo feem ntau txiav txim siab txog kev kho mob thiab tuaj yeem cawm tsis tau tsuas yog kev noj qab haus huv xwb, tab sis kuj yog lub neej ntawm tus neeg mob. Txoj kev tshawb no yuav qhia txog kev hloov pauv ntawm cov qauv ntawm cov ntaub so ntswg ntawm cov hlab ntsha, circulatory disorders, localization ntawm qhov txhab, echo ntom ntawm cov ntaub so ntswg. Txoj kev tshawb no tseem suav nrog cov cim qhia: ua daus no, mob lub cev, insomnia, tsis qab los noj mov, mob taub hau. Kev ntseeg siab ntawm cov txiaj ntsig ntawm kev kuaj ultrasound yog qhov siab heev. Qhov yuam kev hauv kev txhais lus tuaj yeem yog vim muaj qhov abscess lossis cyst ntawm qhov chaw kawm. Nyob rau hauv cov ntaub ntawv no, ib qho kev kuaj ntxiv yog muab: tomography los yog biopsy. Kev kuaj ultrasound ntawm cov qog ntshav qab zib tsis muaj contraindications, tsis irradiate thiab tsis muaj teeb meem rau kev noj qab haus huv.
Cov qog ntshav hauv cheeb tsam ntawm lub mis
Cov kab mob lymphatic ntawm lub caj pas mammary yog sawv cev los ntawm cov chaw sab hauv thiab sab nraud ntawm lub cev. Lub cev sab hauv yog sawv cev los ntawm cov ntaub so ntswg rog, capillaries thiab parenchyma ntawm cov qog mammary. Cov qog ntshav hauv cheeb tsam ntawm lub mis yog axillary, subclavian thiab parasternal lymph nodes. Kev nce hauv axillary nodes thiab qhov tsis muaj lawv qhov mob yog ib qho kev ceeb toom ntau tshaj qhov muaj edema thiab mob palpation. Painless enlarged nodes qhia qhov pib ntawm metastasis ntawm malignant qog.
Cov qog ntshav hauv cheeb tsam ntawm cov thyroid caj pas
Cov kab hauv cheeb tsam ntawm cov thyroid caj pas suav nrog cov pob hauv caj dab thiab cov tom qab lub sternum. Cov txheej txheem inflammatory pib nrog kev nce hauv cov leeg, o thiab mob palpation. Hauv qhov no, qhov kev pheej hmoo ntawm kev kis kab mob los yog mob qog noj ntshav yog qhov txaus ntshai vim qhov sib thooj rau lub hlwb.
Kev kis ntawm oncological neoplasms
Cov kab mob qog noj ntshav kis hauv lub cev raws li hauv qab no:
- txoj kev hematogenous (los ntawm cov hlab ntsha);
- txoj kev lymphogenic (los ntawm cov hlab ntsha lymphatic, los ntawm cov qog nqaij hlav);
- kev sib tov.
Cov qog nqaij hlav ntawm lub caj dab yog qhov cuam tshuam loj rau kev kis kab mob thiab cov qog ntawm lub taub hau; cov pob txha ntawm caj npab tiv thaiv cov qog mammary, caj npab, lub xub pwg hniav. Kev mob ntawm cov kab mob inguinal tuaj yeem tham txog kev mob ntawm zes qe menyuam, syphilis, colitis thiab colpitis, appendicitis thiab mob caj dab. Nrog o nyob rau hauv lub qhov ncauj kab noj hniav thiab oncology ntawm daim di ncauj, puab tsaig los yog tus nplaig, lub submandibular lymph nodes nce. Oncological neoplasms nyob rau hauv lub plab kab noj hniav muab metastases rau cov qog nqaij hlav ntawm cov leeg sternocleidomastoid.
Cancer & Lymph
Nws yog los ntawm kev nce hauv cheeb tsam cov hlab ntsha lymphatic uas ib tus tuaj yeem txiav txim rau thawj theem ntawm cov qog nqaij hlav malignant. Nyob rau hauv lub ntiaj teb no, oncology nyob rau hauv cov nqe lus ntawm kev tuag niaj hnub no yog nyob rau hauv ob qhov chaw tom qab lub plawv pathologies. Lub Koom Haum Saib Xyuas Kev Noj Qab Haus Huv (World He alth Organization) tau kwv yees tias yuav muaj 2 npaug ntawm kev tuag los ntawm cov kab mob malignant nyob rau hauv nees nkaum xyoo tom ntej. Nov yog qee qhov tseeb uas hais rau lawv tus kheej.
Kwv yees li 25% ntawm tag nrho cov mob qog noj ntshav yog tshwm sim los ntawm kab mob siab thiab tib neeg papillomavirus.
Ib feem peb ntawm kev tuag mob qog noj ntshav yog tshwm sim los ntawm zaub movqhov chaw ntawm kev pheej hmoo. Cov no yog kev rog, zaub thiab txiv hmab txiv ntoo tsawg hauv kev noj haus, tsis muaj kev tawm dag zog, haus cawv thiab haus luam yeeb.
Ntawm cov kab mob oncological, mob ntsws cancer ua rau, ua raws li mob qog noj ntshav, plab hnyuv thiab qhov quav, plab thiab lub mis.
Cov txiv neej tuag ntau tshaj plaws nyob rau hauv nruab nrab thiab sab hnub tuaj Europe, thiab cov poj niam feem ntau yuav tuag los ntawm mob qog noj ntshav hauv East Africa.
Raws li WHO, ntau dua 200 txhiab tus menyuam yaus mob qog noj ntshav txhua xyoo hauv ntiaj teb.
![lub regional lymph nodes ntawm lub mis yog [1]](https://i.medicinehelpful.com/images/010/image-29160-9-j.webp "lub regional lymph nodes ntawm lub mis yog [1]")
Kev noj qab haus huv yog khoom plig uas tsis muaj nqi uas tsis tuaj yeem yuav lossis qiv. Txhua tus neeg uas xav ua tus coj txoj kev ua neej nyob thiab tuav ib txoj haujlwm hauv zej zog yuav tsum tau saib xyuas nws txoj kev noj qab haus huv. Niaj hnub no, noj qab nyob zoo yog fashionable, nws txhais tau tias nyob rau hauv trend. Kev noj qab haus huv noj qab haus huv, ua kom lub cev ua tau zoo, tsis lees paub tus cwj pwm tsis zoo - tag nrho cov no yuav pab kom tsis txhob muaj mob thiab txhawb nqa koj lub cev. Txawm li cas los xij, ntawm thawj cov tsos mob thiab cov tsos mob ntawm lymphatic system, koj yuav tsum sab laj nrog kws kho mob. Kev kho mob raws sij hawm, kev ntsuam xyuas zoo thiab kev kuaj mob kom raug yog tus yuam sij rau kev kho kom zoo, rov qab muaj kev noj qab haus huv thiab ua kom lub neej ntev.
