Kev nqhis dej tas li thiab qhov ncauj qhuav yog qhov tshwm sim los ntawm kev txo qis hauv qhov ncauj mucosa. Nws yog tshwm sim los ntawm ntau yam ua rau - physiological lossis pathological. Hauv qhov no, kev ua haujlwm ntawm cov qog nqaij hlav hauv qhov ncauj (salivary) cuam tshuam. Tej zaum lawv yuav tsim cov qaub ncaug uas khov heev lossis tsawg dhau.
qhov ncauj qhuav hu ua xerostomia. Nws implies dryness ntawm tej keeb kwm. Nws cuam tshuam txog 10% ntawm cov neeg nyob hauv ntiaj teb, cov poj niam muaj feem ntau dua li txiv neej. Hauv cov neeg laus, tus lej no twb tau txog li 25%. Qhov no yog vim lub fact tias cov neeg laus noj ib tug loj tus naj npawb ntawm cov tshuaj sib txawv vim lub bouquet ntawm kab mob yam ntxwv ntawm lub hnub nyoog no. Qhov no yog nrog los ntawm qhov muaj hnub nyoog txog kev txo qis hauv cov qog ua haujlwm ntawm lawv tus kheej.
Nyob qaub ncaug
Nquag, cov qog noj qab haus huv rau cov neeg laus muaj li 2 litres qaub ncaug. Nws yog imperceptible vim nws nqos tas li. Muaj 3 khub ntawm cov qog qaub ncaug loj tshaj plaws - submandibular, sublingual thiab parotid. Tag nrho cov ntawm lawv muaj lawv tus kheej excretory ducts nyob rau hauv lub qhov ncauj kab noj hniav. Kuj tseem muaj ntau lub qog me me hauv lub qhov ncauj, tab sis lawv tsim cov qaub ncaug.me ntsis.
Sim qaub ncaug tas li moisturizes lub qhov ncauj mucosa, uas tiv thaiv nws ntawm tawg, yaig thiab rwj. Tsis tas li ntawd, nws muaj lysozyme, cov kab mob bactericidal ntawm cov qaub ncaug, nrog rau npaj cov tshuaj tiv thaiv kab mob.
Sim qaub muaj dej, ntxhia ntsev thiab carbohydrate ua enzymes twb nyob rau hauv lub qhov ncauj. Tseem muaj lwm cov enzymes rau ntub cov zaub mov bolus thiab nws tsim nrog ntxiv nqos.
Lub siab ntawm saj yog tsim los ntawm kev pab ntawm qaub ncaug. Salivation kuj neutralizes lactic acid, uas tso tawm los ntawm cov kab mob thaum lub sij hawm caries thiab tiv thaiv cov hniav.
Calcium ions kuj pom muaj nyob hauv cov qaub ncaug thiab tiv thaiv cov hniav los ntawm kev lwj, vim tias lawv tau koom nrog hauv kev tsim cov enamel. Cov qaub ncaug kuj xav tau kom meej meej ntawm kev hais lus.
Qhov tshwm sim ntawm qhov tsis muaj qaub ncaug tsis yog qhov qhuav tas li ntawm qhov ncauj thiab nyuaj zom zaub mov. Xerostomia ntawm lub sijhawm sib txawv tuaj yeem ua rau caries, candidiasis thiab stomatitis, kev hloov pauv ntawm saj thiab halitosis vim cov kab mob loj hlob. Lub cev ua rau qhov no txo qis hauv kev tiv thaiv kab mob.
Xerostomia tuaj yeem yog qhov tshwm sim ntawm pathology lossis qee yam mob ib ntus vim yog qhov tshwm sim.
Lub qhov ncauj qhuav cuam tshuam cov saj thiab cov khoom noj saj hloov pauv, tuaj yeem ua rau hoarseness, tawg ntawm cov ces kaum ntawm lub qhov ncauj, tso zis ntau ntxiv, hlawv, liab ntawm tus nplaig thiab daim di ncauj. Tsis tu ncua viscosity nyob rau hauv lub qhov ncauj noticeably impairs diction.
Etiology ntawm qhov tshwm sim
Qhov tshwm sim feem ntau yog siv qee yam tshuaj,uas, ntawm nws cov kev mob tshwm sim, ua rau txo qis ntawm cov qaub ncaug. Vim li no, qhov nqhis dej tas li thiab qhov ncauj qhuav feem ntau tshwm sim hauv cov neeg laus.
Tshuaj ntawm cov khoom no suav nrog:
- hypotensive thiab hypoglycemic;
- steroid inhalers, neuroleptics thiab antidepressants;
- tshuaj tiv thaiv kab mob;
- Ydiuretics;
- tshuaj tiv thaiv tsis-steroids; euthyrox;
- tshuaj tiv thaiv kab mob.
Qhov no tshwj xeeb tshaj yog yog tias 2 yam tshuaj sib txawv tau noj hauv 1 koob.
Kev tsis txaus siab ntawm qhov ncauj qhuav hnyav thiab nqhis dej tas li tsis tas yuav ua rau tus kws kho mob tshawb xyuas qhov ua tau zoo. Qhov no nyuaj rau kev kuaj mob thiab qhia tau tias kev saib xyuas tsis zoo.
Tus kws kho mob feem ntau sau ntawv hauv daim npav ntawm tus neeg mob: xerostomia ntawm qhov tsis meej etiology. Rau kev kuaj xyuas thiab txheeb xyuas cov laj thawj, nws yog qhov zoo dua hu rau cov chaw kho mob loj.
Kuj, qhov ua rau nqhis dej tas li thiab qhov ncauj qhuav tuaj yeem ua txhaum ntawm lub hlwb ua haujlwm ntawm lub hlwb, qhov no yog:
- mob stroke thiab microstrokes;
- Alzheimer's lossis Parkinson's disease;
- pathology ntawm lub paj hlwb trigeminal.
Qhov tseeb yog tias nrog cov kab mob no, cov teeb liab mus rau lub paj hlwb peripheral mus rau cov qog qaub ncaug tsis tuaj txog lossis kis tau mus ib ntus. Glandular dysfunction nyob rau hauv, ib qho kev xav tsis tu ncua ntawm nqhis dej hauv lub qhov ncauj thiab dryness.
Qu tsis nqhis
Zoo ib qho tshwm sim, vim nws qhov laj thawj tseem ceeb yog hypotension. Cov neeg mob Hypotonic xav tias cephalalgia hauvcaj dab thiab lub tuam tsev, tsis muaj zog, qaug zog sai twb 2 teev tom qab sawv ntxov, tshwj xeeb tshaj yog thaum sawv ntxov los ntawm txoj kab rov tav, qhov ncauj qhuav tsis nqhis thaum sawv ntxov.
Nws tsis yog qhov txawv rau cov neeg no tsis muaj tsos mob dab tsi, thiab qhov qub. Tab sis hypotension nyob rau hauv txhua rooj plaub ua rau ib tug deterioration ntawm cov ntshav khiav, uas tsis tuaj yeem tab sis ua rau lub cev ua haujlwm tsis zoo.
Lub qhov ncauj qhuav tsis nqhis dej nrog ntxiv rau hauv daim ntawv ntawm belching, xeev siab, flatulence, raws plab thiab rub qhov mob nyob rau sab laug hypochondrium yog ib qho cim ntawm pancreatitis. Cov kab mob zoo li no qee zaum tshwm sim los ntawm kev qhuav. Yuav kom paub meej qhov kev kuaj mob, koj yuav tsum sab laj nrog kws kho mob.
Nyob rau hauv cov poj niam laus, qhov ncauj qhuav yam tsis nqhis dej yog tshwm sim los ntawm kev laus. Kev ua txhaum ntawm hormonal keeb kwm yav dhau nrog nres hauv kev sib txuas ntawm cov tshuaj estrogen cuam tshuam rau kev ua haujlwm ntawm txhua lub cev. Tsim, ntawm lwm yam, dryness ntawm mucous daim nyias nyias thiab lub qhov ncauj kab noj hniav kuj raug rau qhov no.
Lwm cov kab mob uas muaj cov tsos mob no suav nrog:
- hmoob;
- Mikulich tus kab mob (symmetrical o ntawm cov qaub ncaug thiab lacrimal qog ntawm ib tug reactive xwm);
- sialoadenitis (mob ntawm cov qog qaub ncaug);
- sialostasis (nqe salivation);
- sialolithiasis (kev loj hlob hauv qog ducts);
- Sjögren's disease.
Kev nqus cua nrog cov khoom tsis zoo tuaj yeem ua rau lub qhov ncauj qhuav.
Hmo ntuj qhuav
Cov tsos mob no tsis yog qhov tsis zoo ntawm nws tus kheej xwb, tab sis kuj cuam tshuam kev pw tsaug zog. Irritability thiab tsis mloogcephalgia, qaug zog. Feem ntau ua rau muaj kev nqhis dej tas li thiab qhov ncauj qhuav thaum hmo ntuj yog lub qhov ntswg txhaws nrog hnoos qeev nrog SARS.
Tshuaj rau rhinitis, ua xua, sinusitis, qhov ntswg deformities, vim lub cev yam.
Qhov kev sib xyaw ua ke no tuaj yeem ua rau muaj kev mob ntshav qab zib, qog (lymphoma), leukemia, qhov tshwm sim ntawm HIV, concussion, ntshav kab mob. Thaum tsaus ntuj, qhov ncauj qhuav tuaj yeem tshwm sim los ntawm cov khoom noj muaj protein ntau - cov mis nyuj, nqaij, taum - vim nws xav tau dej ntau kom zom thiab zom. Txhawm rau zam qhov no, noj hmo yuav tsum teeb.
Lwm qhov laj thawj thiab yooj yim yog pw nrog koj lub qhov ncauj qhib. Hom rau snoring neeg. Lub tshuab cua txias kuj tseem pom tias huab cua qhuav hauv chav, yog li xav tau humidifiers.
iab thiab qhov ncauj qhuav
Yog tias, ntxiv rau qhov qhuav, ib tus neeg xav tias iab hauv lub qhov ncauj txhua lub sijhawm, nws tuaj yeem tsuas yog 2 pathologies - kab mob ntawm daim siab thiab lub gallbladder. Kev ua txhaum ntawm kev ua haujlwm ntawm cov kabmob no ua rau kev tso tawm ntawm cov kua tsib thiab nqus cov khoom lwj mus rau hauv cov ntshav, los ntawm qhov uas lawv nkag mus rau hauv cov qog ua kua qaub. Qhov no provokes iab.
iab nrog qaub belching thiab ua pa phem yog pancreatitis. Mob plab rwj thiab gastritis tuaj yeem ua rau cov tsos mob zoo li no.
Nrog lub qhov ncauj qhuav, tej zaum yuav muaj qhov kub hnyiab ntawm tus nplaig, cov pos hniav, palate, sab hauv ntawm lub puab tsaig. Qhov no yog qhov hu ua: hlawv nplaig syndrome lossis glossodynia. Feem ntau, qhov no yog qhov tshwm sim ntawm kev tso kua txiv rau hauv txoj hlab pas.
Kev kub nyhiab tuaj yeem tshwm sim thiabntawm:
- ua xua, noj zaub mov ntsim, siv tshuaj txhuam hniav lauryl sulfite;
- cov hniav tsis zoo, zawv zawg thiab txhaws;
- qhov ncauj candidiasis;
- kev kho mob qog noj ntshav;
- deficiency ntawm vitamin B6, zinc thiab hlau; aphthous stomatitis;
- siv tshuaj tua kab mob thiab tshuaj tiv thaiv kab mob;
- amenorrhea;
- nquag noj cov tshuaj yej dub thiab kas fes txhua hnub.
Morning dryness
Thaum sawv ntxov, qhov ncauj qhuav tuaj yeem yog vim cov qaub ncaug tsis txaus lossis nws cov viscosity nce ntxiv. Tom qab ntawd dryness tsis suav nrog hmo ntuj.
Lub qhov ncauj qhuav thaum sawv ntxov tau sau tseg nrog mob khaub thuas, adenoids, tonsillitis. Cov neeg haus luam yeeb yeej paub qhov ncauj qhuav thaum sawv ntxov txhua hnub.
Ua rau nqhis dej tas li
Yog vim li cas nqhis dej tas li thiab lub qhov ncauj qhuav tuaj yeem yooj yim heev thiab banal: ntau dhau insolation, siv ntau cov khoom noj haus luam yeeb thiab pickled. Txawm li cas los xij, ntau zaus nws cuam tshuam nrog pathology xws li ntshav qab zib. Tus kab mob no txaus ntshai heev rau nws qhov tshwm sim.
Qhov pib ntawm cov tsos mob ntawm nqhis dej thiab qhov ncauj qhuav feem ntau yog cov tsos mob tseem ceeb ntawm ntshav qab zib. Ntxiv mus, qhov nqhis dej no tsis txaus, uas ua rau tus neeg mob haus ntau dua 3 litres ib hnub, tab sis qhov no tsis pab. Cov neeg mob ntshav qab zib yws yws txog qhov nqhis dej tshwj xeeb, lawv hu nws cov tshuaj, tsis zoo - nws muaj zog heev.
Tawm tsam qhov tsos mob tas mus li no, muaj lwm qhov - nquag tso zis tawm tsam keeb kwm ntawm qhov nqhis dej tas li thiab qhov ncauj qhuav. tsaCov zis ntau lawm tshwm sim nyob rau hauv qhov cuam tshuam ntawm hyperglycemia.
Lwm cov cim muaj xws li: tawg thiab jams nyob rau hauv lub ces kaum ntawm lub qhov ncauj, tsis muaj zog, hnyav hloov nyob rau hauv txhua txoj kev, nce qab los noj mov, cravings qab zib, khaus thiab pustules ntawm daim tawv nqaij.
Nyob rau hauv cov txiv neej - balanoposthitis, impotence. Qhov peculiarity ntawm polydipsia hauv ntshav qab zib yog tias nws tsis txaus thiab tsis nyob ntawm lub sijhawm nruab hnub thiab qhov kub thiab txias. Triad ntawm cov tsos mob - nqhis dej heev, qhov ncauj qhuav thiab tso zis ntau zaus - ib txwm muaj nyob hauv ntshav qab zib.
Nyob rau hauv cov poj niam cev xeeb tub, qhov ncauj qhuav yuav tsum tsis nquag tshwm sim, txij li lub cev ntawm leej niam lub cev ua rau qaub ncaug thiab ntau ntxiv. Cov cim qhia tias nqhis dej tas li thiab qhov ncauj qhuav thaum cev xeeb tub tsuas yog nyob rau lub caij kub nrog cua qhuav xwb.
nqhis dej ib txwm thaum cev xeeb tub yuav tshwm sim tom qab thaum cev xeeb tub vim tias zis tso zis ntau ntxiv. Qhov no ua rau qee lub cev qhuav dej thiab qhov ncauj qhuav. Yog tias tus poj niam cev xeeb tub tsis tsuas yog nqhis dej, qhov ncauj qhuav thiab tso zis ntau zaus, qhov no yuav qhia tau tias muaj ntshav qab zib gestational. Tsis tas li ntawd, muaj xim hlau qaub saj. Tus kab mob yuav tsum tau kho.
Lwm qhov laj thawj rau qhov nqhis dej tas li thiab qhov ncauj qhuav hauv tus poj niam cev xeeb tub tuaj yeem yog qhov tsis txaus hauv lub cev ntawm cov poov tshuaj tiv thaiv keeb kwm yav dhau los ntawm magnesium ntau dhau. Tom qab ntawd cov ntxhia complexes raug sau los daws qhov teeb meem.
Ntau yam kab mob thiab kab mob nrog lub qhov ncauj qhuav
- HIV/AIDS, mob cancerprovoke atrophy ntawm cov qog qaub ncaug.
- mob caj dab (rheumatoid), strokes thiab plawv nres ua rau hws, uas ua rau lub cev qhuav dej thiab cov mucous qhuav.
- YHypovitaminosis vit. A - ua rau dryness ntawm daim tawv nqaij, plaub hau thiab mucous daim nyias nyias. Retinol deficiency ua rau muaj kev puas tsuaj loj rau lub epithelium. Nws regeneration yog cuam tshuam thiab atrophy tsim. Xws li ib tug epithelium yog heev exfoliated thiab clogs lub ducts ntawm lub excretory ducts ntawm lub salivary qog, qhov twg cysts tseem tuaj yeem tsim vim qhov no. Thiab txawm hais tias cov qog nqaij hlav yog qhov qub, cov qaub ncaug ntau zuj zus.
- Kev poob kua ntau ntau tshwm sim nrog los ntshav, kub hnyiab, kub taub hau, raws plab thiab ntuav, xws li AII lossis hyperhidrosis.
- Thaum muaj mob, raug mob ntawm caj dab, taub hau, txheej txheem oncological, tshem tawm cov qog qaub ncaug tuaj yeem ua tau.
- Kev raug mob rau glossopharyngeal thiab lub ntsej muag paj hlwb lossis lawv cov nuclei hauv medulla oblongata impairs salivation.
- Kev ntxhov siab thiab kev ntxhov siab, kev ntxhov siab-kev ntxhov siab tuaj yeem qee zaum kuj ua rau lub qhov ncauj qhuav.
kab mob pathologies
- Scleroderma - yog tshwm sim los ntawm kev mob fibrosis ntawm daim tawv nqaij, cov kab mob hauv nruab nrog cev (lub plawv, ntsws, plab hnyuv, ob lub raum), vascular puas ntawm hom obliterating endarteritis nrog txo qis hauv lawv cov lumen vim cov leeg nqaij. Tsis tsuas yog cov tawv nqaij raug cuam tshuam, tab sis kuj cov mucous daim nyias nyias, ces tus nplaig thickens, nws frenulum shortens thiab lub qhov ncauj mucosa dries. Scleroderma feem ntau ua ke nrog Sjögren's syndrome.
- Sjögren's disease yog ib hom kab mob autoimmune uas muaj qhov qhuav ntawm tag nrho cov mucous daim nyias nyias vim lymphoid.proliferation ntawm exogenous glands (tshwj xeeb yog salivary thiab lacrimal).
- Cystic fibrosis yog ib yam kab mob uas muaj nyob rau hauv uas tag nrho cov qog exocrine raug cuam tshuam. Tom qab ntawd cov kab mob ua pa, kab mob plab, thiab lwm yam kuj raug cuam tshuam. Cov menyuam no muaj kev noj qab haus huv zoo, tab sis tsis muaj qhov hnyav. Lawv pib raug kev txom nyem los ntawm qaub ncaug viscosity, ua tsis taus pa thiab cyanosis, bouts ntawm qhuav hnoos.
Txoj Cai Kho Mob
Kev kho mob yuav tsum ua tiav, xaiv tom qab kuaj pom tseeb ntawm qhov ua rau tus kab mob. Tsis tas li ntawd, nws yuav tsum tau nrog kev haus luam yeeb. Yog tias cov tshuaj yuav liam rau qhov qhuav, koj yuav tsum tau txo qhov koob tshuaj.
Tsis txhob noj zaub mov ntau dhau. Nws yog qhov zoo dua tsis txhob siv cov dej cawv uas muaj cawv. Rau cov teeb meem kev kho hniav, tus kws kho hniav tuaj yeem muab cov qaub ncaug hloov pauv.
Cov tsos mob tshwm sim ntawm dryness
Cov tsos mob ntawm kev nqhis dej tas li, qhov ncauj qhuav thiab ua rau:
- Tsis muaj zog. Thaum lub qhov ncauj dries, ib tug neeg sai sai pib xav tias tsis muaj zog tas li yam tsis muaj ib tug hint ntawm cheerfulness. Qhov no tej zaum yuav yog vim muaj kab mob viral, sab nraud intoxication; manifestation ntawm anemia; oncology; Cov kab mob CNS. Kev qaug zog yog ib qho cim ntxov ntawm ntau yam kab mob. Tshwj xeeb tshaj yog tias nws ua ke nrog lub qhov ncauj qhuav.
- Ntaus. Qhov ncauj qhuav thiab xeev siab feem ntau cuam tshuam nrog nqhis dej. Feem ntau tshwm sim nrog AII thiab noj tshuaj lom. Lawv tshwm sim thawj zaug hauv daim duab kho mob. Tab sis lawv kuj tuaj yeem yog qhov yuam kev hauv kev noj haus - piv txwv li, tom qab noj zaub mov nrujib tug txiv neej mam li txiav txim siab ua noj ua haus.
- daim di ncauj qhuav. Nws tshwm sim nrog qhov loj ntawm cov excretory ducts ntawm cov qog qaub ncaug uas ciam teb daim di ncauj. Daim di ncauj hauv qab yuav chapped, qhuav thiab flaky. Jams thiab kab nrib pleb tshwm nyob rau hauv cov ces kaum ntawm lub qhov ncauj. Hauv cov mob cheilitis ntev, cov txheej txheem yuav dhau los ua phem.
- Plaque ntawm tus nplaig. Qhov ncauj qhuav thiab tsis tshem tau cov quav hniav ntawm tus nplaig tshwm sim nrog gastritis, colitis, plab rwj, duodenal ulcers. Plaque ntawm tus nplaig tuaj yeem yog dawb - nrog pathologies ntawm lub plab; daj - nrog cholecystitis thiab kab mob siab, pancreatitis.
- tus nplaig liab thiab o tonsils yog kab mob nasopharyngeal. Yog hais tias tus nplaig kub hnyiab, muaj xim hlau saj nyob rau hauv lub qhov ncauj - kab mob ntawm cov pos hniav los yog caries. Yog tias mob mob hauv plab lossis mob plab kuj koom nrog, mob plab plab lossis mob pancreatitis tuaj yeem raug xav tias. Pom tus kws phais zoo dua.
- Ntshai hauv qhov ncauj. Kev sib xyaw ua ke ntawm dryness nrog iab hauv qhov ncauj - qhia meej txog cov kab mob ntawm cov kab mob biliary, raws li twb tau hais lawm.
- Mob kiv taub hau thiab qhov ncauj qhuav qhia tias mob hlab ntsha tawg. Qhov no tej zaum yuav yog kab mob hauv lub hlwb nyob rau theem pib lossis ua rau lub cev qaug cawv.
- tso zis ntau zaus. Nws nrog polydipsia, tawm hws thiab lub qhov ncauj qhuav tas li, tag nrho cov tsos mob ntawm ntshav qab zib. Qhov tseeb yog tias hyperglycemia nce osmotic siab, uas nyiam thiab khaws cov dej hauv cov hlab ntsha. Cov mucous daim nyias nyias pib qhuav, lawv muab cov kua rau hauv cov ntshav. Li no qhov nqhis dej tas li. Muaj lub voj voog vicious - polydipsia ua rau tso zis ntau zaus, tawm hws, ua rau nqhis dej dua.
Ua koj tus kheej
Yog hais tias qhov qhuav ntawm tus nplaig tsuas yog cuam tshuam nrog lub cev, kev ua neej nyob tuaj yeem hloov pauv: chav pw yuav tsum txias, siv kiv cua lossis cua txias rau qhov no.
Nws yog ib qho tseem ceeb uas yuav tsum tau saib xyuas cov dej haus - tsawg kawg 2 litres dej ib hnub. Cov kua txiv hmab txiv ntoo thiab tshuaj ntsuab - nrog chamomile, mint, txiv qaub balm - lawv muaj sedative thiab anti-inflammatory nyhuv.
Raws li cov neeg mob laus, mint yog qhov zoo rau ua pa tsis zoo. iab hauv qhov ncauj yuav raug tshem tawm los ntawm zom cov pos hniav yam tsis muaj suab thaj. Los ntawm cov kua txiv hmab txiv ntoo nws yog qhov zoo los haus kua txiv, txiv kab ntxwv, txiv qaub, cranberry. Lawv nce kev tiv thaiv kab mob thiab ua kom cov qaub ncaug ntau ntxiv. Khoom noj khoom haus yuav tsum sib npaug - ntsev thiab qab zib yuav tsum tsis suav nrog, tshwj xeeb tshaj yog nyob rau hauv daim ntawv ntawm cov khoom noj txom ncauj hmo ntuj.
Ob tus kws kho mob thiab cov neeg mob hauv kev tshuaj xyuas nco ntsoov tias cov kua txob kub hauv cov zaub mov ua rau cov qaub ncaug ntau ntxiv. Txhawm rau quench nqhis dej thiab qhuav thaum sawv ntxov, koj tuaj yeem khaws ib khob dej nrog kua txiv qaub los yog tshuaj ntsuab tshuaj yej npaj los ntawm lub txaj.
Ua ntej yuav mus pw, koj tuaj yeem nqus tau cov lollipop tsis muaj qab zib lossis tuav ib qho dej khov rau hauv koj lub qhov ncauj. Tsis tas li ntawd, ntau tus neeg mob tau qhia kom yaug lawv lub qhov ncauj rau 10 feeb nrog txiv ntseej, hiav txwv buckthorn lossis lwm yam roj zaub. Xaiv cov tshuaj txhuam hniav zoo thiab tshuaj ntxuav qhov ncauj.
