Mikulich's disease (Sjögren's disease) yog ib yam kab mob uas tsis tshua muaj mob uas tshwm sim nws tus kheej raws li qhov sib npaug ntawm cov qog qaub ncaug thiab lacrimal thiab lawv cov hypertrophy ntxiv.
Kev piav qhia ntawm pathology
Lub ntsiab tseem ceeb hauv qab nws txoj kev loj hlob yog kab mob kis kab mob, kab mob ntshav, ua xua thiab autoimmune txheej txheem, mob hauv cov kab mob lymphatic. Tus kab mob no tshwm sim tsuas yog rau cov neeg laus, feem ntau yog cov poj niam. Nws yog thawj zaug piav qhia los ntawm German kws phais neeg I. Mikulich hauv xyoo 1892. Tam sim no nws ntseeg tau tias glandular o tsis yog ib qho kab mob ywj pheej, tab sis ib qho kev sib txuam nrog ntau yam kab mob endocrine.
Ua rau kab mob
Cov kws tshawb fawb tseem tsis tau txheeb xyuas qhov tseeb ua rau mob Mikulich tus kab mob. Tsuas yog lub hauv paus hypothetical yog muab tso rau pem hauv ntej, piv txwv li:
kab mob autoimmune;
Thawj theem ntawm kev txhim kho qog nqaij hlav malignant;
Cov kab mob hematopoietic;
TB;
syphilis;
mumps (qog);
kis mobencephalitis.
Qhov kev puas tsuaj loj rau cov kabmob thiab cov kab ke ntawm lub cev cuam tshuam rau kev tswj hwm kev noj qab haus huv ntawm cov qog lacrimal thiab salivary, hloov pauv lawv txoj haujlwm zais cia. autoimmune los yog kev tsis haum tshuaj ua rau muaj kev cuam tshuam ntawm cov hlab ntsha ntawm cov qog nrog eosinophilic plugs, khaws cov ntaub ntawv zais cia, thiab txo cov ducts ntawm cov leeg nqaij thiab cov hlwb myoepithelial. Yog li ntawd, cov ntaub so ntswg interstitial thiab lymphoid proliferate, compress cov ducts, thiab ua rau kom puas-tsoo hypertrophy ntawm salivary thiab lacrimal qog. Cia peb saib cov tsos mob ntawm Mikulich tus kab mob.
Cov tsos mob
Feem ntau tus kab mob no tshwm sim thaum muaj hnub nyoog 20 txog 30 xyoo. Cov neeg laus raug kev txom nyem tsawg dua, nws tsis tau sau tseg hauv cov menyuam yaus. Hauv thawj theem, cov tsos mob zoo ib yam li cov mob parotitis ntev, ntxiv rau, yog tias muaj teeb meem tshwm sim, nws tuaj yeem ua rau mob.
thawj thiab tseem ceeb tshaj plaws cov tsos mob ntawm Mikulich tus kab mob yog o ntawm cov qog lacrimal. Maj mam, lawv dhau los ua mob thaum nias, thiab qee zaum lawv nce qhov loj heev uas nyob rau hauv lawv qhov hnyav lub qhov muag poob thiab txawm protrudes rau pem hauv ntej. Txawm hais tias qhov sib xws ntawm cov qog yog tuab heev, suppuration tsis pom.
Cov tsos mob thib ob yog qhov nce hauv cov qog qaub ncaug (submandibular, parotid, tsawg dua sublingual). Feem ntau cov txheej txheem no yog ob sab, o tshwm sim ntawm ob sab, thiab tsuas yog hauv cov xwm txheej tshwj xeeb - ntawm ib sab. Feem ntau muaj cov qog ntshav nce ntxiv.
Thib peb cov tsos mob- tsis txaus siab ntawm qhov ncauj qhuav, conjunctivitis qhuav thiab ntau yam kab mob caries. Nyob rau hauv cov ntaub ntawv ntawm ib tug raug tus kab mob, lub siab thiab spleen nce, leukocytosis thiab lymphocytosis raug soj ntsuam.
Kev kuaj kab mob
Mikulich tus kab mob yog kuaj los ntawm kws kho mob los ntawm daim duab kho mob dav dav. Feem ntau ib tug sialogram yog tsim, uas qhia dystrophic hloov nyob rau hauv cov qog nqaij hlav, uas qhia meej txog kev nce hauv cov qog ua kua qaub, nqaim ntawm lawv cov excretory ducts. Yog tias lawv tsis cuam tshuam, cov qog ntshav qog ntshav yuav tsum tau ua tib zoo tshuaj xyuas.
Puncture histobiopsy kuj tau siv dav. Histologically, nws muaj peev xwm mus ntes hyperplasia ntawm lub lacrimal thiab salivary qog, txiav txim siab hloov kho atrophic ntawm parenchyma thiab muaj cov lymphoid infiltration ntawm lub stroma.
Cov txiaj ntsig zoo rau kev kuaj mob thiab txhim kho kev kho mob yog cov kev tshawb fawb sib npaug ntawm cov ntshav nyob ib puag ncig cov qog ntshav thiab tshuaj xyuas cov pob txha pob txha.
Nws yog ib qho tsim nyog sau cia tias thaum lub sij hawm Mikulich tus kab mob (kev kho mob uas peb yuav xav txog hauv qab no), cov tshuaj ntsiav ntawm lub caj pas tsis cuam tshuam, yog li ntawd, cov ntaub so ntswg ntawm salivary thiab lacrimal qog tsis txuas nrog cov mucous membranes. thiab daim tawv nqaij, ua tsaug rau qhov no, tus mob no tuaj yeem paub qhov txawv ntawm ntau hom kev ua rau mob ntev.
Kev kuaj ntshav hauv chav kuaj pom ib daim duab uas qhia txog cov kab mob lymphoproliferative, thiab kev kuaj zis feem ntau tsis pom muaj kab mob.
Nrog kev pab los ntawm kev suav tomography, koj tuaj yeem txiav txim siab ntau dua qhov qauv thiab qhov loj ntawm salivarycov qog, tsis suav nrog cov tsos ntawm malignant neoplasms.
Kev kuaj mob ntawm tus kab mob suav nrog kev tshuaj tiv thaiv kab mob thiab tshuaj tiv thaiv kab mob nrog kev tshuaj xyuas los ntawm tus kws kho qhov tsis haum-immunologist, nrog rau kev sab laj nrog tus kws kho qhov muag, ua ib qho kev sim Schirmer thiab coj mus kuaj nrog fluorescein.
Kev kho mob
Kev kho mob Mikulich tus kab mob yuav tsum nyob rau hauv kev saib xyuas ntawm tus kws kho mob hematologist. Cov tshuaj tseem ceeb yog kev npaj arsenic, feem ntau yog cov tshuaj sodium arsenate hauv 1% concentration. Nws yog siv rau kev txhaj tshuaj subcutaneous, pib ntawm 0.2 milliliters thiab maj mam nce qhov ntau npaum li 1 milliliter ib hnub ib zaug. Thaum kawg ntawm kev kho mob, koob tshuaj txo qis. Rau kev kho kom tiav, kwv yees li 20-30 txhaj tshuaj yuav tsum tau ua. Hauv tib koob tshuaj, cov tshuaj "Duplex" yog siv. Ob mus rau peb zaug hauv ib hnub, tus neeg mob tau txais cov tshuaj potassium arsenate rau kev tswj qhov ncauj. Cov kev kho mob yuav kav li peb mus rau plaub lub lis piam. Koj tuaj yeem haus cov tshuaj arsenic, dopan thiab myelosan.
txoj kev ntxiv
Compresses ntawm cov qog thiab cov tshuaj tua kab mob tau siv dav. Ntxiv nrog rau kev kho tshuaj, kev siv ntshav ntxiv. Qee qhov xwm txheej, kev ua tiav ntawm qhov kev ua tau zoo tuaj yeem ua tau vim X-ray kho, uas nres cov txheej txheem inflammatory thiab txo qis ntawm cov qog ib ntus, kho lawv cov secretory ua haujlwm, thiab tshem tawm qhov ncauj qhuav. Noj cov vitamins pab txhawb lub cev tag nrho.
Peb tau tshuaj xyuas cov yam ntxwv ntawm tus kabmob thiab Mikulich's syndrome.
