Hepatomegaly ntawm daim siab: kuaj mob, tsos mob, kho

Cov txheej txheem:

Hepatomegaly ntawm daim siab: kuaj mob, tsos mob, kho
Hepatomegaly ntawm daim siab: kuaj mob, tsos mob, kho

Video: Hepatomegaly ntawm daim siab: kuaj mob, tsos mob, kho

Video: Hepatomegaly ntawm daim siab: kuaj mob, tsos mob, kho
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Hepatomegaly ntawm daim siab yog ib qho mob hnyav uas tshwm sim los ntawm kev nce hauv nws qhov loj. Nws tshwm sim nrog ntau yam kab mob uas cuam tshuam rau lub cev.

Dab tsi yog qhov pathology fraught nrog? Cov tsos mob dab tsi qhia tias nws muaj? Kev kuaj mob ua li cas? Dab tsi yog xav tau rau kev kho mob? Tam sim no cov lus nug no thiab ntau lwm cov lus nug yuav tsum tau teb, txij li txhua tus neeg yuav tsum paub tias nws yog dab tsi - hepatomegaly ntawm daim siab. Thiab hais txog kev kho mob, ib yam nkaus, vim qhov no pathology tsis tsawg.

Hepatomegaly yog diffuse kev hloov hauv daim siab
Hepatomegaly yog diffuse kev hloov hauv daim siab

Kev tshwm sim

Hepatomegaly ntawm daim siab tuaj yeem dhau los ua qhov teeb meem ntawm ntau yam kab mob loj, cov cim qhia ntawm tus neeg tsis quav ntsej (lossis yog tias kev kho mob tsis zoo). Cov laj thawj muaj nyob hauv qab no:

  • txheej txheem ntawm qhov xwm txheej infiltrative. Cov no suav nrog kev rog rog, leukemia lossis lymphoma, amyloidosis, extramedullary hematopoiesis, ntshav qab zib, cytomegalovirus, glycogenosis,Gaucher kab mob, thiab lwm yam.
  • Vascular congestion. Nws feem ntau tshwm sim los ntawm Buddy-Chiari kab mob lossis txoj cai ventricular tsis ua haujlwm.
  • Kab mob kis kab mob. Feem ntau cirrhosis thiab tshuaj-induced/viral hepatitis.
  • Tumor formations. Qhov txaus ntshai tshaj plaws yog daim siab adenoma, thawj carcinoma, nodular focal hyperplasia thiab mob qog noj ntshav.
  • polycystic.
  • kab mob siab.
  • Congestive heart failure.
  • mob khaub thuas thiab intoxications.
  • Tumor infiltration ntawm lub siab.
  • Leukemia thiab lwm yam hemoblastoses.

Txawm li cas los xij, qhov laj thawj tseeb ntawm pathology yog txiav txim los ntawm tus kws kho mob. Txawm hais tias, vim tias daim siab tsis loj ntawm nws tus kheej, tus neeg mob tej zaum yuav twv seb qhov yuav tsum tau ua ua ntej.

Ua li ntawd, koj yuav tsum tau kho, thiab sai li sai tau. Hauv cov xwm txheej siab, qee zaum lub siab nce mus txog qhov loj me, nyob ntau dua li ib nrab ntawm lub plab kab noj hniav. Qhov hnyav ntawm lub cev li 10-20 kilograms.

Symptoms

Qhov muaj lub siab hepatomegaly tuaj yeem qhia los ntawm ntau yam cim. Daim duab kho mob tag nrho feem ntau yog sawv cev los ntawm cov tsos mob hauv qab no:

  • Tsis xis nyob hauv txoj cai hypochondrium.
  • mob siab uas nce nrog kev txav mus los.
  • Kev tsis txaus siab dyspeptic, tshwm sim hauv flatulence, quav quav thiab xeev siab.
  • ua pa tsis zoo.
  • -tawg thiab khaus.
  • Condensation ntawm parenchyma (cov txheej txheem hlwb) ntawm daim siab.
  • daj ntawm daim tawv nqaijnpog thiab sclera.
  • Cim qhia kev qaug cawv.

Daim ntawv mus rau. Qhov tseeb, cov tsos mob nyob ntawm seb dab tsi yog qhov ua rau lub siab loj. Piv txwv li, nrog cirrhosis, daim tawv nqaij ua av thiab zoo li los ntshav. Thiab nrog benign formations nyob rau hauv tib neeg, ib qho asymmetric nce nyob rau hauv lub plab yog feem ntau pom.

Cov tsos mob me me tshaj plaws tau pom nrog cov kev hloov pauv degenerative thiab kev puas tsuaj lom. Thiab daim siab tuaj yeem ncav cuag qhov loj tshaj plaws nrog amyloidosis - ua txhaum ntawm cov metabolism hauv cov protein.

Kev kuaj mob hepatomegaly ntawm daim siab
Kev kuaj mob hepatomegaly ntawm daim siab

Diagnosis

Feem ntau, cov neeg mob muaj mob hepatomegaly ntawm daim siab. Ntawd yog, nws qhov kev hloov pauv tsis tseem ceeb hauv qhov loj. Nws tsis tuaj yeem txheeb xyuas nws ntawm koj tus kheej, txij li thaum lub sijhawm no cov tsos mob tsis meej. Thiab kom pom kev pom qhov nce hauv qhov ntim ntawm lub cev yog qhov tsis muaj tseeb.

Kev kuaj mob xav tau. Yog tsis muaj nws, nws yuav tsis tuaj yeem nrhiav kev kho mob hepatomegaly ntawm daim siab, vim qhov ua rau ntawm pathology yuav tsis meej. Kev kuaj mob suav nrog cov txheej txheem hauv qab no:

  • kuaj ntshav biochemical thiab kuaj ntshav.
  • Kua daim siab ua piv txwv.
  • Testing for cancer markers.
  • Coagulogram.
  • Immunogram.
  • X-ray.
  • Fecal tsom xam.
  • Computed tomography.
  • Ulra ultrasound.

Cov tsos mob ntawm hepatomegaly siv cov qauv no tuaj yeem lees paub, ntxiv rau, nws hloov tawm kom pom cov laj thawj tseeb rau kev tsim.syndrome. Tom qab tso tag nrho cov dots dhau kuv, tus kws kho mob piav qhia txog kev kho mob zoo tshaj plaws rau nws tus neeg mob.

Echoes ntawm hepatomegaly ntawm daim siab
Echoes ntawm hepatomegaly ntawm daim siab

Dab tsi tshwm sim hauv kev tshawb fawb?

Txuas ntxiv los txiav txim siab lub ntsiab lus ntawm kev kuaj mob, nws tsim nyog them nqi rau qhov teeb meem ntawm daim siab ultrasound.

Hepatomegaly tshwm rau ntawm qhov scan raws li qhov mob focal. Nyob ze nws, nws tuaj yeem pom cov cheeb tsam tshwj xeeb los ntawm kev txo qis ntawm radionuclides. Topographic hloov nyob rau hauv txoj hauj lwm, kev hloov nyob rau hauv cov qauv ntawm cov segments ntawm lub cev thiab, ntawm chav kawm, nws nce kuj pom.

Qhov zoo ntawm txoj kev ultrasound yog tias nws tuaj yeem siv los txheeb xyuas cov kab mob focal ntawm txhua qhov xwm txheej. Tom qab ua kev tshawb fawb, tus kws kho mob txiav txim siab tsis yog tsuas yog qib ntawm daim siab loj, tab sis kuj yog lub xeev ntawm tus po thiab lwm yam khoom nruab nrog cev.

Txawm li cas los xij, qhov no tsis txaus. Thiab tom qab ntawd koj yuav tsum mus rau echohepatography. Txoj kev no suav nrog kev xa ultrasonic pulses mus rau hauv qhov tob ntawm lub cev nyob rau hauv txoj kev kawm, uas tau cuam tshuam los ntawm nws thiab tsim cov duab ntawm nws qhov ntom ntawm qhov screen.

Thiab ncha ntawm hepatomegaly ntawm daim siab, qhov tseeb, ua lub luag haujlwm tseem ceeb hauv kev txiav txim siab cov kab mob uas ua rau lub siab loj. Nov yog cov txiaj ntsig ntawm cov txheej txheem:

  • Homogeneous echostructure ntawm lub cev. Pom hauv plawv tsis ua hauj lwm, kab mob parasitic, thiab mob kab mob siab.
  • Hloov echostructure. Nws taw rau cirrhosis, fatty siab thiab mob siab hepatitis.
  • Ntxhais kev cuam tshuam. Hais tias tej zaum yuav muaj abscess, cyst los yog qog nyob rau hauv daim siab.

Plus, echohepatography pab txiav txim siab qib ntawm pathology. Nws tuaj yeem nthuav tawm, nruab nrab thiab tsis nthuav tawm.

YHepatoprotectors

Hnub no, cov tshuaj niaj hnub no muaj ntau txoj hauv kev zoo, siv qhov twg, koj tuaj yeem tshem tau cov kab mob tshwj xeeb. Yog tias peb tham txog kev kho mob siab hepatomegaly, thawj qhov uas yuav tsum tau tham txog yog hepatoprotectors.

Qhov no yog dab tsi? Cov tshuaj tiv thaiv lub siab los ntawm kev puas tsuaj los ntawm lwm yam tshuaj, nrog rau kev khaws cia nws txoj kev noj qab haus huv thiab pab rov ua haujlwm zoo. Qhov nrov tshaj plaws hepatoprotectors yog:

  • "Essentiale N" thiab "Essentiale Forte N". Lub hauv paus ntawm cov tshuaj no yog qhov tseem ceeb phospholipids. Tus nqi pib los ntawm 500-1500 rubles
  • "Essliver Forte". Cov tshuaj no suav nrog cov vitamins ntawm pawg PP, E, B, nrog rau phospholipids. Cov tshuaj raug nqi los ntawm 250 rubles thiab ntau dua.
  • "Phosfonciale". Cov khoom xyaw tseem ceeb ntawm cov tshuaj ntsiav yog lipoid C-100 thiab silymarin. Tus nqi ntawm cov tshuaj pib los ntawm 300 rubles
  • "Txhob Cia Siab". Cov tshuaj no yog tsim los ntawm phospholipids thiab vitamin E. Nws tus nqi pib los ntawm 300 rubles.
  • "Phosphogliv". Cov tshuaj no suav nrog trisodium ntsev ntawm glycyrrhizic acid thiab phospholipids. Tus nqi pib ntawm 500 rubles
  • Rezalyut. Cov khoom no muaj phospholipids, soybean roj, vitamin E, glycerol mono / dialconate, nruab nrab saw triglycerides thiablipoid PPL 600. Tus nqi yog 600 rubles.

Tseem muaj ob hom hepatoprotectors ntawm tsiaj keeb kwm - Sirepar thiab Hepatosan. Lawv yog tsim los ntawm hydrolyzate ntawm lub cev thiab cov hlwb ntawm daim siab porcine, feem. Xws li ib qho "raws li cov khoom siv" txiav txim siab muaj cov amino acids, cov metabolism hauv qis molecular, cyanocobalamin hauv kev npaj.

Tseem muaj tshuaj hu ua Progepar. Nws raug sau tseg rau ob qho tib si rau nruab nrab hepatomegaly ntawm daim siab, thiab rau cov mob hnyav dua. Cov tshuaj pab ua kom cov ntshav ncig hauv lub cev, rov ua kom cov qauv ntawm hepatocytes thiab inhibit tsim cov ntaub so ntswg. Tsis tas li ntawd, cov tshuaj muaj txiaj ntsig zoo rau lub siab ua haujlwm thiab nce diuresis.

Essentiale Forte N pab nrog diffuse siab hloov
Essentiale Forte N pab nrog diffuse siab hloov

YDiuretics

Nov yog lub npe ntawm cov tshuaj diuretic uas pab ntxuav cov ntshav thiab txo qhov hnyav ntawm daim siab. Lawv txais tos kuj tau qhia rau kev kho tus kab mob no. Nov yog cov tshuaj nto moo tshaj plaws los ntawm pab pawg no uas tuaj yeem raug sau rau hepatomegaly thiab diffuse siab hloov:

  • Saluretics uas tshem cov poov tshuaj thiab sodium ions ntawm lub cev: "Diakarb", "Fonurite", "Furosemide", "Priretanide", "Dekidratin", "Indapamed"
  • tshuaj Osmotic uas normalize ntshav ntshav hauv lub sijhawm luv tshaj plaws: Urea, Manit thiab Sorbitol.
  • Potassium-sparing tshuaj: Triamur, Spironolactone, Amiloride, Aldactone, Triamteron.
  • Calcium-sparing tshuaj: Indyur, Arindap, Gigroton, Pamid, Retapres, Indap.

Yog tias tsis muaj lub siab xav siv cov tshuaj diuretics, koj tuaj yeem xyuam xim rau cov khoom ntawm lub hauv paus chiv keeb. Ntawm cov no, koj tuaj yeem ua diuretics koj tus kheej:

  • kua txiv qaub tsuas yog txuag ntawm qhov o. Nws yog txaus kom dilute nws nrog dej thiab haus nws rau kev tiv thaiv thiab kho lub hom phiaj.
  • Cranberry kua txiv yog ib qho tshuaj diuretic uas tseem muaj txiaj ntsig zoo rau kev ua haujlwm ntawm ob lub raum thiab cov kab mob genitourinary. Nws tuaj yeem haus cawv zoo.
  • Tsis muaj tshuaj yej nrog qhov sib ntxiv ntawm cov qhiav ntuj los yog kev tso dej ntawm cov hauv paus hniav no ntxuav lub cev ntawm co toxins.
  • Decoctions ntawm dandelion, nettle thiab cranberry nplooj kuj muaj diuretic zog.
  • Kua cider vinegar, zaub qhwv, eggplants, dib, txiv kab ntxwv - tag nrho cov no kuj yog cov npe ntawm cov tshuaj diuretics zoo.

Tab sis txawm tias cov tshuaj ntsuab yuav tsum tau siv nrog kev saib xyuas. Txwv tsis pub, koj tuaj yeem ua dhau nws thiab coj lub cev mus rau lub cev qhuav dej.

Carsil tshuaj

Kuv xav tham txog cov tshuaj no cais, vim peb tab tom tham txog kev kho mob thiab cov tsos mob ntawm hepatomegaly ntawm daim siab. Karsil yog dab tsi? Qhov no yog tshuaj ntsuab npaj raws li mis thistle txiv hmab txiv ntoo extract. Cov tshuaj nquag tshaj plaws yog silibinin, uas muaj cov nyhuv hepatoprotective.

Nws ntseeg tias Karsil yog ib qho tshuaj zoo tshaj plaws uas tuaj yeem tiv thaiv cov tsos mob ntawm hepatomegaly diffuse siab hloov.

Koj yuav tsum noj nws peb zaug ib hnub, ib lub tshuaj ntsiav nrog dej. Kev kawm yuav kav ntev npaum li cas, tus kws kho mob yuav txiav txim siab, tab sis feem ntau txoj kev kho mob yog li 1 lub hlis.

Cov tshuaj noNws muaj cov tshuaj tua kab mob antioxidant, daim nyias nyias-stabilizing thiab tiv thaiv kev mob. Los ntawm txoj kev, kuj tseem muaj Karsil Forte, thiab qhov kev kho no txawv ntawm cov qauv ib txwm muaj nyob rau hauv ntau dua cov ntsiab lus ntawm cov nroj tsuag nquag muaj nyob hauv nws.

Karsil - tshuaj
Karsil - tshuaj

kev kho neeg zoo

Txuas ntxiv los xav txog lub ntsiab lus ntawm qhov hepatomegaly ntawm daim siab txhais tau li cas, nws yog ib qho tsim nyog yuav tsum tau ua tib zoo saib xyuas cov txheej txheem tsis yog kev kho mob. Nov yog qee cov zaub mov txawv:

  • Y Hauv qhov sib npaug, sib tov chicory, peony, May dandelion cag, motherwort thiab sage. Noj 3 tbsp. l. sau thiab ncuav boiling dej (0.5 l). Nqa mus rau ib lub boil, thiab ces simmer rau li 30 feeb. Cia nws so rau lwm ib nrab teev. Lim thiab haus dej txhua hnub hauv qhov me me.
  • Sib tov sib npaug ntawm motherwort, immortelle paj, St. John's wort thiab mint nplooj. Sib tov tag nrho. Noj 2 tbsp. l. Lub resulting sib sau thiab ncuav boiling dej (0.5 l). Npog lub thawv nrog phuam, tos 40 feeb. Ces lim. Haus 100 ml ua ntej noj mov.
  • YMix St. John's wort, coltsfoot, calendula, plantain, celandine thiab miv paw nyom hauv qhov sib npaug. Ua raws li cov kauj ruam hauv daim ntawv qhia dhau los. Haus peb zaug ib hnub twg 20 feeb ua ntej noj mov, 100 ml. Hoob no kav 3 lub lis piam. Tom qab ntawd - so rau ib nrab ib hlis. Thaum lub sij hawm no, noj me ntsis mis thistle noob hmoov txhua hnub.
  • Thaum sawv ntxov thiab yav tsaus ntuj koj yuav tsum tau dilute zib mu (2 tsp) thiab kua txiv qaub (2 tsp) hauv ib khob dej sov boiled, sib tov kom huv si thiab haus.ntawm lub plab khoob.
  • Txias kua txiv los ntawm cov txiv apples ntsuab (yuav tsum ua 0.5 l) thiab sib tov nrog zib mu (tsis ntau tshaj ¼ khob). Haus cov dej haus uas tau tshwm sim thaum nruab hnub hauv qhov sib npaug rau 6 zaug.
  • Tsib loj walnuts, tev, crushed thiab tov nrog ib tug zoo tib yam npaum li cas ntawm zib mu. Muaj qhov sib tov no rau 1 tbsp. l. txhua hnub.

Muaj ntau lwm cov kev kho mob pej xeem uas pab kom tshem tawm cov tsos mob thiab cov tsos mob ntawm hepatomegaly diffuse hloov pauv hauv daim siab parenchyma.

Cov neeg txhawb nqa ntawm lwm cov tshuaj hais tias koj tuaj yeem tiv tau tus kab mob yog tias koj noj 100-150 grams boiled beets lossis taub dag txhua hnub (nws tuaj yeem ua tau ntau dua). Thiab nws yog qhov zoo dua kom muaj ib lossis lwm qhov. Cov zaub no muaj cov tshuaj uas ua rau kom rov ua kom lub siab ua haujlwm sai.

Tab sis feem ntau, tau kawg, nws yog qhov zoo dua los muab cov kev kho mob. Lub hauv paus yuav tsum yog cov kev kho mob uas kws kho mob tau sau tseg, thiab txhawm rau txhawm rau txhawm rau ua tiav, koj tuaj yeem siv tshuaj kho ib txwm siv. Tab sis ua ntej ntawd, koj yuav tsum sab laj nrog kws kho mob.

Yuav ua li cas kho hepatomegaly ntawm daim siab
Yuav ua li cas kho hepatomegaly ntawm daim siab

Kev noj haus

Tau kawg, kev noj zaub mov kom zoo yog ib qho ntawm cov xwm txheej tsim nyog los tshem tawm hepatomegaly. Kev hloov pauv hauv daim siab yuav tsis ploj mus yog tias ib tus neeg haus tshuaj, tab sis tib lub sijhawm siv cawv thiab zaub mov tsis raug cai.

Yog li, ntawm no yog qhov tso cai noj hauv lub xub ntiag ntawm tus kab mob no:

  • khob cij dawb qhuav los yog croutons ua los ntawm nws.
  • Zaub mov hauv zaub broths nrog zoo-boiled cereals.
  • - Kev noj zaub mov nqaij loj thiab nqaij nyug, qaib ntxhw, nqaij qaib thiab luav nqaij.
  • ntses tsis rog. Cov no muaj xws li cod, pollock, bream, hake, perch, pike perch.
  • Porridge nrog dej los yog mis nyuj tsis muaj roj.
  • muas pasta.
  • zaub. Lawv tuaj yeem noj tau hau, ci, lossis hauv cov zaub xam lav.
  • Cov khoom noj muaj roj tsawg, cov cheese hauv tsev, cov tsev cheese uas tsis yog acidic.
  • txiv hmab txiv ntoo qab zib thiab berries.
  • kua txiv tshiab (yuav tsum tau diluted nrog dej).
  • YCompotes, jelly, jelly.
  • Nyob zoo ib tsoom niam txiv kwv tij phooj ywg sawv daws. Tab sis nyob rau hauv me me.
  • Txiv hmab txiv ntoo, tshuaj ntsuab thiab txiv ntoo txiv ntoo, dej ntxhia, rosehip infusion.

Tab sis qhov txwv tsis pub:

  • Ntsuab thiab qab zib hauv daim ntawv xoob.
  • -rog nqaij thiab ntses, waterfowl, offal.
  • Tsiaj thiab roj ua noj. Qhov siab tshaj plaws ntawm 40 ml roj tau tso cai ib hnub.
  • Cov khoom qab zib (khoom qab zib, ncuav qab zib, chocolate, butter thiab puff pastry).
  • Npuag zaub thiab legumes.
  • YSorrel, dos, spinach, radish, qej, nceb, radish.
  • Nyob hauv cov kua ntses (ketchup, mayonnaise, mustard, thiab lwm yam).
  • ntsim thiab cov kua ntsev, cov mis nyuj tag tag, cov mis nyuj puv, qab zib, qaub cream, glazed curds.
  • Qe. Ntau tshaj 3 lub lis piam tso cai.
  • ice cream, cocoa, kas fes thiab tshuaj yej.
  • Cawv, ntim cov kua txiv hmab txiv ntoo thiab dej qab zib.
  • Txhua yam yog kib, ntsim thiab kub. Cov zaub mov yuav tsum yog nruab nrab thiab siavlos ntawm boiling / ci los yog steaming.

Raws li koj tuaj yeem pom, kev noj zaub mov rau hepatomegaly tsis nruj heev. Muaj ib yam dab tsi los ua koj cov zaub mov. Kev noj zaub mov kom raug thiab noj cov zaub mov uas muaj cov vitamins, macro- thiab microelements yuav pab txhawb lub cev tiv thaiv kab mob thiab ua rau lub siab rov qab sai.

Hepatomegaly ntawm daim siab - yog dab tsi
Hepatomegaly ntawm daim siab - yog dab tsi

Huab cua thiab tiv thaiv

Ntau tau hais saum toj no txog cov tsos mob, cov tsos mob, ua rau thiab kev kho mob hepatomegaly. Dab tsi yog qhov tseeb. Thiab yuav ua li cas nrog nws, ib yam nkaus thiab. Yog li ntawd, thaum kawg, kuv xav tham txog kev kwv yees thiab kev tiv thaiv.

Feem ntau, yog ib tug neeg mus cuag kws kho mob raws sij hawm, kev kho mob tsis siv sij hawm ntau. Feem ntau, ib hlis yog txaus rau tus neeg mob kom zoo. Lub sijhawm no, daim siab ua rau poob qis, nws txoj haujlwm pib rov zoo, thiab kev nce qib feem ntau pom.

Txawm li cas los xij, txhua yam yog nyob ntawm qhov ua rau tus mob, qhov kev puas tsuaj rau hepatocytes thiab qhov tsis tuaj yeem ntawm cov txheej txheem. Qhov kev kwv yees phem tshaj plaws yog tsim nyob rau hauv cov xwm txheej uas ib tug neeg lub siab pib nce vim cirrhosis, toxic puas tsuaj, thiab nyob rau hauv thawj txheej txheem neoplastic.

Yog tias peb tham txog kev tiv thaiv, qhov tseem ceeb tshaj plaws ntawm no yog kev tiv thaiv kab mob uas tuaj yeem ua rau pom cov kab mob no. Txhawm rau ua qhov no, koj yuav tsum tau saib xyuas koj lub siab: tsis txhob noj cov zaub mov uas txhawb kev tsim cov pa roj, qee zaum "ntxuav" nrog cov hluav taws kub hnyiab, haus tsawg kawg 2 litres dej huv txhua hnub.

Thiab yog tias muaj tshuaj lom dheev tshwm sim, los ntawm qhov tsis muaj leej twg tiv thaiv kab mob, nws yog qhov yuav tsum tau tshem tawm kev qaug cawv. Piv txwv li, haus dej haus tshiab ntawm cov qus sawv, piv txwv li, los yog noj magnesium sulfate, kho cov nyhuv los ntawm cua sov lub siab nrog lub tshuab cua sov. Holosas tseem tuaj yeem pab tau, uas muaj cov tshuaj ntxuav me me ntawm daim siab, nrog rau sodium thiosulfate, uas tshem cov ntsev thiab cov hlau hnyav.

Thiab, tau kawg, tsawg kawg ib zaug txhua rau lub hlis (thiab thaum ncav cuag kev zam txim - txhua 3 lub hlis) mus ntsib kws kho mob kom kuaj xyuas. Thiab tsis muaj ib qho xwm txheej tsis quav ntsej cov tsos mob uas yuav qhia tau tias muaj teeb meem kev noj qab haus huv. Kev tiv thaiv kab mob yooj yim dua li kho nws.

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