Cov qog nqaij hlav loj hauv cov poj niam tuaj yeem qhia cov kab mob loj, lawv feem ntau tshwm sim ntawm keeb kwm ntawm kev mob hauv lub cev. Lymph nodes yog ib hom teeb liab uas muaj ib yam dab tsi tau ploj mus hauv lub cev.
Qhov ua rau mob qog nqaij hlav hauv plab hauv cov poj niam tuaj yeem yog kev txiav banal lossis kis kab mob. Txawm li cas los xij, tus poj niam yuav tsum sab laj nrog kws kho mob. Raws li cov tsos mob thiab keeb kwm kev kho mob, tus kws kho mob sau cov kev sim thiab kev tshawb fawb uas tsim nyog, thiab tom qab ntawd xaiv cov kev kho mob.
Tsis tas yuav ntshai, vim cov qog ntshav qab zib tuaj yeem nce nrog tus mob khaub thuas, tab sis koj yuav tsum tsis txhob yig tiv tauj lub tsev kho mob.
Qhov no yog dab tsi?
Ib lub qog ntshav qab zib yog ib yam ntawm lub cev lim dej uas ntxuav cov qog ntshav los ntawm ntau yam kab mob thiab co toxins, nrog rau cov khoom lag luam ntawm tes. Cov kab mob tuaj yeem nkag mus rau cov qog ntshav los ntawm cov ntaub so ntswg peripheral, thiab nyob rau hauv cov qog ntshav qab zibdecontamination los ntawm lub cev tiv thaiv kab mob. Tsis tas li ntawd, cov tshuaj tiv thaiv kab mob loj hlob hauv cov qog ntshav: T-killers thiab T-helpers. Lawv tiv thaiv lub cev los ntawm cov kab mob thiab qog.
Cov qog ntshav hauv cov puab tsaig tshem tawm cov kua dej ntawm lub plab me me nrog rau cov leeg qis. Nyob rau hauv lub cev noj qab haus huv, qhov luaj li cas ntawm node nyob rau hauv thaj tsam ntawm 1.5-2 cm. Yog hais tias ib tug kab mob los yog kab mob tau nkag mus rau hauv lub cev, lub lymph node yuav nce.
Qhov chaw ntawm inguinal lymph nodes
Cov qog ntshav qab zib nyob qhov twg? Lub cev nqaij daim tawv ntawm tib neeg cov qauv koom nrog tag nrho cov lymphatic system ntawm lub cev. Tsis muaj cov qog nqaij hlav inguinal nkaus xwb, txhua chav haujlwm muaj nws tus kheej "cov kab mob lim". Nws yog ib qho yooj yim to taub qhov twg cov qog nqaij hlav nyob rau hauv lub puab tais ntawm cov poj niam, vim hais tias lawv yog heev yooj yim mus xav. Qhov chaw yog lub perineum nyob rau hauv lub quav ntawm ob txhais ceg thiab pelvic cheeb tsam. Lawv kuj yog palpable nyob rau hauv daim duab peb sab femoral.
Qhov kev teeb tsa ntawm cov qog ntshav qog qhia peb pawg:
- theem sab sauv ntawm cov qog ntshav nyob hauv thaj tsam femoral thiab qis plab;
- ntxhi rau qhov qhib qhov quav yog theem nruab nrab;
- ntawm ceg - qis dua.
Lymph nodes, uas nyob nruab nrab ntawm tus ncej puab thiab thaj chaw inguinal, yog palpated yam tsis mob siab. Tab sis tsis yog tag nrho cov qog ntshav hauv lub puab tsaig tuaj yeem ua palpated - qib siab thiab nruab nrab tsis tuaj yeem palpable.
Cov hauv qab no yog daim duab qhia qhov chaw ntawm cov qog nqaij hlav hauv plab hauv pliaj poj niam.
Qhov chaw ntawm cov qog ntshav hauv cov txiv neej
Cov qog ntshav qog ntshav nyob qhov twgtxiv neej? Inguinal lymph nodes nyob rau ntawm qhov sib txuas ntawm tus ncej puab nrog lub peritoneum, lawv nyob ib sab ntawm cov hlab ntsha, spermatic qaum, inguinal kwj dej.
Txiv neej inguinal lymph nodes rhiab heev rau ntau yam kab mob, lawv tuaj yeem ua rau mob khaub thuas lossis ua xua, mob nqaij lossis pob txha. Txo kev tiv thaiv kab mob thiab kev ntxhov siab tuaj yeem ua rau muaj kev nce ntxiv hauv cov qog ntshav hauv cov txiv neej.
Feem ntau, cov tswv yim uas cov qog nqaij hlav hauv pliaj ntawm cov poj niam tsis txawv ntau ntawm cov txiv neej.
Lymphadenitis
Ib kab mob uas mob ntawm cov qog nqaij hlav inguinal raug kuaj pom yog hu ua lymphadenitis. Rau kev kho kom raug, koj yuav tsum nco ntsoov tias muaj cov laj thawj zoo uas ua rau cov kab mob lymphatic thiab tiv thaiv kab mob. Hauv kev kho mob, nws yog ib txwm ua kom paub qhov txawv ntawm ntau hom lymphadenitis, nyob ntawm qhov chaw ntawm cov qog ntshav hauv cov puab tsaig hauv cov poj niam thiab qhov ua rau ntawm keeb kwm.
Muaj qhov dav dav thiab hauv cheeb tsam inguinal lymphadenitis.
Kev mob ntawm ib lossis ob peb lub qog ntshav yog xa mus rau hauv zos, o tuaj yeem ua rau ib leeg lossis ob sab.
Nrog unilateral inguinal lymphadenitis, tus kab mob nkag mus rau cov qog nqaij hlav los ntawm sab nraud. Nrog ob sab lymphadenitis, peb tuaj yeem tham txog cov kab mob sib kis ntawm cov kab mob hauv nruab nrog cev.
Type of inguinal lymphadenitis
Muaj ob hom lymphadenitis:
- specific;
- non-specific.
Tshwj xeeb lymphadenitis tshwm sim vim muaj cov kab mob loj, nws tuaj yeem ua tautuberculosis, pneumonia, syphilis, kab mob oncological. Nonspecific lymphadenitis tuaj yeem ua tau vim qhov chaw tshwj xeeb ntawm cov qog ntshav hauv cov puab tsaig hauv cov poj niam: kev kis mob tshwm sim (feem ntau yog kev sib deev), qhov no ua rau cov qog ntshav nce ntxiv.
Tsis tas li, lymphadenitis tuaj yeem ua mob ntev lossis mob. Nyob rau hauv mob, tus neeg mob muaj ib tug ntse deterioration nyob rau hauv tus mob nrog nce nyob rau hauv lub cev kub thiab mob hnyav nyob rau hauv lub inguinal cheeb tsam. Cov kab mob lymphadenitis ntev yog ib qho mob hnyav dua, uas tshwm sim los ntawm kev nce ntxiv hauv cov qog nqaij hlav uas tawv, ua rau tsim cov adhesions.
Ua rau cov qog nqaij hlav loj
Ib yam ua rau cov qog ntshav qab zib o hauv pliaj yog kev kho tus kab mob uas tsis ua raws li cov qauv kev kho mob, yog li nws yog ib qho tseem ceeb kom mus ntsib kws kho mob thiab tsis txhob noj tshuaj rau tus kheej. Feem ntau, cov kab mob sib kis tuaj yeem ua rau cov qog ntshav loj.
Qhov ua rau mob qog nqaij hlav hauv plab hauv plab hauv cov poj niam tuaj yeem yog cov hauv qab no:
- Kev puas tsuaj ntawm daim tawv nqaij: txiav thaum tshem tawm cov plaub hau nrog rab chais hauv thaj tsam bikini, bruises hauv puab tais, miv khawb (nrog me ntsis raug mob, tus kab mob Bartonella tuaj yeem ua rau cov qog ntshav nce ntxiv), stab qhov txhab ntawm qhov qis. extremities, ceg pob txha.
- Kev ua xua: qhov ua rau tej zaum yuav yog cov khoom siv tu cev uas tsis tau siv yav dhau los lossis cov gel da dej; Kev mob tshwm sim ntawm qee yam tshuaj ("Finlepsin", "Penicillin")
- Kab mob ntawm qhov chaw mos: mob thrush, vulvovaginitis,Kev mob ntawm Bartholin Canals (bartholinitis).
- Purulent ntawm daim tawv nqaij ntawm lub puab tsaig lossis qis qis: cov kab mob no tuaj yeem tshwm sim los ntawm E. coli lossis streptococcus.
- Kab mob ntawm tus kab mob etiology: mob khaub thuas mob khaub thuas hauv tus neeg mob uas muaj lub cev tsis muaj zog tiv thaiv kab mob, Epstein-Barr tus kab mob, mob qog nqaij hlav hauv qhov chaw mos, rubella, qhua pias.
- Kab mob ntawm ib qho venereal: thawj theem ntawm syphilis, chlamydia, gonorrhea nyob rau hauv thawj theem, latent los yog asymptomatic ureaplasmosis.
- Kab mob ntawm poj niam qhov chaw mos ntawm cov kab mob uas tsis yog-inflammatory etiology: cov txheej txheem nplaum, zes qe menyuam, cuam tshuam hormonal ntau ntau.
- Kab mob ntawm cov urinary system: mob cystitis, urethritis, zais zis pob zeb (thaum lawv dhau los ntawm cov urethra, lawv cuam tshuam rau cov mucous membrane, ib qho inflammatory tshwm sim), mob pyelonephritis.
- Cov tshuaj tiv thaiv ntawm lub cev rau kev phais: tsis muaj kab mob lymphadenitis tuaj yeem pib tom qab kev ua haujlwm ntawm purulent o (appendicitis nyob rau theem kawg, peritonitis), thiab o kuj tuaj yeem ua tau thaum lub cev tsis lees txais kev cog qoob loo thaum phais yas ntawm lub cev. lub cev nqaij daim tawv.
- Ntau yam kab mob: cytomegalovirus, tuberculosis, HIV, mononucleosis, toxoplasmosis thiab lwm yam.
- Pathologies ntawm qis extremities: trophic ulcer, mob caj dab ntawm lub duav pob qij txha, erysipelas, mob caj dab ntawm lub hauv caug sib koom.
- Cov kab mob Oncological: Hodgkin's lymphoma, lymphosarcoma, malignant neoplasm ntawm qhov quav, nrog rau qhov chaw mos,metastases nyob rau hauv lub plab hnyuv siab raum, mob qog noj ntshav ntawm cov qog nqaij hlav (nws tsis tuaj yeem txiav txim siab theem ntawm qhov txhab los ntawm txoj kev mob qog noj ntshav ntawm cov qog nqaij hlav hauv puab tais zoo li).
Symptoms
Qhov chaw ntawm cov qog ntshav hauv cov puab tsaig hauv cov poj niam ua rau nws muaj peev xwm ua rau tus kab mob lymphadenitis unilateral lossis ob tog. Raws li txoj cai, cov txheej txheem ntawm tus kab mob pib nrog kev mob ib txwm, uas, yog tias tsis kho, tuaj yeem ua rau tsim cov suppuration, kev loj hlob ntawm adenophlegmon, lossis mob ntev ntawm cov qog nqaij hlav.
Cov tsos mob hauv qab no yog qhov zoo rau cov qog nqaij hlav inguinal loj:
- txoj kab uas hla ntawm cov qog ntshav nce ntxiv, hauv cov kab mob hnyav, cov qog ntshav qog tuaj yeem ua qhov loj ntawm lub qe qaib;
- mob siab rau hauv puab tais: nyob rau hauv lub xeev siab, cov qog nqaij hlav tsis mob, txawm li cas los xij, qhov mob hnyav tuaj yeem ua rau palpation, thiab cov tsos mob tsis zoo tuaj yeem tshwm sim thaum khiav lossis taug kev nrawm;
- daim tawv nqaij saum toj thiab ib puag ncig cov qog ntshav hloov pauv: pom kev, koj tuaj yeem pom cov tawv nqaij reddening, tev thiab khaus;
- qhov nce siab hauv lub cev kub: cov tsos mob no feem ntau tshwm sim tawm tsam keeb kwm ntawm lwm tus kab mob, tab sis kuj yog cov tsos mob ntawm cov qog nqaij hlav loj;
- qaug zog: thaum kis kab mob los yog txheej txheem purulent tshwm sim hauv lub cev, tus neeg mob xav tias tsis muaj zog;
- tsis qab los noj mov: yog hais txog cov tsos mob ntawm cov kab mob uas ua rau muaj kev nce hauv cov qog nqaij hlav.
Nyob rau hauv cov mob lymphadenitis, cov tsos mob me me los yog tsis tuaj, tab sis thaum lub sij hawm exacerbation, cov tsos mob yuav tshwm sim.
Diagnosis
Rau qhov kev kuaj mob kom raug thiab raug, nws yog ib qho tseem ceeb uas yuav tsum tau siv ntau qhov kev tshawb fawb soj ntsuam raws li qhov ua tau kom daim duab kho mob pom tau meej thiab meej. Yog tias pom cov qog inguinal loj, tus poj niam yuav tsum hu rau tus kws kho mob gynecologist lossis venereologist, tom qab ntawd kev kho mob yuav raug sau tseg raws li keeb kwm thiab kev tshawb fawb thawj zaug.
Kev tsis txaus siab thiab kev tsis txaus siab
Cov tsos mob tseem ceeb ntawm tus kab mob tuaj yeem mob me lossis, ntawm qhov tsis sib xws, hais tau, nws nyob ntawm hom kab mob thiab qhov chaw ntawm cov qog ntshav hauv tus poj niam lub puab tsaig, yog li nws tseem ceeb heev uas yuav tsum tau noj anamnesis txog kev ua neej nyob, hais txog kev sib deev, hais txog kev raug mob thiab kev raug mob, hais txog tus neeg mob cov txheeb ze uas tej zaum yuav muaj cov kab mob txaus ntshai.
Feem ntau tus neeg mob yws txog:
- mob plab;
- ntau cov qog nqaij hlav;
- mob thaum ua si;
- tshav kub hauv pliaj;
- reddening ntawm daim tawv nqaij;
- Vaginal tawm hauv poj niam.
Kev tshuaj xyuas
Thaum kuaj pom tus neeg mob, tus kws kho mob yuav tsum ua tib zoo tshuaj xyuas qhov loj ntawm cov qog ntshav thiab nws txoj kev txav mus los. Cov tsos mob hauv qab no yuav qhia tau tias mob mob:
- mob hauv cov qog ntshav ntawm palpation;
- o ntawm cov ntaub so ntswg uas nyob ib sab ntawm cov qog nqaij hlav o;
- cov qog ntshav tsis txav vim qhov tseeb tias nws tau loj hlob ua ke nrog cov ntaub so ntswg nyob sib ze;
- dense lymph node sib xws;
- ci liab ntawm daim tawv nqaij hla cov qog ntshav.
Yog tus kws kho mob pom qhov ntawd hauvNyob rau hauv nruab nrab ntawm lub lymph node muaj ib tug softening ntawm cov ntaub so ntswg, ces qhov no yog ib tug kos npe rau ntawm tsim ntawm purulent masses nyob rau hauv lub node. Nrog rau tus kheej qhib ntawm ib tug purulent abscess nyob rau hauv lub puab tais, ib tug phlegmon yog tsim - ib tug compacted cheeb tsam uas tsis muaj ib tug meej ciam teb. Pus tuaj yeem raug ntiab tawm los ntawm cov kab lus tsis txaus ntseeg.
Thaum cov qog tsim, qhov mob ntawm cov qog nqaij hlav me me:
- daim tawv nqaij ntawm cov qog nqaij hlav tsis sib txawv ntawm cov xim ntawm cov tawv nqaij;
- cov qog ntshav qab zib tsis txuas nrog cov ntaub so ntswg noj qab nyob zoo;
- tsis mob;
- cov qog ntshav qab zib nyuaj rau palpation.
Kev Tshawb Fawb thiab Kev Tshawb Fawb
Kev tshuaj ntsuam xyuas:
- Ua tiav cov ntshav - thaum muaj qhov mob hauv lub cev, cov leukocytes hauv cov ntshav tau nce, ESR nrawm dua.
- Kev tso zis ntau ntau - hauv cov neeg laus uas muaj mob, muaj protein ntau pom hauv cov zis, thiab hauv cov menyuam yaus - ketone lub cev.
- Kev kuaj ntshav biochemical - cov ntsiab lus protein ntau hauv cov ntshav ntshav.
- Kev kuaj ntshav rau cov tshuaj tiv thaiv - pab txheeb xyuas qhov ua rau mob.
- Kev tshawb fawb nyob rau hauv lub tshuab tsom - txhawm rau txheeb xyuas cov qog hlwb thiab cov kab mob ua rau tus kab mob, cov qog ntshav qab zib tau tshuaj xyuas hauv lub tshuab ntsuas.
- Bakposev - cov khoom ntawm cov qog ntshav qab zib tau tshuaj xyuas rau cov khoom noj khoom haus thiab qhov rhiab ntawm cov kab mob mus rau ib hom tshuaj tua kab mob yog txiav txim siab.
- X-ray kev kuaj - qhia tau tias muaj kev hloov pauv hauv tuberculosis, thiab tseem pab tsim kom muaj calcifications hauv cov qog ntshav.
- Kev kawm Ultrasound - saib kev swbCov ntaub so ntswg nyob sib ze, qhov loj ntawm cov qog thiab nws cov ntsiab lus.
- Biopsy - cov qog ntshav qog tau raug tho thiab cov khoom raug coj mus rau kev tshawb fawb ntxiv.
Kev kho mob
Ntau tus kws kho mob koom nrog hauv kev kho mob pathology, nws nyob ntawm qhov chaw ntawm cov qog ntshav hauv tus poj niam lub puab tsaig. Raws li txoj cai, kev kho mob tuaj yeem raug sau los ntawm kws kho mob gynecologist, kws phais mob lossis tus kws kho mob tshwj xeeb. Feem ntau siv cov kev kho mob conservative. Yuav muaj ntau yam ua rau o ntawm cov qog nqaij hlav hauv puab tais. Kev kho mob yog sau nruj me ntsis rau tus kheej.
Kev kho tshuaj yog siv tshuaj thiab tshuaj tua kab mob rau kev kho mob. Cov poj niam raug muab tshuaj hormonal tshuaj tua kab mob, cov tshuaj feem ntau yog Penicillin. Tus kws kho mob txiav txim siab npaum li cas thiab lub sijhawm ntawm kev tswj hwm tus kheej rau txhua tus neeg mob. Kuj tau sau tshuaj pleev rau kev siv sab nraud - "Levomekol", salicylic thiab tetracycline. Cov tshuaj pleev ib ce muaj txiaj ntsig zoo tsuas yog hauv kev kho mob nyuaj nrog tshuaj tua kab mob.
Ntxiv rau cov tshuaj, kev kho lub cev yog muab: electrophoresis thiab UHF. Cov txheej txheem physiotherapeutic muaj cov tshuaj tiv thaiv kab mob, tab sis lawv tsis siv rau cov kab mob purulent, vim tias cov ntaub so ntswg tau rhuab thiab purulent masses raug tso tawm.
Kev cuam tshuam kev phais yog ua nyob rau hauv feem ntau tsis quav ntsej, yog tias tshuaj thiab kho lub cev tsis zoo. Ntawm cov neeg mob sab nraud, cov qog nqaij hlav uas muaj cov kab mob purulent tau qhib, cov kua dej tau raug teeb tsa - lub raj silicone, uas txhawb nqa cov dej ntws tawm ntawm purulent masses.
Huab cua
Kho nrawmmuaj kev vam khom ncaj qha rau theem ntawm tus kab mob, nrog rau cov xwm txheej ntawm chav kawm. Feem ntau koj yuav tsum xub kho qhov ua rau ntawm cov qog nqaij hlav o, thiab tsuas yog tom qab ntawd qhov mob ntawm lub puab tais nws tus kheej. Daim ntawv mob ntev yuav tsum tau kho cov txheej txheem mus sij hawm ntev, qee zaum nrog ib daim ntawv nyuaj, kev kho mob tuaj yeem kav ntev li ob peb lub hlis.
Cov qog ntshav qab zib tau teb zoo rau kev kho mob, rau cov tshuaj niaj hnub, xws li pathology tsis yog teeb meem loj.
