Lymph nodes yog cov qauv ntawm tib neeg cov kab mob lymphatic, thiab lawv qhov o ua rau ntau lub cev tsis ua haujlwm. Muaj lub ncauj tsev menyuam, intrathoracic, femoral, submandibular, supraclavicular, popliteal, inguinal thiab axillary lymph nodes, uas feem ntau txiav txim siab ua haujlwm ntawm tag nrho cov hauv nruab nrog cev. Yog tias muaj cov qog nqaij hlav hauv caj dab hauv tus neeg laus lossis menyuam yaus, uas yog, lawv loj tuaj, qhov no suav tias yog ib qho mob txaus ntshai.
Txog kab mob ntawm lymphatic system
Tshuaj paub ntau yam kab mob, kev loj hlob ntawm cov uas tuaj yeem nrog rau cov kab mob hnyav ntawm cov qauv ntawm lymphatic system. Lawv tshwm sim tsis yog rau cov neeg laus xwb, cov menyuam yaus tuaj yeem dhau los ua tus neeg raug tsim txom ntawm cov tsos mob txaus ntshai no. Txhua tus kab mob ib txwm ua ke nrog cov txheej txheem inflammatory, yuav tsum tau kuaj xyuas thiab sau cov ntaub ntawv anamnesis.
Nyob ntawm pathologies
Cov kab mob tseem ceeb yog:
- Regional lymphadenitis, uas tuaj yeem tshwm sim los ntawm kev raug mob lossisKev ua haujlwm ntau dhau ntawm cov kab mob pathogenic. Nrog rau qhov mob, cov qog nqaij hlav loj zuj zus tuaj, pib mob, thiab ua kom muaj kua paug. Hauv qhov xwm txheej no, yuav tsum muaj kev cuam tshuam kev phais.
- Lymphangitis yog ib yam kab mob uas tshwm sim los ntawm kev mob ntawm cov hlab ntsha ntawm lymphatic system, feem ntau kis mus rau hauv lub cev. Muaj qhov mob hnyav, qhov o hnyav tau pom, kev ua haujlwm ntawm cov ceg li qub tau cuam tshuam.
- Angioimmunoblastic lymphadenopathy yog ib qho kev phom sij txaus ntshai ua ntej los ntawm kev kis kab mob thiab kab mob. Cov txheej txheem inflammatory no ua rau muaj teeb meem uas tuaj yeem ua rau muaj kab mob oncological.
Lymphadenitis: piav qhia luv luv ntawm pathology
Lymphadenitis (ICD-10 code L04) yog ib qho tshwj xeeb lossis tsis yog qhov tshwj xeeb ntawm cov qog nqaij hlav qog. Tus kab mob no tshwm sim los ntawm lawv qhov mob thiab nce, mob taub hau, tsis muaj zog, malaise, kub taub hau. Cov tshuaj tiv thaiv kab mob hauv lymphadenitis yog qhov cuam tshuam kev ua haujlwm ntawm lymphatic system, uas txwv tsis pub kis kab mob thoob plaws hauv lub cev. Feem ntau, cov kab mob ntawm cov qog ntshav qog tshwm sim raws li qhov teeb meem ntawm o ntawm ib qho chaw hauv zos. Cov kab mob kis tau nkag mus rau hauv cov qog ntshav hauv cheeb tsam nrog cov qog ntshav uas ntws los ntawm qhov tseem ceeb purulent. Hauv lwm qhov xwm txheej, tus kab mob tshwm sim thaum tus kab mob nkag mus rau hauv cov lymphatic network ncaj qha los ntawm cov mucous membranes lossis daim tawv nqaij puas.
Ua rau lymphadenitis
Tus neeg sawv cev ntawm tus kab mob no ntawm cov qog ntshav qab zib yog pyogenic flora -streptococci thiab staphylococci, nrog rau cov co toxins uas lawv tso tawm. Lawv nkag mus rau cov qog ntshav los ntawm hematogenous, lymphogenous lossis kev sib cuag. Thawj qhov kev tsom xam tuaj yeem yog qhov txhab purulent, boils, panaritiums, carbuncles, erysipelas, phlegmon, trophic ulcers, caries, thrombophlebitis, osteomyelitis. Cov txheej txheem inflammatory hauv zos feem ntau nrog rau hauv daim ntawv hauv cheeb tsam.
Dab tsi yog qhov ua rau mob qog nqaij hlav hauv cov menyuam yaus? Tus kab mob no feem ntau cuam tshuam nrog mob khaub thuas, mob tonsillitis, otitis media, kab mob me nyuam yaus, kab mob ntawm daim tawv nqaij. Qhov ua rau ntawm lymphadenitis tshwj xeeb yog cov kab mob syphilis, tularemia, tuberculosis, gonorrhea, plague, actinomycosis, anthrax, thiab lwm yam.
Cov tsos mob tseem ceeb ntawm lymphadenitis yog dab tsi?
Cov txheej txheem tsis muaj tshwj xeeb pib nrog qhov mob hauv cheeb tsam ntawm cov qog ntshav hauv cheeb tsam thiab lawv qhov loj. Nyob rau hauv cov ntaub ntawv hyperplastic thiab catarrhal, cov nodes loj yog yooj yim palpable, lawv qhov mob yog tsis tseem ceeb, cov kab mob loj yog me me.
Thaum suppurated, pob caus yuav mob thiab ntom, intoxication tshwm sim - poob qab los noj mov, kub taub hau, mob taub hau, tsis muaj zog. Kev tshwm sim hauv zos nce - edema thiab hyperemia nyob rau hauv thaj tsam ntawm qhov cuam tshuam ntawm node, nws cov contours ua fuzzy. Yog tias qhov tsim abscess tsis qhib rau lub sijhawm, cov paug tuaj yeem tawm los yog mus rau hauv cov ntaub so ntswg nyob sib ze.
Lymphadenitis (raws li ICD-10 - L04) hauv cov menyuam yaus kis tau kub taub hau, poob qab los noj mov, malaise, pw tsaug zog.
Kho ntawm xws li pathology,zoo li lymphadenitis
Hyperplastic thiab catarrhal mob lymphadenitis feem ntau yog kho kom zoo. Kev kho tshuaj tua kab mob yog nqa tawm raws li kev nkag siab ntawm cov nroj tsuag, vitamin thiab UHF kho. Nrog rau cov txheej txheem purulent, nws ua ib qho kev cuam tshuam kev phais, thaum lub sij hawm cov kua paug tawm, kev huv huv thiab kev tso dej ntawm qhov tsom xam yog nqa tawm. Kev kho mob detoxification tseem raug sau tseg. Nyob rau hauv cov kab mob ntev ntawm cov qog nqaij hlav ntawm ib hom tsis tshwj xeeb, yuav tsum tau kho cov kab mob hauv qab no.
Ib kab mob ntawm cov kab mob lymphatic hu ua lymphangitis
Lymphangitis - o ntawm lymphatic capillaries thiab pob tw ntawm qhov mob hnyav lossis mob ntev, tshwm sim thib ob, nrog cov txheej txheem purulent lossis inflammatory hauv lub cev. Lymphangitis yog nrog los ntawm qhov mob o thiab hyperemia nyob rau hauv cov hlab ntsha, lub regional lymphadenitis, edema, kub taub hau, ua daus no, thiab qaug zog. Nrog rau tus kab mob no ntawm cov qog ntshav, cov hlab ntsha lymphatic ntawm qhov sib txawv ntawm qhov tob ntawm qhov chaw thiab caliber tuaj yeem cuam tshuam. Feem ntau pom nrog lymphangitis ntawm extremities, uas tau piav qhia los ntawm lawv cov microtrauma nquag, ntau tus kab mob microbial thiab peculiarities ntawm lymph ncig.
Ua rau lymphangitis
Tus kab mob no tshwm sim zaum ob, tawm tsam keeb kwm yav dhau los ntawm kev sib sib zog nqus los yog sab nraud purulent-inflammatory focus - furuncle, kis kab mob lossis abrasion, abscess, phlegmon. Cov kab mob tseem ceeb hauv qhov no yog beta-hemolytic streptococcus, Staphylococcus aureus, qee zaum Proteus thiab Escherichia coli. Tej yam mob lymphangitisvim muaj mob tuberculosis hauv tus neeg mob.
Cov kab mob microbial tau los ntawm kev tsom mus rau qhov chaw nruab nrab, tom qab ntawd mus rau lymphatic capillaries, thiab raws li cov qog ntshav mus rau cov qog ntshav loj thiab cov hlab ntsha. Reactive o ntawm phab ntsa vascular yog qhia nyob rau hauv edema ntawm endothelium, nce nyob rau hauv nws permeability, tshwm sim ntawm exudation, intravascular thrombosis, thiab fibrin clots. Cov kev hloov no provoke lymphostasis - ib qho teeb meem ntawm cov qog ntshav hauv zos. Nrog rau kev loj hlob ntawm o, purulent lymphangitis thiab melting ntawm cov ntshav txhaws tshwm sim.
Cov tsos mob ntawm tus kab mob hu ua lymphangitis
Nrog rau qhov pathology no, intoxication ntawm lub cev yog nthuav qhia, uas feem ntau nrog cov txheej txheem mob hnyav. Tus neeg mob muaj kub taub hau, ua daus no, tawm hws, mob taub hau, tsis muaj zog. Reticular lymphangitis tshwm sim nrog cov tsos mob hnyav hyperemia ntawm daim tawv nqaij nyob ib ncig ntawm qhov chaw kis kab mob (qhov txhab, abscess) nrog kev txhim kho mesh qauv tiv thaiv keeb kwm ntawm erythema. Raws li daim duab kho mob, lymphangitis zoo ib yam li erysipelas, tab sis liab yog tus cwj pwm los ntawm qhov muag plooj, tsis muaj tus yam ntxwv ntawm erysipelas.
Ib lub cim hauv zos ntawm lymphangitis yog muaj kab txaij liab ntawm daim tawv nqaij raws cov hlab ntsha lymphatic hla mus rau cov qog ntshav hauv cheeb tsam. Nyob rau tib lub sijhawm, o, mob thiab compaction ntawm cov hlua, nro ntawm cov ntaub so ntswg ib puag ncig sai sai.
Nrog cov lymphangitis sib sib zog nqus, hyperemia tsis tau pom, tab sis qhov mob thiab o ntawm cov ceg ceg nce sai. Kuj muaj mob hnyavlymphedema tshwm sim.
Cov tsos mob ntawm tus kab mob lymphangitis feem ntau yog qhov muag plooj thiab yog qhov tshwm sim los ntawm kev mob edema vim yog txhaws ntawm cov hlab ntsha sib sib zog nqus thiab lymphostasis.
Yuav ua li cas kho cov qog ntshav qog ntshav hauv qhov no?
Kev kho mob lymphangitis yog dab tsi?
Nrog mob lymphangitis, nws yog ib qho tsim nyog yuav tsum tshem tawm cov ntsiab lus tseem ceeb, los ntawm cov kab mob uas tau khaws cia hauv cov hlab ntsha lymphatic. Kev kho mob ntawm qhov txhab, qhib phlegmons, abscesses, felons, lawv cov dej huv thiab cov kua dej yog nqa tawm. Qhov cuam tshuam limb yog tsau rau hauv qhov chaw siab. Nrog lymphangitis, koj tsis tuaj yeem zaws thiab sov qhov chaw mob. Rubbing ntau yam tshuaj pleev kuj yog contraindicated. Kev kho tshuaj suav nrog kev siv tshuaj tua kab mob (cephalosporins, semi-synthetic penicillins, lincosamides, aminoglycosides), tshuaj tua kab mob thiab tshuaj tiv thaiv kab mob, kev kho mob infusion, ultraviolet ntshav irradiation.
Nrog cov kab mob lymphangitis sluggish, hauv zos hnav khaub ncaws nrog tshuaj pleev, compresses nrog dimethyl sulfoxide los yog ib nrab dej cawv, UV hluav taws xob, kho av nkos yog sau.
Txawm tias muaj kab mob dab tsi ua rau cov qog ntshav nce ntxiv?
Vim li cas lymphadenopathy txaus ntshai?
Angioimmunoblastic lymphadenopathy kab mob yog ib qho mob tshwj xeeb uas tam sim no tsis muaj ib qho chaw tshwj xeeb hauv kev faib cov kab mob lymphatic. Tus mob no, nyob rau hauv nws cov kev kawm sai sai thiab cov duab kho mob, zoo li lymphosarcoma thiab lymphogranulomatosis. Txawm li cas los xij, raws li kev tshawb fawb histological ntawm cov ntaub so ntswg thiabtsis muaj cov cim qhia ntawm cov txheej txheem malignant hauv kev kawm txog cov khoom siv biopsy. Ntau tus kws tshawb fawb tau taw qhia tias kev hloov pauv ntawm morphological muaj cov yam ntxwv zoo sib xws nrog cov tshuaj tiv thaiv kab mob qog noj ntshav; angioimmunoblastic lymphadenopathy yog suav tias yog cov tshuaj tiv thaiv kab mob los yog cov tshuaj tiv thaiv hyperergic rau endo- lossis exogenous antigen. Raws li cov ntaub ntawv no, etiological yam rau qhov tshwm sim ntawm tus kab mob no txawv nyob rau hauv ib tug xov tooj ntawm cov neeg mob.
Qhov laj thawj tseem ceeb ntawm lymphadenopathy
Nws tau raug tsim tsa tias qhov kev mob tshwm sim no tshwm sim los ntawm kev siv tshuaj ntev ntev xws li tshuaj aspirin, oletethrin, ampicillin, penicillin, tshuaj psychotropic, thiab tom qab txhaj tshuaj tiv thaiv kab mob me. Ntev rhiab heev ua rau cov tshuaj tiv thaiv immunoproliferative. Txawm li cas los xij, hauv cov neeg mob feem ntau nws tsis tuaj yeem txheeb xyuas qhov xwm txheej etiological ntawm tus kab mob.
Hnub no, hauv cov ntaub ntawv kho mob muaj qhov qhia txog kev hloov pauv ntawm tus kab mob no mus rau qhov tseeb immunoblastic daim ntawv ntawm lymphosarcoma. Vim yog qhov tseeb tias angioimmunoblastic lymphadenopathy feem ntau hloov mus rau lymphosarcoma, ntau tus kws kho mob xav txog qhov pathology no ua ib theem ua ntej kev loj hlob ntawm cov qog nqaij hlav.
Tus kab mob ntawm lymphatic system feem ntau cuam tshuam rau cov neeg laus, tab sis muaj cov kab mob pathology hauv cov menyuam yaus.
Cov tsos mob ntawm lymphadenopathy yog dab tsi?
Raws li txoj cai, cov txheej txheem pathological tshwm sim acutely, uas yog nrog los ntawmmob hnyav zuj zus. Tus neeg mob tsim ib tug ntse lethargy, tsis muaj zog, mob taub hau, kub nce mus rau 38-39 ° C. Lub xeev febrile muaj tus cwj pwm tas mus li, qhov mob subfebrile tsis tshua pom. Tawm tsam keeb kwm yav dhau los no, feem coob ntawm cov neeg mob tau nthuav cov qog ntshav qog. Ib qho kev nce ntxiv hauv cov nodes yog tus yam ntxwv ntau dua, tab sis peripheral hauv zos lymphadenopathy tuaj yeem ua tau, uas yog asymptomatic rau lub sijhawm ntev. Cov txheej txheem pathological suav nrog mediastinal thiab peripheral lymph nodes, nrog rau cov nyob hauv lub plab kab noj hniav. Lawv tsis yog soldered rau cov ntaub so ntswg nyob sib ze, txawb, tsis muaj ib tug nyiam fester.
Ntau tus neeg mob muaj pob khaus ntawm daim tawv nqaij zoo ib yam li khaus khaus, uas tshwm sim los ntawm qee zaus khaus. Cov tawv nqaij yog me ntsis hyperemic, muaj me me papular ntsiab thiab khawb. Qee zaum yuav muaj qhov nce ntawm tus po thiab daim siab, uas ncav cuag qhov loj. Kev puas tsuaj rau lub ntsws yog qhov tsawg kawg nkaus. Lawv feem ntau yog vim muaj ntau yam sib kis. Thaum kawg ntawm tus kab mob, cov tsos mob ntawm intoxication tshwm sim. Cov kab mob plawv raug kev txom nyem - tus neeg mob tsim tachycardia, systolic lub plawv yws, muffled tones. Cov neeg mob feem ntau tsis qab los noj mov, lawv cuam tshuam los ntawm kev tawm hws hmo ntuj. Ua rau muaj kev kis kab mob ntau ntxiv, uas feem ntau ua rau tuag taus. Angioimmunoblastic lymphadenopathy yog tus cwj pwm los ntawm kev mob hnyav heev, thiab cov neeg mob feem ntau tuag hauv1-2 xyoos. Tab sis qhov ua rau tuag feem ntau yog kis kab mob.
Kev kho mob lymphadenopathy
Cov neeg mob los ntawm tus kab mob no yog cov tshuaj corticosteroid. Yog tias tsis muaj txiaj ntsig zoo los ntawm kev kho hormonal, cov tshuaj cytostatic tau sau tseg - "Chlorbutin", "Cyclophosphan", "Vinblastine" - lossis kev kho mob hnyav yog ua raws li cov tswv yim ntawm TsOPP, VAMP, TsVPP. Lub luag haujlwm tseem ceeb yog ua los ntawm kev ntsuas txhawm rau tiv thaiv kev txhim kho ntawm cov kab mob sib kis. Qhov no tsim cov kev mob rau qhov siab tshaj plaws sterility, kho cov mucous daim nyias nyias thiab daim tawv nqaij nrog bactericidal daws. Yog tias muaj teeb meem sib kis, tau muab tshuaj tua kab mob.
Peb tau tshuaj xyuas cov npe ntawm cov kab mob uas muaj kab mob qog nqaij hlav.
