Hepatomegaly: ehlasela umzimba izinguquko isibindi. Isakhiwo kwezitho zangaphakathi

Ukuze ukuphila komuntu evamile abantu ngothi lwabo, nemizimba ezibalulekile, njengoba ngamunye wabo wenza umsebenzi othile. Lapho omunye ehluleka, abanye aphazamiseka, futhi wonke umzimba. Ngakho, izinkinga isibindi kubangele Ukuwohloka ipheshana wokugaya ukudla, izinhlelo kwegazi futhi excretory, okuyinto nakanjani kuholela ukwehla amasosha omzimba, futhi eziningi nezinye izinkathazo impilo. Kanjani isibindi womuntu, nezinguquko ezihambisana sokugembula kuwo?

Isakhiwo kwezitho zangaphakathi

Ngaphambi kokuba ukhulume ngomunye kwesibindi, cabangela indlela isakhiwo kahle kwezitho zethu zangaphakathi, okuyinto kukhona ukuhlobana phakathi kwabo. Kubantu, kukhona izinhlelo eziningana: kwegazi, zokuphefumula, zemisipha, wokugaya ukudla, excretory, abakaze, zokuzala. Ngamunye wabo has a isakhiwo eziyinkimbinkimbi. Njengoba lena isibindi, ahlaziye emizimbeni esixhumene nalo, futhi eduze ngokushesha ke. Ngakho, isibindi sethu - indlala elise ngezansi nje diaphragm ohlangothini kwesokudla umzimba, e komgodi ongaphakathi kwamathumbu. Unqenqema engezansi lithinta emphinjeni, esiswini, gallbladder futhi duodenum. Futhi izingxenye zalo nabo izinso kwesokudla kanye indlala adrenal. Kwamanyikwe amanga nje ngemva kwesisu. I gallbladder kubhekwa yithi emzimbeni jikelele Amapayipi isibindi Bile. Ngaphezu kwalokho, imizwa isibindi, igazi lymph izitsha efanelekayo.

Isakhiwo isibindi

Hepatomegaly (ekubhebhetselisa izinguquko isibindi) kwenzeka, lapho Ubukhulu bayo nomuntu omdala idlule 12-13 cm. Lesi sitho siqukethe iyizingxenye kwesokunxele bese kwesokudla, futhi uhlelo Claude Quinn ihlukaniswe 8 izingxenye. Ngasinye ingxenye ngabanye (ingxenye) inezidingo liningi igazi, inethiwekhi zhelchevyvedenie futhi nezinzwa zawo. Izicubu tincetu (parenchyma) ifomu side amaseli (imishayo hepatic). Parenchyma kwakwande Bile capillary kakhulu futhi imithambo yegazi. Maphakathi ingxenye ngayinye ubabonisa hepatic eyodwa emaphakathi Vienna, futhi phakathi kwawo - lemithambo Bile Amapayipi nezinye emithanjeni. Ingxenye engezansi yomzimba olucutshungulwayo has anemifantu ezimbili longitudinal futhi omunye transverse. Lokhu okuthiwa isibindi esangweni. Lapho zihlanganiswa zonke Amapayipi Bile, ukwakha ezivamile, Ngokuqhubeka phakathi duodenum. emithanjeni Hepatic ukwakha - Ingosi. Kusukela, futhi kusukela imithambo kule ebalulekile sitho igazi notshwala. izinguquko ehlasela umzimba kungase kuthinte zonke izici ezingenhla.

kwesibindi

Omunye wemisebenzi eyinhloko yethu isibindi - ubuthi zokuyithena, ubuthi, zonke izinhlobo izinto alien futhi okungadingekile. Le ndlala ehilelekile zonke ezenzeka emzimbeni amafomu womuntu umzimba, ukugaya, igazi, enkulu ekwakhekeni namavithamini namaphilisi amaningi hormone. Kuyinto uhlobo yokugcina igazi trace izakhi. Ilokhu imodi umatasa, isibindi echayeke nesenzakalo therein izinqubo ezihlukahlukene sokugembula. Omunye wabo - hepatomegaly, izinguquko ngokukhukhumala kwentamo esibindini, izimpawu izithelo zalo. Kunqunywa palpation by ultrasound futhi computed tomography. Eminyakeni emibili izinhlobo izifundo avumela ukuhlukanisa isibindi Lowaya lakhulisiwe isifo esifana izitho eduze (izinso kwesokudla, nenyongo sesinye, amathumbu).

Izimbangela zesifo

Umqondo izinguquko ehlasela umzimba wonke umzimba, hhayi nje ingxenye yalo, njengoba kule zokugula eqondile. Uma kwenziwa hepatomegaly? izinguquko isibindi ehlasela umzimba wonke babonakala e lezi zifo ezilandelayo:

• isifo sokusha;
• ukuhluleka kwenhliziyo;
• ingozi nesibulalayo (umdlavuza) izimila;
• hemangioma;
• izinhlumba yisinanakazana futhi okungezona yisinanakazana;
• izifo helminth;
• abscesses;
• isifo sofuba nezinye sifilisnoy ezithathelwanayo kokunqotshwa;
• ukudakwa;
• amanzi emzimbeni;
• Ukudlulela emazikweni angomakhelwane;
• ukusha kwesibindi kohlobo ezinobuthi futhi samafayela;
• adenoma;
• carcinoma;
• Hyperplasia.

Kwezinye izimo, kukhona hepatomegaly omnene, uphawu concomitant of umkhuhlane, abanye izifo ezithathelwanayo, ukungondleki.

izimpawu

Izimpawu izinguquko isibindi ngokukhukhumala kwentamo kusaqalwa yalesi sifo ziyabonakala kakhulu. Isiguli angase azizwe kabi ilungelo quadrant engenhla, sibi emva okunamafutha ukudla okunezinongo, utshwala. Nokho, kuneziguli abangafuni ukuzizwa lutho nhlobo kuze isifo ezabangela hepatomegaly awangeni amafomu acute, futhi ngeke kwenzeke nokwanda okuphawulekayo isibindi. Izimpawu zincike sifo ecashile. Ezivamile zibandakanya:

• ubuhlungu ngakwesokunene sayo, ikakhulukazi uma abukhali kokucindezelwa ngemishini;
• isicanucanu, kwezinye izimo labona ukuhlanza;
• isilungulela;
• esesuthi ukuncishiswa;
• umbala jaundice kwesikhumba;
• iphunga ezingemnandi kusukela ngalo ingaphakathi ngomlomo;
• ngezinye izikhathi ukuqubuka ephelezelwa ukulunywa;
• nokucekelwa Imininingwane.

izimpawu ezithile okufanele hepatomegaly

Staphylococcal, streptococcal kanye nezifo Pneumococcal kungabangela abscesses (suppuration) ku elikhulu kunawo wonke okwake wendlala indlala futhi ngenxa yalokho, ukukhulisa kwesibindi. Izimpawu zalokhu zihlanganisa: babeqhaqhazela ngenxa yezihlambi zemvula, tachycardia, ukujuluka ngokweqile, ezidabukile ubuhlungu ohlangothini lwesokunene umzimba, besekela ngisho lomshini bese ingalo. Ukwelashwa kulokhu kuhlinzwa kuphela. Esikhathini nezinye izifo ezivamile - umdlavuza kwesibindi, okuyinto unyaka ngamunye ubulala abangaphezu kwesigidi izimpilo zabantu - hepatomegaly, plus izici ezingenhla, ephelezelwa eyisimanga kwesisindo, ubuthakathaka, wamathumbu ukungasebenzi kwekhono, ukubuyisa. Kwesibindi (imbangela eyinhloko esikhathazeka ngayo ukuluthwa utshwala) kanye hepatomegaly concomitant libhekene ubuhlungu ngakwesokudla quadrant engenhla, emalungeni, umfutho ophakeme wegazi portal, kweNdikimba ubende. Ngo-hepatitis isibindi ukwandisa futhi ephelezelwa ubuhlungu ngakwesokunene, is kakhulu buyaqina lapho ukucindezeleka ngokomzimba (isib, ngesikhathi ukuhamba okusheshayo), isicanucanu, ubuthakathaka jikelele.

ukuhlola

Uma isiguli ekhononda zobuhlungu ngakwesokudla quadrant engenhla, into yokuqala udokotela uzokwenza palpation futhi mhlawumbe ukuxilonga hepatomegaly. Ehlasela umzimba Isibindi izinguquko kungatholakala (noma siphikise) usebenzisa assays ezengeziwe. Ngomqondo onabile, palpation ungakwazi kuphela ukunquma kwemingcele umzimba yanda, degree of ubuhlungu, futhi ngezinga elithile kwabantu parenchyma. Futhi uphethwe okwengeziwe aqokwe ultrasound, CT, i-MRI, futhi eziningi amasampula. Lezi zihlanganisa:

• ukuzimisela bilirubin, namaprotheni Imininingwane egazini;
• ukuzimisela stercobilin e kwesihlalo;
• amasampula nge izinto umthwalo zhelchevyvodimymi (bromsulfoftalein, galactose);
• izifundo radioisotope;
• isibindi biopsy.

Bilirubin ichazwa mahhala futhi lesibopho isimo. Kumuntu ophile kahle likhona kuphela khulula (0.4-1 mg / dl). Ukukhubazeka ebonwe jaundice, ukuvuvukala kanye ukucinana tubules hepatic, ezinye izinhlobo isifo sokusha. Ukusebenzisa amasampula wayezimisele njengoba ukugeleza amaprotheni-umzimba esibindini. Bromsulfoftaleinovaya isampula ikuvumela ukuba anqume ukuthi bukhona kungukuphula nezindlala excretory (secretory) umsebenzi. Ngo abantu enempilo kumaminithi 45 emva kusungulwa udayi egazini it has ngaphansi kwama-5%. Isingeniso galactose kwenza kube nokwenzeka ukulandelela indlela umzimba carbohydrate. I biopsy wenziwa khona ngaphansi kwezimo zelabhorathri kwesibindi okusolakala isigaba esicashile, isifo sokuqina kwesibindi umdlavuza, cystic, kanye nezinye izifo. It is contraindicated ku abscesses, ascites, isikhathi eside jaundice obstructive, oluhambisana syndrome. radioisotopes Research (ukwethulwa Bengal rose igazi) wenziwa izifo eziningi isibindi. Ngo abantu abayimiqemane igazi isigamu-usule kapende imizuzu 8.

Pathology kwamanyikwe

Isibindi sihlobene eduze nezinye izindlala - amanyikwe. Pathology eyodwa nakanjani kuholela ukuphazamiseka ezinye, ngakho ngesikhathi uphethwe, lezi zindikimba ezimbili ngesikhathi esifanayo isheke. izinguquko ehlasela umzimba amanyikwe (isibindi, akakhathazekile nakancane) bungabonakala kuphela esebenzisa ultrasound. Palpation akachaziwe. Ultrasound luhlolo libonisa Ubukhulu, ukuminyana nekufana kwezicubu echogenicity kanye (umsindo kubonakala) ukuthi umzimba ebalulekile ukuthatha ukuhlanganyela ngenkuthalo ukugaya kanye ukumuncwa glucose (insulini uketshezi). izinguquko ehlasela umzimba kuyagcinwa e pancreatitis, cystic, futhi ngokuqondene ubudala. Ukuthola izinguquko ku-ultrasound, isiguli kungenzeka idluliselwe ukuhlolwa eyengeziwe (blood donation, Endoscopy we duodenum).

ukwelashwa

Uma kwamanyikwe wembula izinguquko ehlasela umzimba wonke, kodwa isiguli ayinakho izikhalazo, impatho ayidingekile. Noma iphathwa hepatomegaly omnene. Ngokuvamile, lokhu isimo kuxazululwa ngokwa emva ukuzinza samandla ukunyamalala izifo ezingena ngentuba. Lapho isibindi hepatomegaly ngempela uqhubekele ekwelapheni lesi sifo ecashile, lo zokugula kubangelwa. Ngaphezu kwalokho, lesiguli ephonswa Ukudla okuqinile ukuthi akufaki yonke imenyu ethosiwe, okubabayo, okunosawoti, amafutha kanye notshwala. Folk imithi uncoma ukuphuza infusions of rose okhalweni, chokeberry, abanye lamanzi esiphethu, udle ephansi fat cottage shizi ngoju. umuntu ogulayo Kunconywa engashiyi lwemithi, umsebenzi akuvunyelwe.