Splenomegaly - chii ichocho? Zviratidzo, zvinokonzera, kurapwa kweplenomegaly

Splenomegaly - chii ichocho? Mhinduro kumubvunzo waunokumbira ichapiwa pasi apa. Mukuwedzera, isu tichataura nezve chikonzero nei chirwere ichi chikaitika, chii zviratidzo zvayo, nzira dzekuongororwa uye kurapwa.

General information

Splenomegaly - chii ichocho? Muchiito chekurapa, izwi iri rinoreva chirwere chinoratidzika nekuwedzera kukuru muchero. Sezvo mutemo, izvi zvinowanikwa apo nhengo inoratidzirwa inobatanidzwa mukugadzirisa zvirwere kubva kune rumwe rutivi. Zvisinei, inofanira kuonekwa kuti uwandu hwepleen, kunyange mumamiriro ehurumende, hungave hukuru (2 kaviri) kupfuura chero imwe nhengo. Ndicho chikonzero chibvumirano chakasimbiswa, kubva apo kuwedzera mumuviri uyu kunoonekwa seplenomegaly, nguva dzose inogadziriswa. Saka, mumamiriro ehurumende, uwandu hwepleen mumunhu mukuru huri pakati pe100-150 g.Pano kuve nechirwere chine utano hakufaniri kudarika masendimita manomwe (diagonally). Kuonekwa kwe "splenomegaly ye spleen" hakuwanzogadziriswa. Izvi zvinoitika pasi pemamiriro ezvinhu anotevera:

• Kana ukama hwomuviri huri kupfuura huwandu hwakadaro;
• Kana kuora kweplenic kunowedzera zvakanyanya;
• Kana chirwere chacho chiri pachena.

Basa repeni mumuviri womunhu

Splenomegaly - chii ichocho? Mhinduro kumubvunzo watakurukura pamusoro apa. Iyo spleen ndiyo nhengo inonyanya kukosha yezvirwere zvemuviri. Sezvaunoziva, ine chimiro chakaita senyuchi uye iri munzvimbo yekumusoro yakasara chikamu chemuviri wepamu, kana kupfuura zvakanyanya - pasi pechidimbu. Muchiitiko ichi, chirwere chinopindirana pakati pemakwenzi 9 ne11. Munhu mukuru ane utano anorema anenge magiramu 150. Inobatanidza nzvimbo inowanikwa mumimba inenge inenge masentimita gumi nemasere pakatarisana.

Mabasa epepleen

Nhengo iyo inomiririrwa inoita basa rinokosha mumuviri womunhu. Basa rake nderokusiya zvisikwa zvekune dzimwe nyika kana mabhakitiriya kubva pakuparadzirwa, uyewo kukudzivirira zvirwere zvemasimba ezvirwere uye kubvisa masero eropa asina kuchena.

Iyo inofanira kunge yakanyatsotsanangurwa kuti spleen inogona kukura muhukuru kunyange kana ichiita mabasa ayo anowanzoitika mukupindura chirwere. Izvi zvinokonzerwa nekuti dzimwe zvirwere zvinokanganisa masero eropa zvinogona kuwedzera kubuda kweropa munhengo iyi. Maererano nenyanzvi, zvirwere zvinokonzera chirwere chacho kazhinji zvikonzero zvekukura kwayo kukuru. Zvisinei, kuongororwa kwe "splenomegaly" kunowanikwa mune zvisingawanzoitika. Mushure mezvose, kuwedzera mumuviri uyu hakurevi nguva dzose kusati kwaitika.

Zviratidzo zvehutano hwepleen

Splenomegaly - chii ichocho? Izvi zvinogadziriswa zvinowanikwa nepleen isina kukudzwa. Muchiitiko ichi, muviri unogona kuenzana magiramu 500, uye hukuru hwahwo hukuru - hunosiyana kubva pa11 kusvika ku20 masentimita. Splenomegaly, zvikonzero zvatichakurukura pasi apa, pamwe chete nechiremera chemuviri zvinopfuura 1000 gramu uye kureba kwemasentimita makumi maviri, inonzi yakakura kana yakaoma. Kuchengetedza chirwere chakadai, murwere angada chirwere chakakosha kana kunyange kupindira kwekuvhiya.

Splenomegaly: zvinokonzera chirwere chacho

Pane zvikonzero zvakawanda zvechiitiko ichi. Izvo zvakasiyana uye zvinowanzosiyana nemaronda akaipa (kenza), kuwandisa (kana kuwedzerwa kwakasimba kweropa rinoyerera), zvirwere uye kupindira kwomuviri nezvimwe zvirwere kuzvirwere zvinopisa uye zvirwere zvemasero eropa.

Chimbofunga zvikonzero zvinowanzoita zvekuwedzera kwepleen, iyo inosanganisira zvinhu zvakadai se:

• Kenza yeropa (p., Leukemia, lymphoma kana myelofibrosis);
• Zvirwere zvemasero eropa (semuenzaniso, spherocytosis, thalassemia kana sickle-cell anemia);
• Chirwere chechiropa (semuenzaniso, chirwere chisingaperi chehepatitis C, cirrhosis nemhaka yehutachiona hwehupatachi B, kushandiswa kwenguva refu kwezvinwiwa zvinodhaka nemafuta echiropa) ;
• Zvirwere zvinopisa (rheumatoid arthritis uye lupus erythematosus);
• Gaucher's disease (kana kurwara kwepidid metabolism);
• Kusapisa ropa nekuyerera kwemitsipa yeropa, mitsipa (semuenzaniso, spleen vein thrombosis, congestive moyo kusagadzikana uye kuvhara muvharo wemvura);
• Thrombocytopenic idiopathic purpura;
• Zvirwere zvakasiyana-siyana (bhakitiriya endocarditis, mononucleosis, AIDS, malaria, leishmania, mycobacteria, nezvimwewo).

Splenomegaly: zviratidzo zvechirwere

Sezvazvinozivikanwa, kupotsa kwakadaro, seplenomegaly, haina zviratidzo zvakananga. Zvisinei, zvakanyanya pakati pavo zvinorwadza zvakanyanya mumudumbu uye kubhururuka. Zvose zvinoratidzwa zviratidzo zveplenomegaly zvinonzi hazvisi zvepecific. Inofanira kunge yakanyatsoonekwa kuti vamwe vanhu vane chirwere chakakura zvikuru vanowanzonyunyutika nekukurumidza nekuzadza uye zviratidzo zvegastric reflux.

Chiratidzo chekupedzisira chechirwere ichi chikonzero nekuda kwekuti nekuda kwekumanikidzwa kwechipfuva chemuviri kunotanga kuchinja mudumbu.

Mune dzimwe nguva, zviratidzo zvinosanganiswa nekuwedzera mumuviri uyu, zvinosanganisira zvinotevera:

• Night sweats;
• Fever;
• Weight loss;
• General kushaya simba;
• Pallor;
• Zviri nyore kupwanya;
• Kuneta.

Ndeipi uye ndipi wandinofanira kutsvaga rubatsiro rwechiremba?

Splenomegaly pakati pevana nevakuru vanoda kuteverwa zvakamanikidzwa kubva kune chiremba ane ruzivo. Zvisinei, kwete munhu wose ane chirwere chakadaro, anoziva kuti chiremba waanofanira kushandisa. Panyaya iyi, zvinofanira kuonekwa kuti kusarudzwa kweumwe nyanzvi kunotanga, kutanga kune zvose, pane zvakakonzera kukura kwechirwere ichi. Nokudaro, varwere vanogona kutaura kune anhematologist (chiremba anonyanya mukurapa zvirwere zveropa), an oncologist (nyanzvi mune zvipembenene zvekenza) uye gastroenterologist (nyanzvi mune zvirwere zvegomba rekudya, kusanganisira chiropa). Mushure mekuenda kuna chiremba, wekupedzisira anofanira kufambisa chiremba chizere chekurapa, uye ozogadzira mushonga unoshanda.

Zvichienderana nezvinokonzera chirwere ichi, vanhu vane chirwere ichi vanogona kudikanwa muchipatara. Kazhinji, izvi zvinoitika kana varwere vasina kurwadziwa mumimba, uyewo kubuda ropa zviratidzo uye zvirwere zvisingatauri kutapwa kumba.

Kuongorora

Mushure mokunge taudza unyanzvi, murwere achatanga kuongororwa. Kuti vaite izvi, vanachiremba vanoshandisa nzira dze palpation uye kuputika. Nekubatsira kwemaitiro akadaro vanoona ukuru hwepleen. Munzvimbo inowanzogara, inenge 3% yevanhu ine nhengo ine nyore nyore. Kunyange zvakadaro, kuwanda kwepamuviri kumucheto kwekumusoro kwechikamu chemuviri wemimba kunogona kunge kune chikonzero chakasiyana zvakasiyana, panzvimbo yepleen yakakura. Ndokusaka nyanzvi dzinoshandisa dzimwe nzira dzekuongorora.

Kana splenomegaly isingawaniki pamarpation, asi zviratidzo zvose zvinoratidza kuvapo kwayo, kuongorora ropa kunogona kugoverwa kumurwere. Mukati yekuongorora kwakadaro, nyanzvi dzinoongorora kuumbwa, maitiro uye chiyero chemasero machena eropa, maplatelets uye masero matsvuku eropa. Izvi zviratidzo zvinogonawo kuramba kana kutsigira kuvapo kwechirwere.

Kuongororwa kweplenomegaly

Kana mushure mokuongorora uye kuendesa mimwe miedzo yeongororo nyanzvi dzisina chokwadi nemigumisiro, saka kuongororwa kwema ultrasound, pamwe nekombiyuta uye magnetic resonance imaging, inoitwa kuti iongororwe zvakajeka. Aya maitiro anokwanisa kupa chimiro chakazara chemuviri wechipfuva, uye naizvozvo, nekururamisa kwakakwirira kusarudza kuvapo kana kusavapo kwechirwere. Inofanirawo kutariswa kuti magnetic resonance imaging inonyanya kushanda panguva yekugadzirisa kweplenic vein thrombosis kana portal thrombosis.

Mukuwedzera kune mamwe ose, ruzivo rweredisisope runoshandiswa kuongorora chirwere chakadaro. Iyi inzira yakarurama kwazvo inokwanisa kunyatsojekesa tsanangudzo yemasukisi epleen. Zvisinei, iyo yakataurwa nzira haisi nyore kuita uye inodhura zvikuru.

Mhando dzechirwere

Zvichienderana nezvinokonzera chirwere chakadaro, kurapa kwake kungave kwakasiyana. Inofanira kunge yakanyatsozivikanwa kuti nhasi kazhinji varwere vanotaura pamusoro pekuziva kuti "splenomegaly pachiropa". Kunyange zvazvo shoko iri harisi rakakwana, asi chaizvoizvo kuwedzera kwepleen kunowanzoenderana nekuwedzera kune dzimwe nhengo dzomukati. Mufananidzo wakadaro unogona kukuvadza mamiriro ekurapa uye kurapa.

1. Muenzaniso splenomegaly - chii ichocho? Ichi ndicho kuwedzera kwepleen, yakasimuka semagumisiro ezvimwe zviitiko zvepachivi kubva kumativi.
2. Hepatomegaly rudzi rwekuwedzera kwechiropa, iyo inosanganiswa nekuwedzera kwechirongwa chataurwa pamusoro apa.
3. Hepatolyenal syndrome inowedzera panguva imwe chete mucheche uye chiropa.

Kurapa kwechirwere

Zvakadini kana murwere akaonekwa kuti ane splenomegaly? Kurapa kwemuviri uyu kunofanira kutungamirirwa kune chikonzero chikuru chekutanga kwechirwere. Mushure mezvose, sezvatinoziva, chirwere ichi chinongova kuratidzwa kweimwe hutano. Izvi zvakakoshawo kuziva kuti chirwere chakareruka hachidi kutarisirwa kusvikira chirwere chakaipa chinowedzera mumuviri wemurwere.

Kazhinji, zvakaenzana nekurapa kwechirwere chepachirwere, nyanzvi dzinoita mutsara wematanho ekuvandudza mamiriro ekurapa uye kubata chirwere cheplenomegaly. Izvozvo zvinosanganisira zvinotevera:

• Kuwedzerwa kwemaukocyte masero;
• Kuwedzerwa kweplatelet mass;
• Kurapa kwomurwere ne glucocorticoids (pamwe nemishonga "Prednisolone" muwandu hwemamirigramu 20-40 pazuva pamwedzi 4-6);
• Kubviswa kwenhengo yakakura kana splenectomy.

Kupindira kwokuvhiya

Splenectomy inowanzoitwa neyanyanzvi. Sezvo mutemo, kushanda kwakadaro kunangwa kurwisana nechirwere chepasi. Kazhinji splenectomy inoshandiswa nemamiriro ezvinhu akadai se thalassemia, kuvhara kweplenic veins, Gauchers chirwere uye leukemia. Chisarudzo chokubvisa chirwere chakawedzerwa chinotorwa nachiremba mumwe oga kune mumwe murwere. Izvi zvinoenderana nemamiriro ezvinhu uye zvichida ngozi kune hupenyu hwomurwere. Pashure pezvose, nekukuvadza kwakakomba mumuviri, kupera kwepleen kunogona kuitika, izvo zvinotungamirira mukati memhembera. Nenzira, ndezvechikonzero ichi kuti varwere vanoonekwa kuti vane splenomegaly vanorambidzwa zvakanyanya pakuita mitambo uye chero basa remuviri.

Chii chinotyisa kubviswa kwepleen?

Kusavapo kwechirongwa ichi, kana kuti kunonzi aspiration, kunowedzera ngozi yakawanda yehutachiona hwemuviri nezvimwe zvirwere zvinopisa upenyu, zvinosanganisira zvinotevera: Neisseria meningitidis, Hemophilus influenzae uye Streptococcus pneumoniae. Ndokusaka mushure mokushanda pane splenectomy, zvakakosha kuti vachengetedze kurwisa mabhakitiriya ose akanyorwa.

Kuwanazve

Splenomegaly pachayo haigoneki. Mushure mezvose, inomiririra chete kutaridzirwa kwepleen kune chero humwe hutano huri mumuviri womunhu. Mukana wekushaya ropa, murwere anorayirwa iron uye arsenic. Kana kukanganisa uku kunosangana ne thrombopenia uye leukopenia, saka vanachiremba vanobvisa chikamu chinopisa. Inofanira kunyanya kutaurwa kuti mushure mekushanda, murwere wacho akabva atanga kuwedzera kuwanda kwenhamba yemaplatelets uye machena masero eropa, zviratidzo zvehemorrhagic diathesis zvinopera, murwere anocherechedza kuwedzera uremu uye anovandudza mamiriro ake ose. Kana mwana wechidiki ane chirwere chakadaro akachera kukura, zvino mushure mekunge splenectomy zvinhu zvose zvinodzokera kune zvakasikwa. Kana panguva yekushanda murwere akanga asina kuora kwemuviri, uye hapana kuchinja mune chikamu chemuviri nemapfupa zvakaonekwa, ipapo kuregererwa kunouya nekukurumidza.

Ngationei mhinduro

Kazhinji, kuongororwa kwakafanana seplenomegaly haisi mungozi sezvinoitwa nechirwere chepfungwa. Inofanira kunge yakanyatsoratidzwa kuti mumazuva ano kurapwa kwemazuva mazhinji kwaiva nematambudziko mazhinji kunyange kunyange chirwere chakawedzerwa zvakadzoka pakukura kwayo chaiyo mushure mekubatanidzwa kwechirwere chepachirwere ichi. Chikamu chezvizvi ndechokuti nzira dziripo dzekuongororwa dzinogona kukurumidza kuratidzira chikonzero chechokwadi cheplenomegaly uye kutanga chirwere chakakwana.