ingquza yomuntu

Ubende ungenye yezitho ezimbalwa ezingabhekwa njengezibalulekile. Siyakutshela ukuthi kungani umuntu edinga i-spleen, lapho itholakala khona nokuthi kungani ingaba buhlungu

Ukwakheka komuntu kugcwele izimfihlakalo. Esinye sazo yi-spleen.

Njengazo zonke izitho ezingasebenzi, i-spleen, ngokunengqondo, kufanele "ifihlwe" ngokucophelela emzimbeni ngemuva kwezicubu namathambo. Kodwa eqinisweni, iseduze kakhulu nendawo futhi ngenxa yalokho ilimala kalula. I-spleen ayinayo imisebenzi eyingqayizivele ezinye izitho ezingakwazi ukuyenza. Yebo, futhi umuntu angaphila ngaphandle kwayo (yebo, ngokushintsha kwendlela yokuphila). Kodwa ngesikhathi esifanayo, i-spleen isekhona ngesizathu esithile kuzo zonke izilwane ezinomgogodla. Futhi eChina, kubizwa ngenhlonipho - "umama wesibili womzimba."

Ubende wenzani, ingabe ungaba buhlungu, futhi welashwa kanjani? Siphendula le mibuzo neminye nge ikhandidethi lesayensi yezokwelapha, udokotela ojwayelekile wesigaba esiphezulu esiqeqeshelwe i-gastroenterology kanye ne-cardiology u-Yulia Esipenko.

Okubalulekile ukwazi nge-spleen yomuntu

Umumo nombala	Okusaqanda (okumise okwebhontshisi) okuyisicaba, okubomvu okumnyama (okubomvu).
Usayizi wabantu abadala	I-Fickle. Ngokwesilinganiso, ngaphakathi: ubude - 12-14 cm, ububanzi - 8-9 cm, ukujiya - 3-4 cm. Kubhekwa njengesitho esikhulu kunazo zonke sokuzivikela komzimba.
Isisindo somuntu omdala	150-200 g (ngezinye izikhathi ngaphezulu).
imisebenzi	1) I-spleen iyisitho samasosha omzimba, ibamba iqhaza ku-hematopoiesis kanye nentambo yomgogodla kanye nama-lymph nodes. I-2) Ikhiqiza amasosha omzimba avikelayo, ihlanza igazi lamagciwane namaseli afile, ibhubhise amangqamuzana egazi abomvu amadala noma awonakele.¹. I-3) Ibamba iqhaza ezinkambisweni zokuqeda ukuvuvukala².

Iphi ingquza yomuntu

I-spleen itholakala engxenyeni engenhla yesobunxele yesisu sesisu, kancane ngemuva kwesisu, ezingeni lezimbambo ezingu-9-11. Okusho ukuthi, uma kubuhlungu ngaphezu konqenqema olungezansi lwezimbambo ngakwesobunxele, lokhu kungase kube i-spleen ukuze uzizwe uzizwe.

Uma ubheka indawo yezitho, i-spleen itholakala phakathi kwesisu, izinso zesokunxele kanye nekholoni.

Ubende bomuntu ubukeka kanjani futhi usebenza kanjani?

Ngaphandle, i-spleen yomuntu ibukeka njengobhontshisi oyisicaba: i-oval shape emide, umbala onsomi (njengoba kufanele kube ngesitho se-hematopoietic). I-spleen iyingxenye yezitho ze-parenchymal: okungukuthi, akukho mgodi ngaphakathi (njengesibonelo, esiswini), futhi izicubu ezisebenzayo zibizwa ngokuthi i-parenchyma. Kubukeka njengesipontshi, futhi zonke izinqubo zomzimba zenzeka kuwo.

"I-pulp" ye-spleen iqukethe i-pulp emhlophe nebomvu. Elokuqala likhiqiza ama-B cell, akhiqiza amasosha omzimba avikelayo, nama-T cell, athola futhi abhubhise amangqamuzana anama-antigen angaphandle. I-pulp ebomvu iyadingeka ukuze kuvuselelwe igazi (ibhubhisa ama-erythrocyte amadala nangasebenzi, ibamba iqhaza ekucutshungulweni kwensimbi), futhi isusa amagciwane ayingozi ngosizo lwama-macrophages nama-granulocytes.⁴isebenza njengendawo yokugcina ama-leukocyte namaplatelet. Njengechibi, i-spleen iqukethe cishe ingilazi yegazi, elikhishelwa ohlelweni olujwayelekile lokujikeleza kwegazi lapho kudingeka.

Kunezindawo ezimbili ze-spleen: i-diaphragmatic ne-visceral. Ekugcineni kukhona amasango e-spleen - uhlobo lwechweba. I-splenic artery idlula esangweni, lapho igazi lingena khona esithweni, futhi i-splenic vein iphuma. Iqoqa igazi kusuka ku-spleen, isisu, amanyikwe, kanye ne-omentum enkulu, bese ihlangana nemithambo ye-mesenteric ukwakha i-portal vein. Kusukela lapha, igazi elinemikhiqizo yokubola lingena esibindini ukuze likhishwe ubuthi, empeleni, licutshungulwa okokugcina.

Kungani ingquza yomuntu ingaba buhlungu

Lesi sitho sinama-nerve endings (okungenxa yokuthi umuntu ezwa ubuhlungu) akwi-capsule. Ngakho-ke, i-spleen ingalimaza kuphela ngokukhuphuka kwevolumu, ngaphezu kwalokho, ngokushesha okukhulu⁵. Lokhu kungenzeka ngenxa yezizathu eziningi.

Ubuhlungu bomzimba bungase buvele, isibonelo, ngesikhathi noma ngemva kokugijima. Ngenxa yomthwalo, umthamo wegazi ukhuphuka kakhulu, i-spleen inwetshiwe, futhi lezi zinzwa ezingathandeki zivela ku-hypochondrium kwesokunxele, ezijwayele abaningi (khumbula okungenani izifundo zemfundo yomzimba). Kwabesifazane abakhulelwe, i-spleen, kanye nezinye izitho zesisu, "icindezelwa" yisibeletho ngezigaba zakamuva, ezingabangela ubuhlungu.

Ngokuvamile i-spleen ibonakala eziphethweni zochwepheshe bezokwelapha: isitho sivame ukulimala ngesikhathi sokulwa nezenzo zobudlova. Futhi nakuba i-spleen itholakala ngemuva kwezimbambo, itholakala eduze nendawo, ngakho-ke ingalimala hhayi kuphela ngesikhali, kodwa ngokumane ngesibhakela noma ngisho nalapho iwa.

Kunezizathu ezengeziwe ze-pathological zobuhlungu endaweni ye-spleen. Azibonakali kuphela ngobuhlungu, kodwa nangezinye izimpawu. Ake sixoxe ngazo.

Kuyavunywa ukuthi umuntu unobende olulodwa kuphela. Kodwa kunezimo ezingavamile zokukhula kwezicubu: ngaphandle, kubukeka "njenge-mini-spleens" eyengeziwe. Babizwa ngesayensi - i-accessory spleens.³. Inkinga yukuthi naphezu kobukhulu babo obuncane (ngokuvamile kufika ku-2 cm), bangakwazi ukucindezela imithwalo yegazi, okuthinta kabi impilo.

Ukususwa kwe-spleen

Ngokuvamile i-spleen ayinyakazi ngenxa yemisipha ewuphethe. Kodwa ngezinye izikhathi, isibonelo, ngemva kokukhulelwa okuningi noma ukwanda kwezitho, i-ligamentous apparatus iba buthaka, futhi i-spleen ingashintsha futhi iguquke. I-Volvulus ye-spleen iyinhlobonhlobo eyingozi kakhulu yokufuduka, ngoba ingaholela ku-thrombosis noma ngisho ne-necrosis yezicubu zesitho (necrosis).

Umuntu onobende osusiwe uzwa ubuhlungu ngenxa yokungezwani kwemigqa nokuphazamiseka kwenqubo yokujikeleza kwegazi.

I-Thrombosis ye-splenic vein

Ngokumelene nesizinda se-pancreatic noma izifo ezithathelwanayo, ngemuva kokulimala, inkinga efana ne-thrombosis ye-splenic vein ingakhula. Kodwa ngezinye izikhathi amahlule egazi ku-lumen yefomu le-vein ngokwawo, ngaphandle kwezinkinga zangaphambilini.

Ngokuvinjelwa okuphelele komkhumbi wegazi, ukuphuma kwegazi kusuka ku-spleen kuyeka, isitho sanda ngosayizi.

Isici salesi sifo ukuthi ekuqaleni siqhubeka singabonwa ngumuntu. Kamuva, kukhona ubuhlungu kanye nomuzwa wobunzima ohlangothini lwesobunxele, ngezinye izikhathi izinga lokushisa eliphezulu liyakhuphuka. Yile ndlela inqubo yokuvuvukala ezibonakalisa ngayo. Kwesinye isikhathi kuba ne-hemorrhagic syndrome: ukuphuma kwegazi ekhaleni, ukuhlanza ngegazi.

Ngezimpawu zokuqala, kufanele uthintane nodokotela: kungase kudingeke umise ukopha ukuze ugweme izinkinga.

I-spleen infarction

Lesi sifo sihlotshaniswa nokuphulwa kokunikezwa kwegazi: lapho isikhathi eside igazi lingagelezi kahle endaweni eyodwa noma kwenye indawo, kancane kancane liyafa. Lokhu kwenzeka ngoba amagatsha omthambo we-splenic awaxhumani nomunye nomunye futhi awakwazi ukusiza ukusungula ukugeleza kwegazi uma kwenzeka "ukwehluleka".

I-infarction ye-spleen ingabonisa:

ubuhlungu ku-hypochondrium yangakwesobunxele, ephuma ehlombe lesokunxele (ukwanda ngokuhogela);
amakhaza, i-subfebrile fever⁶.

Ngokwezibonakaliso, i-splenic infarction ingadideka ne-pancreatitis eyingozi noma i-pyelonephritis. Kodwa kwezinye izimo, ukuhlaselwa yinhliziyo kungase kungabonakali.

Ama-Neoplasms

I-cyst ingaphakathi elingavamile ku-spleen elingase lizalwe noma litholakale (isibonelo, ngemva kokuhlukumezeka noma izifo ze-parasitic). Kungaba nama-neoplasms amaningana esithweni esisodwa. Izimpawu zingase zingabonakali isikhathi eside kuze kube yilapho i-cyst (noma ama-cysts) ekhula ngosayizi. Ubuhlungu buphakathi. Phakathi kwezinye izimpawu: ubunzima ku-hypochondrium yangakwesobunxele, ubuthakathaka, ukuphazamiseka kokuchama, izinguquko zesitulo.

Uma zingekho izinkinga, futhi i-cyst ngokwayo ayikhuli ngokushesha, ngokuvamile akukho ukwelashwa okudingekayo - kodwa kufanele kuqashelwe njalo. Ezimweni ezinzima, izinketho ezihlukahlukene zingenzeka, kuze kufike ekususweni.

Amanye ama-neoplasms nawo ahlukaniswa: i-benign (isibonelo, i-hemangiomas, i-lipomas) kanye ne-malignant.

Ukukhathala, ukucindezeleka okungenasizathu, ubuhlungu kanye nobunzima ohlangothini lwesobunxele, ukulahlekelwa ukudla kanye nokulahlekelwa isisindo kungazelelwe - lezi zimpawu kufanele zinakwe futhi ngokushesha uthintane nodokotela.

Abscess

Imbobo egcwele ubomvu kwakheka ubende. Ngokuvamile, ithumba livela njengenkinga yesinye isifo. Isizathu singase sibe ukutheleleka, ukuhlukumezeka (lapho i-hematoma iqala ukubola), noma i-spleen infarction. Ngaphezu kobuhlungu, izimpawu zingase zihlanganisa imfiva, ukugodola, nokujuluka.

Welashwa kanjani udaka lomuntu?

Kunoma yiluphi ushintsho empilweni, kufanele uthintane nodokotela. Ukuze uqale, bheka umelaphi. Udokotela uzohlola, anikeze ukuhlolwa nezinye izifundo, uma kunesidingo, abhekisele kuchwepheshe omncane. Ukuxilongwa kungadinga ukuhlolwa kwelabhorethri, i-ultrasound, i-fluoroscopy, i-computed tomography.

Ngemuva kokuthi ukuxilongwa kusungulwe, udokotela uzobeka ukwelashwa. Ukwelashwa kwe-Conservative, okokuqala, kuhlinzeka ngokuthula nokubanda esifundeni se-hypochondrium yangakwesobunxele. Okunye kuncike esifweni.

Ukulungiswa

Ukusetshenziswa kwemithi kubhekisela ekwelashweni okudala. Imithi inqunywe udokotela kuphela futhi kuphela ngokwezinkomba.

Isibonelo, nge-abscess etholakele, izidakamizwa ze-antibacterial ezibanzi zinqunywa ngaphezu kwezindlela zokuhlinzwa zokwelapha.

I-Splenopexy

Lapho i-spleen isuswa ngaphandle kwezinkinga (ngesimo sezibazi noma i-necrosis), kwenziwa ukuhlinzwa ukuze kuxhunywe isitho ku-diaphragm. Eqinisweni, i-spleen i-spleen ukuze inganyakazi emgodini wesisu ukugwema ingozi yokusonteka.

Ukususwa kabusha

Ukuhlinzwa kwenziwa uma ukuhlinzwa kuyadingeka engxenyeni engenhla noma engezansi ye-spleen, futhi ngesikhathi esifanayo kungenzeka ukusindisa isitho. Ingxenye ye-spleen ingasuswa, isibonelo, nge-benign tumor.

Splenectomy

Leli igama lokuhlinzwa ukuze kukhishwe ubende. Izinkomba zalokhu zingase zibe izifo ezihlukahlukene kanye ne-anomalies (isibonelo, ukuxoshwa kwesitho esicasule i-volvulus ne-necrosis).

Kungenzeka ukuthi uphile ngaphandle kwe-spleen: imisebenzi eyinhloko yesitho "ihlukanisa" isibindi nama-lymph nodes phakathi kwabo. Kodwa ngesikhathi esifanayo, ingozi yokuthola izifo eziyingozi, njenge-meningococcus ne-pneumococcus, iyakhula. Ngakho-ke, abantu abasuswe ubende ngesizathu esithile batuswa ukuthi bagonyelwe izifo eziningi, kuhlanganise nomkhuhlane.⁴.

Okunye Ukwelapha Ubende

Kuye ngenkomba, kungase kudingeke ukwelashwa okuhlukile.

Amathumba kanye nama-cysts athile angadinga ukugeleza kwamanzi nge-percutaneous. Ngembobo encane, udokotela ufaka ithubhu lokudonsa emanzini esitho, lapho okuqukethwe kwe-cavity kukhishwa futhi kuphathwe ngesisombululo se-antiseptic.

Uma umdlavuza utholakala, udokotela angase anikeze ukwelashwa ngamakhemikhali kanye/noma ukwelapha ngemisebe. Kodwa kuphela ezigabeni zokuqala. Izigaba 3 no-4 ze-oncology zibandakanya kuphela ukukhishwa kwe-spleen.

Ungagcina kanjani ubende uphilile ekhaya

Ukuvimbela izifo ze-spleen kuhlanganisa izincomo eziyisisekelo zokugcina impilo. Lokhu kudla okulinganiselayo okunemifino eminingi, amakhambi namajikijolo, indlela yokuphila esebenzayo, ukungabikho kwemikhuba emibi. Kodwa kunemithetho ethile okufanele uyilandele uma ungafuni ukuya kudokotela.

Ukuzivocavoca okunengqondo. Kuyasiza ukunyakaza, ngoba ngale ndlela ungagwema ukuqina emzimbeni. Kodwa kubalulekile ukulandela imithetho yokuphepha - khumbula ukuthi i-spleen isengozini, kulula ukuyilimaza.
Izingubo ngokwesimo sezulu kanye nosayizi. I-spleen ingasabela kahle ku-hypothermia, kodwa lokhu kungagwenywa ngokugqoka izingubo ezihambisana nesimo sezulu esimweni sezulu esibandayo nesinomoya. Ngesikhathi esifanayo, izingubo kufanele zibe ngobukhulu, zingaqini kakhulu: amabhande namabhande angaphazamisa ukujikeleza kwegazi.
Ake sikhulume nge-detox. Ubende uzozizwa kahle uma uphuza amanzi ahlanzekile anele nsuku zonke (okungukuthi amanzi, hhayi itiye, ikhofi noma ijusi). Kubalulekile futhi ukunaka ukwakheka kokudla okudlayo (ama-E-Necks ahlukene kufanele agcinwe okungenani). Futhi ungasebenzisi kabi izidakamizwa: noma iyiphi "ikhemikhali" ithinta kabi isimo se-spleen nezitsha zayo.

Imibuzo nezimpendulo ezidumile

Indlela yokubona izinkinga zokuqala nge-spleen, neminye imibuzo ethandwayo eyaphendulwa ikhandidethi lesayensi yezokwelapha, udokotela ojwayelekile wesigaba esiphezulu onochwepheshe kwe-gastroenterology kanye ne-cardiology u-Yuliya Esipenko.

Imuphi udokotela owelapha ubende lomuntu?

- Njengoba i-spleen iyisitho se-hematopoietic, ihlale isabela ezifweni zegazi, futhi zonke izinkinga zempilo yayo zihlotshaniswa nokushintsha kobukhulu nokusebenza kwesitho ngokwaso. Azikho izifo ezithile, njenge-cholecystitis noma isilonda se-peptic, ku-spleen. Ngakho-ke, uchwepheshe oyinhloko osebenza nenkinga yi-hematologist. Ukulimala kobende, amathumba noma amathumba kuwumsebenzi wodokotela abahlinzayo.

Yiziphi izimpawu zokuqala zezinkinga ze-spleen?

– Emgodini wesisu ngakwesobunxele, ngaphezu kobende, kukhona amanyikwe, izinso. Ngakho-ke, ekuqaleni kunzima ukuqonda ukuthi yini ngempela i-spleen "egulayo" esimweni esithile. Njengoba isitho sitholakala ngaphansi kwe-arch costal, esimweni esivamile asikwazi ukushaywa. Kodwa uma ubende luqala ukuphuma ngaphansi kwezimbambo, lokhu kubonisa ukuthi isitho sisabela enqubweni ethile emzimbeni. Ngokuyisisekelo, lezi yizifo zegazi.

Kukhona futhi isifo esithinta ubhontshisi - i-cirrhosis yesibindi. Kukhona i-hepatolienal syndrome, etholakala ekuhlolweni kwegazi, okubonisa ukwanda kobende. Ngesikhathi esifanayo, umuntu ngokwakhe angase angezwa ubuhlungu nezinye izinzwa ezingavamile. Udokotela kuphela ongakwazi ukuxilonga isifo ngokusekelwe emiphumeleni yokuhlolwa nokuhlolwa okuphelele.

Ngokuvamile, uma kuziwa ezinkingeni ze-spleen, sikhuluma ngohlobo oluthile lokulimala ngemva kwento efiphele esiswini noma ukuwa. Kwenzekani: i-capsule iyaphuka ngenxa yomthelela, ukopha okukhulu. Ngokuphawulekayo, lokhu kuzibonakalisa kanje: umuntu uphenduka aphaphatheke, ajuluke, ukushaya kwenhliziyo yakhe kuyashesha, futhi konke lokhu ngokumelene nesizinda sobuhlungu obubukhali esiswini. Lesi simo sidinga ukungenelela kwezokwelapha okuphuthumayo. Ngakho-ke, uma kwenzeka ukulimala, okokuqala sicabanga nge-spleen.

Ukuhlolwa kwegazi okujwayelekile kuzosiza ukukhomba ezinye izinkinga, ikakhulukazi uma kukhona ukwehla kwe-hemoglobin, ukwanda noma ukwehla kwezinga lama-leukocyte, amaplatelet.

Yikuphi ukudla okulungele i-spleen?

- Uma kucatshangelwa ukuhlunga okujulile, i-hematopoietic, ukuzivikela komzimba we-spleen, kuyadingeka ukuthi umsoco ulinganise. Kuyafaneleka ukugwema ukudla okubabayo nokunosawoti omningi, inani elikhulu lamafutha alula nama-carbohydrate. Ukudla kufanele nakanjani kufake izinhlanzi, ama-beet (ngokuqapha uma unesifo sikashukela), ukudla okuyimithombo yensimbi: i-avocado, i-apula, ihalananda. Ezimweni lapho ukusebenza kwe-spleen kuphazamiseka, uju (uma kungabikho ukungezwani komzimba), izinhlobo ezihlukahlukene zokusanhlamvu (uketshezi), amantongomane ngenani elincane angasiza. Ukudla kufanele kube okuhlukahlukene futhi kuphelele.

Ishintsha kanjani impilo yomuntu ngemva kokukhishwa kobende?

– Ngokuphawulekayo, inhlalakahle yomuntu ayishintshi. Kodwa-ke, ingozi yokuthola izifo ezithathelwanayo, izifo ezibangelwa amagciwane iyanda, njengoba isitho esibhekele ukusebenza kwamasosha omzimba sisuswa. Ngokuvamile kuba ne-thrombosis, i-atelectasis (ukuwa kwezicubu zamaphaphu), i-hernial protrusions endaweni ye-postoperative sutures.

Esikhathini sokuqala se-postoperative, kungase kube nezinkinga ezithile, ezibonakaliswa umkhuhlane, ukwanda kobuhlungu, nokopha.

Ngemuva kokukhishwa kwe-spleen, kubaluleke kakhulu ukuqapha impilo yakho. Kunconywa izinqubo zokuqinisa jikelele, kuhlanganise nokuqina komzimba, ukugoma ngokumelene nomkhuhlane. Impela udinga isikhathi esithile ngemuva kokuhlinzwa (okungenani iminyaka emi-2-3) ukuze ubhekwe udokotela wegazi ukuze ulungise ukwelashwa. Kungenzeka ukuthi ubeke izidakamizwa zokuvimbela i-thrombosis, ngoba lokhu kuyinkimbinkimbi eyingozi kakhulu eyenzeka ngemva kokususwa kwe-spleen.

Nokho, umuntu onobende olususiwe angaphila ukuphila okuvamile, ukuxhumana nabantu ngisho nokudlala imidlalo.

Imithombo ye:

Ukwakheka nokusebenza kobende. UReina E. Mebius, uGeorg Kraal // Imvelo ibuyekeza i-immunology. I-URL: https://www.nature.com/articles/nri1669
Ukuhlonzwa kwama-Splenic Reservoir Monocytes kanye Nokuthunyelwa Kwawo Ezindaweni Ezivuvukalayo. Filip K. Swirski, Matthias Nahrendorf, Martin Etzrodt, abanye // Isayensi. 2009. 325(5940). 612–616. I-URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2803111/
Isesekeli sobende silingisa isimila se-retroperitoneal esingakwesokudla. TA Britvin, NA Korsakova, DV Undercut // Bulletin of Surgery. 2017. URL: https://cyberleninka.ru/article/n/dobavochnaya-selezyonka-imitiruyuschaya-pravostoronnyuyu-zabryushinnuyu-opuhol/viewer
Uhlolojikelele Lwe-Spleen. Harry S. Jacob // Ibhukwana le-MSD. I-URL: https://www.msdmanuals.com/en-gb/professional/hematology-and-oncology/spleen-disorders/overview-of-the-spleen
Ubuhlungu besisu: ukuxilongwa okuhlukile, izindlela zokwelapha ezingenzeka. HE. I-Minushkin // RMJ. 2002. No. 15. URL: https://www.rmj.ru/articles/gastroenterologiya/Abdominalynaya_boly_differencialynaya_diagnostika_vozmoghnye_lechebnye_podhody/
Ukuhlinzwa kwezifo ze-spleen. Insiza yokufundisa. AV Bolshov, V.Ya. Khryshchanovich // BSMU Minsk. 2015. URL: http://rep.bsmu.by/bitstream/handle/BSMU/7986/366534-%D0%B1%D1%80..pdf?sequence=1&isAllowed=y