Taataabasho of caajisnimo ah, isku geynta iyo technology

Beeryarada - xubin unpaired in waxa uu ku yaalaa dhinaca bidix ee caloosha. qaybta jirka hore waa ku xiga si ay caloosha, iyo dhabarka - kelyaha, adrenal iyo xiidmaha.

Dhismaha beeryarada

Halabuurka The beeryarada qeexay cover nabarrada iyo kaabsal gaarka ah, tan dambe ayaa la sameeyey by isku-dar ah unugyo, muruq iyo macdantaa laastikada.

kaabsal The galaa lafaha ee jidhka, kala saxarka (parenchyma ah) galay "jasiiradaha" gaar ah la trabecular. In saxarka (derbiyada arterioles ah) waxaa lagu abaabulaa wareega ama qanjira gadood unugyada lymphoid (kiishashka lymphoid). Wadnaha ee saxarka waa dhar reticular ah oo ka dheregsan yahay noocyo kala duwan oo unugyada: unugyada dhiigga cas (inta badan kharribmayo), leukocytes iyo limfosaytis.

function xubin

• beeryarada waa lug lymphopoiesis (ie il limfosaytis).
• Qaybgalaysa hematopoietic iyo difaaca hawlaha ee u shaqeeyo.
• burburinta qaaca ee platelets iyo unugyada dhiigga cas.
• Dhigaalka oo dhiig ah.
• In marxaladaha hore ee embryogenesis shaqeeya sida xubin hematopoietic.

Taasi waa, jidhka u qabata hawlaha badan oo muhiim ah, sidaas darteed si loo ogaado aan caadi ahayn ku jira marxaladaha hore ee sahanka waa fulinta ee hore ee taataabasho iyo durbaanada of caajisnimo ah.

Amarka waxaa of taataabasho ah xubnaha gudaha

Ka dib markii ururinta cabashooyinka, taariikhdaada caafimaad iyo baaritaan guud, dhakhtarka caadiga ah bilaabo inuu hababka jirka ah ee waxbarasho, oo ay ka mid taataabasho iyo durbaanka.

kala saaro:

• taataabasho dusha at kaas oo la ogaado xanuun kala duwan danab beerta murqaha caloosha, barar, iyo noocyo kala duwan oo formation shaabaddii (Sheelada, burooyinka, qanjidhada). qaado by cadaadiska tur faraha bar-laaban yihiin, laga bilaabo gobolka iliac bidix counterclockwise.
• taataabasho Deep fuliyay xigxiga soo socda: indha la ' , axalaha (qayb dhamaadka), colon (u kacaya oo ku soo degaya qeybaha), xiidmaha transverse colon, caloosha, beerka, xameetida, caajisnimo, kelyaha, waxaa lagu fuliyaa iyadoo la isticmaalayo faraha lays qoto dheer dhakhtarkaaga in saabka caloosha.

In the case of shaki cudurada splenic (ama midhihiisa ay sabab u tahay cudur beerka) haysta durbaanka daruuri, taataabasho ah beerka iyo caajisnimo.

xeerarka Guud taataabasho

Taataabasho (taataabasho) ee beeryarada - mid ka mid ah hababka ugu wargelin ah ee cilmi-baarista jirka, ay qabatay dhakhtar. In the case of koror yar ee jirka, marka caajisnimo ah ma fududa in ay baadhaan, hubi dhakhtar ku taliyo maris ah ultrasound si loo xaqiijiyo / doodeen cudurada ku eedeeyay in ilmo ama qof weyn.

xaaladda bukaanka:

• Jiifo (booska this waxaa la qabtaa taataabasho beerka iyo caajisnimo).
• Isagoo Jiifa midig. oo gacanta midigta madaxaygay ka hoosaysaa, iyo bidix waa in la qaloocsan tahay xagasha, iyo xabadka dhigay (farsamada tani waxaa la yiraahdaa taataabasho of caajisnimo ah ee Sali). Waxaa intaa dheer, madaxa bukaan-socodka waa in la yar janjeera in ay xabadka, lugta midig si toos ah iyo lugta bidix waa in la wada xodan yihiin ee kala goysyada misigta iyo jilibka.

Taataabasho of caajisnimo ah, isku geynta

1. Uu dhakhtar gacantiisa bidix waa in la taagan yahay in ay u taalaa dhinaca bidix ee xabadka mawduuca, bareeg u dhexeeya 7aad iyo feeraha 10-kii iyada oo la raacayo khadadka axillary, iyo si ay u bixiyaan cadaadis yar. Marka farood ee gacanta midig waa in uu leeyahay bar-xodan iyo yaal xafiiltamaan ka tagay Xeebaha si ay farta dhexe ku xiga si ay feeraha 10aad.
2. Marka bukaanka neefsado, maqaarka la wareejiyay hoos si ay u sameeyaan laab maqaar.
3. Ka dib markii takhtarka oo katimaada gacanta u guskiisa caloosha (caloosha).
4. Bukaanku waxaa codsi ka yimid dhakhtarka qaadataa neefta ah oo qoto dheer, halka sarkhaansan diaphragm beeryarada hoos u guuro. In the case of sii kordhaya dhakhtarka faraha la kulmi doonto pole hoose. Waa in talaabo noocan oo kale ah lagu celiyo dhowr jeer.

fasiraadda natiijada

Under xaaladaha caadiga ah (in dadka caafimaadka qaba), caajisnimo ma aha dareemi. Ka reeban asthenics (inta badan dumarka). Palpate caajisnimo ah mararka qaarkood waxaa laga yaabaa in laga tegay ee diaphragm ka (pneumothorax, pleurisy) iyo splenomegaly, in uu yahay, in la kordhiyo xajmiga jirka. Xaalad la mid ah wuxuu ku badan yahay dalalka soo socda:

• Cudurada ee dhiigga.
• heley beerka Chronic (splenomegaly Waxakanu waa calaamad ka mid ah hypertension portal ama hepatolienal syndrome).
• Xiisad iyo geedi socodka faafa chronic (infection endocarditis, duumada, qandho tiifowga, sepsis).
• Cudurada of nudaha connective.
• Infarctions ama ka soo bax ee beeryarada.

Inta badan, xataa taataabasho caajisnimo la weyneyn aan xanuun lahayn. Ka reeban infarcts xubin, kaabsoosha siligga degdeg episplenitis. Xaaladahan, caajisnimo uu noqdo mid aad u xasaasi ah (ie, xanuun on taataabasho).

In cirrhosis of beerka iyo cudurada kale ee raaga ee ku laayeen beeryarada ee cufan, geedi socodka isku ba'an - jilicsan.

Joogta ah inta badan waa mid fudud in caabuqyada ba'an, cudurada raaga iyo beerka cirrhosis noqdo cufan.

Iyadoo la raacayo qayb jidhka weyneeyey taataabasho waxaa laga yaabaa in qiimaha yar yar ama waaweyn, iyo sida beeryarada miiqeen baxay cidhifyada ayaa tilmaamaya laga yaabaa in xadka run jirka ka weyn. Sayidka, koror yar muujinaysaa laayeen jirka wax soo saarka ah ee ay xafiiltamaan ee Xeebaha at 2-7 cm, kaas oo lagu arkay caabuqyada ba'an ee (tiifowga, meningitis, sepsis, pneumonia lobar, iyo wixii la mid ah) ama cudurada raaga (cudurka wadnaha, cirrhosis, erythremia, leukemia, anemia) iyo etiology oo aan la garaneyn in dhacdaa inta badan dadka dhalinyarada ah (waxa suurto gala in syphilis dhaxlo, rickets)

Iyadoo la raacayo cufnaanta laayeen beeryarada u dareemi (haddii la kordhiyo) waxaa suurtagal ah in gebagebo ku saabsan habka daawada. Taasi waa, ka dheer caabuq xaadirka ah ee jirka ku jira, denser iyo dhib badan, oo ay parenchyma, kaas waxaa soo socota in ka badan jilicsan oo dabacsan badan qarkii beeryarada chronic ee geedi socodka ba'an.

Marka jidhku waa mid aad u weyn, marka laayeen hoose waxaa lagu qeexaa in saabka miskaha, si ay u qabtaan taataabasho of caajisnimo ah waa mid aad u fudud oo aan u baahnayn xirfadaha gaarka ah.

In the case of splenomegaly keentay burooyinka splenic taataabasho (more hufan, oo ay crenatus margo) waxaa go'aamiya Burr a (1 ilaa 4). Noocan oo kale ah calaamad lagu ogaanayo waxay muujinaysaa joogitaanka amyloidosis, leukaemia (chronic Blodcancerförbundet ama psevdoleykemii), duumada, fiix iyo endothelium.

Taasi waa, inta lagu guda jiro taataabasho beeryarada dhakhtarka waa awoodaa si ay u qiimeeyaan xaaladda ay dusha, si loo ogaado dhigaalka fibrin (sida marka perisplenitah), protrusions kala duwan (taasi waa, tusaale ahaan, soo bax, dhiig-bax iyo fiix nabarrada, echinococcosis) iyo si loo ogaado cufnaanta ee nudaha. In bax badanaa laga helaa oo is beddel. Wax walba waxaa go'aaminaya warbixinta taataabasho waa mid aad u qiimo leh lagu ogaado cudurrada ugu badan ee beeryarada, iyo qeexidda cudurka, taas oo keeni karta in splenomegaly.

beeryarada caadiga ah waxa uu ku yaalaa ee gobolka tagay subcostal, ay dhidibka dheer ku taalaa feeraha tobnaad. Hay'adda ayaa gadood (bean) qaab ah.

Beeryarada ee carruurta

The dhinacyada beeryarada waa caadi, ku xiran da'da,

• Ilmaha dhashay: width - 38 milimitir oo dherer ah - ilaa 40 milimitir.
• 1-3 sano, oo dhererkiisu - ilaa 68 milimitir, width - ilaa 50 milimitir.
• 7 sano, oo dhererkiisu - 80 mm, width - ilaa 55 milimitir.
• 8-12 sano: width - ilaa 60 milimitir oo dherer ah - ilaa 90 milimitir.
• 15 sano: width - ilaa 60 mm, iyo dhererka - 100-120 mm.

Waa in la xusuustaa in taataabasho of caajisnimo ah in carruurta iyo sidoo kale dadka waaweyn, waa in aan xanuun lahayn, marka lagu daro, beeryarada waa caadi in ilmaha aan loo go'aamiyo. The tirada kor ku xusan ma aha buuxda, in uu yahay, leexashooyinkaasi yar jihada of hoos / kordhaya jidhka ma lagama maarmaan ah in la arkaa dhinacyada bahal ah.

durbaanka beeryarada

Habkani waxaa loo isticmaalaa in la qiyaaso cabbir ah (xuduudaha) ee jirka.

Bukaanka waxaa la dhigayaa booska polubokovoe xaq gacmo yeellay madaxa, iyada oo cagihiisa oo kali ah qaloocsan ee kala goysyada misigta iyo jilibka. Percuss soo socota, ka soo cad xubnaha urukaasi oo codka la isticmaalayo foori xasilloon percussive.

durbaanka Qaadashada

1. Farta-plessimetr waa in lagu dhejiyaa on darafka xafiiltamaan ee Xeebaha dhinaca bidix ee jirka dadab iyo in ay feeraha 10aad.
2. Bixiya durbaanka daciif ah ee feeraha 10aad, bilowgii xafiiltamaan ee Xeebaha (bidix) ilaa dhawaaqa caajis (blunting). At-guurka ah ee codka calaamadee on maqaarka. Markaas percussing ka line axillary (gadaal) anteriorly ilaa deadening codka iyo sidoo kale calaamad on maqaarka.
3. dhererka qeybta dhexeeya marks - waa caajisnimo dlinnik (ama feeraha 10-kii). Sida caadiga ah, tilmaame tani waa 6-8 sentimitir.
4. Laga soo bilaabo bartamihii dlinnika dadab iyo in ay feeraha tobnaad oo waxay soo saartaa durbaanka dheeraad ah si loo ogaado dhexroorka of caajisnimo ah, kaas oo sida caadiga ah u dhaxeysa 4 ilaa 6 sentimitir.
5. Caadi ahaan, qaybta hore ee beeryarada (sida ay ku laayeen) waa in aan tago line dillaac fudud isku xira iyo dhamaadka free of feedhii 11 iyo wadajirka ah sternoclavicular. Waa in la ogaadaa in xisaabinta of size ee beeryarada isticmaalaya durbaanka - tiradaasi aad u qiyaas. size unug ayaa la duubay sida jajab, halkaas oo sarreeye - dlinnik waa, iyo hooseeyaha - dhexroorka of caajisnimo ah.