Udindo wotulutsa malovu, pali mitundu iwiri ya tiziwalo timene timatulutsa m'malovu: tiziwalo timene timatulutsa malovu akuluakulu ndi tiziwalo timene timatulutsa malovu. Iwo akhoza kukhala malo a bakiteriya kapena mavairasi matenda, lithiasis, benign zotupa kapena, kawirikawiri, zotupa zoipa. Makhansa a m'matumbo a salivary ndi khansa yosowa kwambiri.

Pali mitundu iwiri ya glands ya salivary:

• zotupa zowonjezera, zomwe zili m'mphepete mwa m'kamwa ndi lilime. Iwo ndi ang'onoang'ono mu kukula ndi ophweka mu kapangidwe;
• ziwawa zazikulu za salivary, zomwe zili kunja kwa khoma la pakamwa. Zokulirapo, ndi ziwalo zapayokha zomwe zimakhala zovuta kwambiri. Iwo apangidwa ndi mayunitsi secretory ndi ena, excretory.

Pakati pa zotupa zazikulu za salivary tikhoza kusiyanitsa:

• minyewa ya parotid yomwe ili kutsogolo kwa khutu, m'masaya. Choncho pali awiri. Ngalande yawo imatseguka pankhope yamkati ya tsaya, pamlingo wa molars;
• ma glands a submandibular ali pansi pa nsagwada. Ngalande yawo imatseguka pafupi ndi frenulum ya lilime;
• tiziwalo timene timatulutsa ting'onoting'ono timakhala pansi pa lilime. Ngalande yawo imatsegulanso pafupi ndi phokoso la lilime.

Mitsempha ya salivary imatulutsa malovu. Monga chikumbutso, malovu ndi osakaniza madzi, ma electrolyte, maselo a desquamated ndi serous secretions, kuphatikizapo ma enzyme. Malovu amakwaniritsa ntchito zosiyanasiyana: amasunga hydration mkamwa, amatenga nawo gawo pagawo loyamba la chimbudzi chifukwa cha ma enzymes, amaonetsetsa kuti antibacterial amathandizira chifukwa cha ma antibodies.

Tizilombo toyambitsa matenda timatulutsa malovu poyankha kukopa pamene zotupa za salivary zimatulutsa mosalekeza.

Lithiasis (sialolithiasis)

Miyala imatha kupanga m'mitsempha yamalovu amtundu wina wa submandibular glands nthawi zambiri. Amalepheretsa malovu kutuluka, zomwe zimapangitsa kutupa kosapweteka kwa gland ya salivary. Ndi benign pathology.

Matenda a bakiteriya

Malovu akamatuluka mu gland chifukwa cholepheretsa kutuluka kwake (lithiasis, kutsika kwa njira), amatha kutenga kachilomboka. Izi zimatchedwa sialitis kapena matenda a glandular, parotitis pamene gland ya parotid imakhudzidwa ndi submandibulitis ikafika ku submandibular gland. Thupi limakhala lotupa, lokhazikika, lopweteka. Mafinya amatha kuwoneka, komanso malungo.

Ana obwerezabwereza parotitis

A makamaka mawonekedwe a parotitis okhudza ana ndi achinyamata, iwo mobwerezabwereza bakiteriya matenda a chimodzi kapena onse parotid tiziwalo timene timatulutsa. Kuopsa kwake kukhala, m'kupita kwa nthawi, kuwonongeka kwa glandular parenchyma (maselo omwe amapanga minofu yobisika).

Matenda a virus

Mavairasi ambiri amatha kufika m'matumbo a salivary, makamaka parotid glands. Chodziwika bwino ndi cha mumps, kachilombo ka paramyxovirus kotchedwa "mumps" kachilombo kamene kamafala mosavuta kudzera m'malovu. Nkhungu zimaonekera ndi kutupa kowawa kwa gland imodzi kapena zonse ziwiri, kupweteka kwa khutu, kupweteka kwa mmero, kutentha thupi, ndi kutopa kwambiri. Kawirikawiri wofatsa ana, matenda kungayambitse mavuto achinyamata, akuluakulu ndi amayi apakati: oumitsa khosi, kumva kumva, kapamba, testicular kuwonongeka kungayambitse kusabereka. Katemera wa MMR ndiye njira yabwino kwambiri yopewera mphuno.

Pseudo-allergenic sialitis

Zosadziwika bwino komanso zomwe nthawi zambiri zimayambitsa kuyendayenda kwachirengedwe, pseudo-allergic sialitis imawonekera ndi kutupa kowawa kwa gland imodzi kapena zingapo panthawi ya chakudya kapena kukondoweza kapena kununkhiza, limodzi ndi kuyabwa kwakukulu. Zomwe zimayambitsa matendawa sizikudziwikabe mpaka pano.

Zotupa za Benign

Zotupa zambiri za salivary gland ndi zabwino. Nthawi zambiri amakhudza zotupa za parotid. Amawoneka ngati mphuno yodzipatula, yolimba, yoyenda komanso yopanda ululu yomwe imakula pang'onopang'ono.

Chotupa chofala kwambiri ndi pleomorphic adenoma. Imatha kukhala chotupa choopsa, koma patatha zaka 15 mpaka 20 chikaonekera. Pali zotupa zina zosaopsa: monomorphic adenoma, oncocytoma ndi cystadenolymphoma (chotupa cha Warthin).

Zotupa zowopsa - khansa ya m'matumbo a salivary

Zotupa zowopsa za m'matumbo am'malovu zimawoneka ngati zolimba, zolimba, zomwe nthawi zambiri zimamatira ku minofu yoyandikana, yokhala ndi mawonekedwe osadziwika bwino. Izi ndi zotupa zosowa (zosakwana 1/100), zomwe zimayimira zosakwana 000% zotupa zamutu ndi khosi. Kusintha kwa metastatic kumawonedwa pafupifupi 5% ya milandu.

Pali zotupa zosiyanasiyana za khansa za m'matumbo a salivary. Gulu laposachedwa la World Health Organisation (2005) motero limazindikira mitundu 24 ya zotupa zowopsa za epithelial ndi mitundu 12 ya zotupa zoyipa za epithelial. Nazi zazikulu:

• mucoepidermoid carcinoma ndi khansa yofala kwambiri m'matumbo a salivary. Nthawi zambiri imakhudza gland ya parotid, makamaka submandibular gland kapena gland yaing'ono ya m'kamwa;
• Adenoid cystic carcinoma ndi mtundu wachiwiri wofala kwambiri wa chotupa. Nthawi zambiri amakhudza chowonjezera malovu tiziwalo timene timatulutsa ndipo akhoza kufalikira kwa mitsempha pamaso. Malingana ndi momwe maselo a khansa alili, kusiyana kumapangidwa pakati pa cribriform adenoid cystic carcinoma (yodziwika kwambiri), yolimba adenoid cystic carcinoma ndi tuberous adenoid cystic carcinoma;
• salivary duct carcinoma nthawi zambiri imakhudza parotid gland. Kukula mwachangu komanso mwaukali kwambiri, kumafalikira mosavuta ku ma lymph nodes;
• acinar cell carcinoma nthawi zambiri imakhudza gland ya parotid, nthawi zina zonse ziwiri;
• ma lymphoma oyambirira a m'matumbo a salivary ndi osowa.

Mitundu ina ya zotupa za salivary gland zilipo, koma ndizosowa kwambiri.

Matenda a bakiteriya

Mankhwala opha tizilombo amaperekedwa. Kufufuza kwa ultrasound kumachitidwa kuti zitsimikizire kuchira kwathunthu kwa gland.

Matenda a kachilombo

Makutu nthawi zambiri amachira okha mkati mwa masiku khumi. Popeza matendawa ndi ma virus, palibe maantibayotiki omwe amafunikira. Kutentha thupi ndi ululu kokha ndi zomwe zingathe kuchiritsidwa ndi antipyretics kapena analgesics.

Matenda a virus a m'matumbo a salivary amatha kukhala achiwiri ku matenda a bakiteriya. Pamafunika chithandizo cha maantibayotiki.

Malovu a lithiasis

Miyala ya salivary nthawi zambiri imachoka mothandizidwa ndi kutikita minofu nthawi zonse. Ngati apitiliza, sialendoscopy (endoscopy ya ducts ndi salivary glands) ikhoza kuchitidwa. Njira inanso, yotchedwa extracorporeal lithotripsy, imakhala ndi kugawa miyalayo ndi mafunde a extracorporeal shock.

Sialectomy (opaleshoni yotsegula njira yamalovu kuti muchotse kalculus) yachitika mocheperapo kuyambira pomwe njira ziwirizi zidapangidwa.

Pseudo-allergenic sialitis

Kasamalidwe akuyamba ndi mankhwala kuukira 2 milungu kuphatikiza bi-antibiotic mankhwala, corticosteroid mankhwala, antispasmodics, antiallergics ndi benzodiazepine. Chithandizo chanthawi yayitali chochokera ku corticosteroids ofooka ndi antiallergic chimayikidwa.

Zotupa za Benign

Chithandizo cha zotupa zabwino ndi opaleshoni excision. Iyenera kukhala yokwanira komanso yokhala ndi malire achitetezo kuti muchepetse chiopsezo chobwereza.

Zotupa za khansa

Chithandizo cha zotupa zowopsa za gland ya salivary ndi opaleshoni yokhala ndi chitetezo chokwanira, nthawi zina kumatsatiridwa ndi radiotherapy pamakhansa ena. Malingana ndi kufalikira, ma lymph nodes pakhosi nthawi zina amachotsedwa. Chemotherapy sisonyezedwa, kupatula nthawi zina.

Matendawa amasiyanasiyana malinga ndi mtundu wa khansara, kufalikira kwake, siteji ya chitukuko ndi kupambana kwa opaleshoniyo.

Nthawi zambiri ndi kupezeka kwa misa komwe kumapangitsa wodwalayo kuti akambirane ndi dokotala wake wamkulu kapena dokotala wake wa ENT. Poyang'anizana ndi chotupa mu salivary gland, mayeso osiyanasiyana atha kuperekedwa:

• kuyezetsa kwachipatala kuti awone miyeso ya zilonda, kufalikira kwapafupi ndi chigawo ndikufufuza khomo lachiberekero lymphadenopathy (ma lymph nodes);
• X-ray imasonyeza miyala;
• sialography imaphatikizapo jekeseni chinthu chosiyana mu gland ya salivary kuti ipangitse kusawoneka bwino. amagwiritsidwa ntchito makamaka pofufuza matenda opatsirana a m'matumbo a salivary;
• kuwunika kwa anatomo-pathological of the sample pakakhala zotupa; kutsimikizira matenda a zilonda neoplasia, mwachindunji mtundu wake histological ndipo ngati n`kotheka kalasi yake;
• MRI, kapena kulephera kuti ultrasound kapena CT scan;
• CT scan ya khosi ndi thorax kuti muwone zotheka kukhudzidwa kwa metastatic.