MEDA

MEDA (Ventriculus), uzvi guvorish. M. az qismi bolo bo surkhruda, az qismi poyon bo rudai duvozdahangushta payvast ast. Dar M. gizo jam va omekhta shuda, davri avvali guvorishro meguzarad va badan ba rudai duvozdahangushta mefaroyad.
M. dar qismi boloi javfi shikam joygir ast. SHakl va hajmi M. doimi nest. On vobasta ba holati tonusi mushakhoi M., puri, davrai guvorish (hazm), mavqei badan, khususiyati jism, hamchunin vazi uzvhoi nazdik tagyir meyobad. Darozii M. (hangomi miyona budani darajai purshavii on) 14 – 30 sm, barash 10 – 16 sm ast. Gunjoishi on 1,5 – 2,5 l meboshad. M.-ro shartan ba 4 hissa judo mekunand: daromadgoh, tana, qar va baromadgoh. Baromadgohi M. ba du qism taqsim karda meshavad: javf va guzargohi on.
M.-ro arteriyahoi chap va rosti meda, hamchunin arteriyahoi chap va rosti medayu charbu bo khun tamin mekunand. Venahoi M. az shabakai dokhiluzvi tashakkul yofta, az nazdi arteriyaho meguzarand va ba shokhchai venai daromadgohi jigar mepayvandand. Faoliyati M.-ro shokhahoi bofti asabhoi batn va gumroh nazorat mekunand. Asabhoi his az harommagz meoyand.
Devorai M. az luobparda, zerluobparda, mushakho va pardai serozi tarkib yoftaast. Luobparda az epiteliyai ustuvonavii yakqabata, qabati asosi va lavhachahoi mushaki iborat meboshad. Dar qabati asosi gadudhoi naychashakl joy giriftaand, ki doroi se navi hujayra meboshand: glandulosithoi asosiyu parietali va mukositho (hujayrahoi ilovagi). Glandulosithoi asosi pepsinogen (profermenti pepsin) va khimozin, glandulosithoi parietali kislotai khlorid, mukositho usorai mukoidi hosil menamoyand. Dar gadudhoi baromadgoh hujayrahoi gormonii faol joy dorand, ki gastrin ikhroj menamoyand. M. az mushakhoi darozruya, davri va kaj iborat meboshad. Qabati serozi (qabati berunii meda) az boftahoi payvandi va epiteliy (mezoteliy) tarkib yoftaast.
Vazifai asosii M.: zakhira kardan va hazmi avvalini gizo; tadrijan ba ruda firistodani on; ishtirok dar mubodilai moddaho (khorij kardani baze mahsuli mubodilai moddaho) va obu namak; dar yak saviya nigoh doshtani pH-i khun; ishtirok dar hosilshavii khun. Gizo dar M. zeri tasiri shirai meda guvorish meyobad. Kislotai khlorid sellyulozaro narm karda, ba hazmi minbadai on musoidat menamoyad; on tasiri antiseptiki niz dorad. Ishtiroki M. dar ravandi khunofari ba omili dokhilii Kasl vobasta ast. Omili dokhilii Kasl dar M. hosil shuda, jabbishi vitamini V12-ro oson megardonad. Gormoni gastrin, ki mansubi peptidhost, tarashshuhi kislotai khloridro metezonad. Angezai tabiii hosil shudani gastrin gizo ast; kam budani buzurgii pH-i shirai meda ravandi hosil shudani onro bozmedorad. Kalsiy va adrenalini khun ba ikhroji gastrin taqviyat mebakhshand.
Tagyiroti sinnusolii M. ba invalyutsiya (tanazzul)-i luobparda, ki boisi tadrijan kohish yoftani faoliyati gormoni va tarashshuhii on megardad, vobasta ast. CHunin holat beshtar bo nishonahoi dispepsiyai ruda, damishi shikam, bazan ishol, kharobi, gipovitaminoz, kamkhuni, sust shudani muqobilati organizm ba bemorihoi siroyati zohir megardad.
M.-ro bo usulhoi gunogun tahqiq menamoyand. SHikoyati bemor dar bobati dard kardani sari dil, qay, khun partoftan, orug zadan, zardajush va g. bisyor vaqt baroi muqarrar sokhtani tarzi illati M. kumak merasonad. Tadqiqi faoliyati tarashshuhii M., ki tavassuti zond guzaronda meshavad, baroi tashkhisi bemorihoi on va intikhobi usuli muolija ahamiyati kalon dorad. Tadqiqoti rentgenologi doir ba tagyiroti uzvii M. va faoliyati on malumot medihand. Hangomi tadqiqi rentgenokontrastii M. az mahluli obii sulfati bariy, bazan sulfati bariy va gaz istifoda mekunand.
YAke az usulhoi mamuli tadqiqi M. gastroskopiya ast. On imkon medihad, ki holati luobpardai M. daqiqona omukhta shavad. Bo rohi gastroskopiya luobpardai M.-ro metavon biopsiya (gastrobiopsiya) niz kard (mavodi biopsiya baroi tadqiqi minbadai gistologi va sitologi zarur ast).
Bemorihoi M.-ro hamchunin bo usulhoi peritoneoskopiya, tadqiqi ultrasadoi va tamografiyai kompyuteri tashkhis mekunand.
Bemorihoi M. bo rohhoi gunogun padid meoyand, mas., dard kardani sari dil, dispepsiyai meda, qay, khunshori, sustiyu beholati va g. Nishonahoi mazkur baroi tamomi bemorihoi M. khos nameboshand. CHunonchi, dard, odatan, hangomi zakhmi meda va bemorii saraton ba vujud meoyad. Zardajush, orug zadan, ehsosi fishor dar sari sina, qurquri shikam, dilbehuzuri, qay va ishol alomathoi dispepsiya va jarrohi meboshand. Baze amrozi M., mas., gastriti muzmin, polipoz, zakhm, omoshoi saratoni mumkin ast biduni nishonahoi vozeh rukh namoyand.
Az nuqsi inkishofi M. beshtar pilorostenoz mushohida megardad. On tangii modarzodi baromadgohi M. meboshad. Alomati asosii pilorostenoz qay kardani muhtavoi meda ast. Bemori dar haftai 2 – 4 hayot ba mushohida merasad. Divertikuli M. mumkin ast biduni yagon alomat padid oyad. Iltihobi on (divertikulit) az rui alomathoi bolini ba zakhmi meda monand ast.
Osebhoi M. pushida va kushoda meshavand. Osebhoi pushida, mas., kame daridani devorai M., hangomi ba shikam sakht aftodan yo zarb khurdan ba vujud meoyand. Osebhoi kushoda dar natijai zakhm bardoshtan, mas., az zakhmi tir, paydo meshavand. Sukhtagi az kislotayu ishqorho niz ba osebhoi M. taalluq dorad.
Bisyor vaqt ba M. jismhoi begona niz roh meyoband. In holat beshtar dar kudakon duchor meoyad. Bazei onho biduni ehsosi dard khud az khud berun meoyand. Bazei digarro bo yorii gastroskop, laparotomiya va gastrotomiya badar meorand.
Dar M. «sang» ham paydo meshavad (bezoar). Sababi on furu burdani muy, nakhi rastani, moddahoi mummonand, saqich va g. ast. Onho dar M. jam va lunda shuda, boisi dard, dilbehuzuri, qay megardand.
Nig. niz ba maqolahoi judogona oidi bemorihoi meda.

G. Q. Mirojov.