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动物医学论坛 兽医教学参考,兽医临床交流 - Discuz! Board
Wefrequentlyseecaninepatientsatourclinicwithahuge巨大的,fluid-filledcyst充满液体的locatedeitherundertheirjaw下巴orwithintheirmouth在口腔中.Whenwesayhuge,wereallymeanwhatwesaybecausesomeofthosefoundbelowthelowerjawarelargerthangrapefruits.Therearemanyothercausesofswellinginthisareasuchaspuncturewounds刺伤,abscesses,infectionsoftheteeth,andtumors,butmostcommonrelatetothesalivaryglands.有许多情况如牙龈感染等都会出现这些症状，但是唾液腺的囊肿是最为常见的。兽医人技术联盟_中国专业兽医人的技术交流平台/u&X*j.p0yG!G%mThesalivaryglands,astheirnameimplies意味着,areresponsiblefortheproductionofsaliva.Severalsetsofthemlieinthetissueareabeneaththeskinintheupperandlowerjaw.Salivaproductiongoesonconstantly.Itcontinuouslymakesitswayintothemouththroughsmall小管ductsthatoriginatewithinthesalivaryglandsandcourseundertheskin,openingdirectlyintotheoralcavity.Thepurposeofsalivaistolubricatethemouth,moistenthefood,andbeginthedigestiveprocess.Salivabreaksdownstarchintoindividualsugarmolecules,bothwithinthemouthandduringchewing,andlateroninthestomachandsmallintestine（主要介绍的是唾液腺的结构、作用哈）（H!U2m7r1L1D%i*i1{动物医学论坛Whatcausessalivarycysts?兽医教学参考,兽医临床交流,犬病辅助诊断系统7Z#X6J（W:W.T.n6B:t0[Salivarycystsoccurwhensalivaleaksfromthesalivaryductsintothetissuesnearorwithinthemouth发生的原因主要是因为分泌的唾液腺进入了唾液腺的附近组织和皮下。.Thismaybecausedsimplybytraumatotheducts简单的导管外伤.Insomeinstances,theductmayhavebeenbrokenoritmayhavebeenbruisedwiththeresultantswellingclosingofftheduct导致导管阻塞.Inothercases,anabscessortumorintheareamayputenoughoutsidepressureontheducttopinchitoffasyoumightagardenhose另外、等都可以由于挤压唾液腺导管而是导管狭窄堵塞.Finally,thereareinstanceswhentheglands,becauseofaninternalinflammatoryprocess,releaseafluidthatisjusttoothicktomakeitswaythroughthetinyducts.Thisagainleadstoanobstruction另外唾液腺的自身感染而分泌的浓稠得液体也会导致淤滞。.Allofthesecaseshavethesamefinalresult.Whethertheductwasoriginallyrupturedornot,thepressureofcontinuedsalivaproductionbytheglandswillfinallycausethewallsofthesetinytubestobreakandallowsalivatoleakintothesurroundingtissue.4X#O）R/O4R5F&RU兽医教学参考,兽医临床交流,犬病辅助诊断系统Asmallamountofafluidleakingintotissuerarely,ifever,causesaproblemandwillusuallygounnoticed.Weoftengivelargequantitiesoffluidsdirectlyundertheskintoadehydratedpuppyorkitten.（Itissometimesimpossibletofindaveininthesetinyanimalsforthepreferredintravenousroute.）Itisabsorbedbythebloodsysteminafewhoursanddistributedthroughoutthebody.However,salivaleakingintothetissuesalmostalwaysdevelopsintoamajorproblembecausethefluidisproducedconstantlyandinlargequantities.Additionally,possiblybecauseoftheviscosity,thebodyhasadifficulttimereabsorbingit.Itsimplycontinuestobuildandformslargecysts.1q,M%x0L:Z1|Whatdosalivarycystslooklike?转自动物医学论坛6v$u6s8a9U$B2\8WSalivarycystsshouldbeseenbyaveterinarianassoonaspossible.兽医人技术联盟_中国专业兽医人的技术交流平台2N%H"Y6x4l6n3Ik2nInanaffectedanimal,weseethesalivarycystsineitheroftwoplaces.Typically,alargepocketofsalivawillformunderthejawatthebaseoftheneck.Itwillinitiallybeonthesamesideastheinjuredduct,butafterabriefperiod,thecystcanbecomesolargethatitfillstheentireareabelowthejaw.Itfeelslikeathick-walledballoonfilledwithhoney.Theanimalisabletobreathe,eat,anddrinkinanormalfashion.Swallowingrarelyseemstobeimpaired.Theotherareawherecystsarefoundiswithinthemouth,underthetongue.Theyarereferredtoasa'ranula'inthislocation.Thesecystsoftenwillcauseproblemswitheatinganddrinking.Theymaylimitnormalmovementofthetongueduringdrinkingorgetinthewaywhenfoodisbeingchewed.兽医人技术联盟_中国专业兽医人的技术交流平台6_1F$U5~:L;PWhatisthetreatmentforsalivarycysts?兽医教学参考,兽医临床交流,犬病辅助诊断系统"H0W.W）_$^+m8p$qTWhendealingwithasalivarycyst,medicaltherapyaloneisrarelysuccessfu药物治疗很少有作用l.Thereareisolatedinstancesinwhichalocalinfectionorinflammationcanbeeliminatedwithmedication.Ifthesalivaryductflowhasonlybeenrestricted,allmayreturntonormal.Oncethesalivaryducthasruptured,however,theleakagewillcontinue.Wedonotknowofanycaseinwhichaductclosedorhealedonitsownafterinjury.Theproblemdoesnot'justgoaway.'动物医学论坛2W+p*R3^.|/_*dSurgeryisrequiredincaseswheresalivaisleakingintothesurroundingtissues如果唾液腺液体已经在附近的组织发生了滞留就应该尽早的手术。Inthoseanimalswithalarge,fluid-filledcystbelowthejaw,thesalivaryglandsontheaffectedsidearecompletelyremoved.Usuallythismeansallofthemandibularandsublingualglandsononeside.Althoughthismayseemextreme,theremainingglandsrespondtotheincreasedneedandadjusttheirproductiontocompensatefortheremoval.First,thecystisopened,thenexcesstissueisremovedandtheskinisclosed.Asecondincisionisthenmadeoverthemainbodyofglandsandtheyareremovedalongwithaportionoftheduct.Thisiseasiersaidthandonebecauseofthemanynervesandmajorbloodvesselsinthisarea.Incasesinvolvingaranula,thesurgeryismuchmoresimple.Theranulaisopenedanditswallsarebasicallyturnedinsideoutandsutureddowntotheliningofthemouth.Thiscreatesanevertedpouchthatslowlyheals,forminganewopeningforthesalivaryduct.Thesalivaryglandsthemselvesarenotaffectedinthesurgicalcorrectionofaranula.兽医人技术联盟_中国专业兽医人的技术交流平台.F0Q,W6_8H1YTheimportantpointforownerstorecognizeisthatsalivarycystsshouldbeseenbyaveterinarianassoonaspossible.Iftheownerwaitstoolonginacaseofthecystbelowthejaw,itisdifficultforthecliniciantodetermineonwhichsideitoriginated.Noonewantstosurgicallyremoveallthemandibularandsublingualglandsfromonesideandthendiscoveritwasthewrongside.Helpyourveterinarianandyourdogwithanearlytriptotheclinic.&j%D（C.R7x's!G$D7Q"Yu+i兽医人技术联盟_中国专业兽医人的技术交流平台兽医人技术联盟_中国专业兽医人的技术交流平台*y0{0x'I${#k4P兽医教学参考,兽医临床交流,犬病辅助诊断系统;L.P1a!x%p*[-@5N1k7r5DSALIVARYMUCOCELE（SIALOCELEORSALIVARYCYST）动物医学论坛#x9u.X:At/l0}-VOverview动物医学论坛%q9^+d!x'c9|（DAsalivarymucoceleisacollectionofsalivathathasleaked泄漏、漏fromadamagedsalivaryglandorsalivaryduct,andhasaccumulatedinthetissues.Thisisoftennotedasafluctuant,painlessswellingoftheneckorwithintheoralcavity.Whileofteninaccuratelycalledasalivarycyst,mucocelesarelinedbyinflammatorytissue（calledgranulationtissue）whichissecondarytotheinflammationcausedbythefreesalivainthetissues,whileacystislinedbyepithelial（glandular）tissuewhichisitselfresponsiblefortheproductionofthefluid.Salivarymucocelemaybeclassifiedasfollows:兽医教学参考,兽医临床交流&H$Z/j/}nP1f+j•CervicalMucoceles（Figures1and3）Thisisprobablythemostcommontypeofmucocele.Itisacollectionofsalivaintheupperneckregion,attheangleofthejaw,orbetweenthemandibles.兽医教学参考,兽医临床交流!~"?8D.A!S.Q）t1g•SublingualMucoceles舌下腺（alsocalledaRanula）（Figure2）,Anotherfrequentlocationfortheformationofamucoceleisonthefloorofthemouthalongsidethetongue.Thisisfrequentlyseeninassociationwithacervicalmucocele.;E）Z5K6k+O兽医教学参考,兽医临床交流•PharyngealmucocelesThistypeofmucoceleismuchlesscommon.Itisessentialavariationofthecervicalmucocele,butthefluidaccumulationisalmostentirelywithinthethroat（pharynx）.兽医人技术联盟_中国专业兽医人的技术交流平台3\&}*t#I:k;q0FV*k"M•ZygomaticMucoceleThisisaveryraretypeofmucocelewherethesalivaisoriginatingfromthesmallzygomaticsalivaryglandswhicharelocatedjustbelowtheeye4H3c.d!_*q.Q兽医教学参考,兽医临床交流,犬病辅助诊断系统CausesF/d/c/H0e3t;N$d兽医教学参考,兽医临床交流Thecauseofsalivarymucocelesisrarelyidentified,althoughtrauma外伤、损伤、suchasfromchokecollars,bitewounds,orchewingonforeignmaterialsisgenerallyconsideredtobethemostlikelyinitiating启动event.Asthesalivaleaksfromthetornsalivaryglandorduct,itaccumulates积累、蓄积inthetissueandinitiatesanintenseinflammatoryresponse.Aconnectivetissuecapsulegraduallyformsaroundthesalivatopreventitfrommigratingfurther.0Y6w:N/u*W.G兽医教学参考,兽医临床交流,犬病辅助诊断系统IncidenceandPrevalence&Y1D.p-S-Z;@%o:j!V兽医教学参考,兽医临床交流,犬病辅助诊断系统Thisconditionisalmostexclusivelyseenindogsandveryrarelyincats.AllbreedsaresusceptiblebutthereseemstobeanincreasedincidenceinPoodles,GermanShepherds,DachshundsandAustralianSilkyTerriers.Thereisnoagepredispositionandthisconditionmayoccuratanytime.这种疾病在犬比较常见，很少发生在猫的身上，没有明显的品种易发性，但是对于贵宾犬、德国牧羊犬、腊肠犬等相对多发，没有明显的年龄易发性。/R"Z'w7{"s!l）?兽医教学参考,兽医临床交流,犬病辅助诊断系统SignsandSymptoms兽医人技术联盟_中国专业兽医人的技术交流平台1z1K）^$R1j"P*P*P1FGenerallythedevelopmentofacervicalmucocele（Figure1）isseenasagraduallyenlargingsoft,painless,fluctuantmassintheuppercervical（neck）orintermandibular（betweenthejaws）region.Inmostanimalstherearenoproblemsassociatedwiththedevelopmentofthemass.Ifthemucoceleisasublingualmucocele（ranula）（Figure2）,thedogmayhavesomedifficultyeatingandmaydevelopbleedingfromtraumatothemucoceleasthedogchews.Apharyngealmucoceleisgenerallytotallyundetectableuntiltheoralcavityisexaminedwithsedation.Theanimalmaypresentwithrespiratorydistressbecausethemassdevelopinginthethroatisbeginningtoobstructtheairways.Thisisapotentiallyveryseriousproblemandtreatmentmustbeinstitutedrapidlybecausetheseanimalsmaydiefromacuterespiratorydistress急性的呼吸抑制Dysphagia（difficultyswallowing）maybeanothersignthatapharyngealmucoceleispresent.兽医教学参考,兽医临床交流*x6q"w!n%L3S!{:z转自动物医学论坛5@1C.T（G$p#V-j!]）{&I（s2V1Y.a/h*m"z转自动物医学论坛Figure1.ThisBoxerhasmassiveswelling膨胀、、belowthenecksecondarytoaverylargesalivarymucocele.Itisimportantforownerstorecognizewhichsidetheproblembeginstodevelopon.Whenthemucocelebecomesextremelylargeasithasinthiscase,itisverydifficulttodeterminewhichsalivaryglandtoremove.对于主人而言，尽早的注意肿胀、发生于哪一侧是非常重要的，这对于切除哪一侧的唾液腺是非常重要的。转自动物医学论坛+R*O1y0y1h8i8s#w'|&J）E.V1l）b"`Ci兽医人技术联盟_中国专业兽医人的技术交流平台兽医教学参考,兽医临床交流,犬病辅助诊断系统&H5]'Q8e!Y）p;D&R9aFigure2.ThisBostonTerrierhasasublingual舌下腺mucocele,alsoknownasaRanula.Themandibular下颌的andsublingualglandswillberemovedandtheRanuladrained.兽医教学参考,兽医临床交流,犬病辅助诊断系统5k5b$v2U1U.r5u/b）lRiskFactors）u+e2R）[9O4{%C动物医学论坛Otherthansometendencyforcertainbreedstodevelopmucocelesasmentionedabove,therearenosignificantriskfactorsthathavebeenidentified.兽医人技术联盟_中国专业兽医人的技术交流平台7{（y2J3K8qExam,ScreeningTests,andImaging2n!m0J7X6R1J!~5Y9S动物医学论坛Generallydiagnosisofasalivarymucoceleisfairlystraightforward.Palpationofthesalivaryglandsinnormallyeasilyaccomplished,andwiththeexceptionofthepharyngealmucocele,themucocelesareeasilyidentifiedasasoft,fluctuantswellingthatisnon-painful.Tumorsandabscessesmayappearsimilarbutaregenerallyeitherfirm坚实orpainful疼痛感、Occasionallycervicalmucocelesmigratetotheventralmidlinemakingitdifficulttodeterminewhethertheprobleminvolvestheleftorrightsidedglands（Figure1）.Examiningtheanimalswithsedationindorsalrecumbency（ontheirback）（Figure3）oftenallowsthemucoceletomigratetotheaffectedside.兽医教学参考,兽医临床交流,犬病辅助诊断系统;V（r/d3OK,l（["}8^,}&V3K1Q（w!C0T!O!W兽医教学参考,兽医临床交流%~8N6O:l:D!l.?Figure3.ThisHuskydoghadacervicalmucocele.Frequentlywhenplacedontheback,itiseasiertodeterminewhichsidethemucocelehasdevelopedfrom.兽医教学参考,兽医临床交流0P5X"?）^8^.E5O5W#iLaboratoryabnormalitiesaregenerallynothelpfulinthediagnosisofsalivarymucocele.Ifuncertaintyexistsaboutwhetherthemassisamucoceleorandabscess,asterileaspirationofthefluidcanbeperformed.Aspirationofaclear,yellowishorblood-tingedthickropyfluidwithalowcellcountisconsistentwithsaliva（Figure4）.Anelevationofthewhitebloodcellcountinthefluidmayindicateaninfectioninthesalivarygland（sialadenitis）oranabscess.（?;@7Q）X;L-f&N兽医教学参考,兽医临床交流7g+G.J/D.p%c'j7R'u9A-转自动物医学论坛）m3h-O'z.]6ghFigure4.Aspirationofasalivarymucoceleshouldbedoneunderasepticconditionstopreventcontaminationbybacteria.Thetypicalcontentsofamucoceleareayellowish,thickropyfluidwithalowcellcountasseenhere.兽医教学参考,兽医临床交流&I8K;J9D*c.fRadiographsarerarelyneededtodiagnosesalivarymucoceles,however,ifneoplasia（tumor）issuspected.X-raysofthethoraxareindicatedtolookformetastasis.转自动物医学论坛（T$V5L6o._!z/w1g'q3~:L9lSwellinginthecervicalareafromanysourcemayinitiallyappeartobeasalivarymucocele.Possiblecausesofthisswellinginclude:兽医教学参考,兽医临床交流（X5j6a+a4G7B0I;I8f•Sialadenitis（inflammationofasalivarygland）唾液腺炎动物医学论坛/].}-J6R!X/U6o•Salivaryneoplasia（tumor）唾液腺肿瘤转自动物医学论坛$qi2g（u8O1q（Z•Sialoliths（stonesthatforminthesalivaryduct）（Figure5）唾液腺结石兽医人技术联盟_中国专业兽医人的技术交流平台q"n7c#`0p#Kc•Cervicalabscess颈部脓肿动物医学论坛"V.J!^'s4Fk$P:T•Foreignbodies异物L'U/J7D&T•Enlargedlymphnodes淋巴结增大、动物医学论坛8M:d!e!m0h,u•Thyroglossalcyst下颌囊肿兽医教学参考,兽医临床交流&b6c2F$Yo3B0U•CysticRathke’spouch0|/W#B6o,L2`+J4V兽医人技术联盟_中国专业兽医人的技术交流平台•Branchialcyst腮腺囊肿;k2QCj0}!l:p兽医教学参考,兽医临床交流6J3B5B"}6G&R'I&f.P兽医教学参考,兽医临床交流,犬病辅助诊断系统转自动物医学论坛&s5b4z8j*I"y7r0H#c'[|5MFigure5.Occasionallystoneswillforminthesalivaryductsandbethecauseofasalivarymucocele.Thisisamucocelethathasbeenremovedanditcontainshundredsofsmallstones.Itislikelythatthesestonesformedafterthemucoceledeveloped.#d%j.f$_0n'J9y兽医教学参考,兽医临床交流Differentiationofamucocelefromacystortumormustbemadebypathology.Congenitalcystsasisseenwiththyroglossalduct,Rathke’spouchorBranchialcystwillhaveanepithelialliningratherthanthegranulationtissueseeninamucocele3J%V+`-I$I$G2x8k兽医教学参考,兽医临床交流,犬病辅助诊断系统TreatmentOptions转自动物医学论坛.@3Y0S$x0u"`Theonlysatisfactorytreatmentforasalivarymucoceleisremovalofthesalivaryglandorglandsthatareinvolvedwiththemucocele（Figure6）.Continuedaspirationofamucocelewillnotpermanentlyeliminatetheproblem.Itwilloccasionallyresolvetheproblemforweekstoseveralmonths,butmostwillrecur.Aspirationalsorisksintroducingbacteriaintothemucocelewhichcanpotentiallycauseanabscesswhichwillsignificantlyincreasethedifficultyofsuccessfulsurgicaltreatment.兽医人技术联盟_中国专业兽医人的技术交流平台）a"o0U:|"s兽医教学参考,兽医临床交流,犬病辅助诊断系统1y9f6Q;C*s*u!LSurgicalremovalofthemandibularandsublingualglandsonthesideofthemucoceleisthenormalsurgicaltreatment（Figure6）.Theglandsareremovedtogetherbecausetheductofthemandibularglandtravelsthroughthesublingualglandandremovalofoneglandwouldunavoidablytraumatizetheother.ThemandibularglandiscloselyassociatedwiththelargeveinsthatjointoformthejugularveinRemovalofthesalivaryglandsrequirescarefuldissectiontotheareaofseveralcriticallyimportantnerves.8JV*x;m._$l8s0P4p兽医人技术联盟_中国专业兽医人的技术交流平台动物医学论坛:H'H2X4v.l'n&_J兽医教学参考,兽医临床交流,犬病辅助诊断系统/Ey,x&R+Y0G/H+B'N7AFigure6.Surgicalremovalofthemandibularandsublingualglandsisrequiredtoadequatelytreatsalivarymucocele.Thispictureshowsthemandibularglandbeingdissectedfree.Notethecloseproximitytoseverallargeveins.:?"k/x%w'I转自动物医学论坛Sublingualmucoceles（ranulas）（Figure2）maybetreatedwithmarsupialization（inadditiontoremovalofthemandibularandsublingualglands）tofacilitatedrainageintotheoralcavity.Marsupializationisperformedbyexcisinganellipticalportionofsublingualmucosaoverlyingthemucoceleandsuturingtherimoforalmucosatoconnectivetissue2_*D9k:Q4Z;u0X兽医教学参考,兽医临床交流&x:?/_-n'K%c4B兽医教学参考,兽医临床交流Frequentlyadrainisplacedintheareaofthemucoceletoallowfluidtoescapefromtheareauntilithasachancetoheal.兽医教学参考,兽医临床交流/j8I&c-P._.q8d"R0{x1l&A#_%{,U;C*W,|Salivarymucoceleisasurgicalproblem.Ifyourveterinariansuspectsthatyourpethasasalivarymucocele,surgeryshouldbetherecommendation.Becausethisisanareathatmostveterinariansdonotfeelcomfortableoperatingin,youmaybereferredtoasurgicalspecialist.TofindanACVSveterinarysurgeoninyourarea,clickhere:FindaSurgeon.4A3D8R7L&U6I6c9?9XPotentialComplicationsFollowingTreatment%S6G-P+Q8J%C'C%D+G3c兽医人技术联盟_中国专业兽医人的技术交流平台Postoperativecomplicationsareuncommoniftheprocedureisperformedbyanadequatelytrainedsurgeon.Occasionallyafluidpocket（seroma）maydevelopintheareawherethemucocelewas.Thiscaneitherbedrainedormaybeallowedtoresorbbyitself.Infectionsarerareifattentionispaidtoaseptictechnique.Ifinadequateglandulartissueisremoved,itispossiblethatthemucocelewillrecur.兽医人技术联盟_中国专业兽医人的技术交流平台;E:v!C+z2D2hy%h+eAftercare（]/|:P7L2|7d兽医人技术联盟_中国专业兽医人的技术交流平台Ifadrainwasleftinthesurgicalsite,yourpetwillexperienceseveraldaysofdrainage.Ifthewoundisbandageditwillbenecessarytochangethebandagefrequently.Ifthewoundisnotbandaged,itishelpfultoapplywarmcompresseswithadamptowel.Thiswillhelpcleantheskinintheareaofthesurgeryandwillhelpencouragedrainageoffluidfromthearea.5g#~6x2V4W&x'_动物医学论坛Prognosis;~9g.F2r,@"U9J8?#O8V）b转自动物医学论坛Prognosisisexcellentforanormallifeafterdrainageofamucoceleandadequateremovaloftheaffectedsalivaryglands.Dogsdonotsufferfromadrymouthfollowingremovalofthemandibularandsublingualglands,evenifperformedbilaterally.（Ih#y&g;―MarkDavis,DVM8Y.f,P6f*e兽医人技术联盟_中国专业兽医人的技术交流平台DiplomateACVSH:?2B（a:~6t兽医教学参考,兽医临床交流转自动物医学论坛7g&Z$F*R$v"u1D-l病例资料转自动物医学论坛&`.u:k"u:q）v一岁吉娃娃，雄性。来时于左侧下颌处出现一约略小余拳头大小肿物，轿硬，触诊内容物为液态。使用10毫升注射器抽吸抽出月50毫升以上的较清亮略粘稠液体，主要成分应为唾液。打开口腔于舌根部位的口腔底面发现一约小鸡蛋大小的类似气球样的小泡，内容物也为唾液，与下面的肿物为一个肿囊。经2次抽吸，每次抽吸完成后能过恢复如没有任何症状，但约经过2-3天后肿囊重新如初；宣告抽吸这种方法不能根本解决该病。在肿囊存在的同时一般患犬的食欲等不受影响，对呼吸顺畅有一定影响。经查询给病应该为典型的唾液腺囊肿，遂决定手术。手术摘除患犬左侧最大的一唾液腺颌下腺，由于经验不足和对该部位解剖的部熟悉，没有能够同时摘除左侧的舌下腺。手术第二天（约36小时），下颌再次出现皮下的肿大，应为唾液腺在下颌部皮下聚集的结果。h"`7T6p4V@0z:O3G+A（手术注意：1、对于面部的这一区域的解剖结构一定要熟悉，因为该处有数条大的静脉、动脉和神经。另外如果对于小体型犬而言，舌下腺一般是比较难找的，因此如果不熟悉很容易导致无法真确找到腺体而导致手术的失败。同时也容易出现伤害大的血管、神经而导致手术的失败。"V6a4\*o7T1Zf（k4p兽医教学参考,兽医临床交流、唾液腺结构图、3]&^2sW4?7a,\2\&X0F兽医教学参考,兽医临床交流唾液腺囊肿手术后%^g5Y7e"Lz,兽医教学参考,兽医临床交流$t+j5Q`!kMc）~8^8N%@兽医教学参考,兽医临床交流,犬病辅助诊断系统0x.\（X+?*`5e唾液腺囊肿且开时，积留唾液的包囊。动物医学论坛.Z;[-g.f$\0Y,|J.\,]%c%N!u5a2`8o/y/s*|转自动物医学论坛1A!Y9{6y5Z4O）y7[.m2_且开时显示的颌下腺。/E$`1C:b%c-y&P兽医人技术联盟_中国专业兽医人的技术交流平台-U2E-~,J6Z/e.R,W.@0l7f,Z动物医学论坛包囊内壁组织。包囊内壁由于长期唾液腺的作用，使这种薄膜组织变得有如组织
我也有同样问题，不知道是什么原因，咳嗽过度会不会引起牙龈出血呢
你好！建议你做纤支镜检查，排除支气管结核或气管结核．
你好！已在另一个提问中回复过了，有颈部淋巴结结核可能，建议尽早到医院诊治。
你好！应该是颈淋巴结结核，建议立即到医院就诊，本病治疗和肺结核基本相同。颈淋巴结结核中医称为“瘰疬”，多见于...
涎腺囊肿疾病
1.对于小形囊肿，临床易于确诊者，选用“A”项检查，即可确诊。
2.对于体积大，与其他肿块不易区别者可包括选用“B”和“C”项检查。
主任医师 副教授
擅长:胸外科
主任医师 副教授
擅长:各种心血管
主任医师 副教授
擅长:胸腔镜
[功能主治]清热解毒，透表豁痰。用于急性惊...详情
[功能主治]用于气血不足。心悸。失眠。食少乏...详情
[功能主治]清血败毒。消肿止痛。用于脏腑毒热。...详情
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