Cancreas ndiye chiwalo chofunikira kwambiri, popanda momwe thupi limagwirira ntchito.
Mphamvu ndi kutulutsa kwa kapamba ndizovuta kwa munthu wamba kuti amvetsetse, chifukwa chake tikambirana mwatsatanetsatane nkhaniyi.
Zochitika zathupi
Ntchito yayikulu ya kapamba ndikupanga madzi a kapamba, omwe amapereka njira za chimbudzi. Mapangidwe a chithokomiro ndi achindunji, omwe amafotokozedwa ndi ntchito ya kubisala, komwe zimatengera.
Mfundo zoyendetsera thupi ndi zosavuta. Munthu akayamba kudya, pang'onopang'ono kukula kwamadzi a pancreatic kumayamba. Izi ndichifukwa choti mumkamwa mwa munthu aliyense pamakhala ma receptors apadera omwe amapatsira chizindikirocho kumapazi, pambuyo pake ntchito yake imayamba.
Chifukwa chake, ntchito ziwiri zazikuluzikulu zamthupi zimatha kusiyanitsidwa:
- Kutenga mbali mokwanira pakukamata.
- Kusintha shuga.
Ntchito ya pancreatic
Pakupanga kwamadzi a pancreatic, omwe amakulolani kugaya chakudya cholowa mthupi, acini ndi omwe ali ndi udindo. Kuphatikiza apo, amanyamula madzi kupita nawo ku Wirsung duct, ndiye njira yayikulu ya chiwalochi.
Madzi a m'mimba palokha ali ndi magawo awiri:
- Enzymes. Aliyense enzyme iliyonse imayang'ana mkati mwa zakudya zomwe zikubwera, i.e. imaphwanya chakudya, mapuloteni ndi mafuta pazinthu zomwe thupi limatha kuyamwa.
- Bicarbonates Zinthu izi zimalepheretsa ma acid omwe amachoka pamimba kupita ku duodenum.
Ngati kapamba wayamba kugwira ntchito molakwika, ma ducts ake amayamba kutha, ndipo michere yamagayilo imayamba kukhazikika mkati mwake. Mwachilengedwe, ntchito ya ma enzyme imakhalabe yemweyo, i.e. amayamba kuswa osati mapuloteni komanso zakudya zamafuta, koma ma cell a pancreatic, omwe amatsogolera pakupanga kwa poizoni ndi necrosis.
Makamaka, pancreatitis yachilendo imayamba chimodzimodzi. Vutoli limadziwika ndi kupweteka kwakukuru mu kapamba, komwe kumafuna kuyambika kwa kuchitapo kanthu kwakanthawi.
Kuphatikiza pa gawo la exocrine, pali tsamba la endocrine. Ngati acini atenga pafupifupi 98% ya tinthu tambiri, ndiye kuti 2% yokha ya maselo otchedwa islets of Langerhans omwe amazindikira kugwira ntchito kwa endocrine. Maselo amenewa amatulutsa mahomoni apadera omwe amapanga mafuta ndi chakudya chamagulu ambiri.
Mitundu yotsatirayi ya mahomoni imapangidwa:
- Insulin ndi mahomoni omwe amayang'anira zinthu zonse zomwe zimalowa m'maselo.
- Glucagon imayang'anira kuthamanga kwa shuga m'magazi. Kuphatikiza apo, ngati pali kusowa kwa glucose, ndiye kuti glucagon imatulutsa kuchokera m'masitolo a adipose minofu.
- Polypeptin. Ili ndi ntchito yofanana ndi somatostatin, i.e. Amatha kuyimitsa kugwira ntchito kwa mahomoni onse ngati kugwira ntchito kwawo sikufunikira.
Pankhaniyi, insulin imachita mbali yapadera. Ngati sikokwanira mthupi, ndiye kuti matenda ashuga amayamba - matenda omwe amawonedwa ngati osachiritsika.
Mu moyo wonse, munthu amayenera kuyang'anira kuchuluka kwa shuga m'magazi ake, kutsika kapena kukulitsa kuchuluka kwa insulin.
Mawonekedwe anatomical
Pancreas anatomy ndiyofunikira kwambiri pakumvetsetsa kugwira ntchito kwa chiwalo ichi, komanso gawo lake mthupi lonse. Mphengoyi ndi chiwalo cholowera pang'ono komanso chopindika. Ngati mumayesa kukula kwake, ndiye kuti ndi gawo ili ndi lachiwiri kokha kwa chiwindi.
Ngati mukuchita ma ultrasound, ndiye kuti kuchuluka kwa kapamba kumafanana kwambiri ndi maphunziro ofanana ndi chiwindi, i.e. Imakhala yopangidwa mwaluso komanso yolingidwa bwino. Chochititsa chidwi, pali ubale wotsimikizika pakati pa kuphatikizika kwa anthu ndi kuphatikizika kwa ziwalozi. Chifukwa chake, mwa anthu ochepa thupi kumakhala kuchulukana, ndipo kwathunthu - kumachepetsedwa.
Pa nthawi yoyembekezera, pafupifupi milungu 5, kukula koyambirira kwa ziwalo izi kumachitika. Njira yopangira kapamba imapitirirabe mpaka mwana atakwanitsa zaka zisanu ndi chimodzi. Mwachilengedwe, kukula kwa ziwalo pang'onopang'ono kumakula, kutengera zaka za mwana:
- Mwana wobadwa kumene - kukula pafupifupi 5.5 cm.
- Mwanayo ali ndi chaka chimodzi - kukula kwake ndi pafupifupi 7 cm.
- Mwa mwana wazaka khumi, kukula kwa kutalika kumafika mpaka 15 cm.
Kukula kwa kapamba, kapangidwe kake
Ngati tizingolankhula za kukula kwa chiwalo mwa munthu wamkulu, ndiye kuti akhoza kukhala osiyana. Pafupifupi, kutalika kwa chithokomiro kumakhala pakati pa 16 mpaka 23 cm, ndipo makulidwe osaposa masentimita 5. Kulemera kwa ziwalo kumasiyana, kutengera zaka za munthu. Mwachitsanzo, mwa bambo kapena mkazi wazaka zapakati, chiwalochi chimatha kulemera magalamu 60 mpaka 80, ndipo mwa anthu achikulire osaposa 60 magalamu.
Ma paramu amthupi sangayane ndi miyeso yomwe ili pamwambapa. Kukula kwa chiwalo kumatha kuchitika ndi kapamba, yemwe amadziwika ndi kutupa ndi kutupa kwa minofu. Chifukwa chake, chiwalo cholimbacho chimakanikizira ziwalo zina zamkati zomwe zili pafupi, zomwe zimapangitsa kuti thupi likhale ndi vuto.
Mbali inayi, atrophy ya parenchyma imadziwika ndi kuchepa kwa kukula kwa kapamba. Ndiye chifukwa chake, ngati muli ndi chizindikiro chimodzi, monga kupweteka kwambiri m'mimba, muyenera kufunafuna thandizo nthawi yomweyo.
Kapangidwe ka limba kali motere:
- Mutu. Ndiye gawo lalikulu kwambiri la gland, ndipo ili m'chiuno cha duodenum, pang'ono kumanja kwa msana.
- Thupi. Ili mkati mwakuya kwam'mimba, ndikupita kumanzere kwa m'mimba.
- Mchira, momwe ma cell opanga mahoni amapezeka. Ili pafupi ndi ndulu.
Pafupifupi, gawo lalikulu la chiwalocho ndi parenchyma, yomwe imakutidwa pamwamba ndi kapisozi kotsika. Gawo la parenchyma la kapangidwe kake ka ziwalo ndi 98 peresenti ya misa yonse.
Malo Okhala
Komwe kuli kapamba ndikofunikira kuti timvetsetse momwe gululi limagwirira ntchito. Monga tidanenera, mawonekedwe a thupilo ndi awa:
- Gawo lalikulu la gland, kupatula mutu, lili kuseri kwa m'mimba. Thupi lonse komanso mchira wa chiwalo chili kumbali yakumanzere ya m'mimba pamwamba pa khangaza - pafupifupi 7 cm.
- Ponena, imakutidwa ndi chiuno chowoneka ngati kavalo wa duodenum.
Komwe kuli kapamba ndizotetezeka kwathunthu kumbali zonse. Mzere wa msana umakhala kuseri kwa chamba, ndipo m'mimba muli kutsogolo. Kumbali zonse, zonse ndizotetezedwa:
- Kumanja kuli duodenum.
- Kumanzere kuli ndulu.
Kulumikizana ndi matupi ena
Ntchito ya kapamba imayenderana kwambiri ndi kugwira ntchito kwa ziwalo zomwe zili pafupi. Kuzungulira gland kuli impso, matumbo, chiwindi, mitsempha yambiri yamagazi, ndi zina zambiri. Mwachilengedwe, ngati chiwalo chimodzi chikukhudzidwa ndi matenda aliwonse, ndiye kuti izi zimatha kuthana ndi ziwalo zina zomwe zili pafupi. Izi zikufotokozera kufanana kwa zizindikiro zamatenda osiyanasiyana.
Zochita za gland zimayenderana kwambiri ndi ntchito wamba ya duodenum. Mwachitsanzo, ngati munthu ali ndi zilonda zam'matumbo, ndiye kuti atha kupezeka ndi matenda apamwamba kwambiri. Chizindikiro cha matendawa ndi kutukusira kwa tiziwalo timene timayambitsa kupindika.
Ngati chithandizo choyenera sichinayambike munthawi yake, ndiye kuti kapamba angasiye kugwira ntchito. Ine.e. thupi silitulutsa ma enzyme okhala ndi mahomoni, ndipo minyewa yathupiyo idzagonjetsedwa ndi necrosis komanso kusintha pang'onopang'ono kwa khungu ndi mawonekedwe osakanikirana.
Kuphatikiza apo, pali chiwopsezo cha matenda opatsirana, omwe ali pachiwopsezo kale pa moyo wa wodwalayo, chifukwa peritonitis imayamba motsutsana ndi maziko awo.
Matenda a kapamba
Malinga ndi ICD-10, kapamba amatha kudwala matenda angapo.
Matenda ofala kwambiri omwe anthu amisinkhu yosiyanasiyana amavutika nawo ndi pancreatitis yayikulu.
Nthawi zambiri, matendawa amapezeka chifukwa cha amene amamwa mowa kwambiri.
Kuphatikiza apo, pancreatitis pachimake imachitika pazifukwa zotsatirazi:
- Kugwiritsa ntchito kwambiri zakudya zovulaza, kuphatikiza mafuta ndi zakudya zosuta.
- Zinthu zoyipa.
- Miyala mu chikhodzodzo.
- Zowopsa, komanso zovuta pambuyo pakuchita opareshoni.
- Matenda opatsirana.
- Kulandila kwamagulu ena amankhwala.
Ndizachidziwikire kuti ndi matenda awa, chakudya chokhazikika chokhazikitsidwa, chimachotsa kwathunthu zakudya zamchere, zokazinga ndi zonunkhira.
Kuphatikiza apo, chotupa pa chiwalo ichi chimapezeka nthawi zambiri. Ndi mawonekedwe owaza odzadza ndi madzi omwe amapezeka parenchyma. Zomwe zimawoneka ngati mapangidwe a cystic sangakhale kokha moyo wolakwika wa munthu, komanso kukhalapo kwa matenda achipani.
Makamaka, kapamba amitundu yosiyanasiyana, matenda, komanso zilonda zam'mimba komanso zotupa zimatha kuwoneka ngati cyst.
Ngati munthu wasokoneza njira yopanga insulin mthupi, ndiye kuti amadwala matenda a shuga. Nthawi zambiri, zimawonekera motsutsana ndi momwe munthu wakhudzidwira matendawo pankhaniyi, koma pakhoza kukhala zifukwa zina:
- Kunenepa kwambiri.
- Matenda ena a chiwalo ichi.
- Kukhala okhazikika pamavuto.
- Chimfine ndi matenda ena opatsirana ndi ma virus.
- Ukalamba.
Nayi mndandanda wa matenda ena omwe kapamba amadwala.
Pancreatic necrosis. Matendawa amadziwika ndi kusintha kwakuwonongeka kwa ziwalo parenchyma, zomwe zimachitika motsutsana ndi maziko a pancreatitis pachimake. Pali zifukwa zinanso zomwe zimapangitsa kuti matendawa apangidwe, koma pafupifupi 10% ya milandu sizotheka kudziwa zonse zomwe zinapangitsa kuti adwale.
Khansa Matendawa amatengedwa ngati osowa, komanso amapezekanso. Zina mwazinthu zomwe zikuwonetsa chidwi ndikuzunzidwa kwa zizolowezi zoipa, kunenepa kwambiri komanso chifukwa cha majini.
Monga momwe tikuonera, mavuto ambiri ndi kapamba akanatha kupewedwa ngati munthu anali okhwima kwambiri pa moyo wake. Mowa, ndudu, zakudya zamafuta ndi mchere - zonsezi, njira imodzi kapena ina, zimakhudza mkhalidwe wa chinthuchi. Zachidziwikire, matenda a pancreatic samangokhala kokha motsutsana ndi maziko ogwiritsira ntchito molakwika zizolowezi zoipa, koma ndi chimodzi mwazomwe zimayambitsa matendawa.
Mankhwala osiyanasiyana amatha kuthandizira polimbana nawo, koma ndikofunikira kumvetsetsa kuti popanda kusintha momwe mumakhalira komanso zakudya, ndizokayikitsa kuti mutha kukwaniritsa zotsatira zamankhwala.
Pomaliza
Zikondazo zimagwira ntchito zambiri zofunika, popanda zomwe thupi sizingatheke. Ichi ndichifukwa chake ndikofunikira kuwunika momwe alili, osadzaza katundu woipa komanso mowa. Izi zimakhudza osati gawo la chiwalo lokha, komanso zimapangitsa mawonekedwe a chotupa.
Kapangidwe ndi kagwiridwe kake kofotokozedwera kanema mu nkhaniyi.
