Ndi kapamba ndi matenda ena a kapamba, pali kusintha pa kukula, mawonekedwe ndi malo a chiwalo mkati mwa m'mimba. Koma ngati magawo awiri oyamba akuwonekera bwino pakuwunikira kwa ultrasound, ndiye kuti kutsimikiza bwino komwe gulu limagwira ndi ntchito yovuta kwambiri ndipo kumafunikira kudziwa kwapadera.
Malo olondola kwambiri a kapamba amatha kukhazikitsidwa pokhudzana ndi mafupa amunthu, makamaka mzere ndi nthiti za msana. Njirayi imatchedwa skeletotopy ndipo imakuthandizani kuti mupeze kupatuka pang'ono kuchokera pazizolowezi, mpaka mamilimita angapo.
Zojambula pamutu
Ndizosatheka kudziwa molondola komwe kapamba asakudziwa kutuluka kwake. Chiwalochi chili m'mimba ndipo ngakhale dzina lake silikhala pamimba, koma kumbuyo kwake. Pansi pamimba, chitsulo chimangogwera pamalo a supine, ndipo ndikakonzedwa motsutsana ndi thupi, chimabwereranso pamlingo womwewo ndi m'mimba.
Kutalika kwa chiwalo mwa anthu osiyanasiyana sikofanana ndipo kungayambike 16 mpaka 23 cm, ndipo kulemera kwake ndi 80-100g. Kuti alekanitse kapamba ziwalo zina ndi minyewa yam'mimba, imayikidwa mu mtundu wa kapisozi kuchokera ku minofu yolumikizana.
Mu kapisolo uyu pali magawo atatu omwe amagawa zikondamoyo m'magawo atatu osagwirizana. Amakhala ndi kapangidwe kosiyanasiyana ndipo amagwira ntchito zosiyanasiyana mthupi. Iliyonse ya iwo ndiyofunikira kwambiri pa thanzi la munthu ndipo ngakhale kugwira ntchito pang'ono kumayambitsa mavuto.
Zikondamoyo zimakhala ndi zigawo izi:
- Mutu;
- Thupi;
- Mchira.
Mutu ndiye gawo lalikulu kwambiri ndipo mu girth imatha kufika masentimita 7. Imalumikizana mwachindunji ndi duodenum, yomwe imawerama mozungulira ngati khosalo. Mitsempha yofunika kwambiri, monga chotupa cha vena cava, mtsempha wama portal, ndi minyewa ya impongo ndi mitsempha, imapita kumutu.
Komanso m'mutu mumadutsa bile duct yodziwika bwino ku duodenum ndi kapamba. Pamalo pomwe mutu umalowera mthupi, mumakhala mitsempha ina yayikulu, yomwe ndi minenteric artery and vein.
Thupi la zikondamoyo monga momwe zimapangidwira limafanana ndi prism yachiwongola ndi kutsogolo komanso ndege yakutsikira. Mitsempha yambiri yam'magazi imayenda m'litali lathunthu la thupi, ndipo pang'ono kumanzere kwa chotupa cha splenic. Muzu wama mesentery wa colon yopingasa imapezekanso thupi, zomwe nthawi zambiri zimayambitsa paresis yake pachimake pancreatitis.
Mchira ndiye gawo lochepetsetsa. Ili ndi mawonekedwe a peyala ndipo malekezero ake amakhala ngati zipata za ndulu. Kumbuyo, mchira umalumikizana ndi impso lakumanzere, tiziwalo timene timatulutsa adrenal, impso ndi mtsempha. Maselo a Langerhans amapezeka mchira - maselo omwe amapanga insulin.
Chifukwa chake, kugonjetsedwa kwa gawo lino kumayambitsa kukula kwa matenda ashuga.
Skeletonotopy
Pancreas ili chapamwamba kumtunda kwa peritoneum ndikuwoloka msana wa anthu pamlingo wamalo o lumbar, kapena, moyang'anizana ndi vertebrae 2. Mchira wake uli mbali yakumanzere ya thupi ndipo umapinda pang'ono, kotero kuti umafika 1 lumbar vertebra. Mutu wagona mbali yakumanja ya thupi ndipo umakhala pamalo omwewo ndi thupi lozungulira 2 vertebrae.
Muubwana, kapamba ndiwokwera pang'ono kuposa wamkulu, chifukwa chake, mwa ana gululi limakhala pa 10-11 vertebrae ya thoracic msana. Izi ndizofunikira kuziganizira mukamazipeza matenda a kapamba.
Cancreatic skeletotopy ndikofunikira kwambiri pakuwazindikira. Itha kutsimikizika pogwiritsa ntchito ma ultrasound, x-ray ndi ma pancreatogram, yomwe ndi njira yamakono kwambiri yofufuzira chiwalo chodwala.
Holotopia
Pancreas ili m'dera la epigastric, lomwe ambiri amapezeka ku hypochondrium kumanzere. Chiwalochi chimabisidwa ndi m'mimba, chifukwa cha opaleshoni yamkati, dokotalayo amafunika kuchita kangapo.
Choyamba, santhani omentum, kulekanitsa m'mimba ndi ziwalo zina zam'mimba, ndipo chachiwiri, kusuntha bwino m'mimba kumbali. Pambuyo pokhapokha izi, dokotala wochita opaleshoniyo azitha kuchitapo kanthu pochita opaleshoni yofunikira mu kapamba, mwachitsanzo, kuchotsa chotupa, chotupa kapena minofu yakufa mu pancreatic necrosis.
Mutu wa kapamba uli kumanja kwa msana ndipo umabisika ndi peritoneum. Otsatirawa ndi thupi ndi mchira, womwe uli mu hypochondrium yamanzere. Mchirawo umakwezedwa pang'ono ndikumalumikizana ndi zipata za ndulu.
Malinga ndi madotolo, ndizosatheka kumva zikondamoyo mwa munthu wathanzi. Amamveka pakhungu palokha mwa akazi 4% ndi 1% amuna.
Ngati chiwalochi chimagwiritsidwa ntchito mosavuta pakuwunikira, izi zikuwonetsa kukula kwake, zomwe zimatheka pokhapokha ngati pali yotupa kwambiri kapena kupanga zotupa zazikulu.
Syntopy
Syntopia ya kapamba imakupatsani mwayi wodziwa malo ake mokhudzana ndi ziwalo zina ndi minyewa yam'mimba. Chifukwa chake mutu ndi thupi zimatsekedwa kutsogolo ndi thupi ndi m'mimba, ndipo mchirawo umabisika pansi.
Kuyanjana kotereku kwa kapamba ndi m'mimba kumakhudza mawonekedwe ake ndipo kumayambitsa mawonekedwe ndi kugundana kwapanja. Zilibe mphamvu pa ntchitozo ndizochita wamba.
Kutsogolo kwa kapamba kumakhala kobisika kwathunthu ndi peritoneum, koma gawo laling'ono lokha lachiberekero limakhala lotseguka. Imayenda motsatira kutalika konse kwa kuthengo ndipo pafupifupi imagwirizana ndi nkhwangwa yake. Choyamba, mzerewu umadutsa mutu pakatikati, kenako umathamanga m'mphepete mwa thupi ndi mchira.
Mchira, womwe umapezeka ku hypochondrium kumanzere, umaphimba impso yakumanzere ndi adrenal gland, kenako umapuma pazipata za ndulu. Mchira ndi ndulu zimalumikizana pogwiritsa ntchito kapamba wam'mimba, komwe ndiko kupitiliza kwa omentum.
Gawo lonse la kapamba, lomwe lili kumanja kwa msana, ndipo makamaka mutu wake, limatsekedwa ndi gastro-colon ligament, colon yopingika komanso chiuno cham'mimba chaching'ono.
Mwakutero, mutu umalumikizana ndi duodenum pogwiritsa ntchito duct wamba, momwe madzi a pancreatic amalowera.
Kuyesa kwa Ultrasound
Kufufuza kwa Ultrasound kwamatumba mu 85% ya milandu kumapangitsa kuti zitheke kupeza chithunzi chonse cha thupilo, m'magawo 15% okhawo. Ndikofunikira makamaka pakuwunikira kuti zitsimikizire ndendende njira yomwe imagwirira ntchito, chifukwa mwa iwo ndi momwe njira zambiri zimachitikira.
Mwa munthu wathanzi, mutu wa kapamba nthawi zonse umakhala molunjika pansi pa hepatic lobe, ndipo thupi ndi mchira zimakhala pansi pamimba ndikumanzere kwa hepatic lobe. Mchira wokhala pa scan ya ultrasound imawonekera kwambiri pamwamba pa impso yakumanzere komanso pafupi ndi chipata cha ndulu.
Mutu wa zotupa pamakanda umawoneka nthawi zonse ngati mawonekedwe akulu a echo-negative, omwe ali kumanja kwa msana. Mitsempha yotsika kwambiri imadutsa kumbuyo kwa mutu, ndipo mitsempha yapamwamba kwambiri imachokera kutsogolo ndi kumanzere. Ndi chifukwa chake wina akuyenera kuwongoleredwa pamene akufufuza mbali ya mutu ya chiwalo pakamayesedwe a ultrasound.
Kuphatikiza apo, kudziwa komwe mutu umakhala, mutha kugwiritsa ntchito mesenteric artery komanso splenic vein ndi aorta ngati malangizo. Mitsempha yamagazi ndi chizindikiro chodalirika cha malo omwe chiwalocho chili, chifukwa nthawi zonse chimadutsa pafupi nacho.
Mukamayang'ana pancreatic scan, ndikofunikira kukumbukira kuti mutu wokha ndi womwe umapezeka kumanja kwa msana, ena onse, omwe ndi thupi ndi mchira, ali kumanja kumanzere kwamimba. Pankhaniyi, mathero a mchira amakhala akukulidwa pang'ono.
Panthawi yoyeserera ndi ultrasound, mutu wa kapamba nthawi zambiri umakhala wozungulira kapena wowongoka, ndipo thupi ndi mchira wake ndi zazitali zokulirapo pafupifupi m'lifupi. Chovuta kwambiri ndi njira yofufuzira iyi ndikuwona pancreatic duct, yomwe imatha kuphunziridwa pokhapokha ngati 30 peresenti ya 100. Pazitali zake sizimapitilira 1 mm.
Ngati kapamba amatchinga pang'ono, ndiye kuti izi zimachitika chifukwa cha kudzikundika kwa mpweya m'mimba. Chifukwa chake mthunzi wamagesi wophatikizidwa mu lumen wa duodenum umatha pang'ono kapena kutseka kwathunthu mutu wa chiwalocho ndipo potero umasokoneza mayeso ake.
Komanso gasi amatha kudziunjikira m'mimba kapena m'matumbo, ndichifukwa chake pakuwunika kwa ultrasound, mchira wa kapamba nthawi zambiri umawonedwa. Zikatero, mayesowa ayenera kuyikidwa tsiku lina ndikukonzekera bwino.
Chifukwa chake musanayambe kugwiritsa ntchito ultrasound, sizikulimbikitsidwa kuti mugwiritse ntchito zinthu zomwe zimathandizira kupanga gasi, izi:
- Ma Leamu (nyemba, nandolo, nyemba, soya, mphodza);
- Mitundu yonse ya kabichi;
- Mitengo yokhala ndi CHIKWANGWANI: radish, turnip, radish, letesi masamba;
- Rye ndi mkate wathunthu;
- Porridge kuchokera ku mitundu yonse ya chimanga, kuwonjezera pa mpunga;
- Zipatso: mapeyala, maapulo, mphesa, plums, mapichesi;
- Kutupa kwamadzi ndi zakumwa;
- Zinthu zopangidwa mkaka: mkaka, kefir, tchizi chokoleti, yogati, mkaka wowotchera, kirimu wowawasa, ayisikilimu.
Kapangidwe ndi kagwiridwe kake kofotokozedwera kanema mu nkhaniyi.
