Kuchita opaleshoni ya kanyumba ndi njira yofunika kwambiri komanso yovuta.
Mankhwala, pancreatectomy imawonedwa ngati imodzi mwamagawo othandizira opangira opaleshoni yomwe amachotsa zonse kapena gawo limodzi la kapamba.
Njira yodalirika yothandizirayi imagwiritsidwa ntchito poti chithandizo cha mankhwala sichinapereke zotsatira zabwino.
Pali mitundu ingapo ya pancreatectomy, kuphatikizapo:
- pancreatoduodenectomy (Njira ya Whipple);
- distal pancreatectomy;
- gawo pancreatometry;
- pancreatometry ambiri.
Njira izi zimagwiritsidwa ntchito kutengera kuzindikira komwe kumachitika kwa wodwala. Koma mwanjira iliyonse, amagwirizanitsidwa ndi kapamba. Tiyerekeze, mutazindikira chotupa chakhansa, kapena khansa paliponse.
Kuti mupeze yankho lolondola la kudziwa kuti pancreatectomy ndi chiyani, ndi njira yanji komanso momwe mungakonzekerere bwino, muyenera kumvetsetsa zomwe zikuwonetsa.
Mndandandandawu umaphatikizapo:
- Kutupa kwa chiwalo.
- Necrotizing kapamba.
- Pancreatitis yosatha ndi ululu.
- Kuvulala
- Tumors
- Adenocarcinoma (85%).
- Cystadenoma (mucinous / serous).
- Cystadenocarcinoma.
- Tumors of islet cell (neuroendocrine zotupa).
- Papillary cystic neoplasms.
- Lymphoma
- Acinar cell chotupa.
- Mkulu hyperinsulinemic hypoglycemia.
Monga momwe ziliri nthawi zina zonse, kupezeka kwa mankhwala amomwe akutsatiridwa ndi dotolo wokhazikika. Kuti muchite izi, muyenera kukayesedwa kwathunthu ndi kuzindikira kufunika kochita opareshoni.
Zojambula zamitundu yosiyanasiyana
Opaleshoni yofala kwambiri yomwe imagwiritsidwa ntchito pochotsa mbali ya kapamba imatchedwa pancreatoduodenectomy. Amakhala ndikuchotsa gawo la distal gawo lam'mimba, gawo loyamba ndi lachiwiri la duodenum, mutu wa kapamba, chimbudzi wamba cha ndulu ndi chikhodzodzo.
Pancreatectomy yonse itha kugwiritsidwanso ntchito. Mwa zina mwazotsatira za pancreatectomy yathunthu kapena pafupifupi yathunthu, pali zosoweka mu endocrine kapena ntchito ya exocrine ya kapamba yomwe imafunikira kulowetsedwa kwa insulin kapena michere.
Pambuyo pa opaleshoni yotere, wodwalayo amatenga matenda a shuga a mtundu woyamba, chifukwa chakuti chifukwa cha kulowererapo kwa opaleshoni, kapamba kapenanso kuti palibe. Matenda a shuga amtundu wa 1 amatha kuthandizidwa ndikuwonetsetsa kuti shuga ndi magazi a insulini ayandikira.
Popeza kapambayu ndi amene amapangitsa kuti pakhale michere yambiri yokumba m'mimba, kapamba ayenera kuchitidwa ngati gawo lomaliza. Chizindikiro chake chimakhala matenda oopsa a kapamba omwe amaopseza moyo, monga chotupa cha khansa. Ndikofunika kwambiri kuzindikira kuti ngakhale pambuyo pancreatectomy, ululu umapitilirabe mwa ambiri odwala.
Distal pancreatectomy ndikuchotsa thupi ndi mchira wa kapamba.
Kodi madokotala odziwa ntchito amalosera chiyani?
Pambuyo pancreatectomy yodziwika bwino, thupi silipanganso michere yake pansi pa kapamba kapena insulin, chifukwa chake, odwala amawonetsedwa ndi insulin ndipo amatenga zakudya zama enzyme. Zomwezi zimachitikanso pakakhala matenda a pancreatic necrosis.
Matendawa akusonyeza kuti mothandizidwa ndi michere yakeyake, gawo limodzi la kapamba limataya ntchito ndikufa. Choyipa koposa, kuti chiwalo chonse chikafa. Chizindikiro ichi chikuwonetsa kuti thupi la munthu silidzatulutsanso kuchuluka kwa mahomoni, ndipo makonzedwe apakhungu a insulin ndi ma enzyme ena amafunikira.
Iwo omwe sanayambebe kudwala matenda a shuga, atazindikira matendawa, mwatsoka, amakhala otero. Chifukwa chake, amakakamizidwa kuti asinthe moyo wawo ndikutsatira malingaliro atsopano a adokotala. Choyamba, muyenera kuphunzira momwe mungayezere index ya glycemic m'magazi ndikuyang'anira nthawi zonse.
Kuwongolera kotereku ndikovuta ngakhale kwa achinyamata komanso athanzi labwino. Koma popanda izi, thanzi lingawonongeke kwambiri. Komanso, chifukwa cha zovuta zam'mimba, kusowa kwa endo native insulin ndi michere ya pancreatic, wodwalayo amafunika jakisoni wambiri wa insulin analogue. Izi zimatha kukhala zovuta kuvutikira kutengera zaka komanso matenda omwe akukhudzana nawo. Pazonse, moyo wa odwala pambuyo pancreatectomy yofananira imafanana ndi moyo wa odwala omwe amakhala ndi mbali yina ya thupilo.
Pali njira ya adjunct yotchedwa islet cell transplantation, yomwe imathandizira kuchepetsa zotsatira za kuchepa kwa endocrine ntchito pambuyo pancreas wamba.
Zachidziwikire, nthawi zonse, njira zomwe adokotala amagwiritsira ntchito ndi momwe amathandizira. Ndiye chifukwa chake, adotolo akhoza kulimbikitsa njira zosiyanasiyana zochiritsira kwa wodwala aliyense.
Kukula kwa opaleshoni ndi nthawi yothandizira
Ponena za momwe zochitika zikuyembekezerera wodwala yemwe adachita izi, ziyenera kudziwidwa kuti zimayambitsa kusokonezeka kwakukulu kwa metabolic ndi exocrine kusakwanira. Zotsatira zake, ndikofunikira kuyang'anira kuwongolera matenda ashuga ndikukhala olemera, ndipo nthawi zambiri zimakhala zovuta kuchita.
Kupulumuka kwa anthu omwe ali ndi matenda oyipa kumakhalabe kosakhutiritsa. Komabe ,imfa ikuwoneka ikuchepa. Izi zimachitika chifukwa chakuti zamankhwala zamakono zikukonzedwa mosalekeza, ndipo chifukwa chake, ukadaulo wa kuchitira opaleshoni ukupitikanso bwino.
Ponena za mtengo wa opareshoni iyi, ziyenera kudziwidwa kuti zimasiyanasiyana kutengera kutengera komwe wodwala wapeza. Koma nthawi zambiri mtengo umayambira ku ma ruble 3,000.
Ndondomeko ya odwala omwe ali ndi zilonda zam'mimbazi komanso zowonda zimafunikirabe pochizira matenda a pancreatic. Komabe, TA imabweretsa zovuta zazikulu za metabolic zomwe zimafuna kuwongolera kosiyanasiyana. Kuwongolera odwala matenda ashuga komanso kusamalira thupi kumakhalabe vuto.
Upangiri wokhudza matenda ashuga komanso opatsa thanzi kuphatikiza ndi insulin, pancreas exocrine, ndi mavitamini othandizira ndizofunikira pakuthandizira kwa postoperative. Kuwerengera ndi kuchepa kwa thupi ndizofunikira ndipo zimawonetsa kuti odwala awa amafunikira kutsatira mosamalitsa komanso zakudya zopatsa thanzi kwakanthawi.
Kufa ndi kusakhalitsa kwa nthawi yayitali komwe kumalumikizana ndi TA kwakhala kukuchepa kwakazaka makumi angapo zapitazo, zomwe zikuwonetsa kuti zoopsa zimawoneka zovomerezeka poyerekeza ndi phindu lotsatira, makamaka kwa odwala omwe ali ndi matenda oopsa. Mwambiri, kupulumuka kumachitika chifukwa cha matendawo, osati pazotsatira zake.
Titha kunena kuti opaleshoni iyi ingakhale yovomerezeka kwa wodwala komanso wophunzira yemwe ali ndi matenda osokoneza bongo a chamba chonse chokhala ndi zilonda zapambuyo kapena khansa yapachibale.
Momwe opaleshoni yamapamba amachitidwira akufotokozedwa mu kanema munkhaniyi.
