Pafupifupi anthu onse amadziwa kuti m'thupi momwe muli chiwalo - kapamba, wotsutsana ndi ntchito yake, matenda a shuga kapena kapamba amayamba. Matenda a m'matumbo amayamba chifukwa cha zifukwa zingapo, zosiyana muzoyesa, njira zamankhwala.
Koma kodi nchifukwa ninji matenda a chiwalo chomwechi akukhala zomwe zimayambitsa kugaya chakudya ndi njira ya metabolic? Yankho la funsoli likuwoneka mu kagwiritsidwe ka kapamba ndi kapangidwe kake.
Mu Chilatini, kapamba amatchedwa kapamba, kuchokera ku mawuwa akuti mawu akuti pancreatic, kapamba amachokera. Thupi limatulutsa michere ya pancreatic yofunikira kuti chimbudzi chikhale, ndikupaka mahomoni osiyanasiyana m'magazi, makamaka a insulin.
Kodi kapamba amapezeka kuti?
Pancreas ili pamimba kumtunda pamalo obwezeretsa pamlingo wa vertebrae yoyamba ndi yachiwiri. Khoma lakumbuyo yam'mimba ndi kutsogolo kwa kapamba kumayesedwa ndi omentum - wosanjikiza wamafuta.
Gland ili pafupi ndi thupi, imachokera ku hypochondrium kumanzere kupita ku ndulu. Patsogopo pa nkhope ya chigawochi chikugwirizana ndi infa wa vena cava, aorta. Mukamayang'ana thupi la munthu pamalo apamwamba, kapamba amapezeka pansi pamimba, mitsempha yamagazi ndi msana zimagona pansi.
Kapangidwe kamakomawo ndi kotakata, gawo lake lalikulupo limatchedwa mutu, m'lifupi mungafike masentimita 7.5. Mutu umayenda bwino kulowa m'thupi lopyapyala, mchira wa kapamba umatuluka kumanzere, kwakukulu, kukula kwa ziwalo kuli pafupifupi masentimita 14 mpaka 23.
Kuzungulira mutu ndi duodenum, pakuwunikira kwake Wuctung duct imatsegulidwa, kudzera momwe madzi a pancreatic amatulutsidwa, omwe amakhala ndi ma enzymes ofunikira omwe amawononga chakudya kupita ku boma la mamolekyulu.
Mapeto a duct amaphatikizika ndi bile duct, kudzera momwe bile limatulutsidwa. Zomwe zikuwonetsa izi:
- umodzi wa m'mimba ntchito za kapamba ndi chiwindi;
- kulumikizana kwa chakudya m'mimba;
- zotheka kufanana matenda a ziwalozi.
Wirsung duct kukhoma kwa duodenum amapanga Vater nipple, pamwambapa ndi gawo lozungulira la minofu ya Oddi. Pa kusungunuka, imaphimba zimbudzi, pomwe ikupuma, madzi a pancreatic ndi gawo lina la bile limakankhidwa m'matumbo. Mwa anthu ena, kapamba amatha kupanga mphete mozungulira duodenum, kufinya.
Chiwalo chomwe chili pamwambacho chimakutidwa ndi kaso kakang'ono kwambiri, kudzera mwa iyo ma gles omwe amawonekera.
Kapangidwe ka histanc kapamba
Kasitomala ndi chiwalo chokhala ndi ma anatomy ovuta, amakhala ndi magawo awiri akuluakulu omwe amagwira ntchito zosiyanasiyana: exocrine, endocrine. Gawo lazopusa limayang'anira kutulutsa kwa zinthu zapancreatic, limakhala gawo lalikulu la chiwalo, limapanga zomwe zili mkati, zomwe zimakhazikitsidwa ndi makoma a gland.
Maselo a gawo ili amapanga timagulu tapadera, tomwe timalumikizidwa mu lobules - maselo acinar a kapamba. Masamba amenewa amapanga ma enzymes, kuphatikizapo: lipase, amylase ndi proteinase.
Ma pancreatic ang'onoang'ono amakoka bwino ndikulumikizana ndi zazikulu, kuti ma enzymes a pancreatic amalowa mu Wirsung duct. Ngati kuwonongeka kwa gawo la exocrine kumachitika, wodwalayo amadwala chifukwa cha kutupa m'mapapo, ndiko kuti, kapamba.
M'mphepete mwa gawo la exocrine, makamaka mumchira wa gland, pali gawo laling'ono la endocrine gawo, amakhala gawo limodzi la kuchuluka kwa ziwalo ndipo amatchedwa islets of Langerhans. Pali pafupifupi miliyoni miliyoni a maselo amenewa, kutengera mtundu omwe amasunga mahomoni awo:
- insulin;
- somatostatin;
- glucagon;
- pancreatic polypeptide.
Pamwamba pa zisumbu za Langerhans pali malo amtundu wamagazi ochepa, omwe amalola ma hormone kulowa kulowa m'magazi nthawi yomweyo. Gain iyi ikakhudzidwa, matendawa amapezeka ndi matenda a shuga (oyamba) kapena achiwiri (kutengera) zomwe zimayambitsa matendawa.
Zikondamoyo zimaperekedwa ndi magazi ochokera kumitsempha yamagulu osiyanasiyana: mesenteric, general hepatic, splenic. Mwazi umatengedwa kuchokera m'mitsempha kulowa m'mitsempha yam portal. Gland imaphatikizidwanso ndi matumizidwe ambiri amitsempha omwe amachokera ku celiac plexus ndi mitsempha ya vagus.
Kuchita zatsopano kumapangitsa kuti pakhale zovuta zowongolera zamahomoni ndi ma pancreatic enzymes, kugwira ntchito kwa gland kumatha kutsimikiziridwa ndi chizindikiro cha mitundu yonse ya zinthu.
Malamulowa amatchedwa amanyazi.
Ntchito ya procrine
Chithunzi chojambula cha mbali ya kapamba ndi dera la endocrine chimathandizira kukhala ndi lingaliro lokhudza chiwalo, ntchito zake. Komabe, ndikofunikira kuti mudziwe momwe gawo limagwirira ntchito m'thupi la munthu.
Malinga ndi kapangidwe ka kapamba, ndikofunikira kuchita ntchito: exocrine (exocrine) ndi intracretory (endocrine). Ntchito ya exocrine ndikobisalira kwa madzi a pancreatic omwe amakhala ndi ma enzymes opangidwa kuti azigaya chakudya: nuclease, lipase, amylase, proteinase, steapsin.
Nuclease ndikofunikira pakuwonongeka kwa ma nikic acid omwe amalowa m'thupi ndi chakudya. Amapanga zinthu zachilendo zomwe zimalowa mgawo kuti zigayike zigawo zing'onozing'ono.
Mapuloteni ndi ofunikira kuti mapuloteni awonongeke, ofunikira kwambiri a michere chymotrypsinogen, trypsinogen, awa ndi:
- opangidwa mwa mawonekedwe osagwira ntchito;
- ntchito matumbo pansi pa entokinase;
- sinthani chymotrypsin, trypsin.
Zomwe zimapangidwira zimakhala zamphamvu zokwanira, zimaphwanya mapuloteni ku ma amino acid.
Chifukwa cha amylase, wowuma ndi glycogen amakumbidwa, lipase ndi steapsin ndikofunikira kuti lipid ikasokonekera.
Zikondazo zimatulutsa madzi a pancreatic m'magawo ang'onoang'ono, zinthu zosiyanasiyana zimathandizira kubisala kwake. Mwa zomwe: mawonekedwe a Reflex (mawonekedwe a chakudya, kununkhira, kukonzekera chakudya), mopanda tanthauzo Reflex (njira yotafuna ndi kumeza chakudya), zochititsa manyazi, kupindika pamimba.
Dongosolo la humoral limatsimikiziridwa ndi matumbo a mahomoni pancreosimine, secretin, yomwe imasungidwa ndi maselo a duodenum pamene hydrochloric acid, mankhwala osokoneza mapuloteni amalowa. Chifukwa chake, kupanga kwa kapamba wa pancreatic kumadalira mwachindunji chakudya.
Zosakhazikika zopanda mawonekedwe komanso zowoneka bwino zimakhudza kubisala kwa madzi am'mimba kudzera pakatikati mwa medulla oblongata, njira yodzipatula ya zinthu za enzyme, mahomoni ambiri amatengera ntchito:
- chithokomiro England
- kutulutsa kwanyani;
- adrenal glands.
Makinawo akaphwanyidwa, kapamba nayenso amavutika.
Ntchito ya endocrine
Mothandizidwa ndi zinthu zochititsa manyazi, maselo a islet secrete mahomoni a insulin, glucagon, somatostatin, ndi pancreatic polypeptide m'magazi. Insulin ndiyofunikira kuti mayamwidwe okwanira a mamolekyu azigawo azikhala ndi maselo a thupi, choyambirira, izi zimakhudza minofu ndi minofu yamafuta.
Pali kusintha kwa shuga kukhala glycogen, kamasungidwa m'chiwindi ndi minofu, kumadyedwa ngati pakufunika. Kuperewera kwa insulin, kuphwanya mayendedwe ake m'thupi kumakhudza kukula kwa matenda a shuga 1 kapena mtundu wa 2 (matenda obadwa nawo kapena matenda a shuga).
Magazi a glucagon ali ndi vuto losiyana ndi insulin; amachititsa kutsekeka kwa glycogen m'chiwindi, komanso kuchuluka kwa glycemia. Zinaoneka kuti mahomoni onsewa amathandizira kuti pakhale chakudya chamagulu ambiri.
Thupi somatostatin limayimitsa katulutsidwe:
- chithokomiro chowonjezera cha chithokomiro komanso chamba;
- bile;
- michere yokugaya.
Polypeptide imawonjezera katulutsidwe ka madzi am'mimba, maselo a islet amatha kubisa mahomoni ochepa (ghrelin), c-peptide. Zinthuzi zimathandizira kuti chimbudzi chikhale bwino.
Ndi kuwonongeka kwa pancreatic parenchyma, zisumbu za Langerhans zimavutika, njira zowongolera kugaya, kuperewera kwa michere yofunika, kusintha. Matenda aliwonse a pancreatic ayenera kuthandizidwa munthawi yake, chiwalocho ndichofunikira ku thanzi la munthu.
Matenda owopsa kwambiri adzakhala adenocarcinoma khansa ya glandular minofu ikakula.
Zizindikiro za kuperewera kwa enzyme
Zotsatira za njira yotupa mu kapamba ndizosakwanira, kuperewera komanso kuchepa kwa michere. Kuphatikiza apo, pakapita nthawi, pamakhala kusintha kwa tinthu tam'mimba tomwe timakhala gawo limodzi.
Choyambitsa matendawa ndicho chizolowezi chomwa mowa, komanso kuperewera kwa chakudya m'thupi, kupezeka kwa matenda enanso, kuvulala, matenda, komanso kugwiritsa ntchito mankhwala kwa nthawi yayitali.
Kuperewera kwa lipase, amylase ndi trypsin kumadzetsa zovuta m'mimba. Zizindikiro za kuperewera kwa kapamba kumakhala kosasangalatsa kumanzere kwammimba pamimba pansi pa nthiti, kuwawa mutatha kudya.
Kuwonetsera kwina kwa matenda
- kusanza, nseru;
- kuchepa kwa chakudya;
- chisangalalo;
- kusintha kusasinthika, mtundu wa ndowe;
- akunjenjemera m'mimba.
Kukula kwa zizindikiro kumatengera kuopsa kwa matendawa. Chifukwa cha chimbudzi chochepa, thupi limakhala ndi vuto la kuchepa kwa michere, kusokonekera kwa metabolic kumayambitsa osteoarthrosis, osteochondrosis, mtima atherosulinosis.
Kuperewera kwa lipase kumadzipangitsa kumverera ngati mafuta, zimbudzi zotayirira, mafuta obisika ambiri. Kuperewera kwa Amylase kumawonetsedwa ndi matenda am'mimba, kuchepa kwa vitamini, kuchuluka kwakukulu kwa microflora, volumetric stool. Kuchuluka kwa trypsin kumafotokozedwa ndi mushy stool, anemia.
Popeza njira yogawanitsa chakudya imasokonekera, potengera zakudya zakukula, pali:
- kuwonda;
- kusowa kwa vitamini;
- khungu louma;
- kusokonekera kwa misomali.
Kuyenda kwamatumbo pafupipafupi, kuchulukitsa kwa mafuta ndi zinyalala kumachitikanso.
Kuphwanya kutulutsa kwa michere m'matumbo kumayambitsa kukhumudwa kwa minyewa ya chifinya, matenda ndi chifuwa cha pancreatic. Maselo a islet atawonongeka, ntchito yopanga ma insulin ya mahomoni imalephereka, zizindikiro za matenda a shuga a mtundu woyamba ndi wachiwiri zimawonjezeka, kuwopsa kwa zizindikiro zimadalira kuchuluka kwa maselo a beta amoyo.
Kuperewera kwa glucagon kulibe vuto ngati izi, chifukwa mahomoni ena omwe ali ndi vuto lofananalo amapangidwa m'thupi. Kuti apange matenda anu, adotolo adzafunika mbiri ya kapamba ndi maphunziro ena angapo.
Ntchito ndi kapangidwe kake kapamba kamakambirana mu kanema munkhaniyi.
