Pancreatic exocrine insufficiency syndrome: ndi chiyani?

Tsiku lililonse, thupi limalandira gawo lazakudya zomwe ziyenera kugayidwa ndikuchotsedwa muzakudya zomwe zimapanga michere.

Exocrine pancreatic insuffence ndi matenda owopsa omwe amatsogolera kuphwanya kupanga kwa michere yomwe imayambitsa chimbudzi cha chakudya cholowa m'mimba.

Zotsatira zake, thupi la munthu limasowa mavitamini ndi zinthu zina zogwira ntchito. Munkhaniyi, mutha kudziwa za pathophysiology ya exocrine insufficiency (zomwe zimayambitsa, limagwirira ndi zotulukapo zake), komanso mfundo za kuzindikira, chithandizo ndi njira zopewera.

Kodi matenda ndi chiyani?

Chimodzi mwazinthu zovuta kwambiri mthupi lathu ndi kugaya chakudya. Imayamba pambuyo poti malowo atalowa mkatikati mwa pakamwa ndikuwanyowa ndi malovu. Zakudya zowilidwa zimalowa m'mimba, zimatulutsa pepsin ndi hydrochloric acid.

Pambuyo pa theka la ola, tinthu tating'onoting'ono timakhala koyambirira kwa matumbo aang'ono - duodenum 12. Apa ndipamene ma enzymes apadera amachititsa kuyamwa kwa chakudya, kuwonongeka kwa mafuta ndi mapuloteni, komanso kuyamwa kwa mavitamini. Chiwalo cha chimbudzi chimatulutsa - kapamba, yemwe amaphwanya mamolekyulu akulu kukhala tinthu ting'onoting'ono.

Thupi ili limagwira ntchito zofunika mthupi la munthu. Nthawi zambiri amalembedwa motere:

1. Ntchito ya exocrine (katulutsidwe wakunja) imakhala ndi chimbudzi cha zinthu zazamoyo - lipase, amylase, ndi proteinase - kulowa mu duodenum pogwiritsa ntchito mawonekedwe a ducts.
2. Ntchito ya Endocrine (secretion yamkati) imalumikizidwa ndi ntchito ya ma pancreatic islets omwe amapanga mahomoni monga insulin, glucagon, pancreatic polypeptide, somatostatin ndi ghrelin ("hormone ya njala").

Mwa munthu wathanzi, kapamba amapanga michere yokwanira ndi mahomoni, chifukwa chake amatha kupatsa chakudya chokwanira ndikuthandizira njira ya metabolic.

Thupi likamalephera kupanga ma enzymes olondola, ma pancreatic insufficiency amakula. Chifukwa cha njira ya pathogenic, kuperewera kwa mavitamini ndi kuchepa kwa michere kumachitika.

Kusakhalapo kwathunthu kapena chithandizo chosagwira ntchito kumabweretsa kukula muubwana, matenda a minofu ndi mafupa kuchepa kwambiri, komwe kumawopseza matenda osiyanasiyana.

Zomwe zimayambitsa mapangidwe a enzyme

Malinga ndi ziwerengero, 10% ya anthu ku United States amapezeka ndi exocrine pancreatic insufficiency syndrome.

Kafukufuku wazachipatala akuwonetsa kuyanjana mwachindunji pakati pa kumwa mowa kwambiri ndi chitukuko cha matenda. Odwala omwe akudwala mowa amadalira gulu lowopsa, chifukwa matendawa amadziwonetsa pokha mwa 80% ya milandu.

Kutsimikizika kwa matenda a zam'mimba kumaphatikizapo zomwe zimakhudza zinthu zambiri. Kusokonezeka pakupanga ma enzymes kumachitika chifukwa cha kubereka komanso zomwe mwapeza.

Pancreatic kusowa kumayamba chifukwa cha kupita patsogolo kwa matenda obadwa nawo otere:

• cystic fibrosis - genetic pathology ya ziwalo zopumira komanso kupukusa chakudya, imadziwika ndi kupanga chinsinsi cha viscous chomwe chimatchingira mapindikidwe a kapamba, bronchi yaying'ono ndi bronchioles;
• Matenda a Schwahman - kusokonezeka kwachilengedwe kwa chifuwa ndi kapamba, komwe kumatulutsa lipase yokwanira;
• lipomatosis - kuwonjezeka kwa thupi chifukwa chakuchulukitsa kuchuluka kwa adipose minofu.

Zomwe zimapezeka zimaphatikizapo kuchotsedwa kwa opaleshoni ya kapamba ndi kufa kwa cell mu kapamba. Pancreatitis ndi matenda omwe amadziwika ndi kulowetsedwa kwa minofu yachilengedwe mu chiwalo. Zotsatira zake, kupanga ma enzyme kumatsitsidwa, ndipo dongosolo logaya chakudya silikutha kugaya chakudya mokwanira.

Ndizofunikira kudziwa kuti pancreatitis yosatha imapezeka mwa odwala akuluakulu. Muubwana, kukula kwa matenda oterewa kumachitika mwadzidzidzi. Komanso, chiopsezo cha pancreatitis chimawonjezeka ndi shuga.

Kuphatikiza apo, zinthu zomwe zimakhudza kupezeka kwa exocrine organ kulephera zingaphatikizeponso:

1. Zovuta za kapamba.
2. Matenda a Crohn ndi kutupa chimodzi mwazigawo zamagetsi.
3. Gluten enteropathy - tsankho la thupi la gluten (mapuloteni am'magazi).
4. Kutaya matenda - kuwonjezeka kowopsa kwa magazi m'matumbo chifukwa cha kumeza chakudya chosagoneka m'mimba.
5. Zollinger-Ellison syndrome ndi chikhalidwe chomwe chimaphatikiza ma pathological monga kupezeka kwa zotupa mu duodenum kapena kapamba, komanso kupanga kwambiri hydrochloric acid m'mimba.

Komanso, kupezeka kwa kusakwanira kumatha kukhudzidwa ndikusunthidwa kwa kulowererapo kwa opaleshoni pamimba.

Zizindikiro za exocrine pancreatic insuffence

Kafukufuku wazama awonetsa kuti ndikapanda kucheperako katemera wa pancreatic, chakudya chizigayidwa. Pankhaniyi, kumayambiriro kwa matendawa, munthu samatha kumva chilichonse.

Chifukwa cha kuyesa kwoletsa kupanga katulutsidwe ka kapamba, zinali zotheka kudziwa kuti matumbo amatha kuyamwa ma protein 63 ndi 84% yamafuta. Zikuoneka kuti ntchito ya enzymatic imasinthidwa ndi zinthu zomwe zimatulutsidwa ndi m'mimba ndi m'mimba.

Chithunzi cha matenda matendawa nthawi zambiri chimafanana ndi ma pathologies ena am'mimba: chilonda cham'mimba, matumbo osakwiya, kupezeka kwa miyala mu chikhodzodzo, ndi zina.

Chizindikiro chodziwika bwino cha kulephera kwa procrine ndi kutsekula m'mimba. Tinthu tosaphatikizika ndi chakudya chitha kuoneka pang'onopang'ono. Vutoli limachitika chifukwa chakuti thupi silingatenge mokwanira mapuloteni komanso mafuta. Kuphatikiza apo, ndowe zimakhala ndi fungo losasangalatsa.

Zizindikiro zina zamatenda a m'mitsempha ndi:

• kuchepa thupi moperewera;
• ulemu wambiri
• hypovitaminosis (kutayika kwa tsitsi ndi misomali ya brittle);
• kutopa ndi kutopa;
• kulakalaka kwakusokonekera;
• ludzu lalikulu ndi polyuria (kawirikawiri);
• kupweteka kwambiri m'chiuno kufikira kumbuyo.

Ululu nthawi zina umakhala wolimba kwambiri kotero kuti wodwalayo amayenera kuchipatala ndi kubayidwa jakisoni.

Exacerbations amawonedwa mukamadya zakudya zamafuta ndi mowa. Zikatero, kusanza ndi kutsegula m'mimba ndizotheka.

Njira zoyambira matenda

Choyamba, katswiri wopezekapo ayenera kumvetsera madandaulo a wodwala. Komabe, anamnesis sangathe kuyankhula zokha za exocrine pancreatic insuffence. Kuphatikiza apo, kutsekula m'mimba sikungayambike kwa nthawi yayitali, chifukwa thupi limakhalabe ndi mphamvu zogwira ntchito, ngakhale kuti silokwanira.

Ndi kuwonekera kwodziwikiratu kwa limba, laparoscopy kapena laparotomy kumachitika. Ngati wodwala akudwala kapamba, ndizosatheka kuchitira opaleshoni cholinga chodziwitsa. Izi zimachitika chifukwa champhamvu chomatira komanso fibrosis.

Kuyesa kwakukulu kwa maabara komwe dokotala angakulembeni ndikuwonetsa magazi ndi magazi. Monga lamulo, kuwonjezeka kwa ntchito za ALT, kuchepa kwa kupanga mafuta, ma polyunsaturated acids, cholesterol, amylase, lipase, isoamylase ndi phospholipase A2 zitha kuwonetsa kusagwira bwino kwa gawo.

Kuti mupeze chifukwa chake panali kuphwanya kwa exocrine pancreatic function, ndikofunikira kuchita computer tomography (CT).

Pokhapokha pamayeso onse omwe ali pamwambapa, dokotala amatha kudziwa ngati ali ndi matenda, ndipo motengera, amapanga njira yothandizirana payekha komanso yothandiza.

Mankhwala othandizira komanso kupewa

Chithandizo cha matendawa chimaphatikizaponso zinthu ziwiri zofunika kwambiri - zakudya zapadera komanso njira yothandizira. Chakudyacho sichimaphatikizapo kumwa zakudya zamafuta osapatsa mphamvu ndi zakumwa zoledzeretsa. M'malo mwake, tikulimbikitsidwa kudya zakudya zamtundu wa masamba - masamba atsopano ndi zipatso.

Maphala osiyana siyana (mapira, oatmeal, buckwheat) ali ndi phindu pa m'mimba. Zili ndi kuchuluka kwa CHIKWANGWANI, chomwe sichikumbidwa kwathunthu m'mimba, koma ndi gwero la michere. Kusintha matumbo a microclora, ndikofunikira kuwonjezera makaka amkaka ku menyu. Koma ndi kuchuluka kwa m'mimba, kudya kwawo koletsedwa.

Chithandizo cha mthupi ndi muyezo wagolide polimbana ndi matendawa. Zimaphatikizanso kumwa mankhwala okhala ndi pancreatic enzyme. Mankhwala oterewa amatha kuphwanya mapuloteni, mafuta ndi wowuma, zomwe zimathandizira ntchito ya thupi.

Gome ili pansipa likuwonetsa mankhwala akuluakulu omwe amagwiritsidwa ntchito pochiza matendawa.

Popewa kukula kwa njira ya pathological, tikulimbikitsidwa kutsatira malamulo otsatirawa:

1. Kanani zizolowezi zoipa - kusuta fodya komanso mowa.
2. Sinthani ku chakudya chamagulu, kuchepetsa kudya kwamafuta ambiri.
3. Tengani mavitamini ndi michere yama mineral.
4. Idyani zakudya zazing'ono, koma nthawi zambiri (nthawi 5-6 patsiku).

Kuphatikiza apo, tikulimbikitsidwa kupewa mavuto osautsa kwambiri.

Zotsatira zake ndizosagwira bwino ntchito?

Kunyalanyaza matendawa kapena kugwiritsa ntchito mankhwala osathandiza kumabweretsa zotsatirapo zoipa zambiri ngakhale kufa. A kwambiri digiri ya exocrine pancreatic kusakwanira kumabweretsa kukula kwa zilonda zam'mimba, cystic formations ndi gastritis.

Ma Jaundice kapena zotupa zopanda pake zimakhala zochepa. Komanso, gawo lovuta la matenda am'mimba lingayambitse kukokoloka kwa kapamba, komwe ndi kowopsa kwambiri pamoyo wa wodwalayo.

Mankhwala a exocrine akusowa, ndikofunikira kuwunika pafupipafupi kuchuluka kwa shuga m'magazi. Popeza pancreatic secretion imalekeka, ndizotheka kuti itulutse insulin yaumunthu, mahomoni omwe amachititsa kuchepetsa shuga. Kupanda kutero, pali ngozi yopezeka ndi matenda ashuga.

Zotsatira zina zoyipa zomwe zimachitika pakanthawi kochepa ndizovuta zomwe zimagwiritsidwa ntchito pakupanga mankhwala opweteka, omwe amagwiritsidwa ntchito mwanjira zina zomwe ndi zosokoneza bongo. Nthawi iliyonse munthu akafuna mlingo waukulu kuti athetse ululu. Monga momwe mumadziwira, zinthu za narcotic zimakhala ndi vuto osati pa kapamba, komanso ziwalo zina zamkati.

Dziwani kuti kudzipereka nokha komanso kugwiritsa ntchito njira zina sikungathandize kuchira. Mankhwala okhawo omwe ali ovuta panthawi yake ndi omwe angatsimikizire chidziwitso chabwino - kuchira bwino komanso kupewa zovuta (kufalitsa kusintha kwa ziwalo ndi matenda osokoneza bongo).

About kupanda kwa procrine pancreatic kufotokozedwa mu kanema munkhaniyi.