Pancreatic chotupa (neoplasia) ndimatenda obisika komanso oopsa. Malinga ndi WHO, pafupifupi zikwizikwi pafupifupi mazana awiri zamatendawa amalembetsedwa chaka chilichonse padziko lapansi. Mwa awa, 213,000 akutha muimfa. Izi ndichifukwa cha kuchuluka kwapakati koipidwa ndi neoplasms.
Pakupita zaka 5 atazindikira kuti chotupa pa kapamba, 90% ya odwala amwalira.
Ndi odwala angati omwe amakhala pambuyo pochizira chotupa chodziwika ndi mtundu wa matenda ndi malo.
Pancreatic neoplasia (kapamba) ndi neuroendocrine matenda, i.e, imasokoneza dongosolo la endocrine. Ngakhale chifukwa chochotsa mawonekedwe osavuta, zotsatira zoyipa za kapamba zimachitika.
Kukula kwa tumor pazinthu zapafupi (ndulu, duodenum, chiwindi, m'mimba) kumayambitsa imfa.
Zizindikiro zoyambira matenda
Kukhalapo kwa pancreatic oncology kumadziwika m'miyambiyambi yoyambirira pokhapokha ngati pakuwunika.
Kupitilizitsanso matendawa kumapereka ndemanga zosakanikirana pazokhudza thanzi, zomwe zimasokonezeka ndi matenda am'mimba.
Ndi chotupa chokhwima chokha chomwe chimapereka zambiri kapena zochepa pazolemba zake za oncology.
Mukukula, neoplasm imafalikira ku ziwalo ndi ziwiya zapafupi.
Kutulutsa kwa ma ducts, necrosis ya maselo amtundu uliwonse kapena zimakhala zimayambitsa zizindikiro zotsatirazi.
- Kupweteka kwapafupipafupi pakati pamimba (dera la vertebrae yoyamba kapena yachitatu). Ndi malo ake omwe amatha kuwonetsa bwino mavuto a khansa ya Prostate. M'tsogolo amakhala shingles. Sizitengera chakudya, zimakulitsa usiku. Mawonetsedwewo amatha kusiyanasiyana kuchokera pakukhudzana ndi kupweteka kosalekeza.
- Matenda a Dyspeptic. Kulemera pamimba, nseru, kusanza. Chimakhala chofala kwambiri makamaka ndi matumbo chifukwa cha kuchuluka kwake.
- Chotupa chowopsa. Kukongoletsa khungu, maso, misomali. Kusintha kwa Stool ndi mkodzo wakuda. Chizindikiro chotsimikizika cha kufinya kwa ndulu, yomwe imayambitsa chotupa m'mutu wa kapamba.
- Sinthani pakudya. Kukana mafuta ndi nyama mbale, khofi ndi mowa.
- Kuchepetsa kwambiri thupi.
- Zizindikiro za matenda ashuga Zimachitika pamene neoplasm ili pa mchira wa kapamba;
- Anemia
Chotupa chovunda cha kapamba chikhoza kunenedweratu ndi kusamwa kwa chiberekero chakupweteka kwa neoplasia.
Mlanduwu umachitika popanda kufooka wamba, kutopa, kutentha thupi, kutsika. Makamaka chiyembekezo ndikusapukwa mseru ndi kusanza.
Zoyambitsa matenda
Ma neoplasms a oncological amadzipangitsa okha kumverera kumapeto kwa chitukuko cha matenda.
Ngati khansa ya kapamba imadziwonetsa pokhapokha pazotsatira zam'mbuyo, ndiye kuti mungadziteteze bwanji?
Ndipo mungadziwe bwanji ngati pali chiyembekezo cha matendawo?
Gulu lamavuto limatsimikiziridwa ndi izi:
- zaka kuyambira 50;
- amuna kapena akazi (omwe amakonda kufala matenda);
- kukhalapo kwa matenda am'mimba, matumbo;
- aakulu kapamba;
- kusuta: kumawonjezera chiopsezo cha chotupa cha pancreatic katatu;
- chibadwidwe: nthenda yachilendo ndiyo imatsimikizira kuthekera kwa matenda;
- uchidakwa
- Zakudya zopatsa thanzi ndi nyama komanso zokhala ndi mafuta ambiri, kuphatikizapo chakudya chofulumira;
- mtundu 1 matenda a shuga;
- malo owononga.
Chimodzi mwazinthu zofunika komanso zotsutsana ndi shuga. Anthu omwe sayenera kukhala ndi shuga wambiri (amuna azaka zapakati, osalemera kwambiri) sayenera kuwonekera, akapezeka, ziphuphu ziyenera kuyang'aniridwa pa oncology. Pano, matendawa sangakhale chiopsezo, koma chizindikiro cha chotupa kapena matenda ena a pancreatic. Nthawi zina, komwe kumayambitsa matendawa ndi matenda am'mimba omwe amayamba chifukwa cha kunenepa kwambiri.
Zizindikiro zomwe zidatchulidwa kale zimatengera mtundu wa kuwonongeka kwa ziwalo komanso mawonekedwe a neoplasm. Pansipa pansipa ndikufotokoza mwatsatanetsatane kufotokozera kwa matendawa.
Pancreatic chotupa chamtundu
Choyamba, pathanatomy imagawa zotupa m'magulu awiri: chosaopsa ndi chovulala.
Mlandu woyamba umakhala wochepa pakukhudza thupi ndipo umatha kuchiritsidwa.
Mbali yake ndi kusiyanasiyana kwa maselo. Zimakuthandizani kudziwa minofu yomwe mapangidwe ake amakula. M'mabuku ena amatchedwa polyp, awa ndi malingaliro ofanana.
Khansa ya pancreatic ya Benign imayikidwa m'mitundu iyi:
- Fibroma (minofu yolumikizira).
- Hemangioma (mitsempha yamagazi).
- Neurinoma (dongosolo lamanjenje).
- Lipoma (minofu ya adipose).
- Cystoma (kapisozi kodzazidwa ndi madzi; kamapezeka m'malo osiyanasiyana).
Njira yabwino kwambiri ndi hemangioma. Nthawi zambiri, uku ndi kuwumbika kwa makanda komwe kumawonongeka kuubwana. Nthawi zina amapezeka pa chiwindi, osati kawirikawiri pa kapamba. Mitsempha ngati imeneyi imatchedwa cavernous hemangioma. Njira zochizira ndizomwe zimachitika pa oncology.
Chotupa choyipa ndi vuto losagwirizana ndi kufalikira kwa ma metastases. Kusatheka kwa chithandizo kumachitika chifukwa cha kukula kwa neoplasm. Amakula kukula m'thupi, nkusintha maselo athanzi kukhala maselo a khansa, kapena kukula m'matumbo oyandikana nawo. Pankhaniyi, chotupacho chimatha kuwononga chilichonse chomwe chimabwera munjira.
Khansa ya pancreatic yovuta kwambiri malinga ndi ICD-10 imatsimikiziridwa ndi tsamba la zotupa:
- mutu wa kapamba, thupi kapena mchira;
- chimbudzi;
- maselo a islet;
- kuthekera zingapo.
Komwe neoplasia imatsimikiza kwambiri momwe amathandizira komanso amathandizira. Yokhala pamutu, imafalikira ku chiwindi ndi duodenum, ndikuyambitsa kusokonekera kwa dyspeptic ndi jaundice. Kuchokera mchira, imatha kufalikira mpaka ku ndulu.
Kupanga chisindikizo cha pathological m'malo ano, chimayambitsa ascites ndi hypersplenism. Maselo a Islet ndiwowonjezera insulin ndi mahomoni ena. Kulephera kwawo ndikutaya kwakukulu kwa dongosolo la endocrine.
Njira zodziwira matendawa
Zizindikiro sizokwanira kupanga matenda.
Ndikofunikira kuchita mayeso wamba ndikuwunikanso mbiri yachipatala. Adzatha kudziwa zomwe zimayambitsa khansa.
Mayeso oyambilira akuphatikiza kufunsa wodwala komanso kupezeka kochokera.
Oncologist amachita:
- Kusanthula kwa mbiri yachipatala (matchulidwe ndi chikhalidwe cha odwala).
- Kulingalira za mbiri ya moyo (kumatsimikizira kukhalapo kwa zinthu zoyipa zomwe zalongosoledwa pamwambapa).
- Kuwona milandu ya oncology mwa abale ake.
- Matsimikizidwe azizindikiro.
Pambuyo pa mayeso oyamba, kuwunika kokwanira kudzaperekedwa. Kusanthula kumachitika:
- magazi (okwanira); kusowa kwa hemoglobin (kuchepa kwa magazi m'thupi) komanso kusintha kwina kwapezeka;
- magazi (biochemical); makamaka, kuchuluka kwa shuga, mtundu 1 shuga mellitus kapena insulomas amawaganizira;
- ndowe; zimachitika ndi kusinthasintha kwake (chizindikiro cha kusowa kwa stercobilin);
- mkodzo ndi jaundice, kuchuluka kwa urobilinogen, komwe amapangidwa kuchokera ku bilirubin, akuti;
- zotupa zolembera CA 19-9, KEA (mapuloteni akuwonetsa kukhalapo kwa khansa).
Komanso, zida zotsatirazi zotupa zimagwiritsidwa ntchito:
- Kuyesa kwa Ultrasound (ultrasound).
- Scut tomography (CT) Scan.
- Magnetic resonance imaging (MRI).
- Endoscopic retrograde chalangiopancreatography (ERCP).
- Magnetic resonance pancreatocholangiography (MRPC).
- Mbiri.
- Angiography.
- Biopsy
Ultrasound ndiyo njira yosavuta kwambiri. Ili ndi mtengo wotsika, koma ndiotetezeka kwathunthu. Imawona kusintha kwa ma morphological mu minofu, kuchuluka kwawo kwa echogenicity.
CT imadziwika ndi kukula, komwe chotupa, komanso kufalikira kwa ziwalo zapafupi. Ndizolondola kwambiri, koma zimagwira pamaziko a x-ray.
MRI ndiyotetezeka kuposa njira yakale, koma yotsika mtengo. Ikuwonetsa momwe neoplasm imamera ndi zotsatirapo zake, kuphatikizidwa kwa mucous membranes ndikuwonongeka kwa motility.
ERCP imawunika ma ducts a bile. Amadzaza ndi sing'anga yosiyana ndipo x-ray imatengedwa. Omalizawa akunena za kusintha kwasinthidwe m'derali, mwachitsanzo, kufinya ndi kukhalapo kwa zolepheretsa.
MRPHG imawunika ndulu ndi ma pancreatic ducts. Mkhalidwe wawo ndi mawonekedwe, zisindikizo za pathological m'makoma amachubu ndizotsimikiza.
Scintigraphy imayang'ana komwe kuli komanso mawonekedwe ena a chotupacho chifukwa chothandizira kuyambitsa zinthu zowulutsa mthupi.
Angiography ndimayeso a x-ray amitsempha yamagazi. Njira yomaliza, posowa deta pambuyo pa CT ndi MRI.
Kuwona biopsy ndikudziwikiratu kodziwikiratu, ndiko kuti, komwe kumapangitsa mtundu wa chotupa. Imachitidwa potenga zitsanzo za minyewa ya zotupa.
Chithandizo cha chotupa cha pancreatic
Mikhalidwe yotsatirayi ndiyofunikira pochita opaleshoni yamatenda a khansa ya pancreatic: kudziwika, kukula kwa chotupa kupitilira sentimita, kuwonjezeka kosalekeza kwamaphunziro kwa chaka chimodzi komanso kupezeka kwa zizindikiro.
Ndiofala kuchotsa chotupa chachi pancreatic pogwiritsa ntchito minofu yomwe ili ndi kachilombo.
Ngati ndizotheka, zitha kusinthidwa ndi njira zina:
- opaleshoni ya laparoscopic;
- mankhwala a radiation;
- chemotherapy.
Kuchita opaleshoni yachikhalidwe kumaphatikizapo kuchotsedwa kwa gawo la chiwalo. Mwachitsanzo, pancreatoduodenal resection ndikuchotsa mutu wa ndulu ndi duodenum. Mwachilengedwe, pambuyo poti wodwala wotereyu sakhala nthawi yayitali. Njira yododometsa ya zotumphukira za ma cell a cell imafotokozedwanso.
Laparoscopy ndi opareshoni yokhala ndi mawonekedwe ochepa. Pankhaniyi, sagwiritsidwa ntchito kawirikawiri, nthawi zambiri pochiza ana hemangiomas. Iyi ndi njira yamakono yogwiritsira ntchito, nthawi zambiri pogwiritsa ntchito laser.
Kuchiza poizoniyu kumangoleketsa kufalitsa matendawa. Kuneneratu pankhani iyi sikotonthoza: kutalika kwa moyo kumakulitsidwa ndi miyezi 12-16.
Chemotherapy siothandizanso, koma umalimbana ndi khansa. Nthawi zina mankhwala a cytotoxic ndi njira yokhayo yotuluka.
Akatswiri azikambirana zamapapo azotulutsa kanema mu nkhaniyi.
