Insulinoma ndi chotupa, imatha kukhala yoyipa komanso yovuta. Amapangidwa ndi maselo a mabungwe ofanana ndi ma Langerhans, zomwe zimatsogolera ku kupanga kwakukulu kwa insulin, komwe kumayambitsa hypoglycemia. Insulinoma ili m'malo kapamba.
Nthawi zambiri, pancreatic insulinoma ndi chosaopsa, mpaka 75% ya matenda athunthu. Popeza tazindikira kuti tili ndi matenda otere, ndikofunikira nthawi yomweyo kuyamba kulandira chithandizo, kuti tipewe zotsatira zoyipa zathupi lathunthu, ichi ndi matenda oopsa.
Aliyense amakakamizika kudziwa zomwe zimayambitsa matendawa kuti akalandire thandizo kuchipatala munthawi yake. Pansipa tikambirana za insulinoma, njira zochizira, kupumula kwa matenda obwera kumene a hypoglycemia, kudziwa momwe angachiritsire, njira zodziwitsira matenda, komanso kupewa.
Insulinoma ndi zizindikiro
Monga tanena kale, insulinoma ndi neoplasm yomwe imatsogolera pakupanga kwambiri kwa insulin, yomwe imayambitsa hypoglycemia. Ndizofunikira kudziwa kuti oposa theka la odwala amathandizidwa kuti apatsidwe matenda osiyanasiyana, popanda kupereka mankhwala odziwika a kapamba. Izi zikufotokozedwa ndikuti chizindikiro cha insulinoma chomwe sichinafotokozedwe moyenera komanso chimasokoneza madotolo.
Hypoglycemia sikuchitika tsiku lililonse, koma sizingachitike. Zachidziwikire, ngati simuchiza matendawa, ndiye kuti kuchepa kwa shuga m'magazi kumachitika ndi pafupipafupi pafupipafupi. Muyenera kudziwa mulingo woyenera, wotsika komanso wapamwamba wa glucose m'magazi.
Pazaka 14 komanso mpaka 60, chiwerengero chokwanira chidzakhala 3.2 - 5.5 mmol / l, pamimba yopanda kanthu. Mukatha kudya, shuga wamagazi amadziwika kuti ndi wabwinobwino mpaka 7.8 mmol / L. Mukakalamba, chizindikirocho chimawonjezeka pang'ono. Chifukwa chake, pamimba yopanda kanthu, mulingo wovomerezeka umasiyana kuchokera ku 4.6 mmol / L mpaka 6.4 mmol / L. Zizindikiro izi ndizoyenera kwa magazi a capillary okha (omwe amachokera pachala). Kwa venous, zizindikiro zikuwonjezeka pang'ono. Kusanthula koteroko kumawerengedwa kuti ndikoyenera kudalirika.
Kwenikweni, kuukira kwa hypoglycemia kumachitika m'mawa, pamimba yopanda kanthu. Wodwalayo amadzimva kuwonjezereka, ndipo kuchuluka kwa shuga m'magazi kumatha kutsika kufika ku 2.2 mmol / L Kuti tithane ndi vutoli, ndikofunikira kuwonjezera shuga m'magazi.
Zizindikiro zambiri za insulinoma:
- Mutu wapafupipafupi.
- Kulemera msanga, kunenepa kwambiri mu shuga.
- Mantha mantha.
- Kusakwiya.
- Tachycardia.
- Kuchuluka kwa miyendo.
- Convulsions - woopsa mitundu ya matenda.
Matendawa amatenga mtundu uliwonse wa azaka, kupatula 1% yokha. Nthawi zambiri, mu 80% yamilandu, odwala amakhala ndi zaka zopitilira 45.
Zizindikiro
Matenda a insulinomas amadziwika nthawi iliyonse ndipo amatha kusiyanasiyana. Choyamba, adokotala ayenera kutengera mbiri ya wodwala kuti akhazikitse kuchuluka kwa kuchepa kwa shuga m'magazi mpaka muyeso wosavomerezeka.
Onetsetsani kuti mwatenganso zitsanzo za magazi za wodwalayo. Mayeso osala kudya amakhala othandiza kwambiri pakuwazindikira, pomwe mayeso omwe amachitika amayenera kukhala mwadongosolo, osachepera sabata limodzi. Ndikofunikira kuzindikira chithunzi chonse chachipatala.
Pamodzi ndi zomwe tafotokozazi, imodzi mwazidziwitso zowonjezerazi zimagwiritsidwa ntchito:
- Pancreas tomography.
- Sinthani X-ray - angiography.
- The catheterization yamitsempha yama portal imathandizanso kuti amvetsetse kugwira ntchito kwa chotupa kuti amasule insulin.
Kudziwitsa za insulinoma ndi imodzi mwanjira izi kumathandiza munthu kuti adziwe opaleshoni kukula kwake, malo enieni komanso kukhalapo kwa metastases.
Chithandizo ndi matenda am'mimba
Insulinomas imatha kuthandizidwa mosavomerezeka ndikuphatikiza njira yopangira opaleshoni yokha. Koma pali zochitika zina, malinga ndi zizindikiro zapadera zaumoyo wa wodwalayo, opaleshoni imaletsedwa. Pankhaniyi, mankhwalawa ndi mankhwala. Cholinga chake ndi kuyimitsa hypoglycemia.
Ngati chotupa chili mchira wa kapamba, dokotalayo amachita zomwe zimachitika mchira wake. Insulinoma ikakhala yocheperako komanso yotulutsa thupi kapena mutu wa nduyo, imalekeka. Ntchito zikuyenera kuchitika m'mawa, kuwonekera kwa hypoglycemia kusanachitike. Wopanga opaleshoni amayang'anira shuga m'magazi onse opaleshoni.
Ngati insulinoma ndi chizindikiro cha chotupa chowopsa ndipo sichingachotseretu khunyu, chemotherapy imagwiritsidwa ntchito. Mankhwala omwe amaletsa kupanga insulin amapatsidwanso kuti ateteze hypoglycemia.
Mankhwala osokoneza bongo a insulinoma, ngati nkotheka kuuchotsa mothandizidwa, muli magawo angapo:
- Kutha kwa hypoglycemia pakukweza shuga, magazi pang'ono, a insulin.
- Chithandizo cha chotupa.
Matenda obwera chifukwa cha kuyambiranso kwa benign insulinoma, atachotsedwa, ndiabwino kwambiri. Nthawi zambiri, sizimapanganso.
Ndi chotupa chowopsa, kuchuluka kwa metastase komanso kugwiritsa ntchito bwino kwa chemotherapy kumathandiza kwambiri.
Momwe mungalere mwachangu hypoglycemia ndi insulinoma
Ngati magazi a shuga agwera pansi pazovomerezeka, zomwe zimaperekedwa pamwambapa, ndiye kuti muyenera kuthana ndi hypoglycemia mwachangu. Kupatula apo, zimatha kubweretsa munthu ku mkhalidwe wamatenda.
Nthawi zambiri, ndikuwonetsedwa kwa chizindikiro chotere ndi insulinoma, wodwalayo amakhala ndi vuto lamphamvu la njala ndikuyamba kudya zakudya zopatsa mphamvu zambiri, koma kwenikweni sizowona. Choyambirira kuchita ndikuwonetsetsa kuti glucose amalowa m'magazi. Piritsi labwino la glucose limatha kuchita izi.
Ngati mankhwalawa sanayandikire, ndiye kuti mutha kugwiritsa ntchito masamba okoma, caramel, uchi ndi shuga woyengeka. Koma chakudyachi chimachepetsa shuga m'magazi, popeza chimakhala ndi kuchuluka kwa shuga ndi fructose.
Pali mapiritsi angapo omwe amakweza shuga m'magazi, mwachitsanzo:
- Hypofree Cherry Flavour. Mapiritsi otsekemera amakhala ndi magalamu 4 a dextrose. Mu ola limodzi, amatha kuwonjezera kuchuluka kwa 0,7 mmol / L. Mtengo wapakati mu Russian Federation ndi ma ruble 150 - 180, zidutswa 12 papaketi iliyonse.
- Dextro 4. Pa mlingo umodzi, mapiritsi atatu amafunikira. Amakhala ndi dextrose, yomwe imayamba kuwonjezeka m'magazi m'mphindi zoyambirira pambuyo pogwiritsa ntchito ndikuwongolera chizindikirocho pakapita mphindi 15. Kutulutsa mawonekedwe - gel ndi mapiritsi. Ngati mumasankha gel, ndiye kuti pamwa limodzi amatenga theka chubu. Iwo ali ndi chitumbuwa, lalanje ndi mtundu wapamwamba. Mtengo wapakati umachokera ku ruble 30 mpaka 190, zonse zimatengera kuchuluka kwa mapiritsi omwe ali ndi chithuza komanso mawonekedwe omwe mankhwalawo amasulidwe.
Mukamwa mankhwala amodzi omwe ali pamwambapa, muyenera kuchita kuchuluka kwa shuga pakatha mphindi 15. Ngati chizindikirocho chikwera mpaka mulingo wovomerezeka wa 3.2 mmol / L (mpaka zaka 60) kapena 4.6 mmol / L (pambuyo pa zaka 60), ndiye kuti mutha kukhala wodekha - hypoglycemia imachotsedwa.
Nthawi yomwe wodwalayo ali ndi vuto loopsa la hypoglycemia, ndipo ali m'mavuto a swoon kapena theka-swoon, palibe chifukwa choti zakumwa ziyenera kutsanulidwa mkamwa mwake, chifukwa amatha kulowa m'malo opumira ndikuyambitsa kupuma. Imbani ambulansi nthawi yomweyo.
Mpaka gulu la madokotala lifika, wodwalayo ayenera kuyikidwa pambali pake ndipo pakamwa pake pakatseguka pang'ono, kugwada. Ngati pali mlingo wa adrenaline mu nduna yothandizira, ndiye kuti jekeseni. 40 mamililita 40% a glucose amatha kutumikiridwa intramuscularly (kumtunda kwa matako), koma jakisoni wotere ndiwothandiza kwambiri.
Kupewa
Kupewa insulinoma ndikutulutsa kwa magazi ndi magazi kwa chaka chilichonse ndi chizindikiro cha magazi, makamaka pamimba yopanda kanthu. Ngati chimodzi mwazizindikiro chidapezeka, muyenera kulumikizana ndi chipatala kuti mudziwe. Palibe chifukwa muyenera kukhala osinkhasinkha ndikumangoyambitsa kupumula kwa zizindikiro.
Kwa anthu am'mgulu lakale, atakwanitsa zaka 45, ndibwino kuti mugule glucometer. Ichi ndi zida zomwe mutha kuyeza shuga wamagazi nthawi iliyonse, potero ndikulamulira thanzi lanu ndikupewa matenda ambiri. Kupatula apo, kuchuluka kwambiri kwa glucose m'magazi kumasokoneza ntchito ya thupi lonse.
Mtengo wake ndiolandiridwa ndi gulu lililonse la nzika, ndipo umasiyana kuchokera ku ruble chikwi chimodzi. Kuphatikiza apo, muyenera kugula nthawi zonse mizere ndi singano za mita. Izi sizingothandiza kudziwa hypoglycemia munthawi yake, yomwe imayamba chifukwa cha insulinoma, komanso kuneneratu za matenda amitundu iwiri.
Chinsinsi cha thanzi labwino ndicho kudya bwino komanso kuchita masewera olimbitsa thupi tsiku lililonse. Ndikofunika kuyang'anira mitundu ya zochitika zomwe zalimbikitsidwa ku gulu lililonse la mibadwo:
- Kuyenda
- Kuthamanga
- Kuyenda mumweya watsopano.
- Kusambira
- General kulimbikitsa mlandu.
- Kuchita masewera olimbitsa thupi.
Zochita zolimbitsa thupi ziyenera kuphatikizidwa ndi zakudya zomwe zimachepetsa kumwa kwamafuta ndi shuga. Izi zimachotsa kwambiri katundu kapamba ndipo zimakhala ndi phindu pobwezeretsa magwiridwe antchito a thupi lonse.
Zakudya za tsiku ndi tsiku ziyenera kuphatikizapo zamasamba, zipatso, mapuloteni a nyama, chimanga, mkaka ndi mkaka wowawasa. Malita osachepera awiri amadzimu ayenera kumwa. Idyani zakudya zazing'ono kasanu kapena kasanu ndi tsiku. Chakudya chomaliza osachepera maola awiri asanagone. Kanema yemwe ali munkhaniyi akuwonetsa bwino za insulinoma ndi chiyani.
