Njira zoyipa za kapamba zikukhazikika pamalo achitatu mwa "kuchuluka" kwa onse omwe amapezeka ndi khansa yam'mimba. Khansa yam'mimba yokha ndi thumbo imapukutira pafupipafupi kukula. Imfa kuchokera ku zotupa za pancreatic mwa amuna ndi malo achinayi pakati pa zifukwa zina, ndipo mwa akazi achisanu.
Zizindikiro zake ndikuwonetsa kwa matendawa ku United States of America amadziwika chaka chilichonse mwa odwala pafupifupi 3,000. Pofika zaka makumi asanu ndi anayi za zana lomaliza, kuchuluka kwa maiko akumayiko aku Europe ndi North America kunali pafupifupi kuwirikiza poyerekeza ndi makumi atatu.
M'dziko lathu, chiwonetsero cha khansa ya pancreatic ndi pafupifupi 8.5 milandu kwa anthu zana lililonse. Chifukwa chake, ndikofunikira kuti aliyense adziwe zomwe zizindikiro zoyambirira za matendawa zingakhale, momwe zimadziwonekera mtsogolo, komanso momwe angathanirane nazo.
Zizindikiro za Cancer Pancreatic
Mawonetseredwe azachipatala a matenda oopsawa amatsimikiziridwa ndi kukula kwa neoplasm, komanso malo ake. Ndi khansa ya mutu wa gland kumayambiriro koyambirira, zizindikirizo sizimawoneka ndipo zimangokhala zovuta zapadera.
Munthu amamva kufooka, kulemera pamimba, kudzimbidwa. Nthawi zina kutsekula m'mimba kumatha kuchitika, zomwe zimawonetsa kuti ntchito ya chinsinsi cha gland imakhala yolakwika.
Zina mwa zizindikiro zoyambirira za khansa ndi izi:
- kupweteka pamimba;
- kuwonda;
- zoponya zambiri;
- kukulitsa chiwindi;
- kuphwanya magwiridwe antchito a kapamba;
- kugona, kusowa kudya, nseru.
Nthawi zina, chizindikiro choyamba chodziwika bwino cha matenda oyipawa, makamaka mwa anthu okalamba, ndimatenda owopsa a kapamba popanda chifukwa.
Zizindikiro za khansa ya pancreatic m'magawo akutali kwambiri
Pakapita kanthawi, zizindikiro za matendawa zimawonedwa, monga kupweteka kwam'mimba kosazungulira komwe kumadziwika komwe kumapezeka mu hypochondrium kapena m'chigawo cha epigastric. Nthawi zina kupweteka kotere kumatha kuyankha kumbuyo, kutsika kumbuyo, kapena kukhala chovala chamba (nthawi zambiri izi zimachitika chotupacho chikakulira m'mitsempha ya celiac).
Pafupifupi 20% ya odwala omwe ali ndi mitundu ya khansa amakhala ndi zizindikiro zamatenda omwe amayamba kupezeka ndi matenda a shuga, omwe amatsimikiziridwa ndi maphunziro a labotale. Zizindikiro zonsezi za khansa ya pancreatic sizodziwika mwachindunji ndipo zitha kukhala zolakwika pazizindikiro za osteochondrosis ya msana kapena chifuwa chachikulu cha khansa.
Kwa anthu ambiri, nthawi zambiri, chizindikiro chokha cha chotupa mu mutu wa kapamba chimatha kukhala choletsa cha jaundice, chomwe chimayamba popanda kupweteka m'mimba. Pang'onopang'ono, matenda a jaundice amapita patsogolo ndipo kuyimitsidwa kwakhungu kumalowetsedwa ndipo zonsezi ndi zizindikiro za khansa yapachifungo.
Odwala omwe ali ndi mitundu ya khansa ya kapamba, amatha kukhala ndi matumbo otsekemera chifukwa cha kupindika kwa gawo la duodenum.
Ma neoplasms m'thupi kapena mchira wa gland nthawi zambiri amapezeka kale kumapeto kwa maonekedwe owawa kwambiri kumbuyo kapena epigastric.
Kufikira pano, alibe mawonekedwe azachipatala. Zopweteketsa zimakulirakulira ngati wodwalayo wagona kumbuyo kwake, komanso pakukhala kapena pakugwada.
Ngati chotupa chikuyamba kufinya mtsempha wa splenic, ndiye kuti thrombosis yake imayamba, yomwe imawonetsedwa ndi splenomegaly. Nthawi zina, khansa ya kapamba, chifukwa cha chitukuko chachikulu cha matenda oopsa a m'magazi, ziwiya za varicose zam'mphepete ndimatumbo pakukota zimawonedwa.
Matenda a Cancer a Pancreatic
Mukamawunika, pafupifupi 35% ya odwala omwe amapezeka ndi khansa yapakhosi amakhala ndi hepatomegaly ndipo pansi pa chikhodzodzo amakhala. Ndikapangidwa ndi jaundice wopewera, chizindikiro cha Courvoisier chimachitika. Ngati ascites ikhala chizindikiro cha khansa, ndiye kuti izi zikusonyeza kuti njira yotupa ili ponseponse ndipo opaleshoni yayikulu ndiyosatheka.
Ndi khansa yodziwika m'malo a gland, zotsatira za kafukufukuyu zimapereka chidziwitso chochepa, chotupacho, komanso kulowetsedwa kwa chotupa, chimatha kugwiritsidwa ntchito pokhapokha ngati chapita patsogolo kwambiri. Ascites ndi splenomegaly amapezekanso m'magawo apambuyo.
Ndi mitundu yoyambirira yamatumbo a khansa, kuyezetsa magazi nthawi zambiri kumawonetsa osavomerezeka. M'magawo apambuyo, kuwonjezereka kwa ESR ndi kuchepa magazi m'thupi kumatha kuonedwa.
Mu zitsanzo zamagazi am'magazi, hypoalbuminuria ndi hypoproteinemia nthawi zambiri zimapezeka, pamaso pa jaundice, hyperbilirubinemia. Mlingo wa phosphatases yamchere ndi transaminases imakulanso, ndikuwonjezereka kwa kuchuluka kwa phosphatase kumawonedwa kwambiri.
Chidziwitso chodziwikiratu pakuwonetsa ma neoplasms oyipa ndi kutsimikiza kwa zomwe zili ndi zotupa m'magazi. Chizindikiro chodziwika bwino komanso chokhudza matendawa ndi khansa ya embryonic carbonic anhydrate glycoprotein. Kuphatikiza apo, adotolo akuwunikira kusintha kwasintha kwa kapamba.
Mwa anthu athanzi, magazi ake sofika mayunitsi opitilira 37, ndipo khansa ya pancreatic kuchuluka kwake kumawonjezeka nthawi makumi ambiri (ndipo nthawi zina ndi mazana ndi masauzande).
Koma m'magawo oyambilira a khansa, zomwe zili mu CA-19-9 nthawi zambiri zimakhala zopanda malire, motero njirayi imakhala ndi malire pakuwunika maphunziro kuti mupeze zizindikiro zoyambirira za khansa, ngakhale odwala ali pachiwopsezo.
M'zaka zaposachedwa, chidziwitso chawonekera pokhudzana ndi kukwera kwakukulu kwa njira yodziwira antigen ya CA 494 m'magazi kuti adziwe kuti ali ndi khansa ya kapamba, makamaka ngati kuli kofunikira kusiyanitsa ndi chifuwa chachikulu cha pancreatitis.
Njira zothandizira kudziwa khansa ya kapamba
Njirazi ndizofunikira kwambiri pakuwonetsa zotupa za pancreatic.
X-ray yogwiritsira ntchito yosiyanitsa m'mimba ndi duodenum imathandiza kuzindikira zizindikiro zina zosadziwika za khansa zomwe zimachitika pamene chotupa chamezedwa ndi ziwalo zapafupi:
- Kusintha kwa m'mimba ndi kusunthira kwawo patsogolo;
- kutsegulidwa ndi kusintha kwa “kavalo” wa duodenum;
- kufinya nthambi yotsika ya duodenum ndi kupezeka kwa chilema chodzaza m'mphepete yamkati.
Ndi chotupa chachikulu, kupimidwa kwa X-ray kumatha kuwonetsa kusintha kwa m'mimba pang'ono komanso kukula kwa m'matumbo a mucosa ndikulowerera m'derali.
Muthanso kuzindikira kufinya ndi kusunthidwa kwa jejunum pamalo a Tretz ligament. Koma zizindikilo zonsezi zimapezeka ndi zizindikiro za khansa kumapeto. Ma X-ray amathandizanso kuwona kupendekera kwa duodenum.
Njira zofufuzira zambiri zopindulitsa ndizoganiza za maginito ndi kuyerekezera kotengera, komanso ma ultrasound. Komanso, tomography ndi njira yovuta kwambiri kuposa ultrasound.
Pofuna kutsimikizira matenda omwe adapangidwa ndi X-ray, kupangira singano yabwino kwambiri ya chotupacho kumachitika ndikuwongolera kowonjezera pogwiritsa ntchito ultrasound kapena complication tomography. Komanso, mwa odwala ambiri omwe ali ndi khansa (90-95%), kupezeka kwa matendawa kumatsimikiziridwa.
Pancreatic khansa yothetsa matenda
Pafupifupi 80% ya odwala, zotupa mu kapamba zimapezeka m'mutu mwa chiwalo ndipo nthawi zambiri zimakhala mu gawo la caudal kapena mthupi la gland.
Ndizachilendo kwambiri kupeza mawonekedwe a chotupa, komanso mawonekedwe a khansa, ophimba ndulu yonse. Mwachizolowezi, chotupa chimayamba kupangika kuchokera ku tinthu tating'onoting'ono tomwe timapangidwa ndipo mawonekedwe ake amakhala ndi adenocarcinoma ndi kusiyanasiyana kosiyanasiyana. Komanso, nthawi zina pofikira kafukufuku wakapangidwe kazachilengedwe, acinar adenocarcinoma (chotupa chomwe chikukula kuchokera ku maselo acinar) kapena cell squcinoma yotsimikizika imatsimikizika.
Nthawi zambiri, khansa ya khansa yapancreatic to the lymph node kumbuyo kwa peritoneum kapena ku ma node omwe ali mu hepatoduodenal ligament. Kudzera m'magazi, metastases imalowa m'chiwindi, impso, mapapu, mafupa, tiziwalo timene timatulutsa ma adrenal ndipo timatsogolera kusokoneza ziwalo zonsezi.
