Chamba ndi gawo lalikulu kwambiri m'thupi la munthu ndi chimodzi mwa ziwalo zofunika kwambiri zam'mimba. Amayang'anira chinsinsi chakunja ndi chamkati, kuphatikiza osati zinthu za enzyme zomwe zimathandizira kuyamwa koyenera kwa chakudya, komanso mahomoni. Ndi kapamba yemwe amathandiza kwambiri mu kagayidwe.
Anatomical kapangidwe
Zikondamoyo zomwe zimakhala mwa anthu zimakhala kumbuyo kwa m'mimba ndipo zimayandikana ndi duodenum. Ali ndi mutu, khosi, thupi ndi mchira. Mutu ndi gawo la thupilo limakutidwa ndi chiuno cha duodenum, ndipo mchirawo umapita mwakuya ndikukwera kumtunda, kumanzere.
Khosi la chala lomwe limakhala pakati pa mutu ndi thupi ndiye botolo. Apa, santorinia duct amachokera, omwe nthawi zambiri amalumikizana ndi duct yayikulu, ndipo nthawi zambiri samabwera mwachindunji mu duodenum kudzera pa santorinia papilla.
Kutalika kwa chiwalo chonse kumakhala pafupifupi 20 cm, makulidwe amasiyanasiyana kuyambira 2 mpaka 3 cm, ndipo kulemera kwathunthu nthawi zambiri sikukuyenda g 80. Chifukwa chake, kapamba m'thupi la munthu amatetezedwa kuchokera mbali zonse: msana umakhala kumbuyo, m'mimba kutsogolo. kumanzere kuli ndulu, ndipo kumanja kuli duodenum.
Mthupi la gland, kutsogolo, kumbuyo ndi kumbuyo kumasiyana. Kutsogolo kumalumikizana ndi m'mimba ndipo pamakhala phokoso lakumaso. Malo am'mbuyo ali chapafupi ndi msana, peritoneal aorta, celiac plexus, infa ya vena cava ndi mtsempha wamanzere wamanjenje. Pano, pamiyala yolinganiza izi, zonyamula ndulu zimapezeka. Gawo lam'munsi la gland limatsikira, kumbuyo kwa mizu. Chophimba chachikulu cha kapamba ndi dambo la Wirsung, lomwe limayenda mozungulira kutalika kwake ndipo limalowa mu duodenum.
Kupanga kwa madzi a pancreatic kumachitika makamaka mthupi la chithokomiro, zisumbu za a Langeran, kupanga mahomoni okhala mumchira,
Ntchito za kapamba ndizogwirizana kwambiri ndi kapangidwe kake ndipo zimagawidwa mu endocrine ndi exocrine. Dera la endocrine limayimiridwa ndi zisumbu za Langerans - kuchuluka kwa maselo omwe amapanga mahomoni:
- insulin;
- glucagon;
- somatostatin;
- polypeptides;
- vasoactive matumbo a m'mimba.
Pazocheperako, ma cell a mabwinja a Langerans amatulutsa gastrin, thyroliberin, somatoliberin.
Mu gawo la exocrine pamakhala dongosolo la ma pretreat ducts ndi pancreatic acini, omwe ndi magawo a ziwalo. Ndi mu acini komwe ma ducts onse amayamba.
Ntchito ya endocrine ya kapamba imadziwika kudzera mu insulocytes - maselo a timabungwe tating'ono ta Langerans, omwe amachititsa kuti pakhale kupendekera kwawanthu komanso ma humichi.
Ntchito ya procrine
Tsiku lililonse, kapamba amatulutsa pafupifupi lita imodzi ya madzi a kapamba, omwe amakhala ndi zinthu za enzyme, mchere ndi madzi. Ma Enzymes amatchedwa "proenzymes" ndipo poyamba satha ntchito. Kubweretsa chakudya chakumaso mu duodenum kumayendera limodzi ndi kutulutsidwa kwa mahomoni, omwe, amachititsa masinthidwe amtundu wa mankhwala. Zotsatira zake, ma proenzymes amayamba.
Chothandizira champhamvu kwambiri cha katemera wa pancreatic ndi hydrochloric acid m'mimba. Pamene ilowa m'matumbo ang'onoang'ono, imayambitsa kaphatikizidwe kakang'ono ka secretin ndi pancreosimine, yomwe imasungidwa ndi mucosa wamatumbo ndikuthandizira kupanga michere:
- zisangalalo;
- lipases;
- trypsin (trypsinogen);
- chymotrypsin;
- ma nucleases;
- prophospholipase.
Ndi izi zomwe ntchito ya pancreatic pancreatic imakhala.
Trypsin (trypsinogen) imangopangika mu kapamba ndipo ndiyofunikira pakuwonongeka kwa ma peptides ndi mapuloteni. Poyamba sizigwira ntchito, enzyme iyi imayendetsedwa ndi enteropeptidase, kapena enterokinase. Ndi index ya trypsin mu mawonekedwe ake ogwira omwe kapamba amatsimikiza.
Amylase ndi enzyme yomwe imathandizira kukonza michere ndipo imapangidwira osati mu kapamba, komanso tiziwalo timene timagwira tchire. Ndi zochulukirapo kapena zosakwanira za amylase m'magazi, kukula kwa matenda mu kapamba kumatha kuganiziridwa. Mlingo wa amylase m'magazi ndi mkodzo ndi chizindikiro chofunikira kwambiri chodziwonera. Mwachitsanzo, kuchepa kwambiri kwa ampilase pazomwe zikuwunikira kungawonetse zovuta za chiwindi ndi cystic fibrosis, komanso pancreatectomy yomwe ikuchitika.
Udindo wa lipase ndikuchepetsa triglycerides omwe amadziwika kale ndi ndulu kuchokera ku ndulu. Enzyme iyi imathandizira kugwetsera mafuta kukhala glycerol ndi asidi apamwamba, komanso imathandizanso pakupanga mphamvu. Lipase imapereka mayendedwe a mafuta ochulukirapo a polyunsaturated kuma cell ndipo amalimbikitsa kuyamwa kwa mavitamini angapo osungunuka a mafuta.
Zikondamoyo, chiwindi, mapapu ndi matumbo ndizo zimapangitsa kuti lipase lipangidwe. Chifukwa cha kuchepa kwa thumbo, ntchito ya lipase imachepa, yomwe imayendera limodzi ndi kusintha kwa utoto wautoto kuti imvi.
Enzyme ya nuc tafadhali imatenga nawo mbali popanga masanjidwe a DNA ndi ma RNA unyolo wa chakudya chomwe amalandila m'thupi. Ndi thandizo lake, ma molekyulu achilengedwe a nucleic acid ofunikira kuti amange zidziwitso zamtundu wa munthu zimamasulidwa.
Profospholipase imagwira ntchito ngati trypsin ndipo imagwira ntchito pamafuta ovuta omwe amatchedwa phospholipids.
Dziwani kuti ma pancreatic proenzymes amasungidwa pokhapokha chakudya, kuyambira mphindi 2-3 mutangoyamba kudya. Pambuyo pake, amapitilizabe kuonekera kwa maola ena 12.
Ntchito ya enzyme yodzaza ndi zonse ndizosatheka popanda kuchuluka kwa bile, yomwe imapangidwa ndi chiwindi. Ndi bile yomwe imapangitsa ma enzyme kuti azigwira ntchito ndikugwetsa ma lipids kukhala tizidutswa tating'onoting'ono, motero amawakonzekereratu. Madzi a pancreatic alibe ma enzyme okha, komanso mchere wa asidi kuti apereke zotsatira zamchere. Chifukwa cha izi, zinthu zam'mimba zomwe zimapezeka m'mimba ndizosasinthika ndipo zimapangitsa kuti pakhale chakudya cham'mimba zomwe zimapangidwa.
Ntchito ya endocrine
Kodi ntchito ya kapamba mu dongosolo la endocrine ndi chiyani? Chiwalochi chimabisalira mahomoni m'magazi, ndikumakhudza njira zonse za metabolic mthupi, kupatula. Ngakhale kukula kocheperako kwa endocrine zone, komwe kuli pafupifupi 2% ya gawo lonselo la gland, kufunika kwa ntchito yake sikungakhale kopambanitsa.
Type 1 shuga mellitus amadziwika ndi kusowa kwathunthu kwa insulin, komwe kumachitika chifukwa cha kuwonongeka kwa maselo a beta
Kuchita mozungulira kwachilengedwe ndimatupi a insulin ndi glucagon. Maselo a Alpha a Langerans amatulutsa glucagon, womwe ndi mdani wa insulin wachilengedwe. Kuphatikiza apo, akuphatikizidwa ndi kapangidwe ka lipocaine, poletsa kukula kwa mafuta a chiwindi. Maselo a Beta amatulutsa insulini yomwe imatulutsa glucose kuzinthu zomanga thupi kudzera m'maproteni olandirira.
Ntchito yamkati mkati mwa kapamba imaphatikizidwa ndi kupangika kwa ma ghostin a mahomoni, omwe amachititsa kuti munthu azilakalaka kwambiri, komanso polypeptide ya pancreatic yomwe imalepheretsa kutulutsa kwa gland komanso imathandizira kupanga madzi a m'mimba.
Ndi kuchepa ndi kuwonongeka kwa maselo a beta, kuphatikiza kwa insulin kumachepetsedwa, zomwe zingayambitse kukula kwa matenda a shuga. Kuperewera kwa timadzi timeneti kumaonekera pakuwonjezeka kwamikodzo ntchito, kuyabwa kwa khungu komanso kumva ludzu losatha.
Somatostatin ndi mahomoni omwe amapangidwa osati mu kapamba, komanso mu hypothalamus. Ndikofunikira kupondereza katulutsidwe ka serotonin, kukula kwa mahomoni, chithokomiro cholimbikitsa chithokomiro, insulin ndi glucagon.
VIP - vasoactive matumbo a peptide amathandizira kuyenda kwamatumbo, kumawonjezera kuyenda kwa magazi kumitsempha, kumalepheretsa kaphatikizidwe ka hydrochloric acid ndikuwonjezera kupanga kwa pepsinogen m'mimba.
Pancreatic polypeptide imakhudzidwa ndi kayendedwe ka chinsinsi chakunja cha kapamba ndikulimbikitsanso m'mimba.
Ntchito zowonongeka
Nthawi zambiri, ntchito kapamba mu thupi la munthu zimaphwanyidwa chifukwa cha kutupa - pancreatitis yayikulu kapena pachimake, momwe ma cell amasintha, ndikulephera kugwira ntchito kumayamba. Ovutika ndi pancreatitis nthawi zambiri amakhala anthu omwe amagwiritsa ntchito zakudya zamafuta, mowa, komanso omwe amayamba kufa ndi njala.
Zotsatirazi zimayambitsa vuto mu kapamba:
Kodi insulin ndi chiyani?- matenda amisili yodwala ndi chiwindi;
- kuvulala ndi kuwonongeka kwamakina kumatumbo;
- kugwiritsa ntchito mankhwala kwa nthawi yayitali, ma diuretics, mahomoni;
- kuledzera ndi zinthu zoopsa m'nyumba kapena kuntchito;
- opareshoni;
- ma virus ndi matenda opatsirana - mumps, mycoplasmosis, hepatitis;
- kunenepa kwambiri;
- kusinthika kwatsopano (kuchepetsa ma ducts) ndi kukula kwa neoplasms;
- endocrine (hyperparathyroidism) ndi matenda amtima;
- helminthic infestations;
- kusokonezeka kwa mahomoni;
- cholowa.
Nthawi zina, chitsulo sichichita ntchito zake pazifukwa zomwe sizingakhazikike.
Kuperewera kwa enzyme kumakhudza kwambiri thanzi la wodwalayo ndipo kumawonetsedwa ndi zizindikiro zotsatirazi:
- kupweteka kumtunda kumanzere kwachitatu kwam'mimba komwe kumachitika mutangotha kudya kapena kudziyimira pawokha;
- kuchepa kwamphongo mpaka kusakhalapo kwathunthu;
- kumva mseru, kusanza;
- kugundana m'mimba;
- Kusintha ndi kusasinthika kwa ndowe.
Interstitial pancreatitis imayendera limodzi ndi kutupa kwa malo a interellular ndipo imakhala ndi tsogolo labwino; pachimake hemorrhagic kapamba ndimatenda owopsa kwambiri, omwe 50% ya milandu imatha ndikumwalira kwa wodwala
Kutengera ndi ntchito yomwe kapamba sichita bwino, pali kusintha komwe kumayendetsa thupi. Ndikusowa kwa lipase, chopondacho chimapeza mtundu wachikaso kapena lalanje komanso kusasunthika kwamafuta.
Kuperewera kwa Amylase kumalumikizidwa ndi kulekerera bwino kwa chakudya cham'mimba komanso mawonekedwe amadzi amtambo chifukwa chazowuma kwambiri. Chifukwa cha kuchepa kwamphamvu kwa michere m'matumbo ang'onoang'ono, kutsekula m'mimba, kuchepa kwa mavitamini kumachitika, ndipo kuchepa kwa thupi kumachepa.
Kuperewera kwa trypsin proenzyme kumawonetsedwa mu ntchito yapamwamba ya kapamba ndipo kumawonetsedwa ndi kuwonjezeka kwa mapuloteni a nayitrogeni ndi undigested (minofu ulusi) mu ndowe. Pondapondayo imakhala phala ndipo amakhala ndi fungo lakuthwa, losasangalatsa.
Chifukwa chosakwanira kugaya chakudya m'matumbo ang'onoang'ono, kupanga kwa mpweya kumachulukitsa ndipo kumalimbikitsa kuti azilephera.
Pancreatin ndiye mankhwala oyambira pancreatic dysfunction.
Potsutsana ndi kutuluka kwa katulutsidwe, kutsegula kwa ma enzymes "owonjezera" omwe amagwira ntchito molakwika kumachitika. M'malo mogaya chakudya, amayamba kupukusa mucous nembanemba, womwe umabweretsa kutupa - kapamba.
Zowonongeka zazing'onoting'ono za Langerans, kuphatikizira kwa insulin kumachepetsedwa, ndipo mtundu wa 1 shuga umayamba. Maselo a beta ochulukirapo ali m'dera lomwe lakhudzidwalo, amavutikanso kwambiri.
Chithandizo cha kukanika
Mutha kubwezeretsa kapamba ndi mankhwala komanso zakudya zoyenera. Kuti akhazikitse gawo logaya chakudya, kukonzekera kwa enzyme ndi mankhwala - Creon, Pancreatin, Festal.
Ngati pancreatitis imatsatiridwa ndi kusanza pafupipafupi, ndiye kuti njira zimagwiritsidwa ntchito kuti pakhale madzi osalala amchere, mwachitsanzo, yankho la Sodium Chloride. Gawo lofunika kwambiri pa chithandizo chamankhwala ndi mavitamini. M'matumbo akulu, zakudya za makolo kapena zamkati zimayikidwa.
Chithandizo cha pancreatitis pachimake chimachitika pokhapokha pachipatala, chifukwa chake, ngati muli ndi mawonekedwe, ndikofunikira kuyimba gulu la ambulansi. Madokotala asanafike, simungadye chakudya, ndikofunikira kuti muzimwa madzi 30-60 aliyense pakapu 1/4. Mutha kuthetsa vutoli mutakhala ndi mawondo anu atakanikizidwa kumimba yanu. Compress yozizira, yomwe imayikidwa kumbuyo pakuyerekeza kwa kapamba, imathandiza kuchepetsa ululu.
