Khansa yapakansa

Ngakhale kupambana kwa zamakono zamankhwala, matenda a oncological tsopano afala kwambiri, ndipo chithandizo chawo chokwanira sichinapezekebe. Mitundu ina, kufa ndi pafupifupi 90%, ngakhale mutagwiritsa ntchito njira zonse zomwe zilipo kale. Njira zopweteka zoterezi zimaphatikizapo khansa ya mutu wa kapamba. Malo apadera a chiwalo ichi, komanso kukula kwa chotupacho, zimapangitsa kuti matendawa akhale amodzi mwa matenda osakwaniritsidwa - amatenga malo achinayi pazakufa.

Makhalidwe wamba

Khansa yam'mutu ya pancreatic ndi amodzi mwa mitundu yotupa kwambiri, ngakhale ndiyosowa. Chachilendo chake ndikuti nthawi zambiri amapezeka pamalo opaleshoni ngati sichingatheke chifukwa cha kuchuluka kwa metastases. Ndipo kudziwitsidwa mochedwa koteroko kumafotokozedwa ndi malo apadera a kapamba mu kuya kwamkati, komanso kusapezeka kwa matchulidwe oyambira.

Ngati kapamba amakhudzidwa ndi chotupa, choposa 70% chimakhala chamitu m'mutu. Ili ndiye gawo lalikulu kwambiri la thupi, maziko ake. Koma apa, njira zonse zofunika za kapangidwe ka enzyme zimachitika, ma ducts amalowa m'matumbo am'mimba. Ndipo ndiye mutu womwe umalumikizana ndi ziwalo zina. Chifukwa chake, chotupa choterechi makamaka chikufanana mwachangu. Nthawi zambiri, chotupacho chimafalikira kudzera m'magazi komanso m'mitsempha ya m'mimba. Ma metastases amatha kulowetsa chiwindi, matumbo, komanso mapapo.

Zosiyanasiyana

Chotupa pamalopo nthawi zambiri chimayamba kuchokera ku ziwalo zake zomwe. Nthawi zambiri awa ndi ma cell a epithelial a milomo ya gland yomwe yakhala ikusintha. Nthawi zina minyewa ya parenchymal kapena ya fibrous imakhudzidwa. Chotupachi nthawi zambiri chimakula mosiyanasiyana, ndiko kuti, chimodzimodzi. Koma kukula kwake kwam'mimba ndikotheka, komanso kumera mwachangu m'matupi oyandikana nawo, mitsempha yamagazi ndi ziwalo.

Nthawi zambiri, ngati ali ndi matenda ofananawo, amakumana ndi carcinoma. Ichi ndi chotupa chomwe chimayamba cha ma epithelial cell a pancreatic duct mucosa. Amakumana ndikusintha, ndipo izi zimachitika mwachangu kwambiri. Khansa yoopsa ya cell carcinoma kapena khansa ya latlastic imapezeka kawirikawiri m'malo ano.

Chotupacho chimayamba kupezeka m'maselo ake omwe, ndipo nthawi zambiri chimakhala mkati mwa zisa, koma nthawi zina pamwamba pake

Masiteji

Ndi owerengeka ochepa chabe omwe ali ndi mwayi wochotsa matenda awa. Inde, nthawi zambiri, chotupa chamutu chachi pancreatic sichitha kugwira ntchito.

Malinga ndi izi, magawo anayi a khansa amadziwika m'malo awa:

• Pa gawo loyamba, chotupacho chimakhala chokhacho kumapazi. Nthawi zambiri imakhala ndi kukula kosaposa masentimita 2. Zizindikiro sizifotokozeredwe bwino, kotero matenda samapezeka kawirikawiri pakadali pano.
• Gawo lachiwiri limadziwika ndi kutuluka kwa chotupa kulowa m'mimba. Nthawi zambiri, maselo ake amakula mumiyeso ya bile bile ndi duodenum. Kuphatikiza apo, maselo a khansa amatha kulowerera ma lymph node. Kuphatikiza apo, kuphatikiza ululu, kusanza ndi kugaya mtima, kuchepa thupi kumayamba.
• M'magawo atatu, metastases imafalikira m'ziwalo zonse zamkati, ndipo imapezeka m'mitsempha yayikulu yamagazi.
• Njira yoopsa kwambiri yamatenda ndi gawo 4. Mwakutero, ma metastases amatha kulowa m'mafupa, m'mapapu, ndi ubongo.

Zifukwa

Matenda a oncological tsopano akuphunziridwa mwachangu, koma mpaka pano, asayansi sangathe kunena chifukwa chake zimawonekera. Nthawi zambiri, chotupa choterechi chimayamba chifukwa cha matenda apamba a nthawi yayitali. Makamaka ngati wodwalayo samvera malangizo a dokotala. Nthawi yomweyo, pancreatic secretion mu gland stagnates. Izi, komanso njira yotupa yomwe nthawi zonse imayambitsa, imapangitsa kuti minofu isawonongeke ndikupanga chotupa. Izi ndizowona makamaka kwa anthu omwe ali ndi cholowa chotsogola chotupa.

Kugwiritsa ntchito mowa pafupipafupi kumatha kudzetsa khansa.

Popeza khansa ya mutu wa kapamba imayamba kuchokera m'maselo ake omwe, kusokonezeka kulikonse kwa ntchito zake kungapangitse izi. Choyamba, chiopsezo chokhala ndi matenda a shuga ndizambiri. Matendawa amatha kubweretsa hyperplasia ya gland epithelium. Kuphatikiza apo, izi zimachitika kawirikawiri ndi uchidakwa komanso kusuta. Kupatula apo, mowa ndi chikonga zimathandizira kuti pakhale poizoni wambiri, ngakhale ma carcinogens. Nthawi yomweyo, kupanga lipids zomwe zimayambitsa epithelial hyperplasia zimawonjezeka.

Kudya pafupipafupi mafuta, zonunkhira komanso zakudya zam'chitini kumayambitsa kupangika kwa kapamba, komwe kumapangitsanso kuchepa kwa maselo. Zotsatira zoyipa zomwe zimachitika chifukwa cha kapamba ndi kudya kwambiri, kumwa kwambiri shuga, zopangidwa ndi mankhwala osungirako, kusala kudya kwakanthawi komanso kusakhalapo kwa chithandizo cha matenda am'mimba thirakiti. Pathologies monga cholecystitis, cholelithiasis, zilonda zam'mimba komanso zilonda zam'mimba zimatha kubweretsa oncology.

Kafukufuku adafotokozanso kuti khansa nthawi zambiri imapezeka patsamba lino mwa anthu omwe amagwira ntchito m'mafakitori owopsa. Awa ndiogwira ntchito zamakina, opanga nkhuni, ndi ulimi. Kuphatikiza apo, anthu omwe akukhala m'malo osavomerezeka mwachilengedwe amakonda kuoneka ngati zotupa zopweteka.

Zizindikiro

Nthawi zambiri, chizindikiro choyamba cha khansa yam'mimbayo, pamaziko omwe chotupa chimapezeka, ndikumva kupweteka. Koma vuto ndikuti kupweteka kwambiri kumachitika nthawi yomwe chotupa chikukula kale mpaka kukula chomwe chimakanikiza ziwalo zozungulira kapena mitsempha yotsalira. Poyamba, Zizindikirozo zimakhala zofatsa ndipo zimatha kutengedwa ndi odwala chifukwa chodya zakudya zosapatsa thanzi kapena kuchulukitsa kwa gastritis.

Koma matenda amapezeka m'magawo oyamba. Kusintha kwa khungu nthawi zambiri kumayendetsedwa ndi kuledzera kwa thupi. Izi zimawonetsedwa ndi kuchepa kwa chikhumbo, kuchepa thupi kwambiri kwa wodwala komanso kufooka. Mkhalidwe wofananawo umayambitsidwanso ndikuphwanya ntchito za chithaphwi ndi kuwonongeka kwa chimbudzi.

Kuphatikiza apo, ndi khansa ya mutu wapa pancreatic, zizindikiro zotsatirazi nthawi zambiri zimawonedwa:

• kusanza, kusanza
• matenda a anorexia;
• belching, flatulence;
• kumva kuwawa mutatha kudya;
• phokoso mokhumudwa.

Ululu wamtunduwu wa khansa umakula kwambiri ndi chotupa chachikulu.

Pamene chotupacho chikukula, chimatha kupanikizika ndi ma ducts a bile. Izi zimasokoneza kayendedwe ka bile ndipo zimadziwonetsa kunja mu mawonekedwe a jaundice wovuta. Khungu la wodwala ndi zimagwira pakhungu zimatha kukhala zachikasu kapena zofiirira, kuyabwa kwambiri kumamveka. Kuphatikiza apo, mkodzo umada, ndipo ndowe, m'malo mwake, umasungunuka. Pankhaniyi, odwala nthawi zambiri amamva kupweteka kwambiri.

Ndi zotupa zotere, zovuta zambiri nthawi zambiri zimayamba chifukwa cha kuwonongeka kwa ziwalo zoyandikana. Izi zitha kukhala kuchuluka kwa chiwindi, kukwera kwa ndulu, kufooka m'mimba, magazi am'mimba, zilonda zam'mimba. Nthawi zambiri kumera kwa metastases muzinthu zoyendayenda kumayambitsa venous thrombosis ya m'munsi malekezero.

Zizindikiro

Kuzindikira khansa ya mutu wapa pancreatic kumakhala kovuta chifukwa cha kuya kwa thupilo, komanso kusapezeka kwa zizindikiro zake. Mawonekedwe a pathology atha kukhala ofanana ndi matenda ena am'mimba. Kusiyanitsa chotupa ndikofunikira ndi chironda chachikulu cha duodenum, aortic aneurysm, benign neoplasms, pancreatitis pachimake, cholecystitis, blockage ya bile ducts.

Chifukwa chake, kuti mupange kuzindikira koyenera, kufufuza koyenera ndikofunikira. Njira zomwe amagwiritsidwa ntchito kwambiri ndi:

• endoscopic ultrasound;
• Pancreatic MRI;
• ultrasonography;
• kutsitsa kwa positron;
• kuwulutsa mawu
• pulogalamu;
• MSCT yam'mimba;
• endoscopic retrograde cholangiopancreatography;
• punct biopsy;
• kuyezetsa magazi.

Kuti mupeze chotupa mu kapamba ndizotheka ndikuwunika kokwanira

Chithandizo

Chithandizo cha odwala omwe ali ndi vutoli chikuchitika kuchipatala. Chotupa choterechi chimapita patsogolo mwachangu, kotero kuphatikiza kwa njira zingapo ndikofunikira: kulowererapo kwa opaleshoni, chemotherapy, kuwonetsera ma radiation. Njira zamakono zimagwiritsidwanso ntchito, mwachitsanzo, biotherapy. Uku ndikugwiritsa ntchito mankhwala apadera omwe amalimbana ndi maselo a khansa. Keithrud, Erlotinib, kapena katemera apadera achire amagwiritsidwa ntchito. Komabe, chithandizo chilichonse cha matenda awa ndi chosakhala bwino komanso chosatsimikizika.

Kuchotsa kapamba

Njira yokhayo yothetsera chotupachi ndi opaleshoni. Kupatula apo, chikuyimira maselo osinthika ake a gland, omwe ndi osatheka kale kubwerera kwabwinobwino. Poyambirira, chithandizo chamankhwala chimaletsa kufalikira kwa chotupacho. Koma pa izi ndikofunikira kuchotsa maselo ake onse. Chifukwa chake, mawonekedwe athunthu a pancreatoduodenal nthawi zambiri amachitidwa. Izi zimachotsa gawo la kapamba, nthawi zina m'mimba kapena duodenum, ziwiya zozungulira komanso ziwalo.

Pazinthu zochepa chabe, ndi opaleshoni yotere, ndizotheka kukhalabe ndi ntchito ya m'mimba. Koma nthawi zambiri, posankha njira yopangira opaleshoni, dokotala amasankha zochepa zoyipa ziwiri. Ndipo ngakhale ndi opaleshoni yotere, kuchuluka kwaimfa ndi 10-20%, izi zokha zimapatsa wodwala mwayi wokhala zaka zowonjezerapo.

M'magawo omaliza a khansa ya mutu wa zikondamoyo ndi ma metastases ku chiwindi ndi ziwalo zina, kuchotsa chotupacho sikuthandiza kale. Chifukwa chake, maopaleshoni opaka paliponse amachitidwa omwe amathandizira kuti wodwalayo akhale moyo, kusintha chimbudzi, ndikuchotsa jaundice. Mwachitsanzo, kudzera mu opaleshoni yam'mimba kapena mawonekedwe a endoscopic stent ya bile ducts.

Chemotherapy imathandizira kuchepetsa kukula kwa chotupacho komanso imalepheretsa kubwereranso pambuyo pochotsedwa

Pambuyo pa opaleshoni, chemotherapy imalembedwa kuti isabwezeretsenso kusintha kwa thanzi la wodwalayo. Mankhwala apadera amafunikanso ngati khansa yomwe singatheke. Chithandizo choterechi chimachepetsa chotupacho komanso kuchepetsa kukula kwake. Wothandizanso ngakhale pambuyo pake pa khansa ndimankhwala Somatostatin ndi Triptorelin.

Ndi khansa yomwe singagwire, radiation imagwiritsidwa ntchito. Chithandizo cha radiation chimatha kuwononga maselo a khansa m'magawo angapo. Izi zimakuthandizani kuti muchepetse kuchepa kwa metastasis ndikuwonjezera moyo wa wodwalayo. Koma ngati tiwerengera ziwerengerozi, momwe zimadziwika kuti ndi odwala angati omwe adakhala ndi matenda amenewa kwa zaka zingapo, zikuwonekeratu kuti njira yothandiziridwira chithandizo sichidapezeka. Ngakhale mutagwiritsa ntchito njira zonse zodziwika, odwala oposa 80% amafa chaka chatha atatha kuzindikira.

Ziwonetsero

Chidziwitso chabwino cha khansa ya mutu wapa pancreatic chitha kukhala chokhacho kwa omwe adapezeka ndi matenda adakali matenda, omwe ndi osowa. Mankhwala akangoyambitsidwa, ndiye kuti ali ndi mwayi woti akuchira. Ngati chotupa chija chapangiratu pancreas ndipo sichinaphatikizidwe, chitha kuchotsedwa.

Mu gawo lachiwiri, nthawi zambiri pamakhala palibe metastasis, koma chotupacho chimakula ndikukula kwakukulu, chomwe chimaswa ntchito za ziwalo zonse zam'mimba. Ntchito imodzi yokha siyothandiza pamenepa. Pofuna kuthana ndi kukula kwa maselo owopsa, chemotherapy ndi radiation zofunika. Ndipo pakuzindikira khansa m'magawo apambuyo, anthu omwalira chaka ndi 99%. Koma ngakhale kuphatikiza chithandizo koyambira matendawa sikutanthauza kuchiritsidwa kokwanira. Nthawi zambiri odwala omwe amadziwika ndi matendawa sakhala ndi moyo kupitilira zaka 5.

Zakudya zoyenera zimathandiza kuchepetsa chiopsezo chanu cha khansa.

Kupewa

Chotupa cha khansa pamutu wa kapamba ndizoperewera, koma ndiye mawonekedwe otupa kwambiri. Kupulumuka kwa odwala kumadalira gawo la matendawa, kukula kwa chotupa ndi kuchuluka kwa kuwonongeka kwa zimakhala zapafupi. Kuti muchiritse bwino, ndikofunikira kuti muyambe kuchiza matenda a metabolism koyambira, omwe ndi osowa kwambiri. Kupatula apo, kuti mupeze khansa m'malo ano ndizotheka kokha ndikuwunika kokwanira.

Chifukwa chake, njira yayikulu yolepheretsira matenda a zam'mimbazi ndiyo mayeso azachipatala pafupipafupi. Izi ndizofunikira makamaka ndi cholowa cham'tsogolo kapena kuwonetsedwa pazinthu zoyipa. Ndikofunikira kuchiza matenda onse am'mimba pakudya panthawi, komanso pamaso pa matenda a shuga kapena kapamba, tsatirani mosamala malangizo onse a dokotala. Ndikofunikira kusiya zizolowezi zoyipa, yesetsani kupewa kupsinjika. Ndipo mu zakudya kuchepetsa kugwiritsa ntchito mafuta, confectionery, kusuta nyama ndi zamzitini chakudya.

Khansa yapakhungu yamutu ndi matenda oopsa kwambiri omwe angayambitse kufa m'nthawi yochepa. Chifukwa chake, muyenera kuyesetsa kudya bwino, kukhala ndi moyo wathanzi komanso kumayesedwa ndi dokotala pafupipafupi. Izi zikuthandizira kuzindikira chotupacho poyambira, pomwe pali mwayi woti uchotse.