Kanyumba ndi gawo lapadera lochita masewera olimbitsa thupi. Ichi ndiye chithito chokhacho cha thupi momwe ntchito za exocrine ndi endocrine zimachitikira. Zilonda zopweteka kapena chovunda zimatha kupanga kapamba. Ma carcinomas odziwika kwambiri m'zaka zaposachedwa ndi neoplasms yoyipa yomwe imachokera ku cell ya exocrine gland.
Amuna amatenga kwambiri khansa. Kuzindikira vuto ndi kovuta. Matenda a oncological a dongosolo la kugaya chakudya m'thupi ndi olimba mwachilengedwe, ndichifukwa chake ndikofunikira kulabadira zoyamba zokayikitsa ndikupita kukayezetsa panthawi yake. Kuthandiza chotupa cha pancreatic ndi njira yovuta kwambiri.
Zomwe zimayambitsa khansa
Thupi laumunthu, mwatsoka, ndilopanda ungwiro ndipo nthawi iliyonse chikavuta chitha kuchitika, chomwe chimakhudza kuchuluka kosaletseka kwa maselo osinthika. Chitetezo cha mthupi chimaleka kuthana ndi maselo oterowo ndipo posakhalitsa munthu amakhala mwini matenda a oncological. Pofuna kuti musavutike ndi oncology, zifukwa zomwe zimayambitsa mawonekedwe ake siziyenera kupatula.
Pali zinthu zingapo zomwe zimapangitsa kuti pakhale zovuta ngati izi:
- Kugwiritsa ntchito mankhwala osokoneza bongo kwambiri zomwe zimapangitsa kuti pakhale matenda a carcinoma a gland.
- Kumwedwa mwandondomeko kwa zakumwa zoledzeretsa.
- Kuperewera kwa fiber mu chakudya.
- Choyipa.
- Kukhalapo kwa matenda kapamba komanso matenda ashuga.
Gulu la tumor
Mitundu ya neoplasms mumimba wogaya dongosolo: benign mtundu (mwachitsanzo, intraductal mucinous), zilonda (pseudopapillary, etc.). Neoplasms (endocrine chotupa) imatha kufotokozedwa molingana ndi kutengera kwina (mwachitsanzo, mchira, mutu), histology, kuwonongeka kwa ntchito. Ma Neoplasms ali pamutu, thupi, mchira, ducts, zilumba za Langerhans.
Malinga ndi histology, chotupa chake chimakhala pafupifupi cha mtundu wa epithelial. Gwero lalikulu pankhaniyi ndi tiziwalo tating'onoting'ono, timitsempha yamagazi yamagazi ndi m'mitsempha yamagazi. Kuphatikiza apo, zoyambira zotupa zimatha kukhala dysontogenetic kapena metastatic mwachilengedwe.
Malinga ndi momwe magulu a neoplasms amagwirira ntchito, zitha kuchitika:
- kusowa kolakwira;
- kugwira ntchito kosatsimikiza;
- Zosokoneza pakugwira ntchito kwa gawo logaya chakudya m'thupi (hypofunction kapena hyperfunction).
Kuperewera kwa fiber mu chakudya kumabweretsa chotupa
Zizindikiro
Nthawi zambiri, zizindikiro za pancreatic oncology zitha kuzindikirika pokhapokha 4 matendawa. Munthu amakumana ndi kusintha kwina kwa thupi panthawi yakumakula. Monga lamulo, amaphunzira za vutoli kwa nthawi yoyamba pa ultrasound. Pali zizindikiro zingapo zomwe zimathandizabe kudziwa kumayambiriro kwa matendawa. Kutengera ndi komwe khansayo ili, zizindikiro zomwe zafotokozeredwa pansipa zingakhale zosokoneza.
Zizindikiro za chotupa chamutu cham'mimba:
- chiwonetsero cha jaundice;
- kuwonda;
- mafuta ochulukirapo pachondapo;
- kupweteka kwakanthawi m'mimba.
Chotupa mchira ndi thupi adzapatsa ululu m'mimba, kuwonda. Khansa pamutu wa kapamba amadziwika pang'ono kale. Zizindikiro za oncology ndi pancreatic-matumbo mwachilengedwe, popeza kukula kwa neoplasm kumachitika pafupi ndi zigawo zikuluzikulu zamagetsi.
Zizindikiro za chotupa cha pancreatic chotupa ndi chofanana ndi zizindikiro za vuto loiplasm. Kusiyanitsa kwakukulu ndikutanthauzira kwakumapeto kwa neoplasm, yomwe panthawiyo imafika kukula kosangalatsa.
Zizindikiro zazikulu za chotupa ndi:
- bloating sensation;
- phokoso mokhumudwa;
- kulumikizana;
- kupweteka pamimba;
- kufooka kwa ndowe ndi kudzikundikira kwa mafuta;
- mkodzo wakuda.
Zizindikiro zazikuluzikulu za pancreatic oncology ndizosowa kudya, kumangokhala kusasangalala, kuchepa kwa thupi kwakanthawi kochepa (odwala khansa, komanso pancreatitis, kutopa kwenikweni), kuchuluka kwa shuga m'magazi, khungu la kuyabwa ndi jaundice. Matenda owopsa kwambiri oncological amayambitsa:
- kusanza
- thukuta
- kumverera kwa nkhawa kosalekeza;
- kukodza pafupipafupi;
- redness la khungu la nkhope;
- zilonda zam'mimba zosachiritsa.
Chotupacho nthawi zambiri chimawonetsedwa ndi kupweteka kwam'mimba komanso kusanza.
Zizindikiro
Kuti mupeze nthawi yeniyeni komanso molondola komanso mutazindikira mtundu wa chotupa, muyenera kukaonana ndi katswiri wazachipatala, wa gastroenterologist, katswiri pa endoscopy. Kuzindikira chotupa pakalibe njira yamakono yolingalira ndikusungiratu chotupa cha HLA ndizovuta. Ngakhale kugwiritsa ntchito zida komanso njira zabwino kwambiri pofufuzira sizipereka mwayi wofufuza mwatsatanetsatane kuwonongeka kwa ziwalo.
Kuzindikira matenda a oncology a ziwalo za m'mimba, kuyezetsa magazi a biochemical, pulogalamu yamaphunziro, maphunziro a chinsinsi cha chakudya cham'mimba ndi mankhwala. Kupitilira apo, monga lamulo, njira zosafunikira zowerengeka zimafotokozedwa molingana ndi mtundu wa gastrography, duodenography, maginito a resonance pancreatocholangiography, Manc ya pancreatic, ndi biliary truted tomography.
Pambuyo chotupa chikapezeka mu minofu ndikukula kwake kutsimikizika (imatha kukhala pakati pa 2 mpaka 200 mm), akatswiri amapitilira kuzindikira kuchuluka kwa mahomoni (adrenaline, cortisol, gastrin, insulin, glucagon, ndi zina), metabolites, ndi chotupa mu dongosolo lamagazi.
Kuti mumvetse bwino momwe zilondazo zilili, njira zina zowonongera zingagwiritsidwenso ntchito, monga:
- endoscopic retrograde cholangiopancreatography;
- kuyesa;
- percutaneous transhepatic cholangiography;
- punct biopsy wa ziwalo zam'mimba dongosolo;
- laparoscopy.
Kuzindikira matenda a oncology ndi njira zovuta kwambiri. Njira yeniyeni yodziwika chotupa sichinadziwikebe. Kusiyanitsa kwa neoplasms mu chiwalo chogaya chakudya kuyenera kuchitika:
- ndi chifuwa chachikulu;
- chotupa cham'mimba;
- extraorganic retroperitoneal chotupa;
- aneurysm ya zombo zazikulu;
- echinococcosis;
- cysticercosis ndi kukhalapo kwa zotupa za hepatopancreatic site.
Ma tumor amatha kukhala oopsa kapena owopsa.
Chithandizo
Kodi kuchitira khansa ya m'mimba dongosolo? Ngati benign neoplasms ikachitika, opaleshoni yomweyo imayenera, yomwe ikuphatikiza ndi chigawo chakumaso kwa chigawo cha dongosolo, kupezanso kwa mutu wa chiwalo, khunyu ya pancreatoduodenal, enulation ya neoplasm. Pambuyo pa opaleshoni, ndikofunikira kuchita kafukufuku wa mbiri. Izi zipangitsa kuti azitha kudziwa bwino mtundu wa chotupacho.
Kodi zikondazo zachotsedwa?Chotupa chotupa chitha kuchiritsidwa kwathunthu ndikuchotsedwa. Ngati kupweteka kwapezeka ndi vuto linalake, ndiye kuti mtundu wa mankhwalawo umasankhidwa poganizira zamankhwala.
Ndikotheka kuchita pancreatoduodenal resection ndikusunga m'mimba mwa pyloric ngati wodwala akudwala khansa yoopsa ya khansa ya m'matumbo kapena khansa yokhala ndi mahomoni, yomwe imadziwika m'mutu wa kapamba.
Ngati wodwala akudwala gastrinoma, ndiye kuti muyenera kuchita gastrectomy, kusankha vagotomy, resection ya pancreatoduodenal. Kuchita bwino kwa njira zopangira opaleshoni zoterezi kumapangitsabe mikangano pakati pa akatswiri opanga ma gastroenterologists komanso opaleshoni mdziko muno. Mankhwala othandizira a neoplasms a m'mimba ochita kupangika amaphatikizanso polychemotherapy ndi radiation therapy.
Mtundu wachiwonetsero wowerengeka wa zotupa zoyipa zimapangitsa kuti pakubwezeretsanso kuchuluka kwa zotuluka za bile ndi kapamba wa pancreatic, kuchotsera kutupa m'magawo a biliary ndikukhalanso bwino. Pofuna kukwaniritsa cholinga, dokotala atha kukulemberani zotsatirazi:
- ngalande zakunja za bile ducts;
- percutaneous transhepatic drainage wa bile duct;
- cholecystectomy;
- endoscopic bougienage wa chotupa kapangidwe ka exthepatic bile duct, etc.
Njira yokhazikika yochizira benign neuroendocrine-mtundu neoplasm yokhala ndi mahomoni ocheperako imalunjikidwa pakuphatikizidwa kwa sandostatin ndi omeprazole. Panthawi yomwe wodwala akudwala gastrinoma, akatswiri amawonjezera chithandizo cha H2histamine receptor blockers ndi anticholinergic. Kuchotsa neoplasm yoyipa sikukhala chitsimikizo cha kuchiritsidwa.
Kodi mukuchotsa chotupa choyipa? kosatheka kutsimikiza
Zotsogola ndi kupewa
Nthawi zambiri ngati chotupa chowopsa chikapezeka pa matenda, matendawa amakhala osavomerezeka. Ichi ndi chifukwa cha asymptomatic course of the matenda, kukula kwa neoplasms ndi kupezeka kwake makamaka pamapeto omaliza. Ndi m'modzi mwa odwala khumi okha omwe amatha kuchotsa neoplasms yoyipa kwambiri.
Chifukwa chake, 50% ya odwala amakumananso ndi vuto, nthawi zambiri atachitidwa opaleshoni, metastases yakutali imawonekera. Kuchiza kwathunthu matendawa kumapangitsa kukhala ndi moyo woposa zaka 5 kokha 4-5% ya odwala. Kuchita opareshoni sikuti nthawi zonse kumatsimikizira kuti matendawo atha. Sichikhala chovuta kuthana ndi metastases. Pakupezeka chotupa chovuta, chitha kuyembekezedwa.
Chifukwa chake, 95% ya odwala amatha kuthana ndi matendawa. Ndikofunika kutsatira malangizo a adotolo molondola, zomwe zingathandize kuthana ndi matendawa. Mwakutero, kupewa kwa oncology kwamigawo ya m'mimba kulibe. Komabe, ndizotheka kuchepetsa mwayi wa chotupa pogwiritsa ntchito moyo wathanzi, chakudya choyenera komanso kupumula kwabwino. Muyenera kuteteza thanzi lanu nthawi iliyonse!
