Kuyesa kwa Ultrasound (ultrasound) kwa kapamba

Pancreas ili kumbuyo kwa matumbo ang'ono ndi chopondaponda, pansi ndi kumbuyo kwa m'mimba, zomwe zimapangitsa kuti azitha kupezeka paliponse ndi dokotala. Mutha kuseketsa kapena mwanjira ina kumangomva pokhapokha patakhala njira yothandizira, imachulukana kukula kapena kusintha kapangidwe kake. Vutoli nthawi zonse limatsatiridwa ndi chithunzi chowoneka bwino chachipatala ndipo dokotala woyenerera amvetsetsa bwino lomwe kuti vuto ndi chiyani ndipo ndi chiwalo chiti chomwe chikufunika kupendedwa.

Chifukwa chake, ultrasound kapena ultrasound ndiyo njira yotetezedwa bwino kwambiri komanso yopanda kupweteketsa mtima kwambiri yomwe imapanga zithunzi za ziwalo zamkati mwathupi, makamaka kapamba, pogwiritsa ntchito mafunde amawu. Kuganiza kwa Ultrasound, komwe kumatchedwanso kuti scanning ya ultrasound kapena sonography, kumaphatikizapo kugwiritsa ntchito probe yaying'ono (transducer) ndi ma ultrasound, omwe adotolo amawaika pakhungu la chiwalo china kapena dongosolo pakudziwunika lokha. Mafunde amawu othamanga amachoka pa projekitiyo kupita m'thupi. Transducer imasonkhanitsa mawu omwe amabwerera, ndipo kompyuta kenako imagwiritsa ntchito mafunde awa kuti apange chithunzi. Mayeso a Ultrasound sagwiritsa ntchito ma radiation a ionizing (monga momwe amagwiritsidwira ntchito mu ma X-ray), chifukwa chake palibe kuwunikira kwa radiation kwa wodwalayo. Popeza zithunzi za ultrasound zimalembedwa munthawi yeniyeni, zimatha kuwonetsa kapangidwe kake ndipo nthawi yomweyo zimalemba kayendedwe ka ziwalo zamkati, komanso magazi akuyenda m'mitsempha yamagazi.

Kafukufukuyu ndi njira yodalirika yopanda chidziwitso chodziwitsa ziphuphu, zomwe zimawona chiwalocho m'magulu osiyanasiyana, kuwunika momwe zimakhalira pakapangidwe kake, komanso nthawi iliyonse. Zimathandizanso akatswiri azachipatala, madokotala a opaleshoni, akatswiri a zamankhwala, madokotala a ana, madokotala azachipatala komanso madokotala ena ambiri munthawi kuti azindikire ndikuthandizira matenda a kapamba.

Zizindikiro zakuthambo ndi zizindikiro monga kupweteka, kuchepa thupi, kutsekemera kwa khungu, kutsekula m'mimba, kutulutsa magazi, kapena matenda osokoneza bongo, kungafunike chidwi chapadera cha kapamba. Ululu nthawi zambiri umakhala m'chigawo cham'mimba cha epigastric kapena kumanzere, komwe kumatha kubwezera. Kuchepetsa thupi, jaundice komanso matenda ashuga kumatha kuwonetsa zovuta m'matumbo. Ultrasound ingathandize pozindikira zotupa zolimba (ductal adenocarcinoma ndi neuroendocrine zotupa) ndi zotupa za cystic (serous ndi mucinous neoplasms, pseudopapillary) zotupa. Zizindikiro za kuperewera kwa pancreatic, monga kutsekula m'mimba kapena kumatulutsa, kungayambitse kukayikira kwa chifuwa chachikulu, makamaka ndi uchidakwa kapena matenda osokoneza bongo. Kuwoneka kwadzidzidzi kwa kupweteka kwodziwika mu mesogastric, kumapereka kumbuyo, nthawi zambiri kumawonetsa pancreatitis yovuta kwambiri. Kuunika kwa Ultrasound kumathandizira kwambiri pakuwonetsa matenda omwe ali pachimake, pakuwunika kwa kapamba, kapena kuwunika mkhalidwe wa kapamba pamankhwala.

Pancreas anatomy

Nthawi zambiri, kapamba mumunthu wamkulu amalemera pafupifupi magalamu makumi asanu ndi atatu, amakhala ndi kutalika kwotalika masentimita khumi ndi anayi mpaka khumi ndi asanu ndi atatu, m'lifupi mwake pafupifupi atatu mpaka asanu ndi anayi, ndi makulidwe pafupifupi masentimita awiri kapena atatu.

Pancreas ili m'malo a retroperitoneal, m'chigawo cha epigastric, pamlingo woyamba ndi wachiwiri wa lumbar vertebra, ndipo ili ndi mawonekedwe osachedwa, pafupifupi omwe amapezeka mpaka pakati. Ndi ma pathologies osiyanasiyana omwe amatsimikiziridwa ndi ultrasound, imatha kukhala ndi mawonekedwe ozungulira, ozungulira, ogawanika, owonjezera mawonekedwe kapena okhala ndi magawo awiriawiri.

Mbali zazikuluzikulu za kapamba ndi mutu, thupi pakati ndi mchira, pakona kumanzere. Gawo lalitali kwambiri la kapamba amapezeka kumanzere kwa midline, ndipo mchira pafupi ndi minyewa yofikira umakhala pang'ono pamwamba pamutu. Kapangidwe kanyumba kamene kamapangika bwino komanso kuyandikira kwake pafupi ndi nyumba zapafupi kumapangitsa kuti zikhale zovuta kuzindikira, koma madokotala odziwa bwino za ma ultrasound amatha kugwiritsa ntchito zida zoyandikana kuti adziwe malire a kapamba. Mwachitsanzo, mutu ndi thupi la kapamba zimapezeka pansi pa chiwindi, kutsogolo kwa vena cava ndi aorta, nthawi zambiri zimakhala kumbuyo kwa mbali yam'mimba. Kona yakumanzere, mchira wa kapamba umakhala pansi pa ndulu, motero, pamwamba pa impso yakumanzere.

Zikondazo zimawoneka ngati maubongo ang'onoang'ono omwe amapanga michere ya chimbudzi, ndi ma ispancreatic omwe amapangira timadzi tofunikira, insulin, m'magazi. Ndiamene amapangitsa kuti mphamvu azilowa mu khungu lililonse laanthu ndipo amatenga gawo la chakudya chambiri. Ma digestive enzyme kapena kapamba wa pancreatic amatenga nawo mbali pang'onopang'ono ndipo amatulutsidwa mu duodenum.

Zisonyezo za ultrasound

Kufufuza kwa ultrasound nthawi zambiri kumaphatikizidwa pakupenda kwathunthu ziwalo zonse zam'mimba. Kupatula apo, imalumikizidwa bwino ndi ziwalo zina zamkati, makamaka ndi chiwindi. Chizindikiro cha phunziroli ndi mtundu uliwonse wam'mimba wamatumbo. Matenda ambiri amatha kuchitika ndi ma signent or latent kapena atachotsedwa kwathunthu. Chifukwa chake, kamodzi pachaka, ndikofunikira kuchita kafukufuku wa pamimba pamimba, kuti mudziwe matenda ambiri.

Mikhalidwe yodziwika kwambiri yomwe makina a ultrasound amalimbikitsidwa:

Ndi ululu wa nthawi yayitali kapena wapakati, kusapeza bwino pamimba kapena kumanzere kwa hypochondrium,
kusokonezeka kwa khoma lamkati lakumbuyo kapena ululu wam'deralo m'chigawo cha epigastric, komwe kunapezeka ndi palpation,
kutulutsa pafupipafupi (kusisita), kusanza ndi kusanza, komwe sikumapereka mpumulo,
kutsekula m'mimba (kusokonezeka kwanyumba), kudzimbidwa, kuzindikira kwa chakudya chosagwiritsidwa ntchito munzake,
kupezeka kwa kutentha kwaubongo kwanthawi yayitali,
Wodwala akamaona kusokonezeka kwa khungu ndi mucous nembanemba, kupatuka kwa magawo a Laborator ku chizolowezi,
kukwera kowopsa kwa shuga m'magazi a anthu ndi kuchepa kosafunikira kwa thupi,
Pambuyo pa x-ray yam'mimba ndikuwonetsetsa kusintha kwa kukula kwake, mawonekedwe, mawonekedwe, kupotoza, kuzindikira chibayo cham'mimba,
ndi akuganiza kukhalapo kwa chotupa, chotupa, hematoma, miyala, abscess mu gland.

Komanso, kuwunika kwa ultrasound kumachitika ngati pali matenda a jaundice syndromes, duodenitis, khansa, matenda a ndulu. Kuvulala kwam'mimba ndi opaleshoni yosankhidwa akuwonetsedwa.

Kukonzekera kuwerenga

Ultrasound ya kapamba imatha kuchitidwa pafupipafupi komanso mwadzidzidzi. Mukamachita masewera olimbitsa thupi, ndikofunikira kutsatira malamulo ena ndikukonzekera njirayi. Kupatula apo, chovuta kwambiri ndi ultrasound ndi kupezeka kwa mpweya pafupi ndi ziwalo. Ndiye amene athe kusokoneza kafukufuku wofufuza, kupotoza zowonera ndikumupangitsa kuti wodwala azindikire molakwika. Madokotala amalimbikitsa kuti azindikire za kapamba, makamaka m'mawa. Zowonadi, theka latsiku, kuyang'ana malamulo onse ndi malingaliro, mutha kupeza zotsatira zolondola kwambiri.

Pokonzekera matenda, muyenera kutsatira zakudya zochepa masiku atatu njirayi isanachitike. Ndikofunika kupatula zakudya zomwe zimayambitsa kupatsa mphamvu komanso kutulutsa m'matumbo, osadya zakudya zokhala ndi fiber ndi mkaka wonse. Tsiku lisanafike phunziroli, tikulimbikitsidwa kuti muchepetse mankhwala ofewetsa m'mimba kuti muyere m'mimba ndi matumbo. Pakupita maola khumi ndi awiri isanachitike mayeso a ultrasound, ndikofunikira kupewa kudya ndi madzi, kupatula kugwiritsa ntchito mankhwala osokoneza bongo ndikusaloledwa. Simungathe kumwa zakumwa zochokera kaboni chifukwa zimapangitsa kuti pakhale mpweya wambiri. Izi zimatha kukhudza zotsatira ndikusokoneza mawonekedwe a ultrasound.

Ndi zizindikiro zadzidzidzi za ultrasound ya kapamba, wodwala safunika kukonzekera. Koma izi zitha kuchepetsa zidziwitso ndi 40%.

Pancreas ultrasound njira

Pancreatic sonography ndi njira yopweteka kwambiri komanso yopatsa chidwi, yotsika mtengo kwa odwala ambiri. Kuphatikiza apo, zimatenga nthawi yochepa kwambiri - pafupifupi mphindi khumi. Ndikofunikira kumasula dera lam'mimba pazovala, ndi pamalopo pomwe adotolo adzalembanso mankhwala osokoneza bongo otchedwa gel osamba. Ndipo imachita zoyeserera ndi sensor ya ultrasound. Wodwalayo ayenera kugona mwakachetechete, choyamba kumbuyo kwake, ndipo pambuyo pake, ndi chilolezo cha dokotala, atembenukire mbali yakumanja ndi kumanzere kuti awone zikondwerero zozungulira mbali zonse. Dokotala wa ultrasound amawunikira chithokomiro kwinaku akumupumira mpweya pakumapumira kwambiri komanso modekha wodwalayo. Amayenera kufotokozanso za zotsatira za matendawo ndi kupatsa wodwalayo mfundo zomaliza ndi zithunzi za kapamba m'manja mwake.

Munthawi imeneyi, momwe kapamba amapangira ziwiya ndi msana, kapangidwe ka kapamba ndi ndulu yake, mawonekedwe ndi kukula kwake zimawerengedwa.

Dokotala adzazindikira nthawi yomweyo ngati chiwopsezocho chakhala chodontha kapena chotupa, ngati mawonekedwe alipo, ngati njira yotupa ikupitilira kapena ayi.

Ngati njira yotupa ikupezeka kale kwa nthawi yayitali, ndiye kuti kapamba amatha kuchepa kwambiri, minyewa yaying'ono imatha kukula, mafuta am'mimbamo amatha kuchuluka, kapisozi wamkati wamkati umakhala wofinya, komanso kufupika kwa ndulu kumakulanso.

Zabwino kapamba

Mukamayang'ana ma ultrasound, adotolo amatha kuwona "soseji", yamapangidwe S, kapangidwe kake kapangidwe kake komanso kokhala ndi mbali yolimba, yopanda mawonekedwe kapena yopindika. otchedwa Wirsung duct sichidzawonjezereka (zabwinobwino - 1.5-2.5 mm). Imawoneka ngati chubu chopepuka cha hypoechoic ndipo imatha kutsika m'mimba mwake, ndikukulira m'mbali mwa mutu wa gland.

Kukula kwa matupi athu kumasiyanasiyana malinga ndi zaka komanso kulemera kwa thupi la odwala, omwe ali ndi mafuta osiyanasiyana. Mukamakula, chicheperocho chimachepa ndipo chimakhala chachilendo kwambiri pakamawunika. Kafukufuku adachitika pomwe 50% ya anthu omwe anali ndi vuto la kapamba limachulukana, ndipo mwa ana, m'malo mwake, adachepetsedwa. Chizindikiro cha kapamba wabwino ndi mawonekedwe ake.

Mwa munthu wamkulu, kukula kwake kwa mutu wa chindayo kumatha kukhala mamilimita 18 mpaka 30, thupi kuchokera mamilimita 10 mpaka 22, ndi mchira kuchokera mamilimita 20 mpaka 30. Mwa ana, zonse zimatengera kutalika, kulemera ndi msinkhu wa mwanayo: thupi limayambira pa 7 mpaka 14 mm, mutu wa gland umachokera 12 mpaka 21 mm, ndipo mchira umachokera 11 mpaka 25 mm.

Ndi kapamba

Pancreatitis ndimatenda a kapamba ndipo amatha kupezeka mosavuta ndikusanthula kwa ultrasound. Kupatula apo, ndikuyamba kwakanthawi kwa matenda kumeneku komwe kumakhudza kwambiri kapangidwe kake, kukula, kapangidwe ka tinthu timene timagwira. Matendawa amatuluka m'magawo angapo ndipo gawo lililonse limakhala ndi momwe limakhalira.

Pancreatitis ndi mitundu yonse, yolunjika, yamtundu. Mutha kuwasiyanitsa wina ndi mzake ndi tanthauzo la kuphatikizika kwa ziwalo. Kusintha kwa echogenicity kumatha kukhala paliponse palokha, komanso pokhapokha.

Poyamba, zikondamoyo zimachulukirachulukira, kukula kwake kudzasokonekera, ndipo mzere wapakati udzakulitsidwa. Masewerawa akamakulirakulira, kuphatikizika kwa ziwiya zazikulu kumachitika ndipo thanzi la ziwalo zoyandikana nalo lidzasokonekera, ndikuwonjezereka kwa echogenicity mwa iwo. Chiwindi ndi ndulu zimakulanso.

M'magawo omalizira a matenda oyambawa, dokotala wodziwa bwino amatha kudziwa nthawi yomwe gawo la necrotic lipita, ziwalo zam'mimba zimatha kusokonekera, pakhoza kukhala ndi ma pseudocysts kapena foci okhala ndi abscesses khoma lam'mimba.

Ndi zotupa ndi zoyipa

Pali mitundu yambiri ya benign neoplasms. Awa ndi ma insulilomas, gastrinomas, omwe amapanga maselo a endocrine system. Lipomas ndi ma fibromas omwe amapanga kuchokera ku ziwalo zolumikizana. Pakhoza kukhalanso zotupa za mtundu wosakanizika, monga neurofibroma, hemangioma, neurinoma, adenoma, ndi ena.

Ndikosavuta kuyiyika iwo ndi ultrasound. Mawonekedwe awo ndi kusintha kwamachitidwe ndi kukulitsa kwa ndulu.

Neoplasm yachilendo imakhala ndi mawonekedwe a hypoechoic vascularized round kapena mawonekedwe opakika okhala ndi mawonekedwe a echo-heterogeneous. Khansa nthawi zambiri imadziwika m'matalala a gland, malo ovuta kwambiri kuwazindikira. Mutu ukakhudzidwa, chizindikiro chachikulu cham'kati mwa wodwalayo chimakhala chosokoneza khungu ndi mucous nembanemba. Zimachitika chifukwa cha kupunthwa kwamakina mu secretion ya bile mu duodenum.

Titha kunena kuti ultrasonography mwina ndiyomwe imagwiritsidwa ntchito kwambiri pofufuza zamankhwala. M'malo mwake, kusasokoneza, kulekerera bwino, kufalitsa, ndi zotsatira zolondola zamankhwala zidapangitsa kuti ikhale njira yokonda kulingalira mwa odwala omwe ali ndi mawonetsedwe osiyanasiyana azachipatala.

Zisonyezo za ultrasound

Zikondwererozo zimakhala kumanzere kwa m'mimba. Imalumikizana ndi chiwindi, m'mimba ndi ndulu. Osangopanga ma ultrasound, adokotala okha ndi omwe amapereka malangizo pakuwunikira kumeneku. Pali zisonyezo zingapo zazikulu za ultrasound:

Ngati munthu wapezeka ndi matenda a shuga okha.
Ndi zomveka zopweteka zazitali zomwe zidatulukira mu hypochondrium kumanzere kuchokera pansi.
Ngati nseru ndi kusanza zimachitika nthawi ndi nthawi.
Ngati wodwalayo ali ndi matenda a malo a ziwalo zina, mwachitsanzo, chiwindi, m'mimba, ndulu.
Pambuyo mwamenya kwambiri pamimba.
Kuchepetsa thupi mwadzidzidzi.
Ngati wodwala akumva kupweteka pakhungu la kapamba.
Dokotala atha kukuwonetsa kukhalapo kwa hematoma, chifuwa, chotupa.

Pali zisonyezo zambiri zolozera wodwalayo kupita kwa dokotala kuti akamupime.

Osakana, chifukwa ndi njira yopweteka kwambiri komanso yophunzitsa.

Zingwe za chipangizo chofufuzidwa

Pazomwe kukula kwa kapamba amadziwika kuti ndiwokhazikika, titha kulankhula pokhapokha tikamvetsetsa kuti ili ndi magawo atatu (mutu, thupi, mchira) ndi gawo limodzi. Nthambi za kuthengo:

Kutalika kwa chiwalo chonse ndi 140−230 mm.
Kukula kwa mutu ndi 25−33 mm.
Kutalika kwa thupi 10−18 mm.
Kukula kwa mchira ndi 20-30 mm.
Dawo lamkati mwa Wirsung duct ndi 1.5-2 mm.

Kumbukirani kuti chizolowezi cha kapamba wochita kupakidwa ndi ultrasound imatha kukhala mwa anthu ena pang'ono, pomwe ena pang'ono.

Chifukwa chake, kupatuka kwapang'onopang'ono kwa zizindikiro mbali imodzi sikusonyeza matenda.

Kukonzekera ndi machitidwe a phunziroli

Pazonse zabwino zakukonzekera phunziroli auzeni adokotala. Koma pali malamulo angapo omwe ayenera kutsatira:

Choyamba, pafupi masiku atatu maphunziro asanachitike, muyenera kuyamba kutsatira zakudya zina zomwe siziphatikiza miyendo, mkate ndi makeke, makeke, mkaka wathunthu, ndiye kuti, zinthu zomwe zimathandizira kupanga magesi m'matumbo. Kuphatikiza apo, mowa, zakumwa zoziziritsa kukhosi ndi khofi ndizoletsedwa.
Kachiwiri, kumbukirani kuti kuwunika kwa ultrasound kumachitika pamimba yopanda kanthu, chifukwa chake muyenera kudya chakudya chamadzulo maola 12 musanapite ku chipatala. Osamadya kwambiri, chakudya chamadzulo chimayenera kukhala chosavuta, koma chamtima.
Chachitatu, maola awiri musanayambe phunziroli, musamamwe, kusuta kapena kutafuna chingamu. Izi zikuchitika chifukwa cha kudzikundikira kwa mpweya m'mimba, zomwe zingakhudze zotsatira zake.

Pambuyo pokonzekera, wodwalayo amatumizidwa kuti akafufuze. Muofesi, amasula m'mimba mwake zovala ndikugona kumbuyo kwake.

Dokotala amayendetsa tsamba loyeserera ndi sensor yapadera ndikulemba zotsatira zake. Dokotala atha kufunsa wodwalayo kuti asinthe malo, ndiko kuti, kugona kumanja kwake kapena kumanzere kapena kupumira mwakuya, ndikudzaza m'mimba ndi mpweya.

Zipangizo zofufuzira za ultrasound zimagwira ntchito mwanjira yomwe imagwira mafunde omwe amawoneka kuchokera ku ziwalo. Zimatengera kuwuma kwa ziwalo ndi madera awo. Chifukwa chake, kukakhala kachulukirapo, mdera lomwe likuwonetsedwa pazenera limakhala.

Dokotala akuwonetsa izi:

Maonekedwe a chiwalo. Nthawi zambiri, limapangidwa mu zonse.
Mphamvu ndi kapangidwe ka chiwalo. Ma contour amakhala omveka nthawi zonse. Ngati ndiwopanda phokoso komanso zowoneka bwino, ndiye kuti izi zikusonyeza kutupa mu kapamba - kapamba. Ndipo kapangidwe ka chiwalo nthawi zonse kamakhala kowoneka bwino, kokhazikika bwino, mutha kuwona zazing'ono zomwe zimayambitsa.
Kukula kwa kapamba. Nthawi zambiri, ndi ultrasound, ndi chimodzimodzi kwa amuna ndi akazi.
Momwe gland imakhalira pamimba, pali zomwe zimasinthana ndi ziwalo zoyandikana.
Kodi pali zosintha zina zamtunduwu womwe.

Mothandizidwa ndi kafukufukuyu, dokotalayo amazindikira matenda omwe ali ndi matenda omwe ali ndi vuto komanso obadwa nawo. Ndipo popeza mothandizidwa ndi ultrasound, matenda amapezeka koyambirira kwenikweni kwa chitukuko, izi zitha kupulumutsa wodwala ku zovuta zomwe zingachitike mtsogolo.

Kuzindikira komaliza

Pambuyo pakuyesa kwa ultrasound, dokotala amalamula kuti pakhale kuyesedwa. Pambuyo pofufuza zotsatira zonse za mayeso a wodwalayo, dokotalayo amazindikira matenda ena ndikuyamba kuwachiza. Ayi, ayi osayesa kudzipanga nokhaPambuyo powerenga zotsatira za ultrasound, ndi katswiri wodziwa bwino yemwe angachite izi molondola.

Koma mutha kuthandizira kuchira ngati mumatsatira malangizo a dokotala ndikutsatira zakudya zomwe zidakhazikitsidwa.

Ndi anthu ochepa omwe amaganiza momwe angasungire zikondamoyo, momwe angatetezere kumatenda ndi zina zoyipa. Izi ndizosavuta. Muyenera kutsatira mosamala pakudya yokazinga, mafuta komanso zakudya zotsekemera. Osamadya kwambiri komanso kumwa mowa. Ndikofunika kuti musiye nicotine ndikupita nawo kumasewera. Kuphatikiza apo, kunyumba ndi kuntchito, ndikofunikira kuti muchepetse nkhawa komanso kulimbitsa chitetezo cha mthupi.

Kutsatira izi pokhapokha mutasunga thanzi osati kapamba, komanso thupi lonse.

Zizindikiro zazikulu za ultrasound ya kapamba

Kapamba ndichinthu chogwirizana ndi chimbudzi. Gland wamkuluyu ali ndi ntchito ziwiri zofunika: amapatula madzi a pancreatic ndi ma enzymes am'mimba, kuphatikiza amapanga mahomoni omwe amawongolera chakudya, mafuta ndi metabolism.

Ultrasound ya kapamba

Pali zinthu zingapo zomwe muyenera kuzitsatira ndi ma pancreas mosalephera:

Ululu : kupweteka kwakanthawi kapena kwakanthawi mu epigastric dera (dera lomwe lili pamwamba pa navel) kapena hypochondrium yamanzere, kupweteka kwa m'chiuno, kupweteka pakukwaniritsidwa kwa epigastric dera.
Matenda Am'mimba : nseru, kusanza komwe kumachitika ndi njala kapena kudya, kutsegula m'mimba mosadziwika (chiyambi), kudzimbidwa, kutulutsa zodandaula, kuchuluka kwam'mimba, kubala.
Mawonetsero akunja : chikopa cha khungu ndi mucous nembanemba, kuwonda kwakanenepa kwambiri.
Kukula bwino : kutentha kwambiri kwa thupi (kumadzuka nthawi yochulukitsa) popanda kuzizira komanso matenda opatsirana omveka bwino.
Zosintha pakuwunika, zizindikiro zowunikira : kukweza shuga kapena kufalitsa matenda a shuga, kupindika kwam'mimba kwa khoma lam'mimba, kupotoza kwake mizere kapena duodenum, kukulitsa kwa kapamba, madzimadzi m'mimba.
Matenda Oyerekeza : kukayikira kwa chosaopsa kapena kupweteka kwapafupipafupi, zovuta za pancreatitis pachimake (necrosis, hematomas, abscesses, etc.).
Kuyesedwa koyenera : Opaleshoni isanachitike kapena itachitika, kuvulala kwam'mimbamo, kapamba (pachimake ndi matenda osachiritsika), impso ndi chikhodzodzo (awa ndi ziwalo zotsamira).

Kodi ndi ma pathologies ati omwe ma ultrasound amawazindikira

Pogwiritsa ntchito njirayi, mutha kuwunika kusintha kukula ndi maonekedwe a chiwalo, mkhalidwe wa milatho, ndikuzindikiranso njira zingapo zowopsa:

pachimake, matenda kapamba,
kubadwa kwatsopano kwa kapamba,
cyst, zilonda (khansa) ndi ma neoplasms oyipa,
zotupa zosiyanasiyana, abscess (purulent kutupa),
matenda a shuga mellitus, kusintha kwa minofu chifukwa cha matenda ashuga, kupweteka kwa pakhungu.

Momwe mungakonzekerere pokonzekera ma kapamba

Mwadzidzidzi Ultrasound ya kapamba kuchitika popanda kukonzekera koyambirira. Ngakhale zotsatira zosokoneza, katswiri wodziwa luso azitha kudziwa matenda omwe amafunikira chithandizo chamankhwala mwadzidzidzi.

Kuti mudziwe bwino, kupereka zotsatira zolondola, kukonzekera ndikofunikira. Ndikofunikira kuyamba kukonzekera masiku 2 asanachitike:

kutsatira zakudya zopepuka zama protein,
osamadya kwa maola 10-12 (kutacha m'mawa, chakudya chamadzulo ndichokwanira)
kupatula pazinthu zomwe zimapangitsa kupangika kwa gasi (yisiti ndi mkaka, masamba abwino, zipatso, nyemba, zakumwa zoziziritsa kukhosi, ndi zina).
kusiya kusuta, mowa, kugwiritsa ntchito chingamu,
kupuma pakumwa mankhwala ndi zitsamba (kupatula - kuvomerezedwa kuchiza matenda osachiritsika: matenda ashuga, matenda oopsa, ndi zina).
patsiku, odwala omwe amakonda kuchita zachinyengo, amatenga adsorbents (espumisan, carbon activated, etc.),
Madzulo a njirayi, yeretsani matumbo (ngati kuli kotheka, gwiritsani ntchito mankhwala ofewetsa thukuta kapena enema.

Kulephera kutsatira malamulo okonzekera kumachepetsa kufunikira kwa ultrasound ndi pafupifupi 70%. Kuyesedwa ndi mthandizi wosiyanitsa ndi ma endoscopic omwe azidzachitika dzulo la ultrasound ya kapamba kumathandizanso pakupotoza zotsatira.

Kuyesedwa kwa kapamba wapamwamba

Njira yochitira ndi ultrasound ya kapamba nthawi zambiri imadutsa m'mimba khoma pogwiritsa ntchito sensor yakunja yakunja. Wodwalayo amagona zovala (zopanda nsapato) pakama ndi nsana wake, ndikuwonetsa m'mimba mwake. Dokotalayo amagwiritsa ntchito gel ya hypoallergenic ya ultrasound, kupereka kulumikizana kwakukulu ndi chipangizocho, kenako, pang'onopang'ono kusuntha kwa sensor kuchokera pakati penipeni pamimba kupita ku hypochondrium yamanzere, amawunika kapamba. Panthawi yolingalira, wodwalayo ayenera kupuma kwambiri. Dokotala adzakupemphani kuti mugwire ntchito (kuti muziyenda m'mimba) kuti matumbo asunthire ndipo palibe chomwe chimalepheretsa kuyesedwa kwa kapamba.

Pofuna kumveketsa bwino zotsatirapo zake, dokotalayo atha kufunsa wodwalayo kuti asinthe maonekedwe a thupi (atagona mbali yake kapena pamimba pake, kuti ayimirire) ndikuyesanso. Ndizotheka kupeza zolakwika chifukwa cha kuchuluka kwa mpweya m'matumbo. Kuti athetse vutoli, wodwalayo ayenera kumwa magalasi atatu amadzi. Madziwo amakhala ngati "zenera" ndipo amakupatsani mwayi wofufuza ziwalo.

Ndondomeko yopanda ululu, wodwalayo samakumana ndi vuto kapena samva bwino. Kutalika sikupitilira mphindi 10-15.

Endoscopic Ultrasound

Nthawi zina, kuyezetsa kwa mapapo am'mimbamo kumayesedwa malo osagwiritsidwa ntchito ndikuchepetsa zolakwika. Izi ndi zosasangalatsa komanso osati zosangalatsa. Kuwona kumachitika pogwiritsa ntchito kanema wozungulira wosasintha (chipangizo) ndi kamera ya kanema komanso sensor ya akupanga.

Pulogalamuyi imayilidwa mosamala kudzera m'mankhwala a m'mimba ndikudutsa mu duodenum. Kuti achepetse wodwalayo mantha, mphindi 30-60 asanachitike, amapatsidwa jakisoni wamkati wothandizira. Endo ultrasound imachitidwa ndi opaleshoni (timitu).

Chizindikiro chazowonekera pa ultrasound cha kapamba

Chiwalocho chimakhala pamalo a epigastric. Matenda athanzi ali ndi izi:

Soseji, dumbbell, S-mawonekedwe kapena mawonekedwe a tadpole

yosalala, yowoneka bwino, yolekezera kuchokera kuzowonda

Echogenicity (kumva kwa mafunde omwe akupanga)

Mapangidwe a Echo (akuwoneka pachithunzi)

kopanda zolakwika (zochulukirapo), zitha kukhala zopyapyala kapena zopindika

yopapatiza, yopanda zowonjezera (m'mimba mwake 1.5 - 2.5 mm)

Zizindikiro za pathological: kupatuka kuzungulira, kuwonekera pa ultrasound

Pathology, kusintha kwakanthawi, matenda

Zizindikiro pa scan ya ultrasound

Zikondwerero ndizochulukirapo kuposa zina zake (kapena ziwalo zake zimakulitsidwa),

chidule, chosasinthika

kapangidwe ka zinthu zakale (makamaka zamakhalidwe),

Wirsung duct inakulitsidwa,

kudzikundikira kwamadzi mozungulira thupi.

Khungu losasinthika, losalala

zopatsa mphamvu, zopangidwe bwino (Hyperechoic),

Wirsung duct watakulitsa (oposa 2 mm),

miyala ndikothekera - mawonekedwe ozungulira oyerekeza omwe ali ndi mayendedwe ena kumbuyo.

Chotupa kapena chotupa

Mapangidwe a Echo-negative (akuda pazithunzi) opangidwa bwino

gawo lomwe chotupacho chikukula.

kapangidwe ka heterogenome (hypoechoic, hyperechoic kapena osakanikirana),

kukulitsa pancreatic ndi bile duct.

Matenda a shuga mellitus kapena pancreatic lipomatosis

kapangidwe kazowonjezera zachilengedwe,

mwachangu, kufooka, mawonekedwe osasinthika a chiwalo.

Pancreas ichulukitsa

2 zikopa,

Kapangidwe ka isohlogenic kumawoneka kosalingana.

Zikondamoyo zooneka ngati mphete

Malo ozungulira duodenum, amakulitsa

amodzi kapena angapo ozunguliridwa, ma hypoechoic (osagwiritsa ntchito mafunde akupanga)

Contraindication

Kwenikweni, kuwunika kwa ultrasound kulibe zotsutsana, koma pali zinthu zina zomwe zimapangitsa kuti njirayi ikhale yovuta kapena yosayenera.

Ultrasound ya kapamba sikuchitika ndi:

thupi lawo siligwirizana,
wamkulu wodwala,
kunenepa kwambiri - thupi limavuta kuyang'ana chifukwa cha kuchuluka kwa mafuta,
kuwonongeka kwa khungu la m'mimba (mabala, matenda opatsirana komanso otupa, fistulas, zotupa za pakhungu ndi matenda a systemic).

Contraindication wa endoscopic ultrasound:

magazi akutaya
kuchuluka kwa ziwalo zopanda pake,
matenda ena kupuma, mtima dongosolo (pachimake myocardial infarction, sitiroko, matenda amphumo, etc.),
kudandaula kwa wodwala,
esophageal wayaka,
zovuta zamagazi ozungulira,
zilonda zapamwamba
nodular goiter gawo 4,
kuvulala kwam'mimba.

Mulimonsemo, ndi ma pathologies ena, dokotala amawona kuthekera kwa kusunthika kwa ultrasound payekha.

Njira zofufuzira, zopindulitsa za ultrasound kuposa njira zina

Pali njira zingapo zoyeserera kapamba:

radiology (radiography, endoscopic retrograde cholangiopancreatography, tomography yophatikizidwa),
njira za fiber optic diagnostic.

Ultrasound ya kapamba ndiye muyeso wagolide. Zimayerekezera bwino ndi njira zina, popeza sizimapereka mphamvu pa radiation poyerekeza ndi ma x-ray, zachuma kwambiri kuposa CT (complication tomography), yolondola komanso yothandiza kwambiri poyerekeza ndi cholangiopancreatography, komanso yosavuta, yachangu komanso yopanda chisoni machitidwe.

Phunziroli lilibe zoletsa zaka ndipo zitha kuchitidwa ngakhale muli ndi pakati. Katswiriyu samangokhala ndi ultrasound ndipo amamuwunikira mayeso athunthu ngati atazindikira njira yomwe imafunikira chitsimikiziro cha matenda ake.

Komwe mungachite ndi ultrasound ya kapamba ku St.

Kuyesedwa kotere kumachitika mu chipatala Diana. Adilesi yathu ku St. Petersburg: Zanevsky Prospect, 10 (pafupi ndi metro Alexander Nevsky Square, Ladoga, Novocherkasskaya). Kuunikira kumachitika pogwiritsa ntchito makina atsopano a kalasi ya ultrasound.

Ngati mwapeza cholakwika, chonde sankhani gawo ndikusindikiza Ctrl + Lowani

Pancreas Ultrasound

Zikondamoyozo zimakhala mkati mwamkati mwa m'mimba: pansi ndi kumbuyo kwamimba. Chifukwa chake, adotolo amatha kumuyambitsa iye pokhapokha kukula kwa ziwalo kumakulitsidwa. Koma mothandizidwa ndi ultrasound, mutha kupenda zikondamoyo mwatsatanetsatane, mwachangu, mwamwayi, mopweteka komanso mosatetezeka.

Pa phunziroli, phunziroli limaphunziridwa:

mawonekedwe (kapamba wathanzi amafanana ndi chilembo S)
contour
kukula (kuchuluka kukuwonetsa kuvulala kapena matenda a kapamba),
kapangidwe.

Pancreas wamkulu umalemera pafupifupi 70-80 g.

Zizindikiro za phunziroli

Anakonzekereratu ndi kuphipha kwa ziwalo ndi ziwalo zina zam'mimba (chiwindi, ndulu ya ndulu, ndulu) mutafika zaka 25 ndikulimbikitsidwa kuti zizichitika chaka chilichonse. Komanso, maphunziro omwe amakonzedwa amapatsidwa:

ndi kapamba,
matenda ashuga
Pamaso pa opaleshoni pamimba,
Ndi matenda am'mimba komanso nthawi zina.

Kujambula kosasindikizidwa ndikofunikira ngati muli ndi zizindikiro zotsatirazi:

kupweteka kwambiri kapena kupweteka kwakumanzere kapena hypochondrium, pansi pa supuni, kumtunda kwa m'mimba,
zomverera zosasangalatsa mukamamverera,
kusanza pafupipafupi ndi kusanza,
zovuta zopezeka pansi
chisangalalo
ukufalikira
kufooka ndi ulesi,
kuwonjezeka pang'ono kwa kutentha kwa thupi,
kusowa kwa chakudya
jaundice
kuwonda msanga popanda zifukwa.

Komanso, ma ultrasound a kapamba amachitidwa:

ndi zonyansa za khoma lakumbuyo yam'mimba (malinga ndi zotsatira za gastroscopy),
Kusintha kwa mawonekedwe am'mimba, duodenum,
chifukwa chotupa choganiziridwa,
ndi kuvulala.

Phunziroli lilibe zotsutsana. Itha kuchitika mobwerezabwereza, zomwe ndizofunikira pounika mphamvu za chithandizo cha matendawa.

Kodi ndimatenda ati omwe amadziwika ndi ultrasound ya kapamba

Phunziroli limalola kuzindikira matenda otsatirawa:

kapamba
chotupa (chotupa),
madipoziti amchere amchere mumisempha yofewa,
kapamba,
cysts, pseudocysts,
zotupa ndi ma neoplasms ena,
lipomatosis (madipoziti amafuta).

Kukonzekera kwa ultrasound ya kapamba

chakudya
matumbo kuyeretsa
kusiya zizolowezi zoipa patsiku la kafukufuku.

Chakudyacho ncholinga chothetsa kuipitsidwa kwamatumbo. Mafuta amachititsa kuti zikhale zovuta kuwona komanso osaloleza adokotala kuti apende mwatsatanetsatane ziwalo ndi minyewa ya m'mimba. Chifukwa chake, ndikofunikira masiku atatu pamaso pa ultrasound kukana chakudya chomwe chimakwiyitsa mpweya. Izi ndi izi:

nyemba
mitundu yonse ya kabichi
zakudya zamafuta ambiri
ufa ndi yisiti
maswiti
masamba osaphika / zipatso,
mkaka wonse ndi mkaka,
koloko
mowa
khofi.

Muyeneranso kusiya mafuta, okazinga, osuta fodya komanso mchere wambiri. Muyenera kudya nyama yophika yophika (ng'ombe, nkhuku, chifuwa cha nkhuku), nsomba zonenepa kwambiri, chimanga. Amaloledwa kudya dzira limodzi patsiku.

M'mawa kutacha kwa ma CD a kapamba, muyenera kumamwa mankhwala otupa (dokotala azikutengani). Nthawi ya chakudya patsikuli iyenera kusankhidwa kuti maola 12 asiyidwe mayeso asanachitike.

Phunziroli limachitika pamimba yopanda kanthu.

Ndikofunikira kuti mutenge khadi yakuchipatala ndi inu ndi zotsatira za ma ultrasounds am'mbuyomu, ngati adachitidwa.

Kodi ndi motani?

Phunziroli limachitika motere:

Wodwalayo amafunsidwa kuti atulutse m'mimba mwake ndi kugona pakama kumbuyo kwake. (Mukamawerengera, adzafunikanso kugona kumanja kwake lamanzere.).
Kenako dotolo amasamalira khungu ndi khungu lapadera, amawongolera madera omwe ali ndi chifuwa ndi sensor ndikuyang'ana chithunzi cha polojekitiyo pa nthawi yeniyeni.
Pamapeto pa njirayi, yomwe imatenga pafupifupi mphindi 10, wodwalayo amapatsidwa lingaliro lomwe lili ndi zolemba za ultrasound.

Ngati kuchuluka kwa kapamba kumachuluka, izi zikuwonetsa kukhalapo kwa akatswiri a zamankhwala. Komanso miyeso ya atypical ya chiwalo ikuwonetsa kukula kwa matenda.