Kodi kupangika kwa kapamba ndi chifukwa chiyani kumakulitsidwa
Kapangidwe kamene kamasinthasintha kapangidwe kake kapamba sikuti ndi matenda osiyana ndi ena, koma kuwunika kwa matenda am'mapapo, omwe amadziwika ndi ultrasound. Kusintha koteroko kumadza osati kokha chifukwa cha matenda a chiwalo, komanso njira ya moyo, chakudya, komanso kupezeka kwa zizolowezi zoipa. Kapangidwe ka gland kamene kamatha kuwoneka pokhazikitsa njira zogwirira ntchito. Kutsimikiza kwa vutoli ndikosatheka mwanjira ina iliyonse - pakuwunika, mothandizidwa ndi mayeso a labotale.
Ichi ndi chiyani
Kapangidwe kakakulu ka kapamba kanapezeka, komwe sikudziwika kwa ambiri.
Kapangidwe kazidole kakang'ono ka pancreatic parenchyma kumaonekera pakamayesedwe ka ultrasound. Minofu yayikulu ya kapamba ndi parenchyma, yomwe imakhala ndi kufotokozera komweko m'malo onse. Ngati kupatuka kukuwonekera pakumveka kotumizira, ndiye kuti izi zikuwonetsa kusintha kwa kapangidwe kake. Mwanjira ina, kapamba payokha adayambiranso, ndikusinthidwa ndi minofu yatsopano yokhala ndi maselo. Pazinthu zomwe zimapangidwa pafupipafupi, madokotala amapanga lingaliro la mapangidwe a matenda mu gland, cysts, kutupa, ndi neoplasms.
Ngati kapangidwe kake kapangidwe kake kamasintha kwambiri, malo omwe amapezeka amapezeka paliponse lachiwalo. Kuphwanya kotereku kumawonetsa kukhalapo kwa matenda omwe ali pachimake komanso osachiritsika, kumatanthauza kusagwirizana kwamatumbo ndi chimbudzi.
Mavuto amtunduwu akaakayikiridwa, dokotalayo amamulembera ma ultrasound, omwe amadziwika kuti amapanga mitundu yotani.
Zimayambitsa kusintha kwa limba pa ultrasound
Kapangidwe kazidole kakang'ono ka kapamba kumapangitsidwa ndikuyambitsa kosalekeza kwa zinthu zosiyanasiyana. Izi zimaphatikizapo zomwe zingasinthidwe, zomwe sizitha kuchiritsidwa, komanso zolimbitsa thupi zomwe zimawonetsa zotsatira zake kwakanthawi.
Zomwe zimayambitsa kusinthasintha, komanso kukula kwa zilonda zam'mimba:
- Kusokonezeka komwe kumachitika m'zaka zapitazi ndi chikhalidwe chachilengedwe,
- cholowa
- kupezeka kwa zizolowezi zoipa,
- gawo lachiwopsezo cha matendawa ndi zizindikiro zowonjezereka za kapamba, ndimatenda, kapamba amasintha kapangidwe kake,
- kusintha kwa kapamba kuyambira pachimake ku matenda osachiritsika. M'mkhalidwe wotere, heterogeneity mu kafukufuku wa ultrasound sangawonekere, ayamba kukulanso matenda obweranso.
- mavuto a kagayidwe kazakudya, chifukwa cha zomwe minyewa ya dystrophy imayamba,
- chotupa chikukula, ma cysts - ma neoplasms opweteka amasiyana ndi ziwalo zomwe zimapangidwa ndikukula kwake, zomwe zimatsogolera ku heterogeneity. Pa ultrasound, amawonekera bwino ngakhale pa nthawi yopanga matendawa,
- magazi oyipa
- dyskinesia, kusokonezeka kwa magwiridwe amachitidwe a bile
- kupsinjika
- kusadya bwino,
- kugwiritsa ntchito mankhwala mosasamala,
- matenda ashuga.
Zomwe zimatsitsimutsa kwambiri pakuwoneka kwa heterogeneity ya kapamba ndikuphatikizira kusuta ndi mowa.
Odwala ena amakhala ndi matupi a thupi kotero kuti, ukasuta kapena kumwa mowa, kuwonongeka kwa nembanemba kumachitika, kutupa kumayamba.
Kuchuluka kwa zinthuzi sikungasinthe mwanjira iliyonse, koma zina mwazomwe zimakhudzidwa ndi chilengedwe.
- A hegengenible parenchyma nthawi zambiri amawonedwa chifukwa cha kuperewera kwa zakudya m'thupi. Mayiko ena amakonda zakudya zokometsera, zokometsera, komanso zokazinga. Zakudya zoterezi zimadziwika kuti ndizofala, koma si thupi lililonse lomwe lingathe kulimbana ndi chakudya chotere. Ndi kugwiritsidwa ntchito molakwika ndi mbale zotere, izi zimayamba kukhala matenda oyamba a zindulu. Chifukwa chake, mukazindikira matenda a heterogeneity, ndikofunikira kusiya mafuta okumba, zakudya zamzitini, nyama zosuta.
- Pamaso pa matenda a shuga, kuphatikizika kwa kapangidwe kake kudzakhala kovuta mu kapamba ndi chiwindi parenchyma. Chifukwa cha kufa kwa maselo a beta, pali kuchepa kwakukulu kwa kupanga kwa insulin, komwe kumakweza chiwopsezo cha ziwalo. Kupereka mankhwala, kuwunika mozama kwa kusintha kumachitika.
- Kugonjera ku mowa ndi nikotini ndizikhalidwe zopanda chitetezo zomwe zimayambitsa matenda a kapamba. Pa ultrasound, heterogeneity idzakhala yunifolomu. Ndipo nthawi zambiri heterogeneity imawonedwa mwa iwo omwe nthawi zina amamwa ndi kusuta. Izi zikuwonetsa kuti ntchito ya endocrine imayankha molakwika zakumwa zoledzeretsa ndi ndudu, chifukwa chake kusuta ndudu imodzi, kapena kumwa mowa pang'ono, izi zimabweretsa chisangalalo cha pancreatic, kutupa kwake ndi kukula kwa heterogeneity.
- Kupsinjika pafupipafupi kumakhudza thupi lonse, kugunda kapamba. Heterogeneity imatha chifukwa cha kuvutika maganizo, nkhawa yayitali, mikangano yabanja yosalekeza.
- Heterogeneity wa chiwalocho n`chotheka chifukwa chomwa mankhwalawa osagwiritsidwa ntchito monga adokotala adanenera. Pankhaniyi, sangapewe matenda, bongo, chifukwa chomwe masinthidwe a kapamba ndi kapangidwe kake amachitikira.
Mukaonana ndi dokotala
Ngati kapamba ndi wolemera, ndizotheka kudziwa mutatha kafukufuku wa ultrasound. Pamene matenda ali pa njira yoti akapangidwe, ndizosatheka kuzindikira heterogeneity. Komabe, ndikuphwanya kwa nthawi yayitali kapangidwe ka michere, kupita patsogolo kwa matendawa kumaonekera, ndipo zizindikilo zodziwikiratu za malaise zimayamba.
Zowona kuti chamba cha pancreas ndichulukidwe chimawonetsa zizindikilo zingapo.
- Ululu pansi pa nthiti yomwe imatsogolera ku flatulence.
- Ziphuphu za khungu zimasanduka chikaso. Chizindikiro ichi chikuwonetsa kupezeka kwa matenda a chiwindi ndi gland.
- Mu ndowe, mafuta amawonedwa.
Kukula kwa zizindikiro kukusonyeza kukula kwa matenda am'mimba ndi kufunika kwa chithandizo cha kapamba. Kukonzekera kwa pulogalamu yothandizirana kwamankhwala kumachitika ndi dokotala, chifukwa chake kudzilimbitsa nokha sikovomerezeka pano.
Njira zowonjezera zowunika
Kuwonongeka kovuta kwa kapamba kumadziwika chifukwa cha maphunziro a ultrasound. Pamene heterogeneity ikukayikiridwa, njira zina zoyesera zimaperekedwa ndi adokotala.
Wodwalayo amayesedwa magazi. Pakusokonezeka kwakukulu. Ngati malfunction adachitika chifukwa chotupa, kuwerengera kwa leukocyte kumakulirakulira m'madongosolo a wodwalayo.
Mkoyo imayang'aniridwa kuti ikhale ndi alpha-amylase, zinthu zopangidwa ndi thupi. Ngati zidapitilira, kuphwanya kwa mapangidwe osungidwa kulembedwa, kutupa kumapezeka.
Chifukwa cha zithunzi za X-ray, mawonekedwe amawonekera mumayendedwe a chiwalocho. Kutulutsa m'thumba la serous ndi kukula kwa mafuta a m'matumbo, omwe amawonedwa ngati chizindikiro cha kapamba, amawonekera bwino m'chithunzichi.
MRI amatanthauza njira yodziwitsa kwambiri yomwe ingadziwitse heterogeneity.
Mapeto ake akakhazikitsidwa, zindikirani njira yothandizira matendawa chifukwa cha kapamba, limodzi ndi kusintha kwa ziwalo. Mfundo yothandizira pancreatitis ndiye chakudya choyenera.
Ndi kutupa kwa kapamba, zakudya ndizofunikira. Pambuyo pakuchulukitsidwa, tebulo No. 5 limayikidwa. Zakudya za pachimake kapamba zimafuna kusala kwa masiku atatu. Mutha kumwa madzi okha, chakumwa cha m'chiuno cha rose. Chifukwa cha njirayi, ndizotheka kuchepetsa kupanikizika ndikulola kuti thupi lipumule.
Matenda a kapamba, zakudya zimaphatikizapo kutenga:
- phala yophika pamadzi,
- pasitala
- mkate wa dzulo
- nyama, nsomba zamitundu yamafuta ochepa,
- msuzi wophika msuzi wachiwiri,
- masamba omwe alibe ma coarse fiber, owiritsa, ophika,
- zipatso zopanda wowawasa, zipatso,
- tiyi, zakudya, zakumwa za zipatso.
Pamaso pa kapamba, adokotala amalimbikitsa maphikidwe azakudya za odwala.
Dokotala amafotokozera kukonzekera kwa enzyme - Creon, Festal, Pancreatin. Chifukwa cha njira, kupanikizika pazitsulo kumachepetsedwa, chimbudzi chimayenda bwino. Pamaso pa nseru, kusanza ndi mankhwala Cerucal, amathetsa chizindikiro. Ululu umathetsedwa ndi ma painkiller.
Kodi mavutowa ndi otani, ndipo ndi njira ziti zomwe zimatsatidwa?
Ngati mankhwalawo anali osayenera kapena matendawa ayambika, izi zimakwiyitsa:
- kunyowa
- khansa mapangidwe
- dziko lodzidzimutsa
- magazi amkati
- duodenal stenosis,
- yabwino.
Kuti muthane ndi mavuto ndi thupi, ndikofunikira kusintha kadyedwe. Ndikofunikira kuchepetsa kapena kuthetseratu zinthu zomwe zimakwiyitsa chiwalo. Kudya kwa wodwala kuti akhale wokwanira komanso woyenera. Komanso musiye nikotini ndi mowa, chitani masewera olimbitsa thupi, khalani ndi moyo wathanzi.
Kodi echogenicity ndi chiyani
Echogenicity ndi kuchuluka kwa mawonekedwe a ziwalo zamkati, pamaziko omwe madokotala angaweruze kuchuluka kwa minofu yamoyo. Poterepa, kuwunika kwa chiwindi kumatengedwa ngati buku. Echogenicity ya ziwalo zina kufaniziridwa ndi iyo, ndipo pamaziko a deta yomwe yapezedwa, ziganizo zimafotokozedwa za momwe zimakhala. Mwachitsanzo, mawonekedwe a kapamba ayenera kukhala ofanana ndi kapangidwe kofananira ka chiwindi. Ngati wakale ali ndi mawonekedwe a chiwindi kapena amasiyana ndi kapangidwe ka chiwindi, ndiye kuti ndi mwayi wofunsa dokotala wa gastroenterologist.
Ziwalo zina zathanzi zimakhala ndi kuphatikizika kwa zachilengedwe. Kodi izi zikutanthauza chiyani? Izi zikutanthauza kuti chiwalochi chimakhala ndi kupingasa kapenanso mitundu ingapo ya minofu yambiri.
Pakuwunikira zida zogwiritsira ntchito ma diagnostics a ultrasound, ziwalo zonse zimawonetsedwa ngati mawonekedwe a grainy silhouettes. Katswiri wofufuza akhoza kuwona kuti kuchuluka kwa ziwalozo ndikwabwinobwino kapena kupatuka kwawamba. Kutengera izi, atha kufotokozera za momwe ziwalo za wodwalayo zilili. Mwachitsanzo, chithunzi chabwino chokhala ndi polojekiti, kuchuluka kwa minofu kumachepa.
Chiwindi, impso, chithokomiro, komanso mafupa amtundu wa munthu zimakhala zowongoka kwambiri. Pachifukwa ichi, mafunde a ultrasound samadutsa kwathunthu, koma amawonekera kuchokera kwa iwo. Chithunzi chooneka bwino kwambiri chitha kuonedwa pachimake. Nthawi zina mapangidwe okhala ndi michere yowuma amatha kupezeka m'thupi la munthu, zomwe zimawonetsera pafupifupi ma radiation onse omwe akupanga. Itha kukhala malo owerengeka a limba kapena mwala mkati mwake. Pankhaniyi, madokotala amazindikira hyperechoogenicity.
Ziwalo zambiri zimakhala ndi mtundu umodzi, wopanda mafayilo, ndichifukwa chake mafunde omwe akupanga amadutsa mosadukiza. Ziwalo izi zimaphatikizanso tiziwalo timene timatulutsa, komanso chikhodzodzo ndi chikhodzodzo. Munthawi yathanzi, iwo samasiyana mu ultrasound, ngakhale
Kodi kuphwanya kwa kachulukidwe kachulukidwe kungayambitse chiyani?
Zikondamoyo zimachita mbali yofunika kwambiri pakudya chimbudzi. Amatulutsa chimbudzi chomwe chimaphwanya chakudya kukhala mankhwala osavuta. Izi gawo lamkati lamkati ndilofunika kwambiri pakapangidwe ka shuga m'magazi, chifukwa limapangitsa kuchuluka kwa glucagon ndi insulin. Ngati kupanga kwa mahomoniwa kuchepetsedwa, ndiye kuti izi zingayambitse matenda ashuga. Chifukwa chake, kusamalira gawo ili laobisika lamkati sikuli kofunikira kuposa kwa mtima kapena chiwindi.
Mwa munthu wathanzi, kapangidwe kake ka zikondamoyo ndi yunifolomu komanso popanda mawanga amdima.
Kapangidwe kabwino ka kapamba kamene kamayambitsa kusintha kwa mawonekedwe ake. Mu pancreatitis yovuta kapena yovuta, kuperewera kwa echenicity (kupindika kwa echo) kumachitika.
Kuphatikiza apo, kuwunika kwa thupi kungasokonezeke chifukwa cha:
- kudzikuza,
- kuchuluka kwa mpweya,
- matenda oopsa a portal
- kupezeka kwa calcification,
- kukhalapo kwa chotupa.
Ndikofunika kuyang'anira kusinthika kotheka kwa kuchuluka kwa gland. Ngati sichinachuluke, koma echogenicity ichulukitsidwa, ndiye izi zitha kuwonetsa kuwonekera kwa matenda monga lipomatosis. Nthawi zambiri, zimachitika mwa anthu achikulire omwe ali ndi matenda ashuga.
Kuchepetsa kuchepa kwa kapamba kumawonetsa hyperplasia - kuchuluka kwambiri kwa maselo amoyo chamoyo kapena chiwalo. Matendawa pawokha siowopsa, koma angayambitse zotupa za m'matumbo.
Iron imatha kuchepa kukula ngati kapangidwe kake kasokonekera ndi maselo olumikizana a minyewa, omwe amatsogolera pakukula kwa fibrosis. Matendawa amatha kuchitika kwa odwala omwe ali ndi vuto lalikulu la metabolic kapena omwe adachita pancreatitis.
Anthu onse ali ndi mitundu yosiyanasiyana ya kapamba. Komanso, imatha kusintha moyo wonse. Dokotala amatha kudziwa kuchuluka kwa ziwalozi, koma sikuti ndizokhazikika.
Refleclication imakhudzidwa ndi chilakolako, mtundu wa zakudya zomwe amakonda, moyo kapena nyengo.
Chifukwa chake, madokotala samapanga mayankho omaliza, pokhapokha pokhapokha pakuwonetsa kuchuluka kwa ziwalo. Akatswiri akufuna zomwe zimayambitsa minyewa ya heterogeneity, kutembenuka, mawonekedwe a mawonekedwe kapena zotupa. Mwachitsanzo, mawonekedwe osakanikirana amisempha omwe apezeka limodzi ndi kuwonjezeka kwa kukula kwa tinthu timene timayambitsa mndandanda wa matenda omwe angakhalepo.
Zoyenera kuchita ngati echogenicity ili ndi vuto
Kuchulukana kwachulukidwe ka kapamba sikuti nthawi zonse kumabisala kupezeka kwa matenda osasangalatsa. Tiyenera kukumbukira kuti chizindikirochi sichikugwirizana ndipo nthawi zambiri chimasintha. Ngati kapambayu ndi woboola kapena wopanda pake, muyenera kufunsa dokotala wa gastroenterologist. Adzatha kulongosola bwino za vutoli, koma pokhapokha atawunikira zingapo.
Zomwe zimakhazikitsidwa, mutha kupitiliza chithandizo. Pankhani yopeza chifuwa chachikulu, wodwala amafunikira kuchipatala msanga.
Pancreatitis pachimake nthawi zambiri imadzipangitsa yokha kumva popanda kufufuza kwa ultrasound. Zizindikiro zake ndi:
- kupweteka kwambiri m'chiuno,
- nseru
- kusanza
- kutsegula m'mimba
- kutsitsa magazi.
Kuzindikira koteroko nthawi zambiri kumafuna kuchitapo opaleshoni.
Kuchulukitsa kwa chifuwa chachikulu sichimafunikira opaleshoni. Ndi matenda awa, wodwalayo amayikidwa kuchipatala kuchipatala chachipatala chachipatala. Kuchiza kwa wodwala kunyumba ndikosatheka, popeza amafunika kupaka jakisoni m'magazi ndi dontho. Amayenera kupita kuchipatala chonse, kutsatira malamulo okhwima komanso kudya pang'ono.
Choyipa chachikulu kwambiri chomwe kachulukidwe ka kapamba wam'mimba kamatha kuwonetsa ndikukula kwa chotupa. Nthawi zambiri, zotupa zimapezeka mwa akulu akulu azaka zopitilira 60. Kuti muwachotse, pakuthandizira opaleshoni, komanso wailesi ndi chemotherapy amagwiritsidwa ntchito. Kuchepa kwa chithandizo chopambana kumadalira kupezeka kwakanthawi kazizindikiro, kuphatikizapo kuchulukana.
Kusintha kwamphamvu mu pancreatic parenchyma
Zikondamoyo ndi gawo lalikulu lamabisidwe amkati ndi akunja. Ili pa khoma lachiberekero lam'mimba m'mphepete mwa retroperitoneal, ili ndi mutu, thupi, mchira, yokutidwa pang'ono ndi m'mimba kutsogolo. Mukukula kwa kapamba pali kakhalidwe kake komwe kamayendetsedwa kuchokera kumchira kupita kumutu. Iron imatulutsa madzi a pancreatic, omwe amakhala ndi ma enzymes omwe amathandizira kugaya mapuloteni, mafuta, ndi chakudya chamagulu.
Tizilombo ta pancreatic tili ndi tiziwalo tating'ono ta endocrine timene timatulutsa timadzi tambiri totchedwa glucose. Pancreas wathanzi ali ndi minofu yofanana, ma contour akulu. Zomwe zimayambitsa kusinthika kwa kapamba ka pancreatic parenchyma, malinga ndi madokotala, ndimatenda achiwindi komanso osakanikirika a shuga.
Nthawi zambiri, kusintha kwakumaso kwa pancreatic parenchyma kumapezeka ndi anthu okalamba, ndimavuto osiyanasiyana amtima, matenda a chiwindi ndi a biliary, ziwalo zam'mimba. Zomwe zimapangitsa kuti asinthe mu pancreatic parenchyma amathanso kukhala matenda opatsirana komanso otupa a ziwalo zamkati zomwe zimapangitsa kusokonekera kwa metabolic.
Kuchulukana kwachulukidwe ka pancreatic parenchyma
Mukamayesa diagnostics a ultrasound, mutha kudziwa kuchuluka kwa ziwalo zamkati. Ngati kufupika kapena kuchepa kwapadera kwa kapamba kwapezeka, ndiye chifukwa chachikulu chokayezetsa mopitilira muyeso, kupereka chidziwitso cholondola ndikuwona njira zamavuto.
Kuchulukana kwa ecancgenic wa pancreatic parenchyma kumawonekera pakhungu ndi mapangidwe a fibrosis, omwe amayamba motsutsana ndi zovuta za metabolic, pamene minofu ya parenchyma yolimba imalowedwa ndi mafuta, komanso mu pancreatitis yovuta kwambiri komanso kuyambiranso kwa kutupa kosasintha komwe kumasintha kachulukidwe ka parenchyma.
Kukula kwa mayamwidwe cholimba cha ma radiation akupanga kumadalira kuchuluka kowonjezereka kwa parenchyma. Zilonda zopweteka zomwe zimapangidwa mu parenchyma zimakhala ndi mayamwidwe apamwamba a akupanga mphamvu kuposa zotupa zam'mimba.
Kupanga kwa pancreatic parenchyma
Njira zofufuzira pancreatic parenchyma zimaphatikizapo kufunsa wodwala, labotale, njira zothandizira ndi radiology. Kuphatikizika kwa parenchyma kungakhale chifukwa cha matenda osiyanasiyana kapamba.
Zizindikiro zimaphatikizira kupweteka m'dera la epigastric ndikusiya hypochondrium, matenda am'mimba omwe amachititsa kuti munthu asamve bwino, kufooka kwathunthu, kuchepa thupi kwambiri. Njira ndi chikhalidwe cha zakudya, kupezeka kwa cholelithiasis, cholecystitis, cystic fibrosis zimakhudzanso mawonekedwe a mawonekedwe a ziwalo parenchyma.
Kapangidwe kamene kamapangidwa ndi pancreatic parenchyma
Zikondamoyo za munthu wathanzi zimakhala ndi mtundu wopangidwira, zofananira, mawonekedwe owoneka bwino, mawonekedwe owumbidwa, malo olondola komanso kukula kwabwinobwino kwa mutu ndi mchira. Kupatuka kuzizwitsa kumatsimikiziridwa ndi kuwonjezeka kwa kukula kwa magawo a kapamba ndi heterogeneity ya kapangidwe ka minofu yake.
Pancreatic heterogeneity ndi umboni wa matenda osiyanasiyana, kuphatikizapo kapamba ndi shuga. Izi zimatha kupezeka paliponse la chiwalochi. Kusintha kovuta-kosakanikira kumatha chifukwa cha edema, kutupa ndi mapangidwe a pseudocysts.
Kusintha kwina kwamphamvu pancreatic parenchyma
Kusintha kwina kwa ma parenchyma ndi chotsatira cha kutupa kwa kapamba chifukwa cha kupsa mtima kwa chiwindi ndi chikhodzodzo. Izi zimabweretsa kupweteka, dyspepsia komanso kuchuluka kwa shuga m'magazi ndipo zimachitika chifukwa minyewa ya m'magazi yotupa ya m'mimba yomwe imagwira pancreas siyipanga madzi ndi mahomoni okwanira. Chimodzi mwazomwe zimayambitsa kuoneka kwa kusintha kwodalira mu parenchyma kukhoza kukhala kusagwirizana.
Kusintha kovuta mu chiwalo chofunikira kumapangitsa kuti pakhale kusintha kosasunthika komwe kumafalikira mofananamo monse mu ziphuphu popanda kuyang'ana kwawoko kosonyeza neoplasms kapena mapangidwe amwala. Chithandizo cha matenda amtunduwu ndi imodzi mwazovuta za gastroenterology yamakono.
Kuphatikiza kwa mankhwala omwe adapangidwa ndi dokotala komanso zakudya zomwe zimakonzedwa moyenera kumaletsa kukula kwa zovuta zosiyanasiyana. Kumbukirani kuti kufikiridwa kwa dokotala panthawi yake ndikuwonetsetsa kuti akupereka mankhwala ndi chitsimikizo cha mankhwala.
Katswiri wa Katswiri: Pavel A. Mochalov | D.M.N. katswiri wamkulu
Maphunziro: Moscow Medical Institute I. Sechenov, wapadera - "Bizinesi yazachipatala" mu 1991, mu 1993 "Matenda a Ntchito", mu 1996 "Therapy".
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Kodi echostosition ndi echogenicity ndi chiyani
Echogenicity ndi echostructure ndizofunikira pakuwonetsa matenda a kapamba ndi ziwalo zina ndipo amagwiritsidwa ntchito pofotokoza kapangidwe ka zinthu zomwe zaphunziridwazi.
Nthawi zambiri, minyewa ya minyewa yake imakhala yopanda tanthauzo. Nthawi zambiri, kuchuluka kwa ziwalo zitha kutsimikizika motsimikiza, i.e. kutengera zomwe adotolo adachita. Izi ndichifukwa choti muzochita zamankhwala pali zitsanzo zosiyana za miyeso ya akupanga zizindikiro za zimakhala zomwe zikukhudzidwa. Akatswiri a Novice amatha kuwunika kapangidwe kazinthu zomwe zaphunziridwazo ndi kapangidwe kake pamaziko a sikeloyo.
- anechoicity (amawonetsedwa ngati chinthu chakuda),
- chinyengo
- isoechogenicity (iyi ndi nyengo yachilendo ya chiwalo, pomwe ikuwoneka pa polojekiti ngati chinthu chamtundu wowala),
- hyperecho (chinthucho chikhala choyera).
Mlingo wa echogenicity zimatengera zomwe mphamvu ya michere imakhala. Mocheperako amadzimadzi, amakula kwambiri zachilengedwe, komanso mosemphanitsa. Chifukwa chake, zinthu za anechogenic ndizomwe zopanda madzi. Zinthu zama Hyperachogenic zimakhala ndi kuchuluka kwamadzimadzi kwambiri.
Mwa chikhalidwe cha kapangidwe kake, homogeneity imasiyanitsidwa (i.e., zinthu zimakongoletsedwa motsatana) ndi heterogeneity (chiwalo m'chithunzicho ndichopanda utoto wofanana).
Mitundu ya zosintha
Kusintha konse kwa kapamba kumatha kukhala ndi zizindikiro zingapo za ultrasound, kutengera zifukwa zosiyanasiyana. Nthawi zambiri, madokotala amagwiritsa ntchito ultrasound kuti awone kusiyana komwe kumachitika ndi dystrophic kapena metabolic kusintha kwa chiwalo. Izi zimachitika ndikuphwanya magazi, kukanika kwa ma ducts a bile, etc.
Kapangidwe kamene kamasinthasintha kamatha kuonekanso ndi kusintha kokhudzana ndi zaka mu kapamba. Chiwalo chimachepetsedwa kukula kwake, ndipo gawo lina limasinthidwa ndi minofu yolumikizana ndi adipose. Ganizirani mitundu ya zosintha kapangidwe ka kapamba.
Echogenicity inakula pang'ono komanso kwambiri.
Kusintha kwa kuchuluka kwa minofu ya limba kungawonetse kukula kwa matenda. Koma nthawi zambiri zimatha kuwonetsa kugwira bwino ntchito kwa thupi.
Ngati pali madera omwe ali ndi kuchulukana kwambiri, nthawi zonse chimakhala chizindikiro cha chisa cha matenda. Hypoechoic foci kulibe.
Kuchulukana modekha kumawonetsa kuti zinthu zomwe zasintha zitha kupezeka mu gland:
- Pseudocists. Awa ndimapangidwe omwe amakhala ndi madzimadzi mkati. Kukula pambuyo pachimake kutupa. Mtambowo umakhala wowoneka bwino, nthawi zina umakhala ndi notches. Pali kuwonjezeka kwapadera kwa echogenicity.
- Kukhalapo kwa kapangidwe kokhazikika ka cystic kumadziwika ngati palibe madzi m'magulu omwe apezeka.
- Mawebusayiti. Amadziwikanso kuti calcifying. Amapangidwa chifukwa cha matenda otupa, ndipo amapezeka mu kusintha kwazovuta m'thupi.
- Kupezeka kwa madera okhala ndi minofu ya adipose. Kuwonongeka kwamafuta kwamapangidwe kumawonedwa chifukwa cha kuchuluka kwa thupi chifukwa cha kunenepa kwambiri komanso ngati wodwala amadya zakudya zamafuta ambiri. Nthawi zambiri kusintha koteroko kumachitika munthu akaledzera.
- Madera ofanana amawoneka pomwe maselo abwinobwino kulibenso, chifukwa amasinthidwa ndi minyewa yolumikizana. Nthawi zambiri, masamba a fibrosis amapanga ndi pancreatic necrosis. Kukula kwa mapangidwe ndi kakhalidwe.
- Kupezeka kwa miyala mumiyala.
- Pancreatic minofu kuwonongeka. Ndizotsatira za chifuwa chachikulu chodwala.
- Ma tumor omwe amawoneka chifukwa chofalikira kwa metastases.
Kuchulukana kwambiri
Kuphwanya komanso kuwonjezeka kwakukula kwa kapangidwe ka gland kamasonyeza kuti chithupsa champhamvu chimayamba mkati mwake. Wodwala wotere amafunikira chithandizo chamankhwala kuchipatala chakuchita opaleshoni. Kutupa kwachimbudzi ndi vuto lanu.
Hyperechoogenicity yowonjezera kwambiri imatha kuwonetsa ntchito yogwira mu michere. Izi zikutanthauza kuti minye yolimba ya kapamba imasinthidwa mwachangu ndi minofu yolumikizana.
Hyperechoogenicity yayikulu imadziwikanso ndi matenda a shuga, makamaka mtundu wodalira insulin, komanso odwala okalamba. Matenda oopsa a portal amatsogolera pakusintha kwodziwika muzizindikiro za ultrasound, i.e. kuchuluka kwa mavuto m'mitsempha yama portal. Izi nthawi zambiri zimabweretsa chakuti echogenicity imachulukitsidwa kwambiri.
Nchiyani chomwe chingapangitse kuti iye apange mapangidwe a kapamba?
Kuchulukana kwachulukidwe ka pancreatic kamayang'aniridwa pazinthu zam'magazi:
- Lipomatosis Izi zikutanthauza kuti gawo la chiwalo limalo m'malo mwa adipose minofu. Kukula kwa kapamba ndizabwinobwino. Munthawi imeneyi, munthu samva chilichonse.
- Edema yomwe imayamba ndi kutupa kwamphamvu kwa minofu. Mkhalidwe wamtunduwu nthawi zonse umakhala limodzi ndi kupweteka kwambiri, kutsegula m'mimba, ndi kusanza.
- Tumors Munthu amawona zizindikiro monga kuchepa thupi kwambiri, kufooka, kusowa kudya, komanso kusokonezeka kwa chopondapo. Zizindikiro zomwezi zimachitika pomwe chiwalo chadzaza ndi cysts.
- Pancreatic necrosis ndimatenda omwe amayenda ndi chiwonongeko ndi kufa kwa minofu ya kapamba. Pa ultrasound, madera a pancreatic necrosis amawonetsedwa kuti ali ndi mawonekedwe a hyperechoic. Ndi pancreatic necrosis, kupweteka pamimba kwambiri, nthawi zambiri odwala amakhala ndi nkhawa. Kuboweka m'malo otere ndikosapeweka, munthu amatupa kwambiri.
- Matenda a shuga Ngati zomwe zimayambitsa matendawa zili mu kusintha kwa chiwalo cha autoimmune, ndiye kuti nthawi zambiri zimachepera kukula.
- Fibrosis ndikupanga minofu yolumikizana. Kapangidwe ka minofu yoterezi sikungafanane. Vutoli limayamba chifukwa cha kutupa.
Kuphwanya kwachulukidwe kazinthuzo kungakhale kwakanthawi. Imadziwonekera yokha chifukwa cha:
- yotupa
- ambiri matenda opatsirana - fuluwenza, chibayo, matenda a meningococcal,
- kusintha kwa zakudya
- kusintha kwadzidzidzi m'moyo wa wodwala,
- chitukuko cha gastritis, cholecystitis ndi zina zofunika kugaya chakudya,
- chakudya chamadzulo chamatope.
Kuwonjezeka kwakanthawi kwa echogenicity kumawonedwanso ndikusintha kwa nyengo - kasupe, nthawi yophukira.
Pa ultrasound, mutha kuzindikira mawonekedwe azidziwitso a heterogeneity ya kapangidwe kake:
- Mukutupa pachimake, ziwalo pazenera ndizowala, masamba ake ndi osagwirizana. Chifukwa cha ntchito yotupa yoyipa, kapamba amakula kwambiri.
- M'matenda osachiritsika, kukula kwamtundu wamunthu kumadziwika, polojekiti sikowala ngati pancreatitis yovuta. Kapangidwe kake ndi kosangalatsa, nthawi zina kopangidwa mwaluso.
- Ndi fibrosis, chiwalo chimachepa pang'ono kukula. Nthawi zambiri imawonedwa ngati yoperewera, modabwitsa.
- Ndikusintha kwokhudzana ndi zaka ngati lipomatosis, gland imakhala yopanikizika. Dokotala amati kusintha kosintha kwakukulu mu tiziwalo timene timatulutsidwa.
Zizindikiro
Dziwani mawonekedwe ophatikizika a ziwalo ndi ultrasound.
Iyi ndi njira yosavuta, yopweteka komanso yopanda vuto yomwe imathetseratu kusokonezedwa ndi thupi ndipo siyimayenderana ndi kuwunikira kwa radiation (monga zimachitika pa radiology). Kuyeserera kumachitika pogwiritsa ntchito ma ultrasound. Amadutsa momasuka m'matumbo onse ndipo amawonetsedwa. Chomvera chimatenga ma ray osinthika kale, ndipo pulogalamu yapakompyuta yapadera imasinthira iwo kukhala fano, lomwe limawonetsedwa pazenera.
Wodwala ayenera kugona pamsana pake ndikuwonetsa matumbo ake. Gel yochepa kwambiri yopanda vuto imagwiritsidwa ntchito pamalo omwe anayesedwa, omwe amasintha ndikusunthira ndikuletsa kupangika kwa thovu. Ngati wodwalayo ali wathanzi, ndiye kuti mukapanikiza pa chiwalocho palibe ululu. Munthu akayamba kutupa, ndiye kuti kusuntha kotere kumayambitsa kupweteka.
Masiku atatu pamaso pa mayeso, wodwalayo asamachotsere menyu zonse mbale zomwe zimapangitsa kuti pakhale matumbo am'mimba. Ngati pali mipweya yambiri, ndiye kuti zotsatira za diagnostic ndizolondola. Kuti muchepetse kuchotsa mpweya, munthu ayenera kugwiritsa ntchito mankhwala apadera.
Kuunika kumayikidwa pamimba yopanda kanthu. M'mawa pamaso pa ultrasound, ndikofunikira kuti musadye chilichonse. Kuphatikiza pa kuyezetsa magazi pa kapangidwe ka chiwalo, wodwalayo amapatsidwa kuyesa kwamwazi wamagazi, kuyerekezera kapena maginidwe amatsenga. Ngati sikotheka kuyerekeza tomography, ndiye kuti wodwalayo adayikidwa radiology. Mtundu wotsirizira wa kufufuzidwa nthawi zambiri umaperekedwa kuti akutsimikiziridwa kuti akupanga kusintha koopsa.
Chithandizo cha sakanikira kapamba kapangidwe kake
Kuchiza kumatengera kuzindikiritsa. Pamaso pa chifuwa chachikulu cha pancreatitis, katswiri amapereka mankhwala okhwima (kwa masiku angapo). Ndikofunika kusiya mowa.
Monga adanenera dokotala, mankhwalawa amagwiritsidwa ntchito kupondereza Reflex Refresh. Awa ndi mapiritsi a Motilak kapena Cerucal. Kuti muchepetse kupweteka kwambiri, ndikofunikira kutenga antispasmodics. Woopsa milandu, chithandizo cha matenda opatsirana pancreatic angasonyezedwe.
M'malo mankhwala
Ndi kapamba ndi zina za ma kapamba, limodzi ndi kusintha kapangidwe ka chiwalo, mankhwalawa alowa m'malo. Amakhala m'lingaliro lakuti wodwalayo adakonzekereratu kukonzekera komwe kumalipirira kuchepa kwa michere yam'mimba. Pancreatin kapena Creon amagwiritsidwa ntchito kwambiri. Ndikofunikira kuwatenga kwa nthawi yayitali.
Pochiritsira, othandizira a insulin omwe amadalira matenda a shuga angathenso kumvetsetsa. Jakisoni woterewa amalimbikitsidwa moyo wonse.
M'masiku oyamba pambuyo povulaza pachimake kapamba, achire mankhwala ndi mankhwala. Kenako chakudyacho chimakula pang'ono. Kuphatikiza apo, ndi mawonekedwe osungika, chakudya No. 5 chikuwonetsedwa.
Maziko azakudya izi ndikuti zinthu zonse zomwe zimatsogolera pakupanga kwa asidi zimachotsedwa kwathunthu pamenyu. Muyenera kusankha maphikidwe omwe sagwiritsa ntchito zonunkhira. Wodwala mosamalitsa amakhala moledzera, komanso moyo wonse.
Zolemba mwa ana
Mu mwana, heterogeneity ya kapangidwe ka parenchyma imatha kuphatikizidwa ndi zotupa kapena kuperewera kwa puloteni. Potengera zomwe zidachitika pamenepa, mwana nthawi zambiri amakhala akuwopseza kwambiri ziwalo.
Chifukwa chopanga kwambiri madzi a m'mimba, minyewa ya glandular ya chiwalochi imavutika. Izi zimakhudza maumbidwe: kuwonjezeka kwa ziwalo kumaonekera pa polojekiti.
Chithandizo cha pachimake matenda a pancreatic mu ana amachitika mu chipatala chokha. Pancreatitis pachimake ndi owopsa kwa mwana.
Kupewa
Pofuna kupewa kusintha kapangidwe ka kapamba, ndikofunikira:
- idyani pomwe
- Pewani kudya kwambiri,
- pewani kuphatikiza zakudya zamafuta ndi mowa,
- pewani zakudya zambiri musanagone,
- kusiya kusuta
- kuthetsa mowa,
- kuchita masewera
- osamadya zakudya zomwe ndizowopsa papangidwe ka tinthu tambiri: maapulo, marinade, zakudya zokazinga, nyama zofunikira.
Gastroenterologist adzapereka malangizo omveka bwino pazakudya komanso kulondola kwa mankhwalawa.
Kodi kuchulukitsidwa kwa zinthu zachilengedwe kumatanthauza chiyani?
Kuchulukanso kosasinthasintha kwa mafunde kwamphamvu kukusonyeza kuphatikizika kwa mafunde ndi kuchepetsa kuchuluka kwa madzimadzi mmenemo. Diffuse hyperechoogenicity, zomwe zimayambitsa zinthu zakunja, sizimatengedwa ngati matenda. Nthawi zambiri, imadziwonekera nthawi yotentha, itatha kudya chotentha komanso chakudya chochuluka, nthawi yachisanu.
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Echogenicity imachulukana kwambiri ndi kutupa. Zovuta zimatha kuphatikizira: zotupa, metastases, calcium calcium ndi miyala, cysts, fibrosis. Makonda oterewa amachitika chifukwa chonyalanyaza zizindikiro zoyambirira za kapamba.
Pancreatitis pachimake ikuwonetsedwa ndi magawo angapo:
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- Kuchulukana kwamitundu yambiri.
- Kukhalapo kwa malo akulu achilengedwe.
- Kukula kwa kapangidwe kake.
- Kuchuluka kwa gland duct m'lifupi.
- M'malire opanda pake.
Mtundu wowopsa wa matendawa umaphatikizapo kusintha kwa milingo ndi milingo ya ziwalo zoyandikana. Mapangidwe a Pseudocyst ndi otheka.
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Mukazindikira matenda a kapamba, chithunzi chotsatirachi chimadziwika:
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- Kuchulukana pang'ono pang'ono.
- Kutalika kwa duct kumawonjezeka kuposa 2 mm.
- Kukula kwa kutulutsa palokha kukukula.
- Zosachita bwino.
- Kapangidwe kazambiri.
- Pali thukuta lomwe limatuluka m'mimba.
Matendawa amatha kutsagana ndi kupangidwa kwa miyala. Mu chithunzicho akuwonetsedwa mawanga ndi mawonekedwe a echogenic. Matenda opita patsogolo amawonekera mosavuta chifukwa cha kupendekera kwakukulu pakuwonjezeka kwa kukula kwa tinthu tating'onoting'ono ku Wirsung duct. Zotsirizirazi zimasefukira kwambiri m'lifupi.
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Magawo monga kuchuluka echogenicity ndi blurrity wa contour zikusonyeza kuti maselo athanzi m'thupi amakhala m'malo mwa mafuta maselo, zomwe zimachitika ndi lipomatosis. Hyperachogenicity limodzi ndi kuchepa kwa kapamba kumawonetsa kukula kwa fibrosis. Kukula kwa minofu yolumikizana ndi kusintha kwa maselo ena abwinobwino nako kumayendera limodzi ndi mawonekedwe a zipsera.
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Kuti mudziwe wodwalayo molondola, njira imodzi ya ultrasound sikokwanira. Wodwalayo amatumizidwa kuti akathandizidwe njira zowathandizira: maginito a resonance kapena compact tomography, laparoscopy kapena biopsy.
p, blockquote 19,0,0,0,0 -> Chithunzi chopepuka cha kapamba chikuwonetsa kuchuluka kwa echogenicity
Heterogeneity yamapangidwe
Mwa munthu wathanzi, minofu ya pancreatic ndi yopanda pake, yosalala bwino, yopanda tanthauzo. Echostform imachulukirachulukira mosakhazikika ndi chifuwa chachikulu, chifuwa ndi zotupa.
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Acute interstitial pancreatitis nthawi zambiri imapezeka kwa anthu omwe amamwa mowa kwambiri komanso zakudya zamafuta. Ali palpation, amamva kuwawa. Zizindikiro zosasangalatsa zimagwirizanitsidwa ndi kutupira kwa ndulu. Pempho kwa dokotala limatha kukhala madandaulo a munthu wopondera pamimba.
p, blockquote 21,0,0,0,0 -> Kukula kwa mapangidwe ake kukuwonetsedwa ndi mivi (malo oyera ndi amdima).
Kupweteka kwambiri kumanzere kapena kumanja kwa hypochondrium kumachitika ndi chifuwa chachikulu. Nthawi zina kuchuluka kwa matendawa, wodwalayo amakhala ndi malungo, kuphwanya magazi, kusintha khungu ndi sclera (yellowness). Wodwalayo amakhala ndi nkhawa chifukwa chokhala ndi mseru nthawi zonse, kusanza, kusowa kudya. Kuphatikiza pa kuperewera kwa vuto la kuperewera kwa zakudya m'thupi, matenda otsatirawa angakhudze kukula kwa kapamba:
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- Cholecystolithiasis.
- Kulowerera kwa zilonda.
- Vuto la chiwindi.
- Masamba (nyongolotsi).
- Matenda a typhoid ndi typhoid.
- Mowa.
Pali okonda zakumwa zoledzeretsa zambiri pakati pa amuna, motero mwayi wokhala ndi pancreatitis yayitali kwambiri m'magulu aanthu ndiwopamwamba kuposa azimayi.
Chifukwa chiyani kupatuka kuli koopsa?
Kunyalanyaza pancreatitis kumatha kukulitsa chiwopsezo chatsopano cha kutupa. Kuphatikizidwa kwa matenda kumakhudza mkhalidwe wamba waumoyo wa anthu. Kuwonetsera kovuta kwa zovuta ndi kulumala.
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Ngati chithandizo cha matendawa sichinayambike koyambirira, ma enzyme a pancreatic amalowa m'magazi ndikupanga zikhalidwe za matenda a ziwalo zina. Yankho lomweli limapeza matenda angapo:
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- Hepatic ndi aimpso kulephera.
- Kutulutsa magazi m'mimba ndi matumbo, kukokoloka, zilonda.
- DIC-syndrome (kusokonezeka kwa magazi).
- Purulent necrotic parapancreatitis.
- Chovala chowopsa.
- Hepatosis ya chiwindi.
- Cholangitis, cholecystitis.
- Mimba.
Gland parenchyma necrosis imayamba zotupa ndi ma cysts. Mitundu yoyipa imakonda kupezeka mwa akulu. Kuchepa kwachilendo, kusowa kwa chakudya, kupweteka pamimba ndi zizindikiro zazikulu za matendawa. Kuchepetsa mwayi wa zovuta zotere kumangoyenera nthawi yake.
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Momwe tiyenera kuchitira
Dokotala wazachipatala amatha kupereka tanthauzo lenileni la mawu akuti "echogenicity". Poyamba, adzatsimikizira kulondola kwa mtundu wa ultrasound, kupatula kuwonetseredwa kwa kuphatikizika kwa mapangidwe a gland.
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Chithandizo ndi mankhwala atazindikira chifukwa cha hyperechoogenicity. Kusanthula kowonjezera ndi maphunziro zimathandizira kumveketsa. Ndi kanthawi kochepa, munthu amakumananso ndi ultrasound yachiwiri.
Potsimikizira mtundu uliwonse wa kapamba, wodwalayo akulimbikitsidwa kugonekedwa. Kutengera ndi kuwopsa kwa matendawa, amatha kuuzidwa: antispasmodics, antisecretory mankhwala, pancreatic Enzymes, mavitamini. Ndikofunikira kuti wodwala azitsatira zakudya zoyenera. Ngakhale magawo ochepa kwambiri azakudya zokazinga, zosuta komanso zamafuta amatha kuwonjezera chithunzithunzi cha zizindikiro zosasangalatsa. Pansi pa choletsa kotheratu mwa odwala ndi mowa.
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Mitundu ikuluikulu ya kapamba amachiritsidwa opaleshoni ya laparoscopy. Anthu omwe ali ndi thanzi labwinobwino amalimbikitsidwa kuti azikawona ma sanatoriums omwe amagwira matenda am'mimba.
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Ngati kuchuluka kwa echogenicity kumalumikizidwa ndi kukhalapo kwa zotupa mthupi, wodwalayo atha kutumizidwa ku chemotherapy ndi radiotherapy. Chithandizo chimasankhidwa kutengera mtundu wa mapangidwe a endocrine.
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Kaya chikhalidwe cha echogenicity, ndikukayikira pang'ono pazotsatira za kuyesa kwa ultrasound, muyenera kufunsa dokotala wodziwa ntchito. Chofunika kwambiri pankhani imeneyi ndi nthawi yofikira. Kuchiza kungayambitse zotsatira zabwino ngati atapangidwa koyambirira. Nthawi zambiri, kuti muchepetse kutupa, ndikokwanira kugwiritsa ntchito mankhwala okha.