Momwe mungaphunzirire zaumoyo wa kapamba

Zakudya zopanda pake, kudya kwambiri mowa ndi kusuta fodya, mankhwala osagwiritsika ntchito samabweretsa kufa nthawi yomweyo. Amayambitsa matenda owopsa kapena otupa, ndipo nthawi zina chotupa, zimachitika mu kapamba, ndipo zimayambitsa matenda ashuga. Ndi okhawo omwe, popanda kudikirira kuti muwone ngati pali zoopsa zilizonse, amadziwa momwe angayang'anire kapamba angatenge nthawi pakupewa komanso kupewa zovuta zazikulu za kapamba. Tiyeni titsegule chophimba chachinsinsi.

Mfundo za Mayeso a Pancreatic

Dziwani za kapamba ayenera kukhala wokwanira: muyenera kudziwa zambiri osati za kapangidwe ka chiwalo, komanso ntchito zake. Tiyeni tifotokoze chifukwa chake.

Pancreas ndimatumbo akuluakulu okhala ndi mawonekedwe apadera ndi ntchito zake. Ndiamene amakhala ndi gawo lofunikira pakukonza chimbudzi, kupanga ma michere ofunikira kuti magazi awonongeke komanso zinthu zina, kamodzi m'magazi, azidyetsa maselo. Insulin imapangidwa mu gland iyi, yomwe imathandizira gawo lalikulu lamphamvu - glucose - kupereka mphamvu ku maselo ndi minyewa. Ma mahomoni ena amapangidwamo.

Kutikako kumakhala pamalo opezekera kumbuyo kwake, kutsogolo kwake kuli m'mimba, m'matumbo opatsirana ndi duodenum, komanso impso mbali zonse ziwiri. Mkati mwa chiwalo, ma ducts amadutsa omwe amatenga madzi a kapamba omwe amakhala ndi ma enzymes ochokera ku maselo a glandular. Zimayenderera mu duct imodzi yayikulu, yomwe imatseguka mu duodenum.

Ngati tinthu tina tambiri touluka tawonongeka, minofu yotsalayo idalowa m'malo mwake, ndipo palibe chizindikiro cha matendawa. Nthawi yomweyo, zinthu zitha kuchitika malo ochepa kwambiri akamwalira kapena kuwonongeka, izi sizikuwoneka pamapangidwe a gawo lonse la chinyezi, koma zimayendera limodzi ndi kusintha kwa mawu mu ntchito ya chiwalo. Ichi ndi chifukwa chake kuwunika kwa kapamba kuyenera kukhala kokulira, ndikufotokoza zonse za kapangidwe kake ndi ntchito yake.

Laborator diagnostics

Kuyesedwa kwa ziphuphu kumazindikira mkhalidwe wa ziwalo. Zilonda zam'mimba za kapamba, kuchuluka kwa michere yomwe amapanga imadziwika. Ena mwa iwo ndi othandiza kudziwa m'magazi, ena mkodzo, ena ndowe. Kuti mudziwe kukula kwa chotupa, Zizindikiro za ntchito za chiwalo chokhudzana ndi kapamba - chiwindi - zimayesedwanso.

Kuzindikira kapamba kumaphatikizapo mayeso otsatirawa:

1. Kuyesedwa kwa magazi konse: Mmenemo, ndi kupweteka kwambiri kapena kuchuluka kwa nthawi yayitali, kuwonjezeka kwa leukocytes, stab ndi neutrophils magawo, ESR imadziwika.
2. Kusanthula kwa biochemical kwa magazi: kuwonjezeka kwa milirubin yambiri komanso mwachindunji - yokhala ndi mawonekedwe a pancreatitis (pomwe ALT ikuwonjezeka pang'ono), kuwonjezeka kwa mulingo wa gamma globulins, seromucoid, sialic acid.
3. Pancreas enieni magazi:
   • magazi alpha-amylase (chizenera chake ndi 16-30 g / l pa ola),
   • kutsimikiza kwa trypsin (ntchito yake idzaposa 60 μg / l),
   • magazi lipase (adzachulukitsidwa kuposa mawalo 190 / l),
   • shuga wamagazi - idzaonjezereka (kupitirira 6 mmol / l) mukakhala mukutupa kapena kuwonongeka kwa endocrine (islet) gawo la kapamba.

Chenjezo! Mitundu ya enzymatic ntchito imatha kusiyanasiyana pang'ono molingana ndi ma labotoreti osiyanasiyana.

M'mbuyomu, kusanthula kwakukulu komwe kumagwiritsidwa ntchito pofufuza matenda a pancreatic anali pancreatic amylase, enzyme yomwe imapangidwa ndi thupi. Mu pachimake ndi kuchulukitsa kwa kutupa kwa gland, kuwonjezeka kwa ntchito ya enzymeyi kumadziwika m'magazi - pamwamba pa 30 g / l pa ola limodzi ndipo mkodzo (pamenepo amatchedwa "mkodzo wa diastasis") - pamwambapa magawo 64 / l pa ola limodzi. Ndi imfa ya malo a pancreatic - pancreatic necrosis, sclerosing pancreatitis - pali kuchepa kwa zochitika za amylase m'magazi (pansi pa 16 g / l paola) ndi mkodzo (pansipa 10 U / l).

Mpaka pano, njira yayikulu yothandizira labotale yowonongeka kwa kapamba ndi enzyme elastase, yomwe imatsimikiziridwa mu ndowe. Pankhani ya kuchepa kwa gland ntchito, ntchito ya pancreatic elastase imakhala ndi zochepa zosakwana 200 μg / g, pakavulaza kwambiri ziwalo - zosakwana 100 μg / g.

Chenjezo! Kuyesa konse kwa magazi kumachitika pamimba yopanda kanthu, koma mayeso ena a kapamba amafunikira kukonzekera. Mfundoyi iyenera kufotokozeredwa ngati sichoncho ndi dokotala, ndiye ndi ogwira ntchito mu labotale omwe mumakonzekera kufufuza.

Mayeso a labotale

Nthawi zina, ndikofunikira kuchita mayeso ena osati pamimba yopanda kanthu, komanso pambuyo pobweretsa zinthu zina mthupi - mayeso opsinjika.

Pali mayeso amtundu wotere:

1. Mayeso a Glycoamylasemic. Kukhazikika kwa magazi amylase kumatsimikiziridwa, pambuyo pake munthu ayenera kumwa 50 g shuga, pambuyo pa maola atatu kuwunika mobwerezabwereza kwa amylase. Ndi pathology, pambuyo pa maola atatu pali kuwonjezeka kwa enzyme iyi kuposa 25% kuchokera pamlingo woyamba.
2. Kuyesa kwa Proserin. Kukhazikika koyamba kwa mkodzo diastase kumatsimikiziridwa, pambuyo pake mankhwala "Proserin" amayamba. Ndiye, theka lirilonse la maola 2, gawo la diastase limayezedwa: nthawi zambiri limakwera osaposa nthawi 2, koma kenako limabweranso kwazonse. Ndi mitundu yosiyanasiyana yamatenda a pancreatic, zizindikiro zosiyanasiyana zimatsimikizika.
3. Mayeso a Iodolipol. Podzuka, wodwalayo akodza, kenako amatenga mankhwala "Iodolipol" mkati. Ndipo mu ola limodzi, theka ndi theka, ayodini. Kuzindikira kwamatenda a pancreatic kumadalira ntchito ya lipase enzyme yopangidwa ndi chiwalochi. Nthawi zambiri, pakangotha ​​ola limodzi, ayodini amayamba kupezeka mumkodzo, ndipo kuchuluka kwake kwa mkodzo kumakulirakulira - m'chigawo chimodzi cha mkodzo pambuyo pa maola 2,5.
4. Kuyesedwa kwa Secretin-pancreosimine. Zimakhazikika pakusintha kwazomwe zimapangidwira zomwe zili mu duodenum pambuyo pokhazikitsidwa kwa chinthu chokhala ndi mahomoni ngati cellin (zimapangitsa secretion yowonjezera ya pancreatic juwisi wokhala ndi ma bicarbonate ndi ma enzyme kulowa m'matumbo).
5. Kuyesa kwa glucose ndikofunikira kuti muzindikire kuwonongeka kwa pancreatic endocrine. Potere, kuthamanga kwa shuga m'magazi kumatsimikiziridwa, ola limodzi ndi awiri atatha kuyamwa kwamkati. Kusanthula kumeneku kumayikidwa ndi endocrinologist yekha, ndipo amawatanthauzira, popeza pamakhala chiopsezo cha zovuta zomwe zimakhudzana ndikuwonjezereka kwa kuchuluka kwa magazi a carbohydrate yosavuta iyi.

Kafukufuku wamagulu

Kafukufuku wa kapamba amatengera zomwe zimachitika minyewa: sizikuwoneka pakuwunika pafupipafupi kwa x-ray, koma ndowe za nduluzo zimatha kupimidwa ndikuwunika, ndikuwonetsera kusiyana. Iron imapezeka kuti ipimidwe ndi ultrasound, ndipo dopplerography imatsimikiza kutuluka kwa magazi m'mitsempha yake. Dongosolo lakatundu wa CD limawonetsetsa momwe limapangidwira m'magulu, koma mphamvu yake yamagalamu ndi yabwino kwambiri kudziwa gawo laling'ono kwambiri la chiwalo. Tiyeni tiwone chilichonse mwadongosolo.

Njira za X-ray

1. Kufufuza kwa radiology kumakupatsani mwayi wowona minyewa yaying'ono, calculi yayikulu mumizere yake.
2. Endoscopic retrograde cholangiopancreatography - kukhazikitsidwa kwa njira yosiyanitsa ndi X-ray kuzungulira ma gland kuchokera ku duodenum pogwiritsa ntchito zida zamagetsi zomwe zimapangidwa ndi fibrogastroscopy.
3. Angiography yosankha ndi kuwunika kwa X-ray pamatumbo a gland pambuyo pothandizidwa ndi wotsutsana naye.
4. Dongosolo la tomography yomwe imagwiritsidwa ntchito pakuthandizira kuzindikira chotupa ndi njira zotupa mu gland.

Njira iliyonse yoyeserera imafunikira kukonzekera kwa wodwalayo.

Kuyesa kwa Ultrasound

Njirayi si yolondola monga yowerengera tomographic, koma chifukwa chosavuta komanso chitetezo, ndizofunikira pakuwunika koyambirira kwa matenda a gland pathologies. Ultrasound imakupatsani mwayi kuwona m'matumbo owopsa komanso otupa, zotupa, ma abscesses, cysts, Doppler ultrasound imathandiza kwambiri pakuyang'ana koyambirira kwa magazi. Njirayi imafunikira kukonzekera kusanachitike. Pazomwe mungachite kuti zotsatira za phunziroli ndizodalirika, tafotokozera m'nkhaniyi: Kukonzekera kwa ultrasound mu matenda a kapamba.

Magnetic resonance imaging

Kuyerekezera kwa NMR ndiyo njira yophunzitsira bwino kwambiri yofufuza zofufumitsa, zomwe zimawona bwino minyewa yazigawo m'magulu. Mukaphatikiza MRI ndikumayambitsa kusiyana pakati pa ma ducts (cholangipancreatography) kapena mitsempha yamagazi (angiography), kudalirika kwakukulu pakuphunzira kwa kapamba kumatheka.

Zizindikiro za pancreatic MRI ndi izi:

• tinthu tating'onoting'ono tating'ono,
• matenda a chiwindi
• kapamba
• kukonzekera opaleshoni yachitsulo,
• monga ziwalo zochizira pakhungu.