Zikondamoyo zamunthu > Matenda a shuga

Zikondamoyo zamunthu (lat. páncreas) - chida cham'mimba, cholocha chachikulu kwambiri, chomwe chimagwira ntchito zina. Ntchito ya exocrine ya chiwalo imadziwika ndi chinsinsi cha madzi a pancreatic omwe ali ndi michere yam'mimba. Popanga mahomoni, kapamba amatenga gawo lofunikira pakukhazikitsa mafuta, mafuta ndi metabolism ya protein.

Zofotokozera za kapamba zimapezeka zolemba za akatswiri akale. Chimodzi mwazomwe amafotokozera pancreas amapezeka mu Talmud, pomwe amatchedwa "chala cha Mulungu." A. Vesalius (1543) motere akufotokozera kapamba ndi cholinga chake: "pakatikati pa mesentery, pomwe magawidwe oyamba amitsempha yamagazi amapezeka, ndimatumbo lalikulu lomwe limathandiza mokhazikika kukhala nthambi yoyamba komanso yofunika kwambiri yamitsempha yamagazi." Pofotokoza za duodenum, Vesalius amatchulanso za glandular body, yomwe, malinga ndi wolemba, imathandizira ziwiya za m'matumbo awa ndikumamwetsa mkati mwake ndi chinyezi chomata. Zaka zana pambuyo pake, duct wamkulu wa kapamba adafotokozedwa ndi Wirsung (1642).

Cancreas ndiye gwero lalikulu la ma enzymes a kupukusa mafuta, mapuloteni ndi chakudya - makamaka trypsin ndi chymotrypsin, pancreatic lipase ndi amylase. Pancreatic secretion ya maselo a duct imakhala ndi ma bicarbonate ion omwe amatenga gawo la acidic gastric chyme. The pancreatic secretion amadziunjikira m'magulu am'magazi, omwe amaphatikizana ndi duct yayikulu, yomwe imatseguka mu duodenum.

Pakati pa lobules inalowa m'magulu angapo a ma cell omwe alibe ma ducts - otchedwa. zilumba za Langerhans. Maselo a Islet amagwira ntchito monga endocrine glands (endocrine glands), kumasula glucagon ndi insulin, mahomoni omwe amawongolera kagayidwe kazinthu, mwachindunji m'magazi. Ma mahomoni awa ali ndi vuto lina: glucagon amawonjezeka ndipo insulin imatsitsa shuga.

Ma enzymes a Proteolytic amasungidwa ku lumen wa acinus mu mawonekedwe a zymogens (ma proenzymes, mitundu ya enzymes) - trypsinogen ndi chymotrypsinogen. Akatulutsidwa m'matumbo, amayamba kupezeka ndi enterokinase, yomwe imapezeka m'matumbo a parietal, omwe amachititsa kuti trypsinogen, isanduke kukhala trypsin. Trypsin yaulere imakokomezeranso ena onse a trypsinogen ndi chymotrypsinogen kumitundu yawo yogwira. Kapangidwe ka ma enzymes mu mawonekedwe osagwira ndikofunikira kwambiri polepheretsa kuwonongeka kwa enzymatic ku kapamba, yemwe nthawi zambiri amawonedwa ndi kapamba.

Hormonal malamulo a exocrine pancreatic ntchito amaperekedwa ndi gastrin, cholecystokinin ndi secretin - mahomoni opangidwa ndi maselo am'mimba ndi duodenum poyankha kusokonezeka, komanso chinsinsi cha madzi a pancreatic.

Kuwonongeka kwa kapamba ndizowopsa. Kuboola pancreatic kumafuna chisamaliro chapadera mukamachita.

Chikondamoyo cha munthu ndi chopindika chokhala ndi imvi ndipo chimakhala m'mimba kumbuyo kwa m'mimba, moyandikana ndi duodenum. Chiwalochi chili chapamwamba pachipupa chakumaso kwa khomo lam'mimba pamimba, malo omwe ali mozungulira matupi a I-II lumbar vertebrae.

Kutalika kwa thumbo la munthu wamkulu ndi 14-22 cm, m'lifupi ndi 3-9 cm (m'dera la mutu), makulidwe ake ndi masentimita 2-3. Unyinji wa chiwalowo ndi pafupifupi 70-80 g.

Mutu Sinthani

Pancreatic mutu (kapamba kapamba) moyandikana ndi duodenum, yomwe ili m'mphepete mwake kotero kuti yotsirizira imaphimba ndulu mu mawonekedwe a khola la akavalo. Mutu umalekanitsidwa ndi thupi la kapamba ndi poyambira pomwe mitsempha ya portal imadutsa. Kuchokera pamutu imayamba yowonjezera (santorinia) pancreatic duct, yomwe imatha kuphatikizika ndi duct yayikulu (mu 60% ya milandu), kapena imayendera yokha mwa duodenum kudzera duilla ya duodenal papilla.

Sinthani Yathupi

Thupi la kapamba (Corpus pancreatis) ili ndi mawonekedwe a patatu (patatu). Imasiyanitsa mawonekedwe atatu - kutsogolo, kumbuyo ndi pansi, komanso m'mbali zitatu - kumtunda, kutsogolo ndi m'munsi.

Pamaso pake (thambo lakunja) yoyang'ana kutsogolo, kumbuyo kwa m'mimba, ndi pang'ono m'mwamba, kuchokera pansi imakhazikitsa malire okutsogolera, ndipo kuchokera kumtunda - kumtunda. Pamaso pa thupi la chithaphako pali chipolopolo moyang'anizana ndi cham'maso bursa - cham'mphepete.

Kumbuyo (mandala omaliza) moyandikana ndi msana, m'mimba msempha, infa vena cava, celiac plexus, kumanzere impso. Kumbuyo kwa tinthu timeneti timakhala timitanda tomwe timadutsa m'mimba mwake. Mbali yakumbuyo imakonzedwa kuchokera kutsogolo ndi m'mphepete lakuthwa komwe ma spellic artery amadutsa.

Pansi pansi (mandulo otsika) zikondamoyo zimayang'ana kutsogolo ndi kutsogolo ndipo zimalekanitsidwa kumtunda ndi kumbuyo. Ili m'munsi mwa mizu ya mesentery ya transverse colon.

Sinthani Matayala

Mchira wa kapamba (cauda kapamba) ili ndi mawonekedwe ofanana ndi mawonekedwe a peyala, wokhala kumanzere ndi kumtunda, imafikira ku zipata za ndulu.

Kupindika kwakukulu (Wirsung) kwa kapamba kumadutsa kutalika kwake ndikumalowa mu duodenum komwe kumatsikira papillor yayikulu ya duodenal. Duct ya bile yodziwika bwino imaphatikizana ndi pancreatic ndikutseguka m'matumbo amodzi kapena apafupi.

Kapangidwe ka Microscopic Sinthani

M'mapangidwe ake, ndimapangidwe ovuta a alveolar-tubular. Kuchokera pamtunda, limba limakutidwa ndi kapisolo wochepa thupi wolumikizika. Chopanga chachikulu chimagawika pakati, komwe kumakhalapo zingwe zolumikizana, kuphatikizira zimbudzi, mitsempha yamagazi, mitsempha, komanso mitsempha ya ganglia ndi matupi a lamellar.

Zikondazo zimaphatikizapo zigawo za exocrine ndi endocrine.

Exocrine Part Sinthani

Gawo lazopanda pancreas limayimiridwa ndi ziphuphu zakumaso zomwe zimakhala m'mabowo, komanso kakhalidwe kakang'ono ngati kamtengo kamene kamagwira: ma ducts oyanjana komanso okhala ndi ma fuluwenza, ndipo, pamapeto pake, wamba pancreatic ductkutsegulira ku lumen kwa duodenum.

Pancreatic acinus ndimapangidwe ndi gawo la chiwalo. Mwanjira, acinus ndi wozungulira wozungulira ma 100-150 maikuloni kukula kwake, komwe kuli gawo lachinsinsi mu kapangidwe kake ndipo kulowetsedwakupereka dongosolo lonse ducts wa limba. Acini ili ndi mitundu iwiri ya ma cell: chinsinsi - exocrine pancreatocytes, kuchuluka kwa 8-12, komanso kokhala - maselo a epithelial.

Zilowezo zodzitchinjiriza zimadutsanso mbali zina, zomwe zimayendera mbali zikuluzikulu. Zotsirizazo zimapitilizabe kukalowa m'magulu am'magazi, omwe amatuluka mumayendedwe wamba a kapamba.

Endocrine gawo Sinthani

Gawo lakumapeto kwa kapamba limapangidwa ndi ma pancreatic islets omwe ali pakati pa acini, kapena zisumbu za Langerhans.

Zisumbu zimapangidwa ndi maselo - insulocytesmwa omwe, pamtundu wa kukhalapo kwa granules zamankhwala osiyanasiyana amthupi ndi morphological, mitundu isanu yayikulu imadziwika:

Kuphatikiza apo, njira za immunocytochemistry ndi ma electros microscopy adawonetsa kupezeka kuzilumba za maselo ochepa omwe ali ndi gastrin, thyroliberin ndi somatoliberin.

Zilumbazi ndi masango owumbika omwe amalumikizidwa ndi makina amakono a mizere yolumikizidwa mwamphamvu yopanga masango kapena zingwe za maselo owoneka bwino. Maselo amayenda kuzungulira kwa zilumbazi m'magawo, poyanjana ndi ngalawa, ma endocrinocyte ambiri amalumikizana ndi sitimayo kudzera mu njira za cytoplasmic kapena oyandikana nawo mwachindunji.

Kupereka kwa magazi Sinthani

Kuthira magazi kwa kapamba kumachitika kudzera m'mitsempha ya pancreatoduodenal, yomwe imachokera kumtundu waukulu wamitsempha yamagazi kapena kwa chotupa cham'mimba (nthambi za celiac thunthu la m'mimba aorta). Mitsempha yapamwamba kwambiri ya mesenteric imapereka mitsempha yotsika ya pancreatoduodenal, pomwe gastroduodenal artery (imodzi mwa nthambi zomaliza za hepatic artery) imapereka mitsempha yapamwamba ya pancreatoduodenal. Mitsempha ya nthambi yolumikizana ndi minyewa yothandizirana ndi minyewa yolumikizirana minyewa imapanga maukonde olimba omwe amayenda mozungulira kuzungulira acini ndikulowera timabowo.

Kukutulutsa kwa venous kumachitika kudzera m'mitsempha ya pancreatoduodenal, yomwe imalowa mumtsempha wa splenic yomwe imadutsa kumbuyo kwa gland, komanso zowonjezera zina za mitsempha ya portal. Mitsempha ya portal imapangidwa pambuyo pakuphatikizika kwa mesenteric apamwamba ndi splenic mitsempha kumbuyo kwa thupi la kapamba. Nthawi zina, mitsempha yotsika kwambiri imalowa mumtsempha wa splenic kumbuyo kwa kapamba (mwa ena, imangolumikizana ndi mtsempha wapamwamba wa mesenteric).

Ma capillaries a Lymphatic, kuyambira mozungulira ziphuphu ndi timadzi tating'ono, timayenda m'mitsempha ya m'mimba yomwe imadutsa pafupi ndi mitsempha yamagazi. Lymph imatengedwa ndi ma pancreatic lymph node, omwe amakhala 2-8 pamphepete mwachindunji cha gland pamalo ake kumbuyo ndi kumbuyo kwake.

Kukula kwa kapamba ndi zaka

Kasitomala amakula kuchokera ku endoderm ndi mesenchyme, mluza wake umawonekera sabata lachitatu la embryonic limapangidwa ngati khoma lamatumbo a embryonic, pomwe mutu, thupi ndi mchira zimapangidwa. Kusiyanitsa kwa primordia kukhala mbali ya exocrine ndi intracecretory kumayamba kuyambira mwezi wa 3 wa embyogeneis. Ma dini a acini ndi ma excretory amapangika, zigawo za endocrine zimapangidwa kuchokera ku impso pamakoma am'mimba ndipo "zimatsitsidwa" kuchokera kwa iwo, ndikupita kuzilumba. Zotengera, komanso ma minyezi amtundu wa stroma, zimapangika kuchokera ku mesenchyme.

Mwa makanda, kapamba ndizochepa kwambiri. Kutalika kwake kumasiyana kuyambira 3 mpaka 6 cm, kulemera - 2,5-3 g, gland imakhala yocheperako poyerekeza ndi akulu, koma imakhazikika pang'onopang'ono kukhoma lam'mimba ndipo limayenda mosavuta. Pazaka zitatu, kuchuluka kwake kumafika magalamu 20, mwa zaka 10-12 - 30 g. Mitundu yamtundu wa achikulire, chitsulo imatenga zaka zapakati pa zisanu ndi zisanu ndi chimodzi ndi zisanu ndi chimodzi. Ndi m'badwo, mu kapamba pamakhala kusintha pa ubale pakati pa mbali zake za exocrine ndi endocrine pakuchepa kwa kuchuluka kwa ma islets.

Ntchito zazikulu

Chikhansa ndi chiwalo chomwe chili m'mimba. Ndi gawo la chimbudzi ndipo chimapanga zinthu zofunika zomwe zimathandizira kuphwanya chakudya. Awa ndi mahomoni ndi ma enzyme. Kansa ndi imodzi mwazinthu zazikulu za endocrine system, chifukwa mahomoni ake, omwe amalowa m'magazi nthawi yomweyo, amatenga gawo lalikulu la chakudya chamafuta, mafuta ndi protein.

Malo

Kodi kapamba mwa anthu ali kuti? Kodi chifukwa ninji matenda onse a chiwalochi, makamaka zotupa ndi njira za khansa, amapezeka mofulumira? Chifukwa chiyani kukula kwa kapamba sikungatsimikizike pa phunziroli? Zonsezi ndichifukwa chakuti ili mkati mwakuya kwam'mimba, chifukwa chake zotupa zingapo zamkati sizikhala paliponse. Izi zikufotokozera chifukwa chake ambiri mwa zizindikiro za khansa ya chiwalo chija samawoneka mpaka chotupa chikukula kwambiri zomwe zimakhudza kugwira ntchito kwa tiziwalo tokha kapena ziwalo zina zapafupi, monga m'mimba, matumbo ang'onoang'ono, komanso chiwindi.

Zikondamoyo, zomwe zimakwana 25 kutalika, zimakhala kumbuyo kwa m'mimba.

Amawoneka bwanji?

Zikondazo zimaphatikizapo mutu, thupi ndi mchira. Miyeso ya kapamba ndi motere: m'litali - 18-25 masentimita, m'mlifupi - kuchokera 3 cm pamutu mutu ndi 1.5 cm m'dera la mchira. Kodi zikondamoyo zili kuti mwa munthu, zikufanana bwanji ndi ziwalo zina molingana ndi malo ndi ntchito yake - dokotala wa opaleshoni kapena gastroenterologist angakupatseni yankho lomveka bwino pafunso ili. Akatswiriwa amathana ndi matenda a chofunikira chija cha thupi.

Kapangidwe kamkati ka kanyengako ndi kamphindi, momwe imapangidwira mwachidwi ndi nsomba, yomwe imakhala mozungulira pamimba. Mutu ndiye gawo lowonda kwambiri, lagona kumanja kwa mimba, pafupi ndi pomwe m'mimba umadutsa gawo loyambirira la matumbo aang'ono - duodenum. Apa ndipamene chyme - chakudya chophatikizidwa pang'ono chomwe chimalowa m'matumbo kuchokera m'mimba, chimasakanikirana ndi msuzi wa kapamba.

Thupi limakhala kumbuyo kwa m'mimba, ndipo mchirawo umachoka m'mbuyo ndipo umalumikizana ndi ndulu, impso kumanzere ndi adrenal gland.

Pali danc ya pancreatic yomwe imayenda kuthamanga kwa kapamba kuyambira mchira kupita kumutu. Amasonkhanitsa ma ducts ochokera m'magulu onse a minyewa yam'mimba. Mapeto ake amalumikizidwa ndi bile duct, kuchokera ku chiwindi ndikupereka bile ku duodenum.

Kapangidwe ka mkati ka kapamba

Pali mitundu iwiri yayikulu yamatumbo yomwe imapezeka mu kapamba: exocrine ndi endocrine. Pafupifupi 95% ya minyewa ya m'matumbo ndi minofu yotulutsa madzi, yomwe imapanga ma enzymes othandizira kugaya. Kuchita zakudya mwachizolowezi sikungatheke popanda kapamba wogwira ntchito bwino. Mulingo wa kupanga juwisi ndi pafupifupi lita imodzi tsiku lililonse.

5% ya kapamba ndi mazana mazana a ma cell a endocrine omwe amatchedwa islets of Langerhans. Maselo osakanikirana awa amatulutsa mahomoni ofunika omwe samangoyang'anira chinsinsi cha katemera, komanso amawongolera shuga.

Zimabala chiyani?

Kodi kapamba amatani? Ma Enzymes, kapena madzi otayira opangidwa ndi chiwalochi, amafunikira m'matumbo ang'onoang'ono kuti apitirize kuwononga chakudya atachoka m'mimba. Gland imapangitsanso mahomoni monga insulin ndi glucagon, ndikuwatulutsa m'magazi kuti athe kutsimikiza kuchuluka kwa shuga kapena shuga m'thupi.

Zikondazo zimatha kupanga zinthu zoyenera panthawi yoyenera komanso m'njira yoyenera kuti tigaye bwino chakudya chomwe timadya.

• trypsin ndi chymotrypsin - pakugaya mapuloteni,

• amylase wokhoza kugwetsa chakudya,

• lipase - yakuwonongeka kwamafuta kukhala mafuta acids ndi cholesterol.

Minofu ya endocrine ya kapamba, kapena zisumbu za Langerhans, imakhala ndi maselo angapo omwe amapanga mahomoni mwachindunji kulowa m'magazi. Insulin ndi timadzi timene timatulutsidwa ndi timaselo ta beta ta ndulu chifukwa cha kuchuluka kwa shuga m'magazi. Mahomoniwa amathandizanso kupulumutsa shuga ku magazi kupita ku minofu ndi minyewa ina kuti azitha kugwiritsa ntchito ngati mphamvu. Kuphatikiza apo, insulin imathandizira kuyamwa glucose ndi chiwindi, ikusunga mu mawonekedwe a glycogen ngati thupi lifunika mphamvu mukapanikizika kapena kuchita masewera olimbitsa thupi.

Glucagon ndi timadzi tomwe timatulutsidwa ndi ma alpha a gland pakakhala kuchepa kwa shuga m'magazi. Ntchito yake yayikulu ndikuphwanya glycogen kukhala glucose m'chiwindi. Mkuluyu amayamba kulowa m'magazi kuti akonzenso shuga kukhala yabwinobwino.

Matenda akulu

Pali matenda ochepa a kapamba: kapamba, zotupa ndi khansa.

Kupweteka kwakukuru pancreatic nthawi zambiri kumalumikizidwa ndi pancreatitis pachimake.Mulimonsemo, nkovuta kuzindikira ndikuwunika mkhalidwe wa chinthuchi, ngati mukudziwa komwe kapambayu ali mwa anthu. Zizindikiro zina za kapamba zimaphatikizira jaundice, khungu lotupa, ndi kuchepa thupi kosafotokozedwa, kuchuluka kwa kapamba ndi maphunziro owonjezera. Ngati mukumva kupweteka m'matumbo, funsani dokotala. Matanthauzidwe enieni akuti "pancreatitis" ndikutupa kwa chiwalo pamene ma enzymes amayamba kugaya kapamba payokha. Itha kukhala yovuta kwambiri kapena yopweteka, koma mitundu iwiri yonseyi imayenera kupezeka ndi nthawi, chifukwa izi zitha kubweretsanso mavuto ena azaumoyo.

Matenda a kapamba

Matendawa amatupa kwakanthawi (masabata opitilira atatu) a kapamba, zomwe zimapangitsa kuti zowonongeka zake zonse zichitike. Chimodzi mwazinthu zodziwika bwino ndi kugwiritsa ntchito moledzera mosiyanasiyana kapena mankhwala osokoneza bongo. Pali zifukwa zina zomwe zimayambitsa matenda a pancreatitis pachimake. Amatha kukhala cystic fibrosis, kuchuluka kwa calcium kapena mafuta m'magazi, kufalikira kwa duct ya bile ndi miyala kapena chotupa, komanso vuto la autoimmune.

Zizindikiro zake zimaphatikizira kupweteka kwam'mimba, nseru, kusanza, kuchepa thupi, komanso mafuta am'mimbamu. Zinyumba zoterezi, kapena cholembera, sizimawoneka mpaka zopitilira 90 peresenti ya ziwalo zapanyumba ziwonongeka.

Pancreatitis yantchito imafuna kudya kwamafuta ochepa komanso kusiya kumwa ndi kusuta. Ngati pancreatitis yosachiritsika singachiritsidwe, ndiye kuti imayamba kuwonjezeka pakapita nthawi, ndipo mankhwalawa azingofunikira pothandizidwa ndi ululu. Chithandizo cha pancreatitis chotere chimatheka pokhapokha: izi ndi zodetsa kapena kuchotsa mutu wa chifuwa chifukwa chakuti zotupa zambiri zimakhalamo.

Pali kulumikizana pakati pa chifuwa cham'mimba, khansa yamatumbo kwambiri. Kafukufuku waposachedwa awonetsa kuti kuwonjezeka kwa khansa ya kapamba kumawonjezera nthawi 2-5 mwa odwala omwe ali ndi chifuwa cham'mimba ndikuphatikizira pazinthu zosiyanasiyana.

Zimakhala zovuta kudziwa matenda oyambira. Tsoka ilo, zizindikiro za khansa zimatha kukhala zosamveka: kupweteka kwam'mimba, jaundice, kuyabwa kwambiri, kuchepa thupi, nseru, kusanza, ndi zovuta zina zam'mimba. Pancreas yokulitsidwa imapezeka kokha ndi ultrasound ndi MRI.

Ndizosatheka kudziwa kusintha kwa kapamba chifukwa chakuti chinthucho sichingatheke palpation. Ngakhale zotupa, monga lamulo, sizingamveke ndi kukhudza. Chifukwa chovuta cha kupezeka koyambirira komanso kufalikira kwa khansa, matendawo nthawi zambiri amakhala osavomerezeka.

Zomwe zimayambitsa kukhazikika kwa oncology ndi: kusuta, shuga wa nthawi yayitali komanso chifuwa chachikulu cha pancreatitis. Njira ya oncological nthawi zambiri imayamba m'maselo omwe amapanga timadziti tam'mimba, kapena m'maselo omwe amakhala m'mizere. Nthawi zina, njira ya oncological ya kapamba imayamba m'maselo omwe amapanga mahomoni. Kuti adziwe khansa, madokotala nthawi zambiri amachita mayeso a zachipatala, kuyezetsa magazi, kuyeretsa, endoscopy, ultrasound, ndi biopsy. Zosankha zochizira zimaphatikizapo opaleshoni, ma radiation, ndi chemotherapy kuti iwononge mwadala maselo a khansa popanda kuvulaza minofu yabwinobwino.