Matenda a kapamba

• CHAKUDYA CHAKUDYA: kuchuluka kwa zakudya zamafuta, kuchepa kwa mapuloteni muzakudya,

• MITUNDU YOSAVUTA: Kuledzera

• ZINSINSI ZOTHANDIZA: matenda am'mimba, G ndi duodenum, mumps, virpatitis hepatitis B, Metabolic ndi mahomoni okhudzana ndi zinthuzo (hyperparathyroidism), kuvulala kwa pancreatic.

Kuchepetsa zakudya, khungu lowuma, lauvi, kuchepa - kutalika kwa nthawi yayitali pancreatitis kapena khansa ya kapamba

• Zojambula pakhungu pakhungu ndi mucous nembanemba ndi kufooka kapena kutulutsa khungu - ndi mawonekedwe a pseudotumor aakulu kapamba kapena chotupa cha mutu wapa pancreatic.

• Khungu la pakhungu lomwe limakhala ndi cyanosis - pachimake pancreatitis chifukwa cha kupuma komanso kuzungulira kwa magazi (chifukwa cha kuledzera kwambiri)

• Kuuma ndi kulocha kwa lilime, kusalala ndi kuwoneka kwa papillae, kununkhira kosasangalatsa, ming'alu ndi zilonda m'makona amkamwa (cheilitis), aphthous stomatitis.

• Mimba imakulitsidwa voliyumu - chifukwa cha kusefukira.

• M'mimba, pachifuwa, ndi zochepa pamsana - zimafotokozedwa momveka bwino kakang'ono kakang'ono kakang'ono kwambiri kamene kamafika pamwamba pa khungu - chizindikiro cha "m'malovu ofiira"

• Khungu loyera khungu la zikondamoyo.

• Nthawi zina - atroph of subcutaneous fat in epigastrium - m'dera lolingana ndi kuchuluka kwa kapamba pa khoma lakunja kwam'mimba khoma (chizindikiro cha Grott).

• Chizindikiro cha Kerte - chokhala ndi ululu wam'mimba kwambiri - kukhumudwa komanso kusokonezeka kwa minyewa yam'mimba m'chigawo cha epigastric, nthawi zina m'chigawo cha hypochondrium kumanzere kapena pamalo omwe akuwonetsedwa kwa kapamba (mu pancreatitis yayikulu).

• ndi palpation mwakuya odwala matenda kapamba ndi chotupa, kapamba amatha kupaka ziphuphu mu mawonekedwe a zingwe zopweteka, zosagwirizana.

• kupweteka kwa gawo la choledochopancreatic la Shoffar, lomwe lili epigastrium kumanja - kuphatikizidwa kwa mutu wa pancreatic mu pathological process

• Zowawa pamunsi pa Desjardins (mtunda wa 6 cm kuchokera ku navel pamzere wolumikizidwa kuchokera ku navel kupita ku axillary patsekeke).

Zowawa palpation kudera la Shoffar komanso pamalo a Desjardins -

Nthawi zambiri ndi mawonekedwe a cholepancreatitis ndi pseudotumor ("mutu") wa CP, popeza amafanana ndi kutulutsa mutu kwa kapamba.

• Chizindikiro chabwino cha kasinthidwe kakang'ono ndi kuchepa kwa zowawa pamalo a Mayo-Robson pomwe wodwala atembenukira mbali yakumanzere.

Zowawa zomwe zimayambitsidwa ndi matenda am'mimba kapena matumbo, pomwe zikukula!

• Ndi kuwonongeka kwa mchira wa kapamba, zilonda zam'mimba zimapezeka pakona yakumanzere ya nthiti (Mayo-Robson II)

Chizindikiro chabwino cha Kacha ndi gawo la cutaneous hyperesthesia m'dera la cutaneous innervation of VIII-X thoracic zigawo, ikhoza kukhala chizindikiro chokhacho cha khansa yapachala yamatenda

• OAK- ↑ ESR, leukocytosis yokhala ndi kosunthira kumanzere

• AK (bioch) -disproteinemia, mayeso abwino a gawo (C-yotakasika mapuloteni, ndi zina) - ndi kukokomeza kwa XP. kapamba

• ntchito ya ↑ amylase m'magazi (kuwonjezeredwa kasanu ndi chizindikirocho kuli ndi vuto lofufuza matenda a CP)

• ↑ trypsin, lipases m'magazi ndi kuchulukitsa kwa CP

• ↑ bilirubin, transaminases (AlAt, AsAT), zamchere phosphatase ndi GGTP

• Kusintha kwa magawo a pancreatic secretion (ma enzyme, ma bicarbonate, voliyumu yamadzuwa) pophunzira madzi a pancreatic musanayambe komanso mutatha kukondoweza ndi secretin ndi pancreosimine.

• Maphunziro a Coprogram: ndi kusowa kwakwanso, kusaka kwa maselo a chiwindi, ndi kupitirira kwa cholerhea ndi amylorrhea.

• Hyperglycemia pamimba yopanda kanthu komanso masana, panthawi yoyesa kuleketsa chakudya - kuleza kwa glucose kapena matenda ashuga.

• Panoramic R-m'mimba patsekeke (zowerengera pamkangano wa kapamba)

• FGDS poyeserera nipple ya Vater (osapatula duodenitis)

• Kuchulukitsa kwa m'matumbo (CT) - ↑ kapena ↓ kukula kwa kapamba, kufalitsa kuchuluka kwa isotopu m'misempha.

• Ultrasound - zambiri za mawonekedwe, makulidwe, mawonekedwe a kapamba.

• Endoscopic retrograde pancreatocholangiography - kusintha kwa pancreatic duct system ndi biliary system (kudziwa kukhazikika kwa stenosis ndi njira zopewera).

Chithandizo cham'mapulogalamu amtundu umodzi ndi njira zolimbikitsira ma angular: Zothandizira za VL - zomangidwa kuti zizisunga mawaya pamalo okwera pamwamba pa nthaka, madzi.

Zambiri zam'mphepete mwa nyanja komanso kumalire kwa gombe: M'matawuni, chitetezo cha banki chimapangidwa poganizira zofunikira zaukadaulo komanso zachuma, koma zimathandizira makamaka pazokongoletsa.

Zolemba zaukadaulo wazachipatala

Odwala omwe ali ndi matenda a pancreatic amatha kudandaula kupweteka m'mimba komanso dyspeptic zizindikiro, kufooka kwathunthu.

Ululu pamimba, wosiyanasiyana pakutalika ndi chilengedwe, umapezeka kuthengo kwambiri, makamaka kumtunda wa epigastric kapena kumanzere kwa hypochondrium, ukugwera kumbuyo. Amatha kukhala pachimake, champhamvu, herpes zoster, ndi zotumphukira ku dera lumbar, lomwe mu pancreatitis pachimake limakhudzana ndi kuphwanya kutulutsa kwa mitsempha kuchokera ku kapamba ndikudziwonetsa ndi ma enzymes awo a protein. Ululu wammbuyo yayitali ndi yodziwika ndi zotupa; nthawi zambiri zimachulukitsa m'malo a wodwalayo kumbuyo, komwe kumakakamiza odwala kuti atenge mbali.

Zizindikiro za Dyspeptic, nseru, ndi kusanza nthawi zambiri zimachitika m'matenda osiyanasiyana amtundu wa kapamba chifukwa cha kusintha kwa ntchito yake ya enzymatic kapena Reflex.

Makina jaundice wokhala ndi khungu loyera Khalidwe lotupa la mutu wa kapamba ndikuphwanya kutuluka kwa ndulu.

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Njira zakuthupi zophunzirira kapamba

Pakufufuza, kutopa, jaundice, ndi mawonekedwe ake pamomwe kukanda, zotupa zimawululidwa. Kuwonongeka kwa kapamba kumakhalabe njira yosagwira. Pokhapokha ngati pali kukulitsa kwina chifukwa cha kuwonongeka kwa chotupa chifukwa cha kuwonongeka kwa chotupa kamene kamatha kuzindikirika.

Njira zowonjezera pancreatic

Ma labotale ndi njira zothandizira zimatha kuzindikira bwino momwe ntchito yowonongeka imayendera mu gland, imayesa ntchito yotsalira ya pancreatic, kuwunika ntchito ya pancreas ndikuwunika mawonekedwe a morphological a gland.

Kuunika kwa X-ray kapamba. Makina amitsempha yamagalasi am'mimba amawuluka. Ndi kuyambitsa kwa barium kusiyanasiyana, zizindikiro zosakhudzana ndi zotupa ndi ma neoplastic mu gawo loyambirira la kapamba zimatha kupezeka, poganizira kusintha kwa mucous nembanemba wa duodenum.

Kuyesa kwa Ultrasound kapamba. Njira iyi yosasokoneza komanso yotetezeka imakupatsani mwayi kuti muwone ma cysts ndi neoplasms mu kapamba, komanso kudziwa kuwonjezeka kwake chifukwa cha edema kapena compaction (fibrosis).

Zolemba pamakompyuta. Odwala omwe ali ndi kunenepa kwambiri komanso kutsekeka m'matumbo, ultrasound nthawi zambiri imakhala yovuta, motero m`pofunika kuti muthe kusanja makina, omwe amakupatsaninso kuwunika kusintha kwa morphological, kuzindikira chotupa, chotupa, chikhazikitso cha kutupa, edema.

Pancreatic Artery Angiography. Kusankha angiography yamitsempha yamagazi yopereka magazi ku kapamba kumathandiza pakuwonetsa zotupa. Zimakupatsani mwayi wochepetsera lumen wa ziwiya ndi kuphwanya udindo wawo. Nthawi zambiri phunziroli limachitika pambuyo pa ultrasound ndi compact tomography.

Endoscopic retrograde cholangiopancreatography. Kafukufukuyu amatenga imodzi mwazida zofunikira kwambiri zowonetsera ma pancreatic ndi biliary ducts. Thupi losiyana ndi ayodini limayambitsidwa mu duct yodziwika bwino kudzera mu endoscope ndipo kenako X-ray imachitidwa, yomwe imalola osati kungoyambitsa zifukwa zowonjezera jaundice, komanso kudziwa kusintha kwa kapamba omwe amadziwika kuti amachititsa kutupa ndi neoplastic. Mu chifuwa chachikulu, matendawa amatha kupunduka, madera ochepera komanso kuwonekera akuwonekera. Pamaso pa chotupa, stenosis yapadera ya duct kapena kutayika kwathunthu ndikotheka.

Pancreatic Radioisotope Examination. Kuwerenga uku kwa kapamba pogwiritsa ntchito methionine yolembedwa ndi radioactive isotope ya selenium, kwakukulu, sikulondola kwambiri kuposa njira zomwe zalembedwera.

Kuwerenga kwa michere ya pancreatic m'magazi ndi mkodzo. Necrosis ya pancreatic minofu chifukwa cha kutsekeka kwa chala cha gland imatha kuwunikira ndikuwonjezera kuchuluka kwa ma pancreatic enzymes m'magazi, mkodzo ndi madzi ena amthupi. Muyezo wodziwika wa ntchito za amylase ndi lipase. Panthawi ya pancreatitis yovuta, ma seramu amylase okwera amapitilira masiku 10 ndipo nthawi zambiri amakhala ndi hyperamilazuria. Kuwonjezeka kwa mankhwala a amylase mu seramu ndi mkodzo kumachitika osati pancreatitis, komanso matenda am'mimbamo, mafuta am'mimba zilonda zam'mimba, kutsekeka kwamatumbo, ndi matenda ena a virus, omwe akuwoneka kuti akuphatikizidwa ndi zotupa zapakhungu.

Chifukwa chakuti amylase amalowa m'magazi osati kuchokera ku kapamba, komanso kuchokera ku tiziwalo timene timatulutsa timayamwa, kuyesayesa pakalipano kukuwonetsa ake isoenzymes. Kugwiritsa ntchito radioimmunoassay, zomwe zimachitika mu seramu yamagazi ya michere ina - trypsin, lipase, elastase - imayesedwa.

Ntchito Yakufufuza Pancreatic. Ntchito ya pocreatic pancreatic imayesedwa pogwiritsa ntchito zolimbikitsa zachindunji komanso zosadziwika. Kukondoweza kwachindunji kumakhala ndi kuperekera kwa mahomoni angapo mahomoni, makamaka secretin ndi cholecystokinin, komanso kuphatikiza kwawo. Kukondoweza kwina kopangidwa ndi kuphatikiza kwa michere. M'magawo onse awiriwa, amagwiritsa ntchito kuchuluka kwa ma pancreatic enzymes - amylase, trypsin, lipase (omwe amagwiritsidwa ntchito ndi secin poyamba amachepetsa pang'ono, kenako amawonjezeka) muzomwe zimakhala, zomwe zimapezeka pofufuza. Njira yowonjezera komanso yofunikira pakuwunikira ntchito ya pancreatic pocrreatic ndikuwerenga ndowe kuti mupeze zomwe zili mumafuta ndi zinthu zomanga thupi m'mapulogalamu.

Kuyeza kochulukirapo kwamafuta omwe amapezeka mu ndowe, komanso chymotrypsin ndi trypsin, amatha kuwona kuchepa kwapang'onopang'ono kwa ntchito ya gland.

Mayeso a kulolera a glucose amalola kuwunika ntchito ya endocrine ya kapamba, yemwe amadwala mu 3/4 ya odwala ndi kapamba kapena chotupa cha kapamba.

Kuwerenga kwa pancreatic ntchito, makamaka exocrine, ndikofunikira kwa odwala omwe ali ndi malabsorption kuti amveke bwino zomwe zimayambitsa matenda awa komanso, makamaka, kuti adziwe gawo la kuchepa kwa ntchito ya pancreatic.

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Zolemba pakuwunika kwa chiwalo

Mukazindikira za kapamba, ndikofunikira kupeza zambiri osati zokhudza kapangidwe kake, komanso za mawonekedwe ogwirira ntchito m'thupi. Chiwalo choterocho chimayimiriridwa m'thupi la munthu m'njira yamtundu waukulu, womwe umakhala ndi kapangidwe kapadera ndipo umachita ntchito zina.

Zikondazo zimagwira ntchito zotsatirazi m'thupi la munthu:

• amatenga nawo gawo logaya chakudya
• amatulutsa ma enzyme omwe amafunikira kuphwanya mafuta ndi mapuloteni kukhala michere
• ndi m'matumbo momwe insulin imapangidwa, chifukwa chake glucose amatha kupereka minofu ndi maselo ndi mphamvu yofunikira
• imagwira mawonekedwe a mahomoni angapo ofunikira kuti thupi lonse lizigwira ntchito

Komwe kuli kapamba mthupi la munthu ndi gawo loyang'ana pang'onopang'ono. Ngati kuwonongeka kwa gawo laling'onoting'ono la minofu ya tinyezi kumachitika, minofu yotsalayo imagwira ntchito yolowa m'malo ndipo nthawi zambiri zisonyezo sizimawonekera. Nthawi zina kutupa kapena kufa kwa gawo laling'onoting'ono kumachitika, zomwe sizikhudza kapangidwe kazinthu zonse. Komabe, izi zitha kupangitsa kuti matenda a kapamba asamagwire bwino ntchito, omwe angakhudze thanzi la wodwalayo. Ndiye chifukwa chake akatswiri amawunikira kufufuza kokwanira kwa kapamba, munthawi yomwe zimatha kuyesa kapangidwe ka chiwalo ndi ntchito yake.

Njira Zofufuzira Ma labotale

Kuwunikira kwa Fecal ndi njira yothandiza yachipatala yozindikira matenda a pancreatic

Kuchita mayeso osiyanasiyana pakuwunikidwa kwa kapamba kumakupatsani mwayi kuti mudziwe momwe dzikolo lilili. Ngati wodwalayo apezeka ndi zochuluka za michere yomwe amapanga, izi zitha kutanthauza kuti anali ndi vuto lotupa.

Magazi, mkodzo ndi ndowe zimatha kugwiritsidwa ntchito kuti mupeze michere yotere. Pofuna kuzindikira kuwonongeka kwa ziwalo, kafukufuku akupangidwa poonetsa momwe chiwindi chikugwirira ntchito, chomwe chimagwirizana kwambiri ndi kapamba. Mukamayesa kapamba, njira zotsatirazi zantchito yantchito zingagwiritsidwe ntchito.

Kuchita magazi pafupipafupi. Zikadachitika kuti wodwalayo ali ndi vuto linalake la matenda kapena matenda akewo akuwonjezeka, ndiye kuti izi zikugwirizana ndi kuwonjezereka kwa izi:

• ESR
• kusuta neutrophils ndi magawo neutrophils
• maselo oyera

Kukhazikitsa kuyesa kwa magazi kwamwazi. Kupita patsogolo mthupi la munthu la kapangidwe ka kapamba, kakulidwe ka bilirubin kokwanira kamawonedwa.

Kanema wothandiza - Pancreas: ntchito ndi matenda omwe angathe.

Kuchita ma pancreatic enieni magazi:

Mimba yopanda kanthu imayikidwa kuti idziwe kuchuluka kwa amylase, lipase ndi trypsin mu duodenal patsekeke. Zitatha izi, yankho la hydrochloric acid limabwezedwa m'matumbo ndipo kutsimikizika kwachiwiri kwa kuchuluka kwa michere kumapangidwa. Ndi kukula kwa kapamba, kuchepa kwakukulu kwa zizindikiro kumawonedwa m'magawo onse.

Kupenda mkodzo pazinthu za amylase ndi amino acid momwemo. Ndi kukula kwa mitundu yosiyanasiyana ya kapamba, kapangidwe kazinthu izi mthupi la munthu amapezeka.

Pulogalamuyi imachitika ndi cholinga chofuna kudziwa kuti wowuma, mafuta, ulusi wamisempha ndi minyewa yopanda tanthauzo yokhala ndi ma enzymes a gland mu ndowe.

Posachedwa, pofuna kudziwa matenda a kapamba, kupenda kunachitika kwa amylase - iyi ndiye puloteni yomwe imapangidwa ndi thupi lokha. Ndi kukula kwa thupi la munthu pachimake komanso matenda mawonekedwe, kuwonjezereka kwa ntchito ya enzyme imeneyi m'mwazi ndi mkodzo kunawonedwa. Zikadachitika kuti wodwalayo adadwala ma pathologies monga pancreatic necrosis komanso sclerosing pancreatitis, ndiye kuchepa kwa ntchito ya amylase mkodzo ndipo magazi adapezeka.

Masiku ano, chizindikiro chachikulu cha ma pancreatic pathologies ndi enzyme elastase, yomwe imatsimikizika mu chopondapo. Ndikofunika kukumbukira kuti kuyezetsa magazi konse kuyenera kuchitika m'mawa, komanso nthawi zonse pamimba yopanda kanthu.Kuphatikiza apo, mitundu ina ya mayeso a labotale imakonzekera kukonzekera kwapadera kwa wodwala, chifukwa chake mawonekedwe awa ayenera kuyang'aniridwa ndi dokotala.

Njira zodziwitsa ena za zida

Ultrasound ya kapamba ndi njira yotchuka kwambiri yodziwira matenda a pathologies

Muzochita zamankhwala, njira zothandizira kupenda ziphuphu zimagwiritsidwa ntchito, zomwe zimatheka kutsimikizira matendawa. Kuphatikiza apo, pogwiritsa ntchito njira zoterezi, ndikotheka kudziwa kusintha kosiyanasiyana kwa kapangidwe ka chiwalocho, kuwunika kukula ndi kapangidwe kake, ndikuzindikiranso mitundu yosiyanasiyana ya ma neoplasms ndi anomalies.

Nthawi zambiri, akatswiri amagwiritsa ntchito njira zotere:

• Kuyang'ana mozama kwa wodwalayo kumakupatsani mwayi kuti muwone kusintha kosinthika, kutulutsa komwe kumakhala chimbudzi cha pancreatic duct ndi duodenum.
• Pancreatic biopsy ndi ma microscopic kuwunika kwa zitsanzo za pancreatic minofu. Pogwiritsa ntchito njira yodziwitsira matenda, ndikotheka kudziwa momwe mankhwalawo amathandizira, kusiyanitsa vuto loipa la neoplasms ndi benign, komanso kudziwa mtundu wa chotupa.
• Endoscopic retrograde cholangiopancreatography imawerengedwa kuti ndi njira imodzi yophunzitsira poyesa kugwiritsa ntchito mwaluso, momwe zingatheke kudziwa kuzungulira kwa milongoyi pazifukwa zotsatirazi: kuwonongeka kwa minofu, kapangidwe ka miyala, mawonekedwe a zotupa ndi mapangidwe a mapuloteni.
• Tomography yophatikizidwa imathandizira kuzindikira ma neoplasms osiyanasiyana ndi ma pseudocysts mu kapamba, komanso kuzindikira njira za atrophic mu chiwalo.
• Endo-ultrasonography imakuthandizani kuti mufufuze mwatsatanetsatane kusintha kwamatumba ndi ma dancts, komanso kudziwa kuwonjezeka kwa kukula kwa ma lymph node.
• Ultrasound imawerengedwa kuti ndi imodzi mwazofala kwambiri pophunzirira kapamba, momwe angathere kudziwa kapangidwe ka chiwalo, kukula kwake, contour, komanso mkhalidwe wa bile ducts ndi ducts. Chifukwa cha njirayi, ndikotheka kufotokozera za kupezeka kwamadzimadzi owonjezera pamimba, zomwe zitha kuwonetsa kusintha kwina: njira yotupa, mapangidwe a miyala, mawonekedwe a cystic, kupweteka kwa minofu, zotupa zamtundu wina komanso kusintha kwokhudzana ndi zaka.

Kuti adziwe zoyenera, katswiri amapereka mankhwala kwa odwala.

Matenda a kapamba

Matenda a kapamba - kapamba: kufotokoza ndi zizindikiro

Matenda a kapamba amasonyezedwa pakupanga njira yotupa, yomwe imatchedwa pancreatitis, komanso nthawi yayitali ya matendawa.

Nthawi zambiri, matenda kapamba amayamba chifukwa cha:

• uchidakwa
• matenda a gallstone

Chimodzi mwa matendawa ndikuti njira yotupa imasokoneza kulowa m'matumbo a ma enzymes omwe amapangidwa ndi kapamba. Zotsatira zake, ma enzymes amathandizira mkati mwa gland yomwe, yomwe imatsogolera ku chiwonongeko chake.

Ndi matenda awa, poizoni amatulutsidwa, omwe amalowa mosavuta m'magazi ndipo amatha kuvulaza ziwalo zina ndi minyewa. Pancreatitis pachimake imawonedwa ngati matenda oopsa omwe amafunikira chithandizo. Ndikofunika kukumbukira kuti chithandizo cha mankhwalawo chikangoyamba, ndiye kuti mwayi wodwalayo ungachiritsidwe.

Pakakhala chithandizo chokwanira, pancreatitis ya pachimake imakhala nthenda yamatenda.

Kupita patsogolo kwa matenda apakhungu pancreatitis m'thupi la munthu kungapangitse kuti pakhale zovuta zingapo, pakati pomwe zowopsa kwambiri ndizo cysts ndi neoplasms yoyipa.

Pakakhala vuto la kapamba, Zizindikiro zotsatirazi nthawi zambiri zimawonekera:

• Matenda a ululu ndi chizindikiro chomwe chimachitika ndi zovuta zosiyanasiyana za kapamba. Zikachitika kuti kapamba amapezeka mu mawonekedwe owopsa, ndiye kuti wodwalayo amakhala ndi nkhawa chifukwa cha ululu waukulu womwe umakhalapo kwa nthawi yayitali. Munthawi yamatenda a matenda, nthawi zambiri kupweteka kwam'mimba sikumatchulika, komanso kumatha kukhalapo. Zomverera zowawa zimayamba mchikakamizo cha zinthu zosiyanasiyana zomwe zimapangitsa kuwonongeka kosatha kwa gland kapena kusokonezeka kwakanthawi. Matenda a ululu amatha kuchitika ndi kapamba komanso kupangika kwa pseudocyst mthupi.
• Chizindikiro chodziwika bwino cha matenda a pancreatic ndi chitukuko cha matenda a tropholoengqondo insufficiency. Chizindikiro chotere chimayamba chifukwa cha zovuta zambiri zam'mimba chifukwa cha kusakwanira kwa michere. Mwachizolowezi, matendawa amayenda limodzi ndi kukula kwa zizindikiro zotsatirazi: maonekedwe a mavuto, masinthidwe oyenda, kuchepa thupi, khungu pakhungu lakuda pamalo opezeka zikondamoyo, kupindika kwa mafuta osunthika kapena kuwonda kwambiri pakhungu ndikuwonekera. imvi.
• Matenda akulu a pancreatic amachititsa kukula kwa exocrine chisokonezo. Zotsatira zakuphwanya kotereku ndi kufa kwa ambiri mwa parenchyma, omwe amachepetsa kwambiri kupanga ma enzyme. Kutsika kwakukulu kwa ntchito ya excretory kumayendetsedwa ndi kuwoneka kwa zizindikiro zotsatirazi: mavuto okhala ndi mawonekedwe am'mimba, kutopa kwambiri kwa thupi komanso kutulutsa.
• Kupita patsogolo kwa matenda a pancreatic kumabweretsa kukula kwake, komwe kumayambitsa kuphatikizika kwa ziwalo zapafupi. Ndi vuto la kufinya ziwalo, wodwalayo amatulutsa jaundice yovuta, kupuma, kusanza, kupweteka kwambiri pakhungu ndi kukonza zonyowa pakhungu lowoneka bwino.

Zikondamoyo zimawerengedwa kuti ndi chimodzi mwazinthu zofunika, chifukwa chogwira ntchito bwino kwa thupi. Pachifukwa ichi, ndikofunikira kuzindikira zopotoka zingapo momwe kapangidwe kake kakugwirira ntchito komanso kogwiritsa ntchito kaja malingana ndi momwe zingathere, zomwe zingapewe kukula kwa zovuta zingapo. Masiku ano, kuyezetsa kapamba kumachitika pogwiritsa ntchito njira zosiyanasiyana zomwe zimathandiza kwambiri ndipo zimakupatsani mwayi wodziwikitsa.

Kufunika kwa kapamba m'thupi

Kasitomala ndi chiwalo chomwe chimakhala m'mimba chomwe chimagwira ntchito popanga zakudya ndikuchita ntchito za endocrine. Amakhala ndi mitundu itatu ya maatomiki: mutu, thupi ndi mchira.

Kutalika kwa kapamba kumakhala kwakukulu. Mutu wake umachokera ku hypochondrium yoyenera, ndipo mchira umatha theka lakumanzere kwa dera la epigastric. Chifukwa chake, ndi njira yotupa, zodziwitsa zowawa zimatha kutulutsidwa pafupifupi pamimba, komanso kukhala ndi mawonekedwe odabwitsa.

Gawo lazopusa la chigawocho limakhala gawo lalikulu la kapamba. Imagwira ntchito yopusa. Chitsulo chimabisa madzi a pancreatic ndi ma enzyme. Izi zimaphatikizapo zinthu monga alpha-amylase, lipase, trypsin ndi chymotrypsin. Iliyonse ya michereyi ndiyofunikira kuti chakudya chisokone, monga mapuloteni, mafuta ndi chakudya.

Gawo la endocrine la chiwalo lili mchira. Chimangokhala dera laling'ono, koma ndikofunikira. Zambiri zakale monga zilumba za Langerhans zimasiyanitsidwa mchira. Amakhala ndi mitundu ingapo ya maselo.

Zomwe zimayambitsa matenda

Zomwe zimayambitsa kutupa ndi:

• uchidakwa
• kugwiritsa ntchito mankhwala ena
• duodenitis ndi zotupa zotupa,
• kuvulala pamimba ndi ziwalo,
• matenda opatsirana - mavairasi a chiwindi, ma mumps ndi ena,
• kagayidwe kachakudya matenda
• matenda aparasitiki,
• zonyansa zotumphukira mu chiwalo kapena ducts,
• matenda a mtima
• kusokonezeka kwa mahomoni
• kugwiritsa ntchito zakudya zopweteketsa (zonunkhira, mafuta, amchere, osuta),
• chibadwa.

Si madokotala okha omwe angayankhe funso la momwe angadziwire zathanzi la kapamba. Kupatula apo, kusintha kwa kutupa m'thupi kumayendera limodzi ndi kupweteka kwambiri ndi mseru. Zizindikirozi nthawi zambiri zimagwirizanitsidwa ndi kumwa m'mbuyomu mowa kapena zakudya zamafuta.

Mowa wa Ethyl ndiye chifukwa chachikulu cha kapamba ndi matenda a chiwindi. Imawononga ma cell a pancreatic, omwe amatsogolera pakupangika kwa michere. Kuledzera kwa nthawi yayitali kumathanso kusintha kusintha kwa mahomoni, makamaka matenda a shuga.

Chifukwa china chopititsa patsogolo matenda a pathologies ndi kuperewera kwa zakudya. Kuzindikira matenda a chiwindi ndi kapamba ayenera kuyamba ndi kafukufuku wodwalayo. Kudya mafuta ochulukirapo kumabweretsa kuti ma enzyme sangathe kuthana ndi katundu. Komanso, mkhalidwe wamthupi umakhudzidwa ndimakonda kudya zakudya zonunkhira komanso zokazinga.

Kodi zizindikiro za kupezeka kwachangu ndi ziti?

Zikondazo sizingamveke zokha kwa zaka, koma izi sizitanthauza kuti limba lidzakhala lathanzi ndipo silisintha. Zizindikiro zoyambirira za njira yotupa zimatha kuchitika ngakhale matendawa atapangapo kapena kubwereranso kwachitika. Zizindikiro za matenda a kapamba omwe tikambirana pansipa.

Ululu mu hypochondrium kapena kupweteka kwa m'chiuno kumatha kuchitika chifukwa cha kutukusira kwa minyewa ya m'mimba. Munthawi yopanda phokoso, ululu umapitilizabe kudzikumbutsa. Mpumulo pang'ono ungadutse ngati wodwala watenga mluza, koma osakhalitsa. Kuchita opaleshoni sikuchotsa vutoli ndipo mukamadya kumangokulira.

Kukhumba kosalekeza kwa mseru ndi kusanza sikungasonyeze kuphwanya kapamba kokhako. Koma ngati mseru umayendera limodzi ndi kupweteka mu hypochondrium, ndiye kuti pali chizindikiro chomveka bwino cha kutukusira kwa England. Zilimbitso zimakulitsa kulimbitsa thupi, kudya komanso kupsinjika.

Zimachitika chifukwa chakuti ma enzyme sangathe kulowa mu duodenum. Mimba siyingathe kuphwanya chakudya popanda chithandizo cha madzi a pancreatic, chifukwa chake imakhala yoteteza ndipo imachotsa chakudya chomwe sichitha kugayidwa,

Kutsekula m'mimba ndi kumatulutsa

Kupsinjika kwa kapamba kumayambitsa dongosolo logaya chakudya. Chifukwa chosowa michere mthupi, vuto lotere limachitika, lomwe limatsatiridwa ndi mpweya komanso m'mimba. Sizipita zokha zokha ndipo zitha kubweretsa vuto lakumadzi,

Ma enzyme akamadzaza mu kapamba ndipo sangathe kulowa m'matumbo, ndiye kuti amayamba kugaya nduluyo. Pakadali pano, poizoni wambiri wochokera kuntchito za ma enzymes amalowa mthupi, zomwe zimapangitsa kuti poizoni wambiri adye. Wodwalayo amamva kufooka kwambiri, chizungulire, kupindika kwambiri,

Ndi edema ya kapamba, amatha kusintha kukula kwake ndikupondereza ziwalo zapafupi. Choyamba, ducts ya bile imavutika, izi zimabweretsa jaundice yovuta. Khungu la munthu limakhala ndi mtundu wachikasu, ngati jaundice, limawonekera kwambiri pamaso ndi manja. Koma chikasu chimatha popanda kutentha.

Zizindikiro zonsezi zikuyenera kukhala ngati pempho kwa dokotala yemwe amayesa kapamba. Ndikofunika kwambiri kumvetsetsa kuti kutupa kwa gland ndi matenda omwe, ngati sanalandiridwe kapena mosayenera, atha kufa.

Kudzimbidwa kwa ndulu kumayambitsa kufa kwa minofu ndikuwopseza ndi peritonitis yam'mimba, yomwe imatha kufalikira ku chiwindi, mapapu, mtima ndi impso. Mukayambiranso, madokotala okha ndi omwe angapereke thandizo labwino lomwe lingapulumutse moyo wa munthu.

“Zikondazo zakula. Sanali kwa dokotala m'modzi. Timawona mahomoni. Kenako adaganiza zokana kupita kwa madotolo pafupipafupi. Mwezi watha, adasiya kusuta, adayamba kuchita masewera olimbitsa thupi, kudya kwambiri kapena pang'ono molondola. Ndipo koposa zonse, ndinayamba kumwa

(Ndamva za iye posamutsa Malakhov). Ndipo dzulo ndidapita ku chipangizo chokonzekereratu, ndipo amandiuza: "Ndipo bwanji usankha kupita kwa dokotala - ulibe ma pathologies." Zikondazo ndizobwinobwino ndipo mahomoni amakhala abwinobwino. Ndinali wokhumudwa kwambiri!

Svetlana Nikitina, wazaka 35.
Nizhny Novgorod

Kuti mukulitse chithunzi, dinani ndi mbewa.

Zizindikiro za matenda a kapamba amawonekera pamitundu yosiyanasiyana:

• kupweteka kwambiri ndi kupweteka kwa hypochondrium yamanzere,
• Nthawi zina mavuto a herpes zoster,
• kusanza ndi kusanza
• malungo
• kutsekula m'mimba, komwe kumatsalira zakudya zosalowetsa ndowe,
• kusowa tulo
• Kuchepetsa thupi
• ukufalikira
• kukodza pafupipafupi.

Matenda aliwonse a kapamba amabweretsa chimbudzi chokwanira cha chakudya, mayamwidwe osayenera ndikuwonongeka kwa zinthu zofunikira mthupi. Izi zimayambitsa zizindikiro zomwe zili pamwambapa, zomwe nthawi zambiri zimakhala zovuta kudziwa poyambira matenda.

Matenda a matenda

Ngakhale kuti zizindikiro za matenda a kapamba ndizofanana ndi chizindikiro cha matenda ammimba ena, dokotala wodziwa ntchito amatha kusiyanitsa. Komanso, kupweteka kwam'mimba, mayeso a labotale ndi othandizawa athandiza ndi izi.

1. Ululu pamimba chapamwamba. Zomverera zosasangalatsa zimaphatikizidwa ndi kudya kwamafuta kapena mowa. Chitukuko chawo chimatengera kuchuluka kwa zowonongeka. Imatha kukhala theka lamanzere la epigastrium, dera lam'mimba, nthawi zambiri kumanja kwa pamimba. Milandu yayikulu, ululu umaphimba kumbuyo, ndiye kuti, imakhala ngati lamba.
2. Khansa ya m'mimba mutatha kudya. Mosiyana ndi ma pathologies ena am'mimba, kusanza ndi kapamba sikubweretsa mpumulo.
3. Kufalikira ndi kusanja. Kuthira kwa zakudya zopanda chakudya kumabweretsa kuchuluka kwa mpweya m'matumbo. Izi zimakwiyitsa kupezeka kwa madandaulo otere.
4. Thupi. Amawonedwa pachimake yotupa ndondomeko ndipo nthawi yowonjezera matenda kapamba.

Ngati zizindikiro zonga ludzu lochulukirapo komanso kukodza pafupipafupi kwapezeka, kuyezetsa magazi kuyenera kutengedwa kuti mupeze kuchuluka kwa shuga. Pancreatitis yotalika nthawi zambiri imabweretsa kuwonongeka kwa zisumbu za Langerhans komanso kusokoneza insulin.

Njira zoyesera

Ndikofunika kudziwa kuti nthawi zambiri kuwunika kofufuza kumakhala ndi njira yokwaniritsira ndi kuwonjezera kwa ma ultrasound, radiology ndi mayeso apadera. Njira iyi imapangitsa kuti athe kuunikanso bwino bwino chiwalocho ndikuwunika ntchito za kapamba.

• njira zofuna kukhazikitsidwa kwa matumbo,
• osati zowonongera komanso zosafunikira.

Njira zoyendetsera bwino ndizophatikiza njira zaposachedwa, popeza palibe zoopsa zikagwiritsidwa ntchito pamaso pa wodwala, komanso mtengo wotsika wa mayeso. Kutengera kuti mungadziwe njira yocheperako ya michere ya kapamba, mayesedwe oterewa sakhala ndi chidwi, choncho ali achindunji, akumapereka chotsatiracho pokhapokha kuchepa kwenikweni kwa chinsinsi chotere.

Gulu lachiwiri la mayeso, lomwe limaphatikizapo njira zoyeserera ndi zopanda mayeso, sizofunikira kuti wodwalayo azindikire. Chisankho chakuzindikira kwa dokotala chimasankhidwa kwa wodwala aliyense payekhapayekha. Ambiri mwa mayeso ndi awa:

• hydrochloric acid
• elastase
• pancreosimine-secretin,
• Kuyesa kwakukulu

Madokotala ambiri akukhulupirira kuti adziwe matenda a kapamba, njira imeneyi ndiye muyezo wagolide. Kuchita izi kumachitika pogwiritsa ntchito fluoroscopy.

Kafukufuku wowonda wowili amaperekedwa kwa wodwala pamimba yopanda kanthu, pomwe chidwi chokwanira chimachitika. Chosalembera cha gastric ndi madzi a duodenal amasonkhanitsa kuchuluka pambuyo pokonzekera kulowetsedwa kwa secretin ndi pancreosimine.

• mulingo wa michere ukuwonjezeka kwambiri,
• kuchepa kwakukulu kwa katulutsidwe komanso kuchuluka kwa ma bicarbonates kumawonedwa.

Malinga ndi kuperewera kwa mphamvu ya enzyme, madokotala amazindikira pancreatitis yayitali. Mayeso a pancreosimine-secretin, pakapezeka bicarbonate alkalinity, wodwala amayenera kutumizidwa ku chipatala cha oncology kuti akalandire.

Kutengera ndi ukadaulo, madokotala amatha kupeza zidziwitso zolondola zodziwikitsa. Komabe, ndi zonsezi, njirayi ili ndi mbali yake yopanda pake, yomwe imakhala pagulu lolemetsa la wodwala, komanso kukwera mtengo kwa matenda komanso zovuta za ntchito yantchito.

Kuyesa kwa hydrochloric acid

Nthawi zina, adokotala amatha kupatsa wodwala mayeso a hydrochloric acid. Zomwe zimagwiritsidwa ntchito, yankho la hydrochloric acid, ndende ya 0,5%, limagwiritsidwa ntchito ngati chothandizira pancreatitis secretion. Wothandizirayo amabailidwa intraduodenally kudzera pa probe; pakupanga, mpendadzuwa kapena mafuta a maolivi amawonjezeranso.

Ubwino wa njira yodziwitsa ndi kuphweka kwake komanso kupezeka kwake. Komabe, kulondola kwa deta yomwe idapezedwa chifukwa chogwiritsira ntchito kumafuna kukhala bwino, mosiyana ndi mayeso a pancreosimine-secretin.

Kuyesa kwakukulu

Kuyesedwa kwa Lund kumaphatikizapo kutola zazing'ono zam'matumbo pogwiritsa ntchito intubation yochita pambuyo podya zakudya wamba. Ndikofunikira kuyang'ana ntchito ya pancreas.

M'mimba yopanda kanthu m'mawa wodwalayo amapatsidwa kafukufuku. Izi zimapangidwa ndi radiopaque polyvinyl yokhala ndi chitsulo kapena mercury pamapeto. Wodwalayo amapatsidwa chisakanizo cha chakudya (mkaka wa mkaka ndi mafuta a masamba omwe ali ndi dextrose).

Kupenda kwamtundu wamtunduwu wa kapamba kumathandizira kudziwa index ya amylase, yomwe nthawi zambiri imayambitsidwa ndi kapamba. Ubwino wa njirayi ndi kuphweka, kupezeka, komanso kusowa kwa jekeseni wamkati.

Mayeso a Elastase

Kuyesedwa kwa elastase poyerekeza ndi mayeso ena osagwiritsa ntchito kumapangitsa kuzindikira kwa endocrine kufooka kwa kapamba kumayambiriro kwa chitukuko. Kuyesedwa kosonyeza kuchepa kwa enzyme kungawonetse kutupira kwakumaso kwa gland.

Kuunika kumeneku, komwe kumayambitsa kupezeka kwa mtundu uliwonse wa kapamba, komanso kudziwa mphamvu ya mankhwalawa, kumaphatikizapo kutsimikiza kwa elastase pampando wa wodwalayo. Kufufuza koteroko kwa ndulu elastase kumathandizidwanso kwa matenda a shuga, matenda a chiwindi ndi cholelithiasis.

Kusiyanitsa mitundu ya pathologies

Asanayambe chithandizo, kufufuzaku kuyenera kupangidwa molondola. Kuti muchite izi, muyenera kufunsa dokotala wa gastroenterologist ndikuyezetsa. Katswiri wokhazikika pamtunduwu ndi yemwe angayese matenda osiyanasiyana a matenda a pancreatic.

Ndikofunikira kuti musiyanitse matenda amodzi kuchokera kwa ena onse omwe ali ndi zofanana. Kutupa kanyumba kamene kamaphatikizidwa ndi kupweteka kwam'mimba komanso matenda am'mimba, cholecystitis, chilonda cha duodenal.

Nthawi zina, kapamba amafanana ndi vuto la mtima. Pankhaniyi, wodwalayo ayenera kupita ku ECG kupatula myocardial ischemia. Popanda vuto la mtima, mayeso a labotale amachitika chifukwa cha kupezeka kwa kapamba.

Ngati ululu umakhala ngati lamba, kapamba ayenera kusiyanitsidwa ndi osteochondrosis ya thoracic msana, aimpso. Munjira yotupa kwambiri, mankhwalawa amayenera kuyamba mwachangu.

Pomaliza

Mzanga adakopa tiyi wa Monastic kuti ayese. Amakhala ndi kapamba - ndipo tangoganizirani, anali atapita! Ngakhale dotolo wake adadabwitsa kwambiri. Kuzindikira kwanga ndiko kutupa kwachifinya. Ndakhala ndikuzunzidwa ndi izi kwa nthawi yayitali. Mapiritsi, otsikira, zipatala zakhala zikuchitika kwa ine pazaka 5 zapitazi. Ndipo masabata awiri okha kuyambira nditayamba kumwa

, ndipo ndamva bwino. Ndikukhulupirira kudabwitsa dokotala tsiku lotsatira.

Elena Shugaeva, wazaka 47
Saint Petersburg

Zikondazo zimafunikira kuthandizidwa mosamala komanso kuyang'aniridwa nthawi zonse. Ndi matenda ake onse, thupi limafunikira thandizo mwachangu, lomwe lingapezeke ngati kuyezetsa kwakanthawi ndi kudziwitsa koyenera kumachitika.

Ndiye chifukwa chake ndikofunikira kuti wodwalayo afunsane ndi dokotala munthawi yake, osadzidziwitsa yekha ndi kulandira chithandizo ndi njira zokayikitsa kunyumba. Ndi dokotala yekha yemwe amatha kudziwa zomwe zimayambitsa ndikuwunika zotsatira zake, komanso kuwunika momwe masinthidwe omwe amapezeka ndi omwe amapezeka.

Kukanda kwa kapamba ndi chiwindi

Kuzindikira matenda a kapamba ndi chiwindi kumayambira ndi mayeso amthupi. Dokotala amawunika momwe khungu limakhalira, amawunika zimagwira pakhungu ndipo amayesa kutentha kwa thupi.

Ndi ma pathologies a hepatobiliary system, kupezeka kwa kukanda kapena kangaude - telangiectasias - kumaonekera pakhungu. Kutupa kwa chiwindi (hepatitis) nthawi zambiri kumayendera limodzi ndi kufalikira kwa khungu ndi khungu. Gawo lazovuta la matenda limatsimikiziridwa ndi kutentha kwambiri.

Pambuyo pakuwunikiridwa pafupipafupi, pamimba pamimba imachitika. Kupweteka pazinthu zina kumawonetsa kuwonongeka kwa kapamba. Wodwalayo amawona kusapeza bwino pamene adokotala akukhudza hypochondrium yamanzere.

Magnetic resonance imaging pamimba

Monga mukudziwira, kulingalira kwa maginito kwakhazikitsa ngati njira imodzi yotetezedwa kwambiri yophunzitsira anthu. Kuphatikiza apo, njirayi siyosasokoneza komanso yopweteka.

Kuthekera kwa kupezedwa kwa MRI kwa matenda a kapamba kumakulirakulira. Phunziroli limakupatsani mwayi kuwona ziwalo zonse zam'mimba zam'mimba, malo awo komanso kapangidwe kake. Pogwiritsa ntchito chosanjikiza cha zikondamoyo, ndikotheka kuwona madera otupa kapena kukhalapo kwa mapangidwe otupa. Kupititsa patsogolo kulingalira, MRI yotsutsana ikulimbikitsidwa.

Chithandizo cha Matenda a Pancreatic

Simungayambe chithandizo nokha. Zodandaula zomwe zikuwonekera, muyenera kulumikizana ndi gastroenterologist kuti mudziwe momwe mungayang'anire kapamba. Mndandanda wa mayeso ofunikira ungaperekedwe ndi katswiri kapena dokotala wamkulu wa opaleshoni.

Ndi kuchulukirachulukira kwa kapamba, mankhwala opha mabakiteriya ndi mankhwala omwe amaletsa kutupa amapatsidwa. Popeza thupi siligwirizana ndi ntchito zake, mankhwala othandizira olimbitsa thupi amafunikira. Izi zimaphatikizapo mankhwala "Pancreatin", "Festal", "Mezim-forte."

Kutupa pachimake kumafunikira kuchipatala mwachangu ndi chithandizo cha opaleshoni. Wodwalayo akayamba kudwala matenda ashuga, timadzi ta mankhwala timene timapatsirana, komanso kudya mosamalitsa kupatula zakudya za chakudya.

Njira zambiri zofufuzira zamankhwala

Kuunika kumayamba ndi kufunsa wodwalayo za zodandaula zomwe zilipo. Pakali pano, ndizotheka kukayikira kuphwanya kapamba, ndipo nthawi zina kudziwa mtundu wawo. Madandaulo ngati kupweteka pamimba, nseru ndi kusanza, matenda am'mimba, komanso zoponderezedwa ndizofunikira.

Zizindikiro za kupweteka zomwe zimadziwika ndi matenda otupa a kapamba ali ndi mawonekedwe. Ululu pamtunduwu umakhazikika pamimba ndipo amakhala ngati lamba. Ululu umatha kukhala wapakatikati kapena wokwera kwambiri, wokwiyitsidwa ndi kudya kwamafuta, mowa.

Ndi zotupa za kapamba, ululu uliwonse kwa nthawi yayitali ukhoza kusakhalapo.

Zovuta zam'mimba zokhala ndi zotupa zam'mimba zimawonetsedwa pakudandaula kwa pafupipafupi, kusintha kosasintha kwake.

Kusowa kwa chakudya, nseru, kusanza, komwe sikubweretsa mpumulo, ndi zizindikiro zomwe zimadziwika ndi kuwonongeka kwa kapamba.

Kuchepa kwambiri kwa chilakolako chofuna kudya, mpaka kudya chakudya, kumatheka ndi khansa ya kapamba. Matenda a tumor a kapamba amathanso kubweretsa kukakamirana kwa ma ducts a bile ndi maonekedwe a jaundice. Mukamayang'ana wodwala, dokotala amatha kuyang'ana kuchepa thupi, kusintha kwa khungu.

Nthawi zambiri, kapamba sayenera kugwiritsidwa ntchito, ndipo pakakhala chotupa kapena kapamba wam'mimba, kupweteketsa kwina kutha kupezeka. Zotupa zotupa za kapamba zimatsatiridwa ndi kupweteka pakukakamizidwa pamimba yapamwamba.