Ndi mayeso ati oti atenge pancreas

Tikukupemphani kuti muwerenge nkhaniyi pamutuwu: "kuyesa kwa kapamba, mndandanda wazoyeserera" ndi ndemanga kuchokera kwa akatswiri. Ngati mukufuna kufunsa funso kapena kulemba ndemanga, mutha kuchita izi pansipa, nkhaniyo itatha. Akatswiri athu a endoprinologist adzakuyankhirani.

Ntchito ya chamoyo chonse chimadalira mkhalidwe wa chinthuchi

Kuwonongeka kwa kapamba sikumachitika mwadzidzidzi. Anthu ambiri samangokhalira kufunikira kuti pakhale zovuta pamimba yapamwamba, yomwe imakula pambuyo pa phwando. Zizindikiro zoterezi zimatha kuwonetsa matendawa:

• Kuchepetsa mseru Imalimbitsa madzi mukamamwa, zakudya zamafuta ndi okazinga. Woopsa milandu, limodzi ndi kusanza, zomwe sizibweretsa mpumulo.
• Ululu Kupweteka kapena kupweteka kwak pachimake kumalimbikitsidwa mu epigastric zone, koma kumatha kuwonekera pansi pa scapula, kumbuyo kwa sternum kapena pansi pa nthiti.
• Mavuto a Stool. Uku mwina kudzimbidwa kapena kutsekula m'mimba, kutengera mtundu wa matenda ndi njira zofunikira pakukula kwake. Ngati pali tinthu tambiri tambiri tofa ndowe, si zachilendo kwenikweni.
• Belching ndi flatulence. Kusokonezeka kwa njira yogaya chakudya kumayambitsa kunyentchera kwa zinyalala za chakudya komanso kuchuluka kwa mpweya. Kulumikizana kumayendera limodzi ndi kumverera kosasangalatsa mkamwa.
• Kutentha Kuwonjezeka kwa kutentha ndi chizindikiro chodziwika bwino chotupa. Pankhaniyi, muyenera kuchitapo kanthu nthawi yomweyo - itanani ambulansi.

Zizindikiro ngati izi zimapangitsa kuti alowe kuchipatala mwachangu.

Ndi chitukuko cha zovuta, zizindikiro monga jaundice, kuwonongeka kwa mawonekedwe, ndi kusokonezeka kwa mgwirizano kumatha kuchitika. Kulemera kumachepera kwambiri, chilala chimasowa.

Zofunika! Kudandaula kwa odwala komanso mayeso apamwamba okha sikokwanira. Pokhapokha mutazindikira kuti matendawa apezeka, chithandizo chitha kutumizidwa ndi dokotala.

Pambuyo pakuyang'aniridwa ndi dokotala ndikupeza anamnesis, kuyesedwa kwa Laborator kumayankhidwa. Ndi mayeso ati omwe akuyenera kuchitika kuti aphunzire kapamba, adotolo azindikire, chifukwa mndandanda wawo umadalira zochitika zina.

Magulu otsatirawa a maphunziro ofananawo amatha kusiyanitsidwa:

• Zoyimira. Kutenga magazi amkodzo, mkodzo kapena ndowe zowerengera monga mwaulimi wazomwe zikuwonekera.
• Ndi katundu. Muli ndi magawo angapo. Zizindikiro zoyambira zimayerekezedwa ndi zotsatira za kusanthula pambuyo kugwiritsa ntchito zinthu zapadera.
• Zapadera. Amapangidwira kuti apeze matenda a pathologies enaake, amatanthauza njira yapadera yochitira zitsanzo ndi kuwunika.

Njira zikuluzikulu zasayansi yodziwitsa za kapamba

Choyambirira chomwe chimaperekedwa kwa matenda a kapamba ndi kuyezetsa magazi. Magazi a minyewa ndi minyewa amakokedwa kuti aunike kwathunthu. Mwa zisonyezo wamba, kuchuluka kwa leukocytes ndi neutrophils, komanso ESR, ndizofunikira kwambiri.

Ndi mayeso ati omwe mumakhala nawo ndi kapamba? Zizindikiro zotsatirazi zimatsimikiziridwa ndi kuyesa kwamwazi wamagazi:

• bilirubin wamba komanso mwachindunji,
• shuga
• alpha amylase
• lipase
• trypsin.

Zikondazo zimatulutsa zinthu zofunika kwambiri: michere ya m'mimba ndi insulini kuti mugwetse shuga. Kuchepa kwa kapangidwe ka michere kumapangitsa kuti pakhale kusanthula kwathunthu ndikutenga michere, ndipo kuwonjezereka ndiko chifukwa chodzivulaza thupi. Insulin ndiyofunikira pakuwonjezera shuga, apo ayi munthu adzakumana ndi matenda a shuga.

Kuyesedwa kwa magazi ndi njira yoyenera yopezera matenda aliwonse

Zofunika! Ndikofunikira kupereka magazi pamimba yopanda kanthu. Tsiku loti lisanachitike, sikulimbikitsidwa kumwa mowa, msuzi wokoma, zakudya komanso zinthu zina zomwe zitha kupotoza zotsatira.

Palibe kuyesa kofunikira kwambiri kwa kapamba, kutengera kuphunzira kwa mkodzo ndi ndowe. Amawonetsa momwe amapangira zinthu zomwe zimalowa m'thupi. Ndikwabwino kutenga zinthu zam'mawa, makamaka mkodzo.

Mu labotale, zitsanzo za mkodzo zimayesedwa kwa magawo amomwe am'magazi monga glucose, amylase ndi amino acid. M'matenda a kapamba, ndi omwe amasintha kwambiri.

Ndibwino kuti mukuwerenga Feces amayesedwa ngati ma program. Zizindikiro zakunja zimasunthidwa (kusasinthika, mtundu, kupezeka kwa tinthu tating'onoting'ono tosiyanasiyana, ndi zina). Njira zofunika zowunikira ndi izi:

• kupezeka kwa CHIKWANGWANI CHAKUDYA CHAKUDYA
• chizindikiritso cha michere yokugaya,
• kuchuluka kwa elastase
• kusanthula kwa kayendetsedwe ka hydrolysis.

Kafukufuku wa Laborator amawulula kuchuluka ndi mtundu wa fiber mu chopondapo

Chowerengera ichi cha matenda apachiwonetsero cha pancreatic chimatha pokhapokha ngati kupatuka kwakukulu sikunapezeke. Pamaso pazotsatira zokayikitsa, mayeso owonjezera amafunikira kuti ayang'ane kapamba ndi njira yoyesera kupsinjika.

Zosankha zotsatirazi zimagwiritsidwa ntchito:

• Kulekerera kwa glucose - magazi amatengedwa kumayambiriro kwa kuyesedwa, kenako wodwalayo amamwa shuga wa glucose, ndipo pambuyo pa ola limodzi kuyezetsa magazi kumabwerezedwa.

Zotsatira zoyeserera za glucose

• Diastasis mu mkodzo - gawo loyambirira limayezedwa, pambuyo poyambitsa prozerin, zitsanzo zimatengedwa theka lililonse la maola 2.
• Mayeso a Iodolipol. Zitsanzo za mkodzo wa m'mawa ndizoyang'anira. Mukatha kutenga iodolipol, muyeso wokhazikika umapangidwa mkati mwa maola 2,5 kuti akhazikitse kuchuluka kwa iodide.
• Ma antibodies kuma cell a beta - muzindikire ma autoimmune pathologies opanga insulin.
• Enzymes mu duodenum. Zitsanzo zoyambirira zimatengedwanso pambuyo poyambitsa hydrochloric acid.
• Kuyesedwa kwa Secretin-pancreasimine. Kupanga kwa amylase, trypsin ndi lipase kumatheka chifukwa cha makonzedwe a secretin ndi cholecysto-pancreosimine, pambuyo pake mulingo wa ma enzymes mu duodenum amafananizidwa ndi woyamba.

Zambiri pazakukula ndi kusintha kwa ziwalo zamkati zitha kupezeka kudzera pazowunikira zamagetsi. Mukamayang'ana kapamba, njira zotsatirazi zimagwiritsidwa ntchito:

• Ultrasound Mafunde akupanga amawonekera kuchokera ku tiziwalo tamatumba ndipo amasinthidwa kukhala chithunzi polojekiti. Kusintha pamlingo wachilengedwe, kukula kwa ziwalo ndi ma contours, komanso kupezeka kwamadzi m'mimba mwake kumawonetsa kukhalapo kwa matenda.

Ultrasound ndi njira yanthawi zonse yovuta yamatenda apancreatic.

• Mayeso a Endoscopic. Kugwiritsa ntchito kafukufuku wa endoscopic, mawonekedwe a minofu yolumikizana ndi mapindikidwe a pancreatic ndi duodenum amawunika.
• ERCP. Njira ya endoscopic retrograde cholangiopancreatography imakulolani kuti muganize momwe pancreatic imadzitsitsira yokha.

Pakati pa ERCP pali chiopsezo cha kuwonongeka kwa ziwalo zomwe sizikwanira kuyeseza kwa diagnostologist

• CT Chifukwa cha CT cha kapamba, kapangidwe ka chiwalo kamayesedwa mwatsatanetsatane, ma neoplasms ndi malo osinthika a minofu yathanzi amawululidwa.
• Endo-Ultrasonography. Amagwiritsidwa ntchito pofufuza mwatsatanetsatane za momwe gland limapangidwira komanso ma ducts ake, komanso ma lymph node omwe amaphatikizidwa nawo.
• Biopsy Pofuna kuzindikira ma neoplasms okayikitsa, kusunthidwa kwa minofu kumachitika pogwiritsa ntchito singano yabwino kwambiri kuti ifufuzidwe bwino kwambiri m'mbiri. Izi zimakuthandizani kuti muzindikira oncology kapena onetsetsani kuti chotupacho ndi chosaopsa.

Zofunika! Chifukwa cha kuzindikira kwathunthu, ndikotheka kudziwa mtundu wa matenda a kapamba molondola momwe zingathekere, komanso zomwe zingayambitse kukula kwake.

Kutengera zotsatira zakafukufuku zomwe zapezeka, pulogalamu yochiritsira imapangidwa, yomwe imaphatikizapo zakudya ndi mankhwala osokoneza bongo pogwiritsa ntchito ma enzymes. Muzochitika zoopsa kwambiri, opaleshoni imafunikira kuti isungitse malo owonongeka a gland.

Mitundu ya mayeso a pancreatic

Tsopano mankhwala amapereka njira zopitilira 5 zosiyanitsa matenda a kapamba. Kafukufuku wazinthu zamagazi, zimakhala (chotupa kapena chotupa), mkodzo, etc. zimagwiritsidwa ntchito.

Ndi mayeso ati omwe amafunikira kuti adutsidwe, adokotala adzakuuzani. Nthawi zambiri, malinga ndi lingaliro la adokotala:

• maphunziro a biopsy, i.e.
• kuyezetsa magazi kapena kopitilira muyeso,
• urinalysis
• pulogalamu.

Njira iliyonse imathandizira kuzindikira matenda ena. Pogwiritsa ntchito njirazi, edema yosavuta imasiyanitsidwa ndi zotupa, kapamba wa khansa.

Pancreatic Biopsy

Kutenga minofu yofewa imaperekedwa ngati mukukayikira. Katswiri wochita izi akufufuza pogwiritsa ntchito kafukufuku wa ultrasound kapena makina a X-ray amapeza malo ovuta, pambuyo pake amatenga tinthu tating'ono kuchokera kudera linalake la kapamba. Phunziro lofananalo limaperekedwa kwa:

• kuchepa thupi mwadzidzidzi,
• kuwoneka kwa ma antijeni a khansa m'magazi,
• kuledzera thupi popanda chifukwa chodziwika,
• kuwoneka kwa kupweteka kosalekeza kwa kapamba,
• kufalikira pafupipafupi, kupukusa chakudya cham'mimba komanso kagayidwe.

Iyi ndi njira yodziwitsa za gawo lachiwiri, ndiye kuti, iyenera kupita patsogolo pa ina. Pamaso pa biopsy, muyenera:

• pezani malo okayikitsa ndi khunyu kapena ma radiation cholowa,
• kusiyanitsa zomwe zili m'derali ngati chotupa.

Popanda kukayikira ma neoplasms, njirayi siyichita chifukwa cha kukwera mtengo kwa opareshoni ndi kupweteka kwake.

Ma puncto amachitika m'njira zingapo: endoscopy, kudzera mu syringe popanda kuthyola khungu, kapena opaleshoni. Kukonzekera biopsy, ngakhale ndi syringe, kuyenera kuchitika pansi pa opaleshoni, popeza kulowa kwa thupi lachilendo kudzera m'magulu angapo a minyewa ya biopsy kumadzala ndi vuto lalikulu.

Malingana ndi malamulo a zamankhwala, kupereka zowawa kwambiri kwa kasitomala ndizoletsedwa.

Chidwi ndi odwala ngati biopsy ya kapamba ikuchitika, mtengo wa njirayi. Ngakhale kuti phunziroli ndi limodzi mwa okwera mtengo kwambiri, mutha kulipirira: ma ruble 1300 amodzi pamutu umodzi amatengedwa kuzipatala za likulu.

Urinalysis

Kuzindikiritsa kapamba kudzera mu mkodzo makamaka kumayikidwa pakhungu. Ndi matendawa, njira yowonekera bwino imaperewera, ndipo ngakhale wodwalayo yemwe ali ndi maliseche amatha kuwona kusintha kwamkodzo kukhala kwamdima, pafupi ndi bulauni, komanso kutupa kwa thupi. Izi zikuchitika chifukwa cha kuwonjezereka kwa zomwe zili mu diastase muzinthu.

Ichi ndi pulumu yomwe mwachilengedwe imabisala thupi kuti ligwetse chakudya. Zimapirira mapuloteni, zakudya zamafuta ndi mafuta. Enzyme imayang'aniridwa mosavuta ndi mabisala ndi urea. Kusanthula kwa ma enzymes kumachitika ndi:

• kutupa kwa gland
• peritonitis
• matenda ashuga
• kulephera kwa aimpso.

Kutsika kwa chizindikirocho kumawonedwa pakakhala mawonekedwe osakhazikika komanso kapamba, pomwe mankhwalawa akuperewera pakatha nthawi yochulukirapo.

Mlozera wabwinobwino wazakale mwa munthu wamkulu ndi magawo 64 achizolowezi. Mwa munthu amene ali ndi vuto la kapamba, zimachulukirachulukira ndipo amatha kufikira magawo 16,000. Ma enzoni a pancreatic amachulukitsa 250.

Diastasis si chizindikiro chodziwika. Kukula kwake kumatha kuchitika mukamamwa mankhwala atsopano, poyizoni kapena uchidakwa. Kungowerenga kokwanira kokha komwe kungathandize kuzindikira matendawo. Akatswiri samangoyang'ana ma diastasis okha, komanso maselo oyera am'magazi, mapulateleti, maselo ofiira am'magazi, omwe amadzaza mkodzo panthawi yotupa kwambiri kwa kapamba. Kenako wodwalayo amatumizidwa kwa x-ray kapena ultrasound.

Kukopera kwa zovuta zapancreatic

Chizindikiro chachikulu cha kukanika kwa pancreatic ndikumasulidwa kwamafuta ochulukirapo mu ndowe. Malinga ndi kafukufuku wapadziko lonse lapansi ndi World Health Organisation, kuchuluka kwa mafuta m'thupi kudzera mwa ndowe sikungopitilira 7 g ndi zakudya zamafuta 100 g. Kuwonjezeka kwa chizindikiro ichi kukuwonetsa kuti chitsulo sichimapanga ma enzymes okwanira kuthyoka kwamafuta, chifukwa chomwe osatsitsidwa amachotsedwa.

Kuyesedwa kwa kapamba ndi kuwunikaku kumatanthawuza kudya kokhazikika kwa masiku osachepera. Lapangidwa molingana ndi machitidwe a Schmidt:

• mapuloteni a tsiku ndi tsiku - 105 g,
• kuchuluka kwa mafuta tsiku lililonse - 135 g,
• pafupifupi 180 g ya chakudya chamafuta

Chakudya choterocho choyang'ana kapamba chimapereka chithunzi chokwanira kwambiri ndi mayendedwe owonjezeranso matumbo. Ndizolondola monga momwe kungathekere (kukula kwake kungasinthidwe moyenerera malinga ndi lingaliro la adokotala kuti akwaniritse zosowa za thupi), ndikugwira ntchito molondola kwamatumbo am'mimba, kupatuka kwakudyidwe kosagwirizana ndi zakudya zotere.

Ukhondo wa mayeso omwe wodwala amayenera kutenga ungakhudzidwe ndi zinthu zingapo. Kugwiritsa ntchito mowa komanso zakudya zamafuta kumakhudza zotsatira zake. Zonsezi zimapangitsa ma enzyme kukhala osagwira. Sizoletsedwa kumwa mankhwala omwe amakhala ndi enzymatic asanapatse chopondapo. Amatha kulipirira kusowa kwazinthu zawo m'thupi ndikubisira adotolo chisonyezo.

Ngati mupeza minofu ya m'mimba yomwe singayikidwe bwino m'zimbudzi, mutha kuweruza matenda amtundu wina wamatumbo - matumbo kapena m'mimba. Ndikofunikira kutsatira malamulo onse oyendetsera kafukufuku pamene matendawa akupita, apo ayi data yomwe yatengedwa siyingafanane ndi zenizeni. Kuzindikira pang'onopang'ono kumathandizanso kukhala ndi chithandizo chamankhwala, zomwe zimawonjezera chiopsezo cha zovuta.

Kuwerengera magazi kwathunthu

Ngati kapamba amayatsidwa, kuyezetsa magazi kumafunika. Kafukufuku wambiri wa hemolytic amachitika chifukwa choganiza kuti ndi kapamba komanso khansa. Chowonadi chachikulu ndi ESR - erythrocyte sedimentation rate. Zimawonjezera kukhalapo kwa zotupa m'mimba.

Kukula kumakhala kwakukulu kwambiri mu mawonekedwe a kapamba, omwe amadziwika ndi edema ndi kufooka kwathunthu. Imodzi ndi ESR, kuwonjezeka kwa zomwe leukocytes ndi neutrophils zimawonedwa. Choyimira, ngakhale ndi chithandizo choyenera, chimangokulirakulira kwa nthawi yayitali, kenako chimatsika pang'onopang'ono. Mwanjira yotupa yotupa, ESR, m'malo mwake, imachepetsedwa: thupi limachepa ndipo pang'onopang'ono limachita ntchito zake. Mu mawonekedwe osakhazikika, kuchuluka kwa michere yomwe singathe kukhutitsa thupi lathunthu pakuchepetsedwa;

Ngati zizindikiro za kuchepa kwa magazi m'thupi (kuchepa kwa vitamini, kuchepa kwachitsulo) zimazindikirika m'magazi, izi zikuwonetsa kusokonekera kwa pancreatic ndi kuphwanya kapangidwe ka mavitamini, omwe amaphatikizidwanso ndi thirakiti la m'mimba.

Kupenda kwazinthu zam'thupi

Ntchito zowunikira komanso zofufuzira za akatswiri azamankhwala siziyenera kutha ndi KLA kokha (kuyesa magazi konse). Nthawi zambiri njira yodziwikirayi sikokwanira kupeza zotsatira zosiyanitsa.

Kafukufuku wamankhwala amodzi amachitika ngati pakukayikira kuti pali matenda oopsa kwambiri kuposa kapamba - zotupa za khansa. Zimaphatikizapo kusaka m'magazi kuti mupeze zizindikiro zotsatirazi:

Chithunzi chonse chokhala ndi vuto la chithokomiro chikuwoneka motere:

• kashiamu wamagazi amachepetsedwa, ndipo kwambiri, kapamba wowopsa.
• kuchuluka kwa cholesterol ndi bilirubin (kukuwonetsa kufalikira kwa ma ducts a bile pafupi ndi gland),
• kuchuluka kwamapuloteni kumayamba kuchepa.

Koma zomaliza zowonjezereka zitha kuchokera ku kafukufuku wa magawo omwe atchulidwa pamwambapa.

Amylase ndi enzyme yopanga kugaya zinthu m'matumbo ndi m'mimba. Koma ndikuphwanya, amatha kuyamba kupukusa mwachindunji chofufumitsa chomwe chimabisala - kapamba. Zinthu zowola zokhala ndi zotsalira za amylase zimafalikira m'magazi, mitsinje imalowa impso, ndipo kuchokera pamenepo, amylase imasinthidwa kupita mkodzo. Pamenepo, chizindikirochi chimatenga nthawi yayitali, chimakwera mwachangu. Amylase amasowa m'magazi kale patatha masiku 2-4 kutukusira kwa kutupa, chifukwa chake enzymeyi singagwiritsidwe ntchito ngati maziko a matenda.

Itha kuonjezeranso ndi njira ndi matenda a chipani chachitatu: mimba, appendicitis, etc.

Kenako, onani elastase ndi lipase. Chotsirizirachi cholinga chake ndi kugaya mafuta. Amatuluka 85% ya milandu ndikutupa kwa ndulu ndi mapere. Chowonetsera bwino kwambiri ndikuwonjezeka kwa elastase. Imakonda kuchuluka kwambiri pakatikati pa matendawa, zomwe zimavuta kuzindikira kuchokera pakuwunika magazi.

Kukhalapo kwa zotupa m'magazi kumatsimikizira kuyambika kwa khansa. Bilirubin ndi zinthu zina zimachuluka.

Chidule: popanga kusanthula kwathunthu

Kusanthula kwathunthu (pogwiritsa ntchito njira zonsezi pamwambapa) sikufotokozedwa kawirikawiri machitidwe azachipatala. Nthawi zambiri, zimakhala zokwanira kugwiritsa ntchito njira imodzi yokha yodziwira magazi kapena mkodzo, ndipo ngati zikupezeka kuti zikupezeka zatsimikizira, onetsetsani kuti mwatsimikizadi zaumbiridwe.

Njira zonse zomwe zimachitika wodwalayo akafufuzidwa ayenera kutsatira malamulo ndi malingaliro a dokotala.

Mayeso odalirika a matenda a kapamba - mndandanda wathunthu

Chikhansa ndichinthu chofunikira kwambiri pakudya cham'mimba ndi endocrine yomwe imayang'anira chimbudzi cha chakudya komanso kuchuluka kwa shuga m'magazi. Momwe mungakonzekerere kuti mupezeke ndi matenda komanso mayeso omwe amaperekedwa kwa matenda a kapamba, muphunzira kuchokera m'nkhaniyi.

Thanzi la pancreatic lili m'manja mwanu!

Choyamba muyenera kuwunika momwe thupi liliri.

Gulu loyambirira la mayeso ndi mayeso a kapamba amaphatikizapo:

1. Kukwanira kwathunthu kwa magazi ndi ziphuphu.
2. Urinalysis
3. Kusanthula kwa biochemical kwa magazi: mapuloteni athunthu ndi magawo ake, bilirubin yathunthu, glucose, lipid mbiri, creatinine, urea, ALT, AST, LDH, gamma-GGT, alkaline phosphatase, potaziyamu, calcium, sodium, chlorine, CRP.
4. Coagulogram.
5. Cop program.

Acute pancreatitis amadziwika ndi kuwonjezeka kwa leukocytes mpaka 20,000 ndikusintha mu formula ya leukocyte kumanzere. Pakadali pano, chizindikirochi chimaposa momwe zimatchulidwira. ESR yothamanga idzawonetsa kukhalapo kwa njira yotupa.

Kusanthula kumeneku sikumakhudza zotupa zapanchipi. Koma ndi kuchepa kwa kulolera kwa glucose kapena matenda a shuga, zomwe zimakhala ndi shuga ndi matupi a ketone zidzachulukitsidwa mkodzo.

Pankhani ya chotupa mu mutu wa pancreatic, matenda a bile duct kutsekeka ndi cholestasis amakula. Mkodzo umasanduka bulawuni wakuda ("mkodzo wamtundu wabiri"), ndipo kuwonjezeka kwa urobilinogen ndi bilirubin kudzapezeka m'matope.

Kuyesedwa kwa magazi kumatha kuuza dokotala zambiri zokhudzana ndi ziwalo.

Zisonyezo zodziwika bwino zomwe madokotala nthawi zambiri amapereka ndizowonetsa ziwalo zonse.

Gland ikakhudzidwa, pakhala zosintha izi:

• kutsika kwamapuloteni onse osakwana 60 g / l chifukwa cha albin,
• kuchuluka mafuta m'thupi ndi otsika kachulukidwe lipoproteins,
• kuthekera kwa atherogenic pamwambapa 4,
• kuchuluka kwa zamchere phosphatase ndi gamma-GGT ndi kukula kwa cholestasis,
• pakhoza kuwonjezeka mulingo wa transaminases ALT ndi AST, yowonetsa kuchuluka kwa kuwonongeka kwa maselo,
• kuchuluka kwa lactate dehydrogenase (LDH) chifukwa cha kufooka kwa glucose,
• mapuloteni a c-omwe amathandizira amawonjezeka pamaso pakuwonetsa kutupa.

Kuti mupeze zotsatira zabwino zoyeserera, ndikofunikira kutenga mayeso onse pamimba yopanda kanthu.

Palibe vuto la kutaya magazi mu chifuwa chachikulu, koma ndi kukula kwa matendawa, antithrombin III adzachepa mu coagulogram chifukwa chotulutsa ma enzyme m'magazi.

Kuwunikira kwa fecal kumachitika kuti mupeze kuwonongeka kwa minyewa. Ndi matenda apancreatic, kudzimbidwa kwa mapuloteni, mafuta ndi chakudya kumachepa. Tizilombo tambiri timene timapezeka timankhwala tambiri timene timapezeka ndipo timatha kununkhira; Zomwe zimakhala ndi minofu ya minofu ndi minofu yolumikizika, mafuta osalowerera, ndi wowuma imachulukitsidwa. Kuphatikiza apo, mutha kufufuza enzyme yeniyeni, elastase-1, yomwe imatuluka m'matumba okhala ndi kapamba.

Sikoyenera kuwerengera ndowe za microflora, njirayi siyothandiza pakhungu la kapamba.

Shingles - chizindikiro cha kapamba

Pozindikira zotsatira za mayeso a matenda a kapamba, adotolo, osataya nthawi, adzakulangizani kuti mupeze maphunziro ochepa.

Zomwe amayesa kudutsa:

1. seramu Fermentogram: pancreatic amylase, lipase, trypsinogen, trypsin.
2. mahomoni azimbudzi.
3. mkodzo diastasis.
4. mtima wa pancreatic michere mu duodenal madzi.
5. mayeso ogwira ntchito ndi kupsinjika.
6. kutsimikiza kwa zotupa zolembera.
7. Kusanthula kwaposachedwa kumakupatsani mwayi wofufuza momwe thupi limagwirira ntchito ndikupanga matenda omaliza.

Ndi pachimake kapena kuchulukitsa kwa matenda a kapamba mu venous magazi, ndende ya michereyi imakulitsidwa. Njira yovuta kwambiri ndiyo kutsimikiza kwa kuchuluka kwa mapuloteni a trypsinogen mu magazi.

Mlingo wa phospholipase A2 enzyme imawonetsa kukhalapo kwa njira zowonongeka. Alpha-2-antitrypsin amatanthauza zakutsogolo chizindikiro cha kapamba: kukwera kwake, ndikoipa matendawa.

Ngati muli ndi mayeso osakwanira: kapamba amakhudzidwa ndi ma enzymes ake, ndikuyamba kudzipanga. Pankhaniyi, kuchipatala kwadzidzidzi kuchipatala chofunikira kwambiri kuyenera kuyang'ana ndikukhazikika kwa zizindikiro zofunika.

Mahomoni atatu amapangidwa mu kapamba:

1. insulini: amachepetsa shuga
2. glucagon: Amodzi mwa mahomoni omwe amawonjezera glucose pakusakwanira kwake,
3. C-peptide: kuchuluka kwa zinthu izi kukuwonetsa kuchuluka kwa ntchito yopanga insulin.

Ngati mayeso akuwonetsa zonyansa, mudzatumizidwa kwa endocrinologist.

Kuyang'ana kuchuluka kwa seramu amylase si njira yodula. Sikuti chipatala chilichonse chachipatala chili ndi malingaliro oyenera. Njira yachangu ndiyo kudziwa kuchuluka kwa diastase mkodzo. Diastase ndi chinthu chophulika cha amylase, chomwe chidzatsimikiziridwa ndi kuwonjezeka kwa kuchuluka kwa enzyme m'magazi.

Kusanthula kumeneku kumakhala ndi vuto losakwanira la kapamba, chifukwa chake, tikulimbikitsidwa kudziwa mulingo wa pancreatic amylase.

Kuti muwone kapamba, ndikofunikira kudziwa zomwe zili mu michere ya duodenum. Pachifukwa ichi, kumveka kwa duodenal kumachitika: wodwalayo ameza chubu chopyapyala chomwe zinthu zamkati zimatengedwa.

Ndi kuchepa kwa kuchuluka kwa michere ndi ma bicarbonates, kuwonongeka kwa ziwalo kumatsimikiziridwa. Njirayi imaphatikizidwa ndi mayeso olimbitsa thupi, omwe amafufuza omwe amamuganizira kuti ali ndi chifuwa chachikulu.

Ntchito zoyeserera zimafunikira kuti muwone ntchito za thupi ngati lili ndi matenda osachiritsika. Pambuyo kuwonjezera katundu paz kapamba zopangidwa ndi mankhwala ena, zimatsimikizika kuti ndi gawo liti lomwe limakhala ndi zovuta - exocrine kapena endocrine.

Endocrine ndi exocrine pancreatic ntchito

Njira zomwe zimagwiritsidwa ntchito kwambiri, kusanja komwe kumachitika molumikizana ndi kusanthula kwina:

1. Mayeso a kulolera a glucose. Ndi kuyesaku, adokotala akuwunika momwe kapamba wanu amatha kuyang'anira shuga wanu wamagazi. Phunzirolo lisanachitike, wodwalayo amafufuza kuchuluka kwa shuga. Kenako muyenera kumwa kapu yamadzi okoma, pambuyo pake maola atatu aliwonse okhudzana ndi shuga. Ngati chiwerengero sichikuchepa pakapita nthawi, amalankhula za kulolerana kwa shuga.
2. Kuyesa kwa mafuta a hydrochloric acid. Pakumveka kwa duodenal, njira yofooka ya hydrochloric acid ndi mafuta a maolivi imalowetsedwa m'matumbo a duodenal. Zinthu izi zimalimbikitsa maselo a pancreatic, potero zimachulukitsa kuchuluka kwa michere.
3. Kuyesedwa kwa Secretin Pancreosimine. Umu ndi mtundu wamakono wa hydrochloric acid test. Secretin ndi pancreosimin, michere yomwe imayambitsa gland, imayambitsidwa mu duodenum. Kuchuluka kwazinsinsi zobisika kumatanthauza, kodi mulingo wa ma bicarbonate ndi ma enzymes ndi chiyani. Kuyeza kumeneku kumawunikira mbali yapadera ya kapamba.

Kwanthawi yayitali ndi khansa ya kapamba, mkhalidwe wa munthu ukhoza kukhalabe wokwanira. Kuti muthandizire kuzindikira koyambirira kwa njira ya oncological sikuti kungokhala kokha ndi ultrasound kapena CT, komanso kuyezetsa magazi kwa zotupa. Awa ndi ma glycoproteins ena, omwe pazochitika zina amawonetsa kuti ndi chiwalo chiti chomwe chikukhudzidwa.

Mutha kukhala ndi chidwi chofuna kudziwa:

Ngati mukukayikira njira ya neoplastic mu kapamba, mayeso otsatirawa amachitidwa:

1. CA-242 ndi chotupa chizindikiritso chomwe chimapezeka m'magazi otumphukira m'matumbo a khansa a kapamba, ang'ono ndi rectum. Komanso, malo ake okwera amatha kupezeka mu pancreatitis ya pachimake, pancreatic cyst.
2. CA 19-9 sigawo lodziwika bwino la khansa ya kapamba. Nthawi zina amapezeka ndi khansa ya m'matumbo, chikhodzodzo, kupweteka kwa kapamba, chifuwa, matenda a chiwindi ndi matenda a ndulu.
3. CA 72-4 - amapangidwa ndi maselo a epithelial, amakula ndikuchulukirachulukira kwa kapamba ndi kupezeka kwa zotupa zachilengedwe.
4. ACE kapena alpha-fetoprotein - amapangidwa ndi maselo a chiwindi ndipo amawonjezeka ndi zotupa za kapamba, chiwindi ndi m'matumbo.
5. CA 125 ndi glycoprotein wina yemwe milingo yake yayitali imalimbikitsa khansa ya pancreatic. Chizindikiro chotupa chimafotokozeranso khansa yam'mimba, chiwindi, matenda osatha a pulmonary system.

Nthawi zina madokotala amapereka mtundu umodzi kapena zingapo za chotupa kuti awonjezere kudalirika komanso kulondola kwa phunziroli. Komabe, njirayi siyolunjika kwambiri, chifukwa imawonetsa zowonongeka osati kapamba, komanso chiwindi, colon, ndi bronchi.

Kuchuluka kwa mafuta komanso chakudya chamafuta m'zakudya, kusuta fodya komanso kumwa mowa mwauchidakwa kumapangitsa kuti ziphuphu ziwonongeke. Zizindikiro zodziwika bwino za kapamba zimawoneka ndi 90% kuwonongeka kwa minyewa. Pakapita nthawi, zizindikiro zoyambirira za matendawa zimatha kupezeka ndi kuyezetsa kuchipatala pafupipafupi.

Ngati mumakonda zokoma komanso kudya kwambiri, ndipo mutatha phwando m'mimba mwanu mumaganizira, za thanzi lanu. Tsopano mukudziwa momwe mungayang'anire kapamba wanu ndi mayeso omwe ayenera kumwedwa. Dokotala adzakuyesani ndi kukupatsani malingaliro.

Njira zakuzindikira zamatenda a pancreatic

Kuunika koyenera kwa wodwala yemwe ali ndi vuto la pancreatic kumathandizira kukhazikitsa kuzindikira koyenera komanso kupereka chithandizo munthawi. Kufufuza kwa katswiri aliyense woyenera kumayambira ndi njira zoyeserera zachipatala ndi zasayansi. Njira zopangira zida zotsimikizira kuzindikira koyambirira: kuyerekezera kophatikizidwa ndi maginito opatsirana, maphunziro osiyanitsa ndi X-ray, maphunziro a ultrasound ndi ena.

Pamsonkhano woyamba ndi wodwalayo, adokotala amakhala ndi chidwi ndi madandaulo ndikuwunika wodwalayo pafupipafupi. Pokambirana, adokotala amaphunzira mawonekedwe a kupweteka, chikhalidwe cha dyspepsia, pafupipafupi komanso kukula kwa zizindikiro zamankhwala. Zizindikiro zotsatirazi ndizothandiza kwambiri kuzindikira matenda a gland:

1. Ululu pamimba pamimba, makamaka m'malo a epigastric ndi subcostal. Ululu nthawi zambiri umakhala ngati lamba, umayamba pambuyo pakulowa kwa zakudya zamafuta ambiri. Masautso ndi zopweteka m'mimba sizimatha nthawi yayitali.
2. Zomverera zimapweteka kumaso, phewa lakumanzere, lomwe limakakamiza munthu kutenga gawo lokakamizidwa kuti athetse vutoli.
3. Chizindikiro chodziwika bwino cha matenda a kapamba ndikusanza ndi mseru nditatha kudya zakudya zamafuta. Chichewa chimatha kupezeka m'masanzi. Kusintha sikumachotsanso chizindikiro cha ululu.
4. Mu matenda a gland, chifukwa chosakwanira kugaya mafuta ndi ma lipids, steatorrhea imabuka - pafupipafupi madzi kapena gruel achikasu chopondapo ndi kuphatikizika kwamafuta. Steatorrhea - chizindikiro cha pathognomonic pakuwonetsa pancreatitis, chotupa ndi khansa ya chiwalo
5. Odwala amasokonezedwa nthawi ndi nthawi chifukwa cha kutulutsa, kutentha thupi, kuledzera, khungu, zomwe zimasonyezanso matenda apamba.

Chidziwitso chofunikira! Chifukwa cha kuchepa kwa enzyme, odwala ena amawona kuchepa thupi kwa thupi, komwe kumalankhulanso koyenera kwa matenda a gland. Ngati chizindikiro ichi chikuchitika, muyenera kufunsa dokotala, chifukwa nthawi zambiri, kutsika kwa thupi ndi chizindikiro cha kukula kwa chotupa cha khansa m'thupi.

Kufufuza kwakunja kumawonetsa jaundice, khungu louma. Pa palpation m'malo a pancreas, zilonda zimapezeka, komabe, chiwalocho sichitha kupimidwa kwathunthu ndikuwonekera chifukwa cha malo omwe ali.

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.

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 amapangidwanso mmenemo.

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.

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 mayeso amtsempha wamagazi:
   • 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.