Benign zotupa za kapamba > Matenda a shuga

Benign zotupa za kapamba - awa ndi ma neoplasms omwe amadziwika ndi kusiyanasiyana kosungidwa kwa maselo, ali ndi njira yabwino, ndipo amatha kupanga kuchokera ku minofu yotulutsa timadzi, mtima ndi mitsempha, komanso epithelium ya organ. Zizindikiro zimatsimikiziridwa ndi mtundu wa neoplasia: ndi zotupa zopanga mahomoni - kuchuluka kwa mahomoni ena, omwe ali ndi mitundu ina - ululu, kupukusa chakudya, zizindikiro za kuphatikizika kwa ziwalo zoyandikana. Njira zazikulu zodziwitsira matenda ndi maphunziro othandiza: ultrasound, CT, MRI. Mankhwala opangira opaleshoni - kuchokera ku kuwonjezeka kwa chotupa kupita ku kufinya kwatsopano.

Zambiri

Benign pancreatic chotupa ndi njira yachilendo. Neoplasia imachitika ndi pafupipafupi ma milandu 1-3 pa munthu 1 miliyoni. Nthawi zambiri anthu azaka zapakati komanso zaka zambiri amakhudzidwa. Amatha kukhala amodzi kapena angapo, opezeka mchira, thupi kapena mutu wa chiwalo. Tizilombo ting'onoting'ono tomwe timagwira m'magazi nthawi zambiri timakhala tosokoneza, timakhala mwangozi pofufuza matenda ena. Ma neoplasms omwe amagwira ntchito mosiyanasiyana amadziwika ndi kusintha kwina kwakumapeto kwa endocrine.

Zomwe zimayambitsa kukula kwa matenda awa sizinakhazikitsidwe. Amakhulupirira kuti chibadwa chomwe chimayambitsa machitidwe a neoplastic, nyengo zovuta za chilengedwe, kusuta fodya, komanso uchidakwa ndizofunikira. Ntchito yofunikira pakukula kwa zotupa zam'mimba mu gastroenterology yamakono ndi ma oncology amapatsidwa njira zotupa za chiwalo, makamaka matenda a kapamba.

Zakudya zopanda zakudya zimakhalanso pachiwopsezo cha kukula kwa benign neoplasms: kuchuluka kwa zakudya zamafuta (makamaka nyama zoyambira), kusowa kwa fiber, mapuloteni, mavitamini, komanso zakudya zosayenera (kusowa kwa chakudya chokwanira, kudya kwambiri).

Gulu

Ntchito zotupa za neuroendocrine zimapezekanso nthawi zambiri: gastrinoma (gastrin yopanga pancreatic neoplasia kuchokera ku maselo a Langerhans), insulin, ndi glucagon. Ngakhale kuti mawonekedwe amtunduwu nthawi zambiri amakhala ocheperako komanso samakonda kukula msanga, mawonekedwe ake ali achindunji kwambiri, chifukwa maselo a neoplasm amatulutsa timadzi timene timalowa.

Benign pancreatic neoplasia imaphatikizanso hemangioma (kapangidwe kamene kamakhala ndi minyewa), fibroma (kuchokera ku minofu yolumikizana), lipoma (kuchokera ku adipose minofu), leiomyoma (kapangidwe ka minofu ya minofu), neuroma kapena schwannomas (neoplasms ochokera ku maselo a Schwann omwe ali nembanemba zamitsempha). Mitundu yamtunduwu imasiyanitsidwa ndi kusapezeka kwa mawonetseredwe azachipatala mpaka atakula kwakukulu.

Zizindikiro za benign pancreatic neoplasms zimatsimikiza ndi mtundu wa chotupa. Ma neoplasein osagwira a Hormone nthawi zambiri amakhala opeza mawonekedwe, popeza alibe zizindikiro mpaka atakula kwambiri komanso kupindika kwa ziwalo zapafupi, kutalika kwa kapisozi kapenanso kuchepa kwa magazi. Nthawi zambiri, zotupa zotere zimapezeka mukazindikira matenda ena.

Zizindikiro zingapo zimaloleza kuwasiyanitsa ndi omwe ali ndi vuto: kusapezeka kwa matenda azachipatala (kuphatikizapo mawonetseredwe a kuledzera matenda: kufooka, kusadya, kutopa, nseru, kuchepa thupi kosachepera), kukula pang'onopang'ono pamlingo wabwinobwino wam'magazi. Ngati chotupa chachikulu chachikulu cha kapamba chimakankhira ziwalo zoyandikana, kupweteka ndikotheka. Ululu umakhala wokhazikika, ukupweteka, umatha kukula ndi kusintha kwa kayendetsedwe ka thupi, kutengera kwawo kutengera ndi neoplasia.

Neoplasms ya mutu wa pancreatic imadziwika ndi ululu mu hypochondrium yoyenera ndi epigastrium, ziwalo zamthupi - kumtunda pamimba, mchira - kumanzere kwa hypochondrium, dera lumbar. Chotupa chimatha kuponderezera kapamba kapena ma ducts wamba a bile, omwe amawonetsedwa ndi mawonekedwe a jaundice ovuta: icteric sclera ndi khungu, kuyabwa, mawonekedwe amtundu wakuda wa mkodzo, ndi kusungunuka kwa ndowe. Ngati gawo lililonse la matumbo limalimba, kutsekeka kwamatumbo kumatha.

Ma chotupa cha mahomoni opanga mahormoni ali ndi zizindikiritso zapadera, zomwe zimatsimikiziridwa ndi mahomoni obisika. Insulomas (insulinomas) imatulutsa timadzi tating'onoting'ono timene timatulutsa shuga. Zizindikiro za kupanikizika kotere ndi zizindikiro za hypoglycemia: kufooka, thukuta kwambiri, chizungulire, kusakhazikika, tachycardia, ndi kuchepa kwakukulu kwa shuga m'magazi, hypoglycemic coma ndiyotheka.

Gastrinoma imawonetsedwa ndi kukula kwa zilonda zam'mimba zambiri, chosinthira ku pharmacotherapy. Zilonda zitha kupezeka m'mimba, bulbar, nthawi zina ngakhale mu jejunum. Odwala amamva kupweteka kwambiri m'chigawo cha epigastric, chodziwika ndi burging ya acid, kutentha kwadzuwa. Chifukwa cha kuchuluka kwa gastrin, kuchuluka kwa hydrochloric acid kumalowa ndikuwunika kwa m'mimba, komwe kumapangitsa kuti matumbo asokonezeke, kuwonongeka kwa nembanizo ya mucous komanso njira zoperewera.

Zizindikiro za glucagonoma zimatsimikiziridwa ndi kuwonjezeka kwa shuga m'magazi. Kuchepetsa kwambiri thupi, kuoneka kwa necrolytic kusuntha erythema (zotuwa zofiirira zofiirira m'magawo osiyanasiyana a thupi, makamaka matako, ntchafu, kupindika), kutsekeka kwa khungu, kuwonongeka kwa nembanemba ya mucous (gingivitis, stomatitis, vaginitis). Poyerekeza ndi glucagonoma, matenda a shuga angayambitse, zomwe zimapangitsa kuti pakhale kulipira msanga, nthawi zambiri zimangokhala mankhwala, komanso chitukuko cha ketoacidosis, angiopathy ndi nephropathy.

Zizindikiro

Kuzindikira kwa matenda amtunduwu kwakhazikika pa mawonekedwe azachipatala a mitundu ina ya neoplasms, komanso zotsatira za njira zofufuzira ndi zofufuza. Kuyankhulana ndi gastroenterologist kukuwonetsa mtundu wa chotupacho, momwe zizindikirazi zikuwonekera komanso ngati zikupita patsogolo. M'mbiri ya moyo wa wodwala, matenda otupa a kapamba, uchidakwa ndiwotheka.

Mukamayang'ana wodwala, dokotala amatha kudziwa kutalika kwa khungu ndi sclera, zomwe zimawonetsa kupindika kwa pancreatic kapena chotupa cha bile. Mukamayezetsa magazi ambiri, kusintha kumakhala kochepa kwambiri. Kuyesedwa kwa magazi m'magazi a insuloma ndi glucagonoma kumatsimikizira kusintha kwa shuga m'magazi. Tanthauzo la zotupa ndizovomerezeka: carcinoembryonic antigen, CA 19-9, yomwe mu mkhalidwe wamakhalidwe oyipa matendawa siwonjezereka.

Njira zophunzitsira zodziwikiratu ndi maphunziro othandiza. Ultrasound yamimba yam'mimba imachitidwa kuti iwone mawonekedwe, mawonekedwe ake, komanso mkhalidwe wa zigawo za m'mimba. Komabe, ndi zotupa zopanga timadzi tating'onoting'ono tating'onoting'ono, njira iyi siyothandiza. Kwambiri CT ndi MRI yodziwitsa za kapamba, kulola kuti azindikire ma neoplasms ang'onoang'ono ndikuphunzira mwatsatanetsatane kuchuluka kwake.

Kuti mudziwe neoplasias yokhala ndi ma protein angapo (izi ndizofanana ndi insulin, gastrin), scintigraphy imachitika - ma radiopharmaceuticals amalowetsedwa m'thupi, omwe amaphatikizidwa ndi ma cell a chotupa, ndipo kuwala kwake kumayikidwa pachithunzicho. Ngati hemangioma ikukayikiridwa, angiography imapangidwa kuti iwone kayendedwe ka magazi ndikupanga kwake ndi ubale wamagazi. Kuphunzira mbiri ya mapangidwe a neoplasm, kusiyanitsa ndi zotupa zoyipa, pancreatic punication biopsy imachitika ndi kafukufuku wotsatira wazotsatira zamankhwala a biopsy.

Chithandizo cha chosaopsa zotupa

Mankhwalawa amangopanga opaleshoni yokha. Ndi zotupa zopanga timadzi tambiri, ma enukula awo (mankhusu) amachitika. Kuyambiranso kwa mutu wa gland kapena mchira ndikofunikira pakakhala neoplasms mu dipatimenti yolingana ya chiwalo. Pankhani ya kufalikira kwa lalikulu neoplasia mu mutu gland ndi gululi zotuluka za ndulu, pancreatoduodenal resection anachita (mapangidwe amachotsedwa limodzi ndi gawo la gland ndi duodenum). Chithandizo chothandiza kwambiri cha hemangiomas ndikusankhidwa kwa mitsempha. Njira imakhala yotchinga magazi kupita ku chotupa.

Nthawi zina, mukakhala ndi ma neoplasms opanga ma hormone ambiri, chithandizo chamankhwala champhamvu sichingatheke, chithandizo chothandizira ndi chofunikira. Ndi insulinoma ndi glucagonoma, cholinga chachikulu ndicho kuphatikizidwa kwa shuga m'magazi. Ndi chitukuko cha zigawo za hyper- ndi hypoglycemia, kukonza koyenera kumachitika ndi insulin kapena glucose solution. Onetsetsani kuti mwasankha zakudya. Mankhwalawa gastrinomas, mankhwala omwe amachepetsa gastric hypersecretion amagwiritsidwa ntchito: ranitidine, famotidine, omeprazole ndi ena. Woopsa milandu, gastrinoma yokhala ndi gastrectomy imayikidwa (pofuna kupewa kutayikiranso chifukwa chotupa chotupa).

Zotsogola ndi kupewa

Benign pancreatic neoplasms nthawi zambiri amakhala ndi tsogolo labwino, lomwe limakhala losavulaza kwambiri. Ndi kuwonjezeka kwa kukula kwa chotupa, zovuta zitha kupezeka m'njira ya jaundice yovuta, matumbo. Ndi kuchotsedwa kwa nthawi yake, kuchira kwathunthu ndikotheka. Palibe prophylaxis yeniyeni. Njira zodziwika popewa kukula kwa zotupa zam'mimba ndizotsatira zamakhalidwe abwino, kukana kumwa mowa, komanso chithandizo chokwanira cha kapamba.

Zimayambitsa zotupa za kapamba

Zomwe zimayambitsa benign pancreatic chotupa sizinakhazikitsidwe. Amakhulupirira kuti amakula mothandizidwa ndi izi:

Ma genetic pathos omwe akuwonetseratu kuti njira za neoplastic,
Zosintha zachilengedwe,
Kusuta fodya
Mowa.

Udindo waukulu pakukula kwa zotupa zam'mimba ndi zotupa za thupi, makamaka kupweteka kwa kapamba. Zomwe zimayambitsa kukula kwa benign neoplasms zimaphatikizapo zakudya zopanda pake - kuchuluka kwa zakudya zamafuta m'zakudya, makamaka kuchokera kwa nyama, kusowa kwa mapuloteni, fiber, mavitamini, kudya kosayenera (kudya kwambiri, kusowa kwa chakudya chokwanira).

Zizindikiro za chosaopsa pancreatic chotupa

Zizindikiro za benign pancreatic neoplasms zimatsimikiza ndi mtundu wa chotupa. Ma neoplasms osagwira ntchito nthawi zambiri amakhala opezerapo mwayi wowapeza. Samawonetsa chilichonse mpaka atafika pamlingo wokulira komanso kutsekeka kwa ziwalo zapafupi, kutambasulira kwa kapamba kapamba kapenanso kuchepa kwa magazi. Madokotala nthawi zambiri amazindikira ma neoplasms omwe ali munthawi yanthawi yofufuza matenda ena.

Amasiyanitsidwa ndi zotupa zoyipa ndi zizindikiro zotsatirazi: kusowa kwa zizindikiro zamankhwala (kuphatikizapo mawonetseredwe a kuledzera matenda - kutopa, kufooka, nseru, kulephera kudya, kutentha kwa thupi kwapang'onopang'ono), kukula pang'onopang'ono pamlingo wabwinobwino wa chotupa m'magazi.

Ndi kukakamira kwa chotupa chachikulu cha kapamba akulu akulu akulu a ziwalo zoyandikana, kupweteka ndikotheka. Odwala amadandaula za kupweteka kosalekeza, kupweteka, kukulitsidwa ndi kusintha kwa ululu wamthupi. Kukula kwawo kumatengera komwe akupanga.

Tumors of the pancreatic mutu amawonetsedwa ndi zowawa mu malo oyenera a hypochondrium ndi epigastric, thupi la chiwalo pamimba pamimba, mchira m'dera lumbar ndi hypochondrium wamanzere. Mapangidwe a volumetric amatha kupanikizana ndi pancreatic kapena wamba ducts. Pankhaniyi, zizindikilo za jajiice zovomerezeka zimapezeka:

Icterus (yellowness) wa sclera ndi khungu,
Kuyabwa
Maonekedwe a khungu lakuda,
Fecal discoloration.

Ngati gawo lililonse la matumbo limalimba, kutsekeka kwamatumbo kumatha.

Hormone yopanga ma benign pancreatic zotupa zimakhala ndi zizindikilo zina. Amatsimikizika ndi mahomoni omwe amatulutsidwa. Insulomas amatulutsa g insulin. Hormone iyi imakhudzanso magazi a magazi. Gastrinoma (chotupa cha gastrin chopanga chotupa chomwe chimachokera ku ma cell a Langerhans) chimawonetsedwa ndi kukula kwa zilonda zam'mimba zambiri ndi zilonda zam'mimba za duodenal zomwe zimagwirizana ndi pharmacotherapy. Odwala amamva kupweteka kwambiri dzenje la m'mimba. Amakhala ndi nkhawa yokhala kuti ndi wowawasa, wowopsa.

Chifukwa chopanga gastrin yambiri, kuchuluka kwa hydrochloric acid kumalowa mu lumen ya m'mimba. Izi zimabweretsa kusokonezeka kwamatumbo, kuwonongeka kwa mucous nembanemba ndikuwonjezera njira zoyipa.

Glucagonoma amawonetsedwa ndi zizindikiro za kuchuluka kwa shuga m'magazi:

Kuchepetsa kwambiri
Maonekedwe a necrolytic osamukira erythema (wotuwa wofiirira m'magawo osiyanasiyana a thupi, makamaka m'maso, m'chiuno, matako),
Khungu
Kugonjetsedwa kwa mucous nembanemba (gingivitis, stomatitis, vaginitis).

Poyerekeza ndi glucagonoma, matenda a shuga amatha. Zina zake ndizodziwika bwino ndikubwezeredwa mwachangu ndi chitukuko chachilendo cha ketoacidosis, nephropathy ndi angiopathy (kuwonongeka kwa impso ndi mitsempha yamagazi).

Chithandizo cha chosaopsa pancreatic zotupa

Mankhwalawa pancreatic neoplasms a chosaopsa chikhalidwe amangokhala opareshoni. Opaleshoni pachipatala cha Yusupov amagwira chotupa chachikulu (chotupa) cha chotupa. Kubwezeretsanso mutu wa ndulu kapena mchira kumachitika ngati pali neoplasm mu dipatimenti yolingana ya chiwalo. Ngati chotupa chachikulu chili pamalo a mutu wa gland ndikuyambitsa kuphwanya kutuluka kwa bile, kuphatikizika kwa pancreatoduodenal kumachitika - neoplasm imachotsedwa limodzi ndi gawo la gland ndi duodenum. Njira yothanirana ndi pancreatic hemangioma ndikusankha kuphatikizira kwamitsempha - kutsekereza magazi kupita ku mapangidwe a volumetric.

Nthawi zina mukakhala ndi zotupa zambiri zopanga ma cell a benign pancreatic, opaleshoni yayikulu sangathe kuchitidwa, madokotala pachipatala cha Yusupov amachita chithandizo chamankhwala. Ndi insulinoma ndi glucagon, endocrinologists amafotokozera mankhwala kuti achepetse kuchuluka kwa shuga m'magazi. Ndi chitukuko cha zigawo za hypoglycemia ndi hyperglycemia, kukonza koyenera kumachitika ndi njira zamagalasi kapena insulin.

Onetsetsani kuti mwapereka mankhwala othandizira kudya. Maphikidwe ku chipatala cha Yusupov amaphika zakudya kuchokera kuzinthu zabwino. Katundu wawo wa psychanoleptic samasiyana ndi kuphika kwakunyumba.

Mankhwalawa gastrinomas, mankhwalawa amagwiritsidwa ntchito omwe amapondera gastric hypersecretion (ranitidine, omeprazole, Famotidine).Woopsa, madokotala ochita opaleshoni amachita kukomoka kwa gastrinoma ndi gastrectomy (kupewa kuti asayambirenso chifukwa chosachotsedwa kwa neoplasm).

Pancreatic adenoma

Pancreatic serous cystadenomas imatha kuchitika pazaka zilizonse, koma imakhala yofala kwambiri mwa okalamba. Amakhala kwambiri asymptomatic. Ngati chotupa chili m'mutu wa kapamba, chimatha kusokoneza kutuluka kwa ndulu.

Pafupifupi mainchesi a serous neoplasms pafupifupi masentimita anayi. Zimapezeka mthupi la kapamba. Chotupacho chili ndi mawonekedwe a volumetric yolongosoledwa komanso yosiyanitsidwa bwino ndi minyewa yazifupi. Pancreatic serous benign chotupa ndi mbali zochepa zomwe zimapangika; ma boles amakhala ndi ma cysts ochepa. Mu ma adenomas akuluakulu a pancreatic, zowerengeka zimatha kuwoneka.

Benign adenomas a endocrine kapamba ndizochepa kwambiri kuposa zotupa zina za kapamba. Pafupifupi 60% ya onse endocrine pancreatic tumors secrete insulin. Izi zikuwonetsedwa ndi hypoglycemia syndrome:

Kuchuluka thukuta,
Kugwedezeka
Maulendo ofooka kwambiri
Kuwonongeka kwakanthawi.

Nthawi zambiri, adenomas amapezeka mchira ndi thupi la kapamba. Amapezeka pansi pa kapsulo. Kukula kwa mapangidwe kungakhale kuchokera pa mamilimita ochepa mpaka masentimita 3-6. Chotupa chija chozungulira, yokutidwa ndi kapisozi woonda. Kusasinthika kwa neoplasms imatha kukhala yowonda kapena yofewa.

Zotsatirazi zosiyanasiyana za ma microscopic kapangidwe ka pancreatic adenomas opangidwa kuchokera ku maselo a islet ndi osiyana:

Parenchymal (tubular, solid, trabecular, cribrotic, adenomatous, pericytic),
Fibrous (ndi hyalinosis kapena amyloidosis),
Angiomatous
Zosakanizidwa.

Ndi chikhalidwe cha mahomoni omwe amapangidwa, ma pancreatic adenomas amagawika m'magulu atatu:

Orthoendocrine - mahomoni obisika omwe amadziwika ndi ntchito yokhudza thupi ma islets (insulinoma, glucagonoma),
Paraendocrine - amatulutsa mahomoni, okhala ndi mawonekedwe komanso zachilendo kwa maselo abwinobwino a endocrine (corticotropinoma, gastrinoma, vipoma, melanocytostimulating neoplasms),
Polyendocrine - maselo awo amodzi amatulutsa mahomoni angapo.

Malo adenoma mu kapamba amatsimikiziridwa ndi madokotala a chipatala cha Yusupov pogwiritsa ntchito angiography, ultrasound ndi computer tomography. Ndi zazikulu zazing'ono chotupa chambiri, madokotala ochita opaleshoniyo amakwaniritsa kukokoloka kwake. Ngati chotupa chachikulu kapena chotupa chambiri chikukayikiridwa, gawo la kapamba limapangidwanso. Ngati mukukayikira kuti muli ndi chotupa chamafinya, pezani nthawi ndi dokotala m'mimba.

Benign pancreatic chotupa: zapamwamba

Munthu aliyense padziko lapansi pano ali ndi matenda osachepera, koma si aliyense amene amadziwa za kukhalapo kwake. Chowonadi ndi chakuti matenda ambiri amadzipangitsa kumverera pokhapokha atakhala nthawi yayitali. Matendawa ndi oopsa kwambiri pamoyo wa munthu, chifukwa matendawo akamakula m'thupi, zimakhala zovuta kwambiri kuchiza. Chitsanzo chochititsa chidwi cha izi ndi zotupa zosiyanasiyana. Nkhaniyi ikuthandizira chotupa chodziwika bwino cha pancreatic chotupa, chomwe nthawi zambiri chimathandizidwa popanda zovuta, koma njira yobisika ya chitukuko chake imatha kuyambitsa zovuta zambiri.

Kanema (dinani kusewera).

Chotupa chaching'ono pancreatic ndi imodzi mwamatenda osowa kwambiri a anthu. Madotolo amangolembetsa ma milandu angapo pa anthu 1 miliyoni, koma akatswiri a zamankhwala amakhala ndi ziwerengero zosiyana: mlandu umodzi mwa 5000 autopsies. Izi zikufotokozedwa chifukwa chakuti chotupacho chimadzipangitsa kumverera pokhapokha ngati chimatambasulira kapisozi kapamba, pamene neoplasm imafika kukula kwakukulu. Zowonjezereka pazizindikiro tidzabweranso pang'ono.

Kanema (dinani kusewera).

Pali mitundu ingapo yamatendawa, koma onse amakhala m'magulu. Gululi, komanso matenda ena ambiri, limapatsidwa nambala yaumboni ya ICD 10. Kwa zotupa zoyipa, chikhazikitso chachikulu ndi D13.6, koma imodzi yosiyanayo imaperekedwa kwa ma islet cell tumors - D13.7.

Kusiyana pakati pa zotupa zoyipa ndi zotupa

Ma neignlasms a Benign ali ndi zosiyana zingapo zingapo zingapo kuchokera ku khansa. Choyamba, ndikofunikira kunena kuti chotupa chovomerezeka cha pancreatic pafupifupi sichimatha muimfa - ichi ndi chimodzi mwamagwirizano wosiyana kwambiri.

Tsopano tiyeni tisunthire mndandanda wazowonjezereka:

Thupi la chotupa chokhala ndi chotupa chimakhala ndi maselo ofanana ndi England, pomwe khansa imapangidwa kuchokera kwa omwe amasinthika.
Zizindikiro za khansa ndizopweteka kwambiri, kudzimbidwa, ndi kukanika. Chotupa chofewa sichimafotokozedwanso kawirikawiri.
Khansa ya kapamba imawonetsa zizindikiro za poyizoni: nseru, kusanza, kuchepa thupi, ndi zina zotero.
Chotupa chovunda chimakula pang'onopang'ono kuposa khansa kapena sichimakula konse.
Khansa imafalikira ku ziwalo ndi ziwalo zoyandikana, ndipo chotupa chokhacho chimangokhala chokhacho chathina kale.

Zimayambitsa benign pancreatic chotupa

Pafupifupi matenda onse ofatsa ali ndi zoyambitsa, mwachitsanzo, kukhala ndi chimfine, mutha kunena motsimikiza kuti mwagwira kachilomboka, koma chotupa mu ndulu ndi chosiyana kwambiri pano. Madokotala sanakhazikitse zifukwa zenizeni zodziwikirira ma neoplasms, komabe, adazindikira gulu lowopsa. Mulinso:

Osuta omwe amamwa mowa mwauchidakwa, komanso osokoneza bongo.
Anthu omwe ali ndi pancreatitis yayitali komanso kutupa kwa nthawi yayitali mu gastroduodenal zone.
Anthu omwe abale awo anali ndi matenda ofananawo.
Kugwira ntchito ndi mankhwala amagetsi ndi radiation.

Chimodzi mwazifukwa zimathekanso kuperewera kwa vuto la kuperewera kwa zakudya m'thupi:

Zakudya zolakwika.
Njala yapafupipafupi kapena kudya kwambiri.
Kudya mafuta ochulukirapo, onunkhira komanso amchere.
Kuperewera kwa zipatso ndi ndiwo zamasamba m'zakudya.

Amayambitsa chosaopsa pancreatic chotupa

Zomwe zimayambitsa kukula kwa matenda awa sizinakhazikitsidwe. Amakhulupirira kuti chibadwa chomwe chimayambitsa machitidwe a neoplastic, nyengo zovuta za chilengedwe, kusuta fodya, komanso uchidakwa ndizofunikira. Ntchito yofunikira pakukula kwa zotupa za pancreatic mu gastroenterology zimapatsidwa njira zotupa za thupilo, makamaka pancreatitis yayitali.

Pancreatic mutu neoplasm: Zizindikiro ndi mankhwala

Chotupa (neoplasia) cha kapamba ndimatenda obisika komanso oopsa. Malinga ndi WHO, pafupifupi zikwizikwi zokwana 200,000 za matendawa amalembetsedwa chaka chilichonse padziko lapansi. Mwa awa, 213,000 akutha muimfa. Izi ndichifukwa cha kuchuluka kwapakati koipidwa ndi neoplasms.

Pakupita zaka 5 atazindikira kuti chotupa pa kapamba, 90% ya odwala amwalira.

Ndi odwala angati omwe amakhala pambuyo pochizira chotupa chodziwikiratu zimatsimikiziridwa ndi mtundu ndi malo omwe matendawa ali.

Pancreatic neoplasia (kapamba) ndi neuroendocrine matenda, i.e, imasokoneza dongosolo la endocrine. Ngakhale chifukwa chochotsa mawonekedwe osavuta, zovuta zoyambazi zimachitika.

Kukula kwa tumor pazinthu zapafupi (ndulu, duodenum, chiwindi, m'mimba) kumayambitsa imfa.

Kukhalapo kwa pancreatic oncology kumadziwika m'miyambiyambi yoyambirira pokhapokha ngati pakuwunika.

Kupitilizitsanso matendawa kumapereka ndemanga zosakanikirana pazokhudza thanzi, zomwe zimasokonezeka ndi matenda am'mimba.

Ndi chotupa chokhwima chokha chomwe chimapereka zambiri kapena zochepa pazolemba zake za oncology.

Mukukula, neoplasm imafalikira ku ziwalo ndi ziwiya zapafupi.

Kutulutsa kwa ma ducts, necrosis ya maselo amtundu uliwonse kapena zimakhala zimayambitsa zizindikiro zotsatirazi.

Kupweteka kwapafupipafupi pakatikati pamimba (dera la vertebrae yoyamba kapena yachitatu). Ndi malo ake omwe amatha kuwonetsa bwino mavuto a khansa ya Prostate. M'tsogolo amakhala shingles. Sizitengera chakudya, zimakulitsa usiku. Mawonetsedwewa amatha kusiyanasiyana kuchokera pakukhudzana ndi kupweteka kosalekeza.
Matenda a Dyspeptic. Kulemera pamimba, nseru, kusanza. Chimakhala chofala kwambiri makamaka ndi matumbo a m'mimba chifukwa chakuchulukana.
Chotupa chowopsa. Kukongoletsa khungu, maso, misomali. Kusintha kwa Stool ndi mkodzo wakuda. Chizindikiro chotsimikizika cha kufinya kwa ndulu, yomwe imayambitsa chotupa m'mutu wa kapamba.
Sinthani pakudya. Kukana mafuta ndi nyama mbale, khofi ndi mowa.
Kuchepetsa kwambiri thupi.
Zizindikiro za matenda ashuga Zimachitika pamene neoplasm ikakhala mchira wa kapamba,
Anemia

The chosaopsa pancreatic chotupa chikhoza kunenedweratu ndi kusamwa wa chiberekedwe mwa vuto losavulaza neoplasia.

Mlanduwu umachitika popanda kufooka wamba, kutopa, kutentha thupi, kutsika. Makamaka chiyembekezo ndikusapukwa mseru ndi kusanza.

Ma neoplasms a oncological amadzipangitsa okha kumverera kumapeto kwa chitukuko cha matenda.

Ngati khansa ya kapamba imadziwonetsa pokhapokha pazotsatira zam'mbuyo, ndiye kuti mungadziteteze bwanji?

Ndipo mungadziwe bwanji ngati pali chiyembekezo cha matendawo?

Gulu lamavuto limatsimikiziridwa ndi izi:

wazaka 50
amuna kapena akazi (omwe amakonda kudwala),
kukhalapo kwa matenda am'mimba, matumbo,
aakulu kapamba
kusuta: kumawonjezera chiopsezo cha chotupa cha pancreatic katatu,
cholowa: mtundu wamtundu wachilendo umatsimikizira kuthekera kwa matenda,
uchidakwa
Zakudya zopatsa thanzi ndi mafuta ambiri, kuphatikizapo chakudya chofulumira,
mtundu 1 shuga
malo owononga.

Chimodzi mwazinthu zofunika komanso zotsutsana ndi shuga. Anthu omwe sayenera kukhala ndi shuga wambiri (amuna azaka zapakati, osalemera kwambiri) sayenera kuwonekera, akapezeka, ziphuphu ziyenera kuyang'aniridwa pa oncology. Pano, matendawa sangakhale chiopsezo, koma chizindikiro cha chotupa kapena matenda ena a pancreatic. Nthawi zina, komwe kumayambitsa matendawa ndi matenda am'mimba omwe amayamba chifukwa cha kunenepa kwambiri.

Zizindikiro zomwe zidatchulidwa kale zimatengera mtundu wa kuwonongeka kwa ziwalo komanso mawonekedwe a neoplasm. Pansipa pansipa ndikufotokoza mwatsatanetsatane kufotokozera kwa matendawa.

Choyamba, pathanatomy imagawa zotupa m'magulu awiri: chosaopsa ndi chovulala.

Mlandu woyamba umakhala wochepa pakukhudza thupi ndipo umatha kuchiritsidwa.

Mbali yake ndi kusiyanasiyana kwa maselo. Zimakuthandizani kudziwa minofu yomwe mapangidwe ake amakula. M'mabuku ena amatchedwa polyp, awa ndi malingaliro ofanana.

Khansa ya pancreatic ya Benign imayikidwa m'mitundu iyi:

Fibroma (minofu yolumikizira).
Hemangioma (mitsempha yamagazi).
Neurinoma (dongosolo lamanjenje).
Lipoma (minofu ya adipose).
Cystoma (kapisozi kodzazidwa ndi madzi amapezeka m'malo osiyanasiyana).

Njira yabwino kwambiri ndi hemangioma. Nthawi zambiri, uku ndi kuwumbika kwa makanda komwe kumawonongeka kuubwana. Nthawi zina amapangika pa chiwindi, kawirikawiri - kapamba. Mitsempha ngati imeneyi imatchedwa cavernous hemangioma. Njira zochizira ndizomwe zimachitika pa oncology.

Chotupa choyipa ndi vuto losagwirizana ndi kufalikira kwa ma metastases. Kusatheka kwa chithandizo kumachitika chifukwa cha kukula kwa neoplasm. Amakula kukula m'thupi, nkusintha maselo athanzi kukhala maselo a khansa, kapena kukula m'matumbo oyandikana nawo. Pankhaniyi, chotupacho chimatha kuwononga chilichonse chomwe chimabwera munjira.

Khansa ya pancreatic yovuta kwambiri malinga ndi ICD-10 imatsimikiziridwa ndi tsamba la zotupa:

kapamba mutu, thupi kapena mchira,
chimbudzi
ma islet cell
kuthekera angapo.

Komwe neoplasia imatsimikiza kwambiri momwe amathandizira komanso amathandizira. Yokhala pamutu, imafalikira ku chiwindi ndi duodenum, ndikuyambitsa kusokonekera kwa dyspeptic ndi jaundice. Kuchokera mchira, imatha kufalikira mpaka ku ndulu.

Kupanga chisindikizo cha pathological m'malo ano, chimayambitsa ascites ndi hypersplenism. Maselo a Islet ndiwowonjezera insulin ndi mahomoni ena. Kulephera kwawo ndikutaya kwakukulu kwa dongosolo la endocrine.

Zizindikiro sizokwanira kupanga matenda.

Ndikofunikira kuchita mayeso wamba ndikuwunikanso mbiri yachipatala. Adzatha kudziwa zomwe zimayambitsa khansa.

Mayeso oyambilira akuphatikiza kufunsa wodwala komanso kupezeka kochokera.

Kusanthula kwa mbiri yachipatala (matchulidwe ndi chikhalidwe cha odwala).
Kuganizira mbiri yakale yachipatala (imatsimikiza kukhalapo kwa zinthu zoyipa zomwe zafotokozedwa pamwambapa).
Kuwona milandu ya oncology mwa abale ake.
Matsimikizidwe azizindikiro.

Pambuyo pa mayeso oyamba, kuwunikira kwathunthu kudzaperekedwa. Kusanthula kumachitika:

magazi (ambiri), kuchepa kwa hemoglobin (kuchepa magazi) ndi kusintha kwina kupezeka,
magazi (biochemical), makamaka, shuga, kupezeka kwa mtundu 1 shuga kapena insuloma,
ndowe, zimachitika ndi kusinthasintha kwake (chizindikiro cha kusowa kwa stercobilin),
mkodzo, wokhala ndi jaundice, kuchuluka kwa urobilinogen, komwe amapangidwa kuchokera ku bilirubin, akuti
zotupa zolembera CA 19-9, KEA (mapuloteni akuwonetsa kukhalapo kwa khansa).

Komanso, zida zotsatirazi zotupa zimagwiritsidwa ntchito:

Kuyesa kwa Ultrasound (ultrasound).
Scut tomography (CT) Scan.
Magnetic resonance imaging (MRI).
Endoscopic retrograde chalangiopancreatography (ERCP).
Magnetic resonance pancreatocholangiography (MRPHG).
Mbiri.
Angiography.
Biopsy

Ultrasound ndiyo njira yosavuta kwambiri. Ili ndi mtengo wotsika, koma ndiotetezeka kwathunthu. Imawona kusintha kwa ma morphological mu minofu, kuchuluka kwawo kwa echogenicity.

CT imadziwika ndi kukula, komwe chotupa, komanso kufalikira kwa ziwalo zapafupi. Ndizolondola kwambiri, koma zimagwira pamaziko a x-ray.

MRI ndiyotetezeka kuposa njira yakale, koma yotsika mtengo. Ikuwonetsa momwe neoplasm imamera ndi zotsatirapo zake, kuphatikizidwa kwa mucous membranes ndikuwonongeka kwa motility.

ERCP imawunika ma ducts a bile. Amadzaza ndi sing'anga yosemphana ndipo x-ray imatengedwa. Omalizawa akunena za kusintha kwasinthidwe m'derali, mwachitsanzo, kufinya ndi kukhalapo kwa zolepheretsa.

MRPHG imawunika ndulu ndi ma pancreatic ducts. Mkhalidwe wawo ndi mawonekedwe ake, zomata zamatumbo mu makoma amachubu ndizotsimikiza.

Scintigraphy imawonetsera kutulutsa kwawoko ndi zina mwa chotupa chifukwa chobweretsa zinthu zowulutsa mthupi.

Angiography ndimayeso a x-ray amitsempha yamagazi. Njira yomaliza, posowa deta pambuyo pa CT ndi MRI.

Kuwona biopsy ndikudziwikiratu kodziwikiratu, ndiko kuti, komwe kumapangitsa mtundu wa chotupa. Imachitidwa potenga chitsanzo cha minyewa ya zotupa.

Mikhalidwe yotsatirayi ndiyofunikira pochita opaleshoni yamatenda a khansa ya pancreatic: chosaopsa, kukula kwa chotupa kupitilira masentimita, kuwonjezeka kwamaphunziro kumapeto kwa chaka chimodzi ndi kukhalapo kwa zizindikiro.

Ndiofala kuchotsa chotupa chachi pancreatic pogwiritsa ntchito minofu yomwe ili ndi kachilombo.

Ngati ndizotheka, zitha kusinthidwa ndi njira zina:

opaleshoni ya laparoscopic
mankhwala poizoniyu
chemotherapy.

Kuchita opaleshoni yachikhalidwe kumaphatikizapo kuchotsedwa kwa gawo la chiwalo. Mwachitsanzo, pancreatoduodenal resection ndikuchotsa mutu wa ndulu ndi duodenum. Mwachilengedwe, pambuyo poti wodwala wotereyu satenga nthawi yayitali. Njira yododometsa ya zotumphukira za ma cell a cell imafotokozedwanso.

Laparoscopy ndi opareshoni yokhala ndi mawonekedwe ochepa. Pankhaniyi, sagwiritsidwa ntchito kawirikawiri, nthawi zambiri pochiza ana hemangiomas. Iyi ndi njira yamakono yogwiritsira ntchito, nthawi zambiri pogwiritsa ntchito laser.

Kuchiza poizoniyu kumangoleketsa kufalitsa matendawa. Kuneneratu pankhani iyi sikotonthoza: kutalika kwa moyo kumakulitsidwa ndi miyezi 12-16.

Chemotherapy siothandizanso, koma umalimbana ndi khansa. Nthawi zina mankhwala a cytotoxic ndi njira yokhayo yotuluka.

Akatswiri azikambirana zamapapo azotulutsa kanema mu nkhaniyi.

Gazetov B.M., Kalinin A.P. Matenda opaleshoni mwa odwala matenda a shuga. Moscow, yosindikiza nyumba "Mankhwala", 1991, 256 pp.
Gurvich, M.M. Zakudya za matenda a shuga mellitus / M.M. Gurvich. - M: GEOTAR-Media, 2006. - 915 p.
Hürter, P. Buku lonena za matenda ashuga a mtundu woyamba. Kwa ana, achinyamata, makolo ndi ena / P. Hürter, L. Travis. - M: Buku la Demand, 2012. - 194 c.

Ndiloleni ndidziwitse. Dzina langa ndi Elena. Ndakhala ndikugwira ntchito ya endocrinologist kwa zaka zoposa 10. Ndikukhulupirira kuti pakadali pano ndili katswiri pantchito yanga ndipo ndikufuna kuthandiza alendo onse omwe amapezeka pamalowo kuti athetse zovuta osati ntchito. Zinthu zonse za tsambalo amazisonkhanitsa ndikuzikonza mosamala kuti athe kufotokoza zambiri zofunikira. Musanagwiritse ntchito zomwe zikufotokozedwa pa webusaitiyi, kufunsana ndi akatswiri ndizofunikira nthawi zonse.

Zowoneka ngati neoplasms

Chikhansa ndichinthu chomwe chimapanga chimbudzi chamunthu. Imagwira ntchito yofunika pakukonza chimbudzi cha zinthu zofunika pamoyo wa munthu. Ili pakati pamimba, ili ndi mawonekedwe okumbikakumbika, osakumbukira bwino nyemba za nyemba. Agawidwa m'magawo atatu: mutu, mchira, thupi. Zovuta zonse za gland zimayambitsa kusakwanira kwa kupanga mahomoni ofunikira, kusokonezeka kwa endocrine ndi machitidwe am'mimba.

Nthendayi ndi chida “chosalimba” mthupi la munthu chomwe chitha kupezeka mosavuta ndi matenda amitundu mitundu: matenda opatsirana ndi zotupa zina, mawonekedwe a mawonekedwe osakhazikika, ndi oncology.

Asayansi akulimbana ndi vuto la kupezeka kwa zotupa mthupi, koma zomwe zimayambitsa matendawa sizikudziwika bwinobwino. Zimadziwika kuti panthawi inayake khungu limawoneka ndi mawonekedwe olakwika a DNA. Ngati chitetezo chamunthu chitha kugwira ntchito, khungu lotere limawonongedwa nthawi yomweyo. Njira ina yosinthira zochitika ndizotheka: kuvuta kumachitika mthupi, maselo owopsa amalowa m'magawo atsopano.

Malinga ndi ziwerengero, chotupa cha pancreatic chadziwika kwambiri kwa amuna pambuyo pa zaka 60. Amayi ndi achinyamata sakonda kuoneka ngati ma neoplasms m'mimba. Chithunzi choyerekeza munthu amene ali pachiwopsezo ndi munthu wamkulu kuposa msinkhu wopuma pantchito, yemwe ali ndi chiyembekezo cha kusuta fodya ndi mowa komanso mbiri yamatenda oyamba a kapamba, chiwindi ndi kugaya chakudya.

Chotupacho chimatha kuphimba mbali yonse ya chiwalo, chomwe chiri mkati kapena kukhudza magawo a kapamba. Gulu la matenda padziko lonse lapansi limagawana neoplasms kutengera kutengera kwachilengedwe. Chotupacho chimatha kukhudza chithokomiro:

mchira
thupi
mutu
duct
ma islet cell
magawo ena
atha kukhala ndi zolemba zowonekera.

Chotupa chamutu wapachifuwa chimapezeka kwambiri kuposa theka la zomwe zimachitika. Pafupifupi kotala ya neoplasms imakhudza thupi kapena mchira wa chiwalo.

Neoplasm ndi mitundu iwiri, monga tafotokozera kale.

Benign sikufalikira kwa maselo athanzi oyandikana, koma pang'onopang'ono amawonjezeka kukula, kufinya minofu ndikuletsa kugwira ntchito kwa chiwalo. Kusiyana kwakukulu pakati pa benign neoplasms ndi oncology ndikuti maselo awo amapangidwa ndi maselo a gland, ndipo zotupa zoyipa zimapangidwa kuchokera ku maselo osinthika.

Pa mtima wa kapangidwe kakhalidwe:

minofu yam'manja
maselo amafuta
mitsempha yamitsempha.

Chotupa cha Neuroendocrine ndi mtundu wapadera, umasungidwa ndi kutulutsa mphamvu ya mahomoni. Kwa nthawi yayitali sichimawoneka ndipo ndi mwayi wambiri umayamba kukhala khansa ya pancreatic.

Chotupa chamtunduwu ndizosatheka kuzindikira matenda oyamba, chifukwa matendawa amapezeka popanda chizindikiro.

Mpweya woipa umafalikira m'maselo oyandikana ndi oyandikana nawo. Madera okhudzidwa amalephera kugwira ntchito moyenera, thupi limayamba kulephera. Zilonda zopweteka zimakula mwachangu kwambiri: ntchito ya pancreatic imatha kusokonezeka pambuyo pa miyezi 3-6.

Mawonetseredwe a pancreatic chotupa

Zizindikiro za matendawa zimakonda kukhala kwakanthawi. Izi zimapangitsa kuti adziwe, wodwalayo akhoza kuphonya mwayi wayamba kulandira chithandizo munthawi yake. Zizindikiro zimawonekera kwathunthu pokhapokha chotupa chachikulu chikufikira komanso zimatengera kutengera kwachilengedwe ndi chilengedwe. Zizindikiro wamba:

Kusanza, kusanza chifukwa cha kuledzera.
Kuphwanya phiko. M'mazinthu owonongeka, zinyalala zopanda chakudya zingaganiziridwe. Zizindikirozi zimachitika chifukwa chakuti ma enzyme okwanira samalowa mgawo.
Ululu ndiye chizindikiro chachikulu chokhala ndi chotupa. Imawoneka mu hypochondrium ya kumanzere kapena kumanja, imafalikira kumbuyo ndi khosi. Matenda a ululu amawonjezereka ndikusintha kwakuthwa kwamthupi.
Mtundu wachikasu umawonedwa ngati chotupacho chikulepheretsa bile duct, kusokoneza kutuluka kwa ndulu kuchokera kwa thupi. Pampando wa wodwala ndiwowoneka bwino pamenepa, ndipo mkodzo umayamba kuda.
Kutulutsa kwamkati kumawonekera pamaso pa magazi m'masanzi, chopondapo chakuda. Zizindikiro zimachitika ngati chotupacho chimapereka metastases pamimba.
Kufooka, kutopa, kudana ndi chakudya, kunenepa kwambiri kumachitika kumapeto kwa matendawo.
Zomverera zosasangalatsa m'mimba mutatha kudya.
Pakamwa pakamwa, ludzu losalekeza, kuyabwa kumawonetsa mawonekedwe a shuga. Matenda amapezeka ngati chotupa chimasokoneza kupanga insulin.
Ululu mu chiwindi.
Kukula kwa kukula kwa ndulu.
Dropsy - kudzikundikira kwa madzi am'mimbamo kumadziwika kokha ndi vuto loyipa la matendawa.
Kuphwanya msambo kwa akazi.
Kutuluka thukuta kwambiri.

Chithandizo cha chotupa cha pancreatic

Chithandizo cha matendawa chimachitika molingana ndi zinthu zambiri:

Chikhalidwe cha neoplasm, malo achitukuko.
Magawo a chotupa.
Kukula kwa maphunziro.
Kuchuluka kwa zowonongeka kwa ziwalo zoyandikana ndi ziwalo.
Zaka za wodwala.

Anthu ambiri omwe ali ndi chotupa cha pancreatic ndi okalamba. Opaleshoni ndiyowopsa kwa iwo: pali kuthekera kwakukulu kwa kumangidwa kwamtima, kuchepa kwambiri kwa magazi ndi kufa. Ngati wodwalayo ali ndi zaka zopitilira 60, dokotalayo wasankha kuti asachite opareshoni ndikudziletsa kuti amuthandize pothandizidwa.

Chithandizo cha khansa

Chotupa choyipa chimakhudza makamaka pancreatic duct. Mitundu itatu yayikulu yamaphunziro:

Zogwira ntchito. Mawonekedwe ang'onoang'ono omwe samakhudzana ndi zimakhala ndi ziwalo zoyandikana. Kuwonekera m'magawo oyamba a matenda. Zotupa zotere zimachotsedwa opaleshoni.
Kwapagawidwa kwanuko. Chotupa sichilinso chachilengedwe mu kapamba ndipo chimapita kupitirira thupi. Nthawi zambiri, pathological process imagwira maselo am'mimba, chiwindi, ndulu.
Metastatic - chotupa chosagwirizana mu magawo omaliza a matendawa. Ma metastases amakhudza osati ziwalo zapafupi, koma amafalikira thupi lonse.

Kukula kwa zilonda nthawi zambiri sikuyenda ndi zizindikiro zazikulu. Izi zimasokoneza kuzindikira kwakanthawi, kulola kuti matendawo apite patsogolo.

Kuzindikira kwa odwala omwe ali ndi khansa ya pancreatic ndikukhumudwitsa. Malinga ndi ziwerengero, opareshoniyi imachitika kamodzi kokha mwa milandu khumi ndipo sikutsimikiza kuchira kwathunthu. Kuvuta kwa kuchitapo kanthu kwa opaleshoni kumapangidwira ndikuchulukirapo kwazinthu zomwe zimakhudzidwa ndi chinthucho, chosatheka, kuyandikira kwa matumbo, m'mimba, chiwindi. Pa gawo lachiwiri, ndizosatheka kuthana ndi matenda, njira yamoyo yomwe munthu akudwala siyidutsa zaka zisanu. Ngati matenda a chotupa chowopsa adapezeka kumapeto kwa matendawa, machitidwe othandizira popanda opaleshoni, odwala satha chaka chimodzi. Mukapanda kuchitapo kanthu, munthu amafa pakatha miyezi isanu ndi umodzi kuchokera ku kuledzera, jaundice ndi zovuta zina.

Zolinga zakuchitikira opaleshoni zimasiyana malinga ndi kukula kwa chotupa:

Kapangidwe kakang'ono kamachotsedwa limodzi ndi gawo la gland.
Ndi chotupa chachikulu, chiwalo chonse chimachotsedwa.
Ngati mapangidwe afalikira metastases kuzinthu zoyandikana ndi ziwalo, sikuwonetsa malire omveka, njira zodziwikiratu zimayambitsidwa. Samachiritsa matendawa, koma amasintha moyo wa wodwalayo, kuchepetsa ululu, jaundice, kutsekeka kwa ndulu ya bile.

Kuphatikiza pa kulowererapo kwa opaleshoni, chithandizo cha radiation ndi chemotherapy amagwiritsidwa ntchito pochiza khansa ya pancreatic.

Radiation chithandizo ndi njira yochizira oncology. Zimakhazikitsidwa pakuwonongeka kwa maselo a khansa omwe ali ndi Mlingo waukulu wa radiation. Mankhwalawa amachitidwa opareshoni kuti achepetse kukula kwa mapangidwe ndipo atachitidwa opaleshoni kuti athetse zotsalazo za maselo ndi minofu yomwe ikukhudzidwa. Mankhwala othandizira poizoniyu amathandiza kuthana ndi mawonekedwe owoneka a matendawa, koma amakhala ndi zotsatirapo za kuchepa kwa tsitsi, kumva, kusowa kwa chilimbikitso, ndi kufooka.

Chemotherapy imakhudzanso kuyambitsa thupi la anthu poizoni omwe amalepheretsa kukula ndi kubereka kwa maselo a khansa. Zimalepheretsa kufalikira kwa njira ya pathological ku ziwalo zina zamkati. Chithandizo cha chemistry chimathandizira kupirira ndi ululu wamphamvu womwe umapezeka mwa odwala khansa, koma umawulula zingapo zoyipa zomwe zimapangitsa thupi:

Kusanza, kusanza.
Mutu.
Kutopa.
Vuto la nkhawa.
Kuphwanya kwam'mimba thirakiti.
Kuletsa chitetezo chokwanira.
Kuwonongeka kwaimpso, chiwindi.
Mavuto ndi endocrine system.

Madokotala ambiri akukhulupirira kuti maphunziro a chemotherapy amafunikira odwala khansa. Kupanda kutero, matendawo angabwerenso.

Zigawo za ASD zimayikidwa ngati mankhwala othandizira pochizira matenda osiyanasiyana a oncology, kuphatikizapo zotupa za pancreatic. Mankhwala ndi antiseptic wamphamvu ndi immunostimulating kwenikweni, imathandizira kagayidwe kachakudya kagayidwe ka ma cell. Poyamba amagwiritsidwa ntchito ndi veterinarians, tsopano amagwiritsidwa ntchito pochiza matenda aanthu, kuphatikizapo zotupa ndi zotupa. Imapezeka mu mawonekedwe a madontho, omwe amatha kutengedwa kokha moyang'aniridwa ndi dokotala. Ngakhale kuti zigawo za ASD ndi mankhwala osagwiritsidwa ntchito mosadukiza, odwala adawonetsa mawonekedwe abwino akumwa mankhwalawo.

Chithandizo cha chosaopsa pancreatic

Kuzindikira chotupa cha pancreatic ndicholinga chodziwitsa mtundu wake. Ngati zikuwoneka kuti chotupa sichabwino, njira zotsatirazi zamavuto ndizotheka:

Kuwona kumayikidwa pamaso pa magulu ang'onoang'ono. Wodwala ayenera kutsatira mosamalitsa malangizo a dokotalayo ndikupita kukayezetsa mankhwala munthawi yake.
Opaleshoni imachitidwa ngati chotupacho chili chachikulu ndipo pali chiopsezo chachikulu chosintha kukhala chotupa chowopsa.

Kuchita kwa Whipple kumachitika kuti athetse chotupa chamtundu uliwonse. Mapangidwe ake amachotsedwa limodzi ndi gawo la chisa chomwe chimapangidwira. Panthawi yokonzekera, wodwalayo amayesedwa koyambirira, kuphatikizapo:

Kuyesa kwamwazi wamagazi.
Ultrasound kuzindikira kwa kapamba.
Magnetic resonance cholangiopancreatography - imakupatsani mwayi wofufuza ndulu ndi ndulu.

Pakupanga opaleshoni, opaleshoni yovomerezeka ndi minofu yopuma imagwiritsidwa ntchito. Opaleshoni imawonedwa ngati yowopsa, panthawi yayitali kwambiri yotayika magazi komanso kuwoneka kwa zovuta. Nthawi zina, madokotala ochita opaleshoni amafunika kuchotsa chiwalo chonse. Zotsatira za kudalitsika kumeneku ndikupanga mtundu wamphamvu wa matenda a shuga, omwe samakonzedwa ndi insulin. Nthawi yochira pambuyo pakuchita opaleshoni imatenga nthawi yayitali, wodwalayo amakhala kuchipatala kwa mwezi osachepera. Pambuyo pa kukonzanso, wodwala ayenera kuwonjezera michere yapadera ku chakudya chomwe chimalimbikitsa chimbudzi. Izi zimachitika chifukwa cha kusokonezeka kwa kapamba chifukwa kuchotsedwa kwathunthu kapena pang'ono. Pambuyo pa opaleshoni, kupita kwa dokotala kamodzi kotala ndikofunikira.

Laparoscopy imachitika popanda kutsegula m'mimba, pogwiritsa ntchito zida zapadera pansi pa mankhwala ochita kupanga. Mafuta amaphatikizidwa pamimba pamimba kudzera pakutseguka komwe kumapangidwa kale mchombo. Gawo lotsatira la opareshoni: kudula ma microscopic awiri. Mpweya umaperekedwa kumimba yam'mimba ndikuyambitsa laparoscope ndi manipulator. “Laparoscope” ndi chubu chopyapyala chomwe chimatha ndi kamera. Zabwino zazikulu za opaleshoni yamtunduwu: kusowa kwambiri kwa magazi, mwayi wochepetsetsa wamavuto, kwakanthawi kochepa. Ngati opaleshoni sachitidwa moyenera, kuvulala kwam'mimba ndi mitsempha yamagazi ndikotheka.

Chotupa cha pancreatic nthawi zina ndi chosaopsa. Malinga ndi ziwerengero, gawo lililonse lakhumi lomwe lapezeka mthupi ili silizindikiridwa ndi oncology. Matenda a benign pancreatic chotupa ndi abwino. Nthawi zambiri, opaleshoni itatha, kuchira kwathunthu kumachitika, kuthekera kwa kuyambiranso kwamatenda kumakhala kochepa.

Chakudya pa chotupa mankhwala

Ndikofunikira kutsatira zakudya, makamaka kwa odwala omwe ali ndi chotupa cha pancreatic. Pakadwala, chiwalo sichingalimbikitse chakudya chokwanira. Odwala adzafunika kuti achepetse ntchitoyi kuti chisa chitha kukhala ndi mphamvu zochulukirapo kuti athane ndi matendawa.

Maziko ake azikhala chakudya chama protein ndi chakudya:

Masamba otenthedwa.
Zipatso.
Nyama yochepa yophika.
Zochita mkaka wolimba: kefir, tchizi chinyumba.
Opepuka nyama msuzi.
Masamba ophika masamba.

Sizoletsedwa kudya yokazinga, kusuta, zokometsera, zakudya zamafuta, kumwa zakumwa zoledzeretsa, khofi, koloko. Muyenera kuchepetsa kapena kukana kuphika konse, zakudya zamzitini, mazira owiritsa, tiyi wakuda wamphamvu.

Idyani m'magawo ang'onoang'ono pafupipafupi. Kudyetsa ndi kumeza chakudya chochuluka kwambiri. Kuchuluka kwa madzimadzi oledzera patsiku ndi pafupifupi malita awiri.

Njira yofunsirayi yogwiritsidwa ntchito pacakudya imagwiritsidwa ntchito kumayambiriro kwa matendawa, munthu akadakwanitsabe kukhala ndi moyo wathunthu. Pakapita nthawi, sizingatheke kudya nokha, wodwala amalandira michere yoyenera kudzera pakukonzekera kwamkati.

Pambuyo pa opaleshoni, chakudya cha wodwalayo chitha kukulitsidwa kuti chikhale ndi zakudya zama protein ambiri.

Chifukwa chiyani pali chotupa cha kapamba?

Asayansi sangathe kunena chifukwa chomwe matendawa amachitikira, koma zifukwa zingapo zosadziwika zimatchedwa:

Kusuta. Oposa theka la odwala omwe ali ndi chotupa amasuta fodya wazaka zambiri. Zinthu mu kapangidwe ka utsi wa fodya zimayambitsa kupezeka kwa neoplasms yoyipa. Vutoli likukulirakulira chifukwa chakuti kusuta fodya pafupipafupi kumasokoneza magazi oyenera kupita mthupi.
Matenda a kapamba Njira yotupa yosalekeza imathandizira kusintha kwa maselo athanzi kukhala zotupa za khansa.
Matenda a shuga. Mwa anthu odwala matenda a shuga kwa zaka zambiri, kuchuluka kwa shuga kumakhala kwabwinobwino, komwe nthawi zina kumawonjezera mwayi wa oncology.
Kudziletsa. Ngati wina m'banjamo wadwala matendawa, wachibale wawo amayenera kuwonetsetsa kuti ali ndi thanzi labwino komanso kuti apimidwe moyenera.
Kunenepa kwambiri. Mafuta ochulukirapo ndi ma carbohydrate amachititsa kuti thupi likhale lolemera kwambiri komanso limayambitsa kupangidwe kwa maselo owonjezera amthupi mu minofu, yomwe imasinthidwa kukhala zotupa zoyipa.
Zakudya zopanda pake. Pali lingaliro loti ngati maziko a chakudyacho ali ndi mafuta a nyama, ndiye kuti chiopsezo cha neoplasms mu kapamba amawonjezeka. Mowa, caffeine, kusowa kwamasamba atsopano ndi zipatso zimakhala ndi zotsatirapo zoipa.
Matenda a chiwindi ndi ziwalo zam'mimba thirakiti. Choopsa kwambiri pamenepa ndi zilonda zam'mimba: matumbo samatha kutulutsa zinthu zonse zapoizoni zopezeka m'thupi.
Matenda opatsirana.
Poizoni ndi zinthu zapoizoni.
Kulephera kuchita zolimbitsa thupi.
Kukalamba kwa wodwalayo.
Kukhala m'malo ovuta zachilengedwe, makamaka kumadera okhala ndi radiation maziko.

Pancreatic tumor prophylaxis

Popeza matendawa alibe zoyambitsa, kupewera kumaphatikiza njira zolimbikitsira thanzi:

Kuthetsa kwathunthu kusuta.
Kuchepetsa kugwiritsa ntchito zakumwa zakumwa zoledzeretsa.
Chithandizo cha matenda osachiritsika ndi kapamba.
Kugwirizana ndi mfundo za zakudya zoyenera, kuphatikiza pazakudya zomwe zimakhala ndi fiber, mavitamini, zambiri.
Kuchita masewera olimbitsa thupi pafupipafupi komanso kuchita zinthu zina zakunja kumalimbitsa chitetezo chathupi komanso kumathandiza kupewa kunenepa kwambiri.
Kukhazikitsa koyenera kwa diagnostics ofunikira. Anthu omwe ali ndi cholowa chokhudzana ndi kubadwa kwa oncology amalangizidwa kuti azichita kafukufuku pothandizidwa ndi zotupa kamodzi pachaka. Zinthu izi zimawonekera mthupi poyankha ngati chotupa. Otsutsana amasiyanitsidwa ndi mapangidwe omwe, ndi maselo oyandikana nawo kapena chitetezo cha munthu mthupi. Pafupifupi mitundu 200 ya mapuloteni amadziwika omwe amachititsa kuti azitha kudziwa mawonekedwe a maselo owopsa miyezi isanu ndi umodzi asanayambe matendawa. Izi zimathandiza akatswiri kuzindikira oncology pa nthawi, kuwunika momwe akuwonekera ndikuwapatsa mankhwala.

Pancreatic chotupa chimafuna kuwunikira pafupipafupi ndi madokotala. Amayenera kuchiza matendawa munthawi yake, apo ayi zotsatira zake zimadziwikiratu. Pamagawo oyamba a chotupa, kuchira kwathunthu ndikotheka kuti opaleshoni, njira zingapo zowonongera maselo a khansa ndi radiation ndi chemotherapy, amachitidwa.

Khansa Yapancreatic

Pancreas imakhala ndi minofu ya exocrine, yomwe imatulutsa michere yokumba, ndi endocrine, ntchito yomwe ikupanga mahomoni ena. Chifukwa chake, kutengera ndi chiyambi, zotupa zoyipa za pancreas ndizopatula. Zoyambilira ndizofala kwambiri. Mukamayankhula za khansa ya kapamba, nthawi zambiri amatanthauza zotupa za exocrine.

Adenocarcinoma - A chotupa glandular ndiye mtundu wofala kwambiri wa khansa ya exocrine. Zimachitika mu 80-95% ya milandu. Nthawi zambiri, chotupa chija chimachokera ku maselo okhala ndi ma pancreatic ducts (ductal adenocarcinoma). Zochepa kwambiri ndi neoplasms zochokera m'maselo omwe amapanga michere yogaya mu acini. Khansa imeneyi imatchedwa kuti acinar cell.

Olekanitsa intraductal papillary ndi cystic mucinous zotupa zogwirizana ndi khansa yowononga. Izi neoplasms ndizabwino, koma pakapita nthawi zimatha kusintha kukhala khansa. Anthu omwe amapezeka ndi matendawa amayenera kuyang'aniridwa ndi dokotala. Ma cystic chotupa nthawi zambiri amachotsedwa opaleshoni chifukwa choopsa cha zilonda. Opaleshoni ya papillary imachitidwa pansi pazinthu zina, mwachitsanzo, ngati neoplasm ili mu duct yayikulu.

Mitundu yoyipa ya pancreatic malignancies: squamous, undifferentiated, adenosquamous khansa, cystadenocarcinoma, cricoid cell carcinoma.

Pansi pa 5% ya ma pancreatic neoplasms onse ndi zotupa zomwe zimachokera ku maselo a endocrine (neuroendocrine zotupa, kapena islet cell chotupa): gastrinomas, insulinomas, glucagonomas, somatostatinomas. Nthawi zambiri amakhala osavomerezeka, koma amatha kukhala ovulaza, kuwonjezera apo, sikuti zimathandizanso kukhazikitsa nthawi yoyenera kudziwa nthawi.

Khansa yapakansa

Khansa yam'mutu ya pancreatic ndiyofala kwambiri. Mwachitsanzo, pafupifupi 75% ya ductal adenocarcinomas amakhala pano. Zotupa zoyipa zomwe zimachotsedwa pamutu zimakula kukula kwa 2,5 mpaka 3,5, pomwe m'thupi ndi mchira nthawi zambiri zimakhala zazikulu. Komabe, chifukwa chakomwe kuli duct ya bile, ngakhale maopyopaleti ang'onoang'ono am'mutu amatha kufinya ndikutsogolera jaundice yovuta. Zina zomwe zimakumana ndi zovuta: duodenal stenosis komanso magazi atayamba kuwonongeka ndi khansa.

Khansa yapakansa

Thupi la kapamba ndi gawo lachiwiri lofala kwambiri pazochitika za khansa. Ductal adenocarcinomas amapezeka pano mu 18% ya milandu. Ngati chotupa chili m'thupi kapena mchira, ndiye, kuyerekeza ndi khansa yam'mutu, zovuta monga thrombophlebitis, phlebothrombosis, ndi shuga mellitus ndizofala. Zikuwoneka kuti, izi zimachitika chifukwa chakuti neoplasms ya thupi ndi mchira ndizokulirapo. Ngati jaundice ikachitika, nthawi zambiri izi zikuwonetsa khansa yomwe yasiyidwa.

Khansa Yapancreatic

Khansa yamatenda a pancreatic ndiyomwe imakhala yodziwika bwino. 7% yokha ya ductal adenocarcinomas omwe ali ndi kutulutsidwa. Chifukwa cha kuyandikira kwa m'mimba, m'matumbo, ndi m'mapapo, zotupa zoterezi ndizovuta kuzizindikira pakufufuza.

Khansa yapakansa

Kugawidwa kwa khansa ya pancreatic kukhala magawo kumakhazikitsidwa pamachitidwe ambiri ovomerezeka a TNM.

Kalatayi T akufotokoza za chotupa chachikulu. T1 - chotupa chomwe chimapezeka mkati mwa kapamba, chimakhala ndi kukula kwa 2 cm (T1a) kapena kupitirira (T1b) ndipo sichikula mu kapisozi, mitsempha yamagazi, ndi ziwalo zoyandikana. Gawo la T2 ndi T3 likuwonetsa kuwonongeka kosiyanasiyana kwa khansa m'magulu osiyanasiyana.

Kalata N ikusonyeza kufalikira kwa maselo a khansa m'mimba. N0 - foci mu ma lymph node palibe. N1,2,3 - kufalikira kwa khansa m'magulu osiyanasiyana a ma lymph node.

M ndi kukhalapo (M1) kapena kusakhalapo (M0) kwa metastases yakutali.

Kutengera ndi kuphatikiza kwa mitundu yosiyanasiyana ya T, N ndi M, khansa ya kapamba imagawika m'magulu anayi ndi magawo:

N0N1N2N3

T1a

T1b

Aliyense T ndi N, M1

Khansa yapakansa yokhala ndi metastases

Tsoka ilo, khansa ya kapamba yokhala ndi metastases (gawo IVb) ndizofala: imapezeka mu 45-55% ya odwala. Nthawi zambiri, malo owoneka ngati sekondale amakhala m'malo osiyanasiyana am'mimba, chiwindi, mapapu ndi mafupa. Kuchiza mosamala pazinthu zoterezi ndikosatheka, koma madokotala amatha kuletsa kupweteka komanso zizindikiro zina zowawa, kukulitsa moyo wa wodwalayo.

Pancreatic metastases

Nthawi zina chotupa chopezeka m'mapapo ndimatenda a khansa ya chiwalo china. Izi sizichitika kawirikawiri: khansa ya metastatic imangokhala 2% yokha ya zotupa zoyipa zonse za kapamba. Chotupa choyambirira chimapezeka kwambiri m'mapapu, gland ya mammoni, impso, matenda am'mimba, ndi gland. Nthawi zina melanoma, osteosarcoma, leiomyosarcoma, Merkel's carcinoma metastasesa to the penancas.

Zoyambitsa Khansa Yapancreatic

Pali zinthu zina zomwe zimayambitsa chitukuko cha zotupa zoyipa m'mapapo. Mitu ikuluikulu ndi:

Matenda a shuga. Pazifukwa zosadziwika, chiopsezo chamadwala chikuwonjezereka mwa anthu omwe ali ndi matenda a shuga a 2. Kuwopsa kwa odwala omwe ali ndi matenda amtundu wa 1 sikunaphunzire.
Matenda a Gallstone.
Matenda a kapamba Chiwopsezo ndichuluke kwambiri pakati pa omwe amasuta. Komabe, kutali ndi anthu onse omwe amatenga kutupa m'matumba a chi pancreatic kumabweretsa chotupa.
Matenda a chiwindi. Pali umboni wosonyeza kuti matendawa amayambitsa khansa ya kapamba.
Zina mwabadwa nazo: milandu ya kapamba kapamba m'mabanja, kusinthika kwa jini la BRCA2, Lynch syndrome, matenda ambiri a dysplastic nevi.
Amagwirizana ndi melanoma.
Kusuta Chimodzi mwazinthu zazikulu zowopsa. Amadziwika kuti pafupifupi 20-30% ya milandu ya oncology imagwirizanitsidwa ndi kusuta ndudu, mapaipi, ndudu.
Kugwiritsa ntchito kwambiri mowa. Chiyanjano chachindunji cha pakati pa kumwa mowa ndi khansa ya pancreatic sichinakhazikitsidwe. Koma ndikudziwika kuti ndi kumwa pafupipafupi, chiopsezo cha pancreatitis yayitali, matenda a chifuwa - matenda, omwe, amathandizanso kuwopsa.
Kunenepa kwambiri. Kukhazikika kuti mwa anthu onenepa kwambiri chiwopsezo chikuwonjezeka ndi 20%. Choopseza chachikulu ndikuthiridwa kwamafuta kwambiri m'mimba, ngakhale munthu atakhala ndi thupi lolemera.
Zaka zopitilira zaka 60-65. Pafupifupi odwala onse ali ndi zaka zopitilira 45. Magawo awiri mwa atatu ali ndi zaka zopitilira 65. Nthawi zambiri, matendawa amapezeka mwa anthu opitilira zaka 70.
Cysts ndi adenomas a kapamba amadziwika ngati matenda opatsirana.

Kodi khansa ya kapamba ingalephereke?

Sikuti pali zinthu zonse zomwe zingawonongeke pangozi zomwe zingachitike, koma njira zina zopewereza zilipo. Choyamba, ndikofunikira kusiya kusuta - izi zithandiza kuchepetsa chiopsezo cha mitundu ingapo ya khansa nthawi imodzi. Kutaya sikunachedwe, phindu laumoyo lidzakhalabe. Yesani kukhala ndi thanzi labwino, perekani mowa - malinga ndi kafukufuku wina, Mlingo wotetezeka mulibe. Ngati muli pantchito muyenera kukumana ndi mankhwala oyipa, samalani malamulo oyendetsera chitetezo ndikugwiritsa ntchito zida zodzitetezera.

Kupweteka Kwa Cancreatic Cancer

Chizindikiro choyamba cha matenda, monga lamulo, ndi ululu. Maonekedwe ake akusonyeza kuti chotupacho chakhala mathero amitsempha. Kuchulukitsa kwa kupweteka kumatha kukhala kosiyana, kuchokera kumalingaliro osasangalatsa mpaka kuwukira kwambiri. Kukula kwachilengedwe kumadalira gawo lomwe limakhudzidwa:

Mutu uli pansi pa nthiti yakumanja,
mchira - pamimba chapamwamba kumanzere,
chikondamoyo chonse ndi kupweteka kwa m'chiuno.

Zomverera zam'mimba zimakulirakulira pamene wodwala wagona kumbuyo kwake, atatenga mafuta, zakudya zonunkhira, zakumwa zoledzeretsa. Nthawi zambiri zizindikirozi zimatengedwa ngati chiwonetsero cha kapamba kapena matenda ena, omwe amadziwika kuti ali ndi zolakwika mu zakudya komanso uchidakwa. Anthu ambiri samapita kwa madokotala nthawi yayitali, ndipo chotupa chikupita patsogolo pakadali pano.

Nthawi zina mawonetseredwe oyamba a khansa ya pancreatic ndi mitsempha yayikulu ya mwendo. Izi zikuwonetsedwa ndi izi:

kupweteka
kutupa
redness
malungo pakhungu la miyendo.

Ngati chidutswa cha magazi chikatuluka, chimasunthira m'matumbo am'mapapu ndikutseka chimbudzi, pamakhala kupindika - pulmonary embolism.

Chovala chowopsa

Vutoli limayamba ngati chotupa chikakamiza bile ya duct. Zizindikiro zake:

khungu, mucous nembanemba ndi maso a khungu amakhala acteric,
mkodzo wayamba kuda, zikuwoneka ngati zakumwa zakuda
chopondacho chimakhala chosakongola
Mimba imachuluka chifukwa cha kuchuluka kwa chiwindi ndi ndulu,
kuda nkhawa ndi khungu loyera.

Jaundice amapanga pang'onopang'ono. Choyamba, khungu limakhala ndi mtundu wachikaso wowoneka bwino, kenako pang'onopang'ono limayamba kulocha. Pakapita nthawi, kulephera kwa impso ndi chiwindi, magazi amatuluka kwambiri, ndipo wodwalayo amwalira.

Intoxication

Ndi kuvunda kwa chotupa m'magazi, zinthu zimamasulidwa zomwe zimatsogolera ku kuledzera kwa thupi. Zizindikiro zotsatirazi zimachitika:

kuwonda mwadzidzidzi
kudya kwakachepa, makamaka pokhudzana ndi zakudya zamafuta, nyama,
kufooka, kutopa,
malungo
kupsinjika kwapafupipafupi
ulesi, kupanda chidwi.

Khansa yapakansa: ICD-10 code

Mu International Classization of Diseases of the Tenth Revision (ICD-10), khansa ya khunyu yapatsidwa cholembedwa C25 - "malopane neoplasms of the pancreas". Imazindikira maulendo asanu ndi atatu omveka - subtopics:

C25.0 - zotupa za mutu wa kapamba,
C25.1 - zotupa zoyipa za thupi la kapamba,
C25.2 - zotupa za mchira wa kapamba,
C25.3 - zotupa za pancreatic duct,
C25.4 - ma neoplasms amaselo ochepa,
C25.7 - zotupa za ziwalo zina,
C25.8 - chotupa chotupa cha magawo angapo omwe atchulidwa pamwambapa,
C25.9 - chotupa chosadziwika.

Mankhwala othandizira

Kuchotsa chotupa pa zotupa kumatheka pokhapokha peresenti ya 10% ya milandu. Pankhaniyi, zinthu zitatu ziyenera kukwaniritsidwa:

khansa ya pakhungu sayenera kumera kukhala ziwalo zoyandikana,
sipayenera kukhala metastases
thanzi la wodwalayo liyenera kuchitidwa opaleshoni yayikulu (chifukwa chake, chithandizo cha opaleshoni chimachitidwa kawirikawiri mwa achinyamata).

Nthawi ya opaleshoni, gawo la kapamba kapena zonse zimachotsedwa, nthawi zina zimakhala ndi gawo la duodenum, m'mimba, bile duct, malo apafupi a lymph, ngati akhudzidwa ndi chotupa. Nthawi zambiri, muyenera kupita ku Whipple ntchito - pancreatoduodenal resection.

Madokotala ochita opaleshoni odziwa ntchito amagwira ntchito kuchipatala cha ku Europe komanso chipinda chogwiritsira ntchito chopangira zida zabwino. Timagwira ntchito za zovuta zilizonse.

Nthawi zina, anastomosis imakhazikitsidwa pakati pa ndulu ndi jejunum, yomwe imapereka mwachindunji kutuluka kwa bile. Ngati chotupa sichingachotseke chifukwa cha kumera kwakuya, madokotala amatengera mndandanda wazomwe amathandizira kuchotsa kwa bile ndikuwongolera thanzi la wodwalayo.

Pambuyo chithandizo chachikulu, wodwalayo ayenera kutenga michere ndi insulin kukonzekera moyo.

Khansa yapakhungu ikukula mwachangu kwambiri. Ngati chithandizo champhamvu sichingatheke, sibwino kuchotsa mbali ya chotupacho, makamaka kwa anthu achikulire omwe ali ndi matenda opatsirana. Kuopsa kochita opaleshoni yayikulu kumaposa phindu lomwe lingakhalepo.

Chimodzi mwazinthu zovuta komanso zovuta kwambiri za khansa ya kapamba ndizolepheretsa. Pofuna kubwezeretsa kutuluka kwa bile, amayamba kuchita nawo zina:

Anastomosis pakati pa jejunum ndi chikhodzodzo cha ndulu.
Kuyika kwa catheter wa drainage nthawi ya endoscopic retrograde cholangiopancreatography (ERCP). The catheter amakhala otsekeka nthawi ndi nthawi, miyezi itatu iliyonse amafunika kusinthidwa.
Kukhazikitsa kwa stent (chitsulo cholimba chokhala ndi khoma lopopera lomwe limakulitsa chimbudzi cha duct) pa percutaneous transhepatic cholangiography.

Chemotherapy

Chemotherapy ya khansa ya kapamba imakhala yofooka. Nthawi zambiri, amawapangira limodzi ndi mankhwala a radiation, makamaka ndi zotupa zosagwiritsidwa ntchito, kuti atalitse moyo komanso kukonza bwino wodwalayo.

Mankhwala othandizira a mahormone amawonetsa zotsatira zabwino, popeza ma estrogen receptors, omwe amalimbikitsa kukula kwawo, nthawi zambiri amapezeka pama cell a chotupa mu kapamba. Nthawi zina, mankhwala a mahomoni amathandizira kuti wodwalayo akhale ndi moyo.

Radiation chithandizo cha khansa ya kapamba

Nthawi zambiri, chithandizo chamankhwala cha radiation chimaperekedwa pambuyo pa opaleshoni kupha maselo a khansa otsala m'thupi. Njira yothandizirana ndi ma neoperative (neoadjuvant) nthawi zina imayikidwa kuti athandizire kuchotsa kwa chotupa. Ndi khansa yosagwira ntchito, chithandizo cha radiation chingakhale njira yayikulu yochizira, zimathandizira kupulumutsa wodwala ku zowawa.

Pancreatic Cancer Nutrition

Anthu ambiri omwe ali ndi khansa ya pancreatic amakhala operewera. Chifukwa cha izi, amachepa kwambiri, amakumana ndi kufooka, kuchepa magazi komanso zovuta zina zimayamba. Chifukwa chake, ndikofunikira nthawi zonse kuwunika momwe odwala alili komanso kuwongolera. Thanzi liyenera kukhala lokwanira momwe lingathere, poganizira luso la wodwalayo.

Odwala ambiri ayenera kumwa michere ya pancreatic mu mawonekedwe a mapiritsi pafupipafupi. Ngati munthu sangathe kudya yekha, kudyetsa kwake kumachitika kudzera mu chubu la nasogastric - catheter woonda yemwe amailowetsa pamphuno m'mimba.

Khansa Yapancreatic: Kuyembekezera Moyo

Khansa ya pancreatic imakhala ndi moyo wotsika kwambiri wazaka zisanu. Mu magawo oyambilira amapanga 5-14%, mu magawo amtsogolo 1-3%.

Ngakhale khansayo akapezeka kuti yachedwa, ndipo matendawo akuwonekeratu kuti sizabwino, izi sizitanthauza kuti wodwalayo sangathandizidwe. Madokotala ku European Clinic amadziwa kupulumutsa ululu ndi zizindikiro zina zopweteka, kutalikitsa moyo, ndikuwonetsetsa kuti ndi yoyenera. Timakhala ndi mankhwala a khansa ya kapamba nthawi iliyonse.

Zizindikiro za chotupa

Pankhani ya chotupa chodziyimira pancreatic, Zizindikiro zimatha kufotokozedwa m'njira zosiyanasiyana, kutengera mtundu wa mbiri, kukula ndi malo. Poyamba, ukalamba ukadali wocheperako, sipangakhale zizindikilo konse kapena ndi zazing'ono kwambiri kwakuti munthu samaziganizira. Nthawi zambiri, m'mbuyomu, chotupa chimapezeka mwadzidzidzi nthawi iliyonse wodwalayo akamayesa.

Ngati ikukula mokulira ndikufika pamlingo wokulirapo, ndiye kuti imayamba kupanikizana ndi ma pancreatic ducts, mitsempha ndi zombo.

Kumayambiriro kwa wodwala, kupweteka kwam'mimba, hypochondrium kumanja, kusokonezeka ndi kupweteka pambuyo podya, kusowa chidwi cha thupi, kuchepa thupi, nseru, kutopa kwambiri kwa thupi kumatha kusokoneza. Pamene chotupacho chikukula, kukula kwakukulu kumawonekera, komwe sikungathe kunyalanyazidwa. Kuchulukana, neoplasm imafinya ndikutseka zitseko za bile, chifukwa chomwe bile limalowa m'magazi a wodwala. Zizindikiro za izi zimatha kukhala pakhungu ndi sclera chikasu, kusungunuka kwa ndowe, kulumala kwam'mimba, nseru, kuyabwa kwambiri pakhungu.

M'magawo apambuyo, wodwalayo nthawi zambiri amasanza atatha kudya, kumangokhala ndi nkhawa, kuzizira, kutuluka thukuta kwambiri.

Ndi chotupa chamtunduwu, monga insuloma, wodwala amakula hypoglycemia, kufooka kwambiri. Mwa odwala ena, Zizindikiro zimawonekera mwadzidzidzi; kwa ena, amatha kuchepa.

Khansa yapakansa

Chotupa chamutu chodziwika bwino kwambiri ndi khansa. Chiwopsezo chachikulu chotenga matendawa ndi okalamba. Neoplasm imakula kuchokera ku ma epithelial maselo a glandular minofu kapena ma ducts. Zomwe zimayambitsa maonekedwe awo sizikudziwika masiku ano, koma zomwe zimayambitsa kupezeka kwawo ndizofanana ndi matenda ena a pancreatic. Uku ndi kunenepa kwambiri, kuledzera, uchikhalidwe, matenda ena.

Khansa ya pancreatic ndi yovuta kudziwa chifukwa chake nthawi zambiri imatha kuti wodwala aphedwe. Izi ndichifukwa cha zifukwa zingapo. Choyamba, zilonda zamanyazi sizikupezeka koyambirira, chifukwa matendawa alibe zizindikiro. Kachiwiri, nthawi zambiri, odwala chifukwa cha ukalamba amakhala ndi zotsutsana pochita opaleshoni (njira yokhayo yothandizira). Chachitatu, chifukwa cha kudziwitsidwa mochedwa, ndizosatheka kuchotsa mankhwalawa.

Khansa yapakansa mwachangu kwambiri metastases mu kapamba ndi ziwalo zoyandikana. Chifukwa cha izi, kuchuluka kwa odwala ngakhale atachitidwa opaleshoni ndizochepa kwambiri.

Mitundu ya neoplasms yoyipa ndi chizindikiro chawo

Pancreatic carcinoma ndi neoplasm yoyipa; imayamba kuchokera ku ma cell a gland. Monga lamulo, chotupacho chimakula mwachangu ndipo chimasiyana ndi ena onse mwaukali waukulu. Kutengera ndi maselo omwe amapanga, ma neoplasms oyipa amagawidwa m'mitundu iyi:

ductal adenocarcinomas - opangidwa kuchokera ku maselo a ma pancreatic ducts,
cystadenocarcinoma - kusintha kwa chotupa kukhala chotupa,
mucinous adenocarcinomas - mtundu wosowa wa khansa ya endometrial, neoplasm imakhala ndi maselo a cystic omwe amatsegula ntchofu, amakhala owopsa ndi metastasis ku ma lymph node,
squamous cell carcinoma - imachokera ku epithelial minofu ndi mucous membrane, amadziwika ndi kukula msanga komanso mwamphamvu maphunziro.

Nthawi zambiri, zizindikiro zosonyeza kukula kwa chotupa chonyansa cha kapamba zimawoneka kale kumapeto, ndikayamba kuponderezana ziwalo zamkati kapena ndulu.

Chizindikiro choyambirira komanso chachikulu ndikumva kupweteka, ndi kukula kwa neoplasm, kumakulirakulira. Kudziwonetsa kwawoko nthawi zambiri kumadalira gawo la kapamba lomwe limakhudzidwa. Ngati mutu wake wakhudzidwa, ndiye kuti ululu umalowerera pansi pa nthiti yakumanja, ngati mchira uli kumtunda chakumanzere kwa m'mimba, ngati matenda adakhudzana ndi zikondamoyo zonse, ndiye kuti ululu umakhala ngati. Momwe munthu wagona kumbuyo kwake, ululuwo umakulirakulira. Makamaka zimatha kudya mafuta, yokazinga, zakudya zonunkhiritsa ndikumwa zakumwa zoledzeretsa. Nthawi zambiri anthu satengera kufunikira kwa zizindikirozi, chifukwa choti ndi kapamba. Chizindikiro china chodziwika bwino cha khansa ya kapamba ndimatenda a kusowa kudya, nthawi zina ngakhale anorexia, omwe amachititsa kuchepa kwambiri kwa thupi.

Ngati mankhusu amakakamiza ndulu ya ndulu, khungu limayamba, khungu limalumikizana ndi mtundu wachikasu, ndipo kuyabwa kwambiri pakhungu kumatha kuonekera. Mseru ndi kusanza kumachitika pamene chotupa chimakankhira duodenum ndi m'mimba. Zodabwitsazi nthawi zonse zimatsagana ndi matenda am'mimba.

Zizindikiro za khansa ya pancreatic imaphatikizanso ndulu yowonjezereka komanso kutuluka kwamkati kuchokera m'mitsempha yamkati yam'mimba, chitukuko cha cholecystitis pachimake ndi kapamba pachimake.

Pancreatic neuroendocrine chotupa (neo chotupa) chimasiyanitsidwa ndi kupuma ndi kukhalapo kwa zizindikiro zowoneka bwino ndi kusokonezeka kwa endocrine m'thupi la wodwalayo. Chifukwa chakuti zimayambitsa kusintha kwakukulu mu endocrine system, zilonda zamatumbo, m'mimba pafupipafupi, bronchospasm, fibrosis imakhala chibadwa mkati mwake.

Pancreatic neuroendocrine chotupa chimakhala ndi matenda osakanikirana kwa wodwala, kugwiritsa ntchito bwino kwamankhwala ake kumadalira kuchuluka kwa zilonda.

Chithandizo cha chotupa cha pancreatic

Chithandizo cha chotupa cha pancreatic sichikuchitika mwamphamvu, kokha. Chotupacho chikapezeka msanga ndipo opaleshoniyo imachitika, ndiye kuti wodwalayo amayamba kudwala kwambiri. Odwala omwe ali ndi chotupa chovuta amatha kuchira. Kwa odwala khansa, matendawa amakhumudwitsa. Malinga ndi ziwerengero, ndi 15% yokha ya odwala omwe angathe kuthandizidwa. Chifukwa chakuti khansa ya kapamba nthawi zambiri imakhala khansa ya metastatic komanso ikupita patsogolo msanga, mwa odwala nthawi yomwe chotupacho chikupezeka, ziwalo zoyandikana ndi ma lymph node zimakhudzidwa kale ndi metastases. Pankhaniyi, madokotala samayesanso kuchititsa chotupacho. Mwa onse omwe adachitidwa, pafupifupi 20% amwalira pakuchita opareshoni. Ndipo mwa odwala onse omwe adachitidwapo khansa ya kapamba, ndi 10% yokha omwe azikhala ndi moyo wopitilira zaka 5 atachitidwa opaleshoni.

Njira monga radiotherapy ndi chemotherapy zimachepetsa kukula kwa neoplasm, yomwe kuphatikiza ndi ma painkillers kumathandizira wodwalayo asanamwalire.

Zakudya za pancreatic neoplasms

Kudya kwa chotupa cha pancreatic ndi imodzi mwamankhwala ofunikira. Iyenera kupangidwa kuti ichepetse nkhawa pamimba ndi kupewa ntchito zosafunikira za kapamba popanga chakudya. Chakudya cha wodwalayo chiyenera kukhala chokwanira, komanso mavitamini ndi michere yokwanira kwa iye. Choyamba, wodwalayo ayenera kusiya zakudya zokazinga, zonona, zosuta komanso zonunkhira, zakumwa zoledzeretsa, zophika ndi zotsekemera, zakumwa za kaboni, khofi.

Wodwala samalimbikitsidwa kudya kwambiri, ndibwino kudya kawirikawiri, koma pang'ono ndi pang'ono. Ndikwabwino kudya chakudya chomwe chimateteza m'mimba: chawotchera, mu uvuni kapena chophika, chosankhidwa musanagwiritse ntchito.

Kuchokera pazinthu za lactic acid, tikulimbikitsidwa kusankha omwe mafuta otsika kwambiri. Zachidziwikire, kudya kokha komwe sikungathetse wodwala chotupacho, koma kutsatira zomwezo kumachepetsa kwambiri matendawa.

Pofuna kuchepetsa chiopsezo chotupa, anthu omwe akudwala kapamba ayenera kudya moyenera, kuyang'anira zakudya zosiyanasiyana, kusiya mowa ndi kusuta, kupewa kudya kwambiri, idyani masamba ndi zipatso zambiri. Pofuna kuti musaphonye mphindi ndi kupezekanso kwakanthawi mu kapamba, tikulimbikitsidwa kuti tikamayesedwa kamodzi pa miyezi isanu ndi umodzi.