Pancreatic chotupa

Nthawi zambiri, benign pancreatic chotupa, kufikira atafika pamiyeso yayikulu, samadziwonetsa mwanjira iliyonse, kotero kuwunikira kumachitika mwamwayi, panthawi yopanga ma ultrasound (ultrasound) yam'mimba. Chosiyana ndi insuloma. Chotupa choterocho ngakhale ndi tating'onoting'ono timene timakhudzira momwe thupi la munthu limasinthira ndikusintha - kuchepa kwa shuga m'magazi kumabweretsa madandaulo ofananirako:

• kufooka
• kumverera kwa mantha
• thukuta kwambiri
• chizungulire, nthawi zina kuwonongeka.

Pali zisonyezo zingapo zomwe zimasiyanitsa zotupa (mtundu wa maselo ndi ofanana ndi mtundu wa maselo a chinthu chomwe amachokera) kuchokera kuzowonongeka (mtundu wamaselo umasiyana ndi mtundu wamaselo omwe adachokera).

• Kupanda mbiri yolemetsa ya khansa ya kapamba.
• Kupanda mawonekedwe owoneka bwino azachipatala (zizindikiro).
• Kusakhalapo kwa chotupa kuledzera (poyizoni) - kufooka wamba, kufooka, kusadya, nseru, kusanza, kutentha thupi, khungu (khungu la khungu) komanso kufinya khungu.
• Mlingo wabwinoko wa zotupa (mapuloteni apadera omwe amapezeka mu neoplasms yoyipa mwambiri) ndi CA 19-9, KEA.
• Zomwe zimagwiritsidwa ntchito yamagazi (kugawa kwamitsempha yamagazi m'm chotupa) panthawi ya angiography (kufufuza kwa x-ray kwamitsempha yamagazi).
• Kupanda chotupa kapena kukula pang'ono pakapita nthawi yayitali.
• Zizindikiro zodziwika bwino zamatenda onse a kapamba.
• Ululu Kuchitika pa makina kukakamiza kwa oyandikana limba ndi chotupa. Zowawa ndizodziwika (zili) kumanzere kumanzere kapena kumanzere kwa hypochondrium (mbali), epigastrium (dera lomwe lili pansi pa sternum, lomwe limafanana ndi kuchuluka kwa m'mimba pakhoma lakumbuyo yam'mimba), pafupi ndi navel, nthawi zambiri limakhala ndi chovala (chomverera paliponse pa thunthu). chakudya chitha kukhala chokhazikika kapena paroxysmal.
• Jaundice Chotupa chikukula chimalepheretsa (chotchinga) ndulu wamba ndi chimbudzi, chomwe chimatsogolera jaundice yovuta, yomwe imawonetsedwa ndi chikasu cha pakhungu, kuyabwa, kusungunuka kwa ndowe ndi khungu lakuda la mkodzo.
• Kusanza, kusanza, kumva kupsinjika pamimba mutatha kudya - zizindikiro zam'mimba zosokoneza (kusokonekera kwa chakudya kudzera m'matumbo) pamene chotupa chimakankhira duodenum.

Mitundu ya chosaopsa pancreatic chotupa.

• Insuloma (chotupa chotupa chochokera ku minofu ya glandular).
• Fibroma (chotupa chotupa chochokera ku minofu yolumikizika).
• Lipoma (chotupa chotupa chochokera ku minofu ya adipose).
• Leiomyoma (chotupa chaching'ono kuchokera ku minofu minofu).
• Hemangioma (chotupa chotupa chochokera kumitsempha yamagazi).
• Neurinoma (chotupa chaching'ono kuchokera ku minofu ya mitsempha)
• Schwanoma (chotupa chotupa chakukula kuchokera ku maselo a Schwann (ma cell m'mitsempha yama nerve).
• Cystoma (kapisolo ndi madzi mkati).

Mwa kutchukitsa (malo), mitundu yotsatirayi imasiyanitsidwa:

• zotupa za mutu wa kapamba,
• zotupa mthupi,
• zotupa za mchira wa kapamba.

Zifukwa matenda samveka bwino.

Pakati zinthu zoopsa kupatula ochepa.

• Zizolowezi zoipa (kumwa, kusuta).
• Heredity (chiopsezo chokhala ndi khansa ya kapamba ndichapamwamba ngati mbiri ya abale apafupi inali ndi zotupa).
• Zolemba muzakudya (kudya zakudya zamafuta ambiri (nthawi zambiri zochokera kuchinyama), kusowa kwa zakudya zomwe zimakhala ndi CHIKWANGWANI (buledi wa tirigu, tirigu, nyemba, buckwheat ndi chimanga, masamba, zipatso).
• Pancreatitis (kutupa kwa kapamba).
• Zovuta zachilengedwe.

Oncologist athandizira pochiza matendawa

Zizindikiro

• Kusanthula kwa mbiri yachipatala ya matendawa ndi madandaulo ((liti) kwanthawi yayitali bwanji ululu wam'mimba, chikasu cha pakhungu, kuyabwa, kusunthika kwa khungu ndi mtundu wakuda wa mkodzo, pomwe wodwalayo amagwirizanitsa ndi zomwe zimachitika).
• Kusanthula kwa mbiri ya moyo wa wodwalayo (wodwalayo ali ndi matenda am'matumbo (makamaka, adokotala amakonda chikhodzodzo (kutupa kwa kapamba), matenda ena akale, zizolowezi zoipa (kumwa mowa, kusuta), chikhalidwe cha zakudya).
• Kusanthula kwa mbiri yabanja (kukhalapo kwa khansa pakati pa achibale).
• Chidziwitso chowunikira. Dotoloyo amawonetsetsa kuti wodwalayo ali ndi:
  • khungu pakhungu lawo,
  • kutuluka thukuta kwambiri
  • Kusintha kwa ndowe, kuda kwa mkodzo.

• Zambiri ndi zolemba ntchito.
  • Kuyesedwa kwa magazi konse. Anemia (anemia, kuchepa kwa magazi hemoglobin (puloteni yomwe imanyamula oxygen m'magazi) imatha kupezeka.
  • Kuyesa kwamwazi wamagazi. Pali kuchepa kwa shuga (shuga) m'magazi (ndi insuloma).
  • Pozindikira kusiyanasiyana (kwapadera) kwa chotupa, chizindikiritso cha zotupa za CA 19-9, KEA (mapuloteni ena apadera omwe amapezeka m'magazi ndi zotupa zina zoyipa (khansa ya m'mawere, kapamba, ndi zina) amagwiritsidwa ntchito.
  • Kusanthula ndowe (pali kusowa kwa stercobilin (mtundu wa bulauni (chinthu cha utoto) pogwiritsa ntchito ma microscope).
  • Urinalysis Urobilinogen (chinthu chopangidwa kuchokera ku bilirubin (chimodzi mwazinthu zokhala ndi ndulu) ndikusintha kukhala urobilin (pigment yomwe imasokoneza mkodzo wachikasu) imatsika kenako nkutha kupezeka mkodzo. Izi zimachitika chifukwa cha chotupa cha jaundice (nyengo yomwe kutsekeka (katsekedwa) kwa dambo la bile ndi kusokonezeka kwa magazi kumachitika.
  • Kuyesa kwa Ultrasound (ultrasound) kwam'mimba ziwalo - chotupa mu kapamba watsimikiza.
  • Scut tomography (CT) scan imachitika kuti ipeze chotupa cha pancreatic.
  • Magnetic resonance imaging (MRI) - amachitidwa kuti apeze chotupa cham'mimba.
  • Endoscopic retrograde cholangiopancreatography (ERCP) ndi njira ya X-ray yowunika ma ducts a bile ndi njira yayikulu yodziwika bwino ya kapamba. Zitsukazo zimadzazidwa ndi ma endoscope (chipangizo chapadera chozindikiridwa m'thupi la munthu) chokhala ndi chinthu cha X-ray (chinthu chomwe chikuwoneka pa X-ray), ndipo adotolo amawona momwe madutsawo adalowera mu gawo la X-ray. Ziliwululidwa ngati chotupacho chimakakamiza ma ducts.
  • Magnetic resonance pancreatocholangiography (MRPC, kusanthula kwa makompyuta, kapangidwe ka mitsempha yowonjezera ndi ma intrahepatic bile kumazungulira mundawo yamagetsi. Zimachitika kuti mudziwe momwe zilili malekezero, kaya apanikizidwa ndi chotupa.
  • Scintigraphy (mawu oyambitsa thupi la zinthu zamagetsi omwe amatha kutulutsa ma radiation amagwiritsidwa ntchito kuti apeze chithunzi cha komwe ndi komwe ziwalozi zimachedwetsedwera) zikuwonetsa kutukula (malo) a chotupa, kukula kwake.
  • Angiography (kuyesa kwa X-ray kwamitsempha yamagazi). Zachitika muzochulukirapo, ngati zotsatira za computer tomography (CT), imagonance imaging (MRI) ndi scintigraphy sizinapange kanthu.
  • Kuboola singano yabwino yofunafuna biopsy (kutenga chidutswa cha zotupa pakuyesa histological (minofu)).
• Kufunsira kwa gastroenterologist, othandizira othandizanso amatha.

Chithandizo cha chosaopsa pancreatic zotupa

Chithandizo chosaopsa pancreatic chotupa chokha opareshoni Ndikothekanso kukhazikitsa chotupa chovunda kapena chotupa pokhapokha pochita opaleshoni ndikupanga kafukufuku wa histological (minofu wapansi pa microscope) wa chotupa chotulutsidwa.

Mpaka pano, ntchito zazikuluzikulu zochotsa chotupa cha pancreatic zikuphatikiza 4.

• Kubwezeretsanso (kuchotsedwa kwa gawo la kapamba). Monga lamulo, opareshoni yotere imagwiritsidwa ntchito pamene chotupacho chili mchira wa gland.
• Kuchotsa kwa tumor (husking). Monga lamulo, zimapangidwa ndi zotupa zopanga ma-hormone - zotupa zomwe zimatulutsa (kutulutsa) mahomoni (mwachitsanzo, ndi insuloma, insulin (mahomoni omwe amatsitsa glucose (shuga) m'magazi).
• Pancreatoduodenal resection - kuchotsedwa kwa chotupa pamodzi ndi duodenum 12 panthawi ya kutulutsa (kuyikika) kwa chotupa pamutu pa chotupa.
• Kusankha kwa arterial embolization (kuphatikizika kwa chotengera) - nthawi zina kumachitika ndi hemangioma (chotupa chotupa chochokera m'mitsempha yamagazi) kuti asiye magazi ake.

Mavuto ndi zotsatirapo zake

Ngakhale kuti zotupa ndizoyipa, zimatha kuyambitsa zovuta zina.

• Chilonda (kusinthidwa kwa chotupa chovunda cham'mimba kukhala chotupa chowopsa cha kapamba).
• Jaundice wovulaza (chikhalidwe chomwe kutsekeka kwa duct ya bile kumachitika ndi kuyenderera kwa bile kumasokonezeka. Amadziwika ndi chikasu cha pakhungu, kuyabwa, kusinthasintha kwa ndowe komanso kuzimiriritsa mkodzo).
• Kuphwanya chimbudzi cha chakudya chifukwa chakuchepa kwa kayendedwe ka bile ndi ma enzyme (mapuloteni omwe amathandizira kusintha kwamphamvu mu thupi) m'matumbo a lumen.
• Kutsekeka kwamkati (kusokoneza pang'ono kapena komwe kusungunuka kwa chakudya m'matumbo) - kumatha kuchitika chifukwa chotupa chachikulu chomwe chikutseka kwambiri kuwala kwa duodenum.

Kupewa kwa chosaopsa pancreatic chotupa

Palibe njira yoletsa yeniyeni ya benign pancreatic neoplasms. Yalimbikitsa:

• samalani mfundo za zakudya zopatsa thanzi (kuchepetsa kudya zakazinga, mafuta, zakudya zonunkhira komanso zosuta, chakudya mwachangu, zakumwa zoziziritsa kukhosi, khofi),
• kudya zakudya zokhala ndi fiber yambiri (masamba, buledi, tirigu ndi mafuta a chimanga), mafuta a masamba, zinthu zamkaka, zakudya zomwe zimakhala ndi chakudya (mapadi omwe amapezeka mu zipatso, masamba, nyemba), madzi ambiri (pafupifupi malita awiri pa tsiku)
• lekani zizolowezi zoyipa (kumwa, kusuta),
• munthawi yake komanso chithunthu cha kapamba (kutupa kwa kapamba).

Dziwani ZOTHANDIZA

Kukambirana ndi dokotala ndikofunikira

• Opaleshoni Yamankhwala: Chitsogozo cha Dziko: 3 Vol. / Ed. V.S. Savelyeva, A.I. Kiriyenko. - M: GEOTAR-MEDIA, 2009.
• Clinical gastroenterology. P.Ya. Grigoryev, A.V. Yakovlenko. Medical News Agency, 2004
• Kuzindikira ndi njira zochizira matenda amkati: Shulutko B.I., S.V. Makarenko. Kusintha kwa 4 kunasinthidwanso. "ELBI-SPb" SPb 2007.

Zolinga zakukula

Monga tafotokozera pamwambapa, akatswiri sanganene chifukwa chake kapamba amakhudzidwa. Koma pali zinthu zomwe zimadziwika zomwe zimawonjezera chiopsezo chotupa chotupa pa chiwalo. Izi zikuphatikiza:

• chibadwire
• kusuta Izi zimawonjezera chiopsezo cha kupangika kwa neoplasm pafupifupi katatu,
• kunenepa
• mbiri ya matenda ashuga
• kuledzera kwa nthawi yayitali,
• kukhalapo kwa kapamba mwa munthu wodwala matenda ake,
• machitidwe ogwirira ntchito. Chiwopsezo cha mapangidwe a chotupa pamutu pa thumuyo chimakulitsa ngati munthu akakamizidwa kuti azikumana ndi zomwe zimachitika ndi nyama chifukwa cha zochita zake.

Chotupa cha Benign

Chotupa chofewa cha mutu wa pancreatic chimakhala ndi zinthu zingapo - sichingafanane, sichimera m'ziwalo zoyandikira, ndipo sichikuphwanya zinthu zoyambira zazida zomwe zimapangidwa. Kutengera kapangidwe kake, zotupa zotere za mutu wa gland zimasiyanitsidwa:

• leiomyoma
• adenoma
• insulinoma
• michere,
• ganglioneuroma,
• hemangioma.

Popita nthawi yayitali, chotupa cha mtundu uwu sichingathe kufotokozedwa ndi zizindikiro zilizonse. Chokhacho chokha ndi insulioma yopangidwa, yomwe imayambitsa kuwonjezeka kwa insulin. Zotsatira zake, izi zimasintha kwambiri momwe thupi la munthu limayambira. Mwambiri, zizindikilo zoyamba zimawonekera pakukula kwakukulu kwa kukula kwa chotupa. Chifukwa chakuti limakanikizika ziwalo zapafupi, ziwonetsero zotsatirazi zimawonekera mwa munthu:

• kupweteka pamimba yamitundu yosiyanasiyana yamphamvu. Nthawi zina amatha kupatsa nkono kapena kumbuyo. Osamadalira chakudya,
• chotupa choteteza. Zikuwoneka ngati neoplasm imafinya bile duct,
• kusanza ndi kusanza
• kulemera pamimba ndi kutulutsa,
• matumbo kutsekeka.

Ngati chithunzi choterechi chachitika, muyenera kufunsa dokotala woyenera yemwe angadziwe, adziwe mtundu wa chotupacho ndikuwachotsa. Kugwiritsa ntchito mankhwala a wowerengeka pamilandu iyi sikuli koyenera, chifukwa sizithandiza kuthetsa maphunziro, koma zimatha kupangitsa kuti wodwala azidwala. Kuthana ndi matendawa kumangowonetsedwa m'malo osakhalitsa.

Zilonda zopweteka

Chotupa chamtunduwu sichili chovuta kudziwa, komanso chovuta kuchiritsa. Titha kunena kuti singathe kuchiritsidwa. Mutha kungokulitsa moyo wa munthu kwakanthawi. Ndikosavuta kudziwa kukhalapo kwa chotupa, chifukwa sichimawoneka koyambirira koyambirira kwa mapangidwe ake. Palinso zochitika zina pamene zizindikiro za khansa sizioneka mpaka gawo 4.

• squamous cell carcinoma
• adenocarcinoma
• khansa yamkati
• khansa yam'magazi,
• cystadenocarcinoma.

Chifukwa chakuti chotupa pamutu chimakhala pafupi ndi chimbudzi, ndiye choyambirira chimadzipangitsa kumverera ndi zizindikiro za kupukusa m'mimba. Munthu amakhala ndi mseru komanso kusanza, kutsegula m'mimba, kudzimbidwa kumasungunuka, kutuluka kumatuluka, mkodzo umayamba kuda. Kuphatikiza apo, pali zizindikiro zingapo:

• kuchuluka kwa shuga m'magazi,
• kuchepa kwamtima
• kuwonda
• chotupa choteteza. Chizindikiro ichi chimadziwika ndi mawonekedwe. Jaundice wovomerezeka umachitika pamene chotupacho chimakakamizidwa ndi bile duct.

Kuopsa kwa neoplasm kumagonekanso chifukwa kumatha kukula kukhala ziwalo zina. Izi zimawonedwa pa magawo awiri kapena atatu a kapangidwe kake. Pa 4, kufalikira kwa metastases ku ziwalo zina kumadziwika. Pankhaniyi, kuyendetsa bwino ntchito sikuchitikanso. Maziko a chithandizo ndi othandizira.

Njira zoyesera

Zimakhala zovuta kudziwa kukhalapo kwa neoplasm pamutu wa England. Pazifukwa izi, kuwunika kuyenera kukhala kokwanira. Njira zonse zasayansi ndi zothandizira zimayikidwa. Gawo loyamba lazidziwitso ndikuwunika kwa odwala komanso kuwunika. Kuphatikiza apo, ndikofunikira kuti adotolo afotokozere mfundo zina - mtundu wa zomwe akuwonetsa, kukula kwake, ngakhale m'modzi mwa abalewo ali ndi khansa (cholowa), ndi zina.

Ndondomeko yodziwira matenda ophatikizira matenda akuphatikizira njira izi:

• kuyezetsa magazi kwakukulu,
• kuyezetsa magazi kwa zotupa,
• ambiri matenda a mkodzo,
• magazi zamankhwala
• kuyesa kwam'mimbamo zam'mimba,
• Ultrasound
• CT ndi MRI
• biopsy.Njira imodzi yophunzitsira, chifukwa imapangitsa kufotokoza momveka bwino ngati chotupa chokhacho kapena chovunda chapanga.

Mutalandira zotsatira zonse zoyeserera, njira yabwino kwambiri yoperekera chithandizo imaperekedwa.

Njira zochizira

Chithandizo cha zotupa za pancreatic ndimangopanga opaleshoni. Mankhwala ochotsa chotupa pomwepo sizotheka. Ngati neoplasm ndi yachilendo, ndiye kuti kuchitapo kanthu kungathandize kuti wodwalayo athe kuchira, ndipo apitilizabe kukhala ndi moyo wabwinobwino. Kuphatikiza apo, mankhwalawa amatha kutumizidwa kuti muchepetse kuchuluka kwa zizindikiro, komanso zakudya zapadera zimalembedwanso.

Chotupa choyipa chimakhala ndi matenda osavutirapo. Chifukwa choti nthawi zambiri zimapezeka m'magawo apambuyo, munthu sangathenso kuchitidwa opaleshoni, chifukwa chotupacho chidzakula kukhala ziwalo zina kapena kupatsanso metastases. Chithandizo cha mankhwalawa ndicholinga chokhala ndi moyo wamunthu. Chifukwa chaichi, radiation ndi chemotherapy, narcotic analgesics ndi mankhwala.