Kuzindikira matenda kapamba

Magawo anayi a chithunzi chachipatala cha CP:
Ndayamba. Gawo loyambirira, lodziwika ndi kusapezeka kwa matenda azachipatala komanso chizindikiritso chosintha mwanjira ya CP mukamayesedwa pogwiritsa ntchito njira zodziwitsira matenda a radiation (CT ndi abdominal ultrasound),

Gawo lachiwiri. Gawo la mawonetseredwe oyamba. Imadziwika ndi ma epicode ochulukirachulukira a CP, omwe amatha kuwawona molakwika kuti OP. Kubwezeretsanso matendawa kumatha kukhala kofatsa kapena kovuta, pamakhala zowopsa pamoyo wa wodwalayo. Pakali pano, njira yovuta ya CP ikhoza kuwonedwa. Matendawa amayamba ndi chizolowezi chokula msanga: kuyambira paziwopsezo zobwereza mpaka kupweteka kwapafupipafupi, limodzi ndi zovuta zamkati, vuto la mitsempha, ndipo, chifukwa chake, kuwonda.

Moyo wabwino sasintha kapena kuchepetsedwa. Gawo limatenga zaka zingapo. Popita nthawi, matendawa amayamba kuchepa kwambiri, komabe, pakadutsa kwamatenda ambiri, zizindikiro zamatenda zimapitirirabe. Nthawi zina matendawa amakula mwachangu, pancreatic atrophy imayamba ndipo ziwalo zimagwira. Kusintha kumatheka ngati matendawa akuwonekera ndi exocrine ndi endocrine kusakwanira,

III gawo. Amadziwika ndi chitukuko cha pafupipafupi zizindikiro zamankhwala ndizodziwikiratu kupweteka kwam'mimba. Odwala pano akhoza kukhala osokoneza bongo, kudya pang'ono. Pali zizindikiro za kulephera kwa exocrine ndi endocrine,

Gawo la IV. Gawo lomaliza la matendawa, lomwe limadziwika ndi pancreatic atrophy, exocrine ndi endocrine kusakwanira, limawonetsedwa ndi steatorrhea, yodziwika ndi kuchepa kwa thupi komanso shuga. Ululu umayamba kutchulidwa pang'ono, palibe zochitika zowawa kwambiri. Pakadali pano, zovuta za CP zimadziwika, makamaka khansa ya kapamba.

Mimba x-ray

Njira munthawi ya kupezeka kwakukulu kwa ultrasound ndi CT pakuwunikira kwa CP sikugwiritsidwa ntchito. Phunziroli limachitika mophweka, pamimba yopanda kanthu, popanda kukonzekera mwapadera. Onani zithunzi pawiri. Odwala omwe amawerengetsera CP mu pancreatic parenchyma kapena m'makonzedwe ake, calculi mwachiwonekere amawulula calculi mu radiographs (onani mkuyu. 4-18).

Ultrasound kuwunika kwam'mimba ziwalo

CP yopanda exacerbation imadziwika ndi kuchuluka kwakukula kwa ziphuphu zakumaso kapena kusinthana kwa magawo apakati komanso apamwamba kwambiri. Ichi ndichifukwa gawo lamatenda osapatsirana, ma fibrosis kapena ma calcication mu parenchyma ali mu mawonekedwe a magawo osiyana a kuchuluka kwa kuchulukana. Kutengera ndi kukula kwa madera omwe akhudzidwa, mawonekedwe a Micro-ndi macronodular sonographic a parenchyma, omwe amadziwika kwambiri pa nthawi ya calcifying CP, amawonedwa. Ma calcations ena akuluakulu amapereka "mthunzi wamtchire".

Ndi kuwonjezeka kodziwika kwa echogenicity (onani mkuyu. 4-19 a) wa pancreatic parenchyma, calculi imadziwika pokhapokha ngati "mithunzi yamaso". Dongosolo la mzere likuwonetsa komwe ali ku GPP (onani mkuyu. 4-19 b). Asanawulule kukula kwakukulu kwa duct distal kumiyala yomwe ili mmenemo. Kuzindikiritsa madera akuluakulu a hypoechoic motsutsana ndi kuchuluka kwa kuchuluka kwa mphamvu ya parenchyma kumawonetsa kukhalapo kwa njira yotupa yopitilira muyeso - kuchulukitsa kwa CP (onani mkuyu. 4-19 c).

Mu gawo limodzi mwa magawo atatu a CP, mawonekedwe a gland amakhala opanda khungu, osagwirizana, osagundika, chifukwa chake, mu CP, malire pakati pa kapamba ndi minofu yoyandikana sangathe kudziwika nthawi zina. Nthawi zina, ma pancreas amatha kukhala osalala, osanunkha kanthu, koma ndi matumba akuluakulu osalala, "humps" omwe amatsutsana ndi mawonekedwe a gland. Mu CP popanda kuchulukitsa, kukula kwa kutulutsa kwachilengedwe kumakhala kwabwinobwino kapena kuchepetsedwa, nthawi zina kwambiri, kotero kuti mu kapamba, ndizokhazo zomwe zimakulitsidwa ndi makhoma owongoka a GLP zimatha kuwoneka, nthawi zina kabowo kamakhala chifukwa cha mafupa owoneka ndi tinthu tating'ono.

Chizindikiro cha ultrasound cha fibrosis yomwe ikupita patsogolo komanso kuchepa kwa kukula kwa kapamba ndikuwonjezera mtunda pakati pa kapamba ndi msempha woposa 20 mm. Kuwonjezeka kwa kukula kwa kapamba kumadziwika ndi kuchuluka kwa CP. Kukula kumakonda kukhala kwanuko, komwe kumalumikizidwa ndi gawo la edema. Kuwonjezeka kwa kukula kwa kapamba kumatha kukhala limodzi ndi kupindika kwa mesenteric vein, pokhapokha nthawi zambiri otsika kwambiri a vena cava, zizindikiro za kupindika za splenic vein thrombosis nthawi zambiri zimatsimikiziridwa. Ndi edema m'dera la pancreatic mutu, kukakamiza kwa wamba duct kotheka ndikotheka, kutsogoza kukulira kwa izi kumapeto kwa gawo lalikulu la zotchinga.

Chifukwa cha kuchuluka kwa maumboni a mbali ziwiri, pali kuthekera kwakuti pakuchulukana kwa CP, madera amisala yochepetsedwa, nthawi zina kwathunthu kapena pang'ono kubisa zizindikiro za CP, zimayikidwa pamachitidwe osagwirizana.

Ultrasound imakuthandizani kuti muwonenso nthawi yomweyo chiwindi, ndulu ya chikhodzodzo, kuzindikira zochitika za ascro- ndi duodenostasis, zambiri zokhudzana ndi lingaliro la etiology, extrapancreatic zovuta, zimapangitsa kukhazikitsa kuphatikizika pamimba. Zizindikiro zazikulu za akupanga za CP zimaperekedwa pagome. 4-13.

Ma interstitial edematous mawonekedwe

Njira yankho la CP pamulingo wowopsa. Malinga ndi ultrasound, pakukula kwa matendawa, kutulutsa kapena kuwonjezeka kwakanthawi kukula kwa kapamba kumawonedwa. Kuwona kosiyana kwa magawo onse a kapamba ndi mawonekedwe ake omveka ndi mawonekedwe.

Kapangidwe ka gland parenchyma nthawi zambiri kumakhala kopweteka komanso kosangalatsa. Oposa 50% ya odwala omwe ali ndi CP amawululira madzi ochepa mchikwama cha omentum ocheperako, omwe amatsimikiza mawonekedwe a hypoechoic madzimadzi mpaka 2 mm wandiweyani pakati pa khoma lakunja kwa m'mimba ndi kunja kwapa kwa kapamba. Odwala ena, kutuluka kwa ndulu kumayipa, monga zimawonetsedwa ndi kuchuluka kwa ndulu yokhala ndi wandiweyani bile, komanso kukulira kwa lumen kwa ndulu yodziwika bwino kuposa mamilimita 6.Nthawi zina, pamayeso amphamvu, amapangidwa pseudocysts yaying'ono (mpaka 10mm). Kusintha kwachilengedwe mu kanyumba ka pancreatic duct molingana ndi ultrasound ndizosavomerezeka.

Fibrossteotic mawonekedwe

Malinga ndi ultrasound, kuchepa kapena kuchepa kwakanthawi kukula kwa kapamba ndi khalidwe. Makulidwe amthupi ali mndandanda wa 7-11 mm. Parenchyma ya kapamba yawonjezera zachilengedwe, zoperewera za kutulutsa ziwonetsero. Mu gulu laling'ono la odwala, omwe ali osagwirizana, ang'onoang'ono owoneka osasinthika amatsimikizika, kapangidwe ka gland kamapangika modabwitsa komanso kamangidwe kakang'ono ka hypoechoic point microcystic. Odwala ena ali ndi chida chachikulu cha pancreatic duct.

Milandu iyi, monga lamulo, ndi ultrasound, hyperechoic yaying'ono yokhazikika yokhazikika, yofanana ndi calculi, yomwe imapezeka mkati ndi kunja kwa dongosolo la ductal, imawoneka. Zovuta mu ultrasound diagnostics zimawonekera mwa odwala omwe ali ndi chakudya chochuluka, lamulo la hypersthenic. Kukula kwathunthu kwa kapamba mwa odwala kumakhalabe kwabwinobwino. Komanso, parenchyma lipomatosis sangafanike ndi fibrosis, chifukwa cha sclerotic process.

Hyperplastic mawonekedwe (pseudotumor pancreatitis) Hyperplastic mawonekedwe a CP ndi mtundu wosiyanasiyana wamatenda. Kuyerekezera kwa Ultrasound kumawonetsa kachulukidwe kakang'ono. Oposa 50% ya odwala amawonetsa kuwonjezereka kwa kapamba, ndipo ena - kuwonjezeka kwa mutu wa ndulu. Pamene ndondomekoyi ikupezeka pamutu wa pancreatic, ndizotheka kulankhula za pseudotumor CP pamene kukula kwake kukuwonjezeka mpaka 40 mm kapena kupitirira.

Kuchulukitsa kwa kapamba kumayendera limodzi ndi kupangika kwa mizere yambiri. Mu gawo limodzi mwa magawo atatu a odwala, malinga ndi ultrasound, mafunde a chinyezi kumbuyo kwake ndiwofatsa, omwe pamodzi ndi kukhalapo kwa zomata mu dera la epigastric ndi zizindikiro za cholecystitis amawonedwa ngati kusintha kwamphamvu mu minofu ya parapancreatic. Odwala ambiri, kuchuluka kwa mawonekedwe a parenchyma yonse kunachepetsedwa; mwa ena, motsutsana ndi izi, adanena heterogeneity yamapangidwe acoustic omwe ali ndi madera ena akuluakulu (a 10-15 mm) omwe adachulukirachulukira.

Kukula kwa pancreatic duct pamutu wam'mutu mpaka 4 mm amapezeka odwala osakwana theka. Tiyenera kudziwa kuti kwa odwala ambiri omwe ali ndi mawonekedwe amtunduwu wa CP pali zovuta pakuzindikira kuti pali malo ochepa a kutupa ndi kapamba chifukwa cha chithunzi chofanana cha kusintha komwe kulipo. Kupatula khansa ya kapamba, odwalawa amapezeka ndi chiphuphu cha pakompyuta. Hyperplastic kusiyanasiyana kwa CP kuyeneranso kusiyanitsidwa ndi OP.

Fomu la cystic. Miyeso ya kapamba imachulukitsa pang'ono kapena imakhalabe yolimba. Odwala onse, mapangidwe angapo a cystic okhala ndi homogeneous hypoechoic m'mimba yaying'ono (mpaka 1.5 cm), yodziwika bwino yomwe imapezeka m'malo onse kapamba, adawonetsa kusintha kwazomwe zimachitika pakadutsa kotentha kokhala ndi madera ena a calcation amatsimikiza. Nthawi zambiri amadziwika kuthupi ndi mutu. Ma CD a kapamba ndiwowoneka bwino, wolimba bwino, GPP wopunduka. Nthawi yomweyo, mwa odwala ambiri, magawo apakati pazowonjezera (mpaka 0.5 cm) za ductal system yokhala ndi mawonekedwe osagwirizana a lumen amawululidwa kuti ndi ochepa kutalika (0.5-1 cm).

Tiyenera kudziwa kuti mukazindikira pancreatic cysts, pakufunika kuwunika kusiyanitsa pakati pa mawonekedwe a cystic a CP ndi dysontogeine ndi posungira cysts, chinyengo cha pancreatic chayamba chifukwa cha kupweteka kwapachifuwa, chifuwa chamimba chifukwa cha kuvulala kwam'mimba, komanso cystadenocarcinoma. Tiyenera kukumbukira kuti dysontogenic ndi posungira cysts ndi osakwatiwa, kawirikawiri ambiri, owumba mozungulira mawonekedwe ndi woonda yunifolomu kapu, zomveka bwino, nthawi zambiri kutikika mu thupi, nthawi zambiri mchira wa kapamba. Nthawi zambiri cysts zotere zimapezeka mwadzidzidzi.

Ma pseudocysts, m'malo mwake, amakhala ndi mawonekedwe osakhazikika komanso kaphatikizidwe kosakwanira kosagwirizana ndi malo osungirako, zomwe zimapezeka m'matopewo ndi malo owondera komanso mawonekedwe a mzere.

Endoscopic ultrasonography

EUS ndi njira yamakono kwambiri yophunzitsira matenda a pancreatic a pancreatic, omwe amalola kuti aphunzire mwatsatanetsatane kapangidwe ka minofu ya ziwalo, mkhalidwe wamkati wa ductal, kutsata mosiyanasiyana pancreatitis ndi khansa ya pancreatic (onani mkuyu. 4-20), kuwunika kukula kwa parapancreatic lymph node ndikuzindikira calculi ya ductal pancreatic system. Udindo wofunikira umaperekedwa kwa ESA pakuwunika kwa choleledocholithiasis mwa odwala omwe ali ndi cancaryitis yodalira pancreatitis, popeza ESA imazindikira kwambiri kuposa transabdominal ultrasound. Kuphatikiza apo, EUS imakupatsani mwayi kuti muzindikire molondola madera a pancreatic necrosis ndi kuchuluka kwa madzi am'madzi a pericancreatic, omwe amatha kukhala ndi phindu lalikulu la Prosticic mu mitundu yayikulu ya CP ndi OP.

Mpaka pano, nkhani yofotokozera mwatsatanetsatane njira zopezera matenda a ESM ponena za kupezeka kwa CP yoyambirira kapena CP yokhala ndi zizindikiro zochepa zamankhwala ndi zasayansi za matendawa sizinathetsedwe mosatsata.

Zizindikiro zazikulu za kuzindikira za CP malinga ndi ESD:
• Kusintha kwa ma ducts: calculi, makoma oonera mipanda yolimba, mipanda yolowera mzere, zopindika, kuchepa kwa milunda,
• kusintha kwa parenchyma: zingwe za hyperechoic, zoyang'ana ndi zotsutsana za lobules, ma calcication, cysts.

Zolemba pamakompyuta

CT imapangitsa kuti idziwe, makamaka pa nthawi yovuta ya kapamba, paka, ma pseudocysts, kuwonongeka kwa ziwalo zoyandikana, atrophy ya pancreatic parenchyma ndi zilonda zam'mimba nthawi zambiri zimapezeka. Mwina chizindikiro chokhacho chodalirika cha CP yopanda zovuta yomwe imatilola kuzindikira njira iyi ndikusintha kwa ma ducts akuluakulu a gland (dilatation kapena stenosis). Kuzindikira komanso kuwonekera kwa CT kumasiyana kwambiri kutengera gawo la matendawa ndikupanga 80-90%. Malinga ndi data ya CT, zizindikiro zosiyanasiyana zitha kugwiritsidwa ntchito ngati njira za CP (Gawo 4-14).

Ndi kuchulukitsa kwa CP, kuwonjezeka kwa kapamba, ma contours okhathamira, kuyamwa kwa zotumphukira zozungulira, heterogeneity ya kapangidwe kazinthu chifukwa cha madera a fibrosis, kuwerengera ndi kuwerengera minofu, ma pancreatic ducts (calcifying pancreatitis) akuwululidwa (onani mkuyu. 4-21). Magawo omaliza a CP amadziwikanso ndi kuchepa kwa kukula kwa kapamba ndi kukulitsa kwa dambo la Wirsung.

Ubwino waukulu wa CT ndi kutsika kocheperako komwe kumapangitsa mayeso (kunenepa kwambiri kwa odwala, mipweya ya m'matumbo), yomwe imawonedwa pa ultrasound. Komabe, zotsatira zoyipa zabodza zimadziwikanso nthawi zambiri; mu maphunziro angapo, mamililon osasinthika amapezeka mwa odwala omwe adatsimikiziridwa ndi CP pambuyo pake.

Olemba ambiri amakhulupirira kuti kuphatikiza kwa ultrasound ndi CT kumathandizadi ku CP, koma ngati kukayikira kukutsalira, muyenera kuyang'ana ku ERCP chifukwa chazidziwitso zapamwamba zodziwikiratu.

Endoscopic retrograde cholangiopancreatography ya ERCP malinga ndi zofalitsa zambiri zasayansi komanso zolemba zamabuku ndizomwe ndizomwe zimagwiritsidwa ntchito masiku ano ndizomwe zimagwiritsidwa ntchito kuti adziwe CP Ku UK, kuzindikira kwa CP m'milandu yaying'ono yokha kumachitika potsatira mayeso apachipatala, pomwe kutsimikizira kwakukulu kumazindikiritsa kumakhazikitsidwa makamaka pa ERCP. Zimakuthandizani kuzindikira stenosis ya GLP ndikuwona kutanthauzira kwa kutsekedwa, kudziwa kusintha kwamapangidwe mumakonzedwe ang'onoang'ono, kuwerengera kwazowoneka ndi mapuloteni opanga mapuloteni, matenda a bile duct (masitayilo, choledocholithiasis, ndi zina). (Onani Matendawa 4-22 ndi 4-23). ERCP ndi njira imodzi yofunika kwambiri yofufuzira yomwe imalola kusiyanitsa khansa ya kapamba.

CP imadziwika ndi kusakhazikika kwa ma ducts, maukidwe awo, magawo a stenosis ndi kuchepa - "mawonekedwe ooneka bwino" kusiyana ndi duodenum. Kusintha kofananako kungaoneke mbali ya duct wamba ya bile. Njirayi imakulolani kuti mupezenso madzi oyera a kapamba ndikuchita mapangidwe am'mimba a pancreas.

Kutengera zotsatira za ERCP ndizotheka kukhazikitsa gawo la CP:
• CP yotheka (ma ducts ang'onoang'ono 1-2 asintha),
• CP yowala (zoposanso zopangira zitatu),
• zolimbitsa CP (zowonongeka mumayendedwe akuluakulu ndi nthambi),
• Kwambiri (kusintha kosalala ndi nthambi, zolakwika zapakhosi kapena miyala, kutsekeka kwa chimbudzi, kukhazikika, kapena kusalinganika kwakukulu kwa chilondacho).

Ndikofunika kuzindikira kuti kuchuluka kwa kusokonezeka kwapachilendo sikungagwirizane ndi kuopsa kwa kusintha kwa magwiridwe antchito, zomwe zimapangitsa kuphatikiza kwa ERCP ndi mayeso ogwira ntchito ngati zomveka.

ERCP - njira yolowerera yozizira yomwe imagwira ntchito mu epematous pancreatitis ndi cholangitis. Pazifukwa izi, muyenera kugwiritsa ntchito ultrasound kapena CT scan ndikusinthira ku ERCP pokhapokha mutazindikira kuti mwazindikira.

ERCP ndiyofunikira kwambiri kuti ifotokoze za autoimmune CP, kulola odwala onse kuti azindikire gawo limodzi kapena kusungunula kosagwirizana ndi GLP - chizindikiritso cha mawonekedwe a CP awa. Kuphatikiza apo, ERCP imalola kuwunika kwamankhwala mochizira kwa odwala omwe ali ndi autoimmune CP, popeza zizindikiro zowoneka bwino za autoimmune CP zimachepetsedwa panthawi yamankhwala ndi corticosteroids, zomwe zimathandiza kuti wachipatala azikhala ndi chidaliro pakufunika kwa mankhwalawo.

Kodi njira ya ultrasonography ndi momwe mungakonzekerere?

Ndondomeko ikuchitika muofesi ya zamankhwala pogwiritsa ntchito zida za ultrasound.Kuti phunziroli lipambane, ndikofunikira kutsatira malamulo angapo musanapiteko.

Nthawi zambiri odwala amakhala ndi chidwi ndi funso loti kodi ndizotheka kudya chakudya chilichonse mayeso asanayesedwe. Pamaso pa ultrasound, simungadye chilichonse. Nthawi yotsiriza yomwe wodwala amaloledwa kudya amakhala atatsala pang'ono kupita kukadwala chakudya chamadzulo. M'mawa njira yam'mimba isanachitike, ndizoletsedwa ngakhale kumwa madzi.
M'mawa musanapite kuchipatala, muyenera kutulutsa matumbo. Ngati izi sizingachitike mwachilengedwe, muyenera kusankha ma enemas. Ngati izi sizichitika, ndiye kuti m'malo omwe akufotokozedwawa padzakhala anthu ambiri omwe angakhudze zotsatira za kafukufuku osati zabwino.
Njira ya ultrasound imachitika m'mawa wokha, ndipo pali chifukwa chomveka chofotokozera izi: m'mawa, thupi la munthu limakhala ndi mpweya wocheperako, chifukwa sanakwanitse kufikira kumeneko ndi chakudya. Izi zimayenera kukumbukiridwa, chifukwa ma thovu am'mlengalenga amatha kupotoza chithunzi cha matendawa.
Phunziroli liyenera kukonzedwa pasadakhale, popeza kuti masiku atatu lisanachitike liyenera kupewa zakudya zomwe zimapangitsa kupsa m'matumbo. Zakudya zotere zimaphatikizapo buledi wonyezimira, nyemba (nyemba, nandolo, nyemba, chimanga), kabichi, mphesa, ndi zinthu zatsopano zophika yisiti. Pewani kumwa zakumwa zilizonse zomwe zili ndi kaboni.
Pofuna kuchepetsa mapangidwe a mpweya m'matumbo, muyenera kumwa mapiritsi ngati Espumisan, ndizothekanso kumwa makala oyambitsa.
Musanapite kwa dotolo kuti mukachite mankhwalawa, musamwe mankhwala aliwonse komanso pewa kusuta kwathunthu.

Yang'anani! Ngati wodwala wadwala mwadzidzidzi (reactive pancreatitis), ndiye kuti njira ya ultrasound imatha kulembedwera popanda kukonzekera koyambirira, pomwe simungathe kutaya nthawi, chifukwa pancreatitis yogwira imayamba mwachangu, ndipo pamakhala chiwopsezo chamoyo wa wodwalayo. Komabe, madokotala ayenera kudziwa kuti zambiri zokhudza wodwalayo zomwe zimapezeka mwanjira imeneyi sizikhala zoona.

Kodi pancreatic ultrasound imafunikira liti?

Sizikunena kuti njira ngati imeneyi sinapatsidwe aliyense. Pakukhazikitsa kwake, zikuwonetsa zina mwazachipatala zofunika, zomwe zimaphatikizapo:

Ululu mu mawonekedwe a kukokana, omwe amapangidwira makamaka kumanzere kwa m'mimba. Monga lamulo, zopweteka zoterezi sizichoka.
Pali zokayikitsa za jaundice, chizindikiro chachikulu chomwe ndi kupindika pakhungu la wodwala. Kuwona ndikosavuta mokwanira.
M'mayeso am'mbuyomu, dokotala amapezeka ndi dokotala.
Kuchepetsa thupi kwambiri popanda kuyesetsa kuchita izi, makamaka metamorphoses yokhala ndi thupi imayambitsa kugwira pancreatitis.
Mavuto ndi kusakhazikika popita kuchimbudzi, ndipo nthawi zina pamakhala zovuta zina zokhudzana ndi izi.
Ululu wamkati wam'mimba.
Pali kukayikira kwa matenda a kapamba poyang'ana ziwalo zina zam'mimba.

Kuwonetsedwa pa ultrasound ya kutupa kwamphamvu kwa kapamba

Monga tafotokozera pamwambapa, njira ya ultrasound imatha kudziwa mtundu wa matenda omwe ali ndi matendawa, owopsa komanso osachiritsika. Chifukwa chake, zizindikiro za pancreatitis pachimake pa ultrasound yam'mimba imakhala motere:

Kukula kwa kapamba kumachulukitsidwa, makamaka ngati wodwala ali ndi pancreatitis yogwira.
Malire a chiwalo ndi opepuka, ali ndi ma curvature, kapamba pa ultrasound amadziwika.
Momwe kuphatikizika kwa kapamba m'malo akumatupa kumawonjezeka. Ndiye kuti, zisindikizo mu chiwalo zimawonedwa.
Kapangidwe ka chiwalo ndi kwakukulu.
Pancreatic ducts amakula mu mawonekedwe osakhazikika. Nthawi zina izi zimapangitsa kuti pancreatitis yogwira iyenso ili ndi yake.
Mu chiwalo chokha, thovu ndi madzi limatha kupezeka.
Chifukwa cha kapamba wodwala, ziwalo zomwe zili pafupi ndi izo zimayamba kuyatsidwa, zomwe zimawonekeranso bwino ndi ultrasound ya pancreatitis yovuta.
Kwa mawonekedwe apamwamba a matendawa, zovuta zimadziwika.

Pali zizindikiro za chifuwa chachikulu chomwe chimathandiza kudziwa wodwala yemwe ali ndi kutupa kwa kapamba, monga:

Danc ya pancreatic imakulitsidwa pafupipafupi ndipo sabwerera mwachizolowezi.
Malire a ziwalo ndi mizere yolumikizana.
Kuchulukana kwa chiwalo sikokwanira ngati kuchuluka kwa matendawa.
Mapangidwe a cystic nthawi zambiri amawonedwa, izi zikusonyeza kuti matendawa adakhala mkhalidwe wonyalanyazidwa. Pamaso pa cysts, kachulukidwe ka ziwalo kamatuluka.
Ngati wodwalayo akuwunika mawonekedwe a zikondwerero zake mwamphamvu, ndiye kuti kuchokera pazithunzithunzi zitha kuzindikira kuti mawonekedwe ake akuwonjezeka nthawi iliyonse.
Mu mawonekedwe a kapamba, miyala mu chiwalo nthawi zambiri imawonedwa. Malo amdima mdera la limba amalankhula izi pamtundu wa ultrasound.
Kapangidwe ka ziwalozi ndi kwakukulu.

Kodi njira ya endoscopic ultrasound pothandiza kudziwa matenda am'mimba?

Mothandizidwa ndi ultrasound ya pancreatitis, mafotokozedwe atsatanetsatane omwe akukhudzidwa ndi mawonekedwe a chiwalo chomwe chikuwunikiridwa amasantidwa. Kugwiritsa ntchito kafukufuku wamtunduwu kumaonedwa ngati chinthu chofunikira pakudziwitsa komanso kuchiza matenda aliwonse. Mothandizidwa ndi ultrasound ndikoyenera kuwunika zochita za mankhwalawa.

Kuchita koteroko kumawonetsa pancreatitis ngakhale koyambirira kwake ndikuyamba kuchiza pakapita nthawi, chifukwa ndikosavuta kupewa matendawa kuposa kuchiritsa.

Zizindikiro ndi contraindication

Ultrasound imalembedwa pafupifupi kwa odwala onse omwe ali ndi vuto logaya m'mimba, limodzi ndi:

kupweteka kapena kupweteka kwambiri mu epigastric dera kapena hypochondrium,
kudzimbidwa kapena kudzimbidwa,
kupezeka kwa ndowe za kuchuluka kwa chakudya,
mafuta ambiri okhala ndi ndowe (amayamba kunyezimira, mafuta),
kusanza ndi kusanza
maonekedwe a kupeerera zakudya zamafuta ndi mowa,
Zizindikiro zopewera jaundice (chikasu pakhungu, sclera ya maso, ndi zina).

Komanso, kuyesedwa kwa ultrasound kumagwiritsidwa ntchito ngati dokotala akukayikira atayeza ndikupanga anamnesis kuti apange matenda otsatirawa:

matenda a ndulu
kapamba
hematoma wa England
chimbudzi pa pancreatic parenchyma,
matenda oncological
kapamba
cholecystitis
papillitis
kutupa kwa duodenum 12.

Kuphatikiza apo, ndikofunikira kuchita sikelo yoyeserera musanachite opaleshoni kapena mutalandira ululu wam'mimba kuti mutsimikizire kuti kukhulupirika kwa gland sikunasokonekere.

Mukamagwira ntchito yopanga tiziromboti, magawo ena a ziwalo zam'mimba amatayikidwanso

Ultrasound imapangitsa kuti izi zitheke osati kungoyesa mkhalidwe wakunja wa ndulu (kukula kwake - kutalika ndi m'lifupi), komanso kudziwa njira zomwe zimatulukiramo, komanso zovuta zomwe zidawatsutsa. Pachifukwachi, nthawi zambiri pamakonzedwe a kapamba, adotolo amawunikanso zokhudzana ndi chikhodzodzo, impso ndi chiwindi, popeza ziwalozi zimakhudzidwa makamaka ndi vuto la chithokomiro.

Ngakhale kuti ultrasound ndi imodzi mwanjira zophunzitsira kwambiri komanso zotetezeka, nthawi zina zimakhala zosatheka kutero.

Ultrasound imatsutsana mu milandu yotsatirayi:

Chizindikiro cha pancreatic MRI

Ngati wodwala samvera bwino ndi gel yomwe amagwiritsidwa ntchito (popanda kutenga nawo mbali, kuwunika sikutheka),
zinthu zomwe zimawopseza moyo wa wodwala (mwachitsanzo, necrosis, abscess, etc.),
kunenepa kwambiri,
thonje,
zotupa pakhungu (herpes, molluscum contagiosum),
matenda opatsirana a pakhungu (chifuwa chachikulu, khate, borreliosis),
matenda a zonse (lupus, syphilis, HIV),
kupezeka kwa mabala m'mimba (mabala, abrasions, burns, etc.),
fistulas pamimba yapamwamba.

Masiku 2-3 pamaso pa ultrasound

Kupatula kuthekera kokupeza data yolondola panthawi ya phunziroli, masiku angapo njira isanachitike ayenera kupereka kupumula kwa pancreatic. Ndipo popeza ntchito yake yayikulu ndikupanga michere yokugaya, yomwe imayambitsidwa chakudya chikamalowa m'mimba, chakudya chofunikira chidzafunika.

Mukamayesedwa, palibe njira zoopsa zomwe zimayenera kupezeka pancreas, chifukwa izi zimabweretsa chidziwitso cholakwika. Chifukwa chake, ndikofunikira kupatula kukhudzidwa kwa zinthu zonse zomwe zingayambitse activation ya pathological mu zimakhala za gland

Kuchokera pachakudya, padzakhala kofunikira kuti muchepetse zakudya zomwe zimagwiritsidwa ntchito, zomwe zimapatsa mphamvu kuchuluka kwa mpweya m'mimba. Izi ndi:

nyemba
masamba abwino, ophika ndi owuma,
amadyera
mphesa
vwende
mkaka ndi mkaka,
zakumwa zoziziritsa kukhosi, kuphatikizapo madzi amchere,
mkate wopanda bulawuni
zonunkhira
nyama zamafuta
zakudya zokazinga
zakumwa zoledzeretsa.

Komanso, pokonzekera njirayi, mudzafunika kusiya kugwiritsa ntchito zakudya, zomwe zimakhala ndi mapuloteni ambiri, chifukwa zimathandizanso pakupanga kwa gasi m'mimba yamagetsi (nsomba, kanyumba tchizi, tchizi, ndi zina zambiri).

Panthawi yoyeserera ndi ma ultrasound, kapamba amayenera kugwira ntchito yopuma. Izi zimathandizidwanso ndi zoletsa izi pazakudya. Komano kodi mungadye chiyani musanayese? Munthawi imeneyi amaloledwa kugwiritsa ntchito:

chimanga chopangidwa kuchokera ku chimanga ndi oatmeal m'madzi,
nyama zamafuta ochepa - nkhuku, nkhuku, kalulu, ndi zina zambiri. (simungathe kudya khungu)
mazira owiritsa kapena ma amamu otentha (osaposa dzira 1 patsiku),
madzi ndi tiyi wazitsamba.

Mankhwala azitsamba amathandizira kukonza pancreatic ntchito komanso kupewa kufalikira kwa njira za m'magazi momwemo

Pankhaniyi, ndikofunikira kudya chakudya moyenera:

chakudya chimayenera kukhala chotentha (mbale zotentha ndi zozizira ndipo zakumwa zowononga zimakhudza ntchito ya kapamba),
chakudya chimayenera kudyedwa pang'ono, koma kangapo patsiku,
Ndikosatheka kudya maola awiri asanagone.

Kumbukirani kuti kusakonzekera kafukufukuyu kumachepetsa kutsimikiza kwa kafukufukuyu ndi 60%! Izi ndizowonetsa kwambiri. Chifukwa chake, kuti mupewe matenda olakwika komanso njira yolakwika ya mankhwala, ndikofunikira kukonzekera ndi ultrasound pasadakhale.

Zizindikiro1
Zopindulitsa2
Kukonzekera3
- Chakudya 3.1
- Mankhwala osokoneza bongo 3.2
- Video - Ultrasound ya kapamba 3.3
- Mawonekedwe3.4
Kafukufuku4
- Chisudzulo 4.1
- Kanema - Zizindikiro za matenda a kapamba 4.2
Malangizo5

Akatswiri amapereka mayeso pogwiritsa ntchito ultrasound ngati akuganiza kuti matenda atagwidwa. Mndandanda wazisonyezo za ultrasound:

kupweteka kwapafupipafupi pamimba, kugunda, kupweteka kwakali,
hematomas, neoplasms, purulent abscesses, akuwoneka kukhalapo kwa miyala mu kapamba, cyst,
kusintha kwamatumba opezeka ndi x-ray,
chitsimikiziro cha chizindikirocho chikufunika,
kusintha kwa khoma lakumaso kwa m'mimba,
pafupipafupi kusanza, nseru,
kutulutsa m'mimba
kutsegula m'mimba, kusokonezeka kwa chopondapo, kugaya chakudya chosakwanira, ndowe zomwe zimadzazidwa ndi chakudya chachikulu,
kuyezetsa magazi kudawonetsa kuchuluka kwa shuga kwa wodwala,
jaundice, kuwonjezereka kwa kutentha kwa thupi (mpaka madigiri 38),
kuvulala kwam'mimba
ntchito anakonza.

Kutupa kwa kapamba

Mapindu ake

Kafukufukuyu ali ndi zabwino zambiri:

Ngati tingayerekeze ultrasound ndi x-ray, ultrasound, palibe radiation.
Kuteteza umphumphu wa khungu. Palibe chomwe chimafunika kudulidwa, kubayidwa, kubayidwa.
Kusowa kwathunthu kwa zowawa.
Zomwe zimafikira polojekiti sizifuna kukonzanso, zomwe zimathandizira njira kuti zitheke.
Ultrasound ili ponseponse. Zidazi zimayikidwa m'makiriniki ambiri, zomwe zikuwonetsa kupezeka kwa kuyesedwa.
Ubwino wina ndi mtengo wotsika.
Phunziroli palokha limatenga nthawi yochepa (pafupifupi mphindi 20).

Ultrasound ya kapamba

Kukonzekera

Mukulondola kwa matendawa, gawo lapadera limaseweredwa ndi kukonzekera kwa ma CD a kapamba:

mfundo yayikulu ndichakudya chapadera masiku angapo masiku ake asanachitike,
kukonzekera thupi ndi mankhwala apadera,
Zochita patsiku la ultrasound.

Kukonzekera pamimba pamimba

Chifukwa chakupezeka kwa kapamba kumbuyo kwa m'mimba, ndikofunikira kutsatira zakudya zapadera, ndipo patsiku la njirayi musadye konse.

Zakudyazo ziyenera kuyambitsidwa masiku atatu isanachitike ultrasound. Kuchokera pachakudya, timafunikira kupatula zinthu zomwe zimapangitsa kupangidwa kwa mpweya:

nyemba (nyemba, mphodza, nandolo),
masamba omwe ali ndi masamba ambiri (kabichi, anyezi, nkhaka, broccoli),
zipatso zina (peyala, vwende, mphesa),
mkate wopanda bulawuni
zakumwa zoziziritsa kukhosi
nyama yamafuta
mowa
zinthu zamkaka zokhala ndi mafuta ambiri (zonona wowawasa, tchizi tchizi, zonona, mkaka, kefir),
mankhwala, maswiti,
chikonga
khofi
timadziti
masoseji
maswiti ndi chokoleti
mazira.

Zogulitsa kuti zisachotsedwe

Osamadya nyama yokazinga, yosuta. Zogulitsa zimaloledwa kuphika kuphika, kuphika wamba, zofunda.

Idyani phala yambiri pamadzi. Idyani nyama yodyedwa, nsomba zopanda mafuta. Tchizi zotsekemera zimaloledwa.

Maola 14 pamaso pa njirayi, muyenera kudya komaliza. Nthawi zambiri ichi ndi chakudya chopepuka, pasanathe 6 pm.

Zakudya zoyenera tsiku lonse:

Chakudya Cha Nthawi

Chakudya cham'mawa - 8-10 a.m.	Porridge pamadzi, dzira limodzi lowiritsa
Wokhwasula woyamba - maola 10-13	100 magalamu a tchizi ophika
Chakudya chamadzulo - maola 135	Nyama yotsika
Wachiphaso wachiwiri	Buckwheat phala
Chakudya chamadzulo	Nsomba zonenepa kwambiri

Zakudya zomanga thupi zimatengedwa kuti ndizopindulitsa thupi. Kuvutitsa magazi sikovomerezeka.

Thanzi pamaso pamimba ultrasound

Imwani zakumwa zambiri, kuposa malita 1.5 patsiku.

Madokotala amalimbikitsa tsiku lisanafike ultrasound kuti ayambe kumwa mankhwala omwe amachepetsa mapangidwe a mpweya: enterosorbents ndi adsorbents.

Yoyambitsa kaboni. Mankhwala amalangizidwa kuti atenge masiku awiri mayeso asanachitike. Mlingo - piritsi 1 pa 10 kilogalamu ya kulemera kwa thupi. Nthawi yolandila - m'mawa ndi madzulo.

Espumisan ndi Enterosgel. Gwiritsani ntchito kawiri pa tsiku 2 masiku 2 musanachitike.

Patsiku la kafukufukuyu, simungadye chakudya, madzi. Amaletsedwanso kusuta, kumwa mankhwala.

Mawonekedwe

Mkhalidwe waumunthu, matenda osachiritsika, kutenga pakati, kunenepa kwambiri, ukalamba - zonsezi zimatanthawuza zina mwa mayeso.

Mwa anthu onenepa kwambiri, mafuta amasokoneza mtundu wa kafukufukuyu. Anthu oterowo amafunika kupanga enema yofunda yoyeretsa maola ochepa asanakachezere dokotala. Zakudyazo ziyenera kukhala zodzaza ndi chimanga. Zipatso, ndiwo zamasamba, zimasiyidwa kwathunthu.

Okalamba amafunika kugwiritsa ntchito mankhwala kuti apewe matenda osachiritsika. Mu ukalamba, izi ndi zovuta zofala kwambiri. Izi zimaphatikizapo matenda a mtima, matenda ashuga, matenda a kuthamanga kwa magazi. Komabe, muyezo ndi dzina zitha kungoonetsa katswiri waluso. Ndi matenda ashuga, pali chosiyana chokhudzana ndi chakudya. Anthu omwe akudwala matendawa amatha kudya m'mawa m'mawa patsiku la mayeso.

Chikumbutso cha pamimba ultrasound

Pankhani ya ana, kuyang'anira pafupi ndikofunikira. Zimakhala zovuta kuti mwana akane kugwiritsa ntchito maswiti, mankhwala opangira ufa, madzi owala. Makolo ayenera kuwongolera mwana. Ngati tirikulankhula za kupewa kudya, pali magulu atatu awa:

Makanda obadwa kumene sayenera kumwa nthawi yayitali pakudya.Musadyetse mwana kwa maola awiri ndi awiri kapena awiri musanachitike.
Ali ndi zaka 1-3, mwana ayenera kudyetsedwa maola 5 asanachitike. Ndikofunikira kupatula kudya kwa madzi maola 1.5 musanayambe kuphunzira.
Kuyambira kuyambira zaka zoyambirira kusukulu, mwana ayenera kupirira maola 8 osadya (osachepera 6).

Kodi nchifukwa ninji ultrasound imalembedwa ngati kapamba?

Ultrasound ya kapamba imawerengedwa kuti ndi njira yofunikira kwambiri yodziwira njira zomwe zimapezeka m'mapapo.

Nthawi zambiri phunziroli, mumatha kumva mawu monga echogenicity ndi parenchyma. M'malo mwake, tikulankhula za kapangidwe ndi kakulidwe kazinthu. Popeza kuwunika kumeneku kumachitika ndikulowera kwa ultrasound, mafunde a ultrasound amatha kudutsa minofu imodzi momasuka, koma osati kudzera inanso, yofinya. Ndi chifukwa ichi kuti echogenicity yotsika komanso yapamwamba imasiyanitsidwa.

Podziwa zikhalidwe za minofu ya glandular, dokotalayo angadziwe zomwe zachitika pa ziwalozo. Maselo abwinobwino ochepa kwambiri a m'matumbo, ndimomwe amaphatikizidwa ndi mafuta, minyewa yochepa kapena mchere wamchere. Izi zimawonetsa kuchuluka kwa ziwalo.

Minofu yophimba chiwalo amatchedwa parenchyma. Ngati, chifukwa cha kuyesa kwa ultrasound, deta yapezeka pakuwonjezeka kwa kuchuluka kwa zovuta parenchyma, ndiye izi zitha kuwonetsa:

kulephera kwa mahomoni
zosokoneza kagayidwe,
kuperewera kwa zakudya m'thupi
kutupa
zizolowezi zoipa
kutupa kwa thupi.

Kuchulukana kwa echo kumawonetsa njira yosinthira minofu yabwinobwino ndi minofu yosinthika.

Matenda a Pancreatic

Chiwalo chimakhala ndi mutu, thupi ndi mchira. Pakusatupa, ultrasound iwonetsa ziwonetsero zotsatirazi zomwe zimatsatira miyezo:

kukula kwa mutu kuyenera kukhala mkati mwa 32 mm,
thupi - mpaka 21 mm,
mchira - mkati mwa 35 mm.

Pancreatitis pakalibe, mavu a gland ayeneranso kukhala omveka bwino, m'mimba mwake wa duct sayenera kupitirira 2 mm.

Kodi ndifunika kukonzekera mwapadera kwa ultrasound

Popeza ziwalo zoyandikana zimawunika nthawi yomweyo pazomwe zimapezeka pancreatic diagnostics, pali zina kusiyapo zomwe adokotala amauza wodwalayo pasadakhale. Pamaso pa ultrasound, zotsatirazi ziyenera kukhazikitsidwa:

Maola 10 musanachite njirayi, simutha kudya.
Masiku awiri tsiku lisanafike lodziwikiratu liyenera kuperekedwa kunja kwa zakudya zomwe zakulitsa mpweya.
Ngati gastroscopy adayikidwa limodzi, ndiye kuti muyenera kuchita bwino.
Pewani kugwiritsa ntchito mankhwala (izi zakambidwa ndi dokotala).
Kuletsedwa kumwa mowa.
Simalimbikitsidwa kuti musute.
Ndikofunikira kuti matumbo akhale omasuka. Ngati munthu wadzimbidwa, mutha kuyamwa mankhwala opatsa thanzi kapena oyeretsa.

Kodi ma ultrasound amawonetsa bwanji kapamba?

Atalandira yankho, gastroenterologist satiyesa mayeso omaliza. Amasankha wodwalayo mayeso angapo a ma labotale, pamaziko ake omaliza. Ndiye kuti, ndi ultrasound, adokotala amawunika momwe mawonedwe amtundu wa metabolism amapezeka m'thupi. Kuzindikira kumachitika kuti muwone ngati pali kusintha m'thupi, ndipo ngati ndi choncho, ndi ziti, popeza zimasiyanitsa pakati pancreatitis yodwala komanso pachimake.

Pa gawo loyamba la kapamba, zimakhala zovuta kudziwa bwinobwino. Matendawa sangathe kuzindikira.

Kodi ndi ziwonetsero ziti zomwe dokotala amamvetsera mukamayang'ana kapamba:

kukulitsa kwa pancreatic duct,
kufewa ndi kukonza kwa parenchyma,
kuchepetsa
kutha kwanyengo.

Awa ndi Zizindikiro zomveka za pancreatitis pachimake. Koma ngakhale zitha kukhala zosavuta komanso zotchipa kudziwa mtunduwu, nthawi zina sikokwanira kutsimikizira kapamba. Pazomwezi, pali njira zowonjezera zowunikira.

Kodi endosonography ndi chiyani?

Pamodzi ndi ultrasound, endosonography imatha kutumikiridwa. Ngati pa pancreatitis adotolo ayenera kupenda malo osavomerezeka a kapamba, adzagwiritsa ntchito chubu cha endoscopic. Ndizosintha mosinthika ndi kamera ya kanema kumapeto kwake. Amayambitsidwa kudzera m'mphepete mwam'mimba ndikufikira duodenum, pomwe ma pancreatic ducts amawonekera bwino.

Ngati wodwala adzaikidwa endoscopy, ndiye kuti ayenera kukonzekera pasadakhale.

Phunziroli limachitika kokha pamimba yopanda kanthu, ndipo tsiku ladzulo, madzulo, ndibwino kukana chakudya kwathunthu. Nthawi zina, impousy imagwiridwa ndi mankhwala oletsa ululu.

Kuti apange chithunzi chathunthu cha kapamba, mawonekedwe apamtundu wa ultrasound amachitika molingana ndi endoscopy, i.e. kuwunika kamodzi sikupatula wina. M'malo mwake, njira zowonjezera zothandizira kudziwa matenda a endoscopy zimachepetsa kwambiri kuzindikira komanso kusankha kwa njira zamankhwala.

Kodi nchifukwa ninji kupenda bwino ziwalozo ndikofunikira? Chowonadi ndi chakuti matenda ambiri am'mimba amtunduwu ali ndi zofanana. Ndipo popewa kulakwitsa ndi matenda, dokotala amagwiritsa ntchito njira zonse zofufuzira.

Zizindikiro za pancreatitis yovuta kwambiri yomwe mawonekedwe amtundu wa ultrasound amawonetsa:

masinthidwe kukula kwa kutulutsa,
kuchuluka echogenicity
kusintha kwa kusintha kwa thupi
zovuta pakuwunika kukula kwa duct ndi kukula kwake,
kutupa kwa ziwalo zapafupi,
kukhalapo kowonjezera kwamadzi m'mimba,
madera owoneka a gland.

Zitsukazo zimakulitsidwa.
Echogenicity yafupika.
Ma contour ndi osafanana.
Parenchyma ndi wandiweyani.

Mu chifuwa chachikulu cha wodwala, kukula kwa kapamba kumachepa, chiwalo chimangokhala chokhota.

Kodi kuyesa kwa kapamba kumawonetsa chiyani?

Njira yodziwira matenda a ultrasound ndi njira yodzionetsera yomwe imagwiridwa mwadzidzidzi, pamwamba pa peritoneum, chifukwa chomwe wodwalayo sakumva ululu uliwonse. Maziko a njirayi ndikuthekera kwa kufalikira kwa ultrasound kudzera m'thupi la taci. Nthawi yomweyo, ultrasound imadutsa muma cell osiyanasiyana munjira zosiyanasiyana ndipo imawonekeranso kuchokera kwa iwo mosiyanasiyana. Chipangizocho chili ndi sensor yapadera yomwe imagwira ndi mafunde omwe akupangika ndikuzindikira zomwe zalandiridwa zimapanga chithunzi. Umu ndi momwe mawonekedwe am'magawo awiri a ultrasound amagwirira ntchito, komabe, zida zamakono kwambiri zomwe zimapereka chithunzi cha mawonekedwe atatu zimakupatsani mwayi kuti musatenge chithunzi, koma kanema wonse. Itha kuwonedwa mu nthawi yeniyeni kapena kujambulidwa pa digito, yomwe imapereka mwayi wabwino wowonera zotsatira zake nthawi zambiri, zikafunika.

Njirayi imagwiritsidwa ntchito kwambiri pophunzira ziwalo zambiri kuphatikizapo kapamba. Odwala ambiri ali ndi chidwi chofuna kudziwa kuti njirayi imawonetsa chiyani komanso ngati nkotheka kuzindikira momwe mankhwalawo amatupa.

Chifukwa chake, ndi ultrasound imathandizira kudziwa:

Kuphwanya kapangidwe ka kapamba,
Kusintha magawo a ziwalo ndi zovuta zake,
Kuchulukitsa,
Kuchepa ndi kufatsa kwa parenchyma,
Kupezeka kwa necrotic foci,
Sinthani mumalingaliro amachitidwe amodzi payekha (kuchepa kapena kuwonjezeka).

Mfundo yomaliza ndiyofunika kuisamalira mwapadera. Nthawi zambiri, pazotsatira, zomwe akatswiri a sonologists amapereka, mutha kupeza mbiri yowonjezereka ya kuchulukana. Sikuti aliyense amadziwa zomwe zili munthawi ya nthawi.

Popeza chiwalo chilichonse chili ndi kachulukidwe kake, ma ultrasound panthawi yodziwitsa aliyense waiwo amawonetsedwa mosiyanasiyana. Mwachitsanzo, ziwalo zomwe zimakhala ndi madzi m'matumbo awo zimawoneka zakuda polojekiti. Ndipo, mmalo mwake, ziwalo zomwe mawonekedwe ake ndi wandiweyani amatsimikiziridwa ndi zoyera. Ndikutengera izi kuti echogenicity imatengera, momwe imakhala chizolowezi kumvetsetsa kuthekera kwa minofu ya thupi kuwonetsa mafunde a ultrasound mwa iwo eni. Ndiye kuti, likukhalira kuti thupi lirilonse limadziwika ndi zomwe limadziwika ndi chizindikirochi.

Gawo la echogenicity limatsimikiza kukhalapo kwa zotupa, metastases, miyala, cysts, necrosis, kapena adipose minofu kusokonekera mu lungu parenchyma.

Chinthu chachikulu chomwe muyenera kukumbukira ndikuti wazist amangogwiritsa ntchito mtundu wina wodziwonetsa yekha, ndipo matendawo omaliza amatha kupezeka ndi dokotala yemwe, makamaka, atumiza wodwalayo kuti amuwonjezere.

Kodi ma ultrasound a kapamba amapezeka kuti?

Kuunika kwa Ultrasound kumakhala koyenera pakuwunika kwa prophylactic a ziwalo, kuphatikizapo kapamba. Koma nthawi zambiri, odwala amatembenukira ku chithandizo ichi pokhapokha ngati ali ndi madandaulo kuchokera m'matumbo am'mimba makamaka chiwalo ichi.

Izi zikuphatikiza:

Kusakhazikika kwa Stool
Kusanza ndi kusanza
Ululu wammbuyo pamimba, nthawi zambiri mbali yakumanzere,
Kumva kupweteka palpation,
Anachepa chilakolako chambiri komanso kuwonda kwambiri popanda chifukwa chomveka
Kukhalapo kwa khungu la chikaso cha wodwalayo,
Kuwonjezeka kowopsa kwa shuga m'magazi, komanso kupatuka m'mayeso ena a labotale,
Zosintha ziwalo zina zomwe zadziwika chifukwa cha mayeso am'mbuyomu,
Kukayikira kwa chotupa cham'mimba.

Contraindication

Masiku ano, njira yofufuzira ma ultrasound ndiyotchuka kwambiri, chifukwa imapereka zambiri zofunikira popanda kupweteketsa wodwala. Ichi ndichifukwa chake palibe zotsutsana zowonekera pamtunduwu wa kafukufukuyu. Mwina uwu ndiye mwayi waukulu wa ultrasound.

Zokhazo zomwe zingakhale zoletsa kwakanthawi kochepa kugwiritsa ntchito ultrasound ndi matenda ena amtundu komanso matenda opatsirana, komanso matenda apakhungu amtundu wotetezedwa m'dera la epigastric:

Chotsani
Wiritsani,
Zipsera
Molluscum contagiosum, herpes,
Khate, borreliosis, chifuwa chachikulu.

Komanso, ngati pali mabala, mabala, abrasions kapena kuwotcha m'derali, njirayi imakanidwa, chifukwa cholumikizana ndi ma gel apadera ndi malo opaka zotupa, zovuta zingapo zimatha kuchitika.

Ultrasound ya pachimake kapamba

Njira yofufuzira iyi imatha kudziwa molondola kupezeka kapena kusapezeka kwa njira yotupa m'mapapo. Ntchito yodziwitsa anthu imathandizira kwambiri ngati kuchuluka kwa matendawa kumakhala kovutirapo kapena kwamphamvu, popeza mu nkhani iyi zizindikiro za kapamba zimatchulidwa kwambiri.

Chifukwa chake, kudzera mu ultrasound, mutha kuzindikira zinthu zotsatirazi:

Kuchulukitsa kwamphamvu kwambiri,
Kusintha kwa mafunde ake: amakhala opusa komanso osafotokozeratu,
Ma pancreatic ducts amachepetsa, mainchesi awo amapitilira 2 mm.

Monga lamulo, kuyezetsa kwa ultrasound sikumangoyang'ana kapamba, komanso ziwalo zina zam'mimba. Mu mawonekedwe apakhungu a kapamba, ena mwa iwo, omwe ndi omwe amapezeka pafupi ndi kapamba, amasinthidwanso: kuwonjezeka kwa magawo awo ndi kutupa kwake kumawonedwa. Nthawi zambiri, madzimadzi amadziunjikira m'mimba, ndipo ma omentums kapena zilonda zimatsimikiziridwa m'makoma ake - zonsezi zimawonetsa kukhalapo kwa njira yotupa m'mapazi, omwe amadziwika ndi ultrasound.

Ultrasound yokhala ndi kapamba

Njira yodwalayo yamatenda imawonekeranso m'chithunzithunzi chomwe wazist amawona akamayendetsa ma ultrasound. Kukhalapo kwa kusintha kwina komwe kumachitika mkati mwa thupi, kumakupatsani mwayi wokhazikitsa pancreatitis yosatha.

Kukula kwa kapamba ndimawu oyamba pamaziko a omwe akatswiri a sonologists amakhazikitsa njira yovuta ya matenda. Chifukwa chake, ndikuchulukirachulukira kwa matenda am'mimba kapamba, kumachulukirachulukira, komabe, ndikusintha kwa matendawa kupita ku mawonekedwe aulesi, magawo a chinthu chokhudzidwa, m'malo mwake, kuchepa, komwe kumalumikizidwa ndi fibrosis ndi minofu pang'onopang'ono ya minofu.
Heterogeneous kuchuluka echogenicity, amenenso amakhala zotsatira atrophic njira. Komabe, ziyenera kukumbukiridwa kuti chizindikiritso ichi ndi chizolowezi kwa anthu onenepa kwambiri, komanso kwa okalamba.
The heterogeneity ya parenchyma ndi kusasiyana kwa m'mbali - yokhala ndi kapamba, izi zimachitika kawirikawiri. Chifukwa cha kusokonezeka komwe kumachitika chifukwa cha fibrosis, zopanga za limba zimayamba kuzizira ndipo zimatchedwa kuti notches.
Kukula kwa dambo la Wirsung: moyenerera, m'mimba mwake ndi 2 mm, koma pamaso pa kutupa kosachiritsika, kukula kwake kungakhale 3 mm. Pakafukufuku wotsatira, zoyeserera zabwino, monga lamulo, sizowonedwa.
Kukhalapo kwa mawonekedwe a cystic kapena miyala ndi njira yomwe nthawi zambiri imakhala yotsatira pancreatitis.

Kodi njira ya ultrasound imathandizira bwanji?

Kuunika kwa Ultrasound kumapangitsa kuti zitheke kupeza zofunikira zokhudzana ndi mkhalidwe wa kapamba. Chifukwa cha matenda amtunduwu, magawo ambiri a chiwalochi amaphunziridwa, kuti adokotala aweruze kukhalapo kapena kusakhalapo kwa njira yotupa.

Ngakhale kuti njirayi ndi yolondola, akatswiri samangodziwa zambiri zake. Kuti adziwe matenda enieni, dokotala amayang'ana pa mayeso a labotale, chithunzi cha chipatala, mbiri, zotsatira zakuwunika kwa wodwala kunja. Kuphatikiza apo, ngati zovuta zilizonse za kapamba zimapezeka ndi ultrasound, wodwalayo amatumizidwa kukapimidwa mopitilira, mwachitsanzo, CT kapena MRI.

Kodi chiwalo chathanzi chimawoneka bwanji?

Kuchita kwanyimbo kwachilengedwe ndizofanana kwa akazi ndi abambo.

Pakuwunika kwa ultrasound ya chiwalochi, wazist amawunika magawo ambiri.

Mtundu wa kapamba: munthawi zonse, imakhala ndi chilembo cha Chingerezi, kusintha kulikonse kukuwonetsa chilema china kapena ma pathologies ena omwe amakhudzidwa ndi kapamba.
Kukula kwa thupi. Kutalika kwa kapamba mwa munthu wamkulu kumayambira 14 mpaka 22 cm, ndipo kulemera kwake kumayambira 70 mpaka 80. Popeza gawo limagawidwa mwamagawo atatu, magawo a gawo lililonse ali ndi chikhalidwe chawo. Chifukwa chake, kutalika kwa mutu wachilengedwe sikuyenera kukhala kosachepera 25 mm ndi kupitirira 30 mm. Kukula kwakuthupi kuyambira 15 mpaka 17 mm, ndipo mchirawo umafikira 20 mm.
Dongosolo la Wirsung duct. Gawo la pancreatic linapangidwa kuti lizitha kunyamula madzi a pancreatic kumimba. 2 mm ndendende mtengo womwe umafananidwa ndi tsambali pakalibe ma pathologies. Ndi kutupa, chisonyezo nthawi zambiri chimakwera (mpaka 3 mm), koma kupendekera kukusonyeza kuti kutulutsa kunja kumapanikizidwa ndi china chake, mwachitsanzo, ndi mwala, cyst kapena chotupa.
Zosalala komanso zowoneka bwino osati zokhazo zokha, komanso mbali zake zonse mosiyana.
Kutalika kachulukidwe ka chiwalo, komwe kamayenera kukhala kofanana ndi kufupika kwa chiwindi kapena ndulu - gawo ili limatsimikiziridwa ndi kufanana kwachilengedwe, kulola kuphatikizika pang'ono.
Granular kapangidwe ka parenchyma.

Ziwerengero zowonetsedwa zimasiyana pang'ono, zomwe sizopatuka pamachitidwe wamba. Poterepa, zomwe zimafotokozedwa ndi malire apamwamba zimatengedwa.

Ndondomeko

Palibe chovuta pakuchita kafukufuku wamapensulo pogwiritsa ntchito chipangizo cha ultrasound. Ndondomeko ikuphatikiza zingapo:

Khazikitsani wodwala pakama: ayenera kugona pamsana pake ndikumasula m'mimba mwake zovala,
Kugwiritsa ntchito chinthu chapadera chokhala ngati galasi kumadera oyandikira, omwe amathandizira kusunthika kosavuta kwa sensor pakhungu.
Kudziyesa palokha: mothandizidwa ndi sensor ndi kayendedwe kakang'ono kosunthira, gawo lamanzere lam'mimba limaphunziridwa, kuti amalize chithunzichi, pakapita kanthawi wodwalayo amafunsidwa kuti apitire kudzanja lamanja kapena atenge malo okhala, zomwe zimathandizira kuwona kwa magawo amodzi a kapamba, makamaka mutu ndi thupi.
Kuwunika kwa kapamba ndi magawo ake: chovomerezeka cha m'mimba chimayesa kutalika, kukula kwa ziwalo, kuwerenga kapangidwe kake, kachulukidwe kakang'ono ndi kapangidwe ka kapamba, kudziwa kupendekeka kwa msewu wa Wirsung, komanso kupezeka kapena kusapezeka kwa mitundu ingapo ya mapangidwe am'mimba mu parenchyma, panthawi yophunzira, sonologist ikuwonetsa madokotala iwo ali mndende
Ngati ndi kotheka, zithunzi zamalo amtundu payokha zimatengedwa - moyenera, dokotala adzafunika izi kuti apitilizenso kuphunzira za pathological ndi kudziwa njira zake zothandizira,

Pamapeto pake, wodwalayo amapatsidwa zotsatira ndi kufotokoza mwatsatanetsatane chithunzi chomwe chinajambulidwa pogwiritsa ntchito chipangizo cha ultrasound.

Kusanthula Kwazotsatira

Mapeto a ultrasound ali ndi chidziwitso chofunikira kwambiri kwa katswiri: pamaziko omwe adalandira, adokotala amatha kutsimikizira kapena kutsutsa kuwunika koyambitsidwa kale. Ngati wodwala ali ndi kapamba, monga momwe akuwonera, dokotalayo amawona kuopsa kwa matendawa, komanso kuchuluka kwake. Ngati chithunzicho sichikumveka bwino kapena kupereka data yosakwanira, wodwalayo amatumizidwa kukayang'anidwanso (CT kapena MRI). Makamaka chidziwitso cholondola komanso chodziwikiratu ndikufunika kuti zotupa zizindikirike.

Ntchito wamba

Wodwala sayenera kuda nkhawa konse za thanzi la kapamba ake, ngati pomaliza pake pali zotsatirazi:

Kukula kwa kapamba kumayambira 14 mpaka 22 cm (chizindikiro chilichonse chomwe chapatsidwa izi),
Magawo owoneka bwino: mutu wa thupi, thupi, mchira,
Kukula kwa mutu wosapitirira 30 mm, thupi - osapitilira 17 mm, mchira - mpaka 20 mm,
Magulu awiriwa ophatikizika am'mimba,
Wosalala ndi m'mphepete momata makoma a kapamba,
Wirsung duct - osakulitsidwa, mulifupi wake ndi 2 mm,
Kuperewera kwa malingaliro a anonkgenic,
Unifiliji yofanana komanso kuchuluka kwa ziwalo.

Komabe, ngakhale zoterezi za ultrasound ziyenera kuwonetsedwa kwa katswiri. Ngati palibe zosintha zenizeni mu kapamba, ndipo ululu umadwalirabe wodwalayo, ndiye kuti kumununkhiritsa kuyenera kupitilizidwa. Mwinanso, chifukwa chake pamakhala matenda ena, omwe amakhumudwitsidwa kuti ayambitse, chifukwa chithandizo chosaneneka nthawi zina chimakhala ndi zotsatirapo zoyipa kwambiri.

Kupatuka pa chizolowezi

Chikhalidwe cha kuphwanya kulikonse, makamaka zimatengera kuuma kwa matendawa. Ndipo ngati pa gawo loyambirira la pathological kusintha kumeneku kungakhale kopanda tanthauzo kapena kufotokozera, ndiye kuti chithunzicho chikuwoneka ndi mawonekedwe akulu am'mimba chikuphatikizika ndi kupatuka konse. Kuphatikiza apo, ndikosavuta kuti wazist azindikire matenda omwe ali pachimake poyerekeza ndi njira yodwala, popeza nthawi yowonjezera, magawo a kapamba amasinthidwa mwamphamvu.

Mwambiri, kuphwanya malamulo kumeneku kumaphatikizapo:

Kukula kwakukulu kwa kapamba, kutupa,
Malire odabwitsa a khoma, kuchepa kwa zovuta za limba,
Heterogeneity ya kapangidwe ka kapamba,
Zisindikizo zowonetsedwa ndi kuchuluka kwa zachuma,
Kukula kwa dambo la Wirsung mpaka 3 mm,
Kupezeka kwamadzi m'mimba,
Zovuta: cyst, pseudocyst, necrotic foci, chotupa,
Kuwonjezeka kwa ziwalo zapafupi.

Chizindikiro china chodziwika ndi mtundu wodwala matenda:

Kukula kwa kapamba, m'malo mwake, kumachepa - izi zimachitika chifukwa cha kusintha kwa ma fibrosis ndi ma atrophic mu tishu, zomwe zimachitika chifukwa cha nthai yayitali ya matenda.
Kapangidwe kabwino ka parenchyma - izi zimawonetsedwa ndi ma hyperechoic inclusions, omwe ndi maziko a fibrosis,
Kusintha kapangidwe kanu kapangidwe kake ndi kutulutsa kwina,
Kukula kwa Wirsung duct (kupitirira 2 mm), komwe sikumapitirira apo - ngati lamulo, zotsatira za ultrasound zotsatirazi zikuchitira umboni izi.

Kutsiliza pambuyo pa diagnostics a ultrasound

Pambuyo pazotsatira zoyesedwa ndi ultrasound zimapezeka ndi dzanja, muyenera kufunsa uphungu wa akatswiri. Dokotala yekha ndi amene angadziwitse matenda ake moyenera komanso kupereka mankhwala oyenera chifukwa cha matenda omwe awadziwika.

Komabe, mfundo zingapo zofunika kuziganizira apa:

Njira yovuta yotupa yopatsirana kwa kapamba siyitha kukhazikitsidwa pokhapokha pazomwe zikuwunikira za ultrasound, moyenera, zotsatira za maphunziro onse ziyenera kuwunikira: kuyesa kwa Laborator ndi njira zina zothandizira, kuwonjezera apo, chisamaliro chapadera chiyenera kulipidwa pazizindikiro zomwe zimapezeka kwa wodwala,
Simuyenera kungodalira zotsatira za ultrasound ndi kusamutsa mankhwalawo pakhadi la wodwalayo,
Zomwe zimapezeka chifukwa cha kupezeka kwa ultrasound zimawerengedwa kuti ndizodalirika ngati wodwala ali ndi zizindikiro zosachepera zisanu zosonyeza mtundu wa matenda.
Nthawi zina, kupweteka kwamatumbo kumakhala kovuta kwambiri kudziwa komwe kumayamba chifukwa cha matendawa, motero ndikwanzeru kupereka mayeso owonjezera: CT kapena MRI ya chiwalo, endoscopy kapena biopsy kusanthula kwa zotupa pakakhala ma neoplasms.
Ndikofunika kuganiziranso chinthu china chofunikira: mwa anthu okalamba, komanso kwa omwe ali ndi kunenepa kwambiri, kusintha kwina kwa kapamba kumawerengedwa kuti ndiye chizolowezi.

Zotsatira za Ultrasound zimapereka zofunikira osati zokhudzana ndi kapamba, zimadziwitsanso kuuma kwa matendawa. Komabe, izi sizingatengedwe ngati maziko opangira matenda popanda kumuunika wodwalayo. Kuphatikiza apo, pakuyamba kwa kapamba, ma ultrasound samangopereka chidziwitso chokwanira, popeza zizindikiritso za nthawi imeneyi sizimatchulidwa motere: mawonekedwe a mawonekedwe sanasinthidwe, mawonekedwe a gawo sanathenso kumveka, ndipo kapamba palokha sanakulire kukula. Kuzindikira kumeneku kumakhala chisonyezero chachikulu cha pancreatitis pachimake, komanso panthawi yomwe ikuwonjezeka.

Okondedwa owerenga, malingaliro anu ndiofunika kwambiri kwa ife - chifukwa chake, tidzakhala okondwa ndi mayankho anu pa ultrasound ya kapamba mu ndemanga, izi zingakhale zothandiza kwa ogwiritsa ntchito ena tsambali.

Alena

Apa ndawululira pancreatitis chimodzimodzi pa ultrasound. Zachidziwikire, wothandizira adatumiza mayeso owonjezera, koma njira zina adawonetsa zotsatira zomwezo: kapamba adatsimikiza kuti adzakulitsidwa ndipo mawonekedwe a Wirsung adakulitsidwa. Ndipo kwakukulu, panali mulu wonse wazizindikiro womwe umawonetsa bwino lomwe kupezeka kwa matendawa.

Irina

Koma ma ultrasound adandilephera. Kwa nthawi yayitali ululu wanga wam'mimba unkandivutitsa, palibe dokotala m'modzi yemwe amandithandiza, chifukwa ma ultrasound adawonetsa kuti zonse zinali zabwinobwino. Mwa njira, pambuyo pa ultrasound, ndinapita kwa mitundu yonse yazomoto zama FGDS kupatula matumbo am'mimba, koma zonse zidapezeka kuti zili bwino, ndipo ululu udapitilirabe. Patangopita kanthawi kochepa, nditafika kwa katswiri woyenera kulipira chindapusa ndikudutsa MRI pazomwe amalangizidwa, ndinapezeka kuti ndimatenda a kapamba.

Kukonzekera gawo lisanafike mayeso

Musanayambe kufufuza zofunikira, ndikofunikira kukwaniritsa zofunikira zingapo:

Osamadya maola 12 musanayesedwe ma ultrasound.
Ngati ndi kotheka, tsiku la mayeso (m'mawa) chitani njira yotsuka matumbo.
Masiku atatu pamaso pa kuyeserera kwa ultrasound, osadya zakudya zomwe zimalimbikitsa kupezeka kwa nayonso mphamvu ndi kapangidwe ka mpweya m'matumbo am'mimba: nyemba, kabichi, mphesa, mapeyala, makeke olemera ndi yisiti, zakumwa za carbonated, ndi zina zambiri.
Mutha kumwa espumisan kapena mankhwala omwe ali ndi vuto lofananalo kuti muchepetse kuyamwa.
Pompopompo m'mawa musanayambe kugwiritsa ntchito ultrasound, musamwe mankhwala, kumwa kapena kusuta chilichonse.

Kutsatira malamulowa pokonzekera ma ultrasound a kapamba ndi kapamba amathandizira kupeza chidziwitso chodalirika kwambiri.

Muzochitika zadzidzidzi, wodwalayo amapezeka ndi phunziroli popanda gawo lokonzekera, lomwe lingakhudze kwambiri zotsatira za kuzindikira zomwe zapezeka.

Kafukufuku

Panyumba, muyenera kutenga thaulo wamba. Zimakhala zothandiza pambuyo pa kuyeserera kupukuta kirimu wapadera pamimba.

M'chipinda chofufuzira za ultrasound, wodwalayo amafunsidwa kuti atulutsire torso, atagona kumbuyo kwake pakama. Mukamayesedwa, adotolo amafunsira wodwalayo kuti agone kumanzere, mbali yakumanja, kuti akhale pansi. Kusintha kwa kayendetsedwe ka thupi, ziwalo zamkati zimasamutsidwa, ndikutsegula chipangizocho kumagawo osiyanasiyana a kapamba.

Algorithm pakukonzekera wodwala kuti azimutsatira

Zofunika! Phunziroli palokha silopweteka konse komanso ndi lotetezeka. Wodwalayo amangomva chinthu chozizira chikuyenda pakhungu lake.

Kusankha ndendende ndi kuwunika kokhazikika kumatha kukhazikitsidwa ndi endocrinologist, gastroenterologist.

Kuchiritsa

Kukula kwenikweni kwa kapamba kumatsimikiziridwa ndi zizindikiro zitatu. Malingaliro awo ndi awa:

mutu ndi kutalika kwake - 25-35mm,
thupi lalikulu ndi 17-25 mm,
mchira - 15-30 mm.

Mwa abambo ndi amayi, kukula kwake ndiofanana, kwa ana, zizindikiro ndizochepa.

Ultrasound ya kapamba

Chinthu chotsatira chomwe chimakopa chidwi ndi mawonekedwe. Chiwalo chathanzi chimafanana ndi tadpole. Ngati kusinthidwa kwa chiwalo kwapezeka, ndiye kuti pali kuphwanya kwakukulu.

Kuwonekera kwa malire ndi chinthu chomwe kupezeka kwa matenda kumadziwika. Ngati zomwe zalembedwazi ndizosakanikirana, kuphatikiza ndi maziko ozungulira, izi zikuwonetsa kukula kwa njira yotupa.

Kapangidwe ka minofu ya chiwalochi nthawi zambiri kumawoneka ngati mawonekedwe ofanana, popanda kusintha, mawanga, mikwingwirima, zophuka, ming'alu. Ngati umphumphu uli wopanda pake, matenda amakhalapo.

Echogenicity. Ngati chizindikiro ichi chikusiyana kwambiri ndi chizolowezi, ndiye kuti matendawo alipo.

Zisonyezo za ultrasound

Mothandizidwa ndi zinthu zambiri (moyo wosayenera, kusuta, kupsinjika nthawi zonse), ntchito ndi ntchito za kapamba zimatha kusokoneza. Izi zikachitika, munthu amayamba kuda nkhawa za kupweteka kwambiri, kupuma mseru komanso kusanza. Popeza zizindikirozi zimachitika mwanjira zambiri m'matumbo am'mimba komanso m'mimba, mawonekedwe a kapamba ndi ziwalo zam'mimba amaperekedwa kwa odwala.

Zomwe zikuwonetsa kwambiri za ultrasound ya kapamba ndi:

kupweteka kumtunda kwa kumanzere kwa hypochondrium ndi mbali yakumanzere,
kupweteka pakhungu pamimba,
kukomoka kwa m'mimba komwe wapezeka ndi gastroscopy,
kulumikizana kosalekeza ndi kusanza,
matenda ndi chiwindi,
zam'mimba komanso zopondera,
kuvulala kwam'mimba
akuwonetsetsa kuti ali ndi matenda ashuga kapena kapamba,
mayeso a labotale omwe amawonetsa matenda amtundu,
jaundice.

Ultrasound ndi njira yosavuta kwambiri komanso yotsika mtengo kwambiri yofufuzira kapamba.

Kodi ma pancreatic ultrasound amachitika bwanji ndipo akuwonetsa bwanji?

Mayeso a Ultrasound a kapamba amachita mopanda kupweteka komanso mwachangu. Nthawi zambiri njirayi imatenga osaposa mphindi 10.

Pa phunziroli, wodwalayo amaikidwa pabedi ndipo gel yina imayikidwa pamimba. Kenako, pogwiritsa ntchito pulogalamu yoyenera ya ultrasound, chiwalo chimasunthidwa, ndipo zotsatira zake zimawonetsedwa polojekiti inayake. Nthawi zina, kuwunika kwa ultrasound kumachitika poimirira kapena kukhala, koma ngakhale pamenepo munthu samamvanso bwino.

Chifukwa cha ukadaulo wamakono, adokotala amatha kuwona zikondwerero zosiyanasiyana ndikuwonetsa momwe amapezera matenda.

Ultrasound imakupatsani mwayi kuti mufufuze momwe khansa imapangidwira, kapangidwe ka minofu yake, kukula ndi kupezeka kwa neoplasms. Njira ya ultrasound ndiyofunikira kwambiri pakufunika kukhazikitsa chotupa, osafunikira opaleshoni.

Nthengwa nthawi zambiri imakhudzidwa ndi zovuta za ziwalo zina (chiwindi, impso, m'mimba). Chifukwa chake, phunziroli, dokotala amatha kudziwa nthawi yomweyo ziwalo zina.

Kawonedwe kapamba mu sonogram

Moyang'aniridwa ndi ultrasound, mutha kuzindikira zotere ndi matenda:

kapamba
cysts ndi pseudocysts,
lipomatosis
fibrosis
kuchuluka kwa zotupa.

Ultrasound ya kapamba imatha kuwonetsa kukhalapo kwa cysts ndi zina mwa ziwalo, kuwunika khansa kumatha kukhazikitsidwa pokhapokha ngati kafukufuku waposachedwa kwambiri ndi mbiri yakale ya minofu.

Zizindikiro zazikulu mwa ana

Pamaso pa zisonyezo, ma ultrasound a kapamba amatha kuchitidwa ngakhale mwa akhanda.

Mothandizidwa ndi kuyezetsa magazi a m'mimba pamimba, n`zotheka kudziwa matenda obadwa nawo ali aang'ono, chifukwa chake, kuyamba kulandira chithandizo panthawi yake

Makhalidwe abwinobwino mwa ana amatengera zaka, jenda komanso kutalika kwa mwanayo.

Gawo "Kukula kwa kapamba kumakhala kwabwinobwino mwa ana"

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Kodi ma ultrasound amawonetsa pancreatitis?

Kuti mupeze kafukufuku woyenerera wa kapamba, ziwalo zoyandikana zimawunika, chifukwa chake, kudziwitsidwa kolondola kwambiri kumafunikira kukonzekera koyenera (kupatula zochitika zadzidzidzi zomwe zimafunikira opaleshoni yofunikira mwachangu). Kuti pancreatitis iwoneke pa ultrasound, ndikofunikira:

Masiku angapo isanachitike phunziroli, zinthu zopangidwa ndi mpweya wambiri (mkaka, zakumwa zozizilitsa khofi, zipatso / ndiwo zamasamba) zimaphatikizidwa pakudya
Chakudya chotsiriza chiyenera kukhala maola 10-12 isanafike nthawi yoikika ya ultrasound,
Ndi zoletsedwa kumwa mowa, kusuta ndi kumwa mankhwala ena (muyenera kukambirana ndi dokotala za izi),
Pomwe phunziroli lisanachitike, tikulimbikitsidwa kuti mupange enema yotsuka kuti muthetse matumbo athunthu,
Kuti muchepetse kusefukira, mutha kuyambitsa makala kapena espumisan.

Zofunika! Ultrasound nthawi zambiri imachitika m'mawa, pomwe chimbudzi chimapanda kanthu.

Kodi ziwonetsero zachilendo zimawoneka bwanji?

Kuti muzindikire matenda a kapamba panthawi ya ultrasound, ndikofunikira kudziwa kukula kwachilengedwe.

Zikondazo zimagawidwa kumutu, thupi ndikudzitama. Miyezi imakonda kuonedwa:

Kutalika kwa chithokomiro chonse ndi 16-22 cm, makulidwe ake ndi 2-3 masentimita, misa ndi 80-90 g.,
Thupi 1.75-2.5 masentimita, mutu 1.8-3.2 masentimita, mchira wa 2.2-3.5 cm,
Mphedwe zoonekera,
Dambo la Wirsung limakhala ndi makulidwe ofika mpaka 2 mm,
Kapangidwe ka ndulu ndi kofanana.

Chizindikiro chimodzi chofunikira kwambiri cha kapamba ndi echogenicity (kuthekera kwa kufalitsa ultrasound). Nthawi zambiri, chizindikirochi chimagwirizana ndi chiwindi komanso ndulu.

Yang'anani! Kukula kwa kutulutsa zimatengera zaka, jenda komanso kutalika kwa munthu. Ndi zaka, chitsulo chimayamba kuchepa, ndipo echogenicity imakulanso.

Zizindikiro za kapamba pamimba

Pali mitundu itatu yayikulu ya kapamba - pachimake (kufalikira mwachangu kwa matendawa), chifuwa chamtundu (chotenga nthawi yayitali ngakhale chitukuko cha matendawa ndi kupweteka kwakanthawi) ndi pancreatic necrosis (gawo lowononga la kapamba). Monga kapamba pa ultrasound amawonetsa mosiyanasiyana, timaganizira pansipa.

Zizindikiro za kapamba kapamba:

Chitsulo chakulitsidwa,
Madzi ozizira ndi opindika,
M'malo otupa, echogenicity imachulukitsidwa,
Bungwe lamapangidwe opanga,
Wuctung duct yawonjezeka,
Kukhalapo kwa madzimadzi m'matumbo, zovuta zamagulu oyandikana nawo,
Cysts kapena zovuta zina ndizotheka.

Mu chifuwa chachikulu cha pancreatitis, zizindikiro zotsatirazi ndizodziwika:

Kufotokozedwa, kupweteka kwakukulu, kosalekeza kwa chikhalidwe chosakhazikika kapena chodula. Ngati simukulandila chithandizo chanthawi yake, mutha kudwala ululu. Kutengera ndi komwe kuli pancreatic lesion, ululu umatha kuwoneka pansi pa supuni, mu hypochondrium mbali zonse ziwiri. ndi zotupa zonse za m'mimba, zowawa zidzakhala herpes zoster.
Kuchulukitsa kutentha ndi kuthamanga kwa magazi. kupanikizika kumatha kukhala kokwezeka kwambiri kapena kotsika kwambiri, kutentha kumatha kukwera mpaka 40 ° C. thanzi lathunthu likuipiraipira.
Kusintha kwa mawonekedwe, kuchokera pakufika pakubala kwa utoto wamtundu, mawonekedwe a nkhope amatha kuwongola.
Kusanza, kupindika, hiccups, pakamwa kowuma, nthawi zina kusanza, komwe sikubweretsa mpumulo.
Matenda a Stool (kudzimbidwa / kutsegula m'mimba). Mpando ndi thovu, uli ndi fungo la fetid. Kudzimbidwa, kutumphuka ndi kuwumitsa minofu.
Kuwoneka kufupika, thukuta lomata, chikwangwani chachikaso pamalilime chifukwa cholephera kugwira ntchito yamtima.
Khungu labuluu, mawanga m'dera lumbar kapena navel, dera la inguinal limatha kukhala mtundu wobiriwira. Izi zimachitika chifukwa cholowera magazi kuchokera ku zodutsa pansi pa khungu.

Zizindikiro za chifuwa chachikulu pakompyuta yosanja:

Kukula kopitilira mpanda wa Wirsung.
Ubwino wabwino, kusinthana kwa maonekedwe a zoumba,
Kuchepetsa zachilengedwe
Makulidwe ochulukirapo.

Zofunika! Matendawa akapita patsogolo, ziwalo zimafalikira ndipo zimayang'ambika ndi fibrosis, minofu ya minyewa, imasinthidwa ndi minyewa yolumikizana, yomwe imapangitsa kuchuluka kwa echogenicity. Zikondazo zimachepetsedwa kukula kwake, mawonekedwewo amakhalabe amadzipaka.