Khansa ya pancreatic - magawo, zizindikiro zoyambirira ndi mawonekedwe, chithandizo

Khansa ya pancreatic ndimatenda a oncological omwe nthawi zambiri amakumana ndi kumbuyo kwa kuchepa kwa chitetezo chokwanira, kapena ngati munthu akudwala matenda opatsirana a chiwalochi (matenda a chifuko chachikulu, matenda a shuga). Matendawa samadziwonetsa kwa nthawi yayitali ali ndi zisonyezo zilizonse, ndipo mawonetsedwe ake amtsogolo amatha kudzipangitsa kukhala matenda oyambitsidwa kapena kukhala “osamveka”, zomwe zimapangitsa kuzindikira kukhala kovuta. Khansa ya pancreatic imakonda kupita patsogolo, ikukulira kukula, ndikupatsa metastases mu lymph node, chiwindi, mafupa ndi mapapu. Zonsezi zimatsimikizira dzina la matendawa - "wakupha chete."

Oncologists amalimbikitsa kuti munthu aliyense wathanzi azitha kuyang'ana pamimba pamimba ndi kubwezeretsa malo kamodzi pachaka. Ndipo ngati mupeza nokha zoopsa ziwiri kapena zingapo zolemba pansipa, ndikulimbikitsidwa kuti muwonjezere MRI yam'mimba komanso kuyesa magazi kwa chikhomo cha CA-19-9 pakuwunika pachaka.

About kapamba

Ichi ndi chiwalo chaching'ono chotalika masentimita 16 mpaka 22. Chimakhala ndi mawonekedwe a peyala atagona mbali yake, mkati mwake mumakhala ma lobules, maselo omwe amatulutsa michere yambiri. Ululu uliwonse umakhala ndi kabowo kake kamene kamalumikizidwa mu duct imodzi yayikulu, Wingsung duct, yomwe imatsegukira mu duodenum. Mkati mwa lobules mumakhala timabowo ta maselo (ma islets of Langerhans) omwe samalumikizana ndi ma ducts. Amabisa chinsinsi chawo - ndipo awa ndi ma insulin, glucagon ndi somatostatin - mwachindunji m'magazi.

Gland ili pamlingo wa vertebrae yoyamba ya lumbar. Peritoneum imayiphimba kutsogolo, ndipo imatulukanso kuti chiwalocho sichikhala m'mimba mwaiwo, koma m'malo obwezeretsanso, pafupi ndi impso ndi adrenal gland. Pang'onopang'ono, chiwalocho chimakutidwa ndi kutsogolo ndi m'mimba ndi "apron" wamafuta wotchedwa "omentum", kumapeto kwake kumatsutsana ndi ndulu. Izi zimapangitsa kuti gland ikhale yosafikirika pakufufuza monga, mwachitsanzo, chiwindi. Komabe, mmanja omwe ali ndi luso, ultrasound ndi njira yabwino yofufuzira matenda (ndiye kuti choyambirira, choyambirira, chokayikira chofuna kumveka bwino pogwiritsa ntchito njira zina).

Zikondazo zimalemera pafupifupi magalamu 100. Misonkhano imakhala yogawa mutu, khosi, thupi ndi mchira. Zomalizirazi zimakhala ndi zisumbu zambiri za Langerhans, zomwe ndi gawo la endocrine.

Zikondazo zimakutidwa ndi kapisozi kamisempha yolumikizirana. "Zinthu" zomwezi zimalekanitsa ubweya wina ndi mzake. Kuphwanya umphumphu wa izi. Ngati ma enzymes opangidwa ndi ma cell a exocrine salowa mu duct, koma m'malo osatetezedwa, amatha kugaya maselo awo aliwonse: amasokoneza mapuloteni onse ovuta, mafuta ndi chakudya m'magawo oyambira.

Amabala

Malinga ndi United States, kukhala osowa kwambiri (kupezeka m'mavuto awiri mwa atatu mwa zotupa zakumaso), khansa ya kapamba imakhala pakati wachinayi mwa zomwe zimayambitsa kupha khansa. Matendawa nthawi zambiri amapha ma oncopathologies ena onse. Izi ndichifukwa choti kumayambiriro matendawa samadziwonetsa konse, koma pambuyo pake zizindikirazo zingakupangitseni kuti muganize za matenda osiyanasiyana. Nthawi zambiri amuna amadwala nthawi 1.5. Chiwopsezo cha kudwala chimakwera pambuyo pa 30, chimakwera pambuyo pa 50 ndikufika pachimake patatha zaka 70 (60% kapena kuposerapo mwa anthu opitilira 70).

Nthawi zambiri, khansa imayamba m'mutu wa kapamba (3/4 kesi), thupi ndi mchira wa chiwalo sichimavutika. Pafupifupi 95% ya khansa imabwera chifukwa cha masinthidwe omwe amapanga maselo a exocrine.Kenako adenocarcinoma amachitika. Yotsirizirayi nthawi zambiri imakhala ndi mawonekedwe, pomwe chotupacho chimakhala ndi minyewa yolumikizika kuposa ma "epithelial" akudzaza.

Khansa ya pancreatic imakonda metastasize kwa ma lymph node, chiwindi, mafupa ndi mapapu. Chotupacho chimatha kukula, kuphwanya umphumphu wa makoma a duodenum 12, m'mimba, matumbo akulu.

Kodi matendawa amakula bwanji?

Maselo a chiwalo chilichonse akagawikana, maselo omwe ali ndi mawonekedwe osakhazikika a DNA amapezeka nthawi ndi nthawi, zomwe zimawasokoneza. Koma chitetezo chokwanira chimaphatikizidwa ndi ntchitoyi, yomwe "imawona" kuti khungu limakhala lachilendo m'mapuloteni ma antigen omwe amapezeka pamwamba pa nembanemba yake. Maselo T-lymphocyte, omwe amagwira ntchito ya tsiku ndi tsiku, ayenera "kuwunika" ma antigen omwe ali m'maselo omwe sanazungulidwe ndi chotchinga chapadera, ndi zomwe zimadziwika mu kukumbukira kwawo. Macheke awa sakuyenera, khungu limawonongeka. Njira imeneyi ikasokonekera, maselo osinthika amayamba kugawanika ndipo, akunjikana, amayamba chotupa cha khansa. Mpaka afikire chiwerengero chovuta, amaphatikiza limagwirira lomwe limawabisa mu chitetezo cha mthupi. Kenako, bukuli likakwaniritsidwa, chitetezo chimazindikira chotupacho, koma sichitha kuthana nacho chokha. Kulimbana kwawo ndipo kumayambitsa kuwoneka kwa zizindikiro zoyambirira.

Palibe chifukwa chenicheni cha khansa yapakansa chomwe chapezeka. Zowopsa zokha zomwe zimafotokozedwa kuti, makamaka akakumana pamodzi, zimayambitsa matenda. Izi ndi izi:

• Matenda a kapamba Maselo amtundu wa gland ali ndi zotupa nthawi zonse amakhala gawo labwino lachitukuko cha masinthidwe mwa iwo. Chiwopsezo chotenga khansa chimachepetsedwa ndikusungitsa matendawa m'njira yokumukhulukira, zomwe zingatheke ngati zakudya zikutsatiridwa.
• Hereditary pancreatitis ndi kutupa kwa kapamba chifukwa chakuti mtundu wawo wolakwika "unalamula".
• Matenda a shuga. Kusowa kwa insulini (makamaka wachibale, wokhala ndi matenda a 2) komanso kuchuluka kwa shuga m'magazi chifukwa cha izi kumawonjezera chiopsezo cha khansa ya kapamba.
• Kusuta. Choyimira ichi chimasinthika: ngati munthu asiya kusuta, kumasula ziwiya zake kuchokera phula ndi chikonga, ndi kapamba wake ku ischemia, chiwopsezo cha matendawa chimachepa.
• Kunenepa kwambiri kumawonjezera mwayi wokhala ndi khansa. Ichi ndichifukwa chosintha muyezo wamahomoni ogonana omwe amakwiya chifukwa chodzikundikira minyewa ya adipocytic (adipose).
• Matenda a chiwindi. Chiwopsezo chokhala ndi khansa ya pancreatic imawonjezeka ndi matenda awa.
• Kupezeka kwa zilonda zam'mimba. Matendawa amasintha ma microflora am'mimba, chifukwa amamuwa amapezeka m'magawo am'mimba. Ndi opaleshoni ya zilonda zam'mimba, chiopsezo cha khansa ya pancreatic imakulanso.
• Chakudya chopatsa thanzi. Pali maphunziro, koma sanatsimikizidwebe kuti awonjezere mwayi wokhala ndi khansa ya kapamba:
  1. "Nyama yophika": nyama, soseji, nyama yankhumba, utsi wambiri: chiwopsezochi chimawonjezeka ndi 20% ndi magalamu 50 aliwonse a nyama,
  2. khofi
  3. owonjezera mafuta osavuta owonjezera, makamaka omwe amapezeka m'makumwa osamwa mowa, omwe, kuwonjezera apo, ali ndi kapangidwe kake ndi koloko.
  4. Nyama yokazinga, makamaka nyama yofiyira - imakhala ndi ma heterocyclic amines omwe amawonjezera chiopsezo cha khansa ndi 60%,
  5. kuchuluka kwamafuta acids mu chakudya.
• Nonspecific ulcerative colitis ndi matenda a Crohn. Pakalipo kwa zaka zambiri, ma pathologies awa "amapha" kapamba ndi mankhwala omwe amapangidwa nthawi yotupa.
• Zochita zolimbitsa thupi.
• Matenda oyambitsidwa ndi matendawa: eczema, dermatitis ya atopic ndi ena.
• Matenda am'kamwa. Pali chosawerengeka koma chotsimikiziridwa kuti caries, pulpitis, periodontitis imawonjezera chiopsezo cha khansa ya kapamba.
• Kulowetsa utoto wosiyanasiyana ndi mankhwala omwe amagwiritsidwa ntchito pazitsulo.
• Pali khansa ya malo ena, makamaka: khansa yam'mimba, chiberekero, matumbo, mapapu, m'mawere, mazira, impso komanso chikhodzodzo.
• Zaka zopitilira 60.
• Kukhala wa liwiro la ku Africa.
• Masinthidwe mu kapangidwe ka DNA yachilengedwe, mwachitsanzo, ku BRCA2, majini omwe ali ndi vuto lodana ndi zotupa. Kusintha koteroko kungatengeredwe. Kuchulukitsa kwa protein proteinasease P1 gene (PKD1) kungathenso kuthandizira ku khansa ya pancreatic. Ponena za momwe jini lomaliza limapezera njira yochizira matendawa, maphunziro akupitilira.
• Kupezeka kwa oncopathology mwa abale apamtima. Makamaka omwe ali pachiwopsezo ndi anthu omwe achibale awo oyamba adapezeka ndi khansa ya kapamba asanafike zaka 60. Ndipo ngati pali zochitika ziwiri kapena zochulukirapo zotere, mwayi wopeza zomwe zimachitika umawonjezereka.
• Chiyanjano cha amuna. Vutoli, lofanana ndi zinayi zakumaso, limayimira zomwe munthu sangathe kuzisintha. Koma, powona njira zopewera (za iwo - kumapeto kwa nkhaniyi), muthanso kuchepetsa mwayi wanu.

Matenda a kapamba ndi kapamba:

Gulu la matendawo ndi kapangidwe kake

Kutengera ndi maselo omwe chotupa chayamba kupangika kuchokera (izi ndimalingaliro ake), chikhoza kukhala ndi mitundu ingapo:

• Ductal adenocarcinoma ndi khansa yomwe imapangidwa kuchokera ku ma cell omwe amalekanitsa ma cell a gland. Mtundu wofala kwambiri.
• Glandular squamous cell carcinoma imapangidwa kuchokera ku mitundu iwiri ya maselo - omwe amapanga ma enzymes, omwe amapanga ma ducts.
• Giant cell adenocarcinoma ndi kudzikundikira kwamitsempha yama cystic, yodzaza ndi magazi.
• Squcinous cell carcinoma. Zili ndi ma cell a duct, ndizosowa kwambiri.
• Mucinous adenocarcinoma amapezeka mu 1-3% ya milandu ya khansa ya kapamba. Imakhala yovuta kwambiri kuposa mtundu wakale.
• Mucinous cystadenocarcinoma amakula chifukwa cha kuwonongeka kwa tiziwalo tamadontho totupa. Nthawi zambiri, khansa yamtunduwu imakhudzanso azimayi.
• Khansa ya Acinar. Ma cell a tumor pano amakonzedwa mwanjira za masango, omwe amachititsa dzina la chotupacho.
• Khansa yopanda chidwi. Maonekedwe ake oyipitsitsa.

Ngati khansa imayamba kuchokera ku endocrine gland, imatha kutchedwa:

• glucagonoma - ngati atulutsa glucagon, timadzi timene timadzutsa magazi,
• insulinoma yomwe imapanga insulin yambiri yomwe imatsitsa shuga.
• gastrinoma - chotupa chomwe chimatulutsa gastrin - mahomoni omwe amalimbikitsa m'mimba.

Gulu la matendawa ndi malo ake

Kutengera kutengera komweko, pali:

1. khansa yam'mimbayo. Umu ndi mtundu wa khansa wofala kwambiri
2. glandular carcinoma
3. khansa yamatumbo a chamba.

Ngati muphatikiza magulu awiri omwe ali pamwambapa, asayansi amapereka izi:

• mu milandu 61%, ductal carcinoma amapezeka m'mutu, 21% mchira, 18% m'thupi,
• mutu wa gland umateteza kwa theka la maselo akuluakulu a adenocarcinomas,
• m'malo opitilira 60%, khansa ya glandular squamous imakhala m'mutu mwa chiwalo, nthawi zambiri zomwe zimayang'ana zimakhala zambiri kapena zimangokhala mchira wokha.
• odziwika bwino m'mutu ndi zopitilira 78% ya mucinous adenocarcinomas,
• kapangidwe ka acinar cell carcinoma ndi motere: 56% ili m'mutu, 36% m'thupi, 8% mchira,
• koma mucinous cystadenocarcinoma amakhala m'mutu mwa milandu 1/5 yokha, kuposa 60% imakhudza thupi, ndipo mu 20% ya milandu amapezeka mchira.

Chifukwa chake, titha kunena kuti mutu wa pancreatic ndi malo omwe chotupa chowopsa chimapezeka nthawi zambiri.

Zizindikiro za matendawa

Khansa yomwe idakulidwa m'mutu wa kapamba poyamba ilibe mawonekedwe akunja.Kenako zizindikiro zoyambirira za matendawo zimawonekera. Izi ndi izi:

1. Kupweteka kwam'mimba:
   • mu "pansi pa dzenje"
   • ndipo nthawi yomweyo mu hypochondria,
   • amapatsa kumbuyo
   • kuchuluka kwa zowawa kumawonjezeka usiku,
   • kuvulaza ngati mutatsamira
   • Zimakhala zosavuta ngati mutakanikiza miyendo yanu m'mimba mwanu.
2. Kufupika kwapakati ndi kupweteka kwa minyewa imodzi kapena imzake. Kugundika kwa magazi kungachitike mwa iwo, chifukwa ndi gawo liti lomwe limasunthasuntha.
3. Kuchepetsa thupi popanda kudya.
4. Magawo oyambilira a khansa amadziwika ndi kufooka wamba, kulephera kugwira ntchito, komanso kulemera atatha kudya "pansi pa supuni".

Zizindikiro zina za khansa zomwe zimakhudzana ndi kukulira kwa chotupa ndi:

• Jaundice Zimayamba pang'onopang'ono, munthu samazindikira kwa nthawi yayitali, mwina, mwina, kulabadira kutulutsa kwa maso. Pakapita kanthawi, kufinya mapangidwe pomwe chimbudzi ndi kapamba zimatseguka, ndipo nguluwe yayikulu yochokera ku chiwindi, jaundice imakulanso kwambiri. Khungu limakhala osati chikasu, koma limayamba kupindika.
• Khungu loyipa la thupi lonse. Amayamba chifukwa cha kusakhazikika kwa bile mkati mwake, pomwe maula a bile amapezeka pakhungu.
• Tizilombo timayala, ndipo mkodzo umakhala wakuda.
• Kulakalaka kutayika.
• Kusagwirizana ndi nyama ndi mafuta kumayamba.
• Matenda am'mimba monga:
  • nseru
  • kusanza
  • kutsegula m'mimba Chopondapo ndimamadzi, fetid, mafuta, zimasinthika chifukwa cha kuwonongeka m'mafuta omwe amapezeka chifukwa choti chitsulo chimasiya kuphatikiza michere yachilengedwe.
• Kulemera kwamthupi kumachepa kwambiri, munthu amawoneka wotopa.

Zizindikiro za khansa ya pancreatic mthupi kapena mchira zimakhala mawonekedwe osiyana. Izi ndichifukwa choti kutukuka kumeneku sikuli kotereku, mwachitsanzo, kupanikizika kwawo kumayambitsa jaundice - chizindikiro chachikulu chomwe chimapangitsa munthu kufunafuna chithandizo chamankhwala. Kuphatikiza apo, zili m'thupi ndi mchira kuti zilumba zambiri zokhala ndi maselo a endocrine gland amapezeka. Chifukwa chake, zizindikiro za khansa yamthupi kapena mchira imatha kukhala:

• Zizindikiro za matenda ashuga:
  • ludzu
  • kamwa yowuma
  • kuchuluka kwamikodzo
  • pokodza usiku.
• Zizindikiro monga pancreatitis yayitali:
  • kupweteka pamimba,
  • mafuta chopondapo, madzi ochulukirapo, ovuta kutsuka kuchimbudzi,
  • pakhoza kukhala kutsegula m'mimba
  • nseru
  • kuchepa kwamtima
  • Kuchepetsa thupi.
• Ngati glucagonoma yakula, izi ziwonekera:
  • kuwonda
  • Maonekedwe a kupanikizana pakona pakamwa,
  • Kusintha kwa mtundu wa lilime kukhala lofiira, mawonekedwe ake amakhala osalala, ndikuwoneka kuti amatupa, kukulira ndi "kunenepa",
  • Khungu limakhala lotuwa
  • chotupa chikuwonekera, nthawi zambiri chimadziwika pamiyendo,
  • dermatitis nthawi zina imawoneka, yomwe imatchedwa necrolytic kusuntha erythema. Uku ndi kuchitika kwa malo amodzi kapena angapo, omwe amasandulika kukhala ma vesicles, kenaka kukhala zilonda, zomwe zimakutidwa ndi kutumphuka. Pamalo pomwe pali kuterera. Mu malo amodzi, zinthu zingapo zimadziwika nthawi imodzi. Njirayi imatha milungu iwiri, kenako imadutsa, itatha - ikhoza kubwerezedwanso. Dermatitis nthawi zambiri imakhala pamimba yotsika, mu groin, perineum, kuzungulira anus. Mankhwala othandizira mafuta sachitapo kanthu, popeza sakhazikitsidwa chifukwa cha kufinya kapena kachilombo kakang'ono, koma kuphwanya kagayidwe ka mapuloteni ndi ma amino acid pakhungu.
• Zizindikiro za Gastrinoma zingathenso:
  • kulimbikira m'mimba
  • ndowe zonenepa, zonyezimira, zonyansa, zochotsedwa kuchimbudzi,
  • ululu "pansi pa supuni" mutatha kudya, womwe umachepetsa mukamamwa mankhwala monga "Omeprazole", "Rabeprazole", "Ranitidine", wolembedwa ngati zilonda zam'mimba,
  • Ndi mavuto a zilonda zam'mimba zomwe zimachitika ndikukula kwambiri kwa gastrin, pakhoza kukhala: kusanza kwa zofiirira, zofiirira zotayidwa, kumva kuti m'mimba sikugwira ntchito ("kuyimirira") mutatha kudya.
• Kutsegula m'mimba.
• Kutupa.
• Kusamba kwa msambo.
• Anatsika libido.
• Kuchiritsa pang'onopang'ono kwa mabala.
• Maonekedwe a ziphuphu ndi mafinya kumaso.
• Zilonda zam'mimba zambiri zimawoneka pamiyendo.
• Pakhungu nthawi zina pamakhala mawanga ofanana ndi matupi awo.
• "Maso otentha" ndikumawona kutentha m'mutu ndi thupi, kufiira kwa nkhope kumawonekera paroxysmally.Minyezi imatha kumwera mukatha kumwa zakumwa zoledzeretsa, mowa, kudya kwambiri kapena kupsinjika. Khungu limatha kukhala lodetsa kuposa kale, kapena, kutenthedwa, kapena kupota utoto.
• Chifukwa cha kuchepa kwa sodium, magnesium, potaziyamu ndi m'mimba, kukomoka kumatha kuwoneka m'miyendo ndi kumaso osataya chikumbumtima.
• Mutha kumva kulemera, kumverera kofalikira mu hypochondrium yamanzere. Ichi ndi chizindikiro cha ndulu yokula.
• Wokhetsedwa pachimake pamimba, kufooka kwambiri, kufooka kwa khungu. Izi ndi zizindikiro za magazi amkati kuchokera m'madzimadzi (chifukwa cha kuchuluka kwa magazi m'mitsempha yamagazi yotumiza magazi ku chiwindi) mitsempha ya esophagus ndi m'mimba.

Chifukwa chake, kuchepa thupi, kupweteka pamimba, mafuta am'mimbamo ndi chizindikiro cha khansa ya malo aliwonse. Amapezekanso pancreatitis yosatha. Ngati mulibe pancreatitis, muyenera kuyesedwa osati kupezeka kwake, komanso khansa. Ngati kutupa kosatha kwa kapamba kumachitika kale, ndikofunikira kuti muzimufufuza khansa osati pafupipafupi, pachaka, komanso komanso ndi chizindikiro chatsopano chomwe sichikupezeka kale.

Apa taunika zomwe zili mu gawo 1 ndi 2. Onsewo, ali 4. Gawo lomaliza, kuwonjezera pa kupweteka kwambiri m'chupi, kutsegula m'mimba komanso kutsekeka kwathunthu kwa zinthu, chifukwa cha metastases yakutali, ziwonetsedwe ndi ziwalo kuchokera ku ziwalo zomwe mwana wamkazi wa chotupacho wafika. Ganizirani zomwe zatsiku lino titatha kudziwa ndi komwe khansa ya kapamba ingapezere.

Kodi khansa ya kapamba imapezeka kuti?

Khansa yapakhungu "imabalalitsa" maselo ake m'njira zitatu:

• Kudzera m'mimba. Imapezeka m'magawo anayi:
  1. Choyamba, ma lymph node omwe amakhala mozungulira mutu wa kapamba amakhudzidwa,
  2. maselo otupa amalowa m'mitsempha ya m'mimba yomwe ili kumbuyo kwa malo omwe m'mimba umadutsira mu duodenum, komanso komwe hepatoduodenal ligament imadutsa (mu tsamba la minyewa yolumikizana imakhala ndi kulowerera kwa bile ),
  3. Mitsempha ya m'mimba yomwe ili kumtunda kwa mesentery (minyewa yolumikizira mkati momwe ziwiya zomwe zimadyetsa ndikugwira matumbo ang'onoang'ono zimadutsa) zimakumana ndi izi:
  4. kuwunika komaliza ndi zamitsempha kumapezeka m'malo a m'mimba, m'mphepete mwa msempha.
• Kudzera kuzungulira kwa magazi. Chifukwa chake maselo a mwana wamkazi chotupa alowa ziwalo zamkati: chiwindi, mapapu, ubongo, impso ndi mafupa.
• Khansa ya kapamba imapukusanso maselo ake m'mbali mwa peritoneum. Chifukwa chake, metastases imatha kuwonekera pa peritoneum palokha, ziwalo za pelvis yaying'ono, m'matumbo.

Komanso, chotupa chokhala ndi khansa chimatha kumera ziwalo zapafupi ndi kapamba: m'mimba, ndulu za bile - ngati khansa yapezeka m'mutu mwa chotupa, ziwiya zikuluzikulu - ngati maselo osinthika apezeka m'thupi la gland, ndulu ngati chotupacho chafalikira kuchokera mchira. Vutoli limatchedwa osati metastasis, koma chotupa kulowerera.

Khansa yapakansa - ndi chiyani?

Khansa ya pancreatic ndikusintha kwa maselo a pancreatic mu zilonda, motsatiridwa ndi kuchuluka kwawo ndikupanga chotupa. Kutengera ndi zida zowonongeka, mitundu yosiyanasiyana ya oncopathologies imakula, yosiyana pa liwiro la kufalikira ndi zizindikiro.

Zikondamoyo sizingatulutse michere yokumba, komanso kupanga mahomoni. Ma cell a glandular omwe amachititsa kuti azipanga madzi a pancreatic amapezeka m'malo opezeka mkati mwa gawo lotchedwa mutu.

Kapangidwe ka maholide kumachitika m'magulu a ma cell omwe amatchedwa islets of Langerhans. Amapezeka makamaka kumbuyo kwa kapamba - mchira. Mahomoni akuluakulu ali motere:

• gastrin, yolimbikitsa kupanga madzi am'mimba,
• glucagon, cholinga chake ndikuwonjezera magazi,
• insulin - kumawonjezera ntchito ya shuga kagayidwe, kuchepetsa ndende yake m'magazi.

Pakati pa mutu ndi mchira pali malo omwe amatchedwa thupi. Malinga ndi ziwerengero, khansa yam'mimbazi yamatenda nthawi zambiri imayamba, ndipo zotupa za ziwalo zina sizachilendo.

Ngati macocois a maselo a ma Langerhans amapezeka, endocrine ntchito ya thupi imavutika. Potengera izi, zotupa za gastrinomas, glucagonomas, insulinomas zimayamba.

Kugonjetsedwa kwa zinthu zopangika pamiyendoyo kumatchedwa squamous cell carcinoma ya kapamba. Maselo a glandular akakhala pa oncotransfform, adenocarcinoma amadziwika. Ndipo glandular squamous cell carcinoma ya kapamba ndi mawonekedwe osakanikirana omwe magawo onse omwe amapanga ma enzyme komanso maselo a ma pulling ducts amakhudzidwa.

Kuphatikiza apo, ma cysts mu kapamba amatha kupweteketsa. Pankhaniyi, chachikulu cell adenocarcinomas ndi mucinous cystadenocarcinomas amakula. Maselo obadwa mwatsopano akapangidwa mwanjira ya masango, amalankhula za khansa ya acinar.

Komabe, chowopsa kwambiri ndi mtundu wa khansa ya pancreatic. Amapita patsogolo mwachangu kuposa ena ndipo amakonda kwambiri metastasis.

Komabe, mitundu yonse ya khansa ya kapamba imapweteka kwambiri. Sipangadutse zaka zingapo kuchokera pomwe matenda amayambukira kupita kumalo owadwalitsa, monga zimakhalira ndi ma oncopathologies ena, koma miyezi 6-8 yokha.

Zoyambitsa Khansa Yapancreatic

Tsoka ilo, silinakhazikitsidwe bwino lomwe lomwe limayambitsa khansa ya pancreatic - akukhulupirira kuti magulu otsatirawa a anthu agwera pagulu langozi:

• Amuna opitirira 60
• kusuta anthu
• oledzera
• omwe ali ndi mbiri yamatenda a ndulu, chiwindi, zilonda zam'mimba, matenda am'mimba,
• anthu omwe ali ndi matenda otupa a kumlomo wamkati (pulpitis, periodontitis),
• odwala omwe amachitidwa zilonda zam'mimba,
• anthu odwala matenda opatsirana: cysts, pancreatitis aakulu, zilonda zam'mimba, matenda a Crohn,
• anthu omwe ali ndi choloŵa cha khansa ya kapamba.

Zowopsa pantchito zimachitanso gawo lofunikira: kukhudzana mwadongosolo ndi asbestos, utoto wazitsulo. Zimatsimikiziridwa kuti chiopsezo cha khansa ya pancreatic imachulukitsa chakudya cholakwika ndi kuchuluka kwa zakudya zamafuta ndi kuchuluka kwakukulu kwa zokometsera.

Nyama yowopsa, yokazinga, soseji, nyama zosuta, nyama yankhumba. Zikondamoyo zimakhalanso ndi zakudya zomwe zimakhala ndi shuga wambiri, zakudya zosavuta zam'mimba, zakumwa za kaboni.

Tiyenera kukumbukira kuti njira iliyonse yotupa yotupa imachulukitsa kwambiri khansa ya mu cell. Zomwezi zimagwiranso kwa kapamba, ndipo khansa imayamba kupezeka kumbuyo kwa zotupa zomwe zimapezeka m'thupi lathu, zomwe zimalumikizana ndi izi:

• duodenum
• chikhodzodzo
• chiwindi.

Chodabwitsa ndichakuti machitidwe owopsa mthupi omwe akukhudzidwawo amakhala ndi "zomwe amakonda". Chifukwa chake, khansa ya kapamba imayamba kugwiritsidwa ntchito ndi anthu aku Africa.

Pancreatic khansa njira

Pali magawo anayi a khansa ya kapamba:

Ndi maselo ochepa chabe omwe amatengeka ndi mucous nembanemba. Amatha kufalikira kulowa mkatikati mwa thupi, ndikupatsa chotupa cha khansa, koma akachotsedwa, mwayi wochiritsidwa kwathunthu umafika 99%.

Palibe zizindikiro, chotupa choterechi chimatha kupezeka pokhapokha ndi ultrasound yokonzekera, CT kapena MRI

Gawo 4 ndi pamene, mosasamala kukula ndi ma metastases am'madzi am'mimba, metastases yakutali kwa ziwalo zina anawonekera: ubongo, mapapo, chiwindi, impso, thumba losunga mazira.

Gawoli likuwonetsedwa:

• kupweteka kwambiri pamimba,
• kutopa kwambiri
• kupweteka ndi kulemera mu hypochondrium yoyenera yokhudzana ndi kukulitsidwa kwa chiwindi, chomwe chimasefa maselo a khansa ndi poizoni omwe amatulutsidwa ndi iwo.
• ascites: kudzikundikira kwamadzi m'mimba. Izi zikuchitika chifukwa cha kusayenda bwino kwa peritoneum yomwe idakhudzidwa ndi ma metastases, komanso chiwindi, chifukwa chomwe gawo lamadzi limatuluka m'mitsempha.
• munthawi yomweyo khungu komanso kusangalala kwa khungu,
• kulemera mu hypochondrium kumanzere, chifukwa cha ndulu yokulitsidwa,
• Maonekedwe a mafinya apakhungu pansi pa khungu (awa ndi maselo amafuta akufa),
• redness ndi kuwawa (nthawi zina ndi redness kapena cyanosis m'mphepete) ya mtsempha umodzi kapena wina

Gawo 4 likapita ndi metastases ya chiwindi, zotsatirazi zadziwika:

• chikaso cha khungu ndi mapuloteni amaso,
• mkodzo umayamba kuda ndipo ndowe zimayaka
• magazi amkamwa ndi mucous nembanemba ukuwonjezeka, kuphulika kwamkati kumatha kupezeka,
• kuchuluka kwam'mimba chifukwa cha kuchuluka kwa madzi mkati mwake,
• mpweya wabwino.

Nthawi yomweyo, kuyesa kwa ultrasound, CT scan kapena MRI ya chiwindi kumawululira metastasis mmenemo, zomwe ndizotheka - chifukwa chofanana ndi chizindikiro komanso kupezeka kwa neoplasm - ndipo adzatengedwa kuti ali ndi chotupa chachikulu. Kuti timvetsetse kuti ndi iti mwa makhansa omwe ali oyamba komanso omwe metastasis imatheka kokha mothandizidwa ndi neoplasm biopsy.

Ngati metastases ikukula m'mapapu, zotsatirazi zadziwika:

• kupuma movutikira: choyamba pambuyo pakulimbitsa thupi, kenako ndikupumula,
• chifuwa chowuma
• ngati metastasis idawononga chombo, pakhoza kukhala hemoptysis.

Mafupa a mafupa amawonetsedwa ndi zowawa zam'mafupa, zomwe zimawonjezereka ndi kukanda kapena kugunda pakhungu la kutukuka kumene.

Ngati chotupa cha mwana wamkazi chidayambitsidwa mu impso, kusintha kumachitika mkodzo (magazi ndi mapuloteni nthawi zambiri amapezeka, zomwe zimapangitsa kuti pakhale mitambo).

Chotupa cha metastatic bongo chimatha kukhala ndi mawonekedwe amodzi kapena angapo osiyanasiyana:

• Makhalidwe osakwanira
• kusintha kwa umunthu
• mawonekedwe a nkhope
• kusintha kwa kamvekedwe ka minofu (kawirikawiri mbali imodzi),
• kuphwanya (kufooketsa, kukulitsa kapena kusintha) kukoma, kununkhiza kapena kuwona,
• kusakhazikika kwa gait,
• kunjenjemera
• Wotsalira pa kumeza,
• mawu amphuno
• kulephera kuchita zophweka kapena zovuta, koma ntchito yoloweza,
• kusamveka bwino kwa ena,
• Kusamvetsetsa kolankhula kwa wodwalayo payekha komanso zina.

Magawo a khansa ya pancreatic, mawonekedwe

Khansa ya pancreatic sikuti pachabe yotchedwa "wakupha mwakachetechete" - zizindikiro zake zimawonekera pokhapokha ngati chotupa chili pa gawo 3 kapena 4. Mu gawo loyambirira la khansa, kugwira ntchito kwa chiwalo sikuperewera, ndipo wodwalayo alibe zowonetsa.

Pa gawo loyamba, chotupa cha khansa m'mapazi sichidutsa 2 cm, sichitha kufalikira kunja kwa thupi, sichikukula m'matumbo.

Ngati neoplasm ikakhala kumtunda kumutu kwa kutulutsa, imatha kuyamba kufinya duodenum, yomwe imawonetsedwa ndi kusokonekera kwa chopondapo mu mawonekedwe am'mimba ndi mseru wamkati. Oncologists amatchula zomwe zafotokozedwazo m'malo mwa 1A. Gawo 1B imadziwika ndi kuwonjezeka kwa chotupa kukula kwake mpaka 2 cm kapena kupitilira apo ndi kutukuka kwake ngakhale mkati mwa ndulu.

Gawo lachiwiri la 2A limangotanthauza kukula kwa mitsempha ya ziwalo zam'mimba (ziwalo za ndulu, zilonda 12 zam'mimba), ndipo pa siteji ya 2B, ma lymph node omwe amakhala nawo amakhudzidwa.

Masiteji atatu a khansa ya pancreatic akuti ngati chotupa chilowerera mitsempha yayikulu ndi mitsempha, ndulu, m'mimba, matumbo. Ma metastases mu lymph node ndi ovomerezeka kapena mwina sangakhale.

Gawo lachinayi la khansa ndi metastases yakutali. Ndi khansa ya kapamba, amamera m'chiwindi, m'mapapu, muubongo, impso, m'mimba.

Zizindikiro zoyambirira za khansa ya kapamba, mawonetseredwe

kupweteka kumatha kuperekedwa kumbuyo kapena m'mimba

Chowoneka cha khansa ya pancreatic imakhala ndikuwonetsedwa kosiyanasiyana ndi kusapezeka kwa chithunzi chachipatala. Khansa imatha kukhala ndi zizindikiro za kapamba kapena kudzikongoletsa ngati matenda a shuga, ndikuwonetsa kuwawa komwe kumawonekera kumbuyo, ndikuwonongeka kumbuyo kwa chiwalo, odwala nthawi zambiri amadziwika kuti ndi radiculitis.

Kutengera ndi omwe maselo adakumana ndi oncotransfform, chithunzi cha zizindikiro zoyambirira za khansa ya kapamba chimasiyananso. Ndi gastrinoma, kupanga msuzi wamatumbo kumawonjezeka, motsutsana ndi komwe kutentha kwamtima kumayamba, chilonda chomwe sichitha kuthandizidwa. Kusanza kwa bulauni ndi chimbudzi, kutsegula m'mimba ndi zomwe zimapezeka m'matumbo a fetid, ululu mutatha kudya zimadziwika.

Glucagonoma imagwirizanitsidwa ndi kuwonjezeka kwa shuga wamagazi ndipo amawonetsedwa ndi zizindikiro za matenda ashuga:

• polyuria (kuchuluka kwa mkodzo),
• ludzu
• kuwonda
• kamwa yowuma
• Odwala amalankhula ndikutulutsa lilime, totupa ta utoto.

Chithunzi cha chipatala cha insulinoma, m'malo mwake, chimagwirizanitsidwa ndi kuchepa kwa shuga m'magazi ndipo amadziwika ndi:

• kufooka
• manja akunjenjemera
• kukomoka, kukomoka, kapena chikomokere
• palpitations.

Zizindikiro zoyambirira za khansa ya pancreatic yoyambirira zimayendera limodzi ndi kuchepa kwa ntchito, kutopa, kufooka. Nthawi zambiri odwala amayamba kudya kapena amadana ndi zakudya zina. Ndikotheka kuwonetsa kupweteka pamimba, ndipo nthawi zina pakati, kumakulitsidwa ndikugwada kutsogolo ndikukhazikika m'malo a mluza.

Mukamapita patsogolo khansa ya kapamba, zizindikiritso zochulukirapo zophatikizana ndi zovuta za michere zimawonekera:

• kulemera "pansi pa dzenje"
• mafuta a m'mimba a fetid,
• Kuchepetsa thupi chifukwa cholephera kuyamwa chakudya,
• anorexia (kusowa kwa chakudya),
• kulolera zakudya zama protein ndi mafuta,
• kusanza ndi kusanza.

Ngati bile duct imapanikizika ndi chotupa, jaundice imayamba, yomwe imawonetsedwa ndi chikaso cha sclera ya maso, khungu, ndi mucous membrane. Fungo limawala, ndipo mkodzo, m'malo mwake, umachita khungu. Chikhodzodzo chimakulitsidwa, ndipo makristulo a bile acid nthawi zambiri amadziunjikira pakhungu, ndikuyambitsa kuyabwa.

Kuphatikizika ndi kupindika kwa ndulu kumayambitsa kulemera ndikuphulika kwa hypochondrium yamanzere. Kukula kwa chotupa mu khoma lamatumbo kumabweretsa kudzimbidwa ndi kutsekeka.

Pa magawo 3 ndi 4, zizindikiro za khansa ya pancreatic zimawonetsedwa ndi kudziunjikira kwamadzi mumimba yam'mimba (ascites). Chiwopsezo cha magazi amkati, thrombophlebitis ikukula. Wodwalayo watopa, akumva ululu womwe nthawi zambiri umakhala herpes zoster.

• Kuthana ndi zinthu zowonongeka za chotupacho kumapangitsa kuti thupi lizitentha kwambiri.

Chithandizo cha Khansa ya Pancreatic

Ngati chotupa sichinakhudze ziwiya zazikulu komanso ziwalo zambiri, sanapereke ma metastases akutali, chithandizo chabwino kwambiri ndichakuchita opareshoni. Popeza khansa ya kapamba imayamba msanga, simuyenera kuchedwetsa opaleshoni. Kutengera ndi gawo la chotupa, mitundu yotsatirayi ya chithandizo cha opaleshoni imasiyanitsidwa:

• Kugwiritsidwa ntchito kwa Whipple - kuchotsa kwa mutu wa m'matumbo, ma lymph node, chikhodzodzo ndulu ndi chimbudzi, gawo la m'mimba, matumbo,
• Full resection
• Kutalikirana kwakapakati kapena kwakamagawo - kuchotsa thupi ndi mchira kapena kokha pakatikati, motero.

Ndi zotupa zosagwiritsidwa ntchito za gawo 3 ndi 4, kukomoka kwa ndulu ya dambo ndikotheka ngati neoplasm ikuletsa kutulutsa kwa bile.

Cancer compression yam'mimba ndi matumbo amachotsedwa ndikusunthika - ziwalo ziwiri izi zimasinthidwa kuti zidutse chotupacho.

Njira yamakono ndikuchita ntchito pogwiritsa ntchito mpeni wa gamma, womwe umakulolani kuti muthe kuchepetsa minofu nthawi yomweyo, ndikupha maselo osachiritsika.

Kuphatikiza pa chithandizo cha opaleshoni, ndi khansa ya pancreatic, radiation ndi chemotherapy amagwiritsidwa ntchito kwambiri. Zotsirizazo zimatha kuchitika ndi mankhwala angapo kapena amodzi (monotherapy). Mankhwala omwe amagwiritsidwa ntchito kwambiri ndi awa:

Mankhwala othandizira poizoniyu amasonyezedwa onse chifukwa cha zotupa zosagwirizana, komanso kuphatikiza chithandizo. Njirayi imachokera pakugwiritsa ntchito ma radiation a ionizing, omwe amapha makamaka kugawa maselo a neoplasm.

Kuphatikiza apo, m'zaka zaposachedwa, njira zatsopano zochizira khansa zidapangidwa ndikuchita kafukufuku: Pazomwe zili kumapeto, mankhwalawa amagwiritsidwa ntchito omwe amalimbikitsa chitetezo chawo kuti athane ndi neoplasm. Njira yochizira yomwe imakulolani kuti mupeze maselo okhawo omwe alibe. Kwa mankhwalawa, mankhwalawa Erlotinib amagwiritsidwa ntchito.

Kuneneratu - kuchuluka kwake komwe amakhala ndi khansa ya kapamba

Khansa ya kapamba imakhala ndi mbiri yabwino m'moyo. Ngakhale ndi opaleshoni ya Whipple yomwe idachitika panthawi yake, kupulumuka kwa zaka 5 sikupitirira 25%, koma ndi mitundu yosiyanasiyana ya matenda, zizindikiro zimasiyana kwambiri.

Chifukwa chake, odwala omwe ali ndi cell yayikulu adenocarcinomas amafa patatha chaka chimodzi atapezeka chotupa, ndipo ndi mucidous adenocarcinoma, 50% ya odwala amatha kukhala ndi moyo zaka 5.

Malinga ndi ziwerengero, khansa ya kapamba imapha anthu asanadutse miyezi isanu ndi umodzi atazindikira: matenda omwe ali ndi metastases m'chiwindi amayeza wodwalayo osaposa masabata 16, omwe ali ndi zotupa zachiwiri, nthawi imeneyi amatha kuchuluka mpaka miyezi 6 mpaka 12.

Ndi magawo anayi a matendawa, odwala 4% okha ndi omwe amakhala ndi moyo wopitilira chaka. Amadziwika kuti kuchuluka kwa kuledzera ndi kupweteka, kumakhala kochepa kwambiri kwa wodwalayo.

Kodi khansa ya kapamba ndi chiyani?

Khansa ya “pancreatic” (khansa ya pancreatic) ndi chotupa chowopsa chomwe chimayamba mkati mwa kapamba. Zikondwererozo zimakhala kumbuyo kwa m'mimba pamimba yapamwamba.

Mwa zina ntchito, kapamba amayang'anira ntchito ziwiri zazikulu: chimbudzi ndi malamulo a shuga.

Zikondazo zimapanga zakumwa kapena "timadziti" timene timadutsidwa m'matumbo ndikuthandizira kuthyola ndi kugaya chakudya. Popanda izi timadziti, thupi silingathe kuyamwa michere kapena kugaya chakudya moyenera.

Pancreas yamunthu imapanganso insulin ndi glucagon. Ma mahormoni amenewa amathandiza kuti shuga azikhala ndi shuga wokwanira. Zikondazo zimatulutsira timadzi tokha m'magazi athu.

American Cancer Society ikuyerekeza kuti mu 2018, anthu opitilira 63,000 ku United States adzapezeka ndi khansa ya kapamba, ndipo anthu opitilira 53,000 adzafa ndi matendawa.

Zoyambitsa Khansa Yapancreatic

Palibe zomwe zimayambitsa khansa ya pancreatic. Gawani mndandanda wazinthu zomwe zikuwonekeratu. Kuchokera pazovuta zawo mthupi, kugawanika kosasunthika kwa maselo owopsa ndikukula kwa neoplasm kumatha kuyamba:

• aakulu kapamba (motsutsana ndi maziko a nthenda yotupa, kuchepa kwa chitetezo cham'thupi kumawonedwa),
• shuga mellitus (kuchuluka kwamphamvu kwa glucose kumabweretsa kuwonongeka kwa maselo ndi minofu),
• Kusuta - Pali kuwopsa kwa utsi wa fodya m'maselo a thupi (30 peresenti ya odwala khansa amaphatikizidwa ndi kusuta ndudu),
• uchidakwa
• Akuluakulu opitirira 60 amatha kupezeka ndi neoplasms,
• Nthawi zambiri amuna amadwala matendawa.
• kuphwanya zakudya - zovuta, zolakwika mwadongosolo zimayambitsa kukulitsa khansa mthupi la munthu (makamaka mowa, khofi, nyama "yokonzedwa"),
• genetic factor (nthendayo imafalikira).

Mphamvu ya chibadwa chathu chakukula kwamatenda imayambira. Nthawi zambiri, njira ya pathological imayambitsidwa pamaziko a kupsinjika kwakanthawi, pamene mphamvu zonse zoteteza komanso zolimbitsa thupi zimafooka.

Zizindikiro za Cancer Pancreatic

Kukhazikika kwa khansa ya pancreatic kumadziwika ndi njira ya asymptomatic. Zizindikiro zina zofala kwambiri zimakhala zazing'ono. Mulinso:

• nseru, belching, kutsekula m'mimba,
• kusowa kwa chakudya
• kuwonda
• mawonekedwe a khungu (kuyabwa, dermatitis, zilonda zam'mimba),
• kufooka, ulesi / kusakwiya,
• pakhoza kukhala zizindikiro za kupweteka kwamatenda kapamba (kupweteka m'chiuno, kusanza),
• Zizindikiro za matenda ashuga (ludzu, shuga wowonjezera wamagazi, kuchuluka kukodza, khungu lowuma).

Njira zopititsira kukula kwa zizindikiro za matenda:

• kufinya ndi minyewa yamitsempha, yokhudza kukomoka kwa mitsempha - njira ya khansa imayambitsa kuyambika kwa kupweteka,
• kuthyoka kwa ngalande zapanchipi, 12 sc / ndulu ndi chikhodzodzo - chotupacho chimakula, chimatseka ma ducts, kusokoneza kutulutsa kwatsopano kwa madzi a bile, jekeseni yamakina imayamba,
• kuledzera - kuchuluka kwawonjezereka kwa kuphwanya kumabweretsa kusakwaniritsidwa kwa ziwalo zofunika, kudziwopsetsa thupi.

Chimodzi mwazinthu zomwe zimawonetsedwa ndi neoplasm ndikukwiyitsa khungu. Zimachitika chifukwa cha kufalikira kwa ma ducts a bile omwe amakhala ndi ma cell a khansa omwe adakula panthawi yamatendawa.

Potere, mchere wa bile umalowa mu plasma ndikukwiyitsa maselo a recermor a dermis. Kusasokoneza kuyamwa kumasowetsa tulo, kumapangitsa wodwala kuyamwa kwambiri.

Zizindikiro zina, kupweteka, ndi jaundice mu chotupa cha pancreatic

Zowawa zimawonedwa mwa 85% ya odwala. Imachitika masabata angapo asanafike nthawi yell.

Ululu nthawi zambiri umachuluka usiku, usiku. Zimapweteka kwambiri mutatha kudya zakudya zamafuta, mowa.

Malo omwe ululu ulipo zimatengera gawo lomwe matenda akhudzidwa ndi matendawa:

• kuwonongeka kwa maselo am'mutu - kupweteka kumawoneka mu hypochondrium yoyenera, epigastrium,
• chotupa mchira ndi thupi - ululu umapezeka mu onse hypochondria,
• chachikulu chotupa - kupweteka kwa epigastric, kusapeza bwino pamimba.

Odwala amatha kudandaula za kuwawa kapena kupweteka kwambiri, kuphulika kapena kupweteka, kusakhazikika kapena kulolera. Ululuwu ndiwokhazikika kapena wa episodic. Amakonda kuthirira mvula kumbuyo, pansi pamapazi, mu msana. Ululu nthawi zambiri umakhala ndi chilengedwe cha paroxysmal.

Kutalika kwa kuzunza kumayambira mphindi zingapo mpaka maola angapo. Odwala amakakamizidwa kuwerama kutsogolo, ndikakanikizani pilo kapena mawondo pamatumbo awo - izi zimapangitsa kuti zisakhale zopweteka. Ululu umatchulidwa makamaka muzochitika komwe chotupa chimakhala m'thupi la kapamba (chifukwa cha kuyandikira kwa mitsempha ya mitsempha).

Mu odwala 80%, kuwonjezera pa zowawa, jaundice imawonedwa.Chifukwa cha kutsekeka kwa ma ducts ndi chotupa, bile sangatulutsidwe kwathunthu kuchokamo. Pali kusayenda kwa madzi a bile, kuwonjezeka kwa chiwindi ndi ndulu. Mlingo wa bilirubin wokwanira umakwera.

A kuphwanya kwanthawi yayitali kumabweretsa kukula kwa chiwindi chozama, magazi. Pafupifupi ndi kusintha kwa khungu la wodwalayo, pamasinthika ndowe, kuda kwa mkodzo.

Kutsimikizika kwa matenda

Mayeso otsatirawa amathandizira pakuzindikiritsa izi:

• kutsimikiza mu magazi a chotupa chikhomo CA-242 ndi chakudya antigen CA-19-9,
• pancreatic amylase m'mwazi ndi mkodzo,
• pancreatic elastase-1 mu ndowe,
• alpha-amylase m'mwazi ndi mkodzo,
• zamchere magazi phosphatase,
• kuchuluka kwa magazi a insulin, C-peptide, gastrin kapena glucagon.

Mayeso omwe ali pamwambawa amangothandiza khansa ya pancreatic. Mayeso ena a labotale, mwachitsanzo, kuyezetsa magazi konse, mkodzo, ndowe, shuga m'magazi, kuyesa kwa chiwindi, coagulogram, kungathandize kudziwa momwe homeostasis imasokonezedwera.

Kuzindikira kumachitika chifukwa cha maphunziro othandiza:

1. Ultrasound yam'mimba. Uku ndi kafukufuku wowunika yemwe amangokulolani kudziwa malo omwe akufunika kuwunikiridwa mwatsatanetsatane,
2. CT - yothandiza, yotengera x-ray, njira yowerengera kapangidwe kake ka kapamba,
3. MRI ndi njira yofanana ndi compact tomography, koma yozikidwa pa ma radiation yamagalimoto. Ikupereka chidziwitso pazamafupi am'mapapo, impso, chiwindi, ma lymph node omwe amakhala m'mimba mwatunthu kuposa CT,
4. Nthawi zina chotupa m'mutu wa kapamba, kuchuluka kwa kuwonongeka kwa Vater papilla wa duodenum, ubale wake ndi ma ducts a bile amatha kuwoneka pa ERCP - endoscopic retrograde cholangiopancreatography. Imeneyi ndi njira yofufuzira pamene buluku wamtunduwu wayikidwira mu duodenum, pomwe ma X-ray sing'anga imalowetsa papilla ya papilla, pomwe pancreatic duct ndi bile duct amatsegulidwa. Onani zotsatira pogwiritsa ntchito ma x-ray.
5. Positron emission tomography. Komanso njira yolondola yamakono. Pamafunika kukhazikitsidwa koyambirira kwa mitsempha, yomwe si njira yokonzekera ayodini, koma shuga wa isotope. Malinga ndi kuchuluka kwake m'ziwalo zosiyanasiyana, kuyendera kumachitika.
6. Endoscopic retrograde cholangiography. Imachitidwa ngati njira yofufuzira yakale sinapezeke. Apa, motsogozedwa ndi ultrasound, kupopera chiwindi kumapangidwa, ndipo kumayamwa ndulu ya bile. Kenako imayenda pamiyendo ya bile, ikalowetsa zilonda 12 zam'mimba.
7. Laparoscopy Monga njira yapita, iyi ndi njira yowononga yomwe imafunikira jakisoni. Apa, pansi pa opaleshoni yakumalo, kutseguka kumapangidwa kukhoma kwamkati komwe kumayikidwa gasi m'mimba, kulekanitsa ziwalo ndikusunthira khoma lam'mimba kutali ndi iwo (kotero kuti chipangizocho, chomwe chidayikidwa pambuyo pake, sichimayambitsa kuvulala kwamatumbo kapena ziwalo zina). Ziwalo zamkati zimasunthidwa kudzera mu endoscope yokhazikika ndikuyika, ndipo chotupa chikuwoneka, biopsy ikhoza kuchitidwa nthawi yomweyo.
8. Kuchita biopsy - kudula zidutswa za neoplasm kuti mumupimitsenso pansi pa maikulosikopu - ndiyo njira yomwe imakupatsani mwayi wofufuzira matenda. Popanda biopsy, palibe amene ali ndi ufulu wonena kuti "khansa ya pancreatic." Chifukwa chake, madokotala - nthawi ya laparoscopy, kapena pa endoscopic, kapena kale pa opaleshoni - nthawi zonse sankhani zinthu zoyenera kuwunika.

Kuti mupeze metastases, complication tomography ya zam'mimba zam'mimba, msana, chiwindi, mapapu, impso, MRI kapena CT yaubongo imachitidwa.

Maphunziro omwe ali pamwambawa amatilola kuzindikira, kudziwa mtundu wa chotupa, komanso kudziwa gawo la khansa malinga ndi dongosolo la TNM, komwe T ndi kukula kwa chotupa, N ndikugonjetsedwa kwa ma lymph node, M ndiko kukhalapo kapena kusowa kwa metastases ku ziwalo zakutali. Mlozera "X" ukutanthauza kusowa kwa chidziwitso cha kukula kwa chotupa kapena metastases, "0" amatanthauza kusowa, "1" pofotokoza N ndi M ikuwonetsa kukhalapo kwa metastase am'madera kapena akutali, mokhudzana ndi chizindikiro T chikuwonetsa kukula.

Masiteji (magawo) a khansa mu kapamba

Gawo la khansa limathandiza dokotala wanu ndi gulu lanu la khansa kumvetsetsa momwe khansa ili patsogolo.

Chidziwitso cha siteji ndichofunikira pakusankha njira zabwino zamankhwala ndi chithandizo. Imakhalanso ndi gawo lakuwonetsa kwanu mtsogolo.

Khansa ya pancreatic imasiyanitsidwa pamlingo kuchokera pa 0 mpaka 4. Masamba amatsimikiziridwa ndi chidziwitso chofunikira:

• kukula kwa chotupa
• kuyandikira kwa mitsempha,
• ngakhale ikukhudzanso ziwalo zina.

Khansa 0 yokhudza khansa siyosokoneza. Gawo la zero ("khansa m'malo mwake") limadziwika ndi kusintha kwa maselo ochepa a minofu ya mucosal.

Maselo owopsa amatha kufalikira ndikupereka chitukuko. Pakadali pano, palibe zomwe zimayambitsa matendawa, njira ya khansa imatha kupezeka kokha ndi ma ultrasound ndi MRI panthawi yamayeso okonzekera.

Pa zero zero, maselo osinthidwa akachotsedwa, pamakhala mwayi wamankhwala ochiritsidwa kwathunthu mu 99% ya milandu yachipatala.

Nthawi zambiri, khansa ya kapamba imapezeka pokhapokha (3, 4) kukula. Pa magawo awa, neoplasm imafikira ku ma cell ndi minyewa ya ziwalo zosiyanasiyana.

Pathology sikhala yothandiza kuchiza. Zoneneratu sizabwino. Pafupifupi 20% ya odwala khansa amafa zaka zisanu zoyambirira atachitidwa opareshoni.

Kuzindikira ndi kunena

Kuzindikira kumadalira mbiri yakale yakuchipatala, zotsatira zake pakuwunika ndi njira zowonjezera zakufufuzira.

Zotsirizirazi zimaphatikizira kufufuza kwa labotale ndi zida.

Zodandaula zakudwala monga kupweteka pamimba, kuchepa thupi msanga, kusintha kwa thanzi lonse kuvuta, kusanza, nseru, ndi zina zazikulu zamatenda zimayang'aniridwa.

Kuyang'ana kowonekera kumawunikira khungu, kupukusira kwa mucous, mawonekedwe owoneka, pallor.

Kuti mutsimikizire / kutsutsa njira ya khansa, njira zogwiritsa ntchito pozindikira zagwiritsidwa ntchito:

• Ultrasound Echography imaphatikizapo kupenda bwino ziwalo zonse zamkati zomwe zili mkati mwa peritoneal patsekeke ndi kumbuyo kwake. Chinsinsi pazomwe zili mu njirayi ndikukonzekera koyenera kwa phunzirolo. Chiwalo chimayikidwa mozama, ndizovuta kuwona. Ngati pali mpweya wambiri m'matumbo kapena chimbudzi cha chakudya m'mimba m'mimba, kuyesa timizere tina tating'ono kumakhala kovuta.
• Mbiri. Kuchokera pagawoli la njira zofufuzira kuti mupeze khansa ya pancreatic imagwiritsidwa ntchito:
  • MRI (imagonance imaging))
  • CT (yowerengera makanema olemba). Yoyamba mwa iwo imawerengedwa kuti ndi yophunzitsa.Ndi chithandizo chake, munthu amatha kuwona bwino minofu ya parenchyma, kudziwa kukula kwake (gawo) ndi kapangidwe ka neoplasm.
• Kubwezeretsa cholangiopancreatography. Ntchito masiyanidwe khansa. Zimathandizira kuwona kupezeka kwa miyala ya duct ya bile.
• Ndikofunikira kwa neoplasm omwe akuwakayikira kuyesa chotupa chaching'ono-125. Njirayi imatengera kuzindikira kwa immunohistochemical kwa maselo enaake, mamolekyulu a mapuloteni, ma antigen m'magazi a wodwalayo, omwe amayamba kupangidwa mthupi pakakhala njira ya khansa m'matumba. Chiwopsezo cha maselo oterewa chimakhazikitsidwa ndi labotale inayake, zomwe zimatengera ma reagents ogwira ntchito.
• Njira yodalirika yodziwira khansa ya kapamba imaganiziridwa histological kuyesa kwa minofu zitsanzo. Mothandizidwa ndi singano yapadera yopyapyala, kukwapula kwamisempha kumachitika. Zochita munjirazi zimayang'aniridwa ndi chida cha MRI kapena laparoscopic chida. Zotsatira zomwe zimakhala ndi minofu zimayesedwa pansi pa microscope.

Kufunika koyambirira kwa zotupa

Kukula kwa khansa ya pancreatic kumadalira kwambiri gawo la khansa pakudziwitsa. Magawo apamwamba a khansa ya pancreatic nthawi zambiri amakhala owopsa kuposa masitepe oyamba, chifukwa cha kufalikira kwa matendawa.

Milandu yambiri ya khansa ya pancreatic siyimapezeka mpaka khansa ikamapita ndikufalikira mbali zina za thupi. Ichi ndichifukwa chake ndikofunikira kuti mupimidwe pafupipafupi ndikukambirana ndi dokotala mavuto aliwonse omwe angabuke okhudzana ndi zizindikiro zanu komanso thanzi lanu lonse.

Pancreatic Cancer Zakudya

Zakudya zimathandizira kuchepetsa mkhalidwe wa wodwala, ngakhale zilibe tanthauzo lodziyimira payekha pakuthandizidwa. Menyu yopangidwa moyenera imachotsa mawonekedwe osasangalatsa a matendawa (kupweteka ndi kugaya chakudya).

Chofunikira pachakudyachi ndikusankha chakudya chomwe sichingawonongeke, mwaukadaulo komanso mwaukadaulo. Nthawi yomweyo, chakudya chizikhala ndi zinthu zonse zofunika m'thupi.

Zokonda zimaperekedwa ku zinthu zomwe sizipangitsa kuti chiwopsezo cha chiwopsezo chiwonjezeke. Nayi mndandanda wachitsanzo:

Kuthira kutentha kumaphatikizapo kuwawa kapena kuwira. Sitikulimbikitsidwa kuti musute, mwachangu. Njira yodyetsera zakudya zimaganiziranso kulekerera kwakomwe kwa chakudya ndi thupi komanso kuchuluka kwa chakudya kwa wodwalayo.

Kukula kwa machitidwe oipawo, gawo la chitukuko, komanso kuopsa kwa mawonetseredwe a matendawa kumathandizira posankha zinthu.

Palibe njira zachidule zopewera khansa ya pancreatic. Ndikulimbikitsidwa kuyendera moyenera pokonzekera. Muyenera kusiya zizolowezi zoyenera kudya, kusiya kusuta.

M'pofunika kupereka chithandizo kwa magawo oyamba a zovuta komanso zaulesi za gland. Amawerengedwa kuti ndi mikhalidwe yoyambirira ya chinthu ichi.

Akuyembekeza chotupa cha pancreatic m'magawo

Mutha kukhala ndi chidwi chofuna kudziwa kuti ndi anthu angati omwe amakhala ndi matendawa ngati inu kapena okondedwa anu mwapezeka kuti muli ndi siteji.

Izi zimachitika chifukwa cha chidziwitso chomwe chimachokera kwa anthu omwe ali ndi khansa yofanana. Ziwerengero zakupulumuka mungakhale zotonthoza kapena zokhumudwitsa.

Mankhwala opulumutsa khansa

Zolosera za moyo nthawi zambiri zimaperekedwa malinga ndi zaka zisanu zomwe zikupulumuka. Chiwerengerochi chimanena za kuchuluka kwa anthu omwe akadali ndi zaka zosakwana zisanu atazindikira koyambirira. Ziwerengero zambiri zakupulumuka sizipitilira zaka zisanu, koma ndikofunikira kumvetsetsa kuti anthu ambiri amakhala ndi nthawi yayitali kuposa ino.

Miyezo yotsalira ya anthu omwe ali ndi

Pancreatic Neuroendocrine Tumors (NEO), yotchedwa islet cell tumors, ndi mtundu wachilendo wa khansa womwe umayamba m'maselo omwe amapanga insulin ndi glucagon.

Mlingo wopulumuka wa mtundu uwu wa khansa ya kapamba ndi wosiyana ndi mtundu wofala wa khansa ya kapamba wokhala ndi zotupa za exocrine.

Kuchuluka kwa zaka zisanu pakupulumuka kuli pafupifupi 42% kwa anthu omwe ali ndi chotupa chamtunduwu omwe ali ndi chidziwitso chabwino kuposa zodziwika kale zamankhwala zapancreatic. Komabe, kuchuluka kwa zaka zisanu kwa munthu yemwe ali ndi NEO yemwe sanachitidwe opareshoni ndi 16 peresenti.

Izi ndi zochokera kwa anthu omwe adapezeka ndi matendawa pakati pa 1985 ndi 2004. Ndikofunikira kudziwa kuti izi zikuwonetsa kuti ndizomwe zikuwonetsedwa pamadongosolo komanso njira zamankhwala zomwe zimagwiritsidwa ntchito zaka zambiri zapitazo. Chaka chilichonse, mankhwalawa amakula bwino (onani kanema pansipa). Uwu ndi uthenga wabwino kwa anthu omwe akuchitiridwa khansa ya pancreatic lero.

Manambala opulumuka awa ndi muyeso wa zaka zapitazi za chithandizo. Monga momwe chithandizo chimakulira, momwemonso kupulumuka. Kuphatikiza apo, zinthu zina zimakhudzanso kupulumuka kwanu, kuphatikiza zanu:

• zaka
• Zaumoyo
• kakhalidwe
• kuwona momwe amathandizira.

Simuyenera kukhala kumbuyo mukamachira khansa yamtunduwu. Dokotala wanu angakuthandizeni kuonetsetsa kuti mukuchita zonse zomwe mungathe kuti muwongolere kuwonekera kwanu ndikukhala ndi moyo wathanzi.

Simudzangomva kuti mukuwongolera zomwe zikuchitika, thanzi lanu la m'maganizo ndi chidziwitso chanu chonse.

Mitundu ndi zoyambitsa

Oncology ya kapamba kwa nthawi yayitali imakhala yopanda zizindikiro, ndipo ikangomva, wodwalayo amapezeka ndi gawo 4, lomwe silingathe. Kodi khansa ya kapamba ingachiritsidwe, zifukwa zomwe zimawonekera nthawi zonse ndizofanana? Inde, ndizotheka, koma pokhapokha pochiritsa komanso chithandizo chamankhwala chapanthawi yake.

Mphepoyi imazunguliridwa ndi ziwalo zina zambiri zofunikira, chifukwa chomwe ntchito zotere zimafunikira kulondola kwathunthu kuchokera kwa dokotala. Khansa ya kapamba mwa amuna imapezeka nthawi zambiri kuposa azimayi. Madokotala sanazindikire zomwe zimayambitsa izi. Mutha kupeza zambiri zotsutsana mu malingaliro amomwe mungachiritsire matendawa, chifukwa chake muyenera kulumikizana ndi akatswiri odalirika.

Zikondamoyo zimakhala ndi zinthu zitatu. Kutengera gawo lomwe ligonjetsedwa, ziwalo zina zimayamba kugwira ntchito molakwika. Zofunikira ndi ubale:

1. Khansa yam'mutu ya pancreatic, zomwe zimadziwika zimatengera komwe chotupacho chili. Ndi ziwalo izi zomwe zimakhudzidwa.
2. Thupi limakhala kumbuyo kwa m'mimba ndipo moyandikana nalo. Chotupacho chimatha kukula m'makoma am'mimba.
3. Malo pakati pa aorta (kumanzere) ndi ndulu. Khansa yamatenda a pancreatic imadutsa mwachindunji pa ndulu.

Chifukwa chake, matendawa amatha kuwoneka m'magulu osiyanasiyana.

Neoplasms imawoneka chifukwa chomwa mowa kwambiri, kusuta, kuperewera kwa zakudya m'thupi, kunenepa kwambiri. Zomwe zimayambitsa zimachitika ndizosiyanasiyana. Atha kukhala matenda ophatikizika (matenda a shuga, matenda a chiwindi, cysts, pancreatic adenoma), ndi ena ambiri, osafunikira kwenikweni.

Ma tumon amawonekeranso chifukwa chobadwa nacho ngati wina m'banjamo wadwala kale matendawa.

Ngati khansa ya kapamba ndi metastasis yapezeka, zomwe zimayambitsa zimatha kukhala zifukwa zosiyanasiyana zakukwiyitsani. Chotupa choterechi ndi amodzi mwa mitundu yoopsa kwambiri ya matendawa. Metastasis ndikubuka kwachiwiri komwe kumayang'ana khansa, yomwe imafalikira kudzera m'thupi kudzera m'magazi. Mukakhala ziwalo zina, maselo a khansa amawamatira ndikuyamba kukula. Njira yokhayo ndi kupanga zotupa zoterezi kumatchedwa metastasis. Nthawi zambiri, chotupa sichikhala ndi nthawi yokwanira, koma ma metastases panthawiyi amakhala ndi nthawi yofalikira thupi lonse.

Pali mitundu ingapo ya maselo a khansa ya metastatic. Mtundu wa cell wa acinar umapezeka mwa odwala ambiri. Chotupa chamtunduwu chimapangika kuchokera ku ma cell omwe amatchukitsa zolowa zathupi. Zina zimapita ku neoplasms yomwe imapangidwa kuchokera ku zinthu za neuroendocrine. Nthawi zambiri amakhala osakhazikika, komanso pali zotupa zoyipa za kapamba. Ngakhale mtundu woyamba sukutengera kufunikira kwa chithandizo cha matendawa, chifukwa chake musanyalanyaze upangiri wa madokotala.

Chomwe chimakonda kwambiri ndi chotupa cha pseudopapillary cha kapamba. Mtunduwu umapezeka kwambiri mwa atsikana ang'onoang'ono, chifukwa ungayambitse kutenga pakati, komwe kumadzutsa maselo ogona mthupi. Ndizofunikira kudziwa kuti SPPO nthawi zambiri simadutsa chotupa choopsa.

Kuzindikira matenda

Kuzindikira khansa ya pancreatic kumayambiriro kumakhala kovuta kwambiri. Pakufufuza, kuwonjezeka kwa chiwindi ndi ndulu ya chithokomiro kumatha kumveka. Madotolo amatha kudziwa chizindikiro cha kulowera kwamadzi pamene madzi ambiri owonjezera amunjikana m'mimba.

Dzina lasayansi pazinthu izi ndi ascites mu khansa.

Kuzindikira matendawa kudzachitika pogwiritsa ntchito maphunziro awa:

1. Chizindikiro cha khansa ya pancreatic chimapangidwa ndimaselo a khansa ndikulowa mthupi limodzi ndi magazi. Zinthu zomwe phunziroli lidzakhala magazi. Kusanthula kwa chotupa chikhomo CA 19 9 sikungakhale kolondola kwathunthu, motero, pofufuza kwina, mitundu ingapo yazowonjezera yaperekedwa.
2. Kuyesedwa kwa magazi a biochemical kuyenera kuwona kuwonjezeka kwa michere, ma asidi a bile, ndi mankhwala ena m'thupi.
3. Kuyesedwa kwa ultrasound kudzazindikira chotupacho ndikukulolani kuwona kuti ndi gawo liti komanso kukhudza ziwalo zamkati.
4. Komabe, zolemba za chotupa cha khansa ya kapamba yokhala ndi ultrasound sizidziwika nthawi zonse, chifukwa chake, amatha kuwonjezera mankhwala a endoluminal endoscopic sonography, endoscopic retrograde cholangiopancreatography (ERCP), laparoscopy ndi cytology.
5. Cholangiography ikupatsani mwayi kuti mulowe mu njira yapadera ndikujambula chithunzi cha ziwalo zamkati.
6. Angiography. Njira yomwe yankho lomweli layamba kale kulowa m'mitsempha yamagazi.
7. Kukonzekera biopsy kumaphatikizapo kuyesa zitsanzo za minyewa ya pancreatic pansi pa maikulosikopu. Pogwiritsa ntchito kuwunikaku, khansa ya pancreatic imatsimikiziridwa kapena kutsutsidwa.
8. Kuzindikira kwa makompyuta.

Kuchiza matenda

Momwe mungachiritsire khansa? Choyambirira kuchita ndikuchotsa maselo onse omwe ali ndi kachilombo mthupi. Ngati izi sizingatheke, ndikofunikira kuyimitsa kukula kwa chotupacho, osaloleza kuti metastasize, ndikuchepetsa zizindikiro za khansa ya kapamba mwa azimayi ndi abambo. Mankhwala, sinthani njira zingapo.

Kuchita opaleshoni nthawi zambiri sikugwiritsidwa ntchito, chifukwa kumatanthawuza zovuta zina komanso zovuta zina. Choyamba, khansa sayenera kufalikira kwa ziwalo zoyandikana. Kachiwiri, metastases iyenera kukhalapo kwathunthu.

Kuchita uku kumaphatikizapo kuchotsa kwathunthu kapena pang'ono kwa oncology, ndipo nthawi zina amachotsa ziwalo zina zomwe zakhudzidwa. Popeza njirayi ndi yovuta komanso yovuta, mapangidwe a chotupa mwa achinyamata nthawi zambiri amachotsedwa ndikuchita opaleshoni, chifukwa ndi thupi lawo lomwe limabwezeretsedwa mwachangu pambuyo poti likulowerere kunja. Pambuyo pa opaleshoni, munthu amene wachira amatenga michere ndi insulin moyo wonse. Njira zopangira opaleshoni ndizoyenera pokhapokha 10% yodziwitsa matendawa, chifukwa khansa imayamba mwachangu kwambiri ndipo pamakhala chiwopsezo chachikulu chowonjezeka pambuyo pa njirayi.

Chemotherapy yokhala ndi chotupa cha khansa ndiyosatheka ndipo imayikidwa kuwonjezera pa mankhwala a radiation kuti muchepetse zizindikiro za wodwalayo. Hormonal chithandizo nthawi zambiri amasiya kupanga zotupa, chifukwa mankhwalawa amakhala ndi zinthu zomwe zimalepheretsa kufalikira kwa metastase. Ndi mankhwala am'deralo, mankhwala amalowetsedwa mu ndulu, komanso munthawi zonse mankhwala opaka minofu kapena mtsempha.

Chithandizo cha radiation imayikidwa pambuyo pa opaleshoni kuti ichotse kwathunthu ma carcinomas onse omwe atsala mu ma cell omwe opaleshoniyo sakanakhoza kupeza. Ndi mankhwala amkati, radiation imachitika pogwiritsa ntchito masingano apadera. Radiation yakunja imaphatikizapo kubera, komwe kumachitika pogwiritsa ntchito matekinoloje apadera.

A chipatala cha khansa omwe ali ndi biological kapena immunotherapy amangodutsa mayeso angapo kuti atsimikizire kuthekera kwake. Zinthu zomwe zimapangidwira zimabayidwa mwachindunji mthupi lathu, zimawakakamiza kuti ayambe kulimbana ndi maselo oyipa. Pa siteji yoyamba, amayamba ndi zinthu zopanda mankhwala, pambuyo pake amasinthana ndi mankhwala osokoneza bongo, kuphatikizapo omwe ali ndi mphamvu. Khansa ya pancreatic yokhala ndi metastases ilibe kanthu.

Madokotala amachotsa zokhazo zomwe matendawa amagwiritsa ntchito pamwambapa.

Njira za anthu olimbana ndi khansa ya pancreatic kulibe. Inde, mankhwala ena amatha kukhala ndi mbewu zina, koma ali ndi zosakaniza zina zambiri. Palibe chifukwa chomwe muyenera kuyesera kuti muthetse matenda oopsa okha nokha ndi njira zokayikitsa. Izi zitha kukhala ngozi yayikulu pamoyo. Osati gawo locheperako lomwe lidzaseweredwe komanso kusankha malo azachipatala oyenera kuti athane ndi matendawa.

Kupewa ndi Kuneneratu

Ngati khansa ya kapamba idapezeka, matendawa amatengera kukula ndi malo a chotupacho, kupezeka kwa metastases ndi kuchuluka kwake kwa kumera m'maselo a thupi. Osati gawo lomaliza lomwe likhala mthupi la munthu. Ngati isanayambike matendawa wodwalayo anali ndi thanzi labwino komanso chitetezo chabwino, ndiye kuti mwayi wochira umakulirakulira m'njira zambiri.

Kwa anthu omwe matenda awo anali kale koyambirira, matendawa adzapulumuka mpaka 24% (malinga ndi zina - 18%). Ndi angati akukhala ndi kansa 4? Kuyembekeza moyo kumangodalira thupi lomwe limakana kukana ndi chemotherapy, radiation ndi mtundu wa chithandizo.

Chiwerengerochi chimachokera ku miyezi ingapo mpaka miyezi isanu ndi umodzi. Ndi chithandizo choyenera cha khansa ndi metastases, ndizotheka kutalikitsa moyo, ngakhale zaka. Pazonse, pafupifupi nthawi ya moyo ndi miyezi 6-12.Ndi chotupa chodziwika bwino, kufa kumakhala kotsika kwambiri. Ngati mukupeza vuto munthawi yake, lichotseni ndikutsatira malangizo ena kwa madotolo, matendawa amathandizika.

Kupewa khansa ya pancreatic nthawi zambiri kumakhala kosavuta. Choyamba, muyenera kusiya kusuta, osamwa mowa wambiri ndikuyesetsa kukhalabe ndi thupi labwino (zizolowezi zoyipa ndizomwe zimayambitsa khansa). Ngati zili zodziwika kuti m'banjamo wina kuchokera kwa achibale ake omwe adadwala matendawa, ndibwino kukambirana ndi a geneticist kapena kudutsa mayeso onse ofunikira kuti mukhale ndi mtendere wamumtima.

Kupewa kwa chitukuko cha matenda ndi njira yabwino kwambiri yothandizira. Ngati munthu wapezeka ndi matenda oterewa, sangathe kuthana ndi vutoli mwachangu. Ndi malingaliro onse a dokotala komanso chikhulupiriro mu mphamvu ya munthu, matenda aliwonse atha kugonjetsedwa.

Zizindikiro za khansa

Khansa ya pancreatic nthawi zina imakhalapo popanda zizindikiritso zoonekeratu, zomwe zimapangitsa kuti zizindikirika zikachedwa kwambiri kugwiritsa ntchito mitundu ina ya chithandizo. Kupatula apo, pali njira zina zabwino, koma kugwiritsidwa ntchito kumaloledwa pokhapokha pakukula kwa oncology.

Chifukwa chake, ambiri ali ndi chidwi kuti adziwe kuti ndi vuto liti? Pazonse, zizindikiro zotsatirazi za khansa zimawunikidwa, kuwonetsa kuwopsa kokhala ndi matenda a pancreatic awa:

1. Zizindikiro zopweteka mu solar plexus, kumbuyo. Nthawi zambiri kumachitika kwambiri, kumapangitsa kupweteka kwamphamvu, pomwe miyendo imakanikizidwa m'mapazi mpaka pachifuwa cha thupi la munthu, imafewa ndikuyenda.
2. Kuonda kwambiri. Kuchepetsa thupi kwambiri popanda chifukwa.
3. Udzu wokhazikika. Kuchotsa ndi kuchuluka kwa madzimadzi, kupukusira pokodze koyenera kumachitika, komwe kungakhalenso vuto la shuga. Matenda osokoneza bongo a insulin, nthawi zambiri amatengera matenda a oncology.
4. Kubweza. Zizindikiro zimadziwika ndi kuphatikizika kwa chotupa, mtundu wa kusintha kuchokera pamimba kupita ku duodenum 12.
5. Hepatitis A, B, C. Ndi matenda awa, chikaso cha nsidze, khungu limachitika. Nthawi zambiri amapezeka ndi oncology ya mutu wa pancreatic gland. Munthawi imeneyi, kuphatikizika kwa duct ya bile kumachitika, komwe kumayambitsa kupezeka kwa chiwindi, limodzi ndi kuyabwa, chifukwa cha kuchuluka kwa mamolekyulu a bile mu khungu.
6. Pewani ululu mu hypochondrium yoyenera. Ndi chitukuko cha khansa, chotupacho chimakanikizira mu mtsempha wa splenic, pali kuchuluka kwa ndulu (splenomegaly).
7. Foido stool (m'mimba). Fecal formations amakhala ndi madzi komanso fungo lamphamvu, makamaka fetid. Chomwe chimapangitsa kununkhaku ndikuchepa kwa michere yomwe imaphwanya gawo lamafuta a chakudya.
8. Insulinoma. Chifukwa chotupa chopanga insulin. Zizindikiro zazikulu za matenda awa: kuwonekera kwa manja akunjenjemera, kufooka kwambiri, kukomoka, kufa ndi njala, kuchuluka kwa mtima. Ndikothekanso kulenga zinthu zomwe zingachitike pakoma. Zonsezi zimawonetsa shuga wochepa m'magazi a munthu.
9. Gastrinoma (kuchuluka kwa gastrin). Matenda amtunduwu amaphatikizidwa ndi kutentha kwadzaoneni, kuwonjezeka kwa acidity m'mimba, komanso zilonda zam'mimba zomwe sizimapita ngakhale ndi zovuta zovuta za matenda. Gastrin imayambitsa zizindikiro zowonjezereka, zomwe zimatsogolera ku chithandizo ndi zotsatira za zero.
10. Glucagonoma. Mphepoyi imatulutsa glucagon wambiri. Ndi chitukuko ichi, pamakhala kuwonda kwambiri, ludzu lalikulu komanso kukodza kwamphamvu. Mapangidwe ofiira ofiira amawonekera pa thupi la munthu, lilime la munthu limakhala lalanje lowala. Zonsezi zikuwonetsa kuchuluka kwa shuga m'magazi a munthu wodwala.

Khansa ya kapamba ndi zizindikiro zimakonda kuwonetsedwa mwa anthu omwe ali ndi matenda a shuga mellitus, kapamba.

Palinso zizindikiro zoyambirira za khansa ya kapamba, chifukwa chomwe mutha kuyankha vutoli munthawi yake. Chowonadi chimatengera malo a neoplasm komanso mawonekedwe ake ankhanza. Khansa yapakansa ndi chizindikiro choyamba cha matenda oopsa omwe adawoneka:

1. Pancreatic khansa ya mutu - kuwoneka kwa hepatitis, kuchepa thupi, kupweteka pamimba, kuchepa kwamafuta m'mimba.
2. Khansa ya mchira komanso thupi lonse la kapamba - kuwonda, kupweteka pamimba.

Zomwe muyenera kulabadira ndizotsatira mawonetsedwe azizindikiro zoyambirira za matendawa. Choyamba, khansa ya mutu wa chindayo imawonekera, kenako thupi ndi mchira. Mwanjira imeneyi, zizindikirazi zimatchedwa "pancreatic intestinal", zomwe zimapangidwa ndi chitukuko cha chotupa pafupi ndi m'mimba.

Zizindikiro zake patali kwambiri

Khansa ya pancreatic siichiritsidwe pamapeto omaliza, koma pali chithandizo chamankhwala chomwe chimatha kuwonjezera kwambiri moyo ndikuchepetsa kwambiri thanzi. Zizindikiro zakukula kwa khansa, zimatengera kuthamanga kwa matendawa komanso komwe chotupacho chikuyang'ana. Pamene chitukuko chikuchitika mpaka zamitsempha ndi mitsempha, mavuto akulu amawonedwa ndi kumeza Reflex, matchulidwe. Hollow vein syndrome imawonekeranso.

Chotupa chikukula mu sternum chimayambitsa kupanikizika kwa ziwalo zapafupi ndi matenda, zomwe zimapangitsa kuti wodwalayo akhale ndi vuto.

Zizindikiro ndi kufalikira kwa matenda a khansa yapamwamba ya kapamba zimadalira kuthamanga kwa kufalikira, kuchuluka kwa chotupa. Chovuta cha matendawa ndikuti sichimangokhala ndi chizindikiro chotsimikiza kumayambiriro kwa chitukuko, ndipo mwachizolowezi, chimadziwika mwangozi kapena ndi matenda osadziwika:

• kumangokhalira kutopa, komanso kugwira ntchito pang'ono kutopa kwambiri,
• kusowa kwa chakudya
• kupuma movutikira
• kuchepa thupi kwambiri
• Kusintha kwa khungu la munthu kukhala mtundu wachikasu kwambiri, chifukwa chakupha poizoni wa thupi,
• kusanza kosalekeza, nseru.

Khansa yomwe imayamba chifukwa cha mutu wa kapamba ilinso ndi chizindikiro chake ndipo imakhala yodetsa nkhawa kwambiri. Mu matenda, mu 98%, odwala amafa zaka 3-5. Akulakwa pakuzindikira matendawa mochedwa. Nchiyani chimayambitsa khansa m'mutu wa kapamba?

Zomwe zimapangitsa kuti pakhale chotupa cha chikhalidwe cha oncological:

• kugwiritsa ntchito molakwika zizolowezi zoyipa (kusuta, mowa, mankhwala osokoneza bongo),
• zakudya zosayenera ndi zina zowonjezera,
• aakulu kapamba
• matenda a choleretic thirakiti ndi ndulu.
• mawonekedwe apamwamba a shuga.

Zowonetsa za oncology ya mutu wa kapamba, ili ndi zizindikiro zotsatirazi za kukula kwake pamapeto omaliza:

1. Ululu m'mazungulira dzuwa, owonjezereka ndi zowawa kumbuyo. Ichi ndichifukwa cha kukakamiza kwa chotupa pamitsempha yamitsempha, kutsekeka ndulu za bile.
2. Kuchepetsa thupi kwambiri, mpaka ku cachexia.
3. Komanso mu magawo apambuyo, chotupacho chimamera m'matumbo a ziwalo zina za munthu, chikukula monse kapamba.
4. Mkodzo wakuda.
5. Mbale zimasanduka zoyera.
6. Sypatomatic hepatitis ndi ofanana ndi gulu C.
7. Khungu loyera, mpaka magazi.
8. Kulephera kwamkati mwa munthu.

Komanso Zizindikiro zomwe zimawoneka ndi khansa ya kapamba mu azimayi, zimagwiritsa ntchito ngati chizindikiro cha moyo wosadziwika:

• kusuta kwakukulu
• kumwa kwambiri
• mankhwala osokoneza bongo
• kunenepa
• kudya kwambiri nyama yokazinga.

Ngakhale ndi kusiyana kwakuthupi, mawonekedwe a matendawa amafanana kwambiri ndi abambo, koma padzakhala kusiyana pakati pa ma syndromes a ululu, chifukwa nthawi zina, chotupacho chimakanikiza ziwalo zamkati za mkazi zochepa.

Matenda a Cancer a Pancreatic

Khansa ya pancreatic, ndikazindikira koyambirira, imabweretsa zovuta chifukwa cha maphunziro osatsimikizika azachipatala. Pafupifupi, pafupifupi 20% ya odwala adalandira mwayi wodziwonetsa kumayambiriro kwa chitukuko, zomwe zidapangitsa kuti azitha kuchira. Chifukwa chake, poyambira kuzindikira thupi kuti muli ndi khansa, kuyeserera kwa Laborator kumagwiritsidwa ntchito.

Laboratory matenda a oncology. Pankhaniyi, kuyezetsa magazi kumachitika. Kufufuza kwamwazi m'magazi, ndi matenda, kuwulula bilirubinemia, kuchuluka kwa phosphatase, kuchuluka kwa michere ya chiwindi, zomwe zikuwonetsa kuwonongeka pamitsempha ya choleretic kapena chotupa kuwonongeka kwa minofu ya chiwindi. Zizindikiro za malabsorption zimapezekanso m'magazi.

Chikondamoyo, chomwe ndi gawo lofunikira la munthu, komanso khansa chimabweretsa kusintha kwakukulu kuntchito yake, yomwe pamapeto pake ndimatenda am'mimba.

Chida Chofufuza Khansa

Khansa ya pancreatic imatsimikizidwanso pogwiritsa ntchito njira yodziwira:

1. Endoscopic ultrasonography. Kuchita ndi ultrasound ya peritoneum, amayang'ana kaye ndikusankha matenda a ndulu ndi chiwindi, zomwe zimapangitsa kudziwa chotupa cha pancreatic. Phunziroli limasankha zitsanzo za biopsy kuti ziwonjezeke kafukufuku wazokhudza thupi la munthu.
2. Dongosolo la tomography ndi MRI imapangitsa kuti athe kuwona mawonekedwe amtundu wa kapamba ndikudziwona ma neoplasms ndi kukula kwa chotupa, ma lymph node.
3. PET - imawulula komwe kuli neoplasms (metastasis) ndikuthandizira kudziwa maselo a khansa ya pathogenic.
4. Laparoscopy ndi njira yowunikira yomwe imazindikira ma metastases pachiwindi, matumbo, kapena peritoneum.

Pazizindikiro zoyambirira kapena zokayikitsa za khansa ya pancreatic, kuyezetsa magazi mwachangu ndi dotolo wothandizira kumafunikira mwachangu.

Malo

Khansa ya kapamba muunyinji wazowonetsera, malinga ndi kufufuza kwazidziwitso, zimapezeka m'mutu wa kapamba. Matenda amtunduwu amakula mu 70-80% ya ozunzidwa. Ndi metastases ya thupi la gland, 10-15%. Nthawi zina, amatenga mchira wa kapamba.

Maonekedwe a chotupa mu pancreatic oncology:

• zam'malo
• hemato native
• zosatheka

Chotupa cha Lympho native chimadutsa m'magawo.

1. siteji. Pancreatoduodenal lymph node (mawonekedwe mu mutu wa kapamba wamunthu).
2. siteji. Retropiloric lymph malo.
3. siteji. Celiac komanso mesenteric nodes apamwamba.
4. siteji. Retroperitoneal lymph node.

Pa nthawi ya hemato native chitukuko cha khansa matenda, amapezeka m'chiwindi, impso, mafupa a wodwala.

Chotupa chokhazikika cha oncological ndikusuntha kwa maselo a oncological ndi a pathogenic mu peritoneum yonse ya munthu (cobweb).

Khansa - matenda a kapamba, muimfa yake, ali m'malo achiwiri AIDS ndi HIV. Pathology imafunikira yankho ku matendawo, omwe amatha kutalikitsa ndi kupulumutsa moyo wa munthu.

Kodi amathandizidwa bwanji?

Chithandizo cha khansa ya kapamba chimatengera gawo la matendawa, ndiko kuti, chotupa chake ndi chokulirapo, komwe adakwanitsa kukula, chomwe adachiphwanya. Makamaka, kukula kwa khansa ndi ma lymph oyandikira ayenera kuchotsedwa, ndiye kuti izi ziyenera kutsitsidwa ndi ma ray a gamma. Koma izi ndizotheka pokhapokha "khansa pamalo" ndi gawo 1. M'magawo ena, kuphatikiza kwa njira zosiyanasiyana zomwe zatchulidwa pansipa zitha kugwiritsidwa ntchito.

Mankhwala othandizira

Mitundu yotsatirayi ikugwiridwa apa:

a) Kugwirira kwa Whipple: kuchotsa mutu wa kapamba limodzi ndi chotupa, gawo la duodenum 12, m'mimba, chikhodzodzo, komanso ma lymph onse apafupi.Opaleshoni iyi imachitidwa pokhapokha magawo oyamba, sangathe kuthana kwanthawi yayitali ndipo sangayimitsidwe, nthawi ikadayika.

b) Kutulutsa kwathunthu kwa kapamba. Amagwiritsidwa ntchito ngati khansa yakula m'thupi la chiwalo ndipo sipanadutse pamenepo.

c) Kutulutsa kwina kwa distal. Amagwiritsidwa ntchito ngati khansa yakula mthupi ndi mchira wa chiwalo, amachotsedwa, ndipo mutu umatsalira.

d) Kutengera magawo. Apa, gawo lokhala pakati pachendayo limachotsedwa, ndipo awiri enawo amasinthidwa pogwiritsa ntchito matumbo.

e) Opaleshoni yopanga. Amachitika ndi zotupa zosawoneka ndipo cholinga chake ndi kuyendetsa moyo wa munthu. Itha kukhala:

• Kuchotsa kwa gawo la chotupa kuti muchepetse kukakamiza kwa ziwalo zina ndi mitsempha yotsiriza, kuti muchepetse chotupa.
• Kuchotsa ma metastase,
• kuchotsa kwa kutsekeka kwa biliary thirakiti kapena matumbo, kukomoka kwa m'mimba khoma kapena kuchotsedwa kwa thupi mafuta.

e) Kulimba kwa Endoscopic. Ngati dambo la bile latsekedwa ndi chotupa chosagwira, mutha kuyika chubu kudzera mu ndulu ya bile yomwe imalowetsa m'matumbo ang'onoang'ono kapena kulowa mu pulasitala wolandila.

g) opaleshoni ya m'mimba. Amagwiritsidwa ntchito pamene chotupa chimasokoneza gawo lazakudya kuchokera m'mimba kupita m'matumbo. Pankhaniyi, ndikotheka kupukusa ziwalo ziwiri izi, kudutsa chotupacho.

Opaleshoni amatha kuchitika ndi scalpel, kapena ndi mpeni wa gamma, pamene minofu yokhala ndi khansayo ikachotsedwa ndipo minofu yoyandikana nayo imachotsedwa nthawi yomweyo (ngati khansa sinachotsedwe kwathunthu, maselo ake adzafa mothandizidwa ndi gamma rays).

Kuchitapo kanthu kuchitike kudzera pama micro-incitions, makamaka ngati chotupa chosagwira (kuti chisagwetse ma cell a khansa). Izi zitha kuchitidwa ndi loboti ya DaVinci yomwe ikhoza kukonzedwa. Amatha kugwira ntchito ndi mpeni wa gamma popanda chiwopsezo.

Pambuyo pa opareshoni, radiation kapena chemoradiotherapy imachitika.

Chemotherapy

Amagwiritsa ntchito mitundu yosiyanasiyana ya mankhwala omwe amalepheretsa kukula kwa maselo a khansa kukhala achichepere komanso osakhazikika. Mofananamo, pamakhala zovuta zomwe maselo amakula, zomwe zimayambitsa mavuto ambiri chifukwa cha mankhwalawa: nseru, kuchepa kwa tsitsi, kufooka kwakukulu ndi pallor, neurosis, kuchepa kwapadera kwa matenda opatsirana.

Chemotherapy ungachitike ngati:

1. monochemotherapy - mankhwala amodzi, maphunziro. Kugwiritsa ntchito mu 15-30% ya milandu,
2. polychemotherapy - kuphatikiza kosiyanasiyana kachitidwe kachitidwe. Chotupacho chimapindika pang'ono. Kuchita bwino kwa njirayi ndi 40%.

Kupititsa patsogolo kulekerera kwa mankhwalawa, kumwa kwambiri, kupatula mowa, komanso kuphatikiza mkaka muzakudya. Munthu amapatsidwa njira yothetsera mseru - "Tserukal" kapena "Sturgeon", amalangizidwa kuti ayendere katswiri wazamisala.

Chithandizo chachiyembekezo

Ichi ndi nthambi yatsopano ya chemotherapy, yomwe imagwiritsa ntchito mankhwala omwe amangogwira maselo a khansa, okhudza zida zamoyo. Chithandizo chotere chimavomerezedwa mosavuta ndi odwala, koma khalani ndi mtengo wokwera kwambiri. Chitsanzo cha njira yochizira khansa ya kapamba ndi Erlotinib, yemwe amaletsa kufalikira kwa kachilombo kamene kamakhala mu gawo la chotupa cha kukonzekera kugawanika.

Chithandizo cha poizoniyu

Ili ndi dzina la zotupa zotupa:

• Pamaso pa opaleshoni - kuchepetsa kuchuluka kwa khansa,
• mkati ndi opaleshoni - pofuna kupewa kubwerezanso,
• ndi inoperability - kuchepetsa ntchito ya khansa, zoletsa kukula kwake.

Chithandizo cha chereza chitha kuchitika m'njira zitatu:

1. kachikachiyama,
2. mu mawonekedwe a gamma yakutali,
3. ma elekitoni othamanga.

Chithandizo chatsopano

Asayansi aku US akugwira ntchito yatsopano - kukhazikitsa katemera m'thupi, komwe kumakhala ndi chikhalidwe chofooka cha bakiteriya Listeria monocytogene ndi tinthu tating'onoting'ono. Mu zoyeserazi, zikuwoneka bwino kuti bacterium imagwera ma cell a khansa okha, ndipo makamaka imakhudza metastases, ndikusiya minofu yathanzi.Ngati atenga chonyamula ma radio tinthu tating'onoting'ono, amatenga kachilombo koyambitsa matenda, ndipo amwalira.

Kukhazikika kwa mankhwala omwe amakhudza chitetezo cha mthupi, omwe ayenera kuthana ndi khansa, akupitiriranso. Mwachitsanzo, mankhwala osokoneza bongo a Ipilimumab kuchokera pagulu la antioxodies a monoclonal.

Chithandizo cha Mankhwala a Cancer

Whipple, distal, segmental resection, pancreatectomy.

Mulingo woyenera - pogwiritsa ntchito njira ya Cyber-mpeni (mpeni wa Gamma)

Zakudya kupatula mafuta anachuma amakhathamira. Njira yovomerezeka yothandizira ndi ma enzyme: Creon (mankhwala oyenera kwambiri, alibe zidulo za bile), Pancreatin, Mezym.

Kwa ululu - ma analgesics omwe si a narcotic: Ibuprofen, Diclofenac

Pambuyo kapena m'malo mwa opaleshoni, mwachangu pambuyo kapena panjira ya radiation.

Mulingo woyenera - wowerengera mankhwala

Zakudya - zomwezo, mapuloteni amafunikira kuti alowe m'thupi, m'malo ochepa, koma nthawi zambiri.

Ululu - narcotic kapena sanali narcotic analgesics.

Ndi nseru - Sturgeon 4-16 mg.

Kusintha hematopoiesis - mapiritsi a Methyluracil

Opaleshoni yam'mimba - pakutseka zitseko za bile, m'mimba kapena matumbo, kuti muchepetse kupweteka, ngati chotupacho chimakanikizira kwambiri mitengo. Mulingo woyenera - Cyber-mpeni.

Ngati chotupa chakhala m'mitsempha yamagazi, izi sizingathetsedwe.

Kukula konse kwa khansa ya kapamba sikuyenera: chotupacho chimakula msanga ndikuwonetsedwa, osadzilola kudzimva kwa nthawi yayitali.

Funso la anthu angati omwe amakhala ndi khansa ya pancreatic alibe yankho lomveka. Zonse zimatengera zinthu zingapo:

• mtundu wa khansa,
• gawo lomwe chotupacho chinapezeka,
• chikhalidwe choyambirira cha thupi
• chithandizo ndi chiyani?

Kutengera izi, ziwerengero zotsatirazi zitha kupezeka:

• Ngati chotupa chija chapitilira England, 20% yokha ya anthu imakhala zaka 5 kapena kuposerapo, ndipo izi ndizotheka ngati mankhwalawa agwiritsidwa ntchito.
• Opaleshoniyo ngati sanagwiritse ntchito, amakhala pafupifupi miyezi isanu ndi umodzi.
• Chemotherapy imatenga nthawi yambiri pakatha miyezi 6-9.
• Chithandizo chimodzi cha radiation, popanda opaleshoni, chimakupatsani mwayi wokhala ndi miyezi 12-13.
• Ngati opaleshoni yayikulu idachitika, amakhala zaka 1.5-2. Kupulumuka kwa zaka 5 kumawonedwa mu 8-45% ya odwala.
• Ngati opaleshoniyo ndi yothandiza, kuyambira 6 mpaka 12 miyezi. Mwachitsanzo, atagwiritsa ntchito anastomosis (kulumikizana) pakati pa ma ducts a bile ndi mgonero, munthu amakhala pambuyo pa miyezi isanu ndi umodzi.
• Pophatikiza opaleshoni yopanga ndi ma radiation, amakhala pafupifupi miyezi 16.
• Pa magawo anayi, 4-5% yokha imakhalabe ndi moyo chaka chimodzi, ndipo 2% okha ndi omwe amapulumuka mpaka zaka 5 kapena kupitilira. Mukamvetsetsa zowawa ndi poyizoni ndi chifuwa cha khansa, ndifupikitsa moyo.

Malinga ndi mtundu wa mbiri:

Zomwe zimayambitsa kupha khansa ya pancreatic ndi hepatic, mtima kapena kulephera kwaimpso komwe kunachitika pa metastasis limodzi ndi cachexia (kutopa) chifukwa cha kuledzera khansa.

Kupewa kwa Khansa ya Pancreatic

Popewa matenda oopsawa, asayansi amalangiza izi:

• Siyani kusuta.Zosintha zomwe zimayamba chifukwa chosuta zimasinthanso m'ziwalo zonse.
• Idyani zakudya zokhala ndi index yotsika ya glycemic (kuchuluka kwa kutsekemera komwe kumakhudza kugwira ntchito kwa kapamba). Zokonda zimaperekedwa osati kwa chakudya chochepa cha mafuta, koma ma legamu, masamba osapsa ndi zipatso.
• Osamadya mapuloteni ambiri, nthawi zina amasintha masiku osala kudya a protein.
• Onjezani zomwe zili muzakudya za kabichi: Brussels zikumera, kolifulawa, broccoli ndi wina.
• Mwa zonunkhira, amakonda turmeric (pali mu zokometsera "curry"). Muli curcumin, yomwe imalepheretsa kupanga kwa interleukin-8, mkhalapakati yemwe amakhudza chitukuko cha khansa ya kapamba.
• Phatikizaninso zakudya zina zokhala ndi ellagic acid muzakudya zanu: makangaza, rasipiberi, sitiroberi, sitiroberi, ndi zipatso zina ndi zina zofiira.
• Pewani malonda okhala ndi nitrate.
• Idyani tsiku lililonse mavitamini C ndi E - antioxidants achilengedwe.
• Ngati mukufuna mtedza ndi nyemba, onetsetsani kuti mwatsopano. Chaka chatha, mtedza wowoneka ngati wokayikitsa ungatengedwe ndi aflatoxin.
• Zakudyazi ziyenera kukhala ndi masamba obiriwira omwe amakhala ndi chlorophyllin.
• Muyenera kudya nsomba ndi mkaka wokhala ndi mpanda wolimba womwe uli ndi vitamini D, womwe umalepheretsa kufalikira kwa maselo a khansa.
• Pali mafuta ochepa momwe mungathere, makamaka nyama: osapitilira 20% ya zopatsa mphamvu zonse za kalori. Zowopsa kwa kapamba ndi nyama yofiira, yolk, offal.
• Idyani zakudya zokwanira ndi mavitamini a B, Vitamini A, ndi carotenoids.

Zoyambitsa za oncology mwa amuna

Malinga ndi ziwerengero za kafukufuku wa zamankhwala, khansa ya pancreatic ndiyotheka kukhudza amuna achikulire kuposa azimayi. Zifukwa zake zimakhala zosiyanasiyana: kusuta pafupipafupi, kusuta kwa nthawi yayitali, kudya zopanda thanzi (zakudya zamafuta ndi zonunkhira), matenda a chiwindi, kumwa kwambiri zakumwa zoledzeretsa, zakudya zolimba, kusowa kwa iron, kunenepa kwambiri, ndi zina zambiri. Amuna azaka zapakati pa 50-70, pamene zizindikiro zoyambirira za khansa ya kapamba zimachitika, muyenera kufunsa dokotala.

Zizindikiro za matendawa mwa akazi

Malinga ndi kafukufuku, matenda a kapamba mu akazi ndi ochepa peresenti kuposa amuna. Komabe, nthawi zambiri azimayi okalamba, mosiyana ndi mavuto ena azaumoyo, osalabadira zizindikiro zoyambirira. Izi zimalonjeza zakuneneratu zomvetsa chisoni. Ngati matenda a jaundice kapena kapamba amawoneka okalamba, omwe amakhala ochulukirapo mwa azimayi kuposa abambo, muyenera kupita kwa akatswiri oncologist.

Zizindikiro zoyambirira za khansa ya kapamba

Zizindikiro zoyambirira za chotupa cha pancreatic zikuphatikiza:

• kukulitsa chiwindi
• mseru, kusanza, kupindika
• kuwonda
• thrombosis
• kuukira kwa pachimake kapamba (akulu kapena akulu),
• kupweteka m'mimba.

Akatswiri azachipatala amapanga zigawo za khansa m'magulu anayi awonekera:

• kupweteka kwa epigastric
• Zizindikiro za chakudya
• zizindikiro zamakina
• zotupa pakhungu.

Kupweteka kwa epigastric

Dera la epigastric limaphatikizapo ziwalo zomwe zimapanga gawo lonse la m'mimba. Ndi khansa ya pancreatic, chimodzi mwazizindikiro zoyambira komanso zowopsa ndizopweteka, zotsekemera mu hypochondria, zomwe zimakhala zolimba kwambiri usiku. Zomverera zosasangalatsa zoterezi zimakhala zomwe zimayambitsa matenda ena aliwonse komanso kutupa kwa m'mimba, kotero odwala nthawi zambiri samathamangira kukaonana ndi dokotala pogwiritsa ntchito njira yodziimira payekha.

Zizindikiro za chakudya

Zizindikiro zam'mimba za khansa nthawi zambiri zimakhala zoyambirira kuzilimbitsa. Zambiri ndizizindikiro zomwe madokotala amatcha "pancreatic-intestinal." Izi ndichifukwa choti neoplasm (benign kapena ayi) imamera limodzi ndi zinthu zina zofunika m'mimba. Zizindikiro zikuphatikiza:

• kupweteka m'mimba
• kutsegula m'mimba
• nseru
• zotakasuka, zamafuta, zotuwa,
• mkodzo wakuda bii.

Zizindikiro zadongosolo

Nthawi zambiri kumayambiriro, matendawa amayenda limodzi ndi ziwopsezo, zamavuto amthupi, monga kufooka, kulemera pamimba, kutopa. Nthawi zina odwala amayamba kudwala matenda otsekula m'mimba, kuwonetsa kuphwanya kwam'mimba. Kuwonjezeka kwa shuga m'magazi ndi kumva kusasangalala kwamkati ndi chizindikiro china cha chotupa choopsa.

Zotupa za pakhungu

Chimodzi mwazomwe zikuwonetsa chotupa cha pancreatic ndi kuwonongeka kwa khungu - jaundice, limodzi ndi kuyabwa m'thupi lonse. Imayenda pang'onopang'ono, pang'onopang'ono imasintha mtundu kuchokera ku chikasu mpaka kubiriwira. Kunja, jaundice akuwonetsedwa ndi izi:

• mucous nembanemba ndi sclera chikasu
• chopondapo chidasungunuka
• kukula kwa ndulu ndi chiwindi kumakulitsidwa,
• Khungu.

Kudziwa matenda oyamba a pancreatic chotupa

Kuzindikira matenda oyamba ndi khansa ya pancreatic kungaphatikizeponso kuyesa kwa wodwala, kuyesa kwa ultrasound, kuyezetsa magazi kwa omwe ali ndi khansa ndi kuyerekezera kotengera. Ngati vuto loiplasm lipezeka, kuunika kwa chotupa kwachitika. Njirayi imagwiridwa ndi kulumikizira mosakwiya - chopereka cha zinthu zomwe zakhudzidwa ndi chiwalo. Pambuyo pa machitidwe onse, chithandizo chachikulu chimasankhidwa - chemotherapy.

Dziwani za khansa ya colorectal - zoyamba kuzindikira ndi matenda.

Kanema: momwe mungayang'anire kapamba wa khansa

Ngati simukudziwa kuti ndizizindikiro ziti zomwe zimagwirizanitsidwa ndi khansa ya chiwalo chofunikira ichi, ndiye mu kanema wothandiza mungapeze mayankho ku mafunso anu onse okhudzana ndi matenda oopsa. Madokotala odziwa ntchito adzagawana zofunikira momwe angadziwire matenda oyamba m'magawo oyambira, komanso kukambirana zomwe zimayambitsa matendawa.