Pancreatic kufalitsa kwa matenda ashuga: mtengo wa opaleshoni ku Russia

Kupatsirana kwa kapamba pofuna kupewa kupangika kwachiwiri kwa matenda ashuga ndikofunikira kwambiri kumayambiriro kwa matendawa. Pali mitundu yosiyanasiyana ya kusinthanitsa kwa ndulu, zomwe zimatsimikizidwa pokhapokha kupenda wodwalayo kwathunthu.

Masiku ano amagwira ntchito zotsatirazi:

Kuyika kwa gawo lonse la chisa ndi gawo la duodenum,
Thonje lamkaka,
Kusinthanitsa gawo la chiwalo,
Pancreatic cell transplantation, yomwe imachitika kudzera m'mitsempha.

Ndi mitundu iti yomwe imagwiritsidwa ntchito nthawi zonse zimatengera mawonekedwe ndi kuchuluka kwa kuwonongeka kwa chiwalo komanso mkhalidwe wa wodwalayo.

Poika pancreas yonse, imatengedwa limodzi ndi gawo la duodenum. Nthawi yomweyo, imatha kulumikizana ndi intestine yaying'ono kapena chikhodzodzo. Pothana ndi gawo la chisa, pancreatic juice iyenera kupatutsidwa, momwe njira ziwiri zimagwiritsidwira ntchito:

Mlendo wobowoleza ndi wotsekedwa,
Madzi a chithokomiro amachichotsa mu chikhodzodzo kapena matumbo aang'ono. Mukamuika mu chikhodzodzo, chiopsezo cha mawonekedwe ndi kukula kwa matenda amachepetsa kwambiri.

Zikondamoyo, monga impso, zimasinthidwa kukhala iliac fossa. Njira yoika ndi yovuta kwambiri, imatenga nthawi yayitali. Amadutsa pansi pa opaleshoni wamba, kotero chiwopsezo cha zovuta chimachepetsedwa kwambiri. Nthawi zina amamuyika catheter ya msana, mothandizidwa ndi zomwe wodwalayo amalandila pambuyo pake pakuwathandizira kuti athandizire wodwalayo kukhala bwino.

Mtundu wa kulowererapo kwa opaleshoni amasankhidwa pambuyo pofufuza zomwe zapezeka pakuwunika kwa wodwalayo. Kusankhaku kumadalira kuchuluka kwa kuwonongeka kwa tiziwalo touluka komanso kuchuluka kwa thupi la wolandirayo. Kutalika kwa ntchito kumatsimikiziridwa ndi zovuta zake, nthawi zambiri zinthu zotsatirazi zimachitika:

ziwalo zonse ndikaziika
kufalikira kwa mchira kapena thupi la kapamba,
kufalikira kwa ndulu ndi duodenum,
intravenous makonzedwe a islet maselo.

Njira zochizira mosiyanasiyana zitha kuchitika mosiyanasiyana. Nthawi ya ntchito, kuziika:

magawo amtundu wa England (mchira kapena thupi),
pancreatoduodenal tata (kwathunthu tiziwalo tokhala ndi gawo la duodenum nthawi yomweyo moyandikana nayo),
zitsulo kwathunthu ndi impso nthawi imodzi (90% ya milandu),
kapamba pambuyo poyambira kupatsirana kwa impso,
chikhalidwe cha opereka ma beta cell opanga insulin.

Kuchulukitsa kwa opaleshoni kumatengera kuwonongeka kwa minofu ya chiwalo, kuchuluka kwa wodwalayo komanso kuchuluka kwa kafukufuku. Lingaliro limapangidwa ndi dokotala wa opaleshoni.

Opaleshoniyo yakonzedwa, chifukwa imafunika kukonzekera wodwalayo ndi kumuika.

Kuzindikira usanachitike kumuika

Kuchita bwino ndi kupambana kwa ntchitoyo kumatengera zinthu zambiri, chifukwa njirayi imawonetsedwa pokha pokha ndipo ili ndi mtengo wokwera kwambiri. Wodwala aliyense ayenera kukayezetsa ndi kufufuzidwa zingapo, malinga ndi zotsatira zomwe dokotala angaganize zoyenera kutsatira. Pali mitundu ingapo yodziwitsa, yomwe yofunika kwambiri ndi iyi:

Kuyesedwa koyenera ndi katswiri wazachipatala komanso kufunsa kwa madokotala odziwa kwambiri - dokotala wazachipatala, dokotala wa opaleshoni, mankhwala opha opaleshoni yamano, mano
Kuyesa kwa Ultrasound kwa minofu yamtima, ziwalo zam'mimba, chifuwa cha x-ray, electrocardiogram, tomography,
Mitundu yamagazi osiyanasiyana
Kusanthula kwapadera komwe kumazindikiritsa kupezeka kwa ma antigen, komwe ndikofunikira pakugwirizana kwa minofu.

Popeza kupusitsika kwina kulikonse ndi njira yoopsa kwa wodwalayo, pali zizindikiro zingapo zomwe kuyika kwa kondomu ndiyo njira yokhayo yotsimikizika yodalirika yomwe anthu amagwirira ntchito:

Pancreatic transplantation mu mtundu 1 wa matenda ashuga isanayambike zovuta zazikulu zamatenda, monga retinopathy, omwe amatha kukhala khungu, mtima wamitsempha, mitundu yosiyanasiyana ya nephropathy, hyperlability,
Sekondale mellitus, yomwe imayambitsidwa ndi maphunziro apadera a kapamba, omwe amapezeka ndi khansa ya khansa, khansa ya pakhungu, chitetezo chokwanira cha insulin, hemochromatosis,
Kukhalapo kwa zotupa zopanga ziwalo, kuphatikiza zilonda kapena chosaopsa, kufa kwa minofu yambiri, mitundu yosiyanasiyana yotupa mu peritoneum.

Chizindikiro chilichonse pamwambapa chimakhala chosemphana, chifukwa chake kufunikira kwa kufalikira kumaganiziridwa kwa wodwala aliyense payekhapayekha ndipo adasankhidwa ndi dokotala yemwe amawunikira zonse zomwe zingachitike ndi zovuta zake.

Kuphatikiza pazomwe zikuwonetsa, pali zingapo zotsutsana momwe kuchita chonyamula zikondamoyo ndizoletsedwa:

Kukhalapo ndi kukula kwa neoplasms yoyipa,
Matenda osiyanasiyana amtima omwe minyewa imakwanira,
Mavuto a shuga
Kupezeka kwa matenda am'mapapo, stroko kapena matenda opatsirana,
Kuledzera kapena uchidakwa,
Mavuto akulu amisala,
Ofooka chitetezo chokwanira.

Ngati ndizosatheka kuchitika popanda opaleshoni, wodwalayo amayenera kupimidwa mozama kuti athe kupatula zovuta zina mwadzidzidzi pa nthawi ya opareshoni ndi nthawi yothandizira.

Mayeso angapo oyenera ogwira ntchito amakhazikitsidwa ndi mapuloteni a opareshoni:

ECG
R0 OGK (chifuwa x-ray),
Ultrasound ya OBP ndi ZP (ziwalo zam'mimba zam'mimba komanso malo a retroperitoneal),
CT scan (computed tomography).

Mayeso ofunika a labotale ndi awa:

ambiri matenda ndi zamankhwala amodzi, kuphatikizapo magazi ndi mkodzo amylase,
kuyesa kwamkodzo kuti aphunzire ntchito ya impso,
mayeso a chiwindi, HIV, RW,
mtima magazi ndi Rh factor.

Upangiri wa akatswiri yopapatiza amakhazikitsidwa:

endocrinologist
gastroenterologist
mtima
nephrologist ndi omwe akuwoneka kuti ndiofunikira ndi madotolo.

Nthawi zina, kuwunika kowonjezereka kumafunikira: amalembera odwala matenda ashuga, ovuta a neuropathy. Muzochitika zotere, wodwala matenda ashuga sangamve kugunda kwa angina, chifukwa chake, samadandaula, ndipo ngakhale atakhala ndi coronary atherosulinosis ndi mtima kulephera, kupezeka kwa matenda a mtima. Kuti mumvetse bwino:

ECHOKG,
angiography yamitsempha yamagazi,
radioisotope kusanthula kwa mtima.

Njira zochizira matenda amtundu 1 shuga

Pakadali pano mankhwalawa, njira yamankhwala yothandizira matenda a shuga omwe amadalira insulin ndiwofala kwambiri. Kugwiritsa ntchito mankhwalawa m'malo pogwiritsa ntchito mankhwala okhala ndi insulin sikutha kukhala ogwira ntchito mokwanira, ndipo mtengo wa chithandizo chotere ndi wokwera kwambiri.

Kusakwanira kogwiritsa ntchito mankhwalawa m'malo chifukwa cha zovuta zosankhidwa zamankhwala, omwe mankhwalawa amagwiritsidwa ntchito. Mlingo wotere uyenera kusankhidwa muzochitika zonse, kukumbukira mawonekedwe onse a thupi la wodwalayo, zomwe zimakhala zovuta kuchita ngakhale kwa akatswiri odziwa za ma endocrinologists.

Zonsezi zidapangitsa madotolo kufufuza njira zatsopano zochizira matendawa.

Zifukwa zazikulu zomwe zidapangitsa asayansi kufunafuna njira zatsopano zamankhwala ndizotsatirazi:

Kuopsa kwa matendawa.
Chikhalidwe cha matendawo.
Pali zovuta pakusintha zovuta munthawi ya shuga.

Njira zamakono kwambiri zochizira matendawa ndi:

njira zamankhwala othandizira,
kupandukira kwapa
kupandukira
kufalikira kwa islet maselo a pancreatic minofu.

Mu shuga mellitus wa mtundu woyamba, thupi limawonetsa kuwonekera kwa kusintha kwa metabolic komwe kumachitika chifukwa chophwanya magwiridwe antchito a maselo a beta. Kusuntha kwa kagayidwe kachakudya kungathetsedwe ndikusintha ma cell a zinthu zazing'onoting'ono za Langerhans. Maselo amalo amtunduwu wa pancreatic ndiwo amachititsa kuphatikizika kwa insulin ya thupi m'thupi.

Opaleshoni yamatenda a shuga a pancreatic amatha kuwongolera ntchitoyi ndikuwongolera kupatuka kotheka mu njira za metabolic. Kuphatikiza apo, opaleshoni imatha kupewa kupitilirabe kwamatendawa ndikuwonekera m'thupi la zovuta zomwe zimakhudzana ndi matenda a shuga.

Opaleshoni yamtundu woyamba wa shuga ndi yolondola.

Ma cell a Islet sangathe kukhala ndi nthawi yayitali kuti akhale ndi vuto pakusintha kwa kagayidwe kachakudya mthupi. Pachifukwa ichi, ndibwino kugwiritsa ntchito golide wopereka yemwe wasunga mphamvu yake momwe angathere.

Kuchita zofananazi kumafunanso kuwonetsetsa momwe zimakhalira kuti zolepheretsa za metabolic zimalephera.

Chinsinsi cha opereshoni

Monga momwe zimachitidwira opaleshoni iliyonse, kuphatikizira kwa pancreatic kumakhala ndi zovuta zingapo, zomwe zimatchulidwa makamaka pakafunika kuchitidwa opaleshoni mwadzidzidzi. Mavuto amayanjana ndikupeza opereka oyenera, omwe ndi achinyamata osakwana zaka 55. Komanso, ayenera kukhala ndi thanzi lokwanira panthawi yakufa.

Chiwalocho chikachotsedwa m'thupi la munthu, chitsulo chimasungidwa mu njira za Vispan kapena DuPont ndikuziyika mchidebe chomwe chili ndi boma lotentha. Chifukwa chake imatha kusungidwa kwakanthawi kochepa (osapitirira maola makumi atatu).

Wodwala akayamba kuwonongeka chifukwa cha matenda a shuga, nthawi zambiri amalimbikitsidwa kuchita opareshoni ya ziwalo ziwirizi nthawi imodzi, zomwe zimakweza mwayi wowoneka bwino.

Monga chithandizo chilichonse chamankhwala, kupatsidwa zinthu kumatha kubweretsa zovuta zambiri, zomwe ndi:

Kukula kwa matenda opatsirana m'mimba,
Kapangidwe kamene kamazungulira dzinthu,
Maonekedwe akutulutsa magazi pamlingo uliwonse wolimba.

Nthawi zina kukana chiwalo chovekerachi kumachitika. Izi zitha kuwonetsedwa ndi kukhalapo kwa amylase mkodzo. Ikhozanso kupezeka ndi biopsy. Mwanjira imeneyi, chiwalo chimayamba kuchuluka. Kuchita kafukufuku pogwiritsa ntchito ultrasound kumakhalanso kovuta.

Ntchito zopatsirana zimapereka nthawi yayitali komanso yovuta yobwezeretsa kwa wodwala aliyense.

Munthawi imeneyi, mankhwala a immunosuppressive amaperekedwa kuti apulumutse ziwalo.

Malinga ndi ziwerengero, pomaliza ntchito zotere, kupulumuka kumawonedwa kwa zaka ziwiri odwala oposa 80 peresenti.

Zomwe zimakhudza zotsatira za opareshoni ndi:

Mkhalidwe wa chinthu chogaliridwa panthawi ya kumuika,
Mulingo waumoyo ndi zaka pa nthawi yomwe wopereka amwalira,
Kuchuluka kwakukulu kwa zopereka ndi zolandilira,
Mkhalidwe wa hemodynamic wodwala.

Pankhani ya kusinthika kuchokera kwa wopereka wamoyo pakapita nthawi, matulukiridwewo ndi abwino kwambiri, chifukwa pafupifupi 40% ya odwala amadziwika ndi kuchira kwathunthu.

Njira yoyendetsera kukhazikika kwa masisamba a Langerhans (maselo a ziwalo) yatsimikizira kuti si yabwino kwambiri ndipo ikuchita bwino. Izi zimachitika chifukwa ndizovuta kugwira ntchito yamtunduwu. Izi ndichifukwa choti kapamba wa woperekayo amapangitsa kuti azitha kupeza ochepa ochepa maselo ofunikira.

Kuphatikiza apo, kukulira kwa kugwiritsidwa ntchito kwa kufalikira kuchokera ku mazira, kugwiritsa ntchito maselo amtundu, komanso zikondamoyo za nkhumba kuti ziwonjezeke kwa anthu zikuchitika, komabe, panthawi yamtunduwu, chitsulo chimabisa insulin kwa kanthawi kochepa.

Nthawi zambiri, kugwiritsa ntchito moyenera zakudya zopatsa thanzi, kudya mokwanira komanso kuchita masewera olimbitsa thupi moyenera kumachepetsa kapamba.

Naturalization magwiridwe antchito a kapamba amalola nthawi zambiri mokwanira kukwaniritsa chikhazikitso chokhazikika pakukula kwa matendawa.

Kukhalapo kwa matenda ashuga mwa wodwala sikuti kuli chizindikiro cha opareshoni.

Kuthandizira opaleshoni m'thupi kumachitika ngati:

Kukwanitsa kwamakhalidwe othandizira.
Wodwala amakana jakisoni wa insulin.
Kusokonezeka kwa kagayidwe kachakudya mthupi.
Kukhalapo kwa zovuta zazikulu zamtundu 1 ndi matenda ashuga 2.

Ngati kupanikizika kwa kapamba ndi matenda ashuga kupambana, ndiye kuti ntchito zonse za chiwalo zimabwezeretseka bwino.

Kuthamanga kwa pancreatic ndikothandiza kwambiri ngati opaleshoniyo ikuchitika koyambirira kwamatenda. Izi ndichifukwa choti pang'onopang'ono matendawa amayambika, zovuta zina zachiwiri zomwe zimawonjezera kubwezeretsedwa kwantchito ya thupi zimawonjezeredwa pamatenda oyamba.

Pankhani yopangira opaleshoni kumbali ya retinopathy yomwe ikukula pang'onopang'ono, zotsatira za opaleshoniyo zitha kukhala zosiyana, komabe, chiopsezo chovuta m'thupi la wodwalayo sichidutsa mwayi woti akuwonjezereka ngati opaleshoniyo itasiyidwa.

Kuthandizira opaleshoni kumafuna kupezeka kwa zinthu zopereka.

Opaleshoni isanachitike, wodwalayo ayenera kudziwa kuti kupezeka kwa zovuta mu chiwindi, mtima kapena impso zomwe zimachitika ndi matenda amtundu wa 1 zimatha kuwonjezera zovuta pambuyo pakuchita opaleshoni.

Cholinga chokana kukana kuchitapo kanthu opaleshoni ikhoza kukhala kupezeka kwa matenda owonjezera monga khansa kapena chifuwa mwa wodwala yemwe ali ndi matenda a shuga.

Kupanikizika kwa kapamba kumachitika ndi chapakati pamimba. Chiwalo chopereka chimayikidwa kumanja kwa chikhodzodzo. Kusoka kwa mtima kumachitika. Opaleshoniyo ndi njira yovuta kwambiri, yovuta kuthandizira pakuchita opaleshoni ili m'chilengedwe champhamvu kwambiri.

Kuchotsa ndulu ya wodwalayo sikuchitika, popeza zodabwitsayo, ngakhale ikasiya kugwira ntchito yomwe idapatsidwa, ikupitilizabe kutenga mbali m'thupi la wodwalayo. Zimatenga nawo mbali pang'onopang'ono.

Atamaliza kuchita opaleshoniyo, patimayo timakola ndipo dzenje limasiyidwa kuti litulutse madzi owonjezera.

Opaleshoni imachitidwa pansi pa opaleshoni yambiri ndipo imatenga pafupifupi maola anayi.

Ndi kuchitapo opaleshoni bwino, wodwalayo amachotsa kudalira kwa insulin, ndipo mwayi wokhala ndi chithandizo chokwanira cha matendawa umachulukana kangapo.

Tiyenera kukumbukira kuti zotsatira zabwino zochokera pancreas kumuika zimatheka pokhapokha ngati pakuchitika opaleshoni poyambira kukula kwa matendawa. Gawo ili la chitukuko cha matendawa limadziwika ndi kusowa kwa zovuta mthupi la wodwalayo zomwe zingasokoneze njira yobwezeretsanso kuchuluka kwa ziwalo zamkati.

Nthawi zambiri, kupanikizika kwa kapamba kumayikidwa mtundu 1 kapena 2 mtundu wa mellitus, limodzi ndi chitukuko cha matenda monga:

shuga wowonjezera
retinopathy yotsogolera ku kutayika kwamaso,
kulephera kwa impso,
Zowonongeka kwa CNS
zovuta za endocrine
kuwonongeka kwa makoma azombo zazikulu.

Kuthanso kungathenso kuthandizira odwala matenda ashuga, ndikupanga matenda otsatirawa:

kwambiri kapamba, limodzi ndi necrosis wa zimakhala,
khansa ya kapamba
kukana kwa insulini komwe kumayambitsidwa ndi matenda a Cushing, matenda a shuga (gestationalabetes) kapena aceromegaly,
hemochromatosis.

Nthawi zina, kumuika umaperekedwa kwa anthu omwe ali ndi matenda omwe amatsogolera kusintha kwa kapamba. Izi zikuphatikiza:

zotupa zambiri za England
chachikulu pancreatic necrosis,
kuchuluka, kumathandizira kuphwanya ntchito za kapamba ndipo sangathe kuthandizika.

Muzochitika izi, kusinthanitsa ndikusowa kwambiri, chifukwa chazovuta zachuma ndiukadaulo zomwe zimakhudzana ndi kufunafuna wopereka mtembo ndi kasamalidwe ka nthawi yotsatila.

Kuyika kapamba sikuchitika:

mu matenda oyamba ndi matenda a mtima,
ndi atherosclerosis yayikulu yamitsempha yamagazi,
ndi cardiomyopathy, yomwe imathandizira kusokonezeka kwamagazi,
kusintha kosasintha kwa ziwalo zamkati zomwe zimapangidwa motsutsana ndi shuga.
ndimavuto amisala
ndi kachilombo ka HIV
ndi chidakwa,
osokoneza bongo
ndi matenda oncological.

Gawoli likufuna kupanga dongosolo la chithandizo chamankhwala ndikupewa zovuta zomwe sizinachitike panthawi ya opaleshoni komanso nthawi yoyambiranso. Pakadali pano, onani zomwe zikuwonetsa ndi zotsutsana, onaninso za njira zochiritsira, pimeni ndikuyang'ana wopereka.

Yotsirizirayi ndi gawo lovuta kwambiri pakukonzekera, kufunafuna wopereka ndalama kumatha kutenga zaka zingapo. Ngati ndi kotheka, kuphatikizika kosakanikirana, nthawi imeneyi imatha chaka. Chiwalo chikapezeka, wolandirayo amachita zinthu zotsatirazi:

Ultrasound yam'mimba. Amagwiritsidwa ntchito kuwunika momwe impso, chiwindi, ndi duodenum zilili.
Kuyang'ana kwa akatswiri opapatiza. M'pofunika kuzindikira contraindication kwa opaleshoni kugwirizana ndi mkhutu ntchito mkati.
Kuonana ndi aesthesiologist. Limakupatsani mwayi kuti muwone ngati wodwalayo alibe vutoli.
PET CT sikani pamimba. Imathandizira kuwona chotupa chachiwiri ku khansa ya kapamba.
Computer enterocolonography. Kuphatikizidwa ndi kukambirana ndi gastroenterologist.
Phunziro la mtima. Kufufuza mozama kumathandiza kudziwa ngati wodwalayo wakonzeka kumuika chiwalo. Ndikulimbikitsidwa kuyang'aniridwa ndi radioisotope scan ndi angiography yamatumbo akuluakulu a mtima.

Kuyesa

Dongosolo lofufuza wodwalayo musanagulitse limaphatikizapo:

kuyezetsa magazi ndi mkodzo,
kuyezetsa magazi kwa matenda aposachedwa,
magazi ndi zamkodzo mayesero,
kuyesa kwamitundu
kusanthula kwa zotupa.

Pakadutsa kanyumba masana, wodwalayo amakhala m'chipinda chothandizira odwala kwambiri. Kugwiritsa ntchito zakudya ndi zamadzimadzi panthawiyi ndizoletsedwa. Kumwa madzi oyera kumaloledwa maola 24 pambuyo pa opaleshoni. Pambuyo pa masiku atatu, kuyambitsidwa kwa zakudya muzakudya kumaloledwa. Chiwalo chimayamba kugwira ntchito nthawi yomweyo. Kuchira kwathunthu kumafuna osachepera miyezi iwiri.

Kuchita njira yochotsera zisumbu za Langerhans

Njira yobwezeretsa zisumbu za Langerhans imachitika mosiyana ndi njira yozambulira. Mwa njira, ndi njirayi matenda a shuga amathandizidwa kwambiri ku USA.

Mtundu wa opaleshoni yamtunduwu umachitidwa kwa mtundu uliwonse wa matenda ashuga.

Kwa opaleshoni, maselo aopereka m'modzi kapena angapo amapereka. Maselo opereka amachokera mumatumba a pancreatic pogwiritsa ntchito ma enzymes.

Ma cell opereka omwe amapezeka amawayika mu minyewa ya chiwindi pogwiritsa ntchito catheter. Pambuyo pakulowetsa mtsempha, maselo amalandila zakudya ndikuyamba kuyankha mwa kuphatikiza kwa insulini kukweza shuga m'magazi.

Zomwe maselo amadziwonetsa pafupifupi nthawi yomweyo ndikuwonjezeka m'masiku otsatirawa. Izi zimadzetsa kuti odwala omwe amathandizira amachotsa kudalira kwa insulin.

Kuchita zolowera mthupi kumabweretsa kuti, ngakhale kuti mapangidwe a kapamba sanabwezeretsedwe kwathunthu, ndizotheka kukwaniritsa zotsatira zabwino zochizira ndi chiopsezo chochepa cha zovuta zina.

Kuchiritsa kwathunthu kwa matenda ashuga mwanjira imeneyi kumatheka pokhapokha ngati palibe ma pathologies ofunikira m'thupi la ziwalo zamkati.

Kugwiritsa ntchito mitundu yamtunduwu kwa opaleshoni m'thupi la wodwalayo kumapangitsa kuti wodwalayo asakhale ndi vuto lalikulu pakukhazikitsa njira za metabolic.

Kugwiritsa ntchito njirayi kumathandizanso kuti matenda ashuga azikula.

Pambuyo pa opaleshoni, wodwala sayenera kuchoka kuchipatala masana.

Pakatha tsiku limodzi chitatha kulowererapo, wodwalayo amaloledwa kumwa madzi. Pambuyo masiku atatu, chakudya chimaloledwa.

Kutupa kwa wodwalayo kumayamba kugwira ntchito pafupipafupi pambuyo ponyamula.

Kuchira kwathunthu kumachitika pakatha miyezi iwiri. Popewa kukanidwa, wodwalayo adalandira mankhwala omwe amachepetsa mphamvu ya chitetezo chathupi.

Mtengo wa opaleshoni ndi pafupifupi madola 100,000 a ku US, ndipo chithandizo chamankhwala obwezeretsa pambuyo pake ndi chithandizo cha immunosuppressive chili ndi mitengo kuchokera pa 5 mpaka 20 madola masauzande. Mtengo wa mankhwalawa umadalira momwe wodwalayo amayankhira.

Kuti mudziwe zambiri za momwe kapamba amagwirira ntchito, mutha kuwonera kanema munkhaniyi.

Zizindikiro pancreatic kupatsidwa zina

Opaleshoniyo amachitidwa pa matenda otsatirawa:

Mavuto azovuta kapena zovuta za mtundu 1 ndi matenda ashuga 2, komanso mtundu wachiwiri wa matenda ashuga ndi matenda oopsa.
khansa
Cushing's syndrome
kusokonekera kwa dongosolo la mahomoni,
nephropathy ndi gawo lothandizira.

Kuika kwa kapamba kumafunika ngati ma michere omwe amatulutsa omwe sanasungidwepo kwathunthu, koma khalani mkati, ndikuwononga gland.

Mtheradi wamba wokhudza kuphukira kwa kapamba ndi:

ma terminal
ndi matenda ashuga - zovuta zina zomwe sizingakonzeke,
Matenda ofunikira a ziwalo zofunika kwambiri zomwe sizingatheke.
komanso matenda osachiritsika am'deralo komanso mwazovuta monga Edzi, chifuwa chachikulu, chifuwa chachikulu cha hepatitis, ndi zina zambiri.

Kuphatikiza apo, opaleshoni yotereyi sichichitika chifukwa cha khansa ya ziwalo zilizonse komanso kwa odwala omwe ali ndi vuto lodzikongoletsa, kwa anthu omwe ali ndi vuto losokoneza bongo (mankhwala osokoneza bongo, mowa), komanso pazinthu zina zama psychosocial.

Zoyenderana ndi izi:

zaka zopitilira 65
atherosulinosis,
kunenepa kwambiri (kunenepa kwambiri 50%),
zilonda zam'mimba ndi zam'mimba,
kachigawo kakang'ono kosakwana 50%.

M'matendawa, kupanikizika kwa kapamba kumachitika, koma chiwopsezo pakuchitidwa opaleshoni ndi mankhwala ochita kupanga chimakhala chachikulu kwambiri.

Kuchepetsa chiopsezo chokana chiwalo chofesedwa, odwala omwe adachita kupanikizana kwa pancreatic amapita ku immunosuppression.

Mu shuga mellitus kwa odwala omwe ali ndi gawo lodzala aimpso kulephera, pali zizindikiro za munthawi yomweyo kuphatikizira kwa kapamba ndi impso.

Potere, mkhalidwe wawo pakulandila chithandizo cha immunosuppressing udzakhala wabwino kwambiri kuposa ngati anali munthawi yomweyo pa dialysis.

Chifukwa chake, titha kusankha njira zotsatirazi ntchito:

vuto la matenda ashuga nephropathy, matenda a impso kulephera kapena kukanika kwa impso, omwe kale adawayika - munthawi yomweyo kuphatikiza kwa kapamba ndi impso,
Odwala omwe ali ndi matenda amtundu wa 1 popanda zovuta mu mawonekedwe a nephropathy amawonetsedwa ndi kukokoloka kwina,
ngati chitetezo mu nephropathy chikufunika, kupatsirana kwa impso komwe kumatsatiridwa ndi kuphatikizira kwa kapamba kumalimbikitsidwa.

Kusaka Opereka

Chikhansa ndi chiwalo chopanda ntchito, kotero kufalikira sikungatheke kuchokera kwa wopereka amoyo.

Kufufuza kwa wopereka kuti atumizidwe kapamba ndikupeza chiwalo choyenera cha cadaveric (pali zoletsa zaka, zosinthira kuchokera kwa wopikirazo ziyenera kukhala zogwirizana ndi minofu ya wolandirayo, ndipo woperekayo sayenera kukhala ndi pathologies panthawi ya kufa).

Palinso zovuta zina - momwe mungapulumutsire chiwalo kuti chiziwike. Zikondazo zimafunikira mpweya wambiri kuti ukhalebe woyenera kuzika.

Njala ya okosijeni yoposa theka la ola imamupha.

Chifukwa chake, chiwalo chofunikira kuphatikizidwa chikuyenera kuyikidwa pansi kuti chisungidwe kuzizira - izi zidzakulitsa moyo wake mpaka maola 3-6.

Masiku ano, malinga ndi ziwerengero, kuphatikizika kwa kapamba kumatha ndi zotsatira zabwino pafupifupi 85% ya milandu.

Kuthiridwa kwa pancreatic kunachitika koyamba mu 1966, koma, mwatsoka, thupi la wodwalayo linakanidwa ndi chiwalocho. Ntchito zopambana zidachitika mtsogolomo, kuphatikiza mdziko lathu. Mu 2004, madokotala aku Russia adasinthanitsa mwana ndi zikondamoyo.

Komabe, lero kwa odwala omwe amafunikira kupanikizika kwa pancreatic, vuto lomwe lingakhalepo sikuti ngozi zomwe zingatheke, zomwe chaka chilichonse zimatha kuchepetsedwa kwambiri, koma kusowa kwa zida zachipatala mdziko lathu komanso mtengo wokwera wogulitsa ma pancreatic onse ku Russia ndi kunja.

Makamaka mitengo yamitengo yayitali - monga mitundu yonse yamachitidwe otere - m'makiriniki ku Europe, USA ndi Israel. Chifukwa cha mtengo wa opaleshoni ya pancreatic transplant, odwala ambiri omwe amafunafuna sangalandire chithandizo chomwe akufuna pamoyo.

Njira ina yodalirika, yosagwiritsidwa ntchito masiku onse, chithandizo m'makiriniki aku Europe ndi kutumiza kwa kapamba ku zipatala ku India.

Chifukwa chake, ku India, maziko azachipatala amakono amakono samakhala otsika, ndipo nthawi zina amapitilira zipatala zotere ku USA ndi Europe. Ziyeneretso za madokotala aku India omwe amagwira ntchito m'makliniki awa amazindikiridwa padziko lonse lapansi.

Zachipatala zaku India zili ndi zipinda zothandizidwa bwino, malo osamalirira odwala kwambiri, malo opangira kafukufuku, ndipo samangochita maopaleshoni omwe ali ndi chiwopsezo chachikulu, komanso amathandizanso odwala kukonza mokwanira.

Mu zipatala zaku India, kupatsirana kwa kapamba kumachitika kwa onse okalamba odwala ndi ana, ndipo chithandizo chokwanira chokwanira chothandizira pakalandira chithandizo chimaperekedwanso.

Ku Chipatala cha Apollo ku Chennai, machitidwe othandizira ma pancreatic amachitika muzipinda zamakono zogwiritsira ntchito zopangidwa ndi sayansi komanso ukadaulo waposachedwa.

Ntchitozi zikuchitika moyang'aniridwa ndi dokotala wina wothandizira opanga ziwalo zambiri, Dr. Anil Vaidya. Ali ovomerezeka ndi American Society of Transplant Surgeons a University of Miami.

Dr. Vaidya adagwira ntchito zaka 11 m'chipatala ku Yunivesite ya Oxford, komwe adaphunzira, mwa zina, chithandizo cha kapamba pochotsa.

Dr. Anil Vaidya ndi m'modzi mwa akatswiri ochepa kwambiri padziko lonse lapansi omwe achita zandalama zoposa 1000 ndipo amapanga ndemanga zambiri kuchokera kwa odwala.

Amalandira chithandizo chamankhwala choyenerera, odwala ku Chipatala cha Apollo ali ndi mwayi uliwonse wokhala ndi moyo wautali komanso wathanzi.

Chiwerengero chaulere cha maola 24: 7 (800) 505 18 63
Imelo: Imelo yotetezedwa
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Lembani ntchito pamalowo

Pancreatic transplantation (kapamba) ndi imodzi mwazofala kwambiri, koma nthawi yomweyo maupaleshoni yayikulu, yomwe imayikidwa ngati chithandizo cha Conservative sichinabweretse zotsatira zabwino. Kuphwanya ziphuphu kumabweretsa zotsatira zoyipa, zomwe nthawi zambiri zimapangitsa kuti wodwalayo afe.

Mitundu yosiyanasiyana yamatenda a kapamba, omwe amathandizira kuti apangidwe pancreatic necrosis ndi matenda a shuga, akukhala chifukwa chachikulu cha kuphatikizira kwa kapamba. Kubwezeretsa pancreatic ndikuchita kwa maola ambiri, pambuyo pake wodwala amayenera kukhala kuchipatala kwa milungu itatu kapena inayi.

Zovuta za ntchito ndi zovuta pambuyo pake

Monga chithandizo chotere cha opaleshoni, kupatsidwa kwa kapamba kumakhala pachiwopsezo chotenga zovuta monga:

Matenda a m'mimba.
Kudzikundikira kwa zotupa zotupa pafupi ndi chodulidwa chija.
Kutulutsa magazi kwakukulu.
Pancreatic necrosis.
Kuperekera chilonda.
Kukanidwa kwa ndulu yoyatsidwa. Chifukwa chachikulu cha kufa kwakukulu kwa odwala pambuyo paziwikirana ndi ziwalo. Kukula kwa kupsinjika kotereku kukuwoneka ndi mawonekedwe a amylase mkodzo. Dziwani zizindikilo zakukanani ndi biopsy. Chiwalo chovalacho chimayamba kukula, chomwe chimadziwika pakumveka kwa ultrasound.

Pancreatic kufalitsa kwa matenda ashuga: ndemanga

Mtundu woyamba wa matenda a shuga a mellitus (wodalira insulin) ndiye matenda ofala kwambiri padziko lonse lapansi. Malinga ndi ziwerengero zochokera ku World Health Organisation, lero anthu pafupifupi 80 miliyoni ali ndi nthendayi, ndipo pali chizolowezi china choti chizindikiro ichi chiwonjezeke.

Ngakhale kuti madotolo amatha kuthana ndi matenda oterewa pogwiritsa ntchito njira zamankhwala zoyambira bwino, pali zovuta zomwe zimakhudzana ndi kuyambika kwa zovuta za matenda ashuga, ndipo kupatsirana kwa kapamba kungafunike. Kuyankhula manambala, odwala matenda a shuga omwe amadalira insulin:

khalani akhungu nthawi 25 kuposa ena
akudwala kulephera kwa impso nthawi 17
amagwidwa ndi gangore kangapo kangapo,
kukhala ndi mavuto amtima kawiri kuposa anthu ena.

Kuphatikiza apo, pafupifupi nthawi yamoyo ya anthu odwala matenda ashuga ndi pafupifupi yachitatu kwambiri kuposa omwe amadalira shuga.

Pogwiritsa ntchito mankhwala othandizira obwezeretsa, zotsatira zake mwina sizingakhale kwa onse odwala, ndipo mtengo wa chithandizo chotere ndiwosakwanira kwa aliyense. Izi zitha kufotokozedwa mosavuta chifukwa chakuti mankhwalawa amathandizira komanso mlingo wake woyenera ndizovuta kusankha, makamaka chifukwa ndikofunikira kuti apange payokha.

Madotolo adakankhira kufunafuna njira zatsopano zamankhwala:

kuopsa kwa matenda ashuga
chikhalidwe cha matendawo,
kuvuta kwawongolera zovuta za kagayidwe kazakudya.

Njira zamakono zopewera matendawa ndi monga:

njira zamankhwala othandizira,
kufalikira kapamba,
kupandukira
kugawa maselo cell.

Chifukwa chakuti mu shuga mellitus, kusintha kosiyanasiyana kwa metabolic komwe kumachitika chifukwa cha kupundika kwa maselo a beta kumatha kupezeka, chithandizo cha matendawa chimatha chifukwa chakujambulidwa kwa ma islets a Langerhans.

Kuchita opaleshoni yotereku kungathandize kuwongolera kupatuka mu njira za metabolic kapena kukhala chitsimikizo chopewa kukula kwa zovuta zachiwiri zamaphunziro a shuga mellitus, wodalira insulin, ngakhale mtengo wokwera opaleshoni, ndi shuga lingaliro ili ndiloyenera.

Nthawi zina, pamakhala mwayi weniweni woti abwezeretse zovuta za matenda ashuga zomwe zayamba kapena kuziletsa.

Thirani yoyamba ya kapamba inali ntchito yomwe idachitika mu Disembala 1966. Wolandila adakwanitsa kukwaniritsa Normoglycemia ndikudziyimira pawokha kuchokera ku insulin, koma sizipanga mwayi wotcha opaleshoniyo kukhala wopambana, chifukwa mayiyo adamwalira pambuyo pa miyezi iwiri chifukwa chokana thupi ndi poyizoni wamagazi.

Posachedwa, mankhwala atha kupita patsogolo kwambiri m'derali. Pogwiritsa ntchito cyclosporin A (CyA) yokhala ndi ma steroid mu Mlingo wocheperako, kupulumuka kwa odwala ndi zida zometera kunachuluka.

Odwala omwe ali ndi matenda ashuga ali pachiwopsezo chachikulu pakufalikira kwa ziwalo. Pali kuthekera kwakukulu kovutikira komwe kumachitika chifukwa cha chitetezo chathupi komanso chitetezo chathupi. Amatha kuyambitsa kuyimitsidwa kwa chinthu chodalitsidwacho ngakhale kufa.

Pofuna kuthana ndi vuto la kufalikira kwa ziwalo, choyamba, ndikofunikira:

sinthani miyezo yodwala yodwala,
yerekezerani kuchuluka kwa zovuta zachiwiri ndi zoopsa za opaleshoni,
kuwunika wodwala matenda.

Ngakhale zili choncho, kuphatikizira kwachiphaso ndi nkhani ya munthu kudzisankhira wodwala yemwe ali pachiwopsezo chamatenda a impso. Ambiri mwa anthuwa amakhala ndi zizindikiro za matenda ashuga, mwachitsanzo, nephropathy kapena retinopathy.

Pokhapokha ngati pakuchitika opareshoni, ndimatha kulankhula za mpumulo wa zovuta za matenda ashuga komanso mawonetseredwe a nephropathy. Pankhaniyi, kupatsirana kuyenera kukhala munthawi yomweyo kapena motsatizana. Njira yoyamba imakhudzanso kuchotsa ziwalo kuchokera kwa wopereka m'modzi, ndipo chachiwiri - kupatsirana kwa impso, kenako kapamba.

Nthawi yotsika ya kulephera kwa impso imayamba kukhala mwa iwo omwe amadwala matenda a shuga omwe amadalira insulin zaka 20-30 zapitazo, ndipo pafupifupi odwala ali ndi zaka 25 mpaka 45.

Funso la njira yoyenera yothandizira opaleshoni silinathetsedwe kwina, chifukwa mikangano yokhudza kupatsirana pamodzi kapena kwazomwe zakhala zikuchitika kwanthawi yayitali.

Malinga ndi ziwerengero komanso kafukufuku wa zamankhwala, kugwira ntchito kwa chiopsezo cha pancreatic pambuyo pa opaleshoni ndikwabwino kwambiri ngati ndikuwonjezera munthawi yomweyo. Ichi ndichifukwa chochepa kwambiri chomwe chingakanidwe ndi ziwalo.

Komabe, ngati tilingalira kuchuluka kwa kupulumuka, ndiye mu nkhani iyi kupatsirana kotsatana kudzachitika, komwe kumatsimikiziridwa ndi kusankha mosamala odwala.

Chifukwa chakuti chisonyezo chachikulu chokomera anthu ena chitha kukhala chiwopsezo chovuta cha zovuta zachiwiri, ndikofunikira kuwonetsa kuneneratu. Yoyamba mwa izi ndi proteinuria.

Pakuwoneka kwa proteinuria yokhazikika, ntchito yaimpso imangosachedwa, komabe, njira yofananira imatha kukhala ndi mitengo yosiyanasiyana yotukuka.

Monga lamulo, theka la odwala omwe adapezeka kuti ali ndi gawo loyambirira la proteinuria yokhazikika, patatha zaka pafupifupi 7, kulephera kwa impso, makamaka, kwa siteji yodwala.

Malingana ndi mfundo imodzimodziyo, nephropathy, yomwe ikungopanga, iyenera kuwonedwa ngati kufalitsa koyenera kwa kapamba.

Mu magawo apambuyo pachitukuko cha matenda a shuga, omwe amadalira insulin, kutulutsa kwa chiwalo ndikosayenera.

Ngati pali ntchito yaimpso yochepetsedwa kwambiri, ndiye kuti kuchotsa njira ya m'matumbo a ziwalozi kuli kovuta.

Malo otsika omwe angathe kugwira ntchito ya impso ya munthu wodwala matenda ashuga ayenera kuganiziridwa kuti ndiomwe amachititsa kusefedwa kwa 60 ml / mphindi.

Ngati chisonyezo chiri pansipa, ndiye kuti titha kulankhula za mwayi wokonzekera kuphatikizika kwa impso ndi kapamba.

Ndi kusefukira kwa glomerular kosaposa 60 ml / min, wodwalayo ali ndi mwayi wofunikira wokhala wolimba wamtundu wa impso. Pankhaniyi, kuphatikiza kumodzi kokha kapamba ndikoyenera.

M'zaka zaposachedwa, kupandukira kwa pancreatic kwakhala kugwiritsidwa ntchito pazovuta za matenda a shuga omwe amadalira insulin. Zikatero, tikulankhula za odwala:

omwe ali ndi matenda a shuga
shuga mellitus ndi kusakhalapo kapena kuphwanya kusintha kwa mahomoni a hypoglycemia,
amene amakana subcutaneous makonzedwe a insulin osiyanasiyana mayamwidwe.

Ngakhale powona kuwopsa kwa zovuta komanso kusapeza bwino komwe kumayambitsa, odwala amatha kukhalabe ndi vuto laimpso ndikuthandizidwa ndi SuA.

Pakadali pano, chithandizo mwanjira imeneyi chachitika kale ndi odwala angapo ochokera pagulu lirilonse lomwe akuwonetsa. Munthawi zonsezi, kusintha kwakukulu kwakanenedwa mu thanzi lawo. Palinso milandu yokhudza kupindikiza kwa kapamba pambuyo pancreatectomy yathunthu yomwe imayambitsidwa ndi chifuwa chachikulu. Ntchito za Exo native ndi endocrine zabwezeretseka.

Iwo omwe adapulumuka pakufalikira kwa kapamba chifukwa cha retinopathy yomwe ikupita patsogolo sanathe kusintha mikhalidwe yawo. Nthawi zina, kusinthanso kunadziwikanso.

Amakhulupirira kuti kuchitika kwakukulu kungachitike ngati opaleshoni itachitidwa koyambirira kwa maphunziro a shuga, chifukwa, mwachitsanzo, zizindikiro za matenda ashuga za azimayi zimatha kupezeka mosavuta.

Cholepheretsa chachikulu pakuchita opaleshoni ndiyomwe imakhala ndi zotupa pamene zilonda zam'mimba zilipo mu thupi zomwe sizingatheke kukonza komanso psychoses.

Matenda aliwonse omwe ali pachimake ayenera kuti adachotsedwa ntchito isanachitike.

Izi zikugwirizana ndi milandu pomwe matendawa amayambitsidwa osati ndi matenda a shuga okha, komanso tikulankhula za matenda omwe ali ndi matenda opatsirana.

Irina, wazaka 20, ku Moscow: “Kuyambira ndili mwana ndinkafuna kuchira matenda ashuga, jakisoni wambiri wa insulin akusokoneza moyo wanga. Nthawi zingapo ndinamva za kuthekera kwa kuponyera zikondwerero, koma sizinatheke kudziunjikira ndalama zogwirira ntchito, kuwonjezera apo, ndinadziwa za zovuta zopeza wopereka. Madokotala andilangizira kuti ndichotsekeredwe kapamba kuchokera kwa mayi anga. Maola ochepa atachitidwa opareshoni, shuga m'magazi abwerera mwakale, ndakhala popanda jakisoni kwa miyezi inayi. ”

Sergei, wazaka 70, wa ku Moscow, dokotala wochita opaleshoni: "Ntchito zakuthira ma pancreatic zimaperekedwa kwa iwo omwe samathandizidwa ndi njira zachikhalidwe. Amawafotokozera wodwala aliyense kuti jakisoni wa insulini ndiwotetezeka kusiyana ndi kufalikira kwa ziwalo. Munthu ayenera kudziwa kuti pambuyo pa opareshoni pakubwera nthawi yovuta yopanga ziwalo zopereka, chifukwa chake ndikofunikira kugwiritsa ntchito ma immunosuppressants omwe amaletsa kukanidwa kwa ziwalo. Ndikofunika kumwa mankhwala osokoneza bongo omwe amawononga thupi lonse. ”