Matenda a shuga ndi kapamba wamafinya > Chithandizo ndi kupewa

Zilumba za kapamba, zomwe zimadziwikanso kuti zisumbu za Langerhans, ndi timagulu tating'onoting'ono tamaselo tomwe timabalalika mosiyanasiyana kapamba. Chikondamoyo ndi chiwalo chokhala ndi mawonekedwe a kutalika kwa 15-20 cm, omwe amakhala kumbuyo kwa m'mimba.

Zilumba za pancreatic zimakhala ndi mitundu ingapo ya maselo, kuphatikiza ma cell a beta omwe amapanga insulin. Zikondazo zimapanganso ma enzyme omwe amathandizira kugaya chakudya komanso kuthira chakudya.

Mitsempha yamagazi ikakwera pambuyo kudya, zikondamoyo zimayankha ndikutulutsa insulin m'magazi. Insulin imathandizira maselo mthupi lonse kuyamwa glucose m'magazi ndikuigwiritsa ntchito kuti ipange mphamvu.

Matenda a shuga amapezeka pamene kapamba satulutsa insulin yokwanira, maselo a thupi sagwiritsa ntchito timadzi tambiri tomwe timagwira bwino ntchito kapena pazifukwa zonsezi. Zotsatira zake, glucose amadziunjikira m'magazi, ndipo samatengedwa ndi maselo amthupi.

Mtundu woyamba wa matenda ashuga, maselo a pancreatic beta amaletsa kupanga insulini, chifukwa chitetezo cha mthupi chimazunza ndikuziwononga. Chitetezo cha mthupi chimateteza anthu ku matenda mwa kuzindikira ndi kuwononga mabakiteriya, ma virus ndi zinthu zina zomwe zingakhale zowopsa zakunja. Anthu omwe ali ndi matenda a shuga a mtundu woyamba ayenera kumwa insulin tsiku lililonse.

Type 2 shuga mellitus nthawi zambiri amayamba ndi matenda otchedwa insulin, pomwe thupi limalephera kugwiritsa ntchito bwino insulin. Popita nthawi, kupangika kwa timadzi timeneti kumachepanso, kotero odwala ambiri omwe ali ndi matenda amtundu wa 2 m'kupita kwa nthawi adzayenera kulandira insulin.

Kodi kuyambitsidwa ndi ma pancreatic ndi chiyani?

Pali mitundu iwiri ya kusamutsa (kufalikira) kwa ma isanc pancreatic:

Kugawidwa kwa magawo onse a Langerhans ndi njira yomwe zigawo zochokera ku zikondwerero za wakufayo zimatsukidwa, kukonzedwa ndikugulitsa kwa munthu wina. Pakadali pano, kuchuluka kwa ma pancreatic islets ndi njira yoyesera, popeza ukadaulo wawo wogulitsa sunakhale wopambana mokwanira.

Pa gawo lililonse lanyumba, asayansi amagwiritsa ntchito ma enzymes apadera kuti awachotsere kapamba ka munthu amene wamwalira. Kenako timisamba timatsukidwa ndikuwerengedwa mu labotale.

Mwawamba, olandila amalandila kawiri-kawiri, uliwonse uli ndi zilumba 400,000 mpaka 500,000. Pambuyo podzilowetsa, maselo a beta a ma isles awa amayamba kupanga ndikupanga insulin.

Langerhans islet allotransplantation imapangidwa kwa odwala omwe ali ndi matenda amtundu wa 1 omwe samayendetsa bwino magazi. Cholinga cha kuziika ndikuthandizira odwala kuti azitha kukhala ndi glucose wambiri malinga ndi jakisoni wa tsiku ndi tsiku kapena wopanda jakisoni.

Chepetsani kapena muchepetse chiopsezo cha hypoglycemia wosazindikira (mkhalidwe wowopsa momwe wodwalayo samadziona nawo chizindikiro cha hypoglycemia). Munthu akamaona njira ya hypoglycemia, amatha kuchita zambiri pokweza shuga m'magazi kuti azichita bwino.

Pancreatic islet allotransplantation imachitika kokha mu zipatala zomwe zalandira chilolezo chakuyesedwa kwamankhwala mwanjira iyi. Zogulitsa zimachitika nthawi zambiri ndi akatswiri a radiology - madokotala omwe amakhazikika pakulingalira kwamankhwala.Katswiri wama radiology amagwiritsa ntchito ma x-ray ndi ma ultrasound kuwongolera kuyika kwa catheter yosinthika kudzera pakayang'anidwe kakang'ono khoma lakum'mimba mu khomo lachiwindi la chiwindi.

Mitsempha ya portal ndi chotengera chachikulu cha magazi chomwe chimanyamula magazi kupita ku chiwindi. Zilumbazo zimayendetsedwa pang'onopang'ono m'chiwindi kudzera mu catheter woyikidwa mu portal mtsempha. Monga lamulo, njirayi imachitidwa pansi pa opaleshoni wamba.

Odwala nthawi zambiri amafunika kumuwonjezera kawiri kapena kupitilira apo kuti akwaniritse ntchito yaying'ono kuti athetse kapena kuthetsa kufunika kwa insulini.

Pancreatic islet autotransplantation imachitika pambuyo pancreatectomy kwathunthu - opaleshoni yochotsa matenda onse a kapamba - odwala omwe ali ndi chifuwa chachikulu kapena cha nthawi yayitali kapamba, yemwe samatha kudziwa njira zina zamankhwala. Njirayi siziwoneka ngati yoyesa. Langenhans islet autotransplantation sizichitika mwa odwala omwe ali ndi matenda a shuga 1.

Mchitidwewu umachitika mu chipatala pansi pa opaleshoni yotupa. Choyamba, dokotalayo amachotsa kapamba, pomwe ma zipu zikuluzikuluzo amaziwachotsa. Patangotha ola limodzi, zisumbu zoyeretsedwa zimayambitsidwa kudzera mu catheter m'chiwindi cha wodwalayo. Cholinga cha kufalikira kotero ndikupereka thupi ndi malo okwanira a Langerhans kuti apange insulin.

Chimachitika ndi chiani pambuyo pochulukitsidwa kwa ma pancreatic islets?

Zisumbu za Langerhans zimayamba kutulutsa insulin posachedwa kufalikira. Komabe, kugwira ntchito kwawo kokwanira komanso kukula kwa mitsempha yatsopano ya magazi kumatenga nthawi.

Othandizira ayenera kupitiliza jakisoni wa insulin ntchito isanayambe. Angathenso kukonzekera mwapadera isanachitike komanso ikatha zomwe zimathandizira pakukonzekera bwino komanso magwiridwe anthawi yayitali a zisumbu za Langerhans.

Komabe, kuyankha kwa autoimmune komwe kumawononga khungu la eni ake a beta kukhozanso kuukira zisumbu zomweaziyika. Ngakhale chiwindi ndi malo achikhalidwe operekera kulowetsedwa, asayansi akufufuza malo ena, kuphatikiza minofu ya minofu ndi ziwalo zina.

Kodi maubwino ndi zovuta za pancreatic islet allotransplantation ndi ziti?

Ubwino wa Langerhans islet allotransplantation umaphatikizanso kuwongolera kwa shuga wamagazi, kuchepetsedwa kapena kuthetsa jakisoni wa insulin, komanso kupewa hypoglycemia. Njira ina yothanirana ndi ma pancreatic isp ndi ma transplanc ose, omwe nthawi zambiri amachitika ndi kupatsirana kwa impso.

Ubwino wakuza kanyengoyi sikungodalira insulini komanso kugwira ntchito nthawi yayitali. Choipa chachikulu cha kufalikira kwa kapamba ndikuti ndi ntchito yovuta kwambiri yokhala ndi chiopsezo chazovuta zambiri ngakhale kufa.

Pancreatic islet allotransplantation ingathandizenso kupewa hypoglycemia wosazindikira. Kafukufuku wa asayansi awonetsa kuti ngakhale magawo omwe amagwira ntchito pang'ono atatha kupatsidwa amatha kupewa izi zowopsa.

Kupititsa patsogolo kayendedwe ka shuga m'magazi kudzera mu islet allotranspgement kumatha kuchepetsanso kapena kulepheretsa kukula kwa mavuto okhudzana ndi matenda a shuga, monga mtima ndi matenda a impso, mitsempha ndi vuto la maso. Kafukufuku akupitiliza kufufuza izi.

Zoyipa za pancreatic islet allotransplantation zimaphatikizapo zoopsa zomwe zimakhudzana ndi njiridwe imodzimodzi - makamaka, magazi kapena thrombosis. Zisumbu zogulitsa zitha kusiya pang'ono kapena kusiya kugwira ntchito.Ziwopsezo zina zimakhudzana ndi mavuto obwera chifukwa cha mankhwala a immunosuppress omwe odwala amakakamizidwa kuti ateteze chitetezo cha mthupi kuti chokana ma islets omwe adaika.

Ngati wodwalayo ali kale ndi impso yolowererapo ndipo akumwa kale mankhwala a immunosuppress, zoopsa zokhazokha zimayambitsa kulowetsedwa ndi zotsatira zoyipa za mankhwala a immunosuppress omwe amaperekedwa panthawi ya kuchuluka. Mankhwalawa safunikira kuti munthu azingokhala nawo mthupi lake, chifukwa maselo omwe amalowetsedwa amatengedwa m'thupi la wodwalayo.

Kodi kupindulitsa kwa zisumbu za Langerhans ndi kotani?

Kuyambira 1999 mpaka 2009 ku United States, allotransplantation of pancreatic islets inachitika kwa odwala 571. Nthawi zina, njirayi inkachitika molumikizana ndi kuphatikizira impso. Odwala ambiri amalandira inflet imodzi imodzi kapena ziwiri. Pakutha kwa zaka khumi, anthu ochepa kwambiri omwe amapezeka nthawi imodzi ndi 463,000.

Malinga ndi ziwerengero, chaka chatha kuchoka, pafupifupi 60% ya omwe adalandira adalandira ufulu kuchokera ku insulin, zomwe zikutanthauza kuti kuyimitsa jakisoni wa insulin kwa masiku osachepera 14.

Pakutha kwa chaka chachiwiri pambuyo pakuwonjezera, 50% ya omwe adalandira amatha kuyimitsa jakisoni kwa masiku osachepera 14. Komabe, kudziyimira pawokha kwa t-insulin kumakhala kovuta kusamalira, ndipo pamapeto pake ambiri mwa odwala adakakamizidwa kuti atengerenso insulin.

Zomwe zimaphatikizidwa ndi zotsatira zabwino kwambiri zamalumikizidwe zidadziwika:

Zaka - zaka 35 ndi okulirapo.
Ochepetsa kuchuluka kwa triglycerides m'mwazi musanaikidwe.
Mlingo wotsika wa insulin musanaikidwe.

Komabe, umboni wa asayansi ukusonyeza kuti ngakhale magawo ochepa ophatikizika a Langerhans amatha kusintha kayendedwe ka shuga m'magazi komanso kuchepetsa insulin.

Kodi ma immunosuppressants ndi chiyani?

Mankhwala a Immunosuppress amafunika kupewa kukanidwa, lomwe ndi vuto lodziwika pazilichonse.

Asayansi akwanitsa kuchita bwino pantchito yakuchotsa zilumba za Langerhans m'zaka zaposachedwa. Mu 2000, asayansi aku Canada adasindikiza protocol yawo (Edmonton Protocol), yomwe yasinthidwa ndi malo azachipatala ndi kafukufuku padziko lonse lapansi ndipo ikupitabe patsogolo.

Edmonton Protocol imayambitsa kugwiritsa ntchito mitundu yatsopano ya mankhwala a immunosuppressive, kuphatikizapo daclizumab, sirolimus ndi tacrolimus. Asayansi akupitiliza kukonza ndikusintha ma protocol awa, kuphatikizapo njira zabwino zochizira zomwe zimathandizira kuwonjezera kupambana. Izi ziwembu m'malo osiyanasiyana zitha kukhala zosiyana.

Zitsanzo za ma immunosuppressants ena omwe amagwiritsidwa ntchito ku Langerhans islet transplantation monga antithymocyte globulin, belatacept, etanercept, alemtuzumab, izvozviximab, everolimus, ndi mycophenolate mofetil. Asayansi akufufuzanso mankhwala omwe si a gulu la ma immunosuppressants, monga exenatide ndi sitagliptin.

Mankhwala a Immunosuppress ali ndi zovuta zoyipa, ndipo zotsatira zake zazitali sizimamvetsetseka kwenikweni. Zotsatira zoyipa zapompopompo zimaphatikizapo zilonda zam'mlomo komanso mavuto am'mimba (monga m'mimba ndikukwiyitsidwa). Odwala atha kukhala:

Kuchuluka magazi cholesterol.
Kuthamanga kwa magazi.
Anemia (kuchepa kwa maselo ofiira am'magazi ndi hemoglobin m'magazi).
Kutopa
Anachepetsa magazi oyera.
Ntchito yeniyeni.
Kuchulukana kwadzaoneni kumatenda a bacteria ndi ma virus.

Kutenga ma immunosuppressants kumawonjezeranso mwayi wokhala ndi zotupa ndi khansa.

Asayansi akupitilizabe kupeza njira zololera chitetezo cha mthupi kuti chisalemo malo ena, momwe chitetezo chamthupi sichizindikira kuti ndi alendo.

Kulekerera kwakukulu kungathandizire kugwiritsidwa ntchito kwa magawo obwezeretsedwa popanda kumwa mankhwala a immunosuppress. Mwachitsanzo, njira imodzi ndikutsitsa ma islets omwe amangidwa mu kupikika kwapadera komwe kungathandize kupewa kukana.

Kodi ndi zovuta ziti zomwe zikupangika kuti ma pancreatic islets azikumana?

Kuperewera kwa opereka oyenera ndikutchinga lalikulu pakugwiritsidwira ntchito kwa ziwengo zambiri za zisumbu za Langerhans. Kuphatikiza apo, siopereka onse opereka omwe ali oyenera kuchotsedwa kwa islet, chifukwa samakwaniritsa njira zonse zosankhira.

Tiyeneranso kukumbukiranso kuti pokonzekera ma islets kuti achiwike, nthawi zambiri amawonongeka. Chifukwa chake, zosowa zochepa kwambiri zimachitika chaka chilichonse.

Asayansi akuphunzira njira zosiyanasiyana kuti athane ndi vutoli. Mwachitsanzo, gawo lokhalo la kapamba wochokera kwa wopereka wamoyo ndi lomwe limagwiritsidwa ntchito; ma pancreatic islets a nkhumba amagwiritsidwa ntchito.

Asayansi adasinthanitsa nkhumba zazingwe ku nyama zina, kuphatikiza anyani, ndikuzitsekera m'chipewa chapadera kapena kugwiritsa ntchito mankhwala kuti zisakanidwe. Njira ina ndikupanga ma maslets kuchokera m'maselo amtundu wina - mwachitsanzo, kuchokera ku maselo a tsinde.

Kuphatikiza apo, zopinga zachuma zimalepheretsa anthu ambiri kupeza. Mwachitsanzo, ku United States, ukadaulo wopanga umaonedwa ngati woyesera, umawonedwa ngati ndalama, chifukwa inshuwaransi siifotokoza njira ngati izi.

Zakudya Zabwino Komanso Zakudya

Munthu yemwe adayatsidwa masisamba a pancreatic ayenera kutsatira zakudya zopangidwa ndi madokotala ndi akatswiri azakudya. Mankhwala a Immunosuppression omwe atengedwa pambuyo pakuwonjezera angayambitse kulemera. Chakudya chopatsa thanzi ndichofunikira pakuwongolera kunenepa kwa thupi, kuthamanga kwa magazi, cholesterol yamagazi, komanso kuchuluka kwa shuga m'magazi.

Matenda a shuga

Matenda a shuga amadziwika kuti ndi mliri wa zaka za zana la 21 lino. Malinga ndi ziwerengero, kuchuluka kwa odwala ndi 8,5% mwa odwala akuluakulu. Mu 2014, odwala 422 miliyoni adalembetsa, poyerekeza, mu 1980 chiwerengero cha odwala chinali miliyoni 108. Matenda a shuga ndi matenda omwe amafalikira mofulumira kwambiri, omwe amapitilira kunenepa kwambiri.

Kukula kwa matenda am'mimba kumayambira ndikusokoneza dongosolo la endocrine. Nthawi yomweyo, zomwe zimayambitsa matenda ashuga sizikudziwika bwinobwino. Komabe, pali zinthu zambiri zomwe zimawonjezera chiopsezo chotenga matendawa: jenda, zaka, cholowa, kunenepa kwambiri, kubereka zam'mimba, ndi zina zambiri.

Mitundu iwiri yayikulu ya matendawa imadziwika - mtundu woyamba (wodalira insulini) ndi wachiwiri (wosadalira insulini).

Mtundu woyamba wa matenda a shuga umapezeka kwambiri ali mwana. Matendawa amadziwika ndi kusiyanasiyana kwathunthu kwa kupanga kwa insulini ndi kapamba, mahomoni omwe amatulutsa shuga m'magazi. Pankhaniyi, mankhwala a insulin amasonyezedwa - jekeseni wa insulin nthawi zonse.

Mtundu wachiwiri wa matendawa umapezeka wazaka 40-45. Monga lamulo, chifukwa cha kunenepa kwambiri kapena chifukwa cha kutengera kwa chibadwa, insulin imasiya kulowa m'maselo a chandamale, chifukwa amayamba kuyankha molakwika. Njirayi imatchedwa insulin kukana. Zotsatira zake, kapamba wam'mimba amatha ntchito ndipo sangathe kupanga kuchuluka kofunikira kwa kutsitsa kwa shuga. Ndi matenda apanthawi yake, shuga amatha kuyang'aniridwa popanda kugwiritsa ntchito mankhwala, chifukwa ndikokwanira kutsata zakudya zoyenera komanso kuchita masewera olimbitsa thupi.Pazinthu zapamwamba kwambiri, muyenera kumwa mapiritsi a hypoglycemic kapena jakisoni wa insulin.

Zizindikiro zazikulu za matendawa ndi polyuria ndi ludzu lalikulu. Izi zimalumikizana ndi ntchito ya kwamikodzo dongosolo. Mafuta ochulukirapo amachotsedwanso ndi impso, ndipo chifukwa cha izi amafunikira madzi ambiri, omwe amachotsedwa m'matumbo. Zotsatira zake, munthu amayamba kumwa madzi ambiri ndikuyendera kuchimbudzi pafupipafupi. Komanso, wodwala matenda ashuga amatha kumva zotsatirazi:

kulira kummunsi ndi kumtunda kwamiyendo,
kutopa kwambiri, kuchepa kwa ntchito,
kuwonongeka kwamawonekedwe,
dzanzi m'manja ndi m'miyendo,
mutu ndi chizungulire,
kugona, kugona tulo,
chilonda chachitali.

Kuphatikiza apo, matenda apakhungu angachitike.

Opaleshoni yamatenda a shuga: mtengo wopatsirana

Mtundu woyamba wa shuga ndi matenda omwe amadalira insulin komanso mtundu wofala kwambiri padziko lonse lapansi.

Malinga ndi ziwerengero zamankhwala, masiku ano padziko lapansi pali odwala pafupifupi mamiliyoni 80 omwe ali ndi matenda amtunduwu. Munthawi imeneyi, pali malingaliro omwe akupitilira kukuwonjezereka kwa odwala omwe akudwala matenda a shuga.

Akatswiri odziwa ntchito zamankhwala pakadali pano ali ndi vuto la kuthana ndi zovuta zomwe zimachitika chifukwa cha matendawo.

Kanema (dinani kusewera).

Ngakhale atapita patsogolo kwambiri pochiza matenda ashuga, mavuto amabwera omwe amakhudzana ndi kuwoneka kwa zovuta pakukula kwa matenda a shuga 1, omwe angafunike kupatsirana kwa kapamba.

Malinga ndi ziwerengero zamankhwala, anthu odwala matenda a shuga amadzidalira, nthawi zambiri kuposa ena:

khalani akhungu
kudwala matenda a impso,
funafunani thandizo pochiza matenda osokoneza bongo,
Funafunani chithandizo mankhwalawa pakukhudza mtima ndi mtima.

Kuphatikiza pa mavutowa, zidapezeka kuti nthawi yayitali yomwe anthu amakhala ndi matenda ashuga omwe ali ndi mtundu woyamba wa shuga ndi pafupi 30% kufupikira kuposa anthu omwe alibe matendawa komanso samadwala matenda a shuga okwanira.

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

Kusakwanira kogwiritsa ntchito mankhwala othandizira m'malo mwa mankhwalawa kumachitika 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 machitidwe omwe amatsekera ma metabolic amalephera.

Nthawi zina, atachitidwa opaleshoni, pamakhala zotheka kukwaniritsa zovuta zomwe zimayambitsidwa chifukwa cha mtundu wa matenda a shuga 1 kapena kusiya kufalikira kwawo.

Pancreatic kupatsirana shuga. Maopaleshoni awa ndiowopsa. Opaleshoni nthawi zambiri imagwiritsidwa ntchito ngati njira zina zothandizira sizili zokwanira. Zithandizo zoterezi zimachitika pamavuto osiyanasiyana aumisili ndi gulu pankhani yamakhalidwe.

Muzochita zachipatala, njira zamakono zopewera matendawa zimasiyanitsidwa.

Njira zochizira Hardware.
Opaleshoni yamapamba.
Kutumiza kwa kapamba.
Pancreatic islet transplantation.

Chifukwa chakuti mu diabetes matenda a shuga ndikotheka kuzindikira kusintha kwa kagayidwe kachakudya komwe kamachitika chifukwa cha kusintha kwachilengedwe kwa maselo a beta, chithandizo cha matenda a pathology chidzakonzedweratu ndi njira yolandirira mashopu a Langerhans.

Mankhwala othandizira opaleshoni iyi amathandiza kuthetsa kusakhazikika mu zochitika za metabolic kapena kutsimikizira kupangika kwakanthawi mobwerezabwereza kwa chiwonetsero cha matenda a shuga, omwe ali ndi shuga, mosasamala mtengo wa opereshoni.

Mu shuga, chisankho ichi chimakhala ndi maziko.

Ma cell a islet a thupi sangathe kukhala kwa nthawi yayitali kuti akhale ndi vuto pakulimbitsa kagayidwe kazakudya kwa odwala. Chifukwa chake, zida zogwirizira m'malo mwa zisumbu za Langerhans za opereka zimagwiritsidwa ntchito, momwe ntchito zawo zimasungidwa mpaka pazokwanira. Zodabwitsazi zikuyembekeza kupezeka kwa zochitika za standardoglycemia ndi gawo lina lama metabolic metabolism.

Nthawi zina, zimatheka kukwaniritsa kupangika komwe kumachitika chifukwa cha matenda ashuga kapena kuwaletsa.

Kuphatikizika kwa pancreatic mu matenda ashuga ndi njira yowopsa, chifukwa zotere zimachitika pokhapokha kwambiri.

Pancreatic organ transplantation nthawi zambiri amathandizira anthu omwe ali ndi matenda amtundu wa 1 komanso 2nd yomwe ili ndi vuto lachiwonetsero lomwe likuwoneka kale wodwalayo asanayambe kukumana ndi zovuta zosasintha monga:

retinopathy ndi kutayika kwathunthu kwa kuwona
Matenda a zombo zazikulu komanso zazing'ono,
mitsempha
nephropathy,
kutsika kwa endocrine.

Kuphatikizika kwa gland kumachitikanso pamaso pa matenda a matenda ashuga omwe amayamba chifukwa cha matenda a kapamba, omwe adayamba kusokonekera kwa kapamba mu gawo lachiwopsezo komanso kapangidwe konyansa.

Nthawi zambiri zomwe zimayatsidwa ndi hemochromatosis, komanso kusamva bwino kwa wolakwayo.

Nthawi zina, kufalitsa matenda a shuga kumayambitsa odwala omwe ali ndi matenda angapo a matenda am'mimba.

Necrosis ya pancreatic minofu.
Kuwonongeka kwa England ndi chotupa mapangidwe a chosaopsa kapena koopsa maphunziro.
Chochulukitsa chotupa cha purulent mu peritoneum, chomwe chimatsogolera pakukula kwa zowonongeka zazikulu za kapamba, zomwe sizimayankha chilichonse chamankhwala.

Nthawi zambiri, ndikuwoneka kuti kuchepa kwa impso, wodwalayo, limodzi ndi chikhodzodzo ndikuthira, amafunikanso opaleshoni ya impso yomwe imachitika nthawi yomweyo ndi kapamba.

Kuphatikiza pazowonetsa, kufalikira kwa kapamba sikungatheke pazifukwa zosiyanasiyana.

The kupezeka ndi mapangidwe neoplasms chotsika kumene.
Matenda a mtima, omwe amadziwika ndi kuperewera kwamphamvu kwa mtima.
Mavuto a shuga.
Kukhalapo kwa mapapu pathologies, sitiroko, matenda opatsirana.
Kusuta kwa mowa, mankhwala osokoneza bongo.
Zovuta za mawonekedwe owopsa amisala.
Zofooka zoteteza thupi.
Edzi

Chithandizo cha opereshoni ndikotheka ngati mkhalidwe wa wodwalayo uli wokhutiritsa. Kupanda kutero, pali ngozi ya kufa.

Asanazindikire kuthekera kwa kuchitapo kanthu pochita opareshoni ndi milandu yokhudza kumuika, mayeso angapo amachitika. Kafukufukuyu akuphatikiza njira zotsatsira izi:

kusanthula kwamtundu wamagazi,
compression tomography,
electrocardiogram
kuyezetsa magazi pamlingo wama biochemical,
ma diagnostics a ultrasound a minofu yamtima, peritoneum,
kuchuluka kwa magazi,
mkodzo ndi kusanthula magazi,
kuphunzira zama antijeni othandizira minofu,
X-ray ya sternum.

Wodwalayo adzafunika kumuyesa kwathunthu ndi wochiritsa, dokotala wa opaleshoni, gastroenterologist. Nthawi zina mumafunika kukayezetsa ndi madotolo otere:

Chifukwa chofufuza kwathunthu, ndikotheka kuzindikira zomwe zikuwopseza kukana chiwalo chomwe chiikidwa. Ngati zisonyezo zonse zomwe zimaperekedwa munthawi yowunikira ndizabwinobwino, ndiye kuti madotolo amakonzekera kuthana ndi kapamba ndikuyang'ana wopereka.

Kuchulukitsa kwa minofu kumachitika mwa munthu wamoyo ndipo wina yemwe ubongo wake unadziwika kuti wamwalira.

Kutengera zotsatira za mayesowo, thanzi lathunthu, komanso momwe zimapwetekera bwino, adotolo amasankha njira yochotsera kapamba.

Kuchita opaleshoni kumaphatikizapo kufalikira chiwalo chonse.
Thirani mchira kapena kanthu kena ka nyemba.
Ndikofunikira kuthetsa chiwalo ndi gawo la duodenum.
Jekeseni wambiri wamaselo a Langerhans.

Mukamaika zikondamoyo zonse, tengani ndi gawo la duodenum 12. Komabe, ndulu imatha kulumikizidwa ndi matumbo ochepa kapena chikhodzodzo. Ngati kachigawo kakang'ono kokha ka kapamba ndiye kuwayika, ndiye kuti kulowererapo kuli ndi kuchotsedwa kwa madzi a pancreatic. Kuti muchite izi, gwiritsani ntchito njira ziwiri.

Kuletsa njira yopanga pogwiritsa ntchito neoprene.
Kuchotsa kwa madzi a limba m'mimba laling'ono kapena chikhodzodzo. Madziyu akamalowetsedwa mu chikhodzodzo, chiopsezo chotenga matenda amachepetsa.

Kuyika kapamba, monga impso, kumachitika mu iliac fossa. Njirayi ndi yovuta komanso yayitali. Nthawi zambiri opareshoni imachitika pochita opaleshoni, yomwe imachepetsa chiopsezo cha zovuta zazikulu.

Zimachitika kuti amadzakhazikitsa chubu cha msana, chifukwa chomwe mankhwala ochita kupanga amatha kupatsirana pambuyo pakuthana kuti athetse vuto.

Opaleshoni mankhwala a gland m'magawo:

Wopereka amapatsidwa mankhwala oletsa kupweteka kudzera mu mtsempha wamaberekero, ndiye kuti njira yotsekerera imagwiritsidwa ntchito.
Kenako, chiwalocho chimachotsedwa ndikuwakhazikika ndi yankho lozizira lamchere.
Chitani zomwe mwakonzekera.Wosanjidwa umapangidwa kwa wolandirayo, ndiye kuti chodyeka chathanzi kapena gawo linaikiridwanso m'dera laalal fossa.
Mitsempha, mitsempha ndi ngalande yolumikizira ziwalo zimaphatikizika m'magawo.

Wodwala akangosintha ntchito ya impso yolimbana ndi matenda a shuga, ndiye kuti kuchitanso kawiri konse kumatheka. Izi zikuwonjezera mwayi wazabwino.

Ndi kufalikira kopambana, wodwalayo amabwereranso ku metabolism yachilendo yamoto, motero, safunikira kupaka jekeseni pafupipafupi, kusintha mapiritsi a immunosuppressive. Kugwiritsa ntchito kwawo sikungalole kuti zikondamoyo zosinthidwa zikanidwe.

Mankhwala a Immunosuppressive amachitika ndi kugwiritsa ntchito mankhwala a 2-3 omwe ali ndi njira ina yochitira.

Monga njira ina iliyonse yothanirana ndi mavutowa, kumizidwa kumatha kupangitsa kuti matenda ashuga, omwe mankhwala ake sangathetse vutoli.

Mapangidwe azinthu zopatsirana mu peritoneum.
Kukhalapo kwa madzimadzi pagulu lazinthu zolocha.
Kukula kwa magazi m'magawo osiyanasiyana mwamphamvu.

Zimachitika kuti kukana kwa zinthu zomwe zimasinthidwa kumachitika. Izi zikuwonetsa kupezeka kwa amylase mkodzo. Komanso izi zimapezeka ngati biopsy yachitika. Chitsulo chidzayamba kuchuluka. Kupenda kwa ultrasound kuli kovuta kuzindikira, chifukwa thupi lili ndi mbali zosavuta.

Kuthandizira pochita opaleshoni kumaphatikizapo kukonzanso kwa nthawi yayitali komanso kovuta kwa wodwalayo. Pakadali pano, mankhwala a immunosuppressive amamulembera, kuti limba limzike mizu.

Kodi zikondazo zimatha kuchiritsidwa pambuyo pothilidwa?

Malinga ndi ziwerengero, kupulumuka pambuyo pochulukitsidwa ndi kapamba kumachitika mu 80% ya odwala kwa nthawi yoposa 2 zaka.

Ngati kapamba adasinthidwa kuchokera kwa wopereka wathanzi, matendawo amawakonda kwambiri, ndipo pafupifupi 40% ya odwala amakhala ndi zaka zopitilira 10, ndipo 70% ya omwe amakhala zaka zosaposa 2.

Kukhazikitsidwa kwa maselo amthupi kudzera mu njira yolowerera kwatsimikizira kuti sikuchokera mbali yabwino kwambiri, njirayi tsopano ikukwaniritsidwa. Kuvuta kwa njirayi kukugona mu kuperewera kwa tinthu timeneti kuti titengemo kuchuluka kwa maselo.

Pancreatic kupatsidwa kwa shuga

Chimodzi mwazinthu zofunikira kwambiri mthupi la munthu ndi kapamba.

Ili m'matumbo am'mimba ndipo imagwira ntchito zingapo, zofunikira kwambiri ndizomwe zimapangidwira ma enzyme omwe amaphatikizidwa ndi kugaya (exocrine) ndikupanga mahomoni omwe amaphatikizidwa ndi kagayidwe ka chakudya. Zochita zolakwika za limba zimatha kuyambitsa zotsatira zoyipa kwambiri - kukhazikitsidwa kwa kapamba, matenda a shuga, komanso nthawi zina kufa. Nthawi zina, pazifukwa zosiyanasiyana, chitsulo chimaleka kukwaniritsa ntchito zake pang'ono kapena mokwanira, chifukwa chake funso limayamba kufalikira.

Pakadali pano, ntchito zogulitsa zimachitika m'maiko ambiri, zomwe zimatipangitsa kuti tizitha kufotokoza za kupitilizidwa kwa mankhwala munthawi imeneyi. Chimodzi mwazinthu zosinthira zikondwerero za matenda a shuga 1 zinapangidwa kale mu 1891, zomwe zinali zaka makumi atatu asanatulukidwe kwa insulin, komabe, opaleshoni iyi idachitika koyamba mu 1966 ku America.

Masiku ano, zamankhwala zachita mbali yofunika kwambiri pantchito yokhudza kufalikira kwa kapamba, chifukwa chogwiritsa ntchito cyclosporin A kuphatikiza ndi ma steroid.

Diagnosis, zikuwonetsa ndi contraindication opaleshoni

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 wazamankhwala komanso kufunsira kwa madokotala apadera kwambiri - dokotala wazachipatala, dokotala wa opaleshoni, opaleshoni ya mano, wazachipatala, wazachipatala ndi ena,
Kuyesa kwa Ultrasound kwa minofu yamtima, ziwalo zam'mimba, chifuwa cha x-ray, electrocardiogram, tomography yodziwika bwino,
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 yofanana ndi zochitika za anthu:

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 pa zomwe zikuwonetsa, pali zingapo zotsutsana momwe kumachitika kuponyera kapamba 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.

Ndikofunika kukumbukira kuti kufalitsa ma gland kumachitika pokhapokha ngati wodwalayo ali bwino komanso wathanzi. Kupanda kutero, pamakhala chiopsezo cha kufa kwa wodwalayo.

Kuthana kwa kapamba ndi kachitidwe ka opaleshoni kamodzikamodzi, cholinga chake ndikobwezeretsa chinsinsi cha insulin m'thupi.

Zomwe zimayambitsa opareshoni zimatha kukhala matenda ashuga omwe amapita patsogolo (okhala ndi vuto kapena kuwopseza aimpso) ndi zina zomwe gawo limasiya kugwira ntchito.

Pancreas ili ndi ntchito ziwiri zazikulu. Choyamba ndi kupangidwa kwa ma cell a ma cell ochulukitsa m'mimba omwe amadutsa mu njira ya chiwalo kupita ku duct wamba la duodenum. Pamenepo amagwira ntchito yofunika kwambiri pakupukusa mapuloteni ndi mafuta.

Katulutsidwe wamkati ndimapangidwe ovuta kwambiri omwe amakupatsani mwayi wolamulira kuchuluka kwa shuga m'thupi.

Chiwalo cham'mimba chimagwira ntchito yachinsinsi. Chifukwa cha kapangidwe kake.

Komabe, machitidwe othandizira pancreatic amachitidwa, popeza wodwala yemwe ali ndi matenda obwera chifukwa cha kupatsirana amatha kudzipatula pawokha pakufunika kowunikira kuchuluka kwa shuga komanso kugwiritsa ntchito insulin. Pakapita nthawi, pewani zovuta zazikulu, zowopsa.

Kwa madokotala ochita opaleshoni, kuchitidwa koteroko kumakhala kovuta kwambiri. Kapamba wamtunduwu amachokera mu ma mitsempha atatu:

chotupa chachikulu kwambiri,
chotupa cham'mimba,
gastro duodenal mtsempha wamagazi.

Ndi kufalikira kofanana kwa kapamba ndi impso, zimayikidwa m'chigawo cha m'chiuno, mkati mwa mafupa a iliac, ndipo mitsempha ya ziwalo zonse ziwiri imalumikizidwa ndi mitsempha yamkati yamkazi.

Makalata ochokera kwa Owerenga

Agogo anga akhala akudwala matenda a shuga kwa nthawi yayitali (mtundu 2), koma posachedwapa mavuto atuluka pamiyendo ndi ziwalo zamkati.

Mwangozi ndidapeza nkhani pa intaneti yomwe idapulumutsa moyo wanga. Zinali zovuta kuti ndione chizunzo, ndipo fungo loipa m'chipindacho linali kundiyambitsa misala.

Kupyolela pa zamankhwala, agogo aja adasinthanso momwe akumvera. Ananenanso kuti miyendo yake sikupweteka komanso zilonda zake sizinayende; sabata yamawa tidzapita ku ofesi ya dotolo. Falitsa ulalo wa nkhaniyo

Kupanikizika kwa kapamba kumachitika chifukwa cha matenda a shuga 1 kapena 2. Kutumiza kwa glandular chiwalo cham'mimba kachitidwe kake ndi njira yokhayo yochiritsira matenda a shuga masiku ano, omwe amatsogolera ku standardoglycemia popanda kufunika kwa insulin.

Kuphatikizika kwa kubwezeretsa kwa procrine ndi endocrine secretion ndi njira yovuta kwambiri, yomwe imayendetsedwa ndi chiwopsezo chachikulu.

Zomwe zimayambitsa kulowererapo zingakhale:

Momwe mungasungire shuga kukhala wabwinobwino mu 2019

kusintha kwa odwala matenda ashuga
Nthawi ya matendawa, pomwe mavuto amakula msanga omwe ungayambitse kulemala kwambiri, kapena kufa.

Chizindikiro chodziwika bwino ndi shuga ndi kulephera kwa impso. Wodwala amatenga mankhwala a insulin ndipo, nthawi yomweyo, amadzipukusa nthawi zonse. Pancreatic kupatsirana kwa odwala chotere kumachitika limodzi ndi impso, kapena pambuyo kupatsirana kwa impso. Izi zimapatsa wodwala matenda a shuga mwayi woti achire kwathunthu.

Odwala omwe sanakhalepo ndi impso zovuta za matenda ashuga, koma ndi zizindikiro zowonekera pancreatic insufficiency, amayenerera zomwe zimadziwika kuti zimagwira. Ngati chiwalo chovekedwa ndikuyenera chija ndikuika sichinakanidwe, ndiye kuti thanzi la wodwalayo lifika pamachitidwe ake:

safunika kumwa insulini,
amatha kubwerera ku moyo wabwinoko ndikugwira ntchito.

Amayi atatha kubereka bwino, ngakhale amafunika kugwiritsa ntchito ma immunosuppressants (pofuna kupewa kusintha kwa kusintha kwa zina), amatha kubereka ndi kubereka ana.

Zizindikiro zotsalira (ngakhale ndizosowa kwambiri) zosintha ndi:

extracorporeal kapamba kuchepa,
kapamba wamanyazi,
atachotsa khansa ya pancreatic, popanda kubwereza khansa.

Izi zimayambitsa kusowa kwa insulini komanso chizindikiro chachiwiri cha matenda ashuga (ndi zovuta zake zonse).

Kutumiza kwa glandular chiwalo cham'mimba kachitidwe kungathandizire kuteteza thupi komanso kagayidwe kazinthu. Zimakupatsaninso mwayi wolimbana ndi zovuta zowopsa, makamaka zoopsa kwambiri za hypo- ndi hyperglycemia, zomwe zimatha kuchitika ndi acidosis kapena kutsogoza kuperewera.

Mphamvu ya kufalikira kwa pancreatic pazinthu zowopsa zamatenda amtima komanso kuchedwa pakupanga zovuta zina zatsimikizidwanso.

Kupanikizika kwa pancreatic ndi chithandizo chothandiza kwa matenda ashuga. Ntchito yoyika ikhoza kuchitika m'njira zitatu zazikulu:

kufalikira kwa glandular palokha
kuphatikizika kwa kapamba limodzi ndi impso,
kupatsirana kwa kapamba pambuyo podziwitsidwa impso.

Kuthana kwa kapamba palokha (kotchedwa kupandukira kwina) kumachitika mwa odwala omwe ali ndi impso zomwe zimagwira ntchito, momwe kusinthika kwakukulu kwa glycemic kumawonedwera, ngakhale atalandira chithandizo chokwanira ndi insulin.

Vutoli limatha kudzetsa kukula kwa zovuta zazikulu za matenda ashuga, ndipo opaleshoni imaletsa izi.

Timapereka kuchotsera kwa owerenga tsamba lathu!

Komabe, kupatsirana kwa kapamba kumachitika kokha mwa odwala ena, chifukwa nthawi zambiri matenda a shuga amatha kuwononga impso ndikuyambitsa zovuta zina. Chifukwa chake, ndikofunikira kwambiri kupatsirana pamodzi kwa impso ndi kapamba. Ili ndiye mtundu wodziwika kwambiri wophatikizira shuga.

Mutha kupangitsanso kupanikizika ndi impso zomwe zinaikidwa kale, koma ziwalo zotere kuchokera kwa opereka awiri osiyanasiyana zimachepetsa mwayi wodwalayo.

Njira ina pamwambapa ndi kufalikira kwa magawo am'mimba kapamba. Chinsinsi cha njirayi ndi kufalikira kwa maselo opereka kudzera mu catheter. Komabe, njirayi siyothandiza kwenikweni poika chiwalo chonse.

Pancreatic transplantation (kuphatikiza kuphatikizika kwa impso) ndi njira yomwe ingathandize kuti wodwalayo azigwira ntchito moyenera popanda kufunika kwa insulin kapena dialysis yokhazikika.

Kuchita koteroko kumathandizira kupewa kutayika kwamaso, kudula miyendo ndi kusintha kwachiwiri. Chifukwa cha zomwe zakwaniritsidwa masiku ano, izi zimachitika mu 60-70% ya opareshoni.

Komabe, opaleshoni ndiyovuta kuchita, zovuta zimatheka. Zodziwika bwino ndi izi:

kutupa kwa chiwalo chogalitsidwapo (chifukwa cha ischemia kapena kugwiritsidwa ntchito mwamphamvu pakuchita opareshoni),
kuziika chiwalo necrosis (chifukwa cha thromboembolic zovuta mu mtima anastomoses),
kukanitsidwa kwina (komwe kungafunikire kufufuzidwa - kuchotsa ziwalo zothandizidwa),
magazi, matenda ndi fistulas ya postoperative.

Nthawi zina, zimatheka kuti kulumikizidwa bwino (popanda zizindikiro zakulephera) sikugwira ntchito yachinsinsi. Chifukwa chake, kuyenerera kwa wodwalayo chifukwa cha kupatsirana kwa pancreatic si ntchito yophweka. Zimafunikira kuyesa kwa wodwala payekha ndi akatswiri ambiri.

Chiwerengero cha zovuta ndizovuta kwambiri. Ngakhale m'malo omwe akatswiri odziwa bwino ntchito amagwira, zovuta zimadza mu 31-32% ya odwala. Maphunziro obwezeretsa pambuyo pa ntchito amatengera kusankha koyenera kwa woperekayo.

Zowopsa zomwe zimapangitsa wodwala kukhala ndi zovuta pambuyo pake:

Pafupifupi 10-20 peresenti ya zovuta za postoperative zimaphatikizira kupatsirana kwa thrombosis. Mu 70 peresenti, imapezeka mkati mwa masiku asanu ndi awiri atachitidwa opaleshoni (nthawi zambiri kuchotsa kwa chiwalo chofunikira).

Kuyamwa kumawerengedwa kuti ndi chimodzi mwazomwe zimayambitsa zovuta pambuyo pakuthana kwa ziwalo. Itha kuphatikizidwa ndi chotupa cha anastomosis, kutaya kwam'mimba, komanso magazi m'matumbo.

Kutupa kwa pancreatic nthawi zambiri kumachitika chifukwa cha kuwonongeka kwa ischemic komwe kumachitika chifukwa cha kupatsirana. Izi zitha kupitilira masabata atatu pambuyo pa opareshoni. Fistula yamkati - imakonda kupezeka miyezi itatu yoyambirira itadzilowetsa, imadziwonetsa pakumva kupweteka kwapakati pamimba. Odwala ambiri amafunikira chithandizo chamankhwala chofulumira.

Pakatha miyezi itatu atachitidwa opaleshoni, matenda amkati am'mimba amatha. Zomwe zimayambitsa ndizo:

ukalamba wa woperekayo,
ntchito kwa peritoneal dialysis musanaikidwe,
nthawi yayitali ischemia,
kutupa kwa kapamba ndi immunosuppression pogwiritsa ntchito sirolimus.

Intraperitoneal fungal matenda - kuonjezera postoperative kufa kwa odwala.

Musanagwiritse njira yonyamula chinsinsi cha kapamba, zinthu zimayang'aniridwa momwe ntchitoyo imayimbidwira:

zotupa zoyipa
patsogolo ischemic mtima,
mavuto amisala
chitetezo chofooka kapena matenda a Edzi,
kusintha kwasintha kwa atherosulinotic,
kupuma kwambiri kulephera,
matenda oyambitsidwa ndi mavairasi ndi bakiteriya omwe sangathe kuthandizidwa,
zaka (opaleshoni siyikulimbikitsidwa kwa anthu azaka zopitilira 45).

Cholepheretsa chachikulu pakuyambitsidwa ndi pamene pali khansa yoyipa m'thupi, komanso kusokonezeka kwamalingaliro. Matenda aliwonse omwe ali mu mawonekedwe owopsa ayenera kuthetsedwa asanachitidwe opareshoni.

Matenda a shuga nthawi zonse amayambitsa zovuta zakupha. Mwazi wamagazi ochulukirapo ndi woopsa kwambiri.

A Alexander Myasnikov mu Disembala 2018 adapereka chidziwitso chokhudza chithandizo cha matenda ashuga. Werengani kwathunthu

Pancreatic kupatsidwa kwa shuga

Njira ina yothandizira ndikusinthira kwa shuga. Kuchita opareshoni kumathandiza kuthetsa kudalira kwamasiku onse a insulin, chithandizo choterechi ndi chofunikira kwa odwala omwe ali ndi matenda amtundu wa 1, komabe, mtundu wa 2 ungawonetse zomwe zingachitike. Koma odwala amafunika kuti aziganizira zovuta zonse zomwe zingachitike chifukwa cha opaleshoni, komanso kuti nthawi zambiri chithandizo cha mankhwala kwa moyo wonse chimafunika kuti munthu akane.

Kupanikizika kwa pancreatic kumachitika kwa odwala omwe ali ndi zovuta zovuta za matenda oyambira. Mphengoyi ndi chiwalo chosalimba kwambiri ndipo kupatsirana kwake kumalumikizidwa ndi zoopsa zambiri komanso zovuta, chifukwa chake zimachitika pokhapokha pakufunika. Zisonyezero zogwiritsidwa ntchito ndi mitundu iyi:

kulephera kwambiri kwaimpso kapena kusinthira ku hemodialysis kwa odwala matenda a shuga,
kukhalapo kwa impso yolowetsa odwala omwe apezeka ndi matenda a shuga,
kusowa poyankha chithandizo cha insulin,
kwambiri mitundu ya chakudya chisokonezo.

Bwererani ku tebulo la zomwe zili

Muzochita zamankhwala, kupatsira kwathunthu kapena pang'ono kwapancreas kumagwiritsidwa ntchito. Poika munthu wopereka, madokotala samachotsa kapamba wa wodwalayo, monga momwe zimakhalira ndi mtima kumuika kapena impso. Chitani zomwezi munthawi yomweyo kapena kupatsirana kwa ndulu, munthawi yomweyo ndi impso. Kuchita koteroko kumapereka zotsatira zabwino pamilandu yambiri. Zochita zamankhwala zimapereka mitundu yotere ya opaleshoni yapancreatic:

Njira yothandiza pochizira matendawa imadziwika kuti ndiyo maselo a zilumba za Langerhans.

Kutumiza kuchokera kwa wopereka - ntchito imachitika ndikusokoneza kwamimba.
Kupatsirana kwa maselo a Langerhans - zigawo za maselo zimatengedwa kuchokera kwa opereka m'modzi kapena angapo ndipo zimayikidwa m'mitsempha ya chiwindi cha wodwalayo pogwiritsa ntchito catheter.
Kuphatikizika munthawi yomweyo kwa ndulu ndi impso, njirayi imalumikizidwa ndi chiwopsezo chowonjezereka, koma ili ndi gawo lochulukirapo la zopatsa mphamvu.
Kusamutsidwa kwa maselo opereka pogwiritsa ntchito zida zapadera zomwe zimawadyetsa oksijeni ndikuletsa njira yakukanira (pophunzira).
Kuyika kwa maselo a beta omwe amapanga insulin.

Bwererani ku tebulo la zomwe zili

Opaleshoni yam'mimba imagwiritsidwa ntchito pachiwopsezo chachikulu, chifukwa chiwalochi ndichopepuka ndipo maselo owonongeka sangabwezeretsedwe, monga ma cell a chiwindi. Pambuyo kumuyika wopereka, nthawi zambiri, kuyamwa kwa mankhwala amoyo kumayenera kuponderezana ndi chitetezo chakunja kwa thupi lachilendo - kukanidwa.

Kuyika kwa ma cell a Langerhans sikugwirizana ndi kupsinjika kwambiri kwa thupi ndipo sikutanthauza kuti pakhale mankhwala a immunosuppression. Popeza maselo amatulutsidwa mwachindunji m'magazi am'magazi, mphamvu ya njirayo imawonedwa mukangotha. M'masiku otsatirawa, ntchito yama cell imachuluka.

Wodwala yemwe akuganiza zodzisintha ayenera kuonetsetsa kuti moyo wake uli pachiwopsezo akutsimikizira zoopsa zomwe zimakhudzidwa ndi opareshoniyo ndi zotsatira zake zomwe ziyenera kukhala moyo chifukwa cha opaleshoniyo.

Kukula kwatsopano kwa asayansi aku Israeli ndi chida chapadera chomwe ma cell ochokera kwa wopereka wathanzi amayikidwa, amalumikizana ndi thupi la wodwalayo ndi machubu apadera, ndikupanga mlingo woyenera wa insulin m'magazi ake. Malinga ndi kachitidwe komweko, maselo amalandira mpweya, pomwe amatetezedwa ku chitetezo cha mthupi, koma zida zoterezi zikupitilizidwa. Monga kupatsirana kwa beta cell, komwe kumatha kusinthanso chithandizo cha matenda ashuga.

Contraindication pancreatic transplantation mu shuga

Opaleshoniyo idapangidwa khansa. Kuika magazi sikuyenera kuchitidwa mwa odwala omwe ali ndi psychoses kapena kusokonezeka kwakukulu pakugwira ntchito kwamanjenje. Chotsutsa china chidzakhala kupezeka kwa matenda oopsa a mtima. Opaleshoni sachitidwa ndipo ngati matenda opatsirana owopsa apezeka, mpaka atathetsedwa.

Yurkov, I.B. Bukhu la zovuta za mahomoni ndi matenda / I. B. Yurkov. - M: Phoenix, 2017 .-- 698 p.
Moroz B. T., Khromova E. A., Shustov S. B., et al. Tekinoloji yatsopano mu opaleshoni yopanga ma periodontics pamankhwala ovuta a odwala omwe ali ndi mtundu wa 2 matenda a shuga, Nauka Printer House - M., 2012. - 160 p.
Malakhov G.P. Kuthandiza Machiritso, Buku 1 (matenda ashuga ndi matenda ena). SPb., Nyumba yofalitsa "Genesha", 1999, 190 pp., Ext. 11,000 makope
Zholondz M.Ya. Kumvetsetsa kwatsopano kwa matenda ashuga. St. Petersburg, yosindikiza nyumba "Doe", masamba 1997,172. Kusindikizidwa kwa buku lomwelo lotchedwa "Diabetes. Kumvetsetsa kwatsopano. ” SPb., Nyumba yosindikiza "Onse", 1999., masamba 224, kufalitsa makope 15,000.
Vinogradov V.V. Tumors ndi ma cysts a kapamba, State Publishing House of Medical Literature - M., 2016. - 218 p.

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

Zizindikiro zakuphatikizira

Muzochita zachipatala, njira zamakono zopewera matendawa zimasiyanitsidwa.

Njira zochizira Hardware.
Opaleshoni yamapamba.
Kutumiza kwa kapamba.
Pancreatic islet transplantation.

Mu shuga, chisankho ichi chimakhala ndi maziko.

Nthawi zina, zimatheka kukwaniritsa kupangika komwe kumachitika chifukwa cha matenda ashuga kapena kuwaletsa.

Kuphatikizika kwa pancreatic mu matenda ashuga ndi njira yowopsa, chifukwa zotere zimachitika pokhapokha kwambiri.

retinopathy ndi kutayika kwathunthu kwa kuwona
Matenda a zombo zazikulu komanso zazing'ono,
mitsempha
nephropathy,
kutsika kwa endocrine.

Nthawi zambiri zomwe zimayatsidwa ndi hemochromatosis, komanso kusamva bwino kwa wolakwayo.

Nthawi zina, kufalitsa matenda a shuga kumayambitsa odwala omwe ali ndi matenda angapo a matenda am'mimba.

Necrosis ya pancreatic minofu.
Kuwonongeka kwa England ndi chotupa mapangidwe a chosaopsa kapena koopsa maphunziro.
Chochulukitsa chotupa cha purulent mu peritoneum, chomwe chimatsogolera pakukula kwa zowonongeka zazikulu za kapamba, zomwe sizimayankha chilichonse chamankhwala.

Nthawi zambiri, ndikuwoneka kuti kuchepa kwa impso, wodwalayo, limodzi ndi chikhodzodzo ndikuthira, amafunikanso opaleshoni ya impso yomwe imachitika nthawi yomweyo ndi kapamba.

Thirani zotsutsana

Kuphatikiza pazowonetsa, kufalikira kwa kapamba sikungatheke pazifukwa zosiyanasiyana.

The kupezeka ndi mapangidwe neoplasms chotsika kumene.
Matenda a mtima, omwe amadziwika ndi kuperewera kwamphamvu kwa mtima.
Mavuto a shuga.
Kukhalapo kwa mapapu pathologies, sitiroko, matenda opatsirana.
Kusuta kwa mowa, mankhwala osokoneza bongo.
Zovuta za mawonekedwe owopsa amisala.
Zofooka zoteteza thupi.
Edzi

Chithandizo cha opereshoni ndikotheka ngati mkhalidwe wa wodwalayo uli wokhutiritsa. Kupanda kutero, pali ngozi ya kufa.

Kuzindikira usanachitike kumuika

Asanazindikire kuthekera kwa kuchitapo kanthu pochita opareshoni ndi milandu yokhudza kumuika, mayeso angapo amachitika. Kafukufukuyu akuphatikiza njira zotsatsira izi:

kusanthula kwamtundu wamagazi,
compression tomography,
electrocardiogram
kuyezetsa magazi pamlingo wama biochemical,
ma diagnostics a ultrasound a minofu yamtima, peritoneum,
kuchuluka kwa magazi,
mkodzo ndi kusanthula magazi,
kuphunzira zama antijeni othandizira minofu,
X-ray ya sternum.

Wodwalayo adzafunika kumuyesa kwathunthu ndi wochiritsa, dokotala wa opaleshoni, gastroenterologist. Nthawi zina mumafunika kukayezetsa ndi madotolo otere:

endocrinologist
mtima
azachipatala
dotolo wamano.

Kuchulukitsa kwa minofu kumachitika mwa munthu wamoyo ndipo wina yemwe ubongo wake unadziwika kuti wamwalira.

Kodi ntchito yopandukira imayenda bwanji?

Kutengera zotsatira za mayesowo, thanzi lathunthu, komanso momwe zimapwetekera bwino, adotolo amasankha njira yochotsera kapamba.

Kuchita opaleshoni kumaphatikizapo kufalikira chiwalo chonse.
Thirani mchira kapena kanthu kena ka nyemba.
Ndikofunikira kuthetsa chiwalo ndi gawo la duodenum.
Jekeseni wambiri wamaselo a Langerhans.

Mukamaika zikondamoyo zonse, tengani ndi gawo la duodenum 12. Komabe, ndulu imatha kulumikizidwa ndi matumbo ochepa kapena chikhodzodzo.Ngati kachigawo kakang'ono kokha ka kapamba ndiye kuwayika, ndiye kuti kulowererapo kuli ndi kuchotsedwa kwa madzi a pancreatic. Kuti muchite izi, gwiritsani ntchito njira ziwiri.

Kuletsa njira yopanga pogwiritsa ntchito neoprene.
Kuchotsa kwa madzi a limba m'mimba laling'ono kapena chikhodzodzo. Madziyu akamalowetsedwa mu chikhodzodzo, chiopsezo chotenga matenda amachepetsa.

Kuyika kapamba, monga impso, kumachitika mu iliac fossa. Njirayi ndi yovuta komanso yayitali. Nthawi zambiri opareshoni imachitika pochita opaleshoni, yomwe imachepetsa chiopsezo cha zovuta zazikulu.

Zimachitika kuti amadzakhazikitsa chubu cha msana, chifukwa chomwe mankhwala ochita kupanga amatha kupatsirana pambuyo pakuthana kuti athetse vuto.

Opaleshoni mankhwala a gland m'magawo:

Wopereka amapatsidwa mankhwala oletsa kupweteka kudzera mu mtsempha wamaberekero, ndiye kuti njira yotsekerera imagwiritsidwa ntchito.
Kenako, chiwalocho chimachotsedwa ndikuwakhazikika ndi yankho lozizira lamchere.
Chitani zomwe mwakonzekera. Wosanjidwa umapangidwa kwa wolandirayo, ndiye kuti chodyeka chathanzi kapena gawo linaikiridwanso m'dera laalal fossa.
Mitsempha, mitsempha ndi ngalande yolumikizira ziwalo zimaphatikizika m'magawo.

Wodwala akangosintha ntchito ya impso yolimbana ndi matenda a shuga, ndiye kuti kuchitanso kawiri konse kumatheka. Izi zikuwonjezera mwayi wazabwino.

Mankhwala a Immunosuppressive amachitika ndi kugwiritsa ntchito mankhwala a 2-3 omwe ali ndi njira ina yochitira.

Monga njira ina iliyonse yothanirana ndi mavutowa, kumizidwa kumatha kupangitsa kuti matenda ashuga, omwe mankhwala ake sangathetse vutoli.

Mapangidwe azinthu zopatsirana mu peritoneum.
Kukhalapo kwa madzimadzi pagulu lazinthu zolocha.
Kukula kwa magazi m'magawo osiyanasiyana mwamphamvu.

Kuzindikira pambuyo pakuchita opaleshoni

Kuthandizira pochita opaleshoni kumaphatikizapo kukonzanso kwa nthawi yayitali komanso kovuta kwa wodwalayo. Pakadali pano, mankhwala a immunosuppressive amamulembera, kuti limba limzike mizu.

Kodi zikondazo zimatha kuchiritsidwa pambuyo pothilidwa?

Malinga ndi ziwerengero, kupulumuka pambuyo pochulukitsidwa ndi kapamba kumachitika mu 80% ya odwala kwa nthawi yoposa 2 zaka.

Ngati kapamba adasinthidwa kuchokera kwa wopereka wathanzi, matendawo amawakonda kwambiri, ndipo pafupifupi 40% ya odwala amakhala ndi zaka zopitilira 10, ndipo 70% ya omwe amakhala zaka zosaposa 2.

Mitundu ya Gland Transplants

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

magawo amtundu wa England (mchira kapena thupi),
pancreatoduodenal zovuta (zokonda zonse zokhala 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.

Kuchulukitsidwa kwa opaleshoni kumadalira kuchuluka kwa kuwonongeka kwa ziwalo za thupilo, kuchuluka kwa wodwalayo komanso kuchuluka kwa kafukufuku. Lingaliro limapangidwa ndi dokotala wa opaleshoni.

Opaleshoniyo yakonzedwa, chifukwa imafunika kukonzekera wodwalayo ndi kumuika.

Kuti wodwala athe kuthandizidwa moyenera ndi mankhwala a pancreatic a shuga, ndikofunikira kudziwa mtundu wamatenda omwe adayamba. Zimatengera zinthu zambiri. Udindo waukulu umaseweredwa ndi zaka komanso pathogenesis yamatendawa.

Matenda a shuga amatanthauza matenda a endocrine kapamba. Imayimiridwa ndi zisumbu za Langerhans ndipo imangokhala 2% yokha ya voliyumu yonse.

Zilumbazi zimapangidwa ndi maselo osiyanasiyana mumapangidwe ndi magwiridwe ake. Amalumikizidwa ndi kubisika kwa mahomoni - magawo omwe amagwira ntchito omwe amawongolera mitundu yosiyanasiyana ya kagayidwe, kugaya, komanso kukula.

Mwambiri, mitundu isanu ya maselo a endocrine amasiyanitsidwa, omwe amathandiza kwambiri pakupanga mahomoni. Zina mwazomwe zimagwirizanitsidwa ndi metabolism ya carbohydrate:

maselo a beta (60%) omwe amapanga insulini komanso ochepa - amylin, omwe amaphatikizanso kayendedwe ka shuga,
maselo alpha (25%) kubisa glucagon - wotsutsana ndi insulin (amawononga mafuta, ochulukitsa kuchuluka kwa glucose m'magazi).

Zosintha zonse pazokondwerero zimagawidwa m'magulu, kutengera kuchuluka ndi njira yolowererapo. Mwa voliyumu, amatha kusungidwa kapena kuchotsedwa kwa ndulu kapena gawo lake.

Ntchito zosungira

Ambiri pancreatic kumuika ntchito amachita nthawi imodzi ndi kupatsirana kwa impso odwala ndi mtundu I matenda ashuga ndi concomitant aimpso kulephera. Gulu lachiwiri lalikulu limaphatikizapo odwala omwe amatsitsidwa ndi kapamba pambuyo poti akuwonjezera impso.

Gulu lomaliza limaphatikizapo odwala omwe alibe kulephera kwa impso, omwe amapatsirana kapamba yekha. The kuchuluka kwa chaka chimodzi kupulumuka mu gulu lodzilekanitsa lachigawo ndi 60-75%, poyerekeza ndi 80-85% mwa odwala pambuyo nthawi imodzi komanso sanali munthawi yomweyo kupatsidwa kwa kapamba ndi impso.

Zizindikiro za kupatsika kukana pambuyo podzipatula pancreatic, monga lamulo, zimawonetsedwa makamaka ndi kuwonongeka kwa impso. Odwala omwe ali ndi matenda amtundu wa shuga ndimelitus, kuwonjezera kwa kupatsirana kwa kapamba kumayambitsa matenda a impso sikuti kukuwonjezera kwakukulu kwa kuchuluka kwa mavuto obwera chifukwa cha wodwalayo ndi kumuika.

Oposa magawo awiri mwa odwala atabadwa nthawi imodzi ndi kapamba komanso impso sizidalira

Otsatirawa akufotokozera njira zopangira pancreatic transplantation mu shuga mellitus.

Ma transplantologists amatha kuchita zotsatirazi zamatenda a pancreatic transplant:

Chiberekero chonse
Kupatsirana mchira,
Thirani gawo la thupi la ndulu,
Kusintha kwa pancreo-duodenal (gland ndi gawo la duodenum),
Intravenous makonzedwe a beta khungu zikhalidwe.

Tanthauzo la mtundu wa ma pancreatic transplant opereshoni amatsimikizidwa pambuyo pakupenda deta yonse yomwe idapezeka pakuwunika kwa wodwala. Zimatengera mawonekedwe a kuwonongeka kwa minofu ya England

Opaleshoniyo imachitika pakukonzekereratu wodwalayo chifukwa chochita opaleshoniyo ndikuzimitsa kuzindikira kwa wodwala. Kutalika kwa kuchitapo kanthu kotereku kumatsimikiziridwa ndikuvuta kwa zovuta zamankhwala, kukonzekera kwa dokotala wakuchita opaleshoniyo komanso gulu la opaleshoni.

Kutengera ndi kukhazikika kwa mkhalidwe wam'magazi, shuga imakhala ndi mawonekedwe osiyanasiyana. Choyamba, wodwalayo amamva kupweteka, amadwala matenda am'mimba, kenako matenda a shuga.

Pa gawo loyamba lachitukuko, matenda oyamba a carbohydrate metabolism amawonedwa, omwe amawonetsedwa ndi kuchepa kwa kuchuluka kwa shuga. Umu ndi momwe matenda a shuga a pancreatic amadziwonekera.Kuperewera kwa insulin kumabweretsa diabetesic ketoacidosis, zombo zazikulu, zapakati komanso zazing'ono zimakhudzidwa nthawi zina.

Kubwezeretsa kapamba mumtunduwu wamatenda kumachitika pogwiritsa ntchito kukonzekera kwa sulfonylurea, zakudya zoyenera komanso kuchita masewera olimbitsa thupi.

Mtundu 2 wa shuga, kuchuluka kwa glucose kumakulanso. Pathology imayendera limodzi ndi kupweteka kwambiri pamimba komanso kuphwanya kwa chimbudzi. Matendawa amakula zingapo:

Nthawi zochulukitsa zotupa m'matumbo momwe zimatithandizirana ndi kuchotsedwa.
Kukwiya kwa maselo a beta kumayambitsa vuto la carbohydrate metabolism.
Matenda a shuga a Type 2 ayamba kupanga.

Ndi isanayambike matendawo, munthu amadwala:

pakamwa kowuma kosalekeza
kulephera kuthetsa ludzu lanu
Kuchulukitsa mkodzo wopangidwa,
kuchepa kapena kuchuluka kwambiri kwa thupi,
kuyabwa kwambiri pakhungu ndi ziume,
Hypersensitivity ngati mawonekedwe a chotupa pakhungu pakhungu,
kufooka ndi thukuta,
kuchiritsa kwamabala.

Izi ndi zizindikiro zomwe zikuwonetsa kuyambika kwa matendawo. Simungawanyalanyaze. M'pofunika kukaonana ndi dokotala komanso kukayezetsa.

Kafukufuku wa Laborator

Zowunikira labotale zimafunikira mukatsimikizira matenda. Kusanthula kumapangitsa kuti athe kuyesa kuchuluka kwa magwiridwe antchito owonongeka pa chiwalo.

Kuphatikiza apo, kuphwanya kwa excretory (kuchuluka kwa michere yopanga chakudya) ndi ma impretory (shuga m'magazi ndi mkodzo) ntchito ya gland, komanso kusinthika kwa kutupa kwa ziwalo zoyandikana zomwe nthawi zonse zimayenda ndi kapamba (milingo ya transaminase, bilirubin ndi zigawo zake, mapuloteni okwanira ndi magawo ake) zimatsimikizika.

kuyezetsa magazi kwapafupipafupi - kumatsimikizira kukhalapo kwa njira yotupa panthawi yophunzirira (kuchuluka kwa ESR, leukocytosis),
maphunziro a biochemical: magazi ndi mkodzo diastasis, magazi ndi mkodzo shuga, Coprogram.

Pankhani yakukwera kwakanthawi kwamasamba amwazi kapena ndi manambala abwinobwino, koma ndi zodandaula zakumwa, nthawi zina pakamwa pouma, ndikofunikira kudziwa shuga yam'mimba ndi chakudya cham'mawa kapena TSH (kuyeserera kwa glucose poyeserera shuga kumapezeka komanso pambuyo 2 patatha maola ambiri chakudya cham'mawa. Chifukwa chake, matenda am'mbuyomu amadziwika.

Chida chozindikira

Chomwe chimagwiritsidwa ntchito kwambiri ndi ultrasound ya malo a retroperitoneal, pomwe kapamba amapezeka, ndi m'mimba.

Kuunika kwa ultrasound kwa ziwalo zam'mimba ndi ziwalo zam'mimba ndi njira yotetezeka kwambiri komanso yosavuta yodziwira, yomwe sipatenga nthawi yambiri, sikutanthauza kukonzekera mwapadera, kupatula kusala kudya musanachitike.

Ultrasound imapangitsa kuyang'anira machitidwe mu kapamba ndikuwayendetsa mu mphamvu, ngakhale mwana wazaka zilizonse amatha kulekerera. Chifukwa chake, ndikofunikira kuchita ndi ultrasound kamodzi miyezi isanu ndi umodzi kuti muwone momwe chitsulo chimabwezeretsedwera pambuyo pa chithandizo.

Ngati njirayi ndi yovuta, kutupira kwa nduyo kumawonedwa, kukula kwake kumawonjezeka, ndipo kachulukidwe ka minofu amasintha.

Ndi nthawi yayitali ya matenda ashuga, ma scani a ultrasound amatha kuwoneka pa ultrasound, makamaka pamutu wapachikondwerero, kukula kwa chiwalo palokha kumakhala chotsika kwambiri kuposa zabwinobwino.

Kusintha kwa ma pancreatic, omwe amawonekera mu shuga mellitus, ali ndi chithunzi cha zovuta za kapamba. Komanso, kusintha kwa ziwalo zoyandikana kumatsimikizika nthawi imodzi: chiwindi ndi ndulu.

Njira za X-ray zimaphatikizapo:

Kufufuza kwa radiology ndi kuyambitsa kwa kusiyanitsa kumakupatsani mwayi wowona ma calculi akuluakulu, madera amtundu wa calcization, kufupikitsa kapena kukulitsa kwa dambo la Wirsung, chomwe ndi chizindikiro chosadziwika cha kusintha kwa minofu ya organic kapena kukakamira kwa chotupa chachikulu, chotupa, masamu.
Endoscopic retrograde cholangiopancreatography - wothandizira mosiyana ndi jekeseni wochokera mu duodenum mu ducts ya gland pogwiritsa ntchito endoscope.
Angiografia - kusiyanitsa (mu ziwiya) kumagwiritsidwanso ntchito.
Kupenda kwamkati mwamimba ndi malo olowera m'mimba, zomwe zimatha kuwonjezera mwayi wazindikira kusintha kwa matenda.

Zida zowunikira, kuwonjezera pa ultrasound, zimaphatikizapo:

EFGDS (esophagofibrogastroduodenoscopy) kuti mudziwe momwe mucous membrane wam'mimba ndi duodenum - nthawi zambiri matenda amtunduwu ndi chizindikiro chosadziwika cha kutupa kwa kapamba kapena kupindika kwake,
MRI - kulingalira kwa maginito.

Chithandizo cha matenda a shuga a pancreatic

Matenda a shuga nthawi zambiri amapezeka motsutsana ndi maziko a kapamba. Matenda awiriwa ndi othandizira chifukwa insulin, yomwe imakhudzidwa ndi metabolism ya carbo, imapangidwa ndi maselo a beta a islets a Langerhans, omwe azunguliridwa ndi zigawo zapadera za glandular - acini yomwe imapanga michere yokumba.

Mu njira yotupa mu kapamba, osati tiziwalo tating'onoting'ono tomwe timagwira ntchito limodzi ndi exocrine zimakhudzidwa, komanso islet, ndikupanga shuga mellitus.

Chifukwa chake, chithandizo chovuta chimayikidwa, kuphatikiza:

kusintha kwa moyo
chakudya
mankhwala
Njira zopangira opereshoni mu milandu yayikulu.

A endocrinologist atha kukulemberani maphikidwe a mankhwala ena omwe ali ndi glycemia wotsika pogwiritsa ntchito mankhwala azitsamba omwe amakhudza shuga.

Mankhwala

Mankhwala osokoneza bongo a pancreatitis mu shuga ndi njira yayikulu yothandizira. Wodwalayo amawonedwa ndi gastroenterologist ndi endocrinologist, amalandira mankhwala ochepetsa shuga, komanso zovuta za mavitamini, mtima, nootropics pokhudzana ndi zotupa zamanjenje ndi mtima. Kuchuluka kwa mankhwalawa kumatengera glycemia komanso zovuta za matenda ashuga.

Enzyme m'malo mankhwala - Mlingo ndi nthawi ya makonzedwe zimatengera kuchuluka kwa kuwonongeka kwa limba. Nthawi zina mankhwalawa amalembedwa moyo, komanso hypoglycemic.
Ma antispasmodics ndi ma painkiller pamaso pa chizindikiro cha kupweteka komanso kuuma kwake.
Mankhwala a antisecretory omwe ali ndi njira ina yochitira: PPIs (proton pump inhibitors), H2-histamine receptor blockers, ma antacid. Chithandizo chotere chimadziwika kuti wodwalayo amathandizidwa kunyumba. Mu pachimake kapamba kapena kuchulukitsa kwa chithandizo chachikulu kumachitika mchipatala, kumayambira mu chipinda chopangira chisamaliro chachikulu, momwe njira zowonjezera kulowetsedwa, othandizira othandizira, analcics ya narcotic amagwiritsidwa ntchito.

Kupanikizika kwa kapamba monga njira yobwezeretsa

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 adalimbikira kufunafuna njira zatsopano zamankhwala:

kuopsa kwa matenda ashuga
chikhalidwe cha matendawo,
kuvuta kwawongolera zovuta za carbohydrate metabolism.

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 pazochita za metabolic kapena kukhala chitsimikizo chopewa kukula kwa zovuta zachiwiri zamaphunziro a shuga mellitus, wodalira insulini, ngakhale mtengo wokwera opaleshoni, ndi shuga lingaliro ili ndiloyenera.

Maselo a Islet sangathe kukhala ndi nthawi yayitali kuti akhale ndi vuto la kusintha kwa kagayidwe kazakudya kwa odwala. Ichi ndichifukwa chake ndibwino kutembenukira ku ziwonetserozo zopereka, zomwe zasungapo ntchito zake mpaka patali.Njira yofananayo imaphatikizapo kupereka zochitika kwa standardoglycemia ndi kutsekeka kwina kwa zoletsa zama metabolic.

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

Pancreatic Cell Transplant
Mapeto

Kupita patsogolo kuchokera gawo lakhululukidwa mpaka gawo lodalira moyo wa insulin nthawi zambiri kumadziwika ndi kuchepa kwapang'onopang'ono pantchito yotsalira ya β-cell. Koma kuchokera ku lingaliro lazachipatala, imatha kuwonjezeka ndi kuwonjezera kwa matenda oyamba.

Pakadali pano, mankhwala obwezeretsa insulin omwe amakhalapo ndi okhawo omwe amakhalapo njira yothandizira ana ndi achinyamata omwe ali ndi matenda a shuga 1. Ngakhale njira zina zoyesera, monga pancreatic cell transplantation, zikufufuzidwa.

Pancreatic Cell Transplant

Kuthana kwa kapamba ndi njira yoyesera yodwala matenda a shuga 1. Kugawika kwa Islet kumatanthauza kuchuluka kwa maselo akutali kuchokera kwaopereka kupita kwa wodwala ndikumulowetsa m'chiwindi.

Pambuyo pa njirayi, mankhwala a immunosuppressive nthawi zambiri amapatsidwa. Mpaka pano, kupambana kwa mankhwalawa kumawonedwa mwa 60% ya odwala.

Ndi kukhazikika bwino kwa zigawo zingapo za Lagergans, kukana insulini ndikotheka mchaka chimodzi.

Kuphatikizika kwa Islet kudakhala kopambana pambuyo poyambitsa ma immunosuppress othandizira kuti asakhale ndi poizoni m'maselo a beta komanso tekinoloje yosinthika kuti atole kuchuluka kokwanira kwa maselo a beta omwe ali achikulire pachikhalidwe.

Chiwerengero cha omwe amakhalapo amadalira insulini amachepetsa ndikuwonetsetsa kwakukulu. Pancreas angapo opereka amafunikira kuti apange maselo angapo amtundu wa beta pozungulitsa.

Pakadali pano, chisonyezo chachikulu ndikuwathandizira kusaganiza bwino kwa hypoglycemia yomwe singagwiritsidwe ntchito pogwiritsa ntchito njira zina. Monga kuchuluka kwa nthawi yayitali kulowetsedwa kwa insulin mwa akulu omwe ali ndi matenda a shuga 1.

Popeza pamakhala chiopsezo cha nephrotoxicity mukamamwa mankhwala a immunosuppressive, njira zambiri zochizira zimaphatikizapo odwala azaka zopitilira 18 omwe amakhala ndi nthawi yayitali yodwala matenda a shuga kuti awonenso tsogolo la chitukuko cha matenda ashuga.

Kukhazikitsidwa kwachipatala chokhudzana ndi kulekerera kwa immunological popanda kufunika kwa immunosuppressive chithandizo ndicho cholinga chachikulu cha mtsogolo. Kuthekera kwa hematopoietic tsinde cell kwa kupatsa mphamvu kulekerera ndi kusinthanso maselo a islet mu vivo ndi vitro neogeneis ndi malo omwe akufufuzira mwachangu.

Kuphatikizika kwa kapamba kumalola kukwaniritsa kupulumuka kochulukirapo kwa chaka chimodzi. Koma pali chiopsezo chachikulu cha opaleshoni ndi kufunikira kwakutali kwa immunosuppression popanda kuwonjezereka kwa impso, zomwe sizimalola kugwiritsa ntchito njirayi kwa ana ndi achinyamata.

Ngakhale kuti maphunziro omwe ali pamwambawa adachita bwino, lero pali zambiri zokhala ndi zotsutsana. Cholepheretsa chachikulu pakugwiritsa ntchito njirayi pochiza matenda ashuga ndi kusowa kwazinthu zothandizidwa ndi kusowa kwa ndalama zopititsira patsogolo moyo.

Koma ofufuza padziko lonse lapansi akuyesetsa kuthana ndi vutoli. Makamaka, imodzi mwanjira zabwino kwambiri zopulumutsira kupulumuka, kuphatikizika kwapadera kwama islets apancreatic kwapangidwa.

Zomwe zimateteza ku chitetezo cha mthupi ndipo sizisokoneza kutulutsidwa kwa insulin. Mtengo wokwera wa pancreatic islet transplantation umalepheretsanso kuchulukitsidwa.

Pazovuta zazikulu, kuthekera kwa mapangidwe oyipa a zotupa ndi kulowetsedwa kwa ma immunosuppressants pantchito yaimpso.

Kodi matenda ashuga ndi chiyani?

Matenda a shuga ndi matenda osokoneza bongo omwe amabwera chifukwa cha shuga m'magazi. Malinga ndi WHO (World Health Organization), munthu aliyense wachisanu amakhala padziko lapansi. Masiku ano, matenda a shuga amawerengedwa ngati matenda osachiritsika. Yankho la funso loti izi ndi zoona kapena ayi lagona pakumvetsetsa kusiyana pakati pa mitundu iwiri ya shuga.

Kodi matenda ashuga angachiritsidwe?

Pali mitundu iwiri ya matenda ashuga: mtundu I shuga (shuga yodwala, shuga wachichepere) ndi mtundu II matenda ashuga (shuga ya okalamba, shuga wonenepa kwambiri). Ngakhale pali zofanana ndi izi, matendawa amayambitsidwa ndimayendedwe osiyanasiyana omwe amapezeka mthupi, chifukwa chake amathandizidwa mosiyanasiyana.

Ngati matenda amtundu wa II amakhudzidwa kwambiri ndi kusachita masewera olimbitsa thupi, kunenepa kwambiri, cholesterol yowonjezereka, ndikusintha komwe kumayenderana ndi zaka zomwe kumapangitsa kuti kapamba asamagwire bwino, ndiye kuti chithandizocho ndicholinga chothetsa mavutowa.

Chithandizo cha matenda ashuga amtundu II ndi, choyambirira, kusiya zizolowezi zoyipa, ndipo chiyembekezo cha wodwalayo chili m'manja mwake.

Matenda a shuga a Type I pano amadziwika kuti ndi matenda osachiritsika. Mwa munthu wathanzi, mulingo wabwinobwino wamagazi umasungidwa mothandizidwa ndi insulin ya mahomoni, yomwe imapangidwa ndi maselo a pancreatic beta.

Odwala omwe ali ndi matenda a shuga, chifukwa cha kuperewera kwa chitetezo m'thupi, kapamba amasiya kupanga insulin mokwanira. Njirayi imapitilirabe mpaka kufa kwathunthu kwa ma cell a beta.

Chifukwa chake, odwala amakakamizidwa kubaya insulin tsiku lililonse, kapena kuyenda ndi pampu ya insulin. Kuphatikiza pa izi, odwala amayesa mayeso a shuga kangapo patsiku.

Ma Technologies a Opaleshoni

Kudya moyenera ndi chimodzi mwazinthu zazikulu zothandizira kuti shuga azikhala bwino komanso kuti azichita pancreatic.

Kusintha kadyedwe kanu ka matenda ashuga 2 kungakuthandizeni kupewa mankhwala.

Anthu odwala matenda ashuga saloledwa kudya zakudya zopatsa mphamvu zamafuta ndi mafuta.

Chiwalo choperekacho chimayikidwa mu iliac fossa (impso imayikidwanso pamenepo) kudzera mu mawonekedwe a midline motsatira chingwe choyera cham'mimba. Amalandira magazi ochepa kudzera m'mitsempha yake kuchokera kwa wolandira.

Vuto lotumphukira kudzera mu njira ya portal vein (iyi ndiye njira yamoyo kwambiri) kapena njira yotsika kwambiri ya vena cava. Zikondamoyo zimalumikizana ndi khoma lamatumbo ang'onoang'ono kapena chikhodzodzo cha wodwalayo mbali.

Njira yachilengedwe komanso yotetezeka kwambiri yotsala pang'ono kupulumuka ndiyo kupandukira kwa kapamba ndi impso. Mtengo wa opaleshoni yotere umaposa zosankha zina zonse, zimatenga nthawi yayitali kukonzekera kwake komanso momwe akuchitira komanso kuyenerera kwakukulu kwa dokotala wochita opaleshoni.

Opaleshoni yogulitsa ziwalo ndipo zotulukapo zake zimadalira mwachindunji pazinthu zingapo. Ndikofunika kuganizira:

kuchuluka kwa ntchito yopatsirana pochita opaleshoni,
zaka ndi zodziwika bwino za woperekayo pa nthawi ya imfa,
kuyanjana kwa opereka ndi zolandilira minyewa muzinthu zonse,
hemodynamic kukhazikika kwa wodwalayo.

Malinga ndi ziwerengero zomwe zilipo, kuchuluka kwa kupulumutsidwa pambuyo pothana ndi kapamba kuchokera kwa wopereka mtembo ndi:

zaka ziwiri - m'milandu 83%,
pafupifupi zaka zisanu - pa 72%.

Momwe mungachiritsire kapamba ndi matenda ashuga, adokotala asankha. Kutengera momwe wodwalayo alili, mankhwala kapena njira zochizira zimapangidwa kuti zithandizire ntchito ya thupi

Ngati njira zochiritsira zothandizira sizinakhale ndi zotulukapo, ndiye kuti kapamba mu shuga amatha kuwongolera kokha ndikusamutsa chiwalo chathanzi kwa wodwalayo.Kuchita koteroko nthawi zambiri kumakhala kofunikira kwa anthu amtundu uliwonse wamatenda. Nthawi zambiri amazika ma cell a kanyumba ka Langerhans, kamene kamayambitsa kapangidwe ka insulin. Kuika matenda a shuga kumachitika ngati:

kukana insulin yovomerezeka ikuwonetsedwa,
kagayidwe kachakudya
matenda ashuga ayambitsa zovuta zazikulu.

Kugwira ntchito moyenera kumathandizira kubwezeretsa kwathunthu kwa gland. Kuchita bwino kwambiri kumatheka ngati kupatsirana kumachitika pang'onopang'ono chitukuko cha matendawa, chifukwa mtsogolomo matenda achisangalalo adzagwirizana ndi matenda ashuga, omwe angatilepheretse kuchira.

Kutengera ndiukadaulo wa opangirawo pa kapamba, pali mitundu itatu:

Opaleshoni yocheperako

Awa ndi opaleshoni ya laparoscopic pa zikondamoyo, zochitidwa ndi zazing'ono zingapo pakhungu la pamimba. Kanema wa laparoscope ndi zida zapadera zimayambitsidwa kudzera mwa iwo. Dokotalayo amayang'anira momwe opaleshoniyo akuwonekera. Pambuyo pa kulowererapo kotere, kukonzanso kumakhala kochepa kwambiri, ndipo kutalika kwa nthawi yayitali kuchipatala kumachepetsedwa kukhala masiku angapo.

Opanda magazi

Amagwiritsidwa ntchito makamaka pochotsa zotupa. Izi zikuphatikiza ma radiosurgery - kuchotsa pogwiritsa ntchito ma radiation amphamvu (cyber-mpeni), cryosurgery - chotupa chozizira, kuyang'ana kwambiri ultrasound, opaleshoni ya laser. Ngati mpeni wa cyber sukutanthauza kulumikizana ndi thupi konse, matekinoloje ena amapangidwa kudzera pa kafukufuku wokhazikitsidwa mu duodenum.

Pambuyo pakuchita opaleshoni yam'mimba, matendawo amatengera nthawi ya ntchito, mtundu wa kukonzanso, zovuta, ndipo sizachilendo. Zina mwazovuta zomwe zimakhalapo:

Kutuluka kwamkati m'mimba.
Supombosis ndi thromboembolism.
Infection, kukula kwa abscesses, peritonitis.
Mapangidwe a pancreatic fistula.

Pafupifupi nthawi zonse zotsatira zosalephera za opaleshoni ya pancreatic zimakhala kuchepa kwa mphamvu ndi kugaya chakudya m'mimba, ndipo matenda a shuga amayamba mchira ukapangidwanso. Izi zitha kulipidwa ndi kusankha kwa enzyme kukonzekera-olowa mmalo ndi othandizira a hypoglycemic.

Mulimonsemo, moyo pambuyo pakuchita opaleshoni ya kanyumba ukusintha ndipo uyenera kuyang'aniridwa. Choyamba, ndikofunikira kuti musiyane ndi zizolowezi zoyipa ndikutsatira zakudya: osasiya mowa, mafuta ndi zonunkhira, confectionery.

Kodi tingatani atachitidwa opaleshoni yapancreatic? Zakudyazi ziyenera kuphatikizapo kuchuluka kwa mapuloteni (nyama yopendekera, nsomba, tchizi chanyumba), fiber ndi mavitamini: mbewu monga chimanga, masamba, zipatso, zitsamba, tiyi kuchokera ku zitsamba zamankhwala. Zakudya ziyenera kumwedwa kangapo pa tsiku pazigawo zochepa.

Zofunika! Kulephera kutsatira zakudya pambuyo pakuchita opaleshoni kumatha kupeputsa zotsatira zake ndikuyambitsa mavuto ena azaumoyo.

Ndikofunikanso kukhala ndi moyo wathanzi, kuphatikiza zolimbitsa thupi ndi kupuma kwabwino ndikuwonetsetsa dokotala pafupipafupi.

Matenda a shuga okha ayi sichizindikiro cha kupatsidwa zina. Opaleshoni ingalimbikitsidwe:

zosagwira ntchito zolimbikitsa zochizira,

kukana subcutaneous insulin makonzedwe,

kagayidwe kachakudya,

zovuta zazikulu za matenda ashuga.

Opaleshoniyo ikayenda bwino, ntchito zonse za gululi zimabwezeretseka bwino. Kuika kumeneku kumathandiza kwambiri kumayambiriro kwa matendawa, chifukwa mtsogolomo zovuta zina zomwe zimalepheretsa kuchira kwachilengedwe zimalumikizana ndi matenda akulu.

Malinga ndi maziko a retinopathy yomwe ikukula pang'onopang'ono, zotsatira za chithandizo cha opaleshoni zitha kukhala zosiyana, komabe, chiwopsezo cha zovuta sichidutsa mwayi wokulira pakulephera kwa opaleshoni.

Mtundu I wa shuga wampira, chithandizo cha insulin chimapitilira mpaka ndikusandusidwa.Wodwala akalandira chithandizo chamankhwala chofunikira kuti akhale wathanzi, ndiye kuti mankhwalawo amakhalabe osasinthika panthawi yonse yokonzekera.

Mosatengera mtundu wamatenda, wodwalayo amayesedwa ndi mtima, amayesedwa kwambiri, amayendera endocrinologist ndi nephrologist, komanso akatswiri ena atakhala ndi zovuta za matenda a shuga. Dokotala wopatsirana amayenera kuwunika mkhalidwe wa kapamba ndi kudziwa zotsatira za maphunziro omwe adapezeka pokonzekera.

Posachedwa opareshoni, muyenera kusiya kumwa ochepa magazi. Osachepera maola 8 asana opaleshoni, chakudya ndi madzimadzi zimatha.

Pakatha tsiku limodzi atachitidwa opaleshoni, wodwala sayenera kuchoka kuchipatala. Pambuyo pa tsiku, kugwiritsa ntchito madzi kumaloledwa, patatha masiku atatu - kugwiritsa ntchito chakudya ndizovomerezeka.

Zikondamoyo zimayamba kugwira ntchito mwanjira yokhayo mutangokokoloka. Komabe, kubwerera ku moyo watsiku ndi tsiku ndizotheka palibe kale kuposa sabata pambuyo pochita opareshoni.

Pakupita miyezi iwiri, kuchira kwathunthu kumachitika. Wodwalayo amapatsidwa mankhwala opondera chitetezo cha mthupi kuti asakanidwe. Panthawiyi, muyenera kuchepetsa kucheza ndi anthu ena ndikukhala m'malo a anthu ambiri chifukwa choopsa chotenga kachilomboka.

Mosasamala mtundu wa kufalikira, odwala ayenera kumwa mankhwala a immunosuppressive amoyo, omwe amachepetsa chitetezo chake, amateteza ku kukanidwa komwe kungachitike ndikuwonjezera chiopsezo cha mitundu ina ya khansa. Ichi ndichifukwa chake odwala ayenera kupatsidwa mankhwala oletsa kupewetsa khansa, makamaka ziwalo zam'mimba.

Kuti muwonetsetse kuzindikirika kwa kufalikira kwa pancreatic, wodwalayo amayenera kupimidwa mozama, protocol yomwe imatsimikiziridwa ndi boma lonse laumoyo. Mitundu ya zothandizira ndi yothandizira ma labotale ingaphatikizidwe mu ndondomeko yoyeserera ya odwala:

Kuyesedwa ndi dotolo, gastroenterologist kapena dokotala m'mimba,
Kuyang'ana kwa akatswiri a akatswiri apadera: endocrinologist, anesthesiologist, cardiologist, mano, gynecologist, etc.,
Ultrasound yam'mimba, mitsempha yamagazi, ndipo ngati ndi kotheka, ziwalo zina,
Kuyesedwa kwa magazi ndi mkodzo
Kuyesa kwa magazi
Kuyesa kwa magazi
Bokosi x-ray,
ECG
Ultrasound wamtima,
Kuyesa kwamwazi wamagazi,
CT
Matupi othandizira antijeni.

Zochita, nthawi zambiri, chithandizo choterechi chimaperekedwa kwa odwala omwe ali ndi mtundu wa I kapena mtundu wa 2 matenda ashuga musanachitike izi zovuta za matenda monga:

Matenda a Hyperlabile
Retinopathy ndikuwopseza khungu,
Gawo lamatenda a nephropathy,
Neuropathy
Endocrine kapena exocrine kulephera,
Zowopsa za zombo zazikulu kapena ma microvessels.

Kuchulukitsidwa kwa England kumatha kuperekedwanso kwa odwala matenda ashuga. Izi zimachitika chifukwa cha zifukwa zotsatirazi:

Chachikulu kapamba ndi chitukuko cha kapamba,
Khansa yapakansa
Hemochromatosis
Kukana kwa insulini komwe kumachitika chifukwa cha matenda a Cushing's, acomegaly, komanso matenda a shuga.

Nthawi zina, kufalikira kwa kapamba kumaperekedwa kwa odwala omwe ali ndi matenda omwe amaphatikizidwa ndi kuwonongeka kwa chiwalo. Izi zikuphatikiza:

Kuwonongeka kwakukulu kwa minyewa ya m'mimba ndi zotupa zoyipa kapena zotupa,
Necrosis yowonjezera yamitsempha,
Kutupa kochulukira m'mimba, komwe kumabweretsa kuwonongeka kwa minofu ya minyewa komanso chosavulaza.

Kuphatikizika kwa ma pancreatic mu zochitika zotere ndi kawirikawiri kwambiri chifukwa cha zovuta zachuma, zamaluso ndi zokhudzana ndi kayendetsedwe ka chithandizo.

Zizindikiro zakuchita opareshoni

Kuphatikizika kwa kapamba kumawonetsedwa kwa odwala onse omwe ali ndi matenda amtundu wa 1, koma sizingatheke pazifukwa zingapo. Kalozera wa boma amalola opareshoni kwa odwala omwe samaloledwa ndi jakisoni wa insulin, ana, anthu omwe sangathe kugwiritsa ntchito pampu ya insulin nthawi zonse, kuti apange jakisoni.

Cancreas iyenera kuthandizidwa kwa odwala omwe sasiyanitsidwa ndi kudzipereka kwina ndi omwe ali ndi chiopsezo chotenga matenda omwe amapezeka ndi kuchuluka kwa shuga m'magazi.

Malinga ndi kafukufuku. Shumakova, opareshoni siinachitike pansi pa zinthu zotsatirazi:

matenda osachiritsika (virus hepatitis, HIV),
zotupa zoyipa
ma terminal
mankhwala osokoneza bongo ndi mowa,
machitidwe asocial
zolakwika zosavomerezeka ndi zosokoneza pakugwira ntchito kwa ziwalo zofunika.

Kuphatikiza pazomwe tafotokozazi, kulowererako sikumachitika chifukwa cha anthu omwe amalephera kulandira chithandizo cha immunosuppressive.

Chidziwitso: Kuchita opaleshoni ya kapamba sikuphatikiza miyezo ya chisamaliro chachipatala ndipo salipiridwa ndi inshuwaransi yokakamiza yachipatala. Mutha kulipira ndalamayo nokha, koma ndiokwera mtengo. Odwala ambiri amasungidwa pansi pa Unduna wa Zaumoyo.

Opaleshoniyo imafunika makamaka ndi odwala kwambiri, pomwe chithandizo chokwanira cha matenda ashuga sichothandiza ndipo pali zovuta zina kale. Chifukwa chake, zotsutsana pochita opaleshoni ndizofanana:

zaka - zopitilira 55
kupezeka kwa neoplasms yoyipa mthupi,
mbiri yakusokonekera kwa myocardial kapena sitiroko,
mtima ndi mtima matenda chifukwa cha kusintha kwakukulu kwa atherosulinotic (mitundu yovuta yamatenda a mtima, kuwonongeka kwakukulu kwa atherosulinosis ya msempha ndi ziac, chithokomiro cham'mbuyo cha mtima
otsika mtima mtima,
Mavuto akulu a shuga
chifuwa chachikulu
uchidakwa, uchidakwa, Edzi.

Sitikulimbikitsidwa kuti tichotsere kapamba ndi kupweteka kwapakati.

Cholepheretsa chachikulu pakuchita opaleshoni ndiyomwe imakhala ndi zotupa pamene zilonda zam'mimba zilipo m'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, koma tikulankhulanso za matenda opatsirana.

Dietotherapy - monga njira yobwezeretsa

Kupewa kukanika kwa pancreatic ndikukana mowa ndi kusuta, kudya (kupatula zakudya zamafuta, kuletsa maswiti). Mu shuga mellitus, tebulo la zakudya No. 9 limayikidwa, kuphatikiza mosavuta kugaya chakudya komanso kuchepetsa zovuta zam'mimba.

Ndi pancreatitis, tebulo nambala 5 limawonedwa: kuwonjezera pa mafuta, zonunkhira, zokazinga, mchere, kusuta ndizoletsedwa. Kuletsedwa kwa zakudya kumatengera kuopsa kwa matendawa komanso momwe matendawa amafotokozera, adokotala amawaunikira.

Mankhwala othandizira olimbitsa thupi okhudzana ndi zochitika zolimbitsa thupi, kuyenda, masewera olimbitsa thupi komanso kutikita minofu yapadera kumalimbikitsidwa. Ndizovuta kwambiri zolimbitsa thupi kupuma pofuna kusintha kamvekedwe ka khoma lakumbuyo kwamkati, kumathandizira zochitika za ziwalo zoyandikana ndi kapamba palokha.

Ndikofunikira kuthetsa kapena kuchepetsa kupsinjika kwa mitsempha ndi kuchuluka kwa zamaganizidwe.

Ngati mukumva zowawa, ndikulimbikitsidwa kukaonana ndi dokotala, osadzilimbitsa.Pankhaniyi, mutha kupulumutsa kapamba: kupewa nthawi yayitali ya chithunzithunzi cha matendawo ndi zovuta zake.

Galina, wazaka 43, Kazan

Za ululu wa kapamba, kuzizira, njala, ndi mtendere zimathandiza kwambiri. Osachepera masiku oyambira atatu itatha isanayambike zizindikiro, matendawa ayenera kuyang'aniridwa.

Kenako mutha kusinthira pang'onopang'ono ku zakudya zosasamala, yambani kumwa mankhwala - ma enzymes, mankhwala antisecretory. Koma tiyenera kukhala okonzekera kuti thupi ili silibwezeretsedwa mwachangu.

Zimatenga miyezi ingapo, osachepera. Ndidakumana nazo ndekha.

Zinali zovuta kutsatira malamulo onse, koma tsopano zinthu zayamba bwino.

Zomwe zimakhudza kugwira ntchito kwa kapamba?

Pancreas ndi chiwalo chokhala ndi mawonekedwe ovuta kwambiri komanso abwino omwe amagwira ntchito zogaya ndi endocrine nthawi imodzi. Mphamvu ya zinthu zakunja ndi zamkati zimatha kusokoneza ntchito yake ndikukhudza gawo la chiwalo palokha. Panthawi ya vuto la khungu lotupa lomwe limapangitsa kuti khungu lizisungidwa, chotupa mu mawonekedwe a kapamba nthawi zambiri chimachitika. Ngati kusintha kwa pathological kumakhudza ntchito ya endocrine, matenda a shuga amakula ndi zizindikiro zake zonse.

Kutupa kwa kapamba kumasokoneza kupanga insulini ndipo kuchuluka kwake kumakhala kosakwanira kuwonongeka ndi kugaya chakudya. Vutoli limafanana ndi matenda a shuga a mtundu woyamba, omwe ali ndi matenda amtundu wachiwiri, momwe matendawa amagwira ntchito sasintha ndipo insulin imapangidwa modabwitsa, koma thupi limatha kuzindikira mahormoni nthawi zonse.

Zinthu zikuluzikulu zomwe zimakhudza kugwira ntchito kwa kapamba komanso kuyambitsa kusintha kwa shuga m'magazi ndi:

Matenda a cystic fibrosis ndi zina mwanjira ya cholowa,
Kutupa komwe kumakhudza minofu ya kapamba mwa mawonekedwe a kapamba ndi zovuta zake, monga pancreatic necrosis ndi kukula kwa fibrosis,
Chotupa chachikulu chokhala ndi mawonekedwe osakhazikika, komanso zotupa zina zomwe zimasautsa thupi
Zochita ndi ma opaleshoni ndikuvulala kwa kapamba,
Matenda okhudza gland ya adrenal
Kuphwanya kayendedwe ka magazi ndi zakudya zamatenda chifukwa chakuchitika kwa atherosulinosis,
Matenda omwe amapezeka pobadwa, koma osagwirizana ndi zovuta zamtundu,
Zomwe zimayambitsa zakunja zimayambitsa kuperewera kwa chakudya komanso kupezeka kwa zizolowezi zoipa,
Kugwiritsa ntchito mankhwala ochulukitsa a carbohydrate, chifukwa cha zomwe hypoglycemic coma ingayambitse ndikuphwanya kupanga kwa insulin.
Nthawi yapakati.

Kuphatikiza pazinthu zamkati izi, palinso zifukwa zakunja zomwe zingasokoneze kugwira ntchito kwa kapamba ndikulepheretsa ntchito yake:

Kunenepa kwambiri
Matenda a m'matumbo a ziwalo zina zam'mimba zokhudzana ndi kapamba, nthawi zambiri izi zimagwira ntchito ya ndulu ndi ma ducts ake,
Kulowerera ndi kufalikira kwa matenda oyambitsidwa ndi ma virus mu kapamba,
Kukhalapo kwa matenda a helminthic,
Kulowa kwa kapamba ndi tizilombo toyambitsa matenda omwe amathandizira kuti purosesa ipangike,
Kugwiritsa ntchito kwakanthawi mankhwala ena mwanjira ya estrogens, ma antietraccline, corticosteroids ndi mankhwala omwe si a steroid,
Kugwiritsa ntchito nthawi yayitali kulera,
Kukhalapo kwa matenda a autoimmune.

Zochitika zoterezi sizingatitsogolera ku pancreas, komabe, ndikupanga zinthu zabwino komanso kufooka kwa mphamvu zawo zoteteza, izi zitha kupitilira kwa moyo wonse.

Kodi shuga wa kapamba amayamba bwanji?

Palibenso mgwirizano pa za etiology ya pancreatic.Kukula kwake kumawerengedwa kuti ndikuwonongeka pang'onopang'ono komwe kumachitika ndikuwonongeka kwa zida zamagetsi m'matumbo, motero zimayankha kutukusira kwa maselo omwe amapanga michere ya m'mimba. Monga tawonera kale, kapamba amadziwika ndi kuphatikizika kwapadera, komwe kumapangidwa ndi michere yopanga chimbudzi ndipo imagwiranso ntchito ngati chiwalo popanga mahomoni omwe amayendetsa shuga wamagazi chifukwa chogwiritsa ntchito.

Kukhalapo kwa mawonekedwe osatha a kapamba kapena kutupa komwe kumachitika chifukwa chomwa mowa kwambiri nthawi zambiri kumathandizira kuti kusintha kwamatenda kumachitika osati mu chiwalo chokha, komanso mu insulin zida, zomwe zimayikidwa mu gland mwa mawonekedwe a islets, yotchedwa Langerhans.

Chomwe chimapangitsa kukula kwa matenda monga matenda a shuga kungakhale kusintha kwina mu endocrine system, nthawi zambiri amatha kukhala:

Matenda a Ischenko-Cushing,
Matenda a Pheochromocytoma,
Kupezeka kwa glucagonoma,
Wilson-Konovalov matenda,
Kukula kwa hemochromatosis.

Zizindikiro za matenda ashuga zimatha kuchitika chifukwa cha matenda a Cohn, pamene kagayidwe ka potaziyamu kamadwala. Zotsatira zakusowa kwa chinthuchi, ma hepatocytes a chiwindi sangathe kugwiritsa ntchito shuga kwathunthu, zomwe zimatsogolera mkhalidwe wa hyperglycemic wa thupi.

Amadziwika kuti matenda a shuga nthawi zambiri amaphatikizidwa ndi kapamba, chifukwa matenda a shuga a pancreatic amayamba kukula motsogozedwa ndi chiwonongeko cha insulin zida, zomwe zimatha chifukwa cha zovuta za autoimmune.

Matenda a shuga amaphatikizidwa m'mitundu iwiri, yoyamba ndi yachiwiri. Matenda a shuga a pancreatic ali ndi chifukwa chakulephera kwa autoimmune, amakula molingana ndi malamulo a matenda amtundu 1, koma ali ndi kusiyana komwe kumadza ndi matendawa komwe kumafunikira njira yapadera:

Pogwiritsa ntchito insulin pancreatic shuga, pachimake hyperglycemia imatha kuyamba.
Insulin yokwanira nthawi zambiri imayambitsa ketoacidosis.
Mtunduwu wa shuga umakonzedwa mosavuta ndi chakudya chokhala ndi zopatsa mphamvu zingapo zamagetsi.
Mtundu wa pancreatic wa matenda ashuga amayankha bwino akamagwiritsa ntchito mankhwala osokoneza bongo.

Kusiyanitsa kwakukulu pakati pa matenda a shuga a pancreatic ndi mtundu wake wamakedzedwe sikusowa kwa insulin, koma kuwonongeka mwachindunji kwa maselo a beta a gland ndi ma enzymes am'mimba. Komanso, matenda a kapamba payokha, motsutsana ndi matenda am'mimba a shuga, amakula mosiyanasiyana, kutupira mu ndulu kumatuluka pang'onopang'ono, kulibe matenda osapsa.

Ndi kukula kwa matendawa, mutha kuwona mawonekedwe ake:

Zizindikiro zopweteka zamitundu yosiyanasiyana
Pali zovuta zam'mimba,
Odwala amayamba kutulutsa, kupweteka m'mtima, kutsegula m'mimba.

Cancreatitis yayitali yakhazikika, pafupifupi hafu ya milandu, imayambitsa matenda a shuga, omwe amatha kawiri kuposa matenda a shuga omwe amayambitsidwa ndi zifukwa zina.

Mitundu ya matenda ashuga

Kuti mankhwalawa akhale othandiza kwambiri, muyenera kudziwa kuti wodwalayo amakhala ndi mtundu wanji wa matenda ashuga. Matenda a shuga amakhudza dongosolo la endocrine, ndipo maselo omwe akukhudzidwa ndi njirayi ali ndi mawonekedwe ena, amagwira ntchito zosiyanasiyana ndipo amagwirizana m'mabwalo amtundu wa Langerhans, omwe amakhala pafupifupi ziwiri peresenti ya zikondamoyo zonse. Kubisalira kwa mahomoni opangidwa ndi maselo awa kumakhala ndi zinthu zomwe zimagwira ntchito mu kagayidwe, kugaya ndi kukula.

Mwa kuchuluka kwathunthu, mitundu ingapo ya maselo a endocrine omwe amagwirizana ndi mahomoni okhudzidwa ndi metabolism ya carbohydrate amadziwika:

Maselo a Beta - kupanga insulin ndi amylin ochepa, ofunikira kuti magazi a shuga apatsidwe,
Ma cell a Alfa -kupanga glucagon, wokhudzidwa ndi kuwonongeka kwa mafuta ndikuwonjezera kuchuluka kwa shuga.

Amasiyanitsa matenda a shuga ndi kagwiridwe kake ka chitukuko, komanso njira zosiyanasiyana zowonetsera matendawa:

Mtundu woyamba wa shuga. Ndi matenda omwe amadalira insulin, nthawi zambiri amakula ali aang'ono, ngakhale awonjezedwa posachedwapa ndipo matendawa amapezeka mwa anthu azaka zapakati pa 40 mpaka 465. Matendawa amakula pambuyo poti ma cell ambiri a beta amwalira, zomwe zimachitika ndimikhalidwe ya autoimmune, ikayamba kupanga kupanga ma antibodies motsutsana ndi maselo ake. Zotsatira zake ndi kufa kwa maselo omwe amapanga insulin ndi kuchepa kwake kovuta.
Type 2 shuga. Matenda osadalira insulini omwe amadziwika ndi insulin yotsika kwambiri. Nthawi zambiri okalamba onenepa kwambiri amadwala matendawa. Njira yotukutsira imapangidwa pakupanga insulin, koma kutha kwake kulumikizana ndi maselo chifukwa cha kuchuluka kwake kwa shuga. Maselo, nawonso, amakhala osakwanira m'makina am'madzi ndipo amayamba kuwonetsa kuti awonjezere kupanga kwa timadzi timeneti. Popeza kukula kotereku sikungathe kupitirira kwamuyaya, pamabwera mphindi yakuchepa kwambiri kwa insulin.
Matenda a shuga oopsa. Zimachitika mobisa, ndikupanga insulini yeniyeni, kapamba pamenepa sakhala wowonongeka komanso wathanzi, ndipo thupi silizindikira timadzi timeneti.
Matenda a shuga. Ndi nthenda yachiwiri yomwe imayamba chifukwa cha ma pancreas. Izi zimabweretsa kutsika kwakukulu pakupanga kwa insulin, monga mtundu 1 wa shuga komanso chithunzi cha chitukuko - monga mtundu 2 matenda ashuga.
Matenda a shuga. Imachitika mwa amayi apakati mu theka lachiwiri la nthawi ya bere. Sizachilendo ndipo zimadziwonetsera pakupanga mahomoni ndi mwana wosabadwayo zomwe zimalepheretsa insulini ndi thupi la mayi. Shuga m'magazi a mkazi amawonjezeka chifukwa cha kupepuka kwa maselo a amayi ake kukhala pamankhwala abwino a insulin.
Matenda a shugakukulitsa chifukwa cha kuperewera kwa zakudya m'thupioyambitsidwa ndi njala. Nthawi zambiri amapezeka mwa anthu amisinkhu yosiyanasiyana omwe amakhala kumayiko otentha ndi otentha.

Mosasamala kanthu za etiology ya shuga, mitundu yake yonse imatsatiridwa ndi hyperglycemia, nthawi zina zovuta zomwe zimayambitsidwa ndi vuto ili m'magazi a glucosuria. Pankhaniyi, mafuta amakhala gwero lamphamvu, motsatana ndi njira ya lipolysis, chifukwa chake ambiri matupi a ketone amapangidwa. Nawonso amakhala ndi poizoni m'thupi wokhala ndi vuto la metabolic.

Zizindikiro za Pancreaticabetes

Matenda a shuga a pancreatic nthawi zambiri amakhudza odwala omwe ali ndi kuchuluka kwamanjenje komanso amakhala ndi chizolowezi kapena pafupi ndi thupi. Matendawa nthawi zambiri amayambitsidwa ndi zizindikiro za kuphwanya kwam'mimba thirakiti ya kukomoka kwa m'mimba, kutsegula m'mimba, komanso kuukira kwa mseru, kutentha pa mtima komanso kuphwanya thupi. Monga zizindikiro, zomverera zowawa mu dera la epigastric, komanso kukhala ndi mphamvu zosiyana kwambiri, ziyenera kutengedwa. Kukula kwa hyperglycemia ndi kutupa kwa kapamba kumachitika pang'onopang'ono, nthawi zambiri kuopsa kwa chizindikirochi kumawonedwa pambuyo pa zaka zisanu mpaka zisanu ndi ziwiri kuchokera pomwe matenda amayambika.

Matenda a shuga amtunduwu nthawi zambiri amakhala osachepera pang'ono ndipo amaphatikizidwa ndi kuwonjezeka pang'ono kwa shuga m'magazi ndipo nthawi zambiri amatsutsana ndi hypoglycemia. Nthawi zambiri, odwala amamva kukhala okhutira ndi hyperglycemia, mpaka 11 mmol / l, ndipo samakumana ndi matchulidwe a matendawa. Ngati chizindikiro ichi chikuwonjezereka kwambiri, ndiye kuti odwala amayamba kuwona mawonekedwe owonetsa a shuga a pancreatic mwanjira ya ludzu losatha, polyuria, khungu lowuma, ndi zina zambiri.Nthawi zambiri pamatendawa ndimatenda omwe amayambitsidwa ndi matenda osiyanasiyana komanso matenda a pakhungu.

Kusiyana pakati pa matenda a shuga a pancreatic ndi mitundu yake ina ndikuyenda bwino kwa mankhwalawa pogwiritsa ntchito mankhwala omwe amawotcha shuga ndi zofunika pazakudya.

Kodi pancreatitis imawonekera bwanji mtundu wa 2 shuga?

Nthawi zambiri, chomwe chimayambitsa matenda a shuga 2 ndikuwotchera kapamba ndimatenda a kapamba. Cholinga cha izi ndikuwonjezereka kwa glucose wamagazi panthawi yamatsenga a ziwalo. Matendawa amawoneka ngati ululu wopweteka kwambiri mu hypochondrium wamanzere ndikuphwanya njira zamkati.

Pali nthawi zingapo za matendawo.

Pali magawo ena achulukane amakulu a kapamba ndi nyengo yachikhululukiro,
Zotsatira za kuyimitsidwa kwa beta-cell, vuto la carbohydrate metabolism limachitika,
Kupititsa patsogolo kwa kapamba kumayambitsa matenda a shuga a 2.

Matenda onse awiriwa, akudziwonetsa palimodzi, amathandizira kuyipa kwa thupi la wodwalayo. Chifukwa chake, odwala omwe ali ndi pancreatitis samangochizira matenda oyambitsanso, komanso amatsatira zina zofunikira zaumoyo.

Zizindikiro zopweteka zomwe zimayamba chifukwa cha kapamba, limodzi ndi matenda amtundu wa 2, nthawi zambiri zimakhazikitsidwa mbali yakumanzere pansi pa nthiti. M'miyezi yoyamba ya matenda, matendawa samakhalitsa, pambuyo pake kumachitika ziphuphu zazitali. Ngati odwala akuchita chidwi ndi izi ndipo satsatira chakudyacho, ndiye kuti kapamba amatenga mawonekedwe osakanikirana, omwe amayamba ndi matenda am'mimba.

Kupweteka kwapancreatic komwe kumayenderana ndi shuga

Matenda a shuga nthawi zambiri amatha ndi ma pathologies osiyanasiyana mu kapamba omwe amasokoneza kupanga insulin. Nthawi yonseyi, kusintha kwa dystrophic kumapitilizabe ku chinthuchi, chifukwa chomwe maselo amtundu wa endocrine amavutika komanso kugwira ntchito kwa gland kumakhala kovuta. Malo omwe maselo a endocrine akufa amakhala ndi minyewa yolumikizana, kusokoneza magwiridwe antchito amaselo athanzi. Kusintha kwachilengedwe mu gawo la chithokomiro kungayambitse kufa kwathunthu kwa chiwalochi, ndipo kukula kwawo pamene matendawa akupita patsogolo kumayendetsedwa ndi chiwonetsero chowonjezereka cha kupweteka, kukula kwake komwe kumatengera mwachindunji kuchuluka kwa kuwonongeka.

Limagwirira ululu

Nthawi zambiri, magawo oyamba a shuga samayendera limodzi ndi kupweteka kwambiri, nthawi zambiri ululu wammbuyo umayamba chifukwa chakuwonongeka kwa kapamba chifukwa cha chotupa chomwe chimayamba m'mimba. Gawo loyambirira, lomwe nthawi amasintha owonetsa zizindikiro zopweteka kwakanthawi kochepa, limatha kukhala zaka khumi kapena kupitirira. M'tsogolomo, ululuwo umakulirakulira ndipo zizindikiro zina zimalumikizana nawo, zomwe zikuwonetsa kusintha kwam'mimba.

Ndi kusintha kwa kapamba mpaka mawonekedwe osakhazikika, kuchuluka kwa kuwonongeka kwa maselo mu kapamba kumawonjezeka, ndikupanga kulekerera kwa glucose. Ngakhale kuti kuchuluka kwa shuga m'magazi kumangotuluka kokha mutatha kudya, ndipo pamimba yopanda kanthu kumakhalabe kwabwinobwino, ululu womwe umatsatana ndi chiwonongeko umakula kwambiri. Nthawi zambiri, zimachitika mutatha kudya, panthawi yopulumutsidwa kwa madzi a pancreatic. Kudziwonetsa kwachizindikiro chodwala kumadalira mwachindunji kuti ndi mbali yanji ya kapamba yomwe wakhudzidwa. Kuwonongeka kwathunthu kwa chiwalo, wodwalayo amamva kupweteka kwakanthawi kolimba, komwe sikungathetsedwe ndi mankhwala amphamvu.

Kupititsa patsogolo Beta

Ndikotheka kuthana ndi vuto la kuchepetsa vernal pancreatic secretion mu shuga mwakuwonjezera kuchuluka kwa maselo a beta omwe ntchito yawo ndikupanga insulin.Pachifukwa ichi, maselo awoawo amasakanikirana, kenako nkuikiridwira mu gland. Chifukwa cha izi, kubwezeretsa kwathunthu kwa zinthu zomwe zinatayidwa ndi chiwalo ndi kukonza kwa kagayidwe kazomwe zimapangidwira zimachitika.

Chifukwa cha kukonzekera kwapadera kwa mapuloteni, thandizo limaperekedwa kuti lisamutsidwe maselo omwe adasinthidwa, omwe amangokhala zida zongowonjezera, m'maselo athunthu a beta okhazikika omwe amatha kupanga insulin yokwanira. Mankhwalawa amathandizanso kupanga insulin chifukwa chokhala ndi maselo owoneka bwino a beta.

Momwe mungabwezeretse chiwalo kudzera mu immunomodulation?

Zowonongeka za kapamba chifukwa cha kutupa kwake, maselo angapo a beta mulimonsemo amasungidwa. Komabe, thupilo, likupitilizabe kupitilizidwa ndi zisinthe zoipa mdziko la kapamba, limapitilizabe kupanga ma antibodies omwe cholinga chake ndi kuwononga zida zomwe zatsala. Ndikotheka kupulumutsa zinthuzo mothandizidwa ndi njira yatsopano ndikuyambitsa mankhwala apadera okhala ndi zinthu zomwe zitha kuwononga ma antibodies. Zotsatira zake, maselo a gland amakhala osasunthika ndikuyamba kuchulukitsa ambiri awo.

Kuchiza ndi wowerengeka azitsamba

Kuchita bwino kwambiri kwa mankhwalawa, mutha kuwonjezeranso ndimankhwala pogwiritsa ntchito wowerengeka azitsamba. Mu mtundu uwu, decoctions ndi infusions zochokera pazomera zamankhwala zomwe zimakhala ndi zofunikira pobwezeretsa kapamba zimagwiritsidwa ntchito.

Kuchepetsa kwapadera komwe kumakhudza mkhalidwe wa kapamba pakakhala kutupa ndikosavuta ndipo, nthawi yomweyo, kugwiritsidwa ntchito kwa decoction ya mbewu ya oat mkaka. Pa kukonzekera kwake, makapu 0,5 a thundu yonse ya oat amaphika mu 1.5 malita a mkaka kwa mphindi 45, pambuyo pake mbewuzo zimaphwanyidwa ndikupitilizabe mphindi zina 15. Msuzi umasefa ndipo umatengedwa ndi theka lagalasi mpaka kanayi patsiku.

Pali njira zina zambiri zogwira mtima potengera zomwe zadziwika zomwe zimathandizira kubwezeretsa kapamba. Komabe, ndibwino kuzigwiritsa ntchito pambuyo povomerezedwa ndi dokotala wanu.

Zakudya ndi kupewa matenda

Zakudya zofunika kwa odwala matenda ashuga ndi imodzi mwazinthu zofunikira kwambiri pakuchiza matendawa. Kwenikweni, amakhala ndi malire pazomwe zimaletsedwa kugwiritsa ntchito zinthu zophatika ndi mafuta mu mawonekedwe a muffin, confectionery, makeke okoma, etc. Maziko azakudya ayenera kukhala zakudya zama protein ambiri, kupatula zakudya zokazinga, zonunkhira zotentha, nyemba, msuzi wambiri.

Monga njira yothanirana ndi chitukuko cha matenda a shuga a pancreatic, ndikofunikira kuwongolera boma lanu la kapamba ndikusamalira thanzi lake. Choyamba, muyenera kusiya mowa uliwonse, kutsatira zakudya, komanso nthawi zonse, osati kokha munthawi yakukokomeza, komanso ndi zizindikiro zoyambirira za kusokonekera mu mkhalidwe wa thupili, osazengereza kuchezera dokotala.

Okondedwa owerenga, kodi nkhaniyi idathandiza? Mukuganiza bwanji zamankhwala othandizira odwala matenda ashuga? Siyani ndemanga! Malingaliro anu ndiofunika kwa ife!

Valery:

Zikuwoneka kwa ine kuti malo abwino kwambiri othandizira matenda a shuga ndi chakudya. Mankhwala aliwonse omwe mumamwa, ndipo ngati mumadya molakwika, ndiye kuti palibe chomwe chingakuthandizeni, chithandizo chonse chimatsikira pakukhetsa.

Inga: