I-pancreas ngesinye sezitho ezibaluleke kakhulu zomgudu wesisu emzimbeni womuntu. Isisindo sakhe sifinyelela ku-200 amagremu. I-gland itholakala emuva, ngemuva kwesisu, njengoba kufakazelwa igama ngokwalo, cishe ezingeni lama-vertebrae amabili okuqala. Isisindo somzimba esiphezulu sigcotshwa siseminyakeni engu-30 kuye kwengama-40, bese siqala ukuncipha kancane kancane ngosayizi.
I-anatomy kuleli cala ilula impela. Ama-pancreas womuntu aqukethe izingxenye ezintathu - ikhanda, umzimba nomsila. Ikhanda likhanye kancane, bese kuba nengxenye encane yobude obufanayo nobukhulu - lo ngumzimba. Igcina ngokuncipha okuncane kwe-gland, okuyisitila. Umsila uthinta izinso zesokunxele nemithambo yayo (i-artery, i-vein), umzimba - i-aorta ne-vein, eqoqa igazi emthanjeni, kanye nekhanda - ngemithambo yezinso nemithambo ehlukahlukene yesisu.
Imisebenzi yama-pancreas ihluke kakhulu. Kuyisitho secretion exubile. Kusho ukuthini lokhu? Umsebenzi we-endocrine ukukhiqizwa kwama-hormone, afaka:
- I-insulin yi-hormone elawula amazinga kashukela egazini. Yehlisa ushukela. Ngokuntuleka kwayo noma ukungatholakali kwayo ngokuphelele, kuba nesifo esidume ngokuthi isifo sikashukela, bese iziguli ziphoqelelwa ukuthi zihlale imijovo yokulungiselela i-insulin impilo.
- I-Glucagon - le hormone ibuye ibambe iqhaza kulawulo lwe-carbohydrate metabolism, kepha umphumela wayo ubhekene ne-insulin. Kwandisa ushukela wegazi. Izifo ezihambisana nokufihlwa kokulimala zivame kakhulu.
- I-Somatostatin yi-hormone evimbela ukukhiqizwa kanye nesenzo se-hormone yokukhula (i-hormone yokukhula).
- I-pancreatic polypeptide iyinto ebandakanyeka ngqo ezinqubweni zokugaya, isiza ukumuncwa kokudla okugcwele.
Zonke izinto zesimo se-hormonal zenziwa ngamaseli akhethekile wamanyikwe, ngokubizwa ngokuthi ama-islets weLangerhans, futhi atholakala ikakhulu emsileni.
Umsebenzi we-Exocrine unqunywa ukukhiqizwa kwama-enzyme wokugaya kanye ujusi we-pancreatic. Ama-enzymes anjenge-trypsin (ibandakanyeka ekuqhekekeni kwama-polypeptides), ama-amylase (asiza ukufaka umzimba kuma-carbohydrate) kanye ne-lipase (iphula phansi amafutha kuye kuma-triglycerides).
Imininingwane ye-duct ejwayelekile
Ama-enzymes nejusi le-pancreatic aqhamuka kumanyikwe ayongena kwi-duodenum ngemigqa yamanyikwe. Kunezinhlobo ezimbili zama-ducts - eyokuqala neyesibili.
I-duct eyisisekelo eyaziwa ngokuthi i-Wirsung. Njengokulindelekile, ekuhambeni kwalolu duct, izimbungulu eziningi ezincane zingena kulo, ngalinye lithwale imfihlo ethile.
Indawo yabo nenombolo yabo kungahlukahluka kumuntu nomuntu. I-Wirsung duct ingaba nesimo esehlukile: i-arched, ngesimo sedolo, ngesimo sencwadi yesiNgisi S, kepha imvamisa iphindaphinda ukwakheka kwendlala uqobo. Njengoba isondela e-duodenum, ububanzi be-duct kancane kancane buyehla.
Kunezinhlobo ezimbili zesakhiwo sohlelo lwe-ductal of pancreas - eyinhloko nelikhululekile. Uhlobo oluphambili luboniswa hhayi inani elikhulu lamadonki amancane ahamba aphambili. Inani elilinganisiwe lingu-18-34, kanti ibanga phakathi kwezindawo zokuhlangana kwabo alidluli isentimitha elilodwa nesigamu. Ngesakhiwo esisele, kuze kufinyelele kuma-ducts amancane angama-60, izikhala phakathi kwazo ezingekho ngaphezu kwamamilimitha amabili.
Izicucu ze-pancreas ezivelele zingavula ngokuhlukile ku-duodenum. Cishe i-60% yabantu ine-fusion yemigqa eyinhloko neyengeziwe mayelana nama-millimitha amathathu ngaphambi kokungena emathunjini. I-Atrophy yegatsha lase-Wirsung duct kwesinye isikhathi iba khona, futhi lonke ujusi we-pancreatic ungena endaweni ebekiwe nge-duct eyengeziwe.
Lokhu kulungiswa kutholakala kuphela kumaphesenti ayi-10. Ku-20%, i-duct enkulu ayixhumeki ne-bile ejwayelekile futhi ivula ngaphakathi kwe-duodenum 2-4 cm ngaphezulu kwendawo okuhloswe ngayo.
Futhi kwezinye izimo, kungenzeka ukuthi uhlanganise izimbambo eziyinhloko nezengeziwe ebangeni elikhulu ukusuka ekuhlanganiseni. Ngokuvamile, ububanzi be-duct abudluli kuma-2 mm.
Yonke imisele ivulwa, njengoba kushiwo ngenhla, iye e-duodenum. Le ndawo ibizwa ngokuthi i- papilla enkulu yama-pancreas, noma i-Vater papilla. Ukulawulwa kwejusi le-pancreatic kanye ne-enzyme kulawulwa ngumsipha oyindilinga epapilla. Elinye igama laso yi-sphincter yase-Oddi. Ukuncishiswa kwaso kuvimbela ukudlula kokuqukethwe kwebhubulethi ku-lumen yamathumbu.
I-papilla encane ye-duodenum nayo ingaba khona, emlonyeni lapho, kwezinye izikhathi, kuvulwa khona i-duct eyengeziwe, noma iSantorinius. Uzungezwe i-sphincter Helly.
Ukuhlukunyezwa kwendlu
Kunezindlela ezahlukahlukene zendawo nokuxhunywa kwama-ducts, kepha kukhona futhi ukwephulwa esakhiweni nasekwenzeni kwasendaweni ama-pancreatic ducts.
Ukwephulwa okunjalo kubizwa ngokuthi ama-anomalies. Ama-Anomalies azalwa futhi atholakala. Izizathu ezibalulekile zokukhula kwazo zibhekwa njengokuphambi kofuzo, imiphumela yokutheleleka ngegciwane kanye ne-virus, kanye nomonakalo odabukisayo kumanyikwe.
Ukuphazamiseka kwemvelo kokubeletha kufaka phakathi i-stenosis yemigqa ye-excretory ducts. Ikhula njengomphumela wokuhlanganiswa kwe-Wirsung duct ibe yimiphumela emibili eyinhloko.
Ngenxa ye-stenosis, ukufakwa kwesithukuthezi se-pancreatic ku-duodenum kungathikamezeka, futhi lokhu kungaholela ekutheni kugaywe nokulimala kokudla, ukuntuleka kwezakhi ezithile emzimbeni kanye nobuhlungu.
Ngaphezu kwe-stenosis yokuzalwa, i-cystic fibrosis iyodwa. Ngalesi ushintsho olungalingani, olulinganiselayo nolulungele ukuthuthukiswa kwejusi le-pancreatic. Lokhu kungaholela ekuphulweni kwesakhiwo sangaphakathi samanyikwe nezifo ezahlukahlukene.
Ukungalungi okutholakele kufaka phakathi ukunwetshwa kanye nokuvinjwa kwemisele. Imvamisa, ububanzi be-tubule abudluli kuma-2 mm. Ukwanda kuholela kuzizathu ezahlukahlukene, ezibandakanya:
- i-benign ne-neoplasms eyingozi endaweni yekhanda le-pancreas;
- ukuba khona kwe-calculi (amatshe) emiseleni;
- ukugqagqana kwe-lumen;
- inqubo yokuvuvukala okungapheli e-gland (noma i-pancreatitis);
- izinkinga ezivelayo ngemuva kokusebenza kweWhipple;
- ukususwa okuyingxenye kwama-pancreas.
Ngaphezu kwalokho, ezimweni ezi-5%, kutholakala isiteshi esengeziwe sokuhlukumeza, esiqala ekhoneni lendlala bese siyavula esifundeni se-Helly sphincter.
Ngokuvaleka kwayo, kubuye kudaleke i-pancreatitis eyingozi.
I-pancreatitis - izimbangela nezimpawu
Njengoba i-pancreatitis ingenye yezimbangela, kanye nemiphumela evame ukuvela yokungalingani kwe-duct, kufanele ukhulume ngayo ngemininingwane eminingi.
I-pancreatitis yisifo esivuvukelayo esithinta i-pancreas.
Lesi sifo sehlukaniswe saba nzima futhi esingamahlalakhona. I-pancreatitis ye-acute kwenzeka ngokuzumayo, inzima kakhulu futhi imvamisa idinga ukwelashwa okuhlinzwa. I-Chronic, ngakolunye uhlangothi, isulwa kakhulu emtholampilo, futhi ibonakaliswa ukuphazamiseka okugaya ukudla okuqhubekayo.
Izimbangela ze-pancreatitis zifaka okulandelayo:
- Ukuphuza kaningi nokuphuza kakhulu.
- Umonakalo odabukisayo kumanyikwe.
- Ukubhema isikhathi eside.
- Ukusetshenziswa isikhathi eside kwemithi ethinta kabi umzimba.
- Ukuba khona ekudleni kwamafutha, okuthosiwe, ukudla okubhemayo.
- Isisulu sokuqothuka.
- Isifo se-Gallstone.
- Ukuphazamiseka okuthe xaxa kwama-hormone.
- Ukuzila isikhathi eside.
- Isifo sokuqina kwesibindi.
- Izifo ezibangelwa amagciwane kanye namagciwane.
- I-cystic fibrosis.
- Izimpumputhe (ukuvuvukala kwezindlala ze-salivary)
- Ukungezwani komzimba nokudla.
Inkambo engapheli yesifo se-pancreatitis ithandeka kakhulu futhi inezimpawu eziphinyiselwe kakhulu kune-acute. Kwezinye izimo, kungenzeka kube yi-asymptomatic, kepha ikakhulukazi kunezimpawu zobuso ebusweni. Ngenqubo engapheli, ukubonakaliswa okujwayelekile yile:
- umuntu ubonakala ngemizwa yokwenyanya emehlweni wamafutha;
- ngesikhathi sokuzivocavoca ngokomzimba, ubuhlungu obungathandeki buvela ngaphansi kobambo olungakwesokunxele;
- kuba khona ukuphazamiseka kokugaya okujwayelekile ngendlela yesifo sohudo kanye nesisu ngenxa yokuntuleka kwama-enzyme;
- iziguli ziphelelwa yisifiso sokudla;
- iziguli zehlisa isisindo ngokushesha futhi azikwazi ukuthola isisindo;
- ukweqile ngokweqile;
- belching;
- ukushaya kwenhliziyo ngaphandle kwesizathu esibonakalayo.
Esigabeni sokwanda kwenqubo yokuvuvukala, ukunakwa kufanele kukhokhwe ngokushesha ekubonakaleni kwezimpawu ezilandelayo:
- Ubuhlungu besimo esibuhlungu, esishayayo, esivame ukwenzeka epigastrium, kepha bese sithatha umlingiswa oxegayo. Ubuhlungu bungakhanyisela ngakwesobunxele. Ubuhlungu bungaba yi-paroxysmal. Zibizwa ngokukhethekile ngemuva kokuphulwa kokudla okubekiwe ngaphambili.
- Isicanucanu esikhulu. Kwesinye isikhathi ukuhlanza kwenzeka kwi-pancreatitis eyingozi.
- Ukuhlanza okufana nomthombo, cishe ngaphandle kokukhululeka.
- Isisu siba “iplanky” ngenxa yokuxaka kwemisipha odongeni lwesisu;
- Kukhulisa umjuluko.
- I-Pallor, ubuthakathaka obukhulu.
- Ukuphakamisa izinga lokushisa ezinombolweni ezi-febrile (38-39 degrees).
- Ngesikhathi sokuhamba kwamathumbu, isiguli sizobheka ukutholakala kwe-liquid engaguqukiyo ngokubakhona kwamafutha, okukhombisa ukuntuleka kwe-lipase.
- Ukushaya kwenhliziyo kuzoba njalo futhi kube namandla.
I-pancreatitis inganda kakhulu, ikakhulukazi ngenxa yokwephulwa kokudla.
Ukuxilongwa nokwelashwa kwalesi sifo
Ukuxilongwa kwe-pancreatitis kwenziwa kusetshenziswa izifundo zaselebhu kanye nezinsimbi. Phakathi kwendawo yokucwaninga, kuhlolwa ukuhlolwa kwegazi kwe-biochemical, okusiza ukuthola ukwanda kwezinga le-pancreatic enzymes (lipase, trypsin, amylase), i-alanine aminotransferase kanye ne-aspartate aminotransferase (amasampula wesibindi). Ukuhlolwa komchamo okujwayelekile kuyenziwa futhi, lapho udokotela angabona khona i-amylase, okungafanele ibe yinto ejwayelekile. Ngaphezu kokuhlaziya, iziguli zidluliselwa nge-ultrasound, firmogastroscopy, isifuba x-ray, i-pancreatic angiography, ukuxilongwa kwe-laparoscopic, i-CT ne-MRI.
Ukwelashwa kwe-pancreatitis kuya ngohlobo lwenqubo yokuvuvukala. I-pancreatitis ye-acute iphathwa ngezidakamizwa ezivimbela ukucasulwa kwama-enzyme e-pancreatic, elinye igama ama-proteinase inhibitors.
Umuthi osetshenziswa kakhulu yi-Contrycal, enikezwa iziguli nge-Drip. Ngaphezu kwalokho, njengakuqala kwenkambo yesifo, ukugcinwa okuqinile kokudla kuyadingeka, kuphakamisa ukukhishwa okuphelele ekudleni:
- utshwala
- iziphuzo zekhabhoni;
- amasoseji;
- ukudla okusemathinini;
- ukubhema inyama;
- ukudla okuthosiwe;
- ukudla okunamafutha nosawoti;
- izinongo eziningi kanye nokosa;
- amaswidi.
Ngaphezu kwalokho, kunconywa ekudleni okushisa kwekamelo.
Ukuvimbela ukwenzeka noma ukwanda kwe-pancreatitis, kufanele udle ngokulingana, kahle nangokujwayelekile. Udinga ukwazi isilinganiso ekusetshenzisweni kotshwala, ukulandela indlela odla ngayo, ukudlala imidlalo, ukugwema ukulimala esiswini, ukuphumelela ngempumelelo nangesikhathi esifanele kuzo zonke izifo ezithi, ngandlela thile, zibangele ukuqala kwenqubo yokuvuvukala. Uma umuntu egula kakade nefomu elingelapheki, khona-ke kufanele alandele ngokuqinile imiyalo kadokotela ohambayo, aphuze yonke izidakamizwa ngokuhambisana nezincomo ezikhishwe.
Ngaphezu kwalokho, umuntu akufanele avumele ukucindezelwa kwezinzwa okungathinta kabi isimo somzimba.
Isakhiwo nemisebenzi yamanyikwe kuchazwe kule vidiyo kule ndatshana.
