Cishe bonke abantu bayazi ukuthi emzimbeni kukhona isitho esinjalo - amanyikwe, wephula umsebenzi waso, isifo sikashukela noma i-pancreatitis sikhula ngokungenakuphikwa. Izimo ze-pathological zidalwa yizici ezahlukahlukene, ziyehluka ngezimpawu, izindlela zokwelashwa.
Kodwa kungani izifo zesitho esifanayo ziba imbangela yokuphazamiseka kokugaya ukudla nezinqubo ze-metabolic? Impendulo yalo mbuzo ilele ezinhlelweni zomsebenzi wamanyikwe kanye nesakhiwo sawo.
Nge-Latin, pancreas ibizwa ngokuthi ama-pancreas, kusuka kuleli gama amagama athi pancreatic, pancreatitis avela. Umzimba ukhiqiza ama-enzyme e-pancreatic adingekayo ekugayweni kokudla, afake ama-hormone ahlukahlukene egazini, ngokuyinhloko i-insulin.
Ama-pancreas akhona kuphi?
Amanyikwe atholakala esiswini esingaphezulu endaweni yokubuyisa esezingeni le-vertebrae yokuqala neyesibili. Udonga lwangemuva lwesisu kanye nengaphambili lamanyikwe lihlukaniswe yi-omentum - ungqimba lwamafutha.
I-gland itholakala cishe phakathi komzimba, ivela kwi-hypochondrium yangakwesobunxele kuya esibondeni. Ingxenye yangemuva yesitho ixhumana ne-vena cava ephansi, i-aorta. Lapho uhlola umzimba womuntu usesimweni sokudla, amanyikwe atholakala ngqo ngaphansi kwesisu, imithambo yegazi nomgogodla kulele ngezansi.
Ukwakheka kwendlala kukhuphukile, ingxenye enkulu yayo ibizwa ngokuthi inhloko, ububanzi bungafinyelela amasentimitha ayi-7.5. Inhloko idlula kahle emzimbeni omncane, umsila wamanyikwe uphuma ngakwesobunxele, ngokuvamile, ubukhulu besitho bungamasentimitha ayi-14 kuye kwangama-23.
Emuva kwekhanda kukhona i-duodenum, ekukhanyiseni kwayo i-Wirsung duct iyavula, lapho kuthunyelwa khona ujusi we-pancreatic, oqukethe ama-enzyme abalulekile adiliza ukudla aye esimweni samamolekyuli.
Ukuphela kwe-duct kuyahlangana ne-bile duct, okuphuma kuyo i-bile. Okukhombisa okulandelayo:
- ubunye bokusebenza kokugaya kwama-pancreas nesibindi;
- ukuxhumana kwezinqubo zokugaya ukudla e-duodenum;
- ukuthuthukiswa kunokwenzeka okufanayo kwezifo zalezi zitho.
I-Wirsung duct odongeni lwe-duodenum yakha i-Vater nipple, kulokhu ukuphakama kuyisiyingi somsipha wesiyingi se-Oddi. Ngesikhathi sokukhubazeka, kuvimbela imicucu ye-pancreatic, ngenkathi iphumula, ujusi we-pancreatic kanye nengxenye ye-bile kufakwa emathunjini. Kwabanye abantu, ama-pancreas angakha indandatho ezungeze i-duodenum, ayinciphise.
Isitho esingenhla simbozwe nge-capsule emincane kakhulu, ngawo
Isakhiwo somlando wamanyikwe
I-pancreas iyisitho esine-anatomy eyinkimbinkimbi, iqukethe izingxenye ezimbili eziyinhloko ezinemisebenzi ehlukene: i-exocrine, i-endocrine. Ingxenye ye-exocrine inomthwalo wemfihlo yokutholakala kwezinto ezi-pancreatic, iba yingxenye eyinhloko yesitho, yakha okuqukethwe okungaphakathi, okukhawulelwe yizindonga ze-gland.
Amaseli ale ngxenye akha izingqimba ezikhethekile, ezihlanganiswe ku-lobules - amaseli e-pancreas. Lezi zingosi zikhiqiza ama-enzyme, kufaka phakathi: i-lipase, i-amylase ne-proteinase.
Ama-dancons amancane e-pancreatic axhumeka ngokushelela nezinkulu, ukuze ama-enzyme e-pancreatic angene kwi-Wirsung duct. Uma kwenzeka umonakalo engxenyeni ye-exocrine yesitho, isiguli sihlushwa inqubo yokuvuvukala kumanyikwe, okuyi-pancreatitis.
Emgodini wengxenye ye-exocrine, ikakhulukazi emsileni we-gland, kunezingxenye ezincane zengxenye ye-endocrine, zihlala cishe iphesenti elilodwa lesisindo sesitho futhi zibizwa ngokuthi izichibi zaseLangerhans. Kukhona cishe isigidi salawa maseli, kuya ngohlobo lwamahomoni akhululeka ngawo:
- insulin;
- somatostatin;
- i-glucagon;
- i-pancreatic polypeptide.
Ngaphezulu kwesiqhingi saseLangerhans kunethiwekhi yama-capillaries amancane egazi, evumela ukuthi ama-hormone angene ngokushesha egazini. Lapho le ngxenye ye-gland ithinteka, lesi sifo senzeka ngohlobo lwesifo sikashukela sohlobo lokuqala (lwe-congenital) noma lwesibili (olutholakele) (kuye ngezimbangela zokuphazamiseka).
Ama-pancreas anikezwa ngegazi kusuka emithanjeni yamaqembu ahlukene: i-mesenteric ephakeme, i-hepatic ejwayelekile, i-splenic. Igazi lidonswa kusuka emthanjeni lingene kuthambo lwe-portal. I-gland nayo ifakwe nenombolo enkulu yemiphetho yezinzwa ekhuphuka kusuka ku-celiac plexus ne-vagus nerve.
Ukungeniswa kwemvelo kwenza sikwazi ukulawula ukugcinwa kwama-hormone nama-enzyme e-pancreatic, ukusebenza kwe-gland kunganqunywa yinkomba yazo zonke izinhlobo zezinto.
Lo mthetho ubizwa nge-humoral.
Umsebenzi we-Exocrine
Umdwebo wesakhiwo sengxenye ye-pancreas nesifunda se-endocrine usiza ukuba nomqondo ngesitho, imisebenzi yaso. Kodwa-ke, kuyadingeka ukuthola ukuthi yiliphi iqhaza lesitho esidlalayo emzimbeni womuntu.
Ngokuhambisana nokwakheka kwama-pancreas, kuyadingeka ukwenza imisebenzi: i-exocrine (exocrine) ne-intracretory (endocrine). Umsebenzi we-exocrine ukufihlwa kwejusi ye-pancreatic equkethe ama-enymes enzelwe ukugaya ukudla: i-nuclease, lipase, amylase, proteinase, i-steapsin.
I-Nuclease iyadingeka ekuqhekekeni kwama-nucleic acid angena emzimbeni ngokudla. Benza izinto ezingaziwa ukuthi zingene emzimbeni wokugaya zihlukane zibe izingxenye ezincane.
Amaprotheni adingeka ekuqhekekeni kwamaprotheni, okubaluleke kakhulu kuma-enzymes chymotrypsinogen, trypsinogen, yile:
- kukhiqizwe ngendlela engasebenzi;
- sebenza emathunjini ngaphansi kwesenzo se-enterokinase;
- iphenduka ibe chymotrypsin, trypsin.
Amakhemikhali aphumelelayo anamandla ngokwanele, aphula amaprotheni kuma-amino acid.
Ngenxa ye-amylase, isitashi kanye ne-glycogen kugayiwe, i-lipase ne-steapsin kuyadingeka ekuqhekekeni kwe-lipid.
Ama-pancreas akhiqiza ujusi we-pancreatic ezingxenyeni ezincane, izici ezahlukahlukene zingathuthukisa ukucasha kwakhe. Phakathi kwalokho: isimo esibonakalayo se-Reflex (ukubukeka kokudla, ukuhogela, ukulungiselela isidlo), i-Reflex ngokungenamkhawulo (inqubo yokuhlafuna nokugwinya ukudla), izinto ezihlazisayo, ukuqina kwesisu.
Ukulawulwa kwe-humoral kuqinisekiswa i-pancreosimine yamathumbu, i-secretin, ekhishwa amaseli we-duodenum lapho i-hydrochloric acid, imikhiqizo yokuqhekeka kwamaprotheni ingena kuyo. Ngakho-ke, ukukhiqizwa kwejusi ye-pancreatic kuncike ngqo ekungeneni kokudla.
Ama-reflexes angenasici futhi anezimo athinta ukugcinwa kwejusi lesisu ngokusebenzisa isikhungo e-medulla oblongata, inqubo yokuhlukaniswa kwezinto ze-enzyme, inani elithile lama-hormone kuncike emsebenzini:
- indlala yegilo;
- indlala yesikhumba;
- izindlala ze-adrenal.
Lapho lo mshini usuqhekekile, amanyikwe nawo abahlupheka.
Umsebenzi we-Endocrine
Ngaphansi kwethonya lezinto ezihlekisayo, ama-islet cell secrete ama-hormone i-insulin, i-glucagon, i-somatostatin ne-pancreatic polypeptide egazini. I-insulin iyadingeka ukuze kuthathwe ama-molecule eglucose amangqamuzana omzimba, okokuqala, lokhu kuphathelene nezicubu zomzimba namafutha.
Kukhona ukuguqulwa kweshukela ku-glycogen, kugcinwa esibindini nasemisipha, kudliwe lapho kunesidingo. Ukuntuleka kwe-insulin ye-hormone, ukwephulwa komphumela wawo emzimbeni kufaka ukuthuthukiswa kohlobo 1 noma isifo sikashukela 2 (isifo sikashukela esenziwe kabusha).
I-glucagon ye-hormone inethonya elehlukile kwe-insulin; ibangela ukuwohloka kwe-glycogen esibindini, kanye nokwanda kwe-glycemia. Kuyavela ukuthi womabili ama-hormone asiza ukugcina inani elifanele lama-carbohydrate.
Umuthi somatostatin umisa ukufihla:
- ama-hormone we-thyroid avuselelayo kanye ne-pancreatic;
- bile;
- ama-enzyme wokugaya.
I-polypeptide inyusa imfihlo yokuphuza ijusi esiswini, amaseli e-islet ayakwazi ukufaka isamba esincane sehomoni yendlala (ghrelin), c-peptide. Lezi zinto zinomthelela ekugayeni okujwayelekile.
Ngomonakalo we-pancreatic parenchyma, iziqithana zeLangerhans ziyahlupheka, izinqubo zokulawulwa kokugaya, ukumuncwa kwezakhi ezibalulekile zenguquko. Noma yisiphi isifo se-pancreatic kumele siphathwe ngendlela yesikhathi, isitho sibalulekile empilweni yabantu.
I-pathology eyingozi kakhulu i-adenocarcinoma lapho umdlavuza wezicubu ze-glandular ukhula.
Izimpawu zokuntuleka kwe-enzyme
Imiphumela yenqubo yokuvuvukala kumanyikwe ingukukhubazeka, ukusweleka kanye nokukhiqizwa okwehlile kwama-enzyme. Ngaphezu kwalokho, ngokuqhubeka kwesikhathi, kukhona ukonakala kwezicubu zeglandular zesitho ku-connective.
Imbangela yokuqala yalesi sifo umkhuba wokusebenzisa kabi utshwala, kanye nokungondleki, ukuba khona kwezinye izifo ezikhona, ukulimala, ukutheleleka kanye nokusebenzisa isikhathi eside kwemithi.
Ukuntuleka kwe-lipase, i-amylase ne-trypsin kuvusa ukuphazamiseka okukhulu kokugaya ukudla. Izimpawu zokungasebenzi kahle kumanyikwe ziyoba yimizwa engathandeki emgobeni wesisu wasesiswini ngaphansi kwezimbambo, usizi ngemuva kokudla.
Okunye ukubonakaliswa kwesimo se-pathological kuzoba:
- ukugabha, isicanucanu;
- ukwehla kwesifiso sokudla;
- ukuthopha;
- ushintsho ekuvumelaneni, umbala wezindunduma;
- kuqhuma esiswini.
Ubukhulu bezimpawu kuncike ekutheni isifo siqine kangakanani. Ngenxa yokugaya kahle umzimba, umzimba uhlushwa ukuntuleka kwezakhi zomzimba, ukuphazamiseka kwe-metabolic kubangela i-osteoarthrosis, i-osteochondrosis, i-vashericherherosis.
Ukushoda kwe-Lipase kuzenza zizizwe kunamafutha, izitofu ezikhululekile, ukugcotshwa ngokweqile kwamafutha ngamanyumba. Ukushoda kwe-Amylase kubonakaliswa yisifo sohudo, ukusweleka kwevithamini, ukugcwala okwandisiwe kwe-microflora enamathuba, istulo se-volumetric. Inani elincane le-trypsin livezwa yi-mushy stool, i-anemia.
Njengoba inqubo yokuhlukanisa ukudla iphazamisekile, ngokubhekisele emuva kokudla okunempilo, kukhona:
- ukunciphisa umzimba;
- ukusweleka kwamavithamini;
- isikhumba esomile;
- ukuqina kwezipikili.
Ukuhamba kwamathumbu okwenzeka njalo, ukukhiqizwa kwegesi okwandayo kanye nokungcola nakho kuyenzeka.
Ukwephulwa kokuphuma kwezinto ze-enzyme emathunjini kubangela ukucasuka kwezicubu ze-pancreatic, izifo kanye ne-pancreatic necrosis. Lapho amaseli e-islet elimele, umsebenzi wokukhiqiza i-hormone insulin uvinjiwe, izimpawu zesifo sikashukela sohlobo lokuqala nolwesibili lukhuphuka, ubukhulu bezimpawu kuncike enanini lamaseli we-beta bukhoma.
Ukuntuleka kwe-glucagon akunamphumela omubi onamandla kangako, ngoba amanye ama-hormone anomphumela ofanayo akhiqizwa emzimbeni .Ukuthola ukuxilongwa, udokotela uzodinga i-histology yamanyikwe kanye nezinye izifundo.
Imisebenzi nokwakheka kwama-pancreas kuxoxwa ngakho kule vidiyo ekulesi sihloko.
