Enye yezitho zomzimba ezibaluleke kakhulu ama-pancreas.
Itholakala emgodini wesisu futhi yenza imisebenzi eminingana, okubaluleke kakhulu okuwukuhlanganiswa kwama-enzyme abandakanyeka ekugayweni (i-exocrine) nokwakhiwa kwama-hormone abandakanyeka ekudleni kwama-carbohydrate. Ukusebenza okungalungile kwesitho kungadala imiphumela emibi impela - ukuthuthukiswa kwe-pancreatic necrosis, isifo sikashukela, kanti kwezinye izimo kufa. Kwesinye isikhathi, ngenxa yezizathu eziningi ezahlukahlukene, insimbi iyayeka ukufeza imisebenzi yayo ngokwengxenye noma ngokuphelele, ngakho-ke kuphakama umbuzo wokufakelwa kwaso.
Njengamanje, imisebenzi yokufakelwa yenziwa emazweni amaningi, okusivumela ukuthi sikhulume ngokuthuthuka okungapheli kwemithi kule ndawo. Enye yamasampula e-pancreatic transplant yohlobo lwe-1 yesifo sikashukela yenziwa emuva ngonyaka we-1891, okwakuyiminyaka engamashumi amathathu ngaphambi kokutholwa kwe-insulin, kepha lokho kuhlinzwa kwenziwa okokuqala ngo-1966 eMelika.
Namuhla, umuthi uthathe isinyathelo esibalulekile emkhakheni we-pancreatic transplantation, ngenxa yokusetshenziswa kwe-cyclosporin A kuhlangene nama-steroid.
Ukusebenza ngempumelelo kanye nokuphumelela kokuphothulwa kokusebenza kuncike ezicini eziningi, ngoba le nqubo iboniswa kuphela ezimweni ezimbi kakhulu futhi inendleko eziphakeme ngokufanele. Isiguli ngasinye kufanele sibhekane nocwaningo kanye nokuxilonga, imiphumela udokotela enquma ukufanele kwenqubo. Kunezinhlobo eziningi zokuxilonga, phakathi kwazo ezibaluleke kakhulu yile elandelayo:
- Ukwenza ukuhlolwa okugcwele ngudokotela wezokwelapha futhi abonisane nodokotela abakhethekile kakhulu - udokotela ohlinzayo ngokuhlinzwa, udokotela ohlinzayo, udokotela wobulala izinzwa, udokotela wamazinyo, udokotela wezifo zabesifazane nabanye;
- Ukuhlolwa kwe-Ultrasound kwemisipha yenhliziyo, izitho ezi-peritoneal, i-x-ray yesifuba, i-electrocardiogram, i-compact tomography;
- Amasampula egazi ahlukahlukene
- Ukuhlaziywa okukhethekile okuthola ubukhona bama-antigen, okubalulekile ukuhambisana nezicubu.
Njengoba noma yikuphi ukukhohlisa kokuhlinzwa kuyinqubo eyingozi esigulini, kunezinkomba ezimbalwa zokuthi lapho kudluliswa kwamanyikwe kuwukuphela kwendlela yokuqinisekisa ukusebenza komuntu okujwayelekile:
- Ukufakelwa kwepancreatic kuhlobo lokuqala lwesifo sikashukela ngaphambi kokuqala kwezinkinga ezinkulu zalesi sifo, njenge-retinopathy, esingaqala ngokuba ubumpumputhe; i-pathology yomsebenzi we-vascular; izinhlobo ezahlukahlukene ze-nephropathy; hyperlability
- I-mellitus yesibili yesifo sikashukela, engabangelwa inkambo ekhethekile ye-pancreatitis, lapho kukhula khona i-pancreatic necrosis, umdlavuza we-pancreatic, immune immune isiguli ku-insulin, hemochromatosis;
- Ukuba khona kwezilonda ezihlelekile zezicubu zezitho, kufaka phakathi i-malignant noma i-benign neoplasms, ukufa kwezicubu okubanzi, izinhlobo ezahlukahlukene zokuvuvukala ku-peritoneum.
Ngayinye yalezi zikhombisi ezingenhla iyangqubuzana impela, ngoba umbuzo wokuthi kungenzeka ukuthi into efakayo uthathwa kanjani esigulini ngasinye ngamunye futhi unqunywa ngudokotela ohlola bonke ubungozi kanye nemiphumela engemihle yenqubo.
Ngaphezu kwezinkomba, kunezindlela eziningi zokuphula umthetho lapho ukufakelwa kwe-pancreas kungavunyelwe ngokuphelele:
- Ukuba khona nokukhula kwe-neoplasms enobungozi;
- Izifo zenhliziyo ezahlukahlukene lapho kuvezwa khona ukungapheleli kwemithambo;
- Izinkinga zesifo sikashukela
- Ukuba khona kwezifo zamaphaphu, unhlangothi noma izifo ezithathelwanayo;
- Umlutha noma uphuzo oludakayo;
- Ukuphazamiseka kwengqondo okukhulu;
- Ukugula okungapheli amandla.
Kubalulekile ukukhumbula ukuthi ukusebenza kwe-gland transplant kwenziwa kuphela uma isiguli sesimweni nenempilo. Ngaphandle kwalokho, kunengozi yokufa kwesiguli.
Ukufakelwa kwepancreatic ukuvimbela ukwakheka kwezinkinga zesifo sikashukela kubaluleke kakhulu ukusenza ekuqaleni kwalesi sifo. Kunezinhlobo ezinhlobonhlobo zokufakelwa kwe-gland, izici zazo ezinqunywa kuphela ngemuva kokuhlolwa isiguli ngokugcwele.
Namuhla benza lezi zinhlobo ezilandelayo zokusebenza:
- Ukufakwa emzimbeni okugcwele kwe-gland ngengxenye ye-duodenum;
- Ukudluliselwa komsila we-pancreas;
- Ukudluliselwa kwengxenye yesitho;
- Ukufakwa kweseli kwe-pancreatic, okwenzeka ngaphakathi emzimbeni.
Yiziphi izinhlobo ezisetshenziswayo esimweni ngasinye kuncike ezimeni nasezingeni lokulimala esitholeni kanye nesimo esivamile sesiguli.
Lapho udlulisa wonke amanyikwe, kuthathwa kanye nengxenye ye-duodenum. Ngaso leso sikhathi, ingaxhuma isibeletho esincane noma i-bladder. Uma kwenzeka kudluliselwa engxenyeni ye-gland, ujusi we-pancreatic kumele uphambukiswe, kusetshenziswe izindlela ezimbili:
- I-duct exretory ivinjelwe yi-neoprene;
- Ijusi ye-gland idedelwa esikhotheni noma emathunjini amancane. Lapho ukhishwa esinyeni, ubungozi bokubonakala nokukhula kokutheleleka kuncishiswa kakhulu.
Amanyikwe, njengezinso, adluliselwa ku-iliac fossa. Inqubo yokufakelwa iyinkimbinkimbi impela, kuthatha isikhathi eside. Kudlula ngaphansi kwe-anesthesia ejwayelekile, ngakho-ke ubungozi bezinkinga buncishiswa kakhulu. Kwesinye isikhathi kufakwa i-catheter yomgogodla, ngosizo lapho isiguli sithola i-analgesia ye-epidural ngemuva kokufakelwa ukuze sikwazi ukwenza kahle inhlalakahle yesiguli.
Njenganoma yikuphi ukungenelela kokuhlinzwa, ukudluliselwa kwamanyikwe kunobunzima obuningana, obizwa kakhulu ezimweni zokuhlinzwa eziphuthumayo. Izinkinga zihambisana nokuthola abanikeli abafanele, okungabantu abasha abangaphansi kweminyaka engama-55. Ngaphezu kwalokho, kumele babe nesimo esanelisayo sempilo ngesikhathi sokufa.
Ngemuva kokukhishwa kwesitho emzimbeni womuntu, insimbi igcinwa kwizisombululo zeVispan noma iDuPont bese ibekwa esitsheni esinombuso othile wokushisa. Ngakho-ke ingagcinwa isikhashana (hhayi amahora angaphezu kwamashumi amathathu).
Uma isiguli siqala ukungasebenzi kwe-renal ngenxa yesifo sikashukela, kuvame ukunconywa ukwenza umsebenzi wokuhambisa izitho zombili ngasikhathi sinye, okungakhulisa kakhulu amathuba okuba nomphumela omuhle.
Njenganoma yikuphi ukungenelela kwezokwelapha, ukufakelwa kungaholela ekukhuleni kwenani lezinkinga ezanele, phakathi kwazo okukhona:
- Ukuthuthukiswa kwenqubo yokutheleleka emgodini wesisu;
- Ukwakheka okungamanzi okuzungeze ukuzungeza;
- Ukubonakala kokopha kunoma yiliphi izinga lokuqina.
Kwesinye isikhathi ukwenqatshwa kwesitho esidlulisiwe kwenzeka. Lokhu kungakhonjiswa ngokuba khona kwe-amylase kumchamo. Kungatholwa ne-biopsy. Kulokhu, isitho siqala ukwanda. Ukwenza isifundo usebenzisa i-ultrasound nakho kunzima kakhulu.
Ngenqubo ephumelelayo, ukulungiswa kwe-carbohydrate metabolism kuyabonakala futhi asikho isidingo sokulungiselela i-insulin.
Imisebenzi yokufakelwa ihlinzeka isikhathi eside futhi sinzima sokuthola isiguli ngasinye.
Ngalesi sikhathi, izidakamizwa ze-immunosuppressive zibekelwa ukusinda okuhle kwesitho.
Ngokwezibalo, lapho sekuphele imisebenzi enjalo, ukusinda kuyabonakala iminyaka emibili ezigulini ezingaphezu kwama-80.
Izici ezibalulekile ezithinta umphumela wokuhlinzwa yilezi:
- Isimo sesitho esidlulisiwe ngesikhathi sokufakelwa;
- Izinga lempilo nobudala ngesikhathi sokufa komuntu onikelayo;
- Amaphesenti wokuhambisana phakathi kwezicubu zabanikelayo nabamukelayo;
- Isimo se-hemodynamic sesiguli.
Endabeni yokudluliselwa kusuka konikelayo ophilayo esikhathini eside, i-prognosis iyathandeka kakhulu, ngoba cishe amaphesenti angama-40 eziguli abonakala ngokululama okuphelele.
Icebo lokuphathwa ngokungena kweziqhingi zamaLangerhans (amaseli we-organ) likhombisile ukuthi alilona elingcono kakhulu futhi lisesigabeni sentuthuko. Lokhu kwenzeka ngoba kunzima impela ukwenza lolu hlobo lokuhlinzwa. Lokhu kungenxa yokuthi ama-pancreas omnikelayo enza ukuthi kutholakale inani elincane kuphela lamaseli adingekayo.
Ngaphezu kwalokho, ukuthuthukiswa kokusetshenziswa kokufakelwa okuvela kumbungu, ukusetshenziswa kwamaseli we-stem, kanye nama-pancreas engulube yokufakelwa kubantu kuyaqhubeka, nokho, ngesikhathi sokusebenza okunjalo, i-iron imisa i-insulin isikhathi esifushane.
Ukufakelwa kwe-pancreatic kungenye yezindlela eziphambili zokwelashwa kohlobo lwe-1 yesifo sikashukela ngenxa yokuthi ukufakwa kwe-insulin kunikezwa ngezinga elanele lesiguli. Abathola ukwelashwa ngemuva kokuhlinzwa basebenzise isidingo semijovo ye-insulin ngama-immunosuppressants, asiza ukucindezela ukungatheleleki komzimba. Ukufakwa kwe-pancreatic ohlotsheni 1 sikashukela kungasithuthukisa kakhulu isimo sesiguli.
Imiphumela yokufakelwa okuhle kwe-pancreatic ezigulini ezine-nephropathy yesifo sikashukela zitholwe ngotshintsho lwezinso nolwama-pancreas. Le nqubo inezibuyekezo eziningi ezinhle futhi ivezwa njengeyona ndlela engcono kakhulu ekwelashweni kwalezi zifo.
Imvamisa, indlela yokuhlinzwa yokuxazulula inkinga inikezwa iziguli ezinomhlobo 1 noma uhlobo 2 lwesifo sikashukela ngaphambi komzuzu lapho imiphumela yesifo iqhubeka.
Ngakho-ke, ukufakelwa kwe-pancreatic kushukela kwesinye isikhathi akubalulekile. Kuyasiza ukuvikela imiphumela emibi yesifo sikashukela.
Imininingwane yokufakelwa kwe-pancreatic inikezwe kuvidiyo ekulesi sihloko.
