Yize lezi zitho zingxenye ehlukile yohlelo lokugaya ukudla, kunobuhlobo obusondelene phakathi kwabo. Imvamisa, izinqubo ze-pathological kwesinye sezitho ziholela ekubukekeni kwezifo kwesibili. Isibonelo, isifo se-gallstone sivame ukuholela ekukhuleni kwe-pancreatitis - ukuvuvukala kwezicubu ze-pancreatic.
Kulokhu, kunesidingo sokuthola ukuthi ama-gallbladder namanyikwe atholakala kuphi, ahlangana kanjani nokuthi ama-pathologies angathintela kangakanani.
Indawo nomsebenzi we-gallbladder
I-gallbladder itholakala engxenyeni engaphandle yegreythi ende yesibindi. Ifana nesimo sethanga noma isigaxa. Ubukhulu besitho bungafaniswa neqanda lezinkukhu elincanyana. Kubukeka njengesikhwama esisebusweni.
Isakhiwo se-anatomical sesitho sihlukaniswe ngombandela ngesigaba esingaphansi (isigaba esandisiwe), umzimba (ingxenye ephakathi) nentamo (ingxenye encishisiwe) ye-gallbladder. Okunye futhi kukhona ama-ducts e-hepatic ne-cystic ducts, ahlanganiswe kwi-duct evamile ye-bile cm eyi-6 cm.Intamo ifinyelela ku-3.5 cm ku-cystic duct.Kusebenzisa i-pulp yemisipha ebushelelezi (iLutkens sphincter), i-bile ne-pancreatic juice ithunyelwa ku-duodenum 12.
I-Bile ekhishwa amaseli wesibindi ingena ngamathumbu ngokwengxenye. Ingxenye yesibili inqwabelana gallbladder. Ungumbala we-viscous oluhlaza. Njengoba amanzi amunca emzimbeni, ukugcwala kwe-bile kukhuphuka kaningana. Ine-bilirubin, cholesterol, i-bile pigment kanye ne-asidi.
Ngosuku olu-1, kukhiqizwa cishe i-1,500 ml ye-bile emzimbeni womuntu. Umsebenzi wayo ophambili ukubamba iqhaza enqubweni yokugaya: i-bile ingumqhafazo osebenzisa zonke izinhlobo zama-enzyme, ikakhulukazi i-lipase. Ngaphezu kwalokho, i-bile yenza imisebenzi enjalo emzimbeni:
- wephula amafutha abe ngama-molecule amancane akhulisa indawo yokuxhumana yamafutha ngama-enzyme;
- kuthuthukisa ukuhamba kwamathumbu, ukumuncwa kwamavithamini K namafutha;
- Inomphumela we-bactericidal futhi ivimbela izinqubo zokubola.
Lapho ukudla kungena esiswini duodenum, isibindi siqala ukukhipha i-bile eyengeziwe.
Isigaxa senyongo sidlala indima yokonga okwengeziwe kwe-bile. Ayikwazi ukubamba umthamo omkhulu we-ketshezi - ama-60 ml kuphela. Kodwa-ke, i-bile engena kulesi sitho iba manzi kakhulu. Le nkomba idlula amahlandla ayi-10 iqoqo le-bile elisanda kukhiqizwa isibindi.
Ngakho-ke, i-gallbladder ekhonzayo, engeza futhi engena amathumbu, yakha i-1/3 yevolumu yansuku zonke ye-bile eyenziwe.
Indawo nomsebenzi we-pancreas
I-pancreas iyisitho esiswini esenza imisebenzi ye-endocrine ne-exocrine.
Itholakala e-peritoneum ngemuva kwesisu esifundeni se-epigastric eduze kwethafa. Ingxenye yayo yesinxele ingena kwi-hypochondrium yangakwesobunxele. Isikhwama se-gland sihlukanisa isisu namanyikwe. Isitho sangasemuva sisondele emithanjeni nase-aorta.
Ama-pancreas anezingxenye eziningana - ikhanda, umzimba nomsila. Ingxenye yesitho sangasese yimigqa ebumbekayo evulekela ukukhanya kwe-duodenum. Yilapho ujusi we-pancreatic, kudingekile inqubo yokugaya ukudla, uthola. Ingxenye ye-endocrine iqukethe iziqhingi zepancreatic, iziqhingi ezibizwa ngeLangerhans, inani elikhulu lazo elisendaweni yomsila wamanyikwe.
Ama-pancreas enza imisebenzi eminingi ebalulekile, ehlukaniswe ngesimo yangaphandle (i-endocrine) kanye nengaphakathi (i-exocrine).
Umsebenzi we-secretra we-Intra - Ukulawulwa kwamazinga kashukela kanye ne-metabolism. Cishe iziqhingi eziyizigidi ezintathu zamaLangerhans akhona kulesi sitho. Ziqukethe izinhlobo ezine zamangqamuzana abandakanyeka ekuphatheni i-glucose egazini. Uhlobo ngalunye lubhekene nokukhiqizwa kwehomoni ethile:
- Amaseli e-Alpha secrete glucagon, okwandisa okuqukethwe ushukela.
- Amaseli weBeta akhiqiza i-insulin, ehlisa ushukela.
- Amaseli eDelta akhiqiza i- somatostatin, elawula umsebenzi wamaseli we-alpha ne-beta.
- Amangqamuzana e-PP akhiqiza i-pancreatic polypeptide (PPP), ecindezela ubumfihlo besitho futhi ivuse ukukhululeka kwejusi esiswini.
Umsebenzi we-exocrine inqubo yokugaya ukudla. I-pancreas ingumthombo wama-enzymes akhethekile asiza ukuphula ama-carbohydrate (ajwayelekile isitashi), amaprotheni kanye ne-lipids (amafutha).
Umzimba ukhiqiza ama-enzyme ngendlela engasebenzi ebizwa ngokuthi ama-proenzymes, noma ama-proenzymes. Lapho zingena ku-duodenum 12, i-enteropeptidase iyawasebenzisa, akha i-amylase (yokuqhekeka kwe-carbohydrate), i-proteinase (yamaprotheni) ne-lipase (yamafutha).
Wonke la ma-enzyme ayingxenye yejusi le-pancreatic, elibandakanyeka ekugayweni kokudla.
Isifo se-Gallbladder
I-pathologies etholakala njalo ye-gallbladder yisifo se-gallstone, cholecystitis, kanye ne-polyps kanye ne-organ dyskinesia.
Kulesi sifo se-gallstone, amatshe (amatshe) akha amafomu ezindundwini nakulwelwe uqobo. Njengamanje, ngaphezu kwe-10% yabantu emazweni athuthukile aba nalesi sifo.
| Izici zobungozi | Ubudala, ubulili (abesifazane bathambekele kakhulu), ngokweqile, i-hepatic choledoch stenosis kanye ne-cysts, i-cirrhosis, i-hepatitis, i-parapapillary diverticulum ye-duodenum 12, anemia hemolytic, ukuhlukunyezwa kokudla kwamaprotheni. |
| Izimpawu | Lesi sifo si-asymptomatic isikhathi eside (iminyaka engama-5 ukuya kwengama-10). Izimpawu eziphambili i-jaundice, i-biliary colic, ubuhlungu bemvelo yokusika, ukuhlaselwa kwe-angina. |
| Ukwelashwa | Ukudla No. 5, i-shock wave lithotripsy, i-cholecystectomy (ukususwa kwesitho), ukuthatha amalungiselelo e-bile acid. |
I-Cholecystitis imvamisa ingumphumela wesifo se-gallstone, lapho kukhiqizwa khona microflora ye-pathological futhi ukuphuma kwe-bile kuphazamisekile. Ngenxa yalokhu, ukuvuvukala inyongo kwenzeka.
Lesi sifo singenzeka ngesimo esingamahlalakhona. I-cholecystitis eyingozi ihlukaniswe izinhlobo eziningi:
- i-catarrhal (ebangela ubuhlungu obukhulu e-epigastrium nase-hypochondrium);
- i-phlegm (izinhlungu zibhekwa ngoshintsho lwesikhundla, ukuphefumula nokukhwehlela, umuntu uhlushwa i-tachycardia kanye namazinga okushisa we-febrile);
- gangrenous (ukwehla okukhulu kokungazinzi, isithombe somtholampilo esivezwe ngokwengeziwe).
| Izizathu | Ukwakheka kwamatshe abangela ukuqina kwe-bile nokubukeka kwamagciwane ayingozi. |
| Izimpawu | I-cholecystitis ebabazekayo: izinhlungu ezibukhali ezinikeza i-hypochondrium, epigastrium, engezansi emuva, ibhande lamahlombe, ibanga lesokunxele kanye nentamo, ukuhlaselwa isicanucanu nokuhlanza, i-hyperthermia, i-tachycardia, ukuqhakaza, uhlangothi olungakwesokudla lwe-peritoneum ngesikhathi sokukhipha umunxa kunesikhathi esithile. I-cholecystitis engapheli: isicanucanu, izinhlungu ezibuthakathaka ku-hypochondrium efanelekile, i-hepatic colic, ubukhulu bezinhlungu ekuseni nasebusuku, i-jaundice. |
| Ukwelashwa | Ukwemukelwa kwemithi elwa namagciwane, ukondleka okhethekile, ama-antispasmodics, ukukhala kwe-duodenal, i-cholecystectomy. |
Kuyaqapheleka ukuthi kuma-99% amacala, ukususwa kwe-gallbladder kuqeda noma yiziphi izinkinga. Ukukhohlisa okwenziwayo akukuthinti kakhulu ukugaya nomsebenzi obalulekile womuntu uwonke.
I-Pathology ye-pancreas
Izifo ezijwayelekile kakhulu ze-pancreatic yi-pancreatitis kanye nesifo sikashukela i-mellitus, i-pseudocysts, i-neoplasms enobungozi kanye ne-cystic fibrosis akuvamile ukutholakala ukuthi ziyatholakala.
I-pancreatitis iyinkimbinkimbi yama-syndromes lapho kwenzeka khona ukuvuvukala kwamanyikwe.
Lokhu kungenxa yokusebenzisa kwama-enzyme egazini uqobo. Ngenxa yalokhu, azipheli ku-duodenum futhi ziqala ukugaya i-gland uqobo. Kunezinhlobo eziningi ze-pancreatitis:
- i-purulent (ukuvuvukala kwe-phlegmous, ukwakheka kwama-macro- nama-microabscesses);
- i-biliary (ukuvuvukala kwama-pancreas ngomonakalo wesibindi kanye ne-emathunjini);
- i-hemorrhagic (ukubhujiswa kwe-parenchyma nesakhiwo se-vascular);
- utshwala obukhulu (kwenzeka ngokuphuza utshwala olulodwa noma njalo).
| Izizathu | Ukuncika kotshwala isikhathi eside, ukubhema, ukudla ngokweqile njalo, ukusetshenziswa kabi kokudla kwamaprotheni, isifo se-gallstone, ukuthatha imishanguzo ethile, i-biliary duct dyskinesia, cholecystitis, izilonda ze-duodenal, hepatitis B no-C, ukuhlaselwa kwe-helminthic, i-cytomegalovirus. |
| Izimpawu | I-pancreatitis eyingozi kakhulu: Ubuhlungu obukhulu be-epigastric (ukuvame ukuzungeza), ukugabha, ubuthakathaka, ukuqina kwezimpawu zesikhumba, ukuqaqanjelwa kwesikhumba, ukubumbeka kwemizwa, ukuqunjelwa noma isisu (izinhlayiya zokudla ezingejwayelekile) zibonwa esitobhini. I-pancreatitis engapheli: izimpawu ezithambile, ubuthakathaka obuphikelelayo, isiyezi, nokucanuzelelwa kwenhliziyo. |
| Ukwelashwa | Ama-enzymatic agents, ama-enterosorbents, ama-probiotic, ama-antispasmodics, ama-painkillers nama-antidiarrheals, ama-vitamin-mineral complexes. Ngokubonakaliswa kwe-pancreatitis ebukhali yezinsuku ezi-2, ukudla okuchanyiwe kunqunyelwe - ke -ukudliwa No. 5. |
Isifo sikashukela yisifo esiqashelwa ubhubhane lwekhulu lama-21. Kubonakala ngokukhetha (uhlobo II) noma okuphelele (uhlobo II) okuvimba ukukhiqizwa kwe-insulin. Ngenxa yalokhu, kukhona ukwanda kweglucose yegazi.
| Izici zobungozi | Isandulela sofuzo, ukukhulupha ngokweqile, ukukhulelwa okungajwayelekile, ukungasebenzi komzimba, izifo ezibangelwa yigciwane. |
| Izimpawu | I-Polyuria, ukoma okungapheli, ukudinwa nokukindla kwemikhawulo, kunciphise ukubonwa okubuthakathaka, ubuthakathaka, ukungakhathaleki, isiyezi, ikhanda, isistimu yokuzala engahambi kahle (ukujikeleza komjikelezo wokuya esikhathini nezinkinga nge-potency). |
| Ukwelashwa | Ukwelashwa kwe-insulin, izidakamizwa ze-hypoglycemic, ezemidlalo. |
Ukuvimbela izifo zezigaya zokugaya
Kukhona inani elikhulu lezinto ezithinta umsebenzi we-gallbladder and pancreas.
Njengoba umsebenzi we-gallbladder ne-pancreas uhlobene kakhulu, udinga ukwazi ukuthi ungazivikela kanjani lezi zitho emiphumeleni yezimpawu ezimbi zangaphandle.
Zonke izimbangela zokuphazamiseka ekusebenzeni kwalezi zitho zinemvelaphi ehlukile, futhi ekususeni kwazo umuntu kufanele alandele imithetho ethile nezincomo.
Izindlela zokuzivikela zifaka izincomo ezilandelayo ezithandwayo:
- Ukuvinjelwa ekudleni kokudla okunamafutha, okunosawoti, okubhemayo, kokhokho kanye ne-carbohydrate. Ukupheka kufanele kubambeke, kubhakwe noma kubiliswe.
- Ukulawulwa kwesisindo somzimba nendlela yokuphila esebenzayo. Umuntu ngamunye kufanele ahambe okungenani imizuzu engama-30- 40 nsuku zonke. Ngasikhathi sinye, ukusebenza nokuphumula kufanele kuguquke.
- Ukugwema ukushaqeka okukhulu okungokomzwelo. Njengoba wazi, ingcindezi iyisidambisi sezifo ezahlukahlukene zabantu, ikakhulukazi umgudu wokugaya ukudla.
- Lungiselela ukudabula izindlela ezithile zokucwaninga zokuxilonga ezizosiza ekuboneni ushintsho lwe-pathological ku-pancreas noma kwesinye isikhathi kwesinye.
Okubaluleke kakhulu umsoco ekudleni. Isisekelo sithathwa inombolo yokudla 5 ngokusho kwe-Pevzner.
Ukuvimbela ukukhula okuqhubekayo kwe-pancreatitis noma i-cholecystitis, kuyadingeka ukwethula imikhiqizo emnene ekudleni. Kulokhu, imifino ithathwa kangcono ngendlela ebilisiwe noma yashizi.
Ukudla kuhlukaniswe izikhathi ezingama-5-6, kanti izingxenye kufanele zibe zincane. Kuvunyelwe ukudla ukudla okushisa aphakathi, kungashisi kakhulu noma kubanda. Esikhathini sokudla sokudla 5 nge-pancreatitis, ungafaka imikhiqizo elandelayo:
- izinhlobo ezinamafutha amancane enyama nenhlanzi;
- ubisi lwe-skim nokuphuma kwalo;
- izithelo ezomisiwe, amajikijolo, ama-aphula nobhanana;
- noma yikuphi okusanhlamvu kanye nesobho yemifino;
- uwoyela wemifino;
- amazambane, utamatisi, ukhukhamba, beet;
- isinkwa izolo, amakhukhi kaMaria;
- itiye eluhlaza, umhluzi we-rosehip, i-kissel, uzvar.
Kumele kuqashelwe ukuthi izifo zepheshana lesisu sezitholwe kakhulu muva nje ngenxa yempilo engasebenzi, ukungondleki kanye nokuba khona kwesisindo ngokweqile kubantu abaningi.
Isifo sokuqaqamba kwesikhumba se-pancreatic kanye nenyongo kufanele siphathwe ngemithi futhi sihlinzwe. Akukho makhambi esintu angalapha lesi sifo.
Izici zes anatomical zesibindi, i-gallder kanye namanyikwe kukhulunywa ngazo kule vidiyo kule ndatshana.
