Nsuku zonke, umzimba uthola izingxenye zokudla okufanele zigaywe futhi zisuswe kuzo izakhi zomsoco.
I-Exocrine pancreatic insuffeed yisifo esiyingozi esifaka ukuphazamiseka ekukhiqizweni kwama-enzyme anezinkinga zokumba kokudla okungena esiswini.
Ngenxa yalokhu, umzimba womuntu awunazo amavithamini nezinye izinto ezisebenzayo. Kulesi sihloko, ungajwayelana ne-pathophysiology yokungalingani kwe-exocrine (izimbangela, indlela yokusebenza kanye nomphumela wayo), kanye nemigomo yokuxilongwa, ukwelashwa nezindlela zokuvimbela izifo.
Yini isifo?
Enye yezinqubo eziyinkimbinkimbi kakhulu emzimbeni ukugaya ukudla. Kuqala ngemuva kokuthi umkhiqizo ungene emthanjeni womlomo futhi uswakanyiswe ngamathe. Ukudla okuswelwe kungena esiswini, kukhipha i-pepsin ne-hydrochloric acid.
Ngemuva kwengxenye yehora, izinhlayiya zokudla zisengxenyeni yokuqala yamathumbu amancane - i-duodenum 12. Kulapha lapho ama-enzyme akhethekile ebhekene nokungenisa ukudla, ukuwohloka kwamafutha namaprotheni, kanye nokufakwa kwamavithamini. Isitho sohlelo lokugaya sizikhiqiza - ama-pancreas, aqhekeza ama-molecule amakhulu abe izinhlayiya ezilula.
Lo mzimba wenza imisebenzi ebalulekile emzimbeni womuntu. Ngokuvamile zihlukaniswa ngokulandelayo:
- Umsebenzi we-exocrine (secretion yangaphandle) uqukethe ukumbumbuluzwa kwezinto ezisebenzayo ngokusebenza - i-lipase, amylase, ne-proteinase - kuyi-duodenum kusetshenziswa uhlaka lwe-ducts.
- Umsebenzi we-Endocrine (secretion yangaphakathi) uhlotshaniswa nomsebenzi wama-islets wepancreatic akhiqiza ama-hormone afana ne-insulin, i-glucagon, i-pancreatic polypeptide, somatostatin ne-ghrelin ("i-hormone yendlala").
Kumuntu ophile kahle, ama-pancreas akhiqiza ama-enzyme namahomoni anele, ngakho-ke uyakwazi ukuhlinzeka ngokugaya kokudla nokusekela izinqubo ze-metabolic.
Lapho umzimba ungakwazi ukukhiqiza inani elifanele lama-enzyme, kuba nokuntuleka kokukhula kwepancreatic. Ngenxa yenqubo ye-pathogenic, ukuntuleka kwamavithamini nokuntuleka kwezakhi zomzimba kwenzeka.
Ukungabikho ngokuphelele noma ukwelashwa okungasebenzi kuholela ekukhuleni emuva ebuntwaneni, izifo zohlelo lwe-musculoskeletal kanye nokwehla okukhulu kokungazinzi komzimba, okusongela ukutheleleka ngezifo ezahlukahlukene.
Izimbangela zokukhiqizwa kwe-enzyme engaphazamiseki
Ngokwezibalo, i-10% yabantu baseMelika batholakala benesifo i-exocrine pancreatic insufficiency syndrome.
Izifundo zobudokotela zikhombisa ubudlelwane obuqondile phakathi kokusebenzisa kabi utshwala nokukhula kwe-pathology. Iziguli ezinenkinga yokuncika otshwaleni ziwela eqenjini eliyingozi eliyingozi, ngoba lesi sifo sizibonakalisa ngamacala angama-80%.
I-etiology ye-pathology ifaka umthelela wezinto eziningi. Ukuphazamiseka ekukhiqizweni kwama-enzyme kwenzeka ngenxa yezizathu zokuzalwa nezokutholwa.
Ukuntuleka kwe-pancreatic kukhula ngenxa yokuqubekela phambili kwezifo ezinjalo zokuzalwa:
- i-cystic fibrosis - i-pathology yezakhi zezitho zezinhlelo zokuphefumula nezokugaya ukudla, ibonakala ngokukhiqiza imfihlo ebonakalayo evala izindunduma zamanyikwe, i-bronchi encane ne-bronchioles;
- I-Schwahman's syndrome - ukuphazamiseka kofuzo komnkantsha kanye namanyikwe, okhiqiza i-lipase enganele;
- lipomatosis - ukwanda kwesisindo somzimba ngenxa yokukhishwa ngokweqile kwezicubu ze-adipose.
Izimbangela ezitholakalayo zifaka phakathi ukususwa kokuhlinzwa kwe-pancreas nokufa kweseli ku-pancreatitis. I-pancreatitis yisifo esibonakala ngokufakwa esikhundleni kwezicubu ezijwayelekile zesilonda esitho. Ngenxa yalokho, ukukhiqizwa kwama-enzyme kuyancipha, futhi uhlelo lokugaya ukudla alukwazi ukugaya ukudla ngokugcwele.
Kuyaqapheleka ukuthi i-pancreatitis engapheli itholakala ezigulini ezindala. Ebuntwaneni, ukukhula kwe-pathology enjalo kuyinto eyivelakancane kakhulu. Ngaphezu kwalokho, ingozi ye-pancreatitis inyuka nesifo sikashukela.
Ngaphezu kwalokho, izici ezithinta ukuvela kokuhluleka kwe-organ exocrine zingafaka:
- Ukulimala kwepancreatic.
- Isifo sikaCrohn ukuvuvukala kwengxenye eyodwa yesistimu yokugaya ukudla.
- I-gluten Enteropathy - ukungabekezelelani nomzimba we-gluten (protein ye-gluten)
- I-Dumping syndrome - ukwanda okubukhali kokugeleza kwegazi emathunjini ngenxa yokufakwa kokugaywa kokudla okungangeni esiswini esiswini.
- I-Zollinger-Ellison syndrome yisimo esihlanganisa izinqubo ze-pathological ezifana nokuba khona kwama-tumor ku-duodenum noma pancreas, kanye nokukhiqizwa ngokweqile kwe-hydrochloric acid esiswini.
Futhi, ukwenzeka kokuntuleka kokukhubazeka kungathinteka ngokudluliselwa kokuhlinzwa kokuhlinzwa endaweni yokugaya ukudla.
Izimpawu zokuntuleka kwe-exocrine pancreatic
Ucwaningo lokuhlola luye lwabonisa ukuthi ngokuntuleka okuncane kokucasulwa kwe-pancreatic, ukudla kusazogaywa. Kulokhu, ekuqaleni kwentuthuko yesifo somuntu, umuntu angazizwa enezimpawu.
Ngenxa yokuvinjwa kokuvinjwa kokukhiqizwa kwe-pancreatic secretion, kungenzeka ukuthi uthole ukuthi amathumbu ayakwazi ukudonsa ama-protein angama-63% nama-84% emafutha. Ngokusobala, umsebenzi we-enzymatic uthathelwa indawo izinto ezisebenzayo ezivulwe yisisu ne-mathumbu mucosa.
Isimo somtholampilo walesi sifo uvame kakhulu ukufana namanye ama-pathologies wesistimu yokugaya ukudla: isilonda se-peptic, isisu esingaxutshwe nalutho, ukuba khona kwamatshe emgodini wesibeletho, njll.
Isibonakaliso esijwayelekile kakhulu sokwehluleka kwe-exocrine ukuhuda okungamahlalakhona. Izinhlayiya zokudla ezingafakwanga kanye nomuhlwa zingabonakala esihlalweni. Le nto yenzeka ngenxa yokuthi umzimba awukwazi ukudonsa ngokuphelele amaprotheni namafutha. Ngaphezu kwalokho, izicubu zinephunga elingajabulisi.
Ezinye izinkomba zokugula kwezifo yilezi:
- ukunciphisa umzimba okunemibandela;
- ukuthopha (ngokweqile)
- i-hypovitaminosis (ukulahleka kwezinwele nezinzipho ezibunjiwe);
- ukukhathala nokukhathala;
- isifiso sokuhlanekezela;
- ukoma okungathi sína ne-polyuria (kuyaqabukela);
- ubuhlungu obukhulu bebhande bufika emuva.
Ubuhlungu kwesinye isikhathi bukhulu kangangokuba isiguli kufanele silaliswe esibhedlela bese sijova ama-painkillers.
Ukuphefumula kuyabonakala lapho uthatha ukudla okunamafutha notshwala. Ezimweni ezinjalo, ukugabha nohudo kuyenzeka.
Izindlela eziyisisekelo zokuxilonga
Okokuqala, uchwepheshe oholayo kufanele alalele izikhalazo zesiguli. Kodwa-ke, ama-anamnesis awakwazi ukukhuluma kuphela ngokungapheleli kwe-exocrine pancreatic. Ngaphezu kwalokho, uhudo kungenzeka lungakhuli isikhathi eside, ngoba umzimba ugcina amandla alo okusebenza, yize kungenjalo ngokugcwele.
Nge-atrophy esobala yesitho, kwenziwa i-laparoscopy noma i-laparotomy. Uma isiguli sigula i-pancreatitis, akunakwenzeka ukwenza ukuhlinzwa ngenhloso yokuxilongwa. Lokhu kungenxa yokunamathela okuphambili ne-fibrosis.
Izivivinyo ezinkulu zaselabhorethri ezingabekwa udokotela ukuhlolwa kwe-fecal kanye negazi. Njengomthetho, ukwanda komsebenzi we-ALT, ukwehla ekukhiqizweni kwamafutha, i-polyunsaturated acid, cholesterol, amylase, lipase, isoamylase ne-phospholipase A2 kungakhombisa ukungasebenzi kahle kwesitho.
Ukuthola ukuthi kungani kunokwephulwa komsebenzi we-exocrine pancreatic function, kuyadingeka ukuthi kwenziwe i-compact tomography (CT).
Ngesisekelo sazo zonke lezi zivivinyo ezingenhla, udokotela angenza ukuxilonga, futhi ngokusekelwe kukho, athuthukise uhlobo lokwelashwa olulodwa nolusebenzayo.
Ukwelapha nezindlela zokuvimbela
Ukwelashwa kwalesi sifo kubandakanya izakhi ezimbili ezibalulekile - ukondleka okhethekile kanye nokwelashwa okunye esikhundleni. Ukudla lokhu kufakwa ngaphandle kokudla ukudla okunamafutha kanzima nokuphuza utshwala. Esikhundleni salokho, kunconywa ukuthi kudliwe ukudla kwemvelaphi yezitshalo - imifino emisha nezithelo.
Izinhlamvu ezinhlobonhlobo (amabele, i-oatmeal, i-buckwheat) zinomphumela onenzuzo ephepheni lesisu. Ziqukethe inani elikhulu le-fiber, elingagaywanga ngokuphelele esiswini, kepha liwumthombo wezakhamzimba. Ukulungisa i-microflora yamathumbu, kungcono ukwengeza imikhiqizo yobisi lwe-skim kumenyu. Kepha nge-acidity ekhuphukile yesisu, ukudla kwabo akuvunyelwe.
Ukwelashwa kokutholwa yizinga legolide ekulweni nalesi sifo. Kubandakanya ukuthatha izidakamizwa eziqukethe i-enzme ye-pancreatic. Izidakamizwa ezinje ziyakwazi ukwehlisa amaprotheni, amafutha kanye nesitashi, zinika amandla ukusebenza komzimba.
Ithebula elingezansi libonisa izidakamizwa eziphambili ezisetshenziswa ekwelapheni lesi sifo.
| Isihloko | Izinkomba | Contraindication |
| I-Pancreatin | I-cystic fibrosis, i-pancreatitis engamahlalakhona, ukutholwa okunzima kokugaya ukudla, ukwanda kwegesi, ukulungiselela ukuhlolwa kwe-Ultra ne-X-ray. | I-Hypersensitivity ezingxenyeni zomuthi, ekuvinjelweni kwamathumbu, i-pancreatitis engapheli noma eyingozi esiteji esibi. |
| Festal | Ukwelashwa okuphathelene nokufakwa ngaphansi kwe-exocrine pancreatic insuffence, uhudo olungatheleleki, i-flatulence, ukwephula ukudla kokuhlafunayo ngesikhathi sokusebenza okujwayelekile kwamapheshana emathunjini, ukudla ngasikhathi sinye kokudla okukulukhuni ukugaya, ukulungiselela ukuhlolwa kwe-ultrasound ne-X-ray. | Ukungabekezelelani komuntu ngamunye ezingxenyeni zomuthi, ekuvinjelweni kwamathumbu, ukukhulisa i-pancreatitis engalapheki noma eyingozi. |
| UMezim | Ukwelashwa okuguqulwayo kokuntuleka kwesikhala se-exocrine pancreatic, ukuqhakaza, i-pancreatectomy, i-cystic fibrosis, i-dyspepsia, i-pancreatitis engapheli, uhudo olungatheleleki, umbuso ngemuva kwemisebe. | I-Hypersensitivity ezingxenyeni zesidakamizwa, i-pancreatitis engapheli noma eyingozi esigabeni esibi. |
Ukuvimbela ukuthuthukiswa kwenqubo ye-pathological, kunconywa ukulandela imithetho elandelayo:
- Yenqaba imikhuba emibi - ukubhema notshwala.
- Shintshela ekudleni okulinganiselayo, kunciphisa ukungena kokudla okunamafutha.
- Thatha amavithamini namaminerali.
- Yidla ukudla okuncane, kepha kaningi (izikhathi ezingama-5-6 ngosuku).
Ngaphezu kwalokho, kunconywa ukugwema izimo ezinzima ezicindezelayo.
Uyini umphumela wokwelashwa okungasebenzi?
Ukunganaki lesi sifo noma ukwelashwa okungasebenzi kuholela emiphumeleni eminingi engathandeki ngisho nokufa. Izinga elibi lokuntuleka kwesibeletho se-exocrine pancreatic kuholela ekuthuthukisweni kwesilonda se-peptic, ukwakheka kwe-cystic kanye ne-gastritis.
Ama-Jaundice noma ama-tumbu esezingeni eliphansi awavamile kakhulu. Futhi, isigaba esibi se-pathology singadala ukwanda kwe-pancreatitis, okuyingozi kakhulu empilweni yesiguli.
Ngesikhathi sokwelashwa kokuntuleka kwe-exocrine, udinga ukubheka njalo amazinga eglucose egazini. Njengoba ukugcwala kwe-pancreatic kukhubazekile, kungenzeka ukuthi kuzokhiqiza i-insulin engaphansi komuntu, i-hormone ebhekele ukwehlisa ushukela. Ngaphandle kwalokho, kukhona ingozi yokuba nesifo sikashukela.
Omunye umphumela ongemuhle wokwelashwa okuhlala isikhathi eside umlutha womzimba emithini yobuhlungu, isakhi esisebenzayo esiyizinto ezi-narcotic. Isikhathi ngasinye lapho umuntu edinga umthamo omkhulu wokuqeda izinhlungu. Njengoba wazi, izinto ze-narcotic zinomphumela ongemuhle hhayi kuma-pancreas kuphela, kodwa nakwezinye izitho zangaphakathi.
Kumele kuqashelwe ukuthi ukuzelapha kanye nokusebenzisa ezinye izindlela ngeke kusize ekwelapheni ukugula. Ukwelashwa okuyinkimbinkimbi okufika ngesikhathi kuphela okungaqinisekisa i-prognosis enhle - ukululama okuphumelelayo kanye nokuvimbela izinkinga (ukuphazamisa ushintsho kulungu nesifo sikashukela).
Mayelana nokuntuleka kwesimo se-exocrine pancreatic kuchazwe kule vidiyo kule ndatshana.
