I-insulinoma isimila, ingaba yingozi kanye ne-benign. Ikhiqizwa ngamaseli weziqhingi zaseLangerhans, okuholela ekukhiqizweni okukhulu kwe-insulin ye-hormone, okuholela ku-hypoglycemia. I-Insulinoma itholakala kumanyikwe.
Imvamisa, i-pancreatic insulinoma i-benign, ifinyelela kuma-75% esifo sonke. Ngemuva kokuthola isifo esinjalo, kuyadingeka ukuthi uqale ngokushesha ukwelashwa, ukuze ugweme imiphumela emibi kuwo wonke umzimba, lokhu kuyinkinga ebaluleke kakhulu.
Wonke umuntu unesibopho sokwazi izimpawu zesifo ukuze afune usizo esikhungweni sezokwelapha ngesikhathi. Ngezansi sizobheka ukuthi kuyini i-insulinoma, izindlela zokwelashwa kwaso, ukukhululeka kwe-hypoglycemia syndrome, i-prognosis yokutakula, izindlela zokuxilonga nokuvimbela.
I-insulinoma nezimpawu
Njengoba kushiwo ngaphambili, i-insulinoma iyi-neoplasm eholela ekukhiqizweni ngokweqile kwe-insulin ye-hormone, ebangela i-hypoglycemia. Kuyaphawuleka ukuthi ngaphezu kwengxenye yeziguli zelashelwa izifo ezihluke ngokuphelele, ngaphandle kokubeka i-ultrasound yokuxilonga yamanyikwe. Lokhu kuchazwa yiqiniso lokuthi uphawu lwe-insulinoma olungachazwanga kahle futhi ludukisa odokotela.
I-Hypoglycemia ayenzeki nsuku zonke, kepha ayilindelekile. Vele, uma ungaselapha lesi sifo, khona-ke ukwehla ushukela wegazi kuzokwenzeka ngokuvama kakhulu. Udinga ukwazi amazinga ajwayelekile, aphansi futhi aphezulu we-glucose egazini.
Eminyakeni engu-14 nofinyelela eminyakeni engama-60, inani elijwayelekile lizoba ngu-3.2 - 5.5 mmol / l, esiswini esingenalutho. Ngemuva kokudla, ushukela wegazi uthathwa njengokujwayelekile ku-7.8 mmol / L. Ebudaleni, inkomba inyuka kancane. Ngakho-ke, esiswini esingenalutho, izinga elamukelekayo liyahluka kusuka ku-4.6 mmol / L kuya ku-6.4 mmol / L. Lezi zinkomba zilungele kuphela igazi le-capillary (elithathwe emunweni). Okwe-venous, izinkomba zanda kancane. Ukuhlaziywa okunjalo kubhekwa njengokuthembeke kakhulu.
Ngokuyisisekelo, ukuhlaselwa kwe-hypoglycemia kwenzeka ekuseni, esiswini esingenalutho. Isiguli sizwa i-malaise ejwayelekile, futhi izinga likashukela wegazi lingase lehle liye ku-2.2 mmol / L Ukumisa i-syndrome, kuyadingeka ukwengeza i-glucose egazini.
Izimpawu ezivame kakhulu ze-insulinoma:
- Ubuhlungu bekhanda obuvamisile.
- Ukuthola isisindo ngokushesha, ukukhuluphala kushukela.
- Ukwesaba ukwethuka.
- Ukucasuka.
- I-Tachycardia.
- Ukuqina kwamalunga.
- Convulsions - ngezindlela ezinzima zenkathi yesifo.
Isifo esinjalo sitholakala kunoma yisiphi isigaba sobudala, kufaka phakathi izinsana (1%) kuphela. Imvamisa, kuma-80% amacala, iziguli zingaphezu kweminyaka engama-45.
Ukuxilonga
Ama-insulinomas wokuxilonga atholakala kunoma yisiphi isigaba futhi angahlukahluka. Okokuqala, udokotela kumele aqoqe umlando wesiguli ukuze asungule imvamisa yokwehla koshukela wegazi ngesilinganiso esingamukeleki.
Qiniseka ukuthi uthatha amasampula egazi aphindaphindwe isiguli. Ukuhlolwa okusheshayo kusebenza kakhulu ekuxilongeni, kanti izivivinyo ezenziwa kufanele zibe ngokuhlelekile, okungenani isonto elilodwa. Kuyadingeka ukuthola isithombe esiphelele somtholampilo.
Kanye nokuhlaziya okungenhla, kusetshenziswa enye yalokhu kuxilonga okwengeziwe:
- I-pancreas tomography.
- Qhathanisa i-X-ray - i-angiography.
- I-catheterization ye-portal vein futhi yenza ukuthi sikwazi ukuqonda ukusebenza kwe-tumor ukukhipha i-insulin ye-hormone.
Ukuxilongwa kwe-insulinoma ngenye yalezi zindlela kuvumela umuntu ukuthi azi ngaphambi kokuhlinzwa ukuthi usayizi ungakanani usayizi we-tumor, indawo ngqo kanye nokuba khona kwe-metastases.
Ukwelashwa nokuqunjelwa yisifo
Ama-insulinomas angalashwa ngempumelelo futhi afaka kuphela indlela yokuhlinzwa. Kepha kunezimo lapho, ngokwezinkomba ezikhethekile zempilo yesiguli, ukuhlinzwa kufakwa kuphikiswa. Kulokhu, ukwelashwa kungumuthi. Yenzelwe ikakhulukazi ukumisa i-hypoglycemia.
Uma isimila sitholakala emsileni wamanyikwe, udokotela ohlinzayo wenza reseation yomsila. Lapho i-insulinoma ingenabala futhi isendaweni emzimbeni noma ekhanda lesikhumba, iyanqanyulwa. Ukusebenza kufanele kwenziwe ekuseni, ngaphambi kokuboniswa kwe-hypoglycemia. Udokotela obulala izinzwa uqapha ushukela wegazi kuyo yonke inqubo yokuhlinzwa.
Lapho i-insulinoma iwuphawu lwesimila esibuhlungu futhi ingenakususwa ngokuphelele kumanyikwe, kusetshenziswa i-chemotherapy. Imithi evimbela ukukhiqizwa kwe-insulin nayo inqunyelwe ukuvikela i-hypoglycemia.
Ukwelashwa okuqinile kwe-insulinoma, lapho kungenakwenzeka ukuyikhipha ngokuhlinzwa, kufaka izigaba eziningana:
- Ukuqedwa kwe-hypoglycemia ngokunyusa ushukela wegazi, ukukhululeka okuyingxenye kokukhiqizwa kwe-insulin.
- Ukwelashwa kwenqubo yesimila.
Isifo sokuphinda sibuyele emuva se-benign insulinoma, ngemuva kokususwa kwayo, siyathandeka impela. Imvamisa, ayakhi futhi.
Nge-tumor enobungozi, inani le-metastases nokusebenza kwe-chemotherapy kudlala indima ebalulekile.
Ungamisa kanjani ngokushesha i-hypoglycemia ene-insulinoma
Uma izinga likashukela wegazi liwele ngaphansi kwesimo esivumelekile, esinikezwa ngaphezulu, khona-ke udinga ukususa ngokushesha i-hypoglycemia. Ngemuva kwakho konke, kungaletha umuntu esimweni sokukhathazeka.
Imvamisa, ngokubonakaliswa kwesibonakaliso esinjalo nge-insulinoma, isiguli sizwa umuzwa onamandla wendlala bese siqala ukudla ukudla okunama-khalori aphezulu, kepha ngokuyisisekelo akulona iqiniso. Into yokuqala okufanele yenziwe ukuqinisekisa ukuthi ushukela ungena egazini. Ithebhulethi yeglucose enhle kakhulu ingakwenza lokhu kangcono.
Uma lo muthi ungekho, ungaphendukela ekusebenziseni amajusi amnandi, ikherimu, uju noshukela ocolisisiwe. Kepha lokhu kudla kukhuphula kancane ushukela egazini, ngoba kuqukethe isilinganiso esilinganayo se-glucose ne-fructose.
Kunenqwaba yamaphilisi akhulisa ushukela wegazi, ngokwesibonelo:
- I-Hypofree Cherry Flavor. Amacwecwe athungwayo aqukethe amagremu ama-4 we-dextrose. Kungakapheli ihora elilodwa, bangakhuphula izinga libe ngu-0,7 mmol / L. Intengo ephakathi yeRussia Federation ingama-ruble ayi-150 - 180, izingcezu eziyi-12 iphakethe ngalinye
- I-Dextro 4. Ngomthamo owodwa, kudingeka amaphilisi amathathu. Ziqukethe i-dextrose, eqala ukwandisa ushukela wegazi emizuzwini yokuqala ngemuva kokusetshenziswa kwayo futhi iholele inkomba emuva kokujwayelekile emva kwemizuzu engu-15. Ukukhishwa ifomu - ijeli kanye amaphilisi. Uma ukhetha ijeli, khona-ke ukuthola umthamo owodwa kuzothatha uhhafu weshubhu. Zine-flavour ye-cherry, i-orange ne-classic. Intengo ejwayelekile isukela kuma-ruble angama-30 kuye kwangama-190, konke kuncike kwinani lamathebulethi ku-blister kanye nasefomini lokukhululwa komuthi.
Ngemuva kokuphuza esinye sezidakamizwa ezingenhla, udinga ukwenza isilinganiso sokulawula ushukela wegazi ngemuva kwemizuzu engu-15. Uma inkomba ikhuphukele emazingeni amukelekile okungenani ayi-3.2 mmol / L (kuze kube yiminyaka engama-60) noma angu-4,6 mmol / L (ngemuva kweminyaka engama-60), lapho-ke ungazola - i-hypoglycemia iyaqedwa.
Esimweni lapho isiguli sinesimo esibi se-hypoglycemia, futhi sisesimweni swoon noma isigamu-swoon, akunakuphikwa ukuthi kufanele siphuze iziphuzo emlonyeni wakhe, ngoba zingangena egabheni lokuphefumula futhi zibangele ukuphefumula. Shayela i-ambulensi ngokushesha.
Kuze kufike iqembu lodokotela, isiguli kufanele sibekwe eceleni kwakhe futhi umlomo wakhe uvuleke kancane, uguqe ngamadolo. Uma kukhona umthamo we-adrenaline kwikhabethe lomuthi, bese uyawujova. Ama-milliliters angama-40% kashukela angalawulwa ngokubandakanyeka (engxenyeni engenhla yebhobho), kepha umjovo onjalo usebenza kahle kakhulu ngaphakathi.
Ukuvimbela
Ukuvimbela i-insulinoma ukulethwa kwaminyaka yonke kwegazi elivela emithanjeni nasezinkombeni zeshukela egazini, kuphela esiswini esingenalutho. Uma okungenani kutholakala eyodwa yezimpawu, udinga ukuxhumana nesikhungo sezokwelapha ukuze uthole isifo. Akunandaba ukuthi udinga ukuzindla futhi wakhe kuphela ekukhululekeni kwezimpawu.
Kubantu besigaba sebudala esidala, ngemuva kweminyaka engama-45, kungakuhle ukuthi kuthengwe i-glucometer. Lokhu kuyindlela yokusebenza ongalinganisa ngayo ushukela wegazi nganoma yisiphi isikhathi, lapho ulawula impilo yakho futhi uvikele izifo eziningi. Ngemuva kwakho konke, izinga le-glucose elikhulayo noma elinciphile egazini liphazamisa umsebenzi wayo yonke imisebenzi yomzimba.
Intengo yayo yamukelekile kunoma yisiphi isigaba sezakhamizi, futhi iyahlukahluka kusuka kuma-ruble ayinkulungwane. Ngaphezu kwalokho, udinga ukuthenga njalo imichilo nezinaliti zemitha. Lokhu kuzosiza hhayi kuphela ukuthola i-hypoglycemia ngesikhathi, okuvela ngenxa ye-insulinoma, kodwa futhi nokubikezela uhlobo 2 sikashukela.
Isihluthulelo sempilo enhle ukukondleka okufanele nokuzivivinya nsuku zonke. Kufanele unake izinhlobo zemisebenzi enconyelwe noma yisiphi isigaba seminyaka:
- Ukuhamba
- Ukugijima
- Ukuhamba emoyeni omusha.
- Ukubhukuda
- Imali ekhokhiswayo yokuqinisa.
- Ukuzivocavoca ushukela.
Ukuzivocavoca umzimba kufanele kuhlanganiswe nokudla okunciphisa ukusetshenziswa kwamafutha nokudla okunoshukela. Lokhu kususa kakhulu umthwalo kuma-pancreas futhi kunomthelela omuhle ekubuyiselweni kokusebenza okujwayelekile kwayo yonke imisebenzi yomzimba.
Ukudla kwansuku zonke kufanele kufake imifino, izithelo, amaprotheni ezilwane, okusanhlamvu, imikhiqizo yobisi nemikhiqizo yobisi olunoshukela. Okungenani amalitha amabili koketshezi kufanele adakwe ngosuku. Yidla ukudla okuncane amahlandla ayisihlanu kuya kwayisithupha ngosuku. Ukudla kokugcina okungenani amahora amabili ngaphambi kokulala. Ividiyo ekulesi sihloko izokhombisa ngemibala ukuthi iyini i-insulinoma.
