Uhlobo lwe-1 isifo sikashukela mellitus (esincike ku-insulin) yisifo esivame kakhulu emhlabeni wonke. Ngokwezibalo zeWorld Health Organisation, namhlanje cishe abantu abangaba yizigidi ezingama-80 bahlaselwa yilesi sifo, futhi kunenkambiso ethize yokuthi lesi sikhombisi senyuke.
Ngaphandle kokuthi odokotela bayakwazi ukubhekana nalezo zifo ngempumelelo yezindlela zakudala zokwelashwa, kunezinkinga ezihambisana nokuqalwa kwezinkinga zesifo sikashukela, kanti nokufakelwa kwamanyikwe kungadingeka lapha. Ekhuluma ngamanani, iziguli ezinesifo sikashukela esincike ku-insulin:
- ube yimpumputhe izikhathi ezingama-25 kaningi kunabanye;
- uhlushwa ukwehluleka kwezinso izikhathi eziyi-17 ngaphezulu;
- bathintwa yi-gangrene amahlandla ama-5 kaningi;
- unezinkinga zenhliziyo izikhathi ezi-2 kaningi kunabanye abantu.
Ngaphezu kwalokho, isikhathi sokuphila esiphakathi kwabanesifo sikashukela sicishe sifane kwesithathu kunaleso esingancikile kushukela wegazi.
Ukwelashwa Kwe-pancreatic
Lapho usebenzisa ukwelashwa okufaka esikhundleni salokho, umphumela wako ungahle ungabi kuzo zonke iziguli, futhi akuwona wonke umuntu ongakwazi ukukhokhela izindleko zokwelashwa okunjalo. Lokhu kungachazwa kalula ukuthi imishanguzo yokwelashwa nemithamo yayo efanele kunzima ukuyikhetha, ikakhulukazi ngoba kudingeka ukuyikhiqiza ngawodwana.
Odokotela baphoqeleka ukuthi bafune izindlela ezintsha zokwelashwa kodokotela:
- ubunzima besifo sikashukela;
- isimo semiphumela yesifo;
- ubunzima bokulungisa izinkinga ze-carbohydrate metabolism.
Izindlela eziningi zanamuhla zokuqeda lesi sifo zibandakanya:
- izindlela zokwelashwa zehardware;
- ukufakelwa kwamanyikwe;
- ukufakelwa kwamanyikwe;
- ukuthunyelwa kweseli kwe-islet.
Ngenxa yokuthi ku-mellitus yesifo sikashukela, ukushintshwa kwama-metabolic avela ngenxa yokungasebenzi kahle kwamaseli we-beta kungatholakala, ukwelashwa kwalesi sifo kungahle kube ngenxa yokufuduka kweziqithi zaseLangerhans.
Ukuhlinzwa okunjalo kungasiza ekunqumeni ukuphambuka ezinqubweni ze-metabolic noma ube yisiqinisekiso sokuvimbela ukukhula kwezinkinga ezibucayi zesibili zesifundo sikashukela, ukuxhomekeka kwe-insulin, yize kubiza kakhulu ukuhlinzwa, ngesifo sikashukela, lesi sinqumo sinesizathu.
Amaseli e-Islet awakwazi isikhathi eside ukuthi abe nesibopho sokuguqulwa kwe-carbohydrate metabolism ezigulini. Kungakho kungcono ukuguqukela ekubumbeni kwamapancake we-donor, okubuye kugcinwe imisebenzi yawo kuze kube sezingeni eliphakeme. Inqubo efanayo ifaka ukuhlinzeka ngemibandela ye-standardoglycemia kanye nokuvinjwa okwalandela kokuhluleka kokusebenza kwe-metabolic.
Kwezinye izimo, kunethuba langempela lokufeza ukuthuthukiswa okubucayi kokuqala kwezinkinga zesifo sikashukela noma ukumiswa kwabo.
Impumelelo Yokufakelwa
Ukufakelwa kokuqala kwamanyikwe kwakuwukuhlinzwa okwenziwa ngoDisemba 1966. Umamukeli ukwazile ukufeza i-standardoglycemia kanye nokuzimela kusuka ku-insulin, kepha lokhu akwenzi ukuthi ukubiza ukuhlinzwa kuphumelele, ngoba owesimame ushone ngemuva kwezinyanga ezi-2 ngenxa yokwenqatshwa kwezitho nobuthi begazi.
Ngaphandle kwalokhu, imiphumela yakho konke ukudluliselwa kwama-pancreas okwalandela kwaba yimpumelelo. Okwamanje, ukufakelwa kwalesi sakhi esibalulekile ngeke kwehle ngokulandela ukusebenza kahle kokufakelwa:
- isibindi
- izinso
- izinhliziyo.
Eminyakeni yamuva nje, umuthi ukwazile ukuqhubekela phambili kule ndawo. Ngokusetshenziswa kwe-cyclosporin A (CyA) enama-steroid ngemithamo emincane, ukusinda kweziguli nokwenziwa okunyakazayo kwanda.
Iziguli ezinesifo sikashukela zisengozini enkulu ngesikhathi sokufakwa kwezitho. Kukhona amathuba aphezulu aphezulu wezinkinga zombili imvelo yokungavikeleki nokuvikelwa komzimba. Zingaholela ekumeni ekusebenzeni kwesitho esidlulisiwe futhi nokufa.
Isisho esibalulekile kuzoba imininingwane yokuthi ngesibalo esikhulu sokushona kweziguli ezinesifo sikashukela ngesikhathi sokuhlinzwa, lesi sifo asisiyongo empilweni yazo. Uma ukufakelwa kwesibindi noma kwenhliziyo kungabambezeleka, khona-ke ukufakelwa kwamanyikwe akuyona ukungenelela kokuhlinzwa ngezizathu zempilo.
Ukuxazulula inkinga yesidingo sokufakelwa kwezitho, okokuqala, kubalulekile:
- thuthukisa izinga lokuphila lesiguli;
- qhathanisa izinga lezinkinga zesibili nezingozi zokuhlinzwa;
- ukuhlola isimo se-immunological isiguli.
Noma ngabe kunjani, ukuthunyelwa kwe-pancreatic kuyindaba yokuzikhethela komuntu ogulayo osesigabeni sokuhluleka kwezinso ukubulala. Iningi lalaba bantu lizoba nezimpawu zesifo sikashukela, ngokwesibonelo, i-nephropathy noma i-retinopathy.
Kuphela ngomphumela ophumelelayo wokuhlinzwa, kuba lula ukukhuluma ngokuyeka izinkinga zesifo sikashukela kanye nokubonakaliswa kwe-nephropathy. Kulokhu, kuyadingeka ukwenza ukufakelwa kanyekanye noma ngokulandelana. Inketho yokuqala ibandakanya ukususwa kwezitho zomnikeli owodwa, kanti okwesibili - ukufakelwa kwinso, bese kuba namanyikwe.
Isigaba esibulalayo sokwehluleka kwezinso sivame ukukhula kulabo abaye bathola i-mellitus yesifo sikashukela esincike eminye iminyaka engama-20-30, kanti iminyaka yobudala yalabo osebenza kubo ingabantu abaneminyaka engama-25 kuye kwengama-45.
Uhlobo luni lokufakelwa okungcono ukukhetha?
Umbuzo wendlela ephezulu yokungenelela kokuhlinzwa awukaxazululwa endaweni ethile, ngoba izingxabano eziphathelene nokudluliselwa ngasikhathi sinye noma okuqhubekayo zilokhu ziqhubeka isikhathi eside. Ngokwezibalo nezifundo zobudokotela, ukusebenza kwe-pancreatic transplant ngemuva kokuhlinzwa kungcono kakhulu uma kwenziwa into efanayo yokufakelwa kanyekanye. Lokhu kungenxa yamandla aphansi wokunqatshwa kwesitho. Kodwa-ke, uma sibheka amaphesenti okusinda, khona-ke kuleli cala kuzophumelela ukufakelwa okulandelanayo, okunqunywa ngokukhethwa kweziguli ngokucophelela.
Ukufakelwa kwamanyikwe ukuze kuvinjelwe ukukhula kwe-pathologies yesifo sikashukela esidala kufanele kwenziwe lapho kuqala ukwanda kwalesi sifo. Ngenxa yokuthi inkomba enkulu yokufakelwa kungaba usongo olukhulu lwezinkinga ezibonakalayo zesibili, kubalulekile ukugqamisa izibikezeli ezithile. Owokuqala walokhu yi-proteinuria. Ngokuvela kwe-proteinuria ezinzile, ukusebenza kwezinso kuwohloka ngokushesha, noma kunjalo, inqubo efanayo ingaba namanani ahlukile wokuthuthuka.
Njengomthetho, engxenyeni yalezo ziguli etholakale nesigaba sokuqala se-proteinuria ezinzile, ngemuva kweminyaka engaba ngu-7, ukwehluleka kwezinso, ikakhulukazi, kwesigaba esibulalayo, kuqala. Uma umuntu onesifo sikashukela i-mellitus ngaphandle kwe-proteinuria, umphumela obulalayo kungenzeka kaningi izikhathi ezi-2 kunezinga lesizinda, khona-ke kubantu abane-proteinuria ezinzile le nkomba inyuka ngamaphesenti ayi-100. Ngokomgomo ofanayo, lelo nephropathy, elisathuthuka kuphela, kufanele libhekwe njengokudluliselwa okufanele kwama-pancreas.
Ngokuhamba kwesikhathi ekwakhiweni kwesifo sikashukela esibizwa ngokuthi yi-mellitus, okuncike ekudleni kwe-insulin, ukufakelwa kwezitho emzimbeni kuyinto engathandeki kakhulu. Uma kunomsebenzi we-renal oncishiswe kakhulu, khona-ke ukuqeda inqubo ye-pathological kuzicubu zalesi sitho cishe akunakwenzeka. Ngalesi sizathu, iziguli ezinje azisenakuphila ngesimo se-nephrotic, esidalwa yi-immunosuppression ye-SuA ngemuva kokufakelwa kwezitho.
Isici esiphansi esinokwenzeka sesimo sokusebenza kwezinso sesifo sikashukela kufanele sibhekwe njengaleso nesilinganiso sokuhlunga okusobala kwe-60 ml / min. Uma inkomba ekhonjisiwe ingezansi kwalolu phawu, khona-ke ezimeni ezinjalo singakhuluma ngamathuba okulungiselela ukufakelwa okuhlanganisiwe kwinso nezinsumpa. Ngokwesilinganiso sokucwilisa okwe-glomerular esingaphezu kwama-60 ml / min, isiguli sinamathuba abalulekile wokuqiniswa okusheshayo kokusebenza kwezinso. Kulesi simo, ukufakelwa kukanye kuphela kwensimbi kuzoba okuphezulu.
Amacala okudlulisa
Eminyakeni yamuva, ukufakelwa kwe-pancreatic sekutshenziselwe izinkinga zesifo sikashukela esincike ku-insulin. Ezimweni ezinjalo, sikhuluma ngeziguli:
- labo abanesifo sikashukela sehyperlabile;
- isifo sikashukela i-mellitus ngokungabikho noma ukwephulwa kokufakwa kwe-hormonal kwe-hypoglycemia;
- labo abanokuphikiswa ukuphathwa kwe-insulin kwamazinga ahlukahlukanayo okufakwa.
Noma yingoba yengozi enkulu yezinkinga kanye nokungaphatheki kahle okudala, iziguli zingakwazi ukugcina umsebenzi wezinso futhi zelashwe nge-SuA.
Okwamanje, ukwelashwa ngale ndlela sekuvele kwenziwa iziguli eziningana ezivela eqenjini ngalinye elikhonjisiwe. Kuzo zonke izimo, kwaphawuleka izinguquko ezinhle ezenzekile esimweni sabo sempilo. Kukhona futhi izimo zokufakelwa kwe-pancreatic ngemuva kwe-pancreatectomy ephelele ebangelwa yi-pancreatitis engamahlalakhona. Imisebenzi ye-Exo native ne-endocrine ibuyiselwe emuva.
Labo abasinda ekushintsheni kwama-pancreas ngenxa ye-retinopathy ethuthukayo abakwazanga ukubona ukuthuthuka okukhulu esimweni sabo. Kwezinye izimo, ukubuyiswa kwempahla kuphinde kwaphawulwa. Kubalulekile ukwengeza kulolu daba ukuthi ukufakelwa kwezitho kwenziwa ngaphandle kwesizinda sezinguquko ezinkulu kakhulu emzimbeni. Kunombono wokuthi impumelelo enkulu ingatholakala uma ukuhlinzwa kwenziwa ekuqaleni kwesifundo sikashukela, ngoba, ngokwesibonelo, izimpawu zesifo sikashukela kowesifazane zingatholakala kalula.
I-contraindication eyinhloko yokufakelwa kwezitho
Ukwenqatshelwa okuyinhloko kokwenza lo msebenzi yilezo zimo lapho kuvela khona isimila emzimbeni ongelulungiswa, kanye neengqondo. Noma yisiphi isifo esisesimweni esibi kufanele ngabe siqediwe ngaphambi kokuhlinzwa. Lokhu kusebenza ezimweni lapho lesi sifo sibangelwa hhayi kuphela yi-insulin ethembele kwisifo sikashukela, kodwa futhi sikhuluma ngezifo zesifo esithathelwanayo.
