Umdlavuza wepancreatic

Naphezu kwempumelelo yemithi yesimanje, izifo ze-oncological manje seziyinsakavukela, futhi ukwelashwa kwazo okusebenzayo akukatholakali. Kwezinye izinhlobo, ukushona cishe kungama-90%, noma usebenzisa zonke izindlela zokwelapha ezikhona. Ama-pathologies anolaka anjalo ahlanganisa umdlavuza wekhanda lamanyikwe. Indawo ekhethekile yalesi sitho, kanye nokukhula okusheshayo kwesimila, yenza lolu hlobo lwalesi sifo lube ngolungemukeleki ngokweqile - kuthatha indawo yesi-4 enanini lokufa.

Isimilo esivamile

Umdlavuza wekhanda we-pancreatic ungenye yezindlela ezinonya kakhulu zesimila, yize sinqabile. Ukuphawuleka kwayo ukuthi kuvame ukutholakala esiteji lapho ukuhlinzwa kungasatholakali ngenxa yenani elikhulu le-metastases. Futhi ukuxilongwa okunjalo sekwephuzile kuchazwa yindawo ekhethekile yama-pancreas ekujuleni kwenhliziyo esiswini, kanye nokungabikho kwezimpawu eziphinyiselwe esigabeni sokuqala.

Uma ama-pancreas ethinteka yisimila, ngaphezulu kwe-70% kuthunyelwe endaweni efanele ekhanda. Le yingxenye enkulu yomzimba, isisekelo sayo. Kepha lapha izinqubo zonke eziyisisekelo zokukhiqizwa kwama-enzyme zenzeka, ama-ducts angena emgodini wesisu. Futhi yikhanda elixhumene nezinye izitho zomzimba. Ngakho-ke, i-tumor enjalo ikakhulukazi ngokushesha i-metastasize. Kaningi, isimila sisakazeka ngezinhlelo zokujikeleza nokujikeleza komzimba. Ama-metastases angahlasela isibindi, amathumbu, ngisho namaphaphu.

Izinhlobo

Isimila kule ndawo sivame ukuvela kwizicubu zomzimba. Imvamisa lawa ngamaseli e-epithelial of the ducts of gland asele eguqukile. Kwesinye isikhathi izicubu ze-parenchymal noma i-fibrous ziyathinteka. Isimila sivame ukukhula ngendlela engafani, okungukuthi, ngokulinganayo kuzo zonke izinkomba. Kepha ukukhula kwalo ngokuduma kwamandla kungenzeka, kanye nokuhluma okusheshayo kwezicubu zomakhelwane, imithambo yegazi nezitho zomzimba.

Kaningi, ngokuxilongwa okufanayo, babhekana ne-carcinoma. Lesi isimila esivela kumaseli epithelial we-pancreatic duct mucosa. Baphenduka izinguquko, futhi le nqubo iqhubeka ngokushesha okukhulu. I-squamous cell carcinoma noma umdlavuza we-anaplastic utholakala kancane kule ndawo.

Isimila sivela kumaseli we-gland uqobo, sisebenza ngaphakathi kakhulu emiseleni, kodwa kwesinye isikhathi ebusweni baso

Izigaba

Amaphesenti amancane kuphela eziguli anethuba lokususa le ndlela yokusebenza kwezifo. Ngempela, ezimweni eziningi, isimila ekhanda se-pancreatic asisebenzi.

Ngokuhambisana nalokhu, izigaba ezi-4 zomdlavuza ziyahlukaniswa kule ndawo:

• Esigabeni sokuqala, isimila senziwa kuphela kumanyikwe. Imvamisa inosayizi ongekho ngaphezu kuka-2 cm. Izimpawu azivezwa kahle, ngakho-ke i-pathology ayitholakali okwamanje.
• Isigaba 2 sivezwa ukuphuma kwesimila singene emgodini wesisu. Ngokuvamile, amangqamuzana ayo akhula abe ama-ducts ne-duodenum. Ngaphezu kwalokho, amaseli womdlavuza angahlasela ama-lymph node. Ngaphezu kwalokho, ngaphezu kobuhlungu, isicanucanu nokugaya ukudla, ukwehla kwesisindo kuyaqala.
• Ezigabeni ezi-3, ama-metastases asakazeka kuzo zonke izitho zohlelo lokugaya, futhi atholakala emithanjeni yegazi enkulu.
• Inkambo enzima kakhulu ye-pathology yisigaba sayo se-4. Kulokhu, ama-metastases angangena emathanjeni, emaphashini nasebuchosheni.

Izizathu

Izifo ze-oncological manje sezifundwa ngenkuthalo, kepha kuze kube manje, ososayensi abakwazi ukusho ukuthi kungani bavela. Ngokuvamile, isimila esinjalo sivela ngemuva kwesizinda se-pancreatitis esingapheli esihlala isikhathi eside. Ikakhulu uma isiguli singahambisani nezincomo zikadokotela. Ngasikhathi sinye, secretion pancreatic in the stagnates gland. Lokhu, kanye nenqubo eqhubekayo yokuvuvukala, kuholela ekuwohlokeni kwezicubu nokwakheka kwesimila. Lokhu kunjalo ikakhulukazi kubantu abanesifiso sokuthola ifa ekuthuthukisweni kwezimbila.

Ukusetshenziswa njalo kotshwala kungavusa ukukhula komdlavuza.

Njengoba umdlavuza wekhanda le-pancreas uvela kumaseli wawo, noma yikuphi ukuphazamiseka kwemisebenzi yako kungavusa inqubo enjalo. Okokuqala, ubungozi bokuthuthukisa i-pathology kushukela sikhulu. Lesi sifo singasiholela ku-hyperplasia ye-gland epithelium. Ngaphezu kwalokho, lokhu kuvame ukwenzeka ngotshwala nangokubhema. Ngemuva kwakho konke, utshwala ne-nicotine kuyasiza ekwakhiweni kwenani elikhulu lobuthi, ngisho nama-carcinogens. Ngesikhathi esifanayo, ukukhiqizwa kwama-lipid okubangela i-epithelial hyperplasia kuyanda.

Ukusetshenziswa njalo kokudla okunamafutha, okubabayo kanye nokwenziwe emathinini kubangela ukukhiqizwa okukhuphukile kwe-pancreosimine, nakho okungadala ukuwohloka kweseli. Umphumela ongemuhle esimweni se-pancreas wukudla ngokweqile, ushukela ngokweqile, imikhiqizo enokulondolozwa kokudla, ukuzila isikhathi eside nokungabikho kokulashwa kwezifo zepheshana lesisu. I-Oncology ingaholela kuma-pathologies anjenge cholecystitis, isifo se-gallstone, ulwelwesi lwesisu kanye ne-duodenum.

Ucwaningo seluthole nokuthi umdlavuza uvame ukutholakala kule ndawo kubantu abasebenza ezimbonini eziyingozi. Lezi yizisebenzi embonini yamakhemikhali, eyokhuni, nezolimo. Ngaphezu kwalokho, abantu abahlala ezindaweni ezingathandeki emvelweni bathambekele ekubukekeni kwamathumba amabi.

Izimpawu

Imvamisa, uphawu lokuqala lomdlavuza wekhanda, lapho isifo sitholakala khona, kubuhlungu. Kepha inkinga ukuthi ubuhlungu obukhulu benzeka ngesikhathi lapho isimila sesivele sikhula saba usayizi onciphisa izitho eziseduze noma izinzwa zezinzwa. Ekuqaleni, izimpawu zimnene futhi zingathathwa yiziguli ngokuphendula ukudla okungelona ikhwalithi ephezulu noma ukwanda kwe-gastritis.

Kodwa i-pathology ingabonakala esigabeni sokuqala. Ukonakala kweseli kuvame ukuhambisana nokudakwa komzimba. Lokhu kuboniswa ukwehla kwesifiso sokudla, ukuncipha okuqinile kwesiguli nobuthakathaka. Isimo esifanayo sibuye sibangelwe ukwephulwa kwemisebenzi yendlala nokuwohloka kokugaya.

Ngaphezu kwalokho, ngomdlavuza wekhanda we-pancreatic, izimpawu ezilandelayo zivame ukubonwa:

• isicanucanu, ukuhlanza
• i-anorexia;
• i-belching, i-flatulence;
• umuzwa wesisindo ngemuva kokudla;
• ethukile.

Ubuhlungu ngale ndlela yomdlavuza buba bukhulu nesimila esikhulu.

Njengoba isimila sikhula, singacindezela izindunduma ze-bile. Lokhu kuphazamisa ukuhamba kwe-bile futhi kubonakale ngaphandle ngesimo se-jaundice evimbayo. Isikhumba nesilonda se-mucous zingaba nsundu noma zibe nsundu ngombala obomvu, uzwakale kanzima. Ngaphezu kwalokho, umchamo uyamnyama, futhi amachaphaza, esikhundleni salokho, ancibilike. Kulokhu, iziguli zivame ukuzwa izinhlungu ezinzima kakhulu.

Njengoba kunamaqhubu anjalo, izinkinga zivame ukuvela ngenxa yokulimala kwezitho zomakhelwane. Lokhu kungaba ukwanda kwesibindi, ama-ascites of the spleen, infarction yamaphaphu, ukopha kwamathumbu, isilonda se-peptic. Imvamisa ukuhluma kwe-metastases ohlelweni lokujikeleza kuholela kwi-venous thrombosis yamaphethelo aphansi.

Ukuxilonga

Ukuxilongwa komdlavuza wekhanda we-pancreatic kuyinkimbinkimbi yindawo ejulile yalesi sitho, kanye nokungabikho kwezimpawu ezithile. Ukubonakaliswa kwe-pathology kungalingana nangezinye izifo zohlelo lokugaya ukudla. Ukwahluka kwe-tumor kuyadingeka nge-peptic ulcer ye-duodenum, i-aneurysm ye-aortic, i-benign neoplasms, i-pancreatitis ene-acute, i-cholecystitis, ukuqhekeka kwama-ducts we-bile.

Ngakho-ke, ukuze kutholakale ukuxilongwa okuyikho, kudingeka ucwaningo olunzulu. Izindlela ezisetshenziswa kakhulu yilezi:

• i-endoscopic ultrasound;
• I-Pancreatic MRI;
• i-ultrasonography;
• i-positron emission tomography;
• umsindo we-duodenal;
• i-coprogram;
• I-MSCT yezitho zesisu;
• i-endoscopic retrograde cholangiopancreatography;
• i-punct biopsy;
• ukuhlolwa kwegazi.

Ukuthola isimila kuma-pancreas kungenzeka kuphela ngokuhlolwa okuphelele

Ukwelashwa

Ukwelashwa kweziguli okunalokhu kutholwa kwenziwa esibhedlela. Isimila esinjalo sithuthuka ngokushesha okukhulu, ngakho-ke ukuhlanganiswa kwezindlela eziningana kuyadingeka: ukungenelela kokuhlinzwa, i-chemotherapy, ukuvezwa kwemisebe. Izindlela zesimanje ziyasetshenziswa, ngokwesibonelo, i-biotherapy. Lokhu ukusetshenziswa kwezidakamizwa ezihlukile eziqondise kumaseli womdlavuza. I-Keithrud, i-Erlotinib, noma imigomo ekhethekile yokwelapha isetshenziswa. Kodwa noma kunjalo, noma yikuphi ukwelashwa kwalokhu kwekhwalithi akukuhle ikhwalithi futhi akuqinisekile.

Ukususwa kwama-pancreas

Ukuphela kwendlela yokususa lesi simila ukuhlinzwa. Ngemuva kwakho konke, imelela amaseli okuwohloka kwe-gland, asevele engenakwenzeka ukubuyela kokujwayelekile. Esikhathini sokuqala, ukwelashwa okuhlinzwa kungamisa ukubhebhetheka kwesimila. Kepha ngenxa yalokhu kuyadingeka ukususa wonke amaseli awo. Ngakho-ke, resection ephelele ye-pancreatoduodenal ivame ukwenziwa. Lokhu kususa ingxenye yamanyikwe, kwesinye isikhathi isisu noma i-duodenum, imikhumbi ezungezile nezicubu.

Ezimweni ezingandile, ngokusebenza okunjalo, kungenzeka ukuthi kugcinwe imisebenzi yohlelo lokugaya ukudla. Kepha imvamisa, lapho ekhetha indlela yokwelashwa kokuhlinzwa, udokotela ukhetha okungaphansi kobubi obubili. Futhi yize kwenziwa imisebenzi enjalo, izinga lokufa liyi-10-20%, lokhu kuphela kunikeza isiguli ithuba lokuphila iminyaka embalwa.

Esigabeni sokugcina somdlavuza wekhanda lama-pancreas nge-metastases esibindini nakwezinye izitho, ukususwa kwesimila sekungasebenzi ngokuphelele. Ngakho-ke, ukuhlinzwa kwe-palliative kwenziwa ukuthi kube lula ukuthi isiguli siphile, sithuthukise ukugaya, futhi siqede i-jaundice. Lokhu, ngokwesibonelo, ukudlula lapho kuhlinzwa noma kugqunywa ngephunga le-endoscopic ye-bile ducts.

I-Chemotherapy isiza ukunciphisa usayizi wesimila futhi ivimbele ukuphinda kwayo ngemuva kokuhlinzwa

Ngemuva kokuhlinzwa, i-chemotherapy inqunyelwe ukuvimbela ukubuyela emuva futhi ithuthukise impilo yempilo yesiguli. Kudingeka nezidakamizwa ezikhethekile kwifomu lomdlavuza ongasebenzi. Ukwelashwa okunjalo kunganciphisa ukukhula kwe-tumor yayo futhi kwehlise nosayizi wayo. Ukusebenza ngempumelelo ngisho nasezigabeni zakamuva zomdlavuza yizidakamizwa uSomatostatin no-Triptorelin.

Ngefomu lomdlavuza ongasebenzi, kusetshenziswa imisebe ye-radiation. Ukwelashwa ngemisebe kungabhubhisa amaseli womdlavuza kumaseshini ambalwa. Lokhu kukuvumela ukuthi unciphise kancane i-metastasis futhi wandise impilo yeziguli. Kepha uma sifunda izibalo, lapho kubhekwa khona ukuthi zingaki iziguli ezihlala nale pathology iminyaka eminingana, kuyacaca ukuthi indlela ephumelelayo yokwelashwa ayikakatholakali. Ngisho noma usebenzisa zonke izindlela ezaziwayo, ezingaphezu kwezi-80% yeziguli ziyafa kungakapheli unyaka ngemuva kokuxilongwa.

Isimo sezulu

I-prognosis enhle yomdlavuza wekhanda we-pancreatic ingaba kuphela kulabo abaye batholakala benenkinga ye-pathology ekuqaleni kwesikhashana, okungajwayelekile. Ukwelashwa kusenesikhathi kuqalile, kuvuleke nethuba lokululama. Uma isimila senziwe kuphela kuma-pancreas futhi singakahlanganisi imastastas, singasuswa.

Esigabeni sesibili, imvamisa akukho metastasis, kepha isimila sikhula sibe ngamasayizi amakhulu, esephula imisebenzi yazo zonke izitho zokugaya ukudla. Ukusebenza okukodwa kuphela akuphumeleli kuleli cala. Ukucindezela ukukhula kweseli okulimazayo, i-chemotherapy kanye nemisebe iyadingeka. Futhi ekuxilongeni umdlavuza ezigabeni zakamuva, ukufa kwabantu phakathi konyaka kungama-99%. Kodwa ukwelashwa okuhlangene kuhlanganiswe emazingeni okuqala esifo akuqinisekisi ikhambi eliphelele. Imvamisa iziguli ezinalesi sifo azihlali isikhathi esingaphezu kweminyaka emi-5.

Ukondliwa okufanele kuzosiza ukwehlisa ingozi yakho yomdlavuza.

Ukuvimbela

Isigaxa somdlavuza ekhanda le-pancreas asikho isikhathi eside, kepha siyindlela yokuhlukumeza kakhulu kunazo zonke. Ukusinda kweziguli kuncike esigabeni salesi sifo, ubukhulu besimila kanye nobungako bokulimala kwezicubu zomakhelwane. Ukululama okuphumelelayo, kubaluleke kakhulu ukuqala ukwelashwa kwe-pathology esiteji sokuqala, okungajwayelekile kakhulu. Ngemuva kwakho konke, ukuthola umdlavuza kule ndawo kungenzeka kuphela ngokuhlolwa okuphelele.

Ngakho-ke, indlela eyinhloko yokuvimbela i-pathology izivivinyo zezokwelapha ezijwayelekile. Lokhu kudingekile kakhulu ngokubonwa njengefa noma ukubonwa ngezinto ezingezinhle. Kuyadingeka ukwelapha zonke izifo zohlelo lokugaya ukudla ngesikhathi, futhi lapho kukhona isifo sikashukela i-mellitus noma i-pancreatitis, landela ngokucophelela zonke izincomo zikadokotela. Kuyadingeka ukushiya imikhuba emibi, zama ukugwema ukucindezela. Futhi ekudleni ukunciphisa ukusetshenziswa kwamafutha, i-confectionery, inyama ebhemayo nokudla okusemathinini.

Umdlavuza we-pancreatic wekhanda uyindlela ebaluleke kakhulu engaholela ekufeni esikhathini esifushane. Ngakho-ke, udinga ukuzama ukudla ngendlela efanele, uhole impilo enempilo futhi uvivinyelwa udokotela njalo. Lokhu kuzosiza ekutholeni isimila esisesigabeni sokuqala, lapho kusekhona ithuba lokuwususa.