Izici ezimbi zemvelo, imikhuba emibi, ukungondleki kahle, ukwelashwa okungalawulwa ngokushesha kungaba nomthelela omubi emzimbeni. Izitho eziningi zangaphakathi ziyahlupheka, kufaka phakathi amanyikwe (ama-pancreas). Kodwa ushintsho olubi kulo aluveli ngokushesha, kepha ngokwakhiwa kwe-pathological esevele kuveziwe yemvelaphi ehlukahlukene. Okwamanje, noma yisiphi isifo se-pancreatic siyingozi kakhulu, ngoba kungaholela ezinkingeni ezinkulu. Ngaphezu kwalokho, izicubu zesitho azinawo amandla anele okuvuselela kabusha, futhi kaningi ngemuva kokuxhaswa kokubonakaliswa okubucayi, ukubuyiselwa okugcwele kokusebenza kwe-pancreatic akwenzeki.
Kungakho kubaluleke kakhulu ukwazi ukuthi ungawabheka kanjani ama-pancreas hhayi ngokukhula kwezimpawu zomtholampilo okwenza sikwazi ukusola noma ikuphi i-pathology yesitho noma yonke indlela yokugaya ukudla. Ukuhlola amanyikwe kungalimazi kulezo zimo lapho kungasenazimpawu, kepha kunomthelela kumuntu wezinto ezahlukahlukene ezingezinhle. Ezimweni ezinjalo, impilo nenempilo ebonakalayo kungakhohlisa futhi kungokwesikhashana.
Imigomo nezigaba zokuqinisekisa
Amanyikwe ane-parenchyma, noma izicubu zayo, ezinamaseli akhe akhiqiza ama-enzymes nama-hormone okugaya abaluleke kakhulu. Ngemisuka emincane, enesakhiwo esikhethekile nethoni, imfihlo iqoqwa endaweni enkulu, evula ngaphakathi kwe-duodenum. Ama-Hormones (insulin, gastrin) angena ngqo egazini, ngenxa yenethiwekhi ethuthukisiwe yama-pancreas. Ngaphandle, lesi sitho simbozwe nge-capsule yezicubu esebenzayo eyenza umsebenzi wokuvikela nokusimamisa.
Ngesikhathi sokuhlolwa, kufundwa kanye nemisebenzi yama-pancreas
Isakhiwo ngasinye se-pancreas singaba indawo yasekhaya yenqubo yesifo noma "sihlupheke" ngenxa yokwakheka kwe-pathology komunye umnyango wesitho. Ngakho-ke, nge-pancreatitis (ukuvuvukala kwe-parenchyma), hhayi kuphela amangqamuzana okugcina abhujiswa, kodwa futhi nesimo semithambo nemithambo yegazi kuyashintsha. Lapho kwakhiwa i-neoplasm, ikakhulukazi enobungozi, cishe zonke izinhlaka ze-pancreatic, bese kuthi ezinye izitho zangaphakathi, zibandakanyeke enqubweni ye-pathological.
Ngakho-ke, isifundo se-pancreas kufanele sithinte:
- zonke izingxenye ze-anatomical zesitho, kanye nezakhiwo eziseceleni kwe-gland (isisu, isibindi, i-gall bladder kanye neducts zayo, amathumbu amancane);
- izinga lapho indlala yenza imisebenzi yayo.
Izindlela ezinjalo zokuqinisekisa kufanele zenziwe ngokufana komunye nomunye ukuze "isithombe" sokugcina se-pathology sibe yiqiniso. Lokhu kungenxa yokuthi ngezigaba zokuqala, ngokwesibonelo, senqubo yokuvuvukala, izindawo ezinempilo ze-parenchyma zisebenza ngokuphumelelayo esikhundleni se-lesion esithintwe yilesi sifo. Amandla okukuthola atholakala kuphela ngezindlela zokuxilonga ezihlola ukwakheka kwesitho. Ngakolunye uhlangothi, izimo azijwayelekile lapho, ngokubhekene nesizinda sesakhiwo se-pancreas esigciniwe, isimo sokusebenza sesitho singaphazamiseka kakhulu.
Ngakho-ke, ekusebenzeni komtholampilo, kusetshenziswa indlela ebanzi yokuxilonga, evumela ukuthola imininingwane ethembekile ephezulu ngesakhiwo nomsebenzi wamanyikwe kanye nezitho zomakhelwane. Ungayihlola kanjani i-pancreas esigulini esithile nokuthi yiziphi izindlela zokuxilonga okufanele uzisebenzise ezihlala zithathwa ngudokotela oholayo, lapho umuntu efuna usizo.
Ukuhlolwa nokuphenywa kwesiguli kunikeza imininingwane yokuqala ngalesi sifo.
Ukuxilongwa okuyinkimbinkimbi kwenziwa ngezigaba eziningana, okuyizinhlanganisela zezindlela zendabuko nezanamuhla:
- ukuqoqwa kwezikhalazo nedatha yomlando wezokwelapha;
- ukuhlolwa kwesiguli (okwenziwe ngokuhambisana nesigaba 1);
- izindlela zaselebhu;
- izindlela ezinamandla.
Izinyathelo Zokuqinisekisa Eziyinhloko
Ubuhlungu besisu wuphawu olujwayelekile kakhulu abantu abaphendukela kulo kochwepheshe. Ngama-pancreatic pathologies, akhula ikakhulu nge-pancreatitis, ngesikhathi sokubonakaliswa kokuvuvukala noma ngokubhebhetheka kwesimo esingapheli sesi sifo. Ubuhlungu obukhulu bubuye bubonwe ngezigaba eziveziwe zamathumbu amlimazayo we-gland.
Ngaphezu kwezikhalazo zobuhlungu nokucaciswa kwezimpawu zalolu phawu (ubukhulu, ubude besikhathi, ukuxhumana nokudla, izinga le-irradiation), udokotela uthola ukuba khona kwezinye izimpawu zesifo. Kungaba umkhuhlane, ukuphazamiseka kwesitulo kanye ne-diureis, isicanucanu, ukugabha, ushintsho ekuthambekeleni ukudla. Isiguli singakhononda ngomlomo owomile, ukoma okungapheli, ukucwazimula kwesikhumba, ulimi, noma i-sclera.
Imininingwane ebaluleke kakhulu nge-pathology nayo yidatha yokuthi isifo saqala kanjani, yini eyasivusayo, ukuthi umuntu unemikhuba emibi nokuthi adliwe kanjani, ngabe ngabe kukhona izingozi emsebenzini kanye nezifo ezihlobene nalokho. Udokotela uzocacisa ngokusobala ukuthi lesi sifo sanda kanjani nokuthi isithombe sikhula kanjani, noma ngabe isiguli sinezihlobo ezinezimpawu ezifanayo.
Ukuhlolwa kwegazi kunikeza umbono wokusebenza kwesitho
Isinyathelo esilandelayo esifundweni samanyikwe ukuhlolwa kwesiguli kwangaphandle. Udokotela ubheka ukuba khona kobuhlungu esiswini nokwenziwa kwaso (amaphoyinti wezinhlungu) usebenzisa i-palpation (palpation), uhlola umbala wesikhumba nolwelwesi lwe-mucous, ngasikhathi sinye ukwengeza ezinye izitho zomzimba wesibeletho kanye nesikhala sokuphindisela emuva, ulalele inhliziyo namaphaphu. Imininingwane etholakala ezimweni eziningi ivumela udokotela ukuthi asikisele i-pathology ye-pancreas, kepha ukuthola ukuxilongwa kokugcina nokunquma ukwelashwa, kuyadingeka ukuthi kwenziwe uhlolo lwelabhorethri kanye nolwamandla
Izindlela zaselabhorethri
Lesi sigaba sokuhlolwa siphathelene nesimo se-pancreas esisebenzayo, okungukuthi, sihlaziya umsebenzi waso ekwenziweni kwama-enzyme namahomoni. Izifo eziningi zithinta i-organ parenchyma, ethinta inani kanye nekhwalithi ye-pancreatic secretions, kanye nezinga lokulawulwa kwe-carbohydrate metabolism nge-insulin. Akubalulekile kuphela isifundo esisodwa salezi zinhlaka, kodwa futhi nokuqapha okunamandla kwezimpawu zabo. Lokhu kunikeza umbono wokuthi inqubo yokubhubhisa izicubu ze-pancreatic iyaqhubeka noma iyekile, noma ngabe kunezinkinga ezisongela, indlela esebenza kahle yokwelapha isebenza kahle.
Ukuthola lolu lwazi olubalulekile, igazi, umchamo, indle kuhlolwa ngezindlela zaselebhu, futhi ezikuvumela ukuthi uhlole isimo sesibindi, isimangalo senyongo, isisu, amathumbu.
Zonke iziguli ezinesifo se-pancreatic esisolwa kufanele zibe nokuhlolwa okulandelayo:
Ngabe yini inqubo evamile yokuhlolwa kweglucose yegazi- Ukuhlolwa kwegazi komtholampilo (Izinga le-ESR, inani le-hemoglobin, ukwakheka kwamaseli ngefomula ye-leukocyte), enquma ukuba khona, ngokwesibonelo, izehlakalo zokuvuvukala emzimbeni.
- Ukuhlolwa kwegazi kwe-biochemical nokuzimisela kwe-bilirubin, transaminases, globulins.
- Igazi likashukela (kwesinye isikhathi lenyuka ngomonakalo kumaseli we-endocrine ama-pancreas).
- Igazi lokuqukethwe kwama-enzyme wokugaya (trypsin, lipase, alpha-amylase).
- Umchamo we-amylase (diastase), nge-pancreatitis, inkomba iyenyuka.
- Izinduku ezikwi-coprogram, lapho kutholakala khona izimpawu zokugaya ukudla okungaphelele.
- Izindunduma elastase, inkomba efundisa kunazo zonke njengamanje; ukwanda ukulimala kwamanyikwe, kwehlisa izinga lale enzyme.
Njengomthetho, ukuxilongwa kwelabhoratri, ikakhulukazi igazi, kwenziwa esiswini esingenalutho. Kwesinye isikhathi, ocwaningweni oluningilizayo lokusebenza kwe-gland, kudingeka izivivinyo ezikhethekile zokucindezela. Ngakho-ke, kusetshenziswa izindlela ezilandelayo:
- ukuhlolwa kweproserin;
- glycoamylasemic;
- iodolipol;
- ukubekezelela ushukela;
- i-secretinpancreosimine test.
Idatha ye-Urinary diastasis ibaluleke kakhulu ekuxilongeni
Ngaphezu kokuthola umsebenzi we-pancreatic enzyme, ukuhlolwa kwegazi elebhu kungenziwa uma kusolwa umdlavuza wesitho. Okubizwa ngokuthi ama-tumor markers, noma amakhompiyutha akhethekile akhiqizwa yisimila esibuhlungu, asiza ukukhomba lesi sifo esibi kakhulu ezigabeni zokuqala zokukhula. Ukuxilongwa kusenesikhathi kwegazi lama-tumor markers kusivumela futhi ukuthi sihlukanise umdlavuza kusuka kwamanye ama-neoplasms (cysts, pseudocysts, benign tumors) nezinqubo zokuvuvukala.
Izindlela zensimbi
Ngokungafani nezindlela zaselabhorethri, izindlela ezinamandla zingasetshenziswa ukutadisha ngokuningiliziwe ukwakheka kwe-anatomical kanye nomlando we-pancreas, okwenza sikwazi ukubona izifo eziningi zesitho ngokuthembeka okukhulu. Ukuze wenze lokhu, sebenzisa:
- indlela ye-microscopic;
- i-radiography;
- ukuskena kwe-ultrasound (i-ultrasound);
- i-compact tomography;
- i-magnetic resonance imaging (MRI).
I-Microscopy isetshenziswa lapho kudingeka ukuthi ihlolwe ngaphansi kwesampuli yesicubu yama-microscope yamanyikwe atholwe ngesikhathi sezinto eziphilayo. Ezimweni eziningi, le ndlela isetshenziselwa umdlavuza osolwayo. Ukutholwa kwamaseli akhethekile we- "atypical" akuvumeli nje kuphela ukuthi kuqinisekiswe ukutholwa, kepha futhi kunquma uhlobo lwesimila.
Ukusetshenziswa kwe-radiography kukhawulelwe ekutheni ama-pancreas aqukethe izicubu ezithambile ezicishe zivunyelwe ngokuphelele kuma-x-ray, okwenza kube nzima ukuthola imininingwane (ngaphandle kokuthi ezimweni zokubala kwesitho). Kepha, ngokusebenzisa ama-ejenti aphambanayo, kungenzeka ukunquma ngokunembile isimo senethiwekhi yokujikeleza noma izindunduma ze-gland. Kulokhu, izindlela ezinjenge-x-ray njengesithombe senhlolovo, i-angiography, i-cholangiopancreatography ziyenziwa.
Nge-compact tomography, njenge-radiography, kukhona ukuvezwa kwemisebe esigulini. Kodwa-ke, le ndlela yanamuhla inolwazi kakhulu futhi ikuvumela ukuthi uhlole zonke izakhiwo zamanyikwe nezitho zomakhelwane, kanye nokwehlukanisa ama-tumors, i-infuse immune kanye nezinqubo zokugxila.
I-MRI ibhekwa njengeyona ndlela yokufundisa kakhulu yama-pancreatic pathologies
Ngendlela ye-ultrasound, ukuthola imininingwane kungenzeka ngenxa yezinga elihlukile lokuxineka kwezicubu ze-pancreatic. Umbono wesimo sesitho udalwa ngokwakha imingcele ezithombeni phakathi kwezakhiwo ezahlukahlukene, kufaka phakathi imvelaphi ye-pathological. Le ndlela ivame ukukhonjiswa ekuxilongeni kokuqala kwezifo ze-pancreatic; ihlinzeka ngemininingwane yama-cysts, ama-abscesses, i-infuse ukuvuvukala, isimila, ukugxila kukasawoti we-calcareous, i-patency ye-ducts. I-ultrasound ehlukahlukene, i-dopplerography, isiza ukuhlola isimo segazi.
I-MRI ingenziwa futhi ngokuhlukile futhi ihlolwe izindunduma nemithambo yegazi. Imininingwane etholakalayo iyadingeka ukucacisa ubukhona be-pancreatitis, umdlavuza, isimila se-benign, ukwakheka kwe-cystic, ama-abscesses, i-foci of sclerosis.
Zonke lezi zindlela zokubheka isimo se-pancreas zivame ukusetshenziswa uma kukhona okukhombisa noma okusolisayo ngesifo sesitho. Kungcono futhi ukubheka indlala uma kunomphumela oqhubekayo kumuntu wezinto ezicasulayo, uma kukhona ukungakhululeki esiswini noma iziphi izinkomba zokucindezeleka.
