I-pancreas iyingxenye yohlelo lokugaya ukudla kanti, kanye nalokhu, kukhiqiza ama-hormone abaluleke kakhulu. Imfihlo yayo, noma ijusi le-pancreatic, elinokwakheka okuyinkimbinkimbi futhi lingena ngaphakathi kwe-duodenum, likhiqizwa yizakhiwo ezahlukahlukene. Kukhiqizwa inkimbinkimbi yama-enzymes wokugaya kumaseli we-acinar, okuhlala cishe ama-95% wevolumu yesitho, kanti isakhi sezinto eziwuketshezi kanye nama-bicarbonates yi-epithelium yemigqa ebekiwe. Ama-Hormones, okuyi-insulin, somatostatin, glucagon, akhiqizwa ngamaseli ahlanganiswe ezindaweni ezibizwa ngokuthi iziqhingi zaseLangerhans futhi enza i-5% yesisindo samanyikwe. Lawa makhemikhali angena ngokuqondile egazini.
Noma iyiphi inqubo ye-pathological, okungukuthi ukuvuvukala, i-autoimmune, isimila, ukubhubhisa, i-fibrous, empeleni "kuthinta" ukusebenza kwesitho. Inani lansuku zonke lejusi le-pancreatic, ukugxilisa kwalo, izinga lokukhuphuka okuvela ku-gland, kanye nezinga lama-enzyme kokuqukethwe kwamathumbu, umchamo, neplasma yegazi kuyashintsha.
Isifo ngasinye se-pancreatic sinezimpawu ezithile ze-pathological. Ngokungeziwe emtholampilo (izinhlungu, isicanucanu, ukugabha, umkhuhlane), udokotela udinga ukuthola izinguquko zokusebenza kwesitho kanye “nobukhulu” bezimo ezonakalisayo. Lokhu kuvumela ukuxilongwa kwelabhoratri, okuyindlela eyinkimbinkimbi yezindlela ezahlukahlukene.
Izindlela zokuxilonga izinsimbi zensimbi (i-ultrasound, i-x-ray, i-MRI, i-CT) zingakhombisa kahle ukwakheka kwesitho futhi sikhombe i-pathological factor. Umuthi wasempumalanga, ngokwesibonelo, lapho uhlola isiteshi samandla we-spleen-pancreas, singakuveza ukungalingani kwalezi zitho esigulini.
Isakhiwo ngasinye siyabandakanyeka ekusithekeni
Indawo yokuhlolwa kwelebhu
Ungayihlola kanjani i-pancreas, okuthi izivivinyo kufanele zidluliswe, kunganqunywa kuphela ngudokotela ohambelayo. Uma isiguli sikhononda ngobuhlungu bekhanda obukhulu noma obulinganiselwe esiswini, isicanucanu nokuhlanza, ushintsho ekudla nesitulo, khona-ke udokotela angasola ukuthi kulimele ama-pancreas, amabele, inyongo, isisu, amathumbu. Ukuhlolwa kokulandela isiguli kuzonikeza eminye imininingwane mayelana namaphoyinti wezinhlungu nosayizi wezitho, kepha ukuhlolwa okuphelele kwamanyikwe kuyosiza ekuxilongeni ngokunembile.
Njengomthetho, ekuhlolweni kwebhubhoratri ye-organ pathologies, kusetshenziswa izindlela ezilandelayo:
- ukuphenya okuqukethwe kwe-duodenal;
- ukuhlolwa kwegazi;
- urinalysis;
- i-coprogram;
- ukuhlolwa kwe-microscopic yamasampula wezicubu (biopsy).
Ezimweni eziningi, akuzona zonke lezi zivivinyo ezidingekayo ukuze ubheke ama-pancreas. Ngokuvamile, isiguli sinikeza igazi, umchamo, indle. Uma isimo siphuthuma futhi isiguli sisesimweni esibi, khona-ke sithatha igazi nomchamo. Kuyinkinga enkulu ukuthatha okuqukethwe kwe-duodenal esigulini esinzima ukuze sicwaninge. Le ndlela, kanye ne-coprogram, imiselwe ikakhulu i-pancreatitis okusolakala njalo noma amanye ama-pancreatic kanye ne-organ organ dysfunctions.
Ukuhlola okuqukethwe kweDuodenal
Okuqukethwe kwe-duodenal yizinqwaba ezigcwalisa i-duodenum. Ziqukethe izingcezu zokudla ezivele ziphathwe nge-hydrochloric acid yejusi yesisu. Ngaphezu kwalokho, kusekukhanyisweni kwesibilini lapho i-duct ye-pancreas ne-gall bladder ivuleka khona. Ngakho-ke, okuqukethwe kwe-duodenal kuhlanganiswa ngejusi ye-bile ne-pancreatic, enayo yonke inkimbinkimbi yama-enzymes wokugaya ukudla. Ukutadisha ukwakheka kwayo kanye nokuqoqwa kwengxenye ngayinye yesikhathi esithile kudlala indima enkulu yokuxilonga, ngoba kusiza ukuhlola hhayi kuphela ama-pancreas, kepha nesibindi ngesinye i-gallder, futhi futhi nokucacisa isimo se-duodenum.
Kumele kuqashelwe ukuthi ukukhiqizwa kwejusi ye-pancreatic, noma kubhekwa njenge-cyclical futhi kuhlotshaniswa nokudla, kodwa empeleni kwenzeka ngaso sonke isikhathi. Ukuqunjelwa emzimbeni ngezikhathi ezithile phakathi kokudla kubizwa ngokuthi okuyisisekelo, noma okuzenzakalelayo, ngalezi zikhathi zejusi kubiwa inani elincane. Ngemuva kokudla, i-iron iyenziwa kusebenze futhi kukhiqizwe ujusi omningi, kuze kufike ku-5 ml njalo ngeminithi. Ngosuku nje, kufinyelela kumalitha ama-2 we-secretion yokugaya athululelwa ku-lumen ye-duodenum.
Ukwemukela okuqukethwe kwe-duodenal kwenzeka usebenzisa i-probe
Uma udokotela esola i-pancreatitis engapheli esigulini, khona-ke kusukela kulolo lonke uhlu lokuthi yiziphi izivivinyo okufanele zidluliswe, ukutadisha kokuqukethwe kwe-duodenal kuza kuqala. Kepha njengesivuseleli, esisebenza ngokushesha kuma-pancreas, akusikho ukudla, kepha ngamakhemikhali akhethekile. Zingangena zilimale ngqo esiswini noma emthanjeni. Ngakho-ke, i-hydrochloric acid noma u-10% wejusi weklabishi usetshenziselwa ukuphatha ngomlomo, kuthi i-siriin ne-pancreosimine emile kusetshenziswe ngabazali (esitsheni se-venous).
Ngaphezu kwalokho, lezi zivuseleli ze-pancreatic juice secretion zinomphumela ohlukile. Ezinye zazo zibangela ukwanda okwandayo kwengxenye kaketshezi kokufihlwa nosawoti wamaminerali, kuyilapho ukuncipha kwama-enzymes wokugaya ukudla kuncipha. Futhi abanye, kunalokho, abaguquli inani lejusi, kodwa bakhuphule izinga lamahomoni nama-enzyme kulo. Ngakho-ke, hlobo luni lwezinto zokuvuselela amakhemikhali okufanele zisetshenziselwe ukubheka isimo sesitho sinqunywa ngudokotela ngokwahlukana, kucatshangelwa ukubonwa kokugabadela kanye nokuba khona kwezifo ezihlangene.
Okuqukethwe kwe-duodenal kusampula ngokukhala. Izinhlobo ezimbili zivame ukusetshenziswa ngasikhathi sinye: enye ithatha isisindo esiswini kanti enye isuka eDuodenum. Isiguli siza siyohlolwa esiswini esingenalutho, bese kuqala okuqukethwe okuzenzakalelayo imizuzu engama-30. Ngemuva kwalokho isivuseleli sifakwa esiswini noma ngaphakathi emzimbeni, kuthi ngemuva kwemizuzu emi-5 amaswidi asevele equkethe inani elikhulu lejusi le-pancreatic aqale "ukukhishwa". Ukuze uhlolwe ngokufanele ama-pancreas, kuyadingeka ukuthi uthathe ama-6-8 servings wokuqukethwe kwe-duodenal.
I-Pancreatic MRIOkuqukethwe okuphenyayo kuhlolwa ngokuya ngezinqubo ezilandelayo:
- ukusebenza ivolumu ku milliliters;
- ithoni yombala;
- sobala
- ukuba khona kokungcola;
- inani lama-bicarbonates;
- ukuhlushwa kwe-bilirubin;
- umsebenzi wama-enzymes wokugaya - ama-amylases, ama-lipases, ama-trypsin.
I-pancreas enempilo noma ye-pathological inamapharamitha ahlukahlukene wokuqukethwe kwe-duodenal. Ngakho-ke, ngokubhujiswa okusebenzayo kwesitho, inani eliphelele lejusi kanye nokuhlushwa kwama-enzymes kushintsha, kuvela ukungcola. Kwi-pancreatitis engapheli, isitho, noma sishukunyiswe ngokwenziwa, asikwazi ukunikeza isilinganiso esanele sama-enzyme kokuqukethwe kwe-duodenal. Inkomba ngayinye yalolu cwaningo ibaluleke kakhulu.
Ukuhlolwa kwegazi
Isimo samaseli we-pancreatic acinous cell akhiqiza ama-enzyatic tata nama-islets ama-Langerhans angacaciswa ngokuhlolwa kwegazi. Igazi leVenous ne-capillary liyasetshenziswa (ukuthola amazinga kashukela).
Amasampula egazi anikezela ngemininingwane yokuhlonza ngokubucayi.
Uma kusolwa izinqubo zokuvuvukala, kwenziwa ucwaningo lwe-biochemical of venous igazi lokuqukethwe kwama-enzymes wokugaya:
- i-alpha-amylase, inyuka nge-pathology hhayi kuphela i-gland, kodwa nezinye izitho zokugaya ukudla;
- i-lipase, nayo inyuka nge-pancreatitis;
- I-trypsin ne-antitrypsin nayo iyakhula, kepha ayifundwa kaningi.
Ngaphezu kwezinga lama-enzymes, ukuhlolwa kwegazi kuhlinzeka ngemininingwane ngamaprotheni e-C-reactive (anda nge-pancreatitis), inani eliphelele lamaprotheni (liyancipha), urea (likhula ngenhlanganisela ye-pancreatitis nesifo sezinso). Ukuhlaziywa kwemitholampilo kuveza izimpawu zenqubo yokuvuvukala: i-leukocytosis, ukuguquka kwefomula kwesobunxele, ukwenyuka kwe-ESR.
Ipharamitha ebaluleke kakhulu ekhombisa izinga le-glucose egazini. Yile nkomba ekhombisa isimo somsebenzi we-endocrine wesitho futhi kuwuphawu lwesifo sikashukela. Uma ama-islets weLangerhans engasebenzi, khona-ke i-insulin ayikhiqizwa ngokwanele, kanti nezinga le-glucose egazini liyakhuphuka.
Ezinye izindlela zaselebhu
Ukuze ubheke isimo se-pancreas, kuyadingeka ukuthatha ukuhlolwa komchamo nokugaya. Ama-enzymes wokugaya, adlula emathunjini, afakwa egazini futhi angena ezinso lapho amafomu omchamo. Ngakho-ke, inani labo kumchamo liyindlela ebaluleke kakhulu yokuxilonga, kucatshangelwa nobulula nokulula kwezinto zesampula zokucwaninga.
Uma i-pancreatitis isolwa, i-urinalysis ye-amylase iphoqelekile
Njengomthetho, izinga le-alpha-amylase linqunywa kumchamo. Ngenqubo yokuvuvukala ekhanyayo, lapho inani lale enzyme lenyuka egazini, liba likhulu nomchamo (ngaphezu kwama-unit ayi-17 / h). Kodwa-ke, ku-pancreatitis engapheli, ehambisana nokuwohloka kanye ne-fibrosis yesitho, ukusebenza kwayo kuncipha kakhulu, okuholela ekuncipheni kwezinga le-amylase kumchamo.
Ukufundwa kwezindunduma, okungukuthi i-coprogram, nakho kuyahlukahluka kakhulu nge-pathologies ye-gland. Isici ikakhulukazi semiphumela yalolu cwaningo kwezifo ezingamahlalakhona, nokwehla komkhiqizo wama enzymes wokugaya ukudla. Kwenzeka futhi lapho umsele we-gland uvinjiwe yisimila noma itshe. Uma imfihlo inganele, khona-ke ukudla kugaywe kahle, inani lamanyathi liyakhuphuka, liba yi-semi-ketshezi, ne-sheen enamafutha nephunga elibolile.
Izimpawu ezilandelayo zivela ku-programme:
- ukukhuphuka kwenani lezinhlayiya ezinamafutha;
- ukukhuphuka kwenani lemicu yemisipha engafakwanga.
I-Microscopy ikuvumela ukuba wehlukanise izimila ze-pancreatic
Ukuhlolwa kwe-microscopic kwamasampula e-izicubu zesitho kwenziwa ngomdlavuza osolisayo noma ama-benign tumors, kanye nezindlela ezithile zokuqina kwesibeletho. Ukutholwa kwamaseli athile kuzosebenza njengesikhombisi esikhulu sokuxilonga.
Izindlela zokuxilonga elabhorethri zihlala zithuthukiswa, futhi izindlela zakamuva zisakhiwa. Imiphumela yabo isiza ukunquma ngesikhathi esifanele ama-pancreas futhi inikeze ukwelashwa okusebenzayo esigulini.
