Ukudla okungalinganiselwe, ukusetshenziswa ngokweqile kwemikhiqizo yotshwala, ukubhema nokuzelapha ngemithi ehlukahlukene ngeke kudale imiphumela ebulalayo ngokushesha.
Benza kancane, baholele ekuvuvukeni, isifo sikashukela, kanti kwezinye izimo kubangela nokubonakala kwezimbila kumanyikwe. Ukuhlolwa ngesikhathi esifanele kwesitho kugwema izinkinga futhi kuvimbele ukuvela kwezimpawu eziyingozi.
Kudingeka ukuthi kuhlolisiswe nini?
Noma iyiphi inqubo ye-pathological eyenzeka kumanyikwe iphazamisa ukusebenza kwayo futhi iphazamise ukusebenza kwayo. Ngenxa yalokhu, isimo sesitho siba sibi kakhulu, futhi umuntu angathola imizwa ehlukahlukene engathandeki esiswini.
Izimpawu ezinjalo azihlali zenzeka ngokuzumayo, ngakho-ke kwezinye izimo, kufanele uhlole ama-pancreas ngendlela ehlelekile, ngaphandle kokulindela ukwanda kwesifo.
Izimpawu zesidingo sokuhlolwa komzimba:
- Izindawo zokucanuzelelwa kwenhliziyo. Isibonakaliso esifanayo siyaqina ngemuva kokuphuza utshwala, ukudla ukudla okuthosiwe kanye namafutha. Kwezinye izimo, isicanucanu kuholela ekuhlanzeni, emva kwalokho isimo sesiguli asisathuthuki.
- Ubuhlungu. Kuzwakala ngaphansi kwezimbambo, kodwa futhi kunganikezwa ezinye izingxenye zomzimba (ngaphansi kwes scapula noma ngemuva kwendawo yesifuba).
- Ukuphazamiseka kwesihlalo. Izimpawu ziveza njengokuqunjelwa noma isifo sohudo. Isibonakaliso esicacile se-pathology ukuba khona kwesitulo sezinhlayiya zokudla, obekungafanele kube yinto ejwayelekile.
- I-Flatulence, i-belching. Izimpawu zikhombisa izinqubo zokuvutshelwa, kanye nokunqwabelana kwamagesi.
- Jaundice. Ukuvela kwayo kungenzeka ngenxa ye-edema ye-organ kanye nengcindezi ye-gallbladder.
- Ukuphakama kokushisa. Ukunyuka kwaso kusho ukuthuthukiswa kwezinqubo zokuvuvukala.
Ngokuvela kanyekanye kwazo zonke lezi zimpawu, kufanele ushayele udokotela ngokushesha noma uthintane naye uqobo nomtholampilo. Imbangela ejwayelekile yemizwa engathandeki kangaka yizifo ezahlukahlukene ze-gland, ngakho-ke umsebenzi womzimba kufanele uhlolwe lapho ubonakala okokuqala.
Izimiso zokuhlola
Ukuxilonga kufanele kube okubanzi, ngakho-ke, lapho ukuqhuba, kubalulekile ukuthola ulwazi ngesakhiwo nemisebenzi eyenziwe ngumzimba.
Amanyikwe adlala indima ebalulekile ezinhlelweni ezinjengokuthi:
- ukugaya
- ukukhiqizwa kwama-enzyme asetshenziswa ekwehlukaniseni ukudla;
- synthesis of insulin namanye ama-hormone.
Ingena esikhaleni esingemuva kwe-peritoneum, phambi kwayo kunesisu, i-transverse eqinile ne-duodenum, nezinso zitholakala ezinhlangothini. Ngaphakathi kwama-pancreas, ama-ducts adlula ephethe ujusi we-pancreatic ngama-enzyme aqhamuka kumaseli akhiqizayo.
Uma noma iyiphi ingxenye yesitho ilimele, izicubu ezisele ziqala ukwenza imisebenzi yazo, ngakho-ke izimpawu zesifo isikhathi eside zingavele. Ukuvuvukala noma ukushona kwezindawo ezincane zesikhumba akuthinti isakhiwo saso, kepha kuthinta kabi imisebenzi yaso.
Ngakho-ke, ukuhlolwa okunconyelwe iziguli kufanele kuveze konke ukwephulwa okungenzeka okuyisizathu sokuthuthuka kokuhlukunyezwa kwe-pathological emzimbeni wokugaya ukudla.
Ukuxilongwa kwelabhorethri
Ucwaningo lukuvumela ukuthi uhlole isimo nomsebenzi womzimba. Izilonda ezikhulu zihambisana nomsebenzi owengeziwe wama-enzyme.
Ezinye zazo zitholakala kalula ngegazi, kanti ukuhlolwa kwesitofu noma komchamo kufanelekile ukuthola abanye. Ubunzima besilonda se-gland buhlolwa ngokusekelwe ekuhlolweni kokusebenza kwesibindi nezinso.
Ukuxilongwa kwebhubhoratri, iziguli zidinga ukuhlolwa okuthile. Uhlu lokuhlolwa okunconyiwe kufanele lunqunywe udokotela kuphela. Esikhathini esiningi, ukubona ukuhlukunyezwa emsebenzini womzimba, kuhlolwa amapharamitha egazi, umchamo kanye nezinduku. Ngokusekelwe kwimiphumela etholakele, izinkinga zokusebenza kwe-pancreatic zingaqinisekiswa noma ziphikiswe.
Uhlu Lokucwaninga:
- Isibalo segazi esiphelele. Kubonisa ukuba khona kwenqubo ye-acute noma engapheli ye-pathological. Izinguquko esithweni zikhonjiswa ngenani elikhulu leukocytes, izinga eliphakeme le-ESR, neutrophils (stab futhi segmented), kanye nokuqina kwegazi.
- I-Biochemistry. Ngokucwaninga okunjalo, izisebenzi zaselabhorathri zikhomba izinga le-bilirubin, kokubili ngokujwayelekile nangokuqondile, ihlole imingcele ye-seromucoid ne-sialic acid.
- Ushukela wegazi. Imvamisa yale nkomba ingu-3.3-5.5 mmol / l. Ukuphambuka kusuka kula manani kukhombisa ukwephula okusobala empilweni yomzimba.
- I-Urinalysis. Lolu cwaningo lukhombisa amazinga e-amylase, amaprotheni nama-amino acid. Umonakalo wesitho ungahlulelwa ngokwanda kwalezi zinkomba.
- ICoprogram. Ukuhlaziywa kusivumela ukuthi sinqume ukungapheleli kwama-enzyme ngokususelwa ekufundweni kwemininingwane kokuqukethwe kwamafutha, i-fiber (engagaywanga ngokuphelele), isitashi, i-elastase nemisipha yemisipha.
Ukuhlolwa kwegazi okungeziwe okunqunyelwe ngqo ukuhlola ukusebenza kwe-gland:
- I-Alpha-amylase - amanani ajwayelekile aqala ku-16 kuye ku-30 g / l ngehora (ukukhuphuka kubonisa ukuvuvukala, kanti ukwehla kubonisa i-necrosis yezicubu zezitho);
- I-Trypsin - okweqile kwama-60 μg / l kubhekwa njengophawu lokuphambuka;
- I-Lipase - inani layo akufanele lidlule i-190 u / l.
Amanani avumelekile womsebenzi we-enzymatic, ilabhoratri ngalinye likhetha ngokuzimela, kuya ngokuthi zisetshenziswa ziphi izindlela zokuhlaziya. Izifundo eziningi zingenziwa esiswini esingenalutho, kepha ezinye kufanele zilungiselelwe kusenesikhathi ukuze zilethwe.
Kubalulekile ukuqonda ukuthi imiphumela yokuhlolwa kufanele ikhonjiswe kudokotela, ngoba ukuxilongwa elabhoratri kuyithuluzi nje lokuthola ukuxilongwa, kepha ngeke ukuqinisekise noma ukuphike lokho.
Ukuhlolwa kokulayisha
Ezinye iziguli akufanele zivivinye kuphela esiswini esingenalutho, kodwa futhi nangemva kokuthatha izinto ezithile ukwenza ukuxilongwa. Ukuhlolwa okunjalo kubizwa ngokuthi izivivinyo zokucindezela.
Izinhlobo eziphambili:
- Ukuhlolwa kwe-Glycoamylasemic.
Ukuqaliswa kwayo kuqukethe ukulinganisa inani le-amylase lokuzila, bese kuthi amahora ama-3 ngemuva kokufakwa kwe-50 g ye-glucose. Ukudlula kwesikhombisi sokuqala ngo-25% ngokulethwa okuphindaphindekile kubonisa ukuthuthukiswa kwe-pathology. - Ukuhlolwa kweproserin. Kukhombisa izinga lokuchayeka komchamo ngokuqhathanisa ingxenye yokuqala nomchamo ngokumelene nesizinda sokuphathwa kweProzerin yezidakamizwa. Amapharamitha wesikhombi aqoshwa njalo ngehora lehora. Ukwanda okumbili-2 kwenani le-diastase kuvunyelwe uma nje kubuyela kokujwayelekile.
- Ukuhlolwa kwe-Iodolipol. Kuqukethe ocwaningweni lomchamo oqoqwe esiswini esingenalutho, nangemva kokudla umuthi "Iodolipol". Izinga le-iodide lilungiselelwe izikhathi ezi-4 (ngemuva kwama-60, 90, 120, amaminithi we-150). Umphumela ubhekwa njengento evamile uma inkomba inqunywa ekuhlolweni kokuqala, ifinyelela esiphezulu sayo ekuhlolweni kokugcina.
- I-Secretin-pancreosimine test. Ukuhlaziywa kufaka ukwethulwa kwe-secretin kokuqukethwe kwe-duodenum, okuholela ekushintsheni kokwakheka kwamakhemikhali. Ama-enzyme akusijusi athunyelwe emathunjini ayobe esehlolwa.
- I-TTG (isivivinyo sokubekezelela ushukela). Kuqukethe ekunqumeni izinga loshukela elisheshayo nokulinganisa inkomba izikhathi ezintathu ngemuva kokuba isiguli sithathe i-glucose ngamanzi ancibilikisiwe.
Ukuqaliswa kwayo kuqukethe ukulinganisa inani le-amylase lokuzila, bese kuthi amahora ama-3 ngemuva kokufakwa kwe-50 g ye-glucose. Ukudlula kwesikhombisi sokuqala ngo-25% ngokulethwa okuphindaphindekile kubonisa ukuthuthukiswa kwe-pathology.Inani lokuhlolwa okwenziwa yisiguli linqunywa udokotela.
Ucwaningo lokuhlelwa kwesakhiwo
Izicubu ze-pancreatic zingahlolwa ngezindlela eziningana:
- izindlela zemisebe
; - I-Ultrasound (i-ultrasound);
- kusetshenziswa i-computer tomography (CT);
- ukubhoboza ngaphansi kokulawulwa kwe-ultrasound - biopsy;
- i-laparoscopy
;Izinhlobo zezindlela zokwelapha ngemisebe:
- Ukubona. Ikuvumela ukuthi ucabangele izinto ezinkulu ezindlini.
- I-Endoscopic retrograde cholangiopancreatography. Kwenziwa ngokungenisa i-ejenti ehlukile emiseleni ngokusebenzisa isisetshenziswa esetshenziswa ku-fibrogastroscopy. Udinga ukulungiselela ukuhlolwa kusenesikhathi.
- I-angiography ekhethiwe. Indlela iqukethe ukuhlola isitho nge-x-ray ngemuva kokuphathwa komenzeli ohlukile.
- I-Tomography ehlanganisiwe. Ucwaningo lusiza ukuthola ukuthi kunama-tumors, kanye nezinqubo zokuvuvukala eziqhubekayo.
I-Ultrasound ibhekwa njengeyona ndlela engenabuhlungu futhi elula yokuhlola izitho zangaphakathi.
Indlela ayilungile njenge-CT, kepha iyasiza ekuhloleni ukuhamba kwegazi esakhiweni nge-Doppler ultrasound, futhi futhi nokuhlonza ama-pathologies amaningi:
- ukuvuvukala ngesimo esibi nesingamahlalakhona;
- ama-neoplasms;
- amasokisi;
- amathumba.
Ukulungiselela inqubo ye-pancreatic ultrasound ukunamathela ekudleni okhethekile, kanye nasekuphuzeni izidakamizwa ezikhethekile.
Izinkomba ze-CT:
- ama-neoplasms anosayizi omncane;
- i-pathology yesibindi;
- ukulungiselela ukusebenza;
- i-pancreatitis
- Ukulawulwa kokwelashwa kwendlala.
I-tomography ehlanganisiwe inika amandla ukubuka kwezicubu ze-gland. Ngokwazisa okufanayo kanyekanye ezinhlwini zesitho noma zemikhumbi, imiphumela yocwaningo iba ethembekile kakhulu.
I-Laparoscopy, noma ibhekwa njengohlobo lokungenelela kokuhlinzwa, kepha ihlinzeka ngamaqiniso amaningi ngenkambo yalesi sifo.
Imvamisa, indlela yenziwa ngesikhathi sokwanda kwenqubo ye-pathological. Ngaphezu kwekhono lokuhlola lesi sifo, i-laparoscopy yenza sikwazi ukususa izicubu zomzimba ofile futhi sikhombe ama-neoplasms ezigabeni zokuqala.
I-biopsy imvamisa yenziwa ukuthola i-neoplasms enobungozi, kanye nokuthola ama-metastases. Inqubo isiza ekuboneni isigaba salesi sifo. I-biopsy yenziwa ngokuhlangana nezinye izindlela zokuhlola, kepha ngokungafani nazo, kuyasiza ukucacisa isithombe futhi kusheshe kutholakale isifo.
Ukulungiselela Ukucwaninga
Ezinye izivivinyo zidinga ukulungiselelwa kokuqala, okungahlanganisi izinto ezithinta okuqukethwe kolwazi okukuso.
Ongakwenza:
- landela ukudla isonto lonke ngaphambi kokuhlolwa;
- ukungafaki kwimikhiqizo yobisi yemenyu, izithelo nemifino engavuthiwe;
- yidla kancane;
- udle ukudla ngezingxenye ezincane ukuze ungalayishi kakhulu isisu;
- yenqaba ukuthatha izidakamizwa ezithile zesikhathi esinconywe udokotela;
- khipha utshwala futhi ungabhemi;
- yenqaba ikhofi eqinile, iziphuzo ezinekhabhoni.
Ukunganaki izincomo ezingenhla kungahlanekezela imiphumela yokuhlaziya.
Imisebenzi ye-pancreas:
Kubalulekile ukuqonda ukuthi ukukhethwa kwendlela yokuhlola ukusebenza kwezitho zangaphakathi, kubandakanya namanyikwe, kufanele kwenziwe ngudokotela kuphela. Ngaphezu kwalokho, izindlela eziningi ngeke zisebenze ohlakeni lomshuwalense ophoqelekile ngaphandle kokudluliselwa kudokotela ngalokhu. Intengo ye-pancreatic ultrasound, ngokuya ngemisebenzi ebekwe uchwepheshe, ingafinyelela kuma-ruble ayi-1,500-2,000, ngokuya ngesifunda.
