I-insulinoma eyenzeka kumanyikwe ibhekwa njengesimila esisebenzayo se-hormonal. Ezimweni eziningi, kuba ukwakheka okuhle futhi kungaholela ku-oncology ku-15% kuphela.
I-insulinoma inezimpawu ezahlukahlukene ezixhomekeke ebangeni lokuvikelwa komzimba, izici zomuntu, ithonya lezinto zangaphandle noma zangaphakathi. Lesi sifo kunzima ukusibona, ngakho-ke iziguli akufanele zingakunaki ukubonakaliswa kwaso, futhi ngisho nezimpawu zokuqala kufanele zibonane nodokotela.
Izimbangela kanye pathogenesis
Izimbangela eziqondile ze-insulinomas azaziwa. Kuphela ukuxhumana kwe-neoplasm nge-adenomatosis, okusebenza njengesifo sofuzo esingandile futhi kufaka isandla ekwakhekeni kwama-tumors e-hormone.
Noma kunjalo, kunemibono eminingana ngomthombo wama-insulinomas, ongakatholi isiqinisekiso sesayensi.
Lezi zizathu zibandakanya:
- kusengaphambili kofuzo ukwanda kwamaseli we-pathological;
- ukuphazamiseka kuzindlela ezisebenzayo eziguqukayo emzimbeni.
I-neoplasm ayinasakhiwo esisodwa, ngisho nezingxenye zesisu esifanayo zingashiyana ngokuhlukile. Umbala wokuqukethwe kwamaseli abo uyahlukahluka futhi ungaba nomthunzi okhanyayo noma amathoni amnyama. Lokhu kuchaza amandla we-insulin ukukhiqiza nokufihla amanani ahlukahlukene e-hormone.
Ama-neoplasms angasebenzi, njengoba imibukiso yemikhuba, imikhulu kakhulu ngosayizi, futhi ngokuhamba kwesikhathi angakhula abe ngama-tumor ayingozi. Le ndlela ivame ukuhlotshaniswa nokuboniswa okuncane kwalesi sifo, kanye nokutholwa kwayo sekwephuzile.
Ukubonakala kwe-insulinoma kunomthelela ekwenzeni i-insulin ngamanani amakhulu. Amazinga amaningi we-hormone emzimbeni abangela i-hypoglycemia, lapho inani likashukela lehla kakhulu. Imvamisa ukwenzeka kwe-neoplasm enjalo kubhekwa njengomphumela wezinkinga nge-endocrine gland. Iqembu elibeka engcupheni ukuthuthukiswa kwesifo esinjalo lifaka phakathi abantu abaneminyaka engama-25 kuye kwengama-55. I-Pathology ayibonakali kakhulu ezinganeni noma ebusheni.
Isisekelo se-pathožisis yesimo se-hypoglycemic state of insulinoma is hyperproduction of insulin, engaxhomekeki kunani le-glycemia.
Ukuzila isikhathi eside kungadala umuntu ophilile ukuthi alahle i-glucose iye emkhawulweni ophansi wesimo esijwayelekile, kanye nokwehla okuqinile kwesilinganiso sehomoni.
Kubantu abane-tumor ethuthukisiwe, i-glycogenolysis iyacindezelwa ngenxa yokwanda kokufakwa kwe-insulin, ngakho-ke, lapho kungekho ukungena kweglucose ekudleni, kuhlaselwa i-hypoglycemia.
Uma lesi simo senzeka njalo, khona-ke ushintsho lwe-dystrophic luba khona ohlelweni lwezinzwa nemithambo yegazi, okungaholela ekwakhiweni kwe-cerebral edema kanye nokwakheka kwezihibe zegazi.
ISymbomatology
Izimpawu ze-pancreatic neoplasm zingahluka ngenxa yezinto ezilandelayo:
- inani le-insulin ekhishwe;
- izigaba zesimila;
- usayizi we-insulinoma;
- izici zesineke.
Izinkomba eziyisisekelo zokusebenzisa i-insulinoma yilezi:
- ukuqunjelwa kwe-hypoglycemic okuvela ngemuva kwamahora ama-3 ngemuva kokudla okulula noma isidlo esikhulu;
- ukuqoqwa koshukela okuku-serum yegazi kungu-50 mg;
- ukumisa izimpawu ze-hypoglycemia ngenxa yokusebenzisa ushukela.
Ukuvela okwenzeka njalo kwe-hypoglycemia kuphazamisa ukusebenza kohlelo lwezinzwa (enkabeni nakwezokuqina). Esikhathini esiphakathi kokuhlaselwa okunje, kukhona ukubonakaliswa kwemizwa, ukunganaki, i-myalgia, ukuncipha kwememori, kanye namakhono engqondo.
Iningi lalokhu kuhlukunyezwa kuyaqhubeka ngemuva kokususwa kwesimila, okuholela ekulahlekelweni kwamakhono obuchwepheshe kanye nesimo esizuzwe emphakathini. Izimo ze-hypoglycemia ezenzeka emadodeni zihlala zingabangela ukungabi namandla.
Izimpawu ze-insulinoma zihlukaniswa ngombandela zibe yizimo ezi-hypoglycemia ezinzima, kanye nemibukiso engaphandle kokuhlaselwa.
Izimpawu zokuhlasela
Ukubonakaliswa kwe-Hypoglycemic okwenzeka ngendlela eyisimanga kuvela ngenxa yokuvela kwezinto eziphikisanayo nokuphazamiseka ezinhlelweni zohlelo lwezinzwa oluphakathi. Ukuhlasela kuvame ukubonakala esiswini esingenalutho noma ngezikhathi ezithile phakathi kokudla.
Izimpawu eziphambili yilezi:
- ukuqala okungazelelwe kwekhanda elinzima
; - ukuxhumeka okungahambisani kahle nenqubo yokuhamba;
- kwehlise i-acuity ebonakalayo;
- ukwenzeka kokukhishwa kwemizwa;
- Ukukhathazeka
- ukushintshanisa imizwa yokwesaba nge-euphoria nolaka;
- ukushuba kwengqondo;
- ukuthuthumela kuvela emilenzeni;
- ukuzindla kwenhliziyo;
- ukujuluka.
;Ngezikhathi ezinjalo, okuqukethwe ushukela kungaphansi kuka-2,5 mmol / L, futhi izinga le-adrenaline liyakhuphuka.
Izimpawu ezingaphandle kokuhlaselwa
Ukuba khona kwama-insulinomas ngaphandle kokukhulisa kunzima ukuthola. Ukubonakaliswa kuyancipha futhi akukhona.
Izimpawu ezingaphandle kokuhlaselwa:
- ukwanda kwesifiso sokudla noma ukwenqatshwa okuphelele kokudla;
- ukukhubazeka komzimba
- umuzwa wobuhlungu, kanye nokungaphatheki kahle ngesikhathi sokuhambisa amashiya;
- ukukhubazeka kwenkumbulo;
- ukulimala kwezinzwa zobuso;
- ukulahleka kokukhalipha okuthile nemikhuba ethile;
- kwehlise ukusebenza kwengqondo.
Isimo lapho izimpawu ezisohlwini zenzeka kwezinye izimo zihambisana nokuphelelwa ukwazi noma ukuqaqanjelwa. Ukuquleka kaningi kungadala ukukhubazeka komuntu.
Abantu abaphoqelelwa ukuba bayeke izimpawu ze-hypoglycemia, ezimeni eziningi, banamafutha ngokweqile noma banesisindo somzimba esandisiwe uma kuqhathaniswa nemigomo. Kwesinye isikhathi izimpawu ze-insulinomas zingadala ukudangala komzimba ngenxa yokuphazamiseka okuthuthukile kokunye ukudla.
Ukuxilonga
Ukubonakaliswa kokuqala kwesici se-insulinomas kufanele kube yisizathu sokuxilongwa kokuxilongwa komuntu.
Izinhlobo zezifundo zokuxilonga:
- elebhu (iqukethe izivivinyo zaselebhu ezibekwe udokotela);
- ukusebenza;
- okokusebenza.
Ucwaningo olusebenzayo lubandakanya:
- Ukuzila kwansuku zonke - kukuvumela ukuthi unqume isilinganiso se-glucose ne-hormone ekhiqizwayo. Ngenxa yale ndlela, kungenzeka ukuvusa ukuqala kokuhlasela kwe-hypoglycemia, lapho kungenzeka khona ukuthola izinkomba eziningi ezibalulekile.
- Ukuhlolwa okucindezelayo kwe-insulin - kususelwa ekutholakaleni kwamazinga kashukela namanani we-C-peptide.
- Ukuhlolwa okuvusa insulin okususelwa ekuqalisweni kwe-glucose ukuze kubhekwe ukuphendula komzimba.
Isigaba sokugcina sifaka izifundo ezilandelayo ezisizayo:
- isiqu
- I-MRI (i-magnetic resonance therapy);
- I-Ultrasound (i-ultrasound);
- catheterization kohlelo lwe-portal ukuthola ama-neoplasms;
- i-angiography (sesha isimila eceleni kwenethiwekhi ye-vascular);
- ukuhlaziywa kwe-radioimmunological - kwembula inani le-insulin.
Isidingo salolu cwaningo ngalunye sinqunywa ngudokotela.
Ividiyo evela kuDkt Malysheva enikelwe i-insulinoma, imbangela yokuvela kwayo nokuxilongwa:
Izindlela zokwelapha ezilandelanayo
Ukwelashwa akuqedi imvelaphi yesifo futhi kungeke kuholele ekubuyeleni isiguli ngokuphelele.
Amacala wokwelashwa okulondoloziwe:
- ukwenqaba komuntu ogulayo ukwenza ukuhlinzwa;
- ingozi eyengeziwe yokufa;
- ukutholwa kwe-metastasis;
- imizamo engaphumeleli yokususa i-neoplasm.
Izindlela zokwelashwa ezilandelanayo:
- ukuthatha izidakamizwa ezandisa izinga le-glycemia;
- ukuphathwa kwe-glucose (emithanjeni);
- chemotherapy.
Ingxenye ebalulekile yokwelashwa okubonakalayo kwe-insulinoma ekudleni okubandakanya okuqukethwe ushukela omningi.
Ukuhlinzwa
Indlela yokusebenza yokuqala ukuthola ithumba, bese uyikhipha. Ukuhlinzwa kubhekwa njengokuwukuphela kwendlela yokuqeda isimila.
I-insulinoma etholakala kumanyikwe ngokuvamile itholakala ngaphezulu kwesitho.
Inemiphetho ecacile, ngakho-ke kulula ukuyisusa. Ama-neoplasms amancane avame ukuba nesakhiwo se-atypical futhi kungenzeka angatholakali ngesikhathi sokuhlinzwa.
Ezimweni ezinjalo, ukususwa kuhlehliswa kuze kube usuku lwamuva, lapho isimila siba sikhulu. Isikhathi sokulinda ukuhlinzwa okulandelayo sihambisana nokwelashwa okulondolozayo ukuvikela i-hypoglycemia kanye nomonakalo oyingozi ohlelweni lwezinzwa.
Ukubuyiselwa emuva kokuhlinzwa kwenzeka kwiziguli ezingaphezu kwesigamu. Ingozi yokufa ikhona cishe ngamaphesenti ayishumi. Kwezinye izimo, ukubuyela emuva kungenzeka. Kubalulekile ukuqonda ukuthi ukuxilongwa kusenesikhathi kwandisa amathuba okuba nekhambi eliphumelelayo le-insulinomas.
