Pancreatic juice ine enzyme inobatanidzwa mukudya kwezvokudya. Iyo yakavanzwa mukati mepancreatic duct, iyo inobatanidza kune yakawanda bile buct duct inotanga kumucheto wepamusoro wemukumbo muduku (mu duodenum). Muchiedza chemukati kuburikidza nemugwagwa uyu kunouya zvose pancreatic juice ne bile kubva zvose bile ducts pachiropa uye kubva ku gallbladder. Mahomoni anobudiswa nepancreas anosanganisira insulini uye glucagon. Izvo zvinopinza zvakananga muropa uye zvinodzora mashiga eropa. Nzira yekurapa kenza yepancreatic uye zvinetso zvipi?
Zviratidzo zvekenza yepancreatic
• Kushungurudza kumashure, kunowanzoipisisa usiku.
• Jaundice.
• Kuchengeta (zvinowanzoitwa nevarwere veicteric).
• Kuremerwa kurasikirwa.
• Utano husina kunaka.
• Kupedza.
• Fatty chigaro (steatorrhea - madota emucheka wakajeka, unobwinya uye nekunhuhwidza kunosemesa).
• Kuvhiringidza kwekudya.
• Zviratidzo zvechirwere cheshuga zvakadai senenyota uye kubuda kwehuwandu hwemuti. Kenza yepancretic inowanzoongororwa pane zvishoma, sezvo zviratidzo zvinowanzova zvisina kufanira uye dzinogona kutevedzera zvimwe zvinhu, somuenzaniso zvinoshungurudza bowel syndrome. Panguva yekuongororwa, chirwere ichi chinowanzokomberedza chakakomba zvivako zvakapoteredza - chiropa, dumbu, matumbo, mapapu uye lymph nodes. Chikonzero chaicho chekenza yepancreatic hachizivikanwi, asi inofungidzirwa kuti kukura kwechirwere kunoshungurudzwa nezviitiko zvinotevera:
• Kusvuta (inowedzera njodzi).
• Kupera kwechirwere chepancreas (chronic pancreatitis).
• Diabetes mellitus, kunyanya kune vakwegura.
• Migumisiro yezvinosvibisa zvezvinoshandiswa uye zveDDT (insecticide).
• Kusarudzwa kunokonzerwa nemudumbu (kunyanya kugadzirisa chirwere).
Morbidity
Mukenza wepancreatic unotora nzvimbo yechishanu pakati pezvirwere zvakashata uye zviitiko zvinowedzera kuwedzera. Pazera duku, chironda ichi chinowanzoonekwa kune varume kupfuura vakadzi, gare gare mutsauko uyu wabviswa. Paunenge uchiongorora varwere nekunetseka kwechirwere chepancreatic, chiremba kazhinji anoona kurwara kwechiganda cheganda uye mucous membrane, kuwedzera mukati mechiropa uye nduru yakatsvaira (inogadzika pasi pemucheto wekodzero yemari yakakwana). Chiratidzo chekupedzisira chinogona kuratidzira zvose tumarara inobatanidza excretory bile ducts uye ndarama. Nzira yeongororo iyi inosanganisira:
• Kuongororwa kweropa kuti uone chiropa chinoshanda (hepatic functional tests).
• Ultrasound scanning - yakashandiswa kuona chirwere, pamwe nekudzora kushandiswa kwesina munguva yebiopsy.
• CT (computed tomography) uye / kana MRI (magnetic resonance imaging) - kupa chidimbu chechigadzirwa chemukati chemuviri wepamuviri.
• Endoscopic nzira - kupa maonero akajeka emadziro emukati emukati muduku.
• ERCP (endoscopic retrograde cholangiopancreatography) inyaya inoshandiswa mukati memukati uye mudumbu mumukati muduku, mushure mokunge mutengesi unopikisa muitiro wevanhu wakawanda kuti uone kugadziriswa.
• Laparoscopy - kuiswa kwelaparoscope mudumbu remuviri kuburikidza nekudhonza kwemuviri mudumbu nemukana wekutora biopsy. Kurapa kwepancreatic mutsara kunoenderana nezera remurwere uye huwandu hutano hwehutano, hukuru hwechirwere uye huwandu hwekupararira kwayo.
Surgery
Zvidumbu zviduku zvinouya kubva pancreatic tissue zvinogona kurapwa nekubvisa zvose kana chikamu chenhengo. Nekushanda kwakanyanya, chikamu chemukati mudumbu uye mudumbu, bongo duct, nduru bladder, spleen uye lymph nodes pedyo nechiremera chinogona kubviswa. Uku ndiko kupindira kwakaoma zvikuru, kufema pashure pazvo kunoramba kwakakwirira, kunyange zvazvo zvakanyanya kuderera mumakore achangopfuura nekuda kwekuvandudzwa kweanesthesia uye inyanzvi yekuvhiya. Nechipfuva chisina kukwana, kurapwa kunotungamirirwa, pane kudaro, kuderedza zviratidzo. Kana chironda ichi chisimbise yakawanda bile duct, chirwere chinogadzirisa chinogona kuitwa kuti chidzore chigadziko chayo nekuisa simbi (conductor) (stent) panguva ye ERCP. Somugumisiro wekugadzirisa uku, murwere anonunurwa nekucheka uye kuderera kwe jaundice.
Zvinodhaka
Radiation therapy uye chemotherapy inoshandiswa kuuraya masero emukenza uye kuderedza chiremera chemahara, asi chiitiko chazvo chiri nani kupfurikidza panzvimbo yekurapa. Chimwe chikamu chinokosha chekurapa kunesimba painkillers, somuenzaniso, nguva refu yakashanda mumuromo morphine kugadzirira; Unyanzvi hunokosha hwekushandisa zvinodhaka mumutambo wemagetsi hunogona kushandiswa.
Forecast
Kufanirwa kwepancreatic carcinoma hakunakidze, sezvo vanenge 80 muzana yevarwere vane tumarara yakanga yatopararira kune lymph nodes panguva yekuongororwa.
Kupona
Asi 2 muzana yevarwere vane kenza yepancreatic vanorarama makore mashanu, gore rinosvika makore mashanu, varwere vane chirwere chisina kushaya vanofa vanopera mavhiki masere mushure mekunyatsoongorora. Kana chironda ichibviswa, chirevo chacho chinowedzera ne10%.