Pehea e nānā ai i ka pancreas

ʻO nā maʻi o ka pancreas (pancreatitis, neoplasms, cysts, nā pōhaku i loko o nā kumulāʻau) me ka hana hewa ʻana o ke kaʻina hana ʻana. A ʻo ka hopena i hoʻohuli ʻia i loko o ke kō o ke ana o ka hormone (insulin a me glucagon) e hoʻoponopono i ke kiʻekiʻe o ka glucose i ke koko e pili ana i ka hana o ka huina o nā mea holoʻokoʻa. No laila, he mea nui e hoʻohana i nā hana o ka maʻi maʻi o ka papa pancreatic e kōkua a pale i nā hopena pōʻino.

E nānā mākou pehea e nānā ai i ka pancreas e hoʻohana ana i nā ala i loaʻa. Pehea ka kūpono o ka hoʻohana ʻana i ka laulā āpau o ka maʻi maʻi ma muli o ke kūlana o ka mea maʻi, ka hiki o ka hale haukapila kokoke loa.

Hoʻomaopopo mākou i ka mea heluhelu e pili ana i ke koho kūikawā o ke ʻano a i ʻole nā hoʻokolohua pono i ka nānā ʻana i ka pancreas e noho pū me ke kauka. Pili ka pili i ka wehewehe ʻana o nā hopena a me nā hoʻoholo ʻana.

Nā Huaʻōlelo kikowaena Interentation

ʻO nā hoʻopiʻi nui e hōʻike ana i nā kulekele o ka pancreas:

ʻeha ka ʻōpū
nā maʻi dyspeptic (ke kala, leʻaleʻa, nā kīwaha, puaʻa)
ʻili o ka ʻili
nāwaliwali laulā
mea kaumaha koʻikoʻi.

ʻO ka hiʻohiʻona o ka ʻehaʻeha o ke kaumaha e wehewehe ʻia e ka mea maʻi:

hōʻeha nā pōkole pōkole he 3-4 mau hola ma hope o ka ʻai ʻana i nā meaʻai momona a lōʻihi paha, mau nō kekahi mau lā, hiki
lawe pinepine ʻia me nā lāʻau antispasmodic,
localization - ka epigastric zone a i ʻole hypochondrium hema, ka ʻili ʻana i ke kua, hopu i ka ʻōpū āpau o luna, uaʻike nā mea maʻi i ka ʻano "kāʻei".

ʻO nā hōʻeha ākea a me ka puʻuwai koʻikoʻi keʻano o ka pancreatitis maʻa. Hoʻopili ʻia lākou e ka blockage o ka dcrcrory i ka nui o ka pulupulu ma muli o ka mānoʻi a me ka hū ʻana o nā ʻili e puni ana.

E pili ana i ke kani ʻana, hoʻomau, hoʻoikaika i kahi kūlana ma hope. Inā kānalua ka maʻi o ke poʻo o ka kelepona, e wehewehe ka mea maʻi i ka ʻeha ma ka hypochondrium ma ka ʻaoʻao ʻākau me ka pālahalaha ʻana i ke kua, ke kino a me ka ʻoi - nā ʻeha ma ka epigastrium, a waiho i ka hypochondrium, "kāʻei" he ʻano. Hiki i nā ʻehaʻeha lōʻihi me ke kūnake maʻi. Ke noʻonoʻo nei i ka mea e kōkua ai i ka wā e hoʻouka ai, hōʻike ka mea maʻi i kahi ʻano kūloko maʻamau.

ilihune
ka hoʻokaʻawale ʻana i ka meaʻai, ʻoi loa ke ʻano o nā aila.
kali kikika
ʻūlū
hānai me ka ʻōlelo huna o nā feces, i uhi ʻia me ka membrane shiny ("stool fat"), me kahi ʻano momona fetid.

ʻO Yellowness o ka ʻili he brownish a ʻulaʻula paha, i ukali ʻia e ka ʻeha nui o ka ʻili, nā hemorrhages (bruises). Inā hoʻopiʻi ka mea maʻi i kēlā mau hōʻailona, a laila me ke ʻano ʻole o ke koko, hiki iā ʻoe ke kahakaha mua i kahi tumō i loko o ke poʻo o ka pancreas a i nā hopena paha o ka maʻi pancreatitis (organ sclerosis).

Ma muli o ke ʻano o ke koi ʻana o ka umauma bile e puka nei i waho o ka pueo. Aia kahi kūlana i ka wā e nānā ai i ka pancreas āu e nānā ai i ka ʻā o ka ate a me ka lolo. ʻO ka hana ʻana o nā maʻi pancreatic e pili ana i ka elucidation o nā mea i kōkua i ka loaʻa ʻana o nā pathology.

Pono e nīnau ʻia ka mea maʻi:

e pili ana i kaʻai a me ka makemake no nā mea momona momona,
inu waiʻona
ka heleʻana ma ka mōʻaukala o ka maʻi o ka ʻikepili i ka cholecystitis maʻi,
predisposition hoʻoili i ka ulu ʻoi ʻana.

ʻO ka loiloi o nā hopena nānā

ʻO ka hoʻokolokolo o ka mea maʻi me ka hana akamai e hāʻawi i ka ʻike pono no ka maʻi maʻi. ʻO ka pancreatitis acute e hōʻikeʻia e ka pallor o ka ʻili me nā ʻona o cyanosis (nā hopena o ka palaka a me ka hōʻino o ka capillary).

I ke kanesa, hoʻopau ʻia ka mea maʻi, ua melemele ʻia ka ʻili, maloʻo me nā ʻōpū o ke kahakaha a me ka hemorrhages. Ka pinepine pinepine ʻana i ka ʻōpū o ka ʻōpū, pua. He paʻakikī loa nā Palpating ʻeha hōʻeha. Hoʻopili i nā ʻōpū ʻōpū. Loaʻa ka ʻeha nui loa i ka epigastrium, liʻiliʻi liʻiliʻi ma ka hypochondrium ma ka hema.

Hiki ke manaʻo i ka nui o ka nui i loko o ka 4-5 mau hihia o nā maʻi wahine, i 1-2% o nā kāne. Ma kahi o kahi hoʻokumu cylindrical kikoʻī, ua hoʻoholo ʻia kahi kaula ākea, tuberous. I ka palpation, hiki ke kuhihewa i nā ʻāpana o nā ʻāpana kuʻuna no ka pancreas:

ʻōpū
ʻōhule kūweʻe
hoʻonui ʻia nā lymph nodes.

He aha nā haʻawina i hoʻokomo ʻia i loko o ka hoʻolālā ʻoihana?

Inā i ka wā o ka enogogui a me ka nānā ʻana i nā hōʻailona o ka maʻi pancreatic kanalua, mālama ke kauka i kahi nānā piha o ka pancreas. No ka hana ʻana, e hoʻohana:

hōʻike koko no nā hoʻokolohua biochemical,
ka nānā ʻana o ka biochemical urine, ʻike i ke kiʻekiʻe o ka diastase,
ka nānā ʻana i ka feces no ka coprology e ʻike i ke koena o ka meaʻai i kāwili ʻia, nā mea momona (steatorrhea),
Kōkua ka kōkua ultrasound i ka ʻike ʻana i nā nui, nā ʻano, nā ʻōpū a me nā cyst,
hāʻawi nā hōʻike hōʻike iā lākou i ka ʻike e pili ana i nā hana hoʻoikaika kino o ke kino,
e like me nā kumuwaiwai hou i ka ʻimi ʻana i nā hōʻailona kūkaʻi e hoʻohana ana i ka x-ray, ka imaging magnetic resonance image (MRI) a me ka huina helu o ka pancreas, nā hui kūwaʻe,
kikokiko biopsy.

ʻO ka waiwai o nā hoʻokolohua biochemical o ke koko a me ka urine no nā enzymes

Hoʻomaka hoʻomaka nā ʻano loiloi pancreas ma nā hōʻike ʻoihana maʻalahi maʻalahi. ʻO ka hiʻona o kā lākou mau hopena ka hōʻike o ka hoʻonui ʻia o ka nui o nā enzyme i loko o ke koko a me ka waiʻai, i hāʻule i loko o kahi ʻano kūwaho ma muli o ka haunaele o ka huna ʻana i ka duodenum.

Hōʻike ʻia ke ala o ke pancreas e ka piʻi ʻana o ka hoʻoulu ʻana o nā enzymes:

Mālamaʻo Amylase i ke kahe koko ma kahi liʻiliʻi mai ke kīhaka pili salivary. I ka 78% o nā mea maʻi me ka pancreatitis, hoʻonui ʻia ka amylase e 2 a i ʻole nā manawa hou aku paha. Kūkulu ʻia nā hana biochemical no ka ʻike ʻana i ka amylase e pili ana i ka hopena hoʻonani starch. E hoʻohana i nā ʻano o Wolgemouth, Smith-Roy.

Hoʻoholo ʻia ka lipase e ke ʻano o ka stalogmometry. Hōʻike ia i ka hoʻololi o ke kūlohelohe i kūkulu ʻia e ka hana a kahi lipase mai ka momona momona i kahi hopena hōʻoluʻolu o tributyrin. Aia i ke koko nā ʻano o lipases. I ka hōʻike ʻana o ka pancreas, ʻoi aku ka mea nui o ka ethoxyl i mea nui loa, hoʻonui ʻia i ka 90% o nā maʻi.

He mea nui ia e loiloi i nā hopena ʻelua, inā ke hoʻokiʻekiʻe ʻia ka amylase, a hiki i ka lipase ke pae maʻamau, pono ʻoe e noʻonoʻo e pili ana i kahi ʻano like ʻole. Lawe ʻia kahi hōʻike koko ma kahi ʻōpū ʻole. Pono e hōʻiliʻili ʻia ka wai i loko o nā kīʻaha maʻemaʻe. ʻAʻole koi kekahi hoʻokolohua kūikawā. Inā pono, hana ʻia kahi loiloi e nānā i ka pancreas e like me nā ʻōmaʻomaʻo i ka manawa kūpono o kēlā me kēia lā.

Ka hana kūpono i ka nānā ʻana i ka hana endocrine o ka līlani ma ke kākoʻo ʻana i ka pae kiʻekiʻe o ka glucose koko me ka insulin a me ka glucagon i nā maʻi āpau, ʻoiai ua hōʻike ka ʻike i ka maʻi i ka 75% o nā mea maʻi me ka pancreatitis a me nā maʻi ʻoi.

Naʻi maʻi mellitus

He mea nui wale ka maʻi hoʻōkena, ʻaʻole wale nō i nā maʻi kaulike. No ka laʻana, ma hope o ka hoʻolaha ʻana i nā pancreas, ulu pinepine ka maʻi diabetes. No laila, ʻo ka pae o ka glucose he hōʻailona koʻikoʻi e hōʻike ana i ka hana o ke kino. ʻO ka maʻamau, nā hōʻiliʻili o ke koko he 3.5 -5.5 mmol / L. I ka lāʻau lapaʻau hou, ua hoʻāla ʻia ka paila gula i 6.2. E pono ke hoʻomaʻamaʻa ʻia ma ka ʻōpū ʻole. He ʻano nui ka hōʻailona o ka glucose, e pane ana i ke kaumaha a hiki i kahi i lawe ʻia ai ke koko (ka lima a me ka vein).

I ka ʻike inā lawa ka nui o ka insulin, ʻaʻole lawa ka hoʻāʻo ʻana i hoʻokahi glucose. Pono e hoʻoholo i ka hoʻohaʻahaʻa glucose, glycated hemoglobin, kaʻina glucose. I kekahi mau hihia, lawe ʻia kahi hana hoʻonaninani no nā antibodies i nā ʻaluna secretory e hana nei i kēia hormone.

ʻO ka pancreatitis

ʻO ka holomua maikaʻi a me ka maʻi wikiwiki ka pilina o hoʻokahi kaula. ʻO ka mea hoʻokahi wale nō ʻaʻole hiki ke maʻalahi. No laila, e kamaʻilio mākou e pili ana i nā abnormalities e hōʻike ana i ka pancreatitis aʻokiʻoki.

Kūʻai alpha-amylase i loko o ke ōpū i hoʻokahi ʻumi. Hoʻokomo kēia enzyme i nā lobules o ka pala a i ka wā i luku ʻia ai lākou, e komo ia i ke koko. Hiki ke hoʻoholo i loko o nā hola 3-5 ma hope o ka hoʻouka ʻana. Me nā pīpī lahilahi o ke kino, hoʻopau koke ia. No laila, he kūpono nā loiloi no ka alpha-amylase no 2-3 mau lā ma hope o ka hoʻomaka ʻana o ka ʻeha.

ʻO Lipase ka hōʻailona koʻikoʻi o ka mumū i kekahi ʻili. Hoʻohana maʻamau ka pancreas i kēia enzyme e wāwahi ai i nā molekala momona i mau mea maʻalahi. Hoʻonui ʻia ka lipase piʻi e 3 mau lā a mau i nā 2 wiki. He kūpono ia i ke kala ʻana o ka nalo ʻana.

Me ka pancreatitis e hōʻemi ʻia e ka stagnation o ka hua bile, hiki i nā hōʻailona aʻe ke hoʻonui;

ALT, ʻo ka AST ka maʻi ʻana o ka hana o ka ate, hoʻonui me ka hana ʻana i ka aʻalā o ke akeʻa,
ʻO GGTP - e hōʻike i ka luku ʻana i ka nui o ka iwi me ka stagnation o ka bile,
alkatine ka phosphatase ka mea nui o ka pōkole i ka pā biliary.

ʻO Elastase ka hōʻike kūpono loa a maikaʻi hoʻi no ka papa hana lāʻau. Hoʻonui kēia enzyme i ka 100% o nā hihia a kūikawā wale nō i kēia ʻāpana. Hoʻoholo ʻia ʻo Elastase i nā hale lapaʻau nui a me nā keʻena olakino pilikino.

ʻO ka hōʻike biochemical i aneane ʻaʻole uninformative ma ke kanesa pancreatic. I nā kūlana holomua, hiki i kekahi mau hōʻailona (stagnation o ka bile, hōʻino i ka hoʻopili kino). Akā, ʻaʻohe mea e hoʻokaʻawale i nā papa mua. Kūkulu ʻia nā kūlana o ka oncological i ke ʻano o ka wehewehe ʻana i nā hōʻailona lāʻau oncological. Me ka maʻi o ka pancreatic, ke nānā nei lākou iā CA-19.9, CA-125, CEA i loko o ke koko. E like me ko lākou pae, hiki ke hoʻoholo i ke ʻano o ka mālama ʻana e nā kauka (e hana ana i ka chemotherapy) paha, e hoʻoholo i ka nui o ka oncology (ʻo ka heleʻana o metastases).

Ka kiko kikoʻī i ka kiko kikoʻī he mea hoʻohālikelike CA-19.9. I ka maʻi maʻi pancreatic, hoʻonui kona kiʻekiʻe i 70-100% o nā hihia. ʻO nā kiʻekiʻe kiʻekiʻe o ka māka (ʻoi aku ma mua o 10,000 U / ml) e hōʻike ana i ka loaʻa o nā metastases mamao. Hoʻonui pū kekahi pae o kēia mau mea me ka maʻi pāpaʻi gall, ke kanesa o ka ate mua, ka carcinoma o ka ʻōpū a me nā ʻōpū nui. Mahele hōʻemi a me ka maʻi kukuna e hōʻemi nui i ka pae o kēia hōʻailona.

ʻO ka mākaʻi CA-125 i kikoʻī kekahi no ka maʻi maʻi ovarian. ʻO ka emi ʻana o kona pae e hōʻike i kahi holomua i lawe ai i ka mālama. Hoʻohana ʻia nō hoʻi ia no ka nalo ʻana o ka maʻi maʻi. Akā me ka pathology oncological o pancreas i loko o ke koko i 20-50% o nā hihia, ʻike ʻia kona piʻi mau ʻana. ʻAʻole kiko ka māka no ka kiko o ka pancreatic, no laila ʻoi aku ka maikaʻi o ka hoʻoholo ʻana me ia me nā antigens ʻē aʻe.

ʻAʻole maikaʻi mau ka mālama maʻi Oncology. No ka ʻike ʻana i ka hoʻomaha mua o ka ʻōpū, ua hoʻohana ʻia ʻo CEA (cancer antry embryonic antigen). Aia ia i ke koko 3-8 mau mahina ma mua o nā hōʻike mua o nā maʻi. ʻAʻole hōʻailona ʻo CEA, kahi hoʻonui me nā carcinomas o ka pancreatic tissue a me nā mea nui he nui.

ʻAʻole e hoʻohuli nā loiloi Laboratory i kahi loea maikaʻi. ʻO ka hāʻawi ʻana i nā hoʻokolohua e hana wale ʻia e nā kauka. ʻO kēia wale nō ka hoʻoponopono ʻana a me ka mālama ʻana.