pancreas yog ib lub qog tseem ceeb tshaj plaws hauv peb lub cev. Nws belongs rau cov pab pawg neeg ntawm cov qog ntawm kev sib xyaw secretion. Qhov no txhais tau hais tias nws ib txhij tsim cov tshuaj hormones uas tso rau hauv cov ntshav (sab hauv secretion) thiab synthesizes enzymes uas tsim nyog rau digestion nyob rau hauv cov hnyuv (sab nraud secretion). Yog li ntawd, nws yog ib qho tseem ceeb heev uas yuav tsum muaj lub tswv yim ntawm qhov teeb meem ntawm tus txiav tuaj yeem tshwm sim hauv ib tus neeg, lawv pom lawv tus kheej li cas, thiab yuav ua li cas nrog lawv.
Qhov tseem ceeb ntawm lub txiav txiav hauv lub cev
Yuav kom nkag siab tias yog vim li cas thiaj muaj qee yam cim qhia txog teeb meem nrog txiav txiav, koj yuav tsum paub seb qhov tseem ceeb ntawm lub cev hauv lub cev yog dab tsi thiab nws ua haujlwm li cas.
Raws li tau sau tseg saum toj no, pancreas yog ib qho khoom siv sib xyaw ua ke. Ua raws li cov qog endocrine, nws secretes peb lub ntsiab hormones:
- insulin - txo cov concentration ntawm cov piam thaj hauv cov ntshav, pab txhawb nws txoj kev siv los ntawm cov hlwb, nce protein synthesis thiab txo.rog rog;
- glucagon yog qhov sib txawv ntawm cov tshuaj insulin, nws ua rau cov piam thaj ntau ntxiv, ua rau kom cov proteins thiab rog ntau ntxiv, vim li ntawd glucagon tseem hu ua cov tshuaj hormone contrainsular;
- somatostatin - inhibits kev sib txuas ntawm cov tshuaj hormones pituitary (somatotropic thiab thyrotropic).
Kev tso tawm sab nraud ntawm lub txiav txiav yog yam ntxwv los ntawm kev tsim cov enzymes hauv qab no:
- amylase - tsim nyog rau kev nqus ntawm carbohydrates, zom cov polysaccharides rau monosaccharides (glucose thiab fructose);
- trypsin - zom cov proteins rau hauv cov amino acids;
- lipase - qhov tseem ceeb rau kev nqus rog.
Los ntawm cov haujlwm tseem ceeb saum toj no ntawm cov txiav txiav, nws ua raws li cov teeb meem nrog nws yuav ua rau mob plab thawj zaug. Thiab nrog rau lub sijhawm ntev ntawm tus kab mob, kuj tseem muaj kev ua txhaum ntawm cov protein thiab carbohydrate metabolism.
Kab mob tshwm sim
Qhov feem ntau ua rau muaj teeb meem pancreatic muaj npe hauv qab no:
- Pancreatitis - o ntawm cov qog nqaij hlav, tuaj yeem mob thiab mob ntev. Feem ntau tshwm sim hauv cov neeg laus, tsis tshua muaj hauv menyuam yaus.
- Neoplasms - benign thiab malignant qog.
- Mob ntshav qab zib mellitus yog kev puas tsuaj ntawm pancreatic cells koom nrog hauv kev tsim cov tshuaj insulin, lossis cov ntaub so ntswg tsis zoo rau insulin.
- Kev ua haujlwm tsis zoo ntawm lub qog - kev ua haujlwm tsis zoo ntawm lub cev thaum tsis muaj kev hloov pauv ntawm lub cev.
- Structural anomalies - feem ntauib qho ua rau muaj teeb meem pancreatic hauv menyuam yaus.
Cov cim qhia ntawm tus kab mob pancreatic
Txawm hais tias muaj ntau yam keeb kwm ntawm cov kab mob ntawm lub cev, muaj ntau cov cim tseem ceeb uas yog tus yam ntxwv ntawm ib qho teeb meem nrog rau tus txiav:
- Mob nyob rau sab laug hypochondrium, feem ntau girdle nyob rau hauv cov xwm thiab radiating rau sab nraum qab. Qhov mob hnyav nce nrog kev ua txhaum ntawm kev noj zaub mov, palpation ntawm lub plab. Nyob ntawm cov pathology, lawv tuaj yeem sib txawv, tsis tu ncua lossis cramping. Mob yog cov tsos mob tseem ceeb ntawm cov teeb meem pancreatic rau cov neeg laus, uas ua rau tus neeg mob nrhiav kev pab kho mob.
- Dyspeptic manifestations. Cov tsos mob no tshwm sim nrog qhov tsis txaus ntawm qhov tso tawm sab nraud ntawm lub txiav, tshwm sim los ntawm cem quav thiab raws plab, xeev siab thiab ntuav.
- Txo qab los noj mov, thiab ua rau poob phaus thiab qaug zog ntawm lub cev.
Cov tsos mob tseem ceeb dua, yog li lawv yuav raug txiav txim siab nyob rau hauv cov ntsiab lus ntawm tus kheej cov kab mob ntawm lub cev.
Nws tseem tsim nyog sau cia tias cov tsos mob ntawm cov kab mob yuav txawv nyob ntawm qhov hnyav ntawm cov kab mob, nws ua rau, tab sis lawv tsis nyob ntawm poj niam txiv neej. Cov tsos mob ntawm tus kab mob pancreatic yog tib yam rau cov poj niam thiab txiv neej.
Pancreatitis: cov ntsiab lus dav dav
Kab mob pancreas lossis pancreatitis yog ib qho teeb meem ntawm kev zom zaub mov hauv cov neeg laus. Qhov no pathology tuaj yeem mob hnyav lossis mob ntev. Mob pancreatitis nyob rau hauvcov neeg laus tshwm sim vim kev haus dej cawv, kev noj haus tsis zoo. Txawm li cas los xij, qhov teeb meem no tuaj yeem tshwm sim hauv cov menyuam yaus. Feem ntau nyob rau hauv thaum yau, tus txiav ua rau mob vim yog kab mob kab mob (mumps), congenital pathologies (cystic fibrosis), kev puas tsuaj rau caj pas los ntawm tej yam tshuaj.
mob pancreatitis feem ntau yog tshwm sim los ntawm kev kho mob tsis zoo. Nws tshwm sim thaum tus neeg mob tsis nrhiav kev kho mob raws sijhawm, tus neeg mob tsis ua raws li kev noj haus thiab noj tshuaj tsis zoo.
Cov txheej txheem ua mob hauv lub caj pas tshwm sim vim qhov txhaws ntawm cov ducts, uas ua rau muaj kev nce siab hauv lawv cov channel. Tom qab ib lub sijhawm, cov ducts raug puas, thiab lawv cov ntsiab lus, ua ke nrog cov enzymes, nkag mus rau hauv cov hlab ntsha, ua rau cov hlwb ntawm lub txiav. Muaj kev tuag ntawm ib feem ntawm lub caj pas (pancreatic necrosis). Hauv cov ntshav, cov enzymes sib sau ua ke ntau dhau (fermentemia), uas muaj cov tshuaj lom hauv lub cev.
Cov tsos mob ntawm tus mob pancreatitis
Dab tsi yog cov tsos mob tshwm sim ntawm cov teeb meem pancreatic hauv cov neeg laus? Tag nrho cov kev kho mob saum toj no yog qhov tseeb: mob hauv hypochondrium, dyspeptic tshwm sim, tsis qab los noj mov thiab poob phaus.
Nws tsim nyog sau cia tias nyob rau hauv mob pancreatitis, qhov mob tau hais tawm heev. Nws tshwm sim nrog kev noj zaub mov tsis txaus (haus dej cawv, ntau cov khoom noj rog thiab kib). Qhov mob npog tag nrho lub plab mog, tawg mus rau sab nraub qaum. Yooj yim rau zaumqis ob txhais ceg. Kev hnov mob nrog rau tus neeg mob qhov mob hnyav: txo qis hauv ntshav siab, nce plawv dhia, tawm hws thiab qaug zog.
Nyob rau hauv mob pancreatitis, qhov mob tsis mob heev, nws kis tau tus cwj pwm rub lossis nias. Ntawm no, qhov tshwm sim ntawm dyspepsia tuaj ua ntej: raws plab hloov nrog cem quav, xeev siab thiab ntuav. Tus cwj pwm los ntawm cov tsos ntawm cov quav rog, uas nyuaj rau ntxuav tawm. Cov tsos mob no tshwm sim vim kev zom zaub mov tsis zoo ntawm cov protein, rog thiab carbohydrates. Cov as-ham nyoos raug tshem tawm hauv cov quav.
Tsis tas li, nyob rau hauv cov kab mob ntev, kev hloov pauv ntawm lub sijhawm exacerbation nrog kev zam txim yog yam ntxwv. Thaum lub sij hawm tshem tawm, tus neeg mob tus mob yog txaus siab, tsis muaj mob thiab dyspeptic tshwm sim.
Pancreatitis: Diagnosis
Cov tsos mob saum toj no yuav tsum ua rau tus neeg mob xav tias muaj teeb meem nrog pancreas, uas yuav tsum tau nrhiav kev pab kho mob thiab tej zaum yuav mus pw hauv tsev kho mob ntxiv.
Thaum kuaj pom tus mob pancreatitis, txoj kev siv yog qhov kev kuaj xyuas ntawm fecal elastase-1, ib qho enzyme uas tsim los ntawm tus txiav. Qhov txo qis ntawm cov tshuaj no hauv cov quav hauv qhov quav qhia tau hais tias sab nraud pancreatic insufficiency. Tsis tas li ntawd, cov txheej txheem raug ua kom pom lub cev no. Ultrasound diagnostics, xam tomography, magnetic resonance imaging yog siv.
YKev kho mob pancreatitis
Kev kho mob thiab cov tsos mob ntawm cov teeb meem pancreatic nyob hauvinextricable kev twb kev txuas. Tom qab tag nrho, txo qhov mob thiab txo cov tsos mob dyspeptic yog txoj haujlwm 1 hauv kev kho mob pancreatitis.
Ytxhawm rau txo qhov mob, antispasmodics ("Drotaverine", "Papaverine"), analgesics ("Analgin", "Baralgin") yog siv. Kev siv cov tshuaj narcotic analgesics rau pancreatitis ("Morphine") yog txwv tsis pub, vim lawv ua rau muaj kev sib kis ntawm cov kab mob pancreatic, uas ntxiv rau kev tiv thaiv kev tawm ntawm cov qog nqaij hlav mus rau hauv cov hnyuv.
Nws tseem yuav tsum tau them nyiaj rau cov enzymes uas nws cov synthesis cuam tshuam hauv cov txiav. Rau qhov no, enzyme hloov kho yog siv. Qhov no yog ib pawg ntawm cov tshuaj uas muaj pancreatic enzymes (lipase, amylase, trypsin). Cov no suav nrog Creon, Pancreatin.
Lwm qhov txuas hauv kev kho cov teeb meem pancreatic yog inhibition ntawm kev ua haujlwm ntawm cov enzymes uas nkag mus rau hauv cov hlab ntsha. Rau qhov no, cov tshuaj "Kontrykal" yog siv.
Kev saib xyuas tshwj xeeb yuav tsum tau them rau cov khoom noj khoom haus hauv cov kab mob pancreas, tab sis nws yuav tau tham hauv seem tsim nyog.
Kab mob hauv me nyuam
Cov teeb meem ntawm tus txiav txiav hauv cov menyuam yaus tuaj yeem yog qhov los yog kis tau.
Ntawm cov kab mob congenital, cov kab mob hauv qab no yog qhov txawv:
- ectopic qog;
- bifurcated pancreas;
- annular (annular) caj pas;
- congenital txo lipase kev ua haujlwm (Sheldon-Reye syndrome);
- congenital amylase deficiency;
- cais txo qis hauv trypsinogen kev ua haujlwm;
- generalized pancreatic insufficiency.
Ntawm cov teeb meem uas tshwm sim nrog pancreas yog:
- kab mob kis mob pancreatitis;
- cystic fibrosis;
- tshuaj pancreatitis;
- mob pancreatitis;
- pancreatitis hauv tus kab mob Henoch-Schonlein;
- pancreatitis vim kev noj zaub mov ntau dhau.
Kev kho mob tshwm sim thiab kho tus mob pancreatitis thaum yau tsis yog qhov txawv ntawm cov neeg laus. Qhov tseem ceeb hauv qhov no yog txhawm rau txiav txim siab qhov ua rau mob pancreas thiab nws tshem tawm.
Yog li no, hauv qab no peb yuav txheeb xyuas cov teeb meem ntawm tus txiav txiav uas tshwj xeeb rau menyuam yaus.
Cystic fibrosis: cov ntsiab lus dav dav
Cystic fibrosis yog ib hom kab mob uas tuaj yeem tshwm sim tau nws tus kheej tam sim ntawd tom qab yug menyuam thiab ob peb xyoos tom qab, nyob ntawm qhov mob hnyav. Nrog rau cov kab mob no, yuav luag txhua lub cev thiab lub cev ntawm lub cev raug cuam tshuam.
Nws tshwm sim vim kev ua txhaum ntawm kev sib pauv ntawm cov tshuaj chlorine ntawm cov hlwb thiab qhov chaw nyob ib puag ncig lawv, uas ua rau muaj kev nce ntxiv hauv cov viscosity ntawm cov zais zais zais los ntawm lub caj pas. Qhov no zais cia accumulates thiab txhaws cov ducts ntawm lub txiav, ua rau o. Qhov no ua rau exocrine insufficiency hnyav.
YCystic fibrosis: kuaj mob thiab kho
Kev kuaj mobmuaj nyob rau hauv kev txiav txim siab ntawm hws chlorides (lawv nce yog yam ntxwv), ultrasound ntawm lub txiav txiav. Kev tshuaj ntsuam caj ces yog tam sim no nce.
Cov tsos mob ntawm cov teeb meem pancreatic thiab kev kho mob yog cuam tshuam ncaj qha rau tus kab mob no. Kev kho mob hloov enzyme thiab kev noj zaub mov zoo, xws li hauv cov neeg laus mob pancreatitis, ua lub luag haujlwm loj.
Kev cais tawm enzyme deficiency
Cov teeb meem ntawm cov txiav txiav hauv cov menyuam yaus tuaj yeem tshwm sim los ntawm qhov tsis txaus nyob hauv ib qho ntawm peb enzymes: lipase, trypsin, lossis amylase.
Lipase deficiency yog tus cwj pwm los ntawm raws plab thiab cov quav rog. Thaum kuaj pom siv coprogram, qhov loj ntawm cov roj undigested hauv cov quav (steatorrhea) raug txiav txim. Tus nqi ntawm fecal elastase-1 kuj txo qis.
Tej zaum muaj kev sib cais ntawm amylase ntau lawm, tus cwj pwm los ntawm raws plab nrog undigested starch (amilorrhea). Trypsin deficiency kuj ua tau, nyob rau hauv uas raws plab nrog protein inclusions (creatorrhoea) tshwm sim. Protein malabsorption ua rau txo qis hauv nws cov nyiaj hauv lub cev (hypoproteinemia), uas ua rau muaj kev loj hlob ntawm edema loj.
Qhov kab mob no, hmoov zoo, tsis tshua muaj, tab sis nws tsim nyog paub thiab nco ntsoov txog nws thaum kuaj pom cov kab mob pancreas hauv cov menyuam yaus.
Kev Noj Qab Haus Huv
Kev saib xyuas tshwj xeeb yuav tsum tau them rau kev noj zaub mov hauv kev kho mob pancreatic. Hauv kev kho mob ntawm cov kab mob noCov neeg mob tau pom zoo kom noj cov tais diav hauv qab no:
- khob cij dawb;
- taws zaub nrog zaub broth;
- nqaij ntshiv: luav, nqaij qaib, qaib ntxhw, lean txiav ntawm nqaij nyug, steamed, boiled los yog ci;
- zaub hauv txhua daim ntawv, tsuas yog kib;
- khoom noj;
- zaub roj - zaub roj, ib qho me me ntawm butter tau tso cai;
- tsis ntau tshaj ib qe ib hnub;
- ntawm cov khoom qab zib, tsuas yog txiv hmab txiv ntoo, compote, zib ntab;
- ntawm cov dej haus, nyiam yuav tsum tau muab rau tshuaj yej, rosehip broth.
Thaum kho cov khoom noj khoom haus rau cov teeb meem nrog pancreas, kev siv cov khoom no raug txwv:
- nqaij thiab ntses;
- fried foods;
- smoked lauj kaub;
- -haus cov nqaij thiab cov txuj lom;
- pastry, khoom qab zib, chocolate;
- cawv.
Ua raws li kev noj zaub mov no nrog rau kev kho tshuaj yuav pab tshem tawm cov teeb meem nrog txiav txiav!
