Kunzwisisa Nzira yePancreas Kuisa
Chirongwa chekuisa chikafu chinhu chakaoma kwazvo chinotungamirira pakuvhiya iyo ndiyo kurapa kwekupedzisira kushandiswa kwechikwata chisina kukwana. Muchiitiko ichi, kudyara kwaizova kurapwa kana kuti kurapa kwekukundikana kwepancretic kana pancreatic chirwere.
Kune vanhu vakawanda, kuiswa hakuzombovi chinhu chakakosha, uye vanogona kugadzirisa chirwere chavo nemishonga, kuvhiyiwa kana dzimwe mishonga.
Kune vanhu vashoma, kuwedzerwa kunova kudiwa nokuti chirwere chavo chakanyanya kukura zvokuti pasina chimiro chitsva havangararami kwenguva refu.
Zvakarehwa, kuiswa kunoitwa apo nhengo iyo murwere akaberekwa nayo yakarwara kana kuti inorwara zvokuti inoda sangano rinotsiviwa kubva kune anopa.
Mabasa ePancreas
Iyo makatekine anoita basa rinokosha mukukwanisa kwemuviri wemunhu kugadzira zvokudya zvakanaka uye kuchengetedza hutano hwakasimba hwehutachiona hweropa muropa. Ivhagresi inoita basa iri nemishonga miviri miviri mumuviri: kuita mahomoni uye kugadzira enzymes inoshandiswa mukudya kwezvokudya.
Mazana makumi mapfumbamwe nemashanu kubva muzana epakreta inoshanda kuti ibudise utachiona hwemakemikari hunoshandiswa mukuparara kwezvokudya mumatumbo. Ipakreas inobudisa maviri enzymes: amylase, lipase, uye protease. Amylase inoputsa mahydrohydrates, lipase inoputsa mafuta, uye protease inoputsa mapuroteni anowanikwa mukudya.
Kana chikamu chepancreas chiri kushanda zvakanaka, chirwere chinonzi exocrine pancreatic insufficiency, aya enzymes anogona kunatsiviwa nemishonga inorayirirwa inotorwa nemuromo. Iko rudzi rwepancreas nyaya haruna kutungamirira pane kupiswa kwepancreas, sezvo chirwere ichi chinogona kurapwa nemishonga.
Basa rinonyanya kuzivikanwa repancre is production hormone. Hemmone yekutanga inokonzerwa ne pancreas glucagon, hormone inowedzera ropa glucose (shuga) muropa. Inosunungurwa apo mazinga eropa ane glucose ari pasi uye anoda kuwedzerwa. Yechipiri yehomoni inobudiswa nepancreas ndiyo insulin . Insulin inosunungurwa apo mazinga eglucose muropa ari akakwirira uye anoda kuderedzwa. Iro hormone yechitatu ndiyo somatostatin, iyo inoshanda kuchengetedza basa re insulini uye glucagon pamakwi akakodzera.
Iyo panikreas inoshanda nesimba kuti irege kuva nepamusoro-soro kana kupfuura zvakanyanya pasi glucose mazinga uye zviratidzo uye utano hunoita kuti hugume. Kuderedza glucose mazinga haisiwo chinetso kuvanhu vazhinji, asi kushaya insulini inowanzosangana nemamiriyoni eAmerica asi anozivikanwa nezita rakasiyana: chirwere cheshuga .
Apo mutumbi unoramba usingaiti ne insulin uye / kana kuti unokundikana kuita insulin yakakwana, chirwere chinonzi chirwere chechipiri cheshuga. Apo pancreas haina kuita insulin, tinoreva izvi sechirwere chechirwere cheshuga. Kazhinji, ndiyo chirwere che diabhesi chinoda kupemha pancreas, sezvo mamwe marudzi evanhu vane chirwere cheshuga vanogona kurapwa nemishonga nguva zhinji.
Izvo zvinogona zvakare kuti chirwere chechipiri diabetics chirege kuisa chero insulini panguva, iyo inogonawo kutungamirira pakugadzirisa.
Kushandiswa kwepancreas kunoitwa apo pancreas haichagoni kushanda zvakanaka zvakakwana kudzora mazinga emushuga muropa, hupenyu hwehupenyu huri husingagamuchiri hurombo, zvinetso zvechirwere cheshuga zvakanyanya kana kuti zvinowedzera, uye kubatsirwa kwekuvhiyiwa kunopfuura dambudziko re kuisa.
Painodiwa
Kuva chimiro ini chirwere cheshuga chega hazviiti kuti kupisa kwepancrea kudikanwe, sezvo vanhu vakawanda vanogona kurarama huzere uye vapfumi hupenyu nehutano hwakanyatsogadziriswa. Izvo zvakaoma-ku-kudzora chirwere cheshuga, chinowanzonzi " brittle " asingagoni kudzora mazinga eglucose uye zviratidzo, izvo zvinotungamirira pakugadzirwa.
Izvi zvinoreva kuti kana kusuruvara kwechirwere cheshuga kwasvika pakatarisa apo murwere anorwara zvikuru uye mishonga haigone kupa zvirwere zvakanaka zvekutarisa, kuwedzerwa kunogona kuva yekupedzisira kurapwa.
Maererano neAmerican Diabetes Association (ADA), zvikwaniro zvekuputika kwepancreas muvanhu vasina zvirwere zvakakosha zvepfungwa zvinotevera:
- Kakawanda, zvakanyanya uye zvakakomba zvinokonzerwa nemagetsi zvakadai seglucose yakanyanya, yakanyanya glucose kana ketoacidosis.
- Kusagadzirisa matambudziko emakiriniki / maitiro ne insulin therapy
- Kutadza kwe insulin kudzivirira zvinetso zvakanyanya
Ngozi
Njodzi dzinosangana nepakcreas transplant dzinokosha kune dzimwe nzira dzakawanda dzekuvhiya, sezvo murwere anowanzova anorwara asati avhiyiwa uye nzira yacho yakaoma. Zvengozi izvi zvinowedzera kune ngozi dzinowanikwa nevarwere pavanenge vachivhiyiwa, uye njodzi dzinobatanidza neaneshesia.
Ngozi Dzose dzePancreas Kufema Kupora
- Kurwara
- Kutambura glucose control
- Bleeding
- Ropa rinovhara
- Kuramba nhengo itsva
- Kukundikana kwebumbiro
- Nausea
- Kudzora
- Diarrhea
- Mhinduro kune anesthesia
- Kuoma kusvimha misodzi kubva kumhepo
Kuwana Chiremba
Kuona chirwere chekuvhiya chikafu chinowanzobatanidza kutumirwa kubva kuchiremba wako kuenda kune imwe nzvimbo inoshandiswa iyo inoita pancreas transplant pedyo neimba yako. Muzviitiko zvakawanda, pane imwe chete inogona kunge iri pedyo, asi mumaguta makuru, iwe unogona kuva nemaitiro akawanda. Kutumira kwacho kunowanzoitwa nehupenyu hwako, chiremba anoongorora mukurapa kwemasvondo ehomoni, kana gastroenterologist uyo anobata nyaya nekudya. Kuendesa mberi kunogonawo kugadzirwa nekutarisirwa kwepamusoro uye zvimwe zviitiko zvakabatanidzwa mukurapa kwako.
Kuwana paTransplant List
Mushure mokunge musangana nevashandi pane imwe nzvimbo yekugadzira, iwe uchaongororwa kuti unogona kuendeswa. Izvi zvinoreva kubvunzurudzwa kwezvinyorwa zvezvechiremba, kuongororwa kweropa, zvingangodaro zvidzidzo zvekufungidzira, uye zvimwe zviedzo zvakagadzirirwa kuziva kana iwe wakakwanisa zvakakwana kubvumira chirwere chekugadzira asi asi kurwara zvakakwana kuti uwane chimiro chitsva.
Kana kuongororwa kunoratidza kudikanwa kwekugadziriswa, pamwe chete nekukwanisa kuponesa kuvhiyiwa, nekugadzirisa nehuwandu hunobudirira, uye kana zvidzidzo zvinowanikwa zvakadai sokukwanisa kupa chirwere uye kukwanisa kugadzirisa mishonga inodiwa pashure kuvhiyiwa, murwere anogona kuiswa pakutsvaga mutsara kuti akamirire nhengo kuti iwanikwe.
Nhamba ye pancreata (yakawanda yemapakasi) inowanika pakugadzira ndeye, zvinosuruvarisa, zviduku. Pane pepancreas chete inowanikwa kune mupi wega. Vanhu vane chirwere cheshuga havakwanisi kuva mupancreas. Uyezve, pancreas yakaoma uye kazhinji inopindura zvisina kunaka kurwara kunotambudza kune mupiro, saka vanhu vakawanda vasina chirwere cheshuga havagoni kupa zvikamu zvavo zvepascreas. Izvi zvinokonzera kushayikwa kwenhengo dzekushandura kune avo vakamirira.
Marudzi eTransplant
Kune mhando mbiri dzepascreas transplants dziri kuitwa iye zvino. Rudzi rwakakurumbira ndeye apo pancreas yose yakabviswa kubva kune mupi uye ichiiswa mumugashiri. Apo vanhu vanoti "pancreas transplant" iyi ndiyo nzira yavari kunyanya kutaura. Imwe rudzi rwekuisa kune iyo pancreatic islet transplant, apo mamwe masero anoumba pancreas anotumirwa kune mupiki.
Chirongwa chepancreatic Transplant
Munguva ye pancreatic islet cell transplant, pancreas inobviswa kubva kune anopa uye masero masero anotumirwa kune mupiki. Mushure mokunge nhengo yacho iporeswa, pancreas inotorwa kubhuku rekutsvakurudza iyo iyo islet masero, inobudisa insulini nemamwe mahomoni, akaparadzaniswa kubva kune mamwe masero epancreas. Izvi zvese masero anongogadzira 5 kubva muzana yehuwandu hwehuwandu hwepascreas, saka chiyero chemasero esero chibviswa chinonyanya kudukusa pane pancreas yose. Icho chiyi chiwi masero anotapurirwa kuva mupiki. Zvinofadza kuti masero aya anotumirwa muchiropa nekuiswa muropa remukati. Masero anoramba ari muchiropa uye anotanga kubudisa insulin munzvimbo iyoyo.
MuUnited States, nzira iyi inowanikwa pazvikuru zvezvipatara zveyunivhesiti dzinoita tsvakurudzo mune pancreatic islet cell transplantation. Iyi nzira yekugadzirisa ichiri kutaridzirwa kuongororwa uye inoitwa chete sechikamu chezvidzidzo zvakawanda zvekutsvakurudza pane zvivako zvakasiyana panguva ino.
Izvo zvigadziriswa zvekutswa kwechiwi dzimwe nguva zvakasiyana nedzimwe nhengo dzinoputika, sezvo kune tsvakurudzo inowanikwa pane basa rekutsvaga kwekugadzirisa sechirwere chekugara kwenguva refu . Izvo zvinoratidzira murwere zvinenge zvichange zviri zviviri uye kakawanda kazhinji katatu chikafu chekugadzirisa nzira kuti uwane zvakakwana kubatsirwa kwekutsvaga.
Multi-Organ Transplant
Kune vamwe vanhu, nyaya dzepascreas dzinogona kukonzera nyaya dzinokosha nedzimwe nhengo, kunyanya itsvo. Kune vamwe vane chirwere cheshuga vane maitiro akaoma-ku-kudzora glucose, itsvo dzinokuvadza zvakanyanya, dzinowanzoita kuti kushaya kwepvo uye kudiwa kwe dialysis.
Kuvanhu ava, kuiswa kwepascreas pachaga kunogona kunge kusina kukwana kuvadzosa kuva noutano hwakanaka, ivo vanodawo kubvongwa kwepvo kuitira kuti vasave vakasununguka zve dialysis. Zvakanaka, vanhu ava vachagamuchira mafungiro uye kuputika kwepascreas kubva kune mumwe chete mupiro panguva imwe chete, asi vamwe varwere vanogamuchira nhengo kubva kune vakasiyana-siyana panguva dzakasiyana.
Maitiro Ayo Akawedzerwa
Pancreas transplant inotanga nenzira yakasiyana-siyana-kuvhiyiwa kubvisa pancreas kubva kune mupi. Chimwe chikamu chekufambisa chinowanzowirirana kupfuura chipo chepancreas segment. Nhengo dzose dzinouya kubva pakufa, vabatsiri-vakafa. Zvikamu zve pancreas zvinowanzobva kumunhu anopa shamwari kana hama inoda kubatsira mubatsiri.
Kana imwe nhengo yakapiwa kana chikamu ichibviswa, pane firiji shoma kuti igochera chigadziko mumugadziri, kazhinji maawa masere kana kuti pasi. Iyo panikresi yakaoma kwazvo, inopindura zvisingabatanidzwi kugunzwa, saka vanachiremba vanoshanda kusangobata chete zvipfeko zvakatarisana panguva yekuvhiyiwa. Kamwe kamwe pancreas inogadziriswa inobatsira kumubatsiri, kana zvichida zvisati zvaitika, avo vanogona kugamuchira vanoziviswa kuti nhengo yave iripo yekugadziriswa. Vanobva vabvunzwa kuti vaudze kune yavo yekuisa miti.
Kana imwe nguva yadzorerwa (izwi rokuti "kukohwa" harisashandiswi zvakare) pancreas inotakuriswa kubva kuchipatara uko inowanikwa kunzvimbo yekuchera iyo apo pancreas ichaiswa mumugamuchiri.
Kuvhiyiwa kuisa chigadziko mumugadziri kunotanga nemurwere ari kuiswa mukati uye kuiswa pavharidzi pamwe chete nehutungamiri hwevanhu vakawanda anesthesia . Kamwe kana murwere akarara, nzira inogona kutanga.
Ganda racho rakagadzirirwa kuderedza dambudziko rehutachiona, uye kuvharwa kunoitwa mudumbu. Iyo panikresi inowanikwa kune duodenum, chikamu chekutanga chemukati mudumbu kuitira kuti majekiseni emuviri anogona kubudiswa pane zvokudya sezvo inobva mudumbu. Kushandisa mishonga yeropa yakawanikwa kubva kune anopa, pancreas inobatanidza neropa rezvido zvaro uye kusunungura mahomoni muropa.
Kazhinji, pancreas inoshandiswa inoswedera pedyo nebhokisi rekumimba kupfuura zvimbamba zvepakutanga, izvo zvinowanikwa zvakadzika mudumbu. Iyi kuiswa mberi kwemuviri kunobvumira kuti biopsy iende nyore nyore mune ramangwana, kana zvichifanira.
Mishonga yemurwere pachake, iyo inonzi "chizvarwa chepancreas", inoramba iri munzvimbo kunze kwekunge pane chikonzero chaicho chekubvisa. Kana kamwe panikete yakabatanidzwa mumukati nemidzi yeropa, iyo incision inogona kuvharwa uye murwere anotorwa kunhengo huru yekuchengetedza (ICU) kunonyatsoongororwa panguva yekudzoka kwavo.
Kudzorera
Izvo zvinoratidzira murwere zvichapedza mazuva mashomanana muCUU mushure mekugadzirisa nzira. Vazhinji vachapedza mazuva manomwe muchipatara vasati vadzokera kumba kuti varambe vachidzoka. Vakawanda varwere vanodzokera kumabasa avo ezvisikwa mukati memavhiki mana kusvika ku6 ekuvhiya.
Upenyu Pashure Kokudhinda
Chimwe chezvinhu zvakaoma muupenyu hwehupenyu uye hutano pashure pekugadziriswa ndiko kudzivirira kukaramba chikwata. Kakawanda kunoshanyira kunzvimbo yekutsvaga zvinowanzoitika mushure mekuvhiyiwa uye hazviwanzopfuura sezvo nguva inopfuura kunze kwekunge pane nyaya nhengo itsva. Kune vazhinji, kudzokera kuhupenyu huripo hunogoneka mushure mekuvhiyiwa, asi vamwe vangawana kuti ivo vanovandudzwa, asi vachiri kufara.
Kune vose vanotakura varwere, chirongwa chemishonga chekudzivisa kurambwa chichava chokwadi chehupenyu. Kunyange kana nhengo isingashandisi zvakanaka, kupesana nekurambwa mishonga kuchadiwa, uye kuti mishonga inogona kutungamirira kune dzimwe nguva zvirwere zvakadai sezvirwere zvinowanzozara uye chirwere ichi sezvo inoderedza zvirwere zvemuviri.
Dambudziko Renguva refu
Zvimwe zvinokonzerwa mumwedzi nemakore zvichienderana nekutengesa kwepascreas zvinoita kunge zvishomanana muchiverengero, asi zvinogona kuva zvakakomba. Kuchengetedza utano hwakakwana nekudya zvakanaka, kutevera murayiridzi wechiremba, uye kugara uchidzidzira kunokosha. Kuchengeta hutano hwako hwepfungwa mushure mokunge kuwedzerwa kunokosha zvakare, uye kazhinji kunokanganwa mukuedza kuve wakanaka.
Uyezve kukosha ndekuve wakangwarira kutarisa zviratidzo zvinotevera:
- Organ rejection
- Chiito chekurambwa kwemishonga
- Kutambura glucose control
- Kuderedza chimiro chinoshanda panguva
- Zvinetso zvinozivikanwa zvekurambwa kwemishonga
Mishonga Inorambidza Kurasikirwa
Mishonga-mamwe acho akafanana neaya anonyanya kutaurwa steroid-anoshandiswa kuita kuti muviri ugamuchire chigamba chitsva, asi mishonga iyi inouya ine zvinetso pamwe chete nemaropafadzo makuru.
Zvinowanzobatwa nemigumisiro yemishonga inorambidza kurambwa inosanganisira:
- Nausea
- Diarrhea
- Kudzora
- Dzorera chiso
- Kudurura gums
- Acne
- Kuora bvudzi
- Kuvhiringidzika kwezuva
- Ropa kudzvinyirirwa kukwirira
- Cholesterol mazinga akakwirira
- Kurasikirwa kweropa (osteoporosis kana osteopenia)
Organ Reject
Kurambwa kwechirwere chinhu chakakosha mushure mekugadziriswa kwemarudzi ose, uye vamwe varwere vachaona chiitiko chekurambwa mumwedzi yekutanga mushure mekugadzirwa. Chinokosha chekupona chikamu chekurambwa nehutano hwakagadziriswa ndechekuona dambudziko rekutanga uye kuwana mushonga pakarepo.
Zviratidzo zvakajairika zvepakanasi kurambwa zvinosanganisira:
- Fever
- Pain in or over over the new organ
- Kusagadzikana kweropa glucose
- Nausea
- Kudzora
- Marwadzo emudumbu
- Mvura yakasviba
- Yakaderedza urine zvakabuda
Migumisiro Yenguva refu
Kakawanda, zvakaguma izvo varwere vanoona mushure mekuputika kwepancreas zvakanaka. Kupona mazinga anenge anenge 95 kusvika muna98 muzana mugore rimwe chete, 91 kusvika ku 92 muzana makore matatu mushure mekutengesa, uye 78 kusvika ku8 muzana mumakore mashanu. Vazhinji verufu vaikonzerwa nehutano hwepfungwa, panzvimbo yezvinetso kubva pakuvhiyiwa, uye zvakaitika kudarika mwedzi mitatu mushure mokunge vasunungurwa kubva kunzvimbo yekutsvaga.
Uyewo kukosha ndeyekuti zvakakanyiridzwa sei pancreata mushure mekuvhiyiwa. Pagore rimwe mushure mekuvhiyiwa, 78-88 muzana yevarwere vaiva nepascreas inoshanda uye 27 muzana vaiva nepascreas inoshanda makore gumi mushure mekuvhiyiwa. Kushanda kunoreva kuti hapana chidimbu che insulini, maitiro ezvisikwa zveglucose kana akaedzwa mushure mekutsanya, uye zvinowanzoitika kana zvishoma zvakakonzerwa ne hemoglobin a1c. Izvi zvinoreva kuti varwere vane pancreas "vasina kushanda" vangave vachiri kusada insulin asi vane hemoglobin yakakwirira a1c, kana kuti inogona kuva yakakwana ye insulini inotarisirwa.
Shoko Rinobva
Kushandiswa kwepancreas, pasinei nhengo yose kana masero masero, inzira yakakomba zvikuru nehupenyu hurefu hwehutano hwehutano nekubudirira. Kune vazhinji, kuiswa kune imwe nzira inogadzirisa dambudziko rakakomba zvikuru uye rinotungamirira pakuvandudza kukuru kwehupenyu hwehupenyu. Zvishoma nezvishoma, nzira yacho inotungamirira kumatambudziko, hutano husina kunaka, uye kune vamwe, hapana kuvandudzwa kwekutarisa glucose.
Zvakakosha kufungidzira kuitika kwepancreatic yemazuva ano kunopesana nemakomborero anokwanisa uye matambudziko anouya nekugadzirisa nzira, uye ramba uchichenjerera mushure mokudzidza zvakanyanyisa pamusoro pekuita.
> Kwakabva:
> Pancreatic uye chizivi chokutsvaga mune chirwere cheshuga mellitus. Kusvika pari zvino. https://www.uptodate.com/contents/pancreas-and-islet-transplantation-in-diabetes-mellitus