ʻO ka maʻi paleka exocrine pancreatic: he aha ia?

I kēlā me kēia lā, loaʻa i ke kino nā hapa o nā meaʻai e pono ke ʻeli ʻia a lawe ʻia mai kā lākou mau mea kanu.

He maʻi maʻi kū hoʻokahi o ka Exocrine pancreatic kahi maʻi i alakaʻi i ka hoʻopōʻino i ka hana o nā enzyme e kuleana ana i ka lawe ʻana o ka meaʻai i loko o ka ʻōpū.

ʻO ka hopena, nele nā ​​kino o ke kanaka i nā huaora a me nā mea ʻano ʻē aʻe hou. I kēiaʻatikala, hiki iā ʻoe ke kamaʻilio me ka pathophysiology o ka exocrine insufficiency (kumu, hana a me ka hopena), a me nā loiloi o ke ʻano maʻi, mālama a me nā mea pale.

He aha ka maʻi?

ʻO kekahi o nā kaʻina paʻakikī i ke kino, ʻo ka lawe ʻana o ka meaʻai. Hoʻomaka ia ma hope o ka huahana e komo i ka waha a palū ʻia a hoʻoilo ʻia me ka lawaiʻa. Komo ka meaʻai i loko o ka ʻōpū, nā huna huna pepsin a me ka waikiko hydrochloric.

Ma hope o ka hapalua hola, aia nā huaʻai i ka hapa mua o ka ʻōpū liʻiliʻi - ka duodenum 12. Aia ia no ke kuleana o nā enzyme kūikawā no ke kahe ʻana o ka meaʻai, ka uhaʻi ʻana i nā pono a me nā palaka, a me ka haʻawina o nā huaora. Hana ke ʻano o ke ʻano o ka digestive iā lākou - ʻo ka pancreas, ka wāwahi i ka mau mololi nui i loko o nā ʻāpana maʻalahi.

Hana kēia kino i nā hana koʻikoʻi i ke kino o ke kanaka. Hoʻopili pinepine ʻia lākou mahele penei:

1. Ka hana o ka exocrine (ka hana huna a waho) nā mea hoʻonaninani o nā mea ikaika biologically - lipase, amylase, a me protease - i loko o ka duodenum me ke kāʻei ʻana i ke kulu o nā kahaki.
2. Hoʻopili ka hana Endocrine (i loko o ka hana huna) me nā hana a nā ʻāpana pancreatic e hana ai i nā hormones e like me ka insulin, glucagon, pancreatic polypeptide, somatostatin a me nā ghrelin ("holi kaumaha").

I loko o kahi kanaka olakino, hoʻopuka ka pancreas i nā enzyme a me nā hormones, no laila hiki iā ia ke hāʻawi piha i ka hoʻowalewale ʻana o ka meaʻai a kākoʻo i nā hana metabol.

Inā ʻaʻole hiki i ke kino ke hana i ka nui o nā huina, e hoʻoulu ai ka maʻi pancreatic exocrine. Ma muli o ke kaʻina pathogen, hiki i ka hapa nui o ka huaora a me ka nele o nā meaʻai.

ʻO kahi hala ʻole a i ʻole ka launa ʻole e alakaʻi i ka ulu ʻana i ka wā kamaliʻi, nā maʻi o ka ʻōnaehana musculoskeletal a me ka emi nui o ka pale ʻana, e hoʻoweliweli ʻia ana i nā maʻi me nā ʻano like ʻole.

ʻO nā kumu o ka hoʻomohala ʻana i ka ʻaina enina

Wahi a nā helu helu, ua loaʻa aku ka 10% o ka heluna o nā United States i ka exocrine pancreatic insufficiency syndrome.

Hōʻike nā haʻawina kauka i kahi pilina pololei ma waena o ka inuʻana i ka waiʻona a me ka hoʻomohalaʻana o ka pathology. ʻO ka poʻe maʻi e hōʻeha nei i ka hilinaʻi ʻana i ka waiʻona e hāʻule i kahi hui kūikawā kūikawā, ʻoiai e hōʻike ka maʻi iā ia iho i ka 80% o nā hihia.

ʻO ka etiology o nā patology e pili ana i ka hopena o nā kumu he nui. ʻO ka hoʻonāukiuki ʻana i ka hana o nā enzymes e hele mai no ka kongenital a loaʻa i nā kumu.

Hoʻoulu ka hakakā pancreatic ma muli o ka ulu ʻana o nā maʻi congenital:

• ʻO ka cystic fibrosis - he ʻano genology o nā kino o nā ke ea a me nā ʻōnaehana o ka ʻōpū, ʻike ʻia e ka hana ʻana o kahi mea huna huna e hoʻopili ana i nā kumuwaiwai o nā pancreas, bronchi liʻiliʻi a me bronchioles;
• ʻO Scholman's syndrome - kahi kuʻi kino o ka iwi a me ka pancreas, e hana ana i ka lipase kūpono ʻole;
• lipomatosis - kahi hoʻonui i ke kaumaha o ke kino ma ke ʻano o ka hoʻemi nui ʻana o nā kiko adipose.

ʻO nā kumu i loaʻa ʻia ke wehe ʻana i ka pancreas a me ka make cell ma ka pancreatitis. ʻO ka pancreatitis kahi maʻi e hōʻike ʻia e ka hoʻololi ʻana o ka ʻili maʻamau i ke kino. I ka hopena, ua hoʻemi ʻia ka hana o nā enzyme, a ʻaʻole hiki i ka ʻōnaehana o ka hanu ke hoʻopiha piha i ka meaʻai.

He mea pono ke hoʻomaopopo i ka maʻi maʻi pancreatitis e hōʻike ana ma nā maʻi pākeke. I ke wā kamaliʻi, he hanana ʻokoʻa nui ka hoʻomohala ʻana o ia ʻano ʻano. Eia kekahi, piʻi ka pilikia o ka pancreatitis me ka maʻi diabetes.

Eia kekahi, nā mea e hoʻopili ai i ka hiki ʻana o nā hana hoʻokūkū exocrine e pili paha:

1. ʻO nā mea hoʻonā pancreatic.
2. ʻO ka maʻi ʻo Crohn kahi hana hoʻonāukiuki i kekahi o nā pauku o ka kūnaehana.
3. ʻO ke kīpati o Gluten - hele ʻole i ke kino o ka gluten (protein cereal gluten).
4. ʻ syndromelelo i ka pīhoihoi - ke piʻi ka nui o ke kahe o ke koko ma loko o ka ʻōpū ma muli o ke komo ʻana o ka ʻai ʻuʻuku ʻē aʻe mai ka ʻōpū.
5. ʻO ka maʻi Zollinger-Ellison kahi kūlana e hui pū ai i nā kaʻina pathological e like me ka hiki ʻana o nā tumors i ka duodenum a i nā pancreas, a me ka nui o ka hoʻouluʻana o ka hydrochloric acid ma loko o ka ʻōpū.

Eia kekahi, hiki i ka loaʻaʻana o ka hemahema ka hopena i ka hoʻopili ʻana i ka hana hōʻemi loa i ka huihui.

ʻO nā hōʻailona o ka haʻahaʻa o ka pancreatic exocrine

Ua hōʻike ʻia nā haʻawina hoʻokolohua a me ka liʻiliʻi o ka huna ʻana o ka pancreatic, e ʻeli mau ka meaʻai. I kēia mea, i ka hoʻomaka ʻana o ka hoʻomohala o ka maʻi, ʻaʻole manaʻo paha ke kanaka i kekahi mau ʻōmaʻomaʻo.

Mahalo i ka hana ʻana i ka hoʻokaʻawale ʻana o ka hana huna huna o ka pancreatic, ua hiki ke ʻike i ka ʻōʻīpī ua hiki i ka 63% o nā protein a me ka 84% o nā momona. ʻO ka mea, ke hoʻololi ʻia ka hana o ka enzymatic i nā mea ikaika e huna ʻia e ka ʻōpū a me ka ʻōpū o ka ʻōpū.

ʻO ke kiʻi lāʻau lapaʻau o ka maʻi pinepine loa i nā ʻano like ʻole o ke kaomi kūwī: ke ʻīpī peptic, ʻokihīpela hoʻonāukiuki, ka hele ʻana o nā pōhaku i ka ʻōpū o ka ʻōpala, etc.

ʻO ka maʻi maʻamau maʻamau o ka hala ʻana o ka exocrine ka maʻi maʻamau. Hiki ke ʻike ʻia nā ʻāpana ʻokoʻa a me ka mucus i loko o ka papa. Ma muli o kēia ʻano e hiki ʻole i ke kino ke komo piha i nā protein a me nā momona. Eia kekahi, ʻo nā feces i loaʻa kahi mea leʻaleʻa maikaʻi.

Nā hōʻailona ʻē aʻe o nā kulekele penei:

• lilo ka momona kaumaha;
• ka hū me ka nui (flatulence);
• hypovitaminosis (nā lauoho lauoho a me nā kui palu);
• luhi a me ka luhi;
• kūʻai hoʻowahāwahā;
• make wai nui a me ka polyuria (jarang);
• ʻO ka ʻeha ʻo ke kāʻei koʻikoʻi e pā ana i ke kua.

ʻO kekahi ʻeha ka paʻakikī o ka mea maʻi e lawe ʻia i ka haukapila a inject painkillers.

Loaʻa nā Exacerbations i ka wā e lawe ana i ka meaʻai momona a me nā mea inu wai. I kēlā mau hiʻohiʻona, hiki ke hoʻopuʻi a me ka maʻiʻeha.

Nā ʻano hana diagnostic maʻamau

ʻO ka mea mua, pono e hoʻolohe i ka ʻaha kūkā hele mai i nā hoʻopiʻi a ka mea maʻi. Eia nō naʻe, ʻaʻole hiki i ka anamnesis ke kamaʻilio kūʻokoʻa i ka exocrine pancreatic insufficiency. Eia kekahi, ʻaʻole paha hoʻomohala ka maʻi maʻamau no ka manawa lōʻihi, no ka mea, e paʻa ana ke kino i kona mau hana, ʻoiai ʻaʻole i piha.

Me nā atrophy o ke kino, hana ka laparoscopy a laparotomy paha. Inā maʻi ka mea maʻi me ka pancreatitis, hiki ʻole ke hoʻokō ʻia ka hana no ke ʻano o ka maʻi. ʻO kēia no ka hoʻopili nui a me nā fibrosis.

ʻO nā hōʻike hōʻike nunui hiki i ke kauka ke kuhikuhi i nā fecal a me nā hoʻokolohua koko. Ma ke kānāwai, he piʻi i ka hana ALT, kahi hoʻohaʻahaʻa i ka hana o nā momona, polyunsaturated acid, cholesterol, amylase, lipase, isoamylase a me phospholipase A2 e hōʻike i kahi hewa o ka huelo.

No ka hoʻokumu i ke kumu o ke kipi hewa ʻana o ka hana pancreatic exocrine, pono ia e hoʻomoʻa i ka tomography compute (CT).

ʻO ka kumu wale nō o nā hoʻokolohua ma luna nei, hiki i ke kauka ke hana i kahi maʻi maʻi, a e pili ana iā ia, e hoʻomohala i kahi lāʻau lapaʻau pono pilikino a me ka maikaʻi.

ʻO ka lāʻau a me nā mea pale pale

ʻO ka mālama ʻana i ka maʻi ka ʻelua o nā mea koʻikoʻi - ka hoʻomaʻamaʻa kūikawā a me nā hana hoʻoponopono. ʻO ka papaʻai ke kaawale i ka ʻai ʻana i nā mea momona a nā mea momona a me nā mea inu wai i makemake ʻia. Ma kahi o ka paipai ʻia e ʻai i nā meaʻai o nā mea kanu mea kanu - nā lau ʻaiʻai a me nā hua.

ʻO nā cereals kūʻokoʻa (millet, oatmeal, buckwheat) i loaʻa kahi hopena kūpono i ka gastrointestinal tract. Loaʻa iā lākou ka nui o nā fiber, ʻaʻole i ʻuʻ atoa ʻē aʻe i ka ʻōpū, akā he kumuʻai nā mea kanu. ʻO ka hoʻokaʻawale ʻana i nā microflora pono i loko o ka papa, pono ia e hoʻohui i nā huahana wai skim i ka papa. Akā me ka hoʻonui nui o ka ʻōpū o ka ʻōpū, ua pāpā ʻia kā lākou intake.

ʻO ka hoʻomaʻamaʻa iki ke kumu o ke gula i ka hakakā ʻana me kēia maʻi. Hoʻokomo pū ʻia ka lawe ʻana i nā lāʻau lapaʻau e pili ana i ka aneā pancreatic. Hiki i nā lāʻau lapaʻau ke wāwahi i ka protein, nā palaka a me ke kō, hana i ka hana o ke kino.

Hōʻike ka papa ma lalo nei i nā lāʻau nui i hoʻohana ʻia i ka mālama ʻia o nā maʻi.

No ka pale ʻana i ka hoʻomohala ʻana o ke kaʻina pili, pono ia e pili i kēia mau lula:

1. E hōʻole i nā hewa maikaʻi - nā uahi a me ka waiʻona.
2. Huli i ka meaʻaiʻai kaulike, hoʻopaʻa ʻia ka ʻaake o nā meaʻai momona.
3. E lawe i ka waiū a me nā minikala.
4. ʻAi nā meaʻai liʻiliʻi, akā maʻamau (5-6 manawa i ka lā).

Eia kekahi, ʻōlelo pono e pale i nā pilikia koʻikoʻi koʻikoʻi.

He aha ka hopena o ka maikaʻi kūpono?

I ka nānā ʻana i ka maʻi a i ʻole ka launa pono ʻana e alakaʻi i nā hopena he nui e pono ai a hiki i ka make. Hōʻea ka nui o ka maʻi pancreatic exocrine i alakaʻi i ka hoʻomohala ʻana o ka maʻi peptic, formstost cystic a me gastritis.

ʻO nā Jaundice aiʻole nā ​​maʻi maikaʻi ʻoi aku ka liʻiliʻi o ka maʻamau. Eia kekahi, hiki i kahi hōʻeha kino o nā pathology ke hana i kahi exacerbation o ka pancreatitis, kahi mea weliweli loa no ke ola o ka mea maʻi.

I ka wā o ka mālamaʻana i ka lawa o exocrine, pono e nānā pinepine i ka pae o ka glucose i loko o ke koko. No ka huakaʻi o ka huni ʻana o ka pancreatic, he mea paha e liʻiliʻi ai i ka insulin o ke kanaka, ua mālama ʻia ka hormone no ka hoʻohaʻahaʻa ʻana i ke kō. A i ʻole, aia kahi hopena o ka hoʻomohala ʻana i ka maʻi diabetes.

ʻO kekahi hopena maikaʻi aʻe o ka hoʻokō lōʻihi, ʻo ke hoʻohui ʻana i ke kino i ka lāʻau lapaʻau hōʻeha, ka hana ikaika a me nā mea narcotic. I kēlā me kēia manawa pono kahi kanaka i kahi papa hana nui e hoʻopau i ka ʻeha. E like me kāu e ʻike ai, ʻaʻole i loaʻa nā hopena narcotic i ka pancreas wale nō, akā naʻe kekahi mau mea o loko.

Pono e noʻonoʻo pono-ka lāʻau lapaʻau a me ka hoʻohana ʻana i nā ala ʻē aʻe e kōkua ai e hoʻōla i ka maʻi. ʻO kahi hiki i nā hoʻokolohua kūpono ke hiki ke hōʻoia i ka prognosis maikaʻi - ke kūleʻa a hoʻōla a me ka pale ʻana i nā hoʻopiʻi (ʻo nā loli i ke kino a me ka maʻi mellitus).

E pili ana i ka hoʻololi ʻana o ka pancreatic exocrine i loko o ke wikiō ma kēia ʻatikala.