ʻO ka maʻi pancreatic (neoplasia) kahi maʻi paʻakikī a make paha. Wahi a WHO, ma kahi o 220 tausani mau maʻi i hoʻopaʻa ʻia i kēlā me kēia makahiki ma ka honua. ʻO kēia o ka 213 tausani i make i ka make. ʻO kēia ma muli o ke kiʻekiʻe nui o nā neoplasms malignant precisely.
I loko o 5 mau makahiki ma hope o ka loaʻa ʻana o kahi maʻi maʻi i luna o ka pancreas, make i ka 90% o nā maʻi.
Ehia mau maʻi maʻi e ola nei ma hope o ka mālama ʻana i kahi ʻaʻa benign e hoʻoholo ʻia e ke ʻano a me ke kūlana o ka maʻi.
ʻO ka neoplasia pancreatic (pancreas) he neʻeendocrine pathology, i.e., hōʻole ia i ka pūnaehana endocrine. ʻOiai ma ka hana maʻalahi ʻana o nā puka, ʻike ʻia nā hopena koʻikoʻi no ka pancreas.
ʻO ka ulu o ke Tumor i nā mea kokoke i nā pūpū (spleen, duodenum, nā ate, ka ʻōpū) e make ai ka make.
Nā hōʻailona maʻamau o ka patology
Hōʻike ka hele ʻana o ka oncology pancreatic i nā hoʻomaka mua wale nō e ke fluke, i ka wā o kahi loiloi kino.
ʻO ka hoʻomohala hou o ka maʻi e hāʻawi i nā loiloi hui e pili ana i ka maikaʻi, ka mea i hoʻopuni ʻia me nā pilikia o ka hana ʻana.
ʻO kahi maʻa wale nō ke hāʻawi i nā hōʻailona a i ʻole ka liʻiliʻi o nā hōʻailona ponoʻī o ka oncology.
Ma ke kaʻina o ka ulu ʻana, e pālahalaha ana nā neoplasm i nā ʻāpana a me nā moku.
Hoʻopili ʻana i nā kumuhā, nā nekrosis o nā pūlima a me nā ʻōnaehana ma muli o kēia mau hōʻailona.
- ʻO ka hōʻeha maʻamau i ka waenakonu o ka ʻōpū (e pili ana i ka vertebrae lumbar mua a ʻekolu paha). ʻO kāna kahi kahi e hiki ke wehewehe pololei i nā pilikia me ka maʻi prostate. I ka wā e hiki mai ana he lilo ia. ʻAʻole hilinaʻi ia i ka kaʻai ai meaʻai, hoʻomākeo i ka pō. Hiki i ka ʻike ke ʻano mai ka Seizures i ke kaumaha mau.
- Nā maʻi Dyspeptic. He kaumaha ma ka ʻōpū, nausea, luaʻi. He mea maʻamau maoli ia me ka pae ʻana o ka bowel ma muli o ka pīhoihoi nui.
- ʻO kahi jaundice kikoʻī. Ke aniani o ka ʻili, nā maka, nā kui. Stool discoloration a me ka pōʻeleʻeleʻele. ʻO kahi hōʻailona ʻo ka līlū ʻana i nā papa o nā bile, ka mea e hoʻokau ai i kahi poki ma ke poʻo o ka pancreas.
- Hoʻololi i ka makemake. Ka hōʻole ʻia o nā momona a me nā meaʻai, nā kofe a me ka waiʻona.
- Leʻoki kaumaha ʻo Dramatic.
- Nā hōʻailona o ka maʻi maʻi Hiki ke loaʻa i ka neoplasm ma ka huʻu o ka pancreas;
- Anemia
Hiki ke wānana i kahi keaka o ka pancreas ma o ka loaʻa ʻole o ka hauā i loaʻa i ka neoplasia malignant.
Ke hoʻomau nei kēia hihia me ka nāwaliwali laulā, luhi, ke kiʻekiʻe kiʻekiʻe, nā pallor. Pae maikaʻi loa ka haʻalele ʻana o ka nausea a puka.
Nā kumu kumu o ke kuʻuna
ʻO nā neoplasms oncological a lākou wale nō i hana i ka hoʻomaka mua ʻana o ka hoʻomohala ʻana i nā pathology.
Ināʻike ka maʻi pancreatic i ka ʻike ma hope i nā makahiki hope aʻe, a laila pehea e pale ai iā ʻoe iho?
A pehea lā ʻoe e ʻike ai inā he predisposition o ka maʻi?
Hoʻoholo ʻia ka hui pilikia e nā ʻano koʻo aʻe:
- makahiki mai 50 makahiki;
- kāne kāne (ʻoi aku ka maʻi i ka maʻi);
- ka hele ʻana o nā maʻi o ka ʻōpū, loko o nā ʻōpū;
- pancreatitis ʻole;
- i ka ulaula: hoʻonui i ka nui o ka maʻi pancreatic i ʻekolu manawa;
- heredity: kahi code genetic abnormal e hoʻoholo mua i ka hiki ke maʻi;
- inu waiʻawa
- heʻai momona eʻai ai i nā ʻiʻo a me nā momona momona, me ka meaʻai wikiwiki;
- maʻi mellitus type 1;
- nā wahi ʻino.
ʻO kekahi o nā mea nui a hoʻopaʻapaʻa i ka maʻi diabetes. ʻAʻole pono nā kānaka e ʻike ʻole i ke kō koko kiʻekiʻe (ʻo nā kāne o ka waena, me ke kaumaha nui) ʻole i ka manawa ke ʻike ʻia ʻo ia, ke nānā ʻia ka pancreas no ka oncology. Eia, ʻaʻole paha ia o ka maʻi i lilo i ka hopena pilikia, akā he hōʻailona ia o ke kuʻi a i ʻole nā maʻi pancreatic ʻē aʻe. I nā hihia maʻamau, ʻo ke kumu o ka maʻi he maʻi hormonal e pili ana i ka momona.
ʻO nā ʻōuli i kau ʻia ma mua e pili ana i ke ʻano o ka hōʻino o ke kino a me nā hiʻohiʻona o nā neoplasm. ʻO kahi liʻiliʻi ma lalo nei kahi wehewehe kikoʻī o ka ʻano o ka maʻi.
ʻO ka papa ʻaina papa pancreatic
ʻO ka mea mua, ua hoʻokaʻawale ka pathanatomy i nā mauʻano i ʻelua mauʻano: benign a malignant.
Ua palena iki ka hihia mua i kona hopena ma ke kino a hiki ke hoʻōla ʻia.
ʻO kona hiʻohiʻona ka hoʻohālikelike o nā ʻokoʻa. Hiki iā ia ke hoʻoholo i ka kiko mai kahi e ulu ai ka hoʻokumu. I kekahi mau kumu i kapa ʻia he polyp, he kūlike kēia mau manaʻo.
Kūkulu ʻia ka maʻi pancreatic Benign i loko o kēia ʻano:
- Kūpono a me ka momona Fibroma.
- Hemangioma (nā ipu koko).
- ʻO ka Neurinoma (ʻōhua o ka hoʻopili).
- Lipoma (ʻōpiopio adipose).
- ʻO Cystoma (mau pūniha i piha i ka wai; aia ma nā wahi like).
ʻO kahi koho palekana he hemangioma. ʻO ka maʻamau, ʻo kahi hana epithelial kēia i loko o nā pēpē e makemake nei e wāwahi i ka wā kamaliʻi. I kekahi mau manawa ma ka ate, lohi ma luna o ka pancreas. ʻO kahi neoplasm kahi e kapa ʻia i ka hemangioma cavernous. Hoʻohana maʻamau nā ʻano o ka lāʻau maʻi ma ka oncology.
ʻO kahi maʻi hōʻeuʻeu kahi hihia kūpono ʻole me ka hoʻolaha ʻana o ka metastases. ʻO ka pohō o ka mālama maʻi ma muli o ka ulu o ka neoplasm. Kūleʻa ia i loko o ke kino, e hoʻohuli i nā pūnaʻi olakino i loko o nā ʻōpū o ke kanesa, a ulu paha i loko o ke kaila e puni ana. I kēia hihia, hiki i ka wahī ke hoʻopau i nā mea āpau e hele mai i ke ala.
ʻO ka maʻi pancreatic malignant e like me ICD-10 i hoʻoholo ʻia e ka pūnaewele o ka lesion:
- ʻohi ʻia ke poʻo, ke kino a me ka huelo;
- kinohi a pancreatic;
- islet cells;
- lehulehu mau kamaʻāina.
ʻO kahi o nā neoplasia e hoʻoholo nui i kāna mau hōʻailona a me ka mālama. Aia ma ke poʻo, e laha aku ia i ka ʻā a me ka duodenum, e hoʻonāukiuki i nā maʻi dyspeptic a me ka jaundice. Mai ka huelo, e hiki ke pālahalaha ʻia a hiki i ka pua.
Ke hana ʻana i kahi hōʻailona holoholo ma kēia wahi, e hoʻoiho ai i ka ascites a me hypersplenism. ʻO nā sela islet he kumu keu o ka insulin a me kekahi mau hormone ʻē aʻe. ʻO kā lākou hōʻoleʻana he pohō nui loa i ka ʻoihana endocrine.
Nā ala e hoʻohuli ai i ka maʻi
ʻAʻole lawa nā hōʻailona mai kahi hana maʻi.
Pono e hoʻokau i nā hoʻokolohua maʻamau a loiloi i ka mōʻaukala olakino. Hiki iā lākou ke kuhikuhi i ke kumu o ka maʻi maʻi.
ʻO nā hoʻokolohua mua.
Hana ka Oncologist:
- ʻO ka nānāʻana i ka mōʻaukala olakino (ka huaʻōlelo a me ke ʻano o ka maʻi).
- ʻO ka noʻonoʻo pono i kahi mōʻaukala o ke ola (e hoʻoholo i ka heleʻana o nā mea hōʻeha i hōʻike ʻia ma luna).
- ʻO ka nānā ʻana i nā hihia oncology ma nā ʻohana o ka mea maʻi.
- ʻO ka hōʻoia o nā hōʻailona.
Ma hope o ka hoʻokolohua mua ʻana, e hāʻawi ʻia kahi maʻi kūʻokoʻa. Hana ʻia nā ʻikepili:
- koko (total); ka nele o ka hemoglobin (anemia) a me nā loli ʻē aʻe i ʻike ʻia;
- koko (biochemical); hōʻike, ʻike i nā pae gula, type 1 diabetes mellitus a i ʻole insulomas e noʻonoʻo;
- ʻoi; hoʻokō pono ʻia me kona discoloration (kahi hōʻailona o ka ʻike ʻole o stercobilin);
- hiō me ka jaundice, ka nui o ka urobilinogen, i hana ʻia mai ka bilirubin, ua manaʻo ʻia;
- nā māka ʻaila CA 19-9, KEA (nā ʻōmoma e hōʻailona ana i ka hele ʻana o ka maʻi maʻi).
Eia kekahi, hoʻohana nā mea hana i ka ʻokiʻoki i lalo.
- Ui (ultrasound).
- Hoʻohui ʻōpiopio (CT) nānā.
- Ka hoʻohana ʻana i ka resonance résonance (MRI).
- Endeoport retrograde chalangiopancreatography (ERCP).
- Magnic resonance pancreatocholangiography (MRPC).
- Scintigraphy.
- Angiography.
- Biopsy
ʻO ka ultrasound ke ala maʻalahi. He uku haʻahaʻa loa ia, akā palekana piha. Hoʻoholo i nā loli morphological i nā kiko, ko lākou kiʻekiʻe o ka echogenicity.
Hoʻomaʻamaʻa ʻo CT i ka nui, kahi o ka pūhaka, a me ka komo ʻana o nā kino kokoke. ʻOi aku ka pololei, akā e hoʻokele ma ke kumu o x-hihi.
ʻOi aku ka palekana ma mua o ka hana ma mua, akā ʻoi aku ka uku. Hōʻike ia pehea ke kūʻe nei nā neoplasm a me kona mau hopena, ka hoʻāʻo ʻana o nā membrane mucous a me ka pohū ʻana o ka motility.
Hoʻopau ka ERCP i nā kumu bile. Ua piha lākou me nā mea hoʻokaʻawale a lawe ʻia kahi x-ray. Ke ʻōlelo nei ka hopena o nā loli morphological ma kēia wahi, no ka laʻana, ka pipiʻi a me ka hele ʻana o kahi pōpilikia.
Hoʻopili ʻo MRPHG i nā kumu no ka hua bile a me nā pancreatic. Ua hoʻoholo i ko lākou kūlana a me ke ʻano, nā kelima pathological i loko o nā paia o nā pā.
E hoʻoholo ana ʻo Scintigraphy i kahi a me nā ʻano ʻē aʻe o ke kinipona ma muli o ka hoʻopuka o nā mea radioaktif i loko o ke kino.
ʻO ka Angiography kahi hōʻike ma ka x-ray o nā moku koko. ʻO kahi hana hope loa, ma ka haʻalele ʻana o ka ʻike ma hope o ka CT a me ka MRI.
ʻO kahi biopsy kahi maʻi hopenaʻokoʻa holoʻokoʻa, ʻo ia hoʻi, e hoʻoholo ana i ka maikaʻi o ke kakano. Hoʻohana ʻia ia e ka lawe ʻana i kahi kiko o ka iwi mai ka lesion.
Hoʻomaka maʻi maʻi pancreatic
Pono ke ʻano o kēia mau pilikia no ka loaʻa ʻana o ka maʻi pancreatic cancer: benignity, ʻoi aku ka nui o ke koʻi i luna o ka centimeter, ke hoʻonui mau ʻana i ka hoʻonaʻauao ma mua o hoʻokahi makahiki a me ka hele ʻana i nā hōʻailona.
ʻO ka maʻamau ka wehe ʻana i kahi maʻi pancreatic i hoʻohana ʻia i kahiʻano maʻamau o ka ʻōpala o nā maʻi.
Inā hiki, hiki ke hoʻololi ʻia e nā ala ʻē aʻe:
- hana ʻoi laparoscopic;
- radiation;
- chemotherapy.
ʻO ka hoʻokūkū pancreatic kuʻuna e komo i ka wehe ʻana o kahi hapa o kahi mea. No ka mea laʻana, ka pancreatoduodenal resection ka lawe ʻana i ke poʻo o ka puhaka a me ka duodenum. Kūlohelohe, ma hope o ka mea maʻi e noho lōʻihi. Hoʻolālā ʻia kekahi ʻano hana hamama no ka huki ʻehā o ka cellletlet.
ʻO Laparoscopy kahi hana hana me ka nui o nā manawa he i. I kēia hihia, ʻaʻole maʻamau i hoʻohana ʻia, pinepine i ka mālama ʻana i nā hemangiomas kamaliʻi hānau. ʻO kēia kahi hana hou o nā hana hana, hoʻohana pinepine i ka laser.
Hoʻokomo wale ʻia ka lāʻau radiadi i ka hoʻolōʻihi i ka hoʻolaha o nā maʻi. ʻAʻole hōʻoluʻolu ka hoʻolahaʻana i kēia hihia: ua hoʻonui ʻia ke ola ma kahi o 12-16 mahina.
ʻAʻole ʻoi ka Chemotherapy i ka mālamalama pilikino, akā ke alakaʻi nei i kahi ʻāpana o ke kauā ʻana i ka maʻi kanesa. I kekahi manawa nā lāʻau cytotoxic wale nō ke ala.
E haʻi nā poʻe loea i nā kani pancreatic i kahi wikiō ma kēia ʻatikala.
