ʻO nā kaʻina hana hōʻeha i ka pancreas aia i kahi kolu ma ka "rating" o nā maʻi maʻi āpau o ka gastrointestinal tract. Hoʻokomo wale ke kanesa o ka ʻōpū a me ka rectum i hiki iā lākou i ka hoʻolōʻihi ʻia ka hoʻomohala ʻana. ʻO ka makeʻana mai nā maʻi pancreatic i nā kāne ma ka hā ʻehā ma waena o nā kumu ʻē aʻe, a i ka wahine i ka ʻelima.
Nā hōʻailona a me nā hōʻike i kēia maʻi ma ʻAmelika Hui Pū ʻIa e ʻike ʻia ana i kēlā me kēia makahiki i ka aneane kanakolu tausani mau maʻi hou. I nā makahiki he ʻumikūmālua o ke kenekulia hope, ua emi iki ka lōʻihi o ke kaʻina o nā ʻāina o ʻEulopa a me ʻAmelika ʻAmelika i ka hoʻohālikelike ʻana me nā thirties.
I ko mākou ʻāina, ʻo ka hōʻike o nā maʻi maʻi pancreatic i like me 8.5 mau hihia no kēlā me kēia 100 tausani kanaka. No laila, he mea koʻikoʻi loa ia e ʻike nā kānaka a pau i ke ʻano o nā maʻi mua, pehea e hōʻike ai iā ia iho i ka wā e hiki mai ana, a pehea e hana ai.
Hoʻomaʻi ʻia nā ʻōmaʻomaʻo Pancreatic Cancer
Hoʻoholo ʻia nā hōʻike olakino o kēia maʻi maʻi e ka nui o nā neoplasm, a me kona wahi. Me ka maʻi o ke poʻo o ke kipi i ke kakahiaka nui, ua ʻike like ʻole nā hōʻailona a hōʻemi wale ʻia i nā maʻi maʻamau.
Puhi kekahi kanaka i ka nāwaliwali, paʻakikī i loko o ka ʻōpū, indigestion. ʻO kekahi manawa e ulu ka maʻi maʻi, e hōʻike ana i ka hana o ka huna huna o ka lāli.
I waena o nā hōʻailona mua o ka maʻi maʻi ma kēia mau hōʻailona:
- ʻeha i ka ʻōpū ma luna;
- waiho kaumaha;
- mau hale lehulehu;
- ka hoʻonui ʻana o ka ʻōpū;
- kaʻole o ka hana hana a ka pancreas;
- walching, nele i ka ai ole, moue.
I kekahi mau hihia, ʻo ka hōʻailona koʻikoʻi o kēia maʻi weliweli, ʻoiai ʻo ka poʻe i ʻelemakule, he maʻi hōʻeha maoli nō ka pancreatitis no nā kumu ʻike ʻole.
Hoʻomaopopo ka hōʻailona o ka maʻi pancreatic i nā manawa mamao loa
Ma hope o kekahi manawa, ʻike ʻia nā hōʻailona o kēia maʻi, e like me ka mau ʻana o ka ʻeha palū puʻupaʻa i hoʻopaʻa ʻia i loko o ka hypochondrium kūpono a i ka ʻaoʻao epigastric paha. I kekahi manawa hiki i nā ʻeha ke pane i ke kua, kua lalo, a i ʻole paha i ke ʻano o ke kāʻei (ʻoi pinepine ka hana ʻana i ka wā e ulu ai ka ʻōpala i loko o nā kiko o ka celiac).
Ma kahi o 20% o nā mea maʻi me nā ʻano maʻi maʻi maʻamau he mau hōʻailona lapaʻau o ka maʻi mellitus maʻi hou i hōʻoia ʻia, i hōʻoia ʻia e nā haʻawina ʻoihana. ʻO kēia mau hōʻailona āpau o ka maʻi maʻi pancreatic ʻaʻole kūpono ʻole a kuhi hewa paha no nā hōʻailona o ka osteochondrosis o ka spine a i ʻole pancreatitis maʻi.
No ka poʻe he lehulehu, pinepine pinepine, ʻo ka manawa hoʻokahi wale nō o ka hūkū i loko o ke poʻo o ke poʻo o ka pancreas hiki ke kau i ka jaundice, e ulu ana me ka ʻeha paroxysmal ma loko o ka ʻōpū. ʻO ka holomua, ka jaundice e holomua a me ka ʻeha ʻo ka ʻili e hui pū me ia a ʻo kēia mau hōʻailona āpau o ka maʻi pancreatic.
I nā mea maʻi me nā ʻano maʻi maʻamau o ka maʻi pancreatic, ʻike paha nā hōʻailona o ke kakaka o ka ʻōpio i hoʻoneʻe ʻia e ka hoʻopiʻi ʻana o kahi kūpaʻa (a i kekahi manawa haʻahaʻa haʻahaʻa) o ka duodenum.
ʻO nā neoplasms i loko o ke kino a i ʻole a ʻo ka lālani o ka gland i ʻike ʻia i ka pae hope loa me ka ʻike ʻana i ka ʻeha nui i loko o ke kua a i ʻole ka epigastric region.
Aia a hiki i kēia manawa, ʻaʻohe o nā hōʻike maʻi. Hoʻoikaika nui ka ʻeha inā ka hoʻomanawanui ka mea ma luna o kona kua, a i ka wā e noho ai a i ka wā nāwaliwali nāwaliwali.
Inā hoʻomaka ka ʻūlū e kāpī i ka vein splenic, a laila hoʻomaka ka thrombosis, kahi i hōʻike ʻia e splenomegaly. I kekahi manawa, me ka maʻi maʻi pancreatic, ma muli o ka hiki ke hoʻomohala ʻia o ka portal hypertension regional, ʻike ʻia nā moku varicose o ka esophagus a me ka hemorrhage i ka wā hānai.
ʻĀnohi ke kanesa ʻo pancreatic
Ke hoʻokō nei i kahi hoʻokolohua kūpono, ma kahi o 35% o nā mea maʻi e maʻi ana i ka maʻi poʻo o ka pancreatic i loaʻa hepatomegaly, a palpated ka lalo o ka puhaka. Me ka hoʻomohala ʻana o ka jaundice obstrate, kahi hōʻailona o Courvoisier e hele mai ana. Inā lilo nā ascites i hōʻailona no ka maʻi maʻi, a laila hōʻike kēia e hana maoli nei ke kaʻina hana a ua hiki ʻole ke hōʻino.
Me nā maʻi maʻi i hoʻokaʻawale i nā wahi mamao loa o ka nui o nā hua, nā hopena o kahi aʻo noiʻi e hāʻawi ai i ka ʻike liʻiliʻi, ka ʻaʻī, a me ka ʻili pūpū, hiki ke palpated wale nō me kahi hana holomua nui. ʻO nā Ascites a me splenomegaly i ʻike ʻia i nā hana hope aʻe.
Me nā ʻano mua o ke kanesa o ka pancreatic, hōʻike pinepine ʻia nā hoʻokahe koko maʻamau me nā hemahema. I nā papa i hala, hiki ke nānā ʻia ka nui o ka ESR a me nā anemia māmā.
Ma nā hiʻohiʻona koko biochemical, ʻike pinepine ʻia ka hypoalbuminuria a me hypoproteinemia, a ma mua o ka jaundice obstrate, hyperbilirubinemia. Hoʻonui hou ka pae o ka phosphatases alkaline a me ka transaminases, me ka hoʻonui ʻana o ka neʻe o ka phosphatase e nānā ʻia ana i kahi nui.
ʻO ka ʻike nui loa o ka ʻike ʻana i ka neoplasms malignant ka hoʻoholo ʻana o nā ʻike o nā māka ʻaʻano i loko o ke koko. ʻO kekahi o nā mea e ʻike pono ai a me ka paʻakikī no kēia ʻano o ke kano, ʻo ka embryonic carbonic anhydrate glycoprotein. Eia kekahi, ke kauo nei ke kauka i ka loli i ka hoʻololi ʻana i ka pancreas.
I nā poʻe olakino, ʻaʻole i hiki ke pae o kona koko i ka nui o nā ʻāpana he 37, a ma ka maʻi pancreatic hoʻomehana ʻia ka piʻi ʻana o ka ʻumi mau manawa (a i kekahi manawa i nā haneli a me nā mau haneli).
Akā i nā manawa mua o ke kanesa, ka mea maʻamau o ka CA-19-9 ma loko o nā palena maʻamau, no laila ke loaʻa nei kēia ʻano i nā palena nui o nā noi ʻana e ʻike ai i nā hōʻailona mua o ka maʻi kanesa, ʻoiai inā he pilikia nā maʻi.
I kēia mau makahiki i hala iho nei, ua ʻike ʻia ka ʻike e pili ana i ka ʻoi loa o ka hana o ke keʻena no ka ʻike ʻana i ka antigen CA 494 i loko o ke koko no ka hoʻomaka ʻana i ka maʻi maʻi pancreatic, inā paha he mea pono ke hoʻokaʻawale ʻana iā ia mai ka maʻi pancreatitis maʻi.
Nā ala hana no ka nānā ʻana i ka maʻi paleka pancreatic
ʻO ke kaʻina mau kēia o nā kaʻina o ka maʻi maʻi pancreatic.
He X-ray e hoʻohana ana i ka hoʻohālikelike ʻana i ka ʻōpū a me ka duodenum e kōkua i ka ʻike wale ʻana i nā hōʻailona mau ʻole o ka maʻi maʻi e kū ana i ka wā e wāwī ʻia ke kīpē e nā ʻāpua a nā ʻaoʻao kokoke.
- deformation o ka ʻōpū a me kona neʻe ʻana i mua;
- ka wehe a me ke neʻe ʻana i ka "nā kāmaʻa lio" o ka duodenum;
- ka pīpī i ka lālā i lalo o ka duodenum a me ka loaʻa ʻana o kahi hemahema hoʻopiha ma ka ʻaoʻao o loko.
Me kahi kakaho nui, hiki i kahi hōʻike X-ray ke hōʻike i kahi hoʻololi i ka curvature liʻiliʻi o ka ʻōpū a me ka hoʻonaninani ʻana i nā lipoka o ka mucosa me ka infiltration ma kēia wahi.
Hiki iā ʻoe ke hoʻomaopopo i ka pīʻī a me ka neʻe ʻana o ka jejunum ma ka pā o Tramentz ligament. Akā ʻo kēia mau hōʻailona āpau i ʻike ʻia he mau hōʻailona o ka maʻi maʻi i ka wā hope. Loaʻa ka X-hihi i kahi hiki ke ʻike i kahi liʻiliʻi o ka duodenum.
ʻO nā ala haʻawina nui hou a me ka noiʻi he magneton resonance imaging a me ka tomography hoʻopiʻi ʻia, me ka ʻai pū kekahi. Eia kekahi, ʻoluʻolu ke ʻano o ka tomography ma mua o ka ultrasound.
I mea e hōʻoia ai i ka hoʻokolohua ʻana i hana ʻia e X-ray, kahi manuahi maikaʻi puncture kahi ʻōpala o ka maʻi ua hana me ka kāohi ʻē aʻe e hoʻohana ana i ka hoʻohana ʻana i ka ultrasound a i ʻole ka pākuʻina i hoʻohui ʻia. Eia kekahi, ma ka hapanui o nā maʻi me ka maʻi maʻi (90-95%), ua hōʻoia ʻia ka maʻi morphologically.
ʻO ke kahua o ke kanesa maʻi pancreatic
Ma kahi kokoke i 80% o nā maʻi, aia ka maʻi ʻana i ka pancreas ma ke poʻo o ke kino a he nui iki ka hapa o ka ʻāpana caudal a i loko o ke ʻano o ka paukū.
ʻAʻole kupaianaha loa ka loaʻa ʻana o ke kūlana multicentric o ka huki, a me ka ʻano like ʻole o ke kano, e uhi ana i ka lepuni holoʻokoʻa. ʻO ka maʻamau, hoʻomaka ka hāmeʻe e hoʻomohala mai nā kiko o nā kumu excretory a i kāna kāpili e hōʻike ana i kahi adenocarcinoma me kahi ʻokoʻa like ʻole. Eia kekahi, i kekahi manawa me ka noiʻi morphological, acinar adenocarcinoma (kahi ulu i ulu mai nā acinar cell) a i ʻole squamous cell carcinoma i hoʻoholo ʻia.
ʻO ka pinepine loa, nā metastases cancer cancer e hōʻoki i nā lepa lika ma hope o ka peritoneum a i ʻole nā nodes e loaʻa ana i ka ligament hepatoduodenal. Ma o ke koko, komo ka metastases i nā palemo, nā ʻōpū, nā puʻupuʻu, nā iwi, nā kelepaʻe adrenal a alakaʻi i ka hōʻakeha ʻana o kēia mau mea āpau.
