Pancreatic decomposition ke eng

Lisosa tsa lefu lena

Joalo ka maloetse ohle a manyeme, "pancreatic necrosis" e hlaha ka lebaka la mathata a tsamaiso ea tšilo ea lijo. Ha e le hantle, lefu lena le ka bakoa ke lintlha tse 'maloa:

Matšoao le ho khetholloa ha pancreatic necrosis

Pancreatic necrosis diagnosis Matšoao a mantlha a lefu lena ke bohloko bo boholo ka lehlakoreng le ka mpeng la mpa, ho thunya lethekeng le ka morao le letsohong le letšehali, ho nyekeloa hoa pelo, ho hlatsa haholo, feberu ho bontša matšoao a ho bolaoa ke lefutso. Bohloko bona bo sa mamellehe ka tlhaho, hangata ho tloha mokokotlong le ka letsohong le letona la mpa. Ka palpation ea lebota la ka ntle la sebaka sa peritoneum le epigastric, hammoho le hypochondrium e nepahetseng, letšoao la bohloko le bobebe. Letšoao la Grey-Turner le bonahala haholo ho lefu lena, ha ho bonahala marotholi a maputsoa lehlakoreng la lebota la mpa la ka hare. Haeba ho na le matheba a maputsoa ho pota-na le mokhubu, letšoao lena le bitsoa Grunwold, 'me ha ho hlahile leqeba mathekeng le tlas'a likhopo ka morao, ho fumanoa lefu la lefu la Davis.

Khafetsa, mokuli o kena sepetlele a se a e-na le matšoao a toxemia, e tsamaeang le ho pepeseha hoa letlalo, ho hema, ho tepella le tachycardia. Boemo bona bo hloka tlhahlobo e felletseng ea tlhahlobo e nepahetseng. Haeba phallo ea secretion e tšoenyeha, ho etsoa opereishene. Hangata kamora ts'ebetso, mokuli o na le nalane e fokolitsoeng ea palo ea li-enzyme. Detoxification le eona e etsoa, ​​sepheo sa eona ke ho tlosa li-cytoxin tse feteletseng.

Ka kalafo e sa reroang, mathata a ka hlaha ka mokhoa oa ho tahoa hoa 'mele, ho thehoa ha li-cysts, maemong a mang, ho tsoa mali ka mpeng ho ea kahare. Haeba lesapo la mokokotlo le hlaha, mokuli o fetoha mofufutso o feteletseng, chores le feberu.

Boloetse bo ka tsamaisana le ho se sebetse hantle ha renal, ka linako tse ling ho hloleha le ho hlaba ka lereeng ho hlaha. Pancreatic necrosis e ka baka tšenyo ea tsamaiso ea methapo. Boemong bona, mokuli o hloka botsitso, o eketsehile thabo, boitšoaro bo sa lokelang. Tabeng ea bongaka, ho na le maemo ha, ka mofuta o tsoetseng pele oa lefu lena, mokuli a oela kelellong.

Ka linako tse ling mokelikeling o fumanehang ka mpeng, ho fumanoa litšila tsa likaroloana tsa mali. Maemong ana, mokuli o fuoa dialysis e sebelisitsoeng laparoscopy.

Pancreatonecrosis kalafo

Ka lefu lena, mokuli o khothalletsoa ho khaotsa ho ja ka botlalo matsatsing a pele. Ka thuso ea lithethefatsi, secretion ea lero la gastric e fokotsehile, mme mpa ka boeona e hloekisoa ka mokhoa oa probe. Matsatsing ana, mokuli o tšoenyehile ka bohloko bo boholo, ka hona o ke ke oa etsa ntle le antispasmodics le painkiller. Ho kenyelletsa tšoaetso, ho laetsoe lithibela-mafu. Bakeng sa ho qoba li-abscesses, mokuli o fuoa kalafo ea antibacterial le immunomodulating. Ka ho se sebetse hantle ha kalafo ea lithethefatsi, mokuli o bonts'oa ts'ebetso ea ts'ebetso ea bongaka, e etselitsoeng ho pepesa lisele tsa pancreatic tse sa sebetseng le ho theha setho sa litho tse phetseng hantle.

Pancreatic pancreatic necrosis upasuaji Ka kalafo e nakong, lefu le ka emisoa qalong. Leha, joalo ka molao, phello e ntle ea lefu lena e ka tlase ho 50% ea linyeoe tsohle. Ba nang le mahlohonolo a lekaneng ho felisa litlamorao tsa lefu lena ba hloka ho latela melao e itseng lijong tsa bona bophelong bohle. Ntho e ngoe le e ngoe e mafura, e halikiloeng, e tsubeloang, e letsoai, e nokiloeng ka linoko, e monate haholo. Ho boetse ho thibetsoe joala, chokolete, lebese, lijo tse halikiloeng, litholoana tse ncha le meroho, bohobe bo sa tsoakoang, soda, tee e matla le kofi. U ka ja nama e halikiloeng e halikiloeng, meroho e halikiloeng kapa e phehiloeng ka metsing, sopho e thehiloeng mapheng a bobebe, lijo-thollo ka metsi, lihlahisoa tse nang le lebese le bolila, bohobe bo omisitsoeng. Lijo tsohle li lokela ho ba mochesong o futhumetseng, o se nang mafura, o sa tsitsang joaloka gruel.

Ka lefu lena, ho bohlokoa ho hopola hore ho iphekola ho ka jella mokuli bophelo, ka hona, ka lipontšo tsa pele tsa pancreatic necrosis, o lokela ho etela ngaka hang-hang.

Acute pancreatic necrosis (pancreatic necrosis)

Ka ts'ebetso e pharalletseng ea necrotic, lefu la mokuli le lona le hlaha ka lebaka la ho se khonehe ha tlhahiso e tsoelang pele ea li-hormone tse itseng le li-enzyme tsa tšilo ea lijo. Lithane tsa "pancreatic", tse senyehileng ka lebaka le le leng kapa le leng, ho ea holimo ha li na bokhoni ba ho iphetola ka boithaopo. Mathata a tloaelehileng ke khaello ea enzyme, lefu la tsoekere la 2 le 3 degrees, pancreatitis e sa foleng.

Ho na le mefuta efe ea li-pancreatic necrosis?

Pancreatic necrosis e ka khetholloa ka mofuta oa ts'ebetso, sebaka sa eona, mofuta oa thupelo le nako. Sebelisa:

• mofuta o hlobaetsang oa ho nyopa le o mong oa pancreatic necrosis,
• hemorrhagic pancreatic necrosis le mefuta ea eona e mafura,
• mefuta e shebileng pele le e tloaelehileng,
• o botsoa kapa o tsoela pele,
• hemostatic, e sebetsang ebile e le ea mefuta e senyang ea timetso ea pancreatic necrosis.

Boemong ba ho khetholla, ho bohlokoa ho tseba ka nepo boikemisetso ba ts'ebetso, tekanyo ea tšenyo ea lisele tsa botšo le nako ea liphetoho tse mpe. Ho latela sena, ho etsoa qeto ka mofuta oa kalafo kapa oa boitšireletso.

Katleho e ntle ka ho fetisisa ea bophelo le bophelo bo botle ke edematous pancreatic necrosis. Sebopeho sena, liphetoho tsohle tsa pathological li khopisoa ke edema ea parenchyma le keketseho ea boemo ba khatello ho li-pancreatocytes. Sena se tsamaisana le hyperemia, microcirculation e sa senyeheng, edema ea ka hare.

Khahlano le semelo sa mofuta ona, mofuta oa "tis" necrosis o tsoelang pele o ka hlaha. Sena se etsahala ha ho sa phekoloe ka nako e loketseng kalafo ea sesosa sa lefu lena. Edema e lebisa ntlheng ea hore li-enzyme tsa sehlopha sa lijo tse silang lijo li khaotsa ho tlohela ka bolokolohi khase ea manyeme. Ts'ebetso ea ho sililoa ha litho tsa litho tsa 'mele ea bona e qala. Phekolo ea Conservative e ka etsahala le sethaleng sena.

Mehato e latelang e tsamaea le nts'etsopele ea mathata a amanang le ho kenella ha purulent exudate sebakeng sa retroperitoneal. Likahare tsa purulent li kena ka mpeng ea mpa. Acit peritonitis ea hlaha. Lekhetlong lena, ho buuoa ka ho buuoa ka tšohanyetso. Ntle le ts'ebetso ea opereishene, e nang le pancreatic necrosis e tsoetseng pele, mokuli o shoa ka mor'a lihora tse 'maloa ho tloha ho purulent sepsis.

Hangata ho tsa bongaka ho na le mefuta e kopaneng ea pancreatic necrosis.

Lisosa tsa Pancreatic Necrosis

Mabaka a ka sehloohong a nts'etsopele ea "pancreatic necrosis" a amahanngoa le ho senyeha ho amanang le tšilo ea lijo. Ka tekanyo e phahameng ea menyetla, pancreatic necrosis e ka baka mabaka a latelang:

1. tšebeliso ea lino tse tahang tse ngata haholo.
2. tšebeliso e ngata ea lijo ho fihlela o ikutloa a tšohile haholo ka mpeng.
3. tlolo ea ho tsoa hoa mahala hoa enzyatic exudate ho tsoa ho pancreatic cavity ka cholangitis, cholecystitis e bonoang, dyskinesia ea biliary.

Ntle le moo, pancreatic necrosis e ka hlaha ka lebaka la tšebeliso e fosahetseng ea lithethefatsi tse ling, e hasantsoeng kahare ho intravascular, mafu a tšoaetsanoang haholo, maemo a sithabetsang a nang le khatello e kholo ea kelello.

Leha ho le joalo, necrosis e hlaha ho latela kamano le microparticle ea setho sena. Sele e le 'ngoe e bitsoa acinus. Ka ho hlola ha eona, ts'ebetso e tloaelehileng ea manyeme e sitisoa mme sena se lebisa ho nts'etsopele ea ts'ebetso ea pathological e eketsehileng.

Mokhoa oa bohlokoahali oa pathological oa nts'etsopele ea lefu lena. H e ipapisitse le lintlha tse peli:

• Moroalo o eketsehileng
• ho haella ha li-enzyme tsa mahala tse hlahisoang ka mokhoa o sa tloaelehang.

Ka lebaka la sena, li-enzyme tse matla tsa tšilo ea lijo tse kang phospholipase le trypsin, elastazin le moemeli oa chymotrypsin li kena ka har'a lithane tsa manyeme. Kaofela ha bona ba mothating oa kholo ea bona ha ba sebetse. Ts'ebetso ea bona e etsoa tlasa ts'usumetso ea trypsinogen le kallikrein ka li-ducts tsa bile. Ho thehoa li-peptide tse tlohang moo, tse ka bolaang litho life kapa life tsa limolek'hule, ho kenyeletsa le manyeme ka boeona.

Haeba ts'ebetso ea li-enzymes e senyehile, e kenngoa sebakeng sa li-pancreatocytes mme ts'ebetso ea ho fifala ka hare (necrosis) e qala. Ka lebaka la sena, lisele tsa serotonin le mast li ntšoa liseleng tse shoang ka bongata, tse ntseng li mpefatsa edema le spasm ea methapo ea mali. Ts'ebetso ea ketane e qala, e ka emisoang feela ka ho kenella kahare ho lithethefatsi tse khethehileng.

Matšoao a pancreatic necrosis le setšoantšo sa kliniki ea lefu lena

Maemong a mangata, pancreatic necrosis e hlaha ka potlako. Mokuli o qala ho khathatseha ka tšohanyetso qalong ke ho ikutloa a le boima ka mpeng le ho nyekeloa ke pelo, 'me hamorao ho fetoha ho hlatsa hangata. Ho na le bohloko bo boholo ba hypochondrium ka ho le letšehali. Hangata bohloko bo tšoana le senyepa - ha halofo eohle e kaholimo ea mmele e potlaka ka tlase ho likhopo. Ka poso ea kahare ea pancreatic necrosis, matšoao a ka tšoana le matšoao a lefu la pelo. Letšoao le nang le litšobotsi - bohloko bo ka khanya lehetleng le ka tlasa lehare.

Ho fihlela bofokoli ba letšoao la bohloko, mokuli o atleha feela maemong a lutseng a maoto a khumameng mangole a huleloang ka mpeng. Sena sohle se ka tsamaisana le:

• Keketseho ea mocheso oa 'mele ho linomoro tse tlase,
• ho hlatsa khafetsa, ka mor'a moo ea kulang ha a imoloha,
• redding ea letlalo kapa pallor ea bona e sethaleng sa nts'etsopele ea ho oa ha vascular,
• keketseho ea boemo ba pancreatic amylase nakong ea liteko tsa mali a biochemical le urine,
• ponahalo ea libaka tsa letlalo la kutloelo-bohloko bo eketsehileng (hyperesthesia).

Khahlano le semelo sa pancreatic necrosis, phlegmon ea ka mpeng, ascites, e ka ba teng. Maemong a tebileng, ho kenella ha mokelikeli ho bonoa ka har'a litho tsa "pericardial membrous", tse thatafatsang mosebetsi oa pelo le methapo e kholo. Ka nts'etsopele ea matšoao a pancreatic necrosis, ho kenngoa ha hemorrhagic ka har'a pleural cavity.

Ka tšenyo ea lisele tsa islet, lisele tsa tsoekere ea mali li eketseha ka sekhahla, e leng se ka lebisang ho nts'etsopele ea hyperglycemic coma. Letšoao le nang le "pancreatic necrosis" ke ponahalo ea matheba a lefifi a maputsoa libakeng tse morao tsa lebota la mpa ea ka ntle. Letšoao lena le bitsoa Grey-Turner. Ka lefu la Grunwold's, mats'oafo a cyanotic le a krimsone a ka fumanoa ho potoloha mothapo oa lesapo la mokokotlo, 'me haeba makhopho a boputsoa mokokotlong le ka tlas'a likhopo ka morao, ho tla theha lefu la Davis.

Boloetse bona bo thehiloe boteng ba ho hlatsa khafetsa hoa bile khahlano le bohloko bo matla ba herpes zoster. Sena se ka tsamaisana le ho thunya le ho boreleli. Ka nako e ts'oanang, palpation ea lebota la mpa ea anterior sebakeng sa epigastric le hypochondrium e nepahetseng ha e fane ka letšoao le joalo la bohloko, leo mokuli a belaelang ka lona. Bohloko hangata bo thata ebile bo sa mamellehe. Bakuli ba na le maikutlo a tukang ho tloha ka morao le hanyane ka letsohong le letona la mpa.

Tšobotsi ea pancreatic

Manyeme ke tšoelesa e kholo ka ho fetisisa 'meleng oa motho. E etsa mesebetsi e 'meli ea bohlokoa ka nako e le' ngoe - e hlahisa li-enzyme tse hlokahalang ho sililoa ke liprotheine, mafura le lik'habohaedreite, le li-hormone tsa sephiri tse khothalletsang tsoekere ea tsoekere le ho laola tsoekere ea mali.

Meroho ea "pancreatic" e hlahisoa kahara gland 'me e tšeloa ka har'a duct ea mantlha moo duodenum, moo ba nkang karolo molemong oa ho thula lijo. Li-enzyme tsena li sebetsa haholo 'me li khona ho hlakola mafura le liprotheine tsohle tsa tlhaho le limela, hammoho le lik'habohaedreite tse bonolo le tse rarahaneng.

Mefuta e joalo ea manyeme e hlalosoa ke palo e kholo ea li-enzyme tse bolokiloeng ke lisele tsa eona. Ka hona, lingaka li re makhopho ke litho tsa bohlokoa, kantle le hore ts'ebetso e tloaelehileng ea 'mele ha e khonehe.

Sebopeho le thepa ea lero la pancreatic:

1. Amylase - e ea hlokahala bakeng sa hydrolysis ea lik'habohaedreite, haholo-holo starch le glucose glycogenado,
2. Lipase - e hlakola mefuta eohle ea mafura, li-polyunsaturated le tse mafura acid hammoho le livithamini tsa motsoako o mafura a A, D, E, K,
3. Pancreatic elastase ke eona feela enzyme e ka robehang likhoele tsa elastin le collagen ka har'a lithane tse sebetsang.
4. Nuc tafadhali - e kenyelletsa li-enzyme tse ngata (exonuclease, endonuclease, ribonuclease, deoxyribonuclease, fokotsa, joalo-joalo) tse hlokahalang bakeng sa li-acid tsa hydrolysanucleic acid, ho kenyelletsa DNA le RNA,
5. Carboxypeptidase, trypsin le chymotrypsin - hlakola mefuta eohle ea liprotheine ho lokolla li-amino acid.

Ho itšehla thajana ka nako e loketseng ea li-enthanme tsa "pancreatic" ho kenya letsoho ho boliseng makhopho. Tsamaiso ea methapo ea kutlo ea parasympathetic, kutloelo-bohloko le metasympathetic ka sebopeho sa methapo ea vagus, methapo e kholo ea leqele, celiac nerve plexus le ganglia ea maiketsetso li ikarabella bakeng sa eona.

Ke karolo ea tsamaiso ea methapo ea kutlo, ke hore, e sebetsang ntle le taolo e tsoang likarolong tse holimo tsa bokong.

Sena se bolela hore ha o ntse o ja lijo, o ipatlela sechu ea othomathiki ea pancreatic, ntle le boiteko ba kelello ho motho.

Ts'oaetso

Ho hlahlojoa ha lefu la pancreatic necrosis ho lokela ho etsoa kapele kamoo ho ka khonehang, kaha ka lefu lena motsotso o mong le o mong o theko e boima. Ntle le gastroenterologist, ngaka e buoang le e hlasimollang e boetse e kenya letsoho tlhahlobong ea mokuli, ea hlahlobang ho teba ha boemo ba mokuli mme a nka mehato eohle e hlokahalang ho pholosa bophelo ba hae.

Mokhoa oa bohlokoahali oa mekhoa eohle ea ho hlahloba lefu lena ke ho tseba hore na enjine ea "pancreatic enz" e maling le moroto ke eng, haholo-holo tlhahlobo ea amylase. Haeba karolo e phahameng ea enzyme ena e fumanoa maling a motho, sena se bontša ka ho toba nts'etsopele ea pancreatic necrosis.

Mokhoa o mong oa bohlokoa oa ho hlahloba lefu ke tlhahlobo ea mali bakeng sa palo ea lisele tse tšoeu tsa mali le sekhahla sa erythrocyte sedimentation. Haeba matšoao ana a phahame haholo, joale sena se bontša tsela ea ts'ebetso e matla maling a mokuli.

Ntle le moo, haeba ho belaelloa ka pancreatic necrosis, mokuli o romelloa hang-hang bakeng sa tlhahlobo ea ultrasound, e u lumellang hore u hlahlobe ka botlalo boemo ba ho ruruha ha pancreatic, 'me u bone li-contours tse futhumetseng le sebopeho se sa lekanang sa sebopeho sa tishu necrosis.

U sebelisa k'homphieutha e sebelisitsoeng ka mokokotlo (CT) le imagonance imaging (MRI), u ka fumana setšoantšo se hlakileng sa tšoelesa e kulang ho feta ka ultrasound. Ka hona, mekhoa ena ea ho hlahloba hangata e sebelisetsoa ho tseba hore na necrosis e hokae, ho kenyeletsoa lintho tse nyane, hammoho le ho fumana ho ata ha lefu lena linthong tse haufi le litho.

Angiography ke mokhoa oa ho etsa lipatlisiso o o lumellang ho bona tlolo ea phepelo ea mali libakeng tsa manyeme a anngoeng ke necrosis, hape le ho fumana phallo ea methapo ea mali ea bohlokoahali, haholoholo methapo ea methapo ea hepatic le gastro-duodenal.

Ntho ea pele e lokelang ho etsoa ka pancreatic necrosis ke ho fa makhopho a phomolo ka botlalo. Bakeng sa sena, mokuli o thibetsoe ka thata ho etsa ntho leha e le efe ea 'mele, ho ja lijo le lino leha e le life. Phepo e nepahetseng ea mokuli e etsoa feela ka methapo.

Ka lefu lena, hangata mokuli o etsoa ho hlatsoa mpa ka metsi a pholileng e le hore a tlose litšila tsa lijo ka botlalo. Sena se o lumella ho emisa ts'ebetso ea tšilo ea lijo le ho fokotsa tlhahiso ea li-enzyme tsa pancreatic.

E 'ngoe ea maemo a bohlokoa ka ho fetisisa bakeng sa kalafo ea ho bola ke pancreatic ke ho tlosoa ha bohloko bo boholo. Bakeng sa morero ona, ho sebelisoa mefuta e fapaneng ea meriana ea bohloko, e kang analgin, baralgin le amidopyrine, e fuoang mokuli ka ente ea methapo.

Hape, molemong oa anesthesia, li-droppers tse tsoang motsoako oa glucose-novocaine ka boholo ba litha e le ngoe tsa 1-2 li sebelisoa. ka letsatsi. Ka bohloko bo sa mamelleheng, mokuli o fuoa novocaine blockade, e felisang li-syndromes tsa bohloko bo boholo mme eu lumella ho fumana phello ea analgesic hang-hang.

Ho imolla bohloko bo bakoang ke spasm ea setho se amehang, antispasmodics, mohlala, papaverine, nopa, platifillin, e fuoa motho. Ntle le moo, mokuli o fuoa lengolo la ngaka ea ho hlapolla, joalo ka lasix le furosemide, tse tlatsetsang phomolong e phethahetseng ea khase ea pancreatic.

Bohlokoa haholo bakeng sa kalafo ea lefu lena le kotsi haholo ke tšebeliso ea lithibela-mafu, tse loantšang ts'ebetso ea ho ruruha le ho senya libaktheria tsa pyogenic tse eketsang tšenyo ea setho. Hape, mokuli ea nang le pancreatic necrosis o khothalletsoa hore a noe li-antihistamines tse potlakisang ho kokobetsa tishu edema.

Phekolo ea pancreatic necrosis e lula e kenyelletsa ho buuoa, ho etsoang feela ka letsatsi la bohlano, kamora ho kena sepetlele ho mokuli. Ka nako ena, lingaka li khona ho emisa ts'ebetso ea ts'oaetso, ho thibela ho ata ha lefu lena liseleng tse phetseng hantle le ho fokotsa kotsi ea mathata a ts'ebetso ea postoperative.

Nakong ea ts'ebetso ea manyeme, mokuli o tlosoa a shoele, likarolo tse omisitsoeng tsa 'mele, a sa kenngoe mali, hape o khutlisa ho tsoa ka bongata ha li-enzymes tsa pancreatic. Maemong a tebileng a lefu lena, mokuli a ka hloka ho kenella ka makhetlo a 'maloa.

Hape, nakong ea kalafo ea pancreatic necrosis, ho etsoa mekhoa e fapaneng ea bongaka e lokelang ho tsosa litho tsa ka mpeng le ho sireletsa mokuli ho hloleha ha litho tse ngata. Tsela e akaretsang ea kalafo sepetlele e ka nka likhoeli tse 'maloa.

Setsebi sa video sehloohong sena se tla bua ka pancreatic necrosis.

Sebopeho sa nalane ea manyeme

Makhopho a makhopho a hlahisa lilithara tse 1.5 tsa lero la pancreatic ka letsatsi. Ntle le eena, e kholo, e rarahaneng ebile e arotsoe ke litšoelesa tse ling tsa 'mele tse hlahisang boholo ba secretion li kenyeletsa mammary, lacrimal, salivary e kholo.

The anatomy ea gland e bakiloe ke ts'ebetso e habeli eo e e etsang: endocrine le tšilo ea lijo. Sena se ka etsahala ka lebaka la sebopeho sa nalane ea parenchyma ea setho. E na le:

• Ho tsoa ho lobules (acini), e arotsoe ke separa sa tishu se kopanang, moo likepe, likhoele tsa methapo, lihloba tse nyane tsa pancreatic li fetang,
• lihlekehleke tsa Langerhans tse lipakeng tsa sebaka seo. Li etselitsoe tikoloho ho pholletsa le lithane tsohle tsa boea ka bongata bo fapaneng, empa boholo bo boholo bo oela mohatleng oa setho.

Acinus e nang le li-ducts tse nyane tse amanang le eona ke motheo oa karolo ea bohlasoa ea manyeme. E na le:

• li-pancreatocytes tse tsoang ho 8−12 lisele tsa sebopeho se nang le sebopeho, se ts'oaretsoeng ke litebele tsa tsona ho fihlela setsing,
• duct lisele tsa epithelial: ha li kopana, ho thehoa sistimi ea ho ikatisa.

• mamina a asiti,
• mahareng
• tse ling,
• interlobar
• tloaelehileng wirsung duct pancreas.

Sebopeho sa mabota a marang-rang a itšetlehile ka boholo ba mohoalo ka booona. Wirsung, e haola le bolelele bohle ba tšoelesa, ho na le lisele tsa "gblet" leboteng tse patang likarolo tsa lero la pancreatic ebe li nka karolo ho li- regulation tsa lehae tsa endocrine.

Lihlekehleke tsa Langerhans li emela karolo e nyane haholo, empa ha e bohlokoa joalo joalo.

Nalane e khuts'oanyane ea nalane ea sehlekehleke sena: e na le mefuta e mehlano e mehlano ea lisele tse bolokang lihormone tse ngata.Mofuta o mong le o mong oa sele ke bophahamo bo fapaneng le sebaka sa sehlekehleke sena mme o hlahisa li-hormone tse itseng:

• alpha (25%) - glucagon,
• beta (60%) - insulin,
• Delta (10%) - somatostatin,
• PP (5%) - polypeptide (vIP) e holofatsang ea intestine le pancreatic polypeptide (PP),
• lisele tsa epsilon (ka tlase ho 1%) - ghrelin.

Lisele tsa Beta li bohareng, tse ling li li pota-potile haufi le paramente.

Ntle le mefuta ena e ka sehloohong, lisele tsa acinoislet tse nang le endo- le mesebetsi ea exocrine li fumaneha ka lehlakoreng.

Phepelo ea mali ea arterial

Makhopho a pancreas ha a na likepe tsa hae tsa ntoa. Ts'ebetso ea phepelo ea mali e tsoa ho aorta (karolo ea eona ea ka mpeng). Hlooho ea celiac e tsoa ho eona, e arohana le likepe tse fanang ka mali a arohaneng ho manyeme. Ba theha marang-rang ohle a li-arterioles tse nyane le calter. Kakaretso e kenelletseng maling a phallo ea mali:

• likepe tse ka holimo tse ka ntle le tse ka morao tsa manyeme,
• artery e tlase ea pancreatoduodenal e nang le makala a ka ntle le a ka morao,
• methapo e tlase ea pancreatic,
• dorsal pancreatic
• artery ea mohatla.

E 'ngoe le e' ngoe ea lijana tsena e kenya makala ka har'a methapo ea methapo e nyane ho fihlela li-arterioles tse nyane haholo tse kenyelletsang phepelong ea mali ho lobule ka leng la manyeme.

Ho lutla ha Lymphatic ho etsoa ka methapo ea methapo e tsamaeang haufi le methapo ea mali: lymph e phallela kahare ho li-pancreatoduodenal le li-pancreas lymph node, ebe li kenella ho celiac le splenic.

Phello e ntle

Ho tsoa ho li-lobules le lihlekehleke, mali a venous a ntlafalitsoeng ka har'a khabone e kenella ka har'a marang-rang a methapo ea methapo le methapo e kenang tsamaisong ea vena cava e tlase le venal. Qalong, mali a feta:

• ka mesenteric (holimo le tlase),
• methapo ea splenic
• gastric ea letsohong
• portal

Madi a venous kamora ho feta hara sebete a kenella ka har'a vena cava e kenang ka pelong e nepahetseng, a tlatsa potoloho e kholo ea phallo ea mali.

Mathata a potoloha ka pancreatic

Ho thata ho tseba hore na mathata a ho potoloha le lefu la pancreas ke afe. Psychology e joalo ha e ikemele, empa e hlaha ka lebaka la mafu a matla a methapo ea pelo. Maemong a joalo, matšoao a lefu lena le ka tlase a hlaha.

Tlhahlobo eo e etsoa ka ho nahanela mafu a teng le ho fokotseha hoa phallo ea mali. Li baka phetoho ho parenchyma ka lefu le liehang ho hlaha la lisele tse tloaelehileng tsa pancreatic ebe li li nkela li-tisy tse sebetsanang - li-fibrosis li nts'etsapele, mesebetsi eohle ea litho ha e senyehe. Makhopho ke setho se amehang ka litšusumetso tse nyane tsa kantle le tsa ka hare. Phetoho efe kapa efe ea phepelo ea mali kapa phepo e nepahetseng e lebisa ho ho kula haholo.

Lisosa le matšoao a mathata

Liphetoho linthong tsa manyeme li amahanngoa le litšoaetso tsa potoloho tse etsahalang:

• ka atherosulinosis,
• ka ho nyekeloa ke pelo,
• le khatello ea mali ea methapo ka lebaka la atherosulinosis.

Sesosa e kanna ea ba mellitus ea butle-butle le ea nako e telele e tsoetseng pele, kapa pancreatitis e bohloko e hlahang ka tšohanyetso ntle le lebaka le hlakileng. Ntho e susumetsang ke infarction ea myocardial.

Pancreatic vascular thrombosis e kotsi. Thrombosis e thatafatsa khatello ea maikutlo e teng, thrombophlebitis, infarction ea myocardial. Ho tšoenyeha ka potoloho ho etsahala ka atherosclerosis, ha marako a methapo ea mali ea likhalase tse fapaneng a fetoloa.

Ka ho nyekeloa ke pelo ho teng, tlolo ea mali e tsoang kapele, e isang pancreatic edema, keketseho e kholo ea boholo ba eona le ho se sebetse hantle. Ts'ebetso ea ho ruruha e etsahala ho parenchyma, e netefalitsoeng ke keketseho e sa rateheng ea mali le diinease tsa moroto.

Ntho e kotsi ka ho fetisisa e bakang tlolo ea mali ke joala. E baka tsitsipano e phehellang ea likepe tse nyane, ka lebaka leo lisele tsa 'mele li khaotsang ho fumana limatlafatsi tse hlokahalang le oksijene. Sena se lebisa lefung la bona mme se ka baka necrosis e felletseng.

Pathology ea kalafo

Ha ho na kalafo e tobileng bakeng sa phallo ea mali e senyehileng le liphetoho tse hlahisitsoeng makhophong. Boloetse bo ka tlase bo a phekoloa. Ka lefu lena le le hole haholo, ha liphetoho tsa ho ruruha kapa tsa necrotic li qala ho pancreas parenchyma, e netefalitsoeng ke lithuto tse sebetsang le tsa laboratori, kalafo e rarahaneng ea pancreatitis e laetsoe. E kenyeletsa:

• lijo tse qobelloang - linomoro tsa tafole ea 5,
• pheko ea enzyme
• ha ho hlokahala - antispasmodics, painkiller le lithethefatsi tse thibelang tlhahiso ea hydrochloric acid.

Haeba kalafo e sa tšoaroe, le haeba ho na le mathata a mangata a potileng, lefu la tsoekere le fetoha ha nako e ntse e tsamaea. Sena se bakoa ke lefu la lihlekehleke tsa Langerhans le ho felisoa ha motsoako oa hormone ea sehlooho - insulin.

Litlamorao tsa tšenyo ho bolulo ba manyeme

Pancreas parenchyma e na le marang-rang a marang-rang a methapo ea kutlo. Makhopho a pancreas, joalo ka litho tsohle, a laoloa ke tsamaiso ea methapo ea kutlo - makala a methapo ea kutlo ea vagus (n. Vagus dexter). Ba laola ts'ebetso ea exocrine - tlhahiso le secretion ea li-enzyme. Litlhaselo tse tsoang methating ea methapo ea kutlo li khothaletsa tlhahiso ea li-enzyme.

E hokahanngoa le lefapha le nang le kutloelo-bohloko ka likhoele tse nyane tse tsoang liplelelong:

• splenic
• hepatic
• celiac
• holimo mesenteric.

Karolo e nang le kutloelo-bohloko ea tsamaiso ea methapo e lebisa ho litlamorao tse fapaneng: ho ts'oaroa ha kutu ea celiac ho baka ho felisoa ha secretion ea lero la pancreatic. Empa ho pepesetsoa nako e telele liseleng tsa stem ho tsamaisana le secretion ea li-enzyme.

Lisebelisoa tsa mali tse fanang ka mali ho manyeme li amahanngoa le likhoele tse nang le kutloelo-bohloko: li laola molumo oa marako a venous.

Li-lulules, tse nang le lisele tsa glandular tse hlahisang secretion ea pancreatic ka li-enzyme, li aroloa ke li-partitions, moo ho behiloeng 'mele e ikhohomosang ea Fater-Pacini.

Lihlekehleke tsa Langerhans, tseo lisele tsa tsona li etsang lihormone tse 11 tsa bohlokoa, li na le karolo e arohaneng le acini ke lisele tsa sehlopha sa methapo ea kutlo.

Tšenyo ea methapo maemong afe kapa afe e lebisa ho nts'etsopele ea maloetse a hemodynamic le neurovegetative ho manyeme. Sena ha se bake phetoho e kholo eseng sebeng feela, empa le litho tse ling tse amanang le eona. Phekolo maemong a joalo e rarahane ebile e nka nako e telele.