Qhov ua tiav yog qhov tshwj xeeb ntau yam khoom nruab nrog. Qhov no yog tib lub caj pas ntawm lub cev uas qhov ua haujlwm exocrine thiab endocrine ua. Cov hlav hlav ua mob lossis cov hlav qog ua paug tuaj yeem tshwm sim hauv lub cev ua qab txiav. Feem ntau ntawm cov carcinomas hauv xyoo tsis ntev los no yog cov hlav qog nqaij hlav hlav phem uas nthuav tawm los ntawm exocrine caj pas cell.
Tus txiv neej yog feem ntau ua rau mob cancer. Kev txheeb xyuas cov neoplasm yog qhov nyuaj heev. Tus kab mob oncological ntawm lub plab zom mov plab yog qhov txhoj puab heev, uas yog vim li cas nws yog qhov tseem ceeb uas yuav tau them sai sai rau thawj cov tsos mob txaus ntseeg thiab raug kuaj raws sijhawm. Kho cov qog nqaij hlav ntawm pancreatic yog qhov txheej txheem nyuaj.
Dab tsi ua kom mob cancer
Tib neeg lub cev, hmoov tsis zoo yog kev tsis zoo tag nrho thiab lub sijhawm twg muaj kev ua tsis zoo, uas yuav ua rau tsis muaj kev cuam tshuam loj hlob ntawm cov hlwb hloov pauv. Lub nruab zog tiv thaiv kab mob tsis kam ua rau cov hlwb zoo li no thiab tsis ntev ib tug neeg dhau los ua tus tswv ntawm tus mob oncological. Yuav kom tsis txhob raug kev txom nyem los ntawm oncology, cov laj thawj uas ua rau nws cov tsos yuav tsum raug cais tawm.
Tus nab npawb ntawm ntau yam cuam tshuam qhov tshwm sim ntawm xws li mob hnyav, uas yog:
- Kev siv ntau dhau ntawm cov luam yeeb uas ua rau muaj peev xwm nce ntawm carcinoma ntawm lub caj pas.
- Txheej txheem kev haus dej caw.
- Tsis muaj fiber ntau hauv cov khoom noj.
- Muaj keeb muaj feem.
- Lub xub ntiag ntawm tus kab mob pancreatitis thiab mob ntshav qab zib.
Tumor kev faib tawm
Hom mob neoplasms hauv cov plab hnyuv plab hnyuv siab raum: hom benign (piv txwv li, hno ntshav ntawm lub plab), malignant (pseudopapillary, thiab lwm yam). Neoplasms (cov qog endocrine) tuaj yeem muab faib raws li qhov chaw hauv zos (piv txwv, ntawm tus Tsov tus tw, lub taub hau), keeb kwm, kev ua haujlwm tsis taus. Neoplasms nyob rau hauv lub taub hau, lub cev, tw, ducts, islets ntawm Langerhans.
Raws li keeb kwm, lub qog yuav luag txhua lub sijhawm keeb kwm epithelial. Lub hauv paus tseem ceeb nyob rau hauv cov ntaub ntawv no tsis yog-epithelial cov ntaub so ntswg, cov hlab ntshav ntawm cov ntshav ncig thiab lymphatic. Tsis tas li ntawd, keeb kwm ntawm cov qog yuav ua rau dysontogenetic lossis metastatic hauv qhov.
Raws li kev ua haujlwm ntawm kev faib tawm neoplasms, ib qho xwm txheej yuav tshwm sim:
- tsis muaj kev ua txhaum;
- kev khiav hauj lwm tsis paub tseeb;
- muaj kev ntxhov siab nyob hauv kev ua haujlwm ntawm lub plab zom mov (hypofunction lossis hyperfunction).
Tsis muaj fiber ntau hauv cov zaub mov noj ua rau lub qog
Cov tsos mob
Feem ntau, cov tsos mob ntawm tus kabmob pancreatic oncology tuaj yeem lees paub tsuas yog nyob ntawm 4 qib ntawm tus kabmob. Tus neeg muaj qee yam kev hloov pauv hauv lub cev thaum lub sijhawm loj zuj zus ntawm lub hlwb neoplasm mus rau qhov ua kom pom kev zoo thiab nws kis mus ntxiv hauv lub cev. Raws li txoj cai, lawv kawm txog cov teeb meem thawj zaug ntawm ultrasound. Muaj ntau tus tsos mob uas tseem yuav pab txiav txim qhov pib ntawm tus kab mob. Nyob ntawm thaj chaw muaj mob qog nqaij hlav cancer, cov tsos mob piav qhia hauv qab no yuav ua kev kub ntxhov.
Cov cim ntawm qog taub hau pancreatic:
- kev ua kom pom kev daj ntseg;
- poob phaus;
- cov roj ntau ntau hauv cov quav;
- pheej hnov mob hauv plab.
Cov qog ntawm cov tw thiab lub cev yuav muab qhov mob me me hauv plab, poob tag. Mob kheesxaws ntawm lub taub hau ntawm tus txiav ua leeg paub thaum ntxov. Cov tsos mob ntawm oncology yog pancreatic-plab hnyuv hauv qhov, vim tias kev loj hlob ntawm cov neoplasm tshwm sim ze rau ntu tseem ceeb ntawm cov kua zaub mov.
Cov tsos mob ntawm cov qog nqaij hlav pancreatic zoo ib yam li cov cim ntawm malignant neoplasm. Lub ntsiab tseem ceeb yog lub ntsiab lus lig ntawm lub neoplasm, uas los ntawm lub sijhawm ntawd ncav cuag qhov loj me.
Cov tsos mob tseem ceeb ntawm cov qog yog:
- tsam plab;
- chim quav;
- bouts ntawm xeev siab;
- mob hauv plab;
- pallor ntawm cov quav thiab cov tsiaj rog tso rau hauv nws;
- tsaus zis.
Lub ntsiab ntawm cov tsos mob ntawm tus mob paj hlwb yog ib qho uas tsis qab los noj mov, lub siab ib txwm muaj qhov tsis xis nyob, txo lub cev qhov hnyav hauv lub sijhawm luv luv (cov neeg mob qog nqaij hlav, nrog rau mob pancreatitis, yog sab dhau lawm), cov ntshav qab zib ntxiv, khaus tawv nqaij thiab tawv nqaij. Tsis tshua muaj neeg mob oncological mob ua rau:
- ntuav
- hws
- kev xav ntawm tas li kev ntxhov siab vim;
- nquag tso zis;
- liab ntawm daim tawv nqaij ntawm lub ntsej muag;
- tsis kho neeg mob plab.
Cov qog feem ntau ua rau mob plab thiab ntuav.
Kev kuaj mob
Yuav kom kuaj mob kom sai thiab txiav txim siab txog hom mob qog, koj yuav tsum mus ntsib tus kws kho mob tshwj xeeb hauv kev phais mob, kws kho mob plab zom mov, kws kho mob tshwj xeeb hauv kev phais pob txha. Kev kuaj xyuas lub qog thaum tsis muaj cov qauv tshiab ntawm kev thaij duab thiab HLA kev ntaus pob qog yog qhov nyuaj. Txawm hais tias siv qhov zoo tshaj plaws apparatuses thiab cov tswv yim hauv kev kuaj mob tsis ib txwm tso cai cov ncauj lus kom ntxaws txog qhov raug mob hauv nruab nrog cev.
Txhawm rau kuaj mob oncology ntawm cov khoom hauv nruab nrog plab, kev kuaj ntshav biochemical, coprogram, kev tshawb fawb txog kev zais cia ntawm cov kua txiv hauv plab tau sau tseg. Ntxiv mus, raws li txoj cai, txoj kev tshawb nrhiav uas tsis muaj qhov tsis zoo yog tau txiav txim siab raws li hom mob gastrography, duodenography, sib nqus resonance pancreatocholangiography, pancreatic MRI, thiab biliary huam suav tomography.
Tom qab cov qog tau pom nyob rau hauv cov ntaub so ntswg thiab nws qhov loj me tau txiav txim siab (nws tuaj yeem hloov ntawm 2 txog 200 hli), cov kws kho mob tshwj xeeb los txiav txim siab txog qib ntawm cov tshuaj hormones (adrenaline, cortisol, gastrin, insulin, glucagon, thiab lwm yam), metabolites, thiab cov cim qog hauv cov ntshav ncig.
Yuav kom paub meej qhov xwm ntawm qhov chaw mob, cov tswv yim muaj peev xwm kuj siv tau, uas suav nrog:
- endoscopic retrograde cholangiopancreatography;
- celiography;
- txawj kho qhov muag ntuag;
- txia me me ntawm cov khoom hauv nruab nrog cev;
- laparoscopy.
Kev kuaj pom oncology yog ib qho nyuaj ua. Tsuas muaj tus qauv tseeb ntawm kev lees paub txog cov hlav tau ua kom pom tseeb. Kev sib txawv ntawm neoplasms hauv cov khoom ntawm lub plab zom mov yuav tsum tau nqa tawm:
- nrog kev mob caj dab ntev;
- mob hlab ntsws cyst;
- mob pob qij txha sab nraud;
- aneurysm ntawm cov hlab ntsha loj;
- echinococcosis;
- cysticercosis nrog qhov muaj qhov txhab ntawm qhov chaw hepatopancreatic.
Lub qog yuav ua tau ob qho tib si lossis hnyav.
Kev Kho Mob
Yuav kho kab mob qog nqaij hlav hauv lub plab zom mov li cas? Yog tias benign neoplasms tshwm sim, yuav tsum tau kho mob sai sai, uas yuav tsum suav nrog kev rov ua haujlwm ntawm lub plab hnyuv plab hnyuv plab hnyuv, rov qab ntawm lub taub hau ntawm cov khoom hauv nrog cev, pancreatoduodenal resection, enucleation ntawm lub neoplasm. Tom qab phais, nws yog ib qho kev ceev kom ua qhov kev kuaj keeb kwm. Qhov no yuav ua rau nws muaj peev xwm txiav txim siab seb hom mob qog.
Puas yog lub txiav tawm?Lub qog nqaij hlav uas muaj ntshav liab thiaj tuaj yeem kho tau txhua qhov los ntawm kev tshem tawm. Yog tias pom tias muaj cov hlav qog ua ntshav siab, ces hom kev kho kom raug xaiv coj mus ua qhov kev kuaj mob.
Nws yog qhov ua tau los nqa tawm pancreatoduodenal resection thaum tswj pyloric lub plab nyob rau hauv rooj plaub thaum tus neeg mob cuam tshuam los ntawm malignant carinoid lossis hormonally nquag mob qog nqaij hlav, uas yog nyob hauv thaj chaw ntawm lub taub hau ntawm lub txiav.
Yog hais tias tus neeg mob txom nyem los ntawm gastrinoma, ces nws raug nquahu kom coj tus mob gastrectomy, xaiv vagotomy, pancreatoduodenal resection. Qhov tau txais txiaj ntsig zoo ntawm kev phais mob no tseem ua rau muaj kev sib cav ntawm cov kws kho tus kws kho mob thiab kws phais neeg hauv lub tebchaws. Txoj kev kho nyuaj ntawm cov neoplasm ntawm lub plab system nrog kev kho polychemotherapy thiab hluav taws xob kho.
Cov palliative hom kev kho mob qog nqaij hlav ua rau nws tuaj yeem rov qab qib ntawm cov dej tawm ntawm cov kua tsib thiab cov kua txiv kab mob, ua kom tshem tawm cov mob o nyob rau hauv txoj hnyuv thiab txhim kho kom zoo. Hauv kev ua tiav lub hom phiaj palliative, tus kws kho mob tuaj yeem sau cov haujlwm hauv qab no:
- tso sab nraud ntawm cov kua tsib leeg;
- percutaneous transhepatic tso kua ntawm cov kua tsib;
- cholecystectomy;
- endoscopic bougienage ntawm cov qog qauv ntawm cov kab mob pheeb leeg pheeb leeg ntxiv, thiab lwm yam.
Ib txoj hauv kev khaws tseg ntawm kev kho tus mob neuroendocrine-hom neoplasm nrog cov tshuaj hormones qis yog qhia rau kev sib xyaw ntawm sandostatin thiab omeprazole. Hauv cov xwm txheej uas tus neeg mob txom nyem gastrinoma, cov kws kho mob tshwj xeeb ntxiv rau kev kho mob H2histamine receptor blockers thiab anticholinergic. Kev tshem tawm ntawm kev mob qog ua ntshav (neoplasm) tsis dhau mus ua kev tuaj yeem lav kho.
Tshem tawm cov mob qog? tsis yooj yim sua kom paub tseeb ntawm kev kho mob kom tiav
Kev twv ua ntej thiab Kev Tiv Thaiv
Hauv kev kuaj mob thaum kuaj pom tias qog hlav qog thaum kuaj mob, qhov kev ntsuas pom tsis zoo. Qhov no yog vim asymptomatic chav kawm ntawm tus kab mob, kev loj hlob ntawm neoplasms thiab nws kuaj pom feem ntau nyob rau theem kawg. Tsuas yog ib ntawm kaum tus neeg mob thiaj li yuav tshem tau cov leeg ntshav muaj roj.
Yog li, 50% ntawm cov neeg mob tiv thaiv mob, feem ntau tom qab kev phais mob, cov mob metastases deb tshwm sim. Cov kev kho mob ntau yam ua rau nws muaj peev xwm nyob ntau dua 5 xyoos tsuas yog 4-5% ntawm cov neeg mob. Lub sijhawm ua haujlwm tsis ib txwm muaj hauv qhov no yuav lav tau kom tshem tawm tus kabmob. Nws yuav tsis yooj yim rau kev ua mob nrog cov metastases. Yog tias pom ntawm lub qog benign, ib qho txiaj ntsig zoo tuaj yeem xav tau.
Yog li, 95% ntawm cov neeg mob tswj kom tshem tau tus kabmob kom tiav. Nws yog ib qho tseem ceeb heev uas yuav tsum tau ua raws li cov lus pom zoo ntawm tus kws kho mob, uas yuav pab kom kov yeej tus kab mob. Xws li, kev tiv thaiv ntawm oncology ntawm lub plab zom khoom siv tsis muaj nyob. Txawm li cas los xij, nws muaj peev xwm los txo qhov muaj feem ntawm qog noj los ntawm kev siv lub neej noj qab haus huv, noj zaub mov kom zoo thiab so kom txaus. Koj yuav tsum tiv thaiv koj kev noj qab haus huv thaum muaj hnub nyoog!
