Yini i-insulinoma, izimpawu eziyinhloko nokwelashwa

-Delile

• Izimpawu eziyinhloko
• Ukuxilongwa kwenziwa kanjani
• Izinketho zokwelashwa
• 1. Ukuhlinzwa
• 2. Imithi ye-Hormonal kanye nabalawuli be-insulin
• 3. Ukwelashwa ngamakhemikhali
• 4. Ukudonswa kwe-ablation kanye nokuhlanganiswa komzimba
• Izimbangela ezingaba khona

I-Insulinoma, eyaziwa nangokuthi i-islet cell tumor, iwuhlobo lwesimila kuma-pancreas, anobungozi noma amabi, akhiqiza i-insulin eyeqile, okwenza ukuba ushukela egazini wehle, kukhiqize i-hypoglycemia. Izimpawu ezibangelwa yilesi isimila kungaba yisiyezi, ukudideka kwengqondo, ukuthuthumela nokushintsha kwemizwelo futhi kwenzeka ngenxa yokwehla kweglucose egazini.

Ukuxilongwa kwe-insulinoma kwenziwa i-endocrinologist noma i-oncologist ngokuhlolwa kwegazi, njengokuhlolwa kokuzila ukudla kwe-glucose kanye ne-imaging, okungabalwa njenge-tomography, imaging resonance imaging noma ukuskena kwesilwane sasekhaya, kanti ukwelashwa okufanele kakhulu ukuhlinzwa, ama-hormone emithi nokulawula igazi amazinga kashukela, kanye ne-chemotherapy, i-ablation noma i-embolization.

Izimpawu eziyinhloko

I-Insulinoma wuhlobo lwesimila esitholakala kumanyikwe oluguqula amazinga kashukela egazini, ngakho-ke, izimpawu eziyinhloko zihlobene nokunciphisa ushukela wegazi, obizwa nge-hypoglycemia, njenge:

• Umbono ophuthelwe noma ophindwe kabili;
• Ukudideka kwengqondo;
• Isiyezi;
• Ukuzizwa ubuthakathaka;
• Ukucasuka ngokweqile;
• Ukushintsha kwemizwelo;
• Ukuquleka;
• Umjuluko obanda ngokweqile.

Ezimweni ezinzima kakhulu, lapho i-insulinoma seyithuthuke kakhulu futhi ithinta ezinye izingxenye zomzimba, njengesibindi, ubuchopho nezinso, izimpawu ezifana nokuquleka, ukukhuphuka kwenhliziyo, ukulahlekelwa ukwazi, ukuquleka kanye ne-jaundice kungavela. Funda kabanzi nge-jaundice nokuthi ungayibona kanjani.

Ukuxilongwa kwenziwa kanjani

Ukuxilongwa kwe-insulinoma kwenziwa ngokuhlolwa kwegazi, okumele kwenziwe esiswini esingenalutho, ukuthola inani le-glucose ne-insulin egazini futhi, ngokuvamile, amanani we-glucose aphansi namazinga e-insulin aphezulu. Bona ukuthi kwenziwa kanjani ukuhlolwa kweglucose egazini ngokuzila kanye namanani wenkomba ejwayelekile.

Ukuthola indawo okuyo ngqo, ubukhulu nohlobo lwesimila kumanyikwe nokuhlola ukuthi i-insulinoma isisabalalele yini kwezinye izingxenye zomzimba, ukuhlolwa kwe-imaging okufana ne-computed tomography, imaging resonance imaging noma ukuskena kwezilwane ezifuywayo kukhonjiswa yi-endocrinologist noma oncologist.

Kwezinye izimo, udokotela futhi angahle ahlele ezinye izivivinyo ukugcwalisa ukuxilongwa futhi azi ubukhulu besimila njenge-endoscopy, esetshenziselwa ukuhlola ukuthi ngabe isimila sesifikile ngaphakathi esiswini noma emathunjini, naku-arteriography, ekhomba ukugeleza kwegazi emanyikwe.

Izinketho zokwelashwa

I-Insulinoma wuhlobo lwesimila emanyikwe, okungaba nobungozi noma kube yingozi, okuholela ekuguqulweni kwamazinga kashukela egazini, futhi uma yelashwa kusenesikhathi iyelapheka. Ukwelashwa kwalolu hlobo lwesifo kuboniswa yi-oncologist futhi kuncike endaweni, usayizi nesigaba sesimila, kanye nokuba khona kwe-metastases, futhi kunganconywa:

1. Ukuhlinzwa

Ukuhlinzwa uhlobo oluhle kakhulu lwezokwelapha i-insulinoma, kodwa-ke, uma isimila esikwimanyikwe sikhulu kakhulu, sesisabalele kwezinye izingxenye zomzimba noma umuntu enempilo ebuthakathaka, udokotela angahle angakutusi ukuhlinzwa. Uma kwenziwa ukuhlinzwa, isiguli singadinga ukusebenzisa ipayipi, elibizwa ngokuthi i-penrose, ukuqeda uketshezi oluqongelelwe ngesikhathi sokuhlinzwa. Bona okuningi ukuthi ungawunakekela kanjani umsele ngemuva kokuhlinzwa.

2. Imithi ye-Hormonal kanye nabalawuli be-insulin

Eminye imishanguzo ingasetshenziswa ukwelapha i-insulinoma, njengezidakamizwa ezinciphisa noma zinciphise ukukhiqizwa kwamahomoni enza isimila sikhule, njengezifaniso ze-somatostatin, ezibizwa nge-octreotide ne-lanreotide.

Eminye imishanguzo ekhonjisiwe ekwelapheni lolu hlobo lwesifo ngamakhambi asiza ukunciphisa amazinga e-insulin egazini, okugwema ukwehla kwe-glucose ngokweqile. Ngaphezu kwalokho, ukudla okunoshukela ophezulu kungenziwa ukuze amazinga kashukela ajwayelekile.

3. Ukwelashwa ngamakhemikhali

I-chemotherapy inconywa yi-oncologist ukuthi yelaphe i-insulinoma nge-metastasis futhi iqukethe ukusetshenziswa kwezidakamizwa emthanjeni ukuze kubhubhise amaseli angajwayelekile, aholela ekukhuleni kwesimila, kanye nenani lamaseshini nohlobo lwemithi okufanele ibe esetshenziswa kuncike ezicini zesifo, njengosayizi nendawo.

Kodwa-ke, izidakamizwa ezisetshenziswa kakhulu ukuqeda amaseli e-insulinoma yi-doxorubicin, i-fluorouracil, i-temozolomide, i-cisplatin ne-etoposide. La makhambi ajwayele ukuphathwa ku-serum, ngokusebenzisa ipayipi lomthambo emthanjeni futhi, kwezinye izimo, kungasetshenziswa angaphezu kwelilodwa, kuye ngomthetho olandelwayo osungulwe ngudokotela.

4. Ukudonswa kwe-ablation kanye nokuhlanganiswa komzimba

I-Radiofrequency ablation wuhlobo lokwelashwa olusebenzisa ukushisa, okwenziwa amagagasi omsakazo, ukubulala amaseli e-insulinoma agulayo futhi ilungele kakhulu ukwelapha izicubu ezincane ezingasabalali ziye kwezinye izingxenye zomzimba.

Njengokwehla kwe-ablation, ukuhlanganiswa kwemithambo yegazi kuyindlela ephephile nehlasela kancane, enconywe yi-oncologist ukwelapha i-insulinomas encane futhi ifaka ukusetshenziswa ketshezi oluthile, nge-catheter, ukuvimba ukugeleza kwegazi ku-tumor, kusiza ukuqeda amaseli agulayo .

Izimbangela ezingaba khona

Izimbangela ngqo ze-insulinoma azikachazwa ngokuphelele, kepha zivame ukukhula kakhulu kubantu besifazane kunamadoda, kubantu abaphakathi kweminyaka engama-40 nengama-60 ubudala futhi abanezifo ezithile zofuzo ezifana nohlobo 1 lwe-neurofibromatosis noma i-tuberous sclerosis. Funda kabanzi nge-tuberous sclerosis nokuthi ilashwa kanjani.

Ngaphezu kwalokho, ukuba nezinye izifo ezifana ne-endocrine neoplasia, edala ukukhula okungajwayelekile kwamaseli ohlelweni lwe-endocrine, kanye ne-Von Hippel-Lindau syndrome, ezuzwe njengefa futhi eholele ekubukekeni kwama-cysts emzimbeni wonke, kungandisa amathuba okubonakala kwe-insulinoma .