Insulinoma imhando isingawanzo yebundu mupancreas inokura nekudhura kwemaseru anoburitsa insulin. Kuvapo kwayo ndiko kunokonzera dzimwe nguva kwakasimba hypoglycemia kurwisa. Kazhinji kazhinji nyoro uye diki muhukuru, bundu harisi nyore nguva dzose kuwana. Kubudirira kwekubviswa kwekuvhiya kwakakwirira.

tsananguro

Insulinoma ibundu repancreas, rinonzi endocrine nekuti rinokonzera insulin yakawandisa. Iyi hypoglycemic hormone inowanzogadzirwa nenzira yakarongeka nekirasi yemasero ari pancreas, beta masero, kuderedza mazinga eglucose eropa paanokwira zvakanyanya. Asi secretion ye insulin nebundu haina kudzorwa, izvo zvinotungamira kune episodhi yezvinonzi "basa" hypoglycemia muvanhu vane hutano, vasina chirwere cheshuga.

Inenge 90% ye insulinomas ari ega benign tumors. Chikamu chidiki chinoenderana neakawanda uye / kana mamota akashata - iwo ekupedzisira anosiyaniswa nekuitika kwemasastases.

Aya mapundu anowanzo madiki: mapfumbamwe kubva pagumi haapfuure masendimita maviri, uye matatu mugumi ari pasi pe2 cm.

Zvinokonzera

Iyo yakawanda ye insulinomas inoratidzika zvishoma nezvishoma, pasina chikonzero chakazivikanwa. Muzviitiko zvisingawanzoitiki, zvikonzero zvekugara nhaka zvinobatanidzwa.

chirwere

Kuvapo kwe insulinoma kunofanirwa kutariswa kana munhu asina chirwere cheshuga achiratidzira zviratidzo zvezviitiko zvinowanzoitika zve hypoglycemia pasina chimwe chikonzero chiri pachena (kudhakwa, renal, hepatic kana adrenal insufficiency, zvinodhaka, nezvimwewo).

Insulinoma inoratidzwa nekuderera kwakanyanya kweglucose yeropa yakasanganiswa neabnormally high insulin levels. Kuratidza izvi, tinodzidzira kutsanya bvunzo inotora maawa anodarika makumi manomwe nemaviri tiri pasi pekutariswa nachiremba. Kuongororwa kunobva pakuongororwa kweropa kunotorwa kana zviratidzo zve hypoglycemia zvikaitika. Muedzo unomiswa nekukurumidza kana mwero weglucose weropa uchidonha zvakanyanya.

Kufungidzira bvunzo kunozoitwa kuti uwane iyo insulinoma. Ongororo yereferensi ndeye echo-endoscopy, iyo inobvumira kunyatsoongorora kwerwatata uchishandisa chubhu inochinjika yakaiswa nekamera uye miniature ultrasound probe, inounzwa mukugaya system kuburikidza nemuromo. Mimwe miedzo yakadai seangio-scanner inogona kubatsirawo.

Pasinei nekufambira mberi mukufungidzira, kuwana mazamu maduku kunoramba kwakaoma. Iyo dzimwe nguva inoitwa mushure mekuvhiyiwa kwekuongorora nekuda kwepalpation yakasanganiswa neiyo intraoperative ultrasound, uchishandisa chaiyo ultrasound probe.

Vanhu vane hanya

Kunyangwe iri iyo inonyanya kukonzera bundu hypoglycaemia muvakuru, insulinoma inoramba iri bundu risingawanzo, richibata vanhu 1 kusvika 2 pamiriyoni yevagari (50 kusvika zana zviitiko zvitsva gore rega rega muFrance).

Kuongororwa kunowanzoitwa kutenderera zera remakumi mashanu. Vamwe vanyori vanocherekedza kushomeka kwevakadzi.

Zvinhu zvinotyisa

Kashoma, insulinoma inosanganiswa nerudzi rwekutanga endocrine neoplasia, chirwere chisingawanzogarwa nhaka chinoratidzwa nekuvapo kwemamota mune akati wandei endocrine glands. Chikamu chechina cheizvi insulinomas zvakashata. Ngozi yekuvandudza insulinoma yaizobatanidzwawo kune zvishoma nezvimwe zvirwere zvenhaka (von Hippel Lindau chirwere, Recklinghausen neurofibromatosis uye Bourneville tuberous sclerosis).

Zvikamu zveyakadzika hypoglycemia zvinowanzoitika - asi kwete zvakarongeka - mangwanani padumbu risina chinhu kana mushure mekurovedza muviri.

Mhedzisiro panheyo system yekushaikwa kweglucose 

Zviratidzo zvinosanganisira kunzwa kupera simba uye kusanzwa zvakanaka kana pasina chandaziva, kutemwa nemusoro, kuvhiringika kwekuona, kunzwa, hunyanzvi hwemotokari kana kubatana, nzara yekuerekana ... .

Idya hypoglycemic

Muzviitiko zvakanyanya kuoma, hypoglycemia inokonzera kungoerekana yatanga pakoma, yakawedzera kana kushoma kudzika uye kazhinji inoperekedzwa nekudikitira kukuru.

Zvimwe zviratidzo

Izvi zviratidzo zvinowanzobatanidzwa nezviratidzo zve autonomic reaction kune hypoglycemia:

• kunetseka, kudedera
• nausea,
• kunzwa kupisa uye kudikitira,
• pallor,
• tachychardia ...

   

Zvikamu zvakadzokororwa zve hypoglycemia zvinogona kukonzera uremu.

Kuvhiya kubviswa kwe insulinoma kunopa mhedzisiro yakanaka (yero yekurapa yakatenderedza 90%).

Apo bundu racho rimwechete uye rakanyatsogadziriswa, kupindira kunogona kutariswa zvakanyanya (enucleation) uye kuvhiyiwa kuduku kune dzimwe nguva kunokwana. Kana nzvimbo yacho isina kujeka kana muchiitiko chezvipembenene zvakawanda, zvinokwanisikawo kuita chikamu chekubvisa pancreas (pancreatectomy).

Kudzora shuga yeropa

Paunenge wakamirira kuvhiyiwa kana zviratidzo zvikaramba zviripo mushure mekuvhiyiwa, mishonga yakadai sediazoxide kana somatostatin analogues inogona kubatsira kudzivirira shuga yeropa kubva pakudonha zvakanyanya.

Kutarisana nekusashanda, zviratidzo kana kufambira mberi kwakashata insulinoma, kurapa kwakasiyana-siyana kwegomarara kunogona kuitwa:

• Chemotherapy inofanirwa kutariswa kuderedza bundu rakakura.
• Everolimus, immunosuppressive antitumor agent, inogona kubatsira kana hypoglycemia ikaramba iripo.
• Metabolic radiotherapy inoshandisa radioactive zvinhu zvinopihwa nevenous kana yemuromo nzira, iyo inonyanya kusunga kumaseru egomarara kuti avaparadze. Yakachengeterwa mabundu anoratidza mashoma metastases emapfupa uye / kana kukura zvishoma nezvishoma.