Koj puas muaj tej lub sij hawm koj xav tias koj lub cev tsis muaj zog, tawm hws, muaj qhov muag xiav, thiab kiv taub hau ? Qhov no yuav yog vim koj cov ntshav qab zib poob qis sai sai ( hypoglycemia ). Qhov no yog ib txwm muaj rau ib tus neeg uas muaj ntshav qab zib , xws li yog tias lawv noj tshuaj ntau dhau lossis tsis tau noj mov. Tab sis yog tias qhov no tshwm sim rau ib tus neeg uas tsis muaj ntshav qab zib txhua lub sijhawm, qhov ua rau yuav yog ib yam dab tsi uas koj tsis xav txog. Qhov ntawd yog ib qho mob tsis tshua muaj uas peb txhua tus yuav tsum paub txog, hu ua insulinoma .
Insulinoma yog dab tsi tiag?
Hais yooj yim xwb, insulinoma yog ib qho mob me me, feem ntau tsis yog mob qog nqaij hlav uas loj hlob hauv peb lub pancreas . Peb lub pancreas tsim ib hom tshuaj hormones hu ua insulin. Lub luag haujlwm ntawm cov insulin no yog tswj cov suab thaj (glucose) hauv cov ntshav.
Xav txog qhov no, feem ntau thaum peb lub cev cov piam thaj nce ntxiv, lub pancreas tsim cov insulin. Thaum peb cov piam thaj txo qis, nws tsis tsim cov insulin lawm. Nws zoo li lub khawm uas qhib/kaw thaum lub sijhawm zoo.
Tiam sis thaum cov qog no hu ua insulinoma tshwm sim, nws tsim cov insulin tas li . Zoo li lub qhov hloov pauv nyob rau hauv qhov chaw 'on'. Qhov tshwm sim yog tias insulin tseem tsim tawm txawm tias peb cov ntshav qab zib qis heev. Qhov no tuaj yeem ua rau peb cov ntshav qab zib poob qis heev. Vim tias cov qog no yog ua los ntawm ib hom hlwb tshwj xeeb (cov hlwb neuroendocrine), koj tus kws kho mob kuj tseem yuav hu lawv ua "cov qog neuroendocrine". Cov qog no feem ntau me me heev (tsawg dua ib nti) thiab ntau dua 90% tsis yog mob qog noj ntshav. Yog li ntawd, lawv tuaj yeem kho tau tag nrho nrog kev phais.
Cov tsos mob ntawm tus mob no yog dab tsi?
Vim tias cov insulinoma tseem tsim cov insulin, cov tsos mob yog tshwm sim los ntawm cov ntshav qab zib qis (hypoglycemia). Cov tsos mob no tuaj yeem tshwm sim sai sai.
| Cov tsos mob | Ib qho lus piav qhia yooj yim |
|---|---|
| Kev tsis meej pem | Tsis paub tseeb tias muaj dab tsi tshwm sim, koj nyob qhov twg, thiab koj kiv taub hau. |
| Kev tawm hws ntau dhau (Sweaty) | Cia li txias thiab tawm hws yam tsis muaj laj thawj. |
| Tsis muaj zog | Zoo li koj lub cev tab tom poob nws txoj sia, koj ob txhais ceg tshee hnyo. |
| Kev ntxhov siab thiab lub plawv dhia ceev dua | Ntshai yam tsis muaj laj thawj, zoo li koj lub hauv siab dhia ceev. |
| Mob taub hau hnyav heev | Mob taub hau hnyav heev tam sim ntawd. |
| Kev hloov pauv ntawm qhov muag pom kev | Tej yam xws li pom kev tsis meej, pom ob sab, thiab lwm yam. |
| Kev hloov pauv tus cwj pwm | Npau taws tsis muaj laj thawj, ua rau chim siab. |
| Qaug dab peg | Thaum koj cov piam thaj qis dhau, koj tuaj yeem muaj kev noj qab haus huv zoo. |
Qhov tseem ceeb tshaj plaws: Kev mob ntshav qab zib ntau dhau tuaj yeem ua rau muaj kev phom sij. Nws tuaj yeem ua rau tsaus muag lossis txawm tias tsis nco qab. Yog li ntawd, yog tias koj muaj cov tsos mob no, mus ntsib kws kho mob tam sim ntawd.
Dab tsi ua rau muaj insulinoma? Leej twg muaj feem yuav mob ntau dua?
Qhov ua rau muaj cov qog no tseem tsis tau pom tseeb, tab sis muaj tej yam uas yuav ua rau muaj kev pheej hmoo ntau ntxiv.
- Cov poj niam muaj tus cwj pwm siab dua li cov txiv neej me ntsis.
- Feem ntau nws raug kuaj pom tias muaj mob rau cov neeg hnub nyoog ntawm 40 thiab 60 xyoo .
- Cov neeg uas muaj tej yam mob caj ces kuj muaj feem yuav muaj feem ntau dua. Piv txwv li:
- Multiple endocrine neoplasia type 1: Ib qho mob uas cov qog tsim nyob rau hauv cov qog tsim cov tshuaj hormones.
- Von Hippel-Lindau syndrome: Ib qho mob uas cov qog nqaij hlav thiab cov qauv zoo li qog nqaij hlav ( cysts ) tsim nyob rau hauv ntau yam kabmob ntawm lub cev.
- Neurofibromatosis hom 1: Cov qog nqaij hlav uas tsis yog mob qog noj ntshav ntawm cov hlab ntsha thiab daim tawv nqaij.
- Tuberous sclerosis: Cov qog nqaij hlav uas tsis yog mob qog noj ntshav hauv cov kabmob xws li lub hlwb, qhov muag, lub plawv, thiab lub raum.
Tus kws kho mob nrhiav tau qhov no li cas?
Kev kuaj mob insulinoma tuaj yeem nyuaj me ntsis, vim tias cov tsos mob zoo ib yam li lwm yam kab mob uas tshwm sim, yog li nws yuav siv sijhawm ntev rau koj tus kws kho mob kuaj mob.
Qhov tseem ceeb tshaj plaws yog ua '72-teev kev yoo mov' . Hauv qhov no, koj raug kaw hauv tsev kho mob li ob mus rau peb hnub thiab tsis pub noj lossis haus dab tsi tsuas yog dej xwb. Lub sijhawm no, cov kws kho mob yuav kuaj xyuas koj cov ntshav qab zib thiab cov insulin tsis tu ncua.
Lawv tab tom sim ua kom paub tseeb peb yam no los ntawm kev sim no:
1. Koj puas muaj cov tsos mob ntawm cov ntshav qab zib qis (xws li kiv taub hau, tawm hws).
2. Thaum cov tsos mob ntawd tshwm sim, cov ntshav qab zib puas qis tiag?
3. Cov tsos mob puas yuav ploj mus thaum koj muab qee cov suab thaj (glucose) rau sab nraud?
Yog koj muaj insulinoma, koj cov ntshav qab zib thaum koj noj mov yuav qis heev, tab sis koj cov insulin yuav siab. Qhov no yog pov thawj tseem ceeb. Nrog rau qhov no, kev kuaj ntshav kuj tseem yuav nrhiav cov khoom xws li '(C-peptide)' thiab '(proinsulin)'.
Tom qab ntawd, kev kuaj duab raug ua kom paub tseeb tias qhov twg ntawm cov qog pancreatic nyob.
- Kev luam theej duab CT (CT scan)
- Kev kuaj mob ultrasound (Ultrasound)
- Kev kuaj MRI (MRI)
Cov kev kho mob rau qhov no yog dab tsi?
Txoj kev kho mob tseem ceeb thiab ua tau zoo tshaj plaws rau insulinoma yog phais kom tshem tawm cov qog . Feem ntau, tus kab mob no kho tau zoo tag nrho tom qab phais.
Hom kev phais mob yog nyob ntawm seb hom qog, qhov loj, thiab qhov chaw ntawm lub qog.
- Tshem tawm tsuas yog lub qog: Cov kws phais mob tuaj yeem ua tib zoo tshem tawm tsuas yog lub qog yam tsis ua rau lub txiav ua puas.
- Tshem ib feem ntawm lub qog pancreas: Qee zaum ib feem me me ntawm lub qog pancreas uas cuam tshuam nrog lub qog kuj yuav tsum tau tshem tawm.
Nrog rau kev siv tshuab thev naus laus zis niaj hnub no,Cov qog no kuj tseem tuaj yeem raug tshem tawm los ntawm kev phais laparoscopic. Qhov no txhais tau tias es tsis txhob phais ib qho loj, kev phais yuav ua los ntawm ntau qhov me me nrog kev pab los ntawm lub koob yees duab. Qhov zoo ntawm qhov no yog tias nws tsis mob heev, tus naj npawb hnub koj nyob hauv tsev kho mob luv dua, thiab koj tuaj yeem rov qab mus rau koj lub neej ib txwm sai dua.
Kev kho mob rau cov qog nqaij hlav cancer
Tsis tshua muaj (tsawg dua 10%) cov qog no tuaj yeem ua mob qog noj ntshav. Hauv cov xwm txheej zoo li no, kev kho mob sib txawv. Yog tias tag nrho cov qog tsis tuaj yeem raug phais tshem tawm, koj yuav tsum noj tshuaj kom tiv thaiv cov ntshav qab zib kom tsis txhob poob qis dhau. Koj kuj tseem yuav xav tau chemotherapy . Rau qee hom mob qog noj ntshav, muaj kev kho mob tshwj xeeb, xws li "Lutetium Lu 177 dotatate", uas cuam tshuam nrog kev muab tshuaj radioactive los ntawm cov leeg ntshav.
Puas muaj teeb meem dab tsi tom qab phais?
Txawm hais tias feem ntau qhov kev phais mob no ua tiav los xij, zoo li lwm yam kev phais mob, nws muaj kev pheej hmoo ntawm cov teeb meem me me.
- Los ntshav
- Kev kis kab mob
- Mob
- Yog tias ib feem loj ntawm lub txiav raug tshem tawm, muaj kev pheej hmoo ntawm kev mob ntshav qab zib.
- Kev xau dej ntawm lub pancreas (Pancreatic fistula)
- Txo cov enzymes zom zaub mov.
Yog tias nws yog ib qho mob qog nqaij hlav, tej zaum yuav muaj teeb meem xws li tus kab mob kis mus rau lwm qhov chaw hauv lub cev (metastasis). Koj tus kws kho mob yuav piav qhia qhov no rau koj kom meej.
Cov Lus Qhia Txog Kev Coj Mus Tsev
- Insulinoma yog ib qho mob qog nqaij hlav uas tsis tshua muaj tshwm sim hauv lub txiav pancreas. Qhov no ua rau cov ntshav qab zib qis tas li.
- Yog tias koj muaj cov tsos mob tam sim ntawd xws li kiv taub hau, tawm hws ntau dhau, thiab tsis meej pem yam tsis muaj laj thawj, tshwj xeeb tshaj yog thaum koj tshaib plab, mus ntsib kws kho mob tam sim ntawd.
- Kev kuaj mob yuav tsum tau nyob hauv tsev kho mob thiab kuaj ntshav tshwj xeeb thiab luam theej duab.
- Txoj kev kho mob tseem ceeb yog phais tshem tawm lub qog, uas feem ntau ua rau nws zoo tag nrho.
- Feem ntau cov insulinomas tsis yog mob qog noj ntshav, yog li ntawd tsis tas yuav ntshai. Txawm li cas los xij, nco ntsoov sab laj nrog koj tus kws kho mob kom paub tseeb tias koj tau kuaj mob thiab kho mob zoo.
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Tsis muaj lus teb tau muab tso tawm. Ntxiv koj cov lus tawm ntawm no thawj zaug.
Ntxiv koj cov lus