Ingabe ngezinye izikhathi uzizwa ubuthakathaka, ujuluka, unamehlo aluhlaza okwesibhakabhaka, futhi unesizungu ? Lokhu kungabangwa ukwehla okungazelelwe kwamazinga kashukela egazini lakho ( i-hypoglycemia ). Lokhu kuvamile kumuntu onesifo sikashukela , njengokuthi uphuza imithi eminingi noma uphuthelwe ukudla. Kodwa uma lokhu kwenzeka kumuntu ongenaso isifo sikashukela ngaso sonke isikhathi, imbangela kungaba yinto ongacabangi ngisho nokucabanga ngayo. Leso yisimo esingavamile okudingeka sonke siqaphele, esibizwa ngokuthi i-insulinoma .
Iyini ngempela i-insulinoma?
Kalula nje, i-insulinoma iyisimila esincane, ngokuvamile esingesona umdlavuza esikhula kuma -pancreas ethu . Ama-pancreas ethu akhiqiza i-hormone ebizwa ngokuthi i-insulin. Umsebenzi walo insulin ukulawula inani likashukela (i-glucose) egazini.
Cabanga ngakho, ngokuvamile lapho amazinga kashukela emzimbeni wethu ekhuphuka, i-pancreas ikhiqiza i-insulini. Lapho amazinga kashukela ehla, iyayeka ukukhiqiza i-insulini. Kufana nokushintsha okuvula/ukuvala ngesikhathi esifanele.
Kodwa uma lesi simila esibizwa ngokuthi i-insulinoma sikhula, sikhiqiza i-insulin njalo . Kufana nokuthi iswishi ibambeke endaweni 'yokuvuka'. Okwenzekayo ukuthi i-insulin iyaqhubeka nokukhiqizwa ngisho noma amazinga ethu kashukela egazini ephansi kakhulu. Lokhu kungabangela amazinga ethu kashukela egazini ukuba ehle ngendlela eyingozi. Ngenxa yokuthi lezi zimila zakhiwe uhlobo olukhethekile lweseli yezinzwa (amangqamuzana e-neuroendocrine), udokotela wakho angase futhi azibize ngokuthi "isimila se-neuroendocrine". Lezi zimila zivame ukuba zincane kakhulu (ezingaphansi kwe-intshi) futhi zingaphezu kuka-90% azinawo umdlavuza. Ngakho-ke, zingelapheka ngokuphelele ngokuhlinzwa.
Ziyini izimpawu zalesi simo?
Ngenxa yokuthi i-insulinoma iyaqhubeka nokukhiqiza i-insulin, izimpawu zibangelwa amazinga aphansi kashukela egazini (hypoglycemia). Lezi zimpawu zingavela ngokuzumayo.
| Isibonakaliso | Incazelo elula |
|---|---|
| Ukudideka | Ukungakwazi ukuqonda ukuthi kwenzekani, ukuthi ukuphi, nokuzizwa unesiyezi. |
| Ukujuluka ngokweqile (Ukujuluka) | Kungazelelwe ngizizwe ngibanda futhi ngijuluka ngaphandle kwesizathu. |
| Ubuthakathaka | Uzizwa sengathi umzimba wakho ulahlekelwa ukuphila kwawo, izitho zakho ziyathuthumela. |
| Ukukhathazeka kanye nokushaya kwenhliziyo okukhuphukile | Ukwesaba ngaphandle kwesizathu, uzizwa sengathi isifuba sakho sishaya ngokushesha. |
| Ikhanda elibuhlungu kakhulu | Ukuqala ngokuzumayo kwekhanda elibuhlungu kakhulu. |
| Izinguquko zombono | Izinto ezifana nombono ofiphele, umbono ophindwe kabili, njll. |
| Izinguquko zokuziphatha | Ukuthukuthela ngaphandle kwesizathu, ukucasuka. |
| Ukuquleka | Uma izinga likashukela wakho lehla kakhulu, ungaquleka. |
Okubaluleke kakhulu: I-hypoglycemia enkulu ingaba yingozi. Ingabangela ukuquleka noma ngisho nokukhoma. Ngakho-ke uma unalezi zimpawu, xhumana nodokotela ngokushesha.
Yini ebangela i-insulinoma? Ubani osengozini enkulu?
Imbangela eqondile yalezi zimila ayikatholakali okwamanje, kodwa izici ezithile zingase zandise ingozi.
- Abesifazane bathambekele kakhulu kunabesilisa.
- Ivame ukutholakala kubantu abaneminyaka ephakathi kuka-40 no-60 .
- Abantu abanezimo ezithile zofuzo nabo basengozini enkulu. Isibonelo:
- Uhlobo 1 lwe-neoplasia ye-endocrine eminingi: Isimo lapho kwakheka khona izimila ezindlala ezikhiqiza ama-hormone.
- I-Von Hippel-Lindau syndrome: Isimo lapho amathumba kanye nezakhiwo ezifana namathumba ( ama-cyst ) kwakheka khona ezithweni ezahlukene zomzimba.
- Uhlobo 1 lwe-Neurofibromatosis: Ukukhula okungenawo umdlavuza ezinzwa nasesikhumbeni.
- I-Tuberous sclerosis: Izimila ezingezona ezomdlavuza ezithweni ezifana nobuchopho, amehlo, inhliziyo, nezinso.
Udokotela ukuthola kanjani lokhu?
Ukuxilonga i-insulinoma kungaba nzima kancane, njengoba izimpawu zifana nezezinye izifo ezivamile, ngakho-ke kungathatha isikhathi ukuthi udokotela wakho ayixilonge.
Into eyinhloko ukwenza 'ukuzila ukudla kwamahora angu-72' . Kulokhu, ugcinwa esibhedlela izinsuku ezimbili kuya kwezintathu futhi awuvunyelwe ukudla noma ukuphuza lutho ngaphandle kwamanzi. Phakathi nalesi sikhathi, odokotela bazohlola njalo ushukela wegazi lakho kanye namazinga e-insulin.
Bazama ukuqinisekisa lezi zinto ezintathu ngalolu vivinyo:
1. Ingabe ubhekene nezimpawu zokwehla kukashukela egazini (njengesiyezi, ukujuluka).
2. Uma lezo zimpawu zivela, ingabe izinga likashukela egazini liphansi ngempela?
3. Ingabe izimpawu zizophela uma unikeza ushukela (i-glucose) ngaphandle?
Uma une-insulinoma, izinga likashukela egazini lakho lokuzila ukudla lizoba phansi kakhulu, kodwa izinga lakho le-insulin lizoba phezulu. Lobu ubufakazi obuyinhloko. Kanye nalokhu, ukuhlolwa kwegazi kuzobheka nezinto ezifana ne-`(C-peptide)` kanye ne-`(proinsulin)`.
Ngemuva kwalokho, kwenziwa ukuhlolwa kwezithombe ukuthola ukuthi i-pancreatic tumor ikuphi ngqo.
- Ukuskena kwe-CT `(ukuskena kwe-CT)`
- Ukuskena kwe-Ultrasound `(Ultrasound)`
- Ukuskena kwe-MRI `(MRI)`
Yiziphi izindlela zokwelapha lokhu?
Ukwelashwa okuyinhloko nokuphumelela kakhulu kwe-insulinoma ukuhlinzwa ukuze kususwe isimila . Ezimweni eziningi, lesi sifo siyaphela ngokuphelele ngemva kokuhlinzwa.
Uhlobo lokuhlinzwa olwenziwayo luncike ohlotsheni, usayizi, kanye nendawo yesimila.
- Ukususa isimila kuphela: Odokotela abahlinzayo bangasusa isimila ngokucophelela ngaphandle kokulimaza i-pancreas.
- Ukususa ingxenye ye-pancreas: Ngezinye izikhathi ingxenye encane ye-pancreas ehlotshaniswa nesimila nayo idinga ukususwa.
Ngobuchwepheshe obuthuthukisiwe banamuhla,Lezi zimila zingasuswa nangokuhlinzwa kwe-laparoscopic. Lokhu kusho ukuthi esikhundleni sokusikwa okukodwa okukhulu, ukuhlinzwa kwenziwa ngokusikwa okuncane okuningana ngosizo lwekhamera. Izinzuzo zalokhu ukuthi akubuhlungu kakhulu, inani lezinsuku ohlala esibhedlela lifushane, futhi ungabuyela empilweni yakho evamile ngokushesha.
Ukwelashwa kwezimila ezinomdlavuza
Akuvamile kakhulu (ngaphansi kuka-10%) ukuthi la mathumba abe ngumdlavuza. Ezimweni ezinjalo, ukwelashwa kuyahlukahluka. Uma lonke ithumba lingenakukwazi ukususwa ngokuhlinzwa, kungadingeka ukuthi uthathe imithi yokuvimba ushukela wegazi ukuthi wehle kakhulu. Ungadinga futhi i-chemotherapy . Kwezinye izinhlobo zomdlavuza, kunezindlela zokwelapha ezikhethekile, njenge-"Lutetium Lu 177 dotatate", ehilela ukunikeza umuthi okhipha imisebe ngemithambo yegazi.
Ingabe zikhona izinkinga ngemva kokuhlinzwa?
Nakuba ukuhlinzwa kuphumelela ezimweni eziningi, njenganoma yikuphi ukuhlinzwa, kunengozi yezinkinga ezincane.
- Ukopha
- Ukutheleleka
- Ubuhlungu
- Uma ingxenye enkulu yepancreas isuswa, kukhona ingozi yokuthola isifo sikashukela.
- Ukuvuza koketshezi oluvela ku-pancreas (i-Pancreatic fistula)
- Ama-enzyme okugaya ukudla anciphile.
Uma kuyisifo somdlavuza, kungase kube nezinkinga ezifana nesifo esisakazekela kwezinye izitho zomzimba (i-metastasis). Udokotela wakho uzokuchazela lokhu ngokuningiliziwe.
Umlayezo Wokuya Nawe Ekhaya
- I-Insulinoma iyisimila esingavamile esikhula kuma-pancreas. Lokhu kubangela amazinga kashukela egazini ukuthi abe phansi njalo.
- Uma uzwa izimpawu ezisheshayo ezifana nokuzumeka, ukujuluka ngokweqile, nokudideka ngaphandle kwesizathu esibonakalayo, ikakhulukazi uma ulambile, bheka udokotela ngokushesha.
- Ukuxilongwa kudinga ukuhlala esibhedlela kanye nokuhlolwa kwegazi okukhethekile kanye nokuskena.
- Ukwelashwa okuyinhloko ukususwa kwesimila ngokuhlinzwa, okuvame ukuphumela ekwelapheni okuphelele.
- Ama-insulinoma amaningi awawona umdlavuza, ngakho-ke asikho isidingo sokwesaba. Kodwa-ke, qiniseka ukuthi uthintana nodokotela wakho ukuze uthole ukuxilongwa okufanele kanye nokwelashwa.
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