ʻO Glucagonoma

Anter

• He aha nā hōʻailona o Glucagonoma?
• He aha nā kumu o Glucagonoma?
• Pehea e kuhikuhi ʻia ai ʻo Glucagonoma?
• He aha nā hoʻoponopono e loaʻa ai no Glucagonoma?
• He aha nā pilikia o kahi Glucagonoma?
• He aha kaʻu e manaʻo ai i ka wā lōʻihi?

He aha ka Glucagonoma?

ʻO Glucagonoma kahi tumo laha ʻole e pili ana i ka pancreas. ʻO Glucagon kahi hormone i hana ʻia e ka pancreas e hana me ka insulin e kaohi i ka nui o ke kō i kou koko. Hoʻokumu nā hunaola tumo glucagonoma i ka nui o ka glucagon, a ʻo kēia mau pae kiʻekiʻe e hana i nā hōʻailona koʻikoʻi, ʻeha, a hoʻoweliweli hoʻi i ke ola. Ma kahi o 5 a 10 pakeneka o nā neuroendocrine tumors e hoʻomohala i ka pancreas he mau glucagonomas.

He aha nā hōʻailona o Glucagonoma?

Inā loaʻa iā ʻoe kahi tumo e hua ai i ka nui o ka glucagon, e hoʻopili ia i nā ʻano o kou olakino. Palena ʻo Glucagon i nā hopena o ka insulin ma ka hoʻoponopono ʻana i ka nui o ke kō i kou koko. Inā ʻoi aku ka nui o kāu glucagon, ʻaʻole mālama kāu mau pūnaewele i ke kō a ma kahi o ke kō e noho i kāu kahena koko.

Alakaʻi ʻo Glucagonoma i nā ʻōuli e like me ka maʻi diabetes a me nā hōʻailona ʻeha a weliweli hoʻi, e like me:

• kō kō kiʻekiʻe
• make wai nui a pololi ma muli o ke kō i ke kō
• ala pinepine i ka pō e mimi
• pāhoehoe
• kahi ʻili o ka ʻili, a dermatitis paha, ma ka maka, ʻōpū, pupu, a me nā wāwae e crusty pinepine a hoʻopiha ʻia paha me ka pā
• lilo kaumaha kaumaha ʻole
• kōkō ke koko i nā wāwae, a i kapa ʻia hoʻi ka thrombosis o ka aa hohonu

He aha nā kumu o Glucagonoma?

ʻAʻohe kumu pololei i ʻike ʻia o ka glucagonoma. Inā loaʻa iā ʻoe kahi moʻolelo ʻohana o kahi maʻi maʻi i kapa ʻia he endocrine neoplasia ʻano 1 (MEN1) he ʻoi aku kou makaʻu i ka hoʻomōhala ʻana i ka glucagonoma. Eia nō naʻe, ʻo ka poʻe i loaʻa ʻole nā ​​kumu pilikia ʻē aʻe hiki ke hoʻomohala i kēia mau tumors.

He maʻi maʻi ʻo Glucagonomas, a i ʻole malignant paha, e pili ana i ka manawa. Hoʻolahalaha ʻia nā glucagonomas malignant i loko o nā aʻa ʻē aʻe, ʻo ka maʻa mau ke akepaʻa, a hoʻomaka i ka hoʻopilikia ʻana me ka hana o nā mea ʻē aʻe.

Pehea e kuhikuhi ʻia ai ʻo Glucagonoma?

Hiki ke paʻakikī i ke kuhi ʻana i ka glucagonoma. ʻO ka pinepine, ʻike ʻia nā ʻōuli e kekahi kūlana ʻē aʻe, a he mau makahiki paha i hala ma mua o ka hana ʻia ʻana o ka hōʻailona pololei.

Hana mua ʻia ka diagnostical me kekahi mau hōʻoia koko. ʻO nā pae kiʻekiʻe glukagon ka hōʻailona o kēia ʻano. ʻO nā hōʻailona ʻē aʻe e pili ana i ke kō kō kiʻekiʻe, nā kiʻekiʻe o ka chromogranin A, kahi protein i loaʻa pinepine ʻia i nā tumo carcinoid, a me ka anemia, kahi ʻano e loaʻa ai kahi pae haʻahaʻa o nā hunaola ʻulaʻula.

E hāhai kāu kauka i kēia mau hoʻāʻo me kahi CT scan o ka ʻōpū e nānā i ke kū ʻana o nā tumors.

ʻO nā hapakolu ʻelua o nā glucagonomas āpau he mea hōʻino. Hiki i kēia mau tumors ke pālahalaha i ke kino a komo i nā kino ʻē aʻe. Nui a pinepine nā tumors a hiki i ka 4 a i ka 6 kenimika ākea ke ʻikea lākou. ʻAʻole ʻike pinepine ʻia kēia maʻi ʻaʻai a hiki i ka palahalaha ʻana i ke ake.

He aha nā hoʻoponopono e loaʻa ai no Glucagonoma?

ʻO ka mālama ʻana i ka glucagonoma pili i ka hemo ʻana i nā hunaola tumora a me ka mālama ʻana i nā hopena o ka keu o ka glucagon i kou kino.

ʻOi aku ka maikaʻi e hoʻomaka i ka mālama ʻana me ka hoʻokūpaʻa ʻana i nā hopena o ka nui o ka glucagon. Hoʻopili pinepine kēia i ka lawe ʻana i kahi lāʻau analog analog somatostatin, e like me ka injection o ka octreotide (Sandostatin). Kōkua ʻo Octreotide i ka pale ʻana i nā hopena o ka glucagon ma kou ʻili a hoʻomaikaʻi i ka ʻili o ka ʻili.

Inā ua lilo ka nui o ke kaupaona, pono ʻoe iā IV e kōkua i ka hoʻihoʻi hou ʻana i kou kaumaha o ke kino. Hiki ke mālama ʻia ke kō koko kiʻekiʻe me ka insulin a me ka nānā pono ʻana i kāu pae kō glucose.

Hāʻawi ʻia ʻoe i kahi lāʻau anticoagulant, a lahilahi paha o ke koko. Pale kēia i ka hoʻokumu ʻia ʻana o nā kahe koko i kou mau wāwae, a ʻike ʻia hoʻi me ka thrombosis hohonu. No ka poʻe makaʻu i ka thrombosis o ka aa hohonu, hiki ke kau ʻia kahi kānana i hoʻokahi o kou mau aa nui, ka vena cava inferior, i mea e pale aku ai i nā ʻōpū mai kou hiki ʻana i kou mau akemāmā.

Ke lawa kou olakino, e hemo paha ka tumo. ʻAʻohe pane iki kēia ʻano tumo i ka chemotherapy. Kūleʻa nui ke kaha inā hopu ʻia ka tumo ʻoiai paʻa ʻia i ka pancreas.

Hiki ke hana i kahi ʻimi exploratory o ka ʻōpū ma laparoscopically, me nā ʻoki liʻiliʻi e ʻae ai i nā kāmela, nā kukui, a me nā pono hana, a i ʻole ka hana ʻana i kahi ʻoki ākea ākea.

Loaʻa ka hapa nui o nā glucagonomas ma ka ʻaoʻao hema a i ʻole ka huelo o ka pancreas. Kapa ʻia ka hemo ʻana o kēia ʻāpana he pancreatectomy distal. I kekahi poʻe, hemo ka spleen. Ke nānā ʻia kaʻiʻo tumora ma lalo o kahi microscope, paʻakikī e haʻi inā he maʻi ʻaʻai ia. Inā he maʻi ʻaʻai ia, e hoʻoneʻe kāu mea kauka i ka nui o ka tumor i hiki ke pale aku iā ia mai ka hoʻolaha ʻana aʻe. Hoʻopili paha kēia i kahi ʻāpana o ka pancreas, nā lymph node kūloko, a me kahi ʻāpana o ke ake.

He aha nā pilikia o kahi Glucagonoma?

ʻO ka nui o ka glucagon alakaʻi i nā ʻōuli e like me ka maʻi diabetes. Hiki i ke kō koko kiʻekiʻe ke kumu:

• pōʻino nerve
• makapō
• pilikia metabolic
• poino lolo

Hiki i ka thrombosis hohonu ke kumu i ka hele ʻana o ke koko i nā akemāmā, a hiki i ka make ke make.

Inā komo ka tumo i ke ake, hiki i ka hopena ke hopena i ke akepaʻa o ke ake.

He aha kaʻu e manaʻo ai i ka wā lōʻihi?

ʻO ka maʻamau, i ka manawa e ʻike ʻia ai ka glucagonoma, ua palahalaha ka maʻi ʻaʻai i nā mea ʻē aʻe, e like me ke ake. ʻO ka maʻamau, ʻaʻole maikaʻi ke kaha ʻana no ka mea paʻakikī ka ʻike mua ʻana.

I ka manawa e hemo ai kahi tumo, e emi koke ka hopena o ka nui o ka glucagon. Inā kaupalena ʻia ka tumo i ka pancreas wale nō, ʻo ke ola o ʻelima mau makahiki ke ola, ʻo ia hoʻi 55 mau pākēneka o nā kānaka e ola ana no ʻelima mau makahiki ma hope o ke kaʻi ʻana.Aia kahi ola ola ʻelima mau makahiki inā ʻaʻole hiki ke hemo i nā tumors e ke ʻoki.