Pancreatitis pachimake: Zizindikiro, Zizindikiro ndi chithandizo
Pachimake kapamba - kutupa kwa kapamba. Zizindikiro za pancreatitis pachimake: kupweteka kwapweteka, kosapweteka pamimba. Kutengera gawo liti la gland yomwe yayamba kupindika, kupweteka kwawoko kumatheka mu hypochondrium kumanja kapena kumanzere, m'chigawo cha epigastric, kupweteka kumatha kukhala lamba. Matenda a kapamba am'mimba amaphatikizidwa ndi kuchepa kwa njala, matenda am'mimba, kupweteka kwambiri (monga momwe amapangira mawonekedwe) omwe amapezeka mutatha kudya mafuta, zakudya zonunkhira kapena mowa.
Zambiri
Pancreatitis ndi matenda omwe amadziwika ndi kukula kwa kutupa m'matumbo a pancreatic. Mwa chikhalidwe cha maphunzirowa, kapamba amawagawa pachimake komanso chovuta. Pachimake pancreatitis ndi wachitatu pakati pachimake matenda omwe amafunikira chithandizo kuchipatala cha opaleshoni. Malo oyamba ndi achiwiri amakhala ndi pachimake appendicitis ndi cholecystitis.
Malinga ndi ziwerengero zapadziko lonse lapansi, kuchokera pa anthu 200 mpaka 800 kuchokera pa miliyoni amakhala ndi pancreatitis pachaka pachaka. Matendawa amafala kwambiri mwa amuna. M'badwo wa odwala umasiyana kwambiri ndipo zimatengera zomwe zimayambitsa pancreatitis. Acute pancreatitis chifukwa cha uchidakwa amapezeka pafupifupi pazaka pafupifupi 39, ndipo chifuwa champhamvu chokhudzana ndi cholelithiasis, pafupifupi odwala ali ndi zaka 69.
Zomwe zimapangitsa kuti pakhale pancreatitis ya pachimake:
- uchidakwa, zizolowezi zoyipa (zamafuta, zakudya zazonunkhira),
- cholelithiasis
- kachilomboka (ma mumps, kachilombo ka Coxsackie) kapena kachilombo ka bacteria (mycoplasma, campylobacter),
- zikondamoyo
- othandizira opaleshoni yazinthu zina zamafinya ndi chimbudzi,
- kumwa estrogens, corticosteroids, thiazide okodze, azathioprine, mankhwala ena omwe ali ndi kutchulidwa kwa pancreas (mankhwala pancreatitis),
- kusinthika kwachilengedwenso, kutengera kwa majini, cystic fibrosis,
- yotupa matenda a m'mimba dongosolo (cholecystitis, hepatitis, gastroduodenitis).
Pakupanga kutukusira pachimake kwa kapamba, malinga ndi chiphunzitso chofala kwambiri, chinthu chachikulu ndicho kuwonongeka kwa maselo ndi ma enzymes omwe adakhazikitsidwa kale. Munthawi yovomerezeka, michere yam'mimba imapangidwa ndi kapamba mu mawonekedwe osagwira ntchito ndipo imayikidwa kale m'mimba. Mothandizidwa ndi zinthu zakunja ndi zamkati za m'magazi, njira yopangira imasokonekera, ma enzymes amaikidwa mu kapamba ndikuyamba kugaya minofu yake. Zotsatira zake ndi kutupa, kutupa kwa minofu kumayamba, ziwiya zam'mimba zimakhudzidwa.
Njira ya pathological mu pancreatitis yovuta imatha kufalikira kwa zimakhala pafupi: retroperitoneal minofu, emsa bursa, peritoneum, omentum, mesentery yamatumbo ndi michere ya duodenum. The kwambiri mawonekedwe a pachimake kapamba amachititsa kuwonjezeka kwambiri kwa mitundu yosiyanasiyana yachilengedwe yogwira zinthu m'magazi, zomwe zimayambitsa kulumala kofala: kuvulala kwachiwiri ndi kusokonezeka kwa dystrophic mu minofu ndi ziwalo - mapapu, chiwindi, impso, mtima.
Gulu
Pancreatitis pachimake imayesedwa ndi zovuta:
- mawonekedwe owala limakhala ndi kuwonongeka kochepa kwa ziwalo ndi machitidwe, limafotokozedwa makamaka ndi ma edema am'mimba, limagwira ntchito mosavuta pakubwezeretsa ndipo lili ndi chiyembekezo chabwino chakuchira msanga,
- mawonekedwe owopsa pachimake kapamba amadziwika ndi chitukuko cha matenda owopsa mu ziwalo ndi minyewa, kapena zovuta wamba (minofu necrosis, matenda, cysts, abscesses).
The kwambiri mawonekedwe a pachimake kapamba angayende limodzi ndi:
- kudzikundikira kwadzulu kwamadzi mkati mwa kutulutsa kapena malo a periopancreatic, omwe mwina sangakhale ndi pang'onopang'ono kapena makoma otupa.
- pancreatic necrosis yokhala ndi zotheka kufalitsa minyewa (pali malire kapena otayika a kufera kwa maimidwe amisempha ndi zotumphukira, ndi kuwonjezera kwa matenda ndi kukula kwa chifuwa cha purulent, kuthekera kwa zotsatira zakupha kumawonjezeka),
- pachimake pseudocyst (kudzikundikira kwa madzi a pancreatic ozunguliridwa ndi linga la fibrous, kapena granulation komwe kumachitika pambuyo povulaza pancreatitis yovuta, amapanga mkati mwa masabata 4 kapena kupitilira apo),
- chithuza chotupa (kudzikundikira kwa mafinya mu kapamba kapena ziwalo zapafupi).
Zizindikiro za Acute Pancreatitis
Zizindikiro za pachimake kapamba.
- Ululu wammbuyo. Zowawa zimatha kutulutsidwa mu epigastrium, hypochondrium ya kumanzere, yokhala ndi lamba, ndikuwonekera pansi pa phewa lakumanzere. Ululu umatchulidwa mosalekeza muchikhalidwe, mu supine udindo ukuwonjezeka. Kukula kwa ululu kumachitika ndikatha kudya, makamaka mafuta, zonunkhira, yokazinga, komanso mowa.
- Kusanza, kusanza. Kupumira kungakhale kopanda tanthauzo, kuli ndi bile, sikubweretsa mpumulo.
- Thupi.
- Mwanjira yanthawi ya sclera. Nthawi zambiri, khungu loyera.
Kuphatikiza apo, pancreatitis pachimake imatha kutsatiridwa ndi zizindikiro za dyspeptic (flatulence, kutentha kwadzidzidzi), mawonekedwe owoneka pakhungu (mawanga amtundu wa m'thupi, zotupa mu msomali).
Mavuto
Kuopsa kwa pancreatitis pachimake ndi mwayi waukulu wokhala ndi zovuta zazikulu. Pamene minyewa yopatsirana ya gland imayambukiridwa ndi mabakiteriya omwe amakhala m'matumbo aang'ono, necrosis ya malo am'mimba ndi kupezeka kwa zotupa ndizotheka. Vutoli popanda kulandira chithandizo munthawi yake (mpaka opareshoni) limatha kupha.
Mu pancreatitis yayikulu, vuto ladzidzidzi, chifukwa, kufooka kwamankhwala angapo kumatha kukula. Pambuyo pakupanga pachimake kapamba, ma pseudocysts (kuchuluka kwa madzimadzi mu parenchyma) amatha kuyamba kupanga minyewa, yomwe imawononga mapangidwe a ndulu ndi ndulu. Ndi chiwonongeko cha pseudocyst ndi kutayika kwa zomwe zili mkati mwake, ascites zimachitika.
Zizindikiro
Kuzindikira kwa pancreatitis ndi gastroenterologists kumadalira madandaulo, kuyezetsa thupi, komanso kuzindikira zizindikiritso. Mukayeza kuyeza kuthamanga kwa magazi ndi kukoka, hypotension ndi tachycardia nthawi zambiri zimadziwika. Kutsimikizira kuzindikiritsa, kuyesa kwa labotale magazi ndi mkodzo, MSCT ndi ultrasound yam'mimba, komanso MRI ya kapamba imagwiritsidwa ntchito.
- Kuphatikiza kwamwazi. Pakuwunika kwa magazi, zizindikiro za kutupa zimawerengedwa pakuwunika kambiri (ESR imathandizira, kuchuluka kwa leukocyte kumakulitsidwa), kuwonjezeka kwa ntchito ya pancreatic enzymes (amylase, lipase) imapezeka mu kuyesa kwa magazi a biochemical, hyperglycemia ndi hypocalcemia. Bilirubinemia komanso kuchuluka kwa michere ya chiwindi kungadziwike.
- Njira zamkodzo zamkodzo. Dziwani za kuchuluka kwa michere mkodzo. Pozindikira pancreatitis pachimake, kupenda kwamkodzo kwamkati kumatengedwa ndipo ntchito ya mkodzo imatsimikiza.
- Njira zopangira zida. Kupenda kowonekera kwa kapamba ndi ziwalo zapafupi (ultrasound, CT, MRI) kumakuthandizani kuzindikira kusintha kwa pathological parenchyma, kuwonjezeka kwa voliyumu ya thupi, kuti mupeze ma vaccesses, cysts, kukhalapo kwa miyala m'miyendo ya bile.
Kusiyanitsa kwakusiyana kwa kapamba kapamba kumachitika ndi:
- pachimake appendicitis ndi pachimake cholecystitis,
- mafuta onunkhira a ziwalo zopanda pake (zilonda zam'mimba ndi matumbo),
- pachimake m'mimba
- magazi am'mimba otupa (magazi am'mimba zilonda zam'mimba ndi matumbo a 12p. Kutuluka kwa magazi kuchokera m'mitsempha ya varicose ya esophagus, magazi m'mimba),
- pachimake ischemic abdominal syndrome.
Njira zochizira:
- novocaine blockade ndi antispasmodics kuti muchepetse ululu waukulu,
- njala, ayezi pathanthwe la projekiti ya gland (kulengedwa kwa hypothermia yakumaloko kuti achepetse ntchito zake), zakudya zimachitika ndi makolo, zomwe zili m'mimba ndizofunikira, antacid ndi proton pump zoletsa zotchulidwa,
- pancreatic enzyme deactivators (proteinolysis inhibitors),
- kukonza koyenera kwa homeostasis (madzi-electrolyte, acid-base, protein protein) mwa kulowetsedwa kwa saline ndi mapuloteni,
- chithandizo chakuthanso,
- mankhwala oletsa antiotic mankhwala (mankhwala ophatikizika amitundu yayikulu pamiyeso yayikulu) monga prophylaxis yamatenda opatsirana.
Mankhwala othandizira
Njira zopangira opaleshoni zimasonyezedwa ngati:
- miyala mu ndulu ducts
- kuchuluka kwa madzimadzi mkati kapena kuzungulira England,
- masamba a pancreatic necrosis, cysts, abscesses.
Zochitikazo zimachitika mu pancreatitis yapachimake ndi mapangidwe a cysts kapena abscesses zimaphatikizapo: endoscopic drainage, cystic marsupialization, cystogastrostomy, etc. Ndikupanga madera a necrosis, kutengera kukula kwawo, necrectomy kapena resection ya kapamba imachitika. Kukhalapo kwa miyala ndi chizindikiro cha ntchito pa pancreatic duct.
Kuchita opaleshoni kungathenso kuthandizidwanso ngati mukukayikira kuti mwazindikira komanso kuti pali mwayi wina wakumananso ndi matenda ena omwe amafunika opaleshoni. Nthawi ya postoperative imatanthawuza machitidwe owonongera popewa puruse-septic zovuta komanso kukonzanso chithandizo.
Chithandizo cha kapamba wofatsa, monga lamulo, sichovuta, ndipo mawonekedwe abwino awonedwa kwa sabata limodzi. Kuchiritsa munthu matenda amtundu wa kapamba kumafuna nthawi yambiri.
Zotsogola ndi kupewa
Kukula kwa pancreatitis pachimake kumatengera mawonekedwe ake, kukwana kwa mankhwala ndi kukhalapo kwa zovuta. Aofatsa mawonekedwe a kapamba nthawi zambiri amapereka wabwino matenda, ndipo necrotic ndi hemorrhagic kapamba, mkulu imfa. Kusalandira chithandizo chokwanira komanso kusatsatira malangizo a zachipatala pazakudya ndi regimen kungayambitse matenda ndikukula kwa kapamba.
Choyambirira kupewa ndichakudya chopatsa thanzi, kupatula mowa, zokometsera, mafuta, chakudya chochuluka, kusuta. Pancreatitis yachilendo imatha kukhala osati mwa anthu omwe amamwa mowa nthawi zonse, komanso chifukwa cha kumwa kamodzi kwa zakumwa zomwe zimakhala ndi zakumwa zazikulu, zokhazikitsidwa komanso zokometsera.
Kodi matenda ndi chiyani - zambiri
Ntchito yayikulu ya kapamba ndikupanga ma enzymes opukusa mafuta, chakudya ndi mapuloteni, omwe amadziwika ndi kutulutsidwa kwa madzi a pancreatic. Chinsinsi chakunja, chodziunjikira mkatikati mwa kapamba, chimapukusidwa ndi dothi wamba la duodenum. Pamene mulingo wa njira zothetsera njirazi zimasokonekera, kutseguka kwa ma enzymes mu kapamba kumabweretsa kudzipangitsa kwake ndi kuwononga ziwalo zozungulira, zomwe zimapangitsa kwambiri chiopsezo cha pancreatic necrosis.
Zotsatira zake, gawo logaya chakudya limatha kuwonongeka mosagundika, ndipo makoma a mitsempha yamagazi ndi gawo logaya chakudya kumaika pachiwopsezo cha kufafaniza kapena kutaya magazi mkati. Kutupa kwa pancreatic, kapena pancreatitis yovuta kwambiri, ndi njira yodzitetezera yomwe thupi limadzipulumutsira lokha kugaya chakudya m'thupi. Pamene ziwalo zingapo zofunika zimaphatikizidwa ndi zotupa, Zizindikiro za pachimake kapamba zimafanana ndi zizindikiro za sepsis. Mavuto a pancreatitis pachimake ndi aimpso komanso / kapena kulephera kwa chiwindikusokonezeka kwa kupuma ntchito ndi magazi, komanso kuphwanya kagayidwe kazakudya (amyloid dystrophy) mu 10% ya milandu yomwe imatsogolera kuimfa.
Zoyambitsa Acute Pancreatitis
Kwenikweni, chilichonse chomwe chimapangitsa kuwonongeka kwa maselo a pancreatic chimakhudza kuwonongeka kwa makina opanga ma enzyme. Izi ndizomwe zimayambitsa pancreatitis yovuta kwambiri:
- kumwa kwambiri mowa
- kudya mwadongosolo,
- kulakalaka kwambiri zakudya zamafuta,
- bulimia
- kagayidwe kachakudya
- kuwonongeka kwamakina pamimba,
- masinthidwe obadwa nawo
- matenda a mtima
- chifukwa chosasamala endoscopic.
Komabe, chinthu chofunikira kwambiri chodzetsa chiwopsezo cha kupha pachimake pancreatitis pamlingo wapadziko lonse lapansi ndi matenda opatsirana, omwe, amayamba chifukwa cha kunenepa kwambiri kwa kunenepa kwambiri komanso chidakwa kapamba.
Zizindikiro za pancreatitis pachimake zimadziwika chaka chilichonse mwa anthu 10-50 pa anthu 100,000.
Kodi zizindikiro za kapamba kapamba zimatsimikiza motani?
The etiology ya pachimake kapamba, Zizindikiro zake ndi chithandizo mu akulu ndi ana, kwathunthu zimatengera chikhalidwe chowonongeka-chotupa. Aseptic kutupa kwa kapamba alibe chipatala chofotokozedwa bwino. Kuzindikira matenda a kapamba kumafunikira kafukufuku wina wazachipatala. Zodandaula za wodwala wamba ndi:
- kupweteka kwam'mimba epigastric,
- nseru
- kusanza kwam'mimba,
- mpweya, kutulutsa ndi kuyamwa,
- malungo
- kuthamanga kwa mitsempha ya mtima (tachycardia),
- Zizindikiro za peristaltic matenda am`mimba thirakiti.
Mu gawo limodzi mwa magawo atatu a odwala, chifukwa cha kuphwanya kwa mapangidwe a bile, kutuluka kwa chikasu pakhungu ndi mapuloteni amaso. Pali chotchedwa jaundice chotchinga. Ndi chiwonetsero cha zizindikiro zotere, chisamaliro chachipatala chofunikira chimafunikira. Mu kapamba ka pachimake, kuyimbira foni ya ambulansi kumafunika.
Chithandizo cha pachimake kapamba
Kuphatikiza mankhwala a matenda ofatsa amatanthauza njira yotsatira ya kapamba:
- zakudya kwa masiku 3-5,
- kumwa mankhwala a analgesic
- kulowa kwamkati kwa thupi.
Ngati chomwe chikuyambitsa matenda a gallstone, ndiye kuti ndulu iyenera kuchotsedwa nthawi yomweyo.
Pankhani ya pancreatitis pachimake, zakudya ndizofunikira kwambiri pakuchipatala zomwe zingachepetse kupweteka kwa epigastric zone, kuthetsa nseru, kusanza komanso zizindikiro zina zokhudzana ndi kutupa kwa pancreatic.
Chithandizo cha pachimake kapamba (kanema):
Ndikosavuta kulingalira za mtundu wina wa matenda oopsa a kapamba. Kuyambira maola ochepa kapena masiku angapo matendawa, mutha kukambirana za zovuta zomwe zingachitike. Njira yoyenera yamankhwala imasankhidwa yomwe imateteza ku kufalikira kwa kutupa kwa zimakhala. Pankhaniyi, zakudya za makolo ndi mankhwala a pharmacotherapy amagwiritsidwa ntchito, omwe samaphatikizapo mankhwala a analgesic okha, komanso maantibayotiki. Kwambiri, madokotala amalingalira za kuchotsedwa kwa opaleshoni yonse ya kapamba (resection) kapena gawo la chiwalo ndi duodenum. Ngati wodwalayo apulumuka ndi pancreatitis yovuta kwambiri, ndiye kuti chimbudzi chitha kupatsidwa mphamvu yogwira ntchito ya endocrine, munthu ayenera kutenga michere ya pancreatic ndi insulin.
Kodi matenda a kapamba ndi chiani?
Kodi kapamba ndi momwe angachitire. Pancreatitis ndi njira yotupa yotupa yomwe imabisala mkati ndi kunja kwa katulutsidwe - kapamba. Gulu lonse la matenda ndi ma syndromes amafotokozedwa ndi dzinali. Mukazindikira pancreatitis, ndikofunikira kugawa matenda omwe amabisika pansi pa chotupa.World World Organisation imagawa matenda a pancreatic:
- Njira yothandizira. Amayamba mwadzidzidzi ndi chithunzi chowoneka bwino chachipatala, kuchipatala kwadzidzidzi ku dipatimenti ya gastroenterology ndikofunikira.
- Njira yayitali, kuphatikiza zakumwa zoledzeretsa ndi mitundu ina. Kukula kwa chifuwa chachikulu nthawi zambiri kumachitika chifukwa cha mawonekedwe owopsa.
- Pancreatic cyst. Maonekedwe amtundu wamatumbo chifukwa chodutsa ndi njira zowonongeka.
- Pseudocyst. Zotsatira za zovuta kapena zovuta. Amadziwika ndi kudzikundikira kwa madzi ambiri a pancreatic atazunguliridwa ndi minyewa ya fibrous.
- Pancreatic steatorrhea. Amayamba motsutsana ndi maziko a chifuwa cham'mimba ndipo amadziwika ndi kuphwanya kwamatumbo omwe amagwirizana ndi chimbudzi komanso mayamwidwe amafuta.
Pancreatitis pachimake imagawika abscess ndi pancreatic necrosis, komanso pancreatitis yoyenera, yomwe imapezeka mu mitundu:
- lakuthwa
- zinthawi zonse
- hemorrhagic
- kugonjera
- purulent.
Mitundu ya pancreatitis imatha kusiyanitsidwa ndi zizindikiro zowonetsera komanso zotsatira zoyesedwa zasayansi. Ululu ndiye chizindikiro chachikulu cha kutupa kwa kapamba.
Pakati pa mitundu ya pancreatitis yosatha, njira zopewera komanso zosagwiritsa ntchito zimasiyanitsidwa. Kukula kwa matenda oyamba kumadziwika ndi kufa kwa maselo a pancreatic ndikubwezeretsanso minofu yokhala ndi ma fiber osakanikirana ndikupanga ma pseudocysts. Pankhaniyi, ntchito zonse zamkati zakunja ndi zamkati zimatayika ngakhale pambuyo pancreatitis ndi kuchotsedwa kwa zomwe zimayambitsa matendawa. Njira ina yopatula ikuwerengera kapamba - chifukwa cha kupangika kwa ziwalo kunja kwa thupi, parenchyma ndi nembanemba.
Matenda osapinga a pancreatitis amadziwika ndi mapangidwe amiyala m'thupi la gland, kukula kwa ma ducts ndi fibrotization ya zimakhala. Kuwopsa kwa maselo omwe amapanga michere kumachitika.
Kukula kwotsatira kwamatendawa kumabweretsa mitundu yambiri ya kapamba, yomwe imasiyana m'dera lowonongeka. Njira yowonongeka iyi ya pancreatitis ndiyofunikira, popeza kutha kwa pancreatic necrosis ndi kakhalidwe komanso kogwiritsa ntchito ndipo sikugwiritsidwa ntchito ngati matenda.
Anthu omwe akudwala matenda am'mimba am'mimba ayenera kudziwa zonse za kapamba. Kusokonezeka kwa kapangidwe ka kapamba kumabweretsa kudzipatula kosayenera ndikupanga ma enzyme ofunikira kuti muchepetse michere, motero, kuphwanya kayendedwe kazinthu zoyambira mthupi. Kupanga kwamahomoni ofunika - insulin ndi glucagon - kumasintha pakutupa, komwe kumayambitsa kukula kwa matenda ena apancreatic, monga matenda a shuga.
Zizindikiro zoyambirira za kapamba zimawonetsa kusintha kulikonse mu minyewa ya kapamba ndi magwiridwe antchito.
Mukamaphunzira kapamba, zomwe zimayambitsa ndi zizindikiritso, kumbukirani ntchito zofunika zomwe kapamba amachita:
- Kutenga mbali mu kagayidwe kachakudya poyamwa.
- Kupanga kwa mahomoni (insulin ndi glucagon) kuti muthe kutenga nawo kagayidwe kazinthu kakang'ono ka thupi.
Makina a kapamba ndizovuta kwambiri. Thupi limakhala losiyana ndi kapangidwe kake ndipo palibe choloweza m'malo mochita bwino. Njira zonse zachilengedwe zowonongeka sizingasinthe.
Zoyambitsa Pancreatitis
Kutupa kwa kapamba kumayambitsa matenda omwe amapezeka mwa anthu.
- Matenda a gallbladder. Biliary dyskinesia, mapangidwe amiyala, ndi ntchito zina pamtondo zimayambitsa kukula kwa chifuwa chachikulu ngati njira yokhala ndi thanzi siyitsatira.
- Matenda am'mimba. Gastritis, duodenitis, colitis, enterocolitis, zilonda zam'mimba ndi matenda ena otheka.
- Matenda a chiwindi ndi ndulu: cirrhosis, hepatitis.
- Momwe thupi lawo siligwirizana limayambitsa chotupa mu chiwalo, chifukwa cha kupangika kwa michere yogwira magazi m'magazi, zomwe zimasokoneza gawo la parenchyma.
- Matenda Matenda a etiology opatsirana, opangitsa kuti pancreas iwononge pang'onopang'ono. Mwachitsanzo, tizilombo hepatitis, chimfine.
Zomwe zimayambitsa pancreatitis zokhudzana ndi zoopsa ndizosiyanasiyana.
- Kuzunza. Chakudya chochuluka chimapangitsa kuti zikondamoyo zizitulutsa timadzi tambiri tambiri, tomwe timayambitsa kuchuluka kwa ziwalo, timadzi tambiri tomwe timayambira madzi osokoneza bongo.
- Mowa.
- Kuvulala kwam'mimba.
- Zomera za parasitic.
- Kugwiritsa ntchito mafuta pafupipafupi, okazinga, zonunkhiritsa, zakudya zotentha.
- Kumwa mankhwala.
Choyambitsa cha pancreatitis chitha kukhala chachilendo pakukula kapena kapangidwe ka kapamba ndi ziwalo zam'mimba, komanso cholocha cholowa.
Magawo a Pancreatitis
Madokotala akuwonetsa kuopsa kwa kapamba:
Njira iliyonse yamphamvu yokoka imagwirizana ndi chizindikiro china chake:
- Pancreatic edema. Cell edema ndi imfa yawo yotsatirayi imadziwika, limodzi ndi njira yotupa mu peritoneum, ya ziwalo zoyandikana. Kuledzera kwa thupi chifukwa cha kuponyedwa kwa zinthu zomwe zimayambitsa khungu kapamba, kuwonongeka kowopsa m'moyo wonse, zotsatira zake zingathe chifukwa chakufunika kosafunikira kuchipatala.
- Hemorrhagic siteji. Pali kapangidwe kachulukidwe kamene kamalowa mu chiwalo, kuwonjezeka kwa kutentha kwa thupi, zilonda zam'mimba zimatha kuwonekera chifukwa cha kuchuluka kwa mapangidwe am'mimba a pancreatic, kukula kwa jaundice chifukwa cha kutupa kwa ma ducts.
- Pancreatic necrosis imadziwika ndi purulent process ndipo imayendera limodzi ndi mapangidwe a phlegmon, abscesses, fistulas okhala ndi purulent zomwe zimatha kulowa ziwalo zina.
- Cholecystopancreatitis. Chikhodzodzo ndulu ndi mavu ake zimakhudzidwa, septicemia kapena septopolyemia, kutulutsa kwamkati kumatha kuyamba. Chiwopsezo chachikulu chofika pagome la opareshoni.
Pakakhala chisamaliro kuchipatala, moyo wa munthu uli pachiwopsezo. Pambuyo pa chithandizo choyenera, nthawi yochira imayamba, yomwe imadziwika ndi magawo atatu azovuta: ofatsa, odziletsa komanso okhwima. Zotsirizira ,zigawika:
- Gawo la kutopa. Chitetezo chamthupi chambiri chimachepa, minofu yowonongeka ya pancreatic imachiritsa bwino. Zimaphatikizidwa ndi zizindikiro zowonjezera mu mawonekedwe a zovuta zovuta, chitukuko cha thrombophlebitis, mawonekedwe a kukhumudwa ndi asthenic syndrome.
- Gawo lachiwonetsero limadziwika ndi mawonekedwe a pancreatic cyst, kukula kwa matenda a shuga mellitus, kapena njira yayitali.
Matenda a pancreatitis amagawidwa malinga ndi zomwe zikupitilira:
- mawonekedwe asymptomatic
- zopweteka
- zinthawi zonse
- pseudotumor.
Malinga ndi kutalika kwa njirayi, kutupa kwa kapamba kumadutsa magawo angapo:
- Enzymatic (masiku 3-5),
- Kutakataka (masiku 6 mpaka 14),
- Kusanja (kuchokera masiku 15),
- Ekisodo (kuyambira miyezi 6).
Gulu la kapamba ndi kuchuluka kwa kusintha kwa necrotic:
- Zosangalatsa, kapena zodalirana - njira yofatsa,
- Ang'onoang'ono oyambira mafuta necrosis - odziletsa
- Yaikulu-yokhazikika yofalikira necrosis ndi hemorrhagic syndrome - kwambiri Inde,
- Chiwonetsero chonse komanso chapamwamba cha imfa chimakamba za imfa.
Mitundu yonse ya kapamba imasiyana mu chithunzi cha chipatala, njira zamankhwala othandizira ndi zotsatira zakepi la munthu.
Zizindikiro mawonekedwe pachimake
Zizindikiro za kapamba zimasiyanasiyana mu maphunzirowo, kutengera magawo a chotupa ndi kuuma kwa njira ya matendawa.
Zizindikiro za kapamba kapamba:
- Ululu Nthawi zambiri amakhala "womangidwa", imangotembenukira kumanzere kumanzere, kumapewa mbali ziwiri, kumutu wamtengo wapatali kumanzere. Ululu umakhala wopanda chakudya, samayimitsidwa ndi mankhwala.
- Matenda obwera chifukwa cha kupuma, kutulutsa, osabweretsa mpumulo, kubwerezabwereza, nseru, kugunda, kupumira m'mimba, kudzimbidwa. Zovuta za Stool zimayimira pawokha pakudya ndipo zimasinthana mkati mwa sabata loyamba: ukufalikira, kusangalatsa.
- Kuchuluka kwa kuthamanga kwa magazi.
- Tachycardia.
- Kuwonjezeka kwa kutentha kudzachitika chifukwa cha kusintha kwa njira za purulent. Zikwera manambala, zimakhala zovuta kuchita.
- Khungu kapena kufinya kwa khungu komwe kumalumikizidwa ndi kutupa kwa ma pancreatic ducts.
Mu gawo la chitukuko chachikulu, kapamba ayenera kuthandizidwa kuchipatala.
Zizindikiro zosapanganika za pancreatitis zimatha kuchitika pofufuza zamkati zam'mnyewa wam'mimba, zilonda zangwiro kapena kuukira kwa pachimake appendicitis, motero, ndikofunikira kusiyanitsa matendawa.
Zizindikiro za matenda osachiritsika
Kutupa kwa kapamba pambuyo pancreatitis pachimake kumabweretsa kukula kwa matenda. Chithunzi cha chipatala ndichosiyana pang'ono ndi zomwe zimachitika chifukwa cha zovuta. Kusintha kwa magawo akhululukidwe ndikuchulukirachulukira ndi khalidwe. Kukhalanso kwa zizindikiro za kapamba kumayambitsidwa ndi kusayang'anira kapena kuphwanya zakudya, uchidakwa, nkhawa.
Zizindikiro za matenda aakulu mwa akulu:
- Ululu mu kapamba, hypochondrium wamanzere. Zimachulukana ndikuwonjezera mphamvu kwa thupi, kuphwanya zakudya, mavuto. Kuti mudziwe komwe kumayambira pancreatitis, ndi bwino kunena kuti ndi gawo liti la kapamba lomwe lasintha.
* Kutupa mumchira wa chiwalo kumadzapweteketsa ululu kumanzere kwa hypochondrium,
* Ndi zotupa m'mutu, zopweteka zimakhazikitsidwa kudzanja lamanja la nthiti,
* Dera lonse la epigastric lidzakhala lopweteka pakulimbana kwamatenda m'thupi la gland. - Matenda a Stool, amadziwika ndi matenda otsegula m'mimba, omwe amasinthidwa ndi kudzimbidwa. Izi zimachitika chifukwa chosakwanira kupanga michere yofunikira pakuchepa kwa michere. Kuwoneka kwa kupangika kwa gasi kumalumikizidwa ndi kuwonjezeka kwa kukula kwa tizilombo tating'onoting'ono.
- Kuchepetsa thupi nthawi zambiri kumagwirizanitsidwa ndi kusowa kwa chakudya.
- Kuwonongeka kwa khungu: kufinya, kuwuma, kufalikira, kawirikawiri - cyanosis ya zala.
- Kukula kwa kuchepa kwa magazi m'thupi, hypovitaminosis, kupha mphamvu chifukwa cha chimbudzi chokwanira cha chakudya.
Panthawi yachikhululukiro, munthu amakhala ndi mwayi, nthawi zina pozindikira chimbudzi ndi chimbudzi.
Kodi chimayambitsa pancreatitis pachimake ndi chiyani?
Matenda amisala yodwala komanso zakumwa zoledzeretsa zimaposa 80% ya zinthu zoyambitsa matenda a pancreatitis pachimake. 20% yotsalayi ndiyotheka pazifukwa zosiyanasiyana.
Makina enieni a chitukuko cha pancreatitis pokhudzana ndi kutsekeka kwa sphincter ya Oddi ndi ndulu kapena microlithiasis (sludge) sizikudziwika mokwanira, komabe, izi ndizotheka kwambiri chifukwa cha kuwonjezeka kwa kukakamiza kwina. Kumwa mowa kwa nthawi yayitali (> 100 g / tsiku>> zaka 3-5) kungayambitse kuchuluka kwa mapuloteni olimbitsa ma pancreatic enamel ku lumen ang'onoang'ono a pancreatic. Kutalika kwa duct ndi mapuloteni awa akhoza kukhala chifukwa cha kutseguka koyambirira kwa michere ya pancreatic. Kuledzera kwa odwala kotereku kumatha kuyambitsa pancreatitis yapadera chifukwa cha kuyambitsa kwa michere ya pancreatic.
Apezeka masinthidwe ambiri azomwe akuwonetsa kupangika kwa pancreatitis. Yoyamba ndi kusintha kwachilengedwe kwamatenda a cationic trypsinogen, omwe ali chifukwa cha kapamba mu 80% ya milandu, yokhala ndi mbiri ya banja. Nthawi zina, kusintha masinthidwe kumakhala kulowerera pang'ono ndipo sikuvuta kupezeka nthawi zonse, kupatula maphunziro a chibadwa. Matenda amtundu wamtundu amachititsa cystic fibrosis, yomwe imapangitsa kuti chiwopsezo chowonjezereka cha pancreatitis pachimake chikhale.
Mosasamala za etiology, ma pancreatic enzymes (kuphatikiza trypsin, phospholipase A2, ndi elastase) amathandizidwa mwachindunji mkati mwa gland. Enzymes imawononga minofu, imayambitsa makina, ndikuyambitsa masewera otupa, ndikupanga ma cytokines. Izi zimayambitsa kutupa, kutupa, komanso nthawi zina necrosis. Ndi pancreatitis yolimbitsa thupi, kutupa kumangokhala kwa kapamba, kufa kumakhala kochepa kuposa 5%. Woopsa pancreatitis, kutupa kwambiri kumawonedwa ndi necrosis ndi zotupa m'matumbo ndikuwongolera kwadongosolo, kufa kumafikira 10-50%. Pambuyo masiku 5-7, matumbo amatenga gawo limodzi ndi necrosis ya pancreatic minofu.
Ma enzymes ophatikizidwa ndi ma cytokines omwe amalowa m'matumbo am'mimba amachititsa kuti peritonitis yamitsempha ndipo kutuluka kwam'mimba kumalowa. Zotsatira zamachitidwe zimachitika makamaka chifukwa cha kuchuluka kwa capillary permeability komanso kutsika kwa kamvekedwe ka mtima. Phospholipase A2 akuganiza kuti iwononga mapangidwe am'mapapu.
Pafupifupi 40% ya odwala, kudzikundikira kwamadzi ndi michere ya minyewa imapangidwa mu ziphuphu ndi kuzungulira. Mu theka la milandu, njirayi imatsimikiza zokha. Nthawi zina, izi zimayambitsa matenda a pseudocysts. Ma pseudocysts ali ndi kapisozi kopukutira popanda zingwe za epithelial. Pseudocysts amatha kuthana ndi magazi, kupasuka, kapena matenda.
Imfa m'masiku ochepa oyambilira nthawi zambiri imakhudzana ndi vuto la mtima (kuthamanga kwambiri komanso kulephera kwa impso) kapena kulephera kupuma (ndi hypoxemia komanso nthawi zina kupuma kwa matenda okalamba). Nthawi zina kufa kumachitika chifukwa chakulephera kwa mtima kwachiwiri chifukwa chakusadziwika bwino kwa mtima. Imfa pambuyo pa sabata limodzi la matenda itha kuchitika chifukwa cha matenda apamba kapena kupasuka kwa ma pseudocysts.
Pancreatitis Pancreatitis
Chithandizo cha pancreatitis ndi zizindikiro komanso kukula kulikonse kwamatenda ndikofunikira nthawi yomweyo. Pazizindikiro zowopsa, mankhwalawa amachitika kuchipatala poika kulowetsedwa kwamitsempha kuti abwezeretse mchere wamthupi mthupi komanso kupewa kutaya madzi m'thupi. Ozizira m'mimba amachepetsa kupanga ma enzyme omwe amawonongeratu minyewa ya cholowacho. Kutsatira zakudya zokhwima ndi gawo lofunikira panjira yakuchira. Ndikofunika kugwiritsa ntchito ma pinkiller kuti muchepetse ululu.
Pancreatic kutupa mu matenda a kapamba amafunikira chithandizo panthaka. Komabe, ndi zovuta zaumoyo wa anthu, dipatimenti ya gastroenterological ikuwonetsedwa. Mankhwala amathandizidwa kuti muchepetse kupweteka, kuletsa kapena kuletsa kupanga kwa michere.
Zoyenera kuchita ngati kapamba apsa:
- Osamadya kapena kumwa.
- Bodza kumbuyo kwanu ndikuyesera kupuma.
- Osamamwa mabotolo.
- Ikani ozizira kwa kapamba.
- Imbani ambulansi.
Momwe mungachiritsire wowerengeka azitsamba
Chithandizo cha pancreatitis chimachitika ndimankhwala mwina kuphatikiza njira zina. Kuthana ndi zomwe zimapangitsa kupweteka ndi chakudya ndiyo njira yayikulu yobwezeretsanso magwiridwe antchito.
Dokotalayo amapereka mankhwala othandizira ndipo akufotokozera mwatsatanetsatane za njira zina.Kusankha - momwe mungagwiritsire kapamba komanso momwe mungagwiritsire ntchito mankhwala amchikhalidwe, ndikupewa kuyambiranso matenda.
Momwe mungachepetsera kutupa kwapancreatic:
- chamomile
- yarrow
- khungwa la oak
- mbewu za fulakesi
- barele wa barberry ndi zipatso,
- sage
- calendula
- wosafera
- stigmas,
- chicory mizu
- Masamba a lingonberry, zipatso zamtchire,
- elecampane
- mizu ya burdock
- dandelion
- Wort wa St.
Ndi kuphatikiza kwa mankhwala azitsamba, zotsatira zabwino zimalimbikitsidwa. Mankhwala azitsamba monga momwe amasonyezera phukusi ndi kumwa kuyambira ndi yaying'ono pamimba yopanda kanthu. Poona momwe thupi liliri, kugwiritsa ntchito maphikidwe a anthu wowerengeka mpaka 100-150 ml patsiku.
Mutazindikira momwe kapamba amathandizidwira, kumbukirani kuti kulowetsedwa kwazitsamba kuyenera kukhala ndi izi:
- antispasmodic,
- choleretic
- onjezerani chidwi
- kulimbitsa thupi.
Kulandila ndalama zomwezi sikuyenera kuchepetsedwa kwa miyezi yopitilira iwiri.
Pancreatitis Zakudya
Chithandizo chothandiza pancreatitis ndikutsatira mosamalitsa zakudya zomwe dokotala wakupatsani.
- Gawo lazakudya mpaka nthawi 6-7 patsiku.
- Chakudyacho ndichotentha.
- Madzi okwanira, kuphatikiza ndi mchere wamadzi ochepa kutentha.
- Magawo ang'onoang'ono a chakudya.
- Kuchiza kutentha koyenera-kuphika, kudyetsa ndi kuphika.
- Kusala kudya ndikulandila.
- Kudya kwa chaka chonse.
- Kuchuluka kwa mapuloteni pakukonzekera menyu.
Mitundu yonse yamatenda a kapamba imakhala yotheka kuchira mosamalitsa ndikusinthidwa kwa zakudya panthawi yowonjezera kutupa. Malonda oletsedwa kwathunthu ndi:
- mafuta, okazinga, osuta,
- zotsekemera zotsekemera
- mowa
- kuteteza
- mtanda wa batala
- zipatso ndi masamba.
Mfundo ya kadyedwe ka matenda opatsirana kapamba imakhudzira thupi.
Kupewa kwa Pancreatitis
Chomwe chimapangitsa kupewa kukhala ndi thanzi labwino, kukhalabe ndi moyo wathanzi komanso kugwiritsa ntchito nthawi yake mothandizidwa ndi matenda ophatikizika. Zotsatira za kapamba pambuyo pa matenda nthawi yonse ya moyo zimasokoneza munthu:
- matenda amkuwa
- kuopsa kwa kuyambiranso kwamatenda,
- chitukuko cha matenda ena am'mimba thirakiti.
Kodi kapamba ndi zomwe zili zowopsa, aliyense ayenera kudziwa. Kukula kwa pachimake komanso kosatha, komanso zotulukapo za matendawo, zimatengera wodwalayo.
Zovuta zazikulu zidzakhala matenda a oncological, kukula kwa kapamba, zomwe zimapangitsa kuti gawo lizichotsedwa.
Nthawi zina ziwalo zamagulu ena amthupi zimavutika: matenda a mtima, kupuma, pamakhala kusintha kwa sepsis kapena matenda otupa a muubongo.
Kodi nchiyani chomwe sichingachitike ndi chifuwa chachikulu cha kapamba?
Zakudya zochiritsira komanso zakudya zoyenera mu pancreatitis yachilengedwe ndizofunikira kuti kubwezeretsanso thupi kuyenera. Mfundo za kadyedwe kazakudya zam'mimba za kapamba sizimasiyana ndi malingaliro pazachipatala pazomwe zimayambitsa matenda a kapamba, ndipo zimakhazikitsidwa motere:
- M'masiku atatu oyamba, wodwalayo amalimbikitsidwa kuti azikhala ndi njala. Njirayi imakupatsani mpata wopuma komanso kubwezeretsa kapamba. Wodwalayo amaloledwa kokha mchere wopanda madzi.
- Zizindikiro zikatupa kwambiri zatsika, munthu ayenera kutsatira zakudya zofunika kwambiri masiku otsatirawa.
Malangizo onse azakudya amachitidwa motsutsana ndi maziko a chithandizo chamankhwala kuchipatala chachipatala.
Maupangiri ambiri azakudya
Zakudya tebulo lambala 5 la kapamba, wopangidwa ndi akatswiri azakudya zaku Soviet akutsogoleredwa ndi M. I. Pevzner - iyi ndiye chisankho choyenera kwambiri pankhani yazakudya zachipatala. Njira yayikulu yothandizira pakudya mankhwalawa pachimake, komanso matenda a kapamba, ndi chakudya chamagulu kagawo kakang'ono kangapo ka 5-6 patsiku.
Zakudya ziyenera kukonzedwa popanda mchere ndi shuga, ndipo zakudya zingapo zowonjezera mwanjira ya tsabola, zonunkhira ndi zina zotero sizimachotsedwa. Chakudya sichiyenera kukazinga ndi mafuta. Njira yabwino yokhala ndi zakudya zopezeka mu pancreatitis pachimake ndi yophika komanso / kapena chakudya chofupika. Kuti tifulumizane kugaya, ndi bwino kupatsa chakudya chambiri kapena chaphikidwa. Kuphatikiza apo, akatswiri azakudya zamagetsi komanso gastroenterologists amalimbikitsa kumwa madzi osachepera malita awiri patsiku. Kuchuluka kumeneku kumaphatikizapo, koma sikuchepera, zakudya zamadzimadzi - sopo, broths, ndi zina. Zosakhazikika ndi kudya usiku ziyenera kupewa. Zakudya za tsiku ndi tsiku siziyenera kupitilira 1800-2200 kcal.
Zololedwa ndi Zoletsedwa
Mu chilonda chachikulu cha pancreatitis, monga momwe ziliri mu mitundu ya zotupa zam'mimba, pali zoletsa zamitundu ina. Pafupifupi zofunikira za pancreatitis pachimake zitha kupezeka kuchokera kwa katswiri wa zaumoyo kapena wopita kwa asing'anga. Zakudya zomwe zimalimbikitsidwa zimaganizira zaka za wodwalayo, mawonekedwe a thupi, jenda komanso kupezeka kwa matenda oyanjana.
Gome la chakudya chololedwa komanso choletsedwa mu kapamba:
