Momwe mungadziwire matenda a kapamba

Wodwala yemwe ali ndi kutupa kwa kapamba (pancreatitis) ndiwowonjezereka kuposa ena kuyimbira ambulansi chifukwa cha kupweteka kwambiri. Matendawa amatuluka pachimake kapena mawonekedwe osakhazikika. Kufufuza kwa dotolo sikokwanira kuti azindikire kapamba.

Kuphatikiza pa zodziwika bwino, zimakhazikitsidwa pazotsatira za kuyesedwa, kulola kuweruza kuchuluka kwa vuto la ziwalo. Njira yokhayo yophatikizira kuzindikira matenda ndiyo imakupatsani mwayi wosankha wodwala.

Momwe mungadziwire kapamba ndi zizindikiro?

Zizindikiro za kapamba nthawi zambiri zimachitika pambuyo podzaza ziphuphu ndi mafuta ambiri komanso zakudya zamafuta, zakudya zonunkhira komanso zakumwa zoledzeretsa. Monga lamulo, kapamba mu akuluakulu amatsatiridwa kapena kumayambitsidwa ndi mavuto amadzimadzi am'mitsempha chifukwa cha cholelithiasis, cholecystitis, ndi biliary ductkysia. Ubalewu ndi chifukwa cha malo omwe amapezeka mu duodenum. Zizindikiro za matenda owopsa komanso aakulu zimasiyana mwamphamvu.

Njira za Matenda a Pancreatitis

Kupambana kwa chithandizo cha matendawa mwachindunji kumadalira pakuwunika koyenera komanso kuzindikira koyenera. Popanga matenda, katswiri samangodalira zofufuza, komanso zizindikiro zomwe zimayenderana ndi matendawa. Izi zikuphatikiza:

kupweteka kwapweteka pamimba lamba,
kumangokhala phewa komanso kusanza komwe sikumadzetsa mpumulo,
kufooka wamba
kuchepa kwakukulu kwa kupanikizika,
thukuta kwambiri
kudumpha kutentha kwa thupi,
matenda amkuwa
kamwa yowuma, mawonekedwe akuwoneka oyera pamalirime.

Muzochita zamankhwala, pali njira zingapo zodziwira pancreatitis osagwiritsa ntchito mayeso ogwiritsira ntchito, pokhapokha pazikhalidwe zomwe ali nazo. Izi zimapangitsa kuti azitha kudziwa munthu wamkulu akadali mwana. Zizindikiro zake ndi monga:

pamaso pa kapamba, wodwalayo samva kupweteka kwam'mimba m'mimba.
mawonekedwe amtundu wabuluu khoma lamkati pamapangidwe a kapamba.
mawanga amtundu wabuluu m'chigawo cha umbilical. Mawonekedwe awo amaphatikizidwa ndi zochita za zovunda za kapamba pamisempha ya ziwalo ndi minofu.
kupweteka komwe kuli kapamba.
kupezeka kwa ululu pakhungu ndi katswiri wakumanzere kwa sternum, pamphepete mwa nthiti ndi msana.
kupweteka mukamayendetsa kapamba. Kupezeka kwa zowawa kumalumikizidwa ndi kupangika kwa chiwalo.
kupweteka kwambiri pamene kanjedza adalowetsedwa mkati mwa khoma lam'mimba, limagwirizanitsidwa ndi kuyamwa kwa peritoneum.

Zizindikiro ndi matenda a chifuwa chachikulu

Kuti adziwe matenda a kapamba, dokotala amayenera kuyang'anitsitsa zomwe akudwala. Kwa matendawa, zizindikiro zotsatirazi ndizodziwika bwino:

kupweteka kwakanthawi pansi pa nthiti kumanzere kwa msana,
kufalikira kwa zowawa kuchokera kapamba kumbuyo,
kupezeka kwa zowawa mutatha kudya kusuta, nyama yokazinga kapena mafuta, komanso kumwa mowa,
kumverera kokhazikika kwa mseru
matenda am'mimba,
Kuchepetsa thupi mwadzidzidzi komwe kumakhudzana ndi kuchepa kwa michere m'thupi kuchokera pakudya.

Kuchiza matenda a kapamba angatenge nthawi yayitali. Munthawi yamankhwala, kuchulukitsa kapena kutuluka kwa matendawa ndikotheka, chifukwa chake ndikofunikira kwambiri kuti muzindikire molondola .. Matenda okhalitsa chotere, zizindikiro zotsatirazi ndizodziwika:

kufooka, chizungulire, kufupika, kulephera kukumbukira,
shuga wowonjezera, shuga yachiwiri,
kuvulaza kwam'mimba, kutsekula m'mimba kapena kudzimbidwa, mseru komanso kusanza,
kuwonjezeka kwa kapamba wokuphipha kwa msana,
kusayenda kwa bile mu thupi ndi kumachitika jaundice.

Mapazi amwazi

Uku ndikusanthula koyamba komwe kumaperekedwa kwa odwala pancreatic matenda. Ndiosavuta komanso yothandiza. Malinga ndi zotsatira zake, mtundu wa matenda amtundu watsimikiza. Ndi kapamba, kuyezetsa magazi kosiyanasiyana kungavumbulutse njira zotsatirazi pazomwe zimachitika:

kuchuluka kwa alpha-amylase. Ichi ndiye puloteni yopangidwa ndi kapamba ndipo imathandizira kupasuka kwa wowuma m'thupi. Mulingo wake wokwera umawonetsa kuti ndi nthenda ya chiwalo. Komabe, kutengera chizindikiro ichi, sikotheka kukhazikitsa matenda.
kuchuluka kwa lipase, enzyme yofunikira pakuwonongeka kwa mafuta mu chakudya,
kuchepa kwa insulin ndipo, chifukwa chake, kuchuluka kwa shuga
kutsika kwa mapuloteni m'magazi, makamaka mapuloteni a albin,
kuchuluka kwakukulu kwa mapuloteni othandizira,
kuchuluka kwa magazi urea vuto laimpso.

Electrolytic ndi kusanthula kwa magazi kwa magazi

Kuphonya kwa kapamba kumakhudza kusintha kwa magazi, komanso kuchuluka kwa madzi omwe amapezeka m'magazi. Izi zimatha kutsitsa mitsempha yamagazi ndi magazi.

Pancreatitis imabweretsa kuchepa kwa magazi m'magazi monga potaziyamu, calcium ndi sodium. mchere umakhudza magwiridwe antchito a mtima.

Njira zodziwitsa ena za zida

Njira zothandizira kufufuza zamatenda a pancreatic ndichinthu chofunikira kwambiri pakuwazindikira. Mukamachita kafukufuku wothandiza, zimatha kuwona zodabwitsa, komanso kudziwa zovuta za kapamba komanso momwe zimakhudzira ziwalo zina.

Njira zofufuzira zodziwika bwino ndizotsatirazi:

Ma Ultrasound diagnostics

Iyi ndi njira yothandiza kwambiri yodziwira matenda a kapamba, komanso kuzindikira kusintha kwa minyewa ya ziwalo, kukhalapo kwa kutupa. Ultrasound imakhala ndi mwayi wowona momwe ma ducts a bile, kupezeka kwa zotuluka za purulent ndi madzimadzi.

Ndikofunikanso kudziwa kuti wodwalayo ayenera kudziwa momwe kukonzekera kwa pancreatic ultrasound kumayendera, kotero kuti phunzirolo ndi lothandiza monga momwe kungathekere.

Mbiri

Njira yodziwitsa matenda a kapamba. Ndi chithandizo chake, mutha kudziwa kukula kwa thupilo, kukhalapo kwa minofu yakufa ndi kutupa. Komabe, njirayi siigwiritsidwa ntchito kawirikawiri chifukwa cha mtengo wake wapamwamba komanso kupezeka kwa ma tomographs m'makiriniki akuluakulu.

Kupambana kwa chithandizo cha kapamba kumadalira kuzindikira kwakanthawi, kuzindikira komanso kutsatira malangizo onse omwe adokotala amapita. Dokotala amatengera deta ya labotale, zizindikiro za matendawa.

Momwe mungadziwire kapamba? Zizindikiro za pancreatitis ndi ululu wamkati wam'mimba, kutsekemera kosalekeza, kusanza, kufooka kopanda pake, kuchepa kwamphamvu kwa magazi, kusintha kwa kutentha kwa thupi, kutuluka thukuta kwambiri, khungu lambiri.

Chifukwa cha kusayenda kwa ndulu mu kapamba, chikasu pakhungu, kusokonezeka kwa kugaya chakudya kumawonedwa, kupezeka kwa mtundu wachiwiri wa matenda osokoneza bongo, hyperglycemia, sikutha.

Mawonekedwe awonetsero wakutupa mu kapamba ndi:

zokutira yoyera palirime,
kusapeza bwino pakhungu
ululu pamlingo wa msana ndi nthiti.

Zizindikiro zoyambirira zimachitika kudzimbidwa pafupipafupi, kuphatikizira kuphuka, kuwonda mukatha kudya, nseru komanso kusasangalala pamimba. Odwala ena amadandaula za kupweteka kumanzere, ena kumanja, ndipo mwa ena kumapweteka pakati pamimba.

Kudziwonetsa kwawoko kutengera ndi gawo liti la kapamba amene amayatsidwa. Mutu wa chiwalo ukawonongeka, umapweteka kumanja, ndikutupa kwa khungu lonse la chindacho, kupwetekako kumamveka mkatikati, ndipo akavulala akakhudza mchira, kupweteka kumachitika kumanzere. Munthu yemweyo amapweteka kulikonse nthawi ndi nthawi.

Madokotala amadziwa njira zodziwira pancreatitis, omwe amathandizira kuzindikira kumayambiriro kwa matendawa. Minyewa ya m'mimba itayamba kuyaka, wodwalayo samva cham'mimba pafupi ndi m'mimba, ndipo akapanga chiwalo kumimba, mawanga amtambo amawonekera. Chizindikiro ichi chimalumikizidwa ndi zotsatira zowopsa za zinthu zowonongeka pamisempha ya minofu ndi ziwalo zamkati.

Kuchepetsa thupi, kuchepa kwamphamvu kwa michere, kutsekula m'mimba pafupipafupi ndi fungo losasangalatsa la fetid kungathandize kuzindikira matendawa. Ndi nthawi yayitali ya matendawa, wodwalayo amadwala kwambiri kufooka, kulephera kupuma, kulephera kukumbukira, komanso kulephera kulolera. Chisamaliro makamaka chidzafunika kupatsidwa kwa odwala nthawi yapakati, zizindikiro zawo zimatchulidwa kwambiri.

Kafukufuku wa Laborator

Kuyesedwa kwa magazi kwamomweku kumathandiza kuzindikira kutupika, uku ndi kuphunzira koyamba komwe dokotala amakupatsani. Kuwunikaku ndikosavuta, kophunzitsa, kumathandiza kumvetsetsa mtundu wa matenda.

Ngati pali pancreatitis, magazi amawonetsa kuchuluka kwa alpha-amylase, lipase, kuchepa kwa insulin (motsutsana ndi maziko awa, kuchuluka kwa shuga, boma la prediabetes), mapuloteni a magazi (albin), kukula kwa urea ndi protein yothandizira.

Alfa amylase amapangidwa ndi kapamba kuti agwetse wowuma, ndipo milingo yokwezeka imathandizira kuzindikira koyenera. Kuwonjezeka kwa ndende ya urea kumasonyezanso kuphwanya impso.

Zindikirani zonyansa m'thupi zimathandizira kuyezetsa magazi ndi madzi amadzimadzi. Amadziwika kuti kusokoneza ntchito kwa kapamba kumabweretsa mavuto otere:

kusintha kwa magazi,
kuchuluka kwamadzi m'magazi,
kutsekeka kwamitsempha yamagazi
kuundana kwa magazi.

Zizindikiro zosiyanitsa kapamba chifukwa cha kutupa kwambiri kwa kapamba

Pancreatitis yovuta kwambiri komanso yodwala ndiye matenda omwe matendawa amakhudzana ndi kutupa.

Ndikofunikira kudziwa kuti chiwalochi ndichofunikira pa thupi la munthu, ndikuchita chimodzi mwazinthu zofunikira kwambiri m'matumbo am'mimba komanso metabolism.

Ndiye kapamba yemwe amapanga zinthu zapadera za enzymatic zomwe zimathandizira kutha kwa mafuta ndi mapuloteni, omwe amalowa m'thupi limodzi ndi chakudya.

Kuphatikiza apo, imaperekanso mahomoni ofunikira monga insulin, omwe amafunikira kuyamwa kwa shuga. Njira zina zochiritsira komanso kuthekera kochira zimadalira mawonekedwe a kuphwanya kwa ziwindi. Kodi pali kusiyana kwanji pakati pa chifuwa chachikulu ndi chifuwa chachikulu, ngati zomwe zimachitika zimafanana? Tidzakambirana pankhani iyi.

Kusiyana kwakukulu pakati pa pathologies

Mwa munthu wathanzi, njira zopukusa zomwe zimakhudzidwa ndi michere yopanga ndi zikondamoyo zimayamba m'matumbo, kudutsa ma dancts a pancreatic.

Koma, ndi kukula kwa kuphwanya kwa pathological kwa magwiridwe a ziwalo za parenchymal, kutseguka kwa machitidwe a ma pancreatic enzi kumatha kuchitika musanawonekere m'matumbo, mwachitsanzo, kapamba palokha.

Izi zikuthandizira pakupitilizika kwazomwe zikuchitika pakudzipukuta kwa ndere komanso kufa kwa omwe akhudzidwa.

Kusokonezeka kotereku kumayambitsa mawonetsedwe otsatirawa:

kupezeka kwa owawa pachimake ndi lakuthwa kutuluka kwam'mimba, kumanzere kapena kumanzere kwa hypochondrium ndi m'mimba,
kukulira kwa mseru komanso kutentha pa chifuwa, komwe nthawi zambiri kumayenderana ndi kusanza,
kudzimbidwa
chisangalalo ndi kuphuka.

Mukamayang'ana mozama, khungu limakhala likuwunika pang'ono komanso matumbo ake amayamba kuchepa kwambiri. Ichi ndiye matenda a pancreatic a kapamba.

Ndiye, pali kusiyana kotani pakati pancreatitis yovuta komanso yopweteka? Chomwe chimasiyanitsa ndi mitundu iyi ya matenda ndi mtundu wawo wa chitukuko.

Acute pancreatitis amawoneka mosayembekezereka ndipo ali ndi mawonekedwe otukuka mwachangu. Kawirikawiri kutalika kwake kuyambira pakuwukira koyamba kufikira zotsatila zamatsenga sikupitirira masabata awiri.

Ndi mawonekedwe amtunduwu, wodwala panthawi inayake amamva kupweteka komanso kupweteka m'chigawo cha epigastric cha mawonekedwe osagwirizana ndi mawonekedwe, koma mutatenga mankhwala apadera ndi njira zina zochizira kuphatikiza kusala komanso kupitiriza kutsatira zakudya, chitetezo chokwanira chimatha . Zowonongeka kwa kapamba ndizochepa, kotero limba limatha kupitilizabe kugwira ntchito ngati zinthu zonse zomwe zikuyambitsa matendazi zichotsedwa kwathunthu. Nthawi zina pangafunike kumugoneka m'chipatala odwala omwe ali m'chipatala chopulumutsa kapena ku opaleshoni kuti akwaniritse zofunika kuti athetse matendawa.

Ndi chithandizo chamankhwala chosayembekezereka, kapamba wam'mimba amatha kupha. Koma nthawi zambiri, odwala amatha kuchiritsidwa kwathunthu matenda awa.

Kukula kwa mtundu wa pancreatic pathology kumatha kupitilira sabata, mwezi, kapena ngakhale zaka zingapo, chifukwa chake chopita patsogolo pang'onopang'ono ndikuyenda mosadukizadukiza kwazomwe zimachitika podzilowetsa m'matumbo.

Njira yotere yamatenda imadzetsa kuwonongeka kwakukulu ndi ziwalo zina zamkati.

Chizindikiro cha matendawa sichitha kuwonekera mwanjira iliyonse, ndipo wodwalayo amakhalabe wokhutira kwa nthawi yayitali, pomwe kuwonongeka kwa pancreatic pachiwalo cha parenchymal kumapita patsogolo ndikukula. Zonsezi zimatha kuyambitsa zovuta izi:

Maonekedwe a zotupa zamkati,
kukula kwa zotupa zapakhosi,
kuledzera kwa thupi lonse, makamaka mtima, impso ndi pulmonary dongosolo la ziwalo.

Sizotheka kuthetsa kwathunthu mawonekedwe a pancreatic pancreatic lesion nthawi zambiri.

Chifukwa chake, anthu omwe akudwala matendawa amafunika kutsatira njira yolimbikitsira zakudya pamoyo wawo wonse, kukhalabe magwiridwe antchito a mankhwala a pancreatic komanso osaphwanya malamulo a moyo wathanzi.

Ndikofunikira kukumbukira kuti kupumula pang'ono, kapena kupatuka komwe kumatsatiridwa ndikuchoka pamalamulo omwe ali pamwambapa pancreatitis yayitali, ikhoza kukhala chochititsa chachikulu cha kukokomeza kwambiri kwa matenda a m'matumbo, kuwonongeka kwadzidzidzi muumoyo wonse komanso kukulira kwa zovuta zazikulu, zotsatira zake zomwe zingakhale zowopsa osati thanzi la munthu, komanso moyo wake. .

Zoyambitsa

The pachimake mawonekedwe pancreatic pancreatic lesion amatha kupezeka kangapo moyo wonse wodwala yemweyo. Zomwe zimatsitsimutsa zamatsenga ndi izi:

Chakudya chopanda malire, osati chakudya choyenera, chomwe chimalembetsedwa ndikugwiritsa ntchito zonunkhira zamafuta, mafuta, okazinga ndi amchere, omwe nthawi zambiri amakhala akupanga pancreatic.
Mankhwala osokoneza bongo omwe amakhala ndi zakumwa zoledzeretsa.
Kukula kwa cholelithiasis, pomwe miyala inkapangira zobowoleza zikondamoyo za ziwalo za parenchymal, zimawakhumudwitsa ndipo zimathandizira kuyambika kwa kutupika, kukulitsidwa ndi kuchuluka kwa ntchito ya michere yopangidwa ndi kapamba.
Okwatirana Malinga ndi ziwerengero, theka la amuna limadziwikiratu ndi chitukuko cha matenda opatsirana, omwe amayamba mwamphamvu kwambiri kuposa kugonana kosafunikira. Zonsezi zimachitika chifukwa choti azimayi, mosiyana ndi abambo, amamwa zakumwa zochepa zomwe zimakhala ndi zakumwa zoledzeretsa, zakudya zamafuta ndi yokazinga, komanso amayesa kufunafuna thandizo la kuchipatala munthawi yake paziwonetsero zoyipa za pancreatic.

Ndikachulukirachulukira kwa kapamba, munthu amayamba kumva kupweteka m'dera la epigastric, flatulence ndi bloating amayamba kukula. Ndipo pali malingaliro osaletseka a nseru, omwe amatsogolera gawo la kusanza.

Kutentha kwa thupi kumakwera mpaka madigiri 40, ndipo phokoso la kupundika limakulanso. Ngati kuledzera kwamphamvu kumayamba, ndiye kuti chotupa chimakhudzanso mafupa a ziwindi, chiwindi, komanso dongosolo lonse la mtima.

Pali kuchepa kwa kuthamanga kwa magazi ndi kukula kwa zizindikiro zakusowa madzi m'thupi.

Zonsezi zimatha kutulutsa magazi mkati mwa kapamba, omwe, popanda kuchitapo kanthu mwachangu, amatha kupha.

Fomu yovuta ya pancreatic pancreatic lesion imachitika motsutsana ndi maziko azomwe zimayambitsa zomwe zimapangitsa monga pachimake cha matenda.

Izi pathologies zimasiyanitsidwa ndikuti matenda owopsa amatha kuchoka osatha pambuyo pa masiku 3-4 pochitika kuti chiwopsezo cha pancreatic chidawonetsedwa pang'ono, ndipo patatha masiku 6-8 pambuyo pazinthu zina zochiritsira zamankhwala zomwe zimakhala zowonjezereka.

Zikachitika kuti mawonetseredwe azizindikiro zowoneka bwino zamatenda akupitilizabe kuchitika motsutsana ndi maziko osowa kutsatira mankhwalawa komanso malangizo omwe akutsatiridwa ndi katswiri woyenera, ndiye kuti chitukuko cha pancreatitis yovuta kwambiri chimasanduka mawonekedwe osakhazikika.

Kuwonongeka kwakanthawi kwa ziwalo za parenchymal zotupa zamtunduwu nthawi zambiri kumachitika mwa amuna azaka 30 mpaka 40 omwe amadalira mowa.

Koma, nthawi zina, chomwe chimayambitsa matendawa sichingakhale kugwiritsa ntchito mankhwala omwe ali ndi zakumwa zoledzeretsa, komanso cholowa chamtsogolo.

Zowonadi, ngakhale mwa odwala ochepa kwambiri, chotupa chabodza kapena chobadwa nacho cha pancreatic duct chitha kupezeka, chomwe pambuyo pake chimadzipangitsa kudziwononga ndekha.

Mtundu wobadwa nawo wa matenda opatsirana amatha kukhala ndi mtundu wina wa chitukuko koma osadziwonetsa kwa zaka zitatu kapena zingapo. Chizindikiritso chake chimachitika mwangozi pakaunikiridwa matenda pafupi ndi ziwalo zopezeka kapena pakafika modzidzimutsa.

Acute pancreatitis ndi pancreatitis aakulu ali ndi mawonetsero ofanana, koma ndi mawonekedwe osakhazikika amatha kuchitika, amadutsa nthawi yayitali, ndipo patatha mwezi, awiri, kapena atatu amadzimva nawonso.

Ndikofunika kudziwa kuti matenda ophatikizika amatha kukhala othandizira pakupanga matenda oyambitsidwa ndi matenda, omwe amadziwika kuti:

nthenda yachilendo pakukula kwa thunthuymal
gawo la cystic fibrosis,
kupezeka kwa hypocalcemia kapena lipid-kutsitsa,
njira za autoimmune
kukhudzana ndi mankhwala ena ake.

Choyambitsa chibadwa cha matenda osachiritsika chimatha kuchitika pokhapokha ngati mabanja angapo ali ndi matenda omwewo.

Kusiyana kwazizindikiro

Palibe kusiyana pakati pa mitundu iwiri iyi ya kuphwanya kwatsamba kwa magwiridwe antchito a kapamba. Chokhacho ndikuti poyerekeza ndi pancreatitis yosatha, zopweteka ndizomwe zimawonekera nthawi zonse ndi kuwonjezeka mwamphamvu pambuyo podya chakudya kapena kugwira ntchito yolimbitsa thupi.

Poyerekeza ndi gawo la chotupa chakumimba kwa mafunde a parenchymal, kupangika kwa michere yofunikira kuti chimbudzi chikhale chochepa kwambiri kuposa momwe zimakhalira, chifukwa cha matenda osatha, odwala amadandaula kuti nthawi zambiri amakhala ndi vuto la mseru, ndicho chifukwa chamasanzire komanso kutsika koonekera m'thupi.

Kuphatikiza apo, kuyesa kwa ndowe kumawonetsa kuchuluka kwa chakudya chosasankhidwa.

Kuwopsa kwa matenda awa

Pancreatic lesion of the parenchymal organ, yomwe imakhala ndi kutupa kwa maphunzirowa, imatha kukhala chifukwa cha imfayo kapena kukulitsa kuphwanya kwakukulu kwa magwiridwe ena a ziwalo zamkati mwa munthu.

Ganizirani mitundu yayikulu yamatenda a kapamba owopsa komanso osapweteka:

Kuwonongeka kwa mapapu a ziwalo zam'mimba kungayambitse kukula kwa hypoxia, kumafunikira njira zothandizira kuchipatala, komwe, ngati kuli koyenera, wodwalayo adzapatsidwa mankhwala owonjezera a okosijeni.
Njira zopatsirana zomwe zimayambika motsutsana ndi maziko a chotupa chachikulu cha zotsekerazi komanso kutulutsa magazi kwakutali.
Ndi kuchepa kwakukulu kwa kupanga kwa insulin, kukula kwa matenda ashuga kumayamba kupita patsogolo.

Mwachidule, titha kunena kuti mfundo zakukula motere m'thupi la munthu zimatulukira motsutsana ndi moyo wopanda tanthauzo, malingaliro osadzidalira komanso kulephera kudziletsa pa kufunika kwa chakudya ndi zakumwa.

Chifukwa chake, kuti muchepetse kuwonongeka kwa pancreatic pancreatic, ndikofunikira kupatula kwathunthu kugwiritsa ntchito mankhwala omwe ali ndi mowa ndikuwunika zomwe mumadya, apo ayi, mutha kudzipangitsa nokha kuvutika kosalekeza ndi zizindikiro zosatsutsika zomwe zimayambitsa gawo la gawo la parenchymatous.

Matenda a kapamba: momwe mungadziwire pang'onopang'ono

Kuti muyambe kulandira chithandizo - ndikofunikira kuyambitsa matenda. Pali matenda angapo omwe zizindikiro zake ndizofooka ndipo ndizosatheka kuzizindikira. Matendawa amaphatikizapo kapamba.

Laparoscopy

Njira zonsezi ndi kuzindikira komanso kuchiza matendawa. Chitani kafukufukuyu muzipinda zofunikira kapena zipinda zogwiritsira ntchito.

Laparoscopy imatha kuwona ma pathologies a organic munthawi yeniyeni ndipo, nthawi zina, amachitapo kanthu kuti achepetse mphamvu zawo mthupi. Njirayi imagwiritsidwa ntchito pazovuta kwambiri zamatenda.

Endoscopy

Njira yofufuzira iyi imakuthandizani kuti muwone kusintha konse kwa kapamba ndi duodenum. Kuti muchite izi, ma endoscope okhala ndi kamera yoikika amaikidwa kudzera m'mphepete ndipo chiwalo chimayesedwa.

Chifukwa cha endoscopy, ndikotheka kudziwa kuchuluka kwa katulutsidwe komanso momwe zimayendera pancreas.

Kusiyanitsa kwapadera kwa kapamba

Kwa kapamba, zizindikiritso zazikulu ndi kupweteka pamimba, zomwe zimapereka kumbuyo, kutsegula m'mimba ndi kusanza. Komabe, matenda ena angapo okugaya ali ndi zizindikiro zofananira.

Nthawi zina ngakhale zotsatira za kusanthula sikungapereke chithunzi chonse, kotero kuti katswiriyo amazindikira. Ndikofunikira kusiyanitsa kapamba ndi matenda ena.

Kusiyana pakati pancreatitis ndi zilonda zapamwamba

Nthawi zambiri, kapamba amakhalanso ndi zofanana ndi zilonda zapamwamba. Matendawa amadziwika ndi kupweteka kwambiri komanso kupweteketsa mtima chifukwa cha kupweteka, kutsika kwa mtima ndi mavuto a makoma am'mimba.

Komabe, pali zosiyana zambiri zomwe zikufunika kudziwa mukamawunika komanso popereka mankhwala. Wodwala wokhala ndi zilonda zopaka mafuta akuyesera kutenga malo amodzi momwe ululuwo sungamveke. Komanso ndi matenda ngati awa, kusanza kumachitika kawirikawiri.

Ndi kapamba, wodwalayo amakhala ndi vuto. Satha kupeza malo amodzi ogona. Komanso matendawa amaphatikizidwa ndi kusanza kosalekeza. Chifukwa cha matendawa, magazi omwe amapezeka m'magazi amatha kukhala osokonezeka.

Kusiyana pakati pa kapamba ndi cholecystitis

Matenda awiriwa ali ndi zizindikiro zofanana. Ndipo nthawi zambiri cholecystitis imakhala chifukwa cha matenda amunthu. Cholecystitis imadziwika ndi kupezeka kwa kupweteka kumanja kwam'mimba komanso kusintha kwa zowawa kumapewa. Pa ultrasound, njira yotupa imatchulidwa.

Kuphatikiza apo, wowerenga apeza zothandiza pazomwe cholecystitis ili ndi momwe angachitire pamasamba atsamba lathu.

Kusiyana pakati pa kapamba ndi kufinya kwam'mimba

Pancreatitis imatsatana ndi matumbo osokoneza. Ululu m'matumbo amachitika kwambiri, kusanza, kusefukira, kenako kudzimbidwa kwakanthawi - zonsezi ndi chizindikiro cha kapamba.

Mutha kusiyanitsa matendawa kuchokera m'matumbo amtsempha wamagazi. Ngati magazi a chloride ali otsika, ndiye kuti izi zikuwonetsa kutsekeka kwamatumbo. Mulingo wambiri wa chloride ndi diastases zimawonetsa kukhalapo kwa pancreatitis mwa wodwala.

Mawonekedwe owoneka

Mu chilonda chachikulu cha pancreatitis kapena pakukhathamira kwa matenda, zizindikiro zazikulu za kutupa ndi:

Ululu waukulu mu dera la epigastric wokhala ndi mafinya kumbuyo, m'miyendo, m'munsi, pachifuwa. Zowawa ndizosatha, sizimalimbikitsidwa ndi ma pinkiller ndi antispasmodics. Odwala amasangalala, kukuwa, ngati apita koopsa, kugwedezeka ndi chikumbumtima chitha.
Kusanza kobwereza komanso kopweteka, sikumapereka mpumulo kwa wodwalayo, kumakulitsa kufooka.
Kutulutsa magazi, kuvutika pakumeta kwa gasi, chopondapo.
Odwala amakhala ndi mawonekedwe: maso owoneka, milomo, milomo yamtambo, malo ofiira amtambo pakhungu la matako ndi kotheka.
Kuwonjezeka kwa kutentha kumawonetsa mtundu wa kachilombo ka pancreatitis pachimake. Nthawi zambiri chimakhala pa madigiri 38, motsutsana ndi izi pamachitika kufooka kotsika, kotchulidwa tachycardia kutsimikizika. "Lumpha" lakuthwa ndi kutsika kwa kutentha kukuwonetsa matenda opatsirana mu minofu yapafupi, peritonitis.
Odwala amatha kusinthasintha magazi.

Zodandaula pakamwa pouma (kusowa kwa malovu), zonenedwa zoyera kuphatikiza pazilime ndizotheka.
Madokotala ochita opaleshoni pachipatala nthawi zambiri amayembekeza kuti odwala azifika madzulo ndi usiku kutchuthi

Momwe mungazindikire kapamba: kutsimikiza kwa mitundu yovuta komanso yopweteka

Chifukwa cha kusayenda kwa ndulu mu kapamba, chikasu pakhungu, kusokonezeka kwa kugaya chakudya kumawonedwa, kupezeka kwa mtundu wachiwiri wa matenda osokoneza bongo, hyperglycemia, sikutha.

Mawonekedwe awonetsero wakutupa mu kapamba ndi:

zokutira yoyera palirime,
kusapeza bwino pakhungu
ululu pamlingo wa msana ndi nthiti.

Matenda a kapamba: Zizindikiro, matenda ndi mawonekedwe a mankhwala

Matenda a kapamba ndi matenda am'mimba omwe amaphatikizana ndi kukula kwa njira yotupa yopatsirana. Matendawa amapezeka pafupipafupi mwa azimayi a zaka zapakati komanso okalamba.

Matendawa amatha kukhala chifukwa cha pancreatitis pachimake, koma nthawi zambiri amakula pang'onopang'ono chifukwa cha kupukusa kwam'mimba thirakiti.

Ndikofunikira kuganizira mwatsatanetsatane kuti pancreatitis yayitali ndi chiyani, zizindikiro zake, kuzindikira ndi chithandizo chiti chikufunika.

Zimayambitsa kukula kwa kapamba

Zikondazo zimapanga ma enzymes am'mimba mu mawonekedwe osagwira. Izi zimateteza maselo amthupi ku zotsatira zawo. Kutsegula kwa ma enzymes kumachitika kokha mu lumen ya duodenum. Komabe, zinthu zina zimatha kusokoneza njira zomwe zafotokozedwazo ndi zomwe zimayambitsa kusokoneza njira.

Zinthu zotsatirazi ndizosiyanitsa:

Zakudya zazonunkhira, zamafuta zomwe zimachulukitsa katundu pa kapamba,
Mowa. Izi zimakhala ndi poizoni pakudya chamagaya, madzi a pancreatic amasintha kapangidwe kake,
Kusuta
Poizoni ndi mankhwala oopsa,
Matenda a chiwindi ndi chikhodzodzo (matenda a ndulu, chiwindi, cholecystitis). Matenda amatsogolera pakuwonjezeka kwa katundu pa kapamba komanso chitukuko cha khansa yodalira pancreatitis.
Kuchotsa gallbladder
Matenda a mtima opatsirana
Pathology ya duodenum,
Kuvulala komwe kumayambitsa kuphwanya umphumphu wa gland,
Nthawi zambiri zopsinja.

Zinthu izi zimabweretsa kuwonongeka kwa maselo a kapamba, kakulidwe ka aseptic yotupa, zizindikiritso zapadera. Njira za m'matumbo zimapangitsa kuchepa kwa magwiridwe antchito, kuyimitsidwa pang'onopang'ono kwa minyewa yathupi lathu. Zotsatira zake, matendawa amayambitsa kuchepa kwapang'onopang'ono kwa kuthekera kwa chinsinsi cha zisa zam'mimba.

Kugawidwa kwa matenda kapamba

Kutengera ndi chiyambi, pancreatitis yokhazikika imadzipatula poyambira (poizoni, mowa) ndi sekondale (biliary). Kutengera ndi chithunzi cha chipatala, pali mitundu yotere yamatendawa:

Zowawa (zowonjezera kapena zopitilira)
Pseudotumorous (ndi portal matenda oopsa, cholestatic, ndi pang'ono duodenal kutsekeka),
Zachikazi. Zizindikiro palibe
Kuphatikizidwa. Matendawa amadziwika ndi kukhalapo kwa zizindikiro zingapo.

Malinga ndi chithunzi cha morphological, chifuwa chachikulu chimapangidwa:

Zopindulitsa
Kuletsa
Kutupa
Zododometsa.

Chithunzi cha kuchipatala

Mu chifuwa chachikulu cha khansa, zizindikiro zotsatirazi zimayamba:

Zowawa. Zowawa zimatha kukhala zosapepuka kapena kudula, pakakhala chisamaliro chamankhwala chapanthawi yake, kudandaula kumatha kuchitika. Ululu umapezeka kudera la epigastric kumanja, ngati kutupa kumayamba m'mutu wa kapamba, pomwe zimakhudzana ndi kutupa kwa thupi, m'chigawo cha epigastric kumanzere, komanso kuwonongeka kwa mchira wake, kumanzere kwa hypochondrium. Matenda owonjezera amadziwika ndi kupweteka m'chiuno,
Kubweza Pakuchulukirachulukira, odwala amadandaula za kusanza kosakanikirana ndi bile. Munthawi imeneyi, kukana chakudya kwathunthu ndikofunikira,
Kubwera pansi kwa chopondapo. Kukula kwa matenda otsegula m'mimba ndi chikhalidwe, ndowe zimakhala ndi fungo labwino, zimakhala ndi chakudya chosagwiritsidwa ntchito. Kudzimbidwa sikutheka chifukwa chamtundu wa bata,
Kuphwanya minofu. Pakuwukira, minyewa yam'mimba imasiya kugwirana, yomwe imayambitsa kuphwanya pansi,
Kukhazikika kwa kutentha ndi kuthamanga kwa magazi. Pakakhala vuto, wodwalayo akuipiraipira. Kupsinjika kwa magazi kumayambitsa kusokonekera mu mtima, kupuma movutikira, thukuta lomata, kuwoneka ngati chikasu pamalirime,
Kusintha khungu. Khungu limakhala lofiirira ndipo limayamba kupindika.
Kukha magazi. Kupanga kwa mabala m'chigawo cha umbilical komanso kumbuyo kwakumbuyo ndi khalidwe. Khungu limakhala ngati nthenga. Zomwe zimasinthazi ndikulowerera kwa magazi kuchokera ku gland pansi pa khungu.
Kukhazikika kwa zopinga za jaundice. Khungu ndi sclera zimayamba kupindika. Vutoli limalumikizidwa ndi kukakamiza kwa duct ya bile yodziwika ndi ma pancreatic tis.

Komanso, odwala amadandaula za kuchepa kwa chakudya, pakamwa pouma, akung'ung'udza pamimba. Matenda a kapamba amadziwika chifukwa cha kukhalapo kwa zizindikiro za dyspeptic.

Laborator diagnostics

Kuti mumvetse bwino za matendawa, adotolo adzafunika kafukufuku wa zasayansi wa ndowe, mkodzo ndi magazi:

Kuyesedwa kwa magazi konse. Phunziroli panthawi yowonjezereka ikuwonetsa chithunzi chosachizira: Chiwerengero cha leukocytes ndi ESR chikuwonjezeka,
Kuyesa kwamwazi wamagazi. Kusanthula komweku kumatilola kusiyanitsa matendawa. Ndi kuwonjezeka kwa lipase, amylase, glucose, ntchito ya C-yogwira mapuloteni motsutsana ndi maziko a kuchepa kwamapuloteni onse ndi albumin m'magazi, kupezeka kwa kutupa kwa kapamba kumatha kukayikiridwa.
Urinalysis Kuwonjezeka kwa kuchuluka kwa amylase mumkodzo (zoposa 17 mayunitsi / h) amalankhula za kapangidwe ka kapamba.
Cop program. Mafuta ochuluka, mafupa osasokonekera ndi minofu yamitsempha amatsimikiza.

Kugwiritsa ntchito zida zothandiza

Monga gawo la chida chofufumitsa chodwala, njira zimagwiritsidwa ntchito kuti tiwone ngati kapamba, zomwe zimachitika chifukwa cha chitukuko cha kapamba chifukwa cha thupi. Njira zotsatirazi zimagwiritsidwa ntchito kwambiri:

Ma Ultrasound diagnostics. Izi sizophunzirira zowononga komanso zothandiza. Amakulolani kuti mudziwe momwe ziwalozo zimapangidwira, kukula kwake, kuchuluka kwa madzimadzi kumbuyo kwa peritoneum, omwe ndi purulent kapena necrotic misa.
Roentgenogram. Imagwiritsidwa ntchito ngati miyala yodziwika bwino m'matumbo kapena m'miyala yake. Njira imakuthandizani kukhazikitsa kukhalapo kwa zosadziwika za kapamba: kuphatikizika kwam'mimba, kumatulutsa.
Zolemba pamakompyuta Njirayi ndi ya mitundu yopindulitsa kwambiri, koma yotsika mtengo kwambiri. Tomography imakupatsani mwayi wokhazikitsa kukhalapo kwa necrosis ya chiwalo, kukula kwake, kupezeka kwa madzimadzi mumitsempha yam'mimba komanso m'mimba.
Laparoscopy Njirayi imalola osati kungodziwa matenda, komanso kuchita maopaleshoni. Chifukwa cha chipangizo chapadera (laparoscope), adokotala amapeza mwayi wowunikira mosamala chiwalocho, kuti awone kukula kwa kutupa. Laparoscopy ndi mankhwala okhawo ovuta.

Kusiyanitsa mitundu

Panthawi ya kapamba, wodwalayo amatenga zizindikiro zomwe zimadziwika ndi "m'mimba pachimake". Chifukwa chake, monga gawo lazodziwikiratu, ndikofunikira kupatula njira zotsatirazi za opaleshoni:

Kukwaniritsa chilonda. Amadziwika ndi kukula kwa ululu wopweteka, womwe umalumikizidwa ndi kulowa mkati mwa m'mimba mwa zamkati mwazomwe zili m'mimba kapena matumbo. Izi zimayambitsa kukomoka kwa khoma lam'mimba, wodwala amawopa kusuntha. Zizindikiro zoterezi sizodziwika ndi kapamba. Ndikapangidwa ndi chiwopsezo, ululu wammbuyo umadziwika, kuyambira pomwe munthu amathamangira pabedi,
Pachimake cholecystitis. Kusiyanitsa ndi matendawa kumatha kubweretsa zovuta zina. Komabe, ndi cholecystitis, ululuwo umawonekera kudzanja lamanja, ukugwedezeka kumapewa.
Pachimake matumbo. Pathology imadziwika ndi kukula kwa kupweteka kwamkokomo. Pancreatitis imapangitsa kupweteka kosalekeza. Monga gawo la kuyesa kwa X-ray, chithunzicho chikuwonetsa m'mimba yopanda timbale ta Kloiber,
Mesothrombosis. Matendawa amakula mwaukalamba mwa anthu omwe ali ndi mbiri ya matenda a mtima. Zizindikiro zikukula mwachangu, sizikugwirizana ndi kudya.

Gulu lazakudya zamankhwala

Kodi kuchitira pancreatitis aakulu mawonekedwe? Chithandizo cha matendawa chimaphatikizapo kuchepetsa chiopsezo cha kufalikira komanso kusamalira chimbudzi. Chifukwa chake, kufunika kwapadera kuyenera kuperekedwa kwa zakudya zoyenera.

M'masiku oyamba ochulukirachulukira, muyenera kusiyiratu kudya chakudya. Pazakudya, shuga wambiri umafunika; kuti muchepetse ludzu, gwiritsani ntchito 1% yankho la soda.

Kuyambira masiku 3-4, mutha kuwonjezera chakudya chamagulu pang'onopang'ono. Zakudya za tsiku ndi tsiku (2-2,5 malita amadzi) zimayenera kugawidwa m'magawo 8. Amaloledwa kudya zakudya zopanda mafuta zomwe zimakhala ndi mafuta osavuta a vitamini, Vitamini C, gulu B, madzi ambiri. Chololedwa: zipatso zamasamba, uchi, kupanikizana, decoctions (blackcurrant, rosehip), zakumwa za zipatso.

Pa tsiku lachisanu, mutha kusinthanitsa chakudyacho ndi chakudya chomwe chimakhala ndi mapuloteni ochepa a masamba ndi mkaka. Kungoyambira pa tsiku 7 ndi pomwe amaloledwa kudya mafuta. Chakudya chizikhala chosenda, kuwira kapena kuwiritsa. Kuchokera pazakudya za wodwalayo, zinthu zomwe zimapangitsa kupanga gastric ndi pancreatic juice siziyenera kuyikidwa pambali. Izi zikuphatikiza:

Nyama ndi nsomba zophatikizika,
Zatsopano zamasamba ndi zipatso,
Bowa
Mowa ndi zakumwa zoziziritsa kukhosi,
Chocolate, Khofi, Cocoa,
Ziphuphu
Zonunkhira, zokazinga ndi zamchere,
Mkate wakuda ndi watsopano,
Mazira
Masamba opaka msuzi wowawasa,
Wowawasa zonona
Maswiti aliwonse ndi makeke,
Zakudya zautsi ndi zamzitini,
Zonunkhira.

Kafukufuku wambiri watsimikizira kuti kuchuluka kwamapuloteni ambiri muzakudya kumabweretsa kusintha kwa mkhalidwe wa wodwalayo. Chifukwa chake, odwala ayenera kudya mapuloteni mpaka 140 g tsiku lililonse, ambiri omwe ndi achinyama.

Tanthauzo la pancreatitis yovuta komanso yopweteka

Matenda a pancreatitis ndi gulu la matenda opatsika pancreatic a etiology ambiri, makamaka otupa mwachilengedwe, omwe ali ndi gawo limodzi pang'onopang'ono, osokoneza kapena kuwonongeka, kusintha kowonongeka mu gawo lake la exocrine, atrophy of the glandular element (pancreatitis) ndi kusintha kwa ma membrane (fibrous) minofu. Kapamba, mapangidwe a cysts ndi calculi ndi magawo osiyanasiyana ophwanya exocrine ndi endocrine ntchito. Kusintha kwa morphological komwe kumachitika mu kapamba ndi CP kumapitirira ngakhale atatha kutengera kwa etiological factor.

OP ndi mawonekedwe a nosological osaphatikizika omwe amaphatikiza zizindikiro zamatenda ndi zamtundu ndipo amadziwika ndi kuwonongeka kwakuopsa kwa maselo acinar ndikukula kwa kutulutsa kwawoko komanso ambiri. Kumayambiriro kwa matendawa, njirayo imakhala yodziwikiratu zachilengedwe, kenako nkutupa. Ogonjetsedwa amatha kupita patsogolo (mpaka chitukuko cha necrosis), kudziyimira pawokha ndikubwereza.

Ili ndi magwiridwe antchito osiyanasiyana komanso ochititsa manyazi, oyambira komanso owopsa a m'matupi a wodwalayo, omwe nthawi zambiri amachititsa kuwonongeka kwakukulu kwa ziwalo zofunika, amapanga maziko olimba mwadzidzidzi komanso ovuta kwambiri mwa wodwala ndi OP. Ikhoza kukhala matenda odziyimira pawokha kapena kupsinjika kwa zina.

Mwambiri, milandu yosavuta ya OP imayamba, pomwe njirayo imangokhala mpaka kapamba, pomwe kugonjetsedwa kumawoneka ngati kosinthika. Mu gawo laling'ono, zochitika zopitilira muyeso za edematous OP zimadziwika, njira ya pathological ikupita patsogolo mu kapamba ndikukula kwa necrosis (pancreatic necrosis), zomwe zimapangitsa kuti ziwalo zambiri zilephereke komanso kufa kwa wodwala.

Kuwongolera ululu

Pachifukwa ichi, mankhwala omwe ali ndi njira zotsatirazi amagwiritsidwa ntchito kwambiri:

H2-histamine receptor blockers (Famotidine, Ranitidine). Amachepetsa kupanga hydrochloric acid mwa kutseka ma histamine receptors omwe ali kukhoma kwa m'mimba,
Proton pump blockers (Omeprazole, Pantoprazole, Lansoprazole, Rabeprazole, Esomeprazole). Njira zimapangitsa zoletsa za hydrochloric acid synthesis ndikuletsa pancreatic ntchito,
Mankhwala a Antispasmodic (No-shpa, Mebeverin, Spazmolgon). Mavuto opweteka ndi kapamba amayamba ndi kupsinjika mkati mwa ma ducts, antispasmodics amatha kuchotsa chizindikiro chosasangalatsa.

Zinthu za mankhwala othandizira

Kutupa kwa kapamba kumayambitsa kusokonezeka pakupanga michere ya m'mimba, yomwe imakhudzanso chimbudzi cha chakudya. Chifukwa chake, mankhwala a pancreatitis ayenera kuphatikiza kugwiritsa ntchito kukonzekera kwa enzyme (Mezim, Pancreatin, Creon, Pangrol, Festal). Ndikofunika kusankha mlingo woyenera kuti musinthe kugaya.

Kukonzekera konse kogwiritsa ntchito ma enzyme kumakhala ndi zokutira zapadera zomwe zimasungunuka m'matumbo okha. Mapiritsi amatengedwa ndi chakudya, sangathe kutafuna.

Mankhwala othandizira

Opaleshoni ingafunike ngati:

Zovuta za purulent
Cysts
Stenosis wa phula wa ku Oddi,
Kuletsa milunda ya ndulu ndi kapamba,
Kusintha kwakukulu kw chitsulo,
Chachikulu kapamba, pamene matendawa sangathengedwe njira zochizira.

Kugwiritsa ntchito mankhwala achikhalidwe

Kugwiritsa ntchito njira zina zaphikidwe kuyenera kuvomerezedwa ndi dokotala. Njira zotsatirazi ndizothandiza:

Sinthani zotupa za ndulu. Mwofanana zofanana (supuni 1 iliyonse), sakanizani mizu ya dandelion, tansy, knotweed, chamomile ndi osafa. Osakaniza amapangidwa mu 1 lita imodzi ya madzi otentha ndikuyika kwa maola awiri. A decoction amatengedwa 200 ml patatha mphindi 30 chakudya chilichonse,

Kuchepetsa ululu. Sakanizani ndi pogaya udzu wa zapnik, dandelion, motherwort, radish, chamomile, yarrow, plantain, ndi sinamoni. Supuni ziwiri za osakaniza kutsanulira 500 ml ya madzi otentha, kusiya kwa maola 8. Mankhwala amatengedwa asanagone,
Kuchepetsa kutupa. Kuchokera pa udzu watsopano wa plantain, muyenera kufinya msuzi wake. Amamwa supuni musanadye masiku 30 alionse.

Mavuto a matenda kapamba

Matendawa amabweretsa kusokonezeka pang'onopang'ono kwa ntchito ya ziwalo zambiri zathupi. Mwa zovuta zoyambirira, ma pathologies otsatirawa ndi osiyana:

Matenda oopsa a portal,
Chovala chowopsa,
Kutha kwa magazi chifukwa cha kufukiza kwam'mimba ziwalo
Matenda opatsirana.

Pancreatitis imathandizira pakukula kwa zovuta zamagulu:

DIC
Encephalopathy
Kulephera kwamitundu yambiri.

Ngati wodwalayo atsatira molondola zomwe dokotalayo amamuuza, chifuwa chachikulu chimadziwika. Popanda chithandizo komanso kuphwanya zakudya zopatsa thanzi, matendawa atha kufa.

Kupewa matenda

Potengera njira zoyambirira kupewa, tikulimbikitsidwa kuchita izi:

Idyani zakudya zoyenera
Pewani zizolowezi zoipa (kusuta, kumwa mowa),
Kumwa madzi ambiri
Zokwanira mankhwala a pathologies a m'mimba ziwalo.

Matenda a kapamba am'mimba ambiri. Matendawa amayambitsa kusintha kosasintha kwa kapamba, amafunika chithandizo choyenera.

Pancreatitis yachilengedwe komanso yovuta: kusiyana, kuzindikira, chithandizo

Pancreatitis ndimatenda omwe amakhudza minofu ya kapamba. Pancreatitis yovuta komanso yosatha imasiyanitsidwa kutengera mawonekedwe. Kuti mupeze chithandizo choyenera, ndikofunikira kuchita bwino kwambiri. Maonekedwe a matenda osachiritsika nthawi zambiri amagwirizanitsidwa ndi mtundu wovuta wa matendawa.

Mitundu yamatenda

Pancreatitis pachimake ndi njira yodutsitsa kapamba, pomwe nthawi ikuluikulu imatha kuchitika - kuwonongedwa kwa maselo a gland ndi ma enzymes awo.

Mtundu wokhazikika wa matendawa amadziwika kuti ndi matenda omwe amatanthauza kuti matendawa atha kusintha m'matumbo omwe samatha atatha chifukwa cha matenda.

Zotsatira zamtunduwu wa kapamba ndizovuta chifukwa cha kapamba ndi kuponderezedwa kwa ntchito yake.

Zizindikiro za matendawa

Cancreas ndi yaying'ono kukula, koma imagwira ntchito zofunika kwambiri mthupi, yayikulu ndikuphimba kwa michere ya chakudya yothandiza kupukusa chakudya komanso kupanga insulin, kusowa kwa izi kumabweretsa matenda osokoneza bongo. Mukakhala pancreatitis yachilendo, ma Symbomatology amatha kuwoneka chimodzimodzi ndi poizoni. Ma enzyme opangidwa ndi gland amakhala mkati mwake kapena momwe amagwirira ntchito, ndipo amawononga chiwalocho, ndipo akangokhala m'magaziwo amayamba kuyambitsa ziwopsezo zapoizoni.

Zizindikiro za Acute Pancreatitis

Pancreatitis pachimake ndi kutupa mkati mwa kapamba ndimatenda osiyanasiyana okhudzana ndi minofu ndi ziwalo zina ndi machitidwe. Zizindikiro zodziwika pancreatitis monga:

Ululu Zizindikiro zotchulidwa kwambiri. Ululu wopitilira ululu wamkati wamkati wamtundu wodula kapena wosakhazikika. Ngati simupereka chisamaliro chanthawi yake kuchipatala ndipo simumachotsa ululu wodwala, mantha amayamba. Yang'anirani pafupi ndi hypochondrium, kutengera malo omwe akuwonongeka pancreatic.
Thupi, kuchepa kapena kuchuluka kwa kuthamanga kwa magazi. Panthawi yovutikira, matenda a wodwalayo amayamba kukhala woipa kwambiri, kutentha kumawonjezeka.
Maso a nkhope. Mukukonzekera kapamba, nkhope ya wodwalayo imakhala yofupika, khungu limayamba kupindika, ndipo patapita nthawi mthunziwo umakhala utoto.
Hiccups, nseru. Zizindikiro monga mkamwa youma, hiccups, belching, ndi nseru ndizomwe zimayambitsa matendawa.
Gag Reflex. Kuyamba ndi bile sikupereka mpumulo waukulu. Chifukwa chake, pamayambiriro a pancreatitis pachimake, saloledwa kudya chakudya, mumkhalidwe wotere njala ndiyovuto lalikulu lotsatira.
Kutsekula m'mimba kapena kudzimbidwa. Pakadali pano, mpando umakhala pafupipafupi ndi fungo la fetid. Kudzimbidwa, kutulutsa, ndi minyewa yam'mimba imawuma, komwe kumakhala chizindikiro choyandikira pancreatitis yovuta.
Kupuma pang'ono.Zimachitika chifukwa cha kuchepa kwa ma elekitirodi pa nthawi yonyamula ma gag. Wodwalayo amasokonezedwa ndi kupumira pafupipafupi, thukuta kwambiri, ndipo pamakhala chikwangwani champhamvu palilime lachikasu.
Kufalikira. Matumbo am'mimba pakachulukanso kwa kapamba sikuchepa, chifukwa chake, pakuwunika, katswiriyo amawulula kutulutsa kowonekera, akafufuza, mavuto am'mimba samva.
Kamvekedwe ka khungu lamtambo. Malo amtundu wamtambo amawonekera pafupi ndi msomali kapena m'munsi kumbuyo, komwe kumapangitsa khungu kukhala lopendekeka, m'chigawo cha inguinal khungu limakhala losalala.

Munthawi ya chizindikiro ichi cha pancreatitis pachimake, wodwalayo amakhala woipa kwambiri mphindi iliyonse, osataya nthawi muzochitika zotere, ndipo muyenera kuyitanitsa madokotala.

Zizindikiro za Chronic Pancreatitis

Panthawi yopanga matenda, matendawa awiri amatha kusiyanitsidwa, oyamba - amakhala kwa zaka, omwe amadziwonetsa ngati zizindikiro kapena kuchepa, chachiwiri - zolakwika, zotupa zazikulu zimafotokozedwa ndikudabwitsani wodwalayo pafupipafupi.

Poyamba, wodwalayo amamva kupweteka kwakanthawi kochepa komwe kumawonekera mphindi 15 mutatha kudya komanso kuchokera kwa maola 3-5 mpaka masiku 3-5. Zomverera zowawa nthawi zambiri zimakhazikika m'mimba yapamwamba, pafupi ndi mtima, kumanzere kwa chifuwa, kutsika kumbuyo, pali zoteteza. Izi ndichifukwa chakumwa kwambiri mafuta, yokazinga, zakumwa zoledzeretsa kapena koloko, chokoleti, khofi. Zikondamoyo sizitha kupirira mitundu yambiri ya mapuloteni, mafuta ndi chakudya.
Mu chifuwa chachikulu cha khansa, dyspepsia (kusanza, kusanza, kutsegula m'mimba, kumatulutsa, kuwonda) ndizotheka. Ngati chithandiziro choyenera chikuchitika, ntchito ya thupi yopanga ma enzyme siyolakwika kwambiri ndipo wodwalayo amatsogolera moyo wake wakale mpaka atasiya kugwira ntchito.
Ndi pancreatitis yathanzi yayitali, kapangidwe kazinthu kameneka kamawonongeka, kupanga ma enzyme ndi mahomoni kumachepa, ndipo kuperewera kwachilengedwe kumapangika pakapita nthawi. Pa ululuwu, iwo sangawoneke konse, kapena mwina sangatchulidwe, ndipo kusokonekera kwa dyspeptic kudzakhala chizindikiro chachikulu cha matendawa.
Njira yovuta kwambiri ya kapamba imadziwika ndi khungu pang'ono, khungu, nthawi zina limazimiririka kwakanthawi.
Mu magawo apambuyo, pamene zikondamoyo zimachitika, matenda a shuga amakula.

Chithandizo cha kapamba

Mankhwala ochizira pancreatic matenda ndi njira yofunika kwambiri yochotsekera pachimake komanso chovuta cha kapamba. Mndandanda wamankhwala omwe amadziwika panthawi yamatenda a matendawa ndi ochepa, koma mankhwalawo pawokha samakhala ochepa ndipo amawonjezeredwa ndi mankhwala osiyanasiyana a magulu ena - kagayidwe kachakudya, kuthetsa kuledzera, ndikuchotsa zochitika zodwala.

Chithandizo cha pachimake kapamba

Pa siteji yamankhwala oyamba komanso othandizira othandizira, ambiri omwe ali ndi vuto la pancreatitis pachimake amachira sabata limodzi kuyambira chiyambi cha chithandizo.

Kugonekedwa kuchipatala kumathandizira kupewa kupitilira kwa pachimake kwa kapamba, kupewa kutembenuka kwa mitundu yodwala ya matenda kukhala necrotic, kuti muchepetse kufalikira kwa kusintha kwa necrotic mu gland.

Pakupita masiku awiri, kuzizira kumakhala kolumikizidwa, komwe kumalepheretsa kubisala kwa kapamba. Kuonetsetsa kuti thupi limakhazikika, wodwalayo ayenera kufa ndi njala sabata limodzi.

Maphunzirowa akakhala osavuta pambuyo poti kuchepa kwa kupweteka, kudya kumayambiranso. Iyenera kumwa mankhwala ochepa, koma pafupipafupi (5-6 pa tsiku).

Chakudya chizikhala ndi chakudya chochuluka, mapuloteni ndi mafuta ayenera kukhala ochepa, zomwe zimachepetsa kubisika kwa michere ya pancreatic.

M'magulu azachipatala, sikuti amangogwiritsa ntchito chithandizo chamankhwala, komanso machitidwe ena.

Chithandizo cha matenda kapamba

Njira yovuta ya matenda a kapamba imakhala yothetsa mavuto:

wodwalayo ayenera kusiya zakumwa zoledzeretsa ndikutsatira zakudya zoyenera,
enzyme m'malo mankhwala amafunika kulipirira exocrine pancreatic insufficiency. Njira izi zimapangidwa kuti zisalepheretse kupangika kwa zovuta komanso kupewa kuyambiranso.

Mankhwala osagwiritsa ntchito mankhwala

Mtendere wogwira ntchito m'thupi lino umapangidwa makamaka ndi zakudya, zomwe zimachepetsa kubisala kwa madzi a pancreatic ndikuletsa kupezeka kwa miyala yaying'ono. Ngati kukokoloka kwambiri kwa kapamba kumachitika kwa masiku angapo, tebulo 0 limayikidwa .. Pambuyo masiku 3-5, wodwalayo amatha kusamutsidwira ku chakudya chamlomo.

Payenera kukhala pafupipafupi (mpaka nthawi 4-6 pa tsiku), pakadontho kakang'ono. Chakudya chiyenera kukhala pansi moyenera, chizikhala ndi mapuloteni ambiri osakanikirana ndi zakudya zabwino. Chepetsa kumwa zakudya, zomwe zimatha kubisitsa kutisiti, makamaka mafuta, wowawasa.

Wodwalayo saloledwa kumwa zakumwa zoledzeretsa, zakudya zonunkhira, zakudya zamzitini, koloko, msuzi wowawasa wa zipatso.

Mankhwala

Mankhwala ochizira pancreatitis yoopsa amachitika ndi mankhwala otsatirawa:

Kuchepetsa ululu pakachulukitsa ka mawonekedwe a chifuwa cham'mimba, ma analgesic omwe si a narcotic ndi myotropic antispasmodics amagwiritsidwa ntchito.
Mankhwalawa, antihistamines amagwiritsidwa ntchito zomwe zimalepheretsa kubisala kwa gland ndi ntchito ya ma hydrolytic enzyme.
Kuti muchepetse chidwi chosangalatsa cha peptides wokhazikika pazitulu zakunja za kapamba ndi katulutsidwe ka m'mimba, proton pump inhibitors kapena histamine H2 receptor blockers amalembedwa.
Maantacidid amathandizira kuchepetsa HCI komanso kutsika kwa secretin, ndikupereka bata ku gland.
Kuphatikiza apo, othandizira amagwiritsidwa ntchito omwe amalepheretsa ntchito za ma enzymes a chiwalo ichi omwe amalowa m'magazi. Chizindikiro chogwiritsira ntchito mankhwalawa chidzatchedwa hyperfermentemia.
Munthawi yakuchulukitsa kwa mawonekedwe a kapamba, omwe amaphatikizidwa ndi kupangika kwa peripancreatitis, cholangitis ndi zovuta zina, maantibayotiki omwe ali ndi zotsatirapo zosiyanasiyana amapatsidwa mankhwala.

M'malo mankhwala

Ntchito ya exocrine pancreatic ikakhala yafupika, zizindikiro za malabsorption ndi steatorrhea zimakhalapo kuti zithetse chithandizo, othandizira enzymatic amagwiritsidwa ntchito. Mlingo wa mankhwalawa umatengera kuchuluka kwa kuperewera kwa kapamba.

Othandizira enzymatic sayenera kuchepetsa pH ya madzi am'mimba kapena kusangalatsa katulutsidwe ka pancreatic. Kutalika kwa chithandizo kumatengera thanzi la wodwalayo.

Mankhwala amagwiritsidwa ntchito omwe amachepetsa katulutsidwe ka pancreatic: ma antacid, histamine H2 receptor antagonists, PPIs, anticholinergic mankhwala. Pamene exocrine kusakwanira kwa chiwalochi kupezeka, michere iyenera kutengedwa.

Kuwunikira pafupipafupi ndi katswiri, kadyedwe kazakudya komanso njira yolondola yantchito ndikupumula kwambiri kumachepetsa kuyambiranso kwa chifuwa chachikulu komanso chovuta cha kapamba. Kuchotsedwa kumatha kukhala kwa nthawi yayitali, mpaka zaka 5-7. Pakapita kanthawi, mankhwala othandizira kupewa ayenera kuchitika, kusiya zosokoneza bongo ndikuledzera.

Pancreatitis Epidemiology

Chifukwa cha kuchuluka kwa matenda a zam'mimba, kuchuluka kwa kuchepa kwa thupi, kulumala kwakanthawi ndi kulephera kwa odwala, kapamba amadziwika kuti ndi vuto lofunika kwazachuma komanso zachuma zamankhwala amakono. Potengera momwe ziwalo za m'mimba zimayendera, gawo lawo limachokera ku 5.1 mpaka 9%, ndipo pazochitikira kuchokera ku 0,2 mpaka 0,6%.

Pa zaka 30 zapitazi, pakhala pakuchitika padziko lonse lapansi koonjezeranso kawiri konse za OP ndi CP. Ngati m'ma 1980s. chiwopsezo cha CP chinali 3.5-4.0 pa anthu 100,000, m'zaka khumi zapitazi pakhala pakuwonjezeka - milandu ya 8.210 pa anthu 100,000 chaka chilichonse. Ku USA ndi Denmark, KP inalemba zochitika za 3.5-4 pa anthu zana limodzi. Kuchulukitsidwa kwa OP kumachokera ku 49,5 (ku USA) mpaka 73.4 (ku Finland), ndipo ku Europe ndi milandu 25.0-26.4 pa anthu zana limodzi.

Nthawi zambiri matenda osachiritsika amakhala ndi zaka zapakati (zaka 35-50). M'mayiko otukuka, ndizodziwika kuti "achichepere": zaka zapakati pazazidziwitso zatsika kuyambira 50 mpaka 39. Mwa odwala, kuchuluka kwa azimayi kumawonjezeka ndi 30%; kulemala kwenikweni kwa odwala kumafika 15%.

Ku Russia, chiwonetsero chachikulu cha pancreatitis pakati pa azaka zonse zaanthu zadziwika. Zimakhala milandu ya 9-25 mwa ana ndi 27.4-50 pa 100 miliyoni yaanthu akuluakulu. Chiwerengero cha matenda a kapamba mwa akulu ku Moscow pazaka khumi zapitazi achulukitsa katatu, ndipo mwa achinyamata - kanayi kapena kupitilira apo. Amakhulupirira kuti izi zikugwirizana ndi kuwonongeka kwa chilengedwe m'derali, kuchuluka kwa zakumwa zoledzeretsa (kuphatikizapo mtundu wotsika), ndi kuchepa kwa chakudya komanso miyezo yamoyo.

Kukula kwa matendawa kukukulirakulira, kuphatikiza pa kusintha kwa matenda, kumayambiriro kwa njira zamankhwala zatsopano za mawonekedwe a kupanikizika ndi malingaliro apamwamba, omwe amalola kutsimikizira OP ndikuwona CP kumayambiriro kwa chitukuko.

Matenda a CP amabweretsa kuwonongeka kwakukulu pamlingo wamoyo komanso chikhalidwe cha anthu ambiri azaka zapakati komanso zapakatikati (akulu kwambiri). Ndi mobwerezabwereza maphunziro a CP mu 30% ya milandu, zovuta zoyambirira zimayamba (purulent-septic, magazi kuchokera zilonda zam'mimba za gastroduodenal zone, thrombosis mu portal vein system, stenosis ya duodenum, etc.), ndi kufa kumafika pa 5.1%.

Pambuyo podziwitsidwa koyamba kwa CP, kufa kumafika 20% pazaka khumi zoyambirira za matendawa ndi zina - 50%, patatha zaka makumi awiri - avareji ya 11.9%. 15-20% ya odwala omwe ali ndi CP amafa chifukwa cha zovuta zomwe zimachitika chifukwa chakuwopseza matendawa, ena onse chifukwa cha kupukusidwa kwa m'mimba komanso zovuta zina. Malinga ndi autopsy, kuchuluka kwa CP kumasiyana kuchokera pa 0.01 mpaka 5.4% (avareji ya 0.3-0.4%).

Imfa zochokera ku OP zikukula pang'onopang'ono. Chifukwa chake, mu 1995, 1996 ndi 1997. zinali zokwanira 1.94, 1.98 ndi 2.08 pa anthu 1,000 aliwonse ku Russia.

CP imasewera ngati "kama" wokhudzana ndi chitukuko cha kapamba. Chifukwa chake, ngati muli ndi mbiri ya CP pazaka makumi awiri, chiopsezo chotenga khansa chimawonjezeka kasanu. Kusanthula kwa mawerengero ku United States kwawonetsa kuwonjezeka katatu kwa anthu omwe amwalira ndi khansa ya kapamba nthawi yomweyo ndi zomwe zimachitika ndi CP.

Zizindikiro za mawonekedwe osakhazikika

Njira yayitali ya matendawa imayambitsa matenda am'mimba. Zimawonetsa kuwonongeka kwa kapamba ndipo zimawonetsedwa:

Matumbo ofala, omwe umadzaza ndowe, umakutidwa ndi filimu yamafuta osaneneka, ali ndi imvi komanso fungo la fetid,
Kuchepetsa thupi
kupweteka kwam'mimba komwe kumachitika nthawi ndi nthawi pambuyo pakuphwanya zakudya, osakhala ndi kutuluka kwachidziwitso, kumatha kukhala lamba, mwa odwala ena kulibe,
kusanza kwakanthawi, kusanza kamodzi.

Odwala osakhazikika, pamatha kukhala zizindikiro zakuphwanya kwa endocrine gland (kusinthasintha kwa glucose m'magazi), kotero kunjenjemera m'thupi, chizungulire, njala ndi ludzu, kukokana m'matumbo a miyendo. The Symbomatology ya kapamba ndi ofanana kwambiri ndi matenda ena am'mimbamo.

Ndikofunikira kuzindikira pancreatitis koyambirira, popeza maphunzirowo amayamba kuvuta pang'onopang'ono, amapangitsa kuti necrosis ifalikire komanso kuchuluka kwa ziwalo, komanso kuwonongeka kwa ziwalo zina. Kusiyanitsa kofunikira kumafunikira kudziwa mawonekedwe osiyana ndi matenda omwe ali ndi matenda omwewo.

Kuyandikira kwa kapamba mpaka ziwalo zina ndi mphamvu ya dzuwa kumapangitsa zotsatira za ululu wamkamwa kutupa

Ndi mayeso ati omwe amawonetsa ntchito za kapamba?

Ntchito ya yotupa ndi pancreatitis imadziwika osati ndi ma labotale, komanso ndi mayeso ogwira ntchito. Mayeso a Probe - tchulani zolondola kwambiri. Amakhala ndi kupeza kudzera mu kafukufuku wa gastroduodenal (njira yachindunji) ndi kufunitsitsa kwa zomwe zili mu duodenum ndi kutsimikiza kwa ma pancreatic enzyme ndi michere ya bicarbonate mmenemo.

Kuyesa kwa magazi pa biochemical pancreatitis

Kuyesedwa kwa secretinpanreosimine kumawerengedwa kuti ndi kopindulitsa kwambiri. Njira zosagwiritsa ntchito (Mayeso a Lund) amasanthula zotsatira za katundu wazakudya. Mayeso osafunikira - perekani zambiri zolondola. Direct imawerengedwa kuti iwone zomwe zili mu ndulu za michere (chymotrypsin, elastase).

Njira zosawerengera zimakhazikitsidwa pakuwerengera nthawi yamaphunziro owerengera a kuchuluka kwa kuphwanya zakudya, zakudya zotulutsidwa. Mayeso omwewo amachitika pamkodzo wa tsiku ndi tsiku (pancreolauryl, Schilling), pamlengalenga wotulutsa (triglyceride, protein, amylase).

Kodi ma radiografiti amapereka?

Chiberekero cham'mimba cham'mimba chosinthika chikuwonekera m'chifaniziro cham'mimba cham'mimba; kupanga kwa mpweya m'matumbo ang'ono ndi akulu kumakulitsidwa kwambiri motsutsana ndi pancreatic necrosis. Ndikothekanso kuzindikira miyala mu ndulu kapena duct. Mu chifuwa chachikulu, ma calcified (madontho amchere a calcium) mu kapamba nthawi zambiri amawonekera.

Kuunika pachifuwa kumavumbula zizindikiro zosakhudzana ndi chifuwa cham'mimba: madzimadzi kumanzere kwakumanzere (osadziwika mbali zonse), kukakamira kwa m'munsi m'mapapo, kusunthika kwakanthawi. Zambiri mwatsatanetsatane zimapezeka ndikuwunika kwa m'mimba mwa x-ray, duodenum yosakaniza barium yosiyanasiyana, ndi cholecystography.

Ultrasound yokhazikika ya kapamba imawulula ma calcication mu bile ducts ndi gland parenchyma

Kuthekera kwa diagnostics a ultrasound

Mapeto ake a ultrasound a kapamba amachokera pa chizindikiritso cha:

kukulitsa ziwalo
chingwe cha ma contour pa edema ndi blur, ngati chotupa chitha kupita kuzinthu zapanchipisi,
Mphamvu ya kuchuluka kwa mapangidwe a parenchyma ndiwokwera kwambiri mu gawo la chikhululukiro, kugwa panthawi yowonjezereka, ndi kupindika kwachiphamaso cha heterogeneity yotchulidwa,
gulu losinthika, lomwe limawonetsa ma pseudocysts, madera okukulitsa kwa duct yapakati.

Zowonjezera ndiz:

kufinya mitsempha yayikulu yam'mimba,
madzimadzi m'mimba
kuchuluka kwa dambo la wamba bile,
splenomegaly,
timitsempha tambiri ta minyewa ta m'mimba.

Ndi pancreatitis yayitali yayitali, kapamba amakhala mnofu umodzi, amachepa chifukwa cha fibrosis. Ultrasound mu Doppler mode imawulula kusiyana pakati pa khansa ndi kapamba, imasankha magazi osinthika malinga ndi dongosolo la mtima. Dokotala wofufuza amawunika kusintha konse, poganizira zikhalidwe zokhudzana ndi zaka.

Pakuwerenga kwathunthu m'makliniki apadera, njira zogwiritsira ntchito intraductal ultrasound zimagwiritsidwa ntchito (mawu pamawu, mawonekedwe a biliary thirakiti), pancreatography yokhotakhota, kuyerekezera kwa laparoscopic kuchitika poyang'aniridwa ndi ultrasound.

Kodi kuyerekezera ndi kulingalira kwamatsenga kumawonetsa chiyani?

Njirazi zimazindikira bwino kufalikira kwa kutuluka kwa kapamba mpaka ziwalo zam'mimba, malo opatsirana, ndi ma lymph node.Zophwanya momveka bwino zimapezeka kuposa ndi ultrasound chifukwa cha edema ya parenchyma, ngakhale kukula kocheperako komanso kulowetsedwa kwa kapamba, malo oyandikana, ma pseudocysts, kusintha kwa mawonekedwe akulu, kuwerengera.

Angiography yamakompyuta imakupatsani mwayi wowerenga kayendedwe ka magazi mu kapamba.
Maphunziro a Magnetic resonance samasokoneza kuchuluka kwa kupangika kwa mpweya m'matumbo a matumbo

Njira za Endoscopic

Mothandizidwa ndi endoscopic retrograde cholangiopancreatography, mawonekedwe a cystic mu gland, kusintha kwa gawo lapakati mu gawo linalake la chiwalo (kawirikawiri mchira) amapezeka. Laparoscopy (kuwunika kwam'mimba kudzera pakatikati kakang'ono) kumakuthandizani kuti muwone kusintha kwakunja kwa ziwalo (steatonecrotic mafupa am'madzi pa mesentery ndi matumbo), kutulutsa madzimadzi pamimba, ndi biomaterial kuchokera kumadera ena a gland kuti muwoneke.

Myocardial infaration

Matendawa amayambitsidwa ndi coronary artery thrombosis. Ululu umakonda kuwonekera kumbuyo kwa sternum ndipo umakhala ndi chidwi, "chowotcha". Zosagwirizana ndi kudya kwambiri, cholelithiasis. Chosiyanasiyana cha gastralgic sichingasiyanitsidwe ndi kutupa kwa kapamba.

Koma mayeso owonjezera a kapamba akuwonetsa leukocytosis yayikulu, ESR, kukula kwa michere ya pancreatic. Zowonongeka kwa myocardial, kuwonjezeka kwa aspartic transaminase, lactate dehydrogenase, creatine phosphokinase ndizodziwika bwino. Palibe kusintha kwamkodzo komanso ndowe. Zotsatira za ECG zimathandizira kutsimikizira matendawa.

Khansa yapakansa

Tanthauzo la zotupa (khansa-embryonic antigen ndi carboantigen) zimathandizira kusiyanitsa ndi pancreatitis. Amakwezeka pang'ono ndi kapamba, komanso khansa kambirimbiri.

Njira zowunikira pancreatitis ndizofunikira osati kungodziwa matenda, komanso kuwunika kwa njira zochiritsira, kusankha kwa mawonekedwe a opaleshoni. Dispensary kuonedwa ndi gastroenterologist kumafuna kuunikanso boma la kapamba mu nthawi yayitali ya matenda.

Pachimake kapamba

Pachimake kapamba chifukwa cha chimbudzi ndi michere ya pancreatic zimakhala zawo, ndikulimbana ndi kutupa.

Zizindikiro za pancreatitis pachimake ndizosiyana, zimatengera zomwe zimayambitsa matendawa, momwe thupi liliri, zaka za wodwalayo komanso kupezeka kwa matenda owonjezera kuchokera ku ziwalo zofunika: ubongo, mtima, chiwindi, impso.

Zizindikiro za kupweteka kwa kapamba amaphatikizidwa ndi kupweteka kwambiri. Ululu ndi chizindikiro choyamba cha matenda. Kukula kwa ululu kumakhala kwamphamvu kwambiri kotero kuti odwala amagwa osazindikira kapena malingaliro ofuna kudzipha amawonekera. Kuwukira koteroko kumatchedwa "pancreatic colic." Chizindikiro chokhala ndi vuto la ululu wamtunduwu ndikulimbitsa kwake mutatha kudya, koma palibe kuwonjezeka pambuyo kutsokomola kapena kupuma kwambiri pakuyenda. Zowawa zimapereka kumbuyo kwa sternum, kumbuyo, pansi pamapewa, kumanzere kwa hypochondrium, nthawi zina kumakhala ngati lamba. Chifukwa chake, nthawi zambiri ndi pancreatitis yovuta kwambiri, amapezeka molakwika ndi infrction ya myocardial, angina pectoris, ndi cholecystitis. Zofunika! Kuti muzindikire matenda anu ndi kusiyanasiyana ndi matenda ena, muyenera kupita kuchipatala kwa adotolo, omwe akupatseni mayeso apadera ndi maphunziro.
Chizindikiro chotsatira cha pancreatitis pachimake imabwerezedwa ndikusanza mobwerezabwereza. Choyamba, masanzi magawo a chakudya omwe atengedwe madzulo, kenako ndulu yobiriwira ndi ntchofu. Pambuyo pakusanza, mkhalidwe wa wodwalayo sukusintha, koma, m'malo mwake, umangokulira, kusanza sikubweretsa.
Mphamvu ya kupweteka ndi kusanza imayambitsa chotsatira chodziwika kwambiri cha kapamba - kusokonezeka kwamanjenje: kuda nkhawa, kusokonekera, kusokonekera. Komabe, musasokoneze mawonetseredwe awa ndi zizindikiro za kuledzera kosatha, hepatic encephalopathy, pancreatogenic psychosis. Matendawa amatenga mwa odwala ndi pancreatitis yovuta, pomwe ziwiya zaubongo zimakhudzidwa. Psychosis poyamba imawonetsedwa ndi kuwonjezeka kwa machitidwe, kupsinjika, kunjenjemera m'manja, pambuyo pake boma ili limasinthidwa ndikusunthika ndi kuyerekezera zinthu (zowoneka ndi zowerengera), ndipo ngakhale pambuyo pake, posowa chithandizo chamankhwala, kufooka kwa chikumbumtima, stupor imachitika. Zofunika! Mu anthu omwe ali ndi matenda amkati mwa mtima, impso, chiwindi, ubongo ndi odwala a senile, ukalamba, vutoli limatha kukula chifukwa chopezeka ndi ziwalo zingapo.
Zotsatira zake zobwera chifukwa cha kuchuluka kwa ma enzymes kuchokera ku kapamba kupita m'mitsempha yamagazi, njira ya thrombosis imayamba m'matumbo. Mitsempha yamagazi imapangika m'mitsempha yamutu, mapapu, matumbo, ndi mtima. Ndipo gawo lotsatira la thrombosis limatchedwa "kumwa coagulopathy", ndiye kuti, magazi samangoboweka chifukwa chosakhalako ndi zinthu za hentaticatic mmenemo, zomwe zimagwiritsidwa ntchito popanga mapazi amwazi, ndipo magazi amatuluka m'malo a subcutaneous, jakisoni wambiri, catheters.
Kutentha kumakhala koyenera m'masiku oyamba, kenako ndikuwuka. Koma imakwera, monga lamulo, kokha kwa ziwerengero zochepa. Kukwera kwapamwamba kwambiri (pamtunda wa 38 madigiri) ndi chizimba cha kapamba ndi kukula kwa zovuta.
Zizindikiro zosadziwika pancreatitis: khungu limatha kusintha.

Khungu limatha kukhala loyipa pakhungu lotupa, pakhungu lowonjezereka limakankhira zikhomo zodziwika bwino ndi chiwindi, kapena mwala utatseka ndulu ya bile. Khungu la pakhungu limadziwika panthawi yopanga kupweteka kwa khunyu komanso kuledzera, kutuluka magazi kuchokera ku zilonda zam'mimba ndi duodenum. Kutsekeka kwa khungu ndi khungu la malekezero a manja, mapazi, mphuno kumachitika ndi kupuma komanso matenda akulu amtima.

Cyanosis imatha kukhala yofala kapena wamba. Ndi cyanosis yakomweko, mawanga a cyanotic amawoneka mbali zam'mimba, mozungulira msomali, kumaso. Pakhoza kukhala zotupa m'matako komanso pafupi ndi navel. Mtundu wotchulidwa wa buluu umakhala ndi mitundu yayikulu ya kapamba ndi kuledzera komanso kuwonongeka kwa mtima. Maonekedwe a cyanosis pakhungu la epigastrium, hypochondrium ya kumanzere imawonetsa njira yabwino ya matendawa.

Zizindikiro zakumaso kwa kapamba: m'chigawo cha epigastric pamakhala kupweteka kosakhazikika - kulowerera, kulowetsedwa, kutupira kumbuyo, kuphwanya gawo lazakudya zomwe zimatengedwa m'mimba thirakiti chifukwa chamachitidwe am'mimba a m'mimba, duodenum, matumbo. Ululu umadziwika pamene palpating epigastrium, hypochondrium lamanja ndi lamanzere ndi ngodya pakati pa nthiti yakumanzere ya XII ndi msana.

Mitundu ya Acute Pancreatitis

Pali mitundu iwiri ya pancreatitis pachimake: interstitial and necrotic (pancreatic necrosis). Mawonetsedwe azachipatala a mitundu iwiriyi ndiosiyana.

Interstitial (edematous) pancreatitis imadziwika ndi kuyambika mwachangu, njira yofatsa komanso zotsatira zabwino kuchokera ku mankhwala osokoneza bongo. Zizindikiro zonse zamankhwala zimazimiririka patsiku la 5-7 la mankhwalawa, ndipo kusintha kwa matenda m'thupi la odwala kumatsimikizika pa tsiku la 10-14. Ndi interstitial pancreatitis, zovuta za ziwalo zina sizimawoneka. Zowawa ndi kusanza ndi chifuwa chachikulu sichikhala chowawa ngati necrotic pancreatitis. Kutentha kwamthupi kumakhalabe kozungulira.

Necrotic pancreatitis imadziwika ndi njira yayitali, yowopsa. Ndi necrotic pancreatitis mu kapamba, pali malo a necrosis (necrosis), ali amitundu itatu: mafuta, hemorrhagic komanso osakanizidwa. Matenda akuwonetsa matendawa alipo mpaka milungu inayi, ndipo kusintha komwe kudwala kumapezeka ngakhale miyezi 1.5 kuchokera pomwe matendawa adayamba.

Matenda a ululu amakhala owonjezereka, owawa, osatha, komanso obwereza mobwerezabwereza. Khungu ndi kuzungulira kwa khungu, mthunzi wokhazikika wa sclera ndi wakhalidwe. Zizindikiro zosadziwika za pancreatic necrosis ndi: kusokonezeka kwa minofu yam'mimba, kutupa kwa dera lumbar (pakona pakati pa msana ndi nthiti za XII), kusowa kwamatumbo ndi kuwawa pakumva m'mimba pamimba.

Odwala ena omwe ali ndi mawonekedwe amtunduwu wa kapamba ali ndi chithunzi cha kugwedezeka kwamatumbo ndi zovuta kwambiri pakugwira ntchito kwa mtima, chiwindi, impso ndi mapapu, ndikukula kwa kuledzera psychosis.