Chithandizo cha pancreatic pseudocyst

Chiwalo chilichonse chitha kupitilizidwa kukamwa, kapamba sangakhale wopanda lamulo. Nthawi zina pseudocyst imawonekera m'mutu mwake, thupi kapena mchira wake, matendawa sapereka matendawo mwatsatanetsatane motero sangadziwike kwa nthawi yayitali.

Madokotala amati matendawa amapezeka pafupipafupi chifukwa cha kupweteka kwambiri kwa kapamba, komanso vuto la matenda omwe amapezeka m'misempha. Kunja, neoplasm imafanana ndi hematoma, pakati imakhala ndi michere yambiri.

Pamene pancreatic cyst yabodza imayamba chifukwa chovulala, akuwonetsa opaleshoni, kuchotsa chotupa. Malinga ndi ndemanga, pambuyo pa opareshoni pali zochitika zina zabwino, kusintha kwakukulu paumoyo.

Pafupipafupi kuphatikiza kwa ACE zoletsa kumatha kuyambitsa pseudocyst, mwatsoka, chithandizo choterechi ndi chofunikira mu matenda a kapamba. Chifukwa chake, musanagwiritse ntchito mankhwala a gululi, ndikofunikira kuzindikira kukula kwa cyst yabodza.

Nthawi zambiri, mapangidwe amawoneka pambuyo pa kuvutika kwa atherosulinosis ya kapamba. Vuto lina ndi iatrogenic cysts abodza, amakhala zotsatira za opaleshoni. Izi sizikutanthauza kuti vuto lachiphuphu ndi zotsatira za cholakwika chachipatala, limakhala mtundu wa zomwe thupi limachita pomupweteketsa mtima.

Gawo la matenda ndi zizindikiro

Ndi chizolowezi kusiyanitsa mitundu ingapo ya ma pseudocysts, amapezeka pamutu, thupi la kapamba, nthawi zina amapezeka mchira wa chiwalo. Kuphatikiza apo, neoplasms imagawidwa ndi etiology: postoperative, pancreatic, post-traumatic.

Chithandizo chimatengera malo a cyst abodza komanso kunyalanyaza kwa njira yachipatupacho. Gawo loyamba limatenga pafupifupi mwezi ndi theka, munthawi imeneyi khosi lamatumbo limapangidwa. Gawo lotsatila limatenga miyezi itatu, mzerewo umamasuka. Gawo lachitatu limakhala pafupi miyezi isanu ndi umodzi, tsopano kapisozi kakang'ono kakuyamba kuwonekera.

Kumayambiriro kwa matendawa, mapangidwe amachiritsa bwino, mphamvu zake zimakhala zabwino, odwala ena amangomva mavuto, nthawi zambiri amaphatikizidwa ndi mtundu wina wamatenda oyamba.

Gastroenterologists amatha kugawa ma cyst malinga ndi gulu lina, malinga ndi momwe pali mitundu ya matendawa:

pachimake (kumatenga miyezi yochepera atatu),
subacute (osaposa miyezi isanu ndi umodzi),
aakulu (a zaka zopitilira miyezi isanu ndi umodzi).

Chithandizo chophweka kwambiri ndi pseudocyst wa kapamba mu mawonekedwe owopsa a kutupa, ma cyst aakulu amatha kuthetsedwa kokha mwa kuchitidwa opaleshoni. Muyenera kudziwa kuti ma cyst samachitika mu kope limodzi, wodwala amakula zingapo nthawi imodzi.

Ma pseudocyst a mutu wa pancreatic poyamba samapatsa zizindikiro, wodwalayo sangayerekeze ngakhale pang'ono kukhalapo kwa matendawa. Madokotala amalimbikitsa kuti muzimvera thanzi lanu, samalani ndi zizindikiro za atypical. Choyamba, awa ndi ululu pamimba pamimba, poyamba amakhala owawa, pamene vutolo likukula, ululu umayamba kufooka kapena umangobwera, zongomverera zazing'ono zosatsalira.

Ngati neoplasm ikasokonekera, zizindikiro zapadera komanso zamtima zimayamba. Kuchokera kumbali yamtima kumatha kukhala:

dziko lodzidzimutsa
tachycardia
hypotension.

Zizindikiro zapadera ndimimba yovuta, Zizindikiro za peritonitis, kupweteka kwapweteka. Matenda akayamba, kutentha kwa thupi kumakwera, kusinthasintha pakati pa 37.9 ndi 39 digiri, wodwalayo akunjenjemera, leukocytosis ya neutrophilic imayamba.

Odwala ena amakhala ndi mseru komanso kusanza, koma kudwala matenda akewa sikuti kwadziwika. Zizindikiro izi zitha kuwonetsa kuyambika kwa zovuta .. Odwala omwe adakumana ndi vuto lachire lamankhwala amapweteka mkati mwa nthiti yakumanja ngati mutu watupa, kapena hypochondrium kumanzere vuto likakhudza mchira kapena thupi la kapamba.

Zisangalalozi zimakhala ngati mafunde, nthawi zambiri zimakhala zowawa komanso zowawa za paroxysmal.

Gulu

Palibe gulu lililonse lomwe limavomerezedwa.

Magawo otsatirawa amagwiritsidwa ntchito pofotokozerako:

1. Zachitukuko:
- m'mutu wa kapamba (15%),
- m'thupi ndi mchira (85%).

2. Chiwerengero:
- osakwatiwa
- zingapo.

3. Kukula:
- zazing'ono
- chachikulu
- chachikulu.

4. Mavuto (onani gawo lolingana).

Zizindikiro

1. Chidziwitso cha kupezeka kwa kapamba.

3. Zolemba pamakompyuta tcheru kwambiri kuposa ultrasound. CT imalola kuzindikira kusiyanasiyana kwa pseudocyst. Kuphatikiza apo, kuboola komanso kukoka kwa pseudocyst yoyang'aniridwa ndi CT ndikotheka.

4. Magnetic resonance imaging. Pali zambiri zomwe zingagwiritsidwe ntchito MRI pozindikira ma pseudocysts, koma zimapangitsa kutsegulira njirayi ngati pakufunika kambiri pancreatitis yamatenda. Ubwino wa MRI kupitila pa MDCT (ma processor angapo owonera) mukuwunika kuchuluka kwa madzi am'madzi ndikuti kuphatikiza kolimba kumatha kuyesedwa mosavuta pogwiritsa ntchito MRI. Izi zitha kuthandiza kusiyanitsa kuchuluka kwa madzimadzi chifukwa cha kapamba kuchokera ku zotupa zina, komanso kusankha njira zomwe mungagwiritse ntchito. Ubwino wina wa MRI ndikuti njirayi imagwiritsa ntchito poizoniyu.
Mosiyana ndi izi, kugwiritsidwa ntchito kwa ma T2 okhala ndi kulemera kungakhale kothandiza kwambiri pakuwona kapamba, komanso pakakhala madzi mkati mwa pancreatic parenchyma (mfundoyi ikusonyeza necrosis).
Chifukwa chake, MRI imapereka zidziwitso zofananira ndi MDCT, koma ndi chithunzi chabwino cha miyala ndi dongosolo la kapamba ndi bile ducts.
Zoyipa za MRI zimaphatikizaponso kuthekera kwake.

Laborator diagnostics

1. Kutsimikiza kwa zochitika za amylase mu mphamvu.
Mwachizolowezi, ntchito ya amylase imachulukitsa pambuyo pa maola 2-12 pambuyo poti chitukuko chikuwonekera ndikuchepa pang'onopang'ono patatha masiku 3-5. Kuchulukirachulukira kwa ntchito yake ndi mayankho a pancreatitis pachimake kumawonetsa kukhalapo kwa pseudocysts.
Kuwonjezeka kwa amylase kungakhalenso chifukwa cha zotupa zina. Mwachitsanzo, matenda am'matumbo totupa, mapapo, machubu am'mimba, chikhodzodzo, matumbo ochepa, zotupa zina za m'mimba, zotupa zam'mapapo, m'matumbo, m'mimba.
Kuwonjezeka kwa amylase ndi lipase kumatha kuchitika pakalibe zizindikiro za matenda a pancreatitis pachimake. Mwachitsanzo, pamatenda onse omwe amaperekedwa ndi kuwonongeka kwa khoma lamatumbo ang'ono (kukomoka, vuto la mtima, kutsekeka) kapena kuwonongeka kwa ma enzyme mkodzo (aimpso kulephera).
Macroamylasemia amadziwika pankhani ya kulumikizana kwa amylase ndi IgA. Maofesi ngati amenewa ndi okulirapo ndipo samasefedwa ndi impso, amadziunjikira m'magazi. Chifukwa chake, ntchito ya amylase m'magazi imakhalabe yokwera, ndipo mkodzo - wotsika. Komanso, chilolezo cha amylase wachibale ndi creatinine chilolezo chimakhala chotsika.

2. Mafuta a Laborator amathandizidwanso ku Laborator diagnostics. punct pseudocysts. Zomwe zili ndi mapuloteni komanso ma cellular (kuphatikiza atypical) zimatsimikiziridwa, ndipo bacteriosis imachitika.

Mavuto

1. Matenda apakati -10%. Ma CTs amawonetsedwa ndi kupezeka kwa thovu mu mpweya wa pseudocyst mu milandu 30 30%.

2. Phula -3% Ili ndi mawonetseredwe osiyanasiyana azachipatala. Itha kuchitika ndi chipatala cham'mimba kwambiri. Palinso milandu yoyambirira ya asymptomatic ascites kapena pleural effusion.

3. Pancreatic ascites. Gwero la pseudocyst madzimadzi ndi 70%, pancreatic duct ndi 10-20%. Mu kafukufuku wa labotale wa ascitic fluid, amylase yambiri ndi mapuloteni amapezeka mmenemo.

4. Fistula makamaka chifukwa cha zotumphukira ngalande za pseudocysts. Monga lamulo, iwo amadzitseka okha. Ndi zotupa zazikulu, kuthandizira opaleshoni kungakhale kofunikira.

5. Pseudocyst choletsa magawo osiyanasiyana am'mimba thirakiti, infa ya vena cava, kwamikodzo thirakiti. Kuchita opaleshoni mwadzidzidzi kumafunika.

6. Jaundice - 10%. Amayamba chifukwa cha kutsekeka kwa ndulu zowonjezera za bile, ma stenosis a wamba bile duct, cholelithiasis.

7. Pseudo-aneurysm -10%. Amayamba chifukwa cha kukha magazi mu pseudocyst ngati iwononga ziwiya za kapisozi wake kapena zotengera zapafupifupi. Mowoneka, pseudocyst imakulirakulira kukula, kupweteka kumawonekera kapena kukulira, magazi amayenda pakhungu m'dera lachitseko cha pseudocyst, ndikuwonekera, ndipo zizindikiro zamankhwala zimatulutsa magazi. Ngati pseudocyst ikalumikizana ndi chimbudzi cha pancreatic, ndiye kuti magaziwo amatuluka mumayendedwe amachititsa magazi m'mimba kwambiri ndi kusanza kwamagazi ndi / kapena melena. Pamene pseudo-aneurysm ikang'amba, magazi amatuluka m'mimba.

Kodi pancreatic pseudoxitis ndi chiyani

Pseudo-cyst ili ngati cyst. Amazunguliridwa ndi minyewa yotupa, mkati momwe madzi a pancreatic amadziunjikira. Mwachizolowezi, chotupachi chimachitika motsutsana ndi maziko a kapamba chifukwa cha kuwonongeka kwa minofu ya kapamba. Apa, patopu ya neoplasm imadzaza ndi katulutsidwe ka pancreatic. Muyenera kudziwa kuti chomalizachi ndichinthu chankhanza kwambiri ndipo kupezeka ndi minofu yathanzi nthawi zambiri kumawabweretsera kudzimbidwa. Chifukwa chake, akatswiri a gastroenterologists amalimbikitsa kuwunika mosamala zotupa zoterezi komanso kuchitapo kanthu panthawi yake.

Chipatala cha matenda awa sichosiyana kwambiri ndi zofunikira za pancreatic cyst wamba. Chithandizocho chimakhazikika pamakina amkati, opaleshoni ndi njira zamankhwala, komanso zakudya. M'pofunika kutchera khutu kuti chotupachi chimakhala ndi 90% ya cystic neoplasms ya gland iyi. Amapangidwa pa kuwonongedwa kwa kapamba, ndikovuta mu 40% ya milandu ya kapamba.

Chithunzi cha matenda

Pseudocyst wa kapamba ndi mtundu wa madzi momwe madzi amadzisonkhanira. Mphutsi zomwe zimasungidwa ndi gland nthawi zina zimasonkhana. Muyenera kudziwa kuti pseudocyst amasiyana pang'ono ndi momwe amakhalira, komanso amakhalira mosachita mosayembekezereka. Chotupa chija nchoopsa chifukwa chimakhumudwitsa mapangidwe a zotupa: chitsulo chimayamba kulemera kwambiri, ndipo kukula kwake kumachuluka. Kenako phokoso limaphulika. Izi zimachitika kawirikawiri, koma zimachitika.

Nthawi zambiri, pancreatic cyst yabodza imaphulika chifukwa cha kuwonongeka. Ngati chotupa chikuphulika, munthu amamva kupweteka kwambiri mu kapamba. Chifukwa chake, muyenera kuyang'anira wodwala mosamala, ngati kuli kotheka, imbani dokotala mwachangu. Kuzengereza pankhaniyi kumawopseza ndi zovuta zazikulu, mpaka mpaka.

Ngati wodwalayo ali kunyumba ndipo ali ndi vuto la kufooka - ana amaso atakula, adayamba kutaya chikumbumtima - ndiye kuti simuyenera kuwononga nthawi, koma nthawi yomweyo imbani ambulansi.

Zomwe zimapangira pseudocysts:

Nthawi zambiri, chotupa choterechi chimayamba chifukwa cha kapamba amtundu uliwonse),
Nthawi zina mankhwalawa amawonekera pambuyo pakupanga opaleshoni
Nthawi zina pamakhala chotupa chifukwa cha kuvulala kwa kapamba,
chosowa kwambiri ndikupezeka kwa pancreatic atherosulinosis wodwala.

Chofunikira: pamaso pa zovuta zilizonse za matendawa, muyenera kufunsa katswiri, chifukwa uwu ndi nthawi yofunikira kuchipatala!

Zizindikiro za matendawa

Nthawi zambiri pseudocyst imakhala asymptomatic, koma nthawi zina imawonekera ngati zizindikiro pazifukwa zotsatirazi:

Matenda a chifuwa chifukwa chogwiritsa ntchito njira zozindikira.
Kukhalapo kwa kukakamizidwa kwanuko.
Mapere - amatsogolera pakuwoneka pancreatic ascites kapena peritonitis, omwe ali asymptomatic.
Mitsempha yamagazi: minyewa ya m'mimba, m'mimba pseudo-aneurysm. Wodwalayo amamva kupweteka kwambiri, kuchuluka kwake kwa hemoglobin kumachepetsedwa kwambiri.

Chizindikiro chachikulu cha matendawa ndi kupweteka. Nthawi zambiri chimakhala chiwonetsero chokhacho cha zisonyezo za kapamba. Kukula kwake kumatengera kukula kwa neoplasm, malo. Kupweteka kwambiri kumapangitsa wodwala gawo loyamba, ndiye kuti kupweteka kumachepa. Amakhala "osayankhula" ndipo amamvera ena nthawi zonse. Nthawi zina, pamakhala zosamveka zochepa. Ngati, kuphatikiza ululu wamunthu, nseru, kusanza, ndi kusowa kwa chakudya, izi zikuwonetsa kukhalapo kwa zovuta.

Kuzindikira Matenda

Kuti adziwe zoyenera, dokotalayo ayenera kuphunzira mbiri yakale ya zamankhwala, kusanthula ndi kufunsa wodwalayo. Ndipo maphunziro a mkodzo ndi magazi alibe phindu lililonse pakuzindikira, chifukwa amawonetsa chithunzi chokhacho, ndiko kuti, kupezeka kwa pancreatitis mwa wodwala.

Njira zodziwonera:

EGDS - imapangidwa kuti iwone ngati mitsempha ya varicose mummero, komanso njira zotupa m'matumbo, nthawi zina njira iyi imawululira kuphatikizika kwa ziwalo zomwe zili pafupi ndi chomaliza,
CT - yachitika kuti iwunike kwathunthu kapamba,
X-ray - imawulula za pseudocysts,
ERCP - kuyesa kwa endoscopic komwe kumathandiza kudziwa kupezeka kwa neoplasm,
Ultrasound - imakonza pomwe pali chotupa, ndikuwonetsanso zovuta (ngati zilipo),
kuwunika kwa cytological - kumachitika ngati pseudocyst wapezeka.

Ntchito yayikulu yomwe adotolo athetsa pambuyo poti yapezeka kale ndi kudziwa ngati chotupacho chadziwika. Kutengera kuzindikiritsa, chithandizo cha mankhwala ndi chomwe chimayikidwa.

Mankhwala amathandizidwa ndi adokotala atazindikira kuti pseudocyst ili kuti, magawo ake ndi otani, ali pamlingo wotani, komanso momwe amalumikizirana ndi ma pancreatic ducts. Nthawi zambiri zotchulidwa antihistamines, anticholinergics. Nthawi zambiri zimachitika kuti chithandizo choterocho ndikokwanira kuti uchotse cyst wabodza. Wodwalayo akulimbikitsidwa kuti azitsatira zakudya kuti asiye kutupa.

Ngakhale pseudocyst ndi yayikulu, chithandizo cha mankhwala ndizofunikira kwambiri kuposa opaleshoni. Zotsatirazi nthawi zambiri zimabweretsa zovuta zosavomerezeka.

Kuphatikiza apo, cyst yabodza imachiritsidwa ndi kukhetsa. Nthawi zambiri amagwiritsidwa ntchito mu nthawi yachiwiri, yachitatu yopanga chotupa. Poyamba, machitidwe odikirira amagwiritsidwa ntchito. Ngati vuto la neoplasm likuvutitsa wodwala, mwachitsanzo, kupweteka kapena kufinya ziwalo zapafupi, ndiye kuti madotolo amayamba kuchitapo kanthu.

Mitsempha ikamakula yoposa 6 masentimita ndipo ikupezeka kwa milungu 6 kapena kuposerapo, ndikofunikira kuti muchite opareshoni. The pseudocyst amachotsedwa ndi njira zotsatirazi:

Kukhetsa kwa transillary. Stent imagwiritsidwa ntchito, yomwe imayikidwa mu ERCP.
Mitsinje yamayendedwe. Njira yake ndiyothandiza, koma yodzala ndi mawonekedwe a zovuta. Nthawi zina, kuponya m'mimba kumakhala kokwanira.
Kukhetsa kwamkati. Amagwiritsidwa ntchito kawirikawiri, chifukwa amakhala ndi zovuta zambiri.
Kuchotsa opaleshoni. Mimbulu yam'mimba imadulidwa ndipo chotupa chabodza chimachotsedwa.

Pamaso pa opareshoni, kuyezetsa kowonjezereka kumachitika.Kusankha komwe kumathandizira njira yochotsa chotupa kumatengera kukula kwake, siteji yake, zaka zake, komanso kupezeka kwa ma concomitant pathologies.

Malangizo ambiri, kupewa ndi kudya

Pambuyo pa opaleshoni, nthawi yokonzanso imayamba. Ngati zikuchitika mwachizolowezi ndipo palibe choopseza kuonekanso kwa ma pseudocysts, dotolo amalimbikitsa izi:

mumayesedwa, kumayesedwa, kuyang'anira momwe thupi liliri,
ntchito mankhwala wowerengeka, mwachitsanzo, zakumwa zakumwa zakumwa ndi mankhwalawa,
gwiritsitsani chakudya chamagulu.

Zithandizo za Folk pamodzi ndi zakudya zingathandize kuchotsa kuchuluka kwa bile ndikuthandizanso kugwira ntchito kwa kapamba. Chakudyacho chimapereka kutsatira malamulo awa:

muyenera kuchotsa chakudya chamafuta, mafuta pachakudya kapena kuchepetsa kuchuluka kwawo,
chakudya chizikhala chotentha (osati chozizira komanso osati chotentha),
Zakudya zokazinga, zamafuta siziyenera kuyikidwa pambali, muyenera kuziphika kokha ndi nthunzi kapena chithupsa,
Zakudya zake zachokera pa mfundo iyi: "nyama zochepa, nsomba, masamba ambiri, zipatso."

Ndipo njira zodzitetezera zimaphatikizapo chithandizo cha panthawi yake cha pathologies omwe amathandizira kuti ma pseudocysts awoneke, kutsatira malamulo amoyo wathanzi, komanso kudya kwambiri.

Zoyambitsa matenda

Real cysts ndi kubereka kwa mawonekedwe omwe amakhudzana ndi kuphwanya mapangidwe a pancreatic minofu mkati mwa kakulidwe ka embryonic wa munthu. Monga lamulo, sizimakula, zimamangidwa mkati ndi masanjidwe amtundu wa epithelial, ndipo zimatha kudzazidwa ndi madzi.

Ma cysts abodza amapezeka pomwe pancreatitis yapachaka kapena pancreatic necrosis imawononga minofu ya tinyezi. Thupi limayesetsa kuthana ndi tsamba lamtunduwu ndikupanga chipika cha minofu yolumikizana mozungulira.

Kusungirako kumatchedwa cysts komwe kumachitika gland duct itatsekedwa. Mapangidwe oterewa amatha kukula ndipo amatha kuphulika motsogozedwa ndi zinthu zingapo zowononga.

Ma parseic pseudocysts nthawi zambiri amapangidwa ndi echinococcus. Tizilombo tating'onoting'ono monga opisthorch, timathandizanso kuti khungu lathu lisinthe, chifukwa limalepheretsa kutuluka kwa madzi a kapamba.

Kutengera zomwe zimayambitsa mapangidwe a pancreatic cyst, njira zamankhwala zimasiyana.

Uphungu! Matenda aumunthu ndi echinococcus amachokera kwa agalu odwala, nkhosa ndi nkhumba. Munthu ndi nthambi yomaliza ya tiziromboti, mapangidwe ake ndi chotupa chomwe chimatenga zaka. Pofuna kuti musadwale ndi echinococcosis, muyenera kusenda agalu oweta, kutsatira malamulo aukhondo, komanso kusamba m'manja musanadye.

Nkhani yothandiza? Gawani ulalo

Kuti musadwale ndi opisthorchiasis, muyenera kupenda mosamalitsa nsomba zamtsinje panthawi ya kukhalapo kwa opisthorchiasis. Kuphatikiza apo, ndikofunikira kuti muzitsatira mchere wofunikira mukamayamwa nsomba ndi nthawi yothira kutentha mukamaphika.

Mudziwa bwanji za kukhalapo kwa chotupa mu kapamba?

Njira imodzi yayikulu yodziwira matendawa ndi kuwunika kwam'mimba.

Nthawi zina gawo lalikulu la mutu wa kapamba limatha kumveka kudzera khoma lakumbuyo kwamkati ngati kapangidwe ka chotupa.

Cysts yaying'ono, makamaka yobadwa nayo, sangatulutse chilichonse chamankhwala. Kapangidwe kameneka kamapezeka pakamayesedwa kuti apange matumbo a m'mimba pogwiritsa ntchito ultrasound kapena tomography.

Ma pseudocysts omwe amapanga motsutsana ndi maziko a kapamba wamatumbo omwe amapezeka kale amapereka mawonekedwe a matenda amtunduwu. Ululu pamimba pam'mbuyo komanso mmunsi kumbuyo, kulekerera zakudya zamafuta, kusinthasintha kwa shuga m'magazi, kusanza, ndi zizindikiro zina zamagulu ammimba zimatha kusokoneza.

Zipinda za parasitic cystic ndizosowa. Echinococcal cysts nthawi zambiri imatchulidwa kumutu kwa gland. Pankhaniyi, duodenum imakakamizidwa, pali kuphwanya kutuluka kwa bile, jaundice imawoneka. Kuphatikiza apo, zizindikiritso za kuledzera ndi matupi a thupi zimayamba.

Kutengera kukula ndi malo a cystic patsekeke, mawonekedwe a zomwe zili mkati mwake, komanso kupezeka kwa zizindikiro, titha kulankhula zakukula kwa pancreatic cyst.

Chithandizo choyenera chimakupatsani mwayi wochizira matendawa ndikwaniritsa momwe zimakhalira.

Uphungu! Kupezeka koyamba kwa pancreatic cyst ndi mwayi wopimidwa mozama. Mwina kupangika kwa ma cystic patimana pa gawo la embyogenesis kunakhudzanso impso kapena chiwindi.

Kodi mankhwala a cysts ndi ati?

Opanga maopaleshoni amagwira nawo ntchito makamaka pothana ndi vutoli. Njira zochizira zimaphatikizapo chithandizo cha matenda oyambitsidwa, omwe adayambitsa kupangika kwa cysts, kudya. Acute pancreatitis ndi pancreatic necrosis, chifukwa chomwe pseudocysts nthawi zambiri imapangidwa, ndizofunikira zochitika zofunikira mwadzidzidzi.

Chithandizo Cha cyst Zoona

Kupanga kwakukulu komwe kumayambitsa kusokonezeka kwa pancreatic madzi ndi mapangidwe a kapamba akuluakulu amafunika kuchitidwa opaleshoni. Pankhaniyi, dokotalayo amachotsa chotupa cha cystic kapena amapanga reseanc ngati pali ma cysts angapo.
Ngati ma cyst ndi obadwa kale, ali ndi kukula kosaposa 2 cm, samakula ndipo samayendera limodzi ndi chizindikiro cha kuperewera kwa kapamba, ndiye kuti mu nkhani iyi sikufunika chithandizo chapadera. Ndikokwanira kuyezetsa kamodzi pachaka, onani kukula kwa momwe zimayambira mu zochita zamagetsi ndikukhala ndi moyo wathanzi.

Chithandizo chabodza cha cyst

Mukamachitira pseudocysts a pancreatic, nthawi yomwe idadutsa kuyambira pomwe zomwe zimafunikira kuti zikule zimakhudzidwa. Popanga pseudocyst, yomwe imapezeka patapita pafupifupi chaka chimodzi, magawo anayi amasiyanitsidwa. Izi ndichifukwa cha momwe kapisozi kamapangidwe kameneka kamapangidwira. Kufikira miyezi isanu ndi umodzi, cyst imaganiziridwa kuti ikupanga, kuyambira miyezi isanu ndi umodzi mpaka yotsatira - yopangidwa. Njira zochizira zingaphatikizeponso chithandizo cha opaleshoni kapena kasamalidwe ka wodwala.

Chofunikira ndikuwonetsa kapena kupezeka kwa kulumikizana pakati pa cystic patsekeke ndi kutulutsa kwa gland. Kuti mudziwe izi, tengani zomwe mwakhala mukuyang'aniridwa ndi ultrasound kapena tomography. Ngati kuchuluka kwa puloteni yofunika kwambiri ya pancreatic, amylase, kuli kokwanira, ndiye kuti cyst yolumikizidwa ndi duct. Pankhaniyi, ngalande yam'mimba ya pancreatic imachitika, chomwe chimakhala kuti mothandizidwa ndi chubu yopyapyala yopyapyala, endoprosthesis, cyst imalumikizidwa ndi m'mimba kapena duodenum. Chifukwa chake, mtembowo umakhuthulidwa ndipo zinthu zimapangidwa kuti mapangidwe ake amaloledwa ndi minofu yolumikizana.
Ngati chotupa sichilumikizidwa ndi duct, ndiye kuti chinthu cholumikizira chimayambira mkatikati mwake, moledzera kwambiri, chomwe chimapangitsa kuti makhoma ake amatsekedwa ndipo amasinthidwa ndi minofu yolumikizira. Pankhaniyi, kutsanulira koyamba kwa cystic patsekeke ikuchitika ndi ma puncutaneous punctuation, ngati chotupa chikupanga, kapena mwa kugwiritsa ntchito anastomosis ndi m'mimba kapena duodenum, ngati yatapangidwa kale.
Kutengera komwe kuli ma cyst, kuchuluka kwake komwe kumamatira ku minofu yoyandikana ndi kupezeka kwa zovuta, kuchitidwa opaleshoni yayikulu (laparotomy) kapena endoscopic. Kuchita opaleshoni ya Endoscopic kumakhala kovuta kwambiri ndipo kumachepetsa chiopsezo cha zovuta pambuyo pake. Potere, mapangidwe angapo ang'onoang'ono amapangidwa khoma lakunja lam'mimba momwe zimapangidwira zida zapadera. Kukula kwa ntchito kumayang'aniridwa pogwiritsa ntchito zida zamavidiyo.

Chithandizo cha Conservative

Ngati opareshoniyo sanawonetse, ndikotheka kuchiza matendawa, kutsatira malangizowo:

khalani ndi moyo wathanzi
osamadya kwambiri,
tsatirani zakudya zofananira ndi zakudya zamatenda ena kapamba,

Uphungu! Zakudya ndi pancreatic cyst amatanthauza kukana kwathunthu mowa, kuletsa mafuta, kutsatira mfundo za kuphatikiza zakudya. Kuphatikiza apo, ma legamu, broths, zonunkhira komanso zokazinga sizilimbikitsidwa.

Yang'anani! Musaiwale kuti kukhalapo kwa cystic patsekeke mu kapamba kumafunika chidwi ndi ntchito ya thupilo kuti tipewe kukula kwa zovuta monga kupasuka kwa chotupa, kapamba ndi peritonitis.

Pafupifupi ziwalo zonse za anthu zitha kugonjera neoplasms. Kapamba ndiwonso. Pseudocyst ndi neoplasm yemweyo yomwe imatha kupezeka pamutu, thupi lokha kapena mchira wa chiwalo. Nthawi zambiri, matenda amtunduwu satha kuzindikirika kwanthawi yayitali chifukwa chosowa zizindikilo zake. Nthawi zambiri, odwala samakumana ndi vuto lililonse.

Chifukwa chiyani matendawa amachitika?

Ndikofunika kudziwa kuti ma pseudocyst a mutu wa pancreatic amapezeka nthawi zambiri. Madokotala amati matenda a chiphuphu nthawi zambiri amapezeka motsutsana ndi maziko a chifuwa chachikulu cha khansa kapena chifuwa chachikulu.

Komanso, anthu omwe adakumana ndi zowopsa zapakhungu kapena khoma sakhala pachiwopsezo chotere. Mwanjira iyi, neoplasm yokha imakhala ndi mawonekedwe a hematoma, ndipo mkati mwake mumangokhala ndi ma enzymes apadera. Ngati matenda atulukapo m'mikhalidwe yotere, ndiye kuti kuchitapo kanthu opaleshoni kuyenera kuchitika ndipo pseudocyst mu kapamba amachotsedwa mwa munthu. Ndemanga pambuyo pa chithandizo chabwino.

Komanso, mawonekedwe a neoplasm amatha chifukwa cha kutsekeka kwapafupipafupi kwa kukonzekera kwa IPF. Tsoka ilo, ili ndi gawo lofunikira kwa anthu omwe ali ndi matenda a kapamba. Ichi ndichifukwa chake madokotala amalimbikitsa mwamphamvu kuti popereka IPF, kumayesedwa pafupipafupi kupatula kupangidwa ndi pancreatic pseudocysts.

Chachikulu kwambiri, ma pseudocysts amapezeka motsutsana ndi maziko a chithandizo cha opaleshoni kapena maziko a pancreatic atherosulinosis. Zotsatira zam'mbuyomu ndizosowa kwambiri.

Ma Iatrogenic pseudocysts amayenera kukambirana mosiyana. Mapangidwe oterewa ndi osowa kwambiri. Nthawi zambiri, amapangira opereshoni pambuyo pancreas. Ndikofunika kukumbukira kuti pseudocyst iyi si zotsatira zolakwika zachipatala. Izi zimangochitika mwachilendo kwa thupi kukhala chinthu chomvetsa chisoni.

Magawo akulu

Gastroenterologists amasiyanitsa mitundu ingapo yamaphunziro omwe akuwunikira. Pseudocyst imatha kukhala pamzimba, pamutu, ndipo pseudocyst ya mchira wa kapamba ikhoza kukhalanso.

Ngakhale mawonekedwe amasiyana momwe amapezekera:

kapamba
zododometsa
postoperative.

Komanso, matendawa amatsimikiziridwa ndi magawo angapo a chitukuko. Ndikofunika kudziwa kuti ndi dokotala yekha yemwe angadziwe kuti ndi gawo liti la pancreatic pseudocyst. Chithandizo mankhwala zotchulidwa.

Gawo loyamba limakhala pafupifupi miyezi 1.5. Pakadali pano, mapangidwe a zotupa am'mimba akuyamba kumene.
Gawo ziwiri limakhala mpaka miyezi itatu. Mitsempha yopangidwayo imamasuka.
Gawo lachitatu limatha mpaka miyezi isanu ndi umodzi atadwala matendawa. Pakadali pano, tinthu tating'ono timawoneka kale.
Gawo lomaliza limatsimikizidwa ndi kukhalapo kwa kapisozi kakakulu

Makonda ena

Monga matenda ena aliwonse, kudwala kumeneku ndikwabwino kuti musayambe ndikuthandizira koyambirira. Pa gawo loyamba, mapangidwe a thupi, komanso mchira, komanso pseudocyst wamutu wa kapamba amachiritsa bwino. Chithandizo, ndemanga nthawi zambiri zimakhala zabwino. Ndi chithandizo chakanthawi, odwala ochepa okha ndi omwe adakumana ndi mavuto azaumoyo. Izi zimachitika makamaka chifukwa cha matenda aliwonse okhazikika.

Mu gastroenterology, neoplasm iyi imagawidwanso ndikugawika kwakanthawi, ndiko kuti, kuchuluka kwa matendawa kulipo:

mawonekedwe owopsa amayikidwa pamaso pa maphunziro, omwe sanakwanitse miyezi itatu,
mawonekedwe apamwamba - osapitilira miyezi isanu ndi umodzi,
mawonekedwe osakhazikika amayikidwa pamene kapisozi wapanga kale ndipo zaka zake zatha miyezi isanu ndi umodzi.

Fomu yovuta kwambiri ndiyosavuta kuchiza, pomwe kutupa kumakhudzidwa kwambiri ndi mankhwala. Vutoli likuipiraipirabe ndi mawonekedwe osakhazikika. Nthawi zambiri, pseudocyst wodwala amangochita opaleshoni.

Ndizofunikira kudziwa kuti pseudocyst sikhala mu pepala limodzi. Zimachitikanso kuti dokotalayo ali ndi zophuka zingapo mwa wodwala.

Zizindikiro zomwe zimayenderana ndi matendawa

Nthawi zambiri, neoplasm iliyonse imadziwonekera kwa nthawi yayitali ndipo wodwalayo samangoganiza za kukhalapo kwake m'thupi. Koma madokotala amachenjeza kuti zizindikiro zidakalipo, ndipo munthu anganene kuti apanga pseudocyst ya kapamba. Zizindikiro sizachilendo. Choyamba, kupweteka pamimba. Ndikofunika kudziwa kuti poyambira matendawa ululu umakhala waukulu, koma pakapita nthawi umayamba kuzimiririka kapena kuzimiririka, nkumangosiyira zosasangalatsa.

Komanso, nthawi zina munthu amatha kusanza komanso kusanza. Izi sizoyambitsa matenda. Ndi kukula kwa zotengeka zotere, dokotala atha kukuwuzani kukhalapo kwa zovuta.

Ena mwa iwo omwe adachiritsa pseudocyst ya kapamba amati ululuwu unkakonda kupezeka m'chigawo cha hypochondrium (pomwe panali chotupa chamutu) kapena kudera la hypochondrium yakumanzere (pakakhala chotupa cha thupilo kapena mchira wa ndulu). Zosasangalatsa ndizopweteka m'chilengedwe, ndipo nthawi zina zimasintha kukhala zowawa zopitilira muyeso.

Mitundu yamakono ya diagnostics

Wodwala akatembenukira ku gastroenterologist, ayenera kuphunzira mbiri yachipatala ya munthuyo komanso kuwunika momwe moyo wake ulili. Pambuyo pake, kuyang'aniridwa kwathunthu kuyenera kuchitika. Nthawi zambiri imakhala ndi kachiwalo kofewa ka peritoneum ndi m'mimba. Ndi kukula kwakukulu kwa pseudocyst, adokotala amatha kudziwa mawonekedwe ochepa, komanso kudziwa mpira wawung'ono.

Ndi ululu, wodwalayo amayamba mayeso ndi magazi ndi mkodzo poyesa. Popeza mapangidwe awa ndi oyenera, kafukufuku wazotsatira sawonetsa chithunzi chonse. Wochiritsa amatha kungoganiza kuti wodwala ali ndi kapamba wodwala. The pseudocyst sichimatsimikiziridwa ndi njira yofananira.

Njira zabwino komanso zamakono kwambiri zodziwikitsa matendawa ndi monga:

X-ray mosiyana. Zithunzizi zikuwonetsa zizindikiro za pseudocysts ndi kutuluka kwa ziwalo zamkati chifukwa cha kuchuluka kwake.
Kuwunika kwa Ultrasound kumathandiza kudziwa gawo lomwe maphunzirowo ali, komanso kutsutsa kapena kutsimikizira kukhalapo kwa zovuta.
EDGS imazindikira kupezeka kwa kutupa, kutsekeka kwa ziwalo zamkati ndi kukulitsa kwa mitsempha m'mitsempha.
ERCP. Njira yophunzitsira kwambiri. Zimatengera luso la endoscopic. Nthawi yake, dokotala amatha kupenda mosamala m'dera lomwe lakhudzidwalo ndikuwona ngati munthu ali ndi pseudocyst ya kapamba.
CT Njira ina yophunzitsira. Panthawi ya CT scan, kutupa kumawonetsedwa bwino.
Kuunika kwa cytological ndikofunikira ndi kuzindikira koteroko, chifukwa pseudocyst imatha kulakwitsa kupangika koyipa.

Komanso, maphunziro oterewa amatha kusokonezedwa ndi cyst yoona kapena chotupa chovuta.

Mankhwala

Ntchito zamankhwala zimagwiritsidwa ntchito pokhapokha pseudocyst yapangidwa posachedwa. Komanso, chithandizo chokhazikika chimawonetsedwa pakalibe kupweteka komanso maphunziro ochepera masentimita 6.

Komanso, madotolo ena amakonda kudikirira kwakanthawi panthawi yofufuza matenda oyamba komanso osapatsa mankhwala. Chowonadi ndi chakuti ma pseudocyst a kapamba amatha kusungunuka pazokha. Nthawi zambiri, kuwunika kumachitika miyezi ingapo, ndipo chithunzicho chikapulumutsidwa, chithandizo chimayikidwa kale.

Pulogalamu yamankhwala nthawi zambiri imakhala ndi:

IPP
H2 histamine receptor blockers,
anticholinergics.

Komanso, kugwiritsa ntchito mankhwala osokoneza bongo kumathandizira bwino pakukhazikitsa catheter. Imapezeka mwachindunji mu kapisozi kotsatira. Kudzera catheter, namwino amapereka mankhwala ena chifukwa cha matenda.

Odwala ambiri omwe adakumana ndi kale kapamba amatha kuwona kuti mankhwalawa a pseudocysts omwe ali ndi mankhwala komanso chithandizo cha pancreatitis ndi ofanana kwambiri. Inde, mankhwalawa amathandizanso kupukusira pachimake, pambuyo pake mapangidwe amachedwetsedwa pawokha.

Opaleshoni

Ngati pseudocyst imakula kukula kwakukulu (kupitirira masentimita 6), osadzithetsa yokha, ndipo chithandizo chamankhwala sichimabweretsa zotsatira, mwanjira iyi, kusankha kumachitika pakuchita opaleshoni.

Kuchotsa opaleshoni kungakhale kosiyana:

Mitsinje yamayendedwe. Imawerengedwa kuti ndi njira imodzi yothandiza kwambiri. Pogwira opaleshoni, ngalande zimakhazikitsidwa kudzera pakhungu komanso khoma la England. Madokotala nthawi zina amagwiritsa ntchito njirayi mosamala, popeza odwala ena amakumana ndi zovuta zina.
Linear endoscopic ultrasound imaging. Ndi njirayi, pseudocyst imatsitsidwa kudzera m'mimba kapena matumbo a munthu. Njirayi imagwiritsidwanso ntchito ngati yabwino, koma imatha kuchitika kokha ngati mapangidwewo ali pafupi kwambiri ndi m'mimba.
Kutulutsa kwapaini kwa pseudocyst ya kapamba. Njira imeneyi silingaganizidwe kuti ndi opaleshoni yathunthu. Chofunikira chake ndi kukhazikitsidwa kwa stent yapadera. Imayikidwa m'thupi laumunthu nthawi ya ERCP yotsatira.
Kukhetsa kwamkati. Amawonedwa ngati njira yachikale. Mankhwala amakono, sikuti amachita chifukwa chakuti odwala ambiri amalola opaleshoniyo kuvulala kwambiri.
Kuchotsa kwathunthu kwa pseudocysts. Pakupanga opaleshoni, kupindika kwakukulu kumachitika m'mimba. Njirayi imakhala yowopsa kwambiri, koma imagwiritsidwa ntchito nthawi zambiri pakapangidwa mutu kapena mchira wa kapamba.

Pamaso pa opareshoni iliyonse, wodwalayo ayenera kutsatira zakudya zovuta.

Ndi mavuto ati omwe amawoneka?

Ngati mumalembera pafupipafupi kupita kwa dokotala ndipo simukugwirizana ndi zomwe dokotala amafuna, pseudocyst ikhoza kuvulaza thupi lathu. Nthawi zambiri, kuchitapo kanthu kowonjezera kwa opaleshoni kumafunika kuti muchepetse zovuta.

Kupasuka (ndikosowa kwambiri, kumatha kuchitika pamene chiwalo chitavulala),
kupembedzera
magazi.

Mavuto pambuyo pakuchita opaleshoni amakumananso. Izi zikugwira ntchito pakupanga thupi, mchira, ndipo izi zimathandizidwanso ndi pseudocyst ya mutu wa kapamba. Ndemanga pambuyo pa opaleshoni imangotsimikizira izi. Chifukwa chake, zovuta zotheka:

kutulutsa magazi
kuwonongeka kwa ziwalo zina,
kuyamwa
mapangidwe a fistula
kusintha kwa chotupa kukhala khansa,
matenda

Nthawi yomweyo, zovuta zambiri zitha kupewedwa ngati dokotalayo atachita opareshoni molondola komanso moyenera. Koma, mwatsoka, palibe amene amatetezeka ku matenda. Chifukwa chake, pambuyo pa opaleshoni, kuwongolera kwakanthawi kokhudza malo omwe akhudzidwa kuyenera kuchitika.

Pancreatic pseudocyst sichiri matenda oopsa, koma chiopsezo china chidakalipo. Kufa kwa matendawa sikapitilira 14%, koma izi zimachitika pokhapokha ngati munthuyo anyalanyaza zam'kati ndipo akana chithandizo.

Palinso chiopsezo cha imfa mukam'chita opareshoni. Pano, anthu omwalira ndi 11%. Ngati, atachitidwa opaleshoni, wodwalayo atha kuwonjezereka kapena kutenga kachilomboka, ndiye kuti chiwopsezo cha kufa chimakulitsidwa kwambiri.

Komanso, musaiwale za kuyambiranso kwa neoplasm. Zachidziwikire, si yayikulu ngati ya zotupa zenizeni, koma ilipo. Malinga ndi malipoti azachipatala, kuthekera kobwezeretsanso kwa ma pseudocysts kuli pafupifupi 30%. Kubwereranso kumakhala koopsa kuposa maphunziro oyamba. Mukadzayambiranso, pamakhala chotupa chachikulu chokhala ndi khansa komanso mavuto. Ndi pseudocyst yobwereza, chiopsezo chotsatila choopsa chitha kupezeka.

Njira zopewera

Palibe malamulo okhwima komanso njira zopewera. Inde, kukhalabe ndi moyo wathanzi komanso kusiya zizolowezi zoipa kungachepetse chiopsezo cha maphunziro. Komanso musaiwale za chithandizo chanthawi yake cha matenda. Ndikofunika kukumbukira kuti nthawi zambiri pseudocyst ya kapamba amapezeka motsutsana ndi maziko a kapamba.

Komanso musaiwale za kupewa kwa anthu omwe ali ndi matenda a chiwindi, chifukwa nthendayi imakhudzanso matenda a kapamba. Ngati zili choncho, ndiye kuti wodwalayo ayenera kutsatira kadyedwe kokwanira, kukana chakudya cholemetsa komanso osadzichulukitsa thupi mwamphamvu.

Ngati pseudocysts apezeka, chithandizo ayenera kusiya njira zina. Kugwiritsa ntchito mankhwala azitsamba kapena ma infusions sikungangobweretsa phindu lokha, komanso kungavulaze chiwalo chodwala kale.

Pancreatic pseudocysts nthawi zambiri amadziwika mwangozi - pakaunikidwe pafupipafupi kapena poyesa chiwalo.

Ndi matenda awa, wodwalayo wakhumudwa ndi chopondapo, pali ululu wam'mimba. Nthawi zambiri wodwalayo amayamba kuchiza matenda, kenako nkupweteketsa thupi lake.

Pazizindikiro zoyambirira za kukomoka, muyenera kufunsa dokotala kuti mudziwe zomwe zimayambitsa kusokonekera.

Kodi pseudocyst amawoneka bwanji?

Chiwalo pseudo-cyst ndi thumba mkati lomwe limakhala madzi.

Mathandizo omwe amapangidwa ndi kapamba komanso minyewa ya thupi akhoza kupezekanso. Pancreatitis mu exacerbation state ikhoza kukhala chifukwa cha mawonekedwe ake.

Pseudocyst ndi mtundu wa cyst, ndipo mawu akuti "pseudo" amatanthauza kusowa kwa epithelium pa nembanemba ya mapangidwe.

Ndizofunikira kudziwa kuti cyst yotere ilibe kusiyana kwapadera kuchokera koona, zomwe amachita sizosadalirika.

Masewera abodza ndi owopsa chifukwa amatha kupangitsa kuti pakhale chikumba. Zikondamoyo zimachulukana kukula ndi kulemera, kenako zimaphulika.

Izi zimachitika kawirikawiri, koma ndikofunikira kuganiziranso mofananamo. Nthawi zambiri, chotupa chabodza chimaphulika chifukwa cha kuwonongeka.

Ngati chotupa chikuphulika, wodwalayo amamva kupweteka kwambiri chifukwa cha kapamba. Amachitanso mantha.

Ndikofunika kuyang'anira wodwala ndikuyitanitsa dokotala. Kuchedwa kungakhale koopsa - wodwala agwa.

Ngati wodwala wafinya ana, ali ndi malungo, wodwalayo amadzazindikira, ndikofunikira kuyimba ambulansi, chifukwa thandizo limayenera kuchitika nthawi yomweyo.

Kodi kuchitira?

Dokotala adzalembera chithandizo cha matenda a zam'thupi ndi mankhwalawa, kutengera gawo lomwe maphunzirowo ali, komwe amapezeka, momwe amalumikizirana ndi zolimba za chiwalo.

Nthawi iliyonse ya chitukuko cha ma pseudocysts, wodwalayo ayenera kutsatira kadyedwe - chifukwa mankhwalawa amaletsa.

Dokotala amakulemberani mankhwala, nthawi zambiri amakhala ma proton pump zoletsa, antihistamines, anticholinergics. Nthawi zina chithandizo chotere chimakhala chokwanira kuchiza ma pseudocysts.

Ngakhale wodwala atapezeka kuti akupanga mawonekedwe ambiri, chithandizo cha mankhwala ndikofunikira, popeza kuchitapo kanthu kwa opaleshoni kumabweretsa zovuta zambiri.

Ngati pancreatic cyst yabodza yatulutsa njira zowonongeka ndi kukhalapo kwa necrotic misa, ndiye pamodzi ndi pharmacotherapy, puncutaneous punctuation imagwiritsidwa ntchito.

Potere, catheter imayikidwa mkati mwa mapangidwe ndipo ikhoza kukhalapo kwanthawi yayitali.

Ndi chithandizo chake, kutsanulira kwa ma pseudocysts ndi ma antiseptics, kusangalatsa kwa zomwe zili mkati kapena kudzazidwa kwa patsekeke ndi mankhwala omwe amaumitsa msanga.

Njira ina yothandizira pancreatic pseudocysts ndi kukhetsa ngalande. Nthawi zambiri amagwiritsidwa ntchito nthawi yachiwiri ndi yachitatu yopanga maphunziro.

Mu gawo loyamba, njira yodikira ndi kuwona imagwiritsidwa ntchito - zochita zogwiritsidwa ntchito pokhapokha pseudocyst ikapweteka kwambiri kwa wodwala kapena kukanikiza ziwalo zomwe zili pafupi.

Nthawi zambiri, madokotala amagwiritsa ntchito njira za endoscopic: cystoduodenostomy kapena cystogastrostomy.

Panthawi ya ndalamayi, makoma a chiwalocho amabooleredwa pamalo pomwe pseudocyst imakankhira duodenum kapena m'mimba, ndipo stent imayikidwa.

Chubu chamadziwo chimatha kukhala mthupi kwa milungu ingapo. Chithandizo chotere chiyenera kuchitika pokhapokha kuyang'aniridwa ndi dokotala.

Kupanda kutero, zovuta zimatha kukhala ngati magazi, matenda a pseudocysts, kuchepa kwa anastomosis ndi zina zomwe zimayambiranso.

Ngati pseudocyst ndi yayikulu, ikupitilirabe kukula msanga, adotolo adzalembera opaleshoni yochotsa mankhwalawo kuchotsa mapangidwe.

Kuthandizira koteroko kudzaperekedwanso ngati ma cyst abodza ali ndi kuchuluka kwakanthawi kwamkati, kutsukidwa kwake, kusefukira kwake, ndi fistulas.

Chithandizo cha zakudya

Ngati pseudocyst wa kapamba samadziwonetsa, ndiye kuti palibe njira zochiritsira zomwe zingachitike. Komanso, palibe chithandizo chakuchita opaleshoni chomwe chimachitika.

Njira zoterezi zimatha kutha paokha, ngakhale wodwalayo sanalandire mankhwala.

Ngati palibe zizindikiro, dokotala amalimbikitsa wodwalayo kuti amalize njira zotsatirazi:

ndikofunikira kutsatira zakudya zamagulu,
wodwalayo amayenera kukayezetsa nthawi ndi nthawi, kuti awone ngati kapamba, m'mimba,
Nthawi zina tengani mayeso kuti muwone momwe thupi lanu liliri,
kuchitira mankhwala wowerengeka azitsamba, thamangitsani kusonkhetsa zitsamba.

Zakudya pozindikira ma pseudocysts a kapamba amapereka kukhazikitsidwa kwa malamulo ena:

wodwala sayenera kudya mafuta ndi chakudya chamafuta, owonjezera, kudya kwawo kuyenera kukhala ochepa,
Zakudya musanagwiritse ntchito ziyenera kuwiritsa kapena kuwotcha,
pera musanadye,
kugwiritsa ntchito zakudya zotentha kapena kuzizira kumatsutsana,
zipatso ndi ndiwo zamasamba ziyenera kuphatikizidwa ndi zakudya,
Simungadye mafuta komanso okazinga.

Kuchiza pogwiritsa ntchito njira zina kuphatikiza ndi chakudya choyenera kumathandizira kuchotsa ndulu yambiri ndikufotokozeranso kapamba.

Chithandizo choterechi chimaletsa kukhazikika kwa ma pseudocysts ndikuletsa maonekedwe atsopano. Kuti muchite izi, tengani ndalama zake.

Nthawi zina, kutolera zitsamba kumathandizira kuchotsa ziphuphu za kapamba.

Njira zina zochizira pseudocysts

Kuchiza pogwiritsa ntchito njira zina nthawi zambiri kumakhala ndi zotsatirapo zabwino. Pali maphikidwe angapo omwe angathandize kuthana ndi pseudocysts.

Njira yotsatirayi ndiyotchuka. Zitsamba zotere ziyenera kumwedwa: yarrow, celandine ndi calendula. Zitsamba zonse zidzafunika zofanana.

Thirani madzi otentha mu supuni ya osakaniza, kenako tsimikizani pafupifupi maola awiri. A decoction ayenera kumwedwa musanadye supuni zochepa.

Kuchiza pogwiritsa ntchito njira zina zitha kuchitika ndi zitsamba zotsatirazi: calendula, tansy, mivi yotseka.

Pindani chopereka chiyenera kukhala kapu ya madzi otentha ndikusiya kukapatsa.

Pambuyo kulowetsedwa utakhazikika, adzafunika kusefedwa. Chochita ndi chokonzeka kugwiritsa ntchito. Kumwera ndikulimbikitsidwa kwa kapu ya kotala. Chithandizo chotere chikuyenera kuchitika kwa mwezi umodzi.

Chinsinsi china cha wowerengeka chingakuthandizeni kuchotsa pseudocysts. Kuti muchite izi, muyenera kusakaniza zofanana zofunikira: masamba azomera monga lingonberries, sitiroberi, mabulosi abulu, masamba a nyemba, stigmas za chimanga.

Thirani madzi otentha pamwamba pa osakaniza ndi kuchoka usiku. Tengani tincture mutatha kupinya pafupifupi theka lagalasi. Phwando limachitika kwa milungu iwiri, pambuyo pake yopuma kwa sabata limodzi.

Ngati wodwalayo adaganiza zithandizo la mankhwala ndi njira zina, ndiye kuti musaiwale za zitsamba zomwe zimachepetsa ndikuchepetsa spasms ya ziwalo, kuletsa kukula kwa njira yotupa, ndikuthandizira ziwalo zam'mimba kuti zibwerere.

Mukamasankha chithandizo chamankhwala, ndikofunikira kupita kwa dokotala ndikuyezetsa magazi musanayambe njirayi.

Dokotala yekha ndi amene angakupatseni mankhwala oyenera. Simungathe kudzilimbitsa nokha, kuti musavulaze thupi.

Ichi ndi chiyani

Kodi kanyumba kamene kamakhala ngati kanyengoyi, ndikuyembekezeranso chiyani ngati kuli mthupi? Mafunso awa ali okondweretsa kwa odwala omwe ali ndi vuto lofananalo.

Pseudocyst, yomwe imayamba m'matumbo, imakhala gawo limodzi m'mimba, ndipo mkati mwake mumatha kukhala tinthu tomwe timatupi tofa, timadzi tomwe timatulutsa chithuza, magazi ndi mafinya. Pseudocyst imapangidwa chifukwa cha kapamba, kapena chifukwa chosakwanira pancreatic duct. Pancreatic cyst yabodza ndi njira yeniyeni ya cyst.

Kukhalapo kwa ma pseudocysts ndichangu chochedwa kuchita. Kuyambira lero mwina sangadziwonetse yekha, ndipo zomwe zidzachitike mwezi umodzi, palibe amene akudziwa. Mulimonsemo, zotsatira zoyipa zidzachitika posachedwa.

Chotupacho chimakhazikika m'dera lililonse la kapamba, ndipo zomwe zili mkati zimatha kufikira malita awiri kapena kupitilira apo.

Ngati simutangoyamba kumene zochizira, zovuta za pseudocysts zimawonedwa.

Pancreatic kutupa ngati matenda a cysts.
Kupitilira.
Kutulutsa magazi mkati.
Kupanga kwapakati komanso kulowetsa zamkati mu peritoneum.
Kumenya ziwalo zapafupi.

Zomwe zimawoneka ngati ma cysts abodza, komanso zomwe zimapangitsa kuti zilonda zam'mimba zizikhala:

uchidakwa - nthawi zambiri maonekedwe a chinyengo chamimba,
Matenda a bile ducts, omwe complication yake imayenera kuonedwa ngati pseudocyst
kuchuluka kwa pachimake mawonekedwe ndi matenda matenda,
ziwalo zovulala
matenda kwa ana opatsirana,
kugwiritsa ntchito mosagwiritsa ntchito ma enzymes ochokera koyambira,
maonekedwe a matendawa amagwirizana ndi kusintha kobadwa nako.

Chizindikiro chachikulu cha cyst yabodza ndi kupweteka kwambiri. Kupanga kwakukulu, malo ake ogonjetsedwa, digirii, mawonekedwe omveka bwino komanso mwamphamvu adzawonekera. Kupweteka kosaletseka kumamveka pa gawo la cystic sinus mapangidwe. Pakapita kanthawi, ululuwo umachoka, koma osati kwathunthu, koma ali ndi vuto lopweteka. Nthawi zina pamakhala kusasangalala pang'ono popanda kupweteka.

Ngati nseru, kusanza, kusowa kwa chakudya, kukhudzana ndi thirakiti, kutentha thupi, kutuluka kwa kapamba kumalumikizana ndi ululu, ndiye kuti pseudocyst yakhala yovuta ndipo imafunikira kulowererapo kwachipatala.

Pseudocyst ngalande

Pambuyo pozindikira kuti pali cyst zabodza, chithandizo cha wodwalayo chimayamba ndikulankhula ndi gastroenterologist. Kutengera ndi gawo ndi chitukuko cha pseudocysts, dokotala amafotokozera mankhwala, opaleshoni yochotsa, pseudocyst drainage.Njira yoyamba imagwiritsidwa ntchito ngati paliapangidwe kakang'ono, nthawi zambiri chotupacho chimasokonekera. Njira yopangira opaleshoni imachitika ngati mapangidwewo amapitilira 6 cm ndipo alipo kwa masabata opitilira 6.

Drainage ndi njira yomwe imagwiritsidwa ntchito pancreatic pseudocyst ikayamba. Njirayi ndi yamitundu iwiri - yamkati ndi yakunja. Nthawi zambiri, madokotala amagwiritsa ntchito njira yoyamba.

Kutengera komwe kuli chotupacho, njira yosankhidwa ya opaleshoni imasankhidwa. Ngati chotupa chili pamutu wa kapamba, ndiye kuti cystoduodenoanastomosis imachitika, ndipo ngati mchira wake ndi cystogastroanastomosis.

Njirazi ndizoyenera kwambiri, chifukwa zimatha kuyambiranso kukweza kwa pancreatic madzi, kuchepetsa ululu, kuchepetsa mwayi wobwereza. Pali zovuta.

Kulowa kwamkati mwa zamkati ndi mafinya.
Zilonda zam'mimba.
Kutulutsa magazi.

Zida zakunja sizigwiritsidwa ntchito kawirikawiri. Nthawi zambiri, ntchito zoterezi zimagwiritsidwa ntchito ngati ziwonekera:

kusangalatsa kwa sinus,
kulimba kwamphamvu kwa chotupa,

Kwenikweni, chithandizo chotere cha opaleshoni choterechi ndichachikhalidwe chadzidzidzi, chifukwa chotukula wodwala pazinthu zomwe zikuwopseza moyo.

Anatsegula magazi.
Kutumphuka kwa chiwalo.

Pambuyo pakuchita opaleshoni mwanjira yakunja, kuthekera kwa kutukusira kwa purulent kumawonjezeka, fancula ya pancreatic imapangidwa, yomwe pambuyo pake imatha kuyitanitsa kuchitidwa kovuta kwambiri.

Mitundu yonse yolowerera imangoperekedwa kuti etiology yopanda chotupa imatsimikiziridwa.

Njira zochepa zowonongera komanso ma cyst resection

Asanapange opaleshoni, dokotala adzakuwuzani chifukwa chomwe pseudocyst ya kapamba amawonekera, kuti. Masiku ano, njira zowononga zachilengedwe zochulukirapo zikufalikira.

Chotupacho chimathetsedwa m'njira zosavomerezeka:

kukhetsa kudzera pakhungu ndi njira yothandiza, koma imakhala ndi chiopsezo chotenga mavuto,
sonar endoscopic sonography - kudzimbidwa kumakhudzanso kuchotsa kwa pseudocyst zomwe zili m'mimba kapena matumbo. Chithandizo cha opaleshoni chimalembedwa ngati maphunzirowo ali kutali kuchokera m'matumbo am'mimba,
drapapillary drainage - kuyeretsa kapisozi wa chotupa chifukwa cha kununkhira, komwe kumayambitsidwa pakuyesa kwa endoscopic,
kulowererapo kwamkati - kukhalapo kwa mavuto, chifukwa chake amagwiritsidwa ntchito nthawi zina.

Njira ina yothanirana ndi kukongola kwake. Kuchita opareshoni kumachitika ndikuchotsa gawo limodzi la kapamba limodzi ndi chotupa. Kukula kwa resection kuwululidwa ndi kukula kwa mapangidwewo ndi momwe aliri.

Njira yodzikakamiza ndiyotheka ndi ma piramidi ochepa, kusowa kwa zizindikiro ndi zovuta zake. Chithandizo cha mankhwala ophatikizira

michere
mankhwala anticholinergic
histamine receptor blockers.

Kugwiritsa ntchito mankhwala nthawi zambiri kumaphatikizidwa ndikuyika catheter mu sinus ya chotupa. Chifukwa chake chimatsukidwa kuchokera mkati pogwiritsa ntchito antiseptic solution kuchokera mkati.

Maphikidwe a mankhwala azikhalidwe

Chithandizo cha pseudocysts cha kapamba mothandizidwa ndi wowerengeka azitsamba chimapereka zotsatira.

Ngati mumamwa mankhwala, mumafunikira celandine, yarrow, calendula chimodzimodzi. Mitengo yodzaza supuni ndipo 250 ml ya madzi otentha amatsanuliridwa. Chakumwa chimasungidwa kwa maola awiri. Imwani supuni ziwiri musanadye.
Tengani tansy, calendula, inflaincence ndi maphatikizidwe. Sipuni lalikulu la msanganizo limathiridwa ndimadzi otentha ndikuloledwa kulowetsa. Pambuyo pozizira, msuzi umasefedwa ndikuledzera mu chikho cha ¼. Maphunzirowa amakhala mwezi umodzi.

Zolinga za maonekedwe

Nthawi zambiri, pancreatic pseudocyst amapezeka chifukwa cha zinthu zotsatirazi:

Pancreatitis ndi kutupa kwa kapamba. Mawonekedwe ake owopsa amakhala ndi pseudocyst mu milandu 50%, yayikulu - mu 80.
Kuvulala kwa khoma lam'mimba ndikuwonongeka kwa chiwalo palokha. Post-traumatic benign neoplasms ndi zingwe zokhala ndi ma pancreatic enzyme ambiri. Ali ndi chiwopsezo chachikulu cha kupitilirabe, chomwe chimafuna kuchotsedwa mwachangu.
Mavuto a chithandizo cha opaleshoni. Zithandizirani pakupanga iatrogenic pseudocysts.
Kudya kosalamulika kwa michere yokumba. Zotupa zoterezi zimangopezeka mwa mawonekedwe a kapamba.
Pancreatic atherosulinosis ndi chifukwa chosowa kwambiri cha pseudocysts.
Fibrosis wa limba zimakhala. Kusintha kwachikhalidwe komweko kumapangidwa motsutsana ndi maziko a kutalika kwa njira yotupa.