Kodi pali kusiyana kotani pakati pancreatitis yayikulu komanso yovuta?

Tiziwalo timene timagwira m'thupi la munthu timagawika tiziwalo tating'onoting'ono tomwe timatulutsa chakunja, komwe kumapangitsa khungu kutulutsa kunja, mwachitsanzo, pakhungu (thukuta) kapena kuwala kwa chimbudzi (bile), komanso tiziwalo timene timatulutsa mkati ) Zikondamoyo ndi zamitundu yonseyi nthawi imodzi. Amapanga ma enzymes ofunikira kuti chimbudzi chikhale m'matumbo ang'onoang'ono, komanso insulin ndi mahomoni ena.

Zikondwererozo zimakhala ndi gawo lalitali komanso lathyathyathya, lomwe lili m'mimba kumtunda, kumbuyo kwa m'mimba. Matenda omwe kutupa kumayamba ndi kutchedwa pancreatitis.

Pancreatitis imakhala yovuta kwambiri pamene zizindikirazo zimakula mwachangu ndi kulimbikira kwa masiku angapo, komanso nthawi yayitali pomwe patachitika patatha zaka.

Chifukwa chiyani kapamba amayamba?

Ma enzymes opukutira omwe amapangidwa ndi kapamba ayenera kukhazikitsidwa m'matumbo ang'onoang'ono. Ngati kutseguka kwawo kumachitika mkati mwa chithokomiro, amawononga minofu yake ndikuyambitsa kutupa. Umu ndi momwe pancreatitis yovuta kwambiri imapangira. Pogwidwa mobwerezabwereza ndi chifuwa chachikulu cha pancreatitis, matendawa amatha kudwala matenda osachiritsika.

Zomwe zimayambitsa matendawa:

matenda a ndulu
uchidakwa kwa nthawi yayitali,
matenda ena
cholowa
kagayidwe kachakudya matenda
kuvulala
kapamba amatha kuchitika ngati vuto la opaleshoni kapena kumwa mankhwala ena,
kusuta
cystic fibrosis.

Mu 15% ya omwe ali ndi pancreatitis pachimake komanso 25% pamavuto aakulu, sizotheka kudziwa zomwe zimayambitsa.

Zikondwererozo zimakhala ndi gawo lalitali komanso lathyathyathya, lomwe lili m'mimba kumtunda, kumbuyo kwa m'mimba. Matenda omwe kutupa kumayamba ndi kutchedwa pancreatitis.

Pancreatitis imakhala yovuta kwambiri pamene zizindikirazo zimakula mwachangu ndi kulimbikira kwa masiku angapo, komanso nthawi yayitali pomwe patachitika patatha zaka.

Kodi matendawa ndi ati?

Mu chifuwa chachikulu cha pancreatitis, kupweteka kumachitika pamimba. Ikhoza kukhala herpes zoster, kuupereka kumbuyo, nthawi zambiri imakulirakudya mutatha kudya (makamaka mukamadya zakudya zamafuta). Kutentha kwa thupi kumakwera, nseru, kusanza kumawonekera. Zomwe zimachitika zimachitika.

Pancreatitis yosatha, Zizindikiro ndizofanana, kuchepa thupi kumawaphatikizira (chifukwa kapamba amatenga gawo lofunikira mu chimbudzi). Timbaloyo imadzola mafuta, mafuta, osasamba bwino pampanda wa chimbudzi, amapeza fungo losasangalatsa.

Ngati matendawa amatsogolera pakuwonongeka kwa khungu la endocrine, kupanga insulini kumayipa. Magazi a shuga m'magazi amakwera, matenda a shuga amatha.

About matenda

Pancreatitis ndi njira yotupa. Zomwe zimapangidwira mu mawonekedwe owopsa komanso osasinthika ndikusintha, kapena kuwonongeka kwa minofu mothandizidwa ndi zinthu zilizonse zowopsa:

chakudya chochuluka,
mafuta ochulukirapo kapena zakudya zonunkhira
kuchuluka kwambiri, kapena, kusowa kwa mapuloteni,
mowa
mankhwala
poizoni
kuwonongeka kwamakina ku gland.

Pali zinthu zomwe zimapangitsa kapena zakumbuyo zomwe zimakulitsa chiopsezo cha kapamba. Kupsinjika, mimba, cholowa chamtsogolo, zimakhudzanso matenda am'mimba komanso dongosolo la hepatobiliary - gastritis, duodenitis, cholecystitis, cholelithiasis.

Morphology

Izi zikutanthauza kusintha komwe kumachitika minyewa ya pancreatic pakachitika njira yotupa. Kusiyana pakati pancreatitis pachimake ndi zosasintha zosagwirizana ndikuti zingapo zovuta zimapangidwa:

Kwambiri edema, ndipo nthawi zambiri moyandikana ndi anatomical zida zam'mimba.
Kutupa nthawi yomweyo kumatenga gawo lalikulu la chiwalo.
Pali zotupa ndi madera a necrosis chifukwa chodzipukusa ndi ma enzymes ophatikizidwa omwe amafalikira mwachangu kudutsa lonse kwamatenda (parenchyma), ndikuphatikiza kwa kachilombo kakang'ono kwambiri - purulent foci.

Matenda a pancreatitis amadziwika ndi kupezeka kwa kusintha kwa fibrotic - ndiko kuti, ndikusintha magawo olimbikira a gland ndi ulusi wolumikizika womwe sungathe kugwira ntchito zomwe zimayenera kupangidwa pakupanga ma enzymes ndi mahomoni. Pali masamba omwe amadziwika kuti ndi amodzi, omwe ndi malo omwe amafa, komabe, amapangika pang'onopang'ono, osagwira makulidwe onse a parenchyma. Zotsatira zake ndi atrophy, zomwe zimapangitsa kutopa kwa chiwalo.

Chifukwa chake, pancreatitis pachimake ku matenda amodzi amadziwika ndi kuchuluka kwa kutupa chidwi ndi kuchuluka kwa kusintha kwa necrotic.

Ndi njira yoyamba, parenchyma imawonongeka msanga, munthawi ya maola ndi masiku, yachiwiri - pang'onopang'ono, miyezi yambiri komanso zaka.

Mwa magawo

Mu mtundu wamatumbo otupa, magawo a edema (popanda zovuta) ndi necrosis (wosabala kapena kachilombo) amadziwika. Ndiko kuti, poyambira, gland imakulira kukula, kupanikizika mu ma ducts ake kumachulukitsa, michere yamphamvu imayatsidwa ndipo kufa kwa minofu kumayambira, komwe kumalumikizidwa ndi chiwopsezo chowonjezeredwa ndi ma microfial agents ndikupanga purulent foci.

Ngati ndi kutupa kosachiritsika, magawo amawonedwa:

kuyambiranso (kuchulukitsa) ndi chithunzi chowoneka bwino,
chikhululukiro (kuphatikiza mawonetseredwe) - imatha kukhala yathunthu (popanda zodandaula za boma laumoyo) kapena moperewera (ndikusungidwa kwa zizindikiro zilizonse zosavomerezeka zomwe sizikuthandizira kuti wodwalayo azigwira ntchito komanso kuchita).

Kusiyanaku kukugweranso chifukwa kuwonetsera kwa mawonekedwe owopsa kumachitika mwadzidzidzi ndikuwonjezeka patangopita maola ochepa, ndipo kutupa komwe kumagwira kumatenga pafupifupi masabata 3-6, kenako gawo lotsatira limayamba - kapena gland imataya ntchito yake (yomwe imatha kuchitika ndi necrosis yayikulu ngakhale mu kumayambiriro kwa matendawa), kapena kubwezeretsa kwathunthu kapena pang'ono.

Pakachulukidwe kakakang'ono, matendawa amatha kuchitika mwadzidzidzi, popanda "kuwongolera" mu mawonekedwe a nseru kapena kutaya chidwi, koma kapamba kale wasintha minyewa yomwe singathe kuchiritsidwa ngakhale ndi chithandizo chabwino. Chifukwa chake, kuyang'ana kwa "kubwereranso kubwezeretsedwa" kumasungidwa, ndipo kuchira kwathunthu ndikosatheka.

Malinga ndi chithunzi cha chipatala

Ngakhale kusiyanasiyana kwakapweteka kwa kapamba ndi kuyambiranso kwa matenda osakhazikika kumatha kuchitika ndi zinthu zofananira (nseru, kusanza, kupweteka kwam'mimba), zingapo mwazomwe zikuwoneka ndi amodzi amtundu wa matenda zimatchuka:

Gulu la kutupa kwa kapamba: magawo ndi magawo

Chofala pakati pa pancreatitis yovuta komanso yovuta ndikuti ma pathologies onse amatha kuchitika modekha, pang'ono komanso mozama.

Pachimake kapamba ali ndi magawo lotsatira:

Edematous - njira yofatsa imadziwika. Zikondamoyo zimachulukana kukula, munthu amayamba kumva kusasangalala ndi dera la epigastric, kumanja ndi kumanzere kwa hypochondrium. Foci of necrosis kulibe; necrosis ya maselo obisika amodzi amachitika.
Sterile pancreatic necrosis ndi njira yabwino. Gawanitsani ochepa ngati mbali yayikulu kapena yaying'ono ya minofu yakufa ikatuluka pa limba parenchyma, komanso kufalikira - necrosis imakhudza parenchyma yonse kapena gawo lalikulu la iyo. Zimachitika mafuta - maselo abwinobwino a ndulu amasinthidwa ndi mafuta, njira yodutsamo imayamba pang'onopang'ono, hemorrhagic - madzi a pancreatic amayamba kugaya timinyewa ta mitsempha ndi mitsempha ya magazi ya ndulu, yosakanikirana - imakhala ndi zizindikiro zamafuta ndi hemorrhagic.

Pancreatic necrosis yomwe ili ndi nthenda yoopsa kwambiri, yovuta kwambiri ya kapamba, imachitika chifukwa cha zovuta za purulent-septic.

Pancreatitis yachilengedwe imatha kubweretsa kudwala. Chifukwa chake ndi zovuta zoyambirira - kulephera kambiri. Uku ndikuyankha kovutikira kwa thupi kukhupuka, momwe machitidwe angapo ofunikira amasiya kugwira ntchito nthawi imodzi. Zovuta zammbuyo zimatha - zotupa za purulent-septic.

Popeza nthawi yomwe matendawa akuwonetsa pancreatitis yayikulu ikusintha, madokotala adapereka mayina pawokha magawo a matenda:

Enzymatic - kumatenga masiku 3-5 kuyambira kumayambiriro kwa kufalikira kwa kapamba. Nthawi imeneyi, necrotic foci imayamba kupanga. Ndi chithandizo chokwanira, madera omwe akukhudzidwawo amakutidwa ndi minofu yolumikizira yoteteza, matendawa amasiya kupita patsogolo.
Kuchita - kumatenga masiku 6 mpaka 14. A aseptic kutupa zimachitika kwa cholinga cha kufa minofu. Chizindikiro ichi chikuwoneka mwa kupangika kwa kulowetsedwa mu kuchuluka kwa kapamba, tinthu tomwe timatulutsa timadzi tambiri tambiri.
Sequestration - gawo limayamba kukula pa tsiku la 15 kuyambira pamene matenda amayamba. Maonekedwe a osabala kapena purulent cysts ndi fistulas pamalo amalo a necrotic ndi mawonekedwe.
Zotsatira zake - zimachitika pakatha miyezi 6 kapena kupitilira. Munthu akuchira kapena vuto lakelo likukulira.

Popeza zifukwa zomwe zingayambitse matenda a kapamba, matendawa adagawika m'magulu:

Matenda apakhungu a pancreatitis nthawi zambiri amatuluka mobisa, motsogozedwa ndi matenda a chiwindi kapena matumbo, omwe ali pafupi ndi kapamba. Ndi mawonekedwe asymptomatic, kusintha kwa ma pathological mu kapamba kumadziwika mwamwayi ndi ultrasound ya ziwalo zina zam'mimba. Fomu ya asymptomatic imatha kukhala zaka 5-10.

Pancreatitis yosatha ndi mawonetsedwe azachipatala amagawidwa m'magawo anayi. Iliyonse imakhala ndi malo ake osiyanasiyana okhala ndi zovuta zingapo komanso kukula kwa zowawa:

Ndayamba. Kuperewera kwa kapamba kulibe. Munthu amasokonezeka ndi ululu wam'mimba, womwe umatha kubwereranso kapena kwamuyaya.
Gawo lachiwiri. Kusintha kwachilengedwe kumakhudza endocrine (imatulutsa insulin ndi mahomoni ena) ndi exocrine (imatulutsa madzi a pancreatic) gawo la gland. Njira yotupa imatha kupitilirabe mopweteka kapena kupweteka kwakanthawi.
III gawo. Amadziwika ndi exo- ndi endocrine osakwanira ndi ululu waukulu womwe umafuna ma pinkiller pa exacerbations.
Gawo la IV. Kukula kwa zowawa kumachepa, popeza pali "kutopa" kwa ziwalo zowonongeka ndi mathero a mitsempha ya England.

Kodi pali kusiyana kotani pakati pancreatitis pachimake ndi aakulu

Pakuchulukirachulukira, chifuwa chachikulu chimakhala ndi zizindikiro zomwe sizimasiyana ndi zomwe zimayambitsa matenda. Zomwe zimayambitsa izi ma pathologies, zilibe kusiyana. Kwa matenda awa, njira zodziwika bwino zofanizira zimagwiritsidwa ntchito. Koma ma pathologies amachiritsidwa mosiyanasiyana, chifukwa cha zomwe zimayambitsa matenda, kupezeka kwa zovuta, komanso kukula kwa zowawa.

Kutupa kwa kapamba kumakhumudwitsidwa ndi zinthu zakunja ndi zamkati:

Zakudya zopanda thanzi, moyo wopanda ntchito.
Kuledzera, kusuta.
Kutha kwa ndulu, biliary thirakiti.
Kudziletsa.
Kuvulala kwapancreatic (chifukwa cha zilonda zolowa, nthawi yakugwa, pa opaleshoni).
Kugwiritsa ntchito nthawi yayitali mankhwala a antibacterial kapena mahomoni.
Kuchepetsa kwa ma ducts ndi magazi m'mitsempha.
Matenda am'mimba thirakiti: zilonda zam'mimba, kusokonezeka kwa m'mimba, duodenum.

Munthu wophweka sangathe kusiyanitsa pachimake ndi chifuwa chachikulu, pomwe omaliza adalowa gawo lachiwonetsero, popeza pakadali pano wodwala ali ndi zizindikilo zonse ziwiri:

chimbudzi
kusanza, kusanza,
kutentha kuwonjezeka
kuphwanya chopondapo.

Zizindikiro zowonjezera zamkati pachimake ndi kudzimbidwa, kusanza, komwe kumachitika mutangotha kudya, nthawi zina kumapangidwira bile. Ndi mawonekedwe apakati a pancreatitis pachimake, khungu la wodwalayo limasandulika kukhala ladzuwa. Mabala a cyanotic amawoneka pakhungu m'dera la navel, zomwe zimawonetsa kuwonongeka kwa parenchyma ndi kulowa kwa magazi m'mitsempha ya peritoneal.

Kusiyana pakati pa pancreatitis pachimake ndi mtundu wa matendawa kumatanthauza kuti matendawa amayamba kutha patadutsa masiku ochepa, ngati matendawa ali ofatsa komanso oyenera amagwiritsidwa ntchito, ndipo zizindikilo zachiwiri, zikafika bwino, zimabwerezedwanso.

Matenda apathengo amadzimvekera ndi kupweteka kwam'mimba, komwe kumatha kufalikira kumanzere kwa chifuwa, kutsutsana ndi zizindikiro za matenda a mtima. Zowawa zimawonekera mu ola loyamba mutadya zakudya zamafuta (pambuyo pa mphindi 15-30). Pankhaniyi, wodwalayo watulutsa ndipo m'mimba akuyamba.

Zindikirika bwanji?

Ngati pancreatitis yovuta kwambiri ikukayikiridwa ndikuwonjezereka kwa wodwala wodwala kuchipatala, koma asanapereke mankhwala, matendawo amawafotokozera pogwiritsa ntchito njira zotsatirazi kuti aphunzitse kapamba:

Kusanthula kwamwazi ndi kukosanso kwamwazi. Zotsatira za thandizo loyamba kudziwa kukhalapo kwa kutupa mthupi, chachiwiri chikuwonetsa kuwonjezeka kwa michere ya m'mimba mu seramu yamagazi, yomwe nthawi zambiri imachitika ndi mawonekedwe amtundu wa matenda.
Urinalysis Kuwonjezeka kwa amylase (enzyme yomwe imaphwanya michere yambiri ku glucose) nthawi zambiri imawonedwa mu pancreatitis yovuta kwambiri.
Ultrasound ya peritoneum. Zimathandizira kuwunika kukula kwa kapamba, mkhalidwe wa ndulu ndi zimbudzi zokulira. Kuzindikira kwa ultrasound, pakuzindikira pachimake ndikuwonjezereka kwa chifuwa chachikulu, m'nthawi ya masiku 7 ndi 50-78%.
Endoscopic ultrasound. Zimathandizira kulingalira kusasinthika kwa minofu ya tinyezi, yomwe siziwonetsedwa bwino ndi ochiritsira ultrasound. Mchitidwewo umachitika pogwiritsa ntchito chubu chokhomedwa kudzera m'mphepete.
Zolemba pamakompyuta Kuzindikira kwa njirayi pakuwonetsa pancreatitis pachimake ndikuwonjezereka kwa nthawi yayandikira 90%.
Radiography imathandizira kudziwa momwe mchere wamkati umapangira minofu yofewa ya gland komanso kukhalapo kwa miyala yolowerera.
Cop program. Kusanthula kwa fecal kumachitika chifukwa cha pancreatitis yayikulu komanso pachimake kuti muwone kuchuluka kwamafuta osaphatikizika, fiber ndi mafuta acids.
Fecal elastase mayeso. Amagwiritsidwa ntchito kuti azindikire kusakwanira kwa pancreatic m'magawo oyambira. Mayeso a elastase ali ndi chizindikiro cha 100% chokwanira, chodziwikiratu (palibe cholakwika pakuzindikira) - 96%.

Kuti adotolo apange regimen yothandizira, kupezeka kwa matenda a pancreatitis pachimake komanso aakulu kumachitika pogwiritsa ntchito njira zosiyanasiyana. Amaphatikizaponso maphunziro angapo aukadaulo, kusanthula kwa labotale kwa zinthu zachilengedwe (ndowe, mkodzo, magazi) ndikuwunika zizindikiro zamankhwala.

Chithandizo cha wodwala wokhala ndi pancreatitis pachimake chimachitika mu chipatala. Amamuika kuti adye chakudya cham'mimba, analgesics, dontho la mchere, mankhwala omwe amaletsa ntchito yamagulu enanso ma enzymes. Nthawi zina, zizindikiro zimatha masiku awiri ndi atatu.

Odwala omwe akuganiziridwa kuti ali ndi peritonitis amapatsidwa kutuluka kwamtunda kwa peritoneal. Mimbulu yam'mimba imatsukidwa ndi saline yachilengedwe kudzera m'machubu amadzitha. Pakadali pano, pamafunika kuchita opareshoni kuti muchotse madera a necrotic kapena mbali ya chiwalo.

Ndi matenda osatha a matenda, kupweteka kumaletsedwa mosavuta ndi njala ndi ma pinkiller, omwe amayenera kuyikidwa ndi adokotala okha. Panthawi yovuta, momwe wodwalayo alili ndi zovuta za shuga kapena cholelithiasis, wodwalayo amalizidwa kuchipatala ndikuwapatsa mankhwala.

Popanda kuchitapo kanthu, wodwala wokhala ndi pancreatitis amatha kudwala mankhwala a endoscopic, kuyambiranso kumutu kapena mbali ina ya England, kapena kuchitidwa opaleshoni ya duct yopumira.

Mavuto

Pancreatitis pachimake imapereka mitundu iwiri yamavuto:

Oyambirira. Mkhalidwe wonjenjemera kumbuyo kwa pancreatic necrosis yayikulu komanso tachycardia. Hepatic, aimpso kulephera, enzymatic peritonitis, magazi mkati, sepsis, mapangidwe a cyst.
Mochedwa. Amawonekera sabata lachiwiri la matendawa, chifukwa cha matenda, kapangidwe ka kapamba, puristula wam'mimba, fistula m'matumbo a m'mimba, magazi m'mimba, magazi poyizoni.

Zotsatirazi ndizovuta za chifuwa chachikulu:

Matenda a shuga ndi chifukwa chosakwanira kupanga insulini ndi gland.
Jaundice wolepheretsa - chomwe chimapangitsa ndikutupa kwa bile duct ndi miyala kapena neoplasm.
Mavuto opatsirana (phlegmon, abscess, parapancreatitis).
Matenda oopsa a portal - amapezeka motsutsana ndi maziko akuwonjezeka kwa mitsempha ya portal.

Popanda chithandizo komanso kukula kwa matenda osakhazikika, mawonekedwe a zovuta: kupuma, kulephera kwa chiwindi ndi impso, magazi m'matumbo, kuchepa thupi, komanso chotupa m'matumbo.

Ndi dokotala uti yemwe ndiyenera kulumikizana naye kuti andithandize

Madokotala osiyanasiyana amatha kuchiza matenda a kutupa kwa pancreatic:

Pachimake kapamba. Ogwira ntchito ma ambulansi amatumiza wodwalayo kwa othandizira komanso opaleshoni. Kenako wodwalayo watsimikiza mu dipatimenti ya opaleshoni kapena gastroenterology.
Matenda a kapamba Wodwalayo amatembenukira kwa wothandizirana ndi wodwalayo, yemwe atamuyesa wodwalayo chithandizo chamankhwala kapena amamuwuza kuti apite ku gastroenterology. Muzovuta, chithandizo cha opaleshoni chimasonyezedwa.

Kupewa komanso kudwala

Ndikotheka kupewa kupezeka kwa pachimake kapamba ndi kukokoloka kwa matenda amiseche mwa kuwona njira zotsatirazi zodzitetezera:

Zakudya zoyenera.
Kukana zakumwa zoledzeretsa.
Moyo wokangalika.
Munthawi yake chithandizo cha matenda ammimba.

Osanyalanyaza chilichonse mwa zinthu zomwe zalembedwa. Zolakwika zilizonse zimatha kuyambitsa zotsatira zoyipa. Mu chilonda chachikulu cha pancreatitis, kufa kumatha kuchitika m'masiku oyamba matenda chifukwa cha kugunda komwe kumapangitsa kupweteka kwambiri ndi kuledzera kwa thupi. Anthu omwe ali ndi pancreatitis yodwala yapamwamba sayeneranso kunyalanyaza malangizo omwe adokotala amupatsa. Kusagwirizana ndi malamulo kumabweretsa zovuta zomwe nthawi zambiri zimabweretsa imfa.

Zomwe ndizoyenera kudya pancreatitis ya pachimake

Mu chilonda chachikulu cha pancreatitis mu akulu, ndikofunikira kutsatira zakudya mukatha kudya, komwe wodwala amakhala nthawi zambiri kuchipatala.

Ndi mtundu uwu wa kapamba odwala awonetsedwa okhwima zakudya No. 5, kusankha koyamba, kenako pang'onopang'ono kutembenukira ku mtundu wachiwiri wa zakudya izi.

Zakudya Nambala 5 zimaperekedwa kwa wodwala pafupifupi tsiku lachiwiri kapena lachinayi kuukira. Chakudya chokhala ndi chakudya ichi chimatengedwa m'magawo ang'onoang'ono pafupifupi 5 kapena 6 patsiku. Zakudya zowonjezera, pakati pa zazikulu, siziloledwa.

Ndikofunikira kutsatira mtundu woyamba wa zakudya No. 5 kwa masiku osachepera asanu ndi awiri. Cholinga chake chachikulu ndikuchepetsa ntchito yachinsinsi ya kapamba ndi boma lofatsa kwambiri la chimbudzi.

Mu mtundu woyamba wa chakudya chachisanu, zinthu zonse ziyenera kugwiritsidwa ntchito ngati zoyera. Pa ulalo uwu mutha kudziwa za njira zabwino zopumira zomwe zingakhale ndi zakudya zoyenera.

Mtundu wachiwiri wa zakudya umathandizanso kugaya chakudya pang'ono komanso kuchepetsa kukomoka kwa ndulu. Pazakudya zachiwiri zachakudya chachisanu, komanso mbale zowira, mbale zimayikidwa mu mawonekedwe ophika ndi ophika.

Mkhalidwe wopanda zitsulo pang'onopang'ono umadutsa mumkhalidwe wamba (zidutswa, mapulasitiki, chidutswa), ndipo kutafuna chakudya ndikofunikira. Matenthedwe a mbale amatentha.

Zakudya zomwe zimaperekedwa kwa akuluakulu a pancreatitis akuluakulu zimaphatikizapo supu zosavuta zamasamba, nyama yochepa yophika ndi nsomba, tchizi chochepa kwambiri cha kanyumba tchizi ndi mbale zochokera pa iyo, mkate wowoneka bwino monga zouma, mapira osachedwa, osasenda.

Ndikofunikira kusiya zonse zomwe zingapangitse kupangika kwa ma pancreatic enzymes (kapamba) - mafuta, okazinga, komanso zinthu zokhala ndi mowa.

Madokotala amalimbikitsa kuti odwala azitsatira kudya No. 5 kwanthawi yayitali, yomwe imatha mpaka miyezi isanu ndi itatu, ngakhale itatha. muyenera kutsatira mfundo za zakudya zoyenera. Kukana mwachangu, kudya mwachangu zakudya kumapangitsa kuti matendawa ayambe kudwala.

Dziwani mndandanda wazinthu zopanga mapuloteni kuti muchepetse kunenepa.

Kodi pancreatitis yamphamvu imayamba bwanji?

Acne pancreatitis imayamba chifukwa cha kutsegula kwa ma enzymes, chifukwa chomwe minyewa ya thupi, kapamba, imawonongeka. Kukula kwa izi kumathandizira kuchulukitsa kwachinsinsi cha ntchito ya chithokomiro, kusintha kwa kapangidwe kake (kuwonjezereka kwa mamasukidwe akayendedwe) ndikuchokera kwa madzi a pancreatic.

Mukamachita ma pathologies oterowo, kudzimbidwa kochepa kwa kapamba (kapamba) mwina.

Matendawa amakula msanga komanso moopsa ndi zovuta zomwezi pomwepo necrosis yathunthu.

Kutuluka kapena kuwoneka kwa matenda amtunduwu kumathandizidwa ndi zifukwa zingapo zingapo.

Kodi zifukwa zake ndi ziti?

Pancreatitis nthawi zambiri imawerengedwa ngati zotsatira za mowa woledzera komanso kudya zakudya zamafuta ndi yokazinga. Ngozi zili anthu onenepa kwambiri azaka 30-60 komanso anthu omwe amamwa mowa kwambiri. Koma osiyanasiyana omwe amayambitsidwa ndi matendawa ndi ochulukirapo.

Chifukwa chake, zomwe zimayambitsa pancreatitis yayikulu ndi:

Zakumwa zoledzeretsa - mpaka 40% ya milandu yonse yamatenda a kapamba am'mimba amayamba chifukwa ichi,
Matenda a Gallstone - amayambitsa matenda mpaka 20%,
Zakudya zopanda pake - kusuta kwa mafuta ndi okazinga, zonunkhira komanso kusuta fodya kumatha kukhala ndi zotsatira zoyipa chifukwa chodwala,
Zotsatira zamankhwala pa limba (kapamba) - tetracycline, metranidozole ndi mankhwala anticancer,
Matenda a endocrine system (atha kuchitika chifukwa cha kuchepa kwa timadzi ta parathyroid),
Matenda (herpes, mycoplasma, sepsis, kamwazi), okhudza kapamba amene amayenda mu purother necrosis, amathanso kuyambitsa kupweteka kwapakhosi,
Kuvulala kwam'mimba.

Ndi zakudya ziti zoletsedwa panthawi yowonjezera

Pakudya No. 5 yosungira kapamba, mitundu ina ya zinthu sizovomerezeka kugwiritsa ntchito. Kupatula gulu kukana mowa, wokazinga ndi mafuta. Zakudya zamagetsi zomwe zimakhumudwitsa zimagwira mucous, komanso zinthu zoperewera, siziphatikizidwa ndi chakudya.

Pa chakudya cha pachimake kapamba, pofuna kuchiritsa, odwala akuluakulu amalimbikitsidwa chakumwa chachikulu, kuphatikiza madzi amchere, koma ayenera kukumbukiridwa kuti oletsedwa mafuta zakumwa. Madzi amchere ayenera kukhala opanda mipweya (Smirnovskaya, Borjomi, Slavyanskaya).

Ndikofunikira kudziwa!Pochizira pancreatitis, zinthu monga muffin, zokometsera (adyo, anyezi, tsabola), viniga, yokazinga, mafuta, zakudya zam'chitini, bowa, nyama zosuta, nyama zodyeka zamafuta, marinade ndizoletsedwa..

Malingaliro a akatswiri: Kodi kusala kudya kudzathandiza mu mawonekedwe owopsa?

Mvuto lakusowa kwa chilonda chachikulu cha pancreatitis limawonetsedwa masiku awiri kapena anayi. Itha kuchepetsa kwambiri matendawa. Cholinga chake chachikulu ndi kupereka kupuma kwathunthu ndi kupumula kwa kapamba.

Chifukwa chake, kukana kwakanthawi kudya kapena kulandira chithandizo ndi njala, kwenikweni, kumathandiza kupulumutsa moyo wa wodwalayo. Akatswiri amati izi zimatsutsana pachimake njala kugunda kwa kapamba ndiyofunikira.

Woyankha wa Sayansi ya Zachipatala, a Eliseev Alexander Gennadevich, katswiri wa gastroenterologist, amakhulupirira kuti kusala kudya kwakanthawi ndikolondola, komanso kuti njira yayikulu yothandizira njira zochizira pancreatitis pachimake mwa akulu ndikutsatira zakudya, kumapeto kwa kusala kudya.

A Alexander Barvinsky, dokotala wamkulu, katswiri pa kusala kwachithandizo, ali ndi lingaliro, monga madotolo ena ambiri, kuti kusala kudya koyenera kumakhala kopindulitsa nthawi zonse. Kutumiza katundu kale ndi njira yodziwika bwino yachipatala.

Nthawi yosala kudya imasankhidwa payekha komanso kuyambira masiku awiri mpaka asanu ndi awiri. Koma kusala kochiritsika kuyenera kuphatikizira nthawi yonse yanjala ndi nthawi yayitali yotuluka - chakudya.

Ndikofunikira kukumbukira!Kugunda kwamanja kumachitika, mu mtundu wankhanza wa kapamba, amayenera kukhala m'chipatala moyang'aniridwa ndi dokotala. Pankhaniyi, zakumwa zambiri ndizofunikira (decoction of rose m'chiuno, tiyi ofooka, mchere wopanda madzi. Mankhwalawa pachimake kapamba, munthawi ya njala, kuthetsa kuledzera kwa thupi, ndikofunikira kugwiritsa ntchito kugaya kwa shuga..

Chifukwa chake, zakudya za pancreatitis ndizofunikira, ngati sichoncho, gawo lalikulu la mankhwalawa. Kutsatira ndi ndikofunikira kwambiri kuti zotsatira zabwino za chithandizo. Tiyenera kukumbukira kuti kuphwanya malangizidwe a dokotala kumatha kubweretsa zotsatirapo zowopsa - mtundu wovuta wa matendawa.

Kanemayo amafotokoza njira yochiritsira kapamba kunyumba ...

About zakudya za kapamba ...

Zonse zomwe zimayambitsa, Zizindikiro ndi chithandizo cha kapamba.

Pancreatitis Gulu

Makina a chitukuko cha kapamba amachokera pakuwonjezeka kwa katundu mu ma ducts, ndipo ma michere omwe amalowa mkati mwa ziwalo zamkati amathandizira kuti awonongeke. Ngati pancreatitis yayikulu ikuwoneka (munkhaniyi tikulankhula za necrosis ya minofu), ndiye kuti matendawa amatengedwa ndi necrosis ya gawo lalikulu la kapamba.

Kunyalanyaza zizindikiritso ndi kusowa kwa chithandizo chokwanira kumayambitsa matenda amtsogolo a necrosis, chifukwa, njira ya pathological imafalikira kwa ziwalo zina zomwe zimapezeka paliponeum.

Ngati michere yokugaya imalowa m'mimba, peritonitis imayamba. Panthawi imeneyi, kusowa kwa mankhwalawa kumabweretsa chiyembekezo chabwino - chowopsa.

Muzochita zamankhwala, mitundu ndi mitundu ya pancreatitis imasiyanitsidwa. Kutengera mtundu wa momwe matenda amapangidwira, matendawa ndi acute, achiyambiranso, osakhalitsa, osachiritsika komanso ochulukitsa amtundu wodwala.

Mitundu ya kapamba owopsa:

Mawonekedwe apakati amadziwika ndi kutupa kwa kapamba,
Mawonekedwe a hemorrhagic amapitilira motsutsana ndi kuzungulira kwa zotupa m'mimba,
Pachimake pancreatic necrosis limodzi ndi kuphatikiza zamkati, zofunika minofu kuwola amapangidwa.

M'mazithunzi ena, pancreatitis yovuta kwambiri imayamba limodzi ndi njira ya kutupa pachimake mu ndulu - munthawi iyi, cholecystopancreatitis yapezeka. Fomu ya purulent imadziwika ndi mapangidwe a mafinya mu kapamba.

Mtundu uliwonse wamatenda a pancreatitis amatha kukhala ndi mphamvu yosintha, kotero amatha kusuntha kuchokera kwina kupita kwina. Mwachitsanzo, mawonekedwe a hemorrhagic amatha kusinthidwa kukhala minofu necrosis ndi mapangidwe apamwamba a purulent.

Pachimake pancreatitis kumabweretsa mavuto osiyanasiyana - abscesses, hemorrhages angapo, fibrosis, minyewa atrophy, etc. pamaso pamavuto, matendawa amatha kukhala osavomerezeka, ngakhale atalandira mankhwala okwanira.

Matenda apathengo amatchedwa kutupa, akumakula pang'onopang'ono. Zotsatira zake, fibrosis ya minofu yofewa kapena kuwerengera kwa pancreatic minofu imawonedwa. Kutengera zakumbuyo kwa mawonekedwe awa, kuchotsedwa kumasulidwa ndikuchulukirachulukira. Odwala nthawi zambiri amadwala matenda ashuga.

Mawonekedwe osagawika amagawidwa m'magulu awa:

Maonekedwe a asymptomatic (latent) amakhala ndi nthawi yayitali wodwala kwa nthawi yayitali.
Mtundu wam ululu umakhala ndi kupweteka kosalekeza m'mimba, komwe kumawonjezeka kwambiri panthawi yomwe matendawa amakula.
Mawonedwe apompopompo. Kupweteka kwamatenda kumachitika kokha motsutsana ndi maziko a kufalikira kwa matendawo.

Mtundu wamafuta ngati cystic pancreatitis umachitika limodzi ndi mapangidwe a cysts. Ndizowona (zowonekera kawirikawiri) komanso zabodza (zomwe zimapezeka pazithunzi zambiri).

Akapezeka ndi pancreatitis yogwira, pachimake njira yotupa imakhudzidwa, ndikuphatikizana ndi kufalikira kwamatenda a duodenum, chiwindi, ndi ziwalo zam'mimba.

Zizindikiro za pancreatitis pachimake

Chikhansa ndi chiwalo chaching'ono chomwe chimagwira ntchito yofunika kwambiri mthupi la munthu. Zimaphatikizanso kupanga michere yokugaya, yomwe imawongolera njira yabwino komanso yokwanira kugaya chakudya. Komanso kupanga insulini, kusowa kwa komwe kumabweretsa kukula kwa matenda ashuga.

Kusiyana pakati pa mtundu wa matenda ndi owawa kwambiri kwamatendawa ndikuti kumapeto kwake, motsutsana ndi kumbuyo kwa kuukiridwa, matendawo amawonekera kwambiri. Wodwalayo amadandaula za kupweteka kwakanthawi komanso kosalekeza kwa ululu, othandizira pakhungu samathandiza kuthetsa ululu.

Limagwirira ntchito ya chitukuko cha matenda pachimake amayamba chifukwa cha kuchepa kwa michere mu kapamba ndi ziwalo za mkati, zomwe zimatsogolera ku chiwonongeko cha England. Akalowa m'magazi, zimayambitsa zizindikiro za poizoni m'thupi.

Kuphatikiza pa zowawa, wodwalayo ali ndi zizindikiro zotere:

Kutentha kwambiri kwa thupi, kuthamanga kapena kuthamanga kwa magazi. Ndi kukula msanga kwa kutupa, mkhalidwe wa wodwalayo umachepa msanga, kutentha kumatha kukwera mpaka madigiri 40, kuvutikira kwa magawo amodzi kumadziwika,
Maso a wodwalayo amawoloweka, khungu limasandulika. Popanda thandizo, khungu limakhala la imvi komanso lofiyira. Khungu limazizira kukhudza, kuphimba thukuta,
Kuukira mseru, hiccups, kusanza. Nthawi zambiri zizindikirozi zimatsagana ndi pakamwa lowuma, malamba. Kusunthika sikubweretsa mpumulo, m'masamba mumakhala zakudya za bile /
Kupanda chilimbikitso. Kudya kumayambitsa kusanza kosalephera. Kumayambiriro kwa matendawo pachimake, sipangakhale nkhani ya chakudya, chifukwa njala ndi yomwe ili pakubwezeretsa thanzi la wodwala,
Kusokoneza kwam'mimba, komwe kumawonetsedwa ndi chimbudzi nthawi zambiri kapena kudzimbidwa kwa nthawi yayitali. Poyerekeza ndi pancreatitis, chopondapo pazambiri zojambula ndizamadzi, ndimapangidwe ophatikizika a foam, pali tinthu tating'onoting'ono ta chakudya chosagwira bwino,
Dyspnea imayamba chifukwa cha kuchepa kwa ma elekitiroma pakusanza.Kuphatikiza apo, thukuta likuwoneka, pali chikhazikitso chochuluka chachikasu m'chinenedwe cha anthu.

Zizindikiro zina zodwala kwambiri zimaphatikizapo kuphuka, mpweya wowonjezereka, khungu, komanso kufinya kwa khungu. Ndi zizindikirazi, kuchuluka kwake kumapita kwa mphindi, chisamaliro chamankhwala chofunikira chimafunika.

Chithandizo cha pachimake kapamba

Pancreatitis yovuta kwambiri komanso yodwala imakhala ndi kusiyana komwe kumangowonetsa kuchepa kwa zizindikiro, komanso pamankhwala. Kusiyanaku ndikuti kuukiridwa kokhazikika kuyenera kuyimitsidwa pansi pazomwe zimakhalapo, apo ayi zotsatira zake zingakhale zakupha.

Thandizo loyamba kwa wodwala limakhala kunyumba asanafike akatswiri azachipatala. Pofuna kuchepetsa ululu, chimfine chimayikidwa pamimba. Kugwiritsa ntchito mankhwala antispasmodic, mwachitsanzo, Papaverine, ndikuloledwa. Onetsetsani kuti mwakana chakudya chilichonse.

Maziko a chithandizo chathanzi ndi njala, mtendere ndi kuzizira. Sitikulimbikitsidwa kuchita zodzichitira nokha, chifukwa pali kuthekera kwakukulu kokhala ndi zovuta zingapo za matendawa.

Thandizo ladzidzidzi pakubwera gulu lachipatala limakhala ndi izi:

Kuyambitsidwa kwa dontho lokhathamira ndi mchere.
Mankhwala antiemetic, mwachitsanzo, Cerucal mu mlingo wa 10 mg.
Kuthira mankhwala ochititsa dzanzi - Ketanov.
Jakisoni wa mankhwala a antisecretory mu mlingo wa 250 mg.

Wodwala ayenera kuchipatala. Monga lamulo, pakumenya kwadzaoneni, matenda osiyanasiyana samachitika, chifukwa ndizosavuta kusiyanitsa ndi matenda ena. Ngati pali kukayikira kwa mtundu wowononga wa kapamba, ndiye kuti kuchitapo kanthu kwa opaleshoni ndikofunikira. Chithandizo chowonjezereka chimachitika mu dipatimenti yochita opaleshoni.

Chizindikiro cha laparoscopic ndondomeko ndi kukayikira kwamadzimadzi pamimba kapena zizindikiro za peritonitis. Izi zitha kuchitidwa pofuna kufotokoza bwino zovuta za kuukiridwa kwamphamvu.

Kugwiritsa ntchito mankhwala okodzetsa kuteteza kutulutsa kwamkati ndi kuchotsa michere yokumba m'magazi. Furosemide kapena Diacarb ndi mankhwala (piritsi),
Amavomereza Omez mu gawo la 80 mg patsiku,
Ngati kusanza kulipo, kukhazikitsidwa kwa metoclopramide kudzera m'mitsempha kumalimbikitsidwa,
Mu nthawi yovuta ya kutupa, m'mimba ma enzyme zotsekemera zimayikidwa. Omwe akuyimira gululi ndi a Gordoks, Kontrikal.

Kwa pafupifupi masiku 3-6, wodwalayo amamulembera njala ndi kumwa madzi ofunda. Woopsa matenda, kusala kumatenga masiku 7-14.

Potsirizira pake, zakudya za makolo zimafunikira - kukhazikitsa mapuloteni ma hydrolysates ndi emulsions yamafuta.

Zina za chifuwa chachikulu

Mu matenda osachiritsika, kusintha kwakapangika mwa tiziwalo ta kapamba kumapezeka. Akatswiri azachipatala ambiri amakhulupirira kuti kusiyana kwakukulu pakati pa CP kuchokera pakuwukiridwa kovuta ndikuyenda patsogolo kwa masinthidwe a pathological mu chiwalo ngakhale atachotsa zomwe zimachokera.

Poyerekeza ndi kuzizira kwa njira yotupa, ulesi ndi kulephera kwa chiwalo nthawi zambiri zimapezeka.

Potukula nthenda yamatendawa, nthawi zingapo zimasiyanitsidwa. Woyambayo amatha kukhala zaka, nthawi zina amadzionetsera ngati zizindikiritso, komanso nthawi yomwe kuphwanyidwa kumayendetsedwa ndi chipatala cholimba, kuchepetsa kwambiri moyo wa wodwalayo.

Zizindikiro za kutupira kosalekeza zimakhala kwambiri komanso zofatsa. Nthawi zambiri, pakukhathamiritsa, mawonetseredwe azachipatala amawonedwa, omwe amadzionetsera akuwopsa kwamatenda.

Wodwalayo amalangizidwa kuti azitsatira pafupipafupi zakudya zina, kumwa mankhwalawa azinsinsi za kapamba ka insulin, antispasmodic mankhwala. Chithandizo cha spa cholimbikitsidwa kawiri pachaka.

Njira yovuta kwambiri yothandizira ndi zakudya. Sali wodwala aliyense amene angakane maphikidwe ndi mbale zomwe amakonda. Mfundo zofunika kuzitsatsa:

Zakudya zopatsa thanzi m'magawo ang'onoang'ono mpaka 6-7 pa tsiku. Mutha kudya mpaka 230 g ya chakudya nthawi.
Kukana mafuta, zonunkhira, mchere komanso zakudya zonunkhira.
Kukana / kuletsa zakumwa zoledzeretsa.

Zolakwika mu zakudya zimawonetsedwa ndi zowawa. Ndikofunika pang'ono kudya malonda oletsedwa, chifukwa kupweteketsa m'mimba pang'ono kutuluka. Pofuna kuchepetsa kupweteka, gwiritsani ntchito mankhwala:

Drotaverine ndi antispasmodic yomwe imathandizira kuchepetsa kutupa m'matumbo, motero, ululu wammbuyo umachepa,
Sparex ndi antispasmodic, yodziwika ndi myotropic action. Ikumva kukokana m'matumbo am'mimba,
Ndi mawonekedwe a edematous, Omez amatha kupatsidwa piritsi limodzi kwa masiku atatu. Kulandila kumachitika kokha mu maphunziro owerengeka komanso monga adokotala amafotokozera.

Ndi nthawi yayitali ya matendawa, minofu yachilengedwe yokhazikika imasinthidwa ndi mafuta komanso zigawo zothandizirana, zomwe zimapweteketsa kutayika kwa magwiridwe amkati, chifukwa, matenda a shuga amakula, njira yonse ya m'mimba imasokonekera.

Kuti muchepetse kupweteka komanso kuchepetsa katundu pazinthu zowonongeka, ma enzymes am'mimba amafunikira. Lemberani mankhwala:

Njira zopewa matenda osachiritsika komanso matenda opatsirana zimaphatikizapo zakudya zoyenera komanso nthawi zonse. Ndikulimbikitsidwa kuchepetsa kumwa zakumwa zoledzeretsa, makamaka kuphatikiza ndi zakudya zamafuta.

About pancreatitis yayikulu komanso pachimake akufotokozedwa mu kanema munkhaniyi.

Kodi kapamba ndi chiyani?

Chikhansa (kapamba) ndi chimodzi mwazinthu zofunika kwambiri zaumunthu. Amachita nawo zotsatirazi:

katulutsidwe ka michere yomwe imalowa mu duodenum, kukonza chimbudzi,
kugaya chakudya, mafuta, mapuloteni,
kupanga insulini yomwe imayang'anira kugwiritsidwa ntchito ndikusunga mphamvu yochokera ku chakudya.

Mothandizidwa ndi zinthu zingapo zomwe zimayambitsa, kukanika kumachitika - disancreatism. Amasinthidwa mosavuta ndi mankhwala osokoneza bongo komanso zakudya. Ngati sanachiritsidwe, kapamba amayambika - njira yotupa ndi yoipa ya kapamba. Pathogenesis yamatenda:

Kuphwanya kwatsoka kwa gland.
Kachitidwe ka michere mkati mwa thupi.
Autolysis - kudzimbidwa tokha a zimakhala.
Malangizo a kapamba.
Kuphwanya ntchito zake.

Chifukwa chiyani kapamba amayatsidwa?

Kukula kwa kapamba kumayambitsa kusokonezeka mu ntchito zam'mimba:

matenda a ndulu
matenda a chiwindi,
helminthic infestation,
zilonda zam'mimba
Zotsatira za magwiridwe am'mimba,
gastritis
kusanza,
kamwazi
matumbo sepsis.

Zomwe zimayambitsa kutupa, madokotala amakhulupirira:

kunenepa
kudya kwambiri
mafuta, okazinga zakudya
kuvulala kwam'mimba
kugwiritsa ntchito mankhwala mosasamala,
chifuwa
matenda oopsa
matenda ashuga
atherosulinosis
mumps.

Pangozi yakukula kwa kapamba ndi:

amayi apakati chifukwa cha zovuta za kudya, kuchepa kwa mavitamini ndi michere,
oledzera
anthu omwe ali ndi vuto lobadwa nalo kapamba,
ogwira ntchito m'mafakitale momwe zokutira ndi varnish zimagwiritsidwa ntchito, mchere wazitsulo zolemera, zinthu zoopsa.

Pali ziwerengero pazomwe zimayambitsa pancreatitis:

Peresenti yathunthu ya odwala omwe ali ndi kutupa

Kuvulala kwam'mimba, kugwira ntchito pamimba, kuledzera ndi mankhwala, mankhwala

Zizindikiro za Acute Pancreatitis

ululu wammbuyo mu hypochondrium kapena kumata,
Amapereka pansi pa scapula,
wofanana ndi matenda opweteka omwe ali ndi vuto la mtima.

zingapo
wothira ndi bile
sizibweretsa mpumulo.

chisangalalo
ukufalikira
kupweteka kuchokera kukhudza.

kuloza zotupa,
kuyabwa
khungu:

wotumbululuka - chifukwa cha kuledzera,
chikasu - kuwonongeka kwa chiwindi,
cyanotic - pachimake chikhalidwe.

Kuphwanya ntchito za m'mimba

zokutira yoyera palirime,
nseru
kubwatula.

ludzu
kutsika kwamkodzo pafupipafupi,
khungu lowuma.

kuchuluka kwa kutentha kwa thupi mpaka 39,
kuzizira
thukuta
mutu
nseru

Zizindikiro za matenda a shuga

kamwa yowuma
ludzu.

kuthamanga kwa magazi
kugunda kwa mtima
kulephera kupuma
kupuma movutikira.

Kutupa kosalekeza kwa kapamba

Ngati matendawa amatha miyezi yopitilira atatu, amadziwika kuti ndiwosachiritsika. Kutupa kumadziwika ndi njira yomwe ikupita patsogolo, kuwonongeka kwa minofu ya atrophic. Madokotala amasiyanitsa magawo a kapamba:

Poyamba - mpaka zaka 5, ndikubwereza pafupipafupi.
Kuperewera kwa chinsinsi chakunja ndikuphwanya mayamwidwe a michere, ntchito m'mimba.
Maphunziro ovuta ndi kukula kwa njira zosasinthika: atrophy, shuga, khansa.

Kuchulukitsa kwa matenda a kapamba amayamba chifukwa cha kufooka kwa zizindikiro. Zizindikiro za kutupa kwa kapamba:

okhazikika kapena apakati, ochepa
cramping
kusowa kwachidziwikire
kudya pambuyo pakudya, kumwa mowa, zakudya zamafuta.

chisangalalo
akunjenjemera m'mimba
pafupipafupi kutsegula m'mimba
kusanza
kusowa kwa chakudya
kuwonda.

ludzu
kutsika kwamkodzo pafupipafupi,
khungu lowuma.

mutu
minofu ikunjenjemera
kufooka
thukuta lozizira.

Zizindikiro

Kupimidwa kwa wodwala kumayamba ndi mbiri yachipatala, kuyesedwa kwakunja. Diagnostics imaphatikizapo njira zotsatirazi:

ambiri, kuyesa kwamwazi wamagazi,
mayeso a enzymatic
urinalysis
mayeso apadera,
pulogalamu.

radiology
Ultrasound yam'mimba,
esophagogastroduodenoscopy,
compression tomography,
endoscopic retrograde cholangiopancreatography.

Zizindikiro za kapamba ndi olemba

Kafukufuku wokhudzana ndi kutupa kwa kapamba, kufotokozera kwawo, kunachitidwa ndi madotolo, omwe mayina awo ndi zizindikiro za matendawa. Mukazindikira matenda, zizindikiro za kapamba zimagwiritsidwa ntchito malinga ndi olemba:

Ma pancreatitis ululu mawonetseredwe

Mukadina pachimake, chomwe chimatchulidwa motere:

lumikizani msana ndi pakati pa nthiti yakumanzere,
ogaŵikana magawo atatu,
chofunikira ndi kulumikizana kwa gawo lachiwiri ndi lachitatu, pafupi m'mphepete.

Pakuyerekeza kwa mutu wa gland - 5-6 masentimita kumanja, pamwamba pa navel, pakati pa mzere wapakati wa thupilo ndi chotengera cha mbali ya umbilical.

Pamalo akuti 4-6 cm kuchokera ku navel kupita kumanja lamanja.

Poyerekeza mzere wolumikiza mutu ndi mchira wa gland.

Madontho ofiira m'thupi (ma mtima aneurysms).

Zowawa, kumva kwa khungu pakusintha kwa njira ya eyiti ya thoracic vertebra kumanzere.

Kusapezeka kwa aortic pulsation pakhoma lakunja kwa peritoneum pakuyerekeza kwa gland (ndizovuta kudziwa odwala omwe ali ndi nkhungu ya mafuta osakanikira).

Kuwonjezeka kwa mafuta onunkhira kumanzere kwa navel.

Kuyesa kwa magazi

Kafukufuku wovomerezeka pakuwonetsetsa kuti ali ndi pancreatitis ndi kuyesa kwa magazi konse. Imawulula kupezeka kwa zotupa malinga ndi:

kuchepetsa kwa erythrocyte - ochepera 3.9 x 10 12 cell / l,
hemoglobin kuchepetsa - zosakwana 135 g / l,
kuchuluka kwa maselo oyera - oposa 9 x 10 9,
kuchuluka kwa erythrocyte sedimentation rate (ESR) - kuchokera 15 mm / ola.

Ndi kuyesedwa kwamwazi wamagazi am'magazi, owonjezera a magawo otsatirawa ndi otheka:

kuchuluka kwa enzyme:

lipase - mpaka 190 U / l,
serum estalase - 0.1-4 ng / ml,
amylase - mpaka 64 U / l,

shuga m'magazi - 4.2-6.2 mmol / l,
bilirubin yonse - 8.4-20.5 μmol / l.

Chida chozindikira

Ultrasound (malinga ndi chizindikiro cha echo)

miyala pamiyeso ya England
kuchuluka kwawonjezeka
kupezeka kwa madzimadzi aulere m'thumba lokutira,
cysts.

zotupa zachisoni,
zotupa
kunyowa
mawonekedwe a cystic
zotupa.

Endoscopic retrograde cholangiopancreatography

kulowetsera,
kupezeka kwa calculi.

madera oyenga
miyala
kulowetsedwa mu pleural patsekeke.

mkhalidwe womaliza kumata kwa gland,
sphincter wa Oddi magwiridwe.

Chithandizo cha kapamba

Malingaliro azithandizo zochizira zimatengera gawo la matendawa. Kuukira kwa pachimake kapamba kumati:

kukonzanso thupi
mankhwala
plasmapheresis
chakudya.

Mu nthawi yayitali ya matenda, ndikofunikira kuwonjezera nthawi yakhululukidwa. Madokotala amalimbikitsa:

kudya kwa moyo wonse
kutenga michere ya kapamba,
symptomatic mankhwala
Chithandizo cha matenda amisala, matenda a shuga
makulidwe a acid-base bwino,
vitamini mankhwala
kuchira mu sanatorium chikhululukiro.

Thandizo loyamba

Ngati pancreatitis ikukayikira, wodwalayo ayenera kuonetsetsa kuti pamtendere, itanani ambulansi.

Kuti muchepetse vutoli, mutha:

khazikitsani wodwalayo maondo ake atakhazikika pachifuwa pake,
perekani madzi okwanira theka la mphindi 50 (osavomerezeka kudyetsa),
ikani katundu wambiri
Funsani kupuma kwambiri.

Wodwalayo akapititsidwa kuchipatala, madokotala amagwiritsa ntchito kulowetsedwa kwa saline kuti achotse, kubwezeretsa acid-base usawa. Njira yoyamba yothandizira imaphatikizapo chithandizo ndi magulu oterewa:

ma pinkiller
antispasmodics
antiemetic
ma diuretics (kupatula edema ya England),
ma antibayotiki (wokhala ndi mawonekedwe oyera),
enzyme zoletsa.

Mankhwala a kapamba

Udindo wofunikira pakuthandizira kapamba umaperekedwa kuti kuthetseratu kupweteka. Mwa izi, mankhwalawa amagwiritsidwa ntchito:

antispasmodics - Spazmalgon, Papaverine, Drotaverin,
ma pinkiller - Analgin, Ketorolac,
odana ndi kutupa - Ibuprofen, Diclofenac,
m-anticholinergic mankhwala omwe amatsekereza kuchepa kwa mitsempha - Chlorosil, Atropine,
Ma H2-blockers (okhala ndi ululu wopitilira) - Famotidine, Ranitidine.

Kubwezeretsa ntchito za kapamba, magulu otsatira a mankhwalawa amagwiritsidwa ntchito:

michere - Pancreatin, Mezim, Festal,
Homeopathic - Hovert Pankreatikum,
kuti muchepetse kupanga kwa mahomoni - Atropine, Platifillin,
antienzymes (zopondera ntchito zachinsinsi) - Sandostatin, Contrical, Trasilol,
kuletsa ntchito ya gland - Ribonuclease, Fluorouracil.

Pakutupa, ndikofunikira kubwezeretsa ntchito yam'mimba, chifukwa chaichi:

Omeprazole - amachepetsa kuchuluka kwa hydrochloric acid,
LIV 52 - hepatoprotector,
Lecithin - amawongolera kupanga kwa bile,
Gaviscon - siriyo (imatsitsa acidity yam'mimba)
Linex - imabwezeretsa microflora,
Gastal - imasinthasintha bwino m'mimba,
Smecta, Enterol - siyani kutsegula m'mimba.

Mankhwalawa kapamba, mankhwala angagwiritsidwe ntchito:

Maantibayotiki - ciprofloxacin, chloramphenicol,
amino acid (wokhala ndi chakudya chamagulu, kudutsa chimbudzi) - Aminosol,
diuretic - furosemide,
Hemostatic - Contrivan,
poizoni - Polysorb,
antiemetic - Tserukal,
kukonzanso - Crospovidone.

Mankhwala othandizira

Zizindikiro zakupangika kwa maopaleshoni ndikutupa kwa purosesa, chizindikiro cha kupweteka kosalekeza, ndi zotupa. Mankhwala opaleshoni ya kapamba ikuchitika ndi kuwonjezeka kwa kukula kwake, kuchepa kwina kantchito, zovuta za kapamba. Itha kuikidwa:

Mwadzidzidzi kulowerera kwa peritonitis, kutupa pachimake chifukwa cha kufalikira kwa duodenum.
Opaleshoni yoikidwiratu pambuyo poti zizindikiro zayamba zachotsedwa kuti muyambirenso.

Mankhwala othandizira opaleshoni amafunika madokotala oyenerera odziwa bwino - ziwalo zingapo zofunika, aorta, komanso njira yolumikizira mitsempha yayandikira. Zovuta zingapo siziphatikizidwa: kukhetsa magazi, matenda, kuwonongeka kwa mtima.

Ndi chithandizo cha opaleshoni, njira zotsatirazi zimagwiritsidwa ntchito:

Pancreatoduodenal resection - kuchotsa kwa mutu wa ndulu ndi duodenum.
Necrectomy - kukhathamiritsa kwa minofu ya necrotic.
Kuchotsa kwathunthu kwa kapamba limodzi ndi chikhodzodzo, gawo lamatumbo ang'onoang'ono, m'mimba, ndulu.
Autopsy, drainage wa cysts, abscesses.
Wirsungotomy - kugawa kwa mzere, kuchotsa miyala.

Zithandizo za anthu

Kugwiritsa ntchito mankhwala ochizira kunyumba okhala ndi zosakaniza zachilengedwe kungangowonjezera chithandizo chachikulu. Maphikidwe a asing'anga achikhalidwe amayenera kuvomerezana ndi dokotala - izi zingathandize kupewa zovuta, zomwe zimapangitsa kuti pakhale zotsutsana.

Kupanga kulowetsedwa, muyenera:

Knead ochepa zipatso.
Thirani kapu yamadzi otentha.
Imwani ndi uchi katatu patsiku.

Kuti muchotse kutupa, thamangitsani kusinthika kwa minofu, kubwezeretsa ntchito za kapamba, mano amathandiza. Chifukwa msuzi ntchito mizu, zimayambira ndi masamba a chomera. Ndi mankhwala omwe mukufuna:

Thirani supuni ya zitsamba mu kapu yamadzi otentha.
Kuphika kwa mphindi 5.
Kuumirira kwa ola limodzi, kupsyinjika.
Imwani 50 ml musanadye, katatu patsiku.
Maphunzirowa ndi mwezi.
Pambuyo masiku 10, kubwereza mankhwalawa.

Matenda a digestion mu kapamba amathandiza decoction azitsamba. Kuti mukonzekere, tsanulira supuni ya chopereka ndi kapu ya madzi otentha, imani kwa mphindi 15 posamba madzi. Kuchuluka kwake kumakhala kuledzera masana. Zophatikiza zimaphatikizanso magawo ofanana mbewu:

Kuchepetsa chinsinsi chake, kuthetsa kutupira, kusayenda kwa bile, kudzikongoletsa kuchokera ku chophatikiza cha mankhwala othandizira ndikulimbikitsidwa. Simalola kugwiritsidwa ntchito pa nthawi yowonjezera ya kutupa. Malinga ndi Chinsinsi, 0,5 malita a madzi amawonjezeredwa supuni ziwiri za kusakaniza, owiritsa kwa mphindi 20. Msuzi waledzera atatu waukulu Mlingo theka la ola musanadye. Ndalama zimaphatikizapo:

mbewu za caraway - magawo 4,
coriander, timbewu - 2 mbali iliyonse,
yarrow - 3 magawo.

Kutupa kwa kapamba

Mwanthawi yotupa, mankhwalawa amayamba ndi njala, pang'onopang'ono kupita ku chakudya No. 5P. Mu kutupa kosalekeza, kutsatira ndikofunikira pamoyo wonse.

Nutritionists amalimbikitsa kutsatira malamulo: