Zizindikiro ndi chithandizo cha kutupa kwa kapamba

Chithandizo cha pancreatitis chimaphatikizapo kuikidwa kwa magulu ena a mankhwala ndi chakudya chamagulu. Magawo oyambirira a chithandizo cha pachimake cha kapamba amachitika mu chipatala, kumalizira kwa mankhwala kungachitike kunyumba.

Zimayambitsa kapamba

Pakadali pano, zopitilira 100 zomwe zimayambitsa kutupa kwa minofu ya pancreatic. Izi zikuphatikiza:

Matenda ena am'mimbamo (duodenitis, hepatitis, gastritis),
zolakwika m'zakudya, makamaka kugwiritsa ntchito kuchuluka kwa chakudya kapena kuchuluka kwamafuta, zonunkhira, zakudya yokazinga, komanso kusankha zakudya zosazolowereka (mwachitsanzo, paulendo wapaulendo - zokonda za zakudya zam'dziko),
kukonda zakumwa zoledzeretsa ndi kugwiritsa ntchito zakumwa zingapo zakumwa zopanda zakudya (cologne, mowa waukadaulo),
kugwiritsa ntchito nthawi yayitali mankhwala omwe amawonongera minyewa ya kapamba.

Nthawi zambiri, chidwi cholimbikitsa matenda chiwonetsero cha matendawa chimapereka zotsatira za zifukwa zingapo zopweteketsa mtima. Mphamvu ya chinthu chimodzi chokha chowononga chingakhale chosakwanira pakukula kwa matendawa kapena kungoyambitsa kusintha kwaposachedwa kwamawonekedwe a labotale.

Matenda osachiritsika a matendawa nthawi zambiri amayamba chifukwa chosakwanira kwamankhwala osokoneza bongo kapenanso chifukwa chawonekera pafupipafupi kapena pafupipafupi ndi zotsatira zofananira (mwachitsanzo, ndi matenda ena am'mimba ngalande - chiwindi, m'mimba, matumbo).

Chiwerengero cha odwala omwe ali ndi matenda a pancreatic chaka chilichonse amangochulukirapo. Izi zikugwiranso ntchito pamatenda osiyanasiyana omwe amakhala ndi matenda komanso matenda. Kuwonjezeka kwa kuchepa kwa thupi kumayambitsidwa, kumbali imodzi, ndi zakudya zomwe zikuchulukirachulukira, ndipo, kutsika kwa mtundu wawo komanso kusasamala chidwi ndi anthu ambiri kuumoyo wawo.

Kusintha kwa zotupa m'matumba a pancreatic amapezeka chimodzimodzi kwa akazi ndi abambo. Izi zimawonedwa mwa akulu kangapo kangapo mwa ana. Kukula kwa kapamba mwa mwana (makamaka sukulu yamkaka ndi zaka zoyambira kusukulu) ndi vuto losowa.

Chithunzi cha kuchipatala cha mitundu yosiyanasiyana ya matendawa

Zizindikiro za kutupa kwapancreatic amadziwika ndi kukula msanga komanso kulimba kwakukulu. Amayambitsidwa chifukwa chophwanya mawonekedwe a anatomical a chiwalo (edema ndi kuwonongeka kwa ma cellular), komanso kuphwanya mphamvu yake yogwira (kaphatikizidwe ka mahomoni ndi ma enzymes am'mimba). Kwa mawonekedwe owopsa, zizindikiro zotsatirazi ndi zikhalidwe:

kupweteka kwamitundu yosiyanasiyana, koma mwa odwala ambiri amasiyana kwambiri mpaka osapilira,
kupweteka kumakhazikika m'mimba kumtunda, nthawi zambiri kumafalikira mpaka kumtunda kwa dera lumbar, sternum (yofanana ndi kupweteka kwa angina pectoris), tsamba lamanzere lamanzere ndi nthambi yam'mwamba,
kupweteka ndi kapamba kumakhala ndi chizolowezi chowonjezereka, nthawi zambiri kumakoka kapena kuphulika, sikutha ndi analgesics wamba ndipo sikusintha kukula kwake ndi kusintha kwa malo amthupi,
kusowa kwamtundu uliwonse (mpaka kuda chakudya), nseru yayitali kwanthawi yayitali ngakhale mutangotchula za chakudya, magawo obwerezabwereza a kusanza osaphikidwa, omwe adyedwa kumene chakudya,
Ambiri amakhala ndi matchulidwe am'mimba otupa - amatulutsa matendawa osakhudzana ndi magazi ndi ntchofu, chimbudzi chimbudzi ndi zosafunikira zamafuta,
chikhalidwe cha wodwalayo chimasintha - kutentha kumakukwera kwambiri, kuzizira komanso kufooka kwambiri.

Kusintha kwakukulu kwa kapamba ndi zizindikiro zamankhwala kuli m'njira zambiri zofanana ndi pachimake. Komabe, kuopsa kwa zizindikiro za munthu ndi kochepa kwambiri. Mu chosinthika chodwala chotupa, munthu amadandaula:

Kusintha kwachakudya (kuwonongeka, kupewera zakudya zina),
kukomoka pafupipafupi kusanza ndi kusanza mobwerezabwereza chakudya chosagaya bwino,
kupweteka pamimba, koma kupweteka kale, osaphulika, pamimba pamimba (kufinya kwa ululu kumbuyo ndi mkono wamanzere sikumawonedwa kawirikawiri),
matumbo amadzimadzi, omwe amakwiya chifukwa chophwanya dongosolo la chimbudzi, osati mwa kuwonjezera kwawothandiza.

Ngati zizindikiro zoyambirira za kapamba (onse pachimake komanso chovuta) zimachitika, ndikofunikira kufunsa dokotala posachedwa. Zoyenera kuchita pamkhalidwe wotere, kuyezetsa kwamtundu wanji ndikofunikira komanso ndi mankhwalawa omwe akuyenera kuthandizidwa - adokotala asankha. Katswiri kokha ndi amene angazindikire zovuta mu nthawi ndikupereka mankhwala ofunikira kuti athetse. Mavuto obwera chifukwa cha zotupa za kapamba ndizovuta, angapangitse kuti necrosis yathunthu ikhale yathunthu.

Ndi mayeso ati omwe amaperekedwa pancreatitis?

Ngati kapamba akuyembekezeredwa kuti wapukutidwa, kutsimikizika kwa chizindikirocho ndikuwunika maphunziro a labotale ndikofunikira. Zodziwika bwino ndi izi:

kupenda kwapadera kwa magazi a zotumphukira (leukocyte count ndi leukocyte formula kulocha kumawonjezera kumanzere),
kuyesa kwamkodzo kuti adziwe alpha-amylase (munthawi yomweyo, enzyme iyi palibe),
pulogalamu ya pancreatitis, mafuta ochulukirapo okwanira apezeka),
kuwerenga kwa kuchuluka kwa michere ya kapamba (lipase, trypsin, amylase) - ntchito za michereyi zimachulukana kwambiri ndi kapamba,
Ultrasound yamimba yam'mimba (kuwonjezeka kwa kukula kwa ziwalo, kuphatikizika kwazinthu zowoneka bwino komanso zowundana, kuwonekera kwa kuphatikizika kwa m'mimba kumawululidwa - pachimake cha kapamba, munthawi yayitali ya matendawa.
mwachidule kusiyanitsa kwa radiology ya ziwalo zomwe zimakhala mkati mwa m'mimba zimathandizira kwambiri pancreatitis yayitali, popeza kusintha kwina kuwululidwa (kuwerengetsa kwa duodenum, kuphwanya kwa mgodi wam'mimba).

Chifukwa chazidziwitso zokwanira zomwe zapezeka (kuyezetsa zamankhwala ndi zotsatira za kufufuza kwachipatala ndi zothandizira), dotolo amapanga lingaliro la kuopsa kwa matendawa mwa wodwala wina, zokhudzana ndi mawonekedwe a kutupa ndikupereka malingaliro amomwe angachiritsire odwala, zomwe zingadyedwe komanso nkhani zina zamankhwala.

Zakudya za pancreatic kutupa

Panthawi imeneyi, zakudya ndizofunikira kwambiri, chifukwa ndizosatheka kuchotsa zotupa popanda kuwongolera chakudyacho. Patsiku loyamba la kupanikizika kwa kapamba, wodwalayo ayenera kusiyiratu chakudya chilichonse ndikugwiritsanso kuzizira m'mimba. Matenda a wodwalayo akayamba kuyenda bwino, zakudya zopatsa thanzi zimaloledwa ndikukula kwake pang'onopang'ono. Mndandanda wa tebulo la mndandanda 5 umalola wodwala kuchita izi:

buledi wa tirigu, koma wotchedwa "dzulo", wauma pang'ono,
kuchuluka kwa zotsalira ndi mabisiketi,
supu zosiyanasiyana zamasamba ndi chimanga,
nyama ndi nsomba zokhazokha pazophatikiza ndi zakudya (kalulu, nkhuku, nkhuku), chonyowa, pogaya kapena kuphika,
zogulitsa zamkaka zilizonse, koma pang'ono komanso zamafuta ochepa,
Zakudya zilizonse zamphesa (kasseroles, mbewu zachikhalidwe, soufflé),
mazira ndi pasitala pang'ono,
Zipatso ndi zipatso zokhwima kwambiri ndipo zimakhala zotsekemera,
chakumwa chololedwa chochepa kwambiri osati tiyi wokoma kwambiri, compote, mankhwala azitsamba,
Maminolo am'madzi ndi oyenera kugwiritsa ntchito ngati gawo la mankhwala a spa chifukwa cha chifuwa chachikulu.

Ndikofunikira kuti wodwalayo adye ochepa, ndiye kuti, m'malo ochepa 5-7 patsiku, mbale zonse ziyenera kukhala kutentha.

Mankhwala

Pali mankhwala omwe amayenera kugwiritsidwa ntchito kuti atseke njira yotupa, ndipo mitundu yosiyanasiyana yofunikira ndiyofunika kubwezeretsa magwiridwe antchito. Nthawi zambiri mankhwala omwe amapezeka m'magulu a mankhwalawa:

ma pinkiller a non-narcotic (Diclofenac, Ibuprofen) ndi narcotic (Promedol, Ketanov) mndandanda,
otseketsa otchedwa proton pump (Rabeprazole, Pantoprazole, Lansoprazole) kuti achepetse kubisalira kwa timadziti tam'mimba,
H2 histamine receptor blockers (Ranitidine, Famotidine) pacholinga chomwecho,
zoletsa za proteinolytic fusion ya pancreatic minofu (Gordoks, Kontrikal),
kuchuluka kulowetsedwa mankhwala ndi colloidal ndi saline njira,
ndikusintha, ma enzyme ofanana ndi omwe amaphatikizidwa ndi kapamba.

Kutupa kwa kapamba ndizovuta zokwanira, koma ndi zotheka kutha, ngati chithandizo chachipatala chitha kuperekedwa munthawi yake.

Njira zodziwira pancreatitis

Pancreatitis ndi kutupa kwa kapamba. Zizindikiro za matendawa zimatha kupweteka m'mimba, kufooka kwa thupi, kusinthasintha kwa kutentha kwa thupi ndi kuthamanga kwa magazi, kumva pakamwa pouma, kupuma pafupipafupi komanso kusanza.

Komabe, Zizindikirozi zitha kuonetsa kukula kwa matenda ena angapo omwe sagwirizana ndi kapamba.

Momwe mungadziwire pancreatitis ndipo ndizotheka kuchita izi osagwiritsa ntchito mayeso ogwiritsa ntchito? Ngati pancreatitis ikukayikira, kuyezetsa kofunikira ndikofunikira kuti adziwe zoyenera ndikuyesa mayeso ofunikira (kufufuza kwachipatala). Zitatha izi zisanachitike, zizindikiro zotsatirazi zitha kuwonetsa zovuta ndi kapamba:

Mawonekedwe abuluu pafupi ndi navel kapena khoma lam'mimba,
kupweteka pakhungu kapena kugunda pa kapamba,
kumachitika kupweteka pafupipafupi kumwa mowa, yokazinga kapena zakudya zamafuta,
ndi kapamba, wodwalayo samva kupindika m'mimba,
akaponderezedwa mkati mwa khoma lamimba, wodwalayo amamva kupweteka kwambiri.

Ngati pali zizindikiro zotere, kuyezetsa magazi kwamomwe amodzi adzafotokozereni kwa dokotala kuti adziwe zoyenera pambuyo poti wodwalayo adziwe koyamba. Iyi ndi njira yosavuta, koma yophunzitsa. Malinga ndi zotsatira zake, mtundu wamatendawa watsimikiza. Zizindikiro zotsatirazi zimatengedwa ngati maziko: kuchuluka kapena kuchepa kwa ma enzymes ena a pancreatic, kuchepa kwa mapuloteni amwazi, kuchepa kwa insulin, etc.

Kuwerengera kwathunthu kwa manambala a leukocytes kuwonetsa nthawi yomweyo ngati pali chotupa mthupi. Kuyesedwa kwa magazi kwa electrolytic ndi madzi kumathandiza kuzindikira pancreatitis, popeza zolakwika zamkati zimayambitsa kusintha kwa kuchuluka kwa madzimadzi m'magazi, komanso kuchepa kwa kuchuluka kwa mchere wofunikira pakugwira ntchito yonse ya mtima.

Kusanthula kwamkodzo kwamatumbo ka chifuwa kumawonetsa kupatuka kwakukulu kuchokera pazikhalidwe zabwino.

Njira zothandizira kudziwa kupindika

Chofunikira pakuwunika kwa matenda a kapamba ndi njira zofufuzira, pomwe mutha kuwona zotsatira za kapamba pazinyezi ndi ziwalo zina. Njira yodziwika kwambiri ndi diagnostics a ultrasound. Iyi ndi njira yothandiza kwambiri kuti muwone chilichonse chomwe chimachitika ndi kapamba, kudziwa ngati pakhala kusintha kwamasamba a chiwalo, kaya pali zotupa, zotupa za purifesito, zomwe zachitika ndi bile ducts. Asanayambe kugwiritsa ntchito ultrasound, wodwala ayenera kutsatira zakudya kwa masiku atatu. Pafupifupi maola 12 ayenera kudutsa dongosolo lisanachitike komanso chakudya chomaliza.

Njira yachiwiri yowunikira zikondwerero ndi x-ray. Ndi iyo, mutha kudziwa bwinobwino momwe matendawa alili, kuti muone ngati muli miyala mu ndulu za bile, mululu wokulirapo wamatumbo, mkhalidwe wa ndulu, impso, ndi zina zambiri. Njira yofufuzira iyi imakupatsani mwayi kuti mupeze mavuto ndi gland pamene njira za ultrasound zilibe mphamvu (mwachitsanzo, ndi flatulence yolimba).

Njira yophunzitsira, koma yodula kwambiri ndi tomography. Ndi chithandizo chake, adotolo amawona kukula kwa kapamba, amawona ngati pali masamba omwe anamwalira, kutupa. Khansa ya pancreatic koyambirira imapezeka kwambiri pogwiritsa ntchito tomography. Njira imakulolani kuti mudziwe mtundu wa chotupacho, komanso kutengera kweniyeni.

Woopsa milandu, laparoscopy angagwiritsidwe ntchito matenda. Njirayi imakupatsani mwayi kuti muwone zenizeni komanso zosintha zomwe zachitika ndi izi, komanso kudziwa zomwe zimayambitsa, kudziwa gawo la matendawa.

Ngati ndi kotheka, laparoscopy itha kugwiritsidwanso ntchito ngati njira yopangira opaleshoni.

Njira ina yodziwira matenda a kapamba ndi endoscopy. Njirayi imakhala ndikuyambitsa endoscope kudzera mu kummero, momwe kamera imayikidwira. Pambuyo poyambitsa wothandizira wosiyanitsa, katswiri amatha kuwona njira za ndulu, matumba a pancreatic. Pochita phunzirolo, ngati kuli kotheka, wodwalayo angagwirire ntchito yolimbitsa thupi ya endoscopic mini. Pa endoscopy, ndizotheka kutulutsa zitsanzo za minofu ya mitundu yosiyanasiyana ya maphunziro, kuchotsa ma gallstones, kukhazikitsa stents mu ducts ya bile, chotsani ma polyp, clip ndi magazi mkati.

Zovuta pakuzindikira pancreatitis

Popeza zizindikiro zazikuluzikulu za pancreatitis ndi ululu wam'mimba, nseru, kusanza komanso kukhumudwa, ndikofunikira kulingalira kuti matenda ena am'mimba ali ndi zofanana. Gastroenterologists omwe amazindikira kutupa kwa kapamba, akakhazikitsa kapamba mu akuluakulu ndi ana, ayenera kupatula matenda ena omwe angakhalepo.

Zilonda zodzola mafuta zimakhala ndi zofanana kwambiri ndi zotupa za kapamba. Matendawa amadziwika ndi kupweteka kwambiri, komwe kumatha kudzutsa kupweteketsa mtima, kuchepa kwa mtima, komanso kusokonezeka m'makoma amkati mwa m'mimba. Kusiyanako ndikuti ndi chilonda chopaka mafuta, kusanza kumachitika kawirikawiri, ndipo ndi kapamba kumakhala kosalekeza. Mfundo yachiwiri yomwe imasiyanitsa matenda ndi linzake ndilakuti wodwala wokhala ndi zilonda zodzola mafuta amatha kupeza malo abwino omwe sangamve kupweteka, ndipo ndi kapamba, ululu wammbuyo sutha ndipo sutha mphamvu m'thupi lililonse.

Pancreatitis ali ndi zofanana ndi cholecystitis. Nthawi zambiri, cholecystitis ndi chifukwa cha kutupa kwa kapamba. Ululu wokhala ndi cholecystitis umadziwika kudera lamanja ndipo umaperekedwa kumapewa kuti atsimikizire kuti ali ndi matendawa.

Zizindikiro zomwe zikuphatikizira pancreatitis zimaphatikizapo flatulence, kudzimbidwa, kupweteka m'matumbo. Matumbo a pachimake omwe ali ndi matendawa ali ndi zizindikiro zomwezo. Kuti asatenge matenda, wodwalayo ayenera kuyezetsa magazi.Ngati mulingo wa chloride ndi diastase m'magazi ukachuluka, ndiye kuti wodwalayo amakhala ndi kapamba. Potengera kuti chloride ndi yocheperako, titha kulankhula za kutsekeka m'matumbo.

Momwe mungachepetse chiopsezo cha kapamba

Poganizira zovuta za matenda monga pancreatitis, kuzindikira kwake komanso chithandizo chake kumatha kutenga munthu nthawi yambiri komanso kuchita khama. Chifukwa chake, ndikofunikira kuti musanyalanyaze kupewa. Kuti muchite izi, ndikofunikira kuthana ndi matenda a ziwalo zamkati munthawi yake, kuwunika zakudya, osamwa moledzera ndi zakudya zopanda pake, kuyesa kudya masamba ambiri ndi zipatso, kupatula zotengera za confectionery zomwe zili ndi mafuta ambiri komanso zakumwa za shuga. Njira zosavuta izi zithandizira kuti chithokomiro chanu chikhale chathanzi.

Kuyesedwa kwa kapamba - mayendedwe ndi zotsatira zake

Chimodzi mwazinthu zomwe palibe chithandizo chomwe chitha kuchita ndikuwazindikira. Wodwala amayenera kupitilira mayeso onse kuti atsimikizire ngati wodwalayo wapezeka. Madokotala amathanso kukhala akulakwitsa, makamaka ngati matendawa akuwonetsa zisonyezo zosadziwika. Nenani za kapamba pa zheleza.com.

Kodi matenda ndi chiyani? Uwu ndi njira yotupa yomwe imatulutsidwa m'mapapo.

Mavuto opweteka ndi kugaya zakudya amadziwika pamodzi ndi kapamba, komanso matenda ena ambiri.

Ndiye chifukwa chake akulimbikitsidwa kuti muzifufuza kaye ndi kuzindikira matendawa, kuti, mosakaikira, alandireni, m'malo mopanga nokha kudziwikiratu matenda omwe mwazindikira.

Pancreatitis ilibe zizindikiro zomwe zingaloze mwachindunji. Ichi ndichifukwa chake madokotala amayambira njira zodziwira, zomwe zimayenera kutsimikizira kapena kukana kuti wapezeka kuti wapezeka.

Choyambitsa chachikulu cha pancreatitis pafupifupi 100% ya milandu ndi kumwa mowa kwambiri kapena matenda a gallbladder (gallstone). Zomwe zimayambitsa matendawa ndi izi:

Zilonda zam'mimba.
Kuthekera kwa mahormoni.
Zilonda ndi matenda m'mimba.
Kulephera kwa kagayidwe kachakudya njira.

Mitundu iwiri ya kapamba imadziwika. Mu mawonekedwe owopsa, omwe amapezeka nthawi zambiri, michere yamagaya ya gland simalowa mu duodenum, koma mumabaya gland yokha. Pancreatitis yosatha, minyewa yachilendo ya m'mimba imalowetsedwa ndi cicatricial, yomwe imayambitsa kuphwanya ntchito ndi zochitika zake. Matenda amtunduwu amatha kupha.

Ngati munthu ali ndi kapamba, ndiye kuti amakumana ndi zotsatirazi:

Zofooka zambiri.
Kubweza
Kutsegula m'mimba.
Ululu m'mimba yonse.
Kutaya chikumbumtima.

Ngati kapamba samachiritsidwa, ndiye kuti palinso matenda ena owopsa omwe amakhala:

Kutulutsa magazi mkati.
Matenda a shuga.
Cholecystitis.
Peritonitis (matenda oopsa).

Ngati pali zizindikiro za kapamba, ayezi amayenera kuyikidwa pamalo opweteka ndipo adokotala ayenera kutchedwa. Kuti adziwe zoyenera, azikupatsirani malangizo oti azizindikira.

Dokotala sangathe kuchitira wodwalayo khungu, ngakhale ngati zizindikilo zonse zikusonyeza nthenda inayake. Matenda ambiri amafanana wina ndi mzake mu zizindikiro zawo.

Pofuna kuti asalakwitse molondola njira zamankhwala, dokotala amachititsa maphunziro omwe amatsimikizira kapena kutsutsa kapamba:

Cop program - kusanthula ndowe.
Kuyesedwa kwa magazi konse.
Kutsimikiza kwa ntchito ya transaminase ndi mulingo wa bilirubin.
Kudziwitsa za cholesterol.
Kuzindikira kuchuluka kwa shuga m'magazi.
Phunziro la kulowetsedwa - madzi ochokera m'mimba thirakiti pa laparoscopy.
Kudziwa mapuloteni komanso chidutswa chonse.
Kuzindikira kwa antigen kapamba mu pancreatitis pachimake.
Kuyesedwa kwa nkhani zamkati.
Kusanthula mkodzo, magazi ndi malovu.
Kuzindikiritsa ntchito ya enzyme (trypsin, lipase).

Gastroenterologist kapena othandizira ndi amodzi mwa madokotala omwe amayenera kufunsidwa chifukwa cha kapamba. Onetsetsani kuti mwachita izi ndi izi:

Zowawa zakumanzere kwa hypochondrium kapena dera la epigastric nyengo yamakhazikika, makamaka mukamadya zakudya zamafuta kapena zamkaka, zomwe zimatsika ndikusala kapena kukhala pansi.
Kusilira ndi mseru.
Kuchulukitsa kwa mpweya.
Kuchulukana kwachulukidwe.
Kuchepetsa thupi.
Belching amadyedwa ndi chakudya kapena mpweya.
Kuwonongeka kosatha.
Zofooka.
Kutsegula m'mimba Nthawi yomweyo, ndowe zimakhala ndi fungo loipa kwambiri, udzu kapena mtundu wachikaso chowoneka bwino, yokutidwa ndi kanema wamafuta, simatsukidwa bwino pazitseko za chimbudzi, ndipo zimakhala ndi chakudya chosasamba.
Kutopa

Zizindikirozi zikuwonetsa kupunduka kwa kapamba, komwe kumapangitsa kuti mafuta abwinidwe, mapuloteni ndi zakudya, mavitamini ndi michere. Izi zimabweretsa mavuto azaumoyo: kamvekedwe kacheperachepera, kutopa kumawonekera, tsitsi limatuluka, misomali ikasweka, khungu limakhala louma.

Kuwerengera magazi kwathunthu

Phunziro limodzi ndi kuchuluka kwathunthu kwa magazi. Iye nthawi zambiri amakhala woyamba kuchitapo kanthu poyambitsa zotupa mthupi. Ngati munthu ali ndi kapamba, ndiye kuti kuyezetsa magazi kukuwonetsa izi:

Kuchepetsa hemoglobin ndi maselo ofiira amwazi chifukwa chotaya magazi.
Kuchuluka kwa maselo oyera.
Kuwonjezeka kwa ESR kuli pamwamba pa chizolowezi, chomwe ndi 2-15 mm / h.
Kutseka magazi chifukwa chosokonezeka ndi madzi osowetseka m'madzi.

Ngati mungadziwe momwe thanzi limakhalira, ndiye kuti kuyezetsa kwamwazi wamagazi kumachitika. Ndi kapamba, amasinthanso chithunzi chake:

Kuwonjezeka kwa amylase, komwe kumathandiza kuyamwa zakudya zamagulu. Nthawi zambiri, ndi magawo 10-100. l M'mawola 12 oyamba, imafika pachimake, kenako pang'onopang'ono imayamba kukhala yabwinobwino mkati mwa masiku 7.
Kuchuluka kwa insulin chifukwa cha kusakwanira katemera wa insulin.
Kuchulukitsa kwa milomo, yomwe imakhudzidwa ndi kuphwanya mafuta. Nthawi zambiri, ndi magawo a 190. ml Mu maora 8 oyambilira amakwera mpaka 200, kenako pang'onopang'ono amabwereranso ku sabata ziwiri zokha.
Kuwonjezeka kwa kuchuluka kwa bilirubin chifukwa cha kuchuluka kwa kapamba ndi kuletsa kutuluka kwa ndulu.
Kuchepa kwamapuloteni.
Kuchulukitsa kwa transimanase.

Kusanthula kwamaganizidwe

Njira ina yayikulu yodziwira ndi kuwunika kwa stool. Ngati kapamba sakugwira ntchito moyenera, ndiye kuti tinthu tating'onoting'ono ta chakudya, komanso mafuta, tidzalembedwamo. Zizindikiro zazikulu za kapamba malinga ndi ndowe:

Zakudya zopanda chimbudzi zomwe zimakhala ndi ndowe.
Mtundu wa chopondapo, chomwe chikuwonetsa kutsekedwa kwa thirakiti la biliary.
Mafuta mu ndowe.

Mayeso ena azidziwitso

Kodi ndi mayeso ena ati omwe madokotala akuchita kuti apeze pancreatitis? Njira zina zodziwitsira matenda ndi:

Urinalysis, yomwe imathandizira kudziwa kuchuluka kwa trypsin (njirayi ndiyothandiza 50% chifukwa ikhoza kuwonetsa matenda a impso), komanso diastases (mkodzo umakhala wamdima).
Kuzindikira magazi pamlingo wa trypsin. Amachepetsedwa mu kapamba.
Kuwunika kwa malovu, komwe kumatha kudziwa kuchepa kwa amylase, komwe kumawonetsa matenda apancreatic.
Endoscopic laparotomy - kafukufuku wa malo odwala.
Ultrasound kuti muwone madera okukula kwa kapamba.
Fibrogastroscopy - kuwunika kwa ndulu.
Kuyesa kwa Lasus kuti mupeze mayamwidwe amino acid.

Ngakhale kuti mayesowa ndi ofanana, Zizindikiro ndizosiyana pang'ono pachimake ndi matenda a kapamba. Mtundu wa matendawa ungayambitse imfa kapena kuwoneka kwa zovuta, zomwe zimapereka kulosera kolakwika. Ngati zingachitike zizindikiro zilizonse za matendawa, pitani kuchipatala.

Pancreatitis yokha ndi matenda oopsa ndipo imatha kubweretsa zovuta zakupha. Kuti muchiritse bwino, muyenera kudziwa chithunzi cha njira yake. Kusanthula kosiyanasiyana kumathandizira izi, zomwe zikuwonetsa bwino lomwe chitukuko cha matendawa, omwe mu mawonekedwe ake amafanana ndi matenda ena am'mimba.

Kuyesa kwa kapamba: kusanthula ndi njira

Zaka khumi ndi zisanu zapitazo, udindo wotsogola pakati pa matenda onse am'mimba ophatikizika am'mimbamo unakhala ndi appendicitis ndi cholecystitis. Masiku ano, pancreatitis pachimake imabwera koyamba, kotero kuzindikira kwake ndikofunikira.

Zikondazo zimatulutsa timadzi tokoma tomwe timafunikira pakudya m'mimba, timapanga ma insulin ndi glucagon, omwe amachititsa kuti shuga azikhala m'magazi. Chifukwa chake, kusagwira ntchito kulikonse kwa thupili kungayambitse zotsatira zoyipa ndikuwononga ntchito ya ziwalo zonse mthupi la munthu.

Kuti muzindikire ndi kugwiritsa ntchito bwino ma matenda monga:

kapamba
miyala m'makola
cysts
necrosis
zotupa zoyipa

komanso matenda a duodenum, matumbo, chiwindi ndi m'mimba zomwe zimawoneka motsutsana ndi maziko awa, kapamba ayenera kuyang'aniridwa mosamala komanso munthawi yake.

Mankhwala amakono pazolinga izi ali ndi zida zambiri zamaukadaulo osiyanasiyana, amazindikira ndi kuwunika amagwiritsidwa ntchito, lirilonse lomwe limakhala ndi zake ndipo limapeza ntchito mu ma pathologies ena.

Kuzindikira ndi chiwembu

Kuti ayang'anire kapamba, wodwalayo ayenera kukaonana ndi othandizira, ndipo kenako amutumiza kwa endocrinologist kapena gastroenterologist. Dokotala, potengera madandaulo a wodwala, komanso pazotsatira zoyesedwa ndi pakhungu, chiwindi ndi m'mimba, adzakufotokozerani njira zoyenera zothandizira matenda.

Nthawi zambiri mu pancreatitis pachimake ndi matenda ena a gland, njira zotsatirazi zoyezera zotsatirazi zimagwiritsidwa ntchito:

Mayeso amwazi wamwazi wam'magazi - amakulolani kudziwa zomwe zili pancreatic amylase.
Kuyesa kwa fecal kwa steatorrhea (kuchuluka kwamafuta osalowerera) komanso kukhalapo kwa zidutswa za chakudya zosasankhidwa.
Kusanthula kwamkati mwa mkodzo - kumapangitsa kudziwa kuchuluka kwa diastase.
Kufufuza kwa Ultrasound - kumagwiritsidwa ntchito kuti adziwe kukula ndi mawonekedwe a kapamba ndi kuzindikiritsa zotupa ndi ma cysts.
Kuyesedwa kwa X-ray, CT ndi MRI ya England, m'mimba, chiwindi ndi duodenum - kudziwa kukhalapo kwa chizindikiro chosalunjika cha matenda a ziwalo.
Biopsy
Kuzindikira koyesa ndikusanthula.

Njira zoyesera

X-ray ndi ultrasound ya zikondamoyo nthawi zambiri imagwiritsidwa ntchito limodzi ndi mayesero, omwe mungayang'anire ndikuwunika ntchito ya chiwalo. Komanso pazofunsa matenda, amatha kugwiritsidwa ntchito pawokha. Ziyeso zimagawika m'magulu otsatirawa:

Mayeso ofunikira kafukufuku wamatumbo.
Mayeso osasokoneza (osafunikira).

Ubwino wa gulu lachiwiri ndilotonthoza kwakukulu kwa wodwala, mtengo wotsika mtengo ndipo palibe chiwopsezo kwa wodwala akamagwiritsa ntchito. Koma mayesedwe awa ndi kusanthula ali ndi chopanda, alibe chidwi chokwanira komanso chodziwika.

Kuyesa kumakhazikitsidwa pakutsimikiza kwatsika katulutsidwe ka michere ya pancreatic ndipo kumangogwira ndi kuchepa kwakukulu pakupanga ma enzyme.

Sikuti wodwala aliyense amene ali ndi matenda a kapamba, m'mimba, matumbo, kapena chiwindi ayenera kuyesedwa kapena kufufuza mayeso. Kusankhidwa kwa njira kumasankhidwa kwa wodwala aliyense payekhapayekha.

Mwa mayeso onse azachipatala, zotsatirazi zimagwiritsidwa ntchito nthawi zambiri:

hydrochloric acid
elastase
pancreosimine-secretin,
Kuyesa kwakukulu.

Mayeso a Pancreosimine-Secretin

Madotolo ambiri amaganiza kuti kugwiritsa ntchito mayesowa ndi golide podziwitsa zomwe zimachitika chifukwa cha kapamba. Kukhazikitsa kwake kumaphatikizanso kuyambitsa kutsimikizira kwapang'onopang'ono kwa wodwala.

Ndondomeko ikuchitika pamimba yopanda kanthu poyang'aniridwa ndi fluoroscopy komanso kusangalatsa kosalekeza. Kuwerengeka kofunikira nthawi zingapo mosamalitsa kusonkhanitsa zitsanzo zam'mimba ndi matumbo, mutapanga jakisoni wa kapamba ndi secretin.

Zotsimikizika zomwe zimapezedwa zimayesedwa poyesa kuchuluka kwa ma bicarbonates, ntchitoyo ndi muyeso wa trypsin secretion.

Zizindikiro zotsatirazi zikuwonetsa kupezeka kwa kapamba:

kuchepa kwakukulu kwa katulutsidwe,
kuchuluka kwa michere
kuchepa kwa ndende ya ma bicarbonates.

Zizindikiro zoterezi zimatha kukhala pancreatitis yayikulu komanso matenda oyipa m'dera la mutu wa kapamba.

Zotsatira zabodza zitha kupezeka ngati biliary pancreatitis yapezeka, komanso matenda a shuga mellitus, hepatitis ndi cirrhosis.

Ngati zinthu zonse zaukadaulo panthawi yoyesedwa zakwaniritsidwa, ndiye kuti kudziwikitsa kwa njira imeneyi ndikokwera kwambiri. Zoyipa zake ndizovuta zokhazokha zodandaula za wodwalayo, mtengo wokwera wa ma reagents ndi zovuta za njira yantchito.

Kuyesa kwa hydrochloric acid

Pogwiritsa ntchito mayesowa, njira ya hydrochloric acid yokhala ndi 0,5% imagwiritsidwa ntchito ngati cholimbikitsira cha secretion ya pacreatic, yomwe imayambitsidwa ndi probe intraduodenally ndi kuwonjezera kwa mpendadzuwa kapena mafuta a azitona.

Njira yosonkhanitsira katemera wa pancreatic ndi kuwunika kwake ikufanana ndi zomwe zimachitika ndi intravenous makonzedwe a othandizira.

Njirayi ndi yosavuta kuyigwiritsa ntchito komanso ndiyotsika mtengo, koma imakhala yotsika kwambiri poyerekeza ndi zomwe zapezedwa kuposa mayeso am'mbuyomu. Pankhaniyi, ndikwabwino kuyambitsa mayeso ndi mayeso a pancreosimine-secretin, popeza ndizosavomerezeka kuchititsa maphunziro awiri nthawi imodzi.

Kuyesa kwakukulu

Kuyesaku kunafotokozedwa ndi Lund mu 1962. Ikakwaniritsidwa, zomwe zili m'matumbo aang'ono zimasonkhanitsidwa ndi intubation mutatenga chakudya chokwanira.

Njirayi imapangidwa kuti iwunikenso ntchito ya kapamba. M'mawa, kafukufuku wapa X-ray wopangidwa ndi polyvinyl wokhala ndi chindapusa kapena chitsulo cholumikizidwa kumapeto kwake amaperekedwa kwa wodwala pamimba yopanda kanthu.

Pambuyo pake, wodwalayo amapatsidwa chakudya chosakanikirana ndi kuwonjezera kwa ufa wa mkaka ndi dextrose ndi mafuta a masamba. Zitatha izi, wokonza thupi wa duodenal amatengedwa kwa maola awiri, ndikugawa zomwe zimasungidwa mu ayezi ndi ayezi.

Kuunika kotereku kumakuthandizani kudziwa mulingo wa amylase, womwe nthawi zambiri umakwezedwa ndi kapamba. Ubwino wa njirayi ndikuphatikiza kukhazikitsa, kupezeka, kusowa jakisoni wambiri.

Mwa zoperewera, cholakwika china chazotsatira zomwe zimagwirizanitsidwa ndi kuphatikiza kwa bile ndi madzi a m'mimba chimatha kusiyanitsidwa. M'matenda ena a chiwindi, komanso odwala matenda a shuga kapena gastrostomy, zotsatira zabodza zitha kupezeka.

Mayeso a Elastase

Mosiyana ndi njira zina zomwe sizingawonongeke, kuyesaku kumapangitsa kuti athe kudziwa kufooka kwa endocrine pancreatic ndi pancreatitis koyambirira. Ngati kuperewera kwa enzyme kwapezeka mu kusanthula, ndiye kuti izi zikusonyeza kuperewera kwa chotupa mu England.

Zisonyezero za kuyesedwa koteroko ndi diagnostics a pachimake kapena aakulu kapamba ndi mphamvu ya mankhwala. Njira imakhala yodziwitsa elastase mu ndowe za wodwalayo ndipo amamuchitira chifuwa chachikulu cha matenda a shuga, matenda a shuga, matenda am'mimba a chiwindi ndi matenda a ndulu, kuwongolera ndi chizindikiro cha kapamba.

Zikondamoyo ndi chimodzi mwazinthu zofunika kwambiri m'thupi la munthu, choncho muyenera kuziyang'anira mosamala komanso mosamala. Kwa matenda aliwonse, ndikofunikira kuti nthawi yomweyo ndiyambe kulandira chithandizo chokwanira, chomwe chitha kuperekedwa pokhapokha ngati mukufufuzidwa kwathunthu komanso kudziwa bwino matenda.

Njira zoyeserera za kapamba, kapangidwe kake ndi motani?

Pofuna kudziwa pancreatitis munthawi yake ndikupereka chithandizo choyenera, njira zingapo zowunikira kapamba zimagwiritsidwa ntchito pochita zachipatala. Iliyonse ya izo ili ndi mawonekedwe ake, ndipo pamitundu mitundu yamatenda ndikofunikira kugwiritsa ntchito mitundu ina ya mayeso. Nthawi zina, mungasowe njira imodzi, koma ziwiri kapena zingapo.

Ndi kutukusira kwa gland, wodwalayo ali ndi kuchepa kwakukulu kwa kubisalira, kuwonjezera apo, pakakhala kuchuluka kwa ma bicarbonates komanso kuchuluka kwa michere.

Ngati matenda a bicarbonate alkalinity atapezeka chifukwa cha mayesowo, wodwalayo amayenera kuwunika pa chipatala cha oncology, popeza zizindikiro zotere zimawoneka ndi chotupa cham'mutu komanso mitundu yayikulu ya kutupa kosatha.

Kuzindikiridwa kwa enzyme ndi umboni wa kutupa kosatha kwa kapamba.

Njira yosavuta komanso yotsika mtengo yoyeserera, komabe, kulondola kwa zidziwitso zomwe zapeza chifukwa chake ndizotsika kuposa momwe adayeserera kale. Popeza ndizosavomerezeka kuchita mayeso awiri nthawi imodzi, ndi bwino kuyamba ndi pancreosimine-secritin, chifukwa nthawi zambiri kufunikira kwake kumadzabwerabe, ndipo izi ndizowonjezera kwa wodwalayo.

Pancreatic Examination Plan ya Pancreatitis

Zoyeserera za kapamba zimatha kugawidwa m'magulu awiri akuluakulu: kufufuza kwawoko ndi kusanthula, ndi maphunziro othandizira.

Asanaikidwe mayeso ofunikira, dokotalayo amayang'anitsitsa wodwalayo polandirira, amawunika momwe khungu limapezekera komanso khungu, komanso amalondola ululu pochita kupindika kwa kumanzere kwa hypochondrium yam'mimba. Kenako, mayeso onse ofunikira amapatsidwa.

Pancreatitis test test:

kuyezetsa magazi konse
kutsimikiza kwa pancreatic michere monga alpha amylase, lipase, trypsin. Chiwerengero chawo chidzanena kuti matendawa ali pati,
kuyesedwa kwachindunji kwa ntchito yopanda ntchito kumayambira pa kugwiritsa ntchito mililita 300 ya chakudya chamadzimadzi ndikuwunikira zotsatira za michere,
mayeso ogwirira ntchito mwachindunji akagwiritsidwa ntchito pokonzekera duodenum,
kusanthula ndowe kupezeka kwa lipids,
kuyesa kwa endocrine kumakhazikitsidwa ndi shuga.

Chida choyesera:

Komanso, kuwonjezera pa mayeso ovomerezeka, muyenera kupita kukakambirana ndi akatswiri opapatiza - dokotala wa opaleshoni komanso endocrinologist.

Gosh - 27 Nov 2015, 22:47

Kuyeza kwa chifuwa chachikulu

Kuunika kwa chifuwa cham'mimba nthawi zambiri kumavumbula kutulutsa ndi kupweteka pamimba pamimba, nthawi zambiri limodzi ndi zizindikiro za kuperewera kwa thupi, ndipo nthawi zina jaundice.

Pancreatic calcization, shuga, ndi steatorrhea (the classic triad for chronic pancreatitis) zimachitika osakwana 25% ya milandu, ngakhale mu magawo awiri mwa atatu a odwala omwe akuwonetsa matendawa, kulolerana kwa shuga kwayamba kale kudwala. Zizindikiro za X-ray za pancreatic petrification ndi chizindikiro cha pathognomonic cha pancreatitis chomwe chimachitika mu 30-50% ya odwala.

Ululu umadziwika mu 75% ya odwala. Poyamba, ululu umadziwika ndi mobwerezabwereza, komabe, umakhala wokhazikika ndi nthawi zakhululukidwa kosiyanasiyana nthawi yayitali. Nthawi zina, pakapita nthawi yayitali, ululu "umatha."

Kufunika kwa kuyesa kwa labotale chifukwa cha chifuwa chachikulu chochepa.

Kuchuluka kwa michere ya pancreatic (amylase, lipase) imatha kuchuluka komanso kutuluka, koma si njira yabwino yodziwira matenda osachiritsika, chida cha pancreatic kapena pancreatic resort, komanso osagwirizana ndi zizindikiro za kutupa kosatha.

Maphunziro ogwira ntchito ndiovuta kuchita ndipo nthawi zambiri sagwiritsidwa ntchito kuzindikira matenda awa.

Komabe, kafukufuku wazotsatira zamapangidwe obisika a pancreatic malinga ndi zomwe zili mu duodenum (amylase, lipase, trypsin, chymotrypsin ndi bicarbonates), mkodzo (NBT-PABA kuphunzira ndi kuyesa kwa pancreolauryl) kapena seramu (P-isoamylase ndi trypsin functional). ingathandize kukulitsa njira zamankhwala. Kudziwitsa za ma enzymes a chiwindi ndi ma cell oyera a m'magazi kungakupatseni zambiri zokhudzana ndi zovuta za kapamba.

Njira zoyezera zida zamatumbo a chifuwa chachikulu

Pa radiographs yofufuza, ma pancreatic petrificates amapezeka odwala osakwana 50%, motero, kuwunika kwa X-ray sikutanthauza kuti apezeke pancreatitis.

Ultrasound imathandiza kukhazikitsa chidziwitso chakukula komanso kusasinthika kwa tiziwalo tating'onoting'ono, tchulani mawonekedwe amomwe amachokera komanso kuzindikira zovuta.

Katswiri woyenerera m'munda wa ultrasound amatha kudziwa kutalika kwa kutupa kwa kapamba ndi chidwi chofika 70%.

Kuzindikira kwa CT pakuzindikira matenda a kapamba kumayandikira 90%, ndipo mawonekedwe ake ali pafupi ndi 100%.

Chifukwa chake, njira yofufuzira iyi iyenera kugwiritsidwa ntchito mwa odwala onse kuti azindikire matendawa molondola, kuzindikira zovuta ndi kuvulala komwe kulipo pakuwongolera. Nthawi zambiri, CT ikhoza kukhala njira yokhayo yodziwira matenda.

ERCP imakupatsani chidziwitso chofunikira pazomwe mumayambitsa ma ducts.

Chifukwa cha kuchuluka kovuta kwambiri kwa ERCP, kugwiritsa ntchito kwake kuyenera kukhala kwa odwala omwe amafunika kudziwa mawonekedwe a ma ducts pamene sizotheka kupeza chidziwitsochi pogwiritsa ntchito njira zina, komanso kwa odwala omwe akuwoneka kuti ali ndi bloulka ya ampulla kapena ma ducts ndi miyala, omwe amatha kuthandizidwa ndi ERCP.

Magnetic resonance imaging (MRI) ndi MR cholangiopancreaticography akupanga njira zodziwonera, ndipo posachedwa amatha kusintha CT ndi diagnostic ERCP. Tekinoloje iyi imakupatsani mwayi kuti mufufuze minofu yofewa ndikumveketsa bwino matupi a ma ducts. Endoscopic ultrasound ikupezekanso, yomwe imafunikanso pakuwunika kwa chifuwa chachikulu.

Pancreatitis: kuzindikira ndi kuchiza

Kuzindikira pancreatitis yovuta sikophweka, makamaka koyambirira. Mu izi, kuyesa kwa labotale ndi njira zofufuzira zothandizira zimathandizira katswiri wa gastroenterologist pakuwonetsa pancreatitis.

Kuyesa kwa magazi kwachipatala - kuchitidwa kuti mupeze zizindikiro za kutupa (kuchuluka kwa maselo oyera a magazi, kuchuluka kwa ESR, ndi zina).
Kuyesa kwa magazi pa biochemical - kudziwika kwa kuchuluka kwa michere amylase, lipase, trypsin kutsimikizira kukhalapo kwa matendawa (pafupipafupi, ndimatenda a pancreatitis pachimake. Kuyesedwa kwa shuga m'magazi kumatha kuwonetsa kuchuluka kwa shuga.
Urinalysis - kudziwika kwa amylase mu mkodzo kumasonyezanso kapamba (makamaka pachimake pancreatitis).
Ultrasound yam'mimba imawululira kusintha kwa kapamba ndi ziwalo zina (mwachitsanzo, ndulu).
Gastroscopy (endoscopy) imayenera kuyesa kutenga nawo mbali m'mimba ndi duodenum pakukonzekera.
Zojambula zam'mimba. X-ray yojambulidwa ndi kapamba nthawi zambiri imawulula mawonekedwe a kapamba ndi miyala yolowerera.
Endoscopic retrograde cholangiopancreatography (ERCP). Cholecystocholangiography.
Zolemba pamakompyuta
Coprogram (kusanthula kwapadera).
Mayeso ogwiritsa ntchito (mayeso a secretin-cholecystokinin, mayeso a Lund, mayeso a PABK, etc.)

Chithandizo cha kapamba

Chithandizo pachimake ndi kukokomeza matendakapamba nthawi zambiri amachitidwa kuchipatala cha opaleshoni.

Nthawi yomweyo, chakudya cham'mimba ndichofunikira. Mankhwala a narcotic analgesics (othandizira kupweteka), otsikira ndi mayankho a saline, plasma kapena albumin, proteinolytic enzyme inhibitors (mankhwala omwe amaletsa ntchito ya michere) ndi mankhwala ena.

Ngati izi sizithandiza, komanso pakukula kwa zovuta (mwachitsanzo, peritonitis yayamba), madokotala amatengera njira zochizira opaleshoni.

Kutaya kwam'mimba (zotumphukira zam'mimba). Kuti achite bwino, machubu (ma drains) osakhazikika amawaika m'mimba, momwe timadzi tambiri tomwe timadzaza pamimba timatuluka.
Kuchotsa minofu yowonongeka ya pancreatic (necroectomy) ndi ntchito yovuta kwa onse omwe akuchita opaleshoni komanso wodwala, chifukwa chake sizichitika kawirikawiri.
Nthawi zina pambuyo zizindikiro za pachimake kapamba kuchepa, ndulu amachotsedwa - cholecystectomy.

Momwe tiyenera kuchitira aakulu kapamba :

kudya kokhazikika kwa kapamba ndikofunikira (kukana zakudya zazonunkhira ndi mafuta, kupatula mowa),
kutenga ma pinkil,
enzyme m'malo mankhwala (mwachitsanzo, creon, mezim, etc.),
mavitamini
Chithandizo cha matenda ashuga komanso mavuto ena a endocrine,
munthawi yake chithandizo cha matenda a ndulu.

Nthawi zina, pakalibe mphamvu ya chithandizo chamankhwala, opaleshoni ya kapamba (mwachitsanzo, distal pancreatectomy, Whipple opaleshoni, pancreatojejunostomy) kapena chithandizo cha endoscopic (drainage of pseudocysts, etc.) akhoza kutumikiridwa.

Amasanthula kapamba: zomwe zimayenera kukhala, zikhalidwe za azimayi ndi abambo

Pancreatitis nthawi zambiri imadziwika ndi colic - kupweteka kwa hypochondrium. Kukomoka kwa spasmodic kumatha kuchitika chifukwa chogwiritsa ntchito mbale kwambiri: zokometsera, zotsekemera, zamafuta - zochuluka.

Pakapita kanthawi, kusanza kumbuyo kapena pachifuwa kumatha kupita, zowawa zitatha kudya. Pankhaniyi, muyenera kuchitapo kanthu nthawi yomweyo, osalangizidwa kuti mugone pakamenyedwe.

Zizindikiro za kapamba ndizofanana ndi kuledzera kapena poyizoni:

kufooka wamba
kutopa,
kuwonda kosayembekezereka
makina osokoneza bongo amalephera komanso ena.

Chifukwa cha izi, kuzindikira kwa matendawa ndikovuta. Ndi chifukwa cha ichi kuti ndikofunikira kufunsa madokotala ndi kudziwa kapamba pofufuza, kapena kutsutsa kupezeka kwa matendawa.

Kuzindikira matendawa kumafuna chisamaliro komanso chisamaliro, ndipo muyenera kudziwa bwino momwe mayeso omwe angadziwire matenda a kapamba, ndi monga:

kuyezetsa magazi konse
kuyesa kwamwazi wamagazi,
kuwunikira
urinalysis
kusanthula kwa malovu.

Mutha kuwona kuti mayeso a kapamba ndi cholecystitis ndi ofanana, koma Zizindikiro zomwe zimatsimikizira kuti adziwe ndizosiyana. Pofuna kuti musasokoneze nokha, muyenera kuphunzira mndandanda wa mayeso ofunika.

Zizindikiro ndi zoyeserera zamagazi poyesa matenda a kapamba

Kuyesa kwamagazi (wamba) kumapangitsa kuti chizindikiritso chizitulutsa. Komabe, sizingatheke kudziwa zina mwazomwe zadziwika chifukwa cha kupendaku.

Ngati wodwalayo ali ndi pancreatitis, ndiye kuti zizowonjezera zidzakhala motere:

maselo oyera - pamlingo wa 4 * 10 * 9 - 9 * 10 * 9 / l, kuyesedwa kwa chifuwa choganiziridwa kumawonetsa zotsatira kakhumi,
ESR - pamlingo wa 2-15mm / h, gawo la erythrocyte sedimentation lidzakulitsidwa kwambiri,
antigen - kuyesa kwa chifuwa chachikulu cha pancreatitis kukuwonetsa kukhalapo kwa ma antijeni a kapamba, ndipo mayeso a chifuwa chachikulu sangachizindikire,
hemoglobin - mulingo wake m'magazi udzakhala wotsika kwambiri,
hematocrit - m'malo mwake, chizindikiro ichi chidzakhala chokwera kwambiri.

Mutha kuwona kuti Zizindikiro zimatha kusintha mmwamba, ndiye chifukwa chake muyenera kudziwa malamulo onse ndendende.

Makhalidwe azimayi

Mitengo yabwinobwino yachikazi imasiyana:

erythrocyte - 3.9 * 1012 kuti 4.7 * 1012 maselo / l,
hemoglobin - kuyambira 120 mpaka 140 g / l,
ESR - kuchokera 0 mpaka 20 mm / h,
maselo oyera oyera - ofanana ndi zizindikiro zachimuna,
hematocrit - kuchokera 0.36 - 0.43 l / l.

Kuti mupeze matenda olondola, kusanthula kwamtunduwu kungathe kutumikiridwa kangapo.

Kuyesa kwa magazi pa biochemical pancreatitis

Kusanthula kwa biochemical pancreatitis kumakuthandizani kuti muzindikire bwino momwe zinthu ziliri mthupi lathu. Ndi deta yanji yomwe iyenera kuyang'aniridwa mwachangu, komanso ndizosintha ziti zomwe zikuwonetsa matenda, dokotala amatha kunena motsimikiza. Koma nthawi zina aliyense amatha kudzipenda. Pakati pawo:

glucose - apamwamba kuposa abwinobwino chifukwa chosowa kupanga insulin,
cholesterol - yochepetsedwa poyerekeza ndizomwe zimachitika,
alpha 2-globulin - pansipa,
amylase (amene amachititsa kuti mafuta asungunuke) - maulendo khumi,
trypsin, elastase (kuwonongeka kwa peptide mu mapuloteni) - kuchuluka,
lipase (kusokonekera kwamafuta) - kuposa zabwinobwino,
bilirubin - kumawonjezera magwiridwe antchito ngati chinyezi chimasokoneza machitidwe oyamba chifukwa cha kutupa
transaminase - nthawi zina, akhoza kukwezedwa,
mapuloteni onse - kuchepa kwa chizindikiro ichi kumadziwika.

Kuwonjezeka kwa amylase ndi chimodzi mwazizindikiro zazikulu za pancreatitis yayikulu komanso yovuta.

Biochemistry iyenera kuchitidwa patsiku loyamba pambuyo poti wodwala matenda a khunyu alowetsedwa kuchipatala ndi vuto lodana kwambiri. Pofuna kupewa kugwiriridwa ndi zovuta zamtsogolo, mphamvu za amylase zimayesedwa pakugonekedwa kuchipatala.

Kodi kapamba akhoza kukhala ndi mayeso abwino? Funsoli liyenera kufunsidwa kwa adotolo ndipo, ngati kuli koyenera, muwatsaninso.

Mayeso owonjezera a kapamba ndi cholecystitis

kapamba. Nthawi zambiri, izi zikutanthauza kuphwanya ziwalo zina.

Kuphatikiza pazomwe tafotokozazi, kodi pali mayeso ena a pancreatic pancreatitis omwe amathandizadi pakuzindikira?

Lachiwiri ndilosowa kwenikweni, chifukwa chamtengo wokwera. Pankhani ya matenda otere, osati muyezo, koma kuwunika kwapadera ndikofunikira kuti pakhale trypsinogen mu mkodzo. Mtundu wosagwira ntchitowu wa trypsin umasonyezeratu kutupa m'thupi.

Mukamayang'ana ndowe mu labotale, amayang'ana kwambiri izi:

kupezeka kwa mafuta m'misili - pondapo pang'onopang'ono, chifukwa chakuwonjezereka chifukwa cha kuchuluka kwamafuta,
mthunzi wawo - chopondera chakuda chimatulutsa zovuta kumavuto am'mbali,
kukhalapo kwa zidutswa zosagawika chakudya ndizizindikiro zowonekera bwino zamavuto am'mimba.

Mukamayang'ana malovu, amayang'ana kuchuluka kwa ma amylase: kuchepa kwa kuchuluka kwa ma enzyme kumawonetsa matenda a kapamba.

Chifukwa chake, mutha kuyesa payekha pancreatitis, koma ndibwino kusiya mwayi wopeza chidziwitso chomaliza kwa madokotala. Dokotala wodziwa bwino zamankhwala sangadziwenso bwino za matendawo, komanso atchule mankhwala omwe ali oyenera pa vuto lililonse: kuuma kwake, mawonekedwe ake, ndi zina zambiri.

Kuvuta kwa matendawa kuli m'lingaliro loti mukalandira chithandizo chamankhwala sichingabwerere m'moyo wakale. Zakudya zoyenera, mankhwala, chithandizo komanso mayeso apadera a madokotala azikhala gawo lofunikira kwambiri m'moyo wa wodwalayo. Kusamvera zakudya zabwino kumatha kubweretsa zovuta zina, kapena zoyipanso kwambiri, pamavuto.

Komanso, akayeza mayeso a kapamba, anthu amalingalira za zomwe ziyenera kukhala zizindikiro zabwino. Palibe yankho lotsimikizika: zidzasiyanasiyana malinga ndi zaka, mbiri komanso zizindikiro zina za wodwala.

Kuyesedwa kwa kapamba: magazi, mkodzo, Zizindikiro, choti mutenge

Mayeso a kapamba ndi gawo lofunikira pakuwunika ntchito ya pancreatic.

Kuti dokotala athe kupereka mankhwalawo moyenera komanso kuwunika kuchuluka kwa kuwonongeka kwa ziwalo, ziyeso zingapo zoyenera ziyenera kudutsidwa.

Ntchito yayikulu ndikuzindikira kuchuluka kwa mahomoni omwe amapezeka m'magazi ndi mkodzo (insulin yomwe imakhudza kagayidwe kazakudya) ndi michere yomwe imakhudzidwa ndi kukonza zakudya komanso kuwonongeka kwa mapuloteni ndi mafuta.

Chifukwa chake, ndimayesedwe ati omwe amachitika ndi kapamba:

kuyezetsa magazi konse
magazi a biochemistry,
kuyesa kwamkodzo ndi chopondapo.

Kuphatikiza pa mayeso awa, ena angafunike, monga pancreatic ultrasound kapena MRI.

Matenda a kapamba

Pancreatitis ndiyowoneka bwino kwakuti kwa nthawi yayitali sichimangodzimva yokha. Kutopa, kufoka, kufooka, kutopa kwambiri kumawonekera, ndimangofuna kugona. Amachepetsa kulemera, amasokoneza dongosolo logaya chakudya - zoyamba za matenda a kapamba.

Komabe, munthawi yovuta (ntchito, mayendedwe, moyo mumzinda waukulu), munthu samatengera kufunikira kwa chizindikiro, ndipo amalemba chilichonse kutopa ndikugwira ntchito tsiku ndi tsiku. Pakapita kanthawi, kuukira kumachitika, komwe kumayendetsedwa ndi kupweteka kwambiri, nseru ndi kusanza.

Atayimitsa kuukira, wodwalayo amawunikira ndipo amupeza pancreatitis.

Kuyambira pano, munthu ayenera kudya zakudya zochepa ndikumwa mankhwala nthawi zonse, kupatuka pa zakudya zoyenera kumatha kudzetsa vuto lina komanso zovuta zowopsa.

Kuyesedwa kwa magazi

Kuyesedwa kwa magazi kwa chifuwa cha kapamba, zizindikiro zomwe ziyenera kukhala zabwinobwino:

mwa amuna 3.9 × 10 * 12 mpaka 5.5 × 10 * 12 cell / l,
mwa akazi, 3.9 × 10 * 12 mpaka 4,7 × 10 * 12 maselo / lita.

chizindikiro chachimuna: 135-160 g / l,
chizindikiro chachikazi: 120-140 g / l.

amuna - mpaka 15 mm / h,
akazi - mpaka 20 mm / h.

chizindikiro chachimuna: 0.44-0.48 l / l,
chizindikiro chachikazi: 0.36-0.43 l / l.

Maselo oyera m'magazi onse aamuna 4-9 × 10 * 9 / L.

Kuyesedwa kwa magazi kumapereka chidziwitso chokhudza zotupa zomwe zimachitika mthupi. Ndi kutupa kwa kapamba, zosintha zotsatirazi zikuchitika:

ESR imachuluka
kuchuluka kwa maselo oyera kumatuluka kwambiri
Zinthu za hemoglobin zimatsika
Kuwerengera kwamaselo ofiira
hematocrit ikwera.

Ndi chithandizo cha panthawi yake komanso mwachangu, zisonyezo zomwe zasinthidwazo zimabwereranso kwakanthawi kochepa. Mu matenda osachiritsika, pali kuchepa kwa ESR ndi kuchuluka kwa leukocytes m'magazi chifukwa chosowa michere chifukwa chakuchepa kwa ntchito ya gland.

Mwazi wama biochemistry

Kuyesa kwamwazi wamagazi khunyu kumawonetsa chidziwitso chokwanira kupanga matenda. Ndi matenda, zizindikiro zotsatirazi zimasintha:

Amylase (puloteni ya kapamba yomwe imayambitsa kukhetsa wowuma) ikukwera.
Ma enzyme enanso amakula: lipase, phospholipase, trypsin, elastase.
Mwazi wamagazi ukuwonjezeka chifukwa cha kuchepa kwa insulin.
Hyperrophic gland imatha kufinya ma ducts a bile pafupi. Kutuluka kwa bile kumasokonekera, chifukwa, bilirubin m'magazi imakwera.
Nthawi zambiri amachepetsa calcium. Izi zikuwonetsa kuwopsa kwa matendawa.
Mapuloteni onse amapita pansi.

Milingo yokwezeka ya amylase ndiyo chizindikiro choyamba cha matenda mu mawonekedwe ake owopsa kapena aakulu. Kuyesedwa kwa chifuwa chachikulu, komanso pachimake, kumachitika tsiku loyamba.

Kenako dotolo amayang'anira kusintha kwa matendawa kutengera zotsatira za mayesowo (ndi kapamba, kuyezetsa magazi kungayesedwe kangapo kuti mupeze deta yodalirika) komanso thanzi la wodwalayo.

Kumbukirani kuti magazi amayenera kumwedwa pamimba yopanda kanthu.

Mimbulu, ndowe ndi mayeso ena

Kusanthula kwa mkodzo chifukwa cha kapamba sikuchitika muzochitika zonse chifukwa cha mtengo wake wokwera. Zambiri zokhudzana ndi kukhalapo kwa matendawa siziperekedwa ndi general urinalysis, koma ndi yapadera, yowonetsa kuchuluka kwa diastase.

Diastasis imapangidwa ndi kapamba ndipo imayambitsa kuphwanya kwa michere yambiri. Nthawi zambiri, chizindikirocho sichikuyenera kupitirira mayunitsi 64, koma mwa odwala zomwe zili mu enzymeyi zitha kupitilira magawo 16,000. Mu nthawi yayitali ya matenda, diastasis imatha kuchepa.

Zinthu zochepetsedwa za enzyme zimasonyeza kufooka kwa ndulu.

Kusanthula kwa kapamba kumawonetsa chidziwitso chodalirika pokhapokha ngati chachitika molondola, monga: mkodzo umasonkhanitsidwa m'mawa, ndipo umaperekedwa nthawi yomweyo ku labotale.

Zizindikiro zina zoyesa mkodzo:

utoto - wokhala ndi matenda, mkodzo umakhala wakuda kuposa masiku onse,
ndi matenda oopsa mkodzo mutha kupeza mapuloteni, magazi, masilindala (izi zikuwonetsa kulephera kwa aimpso),
kukhalapo kwa matupi a ketone (nthawi zambiri samakhalapo).

Kuwunika kwa ndowe mu kapamba kumapereka chiyeso cha kagwidwe ka ziwalo. Ndi kuchepetsedwa kwa ntchito ya glandular, katulutsidwe ka michere komwe kamayambitsa kuphwanya mafuta kumachepa. Zotsatirazi zitha kuwonetsa ntchito:

kupezeka kwa mafuta mu ndowe,
kukhalapo kwa chakudya chosagulitsidwa,
ndowe imakhala yopepuka ngati chithokomiro cha hypertrophic chikukakamiza ndulu za bile.

Kusintha kwa ndowe kumatha kuzindikirika popanda kufufuza: kumawala chifukwa cha mafuta osapsa, kutsukidwa bwino kuchimbudzi, kumanunkhira chifukwa chakuwonongeka kwa chakudya.

Kafukufuku wofananayu wataya zomwe wapezeka posachedwa ndipo sagwiritsidwa ntchito kwenikweni. M'malo mwake, kafukufuku amatengedwa kuti amawunika madzi a pancreatic pogwiritsa ntchito kafukufuku.

Ndi mayeso ati a kapamba omwe muyenera kudutsa Gwirizanani ndi buku lalikulu