Parenchymal aakulu kapamba - kutupa kwa kapamba parenchyma

Zambiri zakuyerekezera parenchymal pancreatitis. Nkhaniyi siyitsogolera pakuchitapo kanthu.

Pancreatitis ndi kusintha kwamkati komanso kowononga m'mapapo. Njira yovuta kwambiri ya kapamba yomwe imadziwikiratu kawiri pachaka ikuwonetsa kuti pali kutupa kwa pancreatic parenchyma komwe kumachitika chifukwa cha uchidakwa, kusamwa komanso kusadzidalira, matenda osagwirizana ndi m'mimba thirakiti ndi matenda apakhungu, ndipo osati chifukwa chakuletsa chachikulu cha kapamba kapena zolakwika pakugwira ntchito kwa pancreatic duct system.

Parenchymal chronic pancreatitis nthawi zambiri imachitika motsutsana ndi maziko a zilonda zam'mimbazi, matenda a ndulu, kuwonongeka kwa atherosulinotic malinga ndi zotumphukira, komanso kuchepa kwa mavitamini ndi mapuloteni m'thupi.

Ndi parenchymal pancreatitis, njira zotupa mu kapamba zimayenda pang'onopang'ono komanso mosadukiza. Zotsatira zake, limba atrophies, ndipo pali kuchepa kwa madzi a pancreatic ndi ma enzyme.

Etiology ya parenchymal pancreatitis

Njira zotupa mu kapamba zimayambitsidwa ndi chinsinsi cha madzi a kapamba, komanso lipase ndi trypsin, ma enzyme omwe amapanga mawonekedwe ake. Chifukwa cha kutsegulira kwawo, pali kuwonjezeka kwa minofu yolumikizana, kupindika pancreatic autolysis ndi kuwonda. M'mikhalidwe imeneyi, pakapita kanthawi, kapamba amamuwunikira, ndipo magazi amayenda m'magazi.

Mitundu yotsatirayi ya morrench ya parenchymal pancreatitis imasiyanitsidwa:

kuwerengeka parenchymal kapamba,
sclerotic pancreatitis,
edematous parenchymal kapamba.

Kutupa kwa pancreatic kungakhale zochepamomwe mutu wake kapena mchira wake umakhudzidwa, kapena sokoneza zachilengedwe, zophimba zofunafuna kwathunthu.

Zotsatirazi ndizodziwika mu pathogenis ya matendawa:

sphincter wa Oddi Kulephera
kutupa kwa stenosis
matenda a nthiti ya Vater,
cramping.

Zizindikiro za parenchymal pancreatitis

Zizindikiro za matendawa zimadziwika ndi zizindikiro zotsatirazi:

kusanza, mseru, kuchuluka kwa mpweya, kutulutsa,
kupweteka kumanzere hypochondrium kapena epigastrium,
kudzimbidwa, kusowa kwa tulo, kutsekula m'mimba,
kuchepa kwambiri kwa thupi,
kupezeka kwa matenda ashuga.

Zizindikiro za Dyspeptic zikufanana ndi parenchymal pancreatitis. Dyspepsia imakhala ndi mitundu yosiyanasiyana yamawonekedwe. Mwachitsanzo, itha kufotokozedwa pokana zonse za mafuta ndi mafuta apamwamba kwambiri, komanso mawonekedwe osiyana, akuti: bulimia ndi ludzu lochulukirapo. W ludzu komanso kumangokhala ndi njala ndi parenchymal pancreatitis, monga lamulo, kukuwonetsa chitukuko cha matenda ashuga.

Mwanjira yovuta kwambiri ya kapamba, kupweteka kwambiri. Mtundu wa ululu umatha kukhala lamba, kapena kuthilira kumtima kapena kumbuyo.

Zomwe zimayambitsa matendawa

Nthawi zambiri, matendawa amapezeka chifukwa cha matenda oyamba monga:

pachimake kapamba
zilonda zam'mimba
uchidakwa
cholecystitis
nthawi zambiri imadziwoneka yokha motsutsana ndi kumbuyo kwa ndulu yakutali.

Nthawi zambiri, matenda amapezeka chifukwa cha zakudya zomwe sizipezeka pafupipafupi, kudya mosasamala, komanso kusowa kwa mavitamini ndi mapuloteni zimabweretsa zotsatirapo zake.

Kuphatikiza apo, zochitika zopsinja, ntchito mu ntchito zoopsa, komanso matenda opatsirana pafupipafupi zimatha kukulitsa.

Parenchymal mawonekedwe a kapamba - ndiye chiyani?

Mtundu wamatendawa umadziwika ndi njira yotupa, chomwe chimayambitsa kuphwanya kapangidwe ka michere yopangidwa ndi kapamba. Kuchuluka kwa enzyme kumapangitsa kuti kudzimbidwa kwa minofu ya parenchyma ndikusokoneza komanso makwinya.

Zotsatira zake, zimapangitsa kusintha kwa chiwalo. Izi zikufotokozedwa pang'onopang'ono m'malo omwe akhudzidwa ndi minofu yokhala ndi zigawo zolumikizana ndi kutayika kwa magwiridwe antchito a kapamba. Zotsatira zake, kapangidwe ka michere yamafuta m'mimba amachepetsedwa.

Mankhwala, pali mitundu iwiri ya zotupa za parenchyma:

kusokoneza (kwakukulu) - kumakhudza ambiri a
ochepa - pang'ono amakhudza mutu kapena mchira.

Kuopsa kwa parenchymal pancreatitis ndikuti ndizovuta kudziwa koyambirira kwa chitukuko. Izi ndichifukwa choti matendawa alibe matchulidwe ndipo nthawi zina amadziwonetsa mu nthawi yaying'ono. Zotsatira zake, matendawa amapita patsogolo pang'onopang'ono ndipo pakakhala kuti palibe chithandizo chokwanira chamankhwala amatha kubweretsa pancreatic atrophy.

Mafomu akulu

Parenchymal pancreatitis imagawidwa m'mitundu itatu yayikulu. Iliyonse ya izo imadziwika ndi zizindikiro zamatenda ndi njira ya pathological process:

Zosangalatsa. Fomuyi imayamba chifukwa chakuchuluka kwambiri kwamadzi mu minyewa ya chiwalo. Zolakwika mu zakudya zimapangitsa kuti zikhale zoyambitsa, zomwe zimachulukitsa mowa. Nthawi zina, edematous mawonekedwe amakumana ngati complication ya pathologies am'mimba thirakiti. Zizindikiro zamankhwala zimafotokozedwa chifukwa cha kuledzera kwambiri. Kuchiza sikufuna kuchitapo kanthu opaleshoni ndipo amadziwika kuti ndi akatswiri.
Sclerosing. Amayamba motsutsana ndi maziko a kufalikira kwa ma glandular ducts, nthawi zambiri chifukwa cha matenda am'mimba a dongosolo la m'mimba. Fomuyi imadziwika ndi mapangidwe a kusintha kwa sclerotic mu chiwalo, zomwe zimapangitsa kukulitsa kwakukulu kwa ma ducts ake. Zizindikiro zodziwika bwino zotupa: kupweteka kumanzere hypochondrium, kukhalapo kwa shuga mumkodzo, kukodza pafupipafupi, ludzu. 5% ya omwe amapezeka ndi matendawa amakula kwathunthu. Mankhwala, njira zachikhalidwe zimagwiritsidwa ntchito.
Zowerengera. Amadziwika ndi kufalikira kwa mchere wa calcium m'magulu am'minyewa, komwe kumatha kupangitsa kufalikira kwathunthu kwa lumen. Fomuyi imapita patsogolo kwambiri ndipo imatha kupangitsa kuti pakhale chotupa choopsa.

Masanjidwe ndi exocrine kusakwanira

Kuphatikiza pa mitundu ya matendawa yomwe imayambitsa matendawa, akatswiri amasiyanitsa mitundu iwiri. Aliyense wa iwo amadziwika ndi kusintha kwina kwa pathological komwe kumatsogolera pakuchepera kapena kutayika kwathunthu kwa magwiridwe antchito a pancreatic.

Chizindikiro cha parenchymal pancreatitis ndi exocrine insuffence imakhazikitsidwa ndi kuchepa kwa kaphatikizidwe ka michere yam'mimba. Chifukwa chogonjetsedwa, thupi silitha kupanga michere yofunikira mokwanira. Izi zimakwiyitsa kuchepa kwa thupi, zomwe zimakhudza ntchito ya m'mimba.

Maphunziro a labotale ndi a hardware, omwe amatsimikiziridwa ndi madandaulo a odwala, amathandizira kuzindikira subtype ya matenda.

Matenda a parenchymal biliary amadalira pancreatitis - ndi chiyani?

Njira ina yodziwika bwino ndi kudalira biliary, komwe kumafunika kuyang'aniridwa mwachangu. Amapanga 50% ya milandu yapezeka ya kapamba. Kukula kwa parenchymal biliary-amadalira pancreatitis ndi chifukwa cha zovuta za hepatobiliary zamtundu wina.

Matendawa amagwirizanitsidwa kwambiri ndi kutupa kwa kapamba, komwe kumayamba chifukwa cha maziko a ziwalo.

Matenda a parenchymal biliary amadalira pancreatitis - ndi chiyani? Matendawa amadziwika ndi kuchepa kwakanthawi kapena kokwanira mu mphamvu ya gland popanga ma enzymes ndi mahomoni am'mimba.

Ndi biliary-pancreatitis, kutulutsa kwa bile kuchokera ku duodenum kumabwereranso mkati mwa ma pancreatic ducts. Izi zimabweretsa kusintha kwa kapangidwe ka minofu. Izi subspecies zimadziwika ndi kubwereza kosalekeza komwe kumawopseza zovuta zazathanzi. Chizindikiro chodziwika bwino cha matenda am'mimba ndimakwiya pafupipafupi kapena kawirikawiri pakamwa.

Mavuto omwe angakhalepo chifukwa chotumphukira kwa parenchymal biliary-pancreatitis:

kufalikira kwa ma ducts a bile,
matenda ashuga
kufalikira kwa kutukusira kwa ziwalo zoyandikana ndi minofu,
akusowa kwa ma enzymes, omwe amachititsa kuti matumbo onse asamayende bwino.

Ndi biliary-pancreatitis yodalira, kuchepa kwakukulu kwa magwiridwe antchito a kapamba kumatheka mpaka 70%.

Zizindikiro za nkhawa

Zizindikiro zakuthambo za matendawa nthawi zambiri zimakhala zovuta kuzizindikira, popeza amafanana ndi matenda ambiri am'mimba. Nthawi yomweyo, Zizindikiro sizowala, zomwe anthu ambiri sazinyalanyaza.

Zizindikiro za parenchymal pancreatitis:

Kupweteka kwakumanzere mu hypochondrium yakumanzere kumbuyo kwake kumamveka kwambiri mutatha kudya zokometsera komanso zamafuta, mowa komanso chifukwa chodya kwambiri.
Kuchepetsa mseru nthawi zambiri.
Stool disorder, kudzimbidwa kusinthana ndi kutsegula m'mimba, ndowe zimadziwika ndi fungo la fetid, zimakhala ndi zosungika za mushy komanso zotsalira zopanda chakudya.
Kuchulukana kwadzaoneni.
Kugona nthawi zonse, chidwi chododometsa, zomwe zimapangitsa kuti asamangoganiza za ntchito.
Kuchepetsa kwakukulu komwe kumachitika chifukwa cha kusowa kwa michere ya michere, michere yambiri imalephera kutengeka ndi thupi ndikupitilira kutuluka.
Kuchulukitsa khungu lowuma, malo ofiira pamimba, chifukwa cha kusintha kwa ma hypertrophic pamafelemu a mafuta onunkhira.

Kuwoneka kwa ziwiri kapena kupitirira apo zizowoneka zamtsogolo ndizoyenera kukaonana ndi dokotala ndikuyezetsa. Musangoganiza nokha za matenda anu, chifukwa zizindikirozi ndizambiri zamitundu yambiri. Ndipo akatswiri odziwa bwino okha ndi omwe amatha kuzindikira zomwe zimayambitsa mawonekedwe awo.

Zifukwa zachitukuko

Matenda a parenchymal pancreatitis amakula mothandizidwa ndi zinthu zina zoyambitsa.

Zambiri mwa izo ndi:

cholecestitis, chifukwa chogwiritsa ntchito cholesterol yambiri pamakoma, nduluyo imayatsidwa ndi kutupa, zomwe zimapangitsa kutsika kwa asidi kutulutsa ndi kuponyera kumbuyo kwa ducts ya bile,
urolithiasis, chifukwa chomwe njira zakutuluka kwa asidi zimasiyidwa pang'ono kapena kuti ndi zotsekeka kwathunthu,
mapangidwe a chotupa ndi oyipa katundu,
kuchepa kwakanthawi kwamayendedwe apakati,
kumwa kwambiri mowa, komanso zakudya zamafuta ndi mchere,
kuperewera kwa zakudya zama protein ndi mavitamini,
kupsinjika kwanthawi zonse
chithokomiro cha chithokomiro,
mankhwala osalamulirika
frostbite wamba kapena sitiroko yotentha,
kuvulala chiwalo
matenda opaka m'mimba.

Nthawi zina, parenchymal pancreatitis imayamba ngati vuto pambuyo pa chifuwa chosinthira, malungo ofiira, tenillitis.

Zizindikiro

Kuti adziwe matenda a matenda, dokotala amayambitsa kafukufuku wodwala pakuwonekera kwa zizindikiro zapadera. Kuphatikiza apo, kuyesedwa ndi palpation ndi percussion kumagwiritsidwa ntchito, zomwe zimakupatsani mwayi wodziwa malo opweteka mu hypochondrium yamanzere.

Kuti muwonetsetse matendawa, mitundu yotsatirayi ya mayeso ndi maphunziro zimayikidwa:

kuyezetsa magazi kuti mupeze kuchuluka kwa maselo ofiira am'magazi, maselo oyera am'magazi, kuchuluka kwa ma enzymes, komanso kudziwa kuchuluka kwa calcium, sodium ndi potaziyamu,
ndowe za ma enzyme ena ndi tizidutswa tating'onoting'ono chakudya,
urinalysis kuti muzindikire micromaturia, proteinuria, cylindruria,
Ultrasound ndiyo njira yophunzitsira yodziwika bwino pakusintha kwa kapamba,
Kujambula kwa CT kosiyanitsa mitundu kumakupatsani mwayi kuti muwone bwino za kukhalapo kwa miyala mu ndulu za bile.

Kodi kuchitira?

Chithandizo cha matenda a parenchymal pancreatitis chikuchitika molingana ndi gawo lomwe ladziwika. Poyamba, ndikwanira kuchita mankhwala osokoneza bongo ndikutsatira zakudya zina kuti mubwezeretsenso thanzi.

Ngati matendawa anyalanyazidwa, zomwe zadzetsa mavuto osaneneka kwa kapamba, opareshoni imachitika kuti adule malo omwe akhudzidwa kuti apewe kuwonongeka kwina kwa zinthu.

Mankhwala

Kusankhidwa kwa mankhwala ofunikira kumachitika ndi adotolo potengera kuopsa kwa matenda omwe adadziwika. Mlingo wawo ndi njira yake yoyendetsera amakhazikitsidwa potengera zomwe wodwalayo ali nazo.

Mitundu yayikulu yamankhwala omwe amagwiritsidwa ntchito pochiza parenchymal pancreatitis:

mankhwala omwe amachepetsa kupanga madzi ammimba (Omeprazole, Esameprazole),
antispasmodics yothandizira kupweteka (No-Shpa, Papaverin),
prokinetics yomwe imapangitsa kuti matumbo asamayende bwino komanso kuti izitha kugwiritsa ntchito msanga wa chakudya (Domperidone, Metoclopravid),
M'malo mankhwala omwe amapanga kuchepa kwa ma enzymes.

Zoyambitsa Parenchymal Pancreatitis

Njira yotupa mu kapamba imakhala yotukuka - m'malo ena khwawa limasokonekera, kapena kusakanikirana, thupi lonse likamavutika.

Zinthu zomwe zimabweretsa matenda osachiritsika zimawerengedwa:

The etiology a matenda am'mimba thirakiti - mafuta, yokazinga, zokometsera zakudya osati mu nthawi yambiri, mowa, komanso concomitant matenda awa ziwalo.
Kupsinjika kwanthawi yayitali komwe kumakhudza malingaliro.
Tiziromboti m'thupi.
Matenda opatsirana.
Matenda a mtima.
Kumwa maantibayotiki nthawi yayitali.
Kuvulaza pamimba.

Komanso chifukwa cha parenchymal pancreatitis ndi matenda obwera chifukwa cha kapamba.

Kukula kwa kutupa kwa parenchyma ndikowonjezereka kwa michere ya kapamba. Nawonso, zimakhudza minofu ya pancreatic ndipo imayambitsa masinthidwe ena. Izi zimawonekera mu kupindika ndi kuwongolera kwina kwa ziwalo.

Mitundu yotsatirayi ya matenda a parenchymal pancreatitis ndi osiyana morphologitis:

Fomu ya edematous imadziwika ndi kakulidwe kazinthu zowoneka bwino: kusanza, komwe sikubweretsa mpumulo, kupweteka kwakuthwa pamimba. Madzi ambiri m'maselo a parenchyma amathandizira kukulitsa kuledzera kwa thupi. Fomu yonyansa imawonetsedwa ndi kupweteka pamimba, thupi siligwirizana poyambitsa kuyamwa kwa khungu ndi ludzu.

Mawonekedwe amawerengera amaphatikizidwa ndi mapangidwe amiyala mumiyala, yomwe imakhala yowopsa chifukwa cha zovuta monga matenda a matenda opatsirana, komanso kufalikira kwathunthu kwa mzerewo.

Kuphatikiza apo, pancreatitis yosatha ndi exocrine insuffence komanso biliary-amadalira kapamba amadziwika.

Pancreatitis ndi opuwala exocrine ntchito imayamba chifukwa cha kulephera kwa thupi kugwira ntchito bwino. Izi ndichifukwa choti michere yamagaya simapangidwa zochuluka.

Kutupa kwayamba kwa kapamba kumalumikizidwa ndi kuphwanya kwa ziwalo. Biliary mtundu wa matenda kapamba nthawi zambiri amayambitsidwa ndi matenda ophatikizika: zolakwika mu ndulu ndi mabowo ake, chiwopsezo cha kapangidwe kake, kupindika komanso kufinya kwamizeremizere.Zinthu izi zimakhudza kutembenuza kwam'mbuyo kwa bile, komwe kumayambitsa kusokonezeka kwa minofu. Kudzimva kuwawa mkamwa ndi chizindikiro chodziwika cha mtundu wa hepatobiliary of pancreatitis aakulu.

Chithandizo cha parenchymal kapamba

Chithandizo cha matenda apathengo a pancreatic chikuchitika mokwanira. Ndi kuchulukitsa kwa matendawa, ndikofunikira kuyang'aniridwa mu dipatimenti ya gastroenterological mogwirizana ndi zakudya komanso mankhwala okhwima. Komanso pali mwayi wakuchitapo kanthu opaleshoni pamaso pamavuto. Chithandizo cha parenchymal aakulu kapamba mu chikhululukiro ikuchitika pogwiritsa ntchito wowerengeka azitsamba, osayiwala za zakudya zoyenera, mosakhudzidwa ndi kapamba.

Munthawi ya kukokomeza, kugwiritsa ntchito chakudya sikumayikidwa, kupatula madzi ndi tiyi wopanda mphamvu kwa masiku atatu oyamba. Kenako zinthu zomwe zakhala zikuyenda bwino pamalopo zimayambitsidwa pang'onopang'ono: masamba, broths, phala lamadzimadzi. Nyama yamafuta, nkhuku, sopo wowonda, mankhwala amkaka, mowa samakhazikitsidwa kwathunthu kupewa kupewa kuwonongeka kwa wodwalayo. Mndandanda wazomwe mungadye ndi pancreatitis mu gawo la chikhululukiro ndiwokulirapo, komanso maphikidwe omwe akufuna.

Mwa mankhwalawa mankhwala osokoneza bongo a anti-yotupa, antispasmodics, michere, antiemetic ndi antidiarrheal. Ngati ndi kotheka, maantibayotiki ndi mavitamini amagwiritsidwa ntchito.

Ndi kutupa kwa pancreatic, kodi zitsamba zamankhwala zingagwiritsidwe ntchito? Ndizotheka, koma kuyambira pa 7th tsiku lachiwonetsero ndikuchotsedwa. Izi zimaphatikizapo chamomile, motsatizana, dogrose, dieelle, peppermint ndi ena.

Kumbukirani kuti ngati simukugwirizana ndi dokotala nthawi yomweyo, mkhalidwe wa wodwalayo umakulirakulira, zomwe zimatsogolera pancreatic pancreatic necrosis, matenda ashuga, khansa ya ziwalo, sepsis, kukanika kwa impso ndi ascites.

Matenda a parenchymal pancreatitis

Kuzindikira matendawa kumachitika ndi njira zakufufuzira zasayansi ndi zida. Popeza kupweteka pachiwopsezo cha parenchymal pancreatitis kulibe mtundu wotchulidwa, matendawa atha kupezedwa molakwika ndi akatswiri a gastroenterologists monga enterocolitis kapena enteritis.

Pogwiritsa ntchito x-ray, kuwonjezeka kwa mutu wa kapamba ndi kuwonongeka kwa matalala a duodenum kumakhazikitsidwa. Kuyesedwa kwa magazi kambiri kumawonetsa kuchepa kwa magazi m'thupi kwa hypochromic ndi kupanga parenchymal pancreatitis. Dysproteinemia, hypoproteinemia, neutrophilic leukocytosis ndi kukwezedwa kwa ESR amawonedwa pachimake parenchymal pancreatitis.

Glycosuria ndi hyperglycemia amapezeka m'magazi kuti pakhale chitukuko cha matenda osokoneza bongo a mellitus concomitant ndi parenchymal pancreatitis.

Zotsatira za kupezeka kwa ultrasound, kukula kwa kapamba kumatsimikizika, komanso mthunzi wake wambiri, wolingana ndi chithunzi cha matenda nthawi inayake munthawi.

Chithandizo cha mankhwala a parenchymal pancreatitis

Munthawi ya mankhwalawa chifukwa cha mankhwalawa, mankhwalawa amayenera kuperekedwa pakudya, omwe amafotokozedwa mwatsatanetsatane m'nkhaniyi.

Ndi kuchulukana kwa parenchymal aakulu kapamba koyamba m'masiku atatu, kusala kudya kwathunthu ndikumwa malita awiri a madzi oyera patsiku amalimbikitsidwa. Zakudya zamchere, mchere ndi shuga zimaperekedwa kwa wodwala kudzera m'mitsempha. Patsiku lachinayi komanso lotsatira, wodwalayo amatenga chakudya chovunda kapena chophika chopanda mchere ndi zonunkhira, m'malo ochepa, 6-7 patsiku. Ndikulimbikitsidwa kudya zakudya zamafuta. Ndikofunika kumwa zitsamba ndi mabulosi decoctions ndi zopanga tokha.

Pambuyo ululu utachepa ndipo njira zotupa zimayimitsidwa, kuchuluka kwa zakudya zamankhwala kungakulitsidwe. Werengani zambiri zamalonda zoletsedwa komanso zoletsedwa panthawi yankhani yamalonda.

Zizindikiro za mawonekedwe a matenda

Parenchymal pancreatitis, ngati matenda aliwonse osachiritsika, amadziwika ndi magawo akuchulukitsa ndi kukhululuka. Nthawi zambiri panthawi yopumira, wodwalayo amakhala ndi thanzi labwinobwino, pomwe matenda sakudwala. Chikhululukiro chikadutsa, ndiye kuti pamakhala kukokoloka ndi zizindikiro zotsatirazi:

kupweteka koyambira komwe kumayamba mu hypochondrium ndikufikira kumbuyo,
Zikondamoyo zowonongeka zimatulutsa michere yamagetsi, pomwe chakudya sichikumbidwa kwathunthu. Zotsatira zake zimayamba mseru, kudzimbidwa, kusinthana ndi m'mimba.
chifukwa choti michere imagaya bwino kugaya komanso osayamwa, thupi limakhala ndi njala, zomwe zimapangitsa kuti munthu ayambe kuchepa thupi. Kulephera kudya kumapangitsanso kuti muchepetse kunenepa. Pakadali pano, ndowe zimapeza sheen wonunkhira ndipo zimapangitsa kuti zinthu zina zisaonongeke,
pali zochitika zomwe matenda a kapamba amapita nthawi imodzi ndi matenda osokoneza bongo, chifukwa nthawi imodzimodziyo imatulutsa insulin limodzi ndi michere ya m'mimba. Kuchepa kwa thupi kumabweretsa kutsika kwa kupanga insulini komanso kuwonjezeka kwa shuga mthupi.

Njira Zodziwitsira

Katswiri wodziwa bwino amatha kudziwa pancreatitis potengera ndi zomwe wodwala akuonetsa. Osati kuukira koyamba komwe kukuwonetsa chiwonetsero chodwala. Komabe, kufotokozera mtundu wa kapamba, ndikofunikira kuyesedwa:

Ultrasound yamimba yam'mimba imatha kudziwa bwino kukhalapo kwa kufalikira kwa ziwalo kapena kuchuluka kwake. Matenda amtunduwu amadziwika ndi kuphatikizika kwa chiwalo chochepetsedwa pang'ono kukula, ndipo kukoka kwake kwakukulu sikungasinthe.
Ndi parenchymal pancreatitis, kuyesa kwamkodzo ndi magazi kumawonetsa kuchuluka kwa trypsin, lipase, amylase.
Kuyesedwa kwa magazi kumawonetsa kuchuluka kwa shuga.
Angiography pobweretsa utoto mumakulolani kuti muwone kusintha kapena kuchepera kwa ziwiya zapa pancreatic.

Kuchiza matenda

Pa chithandizo, ndikofunikira kuganizira kuti:

ndizosatheka kuchiritsa matenda a parenchymal pancreatitis,
Mavuto ayenera kupewedwa pomwe amawononga minofu ya kapamba,
ndikofunikira kuwonjezera kukhululukidwa kwa matendawo malinga ngati kungatheke,
ndizoletsedwa kuti muzingoganiza nokha, makamaka pokhudzana ndi gawo la kufalikira.

Chithandizo cha parenchymal pancreatitis chikuyenera kuchitika kuchipatala. Masiku awiri oyamba a wodwalayo amavala chakudya chamankhwala, amaloledwa kumwa madzi amamineral okha ndi mipweya yomwe imatulutsidwa kale. Pambuyo pake amaloledwa kudya chakudya, chakudya No. 5 chimafunikira pamenepa: Kupweteka kwambiri kumachepetsa No-shpa, Analgin, Novocain.

Kuti muchotse kuledzera, njira ya shuga imaperekedwa, ngati matendawa amayamba chifukwa cha kuperewera kwa michere, ndiye kuti tikulimbikitsidwa kumwa mankhwalawa monga: Mezim-forte, Pancreatin, Festal. Pomwe matenda am'magazi amaphatikizidwa ndi kuchuluka kwa michere, mankhwala otsatirawa athandizira kuchepetsa zomwe ali: Gordoks, Kontrikal, Trasilol. Kubwezeretsa kugwira ntchito kwa kapamba, Methyluracil, Cobamamide ndi mankhwala. Kuchepetsa kutupa, Ortofen kapena Diclofenac akuwonetsedwa.

Ngati chithandizo cha Conservative sichikupereka zotsatira zomwe zikuyembekezeka, ndiye kuti pakufunika opaleshoni yofunika kuchitidwa opaleshoni, yomwe ingakuthandizeni kuti mumve bwino ndi zotupa za pakamwa, komanso kufinya kwa ma pancreatic ducts.

Zakudya zamagulu

Pambuyo pochulukitsa, chakudya Nambala 5 chithandizira zikondamoyo, kulola kugwiritsa ntchito zomwe zalembedwa:

buledi wowuma
nyama yopanda, nkhuku ndi nsomba,
mafupa opangidwa ndi mapuloteni
sopo wamafuta ndi masamba,
zopangidwa mkaka,
masamba obiriwira
zipatso zokoma
compotes, odzola.

Tebulo 5 limaletsa kulandira:

mowa
msuzi wowawasa
nyama yamafuta, nkhuku, nsomba,
mazira
kuphika kwatsopano
Zakudya zowuma, mchere, zokazinga,
ankasuta nyama
koloko
chokoleti
khofi, koko.

Zakudya zopatsa thanzi zimakhazikika pakudya pafupipafupi komanso kwapafupipafupi, kawiri pa tsiku, chifukwa mwanjira imeneyi chakudya sikhala ndi nthawi yokuunjikira m'mimba ndipo chimafunikira ma enzyme ocheperako pakugaya.

Matenda ovuta

Izi matenda a pancreatic ayenera kuthandizidwa mwachangu, apo ayi zingayambitse zovuta zamtundu uliwonse, zomwe atsogoleri:

matenda ashuga
ascites
kunyowa
mayankho
sepsis
kuwonongeka kwaimpso,
oncology ya kapamba.

Njira zopewera

Kuti matendawa asavutike wodwalayo, muyenera kutsatira moyo wathanzi, kusiya kumwa mowa ndi kusuta fodya, kutsatira zakudya, kuchiza matenda opatsirana ndi matenda am'mimbamo munthawi yake, pewani kupsinjika, ndipo nthawi zambiri mumapumira mpweya wabwino.

Izi zofunikira zimafunikira chithandizo chamankhwala mwachangu, apo ayi kuwonongeka kwa minofu ya ziwalo ndi zovuta zazikulu zitha kuchitika.

Zakudya zapadera

Kodi kuchitira matenda a parenchymal pancreatitis ndi zakudya? Sizingatheke kuti muchotse matenda popanda kusintha zakudya moyenera. Chifukwa chake, tikulimbikitsidwa kutsatira malamulo otsatirawa mu chakudya:

Pewani mowa, kusuta, komanso mafuta, amchere, osuta, okazinga ndi zakudya zonunkhira.
Chepetsa shuga ndi mchere wambiri.
Zakudya zonse ziyenera kuwiritsa ndi kuwotcha, pomwe ziyenera kumaphwanyidwa kuti zikhale zosaphika za mbatata yosenda.
Ndi kuchulukitsa, tikulimbikitsidwa kumwa kwambiri zakudya zonona.
Porridge iyenera kuphikidwa pamadzi.
Chakudya sichiyenera kuzizira kapena kutentha.
Pafupifupi zipatso zonse zimatha kudyedwa, koma siziyenera kukhala acidic.
Sizoletsedwa kudya mkate watsopano. Ndikwabwino m'malo mwake ndikokugulitsani, mkate, mkate.
Nyama ndi nsomba ziyenera kukhala zonda. Ayenera kuwiritsa.
Katundu wa mkaka azikhala ndi mafuta osakwana 2%, saloledwa kugwiritsa ntchito tchizi tchizi chokhala ndi shuga komanso mafuta amkati.
Ndikulimbikitsidwa kuti muzitsatira chakudya chamagulu ochepa, kudya zakudya zamagawo ochepa 5-6 patsiku.
Zakudya ziyenera kukonzedwa kuchokera pazinthu zochepa.

Chakudya chokhazikika cha parenchymal pancreatitis iyenera kutsatiridwa pakatha miyezi 1-2 mutatha mankhwala.

Chithandizo cha zitsamba

Mankhwala azitsamba ndi njira yabwino yochizira matendawa. Zitsamba zamankhwala zimagwiritsidwa ntchito chikhululukiro kuti musabwezeretsenso matenda. Ndikosatheka kuchiritsa matenda ndi chindapusa chamankhwala, popeza sangathe kubwezeretsa chithandizo chachikulu.

Mutha kugula zosakaniza zopangidwa ndi zitsamba zamankhwala mu mankhwala. Komanso, ngati pakufunika kutero, atha kukonzekereratu. Kuti muchite izi, sakanizani zigawo zofanana ndizofanana.

Masankho Oyenera:

nyongolotsi, mama ,ort, wort wa St.
Soseji, chowawa, wort wa St. John, chamomile, yarrow,
katsabola, timbewu tonunkhira, chivundikiro, chamtchi,
Wort wa St. John, chowawa, sage, elecampane, mizu ya burdock, calendula, akavalo.

Kukonzekera msuzi, kutsanulira 30 g osakaniza azitsamba ndi 250 ml ya madzi otentha. Kuumirira mphindi 40, bwino. Imwani zakumwa tsiku lonse mu magawo ofanana. Njira yonse - masabata atatu.

Chitani masewera olimbitsa thupi monga kupewa kufalikira

Kuchita masewera olimbitsa thupi kumathandizanso munthu kuiwala za matenda ndi kubwerera ku njira yawo yamoyo. Zochita zolimbitsa thupi kwambiri zimaperekedwa ndi adokotala mogwirizana ndi machitidwe a wodwala.

Koma pali malingaliro angapo omwe akuyenera kutsatiridwa:

Zochita zolimbitsa thupi zowonjezereka, choncho ndibwino kuti musakonde kuyenda, kuchita masewera olimbitsa thupi, masewera olimbitsa thupi osavuta.
Osagwiritsa ntchito masewera olimbitsa thupi kupuma: squat, makina osindikizira.
Sizoletsedwa kugwiritsa ntchito mikanda yolimbitsa pophunzira.
Kudya mphindi 60-90 musanayambe kuchita masewera olimbitsa thupi.

Pomaliza

Parenchymal pancreatitis ndi matenda oopsa omwe amafunika chithandizo chanthawi komanso chokwanira. Kunyalanyaza malangizo a dokotala kapena kudzichiritsa nokha kumadzetsa mavuto akulu kwambiri. Tiyeneranso kumvetsetsa kuti mapiritsi sangathetse vutoli popanda kusintha kadyedwe komanso kusiya zizolowezi zoipa. Mankhwala ovuta okha ndi omwe amatha kupewa kubwereranso.

Zofunikira

Mu thupi laumunthu, ziwalo zonse zimalumikizidwa mwachilengedwe ndipo zimagwira ntchito limodzi. Mwachitsanzo, kapamba amalumikizana kwambiri ndi duodenum, chikhodzodzo ndulu ndi chiwindi. Amatulutsa ma enzymes omwe amafunikira kuti chimbudzi cha mafuta, chakudya cham'mimba ndi mapuloteni (ntchito ya endocrine).

Mkati mwa gland palokha, zinthuzi zimakhala zangokhala, zomwe zimapangitsa kuti mkati mwa duodenum, momwe zimalowetsedwe pancreatic ndipo zimayamwa bile ndi madzi a m'mimba.

Nthawi zina, zochitika zamitundu mitundu zimayambira m'mbuyomu, izi zimachitika ndizofunikira kuchuluka kwa katulutsidwe ka pancreatic mothandizidwa ndi izi:

phwando lokhathamira ndi mowa,
chakudya chovomerezeka - mafuta, yokazinga, zokometsera, confectionery ndi zinthu zina zomwe zimapangitsa ntchito mwachinsinsi ya gland,
kudziwitsa zakumwa zoopsa, ziphe, mankhwala ena,
mavuto
kuwonongeka kwamakina ku gland - kuvulala, manipulopo azachipatala, opareshoni.

Zotsatira zakuchuluka kwachulukidwe katulutsidwe ka pancreatic ndi kutsegula kwa michere ya proteinolytic, kudzimbidwa kwa kapamba kumachitika, zomwe zimatsogolera pakupanga kutupa kwa aseptic (kosachiritsika). Zotsatira zake ndi edema yoyamba, kenako necrosis ndi fibrosis ya minofu ya chiwalo. Ndi vuto lililonse lomwe limachitika pambuyo pake, pamakhala zovuta zochepa zogwira ntchito, chifukwa minyewa yolumikizana kwambiri imadziunjikira mu ndulu.

Thandizo! Kutulutsidwa kwa ma enzymes a proteinolytic m'magazi pakadutsa matenda a chifuwa chachikulu kumayambitsa kusintha kwa ziwalo zina ndi minyewa, mwachitsanzo, mapapu, impso, ndi dongosolo lamanjenje.

Chithunzi cha kuchipatala

Zikondamoyo zimatha kupirira nthawi yayitali. Zizindikiro zake zimawoneka ndi chiwopsezo chachikulu cha chiwalo, pomwe wodwalayo akufunika chithandizo chamankhwala mwachangu.

Chizindikiro chachikulu cha mitundu yonse ya kapamba, kuphatikizira parenchymal, ndimawu opweteka. Munthawi yakuchulukirachulukira, kupweteka kumachitika mwadzidzidzi kapena motsutsana ndi maziko a kufalikira ndi kusanja.

Amasanjikizidwa pamimba pamimba, nthawi zambiri imakhala yofanana, ikhoza kuperekedwa kumbuyo, pansi pa masamba.

Kuwukira kwa kupweteka kwambiri kumatenga maola angapo mpaka masiku 1-2. Zizindikiro zotsatirazi ndizofanana:

kutulutsa ndi kutulutsa kwa mpweya,
nseru
kusanza komwe sikubweretsa mpumulo kwa wodwala, koyamba kumakhala ndi zotsalira za chakudya kuchokera m'mimba, kenako kuphatikizika kwa bile
chopondapo chosakhazikika, chamadzi chambiri, chofanana ndi mafuta ophikira, chosasamba bwino ndi madzi,
Kuchepetsa thupi.

Pancreatitis yachilendo kunja kwa gawo la pachimake imawoneka ngati ululu wofatsa, kumverera kwodzaza kumtunda kwam'mimba, kusinthana ndi matenda am'mimba komanso kudzimbidwa. Kulimbikira kwa zizindikiro kumayambitsidwa ndi zolakwa mu chakudya, njira yolakwika. Pancreatitis yokhazikika yomwe ilipo ndi chifuwa chachikulu chonse cha parenchyma kapena ziwalo zina zimabweretsa kuchuluka kwa voliyumu.

Pankhaniyi, ndikothekera kupondereza duct wamba wa bile ndi mutu wokulirapo wa kapamba ndikupanga jaundice yovuta. Kusintha kwamphamvu kwa minofu ya mchira kumapangitsa kuti maselo a Langerhans endocrine apange ma cell a ma cell: insulin ndi glucagon.

Yang'anani! Parenchymal aakulu kapamba angayambitse chisokonezo cha endocrine (intrasecretory) ntchito kapamba ndi chitukuko cha matenda a shuga.

Nthawi yomweyo, pali zizindikiro za hyper- kapena hypoglycemia: kumverera kwa ludzu, khungu limakhala louma komanso lotentha kukhudza kapena kumverera kwanjala, kunjenjemera kudutsa thupi lonse, thukuta lozizira.

Etiology ndi pathogenesis ya matendawa

Kutupa kwa pancreatic parenchyma kumachitika chifukwa cha kudzipatula ndi kutsegulira kwa ma pancreatic enzymes - trypsin ndi lipase, omwe amachititsa kuchepa kwa tiziwalo timene timatulutsa, kuchuluka kwa minyewa yolumikizana, kupindika kwa macryatricial, komwe kumapangitsa kuti ziwande ziwonongeke.
Matenda opatsirana pancreatitis amadziwika ndi kulowa kwa pathogen kuchokera ku lumen ya duodenum, biliary trail kapena magazi.

Zomwe zimayambitsa kukonzekera kwa matenda a parenchymal pancreatitis ndi:

kutupa kwa stenosis
cramping
sphincter wa Oddi Kulephera
Chotupa cha Vater.

Njira yotupa yomwe imagwiritsa ntchito matendawa imasokoneza kapena imangokhala ndi kuwonongeka kokha kwa mutu wa gland kapena mchira wake.
Parenchymal pancreatitis imagawidwa motengera mitundu ina ya morphological: edematous, sclerosing, komanso kuwerengera.

Zakudya zamankhwala

Pofuna kupewa kuchulukana kwa matendawa komanso kupitirira kwake, ndikofunikira kutsatira zakudya. M'masiku oyambilira ochulukirapo a kapamba, kudya kwambiri kumatha. Thupi limaperekedwa ndi intravenous makonzedwe a michere - shuga, saline. Kuti muchepetse ludzu, 1% yankho la kumwa koloko imaloledwa. Kuyambira tsiku lachinayi, chakudya chosasamba ndi mafuta ochepa osavuta osakanikirana, ascorbic acid, ndi mavitamini a B amaloledwa.
Chakudya chimatengedwa m'magawo ang'onoang'ono, mpaka katatu pa tsiku.

Zinthu zothandiza zimaphatikizapo misuzi ya zipatso, zoteteza, shuga, uchi, kiranberi, zakumwa za zipatso ndi mabulosi decoctions.

Pafupifupi sabata kuchokera pochotsa kuukira kwa kufalikira, chakudya chomwe chili ndi mapuloteni a masamba ndi mkaka, chakudya chochuluka ndimaloledwa. Chakudya chiyenera kukhala pansi.

Kuti muchepetse kuwonetseratu kwa gallbladder ndi kapamba, komanso kuchepetsa ntchito yamagetsi m'magayidwe nthawi yochulukirapo, zakudya zomwe zimakhala ndi tinthu tambiri tating'onoting'ono komanso minofu yolumikizana siziyenera kuperekedwa kuchakudya. Mapuloteni okwanira mu chakudya amathandizira kukonza mkhalidwe wa wodwalayo, chifukwa chake, mapuloteni a 140 g, makamaka ochokera ku nyama, ayenera kudya tsiku lililonse. Zakudya zomanga thupi, M'malo mwake, ndibwino kuchepetsa mpaka 350-400 magalamu patsiku. Mafuta amachepetsedwa mpaka magalamu 80 patsiku. Mankhwalawa parenchymal pancreatitis iyenera kuphatikizidwa ndi kugwiritsidwa ntchito kwamakina komanso chakudya modekha, chonyowa, chodulidwa kapena chosenda.

Mankhwala othandizira

Kugwiritsa ntchito mankhwalawa chifukwa cha matendawa kumathandizira kuti muchepetse ululu, kuwongolera kuperewera kwa pancreatic, kuyimitsa njira yotupa munjira yovomerezeka, komanso kuthana ndi kudalira kwa wodwala.
Steatorrhea, kuchepa thupi komanso kuwonjezeka kwa mpweya ndi chizindikiro cha kuperewera kwa mphamvu ya gland, kufuna chithandizo chamankhwala. Mwa izi, mankhwala amakono okhala ndi lipase yayikulu amagwiritsidwa ntchito, omwe amathandizira kukonza kwa steatorrhea ndikulimbikitsa kuyamwa kwa mavitamini osungunuka a mafuta. Awa ndi kukonzekera kwa ma microtanular m'mabotolo, otetezedwa ndi kuphatikizira kwapadera komanso kupewa kuteteza kwa lipase m'malo achilengedwe am'mimba.
Mankhwala a Enzymatic ndi antisecretory ali ndi mphamvu ya analgesic. Amawonjezera zomwe zimapezeka mumaproteni m'matumbo a lumen, amachepetsa kubisalira kwa michere ya pancreatic ndikuchepetsa kuthinana kwamatumbo komanso minyewa ya ndulu.
Ndi chitukuko cha zovuta matenda kapamba, opaleshoni akuwonetsedwa. Pachifukwa ichi, pali magulu awiri akuluakulu ogwira ntchito mwachindunji pa kapamba: kukhetsa mainkeni oyikira ndipo amatsogozedwa kumayendedwe amisempha yotulutsa minyewa.

Matenda a parenchymal pancreatitis ndi matenda osachiritsika pomwe kapamba amadzaza pang'onopang'ono.

Matendawa amayambitsa kutsika kwa ziwalo zamafuta am'mimba, kenako ndikuwonongeka kwa magwiridwe ake.

Chifukwa chiyani matendawa amatuluka?

Nthawi zambiri, anthu omwe amadalira mowa amadwala ndi parenchymal pancreatitis.

Koma, kuwonjezera pa izi, zomwe zimayambitsa matendawa zitha kukhala:

belated komanso chosavomerezeka zochizira pachimake kapamba,
matenda a thupi ndi kachilomboka (mwachitsanzo, bacterium ya rickettsia yomwe imayambitsa matenda a typhoid, gulu A streptococcus, lomwe limapangitsa kuti thupi lizipsa kwambiri,
kusintha kwa kutukusira kwa ndulu kupita ku gland yokhudza chimbudzi, zomwe zimachitika ndi cholecystitis,
zonyansa zam'matumbo a parathyroid, zomwe zimachitika chifukwa cha mawonekedwe a Burnett's
zokhudza zonse matenda ochepa a minofu-zotanuka mtundu.

Parenchymal pancreatitis, monga matenda ena osakhazikika, amayamba ndi kusintha pakukhululuka kwakanthawi.

Matendawa akamachepa, kudutsa pamlingo wokonzanso kwakanthawi, thanzi limayimitsidwa.

Koma pakatha milungu ingapo kapena miyezi ingapo, parenchymal pancreatitis imaberekanso, zizindikiro zotsatirazi zimawonekera:

kupweteka komwe kumakhazikika mbali yakumanzere ya thupi pansi pa nthiti ndikupereka kumbuyo. Komanso, ululu wokhala ndi pancreatitis ya parenchymal imatha kupweteka, osati kutchulidwa kwambiri, kapena kukhala yayikulu, kuwonekera mutatha kudya chakudya chochuluka, komanso kudya chakudya chamafuta kapena chofatsa,
kudwalitsa chilimbikitso, ndipo chifukwa chake, kusanza ndi kutsekula m'mimba, kusinthana ndi kudzimbidwa. Zizindikiro zonsezi ndi parenchymal pancreatitis zimawonekera chifukwa chosakwanira kupanga michere ndi tinthu timene timatulutsa,
mafuta chopangira mafuta okhala ndi tinthu tating'onoting'ono ta chakudya chosakidwa bwino. Izi ndizotsatira zakusokonekera kwa dongosolo logaya chakudya.

Nthawi zambiri wodwala yemwe ali ndi vuto la parenchymal pancreatitis amazindikira kuti watayika kwambiri.

Izi ndichifukwa choti zinthu zopindulitsa kuchokera kuzakudya zomwe zadyedwa chifukwa chazovuta mu kapamba sizimalumikizidwa ndi thupi.

Komanso, ndi parenchymal pancreatitis, amachepetsa thupi, chifukwa kupweteka kwambiri pamimba kumayambitsa kusowa kwa chilimbikitso.

Kutupa kwa kapamba pafupifupi nthawi zonse kumakhudza kuchepa kwa insulin, chifukwa cha matenda a shuga.

Zoti wodwala wake akudwala ndi parenchymal pancreatitis, zizindikiro zina zimamuuza dokotala wodziwa ntchitoyo.

Wodwala akanena kuti sakumana ndi vuto la kupweteka kwa nthawi yoyamba, zimapezeka kuti matendawa ali ndi mawonekedwe osakhazikika.

Koma kuti muwonetsetsetsetsetsetsetsetsetsetsetse, kuyezetsa ngati ma ultrasound kumachitika ndipo kusanthula kumatengedwa.

Parenchymal pancreatitis amasonyezedwa ndikuwonjezeka kwa kuchuluka kwa amylase, trypsin ndi lipase mu mkodzo.

Poterepa, magazi a glucose adzachuluka. Komanso, parenchymal pancreatitis iwonetsedwanso chifukwa cha kuchepa komanso kuchepa kwenikweni kwa kapamba.

Nthawi zina, kafukufuku wosemphana ndi x-ray wamitsempha yamagazi am'mimba amagwiritsidwa ntchito kuti awone parenchymal pancreatitis.

Wodwala akakhala ndi nthenda yotere, ndiye kuti chithunzicho chikuwonetsa kuti mitsempha yomwe ili m'malo ena a chiwalo imakhala yotupa.

Kodi matendawa amathandizidwa bwanji?

Chithandizo cha parenchymal pancreatitis chimadalira pakuchotsa ululu, kusanza komanso kukhumudwitsa chopondapo.

Koma atachotsa izi zizindikiro za parenchymal pancreatitis, sizingatheke kubwezeretsanso thupi lomwe lakhudzidwa.

Mothandizidwa ndi chithandizo, mutha kuletsa mawonetsedwe a parenchymal pancreatitis ndikusintha magwiridwe antchito a kapamba.

Mulimonsemo, ndizomveka kuchita zochiritsira mudagonekedwa kuchipatala kapena kuyang'aniridwa ndi dokotala pafupipafupi.

Choyamba, munthu yemwe ali ndi vuto la parenchymal pancreatitis amapatsidwa mankhwala omwe amatha kuperewera chifukwa cha kusowa kwa michere ya pancreatic.

Mankhwalawa ndi Pancreatin, Festal ndi Creon.

Kuphatikiza pa iwo, muyenera kutenga "Methyluracil" kapena mankhwala ena omwe amakonzanso malo owonongeka a chimbudzi.

Wodwala wina wa parenchymal pancreatitis amafunikira chithandizo chamankhwala.

Ndiwokhwima, chifukwa m'masiku oyamba kukweza kwa matenda, muyenera kuchepetsedwa zakudya komanso ngakhale kuzisiyiratu.

Kuti thupi lipitirizebe kulandira zinthu zofunika, chikwangwani chimayamwa kudzera pomwe saline yakumaso ndi glucose imalowetsedwa m'magazi.

Simungamwe madzi wamba pakadali pano. Iyenera kusinthidwa ndi yankho laling'ono la peresenti imodzi ya koloko yophika.

Nthawi yowonjezereka ya parenchymal pancreatitis ili m'mbuyo kwambiri, imaloledwa kudya chimanga chophika bwino, mchere pang'ono komanso zotsekemera pang'ono, ndi nyama yochepa yophika, masamba ndi zipatso.

Pazakudya, mutha kuphatikiza mbale zomwe zimakhala ndi mapuloteni amkaka. Koma zimatha kudyedwa mwa mtundu wa mbatata zosenda, kuti muthandizire kugaya chakudya chamagetsi.

Ndi parenchymal pancreatitis, chakudya chimayenera kudya pang'ono, koma nthawi 7-8 patsiku. Chithandizo cha zakudya zimafuna kugwiritsa ntchito zakudya zomwe zimakhala zochepa ndi mafuta komanso chakudya.

Parenchymal pancreatitis imatha kuthandizidwa ndi mankhwala wowerengeka, yokonzedwa motengera zotsatirazi:

kupotoza 300 g wa adyo, kuchuluka komwe kwa parsley ndi 4 mandimu ochapidwa limodzi ndi zest mu chopukusira nyama. Kenako muyenera kusakaniza zosakaniza ndi kuziyika mu chidebe chagalasi, chomwe chiyenera kuphimbidwa ndi chivindikiro cholimba ndikuchotsa pamalo ozizira. Pambuyo pa masabata awiri, mankhwalawa amakhala okonzeka kugwiritsa ntchito. Iyenera kudyedwa ndi supuni theka la ola musanadye chakudya cham'mawa, chakudya chamadzulo ndi chakudya chamadzulo, chotsukidwa ndi udzu kuchokera ku masamba a cranberries, sitiroberi, mabuluni, nyemba zosankhwima ndi nyemba za chimanga,
phatikizani mu chidebe chimodzi supuni 6 za maluwa owuma opandaelle ndi ma supuni atatu a motherwort ndi kuchuluka kofanana kwa hypericum. Kenako supuni imodzi ya zitsamba zosakanikirana iyenera kuthiridwa ndi kapu yamadzi otentha ndikuumirira kwa ola limodzi. Kulowetsedwa ayenera kumwedwa mu kapu 30 asanadye. Chithandizo chotere chimayenera kukhala miyezi ingapo.

Chifukwa chake, kuti muthane ndi zizindikiro za parenchymal pancreatitis, muyenera kutsatira zakudya, kumwa mankhwala omwe atenga ma enzymes ndikubwezeretsa gland, ndikugwiritsa ntchito njira zina za anthu.

Pakapangidwe ka matenda am'mimba, gawo la 5.1 mpaka 9% ndi la pancreatitis (CP). Ndi matenda awa, kapamba amakhudzidwa, kutupa kumayamba. Zotsatira zake, kusintha kwanyengo kumachitika m'ziwalo. Poyamba, njira ya pathological imatha kuchitika mchira wa kapamba, mutu wake kapena gawo lapakati. Zotsatira za matendawa ndi kuwonongeka kwa chiwalo chonse. Anthu ena omwe ali ndi pancreatitis yosatha amatha pambuyo pake. Imfa padziko lapansi zimawonjezeka pafupifupi 11%.

Zambiri za matendawa

Ndiye kodi chikhansa chachikulu ndi chiyani? Ndi mawu awa, akatswiri amapanga gulu lonse la matenda a kapamba. Mwa zovuta zonse, zotsatirazi ndizodziwika:

gawo lopita patsogolo ndi zochitika za pachimake kapamba,
zotupa, zamkati kapena zosokoneza zotupa za pancreatic parenchyma ndikutsatira minofu yolumikizana,
Kusintha kwa machitidwe a ziwalo,
mapangidwe a cysts, pseudocysts, miyala ndi zowerengera,
Kukula kwa endocrine ndi exocrine kusakwanira.

Zowona kuti pali matenda osiyanasiyana zimatsimikiziridwa ndi International Statistical Classization ya kukonzanso kwakhumi. Aakulu kapamba ICD-10 agawika:

CP ya zakumwa zoledzera (code K86.0),
ma CP ena - opatsirana, obwereza, obwereza, osatchulidwa (code K86.1).

Zomwe zimayambitsa matenda ambiri a kapamba

Nthawi zambiri, matendawa amapezeka chifukwa chomwa mowa kwambiri kwa nthawi yayitali. Mwa amuna, chifuwa chachikulu cha kapamba amatha kupezeka ngati amamwa zaka zoposa 15. Mwa azimayi, kuthekera kwa matenda kumachulukirachulukira pakumwa mowa kwambiri kwa zaka zoposa 10.

Mowa sindiye wokhawo womwe ukuthandizira kuwoneka kwa chifuwa chachikulu. Choyambitsa matendawa chimatha kusuta. Zinthu zomwe zimalowa m'mapapu ndi utsi zimalowa m'magazi ndikufalikira thupi lonse, zimasokoneza ziwalo zonse zamkati, kuphatikizapo kapamba.

Zomwe zimayambitsa matendawa

Zina zomwe zimayambitsa matenda a pancreatitis (ICD-10 code - 86.0 ndi 86.1) ndi monga:

chakudya chamafuta, mafuta osakhalitsa a protein,
matenda osiyanasiyana am'mimba thirakiti (neoplasms, cholecystitis, etc.),
kunenepa kwambiri, kunenepa kwambiri,
kumwa mankhwala ena (Azathioprine, Furosemide, Prednisolone, estrogens wopanga, Erythromycin, Ampicillin, etc.),
matenda omwe ali ndi ma virus (cytomegalovirus, kachilombo ka hepatitis B, C, etc.).

Kafukufuku yemwe anachitika m'zaka zaposachedwa kwawonetsa kuti pali chibadwa chamtundu wa kapamba wa kapamba. Awa ndi matenda opatsirana pang'onopang'ono omwe ali ndi vuto losakwanira (komanso mawonekedwe amtundu wina wa mawonekedwe a genet phenotype). Mwa odwala, cholowa chamatenda chimadziwoneka koyambirira. Komabe, gawo lomaliza limachitika pambuyo pake kuposa mitundu ina yamatendawa.

Mitundu ya kapamba

Pali magulu osiyanasiyana am matendawa. Chimodzi mwa izo ndi mndandanda wa mitundu yotsatira ya kapamba:

Zotsatira. Zimachitika mu milandu ya 55-60%. Ndi mawonekedwe awa, nthawi zakhululuka zimasinthidwa ndikuchulukirachulukira kwa njira ya pathological.
Kupweteka kokhazikika. Fomuyi imadziwika kawirikawiri (mu 20% ya milandu). Ndi izo, odwala amadandaula za kupweteka kosalekeza, kutikiridwa pamimba pamimba ndikuwongolera kumbuyo.
Pseudotumor (icteric). Pafupipafupi mwadzidzidzi mawonekedwe amtunduwu kapamba ndi 10%. Njira ya pathological imadziwika ndi kukula kwa kutupa m'mutu wa kapamba ndi kukakamiza kwa wamba duct.
Zopanda vuto (latent). Fomuyo ikupezeka mu milandu ya 5-6%. Ululu wokhala ndi matendawa ndi wofatsa kapena samamvetseka konse. Matenda a dyspeptic nthawi ndi nthawi amayamba chifukwa cha kupunduka kwa kapamba.
Sclerosing. Ndi mawonekedwe amtunduwu, ululu umapezeka pamimba yapamwamba. Amakulitsa chakudya ndikamadya. Ululu umayenda ndi nseru, zotayirira zotayirira, kuchepa thupi. Mukamachita ultrasound, akatswiri amawona kuchepa kwa kukula ndi kuperewera kwa kapamba.

Malinga ndi gulu la Marseille-Roman, pali mitundu ina ya kapamba monga kuletsa, kuvulaza, parenchymal ndi fibrosis. Ndi woyamba waiwo, chotupa chosafunikira cha kapamba chimawonedwa. Ma pseudocysts, cysts, calcication, miyala imawoneka mumiyeso. Kodi pancreatitis chodwala ndi chiyani? Ndi matenda amtunduwu, chiwalo chamkati chimakhudzanso chimodzimodzi. Miyala simupanga, kutsekeka kwa mimbulu yayikulu kumayang'aniridwa.Ndi parenchymal mawonekedwe mu parenchyma, cholinga cha kutupa. Ma calcified sanapangidwe, dongosolo la duct silikhudzidwa. Fibrosis amadziwika ndi kusintha kwa parenchyma kwamkati ndi minyewa yolumikizana. Chifukwa cha njirayi, kulephera kwa ex- ndi endocrine kumapitilira.

Zizindikiro za matendawa

Polankhula za matenda a kapamba aakulu, ndikofunikira kulingalira za matenda. Koyamba magawo akuchulukirachulukira, kukomoka kumawonedwa. Amadziwika ndi zowawa m'dera la epigastric. Nthawi zambiri, amawalitsa posachedwa. Chovala cha Herpes sichachilendo. Mwa anthu omwe ali ndi vuto la chifuwa chachikulu, kukomoka kumachitika chifukwa chodziwitsidwa ndi zinthu zomwe zimayambitsa. Ndizakudya zamafuta, zakumwa zoledzeretsa komanso zakumwa zoziziritsa kukhosi.

Matendawa amadziwikanso ndi dyspeptic syndrome. Pafupifupi anthu 56% odwala amadwala mseru komanso kusanza. Mu 33% ya milandu yolemetsa imawonedwa, mu 29% - flatulence, mu 27% - kuchepa kwa njala. Ndi matenda, zizindikiro monga kufooka wamba, kutopa, komanso kuchepa mphamvu kwa ntchito zitha kuwonekeranso.

Njira ya matenda kapamba

Akatswiri amasiyanitsa magawo anayi pakukula kwa matendawa:

Gawo loyesera. Pakadali pano, anthu odwala sawona zizindikiro za chifuwa chachikulu. Matendawa nthawi zambiri amadziwika mwadzidzidzi pogwiritsa ntchito makina omwe amachititsa kuti pamimba pakhale pang'onopang'ono.
Gawo la mawonetseredwe oyamba pokonza matenda monga matenda kapamba. Akuluakulu panthawiyi amayamba kuvutika ndi zizindikiro zoyambirira za matendawa. Kutalika kwa gawo kungakhale zaka zingapo. Nthawi zina, matendawa amakula msanga.
Gawo lachitukuko cha zodwala zamatenda pafupipafupi. Odwala amawonetsa zizindikiro za endocrine ndi exocrine kulephera. Anthu amadya pang'ono, amadandaula za kupweteka kwam'mimba.
Gawo lomaliza. Ululuwo umachepera. Anthu amachepetsa thupi. Pamapeto omaliza, zovuta zingapo za chifuwa cham'mimba zimayamba chifukwa cha kufooka kwa kapamba, endocrine ndi exocrine insuffence. Chimodzi mwa izo ndi khansa ya chiwalo chotchedwa chamkati.

Kutengera ndi mawonekedwe a kukula kwa kapamba, pang'onopang'ono, digiri yolimbitsa thupi komanso njira yoopsa ya matendawa imasiyanitsidwa. Ndi njira yofatsa, nthawi zowonjezera sizimachitika kawiri (kawiri pachaka). Ululu ndi wofatsa. Ntchito za kapamba sizovuta.

Kodi chifuwa chachikulu chokhala ndi pancreatitis ndi chiyani? Ichi ndi matenda omwe amawonjezera 3-4 pachaka. Iwo amakhala motalika kuposa njira yofewa ya kapamba. Mwa anthu odwala, kulemera kwa thupi kumachepa. Ntchito ya pocreatic pancreatic imachepetsedwa pang'ono, kupanikizika kwa hyperfermentemia kumawonedwa.

Woopsa matenda, kukokoloka amakhala pafupipafupi komanso nthawi yayitali. Ululu umayenda limodzi ndi dyspeptic syndrome.

Chithandizo cha matendawa: zolinga ndi njira zofunika

Mu chifuwa chachikulu, mankhwala amathandizidwa kuti akwaniritse zolinga zotsatirazi:

Kuchepetsa kuwonekera kwa matenda,
kubwezeranso kupewa,
Kuchepetsa makamaka zovuta za matenda.

Akatswiri amapereka mankhwala osagwiritsa ntchito mankhwala, mankhwala osokoneza bongo kwa odwala awo. Ngati ndi kotheka, opaleshoni imachitidwa. Chithandizo cha matenda a kapamba akuluakulu amatha kuchitika kunyumba komanso kuchipatala. Chizindikiro chakugonekedwa kuchipatala ndiko kusinthika kwa matendawa kufika pakuwonjezereka, chifukwa ndi munthawi imeneyi pomwe moyo wa wodwalayo umawopsezedwa ndipo makulidwe azachipatala amafunikira.

Mankhwala osagwiritsa ntchito mankhwala

Mankhwalawa matenda a kapamba, kupatsa thanzi kumatenga gawo lofunikira. Ndi kukokomeza kwakukulu, masiku anjala (1-3 kapena kuposerapo) ndi zakumwa zambiri zamchere amasonyezedwa. Malinga ndi zomwe zikuwonetsa, kholo kapena lobala (kukhazikitsa zakudya mu colon pogwiritsa ntchito proeni yapadera) ndi mankhwala. Chifukwa cha izi, ndikotheka kuyimitsa katulutsidwe ka kapamba, kuledzera kumachepa ndipo vuto la ululu limayamba kufooka.

Pambuyo pazinthu zodziwika bwino, odwala amadwalanso zakudya zam'kamwa. Chakudya chizikhala cha pafupipafupi. Zakudya za tsiku ndi tsiku zimakhala ndi soups mucous, masamba osenda, ndi mapesi amkaka osenda. Kuchokera ku zakumwa zopangidwa ndi zipatso, zakudya, tiyi wopanda mphamvu, mchere wa mchere, msuzi wa rosehip umaloledwa.

Onetsetsani kuti simukutulutsa zinthu zotsatirazi:

kuyambitsa chisangalalo,
kuphatikiza utsi wamafuta,
zolimbikitsa kupanga timadziti tam'mimba,
wolemera mu zinthu zina.

Kodi ndizotheka kukhala ndi msuzi wa nsomba ndi nyama, bowa ndi msuzi wamphamvu wamasamba, zakudya zamzitini, nyama zosuta, masoseji, nsomba zamafuta ndi nyama, zakudya yokazinga, zipatso zosaphika ndi ndiwo zamasamba, zamapichesi, makeke, mkate wama bulawuni wodwala kapamba? Izi zonse ndizoletsedwa pakuwonjezera matendawa, chifukwa chake ziyenera kutayidwa. Muyeneranso kuchotsa zonunkhira, ayisikilimu, mowa ku menyu wanu.

Pa kuchotsedwa, zakudya zimasintha pang'ono. Anthu omwe ali ndi matenda othandizira pancreatic pancreatitis amaloledwa kudya pasitala, masamba osaphika ndi zipatso, tchizi zofewa, ndi nsomba yophika. Supu yosenda ingasinthidwe ndi supu wamba zamasamba (kabichi siyenera kuphatikizidwa ndi zosakaniza). Porridge imatha kukhala yopepuka, yolimba.

Pharmacotherapy aakulu kapamba

Ntchito ya mankhwala othandizira mu gawo loyamba ndikuwonetsetsa kuti zikondazo zimagwira. Izi zimatheka ndi:

Kulandila Mlingo waukulu wamakono amakono a polyenzyme. Mankhwalawa akuphatikizapo Mezim-Fort, Creon, Pancytrate.
Mlingo wapamwamba wa asidi chapamimba katulutsidwe pogwiritsa ntchito histamine H2-receptor blockers (Ranitidine, Famotidine) kapena proton pump inhibitors (Omeprazole, Esomeprazole). Mankhwala amaperekedwa ndi makolo kapena kuwamwa.
Kukhazikitsidwa kwa "Octreotide" kapena "Sandostatin." Mankhwalawa ndi mapangidwe apadera a mahomoni somatostatin. Chifukwa cha iwo, matenda oopsa mu kayendedwe ka mikwingwirima amachepa, ndipo chifukwa cha izi, kupweteka kumatsitsidwa ndikuyimitsidwa.

Ngati njira zochizira zochizira pancreatic secretion zilibe mphamvu ya analgesic, madokotala amapereka mankhwala omwe si a narcotic kapena narcotic analgesics. "Analgin", "Ketoprofen", "Paracetamol" - mankhwala aliwonse ochizira matenda kapamba amatha kufotokozedwa ndi dokotala wa gulu loyamba la mankhwalawa. Mwa mankhwala omwe akukhudzana ndi narcotic analgesics, Promedol, Tramal, Fortral akhoza kusankhidwa.

Chithandizo cha matenda a kapamba akuluakulu amatha kuphatikizira mankhwala a multienzyme. Zizindikiro za kagwiritsidwe ntchito kake ndi mafuta owonjezera oposa 15 ga patsiku okhala ndi ndowe, kutsekula m'mimba, komanso kuchepa thupi msanga. Kukonzekera kwa Polyenzyme ndi Abomin, Forte-N, Creon, Pancreatin, Festal, Pancreoflat, Digestal, Wobenzym.

Mankhwala ochizira matenda

Nthawi zina chifuwa chachikulu cha khansa, opaleshoni ndiyofunikira. Zizindikiro ndi:

ululu womwe sutha ndi mankhwala komanso zakudya,
kukhalapo kwa zilonda ndi ma cysts mu kapamba,
bile duct chotchinga chomwe sichingathetsedwe pogwiritsa ntchito njira ya endoscopic,
duodenal stenosis,
fistulas mu kapamba ndi chitukuko cha kuyendera kwa ma cell kapena ma ascites,
khansa yomwe ikukayikira, osati yotsimikizika kapena yotsimikizika.

"Pancreatitis yosatha, Zizindikiro komanso kulandira chithandizo kwa akulu" ndi mutu wofunikira wa chipatala womwe amafunikira chisamaliro. Awa ndi matenda opatsika, opita patsogolo komanso osasinthika. Komabe, chithandizo chikufunikabe. Zimakupatsani mwayi wokhalitsa anthu odwala, kumachotsa zosasangalatsa zomwe zimapezeka mu chifuwa chachikulu. Mwachitsanzo, potsatira malangizo a kadyedwe, kukana mowa, ndi mankhwala oyenera, odwala amakhala ndi zaka 10. Theka la omwe safuna thandizo kuchipatala ndikupitiliza kumwa mowa, kusuta, kudya mosayenera, kufa nthawi ino isanachitike.