Zida zamankhwala a pseudotumor pancreatitis

Pseudotumorous (pseudotumor) kapamba si matenda olekanitsidwa, koma mawonekedwe a kutupa kosatha kwa kapamba, chizindikiritso chachikulu chomwe ndi chosagwirizana cha hypertrophy. Njira yamtunduwu wa kapamba imakhala ndi zizindikiro zingapo zomwe zimadziwika ndi chotupa cha oncological cha chiwalo. Pakati pawo, jaundice wolepheretsa, kuchepa thupi kwambiri komanso kuchepa kwa thupi. Kuphatikiza apo, pali zizindikiro za dyspeptic, kuperewera kwa endocrine ndi ululu, wofanana ndi kapamba. Chithandizo cha pseudotumor pancreatitis nthawi zambiri ndi opareshoni.

Njira ya mwadzidzidzi

Njira zowonongeka mu kapamba zimayamba ndi kutsegula kwa ma enzymes (trypsin, phospholipase, ndi zina) zomwe zimayambitsa edema ndi kudzimbidwa kwa minofu yake, zomwe zimayambitsa kufa kwa cell ndikusokoneza gawo la ziwalo.

Pofuna kupewa kulowerera kwa zinthu zosokoneza minofu kulowa m'magazi, thupi limayendetsa makina oteteza - limachepetsa kufalikira kwa poizoni, kupanga chingwe cha necrotic chokhala ndi minofu yolumikizana ndikupanga ma pseudocysts (mitundu yodzadza ndi necrotic misa). Pakuchulukirachulukira kwa matendawa, mapangidwe ake amakhala ochulukirachulukira, chifukwa cha kutupa, chitsulo chimafooka.

Pambuyo pake, mawonekedwe a pseudocyst amawerengera, omwe mu zaka 10-15 amatsogolera pakuphatikizana ndikukulitsidwa kwa chiwalo. Njira iyi, mbali imodzi, imateteza thupi ku kuledzera ndi kufa, koma, imayambitsa chidwi chachikulu cha thumbo ndi kuponderezana kwa ziwalo zapafupi.

Popita nthawi, ziwalo zotsatirazi zimapanikizika:

bile ducts
duodenum
mitsempha ya portal ndi splenic.

Zotsatira zake, thanzi la wodwala wokhala ndi pancreatitis chifukwa chowonongeka kwa ziwalo zoyandikana limakulanso.

Zizindikiro zamatsenga

Kansa yamtunduwu imayamba pang'onopang'ono. Kusintha kwa chifuwa chachikulu mpaka pseudotumor kumatha kutenga zaka 10 mpaka 15.

Nthawi zina kudziwitsidwa koona kumakhazikitsidwa pokhapokha ngati mukupima mayeso, ndipo nthawi yonseyi wodwala samathandizidwa ndi dyskinesia ya m'mimba thirakiti, cholecystitis yodwala kapena matenda a chiwindi.

Ma pseudotumor mawonekedwe a kapamba ali ndi zizindikiro izi:

chotupa choteteza
kupweteka kwambiri
kusanza ndi kusanza
kukulitsa kwazinthu zopezeka ndi palpation,
kuchepa thupi kwakanthawi kochepa,
kusakwanira kwa exocrine pancreatic ntchito, yomwe imafotokozedwa mu steatorrhea, chikhalidwe chosakhazikika cha chopondapo, kukhalapo kwa zidutswa zosasokonekera za CHIKWANGWANI ndi minyewa ya minofu mkati mwake.

Pa ultrasound, nthawi zambiri kuyerekeza kwamutu kwa minofu ya m'mimba kumawonedwa, mawonekedwe a chipangizocho akutha ndi ma pseudocysts angapo, kukulitsa kwa dambo la Wirsung kumatsimikiziridwa.

Kuzindikira matendawa

Mawonekedwe a pseudotumor a pancreatitis ndi ovuta kusiyanitsa zizindikiro ndi matenda ena ammimba omwe amagwirizana ndi ntchito zapakhansa. Kuchulukitsa kwa maphunziridwe a matenda amenewa kumatha kupangitsa kuti matenda azisokonekera.

Ndikofunikira kwambiri kusiyanitsa mawonekedwe a pseudotumor a kapamba ndi khansa. Nthawi zambiri, chotupacho chimapezeka m'mutu wa kapamba ndipo zimayendetsedwa ndi jaundice yovuta.

Matenda a pseudotumor pancreatitis ndi awa:

kupatula kwa matenda omwe ali ndi zizindikiro zofananira - kapamba wa adenocarcinoma, carcinoma wamatumbo, khansa ya m'matumbo, gastritis kapena matenda am'mimba, gastroduodenal ulcer, etc.
mayeso a labotale: kuyezetsa magazi kwa ma enzymes, kuyesa kwa bentiramine ndi cerulin,
njira zogwiritsira ntchito: endoscopic echolocation, radiography, ultrasound, duodenography, CT,
kubwezeretsa pancreatocholangiography ndi endoscopy ya pancreatic duct yayikulu, gastroduodenoscopy, cholecystography ndi cholangiography ndi othandiza,
umalimbana biopsy a gland ndi kutsimikiza kwa zotupa zolembera.

Matenda a pseudotumor pancreatitis nthawi zambiri amapezeka pokhapokha pokhapokha pa odwala omwe ali ndi kutupa kwa pancreatic, chifukwa chake nthawi zambiri matendawa amakhala ndi zovuta zambiri.

Kusiyanitsa pancreatitis ku pancreatic adenocarcinoma malinga ndi zotsatirazi.

Zizindikiro zake odwala ndi pseudo-chotupa mawonekedwe a kapamba:

zaka (30 mpaka 50),
jenda ndi wamwamuna
Chifukwa chachikulu nthawi zambiri chimakhala chidakwa,
Kutalika kwa matendawa ndi zaka zoposa 1.5,
kuchepa thupi kwambiri (kuposa makilogalamu 10),
kupweteka kwam'mimba
kubwereza jaundice ndi pafupifupi kuchuluka kwa bilirubin osaposa 20% ya odwala,
Kufufuza kwa ma ultrasound ndi makompyuta mu zosakwana 20% ya milandu kumawonetsa kuchepa kwa echogenicity ya mutu wapa pancreatic.

Kuphatikiza pazizomwe tafotokozazi, njira ya pseudotumor pancreatitis imayendera limodzi ndi kufooka komanso thanzi labwino la wodwalayo.

Pancreatic adenocarcinoma, makamaka:

ukalamba (pafupifupi zaka 60),
onse amuna ndi akazi amakhudzidwa chimodzimodzi
kuchepa kwa thupi mpaka 6 kg,
patsogolo jaundice ambiri odwala (pafupifupi 90%) okhala ndi bilirubin yayitali kwambiri,
maphunziro othandizira pafupifupi 75% yamilandu ikuwonetsa kuchepa kwa echogenicity ya mutu wa pancreatic.

Zizindikiro zoyambirira za pancreatic adenocarcinoma nthawi zina zimakhala nseru, kusanza, kukhumudwa, komanso kukhumudwa. Biopsy imagwiritsidwa ntchito pozindikiritsa chotupa ndi PP, koma sizipanga nthawi zonse kuti zithetse mtundu wake. Nthawi zambiri chikhalidwe cha maphunziro chimatha kukhazikitsidwa pokhapokha opaleshoni.

Kuchiza matenda

Pseudotumor mawonekedwe a pancreatitis amathandizidwa makamaka ndi opaleshoni. Kuti muchite izi, njira monga kukhetsa kwa ma pancreatic ducts kusintha kutulutsa kwa pancreatic madzi ndikuchotsa ma hypertrophic minofu ya mutu wa gland imagwiritsidwa ntchito.

Pharmacotherapy ikufuna kuthana ndi zowawa ndikubweretsa mpumulo wosakhalitsa kwa wodwalayo. Satha kukonza vutoli ndikukhala ndi chikhululukiro chokhazikika. Mankhwala osokoneza bongo amaphatikizapo kugwiritsa ntchito mankhwala opweteka (Papaverine, Drotaverinum), mankhwala a antisecretory (Gordoks, Kontrikal). Kuphatikiza apo, chithandizo ndi njala chimagwiritsidwa ntchito masiku 2-3.

Mankhwala osokoneza bongo ndi chikhalidwe chokonzekera, chifukwa munthawi yakukhululuka, wodwalayo amafunikabe kuchitidwa opareshoni.

Kusangalatsa kwa mutu wa gland kumachotsa kupindika kwa ma ducts a bile. Tizidutswa tambiri tokwana pancreatic timatumizidwa ku histology mwachindunji pa opaleshoni. Njira zina zogwirira ntchito zimatengera zotsatirazi:

Ngati maselo atypical apezeka, ndiye kuti PDR (pancreatoduodenal resection) idzagwiritsidwa ntchito. Awa ndi opareshoni yayikulu yomwe ikukhudza ziwalo za kapamba - ma ducts a bile, duodenum ndi CHIKWANGWANI, chomwe chili pafupi ndi England.
Ngati histology sikuwonetsa kusintha kwa khansa m'matumbo a pancreatic, ndiye kuti mutu wa chiwalocho umapendekeka ndi mawonekedwe akulu omwe amapangitsa kukanidwa kwakukulu kwa pancreatic duct. Njira yoperekera opaleshoni imapangitsa kuti matendawa athetse ndikupeza chikhululukiro, ndipo ikatha nthawi yochira, zimasintha kwambiri moyo wa wodwalayo. Kwenikweni, izi zimapewa matenda ashuga, chifukwa mapamba ambiri amatha kugwira ntchito yake ya endocrine mwa kupanga insulini.

Mu nthawi ya ntchito, odwala ayenera kupitiriza kutsatira malamulo oletsa kudya zakudya zopatsa thanzi komanso kupeweratu kumwa mowa. Kuphatikiza apo, kulandira chithandizo chamankhwala ndi kukonzekera kwa enzyme, kusala kwakanthawi ndi spa m'malo a gastroenterological mbiri ndikofunikira.

Zambiri

Pseudotumor pancreatitis si gawo losiyana la nosological, ndi mtundu wa morcological wa chifuwa chachikulu, chomwe chimadziwika ndi njira yotupa, gawo la fibrosis ndi parenchyma hypertrophy. Zosiyanitsa ndi mawonekedwe awa ndi kukhalapo kwa komweko, nthawi zina kumawonekera kukula kwa gawo limodzi la madipatimenti a kapamba, komanso kukhazikitsidwa kwa cholinga chachulukidwe. Chifukwa chake pseudotumor pancreatitis ndikofunikira kusiyanitsa ndi oncopathology ya chiwalo. Nthawi zambiri, mutu wa kapamba umakhudzidwa, motero, jaundice komanso mtundu wina wa matenda oopsa a portal amatha ku chipatala.

Ziwerengero zolondola pa miliri ya pseudotumor pancreatitis sizikupezeka, chifukwa intravital biopsy ya gland zinthu ndizosowa kwambiri, komabe, akatswiri pa nkhani ya gastroenterology amati amakonda kuchulukana. Zambiri mwazomwe zimayambitsa matendawa zimasowanso njira zosiyanasiyana zoyesera matenda: odwala ambiri omwe amapezeka ndi pseudotumor pancreatitis amadziwika kuti ndi anthu omwe ali ndi cholelithiasis, kuledzera kosatha, duodenal papillitis ndi matenda ena.

Zomwe zimapangitsa kuti pakhale pseudotumor pancreatitis ndi kumwa kwa nthawi yayitali ndi matenda a biliary (cholelithiasis ndi matenda ena a chiwindi ndi a biliary thirakiti) - zoposa 80% ya milandu yonseyi imachitika chifukwa cha zifukwa izi. Pafupipafupi, pseudotumor pancreatitis imakhala chotsatira cha kumwa mankhwala ena, matenda ena osakhazikika. Amakhulupirira kuti pseudotumor pancreatitis ya uchidakwa amayamba pambuyo povuta kwambiri mu 10% yokha yamilandu, pomwe zochitika za kuchulukitsa kwa kapamba zimapezeka kawirikawiri motsutsana ndi maziko a kutupa kosakhalitsa. Zimatsimikiziridwa kuti kuthekera kwazovuta kumawonjezeka kwambiri kwa omwe amasuta.

Pafupifupi theka la milandu, biliary pseudotumor pancreatitis (biliary pancreatitis) ndi zotsatira za cholelithiasis, nthawi zambiri mtundu uwu wa matenda amalembetsa azimayi, chiwopsezo cha kukula kwake chimatsimikiziridwa ndi nthawi yayitali ya matenda oyambitsidwa ndi kufalikira kwa calculi. Etiological zifukwa za biliary pancreatitis imaphatikizaponso kusagwirizana kwa biliary thirakiti, matenda a Vater papilla ndi wamba bile duct. The pathogenesis ya kapamba mu nkhaniyi amadziwika ndi kuphatikizika kosalekeza kwaukali ndulu mu pancreatic duct. Makina ofunikira nawonso ndi zotupa zam'mimba za pancreatic, makamaka mutu wa kapamba, momwe kutupa kogwiritsa ntchito kuchokera ku ndulu kumafalikira limodzi ndi unyolo wa ma lymph node.

Mankhwala pseudotumor pancreatitis amakula ndikugwiritsa ntchito nthawi yayitali ya acetaminophen, estrogen ndi mankhwala ena. Komanso, chifuwa chachikulu cha parenchyma hypertrophy chimatha kukhala ndi cholowa chobadwa nacho: mawonekedwe awa amadziwika ndi kupitilira kwatsatanetsatane, kuwonjezeka kwa endocrine ndi exocrine kufooka kwa ziwalo, komanso chiopsezo chokhala ndi zilonda zapakati.

Zizindikiro za pseudotumor pancreatitis

Chithunzi chachipatalachi chimadziwika ndi predominance ya zizindikiro za kupsinjika kwa gawo lachiberekero ndi mutu wokulirapo wa pancreatic, zizindikiro za kusowa kwa endocrine, komanso dyspeptic ndi syndromes ululu.Nthawi zambiri, mtundu uwu wa matendawa umakhala wodwala kwambiri ndipo umatha kukhala asymptomatic m'magawo oyamba. Kuwonetsera koyamba kumakhala nthawi yovuta. Ululu pamimba yapamwamba yamitundu ingapo imakhalanso ndi chikhalidwe, chomwe kwa nthawi yayitali chimangokhala chidandaulo chodandaula. Pambuyo pake, endocrine (kulekerera pang'ono kwa chakudya chamagulu omwe amakhala ndi ketoacidosis, nephropathy) ndi exocrine insufficiency (dyspeptic syndrome ndi steatorrhea) kujowina.

Ngakhale kuti ululu ndi pathognomonic wa kapamba, ndi mawonekedwe a pseudotumor zimachitika mwa 30-40% ya odwala. Zowawa nthawi zambiri zimatchulidwira mu epigastrium ndi hypochondrium yamanja, imachitika pambuyo chakudya chachikulu, makamaka mafuta, chimapitilira maola awiri kapena atatu. Kudandaula kwa dyspeptic kumaphatikizapo mseru, kusanza, ndi kuchepa kwa thupi ndi kutsekula m'mimba komwe kumayenderana ndi kuchepa kwa enzyme komanso kugaya chakudya m'mimba.

Chithandizo cha pseudotumor pancreatitis

Chithandizo cha odwala ndi kutsimikizika kupezeka kwa pseudotumor pancreatitis panthawi yowonjezera ikuchitika mu dipatimenti ya gastroenterology. Chithandizo cha zakudya chimaphatikizira tebulo 5. Udindo wofunikira kwambiri wamankhwala umaperekedwa ku chiwonetsero cha etiotropic - kuchotsedwa kwa zomwe zimayambitsa matendawa (mwachitsanzo, cholecystectomy ndi cholelithiasis, kuchotsedwa kwa papillostenosis ndi njira zina).

Cholinga chachikulu cha chithandizo cha mankhwala ndikukonzanso kwa exocrine ndi intrasecretory pancreatic insufficiency. Kukonzekera kwa enzyme ndi mankhwala - pancreatin osakanikirana ndi lipase kapena solisim. Kubisika kosakwanira kwa ma bicarbonates kumalipidwa ndi kugwiritsa ntchito ma antacid, omwe, akaphatikizidwa ndi kukonzekera kwa calcium, amachepetsa steatorrhea.

Kuti muchepetse zochitika za dyskinetic za sphincter zida, cholinolytics ndi mankhwala. Matenda opweteka amayimitsidwa ndikutenga atropine, antispasmodics. Njira yabwino yolimbana ndi sphincter ya Oddi ndi Gimecromon, mebeverin. Munthawi ya kukokomeza, mankhwala othandizira amakhalanso ndi mankhwala a antibacterial. Ngati mankhwala osathandiza a gland edema ndi hypersecretion a michere, mankhwala a radiation yachigawo ndi hypothermia yakwanuko amagwiritsidwa ntchito.

Mankhwalawa pseudotumor pancreatitis, njira za endoscopic ndizothandiza kwambiri. Zizindikiro zoterezi zikuwonjezereka m'mutu wa kapamba ndi kuponderezedwa kwapadera kwa bile bile komanso zovuta zina, komanso papillostenosis, magawo a gawo la preapillary. Zikatero, papillosphincterotomy imapangidwa kuti ivunde dongosolo la duct.

Zotsogola ndi kupewa

Kukula kwa matendawa pamtunduwu wamatenda ndizabwino: pseudotumor pancreatitis imadziwika ndi kuchepa kwapang'onopang'ono, kuchepa pang'onopang'ono, endocrine insufficiency (pancreatogenic kishuga) sikamatsogolera ku nephropathy ndi angiopathy. Kuchiza kwakanthawi, komanso kutsatira malangizo munthawi yakukhululuka, kumalepheretsa kupitilira. Kupewa ndiko kuchepetsa kugwiritsa ntchito zakumwa zoledzeretsa, mankhwala oopsa, chithandizo cha panthawi yake matenda omwe angayambitse pseudotumor pancreatitis.

Pseudotumor pancreatitis: ndi chiyani?

Zikondazo zimapangidwa kuti zipange ma enzymes (lipase, trypsin, phospholipase, ndi zina) zomwe zimaphwanya chakudya mu duodenum. Komabe, chifukwa cha zochitika zina, kutulutsa kwa ma enzymes kumeneku sikungachitike. Ambiri aiwo amadziunjikira tiziwalo ta kapamba, ndichifukwa chake zinthu zomwe zimapangitsa kuti ma enzymes omwe amapangidwira chakudya azikhala ndi vuto lanyumba.

Komabe, zida zoteteza thupi, zomwe zimalepheretsa kuti zopangidwa kuchokera ku chiwonongeko cha minyewa yake zisalowe m'magazi, zimayambitsa kuchuluka kwa minofu yolumikizira yomwe imagwira ntchito ngati chotchinga. Pseudocysts mawonekedwe. The pachimake kapamba, kuchuluka kwa pseudocystic mitundu kumawonjezeka. Popita nthawi, kuchuluka kwa mapangidwe otere kumakula ndikupangitsa kuti pakhale kupangika komanso kuchuluka kwa kapamba.

Inde, ntchito zoteteza thupi zimathandizira kuti zinthu zapoizoni sizilowe m'magazi, potero amateteza wodwala ku zowawa. Komabe, kusowa kwa chithandizo choyenera kumatsogolera ku chakuti kuphatikizika kwa mapangidwe amkati kumabweretsa kusintha kwakukulu kwa hypertrophic mu gland ndikusokoneza kwa ziwalo zapafupi, monga duodenum, bile ducts, portal and splenic.

Poizoni komanso kagayidwe kachakudya matenda

Lingaliraninso njira ina yothandizira matendawa, chifukwa, nthawi zambiri, chifukwa cha pseudotumor pancreatitis ndimagwiridwe anthawi zambiri a mowa komanso kugwiritsa ntchito mankhwala kwa nthawi yayitali (acetaminophen, estrogens). Ethanol yomwe ili ndi zakumwa zoledzeretsa zimabweretsa kuchuluka kwakukulu kwamapuloteni a protein a madzi a pancreatic.

Free radicals wopangidwa pakugawikana kwa zinthu zapoizoni imathandizira njira yotsatsira calcium calciumate m'thupi. Izi zimapangitsa kuti pakhale miyala yomwe imasokoneza kutuluka kwa michere ndi zilonda zam'makoma a epithelial.

Njira ya chitukuko ndi njira zochizira pseudotumor pancreatitis

Mavuto omwe amagwira ntchito kapamba ndizosiyanasiyana, amodzi mwa iwo ndi pseudotumor pancreatitis.

Iye ndi amodzi mwa zilonda zowopsa zamapazi, chifukwa cha zomwe wodwalayo amatha kufa.

Chifukwa chake, muyenera kudziwa kuti ndi chiyani, momwe matendawa amasiyanirana ndi kapamba wamba komanso chifukwa chake zimakhalapo.

Zizindikiro zamatsenga

Zizindikiro zazikulu za matenda ndi:

kufooka
kutopa,
kusowa tulo
kusakhazikika
kupweteka kwanthawi zonse komanso kwanthawi yayitali
zosokoneza mu ntchito ya dyspeptic system,
nseru
kusanza
kuchepa kwamtima
Kuchepetsa kwambiri thupi
chilonda, khungu la khungu.

kuchokera kwa Dr. Malysheva:

Mtundu wamtunduwu wa kapamba amadziwika ndi chitukuko chochepa. Nthawi zina njirayi imatha kupitirira zaka 10. Kuzindikira koyenera kumakhala kovuta chifukwa zizindikiro za matendawa ndizofanana ndiwonetsero wa matenda ena, ndipo kusintha kwakukulu pamapangidwe ndi mawonekedwe a kapamba sikuwonekere mwachangu.

Ndizowerengeka izi zomwe zitha kukayikiridwa ndi zosintha monga:

kukhalapo kwa nyemba zosasiyanasiyana (zotumphukira),
kukulitsa mutu
kuyanʻanila mu exocrine magwiridwe antchito a kapamba.

Ndizosatheka kuzindikira izi nokha, chifukwa izi zimafunikira chidziwitso kapena njira zapadera zodziwonera.

Njira Zodziwitsira

Phunziro pang'onopang'ono limafunikira kuti zitsimikizireni matendawo.

Mulinso:

Kuyesedwa kwa magazi konse, mkodzo, ndowe. Ndi pseudotumor syndrome, mulingo wa leukocytes ndi ESR m'magazi umakwera. Mkodzo umakhala ndi bilirubin wambiri ndi alpha-amylase pakalibe urobilin. Kusanthula ndowe kumakuthandizani kuti mupeze zonyansa zam'mimba.
Ultrasound Ultrasound yamimba yam'mimba imawonetsa kuchuluka kwa kapamba. Komanso, kuphunzira koteroko kumathandizira kuphunzira momwe zilili ma pancreatic ducts.
Kuyesa kwamwazi wamagazi. Kukhalapo kwa pseudotumorous mawonekedwe a kapamba amasonyezedwa ndi kuchuluka kwa trypsin, lipase, sialic acid, bilirubin m'magazi.
Roentgenography
CT scan (MRI).Chifukwa cha njirazi, mutha kuwunikira momwe chiwalochi chilili komanso kudziwa mwayi wokhala ndi carcinomas.
Kuwerenga kwa ma pancreatic ducts ogwiritsira ntchito endoscopy.
Kufufuza kwakale. Ndikofunikira kuti tilekanitse mawonekedwe amtunduwu wa kapamba ndi khansa ya kapamba.

Ngati ndi kotheka, dokotala atha kukulemberani njira zina: kusanthula magazi, kuyesa kwa cerulin, cholecystography.

Chiwonetsero cha matenda osachiritsika opezeka pancreatitis: a) virsungolithiasis, b) kukulitsa kwa Virsungianov duct

Kupewa komanso kudwala

Ndi chithandizo choyenera komanso chapanthawi yake cha pseudotumor pancreatitis, matendawa ndi abwino. Wodwala amatha kukhala ndi moyo wabwinobwino, malinga ndi chidwi chake popewa kupewa.

Kukana zizolowezi zoipa (uchidakwa, kusuta).
Kumwa mankhwala okhazikitsidwa ndi dokotala.
Munthawi yake chithandizo cha matenda opatsirana, mavuto mu ndulu.
Zakudya zoyenera.

Kutsatira malangizowa kukuthandizira kupewa kuyambiranso matendawa komanso kukulitsa zovuta. Mukanyalanyaza malamulowo, matendawa atha kukulanso.

Kuphatikiza apo, ikhoza kujowina:

msempha
matenda ashuga
peritonitis
jaundice
Kupangidwa kwa ma cysts atsopano,
kusokonekera kwa ma cysts kukhala chotupa chowopsa.

Pseudotumor pancreatitis ndi njira yoopsa, yodzala ndi vuto la khansa. Chifukwa chake, ndikofunikira kuti muzitha kuzindikira nthawi yake ndikupeza chithandizo.

Adalimbikitsa Zolemba Zina Zogwirizana

Chifukwa chiyani pseudotumor pancreatitis imachitika?

Kutupa kwa kapamba wamankhwala osachiritsika kumatha kuchitika chifukwa cha zinthu zambiri - provocateurs.

Ayenera kuwonedwa mwatsatanetsatane:

Mosachiritsika kapena mosayenera mankhwala a pancreatitis pachimake, omwe pang'onopang'ono amasintha kukhala osapweteka.
Ma pathologies omwe akupezeka a ndulu.
Kukonda komanso kumwa mowa kwambiri.
Kukula kwa matenda opatsirana m'thupi.
Matenda a autoimmune.
Makina kuwonongeka kwa chiwalo.
Maonekedwe a kapamba wa cysts kapena zotupa za mtundu wina.

Kuphatikiza pa zifukwa izi, kukulira kwa pseudotumor pancreatitis kumakhudzidwa ndikunyalanyaza malamulo azakudya ndi cholowa chochepa - kukhalapo kwa mavuto a pancreatic m'modzi mwa abale.

Zakhala zikutsimikiziridwa kuti pseudotumor pancreatitis nthawi zambiri imakhala yolimba mwa odwala omwe amasuta.

Kodi matendawa amawonekera bwanji?

Pseudotumor pancreatitis imatha kupanga kwa nthawi yayitali. Kukula kwa matendawa omwe amafunsidwa kuyambira pachiwopsezo cha pancreatitis kupita ku chithokomiro chamagulu chimatenga zaka 10 mpaka 18.

Nthawi zambiri, kupezeka kozindikirika kumatha kutsimikiziridwa pokhapokha ngati wodwala am'peza kwa nthawi yayitali kuchokera ku dyskinesia, mawonekedwe a cholecystitis kapena matenda ena a chiwindi.

Monga tafotokozera pamwambapa, pseudotumor pancreatitis imadziwikanso ndendende ndi njira ya oncological ya kapamba, motero sizotheka kuzindikira nthawi yomweyo.

Chowonadi chakuti wodwalayo amatenga mawonekedwe a kapamba amasonyezedwa ndi zizindikiro zotsatirazi:

Magawo ammimba omwe amapezeka mu hypochondrium yamanzere.
Matenda a dyspeptic pafupipafupi: matenda otsegula m'mimba amasinthidwa ndi kudzimbidwa, ndipo madokotala sangathe kuyambitsa zomwe zimayambitsa izi.
Zizindikiro zakugaya chakudya.
Kusanza, limodzi ndi kusanza, komwe kumachitika mukangotha kudya.
Kuchepetsa kwambiri kulemera kwa thupi popanda chifukwa chomveka.
Kusintha khungu: khungu limayamba kutumbululuka.
Ululu womwe umabuka pakadutsa gawo la epigastric.
Pa palpation, dokotala amamva kuti mutu wa kapamba umakulitsidwa kwambiri.
Kusenda ndi khungu louma kwambiri, chifukwa munthu amayamba kuchepa thupi msanga.
Kutopa kochulukirapo ngakhale mutachita masewera olimbitsa thupi pang'ono.
Kusowa tulo, kuda nkhawa komanso kugona tulo.
Mwadzidzidzi komanso mosinthasintha.

Ngati chizindikiro ichi chikuchitika, muyenera kupangana nthawi yomweyo ndi katswiri.

Ndikofunika kukumbukira kuti ndi dokotala wokhazikika amene amatha kudziwa bwino za mankhwalawa ndikupereka chithandizo chanthawi yake komanso chokwanira, chomwe chithandizira.

Momwe mungadziwire matenda oyenera

Chomwe chimawunikira wodwala ndikuwazindikira pang'ono. Pazifukwa izi, madokotala amachita zinthu zotsatirazi:

Kuyesa: ndowe, magazi, mkodzo. Kuchita kafukufuku wawo wothandiza.
Ultrasound kuwunika kwamkati ziwalo.
Kuphatikiza kwamwazi.
Kuchita radiology.
MRI ndi CT.
Phunziro la pancreatic duct ndi endoscopy.
Mbiri - njira yomwe imakupatsani mwayi wophunzirira womwe umathandizira kusiyanitsa kapamba wa pseudotumor ndi khansa ya mutu wa kapamba.

Popanda izi zonse zowunikira ndi kafukufukuyu, ndizosatheka kukhazikitsa kuzindikira koyenera.

Zomwe zimawoneka m'mayeso a labotale

Munthu amene ali ndi matenda omwe akufunsidwa, zizindikiro zotsatirazi zikupezeka m'magazi:

Kuwonjezeka kwa ESR.
Chiwerengero chachikulu cha maselo oyera oyera.
Kuchuluka kwa bilirubin, lipase, sialic acid ndi trypsin.

Mu mkodzo, bilirubin idzakulanso, koma palibe urobilin. Kuphatikiza apo, pali kuwonjezeka kwa alpha - amylase. Mwa ndowe, mutha kudziwa momwe chimbudzi chawonongeka.

Ultrasound ya ziwalo zamkati

Pogwiritsa ntchito ma diagnostics a pamimba pamimba, dokotala amatha kudziwa ngati kukulira kwa chiwalo kumachitika, ngati phokoso lochokera ku chiwalo cholandiracho limalandiridwanso mosiyanasiyana, momwe kapamba amakhalira, ngati pali kufupika kwa ma ducts kapena ngati kutsekeka kwathunthu.

Kuti aphunzire matendawa mwatsatanetsatane ndikuwasiyanitsa kuchokera ku oncology munthawi yake, akatswiri odziwa bwino amafufuza kuwunika kwa mbiri yakale.

Zomwe MRI ikuwonetsa

Njira yomwe ikuwunikiridwa ndiyo njira yothandiza kwambiri yofufuzira, yomwe imapangitsa kuti athe kuganizira ziwalo za parenchymal. Pakusanthula kwa MRI, simakonda kutsimikizira kapena kutsutsa kukula kwa carcinoma.

Mukuchita MRI, madokotala amatha kuchita ERCP - njira yomwe imathandizira kuwunika ma pancreatic duct ndikumvetsetsa momwe zimakhudzidwira.

Kuphatikiza apo, akatswiri nthawi zambiri amapita kukawunika kwa angiographic zamatumbo a gland.

Njira za chithandizo cha matenda a mtima

Therapy a matenda amathandizira kuthetsa ululu, sinamizidwe njira ya kudzipatula kwa bile, ndi kulipirira kunja - intracretory kusakwanira.

Njira yochizira pseudotumor pancreatitis imaphatikizira njira yophatikizira. Ndi chifukwa cha mankhwalawa kuti chiphunzitso chabwino chitha kuchitika.

Ndikofunikira kudziwa kuti chithandizo chikuyenera kuchitika kuchipatala, motsogozedwa ndi dokotala.

Odwala ena amawopa kwambiri kuchitidwa opaleshoni kotero kuti ali okonzeka kumwa mapiritsi moyo wawo wonse.

Izi ndi zolakwika, chifukwa ngati zikufunika kuchitika, ndiye kuti osavula sizikulimbikitsidwa. Inde, nthawi zambiri kuti chikhululukiro chokwanira, chimachotsedwa m'chiwalo chomwe chakhudzidwa chofunikira.

Mankhwala

Kumwa mapiritsi ndi njira yowonjezera yamankhwala, chifukwa kwakanthawi kochepa kamachepetsa munthu wa zizindikiro, ndipo samalimbana ndi zomwe zimawoneka.

Monga chisonyezo chamankhwala, madokotala amapereka chithandizo ichi:

Spasmodic: No-shpa, Duspatalin, Spazmalgon.
Anticholinergics: Argoprin, Methyldiazil.
Zinthu za enzyme: Mezim, Pancreatin.
Maantacid: Phosphalugel, Maalox.
Mankhwala a antibacterial: Ampicillin.

Ngati ndalama zomwe zikukambidwazo sizipereka chiyembekezo chokwanira, madokotala amasankha kuchita chithandizocho: amachotsa kutentha kwa thupi kapena kuthandizira ndi laser.

Kuthandizira opaleshoni

Pofuna kuchiza matenda amtunduwu, mitundu iwiri ya ntchito ingagwiritsidwe ntchito. Izi ndi izi:

Kusangalatsa kwa minofu yomwe yakhudzidwa. Mtundu wa opaleshoni yamtunduwu umathetsa kupsinjika kwa Versungs ndi ma ducts wamba a bile. Pakukonzekera kwake, akatswiri amasanthula minofuyo mwambiriyakale. Pozindikira zizindikiro za oncological, madokotala amatembenukira ku pancreatoduodenal resection - njira yomwe imakhudza minofu ya duodenum, biliary kapena periopancreatic. Ngati mbiriyo ndi yoyera ndipo chotupa chovunda sichipezeka, mutuwo umatuluka ndipo ma cysts akulu amachotsedwa pamalopo.
Pancreatic duct drainage. Ndondomeko imakhala ndikuyambitsa machubu apadera a silicone mu chilonda, mothandizidwa ndi komwe kumatha kuchotsa madzimadzi ndi mafinya ku chiwalo chomwe chakhudzidwa. Drainage imayikidwa ndi m'mphepete mwa bala, ndipo m'mphepete mwake imatsitsidwa mumtsuko wapadera.

Chifukwa chakuti machubu ali pachilonda kwakanthawi, ayenera kutsukidwa nthawi ndi nthawi ndi mankhwala a antiseptic.

Zochita zoterezi zimathandiza kupewa kulowa muchilonda cha matenda omwe amapezeka chubu akakumana ndi mpweya.

Kukhetsa kwa ntchito kumapewetsa mavuto omwe angaphe. Izi ndichifukwa choti njirayi imawululira chotupa cham'mimba chodonthekera ndi kuyeretsa.

Ndi mtundu uti wa opareshoni omwe muyenera kusankhidwa - ndi madokotala okha omwe akuganiza. Izi zikutsatira m'baleyo poganizira za thanzi la anthu komanso kuchuluka kwa zamatsenga.

Mu zida zamankhwala amakono pali njira zambiri za endoscopic zomwe zikuyenera kupangika pakukulitsa kwambiri gland, kufinya njira ndikuwonetsa jaundice yovuta. Kuphatikiza apo, kutsimikiza kwa magawo a papillary ndi stenosis kungachitike chifukwa cha zomwe zikuwonetsa.

Zolemba zamankhwala azikhalidwe

Kuphatikiza pa njira zamankhwala izi, madokotala angalimbikitse kugwiritsa ntchito ndalama kuchokera kwa anthu. Izi zikuphatikizira decoctions zitsamba, tinctures osiyanasiyana ndi kulowetsedwa kwa mankhwala azomera.

Ma decoctions a chamomile ndi calendula, omwe amasiyana mu antibacterial ndi anti-kutupa, amachiritsa.

Maganizo abwino oyenera ndi kumwa tincture wa barberry.

Kuti muiphike, muyenera kukhala ndi magalamu 20 a zinthuzi zosaphika m'manja, muzithira ndi ma milliliters 200 a mowa ndikuziwulitsa kuti zitheka kwa milungu iwiri.

Tengani kulowetsedwa motere muyezo monga momwe adanenera.

Ndikotheka kuchotsa poizoni onse m'thupi ndikusintha magwiritsidwe a kapamba mothandizidwa ndi decoctions ndi kissels zopangidwa pamaziko a oats.

Ndalama zomwe zimaganiziridwa ziyenera kuledzera pafupifupi masiku 40, atakambirana ndi katswiri.

Mavuto a Pseudotumor Pancreatitis

Matendawa omwe amawaganizira, popanda chithandizo choyenera, amatha kupweteka komanso kuvuta. Muyenera kuwaphunzira mwatsatanetsatane:

Peritonitis
Jaundice
Magazi amafunikira m'mitsempha.
Ma cystic neoplasms.
Kutulutsa magazi mkati.
Chizindikiro.

Ngati matenda atapezeka munthawi yake ndipo chithandizo choyenera chimaperekedwa, ndiye kuti zovuta izi zitha kupewedwa pothandiza wodwala yemwe samva bwino.

Kupewa matenda

Pali njira zingapo zofunika zodzitetezera zomwe zingathandize kupewa pseudotumor mawonekedwe a kapamba. Izi ndi izi:

Kukana zizolowezi zoyipa zomwe zidalipo kale: kusuta, kumwa mowa, kugwiritsa ntchito mankhwala osokoneza bongo.
Unikani zakudya zanu.
Khama yogwira ntchito komanso maphunziro azolimbitsa thupi tsiku ndi tsiku.
Munthawi ya matenda a matenda: caries, otitis media ndi sinusitis.
Kupitiliza kuyendera kochita pachaka.

Madokotala ati mtundu uwu wa kapamba umapereka chidziwitso chabwino cha kuchira. Pathology nthawi zambiri imachulukitsa, imayamba pang'onopang'ono.

Koma apa tiyenera kudziwa kuti kuperewera kwa endocrine kungayambitse nephropathy ndi angiopathy.

Chofunikira kwambiri ndikuyankha mokwanira pazomwe thupi lanu limachita, osanyalanyaza zizindikiro zosokoneza ndikusaka thandizo la kuchipatala munthawi yake.

Zonse Pseudotumor Pancreatitis - Wowononga Pancreatic Wowononga

Pseudotumor pancreatitis - ndi chiyani? Amatchedwa matenda opatsirana a kapamba (omwe amatchedwa kuti kapamba), omwe ndi amodzi mwa maumbidwe a kutupa kwa kapamba. Chiwalo chimakula kukula, minofu yoyandikana imakakamizidwa. Zizindikiro zazikulu zamankhwala ndizopweteka, jaundice yolepheretsa, kusokonezeka kwa mahomoni, dyspepsia.

Kodi zamatenda ndi chiyani?

Pseudotumor pancreatitis ndi mtundu wina wodwala wopatsirana womwe umayambitsa kupumira. Sizimasiyanitsidwa mwa mtundu wina. Hypertrophy ya parenchyma ndi fibrosis zimadziwika.

Fibrosis ndi m'malo mwa limba yogwira ntchito minofu yolumikizana ndi minofu yolumikizidwa. Zomwe zimasinthidwa ziwalo sizitha kugwira bwino ntchito zawo, chifukwa, polankhula, zimakhala zipsera. Izi zimachitika nthawi yomwe thupi limayenera kudzipatula kuti liwuluke kuchokera kuzinthu zosakhudzidwa ndi magazi.

Mtundu wamtunduwu wa kapamba amadziwika ndi kuwonjezeka kwakukulu kwawoko mu gawo limodzi mwa magawo a kapamba. Chochitika chodziwika ndimapangidwe azisindikizo zam'deralo, motero, kusiyanasiyana kwa oncopathology kumachitika.

Odwala ambiri omwe ali ndi vuto lotupa la pseudotumorous ali ndi matenda opatsirana, matenda oopsa a portal, ndipo amathandizanso kumwa mowa mwauchidakwa.

Ngakhale zifukwa zingapo za kapangidwe ka kapamba ndizochulukirapo (kuchokera ku mawonekedwe a cystic kupita ku matenda ndi zotupa zam'mimba), mu 90% ya milandu, matendawa amakhumudwitsa ma biliary pathologies komanso kumwa mwauchidakwa kwamowa. Mavuto amtundu wa biliary amaphatikizapo cholelithiasis (apa - cholelithiasis) ndi zina zomwe zimayambitsa chiwindi ndi biliary thirakiti.

Nthawi zina zomwe zimapangitsa mawonekedwe a pseudotumor pancreatitis kukhala mankhwala ena, kufalikira kwa kutukusira kuchokera ku gallbladder kudzera mu lymphatic system, komanso kupezeka kwa ma concomitant functional and organic pathologies.

Amayambitsa pseudotumor pancreatitis

Ngakhale zifukwa zingapo za kapangidwe ka kapamba ndizochulukirapo (kuchokera ku mawonekedwe a cystic kupita ku matenda ndi zotupa zam'mimba), mu 90% ya milandu, matendawa amakhumudwitsa ma biliary pathologies komanso kumwa mwauchidakwa kwamowa. Mavuto amtundu wa biliary amaphatikizapo cholelithiasis (apa - cholelithiasis) ndi zina zomwe zimayambitsa chiwindi ndi biliary thirakiti.

50% ya milandu ya cholelithiasis ndiyomwe imayambitsa mitundu yotsalira ya pseudotumorous pancreatitis. Amapezeka kwambiri mwa akazi, komanso kuthekera kwa matendawa kutengera nthawi yayitali ya nthenda, komanso kukula, kapangidwe, malo a calculi.

Kukula kwa mankhwala omwe amadalira pseudotumor pancreatitis kumachitika chifukwa chogwiritsa ntchito nthawi yayitali ya paracetamol, estrogen-wokhala ndi mankhwala ena.

Kuchepa kwa matendawa kumawonjezeka pakati pa anthu omwe amakonda mowa komanso omwe amasuta fodya.

Tiona mwatsatanetsatane mtundu wa kapamba wa kapamba ndi chifukwa chake matendawa amayamba. Matendawa afotokozedwa popanda chifukwa, amakhala chifukwa cha ma pathologies angapo, omwe amaphatikizapo:

Aakulu mawonekedwe a kapamba.
Matenda a gallbladder.
Matenda ena opatsirana.
Matenda a autoimmune.
Makina ovulala a kapamba.
Ma tumor ndi cysts pa kapamba.

Nthawi zambiri, kukula kwa matendawa kumachitika chifukwa cha kusowa kwa mankhwala a chifuwa chachikulu, osagwirizana ndi zakudya zomwe zimayikidwa, makamaka, zizolowezi zoyipa - kusuta fodya komanso mowa. Chinthu chobadwa nacho chimawonekera.

Amakhulupirira kuti amuna azaka zapakatikati omwe amamwa mowa wambiri ali pachiwopsezo.

Oposa theka la milandu imayamba chifukwa chomwa mowa kwambiri komanso kupezeka kwa matenda a chiwindi kapena ma ducts a bile. Nthawi yomweyo, kusuta kumakulitsa machitidwe owopsa, ndikupititsa patsogolo chitukuko chawo.

Palinso milandu yodziwika pamene matendawa akuwonekera chifukwa cha kuchuluka kwa mankhwala omwe amaphwanya machitidwe a m'mimba.

Malinga ndi ziwerengero, theka la ovuta kwambiri kapamba amakhumudwa chifukwa chomwa mowa mwauchidakwa. Odwala ena okhala ndi matenda am'mimba komanso popanda chithandizo cha panthawi yake, matendawa amatha kusintha mosavuta. Kafukufuku wina amatsimikizira kuchuluka kwa kusuta pakuwonjezera ngozi za pulogalamu yayitali.

The pseudotumor mawonekedwe a kapamba nthawi zambiri kumachitika motsutsana maziko a chiwindi, ndulu chindoko ndi biliary thirakiti. Kuphwanya kutulutsa kwa bile kumapangitsa kuti pakhale matendawa komanso kupita patsogolo kwa kutupa, kufunikira kwake komwe kumatengera nthawi yayitali chifukwa cha matenda, kukula ndi kutulutsa kwa calculi m'mizere.

Nthawi zina, njira yodutsitsa m'mitsempha ya m'mimba imatha. Anthu omwe ali ndi vuto la parasitic, lomwe limayambitsa matenda osachiritsika, omwe ali ndi cholecystitis, matenda kudzera m'mitsempha yama minyewa ndi ma cell amalowa m'mutu ndikuwakwiyitsa kuyambika kwa matenda.

Kumwa mankhwala ena kungayambitsenso kapamba. Kugwiritsidwa ntchito kwa nthawi yayitali kwa acetaminophen ndi estrogen kumathandizira kuti kukula kwa bile.

Fomu ya pseudotumor ili ndi dzina lake chifukwa chofanana ndi ma morphology a gland omwe akhudzidwa ndi chotupa neoplasms. Kuphatikiza pa parenchyma hypertrophy, kutupa kumachitika, komwe, pakapita nthawi yayitali, kumapangitsa kukula kwa zingwe zopota ndi ma fibrosis. Kusintha koteroko pakapangidwe ka minofu kumabweretsa kufinya kwa ma pancreatic ducts ndikusokonekera kwa chinsinsi.

Kuphwanya kwa ethanol poyipa, mavuto obwera chifukwa cha mankhwala osokoneza bongo komanso kuledzera motsutsana ndi moyo wokonzekera wa bakiteriya womwe umayambitsa kutupa, kumabweretsa kukula kwa msuzi wa pancreatic chifukwa cha kuchuluka kwa protein mu kapangidwe kake. Mothandizidwa ndi zinthu zoipa, kukhazikika kwa calcium carbonate precipitates.

Kutambalala kwa ma ducts kumabweretsa mawonekedwe a cystic protrusions. Kusokonezeka kwa kayendedwe ka magazi mu minofu kumayambitsa kukhazikitsidwa kwa kuwonongeka kwa ziwalo zam'mimba, zomwe zikutanthauza kusintha kwa matendawa ku matenda osachiritsika.

Pamodzi ndi izi, kuperewera kwa chakudya kwa okosijeni kumapangitsa kuti ma cell azitha kusintha. Zowonongeka zimawononga mawonekedwe a lipid a maselo ndipo, kwakukulu, zimalepheretsa kugwira ntchito kwa gland.

Zomwe zimayambitsa kukula kwa minofu ya kapamba ndizomwe zimayambitsa matenda a hepatobiliary system (hepatitis, cholecystitis, cholelithiasis, dyskinesia wa biliary) ndi uchidakwa.

Etiology ya pseudotumor pancreatitis

Kuchepa kwa njira mu gland kumayambitsa kuchepetsedwa kwa kukoka kwake kwakukulu ndikulepheretsa kukhetsa kwa ma enzymes ndi madzi kuchokera ku kapamba. Woopsa matendawa, chimbudzi chachikulu chimatsekedwa, chifukwa choti madzi a pancreatic ndi ma enzyme amatha kugaya ndikuphwanya ndulu yakeyo.

Zizindikiro ndi matendawa

Kafotokozedwe ka kapamba kumayendera limodzi ndi zizindikiro zingapo zosonyeza ma pathological omwe amapezeka mu kapamba ndi ziwalo zina zolumikizana. Odwala ali ndi zizindikiro zokhudzana ndi khansa. Tikulemba zizindikiro za pseudotumor pancreatitis.

Odwala amakhala ndi ululu wolimba wamkaka womwe umatha mutatha kudya zonunkhira, zakudya zamafuta kapena mowa, zimakulitsa usiku.
Odwala amakhala ndi mseru, kusanza mobwerezabwereza kumachitika, kumabweretsa mpumulo.
Kukula kwa m'mimba kumawonjezeka chifukwa cha mawonekedwe a neoplasms komanso kukula kwa kapamba mu kuchuluka.
Mavuto omwe amapezeka pafupipafupi amadziwika (kudzimbidwa amachotseredwa m'mimba).
Khungu la wodwala ndi azungu amaso ake amakhala ndi chikasu (chikuwonetsa kukula kwa jaundice).
Tinthu tating'onoting'ono timapezeka m'zimbudzi, zomwe zikusonyeza kuti palibe chimbudzi.
Odwala amachepetsa thupi, ndipo akuwonjezereka.
Paphwando pa nthawi ya palpation, adotolo adalemba chidindo kudera la mutu wa kapamba.

Zizindikiro zake za pseudotumor pancreatitis ndi ululu wolimba wamkamwa komanso kuchepa thupi mwadzidzidzi.

Chifukwa chokakamizika ndimisempha yothandiza ndi mutu wokulirapo, chithunzi cha chipere cha kupanda mphamvu kwa exocrine chikukula. Mofanananso ndi izi, njira ya pathological imatha kufalikira kuzilumba za Langerhans ndikupangitsa kuphwanya kwa endocrine ntchito. Mwambiri, zizindikiro zotsatirazi zimachitika:

kupweteka kosalekeza m'chigawo cha epigastric komanso hypochondrium yoyenera, yomwe nthawi zina imakhala ndi mawonekedwe a lamba ndipo imakulirakudya pambuyo pakudya zakudya zamafuta, komanso madzulo ndi usiku,
kusokonezeka kwa chopondapo, kudzimbidwa kapena kutsekula m'mimba,
Kusintha kwa ndowe,
Kutayika kwakanthawi ndikuwonetsa kulimbitsa thupi kwakanthawi kochepa,
kupezeka kwa nseru, kusanza,
chikasu pakhungu, mucous nembanemba, makamaka sclera,
mu mayeso a labotale, kuchepa kwamankhwala a insulin ndipo, chifukwa chake, kuwonjezeka kwa ndende ya magazi kumatha kupezeka.

Zizindikiro ndi kuwonetsa matendawa

Pa magawo oyamba, zizindikiro za matendawa zimachotsedwa. Pamene endo- ndi procrine pancreatic insufficiency kukula, imayamba:

chotupa choteteza
kupweteka kwa epigastrium, chikhalidwe ndi kukula kwake komwe kumasiyana,
mawonetseredwe a endocrine kuchepa - kusokonekera kwa shuga kulolera komanso kukula kwa nephropathy, ketoacidosis,
mawonetseredwe a exocrine akusowa - vuto la dyspeptic: kudzimbidwa, mseru komanso kusanza, kutsegula m'mimba.

Ndi mawonekedwe a pseudotumorous, kupweteka kwa epigastric kumachitika mu gawo limodzi mwa magawo atatu a odwala, ngakhale kwa mitundu ina ya kapamba ululu wammbuyo ndi pathognomonic.

Zizindikiro zazikulu za matenda ndi:

kufooka
kutopa,
kusowa tulo
kusakhazikika
kupweteka kwanthawi zonse komanso kwanthawi yayitali
zosokoneza mu ntchito ya dyspeptic system,
nseru
kusanza
kuchepa kwamtima
Kuchepetsa kwambiri thupi
chilonda, khungu la khungu.

Ndizowerengeka izi zomwe zitha kukayikiridwa ndi zosintha monga:

kukhalapo kwa nyemba zosasiyanasiyana (zotumphukira),
kukulitsa mutu
kuyanʻanila mu exocrine magwiridwe antchito a kapamba.

Ndizosatheka kuzindikira izi nokha, chifukwa izi zimafunikira chidziwitso kapena njira zapadera zodziwonera.

Kuwonetsedwa kwa matendawa kumalumikizidwa ndi kuperewera kwa pancreatic enzyme, kusokonezeka kwa endocrine, kuponderezedwa kwam'mimba. Pakati pazizindikiro za matendawa, odwala amawona mtundu wotchulidwa ululu.

Kumayambiriro kwenikweni kwamatenda am'mimba, palibe chizindikiro cha matendawa, patapita nthawi wodwalayo amakhala ndi vuto la chodwala, kuperewera kwa chakudya chosagwiritsidwa ntchito mu ndowe, mseru ndi kusanza, kutsekula m'mimba, kusinthana ndi kudzimbidwa, komanso kuchepa kwa kukana kwa glucose.

Kuphatikiza apo, madokotala amalimbikitsa kuti azisamalira zomwe akumva atamwa mowa kapena kudya zakudya zamafuta, omwe ali ndi mavuto ndi ziphuphu, kupweteka kumachitika kawirikawiri.

Zizindikiro zina ndi:

Kuchepetsa thupi popanda chifukwa
kukulitsa ziwalo
mutu wopangidwa ndi England.

Kutupa kumakhudza mutu wa kapamba, kuchepa kwa kapondedwe, kutsika kwa madzi, kuchuluka kwa ziwalo ndikuwonjezeka. M'matendawa akamakula, kudzimbidwa kwa minyewa ya minyewa yake kumachitika, zimachitika motsutsana ndi maziko akumva kupweteka kwambiri.

Mu makina a chitukuko cha jaundice, gawo lalikulu limapatsidwa kuwonjezeka kwa mutu wa chiwalo, chomwe chimakakamiza bile duct. Zotsatira zake, kudzikundikira kwa bile sikungatuluke mu duodenum, kukakamizidwa kumawonjezeka, bile limayamba kulowa m'magazi.

Pseudotumor pancreatitis amadziwika ndi matenda opweteka kwambiri. Makamaka m'dera la navel komanso pansi pa nthiti. Wodwala aliyense amakhala ndi vuto logaya chakudya (kutsegula m'mimba ndi kudzimbidwa, nthawi zambiri amasintha). Nthawi zambiri, kutsutsana ndi maziko onse, nseru imamveka, nthawi zina, kusanza.

Ndi nthawi yayitali ya matendawa, thupi limachepetsa msanga chifukwa chosowa michere mthupi, chikasu cha pakhungu, kuwonongeka kwa mkhalidwe wa tsitsi ndi misomali. Mukakhala ndowe, mutha kuzindikira zakudya zomwe thupi silinazigaya.

Odwala ena amadwala matenda a shuga mellitus motsutsana ndi mtundu wa matenda amtunduwu.

Kuzindikira kwa pseudotumor pancreatitis kumachitika ndikuwunika kwathunthu. Makina a ultrasound amawonetsa zikondamoyo zokulirapo ndi chotupa m'mutu mwake. A urinalysis awulula kuwonjezeka kwa amylase ndi kukhalapo kwa bilirubin. Kuyesedwa kwa magazi - kuchuluka kwa amylase, maselo oyera, trypsin, bilirubin, komanso kuthamanga kwa ESR.

Pancreatography idzaonetsetsetsetsa kwa kutsekeka kwakukulu kwa ndulu. Kuunika kwa endoscopic kumapereka mpata wofufuza mayendedwe akuluakulu a zodutsitsa ndi ndulu za bile kuti muwone kukula kapena kutulutsa kwawo. Kusanthula kwa X-ray kudzakhazikitsa kupezeka kwa zowerengera komanso malo okumbikakumbika kwa gland, kukula kwake.

Njira za anthu

Zithandizo za anthu zimatchuka kwambiri. Ayenera kutumizidwa pokhapokha atakumana ndi dokotala. Ndi pancreatitis, mankhwala azitsamba ndi decoctions amagwiritsidwa ntchito.

Masamba a Birch, muzu wa barberry, burdck ndi nettle amasakanikirana m'malo olingana. Mutha kuwonjezera calendula ndi wort wa St. Supuni zochepa za osakaniza zimathiridwa ndi 0,5 malita a madzi otentha ndikuloledwa kupatsa kwa tsiku limodzi. Decoction ya 50-100 ml imatengedwa musanadye.

Mawonekedwe Amphamvu

Pamankhwala ovuta, madokotala amalimbikitsa kusintha kadyedwe. Ubwino umaperekedwa ku zinthu zamapuloteni ndi mbewu zina zosiyanasiyana. Siphatikiza zakudya zokazinga, zamafuta ndi zonunkhira, sodas zotsekemera, khofi wamphamvu ndi tiyi. Madzi amchere ochepa okha omwe amakhala ndi mchere wochepa wololedwa. Mu nthawi yowonjezera nthawi zambiri amayenera kusiyiratu chakudya. Pofuna kudya michere, ma dontho amaikidwa.

Zakudya zoterezi zimathandizira kuti matendawa asamachepetse komanso kuti muchepetse kuchira.

Kuphatikiza apo, ndikofunikira kumwa mankhwala omwe amachepetsa ma spasms ndikubwezeretsanso michere ya pancreatic. Amasankhidwa ndi madokotala payekhapayekha.

Pseudotumor pancreatitis imakhudza kwambiri kapamba. Sitha kubwezeretsanso ngakhale ndi chithandizo chakuchita opareshoni. Ndikofunikira kutsatira zakudya nthawi zonse ndikusiya mowa uliwonse. M'pofunikanso kulembetsa ndi katswiri ndipo mumakhala mumayeserera pafupipafupi (osachepera 2 pachaka). Chithandizo chanthawi yake ndi dokotala wamano ndi ENT zimathandizira kupewa kuwonongeka kwa m'mimba.

Kutembenukira kwa akatswiri atangotsala pang'ono kuwonekera kwa zizindikiro zamankhwala oyenera kumathandiza kupewa zovuta ndikukulitsa kuchotsedwa kwa matendawa.

Kuzindikira za mtundu uwu wa kapamba nthawi zambiri kumayambitsa zovuta zina. Madokotala amayenera kusiyira panjira ya oncological, kupenda mozama maupangidwe ndi chiwindi, ma ducts a bile. Odwala ambiri omwe ali ndi mankhwalawa sathanidwe moyenera komanso kuthandizidwa ngati odwala matendawa, papillitis, kapena amawona ngati mawonetseredwe a mowa.

Gawo lazomwe limapereka lingaliro lazoyenera limapereka kufunsa koyenera. Mukamakambirana ndi wodwalayo, gastroenterologist amatha kudziwa kukhalapo kwa wodandaula, komanso kumamuyesa m'mimba. Zowawa zam'malo zimadziwika mdera lamutu wamutu, ndikulimba kwakuya, kukula kwake kwa chiwalocho kumakopa chidwi.

Kuti mupeze matenda olondola, mndandanda wowonjezera wamaphunziro umayikidwa:

kuyesa kwamwazi wamagazi,
kutsimikiza ndende ya pancreatic michere,
secretin-pancreasimine ndi bentiramine mayeso,
cholecystography
esophagogastroduodenoscopy,
kusanthula ndowe ndi mkodzo,
Ultrasound yam'mimba ndikutulutsa malo
MRI ndi CT
kubwezeretsa kapamba,
biopsy ndi histological kuwunika kwa tiziwalo totsekanira kupatula chotupa.

Zofunika! Kungowunika kwathunthu kwathunthu ndi komwe kungapereke chithunzi chonse cha ziwalo zamkati. Kuchita njira iliyonse yodziwira patokha ndi ena sikumakulolani kuti mufufuze mozama ndikupeza kuti ndi gastritis kapena cholecystitis, kapamba kapena khansa yam'mimba.

Monga lamulo, kuchulukitsa kwa kapamba, milingo ya trypsin, lipase ndi magazi amylase imachulukitsidwa.

Pafupifupi odwala onse omwe ali ndi matendawa amalekerera glucose, omwe amatsimikiziridwa pamimba yopanda kanthu komanso pambuyo pa carbohydrate yambiri.

Kuphatikiza apo, ngati pakukayikira pakukayikira, milingo yamagazi yotupa ndi ma pancreatic polypeptide amatsimikiza.

Ultrasound yam'mimba

Njira yodziwira matenda opatsirana pamimba ndi ultrasound. Imanenanso mwatsatanetsatane za kukula kwa ziwalozo, mkhalidwe wa parenchyma ndi ducts zazikulu, komanso zimapangitsa kuzindikira miyala.

MRI ndiyo njira yophunzitsira yofunikira kwambiri yowunika minofu yofewa. Kuchita kafukufukuyu kumathetsa kukhalapo kwa volumetric form okhala ndi ziwopsezo zakupanda.

Ngati mukukayikira mawonekedwe a pseudotumor a pancreatitis aakulu, ndikofunikira kuyambitsa matenda osiyanasiyana ndi chotupa chenicheni - khansa ya kapamba (adenocarcinoma), yomwe mu 80% yamilandu imakhudza mutu wa chiwalo.

Pachifukwa ichi, kuyang'ana kwakumaso kwa kapamba kumachitika ndi kuwunika kwa asayansi omwe adapezeka m'deralo. Ngati maselo atypical (chotupa) apezeka, wodwalayo amapezeka ndi khansa.

Komabe, khansa yopanda khansa mu 56% yokha ya milandu imawulula ma cell atypical, ndipo mwa 12% ya odwala omwe amapezeka ndi pseudotumor pancreatitis, khansa ya kapamba imapezeka (malinga ndi ofufuza achi Germany).Chifukwa chake, mukakhazikitsa matenda pamavuto okayikira, njira zambiri zimawerengedwa.

Zaka ndizocheperako.
Amuna ndi akazi - amuna amakhala ovuta kwambiri.
Mowa.
An anamnesis matendawa kwa chaka chimodzi ndi theka.
Kuchepetsa kwambiri thupi (makilogalamu oposa 10).
M'mimba ululu syndrome.
Jaundice osaposa 20% ya odwala ndiwokhazikika munyama, ndi kuwonjezeka kwapadera kwa bilirubin.
Ultrasound ndi CT scan zikuwonetsa kuchepa kwa echogenicity ya mutu wa gland pafupifupi 18% ya milandu.

Kodi pseudotumor mtundu kapamba amathandizidwa bwanji

Munthawi zowonjezera, kulandira kuchipatala kuchipatala, mu dipatimenti ya gastroenterological kumafunika. Kuchiza kumaphatikizapo:

Kuthetsa zoyambitsa zomwe zidakwiyitsa chitukuko cha matendawa. Izi zitha kukhala chithandizo cha matenda a ndulu.
Zakudya zamankhwala. Matenda amtundu uliwonse wa kapamba amafunikira kudya mosamalitsa. Tebulo logawidwa 5.
Mankhwala. Ntchito yayikulu ndikubwezera mavuto a exo- ndi endocrine. Mankhwala othandizirana ofunika, maantacid, Ca.
Ndi mawonetsedwe a dyskinetic, ndikofunikira kupangira mankhwala a anticholinergic.
Ma antispasmodics amachepetsa ululu.

Nthawi zina njira za endoscopic zitha kuwonetsedwa, zomwe zimawonetsa kukula kwa gawo la chiwalo, zomwe zimatsogolera kufinya kwa duct ya bile.

Kuthetsa pseudotumor pancreatitis, zovuta ndizofunikira, zomwe zimaphatikizapo njira zingapo:

Kuwonetsedwa kwa mankhwala osokoneza bongo. Chithandizo cha Conservative sichimaganiziridwa kuti ndi chothandiza pa matenda. Kugwiritsa ntchito mankhwala kulibe vuto lililonse, makamaka pamlingo wapamwamba wa matendawa. Iyenera kugwiritsidwa ntchito poyambira pseudotumor pancreatitis (ngati matendawa adapezeka kuti adapezeka kale). Komanso, mankhwalawa amathandizira kuchepetsa kuchepa kwa matenda. Nthawi zambiri amagwiritsidwa ntchito kukonzekera opareshoni. Mankhwala amachepetsa mphamvu, amakhala bwino, ndikupangitsa thupi kukhala losavuta kuchitidwa opareshoni. Ndi matenda awa, mankhwalawa ayenera kutumizidwa ndi katswiri potengera mawonekedwe a chithunzi cha chipatala. Nthawi zambiri amagwiritsa ntchito ma pinkillers ndi mankhwala omwe amathandizira kapamba.
Kuthandizira opaleshoni. Njirayi ndiyofunika kuthandizira. Pa nthawi ya opareshoni, zimakhala zokhala ndi thukuta lomwe limakulitsa, zomwe zimapangitsa kutsika kwa ziwalo zapafupi. Ndikofunikira kuyang'ananso mwachangu za minofuyi ndipo ngati maselo a khansa apezeka, kukonza malo owonongeka a kapamba. Ngati palibe maselo a khansa omwe amapezeka, ma cystic akuluakulu omwe amayenera kuchotsedwa ndikutsitsidwa mutu wa kapamba. Izi zimachepetsa kupanikizika kwa ma pancreatic ducts. Opaleshoni ndiye chithandizo chothandiza kwambiri, chifukwa kusintha kumabwera pafupifupi pambuyo pake. Ndikofunikira kwambiri kuzikonza mothandizidwa ndi mankhwala osokoneza bongo komanso wowerengeka azitsamba.
Kugwiritsa ntchito mankhwala wowerengeka. Njira zina zochiritsira nthawi zambiri zimagwiritsidwa ntchito, ngakhale ndizosatheka kukwaniritsa zotsatira zokha ndi chithandizo chawo. Koma kuphatikiza ndi njira zina zochiritsira, ndizothandiza kwambiri. Mwa mankhwala otchuka a wowerengeka azitsamba otchedwa decoctions a limela mankhwala. Amathandizanso kupukusa zochitika za kapamba, kuchepetsa ululu, kuyeretsa thupi, komanso kuchepetsa kutupa.
Zakudya zamankhwala. Zakudya zimachepetsa kukula kwa matendawa. Kuthana ndi zinthu zovulaza m'zakudya, ndizotheka kuchepetsa katundu pamimba. Komanso, kudya zakudya zopatsa thanzi kumakupatsanso mwayi woti uzitsanso zinthu zina zofunikira, kulimbitsa thupi. Ndi kuchulukitsa kwa matenda, nthawi zina kufa ndi njala, komwe kumayeretsa poizoni. Pambuyo pa opaleshoni, chithandizo chamankhwala chimathandizira kuchira mwachangu.

Mukamakonza zakudya za odwala oterowo, ndikofunikira kupatula izi:

Zakudyazo ziyenera kupangidwa kuchokera ku nyama ndi nsomba zamitundu yochepa yamafuta (makamaka mawonekedwe owiritsa), chimanga, mankhwala amkaka a skim. Masamba ndi zipatso musanagwiritse ntchito zimafunikira kutentha. Zakumwa zamphesa, zakumwa za zipatso, zamasamba azitsamba ndizoyenera monga zakumwa.

Matenda a pseudotumor pancreatitis amafunikira chithandizo chanthawi zonse kuchipatala. Mankhwala othandizira amagwiritsidwa ntchito, zomwe zimatengera chithunzi cha matenda ndi momwe wodwalayo alili.

Choyamba, odwala amapatsidwa zakudya zapadera. Gawo lofunikira ndikuchotsa zomwe zimayambitsa kukula kwa matendawa ndikuwunikira ntchito zachinsinsi za kapamba.

Mankhwala othandizira

Ngati pseudotumor pancreatitis adapezeka koyambirira, odwala amapatsidwa zakudya No. 5, zomwe zimachepetsa vutoli. Panthawi yovuta kwambiri, kusala kudya kumalimbikitsidwa masiku angapo oyambira, kenako kudya chakudya chochepa kumayambitsidwa pang'onopang'ono muzakudya za wodwala m'magawo ochepa. Kutsatira ndi tebulo la chithandizo ndikofunikira musanachite opareshoni.

Kuti athetse ululu wammbuyo, odwala amalembedwa antispasmodics (mwachitsanzo, No-shpa, Papaverine).
Kuvomerezedwa kwa mankhwala omwe amawongolera kupanga ma enzymes (pancreatin, amylase).
Pakuganiza kwa dokotala, antibacterial ndi mankhwala ena amawonjezeranso mankhwala.

M'magawo oyamba a matendawa, njira zodzisamalira zithandiza kupewa kulowererapo. Ngati pakufunika opaleshoni, pambuyo pa njirayo, dokotalayo amapereka mankhwala kuti athandize kugwira ntchito kwa kapamba komanso kuchepetsa mkhalidwe wa wodwalayo.

Tsoka ilo, nthawi zambiri, kuchiritsa kwa pseudotumor pancreatitis sikutheka popanda kuchitidwa opaleshoni kuti muchotse chotupa kapena gawo lomwe lakhudzidwa ndi kapamba, komanso kubwezeretsa danc ya pancreatic. Pa opaleshoniyo, ma cysts omwe atulukirawa amalekeka, gawo limodzi la maselo ochotsedwa amatengedwa kuti athe kuwunikira mwachidule m'nthawi yochepa. Ngati khansa yatsimikiziridwa, dokotalayo amasintha machitidwe ake.

Njira zoterezi zimathandizira madokotala kuti azitha kukhululuka, kuti asamangidwe kwina kwa ma pathologies ena - matenda a shuga komanso matenda a gallstone. Komabe, opareshoni sizitanthauza kuchira komaliza. Odwala amafunikira kuti azitsatira zakudya, kumwa mankhwala apadera ndi kukaonana ndi dokotala.

Pathology imadziwika ndi njira yonga mafunde, nthawi zambiri imachulukitsa boma ndikukhululukidwa. Chithandizo cha mankhwalawa chimayamba ndikukhazikitsidwa kwa tebulo la anthu odwala matenda ashuga No. 5 malinga ndi Pevzner, chakudyacho chimapereka chakudya chamagulu, chakudya chimawotchera, kuwiritsa kapena kuwotcha. Sizoletsedwa kudya zakudya zamafuta, komanso zokazinga, khofi wachilengedwe wamphamvu, tiyi, mkaka wonse ndi nkhumba.

Chithandizo chake ndikuchotseratu zomwe zimapangitsa, monga mowa, mankhwala oledzera, ndi maziko a matendawo. Mwachitsanzo, ngati matendawa akuphatikizidwa ndi cholelithiasis, cholecystectomy ndi njira zina zochizira zimasonyezedwa.

Mankhwala kukonza malinga ndi matenda a exocrine ndi intracecretory insuffence akulimbikitsidwa. Pazifukwa izi, pamafunika kukonzekera enzyme:

Ndikotheka kutsika steatorrhea ndimakonzedwe a calcium, maantacid, anticholinergics ayenera kumwedwa kuti athetse dyskinesias, Atropine imagwira ntchito motsutsana ndi ululu. Mankhwala abwino a antispasmodic ndi Gimekromon, Mebeverin.

Ndi kuchulukitsa kwa matendawa, mankhwala omwe akukakamizika azikhala antimicrobials, omwe amathandiza kupewa zovuta za matendawa, kuwonjezereka kwa zizindikiro.Momwe mankhwala othandizira samathandizira kuti matendawa azikula, kutupira komanso kusokonezeka kwa thupi kumapitilira, kuwonjezera apo, adotolo amalimbikitsa kuti wodwalayo athandizidwe.

Pambuyo pakuchita opaleshoni, odwala pseudotumor pancreatitis ayenera kukhalabe akuyang'aniridwa pafupipafupi, kukaonana ndi dokotala osachepera kawiri pachaka. Tanthauzo la exocrine pancreatic function, nthawi ndi nthawi ya ultrasound ya chiwalo imawonetsedwa.

Pancreatitis ya biliary etiology

Zolakwika pakukula kwa bile ducts zimatha kukhalanso zovulaza. Zikatero, pancreatitis imayamba chifukwa cha kupanikizika kwa ndulu mumtsinje wa pancreatic.

Pancreatitis ya etiology

Kukula kwa mankhwala omwe amadalira pseudotumor pancreatitis kumachitika chifukwa chogwiritsa ntchito nthawi yayitali ya paracetamol, estrogen-wokhala ndi mankhwala ena.

Kuchepa kwa matendawa kumawonjezeka pakati pa anthu omwe amakonda mowa komanso omwe amasuta fodya.

Pa magawo oyamba, zizindikiro za matendawa zimachotsedwa. Pamene endo- ndi procrine pancreatic insufficiency kukula, imayamba:

chotupa choteteza
kupweteka kwa epigastrium, chikhalidwe ndi kukula kwake komwe kumasiyana,
mawonetseredwe a endocrine kuchepa - kusokonekera kwa shuga kulolera komanso kukula kwa nephropathy, ketoacidosis,
mawonetseredwe a exocrine akusowa - vuto la dyspeptic: kudzimbidwa, mseru komanso kusanza, kutsegula m'mimba.

Ndi mawonekedwe a pseudotumorous, kupweteka kwa epigastric kumachitika mu gawo limodzi mwa magawo atatu a odwala, ngakhale kwa mitundu ina ya kapamba ululu wammbuyo ndi pathognomonic.

Kafukufuku wa Laborator

M'maphunziro a labotale, umboni wowoneka bwino wa kuwonongeka sikukupezeka nthawi zonse, makamaka magawo oyambira. Zosintha nthawi zambiri zimakhala zopanda phindu, kusanthula mwatsatanetsatane kumafunikira. Chofunika kwambiri ndi chiyani:

Kulekerera kwa shuga. Pamafunika kuzindikira mulingo wa zotupa kuti mupeze khansa yapachifwamba.
Munthawi yakusokonekera pakuwunika magazi (OAC) komanso kuwunika kwamkodzo (OAM), kuchuluka kwa amylase, lipase, ndi trypsin kumadziwika.
Mlingo wa pancreatic polypeptide - ndi kutupa kumachepa, ndi oncopathology imachuluka.

Nthawi zina, maphunziro ena omwe amafotokozera amafunsidwa.

Kufufuza kwazida

Kudzera kwa ultrasound pancreas, kusintha kwa maonekedwe parenchymal kuwululidwa, kuchuluka kwa kuchuluka kwa kapamba, chifukwa cha kupezeka kwa ma calcified kutsimikiza.

Pofuna kumveketsa bwino masinthidwewo komanso kupatula carcinoma, kulingalira kwamatsenga kumayikidwa. Kuti muwone ma ducts ndi kukhalapo kwa kusintha, retrograde cholangiopancreatography ndi mankhwala.

Nthawi zina angiography amachitika kuti apeze zowonjezera.

Munthawi zowonjezera, kulandira kuchipatala kuchipatala, mu dipatimenti ya gastroenterological kumafunika. Kuchiza kumaphatikizapo:

Kuthetsa zoyambitsa zomwe zidakwiyitsa chitukuko cha matendawa. Izi zitha kukhala chithandizo cha matenda a ndulu.
Zakudya zamankhwala. Matenda amtundu uliwonse wa kapamba amafunikira kudya mosamalitsa. Tebulo logawidwa 5.
Mankhwala. ntchitoyo ndi yobwezera zovuta za ex- ndi endocrine. Mankhwala othandizirana ofunika, maantacid, Ca.
Ndi mawonetsedwe a dyskinetic, ndikofunikira kupangira mankhwala a anticholinergic.
Ma antispasmodics amachepetsa ululu.

Nthawi zina njira za endoscopic zitha kuwonetsedwa, zomwe zimawonetsa kukula kwa gawo la chiwalo, zomwe zimatsogolera kufinya kwa duct ya bile.

Kuneneratu ndizabwino. Kuchulukitsa nthawi zambiri kumakhala koperewera. Zimayenda pang'onopang'ono. Kuphwanya shuga kulekerera nthawi zambiri kumabweretsa zovuta ngati mukuganiza bwino za momwe thupi lanu lilili.

Cholinga chopewa pseudotumor pancreatitis ndikukana kumwa kwadongosolo, kumwa kusankha kwa mankhwala (makamaka ngati kuli koopsa), komanso kuthandizira matenda ena omwe amathandizira kukulitsa kapamba.

Zotsatira Zakuchipatala

M'magazi, panthawi yophunzira labotale, mumapezeka:

kuchuluka kwa ESR,
kuchuluka kwa maselo oyera
Maphunziro a biochemical amawonetsa kuwonjezeka kwa bilirubin, lipase, trypsin ndi sialic acid.

Urinalysis ikuwonetsa kuchuluka kwa bilirubin, koma kusowa kwa urobilin, komanso kuchuluka kwa alpha-amylase. Kutengera pakuwunika kwa ndowe, malingaliro amafotokozedwa za kuphwanya kwa chimbudzi.

Pancreatic MRI

Kuzindikira kwa MRI ndi imodzi mwanjira zophunzitsira kwambiri pofotokozera za ziwalo za parenchymal. Pakusanthula kwa MRI kapena CT, kupezeka kwa matendawa kumatsimikiziridwa kapena kukhazikika pang'onopang'ono kwa mapangidwe a carcinoma kumatha.

Kuti tiwone ngati pali ma pancreatic ducts ndikuwunika kuwonongeka kwawo pa MRI, njira ya ERCP imachitidwa, ndipo nthawi zina, kafukufuku wa angiographic wamitsempha yamafinya amatha kupangika.

Chithandizo cha Conservative

Chithandizo cha mtundu uwu sichothandiza pantchito yamtunduwu. Kugwiritsa ntchito ma pinkiller ndi chiwonetsero chambiri, kugunda kwamantha panthawi yowonjezera ya matenda ndi kugwiritsa ntchito othandizira omwe amachititsa kuti chinsinsi cha gland chisaperekenso zotsatira zoyenera komanso samathandizira kusamutsa matendawa ku gawo la chikhululukiro chokhazikika.

Ngakhale, kuchita izi ndikofunikira kuti muchepetse kapamba pang'ono kuchitira opaleshoni yabwino.

Opaleshoni

Pa nthawi ya opareshoni, minyewa yapamwamba ya kapamba imapukusika, zomwe zimathandiza kuthetsa kupsinjika kuchokera ku ma densi a Wirsung ndi bile.

Tizilombo tosangalatsa tomwe timakhudzidwa timayesedwa nthawi yomweyo kuti tipeze mbiri.

Mlanduwo ukadzawunikidwa wowonetsa maselo a khansa ndiye kuti, osasokoneza ma opaleshoniyo, wodwalayo amapezeka ndi pancreatoduodenal excation ya zimakhala zomwe zakhudzidwa.

Ngati, pambuyo pa kufufuza kwa mbiriyakale, kukhalapo kwa maselo a khansa sikunapezeke, ndiye kuti wodwalayo amapita kumbuyo kwa mutu wa nduluyo ndikusiya mawonekedwe akulu kwambiri a cystic omwe ali ndi chidwi kwambiri pancreatic ducts.

Atachitapo opaleshoni yotere, matendawa nthawi yomweyo amakhala m'magawo olimbirana chikhululukiro.

Zithandizo za anthu

Zochizira kapamba, maphikidwe ochokera kwa ochiritsa amagwiritsidwanso ntchito. Kubwezeretsa mphamvu ya chiwalo chomwe chakhudzidwa, kuichirikiza panthawi yomwe chikhululukiro chimatha, monga kulowetsedwa ndi mankhwala kuchokera ku zitsamba zamankhwala, komanso ma tinctures ndi oatmeal jelly, omwe amathandiza osati kungofalitsa matenda

Njira imodzi yothandiza kwambiri ndi decoction yochokera ku calendula ndi chamomile, omwe ali ndi anti-yotupa komanso antibacterial. Musanagwiritse ntchito ndalama zilizonse kuchokera kwa ochiritsa, ndikofunikira kuonana ndi dokotala.

Zakudya ndi Kupewa

Pa mankhwala othandizira kudya, kutsata zakudya kumayikidwa ndi tebulo Na. 5, lomwe limapereka zosiyanitsidwa ndi zakudya zotsatirazi:

tiyi wamkulu ndi khofi, komanso mowa,
kuphika mkate ndi zokondweretsa zophika,
zakudya zamafuta
kabichi ndi nyemba,
zipatso zipatso ndi kukoma wowawasa.

Mitengo yamphesa ndi zipatso,
osati mafuta amitundu mitundu ndi nsomba yophika,
misuzi yosenda
Zopanda mkaka wopanda mafuta
pasitala ndi zakudya
compote, zakumwa za zipatso, zakumwa za tiyi ya zitsamba.

Zakudya zopatsa thanzi ziyenera kukhala kwa odwala kusintha kwakukulu m'moyo wonse, womwe umayenera kutsatira nthawi yonse yotsatira ya moyo. Mwanjira imeneyi ndi pomwe munthu angadalire kuchotsedwa kwakhazikika kwa matenda.

Kukana kwathunthu zizolowezi zoyipa mwa kumwa mowa ndi kusuta fodya kudzakhala njira yodalirika yopewererana ndikukula kwa matenda.

Kukula kwa machiritso ndi zovuta za matendawa

Chithandizo cha mankhwalawa cha matenda a pathology nthawi zambiri chimakhala ndi zotsatira zabwino, koma, ngakhale izi, njira yothetsera matenda okha iyenera kuyang'aniridwa ndi udindo wonse komanso zomwe dotolo limalandira ziyenera kuonedwa. Kupanda kutero, kupita patsogolo kwa mbiri yachipatala kungapangitse zovuta zotsatirazi:

jaundice
peritonitis
msempha
kuchuluka kwa zilonda zam'mimba,
kutaya kwamkati
zilonda.

Komanso mtundu wonyalanyaza wa pseudotumor pancreatitis ungayambitse matenda a shuga.

Zoyambitsa Pseudotumor Pancreatitis

Pafupipafupi, pseudotumor pancreatitis imakhala chotsatira cha kumwa mankhwala ena, matenda ena osakhazikika. Amakhulupirira kuti pseudotumor pancreatitis ya uchidakwa amayamba pambuyo povuta kwambiri mu 10% yokha yamilandu, pomwe zochitika za kuchulukitsa kwa kapamba zimapezeka kawirikawiri motsutsana ndi maziko a kutupa kosakhalitsa.

Zimatsimikiziridwa kuti kuthekera kwazovuta kumawonjezeka kwambiri kwa omwe amasuta.

Etiological zifukwa za biliary pancreatitis imaphatikizaponso kusagwirizana kwa biliary thirakiti, matenda a Vater papilla ndi wamba bile duct. The pathogenesis ya kapamba mu nkhaniyi amadziwika ndi kuphatikizika kosalekeza kwaukali ndulu mu pancreatic duct.

Makina ofunikira nawonso ndi zotupa zam'mimba za pancreatic, makamaka mutu wa kapamba, momwe kutupa kogwiritsa ntchito kuchokera ku ndulu kumafalikira limodzi ndi unyolo wa ma lymph node.

Chithunzi cha chipatala cha pseudotumor pancreatitis chimadziwika ndi predominance ya zizindikiro za kupindika kwa biliary thirakiti ndi mutu wokulirapo wa pancreatic, zizindikiro za kuperewera kwa endocrine, komanso dyspeptic ndi syndromes zopweteka.Nthawi zambiri, mtundu uwu wa matendawa umakhala wodwala kwambiri ndipo umatha kukhala asymptomatic m'magawo oyamba.

Kuwonetsera koyamba kumakhala nthawi yovuta. Ululu pamimba yapamwamba yamitundu ingapo imakhalanso ndi chikhalidwe, chomwe kwa nthawi yayitali chimangokhala chidandaulo chodandaula.

Pambuyo pake, endocrine (kulekerera pang'ono kwa chakudya chamagulu omwe amakhala ndi ketoacidosis, nephropathy) ndi exocrine insufficiency (dyspeptic syndrome ndi steatorrhea) kujowina.

Ngakhale kuti ululu ndi pathognomonic wa kapamba, ndi mawonekedwe a pseudotumor zimachitika mwa 30-40% ya odwala.

Zowawa nthawi zambiri zimatchulidwira mu epigastrium ndi hypochondrium yamanja, imachitika pambuyo chakudya chachikulu, makamaka mafuta, chimapitilira maola awiri kapena atatu.

Kudandaula kwa dyspeptic kumaphatikizapo mseru, kusanza, ndi kuchepa kwa thupi ndi kutsekula m'mimba komwe kumayenderana ndi kuchepa kwa enzyme komanso kugaya chakudya m'mimba.

Matenda a pseudotumor kapamba

Diagnosis ya pseudotumor pancreatitis imakhazikika pakuwunika kwa chipatala komanso kupatula kwa matenda ena am'mapapo ndi ziwalo zoyandikana, zomwe zimatha kuyambitsa zizindikiro zofanana, makamaka khansa ya mutu wapa pancreatic.

Kufunsira ndi gastroenterologist kumawulula zizindikiro zina: popeza mawonekedwe a pseudotumor pancreatitis ndi chiwalo chokulitsidwa, nthawi zambiri mutu wa kapamba umatha kupindika kudzera khoma lakunja kwam'mimba.

Mwa odwala ena, ululu wam'deralo umadziwika mukapukutira kapamba.

M'mayeso a labotale, palibe umboni wowonekeratu wa matendawa: pakhoza kukhala kuwonjezeka pang'ono kwa milingo ya trypsin, lipase, magazi ndi mkodzo amylase panthawi yowonjezera kapena panthawi yopweteka. Oposa 90% ya odwala pseudotumor pancreatitis, kulolerana kwa glucose kumayipa, komwe kumatsimikiziridwa ndi kusala magazi ndikumayambitsa shuga.

Odwala onse omwe akukayikira za matenda awa amawunika ma tumor markers (CA 19-9, CA 125, khansa ya embryonic antigen), yomwe imathetsa khansa ya pancreatic. Pazifukwa zomwezo, mulingo wa pancreatic polypeptide umatsimikiziridwa, womwe umachepetsedwa panthawi yotupa, ndikuwonjezeka panthawi yopweteka.

Njira yothandiza kwambiri yopezeka pseudotumor pancreatitis - ultrasound ya kapamba. Kafukufukuyu amakupatsani mwayi kuti muwone kuchuluka kwa kukulitsa kwa ziwalo, kusintha kwa mawonekedwe mu parenchyma ndi ma ducts, kukhalapo kapena kusowa kwa kuwerengera.

Kuti mumvetse bwino za kusintha ndikumapatula carcinoma yomwe ikukula pang'onopang'ono, tomography yophatikizidwa kapena MRI ya kapamba imachitika. Kuti muwone m'maso main pancreatic duct ndikumveketsa momwe masinthidwe ake, ERCP imachitidwa.

Nthawi zina, kuti mumvetse bwino za matendawa, angiography yamatumba achikondwerero (kusankha celiacography) imafunika.

Kuti muchepetse zochitika za dyskinetic za sphincter zida, cholinolytics ndi mankhwala. Matenda opweteka amayimitsidwa ndikutenga atropine, antispasmodics.

Njira yabwino yolimbana ndi sphincter ya Oddi ndi Gimecromon, mebeverin. Munthawi ya kukokomeza, mankhwala othandizira amakhalanso ndi mankhwala a antibacterial.

Ngati mankhwala osathandiza a gland edema ndi hypersecretion a michere, mankhwala a radiation yachigawo ndi hypothermia yakwanuko amagwiritsidwa ntchito.

Pseudotumor pancreatitis: zimayambitsa, zizindikiro

Zomwe zimatithandizira pakukula kwa matendawa ndi matenda a hepatobiliary system (mwachitsanzo, cholelithiasis) ndi kumwa kwa nthawi yayitali. Nthawi zambiri - kumwa mankhwala ndi matenda ena. Nthawi zambiri, pseudotumor pancreatitis ndi chifukwa cha matenda opatsirana a kapamba ndipo kawirikawiri (pafupifupi 10% ya milandu) amadziwika pambuyo pathupi.

Kukula kwa zizindikiro motsutsana ndi maziko a cholelithiasis nthawi zambiri amalembedwa mwa akazi. Komabe, sikuti zimatha kukhala zokhumudwitsa, kusokonezeka kwa machitidwe am'mabala, matenda a bile duct kapena Vater papilla ndi ofunika kwambiri pano. Milandu iyi, kutupa kumayamba chifukwa chogwiritsa ntchito bile nthawi zonse pancreatic duct.

Njira imodzi yothandizira kuphukira kwa pseudotumor pancreatitis imatha kukhala zowononga minyewa ya m'mimba (nthawi zambiri malo a mutu wa gland), pomwe njira yotupa imafalikira kuchokera ku ndulu kudzera mumitsempha yamagazi ya mitsempha.

Nthawi zina, mawonekedwe a pseudotumor a pancreatitis amatha kupezeka chifukwa cha kugwiritsidwa ntchito kwa nthawi yayitali kwa estrogens, acetaminophen ndi mankhwala ena, kapenanso kukhala cholowa. Kuphatikiza apo, ndi cholowa chamtundu, matendawa akupita patsogolo, mwayi wokhala ndi zilonda (zilonda) ukukula, ndipo kulephera kwa mitsempha kukuchulukirachulukira.

Mawonetseredwe azachipatala

Zizindikiro zamtunduwu wamatenda a kapamba zimagwirizanitsidwa ndi kupanikizika kwa biliary thirakiti, kuperewera kwa endocrine komanso kusowa kwa michere ya pancreatic yomwe ikuphatikizidwa ndi chimbudzi. Kuphatikiza apo, pakati pa mawonetseredwe azachipatala, pali zizindikiro za zotupa ndi kupweteka kwambiri. Gawo loyamba la mawonekedwe a pseudotumorous akhoza kukhala asymptomatic.

Koma nthawi zambiri, odwala amakhala ndi zizindikiro zotsatirazi:

chotupa choteteza
kupweteka m'chiuno komwe kumachitika mutatha kudya zokometsera kapena zamafuta, zakumwa zilizonse kapena kudya kwambiri,

chakudya chosalowetsa ndowe,
nseru wotsatira kutsuka, komwe kumabweretsa mpumulo.
Fat stool (cholembera),
kutsegula m'mimba ndi kudzimbidwa,
kulekerera kwa shuga
kuwonda popanda chifukwa
pa palpation - mutu wopangidwa ndi kapamba,
kukulitsa gland.

Machitidwe a mawonekedwe a zizindikiro zazikulu

Ndi matenda ofotokozedwawo, kuwonjezereka kwa kapamba kumachitika, komwe kumalumikizidwa ndi kupezeka kwa cysts (pseudotumor pancreatitis, pancreatic cyst), kapangidwe ka lipomatosis ndi zotupa za autoimmune.

Njira yotupa, monga lamulo, imakhudza mutu wa kapamba - malo opumira a main pancreatic duct. Zotsatira zake, zomerazi zimacheperachepera, ndipo madzi amamba pancreatic amayenda m'golomo. Zotsatira zake, dontho limasefukira, ndipo kupanikizika kumakulira.Ma Enzymes omwe amapezeka mumadzimadzi amayamba kugaya minofu ya pancreatic, yomwe imayambitsa kupweteka kwakukulu, komwe nthawi zambiri kumayendera limodzi ndi mawonekedwe a pseudotumor pancreatitis.

Njira za Autoimmune monga chifukwa cha chitukuko cha matenda

Ndi kuphwanya kwa autoimmune, kusintha kwa ma pathological pakati ndi ma ducts akuluakulu amodzi nthawi zambiri kumawonedwa. Njira zotupa zomwe zikukula mwachangu zimayambitsa kulowerera kwa ma ducts awa, potero kudzaza njira ndi minofu yokulira ya epithelial. Nthawi zambiri amakhala ndi kapangidwe ka nyenyezi.

Njirayo ikafalikira m'matumba, minofu ya glandular, yomwe imagwira ntchito yoteteza, imataya zoteteza. Mutu wanyini wakula. Neoplasm imakakamiza duodenum, yomwe ingayambitse cholecystitis. Muzochitika zapamwamba, kuphwanya chiwindi ndikotheka.

Biliary pathology, monga chimodzi mwazomwe zimayambitsa matendawa

Kukhalapo kwa cholelithiasis ya chiwindi ndi biliary thirakiti ndi chimodzi mwazinthu zazikulu zoyambitsa mapangidwe a pseudotumor pancreatitis. Biliary pancreatitis, monga momwe ziwerengero zimasonyezera, nthawi zambiri amapezeka mwa azimayi. Nthawi ya matendawa ndi zotsatila zake zimatengera kutulutsa kwina. Zomwe zimayambitsa biliary pancreatitis ndizosabereka zamtundu wa biliary, kusintha kwa matenda mu Vater papillae ndi choledochus.

Bile, yomwe mwachilengedwe chake ndi wankhanza, imaponyedwa nthawi zonse mumadzi a pancreatic. Mitsempha yama minofu ya kapamba imakhudzidwa, makamaka mdera la mutu wa kapamba.

Zomwe zimayambitsa matendawa, chomwe chimatsogolera ku chiwonetsero cha zikondamoyo ndikuchezera kwadokotala. Kale magawo a kapamba kapena kupezeka kwa miyala, kusintha uku m'thupi sikungathe kunyalanyazidwa. Komanso, neoplasm sichimawoneka nthawi yayifupi. Ganizirani zizindikiro zazikulu za matendawa, zomwe ziyenera kukhala chifukwa chabwino chopita kwa dokotala.

Ndi pseudotumor pancreatitis chifukwa cha mutu wokulirapo wa pancreatic, kumverera kwaphokoso kumamveka. Ma dileke odulira amaponderezedwa. Komabe, chizindikiro ichi chimadziwonekera kale mu magawo omaliza a matendawa. Mu magawo oyamba, matendawa amatha kukhala asymptomatic.

Pambuyo pake, mutha kuwona zochitika monga:

chotupa choteteza
kupweteka kwakukulu pamimba pamimba, mu hypochondrium. Nthawi zambiri mukatha kudya, makamaka mukamadya zakudya zamafuta,
kusintha kwa endocrine m'thupi (zotheka nephropathy, ketoacidosis, kutsika kulekerera kwa chakudya),
kuchepa kwambiri kwa thupi chifukwa cha kusowa kwa chakudya,
kusanza, kusanza,
kutsegula m'mimba, chifukwa cha kuphwanya kwam'mimba,
palpation ndi katswiri, mutha kuwona kuwonjezeka kwa chiwalo ndi mutu wa ndulu,
Matenda a wodwalayo amasinthanso chifukwa chofooka, kutopa komanso kusowa tulo.

Chovala chowopsa

Pakukula kwa chizindikirocho, mutu wokuluka wa gland, womwe umakanikiza wamba bile duct (bile duct), umagwira gawo lalikulu. Zotsatira zake, bile yomwe imapangidwa m'chiwindi sichingalowe mu duodenum, chifukwa pomwe kukakamiza kwa duct kumakwera, ndipo bile limayamba kulowa m'magazi.

Zomwe madandaulo akuluakulu ali nazo: Ndi ndowe zosungunuka, kuyamwa kwambiri, mkodzo wakuda, ndi chikasu cha sclera ndi khungu.

Momwe mungadziwe pseudotumor pancreatitis kapena khansa wodwala

Kafotokozedwe kofotokozedwako kamatanthawuza kuti madandaulo onse ndi mawonetseredwe azachipatalawa amatengedwa ndipo matenda ena amawachotsa, osati kokha kapamba (mwachitsanzo, khansa), komanso ziwalo zoyandikana zomwe zimakhala ndi zofanana. Mwa izi, zotsatirazi ndizovomerezeka:

Kufunsira kwa gastroenterologist.
Kutoleredwa kwa anamnesis ndi zodandaula (pancreatitis yapitayi, cholelithiasis, mankhwala, madandaulo a ululu m'dera la hypochondrium ndi epigastric dera, ndi ena).
Kuyesedwa kwa wodwala ndi palpation (kukomoka komanso kudekha mtima kapamba ndizotheka).
Kuyesa kwa magazi. Mtundu wa kapamba wamtunduwu umadziwika ndi kuwonjezeka pang'ono kwa milingo ya trypsin, amylase ndi lipase, kulolerana kwa shuga.
Kutsimikiza kwa zotupa ndi zotupa za pancreatic polypeptide (kupatula khansa). Ndi kuwonjezeka kwa kuchuluka kwa khansa ya embryonic antigen, CA 125, CA 19-9, kapamba pancreatic, kudziwika kwa chotupacho kumatsimikiziridwa, ndipo ndi kuchepa kwa zinthu zomwe zili pamwambapa, zikutsimikiziridwa kuti pali njira yotupa, yomwe imatsimikizira kupezeka kwa pseudotumor pancreatitis.
Ultrasound pancreas (kukhalapo kwa hypertrophy, kusintha kapangidwe ka ma ducts ndi minofu ya tinyezi, kusowa / kukhalapo kwa ma calcifying).
CT kapena MRI (kupatula ma neoplasms oyipa).
ERCP. Njira yowonera kusintha kwa pancreatic duct.
Kusankha celiacography (kutsimikiza kwa dziko la zotengera zapakhonde).

Pseudotumor pancreatitis, mankhwalawa omwe nthawi yochulukitsa imachitika mu mpweya, amadziwika ndi njira ya wavy (kutanthauza kusintha kwina ndi kufalikira).

Chithandizo cha matenda amtunduwu chimaphatikizapo kupangika kwa chakudya chosasamala (tebulo No. 5). Chakudya chokhazikika chimaloledwa (kasanu kapena kasanu ndi kamodzi patsiku), koma m'malo ochepa. Njira zophikira: kuphika ndi kuphika, kawirikawiri - kutsitsa. Zakudya zamafuta, okazinga, mazira osenda, tiyi wamphamvu, khofi amaletsedwa, kuchuluka kwa nyama (makamaka nkhumba) ndi mkaka ndizochepa.

Chofunika kwambiri pa chithandizo chamankhwala ndicho etiotropic, ndiye kuti kuchotsedwa kwa zinthu zolimbikitsa (kumwa mowa, mankhwala osokoneza bongo) ndi zifukwa zomwe zidayambitsa matendawa. Mwachitsanzo, ndi cholelithiasis - cholecystectomy, ndi zina zotero.

Mankhwala osokoneza bongo ayenera kukhala ndi cholinga chokonza kuchepa kwa mitsempha komanso procrine gland. Kuti muchite izi, lembani kukonzekera kwa enzyme: Pancreatin limodzi ndi Solizim kapena Lipase. Maantacid okhala ndi kukonzekera kwa calcium amagwiritsidwa ntchito kuchepetsa steatorrhea.

Pofuna kuchepetsa dyskinesias, anticholinergics ndi mankhwala. Pothandizidwa ndi ululu wammbuyo, antispasmodics kapena Atropine amagwiritsidwa ntchito. Monga antispasmodic wogwira mtima pa sphincter ya Oddi, amagwiritsa ntchito Mebeverin kapena Gimekromon. Munthawi yakuchulukirachulukira, mankhwala a antibacterial amaphatikizidwa ndi mankhwalawa. Ngati mankhwala osokoneza bongo samachepetsa kutukusira kwa khungu ndi vuto la kuchepa kwa magazi, ndiye kuti matenda oopsa a hyperthermia (kwanuko) kapena dera

Kuphatikiza pa njira zamankhwala zomwe zatchulidwa pamwambapa, nthawi zambiri ndi pseudotumor pancreatitis, endoscopic ntchito (mwachitsanzo, papillosphincterotomy) zimachitika ndicholinga chofuna kuwola. Njira zoterezi ndizothandiza kwambiri pamagawo a prealillary dera, papillostenosis, kuwonjezereka kwa mutu wa kapamba, limodzi ndi jaundice yovuta komanso kukakamiza kwa bile duct.

Zimayambitsa Matenda a Pancreatitis

Zoyimira zazikulu za chifuwa chachikulu cha kapamba ndi izi:

kumwa mowa mwauchidakwa, komwe kumayambitsa chiwindi m'thupi ndipo kumathandizanso kusintha kwa minofu ya fibrosis (kuchuluka kwa minofu yolumikizana),
kusowa kwa mapuloteni muzakudya,
zolakwika zopatsa thanzi anthu akamadya zakudya zamafuta ambiri, zakudya yokazinga, makamaka kuphatikiza ndi mowa,
kuchuluka kwa nkhawa m'miyendo ya kapamba, komwe kumayambira kumbuyo kwa cholepheretsa mwala, stenosis ya mphuno ya Vater mu duodenum, komanso edema yake,
matenda a kapamba,
matenda am'mimba am'mimba, ndi zina zambiri.

Chifukwa chake, mndandanda wa zomwe zimapangitsa kutupa m'matumba a pancreatic ndizosiyanasiyana. Kudziwa zinthu izi kumathandizira kupewa kapamba.

Limagwirira a chitukuko cha matenda

Kusintha kwa chotupa pang'onopang'ono kumayambitsa kuphwanya kwachilendo kwa glandular epithelium ya kapamba.

Amasinthidwa pang'onopang'ono ndi maziko osakanikirana a minyewa, osagwira ntchito za kapamba, ndiko kuti, palibe chobisalira cha michere yam'mimba.
Kukula kochulukirapo kwa minofu yolumikizana kumabweretsa kukulira kwa kachulukidwe kakumaso ndi makwinya ake. Vutoli limagwiritsidwa ntchito pofufuza matenda.

Kusaka koyesera

Kuzindikira kwa pancreatitis yokhazikika sikuti kumangoyang'ana mokwanira za zizindikiro zamankhwala, komanso njira zowonjezera zowerengera.
Zomwe zimagwiritsidwa ntchito kwambiri ndi:

kuwunika kwa biochemical zikuchokera pancreatic madzi,
kuwunika kwa ntchito ya amylase, yomwe imapangidwa mu kapamba,
kupanga pulogalamu yodziwitsa zinyalala za chakudya zosavomerezeka,
X-ray ya kapamba, womwe umangowonetsa kusintha kwakukulu kwa chiwalo,
Ultrasound pakadali pano ndiwotchuka kwambiri, chifukwa ndi njira yosazindikira komanso yophunzitsira.

Zakudya ngati mfundo yofunika kwambiri ya chithandizo

Zakudya zopatsa thanzi chifukwa cha matenda a kapamba ndi imodzi mwazinthu zazikulu, makamaka munthawi yachikhululukiro. Zimakuthandizani kuti muchepetse katundu pa zikondwererozo ndikuwongolera njira yobwerezabwereza. Zotsatira zake, izi zimachepetsa kwambiri kubwereranso kwamatenda.
Zakudya za chifuwa chachikulu cha khansa zimakhazikika pa mfundo zotsatirazi:

kuchuluka kwa mapuloteni akuyenera kuwonjezereka, chifukwa amamwa ngati chinthu chomanga panthawi yokonza (kubwezeretsa kapamba),
payenera kukhala zakudya 4-5
Pewani kudya kwambiri
chakudya chimayenera kuphikidwa makamaka (nkofunika kukana nyama yokazinga ndi yosuta),
kuchuluka kwa mafuta ndi michere yamagetsi kumachepetsa kwambiri mu zakudya
Ma broth opanga kwambiri samasiyanitsidwa.

Mofananamo, wodwalayo ayenera kusiya kumwa mowa, zomwe zimabweretsa kuwonongeka kwa kapamba.
Ndikofunika kutsatira mfundo za kadyedwe kake kuti muchepetse kufalikira kwina kwa matendawa ndikuwongolera magwiridwe antchito a kapamba!
Kuti akhalebe ndi chikhululukiro kwa nthawi yayitali, wodwalayo ayenera kusintha kwambiri moyo wake pakusiya mowa ndikuwonjezera zakudya m'thupi. Izi zibwezeretsa kapamba wowonongeka ndikuwongolera magwiridwe ake.

Pancreatitis ndi matenda otupa a kapamba amayamba chifukwa cha kusayenda kwa michere mthupi, kudzimbidwa kwake ndi chiwonongeko. Ma poizoni omwe amaphatikizidwa amalowerera mkati mwa magazi ndikuwononga ziwalo zamkati - mtima, chiwindi, impso.
Pseudotumor pancreatitis ndi mtundu wina wapadera wa kutupa kwa kapamba, wodziwika ndi chotupa m'mutu wake ndikupanga pakalibe chithandizo chanthawi yake. Matenda amtunduwu amadziwika pafupifupi zaka khumi mpaka khumi ndi zisanu kuyambira pa nthawi yakusintha kwa zotupa m'misempha.
Matenda a pseudotumor pancreatitis nthawi zambiri amasokonezeka ndi matenda am'mimba kapena chiwindi ndipo nthawi zambiri amapezeka wodwala akangolowa kuchipatala ndi matenda ena.

Etiology ndi zizindikiro

Zizindikiro zikuluzikulu za pseudotumor pancreatitis ndi kupweteka kwakanthawi, kutulutsa ulesi, kuchuluka kwa kapamba, ndi kuchepa msanga kwa thupi.

Pseudotumor pancreatitis nthawi zambiri imakhala chifukwa cha kusokonezeka kwa machitidwe a biliary: biliary dyskinesia kapena kuwerengetsa cholecystitis. Zomwe zimapangidwira ndikukuledzera, kuledzera, kuledzera.

Izi zimadziwika ndi kufalikira kwa mutu wa kapamba, ma masamba omwe amakhala opanda tanthauzo komanso osalongosoka bwino. Tiziwalo tating'onoting'ono ta tiziwalo timene timakhudzidwa, timayaluka ndi pseudocyst, ndipo chimbudzi chake chimachulukana kwambiri.

Mankhwala othandizira

Pseudotumor pancreatitis amathandizidwa ntchito. Cholinga cha opareshoni ndikuchotsa chotupa, chomwe chimayambitsa kusintha kwa kapamba, kuchepa kwa zizindikiro za matendawa, kupewa zomwe zingachitike ndi matenda ophatikizika - matenda a gallstone kapena matenda a shuga.
Zotsatira za opaleshoni ndiyoyambira kuchotsedwa kwathunthu kapena kosakwanira, mwachitsanzo, zotsalira za pancreatic steatorrhea, duodenostasis, pseudocysts ndizotheka. Pambuyo pa opaleshoni yothandizira pseudotumor pancreatitis, odwala amawunika pafupipafupi ndi kuyendera katswiri kawiri pachaka, kutsimikiza kwa exocrine pancreatic function ndi ultrasound.
Pakadali pano, chiwerengero chokwanira cha mankhwala othandiza chatulutsidwa, kugwiritsa ntchito komwe kunachepetsa kwambiri kuchuluka kwa chiphunzitsochi. Ntchito pa ndulu, m'mimba ndi kapamba posachedwapa zakhala ndi zovuta zochepa kwambiri pambuyo pake. Mu 80% ya milandu yonse, pseudotumor pancreatitis imatha pakuchira kwa odwala.

Njira zopewera

Njira zopewera pseudotumor pancreatitis zimaphatikizapo:

Kusintha zakudya - odwala amalimbikitsidwa zakudya zophatikiza mapuloteni komanso zakudya zamafuta ochepa.
Kugwiritsa ntchito mankhwala omwe amachepetsa kugwira ntchito kwa ma pancreatic enzyme, zomwe zimathandizira kuti thupi liziwoneka bwino.
Kupatula mowa.
Kudziwona kwakanthawi ndi chithandizo cha matenda oyamba ndi matenda mthupi: mano osokosera, tillillitis, sinusitis.
Sanatorium chithandizo.

Ngati mutsatira mosamalitsa njira zonse zofunikira zodzitetezera, mutha kukwaniritsa kuchotsera kwamatenda.

Kutupa kosalekeza kwa kapamba, munthawi yomwe ma hypertrophy ake osasinthika, amatchedwa "pancreatitis" onyenga.

Pseudotumor pancreatitis imawonetsedwa ndi zizindikiro zomwe zimafanana ndi zizindikiro za njira ya oncological, kotero ndikofunikira kwambiri kumvetsetsa kuti izi ndizosiyanitsa zamomwe zimakhalira panthawi yake ndikuyamba mankhwala kapena opaleshoni.