Kuzindikira matenda a kapamba

Ngakhale kupitiliza kopitiliza kwa njira zodziwonera ndi kukonza kwa zida zamaukadaulo zamakiriniki ambiri, akatswiri odziwa bwino ntchito yawo amapatsa odwala awo matenda omwe kulibe. Mmodzi mwa atsogoleri a "diagnostics" oterewa nthawi zambiri amakhala ndi kapamba. Dotolo wadzuwa, atayang'ana pakona pa diso lake pakanema kachipangizocho kapena pomaliza pomwe dokotala akuwonetsa ma ultrasonography (ultrasound), amayamba kupereka lingaliro kwa wodwalayo ndikuopa mankhwala amphamvu. Pakadali pano, pali njira zambiri zoyeselera zomwe zimaloleza kuti munthu athe kupimana komanso kutsimikizira matendawa.

zamankhwala
labotale
zothandiza.

Njira zamankhwala

Dokotala womvetsera amalandila zidziwitso zoyambirira kuchokera pakulankhula ndi wodwala. Kupatula apo, matenda okhudzana ndi kapamba amakhala ndi mawonetsedwe ena azachipatala. Chizindikiro chodziwika bwino ndi kupweteka, komwe:

kukhala ndi mphamvu zosiyanasiyana (kuyambira zazing'ono mpaka zosalephera) komanso kutalika,
amapezeka pamimba yapamwamba (malo awo amatsimikiziridwa ndi kutengera kwa matendawa: ngati mutu wa m'mimba umakhudzidwa, ndiye kuti hypochondrium yoyenera imapweteketsa, ngati thupi likhudzidwa, ndiye kuti kupweteka kumachitika m'dera la epigastric, pamene mchira wawonongeka, ali kumanzere kwa hypochondrium),
amatha kupereka (kutsitsa) kumbuyo, kukhuthala, mkono wamanzere, kutsikira kumbuyo kapena tsamba lamanzere,
kuwonekera kapena kukulira mukatha kudya acidic, mafuta, kusuta, zakudya zonunkhira kapena mowa,

Kuphatikiza apo, odwala amalankhula zakuwazunza:

kutsegula m'mimba
kulimbikira mseru, komwe nthawi zambiri kumachitika ndi ululu,
kusanza popanda mpumulo
Kuchepetsa thupi (kuwonetsa kuledzera kapena khansa kuledzera komanso / kapena vuto pakapangidwe ka michere ya pancreatic),
malungo (woledzera)
kuchuluka kwamimba (chifukwa cha kutulutsa kapena kuchuluka kwa madzi mkati mwake),
jaundice (anazindikira pamene kufinya bile ndulu ya kutupa kapena zowonongeka pancreatic mutu volumetric process),
kuyabwa (nthawi zambiri kumalumikizidwa ndi jaundice),
kuphwanya thanzi wamba.

Kufunika kwake kumaperekedwa pakuwunika kwa wodwala. Poona kuwonongeka kwa kapamba, adotolo amayang'anitsitsa khungu, zimagwira pakhungu pang'onopang'ono, limakhazikika pamimba pamalo a chiwalocho, limadina mbali zapadera za "pancreatic" m'malo osiyanasiyana a thupi. Nthawi zina zimakhala zotheka osati kungodziwitsa ululu m'dera linalake, komanso kutsegula chotupa kapena gawo lachiwalo.

Njira zasayansi

Kafukufuku wa Laborator amathandizira kumveketsa matenda a kapamba, kuwunika ntchito zake, kuuma, kupezeka kwa zotupa pakupanga michere yam'mimba ndi mahomoni. Kutengera ndi mtundu wa kuchipatala komanso kuthekera kwachipatala, madokotala amatha kulembera:

hemogram (ndi zotupa ndi / kapena purulent zovuta, pamakhala kuchuluka kwamitsempha yoyera, mapulateleti, kuthamanga kwa ESR, vuto la kuchepa magazi m'thupi likawonekeranso),
kuyesa kwa zamankhwala am'magazi ndi mkodzo (kukwezeka kwa lipase, kuchuluka ndi pancreatic amylase, elastase-1, trypsin kapena mkodzo wamkodzo amawona kutalika kwa kutupa, ndipo kuchepa kwa michere iyi kumatha kuwonetsa kuchepa kwa maselo a pancreatic ndi kulepheretsa kwapadera kwa protein. imatha kuyenda ndi kutupa kapena njira yolakwika ya chotupa, komanso kuchuluka kwa shuga - kapamba, kuwonjezereka kwa bilirubin, AST ndi ALT, phosphatase ya alkaline, gamma-glutamyl transpeptidase mu seramu TKE zambiri zimasonyeza psinjika wa ya ndulu ritsa)
Komputa (posintha ma cell a ma pancreatic omwe amapanga ma enzyme okhala ndi minyewa yolumikizana - ma fibrosis, mu kusanthula kwa chopondachi, zizindikilo za kudzimbidwa kwamafuta kenako mapuloteni amawululidwa koyamba),
kuwunika kwa fecal elastase-1 (kutsika kwa chisonyezero cha enzymatic mu ndowe kumapangitsa kukhazikitsa kuperewera kwa kapamba koyambirira koyambirira, komwe kumawoneka pancreatitis yayikulu, cystic fibrosis, ndi zotupa zoyipa).
kutsimikiza zotupa chizindikiro (kukweza kwa khansa embryonic antigen, CA 19-9, CA 50, CA 242, pancreatic oncofetal antigen angawonedwe ndi kuzimiririka kwa kupweteka kwa minyewa ya kapamba kapena kupitirira kwa khansa),
mayeso owona enzymatic (excretory) kapangidwe ka kapamba: Kuyesa kwa Lund, kuyesa kwa bentiramine, kuyesa kwa pancreatolaurin, mayeso a methionine, kuyesa ndi ether-mecholyl kapena ndi para-aminobenzoic acid, etc. (osagwiritsidwa ntchito kwenikweni),
glucose kulolerana mayeso kapena masewera olimbitsa thupi ndi wowuma (omwe amagwiritsidwa ntchito kuti azindikire zovuta za endocrine - kupindika kwa insulini ndi maselo a pancreatic beta).

Dokotala yekha ndi amene amatha kutanthauzira molondola zotsatira za mayesowa ndikuwunika momwe zosinthidwa zomwe zimadziwika zimagwirizanirana ndi matenda a kapamba. Kupatula apo, zosankha za labotale zokha ndizomwe zimasokoneza. Mwachitsanzo, kuwonjezeka kwa ma enzymes (amylase, ndi zina) pancreatitis ndi kanthawi kochepa komanso kumachitika ndi matenda ena (ndi kulephera kwaimpso, matenda a m'mimba, ndi zina zambiri). Chifukwa chake, zinthu zomwe zimakhazikika pamadongosolo awa sizikutsutsa kukhalapo kwa kapangidwe kake ka kapamba, ndipo kuchuluka kwawo sikutanthauza mavuto a kapamba.

Njira zopangira zida

Njira zopangira zida zimawonedwa ngati gawo lofunikira pakutsimikizira matenda omwe akukhudza kapamba. Amakulolani kuti muwunikire kukula ndikuwona momwe mawonekedwe a gululi alili, onani edema, miyala, zilonda zam'mimba, cysts ndi pseudocysts, kupindika kwa ma ducts, neoplasms, fibrosis, anomalies of the intrauterine mapangidwe. Mndandanda wamaphunzirowa ungaphatikizeponso:

fibroesophagogastroduodenoscopy (kuyesa kwa ma endoscopic kumatha kukhazikitsa kusintha pamalo pomwe pancreatic duct imalowa mu duodenum),
Kafukufuku wa m'mimba (njira imatha kuwonetsa miyala mu minofu kapena m'miyendo ya kapamba),
kusiyanitsa ndi duodenography (ndi kuwonjezeka kwa mutu wa kapamba, mawonekedwe a kusintha kwa mendulo ya bariamu),
Ultrasound (wowerengeka wowerengeka amafufuza kukula, ma contour, kapangidwe ka kapamba, mkhalidwe wama ductal system yake ndi ducts ya bile, imalongosola kukhalapo kwa madzimadzi owonjezera pamimba yam'mimba, chifukwa chake imatha kuzindikira kutupa, kusintha kwokhudzana ndi zaka, miyala, cysts, zipsera, zotupa (zomwe mulifupi mwake ndi zokulirapo) 2 cm), zotupa za metastatic, zovuta zina),
endo-ultrasonography (imakwaniritsa njira yodziwira matenda am'mbuyomu, kulola kutsimikiza kwatsatanetsatane kwa zovuta zamatenda a pancreatic ndi kusintha kwa duct, kuwonjezeka kwa ma lymph node),
complication tomography (poyerekeza ndi njira zomwe tafotokozazi, kafukufukuyu ndiwothandiza kwambiri pakuwona ma pseudocysts, neoplasms, atrophic process mu kapamba, zovuta za kapamba ndi zotupa za ziwalo zoyandikana, koma akuwonetsa ma radiation),
MRI cholangiopancreatography (njirayi imawunikira patency, mawonekedwe ndi kukula kwa zofunikira za pancreatic system ya biliary, amawunika momwe minofu ya pancreatic imayendera ndi chikhodzodzo),
endoscopic retrograde cholangiopancreatography - ERCP (kafukufuku wofufuza kwambiri kuti adziwe kupendekera kwa mabowo chifukwa cha zipsera, miyala, mapulula a puloteni kapena zotupa, koma nthawi zina zimatha kubweretsa kuchuluka kwa kapamba, chifukwa chake sichichita kwa odwala onse),
kukonzekera kwachikondwerero ndi kuyang'anitsitsa kwa microscopic yowunika pancreatic minofu sampuli (njirayi imakulolani kuzindikira bwino kutupa, atrophy, pancreatic fibrosis, kusiyanitsa chosaopsa ndi neoplasms yoyipa, kudziwa mtundu wa chotupa).

Komabe, madotolo amatha kupanga chidziwitso chomaliza pokhapokha atafufuza mwatsatanetsatane njira zonsezi. Ndi zonsezi, kukhulupirika kwa odwala pakukonzekera dongosolo lolemba, ziyeneretso za madotolo, mtundu wa zida ndi ma reagents ndizotalikira.

Dokotala uti kuti mulumikizane

Ngati muli ndi vuto lililonse logaya chakudya, kuphatikiza ndi kapamba, muyenera kulumikizana ndi katswiri kapena gastroenterologist yemwe akupatseni mayeso athunthu. Pozindikira matenda a kapamba, gawo lofunikira limaseweredwa ndi endoscopists, radiologists.
makanema otchulidwa:

Zolemba pamakompyuta

Kufufuza kwa Ultrasound kwa kapamba ndizopweteka kwambiri komanso zotsika mtengo zomwe zimakupatsani mwayi kuti musinthe kukula kwa kapamba, malo amochepetsedwa kapena kuwonjezereka kwa kuchulukana, kukhalapo kapena kusowa kwa cysts, mainchesi a pancreatic duct. Kutengera ndi phunziroli, munthu sangathe kudziwa kokha kapamba, komanso kudziwa kuopsa kwa kapamba.

Mtundu wa ultrasound ndi minofu elastography. Njira iyi imakupatsani mwayi wodziwitsa kutanuka kwa minofu. Zambiri zomwe zimapezeka kuchokera ku minofu yolimba zimawonetsa mbiri yakale ya kusintha kwa kapamba.

Kusintha kwa makina olemba pamanja |Njira zakuthupi zophunzirira kapamba

Pakufufuza, kutopa, jaundice, ndi mawonekedwe ake pamomwe kukanda, zotupa zimawululidwa. Kuwonongeka kwa kapamba kumakhalabe njira yosagwira. Pokhapokha ngati pali kukulitsa kwina chifukwa cha kuwonongeka kwa chotupa chifukwa cha kuwonongeka kwa chotupa kamene kamatha kuzindikirika.

Njira zowonjezera pancreatic

Ma labotale ndi njira zothandizira zimatha kuzindikira bwino momwe ntchito yowonongeka imayendera mu gland, imayesa ntchito yotsalira ya pancreatic, kuwunika ntchito ya pancreas ndikuwunika mawonekedwe a morphological a gland.

Kuunika kwa X-ray kapamba. Makina amitsempha yamagalasi am'mimba amawuluka. Ndi kuyambitsa kwa barium kusiyanasiyana, zizindikiro zosakhudzana ndi zotupa ndi ma neoplastic mu gawo loyambirira la kapamba zimatha kupezeka, poganizira kusintha kwa mucous nembanemba wa duodenum.

Kuyesa kwa Ultrasound kapamba. Njira iyi yosasokoneza komanso yotetezeka imakupatsani mwayi kuti muwone ma cysts ndi neoplasms mu kapamba, komanso kudziwa kuwonjezeka kwake chifukwa cha edema kapena compaction (fibrosis).

Zolemba pamakompyuta. Odwala omwe ali ndi kunenepa kwambiri komanso kutsekeka m'matumbo, ultrasound nthawi zambiri imakhala yovuta, motero m`pofunika kuti muthe kusanja makina, omwe amakupatsaninso kuwunika kusintha kwa morphological, kuzindikira chotupa, chotupa, chikhazikitso cha kutupa, edema.

Pancreatic Artery Angiography. Kusankha angiography yamitsempha yamagazi yopereka magazi ku kapamba kumathandiza pakuwonetsa zotupa. Zimakupatsani mwayi wochepetsera lumen wa ziwiya ndi kuphwanya udindo wawo. Nthawi zambiri phunziroli limachitika pambuyo pa ultrasound ndi compact tomography.

Endoscopic retrograde cholangiopancreatography. Kafukufukuyu amatenga imodzi mwazida zofunikira kwambiri zowonetsera ma pancreatic ndi biliary ducts. Thupi losiyana ndi ayodini limayambitsidwa mu duct yodziwika bwino kudzera mu endoscope ndipo kenako X-ray imachitidwa, yomwe imalola osati kungoyambitsa zifukwa zowonjezera jaundice, komanso kudziwa kusintha kwa kapamba omwe amadziwika kuti amachititsa kutupa ndi neoplastic. Mu chifuwa chachikulu, matendawa amatha kupunduka, madera ochepera komanso kuwonekera akuwonekera. Pamaso pa chotupa, stenosis yapadera ya duct kapena kutayika kwathunthu ndikotheka.

Pancreatic Radioisotope Examination. Kuwerenga uku kwa kapamba pogwiritsa ntchito methionine yolembedwa ndi radioactive isotope ya selenium, kwakukulu, sikulondola kwambiri kuposa njira zomwe zalembedwera.

Kuwerenga kwa michere ya pancreatic m'magazi ndi mkodzo. Necrosis ya pancreatic minofu chifukwa cha kutsekeka kwa chala cha gland imatha kuwunikira ndikuwonjezera kuchuluka kwa ma pancreatic enzymes m'magazi, mkodzo ndi madzi ena amthupi. Muyezo wodziwika wa ntchito za amylase ndi lipase. Panthawi ya pancreatitis yovuta, ma seramu amylase okwera amapitilira masiku 10 ndipo nthawi zambiri amakhala ndi hyperamilazuria. Kuwonjezeka kwa mankhwala a amylase mu seramu ndi mkodzo kumachitika osati pancreatitis, komanso matenda am'mimbamo, mafuta am'mimba zilonda zam'mimba, kutsekeka kwamatumbo, ndi matenda ena a virus, omwe akuwoneka kuti akuphatikizidwa ndi zotupa zapakhungu.

Chifukwa chakuti amylase amalowa m'magazi osati kuchokera ku kapamba, komanso kuchokera ku tiziwalo timene timatulutsa timayamwa, kuyesayesa pakalipano kukuwonetsa ake isoenzymes. Kugwiritsa ntchito radioimmunoassay, zomwe zimachitika mu seramu yamagazi ya michere ina - trypsin, lipase, elastase - imayesedwa.

Ntchito Yakufufuza Pancreatic. Ntchito ya pocreatic pancreatic imayesedwa pogwiritsa ntchito zolimbikitsa zachindunji komanso zosadziwika. Kukondoweza kwachindunji kumakhala ndi kuperekera kwa mahomoni angapo mahomoni, makamaka secretin ndi cholecystokinin, komanso kuphatikiza kwawo. Kukondoweza kwina kopangidwa ndi kuphatikiza kwa michere. M'magawo onse awiriwa, amagwiritsa ntchito kuchuluka kwa ma pancreatic enzymes - amylase, trypsin, lipase (omwe amagwiritsidwa ntchito ndi secin poyamba amachepetsa pang'ono, kenako amawonjezeka) muzomwe zimakhala, zomwe zimapezeka pofufuza. Njira yowonjezera komanso yofunikira pakuwunikira ntchito ya pancreatic pocrreatic ndikuwerenga ndowe kuti mupeze zomwe zili mumafuta ndi zinthu zomanga thupi m'mapulogalamu.

Kuyeza kochulukirapo kwamafuta omwe amapezeka mu ndowe, komanso chymotrypsin ndi trypsin, amatha kuwona kuchepa kwapang'onopang'ono kwa ntchito ya gland.

Mayeso a kulolera a glucose amalola kuwunika ntchito ya endocrine ya kapamba, yemwe amadwala mu 3/4 ya odwala ndi kapamba kapena chotupa cha kapamba.

Kuwerenga kwa pancreatic ntchito, makamaka exocrine, ndikofunikira kwa odwala omwe ali ndi malabsorption kuti amveke bwino zomwe zimayambitsa matenda awa komanso, makamaka, kuti adziwe gawo la kuchepa kwa ntchito ya pancreatic.

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Kuzindikira mafunso ndi kuyendera

Pamsonkhano woyamba ndi wodwalayo, adokotala amakhala ndi chidwi ndi madandaulo ndikuwunika wodwalayo pafupipafupi. Pokambirana, adokotala amaphunzira mawonekedwe a kupweteka, chikhalidwe cha dyspepsia, pafupipafupi komanso kukula kwa zizindikiro zamankhwala. Zizindikiro zotsatirazi ndizothandiza kwambiri kuzindikira matenda a gland:

Ululu pamimba pamimba, makamaka m'malo a epigastric ndi subcostal. Ululu nthawi zambiri umakhala ngati lamba, umayamba pambuyo pakulowa kwa zakudya zamafuta ambiri. Masautso ndi zopweteka m'mimba sizimatha nthawi yayitali.
Zomverera zimapweteka kumaso, phewa lakumanzere, lomwe limakakamiza munthu kutenga gawo lokakamizidwa kuti athetse vutoli.
Chizindikiro chodziwika bwino cha matenda a kapamba ndikusanza ndi mseru nditatha kudya zakudya zamafuta. Chichewa chimatha kupezeka m'masanzi. Kusintha sikumachotsanso chizindikiro cha ululu.
Mu matenda a gland, chifukwa chosakwanira kugaya mafuta ndi ma lipids, steatorrhea imabuka - pafupipafupi madzi kapena gruel achikasu chopondapo ndi kuphatikizika kwamafuta. Steatorrhea - chizindikiro cha pathognomonic pakuwonetsa pancreatitis, chotupa ndi khansa ya chiwalo
Odwala amasokonezedwa nthawi ndi nthawi chifukwa cha kutulutsa, kutentha thupi, kuledzera, khungu, zomwe zimasonyezanso matenda apamba.

Chidziwitso chofunikira! Chifukwa cha kuchepa kwa enzyme, odwala ena amawona kuchepa thupi kwa thupi, komwe kumalankhulanso koyenera kwa matenda a gland. Ngati chizindikiro ichi chikuchitika, muyenera kufunsa dokotala, chifukwa nthawi zambiri, kutsika kwa thupi ndi chizindikiro cha kukula kwa chotupa cha khansa m'thupi.

Kufufuza kwakunja kumawonetsa jaundice, khungu louma. Pa palpation m'malo a pancreas, zilonda zimapezeka, komabe, chiwalocho sichitha kupimidwa kwathunthu ndikuwonekera chifukwa cha malo omwe ali.

Malamulo onse pokonzekera kusanthula

Kuti mudziwe matendawa, kuyezetsa kumachitika, makamaka ndi pancreatitis yomwe ikukayikira. Momwe mungayang'anire kapamba ndikupeza mayeso oyenera mutazindikira thupi? Ili ndi vuto lalikulu, chifukwa zolakwa posunga zofunika pazomangamanga zimayambitsa kupatuka ndikuzunzidwa molakwika.

Pazomwe tikuzindikira, zofunikira zakonzedwa, monga:

Kuyesedwa kwa kapamba pamimba yopanda kanthu, m'mawa. Kwa masiku 1-2, lekani kudya zakudya zamchere, zonunkhira, zamafuta, siyani kusiya zizolowezi zoipa ndi mowa, lekani kumwa madzi owala, nyemba.
Pazitsanzo zamagazi, siyani kusuta pasanathe maola awiri.
Ngati wodwala wadzimbidwa, ndiye kuti ndikofunikira kuyeretsa matumbo ndi enema, tengani ma enterosorbents (makala oyambitsa ndi ena ambiri). Kupatula apo, kudziunjikira kwa chakudya chochuluka kumakhala ndi poizoni ndipo kumawononga chithunzi chonse cha kupezeka kwa thupi.
Zotengera zonse za zinthu zowunikira ndizosawoneka bwino, manja amasambitsidwa ndi sopo.
Kwa chachikazi, musanapereke mkodzo, chitani zofunikira zaukhondo ndi kumaliseche.
Akadutsa mayeso a mkodzo wapakati, amadutsa gawo lapakati la kutumikirako.

Pancreas ndi matenda ake, amafunikira kutsatira malamulo onse osonkhanitsa zinthu zodziwikitsa. Kulondola kwa zotsatira kumatsimikizira chithunzi cha chithandizo cha kapamba kapena zovuta zina zamatenda.

Kuphatikiza pa kuzindikira mkhalidwe waumoyo, pali zizindikiro zomwe, pamodzi ndi kafukufuku wopezedwa, matenda kapamba amatsimikiziridwa:

kutsegula m'mimba
lunda
akukumbutsa
kufooka kwambiri m'thupi,
mawonekedwe owawa a kupweteka pamizere yoyendera dzuwa ndi mbali yam'mimba.

Ngati zizindikiro zotere zikuwoneka, pitani kuchipatala mwachangu ndi kukayezetsa kapamba ndi matenda amkati a kapamba. Komanso yesani kudziwa nokha matendawa. Zimachitika kuti sizingatheke kupita ku chipatala, chifukwa chake, malinga ndi zomwe zilipo, mutha kumvetsetsa kunyumba kuti kapamba amapweteka.

Gawo la pachimake la matendawa limadziwonekera lokha pambuyo pomwa kwambiri mowa kapena zakudya zamafuta, zomwe zimapangitsa chidwi chotupa. Mwanjira imeneyi, kupweteka kwa m'khosi kumachitika, komwe kumalowera kumbuyo ndikukulira mukagona. Zowawa zimayamba kufinya atagona mbali imodzi ndikusinikiza mawondo pansi pamimba. Mu gawo lachuma kwambiri, ma analgesics sangakhale ndi zotsatirapo zabwino.

Komanso, mkhalidwe wa munthu wakhudzidwayo umachulukirachulukira ndikusanza, kutulutsa, ndi khungu la maso. Zikakhala zotere, kudzipereka pakokha kumakhala koopsa thanzi ndipo kumafunikira kuti mudzindikire mwachangu. Akapita kwa dokotala, amasankha kuti ayesedwe chithunzi chokwanira cha matenda a kapamba, zomwe zingapangitse kuti apereke mankhwala moyenera.

Mu matenda osakhazikika, zizindikirazo ndizosiyana pang'ono ndi mawonekedwe apanja a kapamba:

kuwonda pang'onopang'ono
Zizindikiro zopweteka zamanzeru kumanja ndi kumanzere kwa hypochondrium,
kutsegula m'mimba ndi fungo lamphamvu ndi kuwala kwa ndowe,
kusanza ndi kusanza mseru
kamwa yowuma
ludzu
kumverera kwa kusalamulirika komanso njala yosalekeza.

Popanda maphunziro a udokotala, munthu amatha kudzipangitsa yekha kuti azindikire yekha. Izi sizigwira ntchito bwino, chifukwa choyamba, pezani njira yofufuzira njira zofufuzira, ndikuwona kuwonongeka kwa kapamba.

Kodi mayesero a kapamba ndi kutupa kwa kapamba ndi ziti:

Kuyesedwa kwa magazi konse.
Kuyesa kwamwazi wamagazi.
Kusanthula kwamaganizidwe.

Maphunziro a Laborator amathandizira kukhazikitsa kuzindikira ndikuwunika njira yotupa mu kapamba. Chofunika kwambiri mwa iwo ndi kuzindikira kuchuluka kwa ma enzymes m'magazi. Patsiku loyamba, exacerbations amayang'ana pancreatic amylase, patsiku lachiwiri, kuchuluka kwa lipase ndi elastase.

Laborator diagnostics

Momwe mungayang'anire kapamba, ndimayeso ati omwe akuyenera kuchitidwa pamenepa? Kuzindikira kwa kapamba kumachitika mwa njira ndi njira zambiri. Pakati pawo pali njira zodziwira matenda, awa ndi mayeso a labotale ndi njira zothandizira kuzindikira ziphuphu.

Laboratory matenda a kapamba ndikowongolera kwa ma enzymes ndi mahomoni ntchito ya thupi. Ndi matenda apancreatitis, kutulutsa kwa chakudya cham'mimba (pancreatic) kuchokera ku chiwalo kupita mu duodenum kumayipa, komwe kumapangitsa kusokoneza ntchito ya ndulu. Chifukwa chake, ndi kutupa, timadzi tambiri tomwe timadzisonkhanitsa timalowa m'machitidwe, timalowa m'magazi, dongosolo la zamitsempha, zomwe zimapangitsa kudziwa mwakuwunikira chithunzi chonse cha kuwonongeka kwa chiwalo ndi thupi lonse.

Panthawi yotupa, gland imawonongeka ndipo imabweretsa chisokonezo pakupanga mahomoni ndi ma enzyme. Kuphwanya kapangidwe ka michere ndi mahomoni kumapangitsa kuti matendawa aphatikizidwe ndi matenda amtunduwu:

matenda ashuga
aimpso ndi chiwindi kulephera,
kuwonongeka kwa chitetezo chamunthu mankhwalawa,
necrosis ya zimakhala ndi ziwalo,
kuwonongeka kwa ndulu.

Ngati mutazindikira matendawa molingana ndi zomwe maphunzirowo apezeka, ndiye kuti kudziwonetsa moyenera ndi zizindikirozi sikungatheke ndipo kumakhala ndi zolakwika. Izi ndichifukwa choti kapamba amatha kukhala matenda opatsanso matenda ena ovuta. Chifukwa chake, kuzindikira kwa matendawa ndi kutupa kwa kapamba kumafunika kuyesa kwathunthu kwa magazi, ndowe, mkodzo pogwiritsa ntchito njira zothandizira.

Iron ndi thupi lomwe limapanga ma enzymes ndi mahomoni omwe amakhudzidwa ndi metabolism ya thupi. Chifukwa chake, njira zotupa m'matayala zimayambitsa kukayika kwa dongosolo la chakudya komanso kusintha kwa magazi, mkodzo, ndowe.

Kuyesedwa kwa magazi

Ndi kapamba, mitundu iwiri yoyesa magazi imachitidwa:

Clinical general, amagwira ntchito ngati yothandizira kutsimikizira mitundu ina ya mayeso ndipo ndikofunikira posankha matendawa.

Kodi akawonetsa dokotala kuti:

Choyamba, mulingo ndi kuchuluka kwa hemoglobin, maselo ofiira a m'magazi. Ngati maselo ofiira a m'magazi alipo m'magulu ang'onoang'ono, ndiye kuti izi zikuwonetsa kuchepa kwa magazi, komwe kumatsimikizira kupitilira kwa zovuta zomwe zidapangitsa kutupa kwa chiwalo.
Ndiponso, ngati chiwopsezo cha erythrocyte sedimentation chawonjezereka - ichi ndi chidziwitso chotsimikizika cha kufooka kwa thupi.
Kuwonjezeka kwa maselo oyera amwazi m'magazi. Izi zikutsimikiziranso njira yotupa ndipo mwina necrosis ya minyewa ya ziwalo.
Kuchuluka kwa hematocrit. Uku ndikuphwanya kuchuluka kwa magazi ndi madzimadzi (ma electrolyte).

Kuwerengera kwathunthu kwamwazi kumathandizira kudziwa ndikutsimikizira kupezeka kwa njira zoperekera pancreatic.

Kuyesedwa kwa magazi m'magazi kumaonetsa chithunzi chonse cha matendawa ndi kuwonongeka kwa chithokomiro.

Kuwunikira uku kwa ma enzymes ndi mahomoni a kapamba palokha kudzawonetsa izi:

Kuchuluka kwa Amylase - Ndondomeko yothandizira kupukusa wowuma. Ichi ndiye puloteni yofunika kwambiri ya kapamba.
Kuchuluka kwa shuga - pomwe kuwunikira kukuwonetsa kuti kupanga kwa insulin mu kapamba sikokwanira.
Elastase, lipase, phospholipase - kuchuluka kwa zinthu izi kukuwonetsa kuphwanya kwa kapamba.
Transaminases - pamene kuchuluka kwakupezeka, kukuwonetsa kusintha kwa chiwalo cha nduluyo palokha.
Bilirubin - kuchuluka, amalankhula za kutukusira kwa tiziwalo tamadye tokha komanso kutsekeka kwa milomo ya zotuluka za ndulu.
Pulogalamu yochepetsedwa yamapulogalamu ingakuwuzeni za njala ya thupi osati zakudya zama protein, komanso kuchepa kwa mphamvu.

Kayezetsa wamagazi am'magazi kumafotokozedwa mwatsatanetsatane ndipo malinga ndi iwo, adotolo adzalembera chithandizo choyenera ndikuwonetsetsa kuti ali ndi matendawa komanso ngati ali ndi vuto la chifuwa chachikulu kapena chovuta.

Pancreas yovulazidwa imafuna mitundu iwiri yoyesa magazi kuti adziwe mawonekedwe a matendawa - izi zimapereka chithunzi chonse cha matendawa komanso kumvetsetsa kwa kupendekera kwa kapamba.

Urinalysis

Ngati mukukayikira kutulutsa kapamba, urinalysis ndi mankhwala. Ndi kapamba, mkodzo wa wodwalayo ali ndi milingo yambiri. Diagnostics amachitika wamba:

kuzindikira kwa magazi oyera
mapuloteni
bilirubin,
shuga
ESR

Ndipo amayang'aniranso mtundu wake ndi kununkhira, urea acidity, womwe umaperekanso chitsimikizo cha njira yotupa. Kuti muwoneke, mkodzo wam'mawa umatengedwa pamimba yopanda kanthu. Mkodzo umayikidwa mumtsuko wapadera. Njirayi imayang'aniridwa ndi malamulo aukhondo, omwe amachotsa chiopsezo cha kuipitsidwa kwa nyembayi kuti idziwe.

Ngati ndi kotheka, kuwunika kuchuluka kwa diastase kumayikidwa, kotero kuwunika kumachitika masana ndi nthawi yotalikirana mpaka maola awiri.

Potsatira, kusanthula kwa mkodzo kumachitikanso mozungulira. Izi zimapereka kuphunzira kwathunthu kwamkodzo, kutsimikiza kwa diastase mumkodzo, komwe kumawonetsa kutupa.

Njira ya Nechiporenko imagwiritsidwa ntchito nthawi zambiri. Msempha umadutsa chapakati pa ma centrifuge, ndipo momwe mpweya umapezidwira umaphunziridwa mosamalitsa ndipo pamakhala lingaliro la matenda a impso, chiwindi, ndi ureters, omwe amakhala ngati matenda amodzimodzi a kapamba. Kuwunikira mkodzo wa michere ya pancreatic ndikofunikira ndikumupatsanso kumvetsetsa kwamavuto amisempha ndi matenda okhudzana nawo.

Kuyesa kwa mahormone

Kupanga kwa mahomoni mu kapamba kumachitika mu ma pancreatic islets. Awa ndi ma cell omwe ali ndi ma network a capillary. Ma mahomoni omwe amapangidwa ndi timawu tating'onoting'ono amasintha mphamvu ya kugaya chakudya. Ma mahomoni amaphatikizapo:

Kukhalapo kwa mahomoni mu mkodzo kapena magazi, kumawonetsa kupangika kwamphamvu mthupi ndi kapamba. Chifukwa chake, kuwunika kwa mahomoni ku pancreatic pancreatitis ndikofunikira ndikuwonetsa kukhalapo kwa matenda ophatikizika:

matenda ashuga
kulephera kwa chiwindi.

Matenda onsewa, popanda chithandizo chawo, sangapereke nkhondo yolimbana ndi kutupa kwa kapamba.

Cop program

Ma enzymes apamba omwe adawonekera pakupenda kwa pulogalamuyi akuwonetsa kuvuta kwambiri kwa kapamba. Zikondamoyo ndi momwe angayang'anire ntchito yake? Pachifukwa ichi, adotolo amafotokozera za njira yodziwitsira za pulogalamuyi. Mukazindikira ndowe kudzera munjirayi, samalani maonekedwe ndi mawonekedwe a microscopic. Komanso chisamaliro chimaperekedwa ku utoto, mawonekedwe, fungo, zotulutsa zamagazi kapena chakudya chosasokoneza.

Kodi ndi makina ati omwe amathandizira kuzindikira:

Kuphwanya kwa michere ya michere.
Kulephera kwa Bowel.
Kupanda kukwana kwa zinthu zopangira asidi m'mimba.
Kuwonongeka kwa chiwindi.
Mafuta obowoka mu duodenum 12.
Imazindikira kutuluka mwachangu kwa chakudya kuchokera m'mimba ndi matumbo.
Matenda a ziwalo zonse zam'mimba thirakiti.

Pancreatic MRI

Magnetic resonance imaging ndi njira yodziwira kuwona kukatsimikiza kwam'mimba ndi impso, chiwindi, ndulu. Ndi kapamba, matendawa ndi ovuta kuzindikira, chifukwa chake njira yodziwikirayi ndi yabwino kwambiri, pomwe dokotala amatha kuwona kutukusira kapena kukulitsidwa kwa ziwalo. MRI, imazindikira msanga zovuta m'matumbo am'mimba ndikuyamba chithandizo chamankhwala mwachangu.

Kuti ayambe njirayi, wochotsedwayo amachotsa zinthu zachitsulo mwa iye yekha ndikuyamba thupi. Cholinga chokhazikitsidwa ndi njira yodziwira matenda opweteka kwambiri. Chithunzi chowoneka bwino cha chiwalo chimapatsa wodwala matendawa.

Ngakhale kuti MRI imapereka chithunzithunzi chowoneka bwino cha ziwalo zamkati, mayeso onse amatengedwa kuti awone ngati zikondwererozo zilipo, chifukwa kuphatikiza kumamveka bwino za matendawa ndi kukhazikitsidwa kwa chithandizo choyenera.

Zolemba pakuwunika kwa kapamba

Zikondwererozi zimakhudzidwa m'mimba.

Cholinga cha chiwalocho ndikupanga ma enzyme omwe amathandizira kuphwanya mapuloteni ndi mafuta kukhala tinthu tating'onoting'ono, kenako tinthu tating'onoting'ono timalowa m'magazi ndikuthandizira maselo amthupi.

Kasitomala amathandizanso kupanga mahomoni: insulin, glucagon ndi somatostatin.

Ngati chiwalo chomwe chikufunsidwa chili ndi dzina linalake, ndiye kuti izi sizitanthauza kuti ili pansi pamimba.

Nkhani yothandiza? Gawani ulalo

Zikondwererozo zimakhala pansi pamimba pokhapokha ngati munthu ali pamalo opingasa.

Zowonadi, chitsulo chimakhala kumanzere kumbuyo kwa m'mimba, pamlingo wa 1-2 lumbar vertebrae. Mukukanda kwa palpation, adokotala amachipeza mu hypochondrium yamanzere.

M'derali, kukokana kowawa kumachitika, komwe kumatha kukhala mtundu wa zoster.

Pamakhala zisa mkati mwa kapamba pomwe madzi amakulu amatulutsidwa ndi chiwalo amatumizidwa ku duodenum 12.

Nthawi zambiri, madokotala opitilira m'modzi amathandizira kapamba, chifukwa cha matenda a chiwalo ichi, mutha kupempha thandizo kuchokera kwa onse othandizira komanso a gastroenterologist.

Ngati pakuwunika kudapezeka kuti chotupacho ndi chomwe chidayambitsa kutupa, ndiye kuti wodwalayo amatumizidwa kuti akumane ndi a oncologist. Pambuyo wodwala angavomerezedwe kwa dokotala wa opaleshoni.

Ndi kuwonongeka kwa ziwalo parenchyma, zamatsenga pafupifupi asymptomatic.

Chowonadi ndi chakuti minofu yathanzi ya pancreatic glandular imalowa m'malo mwa zomwe zimakhudzidwazi, zomwenso sizipezeka kuti zimapezeka panthawi yake zimatengera zovuta.

Ichi ndichifukwa chake kuwunika kwa kapamba kuyenera kukhala kokwanira - njira yokhayo yomwe dokotala angayang'anire bwino ndulu ya chisa ndikuwonetsetsa ntchito yake.

Ngati ndi kotheka, onetsetsani kuchuluka kwa zowononga kapamba, adotolo amayang'ananso chiwindi cha wodwalayo, chifukwa ntchito ziwalo ziwirizi zimalumikizana bwino.

Kupanga zowunika zenizeni ndi momwe magwiridwe antchito amapezekera zimapangitsa zotsatira za kusanthula.

Wodwala akuyenera kudutsa mkodzo, ndowe ndi magazi kuti awunikire ngati mukukayikira kuti zachulukira za matenda.

Wodwalayo amatha kusonkhanitsa zida zonse zachilengedwe kuti aziwunika panyumba, kutsatira malamulo ena.

Yofunika kwambiri, yomwe imakupatsani mwayi kuti musonkhe mkodzo kunyumba kuti muyesedwe, imafuna chidebe chosawoneka bwino komanso njira zina zaukhondo.

Kusanthula kunyumba, ndikofunikira kuperekera ku labotale, pomwe ndowe kuti muwonongeke zitha kusungidwa mufiriji mpaka m'mawa, koma osapitilira maola 10.

Laboratory matenda

Panthawi yozindikira, dotolo amaganizira zotsatira za kuyesedwa kwa magazi ndi a biochemical.

Poyambirira, ndi matenda osachiritsika kapena otupa kwambiri a matenda a kapamba, zotsatira za kusanthula kwakanthawi zikuwonetsa kuchuluka kwa leukocytes ndi neutrophils m'mwazi, komanso kuchuluka kwa erythrocyte sedimentation rate (ESR).

Zotsatira za kuyesa kwamwazi wamagazi, ndi chitukuko cha icteric pancreatitis m'magazi, kuchuluka kwa bilirubin kumawonjezeka.

Kukhalapo kwa matendawa kumatithandizanso kudziwa.

asalic acid omwe amateteza mucous nembanemba,
ma globulins (mapuloteni), omwe cholinga chake ndi kuwongolera zochitika zamtima mu mtima,
seromucoid - amatsimikizira kupezeka kwa njira yotupa mthupi.

Dotoloyo amalanganso wodwalayo kuti apereke magazi kuti awunikire mwachindunji, malinga ndi zotsatira zake zomwe zimatha kuzindikira milingo ya lipase ndi trypsin, komanso alpha-amylase (ndi kuchuluka kwa a-amylase m'magazi, kuchuluka kwa mkodzo diastase).

Mosalephera, mulingo wa michereyi mu duodenum watsimikiza.

Poyamba, kusala kudya kumachitika, ndiye kuti mumawunika pambuyo 30 ml ya madzi am'matumbo amtundu womwe umalowetsedwa m'matumbo.

Pokonzekera kuyesa kwamkodzo kwamkodzo, mulingo wa amino acid ndi pancreatic amylase (diastasis) watsimikiza, ndi kapamba wowonongeka, chizolowezi chawo chidzaposa.

Koma ngati adotolo awona kuti mulingo wa amylase m'mwazi ndi mkodzo ndiwotsika, ndiye mu nkhaniyi tikambirana za kufa kwa ziwalo zina za chiwalo.

Zomwe zimapangitsa kupitilira muyeso wa diastases ndi ma amino acid mkodzo imatha kukhala yovuta kapena kupweteka kwa kapamba, komanso chifuwa cha necosis, neoplasms mu kapamba, mitundu yosiyanasiyana ya matenda am'mimba, kutupa kwa chiwindi, matenda am'mimba a ziwalo zamkati ndi ectopic.

Makina osunthira matumbo amachitidwanso. Ndi kuchepa kwa michere yogaya chakudya mu ndowe, fayilo, mafuta, mafupa am'mimba ndi wowuma azindikirika.

Koma chizindikiro chachikulu, chomwe chimatsogozedwa ndi mayeso a labotale, ndiye mulingo wa elastase.

Ngati kusanthula kukuwonetsa kuti mulingo wa enzymeyi umatsitsidwa, ndiye kuti, gland siyigwirizana ndi ntchito zake. Ndikofunikira kwambiri kusamala ngati zochitika za elastase ndizosakwana 100 mcg / g.

Kodi pancreatic ultrasound ndiyofunika liti?

An ultrasound ya kapamba imapangidwa nthawi imodzi ndikuwunika m'mimba. Mavuto otsatirawa azaumoyo ndi mawonetsero a ultrasound a ziwalo ziwiri izi:

Kumva kupweteka kumanzere hypochondrium,
Zizindikiro za neoplasms m'mimba
kufunika kotsimikizira matenda omwe adapezeka kale,
kupweteka pamene dotolo wamala,
kuchepa thupi mwadzidzidzi, madandaulo azachipatala,
amaganiza kuti ali ndi matenda ashuga
kusanza kwakanthawi, kusanza ndi kutulutsa,
madandaulo, thanzi la khungu.

Ultrasound ya England ndi m'mimba zimachitika ndi zotupa. Mitundu ina yopanga mawonekedwe ovuta siivuta kuyipeza chifukwa cha kukula kwawo kocheperako komanso kufanana kwake ndi ziwalo zolimba.

Mukukonzekera kwa ultrasound, zophukira zowonongeka zimatha kupezekanso, zomwe ndizosiyana kwambiri ndi kapangidwe kake.

Ngati chotupa chili chaching'ono (mpaka 1.5 cm), ndiye kuti sichisintha mawonekedwe achilengedwe. Ngati kukula kwake kukukulira, ndiye kuti ma gland amasiyana kwambiri.

Ultrasound imangokulolani kudziwa mawonekedwe, kukula ndi malo a chotupacho, komanso ndikuwonetsa kusintha komwe kwachitika ziwalo zapafupi.

Ngati pancreatitis ikukayikiridwa, ndi ultrasound imayikidwa chifukwa chovuta kuzindikira izi kumayambiriro.

Mukamayesedwa ndi ultrasound, mutha kudziwa mtundu wa matendawa komanso zovuta zomwe zingachitike.

Kukonzekera kwa ultrasound ya kapamba kumaphatikizapo chakudya chopanda mapuloteni. Amatsatiridwa kwa masiku atatu mayeso asanayesedwe.

Komanso nthawi imeneyi simungathe kumwa mankhwala. Wodwalayo ayenera kudya chakudya chamadzulo mma 18:00, atalephera kupanga mpweya, ayenera kumwa makala ozama usiku. M'mawa njira isanachitike, wodwalayo amapatsidwa mankhwala ofewetsa matendawa.

Mukamayesedwa, uzist amayang'ana mawonekedwe a minofu ya tiziwindi - imawonedwa kuti ndiyabwinobwino ngati ikufanana ndi kufupika kwa minofu ya chiwindi.

Ndi mawonekedwe osinthika, ma ray a ultrasound ali ndi mphamvu yochepetsedwa, chomwe chimapangitsa kutupira kwa chiwalo, chomwe chimadziwika kuti ndi chifuwa chachikulu cha pancreatitis.

Ndi matenda amtundu wa patency, ma patency a ultrasound, m'malo mwake, ndi okwera kwambiri.

Kuwerengetsa zotsatira za ultrasound kumachitika m'njira zingapo, pamaziko a chithandizo.

Pancreatitis nthawi zambiri imayamba mu mawonekedwe owopsa. Ngati simukutenga njira zadzidzidzi kuti muimitse, nthawi zina imatha kupha. Komabe, ali pachimake, amadzetsa ululu woopsa, ndipo mkhalidwe wa wodwalayo umakulirakulira mpaka munthu amakakamizidwa kukaonana ndi dokotala. Koma matendawa, atangobuka kamodzi, amakhalabe, ndipo munthuyo amakhalanso ndi moyo mpaka kumapeto kwa masiku ake. Kuyamba kuchotsedwa ndikuchoka pang'onopang'ono kukhala chovuta.

Zoyambitsa Pancreatitis

Kuzindikira matenda kapamba chifukwa cha njira zasayansi

Njira za pathological mu kapamba zimadziwikiratu ndi nthawi yayitali, pomwe madzi a parenchyma amasinthidwa ndi minofu yolumikizana minofu, endocrine ndi exocrine hypofunction ya limba imayamba. Zomwe zimayambitsa pancreatitis:

Kubera nguluwe waukulu,
kapangidwe ka miyala
hyperparathyroidism
chibadwire
uchidakwa

Zomwe zimayambitsa matenda a gland ndikuchokera kwa ma enzymes mumizere. Enzymes amabisa ma ducts, ndipo ichi chimakhala chifukwa chakukula kwawo motsutsana ndi kuwonongedwa kwa ma cell a ziwiya za ziphuphu, zomwe zimayambitsa kuphatikiza mapuloteni. Zotsatira zake, minofu yomwe imakhudzidwa ndi zotupa zimatuluka m'mizere.

Zowonekera zamankhwala a kapamba

Matendawa amatchulidwa mosiyanasiyana:

m'mawonekedwe owawa, ndipo amatha kuwonedwa ngati apamwamba:
Nthawi zambiri ululu umawoneka pamimba ndipo umayambira kumbuyo mpaka kumbuyo,
Herpes zoster ndizofala
kupweteka kumanja kapena kumanzere kwa hypochondrium. Kudziyambitsa kwawoko kumatsimikizika ndi gawo liti la kapamba omwe amakhudzidwa ndi kutupa.

Nthawi zambiri, kuukira kwa kupweteka kumayambitsidwa ndi chidakwa choledzera, mafuta ochulukirapo komanso zakudya zonunkhira. Ndipo kuti muthane ndi izi, muyenera kugwiritsa ntchito olimba mtima, ngakhale okonda mankhwala osokoneza bongo. Nthawi zambiri matenda a kapamba amatikumbutsa mawonetseredwe ake owopsa, koma nthawi zambiri osapweteka kwambiri.

Fomu lomaliza limadziwika ndi kusapezeka kwa ululu. Uku ndi kupenga kwake. Kupatula apo, kumva kupweteka kumakhala chizindikiro cha kuvulala kwamphamvu m'thupi linalake. Chifukwa ngakhale kuti palibe chowawa, anthu amapitiliza kukhala ndi moyo wokhala ndi moyo, osalabadira zisonyezo zina, kapena kuwalandila ndi mapiritsi. Koma mwanjira yaposachedwa, matendawa amadziwoneka okha.

Odwala nthawi zambiri amadandaula chifukwa cha mseru, kusafuna kudya, kukwiya chifukwa cha minyewa ya duodenum, kapena yotupa ya mucosa yake. Kukhetsa, kusanza kumawonedwa. Ntchito yamkati imalephera.

Chida chozindikira

Kuyesedwa kwa wodwala: palpation

Kuunika kwa X-ray kumawonetsa kuphatikiza. minofu yofewa ya kapamba, yemwe amadziwika kuti wagawidwa. Itha kuchitika ndi hyperthyroidism, maselo otupa ma cell, komanso amadziwika ndi anthu omwe amakhala ataledzera.

Scan tomography (CT) scan imakonda kugwiritsidwa ntchito ngati chotupa chakukula pang'onopang'ono chikukayikiridwa. Pokhala njira yodalirika yofufuzira, CT imakulitsa kwambiri mwayi wazotheka kudziwa matenda amtunduwu.

Kuunika kwa Ultrasound kumathandizira kudziwa pancreatitis mu 90% ya odwala, kuzindikira mawonekedwe, kutsitsa kuchepa, kudziwa, kapena kupatula kukhalapo kwa neoplasms. Endoscopic retrograde cholangiopancreatography (ERCP) imazindikira kupendekera kwamakonzedwe, zimapangitsa kudziwa kutengera kwa momwe zimakhalira - - kuwerengera ndi mapuloteni a mapuloteni.

Kuphatikiza apo, kuyesa kwam'matumbo kwathunthu kumachitika mu ERCP, yomwe imalola:

Onani ductor pancreatic,
Samba ya kapamba kuti muphunzire,
Dziwani zovuta zomwe zimapangitsa khansa yapanconitis.

Kafukufuku wa Laborator

Kudziwitsa za kwachilengedwe pancreatic catalysts - michere. Amylase ndi amodzi mwa ma enzyme omwe amawonetsa kutulutsa kwa gland, motero, momwe zimachitikira m'magazi ndi mkodzo amaphunziridwa koyamba. Amadziwika kuti kuchuluka kwa puloteni iyi m'magazi kumakwera pambuyo pa maola 2 mpaka 12 kuchokera pomwe amayamba kuukira, kumafika pachimake pofika masiku atsopano, ndipo ndi njira yabwino matendawa amabwereranso kwina atatha maola 48-96.

Kuukira kwa kapamba kumayambitsa kuphwanya chapakati pa njira ya nephron, chifukwa chomwe kuyamwa kwa amylase kumachepa ndipo nthawi yomweyo, kutsimikizika kwa impso kumawonjezeka (kuthekera kwa impso kupukusa zinyalala kuchokera mthupi).

Koma mwa odwala ena, kuchuluka kwa kutupa kwaminyewa sikumakhudza zochitika za amylase, ndipo kumakhazikika pakadutsa matendawa. Mu gulu ili la odwala, mulingo wa amylase ndiwotsika, chifukwa cha momwe minyewa ya parenchyma imayambira, motero kusintha kwa ntchito ya enzyme sikuonekera kwenikweni.

Apa ndikofunikira - kuzindikira kuti mkhalidwe wa amylase sungangotanthauza matenda a kapamba, komanso chiwonetsero cha zilonda zam'mimba, peritonitis, kulephera kwaimpso ndi matenda ena angapo. Zochita za Amylase zimatha kusintha ngakhale chifukwa chogwiritsa ntchito mankhwala ena: sulfonamides, njira zakulera, okodzetsa, ndi zina zambiri.

Ultrasound - monga matenda a kapamba aakulu

Chithunzi cholondola kwambiri chodziwitsa momwe matendawa amasonyezedwera ndi kuyeza ntchito ya trypsin, makamaka trypsinogen, yemwe zochita zake zimawonetsa hyper-enzymatic pancreatitis. Magazi phospholipase amatsimikiza ndi njira zotsatirazi:

immunofluorometric
zamitundu mitundu
radioimmunological.

Kuphatikizika ndi zochitika za enzymeyi zimaperekanso chidziwitso chodziwika bwino cha pathogenesis ya kapamba. Njira ina ya enzyme yapangidwa - kusanthula kwa elastase. Chifukwa chophunzira momwe ma enzyme amakhudzira boma la kapamba, zidapezeka kuti zomwe zili mu enzymeyi zimatuluka m'mbuyomu kuposa zina zonse ndipo zimasungidwa kwa masiku 10-12. Kuchuluka kwa zigawo zonse za kuwunikaku kumapereka chithunzi chokwanira cha matendawa.

Mkhalidwe wa exocrine gland ntchito

Njira ina yomwe imakupatsani mwayi kuti mupeze momwe gawo liliri ndi mayeso a secretin, omwe amakupatsirani mwayi wogwira ntchito ngati exocrine. Njirayi ndiyothandiza, koma, mwatsoka, siyipezeka paliponse chifukwa cha mtengo wake wokwera. Chinsinsi cha njirayi ndi motere: Choyamba, zikondamoyo zimapangika mwamphamvu ndi siriyo-pacreosimine. Pakapita kanthawi, duodenum imayesedwa ndi chida chapadera chomwe chimasonkhanitsa madzi a pancreatic.

Kukhalapo kwa kapamba kumawonetsedwa ndi mchere wapansi wa bicarbonate, womwe ndi wochepera 90 meq / l. ndi buku labwinobwino lazomwe zili mu duodenum.

Kuchuluka kwa madzi a pancreatic omwe amatulutsidwa m'matumbo awa kumatsimikiziridwa ndi kuchuluka kwa chymotrypsin pazinthu zopangira. Zomwe zimagwiritsidwanso ntchito ndi njira yodziwira kuchuluka kwa elastase 1 mu ndowe za wodwala. Steatorrhea - kuchuluka kwa mafuta pazovomerezeka za wodwalayo zam'mimbidwe ya pancreatitis, ndikuwonetsa kupanga kwaposakwanira kwa ma enzyme omwe amachepetsa mafuta. Kuti mupeze kusanthula koyenera musanachitike, ndikofunikira kukonza zakudya za wodwala malinga ndi zakudya za Schmidt, zomwe zimaphatikizapo:

105 g mapuloteni
135 g mafuta ndi
180 g chakudya.

Kuphatikizika kwakukulu kwa mafuta ndi sopo munthawi yochepa yamafuta acid kumatsimikizira kuchepa kwa ziwalo zomwe zimaphunziridwa.

Mankhwala

Dokotala aliyense wa gastroenterologist amatha kudziwa kuti ali ndi matenda kapamba

Kupulumutsidwa kwa vuto lakupweteka. Chithandizo cha mankhwala osokoneza bongo pachimake chimayimitsidwa pakuletsa ululu wammbuyo pogwiritsa ntchito ma pinkiller - analgesics, Baralgin ndi ena. Pafupipafupi, ngati ochiritsa wamba samathandizira, amagwiritsa ntchito zojambula zolemera - zokhala ndi mankhwala osokoneza bongo.

Ntchito yachepetsedwa

M'mimba, cholecystokine ndi secretin amapangidwa - zolimbitsa pancreatic zomwe zimapangitsa kuti zizigwira ntchito. Chiwalo chodwala pakadali pano chikuyamba kugwira ntchito mopweteka, ndikupangitsa wodwalayo zowawa zina. Ndipo pofuna kukakamiza kapamba kuti achepetse kugwira ntchito kwake, ma blockers (lanzoprazole ndi omeprazole) amaphatikizidwa mu chipinda chothandizira kuchipatala. Komanso, pofuna kuchepetsa kubisalira (onse endocrine ndi exocrine), Somastatin imayendetsedwa. Ngati mavuto atapezeka, mlingo wa mankhwalawa umachepetsedwa.

Thandizo la enzyme

Pakatikati pa mankhwalawa amathandizira pancreatitis ndi mankhwala othandizira am'mimba, makamaka pancreatin. Amathandizanso kupewa kupweteka ndikupanga kufooka kwa enzymeyi mthupi, ndikofunikira mwachangu pakukhudzana ndi gululi. Pali magulu osiyanasiyana azokonzekera za enzyme, zolumikizidwa ndi zigawo zawo:

Mankhwala omwe amapangidwa kuchokera ku akupanga a mucosa wam'mimba komanso kuphatikizapo pepsin - Acidin-Pepsin, Abomin, Pepsidil,
Zokonzekera zomwe zimakhala ndi ma pancreatic enzymes, monga amylase lipase, ndi trypsin. Awa ndi Creon, Pancreatin, Mezim-forte, Triforment, Pancurmen,
kukonzekera kokhala ndi pancreatin kuphatikiza ndi bile ndi hemicellulose mu € 'Festal, Digestal, Enzistal,
Ma enzyme osakanikirana
Anti-kutupa mankhwala. Vuto lililonse pamagulu abwinobwino la chiwalo limayendera limodzi ndi kuyambitsa matenda opatsirana ndi kutupa. Chifukwa chake, ndi kuchulukirachulukira kwa matenda kapamba, ma penicillin, betta-lactams, tetracyclines ndi mankhwala. Komanso, kusankha kwa mankhwala, mlingo ndi nthawi ya maphunzirowa zimatsimikiziridwa payekhapayekha.
Mankhwala a Antispasmodic. Mankhwala omwe amakhudza minofu yosalala amawerengedwa kwa hyper- kapena hypomotoria ya ndulu. Mlandu woyamba, antispasmodics amalembedwa - Papaverine, Platifillin, Galidor, No-shpa, etc., lachiwiri - prokinetics yomwe imalimbikitsa kuyambitsa kwa contractile ntchito ya minofu minofu - Domperidone, Cisapride Eglonil, etc.
Zakudya

Katswiri wazakudya atakupatsirani zakudya!

Kudwala kwambiri kumapangitsa kusintha kwa moyo wake. Munthu amakakamizidwa kusiya mowa kwathunthu, zakudya zamafuta kwambiri, kutsatira zakudya zina ndi zoletsa zomwe amadya.Mu gawo la kuchulukana kwa kapamba, limodzi ndi kuchuluka kwa michere, wodwalayo amamulembera kudya komanso kugwiritsa ntchito mchere wopanda mchere, wobalanso tiyi kapena msuzi wofowoka.

Kuyambira tsiku lachitatu lokha zakudya zopatsa mphamvu zopatsa mphamvu zopatsa mphamvu zomwe zimayambitsidwa muzakudyazo. Ngati kuli kotheka kuyimitsa kukokoloka, wodwalayo amapatsidwa mankhwala othandizira - tebulo No. 5a, lomwe nthawi zambiri limalembedwa kwa odwala omwe ali ndi matenda am'mimba. Tebulo ili

Mapuloteni mpaka 150 gr. (nyama yophika, mitundu ya nkhuku kapena nsomba, mkaka ndi mkaka. 1 dzira limodzi patsiku limaloledwa). 20 peresenti ya mapuloteniwa akhoza kukhala ochokera kumera.
Mafuta - mafuta a nyama amatsutsana kwambiri. Chovomerezedwa 10 gr. batala, kirimu kapena kirimu wowawasa, ndi 20-30 gr. - masamba.
Zakudya zamafuta - (kupanikizana, uchi, shuga) - amaloledwa kudya mkati mwa 70 gr. patsiku.
Sodium chlorine (sodium chloride) - 8. g Madzi - 2-2,5 malita.

Mavitamini A, C, B1, B2, B12, folic acid, PP ndi K ayenera kupezeka menyu tsiku ndi tsiku, chifukwa chake wodwalayo ayenera kudya masamba ndi zipatso mu mawonekedwe owiritsa, nthunzi komanso yaiwisi. Kwa wodwala ndikofunikira kukonza masamba, phala, mkaka, msuzi wosenda wa chimanga. Zakudya zamafuta ndi zinthu zina zimaloledwa (kupatula zinthu zamalaya). Zakudya zokazinga, zokometsera, zamzitini, marinade, zokometsera ndizotsutsana kwambiri. Zakudya zopatsa thanzi ndi gawo limodzi la mapulogalamu onse ochiritsira.

Chifukwa chomwe pancreatitis yayikulu imatchedwa "matenda a tchuthi", muphunzirapo kuchokera pa kanema:

Kutupa kwa pancreatic ndi vuto losasangalatsa komanso lowopsa. Mankhwala, amatchedwa pancreatitis. Mu matendawa, ma enzymes omwe amapangidwa mu kapamba amakhalamo, amayamba kuwononga zimakhala zake. Kuchiza kuyenera kukhala kwakanthawi. Kupanda kutero, kutupa kumakhala kosatha. Kodi ndi njira ziti zodziwikitsa mtundu wa matenda? Kodi matenda osiyanasiyana a kapamba amachitika bwanji? Nkhani izi ziyenera kufufuzidwa mwatsatanetsatane.

Essence of the matenda

Chikhotakhota ndi gawo laling'ono koma lofunikira la chimbudzi. Imagona kumbuyo kwa m'mimba ndikuyamba kuchokera ku duodenum mpaka ndulu. Zikondamoyo zili ndi mawonekedwe. Bola lililonse limakhala ndi duct. Mchiwalo, ma ducts onse amalumikizana ndikupanga dancino chachikulu. Palinso yachiwiri (yowonjezera) duct. Iliyonse ya iwo imalowa mu duodenum.

Chitsulo m'thupi la munthu chimagwira ntchito ziwiri:

Exocrine (exocrine). Madzi otulutsidwa kuchokera ku gland kupita ku duodenum mumakhala michere. Amathandizira kugaya mapuloteni, chakudya chamafuta ndi mafuta.
Endocrine (intrasecretory). Nthenga zimapangitsa mahomoni a polypeptide kulowa m'magazi. Amayang'anira kagayidwe kachakudya kamene kamachitika mthupi.

Ndi kutupa, ntchito za kapamba ndizovuta. Izi zimatsimikiziridwa ndi kupezeka kwa kapamba. Chinsinsi sichobisidwa kuchokera ku limba kulowa mu duodenum. Mwakutero, njira yodzigaya yokha ya zigawo za gland imayamba. Gawo la michere ndi poizoni pamenepa limatulutsidwa m'mitsempha yamagazi, limafalikira mthupi lonse ndikuvulaza ziwalo zina (chiwindi, impso, mapapu, mtima, komanso ubongo).

Matendawa amapezeka mwa anthu pazifukwa zosiyanasiyana. Ziwerengero zikuwonetsa kuti 50% ya anthu amadwala chifukwa chotupa chifukwa cha uchidakwa. Mu 20% ya milandu, kupezeka kwa kapamba mwa akulu kumawonetsa kuti matendawa amakula chifukwa cha matenda opatsika. Zomwe zimayambitsa kutupa kwapancreatic zimaphatikizapo:

matenda opatsirana, a virus ndi parasitic,
matenda oyamba ndi fungus
kuvulala ndi poyizoni,
mankhawala a endoscopic ndi ntchito.

Pancreatitis Gulu

Mwa mtundu wa maphunzirowo, matendawa amatha kukhala owuma (OD) komanso aakulu (CP). Mtundu woyamba wa matendawa umatanthawuza kutukusira komwe kumachitika mu kapamba ndikudutsitsa ziwalo zina ndi ziwalo zina. Matendawa amakula mwadzidzidzi chifukwa chakumwa mowa, zokometsera kapena zakudya zamafuta. Nthawi zina, kuyambika kwa matendawa kumayenderana ndi kudya zakudya zambiri ndikatha kusala kudya kwanthawi yayitali.

Akatswiri a pancreatitis acute amatchula motere:

Pachimake kwambiri kapamba. Ndi mawonekedwe awa, ziwalo zamkati sizigwira ntchito moyenera. Kusiyana matenda a kapamba amawulula kuphwanya kwakukulu.
Fomu lakuthwa. Ndi matenda amtunduwu, ntchito za ziwalo zimasokonezeka pang'ono.
Pachimake kwambiri kapamba, zovuta ndi parapancreatic kulowetsedwa, peritonitis, purulent abscesses, sepsis, magazi.

Matenda a kapamba amapezeka mwa anthu atavutika ndi mawonekedwe a pancreatic kutupa. Kutengera kuzika kwawo, akatswiri amasiyanitsa:

Mawonekedwe olimba. Pancreatitis imadziwika ndi njira yomwe imapitilira mobwerezabwereza. Nthawi zakukhululuka ndizosowa komanso ndizochepa.
Njira yamatendawa imakhala yochepa. Kuchulukitsa kwa kutupa kwa kapamba kumachitika katatu pachaka. Kupweteka kwamimba m'mimba kumatenga nthawi yayitali.
Njira yofatsa yamatenda. Exacerbations ndiyifupi komanso osowa. Amachitika kawiri pachaka.

Zizindikiro za kutupa pachimake

Kupweteka kwa epigastric ndi chizindikiro chowonetsa pancreatitis yayikulu. Kuzindikiritsa mosiyanasiyana pamaso pa chizindikirochi kumachitika nthawi yomweyo, chifukwa ululuwu nthawi zambiri umakhala wolimba kwambiri kotero kuti anthu sanganame ndikungokhala chete. Pambuyo pakuzindikira komanso kuzindikira moyenera akatswiri amatha kuchita chilichonse kuti athetse vuto la odwala.

Chizindikiro china chodziwika bwino chotupa kapamba ndi kusanza, komwe kumachitika mobwerezabwereza. Sizibweretsa mpumulo kwa anthu odwala. Mkhalidwe wawo chifukwa cha kusanza umangokulira. Zizindikiro zina za pancreatitis pachimake ndi monga:

khungu, acrocyanosis (kupeza kwa khungu loyera),
ukufalikira
posungira mafuta, chopondapo,
kufooka kwambiri.

Zizindikiro za Chronic Pancreatitis

Zizindikiro za CP ndizosiyana munthawi yakukhululuka komanso kuchotsedwa. Zimatengera zifukwa zingapo: siteji, zamankhwala zamtundu wa matenda. Ngakhale izi, zingapo zazikulu za chifuwa chachikulu chimatha kusiyanasiyana:

Kudzimbidwa. Zimawonetsedwa ndikuwonjezereka kwa kuchuluka ndi kuchuluka kwa chopondapo. Pancreatitis yayitali, ndowe zimakhala ndi imvi komanso fungo la fetid. Nthawi zambiri mumakhala zakudya zotsalira zomwe sizinapayidwe. Zizindikiro zomwe zili pamwambazi zimachitika chifukwa cha kuchepa kwa kuchuluka kwa mphamvu yogwira ntchito ya prulinine parenchyma komanso kuphwanya chinsinsi cha kutulutsa tulo mu duodenum.
Kufooka, kunjenjemera mthupi lonse, njala, kukokana, kusuntha kwamatumbo ndi kukodza, kusiya kuzindikira. Zizindikiro izi za CP zimagwirizanitsidwa ndi kuphwanya kwa magwiridwe antchito a kapamba.
Ululu wam'mimba. Zowawa sizikudziwikiratu. Itha kuchitika pakati kapena pamimba pamimba ndikutenga herpes zoster. Nthawi zina, ululu suwonedwa.

Kuzindikira matenda apachimbudzi

Potsimikizira kuti ali ndi vutoli, madokotala amapereka mayeso kwa odwala awo. Kuzindikira matenda a kapamba kumaphatikizapo kuyezetsa magazi komwe kumachitika kuti mudziwe kuchuluka kwa michere yomwe imapangidwa mu kapamba. Mayeso wamba a seramu amylase ndiofala. Mlingo wa enzyme imeneyi ndi wokwera kangapo kuposa masiku onse mwa anthu omwe ali ndi pancreatitis yayikulu.

Njira zakuzindikira zimaphatikizanso urinalysis. Malinga ndi zotsatira za kuwunika kwa odwala kwawulula:

proteinuria (zam'mapuloteni mumkodzo),
micromaturia (kukhalapo kwa magazi mumkodzo mopitilira muyeso yachilengedwe),
cylindruria (mawonekedwe a mkodzo wa matupi acylindrical opangidwa m'magazi am'magazi, mapuloteni ophatikizika, aimpso epulelium).

Njira yodalirika yodziwira matenda a pancreatitis pachimake ndi complication tomography (CT). Zimakupatsani chithunzi cha kapamba, ziwalo zozungulira komanso ziwalo zamkati, kuzindikira zovuta za matendawa, kuwunika kukula ndi chikhalidwe cha zotupa zapamba pancreatic necrosis.

Kuzindikira ndi kuchiza pancreatitis yachilendo imatha kuchitika chifukwa cha laparoscopy. Kugwiritsa ntchito, madokotala omwe ali ndi chitsimikizo chachikulu amazindikira mtundu wa matendawa, kuzindikira ndikuchotsa zovuta zina za matendawa.

Njira yodziwika bwino, yophunzitsira, yosavuta komanso yotetezeka yopezera matenda ndi kupezeka kwa matenda a pancreatitis pachimake. Ikachitika, kukula, ma contour, mawonekedwe, mawonekedwe amkati, kuphatikizika kwa kapamba, ndi momwe ductal system imayesedwera.

Kuzindikira mawonekedwe osakhazikika

Kuzindikira pancreatitis mwa akulu kumakhala makamaka ndi ultrasound ndi CT. Anthu odwala amapatsidwa gawo la endoscopic retrograde cholangiopancreatography. Njira yofufuzira iyi ndi kuphatikiza kwa endoscopy ndi fluoroscopy.

Kuzindikira matenda kapamba kumakhalanso ndi kutsimikiza kwa exocrine pancreatic ntchito. Ndizolinga izi kuti akatswiri azichita pulogalamu - yowerengera labotale yomwe imakuthandizani kuti mupeze zotsalira za chakudya chosagwiritsidwa ntchito mu ndowe.

Ntchito ya Exocrine pancreatic imatha kuyesedwa pogwiritsa ntchito mayeso a C-mpweya. Ubwino wawo waukulu ndiosavulaza (kusowa kwaphwanya umphumphu wa zopinga zakunja za thupi). Kudziwona koteroko kwa kapamba kumapangitsanso kudziwa kuyenera kwa enzyme m'malo mwake.

Mankhwalawa pachimake kapamba

Ngati pali zizindikiro zomwe zikuwonetsa kukula kwa OP, wodwala ayenera kupatsidwa thandizo loyamba:

letsa kudya ndi kumwa kwa masiku angapo,
ikani choko
perekani antispasmodics (chifukwa chogwiritsa ntchito "No-shpa" kapena "Papaverine" kupanga ma enzyme kuchepa).

Pambuyo pa thandizo loyamba, muyenera kuyimbira foni dokotala. Munthu ayenera kuchipatala. Kuzindikira kwa ultrasound kwa pancreatitis pachimake kumachitika nthawi yomweyo kuchipatala. Pambuyo pokhazikitsa kuzindikira koyenera, ma analgesics amalembedwa (Baralgin, Analgin) kuti athetse kupweteka.

Mankhwalawa amagwiritsanso ntchito mayankho a amino acid ndi glucose. Amadzipangira zosowa za pulasitiki komanso mphamvu za thupi. Maantibayotiki nawonso amalembedwa. Mankhwalawa ndi ofunikira kuti athandizidwe komanso kupewa matenda a purulent.

Patatha masiku angapo chiyambireni chithandizo, probe woonda amaikidwa m'matumbo ang'onoang'ono. Ndikofunikira pakugwiritsa ntchito njira zamagulu azakudya. Ntchito yamatumbo ikabwezeretsedwa, wodwalayo amaloledwa kudya zachilengedwe. Chakudyacho chizikhala ndi mbewu monga chimanga, masamba ophika, makompyuta.

Chithandizo cha Conservative mu 87% ya milandu chimachita bwino. 13% yotsala ya odwala amafunikira chithandizo chamankhwala. Zimachitika pamene kupezeka kwa matenda a kapamba amawulula zovuta zazikulu. Zolinga zamankhwala opaleshoni ndi awa:

Kuchepetsa endotoxemia. Chifukwa cha izi, kukhetsa ndi kuwonongeka kwa ma ducts a bile, kukoka ndi kukonzanso kwam'mimba pamimba kumayikidwa. Pa nthawi ya opareshoni, ma enzyme, poizoni ndi zinthu zina zomwe zimagwira thupi zimachotsedwa m'thupi.
Chithandizo cha matenda opatsirana ndi necrotic a pancreatic necrosis (abscesses, fistulas, cysts, peritonitis). Kuti mukwaniritse izi, akatswiri amachita zoyeserera komanso kukoka kwa ma post-necrotic, ma purcine patsekeke, resection and sequestrectomy ya kapamba.

Chithandizo chachikulu cha kutupa

Ngati kupezeka kwa matenda a pancreatitis kuwonetsa mtundu wa matendawa, ndiye kuti mankhwala osiyanasiyana angafotokozedwe kwa odwala: kukonzekera kwa pancreatin-enzyme (Mezim, Festal, Creon), maantibayotiki (Abaktal, Amoksiklav, Sumamed) ndi ena Nthawi zina (mwachitsanzo, ndi pseudocyst wopangidwira) pang'onopang'ono madzi am'kati kapena opareshoni amafunikira.

Udindo wofunikira umachitika ndi zakudya. Ndi kuchulukitsa kwa matendawa patsiku la 1-2, odwala amaletsedwa kudya chilichonse. Mutha kumwa madzi okha (malita 1-1,5 patsiku): tiyi wofooka, mchere wamchere wopanda mafuta, msuzi wa rose yamtchire (magalasi 1-2). Patsiku la 2-3, chakudya chimaloledwa. Supu zokonda, amphaka amkaka osenda amkaka, zakumwa zamasamba, zakudya zonunkhira zopangidwa kuchokera ku msuzi wa zipatso zimaloledwa.

Panthawi yachikhululukiro, muyenera kutsatira malangizo awa:

Cook wothira, kusenda kapena kuphika mu uvuni. Pewani mafuta oyera pazakudya ndikuchepetsa mchere mpaka 6 g patsiku.
Idyani zakudya zazing'ono 5-6 patsiku. Kutentha kolimbikitsidwa kwa mbale zotentha sikokwanira kuposa madigiri 57−62, ozizira - osachepera 15−17 madigiri.
Musachotse mu zakudya acidic, zonunkhira, zokometsera ndi zakudya zam'chitini, nandolo ndi nyemba, bowa, zakumwa zozizilitsa kukhosi ndi zakumwa zoledzeretsa, kvass, misuzi yazipatso zamchere, ndi zinthu zina zambiri zophika mkate. Kirimu ndi wowawasa kirimu amaloledwa pang'ono m'mbale.

Njira zina zochiritsira

Mwanjira yovuta yotupa kapamba, njira yokhayo yoyenera ndikuwona dokotala. Sikoyenera kuyesa mankhwala azikhalidwe zaanthu. Ngati Zizindikiro ndi matenda a pancreatitis akuwonetsa mtundu wa matenda, ndiye kuti mutha kuyesa njira zochizira zomwe zimaperekedwa ndi mankhwala ena.

Zotsatira zabwino nthawi zambiri zimapatsa mankhwala azitsamba. Kugwiritsa ntchito mankhwala azitsamba kungathandize kwambiri kuti anthu omwe ali ndi matenda apamba a pancreatitis asamavutike. Nayi chinsinsi cha mankhwala amodzi:

sakanizani magawo awiri ofanana chimanga stigmas, chamomile ndi maluwa a calendula, masamba ophukira ndi udzu wa timbewu,
kutenga 1 tsp. kuchokera osakaniza ndi kutsanulira 2 makapu madzi otentha,
sambani msuzi m'madzi osamba kwa mphindi 15,
tsitsani chomaliza ndi mphindi 45 ndikuvutikira.

Ndikulimbikitsidwa kumwa msuzi katatu patsiku kwa mphindi 15 musanadye chakudya, makapu 0,4, omwe m'mbuyomu amadzipereka ndi madzi ofunda mpaka kuchuluka kwa kapu. Mutha kusunga malonda mufiriji mpaka masiku 5.

Kupewa kwa Pancreatitis

Ndizotheka kuteteza chitukuko cha kapamba. Choyamba, muyenera kuyang'anira thanzi lanu. Matenda ena amisempha yonyansa komanso chikhodzodzo, matenda am'mimba amachepetsa kutupa kwa kapamba. Ngati vuto laumoyo likuwoneka bwino komanso ngati zikuwoneka kuti muli ndi malingaliro okayikitsa, muyenera kufunsa dokotala, mukayezetse mayeso ofunikira ndikupita kukayesedwa.

Njira ina yothanirana ndi kupewa kumwa mowa. Akatswiri amalimbikitsa ngakhale anthu athanzi labwino kuti asamwe mowa wambiri. Mu matenda am'mimba, mowa uyenera kusiyidwa kwathunthu.

Pomaliza, ndikofunikira kudziwa kuti pancreatitis (kliniki, matenda, chithandizo cha matendawa) ndi mutu wachipatala wofulumira. Ngati pali zizindikiro zomwe zikusonyeza kuti zikondazo zimayipa, muyenera kufunsa dokotala. Kuthamanga ndi matenda kumatha kubweretsa zovuta zowopsa m'moyo.

Zakudya zopanda pake, kudya kwambiri mowa ndi kusuta fodya, mankhwala osagwiritsika ntchito samabweretsa kufa nthawi yomweyo. Amayambitsa matenda owopsa kapena otupa, ndipo nthawi zina chotupa, zimachitika mu kapamba, ndipo zimayambitsa matenda ashuga. Ndi okhawo omwe, popanda kudikirira kuti muwone ngati pali zoopsa zilizonse, amadziwa momwe angayang'anire kapamba angatenge nthawi pakupewa komanso kupewa zovuta zazikulu za kapamba. Tiyeni titsegule chophimba chachinsinsi.

Mfundo za Mayeso a Pancreatic

Dziwani za kapamba ayenera kukhala wokwanira: muyenera kudziwa zambiri osati za kapangidwe ka chiwalo, komanso ntchito zake. Tiyeni tifotokoze chifukwa chake.

Pancreas ndimatumbo akuluakulu okhala ndi mawonekedwe apadera ndi ntchito zake. Ndiamene amakhala ndi gawo lofunikira pakukonza chimbudzi, kupanga ma michere ofunikira kuti magazi awonongeke komanso zinthu zina, kamodzi m'magazi, azidyetsa maselo. Insulin imapangidwa mu gland iyi, yomwe imathandizira gawo lalikulu lamphamvu - glucose - kupereka mphamvu ku maselo ndi minyewa. Ma mahomoni ena amapangidwanso mmenemo.

Kutikako kumakhala pamalo opezekera kumbuyo kwake, kutsogolo kwake kuli m'mimba, m'matumbo opatsirana ndi duodenum, komanso impso mbali zonse ziwiri. Mkati mwa chiwalo, ma ducts amadutsa omwe amatenga madzi a kapamba omwe amakhala ndi ma enzymes ochokera ku maselo a glandular. Zimayenderera mu duct imodzi yayikulu, yomwe imatseguka mu duodenum.

Ngati tinthu tina tambiri touluka tawonongeka, minofu yotsalayo idalowa m'malo mwake, ndipo palibe chizindikiro cha matendawa. Nthawi yomweyo, zinthu zitha kuchitika malo ochepa kwambiri akamwalira kapena kuwonongeka, izi sizikuwoneka pamapangidwe a gawo lonse la chinyezi, koma zimayendera limodzi ndi kusintha kwa mawu mu ntchito ya chiwalo. Ichi ndi chifukwa chake kuwunika kwa kapamba kuyenera kukhala kokulira, ndikufotokoza zonse za kapangidwe kake ndi ntchito yake.

Mayeso a labotale

Nthawi zina, ndikofunikira kuchita mayeso ena osati pamimba yopanda kanthu, komanso pambuyo pobweretsa zinthu zina mthupi - mayeso opsinjika.

Pali mayeso amtundu wotere:

Mayeso a Glycoamylasemic. Kukhazikika kwa magazi amylase kumatsimikiziridwa, pambuyo pake munthu ayenera kumwa 50 g shuga, pambuyo pa maola atatu kuwunika mobwerezabwereza kwa amylase. Ndi pathology, pambuyo pa maola atatu pali kuwonjezeka kwa enzyme iyi kuposa 25% kuchokera pamlingo woyamba.
Kuyesa kwa Proserin. Kukhazikika koyamba kwa mkodzo diastase kumatsimikiziridwa, pambuyo pake mankhwala "Proserin" amayamba. Ndiye, theka lirilonse la maola 2, gawo la diastase limayezedwa: nthawi zambiri limakwera osaposa nthawi 2, koma kenako limabweranso kwazonse. Ndi mitundu yosiyanasiyana yamatenda a pancreatic, zizindikiro zosiyanasiyana zimatsimikizika.
Mayeso a Iodolipol. Podzuka, wodwalayo akodza, kenako amatenga mankhwala "Iodolipol" mkati. Ndipo mu ola limodzi, theka ndi theka, ayodini. Kuzindikira kwamatenda a pancreatic kumadalira ntchito ya lipase enzyme yopangidwa ndi chiwalochi. Nthawi zambiri, pakangotha ola limodzi, ayodini amayamba kupezeka mumkodzo, ndipo kuchuluka kwake kwa mkodzo kumakulirakulira - m'chigawo chimodzi cha mkodzo pambuyo pa maola 2,5.
Kuyesedwa kwa Secretin-pancreosimine. Zimakhazikika pakusintha kwazomwe zimapangidwa ndi mankhwala omwe amapezeka mu duodenum pambuyo pokhazikitsidwa kwa chinthu chokhala ndi mahomoni ngati cellin (zimapangitsa secretion yowonjezera ya pancreatic juwisi wokhala ndi ma bicarbonate ndi ma enzyme kulowa m'matumbo).
Kuyesa kwa glucose ndikofunikira kuti muzindikire kuwonongeka kwa pancreatic endocrine. Potere, kuthamanga kwa shuga m'magazi kumatsimikiziridwa, ola limodzi ndi awiri atatha kuyamwa kwamkati. Kusanthula kumeneku kumayikidwa ndi endocrinologist yekha, ndipo amawatanthauzira, popeza pamakhala chiopsezo cha zovuta zomwe zimakhudzana ndikuwonjezereka kwa kuchuluka kwa magazi a carbohydrate iyi.

Kafukufuku wamabungwe

Kafukufuku wa kapamba amatengera zomwe zimachitika minyewa: sizikuwoneka pakuwunika pafupipafupi kwa x-ray, koma ndowe za nduluzo zimatha kupimidwa ndikuwunika, ndikuwonetsera kusiyana. Iron imapezeka kuti ipimidwe ndi ultrasound, ndipo dopplerography imatsimikiza kutuluka kwa magazi m'mitsempha yake. Dongosolo lakatundu wa CD limawonetsetsa momwe limapangidwira m'magulu, koma mphamvu yake yamagalamu ndi yabwino kwambiri kudziwa gawo laling'ono kwambiri la chiwalo. Tiyeni tiwone chilichonse mwadongosolo.

Njira za X-ray

Kufufuza kwa radiology kumakupatsani mwayi wowona minyewa yaying'ono, calculi yayikulu mumizere yake.
Endoscopic retrograde cholangiopancreatography - kukhazikitsidwa kwa njira yosiyanitsa ndi X-ray kuzungulira ma gland kuchokera ku duodenum pogwiritsa ntchito zida zamagetsi zomwe zimapangidwa ndi fibrogastroscopy.
Angiography yosankha ndi kuwunika kwa X-ray ya zonyamula ziwalo pambuyo pothandizidwa ndi wotsutsana naye.
Dongosolo la tomography yophatikizidwa imathandizira pakuwunika zotupa ndi zotupa m'mitsempha.

Njira iliyonse yoyeserera imafunikira kukonzekera kwa wodwalayo.

Kuyesa kwa Ultrasound

Njirayi si yolondola monga yowerengera tomographic, koma chifukwa chosavuta komanso chitetezo, ndizofunikira pakuwunika koyambirira kwa matenda a gland pathologies. Ultrasound imakupatsani mwayi kuwona m'matumbo owopsa komanso otupa, zotupa, ma abscesses, cysts, Doppler ultrasound imathandiza kwambiri pakuyang'ana koyambirira kwa magazi. Njirayi imafunikira kukonzekera kusanachitike. Pazomwe mungachite kuti zotsatira za phunziroli ndizodalirika, tafotokozera m'nkhaniyi: Kukonzekera kwa ultrasound mu matenda a kapamba.

Magnetic resonance imaging

Kuyerekezera kwa NMR ndiyo njira yophunzitsira bwino kwambiri yofufuza zofufumitsa, zomwe zimawona bwino minyewa yazigawo m'magulu. Mukaphatikiza MRI ndikumayambitsa kusiyana pakati pa ma ducts (cholangipancreatography) kapena mitsempha yamagazi (angiography), kudalirika kwakukulu pakuphunzira kwa kapamba kumatheka.

Zizindikiro za pancreatic MRI ndi izi: