Mu 1930, Frey adagwiritsa ntchito bwino trasilol kallikrein inactivator kuchiza pancreatitis pachimake. Pulosesa yoyesedwa yoyamba ya proteinase idapezedwa ndi M. Kunitz ndi J. H. Norlrop mu 1936 kuchokera ku zikondamoyo za nyama.

Chuma wamba cha zoletsa (kukonzekera kwa antienzyme) ndikutha kutsekereza ntchito ya michere ya proteinolytic mwa kupangidwe kwa maofesi okhazikika nawo. Mpaka pano, ntchito zopitilira 2,000 zasindikizidwa pakugwiritsa ntchito antienzyme pokonzekera matenda a pancreatitis pachimake, onse kuchipatala komanso poyeserera. Komabe, panalibe mgwirizano pazovomerezeka zazomwe amagwiritsa ntchito, kugwiranso ntchito, Mlingo, njira zoyendetsera. Madokotala ambiri ochita opaleshoni amakhulupirira kuti kugwiritsa ntchito ma inhibitors sikupereka kanthu, akulozera kuti kukonzekera kwothandizira, ngakhale waukulu, musasokoneze ndondomeko ya necrotic mu gland ndi para-pancreatic fiber. Ndi mawonekedwe odabwitsa a kapamba, kugwiritsa ntchito trasilol ndi mankhwala ena a antienzyme sikuyenera kuchokera kuchipatala komanso momwe chuma chikuwonekera. Komabe, kugwiritsa ntchito ma proteinase inhibitors sikuyenera kusiyidwa kwathunthu.

Zochitika za asing'anga am'nyumba ndi zakunja zikuwonetsa kuti proteinol inhibitors imalepheretsa mapangidwe a kinin ndi Autolysis mwa inactivating trypsin, kallikrein, chymotrypsin ndi plasmin. Tidazindikira kuti mothandizidwa ndi zoletsa zoletsa nthawi zambiri zimatha kuchotsa odwala ku mantha, toxemia, kusintha zomwe zimachitika komanso kusintha magawo ena a biochemical. Kuphatikiza apo, zimadziwika kuti kukonzekera kumathandizira kuletsa esterase, proteinolytic ndi kininogenase ntchito ya plasma ndi pancreatic kallikrein.

Pambuyo pa makonzedwe a antienzyme kwa wodwala kwa mphindi 5, mawonekedwe osagwira a inhibitor-enzyme (Werle, 1963). Mphindi 60 pambuyo pa kulowetsedwa, zomwe zili mu magazi zimachepetsedwa, pomwe nthawi iyi impso zimakhala ndi zopitilira 50% ya zovulaza. Kupangitsa kwathunthu kwa enzyme kumachitika pokhapokha ngati pali owonjezera enhibitor.

Kukhazikitsidwa kuyesedwa kuti mpaka 98% ya ma antienzymes okhala ngati mawonekedwe amaphatikizika ndi impso. Amakhulupirira kuti trasilol ndi kufananiza kwake kumalepheretsa ntchito ya kininogenin (kallikrein) mu minofu ya minyewa, kutsutsana ndi zochita za kagayidwe ka gland parenchyma, kumakhudzanso michere ya cellcirculation ndi oxygen. Hafu ya moyo wa trasilol, kontrikal ndi mapuloteni ena ochokera m'magazi ndi maola 2. Chifukwa chake, kukonzekera kwa antienzyme kuyenera kuperekedwa pafupipafupi. Zotulukapo pakati pa zoyendetsa siziyenera kupitirira maola atatu, ndipo mulingo wa inactivator nthawi zonse uzikhala wokwezeka kuposa mulingo wa ma enzymes a proteinolytic. Pankhaniyi, kuyang'anira kwakanthawi kochepa kwa milingo yaying'ono ya zolepheretsa sikungatheke komanso sikothandiza. Mlingo wa tsiku ndi tsiku wa zoletsa uyenera kutsimikizidwa poganizira theka la moyo wawo kuchokera m'magazi (maola 2). Mlingo waukulu wa kukonzekera kwa antienzyme uyenera kuperekedwa patsiku loyamba la matendawa.

Malinga ndi deta yathu (MayatC. et al., 1976), potengera zotsatira za chithandizo cha odwala 107, njira yoyendetsera kukonzekera kwa antienzyme ngakhale mu Mlingo waukulu siyimitsa kuyambika kwa pancreatic necrosis. Ndikofunika kudziwa kuti kugwira ntchito kwa zoletsa kumatsimikiziridwa ndi kuchuluka kwa nthawi yomwe yadutsa kuyambira nthawi yoyamba matendawa mpaka nthawi yomwe amagwiritsidwa ntchito komanso mlingo wa mankhwalawa. Malinga ndi azachipatala ambiri, kukonzekera kwa antienzyme kuyenera kutumikiridwa mu maola 6 oyambilira kuchokera pomwe matendawa amatha. Zotsatira zolimbikitsanso zinapezeka ndikuyambitsa kwa zoletsa kulowa mumtengo wa celiac. SavlievC. (1983) ikutsimikizira kukonzekera kwamakonzedwe a antienzyme pakadutsa maola 3-4.

G.P. Titova (1989) adawona kuti proteinase inhibitors mu kuyesa kwapancreatitis sichepetsa kukula kwa chiwonongeko komanso samachotsa zovuta zam'deralo hemorheological.

Muzochita zamankhwala, zotsatirazi za protease inhibitors ndizofala kwambiri: Contrical, Trasilol (Germany), Gordox (Hungary), Pantripin (Russia), Tsalol (Italy).

Kuphatikiza ndi mankhwala osiyanitsidwa ndi mapapu a ng'ombe. Imaletsa ntchito ya trypsin, kallikrein, plasmin. Amagwiritsidwa ntchito kudzera m'mitsempha ndipo amayikidwa mu maunititrate a ma antitrypsin (1 unit inactivates 6 μg of trypsin). Mlingo umodzi wampira wamkati pachimake ndimitundu 20,000, tsiku lililonse - 60,000 mayunitsi. Njira ya chithandizo ndi mayunitsi 500,000-700,000. Mankhwalawa angagwiritsidwe ntchito mopitilira muyeso wa parapancreatic fiber.

Trasilol amachokera ku zotumphukira zotumphukira za nyama. Mankhwala amalepheretsa ntchito ya plasmin, kallikrein, trypsin ndi michere ina ya proteinolytic. Komanso, zimakhudza yogwira trypsin kanayi ofooka kuposa zochitika za kallikrein. Nthawi yozungulira yozungulira kuzungulira kwake m'magazi ndi mphindi 150. Amagwiritsidwa ntchito muyezo: mayunitsi 50,000-75,000, omwe ali ovuta kwambiri - mpaka mayunitsi 100,000, amathandizidwa mosavuta mu 250-500 ml ya shuga 5% ya shuga. Maphunziro a chithandizo - 400000-500000 mayunitsi. Njira ya mankhwala a antienzyme nthawi zambiri imatha pofika tsiku la 7-10.

Gordox, ngati trasilol, imapezeka kuchokera ku tiziwalo tating'ono ta nyama. Lumikizanani ndi mafupa. Monga mlingo woyambirira, mayunitsi 500,000 amayenera kuperekedwa pang'onopang'ono, ndiye magawo a 50,000 ora lililonse. M'masiku otsatirawa atatha kukonza, mlingo wa tsiku ndi tsiku umatha kuchepetsedwa kukhala magawo 300,000-500,000.

Pantripin imapezeka kuchokera ku zikondamoyo za nyama. Chimodzi mwa izo chimafanana ndi 800 IU ya trasilol. Mlingo watsiku ndi tsiku ndi magawo 300, omwe ali m'mitundu yayikulu - mpaka 400-500 mauniti nthawi.

Tsalol amachokera ku ma parotid glands a ng'ombe. Mlingo umodzi - mayunitsi 25,000, tsiku lililonse - mayunitsi 50,000. Lowani kudzera mkati. Njira ya chithandizo ndi mayunitsi 300000-400000.

Protease inhibitors imatha kuyambitsidwa mu thumba lokutira, kutsegula mobwerezabwereza pakuchita opareshoni.

Mavuto omwe amagwiritsidwa ntchito popanga ma proteinase inhibitors ndi osowa kwambiri. Pali maumboni ena okhudza anaphylactic ndi khungu lawo siligwirizana, kukula kwa thrombophlebitis m'mitsempha. P. Kyrle (1962) adaona kusintha kwa ma pseudocysts ndi ma abscesses.

Mukamapereka mankhwala othandizira odwala omwe ali ndi vuto la pancreatitis, mfundo zotsatirazi ziyenera kutsatiridwa: 1) kuganizira za nthawi yomwe yapezeka (matenda oyamba, kuchipatala ndi chithandizo), 2) kuganizira za mitundu ya matenda ndi morphological ya pancreatitis yayikulu, 3) kugwiritsa ntchito koyambirira kwa kukonzekera kwa antienzyme, 4) kugwiritsa ntchito kuphatikiza Njira zoyendetsera zoletsa (Savelyev BC et al., 1976).

Njira yolowera pakayendetsedwe ka proteinase inhibitors sichilola kuti pakhale kuchuluka kwa iwo mu kapamba. Pofuna kukonza zotsatira zamankhwala a NS pancreatitis Savliev (1976), Yu.A. Nesterenko et al. (1978) amalimbikitsa kukhazikitsa kwa proteinase inhibitors intra-aortic kapena mwa kusankha catheterization wa celiac artery malinga ndi Seldinger-Edman. Mu chipatalachi, njira iyi idagwiritsidwa ntchito koyamba ndi K.N. Grozinger ndi Wenz (1965). Osatchuka pakadali pano.

B.C. Briskin et al. (1989) adachita mankhwala a intra-aortic mwa odwala 92 omwe ali ndi pancreatitis ya pachimake. Cathetered thunthu la celiac kapena chotupa chachikulu cha mesenteric, nthawi zambiri mitsempha yonseyo. Zomwe zimaphatikizidwa ndi mankhwala osakanikirana ndizophatikizira: gelatin, polyglucin, albin, komanso palibe-spa, papaverine, kutsatira, mankhwala othandizira, gordox (600 000-800 000 patsiku). Kuchuluka kwa kulowetsedwa kudalira BCC ndipo kuyambira 2000 mpaka 3500 ml patsiku. Ngati ndi kotheka, kuchuluka kowonjezera kwamadzimadzi ndi mankhwala kunaperekedwa kudzera m'mitsempha. Olembawo amakhulupirira kuti kufalikira kwa kutukusira mu minofu ya retroperitoneal kutha kuyimitsidwa ndikuyambitsa madzi ndi mankhwala nthawi imodzi m'mitsempha iwiri.

V.P. Grigoriev (1978) pakuyambitsa zoletsa zinaimitsa gastro-omental gland. Ubwino wa zolembedwa zama proteinase zoletsa ndikuti, kuwonjezera pamachitidwe achindunji, zimakupatsani mwayi wopitilira zosefera zachilengedwe - chiwindi ndi mapapu.

Muzochita zamankhwala, ma proteinase inhibitors sanagwiritsidwe ntchito kwambiri pazifukwa zachuma, komanso chifukwa cha kusakwanira kwathunthu kwa pancreatic necrosis. Komabe, ndi toxemia wovuta, kuphatikiza mankhwala ophatikiza ndi cytostatics ndi proteinase inhibitors ndikofunikira, zomwe zimakupatsani mwayi wolepheretsa nduluyi komanso kutulutsa timadzi tating'ono timene timayenderera m'magazi, nymph, ndi zimakhala.

Mankhwala a kapamba

Tiyenera kukumbukira kuti pancreatitis yovuta kwambiri imatanthauzira zofunikira, ndipo chithandizo chake chimachitika kuchipatala chachipatala, pomwe odwala, nthawi zambiri, amagonekedwa kuchipatala ndi gulu lodzidzimutsa. Woopsa milandu, amene amapezeka 20-25% ya odwala, vuto pafupi ndi kupweteka kwam'mimba limawonedwa, ndipo ngati kutaya kwambiri kwamadzi chifukwa cha kusanza, ndi hypovolemia.

Chifukwa chake, mankhwala osokoneza bongo a pancreatitis pachimake, poyambilira, ayenera kuthetsa ululu wambiri, kutsagana ndi mseru, kusanza, kuchuluka kwa mtima ndi kutsika kwa magazi, komanso kubwezeretsani mulingo wamagetsi am'mthupi. Ululu umatsitsidwanso ndi makina a parenteral a analgesics (Novocaine wokhala ndi shuga, Analgin, Ketanov) kapena antispasmodics: No-shpa, Papaverine hydrochloride, Platifillin hydroartate, Metacin kapena Ganglefen hydrochloride.

Nthawi yomweyo, kuchira kwamadzimadzi ndi kukhazikika kwa hemodynamic kumachitika: dontho limayikidwa mobwerezabwereza chifukwa cha kapamba - ndi mchere, glucose ndi zinthu zina zomwe zimathandizira ntchito ya machitidwe ndi ziwalo zosiyanasiyana. Syndrome ya systemic yotupa poyankha, sepsis ndi ziwalo zingapo zolephera zimayamba mwa odwala omwe ali ndi vuto lalikulu la kapamba chifukwa amamuyambitsa ma pancreatic enzymes a cell yake.

Chifukwa chake, njira zoperekera chisamaliro chachikulu zimaphatikizidwa ndi kupewa matenda ophatikizidwa ndi kapamba kapena kulimbana ndi matenda omwe alipo kale, ndipo maantibayotiki amagwiritsidwa ntchito mu gastroenterology kuthetsa vutoli (nthawi zambiri, awa ndi Amoxiclav kapena cephalosporins a m'badwo wachitatu). Pazinthu zomwe amagwiritsa ntchito mu gastroenterology ya ana, onani - Pachimake kapamba mu ana

Ntchito ina ndikuletsa ntchito zachinsinsi za gland kuti isangoleketsa malire ake momwe ingathere, komanso kuimitsa kuwonongedwa kosasinthika kwa maselo, zomwe zimatsogolera pancreatic necrosis. Mwa izi, pali mankhwala omwe amaletsa kaphatikizidwe ka michere ya kapamba. Mayina awo akuluakulu:

• Aprotinin (mavumikizo - Kontrikal, Gordoks, Traskolan),
• Octreotide (Octrid, Octretex, Sandostatin, Seraxtal).

Monga lamulo, amagwiritsidwa ntchito kokha pachimake kapamba mu akulu. Werengani zambiri za iwo pansipa.

Mankhwala ochizira kapamba

Mfundo yofunika kwambiri, yomwe imaphatikizapo njira yothandizira mankhwala a kapamba ndi mankhwala, ndiyo kuletsa kugwira ntchito kwa kapamba, ndiko kuti, kuchepetsa kupanga kwa ma enzymes ake. Zimavomerezeka kuti maselo a gland parenchyma amawonongeka ndi ma protein omwe amapangidwa ndi iye, ndipo kuwonongeka kumayambitsidwa m'maselo a acinar pambuyo poyambitsa kukonzekera kwa ma enzymes asanakwane.

Mu mtundu wa matenda, Pirenzepine (Gastrocepin) kapena Profinia bromide (Riabal) atha kugwiritsidwa ntchito pochepetsa kupanga ma protein a enzymes. Mankhwalawa amathandizidwanso kuti achulukitse ziphuphu: ngati wodwala agonekedwa m'chipatala, Pirenzepine amagwiritsidwa ntchito motere.

Mkhalidwe wa kuchepa kwa michere yam'mimba pancreatic umalumikizidwa ndi kutupa kosafunikira komanso kuwonongeka kwa ma cell achinsinsi a kapamba. Kuti chivundikire, ma gastroenterologists amafotokozera mapuloteni okhala ndi mapuloteni (kugawaniza mapuloteni), amylase (kwa hydrolysis yama carbohydrate ovuta) ndi lipase (kuti thupi lithe kuyamwa mafuta). Izi zikuphatikiza Pancreatin, yomwe ili ndi mayina ambiri amalonda: Pancitrate, Pangre, Pancreasim, Penzital, Mikrazim, Creon, Mezim, Gastenorm forte, Vestal, Hermitage, etc. Kuphatikiza pancreatitis, Zizindikiro zakugwiritsa ntchito kwa ma enzymes zimaphatikizanso mavuto ndi dongosolo logaya chakudya osiyanasiyana a etiology, dyspepsia , flatulence, cystic fibrosis, zolakwika za zakudya.

Pofuna kupondereza kupanga hydrochloric acid m'mimba, kuchuluka kwawomwe kumayambitsa kaphatikizidwe ka madzi a pancreatic, mu mawonekedwe a mankhwalawa aakulu kapamba Mankhwala a magulu ena atatu a mankhwalawa amayamba:

• antisecretory H2 antihistamines: Ranitidine (Ranigast, Atzilok, Zantak, etc.) kapena Famotidine (Pepsidin, Kvamatel, Gastrosidin),
• zoletsa za enzyme hydrogen-potaziyamu ATPase (pampu ya proton): Omeprzazol (Omez, Gastrozole, Promez), Rabeprazole kapena Lansoprol (Lanzol, Clatinol, etc.),
• Maantacid okhala ndi aluminiyamu ndi ma magnesium hydroxides - Almagel (Alumag, Gastratsid, Maaloks), omwe amalepheretsa asidi m'mimba.

Njira zake, mawonekedwe a kumasulidwa, njira yogwiritsira ntchito ndi kumwa komanso mitundu ina ya mankhwala a magulu atatuwa akufotokozedwera mwatsatanetsatane - Zilonda zam'mimba zam'mimba

Pazomwe mungafunike mankhwala a pancreatitis a ana, komanso zomwe amagwiritsidwa ntchito ali mwana, werengani nkhaniyi - Chithandizo cha matenda kapamba

Ndipo mankhwala a kapamba, omwe amalepheretsa kupanga michere ya pancreatic (Aprotinin, Octreotide, Pirenzepine, Prifiny bromide) ndikupanga kufooka kwawo komwe kumadza pambuyo pake (Pancreatin), komwe kukufotokozedwa mwatsatanetsatane pansipa.

Kugwiritsa ntchito ma proteinase inhibitors pochizira kapamba

Mu kapamba, kutsegula kwa mapuloteni kumabweretsa kutupa kwa chiwalo ndikukula kwa malo a necrotic.

Popewa njira zamatenda zamtunduwu, katswiriyo amalembera Contrical, Trasilol, Gordoks kapena Antagozan. Kugwiritsa ntchito mankhwalawa kwa intravenous makonzedwe ndikofunikira tsiku loyamba la kapamba pachimake.

Mitundu ya Pancreatic Enzymes

Ntchito yayikulu ya kapamba ndikuchita ntchito za endocrine (zamkati) komanso za exocrine (zakunja). Ntchito ya Endocrine imakhala pakupanga mahomoni - insulin, yomwe imatsitsa shuga, ndi glucagon, zomwe zimapangitsa kuti shuga chiwindi chiwonjezeke.

Ntchito ya prancine ya kapamba ndikupanga ma enzymes apadera (ma enzymes) okumba chakudya. Iyenera kugawidwa m'magulu angapo - lipolytic, amylolytic ndi michere ya proteinolytic. Tiyeni tikambirane mwatsatanetsatane gawo lililonse.

Lipolytic michere. Gululi ndi lomwe limayambitsa kuthana ndi mafuta kumafuta acids ndi glycerol. Prolipase ndi pulase yosaoneka ya lipase yomwe, ikalowa duodenum, imalumikizana ndi colipase.

Kutsegula kwa lipase kumachitika ndi kuchuluka kwa mchere wa bile ndi trypsin. Kuwonongeka kwa zigawo za lipolytic kumachitika maola 7-14. Renal glomeruli ndi omwe amachititsa kusefedwa kwawo: amalimbikitsa kuyamwa kwa lipase mu kapangidwe ka minofu, chifukwa chake zigawo za zigawo za lipolytic sizipezeka mkodzo. Zinthu zofanana ndi lipase zimapangidwanso ndi chiwindi, mapapu ndi matumbo.

Michere ya Amylolytic. Pali mitundu ingapo - alpha, beta ndi gamma amylase.Gulu la ma enzymes amenewa limatchedwanso kuti wowuma. Mukugaya, ndi alpha-amylase wokha yemwe amakhudzidwa.

Amapangidwanso pang'ono ndi tiziwalo tating'ono, makamaka kutafuna chakudya. Chifukwa chake, timamva kukoma kwakumwa kwakumapeto uku kutafuna zakudya wowuma - mpunga kapena mbatata yosenda. Chifukwa cha amylase, njira yothandizirana ndi wowuma komanso michere ina yovuta imakhala yosavuta.

Mapuloteni a Proteolytic. Ntchito yayikulu ya gululi ndikuwonongeka kwa mapuloteni. Ma enzymes a Proteolytic amathandizira kuwonongeka kwa ma amino acid omwe ali m'matumbo ndi mapuloteni. Pali mitundu iwiri yosiyanasiyana ya proteinase mu madzi a pancreatic:

1. Peptidase, kapena exopeptidase, yemwe amachititsa hydrolysis yama mankhwala akunja a peptides.
2. Proteinase, kapena endopeptidase, yomwe imaphwanya zida zamkati za peptides.

Chifukwa chake, lipase, amylase ndi proteinase amapanga madzi a pancreatic, omwe, pomwe amalowa mu duodenum, amaphwanya mamolekyulu azakudya zovuta kukhala mankhwala osavuta.

Amayambitsa ndi Zizindikiro za kapamba

Mwa munthu wathanzi, kutsegula kwa michere ya pancreatic kumachitika mu duodenum.

Ngati kugwira ntchito kwa amylase, proteinase ndi lipase kuyambika mu kapamba palokha, titha kulankhula za kulephera kwa limba.

Pancreatitis imamveka ngati gawo limodzi lama syndromes ndi matenda omwe amaphatikizidwa ndi ma enzymes mu gland, omwe amatsogolera ku "kudzimbidwa". Zotsatira zake, salowa mu duodenum, ndipo chimbudzi chimasokonekera.

Pali zifukwa zingapo zomwe zimatitsogolera ku izi:

• kumwa pafupipafupi
• Kulephera kutsatira zakudya zoyenera,
• kudya kwambiri nyama yokazinga ndi mafuta,
• kudya kwambiri zakudya zopatsa thanzi mukatha kudya kwambiri kapena kusala,
• kudya kosawerengeka kwamankhwala ena
• kugaya chakudya dongosolo
• matenda a matenda opatsirana.

Ndi kutsegula kwa ma enzymes mu kapamba, kutupa kumachitika: kumakulanso kukula, ndipo madera a necrotic amawonekera. Kuchita kotereku sikungakhale kwa asymptomatic, kuphatikiza apo, ndikuphwanya kwam'mimba thirakiti.

Ndi kuchepa kwa ma pancreatic enzymes mu duodenum ndi kutupa kwa kapamba, zizindikiro zotsatirazi zimawonedwa:

1. Ululu kumanzere hypochondrium, nthawi zambiri wa shingles chikhalidwe.
2. Kuchepetsa kwakukulu kwa kulumala, malaise wamba ndi kufooka.
3. Dyspeptic matenda - kutulutsa, kusanza kapena kusanza, kusowa kwa chakudya, kusokonekera chopondapo.

Zizindikiro za matendawa zimatha kukhala zosiyana kutengera kusowa kwa enzyme inayake:

• Kuperewera kwa Amylase kumatsogolera ku matenda am'mimba, kuchepa kwa vitamini, kuchepera thupi. Tizilomboto timakhala madzi, tinthu tosaphatikizika tomwe timakhalamo.
• Kuchulukitsa kwa lipase komwe kumaphwanya mafuta kumayambitsa steatorrhea - kuwonjezeka kwa kuchuluka kwa mafuta mu chopondapo. Ndi kapamba, matumbo amayenda chikasu kapena lalanje, kusakanikirana kwa ntchofu kumaonekera mwa iwo.
• Ndi kuchepa kwa proteinase, ulusi wama protein osaphatikizika umapezeka mu ndowe. Chizindikiro chakhazikitso ndi kukula kwa magazi m'thupi.

Ngati munthu azindikira zizindikilo zotere, ayenera kupita kuchipatala msanga. Dotolo adzalembera gawo la mayeso ndi chithandizo chokwanira.

Natural Pancreatic Enzyme Inhibitors

Thupi limangotulutsa osati zinthu za enzymatic zomwe zimathandizira kuwonongeka kwa mamolekyulu, komanso zoletsa za pancreatic secretion, i.e. zigawo zomwe zimalepheretsa kupanga kwambiri pancreatic madzi.

Ma Enzyme blockers amaphatikizapo pancreatic polypeptide (PPP), YY peptide, somatostatin, glucagon kapamba, kapamba ndi neuropeptides.

Zilumba za Langerhans, makamaka zomwe zimakhala mchira wa kapamba, zimatulutsa timadzi tambiri, PPP, yomwe imalepheretsa kapangidwe ka madzi, ma enzyme ndi ma bicarbonates. Imalepheretsanso kupanga acetylcholine.

Kubisalira kwa PPP kumawonjezeka pamilandu yotere:

1. ndimaganizo odyetsa kapena kudya chakudya,
2. pambuyo kukondoweza mitsempha ya nyini,
3. ndi duodenal acidization,
4. mukakumana ndi gastrin ndi gastrin-yotulutsa peptide,
5. mukakumana ndi secretin, cholecystokinin ndi VIP.

The distal ileum ndi colon imatulutsa YY peptide atangolowa mafuta kulowa m'mimba. Peptide iyi imathandizira kuchepetsa chiwopsezo cha gland ku zotsatira za cholecystokinin ndi secretin.

Ma cell a Pancreatic D komanso mucous membrane wam'mimba wogaya amatulutsa somatostatin. Hormoni iyi imalepheretsa kupanga ma enzyme ndi ma bicarbonates. Dongosolo lamanjenje la autonomic limatenga nawo gawo pakupanga somatostatin, atangolowa mafuta ndi ma amino acid kuchokera ku chakudya.

Ma pancreatic inhibitors ena amaimiridwa ndi mahomoni otere:

• Pancreatic glucagon, yomwe imaletsa kupanga zamadzimadzi, ma bicarbonate ndi ma enzyme.
• Pancreastatin, akuletsa kumasulidwa kwa acetylcholine. Amapangidwa kumapeto kwa mitsempha ya vagus.
• Neuropeptides, yomwe imakhala ndi calcitonin-information peptide (imalimbikitsa somatostatin) ndi enkephalins (amachepetsa kupanga acetylcholine).

Ndi njira zowonongeka mu gland, secretion ya pancreatic enzyme inhibitors ikhoza kukhala yoperewera, motero muyenera kumwa mankhwala.

Mfundo zochizira pancreatitis

Magawo awiri ofunikira othandizira matendawa ndi chakudya komanso mankhwala. Njira zochizira matendawa zimapangidwa payekha kutengera zovuta za matendawa komanso kuwonongeka kwa kapamba.

Zakudya zapadera za kapamba zimayambira pa chakudya No. 5 malinga ndi Pevzner. Amathetsa kudya kwambiri chakudya chamafuta ndi mafuta, komanso cholinga chake kuti adye zakudya zamapuloteni.

Ndi isanayambike chifuwa chachikulu, masiku atatu a kusala kudya ndi mankhwala. Panthawi imeneyi, muyenera kukana kudya ndikumwa madzi ofunda amchere, mwachitsanzo, Borjomi.

Pambuyo panjala ndi kapamba, zakudya zosakhalitsa zimayambitsidwa m'zakudya zomwe sizingakulemetseni m'mimba. Odwala omwe ali ndi kapamba amaloledwa kugwiritsa ntchito:

• mitundu ya nyama ndi nsomba,
• msuzi wamasamba ndi ma broth odedwa,
• mkate ndi mabisiketi dzulo,
• skim mkaka,
• zipatso zatsopano, zitsamba ndi masamba,
• chimanga chophika m'madzi kapena mkaka wopanda mafuta,
• mazira ochepa,
• msuzi wa rosehip, uchi kapena kupanikizana (ochepa).

Ndi kutupa kwa kapamba, ndikofunikira kukana chakudya chomwe chimakulitsa chimbudzi:

1. Zogulitsa za chokoleti, makeke, makeke.
2. Mkate watsopano.
3. Zakudya zokazinga.
4. Kusunga, kusuta nyama ndi zipatso.
5. Zakudya zamafuta ndi nsomba.
6. Zinthu zamafuta mkaka.
7. Zakumwa za kaboni.
8. Zonunkhira.
9. Ma broth olemera.
10. Pali mazira ambiri.
11. Tiyi wamphamvu komanso khofi.
12. Masoseji.
13. Nthambi ndi tomato.

Ndi kuchulukirachulukira kwa matenda kapamba, m`pofunika kutsatira pogona.

Chithandizo cha kapamba zimaphatikizapo kugwiritsa ntchito:

• enzyme inhibitors kuti muchepetse kutsegula kwa ma protein a pancreatic (proteinase),
• antibacterial othandizira kupewa kutukusira kwa m'mimba, kupukusira kwamatumbo a bursa, kukulitsa kwa necosis ya penancitis ndikuzungulira cellulitis ya cell kumbuyo kwa peritoneum,
• Ma blockers a H2 kuti achepetse kupanga kwa hydrochloric acid,
• Maantacidanti kuti muchepetse hydrochloric acid m'matumbo,
• antispasmodics ya kupweteka kwa minofu yosalala yokhudzana ndi kuphwanya kwa sphincter ntchito pancreatic duct,
• mankhwala a anticholinergic kuti aletse njira zachilendo mu ganglia ndi cortex

Kuphatikiza apo, ma enzymatic othandizira amagwiritsidwa ntchito pokonzanso chimbudzi ndikuchotsa vuto la dyspeptic.

Mankhwala othandiza

Patsiku loyamba la kukomoka kwa mawonekedwe osafunikira, kugwiritsa ntchito mapuloteni othandizira pancreatitis ndi ofunika. Mankhwalawa amachotsa chomwe chimayambitsa kuwoneka kwa yotupa ya foci komanso kufalikira kwa malo a necrotic.

Mankhwala amachokera ku pulmonary parenchyma ndi ng'ombe kapamba.

Pansipa pali mankhwala othandiza kwambiri, mlingo wake womwe umatsimikiziridwa payekha ndi adokotala. Sapezeka mu mawonekedwe a mapiritsi, koma mawonekedwe amtundu wambiri kapena wa lyophilisate wa kulowetsedwa.

Chithandizo cha pancreatitis ndi zoletsa ndi mtsempha wa magazi makonzedwe ikuchitika mu supine udindo. Komanso, namwino ndi dotolo ayenera kuyang'anitsitsa momwe wodwalayo alili. Zakudya Zachisanu 5, zomwe zimaphatikizidwa ndi chithandizo cha mankhwala ziyenera kutsimikizira kuti wodwalayo akuchira popanda zovuta zilizonse, ziyeneranso kuyang'aniridwa.

Momwe mungachitire pancreatitis adzauzidwa ndi akatswiri mu kanema munkhaniyi.