Matenda a kapamba: Zizindikiro ndi zizindikiritso za akulu

Pancreatitis yosatha ndi njira yomwe ikukula yotupa yomwe imachitika m'mapapo. Kutupa kumapitirira ngakhale atatha kuchotsa kwa foci ndi gwero. Izi zimathandizira kuti ma gland akhazikitsidwe mwadongosolo ndi minofu, chifukwa chomwe chiwalocho sichingakwaniritse ntchito zake zazikulu.

Padziko lonse lapansi, pazaka makumi atatu zapitazi, chiwerengero cha anthu omwe akudwala pancreatitis yayambiranso. Ku Russia, kuchuluka kwa odwala m'zaka khumi zapitazi kwawonjezera katatu. Kuphatikiza apo, kutupa kwa kapamba ndi "ang'ono" kwambiri. Tsopano zaka zapakati pazakazindikira matenda zatsika kuyambira 50 mpaka 39.

Mu achinyamata, kapamba adayamba kupezeka kangapo, ndipo chiwerengero cha azimayi omwe ali ndi matendawa chinawonjezeka ndi 30%. Anawonjezeranso kuchuluka (kuchokera 40 mpaka 75%) a kutupa kwa pancreatic pamsana pakumwa zoledzeretsa. Chipatala chilichonse masiku ano chimalemba milandu yambiri ndi HR pancreatitis.

Zomwe zimakhudza chitukuko cha matenda kapamba

Zoyipa zazikuluzikulu zakukula kwa matendawa ndi matenda a ndulu ndi zakumwa zoledzeretsa. Koma pali zinthu zina zomwe zimakhudza mapangidwe a matendawa:

Mowa Pancreatitis chifukwa chakumwa mowa nthawi zambiri imakhalapo mwa amuna ndipo imapezeka mu 25-60% ya milandu.
Matenda a gallbladder. Pancreatitis yomwe imawoneka chifukwa cha zovuta ndi ndulu imapezeka mu 25-40% ya milandu. Akazi amadziwika kwambiri ndi izi.
Matenda a duodenum.
Matenda Tizilombo toyambitsa matenda (mumps), hepatitis C ndi B.
Zovulala zingapo.
Matenda a shuga. Makamaka, ngati kudwala kumeneku kumayendetsedwa ndi kusowa kwa mavitamini ndi mapuloteni muzakudya.
Kugwiritsa ntchito mankhwala oopsa.
Helaminths.
Mwazi wamagazi ambiri.
Kulimbitsa thupi kwa matenda osachiritsika. Poizoni ndi arsenic, lead, phosphorous, mercury, etc.
Khalidweli.

Zizindikiro za chifuwa chachikulu

Ululu kumanzere ndi kumanja hypochondrium mu epigastric dera. Ululu umakhazikika mu epigastrium ndikudziwonetsa kutukusira m'mutu wa kapamba, pomwe thupi lake limayamba kuchita nawo mbali, mbali yakumanzere, ndikutupa mchira wake - kumanja pansi pa nthiti.

Ululu kumbuyo. Nthawi zambiri ululu umaperekedwa kumbuyo, amakhala ndi chikhalidwe chomangira.

Ululu mumtima. Komanso, nthawi zina ululu umapita kudera lamtima, komwe kumapangitsa kutsanzira kwa angina pectoris.

Gawo kapena kupweteka kwadongosolo mu hypochondrium yamanzere. Zimachitika mutatenga zakudya zakuthwa kwambiri kapena zamafuta.

Zizindikiro Mayo - Robson. Izi ndizopweteka zomwe zimachitika pamalo pomwe panali gawo la vertebral mbali yakumanzere.

Zizindikiro Kacha. Nthawi zina, wodwala amayamba kupweteka mkati mwa 8-11 thoracic vertebrae.

Kudzimbidwa. Ndi kutupa kwa kapamba, zizindikirozi zimachitika pafupipafupi. Nthawi zina wodwalayo amakhala ndi kusowa kudya kwathunthu, ndipo amamva kudana ndi zakudya zamafuta.

Koma, ngati munthu akudwala matenda a shuga kuphatikiza ndi kapamba, ndiye kuti zizindikirazo zimatha kubwereranso - kumva ludzu kapena njala. Pancreatitis nthawi zambiri imayendera limodzi ndi kupumula kwamasamba, kusanza, kupindika, nseru, kutulutsa m'mimba ndikung'ung'udza m'mimba. Ndi mitundu yofatsa ya nthawi ya matendawa, chopondapo chimakhala chabwinobwino, ndipo muzoopsa, m'mimba mwadzuka ndi kudzimbidwa.

Zizindikiro za pancreatitis yosatha ndi kutsekula m'mimba, momwe ndowe zimakhala ndi mafuta a sheen, fungo losasangalatsa komanso kusasintha kwa mushy. Kuwunikira kwa zachilengedwe kumawululiranso Kitarinorrhea (kuchuluka kwa CHIKWANGWANI mu ndowe), steatorrhea (mafuta ochulukirapo amamasulidwa ndi ndowe) ndi creatorrhea (pali mitundu yambiri yamitsempha yosagwiritsidwa ntchito mu ndowa).

Kuphatikiza pa izi, magazi akuvutika, apa ndikofunika kulabadira:

Hypochromic anemia (kuchuluka kwa hemoglobin kumachepera m'magazi ofiira)
ESR (erythrocyte sedimentation rate) - imawonekera ngati chiwopsezo cha kapamba,
leukemia wa neutrophilic (matenda osowa anali ndi matenda ochulukirapo)
dysproteinemia (kuphwanya kuchuluka kwa mapuloteni m'magazi),
hypoproteinemia (otsika kwambiri mapuloteni m'magazi).

Pamaso pa matenda a shuga mumkodzo, shuga amatha kupezeka, komanso kuchuluka kwa shuga m'magazi. Muzovuta kwambiri, kusinthana kwa electrolyte kumawonedwa, i.e. Zowonjezera za sodium m'magazi zimakhala pansipa. Komanso, pakuchulukitsa kwa kutupa kwa kapamba, zomwe zili trypsin, lipase, antitrypsin, amylase m'magazi limachulukanso. Chizindikiro china chimawonjezeka mu nkhani ya kulowetsedwa kwa kutuluka kwa pancreatic madzi.

Mayeso a kapamba:

Duo-roentgenography - iwonetsa kupezeka kwa kusinthika mkati mwa duodenum, komanso kuwulula zamkati zomwe zimawonekera chifukwa cha kukula kwa mutu wa gland
Kujambula kwa wailesi ya radioisotope ndi sonography - akuwonetsa kukula kwa mthunzi ndi kukula kwa kapamba,
Pancreatoangio choonera,
Yogwiritsa ntchito tomography - yochitidwa m'njira zovuta kuzindikira.

Pangafunikenso mkhalidwe wodzipatula kuti wapezeka pancreatitis yodwala matenda am'mimba, matenda a duodenum, matenda am'mimba, matenda am'mimba, komanso ma pathologies ena omwe amapezeka m'mimba.

Kutalika kwa matenda

Mwa mtundu wa maphunzirowa, pali:

chifuwa chachikulu
pseudotumor ululu wa kapamba,
latent pancreatitis (ndi mawonekedwe osowa).

kunyowa
cicatricial kutupa kwa duodenal papilla ndi pancreatic duct,
kuwerengetsa (mawonekedwe a mchere wamchere) ndi chotupa mu kapamba,
splenic vein thrombosis,
mitundu yayikulu ya matenda ashuga
makina subhepatic jaundice (amapezeka ndi sclerosing pancreatitis),
khansa yapakhungu yachiwiri (imachitika motsutsana ndi maziko a matendawo omwe amapezeka kale).

Zotsatira za chifuwa chachikulu

Mavuto ambiri omwe amapezeka ndi awa:

Kupanga zisindikizo zodwala
purulent kutupa kwa ndulu ndi bile ducts,
kumachitika kukokoloka mu kummero (nthawi zina amayamba ndi magazi),
mawonekedwe a zilonda m'matumbo ndi m'mimba,
khansa ya kapamba
zilonda zam'mimba,
kutsika kwamphamvu kwa shuga m'magazi,
sepsis (poyizoni wamagazi),
kuwoneka kwa madzimadzi aulere m'chifuwa ndi pamimba,
Kapangidwe ka ma cysts
Kutupa kwa mitsempha (izi zimasokoneza kayendedwe ka magazi m'chiwindi ndi ndulu),
mapangidwe a fistulas omwe amafikira pamimba,
zotupa ndi matenda opatsirana (amapezeka m'mimba, limodzi ndi kutentha thupi, kuchuluka kwa madzi m'mimba, osadetseka),
kupezeka kwa magazi kwambiri, ochulukitsa chifukwa cha kukokoloka ndi zilonda zam'mimba komanso m'mimba chifukwa cha kuthamanga kwa magazi m'mitsempha ya ziwalo,
chakudya chotchinga (kupitilira kwa nthawi yayitali chikhansa cham'mimba chimatha kusintha mawonekedwe a kapamba, chifukwa chofinya
zamavuto amisala ndi mitsempha (kusokonezeka kwa njira zamaganizidwe ndi luntha).

Zoyenera kuchita ngati zizindikiro za chifuwa chachikulu chikuonekera?

Gawo loyamba ndikupanga nthawi yoonana ndi dotolo wam'magazi, yemwe adzakuwunikirani mayeso kuti adziwe ngati ali ndi matendawa. Dziwani kuti poyambira matendawa (kuyambira zaka ziwiri mpaka zitatu), zambiri zothandizira pazinthu komanso zotsatira za mayeso a labotale zimatha kukhala zabwinobwino. Kuphatikiza apo, mikhalidwe ya chipatala siyodziwika ndi matenda amodzi okha.

Njira zodziwira pancreatitis:

Kuyesa kwamwazi wamagazi. Amachitika kuti awerenge ntchito ya ziwalo monga chiwindi, kapamba, komanso kusanthula kwa pigment ndi mafuta kagayidwe.
Kuyesedwa kwa magazi. Zimachitika pofuna kudziwa njira zotupa ndikuwunika madigiri awo.
Cop program. Ikuwonetsa kutukuka kwa chimbudzi, komanso chikuwonetsa kukhalapo kwa chimbudzi cholakwika cha chakudya, mafuta kapena mapuloteni. Zochitika zoterezi ndizodziwika kwa odwala omwe ali ndi matenda a chiwindi, matenda amtundu wa biliary ndi gland.
Kusanthula kwa immunological ndi zolembera. Kafukufuku amachitika ngati anthu akuganiza kuti ali ndi chotupa chonyansa m'mapapo.
Ultrasound Chiwindi, kapamba, ducts za bile, ndulu ya ndulu - ziwalo zonsezi zimafunikira ultrasound. Ultrasound ndiyo njira yayikulu yodziwira matenda a pathological omwe amapezeka pamimba yothandizira komanso kapamba.
Fibrocolonoscopy (FCC), Fibroesophagogastroduodenoscopy (FGDS). Kafukufuku amachitika kuti adziwe kupezeka kwa matenda ofanana kapena kuchita mayankho osiyanasiyana.
Kuyesedwa kutsimikiza mu ndulu za tiziromboti (Giardia).
Yogwirizana yamatumbo athunthu. Ndikofunikira pakuwunika kwa chiwindi, dera la regoperitoneal komanso, kapamba.
Kusanthula kwachilengedwe kwa ndowe. Kufesa kutsimikiza kwa dysbiosis. Dysbacteriosis ndi matenda omwe amasintha kapangidwe ka microflora yamatumbo. Matendawa, monga lamulo, amakula limodzi ndi matenda am'mimba.
Kuzindikira kwa PCR, kuyezetsa magazi ndi ma immunological magazi, mayeso a labotale ndi othandizira amachitika ngati kufufuza koyenera kuli kofunikira.

Zizindikiro zoyambira

Kukula koyamba kwa kapamba kumatha kudziwika ndi zizindikiro zazikulu zoyambirira:

Zowawa zopweteka pamimba.
Intoxication, pomwe mpumulo suchitika ngakhale mutatsuka.
Maonekedwe a mosy chopondera ndi tinthu tating'onoting'ono ta chakudya chomwe timadya.
Kuchepetsa mseru komanso kusanza.
Kuchepetsa chidwi.

Zizindikiro zomwe zimatchulidwa zimatha kupezeka pancreatitis yayikulu komanso pakhungu. Poyambirira, matendawa amakula pang'onopang'ono, ndipo lachiwiri mwachangu. The pachimake mawonekedwe a kapamba limachitika ndi kukha magazi, chithupsa, kapena kufinya kwa njira zowonekera za ndulu.

Nthawi yayitali ya matendawa, odwala amawona kupweteka kwakanthawi kumanzere kwa hypochondrium ndikuwonetsa kwa dyspeptic syndrome yokhala ndi vuto lachifuwa, kutulutsa ndi kutsekula m'mimba. Ndizosatheka kuchira kwathunthu pamatenda a matendawa, chifukwa mawonekedwe amchere amtundu wa calcium mu minofu ya kapamba, ndipo malo owonongeka ali ndi minofu yambiri.

Mawonekedwe owopsa a matendawa amaphatikizidwa ndi kupweteka kwambiri, komwe sikumapuma ndipo kumachitika ponseponse pamimba, kupereka kumbuyo kwa mapewa ndi kumbuyo. Momwe akuuma kwambiri, akhoza kuyamba kudwala. Ululu sutsitsidwa ndi antispasmodics. Pakukhudzidwa kwa kupweteka, kusokonezeka kwa mtima wamagetsi kumatha kuwoneka, komwe kumawonetsedwa ndi chizungulire, kukwera kapena kutsika kwakukulu kwa kuthamanga kwa magazi.

Zizindikiro zowonjezera

Zizindikiro zotsatirazi mwa odwala zimawonekera monga mawonetseredwe owonjezereka a chitukuko cha kapamba:

Kukweza kutentha pamitengo yapamwamba. Kutsika kwa mfundo zake sikuti kumapangitsa kuti zinthu zikhale bwino, koma kumangowonetsa kuchepa kwa kukana kwa thupi, komanso kugwedezeka kwamankhwala.
Kufalikira. Vutoli limayambika chifukwa chophwanya chimbudzi cha chakudya m'matumbo, chifukwa cha kusowa kwa michere ya kapamba.
Chopanda kumasuka ndi fungo la fetid. Chizindikiro ichi chikuwoneka ndi kuwonongeka m'matumbo.
Hiccups ndi burps. Amatuluka chifukwa cha vuto logaya chakudya m'mimba, kukwiya kwa mitsempha ya vagus, chakudya cholowetsedwa m'mimba.
Kusalolera chakudya.
Kuchulukitsa kwa masisitere.
Kusowa tulo
Kuchepetsa thupi.

Mitundu yamatenda a kapamba, kutengera zomwe awonetsa:

Maonekedwe a asymptomatic, pomwe zizindikilo zoyambirira zimakhazikika,
Zowawa
Maonekedwe a dyspeptic, limodzi ndi kusanza ndi ndulu, kutsekula m'mimba, kusowa kwa chakudya ndikutsogolera kufooka kwa ntchito yoteteza thupi,
Zizindikiro-monga mawonekedwe a chotupa. Ndikotheka kusiyanitsa mtundu uwu wa matenda osachiritsika kuchokera ku njira ya oncological pokhapokha pa laparoscopy, maselo a atypical amawunika.

Mawonetsero akunja a kapamba

Mukamayang'ana wodwalayo, dokotalayo amatha kukayikira matenda a kapamba, zomwe zimayamba kuoneka kale. Zizindikiro zotere za matendawa sizikugwirizana ndi kulekerera kwapadera kapena chidwi cha cholowa chopweteka.

Kupaka chikopa, komwe kumawonetsa kuphwanya kwamkati kwa bile, komanso kuchuluka kwa inki m'magazi.
Utoto wonyezimira wapakhungu pamaso pa wodwalayo, womwe pambuyo pake umakhala wanyansi.
Maseketi amaso owonetsedwa.
Maonekedwe a zotupa zakhungu pakhungu pamimba, kumbuyo ndi kupsinjika.
Lilime louma, mawonekedwe amkaso wachikaso.
Mpweya woyipa ndi acetone.
Kufupika, kupumira mofulumira.
Chisoni pa palpation pamimba.
Khungu lowuma ndi kusenda.

Zizindikiro za kapamba wa Voskresensky, Kerte:

Zowawa pakhungu la kapamba komwe kali kumapeto kwa m'mimba, kukwera kwa masentimita 6 mpaka 7. Ichi chizindikiritso cha Kerte pancreatitis.
Zotsatira zoyipa mukamayesa kumva kutuluka kwa m'mimba kwa msempha (chizindikiro cha Voskresensky).
Kusakhalapo kwa phokoso lamatumbo mukamamvetsera, komwe kumayambitsidwa ndi ma atony athunthu a matumbo (ziwalo).

Laborator diagnostics

Zizindikiro za kapamba zimatha kuzindikirika pamaziko a zoyesa matenda pazizindikiro zotsatirazi:

Kuzindikira kwa leukocytosis ndi kakhazikitsidwe kosinthika pakuyesa kwamagazi ambiri, kunathandizira ESR.
Kuwonjezeka kwa bilirubin mu zitsanzo za biochemical za chiwindi, amylase.
Kuchulukitsa kwamikodzo yamkodzo.
Kuwonjezeka kwa kukula kwa kapamba omwe amapezeka mkati mwa scan ya ultrasound.
Zakudya zomwe sizinayesedwe mu ndowe zomwe zimayesedwa.
Kuphwanya kwa magazi.

Ngakhale ndi chiwonetsero chodziwikiratu cha kapamba, sizingatheke kukhazikitsa matenda nokha, muyenera kulumikizana ndi katswiri. Ndi dokotala yekhayo amene amatha kusiyanitsa kutupa kwa kapamba ndi matenda omwe ali ndi zizindikiro zofanana.

Kunyalanyaza zikuluzikulu za matendawa ndi kupita kwa dokotala mosayembekezereka kumabweretsa kudwala khunyu nthawi zonse. Izi zikunyalanyaza ndizovuta kuchiza ngakhale kuchipatala.

Mavuto a kapamba

Zotsatira zoyipa zimayamba ndi mitundu yapamwamba ya kapamba nthawi yayitali. Izi ndichifukwa choti sumu za pathogenic ndi ma enzyme potupa ndizinthu zamphamvu zomwe zimatha kuwononga osati tiziwalo tating'onoting'ono, komanso ziwalo zina.

Mavuto nthawi zambiri amafotokozedwa mwa anthu omwe amamwa mowa kwambiri. Odwala otere, chifukwa cha kusokonezeka kwa magazi, kuwonongeka kwa m'mapapo, impso, ndi chiwindi zimatha kuyamba vuto lina.

Kutupa kwamphamvu kwa kapamba.
Zilonda zam'mimba komanso kum'mero.
Oncology.
Dontho mu shuga wamagazi.
Kupangidwe kwa ma cysts abodza.
Matenda am'mitsempha komanso amisala.

Mutha kupewa zovuta izi ndikuletsa kupitirira kwa matendawa mothandizidwa ndi njira zodzitetezera, zomwe zimachokera pa zakudya zoyenera, kupatula mowa komanso kusuta kufinya.

Chithandizo cha pachimake kapamba

Njira yovuta kwambiri ya pancreatitis imatha kuchiritsidwa kuchipatala kokha, pomwe wodwala akuyang'aniridwa ndi akatswiri oyenerera azachipatala. Pokayikira pang'ono pancreatitis yachilendo, muyenera kuyimbira foni gulu la ambulansi pafoni, kenaka m'gulitseni wodwala. Kupanda kutero, wodwalayo atha kupha.

Ma ambulansi isanafike, ndikofunikira kumaliza njira zotsatirazi:

Ikani munthu yemwe ali ndi zodziwika pancreatitis pamimba zawo,
Patsani kuti muthe kuyamwa ("No-shpu", "Papaverin"),
Musachotsere chakudya,
Apatseni wodwala malo ogona.

M'chipatala chopanda mankhwala osagwiritsidwa ntchito, wodwala yemwe akuganiza kuti akutupa kapena zizindikiro za pancreatitis yowonongeka atha kuwonetsedwa kuti am'thandize. Laparoscopy imachitika pamene madzi am'mimba apezeka pakuwunika, komanso ndi zizindikiro za peritonitis.

Chithandizo cha chifuwa chachikulu cha khansa

Zizindikiro za chifuwa chachikulu cha kapamba sichifotokozedwa nthawi zonse, mawonekedwe a matendawa amatha kukhala ofooka. Ndi kuchulukitsa kwa matendawa, wodwalayo akulimbikitsidwa kugonekedwa.

Kutsatira zakudya zapadera zomwe sizimaphatikiza mafuta, zakudya zonunkhira, zakudya yokazinga, bowa, maswiti, kebabs. Chakudya chiyenera kukhala chosakanizika.
Antispasmodics.
Kumwa mankhwala ofunikira kuteteza kusowa kwazinsinsi kwa thupi (kapamba).
Pewani mowa.
Ndikumva kupweteka kwambiri, dokotala amalembera antispasmodics.
Kulandila kwa michere ya pancreatic yomwe imathandizira pakuwonongeka kwamafuta, zakudya zamapuloteni, chakudya.

Kuopsa kwa matenda omwe ali ndi matendawa pakapita nthawi yayitali ndikuchepa kwa insulin, chifukwa chomwe shuga imayamba. Mukazindikira matendawa, wodwalayo afunika kufunsa wa endocrinologist kuti afotokozere bwino za njira yoyenera yolandirira komanso njira zochizira zakudya.

Zoyambitsa Pancreatitis

Nthawi zambiri, mwa munthu yemwe ali ndi vuto la kapamba, pali zinthu zingapo zomwe zimapangitsa kuti ikule, yomwe iyenera kukhazikitsidwa ndipo mwina kuthe. 98% ya milandu yonse yovuta ya kapamba imakhudzana ndi kumwa mowa mwauchidakwa kapena nthenda ya ndulu. Kuti mumve tsatanetsatane wa zomwe zimachitika m'matumbo a chamba pakhungu, komanso zowopsa za kapamba, onani nkhaniyo.

Zizindikiro za Acute Pancreatitis

Chimbudzi sichinthu chachikulu kwambiri, komabe, chimagwira ntchito zofunika kwambiri mthupi la munthu, chofunikira kwambiri chomwe ndichinsinsi cha michere yazakudya kuti chimbidwe chabwinobwino ndikupanga insulin, kuchepa kwake komwe kumabweretsa matenda oopsa monga matenda a shuga. Chimachitika ndi chiani ndi kutupa kwa England Mu nthawi ya pancreatitis pachimake, zizindikirazo zimakula ngati ndi poyizoni. Ma enzyme omwe amapangidwa ndi kapamba amasungidwamo kapena ma ducts, ndikuyamba kuwononga chiseyeye, ndipo kulowa m'magazi kumayambitsa matenda a chidakwa chachikulu:

Chakudya chofulumira - imodzi mwa adani akuluakulu a kapamba

Ululu. Ichi ndiye chizindikiro chodziwika bwino, kupweteka ndi kapamba nthawi zambiri kumakhala kovuta kwambiri, kosalekeza, chikhalidwe cha ululu chimafotokozedwa ndi odwala monga kudula, kuwuma. Wodwala akangopeza chithandizo chamankhwala osapumira, wodwala amamva kuwawa. Zowawa pansi pa supuni, hypochondrium imapangidwira mbali yakumanja kapena kumanzere, kutengera ndi malo a chotupa, pomwe gawo lonselo limapsa, ululu umakhala ngati.
Kutentha kwambiri, kutsika kapena mosavutikira kwambiri. Ndikusintha mwachangu kwachangu, thanzi la wodwalayo limakulirakulira msanga, kutentha kumatha kukwera mpaka kuchuluka, komanso kutsitsa kapena kukweza magazi.
Kusokonezeka. Ndi kapamba, nkhope ya wodwalayo imakuthwa, poyamba khungu limayamba kutuluka, pang'onopang'ono mawonekedwe ake amakhala ndi imvi.
Hiccups, nseru. Pancreatitis ilinso ndi monga mkamwa youma, hiccups, belching, ndi nseru.
Kubweza Kuukira kwa kusanza ndi bile sikubweretsera mpumulo wodwala. Chifukwa chake, kumayambiriro kwa nyengo yovuta kwambiri, palibe cholankhula chilichonse cha chakudya, kufa ndi njala pancreatitis yovuta kwambiri ndikochita bwino kwina.
Kutsekula m'mimba kapena kudzimbidwa. Mpando wokhala ndi pancreatitis pachimake nthawi zambiri amakhala thovu, pafupipafupi ndi fungo la fetid, wokhala ndi tinthu tating'onoting'ono ta chakudya. Kusungunula kungadyedwenso ndi chakudya (ndikasanza ndimatumbo oyambira pachiwopsezo), kenako bile kuchokera 12 zilonda zam'mimba. Komabe, pali mosemphanitsa, kudzimbidwa, kutuphuka, kufinya kwam'mimba, komwe kungakhale chizindikiritso choyamba cha kuyambika kwamphamvu kwa kapamba.
Kupuma pang'ono. Dyspnea imapangidwanso chifukwa cha kuchepa kwa ma elekitirodi pakusanza. Wodwalayo amasokonezeka ndi kupuma movutikira, thukuta lomata, kuphatikiza kwachikasu pamilomo kumawonekera.
Kufalikira. Mimba ndi matumbo sizimagwirizana pakubwera, chifukwa chake, pakumufufuza, dokotala amayamba kudziwa kutulutsa kwamphamvu, palpation sazindikira mavuto am'mimba.
Cyanosis wa pakhungu. Kuzungulira msomali kapena kumbuyo kwenikweni, mawanga amtundu wa cyanotic amatha kupatsa khungu khungu la nsangalabwi, m'malo otetemera, khungu limatha kukhala ndi utoto wonyezimira. Izi ndichifukwa choti magazi ochokera mu ndulu yoyaka amatha kulowa pansi pa khungu pamimba.
Yellowness of sclera, khungu. Ndi mawonekedwe oopsa a kapamba, jaundice wopatsirana amatha kuchitika, womwe umawoneka chifukwa chofinya gawo limodzi la duct yotupa ya bile.
Ndi zizindikiro za pancreatitis mwa munthu, vutoli limakulirakulira mphindi iliyonse, simungathe kuzengereza pazinthu izi, ndipo muyenera kuyimba ambulansi posachedwa.

Chithandizo cha pachimake kapamba

Mu chifuwa chachikulu cha pancreatitis, chithandizo chitha kuchipatala, moyang'aniridwa ndi akatswiri oyenerera, izi zimawoneka ngati zowopsa. Ngati pancreatitis yokomera ikukayikiridwa, ambulansi iyenera kuyitanidwa mwachangu ndipo munthuyo ayenera kuchipatala.

Nthawi zina chithandizo chamankhwala chosayembekezereka chimatha kupweteka munthu. Thandizo loyamba lomwe lingaperekedwe kwa munthu yemwe ali ndi vuto la kapamba, zizindikiro zomwe zikuwonekeratu, ndikugwiritsa ntchito kuzizira m'mimba, kutenga antispasmodic - Na-shpa, Papaverin, komanso kukana kudya chakudya chilichonse ndi kugona pogona asanafike ambulansi.

The zazikulu 3 zinsomba pomwe mankhwalawa pachimake kapamba amachokera: HUNGER, COLD NDI REST

Thandizo ladzidzidzi loperekedwa ndi Ambulasi:

mtsempha wamkati, woponya ndi mchere
antiemetic - metoclopramide (cerucal) 10 mg
mankhwala a ululu - ketorolac
antisecretory - octreotide (sandostatin) 250 mg kapena quamatel (omeprazole) 40 mg

Mu chipatala, nthawi zambiri amachita:

Mu chipatala, opaleshoni ya sodium mankhwala enaake (saline), reopoliglukin + kontrikal
Amagwiritsa ntchito mankhwala okodzetsa, amalepheretsa kapamba, komanso amathandizira kuchotsa ma enzymes m'magazi ndi poizoni m'thupi. Kuchokera okodzetsa, mwina Furosemide (Lasix) pa kulowetsedwa mankhwala (mu zotanuka gulu pambuyo pa dontho) kapena Diacarb pamapiritsi motsogozedwa ndi potaziyamu kukonzekera.
Omeprazole 80 mg patsiku, pali mitundu ina ya mtsempha wamagazi pakapendekete - Kvamatel.
Antispasmodics - drotaverine hydrochloride, wopanda spa
Ndi kusanza kosatha, intramuscular metoclopramide
Ululu - painkiller
Woonda kapena purulent pancreatitis - maantibayotiki (cephalosporins 3-4 mibadwo kapena fluoroquinolones).
Mu nthawi yovuta kwambiri, ma enzyme enhibitors (contracal ndi gordox) amasonyezedwa.
Vitamini othandizira amaphatikizidwanso pokonzanso thupi lopanda mphamvu, makamaka mavitamini C ndi mavitamini B amawonetsedwa.
Kwa masiku 4-5, wodwalayo amamulembera njala ndi kumwa madzi ofunda opanda mpweya. Woopsa pancreatitis, akamavutika ndi chakudya kwa milungu ingapo, zakudya za makolo zimasonyezedwa (ma protein hydralizates ndi emulsions yamafuta amathandizidwa kudzera mu cholesterol yachilendo m'magazi).
Pambuyo pokhapokha, wodwalayo amaloledwa kudya, poyamba mumatha kudya yogati yokha, pang'onopang'ono kuwonjezera tchizi cha kanyumba ku menyu, ndipo pambuyo pa masiku 3-4, pang'onopang'ono wodwalayo amatha kudya chakudya chamagulu pazakudya zapadera za 5P.

Chithandizo cha opaleshoni chikuwonetsedwa chifukwa cha pancreatitis yowonongeka ndikuwonetsa zizindikiro za kutupa kwa peritoneal, komanso chifukwa chosagwira ntchito mwamphamvu.

Pankhaniyi, laparoscopy imasonyezedwa pakhungu lomwe akuganiza kuti limayamwa kapena zizindikiro za peritonitis. Amachitidwanso kuti apange matenda osiyanasiyana a pancreatitis pachimake ndi matenda ena.

Laparatomy (kufalikira kochulukirapo ndi kudula kuchokera ku sternum kupita ku groin) kumachitidwa ndi maopaleshoni omwe amachitidwa kale pamimba, ventral hernias, magazi osasunthika (mantha).

Zizindikiro zake ndi chifuwa chachikulu cha kapamba

Matenda a kapamba amadziwika kuti ndi matenda otupa a kapamba, momwe masinthidwe amisempha amachitika. Ofufuza ambiri amakhulupirira kuti chizindikiro chachikulu cha pancreatitis yayitali ndikuti atachotsa zomwe zimapangitsa kuti zinthu zisinthe, kusintha kwachilengedwe m'matumbo sikuti kumangopitilizabe, koma kugwira ntchito, zovuta zamtundu wathupi zimayenderera. Poterepa, zosowa zakunja za thupi lathu zimapangidwa.

Pakakhala pancreatitis yosatha, nthawi ziwiri zimatsimikizika, yoyamba - yomwe imatha kukhala zaka kenako kudziwonetsa ngati zikhalidwe, kenako kutsika, komanso nthawi yomwe zosokoneza, zowonongeka kwa kapamba zimatchulidwa ndikusokoneza munthu nthawi zonse.

Munthawi yomwe matendawa atayamba, omwe nthawi zambiri amakhala zaka zambiri, munthu amamva kupweteka kwakanthawi komwe kumachitika mphindi 15 atatha kudya komanso kumatha maola angapo mpaka masiku angapo. Ululu umawonekera pafupipafupi pamimba yapamwamba, nthawi zina m'chigawo cha mtima, kumanzere kwa chifuwa, kumanzere kumadera lumbar, amathanso kukhala herpes zoster. Mphamvu yake imachepa munthu akamatsamira ndikakhala.
Kwenikweni, kuwoneka kwa ululu wamakhalidwe kumayambitsidwa ndi kumwa kwambiri mafuta, zakudya yokazinga, mowa kapena zakumwa zambiri za kaboni, komanso chokoleti ndi khofi. Choyipa chachikulu chomwe munthu amakhala nacho ndi chakuti kuchuluka kwazakudya zingapo zosiyanasiyana zimatengedwa nthawi yomweyo. Zikondazo ndizovuta kupirira mitundu yambiri ya mapuloteni, mafuta ndi chakudya. Chifukwa chake, anthu omwe amatsatira mfundo za zakudya zopatsa thanzi sangatengere matenda a kapamba.
Pakumva ululu, pamakhalanso zovuta zina monga kusanza, kusanza, kutsegula m'mimba, kumatulutsa, komanso kuchepa thupi. Komabe, izi sizichitika nthawi zonse, ndipo ululu ndi dyspepsia wokhala ndi chithandizo chokwanira chamthupi zimatha, ntchito ya gland popanga ma enzyme siyowonongeka kwambiri, ndipo wodwalayo amakhalabe ndi moyo wodekha mpaka nthawi yotsatira yoperewera kapena kulephera.
Pankhani ya kukhalapo kwa nthawi yayitali pancreatitis, kapangidwe kazinthu kamene kamayamba kuchepa, kupanga kwa ma enzyme ndi mahomoni kumachepa, ndipo kusakwanira kwachinsinsi kumapangidwa pang'onopang'ono. Pankhaniyi, ululu wammbuyo ukhoza kusakhalapo kwathunthu, kapena kukhala wofatsa, komanso dyspepsia, m'malo mwake, umakhala chizindikiro chachikulu cha kupindika kwachangu ndi chinsinsi chokwanira.
Komanso, matenda a pancreatitis amakhala ndi khungu lozindikira pang'ono, sclera, silimachitika mwa aliyense ndipo amatha kupezekanso nthawi zina.
Pakumapeto kwa kapamba, matimu akayamba kuoneka, matenda ashuga amatha.

Kutengera mitundu yosiyanasiyana ya matenda omwe amapezeka ndi odwala omwe ali ndi chifuwa chachikulu, mitundu ingapo ya matendawa imadziwika:

Maonekedwe a dyspeptic - ndi mawonekedwe amtunduwu wa pancreatitis, wodwala amadwala matenda otsekula m'mimba, otupa, komanso kuchepa thupi.
Maonekedwe a asymptomatic - mawonekedwe awa ndi achilendo kwambiri, chifukwa kapamba kwa zaka sakhala akuwonetsedwa ndi zizindikilo zilizonse, zizindikiro ndipo munthu samadziwa za kuphwanya komwe kumachitika.
Mtundu wa pseudotumor - mtundu uwu wa kapamba komanso maphunzirowo amafanana ndi khansa ya kapamba. Chizindikiro chachikulu cha matendawa ndikuwonekera kwa khungu la khungu, sclera, ndi zina.
Mtundu wapweteka - kuchokera ku dzinali ndizodziwikiratu kuti amadziwika ndi matenda opweteka, omwe amachitika nthawi zambiri mukatha kudya komanso makamaka mowa.

Zoyenera kuchita ngati mukukayikira kuti ali ndi chifuwa chachikulu?

Zachidziwikire, ngati mukukayikira kuti pancreatitis yayikulu, muyenera kufunafuna kudziwa kwa dokotala wa gastroenterologist. Kutengera madandaulo a wodwala, mbiri ya zamankhwala komanso njira zotsatirazi zodziwikiratu, dotolo akhazikitsa njira yolondola:

Laborator matenda a pancreatitis aakulu - kusintha magawo a stool elastase.
Kuwunikira kwa fecal kumatha kudziwa ngati steatorrhea ilipo, ndiko kuti, zomwe zimakhala zamafuta osalowetsedwa mu ndowe, zomwe zimawonetsa kusayenda bwino kwa ntchito mu gland.
Yesani ndi mankhwala apadera kuti musangalatse kapamba.
An ultrasound ingathandizenso pakuwonetsetsa bwino.
Ngati mukukayika kapena ngati mwapeza chidziwitso chotsimikizika, tomography yothandizidwa imathandizanso.
Kuyesedwa kwa magazi a glucose kuyenera kutengedwa kuti mupeze matenda ashuga, ndipo mutha kuyesanso kulolera kwa glucose.

Kuzindikiritsa kozikidwa pa data ya ultrasound kokha sikodalirika, popeza palibe zizindikiritso zilizonse, ndipo pakhoza kukhala kusintha pang'ono pang'onopang'ono kapangidwe kapenanso kutupa mkati mwa nthawi yowonjezereka. Nthawi zambiri, palibe mawonetsero a ultrasound konse.

Chithandizo cha matenda kapamba

Zizindikiro za pancreatitis yosatha imatha kukhala yofatsa komanso kutchulidwa. Monga lamulo, ndi kuchuluka kwa kapamba, kuperekera kuchipatala ndi mankhwala ofanana kumasonyezedwanso, monga momwe zimakhalira pachimake.

Wodwala ayenera kutsatira zakudya moyo wonse, kumwa mankhwala osokoneza bongo kapamba kapangidwe ka insulin, antispasmodics. Ndikofunika kwambiri kuyendera ma 2 sanatoriums kawiri pachaka, makamaka malo a Stavropol Territory, monga Pyatigorsk, Zheleznovodsk, Kislovodsk, pogwiritsa ntchito zovuta komanso kumwa madzi achilengedwe amchere kuchokera kumagwero (Slavyanovskaya ndi Smirnovskaya madzi ndizothandiza kwambiri). Mfundo zoyambira:

Zakudya zopatsa thanzi

Ichi ndiye mfundo yovuta kwambiri yothandizira kukhazikitsa, popeza zakudya za kapamba zimapatula zakudya zonse zokondweretsa zomwe aliyense amakonda - barbeue, chokoleti, maswiti, bowa, zonunkhira, zakudya yokazinga, chakudya mwachangu. Zinthu zonse mpaka zipatso ndi ndiwo zamasamba ziyenera kuphwanyidwa, zophika zokha, zophika.

Zakudya ziyenera kukhala zopezeka pafupipafupi komanso m'magawo ang'onoang'ono, ndiye kuti, zimayenera kudyedwa maola 3 aliwonse, pomwe kuli koyenera kuti musakanikize mitundu yambiri ya mapuloteni, mafuta kapena chakudya pakudya kamodzi. Werengani zambiri za zakudya zomwe zili mu nkhani yathu Zomwe mungadye ndi kapamba.

Momwe mungachotsere kupweteka pachiwopsezo cha kapamba

Mowa ndiye mdani woipa kwambiri wa kapamba

Ngati mumatsata zakudya, ululu umakhala wocheperako, koma ngati musunthira kutali, dziloleni nokha mafuta kapena okazinga, ndizo zonse - muyenera opanikizika.

Ndikumva kupweteka kwambiri, dokotala atha kukuwuzani antispasmodics - No-Shpa, Drotaverin, omwe amachepetsa kutupa m'mapapo ndipo, potero, amachepetsa ululu.
Masiku ano, adotolo amatha kupatsanso mankhwala a mebeverin (Duspatalin, Sparex) - antispasmodic, myotropic action, amathetsa ma spasms am'mimba.
Ndikotheka kupereka antisecretory (omeprazole) ndi okodzetsa othandizira (diacarb kwa masiku atatu pansi pa chivundikiro chaasparkam mu edematous form) kanthawi kochepa.
Octreotide imagwiritsidwanso ntchito, mankhwala omwe amachepetsa kupanga kwa mahomoni ndi zotulutsa, chifukwa amachikulitsa ndipo mwanjira imeneyi zimapweteka. Mankhwalawa amalembedwa m'm zipatala zokha.

Ma pancreatic michere yokonza kukanika kwa pancreatic

Ndi kuphunzira kwa nthawi yayitali pancreatitis, minyewa yabwinobwino yamtunduwu imasinthidwa, ntchito yake imatayika, chifukwa chake matenda a shuga amawonekera ndipo chimbudzi chimasokonekera. Kupereka mpumulo kwa kapamba ndi kuchepetsa kupweteka kwa odwala, ndikofunikira kutenga ma enzymes ena apachifungo:

Festal - iyenera kuledzera 3 r / tsiku piritsi limodzi ndi chakudya, nthawi zambiri limaphatikizidwa ndi histamine blockers kuti achepetse acidity m'mimba - Famotidine, cimetidine.
Pancreatin (Hermital, Creon, Penzital, Panzinorm, Pangrol, Mikrazim, Mezim, Biozim, Gastenorm, Enzistal) ndi ma enzymes a pancreatic, omwe amatengedwa 3 r / tsiku, mapiritsi awiri. mukamadya, ndikofunika kumwa madzi amchere amchere. Amathandizira kugwetsa mafuta, chakudya, mapuloteni.
Tikulankhula za ma enzyme, tiyenera kukumbukira za ntchito zawo, magawo 10,000 a lipase (piritsi la Mezim Fort) katatu patsiku - chofunikira pakuchotsa mankhwalawa. Mezim yoyambilira imakhala ndi fungo losasangalatsa, ngati palibe fungo, ndiye choko (choko chophwanyika).

Mu chifuwa chachikulu cha pancreatitis, zizindikiro zake zikaonekera kwa nthawi yayitali, kuchuluka kwa insulini kumachepa, komwe posakhalitsa kumabweretsa kukula kwa matenda a shuga. Pankhani yodziwikiratu, wodwalayo ayenera kufunsira malangizo a endocrinologist kuti afotokozere bwino kagwiritsidwe kake ka mankhwala ndi zakudya.