Opaleshoni yochotsa pancreatic, moyo wamtunduwu mukachotsa ndulu ndi zotsatira zake

Ntchito za pancreatic zimachitika malinga ndi zisonyezo zina:

Kuchotsa gawo la kapamba ndiye kulowererapo modekha, popeza ntchito zoyambira zimasungidwa. Povulala ndi kuphwanya chiwalo, malo osagwira ntchito amayembekezeredwa, magazi amatsekedwa, malo openyedwawo amakhala ndi msoko wopota mosalekeza.

Kenako kapisozi kakang'ono kamakola. Gawo lomaliza - peritonization - kutseka kwa chilema cha mbali ndi omentum. Pofuna kupewa zovuta (makamaka kutaya magazi), ma tampon amasiyidwa pamalo oti azisungapo masiku angapo.

Mukamachotsa mutu kupita ku njira ya Whipple. Opaleshoniyo ikuchitika m'magawo awiri - kuchotsa kwa gawo lomwe lakhudzidwalo ndikubwezeretsanso ngalande yokumba.

mutu wa kapamba, chikhodzodzo ndulu, gawo la bile duct ndi duodenum zimapangidwanso. Nthawi zina amentum, gawo laling'ono la m'mimba (pafupifupi 10 peresenti) ndi ma lymph node omwe amakhala pafupi.
Kubwezeretsa patency pakati pa thupi la gland, m'mimba, bile duct ndi matumbo ang'ono.

Zotsatira zakuchotsa kapamba

Nthawi yotsatila ikuphatikiza njala patsiku loyamba. Kenako, maimamu, chimanga, nyama yotsamira ndi nsomba, yoletsedwa kapena yophika, zimayambitsidwa pang'onopang'ono m'zakudya. Mwambiri, nthawi yogulitsira odwala m'chipatala imakwana masiku 21.

Kenako kumakhala nthawi yobwezeretsa yomwe imatenga miyezi itatu mpaka isanu ndi umodzi. Njira yayikulu yothandizira gland ndikupereka zakudya zowonjezera zoletsa zokometsera, zotsekemera, zamafuta, zotsekemera, zamchere. Muyeneranso kuchepetsa kuchita masewera olimbitsa thupi, kupewa nkhawa.

Wodwalayo amakakamizidwa kutenga mankhwala okonzekera - pancreatin, creon - kusintha njira za chimbudzi. Pambuyo pake 70% ya milandu, matenda a shuga amakula ndipo wodwalayo ayenera kugwiritsa ntchito insulin moyo wonse.

Kuwopsa kwa pancreatectomy

Madokotala ambiri opaleshoni sakonda opaleshoni iyi, choyambirira, ndizowopsa, chachiwiri, kuyambika kwa matenda ashuga mwanjira iyi ndikosapeweka, chachitatu, chiopsezo chachikulu cha zovuta zina zakupha (magazi, fistulas, ma abscesses, matenda omatira).

Koma theka lina la madotolo amaganiza choncho opaleshoni yochotsa kapambayu yadzala ndi zotupa. Posachedwa, mobwerezabwereza, mawonekedwe amapezeka m'makonzedwe a gland, kapena ali ndi cholinga chambiri chogawa, zomwe zimayambitsa kukayikira pakuchita bwino kwa ntchito ya Whipple.

Ndi kuchotsedwa kwathunthu kwa kapamba, ziwalo zotsatirazi zimachotsedwanso: ndulu, antrum ndi pyloric m'mimba, duodenum ndi jejunum koyamba, bile duct ndi chikhodzodzo cha ndulu, ma lymph node.

Kenako, uthenga pakati mbali yotsala yam'mimba ndi jejunum imabwezeretseka ndikugwiritsa ntchito anastomosis. Poterepa, matumbo ake amawakongoletsa mu minofu ya m'mimba.

Kuchira wodwala

Mfundo zoyambirira za mankhwala ochiritsira mu chakudya:

Nthawi zambiri chakudya champhongo,
Kumwa madzi okwanira: kutengera kulemera kwa wodwalayo, kuyambira 1.5 mpaka 2.5 malita,
Zakudya za hypercaloric zokhala ndi mapuloteni ambiri komanso kusowa kwathunthu kwamafuta ndi mafuta. Mafuta osatheka kwambiri, amchere, amchere, komanso okoma. Nyama yophika kapena yofinya ndi masamba. Zowonjezera zamtundu wa mavitamini, kufufuza zinthu ndikofunikira.
Chithandizo cha enzyme: creon, pancreatin, mesim, mesim-forte
Mankhwala a insulin popanga matenda a shuga.

Opaleshoni yochotsa pancreatic, moyo wamtunduwu mukachotsa ndulu ndi zotsatira zake

Nthawi zina, matenda osiyanasiyana akachitika, kuchotsedwa kwina kwa chiwalo kapena kutulutsa kwathunthu kwofunikaku kumafunikira. Kodi opaleshoni imakhudza bwanji munthu? Kodi azikhala bwino? Momwe mungadzichirimikize mutatha kuchita opaleshoni? Tiyankha mafunso awa tsopano.

Ntchito za pancreatic zimachitika malinga ndi zisonyezo zina:

Mukamachotsa mutu kupita ku njira ya Whipple. Opaleshoniyo ikuchitika m'magawo awiri - kuchotsa kwa gawo lomwe lakhudzidwalo ndikubwezeretsanso ngalande yokumba.

mutu wa kapamba, chikhodzodzo ndulu, gawo la bile duct ndi duodenum zimapangidwanso. Nthawi zina amentum, gawo laling'ono la m'mimba (pafupifupi 10 peresenti) ndi ma lymph node omwe amakhala pafupi.
Kubwezeretsa patency pakati pa thupi la gland, m'mimba, bile duct ndi matumbo ang'ono.

Ndi kuchotsedwa kwathunthu kwa kapamba, ziwalo zotsatirazi zimachotsedwanso: ndulu, antrum ndi pyloric m'mimba, duodenum ndi jejunum koyamba, bile duct ndi chikhodzodzo cha ndulu, ma lymph node.

Kenako, uthenga pakati mbali yotsala yam'mimba ndi jejunum imabwezeretseka ndikugwiritsa ntchito anastomosis. Poterepa, matumbo ake amawakongoletsa mu minofu ya m'mimba.

Mfundo zoyambirira za mankhwala ochiritsira mu chakudya:

Nthawi zambiri chakudya champhongo,
Kumwa madzi okwanira: kutengera kulemera kwa wodwalayo, kuyambira 1.5 mpaka 2.5 malita,
Zakudya za hypercaloric zokhala ndi mapuloteni ambiri komanso kusowa kwathunthu kwamafuta ndi mafuta. Mafuta osatheka kwambiri, amchere, amchere, komanso okoma. Nyama yophika kapena yofinya ndi masamba. Zowonjezera zamtundu wa mavitamini, kufufuza zinthu ndikofunikira.
Chithandizo cha enzyme: creon, pancreatin, mesim, mesim-forte
Mankhwala a insulin popanga matenda a shuga.

Mtengo wa opaleshoni ya pancreatic m'makliniki ena amafikira ma ruble 379212. Mwamwayi, zipatala za bajeti, molingana ndi zisonyezo, njirayi idaperekedwa mwaulere.

Zotsatira ndi moyo pambuyo pancreatic kuchotsedwa: zamtsogolo ndi kuwunika

Kuchotsa kwa kapamba kumachitika ndi kulephera kwa njira zonse zosungira komanso pazochitika zomwe zimawopsa. Zikondamoyo ndichinthu chofunikira chomwe chimagwira ntchito zongowerengeka komanso zosafunikira. Ngakhale kufufutidwa kwake kosakwanira kumangoyambitsa vuto laumunthu, kusokoneza kwambiri njira za kagayidwe ndi kugaya.

Zikondazo zimasiyanitsidwa ndi kukula kwake kwakukulu poyerekeza ndi tiziwalo timene timakhala m'thupi. Chiwalocho chimakhala ndi magawo atatu: mutu, thupi ndi mchira, zomwe zimalumikizidwa ndi ma ducts ang'ono. Kudzera mwa iwo, madzi a pancreatic omwe amakhala ndi ma enzymes apadera amalowa mu duodenum 12. Zikondazo zimalumikizana mwachindunji ndi chikhodzodzo, komwe bile limachokera. Ma Enzymes ndi bile amalowa mu duodenum, ndipo potenga nawo mbali, njira yopukusa chakudya mu duodenum 12 imayamba.

Amylase ndi lipase amapangika m'maselo a gland, omwe amathandizira kugaya chakudya mu duodenum. Ma Enzymes amathandizira kuthana ndi mafuta, mapuloteni ndi chakudya chamagulu. Kuwonongeka kwa kapamba kumayambitsa matenda a metabolic ndi m'mimba. Chifukwa cha kutuluka kwa tinthu tambiri, ma enzyme opangidwa amadziunjikira mu ndulu ndikuwononga ziwalo za thupilo.

Zikondazo zimatulutsa insulini. Hormone iyi imakhudza shuga wamagazi. Ngati kuchuluka kwa insulini sikupangidwa, kuchuluka kwa shuga kumayamba kukwera kwambiri ndipo matenda a shuga amayamba.

Zomwe zimayambitsa kuphwanya izi ndi kumwa mowa kwambiri, kugwiritsa ntchito mafuta ochulukirapo, kupezeka kwa matenda opatsirana, mawonekedwe a cysts ndi oncological pathologies, kugwira ntchito pamimba yam'mimba, yomwe nthawi zina imayambitsa kupweteka kwamatumbo. Nthawi zambiri chomwe chimayambitsa kusokonekera kwa kapamba ndimatenda a ndulu.

Zikondamoyo ndichida chovuta kwambiri komanso chosalimba, ndipo kuchotsa kwake kumafuna njira yapadera komanso kuyeneretsedwa kwapamwamba. Kuchitapo kanthu kwa opaleshoni kumasonyezedwa pokhapokha ngati pali zovuta kwambiri, pomwe chithandizo sichikuyenda bwino.

Zizindikiro za opaleshoni zingaphatikizepo:

Pachimake kwambiri kapamba, sangagwiritsidwe ntchito pochizira,
Hemorrhagic pancreatitis, limodzi ndi kukoka kwa magazi m'thupi,
Pancreatic necrosis, chomwe ndi necrosis ya mbali zina za kapamba,
Kukhalapo kwa purifiyamu yotupa ndi chotupa,
Kapangidwe ka ma cysts akuluakulu mu kapamba,
Kukula kwa fancula kapamba,
Kupangidwe kwa ma cysts ndi kusasitsa,
Kuvulala kwapancreatic
Mapangidwe a calculi m'magulu akunyumba.

Kuchuluka kwa opaleshoni yochitidwa kumatengera gawo la matendawa ndi mtundu wa matenda. Njira zotsatirazi zitha kuchitika:

Kusokonezeka kwa kapisozi, kuti muchepetse kutupa,
Necrectomy, pamene malo osiyana ndi necrosis amachotsedwa,
Kusintha pang'ono kwa kapamba (kuchotsa mbali ya chiwalo, mwachitsanzo, mchira),
Pancectomy, pamene chiwalo chimachotsedwa kwathunthu.

Kuchotsa pang'ono kumachitika pakakhala cysts, hemorrhage, kutupa, kapena malo okhala ndi vuto lililonse. Kuchotsa kwathunthu kwa kapamba kumasonyezedwa khansa, kupindika kwambiri kwa kapamba, puroses fusion, kuwonongeka kwambiri kwa ziwalo popanda kuthekera kuti ubwezere m'tsogolo. Pambuyo kuchotsedwa kwa kapamba, wodwalayo adapangidwanso m'malo mwake.

Pancreatectomy - njira yochotsera kapamba

Pancreatectomy ndiye njira yayikulu yochitira opaleshoni matenda a kapamba. Mukamagwira ntchito, kapamba kapena gawo lina limachotsedwa. Nthawi zina, kapamba amachotsa chiwalo chomwe chili pafupi ndi kapamba, mwachitsanzo, ndulu, chikhodzodzo, komanso m'mimba.

Pancreatectomy - zovuta ntchito. Chiwalo chikachotsedwa, magazi akulu amatha, omwe amatha kupha. Matendawa amatithandizanso kudwala. Mu milandu yofatsa, imatha kuyambitsa kusanza ndi mseru, m'malo ovuta - kugwedezeka kwa anaphylactic ndi kufa kwa wodwalayo.

Nthawi ya opaleshoni, dokotala amapanga mawonekedwe a m'mimba ndipo, ndikukweza pang'ono, amawunika mkhalidwe wa gland, kudziwa kuwonongeka kwa chiwalo. Pambuyo kapamba onse kapena gawo lake limachotsedwa. Zida zomwe zimalumikiza chiwalocho ndi ena, pomwe zimafinidwa, kuti magazi asatayike kwambiri. Mkhalidwe wamagulu oyandikana nawo amayesedwa, pambuyo pake amadzasiyidwa kapena kukhazikikanso. Choyekeracho chimakongoletsedwa ndi suture zotulutsa kapena mabatani apadera. Pofuna kupewa kukwera kwakukulu, opaleshoni ya laparoscopic imachitidwa.

Pancreatectomy imabweretsa odwala ambiri ku moyo. Chifukwa cha pulogalamu yoyambitsanso yotulutsa, pambuyo pancreas, mankhwala obwezeretsa m'malo amachitika, omwe amalola kuthandizira kudziwa pambuyo pa opaleshoni.

Opaleshoniyo imatha kutenga maola 4-8, kutengera ndi kukula kwa gawo lochotsedwa la kapamba. Pambuyo pa opaleshoni, wodwalayo amalimbikitsidwa kuti ayesedwe pafupipafupi ndi dokotala wa matenda am'magazi.

Pamaso pa opareshoni, njira zokonzekera zimachitika ndi wodwalayo. Ngati khansa yapezeka, mankhwala othandizira amapangika opereshoni isanachitike, yomwe imathandiza kuyimitsa metastasis ndikuthandizira kuchepetsa kukula kwa chotupa.

Maphunziro a labotale ndi othandizira amapatsidwa kuti akhale ndi chithunzi chokwanira chachipatala. Kuyesedwa koyenera kumaphatikizapo kuyezetsa magazi, ma ultrasound a kapamba, kupumira.

Asanamuchitire opareshoni, adokotala amalankhula ndi wodwalayo, amamuwuza za njirayo ndi zoletsa zomwe zilipo.

Pamaso pa opareshoni, wodwala saloledwa kumwa mankhwala osokoneza bongo, a analgesic ndi antipyretic. Pamaso pa opareshoni, saloledwa kumwa mankhwala omwe amachepetsa magazi, komanso mankhwala omwe machitidwe awo amaperekedwa motsutsana ndikupanga magazi. Opereshoni imachitidwa pansi pa opaleshoni yotupa.

Pambuyo pa opaleshoniyo, potengera momwe aliri, munthu wothandiziridwayo amapititsidwa kuchipinda chokhazikika kapena kosamalidwa kwambiri. M'chipatala, wodwalayo amakhala kwa masiku angapo mpaka milungu ingapo. Kutalika kwa nthawi yakukonzanso kumakhudzidwa ndi zomwe zimayambitsa opaleshoni, kukula kwa njirayi ndi zotulukapo zake.

Wodwala amapatsidwa zakudya zapadera ali kuchipatala, zomwe zimaphatikizapo chakudya chokha chamadzimadzi monga mawonekedwe a broth, decoctions a zitsamba, madzi, mchere wamadzi. Chakudya cholimba chimayambitsidwa mumenyu, kuyambira pa 6th tsiku laling'ono. Ululu umatha kuwonedwa kuyambira masiku angapo mpaka miyezi ingapo.

Kwa milungu iwiri, wodwala amapatsidwa mankhwala othandizira, mankhwala a ciprofloxacin, penicillin, kalasi ya macrolide ndi mankhwala. Amathetsa kutukusira kwa minofu yofewa minofu ndikuletsa kukula kwa purulent - zovuta za septic.

Anesthetics imaperekedwa kwa wodwala kudzera mu dontho, ma analgesics amathanso kutumikiridwa intramuscularly.

Dokotala amasankha chithandizo chamankhwala mothandizidwa ndi munthu payekha, poganizira momwe wodwalayo asanachitire opareshoni.

Akachotsa kapamba, wodwalayo amadwala matenda a shuga. Kuti muthane ndi vutoli pamafunika kuti mupeze insulin inayake ya moyo. Akatulutsa, wodwalayo amapatsidwa mankhwala omwe amathandiza kusintha gawo lakutali. Wodwala amatha kukhala popanda kapamba kokha ngati atengedwa mosalekeza.

Zotsatira zomwe zingakhalepo mu nthawi ya postoperative mutachotsa kapamba

Mavuto akulu amatuluka ngati chindacho chachotsedwa kwathunthu. Ma Enzymes opangidwa ndi kapamba amayenera kuthandizidwa kukonzekera zamankhwala, zomwe zimaphatikizapo zinthu zomwe zimaperekedwa kuchokera ku zikondamoyo za ng'ombe.

Kuti mukhalebe ndi insulin, jakisoni wothandizidwa ndi insulin amaperekedwa kwa wodwala. Zina zoyipa zimachitika pambuyo pa opaleshoni. Wodwalayo amatha kudandaula za chizungulire komanso mseru. Vuto lowopsa ndi magazi amkati. Mwina kukula kwa mavuto akulu mthupi.

Zotsatira zakuchotsedwa kwa kapamba:

Kuchepetsa mwadzidzidzi kapena kunenepa kwambiri,
Kupanga matenda otsekula m'mimba,
Pachimake postoperative kapamba,
Kulephera kwazungulira
Zilonda zopatsirana
Peritonitis
Kuchulukitsa kwa matenda ashuga
Kulephera kwa chiwindi.

Pambuyo pa opaleshoni, ndikofunikira kusiya zizolowezi zoyipa, odwala amalangizidwanso kuti apewe kupsinjika ndi zochitika zam'mbuyo, chifukwa mothandizidwa ndi zinthu izi zimawonjezeka.

Zomwe zimayambitsa kupezeka kwamavuto zimaphatikizaponso kusagwirizana ndi zakudya zapadera mu nthawi ya preoperative, matenda a mtima, ukalamba.

Odwala onse omwe adachotsa pancreatic amayenera kuwunika pafupipafupi ndi akatswiri kuti, ngati kuli kotheka, akonzenso kusintha kwa zinthu zofunika pa thupi.

Pambuyo pancreatectomy, moyo wachikhalidwe wa wodwalayo umakhudzidwa kwambiri. Kuti akhale ndi kuchuluka kwa shuga m'magazi, ayenera kugwiritsa ntchito insulin moyo wonse, komanso kukonzekera kwa enzymatic kuti achulukitse chimbudzi. Ndikofunikanso kutsatira zakudya zapadera za moyo.

Kufunsira kwa katswiri wama zamagetsi kumalimbikitsidwa kuti abwezeretse malingaliro komanso kupewa mayiko ovutika.

Pambuyo pa opaleshoni, patatha chaka chimodzi, ngati wodwalayo atsatira malangizo a madokotala molondola, moyo umayenda bwino kwambiri. Kwenikweni, mutachotsa kapamba (makamaka ndi pang'ono pang'onopang'ono), ngati palibe zilonda, matendawo ndiabwino.

Ndikofunikira kutsatira zakudya mutachotsa kapamba nthawi zonse. Opaleshoni itangoyamba, wodwalayo amasankhidwa kuti azisala kudya kwa masiku atatu, amaloledwa kumwa madzi m'magawo ang'onoang'ono (mpaka lita imodzi patsiku). Zakudya zamafuta ndi mavitamini zimayendetsedwa ndi mtsempha wa magazi. Patsiku la 4 amaloledwa kudya masikono owuma angapo kapena mikanda yopanga tokha ya mikate yoyera m'magawo ang'onoang'ono masana, imwani makapu awiri a tiyi osapsa. Patsiku la 5-6 iwo amapatsa sopo wopanda mafuta, owotchera, tiyi. Pakutha kwa sabata, tirigu wowuma-wamadzi (burwheat kapena mpunga), mkate wowuma umayambitsidwa menyu. Kuyambira pa tsiku la 7-8th, kuwonjezera pa sopo, amaperekanso maphunziro awiri - masamba osenda, mbale zotentha kuchokera ku nyama yozama.

Pakatha masiku 10, tchizi chopanda mafuta, tchizi chamasamba ndi mbatata zosenda, nsomba zamafuta ochepa ndi nyama zimayambitsidwa menyu. Mbale zonse ziyenera kudulidwa mpaka yosalala komanso yofinya. Ma cutlets a nthenga ochokera ku nyama zotsalira, nsomba, nkhuku kapena ndiwo zamasamba amathanso kulowetsedwa pamenyu.

Chakudya chizikhala chopindika (nthawi 5-6 patsiku m'magawo ang'onoang'ono). Zakudyazo ziyenera kuphatikizapo mapuloteni a nyama ndi masamba, mafuta a masamba, masamba abwino ndi zipatso, zipatso, amadyera. Mchere uyenera kugwiritsidwa ntchito pang'ono - osapitirira 10 g patsiku. Mpaka 2 malita a madzi ayenera kumwa tsiku lililonse.

Kuchokera muzakudya muyenera kupatula zakudya zamafuta, zamaphiki, chokoleti. M'pofunika kupatula nyama zakusuta ndi zakudya zam'chitini, zokometsera zokometsera, soseji ndi ma ketchups pazakudya. Ndikofunikira kusiya khofi wamphamvu ndi tiyi, zakumwa zoledzeretsa komanso zakumwa zoziziritsa kukhosi, ndikuzisintha ndi msuzi wa rosehip, mafuta odzola kapena shuga.

Pambuyo kuchotsedwa kwa kapamba, wodwalayo amamulembera zovuta za enzyme komanso insulin. Cholinga chachikulu cha mankhwala a enzyme ndikulimbikitsa kupanga ma enzyme omwe akukhudzidwa ndi njira yolimbikitsira kudya. Lemberani mankhwala omwe amaphatikizapo pancreatin. Nthawi zambiri zotchulidwa Mikrasim, Vestal, Creon. Kukonzekera kwa enzymatic kwamtunduwu kumeza chimbudzi, matumbo ntchito ndi chopondapo, kumachotsa kutulutsa, mseru komanso m'mimba. Enzymatic othandizira kwenikweni samayambitsa kuyipa kwa thupi. Amalocha kapamba, natulutsa amylase ndi lipase m'mimba. Muyenera kudya michere ndi chakudya chilichonse pachimodzimodzi.

Mankhwala amakono amathandizira kukhalabe ndi moyo pambuyo pochotsa zikondamoyo pamlingo wambiri. Kusintha thupi kukhala mikhalidwe yatsopano, muyenera kutsatira malangizo onse a madokotala.

Ngati matenda a shuga apezeka, wodwalayo amapatsidwa mankhwala a insulin. Muyenera kuyang'anira kuchuluka kwa shuga kwanu ndi glucometer.

Kusunga chimbudzi, ma encyombone a pancreatic amalembedwa, kugwiritsa ntchito komwe kumapangitsa kuti chakudya chizigwira ntchito komanso kugaya chakudya.

Mtengo wa pancreatic resection umayamba pa 20,000 rubles. Kutengera ndi kuzunzika komanso kuchuluka kwa momwe amachitidwira opaleshoni, mitengo imatha kuchokera ku 25,000 mpaka 42,000 rubles. Pancreatectonymy yathunthu ikhoza kutengera ma ruble 45,000 mpaka 270,000.

Mankhwala amakono amalola wodwala pambuyo pancreatectomy kuti abwerere ku moyo wabwinobwino ngati opaleshoniyo idachitika pa nthawi yake, palibe makhansa ndipo malangizo onse a madokotala amatsatiridwa.

Okondedwa owerenga, malingaliro anu ndiofunika kwambiri kwa ife - chifukwa chake, tidzakhala okondwa kukumbukira zomwe zingachitike mutachotsa kapamba ndi njira zakuthandizira zomwe zakuthandizani mu ndemanga, izi zingakhale zothandizanso kwa ogwiritsa ntchito ena amebusayiti.

Olga

Kuchotsa kansa kunachitika kwa mwamuna wanga. Opaleshoniyo inali yovuta, panali ngozi zambiri. Chiwalo china chinachotsedwa, ndipo pambuyo pake chinapatsidwa mankhwala achiwonetsero. Nthawi yokonzanso inali yayitali. Thupi limachira kokha chaka chotsatira.

Ndinkadwala matenda kapamba. Zikondwererozo sizinakwaniritse ntchito yake, panali zopweteka zosalekeza, zovuta m'mimba. Opaleshoni yosankhidwa - pancreatectomy. Ndinkadandaula kwambiri opareshoni isanachitike, koma zonse zinkayenda bwino. Gawo la kapamba ndi ndulu zimachotsedwa. Pambuyo pa opaleshoni panali zowawa, chithandizo chinkayenera. Anasankha m'malo mankhwala, insulin mankhwala, zakudya. Pang'onopang'ono, thanzi langa limayenda bwino, ndikuyembekeza kuchira.

Greenberg, nthano za Riva 50 zokhudzana ndi matenda a shuga zomwe zingawononge moyo wanu. Zambiri za 50 za matenda a shuga zomwe zingamupulumutse / Riva Greenberg. - M: Alpha Beta, 2012 .-- 296 p.
Dedov I.I., Shestakova M.V. Matenda a shuga ndi matenda oopsa, akatswiri a Medical News - M., 2012. - 346 p.
Matenda a matenda othandizira odwala. - M: MEDpress-dziwitsani, 2005. - 704 p.

Ndiloleni ndidziwitse. Dzina langa ndi Elena. Ndakhala ndikugwira ntchito ya endocrinologist kwa zaka zoposa 10. Ndikukhulupirira kuti pakadali pano ndili katswiri pantchito yanga ndipo ndikufuna kuthandiza alendo onse omwe amapezeka pamalowo kuti athetse zovuta osati ntchito. Zinthu zonse za tsambalo amazisonkhanitsa ndikuzikonza mosamala kuti athe kufotokoza zambiri zofunikira. Musanagwiritse ntchito zomwe zikufotokozedwa pa webusaitiyi, kufunsana ndi akatswiri ndizofunikira nthawi zonse.

Ntchito zolimbitsa thupi

Kapamba amatengedwa mu kaphatikizidwe ka michere yofunikira m'njira yovutikira njira. Amapereka kuwonongeka kwa mapuloteni, mafuta ndi chakudya, komanso amathandizira kuti pakhale chotupa cha chakudya, chomwe kenako chimalowa m'matumbo. Ngati kapamba kakulephera, njira zonsezi zimasokonekera ndipo mavuto akulu azaumoyo amabwera.

Koma kuphatikiza pa michere yokugaya, kapamba amatulutsa mahomoni, omwe chachikulu ndi insulin, omwe amalamulira kuchuluka kwa shuga m'magazi. Kuperewera kwake kumakhala chifukwa chakukula kwa matenda a shuga, omwe, mwatsoka, samadziwika kuti amathandizidwa ndipo amafuna kuti wodwalayo amwe mankhwala nthawi zonse, omwe amathandizanso kuti thupi lizigwira bwino ntchito. Ndipo popanda iwo, wodwalayo sangathe kuchita, chifukwa kulumpha lakuthwa m'magazi a magazi kungayambitse kufa mwadzidzidzi.

Popeza chiwalochi ndichofunikira kwambiri thupi la munthu, kodi amachotsa kapamba? Anthu omwe ali ndi kapamba amathandizidwa kwambiri ndi mankhwala. Koma nthendayi imayambitsa matenda owopsa kwambiri, monga kupangika kwa zotupa pakhungu, mataya, miyala m'miyala, kapena kukula kwa necrosis. Panthawi zonsezi, opaleshoni ndiye chithandizo chokhacho cholondola. Komabe, madokotala sathamangira kukakhazikika pamenepo, chifukwa kapamba ndi gawo lofunikira mthupi la munthu ndipo ndizosatheka kuneneratu zotsatira zomwe zingachitike atachotsedwa.

Ngakhale kutulutsa kachigawo pang'ono pakukonzekera ntchito, izi sizikupereka chitsimikizo kuti 100% yotupa siyikubwereranso. Ngati tikulankhula za khansa ya kapamba, ndiye kuti pamenepa mwayi wochira kwathunthu pambuyo pachitetezo ndi 20% kokha, makamaka ngati matendawa akukhudza ziwalo zapafupi.

Zizindikiro zochotsa

Chotsani kapamba ndi kukula kwa matenda otsatirawa:

pachimake kapamba wovuta kwambiri ndi necrosis,
oncology
cysts
mawonekedwe amiyala m'mitsempha ya ndulu,
kapamba,
kunyowa
kukha magazi mkati mwa chotupa.

Chotsani njira

Potengera kapangidwe kake kapamba kapenanso kotheratu, njira monga pancreatectomy imagwiritsidwa ntchito. Ngati kuli kofunikira kuchotsa chiwalo chonsecho, opareshoniyo imachitika mu njira ya laparatomic, ndiko kuti, mwayi wopita kumaselo omwe wakhudzidwa umapezeka chifukwa cha kupindika kwam'mimba. Pambuyo pochita zinthu zonse, tsamba lachiwonekalo limalumidwa kapena kukhazikika ndi brace.

Nthawi zina pakuchita opareshoni, machubu am'madzi amawaika m'matumbo am'mimba, omwe amakupatsani mwayi kuti muchotse madzimadzi omwe amasonkhana m'dera la ntchito ya dokotala. Nthawi zina, madokotala amakhazikitsanso machubu amadzimadzi m'matumbo. Monga lamulo, izi zimachitika pokhapokha pakufunika thandizo lamagetsi.

Ngati chithokomiro sichichotsedweratu (gawo lokha), ndiye kuti chikhodzodzo chimatha kuchitika ndi njira ya laparoscopic - mwayi wothandizidwa ndi chiwalocho umapezeka kudzera m'matumbo am'mimba mwakuwunikira mu mimbulu yam'mimba chida chapadera chokhala ndi kamera yomwe imakulolani kuti muone zomwe zikuchitika pakompyuta yonse. Kuchita koteroko sikumakhala kowopsa ndipo kumafuna nthawi yayifupi. Koma, mwatsoka, osati m'malo onsewo ndizotheka kugwiritsa ntchito njira yopangira opaleshoni.

Pa nthawi ya opaleshoni, mankhwala a kapamba amachotsedwa, komanso ziwalo zina zomwe zili pafupi nacho, mwachitsanzo:

chikhodzodzo
ndulu
m'mimba.

Nthawi ya opereshoni ndi pambuyo pake, pamakhala zovuta zambiri zovuta. Poterepa, amanenedwa osati zokhudzana ndi mwayi wokhala ndi kutupa kapena matenda, komanso za ntchito yopitilira thupi lonse. Kupatula apo, zaposachedwa kwambiri, machitidwe omwe kuchotsedwa kwachimbirizo sikunachitike mu ntchito zamankhwala, chifukwa amakhulupirira kuti anthu sangakhale chaka chimodzi popanda chiwalo ichi.

Komabe, masiku ano zinthu zasintha, ndipo zotsatirapo zake zitakhala zabwino, pokhapokha ngati malangizo onse a dokotala awonedwa. Kodi thupi lidzachira bwanji nthawi yakukonzanso komanso kuti munthu akhale ndi moyo wautali bwanji zitadalira zinthu zingapo:

kulemera kwa odwala (anthu onenepa kwambiri amachira pambuyo pochita opaleshoni ndikukhala ochepa),
zaka wodwala
zakudya
kupezeka kwa zizolowezi zoyipa mwa munthu,
machitidwe a mtima
wodwalayo ali ndi mavuto ena azaumoyo.

Kodi munthu angathe kukhala wopanda chamba? Zachidziwikire, inde! Koma ziyenera kudziwitsidwa kuti zinthu zoyipa zomwe zimakhudza thupi, ndizowonjezereka kuti pambuyo pa opareshoni pamakhala zovuta zina zomwe zingayambitse kuchepa kwa chiyembekezo cha moyo. Mukachotsa kapamba, mutha kukhala ndi moyo mosangalala pokhapokha mutakhala ndi moyo wathanzi ndikutsatira malangizo onse a dokotala.

Kukonzanso nthawi

Moyo pambuyo pochotsa zikondamoyo mwa munthu zimasintha kwambiri. Ngakhale mchira wa chiwalo kapena gawo lina litachotsedwa, ndikuchita opareshoni pakokha popanda zovuta, wodwalayo adzafunika nthawi yayitali komanso khama kuti achire bwino.

Ngati kapamba achotsedwa, wodwalayo amayenera kutsatira zakudya zowonjezera, kumwa mankhwala apadera ndikugwiritsa ntchito jakisoni wa insulin kuti awononge shuga.

Odwala ambiri kwanthawi yayitali amadandaula kuti akumva kupweteka m'malo omwe amagwiridwapo ntchito, ndipo ululu umatchulidwa. Ndipo kuti muchepetse, madokotala, monga lamulo, amapereka mankhwala opweteka ngati chithandizo chowonjezera. Kuchira kwathunthu kwa thupi pambuyo pakuchita opaleshoni ya pancreatic kumatenga pafupifupi miyezi 10-12.

Zizindikiro zakuchita opareshoni

Zizindikiro za opaleshoni zingaphatikizepo:

Pachimake kwambiri kapamba, sangagwiritsidwe ntchito pochizira,
Hemorrhagic pancreatitis, limodzi ndi kukoka kwa magazi m'thupi,
Pancreatic necrosis, chomwe ndi necrosis ya mbali zina za kapamba,
Kukhalapo kwa purifiyamu yotupa ndi chotupa,
Kapangidwe ka ma cysts akuluakulu mu kapamba,
Kukula kwa fancula kapamba,
Kupangidwe kwa ma cysts ndi kusasitsa,
Kuvulala kwapancreatic
Mapangidwe a calculi m'magulu akunyumba.

Kuchuluka kwa opaleshoni yochitidwa kumatengera gawo la matendawa ndi mtundu wa matenda. Njira zotsatirazi zitha kuchitika:

Kusokonezeka kwa kapisozi, kuti muchepetse kutupa,
Necrectomy, pamene malo osiyana ndi necrosis amachotsedwa,
Kusintha pang'ono kwa kapamba (kuchotsa mbali ya chiwalo, mwachitsanzo, mchira),
Pancectomy, pamene chiwalo chimachotsedwa kwathunthu.

Zowoneka za opareshoni

Maphunziro a labotale ndi othandizira amapatsidwa kuti akhale ndi chithunzi chokwanira chachipatala. Kuyesedwa koyenera kumaphatikizapo kuyezetsa magazi, ma ultrasound a kapamba, kupumira.

Asanamuchitire opareshoni, adokotala amalankhula ndi wodwalayo, amamuwuza za njirayo ndi zoletsa zomwe zilipo.

Zomwe zimayambitsa kuchotsedwa kwa ziwalo

Komabe, pali zochitika zina pamene kuli kofunikira kupanga gawo la kapamba (mutu, mchira) kapena kuchichotsa kwathunthu. Pambuyo pa kulowererapo, zovuta zosayembekezereka zimatha kuchitika zomwe zimakhala zovuta kwambiri kulosera. Zonse zimatengera umunthu wa wodwala aliyense. Zifukwa zazikulu zomwe zingayambitse opaleshoni ndi:

Pachimake pancreatic necrosis. Mkhalidwe wapafupi kufa pang'onopang'ono wa ziwalo parenchyma chifukwa kumasulidwa kwa michere ya proteinolytic.Iron kwenikweni "amasungunuka" mothandizidwa ndi msuzi wake. Wodwala akapanda kuchitidwa opaleshoni mwachangu, adzafa ndi kukhumudwa.
Kuphwanya kodetsa nkhawa. Khansa yam'mutu ya pancreatic ndiyofala kwambiri. Poyambirira kwamatendawa, mutha kudziletsa kuti muchepetse gawo lomwe lakhudzidwa ndi chiwalocho, koma mothandizidwa ndi matendawo, ndikofunikira kuti muchotse kwathunthu.
Mowa. Ndizachilendo kwambiri kuwona zoterezi zotulutsidwa ndi zotumphukira ndi zotumphukira za muyezo. Nthawi zambiri, odwala amakhala ndi mavuto a chiwindi komanso mitsempha ya varicose ya esophagus. Komabe, pali zochitika zina pamene uchidakwa umabweretsa necrosis ya parenchyma.
Blockage wa kubowola kopatsa chidwi. Pancreatitis yowerengeka nthawi zambiri samayambitsa kuchotsedwa kwathunthu kwa chiwalo, koma imangokulitsa mkhalidwe wa wodwalayo. Ndikofunikira kuchita kuthetseratu mwala ndi chithandizo.

Ndikofunikira kumvetsetsa kuti pancreatectomy ndi gawo lokhazikika kwambiri. Ndizosatheka kuneneratu molondola zotsatira zake. Ichi ndichifukwa chake ndikotheka kusankha pazokhazokha zovuta, zikafika pamoyo wamunthu. Pa mwayi wochepa wopulumutsa chiwalo, muyenera kuyesetsa kuchichita.

Mavuto oyambilira atatha opaleshoni

Pazifukwa zodalirika za kuchira kwa wodwalayo, ndikofunikira kupereka chisamaliro chokwanira paumoyo wa wodwalayo patatha maola makumi asanu ndi awiri atatha ndondomeko yozizira. Zowopsa komanso zowopsa ndizikhalidwe zotsatirazi:

Kupuma. Gland imabayidwa ndi zombo zambiri, zomwe zimatha kuwonongeka. Udindo wofunikira kwambiri umachitika ndi luso la dokotala wochita opareshoni ndi waluso lake.
Matenda owopsa. Tizilombo toyambitsa matenda tambiri timayambitsa matenda ofooka. Pofuna kupewa izi, kuphatikiza mankhwala oletsa antibayotiki ndikofunikira.
Kudzidwa kwa seams. M'masiku oyambilira, pamene wodwala ayamba kusuntha, ulusiwo sungathe kupirira katunduyo ndikuphwanya.
Zilonda zipsinjo. Kukhala nthawi yayitali m'malo a supine kumathandizira kuti pakhale zolakwika za khungu zomwe zimafuna chithandizo chokwanira.

Kodi chichitikireni opaleshoni?

Mpaka posachedwapa, anthu amakhulupirira kuti kulowererapo kuti achotse kapamba ndi nthano chabe, ndipo wodwalayo sadzapulumuka pambuyo pake. Komabe, zamankhwala zapita patsogolo kwambiri. Tsopano anthu atha kukhala moyo wabwino popanda ichi chofunikira. Zotsatira zazikulu zomwe zimadikira odwala ndi:

Kudya kwambiri. Popanda kuyang'anitsitsa kadyedwe, sikungatheke kukwaniritsa chilichonse chokhutiritsa. Sizoletsedwa kudya mafuta aliwonse, okazinga kapena osuta. Kwenikweni, mumatha kudya zakudya zamagulu omwe zimaphika mosavuta. Mutha kuwerenga zambiri za zakudya pa intaneti.
Kudya kwa nthawi yayitali kukonzekera enzyme. Popeza chofunikira kwambiri chogaya chimachotsedwa, ndipo ndikofunikira kudya, odwala amakakamizidwa kuti azisinthanitsa ndi mapiritsi a proteinolytic ndi mapiritsi.
Mapangidwe a shuga 1. Izi chifukwa cha kufafaniza kwa ndulu kumakula mu 100% ya odwala. Zimafunikira chithandizo ndi jakisoni wa insulin komanso kudya mosamalitsa.
Matenda amisala. Chimodzi mwazinthu zofunika kwambiri kuti muzigwirapo ntchito. Nthawi zambiri, anthu omwe anachitidwa opareshoni safuna kupezeka. Amakhala otsekeka ndi ena, amawona kuti ndi otsika. Pakadali pano, ndikofunikira kuthandiza odwala oterowo, kuwapangitsa kumvetsetsa kuti anthu ambiri mdziko lapansi amakhalanso ndi vuto lomwelo.

Aliyense wa ife m'banja la makolo ali ndi lingaliro la momwe anthu ayenera kukhalira mosiyanasiyana. Ndipo nthawi zambiri timaganiza kuti iyi ndi njira yolondola yokha yomwe wina aliyense ayenera kugawana. Kulowa mu maubale ndi anthu ena, nthawi zina timawona kuti ali ndi malingaliro osiyana kwambiri pazinthu zambiri ndipo safuna kukwaniritsa zomwe tikuyembekezera. Pakadali pano zinthu zopanda pake zimabuka komanso mkwiyo. Tili ndi mlandu pa ena, koma tiyenera kuvomereza chilichonse - chifukwa tikuyembekezera kuchokera kwa munthu wina zomwe zomwe safuna, sangathe kapena sizili zokonzeka kupereka.

Inde, ndikofunikira kudziwa zomwe mukuyembekeza kuchokera ku ntchito yatsopano, ubale ndi bwenzi lanu. Zimathandiza munthu kuti amve ndikudzimva okha. Zoyembekeza zimayamba kusokoneza moyo pomwe zimakhala zoyembekezera mopyola muyeso. Ngati tikufunadi kena kena kake, ndiye kuti timayamba kudalira zotsatira zake, ndiye kuti tili ndi mantha kuti izi sizingatheke, ndipo mantha nthawi zambiri amabala. Kuphatikiza apo, ziyembekezo zopitilira muyeso zimapanga kufunikira kochulukirapo, komwe kumasokoneza ndikupeza zomwe mukufuna.

Zoyembekeza zopitilira muyeso zikusonyeza izi

Moyo wakhazikitsidwa pamaziko a "Ndikufuna zonse zikhale momwe ine ndikufuna "Zochitika zina zonse za moyo zimakanidwa. Uku ndi kufunikira kwa dziko lapansi komanso kufunitsitsa kukhala Mulungu. Pali kukana zatsopano, chifukwa chake, kukana chitukuko.
Pali chikhumbo chofuna kuwongolera zochitika, i.e. kutenga udindo komwe munthu sayenera kutenga. Kuwongolera ndi chinthu chopatsa mphamvu kwambiri chomwe chimatenga mphamvu zambiri zofunika kuti mukhale moyo wanu.
Pali kudalira kwamalingaliro ndi kufunitsitsa kukhazikitsa dongosolo lolimba la zochitika komanso nthawi yotsiriza. Pamakhala kuleza mtima, zimakhala zovuta kudikira ndikuvomereza kusintha komwe kukuchitika.

Kuyembekezera china kuchokera kwa munthu wina, ife, nthawi zambiri popanda kuzindikira, timamukakamiza. Mwachitsanzo, mkazi amayembekeza mwamunayo kuti akwatirane. Malingaliro ndiwakuthupi, ndipo mwamunayo amawamva. Koma sanasankhebe pa chisankho chake, ndipo kukakamizidwa kumene kumamulepheretsa kusankha payekha, kuchokera pansi pamtima. Ngati mayi akwanitsa kuchotsa zoyembekezerazo, i.e. Siyani zomwe mwachita, kenako atapeza zomwe akufuna.

Momwe mungachotsere ziyembekezo?

Sinthani zoyembekezera ndi chikhulupiriro, ndikudalira chilengedwe chonse. Ndikofunikira kukumbukira kuti zonse m'moyo zimachitika nthawi yina komanso zimatikomera.
Kuvomereza kuti pali malo ambiri opititsa patsogolo zochitika, njira zothanirana ndi vutoli ndi zosankha zamakhalidwe a anthu, ndipo onse ali ndi ufulu kukhalapo. Kulandila ndikuwalola kukhala.
Osangoyang'ana pa cholinga, koma panjira yopita kumene mukufuna. Ngati mukufuna kupeza ntchito yatsopano, muyenera kuganizira, choyamba, za njira zomwe mungapangire.
Sewerani ndikuvomera zosokoneza. Ngati mukufuna kupeza malo omwe mumalakalaka kwa nthawi yayitali, ingoganizirani kuti izi sizinachitike, ndikusankha nokha zomwe mungachite pankhaniyi.

Aliyense atha kukhala popanda kuyembekezera, ndi kuvomereza kwathunthu kwa dziko lapansi ndi anthu ena, okhazikika kwambiri mwanjira zauzimu, koma aliyense atha kupanga ziyembekezo kuti zisasokoneze chisangalalo cha moyo ndikupanga ubale wabwino ndi anthu ena. Mukungoyenera kutenga udindo pazomverera zanu ndikukhala okonzeka kuchita nokha.

Thupi laumunthu limawoneka lofooka, lokhala ndi matenda ndipo limakonda “kusweka” mosiyanasiyana. M'malo mwake, tili ndi gawo lalikulu la chitetezo. Ngakhale atataya ziwalo zina za thupi ndi ziwalo zamkati, munthu amatha kukhala moyo wathunthu. Ndipo ngati alendo akudziwa kusowa kwa mkono kapena mwendo, ndiye kuti kusowa kwa ndulu ngakhale m'mimba sikumenyedwa. MedAboutMe mudaganiza momwe mungakhalire opanda zina "tsatanetsatane" wa thupi lathu?

Zowonjezera ndi appendicitis

Chowonjezera ndi zowonjezera zomwe nthawi zambiri zimaganiziridwa kuti ndizachabechabe zomwe zayiwalika mwachilengedwe pakupanga chisinthiko. Kwa nthawi yayitali, adaganizidwanso kuti azichotsa pasadakhale - osachepera kwa anthu omwe akuyenda maulendo ataliatali kuti apewe kutupa (appendicitis) ndipo, chifukwa chake, opaleshoni yam'mimba yochotsa - apendendomy. Ndipo, komabe, zidapezeka kuti zowonjezera zimakhala ndi minyewa ya lymphoid ndipo zimagwira nawo nawo chitetezo chokwanira. Amakhalanso ndi mabakiteriya ambiri omwe akukhudzidwa ndi chimbudzi cha minyewa ndikuletsa kuperewera kwamatumbo. Chifukwa chake m'zaka zaposachedwa pakhala chizolowezero choti ayesetse kupitiriza kukhalabe ndi zowonjezera ndi kuphatikiza kosavuta ndi ma antiendicitis.

Masiku ano, kuchuluka kwa appendicitis m'maiko a ku Europe ndi America ndi kuyambira 7 mpaka 12%, ndipo magawo atatu a odwala ndi anthu omwe sanakwanitse zaka 35. Ndizosadabwitsa kuti appendectomy ndi imodzi mwazomwe zimachitika mwadzidzidzi, gawo lawo ndi 60-80%.

Ngakhale zimatsimikiziridwa kuti zowonjezera sizotsatira zakuyiwalako, munthu amene adazitaya amakhala ndi moyo wonse, osadziletsa pachilichonse.

Ndulu ndi gawo lathu lalikulu kwambiri la zotchedwa lymphoid, lomwe limatulutsa ma lymphocyte ndi ma antibodies. Ndulu imayang'aniranso pokonza (kubwezeretsanso) maselo ofiira a m'magazi ndipo amathandizira kupanga bile. Mmenemo, kudzikundana kwamapulatifomu kumachitika - mu gawo ili gawo limodzi mwa magawo atatu ali onse a zinthu za m'magazi limayikidwa.

Malinga ndi madotolo, kuwonongeka kwa ndulu kumachitika mu 20% ya odwala omwe amalowetsedwa kuchipatala ndi kuvulala kwa ziwalo zamkati. Zitha kuwoneka kuti chiwalo ichi, chomwe chili kumanzere, pafupi ndi kumbuyo, chimatetezedwa bwino ndi ziwalo. Komabe, ichi ndi chifukwa chake ngati pakumenyedwa kwamphamvu pamimba, imang'ambika mosavuta. Magazi ochokera ku chiwalo chowonongeka amalowa m'mimba, ndiye kuti, m'mimba mumatuluka magazi. Ngati sichinazindikiridwe mwachangu ndipo chithandizo sichinayambike, munthuyo amwalira. Pali zifukwa zina zochotsera ndulu, mwachitsanzo, kupindika kwa chiwalo. Ndulu yowonongeka imachotsedwa - njira yotchedwa splenectomy.

Mwamwayi, kukhala wopanda ndulu kumatha kukhala mosangalala kuyambira kale, koma mosamala. Chiwindi chimagwira mwachangu kwambiri kuposa momwe chimatulutsira bile, ndipo zophatikizika zina za minyewa ya m'mimba ndi m'mafupa zimayambitsa chitetezo cha mthupi. Koma wodwala wotere amakhala pachiwopsezo cha matenda opatsirana, ndipo nthawi zonse ayenera kukumbukira izi.

Chimbudzi Direct: Moyo Wopanda Pathupi

Mimba ndi chiwalo chofunikira kwambiri. Chakudya chomwe chimalowamo chimakhala ndi makina (mwa kufinya makhoma) komanso mphamvu ya mankhwala (mothandizidwa ndi hydrochloric acid, yomwe imapangidwa m'mimba), pambuyo pake zonse zomwe zitha kumeza kudzera mucous membrane wamakoma am'mimba ndikulowa m'magazi, ndikupumula kumapita kufikira gawo lotsatila la chakudya.

Koma kuchita kumawonetsa kuti ukhoza kukhala wopanda mimba. Chifukwa chake, mu 2012, Britain adamwa nayitrogeni wamadzi, chifukwa chomwe madotolo adayenera kuchotsa m'mimba mwake. Emophagus anali wolumikizana ndi intestine yaying'ono. Izi sizikutanthauza kuti wodwalayo wachira kwathunthu - mpaka kumapeto kwa moyo wake adzafunika kuti azitsatira zakudya zinazake, zomwe, komabe, sizokhwima kwambiri, komanso kumwa mavitamini a tsiku ndi tsiku, popeza mavitamini amamizidwa m'matumbo. Komanso, pakakhala kuti palibe m'mimba, ngozi za ma gallstones ndi kuchepa kwa magazi zimachuluka.

Chikhodzodzo ndulu chimakhala kumtunda chakumanja kwa chifuwa cham'mimba pamwamba pa chiwindi ndipo nthawi yomweyo pansi pa nthiti. Chiwindi chimatulutsa bile kuti lizikumba mafuta, omwe amadzaza ndulu. Ngati mulingo wa cholesterol m'magazi utakwezedwa, ndiye kuti nthawi yayitali ma gallstones amapanga ndulu, kutsekeka kutulutsa kwa bile. Zotsatira zake, nthawi zambiri zinthu zimakhala kuti kuchotsedwa kwa ndulu kumafunika - cholecystectomy. Chiwerengero chamiyala yamitengo chidachotsedwa kwa wokhala ku India mu 2015 - zidutswa zopitilira 12,000. Malinga ndi zomwe zikuchitika pakalipano, cholecystectomy ndi njira yopitilira muyeso. Padziko lonse lapansi, madokotala akuyesera kuyesera kuyesa miyala ndi mankhwala, ndipo pokhapokha "amawadula".

Pambuyo pochotsa ndulu, munthu ayenera kutsatira zakudya zina, komanso kudya osachepera 5 patsiku. Chiwindi chimapitilirabe kubereka bile, koma tsopano ilibe podzikundikira, kotero kudya mokhazikika ndiko chinsinsi cha moyo wathunthu wodwala.

Pancreas: Moyo pa Enzymes

Chikondamoyo ndi chiwalo chomwe chili kumbuyo kwa m'mimba ndipo chimagwira ngati fakitale yopanga chakudya cham'mimba. Ndi chiwalo ichi chomwe chimapanga insulin, pomwe sipangakhale shuga mellitus, ndi ma enzyme ena ambiri ofunikira. Kuchotsa kwa ziwalo (pancreatectomy) nthawi zambiri kumayikidwa khansa ya pancreatic. Nthawi zambiri limodzi ndi iyo amachotsanso ndulu ndi gawo lamatumbo ang'onoang'ono kapena m'mimba, etc.

Zikondamoyo zimachita mbali yofunika kwambiri chimbudzi. Pambuyo pochotsa, munthu ayenera kutsatira zakudya zina mpaka kumapeto kwa moyo wake, kukonzekera enzyme ndikupanga jakisoni wa insulin. Odwala otere amayenera kudya kangapo patsiku.

Gland ya chithokomiro ndi gawo la dongosolo la endocrine. Gulu la gulugufe palokha limakhala kutsogolo kwa trachea komanso pansi pa larynx. Amapanga mahomoni okhala ndi ayodini omwe amaphatikizidwa ndi metabolism ndi kukula kwa maselo. M'matenda ena, chithokomiro cha chithokomiro chimatha "kudziwononga" - mwachitsanzo, ndi autoimmune chithokomiro. Ndipo nthawi zina amayenera kuchotsedwa - ndi zotupa zosiyanasiyana za chithokomiro kapena kupanga ndi tsekwe. Opaleshoniyo imatchedwa kuti chithokomiro.

Monga kapamba, mpaka kumapeto kwa moyo, wodwala wotere ayenera kutenga kukonzekera kwa mahomoni a chithokomiro tsiku ndi tsiku. Koma apa zonse ndizosavuta: piritsi limodzi m'mawa ndipo palibe jakisoni kapena zakudya zapadera. Ndi mankhwala a tsiku ndi tsiku, kusowa kwa chithokomiro sikukhudza thanzi la munthu.

Kodi mungasinthe bwanji m'matumbo?

M'matumbo, omwe ndi gawo lomaliza la m'mimba, ndowe zimapangidwa kuchokera ku hummus (chakudya gruel), komanso madzi omaliza omaliza. Zomwe zimachotsa ziwalo zina za m'matumbo kapena chiwalo chonse nthawi zambiri ndimatenda a khansa kapena matenda a Crohn. Njirayi imatchedwa hemicolectomy.

Ndipo mutha kukhala opanda kolimba. Koma nthawi yomweyo, kalopriemnik imayikidwa, popeza wodwalayo sangathe kuyendetsa bwino ntchito ya kudzikundikira ndi kusakaniza ndowe.

Ziwalo zoberekera zimathanso kuchotsedwa. Mwachitsanzo, testis ndi chotupa chotupa mwa amuna chomwe chimapanga umuna ndi mahomoni achimuna a amuna. Kuchotsa (orchiectomy) kwa amodzi kapena ma testic onse amalembedwa khansa, kutupa kosatha, komwe kumayambitsa gangore, komanso kuvulala. Ziyenera kufotokozeredwa: ngati kutayika kwa testicles kudakula, ndiye kuti mwamunayo amakhalabe ndi chilakolako chogonana - mwina osalimba ngati kale. Nthawi zambiri, kuchotsa ma testicles kumamenya kwambiri psyche yamunthu, osati thupi lake. Chochititsa chidwi: zowunikira zikuwonetsa kuti mwa amuna omwe ataya ma testicles, chiyembekezo cha moyo chimawonjezeka.

Amayi, motero, nthawi zina amapezeka kuti ali ndi vuto lothetsa mazira (ovariectomy): zomwe zimayambitsa khansa kapena khansa. Madokotala nthawi zambiri, monga momwe amachitira ma testicles mwa abambo, amayesa kusunga chimodzi mwazophatikizira izi mpaka chomaliza. Omwenso amatulutsa mahomoni ogonana, omwe amafunikira kuti thupi lizigwira ntchito mokwanira, chifukwa amagwira nawo ntchito zambiri zomwe sizikugwirizana ndi ntchito yakubereka ya anthu. Nthawi zina thumba losunga mazira limachotsedwa limodzi ndi chiberekero. Ndipo izi nthawi zambiri zimakhala zovuta kuvomereza ndi akazi ndi amuna awo.

Malinga ndi asayansi, mu nthawi ya 7-10%, thupi laimayi limasinthasintha ndikuwonongeka kwa ziwalo, ndikuthandizira ntchito yopanga estrogen ndi ma adrenal gland. Nthawi zina, adotolo atha kukulemberani mankhwala othandizira obwera ndi mahomoni.

Zotsatira zakuchotsa ziwalo zina

Munthu amatha kukhala ndi moyo wautali komanso wachisangalalo popanda impso imodzi popanda mavuto.Izi ndiye maziko a zopereka za impso zomwe zimaphatikizapo opereka amoyo. Koma popanda impso ziwiri, thupi limakhala lovuta. Impso zimathandizira kuyeretsa magazi amthupi kuchokera pazinthu zovulaza ndi zotayidwa. Mukasiya impso zonse nthawi imodzi, wodwalayo adzafa msanga chifukwa chomwa mowa. Chifukwa chake, pakapanda impso zonse, munthu amatha kupulumuka mothandizidwa ndi dialysis yochitidwa pazida zoyenera.

Chiwalo china chapadera cha thupi lathu ndi chiwindi, chomwe chitha kupulumuka kuchepa kwa magawo atatu a unyinji wake ndikusintha kwathunthu pakapita nthawi. Koma palibe moyo wopanda chiwindi, umakhudzidwa pafupifupi ndi machitidwe onse ofunikira a metabolic. Chiwindi chimathandizanso pakuyeretsa thupi komanso kulephera kwathunthu, kulephera kwa chiwindi ndi imfa zimakula msanga.

Sayansi imadziwanso milandu yapadera yomwe anthu adabadwira ndipo kwakanthawi kwakanthawi amakhala ndi vuto lalikulu lachitukuko cha ubongo, kutanthauza kuti kunalibe. Zochitika zachilendo zachipatala za kutaya kwa gawo laubongo chifukwa chovulala zinajambulidwa. Koma kuyerekeza ndi ntchito zina zambiri zochotsa ndulu, thumba losunga mazira, kapena chithokomiro, kuchepa kwa ubongo ndi vuto lalikulu. Ndikosavuta kuyankhula za moyo wamba wamunthu.

Yesetsani Mayeserowa ndikuyesa kuti mupeze mfundo zingati - pamakwerero khumi - mutha kuwunika thanzi lanu.

Anthu ambiri omwe amachotsera kapamba pazifukwa zingapo amadabwa kuti kodi zingatheke kukhala ndi moyo popanda chiwalo ichi. Madokotala amapereka yankho lenileni la funso ili. Munthu atha kukhala wopanda kanyumba kwambiri, ngati utatsatira malamulo ena. Limodzi mwa malamulowa ndi chakudya chamagulu.

Mankhwala atatha opaleshoni

Pambuyo pakuchita opaleshoni yochotsa ziphuphu, zakudya zowonjezera zimaperekedwa kwa odwala onse popanda kusiyanasiyana. Muyenera kumamatira nthawi zonse. Kuchokera pazakudya kamodzi zichotsedwa:

Zakudya zokazinga ndi zamafuta
ankasuta nyama
maapulo
ufa
zonunkhira
chakudya zamzitini
mankhwala omalizidwa
masoseji,
mbale zokometsera ndi msuzi,
zakumwa zoledzeretsa komanso zakumwa zoledzeretsa,
chokoleti
cocoa
nyemba.

Pazakudya za wodwala tsiku lililonse, payenera kukhala nyama ndi nsomba zamitundu yamafuta ochepa. Komabe, simungathe kuwagwiritsa ntchito ndi khungu. Komanso, tsiku lililonse amafunika kudya mkaka ndi mkaka (zomwe zili m'mafutawo siziyenera kupitirira 2,5%).

Muyenera kudya zakudya motsatira malamulo ena:

miyezi itatu yoyambirira atachitidwa opaleshoni, iyenera kuphwanyidwa kuti ikhale yokhazikika,
muyenera kudya zazing'ono m'malo osachepera 5 patsiku,
Mphindi 30 mpaka 40 musanadye, jakisoni wa insulini ayenera kuperekedwa (pokhapokha ngati agwiritse ntchito insulin), ndipo pakudya, ndikofunikira kukonzekera enzyme,
Chakudya chizikhala chotentha, chotentha komanso cha moto chomwe sichimaletsedwa,
chakudya chomaliza chichitike maola awiri asanagone.

Ngati mumatsatira zakudya mosamala ndikugwiritsa ntchito nthawi yake mankhwala omwe dokotala wamulembera, mutha kukhala ndi moyo wautali komanso wachimwemwe ngakhale zikondazo zitachotsedwa kwathunthu. Ngati mumanyalanyaza malangizo a dokotala, ndiye kuti izi zitha kubweretsa zovuta komanso kuchepetsa kwambiri mwayi wokhala ndi moyo.

Zakudya pambuyo kuchotsedwa

Atangochita opaleshoni, wodwala saloledwa kudya kwa masiku angapo. Zosavomerezeka-zokha zomwe zimaloledwa. Kuphatikiza apo, mumayenera kumwa osati m'mphepete imodzi, koma m'magawo ang'onoang'ono omwe amagawidwa chimodzimodzi tsiku lonse. Muyenera kumwa malita awiri. Palibe chilichonse chosatheka.

Pakatha masiku angapo, munthu amene wachotsedwa kapamba amaloledwa kuyamba ndi tiyi ndi supu yopanda mafuta. Buckwheat phala kapena mpunga ndizovomerezeka. Pafupifupi sabata yatha opaleshoniyo ikamaliza, tchizi ndi tchizi chanyumba, mafuta ochepa, ochepa, owonjezera pang'onopang'ono, amawonjezeranso zakudya. Musachotse kabichi mwamtundu uliwonse. Pakapita kanthawi, amayamba kudya nsomba ndi zikwangwani za nyama, koma osasenda ndi kuphika, koma ophika yekha pang'onopang'ono. Chakudya chimayenera kuwiritsa kapena kuwiritsa.

Moyo

M'moyo wonse, munthu wopanda kapamba ayenera kusiya kusuta ndi kumwa mowa, kuchotsa mchere pafupifupi kwathunthu pachakudya, osatha magalamu asanu ndi atatu patsiku. Muyenera kudya mapuloteni ambiri ndiku kuyiwala zazinthu zamafuta.

Wokazinga, mchere ndi kusuta nawonso samaphatikizidwa kuti apewe zovuta. Chakudya chimayenera kugawidwa m'magawo asanu ndikudya chakudya m'magawo ang'onoang'ono tsiku lonse. Sizoletsedwa kudya zakudya zozizira, chakudya chimangopatsidwa wofunda. Madzi ayenera kukhala patebulo nthawi zonse, makamaka mchere, wopanda mafuta ndi malita awiri patsiku.

Thanzi laumunthu lopanda kapamba

Zikondazo zimachita mbali yofunika kwambiri m'thupi la munthu ndipo, ngati munthu walandidwa chiwalo ichi, njira zambiri za metabolic zimasokonekera. Koma ngati munthu angakhale ndi moyo popanda chamba zimangodalira

munthu yemweyo. Mutha kukhala nthawi yayitali, koma malinga ndi zina. Kuphatikiza pa zakudya zomwe muyenera kutsatira moyo wanu wonse, muyenera kukhalanso ndi thupi ndimankhwala.

Pankhaniyi, gawo lolowa m'malo limaseweredwa ndi ma enzyme, omwe amafunikanso kutengedwa moyo wonse kuti akhalebe chimbudzi. Pambuyo pakuchotsa kapamba, shuga amatha kuchitika, koma kumwa insulini kumathetsa vutoli.

Ndipo ngakhale atakhala kuti moyo wake wonse azitsatira mosamalitsa, adye mankhwala okonzekera ndi insulin, moyo wabwino m'mikhalidwe imeneyi suwonongeka. Odwala amayang'aniridwa ndi dokotala wa gastroenterologist ndi endocrinologist, yemwe angathandize pakakhala mavuto azaumoyo.

Ngati chithandizo sichinachitike panthawi yake ndipo zakudya zapadera sizitsatiridwa, matendawa angayambitse khansa ya kapamba. Kuti apulumutse moyo wa wodwala, nthawi zina ndikofunikira kuti achotse (kwathunthu kapena pang'ono). Mukuyenera kuti mumvetsetse kuti mutha kukhala popanda cholengedwa.

Malingaliro akuti kuchotsa ziwalo zamtunduwu kumayambitsa kufa kwachangu kwapita kale. Njira zamankhwala mtsogolo.

Pakadali pano, pali mitundu yambiri ya mankhwala obwezeretsa omwe amatha kupulumutsa moyo pambuyo poti wachotsa kwathunthu kapena pang'ono pang'ono.

Chifukwa chiyani chitsulo chimachotsedwa kapena gawo lake

Chizindikiro chachikulu komanso chodziwika bwino chochotsa kwake ndi khansa ya kapamba. Zomwe zimachitika zimaphatikizapo kumwa mowa kwambiri, kuchita opaleshoni yam'mimba, zovuta za kudya (kudya kwambiri, kudya zonunkhira komanso zakudya zamafuta), matenda osokoneza bongo, kapamba, kusuta komanso cholocha.

Minyewayi imachotsedwanso ndimatenda a chirengedwe chonse.

Chithandizo choyenera chokha cha khansa kutalikitsa moyo wa munthu ndikuchita opaleshoni. Kusiyana kwake kumakhalapo pamene matendawa amakhudza ziwalo zina zofunika. Kutengera ndi komwe khansayo ikuchotsa, ndiye kuti kuchotsa kwathunthu kapena pang'ono pang'ono kwamankhwala kumachitika.

Mitundu ya kulowererapo kwa opaleshoni:

Biliodigestive anastomosis-kubwezeretsa kutuluka kwa ndulu pogwiritsa ntchito endoscopy.
Gastroenterostomy - m'mimba limalumikizana ndi matumbo ang'onoang'ono chifukwa chophwanya chakudya.
Pancreatoduodenal resection.
Pancreatoduodenectomy yonse.

Kodi chonyansa chimachotsedwa bwanji?

Nthawi zambiri, mutu wa kapamba amachotsedwa. Opaleshoni yochotsa chiwalo chonse pakadali pano sichisowa. Koma, komabe, milandu yotere imachitika. Kuchotsa kwa pancreatic ndi njira yovuta kwambiri yochitira opareshoni. Ili mkati mwakuya kwam'mimba, yomwe imapangitsa kuti ziwalozi zitheke.

Mothandizidwa ndi laparoscope, mutha kuwunika mkhalidwe wa ndulu ndikuyamba kuchita opaleshoni. Pa gawo loyambirira, chodabwitsa chachikulu chimapangidwa pakhoma lakunja kwa m'mimba. Kenako gawo loyenerera la chiwalo kapena chiwalo chonse chimatulutsidwa. Nthawi yayitali yolowererapo ndi maola 5. General opaleshoni imagwiritsidwa ntchito.

Pancreatectomy kwathunthu ndikulowerera kochita kupanga komwe gawo lonse limachotsedwa. Pambuyo pa opaleshoni, kagayidwe kazakudwala kamene kamasokonezeka, insulini m'thupi silingathenso, motero, kwa moyo wake wonse majakisoni ake akufunika.

Ma Enzymes ofunikira kuti chimbudzi chisathe kuonekeranso. Chifukwa chake, titha kufotokoza zakufunika kwakukhalitsa kwathunthu mankhwala a enzyme.

Kupanikizika kwathunthu kwa kapamba kumakhala kosowa kwambiri, makamaka pamene ikufunika kuchotsedwa mwina chifukwa chakutupa kapena chifukwa cha khansa yomwe ikupita patsogolo. Komabe, opaleshoni yotere imakhala ndi maubwino. Poyerekeza ndi pancreatectomy pang'ono, yathunthu imakhala ndi zotsatirapo zochepa.

Nthawi ya postoperative imatha masiku angapo. Kubwezeretsa wodwala, chithandizo cha radiation ndi chemotherapy chitha kuperekedwa (ngati gland imachotsedwa chifukwa cha khansa). Wodwala amalandira mankhwala opweteka a narcotic komanso sanali a narcotic, insulin ndi ma enzymes.

Pambuyo pa opaleshoni yotere, zotsatira zoyipa za thupi (magazi, zotupa, kuwonongeka kwa mitsempha ndi ziwalo zapafupi, matenda a shuga). Komabe, ndizotheka komanso ndizofunikira kukhala popanda chofufumitsa.

Zotsatira zakuchotsa kapamba:

matenda ashuga
kuwonda
kunenepa
matenda ammimba.

Zakudya zopatsa mphamvu

Zitha kukhala ndi moyo pambuyo poti mugwire ntchito ngati zakudya zimayang'aniridwa bwino. Pambuyo pakuchoka kuchipatala, wodwalayo akulimbikitsidwa kuti azitsatira njira inayake yodyera (zakudya 5p).

Njira zake zazikulu ndikuti muyenera kusiyiratu mafuta, okoma, zokometsera, amchere, mowa komanso kusuta. Zakudya zoletsedwa monga soseji, khofi ndi tiyi wamphamvu, makeke ndi mkate watsopano, maswiti onse ndi chokoleti, mankhwala amkaka, zonunkhira ndi zokometsera. Nthawi zina, mumatha kudya mazira.

Chakudya chizikhala chophika zokha, kuwotcha kapena kudyetsa, kusenda komanso makamaka mapuloteni mwachilengedwe. Onetsetsani kuti mwapeza zakudya zolimbitsa (masamba atsopano ndi zipatso) ndi kumwa kwambiri (madzi amchere mpaka 2 malita patsiku). Kalori yatsiku ndi tsiku sayenera kupitirira 2000 kcal.

Zakudya zimaperekedwa patebulo pokhapokha potentha. Ndikulimbikitsidwa m'malo ochepa 5-6 patsiku.

Enzyme yowonjezera

Ntchito yawo ndikuthandizira kugaya chakudya.

Alfa-amylase ndi enzyme yomwe imalimbikitsa chimbudzi cha chakudya. Mlingo amasankhidwa payekha, kumwa mankhwala atatha kudya.

Micrazim ndi mankhwala atsopano. Chofunikira chachikulu ndi pancreatin, yomwe imakhala ndi ma pancreatic enzymes omwe amalimbikitsa kuyamwa kwa mapuloteni, mafuta ndi chakudya. Mlingo watsimikiza ndi dokotala.

Creon ndi mankhwala othandizira omwe amapezeka ndi pancreatin.

Ma enzyme onse omwe ali pamwambawa amatha ndipo ayenera kumwedwa ndi chakudya chilichonse. Amathetsa kumverera mseru komanso kudzimbidwa. Therapy ya enzyme ilibe zotsutsana ndi zovuta zilizonse, mankhwala onse amaloledwa mosavuta. Zotsatira zimatheka pokhapokha, mkati mwa kanthawi kochepa kwambiri, kumwa kamodzi kapena kwinakwake (kotchulidwa ndi dokotala) kumatengedwa.

Mankhwala a insulin

Popanda chofufumitsa, mutha kukhala ndi moyo ngati mutsatira mankhwalawa. Mitundu ingapo ya insulini imagwiritsidwa ntchito, yomwe imafanana kwambiri ndi insulin yopangidwa ndi gland.

Pakadali pano, mankhwalawa amagwiritsidwa ntchito ngati ma jakisoni. Ma syringe odziwika bwino a insulin amapezeka omwe mungalowe nawo pena paliponse.

Ndikofunikira kugula glucometer kuti muzitha kudziwa shuga ya magazi ake munthawi yake.

Mukachotsa kapamba, anthu onse amafunika kukayezetsa pachipatala chaka chilichonse: kuyesedwa kwa ma laboratory, ma ultrasound (complication tomography, kulingalira kwa maginito a maginito), magazi ndi mkodzo mayeso. Izi ndizofunikira kuti muwone zomwe zingachitike ndikuwongolera mankhwala.

Pali nthawi zina pomwe anthu amakhala popanda chindende mpaka atakalamba kwambiri. Akatswiri amalosera za moyo wa odwala otere pakatha zaka zisanu. Mukamatsatira mfundo zonse za mankhwala othandizira komanso kudya, mutha kukhala ndi moyo zambiri.

Kupatsirana kwa kapamba

Ndi anthu ochepa omwe amatha kusinthanitsa chiwalochi. Opaleshoniyi ndiokwera mtengo kwambiri komanso zovuta. Ndizovuta kwambiri kupeza chiwalo chopereka, chifukwa gland ndiyowonda kwambiri. Chifukwa chake, si akatswiri onse omwe amatha kuchita magwiridwe ake. Osati kale kwambiri, njira ngati izi zidayamba kuchitika ku Russia.

Mayiko otsogola kupatsirana kapamba ndi USA, Germany, Italy ndi Israel.

Moyo pambuyo opaleshoni

Kufunsira kwa katswiri wama zamagetsi kumalimbikitsidwa kuti abwezeretse malingaliro komanso kupewa mayiko ovutika.

Enzyme m'malo mankhwala

Kodi ndingakhale opanda kondomu?

Mankhwala amakono amathandizira kukhalabe ndi moyo pambuyo pochotsa zikondamoyo pamlingo wambiri. Kusintha thupi kukhala mikhalidwe yatsopano, muyenera kutsatira malangizo onse a madokotala.

Ngati matenda a shuga apezeka, wodwalayo amapatsidwa mankhwala a insulin. Muyenera kuyang'anira kuchuluka kwa shuga kwanu ndi glucometer.

Kusunga chimbudzi, ma encyombone a pancreatic amalembedwa, kugwiritsa ntchito komwe kumapangitsa kuti chakudya chizigwira ntchito komanso kugaya chakudya.

Mtengo wochotsa RV

Olga

Taras

Pancreatectomy - njira yochotsera kapamba

Pancreatectomy ndikuchotsa kapamba. Amachitika ndi matenda oopsa oopsa, pomwe njira zonse zomwe zingatheke pololera sizinaphule kanthu. Zikatero, mitundu yotsatila iyi ndiyomwe imachitidwa:

kwathunthu - ndulu imachotsedwa kwathunthu limodzi ndi ziwalo zoyandikana nayo (ndulu, gawo lam'mimba ndi matumbo aang'ono, chikhodzodzo),
pang'ono - chifukwa cha chithandizo cha opaleshoni, ndikofunikira kuchotsa mutu kapena mchira wokha.

Opaleshoniyo imagwiritsidwa ntchito molingana ndi ma algorithm otsatirawa: kuyamwa kumachitika pang'onopang'ono, gawo kapena zonse zomwe, limodzi ndi zowonongeka pafupi ndi ziwalo zam'mimba, zimachotsedwa, mawonekedwewo amatha kuwongoledwa ndikukhazikika ndi mabatani kapena mawonekedwe. Chithandizo cha opaleshoni ndichowopsa chifukwa chakuchulukana kochulukira kwa mankhwalawa, zoopsa komanso kufa pafupipafupi.

Pambuyo pakuchita bwino, zovuta zingachitike. Kukula kwawo amakhudzidwa ndi:

kunenepa
zaka
matenda ophatikizika
kuperewera kwa zakudya m'thupi
kusuta

Nthawi yobwezeretsa ndiyitali: zimatenga miyezi yambiri, nthawi zina pachaka. Kuyambira m'masiku oyamba, kumverera kosasangalatsa kumatha kuwoneka, ndipo kumakhala kupweteka pafupipafupi mu hypochondrium yamanzere panthawi yonse yokonzanso. Ndipo pali chizindikiro chilichonse cha asthenic (kufooka pakudya, kufooka kwambiri), ziwengo zomwe zimapangika.

Amayambitsa ndikuwonetsa kuchotsedwa kwa gawo la kapamba

Njira zosinthira zochizira matenda opweteka kwambiri a pancreatic ndi chisankho chotsiriza posakhalapo ndi zotsatirapo zabwino kuchokera ku chithandizo cha magawo am'mbuyomu. Pali matenda aliwonse oopsa a kapamba osagwira ntchito mwamphamvu yotsimikizika amathandizidwa ndi opaleshoni.

Kuyeserera pang'ono kumachitika ngati zotsatirazi zikupezeka:

kutupa, fistula, cyst, mwala, abscess,
neoplasms yoyipa mbali ina ya chiwalo kapena kuwonongeka kwa metastatic pomwe gwero la khansa ndi chiwalo china,
kuwonongeka kwa minofu
peritonitis, komwe gwero lake linali kutupa kwa kapamba,
Kutulutsa magazi kwambiri m'mimba m'matumbo,
kuchulukitsa kwa kutupa kosatha m'matumbo.

Opaleshoni imachitidwa ngati pali:

Mavuto obwera pambuyo pa cholecystectomy (popanda bile, kusokonezeka kwakukuru kwa chimbudzi cha chakudya kumachitika, komwe kumakulitsa kuchuluka kwa ndulu ndipo kumafunikira kutsata malamulo oletsa kudya, zolakwika m'zakudya zimayambitsa matenda oopsa a kapamba),
kukomoka kapena kuchepa kwathunthu kwa ndulu (pali necrosis komanso kufunikira kochotsa ziphuphu zomwe zakhudzidwa, koma ngakhale pakalibe, mutha kukhala ndi moyo wautali, kumakhala ndi moyo wanthawi zonse),
Kukula kwa zotupa: ngakhale pancreatic cyst yodziwika bwino, mothandizidwa ndi zinthu zakunja zakunja (kusuta, mowa, chakudya chopanda thanzi), itha kusintha kukhala chotupa choyipa chomwe chikufunika kuyikanso mwachangu,
ingress ya calculus kuchokera ku ndulu kudzera pa chimbudzi chodziwika bwino chapakati pa opaleshoni yamatenda a gallstone (ndizosatheka kuchotsa kuchuluka kwa mankhwalawa popanda kuwonongeka kwakukulu.
Matenda a kapamba kwambiri pafupipafupi komanso amakula kwambiri.

Mtengo wa chilichonse chomwe wakonzekera, mwachitsanzo, cancts, zipatala ndi malo azachipatala amasiyana malinga ndi malo ndi ziyeneretso za akatswiri omwe akugwira ntchito.

Pancreatic kuchotsa mutu

Kafukufuku akuwonetsa kuti mu 80% ya chotupa cha England, mutu wake umakhudzidwa. Njira ya pancreatoduodenal yothandizira opaleshoni imatchedwa, yomwe amatchedwa wolemba - njira ya Whipple. Opaleshoniyo imachitika m'magawo awiri:

Kuchotsa kachidutswa komwe kakhudzidwa ndi gawo la ziwalo zoyandikana zomwe zimagwira nawo munjira yothandizira.
Kubwezeretsanso kwaminyewa yakufa, chikhodzodzo ndi kugaya kwam'mimba thirakiti.

Njira ya laparoscopic imagwiritsidwa ntchito, opareshoni imachitidwa pansi pa opaleshoni yayikulu.

Laparoscope imayikidwa kudzera pazing'ono zazing'ono, malo omwe amayendetsedwa amawunikira, zotumiza zamagetsi, duodenum imatsekedwa ndikuchotsedwa, gawo loyandikira la lymph limachotsedwa, nthawi zina ziwalo zoyandikana zimayenera kuchotsedwa pang'ono.

Pambuyo pa izi, kulumikizana kwatsopano kumapangidwa pakati pamimba ndi matumbo aang'ono ndi thupi la kapamba.

Opaleshoniyo ndi yowopsa, ndipo imabweretsa zotsatira zowopsa pambuyo pochotsa mutu wa kapamba:

kuphwanya mayamwidwe a michere mokhudzana ndi kuchotsedwa kwa gawo lofunika kwambiri la chiwalo chomwe chimapanga michere yothandiza kugaya chakudya,
Kulephera kwa kagayidwe kazakudya zam'mimba ndi chitukuko cha matenda a shuga.

Pankhani yochotsa mutu nthawi zambiri mumakhala:

zotupa zamitsempha ndi mitsempha yamagazi yoyandikana ndi England,
magazi
matenda.

Pafupifupi nthawi zonse, chifuwa cha postoperative chokhala ndi chinsinsi chachikulu cha kuperewera chimayamba. Malangizo omwe amalimbikitsidwa ayenera kutsatiridwa kwa zaka zambiri. Zitha kukhala chifukwa chakuti pakamwa pokhapokha pakayikiridwa mankhwala ena, ndi zakudya zapadera kwakanthawi. Munthu pambuyo pakuchita opaleshoni amalandira kulumala.

Kugwira ntchito kwa Beger

Kafukufuku wapadera wa mutu wokhudzidwa ndi kapamba popanda kuchotsa duodenum adapangidwa ndikuyambitsidwa ndi Beger mu 1972. Pogwira ntchito imeneyi, babu m'mimba ndi duodenal babu omwe ali pafupi ndi chindacho amasungidwa, zomwe sizisokoneza gawo la chakudya kudzera mumgawo wokugaya. Kubisa kwa gastropancreatoduodenal kuchokera ku ndulu ndi kapamba kudzera mumatumbo ang'onoang'ono amasungidwa.

Zotsatira za kafukufukuyu, zotsatira zabwino zidapezeka mu nthawi yogwirira ntchito, pamaziko omwe njirayo idalandila akatswiri odziwa bwino ntchito yawo komanso kugwiritsa ntchito njira zambiri. Pogwiritsa ntchito njirayi, kapamba wam'mimba amapulumutsidwa m'mphepete mwa kumasulidwa kwa mitsempha yapamwamba komanso ya portal. Pali kuthekera kwa magazi ndi zovuta zomwe zilipo chifukwa cha matenda kapamba, makamaka, ndi chitukuko cha matenda oopsa a portal. Mwazinthu izi, kuwonekera pamitsempha kumakhala koopsa ndikutaya magazi kwambiri.

Kusankha kwa duodenum kosungiramo mutu popanda kudutsa zikondamoyo pamtunda wama portal kumagwiritsidwanso ntchito - mtundu wa Bernese wogwira ntchito pa Beger.

Kuchotsa mchira

Ngati caudal (caudal) gawo la kapamba amakhudzidwa, distal pancreatomy imachitika. Mitsempha ikachitika mchira, womwe umagwira ndulu, gawo lake kapena chiwalo chimachotsedwa kwathunthu. Ndulu zimapangidwanso pamodzi ndi zotengera. Zikatero, zovuta za carbohydrate metabolism ndi kukula kwa matenda a shuga sizichitika. Nthawi yokonzanso imatenga milungu iwiri.

Mu chotupa choyipa ndi kufalikira kwa mchira ndi thupi la kapamba, Corporocaudal resection wa zomwe zimakhudzidwa amagwiritsidwa ntchito. Opaleshoni yotereyi imayendera limodzi ndi splenectomy - kuchotsa ndulu.

Opaleshoni Frey

Makamaka mayendedwe amkati ndi kuchotsedwa kwathunthu kwa mutu kapena mchira kumatanthauza kugwira ntchito kwa Frey pamatumbo, komwe kumakhala kovuta, kowopsa, komanso kovuta kuchitira opareshoni. Amachitika kawirikawiri komanso pokhapokha pazovuta kwambiri, chifukwa njira yake imakhala yovuta kwambiri komanso si yabwino konse. Izi ndi njira zopangira opaleshoni yofunika kwambiri, zomwe ndi izi:

wathunthu komanso wofunikira pancreatic necrosis,
kuvulala kwa gawo lalikulu la
neoplasms yoyipa yokhala ndi kuchuluka kwakukulu kwa minofu yowonongeka.

Nthawi ya ntchito itadalira mphamvu ya opareshoni. Ngati kuyambiranso kwa mchira kudachitika, matendawa amakomera kwambiri, opaleshoniyo imavomerezedwa ndi odwala, zovuta sizimabwera.

Full pancreatic resection

Kuchotsa kwathunthu kwa chiwopsezo sikofunikira komanso mwapadera. Ndi zilizonse, ngakhale zowopsa kwambiri, ndikofunikira kuteteza chiwalo. Pachifukwa ichi, njira zonse zotetezera zimagwiritsidwa ntchito:

wapadera kulowetsedwa mankhwala
mankhwala
physiotherapy.

Kukonzanso kumatanthawuza gawo la ntchito zovuta: kuti apangitse kapamba, dotolo ayenera kukhala wodziwa bwino komanso wodziwa zambiri. Izi ndizovuta chifukwa cha kuyandikira kwa msempha, nthambi zake zowoneka bwino komanso ziwalo zoyandikana kwambiri zomwe zimatseketsa opaleshoni. Izi zikuphatikiza:

m'mimba
duodenum
chikhodzodzo
ndulu
chiwindi.

Opaleshoni imatha maola 6.

Kuchotsa kosafunikira kwa kapamba kumachitika kokha ndi necrosis yake, pakafunika kupulumutsa wodwalayo. Izi zimafuna umboni wokwanira.

Njira yokonzanso pambuyo pancreatectomy

Kukhala nditachotsa kapamba ndi ndulu, makamaka poyamba, ndizovuta. Pali kupweteka kosalekeza pamalo omwe amalepheretsa kulumikizika komanso kumva njala: kumaletsedwa kudya m'masiku ochepa, panthawi yotsatira chakudya champhamvu chimayenera kuchitika. Zitenga nthawi yayitali bwanji, adokotala azindikira.

Pofuna kupewa zovuta, njira yothandizira imachitika:

antibacterial
odana ndi yotupa
mankhwala a insulin.

Kutalika kwa nthawi yayitali, nthawi zina kwa moyo, kumayikidwa. Dzina, mlingo ndi nthawi ya makonzedwe zimayikidwa ndi adotolo, poganizira kuchuluka kwa opereshoni ndi momwe wodwalayo alili. Ngati kuwongolera kwa mutu kapena mchira wa chithokomiro kumachitidwa, ndiye kuti gawo lomwe latsala lidzatenge gawo la ntchitoyi pakapita nthawi. Ndi kuchotsedwa kwathunthu, mavuto amabwera ndi chithandizo chamankhwala komanso zakudya.

Kwa masiku 2-3, wodwalayo amasamalirabe pakapanda kugona ndi njala. Kungololedwa kumwa.
Pambuyo pa masiku atatu, mumaloledwa kukhala pansi, mtsogolomo - kudzuka pakama, kuyenda mwachidule ndi chithandizo. Kuyenda ndi kuyenda ndikofunikira kumayambiriro koyambirira kuti muchepetse kupendekeka pamimba.
Pambuyo pa masiku 8-10, mabala amachiritsa, sutting amachotsedwa, wodwala amachotsedwa kuchipatala. Kutengera ndi kuchuluka kwa minofu ya tiziwiti ndi kukula kwa opereshoni, wodwalayo atha kupita patchuthi kwa masiku ena 10 mpaka 10, atatha kugwira ntchito.

Zotsatira za opaleshoni ya pancreatic

Momwe matulukidwe pambuyo pa chitsulo amapangidwira. Imakulitsidwa ndi gawo la kapamba mu thupi la munthu - ili ndi chiwalo chokha chomwe chili ndi magulu awiri osiyana:

Chifukwa chake, pakatha nthawi yothandizira, vuto la enzyme komanso matenda osokoneza bongo amatha kukhala ndi mwayi wambiri. Izi ndi zovuta matenda omwe amabweretsa zovuta zazikulu. Zotsatira zake zimafuna:

Kutsatira zakudya zokhwima, kuphwanyidwa komwe kungapangitse kuwonongeka kwakuthwa pamkhalidwe,
ntchito kwa nthawi yayitali mankhwala: michere ndi hypoglycemic.

Kodi munthu angathe kukhala wopanda chamba?

Mankhwala amakono apeza njira yothetsera vuto la moyo popanda kapamba. Palibe chiwalo chimodzi chomwe chitha kusintha zomwe zimagwira m'thupi. Kuyambiranso kwa chithokomiro kumabweretsa chiwopsezo chachikulu muumoyo waumoyo ngati malingaliro azachipatala sanatsatidwe. Koma mutha kukhala ndi moyo wabwinobwino, chokhacho choyipa ndichakudya chokhazikika komanso kugwiritsa ntchito mankhwala osokoneza bongo kwa nthawi yayitali. Mukuyambiranso kukonzanso, mungafunike thandizo la katswiri wazama psychology yemwe angakuthandizeni kumvetsetsa kufunika kokhala ndi moyo wabwino mtsogolo.

Ndikofunika kumvetsetsa kuti munthu sangayembekezere kudzanso kwina, komwe kumakulitsa vutolo. Zomwe zidachitika kale, ndikakayikira matenda, zitsogolera mwayi wopezeka kuchipatala. Simungathe kuphonya nthawi yomwe chithandizo chingachitike popanda opaleshoni, ndikupulumutsa chiwalo chofunikira.