Mapangidwe a miyala mu kapamba

Cancreas ndi chiwalo chofunikira, kugwira ntchito kwa chiwalo chonse chimatengera chikhalidwe chake. Kuwongolera kwakukulu kwa ntchito yake ndikutukula kwa ma enzyme omwe amathandizira kutsekeka kwa malonda azakudya komanso kutengera kwawo kwathunthu.

Chifukwa cha kutupa komwe kumachitika mu kapamba kapenanso kufalikira kwa msuzi wa kapamba, miyala imakhala m'matumbo a gland kapena ma ducts ake.

Miyala mu kapamba - matenda osowa kwambiri, koma owopsa ndipo amatha kutsogolera pamavuto akulu. Mankhwala, amadziwika kuti "pancreolithiasis".

Zambiri za matenda

Mkhalidwe wam'magazi, wophatikizidwa ndi kupangidwa kwa miyala mu Wirsung duct (waukulu m'mbali mwa gland), umapweteketsa mtima kwambiri, ndikumapereka gawo lumbar.

Njirayi ikuluikulu yomwe michere imatuluka m'mimba imakhala yabwinobwino ngakhale yosalala. Chifukwa cha kutupa kosalekeza kwa kapamba, limodzi ndi kukanika, mawonekedwe ake amasintha, kupendekera kumawonekera.

Izi zimayambitsa kuchotsedwa kosakwanira kwa madzi a pancreatic ndipo, chifukwa chake, mapangidwe a miyala. Njira ya mapangidwe awo imagwirizanitsidwa ndi mawonekedwe a calcium kapena phosphate salt wa calcium. Kukhalapo kwa mankhwala a aluminium ndi magnesium mwa iwo sikumatha.

Ngozi imayimiriridwa ndi calculi omwe amapanga mwachindunji m'miyendo ya gland, ndi omwe amapanga ndulu. Kuyambira ducts za bile, miyala imagwera mumtsinje wamba ndi Wirsung duct ndipo amatha kuyiletsa. Zotsatira zake, madzi a pancreatic amayamba kukhazikitsidwa mu gland iwowo, zomwe zimayambitsa kutupa ndikuthandizira kuwonongeka kwa minofu yake.

Kuphatikiza pakupanga calculi mu ma ducts, pali mtundu wina wa matendawa - malo awo amasakanikirana mwachindunji pancreatic parenchyma. Kapangidwe kakapangidwe kamiyala, komwe kamatulutsidwa monsemo komanso mumkati mwake, sikasiyidwa.

Magawo a miyala

Odwala ambiri omwe ali ndi matenda a pancreatic ali ndi chidwi chofuna kudziwa ngati pali miyala kapena momwe amapangidwira. Tiyenera kudziwa kuti njira yopanga mawonekedwe olimba ndi yayitali.

Ndi chizolowezi kusiyanitsa magawo atatu:

Gawo loyamba, lomwe limayambitsidwa ndi kusuntha kwa michere ya pancreatic, imadziwika ndi kukula kwawo komanso kupatsa chidwi. Kamodzi mumalowo mu mawonekedwe awa, amapeza mkhalidwe wa insoluble protein. Izi zimakwiyitsa kukula kwa dambo la Wirsung.
Gawo lachiwiri limadziwika ndi kuphatikizika kwamchere wa calcium mu madzi amasintha a pancreatic kale. Izi zimathandizira kukulanso.
Pamapeto omaliza, chifukwa chophatikizidwa ndi njira yotupa ndi matenda, gawo lomaliza la miyala limapangika, zomwe zimatsogolera pancreolithiasis.

Miyala yomwe idayambapo ndi yayikulu mosiyanasiyana. Kutengera izi, chisankho chimachitika chokhudza njira yakuchotsera njira zosiyanasiyana.

Zomwe zimayambitsa komanso zinthu zina

Zomwe zimayambitsa kupanga miyala mthupi sizimamveka bwino. Ndikosatheka kuyankha funso kuti bwanji ena adachita izi, pomwe ena amadutsa.

Dziwani kuti pali zina zofunika kuchita zomwe zimawonjezera mwayi wa kapamba. Zina mwa izo ndi:

njira yotupa m'magawo am'mimba, chikhodzodzo, chiwindi (duodenitis, cholelithiasis, cholecystitis),
lembani 1 ndi matenda ashuga 2
neoplasms pamimba pamimba (chotupa), ndikupangitsa kulephera kwakutulutsa kwa ma enzymes munthawi yake,
kusagwirizana pakati pa chiŵerengero cha calcium ndi phosphorous yoyambitsidwa ndi vuto la metabolic,
kuvutika kwamafuta,
anasamutsa matenda opatsirana omwe amatha kusintha kuchuluka kwa michere ya gland,
chibadwa.

Zoopsa Pancreatic Pancreatic Zowopsa.

Zofunikira ndizofunikanso:

zokhudzana ndi zaka, anthu opitirira 50 ndi omwe amatenga matenda,
onenepa kwambiri
kusowa zolimbitsa thupi zovomerezeka.

Zotsatira zoyipa zakumwa kwa kapamba zimachitika chifukwa chogwiritsa ntchito nthawi yayitali mankhwala osokoneza bongo komanso mankhwala omwe amachepetsa cholesterol. Chakudya chokhwima chimatha kuyambitsa njira yothandizira, mothandizidwa ndi momwe iwo amayesera kuchepera thupi.

Mawonetseredwe azachipatala

Zizindikiro zoyambira kupangidwa kwamiyala mu kapamba kwenikweni sizimasiyana ndi mawonekedwe a matenda kapamba. Zomwe zikuwonetsa kwambiri ndi izi:

Zowawa zowawa, zazitali kapena zazifupi, nthawi zina zimakhala ndi colic,
kusamva bwino pansi pa dzenje makamaka mutatha kudya, kumva kupweteka m'mimba,
Zowawa zimawonedwanso m'dera lumbar komanso pansi pa masamba.
kutulutsa, chisangalalo,
kutsegula m'mimba
kuteteza khungu,
thukuta kwambiri.

Tiyenera kudziwa kuti kukula kwa mawonekedwe a zowawa kumasiyana. Kuukira kulikonse komwe kumachitika kumayendera limodzi ndi kupweteka kwambiri.

Zizindikiro

Kukumana kwakutali chifukwa cha kufalikira kwa dothi la Wirsung kumatha kupangitsa kutupa ndi matenda a kapamba.

Mukuchulukitsa voliyumu, miyala imalepheretsa kutuluka kwa pancreatic madzi, zomwe zimabweretsa kuwonjezeka kwa kupweteka, kusayenda bwino kwa chithokomiro, komanso kusokonezeka kwa njira yogaya chakudya. Zowonongeka za "mchira" wa England, kuwonjezereka kwa shuga m'magazi ndikotheka.

Kuphatikiza apo, mapangidwe amtunduwu amatha kuvulaza ziwiya zam'mimba ndipo zimayambitsa magazi, komanso kupangitsa mapangidwe a chimbudzi m'matumbo a gland.

Njira zopezera matenda

Zizindikiro za pancreolithiasis ndizovuta kusiyanitsa ndi chizindikiro cha matenda am'mimba komanso ziwalo zina zam'mimba. Chifukwa chake, kuwonjezera pa kuyang'ana wodwala ndikuwunika madandaulo ake, zochitika zotsatirazi ndizoyenera:

X-ray, yomwe imalola kuzindikira kukhalapo kwa calcinite, kudziwa kuchuluka kwawo, kukula ndi kutulutsa kwawoko,
Ultrasound pogwiritsa ntchito probe ndi sensor,
CT ndi MRI, zomwe zimathandizira kuwunika mkhalidwe wa gland palokha.

Kuyesedwa kwa magazi ndi mkodzo, ndowe za ma inclusions wamafuta ndi calculi mu mawonekedwe amchere wamchere ndizofunikira.

Njira zamankhwala

Mankhwala othandizira odana ndi kutupa pancreatolithiasis amatha kokha kumayambiriro kwa matenda komanso pamene miyala yaying'ono yapezeka.

Njira imodzi yomwe imagwiritsidwa ntchito pochiritsira ndikugwiritsa ntchito mankhwalawa ndi Henodiol ndi Ursdiol. Mankhwalawa amapezeka mu mawonekedwe a piritsi.

Amatha kuyimitsa bile ndipo amachepetsa mphamvu ya miyala. Ndi thandizo lawo, ndizotheka kupukuta ndikuchotsa miyala yocheperako komanso mtundu wa cholesterol, yomwe imalongosola kugwiritsa ntchito njirayi.

Njira zopweteka ndi zotupa zimachotsedwa ndi mankhwala omwe si a antiidalidal (NSAIDs). Analimbikitsa enzyme m'malo mankhwala, kuvomerezera kudya mavitamini ndi shuga.

Chothandiza kwambiri ndi kulandira mankhwalawa popanda kuchitidwa opaleshoni ya endoscopic retrograde cholangiopancreatography. Imachitika ndikuyambitsa kafukufuku wokhala ndi kamera mwachindunji mu ducts kapena parenchyma ya kapamba. Panthawi imeneyi, ndikotheka kuzindikira ndikuchotsa miyala.

Ngati sichinali choncho kalekale kulowererapo kokha komwe kunapangitsa kuti miyala ichotse wodwala, tsopano magwiridwe anthawi yochepa amagwiritsidwa ntchito kuti awaphwanye. Njira imakuthandizani kuti muphere miyala yayikulu ndikukhala ufa, mabwinja omwe amachotsedwa pamizere ndi madzi a pancreatic madzi.

Nthawi zina, njira yowonjezera yopopera imayenera pogwiritsa ntchito njira ya ERCP yomwe tafotokozayi.

Ngati ndizosatheka kugwiritsa ntchito njira zofatsa, opareshoni imagwira ntchito kuti ichotse mbali ya ndulu yomwe ikukhudzidwa ndi miyala. Mutha kugwiritsa ntchito shunting kuti mupange workaround yomwe imakupatsani kusintha kutulutsa kwa ma pancreatic enzymes.

Zizindikiro zakuchita opareshoni

Njira zamankhwala zimatengera kuthekera ndi kukula kwa calculi, zomwe zimachitika wodwalayo komanso matenda ophatikizana, omwe amafunikanso kuthetsedwa mwachangu. Izi ndi:

pafupipafupi kuukira
kutupa komwe kumayendera limodzi ndi kupitilira kwa ziwalo,
kutopa kwa wodwala
kuthekera kuyimitsa kuukira.

Zotsatira zoyipa zomwe zimachitika chifukwa cha opareshoni ndi kuthekera kwa matenda komanso nthawi yayitali. Chofunikira ndi kukhazikitsidwa kwa maantibayotiki, ma pinkiller ndi ma enzyme.

Pambuyo pa opaleshoni, komanso ndi chithandizo chamankhwala chokhazikika, kutsimikizika kwakukulu ndiku:

ulemu wodwala kwa wodwala,
kugwiritsa ntchito mankhwala othandizira komanso obwezeretsa,
kutsatira zakudya zochizira.

Mwa zina zofunikira za chithandizo chokhwima ndikusankhidwa kwa kuthekera kokuyambiranso ntchito yotupa, komanso kuchotsa kwa matenda omwe amachititsa mapangidwe amwala.

Thandizani mankhwala achikhalidwe

Chithandizo cha pancreolithiasis ndi wowerengeka azitsamba zimakhala ndi zovuta zosayembekezereka. Ngati mankhwala apakhomo atipangitsa kupitiriza kuwerengera kwakukulu, itha kutseka kwathunthu.

Pankhaniyi, chithandizo chamankhwala chodzidzimutsa, chotheratu pakumayendedwe osakonzekera, chidzafunika.

Maphikidwe a miyala mu kapamba:

Decoction wa chicory muzu. Cheka pang'ono muzu wa chomera chimodzi, kutsanulira kapu ya madzi otentha ndikuphika kwa mphindi 10 pa moto wochepa kwambiri. Unasi, ozizira. Imwani masana pang'ono pang'onopang'ono.
Momwemonso, decoction ya barberry bark imakonzedwa (10 g yaiwisi pa 250 ml yamadzi).
Kutolera kwa maluwa a wort a St. John, chamomile, linden, violet ndi timbewu (supuni 1 yamtundu uliwonse) kutsanulira madzi otentha (300 ml). Kuumirira theka la ora, kupsyinjika. Tengani 50 ml musanadye.

Zophikitsira zonse zapakhomo zimatha kukhala ndi zotsatira zothandizira ndipo zimayenera kugwiritsidwa ntchito kuwonjezera pa chithandizo chachikulu chomwe chafotokozedwa ndi gastroenterologist. Kugwiritsa ntchito kwawo kuyenera kuvomerezedwa ndi adokotala.

Mankhwala othandizira

Kutsatira malangizo a katswiri pazakufunika kotsatira zakudya ndikofunikira. Kudya moyenera kumathandizira kuti achire azitha. Zimalingaliridwa:

chakudya chamagulu
kutsatira lamulo lamadzi,
kugwiritsa ntchito chakudya chothira kapena chophika,
kupatula mafuta onenepa, okazinga, okometsera,
kukana marinades, kusuta nyama, zamzitini chakudya.

Zokonda ziyenera kuperekedwa kwa zakudya zamkaka, oatmeal ndi phala la buckwheat, nyama ya nkhuku.

Pancreolithiasis ndi matenda oopsa, ndi owopsa kuyambitsa. Chithandizo choyambitsidwa panthawi yake chimakhala chitsimikiziro cha kulosera kwabwino.

Kupatula kuthekera kwa kubwereza njira, ndikofunikira kutsatira malangizo a adokotala pokhudzana ndi zakudya zoyenera komanso kupewa mayeso.

Limagwirira, zimayambitsa chitukuko cha matenda

Njira yopangira miyala mu kapamba ndizovuta. Kuti mutsegule, muyenera kuphatikiza pazinthu zingapo zosangalatsa. Njira yamapangidwe amiyala imakhazikitsidwa ndi kusasunthika kwa pancreatic secretion, yomwe imakhuthala momwe imadziunjikira. Kuphatikizika kwa mankhwala achinsinsi, kusintha kumachitika ndi mchere wamchere. Kenako, mapangidwe a protein amapangidwa, momwe amawerengera akuyamba kupanga pang'onopang'ono. Miyala yomwe idapangidwapo imayika kukakamiza kwa ma ducts ndi parinhema, zomwe zimapangitsa kusintha kwachilendo.

Zomwe zimayambitsa pancreolithiasis sizimamveka bwino. Koma pali kuphatikiza kwa zinthu zomwe zimapangitsa mwayi wazachipembedzo:

matenda otupa m'matumbo am'mimba (kapamba, duodenitis, cholestitis),
Kuchepa kwa zikondamoyo chifukwa cha chotupa kapena chotupa,
zakubadwa - anthu opitilira zaka 40 atenga kachiromboka,
Kulephera kwa kagayidwe kazakudya (kuperewera kwa calcium, phosphorous),
matenda opatsirana amatenda a syphilis,
kusowa kwa masewera olimbitsa thupi
kunenepa
moyo woyenera - Kusuta, kumwa pafupipafupi, Zakudya zosagwirizana,
kusokonezeka kwa mahomoni.

Chithunzi cha kuchipatala

Kukula kwa zizindikiro kumadalira gawo la kukula ndi miyala yodziwikiratu - imatha kukhala m'mizere kapena pang'onopang'ono. M'nthawi zonsezi, chizindikiro chachikulu cha mapangidwe a miyala ndi ululu. Ululu wokhala ndi pancreolithiasis ukhoza kukhala kwa mphindi zingapo mpaka maola angapo. Ndi chikhalidwe cha zowawa, zoyaka, mwanjira ya colic, zimaphimba m'mimba ndikutsikira kumbuyo, zimaperekedwa kwa scapula. Mitsempha imatha kukhala tsiku lililonse kapena kuchitika kangapo, kangapo pamwezi, kapena ngakhale chaka.

Zizindikiro zina zopanga miyala:

kuwonjezeka kwa ululu pakudya komanso pakukamwa,
kusanza ndi mseru wa ndulu,
kuyatsa kwa ndowe ndi kupezeka kwa mafuta osasinthika mwa iwo (steatorrhea - mafuta mafuta),
profayid
m'mimba mukuwoneka kuti mulibe
ambiri malaise, thukuta.

Ndi nthawi yayitali ya pancreolithiasis motsutsana ndi maziko a kuchepa kwa ntchito zachinsinsi za kapamba, kupanga kwa insulin kumachepa. Pamodzi ndi zizindikiro wamba, zizindikiro za matenda a shuga zimawonekera - khungu lowuma, ludzu losasinthika, polyuria, kununkhira kwa acetone kuchokera mkamwa. Kusunthidwa kwa mwala kuchokera ku zikondamoyo kupita ku duct ya bile kumapangitsa kukula kwa jaundice.

Mavuto a pancreolithiasis ndi owopsa. Ngati mwalawo umachotsa kukoka kwa nthawi yayitali, chifuwa champhamvu chimayamba ndi matenda a tiziwalo timene timatulutsa. Nthawi zambiri motsutsana ndi maziko amiyala, zotupa za purulent ndi cysts zimachitika. Pamaso pa miyala ikuluikulu, pamakhala chiwopsezo chachikulu cha kukha mwazi mu duct kapena parinhema wa gland, kenako ndikufa kwa minofu.

Njira Zowunikira

Kuzindikira kwa pancreolithiasis sikovuta - njira zamakono zoyesera zimatha kudziwa miyala yaying'ono kwambiri. Zokonda zimaperekedwa ku njira zothandiza. Kuyesedwa kwa magazi kokwanira kumasonyezedwa kuti kuzindikira momwe zinthu zilili komanso kupezeka kwa njira zotupa.

Kuwona miyala yamanyazi yomwe ikukayikiridwa ndi monga:

onani mbiri ya pamimba pamimba, pomwe miyala imawonetsedwa ngati mithunzi imodzi kapena yambiri yozungulira kapena mawonekedwe ozungulira,
ultrasonography kuti ayese mkhalidwe wa kutulutsa, kutengera kwa miyala ndendende,
MRI ndi CT scan ya kapamba,
bweretsani cholangiopancreatography kuyesa kutsekeka kwa duct.

Chithandizo cha odwala ndi pancreolithiasis chikuchitika ndi gastroenterologist. Malingaliro a njira zochizira amadalira kuchuluka kwa miyala, kapangidwe kake ndi kukula kwake. Mosasamala kanthu za zovuta za matendawo, mankhwalawa amayamba ndi njira zowonjezera - kuchotsa kutupa, mpumulo wa chotupa ndi ma ducts, ndikukhazikitsa njira za metabolic. Ma Enzymes amaperekedwa kwa odwala (pancreatin), mlingo wa tsiku ndi tsiku amasankhidwa ndi adokotala. Ndi kugwiritsa ntchito bwino kwa chithandizo chamankhwala mosasamala, mutha kuchita popanda opaleshoni - miyala yaying'ono imawonongedwa ndikutulutsa kansalu ndi mapindikidwe.

Pamaso pa miyala yambiri yama volumetric komanso kugwiritsa ntchito mankhwala osagwiritsa ntchito bwino, opaleshoni imasonyezedwa.Zizindikiro zowonjezera zochitira opaleshoni ndi:

Kutalika kwa nthendayi kumachitika pafupipafupi,
kulephera kwapang'onopang'ono,
kupweteka kosaletseka,
yotupa yotakata
kuwonongeka kwakuthwa mu mkhalidwe wa wodwalayo, kukula kwa dystrophy.

Pochita opaleshoni yamakono, pochotsa miyala, amakonda kutengera:

Kuchotsa kwa endoscopic kwa zida zam'magazi pogwiritsa ntchito endoscope yopyapendekera,
laparotomy - kuchotsedwa kwa calculi kudzera pang'ono kukayikika pamimba khoma kapena m'chigawo chodzala,
pancreatotomy - kugawa kwa chitsekerero chotsekeka ndi miyala.
opaleshoni yodutsa - kupangidwa kwa njira yopanga kutulutsa katulutsidwe kazimbudzi ndi bile,
pancreatectomy yathunthu - kutha kwa kapamba komanso gawo loyandikira la duodenum, njirayi imagwiritsidwa ntchito pakuwunika kwakukulu kwa minyewa.

M'mayambiriro oyamba a matendawa, amayesa kugwiritsa ntchito njira zosagwiritsa ntchito opaleshoni pogwiritsa ntchito miyala yopondera komanso kusunthira kwa ufa m'njira yachilengedwe kudzera m'matumbo. Njira zamankhwala izi zikuphatikiza:

kutali mantha wave lithotripsy - njira yozika miyala ndikumata ndi mafunde amtundu wambiri, njirayi imapweteka ndipo imafuna opaleshoni yambiri, pambuyo pake hematomas ikhoza kukhalabe pamimba.
retrograde cholangiopancreatography - kuphwanya kumachitika pogwiritsa ntchito mtundu wokhazikika wowonda, zotsalira za calculi zimachotsedwa posunthira kwachilengedwe kapena kutulutsidwa mwachindunji ndi endoscope.

Mphamvu yamphamvu

Pambuyo pochotsa miyala, ndikofunikira kuti odwala azitsatira zakudya. Chakudyacho ncholinga chofuna kuteteza kapamba komanso kupewa kuchulukana. Malangizo Azakudya Zopatsa Thanzi:

kudya kwambiri ndikosavomerezeka, chakudya chochuluka chimayambitsa kuchuluka kwambiri pakhungu komanso kusangalatsa kwobisika,
Kukana mowa kwathunthu - mowa mwa kuchuluka kulikonse kumayambitsa kutupira ndipo kumatha kuyambitsa kuphatikizana kwa parinhema,
kutsatira mfundo za kuphatikiza zakudya - kudya mapuloteni ndi zakudya zamagulu ena payokha zimathandizira kuyambitsa kukondoweza kwake,
kutsatira mfundo zazikulu za chakudya chopatsa thanzi - kukana zakumwa zamafuta ndi shuga, zakumwa zoziziritsa kukhosi ndi khofi, pamaziko a zakudya za odwala pancreatic ndi masamba ophika, chimanga, sopo wopepuka, nyama yopanda mafuta.

Zotsogola ndi njira zopewera

Kukula kwa pancreolithiasis kumadalira kuopsa kwa matenda ndi kupezeka kwa zovuta za concomitant pathologies. Kwenikweni, ndikuchotsa miyala munthawi yake ndikuika mankhwala ena m'malo mwake, matendawa ndi abwino. Mu 80-85% ya milandu yothandizira opaleshoni, ndizotheka kukwaniritsa kusintha kwazomwe zikuchitika. Pangokhala 2% yokha ya milandu atachitidwa opaleshoni ndiyomwe imapangitsa kuti aphedwe.

Palibe njira zenizeni zotetezera kukula kwa matendawa. Ndikotheka kuchepetsa chiwopsezo cha kupangika kwa miyala mu kapamba potsatira kudya zakudya zosiyidwa, kusiya kusuta fodya komanso mowa. Anthu omwe ali ndi cholowa cham'matenda am'mimba amayenera kufunsa dokotala munthawi yake kuti adziwe zina zam'mimba, duodenum, chiwindi, kapamba.

Kupeza miyala ya pancreatic kumafunika kuyankha mwachangu. Ngati matendawa sanalandiridwe, pamakhala chiopsezo chotupa chotupa mu ziphuphu. Kuchita opaleshoni kumatha kuthetseratu matenda munthawi yochepa. Komabe, miyala ikachotsedwa, ndikofunikira kutsatira upangiri wa zamankhwala ndikukhala ndi moyo wathanzi - chifukwa chake chiwopsezo chobwereranso kumakhala chochepa.