Mavuto a kapamba: aakulu, pachimake ndi purulent

Oyambirira mavuto a pachimake kapamba (magazi, abscess, popergone phlegmon, fistulas, cysts, psychosis, mediastinitis): mankhwala, mankhwala.

Acute pancreatitis ndi matenda otengera njira yotupa ya necrotic yoyambitsidwa ndi machitidwe a autolytic. Pancreatitis Patan а / Pancreas edema - kutupa, kuchuluka, kukula, ntchofu m'mizere, edematous interstitial minofu, hyperemia, kuchepa kwa acini. b / Hemorrhagic pancreatitis - zonse zomwe zimapangitsa kuti magazi akhale ndi mitsempha yotupa + m'mitsempha + necrosis yamisempha yokhala ndi gawo mkati mwa hemorrhage zone, cell imalowa m'malire a hemorrhages. c / purcin pancreatitis - neutrophils, kenako kukundika, m. kunyowa. g / Necrotic pancreatitis - kusintha kwa necrotic konsekonse kapena mbali yake.

Zosintha mu chifuwa chachikulu - kutupa, kulumikizika kwa minyewa, kufa kwa maselo a parenchymal, endarteritis, kuchepa ndi kuwonongeka kwa lumen kwa ma ducts, mapangidwe a cyst, strating. Gulu: Zotsatira zamankhwala: pachimake (edema, hemorrhagic, pancreatic necrosis, purulent), matenda obwerezabwereza, osapezekanso, kupweteka, pseudotumorosis), cholecystic pancreatitis (pachimake, kuyambiranso, kusabwezeranso). Itha kuchitika ndi predominance ya cholecystitis, kapamba. Etiology: Matenda, kuwonongeka, zoopsa, matenda am'mimba, matenda am'mimba ndi duodenum, chakudya chama nyama, kudya kwambiri, uchidakwa, mahomoni. Zokhudzana: zaka, jenda, kusintha kwamasamba, chidzalo, chifuwa, kusanza mobwerezabwereza. Pathogenesis: 1.Maganizo opatsirana (magazi, lymph, ndi zina). 2. Mavuto owopsa a kapamba 30-50% yowononga kapamba. Chitsulo chimatetezedwa ndi minofu yolumikizana -> calcification -> XP. kapamba

Mochedwa mavuto a pachimake kapamba (chifuwa chachikulu, chifuwa, fistulas, matenda a shuga, kuchepera kwa duodenum 12).

CHRIS. PANCREATITIS: nthenda yozikika minyewa ya m'mimba, yotsirizika yomwe imayambitsa matenda a parenchyma ndi kutayika kwa chinsinsi cha amkati ndi amkati. Pancreatitis pachimake ndi njira yowonongeka. Mavuto oyamba a kapamba kapamba: 1. Kutulutsa magazi. 2. Kubwezeretsa phlegmon. 3. Fistulas (kunja, mkati). 4. Cysts (zoona - chipolopolo chake chomwe, makoma amkati amakhala ndi epithelium. Zabodza - palibe chipolopolo, chomwe chimangokhala ndi ziwalo zapafupi). 5. Chilonda 6. Mediastenitis. 7. Psychosis. Mavuto apambuyo pancreatitis pachimake: 1.X. kapamba 2. Cysts (nthawi zambiri zimakhala zowona) 3. Miyala (kawirikawiri, koma imapezeka) 4. Shuga mellitus 5. Kuchepetsa 12per. ma guts. Matenda azachipatala a kapamba aakulu (malinga ndi maphunziro) 1. Opanda ululu (latent), 2. Ululu. 3. Zomwe zimachitika. 4. Pseudotumor kapena jaundice. 5. Cholecystopancreatitis. ETHOLOGY kapamba: 1. Kusintha kwa pachimake mpaka kwamphamvu; ndipo w. chikhodzodzo, 3. Matenda a chiwindi (hepatitis F, cirrhosis) 4. Matenda am'mimba ndi 12 p. CLINIC kapamba: 1. Kukhalapo m'mbuyomu kuukira kwa kapamba kapamba. 2. Kupezeka kwa matenda zh.p. zh.bubble, m'mimba, 12 p.p. ndi mawonekedwe a kupweteka m'chiuno. 3. Mukupweteka kapena kupweteka kuwonongeka kapena kupweteka kwambiri mu epigastrium, kwambiri kumanzere. 4. Kuchulukitsa kwa kupweteka kwa sternum, kumanja kapena kumanzere kolala, mammary gland. 5. Ululu pakhungu la kapamba. 6. Kupweteka pakona yakumanzere kwa nthiti (chizindikiro cha Mayo-Robson). 7.Frenicus ndi chizindikiro.8. Kuphatikizidwa kwa zizindikiro za kapamba ndi kuphwanya kagayidwe kazakudya. 9. Matenda a kukomoka (mseru, masokono, kugona). 10. Kuchepetsa thupi, ulesi, asthenia. 11. Zizolowezi kumatenda owopsa. Njira zapadera zakufufuzira: 1. Echolocation. 2.Computerogram. MALO A CHR. Pancreatitis 1. Conservative: a) perirenal novocaine blockade, b) polyglucin, reopoliglyukin, antienzymes, novocaine, plasma, magazi, AK, c) mapuloteni zakudya (N 5), d) atomin 1t katatu pa tsiku kwa masiku 7-10, nerobol 1t 2 pa tsiku tsiku 15 masiku, retabolil 1t 2 kawiri pa sabata, e) pancreatin, methionine, lipolcain, festal, e) analgesia: papaverine, no-spa antispasmodic myotropic kanthu, baralgin, promedol, g) kupaka kwa njira ya saline ndi mavitamini: h) mankhwala a X-ray (UHF) Chithandizo cha madera ozungulira dzuwa, ndi mankhwala a spa (Zheleznovodsk, Esntuki, Truskavets). - Kulephera kwa mankhwala okhwima (pambuyo pa miyezi ingapo), - cysts ya kapamba, fistula (kunja), zopinga (makina) jaundice, - miyala ya panciras. Gulu la opaleshoni: A. Opaleshoni ya pakhungu: kapangidwe kudula kuchokera kumapeto, kukhazikikanso kuyambira pakati. - Pancreato-duodenal resection, - Pancreatectomy, - Cervical anastomosis, - Pancreato-intestinal anastomosis, int. ndi nar. pancreatic cyst, -Marsulinization - ngalande zakunja ndi cyst yabodza, B. Kugwira ntchito pa biliary system: - cholecystectomy, - biodigestive anastomosis, - zotheka kuwonekera kwa njanji, - opaleshoni pamimba ndi 12p. matumbo, - gastroenteroanastomosis, - resection pamimba, - duodenojejunoanastomosis. B. Kugwira ntchito pa NS yachilengedwe: - resection of solar plexus; - m'mbuyo neurotomy, etc. G. Kudzazidwa ndi Fistula.

Matenda a kapamba: tanthauzo la lingaliro, chifukwa.

Matendawa ndi zotsatira za kapamba kapamba kapenanso kuyambira pamenepo

kumayambika kumayamba pang'onopang'ono, kumatenga nthawi yayitali.

Etiology: zomwe zimayambitsa matenda kapamba ndi matenda am'mimba,

duodenum, chiwindi, chikhodzodzo ndi dongosolo la biliary, i.e.

ziwalo zogwirizana ndi anatomical komanso magwiridwe antchito ndi kapamba

matenda okhudzana ndi zakudya komanso kusintha kwa mafuta kagayidwe (ochimwa pazakudya,

uchidakwa), matenda owopsa komanso osachiritsika, kuledzera, poyizoni, amasintha

mu duct dongosolo la kapamba (chachikulu chotupa, strictures,

excretory duct epithelium metaplasia), chatsekedwa chovulala chamapazi.

Pathogenesis: pancreatitis yosatha imafanana kwambiri ndi pathogenesis ya pachimake

kapamba. Kubwezeranso matendawa kumayambitsa kutenga zonse zatsopano

madipatimenti a kapamba, omwe nthawi yayitali amayambitsa ntchito

parenchyma yamisempha yodziwika bwino imabweretsa kusintha kwa sclerotic

ductal system ya gland komanso mu paravasal minofu.

Pathological anatomy: kuchuluka kumachitika mu minofu ya pancreatic

minofu yolumikizika, yopangitsa fibrosis ndi sclerosis. Pomaliza

itha kukhala yokhala- kapena yodziwika bwino, yophatikizidwa ndi munthawi yomweyo atrophy

minofu ya glandular. Zotsatira zakukula kwamatenda achitsulo

zophatikizika komanso nthawi zambiri zimasintha mawu. Microscopically munthawi yomweyo

minofu fibrosis, kulowa kwake, lipomatosis,

zosintha zotupa m'makoma a ma ducts. Nthawi zina zingapo

ma cysts ang'onoang'ono opangidwa chifukwa chakutha kwa lumen ya ma ducts, madipoziti

mchere wamkati mu minyewa ya m'mimba (kuchulukitsa pancreatitis).

Mitundu yotsatira yamatenda aumwini ndi kapangidwe ka matenda kapamba amodzi: 1)

aakulu insulin kapamba, 2) kapamba wa pseudotumor, 3)

pseudocystic pancreatitis (pancreatitis yayitali yokhala ndi chotupa), 4)

aakulu kuwerengetsa kapamba (virgolithiasis, calcifying

Zochitika za chifuwa chachikulu chodwala matenda ake (osapweteka, opweteka, achibwereza, atrophic, pseudotumorous, cholecystopancreatitis).

K-k, q-k wa chifuwa chachikulu.

Chipatala ndi matenda: Zizindikiro zazikulu za ululu, matenda a dyspeptic,

jaundice, kuchepa thupi, kupweteka m'dera la epigastric ndipo nthawi zambiri kumawonjezeka

kapamba wopezeka palpation.

Zowawa zimatha kukhala zowawa kapena kuzimiririka komanso kutchukitsa dera la epigastric,

hypochondria lamanja ndi lamanzere, nthawi zambiri limakhala ngati lamba

mmbuyo, m'chigawo cha interscapular, hypochondrium yoyenera. Ululu umatha

kapena paroxysmal. Zowawa zowawa zimatha kuchokera maola angapo mpaka masiku a 4-6.

Nthawi zambiri zimayambitsa zolakwika mu zakudya.

Matenda a dyspeptic - nseru, kusanza, malovu, chopondapo chosakhazikika

(kugwirizanitsa kudzimbidwa ndi matenda otsekula m'mimba) - amakhala nthawi zonse, kapena munthawi imeneyi

Jaundice, khungu loyimba ndi sclera zimawonedwa theka la odwala. Amatha

khazikani zonse ndi kukhala kwanthawi zonse. Mkulu jaundice mkati

odwala ambiri ophatikizidwa ndi acholia, ndi chifukwa cha kutupa m'mutu

kapamba, psinjika wa ndulu ya duct chifukwa chotupa

kusintha mu gland, zachilengedwe komanso zotupa kusintha mu ma ducts ndi sphincter

Oddi, miyala pamwambapa a papilla wamkulu wa duodenal.

Kuchepetsa thupi nthawi zina kumafika madigiri akuthwa. Zomwe zimayambitsa kutopa ndi izi:

kupanga osakwanira komanso kupezeka kwa ma pancreatic enzymes mkati

duodenum, zovuta posankha chakudya, kuwopa odwala kuti atenge

chakudya chifukwa cha ululu. Mwa odwala ambiri, kuvutikira kumachitika ngakhale mutatenga

chakudya chochepa chamadzimadzi chomwe chilibe katundu wa sokogonnymi.

Kuunika koyenera panthawi yomwe mukuwonjezeka nthawi zambiri kumavumbula zizindikiro,

Khalidwe la pancreatitis pachimake. Munthawi yopatsirana, nthawi zambiri zimadziwika

zilonda zowoneka bwino pancreas. Odwala oonda, nthawi zina

mutha kubowoleza kapamba wokulirapo ndi wandiweyani.

Wodwala amayenera kuwunikidwa pamalo apamwamba ndi wodzigudubuza woyikidwa pansi kumbuyo

malo kudzanja lamanja ndi torso yopendekera panja ndi 45 °, kuyimirira ndi wowindayo

torso patsogolo - kumanzere. Ndi mafinya a pseudotumor omwe amachitika ndi jaundice,

Courvoisier syndrome nthawi zina imapezeka, imadziwika ndi mitundu itatu yazizindikiro:

chotupa chotupa, champhamvu komanso chosapweteka bile, chikhodzodzo, acholia.

Kuzindikira kwa pancreatitis yokhazikika kumakhazikitsidwa ndi subjential komanso

Zolinga zamankhwala matenda, deta kuchokera mayeso labotale ndipo

Zotsatira za njira zapadera zofufuzira. Ndi zochulukitsa za njirayo

kapamba ndi kuvuta mu kutuluka kwa kapamba wamadzi mu magazi ndi mkodzo

Nthawi zambiri kumawonjezera zomwe zimakhala ndi michere ya pancreatic - diastases, trypsin,

lipases. Munthawi yovomerezeka, ndizabwinobwino. Kulimbikitsidwa kwa zonse zazikulu

michere ya zotupa m'malo mwake, m'malo mwake, yafupika,

aliyense payekha, palibe.

Kufufuza kwa Coprological kumawonetsa kukhalapo kwa ambiri

ulusi wamisempha wosakhazikika (creatorrhea) ndi dontho lamafuta osaloleka

Pokhudzana ndi kutenga nawo gawo pakapangidwe ka zida za islet, gland imawonedwa

hyperglycemia ndi kusintha mu yokhazikika shuga pamapindikira motsogozedwa ndi pawiri

Ndi panoramic fluoroscopy yam'mimba, zowerengeka nthawi zina zimatsimikiziridwa ndi

njira ya kapamba. Ndi kuyeserera kwa x-ray

duodenum zikhalidwe zake hypotension ("wolumala")

duodenography) imatha kudziwa zosadziwika za matenda kapamba:

kuzungulira kwazungulira ("kavalo") wa duodenum, kutanthauza kapena chilema

Dzazani gawo lamkati mwa gawo lake, ndikusintha kupendekera kwamizere

nembanemba mucous m'dera la duodenal papilla ndi mapindikidwe

Ultrasound ndi complication tomography imalola kupweteka

kapamba kuti muwone kuchuluka kwa kutulutsa kwathunthu kapena mutu wake wokha

(pseudotumor pancreatitis), ma cystic amasintha mu makulidwe a gland. Ambiri

milandu kachulukidwe kokhala kumanja ndi kumanzere kwa

msana pamlingo wachiwiri - III ya lumbar vertebrae, kutengera kukhalapo kwa

lumen ya duct miyala kapena calcinates mu makulidwe a parenchyma a gland.

Kujambula kwa wailesi ya radioisotope kumawulula: kuchepa kwatsika

chifukwa cha kupatula kwa sclerotic, zolakwika pakukula kwa isotope, yomwe

ikuwonetsa kusintha kwawo kwa ma cystic kapena kuwongolera kwa parenchyma

Retrograde pancreatography imatha kuwona zizindikiro

aakulu kapamba: kuwonongeka kwa ma ducts apakati kapena owonjezera, kuchepa

mipata yawo, zodzaza zolakwika pamiyeso chifukwa cha kukhalapo kwa miyala.

Kufufuza kwa angiographic (celiac ndi mesentericography) m'mayambiriro oyambirira

aakulu kapamba limawonetsa malo a hypervascularization, ndipo pambuyo pake

magawo chifukwa cha michere yofala

pateni, kusintha kwa zomangamanga, kusamutsa kapena kusamutsa mitsempha yamagazi nthawi

kupanga mapesi a England.

Kusiyanitsa kwamatumbo apakhungu (zilonda zam'mimba ndi 12PC, khansa ya m'mimba, khansa ya kapamba, gastritis yosatha, matenda a cholecystitis, hepatitis.

olimba, ozungulira m'derali. epigastrium ndi irradiation mapewa, masamba amapewa, kutsikira kumbuyo

Amayamba chifukwa chodwala pantchito ya insulin. chikasu

ma gallstones njira, calcification khoma la chotupa, maina a nyamakazi. chikasu

dysproteinemia, hyponatremia, kuchuluka trypsin, kuchuluka yogwira matamandidwe ndi kufalikira

kuyaka, nthawi zambiri pamimba yopanda kanthu kapena usiku ku dera.epigastria nyengo yake ndi yachilengedwe

ngati chilipo, sichikugwirizana ndi matendawa

mukasiyanitsa: zilonda niche, zikolo zimatembenukira kumunsi kwa zilondazo

palibe kusintha kwakukulu

kupweteka kwa kampeni ya koloni, yomwe ndi spasmodic

Poyerekeza: kufinya kwa lumen ya m'matumbo, kusakhalapo kwa gustum, depot ya barium pamalo a zilonda

kuchepa kwa magazi, matenda osagwirizana ndi magazi

cramping., yodziwika mu hypochondrium yamanja, ikuwonekera kudzanja lamanja ndi phewa

miyala m'matumbo am'mimba komanso mu ma ducts a bile

kuwonjezeka kungawonedwe: bi-lirubin, ESR, alkaline phosphatase aminotransferases

Zochizira zochizira matenda kapamba ndi zovuta.

a) perirenal novocaine blockade, b) polyglucin, reopoliglukin, antiferment, novocaine, plasma, magazi, AK, c) mapuloteni zakudya (N 5), d) atomin 1t katatu pa tsiku kwa masiku 7, nerobol 1t 2 pa tsiku kwa masiku 15, retabolil 1t 2 kawiri pa sabata, e) pancreatin, methionine, lipolcain, festal, e) analgesia: papaverine, no-spa antispasmodic myotropic kanthu, baralgin, promedol, g) Kuthira kwa yankho la saline ndi mavitamini: h) radiotherapy (chithandizo cha UHF kuderalo) plexus, ndi chithandizo cha spa (Zheleznovodsk, Esntuki, Truskavets). t kuchokera ku zakudya zapadera zomwe sizipatula

yokazinga, zokometsera, mchere, zakudya zamafuta, mbale za sokogonnye. Komabe, kadyedwe

Ikhale yokhala ndi ma calorie ambiri komanso yokwanira kugaya chakudya mosavuta

mapuloteni. Zakudya za tsiku ndi tsiku ziyenera kukhala 150 g mapuloteni, 30-40 g wamafuta, 350-400 g

Pankhani ya vuto la kuperewera kwa zakudya m'thupi, ndikofunikira kuwonjezera zakudya zamagulu

parenteral, kugwiritsa ntchito mozama amino acid njira izi

shuga njira. Pofuna kukonza chimbudzi, odwala amalimbikitsidwa kutenga

kukonzekera kokhala ndi michere ya pancreatic (pancreatin, chikondwerero,

panzinorm). Nthawi ndi nthawi chitani mankhwala antispasmodics, alkalizing

madzi amchere ngati borzh.

Kukula kulikonse kwa matenda a kapamba amayenera kuonedwa ngati kuukira.

pachimake kapamba. Chithandizo pa exacerbation ziyenera kuchitika molingana

mfundo zochizira pancreatitis pachimake.

Zisonyezero zochizira matenda a kapamba ndi zovuta zake.

2. Ntchito: Zizindikiro: - Kulephera kwamankhwala osakhwima (pambuyo pa miyezi ingapo), - mapapo a kapamba, fistula (kunja), zopinga (zamakina) jaundice, - pseudotumor pancreatitis, - ma cell pancreas. Gulu la opaleshoni: A. Opaleshoni ya pakhungu: kapangidwe kudula kuchokera kumapeto, kukhazikikanso kuyambira pakati. - Pancreato-duodenal resection, - Pancreatectomy, - Cervical anastomosis, - Pancreato-intestinal anastomosis, int. ndi nar. pancreatic cyst, -Marsulinization - ngalande zakunja ndi cyst yabodza, B. Kugwira ntchito pa biliary system: - cholecystectomy, - biodigestive anastomosis, - zotheka kuwonekera kwa njanji, - opaleshoni pamimba ndi 12p. matumbo, - gastroenteroanastomosis, - resection pamimba, - duodenojejunoanastomosis. B. Kugwira ntchito pa NS yachilengedwe: - resection of solar plexus; - m'mbuyo neurotomy, etc. G. Kudzazidwa ndi Fistula.

Matenda a kapamba amapezeka pafupipafupi motsutsana ndi matenda a ziwalo zoyandikana

(aakulu kuwerengetsa cholecystitis, zilonda zam'mimba kapena

duodenum), motero, opaleshoni chithandizo cha matenda

bwino njira ya chifuwa chachikulu. Popeza palibe matenda ochokera

bile duct, m'mimba, ndi duodenum zingachitike

funso loti alowererepo mwachindunji pa kapamba. Zizindikiro za

machitidwe mu nkhaniyi adzakhala: kukhalapo kwa miyala mumiyala ya England, cicatricial

mawonekedwe a ma ducts, mitundu yayikulu ya kupweteka kwa kapamba. Cholinga chachikulu

Mankhwala opangira opaleshoni - kupanga zinthu zoyenera kutuluka

pancreatic madzi m'mimba thirakiti.

Pakupanga opaleshoni, kufufuza mozama zamkati ndikofunikira

kapamba, kachulukidwe ka biliary ndi duodenum. Ndi izi

Cholinga chimachitika ndi intraoperative cholegraphy, kuphunzira kwa ndulu. Mu

mu opaleshoni, kubweza pancreatography kumagwiritsidwa ntchito ndi kufunafuna

dutsani kuphukira ndi piilla wa duodenal kapena kubooleza - mwa kupyoza kudzera minofu

tiziwopsezo tating'onoting'ono ta gawo lake lakutali.

Ndi zigawo zazitali za gawo lomaliza la pancreatic duct

transduodenal papillosphincterotomy ndi transpapillary akuwonetsedwa

kukhetsa kwa pancreatic duct kapena virsungoplasty. M'malo mwa

kukhalapo kwa zigawo zazitali za pancreatic duct ntchito

chosatheka, ntchito yoyenera kwambiri ya anastomosis pakati pa omwe atulutsidwa

kutalika kudutsa makulidwe a gland ndi pancreatic duct ndipo matalala adazungulira mbali ya Ru

Mukachepetsa gawo lalikulu la duct m'dera la mutu ndi thupi la gland

Ndikofunika kuti mupange gawo laling'onolo la gland ndikusoka khungu

m'matumbo kulumikizidwa ndi Ru. Cholinga cha opaleshoni yotere ndikupanga zinthu zoti zitheke

madzi a pancreatic panjira yobwereza.

Mu nthawi pomwe ntchito parenchyma ya ambiri England England

Metological process yafa mosasinthika, munkati mwa mimbulu yomwe ilipo

amasintha kusintha kwa sclerotic, ndi zizindikiro zazikuluzikulu za chifuwa chachikulu

wotchulidwa komanso osagwirizana ndi njira zosasinthira zamankhwala, perekani

resection kapamba (mchira ndi thupi, subtotal pancreatectomy).

Mitundu ya machitidwe a chifuwa chachikulu.

Matenda a kapamba amapezeka pafupipafupi motsutsana ndi matenda a ziwalo zoyandikana

(aakulu kuwerengetsa cholecystitis, zilonda zam'mimba kapena

duodenum), motero, opaleshoni chithandizo cha matenda

bwino njira ya chifuwa chachikulu.Popeza palibe matenda ochokera

bile duct, m'mimba, ndi duodenum zingachitike

funso loti alowererepo mwachindunji pa kapamba. Zizindikiro za

machitidwe mu nkhaniyi adzakhala: kukhalapo kwa miyala mumiyala ya England, cicatricial

mawonekedwe a ma ducts, mitundu yayikulu ya kupweteka kwa kapamba. Cholinga chachikulu

Mankhwala opangira opaleshoni - kupanga zinthu zoyenera kutuluka

pancreatic madzi m'mimba thirakiti.

Pakupanga opaleshoni, kufufuza mozama zamkati ndikofunikira

kapamba, kachulukidwe ka biliary ndi duodenum. Ndi izi

Cholinga chimachitika ndi intraoperative cholegraphy, kuphunzira kwa ndulu. Mu

mu opaleshoni, kubweza pancreatography kumagwiritsidwa ntchito ndi kufunafuna

dutsani kuphukira ndi piilla wa duodenal kapena kubooleza - mwa kupyoza kudzera minofu

tiziwopsezo tating'onoting'ono ta gawo lake lakutali.

Ndi zigawo zazitali za gawo lomaliza la pancreatic duct

transduodenal papillosphincterotomy ndi transpapillary akuwonetsedwa

kukhetsa kwa pancreatic duct kapena virsungoplasty. M'malo mwa

kukhalapo kwa zigawo zazitali za pancreatic duct ntchito

chosatheka, ntchito yoyenera kwambiri ya anastomosis pakati pa omwe atulutsidwa

kutalika kudutsa makulidwe a gland ndi pancreatic duct ndipo matalala adazungulira mbali ya Ru

Mukachepetsa gawo lalikulu la duct m'dera la mutu ndi thupi la gland

Ndikofunika kuti mupange gawo laling'onolo la gland ndikusoka khungu

m'matumbo kulumikizidwa ndi Ru. Cholinga cha opaleshoni yotere ndikupanga zinthu zoti zitheke

madzi a pancreatic panjira yobwereza.

Mu nthawi pomwe ntchito parenchyma ya ambiri England England

Metological process yafa mosasinthika, munkati mwa mimbulu yomwe ilipo

amasintha kusintha kwa sclerotic, ndi zizindikiro zazikuluzikulu za chifuwa chachikulu

wotchulidwa komanso osagwirizana ndi njira zosasinthira zamankhwala, perekani

resection kapamba (mchira ndi thupi, subtotal pancreatectomy).

Insuloma: k-ka, q-ka, chithandizo.

Pancreatic benign chotupa chimaphatikizaponso zotupa,

akubwera kuchokera m'maselo a pancreatic islet. Ena a iwo

olimbitsa thupi, monga beta-cell adenomas (insulomas) ndi

ulcerogenic adenomas (gastrinomas).

Beta-cell adenomas (insulomas) amatulutsa insulin yambiri ndipo

mowonekera ndi hypoglycemia syndrome. Zizindikiro zofala kwambiri ndi

Izi zimachitika: thukuta kwambiri, kunjenjemera, kufooka kwambiri,

kutayika kwakanthawi.

Hyperinsulinism chifukwa cha insuloma imadziwika ndi mitundu itatu yazizindikiro: 1)

kupezeka kwa kuopsa kwa hypoglycemia mpaka kukomoka kumbuyo kwa njala

kapena zolimbitsa thupi, 2) kuchepa kwambiri kwa shuga m'magazi (m'munsi mwa 0,5 g / l, kapena 50)

mg%), 3) kusowa kwa zizindikiro zonse za hypoglycemia pambuyo pokonzekera mtsempha wa magazi

Njira yayikulu yodziwira insuloma ndi kusankha celiacography. Kuyatsa

ma angiograms a insuloma amawoneka bwino osakhazikika ndipo nthawi zambiri amakhala abwino

mapangidwe mtima ndi awiri a 0.5 mpaka 2-3 cm

nthawi zina ma adenomas ambiri amapezeka, amasanjidwa makamaka mkati

madera a mchira ndi thupi la kapamba.

Chithandizo: kokha maopaleshoni, omwe amakhala ndikuchotsa adenoma pamodzi

kapisozi wake. Ndi ma adenomas angapo amchira komanso thupi la kapamba, ndipo

komanso adenomas wokhala ndi zizindikiro zokhala ndi vuto lodana ndi adenomas

hyperinsulinism imachitika mu 10% ya milandu yonse)

pangani mawonekedwe a kapamba.

Ulcerogenic adenoma (gastrinoma) amatanthauza gulu la zotupa zochokera

pancreatic islet zida zosapanga insulin.

Chowoneka mosiyana ndi zotumphukazi ndikuti ma cell awo

kupanga gastrin, yomwe mahomoni amakhudza tiziwalo timene timatulutsa mucosa

nembanemba yam'mimba. Mu 60% ya odwala, gastrinomas amadzuka ndikupereka

metastases kumitsempha yam'mimba, chiwindi, mapapu, peritoneum, ndi khungu. Mu 50% ya odwala

gastrinomas amaphatikizidwa ndi adenomatosis a endocrine glands

(angapo endocrine adenomatosis) ndi chotupa kapena

kusintha kwa hyperplastic kumawonedwanso mu pituitary, parathyroid

Chithunzi cha chipatala cha ulcerogenic adenomatosis chimadziwika ndi matenda

Kuyesa kwa kulumala mu chifuwa chachikulu.

Matendawa ndi zotsatira za kapamba kapamba kapenanso kuyambira pamenepo

kumayambika kumayamba pang'onopang'ono, kumatenga nthawi yayitali.

Etiology: zomwe zimayambitsa matenda kapamba ndi matenda am'mimba,

duodenum, chiwindi, chikhodzodzo ndi dongosolo la biliary, i.e.

ziwalo zogwirizana ndi anatomical komanso magwiridwe antchito ndi kapamba

matenda okhudzana ndi zakudya komanso kusintha kwa mafuta kagayidwe (ochimwa pazakudya,

uchidakwa), matenda owopsa komanso osachiritsika, kuledzera, poyizoni, amasintha

mu duct dongosolo la kapamba (chachikulu chotupa, strictures,

excretory duct epithelium metaplasia), chatsekedwa chovulala chamapazi.

Pathogenesis: pancreatitis yosatha imafanana kwambiri ndi pathogenesis ya pachimake

kapamba. Kubwezeranso matendawa kumayambitsa kutenga zonse zatsopano

madipatimenti a kapamba, omwe nthawi yayitali amayambitsa ntchito

parenchyma yamisempha yodziwika bwino imabweretsa kusintha kwa sclerotic

ductal system ya gland komanso mu paravasal minofu.

Pathological anatomy: kuchuluka kumachitika mu minofu ya pancreatic

minofu yolumikizika, yopangitsa fibrosis ndi sclerosis. Pomaliza

itha kukhala yokhala- kapena yodziwika bwino, yophatikizidwa ndi munthawi yomweyo atrophy

minofu ya glandular. Zotsatira zakukula kwamatenda achitsulo

zophatikizika komanso nthawi zambiri zimasintha mawu. Microscopically munthawi yomweyo

minofu fibrosis, kulowa kwake, lipomatosis,

zosintha zotupa m'makoma a ma ducts. Nthawi zina zingapo

ma cysts ang'onoang'ono opangidwa chifukwa chakutha kwa lumen ya ma ducts, madipoziti

mchere wamkati mu minyewa ya m'mimba (kuchulukitsa pancreatitis).

Mitundu yotsatira yamatenda aumwini ndi kapangidwe ka matenda kapamba amodzi: 1)

aakulu insulin kapamba, 2) kapamba wa pseudotumor, 3)

pseudocystic pancreatitis (pancreatitis yayitali yokhala ndi chotupa), 4)

aakulu kuwerengetsa kapamba (virgolithiasis, calcifying

D-KA NDI KUTULUKA KWA GASTRODUODENAL BLEEDING

Gulu: 1. Kutulutsa magazi m'mimba - 50-60% 2. Matenda am'mimba - 30-40% 3. Kutupa kwam'mimba chifukwa cha matenda ena (magazi, ndulu) - 3-5% 4. Kutulutsa magazi konyenga (mphuno, larynx) Magazi otulutsa magazi: I gululi - khansa, II st. -12%, chosaopsa chotupa-3%, gastritis-10%, m-Mallory-Weiss-7%, cirrhosis-6%, kuvulala-1%, kuwotcha-0.5%, diverticulums- 0,5%, III gr. matenda a magazi (hemophilia, leukemia, opaleshoni ya Werlgof), splenomegaly, opaleshoni ya Banti, thrombophlebitis, opaleshoni ya hypertonic, mankhwala (reserpine, salicylates, mahomoni, anticoagulants) uremia, capillarotoxicosis, aneurysm. limagwirira: Zilonda zam'mimba: kupitirira, dystrophy, necrosis, mafuta, kuwonongeka kwa mtima. Khansa yam'mimba: Kukula kwakukulu, kuperewera kwa zakudya m'thupi, kuwonongeka, kuwonongeka kwamitsempha. Erosive gastritis: kupsinjika, adrenaline kuthamanga, vasospasm, maziko a necrosis, chimbudzi, kukokoloka, zilonda. S. Mallory-Weiss: gastritis, zolakwika za pakudya, zina za b-ni -> kusanza, Cardia ndi mikangano ya diaphragm, kupasuka kwa nembanemba ndi minyewa -> magazi.Mitsempha ya Varicose: cirrhosis ya chiwindi ndi portal block, matenda oopsa, makosi am'kati, kupindika kwa timitsempha, kukokoloka kwa magazi. Zotupa za Benign: kukula, kuperewera kwa zakudya m'thupi, kuvunda, magazi. Kuvulala: kuwonongeka kwa minofu ndi mitsempha yamagazi, magazi, gawo la madzi am'mimba mu hemostasis. Burns: wosanjikiza necrosis, mapangidwe a nkhanambo, kukana kwa necrotic misa, kukhudzana ndimitsempha yamagazi, magazi kwa masiku 3-10. Diverticulums: kusayenda, kukwiya, kutupa, necrosis + kugaya, magazi. Hemophilia: osakwanira odana ndi hemophilic chinthu, magazi magazi + chimbudzi. Nkhondo ya Werlhof: hypersplenism, kuwonongedwa kwa maselo, kusintha kwa capillary, kukha magazi, necrosis, kukana.

Pathogenesis: 1.Kutaya magazi, kusokonezeka kwa hemodynamics, hypoxia, dystrophy, mawonekedwe operewera ndi ntchito, magazi, V = 20-50% -> imfa. 2. Kugawikanso kwamadzi: kuchokera ku minyewa ndi maselo -> kupita kukagona. BCC - hemodilution (dilution). 3. Kuphwanya kagayidwe (madzi, electrolyte, B, F, Y). 4. Kuphwanya kagayidwe (activation ya glycolysis, CTK, PFP, mphamvu kagayidwe). 5. Kulowetsa thupi chifukwa cha kuwonongeka kwa magazi: azotemia, kuchuluka t, kutulutsa matenda.

Njira yolipira: kuphipha kwa mtima, kutuluka kwa magazi kuchokera ku malo ogona, kusintha kwa kugunda kwa mtima, kuchepa kwa SV, SI, kusintha kwa BP, hemodilution, kukondoweza kwa hematopoiesis ndi hemostasis, kusintha kwa kagayidwe kachakudya, kuchepa kwa BCC, vasospasm, kusintha kwa magazi, magazi, kukondoweza kwa hemostasis, kusiya magazi. Kutulutsa magazi, kufafaniza mpaka 10%, kokwanira mpaka 20-25%, kuwongoleredwa mpaka 30%, koopsa mpaka 30-50%.

Njira zofufuzira: Mwazi: Er, Hb, Ht, L, ESR - kuchuluka., Tr - kuchepa., Prothrombin - kuchepa. kapena N, coagulability wa magazi, fibrinolysis., kuchoka. Pali: profuse (profuse) - 2 l, zolimbitsa - 0,7-1.3 l, pang'ono - mpaka 0,5 l, microbleeding.

Zizindikiro, Ntchito: Chabwino, heestasis, gwero (kutulutsa ndi momwe zimakhalira), kuchuluka kwa magazi, gawo la nthendayi yomwe imayambitsa matenda, digiri yolipira. Chidziwitso chofulumira: chiopsezo cha moyo, kuthekera kwa kusokonekera kwa chipukuta mtsogolo, kuthekera kwa kukonzanso magazi -> kufa, mankhwala ena - zotsatira zoyipa. Magulu azachipatala: 1.mobile kapena wamwalira mosalekeza, 2. Wofatsa kapena wolimbitsa thupi mobwerezabwereza, 3.mobile kapena wamwalira wayimitsidwa, 4. wocheperako (anapitiliza, rep., Wayimitsidwa.), 5. micobleeding.

KUDALITSA CLINIC: "mpweya kupha" (magazi), utoto wamtundu (kutulutsa magazi kwambiri), pakafukufuku wam'mimba: kuchuluka kwa peristalsis. S-m tourniquet (Shthenden-Genok) - ma droplets, S-Bergman - kuthetsa ululu kumayambiriro kwa magazi.

Malingalirokutengera mtundu wa kutuluka magazi 1. Kubera (kwambiri) kapena kutulutsa magazi mosalekeza -> Kuchita opaleshoni yothamangira 2. Kukhetsa magazi pafupipafupi -> opaleshoni yothamanga 3. Mankhwala kapena magazi pang'ono anasiya kutaya -> mankhwala, kuwunikira, kuyesa. > mankhwala, kuwunika, kuyesa. 5.Microcirculation -> chithandizo, kufufuza (mayeso a benzidine)

MABWINO 1. Kutulutsa kwam'mimba (B-2, Hofmeister-Finsterrera) 2. Heestasis yakwanuko (kusokoka kwa zilonda pamodzi ndi mitsempha yotulutsa magazi) 3. Ndime 2 + vagotomy (kulowererapo kwa Lyatorge nerve) 4. Kuyambika kwa mitsempha yamagazi yopita ku zilonda. KUTHANDIZA 1. Ku chipatala chopangira opaleshoni (heestasis, kuwunika hemodynamics, makamaka zochitika, opaleshoni) 2. Kupuma pogona! 3. Zakudya Meilengacht (chakudya chosenda) 4. Kutumiza kwa Er misa ndi plasma 5. Hemostasis (viscose, vit. C, Na chloride, thrombin + HACA mkati, E-aminocaproic acid IV) 6. Gastric hypothermia (Chithunzi cha Shalimov )! Endodo

Mitundu yamavuto

Pali zovuta zambiri zomwe zimakhumudwitsidwa ndi kuukira kwa kapamba. Kuti mupewe kupepuka mu mankhwala, gawoli limasiyanitsa mitundu iwiri yayikulu: mochedwa komanso koyambirira zoyipa zomwe matendawa adayambitsa.

Post-necrotic syndrome, zovuta zowononga za pancreatitis pachimake, ndi zotsatira za puluro-pulmonary ndizovuta kwambiri.

Zochitika pambuyo pa necrotic zodabwitsanso zimagawika kukhala zododometsa komanso zaimpso ndi kwa chiwindi.

Kutulutsidwa kwakukulu kwa michere ndi poizoni m'magazi kumabweretsa kukula kwa zovuta zoyambirira:

• Kulephera kwa mtima.
• Kusintha kosasintha m'mapapu.
• Kutulutsa magazi m'matumbo, m'mimba.
• Peritonitis
• Jaundice
• Mavuto amisala
• Mtsempha wamagazi thrombosis.
• Kutupa kwa serous nembanemba.

Ndi kulephera kwa chiwindi ndi impso, chiwindi chimachulukana kwambiri, palibe kukodza (pali kudzimbidwa), kapena, mosiyana, pali kuwonjezeka kwamphamvu kwamikodzo patsiku. Magawo a arterial akukula, khungu ndi mucous nembanemba zimakhala zouma.

Mu 50% ya odwala, zotsatira za kuvulala kwamphamvu kumachitika mwa njira ya peritonitis ya serous kapena purulent form.

Pachimake kapamba ndi zotsatira zake

Pakuwopsa, peritonitis imayamba, yomwe imakhala yachilengedwe. Ili ndi vuto lowopsa, lomwe limayendetsedwa ndi chidwi champhamvu pamimba.

Chifukwa cha kuledzera, ntchito ya impso ndi chiwindi imasokoneza. Mavuto akulu ndi magwiridwe am'mimba, mapangidwe a ziphuphu zakupha, komanso mapapu am'mimba amatha.

Mochedwa mavuto amabwera pambuyo poti wachibale wodwala. Nthawi zambiri pambuyo 20-25 masiku kuchokera isanayambike matenda. Nthawi zambiri, zotsatira zoyipa zimapezeka. Choyipitsitsa cha izo ndi poyizoni wamagazi.

1. Muli m'mimba.
2. Parapancreatic syndrome.
3. Hyperhidrosis.
4. Pancreatic necrosis.
5. Pilephlebitis (kutukusira kwa mitsempha ya portal).
6. Pseudocysts kapena cysts.

Zotsatira zoyipa zimaphatikizidwa ndi chotupa neoplasms, lymphadenitis (imachitika chifukwa cha kuledzera kwa thupi), kuopseza ndi mantha (chifukwa chazovuta za poizoni), kufooka kwamitundu yambiri.

Ngati ma pancreatic minofu amafota, pomwe ma cysts amapanga, chodabwitsa ichi chimawonetsedwa ngati chiopsezo cha moyo. Mankhwala othandizira amafunikira. Matendawa amakomera pokhapokha ngati mungagwiritse ntchito nthawi yake.

Kuwonongeka kwa magazi nthawi zambiri kumachitika - njira yodutsitsa yomwe yapezeka chifukwa chophulika kwa mtsempha wamagazi pakatupa.

Zotsatira za matenda osachiritsika

Zotsatira za matenda osakhazikika zimaphatikizapo kusokonezeka kwamkati, komwe kumalumikizidwa ndi kugwira kwa kapamba. Nthawi zambiri, chiwindi ndi ducts bile zimakhudzidwa.

Wodwalayo amapezeka ndi mtundu wotupa wa hepatitis, cholestasis, cholecystitis - matenda otupa a bile ducts, purulent cholangitis.

Kapangidwe ka ma cysts ndi chifukwa chovuta pakukutulutsa kwa madzi a pancreatic kudzera mumizere mkati mwa chiwalo. Pali mitundu ingapo ya ma neoplasms - zoona ndi yabodza. Pafupifupi 80% ya zithunzi zamankhwala, ma cyst abodza amapezeka.

Kafukufuku wambiri watsimikizira kuti kapamba amatanthauza matenda omwe amayambitsa khansa. Makamaka, khansa ya kapamba.

Zovuta zina zimasiyanitsidwa:

• Mtundu woyamba wa shuga. Chiwopsezo cha kutukuka ndichopitirira ngati wodwala ali ndi zakumwa zoledzeretsa.
• Chuma choperewera magazi.
• GERD.

Mwa akulu ndi abambo, matendawa amatha kudzutsa matenda oopsa a portal, omwe amachititsa kuti pakhale patuluka pamimba. Kuphatikiza apo, mitsempha ya varicose yam'mimba imapangika, yomwe nthawi zambiri imawonetsedwa ndi magazi akulu.

Kuti muzindikire zovuta pakapita nthawi, ndikofunikira kuyang'anira kutentha kwa thupi, kukakamiza, kukoka, kupuma kwa wodwalayo.

Njira zochizira

Zovuta za chifuwa cham'mimba komanso kukokoloka kwake zimachizidwa pang'onopang'ono. Kutengera njira zodziwira matenda ndi mayeso a labotale, dokotalayo amalimbikitsa njira yabwino yochizira. Nthawi zonse zimasiyanasiyana, monga zimatengera zotsatira zenizeni za matendawa.

Fotokozerani chithandizo cha kulowetsedwa - njira yothandizira, yomwe ikutanthauza kumayambira muyezo wa mayankho omwe amateteza kuchepa kwa thupi. Onetsetsani kuti mwapereka mankhwala osala kudya, antibacterial ndi mankhwala ena. Nthawi zambiri, ngalande zochulukirapo za zimakhala ndi kachilombo zimagwiritsidwa ntchito.

Pambuyo pamakina awa, fistula imawoneka yomwe imapangitsa kuti zovuta azimuchiritsa. Mwambiri, zokonda zimaperekedwa kwa mankhwala. Pharmacology imapereka mankhwala osiyanasiyana othandizira.

Ngati kumayambiriro kumakhala kutayika kwakukulu kwa madzi a pancreatic, ichi sichiri chizindikiridwe cha opareshoni. Kuperewera kwa pancreatic, komwe kumayambitsidwa ndi fistula, kumatha kulipiriridwa ndi mapiritsi. Nthawi zambiri, fistula imachiritsa yokha. Ngati cholumikizira ndi cham'mbali kapena ducts, njira yobwezeretsedwera imachepetsedwa kwambiri.

Octreotide itha kutumizidwa kuchitira fistulas. Mlingo watsiku ndi tsiku: 100 mcg subcutaneous katatu patsiku, nthawi ya chithandizo ndi masiku asanu. Mankhwala amaletsa trypsin ntchito, ali antispasmodic kwenikweni, ndipo amaletsa ambiri kuledzera.

Opangawo akuwonetsedwa pazinthu monga:

1. Kukhalapo kwa magazi m'matumbo a cyst.
2. Hemorrhagic kapena purulent mawonekedwe okondweretsa.
3. Wotayika peritonitis.
4. Kuphwanya cysts pamimba pamimba.
5. Kupasuka ndi kuwonjezereka.

Mu nthawi ya postoperative, mankhwala othandizira (mwachitsanzo, Furazolidone) amachitika, zakudya zapadera zimafunika. Lembetsani ma pinkiller, amatumikiridwa mpaka kasanu ndi tsiku.

Kupewa mavuto a kapamba

Mfundo zopewera zimaphatikizapo kuphatikiza zakumwa zoledzeretsa kuchokera pachakudya, kusiya kusuta, kudya mokwanira komanso moyo wathanzi. Kuvulala kwambiri kumayambitsidwa ndimatenda ndimowa, makamaka kugwiritsa ntchito pafupipafupi komanso pamiyeso yayikulu. Ndi kapamba, ndimaletsedwa kumwa. Ngati izi sizingatheke, chepetsani kumwa kamodzi pa mwezi.

Kudya wathanzi ndi kiyi wa moyo wautali. Odwala ayenera kutsatira zakudya mosamala, osalemetsa thupi ndi chakudya cholemera. Ndikofunikira kukana mafuta ndi mchere, kupatula mbale zonse zonunkhira. Muyenera kukana zakudya zomwe zimaphatikizapo ma carcinogens - mankhwala osungira, utoto, zonunkhira, etc.

Pankhani ya matenda osachiritsika omwe ali ndi cholinga cholowa m'malo, tikulimbikitsidwa kumwa Pancreatin. Mlingo wake umachokera 16,000 mpaka 32,000 tsiku lililonse (mpaka mapiritsi 4) pakudya. Pazipita tsiku lililonse mapiritsi 18.

Mutha kuyimitsa kupweteka m'mapazi pogwiritsa ntchito njira zosakhudzana. Odwala ambiri amalimbikitsa kutenga decoction kapena kulowetsedwa kutengera chomera chomwe chimafa (pokhapokha povomerezana ndi dokotala).

Ndi zovuta ziti zomwe zingayambitse akatswiri a pancreatitis mu kanema munkhaniyi.

Kukula kwa zovuta pambuyo pachimake maphunziro a matenda

Pali zovuta zoyambirira komanso mochedwa pambuyo pancreatitis pachimake. Oyambirira abwere masiku angapo kuchokera ku matenda. Izi zimaphatikizapo magazi am'mimba omwe amayamba chifukwa cha kuledzera komanso zilonda zam'mimba zam'mimba zam'mimba, kapamba, matumbo. Kupweteka kwambiri kapena kupweteka kwa msana kumayamba. Zizindikiro:

• khungu lotuwa (loyera) ndi khungu lowuma,
• kuthamanga kwa magazi
• tachycardia
• kuchepa kwamkodzo kutulutsa kapena kusowa kwake.

Mangochita mankhwalawa - chomwe chimapangitsa ndikupweteka kwambiri komanso kuledzera komwe kumachitika chifukwa cha kuphulika kwa minofu ya pancreatic pacrancic necrosis. Dongosolo lakunjenjemera limatsatiridwa ndi pallor, tachycardia, kutsika kwamkodzo ndi psychomotor.

Intoxication psychosis

Intoxication psychosis - yodziwika bwino kwa anthu omwe amamwa mowa kwambiri. Amawonetsedwa mu kusakhazikika pamachitidwe, kuyerekezera zinthu, Hyperthermia.

Pali chiopsezo chokhala ndi minyewa yotupa yomwe imayamba kupindika.

Mavuto akuchedwa amapezeka mkati mwa masiku 15 mpaka 20 sabata kuchokera kumayambiriro a matendawa ndipo amayambitsidwa ndi matenda.

Purulent pancreatitis, parapancreatitis, peritonitis. Amadziwika ndi kutentha kwambiri kwa thupi, mkhalidwe wachisoni komanso thukuta lomwe limakulirakulira. Pali chiopsezo chotenga sepsis, abscesses ndi phlegmon pamimba, komanso cysts ndi fistulas yam'mimba kapena kapamba.

Chibayo ndi pleurisy (nthawi zambiri kumanzere). Zizindikiro:

• kupuma movutikira,
• kupuma movutikira
• kupweteka pachifuwa
• cyanosis wa pakhungu.

Mavuto mu matenda

Njira yodwalayo yamatenda imadziwika ndi pang'onopang'ono ndipo nthawi zambiri imasiyana. Koma musanyalanyaze ngakhale kwambiri, poyang'ana koyamba, zisonyezo zazing'ono. Kupatula apo, kupweteka pang'ono pamimba yakumbuyo kumathanso kudwala khansa ya matumbo.

Zovuta za chifuwa cham'mimba zimafotokozedwera zotupa za ziwalo zogaya chakudya zomwe zimayenderana ndi kapamba. Nthawi zambiri, biliary dongosolo ndi chiwindi amavutika:

• yotupa chiwindi
• cholestasis wokhala ndi kapena wopanda jaundice,
• purulent cholecystitis,
• purulent cholangitis.

Chifukwa cha kutupa, kutuluka kwa msuzi wa kapamba ndizovuta, zomwe zimayambitsa kuphatikizana kwachilendo kwa kapamba - mawonekedwe a cysts kapena pseudocysts. Cysts yabodza imakhala pafupifupi 80% ya milandu.

Chifukwa cha kufupika kwa kapamba mpaka m'mimba komanso m'mimba, kuphatikizika kwa mawonekedwe a kupindika kapena chibayo kumakhala kofala. Pancreatitis yachilendo imawonjezera mwayi wokhala ndi khansa ya kapamba.

Anthu omwe akudwala matendawa kwa zaka zopitilira 20 atenga khansa ya kapamba mu milandu ya 4-8%. Mavuto ochepa omwe amapezeka ndi awa:

• matenda ashuga
• chitukuko cha matenda a m'mimba thirakiti,
• aakulu duodenal chotchinga.

Mavuto a chidakwa cha matendawa

Kumwa mowa mwauchidakwa kumawononga thupi lonse, makamaka makondomu, kupangitsa kuti pakhale zovuta zambiri. Ngakhale kumwa pafupipafupi mowa pang'ono kumatha kuyambitsa mavuto akulu.

Wodwalayo amayikidwa kuchipatala kuti amupimphe ndi kumuyesa. Masiku oyamba amafunikira kukana kwathunthu chakudya, mtsogolo - chakudya chokhwima. Kusuta fodya ndi kumwa mowa ndikoletsedwa.

Pambuyo pa kufufuza, dokotala amafufuza njira zamankhwala zothandizira - njira yosasamala kapena ya opaleshoni. Nthawi zambiri, mavuto amowa pancreatitis amafunika kuchitapo opaleshoni.

Pancreatitis yosatha chifukwa cha uchidakwa imatha kusadziwika kwa nthawi yayitali. Nthawi zambiri, odwala samapita kwa dotolo, amatenga matenda opatsirana chifukwa cha matenda a hangover. Zotsatira zake, matendawa amapita patsogolo, thanzi la munthu limakulirakulira, ndipo zovuta zina zimawoneka mwa magawo 2 mpaka 3 pachimake cha kapamba kapena kapamba wa kapamba.

Kuzindikira komanso kupewa zovuta

Mavuto a pancreatitis pachimake komanso aakulu amatha kupha, ndipo ndi chitukuko cha kapamba, kufalikira kumafikira 70%. Osati gawo lomaliza pakupanga zovuta limaseweredwa ndi matenda ena omwe alipo komanso moyo wa munthu.

Pofuna kupewa kupezeka mochedwa pakukula kwa matenda, kuyang'anitsitsa zochitika za kapamba ndikofunikira - gawo la mayeso a ultrasound ndi kuyezetsa magazi.

Ngati matenda atakula kwambiri - pitani kuchipatala msanga.

Pambuyo pakupereka chithandizo chofunikira, mtsogolomo ndikofunikira kuyang'anira kudya kwanu nthawi zonse:

Ndikofunika kutsatira chakudya cha kapamba

• gwiritsitsani zakudya zina, zakudya,
• kuthetsa mowa ndi fodya,
• munthawi yake kuchitira matenda am'mimba ndi ziwalo zina zam'mimba.

Pancreatitis ndi matenda oopsa omwe amadalira kwambiri munthu mwiniyo. Malingaliro awiri akuluakulu omwe angatengedwe - muyenera kutsatira moyo wathanzi ndikufunsira dokotala munthawi yake. Kupanda kutero, ngakhale kudzutsidwa pang'ono kungayambitse mavuto ena.

Zovuta za pachimake kapamba: purulent zovuta

Dokotala wanu wapezeka kuti ali ndi vuto la pancreatitis pachimake. Mwinanso, munakumana ndi matendawa ndipo simudziwa momwe muyenera kukhalira, kuchita, zomwe mungachite kuti muchotse mofulumira zomwe zikuwonetsa matendawa.

Ndipo apa, kuwopseza zambiri zazotsatira ndi zovuta kumveka kuchokera kumagulu osiyanasiyana. Kuti abale, abwenzi akumenya nkhondo mzonsezi pazokhudza mantha, zovuta pa intaneti, sikungoyipa. Tidzayesa kumvetsetsa matendawa pawokha, komanso kuti kuopsa kwa kapamba kovuta kwambiri ndi owonda bwanji.

Zikondwerero

Pancreas yaumunthu ndi amodzi mwa ziwalo zofunika kwambiri zam'mimba, imapezeka pansi pakatikati pamimba, kutsikira, kumanzere kwa m'mimba (chifukwa chake dzinali lili nawo), lomwe lili ndi magawo atatu (mutu, thupi ndi mchira). Pafupi ndi iye pali ndulu ndi ndulu. Mutu wokulirapo wa gland umakhala mkati mwa bokosi la akavalo, omwe amapanga duodenum.

Mawonekedwe a kapamba amafanana ndi peyala yayitali, kukulira pakati pa matumbo ndi ndulu. Iron ndiye wamkulu kwambiri kuposa ena onse m'thupi la munthu. Zikondamoyo zili ndi utoto wonyezimira, wokhala ndi chotupa, wokutidwa ndi kapisozi kumteteza pamwamba.

Gululi limayang'anira ntchito ziwiri zazikulu - kaphatikizidwe kwama mahomoni angapo (mwachitsanzo, insulin, glucogen, somatostatin, ndi zina) ndikupanga madzi a pancreatic panthawi yakudya, omwe amatenga gawo logaya chakudya omwe amakhala atatha kukonza m'mimba kulowa m'matumbo, kapena m'malo mwake duodenum.

Mu chitsulo, madzi ake amakhala osagwira (chifukwa chake, osadzigaya okha), ndipo akamadutsa Wuctung duct mu duodenum, amasintha mawonekedwe ake kuti azigwira ntchito, ndipo kale ma enzymes ake (ma enzymes) amaphwanya mapuloteni, mafuta, ndi mafuta kukhala oyambira mulingo wofikiridwa ndi maselo.

Pancreatitis: mitundu yake ndi zizindikiro

Ngati pali vuto lina lililonse m'thupi lanu, nthawi zambiri munthu amatenga matenda monga kapamba. Ichi ndiye kuti ndi njira yotupa, yomwe poyamba imatha kuchitika mosadziwika bwino, kotero kuti munthu amatha kudumpha fomu yoyamba ya matendawa ndikuyamba kumva kuti matendawo atakula kale.

Pancreatitis imagawidwa m'mitundu inayi: yoyambirira, yogwira mtima, yovuta komanso yopanda matenda. Nthawi zambiri, matendawa amapezeka ndipo amayambitsidwa ndi kuperewera kwa thanzi la anthu, kusowa njira yodyera, kuzunza okazinga, mafuta, mbale zosuta, mowa.

Gwero lachiwiri lofala kwambiri la kapamba (mawonekedwe ake othandiza) ndi matenda a ziwalo zina zam'mimba thirakiti (m'mimba thirakiti).

Komanso, izi zingaphatikizepo kuchepa kwa ntchito zolimbitsa thupi, kuzunza, kugwiritsa ntchito mankhwala osokoneza bongo, etc. Madokotala nthawi zambiri amapanga matenda a pancreatitis pachimake.wodwala nthawi zambiri amabwera kwa iwo ndi mtundu uwu wa matendawa. Zizindikiro zazikulu za pancreatitis pachimake:

1. Ululu wamitundu yosiyanasiyana yamphamvu, gwero (kutengera zomwe zakupaka: mutu, thupi kapena mchira), monga lamulo, la chikhalidwe cha shingles, mphindi 30 mutatha kudya mafuta, osuta, zakudya zonunkhira, komanso mowa.
2. Kukhala mseru kwa nthawi yayitali, kusandulika kukhala kusanza popanda zizindikiro zakupumula.
3. Kufalikira, kulemera, kusanja.
4. Kuchuluka kwa kutentha kwa thupi, kutopa nthawi zonse, kugona.
5. Kusintha mtundu wa mkodzo, ndowe.
6. Pakamwa pakamwa, khungu limasintha kukhala lachikaso, utoto woyera pa mucosa umapangidwa, etc.

Kuchiza matenda ndi kukonza thupi

Kumva zizindikiro zoyambirira za kukomoka, ndikofunikira kufunafuna chithandizo chamankhwala m'masiku angapo otsatira. Dokotala wa mano, wowunika wodwalayo, akumvetsera madandaulo ake, akutsokomola pamimba, apangitsa kuzindikira koyambako. Ndi zizindikiro zomwe tafotokozazi, pancreatitis pachimake nthawi zambiri imayikidwa.

Kuphatikiza apo, monga lamulo, ngati mkhalidwe wa munthu walola, amatumizidwa kukayezetsa kuchipatala, kukayezetsa zinthu za Hardware, kutengera zotsatira zophatikizidwa zomwe zimabwera paulendo wachiwiri, adotolo amamupangitsa kuti adziwe ngati ali ndi vuto. Ganizirani pamalingaliro a nkhaniyi njira yotsimikizirira kupezeka kwa matenda a pancreatitis pachimake.

Nthawi zambiri, chinthu choyambirira chomwe dokotala amalimbikitsa (ngakhale atayesedwa koyambirira) ndichakudya chokhwima (chanjala malinga ndi chiwembu chimatha masiku angapo oyamba). Ma painkiller, mankhwala omwe amabwezeretsa ntchito yopanga ma enzymes, kukonza ntchito ya parenchyma yolumikizidwa ndi zakudya.

Zakudya zimaphatikizapo kukana zakudya zingapo, mbale. Dokotala amalimbikitsa kudya zakudya zazing'ono, ndikuchulukitsa kuchuluka kwa chakudya mpaka 5-6 patsiku, kudula chakudya, kuwotcha, mu uvuni, kuphika owiritsa, wopatsa mphamvu.

Zoletsedwazo zili pa nyama yamafuta, nsomba, zinthu zamkaka, buledi watsopano (makamaka woyera), yolk (m'masabata oyamba), barele wa pearl, mapira, nyemba, anyezi, adyo, radish, kabichi yoyera, mphesa, nthochi, mankhwala a chokoleti, khofi Mungadye mitundu yochepa yamafuta a nyama, nsomba, mafuta ochepa amkaka, masamba: kaloti, mbatata, beets, zukini, dzungu, etc., kuchokera ku zipatso - zophika kapena grated, mwachitsanzo, apulo, peyala.

Mavuto a kapamba - ndi chiyani?

Ngati pakapita nthawi simusamala za zizindikiro za matenda a kapamba, musapite kwa dokotala mwachangu, mutha kuchedwetsa matendawa, ndiye kuti mu mawonekedwe oopsa kwambiri, ndipo chifukwa chake, zovuta zingapo za kapamba kakakulu zimatha kuwonjezeredwa. Kodi chawopseza wodwala matendawa ndi chiyani? Zambiri pa izi pambuyo pake.

Monga lamulo, wodwala yemwe safuna thandizo la kuchipatala munthawi yake amadwala matenda ovuta kwambiri chifukwa chakuti njira zoyenderana zimalumikizidwa ndi kapamba. Mwachitsanzo, michere yamadzi a pancreatic imalowa m'magazi, ndikusintha kapangidwe kake, komanso zotsalira za kuwonongeka kwa maselo owonongeka a gland.

Kutengedwa palimodzi, ndi malo opatsirana magazi, kuwupatsira. Ziwalo zina zam'mimba (chikhodzodzo, chiwindi, duodenum, m'mimba, ndi zina) zimatha kulephera chifukwa cha mavuto a kutulutsa tokha.

Inde, monga mukudziwa, chifuwa chachikulu cha kapamba ndimatenda amodzi, omwe amaphatikizana ndi kuchuluka kwa michere, yomwe, imayamba "kudya" maselo a gland, ndipo chifukwa chake, kufupika kwake ndi necrosis zimachitika.

Madokotala amatha kusiyanitsa magawo awiri a zovuta za kapamba: koyambirira komanso mochedwa.

Gawo loyambirira la zovuta

Gawo loyambirira la zovuta limatha kumayambika matendawa, ndikukulitsa zovuta za wodwalayo. Zizindikiro zoyambirira zamavuto zikuphatikiza:

1. Gwedeza dziko.
2. Intoxication.
3. Kukula kwa chibayo (pulmonary edema).
4. Pachimake hepatic-aimpso kulephera.
5. Mtsempha wamagazi thrombosis.
6. Zizindikiro za jaundice.
7. Kukhumudwa m'mimba (magazi, zilonda zam'mimba).
8. Peritonitis
9. Matenda amisala, kuphatikizira omwe akudutsa mu kuyerekezera zinthu m'magazi, kutsekemera, kusokonezeka kwamanjenje.
10. Pericarditis, etc.

Mwa zonse zomwe zalembedwa, zowopsa kwambiri komanso nthawi yomweyo zomwe zapezeka pafupifupi theka la odwala ndi peritonitis. Ndi zovuta za purulent zokha zomwe zimawerengedwa kuti ndizotsatira zoyipa kwambiri.

Kuti muwone kuwopsa kwakanthawi, muyenera kuyang'anira kutentha kwa wodwala masana, mtundu wa khungu, mucous membrane, komanso kuchuluka kwa kupuma, mtundu, kukoka ndi kupsinjika.

Matenda apakati

Gawo lachiwiri ndi zovuta za pancreatitis pachimake patapita nthawi, masabata angapo atayamba matendawa. Amatinso akatswiri - matenda achiwiri. Kuphatikiza apo, Zizindikiro zowonjezera zimaloŵa:

1. Zotupa za m'mimba.
2. Thupi.
3. Constant adakulitsa thukuta.
4. Matenda a m'mapapo am'mimba (kusowa kwa mpweya), kupsya mtima, kupweteka.
5. Kupweteka mtima
6. Purulent peritonitis.
7. Phlegmon.
8. Fistulas m'mimba, matumbo.
9. Necrosis wa England.
10. Poizoni wamagazi.
11. Tumor mawonekedwe, cysts mu kapamba.
12. Pylephlebitis.
13. Kutulutsa magazi mkati ndi kunja, ndi zina.

Wodwala akakhala kuti ali ndi nkhawa kwambiri, amakhala ndi "zomwe tafotokozazi", kuphatikiza apo, ma sepsis (njira zoyeretsa zake) wayamba, zonsezi ndizovuta kwambiri mpaka zimatha kupha munthu, kutengera mphamvu ya thupi, zaka zake, momwe alili chitetezo cha mthupi, kuthamanga kwa achibale kulumikizana ndi dokotala ndi kutembenuka mtima komwe kumapereka panthawi.

Mavuto a pancreatitis pachimake ndi owopsa kuposa ngozi, itha kubweretsa masewera pakati pa moyo ndi imfa, musaiwale za izi! Onani momwe wodwalayo alili! Ndikofunika kuti musabweretse thupi kumapeto kwa zovuta za chifuwa cha pachimake, kuti musatuluke ndikuchira nthawi yayitali.

Mavuto aakulu a kapamba

Payokha, ziyenera kunenedwa pancreatitis yayitali komanso zovuta zake, zomwe sizili zochepa komanso zowopsa. Nthawi zambiri, zovuta za kapamba pamavuto aakulu zimadziwika ndi kuwonongeka kwa ziwalo zina ndi machitidwe a thupi.

Gland yodwala imakwiyitsa chiwindi, biliary system, kutupa kumayamba mwa iwo, komwe kumayambitsa chiwindi, cholecystitis, purcin cholangitis, cholestasis ndi jaundice, cholestasis popanda jaundice, kuchepa kwa magazi m'thupi, GERD, ndi zina zotero. pleurisy, chibayo. Pa mucous membrane wam'mimba, esophagus, chiopsezo cha zilonda zam'mimba chimawonjezeka.

Ponena za kutulutsa kake, ma cysts amatha kupanga. Izi ndi chifukwa cha kuwonongeka kwa maselo a makoma a chiwalo. Khansa imatinso kupindika kwachangu kwa kapamba. Matenda a shuga amatha kudwala matenda.

Kuchokera pazomwe tafotokozazi, ziyenera kuganiziridwa kuti zovuta zokhala pachimake, kapamba wambiri, zimakulitsa mkhalidwe wa wodwalayo, kukulitsa matendawa, komanso mpaka kumwalira (mpaka 15% ya milandu yonse). Musadzitengere nokha ndi thupi lanu ku matenda oopsa. Pemphani panthawi yake chithandizo chamankhwala, khalani modzi ndi moyo wanu, tsoka!

Pancreatic kutupa kapena kapamba

Pancreatitis amatchedwa kutupa kwa minofu ya kapamba.

Acute pancreatitis ndi matenda oopsa, limodzi ndi kutupa-necrotic komanso kuwonongeka kwa ziwalo chifukwa cha kuphwanya kwa msuzi wa madzi omwe amapangidwa ndi kapamba mu duodenum.

Kupitilira apo, kupanikizika kumachulukanso, ma cell a gland awonongeka. Chifukwa cha pathological process, autolysis (kudzimbidwa) komanso necrosis yotsatira ya ziwalo.

Ma poizoni omwe amalowa m'magazi atatha kuwonongeka kwa malo a necrotic amawononga thupi, kuwononga ubongo, impso, chiwindi, ndi mapapu.

Matenda a pancreatitis amachitika pang'onopang'ono pancreatic dysfunction chifukwa cha kupindika pang'onopang'ono kwa gland parenchyma (kupatsidwa ulemu). Izi zimayamba chifukwa cha kukula kwa minofu yolumikizana m'malo mwa minofu ya necrotic, mapangidwe a zipsera, ma pseudocysts, ndi kuwerengera mawebusayiti.

Kutsatira matenda

Mwa onse opaleshoni yodzidzimutsa yovuta kwambiri, kapamba amakhala m'malo achi 3 pafupipafupi amapezeka pambuyo pa appendicitis, cholecystitis. Zimachitika makamaka mu ukalamba (zaka 35-60), makamaka zaka 35-45.

Amuna amadwala matenda owopsa komanso osavuta matendawa katatukuposa akazi. Mu ana, matendawa amaphatikizana ndi 10% ya mavuto onse a m'matumbo.

Zoyambitsa Pancreatitis

Pali zifukwa zambiri zomwe zimatha kupangitsa kuti pakhale pancreatitis yayikulu. Komabe, mu etiology yamatendawa malo apadera amapatsidwa zakumwa zoledzeretsa: mu 50% ya milandu, ndimamwa mowa womwe umayambitsa ziphuphu. Kufikira 20% ya anthu amakhala ndi zizindikiro za kapamba chifukwa cha cholelithiasis, ndipo pafupifupi 5% - chifukwa cha opaleshoni yamanja.

Zina zomwe zimayambitsa kupweteka kwa kapamba zimatha:

• Kawirikawiri kudya zakudya zamafuta zochuluka.
• Njala.
• Hyperlipidemia.
• Kuvulala kwamtunduwu ndi kuwonongeka kwa kapamba.
• Thrombosis ndi thromboembolism yamitsempha pafupi ndi gland.
• Zilonda zam'mimba, duodenostasis.
• Zambiri zoyipa zamagetsi.
• Poizoni woopsa.
• Ma virps oyendayenda.
• Kugwiritsa ntchito nthawi yayitali cytostatics, glucocorticosteroids, estrogens, sulfonamides.
• Kuwonongeka kwa impso, kupatsirana kwa impso.
• Hypercalcemia.
• Zithaphwi za kapamba.
• Matenda a shuga.

Matenda a kapamba amatha kukhala chifukwa chodwala. Komabe, nthawi zambiri mawonekedwe amtunduwu wa kapamba amapezeka kwakanthawi motsutsana ndi matenda opatsirana a ndulu, pamaso pa miyala m'miyendo, chifukwa chakudya chosasinthika kapena uchidakwa.

Zomwe zimayambitsa kupezeka kwa kapamba:

• olemedwa ndi chibadwa,
• atrophic gastritis,
• ntchito zamagalimoto otsika
• aakulu cholecystitis
• kukhalapo kwa foci matenda oyamba,
• majeremusi
• kuchepa chitetezo chokwanira,
• zosemphana ndi kapangidwe ka kapamba.

Mu ana, zomwe zimayambitsa kapamba nthawi zambiri zimakhala zovuta pakudya, kuwonongeka kwa ma virus ku ziwalo, zoopsa, komanso kusabereka kwa kapangidwe kake kapenanso kugwira ntchito kwa kapamba.

Gulu ndi mitundu

Pakati pancreatitis aakulu, pali:

• Kuwerengetsa kapamba (mpaka 90% ya milandu).
• Cholepheretsa kapamba.
• Fibro-indental kapamba.

Ngati matendawa akuwoneka ngati njira yodziyimira payokha, imawerengedwa kuti ndi yoyamba. Pakakhala kuti matenda a kapamba amayamba chifukwa cha matenda ena, amatchedwa chachiwiri.

Mtundu woyipa wamatenda umasiyanitsidwa:

• Edematous kapamba.
• Sterile (reactive) kapamba (akhoza kukhala mafuta, hemorrhagic, wosakanizidwa).
• Wosokonekera pancreatic necrosis.

Kutengera ndi dera lomwe lakhudzidwalo, minofu necrosis ya kapamba ndi kachigawo kakang'ono, kokhazikika, chachikulu, kokwanira (kawirikawiri).

Magawo ndi magawo

Pa nthawi ya matendawa, pachimake, kubwerezabwereza, kapamba komanso kufalikira kwa mawonekedwe osakhazikika amatha kusiyanitsidwa. Pankhaniyi, pancreatitis yowonjezereka komanso kuchulukitsa kwa matenda sikuchitika mosiyana.

Magawo mu kukula kwa kapamba:

1. Zosangalatsa Pali necrosis ya kapamba, kuledzera kwamkati kumayamba (mpaka masiku 5).
2. Yogwira. Kubwereza zomwe thupi limachita pokoka minyewa (kulowetsedwa kwa cell, masiku 6-14).
3. Gawo logawika. Pali kulekanitsidwa kwa malo omwe adafa, kumasulidwa kwa poizoni. Pali njira ziwiri zakukonzekera gawo ili - aseptic ndi septic (purulent) ndi magazi, ma abscesses ndi sepsis (kuyambira tsiku la 14 kupita mtsogolo).
4. Gawo lazotsatira. Munthawi imeneyi, thupi "limapulumuka" zomwe zimayambitsa matendawa (mpaka miyezi 6).

Zizindikiro zake

Chithunzi cha chipatala mu gawo la enzymatic chimatchulidwa kwambiri. Chizindikiro chachikulu ndikupweteka pamimba pamimba, lamba komanso mwamphamvu kwambiri, ndikupereka kwa mtima, kumbuyo kwa sternum.

Wodwala amayenera kupeza malo abwino kuti athetse vuto lakelo. Kupweteka kwambiri kumawonedwa ndi hemorrhagic mtundu wa yogwira pancreatitis.

Momwe ma necrotizing amathandizira kumapeto kwa mitsempha, kupweteka kumachepa pang'ono.

Zizindikiro zina zamatendawa:

• kufatsa, koma kufinya pamimba pakhungu,
• mseru, kusanza, nthawi zambiri osagwirizana, ndi kumasulidwa kwa bile ndi ntchofu,
• Zodetsa zamagazi pakusanza, kusanza zakuda,
• khungu, khansa,
• jaundice (ndi mphamvu ya ma ducts a bile),
• kutsika kwa kutentha kwa thupi tsiku loyamba,
• malungo ndi kukula kwa minofu necrosis,
• arrhasmia, ndi pancreatic necrosis - matenda oopsa ndipo opuwala mtima (asanagwe),
• delirious syndrome (kuyerekezera zinthu m'maganizo, kupindika),
• lilime lophimba ndi utoto wokutira,
• ukufalikira
• kuchepa kwa aortic pulsation mu epigastric zone.

Mu gawo lotsatira, mkhalidwe wa wodwalayo umayamba bwino pang'ono. Ululu umakhala wosasunthika, kusanza kulibe, kutentha kwa thupi, kugundidwa mtima kumachitika modabwitsa. Ngati gawo la kubwezeretsa likupita ndi njira za purulent, thanzi laumunthu limakulanso, zizindikiro zomwe zafotokozedwa pamwambapa, komanso kukulira kwa edema pagawo lumbar, alowa.

Matenda apathengo amadziwika ndi kupweteka kwapafupipafupi kumanzere kwa hypochondrium, mu epigastrium, kukuzizira kumbuyo, mtima, kuvala shingles.

Zakudya zowawa zimatha kuchitika pambuyo pamankhwala a zakudya zamafuta, mowa, zakudya zazonunkhiritsa. Odwala amadandaula za kutsegula m'mimba, kuchepa thupi, kusadya, kusoka nyama, kunyamula, kuphwanya nseru, nseru. Kutsekula m'mimba nthawi zambiri kumakhala kakhanda, komwe kumakhala ndi mafuta onenepa. Nthawi zambiri amalowa ndi matenda ashuga. Pankhaniyi, pali ludzu, "wankhanza".

Zotsatira ndi zovuta za kapamba

Mkhalidwe wowopsa kwambiri umawonedwa ndi hemorrhagic pancreatic necrosis. Munthu amatha kufa pasanathe tsiku limodzi chitukuko cha zizindikiro zoyambirira za matendawa. Kukula kwa mitundu yamafuta a kapamba kumatsimikiziridwa ndi dera kufalikira kwa necrosis, komanso kukula kwa pancreatic edema.

Kuyendera mwachangu kwa adotolo, matendawa amatha "kubwezeretsedwa" mu gawo loyamba, kuvomereza kwa kusintha kwa kapamba mpaka gawo lotsatira kukuwopseza gawo lililonse la iwo ndikupanga zovuta zazikulu.

Zotsatira zake zitha kukhala:

• Pancreatogenic mantha, endo native kuledzera.
• Peritonitis
• Muli kapena phlegmon ya danga lobwezeretsa.
• Necrosis yam'mimba ndi m'matumbo.
• Pancreatic fistula.
• Kutulutsa magazi kuchokera mumimba.
• Pachimake impso, chiwindi kulephera.
• Kuvulala kwamapapo.
• Cerebral edema.

Imfa ya pachimake kapamba - mpaka 15%, ndi mafupa a hemorrhagic komanso chachikulu chachikulu kapena chonse necrosis - mpaka 70%. Choopsa chachikulu cha pancreatitis yayitali ndikufalikira, kukula kwa matenda a shuga ndi khansa ya pancreatic.

Zizindikiro

Mu chilonda chachikulu cha pancreatitis, wodwalayo amagonekedwa kuchipatala. Mayeso amitundu yodwalayo amatenga matenda momwe amakonzera.

Mayeso a Laborator omwe amagwiritsidwa ntchito pozindikira:

• zamankhwala amwazi (Zizindikiro za transaminase, amylase, trypsin, phospholipase, ribonuclease, bilirubin zimayesedwa),
• kuyezetsa magazi konse (leukocytosis, kukwezedwa kwa ESR kwapezeka),
• urinalysis (zonse, zamtundu wa amylase),
• pulogalamu.

Mwa zina mwa njira zofunika kwambiri zoyeserera ndi ma ultrasound, radiology, MRI ya kapamba ndi chifuwa chonse cham'mimba, fibrogastroduodenoscopy yam'mimba ndi duodenum. Nthawi zina, amafunika kudziwa ngati pali vuto lina lokhudza matenda obwera chifukwa cha kuperewera kwa m'mimba ndi angiography.

Njira zapadera zowunikira zikondwererozi ndi kubwereza cholangiopancreatography, mesentericography, ndi radioisotope kuwunika kwa minyewa ya gland.

Kuzindikiritsa kosiyanaku kumachitika ndi khansa ya kapamba, cholelithiasis, mafuta am'mimba zam'mimba, enteritis, cholecystitis, mesenteric infarction, matenda am'mimba, aortic aneurysm, appendicitis, ndi matenda ena a ndulu.

Gulu la zovuta

Pancreatitis pachimake imadziwika ndi gawo la magawo komanso mitundu yambiri yamavuto - kusintha kwatsiku mu minyewa ya kapamba ndi ziwalo zapafupi.

Zovuta za purulent za kapamba zimayamba chifukwa chaukali wa kapamba ndi ziwalo zoyandikana ndi kapamba wamwazi, magazi ndi zamitsempha, komanso kulowa nawo gawo lotupa la matenda opatsirana.

Purroc-septic mavuto a kutupa kwa pancreatic:

• enzymatic diffuse peritonitis (kutupa kochulukirapo kwa zotupa za zotupa za peritoneum ndi ziwalo zam'mimba),
• zotupa (zotayidwa purulent patsekeke) makoma am'mimbamo, peritoneum ndi bilayer minofu yophimba ziwalo zam'mimba,
• abscesses wa cholumikizana minofu kapisozi kapamba, parapancreatic CHIKWANGWANI ndi cham'maso bursa,
• retroperitoneal phlegmon (kutulutsa kwa minofu ya retroperitoneal),
• purulent paranephritis (kutukusira kwa mafinya a perinephric),
• chiwindi zotupa
• purulent Mediastinitis (kutupa kwa mediastinum),
• chibayo (chotupa cha m'mapapo),
• yogwira purative pleurisy (kutupa kwa m'mapapo),
• fibrinous pericarditis (kutupa kwa khungu lakunja kwa mtima),
• sepsis (poyizoni wamagazi).

Oyambirira mavuto a pachimake kapamba kumatha mu magawo oyambirira a zilonda zam'mimba, zomwe zimapangitsa kwambiri matendawa.

Izi zikuphatikiza ndi izi:

• kugwedeza
• m'mimba,
• kuphipha kwa minofu ya bronchial ndi mitsempha yamagazi m'mapapo,
• pachimake chiwindi ndi impso,
• kulephera kwa mtima
• matenda edema,
• thrombosis yamitseko yam'madzi ndi mitsempha,
• matumbo paresis (kufoola minofu),
• kuledzera.

Mavuto apakati a pancreatitis pachimake akuphatikizira mitundu yonse ya zotupa za purcin-septic zokhudzana ndi pancreatic necrosis, komanso:

• cysts
• fistulas
• Mitsempha yamkati ndi magazi akunja,
• compression ya wamba bile duct, kutulutsa kwam'mimba ndi duodenum,
• chotupa chotchinga
• kuwonongeka kwa mitsempha yambiri (polyneuritis) chifukwa cha kuledzera kwa thupi kwakanthawi.

Chithandizo cha kapamba

Mu chifuwa chachikulu cha pancreatitis, njira zamankhwala zimadalira momwe wodwalayo adalandiridwira kuchipatala. Ngati sipakufunika kuchitidwa opaleshoni mwadzidzidzi, kusala kudya kumagwiritsidwa ntchito, nthawi zambiri mpaka masiku 4-6 ndikulowetsedwa kwamadzi ndi kulowetsedwa kwa shuga. Zizindikiro zopweteka kwambiri zikatha, chakudya No. 5p chimagwiritsidwa ntchito.

Mankhwalawa edmatous mawonekedwe a kapamba, njira zotsatirazi zotchulidwa:

• Pakusanza kwambiri, chubu cha nasogastric chimayikidwa ndikuyika m'mimba.
• Reopoliglyukin njira zimayendetsedwa kudzera m`mitsempha kuti muchepetse magazi.
• Pofuna kuthana ndi poizoni, hemodezis, jakisoni wa zosakaniza zamtunduwu amachitidwa.
• Kuchepetsa kuphipha kwamatumbo a kapamba - jakisoni wa papaverine, atropine, drotaverine.
• Pofuna kuchepetsa kukhathamira kwa mtima, mphamvu ya kusinkhira - ma antihistamine kudzera mu mankhwala a chloropyramine, promethazine.
• Kuti muchepetse kupweteka, muchepetse kutupa, sinthani kutuluka kwa pancreatic madzi - procaine blockade perirenally, blockade ofzungulira ligament ya chiwindi, jakisoni wa procaine, ganglion blockers.

Njira zochizira pancreatic necrosis:

• Ndi hemorrhagic pancreatic necrosis - kusamutsa mwachangu kwa chisamaliro chachikulu.
• Pofuna kusintha kagayidwe kachakudya njira - kulowetsedwa kwa mayankho a shuga, sodium bicarbonate, hemodeis, kuyambitsa kwa plasma ya magazi, albumin.
• Kukondoweza kwa kutuluka kwa mkodzo (jakisoni wa mannitol, mannitol, furosemide).
• Intravenous Inde mankhwala ndi cytostatics, zosakaniza zamitsempha, proteinase zoletsa kuti athetse kutupa, edema, kuchepetsa kuchuluka kwa kaphatikizidwe ka enzyme. Inhibitors of proteinases nthawi zambiri amathandizidwa ndi mankhwalawa (kugwedezeka kwa mankhwala ndi Gordox, Contrical, Trasilol).
• Ndi zovuta za matenda a kapamba, maantibayotiki amagwiritsidwa ntchito.
• Pofuna kuchepetsa kugawa kwa ma enzymes, intragastric hypothermia imagwiritsidwanso ntchito, pozizira kapamba.
• Ndi kutupa kwambiri - kufinya kwamasamba a magazi a wodwalayo, mankhwala a radiation.
• Kuchotsa poizoni - plasmapheresis.

Njira zochizira matenda kapamba:

• Ma antihistamines (cimetidine, suprastin).
• Antispasmodics (palibe-shpa, drotaverine, nitroglycerin, aminophylline).
• Cholinolytics (platifillin, atropine, scopolamine, pentoxyl, methyluracil).
• Cytostatics (Vincristine, Frorafur, cyclophosphamide). Mankhwala amatha kuyambitsidwa mu thunthu la celiac kudzera mu catheter, yomwe imawonjezera phindu lawo.
• Pancreatic enzymes (methionine, pancreatin).
• Maantibiotic - kupewa matenda a retroperitoneal fiber (Zeporin, Kanamycin, Trichopolum).
• Mavitamini, chithandizo ndi madzi amchere, kuchezera ma sanatoriums.
• Ndi matenda a shuga, kukonza kwake ndi njira zofunikira zamankhwala zimachitika.

Ngati pali vuto chifukwa mankhwalawa, mapangidwe a cysts ndi fistulas kapena kupitirira kwa peritonitis, ntchito akuwonetsa - kutulutsa kwam'mimba, kupuma kwam'mimba, kuchotsa kwa foci ya necrosis, kupweteka kwam'mimba, kuphatikizika ndi splenectomy, kuchotsa kwa m'mimba, etc.).

Post-necrotic

Pambuyo-necrotic mavuto pachimake pancreatic kutupa:

• zotupa zamkati komanso zochulukirapo za zotupa zaumunthu ndi machitidwe,
• kuchuluka kwa madzimadzi m'mimba,
• zazikulu zonama
• Kulephera kwamitundu yambiri (kusokonekera kwa ziwalo zingapo komanso machitidwe nthawi imodzi).

Matenda a pancreatic, opanga ma enzyme ambiri, ovuta kutuluka kwa pancreatic madzi ndikukula kwa zovuta:

• matenda
• matumbo a rectum, zilonda zazing'ono kapena duodenal,
• uchidakwa
• kuperewera kwa zakudya m'thupi
• kuchuluka kwa mitsempha,
• helminthic infestations.

Kutembenuka kwapakati pa ndulu ndi michere ya m'mimba ndi zovuta za pachimake kapamba, komanso kuwonjezeka kwa madzi a enzymatic, kumabweretsa kusintha kwa kachitidwe ka kapamba, kulowetsedwa (kutayikira) kwa katemera wa kapamba m'maselo a thupi ndi kudzimbidwa kwawo. Njirayi ikutanthauza kusintha kwamphamvu kwa chiwalo.

Ma Enzymes, akugwera m'magazi ambiri, amachepetsa mphamvu ya mitsempha yamagazi, kuwonongeka kwa makoma awo ndi kupasuka kwa ma capillaries. Izi zimakwiyitsa ochepa kuphipha, magazi, kutaya magazi, edema ndi necrosis (kufa) kwa minyewa yam'mimba.

Mavuto owononga a purulent amayambitsidwa ndi ntchito ya staphylococci, streptococci, fungi, matenda am'mimba (Escherichia coli) ndi microflora ina ya pathogenic yomwe imakhala m'matumbo am'mimba komanso kayendedwe kazinthu ka magazi ka munthu.

Pancreatitis pachimake ndi zovuta zake amadziwika ndi angapo chizindikiro chosonyeza matenda.

Zizindikiro zakukula kwamasinthidwe owononga m'mapapo:

• kupweteka kwambiri m'chiuno m'chigawo cha epigastric,
• nseru
• kusanza mobwerezabwereza popanda mpumulo,
• tachycardia, kupweteka kumbuyo kwa sternum,
• kuthamanga kwa magazi
• ziume zowuma,
• khungu la khungu ndi khungu la maso (poizoni hepatitis),
• nkhope ziwonekere (redness inayamba chifukwa cha mitsempha ya magazi kusefukira),
• khungu la m'mimba ndi thunthu,
• ukufalikira
• kupuma movutikira
• malungo
• kulephera kudziwa.

Mu kuyezetsa kwachipatala, kusintha kwa ma cell kumadziwika - kuchuluka kwaposachedwa kwamitsempha, leukocytosis.

Zomwe zimachitika mwa amayi ndi abambo:

• lymphocyte - 1.2 - 3.0x10 * 9 / l,
• maselo oyera oyera - 4.0 - 9.0x10 * 9 / l.

Ndi pancreatic syndrome, kusokonezeka kwamaganizidwe kumawonedwa - uku ndikutaya mtima, mantha, kukwiya, ulesi.

Malangizo

Mu chifuwa chachikulu cha pancreatitis, masewera olimbitsa thupi amapindulitsa. Amagwiritsidwa ntchito 2 pa tsiku kwa mphindi 20. Pa chikhululukiro, chithandizo champhamvu zamagetsi, mankhwala othandizira matope, kugwiritsa ntchito ozokerite m'dera lumbar, malo osambira a coniferous amasonyezedwa. Chithandizo cha Sanatorium m'mabungwe amtundu wa gastroenterological zimathandizanso.

Zakudya ndi thanzi thanzi

Wodwala akangololeza kudya, menyu amaphatikizidwa poganizira zovuta zomwe mafuta amaletsa, kuchepetsa kuchuluka kwa mapuloteni ndikuwonjezera kuchuluka kwa chakudya chamafuta. Chakudya chimadyedwa m'magawo ochepa kwambiri mpaka 6 pa tsiku.

Kutengera ndi momwe munthu aliri, kukulira kwa makulidwe a zinthu kumatha kuchitika masabata 1-2 atatha kuukira. Kwa nthawi yayitali, okazinga, mafuta, zakudya zotsekemera, mkate watsopano, msuzi wa nyama, nyama yamafuta, zakudya zamzitini, caviar, mazira, nyemba, zipatso zosaphika, zonunkhira, zakumwa za kaboni, khofi, msuzi wa phwetekere samayikidwa.

Mbale zonse zimadyedwa m'njira yoyera pambuyo poti mwawotcha, mukuwotcha.

Njira zina zochizira

Ochiritsira achikhalidwe pancreatitis amalengezedwa kuti atengere infusions:

1. Zipatso za anise, chimanga stigmas, udzu wa celandine, malo okwera, tricolor ndi dandelion violet zimasakanikirana magawo ofanana, tengani supuni 1 ya chopereka ndikupatseni ndi kapu yamadzi. Imwani 30 ml. katatu patsiku.
2. Maphunzirowa atatha kumwa kale (masiku 14), zotsatirazi zakonzedwa: mbewu za katsabola, masamba a mbewa, zipatso za hawthorn, maluwa a chamomile amaphatikizika ndipo kulowetsedwa kukonzedwa molingana ndi maphikidwe ofanana. Kuchulukitsa ndi 50 ml. Katatu patsiku.
3. Mabulosi amtundu wakuda ndi mabulosi akuda amasintha kapamba. Zitha kudyedwa mwanjira inayake, koma mumatha kuphika zakumwa za zipatso, zakudya zonunkhira, zipatso zabwino, kunena zipatso zouma ndi kumwa ngati tiyi.

Mavuto oyambira

Kuyambiranso koyambirira kumatha kuyenda ndi kapamba kuyambira pachiwonetsero chake ndipo kungakulitse vutolo. Amakula chifukwa cha kusachita bwino komanso kupanga kwambiri ma enzymes olimbitsa thupi.

Mavuto oyambilira akuphatikiza:

• Matenda a pleuropulmonary,
• aimpso ndi chiwindi kulephera,
• kugwedeza
• kulephera kwa mtima
• magazi ndi zilonda zam'mimba ndi matumbo,
• peritonitis
• matenda amisala chifukwa chakumwa thupi,
• jaundice
• Mitsempha yamagazi mumitsempha,
• pericarditis.

Kuwonongeka kofala kwambiri ndi enzymatic peritonitis. Zimachitika pafupifupi theka la odwala. Mtundu wa zomwe zili mkati mwake zitha kukhala zosiyana - kuchokera ku serous mpaka purulent.

Kuti muzindikire matendawa, ndikofunikira kuyang'anira khungu, kutentha kwa thupi, kupuma, kukoka ndi kuthamanga kwa magazi. Pakhoza kukhala Zizindikiro za encephalopathy ndi chiwindi ntchito.

Mochedwa mavuto a pachimake kapamba

Kucheperachepera kumadziwika ndi kuwonjezeredwa kwachiwiri. Amachitika pakadutsa masabata awiri kuchokera pachiwonetsero cha matendawa.

Otsatirawa ndi osiyana.:

• zotupa m'mimba,
• purulent njira ya kapamba,
• phlegmon
• fistulas m'mimba ndi matumbo,
• parapancreatitis,
• fistulas ndi pancreatic necrosis,
• phlebitis
• magazi poyizoni
• magazi (mkati ndi kunja),
• chotupa neoplasms mu gland.

Choopsa kwambiri pakati pawo ndi sepsis. Nthawi zambiri zimatsogolera kuimfa.

Mkhalidwe wopweteketsa umadziwika ndi njira yoopsa ya kapamba.

Kuwonetsedwa kwa nkhaniyi:

1. Kupweteka kwambiri m'mimba khoma kapena kuwonekera kumbuyo.
2. Cyanosis ya pakhungu (acrocyanosis). Izi zimachitika chifukwa choperewera magazi mosavuta kwa capillaries ang'onoang'ono a pakhungu. Monga lamulo, zala zakumapeto, makutu, milomo imatembenukira kwamtambo.
3. Kukongola kwa khungu.
4. Kusintha pakupumira. Imakhala yowonjezereka komanso imakhala yowonjezereka.
5. Mtima palpitations ndi zotheka arrhythmia.
6. Zizindikiro za Ischemic. Imapezeka pogwiritsa ntchito ultrasound.
7. Kuchuluka kwamkodzo tsiku ndi tsiku kumachepetsedwa kwambiri.
8. Kusokonezeka kwamkati mwa dongosolo lamanjenje. Amawonetsedwa mu psychomotor mukubwadamuka.

Hepatic-aimpso kulephera

Zizindikiro zotsatirazi ndi izi:

• kukula kwa chiwindi kukula kwake,
• kusowa kwa mkodzo kapena chimbudzi,
• khungu louma ndi nembanemba
• Kupanikizika kwa magazi kumakwera mpaka 200 kapena kuposa,
• chikasu pakhungu ndi sclera,
• kusokoneza maganizo
• palpitations.

Kusintha kwakukuru m'magazi ndi mkodzo kuyesa kumachitika. Chiwerengero cha maselo amwazi amachepa, zomwe zili mu albumin ndi bilirubin zimachulukanso. Minyewa ndi acetone yamagazi, urea ndi creatinine ikuchulukirachulukira.

Pleuro m'mapapo mwanga zovuta

Matenda ofala kwambiri pakati pa odwala omwe ali ndi pancreatitis pachimake. Kukhalira mbali yakumanzere kumakhala kofala kuposa kumanzere ndipo zimayambitsa zovuta zam'mapapu. Uku ndikulephera kupuma, komwe kumadziwunikira pakhungu la khungu, kupuma kosachepera, kupuma pang'ono ndi kupweteka kumbuyo kwa sternum.

Mothandizidwa ndi maphunziro a X-ray, ndizotheka kuzindikira kukhalapo kwa chidwi cha m'mapapu.

Zovuta za purulent

Mavuto a purulent amakhala ndi zizindikiro zotsatirazi:

• malungo
• kugunda kwa mtima
• thukuta kwambiri
• kulowetsedwa kwa minofu.

Kuti mupewe zovuta zovuta izi ngati muli ndi vuto la pancreatitis yacute, ndikofunikira kuti mupite kuchipatala msanga. Zotsatira zina zimatengera kuthamanga ndi mtundu wa thandizo.

Mavuto a pambuyo ndi kapamba

Pambuyo pancreatitis, zovuta zingapo zimatha kuwonedwa, pomwe zomwe zimachitika kwambiri ndizopanga zomwe zimatchedwa cysts zabodza, zosankhidwa ndi palpation m'dera la kapamba. Zokha, ma cysts abodza sakhala ma neoplasms: ichi ndi kuchuluka kwa magazi, michere yam'mimba ndi minofu yakufa ya pancreatic yomwe imangokhala mwachindunji mu England kapena minofu yowazungulira.

Zomwe zimachitika pancreatitis zimawonedwa pakumuchira odwala omwe ali ndi vuto la pancreatic. Kukula kwa ma cysts abodza kumadalira zinthu zambiri: malo, kapangidwe ndi kukula kwake.

Nthawi zina, amatha kusungunuka okha, koma nthawi zambiri amafunikira kuchitapo kanthu, komwe ma cyst amatsegulidwa ndikutsukidwa.

Ngati izi sizichitika, ma cyst abodza amatha kuthandizira, omwe amachititsa kuti pakhale kupanikizika kwambiri kwa kapamba, komwe kumalumikizidwa ndi abscess komanso mwayi wokhetsa magazi.

N`zotheka kudziwa kukula kwa kuphatikizika kwa kapamba mu mawonekedwe a cyst yabodza pakuwunika kwa wodwala amene akuchira msanga, pomwe malo a ma cysts, komanso kukula kwake ndi mawonekedwe, zimatsimikiziridwa mosavuta.

Pambuyo kuukira kwa kapamba, zovuta za purulent zimawonedwanso.Zifukwa zenizeni zakukonzekera kwawo sizinakhazikitsidwebe. Mu malo azachipatala, zokambirana zikuchitika mosaletseka komwe kumayambitsa matenda opatsirana omwe amalowetsa minyewa ya zikondamoyo zomwe zimayambitsa ndikupanga mapangidwe.

Ngakhale kusowa kwa mgwirizano pazomwe zimayambira purifiyamu, njira yothandizira mankhwalawo imakhala yomweyo: njira zothandizira zimapangidwa, kuchitapo kanthu opaleshoni mwachangu, cholinga chake ndikutsegula thumba ndi kukhetsa.

Mavuto owononga a pancreatitis amatha kutsimikizika pamtunda wa kutentha, kuzizira, komanso vuto lakelo. Ngati zinthu sizitengedwa munthawi yake, munthu akhoza kufa.

Vuto lalikulu kwambiri pambuyo pancreatitis limatha kukhala kutulutsa magazi, omwe amapangidwa chifukwa cha kupangika kwa ziwiya za kapamba. Choyipa chachikulu ndikuwombera kwa splenic artery.

Magazi amatha kudziunjikira mozungulira, komanso m'mimba. Poterepa, pali kutsika kwa kuthamanga kwa magazi, kugunda kwa mtima ndi mantha a wodwala.

Kukula kwa vuto lalikulu motere kumadalira makamaka kuchitapo kanthu pakuchita opareshoni.

Mavuto aakulu a kapamba

Mavuto a chifuwa cham'mimba nthawi zambiri amawonongeka paziwalo, pantchito zake zokhudzana ndi kapamba.

Nthawi zambiri awa amakhala zotupa za chiwindi ndi biliary thirakiti: hepatitis yotupa, cholestasis yokhala ndi kapena ya jaundice, matenda otupa a bile ducts - purulent cholangitis, cholecystitis.

Chifukwa cha kuyandikira kwa diaphragm ndi pleural patsekeke, zovuta monga kugwiranso ntchito kwa kuphatikizika kwam'mimba ndi chibayo sizachilendo.

Nthawi zambiri kuphatikizika kwa matenda kapamba kumawoneka ngati cysts ndi pseudocysts. Izi ndichifukwa choti kutupa kosatha kumapangitsa kuti madzi a pancreatic atuluke kwambiri. Cysts ndi zowona komanso zabodza. Ma pseudocysts ndi ochulukirapo, pafupifupi 80% ya milandu yonse.

Ubale wapakati pakati pa chifuwa chachikulu cha khansa yapakhungu ndi khansa ya pancreatic watsimikiziridwa. Malinga ndikuwonera kwanthawi yayitali, mwa odwala omwe adadwala chifuwa chachikulu kwa zaka 20, chiwopsezo cha khansa ya kapamba chimachokera ku 4 mpaka 8%, omwe ndi okwera 15 kuposa anthu ambiri.

Ngakhale anthu ambiri amakhulupirira, matenda ashuga siwofala kwambiri wa kapamba, komabe, kuonjezeraku kumawonjezeka kwambiri ngati kapamba ndi chidakwa. Chiwopsezo chokhala ndi matenda a shuga chaka chilichonse chikhansa cham'mimba chimakhala pafupifupi 3-3,5%.

Zovuta zam'minyewa ndi m'mimba zimawerengedwa kuti ndizosavomerezeka; izi, monga lamulo, zotupa zam'mimba za mucous membrane wa chimbudzi.

Potengera maziko awa, kuchepa kwa magazi m'thupi kwachuma kumatha kulumikizana - chifukwa cha kuchepa magazi pafupipafupi komanso chifukwa cholumikizira chitsulo ndi nembanemba ya mucous.

Kuphatikiza apo, pafupifupi zaka 10 atadwala matendawa, odwala ena amatenga matenda a gastroesophageal Reflux (GERD).

Matenda a kapamba angayambitse kukula kwa matenda oopsa a portal ndipo, chifukwa chake, kudzikundikira kwa impalation yam'mimba (ascites). Matenda oopsa a portal, nthawi zambiri, amakhumudwitsa mitsempha ya varicose ya esophagus komanso kukula kwa Mallory-Weiss syndrome, yowonetsedwa ndi magazi ambiri akumitsempha. Zotsatira zake, odwala amamva kuchepa kwa magazi m'magazi.

Kuletsa kwa duodenal kusokoneza ndikusowa kwachilengedwe komwe kumagwira ntchito mwachilengedwe. Zimachitika chifukwa cha zokoka zam'thupi zomwe zimabwera ku minofu yomwe imayendetsa lumen ya duodenum 12 kuchokera pakuyang'ana kutupa (kapamba)

Kukula kwa matendawa ndi kukula kwa zovuta zingapo

Pancreatitis pachimake ndi matenda omwe amafa kwambiri. Itha kufikira 7-15%, ndipo mawonekedwe ake monga pancreatic necrosis - mpaka 70%. Choyambitsa chachikulu cha kufa ndi matendawa ndi zovuta za purulent-septic, zomwe zimayendera limodzi ndi kulephera kwa ziwalo zambiri komanso kuledzera kwambiri.

Chithandizo chachikulu pa maphunziridwe ndi kudwala kwa matendawa kumachitika chifukwa cha mowa. Ndi kusiyidwa kwathunthu kwa mowa, kupulumuka kwa zaka 10 kumawonedwa muoposa 80% ya odwala. Ngati wodwalayo akupitiliza kumwa, chizindikirochi chimatsika ndi theka.

Kulephera kwamatenda a kapamba kumafikira pafupifupi 15% ya odwala onse.