Pancreatic cyst > Zikondwerero

Pancreatic cyst (ICD10 code - K86.2) ndi khola lomwe lazunguliridwa ndi kapisozi komanso lodzaza madzi. Njira yodziwika kwambiri yopanga zotupa zam'mimba ndi kapamba ndi post-necrotic cysts. Ku chipatala cha Yusupov, madokotala amazindikira cysts mu kapamba pogwiritsa ntchito njira zamakono zofufuzira: ultrasound (ultrasound), retrograde cholangiopancreatography, maginito a resonance imaging (MRI). Kupimidwa kwa odwala kumachitika pogwiritsa ntchito zida zamakono zofufuzira kuchokera kwa opanga otsogolera.

Chiwerengero cha odwala omwe adapezeka ndi cystic zotupa za kapamba zakula kwambiri m'zaka zaposachedwa. Kuwonjezeka kosawerengeka kwa chiwopsezo cha pancreatitis yovuta komanso yosatha, kuwonjezeka kwa mitundu yowonongeka komanso yovuta yamatenda kumathandizira izi. Kuwonjezeka kwa pafupipafupi kwa-post-necrotic pancreatic cysts kumathandizidwa ndi kufunikira kofunikira kwambiri pobweretsa njira zothandiza zolimbikitsira zochizira pachimake komanso chikhansa chodwala.

Poyerekeza ndi chithandizo champhamvu chamankhwala, othandizira pachipatala cha Yusupov amatha kusiyitsa njira zowonongeka ndikuchepetsa pafupipafupi zovuta za purulent-septic. Opaleshoni amagwiritsa ntchito njira zatsopano zochizira pancreatic cysts. Milandu ingapo yamatendawa imakambidwa pamsonkhano wa Katswiri Wazopanga ndi kutenga nawo gawo kwa akatswiri ndi madokotala a gulu lapamwamba kwambiri. Madokotala otsogola otsogolera pamodzi amaganiza machitidwe a wodwala. Kukula kwa ma pancreatic cysts kumakhudza kusankha kwa chithandizo cha matendawa.

Mitundu ya ma pancreatic cysts

Crents ya Congenital (dysontogenetic) pancreatic cysts imapangidwa chifukwa chakuwonongeka kwa ziwalo zazing'onoting'ono ndi kachitidwe kake ka mzere. Acanc pancreatic cysts ndi awa:

Kusungidwa - kukhazikitsidwa chifukwa chochepetsera zimbira za kutulutsa tizi, kutulutsa kolimba kwa kuwala kwawo ndi ma neoplasms, miyala,
Degenerative - yopangidwa chifukwa cha kuwonongeka kwa tiziwalo tamatumbo nthawi ya kukokomeza necrosis, njira ya chotupa, zotupa za m'mimba,
Proliferative - ma neoplasms oyenda mkati, omwe amaphatikizapo cystadenomas ndi cystadenocarcinomas,
Parasitic - echinococcal, cysticercic.

Kutengera zomwe zimayambitsa matendawa, ma pancreatic cysts a chidakwa komanso kukulira chifukwa cha cholelithiasis amadzipatula. Chifukwa cha kuchuluka kwa zachiwawa zomwe zimachitika pafupipafupi, ngozi zapamsewu, masoka achilengedwe komanso tekinoloje, kukhazikitsidwa kwa ma pancreatic cysts ovulala kwambiri pamimba kukukula.

Kutengera komwe kuli mapangidwe a cystic, pamatha kukhala ndi kuzungulira kwa mutu, thupi kapena mchira wa kapamba. Cysts owona amapanga 20% ya ma cystic omwe amapanga kapamba. Zoona zenizeni zimaphatikizapo:

Congenital dysontogenetic gland cysts,
Wopezeka posungira,
Cystadenomas ndi cystadenocarcinomas.

Mbali yodziwika bwino ya cyst yoona ndi kupezeka kwa chingwe chamkati mkati mwake. Ma cysts owona, mosiyana ndi mawonekedwe abodza, nthawi zambiri samafikira kukula kwakukulu ndipo nthawi zambiri amapezeka mwangozi mukam'chita opareshoni.

Cyst yabodza imawonedwa mu 80% ya pancreatic cysts iliyonse. Amapangidwa pambuyo povulala kwachiwindi kapena kapamba owononga kwambiri, kamene kamayendera limodzi ndi necrosis ya minofu, kuwonongeka kwa makoma a duct, zotupa ndi kutuluka kwa madzi a pancreatic kupitirira England. Makoma a cyst abodza ndi peritoneum yolumikizidwa komanso minofu yolimba, yopanda zingwe za epithelial kuchokera mkati, koma amayimiriridwa ndi minofu ya granulation. Mitsempha ya cyst yabodza nthawi zambiri imadzazidwa ndi minofu ya necrotic komanso madzimadzi. Zomwe zili mkati mwake ndi serous kapena purulent exudate, yomwe imakhala ndi kuphatikizika kwakukulu kwa maunda ndi magazi osinthika, otayika madzi a pancreatic. Ma cyst abodza amatha kukhala m'mutu, thupi ndi mchira wa kapamba ndikufikira zazikulu. Imawululira 1-2 malita okwanira.

Mwa mawonekedwe a cystic a kapamba, madokotala ochita opaleshoni amasiyanitsa mitundu yayikulu yotsatirayi, yomwe imasiyana m'njira ndi zoyambitsa, mawonekedwe a chithunzi cha chipatala ndi morphology yofunikira pakugwiritsa ntchito njira zopangira opaleshoni:

Ma cysts abodza a extrapancreatic amachitika chifukwa cha kuvulala kwa kapamba kapena kuvulala kwapamba. Amatha kukhala ndi chikwama chokwanira, kumanzere ndi kumanja kwa hypochondria, nthawi zina komwe kumakhala m'malo ena a chifuwa ndi m'matumbo am'mimba, malo obwezeretsanso,
Intrapancreatic onyenga cysts nthawi zambiri amakhala complication ya yobwereza-pancreatic necrosis. Amakhala ochepa, nthawi zambiri amakhala m'mutu wa kapamba ndipo nthawi zambiri amalumikizana ndi kayendedwe kake,
Kuchulukitsa kwa ma pancreatic ma ducts amtundu wa kukomoka nthawi zambiri kumachitika ndi pancreatitis yoledzera.
Zoyeserera posungira nthawi zambiri zimachokera ku ma distal pancreas, zimakhala ndi makoma owonda ndipo siziphatikizidwa ndi tinthu tating'ono,
Ma cysts angapo owonda komanso osasinthika samasinthidwa m'magawo otsala a kapamba.

Gawo la pancreatic cyst mapangidwe

Njira yopangidwira kwa postcrotic pancreatic cyst imadutsa magawo anayi. Pa gawo loyamba la mawonekedwe a chotupa mu thumba lokutira, kumapangidwa khomalo, lodzaza ndi exudate chifukwa cha pancreatitis pachimake. Gawoli limatha miyezi 1.5-2. Gawo lachiwiri ndi chiyambi cha kapangidwe ka kapisozi. Vuto lotayirira limawonekera pagulu la pseudocyst wosasinthika. Tishu za Necrotic zomwe zimalowetsedwa ndi polynuclear zimasungidwa mkati. Kutalika kwa gawo lachiwiri ndi miyezi 2-3 kuyambira pomwepo.

Pa gawo lachitatu, kupangika kwa kapisozi kakakulu ka pseudocyst, kamene kamasungidwa mwamphamvu ndi minofu yoyandikana nayo, kumamalizidwa. Njira yotupa ikuchitika kwambiri. Ndi yopindulitsa. Chifukwa cha phagocytosis, chotupa chimamasulidwa ku minofu ya necrotic ndi zinthu zowola. Kutalika kwa gawo ili ndi kuyambira pa miyezi 6 mpaka 12.

Gawo lachinayi ndikudzipatula kwa chotupa. Patangotha chaka chimodzi, njira zowonongera zomatira pakati pa khoma la pseudocyst ndi minofu yoyandikana nazo zimayamba. Izi zimathandizidwa ndi kusasunthika kosasintha kwa ziwalo zomwe zimaphatikizidwa ndi cyst yosasunthika, komanso kutalika kwa nthawi yayitali kwa ma protein a proteinolytic adhesions. Ma cyst amakhala mafoni, amatha kuonekera mosavuta kuchokera kuzinthu zoyandikira.

Zizindikiro ndi chizindikiritso cha pancreatic cysts

Zizindikiro zamatenda a pancreatic cyst zimayamba chifukwa cha nthenda yomwe idayamba, kukhalapo kwa chotupa chake komanso zovuta zomwe zidabuka. Ma cyst ocheperako amatha kukhala asymptomatic. Mu chifuwa chachikulu komanso chakhansa panthawi yomwe matendawa ayambiranso, madokotala a chipatala cha Yusupov amawona mawonekedwe osapweteka kwambiri m'dera lomwe zimayimira pancreas, zomwe zingatanthauze chotupa cha gland. Nthawi zambiri asymptomatic amakhala ndi ma cysts amkati, mawonekedwe osungira ndi cystadenomas ang'ono.

Ululu, kutengera kukula kwa chotupa ndi kupanikizika kwa ziwalo zoyandikana ndi mawonekedwe a mitsempha, pama solar plexus ndi mitsempha yodutsa m'matumbo akuluakulu, imatha kukhala paroxysmal, mawonekedwe a colic, lamba kapena kufooka. Ndikumva kupweteka kwambiri, wodwala nthawi zina amakhala ndi mkono wonyamula mawondo, kugona mbali yakumanja kapena kumanzere, kuyimirira, kutsamira kutsogolo. Kupweteka komwe kumayambitsidwa ndi cyst kumavoteredwa ndi odwala ngati kumverera kolemetsa kapena kukakamiza mu dera la epigastric, lomwe limakulirakudya.

Kupweteka kwambiri kumayendera limodzi ndi mawonekedwe owopsa a cyst koyambirira kwa mapangidwe ake. Ndizotsatira zamapapo a zoopsa kapena zoyambira ndi kupsinjika kwa pang'onopang'ono kwa minyewa. Kupangidwe konga chotupa, komwe kumamveka m'chigawo cha epigastric, ndiye chizindikiro chodalirika kwambiri cha pancreatic cyst. Nthawi zina chimadzuka ndikuzimiririka. Ichi ndi chifukwa kutsanulira kwakanthawi kwamayendedwe a cyst mu pancreatic duct.

Zizindikiro zosowa kwambiri za pancreatic cyst ndi izi:

Kuchepetsa mseru
Kubwula
Kutsegula m'mimba
Kutentha kwamphamvu
Kuchepetsa thupi
Zofooka
Jaundice
Khungu loyera
Ascites (kudzikundikira kwamadzi m'mimba).

Nthawi zina zimakhala zotheka kudziwa kukhalapo kwa mthunzi, malo omwe amafanana ndi malire a cyst, mwa kafukufuku wa radiograph wam'mimba. Ma CD a ma cysts amadziwika kwambiri ndi duodenography mumkhalidwe wochita kupanga. Kuwala kwa thupi ndi mchira wa tinthu tamatumbo tambiri pa x-ray nthawi zambiri kumapangitsa kuwonongeka kwam'mimba. Chikwangwani chozaza chozungulira, chomwe chimapangidwa pamenepa, chimakulolani kukayikira cyst. Ma cyss akuluakulu omwe amatsikira pansi nthawi zina amapezeka nthawi ya irrigoscopy.

Pancreatic cysts amapukutidwa bwino pa angiography ya nthambi za celiac mtsempha wamagazi. Madokotala a chipatala cha Yusupov amalandila chidziwitso chofunikira chokhazikitsa matenda ndi retro-pneumoperitoneum ndi pneumoperitoneum molumikizana ndi urography. Kudziwa kuchuluka kwa michere ya pancreatic (amylase ndi lipase) m'magazi ndi mkodzo ndikofunikira kwambiri kuti munthu adziwe kuti ali ndi vuto lozindikira. Zovuta za chinsinsi cha kapamba ndizosowa kwambiri ndi cysts.

Kodi chiwopsezo cha chotupa chamkati chimakhala chiani? Pancreatic cysts nthawi zambiri imabweretsa zovuta, zomwe zimawonetsedwa makamaka ndi kupindika kwa ziwalo zosiyanasiyana: m'mimba, duodenum ndi ziwalo zina zamatumbo, impso ndi ureter, mtsempha wamtundu, ndi ducts ya bile. Kutupa kwa pancreatic cyst kumayambitsa kutupa kwa peritoneum (peritonitis). Popereka matenda osiyanasiyana, madokotala pachipatala cha Yusupov samachotsa zotupa ndi ziwindi za chiwindi, mitundu yosiyanasiyana ya splenomegaly, hydronephrosis ndi neoplasms ya impso, zotupa ndi ma cysts a retoperitoneal space, mesentery ndi ovary, clumsy zilonda zam'mimba komanso aortic aneurysm.

Chithandizo cha pancreatic cysts

Kuzindikiritsa kwa cancps pancreatic cysts nthawi zambiri kumatsimikizira zomwe zikuwoneka kuti akuchitidwa opareshoni. Mtundu wa opaleshoni zimatengera zinthu izi:

Zoyambitsa mapangidwe a cystic,
Moyo wa cyst
Chitukuko, kukula, mawonekedwe ake,
Mlingo wokhudzana ndi pancreatic duct system,
Mavuto
Kukhalapo kwa zotupa zokhudzana ndi ziwalo zoyandikana ndi kapamba.

Kodi tsogolo la pancreatic mchira cyst ndi chiyani? Mu 8-15% ya milandu, kuwongolera kokha kwa cysts kumatha kuchitika mpaka kutha kwathunthu motsogozedwa ndi anti-yotupa. Chifukwa chake, lingaliro la kuthekera kogwiritsa ntchito machitidwe oyembekezera-pakakhala gawo la kukhalapo kwa pancreatic cyst powerengera "kudzichiritsa nokha" pazambiri zochuluka ndizolakwika. Kuzindikira wodwala wokhala ndi pancreatitis yayikulu ndi ma pancreatic cyst, madokotala a ku chipatala cha Yusupov amawona kuti ndi chidziwitso chokwanira chothandizira opaleshoni. Kusankha kwa nthawi yoyenera, voliyumu ndi mtundu wa opaleshoni yolowerera ikuchitika pamodzi.

Maubwino opangira ma pancreatic cysts amagawidwa m'magulu asanu m'magulu asanu:

Kutulutsa kwakunja kwa cyst
Kukhetsa kwamkati kwa chotupa (kukhazikitsidwa kwa anastomoses wamkati pakati pa khoma la cyst ndi magawo osiyanasiyana am'mimba),
Mitsinje yakunja yamkati,
Njira zopangira opaleshoni yayikulu (kukulitsa ma cyst ndi ma pancreatic resection okhala ndi cyst)
Laparoscopic, endoscopic ndi zina zowonjezera zowononga ma phula-catheterization ngalande, zomwe cholinga chake ndi kukhetsa kwakunja kapena mkati mwamkati mwa cysts moyang'aniridwa ndi zida zoganiza zamankhwala.

Kwambiri komwe kumapangidwa khoma la ma cystic mapangidwe, ndi mipata yambiri yochitira kuchitapo kanthu mosadukiza. Mikhalidwe yabwino kwambiri yothandizira opaleshoni imayamba miyezi isanu ndi umodzi ndi itayi itatha nthawi ya chitukuko cha cyst, pamene khoma lake limapangidwa bwino ndipo kutupa kumadutsa. Pankhaniyi, pakufika pachimake matenda, madokotala ochita opaleshoni amayesa kuchita chithandizo chokwanira, chomwe cholinga chake ndi kupewetsa zovuta. Zowonjezera zowonjezera zowerengeka zimachitika mosasamala gawo la chitukuko cha cyst.

Zomwe zimafunikira pakuthandizira opaleshoni yofunika ndi izi:

Kukhalapo kwa kukaikira koyenera kwa chitukuko cha zovuta za mapangidwe a cystic,
Kukula kopitilira patsogolo kwamaphunziro, ngakhale chithandizo chamankhwala chosasamala.
Kukhalapo kwa zizindikilo zotsimikizika za chotupa cha ma cystic process.

Kuti mupeze mayeso ndi chithandizo cha mankhwala a pancreatic cysts, pezani nthawi ndi dokotala wa opaleshoni kuchipatala cha Yusupov poyimbira tsiku lililonse la sabata, mosasamala nthawi ya tsiku.

Zambiri

Pancreatic cyst ndi matenda, kufalikira kwa komwe m'zaka zaposachedwa kwachulukako kangapo, ndipo achinyamata ambiri amakhudzidwa. Gastroenterologists amawona chifukwa cha ichi pakuwonjezeka kwa pacreatitis yovuta komanso yopweteka yamatenda osiyanasiyana (uchidakwa, biliary, traumatic). Pancreatic cyst ndiye chovuta kwambiri chokhala ndi kapamba (mpaka 80% ya milandu). Kuvuta kwa matendawa kumachitika chifukwa chosowa lingaliro lodziwika lomwe limayambitsa kupanikizana kwa chifuwa, gulu la anthu lomwe limafotokozera za etiology ndi pathojeniis, komanso muyezo wazachipatala.

Olemba ena amati pancreatic cysts monga mawonekedwe omwe ali ndi makhoma ochepa komanso odzazidwa ndi madzi a pancreatic, akatswiri ena amakhulupirira kuti zomwe zili m'matumbo zingakhalenso necrotic organ parenchyma, magazi, kutupa kapena mafinya. Mulimonsemo, malingaliro amavomereza kuti zotsatirazi ziyenera kukhalapo kuti apangidwe pancreatic cyst: kuwonongeka kwa ziwalo parenchyma, kuvuta kutulutsa kwa pancreatic secretion, komanso kusokonezeka kwapazinthu zam'deralo.

Zimayambitsa pancreatic cyst

Pancreatitis ndiyomwe imayambitsa kwambiri pancreatic cysts. Kutupa kwachikale kwa kapamba kumapanikizika ndi kupangika kwa ma cysts mu 5-20% ya milandu, pomwe zamkati zimapangidwa sabata lachitatu kapena lachinayi la matenda. Aakulu kapamba, post-necrotic pancreatic cysts mawonekedwe 40-75% milandu. Nthawi zambiri, chinthu chachikulu chomwe chimayambitsa matenda ndi uchidakwa. Pafupipafupi, cysts amapanga pambuyo pancreatic kuvulala, komanso chifukwa cholelithiasis ndi kufooka kwa pancreatic madzi, chosakhazikika pancreatitis ndi kuwonongeka kutuluka mwa Wirsung duct, zotupa za duodenal nipple, cicatricial stenosis wa sphincter wa Oddi.

Mapangidwe a cancs pancreatic ndi kapamba amachitika motere. Kuwonongeka kwa minofu ya limba kumayendetsedwa ndi kudzikundikira kwanuko kwa ma neutrophils ndi ma lymphocyte, njira zowonongeka ndi kutupa. Komanso, malo owonongeka amachotsedwa pamayendedwe ozungulira. Mmenemo, kuchuluka kwa minofu yolumikizika kumachitika, mawonekedwe a granerals, zinthu za mkati mwanu zomwe zimayang'aniridwa zimawonongeka pang'onopang'ono ndi maselo othandizira, ndipo patsekeke limatsalira malowa. Ngati pancreatic cyst ikalumikizana ndi ductal system ya chiwalo, madzi a pancreatic amadziunjikira, kuphatikiza minofu necrotic zinthu, zotupa zotupa ndizothekanso, ndipo ngati mitsempha yamagazi yawonongeka.

Poyang'aniridwa ndi gawo kudzera pancreatic duct, ma pancreatic cysts amapangidwa omwe ali ndi chingwe cha epithelial, mkati momwe madzi a pancreatic amadziunjikira. Njira yofunika kwambiri ya pathogenetic ya mapangidwe awo ndi intraductal matenda oopsa. Zimatsimikiziridwa kuti kuthinikizidwa mkati mwa cyst patsekeke kumatha kukweza katatu kuposa momwe zimakhalira mkati mwa ma ducts.

Gulu la pancreatic cysts

Misonkhano yonse, ma pancreatic cysts molingana ndi mawonekedwe a morphological amagawidwa m'magulu awiri: omwe amapangika chifukwa cha chotupa komanso osakhala ndi chingwe cha epithelial (olemba ena amawatcha ma pseudocysts, ena sawasiyanitsa kukhala gulu logawanika) ndipo amapangidwa panthawi yotseka ma ducts ndikukhala ndi epithelium (posungira).

Kuti muwone ngati cancreatic cysts, yopangidwa ngati complication ya pancreatitis pachimake, gulu la Atlanta limagwiritsidwa ntchito nthawi zambiri, malinga ndi omwe amapezeka pachimake, subacute madzimadzi am'madzi ndi chindapusa cha kapamba. Mapangidwe opangidwa mosakhazikika alibe mapangidwe awo; magawo awo amatha kusewera ndi ma gland parenchyma ndi ma ducts, minofu ya parapancreatic, ngakhale makoma a ziwalo zoyandikana nawo. Cancsic pancreatic cysts amadziwika ndi makoma omwe amapanga kale kuchokera ku minofu ya fibrous ndi granulation. Chotupa ndi patsekeke lodzaza ndi mafinya mkati mwa kapamba kapenanso kukweza kwa cyst.

Kutengera ndi kufalikira, ma cysts amutu, thupi ndi mchira wa kapamba ndizosiyanitsa. Zosavuta komanso zovuta (mafuta odzola, kukweza, fistulas, magazi, peritonitis, malignancy) cysts zamapancini zimadziwikanso.

Zizindikiro za pancreatic cyst

Chithunzi cha chipatala pamaso pa pancreatic cysts chimatha kusiyanasiyana kutengera kukula, malo omwe adapangidwira, zifukwa zomwe adapangidwira. Nthawi zambiri, ma cancreatic a pancreatic samayambitsa zizindikiro: milomo yokhala ndi mainchesi osakwana masentimita asanu sapanikizika ziwalo zoyandikana, mitsempha ya mitsempha, kotero odwala samakumana ndi vuto. Ndi ma cysts akuluakulu, chizindikiro chachikulu ndi kupweteka. Chizindikiro chodziwika ndi "chowala chowoneka bwino" (kusintha kwakanthawi kachipatala pambuyo pake pancreatitis kapena zoopsa).

Kupweteka kwambiri kumawonedwa pakupanga ma pseudocysts mu pancreatitis pachimake kapena kufalikira kwa nthawi yayitali, popeza pali zochitika zowonongeka kwambiri. Popita nthawi, kulimba kwa ululu kumachepa, ululu umayamba kusweka, kumangokhala kusamva bwino, komwe, kuphatikiza ndi data ya anamnestic (trauma kapena pancreatitis), imakupatsani mwayi wokayikira matenda. Nthawi zina, motsutsana ndi maziko azizindikiro zochepa, kumayambitsa kupweteka, chomwe chimayambitsa matenda oopsa. Kupweteka kwakufotokozedwanso kungathenso kuwonekera kwa kupindika, kuwonjezeka kwapang'onopang'ono kwa ululu poyerekeza ndi kuwonjezeka kwa kutentha kwa thupi ndi zoledzeretsa - pafupi ndi kuchuluka kwake.

Zizindikiro za pancreatic cyst zimasiyana kwambiri ngati zimakanikiza mphamvu ya dzuwa. Nthawi yomweyo, odwala amakhala ndi ululu wowopsa womwe umawombera kumbuyo, komwe kumatha kukulitsidwa ngakhale ndikufinya zovala. Vutoli limatsitsimuka pamalo a bondo-elbow, kupweteka kumayimitsidwa kokha ndi narcotic analgesics.

Zizindikiro za kapamba wa pancreatic amathanso kukhala zizindikiro za dyspeptic: nseru, nthawi zina kusanza (kumatha kutha kupweteketsa mtima), kusakhazikika kwa chopondapo. Chifukwa cha kuchepa kwa ntchito ya exocrine ya chiwalo, mayamwidwe azakudya zam'matumbo amatayika, kulemera kumachepa.

Chizindikiro cha kupsinjika kwa ziwalo zoyandikana ndizomwe zimachitika mwanjira iyi: ngati chotupa chiri m'dera la mutu wakugwedeza, jaundice yotseka ndi yotheka (khungu ndi sclera ictericity, kuyabwa kwa khungu), pamene mitsempha ya portal imapanikizika, edema imayamba m'munsi, ngati mapangidwe amatsutsana ndi kutuluka kwa mkodzo m'matumbo, kuchepa ndi mawonekedwe. pokodza. Nthawi zambiri, zikuluzikulu zazikulu zam'mimba zimakanikizira lumen, motero, matumbo osakwanira amatha.

Kuzindikira kwa pancreatic cyst

Kufunsidwa kwa dokotala wa gastroenterologist yemwe amakayikira pancreatic cyst imalola kuzindikira zodandaula za wodwalayo, zambiri zowonjezera. Mukamayang'ana pamimba, asymmetry yake ndi yotheka - protrusion m'dera la mapangidwe. M'mayeso a labotale, nthawi zambiri pamakhala kusintha kulikonse, leukocytosis yaying'ono, kuchuluka kwa ESR, ndipo nthawi zina kuwonjezeka kwa bilirubin ndi alkaline phosphatase zochitika ndizotheka. Kuchulukitsidwa kwa michere ya pancreatic sikudalira kwambiri pa kukhalapo kwa cyst monga gawo la pancreatitis ndi kuchuluka kwa kuwonongeka kwa gland. Pafupifupi 5% ya milandu, ntchito ya endocrine ya kapamba imasokonekera ndipo shuga yachiwiri imayamba.

Njira zothandiza kwambiri zowonera ndi ma cyst. Ultrasound ya kapamba imakupatsani mwayi kuti mufufuze kukula kwa mapangidwewo, komanso njira zosakhudzana ndi zovuta zina: mukakhala kuti mukusinthika, kusalinganika kwa chizindikiro cha echo kutsimikizika motsutsana ndi maziko a patsekeke, chindapusa - kukula kwa ma contour. Dongosolo la tomography ndi maginito a resonance imaging (MRI ya kapamba) imapereka zambiri mwatsatanetsatane za kukula, malo a cyst, kupezeka kwake polumikizana ndi ma ducts. Monga njira yothandizira, scintigraphy itha kugwiritsidwa ntchito, momwe cyst imatanthauzidwa ngati "ozizira zone" motsutsana ndi maziko a gawo wamba parenchyma.

Malo apadera pakuwonetsa pancreatic cysts amaperekedwa ku endoscopic retrograde cholangiopancreatography (ERCP). Njira iyi imafotokoza mwatsatanetsatane za ubale wa ma cyst ndi mavu a gland, omwe amasankha njira zamankhwala, komabe, pakuwunika, pali chiopsezo chachikulu cha matenda. Chifukwa chake, pakadali pano, ERCP imachitika kokha ndi vuto lotha kuchitidwa opareshoni pofuna kusankha njira yogwirira ntchito.

Chithandizo cha Pancreatic cyst

Chithandizo cha opaleshoni ya pancreatic cysts. Palibe njira imodzi yoyendetsera odwala omwe ali ndi matendawa, ndipo kusankha kwa ntchito kumadalira zomwe zimapangitsa kupangika kwa cyst, kukula kwake, kusintha kwa morphological ndi magwiridwe amtundu wa chiwalo, komanso mkhalidwe wamachitidwe a duct.

Akatswiri omwe ali ndi gawo la opaleshoni ya gastroenterology amasiyanitsa magawo atatu ofunikira a pancreatic cysts: kuchotsa kwake, ngalande zamkati ndi kunja. Mapangidwe amachotsedwa ndi kufufutidwa kwa gawo limodzi la kapamba limodzi ndi cyst, voliyumuyo imatsimikiziridwa ndi kukula kwa cyst ndi boma la lungu parenchyma (kuyambiranso kwa mutu wa gland, distal, pancreatoduodenal resection ikhoza kuchitidwa).

Njira zochotsa mkati mwa ngalande zimatha kuchitidwa pogwiritsa ntchito anastomosis pakati pa cyst ndi m'mimba (cystogastrostomy), duodenum (cystoduodenostomy), kapena intestine yaying'ono (cystoenterostomy). Njirazi zimawerengedwa kuti ndizofunikira kwambiri mwakuthupi: zimapereka gawo la zikondamoyo, zimachotsa ululu, kawirikawiri zimayambiranso kuyambiranso.

Kutulutsa kwakunja kwa cyst sikugwiritsidwa ntchito kwenikweni. Kuchitapo kanthu kumasonyezedwa pakuwonjezera patsekeke, ma cysts osasinthika, kuphatikiza mtima wa mapangidwe, komanso vuto lalikulu la wodwalayo. Ntchito zoterezi ndizopweteka, popeza pali chiopsezo cha kupitiliza ndi kubwereza kwa cyst, mapangidwe a fanculas a pancreatic, omwe samayankha bwino pakupatsidwa chithandizo ndipo nthawi zina amafunikira njira zovuta kwambiri. Mtundu uliwonse wa opaleshoni yamadzimadzi umachitika pokhapokha akatsimikizire za etiology yopanda chotupa.

Posachedwa, njira zowononga zachilengedwe zowonjezera, zomwe zimagwiritsidwa ntchito ngati njira zina zochiritsira, zikuchulukirachulukira. Komabe, ngakhale kuli kwazovuta kwambiri komanso kulonjeza kwa njira zoterezi, zovuta zambiri zimapangidwa mwa mapangidwe a pancreatic fistula, sepsis.

Conservative mankhwala a pancreatic cysts amatsimikiza ndi matenda oyambitsidwa. Pankhani ya kapamba, chakudyacho chimaperekedwa, chofunikira kwambiri pakuchepetsa kwa katemera wa kapamba. Mankhwala othandizira ena, ma analgesics amagwiritsidwa ntchito, mulingo wa glycemia umayang'aniridwa, ndipo ngati kuli koyenera, kuwongolera kwake.

Kuzindikira komanso kupewa pancreatic cysts

Kukula kwa pancreatic cysts zimatengera chomwe chimayambitsa matendawa, kudziwa kwake kwa nthawi yayitali komanso kuthandizira opaleshoni. Izi matenda amadziwika ndi kuchuluka kwambiri complication - kuchokera 10 mpaka 52% ya milandu yonse amakhala limodzi ndi kuchuluka, mafuta, mapangidwe a fistula, zilonda zapakati kapena mkati mwa m'mimba. Ngakhale atachitidwa opaleshoni, pamakhala mwayi woti ubwererenso. Kupewa pancreatic cysts kumakhala kukana mowa, munthawi yoyenera mankhwala a matenda am'mimba thirakiti (m'mimba thirakiti, kapamba), zomveka zakudya.

Zomwe zimayambitsa ndikudziwikiratu

Pancreatic cysts imatha kukhala mwa odwala amsinkhu uliwonse, khalani osiyana siyana komanso ochulukirapo. Odwala ena, makamaka ndi kubadwa kwa cyst, systemic polycystosis (polycystic ovary, impso, ubongo, cysts ya chiwindi) imatha kuonedwa.

Masewera abodza samachitika m'thupi lathanzi - njirayi ndi chifukwa cha matenda. Malinga ndi Pulofesa A. Kurygin, chifukwa chodziwika bwino ndi:

pachimake kapamba - 84.3% ya milandu yonse (onani zizindikiro za kapamba owopsa)
zikondamoyo - 14% kapangidwe ka matendawa, ano ndi malo achiwiri mwadzidzidzi mwadzidzidzi
kutsekeka kwapafupipafupi kwa mwala (ndi mwala, kukokana ndi chotengera) kapena kuphwanya tanthauzo lake - kungathenso kupangitsa kupangika kwa chotupa

Pakadali pano, Russian upasuaji Society imazindikira zinthu zisanu zikuluzikulu zomwe zimayambitsa mavuto. Munthawi ya mayeso azachipatala, kufunikira kwawo kunatsimikiziridwa ndipo chiopsezo chokhala ndi pancreatic cyst chidatsimikizika ngati peresenti:

kumwa mowa mwauchidakwa kwamphamvu - 62.3%,
matenda a gallstone - 14%,
kunenepa - kusokonezeka kwa lipid kagayidwe (kantchito yowonetsa kuchuluka kwa beta ya lipids ndi cholesterol) - 32.1%,
kukhalapo kalelo pa ntchito pa chinthu chilichonse chammimba,
shuga mellitus (makamaka amtundu wachiwiri) - 15.3%.

Kukhalapo kwa imodzi mwazinthu zomwe zili pamwambapa wodwala yemwe akuwoneka ndi zizindikiro za zotupa zam'mimba zimalola kupanga mapangidwe a cyst.

Chithandizo cha Conservative

Chithandizo cha pancreatic cysts ndi njira zochizira zimachitika ngati:

Maganizo athu ndi ochepa,
ili ndi voliyumu yaying'ono komanso mainchesi (mpaka awiri masentimita awiri),
maphunziro amodzi okha
palibe zizindikiro za jaundice wopewera komanso kupweteka kwambiri.

Nthawi zina, pezani njira zochizira.

Kwa masiku atatu oyamba, chakudya cham'malo chimalembedwa. Pambuyo pake, ndikofunikira kuchepetsa kudya kwamafuta, okazinga ndi mchere, chifukwa kumalimbikitsa kubisala kwa michere ya pancreatic ndikuwonjezera chiwonongeko cha minofu (onani zomwe zingadyedwe ndi chifuwa chachikulu cha pancreatitis). Mowa ndi kusuta ziyeneranso kuletsedwa. Dongosolo la wodwalayo ndilo kupuma pabedi (masiku 7-10).

Mankhwala othandizira a Tetracycline kapena cephalosporins adalembedwa, omwe cholinga chake ndi kupewa kulowa kachilomboka kukalowa mu cyst patsekelo ndikuzadza ndi mafinya. Kupanda kutero, ndizotheka kusungunula makhoma ndikufalitsa msanga njirayo kudzera mu minyewa ndi pafupi.

Ndizotheka kuchepetsa ululu ndikuchepetsa kubisalira polemba "proton pump inhibitors" (OMEZ, Omeprazole, Rabeprazole, ndi ena otero). Pakugaya kwabwinobwino kwa chakudya chamafuta ndi mafuta osiyanasiyana, mankhwala a enzyme akuwonetsedwa - mankhwala omwe akuphatikizapo Lipase ndi Amylase, koma palibe bile acid (Pancreatin, Creon).

Ngati chithandizo chawofatsa sichitha kwa milungu 4, opaleshoni imasonyezedwa.

Njira zamakono zochitira opaleshoni

Oposa 92% odwala onse omwe ali ndi pancreatic cysts amathandizidwa kuchipatala cha opaleshoni. Pakadali pano pali zosankha pafupifupi 7 za ntchito zomwe zingachotse matenda awa. Malingaliro a Russian upasuaji Society amapereka zokonda zazomwe zimayambitsa zovuta (pakhungu la wodwalayo silikuwonongeka).

Chiwerengero chovuta kwambiri ndikuchita opaleshoni ya perstaneous cyst, yoyenera kuchitidwa nthawi yomweyo ndi ultrasound. Ndiwothandiza kwambiri kudziwa njira ya volumetric m'mutu kapena m'thupi. Mfundo zoyendetsera maopaleshoni ndizosavuta - pambuyo pa mankhwala opaleshoni, wodwalayo amapaka jekeseni ndi chida (katsitsumzidwe kapena singano yopumira) kudzera pakupunthwa m'dera la epigastric. Kutengera ndi kukula kwa mapangidwe ake, dokotalayo amatha kuchita:

Percutaneous punuction drainage of the cyst - mutatenga madzi onse kuchokera kumkono, ngalande (chubu chopyapyala) imakhazikitsidwa kuti ipange kutulutsa kosalekeza. Samachotsedwa mpaka chinsinsi cha exudate chitha. Izi ndizofunikira kutseka zolakwika ndi minofu yolumikizidwa. Opaleshoniyo singathe kuchitidwa ngati chotupa chikutsekeka kutulutsa kwa gland kapena kukhala ndi voliyumu yayikulu (zoposa 50-100 ml),
Percutaneous sclerosis ya cyst - njirayi imaphatikizira kukhazikitsidwa kwa yankho yogwira mwamphamvu mu patsekeke la chotupa, utatha. Zotsatira zake ndikuyeretsa (kuyeretsa) kwa patsekeke, kuchuluka kwa minofu yolumikizidwa komanso kutsekeka kwa chilema.

Ngati manambala a transdermal sangathe, Miyezo Yopangira Chithandizo imalimbikitsa njira za laparoscopic. Amaphatikizanso kugwiritsa ntchito 2 incitions 1-2 masentimita kutalika, momwe zida za endoscopic zimayikidwira pamimba. Opaleshoni ili ndi zovuta zingapo zomwe zingakhalepo, ngakhale zimayambitsa zovuta zochepa. Izi zikuphatikiza:

Kusangalatsa ndi kutsimikizira kwa chotupa - chomwe chimagwiritsidwa ntchito pamaso pa mapangidwe apamwamba kwambiri. Opaleshoni imaphatikizapo: kutsegula patsekeke la chotupa, kutsukidwa kwake ndi njira zothetsera matendawa komanso kusokonekera kwa chilema "mwamphamvu". Mwinanso, ndikoyenera kugwiritsa ntchito electrocoagulator kuti mutseke, koma pamenepa, ndikofunikira kupanga kutulutsa kosalekeza kwa masiku 3-7,
Kutulutsa kwina kwa gawo la chisautso ndi ntchito yovuta yomwe ikulimbikitsidwa ngati pali vuto lalikulu mkati mwa minyewa ya tizi m'mimba. Mwachitsanzo, ndi chotupa cha mutu wa kapamba wokhala ndi masentimita 5-7, mutu wonse umachotsedwa.Ubwino wake ndi chiopsezo chobwereza matenda,
Operation Frey (resection ya mutu ndi chilengedwe cha pancreatojejunal anastomosis) ndikusintha kwa opaleshoni yomwe takambirana pamwambapa. Kugwiritsidwa ntchito kwake kuli koyenera ndi kufalikira kwamphamvu kwa chisa cha gland. Njira ya opareshoni imathandizidwa ndikuwunikira duct iyi mwachindunji khoma lamatumbo laling'ono, lomwe limalola kubwezeretsa chinsinsi cha michere komanso kuchepetsa mwayi wa pancreatic necrosis.

Kulephera kuchita ma endicopic kapena ma opaleshoni othandizira amakukakamizani kuti muthe kusintha kosokoneza bongo (ndikutseguka kwam'mimba). Amafuna nthawi yayitali yokonzanso, koma amapereka mwayi wochita opareshoni iliyonse. Njira zotsatirazi zotseguka zimasiyanitsidwa:

Kutseguka kwina kwa gawo la chiwalo,
Kukongola ndi kutulutsa kwakunja kwa chotupa,
Kusintha kwa ma cyst - ntchito iyi idayesedwa koyamba mu 70s ya zaka zapitazi ndipo mpaka pano sinathere kufunika kwake. Dongosolo lake ndi loyambirira - kutsegula ndi ukhondo wa chotupa kumachitika, ndikutsatira ndi makoma a mapangidwe mpaka m'mphepete mwa chisonyezo. Pambuyo pake, chilonda cha opaleshoni chimasinthidwa m'magawo. Chifukwa chake, kutsekedwa kwazomwe zakuyambira kumakwaniritsidwa. Zoyipa za njirayi ndi kupangidwe kwapafupipafupi kwa khoma lakumaso lakumbuyo.

Pancreatic cysts ndi njira yachilendo kwambiri. Kuchulukitsa kwa zochitika zake, malinga ndi Pulofesa V.V. Vinogradova ndi 0.006% padziko lapansi. Komabe, Zizindikiro zowopsa zomwe zimachepetsa thanzi la wodwala zimafunikira kuti azindikire komanso kulandira chithandizo nthawi yake. Pakadali pano, madokotala amatha kuthana ndi matendawa. Pachifukwa ichi, wodwalayo amangofunika kugwiritsa ntchito chithandizo chamankhwala choyenerera.

Chithunzi cha kuchipatala

Popanga ma pancreatic pseudocysts, nthawi 4 zimasiyanitsidwa (Karagyulyan R.G. 1974):

Gawo 1 (mpaka milungu isanu ndi umodzi kuchokera pachiwopsezo cha kapamba) - kumachitika kwa chotupa. Mu pancreatic kulowetsedwa, gawo loyambira la cyst limapangidwa,

Gawo lachiwiri (miyezi 2-3 kuyambira kutha kwa kapamba) - chiyambi cha mapangidwe a kapisozi. Khoma la cyst limasulidwa, limang'ambika mosavuta,

3 nyengo (mpaka miyezi 6) - kumaliza mapangidwe a kapisozi. Khoma la chotupa limakhala ndi minofu yowonda kwambiri.

Nthawi ya 4 (miyezi 6 −12) - kudzipatula kwa cyst. Ma cyst amakhala mafoni ndipo amasiyanitsidwa mosavuta ndi zimakhala zoyandikana.

Mu magawo 1 ndi 2, ma cyst amawonedwa kuti akupanga magawo 3 ndi 4 - amapangidwa.

Zosintha za Clinical |Limagwirira ndi zoyambitsa kukula kwa matenda

Zikondazo ndizofunikira kwambiri pakuwonongeka komanso kuphatikizidwa kwa mapuloteni, zakudya, mafuta. Chiwalocho chili ndi mapangidwe am'kati mwake chomwe chikuwoneka bwino ngati cysts. Kapangidwe kazinthu zozungulira mu gland sikuchitika mwanjira iliyonse ndipo zimachitika chifukwa cha kusabereka kwa mapangidwe a ziwalo, kapena zinthu zina.

Mphamvu yamomwe imachitika imangotengera kuwonongeka kwa ziwalo zomwe. Mothandizidwa ndi zinthu zopanda pake, masango a minofu yakufa mu kachigawo kakang'ono ka kapamba, thupi limaphwanya malo am'mimba kuchokera kwa athanzi - kaphatikizidwe kamapangidwa kuchokera ku maselo olumikizika kapena ma cell. Chisipikiro chimadzazidwa pang'onopang'ono ndi zomwe zimapangidwa pang'onopang'ono ndi chinsinsi - Umu ndi momwe cyst imawonekera.

Zomwe zimayambitsa maonekedwe a matenda:

kubadwa kwa zotumphukira za ndulu,
kupezeka kwa miyala
kapamba - pachimake, matenda, mowa,
kapamba,
ziwalo zovulala
endocrine matenda - kunenepa, matenda a shuga,
matenda a majeremusi.

Kutanthauzira kwa matenda a mtima

Ma Cysts amalembedwa kuti:

Zowona (zatsopano) - mapangidwe a patsekeke m'matumbo amapezeka kuyambira pakubadwa, mapangidwe ake amayikidwa mu nthawi ya kubereka. Congenital cysts sikukula, kukula kwawo kumakhala ndi maselo owopsa. Kuwoneka kwa ma cysts owona chifukwa cha kutsekeka kwa ma pancreatic ducts kumabweretsa kutupa ndikapangidwa ndi minofu ya fibrous - matenda awa amatchedwa "cystic fibrosis", kapena polycystic.
Zabodza (ma pseudocysts) - mawonekedwe apazitsulo omwe amawoneka motsutsana ndi maziko a zotupa m'mapapo, kuvulala ndi zina za chikhalidwe chachiwiri.

Mitsempha yachilengedwe imatha kupanga magawo osiyanasiyana a kapamba - pamutu, thupi ndi mchira. Malinga ndi ziwerengero, mutu wam'mutu suwapezeka kawirikawiri, 15% yonse, 85% imayamba chifukwa cha chotupa cha thupi ndi mchira wa chiwalo. Pafupifupi 90% ya milandu, ma cysts ndi achiwiri mwachilengedwe ndipo amakula motsutsana ndi maziko a kapamba. 10% yamilandu imakhudzana ndi zoopsa zomwe zimachitika m'thupi.

Gulu la Atlanta limagwiritsidwa ntchito pa mitundu ya cystic yomwe imawonekera pambuyo pancreatitis yovuta kwambiri:

cysts pachimake - kuwoneka mwachangu, mulibe khoma lopangidwa bwino, milomo ya ndulu, mawonekedwe ofunikira kapena CHIKWANGWANI chingakhale cham'mbali,
subacute (aakulu) - imapangika kuchokera pachimake monga makoma amkati amapangika kuchokera ku minyewa yamkati ndi michere,
abscess - purifying kutupa kwa kapangidwe kake, patimayo timadzaza ndi serous nkhani.

Kuchokera pakuwona komwe zamatenda, ma cysts ndi:

yophatikizidwa ndi fistulas, magazi, mafinya kapena mafuta oyenga,
zosavuta.

Mavuto

Pancreatic cyst ndiyowopsa makamaka chifukwa chokhoza kusinthika kukhala chotupa cha khansa. Mwapangidwe, ma cystic patimatayidwe amatha kukhala ovulaza ndi owopsa. Khansa ya pancreatic ndi yovuta, pafupifupi yosasinthika, yodziwika ndi maphunziro othamanga omwe ali ndi metastasis yayikulu. Benign cysts siwowopsa chifukwa cha chiwopsezo chotumphukira komanso chitukuko cha peritonitis.

Mapangidwe a Fistula ndi vuto linanso lalikulu. Ndi mafuta opangira mawonekedwe a cystic, mafistola athunthu komanso osakwanira amawonekera - maupangiri amakulu omwe amalumikizana ndi chilengedwe chakunja kapena ziwalo zina. Kukhalapo kwa fistulas kumawonjezera chiopsezo cha matenda komanso kukula kwa mabakiteriya.

Cysts yayikulu imasunthira pamatumbo ndi zisa za m'mimba ndi ziwalo zoyandikira zam'mimba, zomwe zimayambitsa mavuto:

chitukuko cha zopinga za jaundice ndi mutu wa cysts pamutu,
Kutupa pamiyendo pakufinya msempha,
matenda osokoneza bongo omwe akukakamizidwa pamitsempha yam'mimba,
matumbo kutsekeka pamene kufinya lumen mu matumbo malupu (vuto losowa lomwe limachitika pamaso pa zikuluzikulu za kapamba).

Kuzindikira matenda

Dokotala yemwe amayesa ndi kuchitira anthu omwe akuwaganizira kuti ndi pancreatic cyst ndi dokotala wa gastroenterologist. Pa chithandizo choyambirira, anamnesis amafunikira, kumveketsa madandaulo a wodwala ndikuwunika ndi palpation. Ndikawunika pamimba pamimba, kumveka kwa malire. Kuunika kwathunthu kumaphatikiza njira zophatikiza zasayansi ndi zothandizira.

Mndandanda wa mayeso a labotore umaphatikizapo kuyezetsa magazi, kuphatikizapo biochemistry. Pamaso pa pathology, kusintha kwa ESR ndi bilirubin zikuwonetsa (kuchuluka), leukocytosis, kuchuluka kwa alkaline phosphatase kudzapezeka. Kuchita mkodzo kumatha kuwonetsa molakwika chizindikiro cha kutupa m'miyeso yovuta - mkodzo wamba ndi maselo oyera amkati amapezeka mu mkodzo.

Zambiri zodalirika mukamatsimikizira za matenda am'masiku zimachitika ndi njira zothandiza:

Ultrasound imakupatsani mwayi kuti muwone kukula kwa michere ya cystic, kuchuluka kwawo, kukhalapo kwa zovuta,
MRI imapangitsa kuti athe kuzindikira bwino komanso molondola, kukula kwa mgwirizano wa ma cystic ndi maukonde a gland,
scintigraphy (radionuclide imaging) imagwiritsidwa ntchito ngati njira yowonjezerapo pofotokoza komwe kumayambira gland ya gland,
endoscopic retrograde cholangiopancretography ngati njira yolondola kwambiri imapereka tsatanetsatane wazomwe zimayambira pamangidwe, mawonekedwe ake ndi kulumikizana ndi ma ducts, koma amakhala ndi chiopsezo chachikulu cha matenda pakubwereza,
Rografic radiographic yam'mimba imagwiritsidwa ntchito pozindikira malire a milomo.

Ngati kapangidwe ka mkati mwa mapangidwe a cystic sikudziwika bwino, kuphatikizidwa kwa minofu ya pancreatic ndizovomerezeka kuti zitsimikizire kapena kutsutsa zilonda. Kuchita biopsy kumachitika moyang'aniridwa ndi ultrasound scan kapena pa scan scan. Kusiyanitsa mosiyanasiyana pa biopsy kumalola kudziwika kwa oncology komanso kupewa kukula kwa maselo a khansa.

Chithandizo cha pancreatic cysts imachitika kudzera mwa kuchitira opaleshoni. Mankhwala okhala ndi ma cysts angapo osatsimikizika ndi osathandiza. Opaleshoniyo sikuwonetsedwa cysts imodzi yaying'ono (mpaka 30-50 mm cysts), ngati sichikhudza ziwalo zoyandikana komanso siziyambitsa zizindikiro zoyipa. Kuchotsa cyst yoyipa, ngakhale yaying'ono yaying'ono, ndikofunikira kuti tipewe metastasis.

Mu opaleshoni ya gastroenterology, njira zitatu zimagwiritsidwa ntchito polimbana ndi cyanc:

Kuchotsa kwa maziko a pathological - mayendedwe,
ngalande zoyambira (zakunja ndi zamkati),
laparoscopy

Mukasunthika, thupi la cyst ndi gawo loyandikana ndi kapamba limachotsedwa. Kuchulukitsa kwa zotengera kumadalira kukula kwa patsekeke, mkhalidwe wodabwitsa wa gland - amachitanso mbali ya mutu, distal, pancreatoduodenal.

Kukhetsa kwamkati kwa cyst kumachitika kudzera mwa anastomosis pakati pa thupi la cyst ndi m'mimba, duodenum kapena intestine yaying'ono. Kukhetsa kwamkati ndi njira yotetezeka komanso yolimbitsa thupi yomwe imawongolera mkhalidwe wa wodwalayo - kudutsa kwamkati mwazitsulo kumatsimikizika, kupweteka kumatha, mwayi womwe ungayambirenso wabwinobwino ndi wochepa.

Kutulutsa kwakunja kwa cyst kumachitika ndi njira yovuta ya matenda:

kudzikundikira kwa purishate exudate,
ma cystic osasinthika,
kuchuluka kwa mtima (kupanga ziwiya zatsopano) m'makoma a cyst,
ambiri ovuta.

Ndi drainage yakunja, zotsatira zoyipa zimatha kupezeka mwa mawonekedwe a fistula, kukulitsa kwa cysts kukula kwake, kukula kwa mawonekedwe atsopano. Nthawi zina, sepsis imayamba. Mulimonsemo, ngalande zakunja ndi zamkati zimachitika pokhapokha ndi mawonekedwe a benign.

Laparoscopy ndi njira yofatsa, phindu lake ndikusakhalapo kwa maopaleshoni ochulukirapo ndikuchira wodwala mwachangu. Laparoscopy ndi yoyenera kuchotsa nyumba zambiri, zamtambo umodzi. Chofunika cha kulowereraku kopanda tanthauzo ndikukhazikitsa singano yopumira muvuto lomwe limayambitsa kulowetsedwa.

Chithandizo cha mankhwala chothandizira kukonza matenda oyamba. Pamaso pa kapamba, kuyika kwa ma enzymes ndikofunikira kuonetsetsa kuti chimbudzi chokwanira komanso kutsitsa kwa kapamba. Kuchepetsa ululu, antispasmodics ndi analgesics amagwiritsidwa ntchito. Kuwongolera kwa shuga m'magazi ndikofunikira, ngati kusokonezedwa, mankhwala oyenera amalembedwa.

Kukhazikika kwa zotupa za cystic kumakhazikitsidwa ndi kuchuluka kwakukulu kwapancreatic. Zakudya zopangidwa moyenera zimatha kuchepetsa ngozi yobwererenso matendawa ndikuthandizira kuthekera kwa michere. Mfundo zomwe zimapatsa thanzi lokhala ndi pancreatic cyst:

zakudya zazing'ono munthawi yomweyo (maola 3-4),
Chakudya chonse chimapukutidwa ndi kudulidwa,
njira zophikira - kuphika, kuphika, kutumiza,
kukana mafuta ndi yokazinga,
kuletsa mkate ndi confectionery,
maziko a chakudyacho ndi chakudya chama protein (mapuloteni ofanana ndi mbewu sayenera kupitirira 30% ya tsiku ndi tsiku).

Odwala amaletsedwa kudya nyama yamafuta, bowa, nyemba. Zinthu zothandiza kwambiri ndi mkaka wokhala ndi mafuta ochepa, nkhuku ndi nyama ya nkhuku, mazira owiritsa, masamba atatha kutentha. Kuchokera kuzakumwa, timadziti tosazingira, mafuta odzola ndi zipatso zabwino. Zakudya - moyo wonse, kupuma pang'ono kungayambitse kuwonongeka.

Kukula kwa kupulumuka kumadalira zomwe zimayambitsa matenda, mapangidwe ake komanso kukwanira kwake. Matendawa amadziwika ndi zovuta zambiri - mu 10-50% ya odwala, nthawi ya matendawa imayendetsedwa ndi oncology, matenda ndi zotupa zamkati. Pambuyo posinthira, pamakhala mwayi wa cysts zatsopano zomwe zikukula. Kutengera uphungu wa zamankhwala, kuwunika pafupipafupi komanso kudya ma enzyme, pamakhala mwayi wokhala ndi moyo wabwinobwino.

Popewa kuyambiranso kukhalanso okhazikika, odwala ayenera:

gwiritsitsani chakudya
lekani mowa
munthawi yake zovuta mavuto ndi m'mimba thirakiti.

Cystic lesion ya kapamba ndimatenda osowa, pakakhala chithandizo choyenera, zotsatira zake zimakhala zomvetsa chisoni. Kuthekera kwa mankhwala amakono kuthana ndi matendawa ndikupangitsa kuti odwala azikhala ndi moyo wonse. Chachikulu ndikuzindikira koyambirira ndi njira yosankhidwa bwino yochotsa ma cysts.