Matenda mobwerezabwereza kapamba

Wodwala yemwe wakhala ndi pancreatitis yofatsa amamva bwino mu sabata la 2-3 la matenda. Chifukwa chake, ambiri amasankha kubwerera ku moyo wawo. Ngati zofunikira kutulutsa zisaonongeke nthawi yomweyo, ndiye kuti kuukira kwatsopano sikuchedwa kubwera. Nthawi zambiri chimalemera kwambiri. Kupatula apo, kuwonongeka kwa maselo kumayenda kwambiri mthupi lofooka. Chifukwa chake, zifukwa zazikulu zobwererera pafupipafupi ndizosagwirizana ndi boma loteteza. Zimaphatikizapo zakudya, pafupipafupi zakudya zopatsa thanzi, kukana mowa ndi kusuta.

Kuphatikiza pa chakudya chosweka, njira yokhazikika imatha kuyambitsa kupweteka kwatsopano kwa kapamba. Chinthu chachiwiri chofunikira kwambiri choyambitsa kutupa mu kapamba ndi matenda a ndulu. Zomwe zimayambitsa kutupa kwake ndizambiri. Kusasunthika kwa kubisala, kupangidwa kwa miyala, kuyenda kwawo motsatira milomo, matenda ophatikizika - zonsezi zimakwiyitsa kutulutsa kwa minofu ya kapamba. Chifukwa chake, kuyang'anira kudya ndikutsatira regimen, mutha kukhalanso ndi vuto lina. Ndikokwanira kukana kuchitidwa opareshoni pochotsa ndulu yodwala.

Zilonda kapena matenda amtundu wa m'magazi ndimayendedwe abwino kwambiri a kutupa kwa kapamba. Matenda osachiritsika m'derali amachititsa kuti asidi azitulutsidwa. Zimathandizanso kupanga madzi a pancreatic. Kupatsirana kwam'mimba m'mimba (Helicibacterpylori) kumatha kubweretsanso matenda.

Pafupipafupi matenda a kapamba amadziwika ndi zochita za autoimmune. Autoimmune pancreatitis ndi osowa kwambiri.

Chithunzi cha kuchipatala

Pancreatitis yam'tsogolo imawonetsedwa ndi zigawo zotsatirazi:

1. Wodwalayo amamva kupweteka kosalekeza mu hypochondrium yamanzere. Amawonekera atatha kudya. Nthawi zina munthu akamalimbana ndi ululu amakhala ndi chikhalidwe chomangira.
2. Kudzimbidwa. Minofu yowonongeka ilibe nthawi kuti ichiritse. Enzyms samakwaniritsa ntchito yawo yopanga chakudya. Zizindikiro zake zimawonetsedwa ndi mseru, kutulutsa, kusanza, kupindika, phokoso.
3. Kukhazikika pansi. Odwala, kudzimbidwa kusinthana ndi kutsegula m'mimba.
4. Dysbacteriosis Njira za kupesa ndi kuwola kwa thupi zimathandizira kuti mapangidwe azitsamba zizipangidwanso. Maimidwe obisika m'matumbo amatha kubweretsa matenda oopsa. Zizindikiro zoyambirira ndi kutentha thupi ndi m'mimba.
5. Kuchepetsa thupi. Kuwonongeka kwa dongosolo la enzyme kumayambitsa kusayamwa bwino kwa michere. Thupi limasowa mphamvu. Odwala amachepetsa thupi msanga. Poyerekeza zakumbuyo kafupipafupi, kudya kumagwirizanitsidwa ndi kupweteka, komwe kumakulitsa chizindikiro cha cachexia.

Matendawa amakula pang'onopang'ono. Chithunzi chachipatalachi chikuwonjezeka pakuwukira kuti awukire. Zizindikiro za ululu zimapezeka mwa ena mwa odwala, pamene kugaya chakudya kumapitilira mwa ena. Mulimonsemo, chifuwa chachikulu chimapatsa wodwala zovuta zambiri. Kudya okhwima kwambiri komanso kulandira mankhwala moyenera kungathandize kuimitsa njirayi.

Mankhwala a Spasmolytic amathandizira kuthetsa zizindikiro za ululu msanga. Kumayambiriro, othandizira a mu mnofu amagwiritsidwa ntchito. Kenako mutha kusinthira pamapiritsi (No-shpa, Drotaverin, Spazmeks).

Kuti muchepetse ntchito zapancreatic, chithandizo chikuyenera kuthandizidwa ndi othandizira omwe amachepetsa kupanga hydrochloric acid. Kuphatikizika kwa mankhwalawa kumaphatikizapo mankhwala Omeprazole, Pantoprazole. Komanso, kuchepetsa kupsa mtima pamimba, mutha kuphatikiza mankhwalawa ndi maantacid (Gefal, Maalox, Almagel).

Ntchito ya gland imachepetsedwa, kotero chakudya sichilandira chithandizo choyenera.Izi zimathandizira njira za kupesa ndi kuvunda kwamatumbo. Kuti chakudyacho chigayike bwino, ndikofunikira kutenga ma enzyme pakudya kulikonse. Tsopano pali kusankha kwakukulu kwa mankhwalawa. Odziwika kwambiri ndi Pancreatin, Creon, Mezim. Mlingo amasankhidwa ndi dokotala. Chithandizo chochepa cha mankhwalawa sichikhala chokwanira. Enzyms pang'ono amaganiza ntchito ya woponderezedwa.

Mavitamini ayenera kuphatikizidwa ndi zovuta zaumoyo. Kuikidwa kumeneku ndikofunika kwambiri ngati wodwala ali ndi vuto la kuchepa kwa vitamini. Ndipo pafupifupi odwala onse omwe ali ndi pancreatitis yayitali amabwera ku izi. Chithandizo chake chizikuphatikizira mankhwala omwe angathe kubayidwa. Izi ndizotheka kwa mankhwala a gulu B.

Woopsa matenda a kapamba, mpofunika kupereka somatostatin kapena octreocide. Ma mahomoni opanga awa amalepheretsa kapamba. Komabe, mankhwalawa amatha kuperekedwa kuchipatala panthawi yowonjezera.

Amawerengedwa kuti ndi matenda oopsa komanso osasinthika. Makamaka ngati matendawa akupita patsogolo ndikuchulukirachulukira kwa kapamba kumachitika pafupipafupi.

Matenda a kapamba - kutupa komwe kumachitika m'ziwonetsero kwa nthawi yayitali, kumapangitsa kuti pakhale kusintha kosasintha kapangidwe kake ka ntchitoyo, kaimidwe kake kapenanso kokwanira. Ndikachulukirachulukira kwa kapamba, anthu ambiri amafa. Izi zikuwonetsa kuwopsa kwa matendawa, kuti zizindikiro zoyambirira siziyenera kunyalanyazidwa.

Zomwe zimayambitsa maonekedwe a pancreatitis aakulu ndizosiyana. Gastroenterologists amatchula zinthu ziwiri zomwe zimayambitsa matenda osachiritsika:

1. Mowa. Malinga ndi ziwerengero, 60% ya odwala amavutika.
2. Matenda a Gallstone.

Nthawi zina chifukwa cha kapamba sichidziwika, mosadziwika imalumikizidwa ndi moyo kapena chimayamba chifukwa cha matenda ena.

Kugwidwa kwakukulu kwa matenda osachiritsika ndikuwonetsa kuti matendawa samangotchulidwa. Nthawi zina, matendawa amakhala asymptomatic. Ndipo nthawi ya kubwezeretsanso kwina kumachitika - wodwalayo amadwala matenda a kapamba. Nthawi zambiri, chifuwa chachikulu chimakhudza azimayi, amuna amakonda kuphulika mwadzidzidzi. Avereji ya zaka zamatendawa imachokera zaka 28 mpaka 37, ukalamba utatha zaka 50, kupezeka kwa chamba chachikulu cha pancreatitis kumakhalapo.

Zizindikiro zakukula kwa kapamba

Nthawi zambiri, Zizindikiro zakukula kwa kapamba zimawonekera mu mawonekedwe amkati, kupweteka kwapweteka komanso kupweteka kwambiri komwe kumamveka pansi pa nthiti, kuwonetsedwa kumbuyo. Nthawi zambiri ululu amakhala atypical, obisala ngati matenda ena, umatchulidwa kumbuyo kumbuyo, kuwumbidwa m'mimba. Nthawi zina ululu umamvekera pachifuwa, kumbali, ndikumva mwakuya kwa thupi, zomwe zimadziwika kuti zikuluzikulu za kapamba.

Ululu nthawi zambiri umatha mukatha kudya kapena kumwa mowa. Zofooka zimakhudzana ndi ma peinkiller omwe amapezeka, nthawi zina mwamphamvu kwambiri kotero kuti mumayenera kugwiritsa ntchito ma narcotic painkillers.

Poyerekeza ndi matenda a gallstone, pancreatitis yayitali imakhala pachimake, kubwereranso kumachitika nthawi zambiri.

Kuphatikiza pa kupweteka kwak pachimake, kufalikira kwamatenda a kapamba kumayendetsedwa ndi zizindikiro:

• chisangalalo
• kutentha kuwonjezeka
• kutsitsa magazi
• kugunda kwa mtima
• kuphwanya chopondapo.

Chizindikiro chowala ndi jaundice yolepheretsa. Amachitika ndi kufalikira kwathunthu kwa bile bile.

Zimayambitsa ndi matenda kuwonekera kwa matendawa

Matenda obwereza kapamba nthawi zambiri amawonedwa ndimatenda a cholelithiasis, kapena matenda a ndulu, omwe amadziwika ndi mapangidwe a miyala (miyala) mu ndulu ya ndulu kapena ndulu ya bile. Zomwe zimayambitsa kupezeka kwa matenda osachiritsika a kapamba amadziwika kuti ndi kumwa mowa mwauchidakwa pamodzi ndi zakudya zopatsa thanzi zambiri. Zomwe zimayambitsa matenda osokoneza bongo a kapamba ndi monga:

• kugaya chakudya chida chamavuto,
• kuwonongeka kwamakina kumayambitsa kugwedezeka kwapancreatic,
• endoscopic kapena opaleshoni yolowera yomwe imabweretsa zoopsa,
• Psychogenic zotsatira: kupsinjika kwamanjenje, zovuta zamavuto,
• kuchuluka kwamitsempha yamagazi,
• minofu atrophy kutuluka kwa pancreatic ndi / kapena bile ducts.

Chofunikanso chimodzimodzi ndi momwe wodwalayo amafotokozera.

Zofunika! Malinga ndi ziwerengero kuchokera ku World Health Organisation (WHO), chiwonjezeko cha 75% chokhala pachiwopsezo cha odwala omwe amasuta.

Mu chifuwa chachikulu, kubwereza komwe matendawa amadziwika ndi kuperewera, ndiye kuti, kupangika kwapansi kwa zikondamoyo za exocrine glandular zinthu (ma enzymes am'mimba). Matenda obwereza a kapamba chifukwa cha matenda owopsa omwe pseudocyst imapanga mu kapamba. Kuzizira kwamadzimadzi, kumachulukana kukula, ndipo, chifukwa cha kupanikizika kwa ziwalo zapafupi za thupi, kumayambitsa kupweteka, kusokoneza magwiridwe antchito a duodenum, m'mimba, komanso dongosolo lonse logaya chakudya. Kukula kwa matendawa kumabweretsa kufooka kwa minofu ya glandular, kuchuluka (fibrosis), m'malo mwa zotupa za pancreatic parenchyma.

Zofunika! Matenda a parenchymal pancreatitis okhala ndi ululu wobwerekera angayambenso kuwonetseredwa kwa kapamba kapamba.

Etiology ndi pathogenesis zamkokomo

Pokonza kapamba, ntchito yayikulu imachitika ndi zinthu ziwiri: mowa ndi matenda amtundu wambiri. Ngati nthendayi yotalika ya matendawa yadziwika mu anamnesis, ndiye kuti ngakhale ndi imodzi mwa izi, izi zimachulukitsa. Pankhani imeneyi, zifukwa zotsatirazi zitha kusiyanitsidwa:

• Kumwa pafupipafupi mowa pang'ono kapena pang'ono pakumwa mowa wambiri.
• Kudya chakudya chochuluka, kudya kwambiri.
• Zolakwika mu chakudya: kugwiritsa ntchito zokazinga, zamafuta, zonunkhira.
• Amayambitsa Iatrogenic: kumwa mosasamala kwa mankhwala.
• Kupsinjika, kutengeka mtima kapena thupi.
• Potengera zakumbuyo ya matenda opatsirana omwe akuchitika mthupi la wodwalayo.

Zimatsimikiziridwa kuti mwa anthu omwe ali ndi mafuta onenepa kwambiri komanso omwe ali ndi zizolowezi zoipa, makamaka kusuta, kuchuluka kwa chifuwa cham'mimba kumachitika nthawi zambiri, kumakhala kovulaza kwambiri.

Zinthu zonsezi pamwambazi, zikamwetsa, zimayambitsa kugwira ntchito kwa enzymatic ya gland yodwala kapena kumakhudza mwachindunji, kuwononga maselo ochulukirapo. Poyankha kuphwanya kutuluka kwa katulutsidwe, kuwonongedwa kowonjezereka kwa maselo amkati mwathupi, chotupacho chimakulirakulira. Edema imachitika, mkhalidwe umakulirakulirabe, ndipo zizindikiritso zakuwonekera.

Zizindikiro zazikulu

Zizindikiro zonse zachipatala zakuchulukirachulukira zimayamba kale patsiku loyamba, kukakamiza wodwalayo kupita kuchipatala msanga. Mutha kuzindikira kuwonjezeka kwa matendawa ndi zizindikiro zotsatirazi:

• Kupweteka kopweteka pamimba yonse, ndi kuthekera kwachilengedwe kumadera a epigastric. Ululu umakhala ngati lamba kapena wonyezimira kumbuyo, kutsikira kumbuyo, tsamba lamapewa, hypochondrium yakumanzere. Zizindikiro zopweteka sizisiya kumwa mankhwalawa. Wodwala sangathe kupeza yekha malo, wokhala mokakamizidwa (atagona pambali pake ndi mawondo ake obweretsedwa kapena thupi la "mluza"). Ululu umadza pambuyo pa cholakwika mu chakudya: kudya zakumwa zoledzeretsa, zakudya zamafuta, chakudya chochuluka.
• Kuphwanya ululu wam'mbuyomu, kapena kumawonekera kutalika kwa ululu. Mbali yodziwika bwino ya chizindikiro ichi - kusanza sikubweretsa mpumulo. M'malo mwake, wodwalayo amalephera kusinkhasinkha mosalekeza.
• Flatulence - kuchuluka kwaulemu m'matumbo.
• Mafuta, mushy, chopondapo chopondapo chachikaso ndi mitundu yambiri yosakanikira yamafuta (steatorrhea).
• Ngati wodwala ali ndi bancary-pancreatitis yodalira, ndiye nthawi zambiri pamakhala kulawa kwamkamwa, kuwawa kowawa. Nthawi zina, mukafunsidwa, masinthidwe acteric a sclera, mucous nembanemba ndi khungu zimapezeka.
• Kuchuluka kwa kutentha kwa thupi, kumva kutentha, kufooka, kufoka.

Milandu yayikulu ya matendawa, ndikofunikira kuyesa molondola vutoli, kuyamba kupereka thandizo nthawi yomweyo ndikuyitanitsa dokotala. Pankhaniyi, mwayi wa opaleshoni ndi kufa umachepa.
Zizindikiro zakukula kwambiri kwa kapamba:

1. Kukhumudwitsidwa, kukomoka kapena kusazindikira kwenikweni.
2. Kutsitsa magazi.
3. Kupumira kosasunthika.
4. Kukoka kocheperako ngati ulusi wofooka komanso mavuto.
5. Thupi.
6. Mavuto amisala: dementia, delirium, etc.

Yang'anani! Zizindikiro zonsezi zimawonetsa kuledzera kwambiri kwa thupi. Kuperewera kwa chithandizo choyambirira chofunikira kwa wodwala pakadali pano matenda kumatha kubweretsa kudwala.

Zizindikiro

Mu chipatala, ngati wodwala ali wodekha, njira zingapo zoyeserera zasayansi ndi zina zofunikira zimayikidwa m'njira yoyenera. Woopsa milandu, hemodynamics ndi zofunika thupi lonse kuwunika.

Kuyesedwa kwa magazi kwachipatala kukuwonetsa kukhalapo kwa kusintha kwa kutupa.

Kayezetsa magazi a biochemical ndi omwe azindikire kuchuluka kwa michere yayikulu yonse (kuphatikizapo amylase, transfer ndi ma enzymes a chiwindi), ma pigment (bilirubin) ndi mapuloteni.

Kusanthula kwamkati mwazinthu zamkati kuti mudziwe kuchuluka kwa diastase. Ichi ndi chimodzi mwazofunikira pakuzindikira, chifukwa pancreatitis, diastasis imawonjezera kakhumi. Chizindikiro chake ndichachindunji cha kapamba.

Kupenda kwa Ultrasound kwam'mimba kuti mupeze kusintha kwa minyewa. Onaninso momwe ziwalo zina zimapangidwira. Ultrasound imakupatsani mwayi wotsatira matendawa mumphamvu.

Njira zowonjezera: CT, MSCT, laparoscopy. Sichikugwiritsiridwa ntchito kwambiri ngati pali umboni wa izi. Njira ya laparoscopic sindiye kuti sangazindikire chilengedwe, koma achire, chifukwa panthawi yolowerera dokotalayo amatha kuchotsa miyala, zomatira ndi mawonekedwe omwe amakumana panjira yotulutsa madzi a pancreatic.

Thandizo loyamba kunyumba

Ndi kukula kwa zizindikiro za kuchulukitsa, nthawi yomweyo imbani ambulansi ndikupanga mtendere wathunthu kwa wodwalayo. Kuti muchepetse kupweteka, mutha kutenga ma antispasmodics mu mawonekedwe apiritsi (no-spa, papaverine, drotaverine), koma ndibwino kuyika kuzizira dera la epigastric. Kudya mu izi ndizoletsedwa. Kuchokera ku zakumwa, tikulimbikitsidwa kumwa magalasi angapo a madzi amchere a Borjomi alkaline, omwe ali ndi phindu pa kapamba.

Mankhwala osagwiritsa ntchito mankhwala

Mankhwala osagwiritsidwa ntchito ndi mankhwalawa amagwira ntchito yofunika pothandiza kwambiri pancreatitis yayitali, ndi imodzi mwazinthu zazikulu zothandizira poyamba, kunyumba komanso kuchipatala. Choyamba, tikambirana za zakudya zomwe wodwala amayenera kutsatira pamoyo wake wonse, makamaka ndi kuchuluka.

M'masiku 4-5 oyambira kuchipatala, kusala kwathunthu kumayikidwa, pambuyo pake ndizochepa zochepa zomwe zimaperekedwa kwa wodwala. Chakudya chosasamala choterocho cholinga chake ndikuchepetsa gawo la kapamba, zomwe zimapanga mtendere wake wonse. Zakudya zimatanthauzira mfundo izi:

• Kukana mafuta, mafuta ophika ndi zokometsera,
• Zakudya zotentha, kapena zowiritsa,
• Kukana kudya nyama yamafuta (nkhumba, ng'ombe, mwanawankhosa). Mitundu yonda nyama imaloledwa (nkhuku, lingaliro, kalulu, nyama yamwana),
• Amaloledwa kugwiritsa ntchito mitundu yamafuta amchere. Ndikwabwino kuphatikiza pa chakudya chamadzulo kapena chamasana.
• Kuchepetsa kudya mkate watsopano, ndibwino kuti muzimuphika mutawuma ndi timadontho tating'ono,
• Kuyambira masamba, tsabola wowotcha, adyo, anyezi, radara, radishes ndizoletsedwa. Masamba omwe amaloledwa ndi owiritsa kapena otentha,
• Za zipatso, mapeyala ndi maapulo amaloledwa. Amaphika chifukwa cha nkhomaliro kapena tiyi wamasana,
• Kuchepetsa kumwa kwa mkaka wonse m'malo mwa mkaka,
• Kuchepetsa kudya kwa dzira, ndibwino kudya mapuloteni okha,
• Mwa zakumwa, tiyi wobiriwira ndi wakuda, zakudya zonunkhira, zipatso kapena zipatso, ma decoctions, kefir ndi zakumwa zina mkaka wowawasa zimamwa,
• Kukana kugwiritsa ntchito mapira. Maphala otsala amaloledwa, ndibwino kuwaphatikiza muzakudya zam'mawa.
• Kukana kudya mitundu yonse ya mtedza, bowa, zonunkhira, zipatso za zipatso ndi ginger.

Zakudya za wodwalayo ziyenera kukhala kasanu patsiku, zazing'ono. Zakudya zonse zimaphikidwa mofunda. Zakudyazi zimapangidwa kuti zizikhala ndi protein yokwanira komanso zochepa zamafuta osavuta.

Zofunika! Ngakhale atatuluka m'chipatala, wodwalayo ayenera kutsatira mfundo zofunika zodya zakudya zochepa. Pokhapokha ngati izi ndizotheka kuti zithetsenso zonse zomwe zikuwonetsa matenda. Mankhwala amagwira ntchito pokhapokha ngati zakudya zomwe zimatsatiridwa zimatsatiridwa mosamalitsa.

Kutengera malamulo onse omwe ali pamwambapa, zizindikiro za kufalikira zimatha patapita masiku angapo, zimathandizira kwambiri mkhalidwe wa wodwalayo.

Mankhwala

Thandizo loyamba kuchipatala mothandizidwa ndi mankhwala limaperekedwa mwachangu. Choyamba, chithandizo chamankhwala chimayikidwa. Chifukwa cha izi, antispasmodics, kukonzekera kwa enzyme, mankhwala antisecretory, maantibayotiki amagwiritsidwa ntchito. Nthawi zina, chithandizo chimaphatikizapo histamine blockers, glucocorticosteroids, narcotic analgesics.

Ma antispasmodics amagwiritsidwa ntchito pochepetsa ululu (no-spa, papaverine, platifillin). Ngati mankhwalawa sagwira ntchito, amasinthidwa ndi narcotic analgesics. Woopsa milandu, kuthetsa zizindikiro za kupweteka, mutha kugwiritsa ntchito blockade wa mitengo ikuluikulu ya mitsempha ndi plexuses novocaine.

Kukonzekera kwa enzyme kumapangidwira kuti ithandizire kugaya chakudya kwinaku akuchepetsa kupanga kwa secretion ndi kapamba. Substitution chithandizo imalembedwa kuti ichiritsidwe osati kuchipatala, komanso kunyumba. Ndikwabwino kutenga ndalamazi kwa moyo wathu wonse.

Mankhwala a Antisecretory (famotidine, ranitidine, omez, omeprazole) amaletsa kupanga hydrochloric acid m'mimba, yomwe imakwiya kwambiri pakupanga ma enzymes a pancreatic. Chithandizo chamtunduwu chalandiratu. Izi zimapangitsa kuti gland iwonjezere kugwira ntchito, zomwe pamapeto pake zimapangitsa kuti ichitike mwachangu komanso kutha kwa zizindikiro zonse.

Maantibayotiki amawonetsedwa popewa kuteteza matenda owonongeka pamitsempha yowonongeka, komanso kuchepetsa njira yotupa. Kukhazikitsidwa kwa ma anti-sipekitiramu ambiri kwawoneka (3rd cephalosporins, fluoroquinolones, metronidazole).

Histamine blockers ndi glucocorticosteroids amalepheretsa chitetezo cha mthupi, zomwe zimapangitsa kuchepa kwa mphamvu ya chitetezo chathupi mthupi lake.

Zizindikiro zakuchita opareshoni

• Kuchulukitsa kwa pancreatic necrosis komanso kuwonongeka kwa minofu ya pancreatic ndi chowonjezera (kapena ndikuwopseza kupezeka) kwa sepsis ndi septic shock.
• Mavuto a matenda a kapamba (fistulas, kupezeka kwa cysts, pseudocysts, abscesses mu minofu ya chiwalo).
• Kupezeka kwa mwala womwe umaphwanya kutuluka kwa zobisika, zazikulu zazikulu, zomwe sizingachotsedwe pogwiritsa ntchito njira zowononga zachilengedwe.
• Imatsimikiziridwa ndi ultrasound, CT (MRI), biopsy, khansa ya kapamba.

Moyo komanso kupewa kutalika

Pofuna kupewa kufalikira kwina, ndikofunikira kutsatira mfundo za zakudya zoyenera komanso zopatsa thanzi, kutsatira malangizo onse a dokotala.Kusiya mowa komanso kusuta fodya kumathandizanso kwambiri kuti pakhale matenda okhazikika.

Chepetsani kuchuluka kwamafuta omwe mumawononga Chepetsani zopatsa mphamvu zopatsa thanzi kuti muchepetse kunenepa. Kumwa mankhwala, komanso chithandizo ndi njira zina zochiritsira, timaloledwa pokhapokha kukaonana ndi katswiri. Pamafunika kuyezetsa magazi ndi a gastroenterologist chaka chilichonse kuti azitha kuyang'ana momwe magazi amapangidwira komanso kupewa mavuto.

Mankhwala othandizira

Ngati kupweteka sikumalephera komanso kwamphamvu, chisokonezo, kusanza, kutsekula m'mimba kumawonedwa, muyenera kulumikizana ndi ambulansi nthawi yomweyo. Simungatenge ma pinkiller. Izi zidzasokoneza chithunzichi, osalola madotolo kuti azindikire zoyenera.

Ndi kuchulukirachulukira kwa matenda kapamba, kuwonongeka kwa kapamba ndi ziwalo zina zamkati kungayambike.

Opaleshoni

Nthawi ndi nthawi, kutupa kwa kapamba kumachitika kwambiri, ndipo zotsatira zake zimakhala zosasintha. Muyenera kusintha opaleshoni. Zikatero, opaleshoni ya opaleshoni kapena endoscopic imapangidwa kuti ilowetsenso minofu yakufa kapena gawo la chiwalo.

Tsoka ilo, pamakhala zochitika pomwe malo zowonongeka sizikhala malo amodzi, koma zimamwazikana mwangozi. Izi sizimalola kuchotsedwa kwathunthu kwa minofu yakufa, zomwe zimayambitsa kubwereranso pambuyo pake. Nthawi zambiri zimachitika ndi kuchuluka kwa zakumwa zoledzeretsa.

Chithandizo cha Conservative

Pambuyo pa opaleshoni, kapena ngati sichinapewedwe, chithandizo chokhazikika chimayikidwa kuti chiwonjezeke matenda a kapamba:

• Mankhwala opweteka amayikidwa. Choyamba, amafunika kupondereza ululu. Ma analgesics amalembedwa kapena, ndi ululu wosazolowereka, mankhwala omwe amachepetsa mphamvu.
• Mankhwala omwe amaletsa kugwira ntchito kwa kapamba. Amasankhidwa kuti apatse mpumulo chiwalo chovulazidwa, kuti muchepetse kapena kupewetsa kupanga ma enzyme omwe amawononga minofu.
• Ma diuretics adalembedwa. Kamodzi m'magazi, michere ya pancreatic imayamba kuwononga ziwalo zina: mapapu, chiwindi, impso, mtima, komanso ubongo. Kuti muchepetse kuthana ndi poizoni mu mkodzo, okodzetsa ndi mankhwala.
• Zakudya za makolo zimakhazikitsidwa. Kuti nkhanu zizipuma, zimapatsidwa chakudya chokwanira. Masiku angapo oyamba, wodwalayo saganizira za chakudya chifukwa cha kupweteka kwambiri komanso chifukwa chofooka. Ngati matendawo akukhalabe ovuta, michereyo imabayidwa kudzera m'masiku atatu mpaka asanu ndi awiri kuti thupi likhale ndi ntchito.

Zochita izi cholinga chake kuyimitsa kapamba komanso kubwezeretsanso chiwalo.

Chithandizo chakanthawi

Ngati kuukira sikulimba kwambiri kuyitanitsa ambulansi, mutha kuchita zinthu zodziletsa kuti muchepetse chizindikiro:

• Muyenera kusiya kudya kwa masiku atatu. Zakudya pambuyo panjala yodwala zimayambitsidwanso pang'onopang'ono, kuwunika momwe zilili.
• Tengani mankhwala omwe amachepetsa kuphipha (no-spa kapena papaverine) ndi mankhwala oletsa kupweteka (paracetamol kapena ibuprofen, amaloledwa kutenga analgin).
• Yang'anani pogona.
• Posachedwa, kufunsa dokotala.

Kawirikawiri, wodwalayo akudziwa zoyenera kuchita ndi aggravation a kapamba, koma mankhwala amachitidwa yekha ndi dokotala. Cholakwika matenda ndi mankhwala zoipa ndi zotsatira amapha.

Mankhwala othandizira kuchepetsa

Mu aakulu kapamba yaikulu Mankhwalawa ayenera kumwedwa akuchipatala. Mankhwala omwe samachiritsa pancreatitis pa se, koma omwe amachepetsa kuwonongeka komwe kumachitika chifukwa cha kutupa kwambiri. Mankhwalawa matenda bwino asidi-zamchere.

Kenako gastroenterologist amasankha enzyme mankhwala kuti asinthe kapamba. Enzymes amatchulidwa kwa nthawi yayitali komanso kuthetsa zizindikiro za chifuwa chachikulu. Ayenera kutsatira mfundo zokhazikidwa kulandiridwa. Pogwiritsa ntchito ma enzymes komanso chakudya choyenera,:

1. Chotsani kutentha kwa mtima, kupindika, kutulutsa.
2. Amathandizira kugwetsa chakudya mwachangu komanso mosamalitsa kuti chakudya chisakhale m'mimba, sichimayambitsa kupesa.
3. Kuchepetsa katundu pa limba matenda.

Chithandizo cha chifuwa chachikulu ndi njira yovuta yomwe imafuna kuwunikidwa ndi dokotala, kusintha kwa mankhwalawa ndikutsatira kwa moyo wonse. Mukamatsatira malangizo a dokotala, matenda a kapamba amayamba kuchepa kwambiri.

Kapamba ndi matenda ena

1. Matenda a Gallstone. Chimodzi mwa zinthu zazikulu kapamba. Pakadwala matenda a gallstone, zikondamoyo zimatsekeka, chifukwa ma enzymes omwe amapangidwa ndi omwe samamasulidwa mu duodenum, koma khalani m'malo ndikuyamba kuphwanya minyewa ya chiwalo. Pankhani ya matenda a gallstone, kapamba amayamba kuvuta nthawi iliyonse.
2. Cholecystitis. Pancreatitis nthawi zambiri imawoneka ngati complication ya cholecystitis. Zizindikiro za matendawa ndi ofanana, zimapangitsa kuzindikira kukhala kovuta. Koma mankhwala kumachitika kwayekha.
3. Matenda a shuga Kuphatikiza pakupanga ma enzyme omwe amathandizira kugaya chakudya, kapamba ali ndi ntchito inanso yofunika. Uku ndikupanga insulin - timadzi tomwe timayambitsa kuchepetsa shuga. Yaitali kutupa, komanso exacerbation wa kapamba aakulu kuwononga maselo opaleshoni endocrine ntchito, imbaenda matenda a shuga. Shuga woterewu yomweyo, ndi liwonongeke, ndipo limapezeka nthawi zambiri mu nthawi imene wodwala amanyalanyaza zizindikiro ndi mankhwala zotchulidwa dokotala.
4. matenda bakiteriya. Nthawi zambiri, matenda oyambitsidwa ndi bakiteriya, monga staphylococcus, amalumikizana ndi kutupa kwa pancreatic. Zikatero, maantibayotiki Kwalamulidwa. Amathandizanso kupewa zovuta monga abscess, peritonitis, pancreatic necrosis.
5. matenda a mafangasi. Matenda a Candidiasis ndi matenda ena oyamba ndi fungus amathanso kukulira

Kapamba - chiwalo zofunika kwambiri ulimi wa mahomoni udindo yopanga michere zofunika chimbudzi. Kusagwiritsa zakudya, kudya mafuta zakudya, kawirikawiri phwando mowa kuchititsa kutupa kwa zimakhala za kapamba, wotchedwa kapamba mankhwala. Nthawi zambiri, matendawa amapezeka ndimanjenje, m'malo opsinjika nthawi zonse komanso kusowa kwa kupuma koyenera. Kukula kwa matenda amizere kumakhala ndi chiwopsezo chachikulu cha zovuta zowopsa m'moyo.

Mankhwala, ndichizolowezi kusiyanitsa mitundu iwiri ya kapamba - pachimake komanso chovuta, omwe amagawidwa m'magulu ang'onoang'ono. Zovuta zimadalira mawonekedwe a matenda.

Pachimake kapamba

Amadziwika ndi chitukuko chambiri cha kapamba ka necrosis. Chiwalochi chimayamba kudzimbidwa chokha, pomwe minofu imayamba kuwonongeka.

Kwambiri oopsa Vuto mitundu pachimake a kapamba ndi necrotizing, nthaŵi zina ngakhale kudzetsa imfa kwathunthu kwa minofu pancreatic. Ndi matenda ofanana, ziwalo zotsalira m'mimba zimayamba kuvutika. Pancreatic necrosis imawonetsedwa ndi kupweteka kwambiri, nseru, kusanza, kutentha kwambiri kwa thupi. Mu classifications zosiyanasiyana mankhwala, izo lagawidwa subtypes: chowuma, matenda, mafuta, wamagazi, wosakaniza ndi zina zotero.

Mitundu yamatenda

M'mabuku azachipatala pali zosankha zingapo zamatenda azofotokozedwera. Taganizirani tione wa otchuka kwambiri.

Wogawanika pa mawu chiyambi:

• Ngati matendawa amakula kapamba, amatengedwa ngati woyamba.
• kapamba Secondary amapezeka ndi maziko a pathologies Mwachitsanzo, chapamimba chilonda, enterocolitis, cholecystitis.
• Post-traumatic pancreatitis ndi chifukwa cha kuvulala kwamkati kapena pancreatic open, kapena opaleshoni.

Matenda a kapamba mu mankhwala nthawi zambiri amagawidwa m'magulu amtundu, omwe amasiyana chifukwa cha zomwe zimayambitsa, Zizindikiro, matendawa:

• zopatsirana
• kubwereza (kubwereza)
• chidakwa (choopsa).

Pancreatitis yopatsirana amatsatira hepatitis, mumps, ndi typhus.

Matenda obwereza kapamba amadziwika ndi zovuta m'matumbo a kapamba. Kusiyana kwa mtundu wa matendawa posinthanitsa pafupipafupi ndi kuchotsedwa, kuphatikizana ndi kupweteka kwambiri. Kumwekanso kumayamba chifukwa chosagwirizana ndi zakudya zomwe mumamwa, kumwa mowa, kapena kumwa mankhwala. Dziwani kuti kupweteka kwamatumbo komwe kumachitika nthawi zambiri kumawonedwa m'moyo wonse wa wodwala.

Anthu omwe amakonda kumwa mowa mosalekeza amakhala ndi chizolowezi cha poizoni. Mowa wa Ethyl womwe umakhala ndi mowa umabweretsa zowononga pancreas, zomwe zimayambitsa kutupa. Mothandizidwa ndi chinthucho, matendawa nthawi zambiri amakhala ndi hypertriglyceridemia, kuchuluka kwa triglycerides kumapezeka mwa odwala m'magazi.

Zina za chifuwa chachikulu cha ana

Tsoka ilo, chifuwa chachikulu chimapezeka mwa ana, chimachitika ndi mawonekedwe. Matendawa amakula chifukwa cha kuvulala, kubala kwina, kupatuka pantchito ya ziwalo zina zam'mimba, kuperewera kwa zakudya m'thupi, komanso mankhwala. Vuto lalikulu ndikuti mwana wamng'ono sangathe kuwonetsa chizindikiro chosokoneza. Matendawa amatuluka popanda chizindikiro chowoneka bwino;

Zoyambitsa zazikulu za kapamba nthawi zambiri zimakhala:

• zizolowezi zoipa
• kuperewera kwa zakudya m'thupi
• kupsinjika
• kuchuluka kwa matenda (cholecystitis, zilonda zam'mimba, ndi zina),
• kuvulala
• chikhodzodzo msambo.

Madokotala amakhulupirira kuti nthawi zambiri, matenda a kapamba amayamba chifukwa cha matenda a cholecystitis.

Zizindikiro za Chronic Pancreatitis

Malinga ndi chithunzi cha matenda, chifuwa chachikulu chimagawika m'magulu: latent, polysymptomatic, ululu, pseudotumor, dyspeptic. Fomu lopweteka limadziwika ndi kupweteka kwambiri kosalekeza.

Nthawi zina, kapamba wopanda ululu amapezeka m'magawo oyamba a matendawa, nthawi imatha zaka zingapo. Ndi kuchulukitsa, zizindikiro zimawonedwa:

• kupweteka pansi pa nthiti kumanzere,
• chopondapo chopindika
• kuwonda mwadzidzidzi
• kupweteka pambuyo podya zakudya zamafuta,
• kuchuluka kwa masokono
• kamwa yowuma, malamba, mseru, ulemu
• kusowa kwa chakudya.

Kuphwanya kapamba kumakhudza mkhalidwe wamunthu, kumabweretsa kusapeza bwino. Pakakhala chimbudzi chachilendo, kuperewera kwenikweni kwa zinthu zofunika m'thupi kumachitika.

Mwachitsanzo, kuyabwa nthawi zambiri kumachitika ndi kapamba. Izi zimachitika chifukwa cha edema ya pancreatic, zomwe zimabweretsa kukakamiza kwa ziwalo zina zomwe zimayambitsidwa ndi ziwopsezo zamankhwala.

Njira yamatendawa imayendera limodzi ndi kuchepa kwa tsitsi, kutsekeka ndi kupindika kwa misomali. Ngati sagwiridwe ntchito, kumaduka kwamutu kumatheka.

Mavuto ndi zotsatira za chifuwa chachikulu

Matenda omwe afotokozedwawa ndiwotsimikizika chifukwa chakuti zizindikilo zimachepa pakukhululuka, wodwalayo panthawi yomwe akuwunikiridwa zikuwoneka kuti matendawa adachiritsidwa, ndipo abwerera kumoyo wake. Mavuto a chifuwa chachikulu chikukula pang'onopang'ono, mndandandawo umaphatikizapo matenda owopsa.

Nthawi zambiri, odwala amakhala ndi zovuta:

• jaundice wolepheretsa (imayamba chifukwa chophwanya dongosolo la kutuluka kwa ndulu kuchokera ku ndulu),
• magazi amkati chifukwa cha kuwonongeka kwa ziwalo ndi zilonda zam'mimba,
• kukula kwa matenda ndi zotupa,
• kapangidwe ka ma cysts ndi fistulas,
• kukula kwa matenda ashuga
• khansa.

Nthawi zambiri, mayesowo akuwonetsa cysts, kukhala wovuta chifukwa cha matenda kapamba. Zapulogalamu zodzazidwa ndi madzi zimapezeka mukamayesedwa wa ultrasound. Pankhaniyi, opaleshoni ndiyosapeweka. Kuchotsa kumachitika pogwiritsa ntchito opaleshoni ya laparoscopic.

Ngati m'mbuyomu matendawa adachitika mwa anthu achikulire, masiku ano kusintha kwa kapamba kumachitika mwa achinyamata. Zizolowezi zolakwika zosadya zimapangitsa kuti kapamba livutike ndikulephera kugwira ntchito. Matenda ofala amayamba, pomwe ma pancreatic madzi, amafunika kugaya chimbudzi, amasiya kuponyedwa mu duodenum. Vutoli limabweretsa chikhodzodzo ndi kuchepa kwa chitetezo cha m'thupi, chiwopsezo cha matenda a shuga.

Popanda chithandizo, matendawa amawonjezeredwa ndi zovuta zina, ma pathologies ena amakula. Mwachitsanzo, chifukwa cha kupindika kwa pancreatic, atrophic pancreatitis imachitika: kuchuluka kwa gland kumachepa, kupanga kwachinsinsi kumakulirakulira. Nthawi zambiri matendawa amakhala gawo lomaliza la poizoni wa kapamba. Zimatengera mkhalidwe wowopsa: atrophy of cell pancreatic limachitika, chiwalo chimataya ntchito, chakudya chimasiya kugayidwa bwino ndipo thupi limayamba kudwala chifukwa cha kuchepa kwa mavitamini ndi michere.

Matenda a kapamba amathandizanso pakugwiritsa ntchito kayendedwe kazinthu zathupi. Kupsinjika kwa kapamba kumadalira mawonekedwe ndi gawo la matendawa. Mtundu wovuta umadziwika ndi kuchepa mwadongosolo kwa kupanikizika. Kuwonjezeka nthawi zambiri kumawonetsa kudandaula kwamatenda mu matenda.

Ngati pancreatitis ndi yachiwiri, vutolo limakhala lovuta chifukwa munthu amakhala ndi matenda angapo nthawi imodzi, omwe amalumikizana ndikuwonetsa zizindikiro zofanana. Pankhaniyi, kutsimikiza kwa zomwe zimayambitsa kukula kwa matenda ndi zovuta. Mwachitsanzo, nthawi zambiri cholecystitis ndi kapamba zimachitika palimodzi, pomwe mlandu woyamba ndi kutupa kwa ndulu, ndipo wachiwiri ndi kapamba. Zizindikiro ndizofanana. Pancreatitis, complicating cholecystitis, imawonetsedwa ndi herpes zoster.

Pancreatitis yoyambilira imatha kulowa mu mawonekedwe owopsa, momwe moyo wa munthu umakhala pachiwopsezo. Monga lamulo, njirayi imayendetsedwa ndi zovuta zingapo - cysts, abscesses, magazi mkati.

Matenda oopsa a pancreatitis theka la milandu amathera muimfa, chifukwa amachititsa kuti ziwalo zina zofunikira. Odwala omwe ali ndi mawonekedwe oopsa, kupuma nthawi zambiri kumakhala kovuta, ma ultrasound amazindikira misozi mkati, ndipo ma electrocardiogram amawonetsa infunction ya myocardial.

Laparoscopy

Ngati mukugwiritsa ntchito diagnostics wamba sikunali kotheka kuzindikira mawonekedwe a matenda a pathology, kapena matenda monga pancreatic necrosis kapena cystic pancreatitis, dokotala asankha kuchita laparoscopy. Opaleshoni imachitidwa kuchipatala, pambuyo pake imayenera kuonedwa ndi dokotala kwa nthawi yayitali.

Njirayi imawonedwa kuti ndi yotetezeka, yopanda ululu, palibe zipsera zomwe zatsalira pambuyo pa kulowererapo. Nthawi yomweyo, laparoscopy imalekeredwa mosavuta ndi odwala ndipo sifunikira kukonzanso kwakanthawi.

Momwe mungadziwire njira yodwalayo yamatenda mwa zizindikiro zosonyeza

Monga lamulo, musanayambike ululu, wodwalayo amakhala ndi khungu, ndiye kuti, ndowe zimakhala ndi mafuta onunkhira komanso onyezimira, fungo la fetid ndipo satsukidwa bwino ndi madzi kuchokera kukhoma la chimbudzi. Chifukwa chakuphwanya kwa bile yotuluka mu odwala ena, omwe amatchedwa ounikira a jaundice amawoneka, omwe amasintha khungu pakhungu. M'tsogolomu, "sewero" la pancreatic likupitilirabe kumusangalatsa.Matenda a ululu amakhala ndi chovala chakumaso kumanzere kumbuyo, zimakhudza dera la scapula, hypochondrium ndi epigastrium, ndiko kuti, dera la m'mimba. Pakufufuza koyenera chifukwa cha kupindika, akatswiri amawona chidindo chosasunthika m'dera lachiwombolo, chomwe chingasonyeze kuyambika kwa chotupa cha khansa pa kapamba. Zizindikiro zina zamatenda omwe amapezekanso chifukwa chodwala kapamba kovuta kwambiri ndi monga:

• kuwonongeka kwa wodwala,
• kusefukira kwam'mimba, kutsekula m'mimba, komanso kudzimbidwa,
• kusanza ndi kusanza kosalekeza,
• kuchuluka kwa masokono.

Nthawi zambiri zomwe zimayambitsa zizindikirozi ndi kuphwanya kwamakhalidwe azakudya komanso / kapena kugwiritsa ntchito zakumwa zoledzeretsa. Komanso, nkhawa kwambiri komanso / kapena zinthu zopsinjika zimatha kubweretsanso vuto lina logaya chakudya. Matenda a ululu amatha kubweretsa vuto kwa munthu kuyambira maola angapo mpaka masiku 5-7.

Zofunika! Pazizindikiro zoyambirira za pancreatitis yodziwika bwino, muyenera kufunsa dokotala wa gastroenterologist kapena wamankhwala omwe angakupatseni chithandizo chamankhwala ena ndikuwonjezeranso njira zina zochizira.

Kuzindikira kwa chifuwa chachikulu

Chidziwitso chabwino cha kupulumuka mu matenda osachiritsika chitha kutsimikiziridwa ndikugwiritsa ntchito zakudya mosasamala, kusiya kusuta fodya ndi kumwa mowa, kudziwonetsa wokwanira komanso wopezeka munthawi yake, komanso ndikuvomerezedwa ndi dokotala. Mavuto ambiri amatha kupha.

Dzisamalire nokha ndikukhala wathanzi nthawi zonse!

Kusokoneza kwamatumbo ndi vuto lomwe mamiliyoni a anthu padziko lonse lapansi akukumana nalo. Mulingo wapadera wamoyo, kuperewera kwa zakudya, kupsinjika, zovuta zachilengedwe ndi zina zomwe zimapangitsa kuti pakhale matenda am'mimba osiyanasiyana.

Pancreatitis ndi njira yodziwika yomwe imagwirizanitsidwa ndi kuphwanya kwa ntchito ya m'mimba. Matendawa amadziwika ndi njira yotupa yomwe imachitika m'mapapo chifukwa cha kusayambika kwa ma enzymes a thupi.

Vutoli limakhala lowopsa chifukwa ngati chakudya sichikupakidwa bwino, ziwalo za mkati zimawonongeka. Kuphatikiza apo, matenda ophatikizika monga gastritis kapena matenda am'mimba osafunikira amachitika. Mwina kukula kwa zilonda.

Chimodzi mwa njira yotupa mu kapamba ndichakuti matenda am'mimba amatha kuchitika kwa nthawi yayitali popanda kuwonekera. Kuchulukitsa kwa chifuwa chachikulu ndi vuto. Sitha kuyimitsidwa popanda kutenga nambala. Zizindikiro zamakhalidwe zikaonekera, muyenera kufunsa dokotala. Pancreatitis ili ndi code yapadera ya ICD-10. Ndi ya gulu la matenda am'mimba thirakiti (kalasi 11). Kuphatikiza kwa K85 kumatanthauza matenda. Zosankha kuyambira K86 ndiye njira yodwalayo.

The pathological process of biliary pancreatitis amachokera m'njira ziwiri zazikulu: aakulu komanso pachimake. Mutha kuwerenga zambiri za izi.

Matendawa ndi oopsa kwambiri. Nthawi zambiri zimatha ndi magazi amkati. Chifukwa chake, wodwalayo ayenera kupita kuchipatala mwachangu ndikusamalidwa.

Zotsatira zake

Mavuto obwera chifukwa cha kutukusira kwa kapamba wamafuta kapamba amadziwonekera pang'onopang'ono. Zowonongeka za matendawa zimabweretsa kuwoneka kwathunthu, monga zilonda zam'mimba, fistula m'matumbo a chiwalo, cystosis.

Panthawi yowonjezera, kutupa kwa peritoneum (peritonitis) ndikotheka. Odwala ndi kapamba kwa nthawi yayitali amakumana ndi exocrine insufficiency ndi matenda a shuga.Pankhani yowonjezereka komanso yowonjezereka, kuwonongeka pang'onopang'ono kwa maselo othandizira pancreatic kumakhala kolimbikitsa kusintha kwawo komanso kuwoneka ngati chotupa chowopsa.

Makamaka mosamala ndikofunikira kuyang'anira thanzi la azimayi omwe akuvutika.

Nthawi yachikhululukiro imatha kukhala zaka zingapo. Mukamatsatira malamulo osavuta popewa komanso kukhala ndi moyo wathanzi, kufalikira kwa kapamba kumawoneka kochepa kwambiri ndipo kutha kuimitsidwa msanga. Kukaonana ndi dokotala pafupipafupi kumawonjezera mwayi wodziwitsa matenda amisala mu nthawi.

Palibe ziwerengero zenizeni zokhudzana ndi matenda a kapamba, ndipo chifukwa chake izi zimafotokozedwa mu mabuku.

Dziwani kuti matendawa omwe ali ndi matenda a khunyu adayamba kupezeka pafupipafupi kuposa kale, ndikuti ayenera kuyang'anitsitsa kwambiri kuposa momwe zakhalira mpaka pano, osayiwala za izi posiyanitsa ndi matenda ena am'mimba. Kuwonjezeka kotereku kwa matenda a kapamba osakhalitsa kumadalira makamaka kudya mopitirira muyeso kudya zakudya zamafuta ambiri komanso zonunkhira, mowa, ndi zina zotere.

Chithunzi cha kuchipatala ndi maphunziro

Matenda a kapamba amakonda kupezeka pakati pa zaka 30 ndi 70. Chachilendo pakati pa akazi.

Mawonetsedwe azachipatala a pancreatitis osachiritsika amatha kusiyanasiyana ndikudalira kwachulukidwe ndi gawo la chotupa, kutalika kwa matendawa, kuopsa kwa magwiridwe antchito akunja ndi chidwi cha kapamba, etc. Kutengera izi, mitundu yosiyanasiyana ya mitundu yamatenda oyamba a kapamba amadziwika m'mabuku.

Mwa chiyambi chake, pancreatitis yayitali iyenera kugawidwa m'magulu awiri otsatirawa. 1. Pancreatitis yayikulu yosatha yomwe imachitika pakhungu limatupa makamaka mu kapamba palokha. Amatha kudwala matenda osakwanira mapuloteni, kuledzera, kusokonezeka kwa magazi komanso matendawa.

Malinga ndi mawonetseredwe azachipatala omwe ali ndi chifuwa chachikulu cha mankhwalawa, ndikofunikira kusiyanitsa mitundu iyi yotsatira yamatenda ake.
1. Matenda obwereza a pancreatitis: a) pachimake, b) mu gawo la kuchotsedwa.

2. Pancreatitis yosatha ndi kupweteka kosalekeza.

3. mawonekedwe a pseudotumor a pancreatitis aakulu. 4. Mawonekedwe "osapweteka" a kapamba wodwala. 5. mtundu wofinya wa matenda kapamba.

Mwa mitundu iyi, mitundu iwiri yoyambirira komanso makamaka yochita kupezekanso kapamba imakhala yofala kwambiri. Njira yotchedwa yopanda pancreatitis yopweteka kwambiri ndiyosowa kwambiri, ndi mitundu yotsalayo, chizindikiro chotsogola ndi kupweteka, komwe nthawi zambiri kumadziwika m'dera la epigastric kapena hypochondrium kumanzere ndipo nthawi zambiri kumakhala mu hypochondrium yoyenera. Nthawi zambiri amakhala ngati lamba ndipo amatha kukhala okhazikika kapena kuchitika paroxysmally.

Aakulu kupezekanso kapamba, kupweteka kumadziwonekera mu mawonekedwe a kugwidwa koopsa masiku angapo, pambuyo pake chikhululukiro. Ndi mitundu ina ya kapamba, ndi okhazikika. Ululu umatha kukhala wosiyanasiyana komanso kutsagana ndi vuto lodetsa nkhawa: kusowa kudya, kusanza, kugona komanso kusanza. Kutsegula m'mimba kumatha kuchitika, kusinthana ndi kudzimbidwa. Nthawi zambiri mwa odwala omwe ali ndi pancreatitis yayikulu, kuchepa kwambiri kwa thupi ndikukula kwa shuga kumawonedwa. Masewera a fibrosis otchulidwa kapena kutupa m'mimba kwa kapamba, pakatha zovuta zina. Nthawi zina kutuluka kwa m'mimba kumatha kulumikizana ndi izi.

Pa palpation pamimba, kupweteka pang'ono mu kapamba kumatha kudziwika.Ndizotheka kutsegula tiziwalo tating'onoting'ono pokhapokha ngati ndi lakuthwa kapangidwe kake kapena kukula kwa chotupa kapena chotupa mkati mwake. Kuphatikiza pa zovuta izi, nthawi zina, kuwerengera kwa gland ndi kukula kwa fibrosis lakuthwa kumatha kuzindikirika. Odwala omwe ali ndi chifuwa cham'mimba, amakulitsa chiwindi ndi zovuta zake zomwe zimagwira. Nthawi zina kusintha kumeneku kumatha kutsatiridwa ndi splenomegaly chifukwa cha vein thrombosis. Mwina chitukuko cha hypochromic, macrocytic anemia. Pakuchulukitsa kwa njirayi, neutrophilic leukocytosis, liwiro la ROE, imawonedwa. Nthawi zina matenda a kapamba amatha kupezeka ndi eosinophilia, nthawi zina mpaka 30-50%. M'mitundu yambiri yamatenda a kapamba, kuchuluka kwa transaminase ndi aldolase kumawonjezera, ndipo zigawo za protein seramu zimasinthanso. Panthawi yowonjezera, kuphwanya kwa electrolyte metabolism kuonedwa - kuchepa kwa magazi a sodium ndi calcium komanso kuchuluka kwa potaziyamu.

Kuzindikira
Kuphatikiza pa chithunzi cha matenda omwe ali ndi matendawa, kuphunzira kochita ndi ziphuphu ndizofunikira kwambiri. Magazi seramu amawunikira zomwe zili ndi diastase, lipase, trypsin ndi trypsin inhibitors mmenemo, mkodzo wa diastase, mkodzo umatsimikiziridwa kuti uzimu wa pancreatic enzymes muzinthu za duodenal, kuchuluka kwa katulutsidwe ka pancreatic ndi zomwe zili ndi bicarbonate pambuyo pakugwiritsa ntchito pancreatic stimulants, makamaka secretin. Kuphatikiza apo, kuphunzira ndowe pazinthu zamafuta, minofu.

Kafukufuku wamankhwala ogwira ntchito kwa kapamba amathanso kuchitika ndi njira ya isotopes ya radioactive.

Kafukufuku wokhudzana ndi mapapo a kapamba (onani) pancreatitis yokhazikika ayenera kukhala wokwanira, yemwe angapereke chithunzi cholondola cha chipangizochi komanso chithandizira pakuwonetsa matendawa.

Pozindikira matenda a kapamba, ma pancreas amafunikanso kwambiri chifukwa cha kuchuluka kwa glucose, komwe nthawi zambiri kumakhala kwachilengedwe.

Chofunika kwambiri pakadali pano chikugwirizana ndi njira ya kafukufuku wa x-ray.

Matenda a kapamba amayenera kusiyanitsidwa ndi matenda ambiri am'mimbamo - cholecystitis, bysary dyskinesia, chironda cham'mimba, kutsekeka kwamatumbo chifukwa cha chotupa chovuta, khansa yam'mimba kapamba ndi mphuno ya Vater, makamaka pakakhala kuvulaza kwina.

Mukamasiyanitsa matenda awa, kuwunika mwatsatanetsatane, kuwunika kwa duodenal, ndi kuwunika kwa X-ray pamatumbo am'mimba, bile, ndi mapepala amkodzo ndikofunikira kwambiri. Koma kusiyanitsa pakati pa mtundu wofinya wa chifuwa chachikulu cha khansa ndi chifuwa chamutu nthawi zina kumakhala kovuta. Kuvuta kotereku kumadziwika kawirikawiri ngakhale pakati pa madokotala ochita opaleshoni. Milandu iyi, ma pancreatography ndi biopsy a kapamba pano amatumiziridwa pakumwa.

Chithandizo cha odwala omwe ali ndi pancreatitis yayitali amatha kukhala okhazikika kapena opaleshoni, malingana ndi kuopsa kwa matendawa, mawonekedwe amtundu wa kapamba, kutanthauzira kwa njirayi, ndi zina zambiri.

Kumayambiriro kwa matendawa komanso kuwonetsa modekha matenda, ndikofunikira kuchita chithandizo chamankhwala. Milandu yayitali kwambiri, yomwe imayambitsa kuwerengedwa kwa chiwopsezo cha England njira m'mutu wa kapamba, kapenanso pakukula kwa zovuta (cyst, abscess), chithandizo cha opaleshoni ndikulimbikitsidwa (onani pamwambapa-chithandizo cha pancreatitis pachimake).

Pa kukokomeza matenda kapamba, mankhwala ikuchitika chimodzimodzi monga pachimake kapamba.

Chithandizo cha Conservative chili ndi ntchito zotsatirazi: kuyimitsa kupitilira kwa njirayo, kuchepetsa ndi kuyimitsa kupweteka, kuchotsa kuphwanyidwa kwa ntchito yakunja ndi intrasecretory ya kapamba, ngati alipo.

Pali malingaliro osiyanasiyana okhudza zakudya zomwe zimakhala ndi chifuwa chachikulu. Pomwe olemba ena (N. I. Leporsky, F. K. Menshikov, G. M. Majdrakov, ndi ena) amalimbikitsa kuti azikupereka zakudya zokhala ndi chakudya chamagulu, ndizoletsa kwambiri mafuta, kupatula zinthu za sokogonny, ena (I S. S. Savoshchenko, V. A. Shaternikov, S. A. Tuzhilin ndi ena), m'malo mwake, gwiritsani ntchito moyenera zakudya zomwe zili ndi mapuloteni ambiri. Olembapo aposachedwa amalimbikitsa kuti odwala omwe ali ndi pancreatitis yodwala amagwiritsa ntchito zakudya zomwe zili ndi 150 g ya mapuloteni (60-70% ya mapuloteni ayenera kukhala ochokera ku nyama), 80 g mafuta (omwe 85-90% iyenera kuti ndi yochokera nyama), 350 g yama chakudya (ma calories 2800 kcal) . Nthawi yomweyo, chakudya chizikhala pafupipafupi, "chambiri" - pafupifupi 6 pa tsiku. Kuphatikiza apo, mavitamini amayikidwa, makamaka magulu B (B2, B6, B12), nikotini, ascorbic acid ndi vitamini A, komanso lipotropic zinthu (lipocaine, choline, methionine). Mowa, zakudya zamafuta (nyama yamafuta, nsomba, ndi zina), hering'i, kirimu wowawasa, mafuta anyama, masoseji, nyama zam'chitini ndi nsomba, komanso zakudya zosuta.

Milandu ya exocrine pancreatic insuffence, kukonzekera kwa pancreatic kuyenera kuikidwa: kapamba, kapamba, kapamba ndi mankhwala ena osokoneza bongo a 3 mpaka 8 g patsiku.

Kwa odwala omwe ali ndi vuto losatha la kapamba wokhala ndi pancreatic ducts, ndikofunikira kuti mwadongosolo azichita mawu omveka a duodenal kapena kupereka mankhwala a choleretic. Poletsa katulutsidwe wa pancreatic, ndikofunikira kugwiritsa ntchito mkati mwa alkali (madzi a mchere a Borjomi), atropine, kukonzekera kwa belladonna, platifillin.

Ngati pancreatitis yayitali imayendera limodzi ndi kutupa kwa ma ducts a bile ndi ma pancreatic ducts, odwala ayenera kupatsidwa mankhwala opha tizilombo.

Ngati kuphwanya kwa kagayidwe kazakudya, zakudya zoyenera zimagwiritsidwa ntchito ndipo ngati kuli koyenera, mankhwala a insulin.

Kuchepetsa ululu, perinephric kapena paravertebral blockade, intravenous makonzedwe a 0,25% yankho la novocaine, subcutaneous makonzedwe a promedol, omnopon akulimbikitsidwa. Olemba ena amati kugwiritsa ntchito opium, nitroglycerin, ephedrine, barbiturates, intravenous director of aminophylline kuthetsa ululu.

Ndi kuchulukitsa kwa njira yotupa mu kapamba, limodzi ndi ululu wowonda, anti-enzyme mankhwala (trasilol, iniprol, zymofren) akuwonetsedwa, zomwe zikuwonjezera kukonzanso kwakukulu pakumwedwa komanso kuphedwa kwa matenda opweteka. Olemba ena amati pamenepa, kuchitira x-ray chithandizo pa kapamba.

Kapamba - chiwalo zofunika kwambiri ulimi wa mahomoni udindo yopanga michere zofunika chimbudzi. Kusagwiritsa zakudya, kudya mafuta zakudya, kawirikawiri phwando mowa kuchititsa kutupa kwa zimakhala za kapamba, wotchedwa kapamba mankhwala. Nthawi zambiri, matendawa amapezeka ndimanjenje, m'malo opsinjika nthawi zonse komanso kusowa kwa kupuma koyenera. Kukula kwa matenda amizere kumakhala ndi chiwopsezo chachikulu cha zovuta zowopsa m'moyo.

Mankhwala, ndichizolowezi kusiyanitsa mitundu iwiri ya kapamba - pachimake komanso chovuta, omwe amagawidwa m'magulu ang'onoang'ono. Zovuta zimadalira mawonekedwe a matenda.

Zithandizo za anthu

Mwogwirizana ndi adokotala, ndizovomerezeka kuchiza kapamba pogwiritsa ntchito mankhwala achikhalidwe. Burdock, yomwe imadziwika kuti "burdock", imadziwika kwambiri pochiza matenda ngati awa.

Chomera ichi chimadziwika ngati udzu.Komabe, burdock, chifukwa cha tannin, antimicrobial, analgesic, choleretic ndi zinthu zina zambiri, ndi yofunika kwambiri pancreatitis. Burdock ndi antiseptic wachilengedwe.

Maphikidwe ambiri wowerengeka ali ndi mizu ya burdock, pomwe ma tinctures ndi decoctions amakonzedwa. Kuti muchite izi, tengani muzu, womwe umasonkhanitsidwa masamba asanawoneke, kuwaza, kuthira madzi otentha (500 ml pa supuni), sungani thermos usiku umodzi. Masana, mankhwalawo aledzera. Maphunziro a miyezi iwiri akulimbikitsidwa.

Sikuti muzu wokha ndiwopindulitsa. An antiseptic decoction amakonzedwanso kuchokera masamba. Kuti muchite izi, tengani amadyera, otsukidwa, osadulidwa bwino. Zowerengeka zingapo za kuzimata zotere zimathiridwa mu kapu yamadzi ndikubwera kwa chithupsa. Imwani ozizira katatu patsiku.

Recudia stomatitis ndi matenda am'mlomo wamkamwa omwe amakhala ndi njira yodziwikiratu yolumikizira komanso kuchotsedwa. Ikhoza kukhala matenda odziyimira pawokha kapena kupindika kwa matenda ena. Matendawa ali ndi mitundu iwiri: Matendawa (CRAS) komanso.

Mtundu woyamba ndi nthenda yamtundu wosagwirizana, womwe umadziwika ndi zotupa mu mawonekedwe aokha (). Maonekedwe a zilonda zam'mimba pa mucous nembanemba zimachitika popanda kutsatira pafupipafupi. CHRAS ili ndi njira yayitali (zaka zingapo).

Etiology komanso zomwe zimayambitsa CHRAS

Matendawa ndi osokoneza. Ma allergen omwe angayambitse CHRAS ndi monga: zakudya, fumbi, mankhwala osokoneza bongo, mphutsi, ndi zinthu zawo zowonongeka.

Zinthu zotsatirazi zimabweretsa chitukuko cha zomwe zimachitika mobwerezabwereza:

Magawo otukuka

Pali magawo atatu a CHRAS:

1. Choyamba ndi kuwala Gawo lomwe kupweteka kofikira wosabereka m'modzi wokhala ndi zolembera za fibrin kumawonekera. Zizindikiro za matenda am'mimba zomwe zimayang'aniridwa zimawonedwa, pambuyo pake zimayamba kuwonekera komanso chizolowezi chodzimbidwa.
2. Gawo lotsatira ndilo lolemera kwambiri . Nthawi yake, kutupa kwa mucous nembanemba wa aphthae kutsogolo kwa khomo lamkamwa kumawonedwa. Maselo a lymph amakula kukula, chifukwa chomwe amakhala mafoni ndiwowawa. Pulogalamuyi ikuwonetsa kukhalapo kwa ulusi wosakanizika wamafuta, mafuta ndi wowuma.
3. Gawo lotsiriza ndilo zolemetsa . Imadziwoneka yokha ngati tinthu tosiyanasiyana mbali zosiyanasiyana za mucous membrane. Kubwereza mobwerezabwereza ndi mutu, adynamia, chidwi ndi kufooka zimadziwika. Mukamadya, pamakhala kuwawa kwadzidzidzi kwa mucosa. Odwala nthawi zambiri amavutika ndi kudzimbidwa komanso bata. Nthawi zina, matenda am'mimba amayamba.

Zojambula pachipatala

Poyamba, ululu woyaka wa mucous membrane umawonekera, nthawi zina kupweteka kwa paroxysmal kumachitika. Pakapita kanthawi, mawonekedwe a aphthae. Mapangidwe awo amapezeka pamalo a redness of the mucosa. Nthawi zina necrosis ya kumtunda kwa mucous nembanemba imawonedwa.

Aphthae amawonekera m'malo osiyanasiyana. Nthawi zambiri awa amakhala milomo, masaya, mbali yampata yolumikizana ndi zigawo zakumaso ndi chapansi. Kukonzanso kwa zotupa kumachitika kamodzi kapena kawiri pachaka.

Matenda obwereza a aphthous stomatitis amatha kuonekera kwa zaka zambiri; nthawi zambiri za kuchuluka kwa zisonyezo zimadziwika mu nthawi ya masika ndi yophukira. Pakadali pano, kutentha kwa thupi kwa wodwala kumadzuka, kusokonezeka maganizo, ndipo kufooka kumayamba. Nthawi yobwezeretsa ndiyambira mwezi umodzi mpaka zaka zingapo. Kupangidwe kwa zilonda kumayendera limodzi.

Patatha masiku atatu kapena anayi, kukanidwa kwa ma necrotic misa kumachitika, pambuyo pake zimawonedwa pamalo a aphthae.

Zaka zitatu zoyambirira, CHRAS ndi yofatsa.

Mu ana, pafupipafupi stomatitis mu aphthous mawonekedwe pafupifupi nthawi zonse amapezeka limodzi ndi zigawo za lymphadenitis, kuchepa kwa chilala, kugona tulo komanso kuchuluka kwa irritability zimadziwika.Epithelialization ya zilonda kumachitika pang'onopang'ono - pafupi miyezi iwiri. M'malo mwa zilonda zomwe zidachiritsidwa, zipsera zakukhungu zimatsalira zomwe zimapangitsa kuti mucous membrane wamkamwa uyambe.

Kuzindikira

Mwambiri, kuwunika kwa CHRAS kumakhala pakuwunika kwa zamankhwala. Kuzindikira kumapangidwa pamaziko a mawonetseredwe akunja pogwiritsa ntchito njira yopatula. Izi ndichifukwa chosowa mayeso odalirika a labotale komanso maphunziro a mbiri yakale.

Pakati pazizindikiro zofala, zotupa za aphthous pamtunda wa mucosa zimawonedwa. Poterepa, pali chiopsezo cha kuwonongeka kwa mucous membrane wa maso, mphuno ndi kumaliseche. Ngati ndi kotheka, njira zowunikira zothandizira zimayikidwa:

• kuchita polymerase unyolo, pamenepa, amasiyanitsa,
• kuyezetsa magazi koyambira
• kutenga nyemba za pharynx kuchokera m'malo a zilonda zam'mimba.

Mukamayesa magazi ambiri, ma eosinophils ambiri amawonekera. Zotsatira za kuyesa kwamwazi wama biochemical zikuwonetsa kuchuluka kwa histamine ndi kuchepa kwa chiwerengero cha albumin m'magazi. Katemera amathandizira kuzindikira kutayika kwa chitetezo chathupi mthupi, komwe kumawoneka ngati kuchepa kwa kuchuluka kwa enzyme ya lysozyme.

Zovuta za zochitika zamankhwala

Chithandizo chimasankhidwa kutengera mtundu wa zomwe zimawonetsedwa, mtundu wa matenda omwe ali nawo, komanso zaka za wodwalayo yemwe ali ndi vuto losatha la aphthous stomatitis.

Chithandizo chachikulu chimagwiritsidwa ntchito pogwiritsira ntchito desensitizing, immunomodulating ndi Vitamini. Mankhwala omwe amateteza microflora yamatumbo amagwiritsidwanso ntchito. Chithandizo cha mankhwala am'deralo chimaphatikizira mankhwala oletsa kupweteka kwa mucosa, chithandizo ndi antiseptics, kugwiritsa ntchito keratoplastic othandizira ndi kugwiritsa ntchito ma enymes oyambira.

Malangizo a HRAS pafupifupi ndi awa:

Kugwiritsa ntchito njira zingapo zamankhwala nthawi imodzi kumalimbikitsa mpumulo wazizindikiro komanso kufupikitsa nthawi yochira.

Njira zopewera

Mutha kuletsa chitukuko cha CHRAS kutsatira malamulo awa:

• Kuchotsa kwakanthawi magwero a matenda opatsirana,
• Zakudya zoyenera komanso zopatsa thanzi,
• kupita kwathunthu kwa dokotala wa mano,
• kukana zizolowezi zoyipa, zomwe zimadzetsa zowawa m'mimba ndi zotupa za khomo lamkamwa,
• Kutsatira zakudya zomwe sizimaphatikizira kudya kwa zinthu zomwe sizigwirizana zomwe zingakhudze makoma a mucous,
• kuchita masewera olimbitsa thupi pafupipafupi komanso kutsatira boma.

Pamaso pa mawonekedwe ofatsa a aphthous stomatitis, nthawi zambiri zotsatira zake zimakhala zabwino. Ndikosatheka kuchira kwathunthu pamatenda a matendawa, koma ndi chithandizo choyenera, kuthekera kumachitika kawirikawiri kwambiri ndipo nthawi zakukhululuka ndizitali.

Zizindikiro zake komanso matendawa

Pancreatitis yobwereza imadziwika ndi njira ya wavy, yomwe nthawi yowonjezera imasinthidwa ndikhululukidwa. Omalizirawo amatuluka popanda zizindikiro kapena ali ndi zizindikiro zochepa zomwe sizimadziwika ndi matendawa.

Panthawi ya kutulutsa koyamba, kusintha kwachilengedwe m'thupi lathu kumayamba kutchulidwa.

Zizindikiro zoyambirira za kapamba ndi:

1. Ululu m'dera la epigastric, wowalira kumanzere kwa hypochondrium ndi kumbuyo, kumakhala lamba. Zosasangalatsa zomverera ndizokhazikika kapena paroxysmal pachimake. Nthawi zina ululu umafalikira kuderali la mtima, zomwe zimapangitsa kuti azindikire zovuta zake. Pakukhululukidwa, imakhala ndi mawonekedwe ofatsa.
2. Zizindikiro za matenda ammimba. Izi zimaphatikizapo nseru, kusanza, kusefukira, chimbudzi, kutentha kwa mtima, kupweteka. Mavuto a kusanza ndi kuchuluka kwa kapamba nthawi zambiri, samabweretsa mpumulo. Kudzimbidwa kwa nthawi yayitali kusinthana ndi matenda am'mimba. Fermentation ndi kuvunda kumachitika. Kuyamwa kwa michere m'matumbo kumayambitsa kufooka kwa thupi.
3. Kuteteza khungu ndi sclera.Khungu la wodwala lomwe limapezekanso ndi kapamba wamtundu wamtundu wa brownish, limadziwika chifukwa chowuma. Malo ofiira amatha kuwoneka pamimba ndi kumbuyo, zomwe sizimasintha mtundu ukakanikizidwa.
4. Zowawa za mafuta osunthika mu kapamba. Kuphatikizidwa ndi kutupira kwapakati kwa dera la epigastric. Pa palpation, ululu umamveka mbali yakumanzere, kuzungulira navel.
5. Kuchulukitsa kwa chiwindi ndi ndulu.
6. Kuwonetsedwa kwa kuledzera kwa thupi - kuwonjezeka kwa kutentha kwa thupi, kufooka kwathunthu, kumadumphira kuthamanga kwa magazi.

Njira zodziwikiratu za kapamba

Kuwulula pancreatitis yomwe imachitika mobwerezabwereza ndikosavuta. Kuti muchite izi, gwiritsani ntchito:

1. Ultrasound ya kapamba. Imathandizira kudziwa kukulira kwa ziwalo, kupangika kwa minofu, komanso kupezeka kwa ma neoplasms angapo.
2. Fibrogastroscopy. Panthawi ya ndondomekoyi, michere yam'mimba ndi duodenum imayesedwa, yomwe imakhudzidwa ndi pathological process ndi pancreatitis.
3. CT Njira imagwiritsidwa ntchito kuti idziwe mtundu, kuchuluka ndi kuchuluka kwa kusintha kwa parenchyma.
4. MRI Limakupatsani mwayi wodziwa zotchingira zimbudzi.
5. Kuyesa kwazonse ndi zamankhwala am'mwazi. Onani kusintha komwe kumachitika pakulowerera, kudumpha pamlingo wa michere.
6. Cop program. Zimathandizira kuzindikira matenda am'mimba, kudziwa kuchuluka kwa ma enzymes omwe amalowa m'matumbo.

Matenda a pancreatitis amachiritsidwa ndi njira zonse zowonjezera komanso za opareshoni. Njira zochizira zimasankhidwa malinga ndi kusinthika kwa masinthidwe a pathological, kuchuluka kwa kufalikira, kukhalapo kwa zovuta.

Opaleshoniyo akuwonetsedwa kuti akuwonjezera, kufalikira kwa ma pancreatic ducts, kuchepa kwa sphincter ya Oddi, minofu necrosis, pseudocyst wa kapamba.

M'malo mankhwala

Pancreatitis m'malo mankhwala

1. Ma Enzymes ochokera ku nyama (Mezim, Pancreatin, Creon). Chepetsani zochitika za kapamba, kuzimitsa. Odwala ena amakhulupirira kuti kuyambitsidwa kwa ma enzymes osokoneza bongo kumaphwanya ntchito za chiwalo, koma sichoncho. Kumwa mankhwala osokoneza bongo kumakhudzanso kugwira ntchito kwa gland.
2. Secretolytics (Omez, Omeprazole). Kuchepetsa kapangidwe ka madzi am'mimba, ndikuwonjezera mphamvu ya kukonzekera kwa enzyme.
3. Antispasmodics (No-shpa, Spazmalgon). Pancreatitis imayendera limodzi ndi kuwonjezeka kwa kukakamiza mu ma ducts, chifukwa chomwe munthu amamva kupweteka kwambiri. Mankhwala osokoneza bongo amamasuka minofu, kuthetsa kusasangalala.

Pakuchulukirachulukira kwa kapamba kakang'ono, tikulimbikitsidwa kuti tisadye. Pambuyo pakukula, chakudya No. 5 chimayikidwa. Zipatso zowawasa, marinade, zakudya zokazinga ndi zamafuta, zakudya zonunkhira, zakumwa zoledzeretsa ndi zakumwa zozizilitsa thupi sizimaphatikizidwa pazakudya. Amaloledwa kudya masamba atsopano, mkaka, chimanga, nyama yotsika. Chakudyacho chimawotchera, kuwiritsa kapena kuwadyetsa.

Idyani m'magawo ang'onoang'ono, nthawi 5-6 patsiku.

Kupewa

Pewani kubwereza pafupipafupi kwa mankhwala a kapamba:

• kukana kuchita masewera olimbitsa thupi mopitirira malire,
• Kuthetsa kwakanthawi kwamatenda a ndulu ndi m'mimba thirakiti,
• Kuchotsa zizolowezi zoipa,
• zakudya zoyenera
• kukana kudya kwambiri,
• kupatula khofi pazakudya.

Kuwona kuchuluka kwa kuchuluka kwa kuphatikizira kwa pancreatic kumalola kudziwa kuchuluka kwa shuga m'magazi ndi mkodzo; kuzindikira zovuta za metabolism ya carbohydrate, kuyesa kwa glucose kumagwiritsidwa ntchito limodzi kapena kawiri katundu wa shuga. Ngati ndi kotheka komanso kofunikira, fufuzani kuchuluka kwa insulin ndi glucagon m'magazi ndi njira ya radioimmune.

Pazinthu zothandiza pakuwunika pancreatitis yovuta kwambiri, ultrasound ndiyofunika kwambiri. Zimakupatsani mwayi wodziwa kukhalapo, chilengedwe ndi kuchuluka kwa njira ya pathological mu kapamba.Kuuma kwa ma dland a gland, kusintha kukula kwake, kachulukidwe, kukweza kwa dambo la Wirsung, kupezeka kwa ma cysts ndi pseudocysts, ndikuwunika. Ubwino wambiri wa ultrasound ndi kusasokoneza, kusowa kwa zotsutsana ndi zovuta, makamaka kuthekera kokuwona kusintha kwa chiwindi ndi machitidwe amtundu wokhudzana ndi pancreatitis, yomwe imathandizira kuzindikira kusiyanasiyana kwa zotupa za pancreatoduodenal zone. Kuunika kwa X-ray pamtundu wa duodenum pazinthu zofunikira kwambiri sikunataye kufunika kwake. Pankhaniyi, chifuwa chachikulu cha m'mimba chimatha kuwonetsedwa ndi kupunduka kwa mkati mwa khansa yake chifukwa cha kuwonjezeka kwa mutu wa kapamba, kuwerengera kwakhazikika kapena calculi m'dera la zikondamoyo, kusunthika ndikusintha kwa m'mimba, zilonda zam'mimba komanso zam'mimba., kuyimilira kwakumanzere kwa phokoso lamanzere, kudzanja lamanzere, kupendekera kwa m'munsi mwa mapapo amanzere.

Nthawi zina, malinga ndi zikuwonetsa, endoscopic retrograde pancreatocholangiography (ERCP), complication tomography, angiography, radionuclide scanning, intravenous cholecystholangiography, fibrogastroscopy imagwiritsidwa ntchito. Zambiri mwa njirazi sizilola kuti munthu adziwe kuti ali ndi chifuwa chachikulu, koma zimathandizira kumveketsa zinthu zina za etiopathogenetic ndikuwunika momwe ziwalo zapafupi.

Palibe gulu lililonse lomwe limavomerezedwa kuti limayambitsa matenda a pancreatitis. Monga ogwira ntchito amagwiritsa ntchito A.L. yomwe inavomerezedwa mu 1982. A Grebenevs, omwe adafotokozera mogwirizana ndi mawonekedwe a chipatalachi kuti athe kusiyanitsa mitundu yotsatila ya matendawa: 1) kupezekanso (polysymptomatic), 2) kupweteka, pomwe chisonyezo chikuwonekera, 3) chobisika, chokhalitsa, 4) pseudotumor ndikupanga jaundice yolepheretsa. Malinga ndi maphunzirowa, gawo 1 limasiyanitsidwa (kuzungulira kofatsa), pamene zizindikiro zakunja ndi zowoneka bwino za kapamba sizipezeka, gawo lachiwiri (kuvunda mwamphamvu), likatsimikiza ndi gawo 3 (lakuya), lodziwika ndi matenda opindika a "pancreatogenic", omwe akupita patsogolo kutopa, polyhypovitaminosis, yachiwiri shuga mellitus. Kuphatikiza apo, matendawa amathandizidwa ndi chisonyezo cha etiology, gawo (kuchulukitsa, kuchotsedwa), kukhalapo kwa zovuta komanso kusintha kwa morphological mu kapamba.

Matenda a kapamba ayenera kusiyanitsidwa makamaka ndi khansa ya kapamba, komanso kuwerengetsa cholecystitis, chapamimba ndi duodenal ulcer, enteritis ndi colitis, visceral ischemic syndrome.

Chithandizo choyambirira cha kukokoloka kwa chifuwa chachikulu cha kapamba chimaphatikizanso miyeso yomwe imathandizira 1) Kuchepetsa katulutsidwe wa kapamba, 2) kuthetsa ululu, 3) kusunga kuchuluka kwa magazi mozungulira komanso kupewa kugwedezeka, 4) kupewa zovuta zam'mimba, 5) kuthetsa ndikulowetsa zinthu zoopsa komanso zoyipa. .

Popeza udindo wotsogola wa matenda apakhungu a chifuwa chachikulu ndi ntchito yowonongeka ya ma enzymes awo olimbitsa, ntchito yayikulu ndikuchepetsa ntchito ya gululi. M'masiku atatu oyambirira ochulukirachulukira, njala imalembedwa, kutenga njira zamchere zilizonse maola 2 aliwonse (sodium bicarbonate, Borjomi 200 ml iliyonse). Ndizotheka kugwiritsa ntchito ma antiacid okhala ndi buffered (almagel, phosphalugel, maalox, gastal), omwe amadziwikanso 6-8 patsiku. Woopsa, woyamba, ndi zizindikiro za duodenostasis, mosalekeza chidwi cha chapamimba chimachitika kudzera woonda intranasal kafukufuku. Kupititsa patsogolo izi, M-anticholinergics (atropine, platifillin, makamaka gastrocepine) amalembedwa pakamwa kapena mwaubwino, komanso histamine H2 receptor blockers (cimetidine, ranitidine, famotidine).Kuphatikiza apo, amachepetsa kwambiri kupanga ma enzymes 5-fluorouracil, omwe amadziwika kuti amawerengera -12-15 mg / kg / tsiku. mu 5% shuga yothetsera masiku 5. Ndizotheka kugwiritsa ntchito antispasmodics (papaverine, no-spa, cerucal, etc.). M'masiku oyamba kukokomeza, odwala onse amafunika kuperekera malita atatu kapena angapo amadzimadzi m'magazi, kuphatikiza shuga, electrolyte, njira ya albumin, plasma, hemodeis, yomwe, limodzi ndi kuchepa kwa ululu ndi kuledzera, kumalepheretsa kukhazikika kwa hypovolemic.

Lamulo lofunikira kwambiri lachipatala lachiwopsezo cha kupanikizana kwa chifuwa chachikulu ndi kupweteka. Ngati njira zomwe zili pamwambazi zomwe zimapangidwira kuchepetsa pancreatic secretion sinakhale ndi mphamvu ya analgesic, njira zotsatirazi zikulimbikitsidwa. Choyamba, analgesics kapena antispasmodics amalembera (2 ml ya 50% r-ra wa analgin kapena 5 ml ya baralgin katatu patsiku) kapena kapangidwe ka analogus a peptides a opioid - delargin (5-6 mg patsiku.) Pakalibe zotsatira, ma antipsychotic - droperidol 2 amaphatikizidwanso. 5-5 mg (1-2 ml 0,25% yankho) pamodzi ndi 0,05-0.1 mg (1-2 ml ya 0.005% yankho) la fentanyl patsiku i / v. Pambuyo pokhapokha atagwiritsa ntchito narcotic analgesics - promedol, wolimba, etc., kupatula morphine. Ngati izi zilibe phindu kwa masiku opitilira 3-4, ndiye kuti nthawi zambiri izi zikuwonetsa kukonzekera kwa zovuta zomwe zimafunikira opareshoni.

Ngati mukuchulukirachulukira pofuna kupewa zovuta za septic, tikulimbikitsidwa kukhazikitsa mankhwala opatsirana - mankhwala opanga penicillin, cephalosporins mwachangu masiku 5-7. Ali ndi mphamvu yotsutsana.

Pakadali pano, olemba ambiri asiya kugwiritsa ntchito kukonzekera kwa antienzyme (trasilol, kontrikal, gordoks, ndi zina), chifukwa chogwira ntchito kwambiri komanso zovuta zambiri, makamaka zomwe sizigwirizana. Komabe, aminocaproic acid amagwiritsidwa ntchito pazolinga izi (iv mu 200 ml 5% yothetsera 1-2 kawiri pa tsiku kapena mkati 2-3 g katatu patsiku, methyluracil (mkati 0,5 ga 4 pa tsiku), peritol (4 mg katatu pa tsiku), kuthira magazi plasma.

Kuphulika kwa chakudya kagayidwe kachakudya nthawi yowonjezera ya kapamba amawongolera pang'onopang'ono poyerekeza ndi Mlingo wochepa wa insulin.

Pakachulukitsa ndikuchulukirachulukira, chakudya No. 5p (pancreatic) ndikofunikira. Ziyenera kukhala ndi kuchuluka kwa mapuloteni (120-130 g / tsiku), kuphatikiza 60% ya nyama, mafuta ochepetsedwa pang'ono (mpaka 70- 80 g), makamaka ya magwero azomera ndi chakudya (mpaka 300-400 g), zonse zopatsa mphamvu ziyenera kukhala 2500-2800 kcal. Zakudya zofunikira pang'ono zimalimbikitsidwa nthawi zisanu ndi imodzi ndi zisanu patsiku, , maapozi osaphika), zipatso za malalanje, chokoleti, cocoa, khofi, makeke, nandolo, nyemba, ayisikilimu, zakumwa zoziziritsa kukhosi. Pamaso pa exocrine pancreatic insufficiency, mankhwala obwezeretsa amalembedwa ndi enzymatic kukonzekera (onyansa, chimbudzi, mezim-forte, merkenzyme, nigedase, opaza, panzinorm, pancreatin, pancurmen, solysim, somilase, polysim, trinzment, trinzment, terment. Mlingo amasankhidwa payekha malinga ndi mphamvu ya mphamvu yake ndi chikhalidwe cha chopondacho. Ndi kuchepa kwambiri thupi, maphunziro amaperekedwa ndi anabolic steroids (retabolil, nerobol, methandrostenolone, etc.). Kuwongolera kwa hypovitaminosis kumachitika ndi kukhazikitsidwa kwa mavitamini a magulu B, C, A, E. Zifukwa zomwe zimapangitsa kuti matendawa athe kupitiririka zimafotokozedwa ndipo, ngati kuli kotheka, kuchotsedwa (kuyeretsa kwam'magazi am'mimba, chithandizo cha matenda am'mimba ndi duodenum, etc.). Chithandizo chokwanira chomwe chimachitika m'maphunziro, komanso kupweteka kwambiri kwa kapamba nthawi zonse, zimathandizira kuti odwala asungidwe.

Ntchito 1 Choyambitsa chachiwiri chikhansa chachikulu ndi:

1. nthenda ya ndulu

2. kuwonongeka kwa ma virus ku kapamba

3. kuvulala mobwerezabwereza kwa kapamba

5. Cholowa champhamvu

Ntchito 2.Wodwala wachulukitsa matenda a kapamba amadziwika kuti sangasiyidwe pang'onopang'ono chifukwa cha zakudya zake:

Ntchito Z. Panthawi yowunika kwa m'mimba, wodwalayo adawonetsa kuwerengera pang'ono pamlingo wa 2-3 lumbar vertebrae, womwe unkawoneka ngati chizindikiro:

1. nthenda ya ndulu

2. aakulu kapamba

3. hepatitis yayitali

4. Matenda a chiwindi

Ntchito 4. Chithunzi cha chipatala cha matenda a kapamba amadziwika ndi:

1. Kuchepetsa thupi, kupweteka kwa epigastric, kutsekula m'mimba, shuga

2. kupweteka kwa epigastric, kudzimbidwa, kuchepa kwa chakudya, kunenepa kwambiri

3. Kutaya mtima, kugona, kutsegula m'mimba, kutentha thupi

4. kutentha thupi ndi kuzizira, kudzimbidwa, kusilira, shuga

Ntchito 5. Wodwala wodwala kapamba pakukhululukiridwa ndi kusakwanira kwa exocrine pancreatic ntchito ayenera kulimbikitsidwa kuti adye zakudya zofunikira kwambiri:

Ntchito 6. Ndi makina ojambula pamimba pamimba, zizindikilo zitha kuwululidwa:

1. zilonda zam'mimba

2. matenda a chiwindi

3. chiwindi cirrhosis

4. aakulu kapamba

Ntchito 7. Steatorrhea imawonedwa ndi:

1. aakulu gastritis

2. aakulu kapamba

3. kukanika kwa dyspepsia

4. chonde dyspepsia

Ntchito 8. Zizindikiro zotsimikizira kuti matendawa amatha kupezeka ndi:

1. gastroscopy, duodenography mu mkhalidwe wa hypotension

2. duodenography mu machitidwe a hypotension, sonography

3. ngalawa, laparoscopy

4. gastroscopy, laparoscopy

Ntchito 9. Mothandizidwa ndi zomwe zikutanthauza kuti kapamba amawonjezera katulutsidwe ka madzi ndi mabicarbonates:

Ntchito 10. Chizindikiro chofunikira kwambiri chachipatalachi pozindikira matenda a kapamba ndi:

2. mulingo wa aminotransferases

3. mulingo wa phosphatase

4. mkodzo ndi milingo yama amylase

Ntchito 11. Ndi iti mwa mayeso otsatirawa omwe ndi ofunikira kwambiri pofufuza matenda a kapamba:

2. pancreatic scintigraphy

3. Kutsimikiza mafuta mu ndowe

4. Njira zonse zili pamwambazi

5. palibe njira yomwe yatchulidwa

Ntchito 12 Pankhondo yolimbana ndi kupweteka kwa kapamba, mutha kugwiritsa ntchito zotsatirazi, kupatula:

Ntchito 13. Mulingo waukulu wa seramu amylase ukhoza kukhala mu zonse, kupatula:

1. Kutumphuka kwa kapamba

2. Kuuma kwa mtima kosatha

3. Mimba za ectopic

5. kuchuluka kwa matenda a kapamba

Ntchito 14. Ndi chida chiti chomwe chimagwiritsidwa ntchito kupondereza zochitika za michere ya pancreatic:

Ntchito 15. Pancreatitis yosatha yobwereza imawonedwa nthawi zambiri ndi:

1. zilonda zam'mimba

3. aakulu colitis

Ntchito 16. Kuchulukitsa matenda kapamba, madandaulo onse ndi abwinobwino kupatula:

1. kupweteka kwa m'chiuno mu epigastrium

2. kupweteka kwa kumanzere kwa hypochondrium kukunyemukira kumbuyo

4. kusanza

5. Kuchepa kapena kusowa kwa chakudya

Ntchito 17. Zoyambitsa za kapamba ndizonse:

1. magwiridwe antchito, otupa komanso onyansa a papilla wamkulu

2. mkulu acidity wa chapamimba madzi

3. Reflux ya bile ndi matumbo mkati mwa kapamba

4. kulowerera kwa matenda kudzera m'njira zam'mimba kuchokera kwa ziwalo zoyandikana

5. uchidakwa

Ntchito 18. Pancreatitis, magulu onse a mankhwalawa amagwiritsidwa ntchito kupatula:

H. H2 histamine receptor blockers

Ntchito 19. Kukonza kwa exocrine pancreatic insufficiency aakulu kapamba, mankhwala onse amagwiritsidwa ntchito, kupatula:

Ntchito 20: 1. Ndi ziti mwazizindikiro zomwe zikuwoneka koyamba kwambiri pancreatitis yayitali:

Z. kupweteka kwam'mimba

5. ma calcicic owerengera

Ntchito 21. Kodi chizindikirochi choyambirira ndi chiani mu pulogalamu yamatenda a kapamba:

Ntchito 22.Zomwe zimachitika ndikuphwanya kwamphamvu ntchito za kapamba pamafinya:

1. kuchepa kwa insulini yokhala ndi glucagon wabwinobwino

2. kuchepa kwa insulin ndi glucagon

3. kuchepa kwa insulin komanso kuchuluka kwa glucagon

Ntchito 23. Kupezeka kadzidzidzi panthawi yakukhululuka kwa kapamba chifukwa cha:

1.kumva kupweteka kwambiri

2. kutuluka kulowa m'magazi a zinthu zoyipa

3. Kutsika kwa myocardial contractility

4. Zonse zili pamwambazi

Ntchito 24. Pozindikira kuchuluka kwakulephera kapamba, chidziwitso cha ma labotale ndi:

1. milingo ya transaminase

2. mulingo wa phosphatase

3. mulingo wa amylase

4. bilirubin mulingo

Ntchito 25. Kwa odwala matenda ashuga omwe amayamba chifukwa cha chifuwa chachikulu, zonse zimakhala kupatula:

1. chizolowezi cha hypoglycemia

2. kufunika kwa Mlingo wochepa wa insulin

3. zosowa chitukuko cha mtima

4. pafupipafupi chitukuko cha hyperosmolar chikomokere

Ntchito 26. Pochizira kuchulukitsa kwa kapamba, mankhwala onse amagwiritsidwa ntchito, kupatula:

Mayankho: 1-1, 2-1, 3-2, 4-1, 5-2, 6-4, 7-2, 8-2, 9-2, 10-4, 11-1,12-3, 13-2, 14-4, 15-2, 16-4, 17-2, 18-2, 19-4, 20-3, 21-2, 22-2, 23-2, 24-3, 25-4, 26-4

Ntchito 1 Wodwala wazaka 44 amadandaula za kupweteka kwambiri pamimba pamatumbo ndi radiation kupita ku hypochondrium yamanzere, kuchepa kwamlingo, kugona ndi mseru. Zowawa zotere zimabwerezedwa kawiri pachaka. Zaka zinayi zapitazo, adachitidwa opareshoni yamatenda a ndulu. Pambuyo 6 miyezi kuwukira kofananako kunachitika, limodzi ndi kuwoneka kwa jaundice wapakati komanso kuwonjezeka kwamkodzo wa amylase. Ndi laparotomy yobwerezabwereza, miyala mu ducts za bile sanapezeke. Posachedwa, kudzimbidwa kwawonekera. Nthawi yoyeserera: subicteric sclera. Zipsera za postoperative pakhoma lakunja. Kulimba mu gawo la choledochopancreatic ndi Mayo-Robson. Pakuyesedwa kwa magazi: maselo oyera amwazi 6.7,000, mawonekedwe ake sanasinthidwe, ESR 18 mm / ola.

Mafunso: 1. Pangani zodziwikiratu.

2. Lembani zofunikira kwambiri pakuzindikiritsa njira yofufuzira.

3. Fotokozerani dongosolo lamankhwala.

Mayankho: 1. yachiwiri matenda kapamba, pseudotumor mawonekedwe 1-2 siteji, kuchuluka gawo.

2. Kupenda kwa Ultrasound kwam'mimba, makamaka zikondamoyo, magazi ndi mkodzo, kupopera, shuga.

3. Zakudya No. 5p, maantacid (almagel), M-anticholinergics (gastrocepin), antispasmodics (no-spa) Ngati ndi kotheka, ma analgesics (baralgin), michere (pancreatin).

Vuto 2 Wodwala wazaka 48 amadandaula za kusowa chakudya, kupweteka kwa kumanzere kwa hypochondrium, amakhala woipa kwambiri atatha kudya, kutulutsa, kugubuduza m'mimba, kutsegula m'mimba nthawi ndi nthawi. Kuchokera ku anamnesis zinali zotheka kudziwa kuti wodwalayo amamwa zakumwa zoledzeretsa, madandaulo awa adawoneka pafupifupi zaka 6. Mukafufuza za kuchepa kwa zakudya, mawanga ofiira pakhungu lomwe sazimiririka ndikakanikizidwa. Percussion chiwindi chimatuluka kuchokera m'mphepete mwa chipilala chodula ndi 1.5-2 masentimita, pali ululu kumanzere kwa hypochondrium ndi umbilical dera.

Mafunso: 1. Ndi matenda ati omwe tingalankhule?

2. Ndi njira ziti zoyeserera zomwe zikuyenera kufotokozedwa kuti zimveketse bwino matenda athu?

3. Kodi ululu umakulirakudya ukatha kudya?

Mayankho: 1. 0 chachikulu matenda kapamba a uchidakwa etiology.

2. Amylase wamagazi ndi mkodzo, kuyerekezera kwa ultrasound cha kapamba, komanso kupopera, fibrogastroscopy, shuga m'magazi.

3. Chifukwa mutatha kudya, katulutsidwe ka madzi a pancreatic amawonjezeka ndipo kupanikizika kwa dambo la Wirsung kumadzuka.

Ntchito 3 Wodwala wazaka 55 amadwala matenda a cholecystitis owerengeka kwa zaka 12, ndikuwonjezereka nthawi 1-2 pachaka, pamene panali kupweteka kwa hypochondrium, kutentha thupi pang'ono, kuwawa mkamwa, ndi mseru. Panthawi yoyeserera kuchipatala, wodwalayo adawonetsa kuchuluka kwa shuga kwa 7 mmol / l, komanso kuphatikizika ndikuchepetsa kukula kwa kapamba malinga ndi data ya ultrasound. Wodwala saona kusintha kwamatenda ake.Ndi mayeso akunja a kuchuluka kwa zakudya. Khungu ndi la mtundu wamba, louma. Pa palpation pamimba, ululu wapakati pamapeto a ndulu. Kuyesa kwa magazi, mkodzo wopanda mawonekedwe. Amylase magazi ndi mkodzo, transaminases, bilirubin mozungulira moyenera.

Mafunso: 1.Kodi kusintha komwe kwapezeka mu shuga ndi magazi pancreatic ultrasound kungasonyeze chiyani?

2. Ndi njira ziti zowonjezerera zomwe zimayenera kuperekedwa kwa wodwala ndipo ndi cholinga chanji?

3. Kodi ndi kukonza kotani komwe wodwala akuyenera kuchita?

Mayankho: 1. Kudziwa kusintha kwa shuga m'magazi ndi ma data a pancreas atha kuwonetsa kuwonjezeredwa kwa chifuwa cha asymptomatic pancreatitis ndi insretory insuffence mu chikhululukiro.

2. Pofuna kumveketsa kuchuluka kwa kuperewera kwa exocrine, ndikofunikira kupangira kafukufuku wam'mbuyo ndi njira ziwiri zopangidwira ndi kukondoweza kwa secretin ndi pancreosimine, kafukufuku wapamwamba.

3. Ndikofunikira kusamutsa wodwala ku tebulo 9, ngati pakufunika kutero, mupeze Mlingo wocheperako wa insulin, ndipo ngati mukupezeka kupezeka kwina, onjezerani kukonzekera kwa enzyme (pancreatin, mesim forte, etc.).

Ntchito 4 Wodwala wazaka 42 yemwe ali ndi matenda a pancreatitis osatha kwa zaka 8 atadya chakudya chochuluka ndikumwa mowa adamva kupweteka kwambiri mu epigastrium, herpes zoster. Omaliza anali ndi mseru, kukwera pang'ono kwa kutentha. Apulumutsidwa ndi makina a SMP kupita pa desiki lakutsogolo. Pakufufuza: kukula mwamphamvu, wotumbululuka, ndi kupweteka kwa m'mimba kuzungulira kwa choledochopancreatic zone. M'mapapo, kupuma kwamitsempha, kupindika kwamveka kwa m'mapapo. Mawu amtima akumata, akukoka 120 pamphindi, kudzaza pang'ono, kuthamanga kwa magazi - 70/40 mm RT. Art. Pakuwunika kwa magazi, maselo oyera ndi 10,000, mawonekedwe ake sanasinthe, ESR ndi 40 ml / ola. Amylase yamagazi imachulukitsidwa katatu.

Mafunso: 1.Kodi chidziwitso chanu choyambirira ndi chiani? Kodi kufotokoza kusintha kwa hemodynamic?

2. Kodi ndi mayeso ati ofunikira kuti wodwala afotokozere za matendawo?

3. Konzani dongosolo lodzidzimutsa ndi nthawi yake yodwala.

Mayankho: 1. Matenda obwereza kapamba mu gawo pachimake, ophatikizika ndi hypovolemic shock.

2. Ndikofunikira kudziwa BCC, hematocrit, creatinine, mapuloteni amwazi.

3. Wodwala amayenera kufotokozedwa ngati ali ndi njala ndikukhazikitsa kupukusa kwamkati kudzera mu chubu chopyapyala, makonzedwe a makolo a anticholinergics (platifillin, atropine) H2 histamine receptor blockers (cimetidine, famotidine), analgesics. Kuti mumange ma pancreatic enzymes mu / mu 200 ml ya aminocaproic acid 5% yankho 1-2 kawiri pa tsiku, kuthira kwa plasma, albumin, shuga, ma electrolyte osachepera 3 malita patsiku, antihistamines.

Ntchito 5 Wodwala wazaka 48 polandila wowotchera wodandaula akudandaula kuti zimachitika kawirikawiri kupweteka kwakumalo, amachepetsa chilimbikitso, nseru, akung'ambika pamimba, makamaka mutadya zakudya zonunkhira kapena zamafuta, chakudya chambiri cha mushy. Madandaulo awa akuwonekera ndipo akukulira m'zaka zawo zisanu zapitazo. Kuyambira anamnesis amadziwika kuti zaka 8 zapitazo adakumana ndi mliri wa mumps. Nthawi yoyeserera: Mkhalidwe wokhutiritsa, zakudya zochepa. Kuchokera ku ziwalo zopumira komanso zozungulira popanda matenda. Mimba imatupa pang'ono, kupweteka pang'ono m'chigawo cha umbilical palpation. Chiwindi pamphepete mwa chipilala chodula. Impso, ndulu sizokoma.

Mafunso: 1. Pezani zodziwikiratu ndikuzikhululukira.

2. Ndi matenda ati omwe amafunikira kusiyanitsa matenda anu?

3. Fotokozani dongosolo la kuyesa wodwala.

Mayankho: 1. Dongosolo loyambilira ndi matenda a kapamba.

2.M'pofunika kusiyanitsa ndi matenda a biliary dongosolo (cholecystitis, cholelithiasis), aakulu enterocolitis, chironda chachikulu.

3. Amylase magazi, mkodzo, ma ultrasound am'mimbamo zam'mimbamo, kuphatikiza, shuga m'magazi, kuyeserera kwa glucose, kutsimikizira kwa proxenal komwe kumachitika ndi njira ziwiri zowonetsera kukondoweza kwa secretin ndi pancreosimine, fibrogastroscopy, cholera.

Njira ya pathological, yomwe imayendera limodzi ndi kusintha kwa kapamba ndipo imakhala ndi cyclical subacute period (periodic exacerbations), imatchedwa chronic recudia pancreatitis.

Matenda apakhungu omwe amapezeka nthawi zonse, kapangidwe kake ka zikondamoyo kamasintha, chifukwa chake ntchito zake zachinsinsi zimasokonekera

Matendawa amatenga zaka zingapo. Mu kapamba, kuphwanya kwapang'onopang'ono kwa ntchito zake zoyambirira kumachitika. Iron imaleka kupanga ma enzymes pamlingo woyenera, sichilamulira kupanga mahomoni (insulin), omwe amayendetsa shuga m'magazi.

Mavuto oterewa amayamba chifukwa cha kusintha kwa dystrophic mu parenchyma, yomwe imapangidwa pang'onopang'ono ndipo imatsogolera pakupangidwe kwa miyala mu ducts ndi zimakhala za kapamba.

Zomwe zimayambitsa matendawa

Recanc pancreatitis amatchedwa matenda a chitukuko. Posachedwa, ziwerengero zamayiko otukuka zawonjezeka. Chifukwa chachikulu chachitukuko chake ndichinthu chamagulu: zakumwa zoledzeretsa komanso zotsika mtengo. Kugwiritsa ntchito kwawo kumayambitsa poizoni wambiri m'thupi komanso kutsegula kwambiri kwa kapamba. Izi zimabweretsa chobisalira chachikulu, chomwe chimadziunjikira pancreas pang'onopang'ono ndikuyamba kuiwononga.

Malinga ndi ziwerengero, matendawa amafala kwambiri mwa amuna oonda a zaka zogwira ntchito. Mwa akazi, mawonekedwe osakhalitsa amapezeka pambuyo pancreatitis ya pachimake.

Kusokonezeka kwamanjenje kwa nthawi zonse kumatha kupereka chitukuko cha matendawa

Yambitsani chitukuko cha kupezekanso kwa kapamba:

• matenda a ndulu
• kuvulala, poyizoni,
• matenda opatsirana, kuledzera,
• psychogenic factor (kupsinjika).

Payokha, ndikofunikira kuzindikira kusuta, komwe kumayambitsa kuphipha kwamatumbo ang'onoang'ono komanso ma capillaries, omwe amatsogolera ku ischemia (magazi ochepa) a ziwalo za parenchymal. Zotsatira zake, minofu yolumikizana imamera m'gululi m'malo mwa parenchyma, zomwe zimapangitsa kuwonongeka kwa magwiridwe antchito.

Magawo akuluakulu mankhwalawa

Chinthu chachikulu mu chithandizo ndikupereka kupumula kwa thupi kwa kapamba. Iyenera “kulekanitsidwa” kuchokera munjira yachinsinsi. Pachifukwachi, ma enzyme achinyama amatchulidwa - Pancreatin, Creon, Mezim.

Pali lingaliro lomwe kugwiritsidwa ntchito kwa nthawi yayitali kukonzekera kumakhala kosokoneza, chifukwa chomwe, atasiya kudya, zikondamoyo sizitha kugwira ntchito palokha. Izi si kanthu koma nthano chabe. Kudya kwa michere kwa nthawi yayitali, m'malo mwake, kumakhala ndi zotsatira zopindulitsa pantchito ya gland.

Nthawi yomweyo monga mankhwala a enzyme, secretolytics amalembedwa mwachitsanzo, Omez Insta ,. Iwo samangochepetsa kubisalira, komanso amachepetsa acidity ya madzi a m'mimba. Izi ndizofunikira chifukwa ma enzyme samagwira ntchito m'malo acidic.

Kugwiritsa ntchito kosavuta kwa mankhwala a magulu osiyanasiyana ndiko njira yopambana pochizira pancreatitis yosatha

Kuti muchepetse chizindikiro chopweteka, antispasmodics ndi mankhwala. Pa kutupa kwa gland, kupanikizika kwa ma ducts kumawonjezeka, komwe kumabweretsa kupweteka kwamphamvu. Mankhwala a antispasmodic amasangalatsa khoma komanso mkamwa, mumapweteka.

Zovuta zotheka

Ngati pancreatitis yosachiritsika sichichiritsidwenso, zotsatirazi zingachitike:

1. Chotupa chowopsa. Mutu wokulirapo wa pancreatic umaphatikizira ma ducts a bile.Bile simalowa m'matumbo lumen, imadziunjikira, kenako imalowa m'magazi.
2. Kuphatikizika kwa mitsempha ya portal (chotengera chomwe magazi amaperekedwa kwa chiwindi) ndi ndulu yoyaka. Mitsempha yamagazi yotupa imagwera m'makoma am'mimba, esophagus, ndikupangitsa mitsempha ya varicose. Zotengera sizimayimilira, kukhetsa magazi kwambiri ndi zotsatira zakupha kumachitika.
3. Kuphwanya ntchito kwa chithokomiro. Kusintha kwa kagayidwe kazakudya kumabweretsa shuga.

Ndi zovuta zovuta za matendawa, nthawi zina simungathe kuchita popanda kuchitidwa opareshoni

Kuphatikiza apo, zovuta zimatheka momwe chithandizo cha opaleshoni chikusonyezera:

• pambuyo-necrotic cysts okhala ndi mapangidwe atafunsira (kutulutsa),
• aneurysms abodza (uthenga wamkati mwa chotupa chamkati ndi magazi othamanga),
• Kukhalapo kwa kusintha kwa kutupa mu chiwalo, momwe sikungatheketse ululu wamankhwala ululu.

Zakudya za kuchuluka kwa pafupipafupi kapamba

Pa siteji yowonjezereka, muyenera kutsatira lamulo lalikulu: kuzizira, njala ndi mtendere. Ndi ululu waukulu, samalani chakudya chamagulu a masiku 1-2, amangololedwa kumwa madzi amchere.

Pambuyo popuma ululu akuwonetsa:

• sopo wamafuta kapena masamba wopanda kabichi,
• phala
• ma protein
• compotes
• nyama yokhala ndi mafuta ochepa (mbalame, kalulu) mwa mawonekedwe a nyama, zomangira nyama, zidutswa za nthunzi.

Steam nkhuku meatballs - imodzi mwazoleza zomwe zimaloledwa kupweteka kwokhazikika

Zinthu zamkaka zitha kukhala zamafuta ochepa, ochepa. Masamba ophika kapena ophika ndi zipatso. Mowa, nyama zamafuta, batala, mankhwala osuta, marinade, pickles ndizoletsedwa.

Muphunzira za zomwe zimayambitsa chitukuko ndi chithandizo cha chifuwa chachikulu cha kanema:

Amawerengedwa kuti ndi matenda oopsa komanso osasinthika. Makamaka ngati matendawa akupita patsogolo ndikuchulukirachulukira kwa kapamba kumachitika pafupipafupi.

Matenda a kapamba - kutupa komwe kumachitika m'ziwonetsero kwa nthawi yayitali, kumapangitsa kuti pakhale kusintha kosasintha kapangidwe kake ka ntchitoyo, kaimidwe kake kapenanso kokwanira. Ndikachulukirachulukira kwa kapamba, anthu ambiri amafa. Izi zikuwonetsa kuwopsa kwa matendawa, kuti zizindikiro zoyambirira siziyenera kunyalanyazidwa.

Zomwe zimayambitsa maonekedwe a pancreatitis aakulu ndizosiyana. Gastroenterologists amatchula zinthu ziwiri zomwe zimayambitsa matenda osachiritsika:

1. Mowa. Malinga ndi ziwerengero, 60% ya odwala amavutika.
2. Matenda a Gallstone.

Nthawi zina chifukwa cha kapamba sichidziwika, mosadziwika imalumikizidwa ndi moyo kapena chimayamba chifukwa cha matenda ena.

Kugwidwa kwakukulu kwa matenda osachiritsika ndikuwonetsa kuti matendawa samangotchulidwa. Nthawi zina, matendawa amakhala asymptomatic. Ndipo nthawi ya kubwezeretsanso kwina kumachitika - wodwalayo amadwala matenda a kapamba. Nthawi zambiri, chifuwa chachikulu chimakhudza azimayi, amuna amakonda kuphulika mwadzidzidzi. Avereji ya zaka zamatendawa imachokera zaka 28 mpaka 37, ukalamba utatha zaka 50, kupezeka kwa chamba chachikulu cha pancreatitis kumakhalapo.