Pancreatitis: Zizindikiro komanso kulandira chithandizo kwa akuluakulu

Matenda a kapamba, kapena kutupira kwakanthawi kwamankhwala, ndimatenda okalamba wamba, koma opitilira theka la anthu sadziwa kuti akudwala nawo asanayesedwe ndi katswiri wa matenda osiyana ndi ena onse.

Munkhaniyi tikufuna kukuwuzani chikhansa cham'mimba kwambiri komanso momwe mungachitire, komanso kuti ndi zizindikiro ziti zomwe zingadziwitse kutupika kwa kapamba.

Kodi chikhansa chachikulu ndi chiyani?

Matenda a kapamba (CP) ndi kutupa m'mapapo omwe amapita patsogolo, pang'onopang'ono kuyambitsa chiwonongeko chotheratu m'thupi. Zotsatira zake, izi zimabweretsa kuphwanya kwa onse exocrine ndi endocrine ntchito za kapamba.

Pancreatic ductriers, mowa, komanso matenda a autoimmune ndi zina mwa zoyambitsa wamba aakulu kapamba. Kupweteka kwam'mimba, nseru, kusanza, kusowa kwa chakudya, kukomoka ndi endocrine kukanika ndi zina mwazizindikiro zoyambirira za matenda a kapamba.

Epidemiology

Akuti pamayiko olemera okha 3.5-10 mwa 100,000 kudwala ndi chifuwa chachikulu.

Matendawa nthawi zambiri amakula mwa odwala. wazaka 30 mpaka 40, nthawi zambiri mwa amuna kuposa akazi. Akuti pafupifupi milandu pafupifupi 87,000 ya kapamba amadziwika chaka chilichonse zipatala.

Matenda oledzera amapezeka kwambiri mwa amuna, pomwe mawonekedwe amtunduwu amadziwika kwambiri mwa azimayi.

Choyambitsa chachikulu cha matenda a kapamba ndi kagayidwe kachakudya (i.e., zotulukapo zamachitidwe amthupi mu thupi) chifukwa cha kudwala, etc. zinthu.

Matendawa amatha kuchitika chifukwa cha njira zotsatirazi zoyambira mwa anthu:

• kulowetsedwa kwachulukidwe ndi zotupa kapena miyala,
• Ma metabolites a poizoni omwe amapanga ma cytokines (ochokera ku ma acinar cell a kapamba),
• necrosis, kapamba,
• oxidative nkhawa
• ischemia
• uchidakwa wambiri,
• vuto la autoimmune
• Hyperlipidemia, hypercalcemia,
• kutsekereza (kufalikira) kwa pancreatic duct yayikulu (ikhoza kukhala yatsopano kapena yotenga).

Herederal Pancreatitis ndimatenda ofala kwambiri omwe amachititsa 1% ya milandu. Cystic fibrosis, matenda opatsirana pang'onopang'ono, amachititsa matenda ochepa kapamba.

Matenda a autoimmune pancreatitis ili ndi mawonekedwe azachipatala monga kapamba wokulirapo, kupindika kwapancreatic duct, kufalitsidwa kwa gamma globulin komanso kukhalapo kwa autoantibodies. Zomwe zimayambitsa matendawa pafupifupi 30% ya milandu ndi idiopathic (odziimira).

Kuvulala kwam'mimba chifukwa cha ngozi kumabweretsa anapeza zopinga matenda a kapamba.

Kutupa kwa Necrotic mu kapamba ndiko monga poyankha kuvulala. Kukhazikika kwa matrix a extracellular ndi kuchulukana kwa ma fibroblasts mu kapamba kumakhudzana ndi kuyanjana kovuta kwa gulu la mapuloteni onga mahomoni ngati ma cytokines, kukula kwa zinthu, ndi ma chemokines.

Pankhani ya kuwonongeka kwa kapamba pali kutulutsidwa kwa mapuloteni omwe amawongolera kuchulukana (kusintha kukula kwa chinthu cha beta) ndipo mawu ake akumaloko amathandizira kukula kwa masensa a mesenchymal ndikuwonjezera kapangidwe ka mapuloteni amtundu wa extracellular monga fibronectin, proteinoglycans, ndi collagens.

Pali umboni kuti chemokines, banja laling'ono la cytokines, likuthandizira pa chiyambi ndi kukula kwa matenda apamba pancreatitis.

Kupereka zinthu za matenda a kapamba

Cinthu monga uchidakwa, motere, chiwerengero cha matenda chikukula mofulumira. Izi zikugwira ntchito kwa amuna ndi akazi omwe amakonda kuseka.

Chachiwiri chachikulu nthenda ya ndulu ndi matenda oyambitsa, omwe ambiri amapezeka mwa azimayi.

Zomwe zimayambitsa matenda a kapamba zimatha kunenepa kwambiri, kunenepa kwambiri, ma virus ndi mabakiteriya.

Kugwiritsa ntchito mosagwiritsa ntchito mankhwala osiyanasiyana kumadzetsa matenda. M'mimba ndi matumbo ndi njira yolumikizirana, momwe michere yambiri imakhudzira ziwalo zapafupi, kuphatikizapo kapamba.

Zizindikiro zake ndi chifuwa chachikulu cha kapamba

Zizindikiro za pancreatitis yosatha imawonetsedwa ndi magawo azovuta omwe amapezeka pakati, komanso kupweteka kosalekeza.

Chizindikiro chimodzi chachikulu matendawa ndi ululu wam'mimba m'chigawo cha epigastric, chomwe chimatulukira kumbuyo, mwina chifukwa cha kutsekeka kwa pancreatic duct.

Kukula kwa kupweteka kumatha kusiyanasiyana: kuchokera paukali, womwe umafunikanso ma analgesics opeate, kufatsa, osawonekeratu.

Zizindikiro zachiwiri Vutoli limaphatikizapo kutulutsa magazi ndi mpweya, nseru, kusanza, kuchepa kwa chakudya, kuwawa mkamwa, exocrine komanso endocrine kukanika. Kusokonekera kwaubwino kumabweretsa kuchepa thupi, kuchepa kwa mapuloteni, kutsekula m'mimba ndi chiwindi. Kusokonekera kwa Endocrine kumabweretsa chitukuko cha yachiwiri shuga mellitus.

Zovuta zotheka

Pancreatitis yachilendo imayambitsa pancreas pang'onopang'ono. M'magawo oyambilira, ma epicode amthawi ndi nthawi amachitika, ndikupweteka kwambiri.

Popita nthawi, minofu yowonongeka ya pancreatic imasanduka zipinda zodzaza madzi, otchedwa mabala abodza (pseudocysts). Ma pseudocysts amatenga madzi a pancreatic ndikuwatsekera m'zinthu zamagalamu kapena zotupa, zomwe zimayambitsa kutupa, magazi mkati.

Kuphatikiza apo, kuwerengetsa kowonjezereka (mawonekedwe amchere wamchere) kumatha kupezeka mu kapamba ndi ziwalo zapafupi. Zovuta zimapanga mu duct system, ndipo pamapeto pake, miyala ya pancreatic. Zimalepheretsa katulutsidwe ndipo zimapangitsa kudzikundikira kwa timadziti tam'mimba.

Ndi matendawa, endocrine pancreatic ntchito imakhudzidwa, kupanga insulini kumayipa. Ngati kuwonongeka kwa kapamba kumanyalanyazidwa kwambiri, izi zimayambitsa kupweteka kwam'mimba kwambiri ndi kuchepa thupi ndi matenda a anorexia, matenda a shuga. Monga zovuta mochedwa khansa ya kapamba ingachitike.

Zina osavutanso kwambiri matendawa:

• bakiteriya matenda a minofu yakufa chifukwa cha poyizoni wamagazi (sepsis),
• mtima (hemodynamic, circulatory) mantha,
• matenda obanika magazi (otchedwa kumwa coagulopathy),
• kuchuluka kwa magazi m'thupi,
• mtima, kupuma komanso kulephera kwa impso,
• mu zidakwa, zizindikiro za kusiya mowa (hysterical mantha ndi neurosis yamayiko oonera) panthawi yamankhwala.

Zoyeserera zamankhwala

Kuzindikira pancreatitis yovuta sikophweka, chifukwa mayeso owoneka ndi kuyesedwa kwa magazi a matendawa sizolunjika kwenikweni. Kuyesa kwa magazi amagwiritsidwa ntchito poyesa kuchuluka kwa enzyme ya pancreatic, shuga ndi chiwindi, ndi ntchito ya impso.

Stool imathanso kuyesedwa ma enzyme ndi mafuta. Kafukufuku wowoneka kapamba amachitidwa pogwiritsa ntchito computer tomography, radiography, maginito resonance cholangiopancreatography ndi transabdominal ultrasound (ultrasound).

Chithandizo cha matenda kapamba

Chithandizo cha pancreatitis chokhazikika ziyenera kuyamba atapezeka.

Kuchedwa kwakanthawi kwamankhwala kungayambitse kuwonongeka kwa kapamba ndipo kumabweretsa kupweteka kosavuta komwe kungakhale kovuta kuchiritsa.

Odwala ambiri amapeza mpumulo wamawawa akamagwiritsa ntchito mankhwala omwe si a antiidal ibuprofen ndi paracetamol, komanso antioxidants. Jakisoni amatha kuletsa matenda a celiac, kulepheretsa mitsempha ya kapamba kuti isanapweteketse bongo.

Njira zamankhwala othandizira opaleshoni zimaganiziridwa, ndi kulephera kwa mankhwala azikhalidwe. Ntchito idayitanidwa pancreatic jujunostomy imapereka kupweteka kwapafupifupi 80% ya odwala.

Kutupa kwa pancreatic kumatha kutha nawonso Njira za Whipple (ntchito PDR - ntchito pancreatoduodenal resection). Pancreatectomy yokhala ndi autotransplantation ya isanc pancreatic imapereka mpumulo wa chizindikiro.

Kulandilanso kumathandizanso. vitamini C ndi E, methionine ndi selenium mankhwalawa oxidative nkhawa aakulu kapamba.

Momwe mungachiritsire matenda a kapamba kunyumba

Pochiza matenda kunyumba, mbewu za fulakesi zimathandiza kwambiri. Ngati mungagwiritse ntchito mankhwalawa, mutha kugwiritsa ntchito njira zotsatirazi ziwiri:

• Kissel ndi fulakesiThirani madzi okwanira 1 litre m'madzi otentha mu thermos, onjezani supuni zitatu za mbewu za fulakesi, yandikirani ndikusiya kuti mupatse. Chidacho chimayenera kuphikidwa madzulo, ndiye m'mawa chimangokhala chongogwedeza, chimeza ndi kutenga mphindi 30 musanadye theka kapu itatu katatu patsiku.
• ​​Msuzi wowerengeka. Sakanizani magalamu 85 a mbewu ya fulakesi ndi madzi okwanira 1 litre mumsavu wopanda madzi, kubweretsa kwa chithupsa, kwa mphindi 2, kuphimba mwamphamvu ndi chivindikiro.

Kutalika kwa mankhwalawa chifukwa cha chifuwa chachikulu cha fakisi ndi 2-2,5 miyezi.

Pochiza matenda kunyumba, mankhwalawa amagwiritsidwanso ntchito:

• Ma enzyme opatsa mphamvu (Pankral, Pancreatin, Panstal, Festal) - mankhwalawa atagwira chiwalo chilichonse, ndikofunikira kuonetsetsa kuti kupumula kwa thupi, ma enzymes (mapuloteni omwe amathandizira kuti asinthe momwe thupi limayambira limagwirira ntchito) amagwiritsidwa ntchito pamenepa. Mankhwalawa ali ndi zaka zopitilira 100. Mulibe zinthu zodalira.
• Achinsinsi (Drotaverinum) - mankhwala omwe amathandizira kuchepetsa kapangidwe ka madzi a pancreatic, nthawi zina amawapangira kale kuposa enzyme. Chifukwa chakuti chifukwa chachikulu chomwe chimayambitsa kupanga juwisi, malo ankhanza m'mimba, ma secrycytics amaletsa.
• Antispasmodics (Papaverine, No-Shpa, ndi zina) - adalembedwa kuti achepetse kupanikizika mu pancreatic duct, yomwe imakwiyitsa kwambiri.

Matenda a pancreatitis amatanthauza ma pathologies a acid akudalira, mu 90% ya kuchuluka kwa acidity kumazunzidwa, m'malo okhala acidic sizotheka kugwira ntchito michere imodzimodzi, chifukwa cha izi, kuphatikiza kwa mankhwalawa, mphamvu ya mankhwalawa imawonjezeka.

Amadzi am'madzi ochepa omwe samamwa, ndi oyenera kumwa kunyumba:

• Borjomi
• Essentuki No. 4 ndi Na. 17,
• Madzi amchere a Smirnovskaya,
• Luzhanskaya
• Polyana Kvasova,
• Swallow yamadzi.

Madzi amchere awa ali ndi kuchuluka kwa alkali, komwe kumathandizira pakuchizira kwachangu pancreatitis.

Zakudya za pancreatitis aakulu: ndingadye chiyani ndipo sindingathe?

Mkhalidwe wa kapamba kumadalira kwambiri chakudya chomwe chimadyedwa. Ndikofunika kuti muzidya nyama wopanda mafuta, wotsamira. Matenda a kapamba, zotsatirazi nthawi yomweyo zimasiyanitsidwa ndi zakudya:

• batala
• zopangidwa mkaka,
• wokazinga, wosuta,
• zakudya zowuma
• lokoma
• mowa mwa mtundu uliwonse.

Amathandizira kuwonjezera acidity m'mimba, zimapangitsa kuti zikondamoyo zizitulutsa madzi am'mimba ambiri.

Mukamadya zakudya zamafuta, komanso kumwa mowa mwauchidakwa, michere imawononga ma cell a kapamba. M'pofunikanso kuchotsa shuga, kupanikizana, ndi zina. maswiti.

Gome la zonse zololedwa ndi zoletsedwa za kapamba:

Zosintha zamasiku a tsikulo

• azungu awiri azira, omelet ndi sipinachi,
• chidutswa chimodzi cha tirigu wathunthu,
• khofi wofooka kapena tiyi.

• mpunga ndi nyemba zofiira kapena zakuda,
• mkate umodzi,
• 100 magalamu a nyama ya nkhuku,
• madzi kapena madzi.

• tirigu
• nthochi imodzi
• madzi.

• nsomba zam'chitini mu msuzi wake,
• saladi yaying'ono yobiriwira yovala mafuta ochepa kapena viniga wa basamu (wopanda mafuta),
• madzi kapena madzi.

Chakudya chamadzulo (chakudya chamadzulo):

• yogurt yamafuta ochepa yokhala ndi uchi ndi uchi,
• madzi kapena tiyi yazitsamba.

Pali cholesterol yambiri pamafuta azakudya; samasungunuka m'madzi. Ndikofunikira kudya mafuta ochepa, mafuta, masoseji, mafuta anyama. Muyenera kutenga nsomba zambiri, mbewu zonse, ndi madzi ambiri kuti muchepetse kusowa kwamadzi.

Kupewa ndi malingaliro

Popeza nthawi zambiri chifuwa chachikulu cha kapamba chimakhudzana ndi kumwa mopitirira muyeso, kusiya mowa kumatha kuchepetsa mwayi wokhala ndi chifuwa chachikulu. Pazovuta zazikulu zodalira mowa (mwachitsanzo, uchidakwa), thandizo la narcologist woyenera lingafunike. Kumbukiraninso kutsatira zakudya zomwe zili pamwambapa.

Kuzindikira kwa odwala

Zomwe zimachitika pang'onopang'ono chifukwa cha chifuwa chachikulu cha matenda am'mimba ndizovuta kudziwa, kumwa mowa, kusuta komanso kusanza.

Pakafukufuku yemwe anachitika pamlingo wapadziko lonse lapansi, kuchuluka kwa anthu omwe ali ndi pancreatitis yayikulu anali 70% pambuyo pa zaka 10 zodwala ndi 45% atatha zaka 20. Chiwopsezo chokhala ndi khansa ya pancreatic chinali 4% patatha zaka 20.

Zofala zovuta za matenda ndi makina kutsekeka kwa bile duct ndi duodenum, mapangidwe a pseudocysts a kapamba.

Pseudocysts amapanga pafupifupi mu 10% ya odwala ndi chifuwa chachikulu cha khansa. Matenda a shuga ndi pseudo-aneurysm ndi zovuta zina za matendawa.

Kutupa kwa pancreatic, komwe kumakhala kanthawi kochepa (sabata-pamwezi), kumatchedwa pachimake pancreatitis, ndipo umodzi womwe umatenga miyezi 2-3 kapena kwa nthawi yayitali umatchedwa chronic pancreatitis.

Popita nthawi, kapamba amachititsa kuti awonongeke komanso awononge ziphuphu. Miyala ya calcium yomwe imatuluka m'matumbo amatha kulepheretsa kutuluka kapena kupopera kwa kapamba, komwe kumasunthira michere ya pancreatic ndi timadzi ta pancreatic kumatumbo.

Kuchepa kwa kuchuluka kwa michere ya pancreatic kumayambitsa kugaya, pomwe kuchepa kwa mahomoni a pancreatic kumapangitsa kuti magazi asamayende bwino.

Ma enzymes ocheperako amachititsa kuperewera kwa zakudya m'thupi chifukwa cha kuyamwa bwino komanso kuchepa kwamafuta ambiri mu ndowa. Ngati kuchuluka kwa shuga m'magazi sikungokhalabe moyenera, izi zimabweretsa matenda a shuga.

Pancreatitis - nthenda iyi ndi chiani?

Pancreatitis amatanthauza ma pathologies akuluakulu omwe amadziwika ndi kutupa kwa minyewa ya kapamba. Ili pamimba yapamwamba, yolimba mwamphamvu mpaka m'mimba, khoma lake lakumbuyo. Tizilombo timene timatulutsa ma enzyme omwe, limodzi ndi bile, timapukusa chakudya m'malo mwa duodenum. Imasunganso mahomoni ofunikira kuti magazi azikhala ndi shuga - insulin ndi glucagon.

Tiyenera kudziwa kuti kapamba amatenga gawo lalikulu m'thupi, ndipo kutupika kwake ndikosayenera. Ngati ma enzyme samaponyedwa m'matumbo, ndiye kuti amayamba kugwira ntchito ndikuyamba kudya maselo a pancreatic, ndipo zonsezi zimatha polephera.

Mwa akazi, kapamba amapangidwa nthawi zambiri chifukwa cha cholelithiasis. Izi ndi zinthu ziwiri zikuluzikulu zomwe zimakhudza chitukuko cha kapamba. Kuphatikiza pa izi, palinso zifukwa zina zothandizira matenda omwe aperekedwa:

• Kunenepa kwambiri
• Matenda a chiwindi ndi m'mimba, kuphatikizapo zilonda zam'mimba ndi cholelithiasis.
• Kugwiritsa ntchito kwamafuta nthawi zonse, zakudya zonunkhira, koloko, mayonesi ndi chakudya chofulumira.
• Chithandizo ndi ena mahomoni othandizira komanso maantibayotiki.
• Zochita za opaleshoni m'mimba kapena kuvulala, monga kupweteka kapena kuvulala.
• Zovuta pambuyo pa matenda opatsirana: mamps, hepatitis B ndi C.
• Zotupa za Helminthic: opisthorchiasis kapena giardiasis.
• Zotupa kapena zonyansa m'maso.
• Kudziletsa.

Kutupa kwa kapamba kumadziwikanso kwambiri mwa ana omwe amakonda kudya maswiti, tchipisi, ndi zinthu zina zopanda thanzi. Zinthu zomwe zaperekedwa zimakwiyitsa makoma am'mimba, ndikupangitsa kuti gawo lonse logaya chakudya liyambe kuvutika.

Limagwirira a chitukuko cha matenda

Matenda a kapamba am'mimba amayamba chifukwa cha kupweteka kwa m'mimba kwa kapamba. Zimayambitsa kusayenda kwa michere mkati mwa thupi. Nthawi zambiri, chitsulo chimapanga pafupifupi 700 ml ya pancreatic madzi patsiku, omwe amasiya kapangidwe kake pogwiritsa ntchito njira zowoneka bwino. Ntchito yachinsinsi imatengera mtundu wa zakudya komanso momwe mungakhalire, ziwalo zina zamkati.

p, blockquote 2.0,0,0,0 ->

Njira zosasunthika zimayendetsedwa ndi kuchepa mu kapangidwe ka ma enzyme ndi kuyambitsa kwawo kusanachitike. Zinthu izi zimayamba kuphwanya maselo a pancreatic, omwe amatsatana ndi kusintha kwamkati komanso kulowetsedwa. Kutupa kwa minofu kumakulitsa kusakhazikika, ndipo mawonekedwe am'madzi am'mapapo amasokonezedwa. Njira zachidziwitso zimabwerezedwa, zomwe zimawonjezera edema ndikukulitsa kusintha.

p, blockquote 3,0,0,0,0,0,0 ->

Zochita za chitetezo chamthupi komanso kuchepa kwa zinthu zomwe zimayambitsa zimathandizira kuchepa, komabe, maselo omwe awonongedwa alibe nthawi yochira. Njira za m'matumbo zimakhalira ulesi, zimakhala ndi kusintha kowononga mu chiwalo parenchyma (ulusi wa fibrous ndi foci ya necrosis amawonekera, ndipo maselo athanzi amafa).

p, blockquote 4,0,0,0,0,0,0 ->

Matenda a kapamba amadziwika ndi njira yonga mafunde yomwe imakhala ndi nthawi yokwanira komanso kukulira mkhalidwe wa wodwalayo. Kuphatikiza kwa matenda komanso kupezekanso kwa zochitika zomwe zimadzetsa kusokonekera kumapangitsa kukokomeza kwa matenda. Pankhaniyi, parenchymal maselo a chiwalo amavutika, stenosis (kuchepa) kwa ducts kumachitika, calculi mawonekedwe. Kusintha kosasinthika komwe kumachitika chifukwa cha kupweteka kwa kapamba kumayambitsa kuperewera kwa thupi (kunja ndi kwina), komwe kumakhudza gawo lonse lathupi lathu.

p, blockquote 5,0,0,0,0 ->

Chifukwa chiyani matendawa amachitika?

Pachimake, kenaka mawonekedwe a kapamba angayambitse zinthu zambiri. Mwamwambo kuwagawa m'magulu awiri. Loyamba limaphatikizira kukopa kwakunja (kuchokera kunja kwa thupi), chachiwiri - mavuto amkati (matenda, matenda a metabolic). Zomwe zimayambitsa matenda zimafotokozedwa pansipa.

p, blockquote 6.0,0,0,0,0 ->

Gome - Oyambitsa matenda kapamba

p, blockquote 7,0,0,0,0 ->

Malinga ndi ziwerengero, zopitilira 40% zamavuto osatha a chamba amayamba chifukwa chomwa mowa mwa apo ndi apo. Pafupifupi gawo limodzi mwa magawo atatu a odwala omwe ali ndi vutoli ali ndi mbiri yovuta yamatenda a ndulu. Pafupifupi 20% ya milandu imachitika chifukwa cholakwika mu zakudya; ndi zotsatira za kususuka kapena kudya mosamalitsa. Zoyambitsa zina (kuphatikiza ma genetic, autoimmune, zoopsa) zosaposa 10% yonse.

p, blockquote 8,0,0,0,0 ->

Pancreatitis Gulu

Kutupa kosalekeza kwa kapamba kumatha kusiyanitsidwa ndi makina otukula pa pulayimale ndi sekondale. Kugawana kofala kwamatenda kulibe. Njira zazikuluzikulu zomwe zimasiyanitsa matenda ndi mawonekedwe am'thupi, tanthauzo la kusintha kwa gland, mtundu wamatenda omwe amagwira ntchito.

p, blockquote 9,0,0,0,0 ->

Malinga ndi zomwe matendawa amatha kupezeka pancreatitis, imagawika:

p, blockquote 10,0,0,0,0 ->

• kupweteka - ululu wamankhwala ulipo mu chithunzi cha matenda, omwe amapezeka pafupipafupi kapena mobwerezabwereza,
• pseudotumorous - limodzi ndi kusintha kwa matenda oopsa m'mitsempha, amaphatikiza zizindikiro za zotupa ndi ma oncological,
• mawonekedwe - ofooka kapena osapezeka, osasokoneza kwambiri moyo wa wodwalayo,
• kuphatikiza - nthawi yomweyo pali zizindikiro zamitundu yosiyanasiyana.

p, blockquote 11,0,0,0,0 ->

Njira ya matenda a zamatsenga yatsimikizika, ikuyang'ana pa mawonekedwe akusintha kapangidwe ka kapamba:

p, blockquote 12,0,0,0,0 ->

• calcifying pancreatitis - limodzi ndi kufotokozedwa kwa mawonekedwe a chiwonetsero cha ndulu, kutikirana kwa minyewa, kupindika kwa stenosis, mapangidwe a cyst,
• Zovuta - zimayamba ndi kufalikira kwa mizere yayikulu kapena yotsalira, yophatikizidwa ndi zochitika zazovuta kwambiri,
• infiltrative-fibrous - pali kusintha kwa atrophic organ ndi kusintha pang'onopang'ono kwa maselo okhala ndi minyewa ya fibrous,
• fibrossteotic - kusokonezeka kumachitika m'matumbo ambiri, limodzi ndi makwinya ndi kuchepa kukula kwake.

Poyang'ana pa chiyambi cha zovuta zapantchito za kapamba, pancreatitis yayitali ndi hyper- komanso hyposecretory. Madzi amapangidwa mwachizolowezi kapena kuchuluka, owonjezera ma bicarbonates amawonetsedwa, ntchito yowonjezera ya michere imadziwika. Mtundu wa hyposecretory umadziwika ndi kuchepa kwa kuchuluka kwa ma enzymes ndi ma carbonate kwinaku mukusunga kuchuluka kwa madzi. Mtundu wapakhungu wa kapamba limayendera limodzi ndi kupanga timadzi tambiri tambiri tokhala ndi ma enzymes komanso ma bicarbonates ambiri, zomwe zimawonetsa kutulutsa kwazinthuzo mu ma ducts.

p, blockquote 13,0,1,0,0 ->

Kuwonetsedwa kwa matenda

Matenda a kapamba amakula m'magawo. Madokotala amagwirizanitsa magawo ake ndi nthawi zina:

p, blockquote 14,0,0,0,0 ->

1. Gawo loyamba. Ikufotokoza nthawi kuchokera pakuwonekera kwa matendawa, kumatenga pafupifupi zaka 5, imadziwika ndi kusintha kwa kutupa m'magazi a gland, ndipo imatha kuchitika posachedwapa (zobisika).
2. Yaikulu. Zimagwirizanitsidwa ndi chitukuko cha chithunzithunzi chodzaza ndi matenda komanso magawo ochulukirapo ndikukhululuka, imagwera panthawi yopanga njira za dystrophic komanso zowonongeka, zimakhala mpaka zaka 10.
3. Kubedwa kwa kutupa. Zimachitika patadutsa zaka 7 mpaka 15 matendawa atayamba, amadziwika ndi kuchepa kwakanthawi machitidwe (ngati wodwalayo azolowera moyo ndi kapamba) kapena kukulira kwa zovuta mu mawonekedwe a neoplasms (okhala ndi zovuta zina).

Chithunzi cha chipatala chimatengera gawo ndi gawo la matenda, kukula ndi kukula kwa kutupa, kukhalapo kwa foci ya necrosis. Zizindikiro za pancreatitis yosatha imaphatikizira kupweteka, kusokonezeka kwa dyspeptic, komanso kusintha kwachilengedwe. Zizindikiro zolakwika zalembedwa mu gawo la kuchulukitsa kwa matenda.

p, blockquote 15,0,0,0,0 ->

Mawonetsero opanda pake

Zizindikiro zodziwika kale za kapamba zimaphatikizapo kuledzera. Zimakhumudwitsidwa ndikulowa kwa ma enzyme mu kayendedwe kamatenda, kaphatikizidwe kachilomboka, kapena khansa yofanana ya ziwalo zina zamkati. Zizindikiro zosatchulika za kapamba zimaphatikizapo:

p, blockquote 16,0,0,0,0 ->

• kufooka, ulesi, ulesi, kutopa, kuchepa kwa ntchito, chisamaliro chochepa,
• kutentha kwa subfebrile kumayambiriro kwa kusintha kwamatenda, kuwonjezeka kwa ziwonetsero mpaka 39-40 ° C ndi njira za necrotic kapena purulent,
• "matonsi" ofiira pamimba (mawanga omwe sasowa akamapanikizika),
• Maso amtundu wamakutu amtundu (chifukwa cha kuchuluka kwa poizoni m'thupi).

Kuphwanya kwa kukonza kwa michere kumayambitsa kuperewera kwa mavitamini (owonetsedwa ndi khungu lowuma, tsitsi, tsitsi, misomali), kuchepa kwa magazi (kufooka, kufupika kwa mpweya), kutopa kwamphamvu (kuwonda kwambiri, kufooka kwa minofu). Odwala omwe pancreatitis yosatha imaphatikizidwa ndi ma pathologies a bile akhoza kuyambitsa jaundice (yowonetsedwa ndi icteric sclera, mucous membrane, khungu, kusokonekera, mantha, kugona.

p, blockquote 17,0,0,0,0,0,0 ->

Ngati kusintha kwa fibrotic kapena purulent-necrotic kufalikira kuzilumba za Langerhans, shuga imayamba, chifukwa insulin imapangidwa m'dera lino la kapamba. Kenako Zizindikiro za chifuwa chachikulu chimaphatikizidwa ndi polyuria (kuchulukitsa kwamkodzo), ludzu lakuya, Zizindikiro zakutha kwa magazi (khungu lotupa, zotupa za mucous, maso opepuka), kuchepa kwa magazi.

p, blockquote 18,0,0,0,0 ->

Ululu wammbuyo

Zosasangalatsa kum'mimba nthawi zambiri zimakhala mawonekedwe oyamba a kutupa kwapancreatic. Ngati zotupa zakusintha kwa kapamba ndizovuta, kupweteka, kusoka, zolimbitsa kwambiri. Zimachitika makamaka ndikudya, zimakulitsidwa ndi mowa, mafuta ndi zonunkhira. Amakhala padera pamimba yapamwamba (epigastric dera), ali ngati lamba (amapanikizika thupi kuzungulira kuzungulira konse, ngati lamba wolimba kapena wowongoka).

p, blockquote 19,0,0,0,0 ->

Gawo la pancreatitis pachimake limaphatikizidwa ndi kupweteka kwambiri, komwe nthawi zina kumatha kupweteka kwa wodwalayo. Nkhope ya munthu imawoneka yopweteka, khungu limasunthira, ndipo thukuta limayamba kutuluka. Zosasangalatsa zomverera ndizokhazikika kapena cramping. Panthawi yowonjezera ululu, wodwalayo amaganiza kuti akukakamira (nthawi zambiri amagona ndi miyendo yake mwamphamvu). Zovuta zimatha kuwunikira mbali yakumanzere, kutsikira kumbuyo, ndi dera laumbilical.

p, blockquote 20,0,0,0,0 ->

p, blockquote 21,0,0,0,0 ->

Chizindikiro chokhala ndi pancreatitis yayitali ndikuyenda kochepa kwa ma pinkiller ndi antispasmodics. Kuchepetsa chizindikiro kuchipatala, ma analcics a narcotic angagwiritsidwe ntchito.

p, blockquote 22,0,0,0,0 ->

Kutupa kwa pancreatic, komanso kuchepa kwa michere kumakhudzanso chimbudzi ndi kagayidwe. Kupweteka kwapafupipafupi (kumachitika mphindi 30-60 mukatha kudya), kumadzaza ndi mpweya, wowawasa kapena wowawa pakamwa, komanso kulemera (ngakhale munthu atadya pang'ono) kungasonyeze kukwiya kwambiri. Ndi kuchulukitsa, zovuta za dyspeptic zimatchulidwa ndipo zimaphatikizapo:

p, blockquote 23,0,0,0,0 ->

• nseru (imawoneka nthawi yomweyo ndikumva kuwawa komanso kuwawa, imayambitsa kuchepa kwa chakudya kapena kukana kwathunthu chakudya kapena madzi),
• kusanza (kumachitika kuwonjezeka kowawa kapena kuwawa kwa zosasangalatsa, sikumabweretsa mpumulo, bile limatsimikiza mu misa),
• zovuta zakudya zam'mimba (pambuyo pa maola 1‒2 mutadya, m'mimba mwatupa, pamakhala phokoso ndi ziwonetsero zankhanza, kupotoza chimbudzi),
• kusokonezeka kwa chopondapo (nthawi zambiri chifukwa cha kutsekula m'mimba, tinthu tosagwirizana ndi chakudya, ma admixtures a mafuta amapezeka mu ndowe).

Zizindikiro za dyspepsia zimayendera limodzi ndi chifuwa chamimba pafupifupi nthawi zonse. Pakukhululuka, samatchulidwa kokwanira. Panthawi yowonjezera, kugaya kumalephera kupweteka komanso kuchepetsa moyo wa wodwalayo.

p, blockquote 24,0,0,0,0 ->

Zovuta za matenda

Kuukira kwa pancreatitis kumbuyo kwa kukula kwake koopsa kumakhala kowopsa kwambiri pazotsatira zoyipa. Mavuto omwe nthawi zambiri amapezeka mu gawo la pachimake, pamene kusokonekera, kulowetsedwa ndi kusintha kwa dystrophic kumachitika kwambiri, chiopsezo cha matenda omwe amalowa mkati mwa chiwalocho chikuwonjezeka. Matenda a kapamba ndi owopsa:

p, blockquote 25,0,0,0,0 ->

• kapangidwe ka zotupa, fistulas, phlegmon,
• mawonekedwe a pseudo komanso ma cysts owona,
• kukula kwa peritonitis,
• matenda ashuga
• pang'ono pang'ono kapena kufa kwathunthu kwa England (pancreatic necrosis),
• kutupa kwa ndende kuzungulira kapamba,
• kulephera kwa ziwalo zingapo (zamkati, aimpso, kwa chiwindi),
• kufalitsa intravascular coagulation syndrome.

Mavuto ena amtsogolo amaphatikizapo cachexia (kuchepa kwa thupi), kuchepa kwa mavitamini, kusokonezeka kwa mineral metabolism, matenda oopsa a hepatitis, esophageal vein varicose mitsempha komanso chiopsezo chotaya magazi mkati mwa maziko awa, komanso khansa ya kapamba.

p, blockquote 26,0,0,0,0 ->

Kuzindikira matenda kapamba

Ndi zizindikiro za kutupa kwapancreatic, kukaonana ndi gastroenterologist. Pofunsidwa koyamba, adotolo amatenga anamnesis, kumvera madandaulo a wodwalayo, ndikuwunika. Zambiri zokhudzana ndi zakumwa zoledzeretsa, zovuta za kudya, kumwa mankhwala limodzi ndi zodziwika bwino zimathandizira malingaliro a katswiri wapa pancreatitis. Kuti mumvetse bwino za matendawa, kumayikidwa mokwanira:

p, blockquote 27,1,0,0,0 ->

• Kuyesa kwazonse ndi zamankhwala am'mwazi. Onerani momwe thupi lakhalira, kuchuluka kwa michere, mapuloteni enieni, kuchuluka kwa leukocytes, ESR.
• Cop program.Amakulolani kuti muwonere kuchuluka kwa magwiridwe antchito a pancreatic osayesa mayeso ovuta (mu ndowe, kuchuluka kwa zoumba, zotupa za minofu zosafikiridwa, ndipo mafuta azindikirika).
• Urinalysis Zikuwonetsa mkhalidwe wamagulu owonekerawa, zovuta zitha kupezeka.
• CT, MRI, ochiritsira ndi endoscopic ultrasound ya gland. Njira zoganizira zolondola kwambiri zimapangitsa kuti athe kuyesa kukula ndi kapangidwe ka chiwalo, kupezeka kwa zisindikizo, cysts, inclusions, calculi, kutsekeka kwa ma ducts, foci ya necrosis, ndi zotupa.

Asanapereke mankhwala, dokotala ayenera kusiyanitsa kapamba ndi zina zomwe zimayendera limodzi ndi zizindikiro za "m'mimba zopweteka". Nthawi zambiri, kuwonongeka kwamphamvu kwa kapamba kumayenera kusiyanitsidwa ndi zilonda zophatikizidwa, vuto la mtima, chiwindi cham'mimba, kutsekeka kwamatumbo. Mwa izi, electrocardiogram, chiwonetsero chazithunzi cha m'mimba, mawonekedwe a ziwalo zamkati ndi omwe amapatsidwa.

p, blockquote 28,0,0,0,0 ->

Chithandizo cha chifuwa chachikulu cha khansa

Chithandizo cha matendawa chikuyenera kukhala chokwanira. Ntchito yayikulu ndikuchotsa zomwe zimapangitsa kuti pakhale zinthu zoyambitsa ndikusiyitsa kusinthika ndi kusakhazikika kwa thupi. Popeza pamakhala chiopsezo chodabwitsanso kupweteka pakakhala kuukira, kupondereza kusasangalala kumawoneka ngati gawo lofunikira kwambiri la chithandizo.

p, blockquote 29,0,0,0,0 ->

Munthu aliyense yemwe akudziwa za mavuto awo ndi kapamba ayenera kuphunzira - kudzipereka nokha sikovomerezeka. Mwa zisonyezo zilizonse zokhudzana ndi kutupa kwapancreatic, muyenera kufunsa dokotala ndikuwunikiridwa mozama mosalephera. Kuwongolera kwa katswiri ndikofunikira kuti athe kudziwa momwe masinthidwe mkati mwa chiwalo ndikuwonetsetsa panthawi yomwe akuwopseza moyo.

p, blockquote 30,0,0,0,0 ->

Kafukufuku akuti pafupifupi 20% ya odwala omwe ali ndi pancreatitis aakulu amafa zaka 10 zoyambirira za matendawa. Nthawi yomweyi, chiwerengero chaimfa chimakhala pafupifupi 50%. Izi zimachitika chifukwa cha zovuta zamatenda.

p, blockquote 31,0,0,0,0 ->

Thandizo loyamba lothandizira

Kuchulukitsa kwa matenda a kapamba kumatha kuzindikirika ndi kupweteka kwambiri komanso kusanza kosaletseka. Wodwalayo ayenera kukhala omasuka (wokhala pansi kapena atagona kumbuyo kwake). Izi zimachepetsa kutuluka kwa magazi kupita kuchiwalo chopunduka ndikuchepetsa kusasangalala. Gulu la ambulansi liyenera kuyitanidwa chifukwa kudzakhala kovuta kunyamula wodwala kupita naye kuchipatala yekha.

p, blockquote 32,0,0,0,0 ->

Asanachitike madokotala, muyenera kupatsa munthu mtendere wambiri, mwayi wokhala ndi mpweya wabwino. Makina ozizira amaikidwa pulojekiti ya kapamba (chiwiya chotenthetsera ndi madzi kapena paketi ya ayezi wokutidwa ndi thaulo). Kutalika kwake sikuyenera kupitirira mphindi 20. Pambuyo pa nthawi yofananira, njirayi imabwerezedwa.

p, blockquote 33,0,0,0,0 ->

Kuti muchepetse ululu, mutha kupatsa wodwala antispasmodic (No-Shpu, Spazmalgon, Duspatalin, Buscopan). Pakadwala matenda a kapamba, makonzedwe a enzyme (Pancreatin, Creon, Festal) sayenera kutengedwa; izi zimapangitsa kutupa ndi kuledzera. Zakumwa zilizonse (kupatula madzi) ndi mbale ndizoletsedwa.

p, blockquote 34,0,0,0,0 ->

p, blockquote 35,0,0,0,0 ->

Ngakhale kuukiraku kuthetsedwa ndi kupweteka kwathunthu, wodwala amayenera kupita kuchipatala kukayezetsa. Popanda chithandizo choyenera, matenda am'mimba amatha kubweretsa mavuto.

p, blockquote 36,0,0,0,0 ->

Mankhwala

Pachimake kuukira kwa kapamba amachiritsika. Ndi mkhalidwe wokhutiritsa wodwalayo komanso kusapezeka kwa zinthu zosokoneza mu zotsatira za kuyesedwa, chithandizo chamankhwala chitha kuperekedwa. Mankhwala okhala ndi odwala amaphatikizapo:

p, blockquote 37,0,0,0,0 ->

• jakisoni wa analgesics ndi antispasmodics,
• intravenous kulowetsedwa kwa njira zothetsera kuledzera (Reosorbilact, Glucose, Sodium chloride),
• kukhazikitsidwa kwa othandizira kuti athetse ntchito ya ma pancreatic Enzymes (Yothandizirana),
• kukonzekera kwa kholo.

Pankhani ya kufalikira kwamtundu wakachulukidwe, mankhwala opatsirana a cephalosporin ndi omwe amapatsidwa. Gwiritsani ntchito malo ogulika pancreatitis okhazikika:

p, blockquote 38,0,0,0,0 ->

• mankhwala oletsa kutupa (Meloxicam, Voltaren, Sedalgin-Neo),
• antispasmodics (Duspatalin, Buscopan),
• kukonzekera kwa enzyme (Creon, Pangrol, Mezim),
• proton pump inhibitors (Omeprazole, Nolpaza, Pantoprazole),
• mavitamini A, E, C, D, gulu B.

Kuchiza kumatha kukhala masiku 5 mpaka milungu ingapo (kutengera mphamvu ya kutupa, kuchuluka kwa masinthidwe a pathological). Zizindikiro zikachepa, mankhwalawo amaleka kumwa. Mankhwala ochokera ku gulu la enzyme amafunika kuchotsedwa pang'onopang'ono (pofuna kubwezeretsa zochitika zapanchipisi).

p, blockquote 39,0,0,0,0 ->

Moyo & Zakudya

Kuzindikira kwa chifuwa chachikulu kumatanthawuza kuti wodwalayo amayenera kuwunikiranso machitidwe awo akudya ndi moyo. Odwala onse, kupatula, amalimbikitsidwa kusiya mowa ndi kusuta, kugwiritsa ntchito mafakitale odzazidwa ndi mankhwala osungirako komanso zonunkhira. Kuyambira lero, munthu sangathe kuchitidwa zinthu pawokha. Mankhwala am'mutu, chimfine ndi chimfine amayenera kumwedwa malinga ndi dokotala.

p, blockquote 40,0,0,1,0 ->

Ndikofunikira kukonza zochitika zamasiku onse. Muyenera kupuma mokwanira, kusiya ntchito yotopetsa, kupewa nkhawa, kugona mokwanira. Psycho-m'maganizo komanso kutukwana kwakuthupi kungayambitsenso vuto lina.

p, blockquote 41,0,0,0,0 ->

Zakudya ziyenera kuonedwa mu gawo lililonse la matenda kapamba. Ndi kuchulukana, kumakhala kovuta kwambiri ndipo kumayamba ndi njala. Zizirizo zikachepa, zakudya zimakulirakulira, koma muyenera kuyiwala za chakudya chofulumira, nyama zosuta, nyama yamafuta ndi zakudya zomalizidwa kwamuyaya. Lamulo lakupatsa thanzi pakuwukira pancreatitis:

p, blockquote 42,0,0,0,0 ->

• njala ya maola makumi awiri ndi awiri,
• mbale zimaphikidwa zofunda
• servings osapitirira 150 g
• Zakudya za 7‒8 patsiku,
• chakudya chizikhala chofewa,
• woyamba kubweretsa madzi otsekemera otsekemera, mafuta odzola, tiyi wopanda mphamvu, msuzi wa rosehip,
• ndiye mndandanda umapangidwira ndi ma mucous porridge kuchokera ku mpunga, oatmeal, semolina, buckwheat,
• pa masiku 6-7 odwala, kugwiritsa ntchito tchizi tchizi, nyama soufflé (kuchokera nkhuku, nkhuku) imaloledwa,
• kwa masiku 8, sopo amawaphika msuzi wa masamba ndi chimanga, mbatata yosenda,
• kuloleza kugwiritsa ntchito zipatso zosenda ndi zipatso (kutentha kwakonzedwa),
• Kuyambira pa tsiku la 10, zinthu zopanda mkaka wowaka mkaka wopanda mafuta, zophika mkate, makeke amsikono, zakudya za pansi, ndi nsomba yophika mu chidutswa zimayambitsidwa mu chakudya.

Gawo laphokoso likatsala, zoletsa kwambiri zimachotsedwa. Mutha kudya zipatso zosaphika ndi masamba osakhudzidwa, kuphika nyama yophika. Pansi pa chiletso kukhalabe:

p, blockquote 43,0,0,0,0 ->

• Zakudya zopsautsa (zipatso wowawasa ndi masamba, zonunkhira, mowa),
• chakudya chamadzimadzi chamadzimadzi (zotembenuzira, udzu winawake, nyemba, kabichi yoyera, radara, msuzi wolemera kuchokera ku nyama, bowa, nsomba),
• agogo, tsekwe, mwanawankhosa, nkhumba,
• mkaka ndi zonona
• Confectionery
• mankhwala omalizidwa
• masoseji, nyama zosuta, zipatso
• marinade, chakudya zamzitini.

Wodwala amatha kumwa tiyi wakuda ndi mankhwala, compotes, chakumwa cha chicory, msuzi wa rosehip. Monga mchere, mutha kugwiritsa ntchito marmalade, marshmallows, marshmallows, uchi, kupanikizana (pang'ono).

p, blockquote 44,0,0,0,0 ->

Mankhwala othandizira

Chithandizo cha chifuwa chachikulu cha m'mimba kudzera pakuchita opaleshoni nchotheka ngati mankhwalawo amabwezeranso, ngakhale atalandira chithandizo chokwanira. Zowonetsa mwachindunji kulowererapo ndi:

p, blockquote 45,0,0,0,0 ->

• sphincter wa Oddi Kulephera
• calculi mumizere ya kapamba kapena bile (yomwe imaphwanya kutuluka kwa madziwo),
• zilonda zamkati, zodzaza ndi mafinya,
• cholinga cha pancreatic necrosis,
• peritonitis
• oncology a gland.

p, blockquote 46,0,0,0,0 ->

Opaleshoni imatha kuchitidwa lotseguka kapena lotsekeka (laparoscopic) m'njira yotengera zovuta, luso ndi zolinga zake.

p, blockquote 47,0,0,0,0 ->

Izi ndizosangalatsa!

Oncologist wa Moscow Clinical Hospital No. 5, Pulofesa Vyachelav Egorov, adalengeza mchitidwe wopangira opaleshoni yachipatala pancreatitis yayikulu yomwe adamupeza. Malinga ndi wasayansiyo, ndi mitundu ina ya matendawa, vutoli silili mu zodikirira zokha, koma mu duodenum. Mukachotsa malowa, mutha kuthana ndi kutupa kwapakhansa kamodzi kokha. Zinkakhala kuti sizingatheke kuchotsa matenda. Pancreatitis pachaka imapangitsa anthu olumala. Pulofesa adachitapo ntchito zingapo ndipo mu 100% yamilandu idawonedwa.

p, blockquote 48,0,0,0,0 ->

Tsogolo la wodwala wokhala ndi pancreatitis yayitali zimadalira yekha. Kuzindikira kwakanthawi kwamatendawa pakuwonjezereka, chithandizo chokwanira komanso kudya mthupi zimathandiza kutenga matenda omwe amayang'aniridwa ndikukwaniritsa chikhululukiro chokhazikika.

p, blockquote 49,0,0,0,0 ->

Wodwala akapanda kusiya zizolowezi zoyipa ndikuphwanya malamulo azakudya zamankhwala, chiwopsezo cha kuchuluka pafupipafupi komanso zovuta zimachulukitsidwa nthawi zambiri. Matenda osavomerezeka kwambiri amaperekedwa kwa odwala omwe ali ndi chidakwa cha kapamba. Njira yotupa yomwe imagwera m'matumbo mwa iwo nthawi zambiri imaphatikizidwa ndi kusintha kwa purulent-necrotic, komwe kumakhala kodzala ndi zinthu zowopsa m'moyo. Kutupa kosalala, kothandizidwa ndi mowa, nthawi zambiri kumayambitsa khansa ya pancreatic.

p, blockquote 50,0,0,0,0 ->

Kupewa

Popewa kupweteka kwa kapamba, m`pofunika kudya zakudya zamagulu, kupewa matenda oyamba ndi matumbo, kumwa mowa, mankhwala ophera tizilombo, mankhwala osungira, onunkhira komanso owonjezera. Ndikofunika kuti musamadye kwambiri, kudya pafupipafupi, koma pang'ono ndi pang'ono. Gawo la mapuloteni, mafuta ndi chakudya chamagulu m'zakudya liyenera kukhala loyenera. Zosafunanso ndizofunikira zolimbitsa thupi, komanso njira zolimbikitsira chitetezo (kuyenda, kuumitsa thupi, kugwiritsa ntchito mavitamini ndi mchere). Popewa kufalikira kwamatenda a kapamba, muyenera kutsatira kadyedwe, kusiya zizolowezi zoipa.

p, blockquote 51,0,0,0,0 ->

Zofunika kukumbukira

Pathology ndiyowopsa ndi zovuta, chifukwa chake, imafunikira kuzindikira kwakanthawi ndi chithandizo choyenera. Kuti musakhale "wolanda" wake, muyenera kuphunzira izi:

p, blockquote 52,0,0,0,0 ->

1. Matenda a kapamba amayamba ngati mawonekedwe owopsa sanalandiridwe bwino kapena zakudya zitasokonekera pambuyo poti wachira m'maganizo.
2. Zizindikiro za matendawa zimatha kukula komanso kufooketsa, zomwe sizitanthauza kutha kwa matendawa, koma zikuwonetsa kuchepa kwakanthawi kwamankhwala osokoneza bongo.
3. Ngakhale pakukhalabe bwino, zovuta (necrosis, purulent fusion) zimakhala.
4. Zizindikiro zikuluzikulu za chifuwa chachikulu ndi kupindika m'mimba ndi kusanza.
5. Njira yabwino kwambiri yochotsedwera ndikuwonana ndi dokotala komanso kulandira chithandizo kuchipatala.
6. Kupambana kwamankhwala kumadalira kudya ndikusiya zizolowezi zoyipa.

Muyenera kukumbukiranso kuti matenda a kapamba amatha kuchepa kwakanthawi, koma kuti mukulitse gawo lazikhululukiro, ndikofunikira kuwunika zakudya komanso moyo.

p, blockquote 53,0,0,0,0 -> p, blockquote 54,0,0,0,0,1 ->

Matenda a kapamba nthawi zambiri amaphatikizidwa ndi cholecystitis. Pankhaniyi, osati zowawa za m'chiwonetsero, komanso kusakhazikika mu hypochondrium yoyenera, kulawa kowawa mkamwa nthawi ndi nthawi kumavutitsa munthu. Werengani zambiri za cholecystitis ndi chithandizo chake m'nkhaniyi.

Zoyambitsa zazikulu za kapamba

Ntchito ya kapamba wa munthu wamkulu imayendetsedwa ndi zinthu zambiri - kadyedwe, zizolowezi zoipa, thanzi lanu, moyo wonse. Kuti BZHU ibwere ndi chakudya kuti izikhala ndi chakudya chokwanira m'mimba, ma enzyme ena ayenera kupezeka ndikupanga - pancreatin, lipase, ndi trypsin. Ngati, pazifukwa zilizonse, kapamba akuthyoka, sangathe kupanga ma enzyme ofunikira kuti chimbudzi chikhale chofunikira, kugaya chakudya kumachepa, madzi a pancreatic amadzilimbitsa thupi, zomwe zimapangitsa kuti magazi azitupa.

Childs, pachimake pancreatic kutupa mu akulu chifukwa cha:

• chakudya kapena chakumwa choledzeretsa,
• kudya kwambiri
• kudya zakudya zonenepetsa kwambiri kapena zonunkhira kwambiri,
• kuvulala kwa kunja kwam'mimba khoma ndi kufalikira kwamkati.

Monga lamulo, kapamba samakonda kukhala ngati matenda oyima pawokha, nthawi zambiri ziwalo zina zam'mimba zimagwira nawo gawo la pathological - m'mimba, duodenum, chikhodzodzo, komanso matumbo aang'ono. Kuzindikira koyenera kumakhala kovuta chifukwa chakuti kapamba amapezeka mkati mwa m'mimba, kukula kwake ndikochepa, ndipo ndi kutupa kwa chiwalo, zizindikiro zimawoneka ngati njira zina za pathological.

Pali zinthu zingapo zomwe zingayambitse matenda a chamba kapamba:

• Matenda amisala yodwala komanso chikhodzodzo - ndi chimodzi mwazomwe zimayambitsa. Miyala ikakumana mu ndulu, kufinya kwa ndulu zikuluzikulu, kapamba amakumana ndi mankhwala amomwe amachititsa. Imadziunjikira zinthu zomwe zimapangitsa kuti ma enzymes omwe amapanga azitsutsana ndi minofu yawo. Zotsatira zake, minofu ya zikondamoyo imayamba kusokonekera, kuwonongeka kwa mitsempha yamagazi kumachitika, zotupa zimatuluka ndipo njira yotupa yopweteka imayamba.
• Matenda a duodenum ndi m'mimba - ngati sphincter ya Oddi ndi yotsika, zomwe zili m'matumbo zimatha kuponyedwa mumizere ya kapamba, ndikuyambitsa kutupa. Nthawi zambiri zimachitika motsutsana ndi maziko a matenda monga gastritis, zilonda zam'mimba komanso zilonda zam'mimba.
• Kuledzera ndi poyizoni wa thupi - kapamba m'mimba mwa achikulire nthawi zambiri amakula motsutsana ndi poyambira poyizoni ndi zakumwa zoledzeretsa, zakudya zopanda pake, mankhwala osokoneza bongo, mankhwala. Kuphatikiza apo, masamba osakhala a nyengo ndi zipatso omwe ali ndi mankhwala ophera tizilombo komanso zowonjezera zamankhwala zimatha kuyambitsa zovuta pa kapamba ndi kutupa kwake.
• Matenda oopsa a arterial, matenda a shuga, kubereka - pakakhala kusokonezeka kulikonse m'matumbo komanso mthupi lonse, chiopsezo chotenga matenda opezeka pachifuwa chimawonjezeka, chifukwa motsutsana ndi maziko osowa magazi m'mimba, chakudya chake chimasokonekera, ischemia imayamba, kupanga ma enzymes ndi mahomoni kusokonezeka, zomwe zimatsogolera. kwa chotupa.
• Kudyetsa pafupipafupi - kudya kwambiri mthupi, mafuta a metabolism amasokonezedwa chifukwa cha kuchuluka kwa kapamba. Ndi kudya kwambiri nthawi zonse, chiopsezo cha matenda a kapamba komanso kutupa kwake kumawonjezeka.
• Kumwa mankhwala ena - kumwa kwa nthawi yayitali komanso osalamulirika monga tetracycline, sulfonamides, glucocorticosteroids, mankhwala okhala ndi estrogen kumabweretsa vuto la gland ndipo kumawonjezera mwayi wokhala ndi matenda ndikutupa kwa kapamba.
• Kuvulala - kuwomba khoma lakunja kwam'mimba, kuvulala, ntchito zomwe zimachitika pa duodenum 12 zingayambitse kutupa kwa akuluakulu a kapamba.

Zizindikiro za kapamba mwa akulu

Kutupa kwachimbudzi kwa kapamba kumayendera limodzi ndi zizindikiro zofanana ndi poyizoni, wodwalayo ali ndi:

• kupweteka kwambiri pamimba (epigastric zone ndi navel) ya chikhalidwe chomanga chodzaza ndi msana wam'munsi, impso - chifukwa cha kuphatikizika kwa ululu wamankhwala, wodwalayo sangamvetsetse zomwe zikuvutitsa,
• Kutentha kwakukulu ndikulumphalumpha m'magazi - ndikamvekera kwambiri ndi kutukusira kwa ndulu, mkhalidwe wake umadwalanso.Kutentha kwakuthupi mpaka madigiri 39, kuzizira, kutentha thupi kwambiri, kuthamanga kwa magazi kapena kuchepetsedwa kwambiri,
• kusanza ndi kusanza kosalephera - zitatha zam'mimba kutulutsidwa kunja, wodwalayo samva kupumula, nseru ikupitilirabe kumuzunza ndikuwatsuka.
• malamba, kutentha kwache,
• kutsekula m'mimba - chopondapo pachimake cha kapamba wokhala ndi vuto lofooka, chokhala ndi mafuta ambiri, zotsutsa, zobiriwira, komanso chakudya chosapezeka bwino zimawonekera pang'onopang'ono.
• khungu, mawonekedwe amdima, mawonekedwe a halitosis, kufupika kwa mpweya,
• ukufalikira.

Zofunika! Mu chilonda chachikulu cha pancreatitis, mkhalidwe wa wodwalayo umakulirakulira msanga, zomwe zimapangitsa kuti matendawa asinthe kwambiri kapena angayambitse matenda a chamba (pancreatic necrosis) Kuti mupewe kukula kwa zovuta pazizindikiro zoyambirira za matendawa, muyenera kufunsa chithandizo chamankhwala msanga.

Zikondwererozo zimakhala ndi mutu, thupi ndi mchira. Kutengera gawo lomwe gawo lachiberekero limapangidwira, zizindikirozo zimasiyana pang'ono:

• ndi kutupa kwa mutu wa England, wodwala amamva kupweteka mu hypochondrium yoyenera,
• ndi kutupa kwa thupi lachitsulo - m'chigawo cha epigastric,
• ndi kutupa kwa mchira - kumanzere hypochondrium.

Ngati tiziwalo timene timayaka, ndiye kuti wodwalayo amakhala ndi nkhawa chifukwa cha ululu wowopsa wa herpes zoster ndi zotupa pansi pa masamba, msana, impso.

Matenda a kapamba: Zizindikiro

Matenda osachiritsika a kutupa kwa pancreatic amadziwika osati ndi kufooka kwa chiwalo, komanso kusintha kwapang'onopang'ono mu minofu yake, chifukwa chomwe wodwalayo amayamba kudwala chifukwa cha kuchepa kwa nthawi yayitali, pomwe matenda omwe amaphatikizana ndi kugaya chakudya m'thupi amayamba msanga.

Mu chifuwa chachikulu cha anthu akuluakulu, zizindikiro za matendawa zimakulirakulira kapena kuchepa, pang'onopang'ono kupweteka kwa kapamba kumayamba kusokonekera mosalekeza, kumakulirakudya. Mukamadya yokazinga, mafuta, osuta, zonunkhiritsa, mowa, kuchitika kwa pancreatitis yamphamvu, yomwe imadziwika ndi zizindikiro zotsatirazi zamankhwala:

• ululu wamkokomo wopweteka kwambiri m'chigawo cha epigastric wokhala ndi ma radiation ku hypochondria, kumbuyo, masamba, sternum,
• kusanza kosalephera komwe sikubweretsa mpumulo,
• kutsekula m'mimba - ngakhale ndowe sizitsukidwa bwino chifukwa cha mafuta ambiri omwe amapezeka mkati mwake, tinthu tating'onoting'ono ta chakudya chosapezeka timawoneka bwino,
• Zizindikiro za kuledzera kwamthupi - kupuma movutikira, kutentha thupi, kuzizira, kufooka kwakula, kuchepa thupi kwambiri,
• kutsika kwa magazi.

Ndi malo oyimirira a wodwalayo, ululu umangokulitsa, motero wodwalayo amakhala m'malo mokakamizidwa - atakhala, atatsamira pang'ono pang'ono.

Kuukira kwa chifuwa chachikulu cha pancreatitis ndi kowopsa chifukwa kungayambitse kukulira kwa mankhwalawa ndikumwalira chifukwa chosowa chithandizo chamankhwala panthawi yake. Chithandizo cha kuukira kotereku chimachitika, monga lamulo, kuchipatala, popeza vutoli ndi loopsa chifukwa cha zovuta zake.

Matenda a kapamba

Kuzindikira kumachitika chifukwa cha madandaulo odwala komanso zotsatira za mayeso ndi maphunziro:

• pakuwunika mkodzo, kusintha kwa kuchuluka kwa magazi kumapezeka,
• pakuwunika ndowe, kupezeka kwa steatorrhea ndiko kupezeka kwa mafuta osaphatikizika ndi tinthu tating'onoting'ono tambiri m'ndowe,
• mayeso olimbitsa thupi,
• Ultrasound wa kapamba,
• magazi kuyesa kwa shuga kulolerana mayeso ndi michere ya pancreatic.

Kutengera zotsatira za matendawa, wodwalayo amamulembera mankhwala ena.

Chithandizo cha kapamba mu akulu

Mfundo zazikulu zochizira pancreatitis pachimake mu akulu ndi njala. Ndi kuchulukitsa kwa matendawa kwa masiku 1-2, chakudya chilichonse chimasiyidwa kwathunthu. Ingomwa madzi oyera, madzi okha. Ngakhale kuthana ndimatenda a wodwalayo ndikusanza kumapitilizabe, kutsekula m'mimba kumapitilizabe, pofuna kupewa kupewetsa madzi mthupi, kugwiritsa ntchito magazi mthupi kumachitika - kulowetsedwa kwa mayankho a saline ndi glucose wokhala ndi mavitamini.

Chikhodzodzo cha ayezi chimayikidwa pa epigastrium ya wodwalayo, yomwe imachepetsa ululu, kuchepetsa ululu komanso kutulutsa kutupa. Wodwala amayenera kupuma pabedi ndikuonetsetsa kuti akupumula kwathunthu.

Zofunika! Ngati matendawa adayamba kwa nthawi yoyamba, ndiye kuti sikulimbikitsidwa kumwa mankhwala aliwonse opweteka kapena antispasmodics asanafike ambulansi, chifukwa izi zimatha kupangitsa kuti azindikire. Kuphatikiza apo, kupweteka kwam'mimba m'mimba, mseru ndi kusanza zimatha kupereka chizolowezi pakuchita opaleshoni yomwe imafunikira kuchitapo kanthu mofulumira kuti apulumutse moyo wa wodwalayo.

Njira yothetsera kutupa itatha, wodwalayo akuwonetsedwa zakudya zopatsa thanzi komanso mankhwala - michere, antispasmodics, probiotic.

Zakudya ndizopatula kwathunthu kuzakudya:

• Zakudya zokazinga, zonunkhira, zonunkhira, viniga, mafuta osuta,
• bowa
• nkhumba, mwanawankhosa, wochotsa,
• mafuta
• batala
• pasitala (vermicelli yekha amaloledwa),
• mowa
• khofi
• chokoleti, koko
• makeke, makeke, maswiti,
• buledi watsopano.

Maziko a chakudyacho ndi mbale zamphaka ndi zamasamba, zophika, zophika ndi kuwira ndi kutumiza ndi mafuta ochepa.

Nthawi ya chakudya, wodwala ayenera kukonzekera michere yomwe imathandizira kapamba ndikuthandizira kugaya bwino:

Popeza pancreatitis pachimake imayendera limodzi ndi kutsekula m'mimba, ma protein amapatsidwa kuti abwezeretse matumbo a microflora kwa wodwalayo panthawi yomwe akuchira:

• Linex
• Biogaya
• Lactofiltrum,
• Mafuta a ng'ombe ndi ena.

Pachimake kapamba

Pancreatitis yachilengedwe imayamba kuthamanga ndipo imawopsa chifukwa cha zovuta zake. Zizindikiro zotsatirazi zitha kuchitika chifukwa cha izi:

• Kutengera gawo liti la chiseyeye chotupa, kupweteka kwambiri kumachitika pamimba. Ngati yayaka yonse, ndiye kuti ululuwo uzikhala wakuthwa komanso lamba, perekani pansi pa tsamba lamanzere kumbuyo, kumbuyo kapena kumbuyo.
• Kusowa kumatha, nseru imamveka, kusanza nthawi zambiri.
• Matendawo akudwala.
• Mimba imatupa ndipo imakhala yolimba.
• Nthawi zina manjenje amakula.
• Kutentha kumakwera mpaka kukhala ma subfebrile alama.

Pofuna kupewa zovuta pamatenthedwe, ambulansi ayenera kuyitanidwa nthawi yomweyo.

Reactive Pancreatitis

The yogwira pancreatitis ndi kuukira pachimake ndi munthawi yomweyo kuphatikizika kwa matenda am'mimba, chiwindi, ndulu ndi duodenum. Matendawa samateteza ngakhale ana, ndipo nthawi zambiri amakula ngakhale mwa makanda. Cholinga chakupezeka kwawo ndi mtundu wamba wa ARI. Makanda, izi zimadziwika chifukwa cha kubadwa kwa matenda a ziwalo ndi ma ducts.

Matenda mwa ana

Pancreatitis mu ana imachitika ndi zizindikiro zomwe zimachitika mwa akuluakulu - kupweteka kwambiri, nseru, dyspepsia. Koma mwa ana, zizindikiritso zawo zimawululidwanso:

• Stool chisokonezo ndi kudzimbidwa, kutsekula m'mimba, ndowe zimatembenukira chikasu ndipo zimabwera ndi ntchofu.
• Mkodzo umakhala ndi utoto wachikasu.
• Chikaso cha khungu kumachitika.
• Ana mpaka chaka chimodzi amatha kulira kwambiri kapena kufuula.

Matenda a ana amafunika chisamaliro chamankhwala chamankhwala, makamaka ngati sichitha. Ichi ndi matenda oopsa, owopsa chifukwa cha zovuta zake.

Mawonekedwe azizindikiro mwa akazi

Zizindikiro za kapamba mwa azimayi zimasiyana ndi abambo chifukwa chakukula kwake. Matendawa amayambika ndi nseru yofatsa komanso kudana ndi mafuta, zonunkhira komanso yokazinga. Chimafanana ndi toxosis nthawi yapakati. Koma nthawi zambiri matendawa amawonetsedwa ndi zowawa zam'mimba, zomwe zimacheperachepera ngati mumagona fetal.

Zisonyezo za amuna

Zizindikiro za kapamba mwa abambo ndizosiyana pang'ono, chifukwa matendawa amakhala athanzi. Chifukwa chake, nthawi zambiri amakhala ndi ululu wolimba wamkamwa, kutulutsa, mpweya wowonjezereka komanso m'mimba. M'mimba sizigwira ntchito bwino ndipo sizigaya chakudya kwathunthu. Potere, kuthamanga kwa mtima kumadziwika. Popeza kwa amuna kapamba amayamba kudwala, ndiye kuti matendawa ndi osamveka.

Thandizo loyamba la kapamba

Kuukira kwa kapamba sikulimbikitsidwa kuti uchotsedwe palokha. Chithandizo chosalakwika chimatha kubweretsa mavuto ena. Koma ambulansi isanafike kapena kupangana ndi dokotala, wodwalayo ayenera kuthandizidwa kuthana ndi ululu. Izi zimafuna izi:

Mwa zina, ndikofunikira kuyeretsa m'mimba chakudya, ngati kusanza sikuchitika mwachilengedwe. Kanikizani ndi zala ziwiri pamizu ya lilime ndikusanza.

Pakachulukitsa, ndikulimbikitsidwa kukana chakudya konse. Malinga ndi akatswiri, omwe amachiritsa kwambiri pakuwopseza kutupa kwa pancreatic ndi njala, kuzizira komanso mtendere wodwala.

Mankhwala a kapamba

Mankhwala amathandizidwa ndi adokotala mosamalitsa payekhapayekha, poganizira matendawo komanso zina zomwe wodwalayo ali nazo. Mankhwala otsatirawa amathandizidwa pochiza matenda:

1. Kuthetsa ululu. Antispasmodics adalembedwa - No-shpa, Spazmalgon, Maksigan ndi M-anticholinergics - Atropine, Metalin. Ngati kupweteka kumapitirira kwa nthawi yayitali, ndiye gwiritsani ntchito H2 blockers - Ranitidine.

2. Mankhwala a Antenzyme. Amagwiritsidwa ntchito kuyimitsa kuwonongeka kwa minofu ya pancreatic. Kumwa mankhwala umalimbana ndikulepheretsa kuphatikiza kwa michere yambiri, komanso mapuloteni. Amachepetsa ululu, amachepetsa kutupa, matenda am'mimba.

Mankhwala othandiza kwambiri pa antisecretory ndi cytostatics (Ribonuclease, Gordox) ndi ma proton pump blockers (Omeprazole, Nexium) Blockers amachepetsa acidity m'mimba, amene amachepetsa ululu akamaukiridwa. Ngati mawonekedwe a matendawa ndiwosematous, ndiye kuti Asparkam imagwiritsidwa ntchito.

3. Kugwiritsa ntchito ma pancreatic enzymes. Kuti muchepetse katundu pathupi odwala komanso kuchepetsa ntchito zake zachinsinsi, ma enzymes amagwiritsidwa ntchito. Izi ndi michere yomwe chitsulo chimatulutsa kuti timgaye chakudya. Pofika kuchokera kunja, katundu pa chinthucho wadwala kwambiri amachepetsa kwambiri.

Nthawi zambiri amakhala Festal, Pancreatin, Mezim. Amayenera kuledzera atatha kudya ndikutsukidwa ndi mchere wamchere wopanda mchere. Gululi la mankhwalawa limachepetsa mseru, kutulutsa, kukhumudwa komanso kufulumira kuwonda.

4. Kubwezeretsa moyenera acid-base. Pakakhala vuto, nthaka yachilengedwe imagwiritsa ntchito kugaya chakudya. Pachifukwa ichi, mankhwalawa amathandizidwa kuti azisinthasintha pH m'matumbo a ziwalo. Izi ndi monga: Gastal, Almagel, Maalox.

5. Kukonzekera ndi mavitamini. Pochiza matenda omwe amayamba ndi matenda, mavitamini otsatirawa ayenera kulembedwa: A, E, C, D, K ndi gulu B. Kuphatikiza pa iwo, Cocarboxylase ndi Lipoic acid ayenera kumwedwa.

6. Kupititsa patsogolo ntchito yogaya chakudya. Nthawi zina pamavuto, mankhwala amaperekedwa kuti alimbikitse kugaya chakudya: Motilium, Cerucal.

7. Zakudya za makolo. Woopsa milandu matenda ndi osauka mayamwidwe chakudya m'matumbo, intravenous machulukitsidwe mankhwala. Zakudya za makolo zimaphatikizapo: chisakanizo cha zofunika za amino acid Alvesin, Aminosol 250-400 ml iliyonse.

Komanso mayankho a electrolyte: 10% potaziyamu mankhwala enaake a potaziyamu (10-15 ml) ndi 10% calcium gluconate solution (10 ml) Amaperekedwa kudzera m'mitsempha mwaukali.

Chithandizo cha kapamba ndi mankhwala ziyenera kuchitika mokwanira komanso mozama. Kupanda kutero, sizibweretsa mpumulo, koma zimabweretsa zovuta zambiri, kuphatikiza: kudzimbidwa, kuphwanya mapangidwe a bile ndi chiwindi, kutentha kwambiri kwa thupi, komanso kutopa kwambiri.

Njira yovuta kwambiri ya kapamba sangachiritsidwe popanda kutsatira zakudya, ndipo ndi matenda oyenera amafunika kuti akhale amoyo wonse.

Zakudya za matendawa zimaphatikizapo kudya zakudya zomwe zili ndi mapuloteni komanso mavitamini. Kuphatikiza apo, ndikofunikira kuchepetsa zakudya zomwe zimakhala ndi mafuta ndi chakudya chamagulu m'zakudya.