Pseudotumor pancreatitis: Zizindikiro, mankhwala

Chimodzi mwazina za matenda a kapamba omwe amayamba chifukwa chosagwiritsidwa ntchito mosavomerezeka ndi pseudotumor pancreatitis. Fomuyi imatchedwa chomwecho chifukwa zizindikiro za kapamba zimafanana m'njira zambiri ndi zizindikiro za chotupa cham'mimba ("pseudo" - cholingalira, chabodza, "chotupa" - chotupa).

Kodi pseudotumor pancreatitis amawonekera bwanji

Kuchokera pa nthawi yomwe matenda atapezeka kuti ali ndi “pancreatitis” mpaka kukula kwa mawonekedwe a pseudotumorous, zaka 10-15 zitha. Nthawi zambiri wodwala amathandizidwadi matenda a chiwindi, cholecystitis kapena biliary dyskinesia, ndipo matendawa amadziwika pokhapokha atamuunikira mwatsatanetsatane panthawi yomwe amakhala kuchipatala. Pafupifupi 5% ya odwala omwe ali ndi pancreatitis omwe ali ndi mayeso okakamiza, mawonekedwe a pseudotumor apezeka. Mwa odwala pafupifupi 7 mwa 10, matendawa amadziwika kuti ali ndi vuto.

Zizindikiro zotsatirazi ndizofunikira:

Zowawa.
Kuchepetsa kwambiri thupi kwakanthawi kochepa.
Kuchulukitsa kwa pancreatic, komwe kumatsimikiziridwa ndi palpation pamimba.
Kuphwanya kwa procrine ntchito ya chiwalo mwa mtundu wa kusakwanira - chopondapo chosakhazikika, cholembera ("chopondapo mafuta"), kuchuluka kwakukulu kwa fiber ndi minofu.
Chithunzi chojambulidwa mukamayendetsa ma diagnostics a ultrasound: kukula (monga lamulo) la minofu yam'mimba ya pancreatic, kukulira kwa dambo la Wirsung, masamba ake ndi otayirira, opanda pake, okhazikika ndi ma pseudocysts.

Matenda a pseudotumor pancreatitis

Ngati mukukayikira mawonekedwe a pseudotumor a pancreatitis aakulu, ndikofunikira kuyambitsa matenda osiyanasiyana ndi chotupa chenicheni - khansa ya kapamba (adenocarcinoma), yomwe mu 80% yamilandu imakhudza mutu wa chiwalo.

Pachifukwa ichi, kuyang'ana kwakumaso kwa kapamba kumachitika ndi kuwunika kwa asayansi omwe adapezeka m'deralo. Ngati maselo atypical (chotupa) apezeka, wodwalayo amapezeka ndi khansa.

Komabe, khansa yopanda khansa mu 56% yokha ya milandu imawulula ma cell atypical, ndipo mwa 12% ya odwala omwe amapezeka ndi pseudotumor pancreatitis, khansa ya kapamba imapezeka (malinga ndi ofufuza achi Germany). Chifukwa chake, mukakhazikitsa matenda pamavuto okayikira, njira zambiri zimawerengedwa.

Zizindikiro za pseudotumor pancreatitis

Chimodzi mwazomwe chikuwonetsa kutukusira kwa kapamba ndi ululu. Ndi pseudotumor pancreatitis, imatchulidwa. Ululu nthawi zambiri umamanga, umatha kupatsa hypochondria ndi kumbuyo. Ululu umachitika, nthawi zambiri mukatha kudya kapena kumwa mowa. Nthawi zambiri, ululu umachitika usiku.

Tiyeneranso kudziwa kuti kupweteka kumatha kuyenda limodzi ndi mawonekedwe a mseru komanso kusanza. Kukula kwa kupweteka kwa pseudotumor pancreatitis sikugwirizana ndi kuopsa kwa kusintha kwa gland palokha.

Chizindikiro china cha pseudotumor mawonekedwe a kapamba ndi kuchepa kwa thupi. Chomwe chimapangitsa izi ndizosakwanira kwa chithokomiro, momwe zimapezeka kuti kuchuluka kwa madzi omwe amapangidwa sikokwanira kugaya chakudya. Zotsatira zake, njira yogaya chakudya imasokonekera - flatulence, kusakhazikika kwa chopondacho (komwe kungakhale ndi chizolowezi chodzimbidwa komanso kutsegula m'mimba) zitha kudziwika. Kusasinthika kwa chopondapo chimasinthanso - kumakhala kunenepa, kowala ndipo nthawi zambiri kumakhala ndi fungo la fetid.

Mu mbiri yamatenda odwala ndi pseudotumor pancreatitis, dokotala atha kuzindikira izi:

kuchuluka kwam'mimba,
palpation imawulula mutu wokulirapo wa kapamba,
kupweteka m'dera la epigastric.

Kuti mutsimikizire matendawa, ndimayeso a HTML kapena makina ophatikizika, omwe nthawi zambiri amawonetsa kuwonjezeka kwa mutu wa gland, ma contours a chiwalo mu dipatimentiyi ndi opepuka komanso osagwirizana. Cholinga cha kuchepa kwa kachulukidwe m'malo omwe akukhudzidwa ndikuwonetsetsa, kukhala ndi ma pseudocysts, osakanikirana ndi magawo omwe amaphatikizika.

Kuchiza ndi wowerengeka azitsamba

Maphikidwe onse a mankhwala azikhalidwe amatha kungowonjezera pazithandizo zomwe adokotala adapereka. Potere, ma tinctures osiyanasiyana ndi kukonzekera kwazitsamba kungagwiritsidwe ntchito.

Chimodzi mwazomera zomwe zimagwiritsidwa ntchito ngati wowerengeka azitsamba a pseudotumor pancreatitis ndi ndevu zagolide. Kuti mukonze zakumwa zochiritsa, muyenera kutenga mphukira yaying'ono ya mbewuyo (pafupifupi 20 cm), kuidula ndikuphwanya. Kenako gruel iyenera kuthiridwa ndi mowa mu chiŵerengero cha 1: 1 ndikuloledwa kupatsa kwa milungu iwiri pamalo amdima. Pambuyo pa izi, kulowetsedwa kumasefedwa ndikuwamwa mu 5-10 ml pambuyo mphindi 30 mutatha kudya.

Kukula kwa pseudotumor mawonekedwe a kapamba kumadalira nthawi yayitali ya opaleshoni. Ngati idapereka zotsatira zabwino, ndiye kuti thanzi lathu likhale labwino, wodwalayo akulimbikitsidwa kuti azitsatira zakudya zina - pewani mowa, onjezerani mafuta amkaka otsika mu chakudya. Komanso, kuti asunge kapamba, adokotala atha kukupatsirani michere.

Pokhapokha malingaliro onse a katswiri akwaniritsidwa pomwe zomwe zawonekerazi zingakhale zabwino.

Kutupa kosalekeza kwa kapamba, munthawi yomwe ma hypertrophy ake osasinthika, amatchedwa "pancreatitis" onyenga.

Pseudotumor pancreatitis imawonetsedwa ndi zizindikiro zomwe zimafanana ndi zizindikiro za njira ya oncological, kotero ndikofunikira kwambiri kumvetsetsa kuti izi ndizosiyanitsa zamomwe zimakhalira panthawi yake ndikuyamba mankhwala kapena opaleshoni.

Chifukwa chiyani pseudotumor pancreatitis imachitika?

Kutupa kwa kapamba wamankhwala osachiritsika kumatha kuchitika chifukwa cha zinthu zambiri - provocateurs.

Ayenera kuwonedwa mwatsatanetsatane:

Mosachiritsika kapena mosayenera mankhwala a pancreatitis pachimake, omwe pang'onopang'ono amasintha kukhala osachiritsika.
Ma pathologies omwe akupezeka a ndulu.
Kukonda komanso kumwa mowa kwambiri.
Kukula kwa matenda opatsirana m'thupi.
Matenda a autoimmune.
Makina kuwonongeka kwa chiwalo.
Maonekedwe a kapamba wa cysts kapena zotupa za mtundu wina.

Kuphatikiza pa zifukwa izi, kukulira kwa pseudotumor pancreatitis kumakhudzidwa ndikunyalanyaza malamulo azakudya ndi cholowa chochepa - kukhalapo kwa mavuto a pancreatic m'modzi mwa abale.

Zakhala zikutsimikiziridwa kuti pseudotumor pancreatitis nthawi zambiri imakhala yolimba mwa odwala omwe amasuta.

Kodi matendawa amawonekera bwanji?

Pseudotumor pancreatitis imatha kupanga kwa nthawi yayitali. Kukula kwa matendawa omwe amafunsidwa kuyambira pachiwopsezo cha pancreatitis kupita ku hypertrophy ya organic amatenga zaka 10 mpaka 18.

Nthawi zambiri, kupezeka kwazidziwitso kumatha kutsimikizika pakumuwunika wodwala yemwe wakhala akuwathandizira kwa nthawi yayitali kuchokera ku bysary dyskinesia, mawonekedwe a cholecystitis kapena mitundu yambiri ya chiwindi.

Monga tafotokozera pamwambapa, pseudotumor pancreatitis imadziwikanso ndendende ndi njira ya oncological ya kapamba, motero sizotheka kuzindikira nthawi yomweyo.

Chowonadi chakuti wodwalayo amatenga mawonekedwe a kapamba amasonyezedwa ndi zizindikiro zotsatirazi:

Magawo a ululu omwe amamveka mu hypochondrium yamanzere.
Matenda a dyspeptic pafupipafupi: matenda otsegula m'mimba amasinthidwa ndi kudzimbidwa, ndipo madokotala sangathe kuyambitsa zomwe zimayambitsa izi.
Zizindikiro zakugaya chakudya.
Kusanza, limodzi ndi kusanza, komwe kumachitika mukangotha kudya.
Kuchepetsa kwambiri kulemera kwa thupi popanda chifukwa chomveka.
Kusintha khungu: khungu limayamba kutumbululuka.
Ululu wamtundu wa paligastric dera.
Panthawi yamatumbo, dokotala amawona kuti mutu wa kapamba umakulitsidwa kwambiri.
Kusenda ndi khungu louma kwambiri, chifukwa munthu amayamba kuchepa thupi msanga.
Kutopa kochulukirapo ngakhale mutachita masewera olimbitsa thupi pang'ono.
Kusowa tulo, kuda nkhawa komanso kugona tulo.
Mwadzidzidzi komanso mosinthasintha.

Ngati chizindikiro ichi chikuchitika, muyenera kupangana nthawi yomweyo ndi katswiri.

Ndikofunika kukumbukira kuti ndi dokotala wokhazikika amene amatha kudziwa bwino za mankhwalawa ndikupereka chithandizo chanthawi yake komanso chokwanira, chomwe chithandizira.

Momwe mungadziwire matenda oyenera

Chomwe chimawunikira wodwala ndikuwazindikira pang'ono. Pazifukwa izi, madokotala amachita zinthu zotsatirazi:

Kuyesa: ndowe, magazi, mkodzo. Kuchita kafukufuku wawo wothandiza.
Ultrasound kuwunika kwamkati ziwalo.
Kuphatikiza kwamwazi.
Kuchita radiology.
MRI ndi CT.
Phunziro la pancreatic duct ndi endoscopy.
Mbiri - njira yomwe imakupatsani mwayi wophunzirira womwe umathandizira kusiyanitsa chifuwa cha pseudotumor ndi khansa ya mutu wa kapamba.

Popanda izi zonse zowunikira ndi kafukufukuyu, ndizosatheka kukhazikitsa kuzindikira koyenera.

Zomwe zimawoneka m'mayeso amalebhu

Munthu amene ali ndi matenda omwe akufunsidwa, zizindikiro zotsatirazi zikupezeka m'magazi:

Kuwonjezeka kwa ESR.
Chiwerengero chachikulu cha maselo oyera oyera.
Kuchuluka kwa bilirubin, lipase, sialic acid ndi trypsin.

Mu mkodzo, bilirubin idzakulanso, koma palibe urobilin. Kuphatikiza apo, pali kuwonjezeka kwa alpha - amylase. Mwa ndowe, mutha kudziwa momwe chimbudzi chawonongeka.

Ultrasound ya ziwalo zamkati

Pogwiritsa ntchito ma diagnostics a pamimba pamimba, dokotala amatha kudziwa ngati kukulira kwa chiwalo kumachitika, ngati phokoso lochokera ku chiwalo cholandiracho limalandiridwanso mosiyanasiyana, momwe kapamba amakhalira, ngati pali kufupika kwa ma ducts kapena ngati kutsekeka kwathunthu.

Kuti aphunzire matendawa mwatsatanetsatane ndikuwasiyanitsa kuchokera ku oncology munthawi yake, akatswiri oyenerera amafufuza kuwunika kwa mbiri yakale.

Zomwe MRI ikuwonetsa

Njira yomwe ikuwunikiridwa ndiyo njira yothandiza kwambiri yofufuzira, yomwe imapangitsa kuti athe kuganizira za ziwalo za parenchymal. Pakusanthula kwa MRI, simakonda kutsimikizira kapena kutsutsa kukula kwa carcinoma.

Mukuchita MRI, madokotala amatha kuchita ERCP - njira yomwe imathandizira kuwunika pancreatic duct ndikumvetsetsa momwe zimakhudzidwira.

Kuphatikiza apo, akatswiri nthawi zambiri amapita kukawunika kwa angiographic zamatumbo a gland.

Njira za chithandizo cha matenda a mtima

Therapy a matendawa amathandizira kuchepetsa ululu, kusintha njira yochokerako kwa bile, ndikuthandizira kunja - intracretory insuffence.

Njira yochizira pseudotumor pancreatitis imaphatikizira njira yophatikizira. Ndi chifukwa cha mankhwalawa kuti chiphunzitso chabwino chitha kuchitika.

Ndikofunikira kudziwa kuti chithandizo chikuyenera kuchitika kuchipatala, motsogozedwa ndi dokotala.

Odwala ena amawopa kwambiri kuchitidwa opaleshoni kotero kuti ali okonzeka kumwa mapiritsi moyo wawo wonse.

Izi ndi zolakwika, chifukwa ngati zikufunika kuchitika, ndiye kuti osavula sizikulimbikitsidwa. Inde, nthawi zambiri kuti chikhululukiro chokwanira, chimachotsedwa m'chiwalo chomwe chakhudzidwa chofunikira.

Mankhwala

Kumwa mapiritsi ndi njira yowonjezera yamankhwala, chifukwa kwakanthawi kochepa kamachepetsa munthu wa zizindikiro, ndipo samalimbana ndi zomwe zimawoneka.

Monga chisonyezo chamankhwala, madokotala amapereka chithandizo ichi:

Spasmodic: No-shpa, Duspatalin, Spazmalgon.
Anticholinergics: Argoprin, Methyldiazil.
Zinthu za enzyme: Mezim, Pancreatin.
Maantacid: Phosphalugel, Maalox.
Mankhwala a antibacterial: Ampicillin.

Pomwe mankhwalawa ataperekedwa sapereka zotsatira zabwino, madotolo amasankha kuchita chithandizo cham'deralo: amachotsa kutentha kwa thupi kapena kuthandizira ndi laser.

Kuthandizira opaleshoni

Pofuna kuchiza matenda amtunduwu, mitundu iwiri ya ntchito ingagwiritsidwe ntchito. Izi ndi izi:

Kusangalatsa kwa minofu yomwe yakhudzidwa. Mtundu wa opaleshoni yamtunduwu umathetsa kupsinjika kwa Versungs ndi ma ducts wamba a bile. Pakukonzekera kwake, akatswiri amasanthula minofuyo mwambiriyakale. Pozindikira zizindikiro za oncological, madokotala amatembenukira ku pancreatoduodenal resection - njira yomwe imakhudza minofu ya duodenum, biliary kapena periopancreatic. Ngati mbiriyo itakhala yoyera ndipo chotupa chamavuto sichinapezeke, mutu umatulukika ndipo ma cysts akulu amachotsedwa pamalopo.
Pancreatic duct drainage. Ndondomeko imakhala ndikuyambitsa machubu apadera a silicone mu chilonda, mothandizidwa ndi komwe kumatha kuchotsa madzimadzi ndi mafinya ku chiwalo chomwe chakhudzidwa. Manda okhala ndi m'mphepete m'modzi amapangidwira chilonda, ndipo m'mphepete mwake mumatsitsidwa chidebe china.

Chifukwa chakuti machubu ali pachilonda kwakanthawi, ayenera kutsukidwa nthawi ndi nthawi ndi mankhwala a antiseptic.

Zochita zoterezi zimathandiza kupewa kulowa muchilonda cha matenda omwe amapezeka chubu akakumana ndi mpweya.

Kukhetsa kwa ntchito kumapewetsa mavuto omwe angaphe. Izi ndichifukwa choti njirayi imawululira chotupa cham'mimba chodonthekera ndi kuyeretsa.

Ndi mtundu uti wa opareshoni omwe muyenera kusankhidwa - ndi madokotala okha omwe akuganiza. Izi zikutsatira m'baleyo poganizira za thanzi la anthu komanso kuchuluka kwa zamatsenga.

Mu zida zamankhwala amakono pali njira zambiri za endoscopic zomwe zikuyenera kupangika pakukulitsa kwambiri gland, kufinya njira ndikuwonetsa jaundice yovuta. Kuphatikiza apo, kutsimikiza kwa magawo a papillary ndi stenosis kungachitike chifukwa cha zomwe zikuwonetsa.

Zolemba zamankhwala azikhalidwe

Kuphatikiza pa njira zamankhwala izi, madokotala angalimbikitse kugwiritsa ntchito ndalama kuchokera kwa anthu. Izi zikuphatikizira decoctions zitsamba, tinctures osiyanasiyana ndi kulowetsedwa kwa mankhwala azomera.

Ma decoctions a chamomile ndi calendula, omwe amasiyana mu antibacterial ndi anti-kutupa, amachiritsa.

Maganizo abwino oyenera ndi kumwa tincture wa barberry.

Kuti muiphike, muyenera kukhala ndi magalamu 20 a zinthuzi zosaphika m'manja, muzithira ndi ma milliliters 200 a mowa ndikuziwulitsa kuti zitheka kwa milungu iwiri.

Tengani kulowetsedwa motere muyezo monga momwe adanenera.

Ndikotheka kuchotsa poizoni onse m'thupi ndikusintha magwiritsidwe a kapamba mothandizidwa ndi decoctions ndi kissels zopangidwa pamaziko a oats.

Ndalama zomwe zimaganiziridwa ziyenera kuledzera pafupifupi masiku 40, atakambirana ndi katswiri.

Mavuto a Pseudotumor Pancreatitis

Matendawa omwe amawaganizira, popanda chithandizo choyenera, amatha kupweteka komanso kuvuta. Muyenera kuwaphunzira mwatsatanetsatane:

Peritonitis
Jaundice
Magazi amafunikira m'mitsempha.
Ma cystic neoplasms.
Kutulutsa magazi mkati.
Chizindikiro.

Ngati matenda atapezeka munthawi yake ndipo chithandizo choyenera chimaperekedwa, ndiye kuti zovuta izi zitha kupewedwa pothandiza wodwala yemwe samva bwino.

Kupewa matenda

Pali njira zingapo zofunika zodzitetezera zomwe zingathandize kupewa pseudotumor mawonekedwe a kapamba. Izi ndi izi:

Kukana zizolowezi zoyipa zomwe zidalipo kale: kusuta, kumwa mowa, kugwiritsa ntchito mankhwala osokoneza bongo.
Unikani zakudya zanu.
Khama yogwira ntchito komanso maphunziro azolimbitsa thupi tsiku ndi tsiku.
Munthawi ya matenda a matenda: caries, otitis media ndi sinusitis.
Kupitiliza kuyendera kochita pachaka.

Madokotala ati mtundu uwu wa kapamba umapereka chidziwitso chabwino cha kuchira. Pathology nthawi zambiri imachulukitsa, imayamba pang'onopang'ono.

Koma apa tiyenera kudziwa kuti kuperewera kwa endocrine kungayambitse nephropathy ndi angiopathy.

Chofunikira kwambiri ndikuyankha mokwanira pazomwe thupi lanu limachita, osanyalanyaza zizindikiro zosokoneza ndikusaka thandizo la kuchipatala munthawi yake.

Kanema wothandiza

Pancreatitis ndi matenda otupa a kapamba amayamba chifukwa cha kusayenda kwa michere mthupi, kudzimbidwa kwake ndi chiwonongeko. Ma poizoni omwe amaphatikizidwa amalowerera mkati mwa magazi ndikuwononga ziwalo zamkati - mtima, chiwindi, impso.
Pseudotumor pancreatitis ndi mtundu wina wapadera wa kutupa kwa kapamba, wodziwika ndi chotupa m'mutu wake ndikupanga pakalibe chithandizo chanthawi yake. Matenda amtunduwu amadziwika pafupifupi zaka khumi mpaka khumi ndi zisanu kuyambira pa nthawi yakusintha kwa zotupa m'misempha.
Matenda a pseudotumor pancreatitis nthawi zambiri amasokonezeka ndi matenda am'mimba kapena chiwindi ndipo nthawi zambiri amapezeka wodwala akangolowa kuchipatala ndi matenda ena.

Etiology ndi zizindikiro

Zizindikiro zazikulu za pseudotumor pancreatitis zimakhala kupweteka kwakanthawi, kutaya magazi, kuwonjezereka kwa kapamba, komanso kuchepa msanga kwa thupi.

Pseudotumor pancreatitis nthawi zambiri imakhala chifukwa cha kusokonezeka kwa machitidwe a biliary: biliary dyskinesia kapena kuwerengetsa cholecystitis. Zomwe zimapangidwira ndikukuledzeretsanso, uchidakwa, kuledzera.

Izi zimadziwika ndi kufalikira kwa mutu wa kapamba, ma masamba omwe amakhala opanda tanthauzo komanso osalongosoka bwino. Tiziwalo tating'onoting'ono ta tiziwalo timene timakhudzidwa, timayaluka ndi pseudocyst, ndipo chimbudzi chimachulukanso kwambiri.

Monga matenda a pseudotumor pancreatitis:

Zaka ndizocheperako.
Amuna kapena akazi - amuna amakhala ovuta.
Mowa.
An anamnesis matendawa kwa chaka chimodzi ndi theka.
Kuchepetsa kwambiri thupi (makilogalamu oposa 10).
M'mimba ululu syndrome.
Jaundice osaposa 20% ya odwala ndiwokhazikika munyama, ndi kuwonjezeka kwapadera kwa bilirubin.
Ultrasound ndi CT scan zikuwonetsa kuchepa kwa echogenicity ya mutu wa gland pafupifupi 18% ya milandu.

Mtundu wa khansa ya mutu wapa pancreatic:

Ukalamba wokulirapo, pafupifupi, zaka 59.
Amuna ndi akazi onse amakhudzidwa chimodzimodzi.
Kuchepetsa thupi pang'ono mpaka 5,5 kg.
Jaundice wopitilira patsogolo wokhala ndi bilirubin yayikulu mu 90% ya odwala.
Ultrasound ndi CT zikuwonetsa kuchepa kwa echogenicity ya mutu wa gland pafupifupi 75% ya milandu.

Zomwe zimayambitsa matendawa

Akatswiri azindikira zinthu ziwiri zomwe zimayambitsa matendawa:

Malinga ndi ziwerengero, zomwe zili pamwambapa zimayambitsa pafupifupi 80% ya milandu ya pseudotumor pancreatitis.

Pakati matenda matenda a chiwindi ndi ndulu, matenda a ndulu ndi ambiri. Zovuta zakuberekera zochokera munthawi ya biliary thirakiti, matenda am'mimba mwa duodenal papilla, komanso wamba bile. Zolakwika zoterezi zimatsogolera kulowa kwa ndulu mu ziwonetsero za kapamba ndipo, chifukwa chake, kutupa kwawo.

Matenda a kapamba chifukwa cha kukulitsa kwa thupi chifukwa cha majini. Mtundu wobadwa nawo matendawa umadziwika ndi kusowa bwino kwa kapamba komanso kuthekera kwakukulu kwa kuwonongeka kwa minofu yolumikizira mafupa kukhala chotupa.

Chenjezo Matendawa amatha kuchitika chifukwa chogwiritsa ntchito mankhwala kwa nthawi yayitali, omwe amayamba chifukwa cha estrogens, anidlides (acetaminophen).

Kusintha kwa kutupa kosatha kwa kapamba mu mawonekedwe a pseudotumor kumatha zaka 5 mpaka 15 ndipo pafupifupi asymptomatic.

Mawonetseredwe oyambilira a matendawa, monga lamulo, ndi jaundice komanso zopweteka.

Zotsirizira sizimachitika nthawi zonse; zimakhazikitsidwa pansi pa nthiti kumanja kapena epigastrium. Ululu umakhala pang'onopang'ono, umatha kudya pambuyo pake ndikumapumira patatha maola ochepa.

Zizindikiro zina za pseudotumor pancreatitis:

nseru
kusanza, pambuyo pake wodwala apuma,
Kuchulukana kosiyanasiyana kwa kapamba (wapezeka ndi palpation ndi ultrasound),
kumva kutopetsa komanso kudzala mbali,
kuwonda msanga
kuphwanya chopondapo (kutsegula m'mimba, kudzimbidwa),
kupezeka kwa ndowe zamafuta, zotupa ndi minofu,
kuyanika kwambiri pakhungu
kufooka wamba ndi malaise.

Mukamayang'ana kapamba mothandizidwa ndi ultrasound, kuchuluka kwa mutu wa chiwalo kumadziwika, kukhalapo kwa pseudocyst, kukulitsa kwa ma ducts.

Thandizo! Pseudotumor pancreatitis ilibe zizindikiro, imasokonezeka ndi bysary dyskinesia, cholecystitis, ndi matenda a chiwindi.

Njira Zodziwitsira

Kuzindikira matenda kumakhala kovuta chifukwa kufanana kwa zizindikiro zake ndi ma pathologies ena am'mimba: khansa zotupa za kapamba, m'mimba, m'mimba, zilonda zam'mimba.

Kuti adziwe zoyenera, wodwalayo amafufuza mozama:

Mafunso ndi kufufuza wodwalayo. Pa palpation, kuwonjezeka kwa kukula kwa chiwalo kumapezeka, ndipo m'malo mokakamizidwa, kupweteka kwamphamvu kosiyanasiyana kumamveka. Wodwalayo amakhala ndi khungu losasangalatsa labwino.
Kuyesa kwa magazi ndi mkodzo. Kupatuka kwakukulu kwazomwe zimachitika mwa wodwala sikupezeka, koma pakukhupuka kwa ululu wamankhwala, kuwonjezereka kwa kuchuluka kwa michere (amylase, lipase, trypsin) kumadziwika.
Kuyesedwa kwa magazi kulolerana ndi shuga. Ndi pseudotumor pancreatitis, kulolera kwa glucose kumavulala: shuga pambuyo pambuyo kuchita masewera olimbitsa thupi imaposa chizindikiro chovomerezeka.
Kudziwa mtundu wa zotupa (gulu CA 19-9). Njira yake ndi yophunzitsira ndipo imalola kudziwa pseudotumor pancreatitis kapena khansa wodwala wodalirika kwambiri.
Kusanthula kuchuluka kwa mapuloteni a pancreatic. Ndi kutupa kwa kapamba, kuchepa kwa chizindikiro cha peptide kwalembedwa, ndi khansa, kuwonjezeka.
Ultrasound Kafukufukuyu amakupatsani mwayi kuti mudziwe kuchuluka kwa kusintha kwa ziwalo, kumveka bwino kwa ma contour ake, kuzindikira madera omwe ali ndi kusintha kwa kusintha kwa zinthu (xeudocysts, calcifying).
MRI ndi ERCP. Njira zake zimaloleza kafukufuku wosinthika wa kaphatikizidwe ka kapamba ndi milulu yake, komanso kupatula pang'onopang'ono matenda a carcinoma.

Thandizo! Pseudotumor pancreatitis ili ndi code malinga ndi ICD 10 - K86.1.

Mankhwala

Chithandizo cha pseudotumor pancreatitis chikuchitika mu dipatimenti ya gastroenterology. Wodwalayo amamulembera zakudya (tebulo Na. 5), muzovuta kwambiri - Kusala kudya kwachangu masiku angapo. Chithandizo cha mankhwala sichimalola kuchira, chimagwiritsidwa ntchito pothana ndi vuto la wodwalayo kapena monga gawo lokonzekera asanachitidwe opareshoni.

Chithandizo cha Conservative

Pharmacological mankhwala ochizira pseudotumor pancreatitis imagwiritsidwa ntchito kulipirira kusowa kwa kapamba:

Enzymes Wodwalayo amapatsidwa pancreatin limodzi ndi lipase.
Maantacid. Mankhwala osokoneza bongo amathandizira kuchepetsa asidi wa hydrochloric acid, chifukwa chomwe chopondacho chimapangidwira.
Kukonzekera kwa calcium. Kuphatikizika kwa ma antacid kumachotsa steatorrhea ("mafuta" chopondapo).
Antispasmodics. Amatengedwa kuti atulutsire kutsinde kwa ma pancreatic ducts, omwe amasintha kutuluka kwa zinsinsi zake.
Maantibayotiki. Mankhwala a antibacterial amachitika nthawi ya pachimake.
Zopweteka. Amathandizira kuchepetsa ululu komanso kukonza thanzi la wodwalayo.

Njira yopangira opaleshoni

Milandu pomwe pali kuwonjezeka kwakukulu kwa mutu wa zikondwerero ndi kukakamira kwa wamba bile duct, njira yokhayo yothetsera zomwe zimayambitsa matenda ndikupeza chokhazikika ndi kupulumutsidwa.

Yang'anani! Odwala ena omwe ali ndi pseudotumor pancreatitis amakana opaleshoni m'malo mwa njira zochizira. Kusankha koteroko kumangokulitsa zinthu, chifukwa Kugwiritsa ntchito mankhwala kwa nthawi yayitali kumayambitsa chiwindi china, koma sikuti kuchiritsa.

Njira yochitira opaleshoni imaphatikizira kukhathamiritsa kwa minyewa yomwe yakhudzidwa ndi kukoka kwa ma pancreatic ducts.

Kupita patsogolo kwamakono kwa zamankhwala amakulolani kuti mupeze zotsatira zomwe mukufuna pogwiritsa ntchito njira zowononga zachilengedwe.

Ndikosavuta kunena nthawi yayitali yomwe wodwalayo amachira ndi pseudotumor pancreatitis

Kutalika kwa nthawi yochira kumatengera kuuma kwa matendawa, zaka za wodwalayo ndi mikhalidwe ina ya wodwalayo.

Zofunika! Wodwala amayenera kutsatira mosamalitsa zomwe adotolo adatsata ndikutsatira zakudya pamoyo wake wonse!

Zonenedweratu ndi zovuta zotheka

The m'tsogolo moyo ndi pseudotumor pancreatitis zabwino. Matendawa amakula pang'onopang'ono, kuchuluka kwake ndikosowa, koma Popeza palibe chithandizo, wodwala amatha kukumana ndi zovuta zotsatirazi:

kuchulukitsa
jaundice
kufalikira kwa mitsempha
peritonitis
matenda ashuga
magazi amkati
kuwonongeka kwa hypertrophied ziwalo zimakhala mu zoipa kupweteka.

Kutsatira kwambiri zomwe dokotalayo amalola kuti wodwalayo apulumutse moyo wake ndikuwonetsetsa kuti chikhululukiro chokhazikika.

Kupewa

Malangizowa ndi ofunikira makamaka kwa odwala omwe ali ndi vuto lililonse la kapamba:

Kanani mowa ndi ndudu.
Chepetsani kugwiritsa ntchito zakudya zokazinga, zonunkhira, zamafuta. Odwala ayenera kuwachotsa kwathunthu pazosankha ndikutsatira zakudya (tebulo No. 5).
Panthawi yochizira matenda omwe angayambitse chitukuko cha matenda.
Pitani zamasewera, koma nthawi yomweyo pewani zodzaza.
Nthawi zambiri mumayesedwa ndi dotolo wofufuzira.

Zofunika! Mutha kupewa matendawa ngati njira zotsatiridwa zikutsatiridwa.

Zizindikiro

Pseudotumor pancreatitis ndi yovuta kudziwa, chifukwa munjira zambiri amafanana ndi matenda am'mimba, omwe ali ndi magwiridwe antchito ndi ziphuphu. Kuchulukitsa kwa ma pathologies a ziwalozi kungachititse kuchuluka kwa kutukusira kwa matuza.
Chifukwa chake, kuwunika kwa pseudotumor pancreatitis kumachitika m'malo angapo motsatizana:

Kupatula kwa matenda omwe ali ndi chifaniziro cha matenda ofanana ndi chapamimba chapamimba, zilonda zam'mimba, colcin carcinoma, matenda amtundu wa pachifuwa, matenda amtundu wa m'magazi, cholecystitis yovuta, pachimake komanso matenda a chiwindi.
Laborator diagnostics: kuchita ceruline, bentiramine ndi kuyamwa, kutsimikiza kwa ma enzymes m'magazi - amylase, lipase, elastase,
Chida chowunikira: Ultrami wam'mimba, ma radiografia, duodenography, tomography, endoscopic echolocation.
Kudziwitsa zakusintha mu ducts wamkulu wa bile ndi duodenal papilla wamkulu pogwiritsa ntchito gastroduodenoscopy, intravenous cholangiography, radionuclide cholecystography.
Kuyesa kwa Endoscopic kwa pancreatic duct yayikulu ndikukwera kwa pacreatocholangiography.
Kusanthula kwa zotupa ndi zilembo za biopsy.

Matenda a pseudotumor pancreatitis amadziwika mu 5% yokha ya odwala omwe ali ndi kutupa kwa pancreatic, chifukwa chake, pafupifupi odwala onse, matenda amapezeka ndi zovuta.

Mankhwala othandizira

Pseudotumor pancreatitis amathandizidwa ntchito. Cholinga cha opareshoni ndikuchotsa chotupa, chomwe chimayambitsa kusintha kwa kapamba, kuchepa kwa zizindikiro za matendawa, kupewa zomwe zingachitike ndi matenda ophatikizika - matenda a gallstone kapena matenda ashuga.
Zotsatira za opaleshoni ndiyoyambira kuchotsedwa kwathunthu kapena kosakwanira, mwachitsanzo, zotsalira za pancreatic steatorrhea, duodenostasis, pseudocysts ndizotheka. Pambuyo pochita opaleshoni pseudotumor pancreatitis, odwala amawunika pafupipafupi ndi kuyendera katswiri kawiri pachaka, kutsimikiza kwa exocrine pancreatic ntchito ndi ultrasound.
Pakadali pano, chiwerengero chokwanira cha mankhwala othandiza chatulutsidwa, kugwiritsa ntchito komwe kunachepetsa kwambiri kuchuluka kwa chiphunzitsochi. Ntchito pa ndulu, m'mimba ndi kapamba posachedwapa zakhala ndi zovuta zochepa kwambiri pambuyo pake. Mu 80% ya milandu yonse, pseudotumor pancreatitis imatha pakuchira kwa odwala.

Njira zopewera

Njira zopewera pseudotumor pancreatitis zimaphatikizapo:

Kusintha zakudya - odwala amalimbikitsidwa zakudya zophatikiza mapuloteni komanso zakudya zamafuta ochepa.
Kugwiritsa ntchito mankhwala komwe kumachepetsa kugwira ntchito kwa ma pancreatic enzyme, zomwe zimapangitsa kuti thupi liziwoneka bwino.
Kupatula mowa.
Kudziwona kwakanthawi ndi chithandizo cha matenda oyamba ndi matenda mthupi: mano osokosera, tillillitis, sinusitis.
Sanatorium chithandizo.

Ngati mutsatira mosamalitsa njira zonse zofunikira zodzitetezera, ndiye kuti mutha kukwaniritsa kuchotsera kwamatenda.

Pseudotumor pancreatitis ili ndi zizindikiro zomwe zimagwirizana ndi zomwe zimawoneka ndi kukula kwa chotupa cham'mimba. Mu pathology, yomwe ili ndi code malinga ndi ICD 10 K 86.1, hypertrophy ndi fibrosis yaminyewa ya gland imalembedwa. Matendawa amakulitsa kuwonjezeka kwanuko m'dera lachiwalo, komwe kumasokoneza magwiridwe ake.

Matendawa amakulitsa kuwonjezeka kwanuko m'dera lachiwalo, komwe kumasokoneza magwiridwe ake.

Zomwe zimachitika

Njira yotupa mu kapamba, limodzi ndi kukula kwa minofu yake, imachitika motsutsana ndi maziko a matenda a hepatobiliary dongosolo, cholecystitis, matenda a ndulu, chiwindi. Matendawa amakula nthawi zonse pokhapokha ngati mankhwalawa amayamba kupindika. Zina mwazifukwa zazikulu zimaphatikizira cholowa, kumwa mowa mwauchidakwa.

Njira zoperekera matenda ndi:

Matenda a gallbladder.
Makina ovulala a kapamba.
Mapangidwe a cysts.
Matenda a autoimmune.

Matenda opatsirana amatha kupatsitsanso chotupa chabodza pa kapamba.

Njira zochizira

Matendawa amathandizidwa. Izi zitha kukhala kutaya kwa ma kapamba (kapangidwe kake ka madzi ndi kutuluka kwa pancreatic), kapenanso kukhala mutu wa kapamba.

Njira zodzitchinjiriza zimabweretsa mpumulo kwakanthawi ndipo osathetsa vutoli - kuchotsedwa sikungatheke ndi thandizo lawo.Amaphatikizanso kugwiritsa ntchito ma pinkiller (antispasmodics - no-spa, papaverine, duspatalin, ndi zina), mankhwala omwe amachepetsa kubisala (kontrikal, gordoks). Panthawi yowonjezera, njala imayikidwa masiku atatu.

Njira zonsezi zimakonzekera mwachilengedwe, ndipo popeza kuphedwayo kwatha, wodwalayo amafunika kuchitidwa opaleshoni.

Kuwona tinthu tating'onoting'ono tomwe timatulutsa m'mutu mwa nduluyo kumathandizanso kukomoka kwa Wirsung ndi ma ducts wamba a bile. Zidutswa za tinthu tamadutsa timayang'aniridwa mwachindunji pakagwiritsidwe ntchito. Ngati maselo a khansa apezeka, ndiye kuti PDR - pancreatoduodenal resection nthawi zambiri imagwiritsidwa ntchito. Uku ndikulowerera kovuta, komwe kumakhudza ziwalo zoyandikana ndi kapamba - duodenum, ducts ya bile, minofu ya periopancreatic.

Ngati kuwunika kwa mbiriyakale sikuwonetsa zilonda zam'mimba, dokotalayo amatha pomwe mutuwo ndikugwetsa zilonda zazikulu kwambiri, ndikufinya. Opaleshoni yotere imalola kukhululukidwa kwathunthu kapena pafupifupi kwathunthu, ndipo pakapita kanthawi, zimasintha bwino moyo wa odwala. Nthawi zambiri, zimalepheretsa kukula kwa matenda ashuga, chifukwa gawo lalikulu la zofunikira limapitiriza kugwira ntchito ndikupanga insulin.

Kodi nchiyani chomwe chikuwopseza kukanidwa kwa opaleshoni? Kupititsa patsogolo kwa matenda, kuchulukitsa, kuchuluka kwa jaundice ndi kuledzera chifukwa cha kuchuluka kwa ziwalo zoyandikana. Kukula kwa endocrine ndi exocrine pancreatic kusakwanira.

Inde, odwala omwe adamulowetsa azitsatira zakudya za moyo - wolemeretsedwa ndi mapuloteni komanso mafuta ochepa. Adzafunika kusiya mowa. Kuti muchepetse kusakwanira kwa pancreatic, ayenera kutenga michere. Masiku osala kudya nthawi ndi nthawi, chithandizo cha sanatorium kumalo osungirako zakumwa - Kislovodsk, Essentuki, Zheleznovodsk, Truskavets, Morshin, Karlovy Vary ndizothandiza kwa odwalawa.

Ndichitira odwala kuyambira 1988. Kuphatikiza ndi kapamba. Ndimalankhula za matendawa, Zizindikiro zake, njira zodziwira matenda ndi mankhwalawa, kupewa, kudya ndi regimen.

Kukopa kwa chodabwitsachi

Zomwe zimayambitsa matendawa:

uchidakwa, kudya "kolemera", kusuta,
mankhwala a nthawi yayitali
cholowa
poyizoni ndi mankhwala komanso kuvulala kwa m'mimba,
opaleshoni yam'mimba yapita
kuchuluka kwa matenda a kapamba,
matenda osiyanasiyana am'mimba ndi matumbo, miyala mu chikhodzodzo, kuwonongeka kwa chiwindi ndi matenda amanjenje, etc.,
kulephera kwamtima ndi matenda amitsempha,
matenda opatsirana (virus hepatitis, nthomba, tonsillitis, sepsis, etc.),
chifuwa
helminthiasis,
matenda ashuga.

Ndikofunika kudziwa kuti mu 80% ya milandu, chomwe chimapangitsa kuti pakhale pseudotumorous pancreatitis ndimatenda a ndulu, chiwindi ndi ma ducts a bile.

Mawonetsero azizindikiro

Zizindikiro zazikulu za pseudotumor pancreatitis (PTP):

kupweteka kwakanthawi kokhazikika komwe kumakhala mu hypochondrium yoyenera, kupweteka kwambiri mutatha kudya komanso matendawa akamakula,
kuphwanya ntchito zachinsinsi za kapamba,
kusintha kwa kapamba (nthawi zambiri kumawonjezera),
kuwonda
kusowa kwa khungu, maso, kuyimitsa mkodzo ndikuwunikira kwa ndowe, kuyabwa,
kuphwanya chopondapo
kuwonda m'mimba mutatha kudya zakudya zamafuta, mowa,
kusanza ndi kusanza
kusowa chakudya bwino komanso zotsalira za chakudya mu ndowa,
endocrine ndi exocrine pancreatic insufficiency - kuchepa kwa kupanga kwa mahomoni ndi ma enzymes omwe akukhudzidwa ndi moyo wa thupi.

Chosangalatsa ndichakuti zizindikirazi zimawonedwa pang'onopang'ono matendawa atadwala. Popita nthawi, zisindikizo za oncological etiology zimatha kuchitika m'magawo okhudzidwa ndi kapamba, matenda oopsa a subhepatic portal (kuchuluka kowonjezera mumitsempha ya portal chifukwa cha thrombosis) kumatha kuchitika. Pankhaniyi, kutuluka kwa ndulu kuchokera ku chiwindi kupita ku duodenum kumasokonekera, zomwe zimatsogolera pakukula kwa jaundice. Mutu wa pancreatic ndi wopunduka komanso wowonjezereka kukula chifukwa cha minyewa ya cystoma, yomwe imasokoneza kutuluka kwachimbudzi kuchokera ku chiwalo, ndipo ma enzymes ophatikizika amayamba kuwongolera makoma ndi maselo a gland. Bili lophimba m'chiwindi limalowanso kapamba, kukulitsa kugunda kwake komanso kumakhudza kwambiri kapamba. Chifukwa chakuti mutu wa pancreatic umalumikizidwa ndi dongosolo la lymphatic, njira yotupa m'mimba imafalikira thupi lonse.

Mitundu ndi gulu la kapamba

Pali mitundu yambiri ndi mitundu ya kutupa kwa kapamba. Ndikofunikira kwambiri kuwongolera matenda ngati kapamba, kapangidwe ka matendawa. Muzochita zamankhwala, zimakhazikitsidwa ndi International Marseille Classization, yomwe imaphatikizapo mitundu yotsatira ya kapamba:

Lakuthwa.
Pang'onopang'ono pang'onopang'ono ndi kuthekanso kubwezeretsa pancreatic ntchito.
Matenda opita patsogolo, okhala ndi vuto lalikulu, ndikubwezeretsanso pang'ono pang'ono kwa nduyo. Amakhalanso ndi dzina lakuti prenreatitis prenreatitis.
Zopindulitsa, limodzi ndi mapangidwe amiyala, kupangika, kuphwanya patency ya bile kapangidwe ka kapamba ndi kukula kwa minofu yaminga.
Matenda apansi a pancreatitis omwe amachititsa kuti maselo azisintha pakhungu. Nthawi zina zimaphatikizidwa ndi kuyika kwa miyala, kenako kutsegula kapamba kumayamba, ndipo izi ndi njira zachikhalidwe. Acini yomwe imayang'anira kupanga ma enzyme ndi kugaya chakudya amakhudzidwa kwambiri.

Matenda owerengeka a kapamba amadziwika ndi kuphatikizika kwamchere mu kapamba chifukwa chophwanya kapangidwe kazinthu zopanga pancreatic secretion ndipo zimayambitsa kupangidwa kwa miyala kapena mchenga m'mizere ya tinthu timene timayamwa. Zotsatira zake, pamalo opangira ma Calculator, ma necrotic njira ya minofu ya gland imayamba. Cancreatitis yowerengeka nthawi zambiri imakhala ndi vuto losavomerezeka chifukwa chakuti njira zoyipa zimayamba kupanga ndi minofu ya necrosis.

Chikhalidwe ndi malo omwe zilonda zapakansa zimasiyanitsa mitundu yotsatira ya kapamba:

Edematous pancreatitis, monga lamulo, mawonekedwe oyamba a chitukuko cha pachimake komanso chamba cha pancreatitis. Edema imaphimba lobes ya kapamba popanda kusintha kwanyengo. Imafala kwambiri mwa amuna, chifukwa chachikulu ndi chizolowezi chomwa mankhwalawa, chomwe chimayambitsa matenda a edematous syndrome. Edematous pancreatitis imasinthidwanso. Ndi chithandizo cha panthawi yake ndikuchotsa puffness, matendawa ndi abwino.
Parenchymal pancreatitis ndi zotupa zonse za kapamba kapena gawo limodzi, limodzi ndi kuphwanya kwa exocrine ntchito ya chiwalo. Parenchymal pancreatitis ndiowopsa kwambiri chifukwa cha zovuta zake, zomwe zimatha kupha wodwala.
Matenda a kapamba amayambika kumbuyo kwa kachilombo komwe kamayambitsa matenda, makamaka chiwindi cha hepatitis, komwe kumayambitsa kuwonongeka kwa kachilombo koyambitsa matenda a pancreatic ndikuyambitsa kuthamanga kwa njira yodutsitsa ziwalo.
Ndi chithandizo choyipa, mtundu wosasamalidwa wa kapamba kaphatikizidwe ndi matenda opatsirana a kapamba, puranc pancreatic pancreatitis imachitika. Ndi matenda amtunduwu, kupukusira zotupa za m'mimba zimawonedwa. Izi zimafunikira opaleshoni yofulumira. Zotsatira za Lethal ndizotheka. Kutupa kwa purulent nthawi zambiri kumayambitsa necrotic pancreatitis, i.e., njira yofera minofu yomwe ikukhudzidwa.
Mtundu wonyalanyaza wa kutupuka kwakanthawi kwamapapo kumatha kuyambitsa pang'onopang'ono. Atrophic pancreatitis imayamba ndi kusintha kwa fuluwenza m'matumbo, yomwe pang'onopang'ono imafalikira mkati mwake, ndikumapangitsa kuwonda, malovu am'magazi, ma islets a Langerhans, omwe pamapeto pake amachititsa kukanika kwa mahomoni ndi enzymatic. Kuwonongeka kowonjezereka kwa ma ducts ndi mitsempha yamagazi kumapangitsa kuti magazi azituluka ndipo amakwiyitsa hemorrhagic pancreatitis. Itha kukhala yodzaza kapena ina. Chiwalo chimachepetsedwa kwambiri kukula ndikuyamba kukhala cartilaginous, chomwe chimakwiyitsa chiwindi. Matendawa ndi osavomerezeka.
Hemorrhagic pancreatitis ndi chotsatira cha kuwonongeka kwa mtima wam'mapapo chifukwa cha fibrosis kapena kuwonongeka kwa makoma a chotengera ndi ma enzymes ake chifukwa cha kufalikira kwa ndere. Potere, kufalitsa magazi mkati ndi peritonitis kumachitika.
Pakati pa mitundu yamatenda a kapamba omwe amapezeka kwambiri mwa azimayi, idiopathic pancreatitis ndi mkhalidwe pomwe minofu yapamene yathanzi imasinthidwa kukhala minofu yamafuta. Zomwe zimayambitsa kusinthika kwa zinthu sizinaphunzirepobe. Pali mitundu ingapo ya idiopathic pancreatitis: koyambirira (komwe kumachitika zaka 15-20), kotentha (komwe kumapezeka anthu okhala m'maiko otentha ndipo chifukwa cha kuchepa kwa mapuloteni ndi mchere), senile (senile).
Kuwonongeka kwa kapamba ndi mapangidwe amatsenga a fibrous ndi miyala mu minofu imatchulidwa ngati pancreatitis ya induction. Kukula kwa matendawa kumabweretsa kutsekeka kwa zikondamoyo, potero kumapangitsa kuphwanya kutuluka kwa pancreatic madzi kulowa m'matumbo. Zotsatira zake ndikuphwanya kwam'mimba dongosolo, matenda a duodenum, chiwindi, m'mimba. Pancreatitis yozizira imayambika motsutsana ndi maziko azovuta zingapo.
Mtundu wachilendo kwambiri wamatenda a kapamba omwe amapezeka muzochitika zamankhwala ndi autoimmune pancreatitis. Amawonetsedwa mukulakwitsa kwa chitetezo cha mthupi, pamene chitetezo chachilengedwe chikuwonjezeka komanso maselo chitetezo chathupi "chikuwukira" matupi awo. Autoimmune pancreatitis imadziwonekera yowonongeka osati kokha kapamba, komanso ziwalo zonse zomwe zimakhudzana ndi iyo (chiwindi, impso, mitsempha ya m'mimba, tiziwalo tating'onoting'ono, zotupa za bile, ducts ya m'mimba. Imadziwoneka ngati gulu la zizindikiro za mitundu yonse ya kapamba - jaundice, vuto la kusowa kwa magazi, michere ndi kufooka kwa mahomoni, matenda a shuga, kuchepa thupi, kufooka kwakukulu ndi kutopa, ndi zina zambiri.

Malinga ndi gawo la chitukuko cha matendawa, amagawidwa m'magawo otsatirawa:

Gawo la Enzymatic (masiku 3-5) - munthawi imeneyi pali pathogenesis ya pancreatic necrosis (pancreatic necrosis), kuledzera kwa thupi ndi endotoxins (endotoxemia) kumayamba, nthawi zina kusokoneza ziwalo zina chifukwa cha kuwonongeka kwawo (kufooka kwa ziwalo zambiri) ndi endotoxin kumawonedwa.
Rease gawo (masiku 6-15) - yodziwika ndi kuyambika kwa njira yotupa m'magawo a necrotic.
Gawo lodziwikirana (pambuyo pa masabata awiri) - limatanthawuza kapangidwe kake kapamba ka masamba a necrotic (zotsatizana). Pali aseptic sequestration ndikupanga cystoma ndi perforation ndi septic, yomwe imapangidwa ndi purulent-necrotic kutupa kwa kapamba.
Gawo loyambirira - limachitika pakatha miyezi isanu ndi umodzi itatha zizindikiro zoyambirira za kudwala.

Njira zoyesera

Kuzindikira kwa PTP kumayamba ndi kuwonekera kwa zizindikiro za matendawa potengera madandaulo a wodwala. Pambuyo pakuphunzira mwakuya amapatsidwa.

Mayeso a Laborator amatha kudziwa zotsatirazi:

kuyezetsa magazi - dziko la ESR ndi maselo oyera am'magazi, kupezeka kwa bilirubin, ma enzyme osiyanasiyana ndi ma acid.
urinalysis - kukhalapo kwa bilirubin, urobilin ndi amylase,
Coprology - mtundu wa chimbudzi cha chakudya ndi kupezeka kwa mafuta.

CT
Matumbo dongosolo ultrasound,
roentgenogram
endoscopic echolocation,
matenda am'mimba ndi m'mimba thirakiti,
intravenous cholangiography - kuyambitsa kwa madzi osiyanitsidwa mu mitsempha ya pancreatic kuti muphunzire kutsekeka kwa duct, kukhalapo kwa miyala ndi neoplasms,
radionuclide cholecystography - kukhazikitsidwa kwa othandizira kusiyanasiyana kwa x-ray yamalimba, kumakupatsani chithunzi chokwanira cha kapamba amene ali pachithunzichi,
histology - kuphunzira kwa minofu yamoyo yomwe imapezeka kuchokera kwa wodwala pakuchitika kwa oncology.

Mfundo zachithandizo

Chithandizo cha pancreatitis chili ndi magawo angapo. Yoyamba mwa iwo ndi mankhwala osokoneza bongo, imaphatikizapo:

kutenga antispasmodics kuti athetse ululu wammbuyo (No-shpa, Spazmalgon, Drotaverinum),
kuchepa kwa kapangidwe ka michere yomwe imawononga ma gland, - kuikidwa kwa mankhwala omwe amachepetsa katulutsidwe ka michere (Omeprazole, Omez, Contrical, Ribonuclease, etc.),
kutenga ma enzymes kuti abwezeretsere kuchepera kwina (Pancreatin, Mezim-forte, Creon, Gastenorm, etc.),
Kubwezeretsa kachulukidwe kam'mimba ka asidi, kamene kamasokonezedwa ndi kugaya bwino chakudya (Maalox, Gastal, Almagel),
kubwezeretsanso kwa kusowa kwa mavitamini chifukwa chogwiritsa ntchito zovuta komanso zomwe zili m'magulu A, E, C, D, K ndi B,
mankhwala opatsa mphamvu ya m'mimba thirakiti (Motilium, Cerucal, Allohol),
woopsa milandu matenda ndi kutsekeka kwa kum'mero, kukonza makonzedwe amatsogolera ndi makina oyang'anira zinthu zapadera (Alvezin, Aminosol, 10% yankho la potaziyamu chloride ndi calcium gluconate).

Pa mankhwala ndi pambuyo pofunika kutsatira zakudya. Gawo 5 - chakudya chomwe chili ndi mapuloteni komanso zakudya zamagulu ambiri. Zimaphatikizapo kupatula zakudya zamafuta ndi zonunkhira, masamba ndi zipatso zambiri, madzi ambiri, ndi zina zambiri.

Ngati chithandizo cha Conservative chithandizo sichitha, opaleshoni imayikidwa - kuchotsa chotupa kuti chibwezeretse kapamba, kenako ndikuwunikira momwe ntchito ikuwonekera. Chithandizo cha spa chothandizira chingakhale chothandiza. Mukazindikira njira za oncological, chithandizo chamankhwala cha radiation ndi mankhwala.

Pancreatitis Zakudya

Zakudya ziyenera kuphatikizapo kuchuluka kwa mapuloteni ndi mavitamini, kuchepetsa kudya zamafuta ndi chakudya.

Makina oyenerana ndi zakudya No. 5:

Maphunziro oyamba amaphatikiza kugwiritsa ntchito supu "zopepuka" ndikuphatikiza tirigu (mpunga, oatmeal, semolina, buckwheat, barele), masamba ndi nyama yopendekera,
Zakudya zazikuluzinso zimakonzedwa kuchokera ku nyama yotsika kapena nyama ya nkhuku, nsomba, ma omeleette a dzira ndizovomerezeka,
kuloleza tirigu wathunthu, oyambitsa mkate, tsiku lililonse, mafuta ochepa a saladi,
tchizi chopanda mafuta ochepa, kefir, yogati, tchizi, mkaka,
kuchokera masamba mungadye mbatata, beets, kaloti, dzungu, zukini, biringanya, kuchokera ku zipatso - maapulo opanda asidi, mapeyala, zipatso,
zakumwa zoziziritsa kukhosi ndi zakumwa zoledzeretsa zimatsutsana, misuzi ya zipatso, ma compotes a zipatso owuma, msuzi wa rosehip, tiyi wopanda mphamvu, madzi amchere amaloledwa,
kuchokera muzakudya zochuluka zomwe mumatha kudya mumatha kudya uchi wabwino, kupanikizana ndi chokoleti, mabulosi amitundu ndi zakudya.

Mbale zonse zimaphika kapena kuwotchera. Chakudya chizikhala m'magawo ang'onoang'ono (nthawi 5-6), padera. Osamadya chakudya chotentha kapena chozizira.

Kuneneratu ndi kupewa pseudotumor pancreatitis

Ndi chithandizo cha panthawi yake komanso chokwanira cha pseudotumor pancreatitis, zotsatira zabwino zitha kunenedweratu (mpaka 80% ya milandu yochira). Ngakhale pali zovuta zina zomwe zimakhudzana ndikuphwanya dongosolo la endocrine (nephropathy ndi angiopathy), koma milandu yotere ndiyosowa kwambiri.

Njira zodzitchinjiriza kuti mupewe kupezeka kwa anti-TB mankhwala - kumwa moyenera, kusintha mankhwala osokoneza bongo ndi mankhwala achikhalidwe, kuvomerezedwa kwa matenda omwe angayambitse kukula kwa pseudotumor pancreatitis, kupewa matenda opatsirana ndi ma virus (katemera, njira zoteteza, kulimbikitsa chitetezo chokwanira), kuchezera ma sanatoriums ndi malo odyera, athanzi moyo, masewera.