Pancreas: komwe kuli ndi momwe zimapwetekera

Chiwalo chofunikira kwambiri chamkati mwa chimbudzi cha anthu ndi kapamba. Zambiri pazomwe akuchita muzochitika zake ndizambiri zomwe zimachitika. Chifukwa chake, ndikofunikira kufunafuna chithandizo chamankhwala munthawi yake. Kupatula apo, gland iyi ndi chiwalo chokhacho chomwe insulin imapangika kudzera mukuwonongeka kwa michere. Koma chifukwa cha izi, munthu mwiniyo ayenera kudziwa komwe kapamba amapezeka komanso momwe zimapwetekera, zomwe zimadziwika.

Momwe muyenera kuchitira - adokotala anena. Mankhwala odzipaka pano angangoipitsa. Zowawa m'mapapo zikusonyeza kuti kutupa kumayambira. Matendawa amatchedwa pancreatitis. Pachiyambi chake, payenera kukhala zifukwa zofunika zotupa kuti zipangidwe mu kapamba.

Kodi kapamba ndi chiyani?

Cancreas ndi gawo lofunikira la dongosolo logaya chakudya lomwe lili ndi ntchito yosakanikirana: kunja (exocrine) ndi mkati (endocrine). Ntchito ya katulutsidwe wakunja ndi katulutsidwe ka madzi a pancreatic, omwe ali ndi michere yogaya chakudya yofunikira pakugaya chakudya kwathunthu. Ntchito ya endocrine imakhala pakupanga mahomoni oyenera komanso malamulo a kagayidwe kazinthu: chakudya, mafuta ndi mapuloteni.

Ntchito ya procrine

Tsiku lililonse, kapamba amatulutsa 500-1000 ml ya kapamba wa kapamba, wopangidwa ndi ma enzymes, mchere ndi madzi. Ma enzyme omwe amapangidwa ndi kapamba amatchedwa "proenzymes" ndipo amapangidwa mwa iwo osagwira ntchito. Chakudya chikalowetsa mu duodenum, timadzi timadzi timatulutsa timadzi tambiri, mothandizidwa ndi mankhwala omwe timayambitsa michere ya madzi a pancreatic imayambitsidwa. Chowonjezera champhamvu kwambiri cha pancreatic secretion ndi hydrochloric acid wa chapamimba madzi, chomwe, chikalowa m'matumbo ang'onoang'ono, chimayendetsa katulutsidwe ndi kapamba ndimatumbo a m'mimba, omwe, amakhudzanso kupanga kwa michere ya pancreatic.

Ma enzyme amenewa ndi monga:

Zakudya zomanga thupi

Trypsin ndi chymotrypsin okhudzana ndi kugaya zakudya zamaproteni, zomwe zimayamba m'mimba.

Lipase, yemwe amachititsa kuti mafuta awonongeke omwe adatulukira kale mu ndulu.

Kuphatikiza apo, madzi a pancreatic amakhala ndi zinthu zomwe zimapezeka mumchere wamchere, ndikupereka zomwe zimachitika zamchere. Izi ndizofunikira kuti muchepetse gawo lama acidic pazakudya zomwe zimalandidwa m'mimba, ndikupanga malo oyenera a chakudya chamagulu.

Kubisala kwa madzi a pancreatic kumayendetsedwa ndi mitsempha ndipo kumalumikizidwa ndi chakudya, i.e., kuphatikiza kosiyanasiyana kwa chakudya kumapangitsa kuti juisi ikhale ndi voliyumu yosiyanasiyana komanso mavidiyo a michere. Amadziunjikira m'makina am'magulu am'magazi, omwe amalowetsa mu duct yayikulu, yomwe imalowa mu duodenum.

Ntchito ya endocrine

Ntchito ya mkati mwa chofufumitsa imatulutsa timadzi timene timatulutsa timadzi tambiri ndi magazi. Amapangidwa ndimagulu a maselo olowedwa pakati pa lobules komanso osowa ma ducts - otchedwa islets of Langerhans, omwe amapezeka mchira wa gland. Zilumba za Langerhans zimakhala ndi maselo alpha ndi maselo a beta. Chiwerengero chawo mwa anthu athanzi chikufika pa 1 miliyoni.

Insulin imapangidwa ndi maselo a beta ndipo imayang'anira kayendedwe ka kagayidwe kazachilengedwe ndi lipid (mafuta). Mothandizidwa ndi, glucose amalowa m'magazi kulowa m'matumbo ndi maselo amthupi, ndipo potero amachepetsa shuga m'magazi. Maselo a Beta amapanga 60-80% ya zisumbu za Langerhans.

Glucagon imapangidwa ndi maselo a alpha ndipo imatsutsana ndi insulin, i.e., imakulitsa kuchuluka kwa glucose m'magazi. Ma cell a Alpha amathandizanso kupanga lipocaine, yomwe imalepheretsa mafuta kuwonongeka kwa chiwindi. Gawo lawo pazilumba za Langerhans pafupifupi 20%.

Zilumba za Langerhans zilinso ndi maselo ena ochepa, mwachitsanzo, maselo a delta (1%), omwe amatsekereza ma ghrelin a mahomoni, omwe amachititsa chidwi cha kudya komanso amathandizira kudya. Maselo a PP (5%) amatulutsa polypeptide ya pancreatic yopangidwa ndi ma amino acid okwanira 36 ndikuletsa pancreatic secretion.

Kuwonongeka kwa maselo a beta kumabweretsa zoletsa kupanga insulin, zomwe zimayambitsa chitukuko cha matenda ashuga. Zizindikiro za izi ndi ludzu losatha, kuyabwa pakhungu, komanso kutulutsa mkodzo kwambiri.

Zikondazo zimagwirizana kwambiri ndi ziwalo zina zam'mimba. Zowonongeka zilizonse pa izo kapena kusokonezedwa kwa chochitikacho zimakhudza gawo lonse logaya chakudya.

Kodi kapamba mwa anthu ali kuti?

Zikondwererozo zimapezeka m'mimba kumbuyo kwa m'mimba, moyandikana ndi iyo ndi duodenum, pamlingo wam'mwamba (woyamba kapena wachiwiri) wa lumbar vertebrae. Pakaneneratu kukhoma lam'mimba, ndi 5-10 masentimita pamwamba pa msana. Pancreas ili ndi mawonekedwe a alveolar-tubular ndipo imakhala ndi madipatimenti atatu: mutu, thupi ndi mchira.

Mutu wa kapamba umakhala mumphepete mwa duodenum kotero kuti matumbo amawaphimba ngati mawonekedwe a khola la akavalo. Imalekanitsidwa ndi thupi la chithaphwi ndi poyambira pomwe mtsempha wama portal umadutsamo. Momwe magazi amaperekera ku zikondamoyo kudzera m'mitsempha ya pancreas-duodenal, kutuluka kwa magazi kumachitika kudzera m'mitsempha ya portal.

Mthupi la kapamba, kutsogolo, kumbuyo ndi malo apansi ndizodziwika. Zimasiyanitsanso m'mbali zam'mwamba, kutsogolo ndi m'munsi. Kutsogolo kwake kuli pafupi ndi khoma lanyumba yam'mimba, pang'ono pansipa. Kumbuyo kwake kumayandikira msana ndi m'mimba msempha. Zingwe zam'mimba zimadutsa. Malo apansi ndi otsika kuposa mizu ya colon yopingasa. Mchira wa nduluyo uli ndi mawonekedwe ofanana, owongolera kumanzere ndikufikira pazipata za ndulu.

Zikondazo zimakhala ndi mitundu iwiri ya minyewa yomwe imagwira ntchito zosiyanasiyana (endocrine ndi exocrine). Minofu yake yayikulu imapangidwa ndi lobules yaying'ono - acini, yomwe imasiyanitsidwa wina ndi mzake ndi zigawo za minofu yolumikizira. Ululu uliwonse umakhala ndi duct yawo. Zitsamba zazing'onoting'ono zazing'ono zimalumikizana ndikuphatikizidwa mu duct wamba, yomwe imayendetsa kukula kwa kutulutsa kutalika kwake kutalika konse, kuyambira mchira mpaka mutu. Pamphepete lamanja la mutu, duct imatseguka kulowa duodenum, yolumikizana ndi duct wamba wa bile. Chifukwa chake, chinsinsi cha pancreatic chimalowa mu duodenum.

Pakati pa lobes pali magulu a ma cell (ma islets a Langerhans) omwe alibe ma ducts, koma ali ndi ma cell amitsempha yama cell ndi insulin insulin ndi glucagon mwachindunji m'magazi. Pakatikati pa chilumba chilichonse pali ma micons a 100-300.

Makulidwe achikondwerero

Mwa kukula kwake, kapamba amatenga malo achiwiri pambuyo pa chiwindi pakati pa ziwalo zomwe zimapanga michere. Mapangidwe ake amayamba kale sabata lachisanu la mimba. Mwa mwana wakhanda, chitsulo chimakhala ndi kutalika kwa 5 cm, mwana wazaka chimodzi - 7 cm, pofika zaka 10 kukula kwake ndi 15 cm. Imafika pa kukula kwake komaliza paunyamata, mpaka zaka 16.

Mutu wa kapamba ndi gawo lalifupi kwambiri, m'lifupi mwake mpaka 5 cm ndi zina, makulidwe amasiyanasiyana kuyambira 1.5 mpaka 3 cm. Thupi la England ndi gawo lalitali kwambiri, kutalika kwake kuli pafupifupi 1.75-2.5 cm. Kutalika kwa mchira - mpaka 3.5 cm, m'lifupi mwake pafupifupi 1.5 cm.

Chifukwa cha malo akuya, kuwonekera kwa ma pancreatic pathologies ndikovuta kwambiri. Chifukwa chake, chofunikira chodziwitsira matenda ndi kafukufuku wa ultrasound omwe amakupatsani mwayi kuti muwone mawonekedwe ndi kukula kwa kutulutsa, kutengera momwe mungadziwire zoyenera zokhudzana ndi momwe ziliri.

Makulidwe onse a ziwalo, komanso zomwe zimapangitsa kusintha kwawo, zalembedwa mwatsatanetsatane mu protocol ya ultrasound. Munthawi yosasinthika, chitsulo chimakhala ndi mawonekedwe ofanana. Kupatuka kwakung'ono kuchokera kukula kwakukuru kwa mutu, thupi ndi mchira ndizovomerezeka pokhapokha ngati pakuwoneka magazi abwino.

Kodi kapamba ndi chiyani?

Chofunikira ichi chimbudzi chimagwira ntchito za endocrine komanso exocrine m'thupi. Zikondamoyo zimapereka chisa chosasokoneza cha pancreatic madzi, chofunikira pakupanga chakudya chokwanira, kugwira ntchito mokwanira m'mimba. Kuphatikiza apo, imayang'anira kagayidwe kachakudya ka thupi, kuphatikiza chakudya, lipid ndi mapuloteni. Izi ndizomwe kapamba imayang'anira, chifukwa chake kusowa kwa ntchito kumapangitsa kuti pakhale kusalinganika kwathunthu kwa organic.

Kodi kapamba amatulutsa chiyani?

Kupanga madzi a pancreatic ndikofunikira kwambiri chifukwa timadzi timeneti timakhala ndi ma enzymes omwe ndi ofunikira pakugaya chakudya moyenera. Ngati kupweteka kwakumbuyo pamimba ndikusokoneza, ndikotheka kuti ntchito yayikulu ya kapangidwe kameneka ndi yoperewera. Mukudziwa kale momwe kapamba amagwirira ntchito mwa anthu, ndipo pazofunikira zake, ndi nthawi yoti mupeze upangiri wa katswiri - gastroenterologist.

Ili kuti

Kapangidwe kameneka kamapezeka pansi pamimba, chifukwa chake dzina lodziwika bwino. Imasanjikizidwa pafupi ndi khoma lakumbuyo makamaka kumanzere, koma mothandizidwa ndi zinthu za pathogenic imatha kusintha pang'ono, ndikusunthira kumanja. Moyandikana ndi duodenum ndi m'mimba, pafupi ndi vertebra yoyambirira. Kuti mumvetsetse bwino komwe kapamba amapezeka kunja, ndikofunikira kuyang'ana pa mfundo ina. Ili pamtunda wa navel ndi masentimita 5 mpaka 10, pomwe gwero la chisokonezo pamlingo wobwereza limasanjidwa.

Popeza kapamba amapezeka pafupi ndi ndulu, kuyambira kugonjetsedwa kumangokulitsa chotupa. Wodwala ayamba kudwala, nthawi yomweyo mantha. Matenda am'mimba akupanga mofulumira. Ndipo chinthu choyamba chomwe ndikofunikira kuyankha ndi boma la ndowe panthawi yosenda matumbo osakonzekera. Popanda chithandizo, chiwalochi chidzadwala kwa nthawi yayitali.

Momwe kapamba amapwetekera

Mu zolemba pa anatomy, mutha kuwona momwe chiwalocho chikuwonekera, koma ndizovuta kumvetsetsa zowawa zomwe zimachitika ndi kapamba, komwe umayang'ana kwambiri za matenda. Choyamba, wodwalayo amamva kupweteka kumanja, mu hypochondrium. Ngati simuyankha ku zowopsa, ululu wammbuyo umangokulitsa, umawopsa ndi kulimba kwake.

Ngati njira zochizira sizinatengedwe, kapamba amapitilizabe kudzikumbutsa yekha ndi zosasangalatsa pam mbali yolondola. Awa ndi matenda omwe ali kale, momwe sizingathenso kuthetseratu njira yotupa. Komwe kuli kapamba kumapangitsa kuti zikhale zovuta kudziwa komwe kumayambira komanso komwe kumayambira, kotero dotolo yemwe amafunikira angafunike kufufuzidwa kwathunthu kwamatenda onse.

Zomwe zimapweteka

Kugwirizana kwa ndulu ndi njira yotsatsira m'mimba ndizodziwikiratu. Ndi njira yotupa, imakulitsa kukula kwake, imapanikizika kwambiri ziwalo zoyandikana. Izi ndizowopsa chifukwa cha kutuluka kwatsopano, chiopsezo cha oncology chikuwonjezeka. Chifukwa chake, ndikofunikira kwambiri kudziwa munthawi yake zomwe ziphuphu zimapweteka, ndikuchotsa izi zomwe zikuwonjezera moyo wa wodwala munthawi yake. Mu chithunzi chachipatala chotere, zifukwa zotsatirazi zimasiyanitsidwa:

zakudya zopanda thanzi, kulephera kutsatira zakudya zopatsa thanzi, kudya zakudya zamafuta,
matenda a bile duct
cholowa choyipa
zizolowezi zoipa
Kugwiritsa ntchito kwakanthawi mankhwala a magulu osiyanasiyana a mankhwala, monga mahomoni,
zotupa za autoimmune
kupsinjika mtima
mavuto
matenda a ndulu,
onenepa kwambiri chifukwa cha kuchuluka kwa chiwindi.
kuyambiranso kwina kwamatenda am'mimba a mawonekedwe osachiritsika.

Mawonekedwe ndi kulimba kwa ululu wamatenda zimatengera kuthekera kwazomwe zimayambitsa matenda. Dokotala ayenera kuchita zonse momwe angathe kuti adziwe moyenera komanso panthawi yake. Zitha kupweteketsa bwino kumanja ndikumanzere, koma njira yodziwikitsira yazidziwitso iyi sikokwanira. Muzochita zachipatala, pali mitundu itatu ya zizindikiro zowawa, chilichonse chimakhala ndi zomwe chimanena. Chithunzi cha chipatala chitha kutsimikiziridwa ndi izi:

Chizindikiro cha Hubergrits-Skulsky chimadziwika ndi kupweteka kwambiri, komwe kumadziwika mchira wa chiwalo.
Chizindikiro cha Zakharyin chili ndi zotupa zambiri za mutu wa England, makamaka za chotupa.
Chizindikiro cha Fitz chikuwonetsa njira yayikulu yotsatsira, chifukwa ululu wambiri umakhala wolimba kwambiri mpaka umapangitsa kuti ngakhale munthu wathanzi azikumbukira kuti kupanikizana kuli mbali iti.

Choyamba, izi ndikukoka kwa zomverera m'mbali, zomwe zimasandulika kupweteketsa thupi pamene thupi liyenda. Popita nthawi, wodwalayo sangachite kalikonse, ndipo kuukiridwa koopsa kumangochitika. Sichikuphatikizidwa pokhapokha ngati pakhale matenda oopsa ngati kapamba, omwe mu mawonekedwe apamwamba amatsogolera pakupanga zotupa zoyipa za m'mimba. Kupweteka kwapweteka m'mapazi kumayenera kukhala chizindikiro chowopsa, makamaka kwa akazi. Kuukira kumachitika pafupipafupi.

Zizindikiro zamatenda a kapamba

Asanawongolere wodwalayo kuti ayesedwe, adokotala amafufuza kuti apeze njira yoyambira yozitsatira pogwiritsira ntchito deta ya anamnesis. Ndikwabwino kunenanso zowonera kunyumba nthawi yomwe mwapangana ndi katswiri kuti awerenge chithandizo chomwe chayamba pa nthawi yake. Wodwala amafunikira momwe angamvetsetsere zomwe zikondazo zimapweteka, komanso ndi zizindikiro ziti za matendawo kuti azimvera. Izi ndi:

kupwetekedwa mtima pafupipafupi (kumatha kusanza pambuyo chakudya chamafuta),
malungo, kutentha thupi, kutentha thupi,
ulemu, zizindikiro za dyspepsia,
kukodza pafupipafupi (makamaka ndikufuna kuchita izi usiku),
kusanza pafupipafupi, kuchepa kwa ntchito,
kulakalaka kwambiri m'mawa
kusowa tulo.

Ngati kapamba wakuda nkhawa - komwe kuli, ndi momwe zimapwetekera, dokotala wa matumbo anena. Komanso, katswiriyu adzafotokozerani za matenda omwe ali ndi chithandizo chokwanira kuti apulumutse wodwalayo pomuvutitsa. Imwani mankhwalawa munthawi yake, chitani malangizo onse a dotolo, ndipo kuchira kwake kumachitika popanda zovuta.

Pancreas anatomical malo

Nthenga zikupezeka m'mimba, pafupi ndi I - II vertebrae of the lumbar spine. Chiwalocho chimamangika zolimba kukhoma lakhomalo la m'mimba, ndipo duodenum imazungulira, ndikuyigwirizira m'malo ofunikira.

Magawo a kapamba wa munthu wamkulu ayenera kukhala 20-25 cm, kulemera - 70-80 magalamu.

Malinga ndi mawonekedwe a anatomical, chiwalocho chimagawidwa m'magulu atatu: uyu ndi mutu, thupi ndi mchira. Mutu wa kapamba ukuyang'anizana ndi bile duct, thupi limakhala kumbuyo kwa m'mimba, pafupi ndi gawo lake lamunsi. Pafupifupi ndi thupi, kholalo yopingasa imakonda kupezeka. Mchira wa kapamba umasinthidwa kukhala ndulu, ndikupita kumanzere kwa hypochondrium. Pogwirizana ndi navel, kuchokera kumbali ya khoma lamimba, kapamba amakhala pamwamba pake, 5-10 cm.

Muyenera kudziwa komwe kapamba kali mwa munthu kuti athe kusiyanitsa ndi zowawa ndi zisonyezo zina za ziwalo zamkati.

Ntchito za m'mimba michere ya kapamba

Ntchito ya procrine ndikupanga ma enzyme otsatirawa omwe amapanga madzi a pancreatic: trypsin, lipase, ndi amylase:

Trypsin imaphwanya peptides ndi mapuloteni. Poyamba, amapangidwa ndi kapamba mu mawonekedwe a trypsinogen, omwe amalephera, omwe amayamba ndi enterokinase (enteropeptidase), puloteni yotulutsidwa ndi mucosa yamatumbo. Kansa ndi chiwalo chokhacho mthupi chomwe chimapanga trypsin, kotero kudziwa mulingo wake ndikofunikira kwambiri pakuwunika kwa kapamba kuposa kuwunikira kwa ma enzymes ena. Kudziwitsa za trypsin ntchito ndikofunikira kwambiri pakuwonetsa pancreatitis pachimake ndi kuzindikiridwa kwa pathogenesis yake.

Lipase ndi enzyme yosungunuka yamadzi yomwe imagaya ndikusungunula mafuta a triglycerides (mafuta osagwirizana). Amapangidwa ngati mawonekedwe a prolipase, ndipo kenako mothandizidwa ndi ma enzymes ena ndi ma asidi a bile amadutsa mu mawonekedwe othandizira. Lipase imaphwanya mafuta osalowerera m'thupi kukhala mafuta ochulukirapo komanso glycerin. Komanso enzymeyi imakhudzidwa ndi kagayidwe ka mphamvu, popereka minyewa yamafuta achilengedwe a polyunsaturated mafuta komanso kutenga mavitamini ena osungunuka. Kuphatikiza pa kapamba, lipase imapangidwa ndi chiwindi, matumbo, mapapu, ndipo mtundu uliwonse wa lipase ndizomwe zimapangitsa kuti gulu lina la mafuta lisokonekere. Ndi hypofunction ya kapamba, ntchito ya lipase imachepetsedwa makamaka. Chizindikiro choyamba cha izi ndi chopondapo chamafuta cha imvi.

Amylase (alpha-amylase) ndiyofunikira pakuwonjezera mafuta omwe amalowa mthupi. Imasungidwa ndi kapamba ndipo (pang'ono pang'ono) ndi tiziwalo tating'ono. Zosintha pazomwe zili mu enzymeyi m'magazi ndizomwe zimayambitsa matenda ambiri (matenda a shuga, hepatitis, etc.), komabe, izi zimawonetsa pancreatitis yovuta kapena yosatha.

Mosiyana ndi zinthu zina zomwe zimakhudzidwa ndikugaya, michere ya pancreatic imachotsedwa pakudya pokhapokha - chinsinsi chake chogwira ntchito chimayamba mphindi 2-3 chakudya chikamalowa m'mimba ndipo chimatha maola 12-14. Enzymes amatha kugwira ntchito zawo pokhapokha ngati pali kuchuluka kokwanira kwa bile kamene amapangidwa ndi ndulu. Bile imayendetsa ma enzymes, komanso imaphwanya lipids m'magulu ang'onoang'ono, i.e., imawakonzekereratu. Ma pancreatic michere amapangidwa osagwira ntchito ndipo amangopangika mu lumen ya duodenum pansi pa entokinase.

Zizindikiro za kuperewera kwa pancreatic enzyme

Kuphulika kwa katulutsidwe, kuchepa kwake ndi kuchepa kwa michere ya kapamba mwa munthu wamkulu nthawi zambiri kumachitika chifukwa cha chifuwa cham'mimba - kutukusira kwa chiwalo ichi, komwe kumayendetsedwa ndi kupindika pang'onopang'ono kwa minofu ya glandular.

Poyamba pakati pazomwe zimayambitsa kupweteka kwa kapamba ndi kumwa mowa mwauchidakwa, mwa zina mwazomwe zimadziwika kuti ndizosayenera, zakudya zopanda pake, matenda opatsirana (cholelithiasis), matenda, kuvulala, kumwa mankhwala.

Kuperewera kwa trypsin, lipase ndi amylase kumayambitsa matenda akulu am'mimba.

Zizindikiro zodziwika za mavuto a pancreatic:

kupweteka pamimba kwakumanzere pansi pa nthiti, zomwe zimakonda kupezeka mutatha kudya, koma sizingagwirizane ndi kudya,

kuchepa kapena kusowa kwa chakudya,

kugwedezeka pamimba, kusefukira,

kusintha kwa maonekedwe ndi kusasintha kwa chopondapo.

Kukula kwa zizindikirozi kumatengera kuwonongeka kwa ndulu. Chifukwa cha chimbudzi chochepa, thupi limasowa michere, komanso kusokonekera kwa metabolic kungayambitse matenda a osteochondrosis, nyamakazi, komanso mtima wamatumbo.

Steatorrhea imakhala ndi vuto la kuchepa kwa lipase (kutulutsa kwambiri mafuta ndi ndowe), chopondapo chimatha kukhala ndi chikaso cha chikasu kapena lalanje, nthawi zina pamakhala kutulutsidwa kwamafuta amadzimadzi popanda ndowe, chopondapo ndimadzi, mafuta.

Ndi kusowa kwa amylase, kusalolera zakudya zopatsa mphamvu wamagazi kumawonedwa, pafupipafupi, mosasunthika, kuthina kwamadzi ambiri chifukwa cha wowuma wowonjezera, kupweteka kwa malabsorption (malabsorption a michere m'matumbo ang'onoang'ono, limodzi ndi matenda am'mimba, kuchepa kwa vitamini, kuchepa kwa thupi), zazambiri zama microflora a pathogenic mu matumbo.

Kuperewera kwa Trypsin kumawonetsedwa pang'onopang'ono kapena mozama mu michere (kuchuluka kwachuma mu mpweya wa nayitrogeni ndi minyewa yopanda minofu, i.e. protein), zopondera ndi mushy, fetid, kuchepa magazi.

Popeza njira yogawa ma cell mamolekyulu a chakudya imasokonekera, ndipo siimakhudzidwa kwathunthu ndi thupi, ngakhale ndimphamvu zopatsa thanzi, kuchepa kwa thupi, kuchepa kwa vitamini, khungu lowuma, misomali ya brittle ndi tsitsi zimatha kuwonedwa. Chakudya chosakonzedwa bwino chikafika kuchokera m'matumbo ang'ono kulowa m'matumbo akulu, kumachitika pang'onopang'ono (kupangika kwa gasi ndi mpweya wotuluka), matumbo amkati.

Ndi kuchepa kwa katulutsidwe ka michere ndi kapamba, mankhwala amaloledwa, komabe, ma enzymes amachokera ku chomera sangakulipire zonse chifukwa cha kuchepa kwa katulutsidwe wake wakunja.

Ngati kutuluka kwa ma enzymes m'matumbo kumayipa, izi zimatha kuyambitsa kukhumudwa kwa minofu ya m'mimba ndi edema yake, kenako ndikuwonongeka komanso necrosis.

Zowonongeka zazing'onoting'ono za Langerhans, kupanga insulini kumapanikizika ndipo zizindikiro zamatenda a mtundu woyamba wa 1 zimayang'aniridwa, kuwopsa kwake komwe kudzadalira kuchuluka kwa maselo a beta osungidwa komanso ogwira ntchito kwambiri. Kuperewera kwa khungu la glucagon sikumveka kwambiri, chifukwa pali mahomoni ena omwe ali ndi vuto lofananalo: mwachitsanzo, mahomoni a steroid opangidwa ndi ma adrenal gland ndikuwonjezera kuchuluka kwa shuga m'magazi.

Zizindikiro

Ngati pancreatitis ikukayikiridwa, adokotala amafufuza ndikuwunika wodwalayo, kuti apenyerere khungu lake ndi nembanemba. Nthawi zina ululu umatha kukhala ndi kutengera kosiyanasiyana kutengera gawo la gland lomwe lawonongeka. Ngati zimapweteka msomali mu hypochondrium yoyenera, zikutanthauza kuti mutu wa gland umakhudzidwa ndi pathological process, ngati kumanzere - mchira. Ululu wopanda pake m'mimba kumtunda umawonetsa kuwonongeka konsekonse. Mutha kusiyanitsa zovuta ndi kapamba ndi chimbudzi choponderezana motere: adotolo amatsutsa malo opweteka, woyamba pamalo apamwamba, kenako kumanzere. Ndi zowonongeka kwa kapamba, ululu womwe uli pambaliyo udzakhala wocheperako, mavuto omwe ali ndi colon yopingasa, amakhalabe omwewo.

Kuchokera pa mayeso a labotale, kutsimikiza kwa serum amylase, lipase, ndi milingo ya trypsin ndi mankhwala. Ndi kuyesedwa kwa magazi, kuwonjezeka kwa mulingo wa leukocytes kumawonedwa. Kuphatikiza apo, ntchito yama enzymes a chiwindi imatha kufufuzidwa: ALT ndi alkaline phosphatase, komanso bilirubin, kuchuluka kwawo kumatha kukhala chizindikiro cha kuukira kwa kapamba chifukwa cha ma gallstones. Kuyeserera kwa mkodzo kwa amylase kumapangidwanso pogwiritsa ntchito mayeso a PABA (PABA), kuyeserera kwa chopondapo kupezeka kwa chymotrypsin, trypsin komanso kuchuluka kwamafuta. Kuti muwone kusokonezeka kwa kagayidwe kazakudya, kuchuluka kwa shuga m'magazi kumatsimikizika.

Kuchokera munjira zothandiza;

X-ray - ndi thandizo lake imatsimikizika ngati kapamba amakulitsa kapena ayi,

Dongosolo la tomography kapena MRI - kufotokozera bwino za matendawa, kuzindikira pancreatic necrosis kapena kuchuluka kwa madzimadzi m'mimba,

Ultrasound - kuphunzira kapangidwe ndi mawonekedwe a mavu a gland, dziko lodziwika bwino la duct, kudziwa kukhalapo kwa ma gallstones.

Ndi vuto la pancreatitis yovuta kwambiri, kusala kwathunthu ndikofunikira masiku 1-2, chifukwa madzi a pancreatic pamenepa adzapangidwa pang'ono, ndipo katundu wochokera ku gland amachotsedwa. Nthawi zambiri, chilala chimachepa kapena kusowa kwathunthu masiku angapo chisanachitike kukokosera. Munthawi imeneyi, muyenera kumwa madzi amchere (madzi amchere opanda mpweya, yankho la soda) kapena msuzi wa rosehip.

Ngati muli ndi ululu wam'mimba kwambiri, kusanza kwambiri, kapena kupweteka pang'ono kwa masiku angapo, muyenera kulumikizana ndi achipatala, chifukwa izi zimatha kukhala zizindikiro za cholecystitis, appendicitis, zilonda zam'mimba kapena matumbo.

Pankhani ya pancreatitis pachimake, kuchipatala ndi kulandira chithandizo kuchipatala ndikofunikira. Popewa kuchepa kwamatenda ndikuchepetsa kukakamiza, amachepetsa dontho. Ma painkiller ndi mankhwala omwe amachepetsa kubisala kwa michere ndi mankhwala. M'masiku oyamba a 3-4, amathandizidwa kudzera m'mitsempha, ndipo pambuyo pothandizidwa ndi mapiritsi. Pofuna kuchepetsa ululu mu kapamba, ayezi angagwiritsidwe ntchito.

Zopweteka

Ma antispasmodics omwe amagwiritsidwa ntchito kwambiri: Baralgin, No-Shpa, Papaverin, Drotaverin, wokhala ndi ululu wokwanira, mutha kugwiritsa ntchito Acetaminophen kapena Ibuprofen. Ma analgesics nthawi zina amagwiritsidwa ntchito: Aspirin, Paracetamol. Cholinolytic ndi antihistamines angagwiritsidwenso ntchito: Atropine, Platifillin, Diphenhydramine.

Maantacid

Kuti muchepetse kupweteka komanso kupewa kukwiya komanso kupweteka kwam'mimba, mankhwalawa amagwiritsidwa ntchito ngati ma suspensions ndi ma gels omwe amalepheretsa hydrochloric acid (Almagel, Fosfalugel) ndi mankhwala omwe amachepetsa kupanga kwake (Kontralok, Omez, Omeprazole, Gastrozole, Proseptin, Ocid). M'm zipatala, H2-blockers Ranitidine, Famotidine kapena analogues Acidex, Zoran, Gasterogen, Pepsidin ndi omwe amapatsidwa.

Kukonzekera kwa enzyme

Pofuna kuchepetsa kupanga ma enzyme, Contrical kapena Aprotinin amagwiritsidwa ntchito. Pambuyo pochotsa matenda osokoneza bongo komanso kupweteka kwamatumbo, mankhwala a enzyme adayikidwa kuti azigwira ntchito kapamba ndi kukonza chimbudzi. Mankhwala omwe amakonda kwambiri ndi Pancreatin, Mezim, Festal, Creon, Panzinorm. Komabe, zimapangidwa pamaziko a mapuloteni a nkhumba, chifukwa chake, pakakhala zovuta zonse za nkhumba, sizingatengedwe. Ana, zotere sizingayambitse matumbo. Pankhaniyi, kukonzekera kwazitsamba kutengera mpunga wa mpunga kapena papain kumayikidwa: Unienzyme, Somilase, Pepfiz.

Enzymes amatengedwa atangodya, mlingo umayikidwa ndi dokotala payekha. Njira ya chithandizo ndi yayitali, nthawi zambiri othandizira amakhala ofunika pamoyo wawo wonse.

Mwa mankhwala ena, pancreatic secretion imalimbikitsidwa ndi pilocarpine, morphine, vitamini A, magnesium sulfate, ndi histamine ndi atropine amatsitsidwa. Posemphana ndi exocrine ntchito, kukonzekera kwa insulin kumayendetsedwa kuti azilamula kuchuluka kwa shuga m'magazi. Njira yodzipulumutsira nokha yopweteketsa kapamba ndizosavomerezeka. Izi zimatha kubweretsa necrosis, matenda ashuga, kapena poyizoni wamagazi.

Zovuta za chifuwa cham'mimba chimatha kusokoneza mitsempha ya ziwalo, ma ducts, zotupa, matenda kapena necrosis ya zimakhala zake (necrosis).

Kuthandizira opaleshoni

Mapaipi ndi chiwalo chokhwima kwambiri komanso chopanda chidwi, motero kuchitapo kanthu kuchitidwa opaleshoni sikofunikira. Opaleshoniyo ikhoza kufunikira pamene chotsekera cha ndulu chitsekeka, ngati pali chotupa, ndimiyala mu ndulu (nthawi zina ndulu imachotsedwa), ngati kuli kofunikira, chotsani gawo lina la kapamba chifukwa cha chitukuko cha kapamba.

Ntchito ya zakudya mankhwalawa kapamba

Kudyetsa chakudya ndi gawo lofunikira kwambiri pothandizira komanso kupewa kufalikira kwa kapamba. Mukanyalanyaza izi, mankhwala aliwonse sangakhale opanda mphamvu. Popeza kuchuluka ndi kuchuluka kwa ma enzymes omwe amapangidwa ndi chitsulo kumasiyanasiyana malinga ndi zomwe zimapangidwa pazakudya chimodzi, ndikulimbikitsidwa kuti musinthane ndi zakudya zopatsa thanzi kuti muchepetse katundu pazitsulo, i.e. Komanso, munthu sayenera kudya mopitirira muyeso: kudya zakudya za tsiku ndi tsiku za caloric sikuyenera kupitirira zofanana ndi zaka, kugonana komanso mtengo wa mphamvu ya thupi.

Zakudya zamafuta, zakudya zokazinga,

Soseji, zakudya zam'chitini, nyama zosuta, zipatso

Tiyi wamphamvu komanso khofi

Confectionery (makeke, makeke), ayisikilimu,

Zonunkhira zokometsera, zonunkhira ndi zokometsera, mpiru, horseradish.

Nkhuku, nkhuku, kalulu, kuchokera ku nsomba - nsomba zamkati, zofanizira, nsomba za pike, pike,

Zakudya zotentha

Sort curd, tchizi watsopano,

Masamba ophika kapena ophika,

Masamba amphaka, phala, vermicelli,

Mpunga, oatmeal, buckwheat, pasitala,

Batala ndi mafuta ophikira masamba popanda kuchitira kutentha,

Kissel, compote, zakudya.

Maphunziro: Dipuloma mu "General Medicine" yapadera idapezeka ku Russian State Medical University. N.I. Pirogova (2005). Maphunziro omaliza maphunziro mu "Gastroenterology" yapadera - maphunziro ndi sayansi yazachipatala.

Maphikidwe A tsitsi Labwino Kwambiri 5!

Zopezeka muzapulasitiki: zowona ndi zabodza!

Kufalikira kwa matenda kapamba kumachitika chifukwa cha kupatsirana komwe kumachitika mu kapamba. Amuna opitilira 40 ndi omwe amatenga matendawa mosavuta, koma m'zaka zaposachedwa pakhala chiwopsezo cha kapamba wamafuta kwambiri azimayi ndi achinyamata.

Mphepoyi ndi chiwalo chamkati chofunikira kuti mayamwidwe a glucose omwe amalowa mthupi la munthu ndi chakudya. Imasunga ma mahomoni monga glucagon ndi insulin, komanso ma enzyme ena ndi mahomoni ofunikira kuti azilowetsa chakudya moyenera. Kutupa kwa chiwalochi kumatchedwa pancreatitis. Ngati ma enzymewo akhazikika.

Chimodzi mwazinthu zofunika kwambiri zam'mimba, zomwe zimaloleza kuti zizigwira bwino, ndi kapamba. Amapanga ma enzymes onse am'mimba ndi mahomoni (insulin ndi glucogan), omwe amachititsa shuga m'magazi. Kuti thupi lizigwira ntchito bwino, pamafunika "kuzidyetsa" bwino.

Pancreatitis si matenda omwe mutha kuiwala bwinobwino ndikudikirira kuchotsedwa kwa kapamba. Ngati mukukayikira ngakhale zamatenda awa, ndiye kuti muyenera kufunsa dokotala. Kutengera ndi kuopsa kwa matendawa, amatha kuthandizidwa kunyumba komanso kuchipatala.

Choyambitsa chachikulu cha pancreatitis ndi kuperewera kwa zakudya m'thupi ndizakudya zamafuta ambiri ndi zonunkhira komanso kumwa mowa kwambiri. Matendawa amadziwika ndi kupweteka kwa m'chiuno m'chigawo cha epigastric cham'mimba, chomwe chimatha kubwezeretsanso kumbuyo. Mosiyana ndi zilonda zam'mimba, kupweteka sikuyenda ndi kutentha kwa mtima, sikukula.

Cancreas ndi gawo lamkati la secretion lomwe limatulutsa glycogen, insulin ndi pancreatic juice. Loyamba ndi michere yosungirako thupi. Imayimira mtundu wa mphamvu, womwe umagwiritsidwa ntchito ndi thupi pakafunika.

Kutupa kwa pancreatic, kapena pancreatitis, ndi njira imodzi yosasangalatsa komanso yovuta kuchiza matenda am'mimba. Zizolowezi zoyipa komanso chakudya chopanda thanzi, chokhala ndi mafuta ambiri komanso zowonjezera zakudya, zimathandizira kuti zizichitika. Ichi ndichifukwa chake motsogozedwa ndi chithunzithunzi chamakono chamatauni.

Kodi kapamba amapezeka kuti?

Katswiri wopangika wa kapamba ali m'mimba, pamlingo I - II wa lumbar vertebrae. Chiwalo chimagona kumbuyo kwa m'mimba. Duodenum imayenda mozungulira kapamba munjira ya "kavalo". Mwa munthu wamkulu, kukula kwa kapamba ndi 20 - 25 cm, kulemera - 70 - 80 magalamu. Chiwalocho chili ndi nthambi zitatu: mutu, thupi ndi mchira.Mutu umakhala pafupi ndi duct ya bile, thupi limakhala kumbuyo kwa m'mimba ndipo pang'ono pansi pake, pafupi ndi colon yopindika, mchirawo uli pafupi ndi ndulu. Ikayikidwa kutsogolo kwa khoma lamatumbo lachitsulo, ili pamwamba pa msomali wa masentimita 5 mpaka 10. Mutu umakhala mbali yakumanja kwa midline, mchira umapita pansi pa hypochondrium yamanzere. Ntchito ziwiri zofunika kwambiri za pancreatic ndi exocrine ndi endocrine. Ntchito ya exocrine imakhala yopanga (secretion) yamadzi apachifini ofunikira kuti chimbudzi cha chakudya chikhale mu duodenum. Zakudya zam'mimba za pancreatic juice zopangidwa ndi kapamba:

trypsin ndi chymotrypsin omwe amaphatikizidwa ndi chimbudzi cha protein,
lactase ndi ma amylase zofunika pakuwonongeka kwa chakudya,
lipases yomwe imaphwanya mafuta a bile kale oonekera kale.

Kuphatikiza pa ma enzyme, madzi a pancreatic ali ndi zinthu zomwe zimapangitsa kuti acidic ikhale ndi madzi a m'mimba kuti iteteze matumbo a mucosa pakuwonekera kwa asidi. Ntchito ya endocrine ya gland imapangidwa pakupanga insulin ndi glucagon - mahomoni omwe amaphatikizidwa ndi kagayidwe kazachilengedwe. Mothandizidwa ndi insulin, shuga m'magazi amatsika, mothandizidwa ndi shuga amadzuka. Pa chikhalidwe cha insulin ndi glucagon, kagayidwe kazakudya kamene kamachitika mokwanira, motsatira - shuga imatha kuchitika. Ululu pamimba ndi zizindikiro za kupukusa m'mimba zimachitika ndi matenda osiyanasiyana. Ndikofunika kumvetsetsa pamene mawonekedwe owawa akuphatikizidwa ndi matenda a kapamba, ndikuchita zinthu zofunika panthawi.

Zizindikiro zazikulu za matenda a kapamba

Mavuto aliwonse omwe amakhalapo chifukwa cha kuchepa kwa mapangidwe a enzoni ya pancreatic amayenda limodzi ndi zizindikiro. Zizindikiro zofala kwambiri ndizopweteka komanso kudzimbidwa. Mwa akazi ndi abambo, zizindikilo ndizofanana. Kutengera ndi kuuma kwa njirayi, kukula kwa kupweteka, komanso kuuma kwa zovuta kwaysyspeptic, zitha kukhala zosiyana. Matenda omwe amawonetsa kwambiri ndikuphwanya kapamba:

kupezeka kwa kupweteka, kufalikira kwa kupweteka - kumtunda kwa m'mimba, kumanzere kwa hypochondrium, kupweteka kumatha kugwirizanitsidwa kapena kusakhudzana ndi kudya,
kusanza pafupipafupi, kusanza ndikotheka,
chilala chodumphira m'munsi mpaka pomwe palibe,
kutulutsa ndi kugudubuka m'mimba (bata),
kusokonezeka kwa chopondapo, pafupipafupi - kutsekula m'mimba, ndowe zimatha kukhala zosafunikira zamafuta osaphatikizika, mafuta,
Zizindikiro za kuledzera (nkhawa zam'mtima, kutopa, kufooka, thukuta, kupweteka mutu),
kukulitsa chiwindi
kusintha kwa khungu (jaundice), nthawi zambiri m'malo a pancreas.

Matenda omwe amayamba chifukwa cha kuchepa kwa michere:

pachimake kapamba (kutupa kwa kapamba, nthawi zambiri limodzi ndi edema),
aakulu kapamba
zotupa mu kapamba,
kukula kwa matenda ashuga
kapamba.

Kodi kapamba pakati pa anthu ndi kuti

Iron ndiye chiwalo chomwe chimapereka kupangidwa kwa madzi a m'mimba ndi michere yofunika. Nthambi zopangidwa ndi iye zimathandizira kukonza mapuloteni ndi mafuta. Kuphatikiza apo, timadzi tating'onoting'ono ta endocrine timene timapezeka m'maselo a islets timayambitsa kuphatikizidwa kwa insulin ndi glucagon omwe amatenga nawo gawo la metabolic yama carbohydrate ndikuwongolera kuchuluka kwa shuga m'magazi.
Kunja, chiwalocho chimayimilidwa ndi chinthu chotalikirapo, chomwe kukula kwake ndi 16-23 cm.

Zikondwererozi zimakhala ndi magawo atatu - mutu, thupi ndi mchira.

Kodi kapamba mwa anthu ali kuti? Kukula kwachilendo kwa thupi kumbuyo kwa m'mimba, pafupi ndi duodenum, kuphatikiza ndi iyo kudzera mu ma ducts. M'matumbo mwake mumakhala zodutsa, ndikupanga mawonekedwe a kavalo, ndipo amabweretsedwa mwachindunji ndi ndulu ya bile. Thupi limayandikana ndi mbali yakumbuyo ya m'mimba ndikusunthira m'matumbo, ndi mchira, pakufika pamimba ndi zipata za chiwindi ndi ndulu.

Kodi kapamba amapezeka kuti pamene munthu wagona? Imagwera pansi pamimba, chifukwa imatchedwa - kapamba.

Kodi kapamba wamkulu amapezeka mbali iti? Ngati mukuyang'ana momwe munthu adapangidwira kuchokera kumbali ya msana, ndiye kuti chiwalo chimayikidwa pamalo omwe msana umayambira. Kodi mchira wa kapamba umakhala mbali iti? Ponena zam'mimba, gland imangokhala pamwamba pa dera loyambira, pafupifupi 5 cm, kuchokera kumanzere pansi pa nthiti, moyandikana ndi ndulu.

Zizindikiro za matenda apamba

Pamene kaphatikizidwe ka michere ya pancreatic ikachepa, zizindikiro zomwe zimagwirizanitsidwa ndi kudzimbidwa zimawonekera. Kulimba kwawo kumatengera kuuma kwa dyspepsia.

Zizindikiro zopatsa chidwi kwambiri kwa dokotala:

ululu umawonekera kumtunda kwa m'mimba, umapereka pansi pa nthiti zakumanzere, kumbuyo,
nseru wokhala ndi chizolowezi chambiri
kutentha kumakwera
munthu amayamba thukuta kwambiri,
kusowa kwa chakudya
pali ludzu lamphamvu
kutupa ndi kubuma m'mimba
Tulo timakhumudwa, kutsegula m'mimba kumachitika pafupipafupi,
Zizindikiro zakumwa zoledzeretsa zikuonekera,
kuwawa kumawonekera mkamwa
chiwindi chikukula,
Kuukiridwa mwamphamvu kumayambitsa kukhumudwa.

Nthawi zambiri khungu limasinthira mtundu wake, kupindika kumawonekera, makamaka pamimba, pamwamba pa kapamba. Ndi zizindikiro zotere, munthu ayenera kupita kukagona ndikuyimbira ambulansi.

Kutsika kwa mitundu yama michere kumayambitsa matenda:

kapamba pachimake,
edema kapamba,
matenda ashuga
kapamba,
cysts
cystic fibrosis.

Ndi zovuta mobwerezabwereza, pancreatitis pachimake imakhala yovuta. Ululu umachitika mutatha kudya, koma ngati kulibe kudya, ndipo munthu samadya kanthu, ndiye kuti ululu suwoneka konse. Nthawi zambiri wodwalayo amakhala ndi zizindikiro za toxicosis, zomwe zimatsutsana ndi zinthu zina.

Kutupa pakayamba gawo limodzi la kapamba, izi zimasonyezedwa ndi zizindikiro zapadera:

Mutu wopunduka umapweteka pansi pa nthiti zakumanja,
kutupa m'thupi limatumiza chizindikiro cha zowawa ku epigastric zone,
kutupa komwe kumakhudza mchira wa chiwalo kumabweretsa zowawa pansi pa nthiti zakumanzere,
kutupa kuphimba chiwalo chonse kumapereka ululu wamtundu wamkati, kuphukira kumbuyo, zopweteka zazikulu zimapezedwa pansi pa tsamba lamanzere.

Komwe gawo la gland limakhalapo, ululu waukulu umawonekera pamenepo. Komabe, ndi kutupa kwazonse, kupweteka kumafalikira mu groin, mchira, m'chiuno ndi perineum kumayamba kupweteka. Ululu wosiyanasiyana wotere umapangitsa kuti azindikire zovuta.

Ululu pamimba ndi matenda am'mimba umachokera ku ma pathologies osiyanasiyana. Ndikofunika kuti adotolo azindikiritse matenda ena, kuti adziwe zifukwa zoyenera kukhalira ndi matendawo.

Kodi kuchitira matenda a kapamba?

Pambuyo popenda bwino, ngakhale opaleshoni yodzidzimutsa siyofunika, kuchipatala ndikofunikira. Zowopsa za kapamba zimaperekedwa kuchipatala ndikupanga kupuma motsatira kupumula kwa kama. Kusala kwathunthu kumayikidwa masiku 1 mpaka 2. Mayankho olakwika a painkiller ndi antispasmodics (Baralgin, Platifillin), anticholinergics (Atropine) amayamba. Chikhodzodzo cha ayezi chimayikidwa kangapo kwa maola 0,5 ku dera la epigastric. Ndi mankhwala ati omwe muyenera kumwa omwe adokotala amapanga. Zokonzekera zomwe zimachepetsa enzymatic ntchito za kapamba (Trasilol, Contrical, Gordox, Aprotinin) zimathandizira. Pofuna kupewa kuchepa kwamatenda am'madzi, michere yapadera yamchere imayendetsedwa pamankhwala omwe adokotala adawauza. Pambuyo pochotsa zisonyezo zowopsa, njira yofatsa yodyetsera komanso mankhwala othandizira amathandizira - kukonzekera kwa pakamwa komwe kumapangitsa kuti chimbudzi chikhale (Creon, Mezim-forte, Pancreatin, Panzinorm, Festal, Enzistal).

Kodi kudya?

Mu nthawi yovuta yamatendawa, msuzi wofowoka ndi ma decoctions, chimanga pamadzi chimaloledwa, chakudya chimakhala chophika kapena chowotchera:

yosenda
ma mbatata yosenda,
m'mawonekedwe.

M'tsogolo, kuphika, muyenera kugwiritsa ntchito nyama, nsomba, nkhuku ndi mafuta ochepa. Zakudya za mkaka wowawasa, mazira, ma compotes, zakudya zamafuta zimayendetsedwa pang'onopang'ono mu zakudya. Chakudya chokhazikika chimakhazikitsidwa kwa miyezi itatu. Munthawi ya chikhululukiro cha matenda a kapamba, zakudya ziyeneranso kutsatiridwa. Malangizo aumwini amapezeka bwino kuchokera kwa dokotala. Zakudya zofunikira za nyama kuchokera ku nyama zopendekera, nkhuku, makamaka - nyama ya kalulu, yamphongo. Zopangira mkaka zizikhala zochepa m'mafuta. Msuzi wokonzekera bwino pa broths zamasamba. Mwa zakumwa, mankhwala opangira zitsamba, ma compote, tiyi, zakudya zamafuta ndizothandiza. Matenda a kapamba, komanso atadwala kwambiri, zakudya zofunika ndizofunikira: kuyambira 6 mpaka 8 pa tsiku pazigawo zing'onozing'ono.

Kodi kupatula zakudya?

Zakudya ndi zakumwa zotsatirazi ndizotsutsana kwambiri ndi zovuta za pancreatic:

mowa
zakumwa zoziziritsa kukhosi
khofi ndi koko
zotsekemera zotsekemera
wolakwa,
ankasuta nyama
zokometsera, zamchere, zophika, zokazinga,
chokoleti ndi makeke, makamaka omwe ali ndi mafuta ambiri (makeke ndi makeke amchere).

Zimayambitsa kutupa kwapancreatic

Zikondamoyo zimakhudzidwa ndi chimbudzi cha zakudya zamafuta kwambiri, mapuloteni, komanso zakudya zamafuta. Chimodzi mwazomwe zimagwira ndikuwongolera kagayidwe kazinthu, kamene glucagon ndi insulin zimapangidwa ndikulowera m'magazi. Pali zinthu zambiri zomwe zimakhudza mkhalidwe wamthupi.

Zomwe zimayambitsa matenda a pancreatic ndi:

kumwa mowa
malo okhala
monga matenda achiwiri pakupanga calculi mu limba ndi ma ducts,
poyizoni
matenda a virus
matenda oyamba ndi fungus
helminthic nkhondo,
zovuta pambuyo pa opaleshoni.

Pamaso pa zinthu zotere, zizindikiro za matenda a kapamba zimayamba. Komabe, ziwonetsero zimawonetsa kuti matendawa amatha kukhala ndi vuto la pentreatitis, pomwe pancreatitis yomwe idayamba kale kupangika sichimamveka pakulimbana kwakanthawi yayitali, ndipo munthu amakhudzana ndi zopweteka zazing'ono ndi zovuta chifukwa cholakwika pakudya.

Zizindikiro zakuyenda kwapafupipafupi ndi kusokonezeka kwapakhosi, kusintha kwa maonekedwe ndi kapangidwe ka ndowe, kufooka kwakukulu, ndi kuchepa thupi.

Njira zoyesera

Dokotala amamulembera chithandizo atazindikira mwatsatanetsatane. Pankhani yakumva zowawa, kuwunika kwa wodwalayo kumachitika makamaka.

Kenako kuyesedwa kumayikidwa:

labotale - kuyezetsa magazi ambiri, kuyesa kwamikodzo,
Kuwona zamankhwala a pancreatic mu seramu,
biochemistry yowonetsa kupezeka kwa glucose, michere ya chiwindi,
kuyezetsa magazi kudziwa bilirubin,
urinalysis kuti mudziwe zamtundu wa amylase,
kusanthula ndowe kuti muzindikire zotsalira za michere ndi mafuta,
Ultrasound yam'mimba, kuwunika kokwanira komwe kumapatsa dokotala chidziwitso cha kapangidwe kake, mapangidwe a kapamba, kutsekeka kwa mpweya, kupezeka kwa calculi,
Radiography imachitidwa kuti ipeze zambiri zomwezo,
CT kapena MRI, imapereka chidziwitso cholondola chokhudza momwe ziwalo zonse zimagwirizanirana ndi kapamba.

Kufufuza pa ultrasound, CT, makina a MRI amapereka chithunzi chomwe chikuwonetsera bwino za kutulutsa konsekonse ndi ziwalo zapafupi ndi minofu yake.

Ululu m'matumbo, chifukwa cha zovuta kutengera malo, nthawi zambiri umasokonezeka ndi zizindikiro za zina zam'mimba, chifukwa chake, kupenda ndikofunikira kuti tifotokozere bwino za kutupa kwa kapamba. Kufufuza konse ndi chithandizo chowonjezereka chikuchitika moyang'aniridwa ndi gastroenterologist.

Kodi matenda a kapamba amachiritsidwa bwanji?

Kufufuza kwathunthu kuti mumvetsetse matendawa nthawi zambiri kumafuna kuchipatala. Matenda onse a pancreatic amathandizidwa pang'onopang'ono. Nthawi zina kukaonana ndi madokotala kumafikira kuti pakufunika kuchitapo kanthu mwachangu.

Chithandizo cha kuvulala kwakadwala kuchipatala kumapereka wodwalayo kupumula kwa magalimoto, kupumula kwa kama ndikoyenera. Magawo atatu ofunikira a chithandizo chachikulu ndi ozizira, njala, ndi mtendere.

Masiku awiri oyamba, kufa ndi njala kumalimbikitsidwa, mphamvu ya thupi imathandizidwa ndi kulowetsedwa kwamkati mu saline, kuyambitsa kwa choloweza mmalo mwa plasma. Amaloledwa kumwa mpaka magalasi 6 patsiku la decoctions a mankhwala azitsamba.

Dokotala wofikapo amakupangirani:

jakisoni wa mankhwala a ululu,
jakisoni wa antispasmodics, nthawi zambiri Baralgin, Platifillin, No-Shpa, Drotaverin, Acetaminophen, Ibuprofen,
jakisoni wa anticholinergics, nthawi zonse ndi Atropine.

Masana kangapo kwa ½ ola limodzi pa epigastric zone yikani kutentha kwa ayezi. Mankhwala am`kamwa amalembedwa pakalibe kusanza. Pano, kusankha kwa mankhwala kumakhalabe ndi adokotala.

antihistamines
maantibayotiki
insulinoglucose wothandizira
anabolics
mavitamini.

Mu gawo loyamba la matenda owopsa, mankhwala a antacid amathandiza bwino. Amagwiritsidwa ntchito ngati ma gels, kuyimitsidwa, komanso kuteteza chilengedwe acidic - Almagel, Fosfalugel. Kuchepetsa kupanga asidi m'mimba Contraloc, Omez, Omeprazole, Gastrozole, Proseptin, Ocid.

Ku chipatala, H2-blockers amalembedwa: Ranitidine, Famotidine, Acidex, Zoran, Gasterogen, Pepsidin.

Mitsempha yama intravenous imabaya mankhwala omwe amachepetsa kaphatikizidwe ka michere ya pancreatic. Monga lamulo, awa ndi Trasilol, Contrical, Gordox, Aprotinin. Pofuna kupewa kuchepa kwa madzi m'thupi mukamasala kudya, michere ya saline ndi electrolyte imayendetsedwa mu ma dontho omwe akusankhidwa ndi dokotala malinga ndi momwe wodwalayo alili, komanso kukhalapo kwa matendawa.

Zizindikiro zopweteka kwambiri zikatsitsimuka, wodwalayo amayamba kulandira zakudya zosafunikira ndikumamwa mapiritsi a enzymes - Creon, Mezim, Pancreatin, Panzinorm, Festal, Enzistal - monga adanenera dokotala.

Enzymes kubwezeretsa chimbudzi, kukulolani kuti musinthe chakudya. Kukonzekera kogwira mtima ndi Kontrikal, Aprotinin. Amachepetsa kapangidwe ka michere, kuyendetsa chimbudzi.

Komabe, ma michere wamba amapangidwa pang'onopang'ono ndi mapuloteni a nkhumba, pamaso pa ziwengo kuti nyama ya nkhumba izitha kugwiritsidwa ntchito kuti isayambitse kutsekeka kwamatumbo.

Pankhaniyi, mu zida za madotolo pali mankhwala azitsamba omwe amapangidwa kuchokera ku fungus kapena mpunga: Unienzyme, Somilase, Pepfiz.

Njira yamankhwala yokhala ndi ma enzymes ndi yayitali, amatengedwa ndi wodwala moyo wawo wonse ngati othandizira kukonza, ngakhale pagawo lokhululukidwa kwa matendawa. Odwala pawokha amazindikira komwe chitsulo chimapweteka, ndipo amatsatira kwambiri zakudyazo. Mankhwala othandizira enzyme amafunikira ngakhale pakudya.

Kuti tikometse katulutsidwe wa kapamba, pilocarpine, morphine, vitamini A, magnesium sulfate ndi mankhwala. Histamine ndi Atropine amagwiritsidwa ntchito kuti achepetse kubisala. Matendawa akamayambitsa matenda ashuga, dokotalayo amaphatikizanso insulin panthawi yamankhwala.

Chithandizo Cha Mchiritsi

Othandizira azitsamba ndi ochiritsa amapereka mankhwala azitsamba kuti azisamalitsa kapamba pakachotsedwa. Maphikidwe oterewa amalimbikitsidwanso ndi akatswiri othandizira, akatswiri a gastroenterologists, pomwe wodwalayo ali ndi gawo lokhululukidwa ndipo amalamulidwa kuti azigwira ntchito kunyumba.

Ngakhale munthu atapita ku chipatala chapadera pambuyo poti am'peze chithandizo kuchipatala, pamenepo dokotala amafunsira kuti amwe mankhwalawa, kwa munthu aliyense malinga ndi zomwe akufuna. Koma mutha kukonzekera infusions, decoctions kunyumba, nokha, musanalandire malangizo a dokotala.

Onse maphikidwe amaphatikiza kuphatikiza angapo mankhwala azomera. Chifukwa chake, muyenera kudziwa kaye ngati pali chilichonse chomwe chingagwirizane.

Kulowetsedwa kwa chisakanizo cha zitsamba zouma. Zosakaniza: 2 tbsp. l Wort wa St. John, mayi, peppermint. Kukonzekera: kutsanulira zitsamba mu 0,5 l madzi otentha, lolani kuti imwenso itenthe kwa mphindi 40. Kenako yambitsani kulowetsedwa kudzera mu multilayer gauze. Imwani 150 ml kwa ½ ola limodzi musanadye. Njira ya mankhwala ndi milungu iwiri, kenako m'malo mwamankhwala ena.
Decoction wa osakaniza zitsamba. Zosakaniza: 2 tbsp. lphokoso losweka la elecampane, 3 tbsp. l Muzu wakugawikana wa valerian, 1 tbsp. l mbewu za katsabola, 1 tbsp. l maluwa a violet. Kukonzekera: sakanizani mbewu zonse, kuchokera ku zosakaniza zonse 1 1. l., kutsanulira kapu yamadzi otentha, kuphika ½ ora mumadzi osamba, kenako alole kwa mphindi 15. Sefa msuzi wotsatira, imwani 3 tbsp. l pamaso chakudya chilichonse.

Ndikosatheka kuti muchepetse kutupa kwa kapamba kosatha ndi chakudya, kugwiritsa ntchito mankhwala azitsamba.

Kuphwanya pang'ono malingaliro a adotolo kumabweretsa kubwereranso. Zizindikiro za matenda kapamba zimavutitsa munthu moyo wake wonse. Chifukwa cha izi, chithandizo chimasankhidwa kuti chisathe kupweteka kamodzi, koma kubwezeretsa ntchito za chiwalo.

Magwiridwe antchito

Monga momwe mukudziwa, komwe kapamba amapezeka m'thupi la munthu ndi yopingasa, chiwalo chimagwira kumbuyo kwa m'mimba. Ntchito yofunika kwambiri ndikugwira ntchito kwa nyumba za endocrine ndi exocrine.

Gawo la endocrine limaphatikizanso kuyika kwa kagayidwe kazakudya m'thupi. The organ parenchyma has islets of Langerhans yomwe ili mchira. Muli maselo omwe amapanga glucose m'magazi.

Ma hormone awa amapatsidwa zotsatira zosiyana.

Glucagon - amawonjezera shuga mumagazi.
Insulin - imachepetsa mgwirizano.

Kuphatikiza apo, thupi limagwira ntchito yofunika kwambiri chimbudzi. Imatha kupanga madzi am'madzi, omwe ali ndi mawonekedwe osakanikirana ndi ma enzyme. Zinthu izi zimawola chakudya, mapuloteni, mafuta.

Ma Enzymes opangidwa ndi thupi poyamba ndi osagwira ntchito. Chisangalalo chawo chimayamba mu duodenum 12, momwe zimalowa.

Vuto loyipa limasokoneza mucous nembanemba wa michere, motero, kuonetsetsa kuti, thupi limatulutsa michere ya bicarbonates, yomwe sinanso yofunika kwambiri yogwira pancreatic.

Zakudya zam'madzi zimatha kuthyoka pomwe kapamba akugwira ntchito mwachizolowezi. Ngati, malinga ndi zinthu zosiyanasiyana, kutupa kumayamba mwa iye kapena kusintha kwina kuntchito kumachitika, ndiye kuti kupweteka kwapachisangalalo kwanjira yosasangalatsa ndikuwonetsedwa kwina kwamatenda kumveketsa.

Zizindikiro ndi zizindikiro za pathologies

Zochita pancreatic zikasintha, zizindikilo zambiri zimayamba. Zizindikiro zazikulu za matenda a kapamba mwa amuna ndi akazi ndi motere:

kumva kupweteka - kumamveka kuchokera kumbali yakumanja kapena njira yodzimanga.
kusintha kwa zakudya
akudwala, asanza,
kulemera kwa thupi kumachepa
kutulutsa, kudzimbidwa, kutsekula m'mimba,
matumbo,
khungu limasintha - limasandulika, limasinthasintha.

Mwa chachikazi, Zizindikiro zamavuto am'mimba zimatha kuphimba gawo lonse la epigastric ndi mbali zina za thupi. Mwachitsanzo, pancreatitis ikadutsa pachimake, chizindikiritso cha lilime chimapezeka nthawi zambiri.

Zizindikiro za matenda a kapamba mu azimayi ndizofatsa kwambiri, chifukwa amayang'anira zakudya zawo, samamwa mowa.

Zizindikiro za mtundu wankhanza wa kapamba zimawonetsedwa ndi kupweteka mwadzidzidzi, kunjenjemera, kuwonjezeka kwa kutentha. Nthawi zambiri, amuna azaka zapakati amakumana ndi mawonekedwe otere. Ngati tizingolankhula za pancreatitis yodziwika bwino, ndiye kuti zizindikiro zake ndizofanana ndi pachimake, kungosiyanitsa pakati pawo ndikosavuta. Matendawa amakhudza kwambiri amuna ndi akazi amsinkhu wapakati.

Mu mtundu wa kapamba kakakulu, ululu wammbuyo umapangika, kupweteka, ndi herpes zoster, kusintha kwa kugaya chakudya kumawonedwa ngati zolakwa zimachitika pagome la zakudya. Nthawi zambiri, matendawa amakonzedwa mwa azimayi azaka zapakati komanso zazitali. Pancreatitis yayikulu ikamakulirakulira, pafupipafupi matenda amachepetsa, ululu umakulirakulira, wodwala amadwala, ndipo chilakolako chofuna kudya chimatayika. Vutoli limadziwika kwa onse amuna ndi akazi a zaka zapakati komanso zakale.

Kugwirizana kwa zizindikiro ndi chikhalidwe cha zotupa

Ntchito ya gland ikachepetsedwa, imawonetsedwa pantchito yokumba. Pankhani yakusowa kwa lipase mwa wodwalayo, mthunzi ndi machulukidwe a ndowe amasintha. Chifukwa chochulukirapo cha zinthu zamafuta, zakudyazo zimakhala wachikasu, lalanje, mafuta.

Kuperewera kwa Amylase kumadziwika ndi kusintha kwa machitidwe a kuperewera kwa chakudya chamafuta ambiri. Mpando wodwala amakhala ndi madzi osasunthika, amadzi, amapitilira muyeso.

Kuperewera kwa Trypsin kumawonjezera kuwonjezeka kwa kuchuluka kwa zotumphukira zama nitrogen. Fungu la wodwalayo ndi mushy, wokhala ndi mapuloteni a fiber protein, fetid. Zimatipatsa chitukuko cha magazi m'thupi.

Kuperewera kwa kupanga glucagon kumatha kukhala wopanda mphamvu pa thupi. Ngati ndi kotheka, kusowa kwa glucose m'magazi a magazi kumathandizira ndi ma adrenal gland.

Pakufufuzidwa ndi dokotala, ndikofunikira kwambiri kuti mudziwe mtundu wanji wa kupweteka kwa kapamba komwe kumamveka, komwe kapamba amapweteka. Izi zidzakuthandizani kuti muzindikire moyenera ndikupeza chomwe chimayambitsa matendawa.

Zotsatira zoyipa zazizindikiro za munthu aliyense

Poyerekeza zakusintha kwamachitidwe owola a zinthu zomwe zamwedwa, kusowa kwa kufufuza zinthu ndi mavitamini amawoneka m'thupi.

Wodwalayo amakumana ndi mawonekedwe:

kutaya tsitsi
khungu lowuma
kuchepa thupi
fragility ya msomali mbale.

Zidutswa zopanda chakudya zikamalowa m'matumbo, mapangidwe a gasi amapezeka ndipo matumbo amatulutsa pafupipafupi. Kusintha kwa ntchito ya maselo a islet omwe amatulutsa mahomoni amadziwika ndi kuchepa kwa shuga ndikupanga gawo loyambirira la matenda ashuga.

Kusintha kwa kuchoka kwa michere mthupi, vuto la minyewa yapang'onopang'ono imawonedwa, amakwiya ndipo amatupa.

Pafupifupi matenda aliwonse am'mimba, oyambitsidwa ndi Helicobacter pylori. Zakudya zikagwidwa, michereyi imasokoneza nembanemba ndipo imayambitsa mapangidwe a kukokoloka, kutupa kwa thupi, monga colitis, appendicitis, ndi dysbiosis. Kuphatikiza apo, ma virus amatha kuwononga ma chiwindi ndi minyewa, zomwe zimapangitsa kuti pakhale pancreatitis, cholelithiasis. Wodwalayo amamva kuwawa, amalimbikitsa kutopa, kusokonezeka kwa chakudya, komanso matupi awo saoneka.

Kodi ndimatenda ati omwe akuwonetsa?

Vuto lalikulu ndikuti zizindikiro zomwe zimadziwika ndi matenda a gland zimadziwikanso ndi mitundu yosiyanasiyana ya matenda. Izi nthawi zambiri zimayambitsa kukhazikitsidwa kwa matenda olondola ndikupereka mankhwala olondola. Chifukwa chake, pamene kapamba amapweteka, zomwe zimayambitsa matenda zimayenera kuzindikirika pamlingo wa chitukuko.
Ndikofunikira kudziwa ngati kapamba angadwale ngati ntchito yake yafupika komanso ndi matenda ati omwe amatulukapo.

Nthawi yayikulu ya kapamba imawoneka chifukwa cha kutukusira kwa ndulu, kuwonetseredwa ndi kupweteka, kutsegula m'mimba, kumva ngati kuphulika pansi pa nthiti, kuphwanya msana.
Kuwonongeka kwa chiwalo cha mawonekedwe osakhazikika - kupweteka kwakumwa kumachepa kwambiri, kumawonekera pakudya mopambanitsa, kumwa mowa, mafuta ndi ziwalo zomwe zimakwiyitsa.
Kukuchepa kwa enzymatic kumene - matendawo amawonekera pakusintha kwa mtundu wake ndi kuchuluka kwa chimbudzi, mkodzo umakhala mumdima, wodwala amadwala, pamakhala kusefukira kwa m'mimba, kulemera kumatayika.
Kukhalapo kwa miyala mu chiwalo kumawonetsedwa ndi kupweteka kwapamwamba kumtunda kwa peritoneum, kusanza ndi bile, nseru, mafuta owonjezera pankhope, malovu ambiri.
Khansa yapakansa - yokhala ndi vuto loyipa, wodwalayo amataya mtima, amapweteka pansi pa nthiti, mtundu wa ndowe ndi kusintha kwamkodzo, amachepetsa msanga, ndipo kusakhazikika kwa mahomoni kumawonedwanso.
Type 1 shuga mellitus - yodziwika ndi ludzu lalikulu, chilimbikitso chambiri, kukodza pafupipafupi.

Matenda aliwonse omwe amachititsa kuti thupi lizigwira ntchito limayambitsa chiopsezo cha kugaya chakudya komanso moyo wa wodwalayo.

Zoyenera kuchita ngati kapamba apweteka

Ndikofunikira kumvetsetsa kuti matenda osavomerezeka, monga chithandizo, amakhala ovulaza thanzi.

Ndikofunikira kudziwa momwe mungachitire kapamba kuti mumve bwino kunyumba. Zowawa, zomwe zimakhala ndi mawonekedwe osalala, opweteka, zimathetsedwa pang'onopang'ono. Nthawi zambiri, kusamva bwino kwa ululu kumachitika chifukwa cha kuchuluka kwa ziwalo.

Kuti muchepetse katundu, tsatirani malangizowo.

Zakudya zamafuta zimachotsedwa muzakudya.
Tsatirani zakudya zabwino.
Pewani kumwa mowa, kusuta.
Ngati kunenepa kwambiri, kuchepetsa.
Imwani pancreatin kuwonjezera pa chakudya.

Kodi kapamba amathandizira bwanji pamene m'mimba upweteka? Monga chithandizo cha mankhwala osokoneza bongo, ngati ululu wam'mimba ukuwonjezeka, perekani mankhwala:

Sizovomerezeka kumwa mankhwalawa osakhudzidwa ndi dokotala.

Ngati pali ululu wopwetekedwa wowonetsa bwino womwe umachitika pansi pa nthiti, muyenera kuyimbira foni dokotala. Kuti muchotse zowawa mu peritoneum, njira zosagwiritsa ntchito mankhwala ndizofunikira.

Tengani bondo-mkono, potero muchepetse kuthinikizidwa kwa ziwalo pamalo oyendera dzuwa.
Ikani ozizira kumimba, komwe kumachepetsa ntchito ya gland.
Zochita zolimbitsa thupi siziyenera kukhala.

Ndi zoletsedwa kudya, kumwa ndi kugwiritsa ntchito mankhwala osokoneza bongo pakuchitika.

Zakudya za matenda

Zikondazo zikapweteka, njira yochiritsira siyokwanira popanda zakudya. Kuti muwonjezere kuchuluka kwa mankhwala, muyenera:

Osamadya mopitirira muyeso, zomwe zimachitika tsiku ndi tsiku zimagawidwa m'magulu a 5,6
Zakudya zopatsa thanzi, zikondamoyo zikafika padera, sizikulimbikitsidwa kudya zakudya zamapuloteni ndi zopatsa mphamvu.
Palibe zinthu zomwe zimawononga ntchito ya thupi. Pa matenda a gland, tebulo No. 5 ndilovomerezeka kwambiri.

Pankhani yazakudya ndi zakudya, komanso kupumula, upangiri wa katswiri wazakudya umakhala wothandiza, yemwe angathandize pankhaniyi aliyense payekha.
Mndandanda wazinthu zomwe zingagwiritsidwe ntchito popanga mchere ngati nthenda ya chiwalo.

Maswiti osiyanasiyana, zakudya zodzipangira tokha.
Ma makeke osatulutsidwa, makeke owuma.
Mtedza wa shuga.
Zipatso zolemba.
Marmalade, marshmallows, maswiti.
Kupanikizana, kupanikizana, kupanikizana.

M'maswiti oterowo, mumakhala mafuta ambiri oyipa, koma ndizovomerezeka kuti muzimudya zosaposa 50 magalamu patsiku.

Kuchokera pazinthu zosaletsedwa, kupweteka kwa kapamba kumazunzidwa, pali:

nyama, nsomba, nkhuku zamitundu yamafuta ochepa,
masamba ophika, masamba, zipatso, zipatso, peeled,
compotes, decoctions, zakumwa za zipatso, tiyi,
zopangidwa mkaka zimangogwiritsidwa ntchito pokhapokha mafuta ochepa komanso ndi masiku atsopano omalizira,
mkaka wosakhazikika ndi mazira amaletsedwa.

Ndizofunikanso kupatula kumamwa nyama yosuta, zipatso, zokometsera, zakudya zamafuta, zophika, zonunkhira ndi zonunkhira.
Kuphatikiza poti mankhwalawa amagwiritsidwa ntchito pochiza, mankhwala achikhalidwe komanso zakudya zothanzi amatha kuthetsa ululu, pokhapokha ngati njira zina zikugwirizana ndi dokotala. Pogwiritsa ntchito njira zonsezi, madera omwe akukhudzidwawo amabwezeretsedwanso, ndipo ntchito ya gululi imayamba kuyenda bwino.

Pofuna kuchiritsa kapamba, muyenera kulumikizana ndi madotolo osati kudziletsa, zomwe zingachitike.