Steatorrhea ndi

Pancreatitis yachilendo imawonedwa kuti ndiwowonongeka pancreas yamatenda otupa, yomwe imayambitsa zovuta za exocrine ndi intrasecretory function. Izi, zimabweretsa kuchepa kwa kupanga kwa ma enzyme omwe akukhudzidwa ndi chimbudzi, mahomoni ofunikira (mwachitsanzo, insulin) ndi zinthu zingapo zomwe zimagwira ntchito pazamoyo. Chifukwa chake, odwala onse amafunikira kuzindikira zizindikiro mwachangu ndikutsatira chithandizo chakanthawi komanso chokwanira chokhazikitsidwa ndi adokotala.

Kenako, tikambirana zomwe zimayambitsa matendawa kukula, ndichizindikiro komanso chizindikiro chani mwa akulu, komanso njira zabwino zamankhwala zomwe zilipo.

Kodi chikhansa chachikulu ndi chiyani?

Matenda a kapamba ndimatenda otupa a kapamba omwe amakhala ndi njira yayitali yobwereza, yodziwika ndi kusintha kwapang'onopang'ono kwa kagayidwe kake ka cell ndi chitukuko cha magwiridwe antchito.

Zotsatira zakukula kwa matenda oterowo, kubisalira kwa michere, trypsin ndi lipase, kumachepa m'matumbo. Chifukwa cha izi, kufalikira kwa magazi a chiwalo kumakulirakulira, minyewa yolumikizana imakula, ndipo zipsera zina, madera omwe amapezeka ndi sclerosis amapangidwa.

Nthawi zambiri, matendawa amapezeka chifukwa chomwa mowa kwambiri kwa nthawi yayitali. Mwa amuna, matenda a pancreatic pancreatitis amatha kukhala ngati amamwa zaka zopitilira 15, mwa amayi omwe amamwa mowa kwambiri kwa zaka zoposa 10.

Makina akulu opangira matenda a kapamba ndi kuwonjezeka kwa kupanikizika kwa kapamba ndi kusuntha kwa madzi a kapamba. Kusasunthika kwanthawi yayitali mu duct kumayambitsa kuphwanya mawonekedwe ake, chifukwa chake ma enzymes apachifini amalowa mosavuta mu minofu yawo, ndikuwononga maselo ake (autolysis) ndikukula kwa njira yotupa

Zitha kutenga zaka 10-15 pamene zizindikiro za chifuwa chachikulu cha khansa zimayamba kufotokozedwatu kotero kuti pasakhale kukaikira za matendawo. Matendawa amatha kuchitika chifukwa cha:

• Cholecystitis, gastritis kapena duodenitis yovuta mawonekedwe.
• Zilonda zam'mimba kapena zam'mimba.
• Zilonda zopatsirana - mumps, typhoid kapena typhus, virus hepatitis.
• Kumwa kwambiri.
• Zakudya zosavomerezeka.
• Matenda a atherosulinotic.
• Kulowa kwa mphutsi kulowa mthupi.
• Kulowa ndi zinthu zovulaza - arsenic, phosphorous, mercury, lead.

Gawo la chitukuko cha mawonekedwe

Zizindikiro za Chronic Pancreatitis

Nthawi zambiri, kusintha koyamba kwa matenda m'thupi la minyewa ndi kukula kwa kapamba kumachitika popanda chizindikiro. Kapenanso zizindikiro zake ndi zofatsa komanso sizili zachindunji. Pamene kufotokozera koyamba kufalikira kumachitika, zovuta zamatenda zimayamba kale kwambiri.

Matenda a kapamba ndi vuto limodzi ndi:

• Kupweteka kwakumwa, ndipo kuchuluka kwa mphamvu kungakhale kosiyana. Tsamba lachitukuko ndi gawo la epigastric ndi hypochondrium yamanzere. Ululu umakhalapo nthawi zonse kapena kuwoneka paroxysmally. Wodwala akatha kudya china chake, chizindikirocho chikukula.
• Dyspeptic matenda - nseru, chidwi kusanza, kumva kuwawa pamimba, chosasangalatsa pambuyo pakamwa patsekeke, phokoso. Wodwala amatha kudana ndi zakudya zamafuta, ndipo nthawi zina chidwi chake chimatha.
• Pakupita kwa zaka, wodwalayo amatha kumadzinenera zizindikiro zosasangalatsa mwanjira yovutikira kwakanthawi komwe kumamukhudza atatha mphindi 15 atatha kudya. Zovuta zimatha ola limodzi mpaka masiku 3-5. Malo omwe amakhala ndi m'mimba, nthawi zina ululu umamveka pafupi ndi mtima kapena kumanzere kwa chifuwa kapena lumbar. Nthawi zina, ndi herpes zoster. Mutha kutsitsa mphamvu yake ngati mutapinda cham'mbuyo kapena squat.
• Khungu la wodwalayo limayamba kukhala lachikasu. Zomwezi zimagwiranso ntchito ku sclera. Kukula kwa khungu kumadutsa nthawi ndi nthawi.
• Chifukwa cha kuchepa kwa michere ya pancreatic, njira yogawa ma cell mamolekyulu azakudya zomwe timadya m'magawo ang'onoang'ono omwe amatha kulowa m'matumbo amasokonezedwa. Pankhaniyi, ndi kapamba, ngakhale chakudya chowonjezereka chimatha kutsagana ndi kuchepa kwa thupi, kuchepa kwa mavitamini m'thupi, khungu lowuma, misomali yokhala ndi brittle, kusowa kwachitsulo m'thupi (kuchepa kwa magazi m'thupi) ndi zizindikiro zina.

Ndi chifuwa chachikulu, kupweteka kumachitika chifukwa cha:

• mavuto ndi kutuluka kwa pancreatic madzi,
• kutulutsa kwachilengedwe
• pancreatic ischemia,
• kutupa kuzungulira CHIKWANGWANI
• kusintha kwa mathero a mitsempha,
• kufinya ziwalo pafupi.

Ndi chitukuko cha matendawa, pafupipafupi kufalikira, monga lamulo, kumakulira. Kutupa kosalekeza kwa kapamba kumapangitsa kuti ziwonongeke tokha komanso tiziwalo tating'ono. Komabe, zitha kutenga zaka zambiri matenda asanawonekere matenda (zizindikiro).

Mgwirizano

Matenda a kapamba amatha kuperewera chifukwa chimodzi mwazomwe zimayambitsa:

• kumwa mowa waukulu,
• kukanika kwa chithokomiro.

Palinso zifukwa zambiri zosafunikira, koma zimachulukitsa kwambiri kuchuluka kwa kupweteka kwa kapamba:

• kumwa pafupipafupi mowa.
• amakonda kudya kwambiri,
• kusuta
• onenepa kwambiri
• kudya mafuta ochulukirapo,
• kumwa mankhwala
• matenda opatsirana
• zopsinjika pafupipafupi.

Nthawi zambiri, Zizindikiro zakukula kwa kapamba zimawonekera mu mawonekedwe amkati, kupweteka kwapweteka komanso kupweteka kwambiri komwe kumamveka pansi pa nthiti, kuwonetsedwa kumbuyo.

• Nthawi zambiri ululu amakhala atypical, obisala ngati matenda ena, umatchulidwa kumbuyo kumbuyo, kuwumbidwa m'mimba.
• Nthawi zina ululu umamvekera pachifuwa, kumbali, ndikumva mwakuya kwa thupi, zomwe zimadziwika kuti zikuluzikulu za kapamba.

Zizindikiro za kuchulukitsa kwa kapamba:

1. Ululu wowawa, womwe umatha kukhala wowuma kapena wowongoka m'matumbo popanda kudziwa kwawoko, kuwonjezeka mutatha kudya ndikupereka kumbuyo.
2. Pafupipafupi kutsegula m'mimba ndi kuphatikiza kwamafuta tinthu tambiri mu chopondacho.
3. Kumva kuwawa pamkamwa.
4. Kusungunuka mkati mwa ndulu, kovuta kupereka ndi mankhwala.
5. Chilichonse.
6. Kuchepetsa chidwi.
7. Zovala zoyera pamalirime.

Zizindikiro zonse pamwambapa zitha kuwonekera monga maluwa onse, kapena chimodzi. Ngati munthu akumva kupweteka kwambiri, ndiye kuti dyspeptic syndrome imatha kuchitika, pomwe thanzi la wodwalayo limayamba kufooka.

Mavuto

Ngati patapita nthawi simukugwira bwino matenda a kapamba, ndiye kuti zovuta zotsatirazi ziyamba kupita patsogolo:

• ma pancreatic ascites,
• kapamba ka shuga kapamba,
• kunyowa
• mapangidwe a phlegmon m'malo opatsirana,
• yotupa mu ma ducts,
• chotupa chakutchinga,
• B12 kuchepa magazi
• matenda oopsa a portal
• kutulutsa magazi m'mimba kumatha kuchitika chifukwa chotumphukira cha ma pseudocysts,
• mapangidwe zotupa zoyipa.

Mitundu yayikulu ya matenda

Zomwe zimapangitsa kuti masinthidwe azinyalala azitha kukhala steatorrhea, creatorrhea, amylorrhea. Timaganizira za chochitika chilichonse mosiyana.

1. Steatorrhea ndi vuto la m'mimba, momwe mafuta osaloleka kapena mafuta achilengedwe amadzisonkhanitsa ndowe.
2. Creatrhea ndimatenda omwe amapezeka poyankha malabsorption a michere m'matumbo. Zimaphatikizidwa ndi kudzikundikira kwa nayitrogeni mu ndowe. Pakakhala chithandizo choyenera, chimatha kukhala kapamba.
3. Amylorrhea ndi chochitika chodziwika ndi mawonekedwe ampweya wamafuta wowuma, omwe sagawika mu shuga ndi m'mimba.

Mitundu ya cholembera

Akatswiri amasiyanitsa mitundu iyi ya matenda:

1. Alimentary steatorrhea - yomwe imayambitsidwa ndi mafuta ochulukirapo m'thupi, dongosolo logaya chakudya limatha kuthana ndi chimbudzi.
2. Steestinal steatorrhea - kulephera kwamatumbo kuti amwe mafuta kumabweretsa kukula kwa matendawa.
3. Pancreatic steatorrhea ndi njira yomwe kapamba samatulutsira zokwanira za lipase zofunikira pakuwonongeka kwa mafuta.

Zovuta za kubadwa kwa chitukuko cha ziwalo zam'mimba, zomwe zitha kuchitika zaka zochepa, zimatha kuyambitsa matendawa. Nthawi zambiri kuoneka kwa zolephera zotere m'thupi kumabweretsa kupangika kwa zakudya za tsiku ndi tsiku kutengera kuchuluka kwa zakudya zamafuta, zomwe m'njira zoyipa zimakhudza kapamba.

Ndi chiani chinanso chomwe chingapangitse munthu kuti akhale wosabereka? Zomwe zimayambitsa matendawo zimagonekanso pakutha kwa mphamvu ya gland ya endocrine. Makamaka, matenda a ndulu, kutupa kwa ma ducts ake kumathandizira kukulitsa kwa matenda a mtima.

Zizindikiro

Steatorrhea, creatorrhea imatsogolera ku zochuluka zokhala zotayirira. Calla amapeza imvi kapena kuwala. Odwala nthawi zambiri amafuna kuti azilephera. Ndi mafuta ochulukirapo kwambiri mu mafoni, kudzimbidwa kumatha kuchitika. Pamodzi ndi mawonekedwe owonetsedwa, odwala nthawi zina amakhala ndi chizungulire chachikulu, akung'ung'uza m'matumbo, ndipo akuvutika kutulutsa.

Chowonetsa chachikulu cha steatorrhea kumachepetsa thupi msanga ndi zakudya zambiri komanso kuchita masewera olimbitsa thupi pang'ono. Khungu la anthu omwe adakhudzidwa ndi matendawa adakutidwa ndi kutumphuka kowuma, akumerera. Popita nthawi, milomo yotuwa imawonedwa, ming'alu imakhazikika m'makona amkamwa. Umu ndi momwe steatorrhea imadziwonekera, zizindikiritso zake zomwe zimawonetsa kukwaniritsidwa kwa minofu yokhala ndi mafuta acids.

Zizindikiro

Kuti atsimikizire matenda okhumudwitsa, wodwalayo ayenera kupita kukakumana ndi gastroenterologist. Dokotala amamvera madandaulo, amatulutsa pakhungu pamimba, zomwe zimakuthandizani kuti muzindikire kuchuluka kwa mafuta m'matumbo aang'ono.

Kenako, bwerezani njira zofufuzira. Makamaka, retroscopy yamatumbo am'mimba imathandizira kudziwa kuchuluka kwa atrophous a membrane wa mucous, kuti azindikire kudzimbira.

Chofunikira kwambiri pakupezeka kwazofufuza ndikusanthula kwa chopondapo, kafukufuku watsatanetsatane wa kapangidwe kake. Apa mukuyang'ana kuwunika kwa ma microscopic ndi macroscopic a matumbo a matumbo. Kuphatikiza apo, colonoscopy, njira yofufuzira ya radioisotope, ma ultrasound angagwiritsidwe ntchito.

Kupewa

Monga njira zothanirana ndi matenda zomwe zingathandize kupewa matenda, tiyeni tiwone izi:

• Kukhazikitsidwa kwa kadyedwe ka zakudya zamafuta, chakudya chopatsa mphamvu komanso zomanga thupi,
• kukana kumwa mowa, zomwe zingayambitse kusagwira bwino ntchito kwa ziwalo zomwe zimayambitsa chimbudzi ndikuchotsa zinthu zakupha m'thupi,
• kudya moyenera zakudya zokazinga ndi zakudya zokhala ndi zonunkhira zambiri.

Njira zachiwiri zodzitetezera zimaphatikizira kudziwonera kwakanthawi ndikuchotsa matenda omwe angayambitse kuperewera kwa mafuta m'thupi ndipo, chifukwa chake, mapangidwe ofikira amayikamo ndowe. Mwachitsanzo, pazifukwa izi, nthawi zambiri amatengera mankhwala osokoneza bongo omwe amapezeka m'matumbo aang'ono.

Steatorrhea: chithandizo

Mankhwala, wodwalayo amapatsidwa njira yokhala ndi mankhwala ambiri okhala ndi lipase. Zogwira pophika mankhwala omwe ali ndi mapulani ofananawo zimalepheretsa kuwonongeka msanga kwa michere yogaya chakudya mothandizidwa ndi timadziti tam'mimba.

Mwa mankhwala ogwiritsa ntchito, omwe amagwiritsa ntchito omwe amachotsa mawonetsero a steatorrhea, ziyenera kudziwika:

Odwala apamwamba kwambiri, odwala amamwa mankhwala omwe amakhala ndi adrenocorticotropic timadzi ndi hydrochloric acid. Odwala amalangizidwa kuti azitenga mavitamini. Mofananamo, mankhwalawa amachitika pogwiritsa ntchito ascorbic ndi nicotinic acid.

Pochizira steatorrhea, kutsimikizika ndikugwiritsa ntchito nyama yamafuta ochepa, nsomba yophika, mkaka wopanda mafuta. Odwala amaloledwa msuzi wamasamba. Pochepa, msuzi wachiwiri kuchokera ku nkhuku yoyonda kapena nyama yodala imaloledwa.

Mavuto omwe angakhalepo

Popanda chithandizo choyenera, kutsetsereka kumapeto kwa matendawo kungayambitse zotsatirazi zoyipa za thupi:

1. Kuperewera kwamapuloteni - boma loponderezedwa limalumikizidwa ndi kuyamwa kosakwanira kwa mapuloteni mu minofu.
2. Hypovitaminosis - imachitika chifukwa cha kusowa kwa thupi la zinthu zokwanira zosungunuka zamafuta.
3. Kutopa kwathunthu kwa thupi.
4. Kukula kwa kusowa kwa mchere wamchere kumasonyezedwa ndikumva ludzu losatha, kuchepa mphamvu kwa madzi, kumachitika kwa thupi pang'onopang'ono, kuwuma kwambiri kwa ziwalo za mucous.
5. Mikhalidwe yopweteka ndiyopanda minyewa yochita kupangika paroxysmal.
6. Oxaluria - kuchotsedwa kwa oxalic acid wambiri m'thupi. Matendawa amadziwika ndi mapangidwe amiyala osasungunuka, omwe amalepheretsa kwamkodzo thirakiti ndi ngalande zaimpso.
7. Kugonjetsedwa kwa ziwalo zofunika ndi machitidwe - mtima, mapapu, ubongo.
8. Kukula kwa mavuto amisala - ntchito yochepetsedwa, kusokonezeka kwa tulo, kuchepa kwa ndende, zovuta zamagulu amisala.

Steatorrhea pa nthawi yapakati

Steatorrhea ndi chikhalidwe cha azimayi omwe ali ndi mwana wosabadwa. Nthawi zambiri, matenda amadziwonekera okha pakatha mimba. Nthawi zambiri, zimasokoneza mapangidwe am'madzi mu stool, ndikuchepetsa kutuluka kwa bile chifukwa cha kukondoweza kwa chiberekero.

Mwa amayi apakati, matendawa amawonekera mu kupangika kowonjezereka kwamadzi am'madzi a fetid, omwe ali ndi mtundu wopanda pake. Pankhaniyi, ntchofu zomwe zimalandidwa ndi thupi zimasanduka chikaso.

Pambuyo pake, matendawa amatha kupangitsa kuchepa kwa magazi, zomwe zimapangitsa kuti zikhale zovuta kusiya magazi mwachindunji pakubadwa kwa mwana. Popanda chidziwitso chokwanira komanso chithandizo, kuphwanya kumayambitsa kufooka kwa minofu ya mafupa a mwana wosabadwayo. Nthawi zina, zotsatira za zomwe zimachitika pakukula kwa matendawo ndi kuwonongeka kwakuthupi kwa mayi ndi mwana.

Kugwiritsa ntchito njira zovuta zamankhwala kumathandizira kuti kuthetseratu mawonekedwe a steatorrhea pa nthawi ya bere. Kuphatikiza pa kumwa mankhwala oyenera, mayi woyembekezera amakupatsani chakudya chokhacho. Makamaka, mayi woyembekezera amakulimbikitsidwa kukana zokometsera, mafuta, zakudya zokazinga, ndi mavitamini a magulu A, D, E, K ndi mankhwala.

Steatorrhea mu makanda

Kukula kwa matendawa nthawi zambiri kumachitika chifukwa cha chiwindi chosakwanira, chomwe chimayambitsa chibadwa. Chofunikira pakuwonekera kwa matendawa chimatha kukhala zotupa za ziwalo zam'mimba thirakiti.

Ponena za zifukwa zazikuluzikulu za steatorrhea mu makanda, ndikofunikira kudziwa, choyambirira, kuchuluka kosakwanira kwa michere ya m'mimba yomwe ikukhudzidwa ndi kuwonongeka kwamafuta. Kapangidwe ka zinthu zomwe zimathandizira kuti mapangidwe a metabolism athanzi apangidwe mwachilengedwe m'miyezi itatu yoyambirira ya moyo. Mpaka nthawi ino (ngati pali vuto m'thupi), kugwiritsa ntchito mankhwala kumathandizira kuthetsa kusowa kwa michere.

Pomaliza

Steatorrhea ndimavuto osasangalatsa, chiwopsezo chachikulu chomwe chiri kuthekera kwakukulu kwa chitukuko chonse cha kupatuka pakugwira ntchito yamagulu ndi machitidwe ofunikira.

Monga momwe masewera amasonyezera, kuthana ndi matenda moyenera kumapangitsa kuti muzitha kudya zakudya zamagulu ochepa zamafuta ndikuwonjezera thupi mavitamini. Njira zosavuta ngati izi zimakulolani kuti musamutsireni matendawa mwachangu pachikhululukiro ndi kupewa zoyipa.

Kufotokozera kwapfupi

Nthawi zambiri, PS si njira yodziyimira payokha, koma zotsatira (zovuta) zamatenda ena.

Zolemba
1. Ngati PS ndi chifukwa cha matenda ena, nambala ya nthendayi yomwe imatchulidwa imagwiritsidwa ntchito polemba.
2. Kulakwilidwa chifukwa cha opaleshoni yam'mimba sikumaphatikizidwa ndi gawo lino (K91.2).

Gulu

Mwa etiology:

1. Poyamba:
- idiopathic pancreatic steatorrhea,
- steatorrhea yachilengedwe yakusowa yocheperako kapamba kapamba,
- ndi kobadwa nako hypoplasia, dysplasia kapena aplasia wa kapamba (kapamba).

2. Chachiwiri:

2.1 Ndi matenda apamba:
- chifuwa chachikulu,
- nyengo pambuyo pancreas,
- cysts yayikulu, zotupa za pancreatic, zikubweretsa kuchepa kwa kuchuluka kwa ntchito yogwira parenchyma,
- kutsekerezedwa kwa ma pancreatic ducts chifukwa cha zifukwa zingapo,
- matenda ashuga
- Zollinger-Ellison syndrome,
- cystic fibrosis.

2.2 Matenda a ziwalo zina:
- m'mimba: gastritis yokhazikika yochepetsedwa chapamimba kapena achilia, mikhalidwe pambuyo pamimba, kutaya matenda,
- yaying'ono ndi yayikulu matumbo: enteritis yayikulu, kukula kwama bakiteriya,
- chiwindi ndi biliary thirakiti: cholestatic chiwindi matenda, pambuyo cholecystectomy, aakulu cholecystitis ndi hypomotor kukanika kwa ndulu.

Osowa kawirikawiri, pancreatic steatorrhea ndikuwonetsera komwe kumachitika pambuyo pa kukwiya, pamimba ischemic syndrome, kudya kwambiri (kudya mafuta ochulukirapo omwe amatha kupitiriza kupanga ma enzyme a lipolytic).

Zizindikiro, kumene

Mawonetseredwe omwe amapezeka kwambiri ndi PS kulekerera bwino kwa zakudya zamafuta (makamaka yokazinga ndi kusuta), itatha kumwa pomwe odwala amakhala ndi vuto la m'mimba ndipo amakhala ndi mafuta ambiri a mushy "mafuta". Pafupipafupi ma matumbo a matumbo nthawi zambiri sakhala upitilira katatu kwa tsiku ndi tsiku ndi limodzi.
Njira yophweka yodziwira 'mafuta' omwe amapezeka ndowe ndikutha kusiya mafuta onunkhira, osasamba pachimbudzi.
Pakhoza kukhala kupweteka ndi kupweteka pakati pake.
Ndi malire pazakudya zamafuta am'mimba komanso michere yamagayidwe am'mimba, zovuta zowonetsera zimachepa, nthawi zina mpaka kutha kwawo kwathunthu.

Zowonetsera koyambirira kwa PS:
- kuchepa thupi,
- polypecal,
- "chopondapo mafuta"
- linterea (zotsalira za macroscopic zama chakudya osavomerezeka mu ndowe),
- chisangalalo,
- kupweteka kwam'mimba.

Mawonetsedwe atheka ku PS:

9. Mu PS, monga lamulo, kapangidwe kazinthu zam'mimba zimasokonekera. Odwala, enteropancreatic syndrome (kuchuluka kwambiri kwa mabakiteriya, enteritis) kumachitika ndipo pali chiopsezo cha kufalikira kwamatumbo kuchokera kumatumbo a lumen mpaka m'mimba, zomwe zimayambitsa kukula kwa mabakiteriya.

Laborator diagnostics

Kuti muzindikire mafuta a pancreatic steatorrhea (PS), ndikofunikira kudziwa momwe mafuta amaperewera ndi ndowe. Pozindikira matenda am'madzi am'madzi, kutsimikiza kwa mafuta mu ndowe kumalimbikitsidwa pambuyo pamafuta ambiri.

Gulu la mayesero a pancreatic

1. Probe - kutsimikiza kwa bicarbonates, michere mu duodenal nkhani:

1.1 Direct (secretin-pancreosimine, secretin-cerulein, aufillino-calcium calcium) - kukondoweza kwa maselo a ziphuphu zakumaso ndi a duct a kapamba (kapamba).

1.2 Indirect (Kuyesa kwa Lund, mayeso a hydrochloric acid-mafuta) - kukondoweza kwa secinin ndi kapamba wa kapamba.

2. Mayeso osafunikira:

2.1 Direct (elastase-1, chymotrypsin ndi ena) - kutsimikiza kwa zomwe zili ndi pancreatic michere mu ndowe.

2.2 Molunjika - kutsimikiza kwa zomwe zili zigawo za hydrolysis:
- mu ndowe (coproscopy, kumasulidwa kwamafuta tsiku ndi tsiku),
- mu mkodzo (mayeso a PABK, mayeso a pancreolauryl, mayeso a Schilling),
- mu mpweya wotuluka (triglyceride, mapuloteni, amylase ndi ena).

Mayeso a Probe

Kuyesedwa kwa Secretin Pancreosimine
Chiyeso chodalirika kwambiri chofuna kudziwa za exocrine pancreatic insuffence. Kuchita mayesowa, mutatenga secretion ya basal mkati / mkati pang'onopang'ono (mkati mwa mphindi 3-4), secretin imayendetsedwa pa mlingo wa 1 U / kg kulemera kwa thupi. Musanagwiritse ntchito, 10 ml ya osabala isotonic sodium kolorayidi njira imalowetsedwa mu vial ndi secretin. Mu 1 ml ya njira yothetsera mavutowa azikhala ndi ma PIERES 10 a secretin. Pamakilogalamu 10 alionse a kulemera kwa thupi, 1 ml ya secretised yothandizidwa imaperekedwa. Pambuyo pa kayendetsedwe kake, zomwe zili mkati mwake zimasonkhanitsidwa m'magawo atatu a mphindi 20.
Komanso, momwemonso, pancreosimine pa mlingo wa 1 U / kg kulemera kwa thupi (kuchepetsedwa m'njira yomweyo ngati secretin). Pambuyo pancreosimine, zomwe zili mkati mwake zimasonkhanitsidwa m'mphindi zitatu zamphindi 20.

Makhalidwe abwinobwino a testin-pancreosimine test:
- kuchuluka kwa katulutsidwe - 184 ml / h,
- kuchuluka kwa ma bicarbonates ndi 85 mmol / l,
- ntchito ya amylase - 111 ncat / kg,
- ntchito ya lipase - 61 ncat / kg,
- ntchito ya trypsin - 4.9 nkat / kg.

Mayeso opanda pake

Njira yodziwira fecal elastase-1 - mayeso owopsa, osasokoneza a matenda a chifuwa chachikulu. Kuyesaku kumakhala kovutirapo kuposa fecal chymotrypsin pakupezeka kwa chifuwa chachikulu, koma sikodalirika ku matenda ofatsa kapena olimbitsa.
Njira yodziwira matenda apakhungu pancreatitis ya fecal elastase-1 ikugwirizana ndi kutsimikiza kwa njira yolowerera yomwe ili mkati mwazinthu zazikulu za pancreatic: amylase, lipase, trypsin ndi chymotrypsin.

Njira ya Van de Camera - tnthawi zonse komanso njira yosavuta yothandizira kuchuluka kwa mafuta mu ndowe. Ndikulimbikitsidwa kuyesedwa pamene odwala akudya chamagulu omwe ali ndi 50-100 g yamafuta.
Mafuta okwanira, mafuta achilengedwe ndi mafuta osalowerera ndindende, omwe amatsimikiziridwa pa 100 g ya ndowe, samasinthidwa kukhala kuchuluka kwa ndowe. Zambiri zomwe zapezedwa ndi njirayi ziyenera kuchokera kumagawa tsiku lililonse a mafuta okhala ndi ndowe.
Chosimbacho chimasonkhanitsidwa mkati mwa masiku atatu (ndi kudzimbidwa - masiku 5), kafukufuku wotsatira wa ndowe iliyonse amachitidwa, ndiye kuti mitengo ya masiku atatu imawonetsedwa.
Mwa anthu athanzi omwe amatenga mafuta mkati mwa thupi, kutulutsa kwamafuta tsiku lililonse ndi ndowe sikupitirira 5 g. Steatorrhea wolembedwa amatulutsidwa ndi mafuta 5-10 g ndi ndowe, zotchedwa steatorrhea - zoposa 10 g.

Kusintha kwa makina owonera a Fourier - ndowe lipid njira yoyezera (ofunsira ndi Songein ndi Schroeder).

RAVA kapena PABK mayesokomanso peptide kapena bentiramine mayeso: para-aminobenzoic acid tripeptide imayambitsidwa mkati mochuluka kwa 1,0-2.0 g (kutengera zaka ndi kulemera kwa thupi), 1 g ya mankhwala ili ndi 340 mg ya para-aminobenzoic acid. Thupi limasweka m'matumbo ang'ono ndi chemotrypsin. Makina amaperewera a para-aminobenzoic acid amadziwika chifukwa cha kuphipha kwa mkodzo mu mkodzo.
Urinalysis imachitika mkati mwa maola 8, nthawi zambiri osachepera 50% ya mafuta a para-aminobenzoic amamasulidwa nthawi imeneyi.

Kuyesa kwa fecal kumakhala kovuta chifukwa kumafunikira kusonkhanitsa matumbo onse m'masiku ochepa ndipo pali ngozi yosakanikirana ndowe ndi mkodzo. Mphamvu yakuzindikira kwa njira ya radioisotope imachulukirachulukiranso ndi kugwiritsidwa ntchito koyeserera kwa magazi ndi zoyeserera zamkati. Kafukufuku wokhudza ntchito ya mkodzo ndi njira yodalirika kuposa kuyezetsa magazi.

Pogwiritsa ntchito njira ya radioisotope, kudziwitsidwa koyambirira kwamatenda oyamwa kumathandizidwa.

Njira zochokera pakuyesa magazi (njira ya "kuputa hyperlipidemia", njira ya chromatographic yowerenga zigawo zingapo za lipid, kuyesa kwa trero, kusintha kwa mayeso ndi lipiodol, kusiyanasiyana kwa mayeso a PABA) sikodalirika. Njira yodalirika komanso yosavuta ndiyo kutsimikiza kwamafuta amadzimadzi ndi ndowe. Izi ndichifukwa choti 95% yamafuta amamwa ndikuchepa pang'ono peresenti iyi kumaonekera kwambiri pakuwona kuchuluka komwe kwatulutsidwa kuposa kuyeza kuyamwa kwake.

Pozindikira PS, njira yosavuta monga mayeso a iodolipol imagwiritsidwanso ntchito. Iodolipol, amatengedwa pakamwa, amawonongeka m'matumbo ndi lipase ndikuthira mkodzo. Pofika nthawi ya chimbudzi komanso kuchuluka kwa ayodini mu mkodzo, ntchito ya lipase ikhoza kuweruzidwa.

Ngati alipo:
- chitsulo, calcium, magnesium, potaziyamu, sodium m'magazi: otsika,
- mavitamini A, D, E, K m'mwazi: kuchepa,
- Mayeso a PABA, mayeso a pancreolauryl kapena mayeso ena omwe amawonetsa kuperewera kwa pancreatic,
- bacteriological kuwunika ndowe: mkhutu zikuchokera matumbo zimayambira, enteropancreatic syndrome (kuchuluka bakiteriya kukula, enteritis).

Zambiri

Steatorrhea si kawirikawiri ndi njira yodziyimira payokha, nthawi zambiri ndi chizindikiro cha vuto lina, lomwe limayendera limodzi ndikuphwanya njira zakusokonekera ndi kuperewera kwa mafuta. Zizindikiro zodziwika kwambiri za steatorrhea zimawonedwa pakavulaza pancreatic ntchito. Pathology imadziwikanso chimodzimodzi mwa amuna ndi akazi. Nthawi zambiri zimatha zaka 25-30, ngakhale mitundu yobadwa nayo imatha kuubwana. Popeza kuphatikizidwa kwamafuta osagwiritsidwa ntchito, akatswiri omwe ali m'magulu othandizira gastroenterology amasiyanitsa mitundu itatu yamatenda: ndi 1stant ya steatorrhea, mafuta osagwirizana ndi ndale m'matumba, omwe ali ndi mitundu yachiwiri ya mafuta ndi sopo, wachitatu - zonsezi.

Steatorrhea ali ndi chiyambi cha polyetiological. Mitundu yayikulu (yokhayokha) yamatenda imawonongeka ndi kuwonongeka kwa kapamba - dysplasia, hypoplasia ndi aplasia wa chiwalo, cholowa chotengera pancreatic lipase. Zomwe zimapangitsa kuti cholembera yachiwiri (monga chizindikiro) chizindikire ndi zina:

• Matenda a kapamba. Pancreatic lipase ndi colipase enzymes amafunikira mafuta hydrolysis. Kupanga kwawo ndi katulutsidwe umasokonezeka chifukwa cha kupweteka kwa kapamba, mapangidwe a kapamba, kapangidwe ka mapindikidwe a kapamba.
• Matenda am'mimba. Mafuta osakwanira m'matumbo amadziwika ndi kuchepa kwa chinsinsi cha epithelium ya m'mimba. Zizindikiro za steatorrhea amapezeka matenda a gastritis yochepetsedwa katulutsidwe, zilonda zam'mimba ndi matenda am'mimba.
• Hepatobiliary matenda. Chiyero chokwanira cha bile ndi chofunikira kuti mayamwidwe am'mimba ndi khoma lamatumbo. Kukula kwa steatorrhea kumalimbikitsidwa ndimatenda omwe ali ndi vuto la bile secretion: cholestatic hepatitis, hypomotor biliary dyskinesia.
• Matenda amkati. Ndi matenda am'mimba kwambiri komanso kukula kwambiri kwa mabakiteriya, njira ya adipose micelles omwe amalowa mu enterocytes imavutika. Zotsatira zake, mafuta omwe sanadutse kukhoma lamatumbo amathandizidwa mu ndowe, zomwe zimawonetsedwa ndi steatorrhea.
• Matenda a Endocrine. Odwala matenda a shuga, chomwe chimayambitsa matenda a shuga ndi matenda ashuga a shuga. Mafuta omwe amakhala ndi ndowe zambiri amapezeka mu polyglandular syndrome ndi hypoparathyroidism.

Mafuta amathandizira kumera ndikukula kwamatenda komanso matumbo. Pafupipafupi, kupezeka kwa steatorrhea kumalumikizidwa ndi zovuta zamtundu umodzi wamankhwala kapena kudya - kugwiritsa ntchito mafuta ochulukirapo omwe amapitilira kutulutsa zinthu za lipolytic. Chimbudzi chosakwanira ndi mayamwidwe amafuta amawonedwa ndikugwiritsa ntchito mankhwala othandizira mankhwala ndi mankhwalawa pochizira kunenepa kwambiri, komanso chemotherapy yothandizira khansa. Palibe zifukwa zomveka zowonjezera mafuta mu ndowe, amalankhula za mtundu wina wamatendawa.

Limagwirira chitukuko cha steatorrhea zachokera kuchuluka zikusiyana mafuta kudyedwa ndi mphamvu zinchito za chamoyo chimbudzi ake ndi mayamwidwe. Matenda otsogolera a pathogenesis ndiko kuphwanya magawo osiyanasiyana a kusintha kwa lipid m'mimba. Kusakwaniritsidwa kwenikweni kwa mafuta chifukwa chakuchepa kwa katulutsidwe ka m'mimba. Hydrolysis yosakwanira imawonedwa ndikusowa kiyi ya lipolytic zinthu (ma pancreatic enzymes, bile acids), kuwonongeka kwa enterocytes komanso kuthamanga kwa chyme kudzera m'matumbo.

Zizindikiro za steatorrhea

Chizindikiro cha pathognomonic cha matendawa ndi kutulutsidwa kwamadzimadzi amafuta ambiri osagwira omwe amakhala ndi mafuta ambiri osaloledwa ndipo osatsukidwa kuchimbudzi. Pondapondayo nthawi zambiri imafulumizitsidwa mpaka katatu kwa tsiku ndi tsiku. Odwala amatha kuwona magawo a zakudya zosaphatikizika m'matumbo awo. Polyfecalia mu steatorrhea nthawi zambiri imagwiritsidwa ntchito ndi zakudya yokazinga kapena mafuta. Mawonetseredwe ena a dyspeptic amawonetsedwa: kuwonda ndi kusapeza mu epigastric dera, kutulutsa, kukokana kwam'mimba.

Ndi njira yovuta ya matendawa, odwala amatha kukhala ndi zizindikiro kuchokera ku ziwalo zina ndi machitidwe ena. Steatorrhea imadziwika ndi kutupa komanso mawonekedwe a kukokoloka pa lilime, milomo ndi mucosa mkamwa chifukwa cha kuchepa kwa vitamini. Mwa amayi, kusakhazikika kwa msambo, msambo wa oligomenorrhea, kumadziwika. Mkhalidwe wamba wa odwala akusintha, kuchepa kwa mphamvu yogwira ntchito, kufooka kwa minofu, kupweteka kwamutu komanso chizungulire kumadziwika.

Chithandizo cha Steatorrhea

Kusankhidwa kwa njira zamankhwala kumadalira zomwe zimayambitsa matendawa. Popeza mwa odwala ambiri matendawa amayanjana ndi kugwira ntchito kwa kapamba kapena m'mimba, kukondoweza kwachindunji ndi kutulutsa kwina kumachitika. Malangizo a mankhwala a steatorrhea atha kuphatikizira magulu otsatirawa a mankhwala:

• Gastric secretion stimulants. Amasonyezedwa matenda am'mimba ndi zoletsa zachinsinsi ntchito. Kuonjezera kupanga pepsin ndi hydrochloric acid, histamine ndi mapangidwe ake ophatikizira nthawi zambiri amagwiritsidwa ntchito. Ndi kusagwira kwa othandizira ndi cholinga cholowa, othandizira omwe ali ndi timadzi ta m'mimba amadziwika.
• Pancreatic michere. Mankhwala othandizira enzyme amathandizira steatorrhea ndikutayika kwambiri kwa mafuta tsiku ndi tsiku ndowe (kuchokera ku 15 g), kuchuluka kwa matalikidwe, kuperewera kwa m'mimba ndi dyspepsia. Kuti m'malo mwa exancine ntchito ya kapamba, sinthani chimbudzi cha mafuta, makina okhala ndi lipase amagwiritsidwa ntchito.

Ndi mitundu ya extrapancreatic yamtundu wa steatorrhea, nthendayi imayang'aniridwa mothandizidwa ndi ma protocol a achire. Pankhaniyi, wodwala amatha kupatsidwa mankhwala a antibacterial ndi antiparasitic, antidiarrheals, antifoam othandizira, prokinetics ndi myotropic antispasmodics kuti athetse secretion ya bile, pre- ndi probiotic. Kuwongolera zovuta zamtundu wa tropholoengqondo, mavitamini K, A, D, E, B12, folic acid, ma vitamini-mineral complexes ndi amino acid zosakaniza zimagwiritsidwa ntchito.

Mosasamala kanthu za etiology ya steatorrhea, odwala amafunikira kukonza zakudya: pafupipafupi chakudya chopatsa thanzi, kuthetsa kudya kwambiri (makamaka masana), kuchepetsa kuchuluka kwa mafuta omwe amadya tsiku lililonse mpaka 40-60 g, makamaka chifukwa cha nyama ndi mafuta omwe amathandizidwa ndi kutentha. Kuthetsa kwathunthu kusuta fodya ndi kumwa mowa ndikulimbikitsidwa.

Zotsogola ndi kupewa

Zotsatira zake zimatengera chomwe chimayambitsa matendawa komanso kuthandizira kwakanthawi kwamankhwala. Mu steatorrhea chifukwa cha kuwonongeka kwa pancreatic England, matendawa amakhala osavomerezeka, popeza odwala amafunikira chithandizo chamankhwala kwa moyo wonse. Miyeso ya prophylaxis yamatenda siyipangika. Pofuna kupewa matendawa, chithandizo chokwanira cha matenda opatsirana chomwe chimayambitsa kuphwanya chimbudzi ndi kuyamwa m'matumbo ndichofunikira.

Mitundu ndi zoyambitsa za steatorrhea

Matendawa ali ndi mitundu ingapo, kutengera mtundu wa chitukuko cha matenda. Mitundu 1 kapena chakudya cha mtundu wa steatorrhea chitha kuchitika pakudya kwambiri kwamafuta omwe ngakhale thupi labwinobwino silitha kugaya.

Mtundu wamatumbo amtunduwu umapezeka pamene ziwalo zomwe zimakhudzidwa zimayamwa matumbo ang'onoang'ono sizingathe kuyamwa mokwanira mafuta.

Pancreatic steatorrhea imapezeka ngati zikondamoyo sizigwira bwino komanso lipase, yomwe imaphwanya mafuta, imapangidwa mopanda kuchuluka.

Komanso, kamangidwe ka matendawa kamagawika magawo atatu:

1. Steatorrhea - chifukwa cha kusachita bwino mu chakudya chamagaya, kupezeka kwa mafuta osaloweka mu chopondapo kwapezeka,
2. Creatrhea - chifukwa cha kupweteka kwamankhwala m'matumbo, ndowe zimaphatikizapo nayitrogeni, mafuta acid ndi sopo,
3. Amylorrhea - mu ndowe, kusanthula kwa zamankhwala amuzolengedwa kumawonetsa kuphatikiza kwamafuta osaloleka komanso mafuta acids.

Tizilombo toyambitsa matenda tomwe timatulutsa, monga lamulo, zimalumikizidwa ndikuti thupi silingathe kugaya bwino komanso kuyamwa mafuta.

Chochititsa chosowa kwambiri cha matendawa ndichotuluka mofulumira cha ndowe. Zofananazo zimawonedwa ngati munthu agwiritsa ntchito mankhwala ozunguza bongo.

Komanso matendawa amatha kudzetsa mavuto m'matumbo ang'onoang'ono, chiwindi ndi kapamba. Nthawi zambiri chovalacho chimakhala chikhansa chodwala, makamaka ngati chayamba chifukwa cha uchidakwa.

Cardiospasm imatha kuyambitsa steatorrhea pokha pokha. Kusasunthika kwa bile kumatha kubweretsa zotsatira zosasangalatsa, chifukwa chake ndowe zimakhala ndi mthunzi wopepuka.

Zizindikiro zakuzizira

Ngati munthu wayamba kudya, chizindikiro chachikulu cha matendawa chimakhala chovuta kwambiri chofuna kusiya. Nthawi yomweyo, ndowe zimakhala zosasinthasintha zamadzimadzi, chopondapo ndicochulukirapo, zolimbikitsana zimadza nthawi zambiri. Nthawi zina, wodwalayo, kudzimbidwa.

Kuyenda kwamatumbo kwamtundu uliwonse kumayendera limodzi ndi mapangidwe azitseko za chimbudzi cha chimbudzi cha malo osambiramo amafuta komanso malo onyezimira. Fandi amatha kukhala opanda mbali, opepuka kapena imvi.

Wodwala amakhala ndi chizungulire, ukufalikira ndi kugundana m'matumbo, kuyanika kwamtundu wamkamwa ndi m'mphuno, ulesi, kuchepa kwa magwiridwe antchito, kupweteka kwakanthawi.

Komanso, odwala omwe ali ndi matenda a steatorrhea ali ndi zizindikiro zotsatirazi:

• Kukhosomola kouma, kuchuluka kwamatumbo ambiri,
• Ululu m'dera la mafupa, mafupa ndi msana,
• Kuchepetsa thupi komanso kutopa msanga, nthawi zina magazi amapezeka,
• Milomo imawuma ndikusunthika, ngodya za pakamwa zimasweka,
• Pamkamwa pakamwa, zizindikiro za stomatitis zimayang'aniridwa, lilime limakhala ndi mtundu wowala, papillae ikhoza kuthothoka, zotsekemera zimatseguka ndi kutuluka magazi.
• Chifukwa cha mafuta osakwanira, khungu limawuma, limapindika, ndipo nthawi zambiri limakhudzidwa ndi erythema ya polymorphic.

Nthawi yodwala, madokotala azachipatala amatha kudziwa kuwonongeka ndikumayendayenda mbali yamanzere pamimba, m'dera la cecum. Ndulu ndi chiwindi sizokoma.

Nthawi yayitali imadziwika ndi matendawa. Kutalika kwa chikhululukiro nthawi zina kumafupika. Matenda apakati, zovuta za neuropsychic zimayambiranso. Zofananazo zimachitika ngakhale popanda zifukwa zomveka.

Chifukwa cha matenda, pamakhala kuchepa kwamafuta ndi mapuloteni, chifukwa zomwe ziwalo zamkati ndi minofu yake zimatha. Munthu alibe mavitamini, nicotinic ndi folic acid. Izi zimabweretsa hypoproteinemia, hypocholesterolemia, hypolipemia, leukopenia, hypochromia, nthawi zambiri hyperchromia, kuchepa magazi, hypocalcemia, hyponatremia.

Kusiyanitsa mosiyanasiyana ndi kuchiza matendawa

Kuti adziwe kuwonongeka kwa nembanemba ya mucous, adotolo amatipatsa rectoscopy. Mothandizidwa ndi kuyesedwa kwa X-ray, kuchuluka kwa kutupa, kufalikira ndi kuchepa kwa kamvekedwe ka mapangidwe a mucosa kumawululidwa.

A biopsy imakulolani kuti muwone ngati pali atrophy, palibe tsitsi losakhalitsa, villi idafupikitsidwa, epylindrical epithelium ili pansi pa mulingo wabwinoko, ma cell a cell cell amakhala m'malo osadziwika.

Ziwalo zolumikizana nthawi zina zimatupa, ndipo mitsempha ya mitsempha imapunduka. Kuphwanya kotereku kumachepetsa m'mimba ntchito.

1. Mukamayang'ana ndowe, kusinthasintha kwamafuta kumatha kupezeka. Ndibwino kuti mumakhala ndende zambiri zamadzimadzi ndipo zimakhala ndi mthunzi wowala.
2. Kusanthula kwa Laborator kumawonetsa kuchuluka kwamafuta acid, mafuta ndi sopo. Steatorrhea imapezeka ngati chopondapo chili ndi mafuta ochulukirapo 7 g.
3. Kuti mudziwe chomwe chimayambitsa kuphwanya kusweka ndi kuthira kwa zinthu zamafuta, kafukufuku wa radioisotope amachitika. Kupatula matenda a kapamba (yogwira pancreatitis, shuga, cyst), njira yotsitsa mafuta imagwiritsidwa ntchito.
4. Pulogalamuyi imakuthandizani kuzindikira matenda angapo am'mimba.

Ndikofunika kusamalira osati steatorrhea, koma matenda omwe adabweretsa kukula kwa matenda. Mankhwalawa amachitika ndi mankhwala omwe ali ndi lipase yayikulu, mapiritsi oterewa ali ndi nembanemba yapadera yomwe imalepheretsa kuwonongeka kwa ma enzymes atayamwa madzi a m'mimba.

Dotoloyo amalemba Pancytrate, Creon ndi Pancreatin, kuwonjezera apo amagwiritsa ntchito mankhwala a antacid: maantacid: Almagel, Maalox, Phosphalugel, Gastal, iwo amatha kusokoneza zotsatira za m'mimba acid. Komanso, wodwalayo amapatsidwa hydrochloric acid, Cortisone ndi adrenocorticotropic timadzi. Kuphatikiza pa chithandizo chachikulu, njira zochiritsira zina ndizothandiza.

Popewa kukonzanso kwa matendawa, chakudya chofunikira komanso chopatsa thanzi ndichofunikira. Wodwalayo adapangidwa kuti azigwiritsa ntchito mapuloteni omwe amapezeka ndi mapuloteni, mavitamini A, B12, B15, D, E, K. Nicotinic ndi ascorbic acid amagwiritsidwa ntchito ngati adjunct.

Ngati munthu ali ndi chizindikiro cha kuzizira kwa petechial, chisamaliro chimayenera kutengedwa kuti atenge mavitamini P ndi K. Mndandanda uyenera kukhala wa mkaka, tchizi tchizi, nsomba, mitundu yamafuta ochepa am'mafuta, nsomba zamafuta ochepa ndi msuzi wa nyama.

Zakudya zoterezi zimapangitsa kuti chakudya chizikhala chabwino. Pakugaya bwino, nyama ndi nsomba zimaphika.

Kodi kuchitira matenda a kapamba?

Polembera wodwala dongosolo lamankhwala omwe akubwera, adokotala amakhazikitsa zolinga zodziwika bwino. Ndikofunikira:

• Chotsani ululu
• patsani nkhondoyi ndi mtendere,
• chepetsa ntchito yake yachinsinsi,
• bwezerani kuchepa kwa michere ya kapamba,
• Malangizo a mitsempha ya mafuta owonongeka (ngati pakufunika).

Kuti tikwaniritse zolinga izi posagwiritsa ntchito mankhwalawa odwala omwe ali ndi mitundu yosiyanasiyana ya kapamba, njira zosiyanasiyana ziyenera kugwiritsidwa ntchito.

Zovuta zakuchuluka kwa zinthu zingapo zochizira (chithandizo cha zakudya, mankhwala, njira zolimbitsa thupi, ndi zina zambiri) ndizothandiza kwambiri.

Mankhwala

Matenda a kapamba, mankhwala otsatirawa akhoza kulembedwa:

1. Zinthu zokhala ndi enzyme. Cholinga chake ndikuchepetsa katundu pa kapamba ndikufulumizitsa njira yosinthira minofu. Ma enzymes am'mimba amathandizira kugaya chakudya komanso kugwirira ntchito, ndikuthandizira ntchito ya m'mimba. Ndi kudya kwawo kosalekeza, mseru umasowa, chilakolako chimawonekera. Mankhwala okhala ndi enzyme akuphatikizapo: Creon, Pancreatin, etc.
2. Maantacidids omwe amachepetsa acidity. Malinga ndi lingaliro la kuchitapo kanthu, agawika kukhala: odziwikiratu (Rennie) ndi nonabsorbable (Almagel, Maalox). Pampu za suction zimapereka chithandizo mwachangu, koma kwakanthawi. Kuchita kwa osagwiritsa ntchito kumatenga nthawi yayitali, zotsatira zake zimachitika pakadutsa makonzedwe.
3. Ndipo ma pinkiller amafunikira kuti athetse kupweteka komwe kumachitika ndi kapamba panthawi yanthawi yochulukirapo. Ma antispasmodics (No-shpa, Papaverine) amalembedwa kuti athetse mbali zapadera za pancreatic duct.
4. Mankhwala a Antisecretory (Famotidine, Omeprazole) amadziwika kuti asalole asidi.
5. Mankhwala ochepetsa mphamvu ya kutupa (Diclofenac) amachepetsa ululu pochepetsa kutupa mu kapamba.
6. Kuchepetsa katulutsidwe yogwira gland, mankhwala osokoneza bongo (Octreotide, Sandostatin) amagwiritsidwa ntchito pakukulitsa kwa kapamba, kupweteka kwambiri, osaletsa antispasmodics.
7. Prokinetics (Motilium, Tserukal) amagwiritsidwa ntchito kupondera mseru pa kusanza pa nthawi yayikulu.

Chithandizo cha kukokomeza matenda kapamba

Zomwe zimathandizira pakuwopseza kwambiri zimaphatikizira kutsatira kupumula kwa kama, kudya ndi kumwa mankhwala oyenera kuchipatala, popeza pali chowopseza osati thanzi, komanso moyo wa munthu. Ma ambulansi isanafike, wodwala ayenera kulandira thandizo loyamba:

• Njala yeniyeni.
• Ikani ozizira ku pancreatic dera.
• Kupumula kwathunthu ndi kugona.

Odwala ambiri akufuna kufotokozera kuti kutalika kwa chifuwa chachikulu chitha kukhalapo mpaka liti? Madokotala amatsimikiza kuti m'malo ambiri obwezeretsanso matendawa sapitirira masiku 7.

Chithandizo chothandizira kupumula kwa zowawa:

• Ma enzyme (Creon kapena Pangrol),
• antispasmodics (drotaverine kapena papaverine),
• proton pump inhibitors (lansoprazole, rabeprazole).

Pofuna kutsitsa kapamba, gwiritsani ntchito:

• Zakudya zomwe zili ndi mafuta ochepa kapena osatha kudya kwa masiku angapo,
• kusiyiratu kumwa mowa ndi kusuta,
• octreotide ndi mankhwala omwe ali analogue of the pancreatic hormone somatostatin.

Opaleshoni yamatenda oyamba a kapamba:

• sphincterotomy ndi kutsekeka kwa sphincter ya Oddi,
• kufukula kwa miyala m'miyala ya kapamba ndi choletsa chotchinga,
• kutsegula ndi ukhondo wa purulent foci (abscesses, phlegmon, cysts),
• Pancrectomy (kwathunthu kapena pang'ono),
• vasectomy, splanhectomy (kuchulukitsa kwa mitsempha yomwe imayendetsa kubisalira kwa kutulutsa kwa thumbo), pang'ono
• chapamimba chapamwamba (chapafupi),
• Kuchotsa ndulu panthawi ya zovuta za ndulu yayikulu ndi ndulu,
• njira zopangira potengera gawo la bile lotuluka kuti muchepetse kupsinjika kwa ma pancreatic ducts (wirsungoduodenostomy, etc.).

Zakudya ndi mfundo za zakudya

Akuluakulu, matendawa amakhala osachiritsika, zomwe zikutanthauza kuti chisamaliro choyenera chimayenera kulipira thanzi, chifukwa chingalepheretse kuchulukana. Kuchulukana kwina kulikonse kumatanthauza kulowetsa tiziwalo tamatumbo tambiri. Chifukwa chake, pazaka zambiri, wodwalayo amakula ndi exocrine ndi intrasecretory gland insuffence.

Mfundo zazikuluzikulu za zakudya zopatsika matenda kapamba:

1. Zakudya No. 5p yodwalitsa kapamba imayambitsa kukhazikitsidwa kwa zakudya zamapuloteni ambiri m'zakudya chifukwa chopatula mafuta ndi chakudya. Ndikofunikanso kusiya ulusi wamafuta wowola ndi nyama yamafuta.
2. Zakudya zophika siziloledwa. Chakudya chikulimbikitsidwa kuphika mu chowiritsa chowirikiza, kuwira ndikuphika mumadzi awo.
3. Zinthu zonse zomwe zimayambitsa dyspepsia ndikuthandizira kupanga ma enzymes sizikuphatikizidwa pamenyu.
4. Zakudya zodwala zomwe wodwala amadwala matenda a pancreatitis osafunikira amayenera kugwiritsidwa ntchito moyenera, zimaphikidwa monga ofunda ndi theka lamadzimadzi.
5. Chakudyacho ndichoperewera, chimakhala ndi chakudya chambiri ndi 5-6, komanso magawo a buku laling'ono.
6. Kuletsedwa kwathunthu kwa zakumwa zoledzeretsa kumachotsa chiopsezo chachikulu cha kapamba.
7. zakudya zatsopano ziyenera kuyambitsidwa mosamala m'magawo ang'onoang'ono.
8. Ndi malaise wocheperako ayenera kusiyidwa kuti pakhale chikhazikitso chonse,
9. Upangiri wofunafuna kudya kwathunthu ndiwofunikanso kuti ukhale wathanzi, koma ndi matenda a kapamba, lamuloli liyenera kuchitika mosamalitsa, ngakhale msuzi utaphikidwa.

Zakudya zomwe zimachulukitsa matenda a kapamba, ngakhale zili ndi malire, ndizosiyanasiyana. Amaloledwa kuphatikiza ndi zakudya:

• nyama yopanda nkhuku,
• nsomba yamafuta ochepa,
• masamba ophika masamba
• masamba omwe amapezeka ndi mpunga, ndi vermicelli, wokhala ndi buckwheat, semolina, oatmeal,
• Masamba ophika (mbatata, kaloti, zukini, kolifulawa, dzungu),
• maelemu ochokera ku mazira awiri,
• zinthu zamafuta zopanda mkaka, tchizi wopanda mafuta komanso mafuta ochepa, kirimu wowawasa ndi zonona pang'ono, zinthu mkaka wowawasa,
• zipatso zokhala ndi acidity yochepa, zipatso zosenda, maapulo ophika,
• zipatso zosafunikira ndi tiyi wopanda mphamvu ndi mandimu,
• kuchuluka kwa batala ndi mafuta a masamba,
• chimanga chophika m'madzi ndi mkaka muyezo wa 1: 1,
• nyama yophika,
• ma cookie aulere opanda pake komanso zopanga zomwe zimapangidwa kuchokera ku mkate wa tirigu.

Odwala ndi contraindicated mbale ndi sokogonnym kanthu:

• nyama
• fupa
• msuzi ndi nsomba,
• zakudya zokazinga.

Chofunika kwambiri ndikukana zakumwa zoledzeretsa, chifukwa zimatha kutulutsa zinsinsi za pancreatic.

Panthawi yachikhululukiro, mndandanda wazinthu umakula ndikuyika masamba ndi zipatso zimawonetsedwa kale komanso mwanjira yopanda. Masamba amagwiritsidwa ntchito ngati gawo la saladi, mbale zam'mbali, vinaigrette komanso monga mbale zodziyimira pawokha. Kuphatikiza pa mbewu monga chimanga, mutha kupanga pilaf ndi zipatso zouma ndi nyama yophika, pasitala, groats. Msuzi amaphika osaphika komanso kachikumbu, msuzi ndi kabichi msuzi zimayambitsidwa bwino. Kusintha kukoma kwanu pogwiritsa ntchito soseji zopangira tokha ndi zonunkhira.

Matenda apakhungu, njira yochiritsira madzi amchere nthawi zambiri imayikidwa. Kuti akwaniritse izi, amamwa madzi kuti asathetse ludzu lawo, koma malinga ndi malingaliro omwe amamwa, mitundu ina ya iwo komanso malinga ndi dongosolo lotchulidwa.

Gawani njira yodzatenga mtundu wa madzi a Essentuki No. 4, Borjomi ndi Smirnovskaya, makamaka pancreas:

• Pewani kusunthika kwa ndowe, mu kapamba,
• chepetsani ngozi yotupa,
• sinthanso ntchito yam'mimba ndi matumbo.