Pancreatitis yoyamba ndi yachiwiri: ndi chiyani?

Matenda a kapamba ndimatenda ofala kwambiri, omwe amasonyezedwa ndi kupweteka kosalekeza kapena kwakanthawi pang'ono ndi zizindikiro za kuchepa mphamvu ndi endocrine. Amadziwika ndi kusintha kosasinthika kwa pathological mu pancreatic parenchyma - kumakwinya, m'malo ena kuwonongeka kwa acini, proliferative fibrosis, komanso kukakamiza kwa duct, kupangika kwa calculi mkati mwake kapena minofu ya tiziwalo. Itha kuchitika ndi ma kliniki ochepa kapena kuwonekera kwa matenda ena am'mimbamo (cholesterstitis, bysary dyskinesia, chironda cham'mimba ndi duodenum, hiatal hernia). Zotsatira zake, sikotheka kukhazikitsa pafupipafupi matenda.

Etiology

• Woopsa komanso kagayidwe kachakudya matenda kapamba
• Idiopathic aakulu kapamba
• Herederal Chronic Pancreatitis
• Autoimmune aakulu kapamba
• Nthawi ndi nthawi matenda kapamba
• Cholepheretsa matenda kapamba
• Njira yoyamba ya matenda a kapamba
• Yachiwiri mawonekedwe a chifuwa chachikulu

Kugawidwa kwa matenda apakhungu a pancreatitis malinga ndi M.I. Msuwani

• Mowa
• Chifukwa cha kuperewera kwa zakudya m'thupi
• Mankhwala Pancreatitis
• Kutengera zovuta za metabolic
• Etiology yosasankhidwa

• Chifukwa chotseguka pancreatic
• Chifukwa chakuvulala
• Pambuyo pa intraoperative kuwonongeka
• Kutengera ERCP

• Cholangiogenic, kuphatikizapo:
• lympho native cholecystopancreatitis, chifukwa cha choledocholithiasis, ndi papillostenosis.
• Ndi matenda am'mimba thirakiti, kuphatikiza: ndi pulayimale yachiwiri ndi yachiwiri, ndi duodenal diverticula, zilonda zam'mimba,
• Ndi occlusion wa nthambi zam'mimba
• Ndi endocrinopathies
• Pamaziko a zina za ukadaulo

Gulu la apancreatitis aposachedwa kwambiri ndi M-ANNHEIM (2007), lomwe linapangidwa ndi ma pancreatologists aku Germany. Kugawikaku kumaganizira zinthu zambiri zomwe zingayambitse matenda a chifuwa cham'mimba ndipo kumakupatsani mwayi wogawa odwala m'magulu molingana ndi etiology, gawo lazachipatala komanso kuopsa kwa matenda kapamba. Kuopsa kwa nthendayi kumaikidwa m'gulu molingana ndi njira yowerengera. gwero silinatchulidwe masiku 2282

Sinthani ya Etiology |Zambiri

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. Mu gastroenterology, pancreatitis yayitali imakhala 5-10% yamatenda onse am'mimba. Posachedwa, m'maiko otukuka, matenda a pancreatitis "akucheperachepera", ngati kale anali otchuka kwa anthu azaka zapakati pa 45-55, ndiye kuti kuchuluka kwa azimayi kumatha zaka 35.

Amuna amadwala matenda a chifuwa chachikulu pafupipafupi kuposa azimayi, m'zaka zaposachedwa kuchuluka kwa kapamba chifukwa chomwa mowa kwambiri kwawonjezeka kuchokera pa 40 mpaka 75 peresenti mwa zina zomwe zimapangitsa kuti matendawa akule. Kuwonjezeka kwa kupezeka kwa neoplasms yoyipa mu kapamba motsutsana ndi maziko a chifuwa cham'mimba kunadziwikanso. Kuchulukirapo, pali ubale wolunjika pakati pa chifuwa chachikulu komanso kuwonjezereka kwa matenda ashuga.

Monga momwe zilili ndi pancreatitis ya pachimake, zomwe zimayambitsa kukula kwa kutupa kwa kapamba ndi kumwa mowa kwambiri ndi cholelithiasis.

Mowa umakhala ndi poizoni ku m'matumbo a England. Mu cholelithiasis, kutupa ndi njira yodutsa matendawa kuchokera ku ma ducts kupita ku chithokomiro kudzera m'matumbo a lymphatic dongosolo, kukula kwa biliary thirakiti lamatenda oopsa, kapena kuponyera mwachindunji kwa bile mu kapamba.

Zina zomwe zimathandizira pakupanga matenda a kapamba:

• kuchuluka kosalekeza kwa zomwe zimakhala ndi calcium mu magazi,
• cystic fibrosis,
• hypertriglycerinemia,
• kugwiritsa ntchito mankhwala osokoneza bongo (corticosteroids, estrogens, thiazide diuretics, azathioprine),
• yaitali stasis ya pancreatic secretion (kutsekeka kwa sphincter ya Oddi chifukwa cha kusintha kwamankhwala mu duodenal papilla),
• autoimmune kapamba,
• chibadwa mtima kapamba,
• idiopathic pancreatitis (etiology yosadziwika).

Gulu

Matenda a kapamba amatchulidwa:

• mwa chiyambi: pulayimale (mowa, poizoni, ndi zina) ndi sekondale (biliary, etc.),
• malinga ndi mawonetseredwe azachipatalaululu (wobwereza komanso wopitilira), pseudotumor (cholestatic, ndi matenda oopsa a portal, ndi gawo lochepetsa duodenal), latent (chipatala chosafotokozedwera) komanso kuphatikiza (zizindikiro zingapo zamankhwala zafotokozedwa),
• malingana ndi chithunzi cha morphological (calcving, olepheretsa, yotupa (infiltrative-fibrous), induction (fibro-sclerotic),
• malingana ndi chithunzi chantchito (hyperenzymatic, hypoenzymatic), mwanjira yamatenda omwe amatha kugwira ntchito amatha kusiyanitsa hypersecretory, hyposecretory, blockative, ductular (chinsinsi cha kusowa kwa chinsinsi chimagawidwanso ndikuvuta kwa kufatsa, kwapakati komanso kwambiri), hyperinsulinism, hypoinsulinism (shuga ya pancreatic),

Matenda apathengo amadziwika ndi kuwopsa kwa maphunzirowo ndi zovuta zake (zovuta, zolimbitsa thupi komanso zofatsa). Munthawi ya matendawa, magawo ochulukitsa, chikhululukiro ndi kusasunthika kosakhazikika zimasiyanitsidwa.

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.

Chodandaula chachikulu ndi kukokoloka kwa chifuwa chachikulu cha m'mimba chimapweteka kwambiri pamimba pamimba, hypochondrium yamanzere, yomwe imatha kukhala shingles. Ululu umatchulidwa mosalekeza, kapena ndi paroxysmal mwachilengedwe. Ululu umatha kuwonekera kudera lomwe mtima wako walosera. Ululu umatha kutsatiridwa ndi dyspepsia (nseru, kusanza, kutentha pa chifuwa, kuphulika, kukondera). Kusintha pakachulukidwe ka matenda kapamba kumatha kukhala pafupipafupi, kufooketsa, komanso kopweteka. Mpando ukhoza kukhala wosakhazikika, kutsekula m'mimba kusinthana ndi kudzimbidwa. Kuchepa kwa chakudya ndi kudzimbidwa kumathandizira kuti muchepetse kunenepa.

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).

Pazotsatira zakunja kwa odwala omwe ali ndi pancreatitis yayikulu, kufalikira kwa khungu ndi khungu nthawi zambiri kumadziwika. Mtundu wa jaundice ndi brownish (thibitiro ya jaundice). Kupaka khungu pakhungu ndi khungu lowuma. Pa chifuwa ndi pamimba, mawanga ofiira ("madontho ofiira") omwe samasowa pambuyo poyeserera angadziwike.

Mimba pa palpation imatupa pang'ono mu epigastrium, atrophy yamafuta opindika amatha kuzindikirika m'dera la mapenshoni. Palpation pamimba - ululu kumtunda, kuzungulira navel, kumanzere hypochondrium, mu ngodya-vertebral kona. Nthawi zina matenda a kapamba amodzi amakhala ndi hepato- komanso splenomegaly.

Mavuto

Mavuto oyambilira amakhala otupa jaundice chifukwa cha kufooka kwa chotupa, matenda oopsa a m'matumbo, kutuluka kwamkati chifukwa cha zilonda zam'mimba kapena matenda a m'mimba, matenda ndi zotupa zosafunikira (abscess, parapancreatitis, retroperitoneal cellulitis, kutupa kwa biliary thirakiti).

Zovuta za mwadongosolo lachilengedwe: Matenda ambiri ophatikizika, ziwalo zina zosakwanira ndi ziwalo (aimpso, pulmonary, hepatic), encephalopathy, DIC. Ndi chitukuko cha matendawa, kutuluka kwa magazi kum'mero, kuchepa thupi, matenda ashuga, kupweteka kwa m'mimba kumachitika.

Zizindikiro

Kuti afotokozere za matendawa, dokotala wa matenda am'mimba amauza mayeso a labotale magazi, ndowe, njira zodziwira kuti azitsatira

Kuyesedwa kwa magazi nthawi yonse ya kukokomeza, monga lamulo, kumawonetsa chithunzi cha kutupa kwamkati. Pozindikira matenda osiyanasiyana, zitsanzo zimatengedwa kuti zimachitika chifukwa cha ma pancreatic enzymes m'magazi (amylase, lipase). Kuwunikira kwa Radioimmune kumawonetsa kuwonjezeka kwa ntchito ya elastase ndi trypsin. Pulogalamuyo imawululira mafuta ochulukirapo, ndikuwonetsa kuchepa kwa kondomu.

Kukula ndi kapangidwe ka pancreatic parenchyma (ndi ziwalo zozungulira) zitha kuyesedwa pogwiritsa ntchito ma ultrasound am'mimba, CT kapena MRI ya kapamba. Kuphatikiza kwa njira ya ultrasound ndi endoscopy - endoscopic ultrasonography (EUS) kumakuthandizani kuti mufufuze mwatsatanetsatane minofu ya England komanso makhoma am'mimba kuchokera mkati.

Ndi pancreatitis, endoscopic retrograde pancreatocholangiography imagwiritsidwa ntchito - chinthu cha radiopaque chimabayidwa endoscopically mu duilla ya duodenal.

Ngati ndi kotheka, kumveketsa kuthekera kwa kutulutsa ziwalo kupanga michere ina, mayeso ogwira ntchito amalembedwa ndi zolimbikitsa za chinsinsi cha michere ina.

Mankhwala othandizira

• Zakudya zamankhwala. Odwala omwe ali ndi pancreatitis yovuta panthawi yanthawi yochulukirapo amalimbikitsidwa kupewa zakudya zophatikizana, ndipo akadzamwalira, amapatsidwa zakudya No. 5B. Mu chifuwa chachikulu, kugwiritsa ntchito mowa kumaletsedwa, zokometsera, zamafuta, acid acid, ma pickles amachotsedwa mu zakudya. Ndi pancreatitis yovuta ndi shuga mellitus, kuwongolera kwa mankhwala okhala ndi shuga.
• Kuchulukitsa kwa matenda a kapamba amathandizidwa chimodzimodzi monga pancreatitis ya pachimake (symptomatic therapy, analgesia, detoxation, kuchotsa kutupa, kubwezeretsa ntchito m'mimba).
• Pancreatitis ya zakumwa zoledzeretsa, kukana kugwiritsa ntchito zinthu zomwe zili ndi mowa ndichinthu chofunikira kwambiri pa mankhwalawa, m'malo ovuta kwambiri kumabweretsa mpumulo wa zizindikiro.

Purothing zovuta (abscess ndi phlegmon), kutsekeka kwa ndulu ndi kapamba, kupindika kwa kupindika kwa Oddi, kusintha kwakukuru kwa tiziwalo timene timatulutsa thumbo, kupindika, cysts ndi pseudocysts a kapamba, koopsa, chithandizo chosayenera chitha kukhala chisonyezo cha opaleshoni yayikulu ya kapamba .

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 kutulutsa kwa gland), gawo loyang'ana m'mimba (resection),
• 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.).

Kupewa

Njira zoyambirira kupewa:

• Kuletsa kumwa, kudya zakudya zopatsa thanzi, kudya mokwanira popanda kudya kwambiri, kuletsa zakudya zamafuta, chakudya chamafuta,
• kusiya kusuta
• kumwa madzi okwanira (pafupifupi lita imodzi ndi theka patsiku),
• kuchuluka kwa mavitamini ndi michere muzakudya,
• Kufikira kwa dokotala panthawi yokhudza kuphwanya kwam'mimba, chokwanira komanso chokwanira cha matenda a m'mimba.

Pofuna kupewa kufalikira kwamatenda a kapamba, muyenera kutsatira malangizo onse a dokotala pazakudya ndi moyo wanu, kawiri kawiri pachaka. Ntchito yofunikira pakukulitsa chikhululukiro ndi kukonza moyo wa odwala omwe ali ndi chifuwa chachikulu cha chimbale chimaseweredwa ndi mankhwala a spa.

Mukamatsatira malangizo othandizira kupewa kukokoloka, chifuwa chachikulu ndichosavuta ndipo chimatha kupulumuka. Kuphwanya zakudya, kudya zakumwa zoledzeretsa, kusuta fodya ndi chithandizo chosakwanira, njira za dystrophic mu minofu ya minofu ya gland ndikusintha koopsa, zambiri zomwe zimafunikira kuchitidwa opaleshoni ndipo zimapha.

Malinga ndi mawonekedwe azachipatala

a) Ndikumva kuwawa koopsa,

b) Ndi zowawa mosalekeza (monotonous).

2. Pseudotumor CP:

a) ndi subhepatic cholestasis ndi jaundice,

b) ndi yachiwiri matenda a duodenalriers (CDI).

3.Painless CP (yokhala ndi exocrine ndi / kapena endocrine pancreatic insuffence).

Malinga ndi mawonekedwe a morphological

Infiltrative-fibrous (interstitial-edematous) CP.

4. Induction (fibro-sclerotic) CP.

Pogwira ntchito

Ndi kuphwanya kwa exocrine pancreatic ntchito:

a) Hypersecretory (hyperenzyme) mtundu,

b) mtundu wa hyposecretory (hypoenzymatic) (wobwezerera,

c) Mtundu wopinga,

d) mtundu wa dancular secretion wa kapamba.

3. Njira zingapo.

a) cholestasis yokhala ndi subhepatic jaundice,

b) njira yochepetsa matenda oopsa a portal,

c) Kutaya magazi m'mimba,

d) posungira ndi post-necrotic cysts ndi pseudocysts.

a) duodenal stenosis ndi kulowerera kwam'malo mwa duodenal,

b) pancreatic steatorrhea ndi creatorrhea,

c) matenda am'deralo (kapamba wam'mimba, parapancreatitis, mbali yakumanzere

pleural effusion ndi chibayo, paranephritis,

d) arteriopathy yam'munsi,

Zitsanzo zakuzindikira:

1. Matenda apathengo, okhala ndi ululu wofowoka, opatsa mphamvu, omwe ali ndi vuto la exocrine, mwamphamvu.

2. Chronic pancreatitis pseudotumor ndi subhepatic cholestasis ndi jaundice, zopatsa mphamvu, zolimbitsa.

3. Matenda apansi a pancreatitis, obisika, komanso mkhutu wa pancreatic ntchito, kufatsa kwambiri.

Pancreatitis akuluakulu

Kugwiritsa ntchito mwachidakwa zakumwa zakumwa zoledzeretsa ndi chimodzi mwazomwe zimayambitsa chisokonezo m'mimba, makamaka kapamba. Popeza achikulire nthawi zambiri amaika pangozi thanzi lawo pomwa mowa, ndiye omwe ali pachiwopsezo chachikulu chotenga kapamba. Ziwerengero zamibadwo ya odwala akumayiko osiyanasiyana ndizosiyana. Izi zikufotokozedwa makamaka ndi zizindikiro za kuchuluka kwa anthu omwera mowa. Komanso, mwayi wokhala ndi matenda umatengera mawonekedwe a zakudya komanso zina zambiri, kuphatikizapo jenda.

Pancreatitis mwa amuna

Amuna, poyerekeza ndi azimayi, amakonda kukhala ndi zovuta zoyambitsidwa ndi kapamba. Chifukwa chazachilendo pamalingaliro awo pa moyo, mamembala ambiri ogonana mwamphamvu nthawi zambiri samatembenukira kwa madotolo pakagwa ululu wochepa ndipo amachita izi mochulukitsa matenda atayamba "matendawa". Amuna amakhala ndi chizolowezi chomwa mowa mwauchidakwa, chomwe ndicho chifukwa chachikulu chakhazikitso cha kapamba.

Kapamba mu azimayi

Mwa akazi, matenda amtundu wamatumbo ndiwofala kwambiri kuposa amuna, omwe ndi omwe amachititsa kwambiri kuti asamangotulutsa kapamba, komanso cholecystitis. Kuphatikiza apo, thupi la kugonana koyenera limakonda kusintha kwa mahomoni, omwe angayambitsenso kukula kwa kapamba. Chifukwa chake, kukula kwa njira yotupa m'matumba a kapamba amalimbikitsidwa ndi kusintha kwa kubereka, kutenga pakati komanso kubereka ana, kugwiritsa ntchito mankhwala osokoneza bongo kwakanthawi.

Pancreatitis mwa ana

Kudziwa zoyambitsa kukula kwa kapamba mu ana ndikovuta. Koma nthawi zambiri, zomwe zimapangitsa kuti matendawa ayambe kudwala ndizovulala zapachifuwa zomwe zimachitika chifukwa cha opareshoni kapena kuvulala, komanso kutengera kwa chibadwa. Pancreatitis imakonda kupezeka mwa ana omwe ali ndi matumbo, pulmonary, kapena mitundu yosiyanasiyana ya cystic fibrosis. Zakudya zopatsa mphamvu, nthawi yayikulu yotengera matenda, kuvuta kwa kutulutsa madzi am'mimba, matendawa kumatenda - zonsezi ndi zina zambiri zimatha kuyambitsa zovuta za kapamba mwa ana. Dotolo ndi gawo la mayeso omwe adayikidwa ndi iye athandizira kudziwa zomwe zimayambitsa kukula kwa kapamba.

Gawoli la kapamba chifukwa cha chitukuko cha matendawa

Zikondamoyo, chakudya chikamalowa m'thupi, chimatulutsa madzi a kapamba. Muli ma enzymes omwe amachititsa kuti pakhale chakudya chamafuta, mafuta ndi mapuloteni. M'matumbo a glandular organic, ma enzyme awa sagwira ntchito. Koma kusiya limodzi ndi msuzi wa pancreatic kudutsa mumkati mwa duodenum, amayamba kuchitapo kanthu. Ngati pazifukwa zina kutulutsa kwamadzi opanga sikutheka, ma enzymewo amayamba mu kapamba ndipo amayamba kugaya maselo ake. Pankhaniyi, kutupa kumayamba ndi ziwalo zowonongeka za chiwalo, zomwe zimatsogolera kapamba. Zomwe zimayambitsa kuphwanya malamulo kotereku zimakhala zambiri.

Pancreatitis yoyamba

Pancreatitis yayikulu imayamba motsutsana ndi kuwonongeka kwa minyewa ya kapamba palokha. Mwa zina zazikulu zoyambitsa zowonongeka ndikofunikira kudziwa:

• uchidakwa komanso kusuta,
• kuwonongeka kwa kapamba chifukwa cha kuvulala kwam'mimba, kulowererapo kwa ma cell ndi njira zina zodziwira, mwachitsanzo, endoscopy (retrograde pancreatocholangiography and endoscopic papillosphincterotomy),
• kugwiritsa ntchito mankhwala kwa nthawi yayitali komwe kumakhudza ziphuphu,
• chibadwidwe chamtsogolo cha matenda ammimba komanso matenda a kapamba,
• kudya kosayenera ndi kudya kwambiri mafuta ndi zonunkhira, makamaka, monga momwe akunenera, pamimba yopanda kanthu.

Pancreatitis yoyamba imatha kubadwa nthawi iliyonse. Kuyamba kwakanthawi kwa chithandizo chake kumalola kuyimitsa kapena kuchepetsa njira zowonongeka m'maselo a kapamba, kubwezeretsa ntchito zotayika ndikupewa zovuta.

Sekondale pancreatitis

Second pancreatitis ndi matenda otupa a kapamba, omwe amayamba chifukwa cha matenda omwe amapezeka m'ziwalo zam'mimba. Zifukwa zake zazikulu zakukwera kwake ndi izi:

• matenda a gallstone, omwe ndi chimodzi mwazinthu zazikulu zomwe zimathandizira kukulitsa kapamba,
• Matenda opatsirana, matenda a chiwindi,
• Matenda obadwa nawo, mwachitsanzo, cystic fibrosis kapena matenda a Crohn,
• kukomoka kwa helminthic mundime ya biliary.

Ndizotheka kudziwa nthawi zonse zomwe zimayambitsa kupamba kwa kapamba. Koma kupambana kwa chithandizo kumatengera kuchotsedwa kwa zinthu zomwe zimapangitsa kuti matendawa ayambe.

Mitundu ya kapamba mu mawonekedwe ndi mawonekedwe a njira ya matendawa

Njira yotupa yomwe imagwirira mu kapamba imayambitsa kutayika pang'ono kapena kwathunthu ndi thupi la ntchito zake zoyambira. Imfa ya maselo a glandular cell imawopseza osasintha. Palibe thupi lina lililonse lomwe limatha kugwira ntchito za kapamba. Pancreatitis yovuta komanso yopweteka imadziwika chifukwa cha matendawa. Mitundu yonse iwiri yamatendawa imasiyana mzake mu njira, njira zamankhwala ndi zotsatira za thupi.

Pachimake kapamba

Acute pancreatitis amatanthauza matenda otupa a kapamba, omwe amapita mwachangu ndikuwopseza kusintha kosasintha kwa kapangidwe ka chiwalo, kuwonongeka kwa machitidwe ena a thupi ngakhale kufa kwa wodwalayo. Mu chifuwa chachikulu cha pancreatic, michere ya pancreatic yokhala ndi michere yazakudya pazifukwa zina sizingadutse kulowa mu duodenum. Mphutsi zomwe zimayambitsidwa ndi kapamba zimayamba "kugunda" maselo ake, ndikuziwononga. Ndi matenda amtunduwu, maselo am'mimba mwake amawonongeka ndipo edema yake imayamba.

Gulu lomwe likuika pachiwopsezo chachikulu cha kukhazikika kwa kapamba ndi akuluakulu, azaka zapakati pa 30 mpaka 60. Komabe, malire oterewa ndi achiwembu kwambiri. Pancreatitis yachilendo imatha kupezekanso mwa ana chifukwa:

• kusowa kwa chakudya choyenera,
• kuchuluka kwa zakudya zamafuta ndi zonunkhira, chakudya mwachangu m'zakudya,
• kuvulala kwam'mimba
• kukoka kwa helminthic mumimba
• kubadwa kwa maliseche a ndulu ndi ndulu za bile, duodenum, komanso ma dancts a pancreatic,
• matenda obadwa nawo komanso matenda opatsirana, etc.

Muubwana, pancreatitis pachimake imachitika, monga ulamuliro, wofatsa. Zizindikiro zake, njira zodziwira ndi njira zochiritsira zimasiyana ndi mawonekedwe a kapangidwe ka kapamba ka pachimake mu akulu.

Kuchulukana kwa matenda kapamba

Kukula kwa chifuwa chachikulu chimagawika m'magawo awiri. Gawo loyamba limadziwika ndi kuwonetsa pang'ono zizindikiro zake ndipo limatha kukhala kwa zaka kapena makumi, kutengera ndi moyo wa wodwalayo komanso thanzi lakelo. Gawo loyamba litatha, pamakhala nthawi yomwe zovuta m'matumbo zimatchulidwa ndikusokoneza wodwalayo pafupipafupi.

Kuchulukirachulukira kwa matenda kapamba nthawi zambiri kumachitika chifukwa chogwiritsa ntchito zonunkhira, mafuta kapena zakudya yokazinga, zakumwa zoziziritsa kukhosi ndi mowa. Zimakhala zovuta kuti kapamba azitha kuthana ndi mapuloteni, zakudya ndi mafuta omwe amabwera ndi chakudya. Kuchoka pakudya, kudya kwambiri ndi kumwa mowa pamimba yopanda kanthu kumadzaza.

Zizindikiro ndi zovuta za kapamba

Zizindikiro za pancreatitis yovuta kwambiri komanso yosatha imasiyananso, komanso mawonekedwe a maphunzirowa ndi zovuta zake. Zizindikiro za pancreatitis yachilendo nthawi zambiri imafufutidwa. Zizindikiro za matenda owopsa zimatchulidwa nthawi zonse, koma ndikofunikira kuti musawone dokotala mwachangu, komanso kuti musatenge matenda ena oopsa, mwachitsanzo, cholecystitis kapena appendicitis.

Zizindikiro za Acute Pancreatitis

Wophatikizidwa ndi kapamba palokha, ma enzyme omwe amapukusa m'mimba amathandizira zimakhala zake. Chifukwa chake, zochita za lipase, zomwe zimapangidwa kuti zigwetse mafuta, zimabweretsa kuwonongeka kwamafuta m'maselo. Trypsin, puloteni yokumba, imayambitsa maukadaulo osiyanasiyana amthupi, zomwe zimapangitsa kuti minofu ya cell ikhale ndi kutupa komanso kufa kwa maselo ake. Poyamba, necrosis ndi aseptic, pambuyo pake matenda omwe amachititsa mapangidwe a purulent foci amatha kujowina. Zizindikiro zodziwika pancreatitis yachuma imaphatikizaponso:

• Ululu, womwe nthawi zambiri umazunguliridwa, hypochondrium kumanja kapena kumanzere. Zomva zowawa ndizapamwamba ndipo sizingathetsedwe mothandizidwa ndi mankhwala ngakhale ndikuyambira koyenera kwa chithandizo patsiku lake loyamba. Odwala ena amatha kudwala matenda opweteka chifukwa chodwala ziphuphu zakumaso.
• Kusowa kudya kwathunthu, nseru komanso kusanza kosaloledwa, komwe sikubweretsa mpumulo kwa wodwala. Vomit, monga lamulo, muli zomwe zili m'mimba ndi bile.
• Kuchuluka kwa kutentha kwa thupi (kupitirira 38 ° C), kuchuluka kwa mtima (zoposa kumenyedwa kwa 90 / min.) Kupuma, kutsitsa magazi (osakwana 90 mm / Hg).
• Kusokonezeka kwa khoma lam'mimba pamimba yomwe ili pansi pa chipilala chamtengo kumanzere.
• Kuphulika, kumveka bwino pamimba. Kuwoneka kwa chizindikiro chotere kumachitika chifukwa chophwanya dongosolo la chimbudzi.

Kuphatikiza apo, khungu la khungu loyera kapena kukula kwa jaundice yodwalitsa imadziwika ndi chifuwa chachikulu cha kapamba ngati matenda a ndulu ndi omwe amayambitsa matenda.

Cholecystitis ndi kapamba

Cholecystitis, kapamba ndi matenda otupa am'mimba. Ndi cholecystitis, chikhodzodzo ndimatenda a kutupa, ndipo ndi kapamba, kapamba. Njira zonsezi zimatha kupitilira payekha kapena molumikizana. Pali nthawi yayitali ya matenda onse omwe amapezeka mu zovuta - cholecystopancreatitis.

Cholecystitis, kapamba amachititsa kupweteka pamimba pamatumbo a wodwalayo. Koma kusiyana kwawo kwakukulu ndikuti ndi kutukusira kwa ndulu, ululu umapezedwa mu hypochondrium yoyenera, ndipo ndi kutupa kwa kapamba ndi herpes zoster.

Ndi kapamba, wodwalayo amamva kuwawa m'mimba, amakula mukatha kudya, kutulutsa magazi ndi kusokosera kumayang'aniridwa. Ndikosavuta kusiyanitsa cholecystitis ndi kapamba ndi zizindikiro zakunja. Kuzindikira kumatha kuchitika pokhapokha patapezeka mitundu yosiyanasiyana.

Kafukufuku wa Laborator

Ngati achulukitsa matenda a kapamba kapamba kapenanso amadwala kwambiri, ndikofunikira kuti odwala azikayezetsanso magazi komanso kudziwikiratu, komanso urinalysis ndi ndowe. Chifukwa cha kuyesa kwa magazi kwamitsempha yamagazi kuchokera m'mitsempha, madokotala amatha kudziwa kuchuluka kwa enancme ya pancreatic amylase. Kuchuluka kwa amylase, komwe kumayamba kukula patatha maola awiri kutayamba kuchulukana, kumatsimikizira kuzindikira kwake ndikuwonetsa kukula kwa njira yotupa. Ngati kuchuluka kwa amylase kukuchuluka mthupi kwambiri, kuwunika mkodzo kungathandizenso kudziwa izi, popeza enzyme yowonjezera imachotsedwera limodzi nayo.

Mlingo wa lipase umachulukitsa patatha masiku 2-4 kuchokera pamene isanayambike, chifukwa chake, kusanthula koteroko sikungakuthandizeni kuzindikira koyambirira kwa matendawa. Kudziwitsa kuchuluka kwa kuchuluka kwa pulotini ya trypsin kumalola kutsimikizira kugonjetsedwa ndi njira yotupa ya minofu ya pancreatic. Kuphatikiza apo, mayeso amatha kutengedwa kuchokera kwa wodwala kuti azindikire kuchuluka kwa shuga m'magazi ndi kuchuluka kwa bilirubin, yomwe imatha kuchuluka ndi kufalikira kwa kapamba.

Kafukufuku wa Laborator wa ndowe amatha kudziwa mafuta omwe amagawanika, mapuloteni komanso chakudya. Izi zitsimikizira kusowa kowonetsa kwa ntchito ya pancreatic. Kuyesedwa kwa magazi kokwanira kuwonetsa kuchuluka kwa leukocytes ndi kuchuluka kwa erythrocyte sedimentation, omwe Zizindikiro zake za kapamba zimachuluka.

Chida chozindikira

Njira zodziwitsira kuti ali ndi chida amathandizanso kudziwa pancreatitis komanso kuyamba kwa chithandizo chake. Izi zikuphatikiza:

• Ultrasound kuwunika kwam'mimba ziwalo.

Ndi chithandizo chake, katswiri adzatha kudziwa kukula kwa kapamba ndi kapangidwe ka minofu yake. Kuphatikiza apo, ultrasound imakupatsani mwayi kuti muwone zosokoneza mu contour ya chiwalo ndi kukhalapo kwa mawonekedwe mkati mwake. Kuphwanya zochita za phunziroli ndikukutulutsa kwam'mimba, mawonekedwe a kufalikira kwamatenda a kutupa.

• Makina ophatikizika kapena maginito a resonance.

Maphunziro oterewa amaperekedwa kwa odwala, ngati kuli kofunikira, kuti azindikire kuchuluka kwa minyewa yomwe imakhudzidwa ndi necrosis, kupezeka kwa neoplasms komanso kuyambitsa ziwalo zapafupi ndi ziwalo pakatupa.

The x-ray yam'mimba ziwalo zitha kuperekedwa kwa odwala omwe akuwakayikira m'matumbo kutsekeka. Komanso, kafukufuku wotereyu amatha kugwiritsidwa ntchito kuti adziwe momwe phala lam'mimbamo limakhalira.

Mukamapangira njira yodziwitsira, khoma lam'mimba limakhomedwa pogwiritsa ntchito chipangizo chapadera cha trocar, chomwe chimapangitsa kuti kafukufukuyu kuchitidwe ndi chipangizo chowoneka pogwiritsa ntchito laparoscope. Kukhazikitsa kwake ndikofunikira ndikulimba kwa minofu necrosis kuti muwone kukula kwa chitukuko ndikuzindikira zovuta.

Ndi aakulu pancreatic minofu necrosis, wodwalayo atha kupatsidwa njira yopumira. Njirayi imakuthandizani kuti muthe kupeza zotsalira za biopsy kuti mupitirize maphunziro a bacteriological. Kudzifufuza moyenera komwe kumakupatsani mwayi kumakuthandizani kudziwa matendawa ndi zovuta zake pakapita nthawi, ndikuyamba chithandizo chokwanira cha kapamba.

Zimayambitsa yachiwiri kapamba

Njira yotakataka yomwe imagwera m'matumbo ndimayankho a ziwalo pakukhumudwitsidwa kwa ngalande zapanchipi. M'mazithunzi ambiri azachipatala, chomwe chimapangitsa chidwi ndi kuponyera kwa bile kuchokera ku chikhodzodzo, kupezeka kwa calculi m'makonzedwe kapena chikhodzodzo, kutsimikizira kwa kapamba ndi acidic yam'mimba.

Second pancreatitis yachilendo nthawi zina imayamba chifukwa chotupa m'mimba mwa munthu. Malo achitetezo chachilengedwe ndi dongosolo logaya chakudya.

Nthawi zina chifukwa chakukula kwa matenda a pathology imagona kuphatikiza kwa zinthu zingapo zopangitsa zomwe zimapangitsa kuphatikizidwa kwa njira kuchokera kunja. Mwachitsanzo, chifukwa cha kutupa kwa kapamba kapena chotupa, chomwe chimakulirakulira ndikuyamba kuponderezana zimakhala zapafupi. Izi zimatha kukhala khansa ya duodenum 12, bile ducts, kapena capanc pitisreatitis yomwe imayambitsidwa ndi oncology.

Zoyambitsa sekondale:

• Kuchuluka kwamphamvu mu duodenum 12 (zomwe zimapangitsa posachedwa ndizowonongeka pamimba kapena duodenum),
• Njira zopatsirana mthupi, matenda oyamba ndi majeremusi, ma bacteria ena amatsogolera kumatenda otupa, chifukwa chake kapamba amayamba.
• Kutulutsa kwa ngalande zokhala ndi calculi (gwero lalikulu ndi cholecystitis),
• Reflux wa bile bile (cholangitis - kutukusira pachimake mu bile ducts),
• Ndi kuwonongeka kwa chiwindi ndi ma ducts a bile, kupuma kwa biliary (kudalira-biliary)
• Kuphwanya kutulutsa kwa bile ndi cholelithiasis (cholelithiasis).

Ngati wodwala ali ndi pancreatosis, nambala ya ICD-10 ndi K86.1, ndiye kuti matendawa amatha. Ndi blockage ya bile ducts, matendawa amawonekera patatha masiku angapo pambuyo poyambira matenda oyamba.

Zizindikiro zimatchulidwa komanso zowala, zofanana ndi kuukira kwadzuwa kwa kapamba. Ndi matenda opatsirana mthupi, kutupa kwa kapamba kumatha kuoneka ngati chinthu chapambuyo, kumakulirakulira patatha milungu iwiri.

Kodi kapamba ndi chiani ndipo chifukwa chiyani ndi kowopsa? Kufotokozera kwamatenda, Zizindikiro, Kanema

Kodi kapamba ndi chiani ndipo chifukwa chiyani ndi kowopsa? Kodi kapamba amawonekera bwanji? Kodi matendawa amapezeka bwanji? Mafunso ngati amenewa atha kubuka mwa anthu omwe amva izi.

Pancreatitis ndi imodzi mwazovuta komanso zovuta matenda omwe angayambitse kufa popanda chithandizo. Chifukwa chake, ndikofunikira kwambiri kupewa matendawa panthawi yake, kuzindikira zizindikiritso zoyambirira kuti muimitse matenda, kapena kuyambitsa chithandizo cholondola pakukula kwa matendawa.

Kuti mumvetsetse pancreatitis ndi chifukwa chake matendawa amachitika, muyenera kudziwa pang'ono za kapamba.

Kamba ndi chiwalo cham'mimba m'thupi la munthu, cholemera pafupifupi 85 g. Zikondwererozi zimatha, amafanana ndi chidutswa cha mtanda wofewa.

Ili mkati mwa m'mimba ndipo imatseguka ndi kuyiyika mu lumen ya duodenum.Kapamba amachita ziwiri zosiyana, koma ndizofunikira kwambiri komanso ntchito zofunika:

1. Amatulutsa ma enzymes chifukwa cha kuwonongeka komanso kuperewera kwa mapuloteni, chakudya, mafuta. Popanda michere, michere ndi mavitamini kuchokera pachakudya siziikumbidwa kapena kuyamwa. Ma Enzymes mkati mwake amapangidwa osagwira ntchito. Mukatha kudya, kapamba amatumiza chizindikiro kuchokera ku ubongo ndi m'mimba kuti ma enzyme amafunikira kugaya ndi kuphwanya chakudya. Poyankha izi, zimapanga chymotrypsinogen, lipase, amylase ndi trypsinogen m'malo opanda ntchito chifukwa chakusokonekera, chimbudzi ndi mayamwidwe a mapuloteni, chakudya, mafuta. Ma Enzymes awa mu khoma lamatumbo amathandizira ndikuyamba ntchito yawo.
2. Amapanga mahomoni omwe amawongolera kagayidwe ka chakudya: insulin - amachepetsa shuga, glucagon - amawonjezera shuga.

Chifukwa cha zinthu zingapo zomwe zimakhudza kapamba, ntchito izi sizikuchitika, chifukwa cha izi zofunika kwambiri m'mavuto: mtima, chiwindi, impso, mapapu, mtsempha wamagazi.

Ndiye kodi kapamba ndi chiani? Pancreatitis ndi matenda otupa a kapamba. Zomwe zimayambitsa kutupa mu 80% ya milandu ndikugwiritsa ntchito zakumwa zoledzeretsa kapena miyala mu ndulu ndi duct.

Zomwe zimayambitsa matendawa: kuvulala kwam'mimba, zinthu zakumwa zoledzeretsa, mankhwala (njira zakulera zam'mimba, sulfonamides, nitrofurans, tetracycline, diuretics, azothioprine), zilonda zam'mimba, metabolic pathology. Mu 25% ya odwala, chomwe chimayambitsa matendawa sichikudziwika bwinobwino.

Pali pancreatitis yachiwiri komanso yoyamba. Pancreatitis yoyamba imachitika pamene causative wothandizila am'mapapo: mowa, mankhwala, poizoni. Second pancreatitis ndi chifukwa cha matenda a machitidwe ena ndi ziwalo: matenda a duodenum, m'mimba, dongosolo la biliary, kagayidwe.

Mawonetseredwe azachipatala

Pancreatosis mkati mwa njira yotupa imakhala yofatsa, yolimbitsa komanso yovuta. Pa gawo loyamba la matendawa, zizindikiro za exocrine ndi intrasecretory matenda sizipezeka.

Pancreatitis ya digiri yachiwiri imachitika kale ndi zizindikiro za zovuta izi.

Pancreatitis ya Giredi 3 imadziwika ndi kutseguka kwa nthawi yayitali komanso kupitilira kwa nthawi yayitali, kutopa kwa munthu komwe kumachitika pang'onopang'ono, kuyesedwa kwa labotale kumawonetsa kuchepa kwa mavitamini opindulitsa ndi mchere.

Monga tanena kale, chipatalachi chimadalira matenda enieniwo, zimachokera ku chiwalo chomwe chikukhudzidwa ndikuwonetsa zizindikiro zake.

Syndromes of Second pancreatitis:

1. Zowawa. Zomverera zowawa zimawonedwa mu epigastric zone, zimatha kuchitika m'dera la nthiti yakumanja. Pambuyo ululu "umayenda" pansi pa hypochondrium yamanzere, yodziwika ndi herpes zoster. Nthawi zambiri ululu umakulirakumwa pakumwa zakumwa zoledzeretsa, chakudya - chimayamba pambuyo pa maola angapo.
2. Digestive syndrome imagwirizanitsidwa ndi kuphwanya magwiridwe antchito. Odwala amadandaula za kusanza kokhazikika, kusanza mobwerezabwereza, kulawa kowawa pamlomo wamkamwa. Kuchulukitsa kwa mpweya kumadziwika nthawi zambiri, ndipo ziphuphu zotayirira zimasinthana ndi kudzimbidwa kwa nthawi yayitali. Mavuto amakula pambuyo podya zakudya zamafuta ndi zonunkhira.
3. Intoxication syndrome imayendera limodzi ndi kufooka kwambiri, ulesi ndi kugona, kusasangalala. Ndi mawonetsero ofooka, mphamvu yogwira ntchito ya wodwalayo imachepa, amadandaula kutopa kosalekeza.
4. Matenda otentha. Ngati wodwala ali ndi vuto la kutupa kwa ndulu ya bile chifukwa cha cholangitis, cholecystitis ndi matenda ena, ndiye kuti matupi awo amakhala akhungu. Kutentha kwa subfebrile kumayambira mu zotupa neoplasms, virpatitis hepatitis (kulumikizana ndi wodwala panthawi inayake ya makulitsidwe ndikosokoneza).

Ndi zizindikiro zotere, wodwalayo amapezeka pafupipafupi ndi dysbiosis - mkhalidwe wamatumbo am'matumbo, momwe osakwanira mabakiteriya opindulitsa ndi kuchuluka kwakukulu kwa tizilombo tating'onoting'ono timapezeka. Dysbacteriosis imawonetsedwa chifukwa cha kuchepa kwa ntchito ya michere. Panthawi yotupa kwambiri kwa kapamba, amalowa m'magazi ndipo sachita ntchito zawo, motere, chakudya sichikumbidwa bwino, thupi limasowa zakudya zopatsa thanzi. Mu ndowe mumakhala ulusi wazinyalala wazomera, mafuta ambiri.

Chipatala cha pancreatitis sichitha kuwoneka motsutsana ndi kuzungulira kwa zovuta zamomwe zimayambira matenda.

Muzochitika zotere, pamafunika kugwiritsa ntchito njira zothandizira kuzindikira - mayeso a labotale ndi mayeso othandizira.

Muli mankhwala a pachimake ndi aakulu kapamba

Njira zochizira pancreatitis yayikulu komanso yovuta ndizosiyana. Kusankha kwawo kumatengera kutha kwa matendawa, kupezeka kwa matenda opatsirana, kuchuluka kwa thanzi la wodwalayo komanso msinkhu wake. Chithandizo cha pachimake kapamba uyenera kuchitika kokha kuchipatala. Komabe, lingaliro lalikulu ndikusala kudya masiku ochepa. Komanso, wodwalayo amapatsidwa mankhwala othandizira odwala ndipo, makamaka pamitundu yoopsa ya matendawa, njira zochizira zomwe zimapangidwa kuti zichotse madera a minofu yowonongeka yomwe ikukhudzidwa ndi necrosis, kapena kukhazikitsa ngalande.

Pancreatitis yosachiritsika pakukhululuka, wodwalayo amawonetsedwa zakudya zomwe sizimaphatikizapo zakumwa zomwe zimakhala ndi zakumwa zoledzeretsa, zamafuta, zonunkhira komanso zokazinga. Ndi zowonjezera, kusala kudya kwa masiku awiri ndikulimbikitsidwa. Onse pakukhululuka komanso pakukokomeza, odwala amapatsidwa mankhwala.

Kuwonekera kwa Pancreatitis

Pancreatitis ndi matenda wamba. Zowopsa za kapamba zikukula: kuyambira pafupifupi 1980, kuchuluka kwa anthu odwala matendawa padziko lapansi kwachulukanso.

Pancreatitis yovuta komanso yosatha imapezeka padziko lonse lapansi pomwe pali anthu 8,2 - 10 milandu mwa anthu 100,000.

Dziwani kuti kufala kwa matenda a kapamba ku Russia ndiwokwera kwambiri: mwa ana, kuchuluka kwa anthu 9 - 25 pa anthu zana, mwa akulu 27 - 50 pa anthu 100,000.

M'zaka khumi zapitazi, mdziko lathu mwakhala mukuchulukitsa odwala omwe ali ndi matenda kapamba: mwa akulu, kuchuluka kwawonjezeka katatu, ndipo mwa achinyamata - maulendo 4.

Chiwopsezo chachikulu cha pancreatitis makamaka chimakhudzana ndi kufalikira kwa chiopsezo cha kapamba.

Pancreatitis nthawi zambiri imakhudzidwa ndi omwe amadya kwambiri, kudya mafuta, zakudya zokazinga komanso zakudya zomwe zimakhala ndi mafuta ambiri komanso zakudya zamafuta, kumwa zakumwa zoledzeretsa, utsi, kudya zakudya zopanda mafuta ndipo sakonda kudya masamba ndi zipatso, mwa anthu onenepa kwambiri komanso wokhala ndi moyo wokhazikika. .

Mankhwala

Mu chilonda chachikulu cha pancreatitis, kuphatikiza pa kumaliza kudya, kupumula komanso kulandira chithandizo kuchipatala, odwala amapatsidwa mankhwala ena, omwe amathandiza awa:

• Kuletsa njira yotupa. Pachifukwa ichi, odwala amatsogolera kukhazikitsidwa kwa cytostatics, mlingo womwe umawerengeredwa payekhapayekha.
• Opaleshoni Mankhwala amapatsidwa mankhwala owawa a ululu womwe umachitika pachimake pancreatitis. Ndi ululu waukulu, mankhwala a narcotic amatha kutumizidwa, kupweteka kwa spasmodic chikhalidwe - antispasmodics.
• Kukula kwa michere. Mankhwala omwe amalepheretsa kupanga michere ya pancreatic ndiyofunikira kuti achepetse zovuta za necrosis yama cell cell.
• Polimbana ndi kuledzera kwa thupi komwe kumayambitsidwa ndi michere yokugaya yomwe ikuzungulira m'magazi. Kubweretsa njira zapadera kumachitika kudzera m'mitsempha.

Mu chifuwa chachikulu cha pancreatitis, odwala amawonetsedwa mosadya komanso kumwa mankhwala okhala ndi ma enzymes omwe samapangidwa mokwanira chifukwa cha zotupa za kapamba. Dokotala yekha ndi omwe angadziwe mankhwalawa ndi kuchuluka kwake, amawunika zotsatira za kuyezetsa magazi, mkodzo ndi ndowe. Kuphatikiza apo, mankhwalawa atha kupatsidwa mankhwala omwe angapangitse kuti magawo azikhala ndi matenda.

Momwe mungadziwire kuti ali ndi kapamba?

Pali pancreatitis pachimake ndi aakulu, pulayimale ndi sekondale.

Mu chifuwa chachikulu cha pancreatitis, ma enzyme opangidwira chimbudzi ndi chimbudzi sangalowe ndikuwunika kwamatumbo ang'onoang'ono, ndipo kapamba wa pancreas parenchyma amadzipukusa ndi michere yomweyo.

Njira yodzipewulira imayamba nthawi zambiri mutatha kudya mankhwala a choleretic ndi sokogenny - mafuta, okazinga, zonunkhira, nyama zonona, bowa wokazidwa, nkhaka, kumwa mowa wambiri, kusuta, makeke amchere.

Anthu ambiri omwe ali ndi vuto la kufinya kwamankhwala samapita kuchipatala. Malinga ndi ziwerengero, abambo amaletsa zowawa pomwa mowa ndi ma pinkil, komanso azimayi mwachangu.

Kodi pancreatitis pachimake imawoneka bwanji? Chizindikiro chachikulu cha pancreatitis pachimake ndi kupweteka kosapweteka, komwe kumayendetsedwa ndi mseru wokakamira komanso kusanza mobwerezabwereza.

Kupweteka kumeneku kumakhudzana ndikukhudzana ndi mathero a mitsempha pakudzipatula.

Matenda a ululu amayimitsidwa ndi ma painkillers, mphamvu ya mankhwala a antispasmodic ndi yochepa kwambiri. Chakudya chowawa chimayamba chifukwa chodya. Nthawi zina, ndimatenda a biliary system, pancreatitis yovuta kwambiri imatha kuwoneka ngati jaundice.

Odwala onse omwe ali ndi vuto lodzikayikira kuti ali ndi vuto la pancreatitis yayikulu ayenera kuthandizidwa kuchipatala.

Ku chipatala, madokotala amayesa mayeso apadera, kuyezetsa, kufufuza, kupereka zakudya ndi kulandira chithandizo. Odwala ayenera kuyang'aniridwa ndi dokotala.

Acute pancreatitis ndiowopsa chifukwa ngati simupita kuchipatala komanso popanda chithandizo, kufa kumatha kuchitika.

Zikondamoyo ndi chinthu "chosawoneka bwino", kotero, kuchitikira kwake kuyenera kukhala koyenera. Kupanda kutero, kulowererapo kosafunikira komanso kosafunikira kwa chiwalochi mu 25 - 40% ya milandu kumabweretsa imfa.

Choyamba thandizo kuukira kwa pachimake kapamba

Kuwoneka kwa zizindikiro zoyambirira za pancreatitis pachimake ndi nthawi ya kuyimbira kwadzidzidzi. Asanafike akatswiri, malingaliro ena akuyenera kuonedwa:

• Palibe chifukwa chomwe mungadye kapena kumwa, chifukwa izi zimatha kupanga ma enzyme ochulukirapo ndi maselo a kapamba ndikubweretsa kuwonongeka kwakukulu kwa chiwalo,
• ndikofunikira kuyimilira ndikuyesa kupumula minofu yam'mimba (ngati kuukira kumayendetsedwa ndi kusanza kosayenera, ndibwino kunama kumbali yanu),
• kuzizira kuyenera kuyikidwa pamimba pogwiritsa ntchito chopukutira kapena botolo lamadzi owundana lomwe limakulungidwa thaulo (izi zimachepetsa kukula kwa njira yotupa yopweteka kwambiri).

Ndi vuto la pancreatitis yayikulu, anthu ambiri, osatha kupirira kupweteka, amayesa kuimitsa mothandizidwa ndi mapiritsi ndi mankhwala ophera jekeseni. Koma njira zoterezi sizothandiza ndipo zimatha kufooketsa chithunzi cha matendawa, chothandiza kwa dotolo yemwe adzamuyezetsa. Chifukwa chake, maziko othandizira odwala omwe ali ndi vuto la pancreatitis yovuta kwambiri ndikutsatira malamulo atatu: kuzizira, njala ndi kupuma kwathunthu. Mankhwalawa pachimake kapamba ayenera kuchitika mu chipatala moyang'aniridwa ndi dokotala.

Chofunika ndi chiyani chomwe sichiyenera kuchitikira kunyumba ngati pancreatitis yovuta ikuwoneka?

1. Imbani ambulansi.
2. Osamwa mankhwala aliwonse: ma pinkiller ndi antispasmodics asanafike ambulansi. Izi zimathetsa chipatala cha matendawa ndipo matendawa amachedwa, osafunikira kwenikweni.

Osamadya chilichonse. M'masiku awiri oyamba, madokotala amakupatsani zakudya - njala yopanga kupuma kwa kapamba wodwala.