Momwe mungachepetse ululu, ndipo ndi ma pinkiller omwe amayenera kutengedwa chifukwa cha pancreatitis yovuta?

Kupezeka kwa matenda owawa kwambiri ndiko chizindikiro chachikulu cha kuchepa kwa kapamba, komwe kukusonyezedwa ndi chitukuko cha matenda amkati am'mimba. Zizindikiro zake zowoneka bwino zimadzetsa nkhawa komanso kufooketsa, zomwe zimachepetsa kwambiri chizindikiro cha wodwalayo. Kuti muchepetse thanzi lanu mwachangu, muyenera kudziwa zinthu zotsatirazi: momwe mungachepetse kuukira ndikuchepetsa ululu wa kapamba molondola. Munkhaniyi, tikambirana mwatsatanetsatane kuti ndi ma pinkiller a pancreatitis pachimake omwe angagwiritsidwe ntchito pochepetsa malingaliro osasangalatsa, komanso zomwe zimayambitsa kupezeka kwawo komanso chikhalidwe chowonekera.

Zinthu zomwe zimayambitsa kupweteka

Kukula kwa zopweteka kumachitika chifukwa cha zinthu zambiri zopangitsa, zomwe zazikulu zake ndi:

kugwiritsa ntchito mafuta ophika pokazinga komanso kukhala ndi mafuta ochulukirapo, komanso zakudya zomwe zimakhala zowola kwambiri, zosuta fodya komanso mchere wambiri,
uchidakwa
kuledzera kumapangitsa thupi,
kuchuluka kwa matenda am'mimba, chiwindi ndi zilonda 12 zam'mimba,
matenda a helminth,
kudziwana ndi mavuto.

Nthawi zambiri, zilonda zimayamba kuwoneka ngati theka la ola mutatha kudya chakudya. Izi ndichifukwa choti zimatenga nthawi yochulukirapo mutatha kudya musananyamula zonse pa kapamba, zomwe zimapanga ma enzymes ena ofunikira kuti zitsimikizike mulingo woyenera wam'mimba.

Kuwonetsedwa kwa ululu mu epigastric dera mwachindunji kumatengera kuwonongeka kwa chida cha parenchymal, chomwe chimatha kutsatiridwa ndi mitundu yotsatila yamatenda a pathological:

mapangidwe a kutupa ndikuwoneka kutupa m'matumba a kapamba,
patency yovuta m'matumbo a chimbudzi, zomwe zimapangitsa kuchepa kwa michere ya enzymatic mu kapamba payekha ndikuyambitsa njira yodzimbira pang'onopang'ono,
kusakwanira kwa magazi ku chiwalo cha parenchymal,
kusowa kwa mpweya
kukula kwa dystrophic kusintha kwa gland.

The pachimake maphunziro a kapamba amadziwika ndi kukula kwa yotupa, kupangitsa kutentha kwamphamvu, kupezeka kwa kutupa, kupweteka ndi matenda am'mimba a mulingo woyenera kwambiri wa magwiridwe antchito. Kufalikira kwa zovuta za dystrophic mu kapamba kumatha kukhala chifukwa chakukula kwa kapamba ka penancic. Ndi chotupa chachikulu cha chotupa cha parenchymal chomwe chimakhala ndi madzi a pancreatic, kufalikira kwa zopweteka kumawonekera kwambiri ndikuwonetsa kwa michere ya enzymatic m'mitsempha ya peritoneal komanso kukhumudwitsa kwake.

Makhalidwe amawonetsera kupweteka kwambiri pachimake cha pancreatic pathology

Chikhalidwe cha kupweteka komanso malire a kupezeka kwake pakupanga matenda amkati a pancreatic zimatengera kutanthauzira kwake komwe kumayang'ana pakukonzekera komanso magawo omwe amafalikira. Kukula kwakukulu komanso kowopsa kwa kupweteka kumayendera limodzi ndi kupangika kwa mawonekedwe a pancreatic pathology, ndipo kufalikira kwa matenda osachiritsika kumawonetsedwa ndi kupepuka komanso kuopsa kwa kupweteka kwamawu.

Kwenikweni, kupweteka ndi pancreatitis kumachitika pakatikati pa epigastrium kapena mu hypochondrium kumanzere ndipo ali ndi maphunziro owopsa.

Nthawi zina kupweteka kwa pancreatitis yachilendo kumatha kuchitika mu gawo la sternum mbali yakumanzere ndikukhala ndi mawonekedwe owala ndi chiwonetsero chazowawa m'dera la khosi, komanso malo owopsa komanso dera la nsagwada yapansi. Mawonetsero ofanana a kapamba ndi ofanana kwambiri ndi chizindikiro cha angina pectoris. Chifukwa chake, pankhaniyi, wodwalayo amapatsidwa njira yowonjezera yowunikira kuti azindikire matenda amtundu wamtima ndikutsimikizira kukula kwa matenda a kutupa kwa kapamba.

Kutha kwakanthawi kwa chiwonetsero cha matenda opweteka, makamaka ngati zizindikiro zake zili ndi mawonekedwe owopsa ndi ululu wosapweteka, ndi chizindikiro chotsimikizika cha chitukuko cha zotupa za zikondwerero zazikuluzikulu, momwe wodwala amafunikira kuchitapo kanthu pochita opaleshoni yochotsa madendawo . Kupanda kutero, chiopsezo chaimfa chikuwonjezeka nthawi zina.

Kuthetsa ululu kunyumba

Kapangidwe ka kupweteka kwakanthawi kachilengedwe kumayambika kwa vuto la matenda a pancreatic limadziwoneka mosayembekezereka, ndipo, kwenikweni, thandizo liyenera kuchitikira kunyumba kapena malo ogwirira ntchito. Chimodzi mwazinthu zazikulu momwe mungachepetse kuukira ndikusangalatsa wodwala ndikutsatira izi:

kupatsa wodwalayo mwayi wopuma kwathunthu pamlingo wamthupi ndi mwamalingaliro,
kukhazikitsidwa kwa mpando wokhala pansi, kutsamira pang'ono kupita kolowera bondo, kapena ngati kuukira kwachitika kunyumba, kukhazikitsidwa kwa mawonekedwe a "mluza",
Kuchedwa kwakanthawi kochepa kupuma komanso kupumira mosachedwa kumathandizanso kuchepetsa ululu.
kusiyiratu kugwiritsa ntchito zakudya zilizonse,
ngati pali ofuna kusanza, simuyenera kugwiritsa ntchito mitundu ingapo ya mankhwala ndi mayankho a njirayi kuti muyere matumbo. Ndikofunikira kusanza ndikusuntha zala ziwiri pagawo lamunsi la lilime,
Osagwiritsa ntchito mankhwala omwe amapangidwa pamaziko a pancreatic enzyme ndi mankhwala omwe ali ndi mphamvu ya analgesic. Popeza izi sizikulola katswiri wa ambulansi kuti awone momwe vutoli lakhalira komanso kuti adziwe zoyenera kudziwa,
ndikofunikira kuonetsetsa kuti madzi amalowa mthupi la wodwala nthawi zonse pakumwa zakumwa zamkati kapena chakumwa chochepa mphamvu cha 50 ml pa theka la ola lililonse.
tikulimbikitsidwa kuyika phukusi lotenthetsera kapena botolo la pulasitiki lokhala ndi madzi oundana kuzowawa kwambiri. Kuzizira kumathandiza kumasulira masamba m'matumbo amitsempha,
Kuchuluka kwa mankhwalawa tikulimbikitsidwa kuti mutenge piritsi la mankhwala Drotaverinum. Ndipo kuti muchepetse kupweteka mwachangu, komanso kukonza bwino thanzi la wodwalayo, ndikofunikira kuyambitsa No-Shpu ndi jekeseni wamitsempha,
chinthu chotsiriza ndikuyitanitsa "03" ndikuyitanitsa ntchito yoyenera.

Wodwala akagonekedwa m'chipinda chopangira odwala kapena opaleshoni ndikuwazindikira mozama - - "pancreatitis" yayikulu, njira zoperekera chithandizo ndi mankhwala opha odwala zimapangidwa ndikutsatira kwambiri kugona.

Kuti muchepetse kupweteka, akatswiri amatha kupereka amodzi mwa awa mankhwala ndi ma analgesic sipekitiramu:

Adalits
Novocaine wokhazikika pa novocaine blockade,
Ketones
Tramadol.

Acute pancreatitis ndi zizindikiro zonse zowawa za mawonekedwe ake zimatha kuthetsedwa pogwiritsa ntchito mankhwala monga antidepressant mankhwala, tranquilizer, antipsychotic, antiseptics, etc.

Kuti muchepetse ululu mokwanira momwe mungathere, ma pinkiller amayenera kuperekedwa motsutsana ndi maziko a antispasmodics, mankhwala opha maantibayotiki, komanso mankhwala a inhibitory-spectrum omwe amathandizira kuzimitsa kwa michere ya enzymatic mu kapamba. Kuphatikiza apo, jakisoni wa mchere, mapuloteni ndi njira yotsatsira.

Njira yokhayo yokwaniritsira mankhwala yothetsera kupha pancreatitis yachilengedwe ndi yomwe ingapereke zotsatira zabwino ndikuwongolera thanzi la wodwalayo kwakanthawi kochepa.

Kupweteketsa kupweteka pakuchulukitsa mtundu wa matenda

Ndi kuchulukitsa kwa chotupa mu gawo la parenchymal chiwalo, zilonda zitha kuthetsedwa mothandizidwa ndi malingaliro omwe afotokozedwa kale pothandiza kuchepetsa ululu wambiri pancreatitis.

Ngati munthu akutsimikiza kuti akuda nkhawa ndi kufalikira kwa matenda omwe alipo m'dera lanyumba ya parenchymal, ndiye kuti muthandizire ndipo mukathetsa vutoli, mutha kumwa piritsi ya mankhwala monga:

Paracetamol
Diclofenac
Ibuprofen
Kapena Metamizole.

Kupumula kwamatenda pakukonzekera mtundu wokhudzana ndi matendawa kumatha kuchitika ndikumwa mankhwala ena, njira yayikulu yothandizira yomwe cholinga chake ndikuchotsa zomwe zimayambitsa kufalikira kwa matenda.

Kuikidwa kwa mankhwalawa kuyenera kuchitika kokha ndi katswiri woyenera, yemwe phwando lingaperekedwe:

zoletsa: Gordox, Cortical kapena Contriven,
mankhwala a mahomoni: Somastotin kapena Octreotide,
michere ya pancreatic mu mawonekedwe a Creon, Mezim ndi Pancreatin,
proton pump inhibitor mu mawonekedwe a Ezokar,
mankhwala okodzetsa: Diakarba kapena Triampura,
antispasmodics: Palibe-Shpy, Drotaverina, Papaverina kapena Platifilina,
antihistamine wambiri wa mankhwala ochita, omwe Superiorin, diphenhydramine, Peritol ndi Pipolfen ndi othandiza kwambiri.

Kuphatikiza apo, kutsatira njira yapadera yazakudya sikungathandize kuthetsa ululu wamankhwala, komanso kupewa kuti kukonzanso kwa matenda oopsa a pathological.

Limagwirira ululu pancreatitis

Machitidwe otupa ndi osachiritsika omwe amapezeka m'mapapo amatchedwa pancreatitis. Njira zotsatirazi zomwe zimachitika m'matumbo zimakhudza mawonekedwe a mawonekedwe a kupweteka:

Kufalikira (kutsekereza) kwa ductal system ya gland chifukwa cha kusayenda kwa pancreatic madzi ndi bile mu ducts. Kusunthika kumachitika chifukwa chakuthwa kwakanthawi kwa milomo ya tiziwiti, kusintha kosasinthika (kuchuluka kowonekera chifukwa cha uchidakwa, poizoni m'thupi) kwamadzimadzi kapena chifukwa cha chotupa, miyala, ntchito ya duct (ma parasites (mphutsi) m'mizere.
Kuwonongeka kwa microcirculation wa zimakhala. Pancreatitis ikachitika, pamakhala kuchepa kwa magazi m'matumbo, ma cell omwe amaperekedwa bwino ndi magazi.
Kusintha kwa Dystrophic mu kapamba. Zingwe zimapangidwa ndi ma pancreatic enzymes, omwe amadziunjikira zochuluka kuposa zofunika.
Njira zotupa zomwe zimatupa tiziwalo tating'ono tating'ono ndi tinthu tating'ono timene timatulutsa. Zotsatira zake, kuchuluka ndi kutupa kwa kapamba kumachitika.

Zoyambitsa

Akatswiri amadziwa zifukwa zambiri zoyambira ndi kupindika kwa kapamba. Malinga ndi ziwerengero, mu 30% ya odwala chomwe chimayambitsa matenda opatsirana pancreatic sichingadziwike. Matenda a kapamba amayamba chifukwa cha:

Kugwiritsa ntchito mowa kwambiri. Mowa ndi chimodzi mwazomwe zimayambitsa pancreatitis, kumamwa pafupipafupi zakumwa zachitsulo kumatha kugwira ntchito bwino, komwe kumakhala koyipa kwambiri chifukwa cha thanzi lathunthu.
Zolakwika mu zakudya. Zakudya zonona, zokazinga ndi zonunkhira, kudya mafuta mwadongosolo kumabweretsa kupanga kwambiri madzi a m'mimba ndikuwonongeka kwa gland.
Anomalies mu ntchito ya gallbladder (matenda a ndulu). Zikondamoyo ndi ndulu zimakonda kulowerera mu duodenum. Ngati densi yolekeka ndi miyala, kukokoloka kwa chimbudzi kumachitika, zomwe zimayambitsa kutupa kapena kuwononga kwa ndulu.
Zinthu zovuta, mavuto amanjenje.
Kuvulala, kupweteka kwam'mimba, kuvulala kwam'mimba, m'mimba, komwe magene a pancreatic amatha kuwonongeka.
Matenda a shuga.
Matenda a mahomoni.
Matenda (chimfine, mumps, chimfine, hepatitis).
Neoplasms mu peritoneum.
Kudziletsa.
Kuthamanga kwa magazi.
Kutupa matenda am'mimba thirakiti ndi duodenum. Gastritis, duodenitis, zilonda zam'mimba zimatha kukhudza kutulutsidwa kwa madzi am'mimba.
Zotsatira zoyipa za zida zamankhwala. Mankhwala ambiri amakhala ndi mankhwala othandizira, mahomoni, mankhwala osapweteka a antiidal omwe ali ndi vuto lanyumba ndipo amatha kuyambitsa kutupa.

Chikhalidwe ndi kufalikira kwa kupweteka kwa kapamba

Pancreatitis ululu sensations ndi osiyana, amakwaniritsidwa kubwereza tsiku lililonse ndipo zimatengera malo anatomical - malo a chotupa chotupa (mutu, thupi, mchira), mtundu wa njira yotupa. Chikhalidwe cha kupweteka kwa kapamba ndizosiyana:

Matenda a kapamba, palibe kuwonekera kwachilendo kwa kupweteka, kumatha kukhala kosiyanasiyana mwamphamvu, kumachitika nthawi ndi nthawi (cramping mtundu). Kulimbitsa ululu kumachitika usiku. Pakukhumudwa kwamatenda, zowawa zimapezekamo:

kumtunda ndi pakati pamimba,
dera lumbar, mawonekedwe a lamba wathunthu kapena pang'ono - kumanzere,
dera kumbuyo
pachifuwa chotsika (dera la nthiti m'munsi).

Mu chifuwa chachikulu cha pancreatitis, odwala amamva kukoka, osalolera, pachimake, kupsinjika, kupweteka komanso kumangika, komwe kumadziwika kuti:

wam'mimba
kubwerera
hypochondrium wamanzere,
m'mimba.

Momwe mungazindikire pancreatitis yachilendo

Pakuwopsa kwa kapamba, kapamba samayamba kugaya chakudya, koma yekha. Ngati simukufuna thandizo la kuchipatala pa nthawi yake, osayamba kutsatira malamulo azakudya, pali kutupa ndi kutupa kwa utsi kuzungulira kapamba. Muzochitika zapamwamba, necrosis ya gland imayamba. Zizindikiro za pancreatitis pachimake ndizosavuta kuzindikira:

nseru
ukufalikira
kukomoka mtima,
kuchepa kwakukulu kwa kuthamanga kwa magazi,
osafuna chakudya ndi madzi akumwa,
chizungulire
kupweteka kwambiri pansi pa nthiti yakumanja,
chisangalalo
ma emetic amatuluka ndi zosafunikira za bile,
khungu lotuwa,
kupweteka pachimake kupweteka ndi kapamba, yemwe amakhala pansi kapena ngati wagona, ngati mukugwada.

Momwe mungachepetsere kupweteka mu kapamba kapamba

Kutupa kovuta kwa kapamba kumachitika mwadzidzidzi, nthawi zambiri wodwala amayenera kupereka thandizo koyamba kuntchito kapena kunyumba. Therapy yamtunduwu wa kapamba imachitika kokha kuchipatala moyang'aniridwa ndi dokotala. Pankhani ya ululu wamkati pachimake, ndikofunikira kuyimbira ambulansi ndikuchita izi:

Patsani wodwala mtendere - pathupi (kusuntha kwadzidzidzi kumayambitsa kupweteka), komanso kutengeka mtima.
Chotsani kapena chovala chosasunthika chomwe chimasokoneza kupuma kwabwinobwino kapena komwe kumayambitsa m'mimba.
Kuti muchepetse kupweteka, ndikofunikira kukhazikitsa wodwalayo pofewetsa thupi, kapena kulimbikitsa kugona m'mimba mwake.
Wodwala amafunika kumwa tsiku lililonse kotala kapu imodzi ya madzi owiritsa kapena mchere wa mchere wopanda mafuta.
Kuzizira kumachepetsa ululu.Kwa mphindi khumi ndi zisanu, mutha kuyika chotenthetsera ayezi, matumba otsekemera ndi gel kapena botolo lamadzi owundana pamimba yanu (m'dera la kupweteketsa ululu).
Apatseni wodwala kuti atenge antispasmodic - No-shpa, Papaverine kapena Drotaverin, ngati nkotheka, perekani jakisoni wamkati ndi imodzi mwazomwezi.

Madokotala okha ndi omwe amatha kudziwa mtundu wa kutupa. Pofuna kukulitsa vutoli ngakhale madokotala asanafike, kuukira kwadzaoneni, wodwalayo amaletsedwa:

Pumirani kwambiri - zimakulitsa ululu.
Idyani zakudya.
Tengani ma pinkiller (Spazmalgon, Analgin, Baralgin) - amachepetsa ululu ndipo amatha kulepheretsa akatswiri kudziwa bwino matendawa.
Tengani kukonzekera kwa enzyme (Mezim, Creon, Festal), komwe kumatha kulimbikitsa mkhalidwe wa wodwalayo.
Mukamasanza, musagwiritse ntchito njira zothetsera kapena mankhwala kuyeretsa m'mimba.
Kuwotcha pamimba - izi zimatha kutupa ndi sepsis.

Mankhwala othandizira

Pambuyo pakupita kuchipatala, kuti mupeze zizindikiro za kapamba, wodwalayo amayankhidwa kuti adziwe matenda omwe akuphatikizira:

kuyezetsa magazi konse
X-ray ndi ultrasound ya peritoneum,
kuyesa kwamwazi wamagazi,
fibrogastroduodenoscopy (kumveka),
laparoscopy
zopangidwa tomography.

Kuchepetsa ululu, madokotala amatha kupereka mankhwala a narcotic analgesics, ndipo muzovuta kwambiri, pulogalamu yothandizira opaleshoni imathandizidwa ndikukhazikitsidwa kwa antipsychotic, antispasmodics, maantibayotiki, ma tranquilizer, antidepressants. Ma analgesics omwe amakonda kwambiri:

Chithandizo cha pancreatitis pachimake chimasankhidwa payekha kwa wodwala aliyense. Kuphatikiza pa kumwa mankhwala, wodwalayo ayenera kutsatira zakudya zokhwima. M'masiku oyambira atapita kuchipatala, madokotala amalembera:

Pogona pogona. Kutuluka pakama ndi kusuntha kuyenera kukhala pang'onopang'ono, chilolezo cha dokotala chitachitika.
Njala - nthawi yake imatsimikiziridwa ndi katswiri, chakudya chikatha, amayamba kukula pang'onopang'ono.

Thandizo loyamba la kuchulukitsa kwa matenda a kapamba

Mu chifuwa chachikulu cha kapamba, wodwalayo amakhalanso ndi zofanana - monga kutupa kwadzuwa, koma sakutchulidwa. Poyamba, ululu umakhala paroxysmal ndikudula, kenako umayamba kupweteka. Nthawi zambiri pamakhala zowawa za pancreatitis, zomwe zimatsitsimuka nditatha kudya, koma osazimiririka. Nthawi zambiri, zizindikiro za chifuwa chachikulu chimayamba pambuyo:

kuphwanya zakudya
mantha amanjenje
uchidakwa
kusuta kwambiri.

Ngati kutupa kwambiri pachimake kukuchitika, simuyenera kudzimvera chisoni - muyenera kuyimbira foni dokotala. Ma ambulansi isanafike, muyenera kupereka chithandizo choyamba kwa odwala (chimodzimodzi monga kutupa kwambiri) ndikupereka mankhwala otsatirawa:

Ma Painkiller (Paracetamol, Ibuprofen, Metamizole, Dicloberl, Spazmalgon, Baralgin, Ibufen). Amatha kumwedwa pokhapokha ngati wodwala akutsimikiza kuti ululuwo umayamba chifukwa cha kufalikira kwamatumbo. Mlingo ndi mtundu wa mankhwalawa zimatengera malangizo a katswiri pa nthawi yomwe akumenyedwa kale.
Mapiritsi awiri a Allohol osakanikirana ndi antispasmodic (Drotaverin, No-spa). Mankhwalawa atha kumwa mankhwalawa pakalibe ma gallstones, amathandizanso kutulutsa kwa bile ndi kutulutsa kwa m'mimba kuchokera ku gland.

Chithandizo cha ululu wa kapamba

Chithandizo cha kutupa kwamatumbo ndikufuna kufewetsa thupi, kuthetsa ululu, kuthetsa njira yotupa, komanso kufinya chimbudzi. Pambuyo pakupenda mosamalitsa kwa peritoneum komanso pamaso pa zotsatira zoyesedwa, dokotala wa gastroenterologist aliyense payekhapayekha amapanga dongosolo la mankhwala lomwe limaphatikizapo kugwiritsa ntchito mankhwala, kukonzekera kwa antienzyme, mavitamini, ndi zakudya. Mwa mankhwala, madokotala amalembera:

Pancreatic secretion inhibitors - amagwiritsidwa ntchito popewa kwakanthawi (kutsekeka) kwa ndulu. Mankhwala a gululi akuphatikizapo Gordoks, Kontrikal, Kontriven, Aprokal. Mankhwalawa:
- chepetsani kugwira ntchito kwa proteinase ya ma cellular ndi ma plasma amwazi,
- pewani neancosis ya pancreatic,
- sinthani dongosolo la kinin-kallikreinovoy (KKS).
Hormonal mankhwala Somatostatin kapena analogues (Octreotide) - omwe amagwiritsidwa ntchito pochepetsa kupweteka pachiwopsezo cha pancreatitis, kupondera chinsinsi cha serotonin.
Mankhwala a enzyme (Panzinorm, Mezim, Festal, Pancurmen, Creon, Enzistal Pancreatin) - ali ndi zotsatirazi paumoyo wa wodwalayo:
- gwiritsani ntchito njira yogwiritsira ntchito chakudya,
- chepetsa mphamvu zowawa
- sinthani ntchito ndi kuchepetsa katundu pa kapamba,
- zimathandizira kuyamwa koyenera kwa zinthu zachilengedwe.
H2 histamine receptor blockers (Famotidine, Nizatidine, Cimetidine) - adapangidwa kuti alepheretse zobisika m'matumbo a pancreatic poletsa kupanga kwa hydrochloric acid m'matumbo.
Ma blockers (zoletsa) a pampu ya proton - Ezokar, Omeoprazole, Rabeprazole. Cholinga chachikulu cha mankhwalawa ndikuwonetsetsa kuti kutulutsa kwa hydrochloric acid ndikolepheretse pampu ya proton m'maselo a parietal.
Mankhwala a diuretic - Diakarb, Triampur, Furosemide.
Ma antihistamines (Pipolfen, Suprastin, Peritol, Diphenhydramine) - adapangidwa kuti achepetse kutulutsa kwa minofu ya tinyezi.
Maantacid (Fosfalugel, Palmagel, Maalox, Altacid) - adapangidwa kuti asakanikize hydrochloric acid, yomwe imabisidwa ndi m'mimba.
Antispasmodics (Drotaverin, Papaverin, Eufillin, No-shpa, Riabal, Spazmolin) - adapereka njira yothandizira kupweteka.
Mankhwala a antibacterial (Amoxilav, Azithromycin, Abactal, Sumamed) - amagwiritsidwa ntchito kuthetsa microflora ya bakiteriya, yomwe ingayambitse matenda. Maantibayotiki amathetseratu microflora yonse m'matumbo, kotero amagwiritsidwa ntchito limodzi ndi ma probiotic (Linex).
Cholinolytics - Chlorozin, Metacin, Platifillin, Antopit. Mankhwala a gululi amatithandizira kugaya chakudya.
Mankhwala a Antisecretory - Omeprazole, Lansoprazole, Omez. Mankhwala amachepetsa ululu, amalepheretsa katulutsidwe ka hydrochloric acid, komanso amachepetsa njira yotupa.

Kupewa

Njira zopewera matenda amtundu uliwonse wa kapamba ndizosavuta. Pofuna kupewa kuwonongeka, muyenera kutsatira malamulo otsatirawa:

Pewani zizolowezi zoyipa. Chepetsani kapena siyani kumwa mowa, kusuta.
Khalani ndi moyo wokangalika, kuchita nawo masewera olimbitsa thupi (mwachitsanzo, masewera olimbitsa thupi.
Okonda khofi amaloledwa kumwa zosaposa 1 chikho patsiku. Zokonda ziyenera kuperekedwa pazinthu zachilengedwe.
Onani maulamulidwe amasana, osamadya usiku ndi nthawi yogona.
Ndikofunika kuletsa kugwiritsa ntchito chakudya chofulumira, mafuta, osuta, zonunkhira, Zakudya zothira.
Pang'ono pang'ono, gwiritsani ntchito zakudya zokhala ndi shuga.
Muyenera kudya pang'ono, m'malo ochepa, pali mbale zatsopano.
Phwando lisanachitike, ndikofunikira kumwa mankhwala a enzyme (Pancreatin, Mezim, Festal).

Kupweteka kwa kapamba: Zizindikiro ndi chithandizo

Zovuta pakuchitika kwa kapamba zimayambitsa zovuta zambiri kwa munthu, zimasokoneza moyo wabwinobwino. Matenda a kapamba amadziwika ngati ali pachimake kapena mawonekedwe osakhazikika. Kupweteka ndi kapamba kumatha kuthamanga kwambiri, kumayendetsedwa ndi kuchepa kwa chakudya, kuchepa thupi, kulephera kukhala bwinobwino, kuyenda. Ndikofunikira kudziwa momwe mungadziwire pancreatitis ndikutha kupirira ululu kunyumba komanso kuchipatala.

Momwe mungachepetse ululu m'mapamba?

Munthu aliyense amene wakumana ndi vuto losasangalatsa ili ayenera kudziwa kuti ndizosatheka kuchedwetsa chithandizo chilichonse. Kupatula apo, kupweteka kwa kapamba kumachitika pazifukwa zosiyanasiyana. Kwa matenda aliwonse, choyambirira, kufunsira kuchipatala ndikofunikira.

Pankhaniyi, sizingatheke kugawa ndi wowerengeka azitsamba. Mutha kutaya nthawi yayitali, chifukwa cha matenda omwe amakhala ovuta, chithandizo chomwe chingatenge mwezi umodzi, ndipo nthawi zina choposa chaka chimodzi. Njira zonse zokhudzana ndi kapamba zimakhudza njira yamagayidwe am'mimba.

Zizindikiro za matendawa ndi zoonekeratu: amatchulidwa. Makamaka, ululu wowawa umawonedwa mwa odwala omwe akudwala matenda a pancreatitis. Ululuwu nthawi zambiri umatha kukhala kumtunda kwa ma umbilical dera, komanso - kufalikira mpaka kumbuyo.

Odwala amadziwa kuti ululuwo umakulirakudya atatha kudya kwambiri, kumwa mowa. Kuphatikiza pa kuwoneka ululu, kuwonda kwambiri pamimba kumawonedwa, nthawi zambiri - kumatulutsa, komanso mseru. Osati nthawi zambiri, koma kusanza kumachitikabe. Komanso, ngakhale sizibweretsa mpumulo. Wodwalayo akuti zowawa zomwe zimapweteka m'mimba zimangokulitsa.

Ngati mungasankhe kuchitiridwa nokha, kumbukirani kuti mwanjira imeneyi mutha kuvulaza thanzi lanu. Musanayambe chithandizo popanda dokotala, lingalirani zoopsa zonse. Koma ndikulimbikitsidwa kukaonana ndi dokotala.

Momwe mungachepetsere kupweteka m'matumba a kapamba mwachangu?

Kuti muchepetse kupweteka, musatenge-shpu. Ichi ndi chida chofala komanso chokhacho chomwe sichimawononga chimbudzi. Iye samangolimbana ndi ma spasms, komanso amakulitsa ma pancreatic ducts. Kodi mudamve zowawa m'mapamba pambuyo pa chakudya chamtima? Kenako, choyamba, pukutsani m'mimba pakumwa madzi ambiri.

Momwe mungachepetse kupweteka kwapancreatic?

Mankhwala otsatirawa amagwira ntchito mwangwiro: Festal, Mezim ndi Pancreatin. Piritsi limodzi lokha patsiku ndilokwanira kusintha moyo wanu. Mukatha kugwiritsa ntchito, kapamba amasiya kupweteka, chifukwa kapangidwe kake kamankhwala kamakhala ndi ma enzymes apadera omwe amapanga.

Kuti muchepetse kupweteka mwachangu, ndikofunikira kugwiritsa ntchito chopukutira ndi ayezi. Ngati m'nyumba mulibe zotenthetsera, ndiye kuti mutha kunyowetsa chopukutira m'madzi ozizira ndikuchiyika mufiriji kwa mphindi khumi ndi zisanu mpaka makumi awiri. Pambuyo pake, gwiritsitsani mbali yakumanzere.

Momwe mungachepetsere kupweteka kwa kapamba kunyumba?

Madokotala amalimbikitsa kutsatira njira yapadera, kusiya zinthu zambiri. Masiku oyamba amakulimbikitsidwa kukana chakudya chonse, ndi kumwa madzi amchere okha. Kukana chakudya kwa tsiku, awiri, atatu, ndiye kuti, kwamasiku ambiri momwe thupi lanu lingakhalire.

Zowawa m'mapapo zimatha kanthawi chakudya chikatha. Osazengereza ndikupita kwa dokotala, pitani ndi ultrasound yamatumbo oyenda. Mankhwala ena, komanso njira zochiritsira, ziyenera kutumizidwa ndi dokotala woyenera. Ngati ichi ndiye kapamba, ndiye kuti chithandizo chikuyenera kuchitika kuchipatala.

Momwe mungachepetse kupweteka ndi kapamba

Zowawa zimayendera limodzi ndi ma pathologies ambiri m'thupi: khunyu, njira zotupa. Kuwalekerera nkovuta ndipo sikofunikira. Fomu yovuta ndi zofananira imafunikira chithandizo chamankhwala apadera. Mu nthawi yayitali ya matendawa, kuwonetsa kwa matendawa nthawi zina kapena mwadongosolo kumakhala kotheka. Momwe mungathetsere kupweteka mwachangu ndi kufalikira kwa kapamba? Ndi makhwala ati omwe amayenera kukhala othandizira odwala nthawi zonse?

Pamodzi ndi maselo am'mimba, chiwalochi chimakhala ndi timadzi tating'onoting'ono ta Langerhans timene timatulutsa insulini. Nthawi zambiri, chotupa chotupa chimawakhudzanso. Ntchito ya mahomoni imalephera, wodwala amapezeka ndi matenda a shuga. Matendawa amafunika kugwiritsa ntchito othandizira a hypoglycemic.

Zomwe zimayambitsa kapamba zimatha kugawidwa m'magulu atatu:

Choyambirira, zatsopano zam'mimbamo zomwe zimalumikizidwa ndi ma ducts ochepa ndipo zimapangitsa kuti madzi asungidwe,
Kachiwiri, adatenga matenda a ziwalo zogwira ntchito kapena zimagwirizanitsidwa ndi kapamba (zilonda zam'mimba ndi zilonda zam'mimba, cholecystitis, cholelithiasis),
Chachitatu, zakudya zopanda pake.

M'nkhani ziwiri zoyambirira, kulandira chithandizo chamankhwala ndikofunikira, mwina kuchitapo opareshoni. Pomaliza, munthu amatha kukhazikitsa zakudya zake. Ndi kupanikizika pang'ono kwa kapamba kunyumba, thanani ndi vuto lanu.

Kuphwanya chopondapo ndi mseru kumayendera limodzi ndi zowawa, zozikika kumtunda kumanzere kwa hypochondrium. Imakhala yopindika ndipo imabwerenso nthawi iliyonse yomwe wodwala akaphwanya zakudya kapena kugwiritsa ntchito mafuta, zakudya yokazinga, zakumwa zoledzeretsa.

Mankhwala Anesthesia

Kupweteka kupweteka pogwidwa ndi kapamba mwina chifukwa cha kuchuluka kwa acid zam'mimba. Kuchepetsa zomwe zimapezeka mu hydrochloric acid mu msuzi wa m'mimba zimatha kukhala ma antacid (Fosfalugel, Maaloks, Almagel). Tengani maola awiri aliwonse.

Ma H2-blockers amachepetsa chinsinsi cha kapamba, amakupatsanso mwayi kuti muchepetse matenda a kapamba, woletsa thupi. Rhinitidine (mpaka 450 mg patsiku) amapatsa thupi mpumulo. Ma analgesics omwe si a narcotic a Analgin kapena Baralgin, osakanikirana ndi mankhwala a antispasmodic (Papaverine, No-shpa), siyani kupweteka.

Ndi mankhwala ati omwe nthawi zambiri amauzidwa ndi dokotala? Mankhwala odziwika bwino a kupweteka kwa kapamba amatchedwa Analgin. Mphamvu yogwira popanga ili ndi mankhwala:

analgesic, odana ndi yotupa, antipyretic.

Kwa akulu, mulingo woyenera kutenga Analgin ndi 0,25-0,5 g mpaka katatu pa tsiku. Pazipita limodzi mlingo 1 g, tsiku lililonse - 3. Kuchulukitsidwa kwa kuchuluka kwa mankhwala m'magazi kumabweretsa kuyambitsa hematopoiesis, kuchepa magazi. Ana amawerengeredwa potengera kulemera kwa thupi: 5-10 mg pa kilogalamu 1, mukatha kudya, mpaka kanayi pa tsiku. Ndi kusanza kosalephera, mankhwalawa amaperekedwa kudzera mu intramuscularly.

Panzinorm-forte yophatikizika, mu mawonekedwe a dragee, imakhala ndi zotumphukira za amino acid, kapamba, pepsin, ndi cholic acid. Chipolopolocho chimalola kuti mankhwala asungunuke m'matumbo okha, amapita kutali osakhudzana ndi michere yam'mimba. Gawo lomaliza, Panzinorm-forte imafotokozera mawonekedwe ake ochitapo kanthu, imathandizira kugaya kwathunthu komanso chidwi chokwanira cha chakudya.

Mafuta mu kipimo cha zidutswa za 1-2 amatengedwa, osafuna kutafuna, katatu patsiku, pakudya kwamtima. Kugwiritsa ntchito mankhwalawa kuli ndi malire ake:

matenda omwe alipo (gastritis yokhala ndi acidity yayikulu, hepatitis yopanda matenda), hypersensitivity kuti mapuloteni amtundu (ng'ombe, nkhumba), mkaka wa m'mawere, pakati, odwala matenda a shuga amafunika kusintha kwa mlingo chifukwa cha shuga. Popewa kupewera matenda, dotolo amatumiza mankhwala opatsirana (Ampioks, Cefuroxime).

Ndi chiyani china chomwe chingathandize thupi kupweteka?

Mphindi yachilengedwe pakutha kuthetsa kuukira ndikukana chakudya masiku angapo. Malinga ndi chakudya No. 5, zakudya zabwinobwino zimasamutsidwa pambuyo poti zatha. Njira zomwe zimachepetsa ululu pancreatitis sizongomwera pakumwa mankhwala.

Ululu umavomerezedwa mosavuta mukakhala kapena malo abodza. Nthawi zina, makamaka odwala hypotensive (anthu omwe ali ndi kuthamanga kwa magazi), amatsikira pazofunikira kwambiri, ndipo kugunda kwa mtima kumawonjezeka. Munthu akhoza kugwa.

Pankhaniyi, wodwalayo akulimbikitsidwa kutenga lingaliro. Zimakuthandizani kuti muchepetse minofu yam'mimba ndikuwongolera kwambiri momwe muliri: miyendo imagwada mawondo ndikuwakanikizira momwe mungathere thupi. Nthawi zambiri malo osungirako ena amatengedwa mwachilengedwe.

Muyenera kupumira palimodzi, ndikupuma mokwanira.Mukamapuma - kugwiritsa ntchito makoma onse am'mimba - "funde". Kupuma kwamkati, kufinya kwam'mimba kumachitika. Ululu pakuwukira nthawi zambiri umatsagana ndi kusanza, popeza kuyenda koyenera kwa chakudya m'matumbo a m'mimba (GIT) kumasokonekera. Chizindikiro chokhala ndi chizindikiro cha emetic mu pancreatitis ndikuti ndichulukana.

Kuphulika kwa zakudya zopanda chakudya sikumabweretsa munthu mpumulo, kufooka ndikufooketsa thupi, kutentha kwa thupi kumadzuka. Wotsogolera kusanza ndi mseru, womwe ungakhale wolowerera kale.

Zimathandizira kuthetsa kusapeza bwino pamtunda wam'mimba wamatenda azitsamba, omwe amaphatikizapo mankhwala a valerian, chamomile yamtchire, peppermint. Chifukwa chake, 2 tbsp. l kusonkhanitsa kutsanulira 200 ml ya madzi otentha, kunena 1 ora. Kuchiritsa tiyi, kutentha kwa chipinda, kumwa theka lagalasi. Ngati munthu sakhudzidwa ndi njuchi, onjezerani 1 tsp ku chakumwa. uchi wachilengedwe.

Kumwa madzi amchere m'njira yapadera kumathandizanso kuchepetsa ululu wa kapamba. Madzi amchere (Smirnovskaya, Essentuki No. 4, Slavyanovskaya, Borjomi) amapangidwa ndi kutentha kwambiri. Tsegulani botolo kuti mpweya utuluke, ndikugwedeza kangapo. Tengani madzi kuchokera kumagwero achilengedwe a 1-2 tbsp. l mphindi 30 mpaka 40 zilizonse. Chipale chofunda chimayikidwa pa kapamba.

Momwe mungathandizire kupweteka ndi kapamba

Ngakhale kale, madokotala oyamba achi Greek adazindikira kufunikira kwa kapamba. Kupatula apo, ntchito ya gawo lamkati ili imakhudza kugwira ntchito kwa chiwalo chonse. Ntchito yayikulu ya kapamba ndikupanga ma enzymes omwe chakudya chimayimbidwa.

Ma enzyme amenewa ndi gawo la madzi a pancreatic ndipo amayamba kugwira ntchito atadziwitsidwa ndi madzi a bile ndipo ma enzyme omwe amapangira matumbo kuti agwetse chakudya kukhala mafuta, mapuloteni ndi chakudya. Chifukwa cha njirayi, thupi limakhazikika ndikugaya chakudya, ndipo mavitamini opindulitsa omwe amabwera ndi chakudya amalowa mosavuta m'magazi.

Kupatula apo, kusunga kuchuluka kwa glucose m'magazi (izi ndizomwe zimachitika mothandizidwa ndi insulin ndi glucagon wopangidwa ndi kapamba) ndizofunikira kwa munthu aliyense, chifukwa amachita zambiri pazochita zonse za metabolic.

Kasitomala ndi gawo lapadera la thupi la munthu, chifukwa limasinthasintha pafupifupi ndi chakudya chamtundu uliwonse, ndikupanga madzi enaake a kapamba chifukwa chake. Chifukwa chake, kuyang'anira ndi kuyang'anira thanzi la chiwalochi ndikofunikira kwambiri.

Kodi kapamba ndi chiyani?

Pancreatitis ndimatenda a kapamba pomwe amadzaza ndikukula. Akatswiri amagawana mitundu iwiri ya matendawa: pachimake komanso chovuta. Poyamba, matendawa amakula mwachangu komanso mosayembekezereka, amayambitsa mavuto ambiri ndipo amafunikira chisamaliro chamankhwala msanga, chachiwiri, kapamba amayamba nthawi yayitali komanso ulesi, amafuna chithandizo chamankhwala, samayambitsa chisangalalo chachikulu kwa nthawi yayitali.

Zizindikiro za Pancreatitis

Zomverera zowawa. Mphamvu ya kupweteka ndi kapamba imakhala yothandiza kwambiri. Pachimake, kwambiri, kulimbikira ululu khalidwe la pachimake kapamba. Odwala omwe ali ndi matendawa amadandaula za ululu wosakhazikika komanso m'mimba.

Ngati simukufunsira kwa katswiri pakapita nthawi, mutha kumva kuwawa, komwe kumakhala ndi zotsatirapo zosiyanasiyana. Ndizofunikira kudziwa kuti pachimake, pancreatitis yovuta kwambiri, wodwalayo nthawi zambiri amakhala ndi ululu m'chigawo cha epigastric komanso mbali yakumanzere ya thupi, ndipo pancreatitis yovuta kwambiri, wodwalayo amakhala ndi chapakati komanso chapakati pamimba, pachifuwa chochepa, lumbar, kumbuyo ( osasekerera mbali zina za thupi.

Kutentha kwambiri kwa thupi, kuthamanga kapena kutsika kwambiri. Ndi kutupa komwe kumakula msanga, mkhalidwe wa munthu umachepa mphamvu ndipo umayenda limodzi ndi kupsinjika ndi kutentha. Mawonekedwe osakhala bwino. Ndi mtundu uliwonse wa kapamba, munthu amakhala wotumbululuka, masaya kugwa, zikwapu zachikasu zimawonekera pansi pa maso. Hiccups, nseru, kusanza, belching, pakamwa kowuma. Kutsekula m'mimba / kudzimbidwa. Chifukwa cha kagayidwe kosayenera ndi chimbudzi cha chakudya, ntchito ya m'mimba imasokonekera, zomwe zimayambitsa kutsekula m'mimba kapena mosemphanitsa. Maso achikasu pamalilime.

Zoyambitsa Pancreatitis

Pakhoza kukhala zifukwa zambiri za kapamba, chifukwa kutupa kwa kapamba kumachitika mosavuta, koma zazikulu ndi izi:

aakulu uchidakwa chitetezo chokwanira (autoimmunity, chitetezo cha mthupi chimalimbana ndi ake omwe) gallbladder matenda, makamaka, miyala mu ndulu ya chindulu cha ndulu ya chimbudzi kapena kapamba wotsekemera wamkati wamatumbo woyipa chifukwa cha kuzungulira kwa milondoyi. mafuta a triglycerides (magazi) m'magazi; magazi amayenda m'matumba; kuvulala kwamatumbo ndi chikhodzodzo; tory zinachititsa kuti kusokoneza matendawo pancreatic wa enaake fibrosis, hyperparathyroidism Kawasaki matenda Reye a syndrome zosokonezeka pambuyo chithandizo ndi mankhwala ena (estrogens, corticosteroids, thiazide okodzetsa), matenda tizilombo (chifuwa chachikulu, matenda a chiwindi, mycoplasma) Zotsatira pambuyo zilonda, enteritis, matenda a m'matumbo, enterocolitis, diverticula

Matenda a kapamba

Kuzindikira matenda a kapamba kumabweretsa zovuta kwa wodwalayo komanso madotolo, chifukwa chifukwa cha malo osokoneza bongo omwe amapezeka, ndizovuta kudziwa. Koma izi ndizofunikira kwambiri, chifukwa chithandizo chamankhwala chanthawi zonse sichimabweretsa zabwino, mankhwalawa amagwiritsidwa ntchito pothandiza kuchepetsa ululu womwe umakhudza kugwira ntchito kwa chiwindi ndi ziwalo zina zam'mimba, ndipo kapamba palokha samachiritsidwa.

Pali njira zingapo zodziwira matendawa, chimodzi mwazomwe akumva. Zotsatira zosiyana pambuyo poti mumvekere zimawonetsa matenda osiyanasiyana, ndiko kuti, mitundu yosiyanasiyana ya kapamba. Umboni wa matendawa ndi:

kusatheka kwa palpating msempha mu gawo pansi pa chifuwa; kapangidwe ka malo owoneka bwino khoma lachiberekero; kuphulika mu navel; kupweteka pakumva kupweteka; kupweteka kosasangalatsa pakuwona malo pakati pa msana ndi nthiti yakumanzere

Pancreatitis imatsimikizidwanso kugwiritsa ntchito mayeso a labotale, monga:

kusanthula kwa zamankhwala amwazi m'magazi a anthu (mu zotsatira za kafukufuku wotereyu, pakhoza kukhala kuchuluka kwa michere ya gland, yomwe si yachilendo, kuwonjezereka kwa lipase, kuchuluka kwa glucose, ndiye kuti, kuchuluka kwa insulini, kuchuluka kwa mapuloteni, urea wambiri m'magazi)
Kuyesa kwa magazi-electrolyte magazi bwino. Chifukwa cha kusanthula uku, ndikotheka kudziwa mawonekedwe osakanikirana amadzimadzi m'thupi la munthu, omwe akuwonetsa matenda osiyanasiyana
Kuyesedwa kwa magazi kumachitika pofuna kudziwa kuchuluka kwa maselo ofiira am'magazi, maselo oyera azigawo ndi zina za magazi a munthu, kupatuka komwe kumawonetsa kukhalapo kwa matenda osiyanasiyana

Urinalysis, kuchuluka kwa alpha-amylase mu mkodzo kumawonetsa kutupa, komwe amadziwika kwambiri ndi odwala kapamba. Kuzindikira kwa Hardware ndizothekanso: kuwunika kwa ultrasound kwa zikondamoyo, kuyesa kwa X-ray, tomography yokhala ndi pakati, laparoscopy ndi endoscopy.

Njira yolimba yochizira khansa ndiyo kulumikizana ndi katswiri nthawi kuti asayambitse nthendayi, chifukwa mavuto atatha kupha.

Pulumutsani ululu wa kapamba

Mu zilonda zamkati komanso zopweteka kwambiri za kapamba, kupweteka ndi chimodzi mwazizindikiro zazikulu zamankhwala. Ndizovuta zopweteka zomwe zimayambitsa zovuta zambiri kwa munthu yemwe ali ndi kapamba ndipo zimamupangitsa kuti atembenuke kwa dokotala. Zosankha zingapo zothandizira kupweteka kunyumba komanso nthawi yayitali kuchipatala ndizimodzi mwazinthu zofunikira kwambiri pochizira matendawa.

Mu mawonekedwe

Kulimba kwa pancreatitis pachimake kumayambika chifukwa cha kutupa kwa dambo la Wirsung komanso minyewa ya m'mimba. Nthawi zambiri choyambitsa kupweteka ndi spasmodic sphincter ya Oddi, yomwe imalepheretsa kutulutsidwa kwa ma enzymes a bile ndi pancreatic. Chifukwa chake, ndikofunikira kuti muchepetse kuphipha. Kuphatikiza apo, mu pancreatitis yovuta kwambiri, chitsulo chimawonongeka ndi ma enzymes ake, motero ndikofunikira kuchepetsa kupanga ma enzyme.

Pothandizira kupweteka, magulu angapo a mankhwala amagwiritsidwa ntchito:

Narcotic komanso sanali narcotic analgesics osakaniza antihistamines.
Myotropic antispasmodics, anticholinergics.
Calcium calcium blockers.
Gastric secretion inhibitors - Omeprazole, Ranitidine, Dalargin.
Droppers ndi ma pancreatic enzyme zoletsa - Gordoks, Kontrikal.
Hormone somatostatin - Octreotide, Sandostatin.
Ma antipsychotic, antidepressants, tranquilizer.
Ma antihypoxants.

Njira yothandizira ululu yomwe imayenera kukhala m'makhabati aliwonse azachipatala ndi Papaverine kapena Drotaverin (No-shpa). Izi zimalepheretsa mphamvu za ma enzyopu kutsidya la Wirsung, kuwamasula njira yopita ku duodenum kudzera mu sphincter ya Oddi.

Kunyumba, gwiritsani ntchito mapiritsi 2 a No-shpa. Chipatala chimapanga jakisoni wamkati wa Drotaverine, ndikuwonjezeranso njira yothetsera dontho ndi sodium chloride.

Cholinolytics amachepetsa kubisalira kwa michere, komanso kumasula ma spasms. Lemberani Buscopan, Atropine.

Ma calcium blockers, monga Nifedipine, Amlodipine, amagwira ntchito ngati antispasmodics, amasintha magazi.

Ma analgesics omwe si a narcotic - Ketorolac, Analgin - ndi amphamvu kwambiri polimbana ndi ululu ndi kapamba. Komabe, salowa m'malo mwa mayeso a kuchipatala ndi chisamaliro. Kuphatikiza apo, ndikofunikira kuwonetsetsa kuti chomwe chimayambitsa kupweteka chili m'mapazi, osati mu ma pathologies ena okhala ndi zilonda zam'mimba zam'mimba (zilonda kapena zilonda zapakhungu, appendicitis, kutsekeka kwamatumbo). Amagwiritsidwa ntchito ndi Diphenhydramine, imalepheretsa sayanjana, imathandizanso edema yotupa, komanso imalola wodwala kugona.

Ma analcics a narcotic amagwira ntchito mwamphamvu kwambiri kuposa omwe samakonda. Zimakhudza ma opiate receptors, kuchepetsa ululu. Mphamvu yofulumira komanso yolimba imapezeka ndikuphatikiza ma opioids (Fentanyl, Promedol, Tramal) omwe ali ndi antipsychotic, antidepressants.

Omeprazole amachepetsa kubisika kwa hydrochloric acid pamimba, yomwe imaletsa kupanga michere mkati mwake.

Proton pump inhibitors (Omeprazole, Lansoprazole), H2-histamine receptor blockers amachepetsa katulutsidwe ka hydrochloric acid pamimba, kamene kamayimira kupanga ma enzyme mkati mwake. Dalargin amachepetsa kapangidwe ka trypsin mu kapamba, kumabweretsa mpumulo.

Sandostatin kapena Octreotide - mahomoni a maselo a pancreatic delta omwe amachepetsa kubisika kwake. Pewani pancreatic necrosis.

Zoletsa za michere ya proteinolytic - Trasilol, Kontrikal, Gordoks - kupewa magazi omwe amayamba chifukwa cha trypsin, kufooketsa kupweteka kwambiri mu hypochondrium yamanzere.

Ma antihypoxants - Mexicoidol, Reamberin - popewa kufa kwa maselo pamavuto.

Ndi zochulukitsa

Kuchulukana kwa matenda a kapamba kumayamba mwadzidzidzi, kuwonetsa kupweteka kumanzere kwa chifuwa.

Nthawi zambiri izi zimachitika pakudya zakudya yokazinga ndi zokometsera, kupsinjika. Kugwiritsa ntchito mankhwala a antispasmodic - Drotaverin, Platifillin pothandizira kupweteka kumawonetsedwa.

Zakudya zamafuta, zonunkhira, mowa ndizoletsedwa. Kukonzekera kwa enzyme ndikofunikira kuti muchepetse katundu pazitsulo - Cholenzym, Mikrasim, Mezim.

Mukukhululuka

Mukachotsa chikhululukiro, chinthu chachikulu sikuti ndikwonjezera mkwiyo wa mafuta ochulukirapo kapena zakudya zonunkhira.

Kusintha ntchito ya sphincter ya Oddi, mankhwala amagwiritsidwa ntchito - Gepabene, Odeston, No-shpu, Urolesan.

Popewa kuchulukana kwambiri pakudya chakudya chopakidwa m'mimba, kukonzekera kwa enzyme kumachitika pakudya.

Mtundu wa zowawa

Kukula kwawoko ndi chikhalidwe cha kupweteka kwa kapamba ndiye munthu payekha, koma, kutsimikizika ndi chikhalidwe cha chotupa. Mu kapangidwe kachulukidwe ka kapamba, kupweteka kumachitika kanthawi kochepa pambuyo poyambitsa chinthu chopatsa thanzi.

Momwe ma pathological amasinthira, kuchuluka kwa ululu kumawonjezeka, munthu amathamangira pakama osagwiritsa ntchito njira yabwino yopumulayo.

Nthawi zambiri, palibe miyendo yomwe imabweretsedwa m'mimba ("mluza"), kapena kugona mbali imodzi, kapena kukhala pampando pakubwezeretsa. Kupweteka kwambiri kwapweteka kumadziwika mu supine udindo.

Nthawi zambiri, kupweteka kwa kapamba kumawonekera pamimba. Nthawi zambiri pakati pa gawo la epigastric, nthawi zina ululu umasunthira kumanzere kwa hypochondrium. Nthawi zina, ululu wammbuyo wamitundu yosiyanasiyana wa kapamba umapezekanso ndi momwe angina pectoris. Munthu akumva kuwotcha kapena kuphika kupweteka kwambiri kumbuyo, ndikufalikira mpaka kumanzere kumbuyo, nkono kapena theka lamanzere.

Mu kapangidwe kake ka kapamba, kupweteka sikumadziwika bwino kwawoko. Munthu amatha kumva ululu osiyanasiyana:

kumtunda kapena pakati pamimba, m'chigawo chakumapeto kwa nthiti, ndiye kuti, m'chigawo cha m'munsi pachifuwa, kumbuyo komwe osakhudzidwa ndi madera ozungulira, dera lumbar momwe amadziwika kuti "lamba wamanzere" kapena "lamba wathunthu".

Anthu ambiri omwe ali ndi vuto la kutupa kwa kapamba amatha kudziwa kupweteka kwakanthawi, komwe kumatchedwa kukokana. Zowawa ndi kapamba zimatha kukulira mosiyanasiyana, koma nthawi zambiri zimakhala zokwera kwambiri, mpaka pakachitika zovuta zamaganizidwe.

Ululu umayamba theka la ola mutatha kudya. Zowoneka ngati zilonda zam'mimba sizimawonedwa kawirikawiri, ndiye kuti, ndi m'mimba yopanda kanthu. Nthawi zambiri kusintha kwina kumasintha ndi kuphatikizana kwa kuwawa.

Kutha kwa ululu, makamaka ngati ululuwo unali waukulu, ndi chizindikiro chosasangalatsa, chifukwa chikuwonetsa kukula kwa necrosis ya gawo lofunika kwambiri la gland.

Momwe mungadziwire kapamba

Pancreatitis ndi kutukusira kwa kapamba komwe zimayambira michere. Izi zimatsogolera pakupanga kutupa ndi kuyamwa, komwe kumayambitsa kupweteka.

Mwachilengedwe, matendawa amatha kukhala odwala komanso osachiritsika. Pazosinthana zilizonse, kapamba amachititsa kuti ziwonongeko zisawonongeke.

Ululu Imatha kukhala paroxysmal kapena yokhazikika, kupweteka, kuwotcha komanso lakuthwa. Nthawi zambiri ndimamva kum'mimba kumanzere kwam'mimba, mu hypochondrium, koma ndi matenda a ndulu amathanso kukhala mbali yakumanja, kupatsa kumbuyo ndikukhala ndi chikhalidwe chomangirira.
Stool matenda, nthawi zambiri amatsegula m'mimba.
Kuchepetsa thupi. Monga lamulo, ndi nthawi yayitali ya matenda.
Kusanza ndi kusanza komwe sikubweretsa mpumulo kwa wodwala.
Pakumeza kufinya, kutha kwa khungu ndi maso ndi ma mucous nembanemba.
Kuwonjezeka kwa kutentha kumawonetsa njira yotupa, chomwe ndi chizindikiro chowopsa.

Zizindikiro zonsezi zikuwonetsa kukula kwa kapamba am'mimba, omwe amafunikira chithandizo chamanthawi komanso chokwanira, apo ayi matendawa amatha kukhala osachiritsika kapena akupha.

Choyamba thandizo kuukira kwa kapamba

Nthawi zambiri zimachitika kuti munthu akumana ndi vuto kunyumba, kuntchito, kutali ndi kuchipatala. Njira zotsatirazi zikuthandizira kupweteketsa kupweteka ndi kapamba komanso kupereka chithandizo chisanachitike madokotala:

Ndikofunikira kukhazikitsa mtendere wathunthu kwa wodwalayo.
Ndikulimbikitsidwa kuti munthu azikhala nthawi yomweyo, ndikuonetsetsa kuti thupi lakhazikika. Sizoletsedwa kugona, chifukwa izi zimangokulitsa ululu.
Mothandizidwa ndi kupuma kosakhazikika ndi kuchedwa kwake, thandizani ululu.
Ikani kutentha kwazizira pa kapamba, makamaka kuchokera kumbuyo. Simungagwiritse ntchito ma compress ofunda komanso mapiritsi otenthetsera - izi zimangokulitsa zinthu.
Osamadya. Ngati palibe kusanza, imwani madzi amchere opanda mpweya kapena msuzi wofowoka wa nyama zakuthengo m'malo ang'onoang'ono.
Simungathe kuchita zam'mimba, mutha kukanikiza muzu wa lilime ndi zala ziwiri kuti musinthe.

Zimatanthawuza kuti atithandizire kuukira kwa kapamba kunyumba

Kunyumba, mutha:

Kusunga kusala kovomerezeka kwa maola osachepera 24.
Tengani ma pinkiller Spazmalgon kapena Baralgin, koma ndibwino kuti musachite izi ambulansi isanafike, pokhapokha ngati pali ululu wosapirira.
Kutenga No-shpa kapena Papaverine ndi antispasmodic. Itha kugwiritsidwa ntchito pamene kuukira kwayambitsa matenda amisempha. Ndikwabwino kubaya mankhwala.
Zowawa zikasiya, mutha kutenga zokonzekera za Festal, Mezim, Creon ndi chakudya.

Njira zochizira

Chithandizo cha matenda a pancreatic amatha kukhala osakhazikika komanso opaleshoni, kuchipatala komanso kunyumba.

Woopsa matendawa, kuphatikizapo painkillers ndi antispasmodic mankhwala, tranquilizer, antidepressant ndi mankhwala, chifukwa matendawa amakhudzanso wodwala matenda amisala. Ngati pancreatitis ndi yachilengedwe, ndiye kuti maantibayotiki awiri amapatsidwa mankhwala. Chithandizo chimathandizidwa ndi jekeseni wa saline ndi mapuloteni.

Nthawi zina zimachitika kuti wodwala safuna kugonekedwa. Pambuyo pakuwunika bwino ndi dokotala, wodwalayo amasiyidwa kunyumba ndipo chithandizo chimalembedwa. Ndikofunikira kuonetsetsa kuti mankhwala ofunikira nthawi zonse amakhala ku khabati yamankhwala kuti muime mwadzidzidzi. Chakudya chokhazikika chimalimbikitsidwa.

Chakudya chiyenera kuphwanyidwa kapena kusungunuka, popanda kuwonjezera zonunkhira.

Wodwala akuyenera kutsatira malangizo atatu:

Njala. Ziwalo zogaya chakudya ziyenera kukhazikika kuti zithetse mkhalidwe wa kapamba.
Limbani.
Mtendere wathunthu. Yang'anani pogona.

Njira zina zochizira

Njira zina zamankhwala monga kugwiritsa ntchito:

mankhwala azitsamba, zowonjezera, zodzikongoletsera ndi tiyi,
mankhwala apanyumba
zopangira njuchi,
kuphunzitsa dongosolo la autoimmune
hirudotherapy (chithandizo ndi leeches).

Pakapanda kuukira, zakudya zonunkhira kuchokera ku mafuta ophukira amathandiza bwino, womwe ndi ufa, kuthira madzi ndi kuwiritsa kwa mphindi 1-2. Chida chimagwiritsidwa ntchito mwatsopano, 150 g musanadye.

Mobwerezabwereza kupweteka kwapafupipafupi kumatha kuwiritsa bwino pogwiritsa ntchito machubu a calendula, eleutherococcus kapena echinacea kwa 1 tsp musanadye katatu pa tsiku.

Njira yabwino yothetsera vutoli ndi muzu wa magazus, womwe uyenera kukhala grated ndi 1 tbsp. l kutsanulira kapu ya madzi otentha, kubweretsa kutentha kwa chipinda ndi kupsinjika. Tengani supuni, ndikutsukidwa ndi kulowetsedwa kwa centaury.

A decoction wa barberry muzu ali ndi analgesic kwenikweni. 1 tbsp. l kutsanulira kapu yamadzi otentha ndikuumirira kwa mphindi 15. Imwani 1 tbsp. l katatu patsiku.

Chida chake chimachepetsa komanso kuukira matenda a ndulu, womwe ndi satana wa kapamba.

Njira yothandiza kwambiri yothetsera kupweteka komanso kuthandizira pancreatitis ndi kulowetsedwa kapena msuzi wa kryptei. Mphamvu zamachiritso zimathandizira kuti acidity yam'mimba ikhale ndikulimbikitsa kukonzanso minofu, yomwe ndi yofunika kwambiri pakuwonongeka kwa pancreatic. Tincture amatengedwa 20 akutsikira katatu patsiku 20-30 mphindi musanadye. Njira ya mankhwala ndi miyezi itatu. Bwerezani mwezi umodzi.

Madzi ochokera ku Brussels amatumphuka, letesi, kaloti ndi nyemba zobiriwira ali ndi zotsatira zabwino zowawa. Dutsani zida zonse mosiyanasiyana kudzera pa juicer. Imwani 1/2 tbsp. Mphindi 30 musanadye m'mawa. Njira ya mankhwala ndi masiku 30.

Mbewu za fulakesi zimathandizanso chiwalo choduliracho ndikuchotsa ululu. Amayikidwa mu mawonekedwe a zakudya ndi zakudya. Kuti mukhale odzola muyenera 1 tbsp. 1 lita imodzi ya mbewu kutsanulira 1 chikho cha madzi ndikuphika kwa mphindi 10. Lolani kuti aleke kwa ola limodzi. Vutani ndi kumwa m'mawa pamimba yopanda kanthu. Kuti mupeze decoction, muyenera 80 g wa nthomba. Thirani ndi madzi okwanira 1 litre ndi simmer pansi pa chivindikiro. Imwani m'mawa pamimba yopanda kanthu. Njira ya mankhwala ndi miyezi iwiri.

Musanachepetse kupweteka ndi kapamba pogwiritsa ntchito maphikidwe a wowerengeka, ndikofunikira kukaonana ndi dokotala ngati angagwiritsidwe ntchito. Mukadzilimbitsa nokha, ndikofunikira kuti musadzivulaze.

Kutumiza ululu kunyumba

Mu kapangidwe kachulukidwe ka kapamba, kuchotsedwa kwa zopweteka mwadzidzidzi kumatha kukhala ndi zotsatirapo zoyipa. Chithunzi chomwe chikukula cha "pamimba pamimba" chitha kupezeka kuti ndi yoyenera ndi dokotala wodziwa bwino za vivo.

Mu njira yotupa yotupa m'matumbo a pancreatic, njira zamankhwala zosokoneza bongo ndizosiyana kwambiri. Kuzindikira kwakhalapo kwanthawi yayitali, ndipo cholinga chamankhwala ndikuwongolera moyo wa munthu amene akuvutika. Kumverera kwathanzi lanu, kuthekera kokhala moyo wabwinobwino kumakhudzana makamaka ndi kusowa kwa ululu.

Zotsatira zabwino zamankhwala zimayamba ndi kudya. Kusowa kwa kukhumudwitsa komanso kosangalatsa kwa zotsatira za ma enzymes kumakuthandizani kuti mugwiritse ntchito pokhapokha ngati pakufunika pakugwiritsa ntchito mankhwala ochepetsa ululu.

Ndi kuchepa kwa analgesic zotsatira, kusankha NSAID ina ndikulimbikitsidwa (diclofenac, ibuprofen). Pokhapokha ngati mukupweteka kwambiri komwe mungathe kuchepetsa ululu pochita zomwe NSAIDs zimagwira ndi ma antipsychotic kapena ma tranquilizer.

Mankhwala ochizira matenda a kapamba, magulu otsatirawa a mankhwalawa amaphatikizidwa:

Pancreatic enzymes Pancreatic enzymes, ndiye kuti, pancreatin, kumbali imodzi, kusintha njira zamkati, kuchepetsa katundu pa minyewa ya glandular. Komabe, kuchepa kwa magwiridwe antchito kungathandize kuchepetsa ululu, kapenanso kuchepetsa kukula kwa ululu. Hormone somatostatin ndi mankhwala ena opangira

Somatostatin ali ndi mphamvu yochepetsera kupweteka kwamphamvu kwa thupi lonse lathunthu komanso kukula kwa zowawa makamaka pancreatitis. Analogue yake yopanga, octreotide, imakhala nthawi yayitali, kotero ngakhale yochepa-pang'ono (masiku atatu) imakupatsani mwayi wokhala ndi zotsatira zokhalitsa. Tsoka ilo, zovuta zingapo zoyipa sizilola kugwiritsa ntchito somatostatin ndi mawonekedwe ake osiyanasiyana odwala. Histamine receptor blockers

Kupanga kwa komwe kumatchedwa "magwiridwe antchito" kwa kapamba kumatheka osati kokha mwachindunji mwachindunji ndi chinsinsi ndi michere ya pancreatic. Mwinanso chosakhudzidwa motere ndikugwiritsa ntchito histamine receptor blockers kapena proton pump inhibitors. Pakati pa blockers a H2-histamine receptors, famotidine ndiwotchuka kwambiri.

Imakhala ndi ntchito ya antioxidant, imasintha magazi m'magazi, komanso imakhala ndi zotsatirapo zoyipa. Famotidine imatha kuchepetsa chinsinsi cha mbali yotsalira ya kapamba, chifukwa imalepheretsa kutulutsidwa kwa hydrochloric acid m'mimba. Proton pump inhibitors (lansoprazole, esomeprazole, rabeprazole) ali ndi chiopsezo chotsika cha zotsatira zoyipa, zomwe zimapangitsa kuti azitha kupondereza kubisalira kwa hydrochloric acid mkati mwa m'mimba motetezeka. Mwinanso kugwiritsa ntchito mankhwalawa kwa nthawi yayitali mosiyanasiyana.

Kupuma pachipatala

Kugwiritsira ntchito kuchipatala kwa wodwala ndi kapamba kumachitika chifukwa cha matenda. Kuthandizira kupweteka, ma analcics a narcotic amatha kugwiritsidwa ntchito, chifukwa ululu wammbuyo ndiwowopsa. Nthawi zambiri amagwiritsidwa ntchito:

promedol, omnopon, tramadol, ketani.

Amayambitsa ndi njira za kukula kwa kupweteka kwa kapamba

Pancreatitis pain syndrome imayamba chifukwa cha zifukwa zambiri. Itha kutchedwa:

Mafuta, okazinga, osuta, mchere kapena zakudya zonunkhira;
Kumwa mowa
Poizoni
Kuchulukitsa kwa matenda am'mimba, duodenum kapena chiwindi,
Zinthu zovuta.

Nthawi zambiri, ululu umawonekera mphindi 30 mutatha kudya, chifukwa Pambuyo pa kanthawi kochepa pomwe kapamba amayamba kuwona chinsinsi chachikulu kwambiri. Limagwirira kukula kwa matenda a ululu zimatengera mtundu wa chotupa ndipo amaphatikizidwa ndi kusintha kosiyanasiyana m'thupi:

Kutupa ndi kutupa m'matimu a kapamba, Kulepheretsa zonyansa za m'matumbo, Kuchulukitsa kwathina m'matumbo, Kuthira magazi kosakwanira kwa kapamba, Njala ya O oxygen, kusintha kwa Dystrophic.

Mu pachimake kapena kufalikira kwamatenda kapamba mu kapamba, kutupako kumatchulidwa kwambiri, komwe kumayambitsa kuthamanga kwa magazi, kutupa, kupweteka komanso kuphwanya thupi. Kutengera kulimba kwake, kusintha kwa dystrophic kumayamba, komwe kumayambitsa pancreatic necrosis.

Mu chifuwa chachikulu cha pancreatitis, kutupa kumayamba kutchulidwa pang'ono, ndipo zizindikiro zosakwanira zamagazi zimaphatikizira minofu ya pancreatic. Tiziwalo tamadonthina tomwe timakhudzidwa panthawi ya pachimake timasinthidwa ndi minyewa yolumikizana, ndipo ma cysts kapena magawo a calcation amawoneka m'malo osiyanasiyana omwe amapangitsa kupweteka, kufinya ziwalo zosasintha ndi ziwalo zake.

Momwe mungachepetsere kupweteka ndi kufinya kapena kupweteka kwamatumbo?

Ndi kuchulukitsa kwa chifuwa chachikulu, kusamala kuyenera kugwiritsidwa ntchito pogwiritsa ntchito ma pinkiller, kugwiranso kofananako kungayambenso chifukwa cha matenda ena ndipo kumatenga matenda a analgesic kumapangitsa matenda azovuta.

Kupweteka kwambiri kumatha kuthetsedwa kunyumba pogwiritsa ntchito zomwe zomwe tafotokozazo kuti zithandizire pancreatitis yayikulu.

Ngati kulondola kwazomwe zikuwoneka ngati kupweteka kwamankhwala ndikosakayikitsa, ndiye kuti wodwalayo atha kumwa mankhwala ena a ululu asanafike kwa dokotala kapena wa ambulansi.

Kuthetsa ululu wotere ndikoyenera:

Paracetamol, Baralgin, Ibuprofen, Diclofenac (Dicloberl), Metamizole.

Mankhwalawa amatha kugwiritsidwa ntchito kuti athetse ululu wa kapamba. Mlingo wawo ndi kusankha kwawo kumatsimikiziridwa ndi dokotala kutengera zaka komanso zovuta za wodwala.

Kuperekanso ululu chifukwa cha kukokoloka kapena chifuwa chachikulu kapena chokhazikika chitha kuperekedwanso mwa kumwa mankhwala omwe amathetsa chifukwa cha mawonekedwe awo. Dokotala yekha ndi amene angalimbikitse kugwiritsa ntchito mankhwalawa. Kusankhidwa kwa mankhwalawa, mankhwala ake ndi muyezo wawo zimachitika pambuyo pofufuza mwatsatanetsatane wodwala.

Pofuna kuthetsa kupweteka pachiwopsezo cha pancreatitis, zotsatirazi zitha kugwiritsidwa ntchito:

Zoletsa za pancreatic secretion (gordox, contracitive, contracal) - zimayikidwa kuti zitsimikizire kupumula kwa pancreatic kumayambiriro kwa ululu, mahomoni somatostatin ndi kapangidwe kake kapangidwe kake (octreotide) - amagwiritsidwa ntchito pochepetsa chidwi cha kupweteka komanso kupondera katulutsidwe mu kapamba, ma pancreatic enzymes (creon mezim, pancreatin) - amagwiritsidwa ntchito kuchepetsa katundu pa kapamba ndikuwongolera njira zonse za chimbudzi, histamine receptor blockers (Famotidine) amapangira Ndimalimbitsa kubisala mu kapamba mwa kuletsa kupanga kwa hydrochloric acid m'mimba ndikuwapatsanso mphamvu, Proton pump inhibitors (esecar) - amagwiritsidwa ntchito pobisalira katulutsidwe ka hydrochloric acid ndi kupondera katulutsidwe mu kapamba, ma Diuretics (diacarb, furosemide, triampuride are prampuride are triampuride are triampuride are triampuride are. kuthetsa kufinya kwa tiziwalo ta pancreatic, Antispasmodics (no-spa, papaverine, platifillin, aminophylline) - adayikidwa limodzi ndi noncotic analgesics komanso kuthetsa kukokana, Antigis njira amine (Pipolphenum, Peritol, Suprastinum, ndi diphenhydramine, etc.) - ntchito kuchepetsa kutupa kapamba minofu.

Kuchotsa kupweteka ndi kapamba kumathandizidwanso ndikuwunika kwa zakudya zomwe zimayikidwa kwa wodwala, kutengera gawo la matendawo. Pakukulitsa matendawa, pakulimbikitsidwa ndi njala ya masiku atatu, yomwe imaphatikizidwa ndi tiyi wotsekemera ndi uchi kapena madzi amchere. Kupitilira apo, malinga ndi momwe wodwalayo alili, chakudya chake chimakula.

Kupweteka kwa Yoga ndi mankhwala ena achikhalidwe kungathandize kuchepetsa ululu wa kapamba. Kugwiritsa ntchito njirazi kuthetsa ululu kuyenera kuchitika mosamala komanso pokhapokha mutakambirana ndi dokotala. Ndi zoletsedwa kugwiritsa ntchito mitundu ingapo kuti muchepetse ululu, chifukwa Kukhalapo kwa mowa kumatha kukulitsa kutukusira kwa kapamba.

Matenda obwereza obwereza

Kutupa kwa minofu ya pancreatic kumachitika pang'onopang'ono, pamene maselo a ziwalo amawonongeka. Mu chifuwa chachikulu cha pancreatitis, njira zimachitika mwadzidzidzi. Ma enzyme opangira ma cell amawongolera nduluyo. Ikutsatira necrosis ya minofu, puroses fusion wake.

Zomwe zimayambitsa kapamba zimatha kugawidwa m'magulu atatu:

Choyambirira, zatsopano zam'mimbamo zomwe zimalumikizidwa ndi ma ducts ochepa ndipo zimapangitsa kuti madzi asungidwe,
Kachiwiri, adatenga matenda a ziwalo zogwira ntchito kapena zimagwirizanitsidwa ndi kapamba (zilonda zam'mimba ndi zilonda zam'mimba, cholecystitis, cholelithiasis),
Chachitatu, zakudya zopanda pake.