Matenda a Pancreatitis

Matenda a pancreatitis ndimatenda a pancreatic omwe amakhala ndi matenda opatsirana pang'onopang'ono omwe amakhala ndi insocrine ndi endocrine.

Matenda a kapamba amachititsa 5.1-9.0% ya matenda am'mimba. Kulemala kumakhala m'malo achitatu pakati pa odwala gastroenterological, ndikulimbikira mwachilengedwe, ndipo odwala ambiri amazindikiridwa ngati invalids a gulu lachiwiri pakuwunika koyambirira.

Njira zoyeserera zoperewera. Mawonekedwe a kapamba. Mwa gulu la odwala kapamba, omwe ali ponseponse mu Russian Federation ndi gulu la A. A. Shelagurov (1970), malinga ndi momwe amasiyanitsira:

- Matenda apakhungu omwe amapezeka pafupipafupi,
- chifuwa chachikulu chokhala ndi ululu wammbuyo,
- mawonekedwe a pseudotumor,
- mawonekedwe obisika (osapweteka).

Mu ulemu kwa pathogenetic, kupweteka kwamatenda a pancreatitis sikuti ndi matenda odziyimira okha, koma gawo lokhalo, kupitiliza ndi zotsatira za kapamba owopsa. Kukula kwa pancreatitis yobwerezabwereza sikumadziwika chifukwa cha kusintha kwakukulu kwa matomiki komanso zovuta zamagulu. M'malo mwake, pakubwezeretsanso kosapindulitsa kwa maphunzirowa (kawirikawiri kamakhala kachidakwa), kukulitsa kusintha kwakumatha komanso kuopsa kosakwanira kwa zochitika zowoneka bwino komanso zosabereka ndi zachilengedwe. Pochita opareshoni, odwala omwe ali ndi pachimake kapena kuwonjezereka kwa chifuwa chachikulu cha chiberekero nthawi zambiri amawonedwa, chifukwa chachikulu chomwe chimakhala matenda a hepatobiliary zone kapena ziwalo zina zam'mimba thirakiti. Pali magawo atatu a kukula kwa kapamba.

Gawo I - pafupipafupi 1-2 pachaka. kutulutsa kosatha mpaka masabata awiri, ntchito ya gland siyowonongeka. Ultrasound yachibadwa.

Gawo II - pafupipafupi mpaka 5 pachaka, kutalika kwa nthawi mpaka miyezi 1.5, ntchito yowonjezera imalephera (kutsika kobisalira kwa bicarbonates, lipase, amylase ndi trypsin). Nthawi zina matenda abwinobwino a shuga. Ultrasound - chizindikiro cha cholecystitis. Kutaya chakudya pang'ono.

Gawo lachitatu - kuchuluka kwa nthawi zopitilira 5 pachaka, kutalika mpaka miyezi itatu, kuphwanya kokwanira kwa ntchito yopatsirana, nthawi zambiri matenda ashuga. Kutaya kwambiri kwam'mimba, kuchepa thupi pang'onopang'ono. Ultrasound - mavuto a kapamba (miyala ikuluikulu ya kapamba, cysts, magazi, mitsempha thrombosis).

Kukula kwa matenda a kapamba akulu kumadalira:
- etiological factor (pulayimale, sekondale),
- magawo
- zovuta
- kuchuluka kwa kuphwanya kwa exocrine ndi endocrine ntchito.

Chithandizo cha matenda kapamba.
Mu milandu ya cholangiogenic pancreatitis, ntchito pa biliary thirakiti amachitidwa - cholecystectomy, kutsekeka kwa pancreatic duct - papillosphincterotomy, pancreatoenterostomy, mitundu yosiyanasiyana ya biliodigestive anastomoses imayikidwa. Ndi kusintha kosasinthika (fibrosis, sclerosis), mchira ndi thupi lam'mimba zimapangidwanso, resetotal resection, nthawi zina pancreatoduodenectomy. M'zaka zaposachedwa, zipatala zapadera zayamba kudzaza kapena cryodestruction of the pancreatic duct, yomwe imabweretsa kupweteka.

Mikhalidwe ndi mawu othandiza a VUT. Njira za CUT:
- Kuchulukitsa kwa njirayi (mawonekedwe abwereranso),
- ululu waukulu ululu (mawonekedwe a ululu),
- chosakwanira komanso chosakwanira (zovuta zogaya ntchito),
- kukula kwa zovuta.

Maganizo a VUT:
ndiwofatsa mankhwala, kutengera siteji, kuyambira milungu iwiri mpaka miyezi itatu, ndikuchita opaleshoni ya VUT, zimatengera njira ndi kuchuluka kwa opereshoni, kugwira ntchito kwake, kuchuluka kwa kutheka kwa ndulu ndi chimbudzi.

Pambuyo opaleshoni mankhwala (kuchotsedwa kwa kutsekeka kwa biliary thirakiti, makulidwe a kutuluka kwa pancreatic, kuchotsedwa kwa pseudocysts) popanda mkhutu pancreatic ntchito kapena kufatsa VUT - mpaka miyezi 10. Nthawi zina zonse (kuchitira opareshoni yothandiza, koma kuphwanya kapena kutchulidwa kwa kapamba kapena chimbudzi, chithandizo chamankhwala chosagwira ntchito) VUT - mpaka miyezi 4, ndikutsatiridwa ndikupereka ITU.

Mitundu ndi zikhalidwe zomwe zimatsimikiziridwa zikufotokozedwa mu gawo "Acute pancreatitis".

Zisonyezo zolozera ku ITU.
Odwala omwe ali ndi pancreatitis aakulu amatchulidwa ku ITU:
- m'magawo II ndi III a matendawa,
- ndikutuluka magazi pafupipafupi,
- wokhala ndi mitsempha yayikulu ndikuwonongeka kwa ziwalo zamkati ndi mphamvu yodabwitsa yamphamvu yam'munsi,
- pambuyo opaleshoni chithandizo chokwanira kwambiri kugaya chakudya,
- pambuyo opaleshoni chithandizo ndi kukhalapo kwa fistulas akunja kosavomerezeka.

Miyezo yofufuza yotumizira ku ITU:
- pafupipafupi amasanthula
- kutsimikiza kwa ntchito ya michere m'magazi,
- kutsimikiza ntchito amylase mu mkodzo,
- kutsimikiza kwa ntchito ya enzyme zomwe zili mu duodenum (pamimba yopanda kanthu komanso katundu),
- pulogalamu,
- Staub - Sampweya wa Traugott wokhala ndi shuga wambiri,
- fluoroscopy yam'mimba ndi duodenum (zokhudzana ndi hypotension),
- Ultrasound ya chiwindi, zowonjezera biliary thirakiti, ndulu ya ndulu, kapamba,
- yowerengeka ya m'matumbo a gland (ndi miyala yamkokedwe wamkulu wa kapamba).

Njira zamagulu opuwala.
Kuchepetsa malire amoyo kumatsimikiziridwa ndi odwala omwe ali ndi matenda a II II, odwala pambuyo pa chithandizo cha opaleshoni popanda zovuta, popanda kuwonongeka kapena kuwonongeka kwapang'onopang'ono kwa ntchito za pancreatic m'magwiridwe ophatikizika, komanso kuthekera kwantchito yopanda nzeru popanda kuchepetsa ziyeneretso kapena kuchepetsa kuchuluka kwa ntchito yopanga (gulu la III ovomerezeka).

Kuchepetsa kwaumoyo wamoyo kumatsimikiziridwa ndi odwala omwe ali ndi nthenda ya III, omwe amatuluka magazi pafupipafupi komanso osasamala kwambiri, odwala omwe amachitidwa opaleshoni yokhala ndi ndulu yakunja ndi fanculas, odwala omwe ali ndi pseudocysts yayikulu (gulu lolumikizidwa II).

Kodi ndizotheka kugwira ntchito

Chithandizo cha odwala odwala matenda a pancreatitis pachimake chimachitika mu chipatala, nthawi yonse yomwe adokotala amakupatsirani satifiketi yoyambira kulumala. Nthawi imeneyi zimatengera kuumirira kwa matendawa, kupezeka kwa ntchito, kuchuluka kwa minofu yomwe yakhudzidwa, kupezeka kwa njira zothandizirana ndi kugwiritsa ntchito njira zochizira.

Pambuyo pakuchotsa, wodwalayo amapitiliza chithandizo kuchipatala, yemwe dokotala amamuthandiza kuti atuluke mpaka chiwonetserocho chithe ndikuchotsedwa kwokhazikika.

Pamaso pa gawo loyambirira lazovuta, munthu amakhalabe wogwira ntchito ndipo amatha kubwerera kuntchito yake ngati sikufunika:

• kulimbitsa thupi kwambiri,
• kukhalabe kwathanzi kwakanthawi osakhala womangika,
• kupsinjika kwamphamvu kwamalingaliro
• onyamula zinthu zolemera
• kulumikizana ndi zinthu zovulaza kapena zapoizoni.

Muzochitika izi zikamachepetsa kwambiri akatswiri ogwira ntchito, gulu III limasankhidwa.

Ndi kafukufuku uti amene akufunika kuchitika?

Ultrasound ndi njira imodzi yodziwira kulemala kwa matenda omwe amapatsidwa.

Asanatumize munthu kuti akamuyezetse, madokotala amachita maphunziro angapo, omwe amaphatikizapo:

• Ultrasound wa kapamba, ndulu ya ndulu ndi njira zake, chiwindi.
• CT scan ngati miyala ikupezeka mu pancreatic duct
• kuwerenga kwa enzyme pamimba yopanda kanthu ndikatha kudya,
• kusanthula magazi, mkodzo,
• pikachiyama.

Bwererani ku tebulo la zomwe zili

Zizindikiro za ITU ndi njira zofufuzira

Matenda apathengo ndi matenda oopsa omwe amatsogolera kusokoneza kwam'mimba komanso m'mimba. Kuwonongeka kwa kapamba kumatha kudzetsa kusokonezeka kwa endocrine mu mawonekedwe a matenda a shuga ndi zina.

Amadziwika ndi njira yofatsa yamatenda yomwe odwala amatha kugwira ntchito. Koma gulu la odwala limaphatikizidwa ndi kuchuluka kwa thupi, kulumikizana ndi mankhwala opanga mafakitale. Poterepa, kusintha komwe kukuyenera kuchita pamafunika.

Mu chifuwa chachikulu, kuperekera ku chipatala ndi kuwunika mayeso kuyenera kuperekedwa ngati wodwala ali ndi magawo 2 ndi 3 a pathological process. Mwanjira ina, kufalikira kumachitika ka 5 kapena kupitilira kasanu m'miyezi 12.

Chithunzicho chiwonjezeredwa ndi kuphwanya kwapakati kapena kuphwanya kwakukulu kwa kupanga michere ya m'mimba, kuchuluka kwa shuga m'magazi, kutupa kwa ndulu (cholecystitis) ndi zina zoyipa za matendawa.

Kodi kulemala kwamatumbo a pancreatitis kumapereka? Yankho ndi lakuti inde. Lamulo limapereka kulumala pazotsatirazi:

• Mbiri yokhudza kutuluka magazi pafupipafupi.
• Pambuyo pa opaleshoni, poyambira maziko a kukamwa kwakanthawi kapena koopsa.
• Mitsempha thrombosis ya m'munsi malekezero.
• Kusokonezeka kwa ziwalo za m'chifuwa.

Ngati pali zovuta zomwe zikufotokozedwazo, dokotala yemwe akupezekapo amapereka chitsogozo chachipatala ndi mayeso a anthu. Zimaphatikizapo kafukufuku wanthawi zonse. Mndandanda:

1. Njira zowunikira. Ntchito ya kugaya chakudya michere mthupi imaphunziridwa, ndende ya amylase mu mkodzo imatsimikiza.
2. Ntchito ya enzyme pamimba yopanda kanthu komanso yokhala ndi katundu mu duodenum imaphunziridwa, pulogalamu yochitidwa imachitika.
3. X-ray ya duodenum, m'mimba.
4. Sampuli ya Staub-Traugott yokhala ndi shuga iwiri.
5. Ultrasound wa kapamba, chiwindi, ndulu ya ndulu, ma ducts a bile.
6. Tomography yowerengeka imatha kuzindikira kukhalapo kwa miyala mu kapamba wa pancreatic - kuwerengedwa kwa kapamba.

Kufufuza zamankhwala ndi chikhalidwe cha anthu ogwira ntchito omwe adachitidwa opaleshoni ndizovuta kwambiri. Popeza ndikofunikira kuganizira zotsatira zomwe zakwaniritsidwa - ngati kunali kotheka kuchepetsa ululu wam'mimba, kukonza kutuluka kwa pancreatic juwisi, kubwezeretsa ntchito za pancreatic, kutseka fistulas, kuthetsa pseudocysts, etc.

Ndikofunika kulingalira za kukhalapo / kusakhalapo kwa zovuta zoyambirira ndi zoyambirira zamankhwala opaleshoni, popeza ndizo maziko a chithandizo chamankhwala kapena chithandizo chamankhwala.

Kulephera Pancreatic

Kulemala kapena kulemala kosatha mu kapamba nthawi zambiri kumakhazikitsidwa. Izi matenda ali pa 3 malo pakati pa matenda onse am'mimba, omwe amapereka chilema. Ambiri mwa odwala chifukwa cha kuyesedwa koyambirira (ITU) amadziwika nthawi yomweyo ngati maalidi a gulu lachiwiri.

Kodi kulemala kwamatenda apakhungu kumapereka?

Ndi kuphunzira kwa nthawi yayitali pancreatitis wodwala (wamkulu kapena mwana), kulephera kwa chithandizo, kutulutsa pafupipafupi, kapamba limasinthidwa kwambiri - kapangidwe ka ziwalo kamasintha, ntchito zake zimaphwanyidwa mosiyanasiyana.

Kuthekera kwakukhazikitsa kulumala kumawoneka ndi chitukuko cha matenda osokoneza bongo komanso zizindikiro za kuchepa kwa inshuwaransi.

Kulemala ndi pancreatic necrosis

Pancreatic necrosis ndikuwonongeka kwa minyewa ya minyewa chifukwa cha kupweteka pachimake ndi zomwe zimayambitsa ma enzymes ake a pancreatic.Kukula kwa matendawa kumadzetsa chiopsezo pamoyo wa wodwalayo ndipo kumafunikira kuonana ndi dokotala wa opereshoni ndi wothandizira (pancreatic resection). Pambuyo pa ntchito yovutayi, wodwalayo amakakamizidwa kumwa mankhwala osiyanasiyana amoyo monga mankhwala obwezeretsa (jakisoni wa insulin, ndikukonzekera enzyme).

Odwala oterowo amakhala okakamizidwa ku ITU, kudziwa kuchuluka kwa kulumala ndikugawa gulu lolemala loyenerera.

Zoyimira Gulu

Gululi la odwala omwe ali ndi pancreatitis limakhazikitsidwa malinga ndi njira zomwe zakhazikitsidwa pamalamulo apamwamba aku boma (mu Order 664 / n ya Ministry of Labor and Social Protection of the Russian Federation, yomwe idakhazikitsidwa mu 2014).

Chitsimikizo chokhazikitsa wodwala wa gulu loyambalo ndikuchepa kwa mphamvu yake yovomerezeka, kusokonezeka kwa ntchito zofunika za wodwalayo chifukwa cha kusokoneza kwazomwe zimapangitsa kuti pakhale vuto la chinsinsi.

Potere, wodwalayo amawona zovuta monga izi: zosasinthika, monga:

• kuperewera kwambiri kwa mphamvu zama protein (BEN),
• kukanika kwa yachilendo ndondomeko kukondoweza chakudya.

Chitsimikizo chokhazikitsa wodwala wa gulu loyambalo ndikuchepa kwa mphamvu zake zalamulo.

Kulephera kokhazikika kwa ntchito ndi pancreatitis kumawonetsa wodwalayo kudwala kwambiri, atalephera kuchita zinthu zosavuta ndi ntchito zosamalira yekha, kuphatikizapo kupita kuchimbudzi, kuyenda momasuka komanso njira yodyera chakudya.

Gulu lachiwiri lomwe lili ndi kapamba chifukwa cha kuphwanya kutchulidwa kwa zomwe wodwalayo angagwirire ntchito chifukwa cha kuchepa kwa mphamvu ya protein.

Vutoli limawonedwa mwa odwala omwe kapamba awo amawotcha kwambiri. Pankhaniyi, milandu yowonjezereka ya matendawa imachitika kangapo ka 5-7 m'miyezi 12 ndipo imadziwika ndi matenda a kupweteka kwa nthawi yayitali, omwe sangathetsere pakokha popanda chithandizo chamankhwala chodzidzimutsa, chifukwa nthawi zambiri izi zimapangitsa kuti magazi abwere mkati ndipo mankhwala alibe njira yofunira achire.

Kulephera kwa wodwalayo pazinthu zotere kumasiyana kuyambira mwezi umodzi mpaka 1.5.

Kulephera kwa wodwalayo pazinthu zotere kumasiyana kuyambira mwezi umodzi mpaka 1.5.

Gulu lachiwiri lopuwala mu kapamba limakhazikitsidwa ngati wodwalayo ali ndi fistulas yakunja, yomwe sachiritsa, komanso mabala ofanana omwe adawonekera atachitidwa opaleshoni, ndipo pali ma cancotey pancreatic abodza.

Gulu lachitatu limakhazikitsidwa molingana ndi zotsatira za mayeso ngati wodwalayo ali ndi vuto logaya chakudya, kuphatikiza zovuta ndi magwiridwe antchito a kapamba, omwe samakhala ndi mphamvu pakugwira kwake ntchito.

Pazotsatira zamankhwala za wodwala ndi gulu lachitatu pali njira zopangira opaleshoni zomwe sizimakhudzana ndi zovuta zilizonse, komanso kukhalapo kwa opuwala olimbitsa thupi la odwala omwe ali ndi mawonetseredwe a chipatala, ofotokozedwa modekha kapena mofatsa.

M'mbiri yachipatala ya wodwala wokhala ndi gulu lachitatu pali njira zochitira opaleshoni zomwe sizimakhudza zovuta zilizonse.

Zimayambitsa Matenda a Pancreatitis

Zoyimira zazikulu za chifuwa chachikulu cha kapamba ndi izi:

• kumwa mowa mwauchidakwa, komwe kumayambitsa chiwindi pakhungu lanu ndipo kumathandizanso kusintha kwa minofu ya fibrosis (kuchuluka kwa minofu yolumikizana),
• kusowa kwa mapuloteni muzakudya,
• zolakwika zopatsa thanzi anthu akamadya zakudya zamafuta ambiri, zakudya yokazinga, makamaka kuphatikiza ndi mowa,
• kuchuluka kwa nkhawa m'miyendo ya kapamba, kamene kamayambira kumbuyo kwa cholepheretsa mwala, stenosis ya mphuno ya Vater mu duodenum, komanso edema yake,
• matenda a kapamba,
• matenda am'mimba am'mimba, ndi zina zambiri.

Chifukwa chake, mndandanda wa zomwe zimapangitsa kutupa m'matumba a pancreatic ndizosiyanasiyana. Kudziwa zinthu izi kumathandizira kupewa kapamba.

Limagwirira a chitukuko cha matenda

Kusintha kwa chotupa pang'onopang'ono kumayambitsa kuphwanya kwachilendo kwa glandular epithelium ya kapamba.

Amasinthidwa pang'onopang'ono ndi maziko osakanikirana a minyewa, osagwira ntchito za kapamba, ndiko kuti, palibe chobisalira cha michere yam'mimba.
Kukula kochulukirapo kwa minofu yolumikizana kumabweretsa kukulira kwa kachulukidwe kakumaso ndi makwinya ake. Vutoli limagwiritsidwa ntchito pofufuza matenda.

Mawonetseredwe azachipatala

Zizindikiro za chifuwa chachikulu chimakhala chosiyanasiyana. Iwo, monga lamulo, samawoneka bwino kwambiri munthawi yachikhululukiro, chomwe chimapangitsa kuti matenda azitsimikizira.
Zizindikiro zimafika povuta kwambiri pakukula kwambiri kwa matendawa.

Chifukwa chake, zilembo zazikulu zamatenda a pancreatitis ndi awa:

• Chizindikiro chachikulu ndi kupweteka, komwe kumachitika pakatikati pamimba,
• chikhalidwe cha ululu chimatha kukhala osiyanasiyana,
• kupweteka kwamatumbo a pancreatitis kumawonekera mpaka pachifuwa kapena kutsikira kumbuyo, komwe kumayambitsa zolakwitsa zodziwitsa,
• kupweteka kumachitika masana, kumakulira kwambiri madzulo, komanso mukatha kudya (makamaka mafuta komanso okazinga),
• odwala amachepetsa thupi kwambiri, chifukwa amayesa kudya zochepa chifukwa chakuti ululu umakulirakudya mukatha kudya,
• Chifukwa chophwanya ntchito ya kapamba, kuyimbira m'mimba, kuphwanya chimbudzi, kupindika, kunyansidwa komanso kusanza
• Zizindikiro zingapo za kuchepa kwa mavitamini- ndi mavitamini pang'onopang'ono zimayamba kuonekera chifukwa cha kulowetsedwa kwa m'mimba,
• kuwonjezeka pang'ono kwa kutentha kwa thupi kumaonekera pamene dongosolo lothandiza limayambitsa matenda.
• kupindika kwa khungu ndi sclera.

Kutengera ndi mtundu wa chithunzi cha chipatala ndi kutha kwa chizindikiro china chake, mitundu ingapo ya matenda apathengo amalekeka. Izi ndi izi:

• aakulu kupezekanso kapamba,
• kapamba wokhala ndi ululu wosalekeza,
• mawonekedwe apangidwe
• mawonekedwe a pseudotumorous (amakumbukira mawonetseredwe a chotupa chotupa cha kapamba).

Nkhani yothandiza? Gawani ulalo

Zizindikiro zosiyanasiyana zamatenda a pancreatitis aakulu mwa achikulire zimapangitsa kuti zikhale zovuta kudziwa matenda amtunduwu, zomwe zimapangitsa kuti azindikire zolakwika. Tiyeneranso kutsimikiza kuti kusowa kwa chithandizo chokwanira komanso chokwanira panthawi yake kumatha kubweretsa chitukuko cha matenda a shuga chifukwa chothandizidwa ndi ma islets a Langerhans omwe amapanga insulin mu pathological process.

Kusaka koyesera

Kuzindikira kwa pancreatitis yokhazikika sikuti kumangoyang'ana mokwanira za zizindikiro zamankhwala, komanso njira zowonjezerapo kafukufuku.
Zomwe zimagwiritsidwa ntchito kwambiri ndi:

Kuchiza matenda

Kodi kuchitira matenda a kapamba? Pulogalamu yamachiritso imatengera zinthu zingapo, monga:

1. nthawi yowonjezereka kapena kuchotsedwa,
2. chachikulu matenda chizindikiro
3. pancreatic secretion state
4. mkhalidwe wa pancreatic mkati secretion (ntchito ya endocrine).

Ambiri ali ndi chidwi ndi funso loti chikhansa cham'mimba chitha kuchiritsidwa. Sizotheka kupondereza kwathunthu kutupa ndi njira zotsatira za dystrophic pamlingo uwu wa chitukuko cha mankhwala.Komabe, kulandira chithandizo munthawi yake komanso kudya zakudya zabwino zitha kuchepetsa kuchepa kwa njira ya pathological, yomwe sikupangitsa kuti wodwalayo athe kuchepa.
Chifukwa chake, pulogalamu yamankhwala ochizira matenda a kapamba panthawi yowonjezera ndi motere:

• m'masiku oyambilira, kuzizira kumayikidwa pamimba kumtunda, njala ndi kugwira ntchito kwa kapamba,
• ndiye kukonzekera kwa pharmacological kumachitika - mankhwala a antisecretory amalembedwa (amachepetsa kupanga madzi am'mimba, omwe ndi othandizira amphamvu a secretion ya chapamimba), antispasmodic ndi analgesic mankhwala. Kuti muchepetse ntchito zapancreatic, tikulimbikitsidwa kugwiritsa ntchito kukonzekera kwa enzyme ndi cholinga china.

Zakudya ngati mfundo yofunika kwambiri ya chithandizo

Zakudya zopatsa thanzi chifukwa cha matenda a kapamba ndi imodzi mwazinthu zazikulu, makamaka munthawi yachikhululukiro. Zimakuthandizani kuti muchepetse katundu pa zikondwererozo ndikuwongolera njira yobwerezeranso momwemo. Zotsatira zake, izi zimachepetsa kwambiri kufalikira kwa matenda ena.
Zakudya za chifuwa chachikulu cha khansa zimakhazikika pa mfundo zotsatirazi:

1. kuchuluka kwa mapuloteni akuyenera kuwonjezereka, chifukwa amamwa ngati chinthu chomanga panthawi yokonza (kubwezeretsa kapamba),
2. payenera kukhala zakudya 4-5
3. Pewani kudya kwambiri
4. chakudya chimayenera kuphikidwa makamaka (nkofunika kukana nyama yokazinga ndi yosuta),
5. kuchuluka kwa mafuta ndi michere yamagetsi kumachepetsa kwambiri mu zakudya
6. Ma broth opanga kwambiri samasiyanitsidwa.

Mofananamo, wodwalayo ayenera kusiya kumwa mowa, zomwe zimabweretsa kuwonongeka kwa kapamba.
Ndikofunika kutsatira mfundo za kadyedwe kake kuti muchepetse kufalikira kwina kwa matendawa ndikuwongolera magwiridwe antchito a kapamba!
Kuti akhalebe ndi chikhululukiro kwanthawi yayitali, wodwalayo ayenera kusintha kwambiri moyo wake pakusiya mowa ndikuwonjezera zakudya m'thupi. Izi zibwezeretsa kapamba wowonongeka ndikuwongolera magwiridwe ake.

Ngati kapamba amavutika chifukwa cha kuledzera kwaukapena, matenda oterewa omwe ali ndi vuto lotupa amatchedwa chidakwa cha kapamba. Chithandizo chowongolera chiyenera kukhala chapanthawi yake, apo ayi wodwalayo amatha kufa. Chifukwa chakumwa mowa kwambiri, chizolowezi chopanga chizolowezi chomanga thupi mwa kusokonekera chimasokonekera, kapamba amadzaza. Matenda oledzera a pancreatitis samachiritsidwa, motero ndikofunika kuzindikira matendawa pachimake.

Kodi mowa kapamba ndi chiani?

Ngati, atakhala kwa nthawi yayitali ku ethanol, kutupa kwa kapamba kumachitika, pakati pazovuta, madokotala samachotsa chiwindi cha chidakwa cha chiwindi ndi kufa kwa wodwala wodwala. Matenda omwe ali ndi khalidwe limayendera limodzi ndi mbiri yayitali, ndipo zizindikiro zosasangalatsa zimawonjezeka pang'onopang'ono, zimakhala kwambiri, ndikuchepetsa moyo. Pancreatitis yamtunduwu imakonda kuchitika motsutsana ndi maziko a zakumwa zoledzeretsa kapena kuponderezana mwamafuta kwa zakudya zamafuta.

Kuchulukitsa kwa matenda kapamba kumayamba ndi kuwawa kwakapweteka kwa m'mimba. Ululu wamankhwala ulili mu chiberekero cha herpes zoster, paroxysmal contractions, pomwe pakalibe chithandizo chamankhwala chimangokulira. Pali kuchepa komwe kumapangika kwa michere ya pancreatic mwa matenda am'mimba, omwe amayimiriridwa ndi matenda am'mimba, zizindikiro za dyspepsia, zizindikiro za nseru, ndi kusanza. Zizindikiro zina zamatendawa zimaperekedwa pansipa:

• ndowe
• Chakudya chosazaza ndowe,
• kuthawa popanda mpumulo womwe ukuyembekezeredwa kwa nthawi yayitali,
• kuchuluka kwa maulendo akuchimbudzi - mpaka katatu pa tsiku,
• kuwonda kwambiri
• kusowa kudya kwathunthu,
• kutsitsa magazi
• kutentha kwambiri kwa thupi
• kusakhazikika kwa dongosolo lamanjenje,
• kufooka kwa minofu.

Kuonetsetsa kubwezeretsanso kwa kapamba pambuyo pa mowa, gawo loyamba ndikuwona kuti etiology yamatenda, kuthetseratu mbali ya pathogenic m'thupi. Pafupipafupi kuukira kwathunthu kumatengera mlingo wa mowa ndi nthawi kumwa mowa. Mowa umaphatikizira, monga zoledzeretsa zamphamvu, ndizomwe zimayambitsa khansa yoledzera.

Odwala achikulire omwe amakonda kumwa mowa mwauchidakwa, amanenepa kwambiri, amasuta fodya, ndipo amakhala ndi moyo wopanda ntchito. Pafupifupi, chithunzi chamankhwala chapadera chimatengera mtundu wa zakumwa zoledzeretsa, mwachitsanzo, "vodka yophika" imangochulukitsa zovuta zowonongeka kwa chiwindi, ndipo necrosis imayamba.

Njira ya matendawa

Mothandizidwa ndi zinthu zovulaza, minofu yathanzi itawonongeka, michere ya gland imayatsidwa ndipo maselo awo amawonongeka. Zotsatira za njira imeneyi, zikondamoyo zimatupa ndikukula, zimakulitsa ziwalo zina zoyandikana. Popita nthawi, ndulu yoyaka imatambasulidwa, wodwalayo amakumana ndi zovuta zopweteka. Pakadali pano, chidwi chachikulu cha necrosis chikufalikira mthupi, zomwe zimasokoneza magwiridwe antchito ofunikira.

Gulu la Alcoholic Pancreatitis

Njira yodziwika bwino imadziwika ndi mtundu wovuta kwambiri komanso wosakhazikika, pomwe wina umayamba kukhala wina, pomwe wina sukhalanso kuchira komaliza. Kufotokozera kwachidule kwa njira ya pathological yomwe yaperekedwa pansipa:

1. Mu pancreatitis pachimake, zinthu zingapo za pathogenic zimachitika mwachangu, mwachitsanzo, pamene wodwala adya zakudya zamafuta, amamwa mowa tsiku lililonse, komanso akusuta fodya nthawi zonse. Mowa pancreatitis nthawi zambiri amadziwika ndi anyamata, ndizovuta kusunga mawonekedwe.
2. Njira yovuta ya kapamba imatha kuyambika, imayamba ngati matenda odziyimira pawokha. Zizindikiro zoyambirira zimachitika patapita zaka zingapo zakumwa zakumwa zoledzeretsa, matendawo amatengedwa ndi kutupa komanso lamba lachigonjetso la mitundu ingapo. Kugwiritsa ntchito moyenera kumachitidwa ndikuwonjezera mphamvu yotupa.

Zovuta zotheka

Pancreatitis ku mowa kumathandizira kuwonongeka kwa chiwindi ndi kugaya chakudya enzyme. Kuledzera kwapang'onopang'ono kumatha kubweretsa kulumala ndi kufa kumene, kumapangitsa wodwala kuzunzidwa mwamphamvu. Poyerekeza ndi kuyanika kwa nthawi yayitali kwa ethanol, hepatitis ya viral, cirrhosis ya chiwindi, chofunikira kwambiri cha pancreatic necrosis, fistula ndi cyst sizikhala padera. Matenda a shuga ndi adenocarcinoma amakula.

Matenda a chidakwa kapamba

Ndikosavuta kudziwa kapamba a mawonekedwe amowa mthupi, popeza zizindikiro ndi zofanana ndi matenda ena am'mimba. Chifukwa chake, kuwonjezera pakuphatikiza deta ya mbiri yachipatala, ndizofunikira kugwiritsa ntchito matenda osiyanasiyana, omwe amaphatikizapo maphunziro a labotale ndi a kachipatala:

• kuyesa kwamagazi ndi kwamilandu yambiri,
• kuyesa kwamkodzo kuwunika ma diastase,
• Ultrasound ya ziwalo zoyipa,
• CT ndi MRI
• kuzunzika kozindikira pazamankhwala.

Chithandizo cha kutupa kwa kapamba

Ndi kuledzera. Ndikofunikira kuti muchepetse ndikuchotsa kutupa kuchokera ku kapamba wamkwiyo. Popeza pancreatitis yoledzera imadzala ndi matenda ashuga, madokotala akutenga njira zobwezeretsanso nthawi yowonjezera.Nawa malingaliro ofunikira m'chithunzichi:

• pofuna kusamalira ndi kulimbitsa ntchito ya chiwindi, wodwalayo amaletsedwa kudya zakudya zolemetsa muzakudya panthawi yanthawi yamankhwala ndi chikhululukiro - mafuta, nyama zosuta, mankhwala osungirako,
• popeza ntchito za thupi lonse limafooka ndi kapamba, ndikofunikira kuyendera kufunsira kwa akatswiri opapatiza monga gastroenterologist, dokotala wa opaleshoni, endoscopist, endocrinologist, radiologist, psychotherapist, ndi narcologist.
• Popeza zakumwa zoledzeretsa zimachulukitsa kuchuluka kwa shuga m'magazi, wodwalayo amafunika kuwunika mwatsatanetsatane chizindikiro ichi, kudya mkamwa mwa mavitamini osungunuka a mafuta, kufufuza zinthu.
• pakuyambiranso, ndikofunikira kutenga malo opingasa, mutenge mapiritsi angapo a No-shpa mkati ndikuyika ozizira pamimba. Ndikulimbikitsidwa kudzipha kwakanthawi, osachulukitsa ziphuphu zoyipitsidwa.
• opaleshoniyo akuwonetsedwa pazithunzi zovuta za chipatala mwa kutsegula ndi kungotulutsa ma cyst, potero kuthetsa kuopsa kwa zovuta zoopsa.

Mankhwala othandizira

Ndi mowa pancreatitis, kukonza zakudya tsiku lililonse kumafunika. Confectionery, maswiti, shuga, mkaka, mchere, zakudya zonunkhira ndizoletsedwa kwa wodwala. Zakudya izi zimathandizira pakupanga madzi a pancreatic, kuchuluka kwa obwerera. Zakudya zina ndizoletsedwa, kuphatikizapo:

• masoseji,
• zoteteza
• oyambira msuzi
• zipatso zowawasa
• zonunkhira ndi mchere
• koloko, mowa, khofi.

Mukamadya chakudya, timalimbikitsidwa kutsimikiza mwapadera pazakudya zotsatirazi zothandiza zidakwa za pancreatitis:

• msuzi wamafuta ochepa
• kudya nyama
• phala lopanda
• nsomba zopanda mafuta,
• maapulo ophika
• tiyi wazitsamba, mankhwala
• masamba ophika.

Matenda obwera ndi matenda

Zotsatira zamankhwala sizabwino, popeza nthawi yodwala imachepetsedwa, ndipo zotsatira zomwalira mwadzidzidzi siziyikidwa pambali. Pancreatitis ndi matenda osachiritsika, ndipo pakapanda chithandizo chamanthawi yake, kuchuluka kwa zovuta zowonjezereka kumangokulira. Kufunika kokakamizidwa kuchipatala mwachangu ndi kutembenuka mtima sikumachotsedwa. Matendawa akuwonetsa pazovuta za matenda azachipatala amachititsa kuti pancreatic necrosis ifenso chifukwa cha kufa kwa thupi.

Kutalika kwa moyo

Odwala omwe ali ndi vuto losakanikirana la pancreatic mwina kwa nthawi yayitali sangazindikire kukhalapo kwa matenda akupha mthupi. Matenda a pathological amapita patsogolo mosadziletsa, pomwe pali kale chifuwa cha kapamba. Pambuyo pa kuukira koyamba, chiyembekezo cha moyo chimachepetsedwa, ndipo ndikuwonjezeka kwa zovuta, wodwalayo sadzakhala ndi moyo zaka 2 - 3. Ngati mukuthandizidwa ndikutsatira gawo la chikhululukiro, mutha kukhala ndi moyo zaka 10, koma mutakana kwathunthu zoyipa.

Kupewa

Njira yayikulu yodzitetezera ndiko kukana zakumwa zoledzeretsa zilizonse. Wodwala amayenera kutsatira "lamulo louma" mpaka kumapeto kwa moyo wake, kuti achepetse zakudya zomwe ziphe ndi poizoni (mwachitsanzo, ndudu). Kugwiritsa prophylaxis wa kapamba amowa mu mawonekedwe aukazitape amakhala ndi zakudya zoyenera, zakudya zamankhwala. Kutsindika makamaka ndikofunikira pazinthu zotsatirazi:

• kuchulukitsa zakudya za tsiku ndi tsiku ndi mapuloteni okwanira,
• amayesedwa chaka chilichonse ndi gastroenterologist.

Pancreatitis ya kapamba ndimatenda oopsa omwe matendawa amawonongeka, ndipo mtsogolomo izi zimabweretsa kusintha kwa metabolic. Lero tilingalira zomwe zimayambitsa matenda, momwe mungathane nawo, njira zogwiritsira ntchito.

Zomwe zimayambitsa matendawa

Kuzindikiritsidwa kwa kapamba kapamba munthawi yathu yathu.Koma kodi chifukwa chiyani anthu akuvutikirabe? Mudzamvetsetsa chilichonse mukazindikira zifukwa zomwe zimakulimbikitsani maonekedwe anu.

1. Kumangika ndi zakumwa zoledzeretsa.
2. Zakudya zoperewera, zomwe ndimakonda kugwiritsa ntchito zakudya zamchere, zonunkhira komanso mafuta.
3. Kulemera kwambiri.
4. Matenda onga, monga: cholecystitis, hepatitis, cholelithiasis, zilonda zam'mimba, gastritis, kutupa.
5. Opaleshoni yam'mimba kapena kuvulaza kwake.
6. Kusuta
7. Zakudya.
8. Khalidweli.
9. Kumwa mankhwala, pambuyo pake matendawa amawoneka (tetracyclines, cytostatics, sulfonamides).

Zizindikiro za pancreatitis pachimake

Ndi matenda amtunduwu, kutulutsa kwaulere kwa pancreatic madzi kumasokonekera, kumatha kugayidwa ndi michere yake. Pa matenda a pancreatic pancreatic pachimake, zotsatirazi ndi zikhalidwe:

1. Zowawa. Imachitika kumanzere kwam'mimba, ndipo patapita kanthawi imafalikira kumimba yonse.
2. Kuchepetsa mseru komanso kusanza.
3. Kuthamanga kwa magazi sikunapangidwe.
4. Kumvetsetsa kwenikweni kumaphwanyidwa.
5. Vuto ladzidzidzi lingachitike.

Zizindikiro zake ndizazikulu kwambiri pochiza matendawa kunyumba. Chifukwa chake, mu pancreatitis yovuta kwambiri, ambulansi imayenera kuyitanidwa mwachangu. Dokotala wodziwa bwino adokotala ayenera kumuyesa wodwalayo, ndipo alephera, amuzindikiritse kuchipatala kuti apitirize chithandizo. Sizokayikitsa kuti opaleshoni ya pancreatic ikhoza kupewedwa m'njira yamatenda.

Matenda a kapamba: zizindikiro ndi chithandizo koyamba

Zizindikiro za matenda amtunduwu sizowopsa ndipo sizikufunika chisamaliro chofunikira. Tsopano tikambirana za pancreatitis yayitali, zizindikiro ndi chithandizo cha matenda amtunduwu.

Poyamba, ndikofunikira kusiyanitsa magawo awiri mu kutupa kosapumira:

1. Woyambira.
2. Nthawi yowonongeka kwanyumba.

Nthawi yoyamba imatha kukhala nthawi yayitali - mpaka zaka 10. Zizindikiro zanyengo iyi:

1. Ululu wammbuyo Zowawa zimatha kutulutsidwa kumtunda ndi pakati pamimba, m'chigawo chakumanzere cha lumbar ngakhale pagawo la mtima. Nthawi zambiri, zosasangalatsa zoterezi zimachitika pakadutsa mphindi 15 mpaka 20 mutatha kudya.
2. Kusanza, kusanza ndikotheka.
3. Kufalikira.
4. Kutsegula m'mimba.

Choyambirira chimawonedwa mwa odwala nthawi zambiri, koma zina sizingachitike. Ngakhale chizindikiro chikawoneka, ndiye kuti mothandizidwa ndi mankhwala mutha kuthetsa vutoli mwachangu.

Nthawi Yawonongeka Pancreatic

Izi ndi izi:

1. Zowawa sizodziwikiratu ngati poyamba.
2. Pankhaniyi, dyspeptic syndrome predominates: kutentha pa chifuwa, kupindika, nseru, kutulutsa.
3. Pali matenda a maldigestion. Apa ndipomwe pali kuphwanya kwa chimbudzi cha chakudya kuzinthu zomwe zimayamwa.
4. Pali matenda a malabsorption. Poterepa, kachipangizo kamene kamayamwa matumbo ang'onoang'ono sikasokonezeka konse.

Pa maldigestion ndi malabsorption, zizindikiro zotsatirazi ndizodziwika:

• fetid, zopondera zambiri,
• kuwonda
• Kuchepa kwamadzulo usiku,
• kutulutsa magazi kumachitika
• conjunctivitis, stomatitis, ndi kuyabwa kwa khungu kumachitika
• kuchepa kwa magazi kumayamba
• chifukwa chakuti pali kuphwanya mayamwidwe kashiamu, pamakhala kukokana ndi mafupa,
• neuropsychic arousal,
• mawonekedwe a thukuta lozizira
• kunjenjemera m'thupi
• khungu lowuma
• pali kumverera kwa ludzu losalekeza.

Ndikofunikira kuchiza pancreatitis yayitali kuti mupewe opaleshoni ya pancreatic. Mankhwalawa ayenera kukhala okwanira komanso ovomerezeka. Pambuyo poti mwadutsa mayeso onse ofunikira, komanso kufunsa dokotala, chithandizo chitha kutumikiridwa. Tsopano tikambirana za matenda omwe wodwala amayenera kupeza kuti chithunzi chake chikhale bwino.

Kuzindikira matenda

Mitundu yotsatirayi yazidziwitso ipereka chithunzi chonse cha matendawa:

1. Kuyesa kwa UltrasoundPancreatic ultrasound ya kapamba ndi njira yofunika kwambiri yowunikira. Matenda amtunduwu akuwonetsa kuchuluka kwa kuchuluka kwake, kukuwonetsa kupendekeka kwa kapangidwe, kupezeka kwa cysts ndi kukula kwa ma ducts. Kulondola kwa phunziroli ndi 80-85%. Izi sizotsatira zapamwamba kwambiri, kotero kuyesa kwa labotale kuyeneranso kutengedwa.
2. Kuyerekezera ndi maginito okonzanso. Mitundu yodziwitsa, monga ija, imawonetsa kuchuluka kwa kapamba amakulitsidwa. Kuphatikiza apo, mothandizidwa ndi kafukufuku wotere, mitundu yoipa, mapangidwe apadera, ndi zotupa za ziwalo zapafupi zitha kupezeka.
3. Endoscopic retrograde cholangiopancreatography. Iyi ndiye njira yolondola kwambiri, yomwe ikuwonetsa pafupifupi 100% zotsatira. Komanso, mtundu wodziwonetsa ndi wotsika mtengo kwambiri pamwambapa. Zowona, pali opanda: njira imeneyi si yosangalatsa kwambiri, ndipo nthawi zina imakhala yopweteka.

Kodi kudwala kwa kapamba kumatenga nthawi yayitali bwanji?

Ndi chitukuko cha pancreatitis pachimake, wodwalayo nthawi zambiri amalowa mu chipatala cha opaleshoni, chachipatala kapena matenda am'mimba, pomwe adokotala amamulembera satifiketi yapamwamba ya odwala (tchuthi chodwala) nyengo yonse yamankhwala othandizira odwala. Atatuluka m'chipatala, chipatala cha pancreatitis chimawonjezeredwa ndi dokotala wa polyclinic, momwe wodwalayo amawonjezeredwa ndikuwathandizidwira pokhapokha atadwala.

Ndi chithandizo chokhazikika, kulumala kwakanthawi kumatenga masiku 14 mpaka miyezi itatu. Wodwala amakhala masiku angati patchuthi chodwala zimatengera kuopsa kwa kapamba.

Ngati opaleshoniyo idachitidwa, ndiye kuti nthawi yayitali ya kuchipatala imatsimikizika poganizira mtundu wa opaleshoni yolowerera, mphamvu ya chithandizo chotere komanso boma la kapamba (kuchepa kwa ntchito ya chiwalo).

Ambiri ali ndi chidwi chofuna ngati wodwala amalemala pambuyo pakuchita opaleshoni. Pano, zomwe zimapezeka pambuyo pa opaleshoni yamankhwala ziyenera kukumbukiridwa. Pankhani yakupeza kwapabwino kwa kubwezeretsa kapamba, pepala lolemala kwakanthawi litha kukulitsidwa mpaka miyezi 10.

Ngati opaleshoniyo sinagwire ntchito kapena ngati ntchito za chiwalo sizimalephera, ndiye kuti tchuthi chodwala chimawonjezeredwa mpaka masiku 120 momwe mungathere. Kenako wodwalayo amatumizidwa kukayezetsa zachipatala ndi mayanjano (ITU) kuti adziwe gulu lakelo, popeza wodwalayo sangathe kugwira bwino ntchito komwe anali kale ndipo sangathe kubwezeretsanso thanzi lake.

Ndi mayeso ati omwe akuyenera kuchitika kuti adziwe matenda?

Kuphatikiza pa njira zomwe zatchulidwazi pakuzindikira matenda, dokotala amapereka malangizo operekera maphunziro awa:

1. Kuyesedwa kwa magazi konse. Zotsatira zake zikuwonetsa zizindikiro za kutupa ndi kuchepa kwa magazi m'thupi.
2. Kupereka magazi kuti mupeze shuga. Kusanthula koteroko ndikofunikira kuti mudziwe ngati wodwala ali ndi shuga.
3. Urinalysis Ikuwonetsa matenda a impso.
4. Electrocardiogram ndi echocardiography zimapatula matenda a mtima.

Pambuyo pakupereka mayeso omwe ali pamwambapa, chithunzicho chidzaonekera bwino, komanso kuwunika kwa kapamba kapangidwe kapangidwe kapena ayi.

Udindo wa akatswiri pochiza matendawa

Matenda a kapamba amafunika chithandizo choyenera. Chifukwa chake, wodwalayo sayenera kukafunsidwa ndi dokotala m'modzi, koma ndi angapo, kuti chithunzi cha momwe akuwonera chikuchitika, ndipo madotolo adamupatsa chithandizo choyenera.

Wodwalayo ayenera kukumana ndi akatswiri ngati awa:

1. Gastroenterologist. Amapereka chithandizo.
2. Kwa dotolo. Kuthandiza kwa katswiriyu ndikofunikira ngati zowawa sizisiya kapena pali zovuta zina.
3. Endocrinologist. Ndikofunikira ngati wodwala ali ndi matenda a shuga.
4. Kwa wa mtima.Kulumikizana ndi katswiriyu ndikofunikira kupatula zotheka za mtima ndi mtima.

Zotsatira za chithandizo zimadalira ziyeneretso za madokotala. Chifukwa chake, muyenera kusankha zabwino kwambiri pazigawo zawo. Mutha kufunsa za zomwe adotolo adakumana nazo, kuchuluka kwa maopa omwe adachita, ngakhale pali ziwerengero. Thanzi lanu lili m'manja mwanu. Ndipo chifukwa cha luso waluso, kuthamanga ndi chithandizo chamankhwala anu ndikuchira mwachangu zimadalira 80%.

Nthawi yayitali

Akatswiri a ITU amaganizira za kapangidwe ka matenda kapamba omwe amapangidwa ndi A.A. Shelagurov, ndi kuganizira magawo chitukuko cha kukula anatomical kusintha chovulazidwa chiwalo ndi kuzama kwa magwiridwe antchito.

Gulu loyamba kapena lachiwiri limakhazikitsidwa kwa odwala omwe ali ndi mawonekedwe amtundu wa nthawi yayitali, omwe ali ndi vuto lalikulu la m'mimba, kagayidwe kazakudya, ndikupanga jaundice, kutsekula m'mimba komanso kulephera kugaya chakudya.

Mu mawonekedwe

Mukakhazikitsa gulu, zotsatira za opaleshoni zimaganiziridwanso. Gulu loyamba limaphatikizapo odwala omwe ali ndi vuto logaya chakudya, kusokoneza kwamatumbo ang'ono, cachexia, komwe nthawi zambiri kumayambitsa kusokonezeka kwa malingaliro.

Gulu loyamba limaphatikizapo odwala cachexia, omwe nthawi zambiri amabweretsa mavuto m'maganizo.

Gulu lachiwirili litha kuthandizidwa ndi mawonekedwe owopsa ngati pakachitika zovuta pambuyo pakuchita opaleshoni: fistulas yosachiritsa, thrombosis, kudzikundikira kwa zotupa m'matumbo a minyewa, kukomoka kwa pelvic.

Ngati opaleshoniyo idapita popanda zovuta, ndikotheka kukhazikitsa gulu lachitatu.

Ndi kuchulukitsa kwa matendawa

Kuchulukitsa kwa matendawa kuli ndi chikhalidwe china (kutalika, kuchuluka, kulimba, ndi zina). Madokotala ayenera kuganizira kuwonetsedwa kwa matendawa chaka chonse. Odwala omwe adathandizidwapo akhoza kutaya mwayi wobwerera ku ntchito zawo zakale (kutengera katundu ndi mtundu wa ntchito). Amakhazikitsa magulu awiri oyamba ndi olemala.

Ndi kapamba ndi gastritis

Nthawi zambiri ndimatenda a kapamba komanso kupukusira m'mimba ntchito (kuphatikizapo kapamba wam'mimba) kungakhale chifukwa cha kulumala kwakanthawi.

Wopezekapo gastroenterologist amatha kuyambitsa njira yosonkhanitsa zolemba kuti zigwiritsidwe ndi ITU. Wodwala amatha kupatsidwa gulu la olumala awiri kapena atatu.

Cholecystopancreatitis

Cholecystitis, yomwe imachitika nthawi yomweyo ndi kapamba, imafunika kuti wodwalayo azitha kupeza njira zina zowunikira pokonzekera zikalata zokhazikitsa gulu lolumala. Zambiri pa kuchuluka, kukula ndi mtundu wa calculi ndi zofunika. Katswiri wodziwikiratu azindikira kuopsa kwa kutupa kwa kapamba komanso kutsimikiza kwa kutupa kwa ndulu.

Kwa ana omwe ali ndi mbiri ya pancreatitis, kulumala kumatha kukhazikitsidwa pokhapokha kutaya mwayi wovomerezeka. Kuchulukitsa kwa ziwalo zogaya chakudya kumatsimikiziridwa ndi katswiri wazachipatala atapereka njira zodziwikiratu zomwe akulu amakumana nazo.

Mfundo za zakudya zoyenera za kapamba. Zakudya

Ndi matendawa, ndikofunikira kutsatira malamulo ena okhudzana ndi zakudya. Popeza kukhala wodwala kumadalira mtundu ndi chakudya chomwe chimatengedwa. Mfundo zotsatirazi zomwe muyenera kudziwa:

1. Muyenera kudya zakudya zosachepera 5-6 patsiku. Muyenera kudya pang'ono, pang'ono.
2. Ndikofunika kudya zakudya zosenda bwino. Chowonadi ndi chakuti, monga kuphatikiza kwa mbale, kupukusira kwa m'mimba sikungakwiyitsidwe.
3. Mapuloteni (magalamu 150 patsiku) ayenera kuchuluka m'zakudya. Kuchuluka kwa mafuta sikuyenera kupitirira 80 magalamu patsiku. Zakudya zomanga thupi zimafunikiranso kusamala.
4. Taboo ndi yotentha kwambiri kapena, m'malo mwake, mbale yozizira.
5. Munthawi yakuchulukirachulukira kwa vutolo, ndikofunika kusiya chilichonse chokwanira chakudya tsiku limodzi.

Tsopano taonani zakudya zomwe zili ndi phindu pa boma pa kapamba.

Mndandanda Wazogulitsa

Mkhalidwe waukulu wamatenda monga pancreatic pancreatitis ndi zakudya. Ili ndiye mfundo yayikulu yothandizira. Kodi tanthauzo la chakudya ndi chiyani? Gwiritsani ntchito zakudya zokha ndi mbale zomwe sizimakwiyitsa mucous membrane wa kapamba. Zotsatirazi zingathe ndipo ziyenera kudyedwa ndi anthu omwe akudwala matendawa.

1. Dzulo ndi mkate wakale wa tirigu.
2. Yachiwiri nkhuku kapena msuzi wa ng'ombe.
3. Nyama: nkhuku, nyama yamphongo, nkhuku. Njira kukonzekera: wiritsani, kuphika mu uvuni. Nyama siyenera kukhala ndi zokometsera zilizonse.
4. Nsomba zaphika, zophika kapena kuphika mu uvuni.
5. Zinthu zamkaka zokhala ndi mafuta ochepa.
6. Yophika masamba. Ngati mukufuna yaiwisi, ndiye pokhapokha mu grated mawonekedwe.
7. Mitundu yosiyanasiyana ya pasitala.
8. Groats (buckwheat, mpunga, oatmeal).
9. Zipatso zophika (maapulo ndi mapeyala m'maganizo).
10. Jelly.
11. Chipatso chofewa, zakudya, tiyi wopanda mphamvu.

Mndandanda wazakudya zomwe zimapangidwa ndi kapamba

1. Nyama yoyamba kapena msuzi wa nsomba. Ndiye kuti, mafuta oopsa, opatsa mphamvu.
2. Mapira sayenera kudyedwa kuchokera ku chimanga.
3. Nyama zamafuta, nsomba, nkhuku.
4. Kuyambira masamba, masamba a radish, radish, kabichi, sorelo ndi sipinachi.
5. Mkate watsopano kapena makeke aliwonse.
6. Mitundu yosiyanasiyana ya soseji, zakudya zamzitini.
7. Zakumwa zoledzeretsa.
8. Ayisikilimu.
9. Tiyi yamphamvu, khofi.

Kugwiritsa ntchito zinthu zomwe zatchulidwazi kumabweretsa zotsatira zoyipa, zomwe zimatchedwa "kutupa kwa kapamba" (kapamba, pongoyika). Pofuna kuti musasewere roulette ndi thanzi lanu, kumbukirani zakudya zomwe zaletsedwa kudya ndi matendawa. Kupatula apo, kudya kale 60% yazotsatira zabwino zamatenda.

Chithandizo cha matenda kapamba

Chithandizo cha matendawa ndikufuna kuchepetsa kuchuluka kwa bile. Pancreatitis ya kapamba, mankhwalawa omwe amachepetsa kokha kugwiritsa ntchito mapiritsi apadera, apereka zotsatira kwakanthawi. Ndipo, kuphatikiza pa izi, wodwalayo azidya molondola, kutsatira zakudya, ndiye kuti izi zikhala pafupifupi chitsimikizo cha kuchira kochita bwino.

Koma tsopano tiyeni tiganizire za mankhwala omwe amathandiza kulimbana ndi matenda.

Chifukwa chake, mankhwala omwe amathandizira kuchotsa kuphipha kwa minofu:

1. Awa ndimapiritsi a kapamba. Pancreatitis imachiritsidwa ndi antispasmodics otsatirawa: No-Shpa, Spazmoverin, Spazmol.
2. Dongosolo lokonzekera milingo "Papaverine".

Mankhwala otsatirawa amachepetsa kubisala kwa madzi a m'mimba:

1. Makapisozi Omeprazole.
2. Mapale "Ranitidine", "Famotidine".

Mankhwalawa otsatirawa amateteza kugaya chakudya ndikuwongolera ntchito ya pancreatic. "Allohol", "Pancreatin", "Phenipentol" - awa ndi magome ochokera ku kapamba. Pancreatitis si sentensi.

Komanso, mankhwala omwe amalepheretsa kupanga ma pancreatic enzymes amapatsidwa mankhwala ochizira kapamba. Pakati pa mankhwalawa, yankho la Aprotinin limagwiritsidwa ntchito nthawi zambiri.

Ngati ululu wowopsa ulipo kapena munthu akuonda, ndiye kuti kulandira kuchipatala ndi chithandizo chowonjezereka ndizotheka mosamalitsa ndi akatswiri. Kuchitapo kanthu kwa opaleshoni kumayikidwa ngati zikondamoyo sizikuliranso. Kuchiza, kudya ndi kugonjetsedwa kwambiri sikungathandize. Kuchotsa kokha gawo limodzi lomwe kudzapulumutse ku chiwonongeko chowonjezereka.

Izi sizikutanthauza kuti mukalandira chithandizo cha mankhwala, kuchira kwathunthu kumachitika. Zachisoni kuti, koma kapamba sangathe kuchiritsidwa kwathunthu. Koma kuti zikondamoyo zisawonongeke, ndikofunikira kulandira chithandizo, ndikutsatira zakudya zosasunthika, zomwe tafotokozazi.

Chithandizo cha pachimake kapamba

Matenda amtunduwu amafunikira kuchipatala.M'chipatala, wodwala amayankhidwa kuti azitsatira:

1. Kulowetsedwa kwamitsempha komwe kumathandiza kuyeretsa magazi a poizoni ndi michere ya pancreatic.
2. Mankhwala opweteka.
3. Mapiritsi omwe amawononga ma enzymes a gland. Mwachitsanzo, mapiritsi a Cordox.
4. Mankhwala oletsa kusanza.
5. Maantibayotiki.
6. Antispasmodics.

Kuphatikiza apo, chithandizo chamankhwala chimaphatikizapo:

1. Kusokonezeka kwathunthu kwa zakudya kudzera pakamwa mpaka masiku 6. Izi ndizofunikira kuti ntchito ya kapamba iyimitsidwe kwakanthawi.
2. Mitseko yamkati.
3. Kupanga kwa kukodza kuti mkodzo ukhale wambiri kuti uchoke m'thupi ndi mkodzo.
4. Bowel lavage.

Kodi opaleshoni ya kapamba imachitika liti?

Kufunika kwa mankhwalawa kumachitika chifukwa cha zovuta za kapamba powona zilonda zam'mimba. Monga lamulo, opareshoni imachitika panjira pomwe zosankha zina zimangoyambitsa kulephera, kapena pomwe wodwalayo ali woopsa kwambiri.

Tiyenera kukumbukira kuti kulowererapo kwina kulikonse m'thupi la munthu kumakhala ndi zotsatirapo zosiyanasiyana zoyipa. Njira yamakina silipereka chitsimikizo cha kuchira kwa wodwala, koma, m'malo mwake, pamakhala chiopsezo chowonjezeka cha chithunzi chonse chaumoyo. Zizindikiro ndi mankhwala a pancreatitis mwa akulu nthawi zambiri amaphatikizidwa.

Kuphatikiza apo, ndi dokotala yekha wodziwa bwino kwambiri za akatswiri ochepa kwambiri omwe amatha kuchita opareshoni, ndipo si onse mabungwe azachipatala omwe angadzitamande ndi akatswiri otere. Chifukwa chake, opaleshoni ya pancreatic pamaso pa kapamba amachitika motere:

• Mkhalidwe wodwala, wodziwika ndi gawo lowopsa la matenda owononga. Ndi chithunzithunzi chofananira, kuwonongeka kwa tiziwalo tomwe tili ndi matenda amtundu wa necrotic kumayang'aniridwa, pomwe njira zoyeretsa zimatha kuwonjezeredwa, zomwe zimawopseza moyo wa wodwalayo.
• Kukhalapo kwa pancreatitis mu pachimake kapena mawonekedwe osakhazikika, omwe wadutsa mpaka gawo la pancreatic necrosis, ndiko kuti, necrotic stratization yamoyo minofu.
• Matenda a kapamba, omwe amadziwika ndi kupweteka kwapafupipafupi komanso kwakanthawi kochepa.

Zonsezi ma pathologies posowa opaleshoni zimatha kubweretsa zotsatira zoyipa. Kuphatikiza apo, njira zilizonse zamankhwala othandizira sizingapereke zotsatira zoyenera, chomwe ndichizindikiro chogwira ntchito.

Zovuta zazikulu pakuchita opareshoni

Kuchita opaleshoni kumbuyo kwa pancreatitis nthawi zonse kumakhala kovuta, komanso kovuta kulosera, komwe kumachokera pazinthu zingapo zomwe zimagwirizanitsidwa ndi anatomy a mkati mwa ziwalo zophatikizika.

Tizilombo ta ziwalo zamkati timakhala osalimba, chifukwa kutulutsa magazi kwambiri kumayamba chifukwa cha chinyengo chochepa kwambiri. Vuto lofananalo pakumuchiritsa wodwala silimachotsedwa.

Kuphatikiza apo, kufupi kwenikweni kwa nduluyo ndi ziwalo zofunika, ndipo kuwonongeka kwawo pang'ono kumatha kuyambitsa zovuta mu thupi la munthu, komanso zotsatira zosasintha. Chinsinsi, limodzi ndi ma enzyme omwe amapangidwa mwachindunji m'gululi, zimakhudza mkati, zomwe zimapangitsa kuti minofu ikhale yovuta, zomwe zimapangitsa kuti ntchitoyo igwirike bwino kwambiri.

Mitundu yovomerezeka

Wodwala akapatsidwa gulu lachitatu la olumala, amaloledwa kuti apeze ntchito yopepuka.

Malo ogwirira ntchito omwe ali ndi mawonekedwe ena ogwira ntchito amagawidwa kwa anthu olumala:

• ogwira ntchito molimbika komanso molimbika,
• ntchito yokhudzana ndi kupsinjika kwakukuru m'maganizo,
• kulephera kutsatira malingaliro a dokotala pazakudya zamatenda kuntchito (ntchito yodumphitsa zakudya kapena kulephera kudya zakudya zovomerezeka ndi adokotala),
• kulumikizana ndi mankhwala oopsa omwe amakhudza chiwindi ndi kapamba (hepatotropic ndi pancreatotropic poisons).

Kuyesedwa kwa olumala kumayesedwa kuti ndipo

Ngati pali umboni wa kulumala, dokotala yemwe akupezekapo (adotoloza, gastroenterologist kapena dokotala wa opaleshoni) atumiza wodwalayo ndi chifuwa chachikulu ku office ya ITU komwe amakhala.

M'mbuyomu, adotolo amakonzekera pepala lolembera - zikalata zambiri zotsimikizira matendawa, kupezeka kwa zovuta, zotsatira za maphunziro onse ofunikira, kufunsa kwa akatswiri okhudzana ndi izi.

Zambiri za pancreatic necrosis

Ndi necrotic pancreatitis, gawo limodzi mwa kapamba limamwalira. Ichi ndichifukwa cha pathological momwe minofu yama michere yopanga thupi. Izi nthawi zambiri zimaphatikizidwa ndi kufalikira kwa matendawa kapena kukula kwa kufalikira kwa matendawo.

Mitundu yotsatirayi ya pancreatic necrosis ndi:

1. Pachimake edematous.
2. Hemorrhagic.
3. Zachangu.
4. Zopepuka.
5. Zowononga zowononga.

Udzu wabwino kwambiri wa edematous pancreatic necrosis. Vuto lowopsa kwambiri ndi peritonitis. Matendawa akamakula, amafunika kuchitidwa opaleshoni mwachangu. Kupanda kutero, sepris ya purulent imayamba ndipo wodwalayo amafa patangotha ​​maola ochepa.

Zomwe zimayambitsa pancreatic necrosis

Cholinga chachikulu cha khansa ya pancreatic ndi kugwiritsa ntchito mankhwala osokoneza bongo kwa nthawi yayitali. Pafupifupi 25% ya odwala ali ndi mbiri ya cholelithiasis. Pafupifupi 50% ya odwala omwe ali ndi vutoli nthawi zambiri amadya kwambiri. Zakudya zawo zimakhala ndi nyama yokazinga, yosuta, mafuta.

Zifukwa zina za chitukuko cha pancreatic necrosis zimaphatikizapo:

• kuvulala kwam'mimba
• Kupita patsogolo kwa zilonda zam'mimba,
• kulowetsa kachilombo
• kukula kwa matenda opatsirana,
• zilonda zam'mimba.

Chochititsa china chokhalitsa ndi kukhala nthawi yayitali m'mavuto opanikizika. Nthawi zina pancreatic necrosis imayamba motsutsana ndi maziko osayenera a mankhwala ena.

Magawo a chitukuko cha necrotic pancreatitis

Kukula kwa pancreatic pancreatic necrosis kumachitika m'magawo. Zonse zimayamba ndi toxemia. M'magazi a wodwala, ziphe zomwe zimakhala ndi mabakiteriya zimapezeka. Michere yomwe imatulutsa mabakiteriya sipezeka nthawi zonse.

Gawo lachiwiri, chikopa chimawonedwa. Nthawi zina zimakhudza ziwalo zapafupi. Maonekedwe a kusintha kwa purulent m'matumba a pancreatic ndi amtundu wa magawo atatu.

Zizindikiro zazikulu za matenda

Chizindikiro chachikulu cha matendawa ndi kupweteka. Imachitika kumanzere kwa m'mimba. Mphamvu yake imagawika m'mitundu inayi:

Nthawi zina ululu wammbuyo umafalikira kumanzere kumtunda kwa dzanja kapena lumbar. Kutentha kwa thupi kumakwera, nseru imayamba, kusanza kumatseguka, ndipo chopondapo chimasokonekera.

Poyerekeza ndi kumbuyo kwa zovuta za purancicic pancreatic necrosis, wodwalayo amatuluka thukuta kwambiri. Amanjenjemera komanso kutentha thupi. Anthu ena ali ndi zizindikiro za kulephera kwa impso. Matenda a dongosolo la mitsempha nthawi zina amapezeka. Ndi chithunzi chowawa kwambiri chodwala, wodwalayo amagwa.

Mankhwala othandizira

Ngati zilonda zam'mimba zimayambira pancreatic pancreatic necrosis, zotsatira zakupha ndizotheka. Chifukwa chake, wodwalayo amapatsidwa ntchito yofunikira mwachangu.

Dokotalayo amachotsa minofu yakufa. Gawo lotsatira ndikubwezeretsa duct conduction. Ngati chithandizo sichikubweretsa zotsatira, yachiwiri imayikidwa. Kwa odwala 48%, zimatha bwino.

Chifukwa chiyani odwala amafa

Chiwerengero cha anthu omwe amafa ndi matendawa ndiokwera kwambiri. Amasiyana 20 mpaka 50%. Choyambitsa chachikulu chaimfa ndi kuchedwa kwa septic komanso zizindikiro zoyambirira za poizoni. Zimayenda ndi ziwalo zingapo. Amapezeka mwa odwala anayi alionse omwe ali ndi vutoli.

Chinanso chomwe chimapangitsa kuti wodwalayo afe ndi vuto loopsa lomwe limabweretsa. Zimakwiya chifukwa cha zovuta za matendawa.

Matenda a pancreatic necrosis ndi osauka ndi:

• kukhalapo kwa kusintha kwodalirika mu necrotic foci,
• kusintha kwamapangidwe amisempha ndi maselo a ziwalo,
• mapangidwe a necrotic foci.

Kuthekera kwa kufa kwa wodwala kumasiyana maola 3-4 mpaka masiku awiri. Nthawi zambiri, wodwalayo amakhala ndi moyo wopitilira masiku 14.

Kuchiritsa kwa kapamba

Pambuyo pa opaleshoni, wodwalayo akuwonetsedwa zotsatirazi zochizira:

1. Physiotherapy.
2. Ochita masewera olimbitsa thupi odekha.
3. Kutikita minofu.

Kugwirira ntchito kwambiri kwa anthu kumatsutsana. Mukatha kudya, ndikofunikira kuti mupumule. Zochita poyenda zimasinthidwa ndi adokotala.

Yankho la funso ngati zikondazo zimachira pambuyo pancreatic necrosis zitha kupezeka kuchokera kwa gastroenterologist kapena endocrinologist. Kuyambiranso ntchito za thupili ndizotheka mothandizidwa ndi njira zoyeretsera. Koposa zonse, kulowetsedwa kwa chiphalaphala kumathandiza.

Kuti mukonzekere bwino, muyenera kubzala masamba 10 a mbewu 200 ml mu thermos. madzi atsopano owiritsa, tsimikizani maola 24. Tengani 50 g. theka la ola musanadye.

Pofuna kubwezeretsanso michere ya chiwalo, wodwalayo adayamwa kutenga Creon, Pancreatin, Mezim-forte. Muli proteinase, lipase, komanso amylase. Zinthu izi ndizofanana ndi ma enzyme omwe amapangidwa ndi kapamba.

Moyo pambuyo pancreatic necrosis mankhwala

Pambuyo pa opaleshoni, wodwalayo amakhala dispensary. Pakatha miyezi isanu ndi umodzi, munthu amayeserera kugaya chakudya. Amawonetsedwa gawo la ultrasound. MRI yam'mimba nthawi zina imakhazikitsidwa.

Moyo wa wodwala pambuyo pancreatic necrosis ya kapamba umasiyanasiyana. Amupatsa zakudya zoyenera kwambiri. Ndikofunikira kupatsa zakudya zazakudya zambiri. Chakudya chiyenera kutenthetsedwa. Kugwiritsa ntchito zakumwa zoledzeretsa, zakumwa zoledzeretsa sizimaphatikizidwa. Phindu lalikulu kwa thupi ndikukana maswiti.

Munthu akasiya chakudyacho, moyo wake umachepa. Machitidwe a latent akachitika, mndandanda wazinthu zololedwa zimatha kukulitsidwa.

Mwa odwala ena atachitidwa opaleshoni, kuthamanga kwa magazi kumachepa ndi 20%. 30% ya anthu ali ndi mavuto akulu ndi ziwalo zawo zamasomphenya. Ambiri amakhala akhungu. Nthawi zina ochepa hypoxia amapezeka m'mapapo. Ma syndromes owala a kupuma amayamba. Odwala ena amakhala ndi chotupa choopsa.

Kupeza chilema ndi pancreatic necrosis

Kulumala kumachitika ndi vein thrombosis komanso kukhalapo kwa zilonda zam'mimba. Ndi malire ochepera amoyo, wodwalayo amalandira gulu 3. Ngati munthu wapezeka ndi vuto logaya chakudya mozama, amapatsidwa magalamu awiri. Kulumala 1 gr. kuperekedwa pokhapokha ngati pali chiopsezo cha kufa komwe kuli pafupi.

Ndi mapiritsi ati omwe ndi abwinoko pochiza pancreatitis?

Ngati wodwala yemwe ali ndi vuto la kapamba amakhala ndi vuto la m'mimba, mawonekedwe a dystrophy, amavutika kusamalira thupi lake komanso kuchepa kwa ntchito, ndiye kuti amapatsidwa gulu limodzi. Maonekedwe akutulutsa magazi, pseudocyst yayikulu ikusonyeza gulu 2.

Ngati opaleshoniyo atachitidwa opaleshoniyo alibe mavuto, ntchito zofunika kwambiri sizichepetsedwa, ndipo minyewa yake imagwira ntchito moyenera, kenako gulu limayikidwa pagulu lachitatu. Potere, wodwalayo atha kupeza ntchito yomwe sikutanthauza kuti azichita zolimbitsa thupi.

Pambuyo pa opaleshoni yodutsa kwamitsempha yamtima, kulumala kwakanthawi (pakudwala) kumachitika mpaka miyezi inayi.Pambuyo pake, odwala amatumizidwa ku ITU (kuyezetsa zamankhwala ndi chikhalidwe), panthawi yomwe zimasankhidwa kupatsa wodwala ndi gulu linalake lopuwala.

Gulu lachitatu limaperekedwa kwa odwala omwe ali ndi zovuta zosavuta pambuyo pake komanso masekondi 1-2 (FC) a angina pectoris, komanso opanda kapena ndi vuto la mtima. Amaloledwa kugwira ntchito m'magulu a akatswiri omwe sakhala owopseza mtima wa wodwala. Maluso oletsedwa akuphatikiza - kugwira ntchito motalika, ndi zinthu zapoizoni, m'munda, ntchito ya woyendetsa.

Gulu II limaperekedwa kwa odwala omwe ali ndi zovuta zovuta postoperative.

Gulu I limaperekedwa kwa anthu omwe ali ndi matenda osatha a mtima omwe amafuna chisamaliro cha anthu osavomerezeka.

Mawu akuti pancreatitis mu chipatala amatanthauza chilichonse chotupa cha pancreatic minofu. Chithandizo chachikulu masiku ano ndi njira yothandizira. Koma, izi sizitanthauza kuti kwa wodwala aliyense mapiritsi amodzi a kapamba amalembedwa. Mankhwala amasankhidwa poganizira mawonekedwe a matendawa, kukula kwa chotupa cha pakhungu, kupezeka kwa concomitant pathologies komanso momwe wodwalayo alili.

MCE wokhala ndi glomerulonephritis

Zowonetsera
nthawi yodwala kwakanthawi
mu pachimake glomerulonephritis popanda
zovuta zake ndi 60 - 90, ndi zovuta
- Masiku 90 -120. Chizindikiro chowonjezera
kulumala kwakanthawi kuposa 4
miyezi yothandizanso
njira yosaletseka yotupa
ndi zoyeserera zabwino choncho
zabwino matenda ndi ntchito
kuneneratu.

Chachikulu
muyezo wa MSE mwa odwala aakulu
glomerulonephritis ndi: zamankhwala
mawonekedwe a matenda, kuchuluka kwa kufalikira,
digiri ya zotupa ntchito
dongosolo ndi kuchuluka kwa kupita patsogolo,
kukula kwa zovuta kuchokera
mtima, pakati mantha
ndi mafupa dongosolo, gawo la matenda
kulephera kwaimpso (CRF),
chithandizo chamakhalidwe ndi ochezeka
zinthu.

Nthawi yowerengeredwa
kulumala panthawi yowonjezera
aakulu glomerulonephritis ndi
Masiku 60 - 75. Chizindikiro chowonjezera
kulumala kwakanthawi kuposa 4
miyezi yothandizanso
njira yomwe sinathe
ndi zabwino zake komanso
zabwino matenda ndi ntchito
kuneneratu.

Odwala
ndi matenda a glomerulonephritis
ntchito muzoyipa ndi zotsutsana
microclimatic zinthu, zochitika,
zimagwirizana ndi hypothermia, kukhudzana
Ziwopsezo za nephrotoxic
kupsinjika kwakuthupi.

At
mawonekedwe obwera
matenda) odwala ambiri amasungabe
luso lotha kugwira ntchito ndi mitundu yomwe ilipo
ndi magwiridwe antchito. Pamaso pa mtheradi
zopinga zomwe zimafuna kumasulira
ku ntchito ina ya kuyeneretsedwa kotsika,
ali gulu la olumala la III.

Katswiri
ntchito kuchuluka kwa odwala matenda oopsa
mawonekedwe a glomerulonephritis
popanda aakulu aimpso kulephera zimadalira kuchuluka kwa patsogolo
ochepa matenda oopsa. Pang'onopang'ono
Kupita kwa njirayi kudwala,
kugwira ntchito yapakatikati komanso yolemetsa
ntchito yakuthupi, ngati nkosatheka
ntchito yovomerezeka
wolumala III
magulu.

Ngati matenda oopsa apita patsogolo
kulumala msanga kutsimikiza
III
kapena gulu II kutengera zovuta
kuchokera pamtima komanso wamanjenje
machitidwe.

Kulemala
anthu okhala ndi nephrotic mawonekedwe osachiritsika
glomerulonephritis imatsimikiza ndi liwiro
kupita kwa edematous syndrome.
Ndi kukula pang'onopang'ono (mawonekedwe a edema
pokhapokha pakukula kwa glomerulonephritis,
zovuta zawo) odwala okhudzidwa
zolimbitsa thupi ndi zopepuka,
pitilizani ntchito, anthu
wapakati komanso wolemera
ntchito, yodziwika ngati gulu laoleza III,
ndi kupita patsogolo kwa edematous
matenda motsutsana ndi maziko a ntchito zonse
njira - olumala II
magulu.

Nkhope
ndi wosakanikirana mawonekedwe
glomerulonephritis nthawi zambiri kwathunthu
amalephera kugwira ntchito wamba
machitidwe opangira ndi kwa iwo
olumala okhazikitsidwa II
magulu, komanso ndikuwonjezereka mwachangu kwa edema
ndipo matenda oopsa amadziwika
ndalemala
magulu.

Kodi kukopeka ndi chiyani?

Biopsy ndi njira yofufuzira yomwe imaphatikizapo kutenga kuyimitsidwa kwa maselo kapena kuzimitsa zimakhala zazamoyo kuti zikhale ndi mayeso a microscopic. Musanaphunzire pansi pa maikroskopu, kukonzekera kumakonzedwa, kumakonzedwa kale ndi utoto wapadera.

Pambuyo pa izi, mankhwala omalizidwa amatumizidwa kukayesedwa kwa histological, pomwe katswiriyo amapereka chiyembekezo chokhudzana ndi ma morphological mawonekedwe a minofu yogwidwa komanso kupezeka kapena kusowa kwa maselo am'magazi. .

Nthawi zambiri amatengera biopsy, ngati pali kukaikira khansa. Itha kugwiritsidwanso ntchito ngati kuli kofunikira kudziwa mtundu wa magwiridwe anthawi iliyonse omwe angagwiritsidwe ntchito ndi njira ya dystrophic kapena yotupa.

Ponena za kapamba, kukonzekera biopsy kumagwiritsidwa ntchito pakafunikira kusiyanasiyana pakati pa chotupa ndi chotupa chowopsa.

Omalizawa akuphatikizapo khansa ya sarcoma ndi khansa ya pancreatic. Yoyamba ndi yopanda pake, nthawi zambiri pakati pa zotupa za ndulu izi zomwe zikukula, khansa imapezeka. Zowona, izi zimapangidwa pokhapokha pazotsatira za biopsy.

Kodi opareshoni amachitika bwanji?

Kwa biopsy, singano zapadera zimagwiritsidwa ntchito nthawi zambiri, kukulolani kuti mupeze mzere wa minofu ya kapamba. Njira yodziwira matendawa imatha kuchitika motsogozedwa ndi ultrasound, pa computer tomography kapena pa opaleshoni ya laparoscopic.

Njira yomwe imagwiritsidwa ntchito kwambiri ndi singano yoyenera ya biopsy, yomwe imatha kuchitidwa motsogozedwa ndi compact tomography kapena ultrasound.

Akatswiri azachipatala mumzinda wanu

Pambuyo pokonzekera makonzedwe, kuphatikiza kukhazikika kwa ma sedenti ndi ma tranquilizer (phenobarbital, phenazepam, ndi zina) kuti akwaniritse zotsatira zabwino za opaleshoni, wodwalayo amapititsidwa ku chipinda chogwiriramo ntchito, komwe amachitidwa opereshoni mkati mwa maola 4-6 otsatira.

Opaleshoni ya Bypass nthawi zonse imachitidwa pansi pa opaleshoni yotupa. M'mbuyomu opaleshoni idachitidwa pogwiritsa ntchito sternotomy - sternum dispar; Posachedwa, ntchito yochepetsera malo osungika kumanzere kumanzere kwa mtima ikuchitika.

Nthawi zambiri, pakuchita opareshoni, mtima umalumikizidwa ndi makina am'mapapu amtima (AIK), omwe nthawi imeneyi amatulutsa magazi kudzera mthupi. Ndikothekanso kuchita masewera olimbitsa thupi popanda kulumikiza AIC.

Pambuyo pakuwongolera msempha (kawirikawiri kwa mphindi 60) ndikulumikiza mtima ndi chipangizocho (nthawi zambiri kwa ola limodzi ndi theka), dokotalayo amasankha chida chomwe chikhala chopanda pake ndikubweretsa mbali yam'mitsempha yomwe ikukhudzidwa.

Chifukwa chake, kuthamanga kwa magazi kupita kumitsempha yama coronary kumachitika kuchokera ku msempha, kudutsa malo omwe amapezeka. Pakhoza kukhala zingapo zoyikapo - kuyambira awiri mpaka asanu, kutengera kuchuluka kwa mitsempha yomwe yakhudzidwa.

Zikopa zonse zitakonzedwa kumalo oyenera, zopunthira zopangidwa ndi chitsulo zamafuta zimayikidwa kumapeto kwa sternum, minofu yofewa imasungidwa ndipo kuvala aseptic kumayikidwa.Madzimadzi nawonso amatulutsidwa, kudzera pomwe madzi a hemorrhagic (wamagazi) amatuluka kuchokera kuthambo lamadzi. Pambuyo pa masiku 7-10, kutengera muyeso wa machiritso a bala la postoperative, ma sutures ndi kavalidwe amachotsedwa. Munthawi imeneyi, kuvala tsiku ndi tsiku kumachitika.

Chinsinsi cha opareshoni

Kuchita opaleshoni iyi ndi kwapancreatic cyst yomwe Hussenbauer (1882) amakhalabe chithandizo chamankhwala chofala kwambiri. Malinga ndi mawonedwe amakono, opaleshoni iyi ndiyoyenera kupezeka pamankhwala ovuta kapena opweteka, pakachitika zotupa zomwe sizingachotse, komanso ngati milandu yayikulu ya wodwalayo ikupangitsa kuti zovuta kuvuta.

Nthawi zambiri, ntchito yoyendetsa ngalawa ndi motere. Kusunga mosamala malo owonekera a cystic neoplasm ndi ma napkins, zomwe zili mkati zimachotsedwa ndikugwiritsa ntchito trocar yokhala ndi chubu cha mphira ndipo lumen imatsegulidwa pamalo opumira.

Kutenga m'mbali mwa khoma lozungulira la ma cystic pamakanda, minofu yowonjezerayo imatulutsidwa, ndikumaliza kugwira ntchito ndikukhomera makoma kupita ku peritoneum ya parietal pamalo ovulalawo. M'mbuyomu, ngalande za mphira kapena tampon zimayambitsidwa mkati.

Zilonda za pakhungu zatsekedwa, kupatula malo achotsetsedwe ndi ngalande. Njira ziwiri zogwirira ntchito zomwe zalimbikitsidwa mu ntchito ya madokotala akale, pomwe zipupa zidakonzedwa kukhoma lam'mimba, ndipo patatha masiku angapo mapangidwe a cystic adatsegulidwa ndikuwongoleredwa, alibe ntchito ndipo adasiyidwa pakadali pano.

Odwala ena omwe ali ndi pancreatic cysts omwe amapezeka kumbuyo kwa lumbar, ngalande zina zowonjezera nthawi zina zimagwiritsidwa ntchito molingana ndi njira ya Martynov, pomwe kuwonetsa mapangidwewo kumachitika pogwiritsa ntchito mbali yakumanzere pamphepete mwa nthiti ya XII.

Odwala atagwiritsa ntchito kukhetsa kwa ma cysts amachitika m'njira yotseguka mpaka patsekeka ndipo fistula atseka pamalo oyamba akhazikitsa ngalande ndi ma tampons.

Zotsatira za opaleshoni yamapapo sizingatheke kulosera. Zonse zimatengera momwe wodwalayo alili, kufalikira kwa kayendedwe ka matenda, chitetezo chamthupi ndi zina.

Koma zotsatira zoyipa zomwe zimachitika nthawi ya opereshoni ikatha zimatha kusiyanitsa: • Kutulutsa magazi komwe sungathe kuyimitsidwa ndi njira zotukuka, • kukula kwa matenda a shuga m'magwiridwe antchito, • matenda a ziwalo zamkati, • kuwonongeka kwa mitsempha ndi mitsempha yamagazi.

Pambuyo pakuchita opaleshoni, madziwo amatsalira m'mimba kwa sabata imodzi kuti achotse madzimadzi. Ndikulimbikitsidwa osapitirira mwezi umodzi kuchotsedwa kwa zonyansa kuti muwonongere kunyumba, kukhala pa tchuthi chodwala, komanso kupewa kugwira ntchito zolimbitsa thupi, kugonana. Ndikulimbikitsidwanso kuchita katemera motsutsana ndi matenda opatsirana, ndikulandila Mlingo wa enzyme ndi insulin. Mlingo wotsirizira umatsika kwambiri pambuyo pochotsa kapamba.

Mitundu ikuluikulu ya kapamba wamkati, osagwiritsidwa ntchito momasuka. Hemorrhagic kapamba ndi hemorrhage m'thupi la gland. Pancreatic necrosis - necrosis ya England ndi kapamba. Kutupa kwa purulent, kutulutsa kwa gland. Makungu akulu. Pancreatic fistula. Kutumiza kwa cyst. Zovulala zowopsa. Kupezeka kwa miyala mu ducts ya gland.

Kuchotsa chofufumitsa kwathunthu nthawi zambiri kumachitika ndi chotupa cha khansa.

kugawanika kwa kapisozi kuchepetsa edema, necrectomy - kuchotsa kwa malo amodzi a necrotic, kuchotsedwa kwina (kutsitsimuka kwa kapamba - mutu, thupi, mchira), kuchotsedwa kwathunthu - kapamba.

Kuchotsa pang'ono kapamba kumachitika pamaso pa cysts, necrosis, hemorrhage, chotupa chaching'ono.Kuchotsa kwathunthu - ndi khansa, kukula kwa pancreatic necrosis, kuphatikizika kwa purseine ndi kuwonongeka kwakukulu pamene kuchira sikungatheke.

Zotsatira zake ndi moyo ndi chiyani atachitidwa opaleshoni yam'mimba - kuchotsedwa kwathunthu kapena pang'ono? Zotsatira zake sizingakhale, chifukwa thupi limataya chiwalo kapena gawo lina lake, zomwe ndizofunikira chimbudzi chambiri komanso kagayidwe ka glucose. Kuchulukitsa komwe kumagwirako ntchito, ndiko kuti, momwe minyewa yambiri imachotsedwa, ndizomwe zimayambitsa chisokonezo.

Zotsatira za kapangidwe ka pancreatic

Gland ikapangidwa, malo ake osinthika amachotsedwa: mutu, gawo la thupi kapena mchira, pomwe madokotala ochita opaleshoni amayesetsa kuteteza minofu ya glandular momwe angathere. Ngati mutu kapena gawo la thupi la chindacho lachotsedwa, gawo logaya chakudya limasowa ma enzymes.

Gland ikapangidwa, mchira wake, gawo limodzi la thupi, kapena mutu umatha kuchotsedwa.

Zotsatira zake, kuyamwa kwa michere kumasokonekera, ambiri amachotsedwako osaphatikizidwa ndi matumbo. Wodwalayo amakula kuchepa thupi, kufooka, kuthamanga, kufooka kwa metabolic.

Chifukwa chake, kukonza kogwiritsa ntchito njira yogaya chakudya kudzera pakubwezeretsa ndikuthandizira kuchiritsa kwofunikira kumafunika. Monga chithandizo cholowa mmalo, kukonzekera kwa enzyme kumayikidwa pakudya: Pancreatin, Mezim-forte, Creon, Wobenzym ndi ena ofanana.

Pambuyo pa CABG, wodwalayo amakhala mu chisamaliro chachikulu, komwe kubwezeretsa koyamba kwa ntchito ya minofu ya mtima ndi mapapu kumayambira. Nthawi imeneyi imatha kufikira masiku khumi. Ndikofunikira kuti munthu yemwe akugwiritsidwa ntchito panthawiyi apume molondola. Zokhudza kukonzanso, kukonza koyambirira kumachitika mu chipatala, ndipo ntchito zina zimapitilirabe kuchipatala.

Kusoka pachifuwa ndi pamalo pomwe zinthu za shunt zidatengedwa zimatsukidwa ndi ma antiseptics kuti asadetse kuipitsidwa ndi kupitilira. Amachotsedwa ngati zikuchiritsa bwino mabala patsiku la 7. M'malo a mabala mumakhala kumverera kowotcha ngakhale kupweteka, koma pakapita nthawi kumadutsa. Pambuyo pa masabata 1-2, pakhungu limapola pang'ono, wodwala amaloledwa kusamba.

Fernum bone amachiritsa motalika - mpaka anai, ndipo nthawi zina miyezi isanu ndi umodzi. Kuti muchepetse njirayi, sternum imafunikira kupumula. Ma bandeji pachifuwa omwe adapangira izi amathandiza. M'masabata 4-7 oyambilira, masheya apaderadera ayenera kuvalidwa pamiyendo kuti musapupulume komanso kupewa matenda a thrombosis, ndipo muyenera kusamala ndi kuchita masewera olimbitsa thupi panthawiyi.

Chifukwa cha kuchepa kwa magazi pakuchita opareshoni, wodwalayo amatha kukhala ndi magazi m'thupi, koma safunikira chithandizo chapadera. Ndikokwanira kutsatira zakudya zomwe zimaphatikizapo zakudya zokhala ndi chitsulo chochuluka, ndipo mu mwezi hemoglobin imakhala yabwinobwino.

Pambuyo pa CABG, wodwalayo amayenera kuyesayesa kuti abwezeretsenso kupuma bwino, komanso kupewa chibayo. Poyamba, ankayenera kuchita masewera olimbitsa thupi omwe anaphunzitsidwa opareshoni isanachitike.

Kupitiliza kukonzanso ndikofunikira pang'onopang'ono zolimbitsa thupi. Pambuyo pa opaleshoni, wodwalayo samavutikanso ndi angina akuwukiridwa, ndipo amamulembera njira yofunikira yamagalimoto. Poyamba, kumayenda m'mbali mwa zipatala kwa mtunda waufupi (mpaka 1 km patsiku), ndiye kuti mitolo imachulukitsa pang'ono, ndipo patapita nthawi ambiri zoletsa zamagetsi zimachotsedwa.

Kuwonongeka kwa gawo kapena yamitsempha yama coronary, kupendekera kuunikira kwa gawo lamanzere.

Lingaliro pa opaleshoni limatengedwa paliponse payokha, poganizira kuchuluka kwa kuwonongeka, mkhalidwe wa wodwalayo, zoopsa, ndi zina zambiri.

Gawo 1: lipirani malangizowo pogwiritsa ntchito mawonekedwe Step Gawo 2: mukalipira mufunseni funso lomwe lili m'munsimu ↓ Gawo 3: Muthokozanso katswiriyu pomulipirira ndalama zochepa chabe ↑

Mitsempha yama coronary ndi ziwiya zomwe zimatuluka kuchokera ku aorta kupita pamtima ndikudyetsa minofu yamtima. Pankhani ya zikwangwani zoika kukhoma lawo lamkati komanso kuwonjezereka kwakukulu kwa lumen, kuthamanga kwa magazi mu myocardium kumatha kubwezeretsedwanso pogwiritsa ntchito stenting kapena coronary artery bypass grafting (CABG).

Pakumalizira, shunt (detour) imaperekedwa m'mitsempha yama coronary pakuchita opaleshoni, ndikudutsa gawo lokhotakhota la mtsempha, chifukwa chomwe magazi amkati amabwezeretsedwa, ndipo minyewa yamtima imalandira magazi okwanira.

Monga mkangano pakati pamitsempha wama coronary ndi msempha, mtsempha wamkati wamkati kapena wama radial, komanso minyewa ya m'mimba ya m'munsi, imagwiritsidwa ntchito. Mitsempha yama thoracic yamkati imawerengedwa kuti ndi yofunika kwambiri mwakuthupi, ndipo kuvala kwake kumakhala kotsika kwambiri, ndipo kugwira ntchito ngati shunt kumatanthauza kwazaka zambiri.

Mitsempha yamanzere yamanzere yam'mimba imasungidwa ndi kupitirira 50% ya mawonekedwe ake, Mitsempha yonse yam'mimba imasungidwa ndi oposa 70%, Stenosis (ikutsitsa) m'mitsempha itatu ya coronary, yowonetsedwa ndi angina.

Ntchito yolambalala imatha kuchitika mwanjira kapena mwadzidzidzi. Ngati wodwala alowa mu dipatimenti ya mtima kapena ya mtima ndi infarction yovuta kwambiri, amadzakumana ndi matenda atangomaliza kukonzekera kumene, komwe kungawonjezeke kuti kuchitidwe opereshoni kapena kuchitira opaleshoni njira.

Pankhaniyi, ndimayeso okhawo omwe amayenera kuchitidwa - kutsimikiza kwa gulu la magazi ndi njira ya magazi, komanso ECG mu mphamvu.

ECG, Echocardioscopy (ultrasound ya mtima), Chest X-ray, magazi ndi mkodzo mayeso, Momwe umapangidwira magazi ndimagazi, kuyezetsa magazi a Syphilis, hepatitis ya HIV, kachilombo ka HIV, Coronaroangiography.

Operation CABG imatengera mitundu yapamwamba yamankhwala osamalira, motero mtengo wake ndi wokwera kwambiri.

Pofuna kupeza chiwerengero, wodwalayo amayenera kufufuza njira zowunikira (ECG, coronary angiography, ultrasound ya mtima, ndi zina), mothandizidwa ndi madokotala omwe amapita kuchipatala, mtima ndi dokotala wa mtima. Kuyembekezera chindapusa kumatha kutenga milungu ingapo mpaka miyezi ingapo.

Zilonda za postoperative zimayamba kuchira pambuyo pake patatha masiku 7-10 pataduka. Sternum, pokhala fupa, amachiritsa pambuyo pake - miyezi 5-6 atachitidwa opareshoni.

Kuthetsa kusuta ndi kumwa mowa mokwanira, Kutsatira ndizoyambira zakudya zopatsa thanzi - kupatula mafuta, okazinga, zonunkhira, zakudya zamchere, kumwa kwambiri masamba komanso zipatso, mkaka, mafuta ochepa komanso nsomba, zolimbitsa thupi zolimbitsa thupi - Kuyenda, masewera olimbitsa thupi , Kukwaniritsa kuchuluka kwa kuthamanga kwa magazi pogwiritsa ntchito mankhwala a antihypertensive.

Momwe tanthauzo ndi tanthauzo la kulumikizana kwa mitsempha ya m'mimba zimapangika ndikupanga njira zatsopano, zodutsa mtima kuti zibwezeretse magazi ku myocardium (minofu yamtima).

Kuwunikira kowonjezera, kufufuza zowonjezera ndi kufunsira kwa akatswiri osiyanasiyana zimachitika, ngati pakufunikira izi. Odwala amalankhulana ndi adotolo omwe amapita, ndi odwala ena omwe akuchira kale. Izi zimachepetsa kwambiri chisangalalo ndi nkhawa, zimakhazikitsa munthu pazotsatira zabwino. Amapereka mpumulo wokwanira, kuphunzitsa kupuma koyenera pakatha nthawi yothandizira.

Patsiku la opareshoni

Opaleshoni imayamba m'mawa. M'mawa kwambiri akumeta tsitsi pachifuwa kuti akonzekeretse malo ogwirira ntchito. Wodwalayo amawunikidwa ndi opaleshoni yachipatala (dokotala yemwe amachititsa opaleshoni), amayeza zofunikira zonse. Simungadye chilichonse m'mawa, chakudya chomaliza usiku watha musanadye chakudya chamadzulo. Ngati zonse zikuyenda molingana ndi dongosolo, wodwalayo amatengeredwa kupita ku chipinda chogwiritsira ntchito pa gurney yabodza.

Ntchito ikuyenda bwanji?

Nthawi yayitali yodutsa m'misewu yolumikizana ndi maora ndi ma 3-6 maola (minyewa ikamakokoloka komanso mafupa am'mitsempha amakhudzidwa, nthawi yayitali imagwira ntchito).Kuchita opaleshoni yozama kumafunikira pakukhumudwa.

Kutengera ndi zovuta kuzidutsa, funsoli limathetsedwa - ngati kuli kofunikira kuyimitsa mtima wa wodwalayo, ndikupereka kufalikira kwa magazi ndi zida zokumba. Ngati pali shunt imodzi yokha, ndipo dokotala wakuchita opaleshoni ali ndi chidaliro kuti sipangakhale mavuto ndi misempha yovulala m'mitsempha, njirazi zimachitika pa mtima wogwira ntchito.

Kupanda kutero, amapita kukadutsa mtima.

Malo omwe mabala amtundu wa coronary artery adadutsa adalumikiza opaleshoni

echocardiography, mayeso a labotale, ma ultrasound am'mimba, dopplerography yamatumbo a ziwalo ndi ubongo, coronary shuntography, esophagogastroduodenoscopy, radiography, ECG.

Nthawi yomwe opaleshoni ya coronary artery inadutsa ndi maola 3-6. Munthawi imeneyi, gulu la opaleshoni limapereka zabwino zake zonse, popeza kudzipereka kwathunthu pakufunikira ndikofunikira.

Pambuyo pokonzekera, kufikira kwa minofu ya mtima kumachitika. Kuti muchite izi, santhani minofu yofewa, kenako ndikugawana gawo la sternum.

Njira imeneyi imatchedwa Median sternotomy. Pamaso pake asanapange njira zapadera zokonzekera zomwe zimachepetsa kuwonongeka.

Makamaka, mtima umawuma pogwiritsa ntchito madzi oundana ozizira, ndipo njira yapadera imawonjezeredwa m'mitsempha yamtima yomwe imasunga. Minofu imaletsa ntchito yake.

Asanayambe njira ya CABG, wodwalayo amalumikizidwa ndi mtima wodutsa mtima, motero, zotsatira zowopsa za kumangidwa kwa mtima zimachepetsedwa. The aorta ukuwomba, zomwe zimathandiza kuchepetsa kuchepa kwa magazi.

Izi ndizofunikira pakulumikizana kwa shunts kwa izo. Mwambiri, makina am'mapapu amtima amagwira ntchito pafupifupi ola limodzi ndi theka, ndipo msempha umapinira pafupifupi ola limodzi.

Kusangalatsa kwamitsempha yamagazi kumatuluka kunja kwa malo a stenosis - ndi pomwe ma cell amitsempha amaikidwa. Mapeto ena a shunt amalumikizana ndi aorta, omwe amachotsa kwathunthu kulowa kwa magazi kumalo omwe akukhudzidwa.

Coronary artery bypass grafting (CABG) ndiyo njira yofunika kwambiri yochizira matenda amitsempha yamagazi, yoyendetsedwa ndi mitsempha ya mtima komanso yolimba ya angina pectoris.

CABG ikuchitika pa

Kusintha kwachilengedwe mu minofu ya mtima ndi chiwonetsero cha matenda a mtima chapamtima chifukwa cha kupezeka kwa kutsekeka kwa magazi mu mitsempha yomwe imadyetsa myocardium. Pochita opaleshoni, dokotala wa opaleshoni ya CABG amayambiranso magazi okwanira pogwiritsa ntchito workaround.

Kuti tichite izi, iye amatenga mbali imodzi ya zotupa m'mimba, ndipo inayo kumapeto kwa malo ogwedeza. Nthawi zambiri pamakhala zikopa zingapo.

Zotsatira zake, minofu yamtima imayamba kulandira mpweya wokwanira ndi michere.

Chifukwa cha shunting, mawonetseredwe a angina pectoris amachoka kapena kuchepa, ndipo ntchito za kulera ndi kupopa kwa mtima zimasintha. Odwala amakulitsa zochitika zosiyanasiyana zolimbitsa thupi, kubwezeretsa magwiridwe antchito.

Zida za arterial pambuyo pa coronary artery bypass grafting ntchito, monga lamulo, lalitali kuposa la venous.

Monga ma venous shuns, mitsempha ya mwendo wodwala imagwiritsidwa ntchito, popanda zomwe munthu angathe kuchita mosavuta. Pa ntchito iyi, radial artery of arm ingagwiritsidwe ntchito ngati zinthu.

CABG mwa mtundu wa mtima wamphwa ndi mtima wamtima, CABG yopanda mtima, ndi CABG pamtima, yomwe siyimitsa ntchito yake ndi mtima. Mitsempha yama coronary imadutsa kolowera pamtima imagwiritsidwa ntchito ndi angina pectoris a gulu lalitali kwambiri, ndiye kuti, pomwe wodwala sangathe ngakhale kugwira ntchito zapakhomo, monga kuyenda, kudya.

Msewu wam'mbuyo umalumikizidwa ndi msempha ndipo umatsogolera gawo labalalano la chotupa cha coronary

Chizindikiro chinanso ndikugonjetsedwa kwa mitsempha itatu ya coronary, yomwe imatsimikizidwa ndi coronarography. Kuchita CABG ndi aneurysms a mtima motsutsana ndi maziko a atherosulinosis.

Kuchepetsa kubwerera m'mbuyo kapena kuthetsa kwathunthu kuukira kwa angina, kuchepetsedwa kwakukulu kwa chiwopsezo cha myocardial infarction, kuchepa kwa chiwopsezo cha kufa mwadzidzidzi, kuchuluka kwa nthawi ya moyo, monga zikuwonetsedwera ndi kuwunika koyenera.

Zizindikiro ndi mankhwala a kapamba mwa akulu

Pancreatitis pachimake imadziwika ndi zizindikiro zotsatirazi:

• Zowawa zam'mimba ndi kutulutsidwa kwa hypochondrium kumanja komanso kumanzere.
• General malaise.
• Kukweza kutentha kwa thupi.
• Kusanza ndi kusanza, koma utatulutsa m'mimba, kupuma sikumachitika.
• Kudzimbidwa kapena kutsegula m'mimba.
• Dyspnea wolimbitsa.
• Hiccups.
• Kuphulika ndi kusapeza bwino m'mimba.
• Kusintha kwa khungu - mawonekedwe a khungu loyera, chikaso kapena kufiyira nkhope.

Wodwalayo amamuika m'chipinda chomwe odwala amawongolera kwambiri. Woopsa, opaleshoni imafunika.

Fotokozani mankhwala:

• maantibayotiki
• anti-yotupa mankhwala
• michere
• mahomoni
• calcium
• mankhwala a choleretic
• Zovala zazitsamba.

Mavuto atandichita opareshoni

Pambuyo opaleshoni ya kapamba, zotsatirazi zovuta zimachitika:

• M`kati mwa m'mimba, ma necrotic kapena purulent zomwe zili mkati zimayamba kudziunjikira, zomwe zimafotokozedwa mchilankhulo cha sayansi, wodwalayo amapezeka ndi peritonitis.
• Izi zimachitika kuti pali zochulukitsa za matenda obwera chifukwa cha kapamba komanso kupanga michere.
• Pali njira yotsekera njira zikuluzikulu, zomwe zingayambitse kufooka kwa kapamba.
• Tizilombo zofewa za matenda odwala sitingathe kuchiritsa, ndipo kusintha kwamphamvu kwa kapamba sikungawoneke.
• Mavuto owopsa kwambiri akuphatikizapo kulephera kwamphamvu kwa ziwalo limodzi ndi kukokoloka kwa pancreatic ndi septic.
• Zotsatira zoyipa pambuyo pake za opaleshoni ya kapamba zimaphatikizira mawonekedwe a pseudocysts limodzi ndi fanculas ya pancreatic, kukula kwa matenda osokoneza bongo a shuga ndi exocrine.

Kukonzekera kwa opareshoni

Mosasamala mtundu wa kapamba, kaya ndi parenchymal, biliary, chidakwa, kuwerengera, ndi zina zambiri, chochitika chachikulu pokonzekera ndi kufa kwathunthu ndi njala, yomwe, mwatsoka, imagwira ntchito ngati yowonjezera matenda. Zomwe zimachitidwa ndi kapamba, tikambirananso.

Kuperewera kwa chakudya m'magawo am'mimba kumachepetsa kwambiri zovuta za postoperative. Pomwepo patsiku la opareshoni, wodwalayo sangadye, amapatsidwa enema yotsuka, kenako kukonzekereratu kumachitika. Njira yotsirizayi imaphatikizapo kuperekera mankhwala othandizira kuti athandize wodwala kuyambitsa kulowetsedwa. Mankhwalawa amathetseratu mantha obera mankhwalawa, amathandizira kuchepetsa kutulutsa kwa gland komanso kupewa kutulutsa ziwopsezo zosiyanasiyana. Pachifukwa ichi, mitundu yosiyanasiyana ya mankhwala imagwiritsidwa ntchito, kuyambira pamtendere ndi ma antihistamines mpaka cholinolytics ndi antipsychotic.

Njira zotsatirazi ndi njira zochitira opaleshoni ya pancreatitis pachimake.

Mitundu ya njira zochitira opaleshoni ya kapamba

Mitundu yotsatirapo ya opaleshoni ya pancreatitis ilipo:

• Distal organ resection process. Panthawi ya chithandizo, dokotalayo amachotsa mchira, komanso thupi la kapamba. Ma voliyumu amawonekera ndi kuchuluka kwa zowonongeka. Kudzinyenga kotereku kumaonedwa kuti ndi koyenera panthawi yomwe chindoko sichikhudza thupi lonse. Zakudya za pancreatitis pambuyo pa opaleshoni ndizofunikira kwambiri.
• Kudzera kwamtunda kumatanthawuza kuti kuchotsedwa kwa mchira, kwambiri mutu wa kapamba ndi thupi lake. Komabe, magawo ena oyandikira duodenum ndi omwe amasungidwa. Izi zimachitika pokhapokha ndi mtundu wonse wa zotupa.
• Necrosecvest sahihiomy imagwira ntchito ngati gawo la kuwongolera kwa ultrasound, komanso fluoroscopy. Nthawi yomweyo, madzimadzi amapezeka m'goli, amayendetsa ngalande kudzera m'matumba apadera. Pambuyo pake, zimayambira zikuluzikulu zowerengeka kuti zitsuke mzerewo ndikutsata utupu. Monga gawo lomaliza la chithandizo, madontho akulu amakhazikika m'malo ang'onoang'ono, zomwe zimathandiza kuti pang'onopang'ono machiritso am'mimba atithandizire kutuluka kwamadzi. Zizindikiro za opaleshoni ya kapamba ziyenera kuyang'aniridwa mosamalitsa.

Pakati pazovuta zambiri, zotupa za purulent zimapezeka. Amatha kuzindikiridwa ndi zizindikiro izi:

Kukhalapo kwa mavuto

Pambuyo pakuchita opaleshoni ya kapamba, wodwalayo amapita kuchipatala chopatsa chidwi. Poyamba, amasungidwa kwambiri, komwe amathandizidwa, ndikuwunikira.

Kukhala bwino kwa wodwala mu maola makumi awiri ndi anayi oyamba kumapangitsa kuti pakhale zovuta za postoperative. Kuyang'anira kwamikodzo, kuthamanga kwa magazi, komanso hematocrit ndi shuga m'thupi. Njira zofunika zowunikira zimaphatikizapo x-ray ndi electrocardiogram ya mtima.

Patsiku lachiwiri, pokhapokha ngati ali ndi vuto lokwanira, wodwalayo amapititsidwa ku dipatimenti yopanga opaleshoni, komwe amapatsidwa chisamaliro chofunikira, limodzi ndi zakudya zoyenera komanso zovuta kuchita. Zakudya pambuyo pancreatitis opaleshoni amasankhidwa mosamala. Njira ya chithandizo chotsatira zimatengera kuuma, komanso, kupezeka kapena kusakhalapo kwa zotsatira zoyipa.

Opaleshoni amadziwa kuti wodwalayo amayenera kuyang'aniridwa ndi ogwira ntchito zamankhwala kwa mwezi umodzi ndi theka mpaka awiri atachitidwa opaleshoni. Nthawi ino nthawi zambiri imakhala yokwanira kulola kuti dongosolo la m'mimba ligwirizane ndi zosintha, komanso kubwerera ku ntchito yake yokhazikika.

Monga malingaliro a kukonzanso, odwala atatha kuyamwa amalangizidwa kuti azitsatira mosamalitsa, komanso kupumula pakama, kuwonjezera apo, odwala otere amafunika kupuma masana komanso kudya. Chofunikanso chimodzimodzi ndi mnyumba ndi banja. Madokotala amadziwa kuti achibale komanso abale amafunika kuthandizira wodwalayo. Njira zoterezi zithandizira wodwala kuti azikhala ndi chitsimikizo chifukwa chotsatira bwino pambuyo pake.

Pakatha milungu iwiri atatuluka m'chipatala, wodwalayo amaloledwa kupita panja, akuyenda mwachidule ndi njira yosavutikira. Iyenera kutsimikiziridwa kuti pakuchira, odwala saloledwa kugwira ntchito mopitirira muyeso. Zotsatira za opaleshoni ya kapamba zimaperekedwa pansipa.

Mankhwala othandizira pambuyo pake

Mwakutero, chithandizo cha algorithm pambuyo pa opaleshoni yolimbana ndi pancreatitis imatsimikiziridwa ndi zinthu zina. Pofuna kupereka chithandizo, dokotala amayang'anitsitsa mbiri yachipatala ya wodwalayo limodzi ndi zotsatira zomaliza za kulowererapo, kuchuluka kwa kubwezeretsa kwachimbudzi, zotsatira za mayeso a labotale ndi zida zothandizira kudziwa zamankhwala.

Ngati pakhale insulin yokwanira ya insulin, chithandizo cha insulin chitha kuphatikizidwanso. Mahomoni opanga amathandizira kubwezeretsa ndikupangitsa shuga kukhala m'thupi la munthu.

Ndikulimbikitsidwa kumwa mankhwala kuti muthandizire kukulitsa michere yokwanira, kapena muli nayo kale. Mankhwalawa amathandizira kuti magawo azigwira ntchito. Ngati mankhwalawa sakuphatikizidwa mu mankhwalawa, wodwalayo amatha kukhala ndi mawonekedwe monga kuwonjezereka kwa kapangidwe ka gasi limodzi ndi kutulutsa, kutsegula m'mimba ndi kutentha kwa mtima.

Ndi chiani chinanso chomwe chimaphatikizapo chithandizo chamankhwala othandizira kapamba?

Kuphatikiza apo, odwala amalimbikitsidwanso zochitika machitidwe a zakudya, achire olimbitsa thupi ndi physiotherapy. Zakudya zoyenera ndi njira yabwino kwambiri pakachira. Kuthana ndi zakudya mutatha kuyambiranso chiwalo chimaphatikizanso kusala kwa masiku awiri, ndipo tsiku lachitatu kusungirako zakudya kumaloledwa. Pankhaniyi, ndizovomerezeka kudya zotsatirazi:

• Tiyi yopanda shuga yokhala ndi zophera komanso msuzi wosenda.
• Porridge mkaka ndi mpunga kapena buckwheat. Pakuphika, mkaka uyenera kuchepetsedwa ndi madzi.
• Omeled yolimba, yokhala ndi mapuloteni okha.
• Mkate wouma dzulo.
• Mpaka magalamu khumi ndi asanu a batala patsiku.
• Tchizi chamafuta ochepa.

Asanagone, odwala amalimbikitsidwa kumwa kapu imodzi ya kefir yamafuta ochepa, yomwe nthawi zina imatha m'malo mwake ndi kapu yamadzi ofunda ndikuphatikizira uchi. Ndipo pokhapokha masiku khumi wodwala amaloledwa kuphatikiza nsomba kapena nyama zina menyu.

Kupita patsogolo kwa zamankhwala kwa opaleshoni ya kapamba chifukwa cha kapamba

Tsoka la munthu pambuyo pakuchita opaleshoni yamapenchi limatsimikiziridwa ndi zinthu zambiri, zomwe zimaphatikizapo opareshoni, njira za kukhazikitsidwa kwake komanso mtundu wa njira zochiritsira komanso zotsatsira, komanso, thandizo la wodwalayo payekha komanso zina.

Matenda kapena mkhalidwe wam'magazi, ngakhale uli mtundu wovuta kwambiri wa kutupa kwa kapamba kapena cyst, chifukwa chomwe mankhwalawa azachipatala adagwiritsidwa ntchito, monga lamulo, akupitilizabe kukhudzana ndi thanzi la munthu, komanso kutha kwa matendawa.

Mwachitsanzo, ngati kuyambiranso kumachitika chifukwa cha khansa, ndiye kuti pamakhala chiopsezo chobwereranso. Zomwe zikudziwikiratu zomwe zidzachitike pakadutsa zaka zisanu zomwe odwalawa ali nazo ndizokhumudwitsa ndipo zimafika mpaka pa khumi.

Ngakhale osagwirizana pang'ono ndi zomwe adotolo adachita, mwachitsanzo, kutopa kwakuthupi kapena m'maganizo, komanso nkhawa ya zakudyazo, zingakhudze mkhalidwe wa wodwalayo, kupangitsa kufalikira, zomwe zingayambitse kufa.

Chifukwa chake, moyo wa wodwalayo, komanso nthawi yake atachitidwa opareshoni kapamba, zimatengera mwachindunji kulangizidwa kwa wodwalayo ndikutsatira malangizo onse azachipatala.

Kodi kapamba amachitidwa? Tidazindikira kuti inde.