Matenda a biliary pancreatitis

. kapena: Biliary pancreatitis

Biliary-amadalira pancreatitis yayitali ndi miyezi yotalikirapo (kuposa miyezi 6) yamatenda omwe amayamba kulimbana ndi matenda komanso kubereka (kupezeka pobadwa) pathologies (kupatuka panjira yanthawi zonse) yam'mimba yodutsa (chikhodzodzo cha ndulu ndi ndulu ya bile - malekezero a mbali yomwe amayenda bile (madzimadzi omwe amapangidwa ndi chiwindi) ndikuwonetsedwa ndi kuchotsedwa kapena kutayika kwathunthu kwa zochitika za pancreatic (secretion ya mahomoni (zinthu zomwe zimayendetsa thupi) ndi ma enzymes (mapuloteni omwe amalimbikitsa michere imelo anachita mu chamoyo)).

Matendawa amadalira pancreatitis ya Biliary - ndizovuta zomwe zimayambitsa pafupifupi theka la matenda onse kapamba.

Zizindikiro za pancreatitis aakulu biliary-amadalira

Ululu - monga lamulo, lomwe limatuluka ngati biliary (hepatic) colic (kuwukira kwa kupweteka kwambiri pachimake hypochondrium ndi m'mimba chapamwamba, nthawi zambiri kumawonekera usiku ndipo nthawi zina kumawunikira (kufalikira) kumbuyo, phewa lamanja, phewa lakumanja, khosi). Kuukira kwa biliary colic nthawi zambiri imaphimbidwa ndi mawonekedwe a matenda (zizindikiro) za kapamba.
Zizindikiro za Dyspeptic (kutulutsa ndi / kapena kung'ung'udza pamimba, kupindika, mseru komanso kusanza).
Kutsekula m'mimba (pafupipafupi zotulutsa) - kawiri pa tsiku. Pondirayo ndi yochulukirapo, fetid, yokhala mosasintha mosy, imatha kukhala ya utoto ndipo imakhala ndi zotsalira zopanda chakudya (linterea), ndowe zimasanduka mafuta, ndipo sizitsukidwa bwino bwino kukhoma la chimbudzi cha chimbudzi (cholembera).
Jaundice wowopsa (wachikasu pakhungu, mapuloteni am'mimba ndi sclera (mapuloteni amaso) chifukwa cha kuchuluka kwa magazi ndi minyewa ya bilirubin (bile pigment (utoto)), chifukwa cha kutsekeka kwa ndulu ya bile (magawo omwe bile limatulutsira madzi) .
Matenda a shuga.
Kuchepetsa thupi.

Zifukwa Matenda otsatirawa amatha kukhala pancreatitis yotsalira.

Matenda a Gallstone.
Anomalies (zosokoneza masanjidwe) a ducts ya bile.
Hypokinesia ya ndulu (kuphwanya kwachilendo kwa ndulu, chifukwa chake bile limatulutsidwa mu duodenum).
Osawerengeka (wopanda miyala, ndiye kuti, samapanga miyala) cholecystitis (kutupa kwa ndulu).
Matenda a chiwindi.
Papillitis (kutupa kwa kamwa ya duodenal papilla yayikulu - mapangidwe a anatomical a duodenum 12, mothandizidwa ndi omwe madzi a pancreatic ndi bile amalowamo.
Kuphipha (kupindika kosaleka) kwa sphincter ya Oddi (minyewa yooneka ngati mphete yomwe ili mkati mwa duodenal papilla).
Zingwe (zopitilizitsa) za papilla wamkulu.
Kutalika (kufalikira) kwa duodenal papilla yayikulu ndi mwala, chotupa, majeremusi (zolengedwa zomwe zikupezeka ndikuchotsa zolengedwa zina).

Zinthu oyambitsa kupweteka kwamankhwala pancreatitis a biliary amadalira:

kugwiritsidwa ntchito kwa zinthu zomwe zimakhala ndi choleretic (kukulitsa kapangidwe ka bile), - caviar, yolk ya mazira, ndi zina zambiri,
kumwa mankhwala a choleretic (kuphatikizapo azitsamba),
kuwonda msanga.

Dokotala wazachipatala amathandizira pochiza matendawa

Zizindikiro

Kusanthula kwa mbiri ya wodwala wodandaula ndi madandaulo ake (liti (nthawi yayitali) ululuwu udawoneka mu hypochondrium ndi m'mimba chapamwamba, mseru ndi kusanza, kutulutsa, kuyamwa, kutsegula m'mimba (pafupipafupi zotulutsa), kuchepa thupi, komwe wodwalayo amaphatikizana ndi zomwe zimachitika) .
Zambiri zasayansi.
- Kuyesedwa kwa magazi kwachipatala kokwanira: kuchuluka kwa magazi a leukocytes (maselo oyera am'magazi), kuchuluka kwa maselo ofiira a magazi (maselo ofiira a magazi) - chisonyezo cha zasayansi chomwe chikuwonetsa kukhalapo kwa kutupa mthupi (ESR). Zochitika izi zimawonedwa, monga lamulo, pa kuchuluka kwa matendawa.
- Kusanthula kwa magazi pa zinthu zosiyanasiyana: kuchuluka kwa shuga m'magazi (shuga), lipase (puloteni yomwe imathandizira kusintha kwamphamvu mu thupi), yomwe ikuphatikizidwa ndi kuphwanya mafuta), amylase (enzyme yomwe ikukhudzana ndi kuwonongeka kwa chakudya cham'mimba), trypsin ndi elastase I (ma enzymes omwe amaphatikizidwa mu kuwonongeka kwa mapuloteni), chiwindi transaminases (alanine aminotransferase (ALT) ndi aspartate aminotransferase (AST)) - mapuloteni omwe amathandizira pakusinthana kwa amino acid (mamolekyu omwe amapanga mapuloteni) ndikulowa m'magazi pomwe minofu ya chiwindi imawonongeka, gamma-glutamyltranspeptidase (mphamvu ya chiwindi ndi kapamba, kuchuluka kwa komwe m'magazi kumachulukanso ndi matenda a chiwindi), bilirubin ( bile pigment (chinthu cha utoto), chotengera kuwonongeka kwa maselo ofiira am'magazi), alkaline phosphatase (enzyme ya chiwindi, kuwonjezeka kwa gawo lomwe m'magazi limawonetsa kuwonongeka kwa minofu yake).
- Kusanthula kwakanthawi kachipatala: mkodzo wakuda (mtundu wa mowa wamdima) chifukwa cha kupezeka kwa bilirubin mmenemo. Mu mkodzo, shuga yemwe sapezeka mwazonse (wokhala ndi matenda oopsa a shuga) amatha kupezeka.
- Kawunikidwe ena azachipatala angawonetse kuphwanya kwa kapangidwe ka kapamba. Nkhani yowonjezera mu chopondera chamafuta osagwiritsika ntchito (mafuta m'zakudya zomwe sizinayesedwe kapena kusakanizidwa ndi kuchotseredwa osasinthika), mafuta acids, ndi fiber yoperewera (fiber fiber) ingadziwike.
- Kuyesedwa kwa Secretin-pancreosimine (cerulein) - kumakhala ndi njira yolimbikitsira ntchito (ntchito yopanga chakudya cham'mimba) cha kapamba chifukwa cha kutsekeka kwa ndulu ya secretin (timadzi tomwe timayambitsa katulutsidwe ka madzi a pancreatic), ndipo patatha mphindi 30 - cholecystokinin (mahomoni opangidwa poyankha chakudya cham'madzi mu duodenum ndikupangitsa kupendekeka kwa ndulu komanso kupanga ma enzymeri amphika pancreatic. Kuchuluka kwa katulutsidwe (zinthu zobisika) pakupeza 6 zomwe zili mu duodenum 6, kuchuluka kwa ma bicarbonates (mchere womwe umapangidwa ndi kapamba) koyambirira 3 ndi ma enzyme mu ma seva atatu omaliza akuyerekezedwa. Kuyeseraku kumagwiritsidwa ntchito poyesa magwiridwe antchito a kapamba (kuthekera kwa thupi ili kuchita nawo chimbudzi).
Zambiri Zachida. Pali njira zambiri, ndipo sizomwe zimagwiritsidwa ntchito kuti azindikire pancreatitis yochokera ku biliary - zambiri mwa izi ndizotsatirazi.
- Kufufuza kwa Ultrasound (ultrasound) kwam'mimba ndikosagwira (popanda kulowa mkati mwa khungu kapena mucous). Amakulolani kuti muwone kusintha kwa minofu ya kapamba, kutsekeka kwa ndulu ya bile, kupezeka kwa miyala mu chikhodzodzo.
- Computed tomography (CT) yam'mimba ndi njira yomwe imakuthandizani kuti mufufuze ziwalo zosiyanasiyana m'magawo ogwiritsira ntchito radiation ya x-ray. CT imagwiritsidwa ntchito kuwunika mkhalidwe wa kapamba ndi ziwalo zoyandikana, kuzindikira kutsekeka kwa duct ya bile, miyala mu chikhodzodzo cha ndulu.
- Magnetic resonance imaging (MRI) ndi njira yophunzitsira kwambiri matenda ake. Amagwiritsidwa ntchito makamaka pophunzira njira za pathological (kulibe momwe zimakhalira) mu minofu yofewa (minofu, ziwalo zamkati). Ntchito yodziwitsa za MRI mu biliary-amadalira pancreatitis ndi yofanana ndi ya CT.
- Transabdominal ultrasonography (TUS) ndi njira yodziwira matenda a pancreatic, momwe kuwunika kumachitidwa kudzera khoma lam'mimba (khoma lakutsogolo kwa m'mimba). Amakulolani kuti mufufuze momwe minofu ya pancreatic ilili, duodenal papilla yayikulu (anatomical mapangidwe a duodenum 12, omwe bile (madzimadzi opangidwa ndi chiwindi) ndi madzi a pancreatic amalowa mu duodenum 12), kuti azindikire kutsekeka kwa ndulu ya bile, kukhalapo kwa miyala mu ndulu kuwira.
- Endoscopic ultrasonography (EUS) ndi njira yodziwira matenda a pancreatic, momwe kuwunika kumachitika kudzera m'makoma am'mimba ndi duodenum. Ntchito yofufuzira matenda ndi yofanana ndi ya TUS. Amagwiritsidwa ntchito pazochitika pamene pa TUS sikutheka kupenda mwatsatanetsatane kapamba ndi duodenal papilla yayikulu (kufalikira), kwa odwala onenepa kwambiri.
- X-ray yam'mimba - Kuyesa kwam'mimba pogwiritsa ntchito x-ray. Amakulolani kuti mufufuze momwe ziphuphu zimakhalira komanso ziwalo zapafupi, kuti mudziwe kupezeka kwa miyala mu chikhodzodzo.
- Endoscopic retrograde cholangiopancreatography (ERCP) ndimaphunziro a bile and pancreatic ducts. Pogwiritsa ntchito chida chapadera cha fibrogastroduodenoscope, ma ducts amadzazidwa ndi sing'anga yosiyana, magawidwe ake amatha kuwoneka pogwiritsa ntchito x-ray. Kafukufukuyu amathandiza kudziwa kuyipa kwa kutuluka kwa bile ndi kapamba wa pancreatic (madzi a pancreatic).
- Magnetic resonance pankeratocholangiography (MRPHG, njira yowunika ma ducts a bile, omwe amalola kuti awone ngati ali ndi zotupa komanso kuti adziwe ngati ali ndi zotupa.
- Percutaneous transhepatic cholangiography ndikuwunika kosatha kwa mapangidwe a bile ducts pambuyo poyendetsa ayodini wokhala ndi zosiyana pakati.
- Intravenous cholangiocholecystography ndi njira ya X-ray yomwe imagwiritsidwa ntchito poyang'ana ma ducts a intra- ndi exthepatic bile. Ndi njira yofufuzira iyi, wothandizira wosiyanayo amaperekedwa ngati jekeseni.
- Angiography yamitsempha yama visceral - njira yowunika ma x-ray pamitsempha yamagazi, imagwiritsidwa ntchito poyesa kuchuluka kwa mitsempha yomwe imadyetsa ziwalo zam'mimba.
- Scintigraphy ndi positron emission tomography ndi njira zomwe ma radioactive (kupatula ionizing - zomwe zimapangitsa kupangidwa kwa tinthu tating'onoting'ono - ma radiation) zimalowetsedwa m'thupi kuti mupeze chithunzi.
Kulumikizana ndi akatswiri othandizirawa ndi kothekanso.

Chithandizo cha matenda a biliary amadalira pancreatitis

Gawanani chosasintha ndi opaleshoni mankhwala a matenda,komanso Malangizo ambiri.

Malangizo onse.
- Zakudya zamankhwala. Zakudya ziyenera kuchitika pa moyo wonse - tebulo nambala 5p molingana ndi Pevzner (chakudya chomwe chili ndi mapuloteni ambiri osakanikirana (koma osapitirira 110 g / tsiku), mavitamini ndi michere ndi kuletsa kwamafuta (makamaka nyama). Ngati matenda akuchulukirachulukira, odwala samangodya chakudya chilichonse kwa masiku atatu, amaloledwa kumwa madzi osowa a carbonated alkaline.
- Kukana mowa.

Chithandizo cha Conservative ikuchitika kuti athetse zizindikiro za matendawa.
- Substitution chithandizo (mankhwala omwe cholinga chake ndi kubwezera omwe atayika kapena ofooka a exocrine (mawonedwe) ntchito ya kapamba - chinthu chomwe chimaphwanya chakudya ndi mafuta). Kuchulukitsa kwa mankhwala kumachitika popanda kuchulukitsa ndipo kumachitika pogwiritsa ntchito michere yopanga michere (mapuloteni omwe amaphwanya michere (mapuloteni, mafuta, michere) ndipo amatsekedwa).
- Thandizo labwino la wodwalayo panthawi yowonjezera ndikulowetsa mu thupi la zosakanikirana zopatsa thanzi ndi njira zochizira.
- Analgesic (painkillers) ndi mankhwala antiemetic - amagwiritsidwa ntchito kuthetsa / kuthetsa ululu, nseru ndi kusanza.
- Mankhwala a Antisecretory - amagwiritsidwa ntchito pochepetsa kupanga madzi a m'mimba.
- Mankhwala a antibacterial - amatchulidwa kuti apewe matenda osokonezeka.
- Malangizo a glycemia (mulingo wa shuga) m'magazi - - kukhalabe ndi glucose woyenera m'magazi.
Mankhwala othandizira ikuchitika ndi kuwerengetsa cholecystitis (kukhalapo kwa miyala mu ndulu) ndipo imachitika m'njira ziwiri:
- chakale (laparotomy) - khomo lakunja lam'mimba limatsegulidwa, ndipo chikhodzodzo chokhudzidwa chimachotsedwa limodzi ndi miyala.
- laparoscopic - machitidwe onse amachitidwa kudzera m'makina am'mimba (0.5-1,5 cm) khoma lam'mimba, ndikugwiritsa ntchito zida zamakanema, ndipo dokotala wofufuzira akuwunika momwe opaleshoni ikugwiritsidwira ntchito pakanema.

Matenda a parenchymal biliary amadalira pancreatitis

Kusanthula kwa mbiri ya wodwala wodandaula ndi madandaulo ake (liti (nthawi yayitali) ululuwu udawoneka mu hypochondrium ndi m'mimba chapamwamba, mseru ndi kusanza, kutulutsa, kuyamwa, kutsegula m'mimba (pafupipafupi zotulutsa), kuchepa thupi, komwe wodwalayo amaphatikizana ndi zomwe zimachitika) .
Zambiri zasayansi.
- Kuyesedwa kwa magazi kwachipatala kokwanira: kuchuluka kwa magazi a leukocytes (maselo oyera am'magazi), kuchuluka kwa maselo ofiira a m'magazi (ma cell ofiira am'magazi) ndizowonetsera zomwe zikuwonetsa kukhalapo kwa kutupa mthupi (ESR). Zochitika izi zimawonedwa, monga lamulo, pa kuchuluka kwa matendawa.
- Kusanthula kwamwazi mu magazi: kuwonjezeka kwa shuga m'magazi (shuga), lipase (puloteni yomwe imathandizira zimachitika mu thupi) kuthana ndi kuphwanya kwamafuta, amylase (enzyme yomwe ikukhudzidwa ndi kuwonongeka kwa ma carbohydrate), trypsin ndi elastase I (ma enzymes omwe akukhudzidwa mu kuwonongeka kwa mapuloteni), chiwindi transaminases (alanine.
  amawonetsa kuwonongeka kwa minofu yake).
- Kusanthula kwakanthawi kachipatala: mkodzo wakuda (mtundu wa mowa wamdima) chifukwa cha kupezeka kwa bilirubin mmenemo. Mu mkodzo, shuga yemwe sapezeka mwazonse (wokhala ndi matenda oopsa a shuga) amatha kupezeka.
- Kawunikidwe ena azachipatala angawonetse kuphwanya kwa kapangidwe ka kapamba. Nkhani yowonjezera mu chopondera chamafuta osagwirizana (mafuta m'zakudya zomwe sizinayesedwe kapena kusakanizidwa ndi kuchotseredwa osasinthika), mafuta acids, ndi fiber yoperewera (fiber fiber) ingadziwike.
- Kuyesedwa kwa Secretin-pancreosimine (cerulein) - kumakhala ndi njira yolimbikitsira ntchito ya pancreas ndi kachulukidwe kake kamene kamayikidwa mkati mwa cellin (timadzi tomwe timayambitsa kutulutsa madzi a pancreatic), ndipo patatha mphindi 30 - cholecystokinin (mahomoni opangidwa poyankha chakudya cham'madzi mu duodenum ndikupangitsa kupendekeka kwa ndulu komanso kupanga ma enzymeri amphika pancreatic. Kuchuluka kwa secretion (chinthu chobisalira) muzomwe mudalandira 6 za zomwe zili mu duodenum 6, kuchuluka kwa ma bicarbonates (mchere womwe umapangidwa ndi kapamba) koyambirira 3 ndi ma enzyme mu ma seva atatu omaliza akuyerekezedwa. Kuyeseraku kumagwiritsidwa ntchito poyesa magwiridwe antchito a kapamba (kuthekera kwa thupi ili kuchita nawo chimbudzi).
Zambiri Zachida.Pali njira zambiri, ndipo sizomwe zimagwiritsidwa ntchito kuti azindikire pancreatitis yochokera ku biliary - zambiri mwa izi ndizotsatirazi.
- Kufufuza kwa Ultrasound (ultrasound) kwam'mimba ndikosagwira (popanda kulowa mkati mwa khungu kapena mucous). Amakulolani kuti muwone kusintha kwa minofu ya kapamba, kutsekeka kwa ndulu ya bile, kupezeka kwa miyala mu chikhodzodzo.
- Computed tomography (CT) yam'mimba ndi njira yomwe imakuthandizani kuti mufufuze ziwalo zosiyanasiyana m'magawo ogwiritsira ntchito radiation ya x-ray. CT imagwiritsidwa ntchito kuwunika mkhalidwe wa kapamba ndi ziwalo zoyandikana, kuzindikira kutsekeka kwa duct ya bile, miyala mu chikhodzodzo cha ndulu.
- Magnetic resonance imaging (MRI) ndi njira yophunzitsira kwambiri matenda ake. Amagwiritsidwa ntchito makamaka pophunzira njira za pathological (kulibe momwe zimakhalira) mu minofu yofewa (minofu, ziwalo zamkati). Ntchito yodziwitsa za MRI mu biliary-amadalira pancreatitis ndi yofanana ndi ya CT.
- Transabdominal ultrasonography (TUS) ndi njira yodziwira matenda a pancreatic, momwe kuwunika kumachitidwa kudzera khoma lam'mimba (khoma lakutsogolo kwa m'mimba). Amakulolani kuti mufufuze momwe minofu ya pancreatic ilili, duodenal papilla yayikulu (anatomical mapangidwe a duodenum 12, omwe bile (madzimadzi opangidwa ndi chiwindi) ndi madzi a pancreatic amalowa mu duodenum 12), kuti azindikire kutsekeka kwa ndulu ya bile, kukhalapo kwa miyala mu ndulu kuwira.
- Endoscopic ultrasonography (EUS) ndi njira yodziwira matenda a pancreatic, momwe kuwunika kumachitika kudzera m'makoma am'mimba ndi duodenum. Ntchito yofufuzira matenda ndi yofanana ndi ya TUS. Amagwiritsidwa ntchito pazochitika pamene pa TUS sikutheka kupenda mwatsatanetsatane kapamba ndi duodenal papilla yayikulu (kufalikira), kwa odwala onenepa kwambiri.
- X-ray yam'mimba - Kuyesa kwam'mimba pogwiritsa ntchito x-ray. Amakulolani kuti mufufuze momwe ziphuphu zimakhalira komanso ziwalo zapafupi, kuti mudziwe kupezeka kwa miyala mu chikhodzodzo.
- Endoscopic retrograde cholangiopancreatography (ERCP) ndimaphunziro a bile and pancreatic ducts. Pogwiritsa ntchito chida chapadera cha fibrogastroduodenoscope, ma ducts amadzazidwa ndi sing'anga yosiyana, magawidwe ake amatha kuwoneka pogwiritsa ntchito x-ray. Kafukufukuyu amathandiza kudziwa kuyipa kwa kutuluka kwa bile ndi kapamba wa pancreatic (madzi a pancreatic).
- Magnetic resonance pankeratocholangiography (MRPHG, njira yowunika ma ducts a bile, omwe amalola kuti awone ngati ali ndi zotupa komanso kuti adziwe ngati ali ndi zotupa.
- Percutaneous transhepatic cholangiography ndikuwunika kosatha kwa mapangidwe a bile ducts pambuyo poyendetsa ayodini wokhala ndi zosiyana pakati.
- Intravenous cholangiocholecystography ndi njira ya X-ray yomwe imagwiritsidwa ntchito poyang'ana ma ducts a intra- ndi exthepatic bile. Ndi njira yofufuzira iyi, wothandizira wosiyanayo amaperekedwa ngati jekeseni.
- Angiography yamitsempha yama visceral - njira yowunika ma x-ray pamitsempha yamagazi, imagwiritsidwa ntchito poyesa kuchuluka kwa mitsempha yomwe imadyetsa ziwalo zam'mimba.
- Scintigraphy ndi positron emission tomography ndi njira zomwe ma radioactive (kupatula ionizing - zomwe zimapangitsa kupangidwa kwa tinthu tating'onoting'ono - ma radiation) zimalowetsedwa m'thupi kuti mupeze chithunzi.
Kulumikizana ndi akatswiri othandizirawa ndi kothekanso.

Gawo lalikulu la matenda a parenchymal aakulu ndi njira yonga mafunde, i.e. magawo ochulukirachulukira amasinthidwa nthawi zonse ndi kuchotsedwa, pomwe wodwalayo amva kupumula. Vutoli limaphatikizidwa ndi kuchulukana pamene masinthidwe osasintha amasintha m'thupi: minofu ya kapamba imakhala yocheperako, kutsekeka kwina, ndi zina zotere.

Pali kutupa ndi pachimake parenchymal kutupa. Mawonekedwe owopsa a matendawa amadziwika ndi kukula msanga komanso zopweteka. Pancreatitis yosatha ndi njira yotupa yopanda zizindikiro zowopsa.

Pali gulu lina. Matendawa ali ndi code malinga ndi ICD-10 - K86, njira zotsatirazi zamatenda a patrenchymal matenda ndizodziwika bwino:

mawonekedwe a parenchymal (njira ya asymptomatic),
mtundu wobwereza (kupweteka kwambiri, makamaka pakukokosera),
kuwona kwamalingaliro (kumapangidwa motsutsana ndi maziko a pafupipafupi a chifuwa cham'mimba).

Parenchymal pathology imatha kudzetsa kukula kwa zovuta, chifukwa chake ndikofunikira kuzindikira matendawa pachiwopsezo ndikuletsa kupititsa patsogolo kwake. Ntchito yayikulu ya wodwalayo ndikukulitsa nthawi yachikhululukiro momwe angathere.

Zomwe zimachitika

Pali zinthu monga kutupa parenchymal kutupa. Matendawa amayamba chifukwa cha zinthu zakunja zomwe sizigwirizana ndi ntchito ya kapamba.

Kupsinjika kwapafupipafupi, kuperewera kwa chakudya, kusuta, kumwa mowa, ndi zina zotere kumatha kubweretsa chitukuko cha matenda akumiseche. Ngati nthendayo idayambitsidwa ndi matenda ena amthupi (monga pachimake kapamba, zilonda zam'mimbazi, matenda am'matumbo), ndiye kuti iyi ndi njira yachiberekero ya matenda a parenchymal.

Zoyambitsa matendawa:

kumwa mowa (oposa theka la odwala omwe ali ndi vuto la uchidakwa),
kusokonezeka kwa metabolic (kukulira kwa dysmetabolic pancreatitis kumatha kuputa cystic fibrosis kapena magazi okwera),
mavuto ndi biliary system (biliary, kapena biliary, pancreatitis angayambitse matenda monga hepatitis, cholecystitis, dystonia ya biliary trailer, gallstone matenda,
matenda oyambitsidwa ndi ma virus (ngati muli ndi matenda a kapamba),
vuto la autoimmune (chitetezo cha mthupi chimateteza ma antibodies kuti awononge ma cell a pancreatic, chifukwa amawaona ngati achilendo),
poyizoni wa mankhwala oopsa,
kuphwanya kutuluka kwa ndulu ndi katemera wa pancreatic,
cholowa.

Nthawi zina ndizosatheka kukhazikitsa yankho lenileni la kutupa kwa parenchymal.

Zizindikiro ndi mawonetseredwe azachipatala

Kwa matenda a parenchymal mu chikhululukiro, kusowa kwa zisonyezo zodziwika ndichizolowezi. Mawonetseredwe azachipatala amawonetsedwa pokhapokha akuwonjezera vutolo. Potere, zizindikirazi zimatengera kusintha kwatsatanetsatane m'thupi.
Zizindikiro zodziwika bwino za kutupa kwa parenchymal zomwe zimachitika pachimake:

Kupweteka kwam'mimba. Kumverera kwadzuwa kumadzuka mbali yakumanzere pansi pa nthiti mutatha kudya kwambiri kapena kumwa mowa.
Matumbo osokoneza bongo, omwe amafotokozeredwa ndi malo osakhazikika, kutulutsa magazi, nseru, kusanza. Pazinyalala za wodwalayo mutha kuwona zotsalazo zopanda chakudya.
Kusokoneza, kumverera kufooka, kugona.
Malo ofiira amatha kuwoneka pamimba.
Khungu limatha kukhala ndimtambo wachikasu.
Kuchepetsa kwambiri thupi, komwe kumatha kuphatikizidwa ndi exocrine kusakwanira. Kuchepetsa kwa michere yamagetsi kumakhudza chimbudzi cha chakudya, chifukwa choti thupi limataya michere yoyenera. Kuphatikiza apo, chifukwa cha kupweteka nthawi zonse mukatha kudya, wodwalayo amadya kangapo.
Matenda a shuga. Matendawa amayamba ndi kuwonongeka kwa kapamba padziko lonse lapansi (80% kapena kuposerapo).

Ngati zizindikiro zimawonedwa nthawi ndi nthawi, ndiye kuti matenda amtundu wa parenchymal amadziwika, omwe amadziwika ndi izi:

Kuchulukitsa kumachitika pakatha miyezi 4-5,
ngati mumatsatira zakudya zosasunthika, zizindikiro zamatendawa zimawonekera kofatsa.

Kuti mupeze matenda a parenchymal pathology, ndikofunikira kukaonana ndi dokotala, makamaka ngati pali zizindikiro zingapo nthawi imodzi.

Kodi aakulu parenchymal pancreatitis

Matenda a parenchymal pancreatitis Ndi matenda am'mimba omwe amakhudza minofu ya kapamba. Matendawa omwe ali ndi chithandizo mosayembekezereka amakhala pang'onopang'ono ndipo amachepetsa kwambiri magwiridwe antchito.

Parenchymal kapamba amadziwika kuti kwanthawi yayitali zimakhala asymptomatic, pomwe mu gland mumakhala kutupa komwe kumapangitsa kutupa kwa parenchyma, komwe kumapangitsa kusintha kwa atrophic mu minofu yomwe. Nthawi zachulukidwe zimasinthana ndi nthawi ya thanzi lathunthu - kuchotsedwa.

Zizindikiro za parenchymal pancreatitis

Ganizirani za matenda a parenchymal pancreatitis:

Khansa ya m'mimba mutatha kudya, makamaka mukamadya mowa, mafuta, zakudya zokazinga,
Shingles mutatha kudya,
Kukhazikika ndi kupindika pamimba yonse,
Mpumulo wa pondapo ndi mushy wokhala ndi mawanga am'mafuta komanso ulusi wosapindika.

Ndi nthawi yayitali ya matendawa, kuwonda kumawonedwa, chifukwa chophwanya chimbudzi cha chakudya.

Zizindikiro za biliary-kudalira kapamba

Mtundu umodzi wamatenda a pancreatic ndi matenda a parenchymal biliary-amadalira kapamba. Pancreatitis yamtunduwu imakhala gawo limodzi mwa magawo atatu a matenda. Amayamba ngati chifukwa chodwala matenda amisempha.

Choyambitsa Biliary Pancreatitis:

Cholecystitis
Matenda a Gallstone ndi cholecystitis yowerengeka,
Cholangitis ndikulira kwa ma ducts a bile.

Zizindikiro za biliary-kudalira parenchymal kapamba:

Epigastric ululu 2 mawola atatha kudya
Kusanza ndi kusanza pambuyo pakulakwitsa mu zakudya,
Zowawa mkamwa ndi mkamwa mwake ndi zoyera kapena zoyera,
Kudzimbidwa kosinthana ndi kumasula kwa chopondapo
Kukweza kutentha kwa thupi mpaka madigiri 37,
Kutupa ndi matumbo kukokana.

Kuphatikiza pa zodandaula zazikulu, zizindikiro za cholecystitis kapena cholelithiasis zimawonjezedwanso - kupweteka kwa hypochondrium pambuyo podya zakudya zamafuta, kukwiya kwamapazi kumapeto kwa phewa, kumbuyo, kulemera mu hypochondrium yoyenera, mawonekedwe a jaundice, kuphatikiza kwa kupweteka komanso kuperewera kwa colic.

Mbiri ya matenda osakhalitsa parenchymal biliary amadalira pancreatitis amayamba ndi kupezeka kwa matenda osachiritsika cholecystitis.

Njira yodziwitsa pancreatitis

Kuzindikira matenda a kapamba amayamba ndi kafukufuku, komanso kufufuza mokwanira kuchipatala. Ganizirani kusintha komwe kumayambitsa pancreatitis:

Kusanthula ndowe za patrology - pakuwunika ndowe, ulusi wosapangidwira chakudya wapezeka, komanso kupezeka kwa madontho amafuta,
Kuyesa kwa magazi pa zamankhwala amodzi - kumawonjezera mulingo wa amylase,
Kusanthula kwamkodzo amylase - kuwonjezeka kangapo pamlingo,
Kuyesa kwa Ultrasound kwam'mimba (UZO OBP) - kuwulula masinthidwe am'mimba pancreatic parenchyma. Ndi biliary-pancreatitis yodalira, kufooka kwa ndulu, ndulu zake komanso miyala mwina zimawululidwanso.
Kuyesedwa kwa magazi kwa glucose - nthawi zambiri, ndi zotupa zam'mimba za kapamba, zida zake zachinsinsi zimakhudzidwanso. Mwanjira imeneyi, insulin yokwanira imayamba ndipo mtundu wa 2 shuga umayamba.

Pa matenda a magazi ndi mkodzo, monga lamulo, masinthidwe apadera a kapamba sapezeka.

Chithandizo cha parenchymal ndi biliary-pancreatitis

Chithandizo cha pancreatitis chimayamba ndikusankhidwa kwa zakudya zam'magazi komanso kupezeka kwa zakumwa zilizonse.

Magulu a mankhwala omwe amaphatikizira chithandizo cha kapamba:

Mankhwala omwe amachepetsa kupanga hydrochloric acid m'mimba - Omeprazole, Rabeprazole, Esomeprazole,
Mankhwala a antispasmodic amasonyezedwa ululu. Lemberani No-shpa, Platifillin, Papaverine,
Prokinetics forony ya m'mimba thirakiti - Domperidone, Metoclopravid. Amathandizira matumbo kuyenda ndikuthamangitsa gawo lazakudya kudzera m'matumbo. Chifukwa chake, mayendedwe achilengedwe ndi kusayenda amachepetsa.
Kuthandizira kwa ulesi kumachitika ndi kukonzekera kwa enzymatic. Kuti muchite izi, gwiritsani ntchito michere ya proteinolytic, lipolytic ndi amylolytic yomwe imaphwanya mapuloteni, mafuta, chakudya.

Ndi biliary-pancreatitis yodalira, chithandizo cha ndulu ndi matenda a chiwindi chimachitika nthawi yomweyo.

Mawonekedwe a zakudya zoyenera

Ndi matenda a parenchymal, ndikofunikira kudya moyenera, popeza kutsatira kwambiri zakudya zopatsa thanzi kumakupatsani mwayi wokuiwalani za mawonetseredwe azachipatala kwa nthawi yayitali. Nthawi yomweyo, zakudya ndizofunika kwambiri kuposa chithandizo chamankhwala.

Ndi kutupa kwa parenchymal, chakudya chomwe chikuyenera kukhazikitsidwa chimakhazikitsidwa pam mfundo izi:

idyani kangapo ka 5-6 patsiku,
kumwa malita 1.5-2 amadzimadzi,
idyani zakudya zazing'ono
mbale ziyenera kukhala zochepa m'malori
Sizoletsedwa kudya zotentha kapena kuzizira (chakudya chizikhala ndi kutentha kwakukulu),
mukamaphika, pukutani mankhwalawo momwe mungathere kuti asakhumudwitse m'mimba (ndizoletsedwa kugwiritsa ntchito zopangidwa ndi fibrous ndi mawonekedwe oyipa, CHIKWANGWANI),
mbale zowotchera, zophika ndi zophika,
yang'anirani zakudya za mapuloteni, pomwe mafuta ndi zakudya zimayenera kudyedwa pang'ono.

Zakudyazo siziyenera kukhala ndi nyama yamafuta ndi nsomba, zophika, nyama zosuta, nyemba ndi zipatso. Zakudya zonunkhira ndizoletsedwa.
Pazakudya, ndikofunikira kuyang'ana pa:

masamba ndi zipatso
Mitundu yamafuta ochepa ndi nyama ndi nsomba,
mbewu zosenda
ma supu mucous (ayenera kupezeka pamenyu tsiku lililonse),
masamba purees.

Zogulitsa zimasankhidwa mwanjira yoti zimakhutitsa thupi ndi mavitamini ndi mchere wofunikira.

Zakudya panthawi yachikhululukiro sizikhala zolimba ngati nthawi yochulukirapo, ndipo ziyenera kuletsa kukula kwa njira yotupa.

Zosankha zikukula. Mndandanda wazakudya zomwe mungadye uyenera kuvomerezedwa ndi adokotala, motsogozedwa ndi kusanthula kwa odwala.

Mavuto

Ndikofunikira kuzindikira matenda a parenchymal pathological momwe angathere. Ndikwabwino ngati iyi ndi nthawi yoyambirira. Chithandizo chokwanira cha mankhwala osokoneza bongo ndi zakudya zimabwezeretsa yeniyeni ntchito ya gland, kupewa matenda ophatikizana. Kutupa kwa makolo ndi kowopsa ndi zovuta zake, popeza ndizovuta kuchitira. Mu chithandizo chamankhwala, nthawi zambiri amathandizira opaleshoni.

Matenda a Parenchymal angayambitse kukula kwa matenda osiyanasiyana:

matenda ashuga
neoplasm mu minofu ya England, amene amakhala ndi mawonekedwe
Njira yosasangalatsa kwambiri ndi khansa,
kukhumudwa kwa m'mimba, komwe kumatha kulowa pachilonda.
matenda a ndulu
colitis (m'matumbo akulu amadzaza)
cholecystitis
matenda a chiwindi, etc.

Mu gawo la chikhululukiro, matenda a parenchymal samapezeka kawirikawiri, chifukwa zizindikiro zake sizikupezeka. Ndikotheka kuzindikira kutupa kwa parenchyma pokhapokha gawo la pachimake, pomwe chithunzi cha chipatala chikuwonetsedwa ndi mawonekedwe amunthu.

Kupewa

Nthawi zambiri zomwe zimayambitsa matenda a parenchymal path ndi njira yolakwika yonyalanyaza thanzi la munthu. Matenda aliwonse amatha kuthandizidwa poyambira chitukuko, ndikofunikira kuti mumayesedwa ndi dokotala nthawi zonse.

Kuti kapamba akhale wathanzi komanso wogwira ntchito mokwanira, ndikofunikira kudya moyenera, kusiya zizolowezi zoyipa, ndikuyesera kupewa zovuta.

Anna, wazaka 47, Chiwombankhanga

Ndimakonda kudya nthawi zonse, pokhapokha nthawi zina ndimangolola. Pa chakudya cham'mawa, ndimadya oatmeal pamadzi ndi sangweji tchizi, ndipo ndimadya masana, onetsetsani kuti mwaphika.

Katya, wazaka 28, Voronezh

Ndimadya, monga kale, koma yesani kudya zochepa yokazinga. Ndimachepetsa mchere komanso zonunkhira. Kwa zowawa, sindidya kanthu kwa masiku angapo. Zimathandiza.

Yuri, wazaka 33, Kemerovo

Nditachulukitsa, ndinatsatira kudya kwamphamvu pafupifupi miyezi itatu. Tsopano ndikudya chilichonse; pachakudya chamadzulo, ndili ndi chitsimikizo. Ululu umachitika pokhapokha ndimamwa mowa. Ndimayesetsa kudziletsa, koma sindimadziletsa nthawi zonse.

Mbiri yazachipatala

Odwala omwe ali ndi cholelithiasis posakhalitsa amakumana ndi kuchulukitsa kwa matendawa. Koma hepatic colic wadutsa, ndipo wodwalayo sabwerera wamba.

Kusanza, kusanza, kupweteka kupweteka kwakumanzere kwa hypochondrium, mpaka kumbuyo, - ochepa mwa zizindikiro za nthendayi yodwala. Umu ndi momwe biliary pancreatitis imadziwonekera.

Nthawi zambiri matendawa amakhala owopsa. Nthawi zambiri, kuukira kumachitika usiku. Munthu wodabwitsidwa modzidzimuka, akumva kupweteka kwambiri komanso ali ndi mseru kwambiri amatha wodwala mphindi zochepa. Kuukira kumeneku kumadzetsa chakudya chochuluka ndi mowa, zakudya zozizira komanso zamafuta, zakumwa zoziziritsa kukhosi.

Matendawa samakula tsiku lomwelo, chifukwa chake ndikofunikira kumvetsetsa momwe zimayambira. Kuchenjeza kumatanthauza zida.

Kodi ntchito ya ndulu ndi yotani?

Biliary Pancreatitis - kutupa kwa kapamba, chifukwa cha zonyansa za ndulu. Chifukwa cha izi, kapamba amatchedwa biliary.

Matendawa amatha kuonekeratu kapena matendawo. Ndi kubwereza pafupipafupi kwa matendawa, kapamba wam'mimba amawonongeka mkati mwa chaka. Kuzindikira kwapangidwa: "aakulu parenchymal biliary-pancreatitis amadalira."

Chinsinsi cha matendawa ndi motere: chifukwa chophwanya chida chazachuma komanso zotulutsa, kutupika m'matumbo kumayamba. Kutumphuka kwa ma ducts kumachitika, ndipo ma enzyme osalowa mu duodenum, khalani mu kapamba ndikuwukonza. Minofu ya nduluyo imavulala, kugwira kwake ntchito kumasokonekera, kudzipweteka pathupi lanu lonse kumachitika.

Zomwe zimayambitsa matendawa

Biliary pancreatitis imapezeka m'magawo anayi:

Lakuthwa.
Matenda
Kuyambiranso.
Kuchulukitsa kwa matenda.

Matenda amisala yonyansa komanso ndulu imatsogolera kutupa kwa kapamba.

Pali njira zitatu zopititsira patsogolo matendawa:

Kufalikira kwa matenda ochokera kumiyendo.
Ndime ya calculi kudzera bile ducts.
Kuponya bile mu kapamba.

Zotsatirazi zimathandizira kuti matendawa athe:

pamimba
aakulu cholecystitis
matenda a chiwindi - hepatitis, matenda enaake,
zosokoneza pa ntchito ya sphincter wa Oddi ndi Vater's nipple,
biliary dyskinesia,
cholangitis - kutukusira kwa minyewa ya bile
blockage wa bile duct ndi calculi kapena majeremusi,
neoplasms mu duodenum molumikizana ndi ma ducts,
cysts mu bile ducts.

Zomwe zimayambitsa matendawa zimatha kukhala zosagwirizana ndi chipangizo cha biliary, kufooka kwawoko kwa sphincter wa Oddi, chibadwa.

Zizindikiro za matenda owopsa komanso matenda

Pachimake kapamba - Ichi ndi matenda otupa komanso owononga a kapamba. Biliary pancreatitis ndi matenda achiwiri, amagwirizana ndi zovuta za hepatolic dongosolo.

Kodi zikutanthauza chiyani pachimake non-biliary pancreatitis mumankhwala? Mkhalidwe wovuta kwambiri chifukwa cha kutupa kwa kapamba, koma pazifukwa zina. Mwachitsanzo, zakumwa zoledzeretsa kwambiri, zoopsa.

Zizindikiro za pancreatitis ya pachimake ya pancreatitis ndi ofanana ndi kuukira kwa chifuwa chachikulu cha kapamba:

kupweteka m'mimba ndi kuwonekera kumbuyo,
kwambiri nseru
kusanza, komwe sikubweretsa mpumulo, ndi kuphatikizika kwa ndulu,
kutentha kuwonjezeka
kuthamanga kwa magazi
chisokonezo, kuyerekezera zinthu m'magazi, kusangalala kwamanjenje ndikotheka,
kutulutsa, kutsegula m'mimba,
Mimba imawoneka kuti ikokedwa ndi lamba, kupuma kumakhala kovuta, kumamva ngati kuti sikungatheke kupuma bwino.

Zofunika! Zizindikiro zosiyanitsa za biliary-pancreatitis yovuta kwambiri ndi yoletsa khansa. Khungu pankhaniyi limasanduka chikaso mwachangu.

Kuyambika kwa matendawa pafupifupi nthawi zonse kumabwera chifukwa chodya kwambiri, kuphwanya zakudya, kuzunza mafuta komanso zakudya zina.

Makamaka owopsa ndi nkhumba yokazinga, ma pie a nyama, aspic, zonse zomwe zimapangitsa ndulu. Pambuyo podya, bile imamasulidwa, ndipo ngati calculi imawonekera m'mizere, kapena ngati mabowo awotchedwa, chiwopsezo chachikulu cha matendawa chimachitika.

Matenda a biliary pancreatitis amakula pang'onopang'ono. Munthu amakhala ndi nkhawa ya kupweteka kwakumapeto pamimba, kusasangalala ndikudya. Pali kuchepa kwa thupi, kufooka kwa minofu, kunjenjemera kwa manja ndi miyendo panthawi yolimbitsa thupi. Ndi kuchulukirachulukira kwa matenda apansi a biliary amadalira pancreatitis, kusanza kumachitika, nseru imakhala mnzake wa odwala nthawi zonse. Palibe chidwi, malingaliro omwe chakudya panthawi yanthawi yochulukitsa satha kupirira.

Zofunika! Matenda a biliary amadalira pancreatitis amatha kukhala asymptomatic.

Ndikofunika kulabadira zizindikiro zotsatirazi zomwe zikusonyeza kuti kuphwanya chiwalo:

kuwawa mkamwa
kuchuluka kwa masokono
kusanza kapena mseru wopanda chakudya,
madzimadzi fetidol katatu pa tsiku,
mafuta, osakhazikika pachimbudzi ndi tinthu tating'onoting'ono ta chakudya,
kutulutsa, kung'ung'udza, kugoneka, kusapeza bwino,
lamba m'chuuno
kusintha kwa khungu ndi sclera ya maso achikasu,
Kuchepetsa thupi
kuchepa kwamtima.

Zizindikirozi zimatsimikiza kupezeka kwa matenda a pancreatic.

Chithandizo cha biliary-amadalira kapamba

Chithandizo cha pachimake ndi chovuta biliary pancreatitis mwina okhazikika komanso opaleshoni. M'magawo onse awiri, zakudya zimakhazikitsidwa, zomwe zimayambitsa matenda a m'mimba ndipo sizimayambitsa ndulu ya ndulu.

Wodwalayo amawunika ndi dokotala wa opaleshoni, gastroenterologist, matenda opatsirana, opatsirana. Mankhwalawa amayang'aniridwa ndi matenda omwe amayambitsa zotupa m'mimba.

Mankhwala oletsa kuwonongeka nthawi zina samabweretsa zotsatira, kapena opaleshoni ndiyo yokhayo yankho. Pambuyo polowa matendawa mu "nthawi yozizira" chikhodzodzo chimachotsedwa.

Cholecystectomy imachitika m'njira zingapo:

opaleshoni yotseguka
ochepa opereshoni. Kuwala kwa masentimita 5-7 kumapangidwa mu hypochondrium yoyenera, yomwe kudzera ndulu imachotsedwa.
laparoscopy Chikhodzodzo chimachotsedwera pamakonzedwe ang'onoang'ono khoma lam'mimba.

Zofunika! Laparoscopic cholecystectomy imakupatsani mwayi wokonza zamatenda ndikufupikitsa nthawi yochira. Opaleshoni ikuchitika ngati wodwalayo anali atachitidwa opaleshoni pamimba chakumanja, kapena ngati chikhodzodzo cha ndulu sichinadziwike bwinobwino.

Mwachitsanzo, chifukwa cha kukhalapo kwa miyala yaying'ono ingapo yomwe imatchinga ndulu, siyitha kuwoneka pa scan ya HTML.

Pambuyo cholecystectomy, nthawi yochira ndikusinthika kwa thupi kukhala mikhalidwe yatsopano kumatenga mwezi umodzi mpaka miyezi isanu ndi umodzi, kutengera njira yopangira opaleshoni.

Chithandizo cha pachimake biliary pancreatitis

Ntchito yayikulu ya madotolo kuti athetsere ululu. Mukakhala pachimake, kupweteka kumakhala kwakukulu kwambiri kotero kuti kungayambitse kudandaula ndi kufa kwa wodwala. Lembani kusala kwachithandizo ndi kukakamira kwa mchere wamchere wopanda madzi popanda mpweya. Kutalika kwa kusala kudya mpaka masiku atatu. Zitatha izi, wodwalayo amalimbikitsidwa kudya No. 5p. Pambuyo pakutha kwa ululu wammbuyo ndikusintha kwa thanzi, chakudya chikukula pang'onopang'ono.

Yang'anani! Chithandizo cha zakudya ndizofunikira kwambiri pazamankhwala. Kuphwanya zakudya kumabweretsa kukuwonjezereka. Munthu amene akudwala kapamba, monga wina aliyense, ayenera kukumbukira: munthu amadya kuti akhale ndi moyo, koma sakhala ndi moyo kuti adye.

Zotsatirazi ndizoletsedwa:

tiyi wamphamvu, khofi, cocoa,
masamba osaphika, zipatso, zipatso. Pakukhululukidwa, mumatha kudya zipatso zosaphika ndi zipatso, koma osati wowawasa,
nyama zamafuta ndi nkhuku - nkhumba, mwanawankhosa, abakha,
ma pickles, pickles,
bowa, sorelo, kabichi, sipinachi, anyezi, adyo,
ankasuta nyama
mayonesi, kirimu wowawasa, adjika, msuzi wina wotentha,
zonunkhira
broth
tchizi chamafuta, tchizi chamafuta,
ayisikilimu
madzi owala
confectionery ndi batala,
buledi watsopano
chokoleti
nyemba.

Zakudya zamasamba, soufflés zamasamba, mkaka wopanda mafuta wopanda mkaka umapindula. Mapuloteni a mazira ndi othandiza, ma yolks saloledwa. Porridge iyenera kukhala theka-viscous mpunga, buckwheat, oatmeal, semolina. Mapira, chimanga, barele la ngale, zipatso za barele ndizoletsedwa.

Mwa maswiti popanda kuchulukitsa kwa matendawa amaloledwa marshmallows, marmalade, osakhala acidic.

Zofunika! Pewani zakudya zamafuta ozizira. Izi zimayambitsa spasms ya ma ducts ndi sphincter a Oddi.

Mankhwala ndi Njira

Mwa mankhwala omwe amagwiritsidwa ntchito analgesics, antispasmodics, michere. Maantibayotiki amaikidwa ngati pali ngozi yakufalikira kwa matenda. Ngati ndi kotheka, mupeze mankhwala omwe amayang'anira shuga.

Ngati matendawa amayamba chifukwa cha kufalikira kwa ma ducts ndi calculi, kapena chifukwa chake ndikulephera kwa sphincter ya Oddi, amachitidwa opaleshoni.

Cholinga chake ndikubwezeretsa kuchuluka kwa ma ducts. Kuchitapo kanthu pakuchita opaleshoni kuli pafupifupi kosapeweka, koma kumachitika pambuyo pochotsa wodwalayo pamavuto. Pokhapokha ngati kudula kwa ma ducts ndi calculi, ndiye kuti ntchito imachitika mwachangu.

Chithandizo cha matenda apansi a biliary pancreatitis

Biliary ndi parenchymal pancreatitis amathandizidwa ndi njira imodzi. Choyamba, mowa samakhazikitsidwa ndipo zakudya zimayikidwa. Nthawi zambiri, kuwonongeka kwa kapamba kumayambitsa matenda ashuga. Lamula mankhwala kuti achepetse kuchuluka kwa shuga m'magazi. Kuphatikiza apo, pachimake pachaka, mankhwala otsatirawa amathandizidwa:

Omeprazole, Rabeprazole, Esomeprazole - amachepetsa kupanga kwa hydrochloric acid m'mimba.
No-shpa, Platifillin, Papaverin - antispasmodics wothandizira kupweteka.
Domperidone, Metoclopravidum - prokinetics kukonza peristalsis. Amalepheretsa kukokoloka kwa chakudya m'ziwalo.
Zothandiza pakuwonongeka kwa mapuloteni, mafuta ndi chakudya. Amathandizira kapamba.

Matenda a chiwindi, chikhodzodzo, m'mimba, ndi duodenum amathandizidwanso munthawi yomweyo.

Kukula kwake kumadalira kuopsa kwa kuukiridwa, mkhalidwe wa wodwalayo, zaka zake, mbiri yovuta. Acute Biliary Pancreatitis nthawi zambiri imayambitsa imfa. Ngati odwala awonetsa kuleza mtima ndi udindo, chithandizo chimapereka zotsatira zabwino. Mosiyana ndi mawonekedwe osachiritsika, ovuta kwambiri nthawi zambiri amachiritsidwa.

Yang'anani! Anthu omwe ali ndi vuto la pancreatitis pachimake kapena akudwala matenda osachiritsika ayenera kutsatira kadyedwe ndikuchepetsa thupi ntchito zawo zonse.

Pansi pa chiletso, kudumpha, chingwe kulumpha, nkhonya, kulimbikira zolimbitsa thupi, zochitika zina zomwe zimapweteka m'mimba. Chakudya chamafuta, chokazinga, chosuta fodya komanso mowa sichiletsedwa. Kukhala ndi moyo wathanzi komanso kutsatira kwambiri zakudya kumapangitsa kukhala ndi moyo wabwino, popanda zovuta zoyipa kudwala.

Matenda a kapamba amachititsa zovuta zazikulu:

matenda ashuga
cysts
zotupa
kapamba - kupindika kwa ziwalo zolumikizika za chiwalo,
pancreatic necrosis - kuphedwa kwa minofu ya kapamba.

Popewa matendawa, anthu omwe ali pachiwopsezo amafunika kuwunika thanzi lawo, kutsatira zakudya, kuchepetsa zakudya zomwe zimapezeka mu choleretic, monga mazira, kirimu wowawasa, batala. Ndikofunika kuyang'ana zisonyezozo ndipo chithandizo chithandizadi. Kuunikiridwa pafupipafupi ndi dokotala wa gastroenterologist kungathandize kupewa zovuta m'mimba. Zakudya zoyenera komanso zakudya zoyenera zomanga thupi ndizofunikira.

Zimayambitsa ndi mitundu ya matenda

Chifukwa chachikulu cha parenchymal pancreatitis ndi mkhalidwe wonyentchera mkhalidwe wa thanzi la munthu, kapena m'malo mwake njira yolakwika: kudya kosasamala, kusuta, kupsinjika, kumwa kwambiri mafuta, zonunkhira komanso mchere, kusowa kwa mavitamini ndi mapuloteni muzakudya, ndi zina zambiri. Nthawi zambiri matendawa amatha kukhala zotsatira za matenda ena. Zikatero, nthawi zambiri amakumana ndi maziko a pancreatitis pachimake, zilonda zam'mimba, uchidakwa komanso matenda ena am'mimba.

Kutengera zomwe zimayambitsa, mitundu ya matendawa imatsimikiza. Pancreatitis ya pulayimale imadzipatula pomwe matendawa amayambitsidwa ndi zinthu zakunja zosagwirizana ndi kapamba. Ndipo yachiwiri - akufotokozera motsutsana ndi matenda a ziwalo zoyandikana ndi England.

Zinthu zazikulu zomwe zingayambitse kukula kwa parenchymal pancreatitis ndi:

Chimodzi mwazomwe chimayambitsa matendawa ndi kumwa kwambiri (uchidakwa umapezeka mwa 60% ya odwala). Ichi ndimowa pancreatitis.
Dysmetabolic pancreatitis imayamba motsutsana ndi maziko a zovuta za metabolic. Matendawa amatha kukhala chifukwa cha cystic fibrosis kapena kuchuluka kwamafuta m'magazi a m'magazi.
Matenda omwe amapezeka chifukwa cha zovuta ndi dongosolo la biliary amatchedwa biliary-based or biliary pancreatitis. Nthawi zambiri amakhudzana ndi maziko a hepatitis, cholecystitis, dystonia ya biliary thirakiti, cholelithiasis.
Zomwe zimayambitsa kukula kwa chifuwa cham'mimba ndizomwe zimayambitsa matenda a virus. Matendawa amapezeka pamene kachilomboka kachilonda kapamba.
Autoimmune pancreatitis imayamba pamene chitetezo cha mthupi chimayamba kuwona maselo a kapamba ngati achilendo, kubisa ma antibodies kuti awawononge.
Mutha kupeza parenchymal pancreatitis chifukwa chogwiritsa ntchito mankhwala kwa nthawi yayitali omwe amakhala ndi poizoni pancreatic. Kuvomerezedwa kwa mankhwalawa kuyenera kuchitika moyang'aniridwa ndi adokotala.
Kuphwanya kutuluka kwa katulutsidwe m'matumbo.
Khalidweli.

Tiyeneranso kutsimikiza kuti pafupifupi 30% ya milandu ya matendawa alibe chifukwa chenicheni. Kenako amalankhula za mawonekedwe a idiopathic a parenchymal pancreatitis.

Zizindikiro ndi matenda chiwonetsero cha matenda

Zizindikiro za matendawa nthawi zina zimakhala zofatsa, makamaka panthawi yachikhululukiro. Zizindikiro zambiri za matendawa zimatha kuonedwa ndi kukokomeza. Kenako zizindikirazi zimatengera momwe wodwalayo alili ndi zovuta zake.

Zina mwazizindikiro zazikulu zamatenda omwe ali pachimake, pali:

Zomverera zowawa. Herpes zoster imatha kuwonedwa (kumanzere pansi pa nthiti). Mwa mawonekedwe - kupweteka, mokakamiza - osati mwamphamvu kwambiri. Mwa zina, munthu akhoza kunena kuti ululu umakonda kumachitika chifukwa cha kudya kwambiri, kudya zakudya zamafuta kwambiri kapena kumwa mowa kwambiri.
Dyspeptic matenda. Imadziwulula yokha mwa malo osakhazikika, pomwe wodwalayo asinthanso kudzimbidwa ndi kutsegula m'mimba. Pankhaniyi, tinthu tating'onoting'ono ta chakudya titha kuwona mu ndowe za wodwala. Mseru ndi kusanza ndi zizowonjezera zina za vutoli.
Kuchepetsa thupi.Poyerekeza ndi kuchepa kwa kupanga michere yokugaya, chakudya sitingigaye bwino, zomwe zikutanthauza kuti michere ya chakudya siyingamwe. Izi zimayambitsa kuchepa thupi. Chinanso chomwe chimapangitsa kuchepetsa thupi ndi kupweteka pambuyo chakudya, chifukwa pomwe wodwalayo amayesa kudya kangapo.
Kukula kwa matenda ashuga. Kukhalapo kwa chizindikiro choterocho kumawonetsa kuwonongeka kwakukulu kwa minofu ya kapamba (kupitirira 80%). Matenda a shuga amayamba chifukwa kupangika kwa insulini kumakhala kovuta, chifukwa ma cell sangathe kuyamwa shuga.

Ngati zizindikiro zomwe zili pamwambazi zimawonedwa mwa munthu osati kwa nthawi yoyamba, koma zimachitika nthawi ndi nthawi, ndiye kuti titha kufotokoza za matenda.

Matenda a parenchymal pancreatitis, chithunzi cha chipatala chimatha kukhala ndi izi:

kutsekula m'mimba (matumbo amayenda atangotha kudya), pomwe fungo la ndowe ndilowonda ndi kununkha,
kusanza pafupipafupi komwe sikubweretsa mpumulo,
m'mawa kunyansidwa
kuwonda kwambiri
khansa yodabwitsayo imatha
zotupa pakhungu
thukuta lomwe limachulukirachulukira.

Mwa zina mwa pancreatitis yosatha yomwe ilipo, izi ndizodziwika bwino:

kuchuluka kwa zinthu kumawonedwa katatu pachaka,
kukokoloka kumachitika mwaulemu, makamaka ndikudya kwambiri,
Mavuto mwa odwala ndi osowa.

Ngati muli ndi zizindikiro, muyenera kuwona dokotala kuti ayambe kulandira chithandizo ngati pakufunika.

Zizindikiro ndi chithandizo cha matenda a parenchymal pancreatitis

Kutengera mawonetseredwe azachipatala komanso njira ya kapamba, matendawa amawerengedwa m'mitundu. Matenda a parenchymal pancreatitis ndi mtundu wofala kwambiri wamatenda a kapamba. Ngati kapamba samachiritsidwa, ndiye kuti matenda amtunduwu angayambitse kukula kwa matenda osokoneza bongo.

Mitundu ya matenda

Kugawidwa kwa matenda a kapamba pakadali pano ali ndi mitundu iwiri ya etiology: yoyamba komanso yachiwiri. Pancreatitis yayikulu matenda amakhala ndi kutupa mu kapamba. Nthawi zina, mawonekedwe amtunduwu amatha kutsatiridwa ndi matenda ena am'mimba, mwachitsanzo, gastritis kapena duodenitis. Gwero la chitukuko chachikulu cha pancreatitis yayikulu imatha kukhala matenda opatsirana, kumwa mowa mwauchidakwa kapena kuwonetsedwa ndi zinthu zoopsa.

Njira yachiwiri ya matenda amapanga motsutsana ndi maziko a matenda ena ammimba. Pankhaniyi, zizindikiro za kapamba sizinenedwe, choncho chithandizo chachikulu chimalimbikirabe matenda oyambitsidwa.

Matenda a kapamba amalembedwanso kuti:

parenchymal
kuwerengetsa
odalira.

Parenchymal pancreatitis imapezeka kwambiri mwa azimayi opitirira zaka 50. Zakudya zamafuta zimatha kukhala chomwe chimayambitsa matendawa. Pancreatitis yowerengeka imachitika ngati ma calculi mawonekedwe mu thupi la kapamba.

Chomwe chimapangitsa kuti pakhale ma biliary pancreatitis ndi mtundu wina wa uchidakwa. Biliary pancreatitis imapezeka masiku ano nthawi zambiri. Choyambitsa matendawa ndimatenda a chiwindi kapena chikhodzodzo. Pankhaniyi, kugwira ntchito kwa kapamba kumalepheretsa. Mwa zina mwa pathogenetic yodwala yokhala ndi biliary-kudalira kapamba, kuchepa kwa magazi, kuphwanya katulutsidwe ka zotulutsidwa ndi biliary-pancreatic Reflux kumatha kusiyanitsidwa.

Kwenikweni, malingaliro osaganizira thanzi la munthu amawonedwa kuti ndiye gwero la chitukuko. Kumwa mowa kwambiri, zakudya zamafuta, kapena gallbladder kapena matenda a chiwindi kungayambitse matenda a kapamba. Nthawi zambiri, nthawi imodzi ndi kapamba, cholecystitis imapezeka.

Zakudya zokometsera komanso zamafuta zimathandizira kuti pakhale michere yopanga. Pogwiritsa ntchito pafupipafupi zinthu zotere, katundu pa zikondamoyo umachuluka. Mowa umachitanso chimodzimodzi. Kuphatikiza apo, mothandizidwa ndi mowa, kapangidwe kake ka madzi kapamba amasintha, ndipo nembanemba ya mucous imawonongeka.

Matenda a kapamba amatha kuchitika chifukwa cha kuvulala kapena kuperewera kwachipatala, pomwe kukhulupirika kwa thupilo kumalephera. Zina mwazomwe zimaphatikizapo kuchotsa ndulu, zilonda zam'mimba, zotupa za mtima, komanso kupsinjika kosalekeza.

Njira zochizira

Ndi kuchulukitsa kwa matenda a parenchymal pancreatitis, chithandizo chikuchitika kuchipatala. Masiku atatu oyambilira atadutsa, wodwalayo amamulembera kudya. Amaloledwa kumwa mchere wambiri wopanda mafuta. Pakuchulukitsa, wodwalayo amapatsidwa mankhwala antispasmodics ndi mankhwala omwe amachepetsa kupanga ma enzyme.

Popanda kukokomeza, zamatsenga zimathandizidwa ndimankhwala. Zolinga zikuluzikulu zamankhwala othandizira kupewa ndikuwonetsetsa kuti magazi achulukane komanso kusungidwa bwino.

Pofuna kuchepetsa ululu, adokotala amalimbikitsa kumwa ma antispasmodics ndi mankhwala omwe amachepetsa kupanga hydrochloric acid. Mankhwalawa akuphatikizapo No-shpa, Omez, ndi Famotidine.

Polimbana ndi kutupa mu matenda a matenda, wodwala amamulembera mankhwala oletsa kutupa. Zothandiza kwambiri ndi Diclofenac ndi Ortofen.

Kuphwanya magwiridwe antchito a kapamba kumakhudzanso chimbudzi.

Chifukwa chake, mankhwalawa chifukwa cha matenda a kapamba zimaphatikizapo kumwa mankhwala omwe ali ndi michere ya gland, mwachitsanzo, Creon, Pancreatin ndi Mezim.

Kuphatikiza pa kumwa mankhwala, ndi pancreatitis yosatha, ndikofunikira kutsatira zakudya zomwe siziyenera kupatula chilichonse chomwe chimapangitsa kukokoloka, ndiko kuti, yokazinga, mafuta komanso zonunkhira. Zimangoyambitsidwa, kuwiritsa komanso kuwiritsa. Ndi njira zoyenera zamankhwala, matendawo ndi abwino.

Parenchymal pancreatitis: Kufotokozera, mitundu, Zizindikiro, chithandizo

Parenchymal pancreatitis - ndi chiyani? Matendawa ndi mtundu wamba wa matenda osachiritsika, omwe amapitilira pancreatic parenchyma pang'onopang'ono ndipo amatulutsa pang'onopang'ono. Zimachitika makamaka mukakula, ndizovuta kuzindikira ndipo nthawi zina zimafunikira opareshoni.

Zimayenda pang'onopang'ono, ndi chipatala chokhazikika, kukokomeza kwakanthawi, ndipo zimabweretsa kutayika kosaletseka kwa luso la pancreatic. Kupambana kwamankhwala kumadalira kuchuluka ndi kutukuka komwe kumachitika, komwe ziwalo zoyandikana zimakhudzidwa nthawi zambiri.

Parenchymal pancreatitis imatha kukhala ndi mitundu yosiyanasiyana ya kuwonongeka kwa kapamba. Chithunzichi ndi mawonekedwe ochulukirapo.

Chofunikira kwambiri pakukula kwa kutupa kwa parenchymal kwa kapamba nthawi zambiri amakhala osasamala pa thanzi lawo. Matendawa akuwonetsedwa mchikakamizo cha nthawi yayitali cha chinthu chotchedwa etiotropic, chomwe chimalepheretsa kutulutsa kwazimbidwe.

Kukula kwake kumatsutsidwa ndi:

uchidakwa
kuphwanya zakudya
kuyamwa kwa chakudya chabwino,
kukonda zakudya zonunkhira, zonunkhira komanso mafuta,
ochepa mapuloteni ndi michere ina
matenda.

Zotsatira zake, izi nthawi zambiri zimabweretsa:

stenosis ndi spasms,
sphincter wa Oddi Kulephera
neoplasms mu duodenal nipple (Vaterova) yayikulu.

Cholinga chodwalitsa sichikhala pakupanga kwambiri kwa ma enzyme obisika. Kukwiya kwamapuloteni ndi lipases kumapangitsa kuti munthu azidzipukula yekha (minyewa).

Kutupa kumayambitsa kusinthika mkati mwake. Amawonetsedwa ndi sclerosis ya glandular minofu - kusintha kwa magawo omwe akukhudzidwawo ndi zigawo zolumikizana, zomwe zimapangitsa kuti ntchito ichoke.

Izi zikufotokozedwa ndikuti madera osinthidwa sangathe kupanga michere yokumba, chifukwa chake, motsutsana ndi maziko awa, kusowa kwa enzymatic kumapangidwa, ndipo pali zosokoneza mu magazi.

Kutupa kwa mafunde a glandular organic agawidwa m'magulu:

Zovuta (zotayika) - zimakhudza kwambiri.
Zochepa - gawo limodzi limakhudzidwa (mutu kapena mchira).

Mbiri ya Morphology

Matenda a parenchymal pancreatitis amagawidwa m'mitundu itatu ya morphological. Amasiyana mu njira ya pathological ndipo amasiyana mu zithunzi zamankhwala:

Edematous - ikuyenera kuwonjezeka kukula kwa kapamba chifukwa cha kuchuluka kwa madzimadzi mu minofu yake. Amakula nthawi zambiri ndi zolakwika mu zakudya, makamaka kuphatikiza ndi mowa. Nthawi zina zimawoneka ngati chifukwa cha zovuta zina zam'mimba (zilonda zam'mimba ndi zina). Ili ndi chipatala chowala kwambiri pakamwa kuledzera. Kukhumudwa kwa pancreatic nthawi zambiri sikuchitika. Fomu ya parenchymal iyi sikutanthauza kuti pakuchitika opaleshoni ndipo ili ndi chiyembekezo chabwino.
Sclerosing - ndi matenda osatha odziwika omwe amayamba chifukwa cha kutsekeka kwa ndulu. Kapenanso, zimakhala chifukwa cha ma pathologies omwe amatayika m'mimba. Fomuyi imadziwika ndi mawonekedwe a sclerotic kusintha mu chiwalo komanso kukula kwakukulu kwa ma ducts ake. Ili ndi zizindikiro zowoneka bwino, pomwe pakati pake pamakhala kupweteka, kukoka pafupipafupi, kuyabwa kwa khungu, glucosuria ndi pakamwa pouma. Nthawi zina imakhala ndi maphunziro apamwamba (5%). The subtype wofinya thupi nthawi zambiri amathandizidwa mosasamala ndipo amakhala ndi vuto labwino.
Amawerengetsa - mawonekedwe omwe amakula ndikuchokera kwa calculi (mchere wopanda calcium) m'malo okumbikakumbika. Ndiwowopsa wa matenda a parenchymal, popeza pali chiopsezo chachikulu cha kutsekeka kwa pancreatic duct. Imakhala ndi chizolowezi chopita chamtsogolo komanso kupweteka koyipa, chifukwa chake matendawo siabwino nthawi zonse.

CHidziwitso! Mitundu ina ya kapamba amafotokozedwa mwatsatanetsatane m'nkhani ina.

Magawo omwe ali ndi ziwalo zina za kunja

Pali gawo lina la matenda - matenda a parenchymal pancreatitis okhala ndi insulin. Kuzindikira kumeneku kumachitika pokhapokha ngati kuchepa pakupanga ma enzyme ena okhudzana ndi chimbudzi. Mapeto ake amapangidwa pamaziko a labotale, kuwunika kwa hardware ndi madandaulo apadera.

Zomwe zimachitika pang'onopang'ono chifukwa cha kuperewera kwa mphamvu ya procrine ndikulephera kwa gawo la "odwala" kuthana ndi ntchito zake. Chifukwa cha kutupa kwakanthawi kwam'mimba, kumayambira "njala" ya enzymatic, yomwe imasokoneza chizolowezi m'mimba. Nthawi yomweyo, kuchuluka kwa ma enzyme nthawi zina kumachepetsedwa ndi chisonyezo chachikulu, chofanana ndi 70%.

α amylase16-30g / l pa ola limodzi GlucoseZoposa 6.0 mmol / L. Lipasekuchokera ku mayunitsi 190 / l ZamaZoposa 6.0 mmol / L.

Maphunziro a Hepatobiliary

Mtundu wina wamatenda omwe amayenera kuyang'aniridwa mwachidwi. Imakhala ndi theka la milandu yonse yamatenda amtunduwu ndipo imachitika chifukwa cha zovuta zina za chiwindi. Amaphatikizanso ndi matenda a pancreatitis a parenchymal biliary-amadalira pancreatitis.

Amaphatikizidwanso ndi ulesi wamatumbo a glandular, omwe amakula chifukwa cha kubereka kapena kupeza ma biliary pathologies. Amadziwika ndi kutayika kochepa kapena kwathunthu kwa ntchito zazikulu zapanchipini - kumasulidwa kwa mahomoni ndi ma enzyme.

Makamaka, zovuta zazodalira zotsalira za biliary zimayambitsidwa ndi:

kutupa kosawerengeka kwa ndulu (cholecystitis) ndi bile duct (cholangitis),
Cholelithiasis (matenda a ndulu),
matenda a chiwindi
zolakwika kapangidwe ka thirakiti lothandiza,
hypokinesia (contractile insufficiency),
chilimbikitso papillitis (chosasinthika),
kuphipha kwa phokoso la ku Oddi,
blockage (chotchinga) cha nipple ya Vater ndi Calculator, neoplasm kapena helminths.

Ndi matenda akutuluka kwa bile mu duodenum, imaponyedwanso mmatumba, ndipo, chifukwa chake, izi zimabweretsa kusintha kwa minofu. Mtundu wodalira biliary umadziwika ndi kubwereranso pafupipafupi komanso kuchuluka kwakukulu kwa zovuta zazikulu. Chizindikiro chodziwika bwino cha fomu iyi ndi kuwawa kwakanthawi kapena kwakanthawi mkamwa.

CHIYAMBI! Ndi mawonekedwe a kuwawa, kufunsira kwa gastroenterologist ndikuwunika kwa ultrasound ya hepatobiliary system ndikofunikira! Izi zimathandizira kuzindikira kwakanthawi vutoli ndikuchepetsa chiopsezo cha zovuta.

Paroxysmal pachimake ululu syndromes m'malo mwa hypochondrium kumanzere, nthawi zambiri kumawala kumanja kwa thupi.Kutsekeka kwa bile ducts (kuchitidwa opaleshoni yofunikira). Dyspepsia (kutulutsa, kusanza, kutsekula m'mimba, mafuta ndi zimbudzi zamkati, zokhala ndi zakudya zopanda chakudya).Mitsinje yowonjezereka ya pathological mu kapamba ndi ziwalo zoyandikana. Yellowness of mucous nembanemba ndi khungu.Kuphwanya zinthu zofunika kwambiri za thupi. Kuchulukitsa kwa magazi.Matenda a shuga. Kuchepetsa thupi ndi asthenia.Kulephera kwamphamvu ndi kusagwira bwino ntchito konse kwamatumbo am'mimba.

Njira zochizira

Chithandizo cha parenchymal chronic pancreatitis ndi chochitika chokwanira komanso chopanga munthu. Njira yamatendawa wodwala aliyense ali ndi zomwe ali nazo. Ndiye kuti, palibe mankhwala amodzi omwe alipo. Kuphatikiza pa mankhwala, ndikofunikira kwambiri pakudya ndi kukana zosokoneza bongo.

Zokhudza mankhwala, omwe ali ndi matenda otere, magulu osiyanasiyana a mankhwala atha kuperekedwa ndi dokotala:

analgesics
antispasmodics ya minofu yosalala,
othandizira enzymatic
okhazikika a peristalsis ndi antiemetic mankhwala,
Maantibayotiki (ngati kuli kotheka)
ma multivitamini.

CHidziwitso! Kuchita opaleshoni ndikofunikira pakhale calculi mu bile ducts, yomwe idayambitsa matenda a biliary. Kapena, n`kofunika mu vuto la kusakhazikika kwawofatsa mankhwala.

Kukhala ndi parenchymal pancreatitis, chisamaliro chimayenera kulipidwa pazakudya. Munthawi yakuchulukirachulukira, njala ya masiku 2-3 imasonyezedwa. Pakadali pano, mchere wamchere wopanda mchere womwe umapatsa mowa wokha womwe umaloledwa kumwa.

Wodwala wodwala matenda a parenchymal pancreatitis ayenera kutsatira zakudya 5. Amakhala ndi mndandanda womwe umakhala ndi zakudya zambiri zomanga thupi kuphatikiza mafuta, okumba mwachangu mafuta. Amaloledwa kugwiritsa ntchito mafuta a masamba, koma osapitirira 60. Zambiri pamndandanda wothandiza wazinthu zalembedwa pano.

Pamene matenda a parenchymal pancreatitis akapangidwa, chithandizo chamankhwala wowerengeka cha matenda oterewa chimatha kukhala chothandizira. Kugwiritsa ntchito mankhwala azitsamba okhala ndi choleretic kwenikweni kumatsutsana m'njira zina za kapamba.

Pomaliza

Mawonekedwe a pancreatitis pancreatitis pang'onopang'ono koma amatsogolera pakugwira ntchito kwa kapamba ka pancreatic. Ndikosatheka kubwezeretsa mphamvu yonse ya thupilo.

Njira yothetsera vutoli ndikungosungidwa kosalekeza kwa zofunikira za gawo lomwe lakhudzidwa. Chifukwa chake, pakuwonekera kwa mawonekedwe oterowo, fulumirani kukafunafuna chithandizo chamankhwala. Izi zikuthandizani kukhala ndi thanzi.

Kuti mumve zambiri, mutha kuwona kanema wothandiza. Tidzakhala othokoza kwambiri chifukwa cha upangiri wothandiza komanso ndemanga zosangalatsa pamutu wamatendawa.

Matenda a parenchymal pancreatitis

Pamba Ι Pancreatitis

Pancreas wakale adasinthanitsa zikondamoyo ndi mawu oti "Pancreas", adatsimikiziranso gawo lawo lalikulu pantchito ya thupi.Inde, "kuphatikiza nyama" kumathandizira kuti chakudya chizimbidwa, kumayendetsa kagayidwe kazinthu, komanso kuteteza ku matenda. Zikondazo zimachita mbali yofunika kwambiri popewa matenda oyipa monga matenda ashuga. Ma mahomoni ake ndi olamulira a insulin ndi glucagon.

Kuteteza thupi ku matenda, kapamba nthawi zonse sitha kudziteteza. Kutupa, komwe kumadziwika pakati pa madokotala monga kapamba, sikuti kumangoipitsa moyo wamunthu. Maganizo osasamala pa matendawa ndi amodzi ndi imfa. Matenda a parenchymal pancreatitis poyamba amakhala popanda kuwonekera ndipo atangofika pamlingo wina, limakhala vuto lenileni osati kwa wodwala, komanso kwa madokotala.

Kodi parenchymal pancreatitis imadziwonetsa bwanji

Parenchymal pancreatitis imadziwika ndi kuwonongeka kwa minofu ya kapamba. Pankhaniyi, kutupa kwa aseptic kumayamba, chiwalo chimasiya kugwira ntchito.

Tizilombo tina towonongeka ta glandular timapereka minofu yolumikizana. Amalephera kugwira ntchito yofunikira pakuchita kwa gland. Kugwa kwanthawi kumachitika, zomwe zimayambitsa matenda a chamoyo chonse.

Kusiyana kwa parenchymal aakulu kapamba kochokera panjira yodalira

Ngakhale kufanana kwa biliary pancreatitis ndi mawonekedwe a parenchymal, kusiyana pakati pawo kumapezekabe. Loyamba limatchulanso yachiwiri, ndipo kupezeka kwake kumathandizidwa ndi kupezeka kwa zovuta zina. Nthawi zambiri pamakhala matendawa pomwe amayamba chifukwa chobadwa nako.

Biliary pancreatitis imawonetsedwa chifukwa cha kupindika kwa bile mu ma pancreatic ducts. Kuchulukitsa kumapangitsa kuti zipupa za ma duct ziphulike. Kamodzi pa parenchyma, bile imayambitsa katulutsidwe kakulidwe ka enzyme, ndipo minyewa imayamba kudzimbidwa yokha.

Zomwe zimayambitsa Matenda a Parenchymal Pancreatitis

Kusintha kwa nthendayo kukhala mawonekedwe osachiritsika nthawi zambiri kumachitika chifukwa cha wodwalayo. Kusasamala thanzi lathu kumangokulitsa thupi, ndipo kufooka kwa thupi kumathandizira kukulira matenda osiyanasiyana. Chimodzi mwazifukwa zazikulu zomwe zimapangitsa kuti matenda a parenchymal pancreatitis apangidwe ndizosakwanira njira zamankhwala zoyamba za magawo.

Zosagwirizana ndi izi:

Pafupifupi 20% ya milandu, sizotheka kudziwa chifukwa chenicheni cha matenda a parenchymal pancreatitis.

Matenda osachiritsika amatanthauza njira yotopetsa, yotsatiridwa ndikulimbana kwadzaoneni. Chikhululukiro (kuwoneka kusintha), momwe marench pancreatitis sikuwonekera, amabwezedwa ndi:

Ululu mu hypochondrium, nthawi zambiri mbali yakumanzere kapena lamba wamakhosi amtengo wapatali. Ululu wopweteka umadzimva pambuyo pakudya kwambiri, kudya mafuta, zonunkhira, ndi mchere wamchere. Mowa wambiri ungayambitse zotsatirapo zake.
Malabsorption. Kuperewera kwa ma enzymere opangidwa ndi kapamba kumawonetsedwa mu chakudya chokwanira. Kufooka ndi ulesi zimawonedwa. Wodwalayo amayamba kuchepa thupi.
Dyspepsia. Kulakalaka kumachepa. Mpando umakhala pafupipafupi. Pali mseru, womwe umatha kutsagana ndi kusanza ndi fungo lokoma ndi fungo.
Zizindikiro zokhala ndi matenda a shuga (kumva kukoma kwa ludzu ndi njala, khungu louma, thukuta kwambiri, ndi zina zotere). Kapamba, komwe ndi gwero la insulin, sikugwirizana ndi ntchito zake, zomwe zimapangitsa kuti shuga azingowonjezereka.

Njira Zodziwitsira

Malonjezo enieni okhudza kukhalapo komanso mtundu wa matendawa amapangidwa ndi gastroenterologist. Izi zimatsatiridwa ndi njira zodziwira matenda zomwe zimapezeka m'maphunziro a zasayansi ndi othandizira.

Njira zasayansi zochokera:

kuyezetsa magazi kambiri kuti mupeze kuchuluka kwa ESR (erythrocyte sedimentation rate) ndi leukocytosis, kuwonetsa mawonekedwe ochulukirapo a kutupa kwa kapamba,
kusanthula kwamwazi m'magazi ndi mkodzo komwe kumatha kudziwa kuwonongeka kwa ziwalo zam'mimba ndi kuchuluka kwa amylase, lipase ndi trypsin,
kudziwa kuchuluka kwa shuga m'magazi ofunika kupewa matenda a shuga,
kulandira pulogalamu, yomwe imapereka chidziwitso cha michere ndi magawo omwe amapangidwa ndi kapamba, chifukwa chake magwiridwe ake.

Njira zopangira zida ndi monga:

Ultrasound, womwe umapereka chidziwitso cha kukula kwa kapamba komanso kupezeka kwa madera amene akhudzidwa.
computed tomography (CT), yomwe imapangitsa kuti ziwoneke bwino mawonekedwe a chiwalo,
endoscopic retrograde cholangiopancreatography (ERCP), yomwe ndi kafukufuku wa X-ray wama pancreatic ducts isanadzazidwe ndi kusiyana kwapakati.

Malinga ndi matenda a parenchymal pancreatitis amapita popanda kukokomeza, chithandizo cha matendawa chimachepetsedwa kuti chithandizire kugwira ntchito kwa kapamba. Izi zimathandizidwa ndi mankhwala othandizira osokoneza bongo omwe cholinga chake ndi kuchepetsa ndikuchotsa ululu, komanso kuthana ndi zotupa.

Kuthetsa ululu ndi kuthetsa njira ya matendawa kumachitika pogwiritsa ntchito ma pulon pump blockers. Amachepetsa kuchuluka kwa hydrochloric acid omwe amapangidwa ndi m'mimba, ndikuchepetsa katundu paz kapamba. Mankhwalawa amaphatikiza mankhwala omwe amathandizira ali pantoprazole, omeprazole, lansoprazole, rabeprazole ndi esomeprazole.

Zodziwika bwino ndi izi:

Kuchepetsa kuchuluka kwa hydrochloric acid m'mimba, kugwiritsa ntchito h3-histamine blockers sikuthandizanso. Zochita zawo zimakhazikitsidwa ndi zomwe zili za ranitidine ndi famotidine. Zitsanzo ndi Ranisan, Zantak ndi Quatemal.

Gulu lina la mankhwala ochizira matenda a parenchymal pancreatitis ndi antispasmodics. Kupweteka kumatsitsidwa ndikuchepetsa kupsinjika mkati mwa zotupa za ductal. Drotaverin, yomwe ndi gawo la No-shpa ndi Spazmol, komanso mebeverin ku Duspatalin, amathandizira kwambiri mkhalidwe wa wodwalayo.

Kugwiritsa ntchito mankhwala osapweteka a anti-yotupa (NSAIDs) kumakuthandizani kuti muchepetse njira zotupa zomwe zimachitika m'mapamba. Amayimiridwa ndi Diclofenac, Voltaren ndi Ortofen.

Ndi mankhwala othandizira, m'malo mwake ma enzymes amabwezeretseka, kusokonezeka chifukwa cha chimbudzi cha chakudya. Lipase, amylase, trypsin ndi chymotrypsin amalowetsedwa mthupi ndi mphamvu. Chidwi chachikulu chimaperekedwa kwa kuchuluka kwake kwa mankhwalawa komanso kugwiritsa ntchito mankhwala moyenera. Mankhwala amaperekedwa ndi chipolopolo chapadera chomwe chimawalola kuti aperekedwe mwachindunji m'matumbo ndipo pokhapokha amatha kuyamba kugwira ntchito. Kumbukirani kuti amatengedwa nthawi yomweyo asanadye. Zitsanzo ndi monga Mezim-forte, Pancreatin, Creon ndi Panzinorm.

Kuphatikiza pazithandizo zamankhwala matenda a parenchymal pancreatitis, njira zina zimagwiritsidwa ntchito. Ndiwothandiza mwachilengedwe ndipo amagwiritsidwa ntchito pokhapokha podziwa dokotala.

Ngati njira zachilendo zamankhwala sizipereka zotsatira zooneka, ndipo njira yotupa m'matayala ikupitilirabe, muyenera kuchitapo kanthu opaleshoni. Poterepa, gawo lomwe limakhudzidwa kwambiri limachotsedwa.

Popeza kapamba amakhudzana mwachimbudzi ndi chimbudzi, chakudya chofunikira kwambiri cha parenchymal pancreatitis chimagwira. Chiwerengero cha zopatsa mphamvu zolowa mthupi chimayenera kukhala chofanana ndi zolimbitsa thupi. Chakudya chomwe chimaperekedwa pafupipafupi chikulimbikitsidwa (mpaka katatu pa tsiku), kuwonjezera apo, ziyenera kupatsidwa zakudya "zopepuka".

Kuti muchepetse njira zochiritsira, thupi liyenera kulandira kuchuluka kwa mapuloteni. Mlingo wa tsiku ndi tsiku wa munthu yemwe akuvutika ndi kutupa kwa kapamba ayenera kukhala 130 g, pomwe gawo limodzi lokha limatha kukhala magawo atatu azomera. Nyama yophatikizidwa muzakudya iyenera kukhala yopendekera. Nthawi yomweyo, siyiyenera kuyikidwa pansi paukazinga, kudyetsa ndi kuphika. Njira yayikulu yophikira kuphika. Zakudya zophatikizira zakudya zimatha kuphatikiza tchizi chazakunyumba ndi mafuta ochepa. Izi zimalepheretsa kuwonongeka kwa minofu.

Mkaka wambiri parenchymal pancreatitis tikulimbikitsidwa ngati maziko a msuzi, chimanga ndi zakudya. Kulandila kwake mwa mawonekedwe ake oyera kuyenera kukhala kochepa kwambiri.

Mazira osachedwa ndi okazinga samachotsedwa muzakudya. Ma protein omeleette okhazikitsidwa ndi nthunzi okha ndiwo amaloledwa kuti agwiritsidwe ntchito. Kuwonjezera mazira pazakudya zina ngati chowonjezera cha zakudya sikuletsedwa.

Mapuloteni azomera zimatha kupezeka limodzi ndi buckwheat, mpunga, semolina, pasitala ndi oatmeal. Mkate ukhoza kudyedwa dzulo.

Mafuta omwe amaphatikizidwa muzakudya za tsiku ndi tsiku za parenchymal aakulu kapamba sayenera kupitirira 80 g, pomwe masamba omwe amapezeka masamba okha ndi 20%. Mafuta azikhala gawo lina la mbale zina komanso zochepa. Mafuta a Margarine, nkhumba, ng'ombe komanso ophika samasiyidwa.

Zakudya zomanga thupi pakudya zimangokhala tsiku lililonse la magalamu a 350. Itha kukhala uchi, shuga, kupanikizana ndi madzi. Zakudya zamasamba zothina ndizolandiridwa. Zipatso zatsopano ziyenera kukhala pansi musanagwiritse ntchito. Ndikulimbikitsidwa kumwa ma compotes, makamaka kuchokera ku zouma zipatso.

Aakulu matenda a parenchymal kapamba, m`pofunika kupewa kwambiri kudya. Mulingo wamba wa munthu amene wadwala matendawa ndi wofika pa 2,5 kg (kuchuluka kwa madzi akumwa kumathandizidwanso pano). Chakudya chizigawidwa m'magawo ang'onoang'ono ndikugawidwa tsiku lonse.

Zovuta zotheka

Mavuto a matendawa nthawi zambiri amakhala achilendo, ndipo kuwonekera kwawo kumawonjezera vuto la wodwalayo. Adanenedwa:

mapangidwe a cysts, fistulas, zilonda zam'mimba, zilonda zam'mimba zam'mimba,
subrenal jaundice,
subhepatic portal matenda oopsa,
abdominal ischemic syndrome,
ma pancreatic ascites,

Zotheka kupezeka ndimatenda opatsirana. Oopsa kwambiri ndi matenda a shuga komanso khansa ya kapamba yodziwitsa matenda ovuta. Kuzindikira mochedwa chotupa chowopsa kumasiya pafupifupi mwayi kwa wodwalayo.

Mavuto ambiri amakhala chifukwa chofunikira kuchitira opareshoni.

Kukhala ndi moyo wathanzi komanso kutsatira miyezo yopatsa thanzi, kupanikizika chifukwa cha matenda m'mimba kumatha kupewedwa. Ngati matenda awa akuwululidwa, musataye mtima. Kudandaulira madokotala panthawi yake ndikuwatsatira kwawo mosamalitsa kumapangitsa kuti akhale ndi moyo wabwino.