Matenda a kapamba, njira zake

Pancreatitis ndi imodzi mwa matenda oopsa kwambiri am'mimba, omwe amawonetsedwa ndikuphwanya kwa kapamba. Kuopsa kwa matendawa kulidi okwera kwambiri, motero ndikofunikira kulinganiza matendawa ndikuchiza kwa matenda ake munthawi yake. Tilankhula zambiri za izi komanso tanthauzo lenileni la kapamba mu nkhani ya lero.

Kodi kapamba ndi chiani ndipo chifukwa chiyani ndi kowopsa

Zakudya zopanda pake ndi zizolowezi zoyipa - njira ya kapamba!

Zikopa za thupi la munthu sizimangobisa madzi ake, zimafunikira kuti chimbudzi chikhale chakudya kulowa m'matumbo am'mimba, komanso zimatenga gawo pazinthu zofunika kwambiri kwa anthu.

Chifukwa, mwachitsanzo, thupi ili, masentimita 15 kutalika ndi masekeli 80 okha, limatulutsa insulin, glucagon ndi lycopene, omwe amawongolera shuga. Popeza ntchito zofunikira kwambiri za nduluyo, kupeputsa ntchito yake ndikosavomerezeka, komabe, ndi chinthu wamba chomwe chimasweka.

Munthawi yabwinobwino, kapamba wa munthu samakhala ndi vuto lililonse, koma zosokoneza pakuchita kwake nthawi zambiri zimawonekera chifukwa cha kuperewera kwa zakudya, moyo kapena kumwa kwambiri. Zotsatira za kuphwanya koteroko ndikuti njira yotupa imayamba mthupi, ndipo sinathanso kuchita ntchito zake mokwanira. Ndi chifukwa ichi pomwe munthu amakhala ndi kapamba.

M'malo mwake, matendawa ndi kutupa kwa kapamba, kamene kamayambitsa chisokonezo pantchito yake.

Mpaka pano, mitundu iwiri ya kapamba amadziwika:

1. Pachimake, chomwe ndi kuphwanya kwachangu komanso kotchulidwa mu ntchito ya kapamba.
2. Matenda osachiritsika, omwe amapezeka pamtundu wa matenda ndipo nthawi zonse amatupa.

Mosasamala mawonekedwe a maphunzirowa, zomwe zimayambitsa pancreatitis, monga lamulo, ndi:

• uchidakwa
• matenda am`mimba thirakiti ndi ndulu
• atherosulinosis
• matenda ashuga
• matenda oopsa
• poyizoni
• kumwa mankhwala ena
• kudya kwambiri
• kuperewera kwa zakudya m'thupi ndi moyo wawo
• zotupa matenda a gland
• chibadwa

Dziwani kuti zomwe zidanenedwa pamwambapa zimapangitsa kuti pakhale kupanikizika kwa kapamba, komwe zimayambitsa kupweteka kwa kapamba m'tsogolo. Zotsirizira, mwa njira, ndizowopsa, chifukwa zimatha kupangitsa kukhazikikanso kwa matenda oopsa kwambiri am'mimba (zilonda, khansa) ndi kufa.

Zizindikiro za matendawa

Kupweteka kwambiri pamimba pamtunda - chizindikiro chachikulu cha matenda

Chovuta ndi chiyani, kuti mtundu wa pancreatitis wopweteka kwambiri ndiwosangalatsa, chifukwa njira yake siyodziwika bwino. Chifukwa chake, kuti mukhale ndi thanzi la "gastric", ndikoyenera kuyeserera koyenda m'chipatala.

Komabe, nthawi zambiri pancreatitis, imadziwonetsa ndi zizindikiro zenizeni, zomwe ndi izi:

1. ululu wamphamvu pamimba
2. malungo
3. kuchepa kapena kuchuluka kwa mavuto
4. khungu la nkhope
5. kusanza
6. kudzimbidwa
7. kupuma movutikira
8. ukufalikira
9. mawanga obiriwira mu navel ndi mmunsi kumbuyo
10. chikasu cha khungu la maso kapena khungu

Mu pachimake kapena kuchulukitsa kwa matenda a kapamba, zizindikiro zomwe zili pamwambazi zimakulitsidwa mowonjezereka. Zotsatira zake, matenda a wodwalayo akuipiraipira ndipo akufunika kuchipatala.

Chifukwa chakuti kukulira kwa zizindikiro kumachitika munthawi yochepa kwambiri, pomwe amawonekera koyamba, ndikofunikira kupita kuchipatala chapafupi, ndikuzindikira njira zoyambira ndikuyambitsa chithandizo choyenera. Kupanda kutero, mawonekedwe a zovuta zowopsa za kapamba ndi nkhani ya nthawi.

Matenda a Pathology

Matenda a kapamba amafunika kumuwunika kwathunthu

Kupanga chithandizo cha kapamba, choyambirira, ndikofunikira kuzindikira bwino kupezeka kwa matendawa. Kuchita ndi kutumiza njira zodziwitsa anthu ndi njira yokhayo ya dokotala wa m'magazi, chifukwa chake, ngati akuwoneka kuti ndi kapamba pakapangidwe kalikonse, kuchezera kwake sikungapewe.

Mwanjira iliyonse, kufufuza muofesi ya akatswiri kumachitika mwa kukhazikitsa njira zotsatirazi:

1. Kusonkhanitsa ndi kusanthula mbiri ya wodwalayo. Pakadali pano, gastroenterologist amalankhula ndi wodwala. Wotsirizayo amauzidwa katswiriyo mwatsatanetsatane momwe angathere paziwonetsero ndi zizindikiro zoyambirira za matenda ake, pambuyo pake dokotala atha kuzindikira zina.
2. Kuthandiza palpation diagnostic njira. Awa ndi matumbo a ziwalo zina kudzera pakhungu la munthu, zomwe zimakuthandizani kuti muzindikire zizindikiro zoyambirira za kapamba.

Kukhazikitsa ndikukhazikitsa kafukufuku wapadera. Pankhani ya kapamba, izi zimachitika:

• Kuyesa kwamwazi wamagazi. Malinga ndi zotsatira zake, zizindikiro zotsatirazi zikutsimikiza: kuwonjezeka kwa alpha-amylase, lipase ndi shuga wamagazi, kuchepa kwa albumin m'thupi, kuwunika kwa mapuloteni a C-reactive komanso kuchuluka kwa urea.
• Kukhazikika kwa kukhazikika kwa kayendetsedwe kazinthu zamagetsi m'magazi. Ndi kapamba, izi zimacheperachepera ndipo madzi ammagazi amakhala ocheperako kangapo.
• Kuyesa kwa magazi. Njira yodziwitsira matenda imeneyi imakuthandizani kuzindikira zizindikiritso zazikulu zakugwira ntchito kwa thupi.
• Urinalysis Zomwe zimakhazikitsidwa ndizofanana ndi mtundu wam'mbuyomu.
• Ultrasound, X-ray, compact tomography, laparoscopy ndi endoscopy. Maphunziro amtunduwu ndi ofunika kuti athe kuwona momwe zinthu zikuchitika m'mimba komanso kapamba wam'mimba, ndizofunikira kwambiri kuti mudziwe bwino.

Dziwani kuti pakuzindikira pancreatitis yamtundu uliwonse, njira zomwe zili pamwambazi ndizovomerezeka. Zokwanira zonse zomwe zingachitike ndi zomwe zingathandize katswiri wazachipatala kudziwa bwino matenda ake.

Zina za mankhwala a pancreatitis

Pa chithandizo, muyenera kutsatira zakudya zapadera

Chithandizo cha pancreatitis yovuta komanso yopweteka ndi njira yophatikizira magawo ambiri. Mndandanda wazomaliza umatsimikiziridwa pamilandu iliyonse payekhapayekha, chifukwa chake, ndikofunikira kuchitira kutupa kwachikondwerero limodzi ndi dokotala waluso.

Nthawi zambiri, mfundo zamankhwala amatithandiza ndi monga:

1. Kuletsa kuukira kwa kapamba. Pakadali pano pamafunika bungwe loti wodwalayo apumire wodwala, kukana kudya ndi kumwa (kusiyapo kumakhala madzi wamba), kumwa mankhwala osokoneza bongo, kupweteka m'malo mwake, ndikupita kuchipatala.
2. Gulu lalikulu la matenda. Zonse zimatengera kuuma kwa kapamba ndi mawonekedwe ake pazochitika zilizonse. Mosasamala kanthu za mtundu wa pathology, ndikofunikira kuti muchepetse zomwe zakula, ndikupanga mtundu woyenera wa chithandizo, womwe ungayimilidwe ndi njira zosasamala kapena za opaleshoni. M'pofunikanso kulinganiza zakudya zoyenera panthawi ya mankhwalawa ndikuyendera makiliniki kuti ayang'anire njira ya matenda. Tiyenera kudziwa kuti mankhwalawa pancreatitis, kugwiritsa ntchito mankhwala osagwiritsidwa ntchito mwanjira ina sikuchotsedwa, komabe, iyenera kulinganizidwa molondola osati chifukwa chothandizira, koma thandizirani.
3. Kusunga zotsatira. Pakadali pano chithandizo, ndikokwanira kutsatira njira zoyenera zothandizira kupewa pancreatitis kapena kufalikira kwake.

Mwambiri, palibe zovuta zina pochizira pancreatitis. Chachikulu pakupanga chithandizo cha matendawa ndikugwirizana kwambiri ndi dotolo, kutsatira upangiri wake komanso njira yabwino yothandizira pakanthawi kachipatala. Tikukutsimikizirani kuti ndi chithandizo chotere, kapamba amachepetsa msanga ndipo sazunza munthu aliyense.

Kukula kwa chithandizo cha matenda ndi kupewa kwake

Pancreatitis ndiosavuta kupewa kuposa kuchiza!

Matenda a pancreatitis pachimake kwambiri amakhala abwino nthawi zonse, makamaka pamene wodwala amapita kuchipatala ndipo anakonza chithandizo chanthawi yake. Pankhani ya matendawa osakhazikika, chilichonse sichikhala chokomera.

Chithandizo cha kapamba mu mawonekedwe amtunduwu makamaka zimadalira kuopsa kwa njira yake komanso nthawi yake ya gulu la mankhwalawa. Mulimonsemo, ndizosatheka kutulutsa zotupa za pancreatic ngati matenda osachiritsika, chifukwa chake, pakawoneka, simuyenera kuchita mantha, koma ndibwino kuyamba kutaya kwa nthawi.

Tiyerekeze kuti matenda agonjetsedwa bwino. Zoyenera kuchita kenako? Mwachilengedwe, khalani ndi thanzi labwino. Pankhani ya kapamba, njira zodzitetezera ndi izi:

• Kukana kwathunthu zakumwa zoledzeretsa, kusuta fodya komanso mankhwala ena osokoneza bongo.
• Kuchita mayeso mwadongosolo mu polyclinics, makamaka ndi mawonekedwe a kusapeza pang'ono m'mimba.
• Kutaya kwathunthu matenda onse omwe mwanjira ina amakhala moyo wawo wonse.
• Kupanga zakudya zoyenera, ndiye kuti, wopanda mafuta ambiri ndi zakudya zina zolemera, komanso kudya zakudya m'magawo ang'onoang'ono komanso ang'onoang'ono.
• Pewani kudya kwambiri.
• Tsindikani mavitamini komanso zakudya zopatsa thanzi.
• Kulimbitsa chitetezo chathupi.

Zambiri zokhudzana ndi kapamba zimapezeka mu kanema:

Ingoganizirani, koma njira zomwe zaperekedwa pamwambapa ndi kukhazikitsa mwadongosolo komanso koyenera ndizofunikira kwambiri popewa pancreatitis yamtundu uliwonse. Sitikulimbikitsa kuti tisiye njira za prophylactic ngati akuvutika ndi kutupa kwa chifuwa, chifukwa munthu wodwala matenda a pancreatitis ali ngati imfa.

Monga mukuwonera, kapamba sindiwo matenda oyipa. Zachidziwikire, pomwe zikuwoneka, ndizosavomerezeka kuti "mukhale kunja thalauza,", sizoyenera kuyika. Pozindikira bwino za matendawa komanso kuthandizira matendawa, ndikokwanira kutsatira zomwe zaperekedwa pamwambapa. Tikukhulupirira kuti nkhaniyi inali yothandiza kwa inu komanso mudapereka mayankho ku mafunso anu. Zaumoyo kwa inu!

Kodi mwazindikira kulakwitsa? Sankhani ndikusindikiza Ctrl + Lowanikutiuza.

Essence of the matenda

Chikhotakhota ndi gawo laling'ono koma lofunikira la chimbudzi. Imagona kumbuyo kwa m'mimba ndikuyamba kuchokera ku duodenum mpaka ndulu. Zikondamoyo zili ndi mawonekedwe. Bola lililonse limakhala ndi duct. Mchiwalo, ma ducts onse amalumikizana ndikupanga dancino chachikulu. Palinso yachiwiri (yowonjezera) duct. Iliyonse ya iwo imalowa mu duodenum.

Chitsulo m'thupi la munthu chimagwira ntchito ziwiri:

1. Exocrine (exocrine). Madzi otulutsidwa kuchokera ku gland kupita ku duodenum mumakhala michere. Amathandizira kugaya mapuloteni, chakudya chamafuta ndi mafuta.
2. Endocrine (intrasecretory). Nthenga zimapangitsa mahomoni a polypeptide kulowa m'magazi. Amayang'anira kagayidwe kachakudya kamene kamachitika mthupi.

Ndi kutupa, ntchito za kapamba ndizovuta. Izi zimatsimikiziridwa ndi kupezeka kwa kapamba. Chinsinsi sichobisidwa kuchokera ku limba kulowa mu duodenum. Mwakutero, njira yodzigaya yokha ya zigawo za gland imayamba. Gawo la michere ndi poizoni pamenepa limatulutsidwa m'mitsempha yamagazi, limafalikira mthupi lonse ndikuvulaza ziwalo zina (chiwindi, impso, mapapu, mtima, komanso ubongo).

Matendawa amapezeka mwa anthu pazifukwa zosiyanasiyana. Ziwerengero zikuwonetsa kuti 50% ya anthu amadwala chifukwa chotupa chifukwa cha uchidakwa. Mu 20% ya milandu, kupezeka kwa kapamba mwa akulu kumawonetsa kuti matendawa amakula chifukwa cha matenda opatsika. Zomwe zimayambitsa kutupa kwapancreatic zimaphatikizapo:

• matenda opatsirana, a virus ndi parasitic,
• matenda oyamba ndi fungus
• kuvulala ndi poyizoni,
• mankhawala a endoscopic ndi ntchito.

Pancreatitis Gulu

Mwa mtundu wa maphunzirowo, matendawa amatha kukhala owuma (OD) komanso aakulu (CP). Mtundu woyamba wa matendawa umatanthawuza kutukusira komwe kumachitika mu kapamba ndikudutsitsa ziwalo zina ndi ziwalo zina. Matendawa amakula mwadzidzidzi chifukwa chakumwa mowa, zokometsera kapena zakudya zamafuta. Nthawi zina, kuyambika kwa matendawa kumayenderana ndi kudya zakudya zambiri ndikatha kusala kudya kwanthawi yayitali.

Akatswiri a pancreatitis acute amatchula motere:

1. Pachimake kwambiri kapamba. Ndi mawonekedwe awa, ziwalo zamkati sizigwira ntchito moyenera. Kusiyana matenda a kapamba amawulula kuphwanya kwakukulu.
2. Fomu lakuthwa. Ndi matenda amtunduwu, ntchito za ziwalo zimasokonezeka pang'ono.
3. Pachimake kwambiri kapamba, zovuta ndi parapancreatic kulowetsedwa, peritonitis, purulent abscesses, sepsis, magazi.

Matenda a kapamba amapezeka mwa anthu atavutika ndi mawonekedwe a pancreatic kutupa. Kutengera kuzika kwawo, akatswiri amasiyanitsa:

1. Mawonekedwe olimba. Pancreatitis imadziwika ndi njira yomwe imapitilira mobwerezabwereza. Nthawi zakukhululuka ndizosowa komanso ndizochepa.
2. Njira yamatendawa imakhala yochepa. Kuchulukitsa kwa kutupa kwa kapamba kumachitika katatu pachaka. Kupweteka kwamimba m'mimba kumatenga nthawi yayitali.
3. Njira yofatsa yamatenda. Exacerbations ndiyifupi komanso osowa. Amachitika kawiri pachaka.

Zizindikiro za kutupa pachimake

Kupweteka kwa epigastric ndi chizindikiro chowonetsa pancreatitis yayikulu. Kuzindikiritsa mosiyanasiyana pamaso pa chizindikirochi kumachitika nthawi yomweyo, chifukwa ululuwu nthawi zambiri umakhala wolimba kwambiri kotero kuti anthu sanganame ndikungokhala chete. Pambuyo pakuzindikira komanso kuzindikira moyenera akatswiri amatha kuchita chilichonse kuti athetse vuto la odwala.

Chizindikiro china chodziwika bwino chotupa kapamba ndi kusanza, komwe kumachitika mobwerezabwereza. Sizibweretsa mpumulo kwa anthu odwala. Mkhalidwe wawo chifukwa cha kusanza umangokulira. Zizindikiro zina za pancreatitis pachimake ndi monga:

• khungu, acrocyanosis (kupeza kwa khungu loyera),
• ukufalikira
• posungira mafuta, chopondapo,
• kufooka kwambiri.

Zizindikiro za Chronic Pancreatitis

Zizindikiro za CP ndizosiyana munthawi yakukhululuka komanso kuchotsedwa. Zimatengera zifukwa zingapo: siteji, zamankhwala zamtundu wa matenda. Ngakhale izi, zingapo zazikulu za chifuwa chachikulu chimatha kusiyanasiyana:

1. Kudzimbidwa. Zimawonetsedwa ndikuwonjezereka kwa kuchuluka ndi kuchuluka kwa chopondapo. Pancreatitis yayitali, ndowe zimakhala ndi imvi komanso fungo la fetid. Nthawi zambiri mumakhala zakudya zotsalira zomwe sizinapayidwe. Zizindikiro zomwe zili pamwambazi zimachitika chifukwa cha kuchepa kwa kuchuluka kwa mphamvu yogwirira ntchito parenchyma komanso kuphwanya chinsinsi cha kutulutsa tulo mu duodenum.
2. Kufooka, kunjenjemera mthupi lonse, njala, kukokana, kuyenda matumbo ndi kukoka, kusiya kuzindikira. Zizindikiro izi za CP zimagwirizanitsidwa ndi kuphwanya kwa magwiridwe antchito a kapamba.
3. Ululu wam'mimba. Zowawa sizikudziwika bwinobwino. Itha kuchitika pakati kapena pamimba pamimba ndikutenga herpes zoster. Nthawi zina, ululu suwonedwa.

Kuzindikira matenda apachimbudzi

Potsimikizira kuti ali ndi vutoli, madokotala amapereka mayeso kwa odwala awo.Kuzindikira matenda a kapamba kumaphatikizapo kuyezetsa magazi komwe kumachitika kuti mudziwe kuchuluka kwa michere yomwe imapangidwa mu kapamba. Mayeso wamba a seramu amylase ndiofala. Mlingo wa enzyme imeneyi ndi wokwera kangapo kuposa masiku onse mwa anthu omwe ali ndi pancreatitis yayikulu.

Njira zakuzindikira zimaphatikizanso urinalysis. Malinga ndi zotsatira za kuwunika kwa odwala kwawulula:

• proteinuria (zam'mapuloteni mumkodzo),
• micromaturia (kukhalapo kwa magazi mumkodzo mopitilira muyeso yachilengedwe),
• cylindruria (mawonekedwe a mkodzo wa matupi acylindrical opangidwa m'magazi am'magazi, mapuloteni ophatikizika, aimpso epulelium).

Njira yodalirika yodziwira matenda a pancreatitis pachimake ndi complication tomography (CT). Zimakupatsani chithunzi cha kapamba, ziwalo zozungulira komanso ziwalo zamkati, kuzindikira zovuta za matendawa, kuwunika kukula ndi chikhalidwe cha zotupa zapamba pancreatic necrosis.

Kuzindikira ndi kuchiza pancreatitis yachilendo imatha kuchitika chifukwa cha laparoscopy. Kugwiritsa ntchito, madokotala omwe ali ndi chitsimikizo chachikulu amazindikira mtundu wa matendawa, kuzindikira ndikuchotsa zovuta zina za matendawa.

Njira yodziwika bwino, yophunzitsira, yosavuta komanso yotetezeka yopezera matenda ndi kupezeka kwa matenda a pancreatitis pachimake. Ikachitika, kukula, ma contour, mawonekedwe, mawonekedwe amkati, kuphatikizika kwa kapamba, ndi momwe ductal system imayesedwera.

Kuzindikira mawonekedwe osakhazikika

Kuzindikira pancreatitis mwa akulu kumakhala makamaka ndi ultrasound ndi CT. Anthu odwala amapatsidwa gawo la endoscopic retrograde cholangiopancreatography. Njira yofufuzira iyi ndi kuphatikiza kwa endoscopy ndi fluoroscopy.

Kuzindikira matenda kapamba kumakhalanso ndi kutsimikiza kwa exocrine pancreatic ntchito. Ndizolinga izi kuti akatswiri azichita pulogalamu - yowerengera labotale yomwe imakuthandizani kuti mupeze zotsalira za chakudya chosagwiritsidwa ntchito mu ndowe.

Ntchito ya Exocrine pancreatic imatha kuyesedwa pogwiritsa ntchito mayeso a C-mpweya. Ubwino wawo waukulu ndiosavulaza (kusowa kwaphwanya umphumphu wa zopinga zakunja za thupi). Kudziwona koteroko kwa kapamba kumapangitsanso kudziwa kuyenera kwa enzyme m'malo mwake.

Mankhwalawa pachimake kapamba

Ngati pali zizindikiro zomwe zikuwonetsa kukula kwa OP, wodwala ayenera kupatsidwa thandizo loyamba:

• letsa kudya ndi kumwa kwa masiku angapo,
• ikani moto wothira pamadzi ozizira kapena kuwira kwa madzi oundana kumadera a epigastric,
• perekani antispasmodics (chifukwa chogwiritsa ntchito "No-shpa" kapena "Papaverine" kupanga ma enzyme kuchepa).

Pambuyo pa thandizo loyamba, muyenera kuyimbira foni dokotala. Munthu ayenera kuchipatala. Kuzindikira kwa ultrasound kwa pancreatitis pachimake kumachitika nthawi yomweyo kuchipatala. Pambuyo pokhazikitsa kuzindikira koyenera, ma analgesics amalembedwa (Baralgin, Analgin) kuti athetse kupweteka.

Mankhwalawa amagwiritsanso ntchito mayankho a amino acid ndi glucose. Amadzipangira zosowa za pulasitiki komanso mphamvu za thupi. Maantibayotiki nawonso amalembedwa. Mankhwalawa ndi ofunikira kuti athandizidwe komanso kupewa matenda a purulent.

Patatha masiku angapo chiyambireni chithandizo, probe woonda amaikidwa m'matumbo ang'onoang'ono. Ndikofunikira pakugwiritsa ntchito njira zamagulu azakudya. Ntchito yamatumbo ikabwezeretsedwa, wodwalayo amaloledwa kudya zachilengedwe. Chakudyacho chizikhala ndi mbewu monga chimanga, masamba ophika, makompyuta.

Chithandizo cha Conservative mu 87% ya milandu chimachita bwino. 13% yotsala ya odwala amafunikira chithandizo chamankhwala. Zimachitika pamene kupezeka kwa matenda a kapamba amawulula zovuta zazikulu. Zolinga za chithandizo cha opaleshoni ndizotsatirazi:

1. Kuchepetsa endotoxemia. Chifukwa cha izi, kukhetsa ndi kuwonongeka kwa ma ducts a bile, kukoka ndi kukonzanso kwam'mimba pamimba kumayikidwa. Pa nthawi ya opareshoni, ma enzyme, poizoni ndi zinthu zina zomwe zimagwira thupi zimachotsedwa m'thupi.
2. Chithandizo cha matenda opatsirana ndi necrotic a pancreatic necrosis (abscesses, fistulas, cysts, peritonitis). Kuti mukwaniritse izi, akatswiri amachita zoyeserera komanso kukoka kwa ma post-necrotic, ma purcine patsekeke, resection and sequestrectomy ya kapamba.

Chithandizo chachikulu cha kutupa

Ngati matenda a pancreatitis adawonetsa mtundu wa matendawa, ndiye kuti mankhwalawa amatha kuperekedwa kwa odwala: kukonzekera kwa pancreatin komwe kumapangidwira (Mezim, Festal, Creon), maantibayotiki (Abaktal, Amoksiklav, Sumamed) ndi ena Nthawi zina (mwachitsanzo, ndi pseudocyst wopangidwira) pang'onopang'ono madzi am'kati kapena opareshoni amafunikira.

Udindo wofunikira umachitika ndi zakudya. Ndi kuchulukitsa kwa matendawa patsiku la 1-2, odwala amaletsedwa kudya chilichonse. Mutha kumwa madzi okha (malita 1-1,5 patsiku): tiyi wofooka, mchere wamchere wopanda mafuta, msuzi wa rose yamtchire (magalasi 1-2). Patsiku la 2-3, chakudya chimaloledwa. Supu zokonda, amphaka amkaka osenda amkaka, zakumwa zamasamba, zakudya zonunkhira zopangidwa kuchokera ku msuzi wa zipatso zimaloledwa.

Panthawi yachikhululukiro, muyenera kutsatira malangizo awa:

1. Cook wothira, kusenda kapena kuphika mu uvuni. Pewani mafuta oyera pazakudya ndikuchepetsa mchere mpaka 6 g patsiku.
2. Idyani zakudya zazing'ono 5-6 patsiku. Kutentha kolimbikitsidwa kwa mbale zotentha sikokwanira kuposa madigiri 57−62, ozizira - osachepera 15−17 madigiri.
3. Musachotse mu zakudya acidic, zonunkhira, zokometsera ndi zakudya zam'chitini, nandolo ndi nyemba, bowa, zakumwa zozizilitsa kukhosi ndi zakumwa zoledzeretsa, kvass, misuzi yazipatso zamchere, ndi zinthu zina zambiri zophika mkate. Kirimu ndi wowawasa kirimu amaloledwa pang'ono m'mbale.

Njira zina zochiritsira

Mwanjira yovuta yotupa kapamba, njira yokhayo yoyenera ndikuwona dokotala. Sikoyenera kuyesa mankhwala azikhalidwe zaanthu. Ngati Zizindikiro ndi matenda a pancreatitis akuwonetsa mtundu wa matenda, ndiye kuti mutha kuyesa njira zochizira zomwe zimaperekedwa ndi mankhwala ena.

Zotsatira zabwino nthawi zambiri zimapatsa mankhwala azitsamba. Kugwiritsa ntchito mankhwala azitsamba kungathandize kwambiri kuti anthu omwe ali ndi matenda apamba a pancreatitis asamavutike. Nayi chinsinsi cha mankhwala amodzi:

• sakanizani magawo awiri ofanana chimanga stigmas, chamomile ndi maluwa a calendula, masamba ophukira ndi udzu wa timbewu,
• kutenga 1 tsp. kuchokera osakaniza ndi kutsanulira 2 makapu madzi otentha,
• sambani msuzi m'madzi osamba kwa mphindi 15,
• tsitsani chomaliza ndi mphindi 45 ndikuvutikira.

Ndikulimbikitsidwa kumwa msuzi katatu patsiku kwa mphindi 15 musanadye chakudya, makapu 0,4, omwe m'mbuyomu amadzipereka ndi madzi ofunda mpaka kuchuluka kwa kapu. Mutha kusunga malonda mufiriji mpaka masiku 5.

Kupewa kwa Pancreatitis

Ndizotheka kuteteza chitukuko cha kapamba. Choyamba, muyenera kuyang'anira thanzi lanu. Matenda ena amisempha yonyansa komanso chikhodzodzo, matenda am'mimba amachepetsa kutupa kwa kapamba. Ngati vuto laumoyo likuwoneka bwino komanso ngati zikuwoneka kuti muli ndi malingaliro okayikitsa, muyenera kufunsa dokotala, mukayezetse mayeso ofunikira ndikupita kukayesedwa.

Njira ina yothanirana ndi kupewa kumwa mowa. Akatswiri amalimbikitsa ngakhale anthu athanzi labwino kuti asamwe mowa wambiri. Mu matenda am'mimba, mowa uyenera kusiyidwa kwathunthu.

Pomaliza, ndikofunikira kudziwa kuti pancreatitis (kliniki, matenda, chithandizo cha matendawa) ndi mutu wachipatala wofulumira. Ngati pali zizindikiro zomwe zikusonyeza kuti zikondazo zimayipa, muyenera kufunsa dokotala. Kuthamanga ndi matenda kumatha kubweretsa zovuta zowopsa m'moyo.

Chipatala cha Pancreatitis

Pancreatitis yosatha imawoneka ngati kutupa kosalekeza, komwe kumabweretsa kusintha kosasintha kokhazikika ndi pancreatic fibrosis. Kusintha kumeneku kumachepetsa ntchito za exocrine ndi endocrine. Dziwani matendawa amalola kuwunika koyenera kwa kapamba. Chipatalachi chimapezeka motere:

Kupweteka kwam'mimba komanso nthawi yomweyo kuwonda. Kulakalaka kumachepa, kudya zakudya kumachepa, chifukwa, kutopa kwambiri ndi kuperewera kwa chakudya. Ululu nthawi zambiri umakhala chizindikiro cha opareshoni.

Amawoneka m'dera la epigastric, mu hypochondrium ya kumanzere, mwina kututira kumbuyo. Nthawi zambiri izi zimachitika nditatha kudya mafuta, zonunkhira pambuyo pa ola limodzi ndi theka, maola awiri, zimachitika kuti pambuyo maola 6-12. Nthawi yayitali kwambiri ululuwu usanachitike atamwa mowa, umafika maola 48-72.

M'mphindi zochepa zotsatira mutadya, ululu umakhala wosowa kwambiri. Nthawi zina izi sizimakhudzana ndi zakudya. Zovuta zimachitika usiku.

Njira zomwe zikuwoneka kuti zikuwonetsa kupweteka zimaphatikizapo: kutupa kwa kapamba, neuroinfigue, kuchuluka kwazovuta zam'mimba, zoyambitsa-ziwonetsero za m'mimba (stenosis ya bile duct) ndizotheka.

Nthawi zina pancreatitis yosatha imakhala ndi njira yopweteka (20% ya milandu).

Asanazindikire matenda apathengo, dokotala amachita kafukufuku wa wodwala. Kukhalapo kwa matendawa kungasonyeze:

• kupweteka kwakanthawi kochepa komwe kumawonekera mu hypochondrium yamanzere,
• kusanza mseru
• matenda am'mimba,
• Kuchepetsa kwambiri thupi
• zoyipa kwambiri mutatha kudya yokazinga, mafuta, zakudya zonunkhira.

Fomu yovuta

Kuzindikira kwa labotale komanso kuchiza matenda a pancreatitis pachimake kumabweretsa mpumulo kwa wodwala. Nthawi zambiri mawonekedwe ofatsa amachoka popanda zovuta. Ziwalo zamkati sizikhudzidwa.

Ngati mawonekedwe ndi otupa kwambiri m'chilengedwe, pali zosokoneza mu minofu ndi ziwalo, chithupsa cha chithuza chitha. Kuposa mwezi umodzi pambuyo pake, cyst yabodza imatha kuwoneka, imadziwika ndi kudziunjikira kwa madzi a pancreatic. Ngati pancreatic necrosis imachitika, chiopsezo cha matenda a minofu chikuwonjezeka. Mwinanso mu mawonekedwe owopsa, kudzikundikira kwachilengedwe mu chithaso kapena malo apafupi ndi pancreatic amadzimadzi. Mukamayang'anira matenda ozindikira, izi ziyenera kukumbukiridwa.

Ngati minofu necrosis yayamba, zotsatira zakupha ndizotheka, nthawi zambiri izi zimachitika ngati mawonekedwe a puranchene amtundu wa kapamba amawonekera.

Kusiyanitsa kwapadera kwa kapamba

Njira zoyenera zamankhwala zimatha kusankhidwa pokhapokha ngati chizindikirocho chiri cholondola. Kuchira kwachangu kwa wodwala kumatengera izi. Pachifukwa ichi, kudziwitsidwa kosiyanasiyana kwa kapamba kumachitika. Ndikofunikira kwambiri kusiyanitsa matendawa ndi ena omwe ali ndi zizindikiro zingapo zofanana. Matendawa ndi monga: zilonda zopangidwa bwino, khansa ya kapamba, kutsekeka kwamatumbo, cholecystitis, kulowetsedwa kwa myocardial, pachimake. Kuti mudziwe zomwe wodwala akuvutika ndizotheka kuchipatala chokha. Dotolo ayenera kudziwa zonse zomwe zimadziwika ndi matendawa, chifukwa chake ndikofunikira kuti mupeze matenda oyenera.

Chotupa chimathandizira kuti tiwone kuchuluka kwa maganizomiki mu 85% ya milandu. Ndikulimbikitsidwa kuyambitsa matenda osiyanasiyana a pancreatitis ndi ERCP.

Chiwerengero chachikulu cha zolakwika zamankhwala zimapangidwa posiyanitsa kapamba ndi chilonda chopangidwa ndi mafuta. "Pamimba pamimba" pakubaya, imakhala ndi chithunzi cha ululu wakuthwa, womwe umatsatana ndi chikhalidwe chododometsa. Kugunda kumakhala kosowa, palibe kusanza, m'mimba makomawo amakhala osasunthika, chizindikiro cha phrenicus, kuwonekera kwa hepatic m'malo mwake kumakhala chizindikiro cha hemmpanic chizindikiro cha mafuta, mawonekedwe a pneumoperitoneum. Ndi chilonda chopaka mafuta, wodwalayo amakhala m'malo mokakamizidwa, ndikusintha komwe ululuwo umakulirakulira. Ndi kapamba, odwala samakhazikika komanso mafoni. Poyambirira, kusanza kulibe; chachiwiri, kusanza mobwerezabwereza kumadziwika.

Kusiyanitsa mitundu yamatumbo kutsekeka ndi kapamba

Ndi kutsekeka kwa m'matumbo, funso la mawonekedwe ake ndilovuta kwambiri kuthetsa, mawonekedwe kapena champhamvu. Dziwani matenda am'mimba kapamba nthawi zambiri amawulula kusuntha kwamphamvu. Zovuta pakuzindikira zimatulukira magawo amtsogolo, pamene kusiyana kwatha kale.

Mavuto azachipatala omwe ali ndi zotchinga ndizosiyana kwambiri, zimatengera:

• Kuchulukitsa (m'matumbo kapena m'matumbo aang'ono),
• mitundu (yakuthanso, kupindika),
• nthawi (yovuta, pachimake),
• chikhalidwe cha cholepheretsa.

Zifukwa zonsezi zimabweretsa zovuta pakudziwikitsa matenda.

Mu chifuwa chachikulu cha pancreatitis, kugwira ntchito kumachepetsa. Mu genesis, njira za neurogenic zimagwira ntchito yayikulu, chifukwa njira za pathological zimakhala ndi kukula kwa Reflex. Pachimake pancreatitis amasonyezedwa kukula, mwadzidzidzi kupweteka m'mimba, kuphimba, kusanza mobwerezabwereza, kugwa.

Ndi zovuta kusiyanitsa matenda a kapamba, ndikofunikira kutembenukira ku fluoroscopy. Ziwalo zam'mimba zimayesedwa (mbale ya Kloiber).

Ma chloride otsika am'magazi amawonetsa matumbo. Ngati mulingo wambiri wa chloride ndi wabwinobwino, ndipo kuchuluka kwa ma diastase ndi okwera, ndiye izi zikuwonetsa pancreatitis.

Matenda ena

Mukazindikira pancreatitis, ndikofunikira kuganizira zamagulu ambiri, kusiyanitsa zizindikiro zofanana ndi matenda ena.

Chithunzi cha chipatala cha matendawa ndi chofanana ziphuphu zakumaso. Yotsirizira imatha kuzindikira kuti palibe kusanza mobwerezabwereza, diastasuria, mwa kukhalapo kwa kutentha kwambiri.

Aneurysm owonjezera amapezeka ndi magazi mu khoma la msempha, kumapeto kumayenderera kwakukulu. M'chifuwa pamakhala kupweteka kwambiri, nthawi zambiri kumavala chovala chomangira. Kutulutsa kumatha kufika pamimba, msempha komanso kuchepa kwa chidwi kumachitika m'munsi.

Kulepheretsa kwa Gastromesenteric Nthawi zambiri umakhala wofanana ndi wosakhazikika, zimachitika mwachangu, ndikusanza, ndikutupa kwa dera la epigastric, pamtunda wabwino. Chithunzicho chikufanana ndi pancreatitis yachuma. Kusagwirizana mu kuwonjezeka pang'ono kwa diastase.

Mavuto ofananawo amatha kubwera posiyanitsa ndi kupindika kokhazikika kapena kutembenuza m'mimba. M'mbuyomu, momwe mawonekedwe am'mimba am'mimba amathandizira pang'onopang'ono; mukamayang'ana kafukufukuyo, pamakhala zovuta kudutsa gawo lam'mimba. Panthawi yomwe ziphuphu zimangokhala zokha, pneumoperitoneum imachitika.

Wothandizira aliyense ayenera kudziwa zoyambira zakuwunika ndi chithandizo cha kapamba. Adziwitsenso zizindikiro za matendawa kuchokera kwa ambiri omwewo, adziwe zoyenera ndi kupereka mankhwala.

Laborator diagnostics

Wodwala akakaikiridwa kuti ali ndi kapamba, amapatsidwa mayeso okwanira. Udindo wofunikira umaseweredwa ndi njira zasayansi zozindikira matenda a kapamba. Choyamba, kuyezetsa kwamwazi wamagazi kumachitika, komwe kumapangitsa mtundu wa matenda. Kusanthula kumakupatsani mwayi wokhazikitsa chithunzi cha matendawa. Ndi kapamba, kuchuluka kwa lipase, alpha-amylase kumakulitsidwa, kulumpha kwakuthwa mu ntchito ya C-yogwira mapuloteni kumachitika. Ngati magazi a urea akwezedwa, izi zikuwonetsa kuti matendawa amaphatikizidwa ndi kuperewera kwa impso. Kutsika kwakukulu kwa albumin ndi kuchuluka kwa mapuloteni.Milingo ya insulin imachepa, kuchuluka kwa glucose kumawonjezeka.

Kusanthula kwa electrolytic ndi madzi kumapangitsa kuzindikira kusintha kwa kapangidwe ka magazi. Kutsika kwamadzimadzi, mwayi wotseka m'mitsempha yamagazi ndi mapangidwe a magazi ukuwonjezeka. Kusantaku kumakupatsani mwayi kuti muwone kuchuluka kwa sodium, potaziyamu, calcium, omwe amachititsa ntchito yamitsempha yamagazi ndi mtima.

Ndi mayeso wamba wamagazi, chikhalidwe chake chimatsimikizika. Chisamaliro chachikulu chimaperekedwa pamlingo wa maselo ofiira am'magazi ndi maselo oyera amwazi, izi zimapangitsa kuti athe kufufuza mozama.

Pancreatitis imakhazikitsidwanso ndimayesero amkodzo, mulingo wa alpha-amylase mmenemo amadzichotsera pazomwe amachita. Ndi kukula kwa matendawa, leukocytes, maselo ofiira am'magazi, ndi zina zomwe zimapangidwira zimapezeka.

Chida chozindikira

Chithandizo chazida za kapamba zimapangitsa dokotala kuti awone kusintha kwa kapamba. Ndikofunikanso kudziwa ngati kutupa kwakhudza matupi komanso ziwalo zapafupi.

Ultrasound imawonedwa yolondola kwambiri. Ultrasound imapangitsa kuti tizitha kuyang'ana moona. Kuwerenga kotereku kumakupatsani mwayi wowona matenda ngakhale mu nthawi ya asymptomatic. Ultrasound imatha kuunanso ma ducts a bile, kudziwa zotupa za purulent koyambirira, ndikuwona kukhalapo kwa madzimadzi.

Ndi laparoscopy, kapamba amadziwika nthawi yomweyo. Nthawi zina pogwira ntchito imeneyi mini kumatha kuchepetsa mphamvu yotupa pa ziwalo zina. Ndizofunikira kudziwa kuti laparoscopy imagwiritsidwa ntchito pokhapokha ngati ndizovuta kwambiri.

Ikaphatikizidwa tomography, kapamba amakhazikitsidwa ndi zizindikiro zamunthu: kukulira kukula kwa tiziwalo, kupezeka kwa minofu yoyaka kapena yakufa.

Chithandizo cha kapamba

Tidadziwana ndi chipatalachi, matenda a kapamba. Chithandizo cha matendawa chimatha kukhala chothandiza komanso mwachangu, mankhwala amakono amalola. Chifukwa cha iwo, ndizotheka kukana kuchitidwa opaleshoni nthawi zambiri. Mankhwala othandizira amagwiritsidwa ntchito. Nthawi zambiri, odwala omwe ali ndi matenda oopsa amatha kulowa kuchipatala. Choyamba, anti-yotupa ndi antibacterial mankhwala ndi omwe amapatsidwa. Akazindikira mawonekedwe a purulent, amayamba kulowererapo pang'ono pazinthu zodetsa nkhawa za antimicrobial.

Zotsatira zabwino zachangu zimatha kuponderezana kuchepa kwa michere, kuchotsa poizoni m'magazi.

Mankhwala otsatirawa amagwiritsidwa ntchito pochiza pancreatitis:

• ma pinkiller - "No-Shpa", "Papaverine", "Analgin", "Ketarol",
• antacid - "Almagel", "Phosphalugel", "Ranitidine",
• enzymatic - "Omez", "Pancreatin", "Creon".

Ndi chithandizo choyenera cha matendawa, dokotala ayenera kuyambitsa ma antacid ndi histamine blockers. Mankhwalawa amathandizira kuteteza makoma anu m'mimba ku zowonongeka za pancreatic madzi. "Ranitidine" ndi "Omeprazole" amalembedwa nthawi zambiri, amachepetsa acidity ndipo amawonedwa kuti ndi othandiza kwambiri. Koma ziyenera kukumbukiridwa kuti ndi kuchuluka kwa mankhwalawa, kuchuluka kwa msuzi wa madzi, komanso kugawaniza, kungaphwanyidwe. Nthawi zina m'malo mwake ma enzymes achilengedwe amagwiritsidwa ntchito - ichi ndi Creon, Pancreatin. Amachepetsa kapangidwe ka madzi a pancreatic, amateteza minofu kuti isawonongedwe.

Mulimonsemo, musamayesetse. Mankhwala ogwiritsira ntchito akuyenera kuperekedwa ndi adokotala, amadziwa zomwe zimafunikira ndendende ndi mawonekedwe anu a matendawa.

Ma labotale njira ndi magwiridwe antchito owunika a kapamba

Laboratory matenda a kapamba ndimaphunziro a magazi, mkodzo, ndowe, zomwe zili mu duodenum. Onetsetsani kuti mwazindikiritsa matenda ofananawo, kuti muchepetse kuzindikira koyipa, kuphatikizapo njira zina. Ganizirani za mayeso omwe amawululira kapamba:

Kuyesa kwa magazi ndi kapamba amanyamula zambiri zothandiza. Kuwonjezeka kwa ESR, kuchuluka kwa maselo oyera ndi kusintha kosangalatsa kwa leukocyte kumanzere kumadziwika. Kukula kwa magazi mu hypochromic magazi kumayendera limodzi ndi hypoenzymatic pancreatitis, yamitundu yosiyanasiyana. Eosinophilia imapezeka mu ziwopsezo za kapamba ndi parasitosis. Hematocrit imachepa ndi pancreatic necrosis, ndikuwonjezeka ndi madzi am'mimba.

Mapazi amwazi chikuwonetsa kusintha kwa ma protein: kuchepa kwa mapuloteni onse ndikuphwanya zigawo zake ndikukula kwa ma globulins ndi kuchepa kwa albumin. Ndi hyperenzyme pancreatitis, kuwonjezeka kwa ALT aminotransferases ndipo makamaka AST imapezeka. Mu pancreatitis yovuta komanso yotakataka, bilirubin yayikulu ndi phosphatase (alkaline phosphatase) imabisalira. Kutsika kwa kashiamu m'magazi kumadziwika, komwe kumalumikizana mwachindunji ndi kuopsa kwa kapamba.

Kuphunzira kuchuluka kwa michere ya kapamba mumkodzo ndi magazi. Ziwerengero za amylase zimachuluka kwambiri (m'magazi ndi mkodzo). Ndi OP komanso ndi CP, mulingo wa amylase umawonjezeka, koma ndi CP imakhala yochepa komanso yowonjezera. Chifukwa chake, njirayi siyogwiritsa ntchito kwenikweni pofufuza za CP. Poganizira kuti ndi CP, fibrosis imayamba, yomwe imapangitsa kuti ma enzymes apangidwe pang'ono ndipo poyamba izikhala yotsika. Zachidziwikire, ndi kuchulukitsa kwa CP, kuchuluka kwa ma enzymes kumawonjezeka, koma poyambira kutsika, kuwonjezeka, kumatha kukhala pakati pa zovomerezeka.

Amylase ali ndi ma isomers awiri: P-isoamylase ndi S-isoamylase. Pakufufuza, P-isoamylase iyenera kuyesedwa, chifukwa ndi pancreatic amylase.

Kuyeza kwa ma enzyme ena patsiku loyamba la kapamba kapamba kumakhala koyenera: elastase, lipase, trypsin, izi zikuwonetsa kulondola kwawo kwakukulu. Manambala a trypsin, alpha-1-antitrypsin, lipase, sialic acid amaonedwa ngati amawunikira kwambiri, koma chifukwa cha zina, zotsatira zake zitha kukhala zosadalirika, chifukwa ma enzyme angapo amatha kusintha ndi matenda ena am'mimba.

Kuzindikira kwa chifuwa chachikulu cha pancreatitis kumaphatikizapo muyeso wa phospholipase A2, kuchuluka kwake kumawonekera pamaso pa necrotic ndondomeko - pancreatic necrosis. Komanso, ndi pancreatic necrosis, leukocyte elastase, alpha 2-macroglobulin, alpha 2 --antitripsin. Kukula kwa kapamba kumatha kupezeka ndikutsimikizira pro-yotupa IL (interleukins).

Mlingo wa zotupa zolembera CEA (khansa-embryonic antigen) ndi CA - 19.9 (carboantigen) umachulukitsidwa pamene kapamba amachitika. Mu khansa ya kapamba, ziwerengerozi ndizokwera kwambiri kapena zabwinobwino kuposa masiku ena.

Ntchito zoyesa

Mayeso a Probe (olondola kwambiri): Zoyeserera mwachindunji - mwachindunji kudzera pa kafukufuku wa gastroduodenal, zomwe zili mu duodenum zimayesedwa ndipo ma bicarbonate ndi ma enzyme amawerengedwa mmenemo. Gold Standard - SPZT - testinpanreosimine mayeso. Mayeso osadziwika - Kuyesa kwa Lund ndi katundu wazakudya.

Mayeso osafunikira (zolondola pang'ono): Zoyeserera mwachindunji - ma enzyme okhala ndi ndowe (fecal elastase-1, chymotrypsin). Mayeso osawerengeka - kuwerengera kuchuluka kwa zinthu zomwe zimayambira pang'onopang'ono (chopondapo chopindika ndi mbiri ya lipid, kudziwa kuchuluka kwa mafuta omwe amatulutsidwa patsiku). Mu mkodzo (PABK mayeso, Schilling test, test pancreolauryl). Mu mpweya wotuluka (mapuloteni, triglyceride, amylase).

Kukhazikitsa chomwe chimayambitsa pancreatitis

Mfundo yofunika kwambiri pakuzindikira - chithandizo chotsatira chimatengera kudziwa zomwe zimayambitsa.

Mowa Pancreatitis chowululidwa ndi mbiri yakale, wodwala samakana mfundo yoti amamwa mowa.

Biliary Pancreatitis - mbiri ya bile duct matenda kapena cholelithiasis. Pa kusanthula, kuwonjezeka kwa bilirubin ndi alkaline phosphatase (alkaline phosphatase) kumadziwika. Kukhalapo kwa matenda (fungal, viral, bacteria, parasitic), matenda a autoimmune, majini, hypercalcemia.

OR OBP - mwachidule x-ray ya m'mimba

Ndi chithunzithunzi, ndikotheka kukonza malo otupa a koloni yodutsa, ndi njira ya necrotic - airiness ya malupu a matumbo ang'ono ndi akulu. Monga chifukwa cha pancreatitis yovuta, kupezeka kwa miyala mu duct kapena chikhodzodzo. Kupezeka kwa zowerengera ndi zowerengera ku CP.

X-ray OGK

X-ray ya OGK (ziwalo zachifuwa) - imawulula kudzimbidwa kwamanzere, sikumakhala konsekonse, kuletsa mayendedwe a diaphragm, kuwonongeka kwa m'munsi mwa mapapo kumanzere. Ndi kutupa kwa kapamba, kuphatikizira kwamadzimadzi kumachitika mu lumen ya patsekeke, madzi amadziunjikira ndikusindikiza mapapo kumanzere.

Chodziwikiratu ndichowonjezera pakuwunika kwa X-ray mosiyana ndi barium, m'mimba ndi duodenum (duodenum), chikhodzodzo cha ndulu ndi ndulu zimayesedwa.

Zojambula za kapamba (ultrasound of the pancreas)

Amagwiritsidwa ntchito kuyeza kukula, mawonekedwe a chiwalo, kuphatikizika kwa mawonekedwe, maumbidwe apangidwe ndi ziwonetsero, kuwunika kapangidwe kazinthuzo, kumveketsa kupezeka kwa madzimadzi aulere, mkhalidwe wamizere, kuyeza kukula kwa wamba bile duct (cystic duct), kukhalapo kwa cysts, pseudocysts, pathological neoplasms komanso minofu.

Mukuchulukitsa kwa CP, kukula kwake kumawonedwa (ponseponse kapena pang'ono), ndi edema ya pancreatic - ma contour ali ngakhale, ndi kufalikira kwa edema mpaka minofu yoyandikana nayo, ma contours ndi opepuka.

Echogenicity ya kapamba imayamba kuchepa, popanda kuchulukirachulukira. Kapangidwe ka nduluyo ndi kopanda ntchito, ma pseudocysts amadziwika, kukulitsa mawonekedwe a Wirsung duct.

Kuphatikiza apo, imatha kupezeka: kupindika kwa mitsempha, kupeza madzi aulere, kukulitsa kwa wamba bile duct, splenomegaly, kukulitsa kwa pancreatic lymph node.

Ndi pancreatic necrosis, kapangidwe ka gland kamakhala kosavuta, kusintha kwa zachilengedwe, anaechogenic, hyperechoic ndi hypoechoic malo amapezeka.

Pancreatitis yayitali yokhazikika imayambitsa kupangidwe kwa zowerengeka mu ma ducts, zowerengeka mu minofu ya tinyezi. Mu magawo apambuyo, kukula kwa kapamba kumachepa chifukwa cha kapangidwe kake, fibrosis, echogenicity imachulukana, kapangidwe kamakhala kopanda pake.

Njira ya Doppler imathandizira pakuwonetsetsa kuti khansa yapakhungu ndiyosiyana, kapangidwe ka kapangidwe kake ka mtima ndi kaperekedwe ka magazi kamadziwika. Kupatuka mu achichepere ndi achikulire kumatanthauziridwa mosiyana chifukwa cha kusiyana kwa umunthu.

Zotsatira zake zimasokonekera ndi dokotala yemwe amapezekapo kuti ateteze matenda osokoneza bongo kapena kutanthauzira molakwika kwa zotsatira zake.

Intraductal ultrasound

Intraductal ultrasound, njirayo imawunika luso la sphincter la Oddi ndi mtundu wa dyskinesia.

CPG yoyang'aniridwa ndi ultrasound (percutaneous pancreatography under control ultrasound) ndikochita kwaposachedwa kwambiri pakuphunzira dongosolo la pancreatic duct.

Intravascular ultrasound imagwiritsidwa ntchito kuzindikira CP kuchokera zotupa.

EUS (endoscopic ultrasonography - endoscopic ultrasound)

EUS (endoscopic ultrasonography - endoscopic ultrasound). Masiku ano, njira yophunzitsira kwambiri isanachitike ultrasound, CT, E RCP. Ili ndi zabwino pakuwona kusintha koyambirira kwa pancreatic parenchyma ndi pancreatic duct, imatha kuzindikira kuvulala kwakukulu kwapancreatic ndikuwona mawonekedwe a pathological osadziwika ndi njira zina. Kutengera ndi kuchuluka kwa zizindikilo za ESM zomwe zapezeka, ndizotheka kupereka lingaliro la matenda a kapamba.

Njira zatsopano za ultrasound (intraductal, laparoscopic, intravascular ndi ESM) ndizosowa muzochitika zachipatala zofunikira chifukwa cha mtengo wokwera wa zida.

Kupatuka konse komwe kwapezeka ndi ultrasound kumatanthauziridwa ndi adokotala omwe amapita, chifukwa amayenera kuphatikizidwa ndi zidziwitso zamankhwala ndi zasayansi chifukwa cha kulondola kwawo kwa 100%.

CT - computer tomography ndi MRI ya kapamba

CT - computer tomography ndi MRI ya kapamba, ziwalo zam'mimba, malo opuma.

Zosintha za pathological zolembedwa ndi CT mu CP ndi OP ndizofanana, koma mu OP ndizofunikira kwambiri. Mukuchulukitsa kwa CP, pancreatic edema, kuwonjezeka pang'ono kwa kukula kwake, zotupa zolowerera mu kapamba, ma pseudocysts, kuwerengera, kuwerengera, kukulitsa kapena kuwongolera kwa danc pancreatic duct. Ndi OP, edema ndi kuwonjezeka kwa kukula kwa kapamba amalembedwanso, koma kutchulidwa, ndizotheka kudziwa zamadzimadzi zaulere ndikulowetsedwa.

ERCP (endoscopic retrograde cholangiopancreatography)

ERCP - izi zikuyimira endoscopic retrograde cholangiopancreatography. Njirayi yatenga malo olimba pakuwunika ndipo akuwonetsedwa ndi "golide muyezo" pakukonzanso kwa CP.

Pogwiritsa ntchito ERCP, amawunika kusintha kwa pancreatic duct yayikulu, ndikuchepetsa "rosaries", cicatricial deficiities, kudzaza zolakwika, pseudocysts, pancreatic cysts.

Poyerekeza, mawonekedwe a cystic amawululidwa, popeza kuti kusiyana kumadzaza m'kati ndipo ndikotheka kuwona m'maso;

Angiography kapena CT Angiography

Angiography kapena CT angiography - kuphunzira kwa ziwiya za kapamba. Endoscopy yam'mimba ndi duodenum (duodenum).

Pancreatocholangioscopy (PCS) imagwiritsidwa ntchito pophunzira mkhalidwe wa dothi lalikulu la bile ndi la Wirsung. M'mikhalidwe yovuta, laparoscopy yodziwika ndi biopsy, NMR imaphatikizidwa.

Matendawa amatha kusiyanasiyana kuchipatala kapena kuchipatala. Zimatengera zifukwa zosiyanasiyana: kuuma kwa njirayo, zovuta za matenda, kufunikira kwa maopaleshoni kapena chithandizo chamankhwala, zaka, kupezeka kwa matenda opatsirana, kuopsa kwa matendawa, kuthekera kwa chipatala, kupezeka kwa zida ndi ogwira ntchito ophunzitsidwa.

Seti ya kusanthula ndi maphunziro ndi amodzi munthawi iliyonse, lingaliro limachitika ndi adokotala.

Omaliza maphunziro ku smolensk State Medical Academy. Imagwira mu GBUZ KDC 4 DZM Nthambi 4, Moscow, mutu. madokotala azachipatala. Zochitika zaka 8.