Ambiri pathogenetic njira ya chitukuko cha matenda kapamba

Pancreatolithiasis ndi kuwerengetsa kwa pancreatic parenchyma zimawonedwa pafupifupi mitundu yonse yachilengedwe ya chitukuko cha CP, kupatula autoimmune CP. Ndikofunikira kusiyanitsa pakati pa pancreatolithiasis (mapangidwe a calculi a ma ducts) ndi kuwerengera (calcificatio pancreatica). M'malo omaliza, ma catarices amapezeka mwachindunji m'matumba a pancreatic. Nthawi zambiri zowerengera zimaphatikizidwa ndi pancreatolithiasis, nthawi zambiri mikhalidwe imeneyi imakhala yokhayokha. Pamaso pa calculi mu ducts, ndichizolowezi kunena za CP zomwe zimalepheretsa chifukwa cha pancreatolithiasis, ndi pancreatic parenchyma catalysis - pang'onopang'ono pancreatitis.

Mpaka pano, homogeneity wa gulu la kapamba omwe amapezeka ndi pancreatolithiasis ndi calcation sizinatsimikizidwe bwino. N. Sarles mu 1991 adalimbikitsa kukhalapo kwa mitundu iwiri ya matendawa, limodzi ndi kupanga miyala mu kapamba. Mitundu yoyambayo imadziwika ndi kukhalapo kwa miyala ya mawonekedwe olondola ndi kuchuluka kwambiri kwa mawonekedwe ndipo imalumikizana ndi kugwiritsa ntchito mankhwala achchogol kapena osakwanira (osakwanira).

Mitundu yachiwiri imadziwika ndi kukhalapo kwa mapuloteni ochepa osakwanira okhala ndi mapangidwe ocheperako. Ma microliths otere nthawi zambiri amakhala a X-ray. Maphunziro awo samayenderana ndi kumwa mowa mwauchidakwa komanso kuperewera kwa zakudya m'thupi, zomwe zimawerengedwa kuti ndi zatsopano. Zomwe zapezedwa m'zaka zaposachedwa, makamaka pakuwongolera kwa pathogenesis ya NP, kudzipatula kwa kapamba wam'malo otentha ngati mawonekedwe osiyana, ndikuwunikira kwa morphological ndi matenda a matendawa, sizikugwirizana ndi malingaliro apakale a N. Sarles.

Tizilombo toyambitsa matenda amtundu wa kapamba timasiyana, koma njira zake zambiri zimagwirizanitsidwa.

Kupachikidwa. Kuwerengetsa CP kumachitika kawirikawiri chifukwa cha chikhazikitso cha pancreatic necrosis ndi magwiritsidwe a calcium m'malo a necrosis am'mbuyomu. Izi ndichifukwa choti pansi pa lipase pakuyang'ana kwa mafuta necrosis, mafuta osalowerera ndendende amagawika mafuta acids ndi glycerol, kenako kashiamu wamatumbo a pancreatic secolactic osakwanira amafuta acids, omwe amachititsa malo a necrosis.

Njira yachiwiri yowerengera yomwe ikuwoneka ikuyendetsedwa pamalingaliro amtundu wamtundu wa N. Sarles (chiphunzitso cha intraductal lithiasis), pomwe kuchuluka kwa mapuloteni m'makina osakanikirana kapena osakanikirana kumabweretsa kutsekeka kwawo ndikukula pang'onopang'ono kwa michere ya acinus. Monga mukudziwa, m'malo otchinga, mpweya wa calcium umapangidwa mokulira, zomwe zimapangitsidwa ndimadera a fibrosis, mosiyana ndi dongosolo la kapamba.

Atatulutsidwa kwa lithostatin, adayamba kukhulupilira kuti ndi puloteni iyi mumalowedwe a mipanda yaying'ono yomwe imamangidwa ndimakristali a calcium imatsogolera ku calcification. Komabe, umboni woti mapuloteni (mapulagi) ambiri amakhala ndi epithelium (ndipo osati mapuloteni), ndipo calcium nthawi zambiri imasowa mkati mwa miyala yoyambitsa pancreatic, mwanjira ina imatsutsa chiphunzitso ichi.

Pancreatolithiasis. Makina opanga miyala sanadziwikebe bwinobwino. Zomwe zimapatsa chiphunzitso cha chitukuko cha pancreatolithiasis zimachepetsedwa mpaka mfundo zitatu: hypersecretion ya calcium ndi lactoferrin, ntchito yogwira lithostatin. Zowonadi, ngakhale kuti kuchepa kwapang'onopang'ono kwa procrine secretion ya bicarbonates ndi michere ya pancreatic mu CP, kuwonjezeka kwa chinsinsi cha calcium ndi lactoferrin kumapezeka.

Hypersecretion wa calcium

Ndi CP, basal calcium secretion imachulukitsidwa, momwe imatulutsira poyambira kutsitsimuka kwa matumbo ndi isotonic sodium chloride ndi intravenous cholecystokinin. Kuchulukitsa kwa katulutsidwe ka calcium kwa odwala omwe ali ndi CP sikudalira kuchuluka kwake mu seramu yamagazi, etiology ya pancreatitis, cholecystectomy yapita komanso kukhalapo kapena kusowa kwa ma calcified otsimikiza a radiologically. Nthawi yomweyo, ndi khansa ya kapamba, katulutsidwe ka calcium kamachepetsedwa.

Chifukwa chake, kuchuluka kwake sikuti chizindikiro chofala cha matenda osiyanasiyana kapamba, koma chizindikiro chomwe chimadziwika ndi CP kokha. Chosangalatsa ndichakuti kuchuluka kwa calcium ndi mapuloteni m'matumba a pancreatic kumawonjezeka kale pachiwopsezo cha matenda osokoneza bongo a pancreatitis (asanafike calcation).

Kuchuluka kwa calcium kwa pancreatic secretion kumathandizira kutseguka kwa trypsinogen, ndipo mchere wake umatha kutsekeka mu chilengedwe chamchere cha pancreatic ducts. Kutsegula kwa trypsinogen mkati mwa gland kuphatikiza ndi kutsekeka kwa ndulu zake ndi calcium-protein microprecipitate, yopangidwa koyambirira kwamayeso amowa a pancreatitis mu agalu, akhoza kufotokozera momwe amapangira kukula kwa calcifying CP (makamaka, kuphatikizapo uchidakwa). Sizikudziwika ngati katemera wowonjezera wa calcium amatsogolera matendawa.

Lactoferrin

Mosiyana ndi malingaliro a lithostatin, adanenedwa kuti ngati choyambitsa mapangidwe a mapuloteni ndi mpweya wofunikira wa protein, zomwe zimatengera momwe amapangidwira madzi a pancreatic, ndiye kuti ndizotheka kudziwa zomwe zili mumapuloteni ena. Chifukwa chake, pakuwunika kwa madzi a pancreatic kwa odwala omwe ali ndi CP, kuchuluka kwakukulu kwa mapuloteni omanga chitsulo, lactoferrin, adapezeka .Kunenedwa kuti lactoferrin ikhoza kuchita nawo mapangidwe a mapuloteni, omwe amalumikizidwa ndi kuthekera kwake kwina mwayi wophatikizira mapuloteni akuluakulu a acidophilic (mwachitsanzo, albumin) .

Pali lingaliro kuti kuchuluka kwa lactoferrin mu pancreatic madzi ndi kokhako kwa odwala omwe ali ndi pancreatolithiasis, popeza matenda ena a kapamba samawonetsa kuchuluka kwa lactoferrin mu madzi a pancreatic. Amakhulupirira kuti katulutsidwe ka lactoferrin sikakhudzana ndi kumwa mowa kwambiri kapena procrine pancreatic insuffence, popeza sizikudziwika ngati matendawa adayambitsidwa ndi kuwonjezeka kwa kuchuluka kwake mu madzi a pancreatic kapena ndi chifukwa chake.

Kusokonezeka kwa lipid peroxidation system ndi nitric oxide synthesis

Kusintha kwa atbumin ndi hydrolysis yake yotsalira mu pancreatic madzi kumachitika pamene lipid peroxidation product (LPO) iwonjezedwa kwa iyo. Izi zimapereka zifukwa zokambirana (zodzetsa) ntchito ya lipid peroxidation ndi zinthu zake muzosakanikirana ma hydrolysis a mapuloteni apamba (kuphatikizapo lithostatin ndi kapangidwe ka mapuloteni osafunikira a calcium calcium).

Zotsatira zakufa kwa ma radicals a okosijeni a okosijeni pamasinthidwe amasinthidwe a morphological mu kapamba mu vivo adaphunzira m'maphunziro ochepa oyesera. Pakulemba kwaposachedwa, zotsatira zakuphunzira zotsatira za hydrogen peroxide pakusintha kwa mphamvu ya GLP ndi kusinthika kwa morphological mu kapamba mu amphaka anaperekedwa. Kuphatikiza kwadongosolo la hydrogen peroxide kunayambitsa OP ndi kusintha kwaposintha kwa mbiri yakale pancreatic parenchyma. Nthawi yomweyo, ndi intravenous management ya H202, palibe kusintha kwakukulu kwa mbiri yakale mu kapamba komwe kunadziwika.

Pali umboni kuti mu zovuta za CP, njira ya antioxidant imakhala yolondola, pomwe akupanga ma cysts, mawonekedwe a pancreatic ndi pseudotumor mitundu ya CP, vuto la antioxidant limapezeka, kutengera kukula ndi kutalika kwa matendawa. Matenda a lipid peroxidation mwa odwala omwe ali ndi mawonekedwe opweteka a CP samawonedwa ngakhale atakwaniritsa chikhululukiro. Odwala omwe ali ndi zovuta PC komanso pafupipafupi OP, kutsika kwa plasma kwambiri kwa selenium, vitamini A, E, P-carotene, xanthine, b-cryptoxanthin ndi lycopene amawonetsedwa poyerekeza ndi anthu athanzi.

Chifukwa chake, momwe muliri wa antioxidant ngakhale mu njira yosavuta ya CP sanganene. Kuphatikiza apo, zidatsimikiziridwa kuti palibe kusiyana kwakukulu pakati pa mbiri ya ma antioxidants mwa odwala omwe ali ndi chidakwa cha CP, idiopathic CP ndi OP yothandizira. Kuwona uku kumagogomezera kufala kwa njira imeneyi ya pathogenetic yamitundu yonse ya kapamba.

Kulimbitsa LP nthawi ya CP kumathandizira njira yotupa yakomweko, kumayambitsa kusokonezeka kwa ma cellcirculation ndi metabolic mu kapamba, kulepheretsa kupuma kwamisempha, komwe, kumabweretsa kuwonongeka kwa minofu ya limba.

Nitric oxide (N0) ndi moatomic yaulere yopitilira muyeso, kusowa kwa mlandu ndipo kukula kwake kakang'ono kumapereka lipophilicity komanso kuthekera kwambiri kulowa mkati mwa ma membranes a cell ndi ma cell cell.

Nthawi yayitali ya moyo munthawi yachilengedwe ndi 5.6 s. Kukhalapo kwa elekitoni imodzi yopanda waya kumapangitsa kuti molekyulu IYI ichuluke kwambiri ndikuwonjezera kuchuluka kwa kwachilengedwe. Mphamvu ya cytotoxic ya N0 idapezeka. Pali umboni kuti pa kapangidwe ka nitric oxide pansi pa zotupa, pawiri uyu amathandizira vasodilation, kuwonongeka kwapazinthu zam'mimba zomwe zimayambitsa kutupa, ndi ischemia. Zotsatira zoyipa za NO zimagwira gawo lofunikira pakukula kwa OP ndi CP.

Zovuta za microcirculation ndi heestasis

Mavuto a kukoka kwam'mimba m'mapapo amaphatikizana ndi mitundu yambiri yamatenda a kapamba ndipo amatumikiridwa ngati chimodzi mwa zigwirizano za pathogenetic za CP. Amawerengedwa kuti akutsogolera ischemic pancreatitis ndi kapamba zomwe zimachitika motsutsana ndi maziko a matenda a minyewa komanso vasculitis. Kufunikira kwa pathogenetic pamatenda am'magazi tosatheka sikungatsutsidwe, chifukwa kuphwanya kwa magazi kufinya m'matumbo kumakhudza kwambiri boma la ntchito yake ya exocrine ndi endocrine.

Malinga ndi Dopplerometry, mwa odwala omwe ali ndi vuto la kutaya kwa magazi a CP, ambiri amatchulidwa m'mutu wa kapamba. Kuchulukitsa kwa CP kumadziwika ndi pre-and postprandial insuffence of splanchnic flow. Malinga ndi kafukufuku wopangidwa ndi kafukufuku wakapangidwe kazakudya zakale, zidapezeka kuti zosintha zamkati mwa ziwalo za kapamba ndimatumbo a hypertrophy, hyperelastosis, kusintha kwa mitsempha yamagetsi yapakati komanso yaying'ono. Kusintha uku kumawonedwa mu 30% ya milandu, zomwe zimatipangitsa kuti tiziwona kuti kuphwanya kwakukulu kwa magazi kumapereka kwa kapamba panthawi ya kuchulukitsa kwa CP.

Panthawi yowonjezera CP, kuchuluka kwa magazi kumachulukitsa ndipo ntchito ya fibrinolytic imachepa nthawi yomweyo. Kuphatikiza kwa magazi kumaundana kumachulukanso, ziwopsezo zamagazi, magazi ake amaphwanyidwa, mphamvu zam'magazi ofiira amasintha.

Mavuto Olimbitsa Thupi

Pakadali pano, pali kuchuluka kwa ntchito zasayansi zomwe zikuwonetsa kuphwanyidwa kwazinthu zina mu chitetezo cham'manja komanso zochititsa manyazi mu CP. M'maphunziro ambiri a chitetezo chokwanira mu ma cell ku CP, kuchepa kwa zomwe zili mu T-lymphocyte kumadziwika. Pakusintha kukhululuka, kuchuluka kwa T-lymphocyte kumawonjezeka, koma kumatsalira kwambiri. Ndi kuchulukitsa kwa CP, kuchuluka kwa othandizira a T ndi othandizira T amachepetsa, ndipo kuchuluka pakati pawo kumasinthanso. Olemba ena, potengera kuchuluka kwa othandizira / othandizira, amazindikira magulu omwe ali ndi odwala omwe ali ndi CP omwe ali ndi gawo la autoimmune (othandizira / suppressors 5.0).

Njira zophunziridwa kwambiri zama cellular zomwe zimachitika ku minofu ya pancreatic mu CP. Oposa theka la odwala omwe ali ndi CP amanenanso za kuphulika kwa mitsempha ya m'mimba. Palibe mgwirizano pa kuopsa kwa ma cell omwe amachititsa kuti ma cell azitulutsa pancreatic mu gawo la kuchulukitsa ndi kukhululuka. Ochita kafukufuku ambiri amawona kuchuluka kwawo pachimake, pomwe pali umboni wa kuchuluka kwawo kwa kukhululuka kwa CP.

Amakhulupirira kuti ma cell a immunological reaction to pancreatic tishu amapezeka mwa odwala omwe ali ndi CP omwe ali ndi pafupipafupi (onse amakhululuka komanso mu gawo la kufalikira kwa matendawa). Odwala omwe ali ndi CP, zotsatira zoyenera zoletsa kusuntha kwa leukocytes ndi antigen kuchokera pancreatic minofu zidadziwika, chidwi cha cell kuti trypsin ndi insulin ndi kusintha kwakukulu munthawi yowonjezereka kwapezeka. Chifukwa chake lingaliro lakutsogolera kwa gawo lachitetezo cha chitetezo chamthupi mu kuperewera kwa thupi ndi kupita patsogolo kwa CP likuwoneka kukhala lomveka, pomwe mu OP, kusintha kwazinthu zochititsa manyazi kumadziwika.

Zambiri pazokhudza magazi zomwe zimapezeka m'magulu akuluakulu a ma immunoglobulin mu CP ndizotsutsana kwambiri ndipo, mwina, kutanthauzira kwake kwayekha sikumakhala ndi phindu lodziwitsa nokha. Cholumikizira chofunikira pakukwiya ndikutseguka kwa magawo a zomwe zimakwaniritsa dongosolo, zomwe zimatha kuwonetsa ntchito ya chemotactic, kuyambitsa maselo l cell, komanso kutenga nawo gawo pakukula kwa zochita zama immunological. Ndi kuchulukitsa kwa CP, kuchepa kwa ntchito zowonjezera kunadziwika, komwe kungafotokozedwe ndi kukhalapo kwa ma antibodies othandizira komanso kutenga nawo gawo pazomwe zimachitika pokhudzana ndi chitetezo chamthupi ndikumwa kowonjezera. Kuchepa kwa ntchito za zigawo za makina othandizira kumapitilira gawo la chikhululukiro cha CP. Zotsatirazi zimafotokozedwa ndikupanga ma cell a chitetezo cha mthupi omwe amakhala ndi ma antibodies kuti trypsin, insulin ndi antigen ochokera ku ma pancreatic tis.

Kusatetezeka kwakomweko mu CP sikumveka bwino. Izi zimachitika chifukwa chovuta cha organic biopsy ndi proteinolysis ya ma immunoglobulins ndi ma enzymes omwe amapezeka mwachinsinsi. Zotsatira zakuzindikira kuchuluka kwa ma immunoglobulins mu madzi a pancreatic amakhalanso ndi chidwi, komanso pamene atsimikizika m'magazi. Pa dzanja limodzi, pali umboni wa kusowa kwathunthu kwa IgA yachinsinsi mu madzi a pancreatic. Kumbali inayo, atachulukitsa kuchuluka kwa kuchuluka kwa CP, akuwonetsa kugwiritsidwa ntchito kwa chizindikirochi monga chidziwitso chotsimikizira.

Pali umboni kuti pakati pa odwala omwe ali ndi CP, kusintha kwakukulu kumapezeka pakupezeka kwa kugawa kwa ma antigen system a HLA poyerekeza ndi anthu athanzi, omwe mwina ndizomwe zimayambitsa kuyipa kwa mayankho a chitetezo chamthupi.

Ma cytokines ovomerezeka-ovomerezeka amawongolera kwambiri pa pathogeneis ya pancreatitis yovuta komanso yovuta. Udindo wofunikira wa ma cytokines pakupanga pancreatic fibrosis, necosis ya pancreatic imadziwika, ndipo akamalowa m'magazi ambiri (ndikusintha kwa chotupa chakomweko chomwe chimayambitsa matenda amodzi) - pakukula kwa kuledzera komanso kuperewera kwa ziwalo zingapo (chifukwa chachikulu cha imfa mu OP).

Ngakhale ndi pancreatitis yolimbitsa thupi yomwe imapangidwa ndi ERCP, kutulutsa kwina kofunikira kwambiri kwa ma cytokines kumachitika. Tsopano zatsimikiziridwa kuti kusayenerana kwa ma pro- ndi anti-kutupa cytokines m'malo mokomera zomwe zimapangitsa kuti pakhale kutupa (kuphatikizapo pancreatitis). Kusokonezeka pakupanga ma cytokines atha kukhala ngati amodzi mwa olumikizira mu pathogenesis ya CP chifukwa cha kuthekera kwa fibrogenesis ndi ena mwa iwo.

Apoptosis ya ma acinar cell imagwira ntchito yofunika kwambiri pa pathogeneis ya kapamba, yomwe imatseka unyolo wa pathogenetic ndikufulumizitsa njira ya fibrogeneis mu kapamba. Apoptosis ndi maselo obadwa kupulumuka a chamoyo, limodzi ndi mawonekedwe a cytological ndi kukonzanso kwa ma genetic.

Zimayambitsidwa ndi zinthu zingapo zowononga: ma virus, poizoni (kuphatikizapo lipopolysaccharide ya mabakiteriya osavomerezeka), mankhwala osokoneza bongo, zovuta zina. Zotsatira za apoptosis zimatha kukhala kupsinjika kwa oxidative, activation ya proteinase, kukomoka kwa calcium metabolism. Kuchokera pamenepa zikuwonekeratu kuti pakuwonjezeka kwambiri kwa apoptosis (ndi OP, gawo lofunikira mu izi limaseweredwa ndi bakiteriya lipopolysaccharide), necrosis imayamba, i.e. chinakulitsa pancreatic autolysis. Ndi kufooka kwa apoptosis, kuchuluka kwa maselo owonongeka kwamtundu kumawonjezeka, komwe kumayambitsa kusintha kwa hyperplasia ndi chotupa.

Mitundu ya p53 imayang'anira apoptosis, ndipo bc12, c-fos, c-myc genit inhibit. Ndi kutupa kwa nthawi yayitali (makamaka ma virus), masinthidwe amtunduwu amachitika: p53 imayamba kuletsa apoptosis, ndipo bc12 imakulitsa zotsatira zake kudzera mu khungu, mapulateni, a- komanso kusintha kwa kusintha. Zotsatira zake, kusinthika kumakhazikika, maselo osinthika amtundu amachulukirachulukira, mphamvu yamoyo ya maselo imakulitsidwa, ndipo mwayi wa kusintha mwa iwo umakulanso. Zonsezi zimapangitsa kuti preneoplastic komanso kuchuluka kwa neoplastic.

Zolinga za maonekedwe

Zomwe zimayambitsa kukula kwachiwiri kwachiwiri yogwira pancreatitis ndi izi:

matenda am'mimba
chikuku, kutentha thupi, chimfine,
ARVI,
nthawi yayitali yovuta
zolakwika m'zakudya,
helminthic infestation,
poyizoni
kulephera kwa mahomoni
atherosulinosis
tsankho pazinthu zina,
kusuta ndi uchidakwa,
matenda am'mimba thirakiti: chiwindi, gastritis, cholecystitis, dyskinesia, biliary thirakiti, zilonda, cholelithiasis.

Tiyenera kumvetsetsa kuti kupezeka kwa chimodzi kapena nthawi imodzi zingapo zaubwinobwino sizititsogolera pakukula kwa dissancreatism. Kukhazikika kwa nthawi yayitali pazinthu izi kumakulitsa chiopsezo cha matenda. Pakakhala chithandizo choyenera, ma dissancreatism amatha kusinthika mosavuta kukhala kapamba, chifukwa chake simuyenera kusiya.

Kuwonongeka kwa kapamba ndi njira yachiwiri yomwe imachitika motsutsana ndi maziko a matenda ena

Ndondomeko amadziwika ndi kutupa pachimake ndi chitukuko mwachangu. Ndi zotheka kuchotsa matendawa pokhapokha pochiza chiwalocho, kusapeza bwino komwe kumapangitsa kuti dissancreatism ayambe. Thupi silingachite ntchito zake mokwanira, zomwe zimatsogolera kugawana kosakwanira kwa michere ya pancreatic ndi metabolic. Zotsatira zake, mapuloteni, mafuta ndi chakudya sichimamwa mokwanira.

Zizindikiro zamatenda a dyspancreatism zimakhudzana mwachindunji ndi kutupa kwa kapamba, komanso ndi zizindikiro za matenda omwe amakhumudwitsa mawonekedwe a matenda. Chizindikiro cha matendawa ndi ululu. Zosasangalatsa zomveka zimatchulidwa kumanzere kwa hypochondrium ndi pamimba pamimba.

Popita nthawi, ululu wosakhazikika umapezeka mu theka lamanzere la thupi. Mu ana, khunyu ndi lamphamvu kwambiri kotero kuti amafanana ndi chipatala cha pachimake chakupweteka. Kusintha kwa chopondapo kumawonedwa. Tizilomboti timakhala gruel kapenanso kuwonda. Zizindikiro zamankhwala sizangokhala izi. Odwala amakhala ndi mseru, malamba, kusanza, kusintha kwa kamwa.

Ngakhale kuwonekera kwa malonda, kuyambika kwa mseru woipa kumakulirakulira. Zizindikiro za kuledzera kwakukulu kumawonetsedwa mu kufooka, ulesi, kugona, kusayang'anira, kuchepa kwa ntchito. Dispancreatism mwa ana imadziwoneka yokha mu kusowa kwa chilimbikitso, kuchepa thupi mwadzidzidzi, nseru, kupweteka kwambiri. Mu ndowe, mumakhala zidutswa za chakudya chosasankhidwa.

Kupweteka kwambiri pamimba kumafanana ndi kuwonetsa kwa pachimake appendicitis. Mwanayo sangathe kupirira ululu

Pomwe njira ya pathological ikupita patsogolo, chithunzi cha chipatala ndichulukirachulukira:

kusanza pafupipafupi
malungo
mutu
kupanikizika
matenda amkuwa
kusowa kwa chakudya
kuwonda
ukufalikira
khungu louma, misomali yophwera.

Zizindikiro

Kutsimikizira kuti matendawa ndi ovuta kungakhale kovuta kwambiri. Wodwalayo amayamba kutumizidwa kuti akumane ndi akatswiri othandizira, kenako gastroenterologist. Chofunikira chofunikira chomwe chikuwonetsa kukhalapo kwa vuto lantchito lamtunduwu ndi kusowa kwa kusintha kwa morphological mu kapamba.

Ngati mukukayikira kuti dissancreatism, adokotala amatha kukupatsani maphunziro awa:

Ultrasound yam'mimba,
kuyezetsa magazi konse
pulogalamu yothandizira kupatula dysbiosis,
sonography
kuyesa kwamwazi wamagazi.

Gawo lalikulu la achire ochiritsira dispancreatism ndi chakudya. Kuwongolera zakudya kungathandize kwambiri kusintha mkhalidwe.

Panthawi yamankhwala, ndikofunikira kupatula kudya zakudya zosavuta, zosungika, mafuta, yokazinga, nyama zosuta, marinade, masoseji. M'masiku ochepa okha madzi amaloledwa kumwa. Ndiye tiyi wokhala ndi zopindika, chimanga chophika chimayambitsidwa muzakudya. Pa tsiku lachinayi, zamkaka zimayambitsidwa. Kupitilira apo, amaloledwa kupangira zakudya ndi masamba msuzi.

Masamba ophika ndi zipatso sangathe kudyedwa osapitilira milungu iwiri.

Imwani madzi ambiri. Ndikofunikira kumwa madzi achilengedwe ang'onozing'ono komanso pafupipafupi

Yesani kudya zakudya kasanu ndi kamodzi patsiku, ngati kungathekere nthawi yomweyo. Zakudya zonse zizikhala zotentha. Mu chakudya muyenera kukhala mbewu monga chimanga, nyama yopanda nkhuku, nsomba, mkaka. Ndikofunikira kuti muchepetse kunenepa kwambiri, ndibwino kuti mupangitse kukonda zakudya zama protein. Kuchokera pa zinthu zamkaka zimalola tchizi chokhala ndi mafuta ochepa komanso kefir.

Kirimu wowawasa imagwiritsidwa ntchito ngati chovala mbale. Mkaka wonse uyenera kuchepetsedwa ndi madzi. Masamba amagwiritsidwa ntchito bwino mu mawonekedwe ophika.

Itha kukhala kaloti, dzungu, squash, dzungu, mbatata, beets, kolifulawa ndi broccoli. Panthawi yamankhwala maswiti samachotsedwa. Pochulukirapo, amaloledwa kudya kupanikizana, uchi ndi shuga.

Masamba ophikira zamasamba ndilolandiridwa. Ndikwabwino kuti muziphika pamsuzi wamasamba, m'malo nyama. Kwa ana, mutha kuphika tchizi cha calcined. Kuti muchite izi, muyenera kugula calcium ku pharmacy. Kenako, supuni ya ufa imathiridwa ndi lita imodzi ya mkaka wotentha. Mkaka uyenera kupindika, kenako nkuuponyera pachiwowo.

Masupu Amasamba Adzakupindulitsani Kwambiri

Thandizo lakuchipatala

Mankhwala osokoneza bongo amaphatikizapo kugwiritsa ntchito mankhwalawa:

Kukonzekera kwa enzymatic: Pancreatin, Mezim, Festal,
antispasmodics yochepetsa ululu ndikuwongolera magwiridwe antchito a sphincter: No-shpa, Drotaverin,
mankhwala opangitsa kuti matumbo azisintha,
mavitamini zovuta.
mankhwala kusintha chimbudzi: Motilium.

Panthawi yovuta, ndikofunikira kupereka thandizo munthawi yake:

itanani ambulansi
Kuti achepetse ululu, wodwalayo ayenera kugona pansi ndikumakanikizitsa miyendo yake, ndikugwada pamaondo, mpaka kumbuyo,
ikani kuzizira pamimba yapamwamba, izi zimachepetsa ululu,
Spazmalgon kapena No-shpa amathandiza kuthetsa kuphipha,
mankhwala antisecretory: Yothandizirana, Omez, Gordox,
Kudya sikuletsedwa. Mulole madzi opanda mpweya.

Zotsatira zake

Chiwopsezo chachikulu cha kupatsirana ndikuti njira ya pathological imatha kukhala yodziwikiratu ndikudziwonetsa yokha mwa kugwidwa kwakanthawi. The yogwira pancreatitis kumatha kubweretsa mavuto:

matenda ashuga
aakulu kapamba
gastritis
cholecystitis
ascites
kapamba,
ndondomeko yomatira
matumbo,
njira zama oncological.

Chifukwa chake, dispancreatism ndikuphwanya ntchito za kapamba. Ino si gawo lovuta kwambiri la kapamba, komanso osati gawo lathanzi la chiwalo. Matendawa ndi abwino, ndikulondola ndi kuthetsa zomwe zimayambitsa, kuyambiranso kuthana. Kuwongolera mkhalidwe kumachitika pambuyo pakuchotsedwa kwa zomwe zimayambitsa. Maziko a mankhwalawo ndi chakudya chamagulu, chomwe chimaphatikizidwa ndi mankhwala osokoneza bongo.

Kuthetsa - vutoli lomwe limachitika chifukwa chaphwanya chizolowezi chochita kupezekanso kwa kapamba (kuchepa kapena kuwonjezeka kwa kupanga kwa ma enzymes kapena kusintha kwa kuchuluka kwawo pakubisika kwa glandular).

Zizindikiro za matendawa

Dyspancreatism nthawi zambiri imayamba modzidzimutsa ndipo ngati sipangakhale nthawi yochepa maphunziro sazindikira. Komabe, odwala ochulukirapo (makamaka ana ndi achinyamata) amadandaula za ululu wosakhazikika wa paroxysmal m'chiuno hypochondrium. Chifukwa cha izi, matendawa nthawi zina amapezeka kuti samadziwika bwino monga appendicitis.

Komanso, odwala amatha kunena zisonyezo zosakhazikika: mseru, kusanza (nthawi zina ndi kuphatikizika kwa ndulu), kuwawa mkamwa, kupuma movutikira, kupindika ndi chimbudzi.

Matenda opatsirana

Zikondazo ndizoyenera kugwiritsa ntchito shuga. Chifukwa chake, muzovuta kwambiri za dyspancreatism, kuchepa kwa glucose m'magazi ndi mkodzo kumayang'aniridwa, zomwe zimapangitsa kuti pakhale zizindikiro zonga matenda ashuga.

Pali kuwonongeka konsekonse pakuyenda bwino, kugona mosalekeza, kutuluka thukuta kwambiri, komanso kusinthasintha kwa mtima. Ma capillaries ang'onoang'ono amakhalanso ndi vuto, lomwe limawonetsedwa pochiritsa mabala, kuwonongeka kwa mawonekedwe.

Chotsatira chosowa kwambiri komanso chovuta kwambiri cha dissancreatism ndikupanga shuga chikomaso kumbuyo kwa kuchuluka kwa shuga.

Njira zochizira matendawa

Zovuta za kapamba zimayankha bwino mankhwala. Monga lamulo, kuphatikiza kwa mankhwala a antispasmodic, ma pinkiller ndi ma pancreatic enzyme amaloledwa.

Kuphatikiza apo, wodwalayo amasamutsidwira kumalo ena osinthika omwe amatsitsidwa ndi madzi ambiri ndikupatula zakudya zamafuta ndi zamafuta, komanso zakudya zazonunkhira.

Ndi chithandizo choyenera, dispancreatism, monga lamulo, imazimiririka pakapita masiku ochepa, ngakhale zizindikiro zotsalira zimatha kuwonekera kwa milungu ingapo.

Njira Zotetezera Matenda

Kuti mupewe kukula kwa dissancreatism, choyambirira, muyenera kusamalira katundu wabwinoko paz kapamba. Izi zikutanthauza kupatula pachakudya chochuluka cha maswiti ndi mowa, kuti musachite nawo zakudya zamafuta ndi zonunkhira.

Komanso, muyenera kulabadira matenda am'mimba ndi matumbo ang'onoang'ono, omwe angayambitse kutukusira kwa ma pancreatic ducts.

Ngati mukumva kupweteka "m'mimba", musatenge zoopsa - lemberani kuchipatala. Apa, akatswiri odziwa ntchito azaka zambiri azakuthandizani kuti musamasuke ku zisonyezo zosasangalatsa ndipo munthawi yojambulidwa mudzabwezeretsa moyo wachimwemwe!

Mawu achifashoni azachipembedzo awa amachokera ku mawu awiri: "dis" - kuphwanya ndi "kapamba" - kapamba. Chifukwa chake, lingaliro la "dispancreatism" mwa mwana limatanthawuza kuphwanya kosiyanasiyana kwa kapangidwe ka chiwalochi, komwe sikumayendetsedwa ndi kusintha kwa kusintha kwa thupi kwa chiwalo. Mawonetsedwe azachipatala ndi kusintha kwa magawo a laboratori ndi ofanana mwa ana a m'badwo uliwonse. Mfundo zazikuluzikulu zamankhwala ndizofanana.

Zoyambitsa Kukana

Pakadali pano, pali zinthu zingapo zomwe zingapangitse kukula kwa ma dissancreatism. Zoyambitsa zazikuluzikulu za izi ndi izi:

njira zopatsirana pachimake, kuphatikiza matumbo ndi kupuma,
kupsinjika m'maganizo, makamaka kosatha kapena kwanthawi yayitali,
kuperewera kwa zakudya m'thupi, makamaka kwa nthawi yayitali,
matenda ena am'mimba ngalande, makamaka m'mimba, chiwindi, matumbo.

Tiyenera kumvetsetsa kuti kupezeka kwa chinthu chilichonse chomwe sikulimbikitsa sikungachititse kuti munthu azitsuka. Komabe, kupitilira kwa zinthu zingapo zomwe zimayambitsa matenda ambiri kumapangitsa kuti chiwopsezo cha matenda obwera chifukwa cha kapamba chikwaniritsidwe.

Dyspancreatism ndi lingaliro lalikulu lofalikira lomwe limasiyanitsa ndi kapamba, ndiko kusowa kwa kusintha kwakuthupi. Mu mawonekedwe apakhungu a kapamba, kusintha kwamkati mwa chiwalo kumadziwika, komwe kumapezeka pakuwunika.

Mu mawonekedwe a kapamba akulu, kuphwanya kwakukulu kwa kapangidwe ka kapamba kumadziwika, zomwe zimapangitsa kusintha kwakukulu pakugwira ntchito kwa chiwalo. Dyspancreatism ndi mtundu wa boma la premorbid (matenda asanafike), omwe, pakakhala kuti palibe chidwi chokwanira, amatha kusintha kukhala pancreatitis.

Makhalidwe azachipatala a dispancreatism

Dyspancreatism mwa ana azaka zilizonse alibe zidziwitso zowonekera zachipatala. Zizindikiro zonse zomwe zikubwera ndizofanana ndi matenda ena ambiri am'mapapo, omwe amathandizira kwambiri pakuzindikira. Zizindikiro zamankhwala zamatenda amtundu wa kapamba sizimasiyana mwa ana amisinkhu yosiyanasiyana. Mwana wamkulu (mwana wa sukulu, wachinyamata) amatha kufotokoza zakukhosi kwawo mwatsatanetsatane, mosiyana ndi khanda. Kuphatikiza apo, palokha kukana kubereka kumakhala kotchuka kwa mwana wamsukulu ndi unyamata kuposa mwana wakhanda.

Zina mwazodziwika kwambiri za dissancreatism ndi izi:

kusowa kwa chakudya mpaka pomwe palibe,
nseru zokulitsa, zomwe zingakulitse ngakhale pakuwona zakudya,
kusanza (komwe kumachitika mobwerezabwereza), nthawi zambiri kumadyedwa komanso kugaya bwino chakudya,
kupweteka pamimba, yomwe imakonda kukoka kapena kupweteka,
Chizindikiro chimakhala kusintha kosuntha: chopondapo chimadzimadzi, chokhala ndi mafuta osafunikira, okhala ndi fungo la fetid.

Kusintha kwachuma kwa mwana kumachitika kawirikawiri, kufooka kumadziwika, komwe kumayambitsidwa ndi kuphwanya kwa chimbudzi cha zakudya. Mosiyana ndi mawonekedwe apakhungu a kapamba, palibe kuwonjezeka kwa kutentha ndi kupweteka kwambiri (komwe kumadziwika kuti "pamimba pamimba").

Mfundo zachikhalidwe zodziwikitsa

Kutsimikizira kuzindikiritsa kwa dissancreatism ndikovuta. Kusakhalapo kwa kusintha kwa morphological mu kapamba panthawi ya ultrasound kapena tomography kungakhale njira imodzi yoperekera matenda amtundu wamtunduwu.

Nthawi zambiri pozindikira matenda a kapamba, maphunziro awa amagwiritsidwa ntchito:

ntchito za alpha-amylase ndi lipase (zimachulukana ndi matenda apamba),
kuwerenga kwa kuchuluka kwa trypsin m'magazi ndi mkodzo (nawonso kumawonjezera),
pulogalamu (yofufuza momwe chakudya chimagwirira ntchito)
ambiri magazi mayeso kupatula zotupa za thupi.

Kuunikira kwa ultrasound kwa ziwalo zonse zam'mimba kumatha kuchitika pa mwana wazaka zilizonse, ndi kafukufuku wopezeka mwachilungamo (kuchokera pamalingaliro azachuma) komanso otetezeka kwathunthu. Tomography (yoyenera kwambiri yamagalasi kapena positron emission) ndiyofunikira pakakhala zovuta zapanthawi yayitali kapamba kupatula matenda ena okhala ndi zizindikiro zofananira.

Mfundo zachikhalidwe zamankhwala

Chofunikira kwambiri ndi chakudya chamagulu. Nthawi zambiri, kungochiritsa zakudya zokha kungathandize kwambiri mkhalidwe wa mwana.

Pa mankhwala a dyspancreatism mwa mwana wazaka zilizonse, zotsatirazi ziyenera kusiyidwa kwathunthu:

zogulitsa zomaliza
Zakudya zokazinga ndi zamafuta
marinade, nyama zosuta, sosi zingapo.

Zakudya za zakudya zamatenda a kapamba ziyenera kukwaniritsa mfundo izi:

zakudya zazing'ono 5-6 patsiku, makamaka nthawi imodzi,
Zakudya zonse zizikhala zotentha, osati kuzizira kapena kutentha,
mafuta onse ayenera kuphika pogwiritsa ntchito kuwira, kudya kapena kuphika,
amakonda kuperekedwa kwa masamba ndi zipatso, zipatso, mkaka, mafuta ochepa, nyama ndi nsomba mitundu yochepa yokha yamafuta.

Chithandizo chokwanira cha dyspancreatism chimaphatikizapo kugwiritsa ntchito magulu ngati awa:

ma pancreatic Enzymes (festal, mezym, pancreatin) kuti athandizire kuyendetsa bwino ntchito yopanga chiwalo,
antispasmodics (drotaverine) kukonza ntchito za sphincters ndikuchepetsa ululu.
ovomereza ndi prebiotic kusintha matumbo microflora.

Mankhwala onse ayenera kuyikidwa ndi dokotala pambuyo poti alembetse ntchito ndi chida.

Malingaliro a akatswiri pankhani yonyansa motero amatha kusiyanasiyana.Mwachitsanzo, Dr. Komarovsky samazindikira kukhalapo kwa matenda ngati othandizira, ndipo sawona kuti chithandizo chake ndichoyenera. Akatswiri ena ambiri amafanana naye pakuwunika mawuwa, chifukwa lingaliro la "dispancreatism" silikupezeka pagulu lapadziko lonse lapansi la matenda. Nthawi zambiri, kuzindikira mosamala kumafunikira kupatula mitundu yofatsa ya kutupa kwapancreatic.

Kupewera kwa matenda aliwonse a pancreatic kumayamba ndi kadyedwe koyenera. Ndipo kukayikira kulikonse kosokoneza ntchito zamtunduwu kumathetsedwa bwino mothandizidwa ndi dokotala wabanja.

Pancreatitis pakati pa ana, makamaka ana aang'ono, sichofala kwambiri, koma zimachitika. Nthawi yomweyo, zizindikiro za nthendayo mwa mwana ndizosiyana ndi chiwonetsero cha kapamba mwa akulu, zomwe zingayambitse kuzindikira koyenera ndikupangitsa kuchepetsedwa kwa chithandizo.

Monga akuluakulu, mu ana kapamba amatha kuchitika pachimake komanso mawonekedwe osakhazikika. Mtundu wapadera wamatendawa mu ana ndi wotchedwa reactive pancreatitis, kapena dyspancreatism, mkhalidwe wobwezeretsanso womwe umayamba ngati yankho la kapamba kumatenda, matenda am'mimba, kuperewera kwa zakudya m'thupi, ndi zina.

Zizindikiro zake zazikulu ndi:

Kupweteka kwam'mimba. Ana okalamba amadandaula za kupweteka kwambiri komwe kumatsitsidwa m'mimba kapena ululu wamkamwa, kupweteka kwa hypochondrium kumanja ndi kutsitsa kwam'munsi kumbuyo, chifuwa, mkono wamanzere.
Monga lamulo, kusanza kosapweteka kopweteka kumayendetsedwa ndi kuukiridwa kowawa.
Zizindikiro zakunjenjemera ndi kuwonongeka kwa ziwalo ndi ma pancreatic michere omwe amalowa m'magazi amapanga mofulumira: kutsika kwa magazi, khungu, khungu kapena zofiirira pakhungu la pamimba, kufooka, chizungulire, komanso kusazindikira. Chifukwa cha poizoni wa ma enzyme omwe amakhala pakatikati kwamanjenje, mwana amatha kukumana ndi kusokonezeka, kusokonezeka, kapena ngakhale kuyerekezera zinthu zina ndi zina mwachinyengo.
Kusokonezeka kwa chopondapo - kudzimbidwa kapena kutsegula m'mimba.
Kufalikira, kusokonezeka kwa khoma lam'mimba.
Youma mucous nembanemba ndi lilime. Chovala choyera kapena chaching'ono chachikasu chikuwoneka pakamwa.
Kutentha thupi.
Chifukwa chophwanya kutuluka kwa ndulu, kufinya kwamatumbo a ndulu zamkati kumayambitsa jaundice: mwanayo amakhala ndi khungu komanso ma mucous nembanemba (diso sclera, mucosa).

Ndizovuta kwambiri kudziwa zizindikiro za pancreatitis pachimake mwa ana ndi ana aang'ono (mpaka zaka 1.5-2), popeza sangathe kudandaula. Kupweteka kwam'mimba mwa makanda kumawonetsedwa ngati kufuula, kulira kosalekeza, kufinya "mu mtanda." Kusokonezeka kwa khoma lam'mimba kumatsimikizidwanso, kusanza sikuchitika nthawi zonse. Koma izi ndi zizindikiro zopanda tanthauzo zomwe zimatha kukhala m'matenda ena (pachimake pyelonephritis, appendicitis, etc.), chifukwa chake, ndikofunikira kuyesedwa ndi dokotala wa ana.

Matenda a kapamba

Mu matenda a kapamba mu ana, pafupifupi zizindikiro zomwezi zimawonedwa monga akulu:

Kupweteka kwam'mimba komwe kumachitika pambuyo pake pakulakwitsa kudya (kudya mafuta, zakudya zonunkhira, yokazinga, kusuta, ndi zina). Ana omwe ali ndi pancreatitis yayitali amakonda kwambiri kupatsa thanzi, ndipo kuwonjezereka kwa momwe zimapangidwira kungayambitse kuphwanya zakudya kwambiri, komanso zolakwika zazing'ono, nthawi yayitali pakudya.
Kusanza ndi kusanza, komwe kumayambikanso chifukwa cha kuperewera kwa zakudya m'thupi.
Kuphwanya njira za chimbudzi, zizindikiro zomwe ndi mafuta onyowa, manyowa, kubala.
Chifukwa chakudya sichimamwa, thupi la mwana lomwe limakula limasowa zinthu zambiri zofunika. Ana amakhala ndi hypotrophy (kutopa) mwachangu kwambiri, zizindikiro za kuchepa kwa magazi m'thupi ndi hypovitaminosis (pallor ndi khungu louma, tsitsi lotupa, misomali, ndi zina). Ndi kuphunzira kwanthawi yayitali, kukula kwambiri, kukula m'maganizo ndikotheka.

Zizindikiro za pancreatitis yogwira

Zizindikiro za pancreatitis yotakataka mwa ana imafotokozedwa ndi kuchepa kwa kupanga kwa michere ndi kapamba ndi zovuta zina zakumayambiriro a kugaya:

Tinthu tambiri tomwe timakhala tomwe timatulutsa timadzi tosiyanasiyana, timene timakhala ndi chakudya chosafunikira, ndi mafuta onyansa, osachotsedwa bwino mumphika kapena pakhoma lamadzi chimbudzi. Ana ena amathanso kudzimbidwa.
Kutulutsa magazi, kugubuduza pamimba, kusefukira.
Ana osaposa zaka 2 nthawi zambiri amadandaula za kupsinjika kapena kupweteka kosakhazikika kuzungulira msomali. Nthawi zambiri ululu umalumikizidwa ndi zolakwika mu zakudya.

Zizindikiro zofanana ndi chiwonetsero cha matenda osachiritsika komanso otupa a pancreatitis zimatha kuchitika mwa ana komanso ndi matenda ena am'mimba otupa - gastritis, bysary dyskinesia, dysbiosis, colitis, ndi zina zotero. kuyezetsa mwana ndi dokotala wa ana kapena gastroenterologist. Ndi dokotala wokha pokhapokha atasanthula, kufunsa komanso kupereka njira zowonjezera zowunika zomwe zingatsutse kapena kutsimikizira kapamba mwa mwana ndikupereka chithandizo chofunikira.

Pancreatitis ndi nthenda yotupa-dystrophic ya kapamba (kapamba) ndi ndowe zake, zomwe nthawi zambiri zimayamba chifukwa cha mphamvu ya michere yake.

Mwa ana omwe ali ndi matenda am'mimba, kapamba amachitika pafupipafupi 5 mpaka 25%.

Nthendayi - chimodzi mwazinthu zomwe zimapanga chimbudzi, ndimakhungu a zonse zakunja ndi zamkati.

Ntchito yake yachinsinsi yochitira zakunja imakhala ndikupanga chimbudzi, chomwe chimadutsa pamizere mu duodenum 12, pomwe imayendetsedwa ndi madzi a m'mimba ndipo imathandizira kugaya chakudya.

Ntchito yodabwitsa ya kapamba imapangidwa ndikupanga mahomoni a insulin mwa maselo apadera a gland, popanda popanda glucose sangatengeke m'thupi.

Zambiri

Pancreatitis mu ana ndi autocatalytic enzymatic yotupa ndi dystrophic lesion ya kapamba. Kukula kwa kapamba pakati pa ana okhala ndi m'mimba thirakiti yam'mimba ndi 5-25%. Njira ya kapamba mwa mwana, mosiyana ndi munthu wamkulu, imakhala ndi zovuta zake: matendawa amatha kupezeka ndi zinthu zingapo zamkati komanso matenda amkati, amatha kukhala asymptomatic, ovomerezeka ndi matenda ena am'mimba: gastritis, gastroduodenitis, dysbiosis yamatumbo, ndi zina. ana ndi ntchito yofunika kwambiri ya ana ndi ma gastroenterology a ana.

Zoyambitsa Pancreatitis

Kukula kwa kapamba mu ana ndi chifukwa cha kagayidwe kachakudya kake kamene kamayambitsa ma enzymes (makamaka mapuloteni), omwe amawononga minofu, ma ducts am'mitsempha yamagazi. Kudziwononga kokhako kumayambitsa kukula kwa chotupa mkati mwake, ndikumasulidwa kwa ma enzymes komanso mankhwala osokoneza bongo omwe amapezeka m'magazi ndi zamitsempha zimabweretsa kuledzera kwa onse.

Kutupa kosalekeza nthawi zambiri kumakhala kwachiwiri ndipo mwina kumakhala chifukwa cha pancreatitis yovuta kwambiri kwa ana. Kuwonetsedwa kwa kapamba mwa ana kumachitika mchikakamizo cha zina zosiyanasiyana zaumunthu wamakina, neurohumoral komanso chifuwa chakupha.

Zomwe zimayambitsa pancreatitis mwa ana zimatha kukhala kuphwanya kutulutsa kwa katulutsidwe kamatumbo kamene kamachitika ndi zotupa pakukonza kapena kutsekeka kwa chikhodzodzo cha chikhodzodzo, duodenum ndi ndulu, kuvulala kwam'mimba, helminthiasis (ascariasis), motsutsana ndi maziko am'matumbo am'mimba, matenda am'mimba. , hepatitis, matenda a gallstone, malungo owopsa (khansa ya kapamba).

Kukondoweza kwambiri kwa kapamba ndi ntchito yowonjezereka ya michere ya pancreatic kumatha kuchitika mwana akapanda kudya moyenera - kudya, kudya, kudya mafuta, zakudya zonunkhira, tchipisi, sodas, chakudya chambiri, ndi zina zotere. zimachitika pakudya ndi mankhwala (corticosteroids, sulfonamides, cytostatics, furosemide, metronidazole, NSAIDs).

Pancreatitis mu ana imatha kuphatikizidwa ndi matenda othandizira minofu, endocrinopathies, kusokonezeka kwa metabolic (kunenepa kwambiri, hemochromatosis), hypothyroidism, cystic fibrosis, kulephera kwa impso, matenda opatsirana ndi tizilombo komanso bakiteriya (mumps, chikuku, matenda a herpes, dysmendemia, septenemia, semenosis).

Gulu

Ndi chikhalidwe cha maphunzirowa, kapamba wa ana amatha kukhala owuma komanso osachiritsika. Pachimake kapamba mu ana amadziwika ndi kutupa kwa catarrhal ndi kutupa kwa zikondamoyo, mu milandu yayikulu - zotupa za m'mimba, minofu necrosis ndi toxemia. Mu chifuwa chachikulu cha ana, zotupa zimayambika motsutsana ndi kusintha kwa kusintha kwa matenda - sclerosis, fibrosis ndi atrophy ya pancreatic parenchyma ndi kuphwanya kwapang'onopang'ono kwa ntchito yake. Kwa ana asukulu, kupweteka kwakanthawi, komwe kumakhala kovuta kwambiri kwa kapamba kumakhala kodziwika, mawonekedwe owopsa sawoneka m'mibadwo yonse.

Acute edematous (interstitial), hemorrhagic, purcin pancreatitis mwa ana ndi mafuta pancreatic necrosis amasiyanitsidwa, kutengera kusintha kwachipatala ndi morphological mu kapamba.

Matenda a kapamba mu ana amatha kusiyanasiyana (pulayimale ndi sekondale), m'maphunzirowa (mobwerezabwereza komanso mosasintha), pakuvuta kwa maphunziridwe (ofatsa, odziletsa komanso ovuta). Pancreatitis yobwezeretsanso mwa ana imadutsa gawo la kuchuluka, kuchuluka kwa kukhululuka ndi kukhululuka, masinthidwe - osatsagana ndi zizindikiro zazikulu zamankhwala.

Mavuto a kapamba mu ana amatha kukhala peresenti yabodza, kapamba wam'mimba, peritonitis, pleurisy, matenda a shuga.

Zotsogola ndi kupewa

Mtundu wofatsa wa kapamba wam'mimba mwa ana ali ndi matenda opatsirana, omwe ali ndi hemorrhagic ndi purulent form, komanso pancreatic necrosis, pamakhala chiopsezo chachikulu cha kufa. Kukula kwa matenda a kapamba mu ana kumadalira pafupipafupi.

Kupewera kwa kapamba mu ana kumaphatikizaponso zomveka, zaka zoyenera kudya, kupewa matenda am'mimba thirakiti, matenda opatsirana, a zonse, matenda a helminthic, mankhwala omwe dokotala anakhazikitsa. Ana omwe ali ndi pancreatitis yosasunthika amayang'aniridwa ndi dotolo wa ana ndi dokotala wa ana, chifukwa chodana ndi kubwezeretsanso komanso chithandizo cha spa.

Ndi kapamba, matumbo a kapamba nthawi zambiri amakhala ndi vuto.

Pachimake kapamba - kutukusira pachimake kwa kapamba.

Matenda a kapamba - Matenda a kapamba, omwe amakhala ndi nthawi yowonjezereka komanso kukhala kwakanthawi.

Reactive Pancreatitis (kapena dyspancreatism) ndikuphwanya kosintha kwa ntchito ya kapamba.

Kuchotsa. Nthawi zambiri, dyspepsia amayambitsa kugaya kwakudya, etc. Mankhwalawa ndi achiwiri, zimachitika zokha, akuwonetsa zolakwika zilizonse mthupi, chizindikiro cha matendawa.

Maziko a purancreatism ndi osakwanira kupanga michere ndi kapamba, chifukwa chomwe chakudya sichilowetsedwa bwino. Pankhaniyi, palibe kutupa kwa kapamba. Pali kuphwanya kwa ntchito yake, komwe kumangochitika mofulumira chifukwa chomwe chinayambitsa zovuta chotere sichitha.

Zizindikiro zomwe zimapezeka chifukwa cha kupatsirana kumawonetsa kugaya bwino: kutulutsa, kuyecha, kusinthana ndi matenda am'mimba komanso kudzimbidwa, osagwirizana ndi kudya. Mukamayesa ma ultrasound (ultrasound), dokotala amatha kudziwa kukula kwa kapamba komanso kutupira kwake pang'ono.

Mu Chithandizo cha dispancreatism kutsatira zakudya Nambala 5 (""), nthawi zina, kukonzekera kwa enzyme ndi mankhwala.

Pachimake kapamba mu ana

Kuphatikizika kwa madzi a pancreatic kumaphatikizapo ma enzymes, zinthu zomwe ndimakumba zomwe ndimalemba. Kodi izi zikutanthauza chiyani? Enzymes amasamutsa chakudya kuchoka ku chakudya kupita kumalo a mamolekyulu. Mwachitsanzo, amatenga chidutswa cha nyama ndikusandutsa mamolekyulu, ofanana ndi nyumba yomwe idasungunuka njerwa. Chifukwa chake, mu kapamba, ma enzyme oterewa ndiomwe amakhala khumi ndi awiri. Amawapanga, amawasunga m'masamba ena ndikuwapatsa magawo kuti ayambe kugaya chakudya akalandira chakudya.

Zonsezi zimachitika nthawi yovomerezeka. Koma zikondamoyo zikaonongeka pazifukwa zina, storage yokhala ndi ma enzymes imawonongeka. Mimba zimayamba kukwera m'mimba - kugaya nyumba yanu, kapamba. Ichi ndi chikhalidwe chowopsa kwambiri, chifukwa ma enzymes a pancreatic amakhala olimba kwambiri (kumbukirani kuti amatha kugaya nyama). Mwamwayi pachimake kapamba mu ana Sizosowa kwenikweni.

Zomwe zimayambitsa kupweteka kwa kapamba:

Matenda a bacteria ndi bacteria (mumps, chimfine, hepatitis).
Kuvulala kwam'mimba.
Thupi lawo siligwirizana.
Mankhwala (mahomoni, biseptolum, etc.).
Vuto la kudya: kutenga mafuta ambiri, zonunkhira, zamankhwala acid, zinthu zina zowonjezera (ma broth amphamvu).
Matenda am'mimba, amaphatikizidwa ndi kuwonongeka kwa pancreatic minofu (mwala mu chikhodzodzo cha ndulu, kutulutsidwa kwamkati pazakumba za pancreatic, etc.)

Zizindikiro za Acute Pancreatitis

Chithunzi chachipatala cha "pamimba pamimba."
Kupweteka kwambiri pamimba. Amadziwika ndi ululu wa herpes zoster (kuzungulira gawo lonse la thupi), kupereka kumbuyo ndi theka lakumanzere kwa chifuwa.
Chifukwa cha kupweteka kwambiri, kugwa ndi kukomoka ndizotheka.
Kusanza, kusanza mobwerezabwereza, kosamasuka, osabweretsa mpumulo.
Kusokonezeka kwa minofu yam'mimba.
Kusinthana m'mimba ndi kudzimbidwa.
Kuwonjezeka kwa kutentha ndi kuwonongeka kwapang'onopang'ono pamikhalidwe yonse.

Chithandizo cha pachimake kapamba . Kugonekedwa kuchipatala. Chithandizo cha chipatala.

Pancreatitis Zakudya

Wodwala wodwala kapamba amasonyezedwa tebulo 5 (onani "Biliary Dyskinesia") ali ndi zina:

Zakudya zomanga thupi kwambiri (nyama, mkaka, nsomba).
Chepetsa shuga ndi maswiti.
Sizoletsedwa kugwiritsa ntchito nsomba, nyama, msuzi wa bowa, mafuta anyama ndi mafuta ena olimba.
Ndi kuchulukitsa, kuwonjezera pazoletsa pamwambapa, ndikofunikira kuchepetsa kumwa zamasamba ndi zipatso, timadziti, shuga, uchi, ndi maswiti ena.
Mbale zonse zimaphika nthunzi, kusenda, kuphwanya.

Mankhwala azitsamba a kapamba

Amayikidwa popanda kuchulukitsa komanso ndi mawonekedwe osavuta. Ndikulowerera pafupipafupi, chithandizo chimachitika kwa nthawi yayitali, osachepera miyezi isanu ndi umodzi ndi zosokoneza zazing'ono za masabata awiri aliwonse 2 miyezi iliyonse. Zomwe udzuwo umayenera kusinthidwa masabata atatu aliwonse. Ndikachulukirachulukira, ndikokwanira kuchititsa maphunziro okonza miyezi isanu ndi iwiri kawiri pachaka.

Mukamveketsa kwambiri ululu, mumachepetsa mlingo wa mankhwala azitsamba omwe mumagwiritsa ntchito, choncho ndi bwino kuyamba kulandira chithandizo ndi theka, kapenanso kotala la mankhwalawo. Pamene ululu umachepa, mlingo umakulitsidwa pang'onopang'ono.

Kulowetsedwa masamba a peppermint. Brew 5 g zitsamba ndi 1 chikho madzi otentha, kunena 30-40 mphindi, kupsyinjika, kufinya. Tengani 1 tbsp. l Katatu patsiku 20-30 mphindi musanadye.

Kulowetsedwa kwa udzu sushitsy marshmallow. Brew 10 g zitsamba ndi 1 chikho madzi otentha, kusiya kwa mphindi 30-40, kupsyinjika, kufinya. Tengani 2 tbsp. l - 1/4 chikho 3-4 pa tsiku 20-30 mphindi asanadye.

A decoction of rhizomes okhala ndi mizu ya elecampane. Thirani 6 g wa miyala yosweka ndi 200 ml ya madzi otentha. Tenthetsani mumadzi osamba kwa mphindi 15. Kuzizira, kupsinjika. Tengani 1 tbsp. l Katatu pa tsiku 20-30 mphindi musanadye.

Hypericum therere msuzi. Thirani 10 g zitsamba ndi 200 ml ya madzi otentha. Tenthetsani mumadzi osamba kwa mphindi 15. Kuzizira, kupsinjika. Tengani chikho 1/4 katatu pa tsiku 20-30 mphindi musanadye.

Kulowetsedwa kwa chiuno cha rose.Thirani 15 g wa zipatso zosankhidwa ndi chikho 1 cha madzi otentha. Kuumirira kwa maola 2-3 mu thermos. Tengani chikho 1/4 katatu pa tsiku 20-30 mphindi musanadye.

Yerusalemu artichoke, kapena peyala yodothi, imathandiza kwambiri kubwezeretsa kapamba. Mankhwala okhala ndi Yerusalemu artichoke: zakudya zowonjezera "Dololet" (Russia, JSC "Diode").

Akulu ndi ana a zaka zopitilira 12 - mapiritsi 3-6 1 nthawi patsiku ndi chakudya. Nthawi yayitali ya masabata asanu. Kulandilidwa mobwerezabwereza pambuyo pa masabata awiri.

Ana - 1 nthawi patsiku, piritsi limodzi pa 25 kg yakulemera kwa thupi. Nthawi yayitali ya masabata asanu.

maluwa a chamomile - magawo 4,
Udzu wa wort wa St. John - magawo 4,
masamba a mbewa - magawo awiri,
udzu wa yarrow - magawo awiri,
udzu wouma - magawo atatu,
masamba odulira - magawo atatu,
Udzu wa chowawa - 2 magawo.

Brew 10 g ya chophatikiza ndi 1 kapu ya madzi otentha, kunena 30-30 mphindi, kupsyinjika, kufinya. Tengani 1/3 chikho 3 pa tsiku musanadye.

Mbeu za katsabola - magawo atatu,
zipatso za hawthorn magazi ofiira - magawo awiri,
maluwa osafa - magawo awiri,
masamba a peppermint - magawo awiri,
maluwa a chamomile - gawo limodzi.

Yogwiritsa mu thermos 2-3 tbsp. l yowuma yosonkhanitsa 500 ml ya madzi otentha, kunena kwa maola 2-3, kukhetsa. Imwani kapu 1/2 katatu patsiku 1 ola limodzi mukatha kudya.

Mungu. Tengani 1 / 2-2 / 3 tsp. mungu, mungu, kapena mungu mphindi 20-30 musanadye (mudzaze ndi 50 ml ya madzi owiritsa ndikuyimira maola 3-4).

Madzi amchere. Kulandila kwa mchere wam'madzi, monga gastritis.

Anayamba kutchuka kwambiri, ndipo nthawi zambiri amauza ana. Mothandizidwa ndi zofalitsa zakunja ndi kafukufuku wasayansi, madokotala azachipatala pang'onopang'ono m'malo mwake adachotsa matenda a chifuwa cham'mimba ndi yogwira pancreatitis « kuyamwa mwa mwana. " Mosakayikira, kwa makolo ambiri mayina awa, omwe amveka panthawi yoyesedwa kwa ana awo ndi dokotala, amachititsa mantha.

Amadziwika kuti kapamba ndi chiwalo chomwe chimagwira nawo ntchito pakukumba, kupanga ndikubisa michere yonse yofunikira kupopera chakudya mu duodenum. Ntchito yapakhunguyi imatchedwa "exocrine." Kuphatikiza apo, mu kapamba, ntchito ina yofunika kwambiri ndi ntchito ya "endocrine", ntchito yayikulu yomwe ndikupanga ndi kutulutsa kwa insulin ya m'magazi ndikusunga kuchuluka kwa shuga m'magazi.

Chifukwa chake, kuwunika kwa pancreatic ntchito kuyenera kuchitidwa mokwanira, monga zigawo zake za exocrine ndi endocrine.

Ndipo pokhapokha pakutsimikizira kuperewera kwa exocrine pancreatic ntchito molingana ndi pulogalamu ya pulogalamu (mafuta osalowerera ndowe), fecal fecal elastase, α-amylase ndi serum lipase, atatsimikizira zosintha mu kukula kapena kapangidwe ka kapamba molingana ndi deta ya kuyesa kwa ultrasound, komanso kufananirana mbiri yachipatala (matenda a kapamba amatsimikiziridwa), kupezeka kwa matenda kapamba kumatha kuyesedwa ngati abwino.

Dziwani kuti kuperewera kwa “kwenikweni” pancreatic kwa ana ndikosowa kwambiri ndipo, monga lamulo, amayamba chifukwa cha zovuta zakubadwa kwa kapamba kapena matenda amtundu (cystic fibrosis).

Kwambiri ndikuchepa kwakanthawi kapena kochepa pantchito ya pancreatic, yomwe madokotala a ana amatcha "Kuthetsa ana" ndi "pancreatopathy."

Izi nthawi zambiri zimafunikira kulowererapo kwa dokotala komanso mankhwala a kapamba.

Zizindikiro za dispancreatism mwa ana

Zizindikiro zamatenda a dissancreatism mwa ana zimayenderana mwachindunji ndi kutupa kwa kapamba, komanso ndi zizindikiro za matenda omwe amachititsa kuti adwale.

Chizindikiro cha matendawa ndi ululu. Zosasangalatsa zomveka zimatchulidwa kumanzere kwa hypochondrium ndi pamimba pamimba.

Zizindikiro zamankhwala sizangokhala izi. Mwa ana odwala, nseru, kupindika, kusanza, kukoma pakamwa kumawonekera.

kusanza pafupipafupi
malungo
mutu
kupanikizika
matenda amkuwa
kusowa kwa chakudya
kuwonda
ukufalikira
khungu louma, misomali yothina

Pomwe njira ya pathological ikupita patsogolo, chithunzi cha chipatala ndichulukirachulukira:

kusanza pafupipafupi
malungo
mutu
kupanikizika
matenda amkuwa
kusowa kwa chakudya
kuwonda
ukufalikira
khungu louma, misomali yophwera.

Chithandizo cha dissancreatism

Mankhwala osokoneza bongo a dispancreatism amaphatikizira kuikidwa kwa mankhwala osiyana siyana.

Pankhani ya kusakwanira kwa chinsinsi chakunja ngati njira yothandizira, yochepa, mankhwala otsatirawa akuwonetsedwa - pancreatin, festal, panzinorm, somilase, solisim. Muthanso kutenga no-shpa ndi mezim.

Chithandizo choyenera nchofunikanso pakugwira ntchito zamavuto oyambitsidwa ndi ziwalo zamagazi. Pankhaniyi, ma tranquilizer, komanso ma sedative, akuwonetsedwa. Kuvomerezeka kwa mankhwala kuyenera kuchitidwa motsogozedwa ndi akatswiri oyenera. Poterepa, ndi neuropsychiatrist.

Mankhwala azitsamba amagwiritsidwanso ntchito pochiza matenda omwe akufunsidwa. Maudindo okhawo akuyenera kupangidwa ndi katswiri. Kudzipatsa nokha sikuloledwa.

Kuti chithandizo cha dispancreatism chikhale ndi zotsatira zabwino, zoletsa zina pazakudya zimalembedwa. Ndikofunikira kukana, pankhani iyi, kuchokera kumafuta amafuta ndi azakudya zonunkhira, kuchokera ku nyama zakusuta. Osalowetsa menyu komanso mbale yokazinga. Ndikofunikira kupatula mbale zonse zomwe zimanyamula katundu paz kapamba.

Mwa zina zomwe zimaphatikizidwa muzakudya za tsiku ndi tsiku ziyenera kukhala nyama ndi nsomba, komanso masamba otentha kapena othandizira. Mkate woti mudye, makamaka wopangidwa wopanda yisiti, ndi madzi ndi kuwonjezera kwa koloko.

Chakudya chizikhala chopindika. Zigawo ndizochepa, pafupifupi gramu kuyambira 180 mpaka 230.

Zizindikiro za dyspancreatism ndi chithandizo cha nthawi yake zimadutsa mwachangu. Pakupita kwa milungu 2 mpaka 4, zotsalira zimatha kuchitika. Zokha sizofunika konse. Chifukwa chake, amachotsedwa mosavuta.

Kuphwanya kapangidwe ka michere kumayambitsa kupatuka kwakukulu m'thupi. Chimodzi mwazinthu zonyansa izi ndi kapamba.

Matendawa amatha kuthana ndi kugwira ntchito, komwe kumakhudza ntchito yogaya chakudya ndipo kumayambitsa kufooka kwa chitetezo chathupi.

Kodi kapamba ndi chiani?

Pancreatopathy ndikuphwanya mu ntchito ya kapamba wamunthu wosakhala wotupa, momwe mumakhala kuperewera kwakuthupi komwe kumafunikira kuti magwiridwe antchito apangidwe. Ngati sichingakwanire, njira yogaya chakudya ndiyovuta. Komanso, kusowa kwa ma enzymes kumakhudza mkhalidwe wa kapamba, kumapangitsanso mavuto.

Pali mitundu iwiri yakuphwanya:

Poyamba Maonekedwe ake ndi chifukwa cha kukhalapo kwa matenda ena.
Sekondale Amayamba ndi moyo wosayenera. Makamaka nthawi zambiri amakwiya chifukwa cha kuperewera kwa zakudya m'thupi.

Monga mitundu yosiyana, yogwira pancreatopathy, yomwe imawoneka mothandizidwa ndi mphamvu zakunja zakunja, imaganiziridwa. Amatha kukhala matenda opatsirana, poyizoni kapena mavuto ena oyipa.

Nthawi zambiri kugwira ntchito kwa pancreatopathy kumachitika mwa mwana, chifukwa thupi la mwana limayamba kugwiritsidwa ntchito ndi zinthu zovuta. Chitetezo cha mthupi cha munthu wamkuluyo sichimatulutsa gawo lina lowopsa, chifukwa chake nchotheka kupewa kusintha kwam'tsogolo.

Ndi kuphwanya kwa dongosolo logaya chakudya, zovuta zimayamba ndi kagayidwe ndi kogwiritsa zinthu zopindulitsa. Choyipa ndichakuti matenda azachipatala sangawonekere kwa nthawi yayitali, chifukwa cha omwe amapezeka pamalo opita patsogolo.

Limagwirira ndi zomwe zimayambitsa

Kuperewera kwa enzyme kungayambike chifukwa zingapo:

Kupanda kukwana kwawo kokwanira ndi thupi lokha.
Kuphuka kwa ma ducts omwe ma enzyme amalowa m'matumbo (ndi kaphatikizidwe wokwanira).
Kupanda enzyme ntchito m'matumbo, ngakhale abwinobwino kupanga ndi chimbudzi.

Pa chilichonse mwa izi pali zifukwa.

Kuperewera kwa enzyme chifukwa chosakwanira kupanga mothandizidwa ndi ma pancreatic pathologies:

mavuto obadwa nawo
matenda a kapamba
Kukula kwa thupi,
anasintha ntchito pa kapamba,
mlangizi
m'malo mwa glandular minofu ndi adipose minofu.

Mavutowa amasokoneza kugwira ntchito kwa chiwalo, chifukwa chomwe kuchuluka kwa ma enzymes ophatikizika amachepera. Chifukwa chake, ndikofunikira kwambiri kuchiza matenda onse, komanso ndibwino kuti muzipewa.

Pancreatitis ndimatenda ofala omwe, ngati sanachiritsidwe, amatha kubweretsa pancreatopathy. Ndipo mawonekedwe ake amatsogozedwa ndi dispancreatism (disancreatitis), yomwe ndi yosavuta kuyimitsa. Koma Zizindikiro zake nthawi zambiri zimanyalanyazidwa, chifukwa cha momwe njira ya pathological imayendera, kudutsa, kenako pancreatopathy.

Kufalikira kwam'mizere kumapangitsa kuwonongeka kwa ziwalo ndi matenda:

zipsera zopangidwa pambuyo pa ntchito,
chotupa mawonekedwe
miyala.

Chifukwa cha izi, ma enzyme opangidwa sangathe kulowa m'matumbo kapena kupita komweko. Nthawi zambiri pancreatopathy imapezeka mwa akulu.

Ngati ma enzyme amapangidwa mokwanira komanso amathira kulowa m'matumbo, koma osagwira, ndiye kuti izi zimachitika chifukwa cha zovuta m'mimba mwake (kuwonongeka kwa matumbo a mucosa).

Pancreatopathy amathanso kuchitika chifukwa cha kuperewera kwa zakudya m'thupi. Kudya moperewera kapena kugwiritsa ntchito zakudya zamafuta kwambiri kumapangitsa katundu m'matumbo ndi m'matumbo, chifukwa cha izi, zovuta zimabuka.

Zizindikiro mwa ana

Ana nthawi zambiri amadwala matendawa - chifukwa chakuti thupi lawo lonse komanso ziwalo zake zonse zikuchita kupangika ndipo amakhala pachiwopsezo chochepa kwambiri. Chifukwa chake, ndikofunikira kulingalira za matendawa makamaka muubwana.

Pathology imatha kukhalapo kwa nthawi yayitali mwamafomu, ndipo zizindikiritso zazing'ono nthawi zambiri zimasokonezedwa ndi kuchuluka kwa ntchito kapena kuchepa kwa vitamini.

Pancreatopathy akuwonetsedwa ndi:

khungu
kufooka
kuwonda
kutsegula m'mimba
Kusungunula kwa ndowe (ndowe zimachita imvi, kumatha kukhala tizinthu tosiyanasiyana)
kulumikizana
kusanza
ukufalikira
kulemera m'mimba
kusadya bwino.

Mosatengera, kukhalapo kwa matendawa kumawonetsedwa ndi kusayang'ana kwa mwana, kusakhala ndi chidwi chofuna kuchita nawo masewera akunja, misozi.

Kanema kochokera kwa Dr. Komarovsky:

Kuteteza matenda

Mutha kuletsa kukula kwa kapamba mothandizidwa ndi njira zopewera. Sangathe kusokoneza momwe zinthu zonse zimakhudzira, koma amatha kuchepetsa zoopsa.

Chitani panthawi yake matenda otupa komanso opatsirana a kapamba.
Osamagwiritsa ntchito mankhwala osokoneza bongo komanso zinthu zovulaza.
Pewani zakudya zopanda pake.
Osamadya kwambiri.
Idyani nthawi zambiri komanso pang'ono.
Gwiritsani ntchito zipatso ndi masamba ambiri.
Chepetsani kuchuluka kwa mchere ndi zonunkhira.
Funsani kwa dokotala kuti mupeze zizindikiro zilizonse zosokoneza m'matumbo.

Njira izi zimathandizira kupewa kuyambika kwa pancreatopathy ndikuyambiranso.

Matendawa sawonedwa ngati owopsa ngati achitiridwa chithandizo chanthawi yake. Koma kunyalanyaza zamatsenga, mkhalidwe wa wodwalayo umakhala wovuta kwambiri, ndipo mawonekedwe apamwamba kwambiri a kapamba amatha kudwala.

Chidule cha makolo

Pancreatitis mwa ana sichachilendo, koma akapezeka, pamafunika malingaliro akulu ndi chithandizo cha odwala, kuti muchepetse kukula kwa pafupipafupi komanso zovuta za matendawa.

Ndikofunikira kumvetsetsa kufunikira kwa mankhwala ochizira piritsi la kapamba. Kubwereza pafupipafupi kwa matendawa, kumamuwonjezera kuphwanya zakudya, kuchedwetsa chithandizo kumayambitsa chitukuko cha shuga, chomwe chidzasokoneza moyo wonse wamtsogolo wa mwana.

Dokotala wa ana E.O. Komarovsky amalankhula za zovuta za kapamba mu ana: