Pancreatitis ndimatenda omwe amatha kuthandizidwa pogwiritsa ntchito njira yothandizira kapena opaleshoni. Lingaliro logwiritsa ntchito njirayi kapena njirayi liyenera kupangidwa kutengera umboni.
Blockade ndi pancreatitis amathandizira polimbana ndi kuledzera, komanso amalepheretsa kukula kwa matenda a gland. Musanachiritse pancreatitis, ndikofunikira kufufuza ndi kapenshoni, komwe kumatha kuwonetsa mapangidwe amadzimadzi kapena zotupa zomwe sizikuwoneka panthawi ya kuyesedwa kwa ultrasound.
Popeza njira yogwiridwira ntchito ndiyotchuka, siyingapikisane ndi njira yosungira, yomwe imagwiritsidwa ntchito nthawi zambiri ndikuigwiritsa ntchito. Iliyonse ya njirazi imapangidwa kuti muchepetse kutuluka kwa chinsinsi mu kapamba, komanso kuchepetsa ululu ndikuchotsa zizindikiro za kusokonekera kwa kapamba.
Zochizira matenda a kapamba
Chithandizo cha Conservative chimaphatikizapo mfundo ya blockade mothandizidwa ndi analgesics:
- Analgin;
- Promedol;
- Novocaine.
Ma antispasmodics amphamvu amagwiranso ntchito:
- Ayi-shpa;
- Papaverine;
- Nitroglycerin.
Gawo loyamba la mankhwala ndilofunika kwambiri pakuchotsa kupweteka kwakukuru mu kapamba. Kuphatikiza apo, madokotala amayang'anizana ndi mankhwala othandizira kuti muchepetse vuto ngati ululu wammbuyo umakula msanga.
Njira yodzikakamiza ilibe dongosolo loyenera kuchitira, ndipo njira zochizira zilizonse zimachokera pazomwe zikuwonetsa matenda a wodwala aliyense. Chithandizo chitha kusiyanasiyana mwa anthu omwe ali ndi vuto la mtima, komanso khansa ndi matenda ashuga. Zikatero, Mlingo wa mankhwalawa umawongoleredwa malinga ndi momwe akuwunikira.
Kuphatikiza pa kuchepetsa ululu, jakisoni amafunikira omwe amachotsa poizoni ndikukhazikitsa zovuta za metabolic. Nthawi zambiri, mankhwalawa ndi:
- Magnesium
- Calcium
- Ma electrolyte osiyanasiyana.
Kuphatikiza ndi mchere, wodwalayo amapatsidwa jakisoni wambiri masiku onse a mankhwalawa.
Kuphatikiza apo, blockade ya pancreatitis imachitika pakumwa mankhwalawa ndi njala komanso kudya madzi amchere (Borjomi). Kupuma kokwanira kwa wodwala ndikofunikira.
Kuphatikiza apo, malinga ndi momwe wodwalayo alili, mankhwala omwe amathandizira ziwiya za kapamba, chiwindi ndi impso zimayikidwa. Izi ndizofunikira, chifukwa chithandizo chilichonse chokhala ndi maantibayotiki amphamvu chimatha kusokoneza ziwalo ndikupangitsa zovuta mu mawonekedwe a kulephera kwa impso.
Njira yodziyimira imalepheretsa matenda kuyambika, omwe pambuyo pake amatha kukhala matenda a kapamba.
Njirayi imapezeka pakuchitikira kuchipatala chilichonse, koma imafunikira kusanthula koyambirira.
Conservative mankhwala a pachimake kapamba
Mankhwala osokoneza bongo a pancreatitis pachimake amagwiritsidwa ntchito pogwiritsa ntchito ma painkillers omwe amatha kuthetsa kuphipha. Chifukwa cha izi, kugwedeza kwamankhwala osiyanasiyana kumagwiritsidwa ntchito ndikupatsidwa kwa wodwala ndi dontho.
Njirayi imathandizira wodwala kuti azimva kupumula msanga, komanso imathandizanso kugona. Kutengera kuthamanga kwa magazi, kukoka, komanso kusintha kwa hematocrit, kuchuluka kwa mainkililon omwe amaperekedwa kumadalira. Nthawi zambiri zimakhala mpaka malita 2 amadzimadzi (ma electrolyte, glucose osakanikirana ndi 2% promedol kapena atropine).
Amagwiritsanso ntchito blockade ndi novocaine, yomwe imathandizira kuthamanga kwa magazi, kuletsa wodwala, komanso kuchita ngati mapiritsi ogona. Ngati novocaine blockade sikuwoneka ndipo sagwira ntchito, izi zikuwonetsa kufooka kwa kapamba ndipo akuwonetsa kuti akuyenera kuchitidwa opareshoni. Pankhaniyi, wodwalayo samva kuwawa.
Ndikofunika kukumbukira kuti tsiku loyamba lodziwitsa mavuto ndilofunika kwambiri, chifukwa amafunika kupuma pabedi ndi jakisoni anthawi yake. Popeza pancreatitis yovuta kwambiri imatha kukhala mawonekedwe a edematous, imayambitsa mawonekedwe a purulent, cholecystitis, ndipo, kutengera matenda ndi poizoni, imatha kupha.
Pofuna kuthana ndi katemera wa pancreatic mu mawonekedwe owopsa, ma anti-enzymes amagwiritsidwa ntchito kuti amachepetsa acidity ya madzi am'mimba ndikuchita ngati ngalande yamadzi mu ducts ya bile. Kuphatikiza pa kupumula pakama ndi kuzizira kozizira pamimba, probe imagwiritsidwa ntchito nthawi zambiri, yomwe imagwiritsidwa ntchito ku hypothermia yam'deralo. Ngakhale njirayi imawonedwa kuti siyothandiza kwambiri, nthawi zina imagwiritsidwa ntchito popempha wodwalayo, kuchepetsa ululu.
Kuphatikiza apo, kafukufukuyo amatha kuikidwa ndikugwiritsa ntchito chubu mkamwa, kudzera momwe kukonzekera kwapadera kumaperekedwa, monga: contracal, tzolol. Njirayi imagwiritsidwa ntchito nthawi zina, ndipo zimatheka pomwe wodwalayo sakudziwa. Kuphatikiza pa mankhwalawa, atropine ndi promedol amagwiritsidwanso ntchito ngati painkiller.
Mankhwalawa pachimake kapamba, kuvomerezedwa mankhwala a inpatient, komwe kwa masiku 4-5, wodwalayo amapaka jekeseni wa trasilol wa mankhwala (nthawi zambiri magawo 10,000 a mankhwala patsiku). Mankhwalawa ali ndi chiwerengero choyenera cha ma antienzymes, ndipo samayambitsa mavuto, omwe ndi ofunikira kuti anthu azigwirizana. Mankhwalawa amachitika pogwiritsa ntchito njira yodutsira madzi kudzera mu msempha, mankhwalawa amamwetsedwa 1 nthawi tsiku lililonse mawonekedwe ake. Chithandizo chokhazikika choterechi chimachotsa msanga ziphuphu ndi m'mimba, chimalepheretsa kuchitika kwa matenda opatsirana, komanso chimalepheretsa kuchitika kwa necrosis.
Ngati wodwala ali ndi matenda monga cholecystitis, zotupa zam'mimba, zovuta zingapo za postoperative, mphamvu ya inhibitor singatchulidwe mokwanira. Zikatero, mankhwala ena owonjezereka amagwiritsidwa ntchito omwe amathandizira mphamvu ya trasilol.
Njira zosasamala zochizira pancreatitis pachimake zimaphatikizanso kugwiritsa ntchito mankhwala a steroid omwe amathandizira kuthetsa kugwa ndi zovuta mu gawo lazovuta la matenda. Ndipo ngakhale si madokotala ambiri omwe amadziwa njira iyi, ali ndi malo ogwiritsira ntchito.
Nthawi zambiri, odwala omwe ali ndi pancreatitis yovuta kwambiri nthawi zambiri amadwala ndi cholecystitis, yomwe imapangitsa njira zochizira ndipo nthawi zambiri zimathandizira kupanga formula. Ndipo popereka mankhwala othandizira, muyenera kuphatikiza ndi mankhwala ena. Ngati dioxin imagwiritsidwa ntchito, ndiye kuti penicillin-mtundu wa antibayotiki ndiwofunikira. Zomwe zimagwiritsidwa ntchito ngati antiseptic, komanso matenda opatsirana ndi mafinya.
Kugwiritsa ntchito mankhwala ochepetsa mphamvu ya antibacterial ndi mankhwala ndikofunikira, chifukwa nthawi zambiri zomwe zimayambitsa kapamba ndi matenda am'mimba, ndipo kutupa kumachitika chifukwa cha mabakiteriya a staph ndi mabakiteriya a streptococcus.
Kwa odwala omwe ali ndi pancreatitis yayitali, ndikofunikira kuti azilowedwa kuchipatala kawiri pachaka, zomwe zimachepetsa chiopsezo cha kutuluka, komanso kuchepetsa ululu.
Kuphatikiza apo, kusala kudya pafupipafupi komanso kugwiritsa ntchito ma compress ozizira kumafunika.
Pancreatitis pachimake: Chithandizo cha Opaleshoni
Ngati zovuta zinabuka panthawi ya chithandizo chamankhwala, peritonitis kapena chithandizo chotere sichinabweretse zotsatira zomwe mukufuna. Zikatero, opaleshoni imagwiritsidwa ntchito. Kugwiritsa ntchito laparoscopy, mutha:
- kuwononga gwero la peritonitis;
- khazikitsani ntchito ya michere mu kapamba;
- sinthani mwachangu vutolo.
Mankhwala othandizira opaleshoni ndi laparoscopy imachitika m'magawo awiri:
- Diagnosis, yomwe imasankha mawonekedwe a kapamba, imakhala chithunzi chatsatanetsatane cha madera omwe akhudzidwa.
- Khalidwe la intraperitoneal perfusion.
Laparoscopy ya kapamba ndiyofunika kwambiri pakuwazindikira, chifukwa imakupatsani mwayi wodziwa pancreatic necrosis, womwe umawonetsa chidwi cha malo amafuta. Amatha kukhala pamatumbo a adipose, akuwononga minofu yam'mimba, komanso malo okhudza matumbo aang'ono. Madera onse ang'onoang'onowa amakhudza kwambiri mankhwalawa, ndipo ngati sapezeka pa nthawi yake, amatha kuchuluka msanga.
Mothandizidwa ndi dongosolo la kukoka kwa madzi, lomwe limalumikizidwa ku ngalande yamkati ndi m'chiuno chaching'ono, timachubu apadera timachotsedwa omwe amawongolera yankho lapadera pamkati mwamkatikati mwa m'mimba. Nthawi zambiri yankho lochokera pa trasilal ndi contractil mu chiwerengero cha 10: 1.
Kwa wodwala aliyense, nthawi ya perfusion imatsimikiziridwa payekhapayekha ndikuyimitsa pomwe mtundu wamadzimadzi wotuluka umakhala mtundu wovomerezeka ndikuwunikira kwa enzyme kusintha. Ngati palibe mawonekedwe abwino a purosesa ndi mtundu wake ndi bulawuni wofowoka - ichi ndi chizindikiro chodziwikiratu.
Ngati pakuchitika kusefukira kwa peritonitis ndi zovuta, kupangira mafuta kumachitika pogwiritsa ntchito ngalande zakunja kudzera mu dac ya thoracic. Chithandizo chotere sichichitika kawirikawiri, ndipo pokhapokha pamene wodwala ali pachiwopsezo, komanso pokhapokha pomwe wodwalayo ali pachiwonetsero.
Kuchitapo kanthu kwa opaleshoni kumafunika kwa odwala omwe ali ndi pancreatitis nthawi yayitali kuti achepetse matenda omwe angachitike komanso kupewa kupezeka kwawo.
Mukamachita opaleshoni yamankhwala othandizira pancreatitis, ndiyenera kuyang'anira kwambiri kupuma, popeza kuchuluka kwa mpweya m'magazi kumachepetsedwa, njira zina zofunika zimafunikira. Ngati palibe mpweya wokwanira wa okosijeni, wodwalayo amatha kulumikizidwa ndi makina owongolera mpweya. Izi zitha kubweretsanso mavuto ku mankhwala a kapamba.
Kutengera ndi zotsatira za mankhwalawa, odwala ena ngakhale atachitidwa opaleshoni amatha kukhala ndi matenda a shuga, zotupa zosiyanasiyana, kapamba nthawi zambiri amapanga mawonekedwe abodza, ndipo zotsatira zakupha zimatheka mwa 4% ya odwala.
Acute pancreatitis akufotokozedwa mu kanema munkhaniyi.
