Pancreatitis - kutukusira kwa kapamba kumakhala koyambirira m'chilengedwe - iyi ndi nthenda yodziimira payokha, kuyang'ana kwa zotupa m'matumbo mwa iko kokha komanso chachiwiri mu chilengedwe ndikuyankha kwokhudzana ndi kapamba mpaka kupezeka kwa njira yodutsitsa mafupa ndi ziwalo zapafupi.
Mu mtundu wachiwiri wa matendawa, mawonekedwe ofunikira azachipatala ndi chizindikiro cha matenda, ndipo chipatala cha kapamba chimazilala kumbuyo (komanso zovuta zina, ngati zili m'mbiri ya wodwalayo).
Kugawidwa kwa matendawa kukhala mtundu woyamba ndi wachiwiri ndikofunikira kwambiri, chifukwa cholinga chake ndi katswiri wazachipatala kuti azitha kuchiza matenda oyambitsidwa, chifukwa popanda kutha kwake, sizingatheke kuchita bwino pachipatala.
Ganizirani chifukwa chachiwiri chikhansa cham'mimba chikukula, ndi zizindikiro ziti zomwe zimayenda ndi matendawa, momwe angathandizire?
Amayambitsa yachiwiri kapamba
Njira yotakataka yomwe imagwera m'matumbo ndimayankho a ziwalo pakukhumudwitsidwa kwa ngalande zapanchipi. M'mazithunzi ambiri azachipatala, chomwe chimapangitsa chidwi ndi kuponyera kwa bile kuchokera ku chikhodzodzo, kupezeka kwa calculi m'makonzedwe kapena chikhodzodzo, kukondoweza kwa zikondamoyo zomwe zimakhala ndi m'mimba.
Second pancreatitis yachilendo nthawi zina imayamba chifukwa cha chotupa m'mimba mwa munthu. Malo achitukuko ndi njira yogaya.
Nthawi zina chifukwa chakukula kwa matenda a pathology imagona kuphatikiza kwa zinthu zingapo zopangitsa zomwe zimayambitsa kupanikizika kwa njira kuchokera kunja. Mwachitsanzo, chifukwa cha kutupa kwa kapamba kapena chotupa, chomwe chimachulukana ndikuyamba kuponderezana zimakhala zapafupi. Ikhoza kukhala khansa ya duodenum, bile ducts, kapena capanc pitisreatitis yoyambitsidwa ndi oncology.
Zoyambitsa sekondale:
- Kuchuluka kwamphamvu mu duodenum 12 (choyambirira ndichowononga m'mimba kapena duodenum);
- Njira zopatsirana mthupi, matenda a parasitic, ma bacteria ena amatsogolera pakupanga kutupa, chifukwa cha momwe pancreatitis imapangidwira;
- Kufalikira kwa ngalande ndi calculi (gwero lalikulu la cholecystitis);
- Reflux wa bile bile (cholangitis - pachimake kutupa mu bile ducts;
- Ndi kuwonongeka kwa chiwindi ndi ma ducts a bile, kupuma kwa biliary (biliary-amadalira) kumayamba;
- Kuphwanya kutulutsa kwa bile ndi cholelithiasis (cholelithiasis).
Ngati wodwala ali ndi pancreatosis, nambala ya ICD-10 ndi K86.1, ndiye kuti matendawa amapatsana. Ndi blockage wa bile ducts, matendawa amawonekera patatha masiku angapo pambuyo poyambira matenda oyamba.
Zizindikiro zimatchulidwa komanso zowala, zofanana ndi kuukira kwadzuwa kwa kapamba. Ndi matenda opatsirana mthupi, kutupa kwa kapamba kumatha kuoneka ngati chinthu chapambuyo, kumakulirakulira patatha milungu iwiri.
Mawonetseredwe azachipatala
Pancreatosis mkati mwa njira yotupa ndi yofatsa, yochepa komanso yovuta. Pa gawo loyamba la matendawa, zizindikiro za exocrine ndi intrasecretory matenda sizipezeka.
Pancreatitis ya digiri yachiwiri imachitika kale ndi zizindikiro za zovuta izi.
Pancreatitis ya Giredi 3 imadziwika ndi kutseguka kwa nthawi yayitali komanso kupitilira kwa nthawi yayitali, kutopa kwa munthu pang'onopang'ono kumawonedwa, kuyesedwa kwa labotale kumawonetsa kuchepa kwa mavitamini opindulitsa ndi mchere.
Monga tanena kale, chipatalachi chimadalira matenda enieniwo, zimachokera ku chiwalo chomwe chikukhudzidwa ndikuwonetsa zizindikiro zake.
Syndromes of Second pancreatitis:
- Zowawa. Zomverera zowawa zimawonedwa mu epigastric zone, zimatha kuchitika m'dera la nthiti yakumanja. Pambuyo ululu "umayenda" pansi pa hypochondrium yamanzere, yodziwika ndi herpes zoster. Nthawi zambiri ululu umakulirakumwa pakumwa zakumwa zoledzeretsa, chakudya - chimayamba pambuyo pa maola angapo.
- Digestive syndrome imagwirizanitsidwa ndi kuphwanya magwiridwe antchito. Odwala amadandaula za kusanza kokhazikika, kusanza mobwerezabwereza, kulawa kowawa pamkamwa. Kuchulukitsa kwa mpweya kumadziwika nthawi zambiri, zikumba zotayirira zimasinthana ndi kudzimbidwa kwa nthawi yayitali. Mavuto amakula pambuyo podya zakudya zamafuta ndi zonunkhira.
- Intoxication syndrome imayendera limodzi ndi kufooka kwambiri, ulesi ndi kugona, kusasangalala. Ndi mawonetsero ofooka, mphamvu yogwira ntchito ya wodwalayo imachepa, amadandaula kutopa kosalekeza.
- Matenda a kutentha. Ngati wodwala ali ndi vuto la kutupa kwa ndulu ya bile chifukwa cha cholangitis, cholecystitis, ndi matenda ena, ndiye kuti nthendayi imawonekera. Kutentha kwa subfebrile kumayambira mu zotupa neoplasms, virpatitis hepatitis (kulumikizana ndi wodwala panthawi inayake ya makulitsidwe ndikosokoneza).
Ndi zizindikiro zotere, wodwalayo amapezeka pafupipafupi ndi dysbiosis - mkhalidwe wamatumbo am'matumbo, momwe osakwanira mabakiteriya opindulitsa ndi kuchuluka kwakukulu kwa tizilombo tating'onoting'ono timapezeka. Dysbacteriosis imawonetsedwa chifukwa cha kuchepa kwa ntchito ya michere. Panthawi yotupa kwambiri kwa kapamba, amalowa m'magazi ndipo sachita ntchito zawo, motero, chakudya sichikumbidwa bwino, thupi limasowa zakudya zopatsa thanzi. Mu ndowe mumakhala ulusi wazinyalala wazomera, mafuta ambiri.
Chipatala cha pancreatitis sichitha kuwoneka motsutsana ndi maziko azovuta zakuya zamomwe zimayambira.
Zikatero, pamafunika kugwiritsa ntchito njira zothandizira kuzindikira - mayeso a labotale komanso mayeso othandizira.
Kuzindikira ndi kuchiritsa matenda a sekondale
Kuti muchiritse munthu, muyenera kumudziwa bwino. Kuti muchite izi, gwiritsani ntchito njira zosiyanasiyana zofufuzira. Wodwalayo amapereka magazi kuti atsimikizidwe a amylase, mkodzo kuti adziwe diastase, mulase ya lipase imatsimikizika. Ultrasound imathandiza kudziwa kutulutsa kwa zikondamoyo, malo owonongeka, ma neoplasms, ofanana ndi cysts.
Monga njira zowonjezera, radiology, MRI, computer tomography ndi njira zopangira opaleshoni yothandizira (mwachitsanzo, laparoscopy) amagwiritsidwa ntchito.
Matenda a kapamba amafunikira mankhwala. Koma choyambirira, cholinga cha mankhwalawa ndikuwongolera matenda omwe amayambitsa. Uwu ndiye mkhalidwe waukulu wa machiritso opambana, chifukwa ngati simungachotse gwero, simungathe kuchira.
Mankhwala othandizira amayamba ndi chakudya, kapena, kudya kwathunthu, komwe kumachepetsa katundu pa kapamba. Malangizowa ndi othandizira pancreatitis, pachimake cholecystitis, zilonda zam'mimba ndi duodenum.
Popeza madzi am'mimba amathandizira kupanga michere ya m'mimba, ndikofunikira kuti achepetse acidity yake. Chifukwa cha izi, ma proton pump zoletsa ndi ma antacid mu kapisozi ndi mawonekedwe a piritsi ndi mankhwala:
- Omez;
- Omeprazole;
- Pantoprazole;
- Lansoprazole.
Kuphatikiza apo, ma statins adayikidwa kuti athandizire cholesterol yotsika. Kafukufuku waposachedwa awonetsa kuti mankhwalawa samakhudzana ndi kapamba, chifukwa chake amatha kugwiritsidwa ntchito ngati kapamba.
Muzochita zamakono zamankhwala, mankhwala antisecretory amagwiritsidwa ntchito. Kumwa mankhwalawa Sandostatin imayang'ana kulepheretsa chinsinsi cha tiziwalo timene timatulutsa m'mimba. Mapiritsi amachepetsa kuchuluka kwa zovuta za kapamba, kukonza bwino kwa wodwalayo, komanso kuchuluka kwa matendawo.
Gwiritsani ntchito mankhwala a antienzyme, mwachitsanzo, Gordoks. Mankhwalawa ali osavomerezeka pa nthawi yomwe ali ndi pakati. Mankhwalawa amagwiritsidwa ntchito pokhapokha ngati akuwonjezereka.
Ngati muzu wake uli mu cholecystitis, cholangitis ndi ma bacteria ena, ndiye kuti maantibayotiki adayikidwa:
- Ampiok.
- Cefixime
- Chloramphenicol.
- Amoxiclav.
Ngati chotupa chikuyimba mlandu, ndiye kuti mankhwalawa amathandizidwa kuti achepetse zovuta zowonekera. Akachepa, kuchitapo kanthu mwakuchita opaleshoni. Ndi zilonda zam'mimbazi, zomwe zimapangidwa ndi pancreatitis, opareshoni imachitika pokhapokha akuwonetsa - kutulutsa magazi, kulowa. Njira ndi njira zamankhwala ndizosiyanasiyana nthawi zonse, kutengera matenda oyambitsidwa. Kutsatira malingaliro onse a adotolo kumene kumakwaniritsa kuchotsedwa kwokhazikika.
Zambiri pancreatitis yayitali zimaperekedwa mu kanema munkhaniyi.
