Zikondazo zimapanga michere yokumba, yomwe mwina ndi zinthu zolusa kwambiri mthupi la munthu. Amatha kugawa chakudya chamtundu uliwonse pazinthu zosavuta, potero azithandizira kukondoweza.
Komabe, chifukwa cha matenda ena, pali kuphwanya kwa kutuluka kwa michere yogaya chakudya m'thupi, yomwe imayambitsa kuwonongeka kwa kapamba. Ichi ndi chiopsezo chowopsa chomwe chimabweretsa chiopsezo chachikulu osati ku thanzi komanso ku moyo wa munthu.
Chifukwa chake, ndikofunikira kwa odwala onse omwe ali ndi matenda a kapamba kuti adziwe chomwe pancreatic necrosis ili, zomwe zimayambitsa, ndizizindikiro ziti zomwe zikuwonetsa matendawa, momwe angadziwire bwino komanso kuthandizira. Izi zikuthandizira pakapita nthawi kuzindikira zizindikiro zoyambirira za matenda oopsa ndikuteteza wodwala ku kulumala ndi kufa.
Khalidwe la pancreatic
Kachilombo kakang'ono kwambiri ndiye kakang'ono kwambiri m'thupi la munthu. Imagwira ntchito ziwiri nthawi imodzi - imapanga michere yokumba yofunikira kugaya mapuloteni, mafuta ndi chakudya, komanso ma cell mahomoni omwe amalimbikitsa kuthamanga kwa shuga ndikuwongolera shuga.
Madzi a pancreatic amapangidwa mkati mwa gland ndipo amatsanuliridwa mumkamwa waukulu mu duodenum, momwe amathandizira kugaya chakudya. Ma enzyme amenewa amagwira ntchito kwambiri ndipo amatha kuthana ndi mafuta ndi mapuloteni amtundu uliwonse wa mbewu ndi zinyama, komanso chakudya chovuta komanso zovuta kupanga.
Mphamvu zoterezi zimafotokozedwa ndi kuchuluka kwa ma enzymus omwe amasungidwa ndi maselo ake. Chifukwa chake, madokotala amati kapambayu ndi ziwalo zofunika, popanda zomwe zimachitika mwanjira yodabwitsa.
Kapangidwe kake ka madzi a kapamba:
- Amylase - ndikofunikira kwa hydrolysis yama chakudya, makamaka wowuma ndi glucose glycogenado;
- Lipase - imaphwanya mitundu yonse yamafuta, ma polyunsaturated ndi mafuta acid, komanso mavitamini osungunuka a mafuta A, D, E, K;
- Pancreatic elastase ndiyo enzyme yokhayo yomwe ingathe kuwononga ulusi wa elastin ndi collagen mu minofu yolumikizana;
- Nuclease - imaphatikizapo ma enzyme angapo (exonuclease, endonuclease, ribonuclease, deoxyribonuclease, restase, etc.) ofunikira ma hydrolysanucleic acids, kuphatikiza DNA ndi RNA;
- Carboxypeptidase, trypsin ndi chymotrypsin-fafaniza mitundu yonse ya mapuloteni kuti amasule ma amino acid.
Kudzilekanitsa kwakanthawi kwa michere ya pancreatic kumapangitsa kuti zikondwerero zizipezeka mkati. Magulu a parasympathetic, chisoni komanso metasympathetic mu mawonekedwe a mitsempha ya vagus, mitsempha yayikulu yakumanja, celiac nerve plexus ndi gangragen ya intramural ndiwo amachititsa.
Ndi gawo limodzi la ziwonetsero zamagetsi, zomwe zimagwira ntchito popanda kuwunikira kuchokera kumadera apamwamba aubongo.
Izi zikutanthauza kuti mukamadya chakudya, mumakhala zotulutsa zokha za ma pancreatic enzymes, osachita chilichonse mwamphamvu mwa munthu.
Zoyambitsa Pancreatonecrosis
Zomwe zimapangitsa kuti ziphuphu ziwonongeke zimatha kukhala zosiyana kwambiri, koma nthawi zambiri matendawa amayamba chifukwa cha kuperewera kwa zakudya m'thupi komanso kumwa mowa kwambiri. Komanso, pancreatic necrosis imatha kudwala osati anthu omwe amamwa mowa nthawi zonse, komanso omwe amamwa mowa nthawi zambiri, koma ambiri.
Zakudya zopanda pake ndi mowa zimachepetsa ntchito yoteteza kapamba, kuonjezera katulutsidwe ka madzi kapamba, kukweza mopitirira muyeso ndi kusokoneza kutuluka kwa ma enzymes mu duodenum. Zotsatira zake, kutseguka kwa michere yam'mimba kumachitika mkati mwa chiwalo, zomwe zimapangitsa kuwonongeka kwakukuru kwambiri kwa minofu ya tinyezi ndi kudzimbidwa tokha.
Mothandizidwa ndi izi, wodwalayo amakhala ndi pancreatic necrosis mwachangu, ndipo minyewa ya chiwalo imafa. Kupitilira apo, mwa odwala ambiri, kuwonongeka kwa mtima kumawonedwa, pomwe madzi a pancreatic amalowa m'magazi a magazi ndikufalikira thupi lonse, ndikuwonjezera poizoni.
Nthawi zambiri ndi pancreatic necrosis, kuphatikiza michere yam'mimba, mabakiteriya a pyogenic monga streptococci ndi staphylococci amalowa m'magazi. Zotsatira zake, wodwalayo amakhala ndi sepsis - zovuta zowonjezera pancreatic decomposition, zomwe zimafunikira chithandizo chamwadzidzidzi.
Zomwe zimayambitsa pancreatic necrosis:
- Kumwa mowa wambiri;
- Kudya kwambiri pafupipafupi komanso kuchuluka kwa mafuta ndi zakudya yokazinga, zakudya zama calorie ambiri, zakudya zonunkhira komanso zonunkhira m'zakudya;
- Ma gallstones
- Zilonda zam'mimba ndi duodenal;
- Kuchulukana kwa ma virus;
- Opaleshoni yam'mimba
- Kumwa mankhwala ena: Azathioprine, Metronidazole, Tetracycline, Isoniazid, Aspirin ndi ma salicylates ena;
- Kumwa mankhwala osokoneza bongo, makamaka amphetamine ndi iopiates;
- Poizoni wazakudya;
- Kuvulala kwam'mimba.
Zizindikiro
Nthawi zambiri, pancreatic necrosis ndi complication ya pachimake kapena aakulu kapamba. Chifukwa chake, odwala omwe adadwala kale chifukwa cha kutupa kwa kapamba ali pachiwopsezo chotenga matenda owopsa.
Kuwonongeka kwa kapamba kumakhala magawo atatu achitukuko. Poyamba, wodwalayo amadzimva kuti amagundana, ndipo nthawi zambiri amaphatikiza kudya kwambiri kapena kumwa mowa. Kenako, kusokonezeka kwa chopondapo, nseru, kusanza, ndi malungo zimawonjezedwanso.
Pa gawo lachiwiri la matendawa, pamene tiziwalo timene timakhudzidwa ndi ma enzymes awo kapamba, kutupa kwambiri kumayamba mthupi ndikupanga mafinya ambiri. Pakadali pano, mbali zonse za minofu yakufa zimapangidwa m'mapamba omwe amayambitsa kuledzera kwa thupi.
Gawo lachitatu la matendawa limadziwonetsera mu mawonekedwe a pancreatic necrosis, yophimba maselo onse a chiwalo. Pa nthawi iyi ya matendawa, kutupa kumachitika kawirikawiri kumapita kwa ziwalo ndi ziwalo zozungulira, ndipo zimakhudza ndulu, duodenum ndi matumbo ang'ono.
Kuyang'ana kwambiri pakhungu kumatha kupangitsa kuti ziwalo zambiri zisalephereke, zomwe zimakhala zakupha ndipo nthawi zambiri zimayambitsa imfa ya wodwalayo. Chifukwa chake, ndikofunikira kumvetsetsa kuti pancreatic necrosis ndi matenda omwe amawopseza moyo wa wodwalayo ndipo amafunika kuti ayambirenso.
Zizindikiro zazikuluzikulu za kuwumba kwapancreatic:
- Kupweteka kwambiri mu hypochondrium yamanzere. Pafupifupi 50% ya odwala amawaona ngati ululu wosapweteka wosagonjetseka ndi mankhwala aliwonse opweteka. Nthawi zambiri amapereka kumbuyo, phewa, mbali yakumanzere ngakhale gawo la mtima. Pazifukwa izi, pancreatic necrosis nthawi zina imasokonezeka ndi kulowetsedwa kwa myocardial;
- Kusanza kwambiri popanda mpumulo. Ngati wodwala wapanga kale zotupa zamagazi m'masanzi, magazi akhoza kupezeka;
- Zizindikiro za hepatitis ndikusanza kwa bile, chikasu cha pakhungu ndi azungu amaso. Ndi pancreatic necrosis, kuwonongeka kwambiri kwa chiwindi kumachitika, komwe kungayambitse kulephera kwa chiwindi;
- Thupi, kuzizira, kutentha thupi;
- Kudzimbidwa, komwe kumachitika chifukwa chakuwonongeka kwathunthu kwa dongosolo la zimbudzi;
- Kutulutsa kwakukulu ndi kupsinjika kwa minofu ya peritoneum;
- Kukamwa kowuma kwambiri, kuchepa kwa mkodzo kuchuluka, kulephera kwa impso ndikotheka;
- Kuchepetsa kwambiri kuthamanga kwa magazi;
- Kulephera kwa kupindulira, kuukira kwakofulumira kumachitika pafupipafupi, komwe kumakhala chifukwa cha kuledzera kwambiri kwa thupi;
- Kapangidwe ka mabala a bulauni mu hypochondrium yamanzere, mawonekedwe a mabala mbali yakumanzere komanso pafupi ndi navel;
- Chisokonezo, chofotokozedwa ndi kuwonjezeka kwa shuga m'magazi mpaka pamavuto ovuta.
Ndikofunikira kukumbukira kuti pancreatic necrosis singakhale mwa munthu wamkulu, komanso mwa mwana. Muubwana, matendawa amatha kukula mwachangu ndikumayambitsa kugwa, ndiko kuti, kugwa kwakuthwa m'magazi.
Ichi ndi chiopsezo chowopsa kwambiri pamoyo, zotsatira zake zomwe nthawi zambiri zimakhala zopanda mtima komanso kufa kwa wodwalayo.
Zizindikiro
Kuzindikira kwa pancreatic necrosis kuyenera kuchitika mwachangu, popeza ndi matendawa mphindi iliyonse ndi okwera mtengo. Kuphatikiza pa gastroenterologist, dokotalayo ndi othandizanso amatenga nawo mbali pakuwunika kwa wodwalayo, yemwe amawunika kukula kwa mkhalidwe wa wodwalayo ndikuchita zonse zofunika kuti apulumutse moyo wake.
Chofunika kwambiri paz njira zonse zodziwira matendawa ndikuwonetsetsa kuchuluka kwa michere ya kapamba m'magazi ndi mkodzo, makamaka, kuyesa kwa amylase. Ngati kuchuluka kwambiri kwa enzyme kumeneku kwapezeka m'magazi a anthu, ndiye kuti izi zikuwonetsa mwachindunji chitukuko cha pancreatic necrosis.
Njira ina yofunika yodziwira ndi kuyesa magazi kwa maselo oyera a magazi ndi kuchuluka kwa maselo a erythrocyte. Ngati zizindikirozi zakwezedwa kwambiri, ndiye kuti izi zikuwonetsa njira yotupa yayikulu mthupi la wodwalayo.
Kuphatikiza apo, ngati pancreatic necrosis ikukayikiridwa, wodwala amatumizidwa nthawi yomweyo kuti akafufuze (ultrasound), yomwe imakupatsani mwayi wowunika kuwona kutulutsa kwapa, ndikuwona mawonekedwe amtunduwu komanso mawonekedwe osagwirizana a gawo la minofu necrosis.
Pogwiritsa ntchito compact tomography (CT) ndi imagonance imaging (MRI), mutha kupeza chithunzi chowoneka bwino cha matenda amtunduwu kuposa ndi ultrasound. Chifukwa chake, njira zamtunduwu ndizomwe zimagwiritsidwa ntchito kudziwa malo enieni a minofu necrosis, kuphatikiza zazing'ono, komanso kuzindikira kufalikira kwa matendawa kufupi ndi ziwalo ndi ziwalo zina zoyandikira.
Angiography ndi njira yofufuzira yomwe imakuthandizani kuti mupeze kuphwanya magazi m'magawo a kapamba omwe amakhudzidwa ndi necrosis, komanso kudziwa kusamutsidwa kwamitsempha yamagazi yofunika kwambiri, makamaka mitsempha ya hepatic ndi gastro-duodenal.
Chithandizo
Chinthu choyamba chochita ndi pancreatic necrosis ndikupereka kapamba kuti apumule kwathunthu. Mwa izi, wodwalayo saloledwa kuchita zinthu zolimbitsa thupi, kudya chakudya chilichonse komanso chakumwa chilichonse. Kupatsa thanzi kwa wodwala kumachitika kokha.
Ndi matendawa, wodwalayo nthawi zambiri amachitidwa kutsuka m'mimba ndi madzi ozizira kuti athetseretu zinyalala zonse za chakudya. Izi zimakuthandizani kuti muimitse chimbudzi ndikuchepetsa kupanga kwa ma pancreatic enzymes.
Chimodzi mwazinthu zofunika kwambiri zochizira kupindika khunyu ndikuchotsa kupweteka kwambiri. Chifukwa chaichi, mitundu yosiyanasiyana ya mankhwala opweteka imagwiritsidwa ntchito, monga analgin, baralgin ndi amidopyrine, omwe amaperekedwa kwa wodwala ndi jekeseni wamkati.
Komanso, pofuna kuthana ndi ululu, omwe akutsikira mu msuzi wa glucose-novocaine wokwanira malita 1-2 amagwiritsidwa ntchito. patsiku. Ndi ululu wolekerera, wodwalayo amapatsidwa novocaine blockade, yomwe imachotsa ululu wopweteka kwambiri komanso imakupatsani mwayi wambiri wa analgesic.
Kuchepetsa ululu womwe umachitika chifukwa cha kuphipha kwa chiwalo chomwe chakhudzidwa, ma antispasmodics, mwachitsanzo, papaverine, nopa, platifillin, amaperekedwa kwa munthu. Kuphatikiza apo, wodwalayo adalandira mankhwala othandizira okodzetsa, monga lasix ndi furosemide, omwe amathandizira kupumula kwathunthu kwa kapamba kapamba.
Chofunika kwambiri kuthandizira matenda oyambawa ndikugwiritsa ntchito maantibayotiki, omwe amalimbana bwino ndi kutupa ndikuwononga mabakiteriya omwe amachititsa kuti chiwalocho chiwonongeke. Komanso, wodwala yemwe ali ndi pancreatic necrosis tikulimbikitsidwa kuti amwe ma antihistamines omwe amachotsa mofulumira kutupira kwa minofu.
Chithandizo cha pancreatic necrosis nthawi zonse chimaphatikizapo opaleshoni, yomwe imachitika patsiku lachisanu, atagonekedwa m'chipatala. Munthawi imeneyi, madotolo amatha kuyimitsa njira yotupa, kupewa kufalikira kwa matendawa kumaselo athanzi ndikuchepetsa chiopsezo cha zovuta pambuyo pake.
Pa opaleshoni ya kapamba, wodwalayo amachotsedwa atafa, ziwalo zouma, kupatsidwa magazi, ndikubwezeretsanso kutuluka kwa michere ya kapamba. Woopsa matendawo, wodwalayo angafunikire kuchitapo kanthu maopaleshoni angapo.
Komanso, pakuthandizira pancreatic necrosis, njira zingapo zamankhwala zimachitika zomwe ziyenera kulimbikitsa ntchito yam'mimba komanso kuteteza wodwalayo pakulephera kwa ziwalo zambiri. Njira zambiri zochizira kuchipatala zitha kutenga miyezi ingapo.
Katswiri mu kanema mu nkhaniyi adzalankhula za pancreatic necrosis.
