Kuzindikira kwa nthawi yapanja pancreatitis ndi imodzi mwazofunikira kwambiri kuti wodwalayo achire. Komabe, chifukwa cha kuchepa kwa chiwonetsero chapadera chazachipatala, ngakhale akatswiri odziwa bwino nthawi zina sangathe kuzindikira izo koyambirira ndikusokoneza ndi matenda ena am'mimba, mwachitsanzo, cholecystitis.
Zotsatira zake, madokotala samatha kupereka chithandizo choyenera kwa wodwala, chomwe nthawi zina chimabweretsa zovuta zowopsa. Kuti mupewe izi, wodwala aliyense ayenera kudziwa momwe kuyesa kwa kapamba kumachitikira, ndi mitundu yanji yazidziwitso yomwe imapereka zotsatira zolondola komanso momwe angawakonzekerere bwino.
Njira zodziwira pancreatitis
Ngati muli ndi madandaulo okhudzana ndi ntchito ya kapamba, muyenera kufunsa katswiri yemwe amvere madandaulo a wodwalayo, ayesere koyambirira ndikulemba kalata kwa katswiri - gastroenterologist kapena endocrinologist.
Katswiri wocheperako amasanthula wodwalayo mosamala, ayang'ane pamimba ndi palpation, osasamala kokha kapamba, komanso m'mimba, chiwindi ndi ndulu.
Ngati pancreatitis yovuta kwambiri, yotupa kapena yotakataka ikukayikiridwa, dokotalayo amutumiza wodwalayo kuti amupatse njira zodziwitsira zomwe zingamuthandize kuzindikira zenizeni. Kuti mupeze zotsatira zoyenera kwambiri, wodwalayo afunika kufufuza zingapo nthawi imodzi.
Pancreatitis Diagnosis Algorithm:
- Kuyesa kwamwazi wamagazi;
- Kuwunikira kwa Fecal;
- Kupenda kwamkodzo kwamkodzo;
- Kupenda kwa Ultrasound kwa kapamba (ultrasound);
- X-ray, maginito a resonance imaging (MRI) ndi compact tomography (CT) ya kapamba, chiwindi, duodenum ndi m'mimba;
- Pancreatic minofu biopsy;
- Njira zoyesera.
Chotsatira, timaganizira njira zodziwika bwino komanso zoyenera zofufuzira kapamba.
Mapazi amwazi
Kuyeza kumeneku kuyenera kuperekedwa kwa wodwala aliyense amene ali ndi vuto la kapamba. Kuthandizanso kudziwa zizindikiro zingapo zomwe zikuwonetsa kukula kwa njira yotupa mthupi. Malinga ndi akatswiri ambiri, kuyezetsa magazi ndiyo njira yolondola kwambiri yodziwira kapamba.
Kuyesedwa kwa magazi kumachitika kokha pamimba yopanda kanthu, chifukwa chake ndibwino kuti mutengere m'mawa musanadye chakudya cham'mawa. Tsiku lisanafike mayeso, wodwalayo ayenera kudziletsa pazakudya zotsekemera komanso zolemera, komanso mowa komanso kusuta. Pankhaniyi, chakudya chomaliza sichikhala mochedwa 22:00 pm.
Ndi kapamba, kapangidwe ka magazi a munthu amasintha kwambiri, zomwe zimachitika chifukwa cha kuphuka kwambiri m'mapapo. Zizindikiro zotsatirazi zikuwonetsa kukhalapo kwa pancreatitis mwa wodwala:
- Mkulu kuchuluka kwa alpha-amylase m'magazi. Nthawi zambiri, ziyenera kukhala kuyambira 28 mpaka 100 U / L. Ndikofunika kudziwa kuti kuchuluka kwa alpha-amylase kumayamba kuwonjezeka patatha maola awiri atayamba matendawa;
- Kuchuluka kwa pancreatic amylase. Mwa anthu athanzi, zimakhala mpaka 50 U / L;
- Chiyero chachikulu cha khungu loyera. Mwambo kwa akulu ndi kuyambira pa 3,98 mpaka 10.4 × 109 mayunitsi / l;
- Mulingo wambiri wa erythrocyte sedimentation. Nthawi zambiri, mwa akulu, amachokera ku 1 mpaka 15 mm / ola;
- Mkulu kuchuluka kwa trypsin. Mwa anthu athanzi labwino, nthawi zambiri zimakhala 25.0 +/- 5.3 mg / l;
- Kuchuluka kwa lipase. Zomwe zimachitika kwa achinyamata ndizofika mpaka mayunitsi a 130 / ml, kwa akuluakulu - mayunitsi 190 / ml;
- Mkulu magazi. Chikhalidwe kwa akulu ndi kuyambira 3.3 mpaka 5.5 mmol / L.
Lero, mtengo wa mayeso amomwe ammagazi ndi otsika. Chifukwa chake mtengo wapakati wakusanthula alpha-amylase ndi pafupifupi ma ruble 150.
Kusanthula kwamaganizidwe
Musanatole ndowe, muyenera kusamba bwino ndi sopo kapena sopo wosambira, kenako ndikupukuta khungu lanu ndi thaulo loyera komanso louma. Izi zimalepheretsa madzi ndi mabakiteriya kulowa ndowe kuchokera pakhungu ndikukulitsa kwambiri kudalirika kwa matenda.
Ndikofunika kutola ndowe mu chidebe chaching'ono cha pulasitiki chokhala ndi chivindikiro cholimba. Pa kusanthula, supuni 1 yokwanira. Mukatola ndowe, zimalimbikitsidwa kugwiritsa ntchito chotengera chachipatala kapena bakha. Ndizoletsedwa kugwira chimbudzi kuchokera kuchimbudzi, chifukwa chifukwa chake chidetsedwa ndi zosayera.
Mukamayang'ana ndowe mu wodwala ndi kapamba, mkhalidwe wofanana ndi steatorrhea nthawi zambiri umawonedwa - kuchuluka kwamafuta am'mimbamo. Steatorrhea nthawi zambiri imayambitsa kuphwanya kwa chopondapo, komwe kumatha kudziwonetsa pakulawitsa kapena kudzimbidwa.
Kuphatikiza apo, mwa munthu yemwe ali ndi kutupa kwa kapamba mu ndowe, tinthu tating'onoting'ono ta chakudya chosatulutsidwa timatha kupezeka. Izi ndichifukwa choti wodwalayo sangatulutse michere yokwanira, yomwe imasokoneza chimbudzi ndi chakudya.
Chizindikiro chinanso cha kapamba ndizochepa pancreatic elastase mu chopondapo - puloteni ya puloteni yofunikira pakugwirira ntchito kwa chakudya. Ndi kutupa kwa kapamba, katulutsidwe kake kamachepetsedwa, komwe kamatha kupezeka ndikusanthula ndowe.
Njira yotsika mtengo kwambiri yowerengera ndowe ndi kuwunika kwa pancreatic elastase, yomwe imalipira wodwala pafupifupi ma ruble 2500. Mapulogalamu omwe amakupatsani mwayi kuzindikiritsa kuchuluka kwa mafuta ndi zotsalira za chakudya zomwe zingawonongeke zingakhale pafupifupi ma ruble 450.
Kuyesa kwa Ultrasound
Kuti ma ultrasound a kapamba apereke zotsatira zolondola kwambiri, ndikofunikira kukonzekera bwino. Kuti muchite izi, masiku awiri 2-3 musanayesedwe, wodwalayo ayenera kutsatira zakudya okhwima, osagwiritsa ntchito zinthu zomwe zimapangitsa kuti mpweya ukhale wopezeka muzakudya zake, monga: mkaka, mkate wopanda yisiti komanso zakudya zopakidwa ndi fiber.
Usiku wotsogola usanazindikire, muyenera kudya chakudya cham'mawa momwe mungathere, osapitirira 18:00 pm, ndipo osadwanso. Tsiku lisanafike pokonzekera ultrasound, tikulimbikitsidwa kuti muthe mankhwala ofewetsa tuvi tokha kuti muyeretse ndowe.
Patsiku la mayeso a ultrasound, ndizoletsedwa kumwa chakudya, mowa, mankhwala osokoneza bongo (kupatula ofunika) ndikusuta ndudu. Kujambula kwa ultrasound ndikosavuta, njira yonseyo simatenga mphindi 15 ndipo siyipangitsa kusasangalala.
Panthawi ya kupumira kwa kapamba, zizindikiro zotsatirazi za kapamba zimapezeka:
- Kukula kwa kapamba kumachulukirachulukira;
- Kutalika kwa thupi la gland kupitirira 22 cm;
- Kutalika kwa mutu wa pancreatic ndioposa 3.5 cm, ndipo m'lifupi ndi zoposa 3 cm;
- Chiwalocho chili ndi masamba osasangalatsa komanso mawonekedwe osasangalatsa;
- Tubules ta gland tili ndi zopunduka zosiyanasiyana;
- Chochulukitsa chachikulu cha kapamba chimakulitsidwa kwambiri (kupitirira 3 mm).
Pakalipano, mtengo wa ultrasound wa kapamba umachokera ku ma 300 300 a ma ruble.
Magnetic resonance imaging
Kuphunzira kwamtunduwu kumakupatsani mwayi wodziwika bwino wa kapamba ndikudziwitsa molondola za 97%. Kukonzekera kwa MRI kumafunikiranso kuyamba masiku atatu asanakudziwe ndi zakudya zolimba.
Munthawi imeneyi, wodwalayo ayenera kusiya kugwiritsa ntchito mafuta, zonunkhira, utsi ndi zakudya komanso mchere. Pewani kumwa mowa uliwonse, kuphatikiza zomwe zimapezeka ndimankhwala, mwachitsanzo, mankhwala opaka pang'onopang'ono ndi mafuta. Lekani kumwa kwakumwa tiyi ndi khofi kwakanthawi.
Nthawi yomweyo asanazindikire, wodwalayo afunika kuchotsa zinthu zonse zachitsulo mwa iye yekha. Wodwala akakhala kuti walowetsedwa pacemaker, pali zikhomo zazikulu ndi zinthu zina zachitsulo, ndiye kuti akukana kupita ku MRI.
Pancreatic MRI imathandizira kuzindikira zotupa zotsatirazi:
- Cholinga ndi kukula kwa kutupa kwa chiwalo;
- Kupezeka kwa ma cysts, pseudocysts ndi ma neoplasms ena, komanso kudziwa kukula kwawo ndi contour;
- Kukula kwa chotupa cha khansa, kupezeka kwa metastases komanso ngati pali zotupa za ziwalo zapafupi ndi minofu;
- Kupeza miyala mumakumba a pancreatic;
- Kukhalapo kwa vuto lililonse pakupanga kapamba ndi mapindikidwe ake.
Magnetic resonance imaging ndi imodzi mwanjira zotsika mtengo kwambiri zoyesera. Chifukwa chake mdziko muno, kusanthula kwa MRI kumawononga wodwala kuyambira 3200 mpaka 3500 rubles.
Zizindikiro ndi zochizira pancreatitis zakambidwa mu kanema munkhaniyi.
