Pancreatogenic mantha ndi vuto lalikulu, lomwe ndi kuphatikizika kwa kapamba kapamba. Matenda oterewa ndi oopsa chifukwa ngakhale munthawi yamankhwala amakono, kuchuluka kwa odwala omwe ali ndi matenda pafupifupi 50 peresenti.
Kukula kwa mkhalidwe wovuta kumayendera limodzi ndi kuwonongeka pakumagwira ntchito yofunika kwambiri kwamkati, kuchepa kwa magazi, ndikuphwanya kwa kufooka kwamankhwala ndi ziwalo.
Monga lamulo, chiwonetsero cha kuphwanya lamulo ndi chifukwa chakuti pachimake pancreatic necrosis imayamba. Chifukwa chodzidzimutsa, mawonekedwe owopsa a kapamba ndizovuta, necrosis imakhudza madera akuluakulu a kapamba. Ngati pancreatic necrosis ikukula, kugwedezeka kwa endotoxin kumatha.
Zomwe zimachitika pancreatogenic
Pancreatogenic kapena pancreatic shock ndi njira yatsoka yomwe imayamba ndikuwonongeka kwakukulu kwa kapamba. Phunziro la izi limapangidwa mu pathophysiology. Pankhaniyi, kuthamanga kwa magazi a wodwalayo kumachepa, kuchuluka kwa magazi omwe amayendayenda amachepetsa, hemodynamics imasokonezeka chifukwa chogwira ntchito mwamphamvu ya ma pancreatic enzymes.
Cholumikizira chofunikira kwambiri mu pathogenesis sichinthu china koma zotsatira za endotoxins pazinthu zamkati. Kuphatikiza pa kuchepa kwambiri kwa kuthamanga kwa magazi, wodwalayo amakhala ndi zizindikiro pakhungu la pakhungu, kuchuluka thukuta, mawonekedwe a kupweteka kwapweteka m'mimba.
Maso amkati amachepetsa, zimachitika kuti zili ndi mawonekedwe ofanana ndi khosi, mkhalidwe umayendetsedwa ndi kusanza, oliguria, anuria, kutsekeka kwathunthu kwamatumbo. Munthu amatha kusokonezedwa ndi psyche, yomwe imadziwika ndi kukhumudwa kwa psychomotor, mawonekedwe a delirium ndi hallucinations.
Popeza Zizindikiro zofananira ndizodziwikanso zazinthu zina zadzidzidzi, ndikofunikira kuti musamadzipangire nokha ndipo mukafunsire kwa dokotala kuti mudziwe momwe aliri.
Kodi zimachitika bwanji?
Mankhwala a pancreatogenic amatha kukhala ndi kumwa mowa kwambiri komanso kudya pafupipafupi. Pankhaniyi, mawonekedwe owopsa a pancreatitis amakhala ngati patsogolo pa vuto lalikulu. Kufotokozera mwatsatanetsatane za momwe vutoli lilili mu ICD-10 International Classization of Disease.
Matenda a kapamba ndimatenda owopsa a kapamba, omwe amachitika chifukwa chodziwonetsa mkati mwa michere yake. Chifukwa cha kuchuluka kwa chakudya, kuchuluka kwa ziwengo kumachitika, chomwe chimakhala chifukwa chogwira ntchito pancreatic.
Makamaka, ma enzyme amakhala asanakhazikitsidwe chifukwa chakuti bile limalowa mu ma ducts a gland, ngakhale mwaumoyo waumoyo ayenera kukhala mu duodenum ndikumalumikizana ndi madzi a pancreatic.
- Bile imaponyedwa chifukwa chakuti ma ducts amaumbidwa pang'ono kapena kusiyanasiyana kumachitika.
- Chifukwa chogwira ntchito kwambiri, ma enzyme amatha kugaya maselo a pancreatic, omwe amachititsa kuti ziwindi ziwonongeke.
- Pambuyo pa michere ya lysosome itawonongeka, michere ya lysosomal imapangidwa mokwanira, zomwe zimayambitsa kukula kwa njira yodzimbira.
Ma enzymes ofunikira kwambiri ndi ma lipases, omwe amachititsa kuti lipids lipangidwe mu cell membrane, trypsins, activate ma enzymes mkati mwa maselo, elastases, omwe amaphwanya mapuloteni kukhala amino acid. Munthu akamamwa mowa, kuphipha kwa mapiko am'mimba kumachitika, zomwe zimapangitsa kutulutsa kwa michere ndi kapamba wa pancreatic kumakhala kovuta.
Chifukwa chodziwononga maselo, minofu necrosis imayamba ndipo njira yotupa imayamba. Zizindikiro zofananazi zimabweretsa kupweteka, komanso kutulutsidwa kwa histamine, kinins, mapuloteni a granulocyte. Komanso, madzimadzi ochokera ku lumen amayamba kutuluka ndikufika pafupi ndi minofu yapafupi, wodwalayo amakhala ndi edema ya kapamba.
Mtundu wowopsa kwambiri wamankhwala owononga pancreatic ndi hemorrhagic pancreatitis, yomwe, mothandizidwa ndi michere yake, chiwalo parenchyma ndi mitsempha yamagazi imagwa mofulumira. Izi zimabweretsa necrosis, hemorrhage ndi peritonitis.
- Pamene kutupa kufalikira ku dongosolo la magazi, njira ya pathological imakulirakulira. Thupi limataya madzimadzi, magazi amadzuka, mitsempha ya magazi imatsekeka, ndipo mitundu ya thrombosis.
- Mavuto akulu amakhalanso ndi DIC, pomwe magazi amayamba kugundana. Izi zimabweretsa kuchepa kwa magazi ozungulira kwathunthu, kutsika kwa kuthamanga kwa magazi, kuchepa kwamphamvu ya mtima, komanso mawonekedwe a kugunda kwam'mimba.
- Chifukwa cha zovuta zopweteka kwambiri, dongosolo la chisoni-adrenaline limayendetsedwa. Chifukwa cha zochita za adrenaline, pali kuchepetsedwa kwa ziwiya zam'mimba, izi zimapangitsa kuti magazi azigwira kwambiri m'chigawo cha mtima ndi ubongo.
- Mitsempha ina yamagazi imakhala yopapatiza, chifukwa chosowa magazi otaya minofu ya hypoxia imayamba. Ndi vuto la kuchepa kwa mpweya chifukwa cha kusayenda bwino kwa magazi, "mapapu owopsa" amapangika. Ngati wodwala atapanda thandizo panthawi yake, amafa.
- Impso sizilandira magazi okwanira, sizingatheke kupanga mkodzo kapena kuti madziwo atuluke pang'ono. Vutoli limadziwika ndi mantha a impso.
Khungu la wodwalayo limasinthasintha, kutaya kwamadzi pang'ono, thukuta limakulirakulira. Popeza mulibe michere mu duodenum, njira yogaya chakudya imasiya.
Mlandu wamankhwala umayendetsedwa ndi kusayenda kwam'mimba, zomwe zimayambitsa kusanza komanso kutsekeka kwamatumbo.
Chithandizo cha matenda a mtima
Gawo lotsogola la matendawa limathandizidwa ndikubwezeretsanso madzi omwe adasowa ndikuwongolera momwe acid yakhalira mothandizidwa ndi mayankho. Njira zimachitidwanso kuti abwezeretse kuphatikizika kwa mankhwala, mamasukidwe akayendedwe amwazi ndi kuchuluka kwa magazi.
Kuti achepetse zochitika za machitidwe omvera chisoni ndikubwezeretsa kamvekedwe kabwino ka mitsempha yamagazi, ma pinkiller amapatsidwa. M'masiku oyambilira, adotolo amafotokozera kusala kwachithandizo. Pofuna kuchotsa zinthu zapoizoni m'thupi, zimakhazikitsa ngalande.
Ngati kuli kofunika kutulutsa m'mimba, kumveka kumamveka.
Kutengera momwe kapamba wakhudzidwira, gawo lamkati limachotsedwa.
- Popeza kugwedezeka kwa pancreatogenic ndi vuto lalikulu kwambiri, limayambitsa mitundu yonse yazinthu zowonongeka. Sangayimitsidwe popanda chithandizo chamankhwala mwadzidzidzi, chifukwa chake, zam'tsogolo zimadziwika ndipo thandizo loyenerera limaperekedwa, kutsika kwake kumatha kuphedwa.
- Chithandizo cha kapamba zimayamba nthawi yomweyo mutazindikira kuti matenda am'matumbo. Wodwala amayikidwa kuchipatala mwachangu.
- Dokotalayo amapereka mankhwala othandizira odabwitsa komanso osokoneza bongo omwe ali ndi antispasmodics, blockers, Sandostatin kapena Octreotide, makonzedwe apakamwa a pancreatic enzymes. Mwadzidzidzi, mankhwala amasinthidwa ndi 5-fluorouracil.
- Monga prophylaxis ya matenda a necrosis, wodwalayo amatenga maantibayotiki. Kuphatikiza apo, njira zikuchitidwa motsutsana ndi mapangidwe a zovuta za thromboembolic ndi kukokoloka kwa gastroduodenal. Ngati ndi kotheka, zakudya zopatsa mphamvu zimayambitsidwa kuti zizolimbitsa thupi.
Kuchita bwino kwa mankhwalawa kumatengera momwe chisamaliro chachipatala chimafikira. Chithandizo chachikulu komanso cholunjika chimachitika odwala akangofika kuchipatala cha opaleshoni.
Ngati njira zosagonjetsera sizikuyenda bwino, makamaka ndi kapamba, piritsi lodziwika bwino limayikidwa. Peritoneal exudate yogwira ntchito ya amylase iyeneranso kuyesedwa. Pambuyo kukonzekera kwa preoperative kumachitika, kuyeretsa komanso kutulutsa kwam'mimba, cholecystostomy, marsupialization, ngati akuwonetsedwa, zimachitika.
About pancreatitis ndi zovuta zake zomwe zafotokozedwa muvidiyoyi.
