Matenda a kapamba chifukwa cha kusakwanira: ndi chiyani?

Matenda a kapamba akuluakulu omwe amakhala ndi kuchepa kwa magazi kwa nthawi yayitali amakula ndi njira yayitali yotupa m'mapapo (zaka 10). Zotsatira za m'malo mwa parenchyma ndi minye yolumikizana, chiwalocho chimataya mwayi wokwanira kuchita zosafunikira ndi exocrine.

Matendawa ndi akulu kwambiri chifukwa amatsogolera kapenanso kutaya kwathunthu kwa kapamba.

Zizindikiro zazikulu za matenda am'mimba ndizovuta zam'mimba, kupweteka kwam'mimba, mseru, khungu, tachycardia, kufupika kwa mpweya, kuchepa kwa mphamvu yogwira ntchito komanso kutopa kosalekeza.

Chizindikiro chachikulu cha kutupa kwa pancreatic ndi kuwonongeka kwa ntchito ndikupezeka kwa chakudya chosagwiritsidwa ntchito bwino mu chopondacho ndi kuphatikizika kwamafuta. Maziko ozindikira ndikuphunzira ndowe. Zomwe zimagwiritsidwa ntchito moyenera ndi zakudya zapadera, kudya kwa michere ya enzymatic ndi proton pump blockers.

Chidule cha Chronic Pancreatitis

Pazaka 30 zapitazi, kuchuluka kwa odwala omwe ali ndi pancreatitis kwachulukanso. Vutoli limafotokozedwa ndi kumwa mowa mwauchidakwa, cholelithiasis, moyo wopanda ntchito, komanso kudya pafupipafupi zakudya zamafuta ndi nyama yokazinga. Madokotala amati pancreatitis ndi "yaying'ono": tsopano matenda a zam'mawere amapezeka pafupifupi pazaka 39, pomwe zaka zapakati zinali pafupifupi 50.

Chikondwererochi ndi chiwalo chokhacho komanso intrasecretory. Chinsinsi chakunja ndikupanga madzi a pancreatic, ndipo chinsinsi chamkati ndikupanga mahomoni.

Pancreatitis imachitika ndi kutsegula kwa michere ya m'mimba michereyo. Zotsatira zake, thupi limayamba "kudzimbidwa." Chronic pancreatitis (CP) ndi mtundu wa matenda omwe amadziwika ndi kusintha kwa dystrophic mu kapamba. Ndi kusinthika kosalekeza kwa matenda, fibrosis, kusowa kapena makwinya kwa ziphuphu (mawonekedwe a kapamba), kusintha kapangidwe ka zigawo, kapangidwe ka calculi mu parenchyma kumawonedwa.

Malinga ndi ICD-10, CP ya zakumwa zoledzeretsa ndi enanso ndizopatukana. Malinga ndi magawidwe ena, pali biliary-kudalira, parenchymal-fibrous ndi cholepheretsa CP.

Mosiyana ndi pachimake, matendawa amakhala ndi chithunzi chochepa cha matenda kapena matenda am'mimba, mwachitsanzo, zilonda zam'mimba ndi duodenal, cholecystitis, bysary dyskinesia, ndi zina zambiri.

Madandaulo a wodwala matenda a kapamba amatha kuyanjana ndi:

• kupweteka ululu hypochondrium;
• kuchuluka kwa mpweya;
• kupumirana mseru komanso kumva kuwawa;
• dyspeptic matenda.

Nthawi zambiri, chifukwa cha kuphwanya malamulo a mankhwala ochiritsira pakudya kwa kapamba, kupweteka kwambiri kumawonekera, pomwe kusala kudya kwathunthu kumasonyezedwa. Matendawa ndi osachiritsika, motero, amafunika kuwunikira komanso kumwa mankhwala mosiyanasiyana.

Akatswiri ambiri amasiyanitsa magawo awiri a nthawi ya matenda a kapamba.

Gawo I (zaka 10 zoyambirira) - kusinthana kukhathamiritsa ndi kukhululuka, vuto la kuuma silifotokozedwa, pali zowawa mu dera la epigastric /

Gawo lachiwiri (zaka zopitilira 10) - kupumira kwa kupweteka, kuchuluka kwa vuto layspeptic.

Ndi gawo lachiwiri lomwe pancreatitis yosatha yomwe imakhala ndi kuperewera kwa pakhungu imayamba, yomwe imadziwika ndi chotupa chachikulu cha kapamba.

Zoyambitsa za exocrine kusakwanira

Njira ya "kudzimbidwa" imayambitsa kusintha kwa dystrophic mu parenchyma ndikutulutsa kwa pancreatic madzi. Poyerekeza ndi momwe njira izi zimapangidwira, chinsinsi, kapena glandular, minofu ya pancreatic imasinthidwa ndi minofu yaying'ono. Zotsatira zake, ziwalozi sizingagwire ntchito ya exocrine.

Ndizofunikira kudziwa kuti pancreatitis yokhazikika sindiye chifukwa chokhazikitsira kukonzekera kwa exocrine. Vuto linanso la izi limatha kukhala cystic fibrosis - nthenda ya autoimmune yomwe imakhudza ziwalo zomwe zimatulutsa madzi obwera. Izi zikuphatikiza chakudya cham'mimba, kupumira, maphesi, maliseche, thukuta, kutulutsa mkamwa ndi m'mphuno.

Matenda a kapamba kwambiri ndi cystic fibrosis ndi njira zazikulu zoyambira kuperewera kwa procrine. Njira zina zachitukuko chake zimaphatikizira njira ya m'magazi momwe kudya kwa michere ya m'mimba mu duodenum 12 sikungathandize kuti chakudya chizigwira bwino ntchito.

Izi ndichifukwa chosakwanira, kutsegula ndikuphwanya tsankho. Pancreatitis yokhala ndi kuchepa kwa procrine, komwe kumachitika pazifukwa zachiwiri, kumakhala ndi mawonekedwe ena. Kwenikweni, matendawa amapezeka molingana ndi "chiwonetsero" chotsatira:

1. Nembanemba yamatumbo ang'onoang'ono amakhudzidwa ndi zinthu zambiri zoyipa. Zotsatira zake, kupanga cholecystokinin ndi secretin kumachepetsedwa.
2. Njirayi imadzetsa dontho la intraduodenal pH pansipa 5.5. Izi zikutanthauza kuti ma enzyme a pancreatic sadzagwira ntchito.
3. Pali kuphwanya kayendedwe ka chakudya kudzera m'matumbo aang'ono. Zakudya zamafuta omwe sanayendetse ntchito zimayamba kusakanikirana ndi tinthu tating'onoting'ono ta chakudya chomwe chikubwera.
4. Zotsatira zake, njira ya kuvunda imayamba - chikhalidwe choyenera cha bacteria wa pathogenic. Matenda osiyanasiyana amalumikizana ndikupanga microflora yoyipa. Kuwonjezeka kwa chiwerengero cha mabakiteriya kumabweretsa kuwonongedwa kwa michere yam'mimba.
5. Pancreatic madzi amasayenda, omwe amatsagana ndi kuchepa kwa bile ndi enterokinase.

Monga lamulo, ndikuchotsa kwathunthu kapamba (gastrectomy), machitidwe onse oyambira komanso apamwamba amatenga nawo mbali.

Gulu ndi chizindikiro cha matenda

Kusakwanira kwazinsinsi zakunja kuyenera kufotokozedwa molingana ndi zizindikiro zingapo - zomwe zimayambitsa matenda ndi matenda opatsirana.

Zowonetsa zazikulu zakuperewera kwa katulutsidwe wakunja ndi:

1. Kulephera kudya mafuta, okazinga komanso osuta zakudya. Ngati wodwalayo adya chakudya chotere, pakapita kanthawi amamva kuwawa m'mimba mwake. Kenako ululu wa colic umawonjezeredwa. Mukachotsa m'mimba, chopondapo cha mushy chimawonedwa - chizindikiro chachikulu cha kapamba. Mmenemo mutha kuwona zosayera za ntchofu (mafuta) ndi tinthu tating'onoting'ono ta chakudya chosagwiritsidwa ntchito. Pafupipafupi kupita kuchimbudzi kumakhala katatu pa tsiku 6 mpaka 6. Zomwe zimakhala zamafuta ndizosavuta kudziwa: tinthu tambiri tambiri timakhala timataya pachimbudzi, chifukwa zimavuta kutsuka ndi madzi.
2. Zizindikiro zakuchepa kwamavitamini sungunuka. Chifukwa cha kuchepa kwawo, ululu m'mafupa umawonedwa, amakhala ochepa mphamvu. Vitamini D hypovitaminosis imayambitsa kukopeka, Vitamini K imayambitsa kuphwanya magazi, Vitamini A imayambitsa "khungu usiku" komanso khungu louma, Vitamini E amachepetsa libido, komanso matenda opatsirana.
3. Zizindikiro zomwe zimakhudzana ndi kuchepa kwa kapamba ka pancreatic. Ma enzyme amenewa amaphwanya mapuloteni. Kusowa kwawo kumabweretsa kuchepa kwa magazi m'thupi kwa B12, komwe kumadziwika ndi kuchepa kwa ntchito, kufupika, khungu, tachycardia komanso kutopa msanga. Chifukwa cha kusakwanira kwa michere, kuchepa kwamphamvu kwa thupi kumawonedwa.

Njira zamatsenga zimakhudza makamaka akuluakulu. Muubwana, kapamba ndi kuphwanya kwa exocrine ntchito kumachitika kawirikawiri. Kutupa kwa chiwalo kumachitika pazifukwa zina - matenda a m'matumbo ang'ono, matenda a ndulu, kuvulala kwamatumbo osiyanasiyana, kutsekeka kwa duodenal, kusokonekera kwa kapamba ndi kapamba.

Njira zodziwitsira ndi njira zochizira

Popeza adazindikira zizindikiro za kuchepa kwa kapangidwe ka pancreatic, ayenera kufunafuna thandizo kuchipatala.

Kutayika kwa nthawi yamtengo wapatali kumatha kubweretsa kuwonongeka kwathunthu kwa kapamba ndi kuchotsedwa kwake.

Njira yothandiza kwambiri yodziwira matendawa ndi kuwunika kwa stool. Zimathandizira kudziwa mulingo wa pancreatic elastase-1.

Zotsatira za phunziroli zitha kukhala:

• 200-500 mcg / g - yachilendo ntchito ya exocrine;
• 100-200 mcg / g - digiri yofatsa komanso yotentha ya exocrine;
• Zosakwana 100 mcg / g - matenda oopsa.

Udindo wofunikira kwambiri pothandizira matenda ndi zakudya. Mwa malamulo oyamba azakudya zapadera za exocrine kusakwanira, ndikofunikira kuwunikira:

1. Kudya zakudya sayenera upambana 4 maola.
2. Muyenera kudya m'magawo ang'onoang'ono 5-6 patsiku.
3. Pewani kudya kwambiri madzulo ndi usiku.
4. Musachotse zakudya zokazinga, zamafuta komanso zautsi kuchokera pachakudya.
5. Ganizirani zokonda za mbewu zomwe zimachokera.
6. Siyani kumwa mowa kwathunthu.

Zomwe zimakhazikitsidwa ndi zakudya ndizopatsa zakudya zopatsa mphamvu - masamba, zipatso, chimanga. Ndi magwero azakudya za fiber, mavitamini, michere yofunika komanso michere yambiri. Simalimbikitsidwa kudya zakudya monga nyemba, kabichi, biringanya, zopangidwa ndi ufa, chifukwa zimawonjezera mapangidwe a mpweya m'mimba.

Kuphatikiza pa chithandizo chamankhwala, odwala ayenera kumwa mankhwala. Maziko a mankhwalawa ndi mankhwala:

1. Ma enzymes am'mimba omwe amasintha njira yolandirira chakudya (Mezim, Pancreatinum 8000, Creon, Panzinorm). Amatengedwa pachakudya, mlingo wake umatengera kuchuluka kwa zakudya zomwe zimadyedwa ndi kapangidwe kake.
2. Proton pump blockers omwe amathandizira kugaya chakudya (lanzoprazolol, esomeprazole, omeprazole). Zochita za mankhwalawa zimapangidwa kuti apange zomwe zimachitika m'matumbo am'mimba.

Pankhaniyi, kudzipereka nokha sikungatheke. Kutsatira malangizo onse a dokotala, zotsatira zabwino za kuchiritsa zingatheke. Zotsatira zake, kupweteka kwamatumbo ndi kutsegula m'mimba kudzadutsa, ndipo sipadzakhala kuphatikizika kwamafuta ndi tinthu tosaphatikizika mu chopondacho. Nthawi ndi nthawi, wodwalayo amayesedwanso. Matenda amtundu wa chakudya amasonyezedwa ndi kuchepa kwa mafuta mu ndowe mpaka 7 g

Akatswiri azikambirana za chifuwa chachikulu cha kanema mu nkhaniyi.