Pancreatic necrosis ndimatenda a kapamba, omwe amadziwika ndi kufa kwa minofu ya ziwalo. Zimachitika chifukwa chodzimbidwa tizi (gololi) ndi ma enzymes ake.
Nthawi zambiri pamakhala pancreatic necrosis yokhala ndi peritonitis, yophatikizika ndi matenda am'mimba komanso mavuto osiyanasiyana. Pancreatic necrosis imatha kutchulidwa ngati matenda odziyimira pawokha, komanso ngati vuto lalikulu la pancreatitis pachimake. Monga matenda olekanitsidwa, nthawi zambiri amapezeka mwa achinyamata.
Mitundu yotsatirayi ya pancreatic necrosis imasiyanitsidwa:
- Kuchuluka kwa ndondomekoyi ndikuyang'ana pang'ono (ndizochepa) komanso kufalikira.
- Malinga ndi kukhalapo kwa matenda omwe amapezeka m'matumbo, ndimakomoka (osadziwika) komanso kachilombo.
Sterile pancreatic necrosis imagawidwa kukhala hemorrhagic, yomwe imadziwika ndi magazi amkati, mafuta ndi osakanikirana, omwe amakhala ambiri.
Njira yamatendawa ndiyachotsa ndipo ikupita patsogolo.
Pali zifukwa zingapo zomwe zimayambitsa matendawa.
Chinthu chofala kwambiri chomwe chimakhudza boma la kapamba ndi chitukuko cha matenda opatsirana ndi kuledzera.
Kuphatikiza pa izi, chimodzi mwazomwe zimayambitsa matendawa zimatha kukhala kuphwanya zakudya, kudya kwambiri mafuta komanso zakudya yokazinga.
Kuphatikiza apo, zinthu zoopsa zimaganiziridwa:
- matenda obwera ndi ma virus mthupi;
- zilonda zam'mimba kapena zilonda zam'mimba;
- ma gallstones
- kuchitapo kanthu kwa opaleshoni kapena kuvulala kwam'mimba;
- matenda omwe apezeka kale m'mimba;
- kugwiritsa ntchito mankhwala osokoneza bongo.
Pambuyo povutikira chifukwa chimodzi kapena zingapo, pancreatic necrosis imatha kuchitika, yomwe ili ndi magawo atatu a chitukuko:
- Toxemia - pamenepa, poizoni yemwe amatulutsidwa ndi mabakiteriya amayendayenda m'magazi.
- Chotupa ndiye kuchepa kwa kapamba ndipo nthawi zina mamembala amakumana nawo.
- Kusintha kwa ma purulent - mu gland ndi fiber pafupi.
Malinga ndi magawo a necrosis, Zizindikiro zomwe zimachitika:
- ululu - odwala omwe nthawi zambiri amawafotokozera kuti ndi olimba kwambiri, osalephera, koma amatha kuchepa ngati mutagona ndi mawondo anu atakankhidwa m'mimba mwanu;
- nseru
- kusanza - kosagwirizana ndi kugwiritsa ntchito chakudya, pomwe munthu akusanza magazi m'magazi, koma osamasuka;
- kuchepa kwa madzi m'thupi - kumachitika chifukwa cha kusowa kwamadzi m'thupi, odwala chifukwa chosanza mosakhazikika, wodwalayo amafuna kumwa nthawi zonse, khungu lake ndi zimagwira pakhungu zimafota, kukodza kumachepetsedwa kwambiri kapena kulibeko kwathunthu;
- kufiyira koyamba, kenako khungu.
- hyperthermia;
- kutulutsa;
- yofunika tachycardia;
- kuwoneka kwa mawonekedwe ansalu pamimba, matako ndi kumbuyo;
Pambuyo pa masiku 5-9, peritonitis ndi kusakwanira kwa ziwalo zonse zamthupi zimayamba.
Choyamba, wodwalayo amapatsidwa mankhwala okhazikika ogona, ochizira kusala kudya. Cholinga chachikulu cha dotolo ndikuletsa ululu wammbuyo.
Chifukwa chaichi, ma pinkiller ndi antispasmodics amayamba. Poletsa ntchito zachinsinsi za kapamba, chifukwa pomwe, chiwonongeko chake chimachitika, wodwalayo adakonzekera kukonzekera kwa antienzyme.
Wodziwika kwambiri mwa iwo ndipo amagwiritsidwa ntchito kwambiri pazachipatala ndi Kontrikal (mayina ake ena ndi Trasilol ndi Gordoks). Gawo lotsatira ndikubwezeretsanso madzi osungidwa omwe asungidwa nthawi yayitali. Pachifukwa ichi, kulowerera kwamitsempha yama colloidal yotsimikizika ndi mankhwala. Ndikofunikanso kuchepetsa kutentha m'dera la kutupa - gwiritsani ayezi. Maantibayotiki ovomerezeka - kuti awononge tizilombo toyambitsa matenda.
Ngati chithandizo chonse sichikuthandiza, matenda a kapamba adachitika kapena njirayi yayamba kufalikira kwa ziwalo zoyandikana ndi peritoneum (peritonitis), akuwonetsa kuti akufunika kuchitidwa opaleshoni mwachangu.
Ntchito zomwe zimachitika ndi pancreatic necrosis zimagawidwa pang'onopang'ono komanso zowonekera, kapena zowongoka.
Ntchito zowukira zochepa zimagwiritsidwa ntchito pokhapokha malo ochepa a kapamba adachitika necrosis, koma gawo lake lalikulu likutha kugwira ntchito.
Patsamba la zotupa, timadzimadzi ndi minofu yakufa timadziunjikira, zomwe zimayenera kuchotsedwa. Ma cell omwe adachotsedwa pambuyo pa njirayi amatumizidwa kuti apange kafukufuku wa bacteriological, histological and biochemical.
Kafukufuku wa bacteria akufotokozera za kukhalapo kwa mabakiteriya am'matumbo mu gland, pomwe kuwunika kwa mbiri kumatsimikizira ngati pali ma cell atypical omwe amatha kukhala gwero la khansa, ndipo kapangidwe kazinthu zamadzi zomwe zimatulutsidwa zimasunthidwa pa biochemical imodzi. Opaleshoniyo ikuchitika motsogozedwa ndi ultrasound.
Pali mitundu iwiri yolowerera pang'ono.
- Zizindikiro - kuchotsera kamodzi kokha kwa chithokomiro. Imachitika ngati osadziwika pancreatic necrosis. Nthawi zambiri, pakapopera kukoka, madzi ena atsopano samakhazikika.
- Drainage ndi kukhazikitsa singano yomwe madzi ake amayamba kuyerera pang'onopang'ono. Kutengera momwe wodwalayo aliri, dera lomwe likuwonongeka pa chiwalocho, ma drafa osiyanasiyana osiyanasiyana osiyanasiyana ndi ma diameter akhoza kuyikika. Kudzera mchotsekerachi, zikondazo zimatsukidwa ndikumatulutsa disinitics. Njirayi imagwiritsidwa ntchito pa matenda a gland necrosis, kapena kupuma sikunabweretse zotsatira zomwe mukufuna.
Ndi mitundu yowonongera yowopsa ya peritonitis yovuta, madokotala ochita opaleshoni amakakamizidwa kuti atembenukire kwawoko mwachangu.
Opaleshoni yotseguka imaphatikizapo pancreatic necondolaomy, i.e. kuchotsa kwa zigawo zake zakufa. Ngati necrosis yakula chifukwa cha matenda am'mimba, ndiye kuti amatha. Nthawi zina ndulu ya ndulu kapena ndulu imayamba kuchotsedwa.
Ngati pancreatic necrosis imayendera limodzi ndi peritonitis, ndiye kuti m'mimba chatsukidwa kwathunthu, ndikuyika zofunikira ndikofunikira.
Ntchito zotseguka zimachitika pogwiritsa ntchito laparoscopy. Chinsinsi cha njirayi ndikuwona kwathunthu pazomwe zimachitidwa. Kuti muchite izi, makamera amapangidwa kudzera pakayikidwe kakang'ono m'mimba, ndipo zonse zomwe zimachitika zimawonetsedwa pazambiri zowunikira.
Kuphatikiza pa laparoscopy, pancreatomento-bursostomy imagwiritsidwa ntchito - wapadera womwe umasiya bala lotseguka pambuyo pa laparotomy kuti alandire zikondamoyo kudzera mu buroma la omental.
Chiwopsezo cha kufa kwa pancreatic necrosis ndi 50%, chizindikiro chikuchokera 30 mpaka 70%.
Odwala opulumuka amafunika kupatsidwa chithandizo chakanthawi komanso chokwanira.
Pambuyo pa matendawa, ntchito yokhayo ya kapamba imalephera, ndiye kuti, katulutsidwe ka michere ya m'mimba imachepa.
Nthawi yomweyo, ntchito ya endocrine ndiyachilendo - mahomoni omwe amayang'anira kuchuluka kwa shuga m'magazi (insulin, glucagon) amawachotsa bwino.
Zotsatirazi zovuta za matenda pamwambapa ndi zotheka:
- chimbudzi;
- aakulu yotupa njira mu kapamba;
- kotala inayi - matenda ashuga;
- ma cyss abodza amatha kupezeka mkati mwa gland;
- kusakwanira kuchuluka kwa lipids m'magazi;
- miyala m'makola.
Mobwerezabwereza pancreatic necrosis ndiyotheka ndi:
- Kunenepa kwambiri;
- Matenda a Gallstone;
- Uchidakwa wambiri;
Kuphatikiza apo, kukonzanso kwamatendawa ndikotheka ndikugwiritsidwa ntchito molakwika ndi zakudya zamafuta ndi nyama yokazinga.
Opaleshoniyo itatha, wodwalayo amasiya kugwira ntchito kwa miyezi itatu kapena inayi kapena kupitirira apo. Nthawi ya ntchito itadalira zaka za wodwalayo (anthu okalamba ndizovuta kwambiri kulekerera njirazi, ndichifukwa chake pali kufa kwakukulu), kuuma kwa vutolo, ndipo koposa zonse, pa chisamaliro ndi chisamaliro cha mabanja ndi abwenzi.
Masiku awiri oyamba, wodwalayo ayenera kukhala m'chipatala kwambiri, komwe anamwino amayeza magazi pafupipafupi, kuyezetsa magazi kwa glucose ndi ma elekitirodi, kuyezetsa mkodzo, kudziwa hematocrit (kuchuluka kwa kuchuluka kwa zinthu zomwe zimapangidwa mpaka kuchuluka kwa plasma). Ndi chikhalidwe chokhazikika, wodwalayo amasamutsidwa ku wadi mu dipatimenti ya opaleshoni yayikulu.
Odwala saloledwa kudya chilichonse ali m'manja. Pa tsiku lachitatu, tiyi wopanda shuga ndi buledi, mkate wowotchera msuzi wamasamba, mpunga ndi phala la buckwheat, mapuloteni omelet (theka la dzira patsiku), mkate wowuma (kokha pa tsiku la 6), tchizi tchizi, batala (15 g) amaloledwa. Sabata yoyamba, mumangofunika kudya mbale zothira, ndipo patatha masiku 7 mpaka 10 mutha kuyambitsa pang'onopang'ono nyama ndi nsomba. Odwala amachotsedwa panyumba pakatha miyezi iwiri.
Kunyumba, odwala ayenera kutsatira zakudya, kumwa mankhwala a m'magazi a hypoglycemic kuti azitha kuwonetsa kuchuluka kwa shuga m'magazi, ma enzymes olimbitsa kusintha kwa chimbudzi, kuchita masewera olimbitsa thupi ndikupita ku physiotherapy.
Mfundo zazikuluzikulu za zakudya pambuyo pancreatic necrosis:
- pafupipafupi zakudya zamagulu ochepa (osachepera 5 pa tsiku);
- kukana kwathunthu zizolowezi zoipa;
- mbale zophika ziyenera kukhala zotentha (mulibe otentha ndi ozizira, chifukwa zimakwiyitsa masitepe am'mimba);
- zimaphika zokha, zophika kapena zowotchera kapena zosenda zokha.
Zakudya zoletsedwa za pancreatic necrosis ndi:
- Mkate wophika kumene ndi mkate.
- Barele, phala ya chimanga.
- Ziphuphu
- Mafuta ndi nsomba.
- Mafuta, okazinga, osuta ndikuwotola.
- Zakudya zamatenda.
- Zakudya zomwe zimakhala ndi bowa.
- Ma broth olemera.
- Nyengo.
- Kabichi yoyera.
- Zinthu zamafuta amkaka kwambiri.
- Mazira.
Chololedwa kugwiritsa ntchito:
- buledi wowuma;
- tchizi chamafuta ochepa;
- zamadzimadzi zakudya masamba soups;
- durum tirigu pasitala;
- masamba obiriwira;
- timadziti tosazungulira;
- nyama yokonda ndi nsomba;
- masamba ndi batala;
Kuphatikiza apo, ndi pancreatic necrosis, mutha kugwiritsa ntchito ma cookie opanda shuga m'malo ochepa.
Mankhwala osokoneza bongo komanso opaleshoni ya pancreatic necrosis ali ndi matenda osakanikirana kwambiri.
Mwayi wopulumuka uli pafupifupi makumi asanu muzana. Zonse zimatengera zotsatira za opareshoni, monga zanenedwa kale, pa jenda ndi zaka za odwala, mtundu wa ntchito ya madokotala a opaleshoni, kutsatira kwa odwala pakudya, komanso kumwa mankhwala mosalekeza.
Ngati wodwala adya chakudya mwachangu, amasuta, amamwa mowa, kuchotsedwa kwawo sikungokhala.
Khalidwe lotere limatha kubweretsa necrosis yobwereza mwachangu, ndipo mtengo wonyalanyaza wotere ungakhale wokwera kwambiri.
Odwala omwe anachitidwa opaleshoni ya pancreatic necrosis ayenera kupitiliza chithandizo chamankhwala omwe amapezeka ndi adotolo moyo wawo wonse, kutsatira mosamalitsa malangizo ake.
Odwala amayesedwa pafupipafupi kuti apewe shuga kuti asaphonye kukula kwa matenda a shuga, kuyezetsa kwamikodzo pafupipafupi ndikuwerengera tsiku ndi usiku kukodza, ndikuyendera chipinda chofufuzira cha ultrasound kuti muwone ngati pali zotupa pambuyo pa opaleshoni.
Ngati muli ndi matenda ashuga, ndikofunikira kudekha komanso kuperekera insulin nthawi yayitali ndikumwa mapiritsi ochepetsa shuga.
Kupewa matendawa ndi motere:
- Munthawi yake komanso chithandizo chokwanira cha matenda a chiwindi (hepatitis, cirrhosis, kuchepa kwamafuta) komanso biliary thirakiti (cholelithiasis);
- Ndikupangika kukana kukhalapo kwa mafuta, amchere, osuta, osankhika, zakudya zamzitini mu zakudya kapena kuchepetsa kugwiritsa ntchito;
- Ndikofunikira kusiya zizolowezi zoipa - mowa, fodya ndi mankhwala osokoneza bongo, chifukwa ali ndi vuto la chiwindi ndi kapamba;
- M'pofunika kusamala ndi kuvulala kwam'mimbamo;
- Ndi zoyipa zoyambirira zam'mimba, muyenera kufunsa dokotala;
- Kuchita masewera olimbitsa thupi moyenera kumalimbikitsidwa kuchitidwa tsiku lililonse;
Kuphatikiza apo, muyenera kusiyiratu kugwiritsa ntchito kapena kuchepetsa zakumwa zoledzeretsa za zakumwa za shuga.
About pancreatic necrosis akufotokozedwa mu kanema munkhaniyi.
