Kukula kwakanthawi kochepa mu minyewa ya kapamba kumayambitsa kukhalapo kwa zosintha zina za pathological mu chiwalo - kapamba.
Matenda amtunduwu alipo pakali pano
Izi matendawa amaphatikizidwa ndi zizindikiritso zingapo zingapo.
Zizindikiro zotere ndi izi:
- kupweteka kumawonekera;
- pali kumverera kwa nseru ndi kusanza;
- pali gawo lokhumudwitsa lomwe likugwira ntchito.
Madokotala apanga malangizo apadera a kapamba wambiri, kugwiritsa ntchito komwe kumangoletsa kuzindikira kukhalapo kwa matenda mwa anthu, komanso kuchita njira zopewera kupewa kuti PC isachitike
Chofunika cha matenda ndi njira yothandizira matendawo kuyambika kwa matendawa
Mukazindikira matenda, malingaliro onse a akatswiri ayenera kutsatiridwa.
Kutsatira upangiri wa adokotala kumakupatsani mwayi wogwiritsa ntchito mankhwalawa posankha mankhwala, mutapatsidwa mawonekedwe omwe amapezeka panthawi yodwala komanso thupi la wodwalayo.
Malangizo othandizira pancreatitis yayitali kwa ogwira ntchito kuchipatala akupangidwa ndi mabungwe apadziko lonse komanso apadziko lonse lapansi.
CP ndi njira yovuta kwambiri, pofotokoza kukhazikitsidwa kwa chithandizo chamankhwala komanso pofotokozera za matenda.
Chimodzi mwa matendawa ndi kupezeka kwa njira ya patali komanso chithunzi cha matendawo chowonetsera matendawa. Nthawi zina, zovuta zachilendo za etiological zimatha kuwonjezeredwa pazovuta zomwe zidadziwika.
Zomwe zikuchitika mkati mwa matendawa zimathandizira kuti pakhale kusagwirizana pakati pa madokotala pankhani yokhudza kupezeka kwa matenda ndi zamankhwala.
Maonekedwe a kusagwirizana kotereku amafunika kuti pakhale njira yolumikizana yanjira yodziwira ndi kuchiza matendawa.
Njira iyi yodziwira matenda ndi mankhwala amawonekera mu njira zomwe mabungwe apadziko lonse lapansi ndi mayiko amapanga.
Pakadali pano, kafukufuku sanakhazikitse njira zonse zothandizira kudziwa za matendawa zomwe zimathandizira kubadwa kwa matendawa, ndipo kuzindikira kwa zomwe zimayambitsa kukulitsa kwa matenda othandizira ndi chinthu chofunikira kwambiri chomwe chimalimbikitsa kusankha njira zamankhwala.
Pakuwunika kwa CP komanso kugawa kwa matenda malinga ndi maumboni, gulu lomwe lidayesedwa ndi bungwe lapadziko lonse lapansi la gastroenterologists limagwiritsidwa ntchito.
Mitundu yotsatirayi ya pathology imasiyanitsidwa:
- Zoopsa, mwachitsanzo, mawonekedwe a mowa kapena mlingo. Amapezeka mu 2/3 pama milandu onse omwe adapezeka ndi matendawa.
- Fomu ya Idiopathic.
- Zopatsirana.
- Othandizira pa Biliary.
- Cholowa.
- Autoimmune.
- Zopindulitsa.
Nthawi zambiri, CP imapitiriza kukula kwa kapamba kapamba, koma pamakhala zochitika zina ngati matenda atayamba kukhala ngati matenda obwera pawokha.
Kuphatikiza pa kuledzera, tikulimbikitsidwa kuganizira zina zomwe zingakhale:
- cholelithiasis;
- poyizoni ndi mankhwala oopsa;
- kukhalapo kwa matenda opatsirana;
- mavuto a kudya;
- kuzungulira kwa matenda am'deralo (ma spasms ndi mapangidwe a magazi);
- kulephera kwa aimpso.
Kuphatikiza apo, njira zingapo za kutupa zimatha kukhala chifukwa cha CP.
Ngati matenda oopsa amtundu wapezeka ndi kuyimitsidwa mwa wodwala, wodwalayo amalandila kuyamwa komwe kumayendetsedwa motsutsana ndikukula kwa matenda osachiritsika m'thupi.
Ku Russia, Association of Gastroenterologists yatulutsa malingaliro apadera amtunduwu pochiza matenda a kapamba.
Cholinga cha malangizowa ndikupanga njira yolumikizirana yodziwira matenda a CP.
Njira zoyesera
Kupezeka kwa CP wodwala kumatha kukayikiridwa mwa wodwala ngati ali ndi kupweteka kwapadera pamimba ndi zizindikiro zamankhwala, kupezeka kwake komwe kumadziwika kuti ndi exocrine pancreatic insuffence. Mawonekedwe awa ndi amodzi mwa odwala omwe amakonda kumwa mowa ndi kusuta fodya.
Chochititsa chomwe chikuthandizira mawonekedwe a matenda, malinga ndi malingaliro omwe apangidwa, mwina kupezeka kwa matenda omwewo m'mabanja.
Kusiyana pakati pa CP ndi pachimake ndizinthu zomwe sizimawonedwa kawirikawiri, zomwe zimapangitsa kuchuluka kwa michere m'mwazi ndi mkodzo.
Ngati zoterezi zimawonedwa, ndiye kuti nthawi zambiri zimakhala zodziwika pakapangidwe ka thupi la pseudo-cystic kapangidwe kapangidwe ka kapamba ka pancreatic.
Ngati kuchuluka kwa amylase kwapezeka m'thupi, wina akhoza kuganiza za zakunja kwa hyperamylasemia kunja kwa thupi.
Njira zotsatirazi zodziwira matenda zimagwiritsidwa ntchito pozindikira:
- Ultrasound yam'mimba.
- Multispiral computed tomography.
- MRPHG ndi EUSI.
- Endoscopic retrograde cholangiopancreatography.
- Classical njira za kutsimikiza pancreatic madzi voliyumu.
- Kutsimikiza kwa elastase-1 mukupanga ndowe pogwiritsa ntchito enzyme immunoassay
Ultrasound yamimba yam'mimba imatha kutsimikizira kukhalapo kwa mawonekedwe owopsa a CP pomwe masinthidwe awonekeratu a kapangidwe ka minofu yam'mimba.
Buku lofunsa la madokotala limalimbikitsa kugwiritsa ntchito ma ultrasound mumayendedwe kuti awone momwe wodwalayo alili pozindikira komanso ngati ali ndi pseudocyst mu kapamba.
Tiyenera kukumbukira kuti kusapezeka kwa zizindikiro zakukula kwa matendawa malinga ndi ultrasound sikumatula kupezeka kwake m'thupi la wodwalayo.
Multispiral computed tomography ndi njira yomwe imakhala yothandiza kwambiri poyerekeza ndi ultrasound yam'mimba.
Chidziwitso chodziwikiratu komanso cholola chazindikiritso cha kusintha kwa ma pancreatic parenchyma koyambirira koyambirira kwa matendawo ndi njira za MRPHG ndi EUSI ndikulimbikitsa munthawi yomweyo ndi secretin, koma secretin sinalembedwe ku Russian Federation.
Kugwiritsa ntchito kwa MRI ndi MRCP kopanda chinsinsi sikupereka phindu pozindikira CP.
Chithandizo cha matenda
Malangizo apadziko lonse a matenda a kapamba amalangiza njira zochizira kuti zithetsenso zomwe zimayambitsa matendawa komanso kupewa kutalika kwa matendawa.
Kuthetsa mawonekedwe osakhala koopsa kumachitika chifukwa chogwiritsa ntchito mankhwalawa, omwe amaphatikiza kusala kwachithandizo, zakudya, 
kukhazikitsa kumveka kwam'mimba, kugwiritsa ntchito kuzizira pamimba m'dera la kapamba, kuperekedwa kwa mankhwala opweteka ndi mankhwala antispasmodic.
Pochitika kuti chithandizo chothandiza pakugwiritsa ntchito njira zoyambirira zamankhwala sichimatheka mkati mwa maola asanu ndi limodzi, kupezeka kwa mawonekedwe owopsa a matenda kumadziwika.
Malinga ndi malingaliro omwe adazindikira ntchito zisanu ndi imodzi zamankhwala:
- kusiya kumwa mowa ndi kusuta;
- kutsimikiza kwa zoyambitsa kupweteka m'mimba;
- kuthetsedwa kwa exocrine pancreatic insuffence;
- chizindikiritso ndikuchotsa kwa endocrine kusakwanira koyambira;
- thandizo lathanzi;
- pancreatic adenocarcinoma.
Njira yochizira imaphatikizira zolimbitsa thupi. Mulingo woyenera wabwino kwambiri wamankhwala umatheka pokhapokha mutangoyamba kumene chithandizo.
Chithandizo cha Conservative ziyenera kuyamba mu maora 12 oyamba atadwala matenda oyamba. Zikakhala zotere, mwayi wopeza zotsatira zabwino ukuwonjezeka.
Malinga ndi malangizo omwe akupangidwira, kuchotsedwa kwa zovuta zomwe sizinakusunthike njira za endoscopic kumachitika pogwiritsa ntchito njira ya opaleshoni - laparotomy.
Zisonyezero zothandizira opaleshoni
Pofuna kuzindikira mawonekedwe owopsa, kulowererapo kumasonyezedwa. Chowonadi ndi chakuti kukula kwa matendawa kumabweretsa kuwonongeka kwa thupi la endocrine yake ndi ntchito za exocrine. Njira ya laparoscopy imagwiritsidwa ntchito ngati njira yodziwira matenda komanso njira zochizira.
Kugwiritsa ntchito njirayi yopangira opaleshoni m'thupi la wodwalayo kumachitika ngati kupezeka kwa peritoneal syndrome kumapezeka.
Kuphatikiza apo, dokotalayo amagwiritsa ntchito laparoscopy pamene kupezeka kwa madzimadzi aulere kwapezeka m'mimba.
Ngati kuchitidwa opaleshoni ya laparoscopy sikutheka, ndiye kuti kugwiritsa ntchito laparocentesis kukuwoneka.
Opaleshoni ya Laparoscopic amatha kuthetsa ntchito zotsatirazi:
- Kutsimikizira kwa wodwala matenda ake.
- Zizindikiro zodalirika za matenda akulu kwambiri.
- Njira yakuchiritsira.
Mukukonzekera matendawa, kupezeka kwa exocrine pancreatic insuffence kumawonedwa. Pambuyo pa opaleshoni, kuwonongeka kwakanthawi kogwira ntchito kumalimbikitsidwa ndipo kubwezeretsa nthawi yayitali moyo kumagwiritsidwa ntchito kulipiritsa. Mlingo wa enzymatic mankhwala wotengedwa zimatengera kuchuluka kwa chitukuko cha kapamba.
Pakukonzekera kugwiritsa ntchito mankhwala olowa m'malo, ndimankhwala omwe amagwiritsidwa ntchito omwe amakhala ndi ma pancreatic enzymes
Kuphatikiza apo, chithandizo chothandizirana chimachitika, chomwe chimakhala ndi kuphatikiza mavitamini osungunuka a mafuta ambiri, kuphatikiza mavitamini A, D, E, K ndi B mu mawonekedwe awo.
Chithandizo chothandizanso ndi mankhwalawa chimaphatikizanso kugwiritsa ntchito kashiamu.
Mavuto a postoperative omwe angathe
Pochotsa matenda, njira zopangira opaleshoni zimagwiritsidwa ntchito pochotsa madera omwe akhudzidwa.
Nthawi yotsitsimutsa ya postoperative imakhala ndi chithandizo chokwanira cha mankhwala komanso kutsatira malangizo a chipatala pochiritsa matenda.
Kupezeka kwa zovuta za postoperative ndizovuta zamtundu wina wa CP. Malinga ndi ziwerengero, zovuta zimachitika mu 40% ya milandu.
Mu postoperative nthawi, mapangidwe a fistula ndikotheka, kuyambiranso kwa mutu wa pancreatic kumatha kupangitsa kuoneka ngati magazi akutuluka kwambiri.
Kuchotsa kwa zovuta za pachimake kapamba kumachitika muchipinda chopangira chisamaliro chogwiritsira ntchito mankhwala a antibacterial. Gulu lotchulidwa la mankhwalawa limagwiritsidwa ntchito kupatula zomwe zimachitika ndi zovuta za septic.
Nthawi yothandizira kuchira imafunika chidwi kwambiri ndi chakudyacho, makamaka kutsatira boma lake.
Malangizo azachipatala a kapamba amayenera kudya zakudya zosenda zokha. Kuphika kuyenera kuchitidwa ndi nthunzi kapena kuwira. Kutentha kwa chakudya komwe kumadyedwa sikuyenera kupitirira 50 digiri Celsius.
Chakudya chozizira kwambiri komanso chotentha chitha kuvulaza kapamba. Zakudya ziyenera kukhala zopindika, kuchuluka kwa chakudya kuyenera kukhala kosachepera sikisi patsiku.
Opaleshoni kuti muchepetse zovuta za CP zimatanthawuza ma opaleshoni ovuta, motero njira zotere ziyenera kuchitidwa ndi madokotala oyenerera omwe amagwiritsa ntchito zida zamakono.
About pancreatitis yayitali akufotokozedwa mu kanema munkhaniyi.
