Mitundu ya pancreatitis yachilendo imayang'aniridwa ndi etiological, mawonekedwe a morphological, mawonetsedwe azachipatala, mawonekedwe a zochitika ndi mkhalidwe, komanso magawo.
Palibe gulu lililonse lomwe limavomerezedwa kuti ndi lodwala. Madotolo ena amapita kuchipatala malinga ndi mitundu ya A. S. Loginov, akatswiri ena azachipatala amagwiritsa ntchito gulu la Marseille-Roman.
Malinga ndi ICD (International Classization of Diseases), chifuwa chachikulu chimakhalapo pansi pa cholembedwa cha K86.0, chomwe chimatanthawuza zakumwa zochokera ku pathological process.
Code K86.1 imaphatikizapo mitundu ina yamatenda osachedwa - chiyambi chopatsirana, mawonekedwe obwereranso, etc.
Mitundu ya pancreatitis yaulesi
Matendawa ndi oyambira komanso a sekondale. Mbali yoyamba, njira yonyansa imayambira mwachindunji m'mapamba. Mu mawonekedwe awiri, matenda am'mimba amadziwika chifukwa cha matenda a ziwalo zamkati zapafupi - chikhodzodzo, m'mimba, ndi zina zambiri.
Zomwe zimayambitsa matenda oyamba zimaphatikizapo kudalira mowa, kudziwikiratu chibadwa, kuledzera kwa mankhwala osokoneza bongo, mbiri yayitali ya kusuta, kupsinjika kosalekeza ndi neurosis.
The etiology ya yachiwiri matenda amayamba ndi pathologies a gallbladder (cholecystitis ndi mapangidwe miyala), matenda a chiwindi, matenda a chiwindi, parasitic matenda, cystic fibrosis (kobadwa nako matenda limodzi ndi kuwonongeka kwa gwero la exocrine).
Malinga ndi Loginov, kutengera chipatalachi, kupweteka kwamatumbo kumachitika:
- Fomu yokhazikika. Matendawa amadziwika ndi nthawi yobwereza matendawa, omwe amasinthidwa ndi nthawi zakhululukidwe.
- Fomu lopweteka limaphatikizidwa ndi kupweteka kosalekeza.
- Pseudotumor mawonekedwe. Chizindikiro chachikulu chachipatala ndi jaundice wovuta.
- Mtundu wopanda ululu kapena wowonda. Dziwa nthawi zambiri ndi exocrine kusowa, penapake intracretory.
- Sclerosing pancreatitis. Matendawa amaphatikizidwa ndi kuperewera kwamkati mwa thupi, kakulidwe ndimatundu enanso.
Malinga ndi gulu la Marseille-Roman, matendawa ndi amtundu uwu:
- Fomu lodziwitsa. Matendawa amatuluka ndikumapangidwa ndi mapuloteni kapena miyala mumiyala ya England. Amawonedwa pafupifupi 50-85% pazithunzi zonse zamankhwala. Kenako imagawika m'magulu ang'onoang'ono. Poyamba, makristulo okhazikika olimba amapangidwa, etiology imachitika chifukwa cha zizolowezi zoyipa za kudya komanso kuledzera. Mu mtundu wachiwiri, miyala yofewa, maphunziro amachokera ku cholowa.
- Pancreatitis yovomerezeka imayendera limodzi ndi kutsekeka kwa kapamba kapena chotupa.
- Fomu lotupa. Gland fibrosis ilipo.
- Pseudocysts kapena cysts owona (mawonekedwe a cystic).
Malinga ndi gulu la Loginov, pancreatitis yaulesi imakhala yamisempha yambiri - yofatsa, yofatsa komanso yovuta.
Matenda owopsa
Fomu yodwalayo imatha kubwerezabwereza, zomwe zimabweretsa kufalikira kwa matenda. Kutupa kungayambitse kuchepa kwa ziwalo kwakanthawi kochepa.
Ndi matenda osakhalitsa m'thupi, kusintha kosasinthika kumawonedwa, kumapangitsa kutsirizika kwake. Pochita zachipatala, matendawa amagawidwa malinga ndi kuuma.
Poyamba (gawo loyamba) kwa nthawi yoposa zaka khumi. Amadziwika ndi kutalika kwakhululuka, komabe, komanso osatalikirana kwambiri. Zowawa pamenepa ndizoyenda, nthawi zambiri ululu wammbuyo umapangidwira kuchokera kumanzere hypochondrium. Dyspeptic syndrome pambuyo mankhwala kwathunthu leve.
M'tsogolomu, matendawa amapita patsogolo. Pali zisonyezo zakusakwanira kwa procrine, ndizowopsa. Matenda a ululu amachepetsedwa pang'ono, koma madokotala amati izi sizabwino, popeza njira zatsopano za zotupa zimapangira kapamba.
Ndi zovuta mawonekedwe a pathological process, zovuta zingapo zimayamba. Pali zopweteka kwambiri, nthawi zambiri mankhwala omwe amakhala ndi analgesic kwenikweni sawathandiza kuti amuchotse. Kukhazikika kwa dyspeptic syndrome kumadziwika.
Mavuto amabuka (malinga ndi gulu la Ivashkin):
- Kutuluka kwa bile kumasokoneza.
- Njira yolembera matenda oopsa.
- Matenda opatsirana.
- Kusintha kwa kutupa - cysts, cholecystitis, mawonekedwe owopsa a kulephera kwa impso, magazi m'mimba, etc.
- Matenda a Endocrine: mawonekedwe apancreatic a shuga mellitus, hypoglycemia.
Kuchepa kwa khansa ya kapamba kwa odwala omwe amapezeka ndi chifuwa cham'mimba kumawonjezeka kwambiri.
Kugawidwa kwa matenda kapamba aakulu monga Khazanov
Zikondamoyo zimakhala ndi thupi, mutu ndi mchira. Kuwerengera sikuganizira malo omwe akutupa. Mankhwala, mitundu yomwe imagwiritsidwa ntchito kwambiri mu kafungo ka kapamba imakhala m'gulu la Khazanov.
Mtundu wa interstitial (edematous form). Mwa mawonetseredwe azachipatala, ali pafupi kwambiri ndi gawo la matenda. Kutalika kwake ndi miyezi isanu ndi umodzi. Odwala amadandaula za kupweteka kwambiri, nseru komanso kusanza. Mukadutsa matenda, minofu yoyandikana ndi kapamba imasinthasintha. Mavuto amakula mu 30 mpaka 40% ya milandu yonse yomwe imachitika.
Pancreatitis yobwerezabwereza imayendera limodzi ndi pafupipafupi mpaka katatu pachaka. Kupweteka kwa ululu sikumatchulidwa pang'ono. Malinga ndi data ya ultrasound, ma contours a chiwalo amasintha pang'ono, kapangidwe kake kamafanana, kapangidwe. Pathology imapezeka mu 50% ya milandu. Ndi kawirikawiri kwambiri mwa odwala kudziwa zovuta. Matendawa amakhala ndi chithandizo chanthawi yake komanso chokwanira.
Mitundu ina ya ulesi pancreatitis:
- Fibrosulinotic. Mwa ultrasound, chitsulo sichimachulukitsa, mwa odwala ena amachepetsa kwathunthu. Pali zowawa. Ma pancreatic ducts amakula. Mtundu wa kapamba nthawi zambiri umabweretsa zovuta. Maphunziro azachipatala akupitilizabe.
- Fomu la cystic. Ultrasound imawonetsa gawo losasinthika la chiwalo, kukulitsa kwa gland, ma cysts ang'onoang'ono odzaza ndi madzimadzi alipo. Zida zazikulu zimakulitsa. Izi matenda akupezeka odwala 6-10%.
- Maganizo. Ululu wammbuyo umatchulidwa kwambiri, odwala amachepetsa thupi, kwanuko amawonjezera chitsulo. Pafupifupi 70% amakumana ndi zovuta. Matendawa ndi akulu.
Pamaso pa chotupa mu kapamba kapena mawonekedwe a kapamba, tumor neoplasms yomwe imagwirizanitsidwa ndi kapamba imatha kupindika.
Kutumiza ndi kusintha kwa kapamba
Kusintha kwa chiwindi ndi kapamba chifukwa cha zifukwa zosiyanasiyana. Izi ndi monga kuperewera kwa chakudya mosasamala, kumwa mowa mwauchidakwa komanso kusuta fodya, kugwiritsa ntchito mankhwala othandizira kuti muchepetse kunenepa.
Nthawi zambiri etiology imachitika chifukwa cha poyizoni wokhala ndi poyizoni mankhwala, mankhwala opha maantibayotiki nthawi yayitali, zotsatira zoyipa za ma virus, tiziromboti komanso matenda ena oyambitsidwa ndi matendawa.
Chiwindi chikayamba kupunduka, chimadziwika ndi zizindikiro zosiyanasiyana. Chithandizo cha Conservative nthawi zambiri chimachitika. Wodwalayo akulimbikitsidwa kukhala ndi zakudya zisanu zapancreatic, mankhwala omwe amathandizira kubwezeretsa chiwindi.
Kugwedezeka kwa kapamba si matenda, popeza kuti chiwalo chamkati chimatha kuwongola komanso kupindika. Odwala ambiri, atamva pa ultrasound za kupindika kwa kapamba, mantha. Komabe, izi sizowopsa kwa akulu ndi ana.
Kuchulukitsa kwa kapamba kumachitika chifukwa cha matenda, pamene chiwalo chikugundana, ndikupotoza duodenum. Koma matenda oterewa ndi osowa kwambiri m'zochitika zachipatala, omwe amaphatikizidwa ndi zovuta zam'mimba.
Mu zojambula zina, kumverera kwa ziwalo kumachitika, zomwe zimaloleza kuyesedwa kwa zinthu zamkati. Njirayi ili ndi ma contraindication ambiri - matenda a mtima, kutulutsa m'mimba, kusanza mobwerezabwereza, matenda oopsa, etc.
Kugwedeza kwa RV kumachitika pazifukwa izi:
- Pachimake ndi mawonekedwe a kapamba. Popanda chithandizo, kupindika kumatha kusintha ndikupanga mawonekedwe, kenako ndikuphwanya magwiridwe antchito amkati.
- Mapangidwe a cysts. Kudziwitsa mozama kumafunikira kuti muzindikire zovuta zina mthupi.
- Tumor neoplasms. Poterepa, kuwonjezera pa scan ya ultrasound, scan scan kapena ma MRI scan. Zithunzizi zimawonetsa chiwalo cholikulika kwambiri, ma contour ndi opunduka. Kwenikweni, chithandizo chimatsikira ku opaleshoni ya pancreatic.
Mwa ana, kupindika kwa kapamba nthawi zambiri kumakhala kwa kanthawi kochepa, popeza momwe munthu akukula ndi kukhazikika, chiwalo chamkati chimachitika ndipo nthawi zambiri chimakhala chamtunda.
Matenda a pancreatitis aakulu amayamba chifukwa cha zinthu zambiri. Izi zikuphatikizapo zomwe zachitika chifukwa cha matendawa, zaka za wodwalayo, chithandizo. Ndi malingaliro onse a dotolo, mwayi wamavuto amachepetsa kwambiri.
The etiology ndi mitundu ya kapamba amadziwika mu kanema munkhaniyi.
