Limagwirira a chitukuko cha zotupa njira kukhazikitsidwa mchikakamizo cha zinthu zoyambitsa. Izi ndi zakumwa zoledzeretsa, zamafuta, zamchere komanso zosuta. Ndi kumwa kwa zinthu zotere, kupanga kwakukulidwe kwa michere yamagaya kumayambira.
Ma ducts sangathe kuthana ndi kuchoka kwa msuzi, zomwe zimapangitsa kuti pakhale kusayenda. Ndipo kenako njira yoopsa yonyansa imayamba - thupi limadzigaya lokha, lomwe limayambitsa kutupa kwambiri. Chifukwa chake edema ya pancreatic imayamba.
Kutupa kumayambitsa kufinya kwa ma ducke, amatsekeka kwambiri. Mukakayezetsa, chotupa cham'mimba chimawonedwa, ngati kuti madzi adalowetsedwa nawo. Chiwalo chimakula kwambiri kukula kwake.
Edema amakwiya pamavuto osiyanasiyana. Nthawi zambiri, zimapangitsa kuti mawonekedwe a parenchyma abscesses, chifukwa ma ducts amadzaza ndi ma secretions, momwe mumakhala kuchuluka kwa leukocytes ndi ma desquamated epithelial cell.
Pathogenesis ndi chizindikiro cha kutupa kwa kapamba
Edema wamkati imayamba chifukwa cha kusokonekera kwa michere. Njira yodabwitsayi imachitika pazifukwa zosiyanasiyana. Izi zimaphatikizapo kumwa mowa kwambiri, kuperewera kwa zakudya m'thupi, cholelithiasis.
Acute edematous pancreatitis imayamba chifukwa cha shuga yemwe amapita patsogolo, kutsekeka kupita kudera lam'mimba kapena atachitidwa opaleshoni m'dera la chimbudzi. Zomwe zimayambitsa ndi matenda opatsirana, kufalikira kwa ma pancreatic ducts, ndikuwoneka ngati chotupa kapena chosaopsa.
Edema imachitika chifukwa chodzimbidwa pamatumbo ndi chotupa chomwe chimalowa. Ma ducts sangathe kuthana ndi kuchotsedwa kwa juwisi mu voliyumu "yatsopano", yomwe imatsogolera kutseka ndi kufinya kwake. Zotsatira zake, pamakhala madzimadzi mu kapamba.
Kutupa kwa mkati kwamkati kumayendera limodzi ndi zizindikiro zazikulu:
- Chizindikiro chachikulu chomwe chikuwonetsa kukula kwa matenda a kapamba ndi ululu. Ululu wammbuyo wotupa wopita ku hypochondrium. Chizindikiro ichi chimadalira kutupa kwa mutu komanso kutsekemera kwa ma ducts. Nthawi zambiri, opukutira mtima samathandiza kuchepetsa ululu. Kuchepetsa kupweteka kwapweteka kumathandizira kuyendetsa thupi patsogolo.
- Zizindikiro zina zachikhalidwe zimaphatikizapo ulesi, hyperhidrosis, kuzizira, kutentha thupi. Dziwani kuti Symbomatology iyi imakhala yothandiza osati kuwonongeka kwa kapamba, komanso cholelithiasis. Zinthu zapoizoni zikaloŵa m'magazi a magazi, kuledzera kumapezeka. Kutentha kwa thupi la wodwalayo kumawonjezeka, khungu limakhala lotuwa.
- Kuchulukana nthawi zambiri kumachitika limodzi ndi mseru, kusanza. Kupuma kumangopereka mpumulo kwakanthawi, kwenikweni pambuyo pa mphindi 20-30 wodwalayo ayambanso kudwala. Nthawi yachipatala iyi imasiyanitsa kapamba ndi zovuta zina zam'mimba.
Ngati matenda a shuga amayamba chifukwa cha chotupa cha ziwalo, ndiye kuti zizindikiro zake ndi izi: mumakhala ndi ludzu nthawi zonse, kuchepa kwa khungu, kuyabwa khungu, kudya, kugona, kuwonjezeka kwamikodzo yeniyeni patsiku, pakamwa lowuma.
Chowonadi cha edema ya pancreatic ndi mawonetsedwe angapo azachipatala sikokwanira kuti azindikire bwino. Kuti mutsimikizire za matenda, mayeso a labotale amafunikira.
Njira zoyesera
Tazindikira chifukwa chake kutupira kwa ziwalozi kumachitika, timaphunzira momwe matendawa amapezeka. Chifukwa cha matendawa, mutha kudziwa kuopsa kwa njira yodutsidwayo, kudziwa komwe ikuwunikirayo - mutu, thupi kapena mchira.
Kuwerengera magazi kwathunthu kumathandiza kutsimikizira kupezeka kwa njira yotupa yopweteka kwambiri. Kudzera pakuphunzira zamadzimadzi zamadzimadzi, kuchuluka kwa michere ya m'mimba kumayesedwa. Amatha kukhala ochulukirapo kapena akusowa.
Kafukufuku wokhudza mkodzo akuwonetsa zomwe zili amylase. Kuphatikiza apo, kuwunika kwa shuga mthupi. Njira zozindikiritsa:
- Esophagogastroduodenoscopy. Kudzimbidwa kumathandizira kuwunika mkhalidwe wa kum'mero kwa wodwala, duodenum ndi m'mimba mwa kuwomba.
- Ultrasound yam'mimba yamagetsi imakhazikitsa pancreatic edema. Pakufufuzidwa, kuchuluka kwa limba mu kukula, kuchepa kwapang'onopang'ono, chiwonetsero chochepa cha chizindikiro chikuwoneka. Zonsezi zikuwonetsa kukula kwa njira yotupa yotupa.
Ngati maphunzirowa ali osakwanira kuti adziwe ngati katswiriyo akukayikira, wodwalayo amalandila chithandizo chakuwunikira, komwe kumakupatsani tsatanetsatane wa zovuta zomwe zingachitike.
Popeza zotsatira za kuyesedwa kwa labotale ndi njira zodziwira matenda, adotolo amapanga dongosolo la mankhwala.
Chithandizo cha pancreatic edema
Momwe mungachotsere edema ya pancreatic kunyumba? Funsoli nthawi zambiri limakhala losangalatsa kwa odwala omwe ali ndi mbiri ya chifuwa chachikulu cha khansa. Kuchiza kunyumba ndizovomerezeka ngati njira yaulesi imawonedwa, kuukira sikuchitika.
Kuti muchepetse kudzikuza, pamafunika zinthu zingapo. Choyamba ndi kusala kudya, chachiwiri ndi kupumula kwa kama. Njira zoterezi zithandiza kuchepetsa kupanga michere yokugaya, kuchepetsa katunduyo mkati, zomwe zimapangitsa kuti magwiridwe ake azigwira bwino ntchito.
Ngati njira yotupa ili m'gululi, ndiye kuti thandizo la madokotala likufunika. Chithandizo chimachitika pokhapokha pompopompo. Pamafunika zakudya komanso mankhwala.
Chithandizo cha mankhwala osokoneza bongo chimakhala ndi zolinga:
- Kuchepetsa kupanga hydrochloric acid. Chifukwa chake, mankhwala antisecretory amachitidwa. Imagwira ntchito kwambiri masiku oyambirira atachulukitsa.
- Pewani ululu, kutupa, kuchepetsa zovuta zam'mimba, kuponderezani kupanga kwa enzyme. Kuchita ntchito iyi, chithandizo cha antienzyme chimachitika.
- Pofuna kuti zinthu zovunda komanso zinthu zakupha zisadziunjike m'thupi, mankhwala oletsa kupatsirana thupi ndi omwe amapatsidwa.
- Pofuna kupewa kupatsidwa zinthu za m'magazi kuundana - rheological yogwira mankhwala.
- Kugwiritsa ntchito maantibayotiki, omwe amadziwika kuti ali ndi mphamvu zambiri, kumathandiza kupewa zotsatira zoyipa ngati zotupa ndi zovuta zina.
- Kubwezeretsani madzi ndi electrolyte bwino, pangani kuchepa kwa mapuloteni.
Matenda a kapamba nthawi zambiri amadziwika ndi zovuta. Kuzindikira koyenera kumatengera nthawi yodziwikiratu komanso chithandizo chamankhwala. Chifukwa chake, odwala ayenera mosamalitsa malangizo onse a dokotala.
Mu gawo la chikhululukiro, mutha kuyang'ana kuchithandizo cha wowerengeka thandizo. Odwala amamaliza, mafuta a azitona, ma sea buckthorn ndi mafuta amkati mkati. Ndizovomerezeka kugwiritsa ntchito decoctions ndi kulowetsedwa kwa mankhwala azitsamba zam'mapapo. Kuunika kwa madotolo amati chithandizo chotere ndi chovomerezeka pokhapokha pakuwonjezera gawo.
Ngati zovuta zakula, ndiye kuti opaleshoni akuwonetsedwa. Mtundu wa operekera opaleshoni zimatengera mawonekedwe a njira yotupa. Potengera maziko a zotayidwa pancreatic, laparotomy imachitidwa - njira yomwe imakupatsani mwayi kuti muchotse zigawo zowonongeka.
Muzovuta kwambiri, dokotalayo amachotsa zikondwererozo limodzi ndi chikhodzodzo. Kudzikundikira kwa madzimadzi m'mimba kumachotsedwa kudzera pachiwopsezo cha peritoneal.
Kutupa monga chizindikiro cha chotupa
Mwa amuna ndi akazi, kutupa kwa ndulu kumachitika chifukwa cha chotupa cha pancreatitis, matenda a shuga, ndi matenda ena omwe amakhudza chimbudzi. Thandizani kutupa pokhapokha moyang'aniridwa ndi dokotala.
Nthawi zina, chotupa chimatulutsa khansa yam'mimba. Malinga ndi ziwerengero, zamatsenga zotere zimachitika mwadzidzidzi. Kuopsa ndikuti koyambirira sikungatheke kudziwa bwino matenda, zomwe zimayambitsa kuwonjezereka kwa matenda.
Zosachitika mu cell zam'mimba mu kapamba pakapita nthawi zimabweretsa kukula kwa chotupa neoplasms. Maselo, akudzilekanitsa ndi kupangika kwa pathological, amalowa m'magazi ndi zamitsempha yamagazi, zomwe zimayambitsa kufalikira kwa metastases m'thupi lonse.
Magawo a khansa yapakansa:
- Kapangidwe kachilengedwe koyipitsa kakang'ono (osati yayikulu kuposa ziwalo zamkati).
- Mitsempha imakulirakulira kulowera ku bile ducts ndi ma lymph node.
- Mitsempha yayikulu ya magazi, mathero amtsempha, m'mimba, matumbo akulu ndi ndulu zimakhudzidwa.
- Chotupa "chikufika" ku ma lymph node, gawo lachiwiri la zotupa limapangidwa - metastases.
Zombo za Lymphatic ndi mtundu wa cholepheretsa maselo kuti asamagwire ntchito. Koma khansa imalowera mkati mwake, maselo a khansa omwe amafalikira mthupi lonse, amakhazikika m'mitsempha, kuletsa zotchinga kuti zigwire ntchito mokwanira.
Pakumalizira magawo abwinobwino, kusayenda kwamadzi am'mimba kumawonedwa, edema ilipo. Potengera maziko awa, kudzikundikira kwamadzi am'mimba pamimba kumapezeka - ascites.
Kuchiza khansa kumaphatikizapo chemotherapy, radiation ndi njira zopangira opaleshoni. Pafupifupi kuchira kwathunthu kumatha kunenedwa pokhapokha poyambira matendawa. Matendawa akapezekanso, ndiye kuti sakhala ndi zotsatira zabwino. Mu magawo apambuyo, sakunena za kuchira. Therapy imayang'anitsitsa kukulitsa ndi kukonza moyo wabwino wodwala.
About matenda kapamba, madokotala adzakuuzani mu kanema munkhaniyi.
