Cancreas ndi gawo lapadera, ndipo osati kokha mwa kagwiritsidwe kake, komanso mwa kutulutsa kwina, kapangidwe kake. Ichi ndi gawo lamkati la parenchymal, lomwe limapangidwa ndi minyewa yolumikizana, yolumikizana ndi ma dense okuta ndi mitsempha yamagazi.
Akatswiri azachipatala adawona kuti kapamba amawoneka kuti ndi wopepuka. Mawuwa adatengera kusatsimikizika kwa momwe gawo lamkati lidzakhalire motsutsana ndi maziko othandizira opaleshoni chifukwa cha pachimake kapamba kapena kuvulala kwambiri.
Kodi opaleshoni yamapamba ndiyowopsa pamoyo? Opaleshoni ndi njira yovuta komanso yayitali. Tsoka ilo, ziwonetsero zimawonetsa kuchuluka kwa kufa kwa odwala.
Kukula kwa chithandizo cha mankhwalawa kumachitika chifukwa chidziwitso cha nthawi yake, gawo la matenda, gulu la odwala komanso momwe alili. Pambuyo pa kulowererapo, nthawi yayitali imafunikira kuti abwezeretse ndikusintha munthu.
Zomwe zimagwirira ntchito ndikuwonetsa
Tikafunsidwa ngati opaleshoni yapancreatic yachitika, yankho ndi inde. Komabe, kudukiza kumachitika chifukwa cha zovuta zamankhwala. Ngati pali mwayi umodzi wopewa njirayi, madokotala adzaugwiritsa ntchito.
Zikondazo nthawi yomweyo zimatanthauzira m'mimba ndi dongosolo la endocrine, lomwe limakhala ndi magawo atatu - mchira, mutu ndi thupi.
Popeza zikondamoyo zimakhala ndi timinyewa tating'ono komanso tolumikizana, timakhala tambiri tomwe timakhala ndi ma ducts ndi mitsempha yamagazi, izi zimasokoneza zovuta, zimawonjezera mwayi wokhetsa magazi, kupezeka kwa fistulas.
Chifukwa cha kufalikira kwa magazi limodzi ndi duodenum 12, pazojambula zina, kuchotsa ziwalo ziwiri ndikofunikira, ngakhale gawo limodzi lokha lingakhudzidwe.
Opaleshoniyo ili ndi zovuta zake, chifukwa mkati mwake muli pafupi ndi kofunikira 
zomangira. Izi zikuphatikizapo chipata cha impso, aorta, ducts ya bile, a vena cava, mitsempha. Pakhoza kukhala zovuta chifukwa cha opareshoni. Mwachitsanzo, ma enzyme opangidwa ndi chakudya amatha kuchita zinthu mwamtopola minofu yawo.
Mukam'chita opaleshoni ziwalo zapafupi pali chiopsezo chokhala ndi pancreatitis pachimake.
Opaleshoni yamankhwala okhala ndi ziphuphu ali ndi izi:
- Pachimake yotupa njira, peritonitis, minofu necrosis.
- Pathologies omwe amadziwika ndi zovuta zambiri za purulent.
- Mapangidwe a calcifying mu bile ducts a kapamba.
- Chotupa, limodzi ndi kupweteka kwambiri.
- Matenda a kapamba pamsana pa ululu waukulu.
- Tumor neoplasms yovulaza ndi yosaoneka chikhalidwe.
- Pancreatic necrosis.
Zomwe zimachitika mkati mwa thupi zimafunikira kuyenda moyenera ndi madokotala. Chifukwa chake, opaleshoniyo imachitika pokhapokha pakuwonekera kwa zofunikira, pamene chithandizo chokhazikika chimayambitsa kulephera.
Mitundu ya njira zopangira opaleshoni
Kuthandizira opaleshoni kumachitika mogwirizana ndi mapulani kapena malinga ndi zadzidzidzi zadzidzidzi. Pamaso pa zizindikiro za peritonitis, magazi, kuchepa kwa magazi sikuletsedwa. Chizindikiro chodzidzimutsa ndi mawonekedwe a necotic a pancreatitis, omwe amaphatikizidwa ndi foci ya zotupa za purulent.
Opaleshoni ya kachilombo ka pancreatic necrosis - lotseguka laparotomy, necrectomy (chotsani necrotic minofu), zotulutsira bedi la postoperative. Nthawi zambiri, pakapita kanthawi kochepa, ndikofunikira kugwiritsa ntchito njira ya laparoscopic kachiwiri, chifukwa ndikofunikira kuchotsa minofu yakufa kachiwiri.
Pancreatic Frey ndiye njira yotchuka kwambiri yochitira opaleshoni. Njirayi imapanganso mutu wa chiwalo, pomwe duodenum imasungidwa.
Mitundu:
- Kuchotsa gland (resection) ndichinthu chovuta kwambiri kuchita opaleshoni chomwe chimafuna dokotala wodziwa bwino ntchito, chifukwa adokotala nthawi zambiri amapanga zisankho zofunikira panthawi ya opaleshoni. Opaleshoni imatenga nthawi yayitali bwanji? Pafupifupi, zimatenga maola 7-16.
- Subtotal pancreatectomy - chotsani gawo lokha lamkati. Katsala gawo laling'ono, lomwe lili pa duodenum.
- Pancreatectomy yathunthu - chotsani kapamba kotheratu, pomwe malo a duodenum agwidwa. Zilonda zopweteka, pafupipafupi kufooka kwa kapamba. Popewa kuyambiranso kwathunthu pancreatitis, peritoneal dialysis tikulimbikitsidwa.
- Mankhwala othandizira othandizira ma cysts amachitika pogwiritsa ntchito laparoscopy. Ubwino: wolekeredwa bwino, zovuta pambuyo pa opaleshoni ya pancreatic zimakhala kawirikawiri. Ndondomeko ikuchitika moyang'aniridwa ndi ultrasound scan.
Kulowa kwa matenda a shuga a pancreatic kumathandiza kukonza njira zama metabolic. Pancreatic transplantation amachitika kwa anthu odwala matenda ashuga ndikusintha kwa timadzi tating'onoting'ono timaselo timaselo. Nthawi zambiri, ntchito zotere zimachitika kuchipatala chayokha, mtengo umasiyanasiyana. Osamachita nthawi yapakati.
Kulowerera koteroko ndikofunikira chifukwa shuga imayambitsa kukula kwa zovuta za matenda ashuga - odwala amakhala akhungu, akuvutika ndi kulephera kwamitsempha, matenda am'mimba, komanso kusokonezeka kwa mtima. Mauthenga osiyanasiyana a madokotala okhudzana ndi mavutowa amatha kupezeka pa intaneti.
Njira zochitira opaleshoni yoyandikira:
- Wodwalayo amalandira opaleshoni ndi minyewa yopuma.
- Kuwulula kwa kapamba.
- Kuchotsa madzimadzi a mthupi muchikwama chodzikongoletsera, chomwe chimalekanitsa chiwalo ndi m'mimba.
- Kukhazikika pamasamba.
- Kutsegula ndi kubudula kwa hematomas.
- Ngati pali pancreatic chophukacho, ndiye kuti ma suture amapangidwa m'malo owonongeka, ndipo ma dancts a pancreatic amawotchera.
- Ndi zovuta ndi mchira, gawo limamasulidwa.
- Ngati zosintha zakhudza mutu, chotsani gawo ndi gawo la duodenum.
- Kukhetsa mabokosi onyamula.
Kuchita opaleshoni kwa madokotala kutha kuchitika kudzera necondolaomy - minofu ya necrotic imayikidwa, resection (kuchotsa kwathunthu kapena pang'ono), drainage of abscesses ndi cystic neoplasms.
Nthawi yogwira ntchito
Popeza zotsatirapo zoyipa zomwe zingakhalepo, wodwalayo ayenera kukhala m'chipinda choperekera chithandizo, kumene chisamaliro chimaperekedwa. Pambuyo pa kulowererapo chifukwa cha pancreatitis pachimake, zovuta zoyambirira zimapezeka nthawi zambiri, motero, mkati mwa maola 24 pambuyo pa opaleshoni, vuto la wodwalayo liyenera kuyang'aniridwa mosamala.
Makamaka, kuchuluka kwa magazi, kuthamanga kwa magazi, kuchuluka kwa shuga m'magazi, kuchuluka kwa mkodzo, kuyeza kutentha kwa thupi. Nthawi zina, radiology ndi kusanthula kwa glycated hemoglobin zimachitika. Patsiku lachiwiri pambuyo pakuchita opaleshoni, wodwalayo amapititsidwa ku dipatimenti yopanga opaleshoni, komwe chithandizo chachikulu chimachitidwa, komwe amalandila zakudya zopatsa thanzi komanso zovuta.
Kutalika kwa nthawi yomwe wodwala amakhala kuchipatala kumasiyana kuyambira mwezi umodzi kapena iwiri. Nthawiyi ndiyofunikira kuti dongosolo lazakudya zigwirizane ndi dziko latsopano ndikubwerera kuntchito yonse.
Kunyumba, ndikofunikira kupatsa wodwalayo kugona ndi kugona kwathunthu. Ndikofunikira kugona mutatha kudya chakudya chamadzulo, chakudya chamagulu (mutha kudya zinthu zomwe zololedwa ndi dokotala). Pambuyo pa milungu iwiri, mutha kupita kunja, kuyenda kwakanthawi kovomerezeka. Odwala omwe ali ndi pancreatic pathologies ali ndi vuto lochepa, motero menyu amayenera kukhala osalala, ndikuthandizira kulemera.
Mfundo zokhudzana ndi chithandizo cha postoperative:
- Thanzi lathanzi.
- Mankhwala a insulini kuti achepetse shuga.
- Kutenga enzyme zowonjezera zomwe zimathandiza kukonza chimbudzi.
- Zodekha tsiku lililonse.
- Chitani masewera olimbitsa thupi.
- Mankhwala olimbitsa thupi.
Zomwe zimachitika pambuyo pa opaleshoni zimasakanizidwa. Kubwezeretsanso zigawo zochotsedwa sizingachitike. Kuneneratu kumadalira gawo liti la kapamba. Poyerekeza ndi kuchotsedwa kwa mchira, zotsatira zabwino zimawonedwa pafupipafupi, ndipo matenda ashuga komanso kupukuta m'mimba amatha kupewedwa. Ngati, kuphatikiza ndi gawo la chiwalo, nduluyo idayatsidwa, ndiye kuti chiwopsezo cha thrombosis ndi kuchepa kwa chitetezo cha mthupi chikuwonjezeka.
Momwe milandu ya kapamba amachitidwa, akatswiri adziwa mu kanema munkhaniyi.
