Biliary pancreatitis ndi matenda opatsirana a kapamba. Chomwe chikuyambitsa matendawa ndikugonjetsedwa, komanso kukanika kwa duct ya bile ndi chiwindi.
Anomalies kumayambiriro koyambirira amatha kudziwitsidwa ndi ma biliary colic, zizindikiro za dyspeptic, jaundice, matenda a shuga komanso kuchepa thupi. Kuti adziwe matenda, dokotala amakupatsani njira yoyezetsa matenda a hepatobiliary system, kapena kuyerekezera kwamphamvu m'mimba.
Chithandizo ndikugwiritsa ntchito mankhwala othana ndi kutupa ndi ma analgesic, kumwa ma michere, komanso kusintha magazi m'thupi. Wodwalayo ayenera kutsatira zakudya zosamalidwa ndi kukana mowa kwathunthu. Ngati calculi adapezeka mu ndulu, opaleshoni ndi mankhwala.
Chifukwa chiyani biliary pancreatitis imayamba?
Posachedwa, chiwopsezo cha biliary pancreatitis chakwera kwambiri. Ku Russia, izi zikuwonetsa pakati pa anthu akuluakulu, ndipo ana amadwala kanayi konse. Chipangizochi chaphatikizidwa ndi International Classization of matenda a Kukonzanso kwa 10, code ya ICD-10 ndi K85.
Nthawi zambiri, etiology imalumikizidwa ndi kupezeka kwa cholelithiasis, panthawiyi pamakhala chiopsezo chambiri cha matenda opatsirana. Matendawa amakula ndikusunthidwa kwa miyala kuchoka munthaka.
Matendawa ndi owopsa, chifukwa chake, kupereka chithandizo chamankhwala mwachangu kwalamulidwa. Opaleshoniyo ikakanidwa, njira ya pathological ingayambitse zovuta zazikulu, zomwe zimafunikira chithandizo choopsa. Pofuna kuti musakhale ndi pancreatitis yovuta kwambiri, ndikofunikira kudziwa kuphwanya kwa ma ducts a bile mu nthawi yake ndipo nthawi yomweyo muchiritse matendawa.
The pathogenesis ya matendawa amatha kuchitika motere:
- Matendawa amalowa ndi kapamba kuchokera pamimba yodutsa m'mimba.
- Wodwalayo amawulula miyala mu ducts wamba ya bile, zomwe zimapangitsa kuti magazi azithamanga komanso kutupa kwa kapamba.
- Pancreatic ducts ndi minofu imawonongeka chifukwa cha kupindika kwa ndulu mu pancreatic duct, chifukwa cha kutupa. Vutoli limakulirakulira ngati munthu ali ndi matenda owonjezera a chiwindi, omwe amatsogolera pakupanga chiwombolo chachikulu chaulere.
Komanso, kutupa kumawonedwa pakupanga biliary sludge. Cholecystitis ndi yotsatira gallbladder kukanika kumayambitsa kuphwanya kwa sayansi ya mapangidwe a bile. Chifukwa cha kuchuluka kwa madzi komanso kuchuluka kwa zinthu zina, miyala yaying'ono imapangidwa, yomwe imatchedwa biliary sludge.
Masango akalowa mu ndulu za bile, mucous nembanemba imavulala, chifukwa chomwe duct ndi papilla ya papillae imachepetsedwa. Zotsatira zake, bile limayenda mu ndulu za kapamba, sichitha kulowa mkati mwa duodenum ndipo sichimalowa nthawi zonse.
Ndi kusasunthika, michere ya kapamba imayatsidwa osati matumbo, koma mumkamwa. Izi zimapangitsa kuwonongeka kwa chotchinga cha kapamba komanso kulowerera kosavuta kwa matendawa.
Chifukwa cha miyala ikuluikulu ya ndulu, ma ducts wamba a bile kapena Oddi sphincter nthawi zambiri amatsekeka, zomwe zimapangitsanso kusokonekera ndi kusokonezeka kwa njira za bile.
Mwanjira ina, kukula kwa matenda amisamba kumatha kuyamba chifukwa:
- Matenda am'mimba;
- Mawonekedwe osasangalatsa a bile ndi pancreatic duct;
- Matenda a cholecystitis;
- Matenda a chiwindi;
- Gallbladder dyskinesia;
- Kuphwanya motility wa biliary thirakiti;
- Matipi a Pathology Vater.
Kuchulukitsa kwa matendawa kumayamba chifukwa cha mankhwala a choleretic kapena kuchepa thupi mwadzidzidzi.
Zizindikiro zazikulu za matendawa
Mukuwonetsedwa kwake, zizindikiro za matendawa ndizofanana ndi zotumphukira za m'mimba thirakiti monga viral hepatitis, chotupa cham'mimba, chapamimba ndi duodenal zilonda zam'mimba, chotupa chamimba. Chifukwa chake, ndikofunikira kuyesedwa kwathunthu ndikupatula kupezeka kwa kuphwanya koteroko.
Zizindikiro zazikulu zimaphatikizapo kukula kwa ululu. Wodwalayo amamva kupweteka kwambiri pamimba, kumbuyo, hypochondria, phewa lamanja. Nthawi zambiri, zizindikiro zotere zimamveka patapita maola awiri kapena atatu munthu atatha kudya. Komanso, kuphwanya kumadzipangitsa kumva usiku.
Kuphatikiza pali zizindikiro zosadziwika za matenda a pancreatic-biliary system. Ululu umayamba chifukwa chogwiritsa ntchito zakumwa zozizilitsa kukhosi, zonona, mafuta ndi zokometsera.
Nthawi yomweyo, wodwalayo amakhala ndi malungo, nseru komanso kuwawa pamkamwa. Ngati chifukwa cha mwala nthenga za nipples ndizotsekeka kwathunthu, kupezeka kwa jaundice komwe kumalepheretsa mawonekedwe a mucous nembanemba.
- Njira yotupa mu kapamba imayambitsa kuphwanya kwa endocrine ntchito. Wodwalayo amakhala ndi vuto la kagayidwe kachakudya, nthawi ya kukomoka, misempha ya magazi imakwera kapena kugwa kwambiri.
- Chifukwa cha zovuta za exocrine, enzymatic pancreatic insuffuffence imayamba, kugaya chakudya m'mimba kumawonedwa.
- Munthu amayamba kukhumudwa komanso matumbo, pomwe kutsekula m'mimba kumachitika kangapo patsiku. Tinthu timene timakhala ndi mafuta onunkhira bwino, timiti tatsitsi ndi fungo la fetid.
- Komanso, zizindikiritso zimayenderana ndi kuwonjezereka kwa bata, kugwedezeka pamimba, kugona, kutentha pa chifuwa, kuchepa kwa kudya.
- Poyerekeza ndi kumbuyo kwa m'mimba, kuchepa kwamafuta kumawonjezera, kugaya kumasokonezeka, ndipo kulemera kwa thupi kumachepetsedwa. Munthu amakhala ndi vuto la kuperewera kwa mavitamini ndi mchere.
Ngati matendawa sanachiritsidwe pakapita nthawi, matenda a pancreatitis a biliary amadalira, omwe amaphatikizidwa ndi mitundu yonse ya zovuta mu mawonekedwe a kugwedezeka, chiwindi cham'mimba kapena kupuma kulephera, encephalopathy, kutulutsa magazi m'mimba, kutsekeka kwam'mimba, chifuwa cha kapamba, matenda ashuga, jaundice.
Gawo lonyalanyazidwa limabweretsa ma pseudocysts, ascites, fistulas, kupendekera kwamatumbo.
Kuchiza matenda
Kuti adziwe matendawa ndikuwapatsa chidziwitso cholondola, dokotalayo akuwunikira kuti ayesere magazi ndi kuyezetsa magazi ake. Ngati matendawa ali pachiwopsezo chosalephera, bilirubin imadzuka chifukwa cha kusintha kwa kutupa.
Cholesterol imachulukanso, kuchuluka kwa mapuloteni akuluakulu kumachepa ndikuwadodometsa, motero ndikofunikira kuwunikira kwachiwiri kuti mupeze
zotsatira zolondola. Kupenda magazi ndi mkodzo kukuwonetsa kuchuluka kwa amylase.
Mothandizidwa ndi endoscopic kapena intraductal ultrasound, dokotala amatha kudziwa miyala, njira iyi imawonedwa ngati yothandiza kwambiri. Compression tomography imagwiritsidwa ntchito kuti mudziwe tsatanetsatane.
- Ngati dokotala azindikira pilireatment pilireatment pilireatment, opaleshoni nthawi zambiri imayenera kupereka chithandizo chodzidzimutsa. Ngati ndi kotheka, ndikofunikira kuchotsa miyala kapena kukonza momwe mphuno ya Vater ikuyendera, chifukwa njira iyi ya endoscopic imagwiritsidwa ntchito.
- Matendawa akachuluka, dokotala amamuchotsa matenda opweteka ndi ma analgesics ndi antispasmodics. Potere, ntchito zakunja ndi zamkati za kapamba zimasinthidwa. Pazifukwa zodzitetezera, maantibayotiki ayenera kumwedwa kuteteza kachilombo.
- Ndi kuchulukana, masiku atatu oyambawa akuwonetsa njala ndi kapamba. M'malo mwa chakudya, imwani madzi amchere a non-carbonated alkaline. Pambuyo pofulumira, zakudya zopatsa thanzi ndizofunikira. Wodwalayo sayenera kugwiritsa ntchito zakudya zamafuta, kudya zakudya za m'magazi nawonso ndizochepa. Muyenera kudya pafupipafupi, koma pang'ono.
Kuti muchepetse zowonongeka za ma enzymes, somatostatin, proton pump inhibitors, proteinase inhibitors ndi omwe amapatsidwa. Kukhazikika kwa pancreatic kukonzanso kumabwezeretsedwa ndi micros michere.
Ndi kuchuluka kwa shuga m'magazi, wodwalayo amatenga mankhwala apadera a hypoglycemic. Insellitus yodalira matenda a shuga imafuna kuunikanso moyo ndi zakudya.
Kusamalira momwe thupi liliri ndikulimbitsa chitetezo cha mthupi, njira ina yothandizira ndi zitsamba ndikulimbikitsidwa. Pazachipatala, muyenera kusankha kuwunika kotsimikizika kapena koyenera.
Mitundu ya kapambafotokozedwa mu kanema munkhaniyi.
