Zaka khumi ndi zisanu zapitazo, udindo wotsogola pakati pa matenda onse am'mimba opweteka kwambiri pamimba umakhala wochotsa ziwindi ndi cholecystitis. Masiku ano, pancreatitis pachimake imabwera koyamba, kotero kuzindikira kwake ndikofunikira.
Zikondazo zimatulutsa madzi a kapamba ofunikira kuti zigayike m'mimba, ndipo limapanga mahomoni a insulin ndi glucagon, omwe amachititsa kuti shuga azikhala m'magazi. Chifukwa chake, kusagwira ntchito kulikonse kwa thupilo kungayambitse zotsatira zoyipa ndikuwononga ntchito ya ziwalo zonse mthupi la munthu.
Kuti muzindikire ndi kugwiritsa ntchito bwino ma matenda monga:
- kapamba
- miyala m'makola
- cysts
- necrosis
- zotupa zoyipa
komanso matenda a duodenum, matumbo, chiwindi ndi m'mimba zomwe zimawoneka motsutsana ndi maziko awa, kapamba ayenera kuyang'aniridwa mosamala komanso munthawi yake.
Mankhwala amakono pazolinga izi ali ndi zida zambiri zamaukadaulo osiyanasiyana, amazindikira ndi kuwunika amagwiritsidwa ntchito, lirilonse lomwe limakhala ndi zake ndipo limapeza ntchito mu ma pathologies ena.
Kuzindikira ndi chiwembu
Kuti afufuze za kapamba, wodwalayo ayenera kukaonana ndi othandizira, ndipo kenako amutumiza kwa endocrinologist kapena gastroenterologist. Dokotala, potengera madandaulo a wodwala, komanso pazotsatira zoyesedwa ndi pakhungu, chiwindi ndi m'mimba, adzakufotokozerani njira zoyenera zothandizira matenda.
Nthawi zambiri mu pancreatitis pachimake ndi matenda ena a gland, njira zotsatirazi zoyezera zotsatirazi zimagwiritsidwa ntchito:
- Kuyesa kwa magazi kwamayikidwe - kumakupatsani mwayi kuti muwone zomwe zili pancreatic amylase.
- Kuyesa kwa fecal kwa steatorrhea (kuchuluka kwamafuta osalowerera) komanso kukhalapo kwa tizinthu tating'ono ta chakudya.
- Kupenda kwamkodzo kwamkati - kumapangitsa kudziwa kuchuluka kwa diastase.
- Kufufuza kwa Ultrasound - kumagwiritsidwa ntchito kuti adziwe kukula ndi mawonekedwe a kapamba ndi kuzindikiritsa zotupa ndi ma cysts.
- Kuyesedwa kwa X-ray, CT ndi MRI ya England, m'mimba, chiwindi ndi duodenum - kudziwa kukhalapo kwa chizindikiro chosalunjika cha matenda a ziwalo.
- Biopsy
- Kuzindikira koyesa ndikusanthula.
Njira zoyesera
X-ray ndi ultrasound ya zikondamoyo nthawi zambiri imagwiritsidwa ntchito limodzi ndi mayeso, yomwe mungayang'anire ndikuwunika ntchito ya chiwalo. Komanso pazofunsa matenda, amatha kugwiritsidwa ntchito pawokha. Ziyeso zimagawika m'magulu otsatirawa:
- Mayeso ofunikira kafukufuku wamatumbo.
- Mayeso osasokoneza (osafunikira).
Ubwino wa gulu lachiwiri ndilotonthoza kwakukulu kwa wodwala, mtengo wotsika mtengo ndipo palibe chiwopsezo kwa wodwala akamagwiritsa ntchito. Koma mayesedwe awa ndi kusanthula ali ndi chopanda, alibe chidwi chokwanira komanso chidziwitso.
Kuyesa kumakhazikitsidwa pakutsimikiza kwatsika katulutsidwe ka michere ya pancreatic ndipo kumangogwira limodzi ndi kuchepa kwakukulu pakupanga ma enzyme.
Sikuti wodwala aliyense amene ali ndi vuto la kapamba, m'mimba, matumbo, kapena chiwindi ayenera kuyesedwa kapena kufufuza mayeso. Kusankhidwa kwa njira kumasankhidwa kwa wodwala aliyense payekhapayekha.
Mwa mayeso onse azachipatala, zotsatirazi zimakonda kugwiritsidwa ntchito:
- hydrochloric acid;
- elastase;
- pancreosimine-secretin;
- Kuyesa kwakukulu.
Mayeso a Pancreosimine-Secretin
Madokotala ambiri amawona kugwiritsa ntchito mayesowa ngati golide podziwitsa zomwe zimachitika chifukwa cha kapamba. Kukhazikitsa kwake kumaphatikizanso kuyambitsa kutsimikizira kwapang'onopang'ono kwa wodwala.
Ndondomeko ikuchitika pamimba yopanda kanthu poyang'aniridwa ndi fluoroscopy komanso kusangalatsa kosalekeza. Kuwerengeka kofunikira nthawi zingapo moyenera kusonkhanitsa zitsanzo zam'mimba ndi matumbo, mutapanga jakisoni wa kapamba ndi secretin.
Malingaliro omwe amapezeka amayesedwa poyesa kuchuluka kwa ma bicarbonates, ntchitoyo ndi muyeso wa trypsin secretion.
Zizindikiro zotsatirazi zikuwonetsa kupezeka kwa kapamba:
- kuchepa kwakukulu kwa katulutsidwe;
- kuchuluka kwa michere;
- kuchepa kwa ndende ya ma bicarbonates.
Kuzindikiridwa kwa enzyme kumawonetsa kukhalapo kwa pancreatitis yayitali. Ngati, chifukwa cha kuyesedwa, bicarbonate alkalinity yapezeka, wodwalayo ayenera kukayezetsa kuchipatala cha oncology.
Zizindikiro zoterezi zimatha kukhala pancreatitis yayikulu komanso matenda oyipa m'dera la mutu wa pancreatic.
Zotsatira zabodza zitha kupezeka ngati biliary pancreatitis yapezeka, komanso matenda a shuga mellitus, hepatitis ndi cirrhosis.
Ngati zinthu zonse zaukadaulo panthawi yoyesedwa zakwaniritsidwa, ndiye kuti kudziwikitsa kwa njira imeneyi ndikokwera kwambiri. Zoyipa zake ndizovuta zokhazokha zomvekera kwa wodwalayo, mtengo wokwera kwambiri wa ma reagents ndi zovuta za njira yantchito.
Kuyesa kwa hydrochloric acid
Pogwiritsa ntchito mayesowa, njira ya hydrochloric acid yokhala ndi 0,5% imagwiritsidwa ntchito ngati cholimbikitsira cha secretion ya pacreatic, yomwe imayambitsidwa ndi probe intraduodenally, ndi kuwonjezera kwa mpendadzuwa kapena mafuta a azitona.
Njira yosonkhanitsa katulutsidwe wa kapamba ndi kuwunika kwake ikugwirizana ndi zomwe zimachitika ndi intravenous makonzedwe a othandizira.
Njirayi ndi yosavuta kuyigwiritsa ntchito komanso yotsika mtengo, koma imakhala yotsika pang'ono poyerekeza ndi zomwe zapezedwa kuposa mayeso apakale. Pankhaniyi, ndikwabwino kuyambitsa mayeso ndi mayeso a pancreosimine-secretin, popeza ndizosavomerezeka kuchititsa maphunziro awiri nthawi imodzi.
Kuyesa kwakukulu
Kuyesaku kunafotokozedwa ndi Lund mu 1962. Ikakwaniritsidwa, zomwe zili m'matumbo aang'ono zimasonkhanitsidwa ndi intubation mutatenga chakudya chokwanira.
Njirayi imapangidwa kuti iwunikenso ntchito ya kapamba. M'mawa, kafukufuku wapa X-ray wopangidwa ndi polyvinyl wokhala ndi chindapusa kapena chitsulo cholumikizidwa kumapeto kwake amaperekedwa kwa wodwala pamimba yopanda kanthu.
Pambuyo pake, wodwalayo amapatsidwa chakudya chosakanikirana ndi kuwonjezera kwa ufa wa mkaka ndi dextrose ndi mafuta a masamba. Pambuyo pa izi, duodenal aspirate amatengedwa kwa maola awiri, ndikugawa zomwe zimasungidwa mu madzi ndi ayezi.
Kuunika kotereku kumakupatsani mwayi wodziwa kuchuluka kwa amylase, omwe nthawi zambiri amakwezedwa ndi kapamba. Ubwino wa njirayi umaphatikizapo kukhazikitsa, kupezeka, kusowa jakisoni wambiri.
Mwa zoperewera, cholakwika china chazotsatira zomwe zimagwirizanitsidwa ndi kuphatikiza kwa bile ndi madzi a m'mimba chimatha kusiyanitsidwa. M'matenda ena a chiwindi, komanso odwala matenda a shuga kapena gastrostomy, zotsatira zotsutsa zabodza zitha kupezeka.
Mayeso a Elastase
Mosiyana ndi njira zina zomwe sizingawonongeke, kuyesaku kumapangitsa kuti athe kudziwa kufooka kwa endocrine pancreatic ndi pancreatitis koyambirira. Ngati kuperewera kwa enzyme kwapezeka mu kusanthula, ndiye kuti izi zikusonyeza kuperewera kwa chotupa mu England.
Zisonyezero za kuyesedwa koteroko ndi diagnostics a pachimake kapena aakulu kapamba ndi mphamvu ya mankhwala. Njira imakhala yodziwitsa elastase mu ndowe za wodwalayo ndipo amathandizira matenda a chifuwa cham'mimba, matenda a shuga, njira zina za chiwindi ndi matenda a ndulu, kuwongolera ndi zizindikiro za matenda a kapamba.
Zikondamoyo ndi chimodzi mwazinthu zofunika kwambiri m'thupi la munthu, choncho muyenera kuziyang'anira mosamala komanso mosamala. Kwa matenda aliwonse, ndikofunikira kuti nthawi yomweyo ndiyambe kulandira chithandizo chokwanira, chomwe chitha kuperekedwa pokhapokha ngati mukufufuzidwa kwathunthu komanso kuzindikira bwino matenda.
