Mothandizidwa ndi pachimake pancreatitis, pancreatic necrosis imatha kupezeka mu 10% ya milandu. CHIKWANGWANI chomwe chimazungulira kapamba chimafa, komanso kapamba. Ichi ndichifukwa cha lipase, enzyme ya kapamba.
Choyamba, mafuta a pancreatic necrosis amayamba, motsutsana ndi matendawa omwe matendawa amatuluka m'matumbo, zomwe zimatsogolera ku hemorrhagic necrosis, limodzi ndi edema mu minofu ya retoperitoneal. Mitundu yosakanikirana ya necrosis yamafuta: okhala ndi malo a hemorrhage ndi hemorrhagic pancreatic necrosis, ndikusintha kwamafuta.
Zotupa za Necrotic ndi zizindikiro
Monga mukudziwa, necrosis ya chiwalo ichi imawonekera mchikakamizo cha kapamba. Gawo loyambirira la matendawa limadziwika ndi umphawi wazizindikiro. Mwa zina mwazizindikiro kwambiri m'chipatalachi titha kudziwa kuchepa kwa khungu, kufinya mtima ndi khungu.
Kugundika kumatha kukhala kwabwinobwino kapena kuthamanga pang'ono, kutentha kwa thupi, monga lamulo, sikusintha. Ngati matenda amachitika m'magawo a necrotic, kutentha kumakwera.
Palpation nthawi zambiri imawonetsa kupweteka mu epigastrium ndi kutulutsa. Poyerekeza ndi maziko a mafuta necrosis, wolowerera amayamba kupanga mwachangu. Itha kumveka m'mimba pamtunda wamkaka, zotulukapo zake zingakhale zosavomerezeka, ndiye kuti, imfa, ndizosiyana.
Matendawa amakula ndikuwonjezereka kwa paresis ndikufalikira ndi kung'ung'udza kosakhazikika, zonsezi zomwe zingasonyeze zizindikiro za khansa ya kapamba, zizindikiro pano nthawi zambiri zimakhala zofanana.
Pancreatic necrosis imakwiyitsa mawonekedwe akuwonekera kwa kayendedwe ka kayendedwe ka kutupa, ntchito zamagulu ofunikira zimawonongeka, zomwe zimatsogolera kuwoneka ngati osakwanira, zotsatira zake sizabwino kwambiri. Ndi matenda, zitha kuchitika:
- Mtima;
- Wowayankha
- Chophimba;
- Hepatic
- Matenda osakwanira m'mimba.
Ziwalo zamkati mwa kupuma zimakhudzidwa, zomwe zimafotokozedwa momwe amaphatikizidwira mu pleural patsekeke ya transudate ndi interstitial pulmonary edema.
Ndi mtima kusakwanira, hypotension imawonekera, kusinthika pafupipafupi kwa mafupa, myocardial ischemia, cyanosis ya pakhungu ndi mucous membrane, kuchepa kwa kuchuluka kwa mtima, zizindikilo zonse izi zimawonetsa pancreatic necrosis.
Kuphatikiza apo, odwala omwe ali ndi vuto la m'maganizo pafupipafupi, lomwe limadziwonetsa ngati chisokonezo komanso (kapena) kusangalala kopitilira muyeso. Kuchita bwino kwa chiwindi kumatayika msanga, mwachangu kumadziwoneka ngati jaundice.
Zovuta zazikulu za pancreatic necrosis ndizodziwika:
- Hypovolemic mantha;
- Kulephera kwamitundu yambiri;
- Pleuropulmonary zovuta;
- Zopanda za retoperitoneal fiber ndi kapamba;
- Fistulas akunja ndi mkati;
Peritonitis ndi magazi amkati ndi zizindikiro zosiyanasiyana. Peritonitis imachitika chifukwa chotuluka cha parapancreatic abscess m'mimba.
Nthawi zambiri, madera a necrosis amayamba kuzunguliridwa, ndiye kuti, atsekedwa ndi kapukusi ka minofu yolumikizana kuchokera ku minofu yathanzi. Masewera amatha kukhala ndi zotsukira komanso zotsalira.
Chithandizo cha Pancreatic Necrosis
Chithandizo chophatikiza chimagwiritsidwa ntchito, chomwe chimakhala ndi ntchito zotsatirazi:
- Kupumula;
- Kukakamiza kwa exocrine pancreatic ntchito;
- Kubwezeretsanso kuchuluka kwa magazi;
- Zakudya za makolo;
- Chithandizo chowonjezera.
Kuchepetsa ululu, ma analgesics omwe si a narcotic amagwiritsidwa ntchito. Ngati mlandu wayambika, ma narcotic analgesics amagwiritsidwa ntchito, chinthu chachikulu ndikuti zotsatira zake sizikhala mankhwala osokoneza bongo.
Pofuna kupondereza ntchito zachinsinsi za gland, kudya pakamwa sikuphatikizidwa. Maantacid ndi anticholinergics (atropine) amagwiritsidwa ntchito.
Kubwezeretsanso kuchuluka kwa magazi, ndikofunikira kuperekera mayankho a crystalloid ndi colloidal. Ma electrolyte angapo ofunikira amapezeka mu mayankho a Crystalloid; awa ndi mankhwala a chlorine, calcium, potaziyamu, ndi sodium.
Chofunikira pakulandidwa kwa makolo ndikutsatira zofunika za thupi la munthu. Amagwiritsa ntchito mayankho a amino acid, glucose ndi mapuloteni hydrolysates.
Pancreatic necrosis imangothandizidwa mwachangu ndi kuchotsedwa kwa kapamba. Opaleshoni ikufuna kuchotsa madera a minofu ya necrotic mpaka kuti iwonjezeke. Ngati pali peritonitis, kukhetsa kwa peritoneum kumachitika.
Kuchulukitsa kwa distal gland kumawonetsedwa kuti kwasintha kwambiri. Zikondazo zimachotsedwa kwathunthu pazochitika zonse za necrosis. Kuchita koteroko ndikowopsa, mwina zitha kukhala zowopsa, motero sizichitika ndipo kusokonekera kwa pancreatic kutha kuthandizidwa ndi njira zotetezeka.
Posachedwa, madokotala amakonda kugwiritsa ntchito njira zosasamala pogwira ntchito ndi necrosis komanso zovuta zake, kotero kuti imfayo ndi chinthu cham'mbuyomu.
Monga lamulo, ma drains amakhazikitsidwa mu purulent patsekeke. Izi zimapangitsa kuthekera kwa kufunitsitsa kwa zomwe zili m'matumbo ndi kuyambitsa kwa antibacterial agents. Mankhwalawa amaloledwa bwino, amakhala ndi kuvulala kochepa ndipo amawonetsa zovuta zochepa.
