Zomwe zimayambitsa matenda a shuga a pancreatogenic ndi chithandizo chiti chomwe chikuwonetsedwa?

Mwa odwala ena, pancreatogenic shuga mellitus amakula motsutsana ndi maziko a pancreatic pathology. Mtundu uwu wa matenda a shuga sugwira ntchito kwa mtundu woyamba (T1DM) kapena wachiwiri (T2DM). Malinga ndi akatswiri ambiri, matenda a shuga a pancreatogenic ndi mtundu wachitatu wa matenda ashuga, omwe ali ndi zizindikiritso ndi maphunzirowa.

Njira yopititsira patsogolo

Zikondwererozi zimakhala ndi minyewa ya exocrine ndi endocrine. Ndi kapamba, pangani kusintha kwakumaso ndi koipa mu minyewa ya ziphuphu kumachitika, ndikutsatira atrophy ya acini, gawo lalikulu la gawo la gland.

Kusintha koteroko kungathenso ku zilumba za Langerhans (zigawo za endocrine mbali ya kapamba), ntchito yomwe ndikupanga insulin. Zotsatira zake, ntchito ya zida za endocrine pancreas imasokonekera, zomwe zimabweretsa kuwoneka kwa matenda a shuga a pancreatogenic.

Matenda a shuga a Mtundu 3 ali ndi mikhalidwe:

• Odwala nthawi zambiri amakhala ndi thupi lolimbitsa thupi;
• Palibe kutengera kwa chibadwa;
• Kufunikira kwa kupanga hypoglycemia;
• Odwala nthawi zambiri amapezeka ndi matenda apakhungu;
• Kufunika kochepa kwa mankhwala a insulin;
• Odwala, choleric mtima imayamba;
• Kuwonetsedwa mochedwa kwa zizindikiro (mawonekedwe). Zizindikiro zolakwika za matendawa zimamveka patatha zaka zisanu ndi ziwiri kuyambira pachiwonetsero cha matenda oyambitsidwa.

Pafupipafupi kuposa ndi shuga wamba, macroangiopathy, microangiopathy, ndi ketoacidosis zimachitika.

Zolinga za maonekedwe

Choyambitsa chachikulu cha matenda a shuga a 3 ndi kapamba. Koma pali zinthu zina zomwe zimayambitsa matendawa.

Izi zikuphatikiza:

1. Zoyipa zomwe kukhulupirika kwa kapamba kumayipa;
2. Zochita zamankhwala ochita opaleshoni (pancreatoduodenectomy, pancreatojejunostomy yotenga nthawi yayitali, pancreatectomy,
3. Resection kapamba);
4. Mankhwala a nthawi yayitali (kugwiritsa ntchito corticosteroid);
5. Matenda ena a kapamba, monga khansa, kapamba, kapamba;
6. Cystic fibrosis;
7. Hemochromatosis

Amawonjezera mwayi wokhala ndi matenda ashuga a 3:

• Kunenepa kwambiri Kunenepa kwambiri kumakulitsa pancreatitis ndipo kumawonjezera mwayi wokhala ndi zovuta zake. Odwala omwe ali ndi kunenepa kwambiri, kukana minofu (kukana) kwa insulin kumakhala kofala, zomwe zimawonjezera chiopsezo cha matenda a shuga.
• Hyperlipidemia. Mlingo wowonjezereka wa lipids m'magazi a anthu umasokoneza kayendedwe ka magazi, chifukwa cha zomwe ma cell a pancreatic salandila kuchuluka kofunikira kwa michere ndikuyamba kutupa.
• Mowa Ndi kumwa mwadongosolo, kuchuluka kwa kupita patsogolo kwa exocrine gland kusowa kwambiri.

Zizindikiro

Zizindikiro za matenda a shuga a pancreatogenic:

• Kumverera kwanjala;
• Polyuria
• Polydipsia;
• Kutsitsa minofu kamvekedwe;
• Zofooka
• Thukuta lakuzizira;
• Kugwedezeka thupi lonse;
• Chisangalalo.

Ndi pancreatogenic shuga mellitus, makoma otupa amalimba, kuperewera kwawo kumawonjezeka, komwe kumadziwonetsa ngati mabala ndi kutupa.

Chithandizo

Mankhwala ovomerezeka samazindikira mtundu wa shuga wachitatu, ndipo pozindikira matenda ngati amenewo ndi osowa kwambiri. Zotsatira zake, chithandizo cholakwika chimaperekedwa chomwe sichimapereka zotsatira zomwe mukufuna.

Chowonadi ndi chakuti ndi shuga wa pancreatogenic, mosiyana ndi matenda amitundu iwiri yoyamba, ndikofunikira kukopa osati hyperglycemia, komanso matenda oyambitsa (matenda a kapamba).

Chithandizo cha matenda a shuga a 3 amaphatikizaponso:

1. Zakudya
2. Mankhwala;
3. Jakisoni wa insulin;
4. Kuthandizira opaleshoni.

Zakudya

Zakudya za pancreatogenic shuga mellitus zimakonzanso kusowa kwa mapuloteni-mphamvu, kuphatikizapo hypovitaminosis. Ndikofunikira kupatula zakudya zamafuta, zonunkhira komanso zokazinga, chakudya chosavuta (chakudya, batala, maswiti).

Zakudya zomwe zimatengedwa ziyenera kudzaza bwino mavitamini ndi mchere wambiri m'thupi. Ndikofunikanso kusiya mowa kwathunthu.

Mankhwala

Mankhwala osokoneza bongo amaphatikizapo kumwa mankhwala:

• Enzymatic;
• Kuchepetsa shuga;
• Opaleshoni;
• Kupereka kubwezeretsa kwa electrolyte bwino;
• Vitamini ovuta.

Mankhwala othandizira enzyme ndi njira ina yowonjezera (yodalirika) yochizira matendawa. Kukonzekera kwa enzyme kochizira matenda a shuga 3 kuyenera kukhala ndi amylase, peptidase, ndi lipase michere mosiyanasiyana.

Cholinga chogwiritsira ntchito mankhwalawa ndikuwongolera kugaya komanso chakudya chamafuta, chifukwa momwe zimakhalira kuwongolera bwino kuchuluka kwa glucose, kuchepetsa chiopsezo cha zovuta, kukhazikika kwa glycogemoglobin ndikuwongolera thanzi la wodwalayo.

Chimodzi mwa zokonzekera zomwe zimagwiritsidwa ntchito kwambiri ndi Creon, yomwe, kuwonjezera pa cholinga chake chachikulu, chimathandizanso kuchepetsa kupweteka kwapancreatic.

Kupweteka kwapancreatic kumatha kubweretsa sitophobia (kuwopa kudya), zomwe zimangoyambitsa kukula kwa hypoglycemia. Kuti muchepetse kupweteka, tikulimbikitsidwa kugwiritsa ntchito ma nonges a narcotic analgesics.

Opaleshoni

Tikuyankhula za autotransplantation of islets of Langerhans kuchokera kwa wopereka kupita kwa wodwala yemwe ali ndi matenda a shuga. Pambuyo pakuika, maselo amtundu wa endocrine amayamba kupanga insulin, kuyang'anira glycemia mwachangu.

Pambuyo pa opaleshoni yotere, pancreatic resection kapena kapamba amatha kuchitidwa.

Jakisoni wa insulin

Ngati ndi kotheka, lembani kuyambitsa kwa mankhwala omwe amapezeka ndi insulin, kuchuluka kwake komwe kumadalira kuchuluka kwa shuga m'magazi, chakudya chomwe chimadyedwa mu chakudya, zochita zolimbitsa thupi.