Pencreatitis yosatha ndi matenda opatsirana otupa komanso a dystrophic a kapamba, omwe amatsogolera kuphwanya ntchito zake zachinsinsi zamkati ndi zamkati. Amadziwika ndi maphunziro a wavy ndipo amadzinenera kuti ndizovuta zopweteka zomwe zimayendetsedwa ndi vuto la dyspeptic - nseru, kusanza, ulemu, ndi zizindikiro zina.
Zifukwa
Pancreatitis imawonedwa ngati yayitali ngati nthawi yayitali miyezi isanu ndi umodzi. Pamene matenda akukulira, kapangidwe ka kapamba kamasintha, ndipo magwiridwe antchito amachepa. Nthawi zambiri, amuna amadwala kapamba, komwe kumakhala kofanana ndi vuto lawo lomwa.
Choyenereradi kuti chiwerengero chachikulu cha anthu omwalira ndichochulukitsa matenda a kapamba. Malinga ndi ziwerengero, zili pafupifupi 10% m'zaka 10 zoyambirira pambuyo poti adziwe, ndipo pafupifupi 50% m'zaka makumi awiri zikubwerazi.
Chimodzi mwa matendawa ndi nthawi yayitali (yachilendo), pomwe sizikuwoneka zizindikiro, kapena yofatsa kwambiri. Kuchulukitsa kwa chifuwa chachikulu ndi vuto lowopsa, lomwe limafuna mankhwala osokoneza bongo.
Ngakhale kupita patsogolo kwakukulu pakuzindikiritsa komanso kuchiza matenda a kapamba, kuchuluka kwa milandu kukupitilizabe kukula, chifukwa cha zifukwa zosiyanasiyana. Pakufunika koyamba ndi kugwiritsa ntchito zakumwa zoledzeretsa. "Wolemekezeka" malo achiwiri amakhala ndi matenda am'mimbamo, chiwindi ndi zilonda 12 zam'mimba.
Chowonadi ndi chakuti ndikuphwanya ntchito za dongosolo la bile, bile imatha kulowa kapamba, potero imayambitsa kukwiya. Ichi ndichifukwa chake anthu omwe ali ndi chifuwa chachikulu amakhala ndi cholecystitis.
Zowopsa zake ndi izi:
- kudya kwambiri komanso kusuta kwamafuta ndi yokazinga;
- kunenepa kwambiri;
- kumwa mankhwala ena;
- matenda apambuyo;
- nkhawa, makamaka yamphamvu komanso yayitali.
Zizindikiro
Zizindikiro zakuchulukanso kwa kapamba zimayamba msanga. Kwenikweni patsiku, wodwalayo amadwala kwambiri, ndipo kupweteka kwambiri kumachitika pansi pa nthiti, kumanzere. Nthawi zambiri, ululu wammbuyo umadziwonetsa ngati ma pathologies ena ndipo umatha kumveka kumbuyo ndi pachifuwa.
Chizindikiro chodziwikiratu ndi kupweteka kwa m'chiuno komwe kumafalikira pamimba ndi m'mbali. Pamodzi ndi ululu kapena kwakanthawi zimachitika, mseru umayamba, kusandulika kusanza, ndikukhala pansi chopunthwitsa.
Kuchulukitsa kwa chifuwa chachikulu mu akulu kumatha kukhala limodzi ndi kutentha ndi kutentha thupi, khungu, kufupika, kuthamanga kwa magazi komanso kupweteka kwa mutu.
Ngati mukukayikira kuukira, muyenera kuyimba ambulansi, ndipo madokotala asanafike azilimbitsa thupi. Kuti muchepetse vutoli, mutha kuthira kupondaponda pozizira. Sizoletsedwa kudya zakudya zilizonse; mumangomwa madzi opanda madzi pang'ono m'magawo ang'onoang'ono.
Simungamwe mankhwala ena kupatula antispasmodics (No-shpa, Papaverin, Drotaverin). Ngati ndi kotheka, ndibwino kubaya. Kuchepetsa mphamvu ya ululu wamankhwala kumathandiza kukhala pakatupi ndi thupi lopendekera chamtsogolo.
Kuchulukana kwa matenda kapamba kumatha masiku asanu mpaka milungu iwiri. Kutalika uku kumachitika chifukwa cha kulephera kwa kapamba kuti ayambe kuchira msanga. Chifukwa chake, ndikofunikira kupeza upangiri wachipatala ndi malingaliro a momwe mungachiritsire matendawa.
Zizindikiro
Kwa anthu omwe akudwala matenda kapamba, khungu limakhala lachikaso chifukwa kusayenda kwa ndulu ndi khalidwe. Kuphatikiza apo, odwalawa nthawi zambiri amapezeka ndi mtundu wachiwiri wa matenda ashuga komanso matenda am'magazi.
Kuti muwone kupanikizika ndi kufalikira kwa njira ya pathological, maphunziro othandizira amalembedwa - ultrasound, x-ray, compact tomography kapena MRI. Njirazi zitha kuthandizidwa ndi kuyesa kwa matenda:
- lunda;
- pancreosemine-secretin;
- elastase;
- hydrochloric acid.
Magnetic resonance imaging ndi imodzi mwanjira zolondola kwambiri komanso zophunzitsira; zimakupatsani kusiyanitsa matenda kapamba ndi kutupa pachimake
Kuyesedwa kwa Pancreosemin-secretin, komwe kumalola kuzindikira kusowa kwa kapamba, imawerengedwa ngati muyezo wofufuza za golide. Pakati pa njirayi, probe-lumen iwiri imaperekedwa kwa wodwala omwe akuyang'aniridwa ndi X-ray. Ndi chithandizo chake, zitsanzo zamkati mwa m'mimba ndi matumbo amatengedwa.
Phunziroli limachitika pamimba yopanda kanthu, jekeseni wa pancreosemin ndi secretin. Mu chifuwa chachikulu cha pancreatitis, kuchuluka kwa katulutsidwe ka pancreatic ndi kuchuluka kwa ma bicarbonates kumachepa, ndipo mulingo wa ma enzyme, m'malo mwake, umakwera.
Zakudya za kukokomeza ziphuphuNgati bicarbonate alkalinity yapezeka pazotsatira zoyeserera, ndiye kuti pali chifukwa chilichonse chokayikira kuti pulogalamu ya oncological iyambika.
Chidziwitso chazidziwitso cha mayeso a pancreosemine-secretin ndiwokwera kwambiri poyerekeza ndi njira zina zama probe. Ngati ndi kotheka, dokotala yemwe akupezekapo akhoza kumuuza kuti apatsidwe gastroscopy, endoscopy (ERCP) kapena biopsy.
Ndikofunika kudziwa kuti pali njira zopitilira 90 zodziwitsa kapamba, koma sizotheka kudziwa matendawa kumayambiriro.
Ndi mawonekedwe amtundu uliwonse wa kapamba, kapangidwe kake ka magazi, mkodzo ndi ndowe zimasinthika. Chifukwa chake, kuyesedwa kwa magazi ndi a biochemical, urinalysis ndi coprogram ndi mankhwala. Kuphatikiza apo, mulingo wamagetsi am'magazi amayesedwa, pomwe pamenepa akuwonetsa kuchepa kwa calcium komanso kuchepa kwamadzi m'magazi amitsempha. Izi zimakhala zowonongeka ndikuwonongeka kwakukuru kwa mtima wamtima.
Kusanthula ndowe (coprogram) kumapangitsa kuti azitha kudziwa kuteteza ntchito m'mimba, zizindikiro zake zazikulu ndizofanana, mtundu, kununkhira komanso kupezeka kwa zosayera
Chithandizo: Mfundo zazikuluzikulu
Chithandizo cha chifuwa chachikulu mu pachimake chimachitika mu chipatala, popeza pali mwayi wokhala ndi hypovolemic shock (kuchepa kwakukulu kwa kuchuluka kwa magazi) komanso zovuta zina. M'masiku awiri kapena atatu oyamba, njala yathunthu ndiyofunikira, tsiku lachitatu kapena lachinayi, chakudya chololedwa m'magawo ang'onoang'ono, osapitirira 200 ml.
Kuchuluka kwa chakudyacho kumayenera kukhala chakudya chamafuta - chimanga, msuzi wosenda ndi zakudya. Mafuta ochokera kwa nyama ali ndi malire, ndipo ndizoletsedwa kudya nyama, msuzi wa nsomba, nyama ndi zakudya zamzitini. Kugwiritsa ntchito masamba ndi zipatso zatsopano, zakudya zosakhwima ndi mowa ndizosavomerezeka.
Odwala ena angafunike kupitiriza kukhathamiritsa kwa madzi a m'mimba ndi kafukufuku kwa masiku angapo. Kuchepetsa kukhudzika kwa kapamba, amayamba ndi kukhazikika kwa proton pump inhibitors, H2-histamine receptor blockers, antacid, ndi mankhwala a ululu. Pambuyo pake, amasintha mitundu yamapiritsi.
No-spa ndi amodzi mwa mankhwala ochepa omwe wodwala mwiniwake angagwiritse ntchito pakagwidwa
Popeza pancreatitis mu mawonekedwe pachimake imayendetsedwa ndi kusanza mobwerezabwereza ndi kutsegula m'mimba, kuchepa kwamadzi kumathandizidwa ndi omwe akuponya mchere.
Chithandizo cha opaleshoni chowonjezera chokhala ndi chifuwa cham'mimba ndizosowa kwambiri pakakhala kutupa kwambiri, komwe sikungathandize pakulimbitsa thupi. Nthawi zina zimakhala zosatheka kuchita opareshoni chifukwa cha chisokonezo cha malo omwe awonongeka mchiwalo chonse. Vutoli ndi lodziwika chifukwa cha kuchuluka kwa kapamba chifukwa chomwa mowa, ndipo kubwereranso m'mbuyo kumakhala kosapeweka.
Kupumula
Kwa ululu wapakatikati, No-shpa, Buskopan, Papaverin, Drotaverin, Baralgin, Paracetamol, Trigan-D ndi Pentalgin adayikidwa. Pazochitika zapadera, ngati wodwala salola ma analgesics ndi antispasmodics, mankhwala osagwiritsa ntchito mankhwala a anti-kutupa amagwiritsidwa ntchito. Izi ndichifukwa chakukwiya kwawo pamatumbo.
Ma antenzymes ndi maantibayotiki
Ndi hyperfunction ya kapamba, mankhwala othandizira kufooka kwa kapamba amathandizidwa ndi mankhwala a antienzyme. Zimalepheretsa kaphatikizidwe ka michere, potero kupatsa mphamvu kugwira ntchito kwa chida chovulazidwa. Kuphatikiza apo, mankhwala a antienzyme amapewa kukula kwa zovuta monga pancreatic necrosis.
Mankhwala a Antenzyme amachitika pokhapokha moyang'aniridwa ndi achipatala. Mankhwala amathandizidwa kutumikiridwa mkati mwapang'onopang'ono, chifukwa ambiri a iwo allergen. Ngati ndi kotheka, ma antihistamine amatha kutumikiridwa limodzi.
Mankhwala otsatirawa ndi a antienzyme:
- Contrakal;
- Gordox;
- Pantripine;
- Trasilol;
- Fluorouracil, Fluorofur, Ribonuclease (cytostatics).
Nthawi zina, mankhwalawa amagwiritsidwa ntchito - mwachitsanzo, ndi kutupa kwa duilla wa duodenal. Pofuna kuthana ndi kachilombo ka bacteria, Azithromycin, Doxycycline, Cefaperazone, Ampiok, Cefuroxime ndi mankhwala.
Pa kukokomeza kwa kapamba, wodwalayo amawonetsedwa kuchipatala kuchipatala kuti akalandire chithandizo choyenera
Ma Enzymes ndi Maantacid
Pambuyo pa mpumulo wa zizindikiro zowopsa, adotolo atha kukulemberani mankhwala okhala ndi enzyme - Pancreatin, Creon, Mezim, Panzinorm, Enzistal, ndi zina.
- kutsitsa ziphuphu chifukwa cha kuchuluka kwa michere;
- kuyamwa bwino kwa chakudya chamapuloteni ndi mapuloteni;
- makulidwe a kagayidwe kachakudya;
- kuthetsa zizindikiro za dyspepsia - flatulence, bloating, nseru ndi kusanza.
Kuthekera kogwiritsa ntchito ma antacid chifukwa cha kukhumudwitsa kwa mucosa wam'mimba pakumasulidwa kwa michere ya pancreatic. Acidity ya m'mimba thovu limachulukana ndipo nthawi zambiri limayambitsa chitukuko cha gastritis ndi zilonda zam'mimba. Kuti muchepetse njirayi, mankhwala amaikidwa kuti muchepetse kaphatikizidwe ka hydrochloric acid kapena ndende yake. Zothandiza kwambiri pancreatitis ndi Maalox, Almagel ndi Phosphalugel.
Kufanana ndi maantacid, ma H2 blockers angagwiritsidwe ntchito kuti achepetse mapangidwe a mawonekedwe a chapamimba, amenenso amachepetsa acidity. Mutamwa mankhwalawa, kusokonezeka kwam'mimba chifukwa cha kupweteka kwa mucosal kumatha.
Zakudya zamagulu
Zakudya za pancreatitis ndizofunikira kwambiri nthawi iliyonse, ndipo mwamsanga pambuyo pa kusala kwachiwongola, ndikofunikira kuyambitsa pang'onopang'ono zinthu zopukusa muzakudya. Sizovomerezeka kuti musinthane ndi zakudya zomwe mumadya nthawi zonse, chifukwa kapamba amatha kuonjezeranso.
Muyenera kudya pafupipafupi, mpaka katatu pa tsiku, koma m'magawo ang'onoang'ono, kuyambira 50 gr. nthawi. Kodi ndingadye chiyani masiku asanu ndi awiri atatha kusala kudya?
- mbewu zadzimadzi pamadzi;
- msuzi wosenda ndi wopanda mafuta, msuzi wa chimanga, kupatula mapira ndi chimanga;
- dzulo kapena mikate yoyera;
- odzola ndi zipatso jellies popanda kuwonjezera shuga.
Zakudya zopatsa mphamvu zochepa sizigwirizana ndi zikhalidwe zathupi ndipo sizikwaniritsa zofuna za thupi, chifukwa chake sizikulimbikitsidwa kuti muzikhala pachakudya chopitilira sabata. Komabe, zakudya zophatikiza ndi calcium zimachepetsa kupanga ma pancreatic enymes, omwe amawapangitsa kuti akhale ofunika. M'masiku otsatirawo, zinthu zamapuloteni zimayambitsidwa - curd soufflé ndi pudding, omelet otentha, mazira ndi nyama yophika yophika.
Popanda kukokomeza, odwala omwe ali ndi pancreatitis osatha amawonetsedwa kudya No. 5, omwe amagwiritsa ntchito mwachilengedwe zinthu zachilengedwe zoletsa za michere ya proteinolytic - mbatata, soya, azungu, mazira, oatmeal. Ndikofunikira kusintha mafuta a nyama ndi masamba a masamba, chifukwa amathandizira njira yotupa ndipo amatha kuyambitsa kukhumudwa.
Kutalika konse kwa mankhwalawa chifukwa cha kuchuluka kwa kapamba kumakhala pafupifupi mwezi, pambuyo pake wodwalayo amamva bwino ndipo atha kubwereranso kwina. Zimakhala zovuta kuneneratu kuti nthawi yomwe chikhululukiro chidzakhala chiani, chifukwa chiopsezo chobwereranso chimakhala chokwanira.
