Chimodzi mwa matenda oopsa kwambiri am'mimba mwa m'mimba ndi pancreatic necrosis. Amatchulidwanso kuti pancreatic necrosis kapena necrotic pancreatitis. Ngakhale ndi chithandizo choyenera, theka la odwala omwe ali ndi vutoli amamwalira. Kupatula apo, matendawa amadziwika ndi kufa kwa maselo, zomwe zimapangitsa kuwonongeka kwa minofu ya minyewa. Chifukwa cha njirazi, ntchito zake zimaphwanyidwa, zomwe zimakhudza kwambiri mkhalidwe wamthupi.
Njira yopititsira patsogolo
Necrosis ndi njira ya kufa kwa cell komwe kumayambitsa necrosis ndikuwonongeka kwa zimakhala. Mu kapamba, izi zimatha kukhazikika chifukwa chotupa kapena zina zoyipa. Njira za m'matumbo zimatha kudzetsa kuti madzi a pancreatic amasuntha m'mizere kapena amaponyedwera mmbuyo kuchokera ku duodenum. Ma enzymes ophatikizidwa ndi pancreatic amakhala ankhanza kwambiri, motero amayamba kupukusa minyewa yakeyo. Izi makamaka zimakhala elastase, zomwe zimaphwanya mapuloteni a minofu yolumikizira.
Choyamba, kutupa pachimake kapena kapamba kumachitika chifukwa cha izi. Popanda kulandira chithandizo chanthawi yake kapena ngati wodwala aphwanya zakudya zomwe dokotala wakupatsani, kutupa kumapita patsogolo. Pang'onopang'ono, njira yowonongeka kwa minofu imafalikira, makoma amitsempha yamagazi amayamba kugwa. Chotupa chikhoza kupangika. Ngati njirayi ikukhudzana ndi mapindikidwe a England komanso mafinya amatuluka, peritonitis ndi sepsis zimayamba.
Zifukwa
Zomwe zimayambitsa pancreatic necrosis ndi pathologies a biliary thirakiti. Dyskinesia, kuwerengetsa cholecystitis, kapena matenda a ndulu angayambitse kufalikira kwa dambo la Wirsung. Nthawi zambiri, necrosis imayamba kumwa mowa kwambiri komanso kudya kwambiri. Malinga ndi ziwerengero, awa ndi opitilira theka la odwala omwe adapezeka ndi izi. Mowa ndi zakudya zomwe zimavuta kugaya zimayambitsa kutupira kwa ndulu ndi kusunthika mumiyendo ya pancreatic madzi. Chifukwa cha izi, kapamba amayamba. Nthawi zambiri, ndi amene amatsogolera kukula kwa necrosis.
Kuphatikiza apo, matendawa ali ndi zifukwa zina:
- zakudya zosayenera - kusala kudya kwotalikilapo, kudya kwambiri, mafuta ochulukitsa, okazinga ndi zokometsera, maswiti ndi zakudya zomalizidwa;
- m'mimba kuvulala kapena opaleshoni;
- zilonda zam'mimba;
- yotupa matenda am'mimba;
- kuphwanya kwam'magazi kugaya chakudya;
- chakudya pachakudya, mowa kapena poyizoni wa mankhwala;
- matenda opatsirana kapena parasitic.
Oposa theka la milandu, kudya kwambiri ndi kumwa mowa kumabweretsa necrosis.
Zinthu zonsezi zimatha kuyambitsa kupanikizika kwa kapamba, komwe, popanda chithandizo, kumayambitsa minofu necrosis. Koma aakulu pancreatic necrosis amatha kukhala chifukwa chogwiritsa ntchito molakwika mankhwala ena, kupsinjika, kuthupi kapena kuthupi kwambiri.
Gulu
Kuti mupeze chithandizo choyenera, kuwonjezera pazomwe zimayambitsa zovuta za necrotic, ndikofunikira kudziwa zosiyanasiyana zake. Mawonekedwe a matendawa amakhudza osati zokhazo zomwe zimawonetsedwa, komanso kusankha kwa njira zothandizira. Nthawi zambiri, matenda amadziwika ndi mtundu wa kukula kwake. Kusiyanitsa pakati pa necrosis yacute, yopita patsogolo, komanso yovuta. Fomu yovuta imayamba msanga ndipo popanda kulandira chithandizo imatha kubweretsa masiku ochepa. Matenda a necrosis amatha nthawi yayitali, koma ndi chithandizo choyenera sichimabweretsa chisangalalo.
Malinga ndi kutengera kwa necrotic ndondomeko, pancreatic necrosis yosiyanitsidwa imasiyanitsidwa, yomwe imangokhudza malo ena a gland, ndi okwana, pamene ziwalo zonse zimawonongeka. Izi zimabweretsa kuphwanya kwathunthu ntchito za gland popanda chiyembekezo choti chiwongola. Nthawi zina matenda amatenga mbali ya necrotic, pomwe mafinya amasulidwa, omwe ndi mtsempha wamagazi amatha kufalitsa ziwalo zina. Mitundu ingapo ya matendawa imadziwikanso monga mtundu wa necrotic process.
Pali necrosis yotere:
Kodi zikondazo zimatha kuchotsedwa?- hemorrhagic - mtundu wowopsa kwambiri wa matenda, momwe kuwonongeka kwa makoma amitsempha yamagazi kumachitika, nthawi zambiri kumapangitsa wodwala kuti aphedwe;
- hemostatic - ndondomeko ya necrotic imayendera limodzi ndi kuphwanya kwamitsempha yamagazi kupita ku gland;
- edematous amapezeka ndi kudzikundikira kwa maellellular madzimadzi mu minofu;
- chogwira - chimaphwanya ntchito zonse za kapamba;
- zowonongeka zimayamba ndi chiwonongeko chachikulu cha minofu, ndipo zitatha izi, sizikukhudzidwanso.
Zizindikiro
Chimodzi mwazomwezi zimachitika ndikuti poyamba magawo sangawonekere mwanjira iliyonse, makamaka ndi mawonekedwe aulesi a necrotic. Zizindikiro zoyambirira ndi zofanana ndi matenda ena am'mimba:
- nseru atatha kudya;
- kusanza kwambiri ndi zosafunika za bile kapena magazi;
- kulemera pamimba, malamba;
- kukwiya kwanyumba;
- colic yamatumbo;
- kuchepa kwa chakudya;
- phokoso mokhumudwa.
Koma ndi necrosis, pali zizindikiro zenizeni zomwe zimatha kuwonetsa kwa katswiri kudziwa kwapadera kwa matenda. Choyamba, ndikumva kuwawa kwakumanzere kwa hypochondrium. Imathanso kufalikira kumimba yonse, mpaka kum'mimba, kumbuyo, phewa. Ululu nthawi zambiri umakulitsidwa ndi gawo lazakudya, ndimayendedwe, komanso malo apamwamba. Itha kukhala yotupa, kuwotcha kapena mawonekedwe a ma spasms. Ndipo mu theka la odwala ululu sulephera.
Chizindikiro chachikulu cha pancreatic necrosis ndi kupweteka kwambiri komanso nseru.
Kuphatikiza apo, kuwonjezereka kwa kutentha kumatha, zomwe zimawonetsa kukhalapo kwa yotupa. Mukamakankhira kapamba, kupweteka kwapweteka kumachitika. Ndipo pakhungu la pamimba, mawanga a cyanotic amatha kuwoneka. Wodwalayo amachepetsa msanga thupi, amayamba kulakalaka kudya, amalephera kununkhira kwamphamvu.
Zizindikiro
Pancreatic necrosis ndi yovuta kudziwa. Ngati njira ya necrotic ndi yaulesi, yokhazikitsidwa m'malo osiyanasiyana, izi sizowoneka ndi njira zambiri zoyeserera. Chifukwa chake, kawirikawiri, kudziwikanso kofananako kumachitika ngakhale muzochitika zotsogola, pamene chithandizo sichitha.
Koma pochezera kwa dokotala panthawi yake, katswiri wodziwa bwino amatha kukayikira kale mayeso a necrosis. Kuti atsimikizire matendawa, wodwalayo amatumizidwa kukayesa mkodzo ndi magazi, komanso kwa ultrasound ya kapamba. Nthawi zina pamakhala kofunikira kuchita kafukufuku wowonjezera: MRI kapena CT, angiography, laparoscopy. Izi zingathandize kusiyanitsa matenda a biliary colic, matumbo kutsekeka, m'mimba aortic aneurysm, myocardial infarction.
Njira yayikulu yodziwira matenda onse a kapamba ndi ma ultrasound
Chithandizo
Nthawi zambiri, chithandizo cha pancreatic necrosis chimachitika mu chipatala. Inde, ngakhale pofatsa, kuyang'anira dokotala nthawi zonse ndikofunikira, chifukwa ndikofunikira kuwunika momwe njira zakuchira zimayendera. Izi zikuthandizira pakapita nthawi kuti mudziwe momwe matendawa amathandizira.
Mu magawo oyamba a necrosis, chithandizo chokhazikika chambiri nthawi zambiri chimakhala chokwanira. Amakhala ndikumwa mankhwala apadera komanso kusintha kwa zakudya. Kugwiritsa ntchito njirazi pokhapokha ndi komwe kungaletse njira ya necrotic. Kuphatikiza apo, m'masiku ochepa oyamba wodwala amawonetsedwa kupuma kwathunthu ndi kusowa kwa chakudya.
Mwa mankhwalawa, analgesics kapena antispasmodics amagwiritsidwa ntchito nthawi zambiri, omwe amathandiza kuchepetsa ululu. Ndi bwino kuwapatsa mankhwala a intramuscularly kapena kudzera m'mitsempha, popeza kusanza kungasokoneze mayamwidwe awo. Nthawi zina novocaine gland blockade imagwiritsidwanso ntchito. Ndi kutupa, NSAID amafunikira, ndipo kukhalapo kwa matenda kumafunika kugwiritsa ntchito maantibayotiki. Ngati wodwala wasowa madzi amchere, saline amapaka jekeseni. Mankhwala apadera a pancreatic necrosis ndi omwe amalepheretsa ma enzymes mwachitsanzo, Contrical kapena Gordox. Nthawi zina antihistamines amathanso kutumikiridwa.
Pambuyo pachimake matendawa atachepa ndipo njira ya necrotic itayima, chakudya chokhazikika chimaperekedwa kuti wodwalayo athetsere nkhawa zake pa kapamba. M'pofunika kusiyiratu kumwa mowa, mafuta ndi zakudya zokazinga, zonunkhira, maswiti, zakumwa zochokera mu mpweya.
M'magulu apamwamba, komanso pogawa njira ya necrotic, opaleshoni ndiyofunikira. Musatchuletu pasanadutse masiku asanu ndi amodzi ndi asanu atazindikira. Kupatula kokha ndi milandu yadzidzidzi yomwe imawopseza moyo wa wodwalayo. Pa nthawi ya opareshoni, minofu yakufa, yotupa ndi mafinya amachotsedwa, zovuta zotulutsa magazi zimachotsedwa, ndipo kutuluka mwachizolowezi kwa madzi a pancreatic kumabwezeretsedwa.
Kuchita opaleshoni kumafunika nthawi zambiri pancreatic necrosis, koma ngakhale sizithandiza.
Ziwonetsero
M'pofunika kufunsa dokotala panthawi yake ngati pali vuto lililonse pamimba. Kupatula apo, minyewa ya necrosis imatha kupanga msanga kwambiri, maselo ochulukirapo amawonongeka, zomwe zimayambitsa kuphwanya kwa ntchito m'mimba. Ngati mutazindikira izi poyamba, mutha kuziletsa. Ndipo edematous necrosis amathandizidwa ndimankhwala othana ndi kutupa. Chifukwa chake, simungakhale otopetsa kapena kungolingalira, kungoyendera dokotala panthawi yake kungakupulumutseni pamavuto.
Koma zakutsogolo kwa pancreatic necrosis sizimangotengera izi. Malinga ndi ziwerengero, ngakhale ndi chisankho choyenera cha njira zamankhwala ,imfa yamatendawa imafika 70%. Kubwezeretsa kumadalira machitidwe a mapangidwe a necrotic, malo ake, kuopsa kwa matendawa, kupezeka kwa zovuta, komanso zaka za wodwalayo. Imfa yayikulu imapezeka kwambiri mwa anthu opitilira zaka 50, komanso odwala omwe ali ndi vuto la asidi kapena shuga, magazi othamanga kapena otupa kwambiri. Kuphatikiza apo, muzochitika zapamwamba za necrosis, odwala ochepera 10% amapulumuka ngakhale ndi chithandizo choyenera.
Ngakhale atachira bwino, munthu amakakamizidwa kutsatira zakudya zapadera pamoyo wake wonse ndikuyang'anira momwe amakhalira. Ambiri amalandila kulumala, popeza amatsatidwa osati kuphwanya zakudya zokha, komanso kugwira ntchito molimbika, komanso kupsinjika. Koma pokhapokha mutakhala ndi moyo wathanzi komanso zakudya, mutha kukhala ndi thanzi la pancreatic ndikupewa mavuto ena.
