Biliary pancreatitis, mosiyana ndi nthenda yotupa ya kapamba, ndi yachiwiri. Kupatula apo, imayamba chifukwa cha matenda a ndulu, ndulu ndi ma chiwindi. Uwu ndiye njira yotchedwa biliary system. Kuphwanya kutulutsa kwa bile, kumera kapena kuponyera mu kapamba kumabweretsa kukula kwa kutupa kwambiri. Matenda achifwamba ndi ambiri makamaka pakati pa achikulire, ndipo nthawi zambiri amapezeka mwa azimayi. Pafupifupi theka la milandu ya kapamba amayamba chifukwa ichi. Kutengera ndi kuopsa kwa maphunzirowo, mawonekedwe amtundu wa matenda komanso kupatsirana kwachilombo komwe kumadalira pancreatitis kumasiyana. Ngati sanapatsidwe, matenda ammimbawa amatha kubweretsa zovuta zambiri ngakhale kufa.
Makina owoneka
Kugwira ntchito kwabwinobwino kwa kapamba kumayenderana ndi thanzi la ziwalo zina zam'mimba. Mkhalidwe wa bile ducts umakhudzanso kwambiri. Ndulu imadziunjikira ndikusunga bile, yomwe imakhala ndi zinthu zina zapadera zamafuta a mafuta. Panthawi yovomerezeka ya ndulu chakudya chikamalowa m'mimba, bile limayenda ndikuyenda m'matumbo, pomwe limakhudzidwa ndi chimbudzi. Ndipo njirayi ikaphwanyidwa, anthu ambiri amaphunzira za biliary pancreatitis.
Kupatula apo, vuto ndilakuti patuluka dothi la bile limaphatikizana ndi Wirsung duct ya kapamba. M'mikhalidwe yokhazikika, sizinenedwe, popeza pancreatic duct imatsekedwa ndi sphincter ya Oddi ndipo kuthamangitsidwira kumakhala kwakukulu kuposa mumimba wa bile. Koma nthawi zina bile limalowetsa kapamba. Izi zimabweretsa kuwonongeka kwa zimakhala zake ndi bile acid. Nthawi zina amatulutsa thukuta nthawi yomweyo, madzi a pancreatic ndi bile amayamba kutundira paliponse la zotupa. Nthawi yomweyo, ma enzyme amatha kuthandizidwa ndi bile acids, ndipo "chimbudzi" cha matulutsa awo amayamba. Izi zimayambitsa kutupa kwamphamvu.
Nthawi zambiri, matenda amapezeka pamaso pa miyala pamiyendo ya bile
Zifukwa
Biliary pancreatitis imayamba ndi kuchuluka kwa matenda osiyanasiyana a ndulu kapena ndulu ya bile. Nthawi zambiri, kutupa kumayamba chifukwa cha jakisoni wa bile mu kapamba chifukwa chotupa cha muluwo ndi mwala. Komanso zimatha kupangitsa chidwi cha mabakiteriya omwe amapanga ziwalozi kulowa mmalirowo.
Zomwe zimayambitsa matenda amtunduwu ndi matenda otsatirawa:
- matenda a ndulu;
- makulidwe a bile ndi mapangidwe a mchenga wabwino;
- zosayenera mu kapangidwe ka biliary thirakiti;
- kuwerengetsa cholecystitis;
- gysbladder dyskinesia;
- cholangitis;
- cysts ndi ma neoplasms ena;
- kulowetsedwa;
- kuphipha kwa kupindika kwa Oddi;
- kusokonezeka kwa ntchito ya Vater papilla, kudzera momwe bile imalowa mu duodenum;
- helminthic infestations;
- yotupa njira mu duodenum;
- zotupa m'malo ano;
- matenda a chiwindi.
Sikuti kusungunuka kwa ndulu za bile komwe kumatha kupangitsa kuponyedwa kwa bile mu kapamba ndikuchulukitsa mphamvu yotupa mkati mwake. Kuwonjezeka kwa kupanikizika kumatha kuchitika chifukwa chogwiritsa ntchito chakudya chomwe chimayendetsa njira zonse za chimbudzi. Awa ndimowa, zakakudya, zokometsera komanso mafuta, zakumwa za kaboni. Zomwe zimayambitsa kukhathamira kungakhalenso kugwiritsa ntchito mankhwala a choleretic.
Zizindikiro
Chifukwa cha kupindika kwa bile kapena mabakiteriya omwe amapezeka m'matumbo, kumayamba kutupa. Acid bile acids ndi ma pancreatic enzymes amachititsa kuchepa kwa tiziwalo tamatumbo, pang'onopang'ono kuwononga maselo ake. Chifukwa cha izi, ntchito za thupi zimasokonekera.
Zizindikiro zikuluzikulu za biliary pancreatitis ndizopweteka zam'mimba, nseru, kufooka, ndipo nthawi zina kutentha thupi
Zizindikiro zazikuluzikulu zodalira pancreatitis ya biliary ndizofanana ndi mitundu ina. Awa ndi ululu wofinya, womangidwa m'mimba kumtunda, mseru, m'mimba mutatha kudya, kusanza, kusefukira, komanso kudzimbidwa. Koma popeza limodzi ndi kutupa kwa kapamba zimayambitsa matenda a ndulu, ndimawu ake amodzi amawonekera. Malinga ndi kupezeka kwawo, dokotala wodziwa zambiri angadziwe zoyambitsa matenda asanafike mayeso.
Pakhoza kukhala miyala mu kapambaKuphwanya kutuluka kwa ndulu kumayambitsa kuoneka ngati pang'onopang'ono ndi zipatso zowawa. Kuphatikiza apo, ululuwo umatha kuwonetsedwa kumanzere, monga zimakhalira nthawi zonse ndi kapamba, koma kumanja, ndipo amaperekedwa kumapewa, mkono kapena kumbuyo. Nthawi zina pamakhala zovuta zina zoteteza khungu. Chizindikiro ichi chikuwonetsa kufalikira kwa dambo la bile ndi mwala. M'malo mwa matenda am'mimba opezeka pancreatitis, mawonekedwe ake am'mimba amachititsa kudzimbidwa kosalekeza, nthawi zina kumathera m'matumbo. Kutentha mwanjira yotupa, ngati ikukweza, pang'ono.
Biliary pancreatitis imadziwikanso ndi kusowa kwazinsinsi mkati komanso kunja. Izi zimayambitsa zovuta zingapo pakudya. Kuchepetsa kuchuluka kwa ma enzymes kumasokoneza chimbudzi cha mapuloteni, kuwonongeka kwa mafuta komanso kuyamwa kwa zakudya zamafuta. Kuphatikiza pa mseru, kutentha pa chifuwa, kusokonezeka kwa thupi ndi matenda am'mimba, izi zimayambitsa kuchepa kwa chidwi, kuchepa thupi komanso kusowa kwa zinthu zofunika kuziwuza. Ngati maselo omwe amachititsa kuti mahomoni asokonekere, hypo- kapena hyperglycemia imawonedwa. Izi zimatha kuyambitsa matenda ashuga.
Zizindikiro
Ngakhale kuti biliary pancreatitis zizindikiro zina zimawonedwa, ndikofunikira kuchita kafukufuku wokwanira. Matenda aliwonse a ndulu, ndulu zake ndi zotupa zake mu kapamba palokha nthawi zambiri zimatsimikiziridwa ndi ultrasound. Ngati mukukayikira kukhalapo kwa miyala, mawonekedwe ndi kukula kwake amawonekera bwino ndi CT kapena MRI, nthawi zina cholangiopancreatography imachitidwanso.
Kuphatikiza apo, kuyesa kwa magazi ndi mkodzo ndikofunikira. Kukhalapo kwa biliary pancreatitis kudzawonetsedwa ndi kuwonjezeka kwa mulingo wa leukocytes, transaminase, bilirubin ndi alkaline phosphatase enzymes. A urinalysis amatha kuwonetsa kuchuluka kwa glucose. Kufufuza kwathunthu koteroko kumathandizira kusiyanitsa matenda am'mimba ndi zilonda zam'mimba kapena duodenum, ma neoplasms osiyanasiyana, hepatitis, cholecystitis ndi matenda ena.
Chithandizo
The kuvulala pachimake biliary pancreatitis, owonetsedwa ndi biliary colic, kusanza ndi zovuta jaundice, amafuna kuvomerezedwa chipatala. Ducts ikakhala yotsekedwa ndi ndulu, opaleshoni ndiyofunikira kwambiri, mwinanso kuwonongeka kwambiri kwa minyewa ya pancreatic ndikotheka, komwe kungayambitse peritonitis, sepsis ndi kufa.
Matenda a biliary pancreatitis, makamaka pofatsa, amatha kuthandizidwa poyang'aniridwa ndi achipatala kunyumba. Chithandizo cha matendawa chikuyenera kukhala chokwanira. Zimaphatikizapo kugwiritsa ntchito mankhwala apadera komanso zakudya zamagulu. Kuchita opaleshoni nthawi zina kungafunikire kuthandiza kubwezeretsa kutuluka kwa ndulu.
Ndi biliary pancreatitis, opaleshoni nthawi zambiri imafunika.
Mankhwala osokoneza bongo a pancreatitis ya biliary ayenera kutumizidwa ndi dokotala. Nthawi zambiri, magulu angapo a mankhwalawa amagwiritsidwa ntchito pamenepa. Chithandizo chovuta choterechi chimathandizira kubwezeretsa mwachangu ntchito za pancreatic komanso kukonza mkhalidwe wa wodwalayo.
Choyamba, ndikofunikira kuti muchepetse ululu. Ma Antispasmodics ndi oyenererana ndi izi: No-Shpa, Papaverin, Drotaverin. Mwanjira yovuta ya matenda, amapatsidwa kudzera m'mitsempha kapena intramuscularly. Ululu wofatsa umatha kuchotsedwa ndi analgesics: Baralgin kapena Analgin.
Kuti muchepetse kutupa, ndikofunikira kuti muchepetse ntchito yogaya michere. Mwa izi, mankhwala antisecretory amagwiritsidwa ntchito. Itha kukhala omeprazole, somatostatin kapena gastrocepin.
Pamaso pa matenda, kugwiritsa ntchito maantibayotiki ndikofunikira. Nthawi zambiri, iyi ndi Ceftriaxone, Amoscicillin kapena Abactal.
Potsutsana ndi exocrine ntchito za kapamba, ma enzymes am'mimba nthawi zambiri amalembedwa: Creon, Pancreatin, Panzinorm. Nthawi zina kugwiritsa ntchito othandizira a hypoglycemic amafunikira.
Mankhwala othandizira, mankhwala osiyanasiyana amagwiritsidwa ntchito. Pamaso pa nseru ndi kusanza - Motilium, Domperidone kapena Tserukal. Sinthani kapangidwe ndi kayendedwe ka bile - Hepatofalk kapena Odeston. Ursofalk imatha kusungunula miyala yaying'ono.
Popanda chakudya chapadera, palibe chithandizo chomwe chingagwire ntchito.
Zakudya zapadera ndizofunikira kwambiri kuti muchiritsidwe mwachangu. Kupatula apo, nthawi zambiri kuukira kumakhudzidwa ndi kugwiritsa ntchito chakudya chomwe chimakhala ndi choleretic kapena kumalimbikitsa ntchito ya pancreatic madzi. Zogulitsa zotere ziyenera kutayidwa nthawi yomweyo. Izi ndi zakumwa zoledzeretsa komanso zopatsa mphamvu, zakudya zamafuta, zokometsera komanso zakudya zokazinga. Zogulitsa za Cholagogue ndi kirimu wowawasa, batala, dzira yolk, amadyera, kabichi, tomato, zipatso za zipatso, zipatso zonse, msuzi wamphamvu. Ayeneranso kupatula kwathunthu muzakudya.
Chakudya cha wodwalayo chizikhala ndi chakudya chophika, chapansi, chomwe chimbidwa. Awa ndi mbewu monga chimanga, nyama kapena nsomba, tchizi chopanda mafuta, mkate wowuma, msuzi wa mucous, msuzi wa rosehip, madzi amchere. Idyani makamaka m'magawo ang'onoang'ono, nthawi 5-6 patsiku.
Mavuto
Ngati biliary pancreatitis siyikuyamba kuthandizidwa pa nthawi yake, zotsatira zoyipa ndizotheka. Choyambirira, bile acid ndi pancreatic madzi omwe agwera pamimba ya minyewa imatha kuyambitsa parenchymal pancreatitis, yomwe nthawi zambiri imapangitsa mucosal atrophy kapena pancreatic necrosis. Kuphatikiza apo, kuwonongeka kwa maselo a gland kumatha kupangitsa kutaya magazi m'mimba, kupindika kwamatumbo, komanso matenda a shuga. Nthawi zambiri komanso kufooka kwa chiwindi kumayamba, chotupa kapena chotupa chimayamba.
Ndizovuta komanso nthawi yayitali kuchitira biliary pancreatitis, koma kukula kwake kungapeweke. Kuti muchite izi, ndikofunikira kwambiri kudya zakudya, kusiya zizolowezi zoipa ndi kudya mwachangu ndikuwunika thanzi lathupi lonse lamatumbo. Kuyesedwa pafupipafupi ndi dokotala komanso moyo wabwino kumathandizira kukhalabe ndi thanzi la pancreatic.
