Chithandizo cha kapamba ndi mankhwala chikuchitika moyang'aniridwa ndi dokotala-gastroenterologist ndipo akuphatikizira njira ina yosiyanitsira. Ndi mankhwala omwe amagwira ntchito yofunika kwambiri poletsa kutupa ndi kubwezeretsanso zovuta za pancreatic.
Njira yovuta kwambiri ya kapamba imadziwika ndi kuyambika kwadzidzidzi komanso nthawi yochepa. Matenda a kapamba amayamba pang'onopang'ono ndipo amapita patsogolo pakapita nthawi, kuchititsa kuwonongeka kwa kapamba.
Popeza pali kusiyana mu etiology ndi morphology ya matendawa, chithunzi cha chipatala chimatha kukhala chosiyana kutengera ndi kuphwanya kwa zobisika za thupi. Mukamasankha njira yoyenera yothandizira, amatsogozedwa ndi zomwe zilipo komanso zotsatira za mayeso.
Mankhwala amtundu wa matenda
Acute pancreatitis amatanthauza zinthu zomwe zimadziwika kuti ndizofunikira kuchipatala mwachangu. Nthawi zambiri, odwala amapititsidwa kuchipatala ndi gulu la ambulansi. Pafupifupi gawo limodzi mwa magawo atatu a odwala, pancreatic pancreatitis imayamba kwambiri, pomwe pali chipatala cha "pamimba pamimba."
Chodabwitsa cha "pamimba pamimba", kapena kugwedezeka kwam'mimba, ndikuti zingafunike opaleshoni yofulumira kuti ipititse peritonitis ndikuletsa kukula kosasintha kwam'mimba. Mwanjira ina, pali chiwopsezo chachindunji pamoyo wa wodwala.
Contrical ndi mankhwala achilengedwe omwe amalepheretsa ntchito za ma enzymes omwe amapangidwa ndi kapamba.
Popeza pakuwukira pancreatitis pachimake, kusanza kwina kopanda phokoso kumachitika, kumakhala kutayika kwamphamvu mthupi. Zotsatira zake, kuchuluka kwa magazi ozungulira kumachepetsedwa, zomwe zimabweretsa kuwonongeka kwamkati ndi ubongo. Zotsatira zoopsa siziyikidwa pambali.
Popewa kukula kwamavuto, pazizindikiro zoyambirira za kutupa kwa kapamba, muyenera kuyitanira ambulansi. Kuyesetsa kwa madotolo azachipatala makamaka cholinga chake ndicholetsa kupweteka kwambiri ndi zizindikiro zokhudzana ndi izi - nseru, kusanza, kuchepa magazi komanso kuthamanga kwa magazi.
Kuchepetsa ululu, kulowetsedwa kwa auberal (intravenous) kwa analgesics - Analgin, Novocain, Ketanov, ndi antispasmodics - No-shpa, Papaverine, Platifillin kapena Metacin amagwiritsidwa ntchito. Nthawi yomweyo, saline ndi glucose amamuthamangitsa kwa wodwala kuti abwezeretse kuchuluka kwa ma-electrolyte ndikuthandizira ziwalo zamkati ndi machitidwe.
Pakadali pano, maantibayotiki amagwiritsidwa ntchito kuti apewe matenda a ziwalo zomwe zakhudzidwa kapena kuthana ndi matenda omwe alipo. Mankhwala a antibacterial a pancreatitis, choyambirira, Amoxiclav ndi cephalosporins a m'badwo waposachedwa.
Ntchito yofunikira kwambiri ndikupondanso zochita za kapamba kuti achepetse katundu pazinthuzo ndikuyimitsa kuwonongedwa kwa maselo a parenchyma, omwe angayambitse matenda a pancreatic necrosis.
Chifukwa chaichi, kukonzekera kwa antienzyme zochizira kapamba:
- Contrakal;
- Gordox;
- Traskolan;
- Aprotinin;
- Octreotide;
- Octrid;
- Octretex;
- Sandostatin;
- Seraxtal.
Mankhwala a Antenzyme a kapamba mwa achikulire amalembedwa mwachidule, osapitilira masiku 10. Mwa ana, gulu la mankhwalawa siligwiritsidwa ntchito.
Chithandizo cha chifuwa chachikulu
Ambiri amavomereza kuti ma cell a pancreatic acinar pawokha amawonongeka ndi ma enzymes omwe amapanga nawo. Mwa munthu wathanzi, michere ya kapamba imayatsidwa ikalowa m'matumbo. Komabe, motsogozedwa ndi zinthu zakunja ndi zamkati, zimakhalabe mkati mwa kapamba, zimagwira ntchito ndikuyamba kupukusa minyewa ya tinyerezi. Zotsatira zake, njira yotupa imayamba, yotsatana ndi edema ndi ululu.
Njira yothandizira yophatikizira matenda a kapamba zimaphatikizira kumwa mankhwala a magulu angapo:
- michere ndi ma entiferments;
- anticholinergics ndi antispasmodics;
- Ma blockers a H2 ndi ma antacid;
- analgesics.
Kuchiritsa kapamba, limodzi ndi mankhwala, amatsata njira zoyeretsera m'mimba kuchokera ku ma pancreatic enzyme ndi zinthu zawo zowola. Mankhwala a Antenzyme a kapamba amalembedwa kokha ndi mawonekedwe amtundu wa matenda, omwe amadziwika ndi kuphwanya kwamphamvu ya ziwiya za kapamba. Poterepa, pali kuchepa kwa katulutsidwe komanso kuwonjezeka kwa kuchuluka kwa ma enzymes mu chakudya cham'mimba.
Poletsa magwiridwe antchito a kapamba, Gastrocepin ndi Riabal amagwiritsidwa ntchito nthawi zambiri. Ndalamazi zimapezeka pamapiritsi ndi ma ampoules. Ndi kuchulukirachulukira kwa chifuwa chachikulu, pamene wodwala amathandizidwa kuchipatala, Gastrocepin ndi zina zowonjezera zimayambitsa njira ya Drip (ya laberal).
Enzymes
Matenda a kapamba nthawi zambiri amapezeka motsutsana ndi maziko a kuperewera kwa kapamba kapamba pancreatic. Kuchulukitsa kwa enzyme kumathandizira kuti chimbudzi chikhale chachilengedwe ndikupanga mawonekedwe achilengedwe.
Cholinga cha mankhwala osokoneza bongo ndi kapamba ndikuphwanya chakudya kukhala ziwiya. Kupatula kwake ndi CHIKWANGWANI, chomwe chimagawika m'madzi a shuga komanso ma asidi mwa kulimbikitsidwa ndi matumbo a cell. Mwachilengedwe, michere imasinthidwa ndi ma bicarbonates, omwe amateteza kumatenda am'madzi am'mimba ndi zinthu zomwe zimalandiridwa m'mimba.
Pancreas wathanzi amapanga mitundu yayikulu 4 ya michere ndi ma proenzymes:
- ma nucleotic;
- mapuloteni;
- lipolytic;
- amylolytic.
Mankhwala a pancreatitis amapangidwa molingana ndi muyezo womwe umatsimikizira mawonekedwe achilengedwe a enzymatic. Amamulembera wodwala muyezo womwe ungakhale wokwanira kuphwanya chakudya. Mwanjira ina, piritsi limodzi kapena kapisozi kamakhala ndi ma enzyme ambiri momwe angafunikire.
Zomwe zimapangira Panzinorm zimapereka chimbudzi chokwanira cha mafuta, chakudya komanso mapuloteni
Pofuna kuti zinthu zochizira zigawe mwachilungamo pa chakudya chomwe chimalandidwa m'mimba ndipo zimayikidwa mu lumen ya duodenum, mankhwala amakono amapezeka mu chipolopolo chosagwira asidi. Kutengera ndi zomwe zikuwonetsa matendawa, mapiritsiwo akhoza kukhala ndi chimodzi kapena ziwiri zoterezi.
Kuphimba kuchepa kwa michere, kapamba amathandizidwa ndimankhwala okhala ndi amylase, proteinase ndi lipase. Amylase akutenga nawo gawo pakuphulika kwa michere yambiri, ntchito ya proteinase ndiyo kuthira mapuloteni, ndipo lipase ndiyofunikira kuti mafuta ayambe. Wodziwika kwambiri pagulu lokonzekera enzyme ndi Pancreatin, yomwe imapezeka pansi pa mayina ambiri amalonda:
Zithandizo za anthu a pancreatitis- Panzinorm;
- Chikondwerero;
- Micrazim;
- Malembo
- Penzital;
- Pankrenorm;
- Chiboni
- Mezim Forte;
- Pancreasim
- Pencrelipase, etc.
Mankhwala okhala ndi enzyme sikuti amangothandiza kuti chithokomiro chizichira, komanso amathandizanso odwala omwe ali ndi vuto la kudzimbidwa - mseru, kutulutsa m'mimba ndi kusefukira. Ngati pancreatitis ikupezeka wofatsa, ndiye kuti mutha kutenga ndalama pamsika kapena tizilombo tating'onoting'ono. Izi zikuphatikizapo Pepfiz, Oraza, Solizim ndi Abomin.
Creon ikupezeka m'mabotolo omwe amakhala ndi ma dozi ambiri omwe ali mu microspheres mini
Analgesics ndi antispasmodics
Anesthesia ndi nambala 1 ya mtundu uliwonse wa kapamba. Ululu syndrome umawonekera pazifukwa zingapo - kutsekeka kwa ma pancreatic ducts, kutupa ndi kutupa kwa parenchyma, kupezeka kwa cysts ndi kusintha kwa pathological mu mitsempha yotsiriza. Kuwongolera kupweteka pancreatitis yamankhwala nthawi zambiri kumayambitsa zovuta, zomwe nthawi zina zimayamba chifukwa cha kuphatikizika kwa ululu. Chifukwa chake, posankha njira yochizira, amatsogozedwa ndi chinthu chomwe chimapambana pakukula kwa matendawa.
Zowawa zilizonse zimayimitsidwa ndi analgesics (Analgin, Pentalgin). Komabe, kugwiritsa ntchito mankhwala a antispasmodic ndikofunikira kwambiri, chifukwa chimodzi mwazinthu zopweteka ndi kuphipha kwamisempha. Kuti muchepetse ma spasms, ndikulimbikitsidwa kugwiritsa ntchito mankhwalawa monga No-shpa, Buskopan, Papaverin, Meteospasmil, Mebeverin.
Makamaka othandizira pancreas ndi myotropic antispasmodics, omwe amathetsa msanga kukokana kwa chilengedwe chilichonse. Mmodzi mwa oimira gulu lino ndi Duspatalin (Mebeverin), omwe madokotala nthawi zambiri amalimbikitsa kutenga ndi kapamba.
Duspatalin amachita mosankha, kupumula kwa kupindika kwa Oddi - minofu yosalala ya duodenal papilla, yomwe imayendetsa mayendedwe a bile ndi kapamba wa pancreatic kupita ku duodenum 12
Asanachize kapamba, yemwe amaphatikizidwa ndi kupweteka kwambiri, dokotala ayenera kuganizira zovuta zomwe zingachitike kwa wodwalayo. Mwachitsanzo, Paracetamol ndi mankhwala osankhidwa chifukwa cha kutupa kwapancreatic, koma sangathe kugwiritsidwa ntchito ngati chiwindi chayamba chifukwa cha hepatotoxicity. Nthawi zina, ndi ululu, ma salicylates (Aspirin) ndi omwe amapatsidwa.
Akatswiri ena amalimbikitsa kumwa kapamba wopanda pancreatin wopanda mankhwala othandiza kupha asidi. Mapiritsi amathandizidwa m'mimba ndi gawo lapamwamba la duodenum. Komabe, zimayenera kumwedwa pokhapokha ngati mankhwala a antisecretory omwe amatchinga kupanga gastric hydrochloric acid.
Panthawi yomwe akuwopseza kwambiri kapena kuwonjezereka kwa chifuwa chachikulu, pamene wodwala amathandizidwa kuchipatala, ululu umatsitsidwanso ndi jakisoni wa Buprenorphine kapena Pentazocine. Novocain blockades ndi Eufillin atha kukhala nawo m'gulu la mankhwalawo.
Woopsa milandu, pakalibe zotsatira za ma pinkiller odziwika, ma analgesics opioid adalembedwa - Promedol, Fentanyl, Codeine kapena Tramadol.
Ndikofunikira kudziwa kuti mankhwala osokoneza bongo omwe si a antiididid amagwiritsidwa ntchito kawirikawiri, chifukwa chaukali wawo m'mimba.
Chizindikiro chotenga Tramadol ndi ululu wolimba wamankhwala womwe sungathetsedwe ndi ochiritsira ochiritsira
Enterosorbents ndi ma proiotic
Pafupifupi gawo limodzi mwa magawo atatu a odwala amapezeka ndi poizoni wa pancreatitis, yemwe amayamba chifukwa cha poyizoni wokhala ndi zinthu zoopsa, zakudya zopanda pake kapena zakumwa zoledzeretsa (zomwe nthawi zambiri sizabwino).
Kuti mudziwe njira yochizira matendawa, ndikofunikira kukhazikitsa chomwe chimayambitsa. Izi zimachepetsa kutengera kwa zomwe zimawonongeka ndikupereka mankhwala okwanira.
Ndi mankhwalawa omwe angagwiritsidwe ntchito pa zovuta pancreatitis?
Mndandanda wa ma enterosorbents ndi ma probiotic amawoneka motere:
- Smecta;
- Iberogast;
- Polyphepan;
- Polysorb;
- Hilak Forte;
- Lactofiltrum;
- STI ya Filtrum;
- Enterosgel;
- Dufalac et al.
Mankhwalawa ali ndi zochepa zotsutsana ndipo amathandizanso kubwezeretsa ntchito m'mimba. Kutenga ma enterosorbents ndi ma protein osokoneza bongo kumachepetsa chiopsezo cha zovuta ku pancreatitis yovuta komanso yoopsa, kumapangitsa kuyamwa kwambiri kwa chakudya komanso kumachepetsa ululu.
Musaiwale kuti ma proiotic samapezeka m'mankhwala okha, komanso muzinthu zosiyanasiyana. Ma tizilombo tating'onoting'ono tambiri tili ndi zakudya zonse za mkaka, mkate wopanda yisiti, tchizi, zinthu za soya (tofu, tchizi chanyumba, miso-phala ndi msuzi-msuzi).
Njira ndi zochitika
Limagwirira ntchito yopanga exacerbations wa kapamba nthawi zambiri amagwirizana ndi nkhawa nkhawa ndi nkhawa. Panthawi yowonjezereka komanso kuukiridwa, kupsinjika kumakulitsa chifukwa cha kupweteka kosalekeza, ndikuzungulira mozungulira. Wodwalayo amakwiya pafupipafupi, amagona molakwika, ndipo sangathe kugwira bwino ntchito chifukwa cha kuchepa kwa ndende.
Iberogast ya mankhwala osokoneza bongo ndi mitundu 9 yatsamba. Muli chamomile, Iberis, ndimu, mandimu, licorice, nthula wa mkaka, celandine, mbewu zakunyumba ndi angelica
Munthawi imeneyi, njira zochiritsira zimachepetsa, motero zinthu zosiyanasiyana zoyeserera zimagwiritsidwa ntchito. Kutengera kuzindikirika kwa zizindikirazi, izi zitha kukhala zitsamba kapena mankhwala amakonzekera - Glycine, Phenibut, Corvalol, Amitriptyline, Doxepin. Samathandizanso kupsinjika, komanso zimathandizira zotsatira za analgesics.
Zodzikongoletsera zofewa ndi infusions, mosiyana ndi mankhwala, zimakhala ndi zofewa ndipo zimatha kugwiritsidwa ntchito kwa nthawi yayitali. Ubwino wa mankhwala achilengedwe azitsamba ndi vuto la antispastic, kusowa kwa poizoni ndi vuto, kutetezedwa kwa magwiritsidwe ndikuwonjezereka kwa nkhawa. Zotsatira zake, ntchito ya kapamba ndi matumbo athu onse amabwezeretsedwa mwachangu.
Ndikofunika kukumbukira kuti mankhwalawa a kapamba ayenera kuchitika kokha ndi katswiri woyenera. Kutengera zomwe zimayambitsa matendawa ndi zomwe zimayambitsa matendawa, regimen ya chithandizo cha munthu payekha ndi mankhwala ofunikira amasankhidwa kwa wodwala aliyense. Khalani athanzi!
