Pokhapokha pakuchitika zabwino zamankhwala othandizira pancreatic yotupa, funso lothandizira opaleshoni limadzutsidwa. Njira zosinthika zitha kugwiritsidwanso ntchito mwachangu. Malo azachipatala akulu okha ndi omwe ali ndi antchito ofunikira akatswiri odziwa bwino ntchito ndi zida za izi. Chofunikira chogwiritsira ntchito opaleshoni ya pancreatic, ndi mitundu yosiyanasiyana ya kapamba, iyenera kuthana ndi zotsutsana zina. Kodi njirayi iyenera kukhazikitsidwa munthawi iti? Momwe mungakonzekerere? Zomwe muyenera kudziwa za nthawi ya postoperative yamankhwala?
Opaleshoni ndi kapamba
Mankhwala amakono ali ndi njira zothandizira kudziwa momwe zimakhalira kapena kutulutsa ma pathologies a chitukuko, kugwira ntchito kwa ziwalo zamkati. Zikondamoyo ndi zam'mimba, zimagwiranso ntchito za endocrine. Maonekedwe ndi malo omwe ali m'mimba, imafaniziridwa ndi zilembo zabodza "S".
Chitsulo chimalemera pafupifupi g 80. Mu munthu wamkulu, kutalika kwake kumafikira 22 cm, makulidwe ake ndi masentimita 2-3. Kukula kocheperako sikungasokoneze kupanga kwa 1 l l wa pancreatic juice. Kapangidwe kamadzimadzi kamasiyanasiyana, kutengera magawo azakudya zomwe zimadyedwa. Kuzungulira gland pali njira zambiri zam'mimba komanso zowzungulira (aorta, apamwamba a vena cava, bile ducts). Ili ndi magawo atatu apamwamba (thupi lokhala ndi mutu ndi mchira). Ma cell opanga mahormone (insulin, glucagon) amapezeka kwambiri mchira.
Kapangidwe ka mkati ka chiwalo nkovuta. Multiple septa amagawa gland kukhala lobules, maselo omwe amapanga madzi a pancreatic. Kapangidwe kakang'ono ka ma ducts kumapeto kwake kumagwirizana kwambiri. Choyimira chachikulu chimalowa mu duodenum. Kapeti yakunja imakhala ndi minofu yolumikizira.
Ndi kapamba, kutupa kwa minofu kumachitika, nthawi zambiri kumapangitsa mawonekedwe a cysts. Panthawi yolowerera, magawo a necrosis (maselo akufa) amachotsedwa. Kupewa zovuta:
Kuchulukitsa kwa kapamba wa kapamba- kufalikira kwina kwa necrotic process;
- kuchotsa kwa kuledzera (poyizoni) wa thupi;
- kuteteza gland ntchito;
- kusintha kwa matenda.
Opaleshoni isanachitike, wodwalayo amayenera kupimidwa. Nthawi, maukadaulo, mtundu ndi luso la njirayi amasankhidwa. Munthawi iliyonse ya matenda okhudzana ndi matenda, funso limafunsidwa: kupulumutsa chiwalo, kuchichotsa kwathunthu kapena pang'ono?
Pamene caudal dera lachiberekero limapangidwanso (kudulidwa), wodwalayo amasamutsidwa kupita ku insulin, ndipo m'malo ena, kugwiritsidwa ntchito mosalekeza kwa enzymatic kukonzekera. Lingaliro la kuchititsa opaleshoni liyenera kutengedwa palimodzi ndi madokotala odziwa bwino ntchito zamankhwala ochita opaleshoni ndikuthana ndi zovuta zonse zomwe zingachitike komanso zotsatira zake.
Zisonyezero za opaleshoniyo ndi: kukhalapo kwa pseudocysts yokulirapo kuposa 5 cm, mapangidwe a kusintha kwa fibrotic mu parenchyma (wosanjikiza) wa England, khansa yomwe akuyembekezeredwa
Kufunika ndi kusatheka kwa opareshoni
Mwa opaleshoni, poyamba, amachotsa zomwe zimayambitsa matendawa: kubwezeretsa mwachilengedwe kutuluka kwa pancreatic madzi, bile. Kachiwiri, kutseguka kwa njira yolumikizira gawo loyambirira la m'matumbo aang'ono (duodenum) kumathandizira kukhazikitsa ululu wolimba womwe ukupitilira. Akatswiri amalingalira za zotsatira zabwino: kuchepa kwa chisonyezo cha kupweteka pakatha masiku 2-3 atachitidwa opaleshoni.
Zomwe zimayambitsa zosiyanasiyana (kuwonongeka kwa makina, kusowa zakudya zoyenera, kulandira chithandizo kwakanthawi ndi corticosteroids) kumayambitsa kupanga kwa michere yokumba m'mimba. Mawonekedwe a "pachimake pancreatitis" samachiritsika.
Zizindikiro zina pokana kugwira nawo ntchito ndi:
- shuga mellitus mu gawo la kuwonongeka (shuga yayikulu);
- kapamba mu mawonekedwe osadziwika;
- mavuto akulu a metabolism (kagayidwe kachakudya) mwa okalamba.
Ndi kobadwa nako kapena kwa cystic organ fibrosis, ma glued ducts sangabwezeretsedwe opaleshoni. Alipo ambiri aiwo ndipo ndi ochepa kwambiri. Kukhazikitsidwa kwa mankhwala ofunikira pokhapokha ndi njira yokhayo yothanirana ndi matendawa ndi hypoplasia yobadwa nayo.
Mu chifuwa chachikulu, opaleshoni yamankhwala, nthawi zina, imakhala yopanda zifukwa. Chifukwa cha kapangidwe kazinthu kakang'ono ka minofu, pali nthawi yake yoyenera kuchitapo opaleshoni:
- mavuto pambuyo pancreatitis pancreatic necrosis, abscess, hemorrhagic mawonekedwe;
- osagwira ntchito yayitali yokhazikika chithandizo, chizindikiro chowawa chachikulu;
- njira zowonongeka mu anatomically pafupi ndi ziwalo (ndulu, chiwindi, m'mimba);
- matenda oyamba (ascites, jaundice) ndi zikhalidwe (peritonitis, chotupa cha cyst);
- kuwerengetsa (mapangidwe amwala kuchokera ku mchere wamchere).
Zimachitika kuti madokotala ochita opaleshoni amayenera kuchotsa gawo loyandikana ndi colitis, cholecystitis
Mukamayesedwa panja, samalani ndi kuchuluka kwakumanja kwa diaphragm. Kusanthula kwathunthu kwamthupi kumachitika pogwiritsa ntchito njira zothandizira (ultrasound, MRI, CT, endoscopic retrograde cholangiopancreatography ndikuyerekeza ndi mitundu ya mankhwala). Ngati oncology ikukayikiridwa, biopsy imayikidwa musanachitike opareshoni.
Atangopanga opaleshoni, biomatadium amatengedwa kuti akaunike (magazi, mkodzo, zam'mimba, ndowe). Ndikofunikira kukhala ndi chidziwitso chazonse pazomwe zimaphatikizidwamo, kuchuluka kwa glucose (mtengo wofulumira wosala kudya wafika pa 5.6 mmol / l). Kuphatikiza apo, zotupa zimatsimikiza, kukhalapo kwa matupi omwe akuwonetsa ma hepatitis, HIV.
Mitundu ya ma pancreatic opaleshoni ya pancreatitis ndi chisamaliro chowonjezereka
Njira yayikulu yolowererapo ndikuti kuchotsa pang'ono kumachitika pamaso pa miyala, fistulas, maselo owonongeka. Kuchotsa kwathunthu - ndi njira yodziwitsira-kudzimbidwa kwa thupi. Mwa zochita zina, kugwira ntchito kwa ndulu kumabwezeretsedwa:
- kusoka kwa zigawo za nsalu;
- kulankhulana kwaulere kumakhazikitsidwa pakati pa kapamba ndi matumbo aang'ono;
- ngalande yokhazikika (chubu cha mphira chitha kugwiritsidwa ntchito) kutulutsa kwa mafinya, ntchofu, ndi magazi.
Monga opareshoni ya mtundu wachindunji, resection (dissection) imagwiritsidwa ntchito, yosalunjika - ngalande. Njira yotseguka imapangitsa chidwi chachikulu. Njira yocheperako yomwe idayesedwa. Zochitika zingapo zing'onozing'ono mpaka 1 masentimita zimachitika. Njirayi imadziwika kuti yopanda magazi, pogwiritsa ntchito ukadaulo waposachedwa (cyberknife, laser, kutentha pang'ono, probe).
Kupewa kuzindikira kwa mkhalidwe wa wodwalayo musanachitidwe opaleshoni ya m'mimba ndi chida chapamwamba komanso chapanthawi yake
Kuchipatala, malo amkati mwa wodwalayo, panthawi ya opaleshoniyo, amawonetsedwa pakompyuta. Kutalika kwa ntchito kungatenge, kutengera njira ndi dongosolo, kuyambira mphindi 15 mpaka 1.5 maola.
Buku: ndi njira yolowerera yolowerera komanso kusintha kwina kothekera, ntchito yolimba ya wodwalayo imabwezeretseka mu sabata limodzi.
Nthawi yogwiranso ntchito siyosafunanso kuti mbali ina ikhale yolimba. Ndi chisamaliro choyenera atatha kulowererapo mwachindunji, atatha masiku 45-60 omwe amakhala kuchipatala, wodwalayo amasamutsidwa kupita kuchipatala, pambuyo masiku 15, kuyenda kwakanthawi kumaloledwa.
Masiku atatu oyamba, wodwalayo ayenera kutsatira kupuma ndikumaliza kufa ndi njala, ndi zovuta - mawuwo amawakulitsidwa. Amaloledwa kumwa madzi otentha owiritsa, opanda mpweya, m'magawo ang'onoang'ono. Nthawi yomweyo, mankhwalawa amachitidwa (ndi maantibayotiki, antispasmodics, painkillers), saline imathandizidwa.
Pang'onopang'ono zakudya zowonjezera zimadyetsedwa ndi broths zamasamba zothandizidwa ndi enzymatic. Wodwalayo amalimbikitsidwa theka lamadzi, phala yowira, mafuta ochepa. Pambuyo pa opaleshoni, zakudya zopangidwa mwapadera ziyenera kutsatiridwa kwa moyo wonse. Ndikofunika kusiya masewera olimbitsa thupi.
