Kasitomala ndi chiwalo cham'mimba chokhala ndi ntchito yofunika.
M'malo mwake, michere yofunika imapangidwa, yomwe imatenga nawo gawo pakudya kwa zakudya ndi insulin, yomwe imathandizira kuwongolera shuga.
Njira zotupa zomwe zimachitika m'matumbo amatchedwa pancreatitis.
Kupezeka kwake kumakwiyitsa matenda angapo komanso ma syndromes. Acute pancreatitis amakhala mliri patatha tchuthi, ndipo chithunzichi chimawonedwa chaka ndi chaka. Chifukwa cha izi, akatswiri ena azachipatala amachitcha matenda "phwando".
Mitundu ndi magawo a matendawa
Akatswiri azachipatala ochokera kumayiko osiyanasiyana anakonza zidziwitso zamatenda osiyanasiyana ndikupanga gulu lonse la matenda (ICD).
Nambala ya ICD yamitundu 10 yamatumbo a kapamba:
- pachimake kapamba - K85;
- aakulu kapamba - K86.0;
- mitundu yina ya matenda a kapamba (matenda opatsirana, obwereza, obwereza) - K86.1.
Mitundu itatu yayikulu ya kapamba owopsa amadziwika:
- Kutupa kapamba - Awa ndi gawo loyambirira la matendawa, omwe amachiritsidwa bwino komanso zovuta chifukwa cha matenda a pancreatic necrosis. Pakadali pano, edema, kuphatikizika kwa minofu ya limba. Fluid inclusions ndi madera ochepa a necrosis amapezeka.
- Oyipa pancreatic necrosis - Uwu ndi mtundu wawopseza matendawa, womwe umadziwika ndi zovuta kwambiri. Pakadali pano, kusintha kosasintha kwa kapamba kumayambira - kufa kwa minofu. Ma Enzym, atatha kukhetsa chimbudzi chake, amapita m'magazi ndikuwononga chilichonse chokhalamo, koma m'magazi mulibe ma virus. Kutengera kuchuluka kwa zotupa, zimasiyanitsidwa
:- limited (yaying'ono) pancreatic necrosis;
- wamba;
- laling'ono laling'ono;
- chachikulu pancreatic necrosis;
- chapansipansi;
- okwanira (olimba).
Potengera chotupa:
- mafuta;
- hemorrhagic;
- kuphatikiza.
- Wosokonekera pancreatic necrosis - Ili ndi gawo lowopsa kwambiri la aseptic pancreatic necrosis complication. Apa ndipamene zinthu zomwe zimapangitsa kuti ziwonongeke zikhale ndi kachilombo m'mimba. Pakadali pano, chiwerengero cha anthu omwalira chimakhala chambiri kwambiri ndipo mothandizidwa ndi opaleshoni ndizotheka kuthetsa vutoli.
:Zizindikiro za pancreatitis pachimake
Kutupa kumachitika chifukwa cha mankhwala kapena mphamvu ya kapamba. Ma enzymes omwe kapamba woyamba amatulutsa samagwira ndipo sangathe kuvulaza nduluyo palokha, koma pazovuta zingapo, ma enzymes ophatikizika amawonekera m'matumbo ndipo amayamba kudzipenda okha.
Zonsezi zimatha kuphatikizidwa ndi kutulutsa kwa purulent komanso njira zosasintha. Mawonekedwe amankhwala amatengera mawonekedwe ndi kuuma kwa njira ya matendawa.
Ululu ngati chizindikiro choyamba
Pa gawo loyambirira la mawonekedwe a kapamba, munthu amadandaula za kupweteka. Ndikosavuta kudziwa komwe kumakhala kuwawa.
Imafalikira pamimba pamimba, imatha kupereka kumbuyo kapena mtima. Zowawa zimayamba kuwonjezeka mwachangu, zimakhala zolimba. Munthu amakhala ndi malo opotoka - izi zimachepetsa ululu.
Pang'onopang'ono, kusanza kumayamba. Zonsezi ndi chizindikiro cha gawo 1 la chitukuko cha matenda kapena apo amatchedwa gawo lachiwopsezo. Imatha kukhala maola angapo mpaka masiku angapo.
Mawonetsero osatsimikizika komanso apadera
Kenako, gawo lachiwiri limachitika - gawo la kutupa komwe kumagwiranso ntchito. Amakhala masiku 6 mpaka 14.
Gawoli limadziwika ndi:
- Kuuma kwa zizindikiro ndi zowawa;
- kutentha kumakwera kufika pa 38 - 38,5 ° C;
- pali ludzu lamphamvu;
- chimbudzi chawonongeka kwathunthu;
- kupuma kumafulumira;
- kupweteka kumachitika podziwika kwambiri - kupweteka kwamankhwala kumachitika mu hypochondrium yamanzere, kumatha kufalikira kudera lamtima kapena kumanzere.
Kenako pakubwera gawo lachitatu - gawo logawanitsa. Kukula kwa ululu kumachepa pang'ono.
Pali zizindikiro za peritonitis pachimake:
- kutentha kwambiri;
- tachycardia;
- zokutira yoyera pa lilime;
- kupuma movutikira
- kutulutsa kwakukulu kumachitika;
- kusanza kumakulirakulira;
- wodwala amakhala ndi nkhawa;
- kupuma kumakhala kwakuya komanso kosowa.
Ntchito zamankhwala zomwe zimaperekedwa pambuyo pake zimaperekedwa, zomwe zimapangitsa kuti matendawo ayambirenso.
Zizindikiro zapadera zimaphatikizapo:
- kuwoneka kwa masamba achikasu a chyanotic mu kapamba, mapangidwe am'mimba ndi chizindikiro chodziwika bwino cha hemorrhagic pancreatitis;
- Malo omwewo amawonekeranso navel;
- mukamayang'ana m'mimba, kupweteka kwa m'mimba kumadziwika;
- kudzikundikira kwamadzi mozungulira gland;
- poyesa magazi, pali kuchuluka kwa hemoglobin ndi maselo ofiira amwazi;
- kuchepa kwa ESR;
- ndi purulent sepsis, kuchuluka kwa ma lymphocyte kumachepa;
- pakuwunika mkodzo, mapuloteni ndi shuga amapezeka;
- zochitika za amylase mu mkodzo zimawonjezeka (pokhapokha gawo loyambira);
- mu biochemistry yamagazi, kuwonjezeka kwa michere ya pancreatic kumawonedwa;
- kuchuluka kwa shuga m'magazi;
- kuchuluka kwa bilirubin;
- kuchuluka kwa urea m'magazi.
Kanema kochokera kwa Dr. Malysheva:
Njira zoyenera
Mawonetseredwe azachipatala samakhala wokwanira nthawi zonse kuti azindikire pancreatitis yacute, amatenga magazi kuti awunikenso pazotsatira zamankhwala komanso zamankhwala amkati, mkodzo umayesedwa, ndipo ziwalo zam'mimba zimayesedwa.
Kuyesa kwa Ultrasound
Kugwiritsa ntchito ultrasound, ndikotheka kudziwa kukula ndi kapangidwe ka kapamba, kudziwa kukhalapo kwa madzimadzi ndi necrosis, kuwona kusintha kwa ziwalo zina zam'mimba, zomwe zingathandizenso kuti muzindikire.
Phunziroli limawonedwa ngati lotetezeka ndipo limaperekedwa kwa ana ndi amayi apakati. Koma mwatsoka, ma ultrasound sangawonetse chithunzi chokhacho, ndiye muyenera kutembenukira ku compact tomography.
Zolemba pamakompyuta
Njira yodziwitsira anthu matenda imawerengedwa kuti ndi yolondola kwambiri pofufuza matenda. Palibe chosokoneza pa kafukufukuyu. Kuzindikiritsa ndi kuyambitsa kwamadzimadzi osiyanitsa kumapereka zotsatira zenizeni.
Mothandizidwa ndi phunziroli, ndizotheka kudziwa molondola kukula kwa kutulutsa, kudziwa cholinga cha necrosis, kudziwa kupezeka kwa madzi ndi zilonda zam'mimba.
Mawonetseredwe a morphological
Mu chilonda chachikulu cha pancreatitis, mapuloteni amapezeka nthawi yomweyo mumitsempha yamagazi, ndipo kupezeka kwa mapuloteni ndi shuga mumkodzo kumawonetsa njira ya pathological. Pakuwunika mkodzo, kuwonjezeka kwa zochitika za amylase kumawonedwa.
Pa morphological angatengere:
- kufooka kwamphamvu mwadzidzidzi;
- kuphwanya kwamchere wamchere wamchere;
- kuchuluka machulukitsidwe a interleukin;
- kuwoneka kwachilengedwe kwamadzi mu peritoneum;
- kuchuluka kwa amylase ndi zinthu zowonongeka mu seramu yamagazi;
- poizoni chiwindi, impso, mtima, chapakati mantha dongosolo ndi kuwola mankhwala (poizoni).
Dongosolo ndi mfundo zamankhwala
Aliyense yemwe akukumana ndi zizindikiro za pancreatitis pachimake ayenera kulandira chithandizo mkati mwa makhoma a chipatala. Kuwunikira pafupipafupi akatswiri odziwa bwino kudzakuthandizani kupewa zovuta za kapamba komanso kuchita panthawi yake njira zoyenera zakuchipatala.
Kupumula
Chithandizo cha mankhwala osokoneza bongo ndicholinga chofuna kuchepetsa ululu. Ndi vuto la kapamba, wodwalayo ayenera kupuma kwathunthu, ndikuyimilira mawonekedwe a mwana wosabadwayo - izi zimachepetsa ululu.
Nthawi zina analcics ya narcotic imatha kutumikiridwa (mwaukali mitundu ya maphunzirowo). Nthawi zambiri, chithandizo cha kapamba chimayamba ndi mankhwala a antispasmodic - No-shpa, Papaverin, Novocain, ndi zina zambiri.
Pofuna kuthana ndi vuto la kupweteka, kupaka kwamankhwala othandizira kumapangidwanso - Novocain, No-spa ndi zina, jakisoni wamkati pokonzekera Analgin, Atropine, Papaverine ndi mankhwala ena.
Mankhwala osokoneza bongo ndi mawonekedwe ake
Onetsetsani kuti mwapereka mankhwala kuti muchepetse kuledzera. Isotonic sodium chloride solution kapena mayankho kutsanzira kapangidwe ka madzi amkati mwake - Trisol, Chlosol ndi ena amayamba.
Poletsa kutupa ndi microflora ya bakiteriya, maantibayotiki amagwiritsidwa ntchito - Ceftriaxone, Pefloxocin, Metronidazole ndi ena.
Kuti muchepetse kubisala kwa chithokomiro, mankhwala a antacid amalembedwa - Rennie, Smecta, Almagel ndi ena.
Kuti muchepetse kupanga kwa hydrochloric acid, histamine blockers - Ranitidine, Famotidine, ndi zina zotchulidwa.
Kuti achepetse acidity yam'mimba, Omeprazole, Rabeprazole ndi mankhwala.
Pofuna kuponderezana ndi michere ya pancreatic enzyme, ma block a enzyme adalembedwa - Gordoks, Kontripal.
Woopsa matendawa, mankhwala a cytostatic - Fluorouracil amatchulidwa kuti muchepetse zovuta za kapamba.
Njira zopangira opaleshoni
Posankha njira zamankhwala, madokotala amakonda chithandizo chamankhwala chosasangalatsa, kuyesa kuyanjana ndi omwe akutsikira, jakisoni, mankhwala osokoneza bongo, njala, komanso kudya kwamphamvu. Koma nthawi zina, kuchitidwa opaleshoni ndikofunikira.
Njira zowukira zomwe zimasankhidwa nthawi zambiri - opaleshoni ya laparoscopic, kapena opaleshoni yoyang'aniridwa ndi scan scanning.
Kugwiritsa ntchito opaleshoni yotere kumachepetsa zoopsa pakuchitidwa opaleshoni - mawonekedwewo amakhala ndi kukula pang'ono kapena ngalande imachitika pogwiritsa ntchito singano yapadera.
Kuchiritsa kwa ma postoperative suture kumachitika kangapo mwachangu kuposa kuchitira kwachizolowezi. Kutengera ndi kuopsa kwa matendawa, nthawi yothandizira ikhoza kupitilira masiku angapo mpaka milungu ingapo.
Zakudya, kusala kudya ndi zakudya za makolo
M'masiku oyamba pambuyo povutitsidwa, wodwalayo amasinthidwa kuti afe ndi njala mkati mwa masiku 5-7 (ngati kuwongoleredwa kwawonedwa). Zochizira pancreatitis pachimake - iyi ndi imodzi mwamalamulo.
Zakudya zilizonse zomwe zimalowa m'mimba mwa munthu pakukhathamira kapena pambuyo poti chiwopseze zimatha kuvulaza thanzi. Kuti munthu asataye michere ndi mphamvu, amapatsidwa zakudya kudzera mu kulowetsedwa, komwe kumatchedwa kuti makolo a michere.
Chithandizo chomwecho chimaperekedwa mu nthawi ya postoperative, komanso nthawi yayikulu matendawa. Anthu omwe ali ndi shuga yayikulu ayenera kusamala ndi chakudyachi, chifukwa izi zimatha kuvulaza. Izi zikuyenera kuyang'aniridwa ndi katswiri wazachipatala woyenerera.
Pambuyo masiku 7, wodwalayo amatha kuyamba kudya, pokhapokha ngati ataloleza ndi kuvomereza mosamalitsa dokotala wowonera. Chakudya chiziyambitsidwa ndi chakudya chochepa, zakudya ziyenera kukhala zatsopano, kutentha.
Ndi zoletsedwa kudya mafuta munthawiyi. Kudyetsa pang'onopang'ono kumatsimikizira zotsatira zabwino.
M'tsogolomu, munthu amasamutsidwa ku zakudya zamankhwala - zakudya 5P. Zakudya zoterezi zimayenera kutsatiridwa pafupifupi miyezi iwiri kuchokera ku kuchira.
Mfundo zoyambirira za zakudya:
- kudya zakudya zabwino komanso zatsopano;
- kugwiritsa ntchito zakudya zofewa;
- kudya chakudya m'malo ochepa;
- kugwiritsa ntchito zakudya zotentha, zamadzimadzi kapena zamadzimadzi.
Zakudya zotere zimathetseratu kumwa mowa ndi fodya.
Pali zinthu zoyimitsidwa zomwe muyenera kuzitaya:
- chakudya chilichonse chamafuta (nyama, nsomba, ndi zina);
- mchere ndi zonunkhira;
- zakudya zilizonse za acidic;
- mankhwala a chokoleti;
- muffin wokoma;
- zakumwa za khofi
- tiyi wamphamvu;
- mkaka
- mazira
- kusungidwa kulikonse.
Kutsatira mfundo za zakudyazi, mu 95% yazochitika zomwe wodwalayo amakhala ndi zotsatirapo zabwino.
Kanema kuchokera kwa Dr. Evdokimenko:
Kuchulukitsa
Pofuna kupewa kupezeka kwa pancreatitis pachimake, ndikofunikira kuyang'anitsitsa boma la thanzi. Matendawa ndi osavuta kupewa kuposa kuchiza zotsatira zake.
Njira zopewera ndi izi:
- Kupenda thupi pafupipafupi. Kuchita ma ultrasound a ziwalo zogaya chakudya chaka chilichonse, kupenda magazi ndi mkodzo.
- Yang'anirani shuga.
- Kuwongolera thupi. Sayenera kukhala yochulukirapo kapena yoperewera.
- Pewani zizolowezi zoyipa - kusuta, kudya kwambiri, kumwa kwambiri.
- Yenderani zolimbitsa thupi. Kuchita zolimbitsa thupi kwambiri, komanso kusachita masewera olimbitsa thupi, kuvulaza thupi.
- Tsatirani malamulo a zakudya zabwino.
- Tsatirani zakudya.
- Osaphwanya boma la ntchito ndikupuma.
- Chepetsani zochitika zovuta.
- Panthawi ya tchuthi simuphwanya mfundo zoyenera za kadyedwe.
- Tengani mankhwala pokhapokha ngati mwalangizidwa ndi dokotala.
- Anthu omwe ali ndi kutupa kwa pancreatic ayenera kuyang'aniridwa ndi dokotala (pitani kwa dokotala osachepera kawiri pachaka, kapena kawiri kawiri).
- Ngati pali matenda, pitani ku spa mankhwala apadera.
- Mu matenda omwe simudwala, musaphwanye malangizo a dokotala, mosamala kudya zakudya zothandizanso.
Ndi njira yoyenera yazakudya zake ndi moyo wake, munthu amatha kudziteteza yekha ndi banja lake pamavuto mwanjira ya kapamba. Zakudya siziyenera kukhala zokoma zokha, komanso zathanzi, kotero posankha, simuyenera kuganizira kukoma kokha.
