Zizindikiro ndi njira zochizira pancreatic cysts

A cyst ndi pathological neoplasm mu mawonekedwe a patsekeke yomwe ili parenchyma ya kapamba kapena pamwamba pake.

Mapangidwe a cystic amapangika chifukwa chovulaza chiwalo kapena kuvulala kwa gland ndipo amafunika chithandizo chovomerezeka chifukwa cha chiwopsezo chachikulu chowonongeka pamakoma amkati mwendo kapena kuwonongeka kwa chotupa chija kukhala chotupa chowopsa.

Gulu

Malinga ndi gulu, mawonekedwe a cystic amasiyanitsidwa ndi mawonekedwe a morphological komanso malo omwe ali m'gululi.

Malinga ndi kapangidwe kake ka cyst, zitha kukhala:

1. A cyst owona ali ndi code malinga ndi ICD 10 - K 86.2. Awa ndimawu osowa kwambiri, nthawi zambiri amabadwa mwatsopano. Mtsetse wotere umapangidwa kuchokera ku maselo a epithelial ndipo samakonda kukula.
2. The pseudocyst kapena zabodza zili ndi code K 86.3. Mitsempha yotereyi imayamba chifukwa cha kuwonongeka kwa ma gland kapena chifukwa cha kutupa kwa ziwalo.

Malinga ndi zizindikiro za kutchera kwa khomalo likupezeka:

1. Pa thupi la chiwalo. Uwu ndi mtundu wofala kwambiri wamaphunziro pomwe neoplasm imakankhira m'mimba ndi m'matumbo.
2. Pa mchira. Pankhaniyi, ziwalo zoyandikana nazo sizikuwonongeka, chifukwa chotupa cha mchira chimapangidwa kunja kwa peritoneum.
3. Pamutu. Pali kuphatikizika kwa duodenum 12, koma malo amtunduwu amapezeka mwa 16% yokha mwa milandu.

Ma cysts osavuta ndi ovuta amadziwikanso, momwe fistulas, kudzikundikira kwa mafinya kapena kuwonongeka kwa makoma amkati amawonedwa.

Potengera komwe kumachitika pancreatitis yayikulu, chotupa chimayamba ngati matenda.

Malinga ndi gulu la Atlanta, agawidwa malinga ndi mfundo iyi:

• pachimake - m'matayala otere alibe khoma lowoneka bwino ndipo amatha kupanga m'mitsempha ya ndulu, mu parenchyma kapena pa fiber;
• aakulu (subacute) - ma cysts ali ndi nembanemba yama cell owoneka bwino;
• abscess - yodziwika ndi kuchuluka kwa mapangidwe ndi kudzikundikira kwa mafinya mu patsekeke.

Zomwe zimayambitsa ndikudziwikiratu

Kupangika kwa mawonekedwe a kapamba kumatha kupezeka mwa odwala amisinkhu iliyonse.

Zifukwa zazikulu chifukwa chomwe kapisozi imapangidwira ndi matenda otupa a England.

• kuvulala kwamakina kwa thupi;
• kukhalapo kwa zotupa mu gland;
• kuphwanya patency ya ma ducts a thupi;
• pachimake kapamba ndi chifukwa chachikulu cha chitukuko cha neoplasm;
• helminthic nkhondo.

Zomwe zimapangitsa kuti pakhale chisokonezo ndi monga:

• opaleshoni yapitayi pa ziwalo zam'mimba;
• matenda a endocrine;
• uchidakwa wambiri;
• kunenepa kwambiri;
• matenda a ndulu.

Malinga ndi ziwerengero, chotupa cha kapamba nthawi zambiri chimapangidwa motsutsana ndi maziko a pancreatitis pachimake komanso kudalira mowa.

Izi ndizomwe zimapangitsa 84 ndi 63% ya milandu yonse yamatenda amtundu, motsatana. Mapangidwe a cystic omwe adayamba chifukwa cha matenda a gallstone ndi kuvulala kwa gland amapezeka 14%.

Zizindikiro zamatsenga

Chithunzi cha chipatala ndi chitukuko cha maphunziro zimatengera kuchuluka ndi kukula kwa maphunziro. Misika yotalikirana pakati nthawi zambiri siziwonetsa zizindikiro zowopsa, pomwe ma cyst yokulirapo kuposa 5 cm amadzipangitsa kumva kuwawa kwambiri.

Zizindikiro zotsatirazi zadziwika:

1. Choyamba, ndikumva kuwawa komwe kumakulitsidwa mutatha kudya ndi kumwa mowa ndikuwunikira mbali yakumanzere ndikutsikira kumbuyo. Ululu sutha ndi antispasmodics ndi painkiller.
2. Zodandaula. Pali matenda am'mimba mu ndowe zamafuta ndikuchulukanso kwa mpweya m'matumbo.
3. Kusinthana kwa nyengo zopweteka komanso zosapweteka ndizodziwika. Nthawi zambiri, pakumva kupweteka kwakanthawi kwa mwezi umodzi, zizindikirizo zimazimiririka, pambuyo pake zimabwerezedwanso m'njira yotchulira.

Komanso, odwala amadandaula za mawonekedwe:

• kumverera kolemetsa pansi pa nthiti yakumanzere;
• nseru kutembenukira kusanza;
• kutentha kukwera mpaka madigiri 38;
• kukamwa kowuma ndi kuchepa mphamvu;
• kukodza pafupipafupi ndikutulutsa mkodzo wambiri.

Nthawi zina, ma ducts a bile amaponderezedwa ndi chotupa, chomwe chimapangitsa chikaso cha mucous nembanemba amaso ndi khungu.

Kuphatikiza apo, motsutsana ndi mapangidwe a cystic mapangidwe, insulin synthesis imasokonezeka, yomwe imayambitsa kusintha kwa kuchuluka kwa shuga m'magazi ndipo kungayambitse hypo- ndi hyperglycemia.

Odwala omwe amapezeka kuti ali ndi mutu waukulu, mawonekedwe amphamvu a khoma lakumbuyo amawonedwa.

Njira Zodziwitsira

Kodi chiwopsezo cha pancreatic cyst ndi chiani?

Unyinji wosakhazikika womwe sukupezeka munthawi yake umatha kubweretsa mavuto akulu:

• kuwonongeka kwa nembanemba ndi kutha kwa zamkati m'mimba, zomwe zimatha kutulutsa magazi ndi peritonitis;
• kuwonjezeka kwa kukula kwamkati ndi kuwonongeka kwa ziwalo zapafupi;
• mawonekedwe a kuvunda ndi minofu necrosis;
• mapangidwe a fistula.

Choopsa chachikulu chagona pakupezeka kwa chotupa cha khansa.

Chifukwa chake, ndikofunikira kwambiri kudziwa zamankhwala mu nthawi ndikuyamba chithandizo. Kafukufuku wofufuza amachitika makamaka ndi njira zothandiza. Kuyesa kwa labotale magazi ndi mkodzo sikunasinthe.

Chitsimikiziro chachikulu chiri pa ultrasound. Pakuwunikira, chotupacho chimawonetsedwa ngati mawonekedwe opepuka mozungulira ndipo malembedwe oyaka motsutsana ndi kapamba wakuda pafupifupi. Kuphatikiza apo, kuchuluka kwa neoplasm kudzachepetsedwa.

Mwazovuta zambiri, compression tomography kapena MRI imapangidwanso. X-ray imagwiritsidwa ntchito pozindikira.

Chithandizo cha Conservative

Chotupa cha pancreatic iyenera kuchotsedwa mochita kuchipatala.

Koma ngati pali maphunziro amodzi okha, ali ochepa, amakhala osakhazikika ndipo sayambitsa wodwalayo nkhawa, ndiye kuti opaleshoniyo achedwa ndipo ayesa kuchitira chipatalacho pogwiritsa ntchito njira zosasamalira.

Pankhaniyi, njira yodikira ndi kuwona imasankhidwa, popeza ma cyst osakwana 2 cm amatha kuthana.

Chithandizo cha Conservative ndi motere:

• kuwunika pafupipafupi kukula kwa vuto la neoplasm komanso momwe ziwalo zapafupi;
• mankhwala a antibacterial amathandizira kupewa matenda am'magazi;
• ma pinkiller ndi ma enzyme akulimbikitsidwa;
• wodwalayo adapangidwa kuti apumule pakati pa sabata ndi kukana zizolowezi zoipa;
• masiku awiri kapena atatu oyamba wodwala akulangizidwa kuti asadye, ndipo mtsogolomo azitsatira zakudya.

Zakudya za neoplasm ziyenera kuchitika muzochitika zonse za chithandizo chokhazikika, ndipo pambuyo pa opaleshoni yonse. Izi zimathandizira kutsitsa komanso kupewa zomwe zitha kubwerezedwanso.

Zakudya zopatsa thanzi zimatanthawuza izi:

• mbale ziyenera kupangidwa ndi kuwongolera, kuwotcha kapena kuphika;
• chakudya kudya maola atatu aliwonse ochepa;
• zogulitsa ziyenera kukhala pansi kapena kusenda;
• osatulutsa nthangala, bowa, zonunkhira, mafuta, mchere komanso zakudya zokazinga;
• kuchepetsa kugwiritsa ntchito shuga, maswiti ndi makeke;
• lekani kusuta, mowa, khofi, tiyi wamphamvu ndi soda;
• konda zakudya zamafuta amkaka otsika, ophika ndi masamba owotchera, nkhuku zosapsa, nsomba ndi mbale zamphesa;
• Kuyambira zakumwa zobiriwira zobiriwira, zipatso za zipatso, timadziti, madzi omveka ndi zakudya zimaloledwa.

Ngati chithandizo cha Conservative sichikubweretsa zotsatira, opaleshoni yokonzekera idakonzedwa.

Njira zamakono zopangira opaleshoni

Kuchotsa opaleshoni kukuwonekera pazochitika zotsatirazi:

• ma cystic angapo kapena ngati kapisozi wafika pamaso opitilira 60 mm;
• chotupa chimafinya bileza ndipo chimayambitsa kukokoloka kwa ndulu;
• matenda amaphatikizidwa ndi kupweteka kwambiri;
• adatsimikizira momwe zilili zoyipa zamkati.

Kuthandizira opaleshoni kumatha kuchitidwa ndi njira zingapo.

Kuongolera kapena kufinya kwamkati mwa kupyoza kwa cyst ndi singano yopumira.

Izi zimachitika nthawi yomweyo ndi ultrasound ndipo imagwiritsidwa ntchito ngati chotupa cha thupi kapena mutu.

Panthawi yopusitsa, zonse zomwe zimachotsedwa pamutuwu ndikuyambitsa chinthu cha mankhwala (sclerosing) kapena chubu chamadzimadzi amaikiratu mpaka madzi atasiya.

Mtundu wa opaleshoni yamtunduwu amaonedwa kuti ndiwowopsa ndipo sikuti umabweretsa zovuta.

Laparoscopy - zosankha zotere pakuchotsa ma cyst, ngakhale zili ndi zabwino zambiri, koma zimatha kugwiritsidwa ntchito ndi zotupa zokha.

Pakupanga opaleshoni, mapangidwe ang'onoang'ono amapangidwira m'matumbo momwe chikhazikitso chomaliza chimayikidwira ndipo ma cysts amachotsedwa:

1. Kusangalatsa. Ngati kapisozi kali padziko lapansi, ndiye kuti amatsegulidwa ndipo zonse zomwe zimachotsedwa zimachotsedwa. Pambuyo zamkati amathandizidwa ndi antiseptic ndi sutured;
2. Kuyambiranso gawo la chiwalo. Imachitika ngati gawo lalikulu la chotupa m'thupi. Chitani kuchotsa kwa neoplasm pamodzi ndi gawo la chindacho. Zotsatira zake, chiwopsezo cha kubwereranso kumachepa;
3. Opaleshoni Frey. Amachitika ngati akutambasula kutulutsa kwa ndulu ndi ma cystic mapangidwe mumutu wa chiwalo. Pambuyo kukhathamiritsa kwa kapisozi limodzi ndi mutu, kusoka kwa nembanemba wamatumbo ocheperako ndi duct yowonongeka kumachitika, komwe kumathandizira kutuluka kwa madzi a m'mimba.

Laparotomy - opaleshoni yam'mimba yochitidwa ndi disgment ya khoma lakunja kwa peritoneum. Kulowerera koopsa kwambiri, komwe kumafunikira nthawi yayitali, koma ndikofunikira ngati ndi vuto loipa.

Kuwona kwakukulu kumathandizira dokotalayo kuchotsa chotupacho popanda kuwononga chipolopolo chake ndikuletsa kufalikira kwa zomwe zili mkati monse pamimba. Pa nthawi ya opareshoni, kuyang'ana kwa chotupa, gawo la ndulu kapena chiwalo chonse chitha kuchitidwa. Pamaso pa metastasis, ndizotheka kuchotsa ziwalo zina zoyandikana.

Kodi kapamba angachiritsidwe ndi mankhwala wowerengeka?

Njira zina sizothandiza ma chotupa cha pancreatic, komabe, kuphatikiza ndi chithandizo chokwanira, amatha kupewa kuyambiranso pambuyo pa opaleshoni yochotsa cyst kapena kuletsa kukula kwa mapangidwe a cystic;

1. Njira yosavuta ndikudya stonecrop. Itha kuwonjezeredwa ku saladi kapena kungodya masamba atatu tsiku lililonse.
2. Wiritsani kapu yamadzi ndi kutsanulira supuni ya calendula ndi tansy, ndi uzitsine wa nthanga zanthete. Imani maola angapo ndikumwa 50 ml tsiku lililonse kwa masabata anayi.
3. Pangani zosowa zofanana za ma stigmas a chimanga, masamba a nyemba, lingonberry, sitiroberi ndi masamba a mabulosi. Wiritsani 250 ml ya madzi ndi kutsanulira 20 g a osakaniza. Khazikikani kwa maola 12 ndi fyuluta. Masabata awiri m'mawa kumwa 100 ml ya kulowetsedwa. Tenga sabata imodzi ndikubwereza nthawi yomwe mwapangana.
4. Njira yabwino ndikuthandizira mbatata. Viyikani ndi tuber ya peeled ndikudya 1 tsp. Mphindi 30 musanadye chakudya cham'mawa. zamkati, pang'onopang'ono kubweretsa kutumikiridwa supuni yayikulu. Bwerezani kwa milungu itatu, pambuyo pake pumulani milungu iwiri ndikubwerera kukalandira. Mutha kulowetsa gruel ndi madzi a mbatata omwe angolowa kumene ndi kumwa tsiku lililonse mugalasi.
5. Amakhala mu kapu yamadzi otentha 10 g osakaniza yarrow, calendula ndi celandine. Tetezani maola angapo ndi zosefera. Tengani 50 ml ya kulowetsedwa.

Ngati simukuyambitsa matenda, chotsani mapangidwe ake a cystic munthawi ndikutsatira malangizo a dokotala, ndiye kuti matendawo ndi abwino. Zowona, pali kuthekera kwa miyambo yatsopano m'mapamba, koma kupenda pafupipafupi ndi kudya, komanso moyo wathanzi, kumachepetsa chiopsezo chobwereranso.

Kanema wochokera kwa Dr. Malysheva okhudza khansa ya kapamba ndi momwe mungapewere:

Ngati mapangidwe ake ndi owopsa, ndiye kuti mwayi wokhala ndi zotsatira zabwino ndi wocheperako, chifukwa khansa ya kapamba ndiosachiritsika ndipo imadziwika chifukwa cha kuchuluka kwa metastases.