I-pancreatitis yisifo esingalashwa ngendlela yokubhula noma yokuhlinzwa. Isinqumo sokusebenzisa le ndlela noma leyo ndlela kufanele senziwe ngokuya ngobufakazi.
I-blockade ene-pancreatitis iyasiza ekulweni nokudakwa, futhi iphinde ivimbele ukukhula kwe-pathological gland. Ngaphambi kokulapha i-pancreatitis, kuyadingeka ukuthi uhlole nge-puncture, engembula ukwakheka kwe-fluid noma inqwaba yokuvuvukala, engabhekwa ngesikhathi sokuhlolwa kwe-ultrasound.
Njengoba indlela yokusebenza isadumile, ayikwazi ukuncintisana nendlela yokulondolozwa, evame ukusetshenziswa futhi isetshenziswe. Noma iyiphi yalezi zindlela ihlose ukunciphisa ukuhamba kwe-secretion emiphungeni, kanye nokunciphisa izinhlungu kanye nokuqeda izimpawu zokungasebenzi kahle kwe-pancreatic.
Ukwelashwa okukhanyayo kwe-pancreatitis
Ukwelashwa kokugada kubandakanya umgomo we-blockade ngosizo lwe-analgesics:
- Ukuhlaziya;
- I-Promedol;
- I-Novocaine.
Ama-antispasmodics aqinile ayasebenza futhi:
- Cha-shpa;
- Papaverine;
- I-Nitroglycerin.
Isigaba sokuqala somuthi sibaluleke kakhulu ekuqedeni izinhlungu ezinzima kumanyikwe. Ngaphezu kwalokho, odokotela babhekene ne-anti-shock therapy uma i-syndrome yezinhlungu ikhula ngokushesha okukhulu.
Indlela yokulondolozwa ayinalo uhlelo olucacile lokusebenza, futhi noma yiziphi izindlela zokwelapha zisekelwa ezinkombeni zomuntu ngamunye zesifo ngasinye. Ukwelashwa kungahluka kuphela kubantu abanezinkinga zesistimu yezinhliziyo, kanye nalapho kukhona umdlavuza nesifo sikashukela. Ezimweni ezinjalo, imithamo yemithi ilawulwa ngokuya izinkomba zokuhlaziya.
Ngaphezu kokunciphisa izinhlungu, kudingeka imijovo ekhipha ubuthi futhi iqinise ukuphazamiseka kwe-metabolic. Imvamisa, le mithi yile:
- Magnesium
- I-calcium
- Ama-electrolyte ahlukahlukene.
Kuhlanganiswe nosawoti, isiguli sinikezwa imijovo e-intravenous kuzo zonke izinsuku zokwelashwa.
Ngaphezu kwalokho, i-blockade of pancreatitis ivela ngesikhathi sokwelashwa ngendlala kanye nokudla kwamanzi amaminerali (Borjomi). Ukuphumula ngokuphelele kwesiguli kubalulekile.
Ngaphezu kwalokho, ngokuya ngesimo sesiguli, kudalwa izidakamizwa ezisekela izitsha zamanyikwe, isibindi nezinso. Lokhu kubalulekile, ngoba noma yikuphi ukwelashwa ngemithi elwa namagciwane anamandla kungaphazamisa izitho zomzimba futhi kudale ubunzima ngezindlela zokwehluleka kwezinso.
Indlela yokulondolozela ivimbela ukuqala kokutheleleka, okungagcina sekuguqukele esimeni esingamahlalakhona se-pancreatitis.
Le ndlela iyatholakala ukuqhuba esikhungweni ngasinye sezokwelapha, kepha idinga ukucutshungulwa kokuqala.
Ukwelashwa okuqandayo kwe-pancreatitis eyingozi
Ukwelashwa okuqapha i-pancreatitis eyingozi kwenziwa ngokusebenzisa ama-painkillers afanayo angaqeda i-spasm. Kulokhu, kusetshenziswa ukunyakazisa okuhlukahlukene kwezidakamizwa futhi kubhekelwa isiguli nge-dropper.
Le ndlela ivumela isiguli ukuba sizwe ukukhululeka ngokushesha, futhi futhi kusiza ukulala. Ngokuya kwengcindezi yegazi, ishayela, futhi nakushintsho lwe-hematocrit, inani lama-painkiller alawulwa lincike. Imvamisa kuba ngamalitha ama-2 amanzi (ama-electrolyte, ushukela ngokuhlanganiswa ne-2% promedol noma atropine).
Baphinde basebenzise i-blockade ene-novocaine, esiza ukwehlisa umfutho wegazi, ukuthambisa isiguli bese isebenza njengamaphilisi okulala. Uma i-novocaine blockade ingabonakali futhi ingasebenzi, lokhu kukhombisa ukuqothuka kwepancreatitis futhi kukhombisa ukwelashwa okuhlinzwa. Kulokhu, isiguli asizizwa izinhlungu.
Kuhle ukukhumbula ukuthi usuku lokuqala lokuthola izinkinga lubaluleke kakhulu, ngoba zidinga ukuphumula kombhede nemijovo esifike ngesikhathi. Njengoba i-pancreatitis ebukhali ingaphenduka ifomu elimazayo, ibangele ukwakheka kwe-purulent, i-cholecystitis, futhi, kuya ngezifo kanye nobuthi, kungaholela ekufeni.
Ukucindezela ukufihla kwe-pancreatic kwifomu elibi, ama-anti-enzymes asetshenziswa enza ukungalingani kwe-acidity yejusi yesisu bese kusebenza njengohlelo lokudonsa amanzi emiseleni ye-bile. Ngaphezu kokuphumula kombhede nokubandakanyeka okubandayo esiswini, kuvame ukusetshenziswa umphenyi, osetshenziselwa i-hypothermia yendawo. Yize le ndlela ibhekwa njengengasebenzi kakhulu, kwesinye isikhathi isetshenziswa ngokucela isiguli, ukunciphisa izinhlungu.
Ngaphezu kwalokho, i-probe ingafakwa kusetshenziswa ishubhu emlonyeni, okuhlinzekwa ngalo amalungiselelo akhethekile, anjengokuthi: contracal, tzolol. Le nqubo isetshenziswa ezimweni ezingandile, futhi kungenzeka lapho isiguli singazi. Ngaphezu kwalezi zidakamizwa, i-atropine ne-promedol nazo zisetshenziswa njengama-painkiller.
Ekwelapheni i-pancreatitis eyingozi, ukwelashwa okuphathelene nokungena emzimbeni kuyadingeka, lapho izinsuku ezingama-4-5, isiguli sifakwa nge-trasilol yezidakamizwa (imayunithi ayi-10,000 yomuthi ngosuku). Umuthi uqukethe inani elifanele lama-antienzymes, futhi awubangeli imiphumela emibi, ebalulekile ekuphendukeni komzimba okungenzeka. Ukwelashwa kwenziwa kusetshenziswa uhlelo lwamamoya nge-aorta, umuthi udliswa isikhathi esingu-1 ngosuku ngendlela yaso emsulwa. Ukwelashwa okunjalo okuqeda amandla kusheshe kudambise ukuvuvukala kwamanyikwe nesisu, kuvimbele ukuvela kwezifo ezithathelwanayo, futhi kuvimbele nokuvela kwe-necrosis.
Uma isiguli sinezifo ezifana ne-cholecystitis, isimila sesisu, izinkinga ezahlukahlukene zangemva kokusebenza, umphumela we-inhibitor kungenzeka ungakhulunywa ngokwanele. Ezimweni ezinjalo, kusetshenziswa izidakamizwa ezengeziwe ezithuthukisa umphumela we-trasilol.
Izindlela zokulondolozwa zokwelapha i-pancreatitis ebukhali zibandakanya ukusetshenziswa kwezidakamizwa ze-steroid ezisiza ukuqeda ukuwa nezinkinga esigabeni esibi sesifo. Futhi yize bengekho odokotela abaningi abayibona le ndlela, inendawo ongayisebenzisa.
Izikhathi eziningi kakhulu, iziguli ezine-pancreatitis eyingozi zivame kakhulu ukugula nge-cholecystitis, eziyinkimbinkimbi inqubo yokwelashwa futhi ngokunokwenzeka zibe nomthelela ekwakhekeni kwe-purulent. Futhi lapho unquma izidakamizwa zokulwa namagciwane, udinga ukuzihlanganisa nezidakamizwa ezingezekile. Uma ngabe i-dioxin isetshenziswa, khona-ke i-antibiotic eluhlobo lwe-penicillin ilungele kangcono kuyo. Okuzosebenza njenge-antiseptic, kanye nokulwa ukutheleleka kanye nobomvu.
Ukusetshenziswa kwama-antibacterial antibiotics kanye nemithi kuyadingeka, ngoba imvamisa izimbangela ze-pancreatitis ziyi-pathologies yepheji le-biliary, futhi ukuvuvukala kwenzeka ngenxa yamagciwane we-staph kanye nama-bacterium e-streptococcus.
Ezigulini ezine-pancreatitis engapheli, kuyadingeka ukuthi ungeniswe esibhedlela izikhathi ezimbili ngonyaka, ezizonciphisa ubungozi bokuqhuma, kanye nokunciphisa izinhlungu.
Ngaphezu kwalokho, ukuzila ukudla njalo nokusetshenziswa kwama-compress abandayo kuyadingeka.
I-Acute Pancreatitis: Ukwelashwa Okuhlinzwa
Uma kuphakama izinkinga ngesikhathi sokwelashwa okulondoloziwe, i-peritonitis noma ukwelashwa okunjalo akuzange kulethe imiphumela oyifunayo. Ezimweni ezinjalo, ukuhlinzwa kuyasetshenziswa. Usebenzisa i-laparoscopy, unga:
- ukucekela phansi umthombo we-peritonitis;
- ukusungula umsebenzi wama-enzymes kumanyikwe;
- ngokushesha lungisa inkinga.
Ukwelashwa kokuhlinzwa kanye ne-laparoscopy ngokwayo kwenzeka ngezigaba ezimbili:
- I-Diagnosis, enquma uhlobo lwe-pancreatitis, kuzoba isithombe esinemininingwane yezindawo ezithintekile.
- Ukuziphatha kwe-intraperitoneal perfusion.
I-lapaparoscopy ye-pancreas ibaluleke kakhulu ekuxilongeni, ngoba ikuvumela ukuthi ukhombe i-pancreatic necrosis, ekhombisa i-foci ethintekile yamathafa anamanoni. Zingatholakala kwizicubu ze-adipose, zilimaze i-ligament yesisu, kanye nezindawo ezithinta amathumbu amancane. Zonke lezi zindawo ezincane zithinta kakhulu ukwelashwa, futhi uma zingatholakali ngesikhathi, zinganda ngokushesha okukhulu.
Ngosizo lohlelo lwe-drainage, oluxhunywe emseleni ongasemuva naku-pelvis encane, kususwa amashubhu akhethekile aqondisa isisombululo esikhethekile emgodini we-intra-esiswini. Imvamisa isisombululo esisuselwa ku-trasilal kanye ne-contractil esesilinganisweni se-10: 1.
Esigulini ngasinye, isikhathi se-perfusion sinqunywa ngawodwana futhi siyamiswa lapho umbala we-ketshezi ophumayo uba umbala owamukelekayo kanye nokuhlaziywa kwe-enzyme kulungiswa. Uma zingekho izindlela zokwakha izihlanza kumkhumula futhi umbala onsundu okhanyayo - lokhu kuyinkomba eqondile yokunqamula ekuqothulweni.
Uma kuba nezikhukhula ze-peritonitis ezinezinkinga, ukufakwa kwethambo kwenziwa kusetshenziswa amanzi angaphandle nge-thoracic duct. Ukuphathwa okunjalo akuvamile ukwenziwa, futhi kuphela lapho impilo yesiguli isengozini, futhi ezimweni lapho isiguli sisekuwohloka.
Ukungenelela kokuhlinzwa kuyadingeka ezigulini ezine-pancreatitis engapheli ngesikhathi sokuqothuka ukuze kuqedwe ukutheleleka okungenzeka nokuvimbela ukwenzeka kwabo.
Lapho wenza ukwelashwa kokuhlinzwa kwe-pancreatitis eyingozi, kufanele unake ngokukhethekile uhlelo lokuphefumula, ngoba izinga le-oxygen egazini liyancishiswa kakhulu, kudingeka izindlela ezengeziwe. Uma kungekho maski we-oksijini owanele, isiguli singakwazi ukuxhunywa komoya omncane wokuphefumula. Lokhu kungabuye emuva kwesikhathi kuholele ezinkingeni ezivela ekwelapheni i-pancreatitis.
Ngokuya ngemiphumela yokwelashwa, ezinye iziguli ngisho nangemva kokuhlinzwa zingahlakulela i-mellitus yesifo sikashukela, izimila ezahlukahlukene, ama-pancreas zivame ukudala i-cyst yamanga, futhi umphumela obulalayo kungenzeka ku-4% weziguli.
I-pancreatitis e-acute ichazwe kuvidiyo kule ndatshana.
