I-pancreatitis (ikhodi ye-ICD K85 ne-K86) yisifo samanyikwe lapho ukusebenza kwawo kuphazamiseka khona. Ngaphakathi kwesitho sakhiwe ngamaseli amaningi we-microscopic - i-acini, exhumeke yenethiwekhi yama-ducts. Kukulezi zingxenye lapho ukwakheka kwama-enzyme wokugaya ukudla kwenzeka ngendlela engasebenzi. Ngaphezu kwalokho emaceleni, ayakhululwa kukhanyise i-duodenum. Ngokuvamile, ukwenziwa kwejusi le-pancreatic kwenzeka emathunjini lapho kuxutshwa nokudla okuvela esiswini.
I-pancreatitis inguquko yokuvuvukala kwezicubu zamanyikwe. Ngalesi sifo, kusebenze ngaphambi kwesikhathi ama-enzymes wokugaya ukudla kwenzeka ngqo ngaphakathi kwe-acini kanye nama-ducts, okuholela ekuqhekekeni kwawo. Kamuva, izindawo ezinezingxenye ezonakele zithathelwa indawo yizicubu ezixhumayo, ezingakwazi ukukhiqiza noma yiziphi izinto ezisebenzayo.
Ngaphezu kwalokho, i-pancreas ingumkhiqizi we-hormone insulin, elawula okuqukethwe ushukela egazini lomuntu.
Ngokuya ngamandla wokuvuvukala, odokotela bahlukanisa:
- Isigaba esibi sesi sifo;
- Isigaba esingamahlalakhona.
Enye yezimbangela eziphambili ze-pancreatitis ubuthi obunobuthi obuhlukahlukene. Ubuthi obujwayelekile futhi obuvame ukusetshenziswa kubantu utshwala. Wonke umuntu ophuza utshwala ngezikhathi ezithile ubeka engcupheni yokuthola i-pancreatitis enotshwala enkambeni eyingozi noma engapheli.
Odokotela bahlukanisa ukubikezela okuhlukahlukene kokukhula kwe-pancreatitis engalapheki yotshwala:
- Ukuvinjwa kwe-duct;
- Imiphumela enobuthi ye-ethanol;
- Ukucindezelwa kwe-oxidative kwezicubu ze-gland kusuka emiphumeleni yemikhiqizo ye-metabolism yotshwala.
I-Alcohol nemikhiqizo yayo yokubola kwamakhemikhali emzimbeni womuntu ibe nomthelela ongemuhle emzimbeni wayo wonke. Isistimu yokugaya ibuye ihlupheke nokudla komuntu utshwala, okuthinta kakhulu izicubu zamanyikwe, zibuphefumulele ubuthi. Ukwakheka kwamaprotheni enjinini ye-pancreatic kuyanda, ukukhiqizwa kwe-hydrochloric acid kuyanda esiswini, ukukhiqizwa kwe-bile kusebenze esibindini, futhi ukuqina kwayo kuyanda. Inani elikhulayo le-gastric acid liba nomthelela ekutheni i-cholecystokinin ikhiqizwe ngemodi ethuthukisiwe futhi ukuqamba kwayo kukhulisa amashumi ezikhathi.
Iqoqo elikhula kakhulu lamaprotheni kujusi we-pancreatic liholela ekwandeni kwawo, emithini nokwakheka kokuqanjwa kwamaprotheni emigungwini yepancreatic. Ngenxa yalokhu, ukuphuma kwemvelo kokukhulula kusuka kumanyikwe kuya emathunjini kuyaphazamiseka. Ngenxa yokuba khona kwalezi zakhiwo ezingenakusebenza, ingcindezi engaphakathi kwama-ducts iyanda. Ama-enzyme asebenzayo angena ngaphakathi kwezicubu ze-pancreatic.
Inani elikhulu lama-enzyme akhiqizwa amaseli we-pancreatic awasebenzi. Ngokugaya okujwayelekile, ukusebenza kwawo kwenzeka ezindongeni zama-ducts e-bile, ngemuva kwalokho abamba iqhaza ekuwohlokeni kwamaprotheni, amafutha kanye nama-carbohydrate. Uma ukuphuma kwejusi le-pancreatic kukhubazekile, kusebenze i-enzyme ngaphakathi kwe-gland uqobo. Izicubu ze-pancreatic zigcwele ngama-enzymes wokugaya, kufaka phakathi i-phospholipase, pepsin, elastazin, kanye ne-chymotrypsin agent. Lokhu kuholela eqinisweni lokuthi ama-enzyme aqala ukugaya izicubu zawo ze-pancreatic.
Inqubo yokubola yangaphakathi nokufa ibizwa nge-necrosis. Ukufa kwamangqamuzana e-pancreatic akhulula i-serotonin, okudingekile ukuncipha kwemithambo yegazi, namaseli emast, okubangela izinqubo zokuvuvukala. Konke lokhu kunikeza inqubo enzima kakhulu yokuma noma yelaphe ngaphandle kokungenelela kwezokwelapha nemithi ekhethekile.
Ukuba khona kokudakwa kwe-pancreatic kunqunywa kalula ngokuhlaziywa kwe-biochemical kwegazi lesiguli, lapho kunokwanda kwe-phosphatase ye-alkaline, i-amylase, kumchamo, ukubonwa okuphezulu kokugqamile, umbala wesikhumba esiswini unemabula ne-cyatonic, izitho nobuso bungumbala we-cytonic ngombala. Ukushintshwa okunjalo kombala wesikhumba kwenzeka ngokuhlobene ne-lesion enobuthi yama-capillaries angama-subcutaneous.
Odokotela bahlukanisa izici eziningana ezifaka isandla ekuqhubekekeni kwe-pancreatitis enobuthi:
- Ukuphuza utshwala obuningi. Ubuthi obudakayo kanye namanyikwe kuxhumene kakhulu, ngoba umenzeli we-causative ubudwala obuphansi bezinga eliphansi;
- Ukwephulwa kwepheshana elisebenzayo, ukuba khona kwamagallini kuwo;
- Ukudla okungenampilo nge-predominance yamafutha, usawoti nokudla okubhemayo ekudleni;
- Ukuxilongwa ngenxa yokutheleleka, ukuhlukumezeka esiswini noma kumanyikwe, ukusabela emithini
Izimpawu ezilandelayo zingakhombisa ukwanda kwe-pancreatitis enobuthi:
- Ama-shingles wezinhlungu ezinzima, ikakhulukazi zasendaweni ku-hypochondrium nasemgodini wesisu;
- Ukwanda okuthe xaxa kwezinga lokushisa lomzimba (ngaphezulu kwama-38 degrees Celsius) kanye nokwanda kwenhliziyo;
- Ukuphambukiswa kokudla (kuvela ngenxa yenani elanele lama-enzyme e-pancreatic emathunjini), isicanucanu nokuhlanza;
- I-Pallor yesikhumba, ezindaweni ezimnyama;
- Ukuqhakaza okunamandla, umuzwa "wokugcwala" ngisho nesisu esingenalutho;
- Ngokulahleka okukhulu koketshezi komzimba, izimpawu zesimo sokuthuthumela ziyabonakala;
- Ukwephulwa kwesitulo (imvamisa kakhulu yesisu).
Kufanele unake iqiniso lokuthi iningi lezimpawu ezingenhla zisezingeni lezifo zesisu, amanyikwe noma amathumbu.
Izimpawu zokuvuvukala zengezelelwa ukungajwayelekile, ubuthakathaka, ukungabi nandaba nokuphila.
Ubunzima bezimpawu buzoxhomekeka ngokuphelele ebukhali be-pancreatitis.
I-pancreatitis enobuthi inezinkinga eziningi ezingenzeka uma isiguli singazilandeli izincomo zikadokotela, singalandeli ukudla, futhi sisebenzisa kabi utshwala.
Imiphumela elandelayo yokuthuthuka kwe-pathology kungenzeka:
- Ukuqoqwa okungamanzi okujulile kwe-pancreatic cavity;
- Ukuthuthukiswa kwe-toxicosis kwezicubu;
- Ukuqhubeka kwe-pancreatic necrosis;
- Ukufa kwezingxenye ngazinye zezicubu eziyinhloko ze-gland;
- Ukubukeka nokukhula kokuncipha, okungaba imbangela yokufa kokukhula kwesifo;
- Ukuqongelela uketshezi ngesimo se-pancreatic juice ezungeze udonga lwe-fibrous;
- Ukuthuthukiswa kobumbano;
- Ukwakheka kwezilonda zamanga ze-cystic;
- Isigaxa se-pancreatic.
Umgomo wokwelapha iziguli ngemithi ye-pancreatitis yile:
- Ukuncishiswa kobuhlungu;
- Ukuthukulula kusuka emzimbeni;
- Ukunikeza umphumela ovuselelayo ukuze kusebenze kabusha kwezindawo ezonakele ze-gland.
Ukuze kuhlanzwe i-plasma yegazi nokugeleza kwe-lymphatic emzimbeni wonke, odokotela banquma iqoqo lezinqubo ezikhuthaza ukukhipha izidakamizwa emzimbeni. Ngaphezu kwalokho, iziguli zinqunyelwe:
- Izidakamizwa ezibukwayo ze-antibiotic, ezibandakanya i-metronidazole, i-flagyl ne-ceftriaxone. Babekelwe ukuthi banciphise ukuvuvukala futhi bacindezele ama-microflora angama-bacterium, athinta kabi isitho;
- Izidakamizwa ze-Spasmolytic, phakathi kwazo okukhona kuzo i-Promedol, i-No-Shpa, i-Papaverin, i-Novocain, i-Plifillin ne-Metacin kusebenza kakhulu. Zisetshenziselwa ukudambisa i-spasm ku-bile and pancreatic ducts, kanye nokudambisa izinhlungu;
- Ukulungiselela kwe-Antacid okusebenza ukunciphisa izinga lokukhiqizwa kwezakhi ze-enzymatic gland;
- I-proton pump inhibitor imiselwe ukucindezela umsebenzi wama-enzymes ocushiwe kumanyikwe, aqinisekise ukubhujiswa kwayo kusuka ngaphakathi;
- Isisombululo samaprotheni kasawoti sisetshenziselwa ukulungisa i-acid, i-alkali, amanzi ne-electrolyte ibhalansi;
- Ukusetshenziswa kwama-cytostatics, elinye lawo yiFluorouracil. Kubekelwe ukunciphisa izinga lokudakwa kwamanyikwe.
Esimweni lapho ifomu elinobuthi lesifo sesitho lifinyelela esigabeni esilandelayo, esibonakaliswa yisimo nemiphumela emibi kakhulu, futhi libizwa nge-purulent pancreatitis, ukuphela kwesinqumo esifanele ukuhlinzwa.
Ezimweni zesimo sezokwelapha zesimanje, isilinganiso esivame kakhulu sokuhlinzwa yi-laparoscopy, okungelona elibuhlungu futhi elibuhlungu ngokulimala kwezilonda ezihlukahlukene zepancreatic.
Ukuvimbela i-pancreatitis yotshwala kufaka izindlela nezindlela eziningi, phakathi kwazo ezibaluleke kakhulu yilezi:
- Ukudla okunempilo ngokulinganayo, ukudla inani elanele lamaprotheni;
- Ukwenqaba ukusetshenziswa kotshwala, ikakhulukazi ngokudla okunamafutha amaningi;
- Ukubhema ukuyeka;
- Ukuhlolwa njalo ngudokotela wamathambo - isikhathi esingu-1 ngonyaka.
Mayelana ne-pancreatitis kuchazwe kuvidiyo kule ndatshana.
