I-pancreatitis yiqembu lezifo kanye nokubonakaliswa kwemitholampilo, lapho izinqubo zokuvuvukala kumanyikwe ziqapheleka. "Izisulu" eziphambili ze-pathology zibandakanya abantu abaxhaphaza ukudla okunamafutha, iziphuzo ezidakayo.
Kufakazelwe ngokokuhlola ukuthi uhlobo olubi lwalesi sifo luyakhula ngenxa yethonya lezinto ezilimazayo. I-pathophysiology imelwa ukulimala kwemishini noma kwamakhemikhali okwenzeka ngenxa yomenzeli owonakalisayo - amakristalu kasawoti, i-bile, isixazululo se-hypertonic, njll. Izinto ezingena ezicutshini zesitho sangaphakathi.
Izibalo ziyabona ukuthi inqubo yokuvuvukala imvamisa itholakala kubantu besifazane kunakwabesilisa. Lesi sifo sithinta iziguli ezinomlando wezifo zesisu, ukukhuluphala.
Cabanga ngezigaba kanye nezinhlobo ze-pancreatitis, futhi uthole umehluko phakathi kwe-pancreatitis eyingozi nokuvuvukala okungamahlalakhona.
Ukuhlukaniswa Kwe-pancreatitis
Indlela yokukhula kwe-pancreatitis isuselwa ekukhuleni komthwalo ezinduneni, kanye nama-enzyme angena ezicutshini zesitho sangaphakathi ashukumisa inqubo yokubhujiswa. Uma i-pancreatitis enkulu ibonwa (kulokhu sikhuluma nge-necrosis yezicubu), khona-ke lesi sifo sihambisana necrosis yengxenye ebalulekile yamanyikwe.
Ukungazinaki izimpawu nokuntuleka kokwelashwa okwanele kuholela ku-necrosis elandelayo yezicubu ezinamafutha ezungeze ama-pancreas, ngenxa yalokho, inqubo ye-pathological isakazeka kwezinye izitho ezakhiwe endaweni ye-peritoneum.
Uma ama-enzyme wokugaya engena ngaphakathi kwesisu, i-peritonitis ingaqala ukukhula. Kulesi simo, ukungabikho kokulashwa kuholela ekuqhamukeni okungenampilo - umphumela obulalayo.
Emsebenzini wezokwelapha, izinhlobo nezinhlobo ze-pancreatitis ziyahlukaniswa. Ngokuya ngohlobo lwenqubo ye-pathological, lesi sifo siyi-acute, ibuye ibuye futhi, i-subacute, ihlala njalo futhi iyandisa uhlobo lohlobo olungapheli.
Izinhlobo zama-pancreatitis acute:
- Ifomu le-interstitial libonakala ngokuvuvukala kwamanyikwe;
- Ukubukeka kwe-hemorrhagic kuhamba ngokubhekene nesizinda se-hemorrhage ku-gland;
- I-acute pancreatic necrosis ihambisana nokuhlanganiswa kwesitho sangaphakathi, kwakhiwa ama-foci wokubola kwezicubu.
Kwezinye izithombe, i-pancreatitis e-acute chronic iqhubeka kanye nenqubo yokuvuvukala okukuwo emzimbeni we-gallbladder - kulokhu, kutholakala ukuthi kune-cholecystopancreatitis. Ifomu le-purulent libonakala ngokwakhiwa kwamaphaphu kumanyikwe.
Noma yiluphi uhlobo lwe-pancreatitis ebukhali inamandla okuguqula, ngakho-ke ingasuka kwelinye iye kwelinye. Isibonelo, ukubukeka kwe-hemorrhagic kungashintshwa kube yi-tisc necrosis ngokwakhiwa okwalandela kwezixuku ze-purulent.
I-pancreatitis ye-acute iholela ezinkingeni ezahlukahlukene - ama-abscesses, ama-hemorrhages amaningi, i-fibrosis, i-atrophy yezicubu, njll. Uma kunezinkinga, i-prognosis ingaba mpofu, noma ngabe unikezwa umuthi owanele.
I-pancreatitis engapheli ibizwa ngokuthi ukuvuvukala, iqhubeka kancane kancane. Ngenxa yalokhu, i-fibrosis yezicubu ezithambile noma ukubalwa kwezicubu ze-pancreatic kuyabonakala. Ngokuphikisana nesizinda saleli fomu, ukuthethelelwa kuthathelwa indawo wukufikisa. Iziguli zivame ukuba nesifo sikashukela.
Ifomu elingamahlalakhona lihlukaniswe yizinhlobo ezilandelayo zenqubo ye-pathological:
- Ukubukeka kwe-Asymptomatic (latent) kubonakaliswa inhlala-kahle ejwayelekile yesiguli isikhathi eside.
- Uhlobo lwezinhlungu luhambisana nobuhlungu obuhlala bukhona esiswini, okonyuka kakhulu ngesikhathi sokuqunjelwa kwesifo.
- Ukubuka okuvamile. I-Pain syndrome yenzeka kuphela ngokumelene nesizinda sokuqhamuka kwalesi sifo.
Lolu hlobo lefomu elingamahlalakhona njenge-cystic pancreatitis lenzeka kanye nokwenziwa kwama-cysts. Baqinisile (akuxilongwa) futhi ngamanga (atholakala ezithombeni eziningi zemitholampilo).
Lapho kutholakala ukuthi kukhona i-pancreatitis esebenzayo, inkambo ebabazekayo yenqubo yokuvuvukala kuthiwa, ehlanganiswe nokwanda kwezifo ze-duodenum, isibindi, nezitho zepheshana lesisu.
Izimpawu ze-pancreatitis esibuhlungu
Amanyikwe yisitho esincane esenza imisebenzi ebaluleke kakhulu emzimbeni womuntu. Kubandakanya ukukhiqizwa kwama-enzymes wokugaya ukudla, okuqinisekisa inqubo yokugaya ejwayelekile nephelele. Kanye nokukhiqizwa kwe-insulin, ukuntuleka kwayo okuholela ekwakhiweni kwesifo sikashukela.
Umehluko phakathi kohlobo lwesifo esingalapheki futhi esibuthakathaka ukuthi ekugcineni, ukubonakaliswa kwesifo kuvezwa ngokwedlulele ngokwasemuva kokuhlaselwa. Isiguli sikhononda ngesifo esibuhlungu futhi esiphikelelayo sobuhlungu, ama-painkillers awasizi ukudambisa izinhlungu.
Indlela yokukhula kokuhlaselwa okubucayi ibangelwa ukubambezeleka kwama-enzyme emanyengeni nasemibeleni yesitho sangaphakathi, okuholela ekubhujisweni komthambo uqobo. Uma zingena ohlelweni lokujikeleza kwezimpawu, izimpawu zokuthi ubuthi bomzimba ziyabonakala.
Ngaphezu kobuhlungu, isiguli sinezimpawu ezinjalo:
- Ukushisa komzimba okuphezulu, umfutho wegazi ophansi noma ophakeme. Ngokuthuthuka okusheshayo kokuvuvukala, isimo sesiguli siwohloka ngokushesha, izinga lokushisa lingakhuphuka liye kuma-40 degrees, ukubalwa kwamamojuli we-arterial parameter kuyabonakala;
- Izici zobuso besiguli ziyalolwa, isikhumba siphenduke sibe mnyama. Uma kungekho lusizo, umbala wesikhumba uba mpunga futhi ube ngumhlaba. Isikhumba siyabanda ekuthinteni, simbozwe ngesithukuthuku esinamathele;
- Ukuhlaselwa isicanucanu, i-hiccups, ukugabha. Imvamisa lezi zimpawu zihambisana nomlomo owomile, i-belching. Ukuqunjelwa akuyilethi impumuzo, ekuhlanzeni kukhona i-bile / izingcezu zokudla ezingaphanjwanga;
- Ukuntuleka kwesifiso sokudla. Ukudla kuvusa ukuhlanza okungenakugwenywa. Ekuqaleni kwesigaba esibi sesifo, akukho kungakhulunywa ngokudla, ngoba ukulamba yisimo esiyinhloko sokwenza impilo yenhle yesiguli;
- Ukuphazamiseka kwendlela yokugaya ukudla, okukhonjiswa yizitulo ezihlala njalo nezicashile noma ukuqunjelwa isikhathi eside. Ngokuphikisana nesizinda se-pancreatitis, indle ekupendweni okuningi kunoketshezi, ngesigaxa sogwebu, kunezinhlayiya zokudla okungaphanjwanga;
- Ukuphefumula kufiphala ngenxa yokulahleka kwama-electrolyte ngesikhathi sokuhlanza. Ngaphezu kwalokho, ukujuluka okuphezulu kuyabonakala, kunobumba obuningi baphuzi olimini lomuntu.
Ezinye izinkomba zokuhlaselwa ngamandla zihlanganisa ukuqhakaza, igesi eyandayo, ukugqama kwesikhumba, kanye nokuxineka kwe-sclera. Ngalezi zibonakaliso, isikolo sihamba imizuzu, ukunakekelwa kwezokwelashwa ngokushesha kuyadingeka.
Ukwelashwa kwe-pancreatitis eyingozi
I-pancreatitis eyingozi futhi engamahlalakhona inomehluko othile hhayi kuphela ekujuleni kwezimpawu, kodwa nasekwelashweni. Umehluko ukuthi ukuhlaselwa kakhulu kumele kumiswe ngaphansi kwezimo zokuma, ngaphandle kwalokho imiphumela ingabulala.
Usizo lokuqala esigulini lusekhaya ngaphambi kokufika kochwepheshe bezokwelapha. Ukudambisa izinhlungu, kubanda kubanda esiswini. Ukusetshenziswa kwezidakamizwa ze-antispasmodic, isibonelo, i-Papaverine, kuvunyelwe. Qiniseka ukuthi wenqaba noma yikuphi ukudla.
Isisekelo sokwelashwa okuphumelelayo yindlala, ukuthula nokubanda. Akunconywa ukuthi ubandakanyeke ekwelashweni kokuzelapha, ngoba kunamathuba aphezulu okuthi kube nezinkinga ezahlukahlukene zesifo.
Usizo oluphuthumayo lapho kufika iqembu lezokwelapha liqukethe lezi zenzo ezilandelayo:
- Ukwethulwa kwe-dropper ene-saline.
- Umuthi we-antiemetic, isibonelo, i-Cerucal kumthamo we-10 mg.
- Ukufakwa komuthi obulala izinzwa - uKetanov.
- Umjovo wemithi ye-antisecretory kumthamo we-250 mg.
Isiguli kufanele silaliswe esibhedlela. Njengomthetho, ekuhlaselweni okunamandla, ukuxilongwa okuhlukile akwenziwanga, ngoba kulula kakhulu ukuyihlukanisa nezinye izifo. Uma kukhona izinsolo zohlobo olonakalisayo lwe-pancreatitis, khona-ke ukungenelela kokuhlinzwa kuyadingeka. Ukwelashwa okuqhubekayo kwenziwa emnyangweni wokuhlinzwa.
Isibonakaliso senqubo ye-laparoscopic ukusola koketshezi emgodini wesisu noma izimpawu ze-peritonitis. Lokhu kwenziwa kungenziwa ukuze kucaciswe ubunzima bokuhlaselwa kakhulu.
Ukwelashwa kwe-pancreatitis esibhedlela kubandakanya:
- Ukusetshenziswa kwezidakamizwa zokugaya ukuvimbela ukudumba kwesitho sangaphakathi nokususa ama-enzyme wokugaya egazini. UFurosemide noma iDiacarb inqunyelwe (ifomu lethebhulethi);
- I-Omez inconywa kumthamo we-80 mg ngosuku;
- Uma ukuhlanza sekukhona, kunconywa ukuphathwa kwe-metoclopramide ngaphakathi kwethambo;
- Esikhathini esibuhlungu senqubo yokuvuvukala, ama-inhibitors wokugaya ukudla anqunyelwe empeleni. Abamele iqembu yiGordoks, Kontrikal.
Izinsuku ezingaba ngu-3-6, isiguli sinqunywe indlala nesiphuzo samanzi afudumele. Esimweni esinzima salesi sifo, ukuzila ukudla kuthatha izinsuku ezingama-7-14.
Endabeni yokugcina, ukondliwa kwabazali kuyadingeka - ukwethulwa kwama-protein hydrolysates nama-emulsions wamafutha.
Izici ze-pancreatitis engapheli
Ngendlela engapheli yesifo, kutholakala izinguquko zokuthinta izicubu zamanyikwe. Ochwepheshe abaningi bezokwelapha bakholelwa ukuthi umehluko omkhulu phakathi kwe-CP kusuka ekuhlaselweni okunamandla ukuthuthuka kokuguqulwa kwezidumbu emzimbeni wesitho noma ngemuva kokuqeda isici somthombo.
Ngokuphikisana nesizinda senqubo yokuvuvukala evilaphayo, ukuhluleka kwe-exocrine kanye ne-intrasecretory organ is zivame ukutholakala.
Ekukhuleni kwesifo esingelapheki lesi sifo, kuhlukaniswa izikhathi eziningana. Owokuqala angahlala iminyaka, kwesinye isikhathi azibonakalise njengezimpawu zesimilo, kanye nenkathi lapho ukwephulwa kuhambisana nomtholampilo onamandla, kunciphisa kakhulu izinga lempilo yesiguli.
Izimpawu zokulimala okungamahlalakhona ziqinile futhi zimnene. Imvamisa, phakathi kokukhulisa ngokweqile, kubonakaliswa ukuboniswa komtholampilo, okubonakaliswa ekuhlaselweni okunamandla kwalesi sifo.
Isiguli siyelulekwa ukuthi silandele njalo ukudla okuthile, siphuze imishanguzo yokuthola ukungabikhona kobuntu bokugcina, izidakamizwa ze-antispasmodic. Kunconywa ukwelashwa kwe-spa kabili ngonyaka.
Iphuzu elinzima kakhulu lokwelashwa ukudla. Akuzona zonke iziguli ezingala ukuphathwa okuthandayo nezitsha. Izimiso zokudla okunempilo:
- Ukudla okunezinhlanzana ezingxenyeni ezincane kuze kube izikhathi ezingama-6-7 ngosuku. Ungadla ukudla okufika kuma-230 g ngasikhathi.
- Ukwenqatshwa kokudla okunamafutha, okunezipayisi, okunosawoti nokunezipayisi.
- Ukwenqaba / ukukhawulelwa kotshwala.
Amaphutha ekudla okunempilo abonakaliswa yizinhlungu. Kuyafuneka ukudla kancane komkhiqizo onqatshelwe, futhi ngemuva kwamahora ambalwa, kuvela izinhlungu esiswini. Ukuqeda izinhlungu, sebenzisa umuthi:
- IDrotaverinum iyi-antispasmodic esiza ukudambisa ukuvuvukala kumanyikwe, ngokulandelana, isifo sezinhlungu siyancipha;
- I-Sparex iyi-antispasmodic, ebonakala ngesenzo se-myotropic. Ukhuphuka ukuminyanisa emgodini wesisu;
- Ngefomu le-edematous, u-Omez angabekwa ithebhulethi eyi-1 izinsuku ezintathu. Ukwemukelwa okwenziwa kuphela ezifundweni ezimfishane futhi njengoba kushiwo ngudokotela oya kuye.
Ngenkambo ende yesifo, izicubu ezijwayelekile ze-pancreatic zithathelwa indawo ngamanqamu anamafutha futhi axhumekile, okuvusa ukulahleka kokusebenza kwesitho sangaphakathi, ngenxa yalokho, isifo sikashukela siyakhula, futhi inqubo yokugaya ephelele iyaphazamiseka.
Ukuze unciphise izinhlungu futhi unciphise umthwalo esitho esonakalisiwe, kuyadingeka ama-enzyme wokugaya ukudla. Nikeza izidakamizwa:
- I-Pancreatin
- Festal.
- I-Panzinorm.
- UMezim et al.
Izindlela zokuvimbela izifo ezingalapheki futhi ezingamahlalakhona zifaka ukudla okufanelekile nokujwayelekile. Kunconywa ukunciphisa umkhawulo ukusetshenziswa kophuzo oludakayo, ikakhulukazi kuhlangene nokudla okunamafutha.
Mayelana ne-pancreatitis engamahlalakhona kanye ne-acute ichazwe ku-video kulesi sihloko.
