Imibhalo evame ukubuzwa ukuthi ifakiwe yini empini nge-pancreatitis.
Naphezu kweqiniso lokuthi lokhu kugula kubonakaliswa ukuvuvukala kwamanyikwe futhi kudinga ukwelashwa okuqhubekayo, akusona isimo esingenamibandela sokuxolelwa empini.
Umbhalo ojwayelekile "ISheduli Yezifo" (Isahluko 59) unquma ukufaneleka komuntu osemusha kwezempi, kuya ngohlobo nobunzima be-pathology.
Ukubuka Pancreatitis
I-pancreatitis ihlanganisa inkimbinkimbi yezifo nama-syndromes lapho kukhona ukwephulwa komsebenzi we-exocrine pancreatic.
Imvamisa, kukhiqiza ama-enzymes akhethekile (amylase, proteinase, lipase), adingekayo kwinqubo yokugaya ukudla. Ukuba sesisungu uqobo, akusebenzi, kepha lapho engena esilonda se-12 duodenal, kuthathwa ijusi le-pancreatic.
Ngalesi sifo, ama-enzyme wokugaya asebenza kumanyikwe bese eqala ukuwalungisa. Umphumela ukubhujiswa kwe-parenchyma nokufakwa esikhundleni kwayo ngezicubu ezixhunyiwe. Inkambo yesifo eqhubeka isikhathi eside iholela ekwephulweni kokucasulwa kwangaphandle nokwangaphakathi kwesitho.
Izimbangela eziphambili ze-pancreatitis yilezi:
- ukusetshenziswa kabi kotshwala;
- ukudla njalo okuthosiwe nokunamafutha;
- isifo se-gallstone;
- ukudla ngokweqile ngemuva kokubulawa yindlala noma ukudla okuqinile;
- ukungalingani kwe-hormonal ngesikhathi sokukhulelwa, ukuya esikhathini, ukuthatha izindlela zokuvimbela inzalo ngomlomo.
Ngokuvamile i-pancreatitis esebenzayo, noma i-pancreatitis yesibili ivela ngokungemuva kwamanye ama-pathologies. Abantu abane-gastritis, izifo zamathumbu, i-cirrhosis yesibindi, i-hepatitis engatheleleki kanye ne-dyskinesia ye-gastrointestinal tract basengozini.
Izimpawu eziphambili zalesi sifo zibandakanya izinhlungu e-hypochondrium yangakwesobunxele, ukuncipha kokusebenza, ukuqwasha okuvamile, ukugabha, isifo sohudo, ukugcwala, isithofu (kanye nokuhlanganiswa kwezinhlayiya zokudla ezingafakwanga kanye namafutha), ukukhipha isikhumba, ukujuluka kokujuluka.
Kunezigaba ezahlukahlukene zesifo, ngokwesibonelo, uhlobo lwenkambo oludinga ukwabiwa kwe-pancreatitis e-acute, acute frequency, chronic kanye ne-extacerbated chronic pancreatitis.
Uhlobo olungapheli lwe-pathology lubonakala ngezimpawu ezinobumnene.
Ngakolunye uhlangothi, i-pancreatitis engamahlalakhona ihlukaniswe ngokuthembela kumoya (ngokubhekene nesizinda sokuphazamiseka ekusebenzeni kwamapheshana asesiswini) kanye ne-parenchymal (ngomonakalo we-organ parenchyma kuphela).
I-pancreatitis ye-inductee
Isahluko 59, "uHlelo lweZifo," sichaza izinhlobo zepancreatitis umuntu obhalile angasebenza embuthweni. Kuya ngokuthi i-pancreas ithinteka kanjani, futhi ukwanda kwesifo kuvame ukwenzeka.
Lo mbhalo olawulayo uqukethe amaphuzu ambalwa mayelana ne-pancreatitis:
- Ngokuphulwa okukhulu komsebenzi we-endocrine (ukukhiqizwa kwe-insulin ne-glucagon) nomsebenzi we-exocrine (ukukhiqizwa kwama-enzyme - amylase, lipase, proteinase).
- Ngokukhubazeka okuncane kokucashelwa kwangaphandle nangaphakathi kwe-gland. Ukuvela okusheshayo kokuxhamazela.
- Ngokuphulwa okuncane kwe-gland, lapho ukwakheka kwezindawo ezingama-necrotic akulona uphawu.
Into ngayinye ihambelana nezigaba ezithile (D, C, B, D) ezinquma ukuthi amadoda afanelekile yini ukusetshenzelwa Emabuthweni Anempi Yezwe laseRussia. Ngakho-ke, ungawazi amathuba akho kusengaphambili ngokubheka ukutholakala kolwazi nokwesesahlukweni 59.
Kufanele kuqashelwe ukuthi amaphuzu omibhalo olawulayo angashintsha. Yize kusetshenziselwe ukubhala imibhalo ka-2017, imininingwane yangonyaka ka-2014 isasebenza.
Ukufaneleka kwensizakalo kunqunywa ngudokotela obhalise empini abahlola ukutholakala kwemibhalo okukhona "ngeSheduli Yezifo". Lolu hlu lwezifo lukhawulela noma alufaki ngokuphelele amathuba okusebenza ebuthweni.
Ukwehla kwezifo
Ithebula elingezansi lizokusiza ukuthola ukuthi isigaba ngasinye kusesahluko 59 sisho ukuthini.
| Iqembu | izincazelo |
| D (ukukhululwa enkonzweni) | Ukuxilongwa: i-pancreatitis eyingozi ejwayelekile. Ukuphazamiseka ekusebenzeni kwendlala kuhambisana nokukhathala, uhlobo 2 sikashukela, isifo sohudo se-pancreatogenic, noma i-hypovitaminosis. Iqembu D labelwe i-pancreatectomy (ukususwa kwesitho) kanye nokuba khona kwe-pancreatic fistula. Le nsizwa ithola "ithikithi elimhlophe", eliqinisekisa ukungafaneleki kwakhe. |
| B (imikhawulo yensiza) | I-Diagnosis: I-pancreatitis engamahlalakhona ihlasela kaningi ngaphezulu kwezikhathi ezi-2 ezinyangeni eziyi-12, ukwehluleka kwezitho. Umuntu uthola ukukhululeka ngesikhathi sokuthula, kodwa nokho unikezwe isitoreji. Angakwazi ukwenza inkonzo ngesikhathi sezitha. |
| B (insizakalo enemikhawulo ethile) | Ukuxilongwa: uhlobo lwe-pancreatitis olungapheli ngokuxhuzula kungabi ngaphezu kwezikhathi ezi-2 ezinyangeni eziyi-12, ukungasebenzi kahle kwezomfihlo. Umbhalo uvunyelwe ukusebenza. Le mikhawulo isebenza kuphela emngceleni, amabutho ahamba ngezindiza, imashi kanye nensizakalo emathangini nasezitimeleni ezingaphansi komhlaba. |
| G (ukukhishwa kwesikhashana) | I-draftee kufanele ibonwe ngaphansi kwezimo zokwelashwa bese uthola ukwelashwa okuphuma ngaphandle kwezinyanga eziyisithupha. |
Umbuzo uhlala uthi ngabe babhalisiwe yini empini nge-pancreatitis engamahlalakhona. Ukuba khona kwalolu hlobo lwesifo kubeka imikhawulo ethile:
- Ukwehluleka ukusebenza ngesivumelwano senkontileka, naphezu kobunzima be-pancreatitis.
- Ukwehluleka ukufunda emanyuvesi ezimweni lapho umuntu osemncane enendlela yokuhlola izifo.
- Ukwehluleka ukusebenzisa i-FSB, i-GRU kanye noMnyango Wezimo Eziphuthumayo. Kodwa-ke, uma isimo sithuthuka, ukufaneleka kwendoda kungabhekwa.
Imibhalo yokuqinisekisa lesi sifo
Ukwamukela isigaba "D" noma "B" futhi ukhululwe emsebenzini wezempi, udinga ukwenza amalungiselelo emibhalo.
Kufanele baqinisekise ukutholakala kwe-pancreatitis, futhi futhi babe nemininingwane ngesimo esisebenzayo sesitho, ubulukhuni besifo, imvamisa yokuqhuma kwempilo ngalesi sikhathi samanje.
Ukususwa emsebenzini wezempi kubalulekile ukufaka:
- Amarekhodi okuqala ezokwelapha anezitembu nokusayina (noma amakhophi aqinisekisiwe).
- Imibuzo etholwe ku-gastroenterologist.
- Iziphetho ngesimo sempilo samadoda okwamanje, kanye nomlando wezokwelapha Imibhalo enjalo ingathathwa emtholampilo lapho uhlala khona.
- Imiphumela yokuhlolwa kwebhubhoratri neyokusebenzisa izinsimbi (i-ultrasound, i-CT, i-MRI, i-radiography, njll.
- Imininingwane mayelana nokwelashwa kwe-inpatient emnyangweni wokuhlinzwa noma i-gastroenterology, okukhombisa ukuthi kuhlaselwa kakhulu i-pancreatitis.
Endabeni yokunikeza isethi yemibhalo engaphelele, kepha ngezimpawu ezithile, imiphumela yokuhlolwa kanye nombono wochwepheshe, umbhali unikezwa isigaba "G". Sekuphele izinyanga eziyi-6 egadwe ukuthi ayoqhubeka nokuhlolwa.
Kumele kuqashelwe ukuthi uma kubhekwa i-pancreatitis emsebenzini wezempi, isosha lithola i-deferment isikhathi esithile noma ikhomishini.
Izinyathelo ezinjengale zinesizathu, ngoba i-pancreatitis iyindlela ebucayi engaholela ezinkingeni ezahlukahlukene - i-pancreatic necrosis, isifo sikashukela, i-pancreatic abscess, i-cholecystitis, i-gastroduodenitis, i-jaundice evimbayo, ukudakwa kakhulu, ukwakheka kwe-cyst nokufa.
Ukuhambisana kwemiqondo efana nebutho kanye ne-pancreatitis kuzoxoxwa ngakho uchwepheshe kule vidiyo ekulesi sihloko.
