Ukuxilongwa ngesikhathi kwe-pancreatitis kungenye yezimo ezibaluleke kakhulu zokuthola isiguli ngempumelelo. Kodwa-ke, ngenxa yokuntuleka kokubonakaliswa okukhethekile komtholampilo, ngisho nochwepheshe abanolwazi ngesinye isikhathi abakwazi ukukuthola kusesekuqaleni futhi bawudidanise nezinye izifo zesistimu yokugaya, ngokwesibonelo, i-cholecystitis.
Ngenxa yalokhu, odokotela abakwazi ukunikeza ukunakekelwa okuyikho esigulini, okuthi kwezinye izimo kuholele ekwakhiweni kwezinkinga eziyingozi. Ukugwema lokhu, isiguli ngasinye sidinga ukwazi ukuthi ukuhlolwa kwe-pancreatitis kwenziwa kanjani, yiziphi izinhlobo zokuxilonga ezinikeza imiphumela enembile kakhulu nokuthi ungazilungiselela kanjani ngokufanele.
Izindlela zokuthola i-pancreatitis
Uma unezikhalazo ngomsebenzi wamanyikwe, kufanele uqale ubonane nodokotela ojwayelekile ozolalela izikhalazo zesiguli, enze ukuhlolwa kokuqala bese ebhala kudluliselwa kudokotela onguchwepheshe - udokotela obambele ubuchopho gastroenterologist noma endocrinologist.
Uchwepheshe onolwazi oluncane uzosihlola ngokucophelela isiguli, ahlole isisu sesisu nge-palpation, anake hhayi kuphela ama-pancreas, kodwa futhi nesisu, isibindi kanye nesinye inyongo.
Uma kusolakala ukuthi i-pancreatitis eyingozi, engalapheki noma esebenzayo, udokotela uzodlulisela isiguli ezindleleni zokuxilonga ezizosiza ekuxilongeni ngokunembile. Ukuthola umphumela ongcono kakhulu, isiguli sizodinga ukucubungula izinhlobo eziningana zocwaningo ngasikhathi sinye.
I-Algorithm ye-Pancreatitis Diagnosis:
- Ukuhlolwa kwegazi kwe-biochemical;
- Ukuhlaziywa kwe-Fecal;
- Ukuhlaziywa kwamachiza omchamo;
- Ukuhlolwa kwe-Ultrasound kwama-pancreas (ultrasound);
- I-X-ray, imaging yama-magnetic resonance imaging (MRI) ne-compact tomography (CT) yamanyikwe, isibindi, i-duodenum nesisu;
- I-pancreatic izicubu ze-biopsy;
- Ukuhlolwa kokuxilonga.
Okulandelayo, sibheka izindlela ezivame kakhulu nezisebenzayo zokuhlola i-pancreatitis.
Amakhemikhali egazi
Lokhu kuhlolwa kumele kudluliselwe kuzo zonke iziguli ezinenkinga ngamanyikwe. Kuzosiza ukukhomba inani lezimpawu ezibonisa ukukhula kwenqubo yokuvuvukala emzimbeni. Ngokusho kochwepheshe abaningi, ukuhlolwa kwegazi kuyindlela enembile kunazo zonke yokuthola i-pancreatitis.
Ukuhlolwa kwegazi kwenziwa kuphela esiswini esingenalutho, ngakho-ke kungcono ukusithatha ekuseni ngaphambi kokudla kwasekuseni. Ngosuku olwandulela isivivinyo, isiguli kudingeka silinganisele ekudleni okumnandi nokunzima, kanye notshwala nokubhema. Kulokhu, isidlo sokugcina akufanele sibe ngaphambi kuka-22: 00 pm.
Nge-pancreatitis, ukwakheka kwegazi lomuntu kuguquka kakhulu, okubangelwa inqubo enkulu yokuvuvukala kumanyikwe. Izinkomba ezilandelayo zibonisa ukuba khona kwe-pancreatitis esigulini:
- Ukuhlushwa okukhulu kwe-alpha-amylase egazini. Imvamisa, kufanele isuke ku-28 iye ku-100 U / L. Kubalulekile ukuqaphela ukuthi ukuqoqwa kwe-alpha-amylase kuqala ukwanda amahora ama-2 ngemuva kokuqala kwesifo;
- Inani elikhulu le-pancreatic amylase. Ebantwini abaphilile, kufinyelela ku-50 U / L;
- Isibalo samaseli amhlophe aphezulu. Imikhuba yabantu abadala isukela ku-3.98 iye ku-10,4 × 109 amayunithi / l;
- Isilinganiso esiphakeme se-erythrocyte sedimentation. Imvamisa, kubantu abadala, isukela ku-1 kuye ku-15 mm / ihora;
- Ukuhlushwa okukhulu kwe-trypsin. Kubantu abaphilile, imvamisa kuba ngu-25.0 +/- 5.3 mg / l;
- Inani elikhulayo le-lipase. Imikhuba yentsha ingafika ku-130 amayunithi / ml, kubantu abadala - amayunithi angu-190 / ml;
- Ukuhlushwa okukhulu koshukela wegazi. Imikhuba yabantu abadala isukela ku-3.3 iye ku-5.5 mmol / L.
Namuhla, izindleko zokuhlolwa kwegazi elinamakhemikhali aphansi ziphansi. Ngakho-ke inani eliphakathi lokuhlaziywa kwe-alpha-amylase lingaba ngama-ruble ayi-150.
Ukuhlaziywa kwe-Fecal
Ngaphambi kokuqoqa indle, udinga ukuzigeza ngokuphelele ngensipho noma ngejeli lokugeza, bese usula isikhumba sakho ngokuphelele ngethawula elihlanzekile nelomile. Lokhu kuzovimbela amanzi namagciwane ukungena ekungeneni kusuka esikhunjeni futhi kwandise kakhulu ukuthembeka kokuxilongwa.
Kungcono ukuqoqa indle esitsheni esincane sepulasitiki ngesivimbo esilingana kahle. Ukuhlaziya, isipuni esisodwa sanele. Lapho uqoqa indle, kunconywa ukusebenzisa umkhumbi wezokwelapha noma idada. Kunqatshelwe ngokuphelele ukubamba izingcolile ezivela endlini yangasese, ngoba kulokhu kuzongcoliswa ukungcola.
Lapho sihlaziya indlama esigulini esine-pancreatitis, isimo esifana ne-steatorrhea sivame ukubonwa - okuqukethwe okwandayo kwezingxenye zamafutha asesitobhini. ISteatorrhea ivame ukuvusa ukwephulwa kwesitulo, esingaziveza ngesimo sohudo noma ukuqunjelwa.
Ngaphezu kwalokho, kumuntu onokuvuvukala kwamanyikwe ezindlebeni, kutholakala izinhlayiya zokudla okungaphanjwanga. Lokhu kungenxa yokuthi isitho esinegciwane asikwazi ukukhiqiza inani elanele lama-enzymes wokugaya ukudla, okuphazamisa inqubo yokugaya ukudla kanye nokwenziwa kokudla.
Enye inkomba ye-pancreatitis ingukuqukethwe okuphansi kwe-pancreatic elastase kusitofu - i-enzyme ye-proteinolytic edingekayo ekusebenzeni okujwayelekile kohlelo lokugaya ukudla. Ngokuvuvukala kwama-pancreas, ukugcinwa kwaso kuncishiswa kakhulu, okungatholakala ngesikhathi kuhlaziywa indle.
Indlela ebiza kakhulu yokufundwa kwezindwangu ukuhlaziya kwe-pancreatic elastase, ezobiza isiguli cishe ngama-ruble angama-2500. Ngakolunye uhlangothi, i-coprogram evumela ukuthi wena ukukhomba esihlalweni esingezansi okuqukethwe okunamafutha nezinsalela zokudla ezingatholwa izobiza ama-ruble angama-450.
Ukuhlolwa kwe-Ultrasound
Ukuze i-Ultra ye-pancreas inikeze imiphumela efanele kakhulu, kuyadingeka ukuyilungiselela kahle. Ukuze wenze lokhu, ezinsukwini ezingama-2-3 ngaphambi kokuhlolwa, isiguli sidinga ukunamathela ekudleni okuqinile, ngaphandle kwemikhiqizo evusa ukwakheka kwegesi ekudleni kwayo, okungukuthi: ubisi, isinkwa se-yeast kanye nokudla okune-fiber.
Ngobusuku bangaphambi kokuxilongwa, udinga ukudla kwakusihlwa ngaphambi kwesikhathi, kungakadluli i-18:00 pm, futhi ungabe usadla. Ngosuku olwandulela i-ultrasound ehleliwe, kunconywa ukuthatha i-laxative ukuze uhlanze ngokuphelele izicubu zomzimba.
Ngosuku lokuhlolwa kwe-Ultra, kuyenqatshelwe ngokuphelele ukuthatha ukudla, utshwala, izidakamizwa (ngaphandle kwalokhu okubalulekile) nokubhema ugwayi. Ukuskena kwe-ultrasound kulula kakhulu, inqubo yonke ayithathi imizuzu eyi-15 futhi akubangeli ukungaphatheki kahle.
Ngesikhathi sokuhlinzwa kwe-pancreas, kutholakala lezi zimpawu ezilandelayo zepancreatitis:
- Usayizi wamanyikwe kukhulu kakhulu;
- Ubude bomzimba wendlala budlula ama-22 cm;
- Ubude bekhanda le-pancreatic lingaphezu kuka-3.5 cm, futhi ububanzi bungaphezu kuka-3 cm;
- Isitho sinemikhawulo engajwayelekile kanye nohlaka olufiphele;
- Tubules of the gland has a deformations ahlukahlukene;
- I-duct eyinhloko ye-pancreas yandiswa kakhulu (ngaphezu kwe-3 mm).
Njengamanje, intengo ye-ultrasound yamanyikwe isuselwa kuma-ruble angama-300-350.
Magnetic resonance imaging
Lolu hlobo lokufunda lukuvumela ukuthi uthole isithombe esicacile se-pancreas futhi wenze ukuxilongwa okulungile ngokunemba kwe-97%. Ukulungiselela i-MRI futhi kudinga ukuqala izinsuku ezintathu ngaphambi kokuxilongwa ngokudla okuqinile.
Ngalesi sikhathi, isiguli kufanele sikuyeke ukusetshenziswa kwamafutha, isipayisi, okubhemayo nokunosawoti nezitsha. Khipha noma yiluphi utshwala, kubandakanya lokho okuqukethwe emithini, isibonelo, ama-tincture nama-balms. Misa okwesikhashana ukuphuza itiye elinamandla nekhofi.
Ngokushesha ngaphambi kokuxilongwa, isiguli sizodinga ukususa zonke izinto zensimbi kuye. Uma isiguli sesifakelwe i-pacemaker, kunezikhonkwane ezinkulu nezinye izinto zensimbi, khona-ke kufanele senqabe ukuya kwi-MRI.
I-Pancreatic MRI isiza ukukhomba izilonda ezilandelayo:
- Ukugxila kanye nezinga lokuvuvukala kwesitho;
- Ukuba khona kwama-cysts, ama-pseudocysts namanye ama-neoplasms, kanye nokucacisa ubukhulu bawo kanye ne-contour;
- Usayizi we-tumor enomdlavuza, ukuba khona kwe-metastases nokuthi ngabe kukhona i-lesion yezitho zomakhelwane nezicubu;
- Ukuthola amatshe emigodini ye-pancreatic;
- Ukuba khona kwanoma yikuphi ukungahambi kahle ekwakhiweni kwamanyikwe neziqu zazo.
Ukucabanga kwama-Magnetic resonance kungenye yezindlela ezibiza kakhulu zokuhlolwa. Ngakho-ke ngokwesilinganiso ezweni, i-MRI scan izobiza isiguli kusuka kuma-ruble angama-3200 kuya kwangama-3500.
Izimpawu nokwelashwa kwe-pancreatitis kuxoxwa ngazo kule vidiyo ekulesi sihloko.
