I-pancreas iyisitho esibalulekile lapho umsebenzi womzimba wonke uncike khona. Ukuvela kweziphazamiso ekusebenzeni kwalo gland kuholela ekucasukeni ekusebenzeni komzimba wonke.
Lesi sifo senzeka lapho amanyikwe egcotshwa ngaphansi kwethonya lezinto ezithile. Ngokuvamile, izifo ze-pancreatic zitholakala engxenyeni yabesilisa. Lokhu kungenxa yokuthi amadoda maningi amathuba okusebenzisa kabi uphuzo oludakayo, isenzo saso esiyisici esivelele sokwenzeka kwezifo ezingena pancreatic.
Ngezinga elikhulayo lokuphuza utshwala, isilinganiso sabantu abanalesi sifo sineminyaka engama-39, futhi ngokumelene nesizinda sezifo ezijwayelekile zohlelo lokugaya ukudla, sineminyaka engaba ngu-69 ubudala.
Izici ezibangela i-pancreatitis eyingozi:
- Umuntu utheleleke noma utheleleke ngomgudu wegciwane.
- Ngesikhathi sokuhlinzwa, maqondana ne-pathologies ehambisana nalesi sitho.
- Uma umuntu ephuze imithi ethile eba nomthelela ongemuhle kumanyikwe.
- Kungahle futhi kube khona i-pathology yokuzalwa, okuthinte ukukhula kwamanyikwe, ifa kungenzeka.
- Umuntu usebenzisa kabi utshwala, aphuze ukudla okungenamsoco ngamanani amakhulu.
- Ngezinye izifo ezivuvukala ezithweni zokugaya ukudla.
- Uma umuntu ethambekele ku-cholelithiasis.
Izimpawu zesifo esithathelwanayo zifaka: Ubuhlungu obukhulu besisu, kungahle kube nobuhlungu ngakwesokunene, noma i-hypochondrium yangakwesobunxele.
Kwezinye izimo, kuphuzi isikhumba noma amehlo kuyabonakala. Umuntu uzwa umuzwa wokucanuzelelwa kwenhliziyo, isifiso esijwayelekile sokuhlanza. Ezimweni ezikhethekile, lingaphuma igazi inkaba. I-localization of pain incike kwisiza sokuvuvukala.
Izimpawu ezijwayelekile zifaka ukwehla kokudla, ubuthakathaka obujwayelekile. Kwesinye isikhathi kuba nokwenyuka kwezinga lokushisa. Inqubo ingathinta izicubu eziseduzane.
Ezimweni ezinzima, cishe zonke izitho zivutha - zisuka enhliziyweni ziye esibindini nasezinso.
Izindlela eziphambili zokwelapha lesi sifo
Izindlela zokwelapha zalesi sifo zinqunywa ochwepheshe abafanele, ngokuya ngezinto ezahlukahlukene. Izinga lomonakalo, isimo sesiguli singathinta amaqhinga okwelashwa. Okokuqala, kusetshenziswa ukwelashwa okulondolozayo.
Ukwelashwa ngezidakamizwa kwenziwa ngaphansi kokubhekwa kukadokotela esikhungweni sasesibhedlela. Kubandakanya ukubuyiselwa kwemisebenzi yesitho, ukucindezelwa kwenqubo yokuvuvukala nokubuyiselwa kwemali esele.
Ngesikhathi sokwelashwa, isiguli sinconyelwa ukuthi sisebenzise ukudla okudlayo ngesikhathi sonke sokwelashwa ukuze sifinyelele umphumela omuhle kakhulu, futhi ukuzila ukudla okwezinsuku eziningana kunconywa ngesikhathi sokwelashwa okuqinile ukuthuthukisa inqubo yezinqubo zokutakula. Esigulini, ukunciphisa umphumela wejusi lesisu kuzicubu ze-pancreatic, isisu sihlanzwa nge-probe ekhethekile.
Ukunciphisa i-acidity, kunconywa i-alkaline.
Ngaphezu kokwelashwa okusemathinini, kungenzeka ukuthi ungenelele ngokuhlinzwa.
Ukungenelela kokuhlinzwa kufanele kwenziwe lapho isiguli sinendlela ethelelekile ye-pancreatic necrosis, futhi nobunzima besimo sesiguli nabo buyabhekwa. Uma isiguli sine-pancreatic necrosis, okuyi-aseptic emvelweni, ukuhlinzwa kuphethwe ngokuqinile, ngoba kunengozi enkulu kakhulu yokuqhamuka kwegazi kwangaphakathi, ukutheleleka kwezindawo ezingafunwanga, kanye nomonakalo omkhulu wephephabhuku lesibeletho.
Kudingeka nini ukuhlinzwa?
Ukuhlinzwa kwe-laparotomy kunqunywa kuphela ngesikhathi sesigaba se-aseptic sesi sifo. Imane nje ayinqunyelwe, kumele kube nezizathu ezinhle.
Inqubo yenziwa uma, ngokubhekela emuva kokwelashwa okuyinkimbinkimbi, ukuqhubeka kwesifo kuvezwa ngokwanda kwenqubo yokutheleleka kwezinye izindawo zesibeletho.
Le nqubo iyinkimbinkimbi kakhulu ngakho-ke yabelwa okokugcina, okungukuthi, ihlala iyindlela edingekayo.
Kuzoba yiphutha uma kunqunywe ngaphandle kwezinyathelo zokuthola ukwelashwa okuyinkimbinkimbi. Le ndlela yokusebenza ayivelakancane, njengoba kunezingozi ezinkulu kakhulu.
Ukuhlinzwa kungenzeka kuphela ngamaphesenti ayi-6-12 eziguli.
Izinkomba zalokhu zingaba ngokulandelayo:
- i-peritonitis;
- ukwelashwa okulondoloziwe akuphumelelanga izinsuku eziningana;
- uma i-peritonitis ihambisana ne-cholecystitis noma ihlanzekile.
Isikhathi sokungenelela sehlukile:
- Ukushesha kubizwa ngokuthi ukungenelela okwenziwa phakathi kweviki lokuqala lesi sifo.
- Ukuhamba kwesikhathi yilezo ezenziwa phakathi nesonto lesibili nelesithathu lesi sifo, ngokunelashwa okungaphumelelanga.
- Ababambezelekile benziwa kakade esikhathini sokukhukhumala, noma lapho lesi sifo sisesigabeni sokuqunjelwa. Ukungenelela okunjalo kwenziwa ngemuva kokuthi isikhathi esithile sesidlulile selokhu kwahlasela umkhuhlane.
Noma yikuphi ukungenelela okuhlinzayo kuhloselwe ukuvikela ukuphindeka kokuhlaselwa kwalesi sifo.
Izinga lokungenela linqunywa yinkimbinkimbi yenkambo yesi sifo. Futhi kuncike ekubeni khona kwe-purulent foci kanye nezilonda zohlelo lwe-biliary.
Ukuthola lokhu, i-laparoscopy, ukuhlolwa kwesisu kanye nendlala kuyenziwa.
Kuyini ukukhipha isisu?
Olunye uhlobo lokungenelela kokuhlinzwa ukuhlukunyezwa kwamanyikwe. Ukusebenza okunjalo kuma-pancreas kuhilela ukukhishwa kwamanyikwe emgodini wesisu kusuka ku-pancreatic fiber. Okokuqala, kunqunywa lapho isiguli sine-peritonitis, i-pancreatic necrosis.
Ngesikhathi sale nqubo, amanyikwe ahlanzwa izicubu eziseduzane ukuze kugwenywe ukutheleleka okwengeziwe. Lokhu kwenziwa futhi ukuze kuvikeleke ukwanda kwezinto ezinobuthi ukuze kunciphise umphumela wazo ezicutshini zesikhumba. Ukuqunjelwa isisu kwenziwa ukuze izicubu zesitho zingabi lula ijusi le-pancreatic.
Ukuze wenze ukuhlinzwa, ukulungiselela okuningiliziwe kuqala kwenziwa. Ukulungiswa kufaka ukuqoqwa kwedatha nokuhlolwa okuningiliziwe ngudokotela, zonke izivivinyo ezidingekayo ukuze kuqinisekiswe ukutholakala kwale sifo zisiwe.
Izinhloso eziphambili zokungenelela kokuhlinzwa yilezi:
- ukukhululeka kobuhlungu;
- neqhaza ekusebenzeni okujwayelekile kwezicubu zemfihlo zesitho;
- ukuqedwa kobuthi nezinto ezinobuthi obuhlukahlukene.
Lo msebenzi uvimba ukuvela kwenqwaba yezinkinga ezihambisana nokuqhubeka kwenqubo yokuvuvukala kwizicubu zesitho.
Ukungenelela kokuhlinzwa kuqukethe lezi zigaba ezilandelayo:
- Isingeniso ku-anesthesia yesiguli.
- Ukuqhuba i-laparotomy yangaphakathi eliphezulu.
- I-gastrocolic ligament iyabulawa, khona-ke i-pancreas ihlolwe, emva kwalokho kuhlolwe i-fiber.
- Ngaphansi kwe-gland, kwenziwa i-incision, kuqondiswe eceleni.
- Amanyikwe ahlanganiswe ukuze kuhlanganiswe ikhanda nomsila kuphela.
- Ukuphela kwamahhala kwe-omentum kudonswa emaphethelweni aphansi ngaphansi kwe-gland. Ngemuva kwalokho, ilethwa emaphethelweni aphezulu ibekwe ebusweni bangaphambili.
- Ishubhu yokudonsa ibekwa ngokufakwa kwesokunxele emuva emuva.
- Udonga lwesisu luthungathwa kancane kancane, ezingxenyeni.
Icebo lokungenelela liyinkimbinkimbi, kepha kungenzeka uma udokotela osebenzayo enolwazi olwanele ekusebenzeni okuyinkimbinkimbi.
Ukuvuselelwa ngemuva kokuqedwa kwesisu
Lapho izindonga zihlanganiswa, kufakwa ibhaluni le-latex kunsimbi, kuyadingeka ukuze kuphole isitho.
Lokhu kwenziwa ngale ndlela: i-incision yenziwa ngaphansi kwembambo yangakwesobunxele, okuphuma kuyo ishubhu lixhuma kwisilinda. Umzimba uphola kathathu ngosuku, ezinsukwini ezintathu zokuqala ngemuva kokungenelela. Lapho isiguli singcono, ibhaluni iyasuswa. Ama-gastroenterologists anombono wokuthi ukupholisa kuqinisa izinqubo zemvelo emzimbeni futhi kusiza ukubuyisela.
Naphezu kokusebenza kwayo, le nqubo inezimpawu ezithile eziphikisayo.
Uhlinzwa ngeke lwenziwe uma:
- isiguli sinenkinga ye-hypotension;
- kunokuqukethwe okuphezulu kwe-glucose egazini;
- isiguli sizwa isimo sokuthuthumela esingadluleli isikhathi eside;
- uma umthamo wegazi elahlekile ngenxa yokuhlinzwa ungeke ubuyiswe.
Ukukhipha isisu yinqubo eyinkimbinkimbi, ngakho-ke ezinye izingqinamba azikhishwa. Zingavela kuphela uma ukuhlinzwa kungenakwenziwa udokotela ohlinzayo ongenalwazi.
Ukutheleleka kungenzeka, okuthi esikhathini esizayo kube nemiphumela engalindeleki.
Kunamathuba amaningi okopha. Umphumela we-Lethal uvame kakhulu, kepha noma kunjalo akufanele ukhishwe.
Umphumela omuhle wokuhlinzwa ngokuncike hhayi kuphela kuziqu zobudokotela osebenzayo, kodwa futhi ngesimo sesiguli, izinga lenkimbinkimbi yokungenelela.
Okubaluleke kakhulu, ukuvikela okuyinhloko, okwenziwa ngaphambi kokuba lesi sifo siziveze, kuzobaluleke kakhulu. Isinyathelo sokuqala ukwethula umsoco ofanele empilweni yakho, kungabandakanyi ngokuphelele ukuphuza utshwala ngokweqile. Indlela yokuphila esebenzayo kanye nokwenqatshwa ngokuphelele kwemikhiqizo kagwayi nakho kunciphisa ubungozi bokuthola lesi sifo.
Ukwelashwa kokuhlinzwa kwe-pancreatic kuchazwe kuvidiyo kule ndatshana.
