Ama-fanculas e-pancreatic amelela umlayezo we-pathological wohlelo lwe-ductal organ nemvelo yangaphandle noma izitho zangaphakathi zomzimba.
Kunamaqembu amabili amakhulu ama-pathologies anjalo - ama-fistulas angaphandle nawangaphakathi.
Ingaphandle - umlomo wesilonda uvuleka esikhumbeni, kuthi ngaphakathi babe nomyalezo onesitho esifihlakele. Izitho ezinjalo zingaba yisisu, isisu esincane noma esikhulu. Ngaphezu kwalokho, ama-fistulas ahlukaniswe agcwele futhi akaphelele.
Lapho uvimba ingxenye engaphezulu ye-duct, kwakheka i-fistula ephelele, eholela ekukhulisweni kwawo wonke ijusi le-pancreatic ngaphandle. Ngomyalezo ophelele we-pathological, ukuphuma kwezingxenye eziphambili zokugcotshwa kwe-pancreatic kubonwa ngokwemvelo ku-lumen ye-duodenum, futhi ingxenye encane ihlukaniswa nomyalezo we-pathological.
Ngokuvamile, i-pancreatic fistula yisikhumba sangaphandle noma se-pancreatic.
Indlela yangaphakathi yokuxhumana kwe-patological ne-patity yesisu se-duodenum noma ikholoni iyivelakancane.
Isinxephezelo sokulahlekelwa kwejusi le-pancreatic kanye nemiphumela yokulahleka okunjalo kwenziwa ngokuphatha ukondleka kwabazali izinsuku eziyi-7 ngokuphathwa kanyekanye kwePiyolfep nemithamo emincane ye-atropine. Ukusetshenziswa kweTrazilol nakho ukunikela ngomphumela omuhle kakhulu lapho kwenziwa ukwelashwa kwezidakamizwa ngalesi sifo. Indlela ephumelelayo ukusetshenziswa kwemisebe ye-pancreatic izikhathi ezi-4-8 kumthamo ophelele we-300-400 R.
Ukwelashwa kwalesi sifo ngokungenelela kokuhlinzwa kwenziwa uma ukuqhubekela phambili kwalesi sifo kubulala isiguli.
Ukuhlukaniswa komlayezo we-pathological
Ngamagama we-anatomical, i-pancreatic fistula isiteshi esinobubanzi obungalingani.
Izindonga zesiteshi zakhiwa izicubu ezinamafutha. Isisekelo somsele sixhuma emithambekeni eyinhloko yamanyikwe. Kuwo wonke ubude be-fistula, kwakhiwa futhi kunciphiswe i-lumen.
Izicubu ze-pancreatic endaweni yomlomo wefistula ziguqulwa ngokwesimo sokuziphatha. Yizinguquko ezinjalo eziholela ekwakhiweni komlayezo we-pathological.
Imvamisa, njengoba izinguquko ze-pathological kwezicubu yilezi:
- i-necrosis;
- ukuvuvukala
- ukwakhiwa kwe-cyst;
- ukwakheka kokugxilwa kwe-tumor.
Kwezokwelapha, kuhlukaniswe ama-fistulas ngenani elikhulu lezimpawu.
Izici zokuhlukaniswa yilezi ezilandelayo:
- I-Etiology.
- Inkambo yomtholampilo.
- Ukuba khona kokuxhuma nohlelo lwe-duct lwesitho.
- Indawo eyisilayezi yomlayezo oshisekayo.
- Inani lemilayezo eyinqaba.
- Izinga lokuxatshaniswa kwamavesi aqondayo.
- Ukuba khona kokutheleleka.
- Ukuxhumana nezinye izitho zangaphakathi.
Ngokuya nge-etiology, izinhlobo ezilandelayo ze-pathologies ziyahlukaniswa:
- i-post-necrotic;
- post-traumatic;
- uhlobo lwefistula olwakheke ngemuva kokudonsa nge-cyst.
Ngokwenkambo yemitholampilo, izinhlobo ezimbili zokuphazamiseka zihlukaniswa - ziphikelela futhi ziphindaphindeka.
Ngokuya ngobukhona bokuxhumana nohlelo lwe-ductal gland, ama-pathologies alandelayo ahlukaniswa:
- Umlayezo unokuxhumana ne-pancreatic duct. Kulokhu, izindlela ezimbili zingenzeka - lapho ubunjalo bendawo buphazamisekile kanti okukhethwa kukho okwesibili, lapho ubunikazi bungonakalisiwe.
- I-fistula inokuxhumana ne-duct eyengeziwe. Ngokufanayo, kuya ngokuthi amandla we-duct akhubazekile noma cha, izinhlobo ezimbili zesimo se-pathological zingase zikhule.
- Imiyalezo kaPato ayinakho ukuxhumana nohlelo lwe-ductal gland. Ama-pathologies anjalo afaka lawo yi-parapancreatic, aqeda ngokwakhiwa kwe-purcin patity kanye nama-fistulas angenayo i-patity eyakhiwe ekugcineni.
Ngokuya ngasendaweni yesifo, i-fancula yangaphandle ye-pancreatic ihlukaniswa, ingaphakathi futhi ixubekile.
Imibiko yendlela ingaba yisiteshi esisodwa kanye neziteshi eziningi.
Ngokwe-degree of branching, wonke ama-fistulas angahlukaniswa abe angabanjiswanga futhi aqhakanyiswa.
Ngokubakhona kwenqubo yokutheleleka, abanegciwane futhi abangagulwanga bodwa.
Uma kungekho ukuxhumana kwama-fistulas nezinye izitho zomzimba, zihlukaniswa njengezodwa. Ngaphezu kwalokho, kunezinhlobonhlobo ezihlangene futhi ezihlangene.
Izimpawu zokuthuthuka kwe-pathology
Uhlobo lokubonakaliswa kwemitholampilo ekwakhekeni kwama-pancreatic fistulas kuncike kakhulu ezinhlobonhlobo zazo, i-etiology, isikhathi sokuthuthukiswa kwesifo, ukusebenza kwaso kanye nezinga lokuthuthuka kwezinkinga.
Ukwenziwa komlayezo kuhambisana nokuvela kobuhlungu esifundeni se-epigastric nakwi-hypochondrium yangakwesobunxele.
Imvamisa Ubuhlungu bufana -ibhande.
Ngaphezu kwalokho, ukuqhubeka kwesifo kuhambisana nokuphazamiseka okulandelayo:
- ukuphazamiseka kwe-dyspeptic;
- ukwanda kokushisa komzimba;
- ushintsho ekwakhekeni kwegazi;
- ukubonakala kokungena endaweni yamapancreas.
Ukuvela kwezimpawu nezibonakaliso ezichaziwe kungenxa yokungena kokukhipha indlala esikhaleni se-parapancreatic space, Autolysis of the parenchyma of the gland kanye nezitho eziseduze nezicubu kanye nokutheleleka kwezicubu ze-retroperitoneal.
Ukufakwa kwesiqu okusobala ekusebenzeni kwe-fistula nokukhula kwezinkinga kubonakaliswa izimpawu zesimo kuphela lapho kusungulwa uhlobo lwangaphandle lwemiyalezo ye-pancreatic.
Imibiko ye-pathological enjalo iba yinkinga ebuhlungu ngemuva kokudonsa kwangaphandle kwe-cyst eyakhiwe ngesikhathi sokuqhubeka kwe-pancreatitis.
Esikhathini somsebenzi we-fancula ye-pancreatic, ukubonakala kokuvuleka kwangaphandle kunesici, okuvela lapho secretion yejusi ye-pancreatic. Isikhumba endaweni yokwakhiwa kwembobo sakhiwe ngamacembe futhi siguqulwe. Inani lokukhipha lincike ohlotsheni lokwephulwa futhi lingahluka kusuka kumalitha ayi-0,5 kuye kwayi-1.5. Ngosuku. Ukwanda kokuqhekeka kwenzeka ngesikhathi sokudla, ikakhulukazi uma imikhiqizo iqukethe amafutha. Esimweni sokuba khona kwenqubo ye-putrefactive ne-purulent in the gland, ubomvu negazi kuhlanganiswa nokugcinwa kokwethukile. Uma kungekho zinkathazo, ukwakheka okuhlukile kunokwakheka okungenamibala futhi kuvezwa ngokuqukethwe okuphezulu kwama-amylase ne-trypsin.
Ukuqhubeka kwezinkinga kungenxa yokulahleka kwesikhathi eside kwejusi le-pancreatic kanye nokuvinjelwa komsebenzi we-exocrine organ. Ukuvinjwa kwenzeka ngenxa ye-atrophy ne-fibrosis yezicubu ze-gland.
Ezigulini ezinokwephulwa okunjalo, ukudangala kuyabonakala, bese i-autolysis ihambisana nokuvela kokuphuma kwegazi.
Ukuxilongwa ukwakheka kwe-fistula
Amathuba aphezulu okuba khona kohlobo lwangaphandle lolwazi lwe-patho akhonjiswa yidatha esesilonda se-pancreatic noma ngokungenelela kokuhlinzwa kuma-pancreas.
Ukucaciswa kokuxilongwa kwenziwa ngokwenza izifundo ze-biochemical ze-secretion ezivezwa nge-fistula.
Ngaphezu kwalokho, kusetshenziswa izindlela ezingeziwe zokuhlola umzimba wesiguli.
Ukwenza ucwaningo, umuntu unikezwa irejimeni esibhedlela esibhedlela.
Ukucacisa ukutholakala kwezifo, kusetshenziswa izindlela zokuhlola ezilandelayo:
- fistulography;
- ukubuyisa i-pancreaticocholangiography;
- i-ultrasonography;
- I-Pancreatic MRI;
- I-compact tomography.
Ukuxilongwa kwe-fistulas yangaphakathi kwenziwa ngokuhlolwa kobukhona bezinkinga ezibuyayo. Lokhu kungenxa yokuthi ukwakheka kwama-pathologies anjalo akuhambisani nokuphazamiseka kwezemitholampilo kanye ne-morphological.
Ukunquma indlela yokwelashwa, kuyadingeka ukwenza ukuxilongwa okuhlukile kwemiyalezo ye-pancreatic patho-imiyalezo.
Ukwakheka kwangaphandle kwe-pancreatic pathological kuhlukanisa ngama-fistulas aqhamuka kusuka ekugxileni kokuwohloka kwesimo se-pancreas, izinso, i-adrenal gland, i-retroperitoneal sarcoma, duodenal ne-gistric fistulas.
Ukwelashwa kwe-pancreatic pathology
Ngokusho kodokotela, iningi le-pathologies eyakhiwe livalekile lapho kukhona ukutholakala okuhle kwe-Wirsung duct ngemithi.
Ngenqubo yokwelashwa, kusetshenziswa uhla lonke lwemithi.
Ukwelashwa kwezidakamizwa kuphokophele ukufeza izinhloso eziningana zokwelapha.
Ukwelashwa kuhloswe uku:
- Ukuvinjwa komsebenzi we-exocrine wezicubu ze-gland.
- I-inactivation ye-pancreatic secretion enzymes (inqubo ifana nalena eyayisetshenziswa ekwelapheni i-pancreatitis eyingozi).
- Ukuchithwa kwenkambo ye-pathological.
- Ukulungisa umonakalo esikhunjeni endaweni evulekile yodlame oluvuthayo.
- Ukulungiswa kokuphazamiseka emgudwini wamaprotheni, ama-carbohydrate, amafutha, amanzi nosawoti we-metabolism.
- Ukwelashwa kwezifo ezihlangene.
Ukukhutshwa kabusha kwekhosi kwenziwa ngokugeza okucashile noma okuqhubekayo kusetshenziswa isifiso esisebenzayo nezixazululo ze-antiseptic kanye nokungeniswa kwama-antibacterial agents.
Ukuvikela isikhumba kuma-enzyme e-pancreatic, imithambo ekhethekile yokugcoba, ama-pastes namafilimu we-polymer asetshenziswa ebusweni bayo.
Izindlela zokwelapha ezisetshenziselwa ukwelashwa zisebenza lapho kungekho khona kokusebenza kwezidakamizwa isikhathi esiyizinyanga ezintathu kanye nokwephulwa kwe-secretion ukuphuma ngaphandle kanye nokuxhumana kwekhosi ngemidwebo engakhanyi kahle etholakala emathanjeni we-retoperitoneal
Ngesikhathi sokuhlinzwa, kusetshenziswa izindlela ezilandelayo zokwelapha:
- ukumbumbuluzwa kwe-fistula ngokuhlelwa kabusha kwendlala, ukusebenza okunjalo kuyindlela yokuthola ukwedelela;
- ukucwaswa kwe-fistula kanye nokwenziwa kabusha kwe-pancreatojejunoanastomosis, lolu hlobo lokungenelela kokuhlinzwa lwenziwa phambi kobuthakathaka obungenakonakala be-Wirsung duct;
- ukwakheka kwe-anastomosis yenkambo engafani nesisu noma amathumbu;
- ukugcwaliswa kwenkambo kanye ne-pancreatic duct ngezinto ezikhethekile ze-polymer.
Ukuqashelwa kwesi sifo kuyinto enhle impela lapho uqhuba ukwelashwa okufika ngesikhathi futhi okwanele.
Imininingwane ngezimpawu zesifo se-pancreatic inikezwe kuvidiyo kule ndatshana.
