Izibalo zithi i-pancreatitis ye-purulent yisifo sesithathu esivame kakhulu kulandela i-cholecystitis ne-appendicitis. Kutholakala isigaxa somzimba we-parenchymal kubantu abangama-500 kwesigidi esisodwa.
Kakhulu, i-pancreatic necrosis ibonwa ezigulini zesilisa. Ezimweni ze-10-15%, ukufa kwezicubu ze-glandular kuholela ekufeni.
Eminye imiphumela eyingozi yezinqubo ze-necrotic ukuthuthukiswa kwe-renal, pulmonary, inhliziyo nesibindi ukwehluleka. Ukusindisa impilo futhi ugweme ukuvela kwezinkinga eziyingozi, kubalulekile ukwazi i-etiology ye-pancreatic abscess, izimpawu zayo futhi uqonde ukuthi ungayelapha kanjani i-pathology.
Izici nezimbangela ze-puranc pancreatitis
I-Parenchymal gland necrosis yisifo esiyingozi esenzeka ngenxa yokuvuvukala kwesitho lapho ipus iqongelela kuso. Imvamisa, i-pathology iba ngenxa yesifo se-pancreatitis esishisayo, igeleza kuyi-pancreatic necrosis.
Izinkinga ezivamile zalesi sifo ukwanda kwesifo sikashukela, i-peritonitis, ukopha, ukuqina kwezinso, ukwehluleka kwesibindi, nokuphazamiseka kokujikeleza kwegazi. Ngakho-ke, ngemuva kokuhlinzwa, isiguli sidluliselwa esikhungweni sokunakekelwa kakhulu, lapho sinikezwa ukunakekelwa komuntu ngamunye.
Ezinye izimbangela zefomu lokuhlanza i-pancreatitis yi-pathgenital ye-gland kanye nezifo ezahlukahlukene zokuvuvukala zohlelo lokugaya ukudla. Ezinye izici zokubonakala kwe-pancreatic necrosis:
- ukutheleleka ngegciwane kanye namagciwane;
- uphuzo oludakayo nolungamahlalakhona;
- ubuthi obuhlukahlukene bomzimba;
- i-appendicitis
- isiphetho sofuzo;
- izifo zamapheshana emathunjini, kufaka phakathi i-gastroduodenitis kanye ne-ulcer;
- isifo se-gallstone;
- ukulimala kwepancreatic.
Futhi, i-pancreatitis, ehambisana nezinqubo zokuhlanza, yenzeka ngemuva kokuphuza imithi ethinta kabi i-pancreas. Lokhu kufaka phakathi i-thiazide diuretics, ama-antibiotics, i-azathioprine, ama-estrogens, ama-corticosteroids, ama-immunosuppressants.
Iningi labodokotela likholelwa ukuthi inqubo yokuvuvukala ebukhali e-gland, okuholela ekutheni i-pancreatitis ye-purulent, ivele ngenxa yomonakalo kumaseli wesitho ngama-enzyme angasebenzi kahle. Ngomsebenzi wemvelo wesitho se-parenchymal, lezi zinto zithunyelwa ngesimo esingasebenzi. Ukwenza kusebenze kwabo kwenzeka ohlelweni lokugaya ukudla.
Kepha ngaphansi kwethonya lezimo ezahlukahlukene ze-pathological, ama-enzyme angaqala umsebenzi wawo kumanyikwe, okufaka isandla ekuzigayeni kwesitho. Ngemuva kwalokho kwenzeka i-edema yezicubu, kuqhume ukuvuvukala okunamandla, amathumba nemithambo ye-parenchyma.
Kancane kancane, izinqubo ze-pathogenic zidlulela ezithweni nasezithanjeni eziseduze - iziqu zezibilini, i-peritoneum, ama-omentums.
Ukuphazamiseka okubalulekile, njengokuvuvukala kwesibili kanye nezinguquko ze-dystrophic ezenzeka ezithweni ezahlukahlukene, kuyaphawulwa.
Izici zomtholampilo zalesi sifo
Izimpawu ze-pancreatitis ye-purulent zihlukahlukene kakhulu. Izimpawu zokuqala zalesi sifo zenzeka ezinsukwini ezi-2-7 ngemuva kokuqala kokushintsha kwezidumbu emzimbeni wesitho.
Isibonakaliso esiholayo se-abscess yi-pancreatic colic. Ubonakala ngeminjunju yebhande eyenziwe endaweni engehla ye-peritoneum.
Imvamisa imvamisa isabalalela emuva nasemaphethelweni amahlombe. Ngokuhlanjululwa kwe-pancreas, ama-sensor angajabulisi awabekezeleleki, futhi isiguli silahlekelwa ukwazi.
Ngokusebenza komzimba, umuntu unobuhlungu besisu obukhulu. Konke lokhu kungahambisana nokuhlanza, okunciphisa ubukhulu benkinga.
Ukungakhululeki kuzoba nzima ngokwengeziwe lapho ama-enzyme akhulisa ingcindezi ye-intrauterine engena kumanyikwe. Lokhu kudala ukuhlanza. Ukunciphisa izinhlungu, umuntu uphoqeleka ukuba alale ohlangothini lwakhe, futhi aphakamise amadolo esiswini sakhe.
Ezinye izibonakaliso ze-pancreatitis ye-purulent:
- ukuzindla kwenhliziyo;
- ukonakala kwempilo jikelele;
- amakhaza;
- hypotension;
- ukunciphisa umzimba ngaphandle kokushintsha ukudla nezinga lomsebenzi womzimba;
- i-tachycardia;
- ukuqunjelwa kanye nesifo sohudo;
- ubunzima bokuphefumula.
Lapho kuqala ukwanda kwalesi sifo, kuvela izimpawu ezinjengokushisa okungaphansi komzimba. Lapho isimo siba sibi kakhulu, sikhuphukela kuma-38- 39 degrees.
Ukungabekezeleli nobuhlungu obukhulu kuholela ekutholakaleni kwe-pancreatic psychosis. Lesi simo sikhonjiswa ukukhathazeka okukhulayo, ikhanda, ukukhathazeka, ukonakala kwempilo yonke. Kuvela i-anemia futhi ama-enzyme anomthelela ongemuhle kumongo wethambo futhi uholele ku-thrombocytopenia.
Lapho i-pancreatitis ye-purulent iqhubeka, isiguli sithuthukisa isiqubu sesikhumba. Ukunobuthi kwendlela yokugaya ukudla kuholela ekwehlulekeni kwe-pulmonary kanye nokunikezwa kwegazi okungekuhle.
Imiphumela yokuhlukaniswa kwezicubu zolwelwesi nezicubu yilezi: sepsis, thrombosis kanye nokwakheka kwama-fistulas.
Ukuxilongwa nokwelashwa
Uma kusolwa indlela yokuhlanza i-pancreatitis, kwenziwa izindlela zokuxilonga ezahlukahlukene. Ngokuthuthuka okusheshayo kwalesi sifo, lapho isiguli singeniswa emnyangweni wokuhlinzwa okujwayelekile noma i-gastroenterology, kodwa ngasikhathi sinye esimeni esizinzile, kwenziwa izifundo eziningi.
I-Pancreatic MRI, i-x-ray yesisu, i-ultrasonography noma i-laparoscopy yenziwa ukuqinisekisa ukutholakala kwale sifo. Ukuhlolwa komchamo negazi kuyenziwa futhi.
Ukuhlanganiswa kwakho konke ukuxilongwa kukuvumela ukuthi ubone ukuba khona kwezinqubo ze-purulent kumanyikwe futhi ungafaki ezinye izinhlobo ze-pathologies ezinamandla. Izifundo zinikeza ithuba lokubikezela umphumela walesi sifo futhi ukhethe indlela efanele yokwelapha.
I-pancreatitis ye-purulent ayikwazi ukwelashwa ngokwayo, ngoba lokhu kungaholela ekufeni. Ukwelashwa kwalesi sifo kwenziwa kuphela esibhedlela sokuhlinzwa.
Ukunciphisa izimpawu ezibuhlungu, ukwelashwa ukumnika, ukuzila ukudla, ukuphoqa okuphoqelelwe, nokwelashwa kwezidakamizwa kuyasetshenziswa. Uma kunesidingo, kususwa ingxenye ethile noma ephelele yesitho esiqale ukubola.
Ukuzila ukudla kunganciphisa ukukhiqizwa kwejusi ye-pancreatic, okuholela ekunciphiseni okungokwemvelo kwenqubo ye-necrotic kumanyikwe. Ngisho nokuntuleka kokudla endaweni yokugaya ukudla kunciphisa ukuvuvukala futhi kwehlise ukuqina kobuhlungu. Ukuthuthukisa umphumela wokwelapha, ama-compress abandayo asetshenziswa esiswini sesiguli.
Ukwelashwa ngezidakamizwa kubandakanya ukusetshenziswa kwe-diuretics ne-saline, okuzosusa ngokushesha ubuthi emzimbeni. Isiguli sinqunyelwe nemithi ekhethekile eyehlisa ukukhiqizwa kwama-enzyme. Isixazululo sikashukela sisiza ukuguqula ushukela wegazi ngokujwayelekile ngokuncipha okunamandla.
Ukudambisa izinhlungu, kudalwa amaphilisi we-spasmolytic ne-narcotic analgesics. Ukuqeda ukuvuvukala, udokotela unquma ama-antibiotic.
Ngezinkinga, njengokubonakala kokuntuleka kwezitho zomzimba ezihlukile, kunikezwa izidakamizwa ezilandelayo:
- izidakamizwa ze-glucocorticoid;
- imithi esekela umsebenzi wamaphaphu futhi ibuyise umsebenzi wokuphefumula;
- amaphilisi athuthukisa ukusebenza kwenhliziyo;
- izidakamizwa ezisekela umsebenzi wezinso nalo lonke uhlelo lokuchama.
Umuthi wokulashwa kwezidakamizwa uvame ukwenziwa ngesikhathi sokubonisana. Ochwepheshe abaningi babamba iqhaza ezingxoxweni - udokotela wobuchopho, i-endoscopist, udokotela ohlinzayo nabanye odokotela.
Ukuhlinzwa kusetshenziselwa ukuphazamisa ukuvuvukala kwesitho se-parenchymal. Ukusebenza kuqukethe ukudonswa kwemithambo ye-purulent.
Uma kunesidingo, izindawo ze-necrotic ze-gland ziyasuswa, zilandelwe ngokukhishwa kwe-peritoneum. Ukugwema i-pancreatitis ye-purulent, ngemuva kokuhlinzwa, kwenziwa izindlela zokuvimbela eziningana, isakhi esiyinhloko saso okuyi-antibiotic therapy.
Isigaba sokwelashwa esibaluleke ngokulinganayo ukuzila ukudla nokubambelela kokudla okuyisipesheli. Ukudla kufanele kube nama-calorie aphansi, futhi ukudla kuthathwa ngezingxenye ezincane, kepha kaningi (izikhathi ezingama-5-8 ngosuku).
Ukuze uthole ukululama okusheshayo, isiguli kufanele siphuze amanzi angenawo amaminerali angenawo amakhabhoni - aze afike kumalitha ayi-2 ngosuku. Kuvunyelwe ukusebenzisa itiye eliluhlaza, ama-decoctions we-chamomile, okhalweni lwe-rose.
Abanye odokotela batusa ukuthi iziguli zabo ziphuze isiphuzo esikhethekile se-pancreatic. Utshwala nekhofi kwenqatshelwe.
Ukudla kwe-pancreatitis ye-purulent kubandakanya ukufaka imifino engeyona i-acid kwimenyu, kungcono efomini elibilisiwe. Ungaphuza futhi amajusi wezithelo nama-berry nama-compotes.
Ukudla imikhiqizo kafulawa, ukudla okumnandi, okunamafutha, okushisa kakhulu, okunezipayisi noma okubandayo akunconywa.
Isimo sezulu nokuvikela
Uhlobo lwe-pancreatitis lwe-purulent yisifo esibi, esihambisana nezinkinga eziningi ezisongela impilo. Ngakho-ke, ngisho nokwelashwa okujulile akwenzi ukuthi i-prognosis ibe yinhle.
Ngenxa yalokhu, ngemuva kokuhlinzwa, isiguli sithola ukwelashwa kokuvuselelwa isikhathi eside futhi kwesinye isikhathi sithintane nodokotela wezitho zangasese. Ngakho-ke, kungcono ukuvimbela ukuthuthukiswa kwe-pancreatic abscess kunokuba ulaphe imiphumela yayo eyingozi.
Ukuhambisana nezinyathelo zokuvimbela kuzokusiza ukuvikela ukubonakala kwe-pancreatitis ye-purulent. Ngakho-ke, udinga ukuqapha ngokucophelela impilo yakho kanye nokwelapha okufika ngesikhathi ezifweni zesibindi, umgudu wokugaya ukudla kanye nesinye.
Ezinye izincomo ezibalulekile zizosiza ukuvikela ukuthuthukiswa kwezinqubo ze-purulent kumanyikwe:
- ukwenqaba ngokuphelele i-nicotine notshwala;
- umsoco ofanele;
- ukusetshenziswa okulinganiselwe kwezidakamizwa ezinamandla kumthamo omkhulu.
Imininingwane nge-pancreatitis inikezwe kuvidiyo kule ndatshana.
