Ukuqhuma kwe-pancreatic kungenzeka ngenxa yokuhlukumezeka, kodwa ngenxa yokuthi itholakala kabusha ngokubhekisele kwe-peritoneum futhi izungezwe yimisipha, izitho zomzimba nomgogodla - lokhu kwenzeka kakhulu.
Ngakho-ke, lapho kulinyazwa isitho, umbuzo uphakama ngokushesha wokuthi kungani amanyikwe kungaqhuma nokuthi ukulimala kwenzeka kanjani, okuholele ekuqhekekeni.
Imbangela yokuqhuma kungenzeka kube yizilonda ezisebenza ngomshini ezihambisana namanxeba wokungena nokungenelela kokuhlinzwa.
Ngaphezu kwalokho, ukukhula nokukhula kwe-neoplasms kungaba imbangela yokulimala kwezicubu. Imvamisa imbangela yama-neoplasms futhi, ngenxa yalokho, ukulimala kwezicubu zesitho kungaba yinto yokulimala kwamanyikwe.
Ukulimala kumanyikwe
Ukuhlukaniswa kwezimbangela zokuqhuma kwe-pancreatic kufaka izinhlobo eziningi zemiphumela elimazayo kwezicubu zezitho.
Ukuzikhethela kwendlela yokwelashwa kuncike ekuzimiseleni okulungile komphumela olimazayo.
Kungaba nemiphumela ebuhlungu kumanyikwe
- Ukuthola ukulimala kwe-gland evulekile.
- Umonakalo wesitho esivaliwe
- Ukulimala kwezicubu zomzimba ngenxa yokungenelela kokuhlinzwa.
- Ukulimala kwe-gland ngesikhathi sokuqhubeka kwe-neoplasms noma i-pathologies yezitho ezizungeze ama-pancreas.
Ukulimala okubangelwa ukuhlinzwa kungenzeka ngenxa yokungenelela njengokufana kwesisu, ukuthatha i-biomaterial ye-biopsy, ukuhlinzwa komdlavuza kanye nomonakalo wephutha ngesikhathi sokunye ukungenelela kokuhlinzwa.
Ukulimala okuvulekile kungumphumela wokulimala kwezinto ezisika noma izibhamu ezibukhali.
Ukulimala okuvaliwe kuvela lapho i-pancreas iqhuma ngenxa yokushayisana kwento eshaywayo esiswini noma ukulimala kwesitho ngemuva kwengozi, nalapho iguliswa yi-pathflora engena emgudwini we-vascular. Kulokhu, izicubu zithinteka ngaphakathi. I-Degenerative-dystrophic pathologies ngesikhathi sokungasebenzi isikhathi eside nokuhamba kancane kwe-gland kuholela kumonakalo wayo. Imbangela yokulimala okuvaliwe ukungena kwezilonda zesisu noma i-duodenum, ukulimala ngenxa yokuqhuma kwe-artery.
Umehluko phakathi kokulimala okuvulekileyo nokuvulekile ngukuthi ngokulimala okuvulekile kuphela kuthinteka umzimba, futhi ngekhanda lesibili, umzimba, ezimweni ezingavamile, umsila wesitho.
Uma kwenzeka ukulimala kwekhanda, kuqhamuka izimpawu zokuphuma kwe-intra-esiswini, futhi uma umzimba nomsila kulimele, izimpawu zokulimala okukhulu kwasemuva kwe-pancreatitis kanye nezinkinga zayo, ukuqunjelwa kanye ne-fistulas.
Kungani kwenzeka ukuqubuka kwezinduna?
Ukusuka esimweni namandla alelo thonya, i-morphology ye-pathology nayo izoshintsha. Ukuqunjelwa, ukopha, izinyembezi zezicubu ze-capular, izinyembezi ezijulile nezingenamkhawulo, ukufafazwa okuningana kuhambisana nokulahleka kwegazi okuningi esifundeni se-retroperitoneal kanye nasezihlangwini zesisu.
Ukubhujiswa kwendlala kuhambisana nokulahleka kokwethembeka kwama-ducts we-pancreatic kanye nokungena kwama-enzyme ezicutshini, okungadala ukuvuvukala, i-necrosis enamafutha, i-vascular thrombosis futhi necrosis yezicubu zomzimba.
Inqubo ehambisana nokuvuvukala iholela ekulimaleni kwezicubu ngokuncibilika, ukuqothuka kwezitho kanye namathumba. Ukuthuthukiswa kwalezi zi-pathologies kuholela ekwandisweni kwezifo ezinjenge-pancreatitis.
I-pancreatitis ye-acute ukuvuvukala okubi kakhulu kwesikhumba, okususelwa ezinqubweni ze-pancreatic necrobiosis kanye ne-enzymatic autoaggression ngokukhula kwe-necrosis, ukukhubazeka kwesikhumba kanye nokunameka kokutheleleka kwesibili.
Uma unganikezeli ukwelashwa okwanele kwalesi sifo, ingathuthuka iholele ku-necrotization, nayo enomthelela ekuqhekekeni kwama-pancreas.
I-pancreatitis noma ukulimala kwesitho kungahle kube nomphumela we-pancreatic cyst (a cavity uncharacteristic of the organ, bladder in a capsule andqukethwe), islides (a cavity in the gland izicubu ezigcwele pus kanye necrotic masisi), ukubalwa noma ukubekelwa emapanceni.
Uma ubheka ukulimala kanye nomonakalo wezitho eziseduzane, okuzocindezela izindawo ezithintekile zamanyikwe, ukuvela kwazo noma ukuqhubekela phambili kwalesi sifo kungaholela ekuqhekekeni kwalezi zinhlaka.
Izimpawu zomtholampilo nokuxilongwa
Enye yezimpawu zokuqhuma kubuhlungu, ubukhulu kanye nokwenziwa kwasendaweni okuncike ebangeni lokulimala kwe-parenchyma ye-gland, isilinganiso sendawo ye-lesion ezintweni ezihambisana ne-celiac plexus, ukujula kokuwa noma ukushaqeka.
Ngaphezu kwalokho, izinhlungu zihambisana nohlobo lokulimala kanye nesimo sezinye izitho zesibeletho.
Ubuhlungu buhlala buhlala, bukhulu esifundeni se-epigastric, bungabuye bube ibhande, imvamisa kakhulu imisebe kwesobunxele kwesokunxele, kwehle emuva, kungakhula esikhundleni sesiguli ngemuva bese buthaka ohlangothini lwesobunxele.
Ngaphezu kwalokho, izimpawu zokulimala kwezicubu zomzimba kungaba:
- i-pallor yesikhumba se-membrane ye-mucous;
- ukwehlisa umfutho wegazi, ukwenza buthaka futhi kwehlise izinga lokushaya kwenhliziyo;
- ukuvela kokungezwani kwemisipha odongeni lwasekhaya lwangaphakathi (isisu esibuhlungu), kutholakala amahora angama-4-6 ngemuva kokulimala;
- ukuvela kokugcinwa komchamo nezinkinga ngokunyakaza kwamathumbu;
- ukuqhakaza nokukhubazeka kwe-peristalsis kukhula;
- ukushaya kwenhliziyo, isicanucanu, nokuhlanza kwenzeka.
Ukuxilongwa kwezilonda ze-pancreatic kuphela ngesithombe somtholampilo kunzima. Okunye ukwenzeka kobunzima obukhulu kusungulwa ukwehlulwa kanye namanyikwe kwezinye izitho, ukuhlala kwesiguli esimweni sokudakwa, njll.
Ekuqaleni, kunconyelwa ukusebenzisa i-ultrasound yamanyikwe ngokuxilongwa, ngenxa yale ndlela yokuhlolwa, kutholakala ukuqunjelwa kwegazi noma i-exudate, ngaphezu kwalokho, indlela ikuvumela ukuthi unqume isimo se-pancreas nezinye izitho zomgodi wesisu nokubuyiselwa esikhaleni.
Ukuqunjelwa kwegazi emgodleni wesisu kungabonakala kusetshenziswa i-catheter “yokuqhuma,” efakwe emgodini wesisu ngokuqunjelwa okuncane. Ngemuva kwalokhu, kuyadingeka ukuthola okuqukethwe kwe-amylase ku-fluid fluid, okubonisa ukulimala kumanyikwe.
Esibhedlela esihlomele kahle, ungasebenzisa i-laparoscopy, ekuvumela ukuthi ukhombe ngokusobala uhlobo lomonakalo futhi wenze namanyala athile noma ukungenelela kokuhlinzwa, njengokumisa ukopha emithanjeni eyonakele, ukudonswa kwamanzi ngemithambo kuya kwindlala eyonakele, njll.
Isibonakaliso sokungenelela okuphuthumayo kwe-laparoscopic ukuqoqwa okukhulu kwegazi endaweni yesisu.
Ukwenza ukuxilongwa kwebhubhoratri kusiza kakhulu ekwenzeni ukuxilongwa okuyikho.
Ukwanda komsebenzi we-amylase kumchamo, ukwanda kokuqukethwe kwama-carbohydrate egazini, ukwanda kwenani lama-leukocytes, ukwehla kwezinga le-hemoglobin ne-ESR esheshayo kukhombisa ukuba khona kwenqubo ye-pathological emzimbeni wesiguli.
Ukwelashwa kokulimala kwe-pancreatic
Ukuvimbela ukulahleka kwegazi okungenzeka nokwakheka kwama-cystic formations, kunconyelwa ukusebenzisa i-laparotomy futhi uyihlanganise nokwenziwa manipulations okuhloselwe imiphumela yokulwa nokwethuka.
Uhlinzwa kufanele lwenziwe ngaphambi kokuba inqubo yokuvuvukala iqale ukukhula e-pancreas, esifundeni se-retroperitoneal noma odongeni lwesisu.
Uma kwenzeka ukulimala kwesitho kanye nokuba khona kokuncipha kwenhliziyo okuncane ngaphansi kwekhompiyutha, kukhawulelwe ekugwazeni ngesisombululo se-novocaine kanye nokusetshenziswa kokudonsa kwebhokisi lokufaka izinto noma ukuhanjiswa nge-peritonization yendawo yomonakalo.
Lapho kulimala ingxenye yesobunxele yesitho ngokuphula ubuqotho bohlelo lwe-duct, kwenziwa kabusha umzimba nomsila wayo.
Lapho ikhanda lilimala ngokubonakala kokuqhuma komgodi oyinhloko, i-pancreatectomy noma i-pancreatoduodenal resection iyenziwa. Isici salezi zinhlobo zokungenelela ubunzima obukhulu kanye nokuhlasela kwenqubo, kanti ukushona komuntu okwenzeka ngemuva kwesikhathi kungafinyelela kuma-80%.
Ukuze uvimbele i-pancreatitis yangemva kokuhlukumezeka ngemuva kokuhlinzwa, kwenziwa ngokuphelele ukwelashwa okulondoloziwe.
Izindlela zokwelapha zihlanganisa
- Ukwelashwa okubonakalayo.
- Ukusetshenziswa kokwelashwa kokudla. Ezinsukwini zokuqala ezintathu kuya kwezine, ukudla nokuphuza kuvinjelwe. Ukudla komzali kubekiwe. Ukusuka ezinsukwini ezi-4 kuya kwezi-5, ukondla ngomlomo kuyaqala. Uhlu lwemikhiqizo evunyelwe luyakhula kancane kancane kancane kancane ngenxa yokufakwa kwama-carbohydrate ekudleni, kepha ngasikhathi sinye, okuqukethwe kwamaprotheni ekudleni kunqunyelwe futhi namafutha awafakwa kuwo.
- Ukuthengiswa kokuqukethwe okuqhamuka esiswini ngesisu esibuthakathaka.
- Ukwethulwa kwekhambi le-glucose le-10%, i-insulin yabantu, isixazululo se-potassium.
Ngaphezu kwalokho, ukuphathwa kwe-intravenous kwezidakamizwa ze-antibacterial kuyasetshenziswa. Ungafaka izidakamizwa emgodini wesisu ngokusebenzisa udonsa lwengono.
Izimpawu zesifo se-pancreatic kuxoxwa ngazo kule vidiyo kule ndatshana.
