I-pancreatitis e-acute ayitholwa kuphela ukubonakaliswa komtholampilo. Ngakho-ke, awukwazi ukuzitholela uzimele. Ngisho nodokotela onolwazi akahlali nje ebona imbangela yokuwohloka kwenhliziyo kwesiguli ngokushesha.
Ukuzilolonga kukhombisa ukuthi ukuxilongwa okwenziwe ngesikhathi kuhlolwa isiguli akuqinisekisiwe cishe ingxenye yesithathu yamacala, ngamanye amazwi, akulona iqiniso. Futhi akusiyona imfanelo ephansi yochwepheshe bezokwelapha.
Iqiniso ngukuthi izimpawu zesigaba esibuhlungu sezifo noma ukwanda kwe-pancreatitis engapheli ezigulini ezihlukile kuhluke kakhulu. Kulokhu, nge-pancreatitis engamahlalakhona, ama-syndromes ayabhekwa afanayo ekubonisweni kwawo ezifweni ezahlukahlukene.
Ukwenza ukuxilongwa okulungile, akwanele ukuthatha umlando wezokwelapha futhi uhlole isiguli ngokomzimba, kuyadingeka ukwenza ukuxilongwa kwelabhorethri - ukuhlolwa kwegazi okujwayelekile nokunamakhemikhali, ukuhlaziya umchamo. Kufanele futhi wenze i-MRI, i-ultrasound, i-compact tomography.
Kuboniswa kanjani ukuvuvukala kwe-pancreatic?
Ngisho nezimpawu eziholayo zenqubo yokuvuvukala yamanyikwe azitholakali kuzo zonke iziguli. Kodwa-ke, kufanele babizwe kuqala. Izimpawu zendabuko zenqubo ye-pathological zinqunywa yi-Mondor triad - lezi zibuhlungu esiswini, ukuqhakaza nokuhlasela kokuhlanza.
Isifo sikhula ngokuhamba kwamahora. Isiguli asikwazi ukusho ngqo ukuthi kubuhlungu kuphi. Ubuhlungu buchazwa yonke indawo; ngokumelene nale ingemuva, ukwenziwa kwasendaweni akuhlali kusungulwa ngokucacile. Inganikeza amahlombe ehlombe, emuva emuva, i-collarbone nezinye izingxenye zomzimba womuntu.
Kwimidwebo eminingi, ukugabha nakho kuqala ngokuzumayo. Yi-20% kuphela yeziguli ezathola isicanucanu ngaphambili. Ehlanzeni kukhona izingcezu zokudla ezingaphanjwanga, ngemuva kwalokho kusala i-bile kuphela.
Izimpawu eziphambili zokwanda kwe-pancreatitis:
- Ukuntuleka kwesitulo kungumphumela wokuphazamiseka kwamathumbu. Noma isiguli sinezitulo ezikhululekile kuze kube kahlanu ngosuku. Izinduna ze-Fecal zinamafutha, zine-luster ebonakalisayo, ekhombisa ukuthuthukiswa kwe-steatorrhea (ukuhlolwa kwe-protrological kukhombisa ukuba khona kwamafutha ezinduneni ngaphezulu kwesijwayelekile);
- Isibonakaliso sokuphelelwa ngamandla ukoma ngokweqile emgodini womlomo. Njengomthetho, uphawu lokuphelelwa ngamandla luyakhuphuka uma isiguli ngasikhathi sinye siveza ukuphindaphindwa kokuhlanza kanye nohudo olungapheli;
- Imisipha yodonga lwesisu lwangaphambi kwesikhumba iyisishubile - i-peritoneal irrit syndrome. Ekwephuphukeni, i-pain syndrome ijwayela ukuqina;
- Isikhumba esintende, ukuphefumula kanzima, ukushaya kwenhliziyo okusheshayo, ukuphuzi kwe-sclera yamehlo, njll.
Emisebenzini yezokwelapha, izimpawu ze-pancreatitis esibuhlungu zihlukaniswa, ezisiza ekuboneni lesi sifo "ngamehlo". Kodwa-ke, ziyivelakancane kakhulu ezigulini - cishe ezingamaphesenti ayishumi ezithombeni zokwelashwa.
Futhi bakhombisa ukubhujiswa kwamanyikwe.
Lezi zibonakaliso zifaka ukubonakala kwamabala ansomi ebusweni, ukulimala esifundeni sombilical, ukugqama kwamaphethelo aphansi, ukukhomba izinsimbi ezigcobeni esifundeni se-lumbar.
Ubuhlungu be-pancreatitis
Ayini ama-syndromes e-pancreatitis? Lapho isiguli siveza izibonakaliso eziningana ezethusayo zokwephulwa kohlelo olulodwa emzimbeni, zivame ukuhlanganiswa zibe yi-syndrome. Ngamanye amagama, lokhu kusethi ethile yezibonakaliso zomtholampilo ezingahlanganiswa zibe yiqembu elilodwa, ngoba zinokufana okuthile.
Noma yisiphi isifo sinama-syndromes athile, i-cholecystitis, i-pancreatitis namanye ama-pathologies, asifani. Ubuhlungu ngokuvuvukala kwamanyikwe luhlala lukhona.
Ekuhlaselweni ngamandla, izinhlungu ziqine kakhulu, kungaholela ekutheni wethuke. Ngokuphikisana nesizinda sefomu elingamahlalakhona, kwezinye iziguli izinhlungu zihlala zikhona, kepha zibonakaliswa ngamandla aphansi.
I-localization of pain ibangelwa yisilonda kumanyikwe. Uma ukusebenza kwekhanda lesitho kukhubazekile, khona-ke izinhlungu zibonwa ohlangothini lwesokunene lwesifunda se-epigastric. Lapho umzimba weglandular ukhanyiswa, uphuthuma ngakwesobunxele. Lapho kutholakala umonakalo esifundeni somsila, uphuthuma ngaphansi kwembambo yangakwesobunxele.
Ubuhlungu bungakhipha kwezinye izingxenye zomzimba:
- Emuva kubuyele izimbambo kukholamu yomgogodla.
- Ngaphansi kwehlombe lesokunxele.
- Ebhande ehlombe.
- Esifundeni esingaphansi se-iliac.
- Endaweni yesifuba (kulokhu, isibonakaliso sifana ne-angina pectoris).
Ukwahluka kwalesi sifo ukuthi ama-painkiller awasizi ukuyisilinganisa. Ezimweni ezihlukile, izinhlungu ziba buthuntu, kanti kwezinye zihlala ziqinile.
Uhlobo lwesibonakaliso ngokuthuthukiswa kwe-pancreatitis eyingozi lihlukahlukene. Umshini wokuvela wenzelwa ekwandeni okukhulu kwengcindezi emithanjeni nasezicubu ze-glandular, ukuvuvukala kwesitho sokugaya ukudla, ngenxa yalokho ukuphuma kwe-secondition ye-pancreatic kuya ngokuya kukhula.
I-Dyspeptic syndrome
I-Dyspeptic syndrome ihambisana nezinqubo eziningi ze-pathological emzimbeni. Umtholampilo wabo uhlukile kakhulu, futhi akunakwenzeka ukuthola ukuthi kuhlaselwa i-pancreatitis okuyi-pancreatitis kuphela.
Kwezinye iziguli, i-dyspeptic syndrome ivela ngokungakhululeki kahle esiswini, kancane kancane iguquka ibe yimizwa ebuhlungu. Belching ibonwa umoya.
Ukuhlaselwa kwenhliziyo nge-pancreatitis akukhona kuwo wonke umuntu. Ngokuvamile, ukuhlanza kutholakala ngokushesha ezigulini. Akalethi impumuzo. Ngemuva kwayo, ukushisa kwenhliziyo okunzima, okuhambisana nokushisa ku-esophagus. Kubangelwa kokuqukethwe okunolaka kwesisu okungena ku-esophagus yomuntu.
I-pancreatitis syndrome ngesimo se-dyspepsia ibonakaliswa yizimpawu ezilandelayo:
- Ukwanda kokugcotshwa, umuzwa wokugcwala esiswini;
- Izitulo ezikhululekile ezisheshayo. Ngokuvuvukala kwamanyikwe, kuhambisana nephunga le-fetid, eligezwe kahle ezindongeni zangasese;
- Ukunambitheka okungathandeki emlonyeni kubonisa ukushoda kwama-enzymes wokugaya ukudla;
- Ukuwohloka okujwayelekile kwempilo, ubuthakathaka kanye nokubabaza, ukuduma okukhulu esiswini.
Nge-pancreatitis, i-dyspepsia ene-Fermentative kungenzeka ngenxa yezinqubo zokuvutshelwa emathunjini. Isiguli sikhononda ngokuqhuma esiswini, ukwenyuka kokwenza igesi, izihlalo ezivulekile ezikhululekile. Ukuqeda amandla emathunjini kubangela usizi. Lapho ujikeleza emathunjini, kubonakala i-dyspepsia ebeka - ubuthakathaka kanye nokushayeka okujwayelekile, okuyi-stool emnyama enephunga elibukhali nelingathandeki.
Njengomthetho, ngokumelene nesizinda se-pancreatitis, ama-syndromes amaningana abonwa ngasikhathi sinye, ngoba ama-pancreas enza imisebenzi engaphezu kweyodwa emzimbeni. Ngenxa yalokho, ukwephulwa kokusebenza kwayo kuholela ekuphazamisekeni kwengxenye yezitho eziningi zangaphakathi nezinhlelo.
Uma izimpawu ze-dyspeptic zihambisana ne-syndrome ebuhlungu obukhulu, okuyisici sokuthuthuka kwe-pancreatitis eyingozi, kunconywa ukubiza iqembu le-ambulensi ngokushesha.
IHemodynamic syndrome ene-pancreatitis
Ezigulini, i-hemodynamic syndrome ye-pancreatitis eyingozi ihlala ibonakaliswa. Ukulimazeka kweHemodynamic kususelwa ekunciphiseni kwezinga lesifo senhliziyo, ukwehla kwesilinganiso segazi se-diastolic ne-systolic kuma-ventricles, aorta kanye ne-pulmonary artery.
Ukumelana kwemithambo yegazi kukhuphuka ngenxa yokukhishwa kwezakhi ezisebenza ngokusebenza - i-serotonin, i-histamine, i-endorphin, njll. Kulesi simo, kutholakala ukwehla kwethamo lamanzi ajikelezayo emzimbeni.
Leli cimbi lonke lidonsela ushintsho ekucindezelweni kwegazi. Ukucindezela kwe-systolic ne-diastolic kwehla kakhulu, kuyilapho ukuqina kwezindonga zemithambo yegazi kukhuphuka.
Kuvela izimpawu:
- I-Tachycardia ekwehlulekeni kwenhliziyo okuhlobene.
- Ukuphefumula esikhunjeni.
- Ukubonakala kokweba ebusweni, emikhawulweni ephansi.
Kwezinye izimo, kuvela inkinga enkulu kwabesifazane nabesilisa - ukopha okukhulu. Ukufa kwezifo zomzimba emzimbeni kuphezulu kakhulu. Ngohlobo lwe-hypodynamic, oluhamba ngokwehla okukhulu komthwalo wegazi, lingaphezu kwama-50%.
Ngohlobo lwe-hyperdynamic, lapho umfutho wegazi ukhuphuka, ukuvuvukala kuyathandeka kakhulu - amathuba okufa awekho ngaphezu kwe-10%.
Amanye ama-syndromes
Ezigulini ezindala, ngesikhathi ukuvuvukala okukhulu kwama-pancreas, isifo sokuphefumula siyazibonakalisa. Imbangela yakhona ngokushesha ingress of exudate into the alveoli - ama-sacs akha amaphaphu omuntu. Izimpawu zifaka ukuphefumula kanzima, ukuphefumula kanzima, isikhumba esiluhlaza okwesibhakabhaka - ngenxa yokushoda komoya-mpilo.
Ngalezi zimpawu, isiguli sidinga ukwelashwa. I-syndrome yokuphefumula ayihlali iqala ukukhula, kepha ukwenzeka kwayo kuyandisa kakhulu ingozi yemiphumela emibi. Ngokwezibalo, ukufa kwabantu phakathi kweziguli ezindala ngenxa yokwehluleka ukuphefumula okukukhulu kungaphezulu kwama-60%, kwesinye isikhathi kuphezulu kakhulu.
Kwi-pancreatitis ebukhali, isibindi siyahlupheka. Iziguli zikhononda ngobuhlungu esibindini. Lapho umthwalo omkhulu esibindini, uba mkhulu lapho ubuhlungu. Isizathu kungukulimala okunobuthi ngenxa yenqubo yokuvuvukala okunamandla ne-edema ye-pancreatic. Ngokuphikisana nesizinda sokulimala kwesibindi, amanye ama-syndromes akhona.
UJaundice - ukugcwala kwesikhumba, ulwelwesi lwamaprotheni lwamehlo, ulwelwesi lwamafinyila nolimi olusetshenziswa ngemibala ehlukene ephuzi. Lokhu kubonakaliswa kwemitholampilo kuhlotshaniswa nokuphazamiseka kokuhamba kwe-bile noma i-bilirubin metabolism emzimbeni. Ngezinkinga zesibindi, kuphakama umfutho wegazi, ukuphazamiseka kwengqondo, ukuphazamiseka kokulala, i-tachycardia ibhekwe.
I-Renal syndrome itholwa ngendlela edematous futhi ebhubhisayo ye-pancreatitis. Izibonakala njengokwehla kwezinga le-diuresis yansuku zonke. Egazini, isilinganiso se-urea ne-creatinine sikhuphuka kakhulu. Izinkinga zezinso zibangelwa:
- Ukomisa ngenxa yesifo sohudo nokuhlanza;
- Ukulimala kwezinso ngemikhiqizo ebolile yezicubu ze-pancreatic;
- Ukulimala kwezinso okunobuthi ngama-bacteric ubuthi ku-pancreatitis e-acute;
- Ukwehla okukhulu komfutho wegazi kuya kumanani abucayi.
Ukuba khona komsebenzi wezinso okuphazamisayo akukubi kakhulu ukuqaqamba kwezifo. Umsebenzi wezitho zomzimba uvuselelwa ngokushesha ngokwelashwa okwanele kwe-pancreatitis.
Ukwelashwa
Ukwelashwa kwe-pancreatitis ebukhali kuhlale kwenziwa ezimweni zokuma, akukho okuhlukile. Kwezinye izimo, i-pathology kulula kakhulu, isiguli sibuyiselwa ngokushesha ngaphandle kwemiphumela emibi yempilo.
Kwesinye isikhathi i-pancreatitis eyingozi idinga ukwelashwa okukhulu nokungenelela okuhlinza - imidwebo eminingi imayelana nefomu lesifo elonakalisayo. I-Edematous pancreatitis kulula ngandlela thile, inezinkinga ezimbalwa.
Amaqhinga okwelapha ukudla. Ekuqaleni, isiguli ngokuvamile siyenqatshelwa ukudla noma yini ukuze singawenzi umthwalo omningi kumanyikwe. Indlala yenzeka ngaphansi kokuqashwa ngudokotela, izinsuku ezi-2-5.
Izinjongo zokwelashwa:
- Yehlisa umthwalo ohlelweni lokugaya ukudla.
- Ijwayelekile ukugeleza kwegazi emzimbeni.
- Nxephezela ukomisa.
- Susa izinhlungu, i-dyspeptic syndrome.
- Ukwelashwa ngama-antibacterial kuvimbela izinkinga ezingenzeka.
Uma isiguli sinendlela ebhubhisayo, kutholakala ukutheleleka kwesibili, khona-ke ukwelashwa kwenziwa ngokuhlinzwa. Kunamasu amaningi ekusebenzeni kwezokwelapha. Ukukhetha kuyame ngesimo esithile.
Ukusebenza kuvulekile futhi kuvaliwe, kusetshenziswa i-endoscope. Izindlela ezivulekile zisetshenziswa kuphela ezimweni ezimbi kakhulu - i-necrosis, ukugcotshwa kwe-abscess, i-puritis peritonitis, ukopha okukhulu.
Ngakho-ke, i-pancreatitis eyingozi noma esebenzayo ihambisana nama-syndromes ahlukahlukene. Kodwa-ke, ukutholakala kwabo kokuxilongwa akwanele. Ngaphezu kwalokho, kuyatholakala izinsiza zokuxilonga nokwenziwa elebhu.
Izimpawu ze-pancreatitis zichazwe kuvidiyo kule ndatshana.
