Emhlabeni lapho singekho isikhathi esisele sokudla okufanele nokulinganiselayo, izifo zepancreatic - i-pancreatitis, isifo sikashukela nezinye izifo ezihambisana nemikhuba emibi yokudla zivame ukutholakala.
Ukuvuvukala kwesitho sangaphakathi kubonakala ngezinhlungu ezikhulayo, ezingeke zelapheke nge-painkiller, kuhambisana nokuhlanza okuphindaphindiwe, izitofu ezithukile, nokugayeka kokugaya ukudla.
Ama-pancreas asondelene nezinye izitho zangaphakathi. Uma ukusebenza kwayo kwephulwa, lokhu kuthinta umsebenzi womzimba wonke uwonke. Kodwa-ke, akunakwenzeka ukwenza ukuxilongwa emtholampilo owodwa; izifundo zelebhu kanye nezinsimbi ziyadingeka.
Ngakho-ke, asho ukuthini amaphuzu e-pancreatitis? Cabanga ngezimpawu zikaShoffar, Kach, Mayo-Robson kanye nabanye odokotela abazimisele ngokubizwa nge-palpation.
Ukuxilonga kanye nemigomo ye-palpation ku-pancreatitis
Ngokwembonakaliso ejwayelekile yomtholampilo, akunakuphikwa ukuthi ukuwohloka okubukhali enhlalakahleni yesiguli kuhlotshaniswa ngqo nokuhlaselwa okukhanyayo kwe-pancreatitis. Ngaphezu kwesimo senqubo ye-pathological, izinhlobo ezahlukahlukene zokulimala kwe-pancreatic ziyahlukaniswa, ezihambisana nemiphumela emibi yesimo esehlukile.
Ukwenza ukuxilongwa kwesiguli esifanele, udinga ukuhlola ngokucophelela. Isiguli sihlola ukuhlolwa kwegazi, ukuhlolwa umchamo, i-coprogram, i-ultrasound, i-radiography, i-CT, i-MRI yenziwa.
Ukuhlolwa ngokomzimba ngokuthuthukiswa okusolwa kwenqubo yokuvuvukala okubandakanya kubandakanya i-palpation ngokwendlela esunguliwe. Le ndlela isuselwa ekuzwelweni kobuhlungu ezindaweni ezithile nokuqonda kwendawo yocwaningo. Isithombe ngasinye sinezimpawu zaso.
Izindawo ze-pancreatitis zibizwe ngemuva kwababhali, abaqanjwa ngemuva kochwepheshe bezokwelapha abaphenya lezimpawu. Isibonelo, uphawu lweShoffar nge-pancreatitis, i-Kacha nabanye odokotela.
I-Palpation njengokuxilonga yaqala ukusetshenziswa ngasekupheleni kwekhulu lama-20, lapho kwakungekho mishini ekhethekile yokusiza ukubona izimbangela zobuhlungu obukhulu kanye nokuqubuka kweziguli esigulini. Odokotela basebenzise iminwe yabo ngesikhathi sokuhlolwa. Ezenzweni zesimanje zokwelapha, indlela ye-palpation ifanela ubuchwepheshe - i-ultrasound, i-MRI.
Inzuzo yayo ukuthi ngosizo lwe-palpation ungasola ngokushesha i-pancreatitis eyingozi, ngokulandelana, ngokushesha okukhulu ukwelashwa okufanele. Kumuntu omdala ongenakho ukusebenza kokulimazeka kwe-pancreatic, akunakwenzeka ukugcobisa isitho.
Ngokuphikisana nesizinda se-palpation kanye ne-percussion endaweni yephancreas, kuyadingeka ukuqapha ngokucophelela ushintsho esimweni sesifo sezinhlungu esigulini.
Izimpawu eziphambili
Lapho wenza isifo, i-palpation iyingxenye yokuxilongwa, okukhombisa ukutholwa kwasekhaya kwemizwa ebuhlungu, ushintsho lwabo enqubweni yokucindezela. Isimpawu sikaVoskresensky se-pancreatitis sichazwa njengukuntuleka kokuqothuka kokushaywa odongeni lwe-aortic - endaweni yokuxhumana nama-pancreas.
Leli phuzu litholakala ngamasentimitha amahlanu ngenhla kwenkaba ngokushintshwa kwamasentimitha amane endaweni yokubalwa kwe-gallbladder. Ukuthola isibonakaliso seVoskresensky kuyadingeka ukudweba iminwe kusuka esifundeni se-epigastric kuya ekubonisweni kwesibindi ngokugqoka okuncane. Ku-70% we-pancreatitis oyingozi, kutholakala umphumela omuhle. Kwezokwelapha, lolu phawu lunolunye igama le "uphawu lweshidi."
Ukubonakaliswa komtholampilo kwe-Mayo-Robson kunqunywa ngobuhlungu obukhulu endaweni etholakala ngokuqagela komzimba nomsila. Ukuthola iphuzu, umugqa udonswa ngokwengqondo kusuka enkabeni kuya maphakathi nembambo engakwesobunxele. Usizi luyozwakala kokuthathu kwalayini.
Lesi sibonakaliso sivela ku-50% wezithombe zokwelashwa. Kunganqunywa ngokucindezela okukhanyayo - ukwanda kobuhlungu kukhombisa ukuthuthukiswa kokuhlaselwa ngamandla.
Ezinye izimpawu:
- I-Shoffar Zone. Ukudakumba kuchazwa phakathi komugqa wangaphakathi ophakathi nomugqa oxhumanisa inkaba ku-armpit yangakwesokudla kanye ne-perpendicular eyehliselwe kulayini ophakathi we-Desjardins;
- Isibonakaliso seKerth sibuhlungu palpation endaweni efakwe amasentimitha ayi-5 ngaphezulu kwenkaba endaweni ebheke ngokuqinile enkabeni. Kutholakale ku-65% wemidwebo. Futhi, isibonakaliso sithathwa njengento enhle uma kutholakala ukungezwani kwemisipha yesisu esifundeni se-epigastric;
- Iphuzu likaKach ku-pancreatitis libuhlungu ngokumelene nesizinda sokuthinta ukuqagela komsila wesitho sokugaya ukudla. Indawo ekhomba: isifunda senqubo yokudlula kwe-vertebra yesi-8. Kwezinye izimo nge-pancreatitis engapheli, kungabonakala njengokucasuka kwesikhumba kule ndawo;
- Isibonakaliso seRazdolsky sitholakala cishe kuzo zonke izimo ze-pancreatitis esibuhlungu. Kuhambisana nobuhlungu obukhudlwana obenzeka ngesikhathi sokucwazimula esikhunjeni endaweni yokubekwa kwamanyikwe. Kususelwa kwinqubo ekhombisa ukuvuvukala yesisu sesisu.
Kodwa-ke, i-palpation ayanele ukwenza ukuxilongwa - ukuxilongwa okugcwele kuhlale kwenziwa, ngoba ukuhlaselwa okubucayi kungabangelwa ezinye izifo - cholecystitis, cholelithiasis.
Ukuba khona kwezimpawu ezichaziwe yisizathu sokulaliswa esibhedlela kweziguli ngenhloso yokuhlolwa esibhedlela.
Izimpawu palpation
Ngaphezu kwalokhu okubalwe ngenhla, ungabiza ezinye izinkomba eziqanjwe ngemuva kodokotela futhi ezinqunywe yi-palpation. Labo asebechaziwe vele babonakala bevame kakhulu, ngokulandelana, kaningi baphendukela ekusizeni kwabo.
Isibonakaliso seMondor, ngokusho kodokotela, sivezwa cishe kuzo zonke izimo ze-pancreatitis eqeda amandla noma esebenzayo. Kuhambisana nokubonakala kwezindawo ezimnyama ze-tint eluhlaza okwesibhakabhaka esikhunjeni somuntu. Zivele zombili emzimbeni nasebusweni. Isizathu ukungena kwezinto ezinobuthi ama-pancreas akhipha ohlelweni lokujikeleza - emva kwalokho angena ezingqimbeni zesikhumba.
Isibonakaliso sikaGrott sivezwa yi-pain pain syndrome, esitholakala ngamaphuzu athile. Kunezindlela eziningana, ngayinye inebizo layo, isiza ukuqinisekisa inqubo yokuvuvukala emsileni, emzimbeni noma ekhanda lesikhumba.
Kwi-palpation kuqondiswa yizimpawu ezilandelayo:
- Desjardins. Ubuhlungu buzibonakalisa endaweni etholakala ngamasentimitha angama-4 ngaphezulu kwenkaba eceleni komugqa oyixhumanisa ne-armpit. Iqondile ngo-71%, ikakhulukazi ngokumelene nesizinda sesifo esonakalisayo.
- Ngenqubo yokuvuvukala okukhulu, ukusabela okuhle kuvame ukutholwa nengcindezi endaweni, etholakala kwifossa yemisipha ye-sternocleidomastoid. Igama lesibonakaliso luphawu lukaMssie-Georgiaievsky. Kubangelwa ukucasuka okukhulu kodonga lwesisu, ukuvutha kwe-nerve endings.
Kuyaqapheleka ukuthi uphawu lukaMushsie-Georgiaievsky alugcini nje ngokumelene nesizinda se-pancreatitis, kodwa futhi nokuvuvukala kwe-gallbladder, ukugcotshwa kwesilonda. Ngakho-ke, ukuba khona kwayo akusona ukuxilonga kokugcina, ukuxilongwa okuhlukile kuyadingeka.
Isibonakaliso seTuzhilin sihambisana nokuvela kwamabala abomvu esikhunjeni, osayizi bawo afinyelela kumamilimitha amane. Kunqunywa ngokubuyela emuva kokuvuvukala okuvilaphayo.
Ukwelashwa kokuhlaselwa okuqandayo kwenziwa esibhedlela. Ngemuva kokukhipha, udinga ukulandela ukudla, uthathe imishanguzo ebekwe udokotela. Ngaphezu kwalokho, kusetshenziswa izindlela ezingezona zesiko - ama-massage complexes, i-acupuncture, ama-decoction we-herbal, njll.
Imininingwane ngezimpawu ze-pancreatitis inikezwe kuvidiyo kule ndatshana.
