I-pancreatitis engapheli enobunzima bokungabikhona: kuyini?

I-pancreatitis engapheli ene-exocrine insufficiency iba nenqubo ende yokuvuvukala kumanyikwe (ngaphezulu kweminyaka eyi-10). Njengomphumela wokufakwa kwe-parenchyma ngezicubu ezixhunyiwe, isitho siphulukana namandla okwenza ngokuphelele umsebenzi we-impretory and exocrine.

Lesi sifo sibi kakhulu ngoba siholela ekulahlekelweni okuyingxenye noma okuphelele kwama-pancreas.

Izimpawu eziphambili ze-pathology ukuphazamiseka kwe-dyspeptic, Ubuhlungu besisu, isicanucanu, isikhumba sesikhumba, i-tachycardia, ukuphefumula komoya omncane, ukuncipha kokusebenza kanye nokukhathala okungapheli.

Isibonakaliso esiyinhloko sokuvuvukala kwe-pancreatic kanye nomsebenzi okhubazekile ukuba khona kwezinhlayiya zokudla ezingaphanjwanga esitobhini kanye nokuhlanganiswa kwamafutha. Isisekelo sokuxilongwa isifundo sezinduku. Izakhi zokwelapha ezisebenzayo zingondli ezikhethekile, ukuthathwa kwama-enzymatic agents nama-proton pump blockers.

Ukubuka konke kwe-Chronic Pancreatitis

Eminyakeni engama-30 edlule, inani leziguli ezihlushwa i-pancreatitis seliphindaphindwe kabili. Le nto ichazwa wukusebenzisa kabi utshwala, i-cholelithiasis, indlela yokuphila engasebenzi, kanye nokudla njalo ukudla okunamafutha nokuthosiwe. Odokotela bathi i-pancreatitis "isencane": manje isifo se-pathology sitholakala ngokwesilinganiso sineminyaka engama-39 ubudala, lapho ekuqaleni iminyaka emaphakathi bekuyiminyaka engama-50.

I-pancreas iyisitho se-exocrine ne-intrasecretory. Ukuqedwa kwangaphandle ukukhiqizwa kwejusi ye-pancreatic, kanti ukugcinwa kwangaphakathi kungukukhiqizwa kwama-hormone.

I-pancreatitis kwenzeka kanye nokwenza kusebenze kwama-enzymes wokugaya gland uqobo. Ngenxa yalokho, umzimba uqala "ukuzicwilisa." I-pancreatitis engapheli (i-pancreatitis) yindlela yesifo ebonakala ngokushintshwa kwe-dystrophic kumanyikwe. Ngokuqhubeka njalo kwe-pathology, i-fibrosis ibonwa, inyamalala noma imibimbi ye-acini (amayunithi wesakhiwo se-pancreas), izinguquko ekwakhekeni kwama-ducts, kanye nokwakheka kwe-calculi ku-parenchyma.

Ngokusho kwe-ICD-10, i-CP ye-etiology yotshwala nabanye bahlukanisiwe. Ngokusho kokunye ukuhlukaniswa, kune-biliary-based, parenchymal-fibrous kanye ne-CP evimbayo.

Ngokungafani nobunzima besifo, ifomu lesifo esingamahlalakhona linesithombe esithambile somtholampilo noma liqhubeka nezifo ezihambelanayo, ngokwesibonelo, izilonda zesisu kanye ne-duodenal, cholecystitis engapheli, i-dyskinesia ye-biliary.

Izikhalazo zesiguli esihlushwa i-pancreatitis engapheli zingase zihlangane ne:

• izinhlungu ezihlungayo kwi-hypochondrium efanele;
• ukwanda kwegesi;
• ukuqothuka kwenhliziyo futhi ube nomuzwa wokuthi uthukuthele;
• isifo se-dyspeptic.

Imvamisa, ngenxa yokwephulwa kwemithetho yokwelashwa kokudla ngemuva kwesizinda se-pancreatitis esingamahlalakhona, kuvela kakhulu, lapho kukhonjiswa ngokuphelele ukudla. Lesi sifo aselapheki, ngakho-ke, sidinga ukubhekwa njalo futhi sithathwe nemithi.

Ochwepheshe abaningi bahlukanisa izigaba ezimbili zepancreatitis engapheli /

Isigaba I (sokuqala iminyaka eyi-10) - ukushintshana okwandayo nokuxolelwa, ukuphazamiseka kwe-dyspeptic akuvezwanga, kunobuhlungu esifundeni se-epigastric /

Isiteji II (iminyaka engaphezu kwe-10) - ukubambelela kobuhlungu, ukukhubazeka okune-dyspeptic.

Kukulesi sigaba sesibili lapho kukhula khona i-pancreatitis engapheli ngokuntuleka kokungapheleli, okubonakaliswa yi-lesion ebalulekile yama-pancreas.

Izimbangela zokuntuleka kwe-exocrine

Inqubo "yokuzicwilisa" iholela ekuguqukeni kwe-dystrophic ku-parenchyma kanye nokuphuma okulimazayo kwejusi le-pancreatic. Ngokuphikisana nesizinda salezi zinqubo, i-secretory, noma i-glandular, izicubu ze-pancreatic zithathelwa indawo yizicubu ezithambile. Ngenxa yalokhu, lezi zingxenye zesitho azikwazi ukwenza umsebenzi we-exocrine.

Kuyaqapheleka ukuthi i-pancreatitis engapheli akusona ukuphela kwesizathu sokuthuthukiswa kokungalingani kwe-exocrine. Enye imbangela yalesi simo kungaba yi-cystic fibrosis - isifo se-autoimmune esithinta izitho ezikhiqiza uketshezi lwezinto eziphilayo. Lokhu kufaka phakathi umgudu wokugaya ukudla, ipheshana lokuphefumula, amanyikwe, izitho zangasese, izithukuthuku zamathumbu, izindlama zomlomo nezomlomo.

I-pancreatitis engapheli kanye ne-cystic fibrosis yizindlela eziyinhloko lapho kuvela khona ukungapheleli kwe-procrine. Amasu wesibili wokukhula kwawo afaka inqubo ye-pathological lapho ukuthathwa kwama-enzymes wokugaya ku-duodenum 12 kungayenzi inqubo yokugaya ukudla.

Lokhu kungenxa yokusebenza kwabo ngokunganele, ukungasebenzi kanye nokwephula ukwahlukanisa. I-pancreatitis enokuntuleka kwe-exocrine, okwenzeka ngenxa yezizathu zesibili, inezici ezithile. Ngokuyinhloko, inkambo yalesi sifo yenzeka ngokuya nge "simo" esilandelayo:

1. Ulwelwesi lwe-mucous lwesisu esincane luthintwa yizinto eziningi ezingezinhle. Njengomphumela, ukukhiqizwa kwe-cholecystokinin ne-secretin kuyancishiswa.
2. Le nqubo ivusa ukwehla kwe-pH ye-intraduodenal ngaphansi kwe-5.5. Lokhu kusho ukuthi ama-enzyme e-pancreatic ngeke asebenze.
3. Kukhona ukwephulwa kokuhamba kokudla okuhamba ngamathumbu amancane. Ama-enzymes wokugaya angasebenzi acashile aqala ukuxubana nezinhlayiya zokudla okungenayo.
4. Njengomphumela, inqubo yokubola iqala - isimo esifanele samagciwane we-pathogenic. Izifo ezahlukahlukene zijoyina ukwenziwa kabusha kwama-microflora ayingozi. Ukwanda kwenani lamagciwane kuholela ekubhujisweni kwama-enzyme wokugaya ukudla.
5. Ama-pancreatic juice stagnates, ahambisana nokushoda kwe-bile ne-enterokinase.

Njengomthetho, ngokususa ngokuphelele ama-pancreas (gastrectomy), zombili izindlela ezisebenza ngokuyinhloko nezesekeli zibandakanyekile.

Ukwahlukanisa nezimpawu ze-pathology

Ukuntuleka kwemfihlo yangaphandle kufanele kuhlukaniswe ngokwezimpawu eziningana - izimbangela ze-pathology nezifo ezihlangene.

Ukubonakaliswa okuyinhloko kokuntuleka kokuqanjwa kwangaphandle yile:

1. Ukungabekezeleli kokudla okunamafutha, okuthosiwe nokubhemayo. Uma isiguli sidla lokho kudla, ngemuva kwesikhashana siyozizwa sisindwa esiswini sayo. Bese kunezelwa izinhlungu zekholic. Ngemuva kokukhipha isisu, kufakwa isihlalo se-mushy - uphawu oluphambili lwe-pancreatitis. Kuyo ungabona ukungcola kwe-mucus (fat) nezinhlayiya zokudla okungaphanjwanga. Imvamisa yokuya endlini yangasese izikhathi ezingama-3-6 ngosuku. Okuqukethwe kwamafutha wesitulo kulula kakhulu ukunquma: izinhlayiya zesithulu zivame ukushiya amamaki ethoyilethi, ngoba kunzima ukuzigeza ngamanzi.
2. Izimpawu zokuntuleka kwamavithamini anyibilikisiwe. Ngenxa yokushoda kwabo, izinhlungu emathanjeni ziyabonakala, ziba brittle ngokwengeziwe. IVitamin D hypovitaminosis iholela ekubambeni, iVitamin K iholele ekulimaleni kwegazi, iVitamin A ibangela "ukungaboni ebusuku" nesikhumba esomile, uVitamin E unciphisa i-libido nezifo ezithathelanayo.
3. Izimpawu ezihambisana nokushoda kwe-pancreatic proteinase. Lama enzymes aphula amaprotheni. Ukushoda kwabo kuholela ku-B12-deficial anemia, ebonakala ngokuncipha komthamo wokusebenza, ukuphefumula, ukuqina kwesikhumba, i-tachycardia nokukhathala okusheshayo. Ngenxa yenani elanele lezakhi zomzimba, ukwehla ngokushesha kwesisindo somzimba kuyabonakala.

Lezi zinqubo ze-pathological zithinta ikakhulu abantu abadala. Ebuntwaneni, i-pancreatitis enokwephulwa komsebenzi we-exocrine iba ngokungajwayelekile. Ukuvuvukala kwesitho kwenzeka ngenxa yezinye izizathu - izifo zesisu esincane, isifo se-gallstone, ukulimala okuhlukahlukene kwesifunda sesisu, ukuvinjwa kwe-duodenal, ukuvuvukala okungahambi kahle kwamanyikwe namanyikwe.

Izindlela zokuxilonga nokwelashwa

Ngemuva kokubona izimpawu zokuntuleka kwe-pocrreatic pancreatic, umuntu kudingeka afune usizo lodokotela.

Ukulahleka kwesikhathi esibalulekile kungaholela kumonakalo ophelele kumanyikwe kanye nokususwa kwawo.

Indlela ephumelela kunazo zonke yokuthola lesi sifo ukucubungula izinyawo. Kuyasiza ukunquma izinga le-pancreatic elastase-1.

Imiphumela yocwaningo ingaba yile:

• I-200-500 mcg / g - umsebenzi ojwayelekile we-exocrine;
• I-100-200 mcg / g - degree emnene futhi elinganiselayo yokungalingani kwe-exocrine;
• Ngaphansi kwe-100 mcg / g - i-pathology enzima.

Indima ebalulekile ekwelashweni kwalesi sifo ukudla. Phakathi kwemithetho eyisisekelo yokudla okuyisipesheli kokuntuleka kwe-exocrine, kubalulekile ukugqamisa:

1. Izikhathi zokudla kakhulu akumele zidlule amahora ama-4.
2. Udinga ukudla ngezingxenye ezincane izikhathi ezi-5-6 ngosuku.
3. Gwema ukudla ngokweqile kusihlwa nasebusuku.
4. Khipha ukudla okuthosiwe, okunamafutha futhi okubhemayo ekudleni.
5. Nikeza ukukhetha kokudla komsuka wezitshalo.
6. Yekani ukuphuza utshwala ngokuphelele.

Isisekelo sokudla ukudla okuqukethe i-carbohydrate - imifino, izithelo, okusanhlamvu Bangumthombo wefiber fiber yokudla, amavithamini, izinto ezibalulekile zama-macro kanye nama-macro. Akunconyelwe ukusetshenziswa kokudla okufana nama-legamu, iklabishi, isitshalo seqanda, imikhiqizo kafulawa, njengoba kukhulisa ukwakheka kwegesi esiswini.

Ngaphezu kokwelashwa kokudla, iziguli kufanele zisebenzise imishanguzo. Isisekelo sokwelashwa yimithi enjalo:

1. Ama-enzymes wokugaya athuthukisa inqubo yokutholwa kokudla (i-Mezim, iPancreatinum 8000, i-Creon, iPanzinorm). Zithathwa ngesikhathi sokudla, umthamo uncike enanini lokudla okudliwayo nokwakheka kwalo.
2. I-Proton pump blockers ezisiza ukugaya ukudla (lanzoprazolol, esomeprazole, omeprazole). Isenzo sezidakamizwa kuhloselwe ukudala ukusabela kwe-alkaline emgodini ongaphezulu wesisu.

Kulokhu, ukuzelapha kungaba nje akunakwenzeka. Ukulandela yonke imiyalelo kadokotela, umphumela omuhle wokwelapha ungatholakala. Ngenxa yalokhu, izinhlungu ezingama-coliny kanye nesifo sohudo zizodlula, futhi ngeke kube nokuhlanganiswa kwezinhlayiya ezinamafutha neziningi ezingatholakali esitobhini. Izikhathi ezithile, isiguli sihlolwa kabusha. Ukujwayelekile kwenqubo yokugaya ukudla kuboniswa ngokuncipha kokuqukethwe kwamafutha kumalondolo kuya ku-7 g.

Ochwepheshe bazokhuluma nge-pancreatitis engapheli esevidiyo kule vidiyo.