Ukwengula i-pancreatitis kungenye yezindlela ezinesifo esiqine kakhulu, esibizwa ngokuthi ngenxa yokwakheka kwama-calculi emigungwini yamanyikwe kanye nasemgqonyeni omkhulu.
Ubukhulu bamatshe buhlukahluka kakhulu - kwezinye iziguli kutholakala okusanhlamvu okuncane kakhulu kwesihlabathi, kungaphansi kwamamilimitha ububanzi, kwabanye abantu, amatshe ahluka kusuka ku-15 kuye ku-30- 40 mm.
Ngenxa yama-neoplasms aqinile emacucwini, kuyacasulwa ulwelwesi lwe-mucous lwe-duodenum, okuholela ekutheni kukhishwe imisebe ye-duodenal papilla futhi kuvuse ukwephula ukuphuma kwe-secondtion ye-pancreatic, inqubo yokuvuvukala iyenzeka.
Ukukhethwa kokwelashwa ngale ndlela ye-pathology engapheli kunama-nuances athile, ngoba noma yiziphi izindlela ezikhethiwe zingadala ukulimala okungalungiseki empilweni. Cabanga ngezimbangela, izimpawu zesifo esinciphisa amandla, thola ukuthi iyini i-pancreatitis ethambisayo.
I-Etiology ye-pancreatitis ebunjiwe
I-pancreatitis inqubo yokuvuvukala kumanyikwe. Kwenzeka kakhulu - kuba ngokuzumayo, izimpawu zesimilo ziqhubeka ngobudlova, zinikeze isiguli isihlukumezi esiningi. Ifomu elingamahlalakhona ukuvuvukala okuvilaphayo, okungathathelwa indawo ukwanda kwazo zonke izimpawu ezihambisana nalokhu.
Ukwelashwa kwe-pancreatitis okungapheli, ngokusho kochwepheshe abaningi bezokwelapha, kuxhumana kakhulu nokusetshenziswa kwemikhiqizo yotshwala, ukudla okungalungile, okuphethwe ukudla okunamafutha nokuthosiwe.
Esigabeni sokuqala sokuthuthuka kwenqubo ye-pathological, ukwakhiwa kwamapulagi amancane wamaprotheni kuyabonakala, akukho zimpawu zokubala. Uma wenza ukuhlolwa kwe-ultrasound noma i-x-ray kulesi sigaba, khona-ke izindlela ngeke zisize ukuthola i-calculi, ngoba incane kakhulu. Ngemuva kwalokho, njengoba lesi sifo siqhubeka, kwakheka amatshe ngokufakwa kukasawoti we-calcium, okudala ukwephulwa kokusebenza kwesitho sangaphakathi.
I-pathogenesis yalesi sifo ibangelwa le mibandela elandelayo engemihle:
- Ukuphuza utshwala;
- Imikhuba emibi yokudla;
- Isakhi sofuzo.
Kwezinye izimo, kubalwa i-pancreatitis ye-idiopathic etiology, ngamanye amagama, izifundo zokuxilonga azange ziphendule umbuzo wokuthi kungani lesi sifo savela.
Kuyiqiniso, utshwala yinto evelele efaka isandla ekuthuthukiseni lesi sifo. Ukusetshenziswa kwemikhiqizo yotshwala kuyaphatha ukonakala kwesisu, okuholela emiseleni yemisipha evimbela ukuphuma kwejusi yokugaya ukudla.
Isizathu sesibili ukungondleki. Uma isiguli sidla ukudla okunamafutha amaningi kakhulu futhi okuthosiwe, lapho kuhlangana khona ama-carbohydrate, khona-ke ingozi yokuthola i-pathology iphezulu impela. I-Factor 1 ne-2 i-akhawunti kuze kube yi-90% yamacala avela kuzo zonke izifo. Futhi inhlanganisela yotshwala nemikhuba emibi yokudla kuyibhomu lesikhathi, kusho abasebenza nge-gastroenterologists.
Isici sofuzo sibala cishe i-3% yezithombe zemitholampilo. Uma ngabe kunale nkinga emlandweni womndeni, khona-ke udinga ukucabanga ngesimo samanyikwe akho - uhlolwe ngokuhlolwa, ulandele indlela odla ngayo.
EYurophu, amadoda acebile aneminyaka ephakathi kuka-30 no-45 asebenzisa kabi utshwala asengozini.
Emazweni ase-Afrika nase-Asia, ababuthaka kakhulu yibona abampofu ngenxa yokungondleki.
Izimpawu nokwelashwa
Ukwehlukanisa i-pancreatitis kuhambisana nobuhlungu. Ubukhulu nobukhulu bobuhlungu kungenxa yobukhulu be-calculi emigungwini ye-pancreatic nomsele omkhulu.
Iziguli zivame ukukhononda ngobuhlungu esiswini sokuqina okuhlukahlukene. Iyakwazi ukunikela endaweni yama-ehlombe amahlombe noma emuva emuva. Isicanucanu kuvame ukutholakala, kufinyelele ekuhlanzeni nge-bile noma izingcezu zokudla ezingaphanjwanga. I-pancreatitis steatorrhea iyimpawu ejwayelekile. Amafutha atholakala ezindlini zesiguli, amalahle aqhakazile, abe nephunga elingathandeki.
Uma, ngezimpawu ezinjalo zemitholampilo, kuhlolwa igazi, khona-ke ukwanda kokuqukethwe kwezakhi zamaprotheni, ukwanda kokuqothelwa kwamafutha, kanye ne-calcium ethe xaxa kuyabonakala kuwo. Njengezindlela zokucwaninga ezengeziwe, i-radiography yezitho zesisu, i-MRI ye-gland iyanconywa.
Uhlelo lokwelashwa luqukethe amaphuzu amabili - hlanganisa ukusetshenziswa kwezidakamizwa nokungenelela kokuhlinzwa. Ukwelashwa kokuqothula kunezinhloso ezilandelayo:
- Ukuvuvukala okubabazekayo.
- Ukulungiswa kwe-calcium ne-phosphorus metabolism.
- Ukuqina kwe-edema ye-pancreatic.
Ukufeza lezi zinhloso, kunqunyelwe imithi, ukudla kwezempilo - ithebula lesihlanu. Uma amatshe emincane, khona-ke i-prognosis iyathandeka futhi ngaphandle kokungenelela kokuhlinzwa - kungenzeka ukufezekisa ukuthunyelwa kwamatshe emathunjini, ngokulandelana, ashiya umzimba ngokwemvelo.
Ngamatshe amakhulu, ukususwa kwawo kwemishini kuyadingeka, ngaphandle kwalokho amathuba okuthuthuka kwezinkinga aphezulu. Izindlela Zokususa:
- Izinqubo ze-Endoscopic ziyindlela yesimanje ebonakala ngesikhathi esifushane sokuvuselela kabusha. Ukukhwabanisa kunconyelwa ezimweni lapho amatshe amancane ngosayizi, etholakala ekhanda lesitho sangaphakathi;
- Ukususa i-calculi enkulu eyenziwe endaweni emzimbeni noma endaweni yomsila, kwenziwa i-laparotomy noma i-pancreatotomy;
- I-pancreatectomy ephelele yenziwa uma kutholakala ukutholakala kwezimpawu ezithambile zepancreatic izicubu ezithambile.
Ukuntuleka kokwelashwa okufika ngesikhathi kuholela ezinkingeni ezinkulu - isifo sikashukela, isisulu sokuhlanza, ukugcwala kwezicubu ezithintekayo noma ukufa kwamangqamuzana esitho sangaphakathi.
Ngokwelashwa okwanele, i-prognosis iyathandeka, isimo sesiguli siyathuthuka, futhi nekhwalithi yempilo ayinciphi.
Izimbangela kanye nezimpawu ze-pancreatitis enqabayo
I-pancreatitis ethambisayo ukuvuvukala okuhlala isikhathi eside (izinyanga ezingaphezu kweziyisithupha) zepancreas, okubangelwa ukuvinjezelwa - ukuqhekeka komsele ophambili we-pancreatic. Ngalesi siteshi, imfihlo yokugaya ingena ngaphakathi kwe-duodenum.
I-pancreatitis engapheli evimbela ukwenzeka ngenxa yezifo ezithile. Ama-tumor neoplasms ku-pancreas, ukuvuvukala ku-duodenal papilla, ukunciphiswa okuqhubekayo kwepagilla ye-duodenal, ukuvuvukala kwe-duodenum 12, ukwakhiwa kwama-cysts "wamanga" kungaholela kukho.
Njengomphumela ovuselelayo, kukhona izibazi ze-postoperative kuma-pancreas, noma i-trauma enzima yesitho sangaphakathi.
Ukuboniswa kwemitholampilo kwefomu elivimbayo:
- Ubuhlungu obujwayelekile esiswini esingenhla. Kuvame ukuqina ngemuva kokudla ukudla ngenkathi ulele emhlane wakho. Ubuhlungu budonsa, bukhali, buthule, bubonwa njalo noma kwenzeka ngezikhathi ezithile.
- Ukuqhuma nokuqhuma esiswini, ukukhuphuka kwamandla kagesi, isicanucanu, ukugabha okuphindaphindekile, ukufakwa komoya.
- Ukuphazamiseka kwendlela yokugaya ukudla. Imidwebo eminingi ikhombisa uhudo, kwesinye isikhathi ukuqunjelwa. Usihlalo unenqwaba, kunephunga le-fetid, kukhona izingcezu zokudla ezingafakwanga kuwo, kugezwa kabi ezindongeni zesitsha sendlu yangasese (kuqukethe amafutha amaningi).
- Ukuthuthukiswa kwe-jaundice evimbayo. Isikhumba, ulwelwesi lwama-mucous, i-sclera yezitho zombono ziphenduka ophuzi. Lesi sibonakaliso sivela ngenxa yokugcwala okukhulu kwe-bilirubin egazini. Ukukhuphuka kwezinga layo kucasulwa ngokuvinjwa kweziqubu ze-bile.
I-pancreatitis eyingozi ingakhula ngenxa yokuvinjwa kweziqubu ngokubala, khona-ke singakhuluma ngoguquko lube yindlela yokubala yesifo.
Ukuqashelwa yisifo esingamahlalakhona kuncike esikhathini sokuxilongwa kanye nokunemba kokwelashwa.
Ukuxilonga nezindlela zokwelashwa kokuvinjwa kwendawo
Ukuxilongwa kufaka umlando wezokwelapha, izivivinyo zaselebhu kanye nokusebenzisa amasu ezinsizakalo. Ukuhlolwa kwegazi okune-biochemical ne-general, kuhlolisiswa imitholampilo ejwayelekile yokwenziwa kwendle.
Ukunquma ukuba khona kwalesi sifo, kuyadingeka ukuthi kwenziwe uhlolo lwe-Ultra - kuveza ushintsho ezicutshini zesitho sohlelo lokugaya ukudla, ukuvimbela okugcwele noma ukuvaleka okuyingxenye kwe-pancreatic duct.
Ukwelashwa kwesimo esithithibayo salesi sifo kufaka izindlela zokwelashwa, ukungenelela kokuhlinzwa kanye nezincomo ezijwayelekile. Ngokwengeziwe, ungasebenzisa amakhambi abantu ngemuva kokubonisana nodokotela wakho. Izincomo zifaka ukudla kokudla nokwenqaba ukuphuza utshwala.
Ukwelashwa kwezidakamizwa kusiza ukuqeda izimpawu ze-pathology:
- Ukwelashwa kwesikhashana kwenziwa ngaphandle kwesikhathi sokwanda kwenqubo yokuvuvukala, kulungiselelwe amalungiselelo e-encyme (Biozim, Pancreatin, Pancreasim, Creon);
- Amacwecwe okubulala izinzwa asiza ukuqeda izinhlungu, ama-antiemetics acindezela umsebenzi wesikhungo sokuhlanza ebuchosheni;
- Ukunciphisa ukukhiqizwa kwejusi yesisu, kunqunywa imithi ye-antisecretory;
- Ukwelashwa kwe-antibacterial kunconyelwa ukuze uvikele imiphumela emibi - ama-purreat abscesses, njll;
- Ukulungiswa koshukela wegazi.
Ukwelapha ngokuhlinzwa kuhilela ukuqedwa kwemishini kokuvinjwa. Izinhlobo ezintathu zokungenelela zihlukaniswa - i-necrosecestrectomy (ukuhlanza ngokuphelele kwe-foci yokubhujiswa), ukuhlelwa kabusha (ukubekwa kwendawo ethintekile) kanye ne-papillotomy (disgment of the duodenal papilla).
Izinkinga zesifo nezindlela zokuthibela
Ukuntuleka kokwelashwa okufika ngesikhathi kuholela ekwakhiweni kwezinkinga. Imiphumela engemihle ayikwazi ukubekelwa phansi ngisho nangasemuva kokwelashwa okwanele, ngoba kunzima ukubikezela umphumela wesifo.
Kuma-pancreas, kuvela ama-cysts - amakhompiyutha akhawulelwe izicubu, agcwele i-exudate. Zivame ukwanda ngosayizi, okuholela ekucindezelweni kwezitho zomzimba eziseduze.
Isifo sikashukela mellitus siyisibonakaliso senqubo ye-pathological kanye ne-complication ye-pathology. Ngokwezibalo, nge-pancreatitis, isifo "esimnandi" sivela ku-50% wezithombe zomtholampilo zazo zonke izimo zokuwohloka komzimba.
Ezinye izinkinga:
- I-jaundice eyingozi.
- I-pancreossteosis
- I-pancreatic necrosis.
Njenge-prophylaxis ye-exacerbation, kunconyelwa ukuthi yonke imiyalo kadokotela ithathwe - umuthi, ukudla. Kuyadingeka ukuthi uvakashele njalo i-gastroenterologist - okungenani kanye ngonyaka, ukwenza i-ultrasound yezitho zesisu.
Imininingwane ngezimpawu nezindlela zokwelapha i-pancreatitis inikezwe kuvidiyo ekulesi sihloko.
