Ukuhlinzwa kwe-pancreatitis eyingozi kungaba ukuphuthumayo noma kuphuthumayo, ukungenelela kwenziwa emahoreni okuqala okuhlaselwa noma ezinsukwini zokugula. Isibonakaliso yi-enzymatic noma i-peritonitis eyingozi, ebangelwa ukuvaleka kwengono enkulu ye-duodenum.
Ukungenelela okuhlinzwa okubambezelekile kwenziwa ngesikhathi sesigaba sokuncibilika nokwenqatshwa kwezindawo ezinobungozi be-pancreas kanye ne-retroperitoneal fiber. Imvamisa yenziwa ezinsukwini eziyi-10-14 ngemuva kokuhlaselwa kanzima kweziguli.
Ukungenelela okuhleliwe kwenziwa ngesikhathi sokucindezela okuphelele kwezinqubo zokuvuvukala esitho sangaphakathi. Umgomo ukuvikela inkambo yesifo esenzeka njalo. Zenziwa kuphela ngemuva kokuxilongwa okuningiliziwe kanye nokuhlolwa kweziguli ngokuphelele.
Cabanga lapho ukwelashwa kokuhlinzwa kwe-pancreatitis kudingeka, futhi yiziphi izinkinga ezingaba khona esikhathini sokululama?
Umsebenzi wenziwa nini?
Isidingo sokwelashwa kokuhlinzwa kungenxa yezifo zama-pancreas, lapho kunomonakalo omkhulu kwezicubu zesitho. Imvamisa, ukuhlinzwa kwenziwa ezimeni lapho ezinye izindlela eziye zaholela ekuhlulekeni, noma isiguli sisesimweni esibi kakhulu.
Lokhu kungenxa yokuthi noma yikuphi ukungenelela kusitho se- "ithenda" kugcwele imiphumela emibi ehlukahlukene. Indlela esetshenziswayo ayiqinisekisi ukululama kwesiguli, kunalokho, kunobungozi bokuqina kwesithombe okubalulekile.
Ngaphezu kwalokho, udokotela ohlinzayo ofaneleke kuphela onolwazi oluncane ongahlinzwa, futhi ochwepheshe abanjalo abatholakali kuzo zonke izikhungo zezokwelapha.
Ukuhlinzwa kwe-pancreatic kwe-pancreatitis kwenziwa ezimweni ezilandelayo:
- Isigaba esibuhlungu sesifo esibhubhisayo. Kulesi sithombe, ukubola kwezicubu zesitho sesimo se-necrotic kuyabhekwa, ukungezwa kwezinqubo zokuhlanza akumele kukhishwe, okusongela impilo yesiguli.
- I-pancreatitis kwifomu elibukhali noma elingamahlalakhona, elaguqulwa laba yi-pancreatic necrosis - ukuguquguquka kwe-necrotic kwezicubu eziphilayo.
- I-pancreatitis engapheli, ebonakala ngokuhlaselwa njalo komzimba kanye nesikhathi esifushane sokuxolelwa.
Onke la ma-pathologies lapho kungekho khona ukwelashwa okungaholela emiphumeleni ebulalayo.
Noma yiziphi izindlela zokwelashwa ezinokulawula azinikezi imiphumela oyifunayo, okuyinkomba eqondile yokusebenza.
Ubunzima bokwelashwa okuhlinzwa
Ukuhlinzwa kwe-pancreatitis kubonakala kuyinqubo eyinkimbinkimbi futhi enzima ukubikezela, esekelwe ezicini eziningi ezihlobene ne-anatomy yesitho sangaphakathi secretion exubile.
Izicubu zesitho sangaphakathi sibonakala ngezinga elithile le-fragility, okuthi ngesikhathi sokukhohlisa kuholele ekopha kakhulu. Le nkinga ayifakwa ngesikhathi sokuthola isiguli isiguli.
Izitho zomzimba zitholakala eduze kwe-gland; ukulimala kwazo okuncane kungaholela kokungasebenzi kahle emzimbeni kanye nemiphumela engenakuphikwa. Imfihlo nama-enzyme akhiqizwa ngokuqondile esithweni, asithinte kusukela ngaphakathi, okuholela ekuhlukaniselweni kwezicubu, okwenza kube nzima kakhulu inkambo yokusebenza.
Izinkinga zangemva kokusebenza:
- Esiqwini sesisu, okuqukethwe kwe-necrotic noma kwe-purulent kuqala ukuqongelela, uma ngolimi lwesayensi, khona-ke isiguli sitholakala nge-peritonitis.
- Ukwanda kwezifo ezihlangene ezihambisana nomsebenzi wamanyikwe kanye nokukhiqizwa kwama-enzyme.
- Ukuhlehliswa kwemidumba esemqoka kuholela ekwandiseni i-pancreatitis.
- Izicubu ezithambile zesitho aziphili, amandla amahle okululama kwe-pancreatic awabhekwa.
Izinkinga eziyingozi kakhulu zibandakanya ukwehluleka kwezitho eziningi, ukushaqeka kwe-pancreatic ne-septic.
Imiphumela emibi yakamuva ibandakanya ukuvela kwama-pseudocysts, i-pancreatic fistula, ukuthuthukiswa kwesifo sikashukela nokuntuleka kwenhliziyo.
Ukulungiselela ukuhlinzwa kanye nezinhlobo zokungenelela
Noma ngabe unjani uhlobo lwe-pancreatitis - i-parenchymal, i-biliary, i-alcoholic, ukubala nezinye izinhlobo, ukulungiswa okuyinhloko kuzoba ukuzila ukudla. Kuvela futhi njengosizo lokuqala lokwanda kwesifo.
Ukuntuleka kokudla emgodini wesisu kunciphisa kakhulu amathuba wezinkinga zokuhlinzwa nezokuhlinzwa. Ngosuku lokungenelela, isiguli asidli, sinikezwa i-enema yokuzihlanza, khona-ke kwenziwa i-premedication.
Umcimbi wokugcina ubandakanya ukwethulwa kwemithi esisiza isiguli ukuthi sikwazi ukungena kwi-anesthesia. Bacindezela ukwesaba ukukhohliseka kwezokwelapha, basize ukunciphisa ukucaseka kwe-gland, futhi bavikele ukukhula kwemiphumela yempilo.
Ngale njongo, kusetshenziswa imishanguzo ehlukahlukene - ama-tranquilizer, ama-antihistamines, ama-anticholinergics, ama-antipsychotic.
Igama lomsebenzi we-pancreatitis:
- Ukuhlukaniswa kabusha kwesitho sangaphakathi Ngesikhathi senqubo yokwelashwa, udokotela ohlinzayo ususa umsila nomzimba wamanyikwe. Umthamo we-excision unqunywa ngezinga lomonakalo. Lokhu kukhwabanisa kuyaluleka kulezo zithombe lapho i-lesion ingasibeki sonke isitho.
- Ukuqalwa kabusha kwe-Subtotal kubandakanya ukususwa komsila, umzimba kanye nenhloko iningi le-pancreatic, izingxenye ezincane kuphela ezisondelene ne-duodenum ziyasala. Le nqubo yenziwa kuphela ngefomu lokulimala eliphelele.
- I-Necrosecvestpointomy yenziwa ngaphansi kokugadwa kwe-ultrasound kanye ne-fluoroscopy. Kutholakala uketshezi esithobeni, kukhishwe amanzi kusetshenziswa amashubhu akhethekile. Okulandelayo, kwethulwa imigqomo emikhulu yama-caliber ukuze kukhanye okuphakathi nendawo futhi kukhishwe izithako. Esigabeni sokugcina sokwelashwa, amachibi amakhulu athathelwa indawo yimincane, okuqinisekisa ukuthi ukwelashwa kancane kancane kwenxeba elisebenza ngemuva ngenkathi kugcina ukuphuma kwamanzi.
Ezinye zezinkinga ezivame kakhulu kukhona ama-purulent abscesses. Ungazibona ngalezi zimpawu ezilandelayo: umkhuhlane, i-hyperglycemia, ukuguquguquka kwefomula ye-leukocyte kwesokunxele, i-ultrasound ikhombisa imisebe egcwele ubomvu.
Ukunakekelwa kwempilo nokunakekelwa kweziguli
Ngemuva kokuhlinzwa, isiguli sithunyelwa endaweni yokunakekela abagulayo. Ekuqaleni, ukunakekelwa okujulile, lapho ukunakekelwa okufanele nokuqashwa kwezimpawu ezibalulekile kwenziwa khona.
Isimo esibi sesiguli emahoreni okuqala angama-24 sikwenza kube nzima ukuthola ukubonwa kwezinkinga ngemuva. Qiniseka ukuthi ubheka umfutho wegazi, umchamo, i-hematocrit, ushukela emzimbeni. Izindlela zokulawula ezinconyiwe zifaka i-x-ray yesifuba, i-ECG.
Ngosuku lwesibili, ngesimo esijabulisayo, umuntu omdala udluliselwa emnyangweni wokuhlinzwa. Lapho enikezwa ukunakekelwa okudingekayo, ukondliwa, ukwelashwa okuyinkimbinkimbi. Isikimu sokwelashwa okuqhubekayo kuncike ebukeni, ukuba khona / ukungabikho kwemiphumela emibi yokusebenza.
Ukubuyekezwa kodokotela kuqaphela ukuthi isiguli kufanele sibe ngaphansi kokuqashwa kochwepheshe bezokwelapha izinyanga eziyi-1.5-2 ngemuva kokungenelela. Lesi sikhathi sanele ukuthi isistimu yokugaya ivumelane nokuguqulwa futhi ibuyele ekusebenzeni okujwayelekile.
Izincomo zokuvuselelwa kabusha ngemuva kokukhululwa:
- Ukuphumula okuphelele nokuphumula kombhede.
- Ntambama.
- Ukudla
Okubaluleke ngokulingene nomoya womkhaya. Odokotela bathi izihlobo kumele zisekele isiguli, lokhu kumnika ithuba lokuthi aqiniseke ngethemba lokuthi uzokuthola yini ukwelashwa okwengeziwe.
Emavikini amabili emva kokukhululwa, ungaphuma ngaphandle uthathe izinyathelo ezimfushane ngesinyathelo esingatatazeli.
Ngesikhathi sokutakula, kwenqatshelwe ngokuphelele ukusebenza ngokweqile.
Ukwelashwa kwe-postoperative
I-algorithm yokwelapha ngemuva kokungenelela ngemuva kwesizinda se-pancreatitis kungenxa yezici ezithile. Ukunikeza ukwelashwa, udokotela ufunda umlando wezokwelapha wesiguli, umphumela wokugcina wokungenelela, izinga lokulungiswa kwe-gland, imiphumela yokuhlolwa kwelebhu nokuxilongwa kwethambo.
Ngokukhiqizwa okunganele kwe-insulin yi-pancreas, kunqunywa ukwelashwa kwe-insulin. I-synthetic synthesia isiza ukubuyisela nokuguqula ushukela emzimbeni.
Kunconywa ukuthatha amaphilisi asiza ukuthuthukisa inani elifanelekile lama-enzyme, noma osuvele uqukethe. Banomthelela ekusungulweni kokusebenza kwendlela yokugaya ukudla. Uma le mishanguzo ingafakwanga ohlelweni lokwelashwa, isiguli siba nezimpawu ezinjengokwenyuka kwamagesi, ukuqhakaza, isifo sohudo, ukushisa kwenhliziyo.
Ngokwengeziwe, imisebenzi elandelayo iyanconywa:
- Ukudla okunempilo.
- Izindlela zokuzivocavoca zokwelapha.
- Ukwelashwa komzimba.
Ukudla okulinganiselayo kubonakala kuyingxenye evelele yesikhathi sokululama kwesiguli. Ukudla ngemuva kokudalwa kabusha kwesitho kubandakanya ukuzila ukudla kwezinsuku ezimbili. Ngosuku lwesithathu, ukudla okusindayo kuyamukeleka. Ungadla okulandelayo:
- Thiya itiye elingenawo ushukela ne-crackers.
- Isobho eligcotshisiwe.
- Iporridge obisini (irayisi noma i-buckwheat). Ngesikhathi sokulungiselela, ubisi luhlanjululwe ngamanzi.
- Ama-omele abiwe (ama-squirrels kuphela).
- Isinkwa esomile, izolo kuphela.
- Kufika ku-15 g webhotela ngosuku.
- Ushizi ophansi wekotishi.
Ngaphambi nje kokulala, kunconywa ukuphuza ingilazi ye-kefir ephansi. Kwesinye isikhathi kufakwa nengilazi yamanzi afudumele ngokufakwa kwenani elincane loju. T
kuphela ngemuva kwezinsuku eziyi-10 isiguli esivunyelwe ukufaka ezinye izinhlanzi nemikhiqizo yenyama kwimenyu.
I-Prognosis ngemuva kokuhlinzwa kwi-gland
Isiphetho somuntu ngemuva kokuhlinzwa kuma-pancreas sinqunywa yizici eziningi. Lokhu kufaka isimo ngaphambi kokuhlinzwa, indlela yokungenelela, ikhwalithi yezindlela zokwelapha nezokuhambisa, usizo lwesiguli uqobo, njll.
Ukugula noma isimo se-pathological, noma ngabe kuyisigaba esibuhlungu sokuvuvukala kwe-pancreatic noma i-cyst, ngenxa yalokho kwenziwa ngobuqili kwezokwelapha, njengomthetho, qhubeka nokuthinta inhlala-kahle yesiguli nokuqashelwa yisifo.
Isibonelo, uma resection kungenxa yomdlavuza, khona-ke kukhona ingozi enkulu yokuphinda ubuye. I-prognosis yokusinda kweminyaka engu-5 yeziguli ezinjalo iyadumaza, ifike ku-10%.
Ngisho nokwephulwa okuncane kwezincomo zikadokotela - ukweqisa ngokomzimba noma ngokwengqondo, ukuqina kokudla, njll., Kungasithinta kabi isimo sesiguli. Zivusa ukwanda okuzophela emiphumeleni ebulalayo.
Njengomphumela: ikhwalithi yempilo nesikhathi sayo ngemuva kokuhlinzwa kumanyikwe kuncike ekuyalweni yisiguli uqobo, kuhambisana nazo zonke izidingo nokuqokwa kukachwepheshe wezokwelapha.
Mayelana nokwelashwa kwe-pancreatitis kuchazwe kuvidiyo kule ndatshana.
