I-pancreatitis engapheli iyiqembu lokugula okuhambisana nokusebenza kokulimala okuvamile kwamanyikwe.
Kwezifo ezifakwe kuleli qembu, ukuba khona kwezicubu zesitho sokugxila kokuvuvukala ne-necrosis, okuhambisana nokuhlukaniswa kwemicu ye-fibrosis, okuholela ekusebenzeni kahle kwe-gland ngamazinga ahlukahlukene obukhulu.
Ukudlondlobala nokwanda kwe-pancreatitis engapheli kuholela ekuqaleni nasekuthuthukisweni kwe-atrophy yezicubu ze-gland. Ngaphezu kwalokho, i-fibrosis iyathuthuka, futhi amangqamuzana asezingeni le-organ parenchyma athathelwa indawo ngamaseli e-tisctivative cell.
Izimbangela ezinkulu zalesi sifo
Lesi sifo sibonakaliswa ukubambezeleka kokuqedwa kwama-enzymes we-pancreatic kanye nokusebenza kwawo kwe-intraorgan.
Okokuqala, i-trypsin ne-lipase zenziwa kulesimo. Lama enzymes abangela ukuguquguquka kwe-parenchyma ye-gland, ukwanda kwezicubu ezithintekayo nokwakheka kokuncipha. Zonke zivusa i-sclerosis ye-gland, okuholela ekubukekeni kokuphazamiseka ekusebenzeni kokujikeleza kwegazi okujwayelekile kumanyikwe.
Okubaluleke kakhulu ekuthuthukiseni ukuvuvukala yi-autoaggression.
Imbangela eyinhloko ukusetshenziswa kabi kotshwala.
Ngaphezu kwalokho, ukudla okudla amaprotheni isikhathi eside kanye nokusebenzisa ugwayi kungakhulisa isimo sesitho.
Ngaphezu kwalokho, izimbangela zenqubo yokuvuvukala kumanyikwe, ezingadala i-pathology, zingaba:
- izifo ezihambisana nomsebenzi wephephabhuku le-biliary kanye ne-duodenum;
- isifo se-gallstone;
- i-pathology ekusebenzeni noma ku-anatomy ye-sphincter ye-Oddi;
- duodenitis;
- isilonda se-duodenal.
Lapho kukhona i-cholelithiasis ne-choledocholithiasis, kwenzeka kaningi kwabesifazane abaneminyaka engama-50-60.
Kaningi, ukuqala kwezimpawu zezifo kuhambisana nokwanda kwe-metabolic syndrome, okuyizimpawu eziyinhloko zazo:
- Ukukhuluphala ngokweqile
- Hyperlipidemia.
- Ukuthambekela kokuya endaweni yomfutho wegazi ongafani.
- Isifo senhliziyo se-Ischemic.
- Ukwephulwa kokubekezelelwa kwama-carbohydrate.
- I-Hyperuricemia
Izimbangela ezikhonjisiwe kungenzeka kakhulu uma kwenzeka kuba nesifo.
Akuvamile, kepha futhi kungadala ukugula:
- i-cystic fibrosis;
- ukugula okuhambisana nokuba khona kobuzwe bokuthiwa kwefa
- izinhlobo ze-idiopathic;
- i-autoimmune factor factor;
- isiguli sinezifo ezihlelekile kanye ne-vasculitis;
- ukulimala komzimba ngamagciwane athile namagciwane we-pathogenic;
- ukuthuthukiswa kwesifo sikashukela emzimbeni;
- izinhlobonhlobo ze-ischemic;
- ukungahambi kahle emzimbeni wokuqina kwamanyikwe;
- ukuthola ukulimala kokugula endaweni yesitho kanye nokuvela kobuthi obukhulu.
Inqubo yokuvuvukala ingashintsha noma inqunyelwe kuphela kumonakalo wesitho ekhanda noma emsileni.
Odokotela bahlukanisa izinhlobo eziningana zezifo - edematous, parenchymal, sclerotic and calculous and fibrocystic.
Izindlela ezijwayelekile zokuhlukanisa
Chr. I-pancreatitis yisifo esiqhubeka kancane kancane esinemvelo yokuvuvukala.
I-Patrusion ihambisana nokwakhiwa kwe-necrosis.
Kunezigaba eziningana zeqembu lezifo ezihlobene nefomu le-pancreatitis elingamahlalakhona.
Ngokuya nge-ICD, izinhlobo ezilandelayo ze-pathology ziyahlukaniswa:
- Unobuthi futhi umzimba.
- I-Idiopathic.
- Ifa.
- I-Autoimmune.
- Kwenzeka njalo.
- Kuyasiza.
- Ifomu eliphambili.
- Ifomu lesibili.
Ngokuhambisana nesigaba esithuthukiswe nguM. M.. I-pathology kaKuzin ihlukaniswe ngezinhlobo ezilandelayo - eyokuqala, eyethusayo neyesibili.
Uhlobo oluyinhloko lwe-pathology, luhlukaniswe lwaba yizinhlobonhlobo ezilandelayo:
- utshwala
- ngenxa yokwephulwa kokudla okunempilo;
- okwelapha;
- ngokumelene nesizinda sokwehluleka kumetabolism;
- I-etiology engacacile.
Uhlobo lwangesikhathi esibuhlungu lesifo sehlukaniswe izinhlobonhlobo:
- I-post-traumatic, ngokumelene nesizinda sesiguli esithola ukulimala kwepancreatic okuvulekile.
- I-post-traumatic, ngokumelene nesizinda sesiguli esilimala kabi.
- Ngokumelene nesizinda sokulimala kokusebenzisana.
Uhlobo lwesibili lwenqubo yokuvuvukala kwezicubu ze-pancreatic lungahlukaniswa:
- cholangiogenic;
- i-lympho native cholecystopancreatitis, ikhula ngokumelene nesizinda se-choldocholithiasis;
- esimweni sokulimala kwezifo zesisu, kufaka phakathi i-duodenostasis eyisisekelo neyesibili, i-duodenal diverticulum, ngokuqhubeka kwesilonda se-peptic, lapho kukhona i-colitis;
- ukugula okuvela ukufiphala kwamagatsha we-aorta yesisu;
- isifo esihambisana ne-endocrinopathy;
- i-pathology, eyakheka lapho ichayeka kwezinye izinto ezixakile.
Okwakamuva ukwahlukaniswa okwenziwe ngodokotela baseJalimane. Ihlukanisa iziguli ngamaqembu ngokuya nge-etiology, isigaba kanye nobukhulu besi sifo.
Izimpawu izici zesifo
Izimpawu ze-pancreatitis engapheli zingahluka kancane esimweni ngasinye futhi zincike kubungako bokulimala kwesitho nendawo ezungezwe inqubo yokuvuvukala.
Kaningi, lesi sifo sihambisana nezikhathi zokuxolelwa kanye nokwanda.
Ngesikhathi sokuqhuma, isiguli siba nobuhlungu obuqhubekayo obuqhubekayo. Lesi sibonakaliso yisona eshiwo kakhulu.
Ubuhlungu bungaba buthuntu noma ukusika. Kwezinye izimo, uma izinyathelo ezifanele zingathathwanga ngesikhathi, ubuhlungu bungavusa ukwethuka kobuhlungu kumuntu.
Ukuqondiswa kobuhlungu kungaba ngaphakathi kwesokudla naku-hypochondrium yangakwesobunxele. Kuya ngendawo yomonakalo wesitho. Uma kwenzeka kulimala isitho sonke ngenqubo yokuvuvukala, ukuvela kwe-herpes zoster.
Izimpawu zomtholampilo ezibonakala kakhulu zesifo yilezi ezilandelayo:
- ukubonakala kwesisu esisesiswini;
- ukuthuthukiswa kwe-exocrine insufficiency syndrome;
- i-endocrine dysfunction syndrome;
- dyspeptic syndrome.
Ngaphezu kwalokho, ukuthuthuka kwe-biliary hypertension kuvame kakhulu ukubonwa.
Kwezinye izimo, ukukhula kwesifo ngendlela engenabuhlungu kungenzeka. Imvamisa, le fomu yandulela izinhlungu, futhi ingaba nesikhathi ehlukile. Ukuqhubeka kwe-pancreatitis engenazhlungu kuvame ukufihlakala ngemizwa engakhululeki eyakha esifundeni se-epigastric.
Ezimweni ezinjalo, isiguli sivame ukuba nesifo esihambisana nokuvela kokugayeka, ukuthambekela kwesifo sohudo kanye ne-steatorrhea.
Ukuntuleka kwezimfihlo zangaphandle, ukuphazamiseka kwethonya le-biliary nokuphazamiseka kwe-endocrine
Ukubonakaliswa okuyinhloko ukugaya.
Ngaphezu kwalokho, ukungapheleli kwe-exocrine kubonakaliswa yi-pathologies ezinqubweni zokufakwa kokudla okugayiwe.
Kulesi sifo, ukubonakala kwezimpawu nezimpawu eziningi kuyinto ethile.
Izimpawu eziphambili zokuntuleka kwe-exocrine yilezi ezilandelayo:
- isifo sohudo
- i-steatorrhea;
- ukunciphisa umzimba;
- ukubonakala komzwa wokucanuzelelwa kwenhliziyo;
- ukugabha njalo
- ukwehla kwesifiso sokudla.
Lapho kwenzeka ukwehluleka kwe-gland, ukuqubuka kokukhula ngokweqile kwamagciwane kuyabonakala, okucasulayo:
- I-Flatulence.
- Ukuqunjelwa amathumbu.
- Ukugqekeza okungathandeki.
Ukuqhubeka okwengeziwe kwe-pathology kuholela ekubonakaleni kwezimpawu zezimpawu ze-hypovitaminosis:
- i-anemia
- ubuthakathaka;
- ukucwilisa isikhumba;
- ukuphazamiseka ezinqubweni ze-metabolic.
Isisekelo sokuthuthuka kokuntuleka kwe-exocrine ukubhujiswa kwamaseli we-acinar we-gland. Ngenxa yalokhu, ukugeleza kwama-enzymes e-pancreatic ku-lumen yamathumbu kuyaphazamiseka.
I-hypertension ye-Biliary ibonakala nge-jaundice evimbayo ne-cholangitis. Ezigulini eziningi, ukuba khona kwe-hyperbilirubinemia eqhubekayo kuyaqoshwa. Imbangela yalesi sifo ukwanda kwekhanda lesikhumba, okuvusa umfutho we-choledochus kanye nokuqhubeka kwe-choledocholithiasis kanye ne-pathology ye-papilla enkulu ye-duodenal.
Ukuphazamiseka kwe-endocrine kwenzeka ngenxa yokulimala kwezicubu ze-gland ye-islet apparatus, okuholela ekuntuleni kwe-insulin ne-glucagon, okucasulayo i-pancreaticabetes mellitus.
Indlela Yokuxilonga
Ukuxilongwa kwalesi sifo kubangela ubunzima obuthile.
Yonke inqubo isuselwa ezicini ezintathu eziyinhloko - umlando wesimilo. Ukuba khona kokuntuleka okungaphandle kwangaphandle kanye nokuhlonzwa kokushintshwa kwezakhi zezakhi ezicutshini zesitho.
Imvamisa, ukuxilongwa kuhlotshaniswa nokuqashwa isikhathi eside kwesiguli esifuna ukubona ukuthi kungenzeka ukuthi isifo sisalaphi.
Ngesikhathi sokuxilongwa, kusetshenziswa izindlela ezilandelayo:
- Ukuhlolwa kwelebhu.
- Ukuhlolwa kwensimbi.
- Ukuxilongwa okuhlukile.
Ukuhlolwa kwelabhorathri kufaka ukuthatha ukuthatha igazi ukuhlolwa kwe-biochemical, ukwenza isivivinyo sokubekezelela ushukela, ukunquma ukuba khona kwamafutha ezinduneni ezinezindlela zokulinganisa neziningi, nokwenza izivivinyo zokusebenziseka kobuhlungu bokuqina.
Njengezindlela ezisetshenziswayo zokuhlola, kusetshenziswa i-ultrasound ne-ERCP. Indlela yokugcina ikuvumela ukuthi ukhombe okokuqina kwendlala eyandisiwe nokukhula kwenqubo yokuvuvukala kuyo.
Izimpawu zokubonakaliswa kwe-pathology zifana nezimpawu zesisu esibuhlungu. Ngakho-ke, lesi sifo kufanele sihlukaniswe nezilonda ezigcotshisiwe, i-cholecystitis eyingozi, ukuvinjwa kwamathumbu, noma i-intestine vein thrombosis. Ngale njongo, kusetshenziselwa ukuxilongwa okuhlukile. Zonke izivivinyo ziqhutshwa esibhedlela.
Ngemuva kokuhlolwa okuningiliziwe, udokotela wenza incazelo ye-pathogeneis futhi anikeze isiphetho mayelana nokuba khona kwesimo se-pancreatitis esigulini, bese kunikezwa ukwelashwa okufanele, futhi kunikezwa izincomo zokushintsha indlela odla ngayo.
Izindlela zokwelapha lesi sifo
Ukwelashwa kwalesi sifo ngaphandle kwezinkinga kungenziwa ngokwelashwa okuphuma ngaphansi kokuqondisa kwe-gastroenterologist.
Izinhloso eziphambili zokwenza ukwelashwa okuphuma kwezokwelapha kungukuqeda ngokuphelele noma ukwehla okubalulekile kokuqhubeka kwesifo kanye nokulwa nezinkinga, akunakwenzeka ukuselapha ngokuphelele lesi sifo futhi ubuyisele amandla okusebenza esitho.
Ehlelweni lokwelashwa kwezidakamizwa kokuhlaselwa okunamandla kwalesi sifo, imisebenzi embalwa ixazululwa.
Izinhloso eziphambili zokwelapha yilezi:
- ukungafakwa ezintweni ezicasulayo;
- ukukhululeka kobuhlungu;
- ukulungiswa kokungalingani gland;
- Ukwelashwa kwezinkinga ezibuyayo.
Umsebenzi oyinhloko wesiguli ukuhambisana nokudla kokudla - kwenqatshelwe ukudla imifino ekhulisa i-acid ye-gastrointestinal ipheshana, ngokwesibonelo, utamatisi, futhi kuyadingeka ngokuphelele ukuyeka ukubhema nokuphuza iziphuzo eziqukethe utshwala. Kwezinye izimo, ukuzila ukudla okwelashwa kusetshenziselwa i-pancreatitis.
Ngesikhathi sokwelashwa, kusetshenziswa imishanguzo ehlobene namaqembu ahlukahlukene emithi yokwelapha.
Ukwehlisa umthwalo ephepheni lesisu ezinsukwini zokuqala ezingama-2-3, kunconyelwa ukwenza ukuzila okwelashwa okubandakanya ukwenqaba ukudla. Ngalesi sikhathi, ungaphuza inani elincane lamanzi amaminerali ngaphandle kwegesi.
Ukwehlisa umthwalo gland, izidakamizwa ezinama-enzymes wokugaya ukudla kufanele zithathwe.
Ngaphezu kwalokho, kufanele uphuze amaphilisi asiza ukunciphisa i-acidity yokuqukethwe futhi ivimbele ukukhiqizwa kwe-acid esiswini. Lesi sidakamizwa singaba yi-pancreatin.
Ama-antibiotic asetshenziselwa ukuvimbela inqubo yokuvuvukala. Umuthi wendabuko uncoma ngesikhathi sokukhulisa ukusebenzisa i-mucous porridgeges ekudleni, okunomthelela ekwenzeni ngcono umgudu wokugaya ukudla. Ungasebenzisa oats ukwenza lolu hlobo lwephalishi.
Uma izimfuneko zokungenelela kokuhlinzwa kuhlonzwe, ukuhlinzwa kwenziwa emtholampilo.
I-prognosis yokutakula ayimnandi kakhulu, ngokwesibonelo, isilinganiso sokushona kwabantu lapho sikhona isifo sinesikhathi seminyaka engama-20-25 cishe singama-50%. Cishe i-20% yeziguli zibulawa yizinkinga ngesikhathi kuqhubeka lesi sifo.
Yini i-pancreatitis engamahlalakhona ezotshela ochwepheshe kuvidiyo ekulesi sihloko.
