I-pancreatitis iyindlela yokuvuvukala ethinta i-pancreas. Ukwenza ukuxilongwa okuyikho kwezokwelapha, kuhlukaniswa izinhlobo nezinhlobo ze-pancreatitis. E-Russia, ukuhlukaniswa kwe-V.S. Savelyev ngokubambisana nodokotela - V.I. Filin, V.A. Gagushina, njll., Kwakusetshenziswa kabanzi.
Ukuhlukaniswa, okuhlongozwe kwi-International Symposium yesibili ngo-1983, kuthathwa njengesisekelo sokuhlukaniswa kwe-pancreatitis. Kusukela ngalesosikhathi, i-algorithm yokwelapha kanye nokuhlelwa ngokwako sekushintshe kancane.
Ngokomhlangano, i-pancreatitis ihlukaniswa ngokuhlukahluka okulula nokwandayo. Isifo esibi futhi esingelapheki sehlukaniswe ngamasakhi waso futhi lezi zinqubo ezimbili ezihlukile ze-pathological.
Lapho uhlukanisa lesi sifo, ukubonakaliswa kwemitholampilo, ubukhulu bomonakalo wamanyikwe, isiteji, izinto zokuzithokozisa, izinkinga ezikhona, njll. Ziyabalwa.
Izici zokuhlukaniswa kwalesi sifo
Umkhuba wezokwelapha wazi ngezigaba ezingaphezu kwamashumi amane kokulimala kwe-pancreatic, okudala ubunzima ekuxhumaneni namazwe omhlaba ngesihloko sokuxilongwa nokwelashwa. Kulokhu, i-ICD - ukuhlukaniswa kwezifo emhlabeni jikelele kwenziwa. I-ICD ihlaziywa njalo yi-WHO. Ukuhlukaniswa kwamanje kusekelwe kukhodi ye-ICD-10. Inombolo yeshumi isho ukuthi i-ICD isho ukubukeza okweshumi.
Ngokuhambisana nalolu lwazi, lesi sifo sihlukile sohlobo lwe-acute (K85) nesifundo esingamahlalakhona (K86). Njengoba sekushiwo, iningi labantu lisebenzisa i-classifier yango-1983, eyakhiwa eMarseille. Ishintshe kancane ngonyaka we-1984, kanye nangango-1992 e-Atlanta.
Ngokuhambisana nokwenziwa lula kwalesi sifo, kunezinhlobo ezine. Lokhu kufaka phakathi ifomu elibuhlungu, ifomu elibuhlungu lesikhathi esizayo, ifomu elingapheli kanye nokwanda kwenqubo ye-pathological engamahlalakhona.
Ukuhlukaniswa okwandisiwe kubheka i-pathogenesis yokuvuvukala, ubukhulu bomonakalo wamanyikwe, izici ezivusa umxhwele ekutholakaleni komtholampilo, amathuba okuvuselelwa kwezicubu ezonakele.
Ngokuvamile, ukwahlukana kubukeka kanjena:
- I-pancreatitis ye-acute.
- Ifomu elibuyelayo lokubuyiselwa emuva ngokubuyiselwa okulandelayo kokusebenza kwesitho sangaphakathi.
- Inqubo yokuvuvukala okungapheli emelene nesizinda sokugcinwa kwama-pancreas.
- Uhlobo olungamahlalakhona lwe-pancreatitis, olwakhula ngenxa yokuvalwa kwe-lumen of the ducts.
- Uhlobo olungapheli lomlingiswa ophinda abuyele emuva ngokubonakaliswa komtholampilo ngokuhlaselwa kakhulu. Akunamathuba wokuzivuselela kabusha kwezicubu ze-pancreatic.
- Ukuvuvukala okungapheli ngokumelene nesizinda sokuqongelela usawoti esitho. Ama-dancts we-pancreatic avinjwe ukubalwa, okuholela ekunwetshisweni kwawo.
Ukuvuvukala okunamandla nokungamahlalakhona kuhlukaniswa ngokwezindlela ezahlukahlukene. Kwesinye isikhathi, izinkinga ezivelayo kusukela kulesi sifo ziyafakwa ekuhlukanisweni.
Izinhlobo nezinhlobo ze-pancreatitis ebukhali
Ukuhlukaniswa kwe-pancreatitis ebukhali kusho ukuhlukaniswa kwenqubo ye-pathological ngokuya ngobukhulu benkambo, ifomu, izici zokuzazisa. Imvamisa, zonke izinkomba zithathwa lapho kutholakala ukuthi kutholakala lesi sifo.
Ngokuya kobukhulu, i-pathology imnene, ilinganisile futhi inzima. Ngefomu emnene, azikho izinguquko eziveziwe ezicutshini zesikhumba, isitho sigcina ngokuphelele ukusebenza kwaso.
Ngokwesilinganiso sokulimala okujwayelekile, kukhona izinguquko ezisebenzayo kumanyikwe, ngokuvamile izinkinga zesimo esisehlelweni zivame ukutholakala. Izinga elinzima libonakaliswa yizinkinga zasekhaya nezesistimu, isiguli kungenzeka kakhulu sife.
Ukuhlukaniswa kwe-pancreatitis ngokuya ngefomu kubheka ubukhulu bomonakalo, ukubonakaliswa kwemitholampilo, ukuhlolwa kwelabhoratri, umphumela wezokwelapha olindelekile wokusetshenziswa kwemithi. Lezi zinhlobo ziyahlukaniswa:
- Uhlobo lwe-Edematous lubhekwa njengohlobo olulula kunazo zonke. Njengomthetho, azikho izinguquko ezibalulekile ezicutshini. Umphumela olindelekile kusuka ekwelashweni uhlala uthandeka. Ukuhlolwa kwelabhorathri kukhombisa ukwanda kwe-fibrin, okubonisa ngokungaqondile ukuvuvukala emzimbeni. Izimpawu zobuntu zinobuhlungu esifundeni sebambo elingakwesobunxele, isicanucanu, ukuqaqeka kwesikhumba, umkhuhlane.
- I-Organic pancreatic necrosis isikisela ukuthi ukugxila kokuvuvukala kwenziwa endaweni eyodwa yezingxenye zesitho sangaphakathi. Kungaba yinhloko, umzimba noma umsila. Indawo yokulala itholakala endaweni enkulu. Ngale fomu, isiguli sikhononda ngobuhlungu obukhulu, ukuqhakaza, ukugabha kanye nenausea. Kwezinye izithombe, ukuvinjwa kwamathumbu, i-jaundice. Ukuhlolwa kwelabhoratri kukhombisa ukugcwala okukhulu kwe-glucose emzimbeni, ukuba khona kwama-enzymes wokugaya egazini.
- I-diffuse (exubekile) i-pancreatic necrosis yenzeka ngenxa yomonakalo omkhulu wezicubu ze-pancreatic. Ngaphezu kwezimpawu ezichazwe ngenhla, isiguli sidakwa, umkhuhlane, ukwehla kwamandla adonsa umchamo ngosuku. Ukuthuthukiswa kokopha esiswini akubandakanywa. Ekuhlaziyeni - ushukela omningi, ukuncipha kwe-calcium egazini. Kulokhu, ukwelashwa ngokushesha kwe-pancreatitis esibhedlela ngokusetshenziswa kwenani elikhulu lezidakamizwa kuyadingeka.
- I-pancreatic necrosis yefomu eliphelele limboza sonke isitho sangaphakathi. Ngenxa yokudakwa kakhulu, kutholakala isimo sokushaqeka, i-pulmonary, renal noma ukuhluleka kwenhliziyo. Uma kungekho usizo olwanele, ubungozi bokufa bukhulu.
Ngokuya nge-pathogenesis, lesi sifo siyisisekelo - senzeka ngenxa yomonakalo kwezicubu zesitho uqobo nesesibili - i-pathology ibangelwa izitho zangaphakathi eziseduze. Ukuhlukaniswa kwamaqembu athile kuyafana, kungaba ingane noma umuntu omdala.
I-pancreatitis ebabazekayo, kuya ngembangela, yile:
- Ibanga lokudla. Lesi sifo sikhula ngenxa yokudla okungafanele, lapho isiguli sisebenzisa kabi izinongo zesipayisi, ezinamafutha, ezinosawoti nezinosawoti. Kwezinye izimo, leli qembu lifaka i-pancreatitis ye-etiology yotshwala. Kepha emipendweni eminingi lolu hlobo luhlukaniswa njengesigaba esihlukile.
- I-biliary pancreatitis itholakala ngenxa yesibindi esibi, i-biliary tract kanye ne-gallder yesinye.
- Ifomu le-ischemic livela ngenxa yokuphazamiseka ekuhlinzekweni kwegazi kumanyikwe; Isici esiyinhloko se-etiological kungaba yizifo ezahlukahlukene, imiphumela yangaphandle noma yangaphakathi emibi.
- Inqubo yokuvuvukala kwe-gastrogenic itholakala ngenxa yezinkinga zesisu, njengesifo se-peptic ulcer noma i-gastritis.
- Ifomu elinobuthi futhi elenzelwa ukuvela ngenxa yokusetshenziswa kwezidakamizwa ezinamandla noma ngama-ejenti anobuthi. Esinye isizathu yimiphumela elimazayo yama-allergener ngokumelene nesizinda sokuphendula "kwe-pathological" samasosha omzimba.
Ukuhlukaniswa okwenziwe nge-etiological factor kungafakelwa i-pancreatitis ethelelekayo (amagciwane kanye namagciwane yizimbangela), ukubukeka okulimazayo (ukulimala kwesisu), ifomu lokuzalwa - kuhlanganiswe namanye ama-pathologies wesimo esingaphakathi noma izitho zofuzo.
Izinhlobo eziyinhloko ze-pancreatitis engapheli
Lesi sigaba ngokwezinga elikhulu sithinta izinga lokubhujiswa kwama-pancreas, izinga lokusebenza kwaso. Emsebenzini wezokwelapha, izinhlobo ezine ziyahluka. Eyokuqala inqubo yokuvuvukala engapheli, ebonakala ngokwakhiwa kwezindawo zokubala.
Uhlobo lwesibili ifomu elingapheli eliyisiqalo, elivele ngenxa yokuvinjwa kweziphethu zepancreatic, kwaholela ebunzimeni bokukhishwa kwejusi kwi-duodenum. Njengomthetho, i-etiology kuleli cala ingenxa yokuvela kwamagallist noma i-tumor yama-pancreas.
Uhlobo lwesithathu yi-fibrosis yesitho sangaphakathi, ngoba izicubu ezithambile ziye zathathelwa indawo izicubu ezithintekayo. I-pancreatitis engapheli engapheli yemvelo ye-fibrous - uhlobo lwesine. Kuhlanganisa ukuguqulwa kwesakhiwo se-pancreatic kanye nobunzima bokuphuma kwejusi le-pancreatic.
I-pancreatic abscess kanye nokwakheka kwama-cysts kwezinye izimo kubhekiselwa kuzo njengenqubo engapheli yokuvuvukala, kwesinye isikhathi kubhekwa njengezinkinga ze-pancreatitis. Ngakolunye uhlangothi, ama-cysts ahlukaniswa ngama-subspecies ahlukahlukene (ama-pseudocysts, ukugcinwa noma ama-cysts we-parasitic, njll).
Imininingwane nge-pancreatitis inikezwe kuvidiyo kule ndatshana.
