I-biliary pancreatitis yisifo esingelapheki sokuvuvukala kwama-pancreas. Isizathu sokukhula kwesifo ukwehlulwa, kanye nokungasebenzi komugqa wesibindi nesibindi.
Ama-anomalies asesiteji sokuqala angabikwa yi-biliary colic, izimpawu ze-dyspeptic, i-jaundice, isifo sikashukela kanye nokunciphisa umzimba. Ukubona i-pathology, udokotela unquma ukudlula kokuhlolwa kwe-ultrasound kohlelo lwe-hepatobiliary, computing noma i-magnetic resonance imaging yesifunda sesisu.
Ukwelashwa ngokuphatha izidakamizwa ezilwa nokuvuvukala nezama-analgesic, ukuthatha ama-enzyme, nokwenza i-glucose ejwayelekile Isiguli kufanele sinamathele ekudleni okuqinile nokwenqaba ngokuphelele utshwala. Uma kutholakele i-calculi emgodini, kuyabekwa ukuhlinzwa.
Kungani i-pancreatitis ye-biliary ikhula?
Muva nje, izinga lezifo ze-biliary pancreatitis lenyuke kakhulu. E-Russia, lezi zinkomba kubantu abadala ziye zaphindeka kathathu, futhi izingane ziye zagula kaningi. Le patology ifakiwe kwi-International Classization of Diseases yokubuyekezwa kwe-10, ikhodi ye-ICD-10 yi-K85.
Kaningi, i-etiology ihambisana nokuba khona kwe-cholelithiasis, kulokhu kunobungozi obukhulu bokuthuthukisa i-pathology. Lesi sifo sanda ngokufuduka kwamatshe kusuka emgudwini we-biliary.
Lesi simo siyingozi, Ngakho-ke, ukungenelela okuphuthumayo okuhlinzekwayo kunqunyelwe. Uma ukuhlinzwa kunqatshiwe, inqubo ye-pathological ingadala izinkinga ezinkulu, ezizodinga ukwelashwa okungathi sína. Ukuze ungakhuli i-pancreatitis ebaluleke kakhulu, kubalulekile ukuthola ukuphulwa kweziqubu ze-bile ngendlela esheshayo futhi welaphe lesi sifo ngokushesha.
I-pathogenesis yesifo ingaqhubeka ngokulandelayo:
- Isifo singena kumanyikwe sisuka emapheshaneni asezingeni eliphansi.
- Isiguli siveza amatshe emigqonyeni ejwayelekile ye-bile, okuholela ekwandeni komfutho wegazi nokuvuvukala kwamanyikwe.
- Ama-dancts we-pancreatic kanye nezicubu ezilimele ngenxa yokufakelwa kwe-bile ku-pancreatic duct, kuholele ekuvuvukeni. Isimo sikhulu kakhulu uma umuntu enesifo esengeziwe sokuvuvukala sesibindi, okuholela ekukhuleni kwenani elikhulu lama-radicals mahhala.
Futhi, inqubo yokuvuvukala ibonwa ngesikhathi kusungulwa i-biliary sludge. I-Cholecystitis nokungasebenzi gallbladder okulandelayo kuholela ekuphulweni kwesimo se-bile se-physicochemical. Ngenxa yemvula nokuqongelela kwezinto ezithile, kwakhiwa amatshe amancane, abizwa ngokuthi ama-biliary sludge.
Lapho iziqu zingena emiseleni ye-bile, ulwelwesi lwama-mucous luyalimala, ngenxa yokuthi umngcele wepelepisi wehliswa. Ngenxa yalokhu, ama-bile stagnates emiseleni yamanyikwe, awakwazi ukungena ngokuphelele kumgodi we-duodenum futhi akahlali engena kwi-pancreatic duct.
Nge-stagnation, ama-enzyme e-pancreatic awenziwa amathumbu hhayi amathumbu, kodwa kwi-duct. Lokhu kudala ukulimala kwesithiyo esivimbayo samanyikwe kanye nokungena kalula kokutheleleka izicubu ze-pancreatic.
Ngenxa yamatshe amakhulu we-gallbladder, izindunduma ze-bile ezivamile noma i-Oddi sphincter zivame ukuvalwa, okubuye kuholele ekugxambeni nasekuphazanyisweni kwezindlela ze-bile.
Ngamanye amagama, ukuthuthukiswa kwe-pathology kungaqala ngenxa:
- Izifo zesisu;
- Isakhiwo esingathandeki se-bile kanye ne-pancreatic duct;
- I-cholecystitis engapheli;
- I-cirrhosis yesibindi;
- I-Gallbladder dyskinesia;
- Ukwephulwa komqondo wepheshana le-biliary;
- Ingono yePathology Vater.
Ukwanda kwesifo kungaqalwa yimithi ye-choleretic noma ukuncipha kwesisindo ngokushesha.
Izimpawu eziphambili zalesi sifo
Ekubonakalisweni kwayo, izinkomba zesifo zifana kakhulu ne-pathologies enjalo yamapheshana emathunjini njenge-hepatitis yegciwane, isimila samathumbu, ulwelwesi lwesisu kanye ne-duodenal ulcer, isimila se-pancreatic, cholecystitis engapheli. Ngakho-ke, kubalulekile ukuthi uhlolwe ngokuphelele futhi ungafaki ukuthi kukhona ukwephulwa okunjalo.
Izimpawu eziphambili zibandakanya ukukhula kwezinhlungu. Isiguli sizwa ubuhlungu obukhulu esiswini, emuva, hypochondria, ehlombe langakwesokudla. Imvamisa, izimpawu ezinjalo zizwakala emahoreni amabili kuya kwamathathu ngemuva kokuba umuntu edlile. Futhi, ukwephulwa kukwenza uzizwe ebusuku.
Kubandakanya kunezimpawu eziqondile ze-pathology zohlelo lwe-pancreatic-biliary. Ubuhlungu bungabangelwa ukusetshenziswa kwesiphuzo se-carbonated, okunamafutha, okuthosiwe nokudla okunezipayisi.
Ngasikhathi sinye, isiguli sinomkhuhlane, isicanucanu kanye nolaka emgodini womlomo. Uma ngenxa yelitshe ingono ye-veter ivinjiwe ngokuphelele, ubukhona be-jaundice obuvimbayo ngesimo sokulondolozwa kolwelwesi lwama-mucous nesikhumba kutholakele.
- Inqubo yokuvuvukala kumanyikwe iholela ekwephuleni ukusebenza kwe-endocrine. Isiguli sinokuphazamiseka kwe-metabolic, ngesikhathi sokuquleka, amazinga kashukela egazi akhuphuka noma awe kakhulu.
- Ngenxa yokuphazamiseka kwe-exocrine, ukukhula kwe-enzymatic pancreatic insuffasure, ukungasebenzi kahle kwesistimu yokugaya ukudla kuyabhekwa.
- Umuntu uhlakulela i-ventricle ethukuthele namathumbu, kuyilapho uhudo luvela kaningana ngosuku. Izindlwana zinokungaguquguquki okunamafutha, i-grey tint nephunga le-fetid.
- Futhi, izimpawu zihambisana nokukhuphuka kokunyethisa, ukuduma esiswini, ukugoba, ukushisa kwenhliziyo, ukuncipha kokudla.
- Ngokuphikisana nesizinda sohudo, ukuncipha kwamafutha kuyanda, ukugaya kuyaphazamiseka, nesisindo somzimba sehlisiwe. Umuntu uthola ukushoda okukhulu kwamavithamini namaminerali.
Uma lesi sifo singalashwa ngesikhathi, i-pancreatitis engamahlalakhona ihlala njalo, ehambisana nazo zonke izinhlobo zezinkinga ngendlela yokushaqeka, isibindi esibuhlungu noma ukwehluleka ukuphefumula, i-encephalopathy, ukopha esiswini, ukuvinjwa kwamathumbu, i-pancreatic necrosis, ikhefu lesifo sikashukela.
Isigaba esinganakwa siholela kuma-pseudocysts, ascites, fistulas, unciphisa amathumbu.
Ukwelashwa kwezifo
Ukuhlonza lesi sifo futhi unikeze i-prognosis enembile, udokotela unquma ukuthi kudlule ukuhlolwa kwegazi okwelashwa kanye nokwenziwe ngamakhemikhali. Uma lesi sifo sisesigabeni esingapheli sokuxolelwa, i-bilirubin inyuka ngenxa yezinguquko zokuvuvukala.
I-cholesterol nayo iyanda, isilinganiso seproteyini enkulu siyancipha futhi siyaphazamiseka, ngakho-ke kubalulekile ukwenza ukuhlaziya kwesibili ukuthola
imiphumela efanele. Ukuhlaziywa kwegazi nomchamo kukhombisa izinga elikhulayo lama-amylase.
Ngosizo lwe-endoscopic noma i-intraductal ultrasound, udokotela angakwazi ukubona amatshe, le ndlela ibhekwa njengesebenzayo kakhulu. I-computer tomography isetshenziselwa ukuthola imininingwane enemininingwane.
- Uma udokotela ehlonza i-pancreatitis eyingozi kakhulu ye-biliary, ngokuvamile kudingeka ukuhlinzwa ukuze kunikezwe usizo oluphuthumayo. Uma kunesidingo, kuyadingeka ukususa amatshe noma ukuthuthukisa isimo se-ingono yeVater, ngoba kusetshenziswa le ndlela ye-endoscopic.
- Lapho lesi sifo siqala ukwanda, udokotela ususa ama-pain syndrome ngama-analgesics kanye nama-antispasmodics. Kulokhu, umsebenzi oyimfihlo wangaphandle nowangaphakathi we-pancreas uyalungiswa. Ngezinhloso zokuvimbela, ama-antibiotics kufanele athathwe ukuvimbela ukukhula kwegciwane.
- Ngokukhuphuka, izinsuku ezintathu zokuqala zibonisa ukubulawa yindlala nge-pancreatitis. Esikhundleni sokudla, phuza amaminerali we-alkaline angenawo amakhabhoni. Ngemuva kokuzila, ukudla okondlayo kuyadingeka. Isiguli akufanele sisebenzise kabi ukudla okunamafutha, ukudla i-carbohydrate nakho kunqunyelwe. Udinga ukudla kaningi, kepha ngezingxenye ezincane.
Ukumisa umphumela obhubhisayo wama-enzyme, i-somatostatin, i-proton pump inhibitors, inqunyelwe i-proteinase inhibitors. I-enzymatic pancreatic dysfunction ibuyiselwa ngama-enzymes we-microsherical.
Ngezinga elikhulayo le-glucose egazini, isiguli sithatha isidakamizwa esikhethekile se-hypoglycemic. I-mellitus encike kwisifo sikashukela idinga ukubuyekezwa kwendlela yokuphila nokudla.
Ukugcina isimo somzimba jikelele nokuqinisa amasosha omzimba, kunconywa ukwelashwa okuhlukile ngamakhambi. Okwelapha, kufanele ukhethe ukubuyekezwa okufakazelwe noma okuhle.
Izinhlobo ze-pancreatitis zichazwe kuvidiyo kule ndatshana.
