I-pancreatitis yisifo esibi esibonakala ngokukhula kwenqubo yokuvuvukala kumanyikwe. Kunezindlela ezimbili ongakhetha kuzo ngalesi sifo - i-pancreatitis eqeda futhi engalapheki.
Yile ndlela yesifo esithatha indawo yesithathu phakathi kwezinye izinkinga ezinkulu emsebenzini wezitho zesisu. Ukubonakaliswa okufanayo kwalesi sifo kunikeza ukwelashwa okugcwele esibhedlela. Uma sikhuluma ngezindawo ezimbili zokuqala, khona-ke baya ku-acendenditisitis enkulu ne-cholecystitis.
Ngokwezibalo, ngonyaka owodwa, kusuka kubantu abangama-200 kuye kwangama-800 abavela kuzo zonke izakhamuzi eziseplanethi bathola i-pancreatitis yaleli banga. Njengomthetho, amadoda ahlushwa yilesi sifo. Iminyaka yabo ingasukela eminyakeni engama-35 kuye kwengama-69, ngaleso sikhathi ukwelashwa kwe-pancreatitis acute kudinga kakhulu njalo.
Izimfuneko zokuvela kwe-pancreatitis eyingozi nokukhula kwayo
Kunezizathu eziningana ezibangela ukuthuthukiswa kwe-pancreatitis eyingozi:
- ukuphuza ngokweqile utshwala;
- umlutha wokusetshenziswa okungenamkhawulo kokudla okunamafutha nezinongo;
- isifo se-gallstone;
- ukutheleleka ngamagciwane ahlukahlukene noma izifo ezibangelwa amagciwane;
- ukulimala okuhlukahlukene kwesisu;
- ukungenelela kokuhlinzwa okuhlangene namanye ama-pathologies we-pancreas;
- ukuthatha lezo zidakamizwa ezinomthelela we-pathological emzimbeni, futhi ikakhulukazi izidakamizwa: thiazide diuretics, corticosteroids, estrogens, azathioprine;
- ukungasebenzi kahle kokuzala kwamanyikwe, i-cystic fibrosis;
- izinqubo zokuvuvukala ohlelweni lokugaya ukudla (i-hepatitis, cholecystitis, gastroduodenitis).
Kunenkolelo-mbono ethandwa kakhulu yokwakhiwa kwe-pancreatitis eyingozi, ethi imbangela eyinhloko yalesi sifo ukulimala kwamangqamuzana ngenxa yokuqalwa kakhulu kwama-enzyme, kepha lokhu akubeki eceleni isidingo sokwelashwa okufika ngesikhathi kwe-pancreatitis eyingozi.
Ngaphansi kwezimo ezijwayelekile, ama-enzyme wokugaya ukudla kufanele akhiqizwe yi-gland esimweni esingasebenzi, bese eqala ukusebenza kuphela ngemuva kokudlula emgodini wokugaya ukudla. Ngaphansi kwethonya lezinto zangaphandle, kanye nezimo zangaphakathi ze-pathological, yonke indlela yokukhiqiza izinto iphazamiseka kakhulu.
Ama-enzymes aqala ukusebenza ku-pancreas uqobo (ngaleyo ndlela eqala inqubo yokuzicwilisa kwesitho), esidala isidingo sokwelashwa. Ngokuvumelana nalokho, ukwelashwa kwe-pancreatitis ebukhali kufanele kuqale ngokushesha. Umphumela wale nto yile:
- ukuvuvukala kwezicubu;
- inqubo yokuvuvukala;
- ukulimala kwemithambo ye-parenchyma yesitho.
Isimo se-pathological ngesikhathi se-pancreatitis esibuhlungu singasakazeka kuzicubu ezizungeze i-gland (izicubu ezibuyayo, i-omental bursa, imiyalezo yezitho zamathumbu, kanye ne-peritoneum ne-omentum).
Ngefomu elinzima lenqubo yokuvuvukala ebabazekayo, isilinganiso sezinto ezisebenza ngokusebenza egazini sikhuphuka kakhulu, okuba yisidingo sokuphazamiseka okukhulu emzimbeni wesitho. Kulesi simo, izidakamizwa zodwa ezinomphumela we-analgesic ngeke zisebenze.
Izinhlobo ze-Acute Pancreatitis
Ngokuya kobunzima, i-pancreatitis ingahlukaniswa:
- engasindi. Ingenzeka ngomonakalo omncane kwizitho zangaphakathi futhi ivezwa kuphela ngokuvuvukala kwamanyikwe. Izinga eliphansi le-pancreatitis ebukhali lisabela kahle ekwelashweni, kanti i-prognosis iyathandeka;
- esindayo. Le ndlela yalesi sifo ifaka ukuthuthukiswa kwezinkinga ezahlukahlukene kulamalume noma izitho eziseduze kwama-pancreas. Ngaphezu kwalokho, izinkinga zingaba sendawo futhi zibonakale njenge-necrosis yezicubu, ama-cystic neoplasms, ama-abscesses, noma ukutheleleka.
Inkambo enzima ye-pancreatitis eyingozi ingahambisana no:
- ukugcwala okukhulu kwe-exudate ngaphakathi emzimbeni noma esikhaleni esizungezile;
- i-pancreatic necrosis enethuba lokutheleleka kwezicubu. Isiza esilinganiselwe noma esichithekile se-parenchyma esiboshwe kanye nezicubu ze-peripancreatic kungenzeka. Ngaphezu kwalokho, ukutheleleka kanye nokukhula kwe-pancreatitis ye-purulent kungajoyina, okuvame ukwandisa amathuba okuba nomphumela obulalayo;
- ukwakheka okuhle kwamanga we-cystic. Ijusi le-pancreatic liqongelela ezungeze izindonga noma imicwecwana ye-fibrous. Lesi simo singenzeka ngenxa yokuhlaselwa yi-pancreatitis ebukhali;
- isisulu se-pancreatic. I-pus inqwabelana kumanyikwe uqobo noma kwizicubu ezizungezile.
Izimpawu ze-pancreatitis esibuhlungu
Kunezimpawu ezibonakalayo ze-pancreatitis eyingozi. Okokuqala, yisifo esibuhlungu. Kungalimaza epigastrium noma ngaphansi kwembambo sobunxele. Uhlobo lobuhlungu bukhona bokugunda, futhi lungahambisa ngaphansi kwes scapula sobunxele. Kungalimala njalo, futhi ikakhulukazi lapho ulele emhlane wakho. Izinzwa ezingemnandi ziyaqina ngesikhathi noma ngemuva kokudla ukudla okunamafutha, okuthosiwe noma okubunjiwe.
I-pancreatitis ebukhali ingabonakala ngokwayo ekuhlafuneni nasezicanukweni. Ukuqhekeka kungenzeka kube njalo futhi kube neminonjana ye-bile.
Kulesi simo, ukwanda okubonakalayo kokushisa komzimba, ukukhalipha okulinganiselayo kwe-sclera, kanye nokuthuthukiswa kwezimpawu ze-dyspeptic, ukubonakaliswa kwesikhumba.
Ungasibona kanjani lesi sifo?
Ukuxilongwa kwe-pancreatitis eyingozi kungenziwa ngesisekelo salezozinkinga ezithinta isiguli, ukuhlolwa kwakhe, kanye nokukhomba izimpawu eziyinhloko zesifo. Uma isiguli silinganisa ukushaya kanye nomfutho wegazi, kuzosungulwa ukuthi kune-tachycardia ne-hypotension. Ukuqinisekisa ukutholwa okusolwayo, kuyadingeka futhi ukwenza inamba yokuhlolwa kwelebhu:
- ukuhlolwa kwegazi nomchamo;
- ukuxilongwa kwe-Ultra kwesibeletho;
- i-multispiral computed tomography (MSCT);
- i-magnetic resonance imaging (MRI).
Ngesikhathi sokuhlolwa kwegazi okujwayelekile, izimpawu zenqubo yokuvuvukala zingaphawulwa, okuboniswa ukushesha kwe-ESR, kanye nokwenyuka kwezinga leukocytes. I-biochemistry yegazi izokhombisa ukwanda komsebenzi we-amylase ne-lipase (ama-enzymes amakhulu we-pancreatic), i-hyperglycemia ne-hypocalcemia. Ngaphezu kwalokho, kuzokwenziwa ukuhlaziya kwe-enzymes kumchamo. Ukwanda komsebenzi we-enzyme yesibindi, kanye ne-bilirubinemia, kungaphawulwa.
Ukuhlolwa okubonakalayo kwesitho esinegciwane kungenza kube nokwenzeka ukusungula ushintsho lwe-pathological ku-parenchyma, ushintsho ngosayizi we-gland, amathumba, amasende, ubukhona noma ukungabikho kwamatshe emaceleni.
Kubalulekile ukwenza ukuxilongwa okuhlukile kwe-pancreatitis eyingozi nezinye izifo:
- i-cholecystitis eyingozi;
- i-appendicitis eyingozi;
- ukugcotshwa kwezitho eziyize;
- ukuvinjwa kwamathumbu ngesimo esibuhlungu;
- i-acute ischemic abdominal syndrome;
- ukuphuma kwamathumbu noma isisu.
Ukwelashwa kanjani?
Lapho eqinisekisa ukutholwa kwalolu hlobo, udokotela uncoma ukuthi ungeniswe esibhedlela somnyango wezokwelapha noma ohlinzayo. Zonke iziguli ezine-pancreatitis ebukhali zikhonjiswa ukuphumula kombhede okuqinile, futhi zonke izenzo zizohlose ukumisa i-pain syndrome, kunciphise umthwalo kusuka ku-gland enesifo, kanye nokukhuthaza ukuzivuselela kwesitho.
Ngalesi sikhathi, ama-painkillers adingekayo, futhi ukwelashwa kuzoba yimithi ngokuqinile.
Izindlela zokwelapha eziphambili zibandakanya:
- ukususwa kobuhlungu obukhulu ngama-antispasmodics, kanye ne-novocaine blockade;
- ukuhambisana kokuphumula kokudla, ukusetshenziswa kwamakhaza wokushisa okubandayo ukukhulisa ukukhishwa kwezimpawu zomsebenzi we-pancreas. Kunikezwa umsoco wabazali, futhi okuqukethwe esiswini kuzosuswa;
- ukuqokwa kwama-deactivators ama-enzymes we-gland;
- ukulungiswa kwe-homeostasis, izidakamizwa kanye ne-infusions yamaprotheni nosawoti kuzodingeka lapha;
- Ukwelashwa okubandakanya ukukhishwa ukudakwa;
- Ukwelashwa kwama-antibiotic njengesinyathelo sokuvimbela esiyinhloko esibhekene nezinkinga zesimo esithathelwanayo, izidakamizwa zokulwa namagciwane zizoza lapha.
Kwezinye izimo, ukungenelela kokuhlinzwa kungavezwa. Ukuhlinzwa kungenzeka kudingeke uma kudalulwa amatshe emiseleni, ukunqwabelana koketshezi ngaphakathi noma eduze kwamanyikwe, kanye nokwakheka kwe-pancreatic necrosis, izilonda ze-cystic noma i-abscess.
Ukungenelela kokuhlinzwa okufanele kwenziwe enkambeni ebangelwa ukuqina kwe-pancreatitis kubandakanya:
- ukudonsa kwe-endoscopic;
- marsupialization ye-cyst;
- cystogastrostomy.
Lapho ukhomba izindawo zezicubu ezifile, kuye ngezinga lomonakalo, i-necrectomy noma ukusetshenziselwa kabusha kwamanyikwe kungenziwa. Uma kutholakala amatshe ku-pancreas, kuzosetshenziswa ukuhlinzwa kwemithambo yesitho.
Ukuhlinzwa kushiwo futhi ezimweni lapho kunokungabaza okuthile khona ekuxilongeni, futhi kunamathuba amaningi okushoda kwezinye izifo ezinzima zokuhlinzwa ezibandakanya ukuhlinzwa.
Ngemuva kwenqubo, kubhekelwa izindlela zokuvimbela ukuqalwa kwezinkinga ezinkulu zokuhlanza, kanye nokwelashwa okuhlose ukubuyisela umzimba emzimbeni.
Indlela emnene yenkambo ye-pancreatitis ebukhali ayinikezeli ebunzimeni obukhethekile ekwelashweni, futhi umphumela wakhona kuphela isonto ngemuva kokuqala kokwelashwa.
Yini engaba yizinkinga?
Ingozi yonke yesifo se-pancreatitis esibuhlungu isengozini enkulu yokuba nezinkinga ezinkulu. Uma ukutheleleka kwenzeka, i-pancreatic necrosis noma i-abscess ingaqala ukukhula. Lesi simo siholela ekufeni kwesiguli, uma ungamnikeli ukunakekelwa kwezokwelashwa okufika ngesikhathi.
Ngenkambo ekhulayo ye-pancreatitis eyingozi, kungahle kube nokuqala kwesimo sokushaqeka kanye nokwehluleka kwezitho eziningi. Ngaphezu kwalokho, ukwakheka kwe-pseudocystic kungaqala ukwakha izicubu ze-pancreatic, ezingabhubhisa ukwakheka kwesitho kanye ne-bile ducts yayo. Uma ama-cysts angamanga ebhujiswa, khona-ke ama-ascites avela.
Izindlela zokuvimbela
Ukuvinjelwa okuyinhloko kokukhula kwe-pancreatitis eyingozi kungukudla okuphezulu futhi okunengqondo, okunikeza ukwenqatshwa okuphelele kweziphuzo ezinotshwala, ukubhema, okunamafutha, okunosawoti nokudla okuthosiwe.
Ukuvuvukala kakhulu kungaba wumphumela wokungasebenzisi kabi utshwala kuphela, kepha futhi kube ngumphumela wokusetshenziswa okukodwa kweziphuzo eziqukethe utshwala kanye nezitsha ezinamafutha ezinamafutha.
Ukuqashelwa kokugula okunjalo kuzoncika ngokuphelele kwifomu nasekwelashweni okusetshenzisiwe, kanye nokuba khona kwezinkinga. Uma i-pancreatitis ebukhali ivela ngendlela emnene, khona-ke kuzoba lula ukuthi iphinde ilulame kuyo. Nge-necrotic ne-hemorrhagic pancreatitis, amathuba okufa aphakeme impela.
Ngokulashwa okunganele nokungahambelani nemiyalelo kadokotela mayelana nohlobo nokudla, ukubuyela esimeni noma ukuguqulelwa kwalesi sifo kwifomu elingapheli kungaqala.
