I-pancreatic necrosis yisifo esinamandla se-pancreatic lapho amaseli aso ezigaya khona. Umphumela walesi sifo ukufa kwamaseli e-organ futhi, ngenxa yalokho, izicubu ze-izicubu. I-pancreatic necrosis inganqunywa kuphela ngemuva kokufa kwesiguli ngokuvula.
Lesi sifo, i-pancreatic necrosis, singadala izinkinga zepancreas. Lokhu kungadala ithumba elihlanzekile noma ukungasebenzi kahle kwezinye izitho zangaphakathi.
Izimbangela ze-pancreatic necrosis
Ngokwezibalo, cishe ama-70% eziguli ezinalolu hlobo lokuhlonza asebenzisa kabi utshwala ezimpilweni zawo zonke, cishe ama-30% eziguli ayenesifo esibuhlungu.
Odokotela baqokomisa izizathu eziningi ezingavusa ukuthuthukiswa kwenkinga efana ne-pancreatic pancreatic necrosis:
- ukusetshenziswa kotshwala isikhathi eside;
- ukudla ngokweqile;
- ukudla okunamafutha nokubhemayo;
- imisebenzi edlule emgodini wesisu;
- izifo ezinzima ezibangelwa ukumunwa kwamagciwane noma izifo;
- isifo se-gallbladder;
- isilonda se-peptic sesisu noma i-duodenum.
Kwesinye isikhathi imbangela yalesi sifo kungaba ukwephula izinqubo ze-metabolic emzimbeni, ngokwesibonelo, ukwephulwa kwemali esele kasawoti. Kulokhu, ama-enymes aqhamuka kuma-lymph node angena kumanyikwe, bese inqubo yokuvuvukala iqala.
Izindlela zokwelapha ze-pancreatic necrosis
Ukwelashwa ngezidakamizwa
Ezigabeni zokuqala zesifo, kusetshenziswa umuthi ukunciphisa izinhlungu. Udokotela ukhetha izidakamizwa ngendlela yokuthi anciphise izinhlungu kumanyikwe futhi, uma kungenzeka, aqede imbangela yalesi sifo.
Isibonakaliso esiyinhloko se-pancreatic necrosis ukuhlanza okukhulu. Njengomphumela walokhu, ukuphuma komzimba okukhulu kanye nokwephulwa kwenani lamanzi kasawoti. Ukuyibuyisela, isiguli sifakwa nge-potassium chloride engezwe kwisixazululo se-infusion.
Isifo se-pancreatic sihambisana nokudakwa kakhulu komzimba kanye nokulimazeka kwegazi emzimbeni wezicubu zesitho. Ukuqeda lezi zimpawu, izidakamizwa ezilandelayo zingabhekelwa isiguli:
- Ukuphathwa kwe-albhamu noma i-plasma kwegazi okuqandisiwe.
- Ukuze uthuthukise i-microcirculation yegazi, kuchazwe i-dextran ne-pentoxifylline.
- Ukunciphisa izinga lokududulwa komzimba, isiguli sinconywa ukuba siphuze amanzi amaningi futhi uthathe ama-diuretics, ngokwesibonelo, i-furosemide.
Nge-pancreatic necrosis, i-pancreas uqobo ibhubhisa amaseli ayo, ngaleyo ndlela umsebenzi wayo uyaphazamiseka futhi uthinta zonke izinqubo emzimbeni ohlanganyela kuzo. Kulokhu, isiguli sinqunywe izidakamizwa ezicindezela ukusebenza kwamanyikwe. Inhloso yokwelashwa okunjalo ukuzama ukubambezela inqubo yokuzibhubhisa kwesitho.
Kulokhu, kwethulwa izinto ezikhethekile emzimbeni wesiguli obambezela inqubo yokukhiqizwa kwe-pancreatic enzyme. Kodwa-ke, muva nje, odokotela bayilahlile le ndlela yokwelapha lesi sifo, ngoba sagcina singasebenzi.
Ezokwelapha zesimanje, izindlela ezilandelayo zisetshenziselwa kabanzi ukucwilisa umzimba wesiguli, njenge-plasmapheresis noma i-ultrafiltration. Noma kunjalo, sebenzisa lezi zindlela ukususa izinto ezinobuthi emzimbeni ngokuqapha okukhulu.
Abanye ochwepheshe baveze umbono wokuthi izindlela ezisetshenzisiwe azilethi imiphumela elindelekile futhi azithinti ukululama kweziguli.
I-pancreatic necrosis yisifo esikhula ngokushesha ngokwanele. Kungaphumela ekuthelelekeni ngegciwane, okuthi ngesikhathi esifushane kungaholele ekufeni kwesiguli. Ngakho-ke, udokotela kufanele anqume ngokushesha imithi elwa namagciwane ukuvimbela ukuthuthukiswa kokutheleleka.
Ukwelashwa kokuhlinzwa kwe-pancreatic necrosis
Imvamisa kakhulu, ngaphandle kokuhlinzwa, amathuba okululama esigulini esine-pancreatic necrosis empeleni. Ukuhlinzwa kubekwa nakanjani lapho ukutheleleka kungena emzimbeni.
Uma ukuhlinzwa kwenziwa ngaphandle kwesikhashana, isiguli singafa.
Uma ukutheleleka kungakangeni emzimbeni womuntu, khona-ke ukubhekela phambili kokungenelela kokuhlinzwa kuhlolwa ngokuya ngezinye izindlela ezithile. Ngefomu lesifo eliyinyumba, ukuhlinzwa kuchaziwe kula macala alandelayo:
- ukwelashwa ngezidakamizwa bekungasebenzi futhi lesi sifo siyaqhubeka;
- kukhona ithuba lokuvuvukala kanye nokutheleleka kwamanyikwe;
- i-pancreatic necrosis ifinyelela ezithweni ezingomakhelwane zesisu.
Uma odokotela beqiniseka ukuthi akukho ukutheleleka kwesitho, khona-ke isiguli sinikezwa enye indlela yokwelashwa, ngokwesibonelo, ukuhlinzwa okungajwayelekile. Kwenziwa ngaphandle kokuvula isisu esiswini, okuqinisa kakhulu amathuba okululama kwesiguli futhi kunciphise nengozi yokopha nokutheleleka emgodini wesisu ngesikhathi sokuhlinzwa.
Ukuhlinzwa okuhlaselayo okuncane
Ngokuyisisekelo, le ndlela yokungenelela kokuhlinzwa isetshenziswa lapho i-pancreas ithinteka kuphela ngokwengxenye ngalesi sifo, futhi i-pancreatic necrosis ingakakhuli. Esigabeni sesi sifo, uketshezi namaseli afile ayanqwabelana. Umsebenzi kadokotela ohlinzayo osetshenziselwa ukuhlinzwa kancane kokuhlasela uwukususa uketshezi namaseli.
Amaseli e-pancreatic athunyelwa kamuva ukuthola uchungechunge lwezivivinyo zaselabhorathri ezisiza ekutholeni imbangela yalesi sifo kanye nendlela yaso yokuthuthuka.
- Isifundo se-bacteriological sisiza ekuboneni ukuba khona kwama-microorganisms kuma-pancreas.
- Ukuhlolwa komlando kuhloswe ukukhomba amaseli angajwayelekile emzimbeni, njengamaseli womdlavuza.
- Ukuhlaziywa kwe-biochemical koketshezi olususiwe.
Inzuzo yalolu hlobo lokusebenza ukuthi yenziwa ngokubheka njalo i-ultrasound. Lokhu kusiza ekuboneni ngokunemba okukhulu kwe-pancreatic necrosis, njengokugxila kwalesi sifo nokuthola indlela yokwethula inaliti emzimbeni ukukhipha uketshezi, kuyilapho kungashayi ezinye izitho nemithambo yegazi.
Umgomo oyinhloko walokhu kusebenza ukususa isisekelo se-pancreatic necrosis futhi ngaleyo ndlela ugweme ukuhlinzwa okuvulekile.
Ukuhlinzwa okuhlaselayo okuncane akuvumela ukuthi unqume ukuthi lesi sifo siqatha kangakanani, ukuba khona kwezifo kanye nenani lezilonda. Ngokusekelwe kwimininingwane etholakele nemiphumela yocwaningo, kwenziwa isinqumo ngokuhlinzwa okuvulekile.
Izinhlobonhlobo zemisebenzi engahlaseli kancane - ukubhoboza nokudonsa
Lapho ukupomela uketshezi oluvela ku-foci ye-necrosis, udokotela ufaka inaliti ekhethekile kumanyikwe. Uma uketshezi lukhungiwe futhi inalithi isuswa kulungu lwesitho, khona-ke lolu hlobo lokusebenza lubizwa ngokuthi ukubhoboza.
Lolu hlobo lokuhlinzwa lusetshenziswa kuphela lapho isiguli sine-pancreatic necrosis eyinyumba futhi kungekho ukutheleleka kwesitho. Futhi, ngemuva kokuba inalithi isusiwe emgodleni, uketshezi aluqongeli.
Ngaphandle kwalokho, kungeniswa amadivaysi akhethekile kuma-pancreas - drainages, lapho kukhishwa khona imikhiqizo ewuketshezi nokubola. Zingafakwa ngamanani ahlukahlukene. Ngokudonswa kwamanzi, kufakwa izixazululo ezikhethekile kuma-pancreas ukuhlanza i-patity yayo futhi kukhishwe i-exudate.
Kwesinye isikhathi izindlela zokwelapha ezisetshenzisiwe azilethi umphumela oyifunayo futhi kukhulu ukwanda kwesifo. Ezimweni ezinjalo, ukuhlinzwa ngokuqondile kubalulekile. Kunoma yikuphi, inkinga efana ne-pancreatic necrosis prognosis ayisoze yaba ne-100% emihle.
Vula ukuhlinzwa kwe-pancreatic
Njengamanje, izindlela eziningana zokwenza imisebenzi kuma-pancreas ziyasetshenziswa. Kodwa-ke, inhloso yabo eyinhloko ihlala ukuvikela ukukhula kwesifo futhi, uma kunokwenzeka, ukuqeda imbangela imbangela yaso.
Ngesikhathi sokuhlinzwa, odokotela abazami ukususa wonke ama-pancreas, kepha bavame ukuthambekela kwi-necrosis. Ukuvimbela ukukhula kwesifo nokuvuvukala kwezinye izitho ngesikhathi sokuhlinzwa, isigaxa senyongo noma iqhubu lingasuswa.
Ukwelashwa ngaso sonke isikhathi kuya ngesilinganiso sokulimala kwesitho; phakathi kokuhlinzwa, kungakhiwa imisele lapho kuzokhishwa uketshezi oluningi. Isiguli esine-drainage esunguliwe kufanele ngokulandelayo sibe ngaphansi kokuqashwa njalo nokubhekwa kodokotela. Ukuhlinzwa okuphindaphindwayo kungasenza sibi kakhulu isimo sesiguli futhi kudale nezinkinga.
Impilo ngemuva kokuhlinzwa
Ngokwezibalo zezokwelapha, ngokwesilinganiso, ama-50% eziguli asinda ngemuva kokuhlinzwa kwe-pancreatic, i-prognosis akuyona induduzo kunazo zonke, kepha izibalo aziqambi amanga kanti nokufa okuvela kwi-pancreatic necrosis kuyinto ejwayelekile. Ukuze uvikele ukusebenza kabusha, isiguli kufanele sibe ngaphansi kokuqashwa njalo kwezokwelapha.
Iziguli ezenze lo msebenzi onzima kangaka zidinga ukuqhubeka nokwelashwa, kanye nokuvimbela ukubuyiselwa kwalesi sifo impilo yonke. Ukwelashwa okuqhubekayo kuncike ekujuleni kwesifo kanye nesimo sesitho ngemuva kokuhlinzwa.
Ngemuva kokuhlinzwa, isiguli esinjalo kufanele sivakashele udokotela waso njalo, senze izivivinyo ezidingekayo futhi sihlolwe i-ultrasound of the cavity esiswini. Kubalulekile futhi ukuthi isiguli silandele indlela esidla ngayo, kulokhu, i-diagnostic ihlale ivuma.
Ngenxa yokuthi ngemuva kokuhlinzwa, ama-pancreas ayaqhubeka nokukhiqiza ama-hormone, kodwa-ke, ukukhiqizwa kwama-enzymes athinta ukugaya ukudla kuncishiswe kakhulu, okulandelayo kungenzeka kube nezinkinga:
- isifo sokugaya ukudla;
- ukwakhiwa kwe-cyst;
- ukwephulwa kwe-lipid metabolism;
- isifo sikashukela mellitus;
- i-pancreatic pancreatitis.
Ngemuva kokuhlinzwa, isiguli senqatshelwe ngokuphelele ukudla ukudla okunamafutha, utshwala nokudla okuqukethe ushukela omningi. Ngaphandle kokuhluleka ngemuva kokuthi ukwelashwa sekuqalile, isiguli kufanele siyeke ukubhema. Uma kwenzeka kubuhlungu emgodini wesisu, isiguli singabekwa ngemithi elwa nokuvuvukala ne-antispasmodic.
