I-pancreatitis yotshwala iyisifo esibi esisemvelo sokuvuvukala okuthinta i-pancreas. Lokhu kungenxa yemiphumela enobuthi yotshwala be-ethyl emzimbeni, okuvezwa ngubuthi obunezakhi ezinobuthi beziphuzo ezidakayo.
I-pancreatitis yotshwala iba imbangela yokuhluleka kwezitho ezisebenzayo. Ngamanye amagama, kunokuphazamiseka ekukhiqizweni kwama-hormone nama-enzyme e-pancreatic. Njengomthetho, isifo salolu hlobo sithinta abesilisa abaneminyaka engama-30 kuye kwengama-50.
Izimpawu eziphambili ze-pancreatitis yotshwala
Ukubonakaliswa kwalesi sifo kungaba nobuhlungu obuqhubekayo emgodleni ongaphezulu wesisu, imvelo kaningi. Ubuhlungu bungakhula ngenxa yokulala isikhathi eside emhlane, kanye nokudla. Uhlobo lobuhlungu abudonsa noma obukhulu, bungenzeka ngezikhathi ezithile. Imizwa engemnandi kakhulu iyaqina ngemuva kokuphuza okulandelayo kotshwala, amafutha, izicubu ezithosiwe noma ezinephunga.
Ngaphezu kwalokho, i-pancreatitis yotshwala, lezi zimpawu ezilandelayo ziyinto engokwemvelo:
- ukwesaba kwe-pathological kokudla, okuhambisana nobuhlungu obandayo ngemuva kokudla (i-sitophobia);
- ukuthuthumela esiswini, ukugcwala kwenhliziyo, isicanucanu, ukugabha, ukuthopha (isizungu);
- ukunciphisa umzimba;
- izihlalo ezivame kakhulu nezizimele (okungenani izikhathi ezingama-2-4 ngosuku). Ngaphezu kwalokho, ukuphuma emzimbeni kuyacasula futhi kungenzeka kube mpunga ngombala ngokungcola kokudla okungaphanjwanga;
- ukuqala kwentuthuko yesifo sikashukela.
Izinhlobo ze-Alcoholic Pancreatitis
Umuthi uhlukanisa izinhlobo ezimbili zalesi sifo: i-acute and chronic, futhi kuzo zonke zazo i-pancreatitis yotshwala iyingozi kakhulu.
Ukuze uthole i-pancreatitis ebaluleke kakhulu yotshwala, inkambo esheshayo nentuthuko ingejwayelekile. Lokhu kwenzeka kaningi ngemuva komthamo owodwa womuthi owanele wotshwala noma we-surrogates, obonakala ngokufakwa esikhundleni sobuthi kwe-ethyl alcohol, kanye nokudla okuthosiwe noma okunamafutha amaningi.
I-pancreatitis yotshwala ngendlela engapheli iba kancane. Lokhu kwenzeka ngemuva kwesizinda sokusetshenziswa kotshwala isikhathi eside.
Izimbangela zokukhula kwalesi sifo
Inqubo yokuvuvukala kumanyikwe ivela ngenxa yemiphumela enobuthi yotshwala, ikakhulukazi lapho umlutha wokusebenzisa i-surrogates. Imbangela yokwakhiwa kwalolu hlobo lwe-pancreatitis kungaba ukuphuza utshwala nsuku zonke iminyaka emi-2 kuya kwengama-20 ilandelana. Sikhuluma ngemithamo ephansi ukusuka kumagremu angama-20 kuye kwangama-100 ngosuku.
Ngaphezu kotshwala, ukuntuleka kwamaprotheni, ukudla okuphansi kwekhalori, nokubhema kungaholela ekwakhiweni kwe-pancreatitis yotshwala.
Kwenziwa kanjani ukuxilongwa?
Okokuqala, izikhalazo zesiguli ezingakhula ngokushesha futhi isikhathi eside zizokhonjiswa emlandweni. Lokhu kubuhlungu, isicanucanu, ukuqhakaza nezinye izimpawu ezichazwe ngenhla. Ukwenza ukuxilongwa okuyikho, udokotela angaqala ukucacisa ngokudla komuntu ogulayo, ukudla kwakhe kanye namathuba okuphuza utshwala, kanye nobungako bawo.
Ngaphezu kwalokho, kuzodingeka ukwenza ukuhlolwa kwelabhoratri, ikakhulukazi, ukuhlolwa kwegazi. Lokhu kuyadingeka ukuthola inani lama-leukocytes kanye nesilinganiso sedimentation samangqamuzana abomvu egazi. Izinkomba ezinjalo zibalulekile ekunqumeni ukuthi kungenzeka yini inqubo yokuvuvukala emzimbeni eyenzeka ngesikhathi lesi sifo sibhebhethekisa.
Igazi Ukunikela ngegazi kwe-biochemistry kuzosiza ukuthola ukuthi:
- izinga loshukela kulo;
- inani le-lipase (into esheshisa ukusabela kwamakhemikhali);
- i-amylase (i-enzyme ebandakanyeka ekwenziweni kwama-carbohydrate);
- izinkomba ze-elastase ne-trypsin (ezihilelekile ekuwohlokeni kwamaprotheni);
- inani le-fructosamine (iprotheni ekhethekile ebonisa ushukela wegazi);
- izinga le-bilirubin (i-bile pigment).
Ngaphezu kwalokho, kubaluleke kakhulu lapho kuhlolwa i-pancreatitis ebangelwa utshwala ukuthola ukuthi kungenzeka ukuthi kukhona ushintsho lwe-gamma-glutamyltranspeptidase (isibindi ne-pancreas enzyme ekhuphuka ezifweni zalezi zitho ngenxa yotshwala).
Umchamo. Udokotela unikeza ukuhlolwa okujwayelekile komchamo, kanye nokuhlolwa kobuchwephesha. Ukufakwa komchamo we-biochemistry kuzokwenza ukuthi kunqume i-microalbuminuria (ukuba khona kwamaprotheni kumchamo), kanye ne-microtransferrinuria (ukuba khona kokulandela kokudluliswa komchamo).
Izinduku. Ukuhlaziywa okujwayelekile komtholampilo kwako kungabonisa izinkinga emsebenzini we-pancreas. Ezindlini, kutholakala inani elithile:
- Amafutha angathathi hlangothi (izingxenye zokudla ezingakwazanga ukugaya noma ukuthambisa);
- okunamafutha acid;
- i-fiber engazange iqhubeke ukugaya.
I-Secretin-pancreosimine (cerulein) test. Le ndlela yokuxilonga iqukethe ukuvuselela umsebenzi ongaphandle wamanyikwe. Lokhu kungatholakala ngokujova ngokulandelana i-secinin emthanjeni (i-hormone ebangela ukwakheka kwejusi le-pancreatic), kanye ne-cholecystokinin. Lesi sakamuva yi-hormone ebhekele ukuphendula kokudla okungena ngaphakathi kwe-duodenum futhi ibangele ukunyakaza okusebenzayo kwesibeletho kwe-gallbladder, kanye nokufihlwa kwama-enzyme e-pancreatic.
Ngemuva kwaloko, kuhlolwa kwempahla esekusheni ngenani lezinto ezi-6 zokuqukethwe kwe-duodenum kwenziwa. Ngaphezu kwalokho, bahlaziya izinga lama-bicarbonates (usawoti wama-pancreas) ezingxenyeni zokuqala ezintathu nezokugcina ezintathu ze-gruel yesisu sabo. Lolu vivinyo lungasetshenziselwa ukuthola umsebenzi osebenzayo wamanyikwe.
Ukwelashwa kokubonakaliswa kwe-pancreatitis yemvelo yotshwala
Ezimweni zokwelashwa, kunezindlela ezimbili zokwelapha i-pancreatitis yotshwala: ukulondolozwa nokuhlinzwa. Usengagcizelela nje izincomo ezijwayelekile zokuqeda lesi sifo.
Izincomo ezijwayelekile zibandakanya:
- ukondliwa kokudla impilo yonke. Sikhuluma ngokwelashwa kokudla ngokuya nge-Pevzner, futhi ikakhulukazi, ithebula No. 5. Le ndlela yokudla okunomsoco ihlinzekela ukususwa okuphelele kweziphuzo ezidakayo, ukwehla kwezinga lama-carbohydrate namafutha, kanye nokwanda kwezinga lamaprotheni emzimbeni;
- ukunqamuka ngokuphelele kokubhema (uma kukhona).
Ukwelashwa kokugada kungenziwa ukuze kuqedwe izimpawu zesifo. Kungaba:
- Ukwelashwa okubuyiselwayo (ukwelashwa ngezidakamizwa ezithatha indawo yemisebenzi engenamandla noma elahlekile yamanyikwe, futhi ikakhulukazi, ukukhiqizwa kwejusi ye-pancreatic, ekuvumela ukuthi uchithule fat nama-carbohydrate). Ukwelapha okufanayo kungenziwa ngama-enzyme ama-microencapsured;
- izidakamizwa ezilwa nokuvuvukala nama-analgesics (ukudambisa izinhlungu) zizosetshenziswa ngokuphelele ekwelapheni;
- Ukulungiswa kweshukela egazini (ushukela) kuyadingeka ukuze kulondolozwe ezingeni elijwayelekile.
Ukwelashwa kokuhlinzwa kungadingeka futhi uma utshwala buhlanganiswa ne-pancreatitis. Umphumela onjalo emzimbeni wesiguli nge-pancreatitis yotshwala ubandakanya ukubuyiswa kwamanyikwe (ukususwa kwengxenye eyodwa yalesi sitho). Lokhu kukhwabanisa kuyadingeka ngokuya ngenkambo eyinkimbinkimbi yesifo ngokuya ngezinkomba ezilandelayo:
- imithambo ye-pathological yavela ezicutshini zesitho (ukwakheka kwe-cystic), kanye nesibumbu (i-capsule ene-pus eqoqiwe);
- fistulas kuma-pancreas (ama-pathological);
- ukuthikamezwa kwe-duct eyinhloko yesitho, ngenxa yokuthi kukhona ukunyakaza kwejusi kusuka gland kuyi-duodenum;
- izinsolo zangempela zokuthuthukiswa kwe-neoplasm enobungozi, engathwala ubungozi obukhulu empilweni nasempilweni yesiguli.
Izinkinga ezingaba khona nemiphumela yesifo
Ochwepheshe bafaka ama-cysts, ama-fistulas, kanye nokukhula kwe-jaundice ethintekayo njengezinkinga ezingaba khona. Umthwalo wokugcina ungabonakaliswa ngokuqedwa komgudu we-biliary, obangela ukudlula kokufaka izinto ze-bile egazini, kubangele umbala wesikhumba, kanye nokufaka ubuthi kuwo wonke umzimba (ukudakwa nge-bile).
Kunezimfuneko ezinkulu impela zokukholelwa ukuthi ukuthuthukiswa kwesifo sikashukela kuzoba umphumela we-pancreatitis yotshwala. Lokhu kugula kungaba yisibonakaliso esibonakalayo sokulimala kwe-pancreatic, kubalulekile futhi ukwazi ukuthi utshwala buthinta kanjani ushukela wegazi.
Ukuthuthukiswa kwe-adenocarcinoma, i-neoplasm enobungozi kumanyikwe, akukhishwa. Isitho ngalesi sikhathi silahlekelwa amandla okuhlukanisa isimila kusuka kumaseli waso uqobo. Inqubo efanayo iyisongo esikhulu ekusindisweni kwempilo yabantu.
Izindlela zokuvimbela
Uma sikhuluma ngezindlela zokuvimbela i-pancreatitis yotshwala, okokuqala-ke, udinga ukuyeka ngokuphelele ukulutha ngendlela yokuphuza utshwala nokubhema ugwayi, ikakhulukazi ngokuhlanganiswa nokudla kokudla okunamafutha, lokhu kuyasebenza futhi.
Okubaluleke ngokufanayo ukudla okuphelele nokunokulinganisela ngokufakwa kwamaprotheni amaningi. Kubalulekile ukuthi ungakhohlwa mayelana nokuhlolwa okuphoqayo ngudokotela wobuchopho okungenani kanye ezinyangeni eziyi-12.
