I-pancreatitis engapheli yinqubo ekhulayo yokuvuvukala eyenzeka kumanyikwe. Ukuvuvukala kuyaqhubeka ngisho nangemva kokuqedwa kwe-foci nomthombo. Lokhu kufaka isandla ekuhlelweni kabusha kwendlala ngezicubu, ngenxa yokuthi lesi sitho sangakwazi ukwenza imisebenzi yaso esemqoka.
Emhlabeni jikelele eminyakeni engamashumi amathathu edlule, inani labantu abahlushwa i-pancreatitis engapheli liye laphindeka kabili. E-Russia, inani labantu abagulayo kule minyaka eyishumi edlule seliphindeke kathathu. Ngaphezu kwalokho, ukuvuvukala kwama-pancreas "kuncane." Manje iminyaka emaphakathi yokuthola ukugula igulile isuka eminyakeni engama-50 iye kwengama-39.
Ezisencane, i-pancreatitis yaqala ukutholakala kaningi ukwedlula, kanti inani labesifazane abanalesi sifo lenyuka ngamaphesenti angama-30. Kwenyuse namaphesenti (kusuka kuma-40 kuye kwangama-75%) okulimala kwe-pancreatic ngemuva kokuphuza utshwala ejwayelekile. Isibhedlela ngasinye namuhla siqopha izimo eziningi zokwelashwa nge-pancreatitis ye-HR.
Izici ezithinta ukukhula kwe-pancreatitis engapheli
Izimbangela eziyinhloko zokuqubuka kwesifo yizifo ezingama-gallstone neziphuzo eziqukethe utshwala. Kepha kunezinye izici ezithinta ukwakheka kwalesi sifo:
- Utshwala I-pancreatitis ebangelwa ukuphuza utshwala ihlala ikhona emadodeni futhi yenzeka ngamacala angama-25-60%.
- Isifo se-Gallbladder. I-pancreatitis ebonakala ngenxa yezinkinga nge-gallbladder ivela ku-25-40% yamacala. Abesifazane bathinteka kakhulu kulokhu.
- Izifo ze-duodenum.
- Ukutheleleka Igciwane le-mumps (mumps), i-hepatitis C no-B.
- Ukulimala okuhlukahlukene.
- Isifo sikashukela mellitus. Ikakhulu, uma lokhu kugula kuhambisana nokuntuleka kwamavithamini namaprotheni ekudleni.
- Ukusetshenziswa kwezidakamizwa ezinobuthi.
- Helminths.
- Amafutha egazi aphezulu.
- Ukuxilongwa kohlobo olungamahlalakhona. Ukunobuthi nge-arsenic, ukuhola, ifosforasi, i-mercury, njll.
- Isizungu.
Izimpawu ze-pancreatitis engapheli
Ubuhlungu ku-hypochondrium yesobunxele nakwesokudla esifundeni se-epigastric. Ubuhlungu bugxile e-epigastrium nge-infuction yendawo yokulimala ekhanda le-pancreas, lapho umzimba wayo uqala ukubamba iqhaza kule nqubo, ngakwesobunxele, ngokuvuvukala komsila wayo - ngakwesokudla ngaphansi kwezimbambo.
- Ubuhlungu emhlane. Imvamisa izinhlungu zinikezwa emhlane, zinomlingiswa ozihlanganayo.
- Ubuhlungu enhliziyweni. Futhi, kwesinye isikhathi izinhlungu zihamba ziye endaweni yenhliziyo, okudala ukulingiswa kwe-angina pectoris.
- Isinyathelo noma ubuhlungu obuhlelekile ku-hypochondrium yangakwesobunxele. Kwenzeka ngemuva kokudla ukudla okubukhali kakhulu noma okunamafutha.
- Izimpawu Mayo - Robson. Le yimizwa ebuhlungu eyenzeka endaweni ethile etholakala engxenyeni yezitho zomzimba ezibizayo ngakwesobunxele.
- Izimpawu Kacha. Ngesinye isikhathi, isiguli siba nobuhlungu ekuqinisekisweni kwe-vertebrae ye-8-11 thoracic.
Ukuqunjelwa. Ngokuvuvukala kwamanyikwe, lezi zimpawu zenzeka njalo. Kwesinye isikhathi isiguli sinokuntula okuphelele kokudla, futhi sizizwa sikuthandi ukudla okunamafutha.
Kodwa, uma umuntu enesifo sikashukela i-mellitus ngaphezu kwe-pancreatitis, khona-ke izimpawu zingabuyiselwa emuva - umuzwa wokoma kakhulu noma indlala. I-pancreatitis imvama ihambisana ne-profuse salivation, ukuhlanza, ukubopha, isicanucanu, ukuqhakaza nokuqhuma esiswini. Ngamafomu amancanyana enkambo yesifo, i-stool ijwayelekile, futhi ngezindlela ezibucayi, kubhekwa isisu esidabukisayo nokuqunjelwa.
Izimpawu ezibonakaliswa yi-pancreatitis engalapheki yisifo sohudo, lapho izindunduma zine-sheen enamafutha, iphunga elingathandeki kanye nokuvumelana kwe-mushy. Ukuhlaziywa kwe-Corrological kwembula neKitarinorrhea (ukukhuphuka kwenani le-fiber ezindlini), i-steatorrhea (okunamafutha amaningi akhishwa ngamalongwe) kanye ne-creatorrhea (kunemisipha eminingi yemisipha engatholakali emgodini).
Ngaphezu kwalokhu, igazi liyahlupheka, lapha kufanele unake:
- i-hypochromic anemia (izinga le-hemoglobin lehla kumaseli abomvu egazi);
- I-ESR (isilinganiso se-erythrocyte sedimentation rate) - kuvela uma kwenzeka ukukhipha i-pancreatitis;
- i-neutrophilic leukemia (isifo esingamahlalakhona esingajwayelekile sasinesifo esandayo);
- dysproteinemia (ukwephulwa kwesilinganiso senani lamaprotheni egazini);
- I-hypoproteinemia (amazinga aphansi kakhulu wamaprotheni egazini).
Lapho kukhona isifo sikashukela emchameni, ushukela ungabonakala, kanye nokuqukethwe okuphezulu kwe-glucose egazini. Ezimweni ezibucayi ikakhulukazi, ukungalingani kokushintshana kwe-electrolyte kuyabonwa, i.e. okuqukethwe kwe-sodium esegazini kungaphansi komthetho osunguliwe. Futhi, ngesikhathi sokwanda kokuvuvukala kwe-pancreatic, okuqukethwe kwe-trypsin, lipase, antitrypsin, amylase egazini kuyanda. Enye inkomba inyuka ezimweni zokuvinjwa kokuphuma kwejusi le-pancreatic.
Inkambo yalesi sifo
Ukuhlolwa kwe-pancreatitis:
- IDuodenoentgenography - ikhombisa ubukhona be-deformation engxenyeni engaphakathi ye-duodenum, futhi futhi iveze ukucasulwa okuvela ngenxa yokukhula kwekhanda lesigaxa;
- Ukuskena kweRadioisotope ne-echography - kukhombisa ukuqina kwesithunzi nosayizi wamanyikwe;
- I-Pancreatoangio radiography;
- I-Tomography eyenziwe ngekhompiyutha - eyenziwa ezimweni ezinzima zokuxilonga.
Kungenzeka futhi kube nesidingo sokuziphatha kokuxilongwa kokuhlukanisa uhlobo lwe-pancreatitis engapheli yesifo se-gallstone, izifo ze-duodenum, izifo zesisu, i-enteritis engapheli, kanye nezinye izifo ezenzeka ohlelweni lokugaya ukudla.
Inkambo evikelwe yilesi sifo
Ngohlobo lwenkambo, kukhona:
- i-pancreatitis engapheli engapheli;
- i-pseudotumor pain pancreatitis;
- i-pentreat pancreatitis (ifomu eliyivelakancane).
Izinkinga:
- ithumba
- inqubo yokuvuvukala ye-cicatricial ye-duodenal papilla kanye ne-pancreatic duct;
- ukucabanga (ukubekwa kosawoti we-calcium) kanye ne-cyst kumanyikwe;
- i-splenic vein thrombosis;
- izinhlobo ezinzima zesifo sikashukela;
- meundice subhepatic jaundice (kwenzeka nge-sclerosing pancreatitis);
- umdlavuza wepancreatic wesibili (kwenzeka ngokumelene nesizinda senkambo ende yesifo).
Imiphumela ye-pancreatitis engapheli
Izinkinga ezivame kakhulu zifaka:
- ukwakhiwa kwezimpawu zokutheleleka gland;
- ukuvuvukala kokuhlanjululwa kwe-gland ne-bile ducts;
- ukuvela kokuguguleka ku-esophagus (kwesinye isikhathi kuhambisana nokuphuma kwegazi);
- ukuvela kwamathumbu kanye nesisu sezilonda;
- umdlavuza wepancreatic;
- ukuphazamiseka kwamathumbu e-duodenum;
- ukwehla okunamandla kwe-plasma glucose;
- i-sepsis (ubuthi begazi);
- ukubonakala koketshezi lwamahhala esifubeni nasesiswini;
- ukwakhiwa kwama-cysts angamahlalakhona;
- ukuqhekeka kwemithambo (lokhu kuphazamisa ukuhamba kwegazi okungokwemvelo esibindini nasebusweni);
- ukwakheka kwama-fistulas angena emgodini wesisu;
- izinqubo zokuvuvukala nezifo (zenzeka esiswini, zihambisana nomkhuhlane, ukuqunjelwa uketshezi esiqwini sesisu, impilo engeyinhle);
- ukuvela kokopha kakhulu, okuchichima kusuka ekuguguleni kanye nezilonda emgodini wesisu kanye nesisu ngenxa yomfutho wegazi ophakeme emithanjeni yezitho zomzimba;
- ukuvinjwa kokudla (inkambo ende ye-pancreatitis engamahlalakhona ingashintsha ngisho ukwakheka kwamanyikwe, ngenxa yalokho okucwiyiwe);
- ukuphazamiseka kwengqondo nokwesaba (ukuphazamiseka kwezinqubo zengqondo nezengqondo).
Yini okufanele uyenze uma kutholakala izimpawu ze-pancreatitis engapheli?
Isinyathelo sokuqala ukwenza isikhathi sokubonana nodokotela wezitho zangasese, oyonikeza ukuhlolwa okuningana ukuthola ukuthi kuthini isifo. Kumele kuqashelwe ukuthi esigabeni sokuqala sesi sifo (kusuka eminyakeni emibili kuya kwemithathu), imininingwane eminingi yezinsizakalo kanye nemiphumela yokuhlolwa kwelebhu kungahlala kuyinto evamile. Ngaphezu kwalokho, izici zomtholampilo aziyona uphawu lwesifo esisodwa.
Izindlela zokuthola i-pancreatitis:
- Ukuhlolwa kwegazi kwe-biochemical. Kwenziwa ukuhlola umsebenzi wezitho ezifana nesibindi, ipancreas, kanye nokuhlaziywa kwe-pigment kanye namafutha metabolism.
- Ukuhlolwa kwegazi okwelashwa. Kwenziwa ukuze kukhonjwe izinqubo zokuvuvukala nokuhlola izinga labo.
- ICoprogram. Kukhombisa amandla okugaya wegaya lokugaya, futhi futhi kukhombisa ubukhona bokugaya okungalungile kwama-carbohydrate, amafutha noma amaprotheni. Izimo ezinjengalezi zimpawu zeziguli ezine-pathology yesibindi, ipheshana lesibindi kanye nendlala.
- Ukuhlaziywa kwe-immunological kanye ne-tumor markers. Kwenziwa ucwaningo uma kukhona izinsolo zokuthi kukhona i-tumor enobungozi emanyikwe.
- I-Ultrasound Isibindi, ama-pancreas, ama-ducts we-bile, i-gallder - zonke lezi zitho zidinga i-ultrasound. I-Ultrasound yindlela enkulu yokuthola izinqubo ze-pathological ezenzeka epheshaneni lokuphamba kanye namanyikwe.
- I-Fibrocolonoscopy (FCC), i-Fibroesophagogastroduodenoscopy (FGDS). Kwenziwa ucwaningo ukuthola ukuthi kukhona kwezifo ezifanayo noma ukwenza isiphetho esingafani.
- Uvivinyo lokunqunywa ku-facks of parasites (Giardia).
- I-Tomography ehlanganisiwe yalo lonke ujiko lwesisu. Kuyadingeka ekuhlaziyweni kwesibindi, isifunda se-retroperitoneal futhi, i-pancreas.
- Ukuhlaziywa kwegacteriological kwezindunduma. Ukuhlwanyela ukuthola ukuthi i-dysbiosis. I-Dysbacteriosis yisifo lapho kwenzeka khona ushintsho ekwakhiweni kwe-microflora yamathumbu. Lesi sifo, njengomthetho, siyaqhubeka ngokuhambisana nezifo zohlelo lokugaya ukudla.
- Ukuxilongwa kwe-PCR, ukuhlolwa kwegazi kwe-virological kanye ne-immunological, ukuhlolwa kwelabhorathri nokwenziwa kuyenziwa uma ukuhlolwa okuphelele kudingekile.
