Ngaphansi kwethonya le-pancreatitis eyingozi, i-pancreatic necrosis ingakhula ngamaphesenti ayi-10. I-fiber ezungeza ama-pancreas iyafa, njengoba kunjalo nange-pancreatitis. Lokhu kungenxa yesenzo se-lipase, i-enzyme yama-pancreas.
Okokuqala, i-fat pancreatic necrosis iqala, ngokumelene nesizinda se-hemorrhages yesifo ivele kwindlala, okuholela ku-hemorrhagic necrosis, ihambisane ne-edema kwezicubu ze-retroperitoneal. Izinhlobo ezixubile ze-necrosis enamafutha: ngezindawo ezine-hemorrhage ne-hemorrhagic pancreatic necrosis, nezinguquko ezinamafutha.
I-Necrotic lesion kanye nezimpawu
Njengoba wazi, i-necrosis yalesi sitho ivela ngaphansi kwethonya le-pancreatitis. Isigaba sokuqala salesi sifo sibonisa ubuphofu bezimpawu. Phakathi kwezimpawu ezivame kakhulu emtholampilo kungaphawulwa ukuthi i-pallor yesikhumba, ukuqina kokuqaqamba kwe-sclera ne-cyanosis.
I-pulse ingaba ejwayelekile noma isheshise kancane, izinga lokushisa lomzimba, njengomthetho, ayiguquki. Uma ukutheleleka kwenzeka ezindaweni ze-necrotic, izinga lokushisa liyenyuka.
I-Palpation ivame ukukhombisa ubuhlungu ku-epigastrium kanye nokuqhakaza. Ngokuphikisana nesizinda se-fatty necrosis, ukufakelwa okuthelelekayo kwakhiwa ngokushesha. Kungazwakala esiswini sangaphezulu ngesikhathi sokubeletha, umphumela lapha kungenzeka ungathandeki kakhulu, okungukuthi, ukufa, awukho umehluko.
Lesi sifo sikhula ngokwanda kwama-paresis kanye nokuqhakaza ngokububula okubuthakathaka kwe-peristaltic, konke lokhu kungabonisa izimpawu zomdlavuza we-pancreatic, izimpawu lapha zivame ukufana.
I-pancreatic necrosis icasulisa ukuvela kwesifo sokuphendula okune-systemic ukuvuvukala, imisebenzi yezitho ezibalulekile iwohloka, okuholela ekubukekeni kokungapheleli, umphumela awulona oluhamba phambili. Ngalesi sifo, kungenzeka:
- Inhliziyo;
- Ukuphefumula
- I-Renal;
- I-Hepatic
- Ukuntuleka kwamathumbu emathunjini.
Izitho zohlelo lokuphefumula ziyathinteka, okuvezwa ngendlela yokuqongelela emgodleni we-transural we-transudate kanye ne-interstitial pulmonary edema.
Ngokunganeleki kwenhliziyo, i-hypotension ivela, ukuhanjiswa okuvame ukuvela emzimbeni, ischemia ye-myocardial, i-cyanosis yesikhumba nolwelwesi lwama-mucous, ukwehla komthamo wokuphuma kwenhliziyo, zonke lezi zimpawu zibonisa i-pancreatic necrosis.
Ngaphezu kwalokho, iziguli ezikhubazeka njalo ngokomqondo, eziziveza njengokudideka futhi (noma) injabulo ngokweqile. Ukusebenza okujwayelekile kwesibindi kulahleka ngokushesha ngokwanele, ngokomtholampilo kuziveza njenge-jaundice.
Izinkinga eziphambili ze-pancreatic necrosis ziyahlukaniswa:
- Ukushaqeka kwe-Hypovolemic;
- Ukwehluleka kwezitho eziningi;
- Izinkinga ze-Pleuropulmonary;
- I-Abscesses ye-retroperitoneal fiber kanye nama-pancreas;
- Ama-fistulas angaphandle nangaphakathi;
I-Peritonitis kanye nokopha kwangaphakathi okunezimpawu ezahlukahlukene. I-Peritonitis yenzeka ngenxa yokuqhuma kwe-parapancreatic abscess in the cavity esiswini.
Ezimweni eziningi, izindawo ze-necrosis ziqala ukufakwa ngaphakathi, okungukuthi, zifakwe yicwecwe lezicubu ezithintekayo kusuka kwezicubu ezinempilo. I-cyst ingaba nokuqukethwe okuhlanzekile kwe-purulent futhi oyinyumba.
Ukwelashwa kwe-pancreatic Necrosis
Kusetshenziswa ukwelashwa okuhlanganisa, okubandakanya imisebenzi elandelayo:
- Ukukhululeka kobuhlungu;
- Ukucindezelwa komsebenzi we-pocrreatic pancreatic;
- Ukuvuselelwa kokubalwa kwegazi okulingene;
- Ukudla kwabazali;
- Ukwelashwa kwe-detoxification.
Ukudambisa izinhlungu, kusetshenziswa ama-analgesics angama-non-narcotic. Uma icala seliqalisiwe, ama-narcotic analgesics asetshenziswa, into esemqoka ukuthi umphumela awuba umlutha wezidakamizwa.
Ukuze ucindezele umsebenzi oyimfihlo wangaphandle we-gland, ukudla ngomlomo akunakwa. Ama-antacid kanye nama-anticholinergics (atropine) asetshenziswa.
Ukubuyisela umthamo wegazi elijikelezayo, kuyadingeka ukuphatha ngaphakathi izixazululo ze-crystalloid ne-colloidal. Ama-electrolyte amaningi abalulekile akhona kuzixazululo ze-crystalloid; lawa yi-chlorine, i-calcium, i-potassium, ne-sodium.
Isimo esibalulekile sokudla kwabazali ukuhambisana nezidingo zamandla zomzimba womuntu. Isebenzisa izixazululo zama-amino acid, ushukela kanye ne-protein hydrolysates.
I-pancreatic necrosis ilashwa kuphela ngokushesha ngokususwa kwama-pancreas. Ukuhlinzwa kuhlose ukususa izindawo ezinegciwane lesifo se-necrotic kuze kufike ezingeni lokuphindaphindeka. Uma kukhona i-peritonitis, kukhipha imisele ye-peritoneum.
Ukusetshenziselwa kabusha kwe-distal gland kuboniswa ushintsho olugxile kumanyikwe. Ama-pancreas asuswa ngokuphelele ezimweni ze-necrosis eziphelele. Ukusebenza okunjalo kuyingozi enkulu, kungenzeka ukuthi umphumela ube obulalayo, ngakho-ke akusenziwa futhi ukungasebenzi kahle kwe-pancreatic kungalashwa ngezindlela eziphephile.
Muva nje, odokotela bakhetha ukusebenzisa izinketho zokubamba iqhaza ekusebenzeni necrosis kanye nezinkinga zalo, ukuze ukufa kube yinto yesikhathi esedlule.
Njengomthetho, kufakwa amadamu ku-patitive patity. Lokhu kudala amathuba okuba nesifiso sokuqukethwe kwama-cysts kanye nokufakwa kwama-antibacterial agents. Ukwelashwa kubekezelelwa kahle, kunephesenti elincane lokulimala futhi kukhombisa inani elincane lezinkinga.
