Izindatshana zokuqala zesayensi ezikhuluma ngezifo zamanyikwe (ama-pancreas), ikakhulukazi - ngokuvuvukala, zavela maphakathi nekhulu le-XIX. Amacala emitholampilo achazwe, kwanikezwa idatha ye-autopsy, nokwakheka kwesakhiwo kanye nesimo sokusebenza kwafundwa. Ekupheleni kwalelo khulu leminyaka, ukungenelela kokuhlinzwa okuphumelelayo ku-gland kwaqala, ukuvumela ukususa imiphumela yenqubo yokuvuvukala (susa i-foci ye-necrosis kanye ne-purreat abscesses) futhi unikeze iziguli iminyaka eminingi yokuphila.
Ukuvuvukala kwe-pancreatic, izimpawu kanye nokwelashwa kwalesi sifo, ngenye indlela esibizwa nge-pancreatitis, kuhlala kuyisihloko esiphuthumayo esikhathini sethu. Ukwanda kwamakhono okuxilonga, kuqhathaniswa nekhulu leminyaka elidlule, kungabizwa njengesizathu esiyinhloko sokuthi izehlakalo ze-pancreatitis ziyaqhubeka nokukhula. Kepha le nqubo ibuye ithonywe indlela yempilo yabantu, ikakhulukazi imisebenzi yokudla kanye nokusebenza okuhle, isidingo, kwezinye izikhathi, sokulayisha izidakamizwa njalo. Eminyakeni engu-40 yobudala, uhlobo olubi lokuvuvukala lwenzeka ikakhulukazi emadodeni, kodwa kwabesifazane ngokuvamile bane-pancreatitis kaningi.
Ngokwemigomo yezokwelapha kanye neye-prosicicic, zonke izinhlobo zokuvuvukala kwe-pancreatic zithathwa njenge-pathology embi kakhulu. Ngokwesidingo sokuhlinzwa okuphuthumayo, i-pancreatitis eyingozi isendaweni yesithathu, ngemuva kwe-appendicitis eyingozi ne-cholecystitis. Ukwehluleka ukuhlinzeka ukunakekelwa kwezokwelapha ngesikhathi kungadala ukwakheka emzimbeni we-hemiha we-hemorrhage, "ukuncibilika" necrosis, okungasongela ngqo impilo yesiguli. Izinhlobo ezingapheli zokuvuvukala kwe-pancreatic, ezenzeka ngokwehla okukhulu kwamakhono okusebenza kwesitho, nazo ziyingozi futhi zingathandeki, okuholela ekwakhekeni kwezifo eziningi ezihlangene.
Emncane, ukuvuvukala kuvame ukukhula emadodeni
Izimbangela eziphambili zokuvuvukala
Inqubo yokuvuvukala ekhula esakhiweni futhi ithinta zonke izakhiwo zayo inganciphisa kakhulu ukusebenza kwamanyikwe, kube nemiphumela emibi kakhulu yomzimba wonke. Kungabizwa nge-polyetiological, okungukuthi, ukuthuthuka ngenxa yokuchayeka ezintweni eziningi kakhulu.
Zonke izimbangela zokulimala kwe-pancreatic zingamelwa kanjena:
- ukulimala kwesisu (kuvaliwe noma kuvulekile);
- ukungenelela kokuhlinzwa kwizitho zesisu;
- ukwephulwa okukhulu kokuhlinzekelwa kwegazi kumanyikwe ngenxa yokwakheka kweziqalo zegazi noma i-embolism emithanjeni yomzimba, ukugoqa kwabo ngesikhathi sokuhlinzwa noma ukuncipha;
- izifo zezitho ezisondelene namanyikwe (ngokwesibonelo, ngama-pathologies wepheshini le-biliary, i-bile ingaphonswa kusuka e-duodenum emgodini omkhulu we-gland, ngenxa yokuthi ingashiswa. Nge-pathology yamathumbu, okuqukethwe kwayo kungangena nama-pancreas, nemiphumela efanayo);
- ubuthi ngezinsimbi ezisindayo, ama-alkaliti;
- izinqubo ze-allergic noma ze-autoimmune;
- ukuphuza ngokweqile utshwala;
- amaphutha kokudla okunempilo (umlutha wamafutha, obhemayo, othosiwe, wokudla okunezipayisi);
- i-pathology yezinye izindlala ze-endocrine (genital, parathyroid);
- ukutheleleka ngegciwane (mumps, hepatitis);
- ukuhlukunyezwa kwezinhlaka (toxoplasmosis);
- ukuphazamiseka kwe-metabolic yamafutha;
- umthwalo wezidakamizwa, ikakhulukazi izidakamizwa ze-hormonal;
- ukungahambi kahle kokuzala kwamanyikwe;
- isakhi sofuzo.
Uhlobo olubi lokuvuvukala luvame ukudinga ukuvuselelwa.
Ukubonakaliswa kwalesi sifo
Isigaba sokuqala senqubo yokuvuvukala sihlala sibonakaliswa yizimpawu ezithile zepancreas ngendlela yezimpawu zokuvuvukala okucashile, kanye nokuwohloka okuqinile esimweni esejwayelekile sesiguli ngenxa yokuqalwa kwesifo sokudakwa kanye ne-carbohydrate metabolism. Kuvela yonke inkimbinkimbi yokubonakaliswa, ecishe ifane yomibili ekubonakalweni kwe-pancreatitis nasekuphakamiseni ifomu lamanje elingelapheki. Endabeni yokugcina, noma kunjalo, ubukhulu bezimpawu ezithile bungancishiswa.
Ngokuvamile, zonke izimpawu zokuvuvukala kwe-pancreatic kubantu abadala zengeza esithombeni somtholampilo esilandelayo:
- Ubuhlungu obukhulu nge -izationization esiswini esingaphezulu, okungabuye kuzwakale ku-hypochondrium yesobunxele nakwesokudla (ngohlobo lwebhande), esifundeni senhliziyo, ngemuva kwe-sternum. Ngokuvuvukala kwekhanda le-pancreatic, izinhlungu ziqine ngaphansi kwesisu naku-hypochondrium yangakwesokudla, futhi ngokuvuvukala komsila we-pancreatic, kukhulu ngokwengeziwe endaweni ye-hypochondrium yangakwesobunxele. Lapho kusinda ukubhujiswa kwesisindo se-parenchyma yesitho somzimba kanye nethoni ye-ducts, namandla e-pain syndrome. Kepha ngokuqala kwe-necrosis, izinhlungu zivame ukuncipha futhi zingabe zisahambelana nobunzima be-pathology.
- Ukuze banciphise izinhlungu, iziguli zilwela ukuguqula njalo isimo sazo, kodwa zingatholakali;
- isicanucanu nokuhlanza okuphindaphindiwe okubuhlungu, ngokungcola kwe-mucus, i-bile, kwesinye isikhathi igazi;
- isikhumba siphaphathekile, sinsipha, simanzi, esihambisana nokwehla komfutho wegazi. Uma ukuvinjwa kwe-bile kugobhoza ngetshe kujoyina ukuvuvukala kumanyikwe (ngesifo se-gallstone), khona-ke kuvela umthunzi osesikhunjeni wesikhumba nolwelwesi lwe-mucous;
- umkhuhlane, ukukhuphuka kwenhliziyo, ubuthakathaka obukhulu kuyizimpawu zokuphuza. Ukushisa okuphezulu (okungaphezulu kwama-degrees angama-39), kungaphenduli izidakamizwa ze-antipyretic, kuvame ukuhambisana nefomu elibhubhisayo necrotic le-pancreatitis;
- ukuthopha (ukuqhakaza) kwesinye isikhathi kuyaphawulwa;
- ezimweni ezinzima, lapho i-pancreas ikhanyiswa ngentuthuko esheshayo yokubhujiswa noma ngokumelene nesizinda seminye i-pathologies, ukusabela okuphathelene nomzimba (ukuphefumula, inhliziyo, isibindi, ukwehluleka kwezinso) ukujoyina.
Inqubo yokuvuvukala iqhubeka nokwakhiwa kwe-foci ye-autolysis necrosis
Uma i-pancreas ikhanyisiwe, khona-ke ukulashwa esibhedlela okuphuthumayo kuyadingeka, ngaphandle kwalokho kukhona amathuba amakhulu okuthola imiphumela esongela impilo. I-Peritonitis, i-phlegmon kanye ne-abscesses yesisu sesisu, i-necrosis yezitho ezingomakhelwane ingajoyina i-pancreatitis eyingozi, ekhulisa kakhulu ukubakhona komphumela odabukisayo.
Kwi-pancreatitis engapheli, izinqubo ezingezinhle kuma-pancreas azivimbi ngisho nangezikhathi zokuxolelwa. Kancane kancane, izingosi ze-autolysis, i-necrosis kanye nokubhujiswa zithathelwa indawo yizicubu ezithintekayo, ezenza kuphela umsebenzi wokwakha, kepha ezingakhiqizi ama-enzyme noma ama-hormone. Ngakho-ke, isimo sesiguli siyaqhubeka siwohloka, kufaka phakathi ukuthuthukiswa kwezinkinga eziningi. Lokhu kufaka phakathi ukwakheka kwesifo sikashukela i-mellitus, i-jaundice evimbayo kanye nokwehluleka kwe-hepatic-renal.
Ukuthola i-pancreatitis, kuhlolwa igazi.
Ngakho-ke, uma i-pancreas ikhanya okokuqala ngqa noma isivele inepancreatitis etholakele, isiguli sidinga ukunakekelwa okukhethekile okuphuthumayo. Akufanele uthathe noma yiziphi izinyathelo ezingagunyaziwe ekwelapheni izinhlungu, uma kungenjalo ungadala ukulimala okukhulu. Kubalulekile ukubonana nabachwepheshe abaphuthumayo esibhedlela lapho kuzokwenzelwa khona ukuxilonga okulukhuni kwe-pathology.
Ukuxilonga
Isinyathelo sokuqala kakhulu sokuxilonga ukuqoqa izikhalazo zeziguli. Cishe kanyekanye nayo, kuhlolwa kwenziwa, phakathi lapho kutholakala khona izimpawu zokuvuvukala kwepancreatic.
Isinyathelo esilandelayo ukuhlolwa kwelabhoratri, kufaka phakathi isifundo segazi nomchamo. Kwezindlela ezisetshenziswayo, i-radiography, i-MRI, i-CT, i-ultrasound inqunyelwe. Ngesinye isikhathi i-laparoscopy ne-gastroduodenoscopy ziyadingeka.
Imininingwane etholakele isiza ukucacisa ukutholakala kokulimala kwe-pancreatic futhi ikhiphe ama-pathologies anjenge-acend appendicitis, i-cholecystitis, ulcer wesisu, ukufakwa kwamathumbu, ukufakelwa kwe-myocardial, ukuvinjwa kwamathumbu.
Ukulungiswa okufanele kwezitsha kuyisiqondiso esiyisisekelo sokwelashwa kokulimala kwamanyikwe
Izindlela nezinhloso zokwelashwa
Ukwelashwa kokulimala kwama-pancreas, okuqhubeka ngesimo esibuhlungu, kwenziwa emnyangweni wokuhlinzwa esibhedlela noma ukunakekelwa okuningana. Uhlobo lokwelashwa lungahlukahluka komunye nomunye, ngenxa yohlobo lwe-pancreatitis, ubunzima bayo, kanye nokuba khona kokudakwa kakhulu. Kunoma yikuphi, ukuthi ungasusa kanjani ukuvuvukala kwe-pancreatic nokuthi ungaselapha kanjani lesi sifo esikhathini esizayo, kunqunywa ngawodwana, futhi izinhloso eziphambili zokwelapha zingamiswa ngale ndlela elandelayo:
Ama-painkiller e-pancreatitis- ukwenza imisebenzi ezosiza izinhlungu, iyeke isicanucanu nokuhlanza;
- ukunciphisa ukukhiqizwa kwama-enzymes wokugaya yi-iron, qinisekisa ukucasulwa okufika ngesikhathi;
- ijwayele ukucindezela kwegazi;
- yenza kube yi-microcirculation esakhiweni;
- ukuvimbela izinkinga ze-purulent;
- yenza ukukhipha izidakamizwa, okungukuthi, hlanza umzimba wobuthi nemikhiqizo yokubola.
Kulokhu, kunqunyelwe yonke imishanguzo yemithi, kepha into esemqoka - ukwelapha ukuvuvukala okukhulu kwamanyikwe kufanele kube ngokumelene nesizinda sokuqedwa kokudla okugcwele ngomlomo kungakapheli izinsuku ezingama-3-5, zonke izakhi zidluliselwa emzimbeni wobuzali. Kulokhu, kuye kwenziwa izingxube ezikhethekile eziqukethe ama-electrolyte nama-amino acid (i-Aminosol, i-Alvezin, i-calcium ne-potassium usawoti).
Yonke imithi ingahlukaniswa ngamaqembu alandelayo:
- ama-painkiller;
- ama-antihistamines;
- i-antienzyme;
- ukukhipha izidumbu;
- ngokusho izinkomba, ukwethulwa kwama-enzyme wokugaya ukudla.
Njengoba ukuvuvukala okukhulu kwamanyikwe, ama-ducts we-spasmodic exretory of the organis angenye yemithombo yobuhlungu, kuyadingeka ukuguqula ithoni yabo, okuholela ekubuyiselweni komsebenzi wokudonsa. Ngakho-ke, ama-antispasmodics ayadingeka, njengeNo-Shpa, iDrotaverin, iPapaverin, iSpazmalgon, i-Duspatalin, okuthi ezimeni eziningi iphathwe ngokuxhamazeliswa ngezikhathi eziphuthumayo. Uma ukusebenza kwabo kuphansi, khona-ke ama-blockages enziwa ngeNovocaine noma i-Lidocaine esifundeni se-ligament esiyindilinga yesibindi noma izicubu ze-perinephric, kuya ngokuthi iyiphi ingxenye yesitho ethinteka kakhulu ukuvuvukala, ikhanda noma umsila wamanyikwe.
Ukwethulwa okwengeziwe kwe-anti-allergic, ikakhulukazi ama-antihistamines, kusho ukuvimbela ukwakhiwa kwemiphumela emibi engaba khona yesimo se-allergic. Ukuze wenze lokhu, udinga ukuthatha i-Cetirizine, i-Allegra, iLoratadin, i-Xizal. Imithi yaleli qembu ngokwengeziwe ikwazi ukususa izakhi ze-edema gland, inciphise ukuqina kwezindonga zemithambo futhi iyeke inqubo yokuphuma kwe-plasma yegazi esikhaleni se-interellular.
Utshwala bungadala i-pancreatitis ebukhali, esongela impilo yomuntu
Inkomba ebaluleke kakhulu ekwelapheni ukuvuvukala okukhulu ukumisa ukukhiqizwa kwama-enzyme wokugaya yi-gland, esiza ukusiza ukugcina ubuqotho besitho. Ukulungiswa kwe-Antisecretory (antienzyme) kunqunyelwe, njengeTrazilol, Kontrikal, Gordoks, Amidopyrine, Ribonuclease. Kodwa-ke, ukugaya kumele kuqhubeke ngokulwa nesizinda sokuvuvukala, lokhu kwenziwa ngokufakwa esikhundleni kwama-enzyme (izidakamizwa Festal, Pancreatin, Mezim, Creon). Ziyadingeka futhi emuva kokudliwa kokulimazeka okukhanyayo, uma kukhona ukungasebenzi kahle kwe-pancreatic.
Ukuze kwenziwe ukuhanjiswa kwezidakamizwa esikhathini esibuhlungu, ukuphathwa okuphathelene nokufakwa esikhundleni kwe-plasma futhi, ngokusho kwezinkomba, kufakwa esikhundleni segazi. Isilinganiso esinjalo siyadingeka ezimweni eziningi zomtholampilo, ukuze ususe ngokuphuthumayo imikhiqizo yokuvuvukala nobuthi emzimbeni. Inani elikhulu le-Reopoliglukin, i-Rondex, noma le-Polyglukin linikezwa iziguli, ezikhulisa umthamo wegazi eliphelele, ngenxa yokuthi lokho kwehla okukhulu kakhulu ekuqoqweni kwezinto eziyingozi ku-plasma kutholakala. Ngaphezu kwalokho, ama-diuretics (ama-diuretics) anqunywa ukuba asuse ubuthi nemikhiqizo yokubola ezinso, ngaleyo ndlela "ahlanze" igazi.
Ukwelashwa kwezidakamizwa kuthatha isikhathi eside ngemuva kokujwayezwa kwesimo sesiguli, kuhloswe ngaso ukubuyisa imisebenzi ye-gland, ukuvimbela ukwanda nezinkinga, ukuqinisa amasosha omzimba. Ukuzikhethela kwezidakamizwa kwenziwa ngudokotela ohambelayo, ngokusekelwe kwifomu nobunzima be-pancreatitis.
Ngemuva kokukhululeka kwezimpawu ezibucayi, ukwelashwa kokuvuvukala kwamanyikwe akuyeki futhi kuthinte indawo yomsoco. Isiguli sabelwa itafula lokwelashwa i-5p, noma isidlo esikhethekile esichaza ngokusobala ukuthi yini ongakudla nokukuphuza nokuthi yini enqatshelwe ngokuphelele. Ngaphezu kohlu lokudla okuvunyelwe nolunqatshelwe, izindlela zokulungiselela kwazo nazo zichaziwe. Njengoba kunikezwe isidingo sokulondolozwa kokulungiswa kwemishini, okushisayo nangokomzimba kwezicubu ze-pancreatic, kanye nezinye izitho zomgudu wokugaya ukudla, imikhiqizo kufanele ibiliswe, i-stewed, ibhakwe noma iphekwe "intshontshiwe." Akunakusho ukuthi kufanele uthele emafutheni noma ku-grill.
Kubaluleke kakhulu ukuthi ekudleni kwansuku zonke kweziguli kungaqukathi okunamafutha, okubhemayo, okubunjiwe, okunosawoti, kanye nokudla okunama-acid okwandisa umsebenzi we-enzymatic wamanyikwe futhi kubangele ukwanda kokugxila kokuvuvukala esitho.
Ngakho-ke, imikhiqizo elandelayo ivunyelwe ngokuphelele:
- isinkwa esisha, i-khekhe;
- izinhlobo ezinamafutha zenyama, inhlanzi, izinkukhu;
- amasoseji nemikhiqizo ebhemayo;
- ukhukhamba, ama-marinade;
- imikhiqizo yobisi enamafutha aphezulu;
- ukudla okune-fiber ephezulu (i-legumes, amabele, ummbila, ibhali leparele, iklabishi, amakhowe, isithombo, isithombo);
- inyama yokugxila kanye nezinhlanzi;
- amaqanda athosiwe;
- izithelo ezimuncu namajikijolo;
- ikofi, itiye elinamandla, amanzi acwebezelayo;
- iziphuzo ezidakayo nanoma yikuphi okuqukethwe i-ethyl alcohol.
Ukwelashwa ngamakhambi kwe-pancreatitis engapheli kwamukelekile
Yonke eminye imikhiqizo ivunyelwe, kubalulekile ukulandela imithetho yokulungiselela kwabo. Akunakwenzeka futhi ukwelapha ukuvuvukala okungapheli kwama-pancreas ngaphandle kokudla njalo, noma ngabe kwakungekho okuqhamukayo iminyaka eminingana. Isiguli akufanele sikhohlwe ukuthi ungadla futhi akufanele udle, uphuze inani elanele loketshezi, amalitha ama-2-2,5 ngosuku.
Ngemuva kokubonakaliswa okunamandla kokuvuvukala kudlulile futhi enkambweni engapheli yesifo se-pancreatitis, ezinye izindlela zokwelapha zamukelekile kakhulu. Ngemvume kadokotela, ungasebenzisa amakhambi anjenge chamomile, celandine, dandelion, violet, mint, hawthorn. Bathuthukisa ukugaya kanye ne-peristalsis, i-anesthetize, "ukunikezela" amavithamini, ama-amino acid, ukulandelela izinto. Ama-decoction kanye ne-infusions alungiselelwe kusuka kubo, azosebenza njengendlela eyengeziwe yokwelapha. Nasi isibonelo sendlela yokupheka ukumiliselwa kwe-herbal mint:
- uthele amanzi abilisiwe ngomthamo we-1 litre isipuni esisodwa seminti eyomisiwe;
- phikelela imizuzu engu-10-15;
- phuza u-100-150 ml ngaphambi kokudla.
Ezimweni eziningi zemitholampilo, izindlela zokugcina zanele. Kepha, ngokwakhiwa kwe-purulent foci, ukuba khona kwamatshe emacandeni noma ukutholakala kwesimila, ukungenelela kokuhlinzwa kuyadingeka.
