Ukwanda kwe-pancreatitis engapheli

I-pencreatitis engapheli iyisifo esiqhubekayo sokuvuvukala kanye ne-dystrophic yamanyikwe, okuholela ekwephulweni kwemisebenzi yayo yobumfihlo yangaphandle neyangaphakathi. Kuboniswa inkambo efana ne-wave futhi ithi uqobo lwayo kungukuhlaselwa kobuhlungu okuhambisana nokuphazamiseka kwengqondo i-dyspeptic - isicanucanu, ukuhlanza, ukubhuqa nezinye izimpawu zomlingiswa.

Izizathu

I-pancreatitis ithathwa njengengapheli uma isikhathi sayo okungenani izinyanga eziyisithupha. Lapho i-pathology ikhula, ukwakheka kwama-pancreas kuyashintsha, nokusebenza kuncipha. Imvamisa, amadoda ahlushwa i-pancreatitis, okukhona ukuthi ngandlela thile kuhlobene nokuluthwa kwawo kotshwala.

Okuqaphelekile ikakhulukazi ukuthi kunokufa okuphezulu kakhulu ekwandiseni i-pancreatitis engamahlalakhona. Ngokwezibalo, cishe yi-10% eminyakeni eyi-10 yokuqala ngemuva kokuxilongwa, futhi icishe ibe yi-50% emashumini amabili eminyaka alandelayo.

Isici salesi sifo isikhathi eside se-latent (senent), lapho kungekho zimpawu khona, noma simnene kakhulu. Ukwanda kwe-pancreatitis engapheli kuyisimo esiyingozi kakhulu, esidinga ukwelashwa okuyinkimbinkimbi.

Ngaphandle kwenqubekela phambili enkulu ekuxilongeni nasekuphatheni i-pancreatitis, inani lamacala liyaqhubeka likhula, ngenxa yezizathu ezahlukahlukene. Okokuqala ngokubaluleka ukusetshenziswa kabi kophuzo oludakayo. Indawo "yesibili ehlonishwayo ihlaselwa yizifo zomgudu wesibindi, isibindi kanye ne-12 duodenal ulcer.

Iqiniso ngukuthi ngokwephula imisebenzi yohlelo lwe-bile, i-bile ingangena kumanyikwe, ngaleyo ndlela ibangele ukucasuka kwayo. Yingakho abantu abane-pancreatitis engamahlalakhona bevame ukuba ne-cholecystitis.

Izici ezinobungozi obukhulu zibandakanya:

• ukudla ngokweqile futhi umlutha kumanoni futhi okuthosiwe;
• isisindo ngokweqile;
• ukuthatha imishanguzo ethile;
• izifo zangaphambilini;
• izingcindezi zezinzwa, ziqinile ikakhulukazi futhi zihlala isikhathi eside.

Izimpawu

Izimpawu zokwanda kwe-pancreatitis engapheli zikhula ngokushesha okukhulu. Ngokwezinsuku ngosuku, isimo sesiguli siba sibi kakhulu, futhi izinhlungu ezinzima zenzeka ngaphansi kwezimbambo, ohlangothini lwesobunxele. Imvamisa, i-pain syndrome izifihla njengamanye ama-pathologies futhi izwakale emuva nesifuba.

Isibonakaliso esibonakalayo sokwanda kobuhlungu bebhande elisakazeka phezu kwesisu nezinhlangothi. Kanye nobuhlungu noma isikhathi esithile ngemuva kokuvela kwayo, kuqubuka isicanucanu, kuphenduke ukuhlanza, kanye nesitulo esidabukisayo.

Ukwanda kwe-pancreatitis engapheli kubantu abadala kungahambisana nomkhuhlane kanye nomkhuhlane, ukufiphaza isikhumba, ukuphefumula, izinguquko emfuthweni wegazi nekhanda.

Uma usola ukuhlaselwa, kufanele ushayele i-ambulensi, futhi ngaphambi kokufika kodokotela bakhiphe ngaphandle ukusebenza komzimba. Ukunciphisa lesi simo, ungafaka i-compress ebandayo ekutholakaleni kwasekhaya kobuhlungu. Kwenqatshelwe ukudla noma yikuphi ukudla; ​​ungaphuza kuphela amanzi angenalutho ngaphandle kwegesi ngezingxenye ezincane.

Awukwazi ukuphuza noma yimuphi umuthi ngaphandle kwe-antispasmodics (No-shpa, Papaverin, Drotaverin). Uma kungenzeka, kungcono ukujova. Ukwehlisa ubukhulu besifo sezinhlungu kuzosiza indawo yokuhlala nomzimba oseluliwe.

Ukwanda kwe-pancreatitis engapheli kungahlala ezinsukwini ezinhlanu kuya kumaviki amabili. Lesi sikhathi kungenxa yokungakwazi kwama-pancreas ukululama ngokushesha. Ngakho-ke, kuyadingeka ukuthola izeluleko zezokwelapha nezincomo zendlela yokwelapha lesi sifo.

Ukuxilonga

Kubantu abahlushwa i-pancreatitis engapheli, ukubukeka kwesikhumba okuphuzi ngenxa yokuqina kwe-bile kuyisici. Ngaphezu kwalokho, lezi ziguli zivame ukutholakala zinesifo sikashukela sohlobo 2 nesifo sofuba.

Ukubona nge-pancreas nokubhebhetheka kwenqubo ye-pathological, kuqhutshwa izifundo ezinamandla - i-ultrasound, i-x-ray, i-computer tomography noma i-MRI. Lezi zindlela zingasekelwa ngokuhlolwa kokuxilonga:

• lunda;
• i-pancreosemine-secretin;
• elastase;
• i-hydrochloric acid.

Ukucabanga kwama-Magnetic resonance kungenye yezindlela zokucwaninga ezinembile kakhulu nezifundisayo; ikuvumela ukuba uhlukanise i-pancreatitis engapheli ngokuvuvukala okukukhulu

Ukuhlolwa kwe-pancreosemin-secretin, okuvumela ukukhomba ukungasebenzi kahle kwe-pancreatic, kubhekwa njengokujwayelekile kwe-diagnostic yegolide. Ngenkambiso, inqubo yokuphathwa kwe-lumen ephindwe kabili inikezwa isiguli ngaphansi kokulawulwa kwe-X-ray. Ngosizo lwayo, kuthathwa amasampula wokuqukethwe esiswini namathumbu.

Ucwaningo lwenziwa esiswini esingenalutho, imijovo yangaphambi kwento eyenziwe nge-pancreosemin neye-secin. Kwi-pancreatitis engapheli, umthamo ophelele we-pancreatic secretion kanye nokuqoqwa kwama-bicarbonates kuyancipha, futhi izinga lama-enzyme, ngokuphambene nalokho, liyakhuphuka.

Ukudla okwenyusa amanyikwe

Uma i-alkalinity ye-bicarbonate itholwa emiphumeleni yokuhlolwa, khona-ke kukhona zonke izizathu zokusola ukuthuthukiswa kwenqubo ye-oncological.

Ukunemba kokuxilongwa kokuhlolwa kwe-pancreosemine-secretin kuphezulu kakhulu uma kuqhathaniswa nezinye izindlela zokuphenya. Uma kunesidingo, udokotela ohambelayo angaqondisa i-gastroscopy, endoscopy (ERCP) noma i-biopsy.

Kuyaqapheleka ukuthi kunezindlela ezingaphezu kuka-90 zokuxilongwa kwe-pancreatitis, kepha kukude kakhulu ukuthola ukuthi lesi sifo sisekuqaleni kwesiphi isikhathi.

Nganoma yiluphi uhlobo lwe-pancreatitis, ukwakheka kwamakhemikhali kwegazi, umchamo nezinduku. Ngakho-ke, kuyahlolwa ukuhlolwa kwegazi okujwayelekile nokwenziwe ngamakhemikhali, i-urinalysis ne-coprogram. Ngaphezu kwalokho, kuhlaziywa ukulingana kwe-electrolyte yegazi, okuthe kulokhu kuzokhombisa ukwehla kwamazinga e-calcium kanye nokuntuleka koketshezi embhedeni wemithambo. Lokhu kugcwele ukuwa nokuphazamiseka okukhulu kohlelo lwezinhliziyo.

Ukuhlaziywa kwezindunduma (i-coprogram) kwenza sikwazi ukubona ukuthi lo msebenzi wokugaya ulondoloziwe kangakanani, izinkomba zawo eziphambili ukuvumelana, umbala, iphunga kanye nokuba khona kokungcola

Ukwelashwa: izimiso ezijwayelekile

Ukwelashwa kwe-pancreatitis engapheli esigabeni esibuhlungu yenziwa esibhedlela, njengoba kunengozi yokuthola ukwethuka kwe-hypovolemic (ukwehla okukhulu kwevolumu yokujikeleza kwegazi) nezinye izinkinga. Ezinsukwini ezimbili noma ezintathu zokuqala, kudingeka indlala ephelele, ngosuku lwesithathu noma lwesine, ukudla kuvunyelwe ngezingxenye ezincane, ezingeqi ku-200 ml.

Ubuningi bokudla kufanele kube ama-carbohydrate abhalwe ngo-ketshezi - okusanhlamvu, isobho elicutshisiwe nejelly. Amafutha emvelaphi yesilwane anqunyelwe ngokuqinile, futhi kwenqatshelwe ukudla inyama, umhluzi wezinhlanzi, inyama nokudla okusemathinini. Ukusetshenziswa kwemifino emisha nezithelo, ukudla okungenamsoco notshwala akwamukeleki.

Ezinye iziguli zingadinga isifiso esiqhubekayo (ukukhipha) ijusi le-gastric yi-probe yezinsuku eziningana. Ukwelapha ukwanda kwe-pancreatitis, kuqala ngokuphathwa kwe-proton pump inhibitors, ama-H2-histamine receptor blockers, ama-antacid nemithi yobuhlungu. Kamuva, baphendukela izinhlobo zethebhulethi zezidakamizwa.

I-No-spa ingenye yezidakamizwa ezimbalwa isiguli uqobo esingazisebenzisa lapho sihlaselwa

Njengoba i-pancreatitis esefomini ebukhali ihambisana nokuhlanza okuphindaphindiwe nesifo sohudo, ukulahlekelwa uketshezi kuhlanganiswa nabadonsela phansi nge-saline.

Ukwelashwa kokuhlinzwa okwandisa i-pancreatitis engamahlalakhona kuyivelakancane kakhulu esimweni sokuvuvukala okunzima, okungezwakali ngokwelashwa okuvumayo. Kwesinye isikhathi akunakwenzeka ukwenza ukuhlinzwa ngenxa yendawo enesiphithiphithi yezindawo ezilimele kuso sonke isitho. Lesi simo sibonisa ukwanda kwepancreatitis ngenxa yotshwala, futhi ukubuyela emuva cishe akunakugwenywa.

Ukukhululeka kobuhlungu

Ngobuhlungu obulinganiselwe, i-No-shpa, iBuskopan, iPapaverin, iDrotaverin, iBaralgin, iParacetamol, iTrigan-D nePentalgin zinqunyelwe. Ezimweni ezihlukile, uma isiguli singabekezeleli ama-analgesics nama-antispasmodics, kusetshenziswa izidakamizwa ezingezona ze-antiidal. Lokhu kungenxa yomphumela wabo onolaka ku-mucosa wesisu.

Ama-antenzymes nemithi elwa namagciwane

Nge-hyperfunction ye-pancreas, ukwelashwa okwandisa i-pancreatitis engapheli kuhlanganiswa nezidakamizwa ze-antienzyme. Zinqabela ukwakheka kwama-enzyme, ngaleyo ndlela zinikeze ukuphumula okusebenzayo emzimbeni wesitho esivuthiwe. Ngaphezu kwalokho, ukwelashwa kwe-antienzyme kugwema ukuthuthukiswa kwezinkinga ezifana ne-pancreatic necrosis.

Ukwelashwa kwe-Antenzyme kwenziwa kuphela ezimeni zokuma ngaphansi kokuqashwa ngudokotela. Izidakamizwa zilawulwa ngaphakathi kancane kancane, ngoba eziningi zazo zingama-allergener aqinile. Uma kunesidingo, ama-antihistamines angahanjiswa ngokufana.

Le mithi elandelayo ingeka-antienzyme:

• Contrikal;
• Gordox;
• I-Pantripine;
• Trasilol;
• I-Fluorouracil, i-Fluorofur, iRibonuclease (cytostatics).

Kwezinye izimo, ama-antibiotics asetshenziswa - ngokwesibonelo, ngokuvuvukala kwepilla ye-duodenal. Ukulwa nokutheleleka ngegciwane, i-Azithromycin, iDoxycycline, iCefaperazone, i-Ampiok, iCefuroxime inqunyelwe.

Ngesikhathi sokukhanyiswa kwama-pancreas, isiguli sikhonjiswa esibhedlela okuphuthumayo esibhedlela ukuthola ukwelashwa okwanele

Ama-enzymes nama-antacid

Ngemuva kokukhululeka kwezimpawu ezinzima, udokotela angakunikeza amalungiselelo aqukethe i-enzyme - Pancreatin, Creon, Mezim, Panzinorm, Enzistal, njll Ukwemukelwa kwaleli qembu kukuvumela ukuba ufinyelele:

• ukuthulula ama-pancreas ngenxa yokunikezwa okwengeziwe kwama-enzyme;
• ukufakwa okungcono kwama-carbohydrate namaprotheni;
• ukuguquguquka kwenqubo yokugaya;
• qeda izimpawu ze-dyspepsia - flatulence, bloating, isicanucanu nokuhlanza.

Amandla okusebenzisa ama-antacid kungenxa yokucasulwa kwe-mucosa yesisu ngesikhathi sokukhishwa kwama-enzyme e-pancreatic. I-acidity yejusi ye-gastric iyakhuphuka futhi ivame ukukhuthaza ukuthuthukiswa kwe-gastritis nezilonda. Ukumisa le nqubo, izidakamizwa zibekelwa ukwehlisa ukwakheka kwe-hydrochloric acid noma ukuhlushwa kwayo. Okusebenzayo kakhulu kwe-pancreatitis yiMaalox, Almagel nePhosphalugel.

Ngokuhambisana nama-antacid, ama-H2 blockers angasetshenziswa ukunciphisa isilinganiso sokwakheka kwama-gastric secretion, okubuye kunciphise i-acidity. Ngemuva kokuthatha izidakamizwa ezinjalo, ukungajabuli kwamathumbu okubangelwa ukucasuka kwe-mucosal kuyanyamalala.

Ukudla kokudla

Ukudla kwe-pancreatitis kubaluleke kakhulu kunoma yisiphi isigaba, futhi ngokushesha okukhulu ngemuva kokuzila ukudla okwelashwa, kubalulekile ukungenisa kancane kancane imikhiqizo yokugaya ekudleni. Akwamukelekile ukuthi ushintshele ngokushesha ekudleni okujwayelekile, ngoba i-pancreatitis ingaphinde ibe nzima.

Udinga ukudla kaningi, kuze kube izikhathi eziyi-8 ngosuku, kepha ngezingxenye ezincane, uqala ngo-50 gr. ngasikhathi. Yini engingayidla ezinsukwini zokuqala ezingama-5-8 ngemuva kokuphuma kokuzila:

• okusanhlamvu okusamanzi emanzini;
• isobho elosiwe futhi elingagundwanga, umhluzi wamakhorali, ngaphandle kwamabele nenyama;
• izolo noma isinkwa esimhlophe esimhlophe;
• jelly kanye nezithelo ngaphandle koshukela ongeziwe.

Ukudla okunama-kilojoule amancane akuhambelani nezindlela zomzimba futhi akunelisi ngokuphelele izidingo zomzimba, ngakho-ke akunconywa ukuhlala ekudleni okunjalo ngaphezu kwesonto. Kodwa-ke, ukudla kwe-carbohydrate okungenani kuvuselela ukukhiqizwa kwama-enzymes we-pancreatic, okubenza babaluleke kakhulu. Ngezinsuku ezilandelayo, kwethulwa imikhiqizo yamaprotheni - i-curd soufflé ne-pudding, i-omelet enosiwe, amaqanda nenyama egobile ebilisiwe.

Ngaphandle kokubhebhetheka, iziguli ezine-pancreatitis engapheli zikhonjiswa ngokudla okungu-5, ezisebenzisa kakhulu imikhiqizo yemvelo ye-inhibitors yemvelo yama-enzyme e-proteinolytic - amazambane, i-soy, abamhlophe beqanda, i-oatmeal. Kuyinto efiselekayo ukufaka esikhundleni samafutha ezilwane ngamafutha emifino, ngoba asekela inqubo yokuvuvukala futhi angadala ukucasuka.

Isikhathi sonke sokwelashwa okwenyanyisa i-pancreatitis engapheli silinganiswa cishe nenyanga, ngemuva kwalokho isiguli sizizwa sanelisekile futhi sibuyele empilweni ejwayelekile. Kunzima ukubikezela ukuthi isikhathi sokuxolelwa sizoba yini, ngoba ubungozi bokuphindelela buhlala busezingeni elanele.