Enye yezifo ezimbi kakhulu zohlelo lokugaya ukudla yi-pancreatic necrosis. Ibizwa nangokuthi yi-pancreatic necrosis noma i-necrotic pancreatitis. Noma ngabe belashwa kanjani, uhhafu weziguli onale nkinga uyafa. Ngemuva kwakho konke, lesi sifo sibonakaliswa ngokufa kwamangqamuzana, okuholela ekubhujisweni kwezicubu ze-gland. Ngenxa yalezi zinqubo, imisebenzi yayo yephulwa, ethinta kabi isimo somzimba jikelele.
Indlela yokuthuthukisa
I-Necrosis inqubo yokufa kweseli okuholela ku-necrosis nasekubhujisweni kwezicubu. Kuma-pancreas, lesi simo singakhula ngenxa yenqubo yokuvuvukala noma ezinye izinto ezingezinhle. Izinqubo ze-pathological zingaholela eqinisweni lokuthi ijusi le-pancreatic ligxuma emiseleni noma liphonswe emuva kubo lisuka ku-duodenum. Ama-enzymes e-pancreatic acashile anolaka olukhulu, ngakho-ke aqala ukugaya izicubu zesikhumba uqobo. Lokhu ikakhulukazi kuyi-elastase, ephula amaprotheni ezinsimbi ezihlangene.
Okokuqala, ukuvuvukala okukhulu noma i-pancreatitis kwenzeka ngenxa yalokhu. Ngaphandle kokwelashwa okufika ngesikhathi noma uma isiguli sephula isidlo esinqunywe udokotela, ukuvuvukala kuyaqhubeka. Kancane kancane, inqubo yokubhujiswa kwezicubu isakazeka, izindonga zemithambo yegazi ziqala ukuwa. Kungakheka ithumba. Uma le nqubo ithinta i-lining of the gland futhi ipus iphuma, i-peritonitis ne-sepsis ingaqhamuka.
Izizathu
Izimbangela eziphambili ze-pancreatic necrosis yi-pathologies yepheji le-biliary. IDyskinesia, ukubalwa kwe-cholecystitis, noma isifo se-gallstone kungaholela ekuqhekekeni kwe-Wirsung duct. Imvamisa, i-necrosis iba nokuphuza ngokweqile kanye nokudla ngokweqile. Ngokwezibalo, lokhu kungaphezu kwengxenye yeziguli ezatholakala zitholwa nalokhu. I-Alcohol nokudla okunzima ukukugaya kuholela ekuqubuseni kwendlala nokushuba emigqonyeni yejusi ye-pancreatic. Ngenxa yalokhu, i-pancreatitis iyakhula. Ezimweni eziningi, kuyena owandulela ukuthuthukiswa kwe-necrosis.
Ngaphezu kwalokho, lesi sifo sinezinye izizathu:
- ukondliwa okungafanele - ukuzila ukudla isikhathi eside, ukudla ngokweqile, ukudla okunamafutha amaningi, ukudla okuthosiwe nezinongo, amaswidi nokudla okuphekwe ngomumo;
- ukulimala kwesisu noma ukuhlinzwa;
- isilonda se-duodenal;
- izifo zokuvuvukala zesisu;
- ukwephulwa kokuhlinzekelwa kwegazi emgodini wokugaya ukudla;
- ukudla okunamandla, utshwala noma ubuthi bamakhemikhali;
- izifo ezithathelwanayo noma izifo ezihlaselayo.
Ezimweni ezingaphezu kwesigamu, ukuphuza ngokweqile nokuphuza utshwala kuholela ku-necrosis.
Zonke lezi zinto zingaholela ekukhuleni kwe-pancreatitis, okuthi, ngaphandle kokwelashwa, ibangele izicubu ze-izicubu. Kodwa i-pancreatic necrosis engapheli ingakhula ngenxa yokusetshenziswa okungafanele kwemithi ethile, ukucindezelwa, ukugcwala ngokweqile ngokomzimba noma ngokomzwelo.
Ukuhlukaniswa
Ukunikeza ukwelashwa okufanele, ngaphezu kokuthola imbangela y inqubo ye-necrotic, kuyadingeka ukuthola izinhlobonhlobo zayo. Izici zalesi sifo azithinti kuphela izimpawu eziboniswayo, kodwa futhi nokukhethwa kwezindlela zokwelapha. Imvamisa, isifo sihlukaniswa yimvelo yokukhula kwayo. Hlukanisa phakathi kwe-necrosis ebukhali, eqhubekayo, nehlala isikhathi eside, evilaphayo. Ifomu elibi landa ngokushesha futhi ngaphandle kokwelashwa kungaholela ekufeni ezinsukwini ezimbalwa. I-necrosis engapheli ingahlala isikhathi eside, kepha uma welashwa ngendlela eyiyo ayibangeli bumnandi.
Ngokuya ngasendaweni yenqubo ye-necrotic, i-necrosis ebalulekile ye-pancreatic ihlukaniswa, ethinta kuphela izindawo ezithile ze-gland, futhi isiyonke, lapho wonke izicubu zomzimba zibhujiswa. Lesi simo siholela ekuphulweni okuphelele kwemisebenzi ye-gland ngaphandle kwethemba lokuthi izolulama. Kwesinye isikhathi ukutheleleka kujoyina inqubo ye-necrotic, kuyilapho kudedelwa ubandlululo, olungasakazekela kwezinye izitho ngomsuka wegazi. Izinhlobo eziningana zesifo zibuye zihlukaniswe ngohlobo lwenqubo ye-necrotic.
Kukhona i-necrosis enjalo:
Ngabe ama-pancreas angasuswa?- hemorrhagic - uhlobo oluyingozi kakhulu lwe-pathology, lapho ukubhujiswa kwezindonga zemithambo yegazi kwenzeka khona, kuvame ukuholela isiguli ekufeni;
- i-heestatic - inqubo ye-necrotic ihambisana nokuphulwa kokuhlinzekwa kwegazi ku-gland;
- ukuvela ngokuxhamazela nokuqwabelana koketshezi olungezwani kwezicubu;
- okusebenzayo - kwephula ngokuphelele yonke imisebenzi yamanyikwe;
- ukwanda okubhubhisayo kwenzeka ekubhujisweni kwezicubu ezinkulu, futhi, emva kwalokho, akusekho ngaphansi kokubuyiselwa.
Izimpawu
Isici salesi sifo sokuthi ekuqaleni kungenzeka kungaveli nanganoma iyiphi indlela, ikakhulukazi ngesimo esididayo senqubo ye-necrotic. Izimpawu zokuqala ziyefana nakwezinye izifo zomgudu wesisu:
- isicanucanu ngemuva kokudla;
- ukuhlanza okukhulu ngokungcola kwe-bile noma kwegazi;
- usizi esiswini, i-belching;
- ukuthokomala okunamandla;
- i-colic yamathumbu;
- ukwehla kwesifiso sokudla;
- ethukile.
Kepha nge-necrosis, kunezimpawu ezithile ezingakhombisa kuchwepheshe ukuphathwa kwe-pathology. Okokuqala, kubuhlungu okwenziwe ekhaya ku-hypochondrium yangakwesobunxele. Inganwebeka kuyo yonke indawo yesisu, kuya esiswini esingezansi, emuva, ehlombe. Ubuhlungu buvame ukukhuliswa insimu yokudla, ngokunyakaza, kanye nesikhundla esiphakeme. Kungaba ukudonsa, ukushisa noma uhlobo lwama-spasms. Futhi engxenyeni yeziguli ubuhlungu abubekezeleleki.
Isibonakaliso esiyinhloko se-pancreatic necrosis ubuhlungu obukhulu kanye nesicanucanu.
Ngaphezu kwalokho, ukwanda kokushisa kungenzeka, okubonisa ukuba khona kwenqubo yokuvuvukala. Lapho ucindezela ama-pancreas, kubuhlungu izinhlungu. Futhi esikhunjeni sesisu, kungabonakala amabala e-cyanotic. Isiguli sinciphisa ngokushesha isisindo, siphelelwe yisifiso sokudla, singabekezeleli iphunga elinamandla.
Ukuxilonga
I-pancreatic necrosis kunzima ukuyithola esigabeni sokuqala. Uma inqubo ye-necrotic ivilapha, yenziwa ezindaweni ezihlukile, lokhu akubonakali ngezindlela eziningi zokuhlola. Ngakho-ke, kaningi, ukuxilongwa okufanayo kwenziwa ngisho nasezimweni ezisezingeni eliphakeme, lapho ukwelashwa kungasenakwenzeka.
Kodwa ngokuvakashela udokotela okufika ngesikhathi, uchwepheshe onolwazi angasola i-necrosis esesivele ekuhlolweni kokuqala kwesiguli. Ukuqinisekisa ukutholakala kwaleso sifo, isiguli sithunyelwa ukuyohlolwa umchamo negazi, kanye ne-ultrasound yamanyikwe. Kwesinye isikhathi kuyaye kudingekile ukuthi kwenziwe ukuhlolwa okwengeziwe: i-MRI noma i-CT, i-angiography, i-laparoscopy. Lokhu kuzosiza ukuhlukanisa i-pathology kusuka ku-biliary colic, isisu se-intestinal, i-aneurysm yesisu, i-myocardial infarction.
Indlela eyinhloko yokuxilonga yawo wonke ama-pancreas yi-ultrasound
Ukwelashwa
Ngokuvamile, ukwelashwa kwe-pancreatic necrosis kwenziwa esibhedlela. Ngempela, ngisho nasezimweni ezibucayi, ukuqapha njalo udokotela kuyadingeka, ngoba kubalulekile ukubheka inqubekelaphambili yezinqubo zokutakula. Lokhu kuzosiza ngokuhamba kwesikhathi ukuthola ukuqhubeka kwe-pathology.
Ezigabeni zokuqala ze-necrosis, ukwelashwa okulondolozayo kuvame ngokwanele. Kuqukethe ukuthatha amakhambi akhethekile kanye nezinguquko zomsoco. Ukusetshenziswa okuhlangene kwalezi zindlela kuphela okungamisa inqubo ye-necrotic. Ngaphezu kwalokho, phakathi nezinsuku ezimbalwa zokuqala isiguli sikhonjiswa ukuphumula okuphelele nokuntuleka kokudla.
Ezidakamizweni, ama-analgesics noma ama-antispasmodics asetshenziswa kakhulu, asiza ukudambisa izinhlungu. Kungcono ukubanikeza intramuscularly noma intravenly, ngoba ukugabha kungaphazamisa ukumuncwa kwabo. Kwesinye isikhathi i-novocaine blockade ye-gland nayo iyasetshenziswa. Ngokuvuvukala, ama-NSAIDs ayadingeka, futhi ukuba khona kokutheleleka kudinga ukusetshenziswa kwamagciwane. Uma isiguli sinamanzi, usawoti ufakwa ngaphakathi emzimbeni. Izidakamizwa ezikhethekile ze-pancreatic necrosis yilezo ezivimbela isenzo sama-enzyme, isibonelo, Contrical noma Gordox. Kwezinye izikhathi ama-antihistamines nawo anqunywa.
Ngemuva kokuthi isigaba sokugula sesihambile futhi inqubo ye-necrotic iyeke, kudliwe ukudla okuqinile ukuze isiguli sehlise umthwalo kumanyikwe. Kuyadingeka ukushiya ngokuphelele utshwala, okunamafutha nokudla okuthosiwe, izinongo, amaswidi, iziphuzo ezinekhabhoni.
Ezimweni ezisezingeni eliphakeme, kanye nokusatshalaliswa kwenqubo ye-necrotic, ukuhlinzwa kuyadingeka. Ungayinikezi ngaphambi kwezinsuku ezingama-5-6 ngemuva kokuxilongwa. Okuwukuphela kokungafani namacala aphuthumayo asongela impilo yeziguli. Ngesikhathi sokuhlinzwa, izicubu ezifile, i-immune exudate ne-pus ziyasuswa, imiphumela yokopha iyaqedwa, bese ukuphuma okujwayelekile kwejusi ye-pancreatic kubuyiswe.
Ukuhlinzwa kuyadingeka ezimweni eziningi ze-pancreatic necrosis, kepha noma kunjalo akusizi ngaso sonke isikhathi.
Isimo sezulu
Kuyadingeka ukubonana nodokotela ngesikhathi ukuze uthole noma yikuphi ukungakhululeki emgodini wesisu. Ngemuva kwakho konke, inqubo ye-tisc necrosis ingakhula ngokushesha okukhulu, amaseli amaningi futhi ayabhujiswa, okuholela ekuphuleni imisebenzi yokugaya ukudla. Uma uthola le nqubo ekuqaleni, ungayeka. Futhi i-edematous necrosis iphathwa ngemithi elwa nokuvuvukala. Ngakho-ke, awunakuhlala ungasebenzi noma uzindle, ukuvakashela udokotela okufika ngesikhathi kungakusindisa ezinkingeni.
Kodwa i-prognosis ye-pancreatic necrosis ayixhomeki kulokhu kuphela. Ngokwezibalo, ngisho nokukhetha okuyikho kwezindlela zokwelashwa, ukushona kule pathology kufinyelela ku-70%. Ukubuyiselwa komzimba kuncike ezimeni zenkambiso yenqubo ye-necrotic, indawo okuyo, ubukhulu besifo, ukuba khona kwezinkinga, kanye nobudala besiguli. Ukufa okuphezulu kutholakala kakhulu kubantu abadala kuneminyaka engama-50, kanye nasezigulini ezinokulimazeka okusisekelo se-acid noma ushukela wegazi, umfutho wegazi ophakeme noma ukuvuvukala okunzima. Ngaphezu kwalokho, ezimweni ezisezingeni eliphakeme ze-necrosis, ngaphansi kwe-10% yeziguli ziphila ngisho nokwelashwa okufanele.
Noma esimweni sokululama okuphumelelayo, umuntu uphoqeleka ukulandela ukudla okuyisipesheli impilo yakhe yonke futhi aqaphe indlela yakhe yokuphila. Abaningi bathola ukukhubazeka, njengoba bephulwa kungagcini nje ngokuphulwa kokudla, kodwa futhi nokusebenza kanzima komzimba, kanye nengcindezi. Kepha ngaphansi kwempilo enempilo nokudla, ungalonda impilo ye-pancreatic futhi uvikele ezinye izinkinga.
