Ukuvuvukala kwe-pancreatic, noma i-pancreatitis, kubhekwa njengenkinga enkulu yezokwelapha nezenhlalo. Kutholakala kaningi: izigameko zale ndlela zempilo ziphakeme impela futhi zifinyelela kubantu abangama-40-50 kubantu abayizinkulungwane eziyikhulu, ngaphezu kwalokho, abantu abanempilo enhle bayahlupheka. Ikota yeziguli ezine-pancreatitis inezindlela ezonakalisayo zalesi sifo, ezihambisana nezinkinga eziyingozi, ukufa kwabantu okufika kuzinkomba ezibaluleke kakhulu.
Ngakho-ke, ukuxilongwa okufika ngesikhathi kwe-pancreatitis kubaluleke kakhulu. Lesi sifo esitholakele emazingeni okuqala kokubhubhisa i-pancreatic sisengalashwa ngempumelelo, sivimbele inqubo ye-pathological ukuthi ingasakazeki, ibe engapheli noma ithinte ezinye izitho zangaphakathi.
Izinyathelo zokuxilonga
Ukunquma i-pancreatitis, akwanele ukucabanga, ngokwesibonelo, izimpawu zomtholampilo kuphela. Cishe konke ukubonakaliswa kwalesi sifo akuyona ubufakazi bokuthi iphesenti elilodwa lokuvuvukala kwamanyikwe. Isibonelo, ubuhlungu obukhulu esiswini ("isisu esibuhlungu") buhambisana nezinqubo eziningi ze-pathological in the cavity esiswini noma esikhaleni se-retroperitoneal.
Kungashiwo okufanayo ngezinkomba zaselebhu. Uma uhlola igazi lesiguli ngezimpawu zokuthi, mhlawumbe, i-pancreatitis eyingozi, lapho-ke ungathola ukukhuphuka okuthe xaxa kwenani lama-leukocytes nge-predominance yama-cell amancane amafomu kanye nokwanda kwe-ESR. Kepha lezi zinhlaka azicaciswanga futhi zinesimo sokugxila kokuvuvukala emzimbeni.
Ukulaliswa esibhedlela kweziguli ezinesisu "esibuhlungu besisu" kufanele kube okuphuthumayo
Ngakho-ke, isethi yezindlela zokuxilonga iyadingeka enganquma zonke izibonakaliso ze-pathology ngokuzithemba okukhulu kakhulu, futhi konke kufanele kube okuhambisana, okucacisayo.
Le yinkimbinkimbi yezindlela zokuxilonga yenziwa ngezigaba eziningana:
- Ukuqoqwa kwezikhalazo nokubuzwa kwesiguli.
- Ukuhlolwa kwangaphandle.
- Ukwenza izivivinyo zaselebhu.
- Ukusetshenziswa kwezindlela ezengeziwe zensimbi.
Impilo yomuntu incike ekutheni isifo se-pancreatitis senziwe ngokushesha futhi ngendlela efanele kanjani. Kubalulekile futhi ukuthi isiguli sifune usizo, ngoba njalo ngehora lokubambezeleka singabulala.
Izinyathelo zokuxilonga eziyinhloko
Ukubonakaliswa kokuvuvukala kwe-pancreatic, noma i-pancreatitis e-acute, ezimeni eziningi kubonakaliswa izimpawu ezinzima zomtholampilo kanye nokuwohloka okukhulu kwesimo esivamile sesiguli. Kuvame ukucasulwa kwiziguli ezindala ngokuphuza ngokweqile iziphuzo ezinotshwala, ukudla okunamafutha noma okubhemayo, i-pathologies yezitho zomakhelwane (isibonelo, i-cholecystitis).
Uchwepheshe kuphela ongazi ukuthi angaxilonga kanjani i-pancreatitis noma omunye umthombo wezinhlungu ezinzima, nokuthi imiphi imithi okufanele ayinikezwe. Ngakho-ke, lapho isiguli sinezinkinga zesisu "esibuhlungu kakhulu", kufanele ushayele i-ambulensi ngokushesha. Ngeke uye emtholampilo futhi ulinde kulayini wokuthola usizo, ngenkathi inqubo ye-pathological epancreas iqhubeka ikhula, kuthinta izingxenye ezintsha zesitho nezinhlaka eziseduze. .
Ukuhlolwa kwangaphandle kunikeza imininingwane eminingi yokuqala
Emnyangweni wesibhedlela ongabekezeleleki kahle, izigaba zokuxilonga, ukuphenya kanye nokuxilongwa, kwenzeka cishe ngokufana. Udokotela uqoqa inani eliphakeme kakhulu lezikhalazo eziphakamisa i-pathology ethile esigulini.
Izikhalazo ezilandelayo zesiguli zisiza ukuqaphela uhlobo olubi lwe-pancreatitis:
Yini ekhombisa i-ultrasound yamanyikwe- izinhlungu ezibukhali esiswini, zifinyelela ku-hypochondrium yangakwesokunxele nakwesokudla, kwesinye isikhathi zifinyelela emgogodleni;
- isicanucanu
- ukuphalaza kobuhlungu okuphindaphindiwe, okungasenzi ngcono isimo somuntu;
- umkhuhlane, ubuthakathaka obukhulu, ukubanda;
- ukwazi okungaphelele, ukufiphala, ukufiphala kwesikhumba, ukujuluka okubandayo (okuhambisana nokwehla komfutho wegazi, okuvame ukubonakaliswa kokuthuthumela kobuhlungu);
- umlomo owomile, ukunambitheka okumnandi.
Izimpawu ezifanayo ziyimpawu yokwanda kwe-pancreatitis engapheli kubantu abadala, kepha zibonakala ngamandla amakhulu. Kulezi zimo, ukuxilongwa kwesiqephu esibuhlungu salesi sifo kusungulwa iqiniso lokuthi isiguli, njengomthetho, sesivele sazi ngokuvuvukala kwaso okungapheli kwesibeletho.
Ngokubambisana nokuthola idatha enhlalakahleni kanye nezikhalazo, udokotela ucacisa ukuthi yisiphi isici esidabukisayo esidale lesi sifo, ukuthi zivele kanjani izimpawu ezahlukahlukene, sanda futhi sanezela (sichaza izici zomlando wezokwelapha). Ubuza ngokubakhona kwe-pathologies enjalo phakathi kwezihlobo, nokuthi ngabe kukhona yini izifo ezihlangene esigulini uqobo.
Ukucashunwa kwesisu ukuthola ukunqunyelwa kwesibeletho i-aorta yesisu
Ukuhlola isiguli, uchwepheshe osendlini yezimo eziphuthumayo uphawula ithoni yombala kanye nomswakama wesikhumba nolwelwesi lwama-mucous, ukuba khona kokungazwani kwe-sclera ne-plaque olimini. Uhlola ama-lymph node, alinganise umfutho wegazi nokushisa komzimba, ama-palpates (ama-probes) kanye nama-percusses (ompompi) wesisu, i-auscultates (ulalela inhliziyo, amaphaphu kanye ne-aorta yesisu.
Kulokhu, idatha yokuthi isiguli inefomu elinamandla le-pancreatitis yizimpawu ezilandelayo:
- i-palpation inqunywa wubuhlungu obukhali e-epigastrium nase-hypochondrium yangakwesobunxele, kanye ne-engela eyakhiwe izimbambo nomgogodla (uphawu lukaMayo-Robson);
- ngombono, ubuhlungu buqina ekuqageleni kwendawo yamaphepha pancreas;
- nge-auscultation, pulsation of aorta esiswini ngaphansi kwe-sternum ayitholakali (uphawu lweVoskresensky);
- lapho uhlolwa, kungaphawulwa (kusichithe) ukugqama kwesikhumba sodonga lwangaphakathi lwesibeletho noma ubukhona bokulimala ngakunye (uphawu lweGrey-Turner).
Vele, izigaba zokuqala zokuxilonga kufanele zenziwe masinyane ukuze kuvikelwe isiguli ukuthi singonakali futhi sinikeze impatho efanelekile ngesikhathi esifanele. Lezi zigaba ezilandelayo, elebhu kanye nelezinsizakalo, ezimweni zokusolwa kwe-pancreatitis eshubile yenziwa yiCito, okungukuthi, ngokuphuthumayo. Ziyadingeka futhi ekubonakalweni okuhlukile kokulimala kwe-pancreatic, okungukuthi, ukukhipha i-pathologies efanayo nezinye izitho zangaphakathi.
Izindlela zaselabhorethri
Ukubona ubukhona benqubo yokuvuvukala, kwenziwa ukuhlolwa kwegazi komtholampilo, kepha imiphumela yayo ayikwazi ukucacisa ukwakheka kwe-pathology. Ngakho-ke, okunye ukuhlolwa kwe-pancreatitis kuyadingeka.
Ukuhlolwa kwamapharamitha egazi kwe-pancreatitis esolisayo kuhlale kwenziwa
Ama-pancreas akhiqiza ama-enzyme abalulekile ekusebenzeni kwamathumbu, nama-hormone anquma umetabolism nomsebenzi wezinso. Ngokuvuvukala kwesibindi, izinga lama-enzyme nama-hormone lishintsha, okuholela ekuphazamiseni umsebenzi nezinye izitho zomzimba. Lezi zinqubo zingatholwa ngokuhlolwa kwelebhu hhayi ngegazi kuphela, kepha nangomchamo kanye nezindunduma.
Ngakho-ke, izivivinyo ezilandelayo ze-pancreatitis ziyadingeka:
- Ukuhlolwa kwegazi klinikhi (kunquma inani lamaseli abomvu egazi, amaseli amhlophe egazi, i-ESR), ngokuvuvukala, i-ESR namaseli amhlophe egazi ayanda.
- Ukuhlolwa kwegazi kwe-biochemical (ukunquma kwezinga le-lipase, i-alpha-amylase, ushukela, i-albhamuin, amaprotheni e-C-reactive). Isibonelo, okuqukethwe kweglucose kukhuphuka ngenxa yokwehla komkhiqizo we-insulin yi-gland, izinga le-alpha-amylase, elinye lama-enzymes wokugaya, livame ukwanda.
- Ukunqunywa kokuhlanganiswa kwe-electrolyte ye-plasma yegazi (inani elincishisiwe le-sodium, potassium, calcium).
- I-Diastasis yomchamo (okuthiwa yi-enzyme alpha-amylase, etholakala kumchamo, nge-pancreatitis, inani layo liyanda).
- I-Urinalysis (ngokuvuvukala okukhulu kwamanyikwe, amaprotheni, amaseli abomvu egazi, namaseli amhlophe amaningi egazi kutholakala umchamo).
- Ukuhlaziywa kwe-Fecal yokutholwa kwezinhlayiya ezingafakwanga ngamafutha (i-coprogram).
Yikuphi ukuvivinya okudingeka kunikezwe iziguli noma izingane ezinqunywe kunqubo ngayinye, kuye ngezimpawu ze-pancreatitis nokuphelela kwemininingwane yokuthola isifo etholakele. Kuyadingeka futhi nokukhetha indlela yokuziphatha kwesigaba sokudlala.
I-Ultrasound ye-pancreas isetshenziswa kaningi yizo zonke ezinye izindlela zokwenza izinsimbi.
Izindlela zensimbi
Ukuqinisekisa ekugcineni ukutholakala kwe-pancreatitis ebi kakhulu noma engamahlalakhona, iziguli zingadinga izindlela ezilandelayo:
- i-radiogra (ukutholwa kokukhanywa kumicengezi yamanyikwe, i-flatulence, i-pleural effusion);
- ukuskena kwe-ultrasound (ukuzimisela kwesakhiwo se-morphological se-gland, ukuba khona kwe-necrosis namathumba);
- imaging noma i-magnetic resonance imaging (ukufundwa kwesendlalelo kwesitho noma ngokungafani nhlobo);
- i-laparoscopy ne-endoscopy (ukubona okuqondile kwesimo se-pancreas).
Kulezi zindlela, ezisetshenziswa kakhulu yi-Ultra, ngenxa yokungahambisi, ukubhebhetheka okwanele kanye nokungabikhona kwento efuthelayo. Futhi, imininingwane ebaluleke kakhulu iza ngesikhathi se-CT, i-MRI, i-endoscopy. Zonke izindlela zamathuluzi, ikakhulukazi ngokuhlanganiswa, zithola i-pancreatitis ngokushesha futhi ngokunembile.
Imiphumela etholakala ekuqalisweni kwe-elebhu kanye nezindlela ezinamandla zisiza ukuhlukanisa i-pancreatitis kwamanye ama-pathologies amaningi. Ngakho-ke, ukuxilongwa okuhlukile kwenziwa nge-appendicitis, isilonda esiswini kanye ne-duodenal, ukuphazamiseka kwamathumbu, i-cholecystitis, ubuthi bokudla, kanye ne-thrombosis yemikhumbi ye-patity esiswini. Ngokushesha lapho isiguli sitholwa ngokunembile futhi kunikezwa ukwelashwa okuyinkimbinkimbi, ukuthandwa okuhle kakhulu kwe-prognosis.
