I-Biliary Pancreatitis

I-pilireatitis ye-Biliary, ngokungafani nesifo esivamile sokuvuvukala kwamanyikwe, isesimweni sesibili. Ngemuva kwakho konke, iba ngenxa yezifo ze-gallbladder, ducts ze-bile nesibindi. Lolu uhlelo olubizwa ngokuthi yi-biliary system. Ukwephulwa kokuphuma kwe-bile, ukuqina kwayo noma ukuphonsa ku-pancreas kuholela ekukhuleni kokuvuvukala okukhulu. Isifo sofuba sisasazeke ikakhulu kubantu abadala, futhi kwesinye isikhathi sitholakala kubantu besifazane. Cishe isigamu samacala e-pancreatitis abangelwa yilesi sizathu. Ngokuya kobunzima benkambo, ifomu eliqhamile lesifo kanye ne-pancreatitis engamahlalakhona esetshenziswayo iyahlukaniswa. Uma kungalashwa, i-pathology ingaholela ezinkingeni ezinkulu futhi nokufa.

Indlela yokubukeka

Ukusebenza okujwayelekile kwamanyikwe kuhlobene kakhulu nempilo yezinye izitho zomgudu wesisu. Isimo se-bile ducts sinomphumela oqinile kuso. I-gallbladder iyaqongelela futhi igcina i-bile, equkethe izinto ezikhethekile zokugaya amafutha. Ngesikhathi sokusebenza okujwayelekile kwe-gallbladder ngemuva kokuthi ukudla kungene esiswini, i-bile igeleza idlule emqubeni, lapho ibandakanyeka khona ekugayweni. Futhi uma le nqubo yephulwa, abantu abaningi bazofunda nge-pancreatitis ye-biliary.

Ngemuva kwakho konke, inkinga ukuthi ekuphumeni kwe-bile duct ihlangana ne-Wirsung duct yamanyikwe. Ngaphansi kwezimo ezijwayelekile, azibikwa, ngoba i-pancreatic duct ivaliwe yi-sphincter yase-Oddi futhi ingcindezi ekuyo iphakeme kunaleyo ye-bile duct. Kepha kwesinye isikhathi i-bile ingena kumanyikwe. Lokhu kuholela kumonakalo wezicubu zakhe ngama-bile acids. Kwesinye isikhathi kuqhuma okuncane ngasikhathi sinye, ujusi we-pancreatic ne-bile kuchithe lonke i-parenchyma ye-gland. Ngasikhathi sinye, ama-enzyme angafakwa amandla yi-bile acids, bese kuthi “ukugaya” kwezicubu zawo ezi-pancreatic kuqale. Lokhu kubangela inqubo eqinile yokuvuvukala.

Imvamisa, i-pathology iba khona lapho kukhona amatshe emigodini ye-bile

Izizathu

I-biliary pancreatitis iba nokukhula kwezifo ezahlukahlukene ze-gallbladder noma i-bile ducts. Imvamisa, ukuvuvukala kubangelwa ukujova kwe-bile emanyikweni ngenxa yokuqhuma kwe-duct ngetshe. Kepha kungavusa nokugqwala kwamagciwane kulezi zitho zingene kuwo.

Imbangela yalolu hlobo lwe-pathology yilezi zifo ezilandelayo:

• isifo se-gallstone;
• ukuqina kwe-bile nokwakheka kwenhlabathi yesihlabathi esihle kuyo;
• ukungafani ekwakhekeni kwepheji le-biliary;
• i-cholecystitis ebaliwe;
• i-gallbladder dyskinesia;
• cholangitis;
• ama-cysts namanye ama-neoplasms;
• ukuvinjwa kwe-duct;
• i-spasm ye-sphincter yase-Oddi;
• ukuphazamiseka komsebenzi we-Vater papilla, lapho i-bile ingena khona kwi-duodenum;
• ukuhlukunyezwa kwe-helminthic;
• izinqubo zokuvuvukala ku-duodenum;
• isimila kule ndawo;
• ukuqina kwesibindi.

Akuwona nje kuphela umgoqo wedayi we-bile ongakhubaza ukuphonswa kwe-bile kumanyikwe nokuqothuka kwenqubo yokuvuvukala kuyo. Ukwanda kwengcindezi kungenzeka ngenxa yokusetshenziswa kokudla okusebenzisa zonke izinqubo zokugaya. Lezi yiziphuzo ezinotshwala, ezithosiwe, ezinosawoti kanye namafutha, iziphuzo ezinekhabhoni. Imbangela yokwanda kungenzeka futhi ukusetshenziswa kwezidakamizwa ze-choleretic.

Izimpawu

Ngenxa yokufakelwa kwe-bile noma ama-bacterium ukungena kwama-pancreas, inqubo yokuvuvukala iba lapho. Ama-acids e-bile asebenzayo kanye nama-enzyme e-pancreatic abangela ukonakala kwezicubu ze-gland, kancane kancane abulale amaseli awo. Ngenxa yalokhu, imisebenzi yalo mzimba iyaphazamiseka.

Izimpawu eziphambili ze-biliary pancreatitis Ubuhlungu besisu, isicanucanu, ubuthakathaka, futhi kwesinye isikhathi umkhuhlane

Izimpawu eziyinhloko ze-bancary-pancreatitis-based pancreatitis ziyefana nangezinye izindlela zawo. Le yiminjunju ebukhali, ebopha isisu esiswini, isicanucanu, isisindo esiswini ngemuva kokudla, ukugabha, ukuthokomala nokuqunjelwa. Kepha njengoba kanye nokuvuvukala kwamanyikwe kukhula i-pathology ye-gallbladder, ngalezi zimpawu ezithile ze-pathology ziyabonakala. Ngokwokutholakala kwabo, udokotela onolwazi angenza ukuxilonga ngaphambi kokuhlolwa.

Kungaba khona yini amatshe kumanyikwe

Ukwephulwa kokuphuma kwe-bile kuholela ekubukekeni kokulunywa nge-aftertaste ebabayo eqhubekayo. Ngaphezu kwalokho, izinhlungu zingabekwa endaweni hhayi ngakwesobunxele, njengoba kunjalo njalo nge-pancreatitis, kepha ngakwesokunene, futhi izonikezwa ehlombe langakwesokunene, engalweni noma emuva. Kwesinye isikhathi kukhona i-jaundice evimbayo. Lolu phawu lukhombisa ukuqothuka kwe-bile duct ngetshe. Esikhundleni sohudo olujwayelekile kwi-pancreatitis, ifomu layo lokuxhuma umoya liholela ekuqunjelweni okungapheli, kwesinye isikhathi okuphelela ekuvinjelweni kwamathumbu. Izinga lokushisa elisesimweni esibuhlungu sokuvuvukala, uma likhuphuka, lincane.

I-biliary pancreatitis nayo ibonakala ngokungapheleli kwangaphakathi nangaphandle kwezimfihlo. Lokhu kuholela kokungasebenzi kahle okuhlukahlukene kwinqubo yokugaya ukudla. Ukunciphisa inani lama-enzyme kuphazamisa ukugaya kwamaprotheni, ukuwohloka kwamafutha nokufakwa kwe-carbohydrate. Ngaphezu kokucanuzelelwa kwenhliziyo, ukushayeka kwenhliziyo, ukuphazamiseka kwengqondo kanye nokuphazamiseka kwesisu, lokhu kuholela ekunciphiseni kwesifiso sokudla, ukwehla kwesisindo kanye nokuntuleka kwezinto ezibalulekile zokulandela. Uma amaseli abhekele ukukhiqizwa kwama-hormone elimele, i-hypo- noma i-hyperglycemia iyabonakala. Lokhu kungadala isifo sikashukela.

Ukuxilonga

Naphezu kweqiniso lokuthi izimpawu ezithile ze-biliary pancreatitis ziyaqapheleka, kusadingeka ukwenza ukuhlolwa okuphelele. Noma yikuphi i-pathology of the gallbladder, ducts yayo kanye nokuvuvukala kumanyikwe ngokwayo kuvame ukunqunywa yi-ultrasound. Uma kukhona izinsolo zokuba khona kwamatshe, ukwakheka nobukhulu bawo kubonakala kangcono yi-CT noma i-MRI, kwesinye isikhathi i-cholangiopancreatography nayo iyenziwa.

Ngaphezu kwalokho, ukuhlolwa kwegazi nomchamo kuyimpoqo. Ukuba khona kwe-biliary pancreatitis kuzokhonjiswa ngokwanda kwezinga lama-leukocytes, i-transaminase, i-bilirubin ne-alkaline phosphatase enzymes. Ukuhlolwa kwe-urinal kungakhombisa izinga eliphakeme likashukela. Ukuhlolwa okunjalo okuphelele kusiza ukuhlukanisa i-pathology kusuka ku-peptic ulcer yesisu noma i-duodenum, i-neoplasms ehlukahlukene, i-hepatitis, i-cholecystitis nezinye izifo.

Ukwelashwa

Ukuhlaselwa ngamandla kwe-bancary pancreatitis, kubonakaliswa yi-bicary colic, ukuhlanza kanye ne-jaundice evimbayo, kudinga ukulaliswa esibhedlela okuphoqelekile. Lapho ama-ducts evinjiwe nge-gallstone, ukuhlinzwa kuvame kakhulu, kungenjalo ukulimala okukhulu kwezicubu ze-pancreatic kungenzeka, okungaholela ku-peritonitis, sepsis nokufa.

I-pancreatitis ye-biliary engapheli, ikakhulukazi ezimweni ezinzima, ingalashwa ngaphansi kokuqashwa kwezokwelapha ekhaya. Ukwelashwa kwalesi sifo kufanele kube okubanzi. Kubandakanya ukusetshenziswa kwemithi ekhethekile nokudla kokudla. Ukungenelela kokuhlinzwa kwesinye isikhathi kungadingeka ukusiza ukusiza ukubuyisela ukuphuma okujwayelekile kwe-bile.

Nge-pancreatitis ye-biliary, ukuhlinzwa kwesinye isikhathi kuyadingeka.

Ukwelashwa kwezidakamizwa kwe-pancreatitis ye-biliary kufanele kunqunywe ngudokotela. Imvamisa, amaqembu amaningi wezidakamizwa asetshenziselwa lokhu. Ukwelashwa okunjalo okuyinkimbinkimbi kusiza ukubuyisela ngokushesha ukusebenza kwe-pancreatic futhi kuthuthukise isimo sesiguli.

Okokuqala, kuyadingeka ukudambisa izinhlungu. Ama-antispasmodics alungele kangcono lokhu: uNo-Shpa, uPapaverin, uDrotaverin. Ngendlela ebukhali ye-pathology, baphathwa ngokuhlinzwa noma nge-intramuscularly. Ubuhlungu obuthambile bungasuswa ngama-analgesics: Baralgin noma Analgin.

Ukunciphisa inqubo yokuvuvukala, kuyadingeka ukunciphisa umsebenzi wama-enzyme wokugaya ukudla. Kulokhu, kusetshenziswa izidakamizwa ze-antisecretory. Kungaba i-omeprazole, somatostatin noma i-gastrocepin.

Lapho kukhona ukutheleleka, ukusetshenziswa kwama-antibiotics kuyadingeka. Imvamisa, le yiCeftriaxone, i-Amoscicillin noma i-Abactal.

Ngokuphula imisebenzi ye-pocrreas, ama-enzymes wokugaya avame ukubekwa: i-Creon, iPancreatin, iPanzinorm. Kwesinye isikhathi ukusetshenziswa kwama-hypoglycemic agents kuyadingeka.

Ukwelashwa okubonakalayo, kusetshenziswa izidakamizwa ezahlukahlukene. Lapho kukhona isicanucanu nokuhlanza - iMotilium, iDomperidone noma i-Tserukal. Ukulungisa ukwakheka nokuhamba kwe-bile - Hepatofalk noma i-Odeston. Ursofalk angahlakaza amatshe amancane.

Ngaphandle kokudla okukhethekile, akukho ukwelashwa okusebenzayo.

Ukudla okhethekile kubalulekile ekwelashweni okusheshayo. Ngemuva kwakho konke, ukuhlaselwa okuningi kuvame ukucasulwa ukusetshenziswa kokudla okunezakhiwo ze-choleretic noma kuvuselela umsebenzi wejusi we-pancreatic. Imikhiqizo enjalo kufanele ilahlwe ngokushesha. Lezi yiziphuzo ezinotshwala ne-carbonated, ukudla okunamafutha, ukudla okunezipayisi nokuthosiwe. Imikhiqizo ye-Cholagogue ukhilimu omuncu, ibhotela, isikhuphasha seqanda, imifino, iklabishi, utamatisi, izithelo zezithelo zomdumo, okusanhlamvu okuphelele, umhluzi oqinile. Futhi zidinga ukukhishwa ngokuphelele ekudleni.

Ukudla kwesiguli kufanele kube nokudla okuphekwe, okugaywa phansi okugaywa kalula. Lezi izinhlamvu, inyama enamafutha aphansi noma inhlanzi, ushizi wekhokho osezingeni eliphansi, isinkwa esomile, isobho le-mucous, umhluzi we-rosehip, amanzi amaminerali. Yidla mhlawumbe ezingxenyeni ezincane, izikhathi ezingama-5-6 ngosuku.

Izinkinga

Uma i-pancreatitis ye-biliary ingaqali ukwelashwa ngesikhathi, imiphumela emibi kakhulu kungenzeka. Okokuqala, ama-asidi e-asidi kanye nejusi le-pancreatic eliye lawa izicubu ze-gland kungadala i-prenchreatal pancreatitis, evame ukubangela i-mucosal atrophy noma i-pancreatic necrosis. Ngaphezu kwalokho, ukulimala kwamaseli we-gland kungaholela ekhipha ukopha emgudwini wokugaya ukudla, isithambo samathumbu, nesifo sikashukela i-mellitus. Imvamisa ibuye iqale ukwehluleka kwesibindi kakhulu.

Kunzima futhi isikhathi eside ukwelapha i-pancreatitis ye-biliary, kepha ukuthuthukiswa kwayo kungagwenywa. Ukuze wenze lokhu, kubaluleke kakhulu ukugcina ukudla, ukuyeka imikhuba emibi nokudla okusheshayo nokuqapha impilo yazo zonke izitho zomgudu wesisu. Ukuhlolwa njalo ngudokotela nendlela yokuphila efanele kuzosiza ukugcina impilo ye-pancreatic.