Izimpawu kanye nokwelashwa kwe-pancreatitis eyingozi

I-pancreas iyisitho sohlelo lokugaya olunenhloso ebalulekile.

Eqinisweni, kwakhiwa ama-enzymes abalulekile kuwo, abamba iqhaza ekugayweni kokudla kanye ne-insulin ye-hormone, esiza ukulawula ushukela wegazi.

Izinqubo zokuvuvukala ezenzeka kumanyikwe zibizwa ngokuthi i-pancreatitis.

Ukuvela kwayo kucasule izifo eziningi nama-syndromes. I-pancreatitis e-acute iba yisigemegeme emaholidini asemva kwalokho, futhi lesi sithombe siyabonakala unyaka nonyaka. Ngenxa yalokhu, abanye ochwepheshe bezokwelapha bayibiza ngokuthi yisifo "sedili".

Izinhlobo nezigaba zesifo

Ochwepheshe bezokwelapha abavela emazweni ahlukene bahlela imininingwane ngezifo ezahlukahlukene futhi badala ukuzibandakanya kwezifo emhlabeni jikelele (ICD).

Ikhodi ye-ICD yezindlela ezi-10 ezihlukile ze-pancreatitis:

• i-pancreatitis eyingozi - K85;
• i-pancreatitis engapheli - K86.0;
• ezinye izinhlobo ze-pancreatitis engapheli (ezithathelwanayo, eziphindaphindayo, eziphindaphindekayo) - K86.1.

Izindlela ezintathu eziyinhloko ze-pancreatitis eyingozi zihlukaniswa:

1. I-swanclen pancreatitis - Lesi yisigaba sokuqala sesi sifo, esingalapheka ngempumelelo futhi sibe yinkimbinkimbi nge-pancreatic necrosis. Kulesi sigaba, i-edema, ukuhlangana kwezicubu zesitho. I-Fluid inclusions nezindawo ezincane ze-necrosis ziyatholakala.
2. I-Sancile pancreatic necrosis - Le yindlela esisongela impilo yalesi sifo, ebonakala ngenkambo enzima. Kulesi sigaba, izinguquko ezingenakuguqulwa kumanyikwe ziqala - ukufa kwezicubu. Ama-enzymes, ngemuva kokugaya indlala uqobo, adlulela egazini futhi abhubhise konke okuhlala lapho, kepha akukho magciwane egazini. Ngokuya ngezinga lokuthandwa kwezilonda, ziyahluka:
   • limited (amancane) i-pancreatic necrosis;
   • ejwayelekile;
   • ukugxila okuncane;
   • i-ebalulekile pancreatic necrosis;
   • ubuncane;
   • inani (eliqinile).

   Ekuqondisweni kwesilonda:

   • okunamafutha;
   • hemorrhagic;
   • kuhlangene.
3. Ithelelekile nge-pancreatic necrosis - Lesi yisigaba esiyingozi kakhulu se-aseptic pancreatic necrosis complication. Yilapho izakhi zokuwohloka kwamanyikwe ziba negciwane ngama-microorganisms amathumbu. Okwamanje, izinga lokushona kwabantu liphezulu kakhulu futhi ngosizo lokuhlinzwa lapho kungenzeka khona ukuthi kuqedwe inkinga.

Izimpawu ze-pancreatitis esibuhlungu

Ukuvuvukala kwenzeka ngenxa yomphumela wamakhemikhali noma owomzimba kuma-pancreas. Ama-enzymes ama-pancreas ekuqaleni akhiqiza awasebenzi futhi awakwazi ukulimaza i-gland uqobo, kepha ngaphansi kwezimo eziningi ezingezinhle, ama-enzyme ocashile avela kumanyikwe futhi aqala ukugaya (ukubhubhisa) uqobo.

Konke lokhu kungaba yinkimbinkimbi ngokuhlanjululwa kwe-purulent kanye nezinqubo ezingenakulungiswa. Ukubonakaliswa kwemitholampilo kuncike kwifomu nobunzima benkambo yesifo.

Ubuhlungu njengophawu lokuqala

Esigabeni sokuqala sokubonakaliswa kwezimpawu kunoma yiluphi uhlobo lwe-pancreatitis, umuntu ukhononda ngokubonakala kobuhlungu. Kunzima kakhulu ukucacisa ubuzwe bendawo yobuhlungu.

Isakazeka esiswini esiphezulu, inganikela emuva noma enhliziyweni. Ubuhlungu buvama ukwanda ngokushesha, buqina. Umuntu uthatha isikhundla esigwegwile - lokhu kunciphisa kancane i-pain syndrome.

Kancane kancane, ukuhlanza kuqala. Zonke lezi yizimpawu zesigaba sokuqala sokukhula kwalesi sifo noma okunye kubizwa ngokuthi isigaba sokwethuka. Ungahlala kusuka emahoreni ambalwa kuya ezinsukwini eziningana.

Ukubonakaliswa okungacacile futhi kuthize

Ngokulandelayo, isigaba 2 senzeka - isigaba sokuvuvukala okusebenzayo. Kuhlala kusuka ezinsukwini ezi-6 kuye kwezingu-14.

Lesi sigaba siphawulwa ngu:

• ukuqina kwezimpawu nobuhlungu;
• izinga lokushisa likhuphukela kuma-38 - 38.5 ° C;
• kukhona ukoma okuqinile;
• ukugaya kuphukile ngokuphelele;
• ukuphefumula kuyashesha;
• Ubuhlungu buba kumlingiswa osendaweni - ukuhlushwa kobuhlungu kwenzeka nge-hypochondrium yangakwesobunxele, kungasakazekela esifundeni senhliziyo noma ehlombe langakwesobunxele.

Okulandelayo kuza isigaba sesithathu - isigaba sokuhlukanisa. Ukuqina kobuhlungu kuncishisiwe kancane.

Kunezimpawu ze-peritonitis eyingozi:

• umkhuhlane ophakeme;
• i-tachycardia;
• ukugoba okumhlophe olimini;
• ukuphefumula
• ukuqhakaza okukhulu kwenzeka;
• ukugabha kuyaqina;
• isiguli sinesimo sokukhathazeka;
• ukuphefumula kuya kujula futhi kungavamile.

Ukunakekelwa kwezokwelashwa okulandelayo kuhlinzekwa, kubi kakhulu i-prognosis yokutakula.

Izimpawu ezithile zifaka phakathi:

• ukubonakala kwezindawo eziphuzi ze-cyanotic aphenyi, imichilo ye-hemorrhage iyisibonakaliso esicacile se-hemorrhagic pancreatitis;
• Izindawo ezifanayo nazo zingavela enkabeni;
• lapho ucwaninga isisu sesisu, kuphakama izinhlungu emthanjeni;
• ukugcwala koketshezi elizungeze indlala;
• ekuhlolweni kwegazi, kunokwenyuka kwe-hemoglobin namaseli egazi abomvu;
• ukwehla kwe-ESR;
• nge-purse sepsis, inani lama-lymphocyte liyancipha;
• ekuhlaziyeni umchamo, amaprotheni noshukela kuyatholakala;
• umsebenzi we-amylase ekunyukeni komchamo (kuphela esigabeni sokuqala);
• ku-biochemistry yegazi, ukwanda kwama-enzymes e-pancreatic kuyabonakala;
• ukukhuphuka kashukela wegazi;
• ukukhuphuka kwe-bilirubin;
• ukukhuphuka kokuhlushwa kwe-urea egazini.

Ividiyo evela kuDkt Malysheva:

Izindlela zokuhlonza

Ukubonakaliswa kwemitholampilo akuvamile ngokwanele ukuthola i-pancreatitis eyingozi, futhi kuthatha igazi ukuze kuhlaziywe imitholampilo nokujwayelekile, umchamo uyahlolwa, kanti nezitho zesisu ziyahlolwa.

Ukuhlolwa kwe-Ultrasound

Usebenzisa i-ultrasound, kungenzeka ukuthola ubukhulu kanye nokwakheka kwama-pancreas, ukuthola ubukhona be-fluid necrosis, ukubona ushintsho kwezinye izitho zokugaya ukudla, okuzosiza futhi ekuxilongeni.

Ucwaningo olunjalo lubhekwa luphephile impela futhi lunqunyelwe izingane nabesifazane abakhulelwe. Kodwa ngeshwa, i-ultrasound ingahle ingasikhombisi ngaso sonke isikhathi isithombe, khona-ke kufanele uphendukele ku-compact tomography.

I-Tomography ehlanganisiwe

Le ndlela yokuxilonga ibhekwa njengelinembe ngokwengeziwe ekuxilongeni. Akukho ukuphazamiseka kulolu cwaningo. Ukuxilongwa ngokufakwa koketshezi lokuqhathanisa kunikeza umphumela oqondile.

Ngosizo lolo cwaningo, kungenzeka ukunquma ngokunembe ngokwedlula ubukhulu besifo, ukukhomba i-foci ye-necrosis, ukunquma ubukhona bemisuka nezilonda.

Ukubonakaliswa kwesimo sokuziphatha

Kwi-pancreatitis eyingozi, amaphrotheni atholakala ngokushesha ku-serum yegazi, futhi ukuba khona kwamaprotheni noshukela emchameni kukhombisa inqubo ye-pathological. Ekuhlaziyeni umchamo, kukhuphuka umsebenzi we-amylase.

Ezingeni morphological kungalandelelwa:

• ukuphuma komzimba ngokungazelelwe;
• ukwephulwa kwemali esele kasawoti;
• ukugcwaliswa okwandisiwe kwe-interleukin;
• ukuvela koketshezi lwezinto eziphilayo ku-peritoneum;
• ukugcwala okukhulu kwe-amylase nemikhiqizo yokubola ku-seramu yegazi;
• ubuthi besibindi, izinso, inhliziyo, uhlelo lwezinzwa oluyimikhiqizo ngemikhiqizo yokubola (ubuthi).

Uhlelo kanye nemigomo yokwelashwa

Wonke umuntu obhekene nezimpawu ze-pancreatitis eyingozi kufanele athole ukwelashwa ngaphakathi kwezindonga zesikhungo sezokwelapha. Ukuqapha njalo kwabachwepheshe abancane kuzosiza ekugwemeni ubunzima be-pancreatitis futhi bafeze izinqubo zezokwelapha ezidingekayo ngesikhathi.

Ukukhululeka kobuhlungu

Ukwelashwa kwezidakamizwa ngokuyinhloko kuhloselwe ukwehlisa i-pain syndrome. Ngokuhlasela kwe-pancreatitis, isiguli kufanele siphumule ngokuphelele, futhi sithathe isikhundla sembungu - lokhu kuzonciphisa izinhlungu.

Kwesinye isikhathi ama-analcics ama-narcotic nawo angahunyushwa (ngezindlela ezinzima zekhosi). Ezimweni eziningi, ukwelashwa kwama-pancreas kuqala ngezidakamizwa ze-antispasmodic - No-shpa, Papaverin, Novocain, njll.

Ukuze ukhulule ukuhlaselwa kobuhlungu, ukuphathwa kwe-intravenous kwemithi yezinhlungu nakho kuyabekwa - I-Novocain, i-No-spa neminye, imijovo ye-intramuscular amalungiselelo we-Analgin, Atropine, Papaverine nezinye izidakamizwa.

Ukwelashwa kwezidakamizwa nezimpawu zayo

Qiniseka ukuthi unikeza izidakamizwa ukuze unciphise ukudakwa. Isotonic sodium chloride solution noma izixazululo kulingisa ukwakheka kwe-intracellular fluid - Trisol, Chlosol nabanye bethulwa.

Ukuvimbela inqubo yokuvuvukala nama-bacterium ama-microflora, kusetshenziswa imithi elwa namagciwane - iCeftriaxone, Pefloxocin, Metronidazole nabanye.

Ukwehlisa ukukhuluphala kwendlala, kunqunywa imishanguzo ye-antacid - uRennie, Smecta, Almagel nabanye.

Ukunciphisa ukukhiqizwa kwe-hydrochloric acid, ama-histamine blockers - amaRanitidine, ama-Famotidine, njll.

Ukunciphisa i-acidity yesisu, kunqunywe i-Omeprazole, iRabeprazole.

Ukucindezela umsebenzi wama-enzymes we-pancreatic, ama-enzyme blockers anqunyelwe - Gordoks, Kontripal.

Ezimweni ezinzima zalesifo, izidakamizwa ze-cytostatic - I-Fluorouracil ibekiwe ukunciphisa imiphumela enobuthi kuma-pancreas.

Izindlela Zokuhlinzwa

Lapho ukhetha amaqhinga okuthola ukwelashwa, odokotela banikeza ukukhetha ekwelashweni okulondoloziwe, zama ukuhambisana nabalahla, imijovo, izidakamizwa, indlala bese kuba nokudla okuqinile. Kepha kwezinye izimo, ukuhlinzwa kumane kudingekile.

Izinyathelo ezihlasela kancane zivame ukukhethwa - ukuhlinzwa kwe-laparoscopic, noma ukuhlinzwa ngaphansi kokuhlolwa kwe-scanner ye-ultrasound.

Ukusetshenziswa kokuhlinzwa okunjalo kunciphisa ukuhlukunyezwa ngesikhathi sokuhlinzwa - ukuvela kunosayizi omncane noma kukhishwa kwenziwa ngenaliti ekhethekile.

Ukuphiliswa kwama-suture we-postoperative kushesha kaningana kunokusebenza okujwayelekile. Ngokuya kobunzima besifo, isikhathi sokuhlinzwa singathatha izinsuku ezimbalwa kuya emasontweni ambalwa.

Ukudla, ukuzila ukudla kanye nokudla kwabazali

Ezinsukwini zokuqala ngemuva kokuhlaselwa, isiguli sidluliselwa ekuqedeni indlala kungakapheli izinsuku ezingama-5-7 (uma kubonakala intuthuko). Ukwelashwa kwe-pancreatitis ebaluleke kakhulu - lokhu kungenye yemithetho eyinhloko.

Noma yikuphi ukudla okungena esiswini somuntu ngesikhathi sokuqhuma noma ngesikhathi ngemuva kokuhlaselwa kungadala ukulimala okungalingani empilweni. Ukuze umuntu alahlekelwe izakhamzimba namandla, unikezwa umsoco ngokusebenzisa ama-infusions, lokho okubizwa ngokuthi ngumsoco wabazali.

Ukuxhaswa okufanayo kunikezwa esikhathini se-postoperative, futhi ezimweni ezinzima zesifo. Abantu abanoshukela omkhulu wegazi kufanele baqaphele kulokhu kudla, ngoba lokhu kungadala ukulimala okungalingani kubo. Lokhu kufanele kubhekelwe uchwepheshe ofanelekayo wezokwelapha.

Ngemuva kwezinsuku ezingama-7, isiguli siqala ukudla, kepha kuphela emva kwemvume nezincomo eziqinile zodokotela obonayo. Ukudla kufanele kuqalwe ngamanani amancane, ukudla kufanele kube kusha, kusesimweni esishisayo soketshezi.

Kunqatshelwe ngokuphelele ukusebenzisa amafutha ngalesi sikhathi. Ukondla kancane kancane kuqinisekisa imiphumela emihle.

Esikhathini esizayo, umuntu udluliselwa ekudleni okondlayo - ekudleni kwe-5P. Ukudla okunjalo kumele kulandelwe okungenani izinyanga ezi-2 ngemuva kokululama.

Izimiso eziyisisekelo zokudla:

• ukudla ukudla okungenamafutha nokudla okusha;
• ukusetshenziswa kokudla okuthambile, okusetshenzelwe ngokwelashwa;
• ukudla ukudla ngezingxenye ezincane;
• ukusetshenziswa kokudla okufudumele, okuwuketshezi noma okune-liquid.

Ukudla okunjalo kuqeda ngokuphelele ukusetshenziswa kotshwala nogwayi.

Kunemikhiqizo yokumisa okufanele futhi uyilahle:

• noma yikuphi ukudla okunamafutha (inyama, inhlanzi, njll.);
• usawoti nezinongo;
• noma yikuphi ukudla kwe-acidic;
• imikhiqizo chocolate;
• muffin omnandi;
• ikhofi iziphuzo
• itiye elinamandla;
• ubisi
• amaqanda
• noma yikuphi ukulondolozwa.

Ukulandela imigomo yalokhu kudla, kumaphesenti angama-95% isiguli sinomphumela omuhle.

Ividiyo evela kuDkt Evdokimenko:

Ukweqisa

Ukuvimbela ukuvela kwe-pancreatitis eyingozi, kubalulekile ukubhekisisa isimo sezempilo. Lesi sifo kulula ukusivimbela kunokuphatha imiphumela yaso.

Izindlela zokuvimbela zifaka:

1. Ukuhlolwa njalo komzimba. Ukwenza i-ultrasound yezitho zokugaya minyaka yonke, ukuhlola igazi nomchamo.
2. Gada ushukela wegazi.
3. Ukulawula isisindo somzimba. Akufanele kube ngokweqile noma ukuntuleka.
4. Susa imikhuba emibi - ukubhema, ukudla ngokweqile, ukuphuza ngokweqile.
5. Gada umsebenzi womzimba. Ukuzivocavoca ngokweqile, kanye nokuntuleka kokuzivocavoca umzimba, kulimaza umzimba.
6. Landela imithetho yokudla okunempilo.
7. Namathela ekudleni.
8. Musa ukwephula umthetho wokubusa kanye nokuphumula.
9. Yehlisa izimo ezicindezelayo.
10. Ngesikhathi samaholide futhi awephuli imigomo efanelekile yokudla okunempilo.
11. Thatha imishanguzo kuphela ngokuyalelwa udokotela wakho.
12. Abantu abanokuvuvukala kwe-pancreatic kufanele babe ngaphansi kokuqashwa ngokuqinile kodokotela (vakashela udokotela okungenani kabili ngonyaka, noma kaningi kakhulu).
13. Uma kunesifo, hlukelwa ukwelashwa kwe-spa ezindaweni ezikhethekile.
14. Enkambweni engapheli yesifo, ungazephuli izincomo zomtholampilo udokotela, uqaphele ngokuqinile ukudla okungenamsoco.

Ngendlela efanele yokudla kwakhe nendlela yakhe yokuphila, umuntu angazivikela yena nomndeni wakhe ezinkingeni ngendlela ye-pancreatitis. Ukudla akufanele kube okumnandi kuphela, kodwa futhi kube nempilo, ngakho-ke lapho ukhetha, akufanele unake ukunambitheka kuphela.