Ukuxilongwa pancreatitis, izindlela zalo. Izimpawu kanye nokwelashwa kwezifo

Ukuvuvukala amanyikwe - akujabulisi futhi kuyingozi. Kwezokwelapha ibizwa ngokuthi pancreatitis. Kulesi sifo, enzyme ezivezwa kwamanyikwe, ahlale kuwo, uqale ukubhubhisa izicubu zakhe. Ukwelashwa kufanele sigcwaliswe ngendlela esifike ngesikhathi. Kungenjalo, ukuvuvukala kuba amahlala khona. Khona-ke, ungakwazi ukuthola ifomu acute zesifo? Kushiwo ngamuphi umqondo ukuthi uphethwe umehluko pancreatitis okungamahlalakhona? Kulezi izindaba kufanele idingidwa.

Ingqikithi yalo isifo

Amanyikwe - isitho esincane kodwa esibaluleke wokugaya ukudla. It amanga ngemva kwesisu kanye elisukela duodenum ukuze ubende. Ngo pancreatic Lobed isakhiwo. Ngo Lobe ngamunye has a imbobo. NgoLwesine kutholakale isidumbu sendoda zonke Amapayipi axhunyiwe futhi yakha main imbobo pancreatic. Kukhona yesibili (ezengeziwe) imbobo. Ngamunye wabo ukuwa phakathi duodenum.

Iron emzimbeni womuntu has imisebenzi emibili:

1. Exocrine (exocrine). Juice ukhululeka indlala phakathi duodenum, iqukethe enzyme. Ababandakanyeka ukugaya of amaprotheni, ama-carbohydrate okunamafutha ukudla.
2. Endocrine (endocrine). Kwamanyikwe bukhipha ku amahomoni polypeptide egazini. Bona alawule izinqubo umzimba emzimbeni.

Lapho ukuvuvukala kwamanyikwe ziphuliwe. Lokhu kuqinisekisa sitholakele pancreatitis. Imfihlo akuyona ukhululeka emzimbeni phakathi duodenum. Mayelana nale nqubo self-ukugaya indlala ezindaweni iqala. Ingxenye enzyme ubuthi ngesikhathi esifanayo adedelwa imithambo yegazi, zibhebhetheka wonke umzimba futhi umonakalo kwezinye izitho (isibindi, izinso, amaphaphu inhliziyo ngisho ingqondo).

Lesi sifo kwenzeka abantu ngenxa yezizathu ezihlukahlukene. Izibalo zibonisa ukuthi u-50% wabantu uhlushwa ukuvuvukala kwamanyikwe ngenxa yokuxhaphaza utshwala. Ngo-20% amacala, ukuxilongwa pancreatitis e abadala ebonisa ukuthi lesi sifo eba ngenxa cholelithiasis. Okunye izimbangela ukuvuvukala pancreatic zihlanganisa:

• izifo ezithathelwanayo, ezibangelwa amagciwane kanye yisinanakazana;
• izifo fungal;
• ukulimala futhi ubuthi;
• manipulations endoscopic kanye nokusebenza.

Ukwahlukaniswa pancreatitis

Ngu ubunjalo Yiqiniso isifo kungenzeka acute (OP) futhi ezingalapheki (KP). Ngaphansi kuqala uhlobo lesi sifo kwakusho i ukuvuvukala izinqubo ezenzeka kwamanyikwe nokudlula kwezinye izicubu kanye izitho. Lesi sifo eba ngokuzumayo ngenxa edonsa ukudla utshwala, okubabayo noma okunamafutha. Kwezinye izimo, lapho kuqala lesi sifo elihlobene ne ukusetshenziswa eliningi ukudla ngemva kokuzila ukudla isikhathi eside.

Acute pancreatitis ochwepheshe uhlukanise kanje:

1. Sinzima pancreatitis oyingozi. Nge lolu hlobo kwezitho zangaphakathi kungukuthi nokusebenza ngendlela efanele. Diff. ukuxilongwa pancreatitis lembula nokwephula.
2. ifomu omnene olunamandla. Nale ezihlukahlukene imisebenzi isifo kancane siyabhubha.
3. Sinzima pancreatitis acute nzima INGENA ISINYENYELA parapancreatic, peritonitis, ubovu abscesses, sepsis, ukopha.

pancreatitis Okungalapheki kwenzeka kubantu ngemva amafomu okukhulu ukuvuvukala kwamanyikwe. Kuye kobukhulu ochwepheshe ukwaba:

1. Sinzima. Ukuze ejwayelekile okuqhubekayo-pancreatitis relapsing Yiqiniso. Izinkathi ukuthethelelwa awatholatholakali futhi ibingaba eyesikhashana ngempela.
2. Ukuze isifo ngokulinganisela ezinzima. Exacerbations 3-4 izikhathi ngonyaka zenzeka ukuvuvukala kwamanyikwe. Buhlungu syndrome besisu isikhathi eside ngokwanele.
3. Yiqiniso Ezintsha lesi sifo. Exacerbations zisheshe futhi ezingavamile. Bona kwenzeke 1-2 izikhathi ngonyaka.

Izimpawu ukuvuvukala acute

ubuhlungu Epigastric - uphawu eyabonisa pancreatitis oyingozi. Imiphumela yaloku kuhlola okungenhla Ukwahlukaniswa ukuba khona lesi sici wenziwa ngokushesha ngemva kokudamba isuke inamandla ukuze abantu abakwazi amanga bathule ahlale. Kuphela emva Ihlahlubo olunembile uphethwe Ochwepheshe kungathatha iyiphi izinyathelo zokudambisa isimo iziguli.

Olunye uphawu ezivamile ukuvuvukala acute kwamanyikwe - is ukuhlanza, ezimweni eziningi kuba amaningi. Akukona ukuletha impumuzo kubantu abagulayo. Isimo sabo kungenxa ukuhlanza kuphela siya siba sibi kakhulu. Ezinye izimpawu of pancreatitis acute zihlanganisa:

• isikhumba ugodo, akrozianoz (yokufuna isikhumba cyanotic umbala);
• ukuvuvukala;
• ukubambezeleka amagesi sezinyawo;
• ubuthakathaka ezinzima.

Izimpawu ze-pancreatitis okungamahlalakhona

Izici sici HP zihlukile ngezikhathi exacerbations futhi remissions. Bathembele ezicini eziningana: esigabeni, lwasemtholampilo uhlobo lesi sifo Yiqiniso. Naphezu kwakho konke lokhu, zikhona izimpawu eziningana ezinkulu pancreatitis okungamahlalakhona:

1. Ukuqunjelwa. Kubonisa uphakamise izwi kanye nokuvama indle. Kalou e pancreatitis okungalapheki esivela umbala lemicu empunga elinamathela othini futhi iphunga fetid. Ngokuvamile iqukethe Izinsalela ukudla, hhayi ngaphansi ukugaya. Izimpawu ngenhla zenzeka ngenxa ukudiliza isebenze exocrine parenchyma kanye gqamisa ukwephulwa uketshezi indlala phakathi duodenum.
2. Ubuthakathaka, ukuzamazama wonke umzimba, indlala, ukuquleka, sokuzikhulula okungalindelekile futhi ukuchama, nokulahlekelwa ukwazi. Lezi zimpawu zihlobene CP ukwephulwa of endocrine umsebenzi pancreatic.
3. Besisu ubuhlungu syndrome. Ubuhlungu ayinakho kwasendaweni ecacile. Kungenzeka esiswini phakathi noma engenhla futhi wenze ezimise okwama-tile uhlamvu. Kwezinye izimo, ubuhlungu is hhayi waphawula.

Ukuxilongwa pancreatitis acute

Ukuze uqinisekise uphethwe, odokotela linqume ukuba iziguli zabo luhlolo. Kuhlanganisa sitholakele ukuhlolwa kwegazi pancreatitis olwenziwa ukunquma inani akhiqizwa enzyme amanyikwe. ukuhlolwa kusakazwe Amylase e serum. Izinga le-enzyme lingaphezulu kunokuvamile e izikhathi ezimbalwa kulabo bantu ukwethula pancreatitis oyingozi.

izindlela zokuxilonga futhi zihlanganisa umchamo. Ngokwe imiphumela yokuhlaziya iziguli wembula lokhu:

• proteinuria (iphrotheni umchamo);
• hematuria ezincane (igazi umchamo ngenhla kuyinsakavukela bokuphila);
• cylindruria (e umchamo cylindrical amaseli ethathwe egazi, amaprotheni coagulated, kwezinso epithelium ijabulise).

Esinokwethenjelwa indlela uphethwe ka pancreatitis acute kuyinto computed tomography (i-CT). Linikeza izithombe kwamanyikwe, izicubu ezizungezile futhi izitho, ukukhomba yezinkinga lesi sifo, ukuhlola i-scope ne uhlobo izilonda kwamanyikwe nge necrosis pancreatic.

Ihlahlubo nokwelashwa pancreatitis acute ungentiwa ngokusebenzisa laparoscopy. Ukusebenzisa ngayo ngezinga eliphezulu ngokuthembeka odokotela ukucacisa uhlobo lesi sifo, tfola ubuye unike ukuyeka eminye yezinkinga sifo.

Okuvame kakhulu, ulwazi, elula futhi ephephile indlela ukuthola isifo - uphethwe ultrasound pancreatitis acute (US). Lapho efeza Ubukhulu bayo kulinganiswa, wabuka, ukuma, Sakhiwo sangekhatsi, echogenicity pancreatic isimo ductal uhlelo.

Ukuhlonza Ukugula ifomu okungamahlalakhona

Ukuxilongwa pancreatitis e abadala kufaka ultrasound kuqala futhi CT. Abantu abagulayo esimisiwe kahle endoscopic cholangiopancreatography retrograde. Le ndlela uphenyo luyinhlanganisela Endoscopy luhlolo fluoroscopic.

Ukuxilongwa pancreatitis ezingamahlalakhona sihlanganisa sokunquma exocrine umsebenzi pancreatic. Nge le njongo, ochwepheshe olwenziwa coprogram - cwaningo laboratory, ukuvumela ukuthola izinsalela endleni yabantu abanaleli undigested ukudla.

Exocrine umsebenzi kwamanyikwe kungabuye sihlolwe C-umoya ukuhlolwa. inzuzo yabo eyinhloko - kuba non-koda (asikho isidingo nokwephula ubuqotho zemvelo isithiyo Ingaphandle zomzimba). kokutshelwa ngokukhubazeka kwengane of pancreatitis Ungase futhi ukunquma ukuthi kusebenza yokwelapha enzyme.

Izindlela kokuphatha pancreatitis acute

Uma uneminye izimpawu ngasocansini yentuthuko OP, umuntu ogulayo kudingeka ibe usizo lokuqala:

• ukuvumela reception okudla nokuphuza izinsuku ezimbalwa;
• babiza esifundeni epigastric heater ngamanzi abandayo noma ice iphakethe;
• ukunikeza antispasmodics (ngokusebenzisa "akukho-spa" noma "Papaverine" ukukhiqizwa ukwehla enzyme).

Ngemuva usizo lokuqala ngokushesha kufanele ushayele udokotela. Umuntu kufanele esibhedlela esibhedlela. Isibhedlela ngokushesha aphethwe ultrasound ukuxilongwa of pancreatitis oyingozi. Ngemva kokumiswa i analgesics ukusazi ngokunembile isifo esikuphethe esimisiwe ( "Baralgin", "Analgin") ukuze abantu bangazazi izinto ubuhlungu.

In the ukwelashwa izixazululo of amino acid kanye glucose esetshenziswa. Akha plastic kanye nezidingo amandla zomzimba womuntu. Umiswe Futhi antibiotic. Le mithi ayadingeka ukuze ukwelapha nokuvimbela yezinkinga ukonakala.

Ngemva kwezinsuku ezimbalwa ekwelashweni kokuqala emathunjini amancane Kumiswa stylet. Kubalulekile isicelo izindlela yokudla enteral. Lapho wamathumbu umsebenzi kubuyiselwa, isiguli uvunyelwe ukuba ukudlele ngendlela engokwemvelo. Ukudla kufanele libe okusanhlamvu, imifino kuphekwe, izithelo iyisitshulu.

ukwelashwa okulondoloza e-87% amacala kuba yimpumelelo. Labo abasele abanga-13% abantu abagulayo abadinga ukuhlinzwa. It wenziwa uma sitholakele pancreatitis lembula eziyingozi. ukuphathwa kuhlinzwa imigomo elandelayo:

1. Ukwehla endotoxemia. Ngenxa yalesi esimisiwe amanzi futhi decompression amanzi biliary nokuthuthwa kwendle we komgodi ongaphakathi kwamathumbu. Phakathi ukusebenza komzimba zihlobene enzyme, ubuthi kanye nezinye izinto eziphila abakhuthele.
2. Ukwelashwa nokuvikelwa ezithathelwanayo necrosis pancreatic kanye nezinkinga necrotic (abscesses, fistulas, izinhlumba, peritonitis). Ukuze afeze lo mgomo, Ochwepheshe Uvula kanye amanzi postnecrotic, ubovu izimbobo emazinyweni, futhi sequestrectomy resection kwamanyikwe.

Ukwelashwa ukuvuvukala okungamahlalakhona

enzyme amalungiselelo ngesisekelo pancreatin ( "mezim", "zemikhosi" "Creon"), imithi elwa namagciwane ( "Abaktal", "Amoxiclav" "Sumamed"): Uma pancreatitis uphethwe wembula ifomu njalo lesi sifo, imithi ehlukahlukene ingasatshenziswa iziguli et al. kwezinye izimo (isib lapho eyakheke pseudocysts) kudinga kancane koda (transcutaneous) noma amanzi ukuhlinzwa.

It adlala indima ebalulekile umsoco. Emhlanganweni exacerbation lesi sifo ngoba 1-2 ngosuku ogulayo kungavunyelwe utho ukuba adle. Singagcina ngokubu- baphuze ketshezi (1-1,5 amalitha ngelanga): itiye ababuthakathaka, lamanzi esiphethu ane-alikhali ngaphandle igesi umhluzi okhalweni (1-2 izibuko). 2-3 ngosuku uvunyelwe ukuba ukudlele. Ivunyelwe isobho lwamafinyila, pureed ketshezi yobisi Cauchy, yemifino purees, jelly kusukela ijusi yezithelo.

Ngo ukuthethelelwa kufanele ihambisane ne ngala macebiso alandelayo:

1. Pheka ambalwa, endaweni shabby noma Bhaka kuhhavini. Ungafaki kwamafutha ifomu okumsulwa kusukela ekudleni futhi ukuthi ubeke umkhawulo chloride sodium ne 6 g ngosuku.
2. Yidla ukudla amancane izikhathi 5-6 ngosuku. Amazinga Kunconywa izitsha ashisayo - akangaphezu 57-62 degrees, abandayo - akukho ngaphansi kuka 15-17 degrees.
3. Ungafaki kusukela ekudleni ukudla okumuncu, abukhali, okubabayo kanye okusemathinini, uphizi nobhontshisi, amakhowe, iziphuzo ezibandayo futhi oludakayo, kvass, okumuncu zezithelo, imikhiqizo amnandi yokubhaka. Ukhilimu omuncu ukhilimu zivunyelwe ezincane eziningi izitsha.

izindlela Nontraditional yokwelashwa

Ngendlela okukhulu ukuvuvukala kwamanyikwe isixazululo kuphela elungile ukuba uxhumane nodokotela wakho. Ukuhlolwa nge amakhambi abantu ngaphansi kwalesi ezihlukahlukene isifo akudingekile. Uma izimpawu kanye ukuxilongwa pancreatitis iphuzu ukuba unesifo esingelapheki, ungazama izindlela zokwelashwa olunikezwa noma imithi yolunye uhlobo.

Umphumela omuhle ezimweni eziningi kunikeza imithi herbal. Ukusetshenziswa herbal ivumela ukwenza ngcono isimo sabantu abaphethwe pancreatitis ezingamahlalakhona. Nansi iresiphi of imithi yendabuko:

• Hlanganisa izingxenye alinganayo corn usilika, izimbali chamomile kanye calendula, amahlamvu ukhova kanye Mint imbiza;
• thatha 1 ihora. l. kule ngxube okuholela futhi uthele 2 izinkomishi zamanzi abilayo;
• ukubeka umhluzi okugeza amanzi imizuzu engu-15;
• izindlela ngomumo sokunika imizuzu 45 kanye lemifanekiso.

Umhluzi Kunconywa ukuba baphuze kathathu ngosuku imizuzu engu-15 ngaphambi kokudla ukudla 0.4 izinkomishi, pre-buhlanjululwe ngamanzi afudumele kuze beaker. Gcina ithuluzi kungenziwa esiqandisini kufikela kuzinsuku ezingu-5.

Ukuvimbela pancreatitis

Vimbela ukuthuthukiswa pancreatitis kungenzeka. Into yokuqala sokunakekela eyenu impilo yabo. Ezinye izifo ipheshana biliary kanye nenyongo sesinye, pheshana emathunjini avuse ukuvuvukala pancreatic. Lapho ukuwohloka kwempilo ukubonakala izimpawu asolisayo kufanele usheshe uye kudokotela, thatha ukuhlolwa ezidingekayo neluhlolo ukuthatha endaweni emisiwe.

Esinye isinyathelo esibalulekile zokuvimbela - ukunciphisa utshwala. Ngisho nabantu ephelele, ochwepheshe ukweluleka hhayi ukuba baphuze esiningi iziphuzo utshwala equkethe. Ngo yezifo pheshana emathunjini utshwala isidingo ukulishiya ngokuphelele.

Ekuphetheni, kuyafaneleka ukuthi pancreatitis (umtholampilo, ukuhlola, ukwelapha lesi sifo) - ukugula esiphuthumayo. Uma uneminye izimpawu ngasocansini ukuvuvukala kwamanyikwe, kubalulekile ukuba kudokotela. isifo Advanced kungabangela eziyingozi futhi ezisongela ukuphila.