Mary Allen
Kutupa komanso kudzipukusa kwa kapamba ndi matenda ofala komanso ofunika kwambiri amphaka omwe amatha kupha moyo mwachangu.
Pancreas (pancreas) ndi endocrine (yogawira mkati) ndi exocrine (yogawira kunja). Gawo la endocrine limapanga mahomoni ofunikira monga insulin, glucagon, ndi somatostatin. Gawo la exocrine limapangitsa katulutsidwe ka glandular kamene kamaphwanya chakudya kukhala zigawo zomwe zingagwiritsidwe ntchito. Katulutsidwe amakhala makamaka osagwira kalambulabwalo wa m'mimba michere. Izi zimayamba kugwira ntchito zikafika m'matumbo. Zoyamba zosagwira izi zimateteza kapamba kuti asadzigayitse.
Pancreatitis imayamba pamene njira yodzitetezerayi ikulephera. Ma enzymes am'mimba amatulutsidwa msanga m'matumbo a pancreatic ndikuyambitsa kutupa ndi kudzipukusa mpaka kuwonongeka kwa kapamba ndi minofu yozungulira.
Timasiyanitsa pakati pa pancreatitis yovuta, yosatha, komanso yosasinthika. Zotsirizirazi zimachitika chifukwa amphaka omwe ali ndi kapamba nthawi zambiri sachira kwathunthu, mwachitsanzo, kutupa nthawi zambiri kumayaka mafunde, chifukwa chake timalankhula za matenda osatha omwe asanduka chiwopsezo chachikulu chokhala ndi zizindikiro zofananira.
Ndi amphaka ati omwe amadwala?
Pancreatitis imatha kupezeka mwa amphaka azaka zilizonse kuyambira milungu inayi mpaka zaka 18, mosasamala kanthu za mtundu kapena jenda. Malinga ndi kafukufuku wina, amphaka a Siamese ndi akulu amakhudzidwa nthawi zambiri kuposa pafupifupi.
Ngakhale chidziwitso cha matendawa chawonjezeka kwambiri m'zaka zaposachedwa, chiyambi cha kapamba sichinafufuzidwe bwino. Kuzindikira ndi kuchiza akadali zovuta zazikulu.
zizindikiro
Monga nthawi zonse, amphaka athu ndi apadera kwambiri pankhani ya matendawa. Mosiyana ndi anthu ndi agalu, omwe amasonyeza zizindikiro zomveka bwino za kapamba (kusanza, kutsekula m'mimba, ndi kupweteka kwambiri m'mimba ndizodziwika bwino), amphaka amavutika mwakachetechete komanso mosasamala.
Makamaka, nthawi zambiri sitizindikira chizindikiro chachikulu cha kapamba - ululu wowawa kwambiri pamene kupanikizika kumagwiritsidwa ntchito pamimba. Komabe, ngakhale popanda zizindikilo zomveka bwino zakunja, timaganiza kuti kapamba ndiwowawa kwambiri amphaka, makamaka popeza mkhalidwe wa mphaka wodwala umayenda bwino mwachangu ndi chithandizo chamankhwala ochepetsa ululu. Ndizodziwika bwino kuti amphaka ndi odziwa kubisa ululu.
chithandizo
Zizindikiro zambiri zimakhala zovuta komanso zimasintha. Amphaka ambiri amangozindikirika potengera zomwe sizikudziwika, monga kuchepa kwa njala (advanced stage anorexia), listlessness (ulefu), ndi kuwonda. Pazifukwa zomwezi, sitingathe kusiyanitsa ngati mphaka akudwala pancreatitis pachimake, chosachiritsika, kapena chosachiritsika.
Ngakhale kuti palibe zizindikiro zenizeni za subclinical, kusintha kwa siteji yowopsya yomwe imagwirizanitsidwa ndi kugwedezeka kwa mtima ndi / kapena kulephera kwa ziwalo zambiri kumatha kuchitika nthawi iliyonse. Kusintha ndi madzimadzi. Odwala ena, kapamba amakhalabe am'deralo, pomwe ena amafalikira mwadongosolo. Zizindikiro zina zotsatizana nazo zimatha kukhala kutsegula m'mimba, kudzimbidwa, ndi jaundice. Pazovuta kwambiri, kutaya madzi m'thupi ndi hypothermia kumachitikanso. Ndi matenda a shuga a mellitus munthawi yomweyo, polydipsia (ludzu lochulukirapo) ndi polyuria (kuchuluka kwa mkodzo) ndizizindikiro zazikulu.
Sizingatheke kuneneratu pamene kusintha kwa moyo woika moyo kudzachitika. Ngakhale mkhalidwe wa mphaka utakhala bwino ndi chithandizo, kubwereranso kosayembekezereka kumatha kuchitika mwachangu kwambiri. Chifukwa chake, kuneneratu kwa mphaka wokhala ndi kapamba kuyenera kukhala kosamala nthawi zonse. Monga lamulo, nyamazo zimangoperekedwa pochita pamene matendawa apita kale. Chifukwa chake, chithandizo chachangu komanso chokwanira chimafunikira nthawi zonse, ngakhale kuti matendawa sanakhazikitsidwebe.
Ndi liti pamene tiyenera kuganizira za pancreatitis?
Pazinthu zonse zomwe sizinatchulidwe zenizeni monga kusanza, kutsekula m'mimba, jaundice, kupweteka kwa m'mimba, kukula kwa m'mimba, polyuria, ndi polydipsia, kuzindikira kosiyana kwa kapamba kuyenera kumveka bwino nthawi zonse. Izi ndizofunikira, ngakhale kuti zizindikiro zotchulidwa nthawi zonse zimatha kuyimira matenda okha. Komabe, amathanso kuwonetsa pancreatitis kapena, pakayipitsitsa, amayambitsanso. Pa nthawi ina ya matendawa, chifukwa ndi zotsatira zake sizingathenso kusiyanitsa wina ndi mzake.
Kutupa kwamatumbo am'mimba nthawi zambiri kumakhala pachiwopsezo chachikulu cha pancreatitis. Chiyambi cha kugwirizana kumeneku ndikuti amphaka omwe akudwala matenda otsekula m'mimba nthawi zambiri amakhala ndi kusanza kosatha (kusanza), kusanza kowonjezereka kumabweretsa kuwonjezereka kwa matumbo. Pomwe kutulutsa kwa bile ndi kapamba kumalowa mu duodenum, kupanikizika kowonjezereka kumapangitsa kuti bile ndi pancreatic secretion zibwererenso mu kapamba. Reflux iyi imakondedwa ndi mawonekedwe amtundu wa mphaka, womwe umakhala ndi njira yolumikizirana yochokera ku bile ndi kapamba kulowa mu duodenum. Komanso, chapamwamba intestine yaing'ono mphaka ali kwambiri tima kwambiri bakiteriya colonization poyerekeza galu, kutanthauza kuti backflow wa majeremusi mu duct dongosolo la bile ndi kapamba kulimbikitsa kutupa.
Ngati pancreatitis ikukula kukhala zochitika mwadongosolo, matendawa amakhala pachiwopsezo cha moyo. Amphaka amatha kufa ndi mantha, kulephera kwaimpso, septicemia, kapena endotoxemia. Nthawi zambiri pamakhala madzi owonjezera pachifuwa ndi pamimba (pleural effusion/ascites).
Matendawa
Tsoka ilo, kuzindikira pancreatitis sikophweka ndipo kumafuna mayeso ambiri. Izi zikuphatikiza kuyezetsa mwatsatanetsatane kwa labotale (hematology, seramu chemistry, urinalysis, ndi mayeso apadera) ndi njira zofananira.
X-ray yokha siyothandiza kwambiri, koma imagwiritsidwa ntchito poletsa matenda enanso osiyanasiyana. Sitingathe kuzindikira kapamba potengera X-ray ya m'mimba yokha, koma imatithandiza kuzindikira zovuta zomwe zimachitika.
Kusintha kwa kapamba kumatha kuwoneka bwino pa ultrasound, koma ziyenera kukumbukiridwa kuti kapamba nthawi zina imakhala yosadabwitsa pa ultrasound. Komabe, pamodzi ndi zizindikiro, kusintha kwa magazi, ndi kapamba, matenda a kapamba amatha kupangidwa. Pa chithandizo, mtengo uwu uyenera kusintha bwino.
Therapy
Kuwunika koyenera kwa pancreatitis ndikofunikira. Pancreatitis yovuta kwambiri nthawi zonse imakhala pachiwopsezo cha moyo ndipo imayenera kuthandizidwa mwaukali, nthawi zambiri ndikukhala m'chipatala nthawi yayitali. Chithandizo cha pancreatitis chili ndi zolinga zazikulu zitatu:
- kulimbana ndi chifukwa,
- symptomatic therapy,
- kuzindikira msanga ndi chithandizo chazovuta zadongosolo.
Ndikofunikira kutsimikizira kutulutsa kwa minofu, kuchepetsa kufalikira kwa mabakiteriya ndikuletsa oyimira pakati otupa ndi ma pancreatic enzymes.
Kasamalidwe ka Zakudya
Amphaka amafunikira kudya kwambiri zomanga thupi. Ngati amphaka sadya chakudya kwa masiku oposa awiri kapena atatu (anorexia), chiwindi chikhoza kudwala kwambiri (chiwindi cha lipidosis = mafuta a chiwindi). Choncho ndikofunika kwambiri kumvetsera kudyetsa. Odwala omwe ali ndi vuto la anorectic, chithandizo chamankhwala kudzera m'madyerero olowa m'thupi chikhoza kupulumutsa moyo.
Amphaka nthawi zambiri amadya akawetedwa kapena akamaperekedwa ndi manja. Pano chikondi ndi chisamaliro cha TFA ndizofunikira kwambiri. Ndi kuleza mtima kwakukulu, mphaka wosasangalatsa amatha kukopeka kuti atenge chakudya m'manja mwanu, chiyambi chilichonse chaching'ono ndi sitepe yaikulu yopita kuchipatala.
Chilengedwe ndichofunikanso kwambiri kuti mankhwalawa achite bwino, akuyenera kukhala opanda nkhawa komanso ochezeka. Amphaka nthawi zambiri amadya kunyumba. Ngati thanzi lawo lilola, akhoza kutulutsidwa kunyumba usiku, komwe nthawi zambiri amadyera m'malo omwe amazolowera. Masana amabwezedwa ku mchitidwewo kuti akapatsidwe mankhwala.
Kuwongolera kwamadzimadzi m'mitsempha
Njira yofunika kwambiri ndikulowetsa madzimadzi mosalekeza kudzera pa pampu yolowetsera.
mankhwala
Popeza nseru nthawi zambiri imayambitsa kukana chakudya, nthawi zambiri amalimbikitsa kugwiritsa ntchito mankhwala oletsa kutupa.
mankhwala
Kugwiritsiridwa ntchito kwa maantibayotiki kumatsutsana chifukwa pancreatitis yamphongo nthawi zambiri imakhala yosabala. Komabe, amphaka omwe ali ndi umboni wa kuwonongeka kwa zotchinga m'mimba, ma prophylactic makonzedwe a ma antibayotiki ambiri amawonetsedwa kuti alepheretse kukula kwa bakiteriya.
analgesia
Popeza khalidwe lopweteka la amphaka nthawi zambiri ndilovuta kuwunika, chithandizo cha ululu ndi gawo lofunikira pochiza pancreatitis. Amphaka nthawi zambiri amakumana ndi zowawa posiya ndikukana kudya, zomwe ndizizindikiro zokha zomwe zimaloza kapamba. Kuphunzitsidwa bwino komanso, koposa zonse, kumvera chisoni mbali ya TFA kumafunikanso pano. Nthawi ndi nthawi, a TFA ayenera kuonetsetsa kuti mphaka sakumva ululu. Glasgow Pain Scale (onani m'munsimu), yomwe imathandiza kufufuza momwe wodwalayo alili potengera kaimidwe ndi maonekedwe a nkhope, amagwira ntchito ngati chithandizo.
glucocorticoids
Kuwongolera kwa corticosteroids kumakambidwa m'njira zosiyanasiyana. Iwo ali mbali ya dongosolo chithandizo amphaka ndi miyambo. Pakadali pano, idiopathic etiology (zochitika chifukwa chosadziwika) ikukambidwanso amphaka. M'nkhaniyi, olemba ena amafotokoza zotsatira zabwino za pancreatitis yosatha.
Mapa
Kuneneratu kwa kapamba ndikosamala ndipo kumadalira kwambiri zovuta zomwe zimatsatira. Amphaka omwe ali ndi kapamba kwambiri komanso kupsa mtima pafupipafupi kapena zovuta zina amakhala ndi chiyembekezo chosakwanira. Matendawa ndi abwino kwa amphaka omwe ali ndi mawonekedwe ofatsa, ngakhale amadwala nthawi zambiri.
Mulimonsemo, kuyezetsa mtsogolo mokhazikika (ma laboratory/ultrasound) ndikofunikira kuti muzindikire kuphulika munthawi yake komanso kuti mukhale ndi chiopsezo cha kuwonongeka kwadongosolo.
Funso Lofunsidwa Kawirikawiri
Chifukwa chiyani amphaka amadwala pancreatitis?
Izi ndi monga chakudya chamafuta ambiri, kuvulala (monga kuvulazidwa ndi ngozi kapena panthawi ya opareshoni), ndi kusokonezeka kwa kayendedwe ka magazi (komwe kungachitikenso panthawi ya opaleshoni). Mu amphaka, kudzitchinjiriza ndi mkhalidwe wakale womwe ungayambitse pancreatitis.
Kodi pancreatitis ya amphaka imachokera kuti?
The mphaka ali anatomical peculiarity ndi wamba excretory dongosolo bile ndi kapamba. Chifukwa cha kusanza kosatha, m'matumbo amachulukirachulukira, zomwe zimapangitsa kuti bile ndi kapamba zibwererenso mu kapamba ndikupangitsa kutupa.
Kodi mungadziwe bwanji ngati mphaka akuvutika?
Kaimidwe Kosintha: Mphaka akamamva ululu, amatha kuwonetsa kukhazikika, kukhala ndi mimba, kukhala wolumala, kapena kupachika mutu. Kusafuna kudya: Ululu ukhoza kusokoneza m’mimba mwa amphaka. Zotsatira zake, amphaka omwe ali ndi ululu nthawi zambiri amadya pang'ono kapena samadya konse.
Zoyenera kuchita ndi pancreatitis yosatha mu amphaka?
Kwa amphaka omwe ali ndi vuto lalikulu, chofunikira kwambiri ndi chithandizo chazizindikiro kuti muchepetse pancreatitis. Izi zimakhala ndi Fluid therapy (infusions) ndi Kudyetsa zakudya zoyenera kudya (ngati kuli kofunikira pogwiritsa ntchito chubu).
Kodi pancreatitis mu amphaka amachiritsidwa?
Ndi njira yofatsa komanso kuzindikira panthawi yake, kapamba amatha kuchira kwathunthu, koma ndi maphunziro owopsa, kulephera kwa ziwalo zambiri kumatha kuchitika. Ngati sichimathandizidwa, pancreatitis yayikulu imatha kukhala yosatha.
Ndi zakudya ziti zonyowa za amphaka a pancreatitis?
Ngati mphaka wanu ali ndi kapamba, tikukulimbikitsani kuti musinthe zakudya zathu zamphaka ndi mapuloteni a tizilombo kuchokera ku mphutsi zakuda zankhondo. Tizilombo toyambitsa matenda timadziwika ndi kuchuluka kwachilengedwe komanso kusamalidwa bwino.
Kodi kudyetsa amphaka woonda?
Ngati mukufuna kudyetsa mphaka woonda kwambiri, ndiye kuti tcherani khutu ku zakudya zopatsa thanzi komanso zapamwamba kwambiri. Palinso zakudya zapadera, zopatsa mphamvu kwambiri za nyama zomwe zili ndi zosowa zapadera, monga amayi oyamwitsa kapena amphaka ochira.
Kodi kulimbikitsa chilakolako amphaka?
Nyowetsani chakudya chouma ndi madzi ofunda kapena kutentha pang'ono chakudya chonyowa: Izi zimawonjezera fungo la chakudya ndikupangitsa mphaka kufuna kudya. Kusintha Kukoma: Ngati mphaka wanu ndi wosankha kwambiri, kusintha zokonda kungathandize.