Mary Allen
Kuzvimba uye kuzvigayira kwepancreas zvakajairika uye nekiriniki zvakakosha zvirwere mumakati zvinogona kukurumidza kutyisa hupenyu.
Iyo pancreas (pancreas) ndeye endocrine (inoparadzira mukati) uye exocrine (inogovera kunze) gland. Iyo endocrine chikamu chinoburitsa akakosha mahomoni akadai se insulin, glucagon, uye somatostatin. Iyo exocrine chikamu inokurudzira glandular secretion iyo inopwanya chikafu muzvikamu zvinoshandisika. Iyo secretion inosanganisira kunyanya kusashanda precursors ye digestive enzymes. Idzi dzinongoshanda kana dzasvika muura. Aya asingashande precursors anodzivirira pancreas kubva pakuzvigaya.
Pancreatitis inokura kana iyi nzira yekudzivirira ikakundikana. Ma enzymes ekugaya anozoburitswa nguva isati yakwana mupancreatic tissue uye zvinotungamira mukuzvimba uye kuzvigaya kusvika pakuparadzwa kwerwatata uye nyama yakatenderedza.
Isu tinosiyanisa pakati peacute, chisingaperi, uye chisingaperi mafomu epancreatitis. Iyo yekupedzisira inoitika nekuti katsi dzine pancreatitis kazhinji hadzina kupora zvachose, kureva kuzvimba kunowanzo kuputika mumafungu, saka tinotaura nezvechirwere chisingaperi chashanduka kuita kurwisa kwakanyanya kune zviratidzo zvinoshamisa.
Ndedzipi katsi dzinorwara?
Pancreatitis inogona kuwanikwa mumakati ezera chero ripi zvaro kubva kumavhiki mana kusvika kumakore gumi nemasere, zvisinei nerudzi kana murume. Zvinoenderana nezvimwe zvidzidzo, Siamese uye katsi dzechikuru dzinobatwa kakawanda kupfuura avhareji.
Kunyange zvazvo ruzivo rwechirwere ichi rwakawedzera zvakanyanya mumakore achangopfuura, kwakabva pancreatitis haisati yanyatsotsvakurudzwa. Kuongororwa uye kurapwa achiri matambudziko makuru.
zviratidzo
Senguva dzose, katsi dzedu dzakanyanya kukosha kana zvasvika pachirwere ichi. Kusiyana nevanhu nembwa, izvo zvinoratidza zviratidzo zvakajeka zvepancreatitis (kurutsira, manyoka, uye kurwadziwa kwakanyanya kwepamuviri ndeyekare), makati anotambura chinyararire uye asingaoneki.
Kunyanya, isu kazhinji hationi chiratidzo chikuru chepancreatitis - kurwadziwa kwakanyanya kana kumanikidzwa kunoshandiswa kudumbu. Zvisinei, kunyange pasina zviratidzo zvekunze zvakajeka, tinofungidzira kuti pancreatitis inorwadza zvikuru kune katsi, kunyanya sezvo mamiriro ekati inorwara inovandudza zvikuru nokukurumidza nekutungamirirwa kwemarwadzo ekurwadziwa. Zvinonyatsozivikanwa kuti katsi inyanzvi pakuvanza marwadzo.
mabatiro
Mhando yezviratidzo yakaoma uye inoshanduka. Mazhinji katsi anongocherechedzwa zvichibva pane zvisina-chaiyo zvakawanikwa senge kuderera kwechido (advanced stage anorexia), listlessness (uleta), uye kuonda. Nechikonzero ichi, isu hatigone kusiyanisa nekiriniki kana katsi iri kurwara neacute, isingaperi, kana isingaperi activated pancreatitis.
Pasinei ne-non-specific subclinical zviratidzo, kuchinja kune imwe nhanho yehupenyu inosangana nekuvhunduka kwemwoyo uye / kana kukanganisa kwenhengo dzakawanda kunogona kuitika chero nguva. Shanduko imvura. Mune vamwe varwere, pancreatitis inoramba iripo, nepo mune vamwe ichipararira systemically. Zvimwe zviratidzo zvinofambidzana zvinogona kuva manyoka, kuvimbiswa, uye jaundice. Mumatambudziko akaoma, kupera simba uye hypothermia kunoitikawo. Nechirwere cheshuga mellitus panguva imwe chete, polydipsia (nyota yakawedzera) uye polyuria (kuwedzera weti yekubuda) ndizvo zviratidzo zvikuru.
Hazvibviri kufanotaura kuti kuchinja kune hupenyu hunotyisa huchaitika rini. Kunyange kana mamiriro ekati anotanga kugadzirisa nekurapa, kudzoka kusingatarisirwi kunogona kuitika nokukurumidza zvikuru. Nokudaro, kufungidzira mukati ine pancreatitis inofanira kugara yakangwarira. Sezvo mutemo, mhuka dzinongoratidzwa chete mukuita apo chirwere chacho chatove chakanyanyisa. Kurumidza uye kurapa kwakakwana saka nguva dzose inodiwa, kunyange kana kuongororwa kusati kwasimbiswa.
Ndirini patinofanira kufunga nezvepancreatitis?
Panyaya yezvose zvisiri izvo zvakawanikwa zvakadai sekurutsa, manyoka, jaundice, kurwadziwa mudumbu, kuwedzera kwemimba, polyuria, uye polydipsia, kusiyanisa kuongororwa kwepancreatitis kunofanira kugara kuchijekeswa. Izvi zvinodikanwa, kunyange zvazvo zviratidzo zvinodudzwa zvingagara zvichimirira hosha pachayo. Nekudaro, ivo vanogona zvakare kuratidza pancreatitis kana, mune yakaipisisa kesi, kutoita kuti iite. Pane imwe nhanho yechirwere, chikonzero nemhedzisiro hazvigone kusiyaniswa kubva kune imwe.
Kuzvimba kwemudumbu kusingaperi kazhinji chinhu chepamusoro-chepamusoro chekukura kwepancreatitis. Mhedzisiro yekubatana uku ndeyokuti makate anotambura nechirwere chisingaperi anowanzotamburawo nekurutsa kusingaperi (kurutsa), kuwedzera kurutsa kunotungamira kuwedzera kudzvinyirira mumatumbo. Panguva iyo bile uye pancreatic secretion inoyerera ichipinda muduodenum, iyo yakawedzera kudzvanywa kunoita kuti bile uye pancreatic secretion idzoke igezwe murwatata. Iyi reflux inofarirwa neatomical peculiarity yekatsi, iyo ine yakajairika excretory duct kubva bile uye pancreas ichipinda muduodenum. Pamusoro pezvo, ura hudiki hwepamusoro hwekatsi hune bhakitiriya yakanyanya kuomarara kana ichienzaniswa nembwa, izvo zvinoreva kuti kuyerera kwehutachiona mu duct system ye bile uye pancreas inosimudzira kuzvimba.
Kana pancreatitis ikawedzera kuita chiitiko chehurongwa, chirwere chinotyisidzira hupenyu. Makati anogona kufa nekuvhunduka, acute renal kutadza, septicemia, kana endotoxemia. Kazhinji pane kuwedzera mvura muchipfuva uye mudumbu (pleural effusion/ascites).
kuongorora chirwere
Nehurombo, kuongororwa kwepancreatitis hakusi nyore uye kunoda huwandu hukuru hwekuongororwa. Izvi zvinosanganisira dzakadzama rabhoritari bvunzo (hematology, serum chemistry, urinalysis, uye yakakosha bvunzo) uye ekufungidzira maitiro.
X-ray yega haibatsiri zvakanyanya, asi inoshandiswa kutonga kunze kwekumwe kusiyanisa kuongororwa. Isu hatigone kuongorora pancreatitis yakavakirwa pamimba X-rays chete, asi inotibatsira kuziva matambudziko anoenderana.
Kuchinja kwepancreas kunogona kuonekwa zvakanaka pa ultrasound, asi inofanira kurangarirwa kuti pancreatitis dzimwe nguva inogona kunge isingashamisi pa ultrasound. Nekudaro, pamwe chete nezviratidzo, yakashandurwa kukosha kweropa, uye pancreas marker, kuongororwa kwepancreatitis kunogona kuitwa. Panguva yekurapa, kukosha uku kunofanira kuchinja zvakanaka.
kurapa
Kunyatsoongorora chiyero chepancreatitis kwakakosha. Yakanyanya acute pancreatitis inogara ichityisidzira hupenyu uye inofanirwa kurapwa zvine hukasha, kazhinji nekugara muchipatara kwenguva refu. Kurapa kwepancreatitis kune zvinangwa zvitatu zvikuru:
- kurwisa chikonzero,
- symptomatic therapy,
- kukurumidza kuonekwa uye kurapwa kwezvinobvira systemic matambudziko.
Izvo zvakakosha kuvimbisa kunhuhwirira kwematishu, kudzikisira kupararira kwebhakitiriya uye inhibit kuputika kwepakati uye pancreatic enzymes.
Dietary Management
Katsi dzinoda kudya kweprotein yakawanda. Kana katsi dzikasadya chikafu kwemazuva anopfuura maviri kusvika matatu (anorexia), chiropa chinogona kurwara zvakanyanya (hepatic lipidosis = chiropa chine mafuta). Saka zvakakosha zvikuru kuchenjerera kudyisa. Mune varwere vane anorectic, rubatsiro rwekudya kuburikidza nekudya kwemukati kunogona kuponesa hupenyu.
Katsi dzinowanzodya padzinenge dzichipuruzirwa kana kuti chikafu chinopiwa nemaoko. Pano rudo uye kutarisirwa kweTFA zvakanyanya kudiwa. Nekushivirira kwakawanda, katsi isingafadzi inogona pakupedzisira kunyengetedzwa kutora chikafu kubva muruoko rwako, kutanga kwega kwega idanho rakakura kumberi mukurapa.
Mamiriro ezvinhu akakoshawo pakubudirira kwekurapa, inofanirwa kunge isina kushushikana uye katsi-inoshamwaridzana. Katsi dzinowanzodya kumba. Kana hutano hwavo huchibvumira, vanogona kusunungurwa kumba usiku, uko vanowanzodyira munzvimbo yavakajaira. Masikati vanodzoswa kupractice kuti vapihwe mishonga.
Intravenous fluid administration
Chiyero chakanyanya kukosha ndechekuenderera mberi nekutsiviwa kwemvura mutsinga kuburikidza nepombi inopinza.
antiemetics
Sezvo kusvotwa kunowanzova chikonzero chekurambwa kwechikafu, kupihwa mushonga weantiemetic kunowanzo kukurudzirwa.
mishonga
Kushandiswa kwemishonga inorwisa mabhakitiriya kune kukakavara nekuti feline pancreatitis inowanzova isina hutachiona. Zvisinei, mumakati ane humbowo hwekuparara kwegastrointestinal barriers, prophylactic administration ye-broad-spectrum antibiotics inoratidzwa kudzivisa kukura kwebhakitiriya.
analgesia
Sezvo maitiro ekurwadziwa kwekatsi kazhinji akaoma kuongorora, kurapwa kwemarwadzo chinhu chakakosha mukurapa kwepancreatitis. Katsi dzinowanzoita marwadzo nekubvisa uye kuramba kudya, izvo chete zviratidzo zvinonongedza nzira yepancreatitis. Kudzidziswa kwakanaka uye, pamusoro pezvose, kunzwira tsitsi kune chikamu cheTFA kunodiwawo pano. Nguva nenguva, TFA inofanira kuona kuti kati haisisiri kurwadziwa. Iyo Glasgow Pain Scale (ona pazasi), iyo inobatsira kuongorora mamiriro emurwere zvichienderana nechimiro uye chimiro chechiso, inoshanda seyamuro.
glucocorticoids
Kutungamirirwa kwe corticosteroids kunokurukurwa nenzira dzakasiyana-siyana. Ivo chikamu chechirongwa chekurapa kwekatsi netsika. Panguva ino, idiopathic etiology (zvinoitika kubva kune chikonzero chisingazivikanwi) iri kukurukurwawo mumakati. Muchirevo chechinyorwa ichi, vamwe vanyori vanorondedzera mhedzisiro yakanaka mune chisingaperi pancreatitis.
kushurudzira
Kufungidzira kwepancreatitis kuchenjerera uye kunoenderana zvakanyanya neanotevera systemic matambudziko. Katsi dzine pancreatitis yakakomba uye kazhinji acute flare-ups kana yakaoma comorbidities vane fungidziro yakaipa. Kufungidzira kwakanakira makati ane chimiro chakapfava, kunyangwe kana vachirwara kazhinji.
Chero zvazvingava, nguva dzose kuongorora kweramangwana (rabhoritari / ultrasound) inokurudzirwa kuti uone kupisa-up munguva yakanaka uye kuva nengozi ye systemic derailments.
Inowanzobvunzwa Mubvunzo
Sei katsi dzichiwana pancreatitis?
Izvi zvinosanganisira kudya kwakanyanya-mafuta, kukuvadzwa (semuenzaniso kukuvara kubva mutsaona kana panguva yekuvhiya), uye kusagadzikana kwekufamba kweropa (izvo zvinogonawo kuitika panguva yekuvhiya). Mukati, kudzivirira inguva yekare iyo inogona kutungamirira kupancreatitis.
Ko pancreatitis mumakati inobva kupi?
Iyo katsi ine anatomical peculiarity ine yakajairika excretory system ye bile uye pancreas. Nekuda kwekurutsa kusingaperi, kune kuwedzera kudzvinyirira mumatumbo, izvo zvinoita kuti bile uye pancreatic secretions idzoke ichidzokera mupancreas uye inokurudzira kuzvimba.
Unoziva sei kana kati iri kutambura?
Altered Posture: Kana katsi iri kurwadziwa, inogona kuratidza kumira kwakasimba, kuita tummy tuck, kuremara, kana kurembera musoro wayo. Kurasikirwa nechido: Marwadzo anogona kukanganisa matumbu ekati. Somugumisiro, katsi dziri kurwadziwa dzinowanzodya zvishoma kana kusatombodya zvachose.
Chii chekuita nekusingaperi pancreatitis mumakati?
Kune katsi dzine kosi yakaomesesa, chiyero chakanyanya kukosha ndeye symptomatic therapy kuderedza mhedzisiro yepancreatitis. Izvi zvinosanganisira Fluid therapy (infusions) uye Kudyisa nechikafu chekudya chakakodzera (kana zvichidikanwa uchishandisa chubhu yekudyisa).
Ko pancreatitis mumakati inorapika here?
Nekosi yakapfava uye yekuona panguva, iyo pancreas inogona kupora zvachose, asi neyakaomarara makosi, kutadza kwenhengo dzakawanda kunogona kuitika. Kana ikasiyiwa isina kurapwa, acute pancreatitis inogona kukura kuita isingaperi.
Ndechipi chikafu chakanyorova chepancreatitis katsi?
Kana katsi yako ichirwara nepancreatitis, tinokurudzira kuti uchinje kune chikafu chedu chekatsi neprotein yezvipembenene kubva kune dema musoja nhunzi. Protein yezvipembenene inoratidzirwa nekukosha kwakanyanya kwebhayoloji uye kugaya kwakanyanya.
Nzira yekudyisa katsi dzakaonda?
Kana iwe uchida kudyisa kati yakaonda zvakanyanya, saka teerera kune kunyanya kudya kunovaka muviri uye kwepamusoro-soro. Kune zvakare akakosha, akanyanya-makoriori ekudya kune mhuka dzine zvinodiwa zvakakosha, senge vanaamai vanoyamwisa kana katsi dzekupora.
Nzira yekusimudzira chido mumakati?
Moisten chikafu chakaoma nemvura inodziya kana kudziya zvishoma chikafu chakanyorova: Izvi zvinowedzera kunhuwa kwechikafu uye kuita kuti katsi ide kuchidya. Kugadzirisa Kunhuhwirira: Kana katsi yako ikanyanya kusarudzwa, kushandura zvinonaka zvinogona kubatsira.