UMary Allen
Ukuvuvukala kunye nokuzicoca kwi-pancreas zizifo eziqhelekileyo kwaye zibalulekile ngokweklinikhi kwiikati ezinokukhawuleza zibe yingozi ebomini.
I-pancreas (i-pancreas) zombini i-endocrine (ikhuphela ngaphakathi) kunye ne-exocrine (ehambisa ngaphandle) idlala. Inxalenye ye-endocrine ivelisa iihomoni ezibalulekileyo ezifana ne-insulin, iglucagon, kunye ne-somatostatin. Inxalenye ye-exocrine ivuselela i-secretion ye-glandular eqhekeza ukutya kwizinto ezisebenzisekayo. Imfihlo iqulethe ikakhulu izandulela ezingasebenziyo ze-enzymes zokugaya. Ezi ziqala ukusebenza kuphela xa zifika emathunjini. Ezi zandulela ezingasebenziyo zikhusela i-pancreas ekuzicoleni ngokwazo.
I-Pancreatitis ikhula xa le ndlela yokukhusela ingaphumeleli. Ii-enzymes zokwetyisa zikhutshwa kwangaphambi kwexesha kwizicubu ze-pancreatic kwaye zikhokelela ekudumbeni kunye nokuzicoca ukuya ekutshatyalalisweni kwe-pancreas kunye nezicubu ezijikelezileyo.
Siyohlula phakathi kweentlobo ezibukhali, ezingapheliyo, kunye nezingapheliyo ze-pancreatitis. Oku kokugqibela kwenzeka ngenxa yokuba iikati ezine-pancreatitis zihlala zingachacha ngokupheleleyo, oko kukuthi, ukudumba kudla ngokugqabhuka ngamaza, ke sithetha ngesifo esinganyangekiyo esijike saba luhlaselo oluqatha oluneempawu ezihambelanayo.
Zeziphi iikati ezigulayo?
I-Pancreatitis inokubonakala kwiikati zayo nayiphi na iminyaka ukusuka kwiiveki ezine ukuya kwi-18 ubudala, kungakhathaliseki ukuba luhlobo luni okanye isini. Ngokutsho kwezinye izifundo, i-Siamese kunye neekati ezindala zichaphazeleka rhoqo kunomndilili.
Nangona ulwazi lwesi sifo luye lwanda kakhulu kwiminyaka yakutshanje, imvelaphi ye-pancreatitis ayikaphandwa ngokucokisekileyo. Uxilongo kunye nonyango iseyingxaki enkulu.
iimpawu
Njengesiqhelo, iikati zethu zikhetheke kakhulu xa kufikwa kwesi sifo. Ngokuchasene nabantu kunye nezinja, ezibonisa iimpawu ezicacileyo ze-pancreatitis (ukuhlanza, isifo sohudo, kunye neentlungu ezibuhlungu zesisu ziyi-classic), iikati zihlupheka ngokuthula kwaye zingabonakali.
Ngokukodwa, ngokuqhelekileyo asiqapheli uphawu oluphambili lwe-pancreatitis - intlungu enzima kakhulu xa uxinzelelo lusetyenziswa kwisisu. Nangona kunjalo, nangaphandle kweempawu ezicacileyo zangaphandle, sicinga ukuba i-pancreatitis nayo ibuhlungu kakhulu kwiikati, ngakumbi ekubeni imeko yekati egulayo iphucula ngokukhawuleza kakhulu kunye nokulawulwa kweentlungu. Kuyaziwa ukuba iikati ziinkosi zokufihla iintlungu.
impatho
Uluhlu lweempawu luyinkimbinkimbi kwaye luyatshintsha. Uninzi lweekati zibonwa kuphela ngokusekelwe kwiziphumo ezingabonakaliyo ezifana nokunciphisa ukutya (i-anorexia yenqanaba eliphezulu), ukungabikho koluhlu (ukuphelelwa amandla), kunye nokunciphisa umzimba. Ngesi sizathu kanye, asikwazi ukwahlula ngokweklinikhi ukuba ikati iphethwe yi-pancreatitis ebukhali, engapheliyo okanye engapheliyo.
Nangona iimpawu ze-subclinical ezingabonakaliyo, ukutshintshela kwinqanaba elisongela ubomi elihambelana nokutshatyalaliswa kwentliziyo kunye / okanye ukungaphumeleli kwamalungu amaninzi kunokwenzeka nangaliphi na ixesha. Utshintsho lulwelo. Kwezinye izigulana, i-pancreatitis ihlala isendaweni, ngelixa kwezinye isasazeka ngokwenkqubo. Iimpawu ezongezelelweyo ezihamba kunye norhudo, ukuqhina, kunye nejaundice. Kwiimeko ezinzima, ukuphelelwa ngamanzi emzimbeni kunye ne-hypothermia nazo zenzeka. Nge-diabetes mellitus ngaxeshanye, i-polydipsia (ukwanda kokoma) kunye ne-polyuria (ukukhutshwa komchamo okwandisiweyo) ziimpawu eziphambili.
Akunakwenzeka ukuqikelela ukuba kuya kwenzeka nini utshintsho kwimeko esongela ubomi. Nangona imeko yekati ekuqaleni iphucula ngonyango, ukuphindaphinda okungalindelekanga kunokwenzeka ngokukhawuleza. Ke ngoko, i-prognosis kwikati ene-pancreatitis kufuneka ihlale ilumkile. Njengomthetho, izilwanyana zinikezelwa kuphela ekusebenzeni xa isifo sele siphumelele. Unyango olukhawulezileyo nolucokisekileyo ke luhlala lufuneka, nokuba ukuxilongwa akukasekwa.
Kufuneka sicinge nini nge-pancreatitis?
Kwimeko yazo zonke iziphumo ezingabonakaliyo ezifana nokuhlanza, isifo sohudo, i-jaundice, intlungu yesisu, ukunyuswa kwesisu, i-polyuria, kunye ne-polydipsia, ukuxilongwa kwe-pancreatitis kufuneka kuhlale kucaciswa. Oku kuyimfuneko, nangona iimpawu ezikhankanyiweyo zinokuhlala zibonisa isifo ngokwaso. Nangona kunjalo, banokubonisa i-pancreatitis okanye, kwimeko embi kakhulu, baze bayibangele. Kwinqanaba elithile lesi sifo, isizathu kunye nesiphumo asikwazi ukwahlula omnye komnye.
Ukudumba okungapheliyo kwamathumbu kudla ngokuba ngumngcipheko ophezulu kakhulu wokukhula kwepancreatitis. Imvelaphi yolu xhulumaniso kukuba iikati ezinesifo sohudo esingapheliyo zidla ngokuba nokuhlanza okungapheliyo (ukuhlanza), ukunyuka kwe-vomitus kukhokelela kuxinzelelo olwandisiweyo emathunjini. Kwinqanaba apho i-bile kunye ne-pancreatic secretion ingena kwi-duodenum, uxinzelelo olonyukayo lubangela ukuba i-bile kunye ne-pancreatic secretion ibuyele ihlanjwe kwi-pancreas. Le reflux ithandwa yinto ekhethekileyo ye-anatomical yekati, enombhobho oqhelekileyo wokukhupha kwi-bile kunye ne-pancreas ukuya kwi-duodenum. Ukongeza, amathumbu amancinci aphezulu ekati anekholoni yebhaktheriya ethe kratya xa kuthelekiswa nenja, okuthetha ukuba ukubuya ngasemva kweentsholongwane kwi-duct system ye-bile kunye ne-pancreas kukhuthaza ukudumba.
Ukuba i-pancreatitis iyanda kwisiganeko senkqubo, isifo sisongela ubomi. Iikati zinokufa ngenxa yokothuka, ukungaphumeleli kwezintso, i-septicemia, okanye i-endotoxemia. Rhoqo kukho ulwelo olongezelelweyo esifubeni nasesiswini (i-pleural effusion/ascites).
Ukuqondwa
Ngelishwa, ukuxilongwa kwe-pancreatitis akulula kwaye kufuna inani elikhulu leemviwo. Oku kubandakanya iimvavanyo zelebhu ezineenkcukacha (i-hematology, i-serum chemistry, uhlaziyo lokuchama, kunye novavanyo olulodwa) kunye neenkqubo zokucinga.
I-X-reyi iyodwa ayiloncedo kakhulu, kodwa isetyenziselwa ukukhupha uxilongo olongezelelweyo olwahlukileyo. Asikwazi ukuxilonga i-pancreatitis esekwe kwi-X-reyi yesisu kuphela, kodwa ziyasinceda ukuchonga iingxaki ezinxulumene nazo.
Utshintsho kwi-pancreas lunokubonwa kakuhle kwi-ultrasound, kodwa kufuneka kukhunjulwe ukuba i-pancreatitis ngamanye amaxesha inokungaphawuleki ngokupheleleyo kwi-ultrasound. Nangona kunjalo, kunye neempawu, amaxabiso egazi atshintshileyo, kunye ne-pancreas marker, ukuxilongwa kwe-pancreatitis kunokwenziwa. Ngexesha lonyango, eli xabiso kufuneka litshintshe ngokufanelekileyo.
unyango
Uvavanyo oluchanekileyo lwenqanaba le-pancreatitis lubalulekile. I-pancreatitis ebukhali isoloko ibeka ubomi esichengeni kwaye kufuneka inyangwe ngamandla, rhoqo ngokuhlala ixesha elide esibhedlele. Unyango lwe-pancreatitis luneenjongo ezintathu eziphambili:
- ukulwa nonobangela,
- unyango lweempawu,
- ukufunyanwa kwangethuba kunye nonyango lweengxaki zenkqubo enokwenzeka.
Kubalulekile ukuqinisekisa ukuchithwa kwezicubu, ukunciphisa ukusasazeka kweebhaktheriya kunye nokuthintela abalamli abavuthayo kunye ne-pancreatic enzymes.
Ulawulo lokuTyelwa
Iikati zidinga ukutya okuphezulu kweprotheyini. Ukuba iikati azityi ukutya ngaphezu kweentsuku ezimbini ukuya kwezintathu (i-anorexia), isibindi sinokugula kakhulu (i-hepatic lipidosis = isibindi esinamafutha). Ngoko ke kubaluleke kakhulu ukunikela ingqalelo ekondleni. Kwizigulane ze-anorectic, inkxaso yokutya ngokutya okungenayo kunokusindisa ubomi.
Iikati zidla ngokutya xa zifuywa okanye xa ukutya kunikelwa ngesandla. Apha uthando kunye nenkathalo ye-TFA ifunwa kakhulu. Ngomonde omkhulu, ikati engathandekiyo ekugqibeleni inokunyanzelwa ukuba ithathe ukutya esandleni sakho, yonke isiqalo esincinci siyinyathelo elikhulu eliya phambili kunyango.
Imeko yendawo nayo ibaluleke kakhulu kwimpumelelo yonyango, kufuneka ingabi noxinzelelo kunye nekati. Iikati zihlala zisitya ekhaya. Ukuba imeko yabo yempilo iyabavumela, banokukhululwa bagoduke ebusuku, apho badla ngokutyela kwindawo abayiqhelileyo. Emini bayabuyiswa kuqheliselo ukuze banikwe amayeza.
Ulawulo lwe-intravenous fluid
Owona mlinganiselo ubalulekileyo kukutshintshwa kolwelo oluqhubekayo nge-intravenous kusetyenziswa impompo yokufakwa.
izinto zokulwa
Ekubeni isicaphucaphu sidla ngokuba ngunobangela wokwaliwa kokutya, ukulawulwa kweyeza lokuthomalalisa igazi kucetyiswa ngokubanzi.
antibiotics
Ukusetyenziswa kwe-antibiotics kuyaphikisana kuba i-feline pancreatitis idla ngokuba yinkqubo enyumba. Nangona kunjalo, kwiikati ezinobungqina bokuqhekeka komqobo wesisu, ukulawulwa kweprophylactic ye-antibiotics ebanzi kuboniswa ukuthintela ukukhula kwebhaktheriya.
analgesia
Ekubeni ukuziphatha okubuhlungu kweekati ngokuqhelekileyo kunzima ukuvavanya, unyango lwentlungu luyingxenye ebalulekileyo kunyango lwe-pancreatitis. Iikati zihlala zisabela kwiintlungu ngokurhoxisa kunye nokwala ukutya, ezo kuphela iimpawu ezikhomba indlela eya kwi-pancreatitis. Uqeqesho olulungileyo kwaye, ngaphezu kwako konke, uvelwano kwicala le-TFA nalo luyafuneka apha. Ngamaxesha athile, i-TFA kufuneka iqinisekise ukuba ikati ayisekho zintlungu. I-Glasgow Pain Scale (jonga ngezantsi), enceda ukuvavanya imeko yesigulane ngokusekelwe kwi-posture kunye nembonakalo yobuso, isebenza njengoncedo.
glucocorticoids
Ukulawulwa kwe-corticosteroids kuxoxwa ngeendlela ezahlukeneyo. Ziyinxalenye yesicwangciso sonyango lweekati ezinezithethe. Okwangoku, i-etiology ye-idiopathic (ukwenzeka kwisizathu esingaziwayo) nayo iyaxoxwa kwiikati. Kulo mongo, abanye ababhali baxela iziphumo ezilungileyo kwi-pancreatitis engapheliyo.
yaqikelelwa
I-prognosis ye-pancreatitis ilumkile kwaye ixhomekeke kakhulu kwiingxaki zenkqubo ezihamba nazo. Iikati ezine-pancreatitis enzima kunye nokugqabhuka okukrakra rhoqo okanye izifo ezintsonkothileyo zine-prognosis embi. I-prognosis ilungile kwiikati ezinefom epholileyo, nangona zigula rhoqo.
Kwimeko nayiphi na into, ukuhlolwa rhoqo kwexesha elizayo (i-laboratory / ultrasound) kuyacetyiswa ukuba kubonwe ukuvutha ngexesha elifanelekileyo kwaye kuqule umngcipheko we-systemic derailments.
Umbuzo obuzwa rhoqo
Kutheni iikati zifumana i-pancreatitis?
Oku kubandakanya ukutya okunamafutha aphezulu kakhulu, ukwenzakala (umzekelo ukwenzakala kwiingozi okanye ngexesha lotyando), kunye nokuphazamiseka kokujikeleza kwegazi (okunokuthi kwenzeke ngexesha lotyando). Kwiikati, ukuzikhusela yimeko yeklasiki engakhokelela kwi-pancreatitis.
Ivela phi i-pancreatitis kwiikati?
Ikati ine-peculiarity ye-anatomical kunye ne-excretory system eqhelekileyo ye-bile kunye ne-pancreas. Ngenxa yokuhlanza okungapheliyo, kukho uxinzelelo olwandisiweyo emathunjini, olubangela ukuba i-bile kunye ne-pancreatic secretions ibuyele kwi-pancreas kwaye ikhuthaza ukuvutha.
Wazi njani ukuba ikati iyabandezeleka?
I-Altered Posture: Xa ikati isezintlungwini, inokubonisa ukuma okuqinileyo, ukuba nesisu, ukuqhwala, okanye ukuxhoma intloko. Ukuphelelwa ngumdla wokutya: Iintlungu zinokuphazamisa izisu zeekati. Ngenxa yoko, iikati ezisezintlungwini zihlala zisitya kancinci okanye zingatyi kwaphela.
Yintoni enokuyenza nge-pancreatitis engapheliyo kwiikati?
Kwiikati ezinekhosi enzima, owona mlinganiselo ubalulekileyo lunyango lweempawu zokunciphisa iziphumo ze-pancreatitis. Oku kubandakanya unyango lwe-Fluid (infusions) kunye noKutya ngokutya okufanelekileyo kokutya (ukuba kuyimfuneko usebenzisa ityhubhu yokutya).
Ngaba i-pancreatitis kwiikati iyanyangeka?
Ngekhosi ethambileyo kunye nokufunyanwa kwangexesha, i-pancreas inokuphilisa ngokupheleleyo, kodwa ngezifundo ezinzima, ukusilela kwamalungu amaninzi kunokwenzeka. Ukuba ayinyangwa, i-pancreatitis ebukhali inokukhula ibe yinto engapheliyo.
Kukuphi ukutya okumanzi kweekati ze-pancreatitis?
Ukuba ikati yakho inesifo se-pancreatitis, sincoma ukuba utshintshe ukutya kwethu kwekati kunye neprotein yezinambuzane ezivela kwi-larvae yejoni elimnyama. Iprotheyini yezinambuzane ibonakala ngexabiso eliphezulu kakhulu lebhayoloji kunye nokugqwesa okugqwesileyo.
Indlela yokondla iikati ezibhityileyo?
Ukuba ufuna ukondla ikati encinci kakhulu, ke nikela ingqalelo kukutya okunezondlo kunye nomgangatho ophezulu. Kukwakho ukutya okukhethekileyo, okunekhalori ephezulu kakhulu kwezilwanyana ezineemfuno ezizodwa, ezinje ngoomama abancancisayo okanye iikati eziphila ubomi obulula.
Indlela yokuvuselela umdla kwiikati?
Fudumesa ukutya okomileyo ngamanzi ashushu okanye ukufudumeze ngokufutshane ukutya okumanzi: Oku kwenza ukuba ikati ifune ukukutya kakhulu. Ukulungelelanisa iiNcasa: Ukuba ikati yakho ikhetha kakhulu, ukutshintsha izinto ezithandayo kunokunceda.