I-Acute & Сhronic Pancreatitis ekati

I-pancreas (ama-pancreas) iyi-endocrine (ekhiphela ngaphakathi) kanye ne-exocrine (isabalalisa ngaphandle) indlala. Ingxenye ye-endocrine ikhiqiza amahomoni abalulekile njenge-insulin, iglucagon, ne-somatostatin. Ingxenye ye-exocrine ivuselela ukukhishwa kwe-glandular ehlukanisa ukudla kube izingxenye ezisebenzisekayo. Imfihlo iqukethe ikakhulukazi izandulela ezingasebenzi zama-enzyme okugaya. Lezi ziqala ukusebenza kuphela lapho zifika emathunjini. Lezi zandulela ezingasebenzi zivikela ama-pancreas ekuzigayweni kwawo ngokwawo.

I-pancreatitis iqala lapho le ndlela yokuzivikela ihluleka. Ama-enzyme okugaya abese ededelwa ngaphambi kwesikhathi esicutshini se-pancreatic futhi aholele ekuvuvukeni nasekuzigayeni ukudla kuze kufike ekubhujisweni kwamanyikwe nezicubu ezizungezile.

Sehlukanisa phakathi kwezinhlobo ze-pancreatitis eziyingozi, ezingalapheki, nezingasebenzi ngokunganqamuki. Lokhu kwakamuva kwenzeka ngoba amakati ane-pancreatitis ngokuvamile awalulami ngokuphelele, okungukuthi ukuvuvukala kuvame ukuqubuka ngamagagasi, ngakho-ke sikhuluma ngesifo esingalapheki esiphenduke ukuhlasela okunamandla okuhambisana nezimpawu ezimangazayo.

I-pancreatitis ingavela kumakati anoma yibuphi ubudala kusukela emasontweni amane kuya kweyi-18 ubudala, kungakhathaliseki ukuthi aluphi uhlobo noma ubulili. Ngokusho kwezinye izifundo, amakati e-Siamese namakati amadala athinteka kaningi kunesilinganiso.

Yize ulwazi ngalesi sifo selunyuke kakhulu eminyakeni yamuva nje, umsuka we-pancreatitis awukakacwaningwa kahle. Ukuxilongwa nokwelashwa kuseyizinselele ezinkulu.

Njengenjwayelo, amakati ethu akhethekile kakhulu uma kuziwa kulesi sifo. Ngokungafani nabantu nezinja, ezibonisa izimpawu ezicacile ze-pancreatitis (ukuhlanza, isifo sohudo, nobuhlungu obukhulu besisu yizinto zakudala), amakati ahlupheka buthule futhi angabonakali.

Ikakhulukazi, ngokuvamile asiboni uphawu oluyinhloko lwe-pancreatitis - ubuhlungu obunzima kakhulu lapho ingcindezi ifakwa esiswini. Kodwa-ke, noma kungekho zimpawu zangaphandle ezicacile, sicabanga ukuthi i-pancreatitis nayo ibuhlungu kakhulu kumakati, ikakhulukazi njengoba isimo sekati eligulayo sithuthuka ngokushesha okukhulu ngokuphathwa kwamaphilisi ezinhlungu. Kuyaziwa ukuthi amakati angompetha ekufihleni izinhlungu.

Uhlu lwezimpawu luyinkimbinkimbi futhi luyashintsha. Amakati amaningi aqashelwa kuphela ngokusekelwe ekutholweni okungaqondile okufana nokuncipha kwesifiso sokudla (i-anorexia esezingeni eliphezulu), ukungabi naluhlu (ukukhathala), nokuncipha kwesisindo. Ngenxa yalesi sizathu, asikwazi ukuhlukanisa ngokomtholampilo ukuthi ikati liphethwe yi-pancreatitis eyingozi, engapheli, noma engapheli.

Naphezu kwezimpawu ze-subclinical ezingaqondile, ukushintshela esigabeni esisongela ukuphila esihambisana nokushaqeka kwenhliziyo kanye/noma ukwehluleka kwezitho eziningi kungenzeka noma nini. Ushintsho luwuketshezi. Kwezinye iziguli, i-pancreatitis ihlala isendaweni, kanti kwezinye isakazeka ngendlela ehlelekile. Izimpawu ezengeziwe ezihambisana naso kungaba isifo sohudo, ukuqunjelwa, kanye ne-jaundice. Ezimweni ezimbi kakhulu, ukuphelelwa amanzi emzimbeni kanye ne-hypothermia nakho kwenzeka. Ngesifo sikashukela i-mellitus ngasikhathi sinye, izimpawu eziphambili yi-polydipsia (ukoma okwandayo) kanye ne-polyuria (umchamo okhuphukayo).

Akwenzeki ukubikezela ukuthi ushintsho oluya esimweni esisongela ukuphila luzokwenzeka nini. Ngisho noma isimo sekati ekuqaleni siba ngcono ngokwelashwa, ukuphindeka okungalindelekile kungenzeka ngokushesha okukhulu. Ngakho-ke, ukubikezelwa kwekati eline-pancreatitis kufanele kuhlale kuqaphile. Njengomthetho, izilwane zethulwa kuphela ekusebenzeni lapho isifo sesivele sithuthuke kakhulu. Ngakho-ke ukwelapha okusheshayo nokuphelele kuyadingeka njalo, ngisho noma ukuxilongwa kungakatholakali.

Kuyo yonke imiphumela engaqondile efana nokuhlanza, isifo sohudo, i-jaundice, izinhlungu zesisu, ukukhuliswa kwesisu, i-polyuria, ne-polydipsia, ukuhlonza okuhlukile kwe-pancreatitis kufanele kuhlale kucaciswa. Lokhu kuyadingeka, nakuba izimpawu ezibaluliwe zingahlala zimelela isifo ngokwaso. Kodwa-ke, zingakhombisa i-pancreatitis noma, esimweni esibi kakhulu, ziyivuse. Esigabeni esithile sesifo, imbangela nomphumela ngeke kusahlukaniswa omunye komunye.

Ukuvuvukala kwamathumbu okungapheli ngokuvamile kuyisici esiyingozi kakhulu sokuthuthukiswa kwe-pancreatitis. Isizinda salokhu kuxhumana ukuthi amakati aphethwe isifo sohudo esingapheli ngokuvamile nawo ahlushwa ukuhlanza okungapheli (ukuhlanza), ukwanda kokuhlanza kuholela ekwenyukeni kwengcindezi emathunjini. Lapho i-bile kanye ne-pancreatic secretion kugeleza ku-duodenum, ingcindezi eyandayo ibangela ukuthi i-bile kanye nokukhishwa kwe-pancreatic kuphinde kugezwe ku-pancreas. Le reflux ithandwa ukuhluka kwe-anatomical yekati, elinomgudu ojwayelekile wokuphuma ophuma ku-bile namanyikwe ungene ku-duodenum. Ngaphezu kwalokho, ithumbu elincane elingenhla lekati line-colonization yebhaktheriya enamandla kakhulu uma iqhathaniswa nenja, okusho ukuthi ukugeleza kwamagciwane ohlelweni lwe-bile kanye nama-pancreas kukhuthaza ukuvuvukala.

Uma i-pancreatitis ikhula ibe yisenzakalo esihlelekile, lesi sifo sibeka impilo engozini. Amakati angafa ngokushaqeka, ukwehluleka kwezinso okukhulu, i-septicemia, noma i-endotoxemia. Ngokuvamile kuba noketshezi olwengeziwe esifubeni nasesiswini (i-pleural effusion/ascites).

Ngeshwa, ukutholakala kwe-pancreatitis akulula futhi kudinga inani elikhulu lokuhlolwa. Lokhu kuhlanganisa ukuhlola okunemininingwane yaselabhorethri (i-hematology, i-serum chemistry, i-urinalysis, nokuhlolwa okukhethekile) nezinqubo zokuthwebula izithombe.

I-X-ray iyodwa ayisizi ngalutho, kodwa isetshenziselwa ukukhipha ukuxilonga okunye okuhlukile. Asikwazi ukuhlonza i-pancreatitis ngokusekelwe kuma-X-reyi wesisu kuphela, kodwa asisiza ukukhomba izinkinga ezihambisanayo.

Izinguquko ku-pancreas zingabonakala kahle ku-ultrasound, kodwa kufanele kukhunjulwe ukuthi i-pancreatitis ngezinye izikhathi ingaba yinto engavamile ngokuphelele ku-ultrasound. Kodwa-ke, kanye nezimpawu, amanani egazi ashintshiwe, kanye nomaka we-pancreas, ukutholakala kwe-pancreatitis kungenziwa. Ngesikhathi sokwelashwa, leli nani kufanele lishintshe kahle.

Ukuhlolwa okufanele kwezinga le-pancreatitis kubalulekile. I-pancreatitis ebukhali ihlale ibeka impilo engcupheni futhi kufanele ilashwe ngonya kakhulu, imvamisa ngokuhlala isikhathi eside esibhedlela. Ukwelashwa kwe-pancreatitis kunezinhloso ezintathu eziyinhloko:

• ukulwa nembangela,
• ukwelashwa kwe-symptomatic,
• ukutholwa kusenesikhathi kanye nokwelashwa kwezinkinga ezingaba khona zesistimu.

Kubalulekile ukuqinisekisa ukugcwala kwezicubu, ukunciphisa ukusakazeka kwamagciwane futhi kuvimbele abalamuli bokuvuvukala nama-enzyme e-pancreatic.

Amakati adinga ukudla okuphezulu kwamaprotheni. Uma amakati engakudli ukudla izinsuku ezingaphezu kwezimbili kuya kwezintathu (i-anorexia), isibindi singagula kakhulu (i-hepatic lipidosis = isibindi esinamafutha). Ngakho-ke kubaluleke kakhulu ukunaka ukudla. Ezigulini ezine-anorectic, ukwesekwa kokudla ngokuphakelwa kwe-enteral kungasindisa ukuphila.

Amakati avame ukudla lapho efuywa noma lapho ukudla kunikezwa ngesandla. Lapha uthando nokunakekelwa kwe-TFA kuyadingeka kakhulu. Ngokubekezela okukhulu, ikati elingathandeki ekugcineni lingancengwa ukuthi likhiphe ukudla esandleni sakho, zonke isiqalo esincane siyisinyathelo esikhulu esiya phambili ekwelapheni.

Imvelo nayo ibaluleke kakhulu empumelelweni yokwelapha, kufanele ingabi nengcindezi futhi ingabi nekati. Amakati avame ukudla ekhaya. Uma isimo sabo sempilo sibavumela, bangadedelwa baye ekhaya ebusuku, lapho ngokuvamile bedla khona endaweni abayijwayele. Emini babuyiselwa esikhungweni ukuze banikezwe imithi.

Isinyathelo esibaluleke kakhulu ukushintshwa koketshezi olungena emthanjeni ngokuqhubekayo kusetshenziswa iphampu yokufaka.

Njengoba isicanucanu ngokuvamile siyimbangela yokwenqatshwa kokudla, ukuphathwa kwe-antiemetic ngokuvamile kuyatuswa.

Ukusetshenziswa kwama-antibiotics kuyimpikiswano ngoba i-feline pancreatitis imvamisa iyinqubo eyinyumba. Kodwa-ke, emakati anobufakazi bokuwohloka kwesithiyo se-gastrointestinal, ukuphathwa kwe-prophylactic kwama-antibiotic abanzi kuboniswa ukuvimbela ukukhula kwamagciwane.

Njengoba ukuziphatha kobuhlungu kwamakati ngokuvamile kunzima ukukuhlola, ukwelashwa kobuhlungu kuyisici esibalulekile ekwelapheni i-pancreatitis. Amakati avame ukusabela ezinhlungwini ngokuhoxa futhi enqabe ukudla, okuwukuphela kwezimpawu ezikhomba indlela eya ku-pancreatitis. Ukuqeqeshwa okuhle futhi, ngaphezu kwakho konke, ukuzwela ngasohlangothini lwe-TFA nakho kuyadingeka lapha. Ngezikhathi ezithile, i-TFA kufanele iqinisekise ukuthi ikati alisabuzwa ubuhlungu. I-Glasgow Pain Scale (bheka ngezansi), esiza ukuhlola isimo sesiguli ngokusekelwe ekumeni nasekubukeni kobuso, sisebenza njengosizo.

Ukuphathwa kwe-corticosteroids kuxoxwa ngezindlela ezihlukahlukene. Bayingxenye yohlelo lokwelapha amakati anamasiko. Okwamanje, i-idiopathic etiology (ukwenzeka ngesizathu esingaziwa) nayo kuxoxwa ngayo emakati. Kulesi simo, abanye ababhali babika imiphumela emihle ku-pancreatitis engapheli.