I-necrosis ye-Pancreatic ye-pancreas - umphumela obulalayo? Pancreonecrosis ukubikezela

Esinye sezifo ezimbi kakhulu zesimiso sokugaya umzimba yi-pancreatic necrosis ye-pancreas, umphumela obulalayo lapho, ngokwezibalo, kwenzeka kumacala angu-40-60%.

Izimbangela ze-necrosis ye-pancreatic

I-pancreatitis enamandla, i- pancreatic necrosis iyinkimbinkimbi, iyingxenye yesithathu emvamisa yokuqala, ishiya kuphela i-appendicitis ejulile ne-cholecystitis ngaphambili. Njengomthetho, kuvela ngenxa yokulimala kwamangqamuzana e-secretary of the pancreas, ukukhiqiza ngokweqile kwe-pancreatic juice nokuphazamiseka kokuphuma kwawo. Lezi zinqubo zingabangela:

• Ukuhlukunyezwa kwesisu;
• Ukusebenza ezingxenyeni zomzimba wesisu;
• Ukuphuza umzimba (kubandakanya utshwala);
• Ukuphendula kwe-allergen;
• I-Cholelithiasis ;
• Izifo ezithathelwanayo noma eziyingozi;
• Ukusetshenziswa ngokweqile kwenyama ethosiwe, ukukhishwa kwemifino, amafutha emvelaphi yezilwane.

Izimbangela ze-pancreatic necrosis ze-pancreas ziningi, kepha ngokuvamile zivame ngemuva kokudla kakhulu utshwala obuhlanganiswe nokudla okunamafutha amaprotheni. Kwenzeka ukuthi lesi sifo sishesha ngokushesha futhi ukuhlaselwa kungase kuthuthuke ngokumelene nesimo senhlalakahle ephelele. Kunezimo lapho i-pancreatic necrosis ye-pancreas, umphumela obulalayo okwenzeka ngemva kwamahora ambalwa emva kokubonakala kwezibonakaliso zokuqala zesifo, ithuthukiswe izinsuku eziningana emva kwedili elikhulu.

Kwenzekani nge-pancreaticecrosis

I- pancreas enempilo ikhiqiza ama-enzyme adingekayo ukuze aphule ukudla okungena esiswini. Kungenxa yabo ukuthi ukudla kuhlukaniswa zibe izakhi ezikwazi ukugeleza ngokusebenzisa i-mucosa esiswini egazini, elizinikela ezicukweni nasezigumbini. Lokhu kwenza i-pancreas ibe yizingxenye ezibalulekile emzimbeni. Ukusetshenziswa kotshwala ngokudla okunamafutha amaningi kuvuselela ukukhiqizwa kwejusi ye-pancreatic, futhi njengoba amadokodo angakwazi ukususa ngokuphelele, iqala ukubuthelela ngaphakathi kwesikhumba. Lokhu kuholela ekuthuthukiseni i-edema, ukucindezelwa okuqhubekayo kwamathanga wokuphuma nokuvinjelwa kwabo okulandelayo. Ama-enzyme asebenzayo ama-pancreas, okwakukhona umsebenzi wawo ekuqaleni ukukhwabanisa kwamaprotheni, ukukhukhuma ezindongeni zamathanga bese uqala ukuwahlakaza, ama-enzyme "agaye" amathiskhi azo. Ama-enzyme asebenzayo nemikhiqizo yokubola, okwakhiwa kulokhu, faka igazi futhi uphakamise ukuhlakazwa kwamanye amalungu kanye nezicubu, okubangela ukudakwa okukhulu. Ngakho-ke, i-necrosis ye-pancreatic yama-pancreas, okusho ukuthi kunzima ukubikezela, isifo esiyingozi kakhulu.

Ukuhlukaniswa kwe-necrosis ye-pancreatic

Kuncike ekutheni izinga le-gland liyizinga elingakanani, i-focus-focal, medium-focus, enkulu-focal, subtotal kanye ne-pancreonecrosis ephelele ihlukile. Yiqiniso, umehluko phakathi kwezinhlobo ezimbili zokuqala zinemibandela. La magama amagama odokotela asetshenziselwa ukucacisa izinga lokulimala komzimba. Nge-necrosis ye-pancreatic subtotal, izinguquko ze-necrotic zithinta iningi lesikhumba. Uma isitho sithinteke ngokuphelele, khona-ke i-necrosis ye-pancreatic ye-pancreas iyatholakala. Kulesi simo, umphumela obulalayo uhlale uphawula.

Kukhona okukhethwa kukho okunye okukhethwa kukho. Ihlukanisa i-necrosis ye-pancreatic zibe izinhlobo ezimbili:

• Kuncishisiwe. Lokhu kufaka hlangana inqubo lapho i-foci yobukhulu obuhlukahlukene ikhona khona.
• Okuvamile. Kule nkinga, iningi le-gland noma lonke isitho kuthinteka.

Izinhlobo ze-necrosis ye-pancreatic

Ngokuya kokutholakala kokutheleleka ezindaweni ezithintekile, i-pancreatic necrosis engenamahloni noma enegciwane ihlukile. Kulolu cala, ukuchazwa kwesimo kungenakulungile esimweni senqubo yesandulela ngculaza, ngoba amathuba okuthuthukisa ukushaqeka okubhebhetheka kalula, futhi kunzima kakhulu ukuhoxisa isiguli kuleso simo.

I-pancreonecrosis oyinyumba ihlukaniswe yizinhlobo ezilandelayo:

• Ukudla - kubonakala ukuthuthuka okuncane phakathi kwezinsuku ezingu-4-5 nokugeleza okulula;
• I-Hemorrhagic - ibonakala ngokugeleza okusheshayo nokuphuma kwegazi njalo;
• Ixubile - ivela kaningi, njenge-necrosis ye-pancreatic, kokubili izicubu ze-adipose kanye ne-parenchyma ye-pancreas zithinteka ngokulinganayo.

Uma kukhona i-pancreatic necrosis eyonakalisayo, ukuhlinzwa akugwemeki. Kodwa kaningi ayiniki umphumela oyifunayo, futhi kungenzeka ukuthuthukisa kabusha i-necrotic foci.

Izimpawu nokuxilongwa kwe-Pancreaticecrosis

I-pancreatitis eyingozi emitholampilo ibonakala ubuhlungu obunzima ku-hypochondrium noma kwesinxephezelo esinomlingiswa obunzima. Kukhona ukuhlanza kokuqukethwe kwamathumbu, hhayi ukuletha impumuzo, isifo sohudo. Ngokumelene nalesi sizinda, ukuphuma kwamanzi umzimba ngokushesha kuqala, futhi ukudakwa kuqinisa. Uma uthola ukuxilongwa, kubaluleke kakhulu ukuthi ube ne-anamnesis. Uma iqukethe ulwazi mayelana nokuhlukunyezwa kotshwala, ukudla okunamafutha noma ulwazi ngezifo zesibindi kanye ne-gallbladder, lokhu kungenzeka ukuvumela ukuxilongwa njenge-pancreatic necrosis yama-pancreas. Isibikezelo salesi simo sizoxhomeke kakhulu esigabeni sesifo isiguli esicele usizo lwezokwelapha, nesilinganiso se-lesion.

Ngokuqondene nokuhlolisisa i-laboratory, lapha sibheka ukuhlaziywa komchamo negazi, lapho kunesidingo esingaphezu kwezinga lama-amylase. Futhi, i-ultrasound yesigxobo esiswini, i-CT noma i-MRI, lapho ungabona ukubonakala kwezindawo ze-necrotic ezicukwaneni ze-pancreas.

Ukwelapha

Ezimweni eziningi, i-necrosis ye-pancreatic idinga ukungenela okuhlinzekwayo. Ngesikhathi esifanayo, naphezu kokuthi amaphesenti okufa aphezulu ngokwanele, ukusebenza okufika ngesikhathi kunika ithuba elikhulu lokuthola. Imithi yokwelapha ihlanganisa izigaba ezilandelayo:

• Ezinsukwini ezimbalwa emva kokuhlaselwa - indlala ephelele, futhi kuye ngokuthi ubuhlungu besifo, ukwethulwa kwezakhi ezinezifo ezincane kungadlulela amasonto;
• Ukuhlanzwa kwegazi (i-hemosorption) - kwenziwa ngokudakwa ngokweqile;
• I-Somatostatin iyi-hormone eyanciphisa imiphumela yokusebenza kwezinso ezikhubazekile, ngokuvamile ehamba ne-pancreatic necrosis;
• Ezifweni ezithathelwanayo - ama-antibiotics.

I-pancreatitis enamandla-ukudla

Njengoba kuyisici sokudla okuvame ukuba imbangela ye-pancreatitis ephawulekayo, yilokho okubaluleke kakhulu ekwenzeni ukwelashwa. Njengoba kukhulunywe ngenhla, ezinsukwini zokuqala ngemva kokutholakala kwe-pancreatitis ephawulekayo, ukudla kunzima kakhulu - kuphele indlala ephelele. Ezimweni ezinzima, ukwethulwa kwezakhi zomzimba ezingaphezu kokubeletha kungadlulela amasonto ambalwa.

Ukudla okunomsoco ne-necrosis ye-pancreatic ye-pancreas kusho ukulungiswa kwemithi, okuqinisekiswa ngokuqedwa okukhulu kwamafutha nama-carbohydrate ekudleni, kanye nemikhiqizo ebangela ukwanda kwegesi. Ukudla kuphefumula futhi kuchotshoziwe ngokuphelele. Kuthathwa ngezigaba ezincane izikhathi ezinhlanu kuya kweziyisithupha ngosuku. Ukusetshenziswa kokukhipha kanye nosawoti kukhishwe ngokuphelele. Ukudla okunjalo, kuye ngokuthi ubuhlungu besifo, kufanele buhlale ezinyangeni eziningana kuya ngonyaka.

Yiqiniso, ngesifo esibi kakhulu njenge-necrosis ye-pancreatic, kungenzeka ukuthi imiphumela ebulalayo ingenzeka, kanti-ke, kungcono ukuletha umzimba wakho kuhlaselwa, kungabandakanyi izimo ezinzima ngangokunokwenzeka. Kodwa uma lesi sifo sisaqhubeka, ukuhambisana ngokucophelela nokudla kuzosiza esikhathini esizayo ukugwema ukubuyela emuva.