Izici zomtholampilo
Kukhona ubuhlungu obukhulu, ukuvuvukala, futhi ngezinye izikhathi ukuhlukumeza komzimba kwesisu esisenhla. Iningi leziguli likhathazekile mayelana nokuhlanzeka nokuhlanza; abanye - kuphela isifiso sokuhlanza. Kungenzeka kube khona okwesibhakabhakeni okuncane endaweni esungeze inkaba (uphawu lukaCullen) noma i-cyanosis (eluhlaza okwesibhakabhaka) yesikhumba ezindaweni ezibonakalayo zesisu (isibonakaliso seGrey-Turner). Lokhu kungabonisa ukubola kwegazi kwangaphakathi emgodini wesisu. Isibonakaliso sikaCullen sifakazela ukutholakala kwegazi langaphakathi, lapho izicubu ezungeze inkaba zigcwele igazi. Ukwehla kwesisu kunomphumela wokuphulwa kwezinqubo zokugwedla igazi ngenxa yomunwe we-enzyme ye-pancreatic. I-pancreas itholakala ngemuva kwesisu esiswini esingaphansi kwesisu. Ikhanda lalo libhekene ne-bod of the duodenum.
Ama-pancreas akhiqiza:
- i-insulini ne-glucagon - i-hormone ekhishwa ngokuqondile egazini kanye nokulawula amazinga kashukela egazi;
- ijusi eliphazamisayo - liqukethe ama-enzyme amane aphula amaprotheni (trypsin, chymotrypsin), kanye namafutha (lipase) nesitashi (ama-amylase). Umzila we-pancreatic ophansi ungena emgodini we-bile ovamile ngokushesha ngaphambi kokuba ushiye i-duodenum.
Ijusi le-pancreatic, kanye ne-bile, lixubene nokudla okugayiwe kancane esiswini, kusebenze futhi kuqedela izinqubo zokuphazamiseka kwezakhi.
Izimbangela ezivame ukwanda kwe-pancreatitis enzima yizi:
- isifo se-bile (45%); isibonelo, ukuqina kwama-gallstones emidayeni ye-bile ngaphambi kokungena kwi-duodenum;
- ukudakwa ngokweqile (35%).
Ezinye izizathu zithi:
- ukuhlukumezeka komzimba okungenangqondo noma okutholayo, isibonelo, ngenxa yokuhlinzwa;
- isilonda esisongayo se-duodenum;
- ukuphazamiseka kwemithi, njenge-hypercalcemia (ngenxa yokwelashwa kwezigulane ezibuhlungu kanye nokudla kwezidakamizwa ezine-calcium); i-hypertriglyceridemia (izinga eliphakeme le-triglycerides egazini); ukuhluleka kwezinso;
- ukusabela emithini yokwelapha, isibonelo, kufakwe kwezinye izitho zomzimba zomlomo;
- Izifo ezithathelwanayo, njenge-parotitis, isifo sofuba, i-HIV;
- izifo eziphilayo, ezifana nomdlavuza we-pancreatic;
- amacala e-idiopathic (okungaziwa emvelaphi). Indlela yokusebenza yalezi zici akukacaci ekugcineni, kodwa, ngokusho komunye wemibono, iqukethe "ukuzigaya" kwegciwane, lapho kusetshenziselwa ama-enzyme ezakhiweni zayo. Ngokubhubhisa i-gland, bona futhi bavuselele amanye ama-enzyme, afana ne-elastase (ukucubungula izintambo ezinwebekayo zegazi) ne-phospholipase.
Inkambo yesifo
Ama-enzyme e-pancreatic acushiwe angaphazamisa amangqamuzana futhi awonakele izicubu, abangela ukuphuma kwegazi, i-edema ne-necrosis ye-pancreas. Njengoba kunesifo esibi kakhulu, izitho eziseduze nazo zingalimaza, okwandisa ingozi yokwethuka nezinye izinkinga. Nge-pancreatitis enobuhlungu obuncane, ukuvuvukala kunqunyelwe kuphela ugandane uqobo. Izimpawu ezifanayo zingabonwa kwezinye izifo zesisu (ukuphazamiseka noma ukuvinjelwa kwamathumbu, ukuvuvukala okunzima kwe-gallbladder), kanye nesifuba (ukushaya kwenhliziyo 'pneumonia).
Ukuhlolwa kwegazi
Igazi libala ngokuqondile ukuthi i-pancreatitis ayikho, kodwa ukuhlolwa kwegazi kusiza ukwengeza isithombe somtholampilo. Ezimweni eziningi, izinga eliphakeme lama-enzyme (ama-amylase ne-lipase) egazini. Lezi zinkomba ziwuphawu lokubaluleka ekutholeni isifo, ngoba kungakapheli isonto babuyele evamile. Izinga eliphakeme lamafutha e-free acids akhiwa isenzo se-lipase kubangelwa i-saponification ye-enzymatic futhi yehla ekuhlungeni kwe-calcium egazini. Izinga lama-leukocyte egazini ezigulini ezine-pancreatitis ngokuvamile ziphakeme (i-leukocytosis), futhi ngenxa yokulahlekelwa kwamanzi, i-hematocrit (isilinganiso somthamo we-erythrocytes kuya kumthamo we-plasma) iyanda.
Izindlela zokubukwa
Ukutholakala kokugcina kwe-pancreatitis enamandla kusekelwe kuphela kwimiphumela etholakala ngosizo lwezindlela zokubukwa: i-ultrasound ne-tomography ehlanganisiwe. I-tomography ehlanganisiwe isenziwa ngokucindezeleka okukhulu futhi uma kwenzeka kunenkinga. Ngosizo lalezi zindlela ngezinye izikhathi kungenzeka ukuthi zibone imbangela yokuphefumula. Ukudalula imbangela yalesi sifo kuvumela ukuqhuba izinyathelo zokwelashwa ezihloswe ekuqothulweni kwayo, okuzosiza esikhathini esizayo ukugwema ukuhlaselwa okuphindaphindiwe kokuphefumula.
• Izakhi ezizungezile eziphuzi okwenziwe nge-pseudocolor scan eyenziwe nge-microscope ye-electron ziyi-lymphocytes (uhlobo lwe-leukocytes). Izinga lama-leukocyte egazini ngokucindezeleka okuvame ukuphakama. Isibikezelo sihlolwe esikalini lesishumi nanye sesikhombiso esekelwe ekuchazeni indlela yokubikezela, okufaka:
- uneminyaka engaphezu kuka-55 ngesikhathi sokubhalisa;
- ukuvivinywa kwama-laboratory (amane kokungeniswa kanye nesithupha ngemva kwamahora angu-48). Uma kunamaphuzu amathathu noma ngaphezulu ngesikhathi sokungena, amathuba okuba nomphumela obulalayo yi-1: 5; Uma kunamaphuzu ayisikhombisa noma ngaphezulu, ivela.
Ezinsukwini ezimbalwa zokuqala, ukufa kwenzeka ngenxa yokuhluleka komzimba okuningi. Ezimweni eziningi (iziguli ezingama-80%) ziyafa ngemva kwesonto, ngokuvamile ngenxa yokuthuthukiswa kokutheleleka (ukubamba i-abscessing) noma ukwakheka kwe-cyst yamanga. Ukuthuthukiswa kokutheleleka ngemuva kwe-necrosis ye-pancreas kufanele kusolwa uma kungekho umphumela wokwelashwa noma ukulimala okungazelelwe. Ukuphefumula kokuqukethwe kwesigxobo esiswini ngaphansi kokulawulwa kwe-computed tomography kungasiza ekuxilongweni. Uma ukufisa kokuqukethwe okuthelelekile kungenzeki ngesikhathi, inani lokufa lifinyelela ku-100%. Ifomu elincane elihle lokuhlukunyezwa lingadlulela ngokuzenzekelayo. Isiguli sinikwe izifo ezithandwayo, ukungena kokudla kanye neziphuzo akukhipha ngokuphelele. Ukuze kuqedwe isicanucanu nokuhlanza nge-tube nasogastric, isisu sisuswe. Lokhu kusiza ukuvimbela ukushuswa, ukunciphisa ukulahlekelwa kwamanzi. I-probe iphinde isetshenziselwe ukuhlinzeka ngezifo zokubulala umzimba, ngezinye izikhathi isebenzisa idivayisi elawulwa isiguli. Lokhu kunikeza isiguli ithuba lokulawula ukudla kwezidakamizwa, kuye ngokuthi ubuhlungu bubuhlungu kangakanani. Ukuze ugweme ukudlula ngokweqile, kunedivayisi ekhethekile eyenzelwe ukusebenzisa inombolo elinganiselwe yokulinganisa isikhathi esithile.
Ukuhlolwa okuphelele
Nge-pancreatitis ekhulu kakhulu, ukuhlolwa esibhedlela kuyadingeka ekamelweni elikhethekile lokunakekelwa okukhulu lapho isiguli sihlolisiswa ngokucophelela futhi izimpawu eziyingozi ezibonisa ukuthi kunengozi enkulu yokufa kubonakala. Ukwelashwa kuhloswe ukuvimbela izinkinga zesifo.