ʻO ka pancreatitis acute kahi hana hoʻonā kino e hele mai ana ma ka pancreas ma lalo o ka hopena o kahi mea hoʻonāukiuki. Aia ia ma muli o ka hopena maikaʻi o ka huina o ka digestive enzyme, e alakaʻi ana i ka hoʻoliʻi kūʻokoʻa o ka huina.
Ka hopu ʻana i ka iho ponoʻī o kā lākou mau kiko pono i hele pū ʻia me ka piʻi ʻana o ka nui o ka pancreas, aia ka mākaʻi nui a me ka make o nā ʻoli, nā wahi necrotic (luku) ka mea, i kū mai i kahi māla o ka maʻi ʻehaʻeha.
Wahi a nā helu helu, ʻike ʻia ka maʻi i loko o nā poʻe maʻi ma ka pūʻulu makahiki mai 30 a 60 mau makahiki. ʻO kēia manawa hou, ua hoʻonui pinepine ʻia ka nui o nā maʻi e pili ana i ka hōʻino ʻana i ka waiʻona, a me nā hana ʻai maikaʻi.
I 20% o nā hihia, hiki ke ulu mai ke kumu o ka maʻi o ka maʻi ma o nā pathologies o ka ʻili biliary. ʻO nā kumu ʻē aʻe kekahi o nā hōʻeha o ka ʻōnaehana o ka hana, ka hopena kūwaho o kekahi mau lāʻau lapaʻau, a me nā maʻi o ka maʻi a me ka maʻi infectious.
ʻO nā kumu a me nā hana o ka pancreatitis hoʻonā
ʻO ka maʻamau, ma nā pancreas, hoʻoulu ʻia nā enzymes digestive i loko o kahi ʻano ʻole. Ma hope aku, ua komo lākou i ka ʻāpana, kahi i hoʻohuli ʻia ai i kahi ʻano ikaika, komo i ka hana hoʻokaʻawale ʻana i ka protein, momona a me nā mea i kālai ʻia.
No laila he aha ka pancreatitis maʻa? Ma muli o ka hoʻonā ʻana o ka pōmaikaʻi ma muli o ka hoʻōla ʻana o nā enzyme digestive, ʻo ia hoʻi, ke hoʻomaka nei lākou e hana i ke kumulāʻau iho, kahi e alakaʻi ai i ka nānā ʻana o kā lākou mau kiko.
ʻO Lipase, ke kuleana no ka uhaʻi ʻana i nā mea momona, ua loaʻa ke ʻano o ka hopena o nā pehu o ke kino, ma muli o ke ʻano o ka huli ʻana o ka momona o kēia mau mea. ʻO ka trypsin hāmeʻa (hoʻohele i nā mea momona) e hoʻonāuki i ka ʻano like ʻole o ke kūmole i ke kuʻi ʻana, ʻeha a me ka ʻeha. ʻO ka hiki ʻole ke hāʻawi aku i ka mālama olakino hiki ke hopena i ka make.
ʻO kēia mau hopena i ke kino o ke kanaka e alakaʻi i ka nui i loko o ka nui i loko o ka nui o ka nui, ka puka me ka necrotic foci i loko o kāna mau ʻā (make nā mea make). I ka hoʻomaka ʻana o ke kaʻina pathological, ua ʻike ʻia ka make me ka aseptically (ʻaʻohe hewa), akā me ka hoʻomohala o ka maʻi e hui pū ai, e alakaʻi ana i ka necrosis purulent, ka hoʻokumu ʻana o ka foci me nā ʻike purulent. I ka hihia hope loa, pono ka hoʻopiʻi ʻōnaʻi koke.
ʻO nā kumu i alakaʻi i nā hopena kūlohelohe o nā enzymes:
- ʻAkohola inu wai;
- ʻO ke ala o nā kiko biliary (ma ka hapanui o nā kiʻi pena he cholelithiasis);
- Mea hōʻehaʻeha;
- ʻAno ʻai maikaʻi ʻole (ʻai kīpī ma ka ʻōpū ʻole);
- Nā kaʻina hana Endoscopic i ka mea ua hōʻeha ka pancreas;
- ʻO ka lawe ʻana i nā lāʻau lapaʻau i nā papa kiʻekiʻe, kahi e hoʻonā ai i ka hopena o nā mea hoʻohāʻe. ʻO ka Metronidazole, tetracycline, a me nā lāʻau lapaʻau'ē aʻe e hoʻopilikia i ka lepa;
- Nā kuʻuna o ke ʻano endocrine. No ka laʻana, hyperparathyroidism.
ʻO nā maʻi maʻi a me nā maʻi maʻi like e like me ka herpes simplex virus, mycoplasma, etc. he hopena koʻikoʻi ma ka pancreatic tissue, i ukali ʻia e kahi hana purulent a me ka hoʻomaka ʻana o ka pancreatitis maʻa.
Nā hōʻike haukapila
Hoʻonui wikiwiki ke ʻano o nā hōʻailona o ka pancreatitis. Hōʻike ʻia ka hoʻouka ʻana me ka ʻeha o ka herpes zoster. He mea hōʻeha ma ka ʻākau a hema hema paha ka hypochondrium, kahi wahi i hoʻopuni ʻia. ʻO ka ʻeha kekahi waiwai o ka hāʻawi ʻana i ka ʻaoʻao hema o ke kua, ma lalo o nā ʻūhā poʻohiwi.
Hoʻomaʻau mau ʻia ka ʻeha. ʻOiai ke kūpaʻa ʻana o ke ʻano o ka mālama ʻana, hoʻomau lākou no kekahi manawa, a ʻaʻole loli ka ikaika. ʻO ke kumu koke o kēia hōʻailona, ka make ʻana o nā io palupalu a me nā aʻa o nā pancreas.
Me ka loaʻa ʻana o kahi hōʻeha ʻeha o ke kaʻina hana maʻi i ka hoʻopalapula, ma kekahi mau mea maʻi ua hoʻemi ʻia ka mea momona, aʻo nā poʻe ʻē aʻe ke kaohi i ka meaʻai. ʻO kēia kahi hopena o kahi hemahema i ka hoʻopauʻana o nā enzyme digestive i loko o nā mea palupalu.
Nā hōʻailona ʻē aʻe:
- Nausea, ma hope o ka lua, a hiki ke hoʻohālikelike ʻia e ka ʻai. ʻO ka pathogenesis o ka hōʻailona ma muli o ka nele o nā māhele enzyme e pono ai no ke kaona maʻamau o ka hoʻoili ʻana i ka meaʻai. ʻAʻole lawe ka mapu i ka hoʻomaha. ʻO ka mua, ma ka luaʻi, aia nā ʻāpana o ka meaʻai, ma hope o ka luaʻi wale nō ka bile.
- Inā hoʻomohala ka mea maʻi i ka nui purulent i ka pancreas, a laila ʻike ʻia nā hōʻailona haukapila o ka hoʻomālamalama. E piʻi ke ea o ke kino i nā ʻāpana he 38 i hala, me ka ʻākio, ʻekahi. Hele pinepine ka pulse - ʻoi aku ma mua o 90 mau beats i hoʻokahi minuke, ua uhi ʻia ka ʻili me ka puʻu paʻa, ke ʻoi ke anu. Nui ka māhā pinepine a me ka hanu.
- Me nā ʻeha koʻikoʻi, ʻike ʻia kahi hōʻailona o ka pīhoihoi - ke emi nei kēia i ka kahe o ke koko.
- Ua hāmama ka ʻōpū ʻōpū o luna, no ka mea, ʻo ke kaʻina o ka kūhai ʻana.
- Maʻa ka ʻili o ke ʻano, uhi wale ʻia kekahi manawa.
Ma ka palpation, ua paʻa ka pā o ka ʻōpū. Hōʻike ʻia kahi hōʻeha hōʻeha e nā hōʻailona o cyanosis, i hele mai ma muli o ka hoʻemi ʻana o ka nui o ka neʻe kahe i loko o ke kino, ka huakaʻi a me ka maʻi maʻamau.
Inā ʻaʻole i kōkua ʻia ka mea maʻi e make ia.
Naʻi hoʻolika
ʻAʻole hiki ke mālama kūʻokoʻa ʻia kahi hōʻeha ma ka home. ʻAʻole hiki i nā Painkillers ke hōʻoluʻolu i ka ʻeha, ʻaʻole i hoʻopilikia i nā kumu kumu o ka maʻi pathological. Pono ka mea maʻi i ka maʻi paʻa ʻana a me ka mālama ʻana ma hope o ka maʻi pancreatitis ma ka haukapila.
Hoʻololi ka hele ʻana o ka maʻi ma ke ʻano, no ka mea ʻo ke ʻano o ka maʻi ʻaʻihaʻi e like me kekahi mau ala o ka nē a me ka pēpē o ka pehu. Ma ke komo ʻana i ka haukapila, hoʻokō ʻia kahi hōʻike kino kino, ka ʻōpū o ka pā o ka ʻōpū. Loaʻa kahi pau ʻole o ka piʻina o ka ʻōpū.
Lawe ʻia kahi hōʻike koko ākea, e kōkua ana e ʻike i nā hōʻailona ʻole i ʻike i ke ʻano o ka hana ʻoi ʻana. Ua hoʻonui ʻia ka piʻi ʻana o ka leukocytes, ke piʻi ʻana o ka erythrocyte sedimentation rate i loko o ke koko koko.
Hōʻike ka hōʻike koko biochemical no ka hōʻeha ʻana i ka huakaʻi.
- Hoʻonui nui ʻia ka ʻike amylase;
- Ke pāpālua ʻia ka ʻaʻī o ka lipase;
- ʻO ka ulu kō i loko o ke kino;
- Ua hōʻemi ʻia ka ʻikepili āpau;
- Kūleʻa ʻo Urea i ke koko.
Ma muli o ka hoʻopiʻi indomitable, ʻike pinepine ʻia nā hōʻailona o ka maloʻo. Hoʻoholo ʻia ka haukapila e ka hoʻohaʻahaʻa o ka kalaiʻa, potasiuma a me ka sodium i loko o ke koko. Ma kahi hoʻouka hoʻouka, hoʻonui ka nui o ka amylase i ka urine.
Hōʻike ka ʻike ultrasound o ka pūpū i loko i ka maʻi o ka nui o ia mea, he echogenicity heterogeneous, nā palena ʻole, ʻike ʻia ʻana o ka wai o ka ʻawaʻawa ma hope o ka peritoneum.
Inā ʻaʻole ʻae ʻia nā ala i wehewehe ʻia e hoʻopaʻa me ka pololei o ka pau ʻana o ke ʻano o ka mea maʻi ma muli o kahi ʻano o ka hoʻouka ʻana o ka pancreatitis maʻa, ua hoʻohana ʻia ke ʻano laparoscopic. Hiki iā ia ke hoʻomaopopo i nā huaʻōlelo ma hope o ka maʻi.
- ʻO ka wai hemorrhagic.
- ʻO nā kiko ma ka peritoneum a me nā pancreas.
- ʻO ka pīpī liʻiliʻi ʻana i ke kahe o ka peritoneum.
Nā hōʻailona hōʻailona ʻole e hōʻike ana i ka hoʻomohala ʻana i kahi hōʻeha kūkaʻi i komo i ke aʻalolo ʻana i ka puʻuwai, paresis o ka ʻōpū, ka huehue ʻana o nā aʻa o ka ate.
ʻO ka lāʻau lapaʻau
ʻO ka hemahema o ke kōkua ma kahi hoʻouka huikau he momona. Lawe ʻia ka mea maʻi ambulance i ka ʻōna mālama mālama kino, ʻike ʻia, hana anesthesia. Ma hope o ke kūpaʻa ʻana, hāʻawi ʻia ka mālama kūpono ʻana i ka hōʻike ʻana i nā hōʻike lapaʻau a me nā hoʻopiʻi hiki.
I ka wā mālama, hāʻawi ke kauka loea i ka pōloli. ʻAe kēia e hoʻoemi i ka ukana mai ka pancreas inflamed. Ma hope o ka hoʻonā ʻana, kuhikuhi ʻia nā meaʻai meaʻai. ʻO ka papaʻai e ʻai wale ana i ka ʻai a me nā meaʻai lau.
ʻO nā mea hōʻeha maoli no ke kōkua ʻana o ke kaumaha ʻaʻole e hāʻawi i ka hopena i makemake ʻia. No ka hōʻoluʻolu ʻana i ke ʻano o ka mea maʻi, hana ʻia nā ʻano blockage ʻano like ʻole, no ka laʻana, epidest anesthesia me ka hoʻolauna ʻana i nā mea kūlohelohe ma o kahi catheter.
E hoʻohālikelike, hoʻohana lākou i nā lāʻau lapaʻau e like me Baralgin, Tramadol. Inā maʻalahi ka maʻi ʻeha, a laila lawelawe ʻia ka No-shpu. E hoʻomaikaʻi i ke kahe koko i loko o ke kino, e mālama ʻia nā lāʻau lapaʻau:
- Hemodez;
- Reopoliglyukin.
I mea e pale ai i nā hopena maikaʻiʻole, hiki i ka exacerbation o cholecystitis, ka mea maʻamau ke kumu o ka hoʻomohala ʻana i kahi hōʻeha hopena, pono ʻoe e hōʻalo i nā huina o ke kino. No kēia, hana ʻia ka diuresis ikaika, ma hope o ke kuhikuhi ʻia o ka diuretic Lasix.
E hoʻihoʻi i ka wai o ka wai a me ka electrolyte i loko o ke kino, ua hoʻolauna ʻia nā hoʻonā i loko o intravenously, ʻo ia ka paʻakai ma kā lākou hui. ʻO nā hōʻailona o ka pīhoihoi (haʻahaʻa i ke koko haʻahaʻa) e hoʻopau me Albumin.
I mea e pale ai i nā hoʻopiʻi septic a me ka peritonitis, hoʻohana lākou i nā mea maʻi antibacterial o kahi ākea ākea o ka hoʻolaha - Metronidazole.
No ka hoʻēmiʻana i ka synthes o nā huina o ka digestive, ka hoʻohana ʻana o statins (somatostatin), nā protease inhibitor hou (Gordox). Hoʻomaopopo ʻia nā lāʻau antisecretory (hiki iā ʻoe ke lawe iā Omez no ka pancreatitis) - kōkua lākou i ka hōʻalelewa ʻana i nā ʻike o ka ʻōpū, no ka mea, ʻo ka wai hydrochloric he mea hoʻoikaika ikaika i ka hana ʻana o nā kūnaehana hoʻoneʻe.
Inā hoʻololi ʻia ka pancreatitis i kahi hāhā o ka hoʻopiʻi purulent, a laila koi ʻia ke keʻakeʻa kiriri. Hana ʻia ia ma lalo o ka hana maʻamau a me ka ulu ʻana o ka māmā. I ka wā e hana ai, ua hoʻōho ʻia ka ʻōpū "make".
ʻO nā hopena o kahi hoʻoulu kaua
Kekahi hopena hōʻeuʻeu e alakaʻi i ka hoʻomohala ʻana o nā pilikia lehulehu. Aia ma muli o kā lākou manawa i kau ʻia ai, helu ʻia lākou i ka hopena maikaʻi a i mua. Hiki i ka mea kahiko ke hoʻomohala i ka manawa like me nā hōʻailona mua o nā patologi. Ua kau ʻia lākou ma ka hoʻokuʻu ʻana o nā enzyme digestive i loko o ka ʻōnaehana ka ka puni. Hoʻomohala nā hopena hoʻopiʻi ma 1-2 mau pule, ma muli o ka maʻi lua.
Kūkulu ʻia ka pīhoihoi hypypolemic i ka emi ʻana o ka nui o ka neʻe i loko o ke kino o ke kanaka, a ma ka hopena o ka huakino a nā huina. ʻAʻole loaʻa nā ʻōpala āpau i ka nui o ka oxygen e pono ai no ka hana maʻamau, hiki i kahi ʻano nui o ke kīhāpai o ka lawa ʻole.
Ma ka ʻaoʻao o ka ʻōnaehana o ka honi, e hoʻomohala ai ka pleurisy o ka puka exudative, ka hoʻopiʻi ʻana o ka ea, hāʻule ka pūpū o ka ʻōpū. ʻO nā ʻōlapa mua e ae i ka:
- Hōʻaha ka maikaʻi ʻili. I nā kiʻi kiʻi māmā e hōʻike ʻia ana e ka jaundice obstrate. Ma kahi hihia koʻikoʻi, hele mai kahi ʻano hopena o nā maʻi hepatitis. ʻO ke kumu kahi ka pīhoihoi a me nā hopena o nā hana o nā kinina. Ma ka pilikia he poʻe maʻi e loaʻa iā ia ka mōʻaukala o kekahi maʻi pepeka - kahi kiʻekiʻe nui o ka make.
- ʻO ka nele o Renal (hoʻokūkū like like me ka hāʻule ʻole o ka ate).
- ʻO ka hōʻinoʻana i nā hana o ke ʻōnaehana cardiovascular.
- ʻO ke koko hoʻoneʻe.
- ʻO ka Peritonitis kahi hana maʻi i loko o ka ʻōpū o ka ʻōpū. Hele ʻia nō me ka ʻole o ka maʻi ʻa ʻole a maʻemaʻe paha.
- Hoʻokumu nā maʻi noʻonoʻo i ka hopena o ka pale kino ma muli o ka loaʻa nui o ka maʻi.
ʻO ka hanana i hala ka hopena me ka hoʻoilo o ke koko, ka ʻōpū o ka purulent i loko o ka ʻōpū o ka ʻōpū, ka hoʻomaʻemaʻe ʻana o ka maʻi o ka pancreas, fistula formise, pancreatic necrosis.
Pākuʻi ʻia no ka pancreatitis ma muli o ke ʻano, ka lawa a me ka wā kūpono o ka mālama ʻana, ka hele ʻana / ka hala ʻana o nā ʻōmole mua. Me kahi ʻano pale o ka hoʻouka, maikaʻi ʻia ka prognosis. Inā loaʻa nā lesil necrotic a hemorrhagic paha, a laila piʻi nui ka hopena o ka make i nā manawa he nui. ʻO ka pilikia kūponoʻole a me ka ʻole hoʻokō ʻole ʻana i nā ʻōlelo a ke kauka a me ka meaʻai i alakaʻi i ka ulu ʻana o ka mumū palepa i ka pancreas - pancreatitis maʻi.
Hāʻawi ʻia ka ʻikepili e pili ana i ka pancreatitis ma ke wikiō ma kēia ʻatikala.
