Ka maʻi pancreatitis me ka lawaʻole excretory: he aha ia?

Hoʻoulu ka pancreatitis maʻi me ka lawaʻole o ka exocrine me kahi kaʻina hana lōʻihi i ka pancreas (ma mua o 10 mau makahiki). Ma muli o ka hoʻololi o ka parenchyma me ka hoʻopili pili, hoʻoneʻe a ka hanu i ka hiki ke hoʻokō i ka hoʻoulu a me ka hana exocrine.

He maʻi koʻikoʻi ka maʻi no ka mea e alakaʻi ana i kahi mahele ʻāpana a hoʻopau paha i ka pancreas.

ʻO nā hōʻailona nui o ka pathology he mau maʻi dyspeptic, ʻeha o ka ʻōpū, ke kuʻina, ka pallor o ka ʻili, tachycardia, ka pōkole o ka hanu, hoʻemi i ka hiki ke hana, a me ka mau ʻana o ka luhi.

ʻO ka hōʻailona nui o ka mumū pancreatic a me ka hana kīnā ʻole o ka lawe ʻana i nā ʻona meaʻai undigested i loko o ka papa nui a me kahi hoʻohui o ka momona. ʻO ke kumu kumu o ka maʻi maʻi o ka hoʻopaʻa ʻana o nā feces. ʻO nā mea kūpono o ka lāʻau kūpono, nā meaʻai kūikawā, ke kō ʻana o nā mea hoʻohui a me nā blockers pump proton.

Hōʻikeʻike o nā maʻi pancreatitis Chronic

I nā 30 mau makahiki i hala iho nei, ʻo ka nui o nā poʻe maʻi e loaʻa ana i ka pancreatitis heʻoi aku i ka pālua. Ua wehewehe ʻia kēia ʻanoʻano e ka hōʻino ʻana i ka waiʻona, cholelithiasis, kahi ʻano hana ʻole ʻole, a me ka ʻai o ka momona a me nā meaʻai ʻai. Ua ʻōlelo ʻo nā kauka, ʻo ka pancreatitis he "ʻōpio": ke nānā ʻia nei ka pathology ma ka awelika ma ka 39 makahiki, ma mua o ka makahiki he 50 mau makahiki.

ʻO ka papa pancreas he mea hoʻonaninani a me nā mea kuʻi intrasecretory. ʻO ka neʻe ʻana o waho ka hana o ka wai o ka pancreatic wai, a ʻo ka neʻe i loko o ka hana ʻana i ka hormone.

Hoʻopuka ʻia ka pancreatitis me ka hoʻōla ʻana o nā huina o ka digestive ma loko o ka huʻu ponoʻī iho. ʻO ka hopena, hoʻomaka ke kino i ka "hoʻoliu ʻana iā ia iho." ʻO ka maʻi pancreatitis (CP) kahi ʻano maʻi i hōʻike ʻia e nā loli dystrophic i loko o ka pancreas. Me ka hoʻomau mau o ka pathology, fibrosis, nalowale a ʻaluhi paha nā acini (i nā ʻano hoʻonohonoho o nā pancreas), nā hoʻololi i ke ʻano o nā ducts, ka hoʻokumu ʻana o nā calculi i ka parenchyma i nānā ʻia.

Wahi a ICD-10, ʻoi aku ka CP o ka ʻānā waiʻona a me nā mea ʻē aʻe. Wahi a nā ʻano like ʻē aʻe, aia ka biliary-depend, parenchymal-fibrous a obstructive CP.

ʻAʻole e like me nā kūlohelohe, ke ʻano pono o ka maʻi he kiʻi haʻahaʻa haʻahaʻa a i ʻole me nā maʻi concomitant, no ka laʻana, ka ʻeha a me nā ʻōpū duodenal, cholecystitis, biliary dyskinesia, etc.

ʻO nā hoʻopiʻi ʻana o ka mea maʻi e loaʻa ʻana i ka maʻi pancreatitis maʻi e pili ana:

• ʻeha nā hōʻeha ma ka hypochondrium pololei;
• ka hoʻonui ʻana i ka mīkini;
• haki o ka paila a me ke ano o ka awaawa;
• ʻeha ka maʻi dyspeptic.

Hoʻomaʻama pinepine, ma muli o ka hōʻino ʻana o nā lula o ka mālamaʻai ʻana i ka meaʻai i ke kūpaʻa o ka papa o ka pancreatitis kūlohelohe, ʻike ʻia ka maʻi, i mea e hōʻike ʻia ai ka pau ʻole o ka meaʻai. ʻAʻole hiki ke maʻi ʻia kēia maʻi, no laila e koi ʻia ka hoʻomau ʻana a me ka lawe ʻana i nā lāʻau lapaʻau.

Ka hapanui o nā mea loea e hōʻike i ʻelua mau papa o ka papa o ka maʻi pancreatitis /

ʻO ke ʻano I (10 mau makahiki mua) - ka hoʻohalike ʻana o nā exacerbations a me ke kala ʻana, ʻaʻole i hōʻike ʻia nā maʻi dyspeptic, aia nā ʻeha ma ka wahi o ka epigastric /

Stage II (ʻoi aku ma mua o 10 mau makahiki) - ka kōkua o ke kaumaha, hoʻonui ʻia ka maʻi dyspeptic.

Aia ia ma ka lua o ka papa ka ulu ʻana o ka pancreatitis maʻi me ka insufficiency excretory, kahi i hōʻike ʻia e kahi palupalu nui o ka pancreas.

ʻO nā kumu o ka hemahema o ka exocrine

ʻO ke kaʻina o ka "hōʻiliʻili ponoʻī" alakaʻi i nā loli dystrophic i ka parenchyma a me ka hoʻopiʻi ʻana o ka wai pancreatic. E kū'ē i ke kua o kēia mau kaʻina hana, ka mea i hoʻopaʻa ʻia, a i ʻole glandular, pancreatic tissue i hoʻololi ʻia e ka ʻōpala kiko. I ka hopena, ʻaʻole hiki i kēia mau ʻāpana o ke hana i ka hana exocrine.

ʻAʻole ia he kumu ʻo ka maʻi pancreatitis ʻaʻole wale ke kumu no ka hoʻomohala ʻana o ka exocrine insufficiency. ʻO kekahi kumu nui o kēia ʻanoʻano hiki i ka fibrosis cystic - kahi maʻi autoimmune e hoʻopā ana i nā kino e hoʻopuka i ka waiola kūlohelohe. Hoʻopili kēia i ka digestive tract, respiratory tract, pancreas, genitals, sweat glands, oral and hidal cavities.

ʻO ka pancreatitis kapa a me ka fibrosis cystic nā hana mua i loaʻa i ka hemahema o ka exocrine. ʻO nā hana o ka lua i loko o kona hoʻomohala ʻana i kahi kaʻina pathological kahi o ka hoʻopili ʻana i ka huina o ka huina a ka huina ma loko o ka duodenum 12, ʻaʻole e hoʻomaikaʻi i ke kaʻina hana o ka ʻai.

ʻO kēia ma muli o kā lākou hoʻōla ikaika, ka hana ʻole a me ka hōʻino ʻana o ka hoʻokaʻawale ʻana. ʻO ka pancreatitis me ka lawa o exocrine, kahi mea i kūpono no ke kekona, he mau hiʻohiʻona. Aia, ke ʻano o ke ʻano o kēia maʻi e like me ke ʻano o ka "scenario" nei.

1. Hoʻokomo ʻia ka membrane o ka ʻāpana liʻiliʻi i nā mea maikaʻi ʻole. A ke hopena, ua hōʻemi ʻia ka hana ʻana o ka cholecystokinin a me nā mea huna.
2. Ke hoʻonāukiuki kēia kaʻina i kahi hāʻule ʻana i ka pH intraduodenal ma lalo o 5.5. ʻO kēia ke kumu e hoʻohana ʻole ʻia ka enzyme pancreatic.
3. Aia he hōʻino i ka neʻe o ka meaʻai ma loko o ka pānaʻi liʻiliʻi. Hoʻomaka ka hana ʻole i nā enzyme digestive e hoʻohui me nā paleke o ka meaʻai e komo ai.
4. A ʻo kahi hopena, e hoʻomohala ke kaʻina o ke pala - kahi kūlana maikaʻi loa no nā huakaʻi pathogen. ʻO nā maʻi ʻē aʻe e hui pū me ka hoʻopiʻi o nā microflora kino. Ke hoʻonui nui ʻia o ka helu o nā huakini e alakaʻi i ka luku ʻia o nā enzyme digestive.
5. Hoʻomoe ka wai ʻai pancreatic, i hui pū ʻia me ka nele o ka hua bile a me ka enterokinase.

Ma ke ʻano he kānāwai, me ka hoʻoneʻe piha ʻana o ka pancreas (gastrectomy), ua pili nā mea ʻelua a me ka lua.

Ka helu ʻana a me nā hōʻailona o nā palola

Pono e helu ʻia nā mea huna pilikino e like me kekahi mau hōʻailona - nā kumu o nā patology a me nā maʻi concomitant.

ʻO nā hōʻike nui o ka lawa ʻole o ka ʻike huna ʻē aʻe:

1. Ke hoʻomanawanui nei i nā momona, nā iʻa a me nā mea i poki ʻia. Inā ʻai ka mea maʻi i kēlā meaʻai, ma hope o kekahi manawa e loaʻa iā ia ka kaumaha i loko o kāna ʻōpū. A laila hoʻohui ʻia nā kaumaha colic. Ma hope o ke kau ʻana i ka ʻōpū, ua nānā ʻia kahi papa mushy - ka hōʻailona nui o ka pancreatitis. Ma loko ʻike ʻoe e ʻike ai i nā haumia o ka moʻoʻala (momona) a me nā ʻikepili o ka meaʻai undigested. ʻO ka alapine maʻamau o ka hele ʻana i ka pahu he 3-6 mau lā i ka lā. Maikaʻi ka nui o nā momona a nā ʻaihue e waiho i nā hōʻailona ma ka lua, ʻoiai ua paʻakikī lākou e holoi ka wai.
2. ʻO nā hōʻailona o ka nele o nā momona-soluble huaora. Ma muli o ko lākou nāwaliwali, ʻike ʻia ka ʻeha o ka iwi i ka ʻili. ʻO ka vitamin D hypovitaminosis e alakaʻi i ka hoʻopiʻi, ʻKepae K - ke kue ʻana i ka coagulability o ke koko, ʻĀpana A - "ka makapō pō" a me ka ʻili maloʻo, ʻalemai E - ke hoʻemi i ka libido, nā maʻi maʻi.
3. Nā ʻōkuhi e pili ana i ka nele o ka protease pancreatic. Hoʻopuka kēia mau enzymes i nā protein. ʻO ko lākou hemahema e alakaʻi ai i ka anemia B12-deficiency, ka mea i hōʻike ʻia e ke kahe ʻana i ka hana hana, pōkole o ka hanu, ka pachor o ka ʻili, tachycardia a me ka wikiwiki wikiwiki. Ma muli o ka lawa ʻole o nā pono o ke kō, ua ʻike ʻia kahi emi wikiwiki i ke kaumaha o ke kino.

ʻO kēia mau kaʻina pili i pili i ka pākeke. I kona wā kamaliʻi, ʻo ka pancreatitis me ka hoʻokūkū o ka hana exocrine i ulu nui ʻole. Hoʻomaka ka huhū o nā mea maʻi no nā kumu ʻē aʻe - nā maʻi o ka ʻōpū liʻiliʻi, ka maʻi gallstone, nā hōʻeha ʻana o nā ʻōpū o ka ʻōpū, ka puʻuwai duodenal, ka hoʻopōmaikaʻi ʻana o nā pancreas a me nā kumuʻi pancreatic.

Nā hana Diagnostic a me ka maʻi maʻi

Ke ʻike nei i nā hōʻailona o ka palapiko pancreatic exocrine, pono ke kanaka e ʻimi i ke kōkua olakino.

ʻO ka nalowale o ka manawa kūpono hiki ke alakaʻi i ka hōʻino piha ʻana i ka pancreas a me kona lawe.

ʻO ke ala e ʻoi aku ka hopena ʻoi loa i ka maʻi maʻi. Kōkua ia i ka hoʻoholo i ke kiʻekiʻe o ka pancreatic elastase-1.

Hiki paha nā hopena o ke ʻano:

• 200-500 mcg / g - ka hana exocrine maʻamau;
• 100-200 mcg / g - ka maʻalahi a me ke kiʻekiʻe o ka exocrine insufficiency;
• ʻOi aku ma mua o 100 mcg / g - pathology koʻikoʻi.

ʻO kahi hana nui i ka mālama ʻana i nā maʻi he meaʻai. I waena o nā lula kumu o ka meaʻai kūikawā no ka phocrine insufficiency, pono pono e hoʻolauna:

1. ʻAʻole eʻoi aku ma mua o 4 mau hola.
2. Pono ʻoe eʻai i nā ʻāpana liʻiliʻi nā manawa 5-6 i ka lā.
3. Hōʻalo i ka ʻai nui ʻana i ka meaʻai i ke ahiahi a me ka pō.
4. E haʻalele i ka mea pīpī, nāʻaila a me nā meaʻai poki mai ka meaʻai.
5. E hāʻawi i ka makemake i ka meaʻai o ka mea kanu.
6. ʻAno kūʻokoʻa i ka inu ʻawa.

ʻO ke kumu o ka meaʻai i ka ʻai i loaʻa ka ʻai - ka lāʻau ʻai, nā hua ʻai, nā cereals. He mau kumu ia no nā kaʻai ai i nā meaʻai, nā huaora, nā huina maikaʻi a me nā mea macro. ʻAʻole ia i kauoha ʻia ka ʻai ʻana o nā meaʻai e like me ka legumes, kāpeti, ʻōpala, nā hua palaoa, ʻoiai lākou e hoʻonui aʻe i ke kūkulu kino ʻana i loko o ka ʻōpū.

Hoʻopili i nā lāʻau papaʻai, pono nā maʻi e lawe i nā lāʻau lapaʻau. ʻO ke kumu o ke ʻano o nā lāʻau lapaʻau:

1. ʻO nā enzyme Digestive e hoʻomaikaʻi i ke kaʻina o ka assimilation o ka meaʻai (Mezim, Pancreatinum 8000, Creon, Panzinorm). Lawe ʻia lākou i ka wā o ka pāʻina, ke hilinaʻi ʻia ka nui maʻa i ka nui o ka meaʻai e ʻai ai a me kona ʻano.
2. Nā mākena palaka proton e kōkua i ka hoʻokaʻawale ʻana i nā meaʻai (lanzoprazolol, esomeprazole, omeprazole). Hāpau ka hana o nā lāʻau lapaʻau e hana ana i ka hoʻokumu ʻana i kahi hopena alkaline i ka gastrointestinal tract kiʻekiʻe.

I kēia hihia, ʻaʻole pono nā lāʻau lapaʻau pilikino. Ma hope o nā kauoha a ke kauka, hiki ke loaʻa kahi hopena therapeutic maikaʻi. A me ka hopena, e hala ka eha o ka ʻeha a me ka maʻi o ka maʻi, a me ka loaʻa ʻole o ka momona o ka momona a me nā ʻōmole undigested i loko o ka papa. Mai ka manawa o ka manawa, ua hoʻomanawanui ka mea maʻi. Hōʻike ʻia ka normalization o ke kaʻina hana a kahi e hoʻemi ana i ka momona o ka momona ma nā feces a hiki i ka 7 g.

E kamaʻilio nā poʻe loea e pili ana i ka pancreatitis maʻi i ka wikiō ma kēia atikala.