ʻO ka pancreatic necrosis he maʻi nō ka pancreas, ka mea i hōʻike ʻia e ka make ʻana o nā ʻiola. Hele ia ma muli o ka hoʻowalewale ʻana pono o ka kelepona (autolysis) e nā ona ponoʻani.
I ka manawa pinepine ʻo ka pancreatic necrosis me peritonitis, i hui pū ʻia me nā hana ʻeha i loko o ka ʻōpū o ka ʻōpū a me nā ʻōmuu like ʻole. Hiki ke helu ʻia ka necrosis pancreatic he maʻi kūʻokoʻa, a me kahi hoʻopiʻi koʻikoʻi o ka pancreatitis o ka maʻi. Ma muli o kahi maʻi ʻokoʻa, hōʻike pinepine ʻia ka poʻe ʻōpio.
Hoʻokaʻawale ʻia nā ʻano ʻehā o ka pancreatic necrosis:
- ʻO ka nui o ke kaʻina hana he kiko (palena) a pālahalaha loa.
- E like me ka heleʻana o ka maʻi i ka pancreas i hoʻopuni ʻia, he paʻakai (uninfected) a me ka pā i ka maʻi.
Ua hoʻokaʻawale ʻia ka ihrosis pancreatic sterile i loko o ka hemorrhagic, ka mea i hōʻike ʻia e ke kaʻe o loko, a momona a kāwili, ʻo ia ka mea maʻamau.
ʻO ka papa pono o ka maʻi e pili ana a me ka holomua.
Aia kekahi mau kumu kumu no ka hoʻomohala ʻana o ka maʻi.
ʻO ka mea maʻamau e hoʻopiʻi nei i ke kūlana o ka pancreas a me ka hoʻomohala ʻana o ka ʻānō he hoʻomake i nā manawa lawaiʻa lōʻihi.
Ma kahi o kēia, ʻo kekahi o nā kumu nui o ka mai ka maʻi e hiki ai ke uhaki i ka meaʻai, ka momona nui o nā momona a me nā mea ʻai aniani.
ʻO ka mea, ua noʻonoʻo ʻia nā mea pili i ka pilikia:
- nā huʻu uila a i ʻole nā pōpoki i ke kino;
- ʻōpū ʻōpū a i ʻole ulī duodenal;
- mea ʻōpala
- kaʻaila mua ʻana a me nā hōʻeha paha o ka ʻōpū;
- nā maʻi i loaʻa i ka maʻi gastrointestinal;
- hoʻohana lāʻau.
Ma hope o ka hūnā ʻana i kekahi o nā kumu a nui paha, hiki i ka neho ana o ka pancreatic, kahi ʻekolu o ka ulu ʻana.
- Toxemia - i kēia hihia, nā mea make i hoʻokuʻu ʻia e nā huapuni e hoʻopuni i ke koko.
- ʻO kahi hemo he palena iki o ka pancreas a i kekahi manawa nā hui a pili me ia.
- Hoʻololi maikaʻi - i loko o ka kelepona a me nā pili pili kokoke.
Wahi a nā palu o ka necrosis, loaʻa nā ʻano ʻano:
- ʻeha - ʻo ka mea pinepine ka mea maʻi e wehewehe nei i kahi ikaika loa, hiki ʻole ke hoʻokaʻawale, akā hiki ke hoʻemi inā e moe me kou mau kuli i paʻa i kou ʻōpū;
- ninini
- makaʻi - ʻaʻole i pili i ka hoʻohana ʻia ʻana o ka meaʻai, aʻo ka mea huʻu mai ke aniani i nā maʻi mucous blood, akā ʻaʻole ia i hoʻomaha;
- hana pāʻālua
- ʻulaʻula mua, a laila me ka pallor o ka ʻili;
- hyperthermia;
- ʻūwā;
- Tachycardia koʻikoʻi;
- ke ʻano o nā ʻōpū ʻulaʻula ma luna o ka ʻōpū, nā ʻoki a me ke kua;
Ma hope o nā lā 5-9, ʻo peritonitis a me ka hemahema o nā ʻōnaehana a pau.
ʻO ka mea mua, ua kuhikuhi ʻia ka mea maʻi i ka hoʻomaha hoʻomaha o ka moena, ke kapa wikiwiki. ʻO ka pahuhopu nui o ke kauka e hoʻōki i ka maʻi ʻeha.
No kēia pahuhopu, hoʻokomo ʻia nā poʻe pena lāʻau a me nā antispasmodics. No ka hoʻokuʻu ʻana i ka hana huna o ka pancreas, ma muli o ia, ʻo ka luku ʻia ana, ʻo ka mea hoʻomanawanui i kuhikuhi ʻia i nā hoʻomākaukau antienzyme.
ʻO ka mea kaulana loa iā lākou a hoʻohana nui ʻia i ka lāʻau lapaʻau ʻo Kontrikal (ʻo kona inoa ʻē aʻe ʻo Trasilol lāua ʻo Gordoks). ʻO ka hana hope aʻe e hoʻopili hou i nā wahi o nā wai o ka wai i nalowale i ka wā o ka luaʻi nui. No kēia, ua hoʻonā ʻia nā hana kuʻuna i loko o nā hoʻonā colloidal. Pono nō hoʻi e hōʻemi i ke kumuʻai i ka pā palau - e hoʻopili i ka hau. Nā maʻi antibiotics kauoha - e luku i ka flora maʻi.
Inā ʻaʻole pono ia nā lāʻau āpau, ua loaʻa mai kahi maʻi o ka pancreas a i ʻole ka laha ʻana o ke kaʻina i nā ʻaoʻao kokoke a me ka peritoneum (peritonitis), hōʻike ʻia ka hoʻōla pālaʻi.
Hoʻohana ʻia nā hana me ka pancreatic necrosis i ka minimally invasive a wehe, aiʻole pololei.
Hoʻohana ʻia nā hana minimally e hoʻohana wale ʻia inā he palena ʻokoʻa wale nō ka lawehala o ka pancreas i hana ʻia i ka necrosis, akā hiki ke hana nui.
Ma ka pūnaewele o ka lesion, hōʻiliʻili ʻia ka wai a me ka ʻōpala make, kahi e hoʻoneʻe ʻia. Hoʻouna ʻia nā kelepona ma hope o ke kaʻina hana no nā maʻi bacteriological, histological a me biochemical Studies.
Hoʻākāka kahi hōʻike bacteriological i ke kuana mai o nā maʻi pathogen i loko o ka palupalu, ʻoiai ʻo ka loiloi histological e hoʻoholo ana inā aia nā cell atypical i hiki ke lilo i ke kanesa, a me ka ʻike loea i nā mea hoʻonaninani i hoʻopuka ʻia ma kahi biochemical. Ke hana ʻia nei ka hana ma lalo o ka mana o ka ultrasound.
ʻElua mau ʻano o ke kikowaena minimally invasive:
- Punctuation - kahi wehe hoʻoiho o ka exudate mai ka lula i hoʻopili ʻia. Hoʻopiʻi ʻia ia ma ka hihia o ka necrosis pancreatic uninfected. Hoʻomaʻamaʻa, ma hope o kahi puncture, ʻaʻole i hoʻokumu ʻia kahi wai hou.
- ʻO ka lepo ka hoʻonohonoho o ka pono kahi e kahe kahe a holo. Aia i ke kūlana o ka mea maʻi, hiki i kahi ʻāpana o ka hōʻino i ke kino, hiki ke kau ʻia i kahi lehulehu o nā kahawai o nā ʻano like ʻole a me nā diameters. Ma o ka lihi ʻana i kau ʻia, holoi ʻia nā pancreas me nā maʻi me nā antiseptics. Hoʻohana ʻia kēia ʻano kumu no nā necrosis kelepona i loaʻa, a inā ʻaʻole i lawe mai ka hopena i ka hopena i makemake ʻia.
Me nā hana hoʻopunipuni maʻamau o ka peritonitis akehu, ua koi ʻia nā mea kauka e hoʻomaʻamaʻa i kahi hōʻiliʻili kaʻa.
Ua wehe ʻia ka wehe ʻana i ka maʻi pancreatic necrectomy, i.e. ka hoopau ana i na pauku make. Inā ulu ka necrosis ma muli o nā pathology o ka tractary tractal, a laila hiki ke hoʻopauʻia. I kekahi manawa he pale o ka pala a palau paha ka spleen.
Inā hui ʻia ka necrosis pancreatic e ka peritonitis, a laila holoi ʻia ka lua ʻōpū o ka ʻōpū, a pono pono ke kau ʻana o nā ʻano wai.
Hoʻohana ʻia nā hana wehe me ka laparoscopy. ʻO ka moʻoʻo o ka hana ka ʻikeʻike piha o nā hana i lawe ʻia. No ka hana ʻana i kēia, ua hoʻokomo ʻia nā kāmelo ma o ka incision liʻiliʻi i loko o ka ʻōpū o ka ʻōpū, a ua hōʻike ʻia nā mea a pau e kū nei i nā hana lehulehu i ka pale kāʻei.
Hoʻohui hou me ka laparoscopy, hoʻohana ʻia ka pancreatomento-bursostomy - kahi waiho kūikawā e wehe ana i kahi maʻa ma hope o kahi laparotomy e komo ai i ka pancreas ma kahi bursa omental e wehe.
ʻO ka awelika huakaʻi maʻamau no ka necrosis pancreatic he 50%, kahi hōʻailona ka neʻe mai 30 a 70%.
Pono e hāʻawi ʻia nā mea hoʻopiʻi e mālama ʻia i ka mālama ʻana i ka manawa kūpono a me ka pono.
Ma hope o ka maʻi, hoʻopiʻi wale ʻia ka hana exocrine o ka pancreas, ʻo ia hoʻi, ua kau ʻia ka ʻike huna ʻana o nā ʻāpana digestive.
Ma ka manawa like, ʻo ka hana o ka endocrine ka mea maʻamau - nā hormones e hoʻoponopono i ke pae o ka glucose i loko o ke koko (insulin, glucagon) e hoʻopili pololei ʻia.
ʻO nā huaʻōlelo aʻe o nā maʻi ma luna nei e hiki:
- kūwili ʻana;
- kaʻeha maʻi mākia i loko o ka pancreas;
- i kahi hapa o nā hihia - diabetes;
- hiki ke kūleʻa ʻia nā cysts hewa i loko o ka wahī;
- ka nānāʻole i ka nui o nā lipids i ke koko;
- nā pōhaku i nā papahele.
Hiki i nā nekrosis pancreatic hiki ke loaʻa:
- ʻO ka momona;
- ʻO nā maʻi ʻoliʻoli;
- Kauaʻawaʻawa ola;
Eia kekahi, ʻo ka hōʻola hou ʻana o ka maʻi e hiki ai me ka hōʻino o ka momona a me nā meaʻai ʻai.
Ma hope o ka hana, pau ka mea maʻi i ka hiki ke hana no nā lā ʻekolu a ʻehā paha mau keu. ʻO ke ʻano o ka manawa postoperative e pili ana i ka makahiki o ka mea maʻi (hikiʻole i nā poʻe ʻelemakule ke hoʻomanawanui i kēia mau kaʻina hana, ʻo ia ke kumu he nui ka hopena o ka make), ka uha o ke kūlana, a ʻo ka mea nui loa, ma ka mālama a mālama pono ʻohana a me nā hoa aloha.
ʻO nā lā ʻelua ʻelua, ʻo ka mea maʻi e pono i loko o ka hānai mālama koʻikoʻi o ka haukapila, kahi e mālama pinepine ai nā kahu hānai i ke koko, nā ʻike koko no ka glucose a me nā electrolytes, nā hoʻomaʻamaʻa i ka urine, e hoʻoholo i ka hematocrit (ratio o ka nui o nā kumuhana i hana ʻia i ka nui o ka plasma). Me kahi kūlana paʻa, ka neʻe ʻia ka mea maʻi i ka uarota i ka keʻena o ka ʻoihana nui.
ʻAʻole ʻae ʻia ka poʻe maʻi e ʻai i kekahi mea ma ka mālama koʻikoʻi. I ke kolu o ka lā, e ʻāpono ʻia ka paʻakai kīwī me nā palaoa, nā kāwili i hoʻomoʻi ʻia i ka hupa huila, ka laiki a me ka pīhoihoi o kāwula, protein omelet (hapa hapalua huaʻai i kēlā lā), ʻulu lau mau (ma ka lā ʻeono wale nō), ʻono kekeʻa, pata (15 g). I loko o ka hebedoma mua, pono wale ʻoe e ʻai i ka kīʻī ʻaʻa, a ma hope o ʻehiku a ʻumi paha hiki iā ʻoe ke hoʻolōʻihi iki i ka ʻiʻo a me ka iʻa. Hoʻokuʻu ʻia nā maʻi i ka home ma hope o 2 mau mahina.
I ka home, pono nā mea maʻi e hahai i kahi papaʻai, lawe i nā lāʻau lapaʻau hypoglycemic waha e hoʻoponopono ai i ke kiʻekiʻe o ka glucose koko, nā enzymes e hoʻomaikaʻi i ka hoʻowalewale ʻana, hoʻomaʻamaʻa ʻia ke kino kino a hele i ka physiotherapy.
ʻO nā mea nui o ka meaʻai ma hope o ka necrosis pancreatic:
- ʻai maʻamau maʻamau ka liʻiliʻi ma ka liʻiliʻi (ma ka liʻiliʻi 5 ma ka lā);
- ka hoole loa ana i na hana ino;
- ʻoluʻolu ke kīʻaha ʻawaʻawa (ma kahi wela a wela, no ka mea hoʻonāukiuki i ka ʻono o ka ʻōpū);
- hoʻolapalapa wale ʻia, ʻeha a ʻaihue ʻia iʻa ʻia i loko o ka ʻāʻī ʻana a i ʻole ka hoʻāla ʻia.
ʻO nā meaʻai i pāpā ʻia no ka necrosis pancreatic:
- ʻO ka papa i hoʻomoʻi ʻia me ka muffin.
- ʻOlua, ʻaila palaoa.
- ʻEluʻi
- ʻO ka momona momona a me nā iʻa.
- Maʻa momona, palaoa, paʻi a ʻālaʻi.
- Nā meaʻai momona.
- Nā ʻōpū i loaʻa i ka pala.
- ʻO nā mau momona.
- Hoʻoulu.
- Kāpē keʻokeʻo.
- ʻO nā huahana momona momona.
- Nā hua.
I ʻae ʻia e hoʻohana:
- berena laʻana;
- keke ʻaʻano kekāhi liʻiliʻi;
- waiʻu meaʻai ʻaila momona;
- durum palaoa pasta;
- aū lauʻaila ʻūlū;
- nā hue ʻole komo;
- ʻai ʻai a me ka iʻa;
- ka palaoa a me ka pipi;
Hoʻohui hou, me ka pancreatic necrosis, hiki iā ʻoe ke hoʻohana i nā kuki kīkē-ʻole i ka nui o ka liʻiliʻi.
Conservative a me na hana lapaau ana o ka pancreatic necrosis ua hui nui i ka prognosis.
Loaʻa ka manawa ola e pili ana i kanalima mau pakeneka. Pili loa ia i ka hopena o ka hana, e like me ka mea i ʻōlelo ai ma luna o ka wahine a me nā makahiki o nā mea maʻi, ma ka ʻano o nā hana o nā mea lapaʻau, ma ke ʻano o nā mea maʻi me ka meaʻai, a me ka hoʻokaʻina mau i nā lāʻau lapaʻau i kauoha ʻia.
Inā ʻai ka mea maʻi i ka meaʻai wikiwiki, nā uahi, inu i ka waiʻona, ʻaʻole e lōʻihi ka kala o kā lākou kala.
ʻO ke ʻano ola like ʻole e hiki ke hele i ka neʻe pinepine o ka nui o ka hoʻopale, a ʻoi paha ke kiʻekiʻe o ke kumukūʻai no ia haʻalele.
ʻO nā mea maʻi e hoʻomaʻamaʻa ana i ka hana maʻi no ka pancreatic necrosis e hoʻomau i ka hoʻomehana i kuhikuhi ʻia e ke kauka komo ʻana i ko lākou mau ola āpau, e hahai pono i kāna mau ʻōlelo aʻoaʻo.
Pono hoʻāʻo ʻia nā mea maʻi no ka glucose i ʻole e haʻalele i ka hiki ke hoʻomohala ʻia o ka maʻi mellitus o ka maʻi maʻi, kahi hōʻike maʻamau uʻi e aʻo i nā diuresis i kēlā me kēia lā a me ka pāʻana o ke ao a me ka urination, a kipa aku i kahi keʻena diagnostic ultrasound e ʻike inā aia kekahi mau maʻi ma hope o ka hana.
Inā loaʻa ʻoe i ka maʻi diabetes, he mea nui ia e hoʻomanawanui a hoʻokele i ka manawa a me ka lawe ʻana i nā papaʻaila haʻahaʻa.
ʻO ka pale aku o nā maʻi penei:
- ʻO ka mālama ʻana i ka manawa kūpono a me nā maʻi o ka ate (hepatitis, cirrhosis, hōʻemi momona) a me ka biliary tract (cholelithiasis);
- He ʻōlelo paipai paha ia e hōʻole i ka hele mai o nā momona, ka paʻakai, ka uahi, ka ʻili, ke kīpoki kai i loko o ka meaʻai a i liʻiliʻi paha kona hoʻohana;
- Pono e haʻalele i ka hōʻino maikaʻiʻole - ka waiʻona, ka tapaa a me nā lāʻau lapaʻau, no ka mea ua haʻi lākou i ka hopena o nā meaʻala i ka pehu a me ka pancreas;
- Pono e makaʻala i nā hōʻeha o ka ʻōpū o ka pūpū;
- Me nā pale mua o ka pēpē, pono ʻoe e kamaʻilio i kāu kauka;
- Hoʻololi ʻia ka hana hoʻoikaika kino e hana i kēlā me kēia lā;
Eia kekahi, pono e haʻalele ʻohi i ka hoʻohana a hōʻemi ʻana i ka hāʻawi ʻana i nā mea ʻawaʻawa ʻawa.
E pili ana i ka mikrosis pancreatic i wehewehe ʻia i ke wikiō ma kēia atikala.
