ʻO ka pancreas kekahi o nā ʻōpū paʻakikī o ke kino o ke kanaka, ʻoi aku ka paʻakikī o ke ʻano he paʻakikī ke ʻike i ke ʻano hōʻola, a hoʻomaʻamaʻa ʻole ʻia ka hoʻōla ʻana i ka lāʻau.
He nui nā noiʻi o nā poʻe lapaʻau kūikawā, i hana ʻia e hoʻoholo ai i nā mea pili i ka hopena o ka hōʻeha ʻana o ka maʻi pancreatitis, e hōʻike i kahi kokoke i ʻelua mau kumu like ʻole. Eia nō naʻe, ʻo nā mea e hoʻonāukiuki nui i loko o ka cholelithiasis me ka hoʻohana ʻana i ka waiʻona.
Hōʻike nā hōʻike i hōʻike ʻia ka nui o nā poʻe maʻi i ka haukapila me ka loaʻa ʻana o ka maʻi pancreatitis aʻeha e loaʻa ana i ka hilinaʻi i ka ʻona. Wahi a kekahi mau ʻike, ma luna o 35% o nā mea maʻi me ka waiʻona me ka mōʻaukala o ka necrosis pancreatic a i ʻole nā mea hōʻeha ola.
E nānā i nā mea koʻikoʻi no ka hoʻomohala ʻana i ka pancreatitis maʻa, nā pathogenesis o ka maʻi, a ʻike pū kekahi i nā hana pale e kōkua ai e pale aku ai i ka exacerbation?
ʻO ka pathogenesis o ka pancreatitis maʻa
Hōʻike ka lāʻau lapaʻau i kekahi helu nui o nā mea kumu i ke kumu o ka hoʻomohala ʻana i ke ʻano o ka hopena o ka maʻi. No kahi hoʻomaopopo maikaʻi o ka etiology, pono e noʻonoʻo i ka pancreas hoʻoikaika.
ʻO ka mea kūloko e pili ana i nā kino o ka mea huna. Hana ia i kekahi mau hana. Hoʻokomo ka mea mua i ka exocrine, ma muli o ka hoʻomohala ʻana o nā enzyme digestive e hōʻoluʻolu i ke kaʻina o ke kūhao ʻana o ka meaʻai e loaʻa. ʻO ka lua hana he endocrine. Hoʻokumu ka pancreas i ka insulin hormone, nā mea pili i ka hoʻoponopono o ke kō i loko o ke kino.
ʻO nā enzyme pancreatic (lipase, protease a me amylase), me ka koena o ka mea huna, e komo i ka ʻōnaehana tubule, kahi e puka ai ka mea i waho o ka pancreatic duct. Kōkua nā Enzyme i ka haki ʻana i nā mea nui o ka meaʻai - nā momona, nā huapalapala a me nā polokalamu.
I mea e pale ai i ke kaʻina o ka hoʻowalewale ʻana o ka mea kūwaho o loko, hoʻohua ʻia nā proteases i kahi kūlana hana. Ma lalo o ka manaʻo o kekahi mau mea ikaika i ka duodenum, ua hoʻohuli ʻia ka maʻi ikaika, ma muli o ke ʻano o ia mea i kōkua ai e uhaʻi i nā pūmua protein. He hemahema ia o kēia kaulahao e hana ai i ka pathogenesis.
Ua hōʻike ʻo Pathanatomy i kekahi mau hana pono no ka hoʻomohala ʻana i nā ʻōnaehana maʻi o ka pancreas. E pili ana kēia:
- Reflux.
- Kahu okoa.
- Hertertensive.
ʻO ka hoʻololi ʻana ke ʻano maʻamau o ka loli o ka nui o nā maʻi pancreatic, i hele pū me kahi maʻi e pili ana i kā lākou hana. ʻO ka ʻokoʻa ma waena o kēia neʻe hoʻomohala ʻana ma muli o ka hopena maikaʻi o ka maka o waho, ʻaʻole ma nā mea kūloko. Hoʻomaka lākou i ke kaʻina o ka luku ʻana i nā cell. Hoʻopili ʻia nā ʻano mea like ʻole:
- Chemical - i nā mea make me nā mea kanu, nā mea alkaline, nā waikawa, nā paʻakai.
- Biological - kahi maʻi maʻi viral a maʻi ʻeha paha.
- Aʻo - trauma, ʻeha.
Me ka ʻano o ka hypertensive, ka piʻi ʻana o ka pilikia i loko o nā kumu pankreatic i ʻike ʻia i nā mea maʻi. Nui nā kumu no ke ʻano o ka pathological:
- ʻO ka hoʻomohala ʻana o ka maʻi ma muli o ka hōʻino o ka waiʻona a me nā meaʻai momona. ʻAʻole hiki i nā kumu kumu no kahi pōkole ke wehe aku i ka pihi huna o ka lula. I kekahi mau kūlana, kau ʻia ka pathogenesis o kēia ʻano maʻi e pili ana i nā hiʻohiʻona anatomical o kahi kanaka.
- ʻO ke kumu ikaika o ka hana paʻa ʻana o nā kumu papa pancreatic. ʻO ka hapanui pinepine ka hoʻopaʻa ʻana e ka ʻōpala i ke ahulau o ka maʻi gallstone a i ʻole e kaʻi ʻia e ka ʻūpī.
Me kahi ʻano reflux, hōʻike ka mea maʻi i kahi maʻi o ka bile i loko o ka papa pancreatic, ka mea e hōʻino ai i nā maʻi pancreatic.
ʻO ke kumu kumu o ka huina o ka ʻōpū, lawa i ke kani o ka sphincter o Oddi.
Nā mea hana e alakaʻi i ka hoʻomohala ʻana i ka maʻi palaki o ka huila
ʻO ka maʻi o ka pancreas ma ke ʻano o kahi kaʻina holokone i kahi kaʻawale aneane ʻaʻole i loaʻa ma ka hoʻomaʻamaʻa lapaʻau. Hoʻopili ka hao i nā ʻano kemika a me nā ʻōnaehana biochemical i loko o ke kino, ke ʻano ka hopena o nā maʻi like ʻole o nā kino kūloko, a ʻo ia hoʻi kahi o ka kūnaʻi ʻana.
ʻO ka pancreatitis ka mea nui a me ka lua. ʻO ke ʻano he ʻua ka mea nui loa, ʻoiai i ka hapa nui o nā kiʻi haumania, maʻi ʻia ke pancreatic e nā maʻi ʻē aʻe, no laila ke kamaʻilio nei lākou e pili ana i ka palua ma waena.
ʻO ka manaʻona no ka ʻoi loa o ka pancreatitis e hoʻoholo ʻia e nā ʻano he nui. Ua noʻonoʻo ʻia ka hui o ka mea maʻi (e ʻoi aku ka kiʻekiʻe o ka mea maʻi inā he ʻelemakule ma mua o 55 mau makahiki), nā maʻi concomitant, ka paʻa ʻana o nā leukocytes a me ka glucose i loko o ke koko, ke ʻano o ka maʻi (inā he exacerbation o ke ʻano maʻi i mālama ʻia).
Hiki ke hoʻokaʻawale ʻia nā mea pilikia no ka maʻi pancreatitis i kekahi mau hui kauka. ʻO ka pinepine, ʻo nā ala āpau i lilo i kumu i loaʻa ʻole ai ka mumū:
- Kuhi hewa ʻana o ka hana o ke ʻōpili. Hoʻololiʻa nā alaala: calculous, acute a chronic cholecystitis, cholelithiasis.
- ʻAno 2 mellitus mika.
- He thrombosis kīʻaha koko, ma muli o kahi o ka pancreas e hōʻeha mai ka hapa o ka oxygen a me nā mea pono kai.
- Bile duct paleʻino i ka ʻano congenital.
- ʻO nā maʻi o ka papilla nui o ka duodenum 12 (neoplasms tumor, nā hana hōʻihihi).
- ʻO ka maʻi o ke aʻalolo o nā akea hopuna (cirrhosis o ka ate, kekahi ʻano o ka hepatitis).
- ʻO ke kuʻuna o ka papa gastrointestinal o kahi papa maʻamau (colitis, nā maʻi Crohn).
- ʻŌnaehana kūloko; biliary dyskinesia ma kahi wahine hāpai; systemus lupus erythematosus; ʻōnaehana ʻōnaehana.
Hiki ke hoʻohui ʻia i ka papa inoa me kahi maʻi maʻi bacterial (syphilis, typhoid fever), sepsis, hoʻonaninani a me ka momona metabolism o ke kino, a me nā ʻōnaehana ʻōnaehana o ka kiko huina.
Ma ka lua e like me ka mea nui o nā mea kuhi hewa maikaʻi o ka mea maʻi. Hoʻopili kēia me ka waiʻona inu kino, ka uahi ʻana, kaʻai maikaʻi ʻole - ka nele o ka protein, ka ʻai ʻana i nā momona momona, a me nā mea ʻē
I ke kolu kahi nā mea hoʻopiʻi i hoʻohana ʻia e ka hoʻohana ʻana i nā lāʻau lapaʻau no ka manawa lōʻihi. ʻO kekahi kumu ʻē aʻe ke hoʻokō kūwaho.
ʻO ka hoʻohana ʻana i nā lāʻau lapaʻau e like me ka glucocorticosteroids, diuretics, sulfonamides, estrogens, Furosemide, Metronidazole, Tetracycline hiki ke hoʻonāukiuki i ka hoʻomohala ʻana o ka pancreatitis akamai.
Ke hoʻomaʻamaʻa ʻana i ke ake o ke ʻano o ka maʻi
I like me ka code ICD 10, hiki i ka pancreatitis ke ʻano o nā ʻano like ʻole. ʻO nā mea i hoʻopilikia kino i ka pancreas e alakaʻi i ka puka hou ʻana o ia ʻano i kekahi manawa a i kekahi ʻano maʻi paha. No ka mālamaʻana, pono ʻoe e maopopo i ke kumu.
ʻO ke kūlana kūloko i ka pancreatitis e hoʻoholo ʻia e nā kaulike: ka palahalaha o ke kāwili, me ka palpation, pain pain hōʻike ʻia ʻo ia iho i ka projection o ka pancreas. ʻO ka ʻōpū o ka ʻōpū, hōʻeha a hōʻeha i ka projection o ke ʻano i hoʻoholo ʻia e ka palpation. Hōʻike ke ʻano o ka ʻōpū i loko o ke alo o exudate i loko o ka ʻōpū o ka ʻōpū.
Ma kahi hōʻeha koʻikoʻi, hoʻopiʻi nā mea maʻi i nā hōʻailona: hōʻeha nui, kahi hōʻeha koʻikoʻi i ka mālama maikaʻi, hoʻomehana a me ka luaʻi, indigestion - ʻeha. Inā ʻaʻole ʻoe e hāʻawi i ka pākeke me ke kōkua o ka manawa, a laila hoʻonui ka hopena o nā ʻōpiopio like ʻole (no ka laʻana, ʻo ka pancreatic necrosis). I nā kuhi mua o ka mumū, pono ke kāhea ʻia kahi ambulance.
No ka noʻonoʻo ʻana, hoʻohana ʻia nā hoʻokolohua laboratory - kahi loiloi maʻamau o ka urine a me ka urine, kahi hōʻike koko biochemical no ka ʻike ʻana i ka amylase, trypsin, glucose. E like me nā hana kōkua, ʻo CT, MRI, radiography, ua hoʻohana ʻia ka ultrasound.
Ke lawe nei ka hana i kahi ʻano kūpono o nā maʻi ma ka haukapila. Ke kau aku nei i nā lāʻau lapaʻau me:
- ʻO ka maʻi infusion kahi ʻoihana intravenous o nā lāʻau lapaʻau e kōkua i ka hoʻomaʻemaʻe i ke koko o nā mea huʻala a me nā enzyme pancreatic.
- ʻO ka lāʻau lapaʻau ʻeha.
- ʻO nā paila e kōkua ana e uhaʻi i nā enzyme pancreatic (Gordox).
- Hoʻokomo ʻia nā mea kanu i ka hōʻemi ʻana i ka hana huna pancreatic (Atropine).
- Nā lāʻau antiemetic.
- Antibiotics, antispasmodics.
Hoʻokō kekahi kauka i kahi hoʻouka huikoa i ka ʻaina, kahi e hiki ai iā ʻoe ke wehe i ka pancreas, hoʻemi i ka kaumaha mai nā mea o loko. ʻO ka hoʻoponopono hou ʻana i ka pancreatitis e pili ana i ka lawe ʻana i nā lāʻau lapaʻau, e pili ana i ka meaʻaiʻai, a me ka hāʻawi ʻana i nā ʻano maikaʻi ʻole.
Kuhi ka helu helu ma mua o ka make ma mua o kahi mea hoʻomanawanui e hoʻomohala i kēlā mau hōʻeha - hemorrhagic pancreatitis, renal a me ka naʻau ʻole, ka hana ʻole a pau, pancreatic necrosis.
Kekahi hopena hoʻohālikelike paha e hoʻomaka. Loaʻa kēia pila ma muli o ke kumu i hoʻopili ai i ka pathology, a pehea hoʻi e hiki ai ke mālama ʻia.
Hiki i nā pilina ke alakaʻi i ke ʻano o kahi ʻano maʻi o ka maʻi.
ʻO nā kumu o ka pancreatitis hoʻonā
ʻO ka pancreatitis Parenchymal e hele pinepine ʻia me ka nele o nā mea huna o ka protein, ulia gastric, atherosclerosis o nā kīʻaha koko, nā maʻi maʻi maʻi - hepatitis viral, typhus, a me nā maʻi parasit.
ʻO ke ʻano biliary he hopena kūpono ia o nā pathologies o ka ʻōpala. ʻO ka pinepine, ʻike ʻia kahi noi hoʻowahāwahā a me ke ala me ka pohala o ke ana, kahi e hiki ai ke hoʻomohala i kahi hana hoʻonāukiuki. Ma muli o ka paʻakikī o ka pancreatitis e hilinaʻi pololei ana i ka maʻi ma lalo.
ʻO ka pancreatitis Alakika ma muli o ka hiki ke kīloi e hoʻopau i nā papa pancreatic. ʻO ka pinepine, e hele ana ka pathology ma kahi o ke kuʻuna o ka hana luhi, ka ulu ʻana o ka cirrhosis. E ola, pono pono e haʻalele ka mea maʻi i ka waiʻona. ʻO ka make mole he 30-40% o nā hihia āpau.
Nā kulana ʻē aʻe:
- Hoʻokomo ka hina i ka mumū o ka pancreas. I ka hapa hapa, ʻo ka pathology he asymptomatic. Hōʻike nā hōʻailona ma nā lā 4-6. I kekahi mau pena pena, hoʻololi ʻia kahi hoʻouka hakakā i ka papa lohi.
- ʻO ka cystic fibrosis he genetic pathology i hōʻike ʻia e kahi mutation o kekahi gen, e like me ke ʻano o ka huina o nā kolo a me nā ʻalā.
Maʻa pinepine ka pancreatitis. ʻO nā ʻōnaehana pilikia koʻikoʻi ka mea o ka cholelithiasis, inu inu nui, i ʻole e inu ana, a me nā maʻi concomitant o ke kūnaʻi.
Kāohi
Ma kahi hōʻeha hōʻeha o ka pancreatitis, he mea pono ʻole ia e hoʻomaha i nā hōʻailona wale nō, akā e pale pū ai hoʻi i kahi hōʻemi o ka maʻi i ka wā e hiki mai ana. Hōʻike nā loiloi o nā kauka e pili nui ana kēia ma ka mea maʻi.
ʻO ka mea mua, ke kuhikuhi ʻia e hāʻawi i ka ʻikina a me ka inu ʻaiwa. Hāʻawi kēia i ka hōʻemi ʻana i ka kaumaha i ke kao o loko. Ma ke alo o kahi ʻano maʻamau o ka maʻi, hōʻoia ka mea maʻi e pale i ka exacerbation o ia mea.
E like me ke keʻena pale, hoʻohana ʻia ka lāʻau kuʻuna. Hoʻokomo maikaʻi i nā hupa e pili ana i ka hips ma nā leaka, kahi kaula, chamomile i kahi lāʻau lapaʻau. Hoʻopuka ʻia kā lākou noi ma nā papa, kōkua lākou e hoʻihoʻi i ka pancreas.
Nā hana ʻē aʻe pale:
- Ka hana pilikino kino, holo, holo, e hele ana i ka lumi kaukau a me ka sauna hiki ke hoʻonāukiuki. ʻO ke koho kūpono no nā hoʻomaʻamaʻa kino ke hele ʻana, ka hoʻoikaika kino, ka ʻōpū, ka hoʻomaʻama ʻana o ka hana ʻana.
- ʻO ke kūlana o nā dile bile a me nā mea pōpilikia i pili i ka hana o ke pancreas. Pono e kūpono i ka mālama ʻana i nā maʻi, e hoʻomaʻamaʻa i nā hoʻokolohua pale.
- ʻO ka kūpono kūpono a me ke kau ʻana. ʻAʻole hiki iā ʻoe ke hōʻaiʻē - ʻo ia kahi ala pololei i ka exacerbation. Me ka exacerbation, hōʻike pinepine ʻia ka pololi me ka pancreatitis.
- Pono ʻoe e hōʻole i nā meaʻai momona a me nā momona, e ʻai i nā meaʻai i loaʻa i ke kahe lau - kāpeti, beets, kāloti. Me ka pancreatitis, nā huaʻai-waiū, nā wai e hoʻoluʻu i ka wai, a me nā meaʻai i hoʻohui ʻia i ka papa ʻaina.
ʻOiaʻiʻo, ʻaʻole hōʻoia ka pale i ka 100% e hiki ke pale ʻia ka hōʻoki ʻana o ka maʻi pancreatitis. Eia nō naʻe, nā hana maʻalahi i loko o ke ʻano o ke ola kino e hōʻemi pono i ka hoʻomohala ʻana i ka maʻi.
Ua wehewehe ʻia nā kumu kumu o ka pancreatitis i ke wikiō ma kēia ʻatikala.
