ʻO ka maʻi pancreatitis kahi hui o nā maʻi i hoʻopili ʻia me ka hana maʻamau o ka pancreas.
No nā maʻi i komo pū me kēia hui, ka loaʻa ʻana o ka foci o ka mumū a me ka necrosis i nā koena o ka huelo, ka mea i hele pū ʻia e ka segmental fibrosis, e alakaʻi ana i ka hana hewa ʻole o ka lula i loko o nā ʻano like ʻole o ka paʻakikī.
ʻO ka holomua a me ka exacerbation o ka pancreatitis kūloko e alakaʻi i ka hoʻomaka a me ka hoʻomohalaʻana i ka atrophy o ke kipi. Eia kekahi, e holomua ana ka fibrosis, a hoʻoliʻi ʻia nā sela glandular o ka parenchyma o nā mea e nā selika i hoʻohui ʻia.
ʻO nā kumu nui o ka maʻi
Hoʻomaʻamaʻa ka maʻi i ka neʻe i ka hoʻopau ʻana o nā enzyme pancreatic a me kā lākou intraorgan activation.
ʻO ka mea mua, hoʻāla ʻia ka trypsin a me lipase i kēia kūlana. ʻO kēia mau kaomi i hana i ka autolysis o ka parenchyma o ka luhi, hoʻomaikaʻi o ka hoʻopili a me ke ʻano o ka ʻāʻī. Ke hoʻohālikelike nei lākou a pau i ka sclerosis o ka lākona, kahi e alakaʻi ai i ke ʻano o nā haunaele i ka hoʻokō ʻana o ke kaila koko ma loko o ka pancreas.
ʻO ka mea nui loa i ka hoʻomohala ʻana o ka mumū nā autoaggression.
ʻO ke kumu kumu nui i ka hōʻemi i ka waiʻona.
Eia kekahi, ʻo ka ʻai o ka protein no ka manawa lōʻihi a me ka hoʻohana ʻana o ka taba hiki ke hoʻonāukiuki i ke ʻano o ke kino.
Eia kekahi, nā kumu o ke kaʻina o ke kaʻina hana i ka pancreas, kahi e hiki ai i ka pathology,:
- nā maʻi e pili ana i ka hana o ka ʻoihana biliary a me duodenum;
- maʻi maʻi pālolo;
- pathology i ka hana a i ʻole anatomy o ka sphincter o Oddi;
- duodenitis;
- ulia duodenal.
I mua o cholelithiasis a me choledocholithiasis, he nui ka mea i loaʻa i ka nui o nā wahine he 50-60 mau makahiki.
ʻO ka pinepine, ʻo ka hoʻomaka ʻana o nā maʻi maʻi me ka neʻe ʻana o ka metabolic syndrome, nā hōʻailona nui o ia ʻano.
- Nā ʻilima
- Hāpopo.
- Ke ulu nei i ka hypertension arterial.
- Maʻi maʻi Ischemic.
- Hōʻemi ʻia ka hoʻomanawanui i nā pale.
- Hāpiha
ʻO nā kumu i hōʻike ʻia he nui loa i ka wā o kahi maʻi.
Kēia luhi, akā hiki i ke kumu no ka maʻi.
- nā cystic fibrosis;
- kahi maʻi e pili ana i ka hele ʻana o kahi predisposition hereditary;
- idiopathic ʻano;
- autoimmune inflammation kumu;
- i ka mea maʻi i nā maʻi ʻōnaehana a me ka vasculitis;
- hana ʻino i ke kino e kekahi mau maʻi a me nā maʻi pathogenic;
- ka hoʻomohala ʻana o ka maʻi diabetes i ke kino;
- ischemic ʻano;
- nā mea uluʻole i ka anatomy o ka pancreas;
- ka hōʻeha ʻana i nā maʻi maʻi ma ka wahi o ka ʻōpala a me ka loaʻa ʻana o kahi lāʻau uhai.
Hiki i ke kaʻina ʻeha ke hoʻopau a hoʻopau wale paha i ka pōʻino o ke kino i ke poʻo a i ʻole ka ʻili.
Hoʻomaopopo nā kauka i nā ʻano o nā maʻi - edematous, parenchymal, sclerotic a calculous a fibrocystic.
Nā ʻano hana ʻano maʻamau
Chr. ʻO ka pancreatitis kahi maʻi holomua holomua e loaʻa ana i kahi ʻano maʻi.
Hoʻokomo ʻia ka Patrusion me ka hoʻokumu ʻana o nā nekrosis.
Nui nā papa o nā pūʻulu o nā maʻi e pili ana i ke ʻano maʻamau o ke maʻi pancreatitis.
I like nō me ka ICD, ʻikea nā ʻano o ka pehu ma lalo nei:
- Toxic a me ka metabolic.
- Idiopathic.
- Hoʻolaulua.
- Autoimmune.
- Hana hou.
- Nāʻaina.
- Puka mua
- ʻAno lua
E like me ka papa i kūkulu ʻia e M.I. Ua mahele ʻia ke ʻano o Kuzin i loko o kēia ʻano. - prim, post-traumatic and Second.
ʻO ke ʻano maʻamau o ka papaʻaina, ma ka ʻāpana e hoʻokaʻawale i nā ʻano e like me kēia:
- waiʻona
- ma muli o ka maleʻole o kahi meaʻai maikaʻi;
- hoʻōla;
- e kūʻē i ka hope o nā hemahema i ka hana kaohi;
- ʻtilelo ʻokoʻa.
Hoʻokaʻawale ʻia ka ʻano maʻi maʻi post-traumatic i nā ʻano:
- ʻO Post-traumatic, e kū i ke kua o ka mea maʻi e loaʻa ana kahi hōʻeha pancreatic wehe.
- ʻO Post-traumatic, e kū i ke kua o ka mea maʻi e loaʻa ana kahi pōʻino.
- E kūʻē ana i ke kumu o ka pōʻino o intraoperative.
Hiki ke hoʻokaʻawale i ke ʻano o ke ʻano ʻelua o ka hoʻōla ʻana i nā ʻoi pancreatic:
- cholangiogenic;
- lacphogenous cholecystopancreatitis, e hoʻomohala ana i ke kua o ke choldocholithiasis;
- inā e pili ana nā maʻi o ka gastrointestinal, e komo pū ana me ka duodenostasis primati a me ka lua, diverticulum duodenal, me ka holo ʻana o ka maʻi peptic, i ke alo o colitis;
- kahi maʻi e loaʻa ai nā komo o nā lālā o ka ʻōpū o ka ʻōpū;
- kahi maʻi i hele pū me ka endocrinopathy;
- pathology, i kūkulu ʻia ma ka hihia o ka hōʻike i nā mea eʻalani ʻē aʻe.
ʻO nā mea hou loa he papa i hoʻomohala ʻia e nā kauka Kelemania. Māhele ia i nā mea maʻi i nā pūʻulu e like me ka etiology, kahi a me ka nui o ka maʻi.
Nā hōʻailona hōʻailona o ka maʻi
Hoʻololi iki nā ʻano o nā maʻi pancreatitis i kēlā me kēia hihia a kau i ke kiʻekiʻe o ka hōʻino ʻana o ke aʻa a me kona wahi i hoʻopaʻa ʻia i ke kaʻina hana.
ʻO ka manawa pinepine, ka maʻi maʻi me ka manawa o ka kala a me ka exacerbations.
I ka wā o ka exacerbations, hoʻomohala ʻia ka mea maʻi i ka hōʻeha mau ʻana. ʻO kēia hōʻailona ka mea i kapa ʻia loa.
Hiki i ka ʻeha ke hoʻopau a ʻokiʻoki paha. I kekahi mau manawa, inā ʻaʻole i lawe ʻia nā lono kūpono i ka manawa kūpono, hiki i ka ʻeha ke hoʻonāukiuki i kahi mea hōʻeha i kahi kanaka.
Hiki i ke ʻae ʻana o ka ʻeha ma ka ʻākau a i ka hypochondrium hema. Aia ia i ke kahua o ka meaʻino kino. I ka hihia o ka hōʻino ʻana i ka huina holoʻokoʻa e ke kaʻina hana, ʻo ka loaʻa ʻana o ka herpes zoster.
ʻO nā ʻano maʻi neʻe maʻi koʻikoʻi loa o ka maʻi.
- ke kūlana o ka ʻōpū o ka ʻōpū;
- ka hoʻomohala ʻana o ka maʻi exocrine insufficiency;
- Endocrine dysfunction syndrome;
- ʻōpio dyspeptic.
Eia kekahi, ʻo ka holomua o ka hypertension biliary e nānā pinepine ʻia.
I kekahi mau hihia, hiki i ka hoʻomohala ʻana o kahi maʻi i loko o ka maʻi hōʻeha. I ka hapanui pinepine, ʻo ka mea mua i mua i ka ʻeha, a hiki ke loaʻa i kahi lōʻihi. ʻO ka holomua o ka pancreatitis mamae ʻole e hoʻokaʻawale ʻia e ka ʻilihune e kū nei i ka ʻāina epigastric.
I kēlā mau hihia, pinepine ka mea maʻi i ka maʻi me ke ʻano o kahi indigestion, ke ʻano o ka maʻi a me ka steatorrhea.
Ka hemahema o ka huna ʻole, ka hypertension biliary a me nā hopena hoʻopau endocrine
ʻO ka ʻike nui ka hoʻoneʻe ʻana.
Eia kekahi, hoʻokaʻawale ka exocrine insufficiency e nā pathologies i nā hana o ke komo ʻana o ka meaʻai i ʻeli ʻia.
No kēia ʻano, ʻo ke ʻano o nā hōʻailona a me nā hōʻailona he ʻano hiʻohiʻona.
ʻO nā hiʻohiʻona nui o ka hemahema exocrine:
- nā ninia
- steatorrhea;
- ka kaumaha o ke kino;
- ke ʻano o ke ʻano o ka hiamoe;
- luaʻi holo ʻole
- hoʻemi i ka momona.
Ke pau ka hana ʻana i ka lekiʻi, e nānā ʻia ka holomua o ka nui o ka maʻi bacteria.
- KeHulelehe.
- Ke haehae nei i loko o nā ʻāpana.
- ʻ burpela ʻole hemahema.
Ke holomua nei ka holomua o ka pathology i ka helehelena o nā hōʻailona hōʻailona o ka hypovitaminosis:
- anemia
- nāwaliwali;
- wehe ʻole i ka ʻili;
- nā hana ʻino i nā kaʻina hoʻokolohua.
ʻO ke kumu no ka holomua o ka exocrine insufficiency ʻo ia ka luku ʻana o nā cell acinar o ka iʻa. A ke hopena, hoʻohālikelike ka kahe o nā enzyme pancreatic i loko o ka lumen intestinal.
Hōʻikeʻike ʻia ʻo Biliary hypertension e ka jaundice obstructive a me ka cholangitis. I ka hapa nui o nā mea maʻi, ua hoʻopaʻa ʻia ka ʻike o ka hyperbilirubinemia transent a kūʻole paha. ʻO ke kumu o kēia pathology he hoʻonui i ke poʻo o ka lipi, i hoʻonāukiuki i ka hoʻoweliweli o ka choledochus a me ka holomua o ka choledocholithiasis a me ke ʻano o ka papilla duodenal nui.
ʻO ka hopena endocrine ka hopena ma muli o ka hōʻino ʻana i ka iwi o nā kola o ka islet apparatus, ka mea e alakaʻi ai i ka maʻi o ka insulin a me ka glucagon, e hoʻonāukiuki i ka maʻi diabetes mellitus.
Poho Kuʻi
ʻO ka Diagnosis o ka maʻi e hoʻomaka ai i kekahi mau pilikia.
Kuhi ʻia ke kaʻina holoʻokoʻa a ʻekolu mau hiʻohiʻona nui - he mōʻaukala hiʻona. ʻO ka loaʻa ʻana o ka lawa o waho a me ka hiki ʻole o ka intracecretory hōʻike a me ka ʻike ʻana i nā loli kūmole pili i loko o ke kino o ka ʻai.
ʻO ka pinepine pinepine o ka maʻi me ka nānā ʻana i ka lōʻihi o ka mālama ʻana i ka mea maʻi i loaʻa ka predisposition i nā pathology.
I ka wā o ka hoʻomanawanui, hoʻohana ʻia nā ʻano ʻoi aku nei:
- Nānā Laboratory.
- Nā hōʻike hōʻike ʻana.
- ʻOkoʻa ka maʻi ʻokoʻa.
Hoʻokahi kahi hōʻike noiʻi i ka lawe ʻana i ke koko no kahi hoʻokolohua biochemical, e hana ana i kahi hoʻokolohua hoʻonaninani glucose, e hoʻoholo ana i ka loaʻa ʻana o nā momona i nā palaka me nā hana qualitative a quantitative, a me ka hoʻokō ʻana i nā hana hoʻokō pancreatic.
E like me ke ala o nā hana hoʻokūkū, hoʻohana ʻia ka ultrasound a me ERCP. ʻAe ke ala hope e hiki ai iā ʻoe ke maopopo i ka leo o ke kelepona hoʻonui nui ʻia a me ka hoʻomohala ʻana o ke kaʻina ʻo ia.
ʻO nā hōʻailona o ka hōʻike o ka patology e like me nā hōʻailona o ka ʻōpū o kahi ʻōpū. No laila, e hoʻokaʻawale ʻia kēia maʻi mai nā ulia perforated, cholecystitis aʻokiʻoki, ke kīpē o ka ʻōpū, a i ʻole ka thrombosis o ka ʻalopolo. No kēia kumu, hoʻohana ka maʻi ʻokoʻa hopena maʻi. Hana ʻia nā hoʻokolohua āpau ma kahi kahua o ka haukapila.
Ma hope o kahi loiloi piha ʻana, hana ka kauka i ka wehewehe o ka pathogenesis a hāʻawi i ka hopena e pili ana i ka heleʻana o kahi ʻano maʻi o ka pancreatitis i ka mea maʻi, a laila hāʻawi ʻia ke ʻano kūpono, a hāʻawi ʻia nā ʻōlelo hāʻawi ma ka hoʻololi ʻana i ka ʻai.
Nā kumu no ka mālama ʻana i ka maʻi maʻi
ʻO ka Therapy o ka maʻi ʻole me nā hoʻopiʻi e hiki ke hoʻokele ʻia e ka hana maʻi outpatient ma lalo o ka mākaʻi o kahi gastroenterologist.
ʻO nā pahuhopu nui ke alakaʻi i ka lapaʻau maʻi outpatient ka hoʻopau piha ʻana a i ʻole ka lohi nui ʻana o ka piʻi o ka maʻi a me ka hakakā ʻana me nā hoʻopiʻi ʻana, hiki ʻole ke hoʻōla maikaʻi i ka maʻi a hoʻihoʻi i nā hana pono o ke kino.
Ma ke kaʻina hana o ka lāʻau lapaʻau i kahi hōʻeha kūleʻa o ka maʻi, nui ka hana i hoʻoholo ʻia.
ʻO nā pahuhopu nui o ka lapaʻau:
- wehe ʻia nā mea hoʻonāukiuki;
- hōʻoluʻolu o ka ʻeha;
- hoʻoponopono ʻana i ka hemahema ma ka pāpale;
- nā hopena hoʻohui.
ʻO ka hana nui o ka mea maʻi e hoʻokō me ka meaʻai meaʻai - pāpā ʻia ka ʻai ʻana i nā mea kanu e hoʻonui ai i ka nui o ka gastrointestinal tract, no ka laʻana o kāmato, he mea pono ʻole hoʻi e haʻalele i ka inu a me ka inu ʻana i nā mea inu wai ʻona. I kekahi mau hihia, hoʻohana ʻia ka wikiwiki o ka therapeutic no ka maʻi pancreatitis.
I ka wā mālama, hoʻohana ʻia nā lāʻau lapaʻau e pili ana i nā hui like ʻole o nā lāʻau lapaʻau.
No ka hoʻoemi i ka lawe ʻana ma luna o ka gastrointestinal tract i nā lā 2-3 mua, ʻoi ʻia ia e lawe i ka ʻaina therapeutic, kahi i kūʻole ai i ka ʻai. I loko o kēia manawa, hiki iā ʻoe ke inu i kahi liʻiliʻi o ka wai mineral me ka ʻole o ka aila.
No ka hōʻemi ʻana i ka ukana ma ka kelepa, pono e lawe i nā lāʻau lapaʻau e loaʻa ana nā enzyme digestive.
Eia kekahi, pono ʻoe e inu i nā papa e kōkua i ka hoʻemi ʻana i ka paʻakai o nā mea a me nā pale ʻana o ka waikawa o ke ake. ʻO kēia lāʻau lapaʻa paha ka pancreatin.
Hoʻohana ʻia nā antibiotics e pale ai i ke ʻano lāʻau. Ke kono nei ka lāʻau lapaʻau kuʻuna i ka manawa o ka exacerbation e hoʻohana i nā porridges mucous no ka meaʻai, ka mea i hāʻawi ʻia i ka holomua o ka digestive tract. Hiki iā ʻoe ke hoʻohana i nā oats e hana i kēia ʻano pāʻai.
Inā ʻike ʻia nā pono mua o ka hoʻomaʻama ʻana ke kikowaena, hana ʻia ka hana i loko o kahi keʻena.
ʻAʻole makemake ʻia ka hopohopo no ka hoʻōla ʻana, no ka laʻana, ka helu haneli ma mua o kahi maʻi me ka manawa 20-25 makahiki e pili ana i ka 50%. Ma kahi o 20% o nā maʻi e make ana mai nā hoʻopiʻi ʻana i ka wā e piʻi nei ka maʻi.
He aha ka maʻi pancreatitis e haʻi i ka poʻe loea i ke wikiō ma kēia ʻatikala.
