ʻO ka pancreatitis Biliary kahi maʻi māpala o ka pancreas. ʻO ke kumu no ka hoʻomohala ʻana o ka maʻi, ʻo ka lalau loa, me ka holo ʻana o ka umauma bile a me nā ate.
Hiki ke hōʻike ʻia i nā anomalies ma kahi manawa mua e ka biliary colic, dyspeptic hōʻailona, jaundice, diabetes mellitus a me ke kaupaona ʻana. I mea e ʻike ai i ka pathology, ke kaukaʻi ke kauka i ka mahele o kahi hōʻike ultrasound o ka ʻōnaehana hepatobiliary, i hoʻohālikelike ʻia a me ka alaina o ka manaʻo nui o ka ʻōpū o ka ʻōpū.
ʻO ka mālama ʻia e ka lawelawe ʻana i nā lāʻau anti-inflammatory a me nā analgesic, ka lawe ʻana i nā enzyme, a me ka hoʻomaikaʻi ʻana i ka glucose koko. Pono ka mea maʻi e mālama i ka papaʻai ikaika loa me ka hōʻole hope loa i ka waiʻona. Inā ʻike ʻia ka lāʻauuliuli i ka gallbladder, i ʻōlelo ʻia ka hana.
No ke aha i hoʻomohala ai ka pancreatitis biliary?
ʻO ka mea hou aʻe, ua hoʻonui nui ka maʻi hōʻemi o ka pancreatitis biliary. Ma Lūkia, ua hele a hōʻailona kēia mau hōʻailona ma waena o ka pākeke aʻehā mau keiki, a ua eha pinepine nā keiki. Ua kau ʻia kēia ʻano kuʻuna i ka International Classification of Diseases o nā loiloi 10, a laila helu ka ICD-10.
ʻO nā pinepine pinepine, ʻo ka etiology i hoʻopili ʻia me ka mua o ka cholelithiasis, i kēia hihia aia kahi kiʻekiʻe o ka uluʻana i nā patology. Hoʻonui ʻia ka maʻi e ka neʻe ʻana o nā pōhaku mai ka ʻāpana biliary.
Pōʻino kēia kūlana, no laila, ua kauoha ʻia ka hoʻoili ʻana ʻoi ʻana. Inā hōʻole ʻia ka hana, hiki i ke kaʻina pathological ke hōʻeha i nā hoʻopiʻi koʻikoʻi, ʻoi aku ka nui o ka mālama ʻana. I mea ʻole e hoʻomohala i ka pancreatitis biliary kūpono, ʻike pono ka ʻike ʻana i kahi hōʻeha o nā dile bile i kahi manawa kūpono a mālama pono koke i ka maʻi.
Hiki i ke pathogenesis o ka maʻi ke hoʻomā i kēia:
- Hoʻokomo ʻia ka maʻi i ka pancreas mai ka lolo biliary ma o ka lymphatic tract.
- Hoʻomaopopo ka mea maʻi i nā pōhaku i nā kumulāʻau maʻamau, nā mea e piʻi ai i ke kahe o ke koko a me ka pā ʻana o ka pancreas.
- Hoʻopilikia ʻia nā pāi pancreatic a me nā ʻōpala ma muli o ka komo ʻana o ka huaʻi i loko o ke kumu o ka pancreatic, e hopena ʻia ana i ka mumū. Piha loa ʻia ke kūlana inā loaʻa paha i kahi maʻi maʻi palupalu ʻoi aku ka mea, ka mea e alakaʻi ai i ka hoʻomohala ʻana i nā ʻāpana manuahi manuahi.
Eia kekahi, nānā ke kaʻina hana i ka wā o ke hoʻokumu ʻana o kahi molud biliary. ʻO Cholecystitis a me kahi hana o ka gallbladder ma hope e alakaʻi i kahi kūlike o ke kūlana physicochemical o ka bile. Ma muli o ka ua nui a me ka hōʻiliʻili ʻana o kekahi mau mea, ua kūkulu ʻia nā pōhaku micro, e kapa ʻia ʻo ia kahi biliary sludge.
Ke komo nā kolo i ka hua bile, ua hōʻeha ka membrane muc, no ka mea e hoʻopili ai ka pā a me ka papilla o ka papillae. A hopena, kūpaʻa ka bile i nā papa wai o ka pancreas, ʻaʻole hiki ke komo piha i ka lua o ka duodenum a ʻaʻole i komo i ka papa pancreatic.
Me ka stagnation, hoʻōla ʻia nā enzyme pancreatic ʻaʻole i loko o ka ʻōpū, akā i ka duct. Hoʻopilikia kēia i ka hoʻopale pale ʻo ka pale ʻana o ka pancreas a me ka maʻalahi o ka komo ʻana o ka maʻi i ka ʻāpana pancreatic.
Ma muli o nā pōhaku gallbladder nui, hoʻopili pinepine ʻia nā kumu bile maʻamau a i ʻole ka spdincter Oddi e hele nei, e alakaʻi ana i ka hōʻalo a me ka haki ʻana o nā ala o nā kuʻi.
I nā huaʻōlelo ʻē aʻe, hoʻomaka paha ka hoʻomohala ʻana o ka pathology ma muli o:
- Nā maʻi gastrointestinal;
- Anomalous hoʻolālā ʻo ka huahelu a me ka papa hana pancreatic;
- ʻĀpio kolecystitis;
- Cirrhosis o ka ate;
- ʻĀpana gastbladder;
- ʻO ka paleʻole o ka motility o ka papa biliary;
- Nā nipple o Patology Vater.
Hiki i kahi exacerbation o ka maʻi ke hoʻoake ʻia e nā lāʻau choleretic a i ʻole ke kaumaha wikiwiki ʻana.
ʻO nā hōʻailona nui o ka maʻi
I kona hōʻike ʻana, like loa nā hōʻailona o ka maʻi e like me nā mālamalama o ka ʻili gastrointestinal e like me ka hepatitis viral, ka ʻōpū o ka ʻawaʻawa, ka ʻōpū a me ka ʻōpū duodenal, pancreatic tumor, kūleʻa stoneless cholecystitis. No laila, he mea nui ke hoʻomākaʻi ʻana i ka nānā ʻana a haʻalele i ke kū ʻana o ia mau hihia.
I loko o nā hiʻohiʻona nui ka hoʻonui ʻana i ka ʻeha. Hoʻomaʻamaʻa ka mea maʻi i ka ʻeha ma hope o ka ʻōpū, hoʻi, hypochondria, ʻōhā ʻākau. ʻO ka maʻamau, ʻike ʻia kēlā mau maʻi ʻelua a ʻekolu mau manawa ma hope o ka ʻai ʻana o ke kanaka. Eia kekahi, ʻo ka hoʻomau ke hoʻomake i kona naʻau iho i ka pō.
Hoʻokomo ʻia me nā hōʻailona kūlohelohe o nā patology o ka ʻōnaehana pancreatic-biliary. Hiki ke hoʻowalewale ka ʻeha ma o ka hoʻohana ʻana i kahi ʻona ʻāmaʻomaʻo, momona, iʻa a me nā meaʻai kaʻi.
Ma ka manawa like, he maʻi ka maʻi, ka maʻi a me ka ʻawaʻawa i ka waha waha. Inā ma muli o ka pōhaku i hoʻopihipiha piha ʻia nā nipple o ke kanaka maʻi, ua ʻike ʻia ka ʻike ʻana o ka jaundice obstrukt i ke ʻano o ka noho ʻana o ka mucosa a me ka ʻili.
- ʻO ke kaʻina hana i loko o ka pancreas e alakaʻi i ka hana hōʻino i ka hana endocrine. ʻO ka mea maʻi he maʻi metabola, i ka wā o ka hopu, piʻi a nui ke kō o ke koko a hāʻule paha paha.
- Ma muli o nā pilikia exocrine, e nānā ka ulu ʻana o ka pancreatic enanthate, ʻike ʻia nā hemahema o ka ʻōnaehana ʻana.
- Hoʻokumu ke kanaka i kahi ventricle huhū a me nā ʻōpū, aʻo nā maʻi ma waena o kekahi mau manawa i ka lā. He kuʻuna ʻaila o ka paleke, kahi pali hina a me ka mea hoʻohuihue fetid.
- Eia kekahi la hoʻi, ua hele pū ʻia nā hōʻailona me ka hoʻonui nui ʻana, ka ʻūhū i ka ʻōpū, ka belching, ka ʻōpū o ka puʻuwai, i hoʻemi ʻia.
- E kū'ē i ke kua o ke aʻalolo, hoʻonui ʻia ka momona, hoʻowalewale ʻia ka nānā ʻana, a hoʻemi ʻia ke kaumaha o ke kino. ʻIke kekahi kanaka i ka hemahema o nā huaora a me nā minela.
Inā ʻaʻole i mālama ʻia ka maʻi i ka manawa, e hoʻomohala ʻia ka pancreatitis biliary dependence, i hele pū ʻia me nā ʻano hoʻopiʻi āpau ma ke ʻano o ka pīhoihoi, ke ake o ka maʻi a me ka hana ʻole ʻana, encephalopathy, ka huhui gastrointestinal, ʻōpū o ka ʻōpū, pancreatic necrosis, koma maʻi, ʻeha.
Ke alakaʻi nei ke kahua e kū ʻole ana i ka pseudocysts, ascites, fistulas, nāʻiliʻili o nā ʻōpū.
ʻO ka maʻi maʻi
E hoʻomaopopo i ka maʻi a hāʻawi i ka prognosis kūpono, kuhikuhi ke kauka i ka kao o kahi hōʻike koko a me ka biochemical test. Inā maʻi ka maʻi i ke ala o ke kala ʻana, ua ala ka bilirubin ma muli o nā loli hoʻololi.
Hoʻonui hou ʻo Cholesterol, a emi mai ka pae o ka nui o ka protein a hoʻopilikia nui ʻia, no laila he mea nui ka hana i ka loiloi kekona e loaʻa
nā hopena kūpono. Hōʻike ʻia kahi hōʻike o ke koko a me nā wai hoʻi i ka nui o ka amylase.
Ma ke kōkua o ka ultrasound endoscopic a intraductal paha, hiki i ke kauka ke ʻike i nā pōhaku, ʻike ʻia kēia ʻano e ke kūpono loa. Hoʻohana ʻia ka tomography compute e kiʻi i ka ʻike kikoʻī.
- Inā hōʻike kekahi kauka i kahi pancreatitis biliary kūpono, koi pinepine ka hana ke hāʻawi i ka mālama pōpilikia. Inā pono, pono e hoʻokaʻawale i nā pōhaku a hoʻomaikaʻi paha i ke ʻano o ka nipple o Vater, no kēia mea ke hoʻohana pono nei o ka endoskopika.
- Ke nui ka ulu ʻana o ka maʻi, neʻe aku ke kauka i ka ʻeha ʻeha me nā analgesics a me nā antispasmodics. I kēia hihia, ke hoʻololi ʻia i ka hana o waho a me ka hana huna o ka pancreas. No nā mea pale, pono e lawe i nā ʻoniʻoni e pale i ka hoʻolālā ʻana o ka maʻi.
- Me ka exacerbation, i nā lā ʻekolu mau lā e hōʻike i ka pōloli me ka pancreatitis. Ma kahi o ka meaʻai, inu i ka wai mineraline non-kalaka. Ma hope o ka wikiwiki, pono keʻai pono. Pono ka mea maʻi e hōʻino i nā meaʻai momona, ua palena ʻia hoʻi ka nui o ka kalaiwa. Pono ʻoe e ʻai pinepine, akā i nā wahi liʻiliʻi.
No ka hoohiolo i ka hopena luku o nā enzymes, somatostatin, protron pump inhibitors, ua koho ʻia nā inhibitor protease. Hoʻihoʻi ʻia ka hoʻoneʻe pancreatic Enzymatic i ka hoʻihoʻi ʻana me nā enzymes microspherical.
Me ka nui o ka glucose i ke koko, lawe ka mea maʻi i kahi lāʻau hypoglycemic kūikawā. Pono ka insulin mellitus hilinaʻi i ka loiloi o ke ʻano a me ka meaʻai.
No ka mālama ʻana i ke kūlana maʻamau o ke kino a hoʻoikaika i ka ʻōnaehana pale, ua hoʻōla ʻia ka mālama ʻana me nā mea kanu. No ka lapaʻau, pono ʻoe e koho i nā loiloi kūpono a maikaʻi paha.
Hōʻike ʻia nā ʻano o ka pancreatitis i ke wikiō ma kēia ʻatikala.
