Ma lalo o ka hopena o ka pancreatitis hoʻonā, hiki i ka pancreatic necrosis ke ulu ma 10% o nā hihia. Pau ka huelo e hoʻopuni ana i ka pancreas, e like me ka maʻi pancreatitis. ʻO kēia no ka hana o ka lipase, kahi mea ulu o ke pancreas.
ʻO ka mua, hoʻomaka ka momona pancreatic necrosis, e kū i ka hope o nā maʻi hemorrhages e kū i ka lula, ka mea e alakaʻi ai i ka hemorrhagic necrosis, hui pū ʻia e edema i ka retroperitoneal tissue. ʻO nā ʻano like o nā momona necrosis: me nā wahi o ka hemorrhage a me ka hemorrhagic pancreatic necrosis, me nā loli momona.
Nā maʻi Necrotic a me nā hōʻailona
E like me kāu e ʻike ai, ʻike ʻia ka nekrosis o kēia ʻao ma lalo o ke ʻano o ka pancreatitis. Hōʻike ʻia ka pae mua o ka maʻi e ka maka o nā hōʻailona. I waena o nā maʻi maʻamau loa i ka haukapila hiki ke hoʻomaopopo i ka pallor o ka ʻili, ka yellowness o ka sclera a me ka cyanosis liʻiliʻi.
ʻO ke ʻāʻina paha ka maʻamau o ka wikiwiki a hele wale ʻia paha, ke ʻano kino o ke kino, ma ke ʻano he kānāwai, ʻaʻole i loli. Inā hele ka maʻi ma nā wahi necrotic, kū ka mahana.
ʻO ka Palpation e hōʻike pinepine ana i ka ʻeha ma ka epigastrium a me ka pua. E kue ana i kahi o ke kua o ka necrosis momona, ua kūkulu koke ʻia ka maʻi infiltrate. Hiki ke manaʻo ʻia ia i ka pūhaka o ka wā o ka palpation, ʻo ka hopena maʻa nei paha ka mea maikaʻi ʻole, ʻo ia hoʻi, ka make, ʻaʻohe mea ʻē aʻe.
Hoʻomaka ka maʻi mai ka piʻi ʻana o ka paresis a hoʻomōhala me nā ʻōmaka ʻelemakule nāwaliwali, nā mea āpau e hōʻike i nā hōʻailona o ka maʻi pancreatic, ʻike pinepine nā hōʻailona ma aneʻi.
Hoʻokumu ka necrosis pancreatic i ke ʻano o kahi maʻi o ka pane ʻana i kahi maʻi kūloko, ka hana ʻana o nā mea nui o nā kino e hele ai, ka mea e alakaʻi ai i ka hemahema, ʻaʻole ka hopena. Me ka maʻi, hiki paha iā ia:
- Cardiovascular;
- Na ea
- Renal;
- Hepatic
- ʻO ka hemahema Gastrointestinal.
Hoʻokomo nā mea ʻai o ka pūnaehana ka mea i hōʻike ʻia, i hōʻike ʻia i loko o nā ʻano o ka hōʻuluʻulu ʻana i ka puʻu pleural o ka transudate a me ka ederstitial pulmonary edema.
Me ka nele o ka cardiovascular, ʻike ʻia, hypotension, pulse pinepine filamentous, isocia myocardial, cyanosis o ka ʻili a me ka membrane molous, he hoʻemi i ka nui o ka puʻuwai output, ʻo kēia mau hōʻailona āpau e hōʻike ana i ka necrosis pancreatic.
Eia kekahi, nā mea maʻi me nā maʻi noʻonoʻo maʻamau, e hōʻike ana iā ia iho me kahi hilahila a (a i) ʻano nui hoʻi ka hauʻoli. Hoʻohiolo koke ka hana maʻamau o ka puʻuwai a lilo i ka maʻi maʻamau.
Hoʻohālike nui nā maʻi koʻikoʻi o ka pankreatic pancreatic:
- Hypovolemic shock;
- Kākau ʻole ʻōnaehana lehulehu;
- ʻO nā hoʻopiʻi Pleuropulmonary;
- ʻO nā hui o ka momona retroperitoneal a me nā pancreas;
- ʻO nā fistulas pancreatic o waho a me loko;
ʻO Peritonitis a me ke koko o ka naʻau me nā hōʻailona like ʻole. Hoʻopilikia ʻia ʻo Peritonitis ma muli o ke kaʻe o ke kīpē parapancreatic i loko o ka lua o ka ʻōpū.
I ka nui o nā manawa, hoʻomaka nā wahi o nā nekrosis e hoʻopili ʻia, ʻo ia hoʻi, e hoʻopuni ʻia e kahi kapula o ka kiko o ka ʻili o nā kiko ola. Hiki i kahi sisti ke loaʻa nā waihona ʻelua a me ka maikaʻi.
Hoʻohana ʻia ka pancreatic Necrosis
Hoʻohana ʻia ka mālama ʻana, ʻo ia hoʻi nā hana penei:
- Hoʻōla i ka ʻeha;
- Ka papa o ka hana exocrine pancreatic;
- Hoʻomaʻi hou i nā helu koko kūpono;
- ʻO ka meaʻai makua;
- Hoʻopili ka detoxification.
E hōʻoluʻolu i ke kaumaha, hoʻohana ʻia nā analgesics non-narcotic. Inā hoʻomaka ka hihia, hoʻohana ʻia nā analgesics narcotic, ʻo ka mea nui ka mea ʻaʻole i hopena ka hopena i ka lawena lāʻau.
I mea e hoʻopau ai i ka hana huna o ka hoʻopale o ka lālani, ʻai ʻia ka ʻai ma ka waha. Hoʻohana nā antacids a me anticholinergics (atropine).
E hoʻihoʻi i ka nui o ke kahe koko, pono ke hoʻopaʻa i ka hoʻonā o nā hoʻonā o ka crystalloid a me ka colloidal. Aia kekahi mau mea nui o nā electrolytes i loko o nā hana crystalloid; he mau chlorine, calcium, potassium, a me sodium.
ʻO kahi kūlana koʻikoʻi no ka pāʻai makua mea pili i ka pono o ka ikaika o ke kino o ke kino o ke kanaka. Hoʻohana ia i nā kūmole o ka waikawa amino, glucose a me ka hydrolysates protein.
Hoʻolaha koke ʻia ka pancreatic necrosis e ka lawe ʻana i ka pancreas. Hoʻokō ka hana ʻana e hōʻoki i nā wahi ʻili o ka necrotic i ʻike ʻia i kahi kūpono o ka mea e hilinaʻi nei. Inā aia ka peritonitis, hana ʻia ka waʻa o ka peritoneum.
Hōʻike ʻia ka wehe ʻana i nā aihue o nā lula ma kahi o ke hoʻololi ʻana i ke kaohi o ka pancreas. Hoʻopauʻokoʻa ka pancreas i nā hihia o nā necrosis holoʻokoʻa. He mea ʻinoʻino kēlā hana, he mea maʻamau ke hopena o ka hopena, no laila ʻaʻohe hana hou a mālama ʻia ʻo ka pancreatic dysfunction me nā ala palekana.
I kēia manawa, makemake nā kauka e hoʻohana i nā koho conservative no ka hana pū ʻana me necrosis a me kona mau koi, no laila, ʻo ka hopena lethal kekahi mea o ka wā ma mua.
E like me ke kānāwai, ua kau ʻia nā wai ma ke ana purulent. Hoʻokumu kēia i ka hiki o ka makemake o nā ʻike o nā cysts a me ka hoʻopuka ʻana i nā māmai antibacterial. Hoʻomaʻamaʻa maikaʻi ka mālama ʻia, ka hapa liʻiliʻi o ka morbidity a hōʻike i kahi helu liʻiliʻi.
