ʻO kekahi o nā maʻi koʻikoʻi loa o ka hana kūnaʻi, ʻo ka pancreatic necrosis. Ua kapa ʻia kēlā ʻo ko ka nano pancreatic a i ʻole necrotic pancreatitis. ʻOiai me ka kūpono kūpono, ka hapalua o nā mea maʻi me kēia maʻi maʻi. Ma hope o nā mea āpau, hōʻike ʻia ka maʻi me ka make o nā pūlima, kahi e alakaʻi ai i ka luku gland. Ma muli o kēia mau kaʻina hana, lele hewa kāna mau hana, ka mea e hoʻopilikia i ka maʻi maʻamau o ke kino.
ʻEnehana hoʻomohala
ʻO Necrosis kahi kaʻina o ka make cell e alakaʻi i ka necrosis a me ka luku ʻana i nā io. I loko o ka pancreas, hiki i kēia ke hāpai i kahi hopena ma muli o ke kaʻina a me nā hopena maikaʻi ʻole. Hiki i nā kaʻina holomua ke alakaʻi i ka ʻoiaʻiʻo a kū ka wai o ka pancreatic i loko o nā kumulāʻau a e kiola ʻia paha i loko o lākou mai ka duodenum. Hoʻokūwī nui nā enzyme pancreatic, no laila hoʻomaka lākou e hoʻokaʻawale i nā ʻili o ka kelepa ponoʻī. ʻO kēia ka mea nui elastase, kahi e hoʻokaʻawale i nā pale o ka pili pili.
ʻO ka mea mua, pili mai ka maʻi paluhiko a i ʻole pancreatitis ma muli o kēia. Ma waho o ka mālama ʻana i ka manawa kūpono a i ʻole ke hōʻino e ka mea maʻi i ka papa i kauoha ʻia e ke kauka, e holomua ka maʻi ʻana. Hoʻomaka i ka wā, e pālahalaha ke kaʻina o ka luku ʻana, hoʻomaka nā paia o nā kīʻaha koko. Hiki i ke kīnā. Inā pili kēia kaʻina hana i ka lula o ka kelepona a me ke kao, e puka mai ana, ʻo ka peritonitis a me sepsis ke ulu.
ʻO ke kumu
ʻO nā kumu nui o ka necrosis pancreatic nā ala no ka ʻāpana o ka biliary. ʻO Dyskinesia, cholecystitis calculous, a me nā maʻi gallstone hiki ke alakaʻi i ka blockage o ka waiʻo Wirsung. ʻO ka pinepine pinepine, ulu nā necrosis i ka hōʻino a me ka overeating. Wahi a nā helu helu, ʻoi aku ma mua o ka hapalua o nā mea maʻi i loaʻa i kēia. ʻAi nā meaʻai a me nā meaʻai e paʻakikī i ka hoʻoili ʻana i ke kahe ʻana o ka lula a me ka stagnation i loko o nā kumu wai o ka pancreatic. Ma muli o kēia, ulu ka pancreatitis. I ka nui o nā hihia, ʻo ia ka mea e hele i mua i ka hoʻomohala ʻana o ka necrosis.
Eia kekahi, he mau kumu ʻē aʻe kēia maʻi:
- nā meaʻai kūpono ʻole - ka hookeʻo lōʻihi, ka hoʻolele nui, ka nui o nā momona, ka palaoa a me nā meaʻai maikaʻi, nā ʻala a me nā meaʻai ʻoi;
- ʻeha a hōʻeha ʻeha;
- ulia duodenal;
- nā maʻi ʻeha o ka ʻōpū;
- ka haʻalele ʻana i ke koko i ka hana ʻana o ka ʻai;
- ka huehue olakino, ʻaina wai ʻole a me ka make ʻole;
- maʻi maʻi maʻamau a palu wale paha nā maʻi maʻi.
Ma mua o ka hapalua o nā hihia, ka nui ʻana a me ka inu ʻona e alakaʻi ana i ka necrosis.
Hiki i kēia mau mea āpau ke alakaʻi i ka pancreatitis, ka mea ʻole, me ka mālama ʻana, e hōʻeha i ka necrosis kiko. Akā hiki ke hoʻomohala i ka maʻi pancreatic maʻi ma muli o ka hoʻohana pono ʻana o kekahi mau lāʻau lapaʻau, ke kaumaha, ke kino a me ke kaumaha paha.
Kahi helu
No ke kuhikuhi ʻana i ka mālama kūpono, i ka hoʻohui ʻana i ke kumu o ke kaʻina hana o ka necrotic, pono ia e hoʻoholo i kona ʻano. ʻAʻole pili wale i nā hiʻohiʻona o nā maʻi i nā maʻi i hōʻike ʻia, akā ke koho ʻana i nā ala therapeutically. ʻO ka pinepine, ʻōkuhi ʻia kahi maʻi e ke ʻano o kona ulu ʻana. Hoʻokaʻahele ʻia ma waena o nā nodrosis kūlohelohe, holomua, a me ka maʻiʻole, lohi. E kūkulu koke ana i ke ʻano ʻoiʻā me ka loaʻa ʻole o ka mālama ʻana ke alakaʻi i ka make i kekahi mau lā. Hiki i ka neʻe ʻana o ka nekrosis lōʻihi i ka manawa lōʻihi, akā me ka mālama kūpono ʻaʻole ia e hoʻoulu i kahi pilikia.
Wahi a ke kaona o ka kaʻina necrotic, hoʻokaʻawale ka pankreatic pancreatic, pili wale i kekahi mau wahi o ka kuhi hewa, a me ka huina, i ka wā a pau o nā kino kino i ka luku. Ke alakaʻi nei kēia kūlana i kahi hana kuʻuna piha loa o nā hana o ka lula inā ʻaʻohe manaʻolana o kona ola hou. I kekahi manawa ua komo kekahi maʻi i ke kaʻina hana o ka necrotic, ʻoiai ke hoʻokuʻu ʻia ʻo ka maʻi, kahi me ka kahawai o ke koko e lele i nā kino ʻē aʻe. Hoʻohana ʻia kekahi mau ʻano o ka maʻi e like me ke ʻano o ke ʻano o ke ʻano o ka necrotic.
Aia kekahi ʻano o nā nekrosis:
Hiki ke hoʻokaʻawale i ka pancreas?- ʻōpū hemorrhagic - kahi ʻano maikaʻi loa o ka palaka, i ka luku ʻia ʻana o nā paia o nā kīʻaha koko, e alakaʻi pinepine ana i ka mea maʻi i ka make;
- hemostatic - kahi hana necrotic i hui pū ʻia e ka pale ʻole o ke kahe koko i loko o ka momona;
- puka ka edematous me ka hōʻuluʻulu ʻana o ka inu intercellular i loko o nā kō;
- paʻa - hana hewa ʻole i nā hana a pau o ka pancreas;
- hana ʻino ʻia me ka luku kino, a ma hope o ka pale ʻole ʻana iā lākou.
Nā Hoʻomaka
ʻO kahi hiʻohiʻona o kēia neʻeʻana i ka papa mua ʻaʻole ia e ʻike ʻia i kekahi ala, me ka ʻano like me kahi ʻano luhi a me nā hana necrotic. ʻO nā hōʻailona mua nā mea like loa me nā maʻi ʻē aʻe o ka gastrointestinal tract:
- pohu ma hope o ka ʻaina;
- ka hopena nui a me ka hoʻopiʻi o ka huahe a i ʻole ke koko;
- kaumaha loa ma ka ʻōpū, belching;
- uhaū kaumaha;
- colic bula;
- ua hōʻemi i ka momona;
- huhū.
Akā me nā nekrosis, aia kekahi mau hōʻailona kūikawā e hiki ke hōʻike i ka loea i ka hoʻohiwahiwa o nā alaʻala. ʻO ka mea mua, he ʻehaʻawaʻāina i hoʻopaʻa ʻia ma ka ʻūhā hema. Hiki iā ia ke hoʻonui i ka puʻu ʻōiwi holoʻokoʻa, i ka ʻōpū o lalo, ke kua, poʻohiwi. Hoʻonui pinepine ʻia ka ʻāʻī ʻana o ka māla meaʻai, me ke neʻe ʻana, a me ke kūlana kūlana. Hiki iā ia ke tingling, ʻā ʻia a i ʻole hoʻi o ke ʻano o nā mākeke. A i ka hapalua o nā mea maʻi ʻaʻole hiki ke pale ʻole ka ʻeha.
ʻO ka hōʻailona nui o ka necrosis pancreatic ka ʻehaʻeha a me nā maʻi maʻi.
Eia kekahi, hiki ke hoʻonui pono i kahi wela, e hōʻike ana i ka hele mai o kahi kaʻina hana. Ke kaomi nei i ka pancreas, ʻeha ka ʻeha o ke ʻano. A ma ke ʻili o ka ʻōpū, ʻike ʻia nā wahi cyanotic. Hōʻalo koke ka mea maʻi i ka paona, hemo kona makemake, loaʻa iā ia ke kūloko i nā mea ʻala ikaika.
Naʻi hoʻolika
He mea paʻakikī loa ka necrosis pancreatic i ka ʻike ma ka mua. Inā he molowa ka hana necrotic, hoʻopaʻa ʻia i nā wahi ʻokoʻa, ʻikea ʻole ʻia me nā ʻano hoʻokolohua he nui. No laila, pinepine pinepine, hana ʻia ka maʻi like ʻole ma nā hanana holomua, i ka wā e hiki ʻole ai ke ho'ōla.
Akā me kahi kipa manawa hiki i ke kauka, hiki i kahi loea mākaukau ke manaʻo i ka necrosis i ka hoʻokolokolo mua ʻana o ka mea maʻi. Ke hōʻoia nei i ka hoʻomohala ʻana, hoʻouna ʻia ka mea maʻi i nā hoʻāʻo a me ka hoʻāʻo koko, ʻo ia hoʻi no ka ultrasound o ka pancreas. I kekahi manawa pono ke hana i kahi hoʻokolokolo hou: MRI or CT, angiography, laparoscopy. E kōkua kēia i ka hoʻololi ʻana i nā kulekele mai ka biliary colic, ʻōpū o ka wahī, ka ʻōpū aortic aneurysm, myocardial infarction.
ʻO ke ala kumu nui no ka holomua ʻana o ka pancreas ma ka ultrasound
Hoʻomaʻamaʻa
ʻO ka manawa pinepine, ʻo ka mālama ʻana o ka necrosis pancreatic i lawe ʻia i loko o ka haukapila. ʻOiaʻiʻo, ʻoiai i nā hihia maʻalahi, pono ka mālama mau ʻana e ke kauka, ʻoiai he mea nui e nānā i ka holomua o nā kaʻina hana o ka hoʻōla. ʻO kēia ke kōkua i ka manawa e ʻike ai i ka holomua o ka pathology.
I nā hoʻomaka mua o ka nekrosis, ua lawa pinepine ka ʻaha conservative. ʻO ia ka lawe ʻana i nā lāʻau lapaʻau kūikawā a me nā loli olakino. ʻO ka hoʻohana pū ʻana o kēia mau hana wale nō ke pani i ke kaʻina necrotic. Eia kekahi, i nā lā mau mua e hōʻike ʻia ana ka mea hoʻomaha a me ka ʻole o ka ʻai.
ʻO nā hua lāʻau, nā analgesics a antispasmodics paha e hoʻohana pinepine ʻia, e kōkua ana e hōʻoluʻolu i ka ʻeha. ʻOi aku ia e lawelawe iā lākou intramuscularly a i ʻole intravenously, inā hiki i ka luaʻi ke pale pū me ko lākou laweʻana. ʻO kekahi manawa hoʻohana ʻia ka poloka novocaine kelepona. Me ka hoʻowalī ʻana, e pono ai nā NSAID, a me ka hele ʻana o ka maʻi e koi ʻia ka hoʻohana ʻana i nā antibiotics. Inā hōʻemi ka mea maʻi, a paʻakai ʻia ka paʻakai ma ka maʻi intravenously. ʻO nā lāʻau kūikawā no ka nekrosis pancreatic ʻo ia ka poʻe e poloka i ka hana a nā kinemona, no ka laʻana, Contrical a i Gordox. I kekahi manawa ua kuhikuhi pū ʻia nā antihistamines.
Ma hope o ka pau ʻana o ke ʻano o ka maʻi a noho ka kaʻina necrotic, ua kī ʻia kahi papaʻai paʻa no ka mea maʻi e hoʻomaha i ka ukana ma luna o ka pancreas. Pono pono e haʻalele loa i ka waiʻona, nā mea momona a me nā meaʻaiʻai, nā mea hoʻonaninani, nā makū, nā kīʻaha kalapona.
I nā hihia holomua, ʻo ia hoʻi me ka pālahalaha nui o ka hana necrotic, pono ka hana. E kuhikuhi iā ia ʻaʻole ma mua o nā lā he 5-6 ma hope o ke ʻano o ka hoʻopaʻa ʻana. ʻO nā meaʻokoʻa wale nō nā hihia hōʻeha e hoʻoweliweli i ke ola o ka mea maʻi. I ka wā o ka hōʻea ʻana, ua hoʻoneʻe ʻia ka ʻōpū make, hoʻopau i ka exudate a me nā pale, a hoʻoneʻe ʻia nā hopena o ke koko, a hoʻihoʻi ʻia ka puka maʻamau o ka wai pancreatic.
Pono ka loiloi i ka hapa nui o nā maʻi nepe o ka pancreatic, akā ʻaʻole nō ke kōkua mau ʻia.
Kahi Waho
Pono e kūkā i ke kauka i ka manawa no kekahi pilikia i loko o ka puʻu ʻōpū. Ma hope o nā mea a pau, hiki ke hoʻomohala hou ke kaʻina o ka necrosis kiko, nui a lehulehu nā mea e luku ʻia, ke alakaʻi nei i ka hala ʻole o nā hana kūwili. Inā ʻike ʻoe i kēia kaʻina i ka papa mua, hiki iā ʻoe ke pani. A kinipiki edematous nekrosis me nā lāʻau anti-inflammatory. No laila, ʻaʻole hiki iā ʻoe ke noho neʻe a hoʻōla ponoʻī iā ʻoe iho, ʻo kahi kipa manawa wale nō i ke kauka hiki ke hoʻopakele iā ʻoe i nā hoʻopiʻi.
Akā ʻaʻole pili kēia i ka prognosis no ka pancreatic necrosis. Wahi a nā helu helu, ʻoiai me ka koho kūpono o nā ʻano lapaʻau, ʻo ka make ma kēia ala ke hele aku a 70%. Aia ka hoʻihoʻi i ka neʻe i nā hiʻohiʻona o ke ala o ke kaʻina necrotic, kona wahi, ka nui o ka maʻi, ka hele ʻana o nā hoʻopiʻi, me ka makahiki o ka mea maʻi. Loaʻa ka hapanui kiʻekiʻe i ka poʻe i ʻoi aku ma mua o nā makahiki he 50, a me ka mea i nā mea maʻi me ka hoʻōla ʻana o ka acid-base kaulike a me ke kōpaʻa koko, ke koko kiʻekiʻe a ka ʻōpū nui paha. Eia kekahi, ma nā hihia koʻikoʻi o ka necrosis, ʻoi aku ma mua o 10% o nā mea maʻi e ola a me ka mālama kūpono.
ʻOiai ke ola maikaʻi, ke hoʻoikaika nei kekahi kanaka e hahai i kahi meaʻai kūikawā i kona ola a nānā i kona ʻano. Hoʻohana ka nui i nā mea kīnā, ʻoiai lākou e contraindicated ʻaʻole wale nō ka pale ʻana o ka meaʻai, akā, ʻo ka hoʻoikaika kino kino hoʻi, a me ke kaumaha. Akā ke kumuhanaia i kahi ola kino a me ka papaʻai, hiki iā ʻoe ke mālama i ka olakino pancreatic a pale i nā pilikia hou.
