ʻO ka neurrosis pancreatic hemorrhagic (helu ICD 10 K86.8.1) ka make piha a ʻāpana paha o ka maʻa pancreatic.
ʻO ka maʻi kekahi o nā ala e hiki ai i ka make ʻana o kahi maʻi maʻi i kahi manawa pōkole.
No ka paʻakikī o ka mālamaʻana e pili pū ana me ka helu o ka hoʻomohala ʻana o ka necrosis pancreatic (1 lā), a me ka manaʻo o ke ʻano i hoʻopili ʻia ʻaʻole i ola hou a hana ʻole ʻia kekahi mau enzyme a me nā hormone a ma hope o ka mālama ʻana.
ʻO ia ke kumu o ka hoʻopiʻi ʻana o ka maʻi i lilo i ka maʻi diabetes mellitus type 2.
ʻEnehana hoʻomohala
He aha kēia maʻi a he aha nā kumu kumu o kona hoʻomohala ʻana? Me ka pancreatic necrosis, kahi fistula i hoʻokumu ʻia, kahi i komo ai nā kiko o ka pancreas i loko o ka ʻōpū o ka ʻōpū ma kahi ʻole i hoʻopuni ʻole ʻia.
ʻO ka ʻili make a me ka exudate hemorrhagic e lilo i impetus no ka hoʻomohala ʻana o ka peritonitis purulent, ma 50% o nā hihia i hala i ka make ʻana o ka mea maʻi.
Tissue necrosis e hele mai ma muli o ka hiki ʻole o ka pancreas e kū i ka wai o loko o ka gastric. ʻAʻole hoʻopili ʻia nā ʻaʻano mai nā mea i hoʻopili ʻia a hoʻomaka ka alkali e wāwahi i ka pūmua protein.
ʻO ia, e hoʻomaka ka pancreas i ka hoʻoilo ponoʻī iā ia iho. ʻAʻole keʻakeʻa kēia luku ʻole i kēia. Holo aku ʻo Necrosis i nā kahe koko e ʻoki ana i ke kumukanawai, e hōʻeha ana iā lākou a e kū hoʻi ke koko.
Nā kumu kumu o ke kuʻuna
ʻAʻole kū i ka hemorrhagic pancreatic necrosis mai ka wā o ke kahaki ʻana.
Hiki i nā mea like ke hoʻonāukiuki i kahi hoʻokūkū koʻikoʻi:
- ka make ʻana i ka wai a me ka ʻai;
- hana hōʻino i nā kīʻaha e hoʻokaʻawale i ka gastrointestinal tract (koi, paʻakai, momona);
- kūlohelohe;
- nā maʻi autoimmune;
- manuahi hōʻino, i hui pū ʻia e ka hoʻoponopono ʻole ʻana i ke koko;
- pani ʻana i ka pā biliary;
- nā maʻi lēpela, kahi e komo ai nā maʻi o ke akepū, nā lupus a me nā hina;
- ka lawe ʻana i nā lāʻau lapaʻau a me nā lāʻau lapaʻau me ka ʻole o ka kauka a ke kauka;
- nā hopena endocrine (hypothyroidism, diabetes mellitus, paʻakikī e nā maʻi o ke kūpaʻa o ke akea).
I waena o nā poʻe i ka pilikia, hiki i kekahi ke hoʻākāka i kēia mau helu:
- mea inu waiʻona a me ka lāʻau inu lāʻau;
- nā poʻe ʻelemakule me kahi hui o nā maʻi concomitant;
- nā mea maʻi me nā pathologies o ka pancreas, ate, gastrointestinal tract;
- nā mea e hōʻino pinepine ʻana i ka momona, ka paʻakai, ka u a me ka momona;
- poʻe me nā ʻeha hōʻeha.
Nā hōʻailona o ka maʻi
Nā hōʻailona maʻamau o ka hemorrhagic pancreatic necrosis i kūleʻa i nā manawa a pau. ʻAʻole hiki ke nānā pinepine iā lākou. I ka hoʻomaka mua, hoʻomaka ka mea maʻi e hopohopo e pili ana i ka ʻōpū, ka ʻehaʻeha o kaʻeha, pinepine pinepine i ka hale ma ka hypochondrium hema.
ʻO kekahi manawa like ke ʻeha o ka ʻeha, i kekahi manawa like ia me nā hōʻailona o ka hōʻā ʻana o ka puʻuwai. Hiki i ka mea ke hōʻemi wale i nā mea hōʻeha ʻeha ma kahi noho, e kū pinepine me kona mau kuli i loko o kona ʻōpū.
Eia kekahi, ʻano hiʻohiʻona i nā hōʻailona:
- ʻōlelo a me ka uwau pinepine ʻana, ʻaʻole ia e haliu mai;
- ke ulu ikaika i ka mahana o ke kino i nā waiwai nui;
- nā hoʻololi i ka ʻili (ʻulaʻula, nā pallor, ke ʻano o ka hematomas, ka piʻi nui ʻana o ka ʻeha me ka pā māmā);
- e kū'ē ana i ke kua o ka necrosis pancreatic, ascites, phlegmon o ka ʻōpū o ka ʻōpū;
- piʻo ke kō i loko o ke koko, kahi mea maikaʻi loa i ka maʻi diabetes a hiki ke alakaʻi i ka comg hyperlycemic coma;
- aia kahi manaʻo o ka hoʻohālikelike ʻana i ka ʻōlelo;
- ka nui o ka urine i hoʻokuʻu ʻia ma ka urination e hōʻemi nui loa;
- kau mai paha ka manawa o ka hanu, wikiwiki ka polu, lele ke koko;
- nā pilikia o ka pūnaehana pīpī (hoʻohiʻa a ʻāʻī paha) i ʻike ʻia;
- e loaʻa i kēlā me kēia hapalima ʻelima kahi kūlana e hina ai, i kēlā me ke kolu o ka mea maʻi i hāʻule i kahi coma.
ʻO nā pae holomua
Nui nā mana kānāwai o ka hoʻomohala ʻana.
I ka mua, nā microorganisms pathogenic hoʻomaka i ka nui e hoʻopili i nā kelenehana pili. Aia ma kahi o ka maʻi e hoʻomaka ai ka luaʻi i ka hōʻeha, lilo ka papa i ka paʻa ʻole, piʻi nui ke ʻano o ke kino.
I ka lua o ka hana, hoʻomaka ka deculposation purulent o nā sela, kahi hōʻaiʻe hemahema i ka mea ʻai. ʻO ka pae ʻino loa ʻo ia ke kolu. Hoʻoulu koke ka maʻi ʻaʻa ma nā wahi o ke kino palupalu, ka wikiwiki o ka luku ʻana i ka pancreas.
Hāʻawi i ka wikiwiki me kahi mau papa e hoʻololi ai i ka mea i hala, ʻaʻole hiki iā ʻoe ke lohi i ke kāhea ʻana i kahi ambulance i kekahi hihia.
Ma hope o ka lawe ʻana i ka mea maʻi i kahi lāʻau lapaʻau, ʻike pono ʻo ia, ke ʻano a me ke ʻano o ke ana o ka necrosis pancreatic, a hoʻomaka ʻia ka mālama ʻana i ke ʻano o nā patology.
ʻO ka maʻi, hiki ke hoʻomohala ma muli o kekahi hopena positing, pono ia i nā hana hoʻokolohua e koi ʻia a me ka mālama ʻana i ka pilikia.
Kahi ʻano a me nā ʻano
Kūkulu ʻia ka necrosis mai ka pathology i kekahi mau ʻano. Hāʻawi kēia iā ʻoe e kuhikuhi i ka hoʻoponopono lāʻau mālama maikaʻi loa a hoʻokau ma luna o ka mea maʻi i hāʻawi ʻia i ka haukapila i ka manawa pono.
Hiki paha ke pio:
- puka liʻiliʻi;
- waena waena;
- ʻohe nui;
- subtotal;
- huakai.
Hoʻokumu ʻia ka maʻi maʻi ma muli o ka nui o ka wahi o ka pancreatic i pā ʻia e ka pancreatic necrosis.
I ka papa mua a i ʻole ka lua, ua maʻule nā palena. I ke kolu, ua ʻike maopopo ʻia a ʻike ʻia. ʻO ka pae subtotal e pili ana i ka make o ka hapa o ka nui o ke kino, ka huina - ka make piha o ke kiko pancreatic.
I nā papa hope loa, nui nā hanana. Pono e hoʻokaʻawale ʻia ke kiko hele.
Pēlā nō, hoʻokaʻawale ka pankreatic necrosis ma ka hele ʻana a i ʻole he launa mai kahi paʻa i hoʻopaʻa ʻia - maʻi a i ʻole ka make.
Diagnosis
Ma ka nānā ʻana a me ke nānā ʻana ma hope, ua ʻokoʻa nā hemorrhagic pancreatic necrosis me nā mau ala ʻē aʻe. No ka hana i kēia, ninaninau ke kauka i ka mea maʻi, ʻike ʻoiai inā hoʻowahāwahā ʻo ia i ka mea ʻawaʻawa a i nā mea momona ahea, nā mea maʻi e pili ana i kāna anamnesis.
ʻO kekahi, ua hele ka mea maʻi i kahi scan CT o ka ʻōpū o ka ʻōpū a i ʻole ke ultrasound, ua hōʻike ʻia nā helu he nui, ʻo ia hoʻi:
- kahi hōʻike koko e hōʻike ana i ka ʻike a ke kauka ma ka ʻike o nā enzyme pancreatic (he hoʻonui ma kēia mau ʻōuli ma o 6.9 mau manawa e hōʻike ai i ka hemorrhagic pancreatic necrosis);
- ka nānāʻana i ka wai o gastric, e hiki ai iā ʻoe ke hoʻoholo wikiwiki a kiʻekiʻe i ka pae o ka acidity;
- urinalysis no ka noiʻi ʻana ma ka ureaplasma a me trypsinogen;
- kani ʻana no ka hoʻoholo ʻana o nā bicarbonates a me nā enzymes;
- hui hanu no amylase a me triglycerides;
- coproscopy pono e aʻo i nā koena momona i nā moʻo.
Ua mālama ʻia kahi puʻukū o ka wahi o ka nekrosis i ka percutaneously, ʻo ka endreatopiko pancreatocholangiography a inā pono, ua hana ʻia ka laparoscopy ʻōpū, kahi e hiki ai ke ʻike i ke ʻano holoʻokoʻa o ka pōʻino i ka pancreas a me nā mea koʻikoʻi kekahi mea ola pono.
Ma hope wale nō o nā kaʻina diagnostic paʻakikī paʻakikī lākou e hoʻomaka e mālama i ka mea maʻi.
ʻO ka maʻi maʻi
I nā ʻōmama mua o ka neka no ka pancreatic, ua mālama ʻia ka mea maʻi. Ma hope o ka hoʻomāʻeha ʻana, hoʻouna ʻia ka mea maʻi i kekahi o ka mālama mālama pilikino, a i ʻole i ka lumi o ka hana. Pono e hana wikiwiki e like me ka hiki e mālama i ka pancreas a me ke ola o ka mea maʻi.
ʻO ka mea mālama:
- e hōʻoluʻolu ana i ka ʻeha a me ka spasm mai nā kumu bile;
- ke pani ʻana i ka hana a ka enzymatic;
- ho'ēmi i ka hana o ka wai gastric;
- ka pale ʻana i ka hoʻopili ʻana o kahi maʻi lua.
Hoʻopaʻa ʻia ka mea maʻi me nā lāʻau lapaʻau e hōʻoluʻolu i ka ʻeha, no ka laʻana, novocaine blockade. Hoʻomaha ʻo Anesthesia i nā panina, hiki i ka wai pancreatic ke puka.
Hiki iā lākou ke hoʻokūkū i ka hoʻoulu ʻana o nā enzymes ma o ka hoʻomākaukau ʻana o ka antienzyme hoʻomākaukau, a me ka mālama ʻana i ka maʻi antibacterial e pale aku i nā maʻi o nā kino a me nā ʻili. Hāʻawi kēia iā ʻoe e hoohi i ke kaʻina hana hewaʻole i ka hana o ka enzymatic a me nā hana humoral o ka pancreas.
Ke lawe ʻia nei ka hana conservative e pili ana i ka ʻenehana o ka wikiwiki ʻona. Hoʻopili wale ʻia nā mea e pono ai nā mea e hoʻokaʻawale i ka mea huna o ka mea huna huna pancreatic.
Ma mua, ua hoʻoneʻe ʻia ka ʻike holoʻokoʻa o ka ʻōpū ma ka holoi ʻana. He mea nui e hāʻawi i ka mea maʻi i ka maluhia a me nā kūlana ʻoluʻolu loa. Pono e hoʻoweliweli ʻia ka lumi me kahi mahana hoʻoluʻolu o ka ea. E kōkua kēia i ka pale ʻana i ka hoʻolaha ʻia o nā toxins i hoʻoiho ʻia e ka mea maʻi.
Inā ʻaʻole e holomua ana, aia kahi pono e hoʻolimalima. Aia ke ʻano o ka hana i ka papa o nā necrosis hemorrhagic pancreatic. ʻO ka pāpaʻi laparoscopy a percutaneous paha he kūpono no nā hihia i nele ai ka maʻi.
Hana ʻia kahi hana cavity ke hōʻiliʻili ʻia ka nui o nā exudate. Hoʻohana nui ʻia ka dialysis peritoneal, kahi e hoʻomaʻemaʻe i ke koko o nā toxins a me nā enzymes a no laila e pale aku i ka mea maʻi mai ka make mai ka make ʻole me nā huahana decay.
Ola ma hope
He lōʻihi a paʻakikī paha ka manawa postoperative. ʻO ke kūlana koʻikoʻi no ka hoʻihoʻi ʻana me ka hoʻōla ʻana me ka hoʻomaha hoʻomaha me ka liʻiliʻi o ka hoʻāliʻi kino no ke kau holo ʻana (ma ka liʻiliʻi he 4 mau mahina)
Pono e lawe i nā lāʻau lapaʻau e pili ana i ka insulin, nā lāʻau lapaʻau e hoʻolauleʻa ai i ka nānā ʻana o nā meaʻai (enzymes).
ʻO ka mea maʻi i loaʻa i ka necrosis pancreatic maʻa ua kauoha ʻia nā hana physiotherapeutic a me nā hoʻomaʻamaʻa physiotherapy e pono ai no ka hoʻihoʻi wikiwiki.
ʻO ke ola mau mea paʻa. Hoʻomaʻina ʻo Diet i ka hoʻemi ʻana i ka ukana ma ka pancreas. He mea nui ia e ʻai maʻamau a mau pinepine (5-6 manawa i ka lā). Pono ka ʻai o ka pākeke a me ka hoʻomau mau ʻana.
Ma waena o nā huahana i manaʻo ʻia no ka hoʻohana ʻana i kēlā me kēia lā.
- kaʻaila a iʻaʻaila ʻole;
- nā cereere ma luna o ka wai;
- ʻai (waʻa);
- mau ʻōpala māmā;
- nā huahana dairy me ka liʻiliʻi momona momona;
- ka ʻai moa.
Nui nā huahana a nā poʻe i loaʻa i kēia maʻi weliweli e hoʻopoina mau loa ai.
Ka lūlū ʻana:
- nāʻaʻaʻai (kai, ʻai, ʻaiā);
- 'ōpau inu,' aʻole ma ka helu liʻiliʻi;
- soda;
- iʻa i kāʻai;
- momona momona;
- nā hana momona hou;
- meaʻai wikiwiki
- waiū piha;
- wailua;
- pickles;
- nā lauala, nā hua ʻai a me nā huaila (hou).
He mea nui ia e pili ana i ia meaʻai e pale ai i ka hoʻoulu ʻia ʻana o nā pilikia pili i ka hiki ʻole o ka pancreas e hana i nā hormones a me nā enzyme e pono ai.
No ka lilo pinepine ka mellitus maʻi maʻi i ka hoʻopiʻi o ka necrosis pancreatic, he mea nui ia e nānā i nā pae o ke kō, a ʻike pinepine ʻia a hahai i nā ʻōlelo lapaʻau a pau o kahi endocrinologist.
Wikiō mai ka mea maʻi i loaʻa ka maʻi:
Kāohi ʻana o ka necrosis pancreatic hemorrhagic
Pono ka mea i pilikia no ka hoʻomohala ʻana i kēia kuʻekuʻe, pono i nā hana pale. No ka hana ʻana i kēia, haʻalele loa i ka hoʻohana ʻana i nā mea inu wai ʻona, pili pono i nā lula o nā meaʻai kūpono.
He mea nui e hōʻoia a mālama i nā maʻi i ka manawa hiki ke alakaʻi i ka hoʻomohala ʻana o ka necrosis hemorrhagic pancreatic - biliary dyskinesia, ulia duodenal a me nā ʻōpū o ka ʻōpū, cholecystitis.
He mea kūpono no ka hoʻomanaʻo ʻana a hiki i ka hoʻokaʻawale manawa i nā meaʻai momona a i ʻole ka mea ʻawaʻawa hiki ke alakaʻi iā pancreatic necrosis a, ma muli o ia, i ka hōʻea kino a hiki nō hoʻi i ka make.
Pono ka poʻe e loaʻa kekahi mōʻaukala o kekahi ʻano maʻi mellitus no ka papa ʻaina. ʻAʻole hiki ke hōʻoiaʻiʻo i nā hana pale maʻalahi e hoʻomohala ka pancreatic necrosis, akā hōʻemi lākou i ka hiki ke ʻike i ka pathology iā ʻoe iho i ka liʻiliʻi.
