Impawu zonyango
Kukho buhlungu, ukuvuvukala, kwaye ngezinye izifo ukuxhatshazwa kwesisu esiswini. Uninzi lwezigulane zixhala malunga nesicathuko kunye nokuhlanza; abanye - kuphela ukucela ukuhlanza. Kukho ukuluhlaza okwebhantshi kummandla ojikeleze inamba (uphawu lukaCullen) okanye i-cyanosis (eluhlaza okwesibhakabhaka) kwesikhumba kwiindawo ezisemgangathweni zesisu (isifo seGrey-Turner). Oku kungabonisa ukungena kwegazi ngaphakathi kwisigxina esiswini. Isibonakaliso sikaCullen singqina ubungqina bokuphuma kwegazi ngaphakathi, apho izicubu ezijikeleze intonga zixutywe ngegazi. Ukunyuka kwegazi kwamanzi kungenxa yokuphulwa kweendlela zokucima igazi ngenxa yokubanjiswa kwee-enzyme ze-pancreatic. I-pancreas ifumaneka emva kwesisu esisemva kwesisu esiswini. Intloko yayo ihlala elukhoneni lwe-duodenum.
I-pancreas ivelisa:
- i-insulini kunye ne-glucagon - i-hormone ekhutshwa ngqo kwigazi kunye nokulawula izinga lezeshukela zegazi;
- ijusi ye-pancreatic - iqukethe ezine i-enzymes eziphula amaprotheni (trypsin, chymotrypsin), kunye namafutha (lipase) kunye nesitashi (amylase). I-pancreatic conduit engaphantsi ikhupha kwi-duct ye-bison ngokuqhelekileyo ngaphambi kokushiya i-duodenum.
Ijusi le-Pancreatic, kunye ne-bile, ixutywe kunye nokutya okutyunyiweyo kwisisu, kusebenze kwaye kuzalise iinkqubo zokuphazamiseka kwezondlo.
Iimbangela eziqhelekileyo ze-pancreatitis ezimbi zi:
- isifo se-bile (45%); umzekelo, ukuqina kwama-gallstones kwimidaka ye-bile ngaphambi kokungena kwi-duodenum;
- utywala obungapheliyo (35%).
Ezinye izizathu:
- ukuphazamiseka komzimba okanye ukungena emzimbeni, umzekelo, ngenxa yokuhlinzwa;
- isilonda esiswini se-duodenum;
- izifo ezibangelwa umxube, ezifana ne-hypercalcemia (ngenxa yokukhubazeka kwezigulane ze-parathyroid kunye nokutya kwezidakamizwa ezine-calcium); i-hypertriglyceridemia (inqanaba eliphezulu le-triglyceride egazini); ukuhluleka kwezintso;
- impendulo kwimithi yokwelapha, umzekelo, ifakwe kwezinye izithintelo zomlomo;
- Izifo ezithintekayo, ezifana neparotitis, i-hepatitis, i-HIV;
- izifo eziphilayo, ezifana nomhlaza we-pancreatic;
- amatyala e-idiopathic (engaziwayo). Inkqubo yesenzo saloo nto ayigcinwanga ngokucacileyo, nangona kunjalo, ngokweminye yeengcamango, iqulethe "ukuzitshisa kwe-self-digestion" ye-gland, xa kusetyenziswa i-enzyme kwiiscupu zayo. Ngokutshabalalisa i-gland, bona, bavulele ezinye i-enzymes, ezifana ne-elastase (i-fibers elastically dissolving mills) kunye ne-phospholipase.
Inkambo yesi sifo
Iimveliso ze-pancreatic zenziwe zingonakalisa iiseli kunye nokulimaza izicubu, kubangele ukuphaphaza, i-edema ne-necrosis ye-pancreas. Ngomzimba omkhulu, izitho ezikufutshane nazo zingonakaliswa, okwandisa ingozi yokuxhatshazwa kunye nezinye iingxaki. Nge-pancreatitis enobuhlungu obunzima, ukuvuvukala kunqunyelwe kuphela kwintsimbi ngokwayo. Izimpawu ezifanayo ziyakubonwa kwezinye izifo zesisu (ukuchithwa okanye ukuvinjelwa kwamathumbu, ukuvutha okukhulu kwe-gallbladder), kunye nesifuba (intliziyo ye-pneumonia).
Uvavanyo lwegazi
Igazi libala ngokuthe ngqo ukuba i-pancreatitis ayikho, kodwa ukuhlolwa kwegazi kunceda ukuncedisa umfanekiso weklinikhi. Kwiimeko ezininzi, inqanaba elongeziweyo le-enzymes (i-amylase ne-lipase) egazini. Ezi zikhombisi zibaluleka bokuxilonga kwinqanaba elisisigxina sesifo, kuba ngeveki babuyele kwisiqhelo. Umgangatho ophezulu we-fatty acid acids owenziwe yi-lipase yenza i-saponification ye-enzymatic kunye nokuncipha kwe-calcium egazini. Umgangatho we-leukocytes egazini kwizigulane ezine-pancreatitis zivame ukuphakanyiswa (i-leukocytosis), kwaye ngenxa yokulahlekelwa kwamanzi, i-hematocrit (ubungakanani bomthamo we-erythrocytes kumthamo we-plasma) uyanda.
Izindlela zokujonga
Ukugqatswa kokugqibela kwe-pancreatitis ephezulu kusekelwe kuphela kwiziphumo ezifunyenwe ngoncedo lweendlela zokujonga: i-ultrasound kunye ne-tomography ecatshulwayo. I-tomography ekhompyutheni iyenziwa ngokugqithisileyo kwimeko ye-pancreatitis kwaye kwimeko yeengxaki. Ngokuncedwa kwezi ndlela, ngamanye amaxesha kunokwenzeka ukuchonga imbangela ye-pancreatitis. Ukutyhila imbangela yesi sifo kuvumela ukuqhuba iindlela zokwelapha ezijoliswe ekuphelisweni kwayo, ekuza kunceda ekukhuseleni ukuhlaselwa ngokuphindaphindiweyo kwe-pancreatitis.
Izakhi ezijikeleziweyo ezimhlophe ezigciniweyo kwi-scan pseudocolor ezenziwe nge-microscope ye-electron zi-lymphocytes (uhlobo lwe-leukocyte). Umgangatho we-leukocytes egazini kwi-pancreatitis ekhuselekileyo ngokuqhelekileyo iphakanyisiwe. Ukugqalwa kwesigxina kuhlolwe kwisilinganisi seshumi elinanye kwisistim esekelwe kwindlela yokuchasisa, equka:
- uneminyaka engaphezulu kwama-55 ngexesha lokubhalisa;
- iimvavanyo zelabhoratri (ezine ekumiseni kunye ezintandathu emva kweeyure ezingama-48). Ukuba kukho iingongoma ezintathu okanye ngaphezulu ngexesha lokungena, umphumo wesiphumo esibulalayo ngu-1: 5; Ukuba kukho iinqonga ezisixhenxe okanye ngaphezulu, iphakama.
Kwiintsuku ezimbalwa zokuqala, ukufa kubangelwa ngenxa yokungaphumeleli komzimba. Kwiimeko ezininzi (i-80%) izigulane ziyafa emva kweveki, ngokuqhelekileyo ngenxa yokuphuhliswa kwesifo (ukusweleka) okanye ukwakha i-cyst yamanga. Ukuphuhliswa kwentsholongwane kwimvelaphi ye-necrosis ye-pancreas kufuneka kukhunjulwe ngokungabikho kwemiphumo yonyango okanye ukuphazamiseka ngokukhawuleza. Ukuphefumula kweziqulatho zesisu esiswini phantsi kolawulo lwe-tomography luyakunceda ukuxilongwa. Ukuba isifiso sezinto ezikhuselweyo asikho ngexesha, inani lokufa lifikelela kuma-100%. Ifomu elincinci le-pancreatitis lingadlulela ngokukhawuleza. Isigulane sinikwa ukunyanzeliswa kwesisu, ukungena kokutya kunye neengxube akuphelelwanga ngokupheleleyo. Ukuphelisa isicupunu kunye nokuhlanza kunye ne-nasogastric tube, isisu sisuswe. Oku kunceda ukuthintela ukutshatyalaliswa, ukunciphisa ukulahleka kwamanzi. Inkqubo isetyenziselwa ukulawula i-anesthetic, ngamanye amaxesha isebenzisa isixhobo esilawulwa ngumguli. Oku kunika isigulane ithuba lokulawula ukungena kweziyobisi, kuxhomekeke kubukhulu beentlungu. Ukuze ugweme ukugqithisa, kukho isixhobo esikhethekileyo esilungiselelwe ukufaka inani elilinganiselweyo lamanani kwixesha elide.
Uvavanyo olupheleleyo
Kwi-pancreatitis enobuchopho obunzima, i-hospitalization iyimfuneko kwiyunithi ekhethekileyo yokunyamekela apho isigulane sihlolisiswa kakuhle kwaye iimpawu ezinobungozi ezibonisa ingozi enkulu yokufa. Unyango lujoliswe ekukhuseleni iingxaki zesifo.