Gịnị bụ ala ala pancreatitis? Mgbaàmà, ọgwụgwọ

Na Ọdịdị nke ọrịa nke digestive akụkụ nkezi nke n'etiti 5.1 na 9%, bụ nke na-adịghị ala pancreatitis (CP). Na ndị a na ọrịa na-emetụta ndị pancreas, mbufụt amalite. N'ihi ya, na ahu ime degenerative mgbanwe. Ná mmalite enweghị nchịkwa usoro nwere ike n'ihu na ndị na ọdụ nke pancreas, nke isi ma ọ bụ n'etiti akụkụ. Pụta nke ọrịa bụ dum ngwa ọdịda. Ụfọdụ ndị na-adịghị ala ala pancreatitis, emecha anwụ. Enwe ọnụego na ụwa na nkezi nke banyere 11%.

GỤKWUO banyere ọrịa

Ya mere, ihe bụ ala ala pancreatitis? Nke a na okwu ndị ọkachamara ịpụta dum ìgwè nke pancreatic ọrịa. Maka ọrịa nile ji ndị na-esonụ atụmatụ:

• adọ-aga n'ihu N'ezie na ngosipụta nke nnukwu pancreatitis ;
• Baịbụl hiwere isi n'ebe, segmental ma ọ bụ asị ibe mmebi nke pancreatic parenchyma na ụdi nnọchi site connective anụ ahụ;
• mgbanwe ndị na-ductal usoro nke ahu;
• guzobe cysts, pseudocysts, nkume na calcification;
• mmepe nke endocrine na exocrine insufficiency.

The eziokwu na e nwere dị iche iche nke ndị ọrịa, na-atụ aro na International Statistical nhazi ọkwa nke iri idegharị. ICD-10 Ala ala pancreatitis ekewa:

• KP mmanya etiology (K86.0 koodu);
• Ọzọ HP - ọrịa, ugboro ugboro, ntighari, unspecified etiology (K86.1 cipher).

The kasị akpata ala ala pancreatitis

Ọtụtụ mgbe ọrịa emee n'ihi ịṅụbiga mmanya ókè ruo ogologo oge. Na ndị ikom, ala ala pancreatitis, pancreatic cancer ike ịzụlite ma ọ bụrụ na ha na-aṅụ ihe karịrị afọ 15. Na ndị inyom, ihe ize ndụ nke ọrịa enwekwu na ịṅụbiga mmanya ókè ruo ihe karịrị afọ 10.

Mmanya - abụghị naanị ihe na-eme ka ntoputa nke-adịghị ala ala pancreatitis. The akpata ọrịa nwere ike na-edina na ise siga. Bekee na-adaba ngụgụ na anwụrụ ọkụ na banye n'ime n'ime n'ọbara na-agbasa ofụri idem, nwere a ezighị ezi mmetụta na niile esịtidem akụkụ, gụnyere pancreas.

Ndị ọzọ na-akpata ọrịa

N'ihi na ihe ndị ọzọ na-eme ka ala ala pancreatitis (code ICD-10 - 86,0 na 86.1), na-agụnye:

• n'ụzọ nke abụba oriri, protein free nri maka a ogologo oge;
• ọrịa dị iche iche nke eriri afọ tract (neoplasms, cholecystitis et al.);
• buru ibu, ibu oké ibu;
• na-ewere ụfọdụ ọgwụ ( "AZA" "Furosemide", "Prednisolone" sịntetik estrogens, "Erythromycin", "Ampicillin" na ndị ọzọ.);
• ọrịa site na nje virus (cytomegalovirus, ịba ọcha n'anya B, C, wdg).

Studies ekenịmde na-adịbeghị anya gosiri na e nwere a butere n'aka-adịghị ala ala pancreatitis pancreas. Ọ bụ autosomal achị na-ezughị ezu penetrance ọrịa (na a dị iche iche ugboro na phenotype nke site n'usoro okwu media). Ọrịa ndị mmadụ ketara eketa ala ala pancreatitis egosipụta n'oge. Otú ọ dị, ndị ikpeazụ ogbo bụ mgbe e mesịrị ka ụdị ndị ọzọ nke ọrịa.

forms of pancreatitis

E nwere dị iche iche classifications nke ọrịa. Otu n'ime ha bụ ndepụta nke ndị na-esonụ iche nke-adịghị ala ala pancreatitis:

1. Ntighari. Ọ na-adị na 55-60% nke ikpe. Na nke a n'ụdị ngbaghara oge dochie exacerbations enweghị nchịkwa usoro.
2. Mgbu mgbe niile. Nke a na ụdị na-achọta ọtụtụ obere ugboro ugboro (na 20% nke ikpe). Mgbe ya ọrịa mkpesa nke persistent mgbu metụtara nanị akụkụ ụfọdụ na elu afo na radiate na azụ.
3. Psevdoopuholevaya (icteric). The ugboro ole nke a n'ụdị adịghị ala ala pancreatitis bụ 10%. N'ihi na-enweghị nchịkwa na usoro e ji mbufụt na mmepe nke isi nke pancreas na mkpakọ nke ndị nkịtị bile duct.
4. Silent (latent). The udi achọpụtara na 5-6% nke ikpe. Mgbu na ọrịa na-kwupụtara weakly ma ọ bụghị mgbe niile obi na-adị. N'oge ruo n'oge e nwere dyspepsia ruru pancreatic malfunctions.
5. Sclerotherapy. Na nke a ụdị ihe mgbu pụtara na elu afo. Ha na-njọ mgbe nri. Pain so site ọgbụgbọ, omume rụrụ stools, arọ ọnwụ. Na-arụ ultrasound ọkachamara mara size Mbelata na compaction nke pancreas.

Dị Marseilles-Rome nhazi ọkwa, e nwere ụdị nke pancreatitis na-calcifying, okpo, na parenchymal fibrosis. The mbụ n'ime ha a hụrụ oge ufodu lobular pancreatic lesion. The ducts apụta pseudocysts, cysts, calcifications, nkume. Gịnị bụ ala ala okpo pancreatitis ke udi? Na nke a dịgasị iche iche nke ọrịa esịtidem akụkụ na-emetụta dokwara. The nkume na-abụghị kpụrụ, e nwere ihe mgbochi nke isi pancreatic duct. Mgbe parenchymal ụdị ke parenchyma ịzụlite mbufụt. Calcifications na-adịghị kpụrụ, na ductal usoro na-adịghị emetụta. N'ihi fibrosis e ji dochie anya nke parenchyma nke esịtidem ngwa connective anụ ahụ. N'ihi nke a, usoro na-aga n'ihu exo-na endocrine insufficiency.

mgbaàmà

E wezụga eziokwu na ndị dị otú ahụ na-adịghị ala pancreatitis, ọ dị mma ịtụle ihe ịrịba ama nke ọrịa a. Na mmalite nkebi rụrụ na nnukwu ọgụ. Ha na-ji ihe mgbu na epigastric mpaghara. N'ọnọdụ ka ukwuu, ha na-radiating na azụ. Ukwuu na-erughị-ọkiké mgbu emee. Ndị na-adịghị ala ala pancreatitis, ọdụdọ ibili si mmetụta na precipitating ihe. Ha na-nnọọ abụba oriri, na mmanya na carbonated ọṅụṅụ.

N'ihi na ọrịa na-na-ji dyspeptic syndrome. Odika 56% nke ndị mmadụ na-ekwu na ha ọgbụgbọ na vomiting. Na 33% nke ikpe hụrụ arọ ọnwụ na 29% - flatulence na 27% - na ọnwụ nke agụụ. Mgbe ọrịa nwere ike na-egosi ihe mgbaàmà ndị dị otú ahụ dị ka n'ozuzu adịghị ike, ike ọgwụgwụ, belata ikike ịrụ ọrụ.

N'ihi na-adịghị ala ala pancreatitis

Ọkachamara mata anọ nkebi na mmepe nke ọrịa:

1. Preclinical ogbo. Mgbe a na ogbo, ndị ọrịa na-adịghị na-achọpụta na ihe mgbaàmà nke na-adịghị ala pancreatitis. The ọrịa a na-ahụrụ site ohere n'oge ultrasound ma ọ bụ agbakọrọ tomography nke abdominal uji eze.
2. Ogbo mbụ ngosipụta nke mmepe nke ọrịa dị ka ala ala pancreatitis. Adults n'oge a na-amalite na-emekpa mbụ mgbaàmà nke ọrịa. Na oge nke ogbo ike ọtụtụ afọ. Mgbe ụfọdụ, ọrịa na-aga n'ihu ngwa ngwa.
3. Na ogbo nke mmepe nke na-adịgide adịgide na-adakarị mgbaàmà. Ọrịa na-egosi ihe ịrịba ama nke endocrine na exocrine insufficiency. Nnọọ ole na ole ndị mmadụ na-eri, mkpesa nke ihe mgbu na afo.
4. The ikpeazụ nzọụkwụ. Pain ibu obere akpọ. People ejighi ibu budata. Na ikpeazụ na nzọụkwụ e nwere dị iche iche na nsogbu nke adịghị ala ala pancreatitis ruru ka atrophy nke pancreas, endocrine na exocrine insufficiency. Otu n'ime ha - a cancer na-akpọ onye esịtidem ngwa.

Dabere na e ji mara nke-adịghị ala ala pancreatitis emit ìhè n'ime, agafeghị oke na oké N'ezie nke ọrịa. Na obere oké oge exacerbation ime adịkarịghị (1-2 ugboro kwa afọ). Mgbu dị nwayọọ. pancreatic ọrụ na-adịghị emebi.

Gịnị bụ ala ala pancreatitis nke agafeghị oke ogo? Nke a bụ a na ọrịa bụ nke 3-4 exacerbations kwa afọ. Na ha dị ogologo karịa nke dị nwayọọ pancreatitis. Na ọrịa na belatara arọ ahụ ndị mmadụ. Moderately belata exocrine pancreatic ọrụ, e nwere a pancreatic hyperenzymemia.

Na oké exacerbations nke ọrịa na-ugboro ugboro na-adịgide adịgide. Pain esonyere oké dyspeptic syndrome.

Ọgwụgwọ nke ọrịa: ihe mgbaru ọsọ na ndị dị mkpa iji

Na-adịghị ala ala pancreatitis ọgwụ bụ iji nweta ndị na-esonụ ebumnobi:

• Mbelata adakarị mgbaàmà nke ọrịa;
• mgbochi nke nlọghachi azụ;
• ibelata ohere nsogbu nke ọrịa.

Ọkachamara nye iwu ha na-agwọ ndị na-abụghị ọgwụ ọgwụgwọ, aṅụ ọgwụ. Ọ bụrụ na ọ dị mkpa, ịwa ahụ na-rụrụ. Ọgwụgwọ nke-adịghị ala ala pancreatitis okenye nwere ike rụrụ ma n'ụlọ ha na ndị ụlọ ọgwụ. The egosi maka ụlọ ọgwụ anamde mgbanwe nke ọrịa na nnukwu ogbo, ọ na-na oge a na e nwere ihe ize ndụ ndụ nke ọrịa na e nwere mkpa maka parenteral ochichi nke ọgwụ ọjọọ.

Drug-free ọgwụgwọ

Na ọgwụgwọ nke ala ala pancreatitis ekere òkè dị mkpa oriri na-edozi. Mgbe kwuru exacerbations gosiri agụụ na-agụ ụbọchị (1-3 ma ọ bụ karịa) na a ọgaranya alkaline mmiri. Site na-egosi kenyere parenteral ma ọ bụ enteral (iwebata nri n'ime colon na a pụrụ iche nyocha) ike. Na nke a nwetụrụ akwụsị pancreatic secretion, ebelata toxicity na-aghọ ike mgbu syndrome.

Mgbe normalisation nke na-arịa ọrịa ndị mmadụ na-agafere na onu nri. Nri kwesịrị ugboro ugboro, fractional. The kwa ụbọchị menu mee nke mucous soups, akwukwo nri purees, mmiri ara ehi porridge pureed mmiri mmiri. Site ọṅụṅụ kwere compotes, jelii, na-adịghị ike tii, ịnweta mmiri, efere n'úkwù.

Ndị na-esonụ na ngwaahịa na-bụchaghị ekwe:

• akpasu flatulence;
• enwe na ya mejupụtara nke crude eriri;
• na-akpali akpali mmepụta nke digestive juices;
• ọgaranya extractive bekee.

Ọ ga-ekwe omume na-adịghị ala ala pancreatitis nwere azụ na anụ broths, mushrooms na ike akwukwo nri broths, mkpọ, na-ese siga soseji, ọdụdụ azụ na anụ, e ghere eghe ihe oriri, mkpụrụ osisi na akwụkwọ nri na ha raw ụdị, ọgaranya pastries, confectionery, aja aja nri? All ndị a na ngwaahịa na-aju mgbe exacerbation nke ọrịa, ya mere, ha ga-tụfuo. Ị na-mkpa iji wepụ gị ose menu, ice ude na mmanya.

N'oge remissions nri dịgasị ubé. Ndị na-a nchoputa nke "ala ala pancreatitis, pancreatic" gēri pasta, raw vegetables na mkpụrụ, ọ dịghị nkọ, adụ chiiz, butere azu. Ofe pureed ike dochie ot anaghị eri anụ (kabeeji nke Efrata ga-ekwe). Porridge nwere ike ịbụ crumbly, ihe na ok.

Pharmacotherapy nke-adịghị ala ala pancreatitis

The nsogbu nke usoro ọgwụ na nzọụkwụ mbụ bụ inye a ọtọ pancreatic ike. Nke a na-enweta site na:

1. Inweta elu doses nke oge a polyenzyme ego. , «Креон » , «Панцитрат » . Ndị a ọgwụ ọjọọ eme ihe na-agụnye "Mezim Chiefs", "Creon", "pantsitrat".
2. , «Фамотидина » ) или ингибиторов протонной помпы («Омепразола » , «Эзомепразола » ). Oke mgbochi nke gastric acid secretion via H2-ihe nnabata blockers, histamine ( "Ranitidine", "famotidine") ma ọ bụ proton mgbapụta inhibitors ( "Omeprazole" "esomeprazole"). Drugs na-ndinọ parenterally ma ọ bụ ingested.
3. или «Сандостатина » . Iwebata "Octreotide" ma ọ bụ "Sandostatin". Ọgwụ ndị a na-sịntetik analogs nke hormone somatostatin. Ekele ha, belata ọbara mgbali na pancreatic ductal usoro, na otú ebelatawo na nyeere site mgbu.

Ọ bụrụ na ọgwụgwọ jikoro iji belata pancreatic secretion, adịghị akpa ihe analgesic mmetụta, ndị dọkịta ji nye iwu ndị na-abụghị narcotic na narcotic analgesics. "Analgin", "Ketoprofen", "paracetamol" - ọ bụla gị n'ụlọnga ke ala ala pancreatitis nwere ike kenyere onye dọkịta si ìgwè mbụ nke ọgwụ ọjọọ. Nke ọgwụ ọjọọ nke narcotic analgesics, nwere ike họrọ "Promedol," "Tramal", "FORTRAN".

Ọgwụgwọ nke-adịghị ala ala pancreatitis okenye pụkwara ịgụnye nnọchi polyfermental ọgwụ. Egosi maka nzube ya - na na nsị iche ukwuu karịa 15 g abụba kwa ụbọchị, afọ ọsịsa, ngwa ngwa arọ ọnwụ. Multienzyme preparations bụ "abomin", "Chiefs H", "Creon", "Pancreatin", "ememme", "Pankreoflat", "Digestal", "Vobenzim".

Ịwa ahụ ọgwụgwọ nke ọrịa

Mgbe ụfọdụ nke-adịghị ala ala pancreatitis achọ ịwa ahụ. Na-egosi:

• mgbu na-adịghị stoped iji ọgwụ ọjọọ na nri;
• ọnụnọ nke cysts na ahụ etuto na pancreas;
• mgbochi nke opi mgbailu, nke ike-egbo iji endoscopic usoro;
• stenosis nke duodenum;
• fistulas na anyịnya mmepe nke pleural effusion ma ọ bụ ascites;
• enyo nke a cancer na-adịghị egosi na Cytology ma ọ bụ biopsy.

"Ala ala pancreatitis, mgbaàmà na ọgwụgwọ n'ihi na ndị okenye" - otu ihe dị mkpa ọgwụ nke na-achọ anya. Nke a-eji nwayọọ ọrịa, na-aga n'ihu na irreversible usoro. Otú ọ dị, ihe omume ka dị mkpa. Ọ-enye gị ohere ịgbatị ndụ nke na-arịa ọrịa ndị mmadụ, eliminates wetara mgbaàmà e ji mara ndị na-adịghị ala pancreatitis. Ihe atụ, na nnabata ya na-atụ aro na nri, ịjụ mmanya, kwesịrị ekwesị usoro ọgwụ ọrịa ndụ ruo afọ 10. Ọkara nke ndị na-adịghị na-achọ enyemaka ahụ ike na-anọgide na-aṅụ mmanya, anwụrụ ọkụ, unu erila, ịnwụ tupu mgbe ahụ.