Pancreatitis pseudotumorous: zimayambitsa, zizindikiro ndi zochitika za mankhwala

Pancreatitis pseudotumorous - imodzi mwa mitundu ya kalembere yotereyi yomwe ili ndi nthawi yaitali. Matendawa amakhudza anthu oposa amuna, osati amayi. Dzina la matendawa limachokera ku mawu akale Achigriki akuti "ziphuphu" - zikondamoyo, "itis" - kutupa ndi "chotupa" - chotupa. Izi zikutanthawuzira kuti zikhoza kukhala-kutupa kwa kapangidwe, kutsanzira ndondomekoyi.

Psevdotumorozny kupanikizika: zifukwa, zizindikiro

Zinthu zomwe zimapangitsa kuti matendawa apitirire, ndizo zomwe zimayambitsa matenda a hepato-biliary (mwachitsanzo, GAD) komanso kumwa mowa kwa nthawi yaitali. Nthawi zambiri - kumwa mankhwala ndi matenda ena. Kawirikawiri, kupwetekedwa kwa pseudotemporous ndi chifukwa cha kutupa kwanthawi yaitali m'magazi a mphukira ndipo sizingatheke (pafupifupi 10 peresenti ya milandu) kuti izindikiridwe pambuyo pa kutupa kwakukulu.

Kukula kwa zizindikiro kumbuyo kwa cholelithiasis nthawi zambiri kumalembedwa mwa amayi. Komabe, sizingakhale zokhumudwitsa zokha, kuipa kwa chitukuko cha biliary, matenda a bongo kapena mapapala a pharyngeal ndi ofunika kwambiri apa. Pazifukwa izi, kutukuka kumapangika chifukwa cha nthawi zonse kutengeka kwa bile mu kanjira ka pancreatic.

Njira imodzi ya chitukuko cha pisudotumorous episititis ikhoza kukhala mitsempha yamatenda am'mimba (nthawi zambiri malo amtundu wamtundu), pamene kutupa kumatuluka kuchokera ku ndulu kumatenda.

Nthawi zambiri, matenda osokoneza bongo omwe amatha kuchitika nthawi zambiri amatha kupezeka poyerekeza ndi kugwiritsiridwa ntchito kwa estrogens, acetaminophen ndi mankhwala ena. Ndipo ndi nthenda yamtundu wambiri, matendawa akukulirakulira, chiwopsezo cha malignancy chimawonjezeka ndipo chilema cholephera chikuwonjezeka mofulumira.

Mawonetseredwe a chipatala

Chidziwitso cha mtundu uwu wa kuperewera kwa thupi ukugwirizanitsidwa ndi kuponderezana kwa kapangidwe ka biliary, endocrine kusakwanitsa ndi kusowa kwa mapulaneti osakanikirana omwe amaphatikizidwa mu chimbudzi. Kuwonjezera apo, pakati pa mawonetseredwe a chipatala muli zizindikiro za zotupa ndi matenda opweteka kwambiri. Gawo loyambirira la mawonekedwe osokoneza amatha kukhala osokoneza.

Koma nthawi zambiri odwala ali ndi zizindikiro zotsatirazi:

• Mankhwala a jaundice;
• Ululu wosadulidwa umene umachitika mutatenga zakudya zamphongo kapena mafuta, kumwa mowa kapena kudya;

• Kudya chakudya mopanda thanzi ;
• Nsea yotsatira ndi kusanza, komwe kumabweretsa mpumulo;
• "Zowawa" zamadzimadzi (steatorrhea);
• Kutsekula m'mimba kusinthana ndi kudzimbidwa;
• Kuchepetsa kusamvana kwa shuga;
• Kupanda kuperewera kwachabechabe;
• Pa palpation - mutu wotsamba wa kapangidwe;
• Gland lokulitsidwa.

Njira zowoneka ngati zizindikiro zazikulu

Ndi matenda omwe amawafotokozera, ziphuphu zimakula, zomwe zimagwirizanitsa ndi ziwombankhanga zapasudotumous pancreatitis, pancreatic cyst), kukula kwa lipomatosis ndi zilonda zapadera.

Njira yotupa, monga lamulo, imakhudza mutu wa zikondamoyo - malo otuluka m'kati mwa njira yaikulu ya pancreatic. Zotsatira zake zimakhala zochepa kwambiri, ndipo madzi amadzimadzi amatsitsimutsa. Chifukwa chake, kuyendayenda kukusefukira, ndipo kupsyinjika kwake kukuwonjezeka. Mavitamini omwe ali mu madzi amayamba kukumba minofu yambiri, yomwe imayambitsa matenda aakulu, omwe nthawi zambiri amaphatikizidwa ndi chiwopsezo chotere.

Mankhwala a jaundice

Pogwiritsa ntchito chithunzithunzichi, chofunika kwambiri chimakhala ndi mutu waukulu wothandizira, kukakamiza holedoch (bile njira). Chotsatira chake, bile yomwe imatulutsa chiwindi singathe kulowa mu duodenum, yomwe imayambitsa kukakamizidwa mu njirayi, ndipo bile imalowa pang'onopang'ono m'magazi.

Madandaulo aakulu ndi mawonekedwe a jaundice ndi awa: zowonongeka zowonongeka, kuyabwa kwakukulu, kuphulika kwa mkodzo ndi chikasu cha sclera ndi khungu.

Momwe mungapezere, kupweteka kwa chifuwa kapena khansa kwa wodwalayo

Chidziwitsochi chimatanthawuza kuti zodandaula zonse ndi zochitika zachipatala zimaganiziridwa ndi matenda ena, osati kagawo kokha (monga khansara), komanso ziwalo zozungulira zomwe zili ndi zizindikiro zofananazo sizinalembedwe. Kwa ichi, zotsatirazi ndizofunikira:

• Kuwonana kwa gastroenterologist.
• Kuchokera kwa anamnesis ndi madandaulo (kale kuperewera kwa matenda, cholelithiasis, mankhwala, kudandaula kwa ululu mu hypochondrium yoyenera ndi epigastric dera, ndi ena).
• Kupenda kwa wodwala ndi matenda a palpation (zotheka kuonjezereka ndi kuchitira chifundo mu dera la chiphalaphala).
• Mayeso a magazi. Mtundu uwu wa kuperewera kwa thupi umakhala ndi kuwonjezeka pang'ono m'magulu a trypsin, amylase ndi lipase, kuphwanya kuvomereza kwa shuga.
• Kutsimikiza kwa magulu a anthu omwe amagwiritsa ntchito mankhwalawa ndi pancreatic polypeptide (kuti pasakhale khansa). Kuwonjezeka kwa chiwerengero cha khansa embryonic antigen, CA 125, CA 19-9, pancreatic polypeptide, matenda a chifuwa amatsimikiziridwa, ndipo kuchepa kwa zinthu zomwe tafotokozazi, kumatsimikizira kuti pali zotupa, zomwe zimatsimikizira kuti matendawa ali ndi pseudotumorous.
• Mapuloteni a ultrasound (kukhalapo kwa hypertrophy, kusintha kwa mapangidwe a mazira ndi minofu, kusakhala / kupezeka kwa calcification).
• CT kapena MRI (kuchotsa mankhwala osokoneza bongo).
• ERCP. Njira yowonetsera kusintha kwa kayendedwe ka pancreatic.
• Kusankha zolinga zokhudzana ndi sayansi (kutsimikiza kwa dziko la pancreatic vessels).

Thandizo

Psevdotumorozny kupweteka kwapakati, omwe amachiza nthawi yovuta kumachitika mu gastroenterology, amadziwika ndi mafunde (mwachitsanzo, kusinthana kwa kuchotsedwa ndi kuwonjezera).

Thandizo la matendawa limatanthauza kukhazikitsidwa kwa zakudya zochepa (tebulo nambala 5). Zakudya zowonongeka zimaloledwa (kasanu kapena kasanu ndi kamodzi patsiku), koma m'magawo ang'onoang'ono. Njira zophika: kuphika ndi kuphika, kawirikawiri - kutseka. Zakudya zopanda mafuta, zokazinga, mazira okazinga, tiyi wolimba, khofi, osati kuchuluka kwa nyama (makamaka nkhumba) ndi mkaka.

Chithandizo chachikulu cha mankhwala ndi mankhwala a etiotropic, ndiko kuti, kuthetseratu zifukwa zopweteka (kumwa mowa, mankhwala) ndi zifukwa zomwe zinayambitsa vutoli. Mwachitsanzo, ndi cholelithiasis - cholecystectomy, ndi zina zotero.

Mankhwala ayenera kuyang'aniridwa kuti athetse vuto la intra- ndi exocrine kulephera kwa mankhwala. Pachifukwa ichi, kukonzekera kwa enzyme kumaperekedwa kuti: "Pancreatin" kuphatikizapo "Solizim" kapena "Lipase". Mavitamini a antiacids ndi calcium amagwiritsidwa ntchito pochepetsa steatorrhea.

Cholinolytics amalamulidwa kuchepetsa discenezia. Kuti athetse vuto lopweteka kwambiri, antispasmodics kapena "Atropine" amagwiritsidwa ntchito. Monga antispasmodic yogwira ntchito ya sphincter ya Oddi, gwiritsani ntchito "Mebeverin" kapena "Gimecromone." Mu nthawi ya kuchulukitsa, mankhwala ophera antibacterial akuphatikizidwa mu chithandizo. Ngati mankhwala osokoneza bongo sachepetsa kutupa kwa gland ndi hypersecretion, ndiye kuti malo otchedwa hyperthermia

Kuphatikiza pa njira zothandizira zomwe tazitchula pamwambapa, kupwetekedwa kwa pseudotumorous is often done endoscopically (mwachitsanzo, papillosphincterotomy) pofuna kupotoza dongosolo la njira. Njira zoterezi zimakhala zogwira mtima kwambiri m'maganizo a dera la prepialillar, papillostenosis, kutambasula kwa kapangidwe kumutu komwe kumaphatikizidwa ndi mawonekedwe a jaundice ndi kuponderezedwa kwa choledochus.

Kupewa

Njira zowonetsera kuti "matenda opatsirana pogwiritsa ntchito pseudotemporous" akuchepetsedwa, choyamba, kukana zakumwa zakumwa zoledzeretsa. Ndikofunika kuti matenda oyenera komanso oyenera a panthawi yake angayambitse matendawa. Zimathandiza kupeŵa matenda ndi zolondola, zolamulidwa ndi adokotala kulandira mankhwala oopsa.

Zolemba

Zolinga zokhudzana ndi zochitika za mtundu wa kuperewera kwa thupi zimakhala zabwino. Matendawa amapezeka ndi zovuta zochepa ndipo amayamba pang'onopang'ono, ndipo kusakwanira kwapopinini sikungathandize kuti chitukuko chiwonongeke komanso kuwonongeka. Kukula kwa matendawa kungalekezedwe ndi kukhazikitsidwa kwa chithandizo cha panthaŵi yake komanso kukhazikitsidwa kwa malingaliro a dokotala yemwe akupezekapo panthaŵi ya kukhululukidwa. Khalani wathanzi!