I-pancreatitis enamandla

I-acute pancreatitis ukuvuvukala okungazelelwe nokuvuvukala kwamanyikwe.

Ama-pancreas isitho esitholakala ngemuva kwesisu. Ikhiqiza ama-hormone insulin kanye ne-glucagon. Iphinde ikhiqize amakhemikhali abizwa ngokuthi ama-enzyme adingekayo ukugaya ukudla.

Isikhathi esiningi, ama-enzyme asebenza kuphela ngemuva kokufinyelela emathunjini amancane.

• Uma la ma-enzyme esebenza ngaphakathi kwamanyikwe, angakwazi ukugaya izicubu zomanyikwe. Lokhu kubangela ukuvuvukala, ukopha nokonakala esithweni nasemithanjeni yaso yegazi.
• Le nkinga ibizwa ngokuthi i-acute pancreatitis.

I-acute pancreatitis ithinta abesilisa kaningi kunabesifazane. Izifo ezithile, ukuhlinzwa, nemikhuba kukwenza ube sethubeni lokuthuthukisa lesi simo.

• Ukusetshenziswa kotshwala kubhekene ne-70% yamacala e-United States. Cishe iziphuzo ezi-5 kuye kwezi-8 ngosuku iminyaka emi-5 noma ngaphezulu zingalimaza amanyikwe.
• Ama-gallstones ayimbangela elandelayo evame kakhulu. Lapho ama-gallstones ephuma egalbladder eya emigodini ye-bile, avimba imbobo ekhipha i-bile nama-enzyme. I-bile nama-enzyme "yenza isipele" kumanyikwe futhi kudale ukuvuvukala.
• Izakhi zofuzo zingaba nesici kwezinye izimo. Kwesinye isikhathi, imbangela ayaziwa.

Ezinye izimo ezixhunyaniswe ne-pancreatitis yilezi:

• Izinkinga zokuzivikela ngokuzenzakalela (lapho amasosha omzimba ehlasela umzimba)
• Ukulimala kwamapayipi noma amanyikwe ngesikhathi sokuhlinzwa
• Amazinga aphezulu egazi amafutha abizwa nge-triglycerides - imvamisa angaphezulu kuka-1,000 mg / dL
• Ukulimala kwamanyikwe ngengozi

Ezinye izimbangela zifaka:

• Ngemuva kwezinqubo ezithile ezisetshenziselwa ukuxilonga izinkinga ze-gallbladder ne-pancreas (ERCP) noma i-biopsy eqondiswa nge-ultrasound
• ICystic fibrosis
• Indlala ye-parathyroid eyeqile
• I-Reye syndrome
• Ukusetshenziswa kwemithi ethile (ikakhulukazi ama-estrogens, ama-corticosteroids, ama-sulfonamides, ama-thiazides, ne-azathioprine)
• Ukutheleleka okuthile, njengamagundane, okubandakanya amanyikwe

Uphawu oluyinhloko lwe-pancreatitis ubuhlungu obuzwakala ohlangothini olungaphezulu kwesobunxele noma maphakathi nesisu. Ubuhlungu:

• Kungaba kubi kungakapheli imizuzu ngemuva kokudla noma ukuphuza ekuqaleni, ikakhulu uma ukudla kunokuqukethwe okunamafutha amaningi
• Iba njalo futhi ibe nzima kakhulu, ihlala izinsuku eziningana
• Kungaba kubi kakhulu lapho ulele phansi emhlane
• Ingasabalala (ikhiphe imisebe) emuva noma ngaphansi kwekhasi lehlombe langakwesobunxele

Abantu abane-pancreatitis enamandla bavame ukubukeka begula futhi benomkhuhlane, isicanucanu, ukuhlanza nokujuluka.

Ezinye izimpawu ezingenzeka ngalesi sifo zifaka:

• Izitulo ezinombala wobumba
• Ukuqunjelwa nokugcwala
• Izikhubekiso
• Ukugaya ukudla
• Ukuphuzi okumnene kwesikhumba nabamhlophe bamehlo (i-jaundice)
• Isisu esivuvukile

Umhlinzeki wezokunakekelwa kwempilo uzokwenza ukuhlolwa komzimba, okungakhombisa:

• Ubumnene besisu noma isigaxa (isisindo)
• Imfiva
• Umfutho wegazi ophansi
• Ukushaya kwenhliziyo okusheshayo
• Isilinganiso sokuphefumula okusheshayo (sokuphefumula)

Ukuhlolwa kwelebhu okubonisa ukukhishwa kwama-enzyme e-pancreatic kuzokwenziwa. Lokhu kufaka phakathi:

• Izinga le-amylase yegazi elandisiwe
• Izinga le-serum blood lipase elandisiwe (inkomba ethe xaxa ye-pancreatitis kunamazinga e-amylase)
• Izinga le-amylase yomchamo elandisiwe

Okunye ukuhlolwa kwegazi okungasiza ukuxilonga i-pancreatitis noma izinkinga zayo kufaka:

• Qedela ukubalwa kwegazi (CBC)
• Iphaneli yemethodi ephelele

Ukuhlolwa kwe-imaging okulandelayo okungabonisa ukuvuvukala kwamanyikwe kungenziwa, kepha akudingeki ngaso sonke isikhathi ukuthola ukuxilongwa kwesifo samaphaphu esihlasela ngamandla:

• I-CT scan yesisu
• I-MRI yesisu
• I-Ultrasound yesisu

Ukwelashwa kaningi kudinga ukuhlala esibhedlela. Kungabandakanya:

• Imithi yezinhlungu
• Uketshezi olunikezwa ngomthambo (IV)
• Ukuvimba ukudla noma uketshezi ngomlomo ukunciphisa umsebenzi wamanyikwe

Ishubhu lingafakwa ngamakhala noma ngomlomo ukuze kususwe okuqukethwe yisisu. Lokhu kungenziwa uma ukuhlanza nobuhlungu obukhulu bungathuthuki. Ishubhu lizohlala izinsuku ezi-1 kuya kwezi-2 kuya emavikini ayi-1 kuye kwezi-2.

Ukwelapha isimo esidale inkinga kungavimbela ukuhlaselwa okuphindaphindiwe.

Kwezinye izimo, ukwelashwa kuyadingeka:

• Khipha uketshezi oluqoqwe ngaphakathi noma ezungeze amanyikwe
• Susa amatshe enyongo
• Yehlisa ukuvinjelwa komgudu wepancreatic

Ezimweni ezinzima kakhulu, kudingeka ukuhlinzwa ukuze kususwe izicubu zepancreatic ezilimele, ezifile noma ezinegciwane.

Gwema ukubhema, iziphuzo ezidakayo, nokudla okunamafutha ngemuva kokuba ukuhlaselwa sekwenziwe ngcono.

Amacala amaningi ayahamba ngesonto noma ngaphansi. Kodwa-ke, amanye amacala akhula abe isifo esongela impilo.

Izinga lokufa liphezulu uma:

• Ukopha kumanyikwe kwenzeke.
• Izinkinga zesibindi, inhliziyo, noma izinso nazo zikhona.
• Ithumba lakha amanyikwe.
• Kukhona ukufa noma i-necrosis yamanani amakhulu wezicubu kumanyikwe.

Kwesinye isikhathi ukuvuvukala nokutheleleka akuphulukisi ngokuphelele. Phinda iziqephu ze-pancreatitis nazo zingavela. Okukodwa kwalokhu kungaholela ekulimaleni kwesikhashana kwamanyikwe.

I-Pancreatitis ingabuya. Amathuba okuthi ibuye incike embangela, nokuthi ingelashwa kanjani kahle. Izinkinga ze-pancreatitis ebukhali zingafaka:

• Ukungasebenzi kahle kwezinso
• Umonakalo wamaphaphu wesikhathi eside (ARDS)
• Ukwakhiwa koketshezi esiswini (ascites)
• Ama-cysts noma ama-abscesses kuma-pancreas
• Ukwehluleka kwenhliziyo

Shayela umhlinzeki wakho uma:

• Unobuhlungu obukhulu, obuhlala njalo besisu.
• Uba nezinye izimpawu zokuqaqamba kwamalunga.

Unganciphisa ingozi yakho yeziqephu ze-pancreatitis ezintsha noma eziphindaphindayo ngokuthatha izinyathelo zokuvimbela izimo zezempilo ezingaholela kulesi sifo:

• UNGABUPHUZI utshwala uma kuyimbangela yokuhlaselwa okunamandla.
• Qiniseka ukuthi izingane zithola imishanguzo yokuzivikela ezifweni zomgogodla nezinye izifo ezinganeni.
• Phatha izinkinga zezokwelapha eziholela emazingeni aphezulu egazi e-triglycerides.

I-Gallstone pancreatitis; Amapancreas - ukuvuvukala

• I-Pancreatitis - ukukhipha

• Uhlelo lokugaya ukudla
• Izindlala ze-Endocrine
• I-Pancreatitis, i-acute - i-CT scan
• I-Pancreatitis - uchungechunge

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UPaskar DD, uMarshall JC. I-pancreatitis enamandla. Ku: Parrillo JE, Dellinger RP, ama-eds. Imithi Yokunakekelwa Okubalulekile: Izimiso Zokuxilongwa Nokuphathwa Kwabantu Abadala. Umhlaka 5. IPhiladelphia, PA: Elsevier; 2019: isahluko 73.

Tenner S, Baillie J, DeWitt J, Vege SS; Ikholeji yaseMelika yeGastroenterology. Umhlahlandlela we-American College of Gastroenterology: ukuphathwa kwe-pancreatitis enamandla. NginguJ Gastroenterol. 2013; 108 (9): 1400-1415. I-PMID: 23896955 www.ncbi.nlm.nih.gov/pubmed/23896955.

I-Tenner S, iSteinberg WM. I-pancreatitis enamandla. Ku: Feldman M, Friedman LS, Brandt LJ, ama-eds. ISleisenger neFordtran's Gastrointestinal and Liver Disease: IPathophysiology / Diagnosis / Management. Umhlaka 10. IPhiladelphia, PA: Elsevier Saunders; 2016: isahluko 58.