Ipancreatitis ebukhali

I-acute pancreatitis kukudumba ngequbuliso kunye nokudumba kwepancreas.

Ipancreas lilungu elibekwe emva kwesisu. Ivelisa iihomoni insulin kunye neglucagon. Ikwavelisa iikhemikhali ezibizwa ngokuba zii-enzymes ezifunekayo ukwetyisa ukutya.

Uninzi lwexesha, ii-enzymes zisebenza kuphela emva kokuba zifike emathunjini amancinci.

• Ukuba ezi enzymes ziyasebenza ngaphakathi kwepancreas, zinokugaya izicwili zepancreas. Oku kubangela ukudumba, ukopha, kunye nomonakalo kwilungu nakwimithambo yegazi.
• Le ngxaki ibizwa pancreatitis etsolo.

I-pancreatitis ebukhali ichaphazela amadoda rhoqo kunabafazi. Izifo ezithile, utyando, kunye nemikhwa kukwenza ukuba ube nakho ukukhula le meko.

• Ukusetyenziswa kotywala linoxanduva lokufikelela kwi-70% yamatyala e-United States. Malunga neziphuzo ezi-5 ukuya kwezi-8 ngosuku kangangeminyaka emi-5 okanye nangaphezulu kunokonakalisa udakada.
• Iigallstones zezona zinto zixhaphakileyo. Xa i-gallstones iphuma ngaphandle kwe-gallbladder ukuya kwimibhobho ye-bile, ivimba ukuvulwa okukhupha i-bile kunye ne-enzyme. Inyongo kunye nee-enzymes "zibuyela umva" kwi-pancreas kwaye zibangele ukudumba.
• Imfuza inokuba yinto ethile kwezinye iimeko. Ngamanye amaxesha, unobangela awaziwa.

Ezinye iimeko ezinxulunyaniswe nepancreatitis zezi:

• Iingxaki zokuzimela ngokuzenzekelayo (xa amajoni omzimba ehlasela umzimba)
• Umonakalo kwimibhobho okanye ipancreas ngexesha lotyando
• Amanqanaba egazi aphezulu amanqatha abizwa ngokuba yi-triglycerides-amaxesha amaninzi angaphezulu kwe-1,000 mg / dL
• Ukwenzakala kwepancreas kwingozi

Ezinye izizathu zibandakanya:

• Emva kweenkqubo ezithile ezisetyenziselwa ukuxilonga iingxaki ze-gallbladder kunye ne-pancreas (ERCP) okanye i-biopsy ekhokelwa yi-ultrasound
• Icystic fibrosis
• Ukudlala okugqithisileyo kweparathyroid
• Isifo seReye
• Ukusetyenziswa kwamayeza athile (ngakumbi ii-estrogens, i-corticosteroids, i-sulfonamides, i-thiazides, kunye ne-azathioprine)
• Usulelo oluthile, olufana noqwilikana, olubandakanya i-pancreas

Olona phawu luphambili lwepancreatitis ziintlungu ezivayo kwicala lasekhohlo elingaphezulu okanye embindini wesisu. Intlungu:

• Isenokuba mandundu emva kwemizuzu emva kokutya okanye ukusela ekuqaleni, ngakumbi ukuba ukutya kunamafutha amaninzi
• Ihlala iqhubeka kwaye iba qatha, ihlala iintsuku ezininzi
• Isenokuba mandundu xa ulele umqolo
• Ngamana ungasasazeka (ukhanyise) ngasemva okanye ngaphantsi kwebala lehlombe lasekhohlo

Abantu abane-pancreatitis ebukhali bahlala bejongeka begula kwaye benomkhuhlane, isicaphucaphu, ukugabha kunye nokubila.

Ezinye iimpawu ezinokuthi zenzeke kwesi sifo zibandakanya:

• Izitulo zombala wodongwe
• Ukuqunjelwa kunye nokuzala
• Iingqungquthela
• Ukutya
• Ubumthubi obunqabileyo besikhumba kunye nabamhlophe bamehlo (i-jaundice)
• Isisu esidumbileyo

Umboneleli wezempilo uya kwenza uvavanyo lomzimba, olunokubonisa:

• Ukuthamba kwesisu okanye isigaxa (ubunzima)
• Ifiva
• Uxinzelelo lwegazi oluphantsi
• Inqanaba lentliziyo elikhawulezayo
• Ukuphefumla ngokukhawuleza (ukuphefumla) inqanaba

Uvavanyo lweLebhu olubonisa ukukhutshwa kwee-enzymes zepancreatic ziya kwenziwa. Oku kubandakanya:

• Ukunyuka kwenqanaba le-amylase yegazi
• Ukunyusa inqanaba le-serum yegazi lipase (isalathiso esithile se-pancreatitis kunamanqanaba e-amylase)
• Ukunyusa inqanaba lomchamo we-amylase

Olunye uvavanyo lwegazi olunokunceda ukufumanisa isifo sepancreatitis okanye iingxaki zayo zibandakanya:

• Gcwalisa ubalo lwegazi (CBC)
• Iphaneli yemetabolism ebanzi

Ezi mvavanyo zilandelayo zinokubonisa ukudumba kwepancreas, kodwa azisoloko zifuneka ukwenza isifo sepancreatitis ebukhali.

• Ukuvavanywa kwe-CT kwesisu
• I-MRI yesisu
• I-Ultrasound yesisu

Unyango kaninzi lufuna ukuhlala esibhedlele. Inokubandakanya:

• Amayeza entlungu
• Ulwelo olunikwa ngomthambo (IV)
• Ukuyekisa ukutya okanye ulwelo ngomlomo ukunciphisa umsebenzi wepancreas

Umbhobho unokufakwa ngempumlo okanye emlonyeni ukususa imixholo yesisu. Oku kunokwenziwa ukuba ukugabha kunye neentlungu ezinzima aziphucuki. Umbhobho uza kuhlala iintsuku ezi-1 ukuya kwezi-2 ukuya kwiiveki ezi-1 ukuya kwezi-2.

Ukunyanga imeko ebangele ingxaki kunokuthintela uhlaselo oluphindaphindiweyo.

Ngamanye amaxesha, unyango luyafuneka ukuze:

• Ukucoca ulwelo oluqokelelwe ngaphakathi okanye ngeenxa zonke zepancreas
• Susa amatye enyongo
• Nciphisa iibhlokhi zepayipi zepancreatic

Kwiimeko ezinzima kakhulu, utyando luyafuneka ukususa izicwili zepancreatic ezonakeleyo, ezifileyo okanye ezosulelekileyo.

Kuphephe ukutshaya, iziselo ezinxilisayo, kunye nokutya okunamafutha emva kokuba uhlaselo luphuculwe.

Uninzi lweziganeko ziyahamba kwiveki okanye ngaphantsi. Nangona kunjalo, ezinye iimeko zikhula zibe sisifo esisongela ubomi.

Izinga lokufa liphezulu xa:

• Ukopha kwipancreas kwenzekile.
• Iingxaki zesibindi, zentliziyo, okanye zezintso zikwakhona.
• Ithumba lenza injeke.
• Kukho ukufa okanye i-necrosis yexabiso elikhulu leethishu kwi-pancreas.

Ngamanye amaxesha ukudumba kunye nosulelo alunyangi ngokupheleleyo. Ukuphindaphinda iziqendu zepancreatitis nazo zinokwenzeka. Zonke ezi zinto zinokukhokelela ekonakaleni kwexesha elide zepancreas.

I-Pancreatitis inokubuya. Amathuba okubuya kwayo axhomekeke kwisizathu, kwaye inyangwa njani. Iingxaki zepancreatitis ebukhali zinokubandakanya:

• Ukungaphumeleli kwezintso
• Ukulimala kwemiphunga yexesha elide (ARDS)
• Ukwakhiwa kolwelo esiswini (ascites)
• Ama-cysts okanye amathumba kwi-pancreas
• Ukumelwa yintliziyo

Fowunela umnikezeli wakho ukuba:

• Unentlungu, isisu esibuhlungu rhoqo.
• Uphuhlisa ezinye iimpawu zepancreatitis ebukhali.

Unokuwunciphisa umngcipheko wokuphindaphinda okanye ukuphinda iziqendu zepancreatitis ngokuthatha amanyathelo okuthintela iimeko zonyango ezinokukhokelela kwisifo:

• Musa ukusela utywala ukuba ngunobangela wohlaselo olubi.
• Qinisekisa ukuba abantwana bafumana amayeza okugonya ukuze bakhusele oonoqwilikana nezinye izifo ezenziwa ngabantwana.
• Phatha iingxaki zonyango ezikhokelela kumanqanaba aphezulu egazi e-triglycerides.

I-Gallstone pancreatitis; Ipancreas - ukudumba

• Pancreatitis - ukubhobhoza

• Inkqubo yokwetyisa
• Amadlala endocrine
• Ipancreatitis, etsolo-CT ukuskena
• Ipancreatitis - uthotho

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IPaskar DD, uMarshall JC. Ipancreatitis ebukhali. Ku: Parrillo JE, Dellinger RP, ii-eds. Unyango oluKhathalelayo oluBalulekileyo: Imigaqo yokuchongwa kunye noLawulo kuLuntu oluDala. Umhla we-5. IPhiladelphia, PA: Elsevier; I-2019: isahluko 73.

Tenner S, Baillie J, DeWitt J, Vege SS; Ikholeji yaseMelika yeGastroenterology. Ikholeji yaseMelika yesikhokelo seGastroenterology: ulawulo lwepancreatitis ebukhali. NdinguJ Gastroenterol. Ngo-2013; 108 (9): 1400-1415. IINKCUKACHA: 23896955 www.ncbi.nlm.nih.gov/pubmed/23896955.

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