Matenda opatsirana

Pancreatitis ndi kutupa kwa kapamba. Matenda a kapamba amapezeka pomwe vutoli silichira kapena kusintha, limakula kwambiri pakapita nthawi, ndipo limabweretsa kuwonongeka kosatha.

Mphepete ndi chiwalo chomwe chimakhala kuseri kwa m'mimba. Zimapanga mankhwala (otchedwa ma enzymes) ofunikira kupukusa chakudya. Zimapanganso mahomoni a insulin ndi glucagon.

Pakakhala zilonda zam'mimba, limba silimatha kupanga michere yokwanira. Zotsatira zake, thupi lanu limalephera kugaya mafuta ndi zinthu zofunika pachakudya.

Kuwonongeka kwa ziwalo za kapamba zomwe zimapanga insulin kumatha kubweretsa matenda ashuga.

Vutoli limayamba chifukwa chomwa mowa mwauchidakwa kwazaka zambiri. Magawo obwerezabwereza a kapamba kakang'ono amatha kudwalitsa kapamba. Chibadwa chingakhale chofunikira nthawi zina. Nthawi zina, chifukwa chake sichimadziwika kapena chimayambitsa miyala ya ndulu.

Zina zomwe zakhala zikugwirizana ndi kapamba kakang'ono:

• Mavuto pamene chitetezo chamthupi chimaukira thupi
• Kutsekeka kwa timachubu (timadontho) tomwe timatulutsa michere kuchokera m'mankhwala
• Cystic fibrosis
• Mulingo wambiri wamafuta, wotchedwa triglycerides, m'magazi
• Kuchulukitsa kwa parathyroid gland
• Kugwiritsa ntchito mankhwala ena (makamaka sulfonamides, thiazides, ndi azathioprine)
• Pancreatitis yomwe imaperekedwa m'mabanja (cholowa)

Matenda opatsirana opatsirana amapezeka kwambiri mwa amuna kuposa akazi. Izi nthawi zambiri zimachitika mwa anthu azaka 30 mpaka 40.

Zizindikiro zake ndi izi:

ZOPUWA ZA M'MANTHU

• Wamkulu kwambiri pamimba pamimba
• Zitha kukhala kuyambira maola mpaka masiku; popita nthawi, mutha kupezeka nthawi zonse
• Zitha kuyipa kwambiri pakudya
• Zitha kukulirakulira ndikamamwa mowa
• Atha kumvekanso kumbuyo ngati kosangalatsa kudzera m'mimba

MAVUTO OTSOGOLERA

• Kuchepetsa thupi nthawi zonse, ngakhale pomwe kudya ndi kuchuluka kwake ndikwabwinobwino
• Kutsekula m'mimba, nseru, ndi kusanza
• Mafuta onunkha onunkha kapena ndowe yamafuta
• Zojambula zofiirira kapena zalalanje

Kuyesa kuti mupeze matenda opatsirana ndi awa:

• Mayeso amafuta
• Kuchuluka kwa seramu amylase mulingo
• Kuchuluka kwa seramu lipase mulingo
• Seramu trypsinogen

Mayeso omwe angawonetse chifukwa cha kapamba ndi awa:

• Seramu IgG4 (yodziwitsa matenda opatsirana pogonana)
• Kuyesa kwa majini, komwe kumachitika nthawi zambiri ngati zifukwa zina zomwe zimafala kulibe kapena kuli mbiri ya banja

Kujambula mayeso omwe angawonetse kutupa, mabala, kapena kusintha kwa kapamba kumawoneka pa:

• CT scan pamimba
• Ultrasound pamimba
• Endoscopic ultrasound (EUS)
• Magnetic resonance cholangiopancreatography (MRCP)
• Endoscopic retrograde cholangiopancreatography (ERCP)

ERCP ndi njira yomwe imayang'ana ma ducts anu a bile ndi kapamba. Zimachitika kudzera mu endoscope.

Anthu omwe akumva kuwawa kwambiri kapena omwe akuchepetsa thupi angafunike kukhala mchipatala kuti:

• Mankhwala opweteka.
• Madzi operekedwa kudzera mumtsempha (IV).
• Kuyimitsa chakudya kapena madzimadzi pakamwa kuti muchepetse zochitika za kapamba, kenako pang'onopang'ono kuyamba kudya mkamwa.
• Kuyika chubu m'mphuno kapena mkamwa kuti muchotse zomwe zili m'mimba (kuyamwa kwa nasogastric) nthawi zina kumachitika. Thubhu imatha kukhala mkati mwa masiku 1 mpaka 2, kapena nthawi zina kwa sabata limodzi mpaka 2.

Zakudya zoyenera ndizofunikira kwa anthu omwe ali ndi matenda opatsirana operewera kuti azitha kulemera bwino ndikupeza michere yoyenera. Katswiri wazakudya akhoza kukuthandizani kuti mupange zakudya zomwe zimaphatikizapo:

• Kumwa zakumwa zambiri
• Kuchepetsa mafuta
• Kudya zakudya zazing'ono, zomwe zimachitika pafupipafupi (izi zimathandiza kuchepetsa kugaya m'mimba)
• Kupeza mavitamini ndi calcium yokwanira mu zakudya, kapena zowonjezera zowonjezera
• Kuchepetsa caffeine

Wothandizira zaumoyo atha kupatsa michere ya kapamba. Muyenera kumwa mankhwalawa nthawi iliyonse yakudya, ngakhale musakhale ndi zokhwasula-khwasula. Mavitaminiwa amakuthandizani kugaya chakudya bwino, kunenepa komanso kuchepetsa kutsegula m'mimba.

Pewani kusuta ndi kumwa zakumwa zoledzeretsa, ngakhale kapamba kanu kali kochepa.

Mankhwala ena atha kukhala:

• Mankhwala opweteka kapena chotchinga chotchinga kuti muchepetse ululu
• Kutenga insulini kuti muchepetse kuchuluka kwa shuga wamagazi (shuga)

Opaleshoni itha kuchitidwa ngati kutseka kumapezeka. Zikakhala zovuta, gawo limodzi kapena kapamba lonse limatha kuchotsedwa.

Ichi ndi matenda oopsa omwe angayambitse kulemala ndi kufa. Mutha kuchepetsa ngozi popewa mowa.

Zovuta zingaphatikizepo:

• Ascites
• Kutsekeka (kutsekeka) kwamatumbo ang'onoang'ono kapena ma ducts
• Magazi atsekereza pamitsempha ya ndulu
• Zosonkhanitsa zamadzimadzi m'matumba (pancreatic pseudocysts) omwe atha kutenga kachilomboka
• Matenda a shuga
• Kutenga mafuta, michere, ndi mavitamini moperewera (nthawi zambiri mavitamini osungunuka ndi mafuta, A, D, E, kapena K)
• Kusowa kwa magazi m'thupi kwachitsulo
• Kulephera kwa Vitamini B12

Itanani omwe akukuthandizani ngati:

• Mumakhala ndi zizindikilo za kapamba
• Muli ndi kapamba, ndipo zizindikilo zanu zimakulirakulira kapena sizikusintha ndi mankhwala

Kupeza chomwe chimayambitsa matenda opatsirana mwachisawawa ndikuchiza mwachangu kungathandize kupewa kapamba. Chepetsani kuchuluka kwa zakumwa zomwe mumamwa kuti muchepetse chiopsezo chanu.

Matenda kapamba - aakulu; Kapamba - matenda - kutulutsa; Kulephera kwa Pancreatic - matenda; Pachimake kapamba - aakulu

• Pancreatitis - kumaliseche

• Dongosolo m'mimba
• Pancreatitis, matenda osachiritsika - CT scan

Forsmark CE. Matenda opatsirana. Mu: Feldman M, Friedman LS, Brandt LJ, olemba. Sleisenger ndi Fordtran's Mimba ndi Matenda a Chiwindi: Pathophysiology / Diagnosis / Management. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016: chap 59.

Chidziwitso cha CE. Pancreatitis. Mu: Goldman L, Schafer AI, olemba. Mankhwala a Goldman-Cecil. 26 wa. Philadelphia, PA: Elsevier; 2020: chap 135.

Paniccia A, Edil BH. Kusamalira matenda opatsirana aakulu. Mu: Cameron JL, Cameron AM, olemba, eds. Chithandizo Chamakono Cha Opaleshoni. Wolemba 12. Philadelphia, PA: Elsevier; 2017: 532-538.