Pachimake kapamba

Pachimake kapamba ndi kutupa mwadzidzidzi ndi kutupa kwa kapamba.

Mphepete ndi chiwalo chomwe chimakhala kuseri kwa m'mimba. Amapanga mahomoni a insulin ndi glucagon. Zimapanganso mankhwala omwe amatchedwa michere omwe amafunikira kupukusa chakudya.

Nthawi zambiri, ma enzyme amangogwira ntchito akangofika m'matumbo ang'onoang'ono.

• Ngati michere iyi imagwira ntchito mkati mwa kapamba, imatha kugaya minofu ya kapamba. Izi zimayambitsa kutupa, kutuluka magazi, ndi kuwonongeka kwa chiwalo ndi mitsempha yake yamagazi.
• Vutoli limatchedwa kuti pachimake kapamba.

Pachimake kapamba amakhudza amuna nthawi zambiri kuposa akazi. Matenda ena, maopaleshoni, ndi zizolowezi zimakupangitsani kuti mukhale ndi vutoli.

• Kumwa mowa ndikochititsa kuti 70% yamilandu ku United States. Pafupifupi zakumwa 5 mpaka 8 patsiku kwa zaka 5 kapena kupitilira apo zitha kuwononga kapamba.
• Mwala wamiyala ndi chifukwa chotsatira kwambiri. Ma gallstones akamatuluka mu ndulu kupita m'matope a bile, amatsekereza kutseguka komwe kumatulutsa bile ndi michere. Mitsempha ya ndulu ndi michere "imabwereranso" m'mapapo ndipo imayambitsa kutupa.
• Chibadwa chingakhale chofunikira nthawi zina. Nthawi zina, chifukwa chake sichimadziwika.

Zina zomwe zakhudzana ndi kapamba ndi izi:

• Mavuto omwe amadzichotsera okha (chitetezo chamthupi chikamalimbana ndi thupi)
• Kuwonongeka kwa ducts kapena kapamba pa opaleshoni
• Magazi okwera kwambiri omwe amatchedwa triglycerides - nthawi zambiri amaposa 1,000 mg / dL
• Kuvulala kwa kapamba kuchokera pangozi

Zina mwa zifukwa zake ndi izi:

• Pambuyo pazinthu zina zomwe zimagwiritsidwa ntchito pozindikira mavuto a ndulu ndi kapamba (ERCP) kapena biopsy yoyendetsedwa ndi ultrasound
• Cystic fibrosis
• Kuchulukitsa kwa parathyroid gland
• Matenda a Reye
• Kugwiritsa ntchito mankhwala ena (makamaka ma estrogens, corticosteroids, sulfonamides, thiazides, ndi azathioprine)
• Matenda ena, monga ntchintchi, zomwe zimakhudza kapamba

Chizindikiro chachikulu cha kapamba ndikumva kupweteka kumtunda wakumanzere kapena pakati pamimba. Ululu:

• Zitha kukhala zoyipa patangopita mphindi zochepa mutadya kapena kumwa, makamaka ngati zakudya zili ndi mafuta ambiri
• Amakhala okhazikika komanso okhwima, okhalitsa masiku angapo
• Zitha kukhala zoyipa kwambiri mutagona chafufumimba kumbuyo
• Itha kufalikira (kunyezimira) kumbuyo kapena pansi paphewa lamanzere

Anthu omwe ali ndi kapamba kakang'ono nthawi zambiri amawoneka odwala ndipo amakhala ndi malungo, nseru, kusanza, ndi thukuta.

Zizindikiro zina zomwe zingachitike ndi matendawa ndi monga:

• Zojambula zofiira
• Kuphulika ndi chidzalo
• Zovuta
• Kudzimbidwa
• Chikopa chofewa cha khungu ndi azungu amaso (jaundice)
• Kutupa pamimba

Wothandizira zaumoyo adzayesa, omwe angawonetse:

• Kutentha m'mimba kapena mtanda (misa)
• Malungo
• Kuthamanga kwa magazi
• Kuthamanga kwa mtima mwachangu
• Kupuma mofulumira (kupuma)

Mayeso a labu omwe akuwonetsa kutulutsa kwa michere ya pancreatic adzachitika. Izi zikuphatikiza:

• Kuchuluka kwa magazi amylase mulingo
• Kuchuluka kwa seramu yamagazi lipase mulingo (chizindikiritso chodziwika bwino cha kapamba kuposa amylase)
• Kuchuluka kwa mkodzo msinkhu wa amylase

Mayeso ena amwazi omwe angathandize kuzindikira kapamba kapena zovuta zake ndi monga:

• Kuwerengera kwathunthu kwa magazi (CBC)
• Zowonjezera zamagetsi

Mayesero otsatirawa omwe angawonetse kutupa kwa kapamba atha kuchitika, koma sikuti nthawi zonse amafunikira kuti azindikire kuti pali kapamba.

• CT scan pamimba
• MRI ya pamimba
• Ultrasound pamimba

Chithandizo nthawi zambiri chimafuna kugona mchipatala. Zitha kuphatikizira:

• Mankhwala opweteka
• Madzi operekedwa kudzera mumtsempha (IV)
• Kuyimitsa chakudya kapena madzi pakamwa kuti muchepetse ntchito za kapamba

Chubu chitha kulowetsedwa kudzera pamphuno kapena pakamwa kuti muchotse zomwe zili m'mimba. Izi zitha kuchitika ngati kusanza komanso kupweteka kwambiri sikusintha. Chubu chimakhala mkati mwa masiku 1 mpaka 2 mpaka 1 mpaka 2 milungu.

Kuthana ndi vuto lomwe ladzetsa vutoli kumatha kupewa kuukira mobwerezabwereza.

Nthawi zina, mankhwala amafunika kuti:

• Thirani madzi omwe asonkhanitsa kapamba kapena mozungulira
• Chotsani ndulu
• Pewani zotchinga zapakhosi

Pazovuta kwambiri, opaleshoni imafunika kuchotsa minofu yowonongeka, yakufa kapena yomwe ili ndi kachilombo.

Pewani kusuta, zakumwa zoledzeretsa, ndi zakudya zamafuta mukatha.

Nthawi zambiri zimatha patatha sabata limodzi kapena kuchepera apo. Komabe, milandu ina imayamba kukhala matenda owopsa.

Chiwerengero chaimfa chimakhala chachikulu pamene:

• Kutuluka magazi m'makondomu kwachitika.
• Mavuto a chiwindi, mtima, kapena impso amapezekanso.
• Chithupsa chimapanga kapamba.
• Pali imfa kapena necrosis yazinthu zazikulu m'matumba.

Nthawi zina kutupa ndi matenda sikuchira bwino. Kubwereza magawo a kapamba amathanso kuchitika. Zonsezi zingayambitse kapamba.

Pancreatitis imatha kubwerera. Mwayi wobwerera umadalira chifukwa, komanso momwe angachiritsiridwe. Zovuta za pachimake kapamba zimatha kuphatikiza:

• Pachimake impso kulephera
• Kuwonongeka kwamapapo kwakanthawi (ARDS)
• Kumanga madzimadzi pamimba (ascites)
• Ziphuphu kapena zotupa m'matumba
• Mtima kulephera

Itanani omwe akukuthandizani ngati:

• Muli ndi ululu wam'mimba, wokhazikika.
• Mumakhala ndi zizindikilo zina za kapamba kakang'ono.

Mungachepetse chiopsezo chanu chatsopano kapena kubwereza magawo a kapamba mwachitapo kanthu popewa matenda omwe angayambitse matendawa:

• Musamamwe mowa ngati mwina zikuwopsa kwambiri.
• Onetsetsani kuti ana alandira katemera kuti awateteze ku matendawa ndi matenda ena a ana.
• Chitani mavuto azachipatala omwe amatsogolera ku milingo yayikulu yama triglycerides.

Kupweteka kwamatenda amiyala; Mankhusu - kutupa

• Pancreatitis - kumaliseche

• Dongosolo m'mimba
• Matenda a Endocrine
• Pancreatitis, pachimake - CT scan
• Pancreatitis - mndandanda

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

Paskar DD, Marshall JC. Pachimake kapamba. Mu: Parrillo JE, Dellinger RP, olemba. Zovuta Zosamalira Mankhwala: Mfundo Zazidziwitso ndi Kuwongolera Kwa Akuluakulu. 5th ed. Philadelphia, PA: Elsevier; 2019: mutu 73.

Tenner S, Baillie J, DeWitt J, Vege SS; American College of Gastroenterology. Upangiri wa American College of Gastroenterology: kasamalidwe ka kapamba kakang'ono. Ndine J Gastroenterol. 2013; 108 (9): 1400-1415. PMID: 23896955 www.ncbi.nlm.nih.gov/pubmed/23896955.

Wopanga S, Steinberg WM. Pachimake kapamba. 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 58.