Pachimake necrosis a kapamba. Zizindikiro, chithandizo

Kapamba chinapangitsa ndi peritoneum pa mlingo I-II lumbar vertebral zigawo. thupi ili kumatanthauza ndondomeko zofunika kwambiri m'thupi. Kenako, ife adzamvetsa, zimene ntchito yake, zomwe zingakhale monyanyira unathandiza. Makamaka, tikambirana zinadziwika pachimake pancreatic necrosis.

mwachidule

Kapamba (wamuyezo: 15-10 cm - kutalika kwa masentimita 2-3 - m'lifupi) imatengedwa lalikulu thupi zokwanira. ake kulemera akuluakulu - 100 ga pobadwa thupi lakelo palibe magilamu atatu. Anthu, thupi amagwira ntchito ziwiri zofunika. Tiyeni tione iwo mwatsatanetsatane m'munsimu.

ntchito limba

Exocrine kapamba n'kofunika duodenum ndi - akuyimila pakatikati ake madzi pancreatic. Lili michere: amylase, lactase, maltase, lipase, trypsin ndi zina. Chifukwa madzi pancreatic kwatha acidic zili muzituluka ndi chimbudzi chakudya. Poyamba, michere amatuluka mu mawonekedwe wofooka, kenako mphamvu ya 12-duodenum. zochita zawo walangizidwa kuwonongedwa kwa chakudya, mafuta, mapuloteni pa zigawo zikuluzikulu. Kutsegula wa michere zimakhudza ya ndulu enterokinase. Internal katulutsidwe ndi kupanga mankhwala ofunika. Zikuphatikizapo, makamaka monga lipokain, glucagon ndi insulin. Otsiriza awiri amatsutsa kwa wina ndi mzake. Iwo nawo lamulo ndende shuga, zimam'patsa kagayidwe. Chifukwa lipokaina mapangidwe amapezeka phospholipids chiwindi. Zimenezi, kumakhudza opindulitsa pa makutidwe ndi okosijeni zidulo mafuta. Pa akusowa lipokaina mwina mafuta m'chiwindi.

ducts

Mkati England ndi apatsira njira akutsegula mu duodenum ndi. Ya ndulu wamba ndi ducts pancreatic, nthawi zambiri anapanga vial. Chifukwa, iwo kutsegula lalikulu nipple 12 mmatumbo chilonda. The pancreatic ducts yachibadwa kuthamanga ayenera kukhala apamwamba kuposa wamba ya ndulu ritsa. Ichi ndi chifukwa kufunika kuteteza amasulidwe nkhani matumbo ndi chikhodzodzo ndulu.

Kuyan'anila za ntchito thupi

Pamene kusintha kusiyana kuthamanga mu ritsa pancreatic akuoneka oopsa. Iwo amagwirizana ndi vuto la outflow wa madzi pancreatic, kumasula nkhani za ndulu kapena matumbo. Against maziko a amayamba kuthamanga maselo awo pancreatic anayamba imawonongeka. Wa michere imeneyi imatulutsidwa ndi adamulowetsa kugwirizana. Iwo kudutsa mu parenchyma, mafuta ndi connective minofu ya prostate. Chifukwa ndi unyolo anachita. Kudzera mwa puloteni imodzi adzamasulidwa onse. Izi amakwiya ndi ndondomeko yotupa chopita chinawonjezeka magazi, ndipo kenako - ndi stagnation magazi. Zimenezi thrombosis ku England lapansi. Chifukwa, magazi matenda amapezeka kapamba, nthawi zambiri n'zothandiza pancreatic necrosis.

Zimayambitsa matenda a

chikhalidwe Pathological zambiri zikuoneka chifukwa cha kuvutika ndi chifundo cha kapamba osakwatira kapena mobwerezabwereza. Mawonekedwe pachimake n'zogwirizana ndi cholelithiasis. Monga zinthu precipitating mutuluka zilonda (m'mimba kapena duodenum 12), ndi matenda enaake, matenda a chiwindi, uchidakwa.

chofunika

Monga tanena imodzi mwa ntchito za zopangitsa endocrine monga ulimi wa mahomoni. Pogwira ntchito imeneyi nawo Pa Zilumba za Langerhans. Pankhani ya kugonjetsedwa awo maziko a pathologies, kuphatikizapo kapamba aakulu mkati, kukhala mafuta alibe ya chiwindi ndi matenda a shuga (shuga). Kapamba amatha kudziletsa kusintha mtundu wa chakudya. Izi zidalira pa kudya chakudya. Mukalandira wambirimbiri zimam'patsa ndi adamulowetsa kuposa komanso yogawanika michere awo. Ngati kulamulira zakudya mafuta, amabala lipase kwambiri, ndipo ngati mapuloteni - trypsin. Komabe, kumwa zinthu izi siziyenera kukhala. mfundo ndi yakuti kapamba sikawirikawiri amapereka zizindikiro za zimamuchulukira zotheka. Kawirikawiri kumaonekera ndithu anachita ziwawa, amene umboni kuti siteji koyamba za matenda, ndi pachimake zake zonse.

Zotsatira za matenda ananyalanyaza

Mwamwano wa boma la kapamba zingachititse mavuto osiyanasiyana. Vuto lagona makamaka chakuti pafupi kuti pali mabungwe ena amene ali n'kofunika thupi. Izi, makamaka, ndulu, chiwindi, m'mimba. Iwo sakhala patali ndi mtima. Pamene kuyan'anila mu ntchito za kapamba ndi thupi anatsindika. Kusintha dongosolo zimachitika mofulumira kwambiri. Kwa maola khansa pancreatic zina chabe.

Pachimake necrosis a kapamba

Zimenezi ndi minofu chiwonongeko thupi. chitukuko zimakhudza zinthu zosiyanasiyana zoopsa. Pa mtima wa iwo lagona kutupa limba. Pachimake necrosis a kapamba akufotokozera mu nkhani ya kumangika kwa Kupenda ake ndi mankhwala. Pa nawo yogwira michere zawo thupi. Kudzera mu ntchitoyi awo chosinkhasinkha kapamba. Pamene adamulowetsa michere interstitial patsogolo njira pathological. Chifukwa, iwo anapanga foci wa necrosis mafuta.

Kufotokozera za ndondomeko

Chifukwa cha akuwaza zidulo mafuta amapezeka pH kosangalatsa. Izi imayendetsa okhudza maselo ambiri tripsogen. Kenako, adziwonetsa trypsin. pawiri Zimenezi, akuziyambitsa proteases kuti apange yeniyeni matumba proteolytic. Michere anayamba kuwononga makoma mtima ndi minofu connective. Zowononga ndondomeko chimafikira kupitirira kapamba. Thupi kuchira mu nkhani zimenezi n'zosatheka. Pamene mawonetseredwe a zizindikiro zoonekeratu imfa kungakhale mwamsanga.

zinthu kukulitsa

Necrosis a kapamba, zizindikiro amene ayankhidwa pansipa, nthawi zambiri zimakhala za mowa kwambiri mowa, kudya, dyskinesia kapepala kakuti biliary, michere kuvutika outflow chifukwa cholangitis, calculous cholecystitis. Challenge kudwala mulole mlingo pachithunzichi mankhwala, kuphwanya mlingo ndi dera ntchito. Pachimake pancreatic necrosis ingayambe ndi matenda opatsirana pafupipafupi nkhawa.

kudwala chifukwa

Malinga kuchuluka kwa, pachimake pancreatic necrosis kungakhale zambiri komanso mogwirizana. Dongosololi akhoza patsogolo mofulumira kapena mwachilungamo waulesi otaya. Malinga ndi mtundu wa pathological Inde pancreatic anapatukana mu zowononga zinchito, hemostatic, hemorrhagic ndi edematous. inawo imatengedwa mawonekedwe ambiri wofatsa. Chifukwa kuchuluka kutupa kapamba kumene kumapangitsa kuwonjezeka kukakamiza pankreotsity ndi matenda microcirculation. Chithandizo cha siteji edematous, kawirikawiri bwinobwino. Ponena za mwadzidzidzi kudwala aluso zimatengera mtundu kuthamanga. Makamaka, necrotic ndondomeko amapereka outflow wa pancreatic khansa ya m'mimba michere. Chifukwa cha chimbudzi kumayambira mkati thupi. M'kupita kwa ndondomeko akuyamba kusalola mafinya mu zonse m'mimba. Chifukwa cha peritonitis akufotokozera mu mawonekedwe pachimake. Izi amatipeza opaleshoni. Apo ayi kuyamba sepsis, kudzetsa imfa.

chithunzi matenda

ndi zizindikiro za necrosis pancreatic chiyani? Zizindikiro za matenda silamphamvu. Lamanzere chapamwamba nusu ululu wa nsungu zoster akufotokozera khalidwe. Zimafalikira thupi lonse pansipa nthiti. Ululu phewa ndi kupereka tsamba monga matenda amtima. Njira ali limodzi ndi kusanza profuse, bloating, flatulence. Wodwalayo watentha thupi, khungu akutembenukira wotumbululuka kapena reddens. The chizindikiro chachikulu cha chikhalidwe pathological amati chizindikiro cha Gray-Turner. Izo kumaonekera mwa mawonekedwe a mawanga bluish pa mbali ya pamimba. Palpation khoma amalembedwa ululu, nkhawa. Matenda ikuchitika zochokera kuzionetsetsa zithunzi, madandaulo mtima, komanso chifukwa cha maphunziro zoimbidwa ndi zasayansi. Kuti aone parenchymal echogenicity akusankhidwa ndi ultrasound. CT ndi Kujambula mapanga sikani, angiography ndi laparoscopy amakulolani anapereka isanayambike chenicheni cha matenda.

miyeso achire

Chithandizo cha necrosis pachimake akhoza kukhala mwina opaleshoni kapena ndiwofatsa. Chisankho kudzadalira kusintha pathological mu thupi. kukhudzana mankhwala akapatsidwa payekha. Mwa mankhwala osavomerezeka chifukwa phwando, - spasmolytics (kutanthauza "No-spa" Mwachitsanzo), ndi mankhwala antifermental cytotoxic zokhudza enzyme kaphatikizidwe. Njira ya opaleshoni ntchito ndi laparotomy ndi laparoscopy. Komabe, m'kupita kwa ntchito izo Sizotheka wokonzeka kuthana ndi kudwala. Ambiri, chithandizo cha odwala pokhazikitsa kuchipatala imagwiridwa.