Parapancreatitis thiab pancreatogenic abscess yog dab tsi?

Pin
Send
Share
Send

Pancreatitis yog pathology, txoj kev txhim kho ntawm nrog uas tshwm sim los ntawm qhov tshwm sim ntawm ntau yam teeb meem. Cov kab mob pathological no tuaj yeem tshwm sim los ntawm qhov tshwm sim ntawm kev zom zaws ntawm cov ntaub so ntswg puag ncig, rhuav tshem cov txheej txheem hauv cov ntaub so ntswg ntawm tus txiav, kis tau tus kab mob mus rau hauv kev tsom mus rau ntawm o.

Hauv cov kab mob pancreatitis, qhov pom tshwm sim ntawm kev ua txhaum tshwm sim sai heev. Feem ntau cov kev ua txhaum cai no yog ib qho txiaj ntsig ntawm kev hloov zuj zus ntawm cov txheej txheem ua txhaum hauv foci ntawm pancreatic necrosis. Nyob rau hauv muaj mob ntawm tus kab mob pancreatitis, cov kev tsis zoo no tuaj yeem tshwm sim qeeb qeeb hauv ob peb lub xyoo.

Feem ntau cov kev tsis txaus siab yuav tsum muaj kev phais mob thaum kho. Ua raws li lub sijhawm ntawm kev tshwm sim ntawm kev ua txhaum, lawv tau muab faib ua ob pawg - thaum ntxov thiab lig. Tsis tas li ntawd, kev faib tawm yog ua tiav raws li cov kev ua kom pom hauv cheeb tsam ntawm qhov teeb meem cuam tshuam nrog rau kev tsom mus rau thawj tus kab mob.

Txheeb ze rau qhov tseem ceeb ntawm kev tsim kho ntawm pathology, cov ntau yam hauv qab no tau txawv hauv kev faib tawm:

  1. Cov nquag - npog tag nrho lub plab zom mov, kab mob pancreatic thiab parapancreatic fiber.
  2. Hauv zos thiab hloov khoom nruab nrog - muaj qhov mob ntawm qhov tshwm sim ntawm ib tus neeg hauv plab uas muaj kev sib txuas ua ke nrog cov txiav

Ua raws li qhov ua haujlwm ntawm lub cev thiab saum toj ntawm lub cev, cov kws kho mob tshwj xeeb paub qhov txawv ntawm sab hauv- thiab sab nraud ntxiv. Cov tsos ntawm cov teeb meem thaum ntxov yog vim qhov kev nqis tes ntawm cov thawj thiab lwm yam yam kev ua phem uas tshwm sim nyob rau thawj hnub ntawm kev mob tshwm sim. Lub ntuj tshiab yog vim muaj cov txheej txheem yaj hauv necrotic foci. Feem ntau, cov teeb meem microbial thiab lub zos purulent-inflammatory tshwm sim rau txoj kev txhim kho.

Feem ntau cov kws kho mob faib cov kev tsis sib haum xeeb ua haujlwm thiab ua organic. Kev ua haujlwm ntawm hom mob pancreatic yog kho tau uas siv txoj kev txhag cia. Organic - nyuaj kho, maj nrawm lossis npaj kev pabcuam phais mob siv rau lub hom phiaj no.

Ib qho ntawm feem ntau yog mob o ntawm cov nqaij ntshiv retroperitoneal thiab pancreatogenic abscess ntawm retroperitoneal cellular chaw lossis mob plab hauv plab.

Parapancreatitis yog dab tsi?

Parapancreatitis yog ib qho kev mob siab hauv ib cheeb tsam ib txwm muaj ntawm tus mob pancreatitis. Qhov no yog ib qho kab mob nyob rau hauv uas retroperitoneal pericanopancreatic nqaij cuam tshuam.

Cov txheej txheem mob ua paug ntawm tus txiav yog hais txog kev kis mob ntxiv ntawm kev ua haujlwm pancreatic.

Pab pawg no suav nrog cov kev ua txhaum hauv qab no:

  1. Cholangitis yog ib qho mob ntawm cov kua tsib txoj hnyuv.
  2. Omentitis yog ib qho kev ua mob nyob hauv omentum.
  3. Ligamentitis yog ib qho mob ntawm txoj hlab hauv plab.
  4. Tus kab mob peritonitis yog tus mob tshwm sim hauv cov phab ntsa peritoneal.

Raws li cov lus qhia, txhua tus kab mob pancreatogenic parapancreatitis yuav muab faib ua ob pawg:

  • mob ntev
  • ntse.

Qhov faib rau hauv cov pab pawg no nyob ntawm kev sib txuas nrog kev tawm tsam ntawm tus mob vwm lossis mob leeg qhuav.

Cov pab pawg ntawm cov kab mob parapancreatitis nyob rau hauv lem tau muab faib ua ntau yam hauv qab no:

  1. Hemorrhagic.
  2. Necrotic.
  3. Purulent necrotic.

Cov pab pawg ntawm tus mob parapancreatitis hauv tshuaj tau muab faib ua ob yam:

  • sclerotic;
  • polycystic.

Txhua ntawm cov pab pawg thiab ntau yam nws muaj nws tus yam ntxwv.

Cov yam ntxwv ntawm cov pab pawg ntawm mob parapacreatitis

Hauv cov theem thaum ntxov tom qab pib ntawm kev tawm tsam, kev puas tsuaj rau fiber ntau hauv cov qauv ntawm edema, hemorrhage lossis kev tsim cov rog necrosis.

Kev kuaj mob ntawm kab mob parapancreatitis tsis yog qhov nyuaj tshwj xeeb rau tus kws kho mob, yog tias peb nco qab tias qhov tshwm sim ntawm qhov mob siab thiab hemorrhagic fiber raug mob tau pom nyob hauv txhua tus neeg mob uas muaj mob hnyav ntawm kev mob pancreatitis.

Kev hloov pauv ntawm cov txheej txheem inflammatory nyob rau hauv cov ntaub ntawv ntawm kev loj hlob nyob rau hauv lub cev ntawm infiltrative-necrotic los yog purulent-necrotic hom kev cuam tshuam ntawm lub mesentery ntawm cov hnyuv me yog nrog cov neeg mob nrog kev tsim cov hnyuv paresis.

Nyob rau hauv cov ntaub ntawv ntawm kev sib kis ntawm cov txheej txheem mus rau lub fiber ntawm qhov tom ntej peritoneal canals, qhov tshwm sim ntawm puffiness ntawm subcutaneous ntaub so ntswg nyob rau hauv lub lumbar cheeb tsam ntawm lub cev tau kuaj pom.

Qhov tshwm sim ntawm qhov mob infiltrative necrotic lesion nrog rau qhov tseem ceeb yog pom los ntawm cov tsos mob ntawm qhov tsos mob xws li mob o. Xws li lub cim ntawm kev muaj tshwm sim tau pom lub sijhawm kuaj cov neeg mob lub cev siv cov ntawv tom tom qab thiab ultrasound.

Qhov tsim ntawm parapancreatitis tseem ceeb, nyob rau hauv kev ua kom thaj tsam ntawm lub ntsiab infiltrate hauv thaj av ntawm lub taub hau ntawm lub qog tshwm sim, feem ntau yog nrog cov tsos mob ntawm cov tsos mob ntawm compression ntawm ducts ntawm lub caj pas thiab choledochus.

Cov yam ntxwv ntawm cov kev mob hnyav

Cov kab mob siab thiab mob hnyav ua rau muaj fiber ntau lub sijhawm thiab kev kho kom zoo ntawm kev mob vwm sai li sai tau tom qab thawj zaug tshwm sim feem ntau ua rau kev thim rov qab thiab tsis ua rau cov txheej txheem ua mob ntxiv.

Tsis tshua muaj, cov ntshav hemorrhages loj heev tuaj yeem tshwm sim hauv qhov chaw muaj keeb kwm yav dhau los, lawv tau nrog los ntawm kev tsim cov txhaws me me hauv cov cheeb tsam uas muaj hemorrhage.

Thaum muaj qhov xwm txheej zoo li no, cov ntshav tau tso rau hauv fiber ntau ua rau pom qhov tawm ntawm cov tsos mob tiv thaiv perifocal, uas yog nrog los ntawm kev tsim ntawm ib qho tseem ceeb ntawm infiltrate puag ncig ntawm tus txiav.

Vim li cas rau kev tsim ntawm ib hom infiltrative-necrotic tej zaum yuav yog:

  • hemorrhagic imbibition;
  • qhov tsim ntawm loj rog necrosis.

Nyob rau ntawm qhov muaj qhov mob aseptic, qhov mob txhab-infiltrative-necrotic muaj peev xwm yauv tau qeeb qeeb, ntau dua li peb lub hlis, ib nrab resorption nrog kev tsim cov caws pliav hloov pauv lossis qhov tsim ntawm parapancreatic cyst hauv qhov chaw mob.

Nyob rau hauv muaj purulent-putrefactive tus kab mob nyob rau hauv lub qhov txhab, kev loj hlob ntawm purulent-putrefactive parapancreatitis tshwm sim. Tus yam ntxwv ua cim yog lub suab yaj ntawm necrotic ua kom pom tseeb nrog kev tsim cov qog.

Kev Kho Mob serous hemorrhagic thiab hemorrhagic ntau hom teeb meem

Txoj kev siv tshwj xeeb feem ntau yog siv los kho hom mob nqaij pob txha lov. Cov hau kev no suav nrog kev kho tus mob pancreatitis. Kev hloov kho kev noj qab haus huv ntawm pancreatic muaj nyob rau hauv kev siv ntawm kev txhim kho detoxification thiab kev siv tshuaj tua kab mob uas ua haujlwm ntawm lub luag haujlwm.

Cov kab mob kis tau zoo siv kev siv tshuaj tua kab mob ntau heev. Thaum kho, cov txheej txheem de-escalation therapy yog siv. Hauv kev ua haujlwm ntawm kev kho, endolymphatic tswj hwm ntawm cov tshuaj tua kab mob yog siv.

Nrog rau txoj kev txhim kho hauv tus neeg mob lub cev ntawm cov mob hnyav ntawm hemorrhagic parapancreatitis, uas nrog los ntawm pib purulent fusions ntawm cov nqaij mos retroperitoneal uas tau ua rau necrotization, nrog rau kev txheeb xyuas ntawm txhua yam mob purulent-necrotic, kev phais mob tau pom zoo.

Nta ntawm daim ntawv ntev thiab nws cov kev kho mob

Daim ntawv uas mob ntev tuaj yeem raug txiav txim siab ua ib qho ntawm qhov tshwm sim ntawm lub zos omentitis lossis ib qho mob sib txawv ntawm parapancreatitis, uas tsis tau ua rau muaj kev hloov pauv purulent.

Tus mob ntev tau ntau yam yog pom los ntawm qhov pom ntawm tus duab tsis meej. Muaj qee kis, kev loj hlob ntawm cov teeb meem nyuaj hauv lawv cov kev sim ua cuam tshuam rov ua dua ntawm kev puas hlwb.

Txheeb xyuas tus kab mob no yooj yim heev yog tias tus neeg mob muaj sab nraud purulent fistulas. Qhov kev nce qib ntawm hom sclerosing tuaj yeem ua rau kev cog lus ntawm cov hlab ntshav uas nyob ze ntawm qhov ua kom pom tseeb. Xws li cov xwm txheej tuaj yeem tsim txoj kev loj hlob ntawm ischemic syndrome thiab thaj tsam ntawm portal hypertension.

Ua cov kev tiv thaiv kev kho mob ntawm cov mob uas mob mus ntev yog qhov tsis txaus ntseeg, tab sis ua txoj haujlwm tau npaj ntawm lub qhov quav yog nqa tawm tsuas yog tias tus neeg mob muaj teeb meem nyob rau hauv daim ntawv ntawm txoj hlab ntaws ntawm cov leeg ntshav thiab cov leeg ntawm qhov chaw mos ntawm thaj chaw thaj chaw. Kuj, kev ntsuas yog qee qhov pom ntawm cov tsos mob ntawm kev kub siab thiab cov tsos mob ntawm ischemic syndrome, uas tiv taus cov kev kho kho.

Yuav ua li cas tiv thaiv tus mob ntawm tus kab mob pancreatitis tau piav nyob hauv cov yeeb yaj kiab hauv tsab xov xwm no.

Pin
Send
Share
Send