Biliary pancreatitis yog ib hom mob ntev ua mob ntawm tus txiav ua ke. Qhov laj thawj ntawm kev txhim kho tus kab mob yog lub yeej swb, nrog rau kev ua tsis tiav ntawm cov kua tsib lub plab thiab nplooj siab.
Anomalies nyob rau thaum ntxov yuav qhia tau los ntawm biliary colic, dyspeptic tsos mob, daj ntseg, mob ntshav qab zib mellitus thiab poob phaus. Txheeb xyuas cov kab mob pathology, tus kws kho mob tau sau ib qho kev tso cai ntawm kev kuaj mob ultrasound ntawm cov kab mob hepatobiliary, suav nrog lossis sib nqus ntawm lub plab hauv thaj av.
Kev kho yog los ntawm kev tswj cov tshuaj tiv thaiv kev tiv thaiv thiab ua kom loog, noj cov enzymes, thiab ntshav ntshav li qub. Tus neeg mob yuav tsum ua raws li cov khoom noj nruj me ntsis nrog kev ua tiav cawv. Yog hais tias xam tau pom hauv lub qias, kev phais yog raug kho.
Vim li cas biliary pancreatitis tsim?
Tsis ntev los no, qhov xwm txheej ntawm biliary pancreatitis tau nce ntau. Hauv tebchaws Lavxias, cov ntsuas no ntawm cov neeg loj muaj hnub nyoog txog peb npaug, thiab cov menyuam yaus tau mob plaub zaug ntau dua. Cov kab mob no suav nrog hauv International Kev faib cov kabmob ntawm 10 kho, ICD-10 code yog K85.
Feem ntau, qhov etiology cuam tshuam nrog qhov muaj cholelithiasis, nyob rau hauv rooj plaub no muaj qhov pheej hmoo siab ntawm kev tsim kab mob pathology. Tus kab mob yog aggravated los ntawm kev tsiv teb tsaws ntawm cov pob zeb los ntawm cov biliary huam.
Tus mob no yog txaus ntshai, yog li ntawd, kev phais mob maj nrawm tau raug kho. Yog tias lub sijhawm ua haujlwm tsis kam, cov txheej txheem pathological tuaj yeem ua rau muaj mob hnyav, uas yuav xav tau kev kho mob hnyav ntxiv. Txhawm rau kom tsis txhob tsim cov mob ua kab mob ntsig ua kab mob, nws yog ib qho tseem ceeb kom pom qhov ua txhaum ntawm cov kua tsib lub nrawm hauv lub sijhawm thiab kho tus kab mob sai.
Lub pathogenesis ntawm tus kab mob tuaj yeem ua raws li hauv qab no:
- Tus kab mob nkag mus rau lub txiav los ntawm nqos biliary los ntawm lymphatic ib ntsuj av.
- Tus neeg mob qhia tawm pob zeb nyob hauv cov kev sib koom nrog cov kua tsib, uas ua rau muaj kev nce ntxiv hauv ntshav siab thiab o ntawm cov txiav.
- Pancreatic ducts thiab cov nqaij ua rau lub cev puas vim yog lub ingress ntawm bile rau hauv cov hlab ntsha, ua rau tus mob o. Qhov xwm txheej zoo heev ua rau mob siab yog tias ib tus neeg muaj tus kab mob rau daim siab ntxiv, uas ua rau kev txhim kho muaj ntau ntawm cov dawb radicals dawb.
Tsis tas li, txheej txheem kev tiv thaiv kab mob raug pom thaum lub sijhawm tsim cov khoom ua kua dej sawbge. Cholecystitis thiab ua rau mob plab zom mov ua rau ua txhaum ntawm physicochemical lub xeev ntawm cov kua tsib. Vim muaj nag lossis daus thiab txuam nrog qee yam, micro pob zeb tsim, uas hu ua biliary sludge.
Thaum pawg nkag mus rau hauv cov kua tsib lub plab, cov qog ua kua xoos raug mob, vim tias lub tog raj thiab papilla ntawm cov papillae tau nqaim. Vim li ntawd, cov kua tsib stagnates nyob rau hauv cov hlab ntawm tus txiav, tsis tuaj yeem nkag mus rau hauv cov kab noj hniav ntawm duodenum thiab tsis tas yuav nkag mus rau txoj hlab ntaws.
Nrog stagnation, pancreatic enzymes yog qhib kom ua tsis yog hauv txoj hnyuv, tab sis hauv cov duct. Qhov no ua rau muaj kev tiv thaiv kev tiv thaiv kev tiv thaiv ntawm txiav thiab yooj yim nkag ntawm kis tau mus rau hauv cov ntaub so ntswg pancreatic.
Vim yog lub pob zeb gallbladder loj, feem ntau cov kua tsib lub plab los yog Oddi sphincter feem ntau txhaws, uas tseem ua rau stagnation thiab cuam tshuam ntawm txoj hauv kev ntawm bile.
Hauv lwm lo lus, txoj kev loj hlob ntawm pathology yuav pib vim:
- Mob plab hnyuv;
- Tus qauv tsim teeb meem ntawm lub bile thiab pancreatic duct;
- Mob txha caj qaum ntev;
- Cirrhosis ntawm daim siab;
- Gallbladder dyskinesia;
- Kev ua txhaum ntawm motility ntawm biliary huam;
- Pathology Vater tus txiv mis.
Kev txav tsis zoo ntawm tus kabmob tuaj yeem tshwm sim los ntawm cov tshuaj choleretic lossis poob ceeb thawj sai.
Cov cim tseem ceeb ntawm tus kabmob
Hauv nws cov kev mob tshwm sim, cov tsos mob ntawm tus kab mob yog qhov zoo sib xws rau cov kab mob pathologies ntawm lub plab zom mov raws li kab mob siab, mob plab hnyuv, mob plab hnyuv thiab duodenal rwj, mob qog nqaij hlav, mob qog nqaij hlav, mob stoneless cholecystitis. Yog li, nws yog ib qho tseem ceeb kom yauv tsum tau soj ntsuam tag nrho thiab tshem tawm qhov muaj ntawm kev ua txhaum.
Cov tsos mob tseem ceeb suav nrog kev txhim kho kev mob. Tus neeg mob hnov mob hauv plab heev, sab nraub qaum, hypochondria, sab xub pwg sab xis. Feem ntau, cov tsos mob zoo li no yog mloog li ob mus rau peb teev tom qab tus neeg tau noj tas. Tsis tas li, qhov kev ua txhaum ua rau nws tus kheej hnov thaum hmo ntuj.
Xws li muaj cov cim qhia tsis ncaj ntawm pathology ntawm tus kab mob pancreatic-biliary. Kev mob tshwm sim tuaj yeem tshwm sim los ntawm kev siv cov pa roj carbon ntau hauv cov dej haus, roj ntsha, roj kib thiab ntsim.
Tib lub sijhawm, tus neeg mob tau kub taub hau, xeev siab thiab duav nyob hauv qhov ncauj ntawm qhov ncauj. Yog tias vim lub pob zeb ntawm lub txiv mis ntawm lub txiv mis yog qhov txhaws kiag li, qhov muaj qhov ntsej muag tawv nqaij rau hauv daim ntawv ntawm staining ntawm mucous daim nyias nyias thiab daim tawv nqaij tau kuaj pom.
- Cov txheej txheem inflammatory hauv cov txiav ua rau tus neeg ua txhaum ntawm endocrine muaj nuj nqi. Tus neeg mob muaj teeb meem metabolic, thaum qaug dab peg, cov ntshav qab zib cov ntshav nce siab los yog poob siab heev.
- Vim yog exocrine cuam tshuam, enzymatic pancreatic tsis txaus tsim, kab mob hauv lub plab tsis ua haujlwm pom.
- Tus neeg mob tawm tsam ua pa thiab txoj hnyuv, thaum mob raws plab muaj ntau zaug nyob rau ib hnub. Cov quav muaj cov roj sib xws, cov pleev kob zas thiab tsw qab.
- Tsis tas li, cov tsos mob yog nrog tus mob nce ntxiv, rumbling hauv plab, duav, kub siab, tsis qab los.
- Tawm tsam ntawm keeb kwm ntawm zawv plab, cov rog rog nce ntxiv, kev zom plab yog cuam tshuam, thiab lub cev poob qis. Tus neeg ntsib cov mob vitamins tsawg tsawg.
Yog hais tias tus kab mob tsis tau kho nyob rau hauv lub sijhawm, mob ntev biliary-pancreatitis, uas yog nrog txhua yam kev cuam tshuam rau hauv daim ntawv ntawm kev poob siab, mob siab rau lub ntsws lossis lub ntsws ua tsis taus pa, mob txha caj qaum, mob plab zom mov, mob plab hnyuv, mob plab hnyuv, mob ntshav qab zib, daj ntseg.
Cov theem uas tsis nco qab ntawd ua rau cov pob khaus, ascites, fistulas, txoj hnyuv nqaim.
Kho kab mob
Txhawm rau txheeb xyuas tus kab mob thiab muab qhov kev ntsuas tau tseeb, tus kws kho mob tau sau nqe ntawm kev kuaj ntshav thiab biochemical kuaj ntshav. Yog hais tias tus kab mob yog nyob rau hauv ntu ntev ntawm kev zam txim, bilirubin nce vim yog hloov hloov.
Cov roj (cholesterol) kuj nce ntxiv, qhov feem ntawm cov protein tseem ceeb txo qis thiab cuam tshuam, yog li nws yog qhov tseem ceeb uas yuav tsum tau ua kev tshawb xyuas theem ob kom tau txais
cov txiaj ntsig yog. Kev tsom xam cov ntshav thiab zis qhia tau nce theem ntawm amylase.
Nrog kev pab ntawm endoscopic lossis intraductal ultrasound, tus kws kho mob tuaj yeem tshawb pom cov pob zeb, cov qauv no suav hais tias yog qhov ua tau zoo tshaj plaws. Tham tomography yog siv los txais cov ncauj lus kom ntxaws.
- Yog tias tus kws kho mob kuaj pom tus kab mob pancreatitis mob sai, txoj kev phais mob ntau zaus yuav tsum tau txais kev kho mob xwm txheej ceev. Yog tias tsim nyog, nws yog ib qho tsim nyog yuav tsum tau tshem cov pob zeb lossis txhim kho cov mob ntawm Vater tus txiv mis, rau qhov no txoj kev siv endoscopic tau siv.
- Thaum tus kab mob no zuj zus, tus kws kho mob tshem tawm qhov mob ua ke nrog analgesics thiab antispasmodics. Hauv qhov no, txoj haujlwm sab nraud thiab sab hauv zais cia ntawm lub tsev ua yeeb yaj kiab yog kho tau. Txog kev tiv thaiv, siv tshuaj tiv thaiv kab mob los tiv thaiv kev txhim kho kev kis mob.
- Nrog exacerbation, thawj peb hnub qhia kev tshaib plab nrog pancreatitis. Hloov chaw ntawm cov khoom noj, haus cov dej tsis-carbonated alkaline ntxhia dej. Tom qab yoo mov, kev noj zaub mov kom tsim nyog yog qhov tsim nyog. Tus neeg mob yuav tsum tsis txhob ua phem rau cov rog cov zaub mov, kev ua kom tau carbohydrate tsawg tsawg. Koj yuav tsum tau noj ntau, tab sis raws feem me me.
Txhawm rau nres qhov kev cuam tshuam ntawm cov enzymes, somatostatin, proton twj tso kua mis inhibitors, protease inhibitors yog tshuaj. Enzymatic pancreatic kawg ua hauj lwm yog rov qab los ntawm microspherical enzymes.
Nrog rau kev nce qib ntxiv cov piam thaj hauv cov ntshav, tus neeg mob tau siv tshuaj tshwj xeeb hypoglycemic. Cov mob ntshav qab zib-insulin-mellitus yuav tsum muaj kev rov xyuas dua ntawm kev ua neej thiab kev noj haus.
Txhawm rau kom muaj qhov dav dav ntawm lub cev thiab ntxiv dag zog rau kev tiv thaiv kab mob, kho lwm txoj hauv kev nrog tshuaj ntsuab yog kev pom zoo. Txog kev kho, koj yuav tsum xaiv qhov tseeb los tshuaj xyuas.
Cov kab mob ntawm pancreatitis tau piav qhia hauv video hauv kab lus no.
