Tus mob cwj mem yog ib tug mob txhim kho thiab mob pob txha caj qaum, uas ua rau muaj kev ua txhaum ntawm nws cov txheej txheem sab nraud thiab sab hauv. Nws yog tus cwj pwm los ntawm cov ntab dej hiav txwv thiab tshaj tawm nws tus kheej kom muaj kev tawm tsam mob nrog kev ua kom mob tsis txaus siab - xeev siab, ntuav, ua pa thiab lwm yam cim ntawm tus yam ntxwv.
Vim li cas
Pancreatitis yog suav tias yog mob ntev yog tias nws kav tau tsawg kawg yog rau lub hlis. Raws li tus kab mob loj hlob tuaj, tus qauv ntawm lub tsev neeg hloov pauv, thiab kev ua haujlwm poob qis. Feem ntau, cov txiv neej raug kev txom nyem los ntawm pancreatitis, uas yog qee yam cuam tshuam rau lawv cov cawv rau cawv.
Ntawm kev ceeb toom tshwj xeeb yog qhov muaj peev xwm tuag nyob rau hauv exacerbation ntawm tus mob txham. Raws li kev txheeb cais, nws yog kwv yees li 10% hauv thawj 10 xyoo tom qab kev kuaj mob, thiab yuav luag 50% hauv ob xyoo tom ntej.
Ib qho tshwj xeeb ntawm tus kabmob yog lub caij ntev (lub caij nplooj zeeg), lub sijhawm tsis muaj tsos mob tshwm sim, lossis lawv tsis tshua mob. Exacerbation ntawm kev mob caj dab ntev yog ib qho txaus ntshai heev, uas yuav tsum muaj kev kho tshuaj kho mob nyuaj.
Txawm hais tias tseem ceeb kev nce qib hauv kev txheeb xyuas thiab kev kho mob ntawm tus kab mob pancreatitis, muaj ntau tus neeg mob ntxiv, vim muaj ntau yam. Hauv thawj qhov chaw tseem ceeb yog kev haus dej cawv. "Muaj koob meej" thib ob yog qhov chaw nyob los ntawm cov kab mob ntawm txoj hnyuv, nplooj siab thiab 12 plab hnyuv duodenal.
Qhov tseeb yog tias nrog kev ua txhaum ntawm cov haujlwm ntawm cov kab mob bile, bile tuaj yeem nkag mus rau lub txiav, yam li ua rau nws voos. Vim li ntawd cov neeg uas muaj tus mob pancreatitis feem ntau muaj cholecystitis.
Qhov muaj feem pheej hmoo txaus siab muaj xws li:
- noj ntau thiab quav ntxiv rau cov rog thiab kib;
- hnyav dua;
- noj qee yam tshuaj;
- cov kab mob yav dhau los;
- kev nyuaj siab ntxhov siab, tshwj xeeb tshaj yog muaj zog thiab lub caij nyoog.
Cov tsos mob
Cov tsos mob ntawm exacerbation ntawm tus mob txhawm rau mob txhawm rau sai sai. Hauv ib hnub, tus neeg mob lub cev sai dua, thiab mob hnyav tshwm sim hauv qab ntawm tus tav, ntawm sab laug. Feem ntau, qhov tsos mob hnov qab nws tus kheej li lwm txoj kev kho thiab tuaj yeem hnov hauv qab thiab hauv siab.
Tus yam ntxwv ntawm exacerbation tus yam ntxwv yog mob girdle uas kis thoob lub plab thiab ob sab. Ua ke nrog qhov mob lossis qee lub sijhawm tom qab nws tshwm sim, xeev siab tshwm sim, tig mus rau hauv ntuav, thiab tso quav.
Exacerbation ntawm kev mob ua paug rau tus neeg laus tuaj yeem nrog tus neeg mob ua npaws thiab kub ib ce, blanching ntawm daim tawv nqaij, ua pa luv, ua pa ntshav tawm thiab mob taub hau.
Yog tias koj xav tias tsam nres, koj yuav tsum hu rau lub tsheb tos neeg mob, thiab ua ntej cov kws kho mob tsis suav nrog kev tawm dag zog. Txhawm rau txo tus mob, koj tuaj yeem siv lub txias txias rau hauv qhov chaw ze ntawm qhov mob. Nws yog txwv tsis pub noj zaub mov; koj tsuas haus tau cov dej dawb tsis muaj roj hauv qhov me me.
Koj tuaj yeem tsis noj ib qho tshuaj tshwj tsis yog antispasmodics (Tsis muaj-shpa, Papaverin, Drotaverin). Yog tias ua tau, nws zoo dua rau kev txhaj tshuaj. Txhawm rau txo qis qhov sib zog ntawm tus mob yuav pab tau kom zaum zaum nrog lub cev tilted rau pem hauv ntej.
Exacerbation ntawm kev mob caj dab ntev tuaj yeem mob txij li tsib hnub mus rau ob asthiv. Lub sijhawm no yog vim qhov tsis haum ntawm tus txiav kom rov qab sai. Yog li, nws yog qhov yuav tsum tau txais kev tawm tswv yim txog kev kho mob thiab cov lus pom zoo kom kho tus mob.
Kev kuaj mob
Rau cov tib neeg kev txom nyem los ntawm tus mob pancreatitis, lub daj ntawm daim tawv nqaij vim stagnation ntawm cov kua tsib yog cov yam ntxwv. Ntxiv rau, cov neeg mob no tau kuaj pom tus mob ntshav qab zib hom 2 tsawg thiab cov tsos mob anemia.
Txhawm rau ua kom pom tseeb ntawm lub txiav thiab feem ntau ntawm cov txheej txheem pathological, cov kev tshawb fawb rau kev kho mob yog kws kho - ultrasound, xoo hluav taws xob, suav tomography lossis MRI. Cov hau kev no tuaj yeem ua ntxiv los ntawm kev kuaj pom:
- lunda;
- pancreosemine-secretin;
- elastase;
- hydrochloric acid.
Magnetic resonance imaging yog ib qho ntawm cov qauv muaj tseeb tshaj plaws thiab cov ntaub ntawv tshawb fawb; nws tso cai rau koj ua kom muaj kev txawv txav ntawm tus mob ua xua nrog tus mob huam sai
Pancreosemin-secretin kev ntsuam xyuas, uas tso cai rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau suav, yog suav tias qhov kub kuaj mob. Lub sijhawm ua cov txheej txheem, kev soj ntsuam ob zaug lumen yog muab rau tus neeg mob nyob rau hauv kev xoo hluav taws xob. Nrog nws cov kev pab, cov qauv ntawm cov ntsiab lus ntawm lub plab thiab cov hnyuv yuav noj.
Txoj kev tshawb no yog nqa tawm ntawm lub plab khoob, npaj ua ntej ntawm kev txiav tawm ntawm pancreosemin thiab secretin. Hauv cov kab mob pancreatitis, qhov ntim tag nrho ntawm cov kab mob zais zis thiab qhov cia ntawm bicarbonates tsawg zuj zus, thiab theem ntawm cov enzymes, ntawm qhov tsis sib thooj, nce siab.
Kev noj haus rau exacerbation ntawm lub txiavYog hais tias bicarbonate alkalinity raug kuaj pom hauv cov txiaj ntsig ntsuas, ces muaj txhua qhov laj thawj xav tias tsam kev txhim kho ntawm cov txheej txheem oncological.
Kev kuaj pom qhov tseeb ntawm kev kuaj mob pancreosemine-secretin yog qhov siab heev piv rau lwm txoj kev sojntsuam. Yog tias tsim nyog, tus kws kho mob tuaj koom yuav ncaj qha rau kev mob caj dab, phais pob txha (ERCP) lossis kuaj me me.
Nws yog tsim nyog sau cia tias muaj ntau dua 90 txoj hauv kev los kuaj xyuas tus mob pancreatitis, tab sis nws tseem nyob deb ntawm ib txwm ua tau los txheeb xyuas tus kab mob thaum pib.
Nrog rau ib hom ntawv twg ntawm cov kab mob pancreatitis, tshuaj lom neeg cov ntshav, zis thiab quav hloov pauv. Yog li, kev kuaj ntshav dav dav thiab biochemical, urinalysis thiab coprogram raug kho. Tsis tas li ntawd, cov dej-electrolyte sib npaug ntawm cov ntshav tau raug ntsuas, uas qhov no yuav qhia tau tias txo qis cov calcium thiab cov dej tsis txaus hauv lub txaj vascular. Qhov no yog fraught nrog kev vau thiab mob hnyav cuam tshuam ntawm cov hlab plawv cov ntshav.
Kev tsom xam cov quav (coprogram) ua rau nws muaj peev xwm txiav txim siab txog kev khaws cia ntawm lub plab zom mov, nws cov cim tseem ceeb yog sib xws, xim, tsw thiab muaj cov impurities
Kev Kho Mob: cov qauv siv dav dav
Kev kho mob ntawm kev mob ntsig txog mob txhawm rau mob hnyav tau nqa tawm hauv tsev kho mob, vim tias nws muaj kev pheej hmoo ntawm kev mob hypovolemic poob siab (qhov txo qis hauv cov ntshav ntawm cov ntshav) thiab lwm yam teeb meem. Hauv thawj ob lossis peb hnub, kev tshaib kev nqhis yog qhov tsim nyog, nyob rau hnub thib peb lossis plaub, cov khoom noj raug tso cai rau hauv feem me me, tsis pub tshaj 200 ml.
Qhov loj ntawm cov khoom noj yuav tsum yog carbohydrates hauv cov kua ua - zaub mov, mashed kua zaub thiab jelly. Cov rog ntawm cov tsiaj keeb kwm yog txwv tsis pub dhau, thiab nws yog txwv tsis pub noj nqaij, nqaij ntses, nqaij thiab zaub mov kaus poom. Kev siv cov zaub thiab txiv hmab txiv ntoo tshiab, cov zaub mov ntxoo thiab dej cawv yog qhov tsis lees txais.
Qee tus neeg mob yuav xav tau kev txuas mus txuas ntxiv (tso tawm) cov kua txiv lub plab los ntawm kev sojntsuam tau ob peb hnub. Txhawm rau kho exacerbation ntawm pancreatitis, lawv pib nrog kev tswj hwm ntawm cov twj tso kua mis tshuaj tiv thaiv kab mob, H2-histamine receptor blockers, antacids, thiab tshuaj kho mob. Tom qab, lawv hloov mus rau cov ntsiav tshuaj cov ntaub ntawv tshuaj.
Tsis yog-spa yog ib qho ntawm ob peb tshuaj uas tus neeg mob nws tus kheej siv tau thaum lub sij hawm nres
Txij li thaum pancreatitis nyob rau hauv daim ntawv mob yog nrog ntuav rov qab thiab zawv plab, kua dej tawm yog ntxiv los ntawm dej ntws nrog qab ntsev.
Kev phais mob ntawm exacerbation ntawm tus mob leeg rau mob yog tsis tshua muaj thaum muaj mob hnyav, uas tsis yog qhov zoo rau txoj kev kho kom zoo. Qee lub sij hawm nws tsis tuaj yeem ua qhov kev ua haujlwm vim qhov chaw chaotic ntawm qhov chaw puas thoob plaws hauv hloov khoom nruab nrog. Cov xwm txheej no yog cov yam ntxwv ntawm kev ua mob hlwb txha nqaj qaum vim yog haus dej cawv, thiab rov tshwm sim yuav luag txhua qhov.
Nyem qhov mob
Txog rau mob pes nrab, Tsis muaj-shpa, Buskopan, Papaverin, Drotaverin, Baralgin, Paracetamol, Trigan-D thiab Pentalgin yog cov muaj cai. Muaj qee qhov tshwj xeeb, yog tias tus neeg mob tsis ua siab ntev rau kev ua kom loog thiab tshuaj antispasmodics, tsis siv tshuaj tiv thaiv kev tsis haum tshuaj siv. Qhov no yog vim lawv qhov kev txom nyem hnyav ntawm lub plab hnyuv tev.
Antenzymes thiab tshuaj tua kab mob
Nrog hyperfunction ntawm lub txiav, kev kho mob rau exacerbation ntawm ntev pancreatitis yog ntxiv nrog antienzyme tshuaj. Lawv inhibit cov synthesis ntawm cov enzymes, yog li muab kev ua haujlwm so rau cov kabmob muaj kabmob. Ntxiv rau, kev kho mob antienzyme zam kev txhim kho ntawm cov kev mob hnyav xws li mob hlwb ua leeg.
Antenzyme txoj kev kho yog nqa tawm tsuas yog nyob ruaj ruaj chaw nyob hauv kev saib xyuas mob. Tshuaj tau txais cov tshuaj tiv thaiv mob maj mam heev, vim tias feem ntau ntawm lawv yog cov ua xua khov. Yog tias tsim nyog, tshuaj tiv thaiv antihistamines tuaj yeem siv ua ke.
Cov tshuaj hauv qab no rau antienzyme:
- Contrikal;
- Gordox;
- Pantripine;
- Trasilol;
- Fluorouracil, Fluorofur, Ribonuclease (cytostatics).
Qee qhov xwm txheej, tshuaj tua kab mob tau siv - piv txwv, nrog o ntawm duodenal papilla. Txhawm rau tiv thaiv kab mob kis kab mob, Azithromycin, Doxycycline, Cefaperazone, Ampioks, Cefuroxime yog cov ntawv kho mob.
Thaum lub sij hawm exacerbation ntawm lub txiav, tus neeg mob yog pom sai mus pw hauv tsev kho mob rau kev kho kom tsim nyog
Cov Enzymes thiab Antacids
Tom qab nyem mob zoo, tus kws kho mob tuaj yeem sau ntawv muaj cov tshuaj enzyme - Pancreatin, Creon, Mezim, Panzinorm, Enzistal, thiab lwm yam. Txais tos ntawm pab pawg no tso cai rau koj ua tiav:
- unloading ntawm lub txiav vim kev muab cov enzymes ntxiv rau;
- kev txhim kho kev nqus ntawm carbohydrates thiab protein;
- normalization ntawm cov txheej txheem plab;
- tshem tawm cov tsos mob ntawm dyspepsia - flatulence, tsam plab, xeev siab thiab ntuav.
Qhov ua tau ntawm kev siv tshuaj tiv thaiv kab mob yog vim tias kev voos ntawm lub plab hnyuv thaum tso tawm ntawm pancreatic enzymes. Lub acidity ntawm lub plab kua txiv nce ntxiv thiab feem ntau provokes qhov kev loj hlob ntawm gastritis thiab mob rau sab hauv. Txhawm rau tso tseg txoj kev no, cov tshuaj tau hais kom txo cov synthesis ntawm hydrochloric acid lossis nws cov concentration. Qhov ua tau zoo tshaj plaws rau tus mob pancreatitis yog Maalox, Almagel thiab Phosphalugel.
Hauv kev sib thooj nrog kev siv tshuaj tiv thaiv antacids, H2 blockers yuav siv tau los txo tus nqi ntawm kev tsim cov plab zom mov, uas tseem txo cov kua qaub. Tom qab noj cov tshuaj no, mob plab tsis xis nyob vim los ntawm kev ua pob ntawm lub qog ua kua ploj.
Noj zaub mov
Kev noj haus rau kab mob pancreatitis yog ib qho tseem ceeb nyob rau txhua ntu, thiab sai li sai tau tom qab kev kho mob ceev nrawm, nws yog ib qho tsim nyog yuav maj mam qhia cov khoom zom rau hauv kev noj haus. Nws tsis tuaj yeem lees txais tam sim ntawd hloov mus rau cov zaub mov ib txwm muaj, txij li kab mob pancreatitis tuaj yeem mob ntxiv.
Koj yuav tsum tau noj zaub mov ntau, mus txog 8 zaug hauv ib hnub, tab sis hauv feem me me, pib nrog 50 gr. nyob rau ib lub sijhawm. Kuv yuav noj dab tsi hauv thawj 5-8 hnub tom qab tau yoo mov:
- kua cereals rau ntawm dej;
- mashed thiab unsalted kua zaub, kua zaub kua zaub, tshwj tsis yog rau pob kws thiab pob kws;
- nag hmo lossis qhuav khob cij dawb;
- jelly thiab txiv ntoo jellies yam uas tsis muaj piam thaj ntxiv.
Kev noj zaub mov kom tsis muaj rog tsawg tsis raug rau lub cev kev coj noj coj ua thiab tsis txaus siab rau kev xav tau ntawm lub cev, yog li nws tsis pom zoo kom zaum ntawm cov khoom noj zoo li no ntau tshaj ib lub lim tiam. Txawm li cas los xij, cov zaub mov carbohydrate tsawg txhawb qhov tsim tawm ntawm pancreatic enzymes, uas ua rau lawv tsis tuaj yeem. Txog ob peb hnub tom qab, cov khoom noj protein tau qhia - curd soufflé thiab paj npleg, fawm nqaij omelet, qe thiab nqaij siav cov nqaij.
Yog tsis muaj exacerbation, cov neeg mob uas mob pancreatitis tau qhia kev noj haus No. 5, uas siv dav cov khoom ntawm ntuj inhibitors ntawm proteolytic enzymes - qos yaj ywm, kua taum, qe dawb, oatmeal. Nws yog qhov xav tau los hloov cov tsiaj rog nrog cov rog cov zaub, vim tias lawv txhawb cov txheej txheem o thiab tuaj yeem ua rau lub plab zom mov.
Lub sijhawm tag nrho ntawm kev kho rau exacerbation ntawm tus mob qaij leeg nyob ntawm thaj tsam li ntawm ib hlis, tom qab ntawd tus neeg mob txaus siab thiab tuaj yeem rov qab rau lub neej zoo. Nws yog qhov nyuaj los twv seb lub caij nyoog ntawm kev zam txim yuav yog dab tsi, vim tias qhov kev pheej hmoo ntawm kev rov huam mob siab txaus.
