Ib tus neeg uas tsis paub ntawm lub cev ntawm lub cev yuav zoo li tsis tshua qhia txog kev teem sijhawm rau txiav, thaum nug cov lus tsis raug: nws ua dab tsi hauv peb lub cev?
Tab sis thawj qhov kev hais tawm ntawm nws twb pom nyob hauv tej hauj lwm ntawm anatomists uas tau nyob ntau txhiab xyoo dhau los. Hauv Talmud, phau ntawv ntawm lub neej kev cai thiab kev coj noj coj ua los ntawm phau Vajlugkub, cov neeg quavntsej tom qab twb raug hu ua "ntiv tes ntawm Vajtswv."
Ua ob qho tib si ib qho tseem ceeb ntawm kev zais sab hauv thiab sab nraud, nws lub luag haujlwm loj hauv kev zom zaub mov thiab kev zom zaub mov.
Vim li cas cov kab mob tseem ceeb no thiaj li o? Vim li cas peb ua kom nws raug yuam kom rov hais nws tus kheej ntawm qhov mob?
Ua rau mob pancreatic
Qhov txiav ua pa yog qhov hloov khoom nruab nrog cev.
Los ntawm kev tsis pub lossis tshem tawm cov laj thawj hauv qab no, koj tuaj yeem pab nws lub neej tau zoo:
- Intoxication ntawm lub cev nrog cawv.
- Tus kab mob ntawm lub gallbladder thiab nws cov ducts (mob, nqaim).
- Raug mob plab.
- Lub pathology ntawm duodenum nyob rau hauv daim ntawv ntawm o ntawm nws mucous daim nyias nyias yog duodenitis.
- Kev noj tshuaj: tshuaj anticoagulants, tshuaj tua kab mob, tshuaj tiv thaiv, sulfonamides thiab lwm yam.
- Cov kab mob cuam tshuam nrog rau cov mob hnyav: kis kab mob siab C thiab B, mob pob qog.
- Kev ua haujlwm ntawm cov qog parathyroid nrog lawv cov proliferation lossis kev ua haujlwm dhau los ntawm parathyroid hormone.
- Qhov tshwm sim hauv lub cev ntawm cov ascariasis yog tus kab mob provoked los ntawm plab hnyuv parasites ntawm ascarids.
- Hormonal tsis khov.
- Mob Vascular.
- Kev nce qib hauv cov ntshiab lipids - cov roj zoo li cov organic sib txuas.
- Kev tshuaj ntsuam genetic predisposition.
- Khoom noj zoo nyob rau hauv cov zaub mov muaj roj thiab ntsim.
Cov tsos mob thiab cov cim qhia ntawm kev hloov pauv pathological
Thawj cov tsos mob ntawm tus kab mob ntawm lub caj pas tshwm, raws li txoj cai, tom qab plaub caug xyoo, tsis tshua muaj menyuam yaus. Qhov no tshwm sim thaum ib tus neeg twb tau ua zoo nkauj rau nws lawm thiab yog li nws tshaj tawm nws tus kheej.
Kev mob siab hypochondrium
Nws yog pancreatitis nyob rau hauv nws cov mob uas ua rau pom cov tsos mob nrog qhov mob. Ua raws li qhov sib txawv ntawm cov ntws, qhov mob tau muab faib: npub, ntse, txiav, rub tawm. Qhov no yog vim qhov tseeb tias cov nqaij mos edematous sib zog nias siab rau ntawm cov leeg xaib.
Yeeb Ncuab
Nrog mob pancreatitis, qhov pom tshwm sim, dyspepsia, feem ntau tshwm sim. Qhov no yog qhov ua txhaum txoj cai ntawm cov hnyuv, ua rau hauv xeev ntuav, ntuav tom qab noj mov, tso quav (mob plab, cem quav).
Xws li cov cim ntawm tus yam ntxwv muaj feem ntau tshwm sim thaum pib ntawm tus kab mob. Cov laj thawj yuav suav nrog kev noj zaub mov tsis zoo, noj zaub mov uas tsis ua rau lub plab ua si, nrog rau kev noj tshuaj thiab dej cawv.
Ntuav li cov cim rau ntawm intoxication
Nrog exacerbation ntawm pancreatitis, lub paum ntawm lub paum tau ua pa, ua rau xeev siab. Hauv 80% ntawm cov neeg mob, qhov no ua rau tso ntuav tawm ntawm lub qhov ncauj.
Nyob rau thawj theem - vim muaj cov ntsiab lus ntawm lub plab, thiab nyob rau hauv ntau lub nra hnyav, yuam kom tso tawm cov kua tsib tawm. Nco ntsoov, thaum ib tug neeg piav qhia txog qhov xwm txheej: tsis muaj ib yam dab tsi los kua muag, tab sis zoo li txhua yam yog "tig" tawm - qhov no yog qhov tseeb.
Lub cev qhuav dej
Qhov no yog mob hnyav uas ua rau lub cev qhuav dej. Thaum tsis muaj "xam" rau kev kho mob sai, nws tuaj yeem ua rau neeg tuag taus.
Qhov txaus ntshai tshaj plaws tsis tsuas yog rau lub cev, tab sis kuj rau lub neej nyob rau hauv dav dav, yog theem thib ob thiab theem thib peb ntawm chav kawm ntawm tus kab mob.
Lawv tshwm sim hauv cov cim hauv qab no:
- hnyav nce txog li 9%;
- ib tug neeg ntsib txoj kev nqhis dej uas tsis txawj tuag;
- cov roj xoos ntawm lub qhov ncauj dries;
- cov xim ntawm cov zis tsaus ntuj nti, nws cov dej ntws tawm qis;
- palpitations nce nrog ib tug nyiam rau kev co atherosclerosis;
- cov pa taws (neurological factors) tshwm sim (qhov muag plooj plooj, nkees nkees, hais lus tsis meej).
Cov tsos mob ntawm daim tawv nqaij
Raws li qhov tshwm sim ntawm cov hlau tsis huv, nws nce rau qhov loj me me, pib ua kom lub siab ntawm nws cov kabmob ib puag ncig thiab tiv thaiv kom tsis txhob muaj qhov tawm ntawm cov kua tsib.
Qhov no yog xav txog ntawm daim tawv nqaij, nws txais ib qho mob daj lossis daj ntseg xim ntxoov ntxoo.
Ib qho ntxiv, vim tias lub cev ua pa tsis ua haujlwm thiab lub cev tsis muaj peev xwm, lub cev xiav ntawm lub qhov ntswg ntawm lub qhov ntswg, ntsia hlau rau ntawm txhais ceg thiab caj npab, tawv nqaij ntawm lub plab thiab sab nraud tuaj yeem tshwm sim.
Lwm cov tsos mob
Ntawm palpation, lwm yam tshwm sim ntawm tus kab mob pancreatic yuav tshwm sim:
- Mob hauv qhov seem rau ib ncig ntawm qhov kev sib tshuam ntawm cov tav thiab qaum.
- Nrog tus xeeb ceem ntawm cov ntsiab lus nyob ib puag ncig ntawm txoj hlab ntaws (sab hauv thiab sab hauv), qhov mob tshwm sim.
- Nyob rau lub sijhawm ntawm kev tshem tawm sai ntawm cov ntiv tes los ntawm lub plab, mob qhov ntse yog qhov xav.
Cov khoom siv video hais txog cov tsos mob thiab kev kho mob ntawm tus kab mob:
Cov tshuaj dab tsi siv rau kab mob pancreatitis?
Pancreatitis yog ib qho mob hnyav uas yuav tsum tau saib xyuas kom zoo thiab ib qho kev sib koom ua ke hauv kev kho.
Thaum noj tshuaj, koj yuav tsum nkag siab meej txog lawv lub hom phiaj.
Lub hom phiaj ntawm txoj kev kho tshuaj:
- Kev phais mob tshem tawm ntawm tus mob huam.
- Kev tshem tawm cov roj ntsha ua haujlwm (tsis ua haujlwm).
- Localization ntawm cov txheej txheem inflammatory thiab ntxiv kev kho mob ntawm tus kab mob hloov khoom nruab nrog.
- Kev tiv thaiv ntawm qhov ua rau pab txhawb kev txhim kho ntawm cov nyom.
Thaum tus mob vias mob siab, cov ntsiav tshuaj hauv qab no yuav pab tswj nws txoj haujlwm thiab ua kom koj xis nyob:
- Txo cramps thiab txo qhov mob - Tsis muaj-shpa, Papaverin, Baralgin pabcuam qhov no. Nws yog tsim nyog kom nco ntsoov tias lawv ib koob tshuaj yuav tsum tsis pub tshaj ob ntsiav tshuaj. Cov kws kho mob pom zoo kom noj Papaverine nrog Platifillin. Qhov mob tsis tshwm sim tsuas yog ua kom mob siab los ntawm kws kho mob los ntawm kev tswj hwm ua kom loog.
- Mezim, Festal, Creon yuav muaj peev xwm ua kom lub zog thiab sib luag ntawm kev ua haujlwm ntawm lub txiav - cov no yog hloov rau cov enzymes.
- Diclofenac thiab Aspirin tuaj yeem tshem tawm qhov mob, thiab nrog nws qhov mob.
- Cov kws kho mob sau ntawv rau lub Octreotide rau cov neeg mob pw hauv tsev kho mob - daim ntawv qhia no yog muab tshuaj rau mob leeg thiab txhaj tshuaj rau lub cev.
Kev faib tawm tshuaj
Kev kho cov kab mob pancreatitis nrog cov tshuaj yuav ua tau zoo tsuas yog muaj kev txhim kho tseem ceeb ntawm kev noj zaub mov noj thiab kev siv ua ke ntawm txhua yam kev kho mob.
Lub arsenal ntawm cov tshuaj niaj hnub muaj ntau dua kaum os tshuaj uas tuaj yeem txo qhov kev txom nyem ntawm tus neeg mob, muaj peev xwm los daws qhov exacerbation ntawm cov txheej txheem mob uas cuam tshuam rau cov kab mob zais cia zais zis.
Kev faib tawm cov tshuaj raws li lub hom phiaj ntawm kev kho mob thiab lawv qhov ua tau kho ntawm tus kab mob tau hais hauv lub rooj:
| Ntawv pov thawj kev lag luam tshuaj | Kho nyhuv | Lub npe tshuaj |
|---|---|---|
| Pob Taum Pleev | Nws localizes thiab relieves mob mob. | Papaverine, Tsis-Shpa, Spazgan, Baralgin |
| Kev tshem tawm cov tshuaj tua kua qaub kom zoo | Tiv thaiv cov txheej txheem ntawm kev rhuav tshem ntxiv ntawm cov nqaij hauv cov hnyuv | Phosphalugel, Maalox, Almagel |
| Rov qab los ntawm enzyme tsis muaj peev xwm | Li qub rau lub plab zom mov los ntawm qhov mob o | Enzyme Forte, Creon, Festal, Pancreatin |
| Kev tshem tawm cov kab mob pathogenic microflora | Txo qhov mob thiab o | Doxycycline, Tobramycin, Cefspan, Ampicillin, Cefobid |
Pob Taum Pleev
Lub hom phiaj ntawm cov tshuaj no los ntawm lawv lub npe, uas yog, lawv yuav tsum txo qhov mob. Nws tsim nyog sau cia tias txawm hais tias qhov mob, hnav xim hais tawm, cov kws kho mob tau sau ntawv noj tshuaj uas tsis muaj cov tshuaj yeeb yaj kiab.
Cov no muaj xws li:
- Antispasmodics: Tsis-Shpa, Mebeverin, Meteospasmil, Papaverine, Buscopan.
- Kev tiv thaiv tsis zoo tshuaj tsis-tshuaj steroid: Voltaren, Indomethacin, Movalis.
- Kev Noj Tshuaj: Acetamifen, Baralgin, Analgin, Paracetamol.
Cov Enzymes
Cov tshuaj noj ntawm cov pab pawg no yog npaj los ua kom yooj yim ntawm kev ua haujlwm ntawm tus txiav, uas tau qee cov ploj qhov peev txheej hauv exocrine.
Raws li lub hom phiaj thiab keeb kwm ntawm cov enzymes, kev faib tawm uas twb muaj lawm faib lawv ua 5 pab pawg:
- Yooj Yim: Abomin, Betaine.
- Ua ke: Flogenzim, Wobenzin.
- Cov tshuaj noj uas muaj cov tshuaj pancreatin nrog nws cov khoom siv (steapsin, starch, protease): Mezim, Creon, Pancreatin, Mikrasim, Pangrol, Hermitage, Festal.
- Synthesized los ntawm cov nroj tsuag: Somilase, Unienzyme, Solisim.
- Cov tshuaj noj uas suav nrog bile, pancreatin, hemicellulase: Enzistal, Digestal, Festal, Panzinorm.
Antiemetic
Nws yuav tsum nco ntsoov tias ntuav tom qab noj zaub mov lom thiab nrog pancreatitis hla hauv kev sib txawv. Hauv qhov xwm txheej thib ob, nws ua ib txoj hauv kev uas tiv thaiv, ua kom poob zoo, uas tsis ua rau muaj kev nyem thiab ua rau lub cev qhuav dej. Hauv qhov no, txoj kev mob plab yooj yim tsis pab.
Ntawm no, ntau cov txheej txheem tseem ceeb uas txuam nrog intoxication coj qhov chaw: co toxins tsim thaum lub cev tuag ntawm cov ntaub so ntswg yog qhia rau hauv medulla oblongata los ntawm cov hlab ntsha thiab ua rau qhov chaw ntuav nyob hauv thaj chaw pericardial.
Txoj kev kho mob zoo tshaj plaws rau cov mob ua paug tau zoo yog Cerucal. Nws yog siv ua tshuaj txhaj.
Tsis tas li ntawd, nrog kev ntuav coj: Motilium, Bimaral, Torekan.
Torecan, nyob rau hauv sib piv rau qhov zoo sib xws Etaperazin, Haloperidol, Meterazin, ntxiv rau cov nyhuv antiemetic, kuj muaj qhov zoo tshaj plaws tsis muaj zog sedative (calming) cuam tshuam.
Antidiarrheal
Zawv plab lossis raws plab yog qhov tshwm sim ntau dua ntawm kev ua kom txaus siab rau mob qog nqaij hlav. Kev ywj pheej, tsis muaj kev pab kho mob, nws yuav tsis tuaj yeem tshem tawm ntawm qhov no tsis tsuas yog qhov tsis txaus ntseeg nkaus xwb, tab sis kuj muaj qhov tshwm sim txaus ntshai heev.
Yog li, nws tsis yog qhov xwm txheej uas cov kws kho mob hauv kev soj ntsuam ntawm tus mob pancreatitis qhia txog kev kho mob raws plab, suav nrog cov chaw hauv qab no:
- Txog "qib" cov txheej txheem hauv kev zom zaub mov, tshuaj enzymatic yog tshuaj: Festal, Mezim, Pancreatin.
- Enterosorbents - cov tshuaj no zoo, thaum nyob hauv plab, nqus ntau cov co toxins. Yav tom ntej, lawv tshem lawv ntawm lub cev hauv txoj kev nrog cev. Cov no suav nrog: Almagel, ua kom cov pa roj carbon, Polysorb.
- Txhawm rau kom lub suab tsis muaj zog ntawm lub qhov quav thiab txhawm rau txo cov zaus ntawm txoj hnyuv quav coj: Loperamide, Lopedium, Immodium.
- Cov tshuaj kho mob thiab tshuaj tua kab mob rau mob raws plab: Baralgin, No-Shpa, Papaverin, Spazmil, Renalgan.
- Txhawm rau kom lub plab hnyuv microflora, kws kho mob pom zoo: Colibacterin, Bactistatin, Lactobacterin.
- Vitamin-ntxhia pob zeb hauv av uas ua kom lub zog tiv thaiv cov haujlwm ntawm lub cev: Supradin, Vitrum, Complivit.
Antacid
Cov kev tso tawm ntau ntawm hydrochloric acid ua kom lub luag haujlwm ntawm cov kua quav zais zis, uas tsuas yog tsis tsim nyog rau thaum muaj kev ua kom zoo dua ntawm pancreatitis. Antacids raug coj los tiv thaiv qhov no.
Lawv muab faib ua cov ntaub ntawv tshuaj uas tsis haum thiab tsis nqus tau. Thaum kho kab mob pancreatitis, cov kws kho mob muaj peev xwm tshaj tawm cov tshuaj aluminium-magnesium uas muaj lossis tsis haus tshuaj.
Cov muaj koob npe tshaj plaws ntawm lawv: Phosphalugel, Almagel, Altatsid, Maaloks, Gastratsid, Maalukol, Alumag.
Cov tshuaj Antisecretory
Ua kom tso zis ntau ntawm cov kua txiv pais plab, uas suav nrog hydrochloric acid, provokes ib exacerbation ntawm pancreatitis. Lub hom phiaj tseem ceeb ntawm kev siv tshuaj tua kab mob yog txo qis qhov tso tawm ntawm hydrochloric acid.
Tsis tas yuav nkag mus rau cov ntsiab lus kho mob tob tob, tsim nyog sau cia tias txhua daim ntawv tshuaj no tau muab faib ua raws li lawv txoj kev kho rau hauv PPIs (cov tshuaj tiv thaiv cov twj tso kua mis tiv thaiv) thiab histamine H2 receptor blockers. Tag nrho cov no txo qis thaum hmo ntuj thiab nruab hnub cov kua qaub tsim tawm. Tsuas yog cov qub tsis cuam tshuam rau cholinergic, thaum tom kawg tsis cuam tshuam rau cov tshuaj receptamine.
H2-histamine receptor blockers:
- Tiam ntawm Cementidin: Keeb Kwm, Altamet, Belomet, Ulcometin, Tagamet.
- Cim ntawm Ranitidine: Zantag, Keeb Kwm, Ranisan, Acidex, Zoran.
- Tiam ntawm Famotidine: Antondine, Ulfamide, Gaster, Quamatel, Pepsid. Topzid.
Cov PPIs lossis cov tshuab thaiv cov twj tso kua mis:
- Tiam Ntawm Omeprazole: Omez, Zerocide, Omizak, Osid, Erosit.
- Tiam ntawm lansoprazole: Lanzap, Lanzopton.
- Tiam Pantoprazole.
- Tiam Ntawv Rabenprazole: Parry.
- Tiam Ntawm Esomeprazole: Nexium.
Broad-spectrum tshuaj tua kab mob
Lawv tau txais lawv cov npe vim hais tias ntawm qhov dav, lossis ntau dua qhov npliag, kev kho thoob ntiaj teb. Lawv cov txiaj ntsig nthuav tawm mus rau ntau yam kab mob, suav nrog pancreatitis.
Lub sijhawm tsim cov tshuaj tua kab mob tshiab, uas cov kws kho mob feem ntau hais rau cov neeg mob laus, suav nrog:
- Ceftriaxone;
- Azithromycin;
- Cefotaxime.
Tab sis tsis txhob hnov qab qhov qub, ua pov thawj, tab sis tsis muaj tsawg dua cov tshuaj muaj txiaj ntsig zoo nrog kev siv dav, uas suav nrog:
- Cefoperazone;
- Doxycycline;
- Sumamed;
- Amoxiclav;
- Ampicillin.
Myotropic antispasmodic
Localization thiab tshem tawm ntawm spastic mob nyob rau hauv cov kab mob ntawm lub gastrointestinal huam, txiav, lub zais zis, lub zais zis thiab cov kua tsib ducts yog lub ntsiab ntawm myotropic antispasmodic tshuaj.
Cov no suav nrog cov ntawv ntim tshuaj uas muaj cov tshuaj antispasmodic thiab vasodilating.
Qhov nrov tshaj plaws rau lo lus uas peb yog (ua pawg ua ke):
- Papaverine, Papaverine hydrochloride;
- Mebeverin, Duspatalin;
- Kev Caij Tsheb Hluav Taws Xob, Halidor
- Drotaverin, Drotaverina hydrochloride, Tsis-Shpa, Tsis-Shpa Forte, Spazmol;
- Otilonia bromide, Spasmomen;
- Pinaveria bromide, Dicetel;
- Platyphyllin;
- Trimebutin;
- Fenicaberan;
- Flavoxate.
Uas tsis yog-steroidal anti-inflammatory
Cov no yog cov ntawv nrov tshaj plaws thiab nrov tshaj plaws. Qee tus neeg kwv yees tias nyob rau hauv Tebchaws Meskas ntau dua 70 lab tshuaj uas tau sau tseg rau kev yuav cov tshuaj no ib xyoos twg.
Txhua daim ntawv tshuaj ntawm cov pab pawg no, tab sis nws tsim nyog sau cia tias cov no muaj ntau dua ib puas lub npe sib txawv, muaj cov khoom qub thiab ua raws tib lub hauv paus ntsiab lus: anti-inflammatory, analgesic thiab antipyretic.
Yam tshuaj twg zoo tshaj plaws, dab tsi los xaiv? Cov lus nug no tau hais ua qhov tsis muaj tseeb.
Txhawm rau tshem tawm cov txheej txheem ua mob cuam tshuam nrog exacerbation ntawm pancreatitis, cov kws kho mob feem ntau kho:
- Acetylsalicylic acid lossis Aspirin;
- Txawv tsis txawv;
- Sulindak;
- Lysine monoacetylsalicylate;
- Phenylbutazone;
- Indomethacin;
- Flurbiprofen;
- Piroxicam;
- Diclofenac;
- Nabumeton;
- Ibuprofen;
- Ketoprofen;
- Mesalazine thiab lwm yam.
Video los ntawm Dr. Evdokimenko:
Tshuaj ntsuab zoo tshaj plaws
Txhawm rau muab qhov tsis teb rau cov lus nug txog cov tshuaj zoo tshaj plaws rau kev kho mob ntawm tus txiav yog tsis tsaug yam li muaj kev sib cav lossis sib ceg uas huab cua cheeb tsam lossis thaj chaw zoo tshaj plaws rau tib neeg kev nyob.
Thiab peb xav tias koj yuav pom zoo tias tib cov lus teb vague, uas yog: nws tag nrho yog nyob ntawm tib neeg lub cev - yuav zoo ib yam rau ob txoj kev xaiv.
Pancreatitis yog ib yam kab mob uas nyuaj heev uas kho tsis tau. Ntau nyob ntawm lub tswv yim thiab kev tawm tsam ntawm kev sib ntaus cov mob no, ntawm kev xaiv cov kev kho mob thiab lawv cov ntawv thov ua txoj haujlwm.
Txawm hais tias qee qhov kev tshaj tawm raws li kev tshawb fawb kho mob tuaj yeem ua.
Feem ntau, nrog mob o ntawm tus txiav, tus kws kho mob sau ntawv yuav tsum: tshuaj tua kab mob, tshuaj tua kab mob thiab tshuaj los ntawm cov pab pawg enzyme.
Cov no suav nrog:
- Kev npaj enzyme: Creon, Panzinorm.
- Antacids: Gaviscon, Rennie, Phosphalugel, Maalox.
- Proton twj tso kua mis blockers: Omez, Lanzap, Pantoprazop, Lanzopton.
- Tshuaj tua kab mob: Azithromycin, Cefotaxime.
- Kws tshuaj kho mob: Tsis muaj-Shpa, Meteoospasmil, Voltaren, Movalis. Baralgin, Paracetamol.
Txhawm rau kom ua tiav cov teeb meem cuam tshuam nrog kev mob pancreatic, koj yuav tsum tau npaj khoom tsis tas nrog kev ua siab ntev. Nws yog ib qho tsim nyog kom ua raws nraim li cov lus pom zoo ntawm tus kws kho mob koom nrog thiab saib xyuas txhua yam kev ua neej, suav nrog kev teeb tsa thiab kev noj haus, nrog rau hom kev so thiab ua si lub cev.
