Hom, cov tsos mob thiab cov tswv yim kho rau kab mob pancreatitis

Qhov txiav ua tiav yog ib feem ntawm ob lub cev ntawm lub cev ib zaug - zom thiab endocrine.

Txawm hais tias qhov nyhav qis (kwv yees li 70 grams), nws lub luag haujlwm hauv kev ua haujlwm ib txwm ntawm cov kab ke no loj heev.

Nws ua lub luag haujlwm ntawm kev zais lwm tus, zais kua txiv qab zib rau duodenum. Nws muaj 3 enzymes - lipase, trypsin thiab amylase.

Lwm qhov kev ua haujlwm ntawm lub cev yog kev tsim cov tshuaj hormones uas tswj ntau hom metabolism hauv - protein, lipid thiab carbohydrate. 5 cov tshuaj hormones yog cov tshuaj ua ke hauv cov hlau, suav nrog insulin, glucagon.

Pancreatitis yog tus mob ntawm daim tawv nqaij hlav. Qhov tseem ceeb ntawm cov khoom hauv nruab nrog ntawm kev zom thiab cov zom zaub mov muaj txiaj ntsig ua rau muaj kev txhim kho kev hloov pauv tseem ceeb hauv tus neeg mob lub cev thiab kev ua haujlwm tsis zoo ntawm tag nrho cov muaj sia.

Kab mob pancreatitis yog dabtsi, thiab vim li cas nws thiaj txaus ntshai?

Hauv cov neeg ua kua (txiav), kua txiv pancreatic yog tsim, uas tom qab ntawd thauj los ntawm cov ducts mus rau hauv cov hnyuv rau cov txheej txheem zom zaub mov. Cov Enzymes neutralize hydrochloric acid ntawm lub plab ua kua thiab koom nrog hauv kev puas tsuaj ntawm cov as-ham hauv plab hnyuv.

Kev mob ntawm cov nqaij mos ntawm cov khoom hauv nruab nrog coj ua rau kev kaw ntawm txoj kev rau kev tawm dawb ntawm kua txiv. Nws nyob rau hauv lub caj pas thiab pib ua rau nws cov ntaub so ntswg - nws dig lawv.

Cov mob ntawm tus txiav ua rau tus neeg tsis tuaj yeem tsim kua txiv, nws muaj pes tsawg leeg thiab ua rau lub cev ua tsis txaus rau lub plab zom mov. Neoplasms thiab pob zeb uas cuam tshuam rau lub txiaj ntsig ib txwm dhau ntawm cov enzymes tuaj yeem dhau los ua lwm qhov ntxiv ntawm cov roj ntsha ua haujlwm.

Cov kua txiv pancreatic, tsis muaj qhov hluav taws xob, ua haujlwm hauv lub cev. Cov Enzymes cia li txiav ua rau txiav. Cov txheej txheem ua tau nrawm dua, cov ntaub so ntswg necrosis tuaj yeem tsim kho. Cov txheej txheem inflammatory tseem cuam tshuam cov kabmob uas nyob ib sab.

Qhov ntau ntawm cov co toxins raug tso tawm rau hauv cov ntshav, uas lom lub cev kom tag nrho lub cev, intoxication tshwm sim. Hauv kev lom hnyav heev, lub siab, lub ntsws thiab lub hlwb muaj kev txom nyem. Kev mob plab nrog mob txhaj thuv hlav tuaj yeem tshwm sim sai.

Ua rau ntawm pancreatic pathology

Qhov laj thawj ntawm kev txhim kho ntawm tus mob ua mob pancreatitis yog ncua ntawm cov kua txiv pancreatic nyob rau hauv lub qog, qhov ua txhaum ntawm nws cov dej tawm. Tus mob hnyav tau tshwm sim feem ntau los ntawm kev haus dej haus cawv thiab thaiv kev tso tawm ntawm cov enzymes vim yog pob zeb (mob gallstone).

Koj tuaj yeem faib cov ua rau ntawm kev mob vwm ua rau 3 pawg:

1. Kev sib tshooj ntawm cov hlab thiab ua kom ncua ntawm cov enzymes hauv lub qog. Qhov no tuaj yeem tshwm sim vim pob zeb, qog thiab pathologies ntawm cov ntaub so ntswg uas nyob ib sab.
2. Kev tsim tawm ntawm cov enzymes ntau dhau ntawm cov yuav tsum tau ua.
3. Thawb cov kua tsib mus rau hauv tus kab mob pancreatic.

Ntau yam ntawm lub neej hauv cov menyuam yaus thiab cov neeg laus ua rau qhov kev txhim kho ntawm cov laj thawj no.

Hauv cov laus

Cov teeb meem tshwm sim ntawm kev txhim kho ntawm daim ntawv mob thiab exacerbations ntawm tus mob yog:

• cov zaub mov tsis zoo - ua haujlwm ntau dhau, mob siab rau cov rog rog, ntsim ntsim, zaub mov tsis xwm yeem;
• kev siv qee yam tshuaj;
• mob plab, nrog rau qhov tsis zoo tom qab phais mob;
• pob zeb hauv cov kua tsib lub raj;
• cov kab mob endocrine (mob ntshav qab zib mellitus) thiab cov kab mob vascular pathologies nrog kev tsis txaus cov ntshav txaus rau hauv lub txiav;
• qhov tshwm sim ntawm kev kis kab mob;
• oncological pathologies, lub raum tsis ua haujlwm.

Qhov nquag tshwm sim ntawm kev loj hlob ntawm tus kab mob hauv cov txiv neej yog kev haus dej cawv ua ke nrog cov khoom noj muaj roj hnyav. Txawm tias lo lus "cawv qab zib" muaj nyob. Tus kabmob feem ntau cuam tshuam rau cov bachelors uas nyiam cov zaub mov yooj yim thiab cov qhaub cij.

Lwm yam ntxiv ua rau tus kab mob hauv cov poj niam yog kev nyiam kev noj zaub mov thiab kev tshaib plab. Kev noj haus tsis sib npaug ua rau lub nra hnyav ntxiv rau lub cev. Kev ntshaus siab, kev xeeb tub, thiab kev siv tshuaj tiv thaiv kuj tseem ua rau kev loj hlob ntawm tus kabmob.

Cov ntaub ntawv ntawm kev tshwm sim ntawm pancreatitis sib txawv raws thaj chaw, huab cua. Qhov no yog vim cov zaub mov ua noj, cov nyiam ntawm cov pej xeem mus haus cawv thiab ntau yam kev nyiam gastronomic.

Cov yeeb yaj kiab hais txog cov laj thawj thiab cov tsos mob ntawm tus mob ua tiav:

Hauv menyuam yaus

Qhov tsis muaj zog tiv thaiv kab mob hauv cov menyuam yaus ua rau lub hauv paus uas lawv muaj feem ntau ua rau muaj mob voos xwm txheej.

Muaj peev xwm ua rau mob pancreatitis nyob rau hauv tus menyuam:

• kev tsis xwm yeem ntawm kev pub zaub mov noj, muaj kev tawg nruab nrab ntawm cov pluas noj;
• cov cab no (tshwj xeeb, cua nab);
• kev tsis haum tshuaj rau cov khoom lag luam;
• cystic fibrosis - mob nqaij hlav ntawm lub cev;
• kev siv cov khoom noj uas tsis tsim nyog rau lub hnub nyoog, ntsim, qab ntsev, khoom noj ceev;
• kev qaug zog thiab ua si lub cev, hauv cov menyuam loj dua, cov chav kawm tom qab tsev kawm ntawv ua voj voog, ntu, xaiv;
• kev raug mob rau thaj tsam mob plab.

Tus kab mob pathology tuaj yeem tshwm sim los ntawm tus kabmob kis lossis tus kabmob sib kis tau (kabmob qhua quav, kabmob pob, pob qog), nrog rau lwm yam teebmeem ntawm lub plab zom mov. Dysbacteriosis feem ntau ua rau kev txhim kho kev mob mus ntev hauv cov menyuam yaus.

Video los ntawm Dr. Komarovsky:

Hom thiab kev faib tawm ntawm tus kabmob

Pancreatitis tau muab faib ua hom vim qhov tshwm sim ntawm:

1. Thawj qhov tshwm sim vim kev puas tsuaj rau pancreatic ntaub so ntswg. Nws yog tshwm sim los ntawm khoom noj khoom haus yuam kev, lom lom lom nrog tshuaj, cov khoom. Qhov ua rau yuav yog caj ces thiab cov kab mob ua tsis taus mis. Cov mob o tuaj yeem tshwm sim ntawm txhua lub hnub nyoog. Kev kuaj mob kom raws sij hawm thiab kev kho kom zoo tuaj yeem rov tuaj yeem hloov cov ntaub so ntswg rau lub cev.
2. Daim foos thib ob (lees paub) tau txiav txim siab yog tias o tau tsim vim muaj lwm yam kab mob. Qhov ua rau muaj kab mob pob zeb (cholelithiasis), kis tus kab mob, kis tus kab mob rau hauv lub plab, mob plawv. Kev vam meej ntawm kev kho tus mob pancreatitis nyob rau hauv cov ntaub ntawv no nyob ntawm kev txheeb xyuas thiab tshem tawm cov laj thawj, uas yog, thawj hom kab mob. Feem ntau cov laj thawj no tsis tuaj yeem tsim thiab tshem tawm.

Feem ntau qhov ua rau mob voos yog gastritis, biliary dyskinesia.

Pancreatitis yog mob thiab mob ntev.

Cov mob hnyav tshwm sim ua rau tus mob sai sai, nce siab ntxiv ntawm cov tsos mob. Cov kua txiv pancreatic, stagnating hauv cov txiav, pib rhuav tshem nws cov hlwb. Lub cev ntawm lub caj pas nce nyob rau hauv loj vim los ntawm edema. Cov mob hnyav yog cov xeeb ceem ntawm cov neeg hnub nyoog 30 txog 60 xyoo thiab menyuam yaus.

Tus mob voos ntev tau tshwm sim hauv daim ntawv ntawm lub sijhawm ntawm exacerbation thiab attenuation ntawm cov tsos mob. Qhov pib theem tsis feem ntau muaj qhov ua kom tsis meej. Lub sijhawm no, cov ntaub so ntswg txiav poob lawv lub luag haujlwm thiab raug hloov los ntawm cov ntaub so ntswg sib txuas. Cov enzymes thiab cov tshuaj hormones yog tsim hauv qhov ntau thiab tsawg, thiab tsis tuaj yeem muab cov kev zom thiab ua tiav tag lawm.

Nrog rau kev ua txhaum ntawm kev noj haus lossis kev ntxhov siab, ib qho kev ua kom txaus ntshai pib. Nrog kev hloov pauv tseem ceeb hauv cov ntaub so ntswg, cov tsos mob tas li ntawm pancreatic kawg ua haujlwm tau pom.

Cov tsos mob thiab cov tsos mob

Cov tsos mob ntawm cov ntaub ntawv sib txawv ntau. Qhov mob ntev li thaum pib ntawm tus kab mob tsis muaj cov cim qhia pom tseeb.

Daim ntawv ntshiab

Kev ncua sij hawm ntawm enzymes hauv caj pas ua rau kev rhuav tshem nws cov ntaub so ntswg. Cov ntsiab lus rog ntxiv nce, o nce. Necrosis (kev tuag) ntawm cov ntaub so ntswg tuaj yeem tsim kho sai heev. Nrog rau qhov xwm txheej aseptic, qhov txheej txheem nce qeeb qeeb tshaj li muaj mob.

Cov tsos mob:

• qhov kub nce siab tshaj 38º, qhov nce siab hauv lub siab (siab dua 90), qhov poob qis hauv siab (qis dua 90 mm / Hg);
• kev ua los ntawm quav tawv thiab raws plab, hauv quav cov quav uas tsis muaj zaub mov;
• xeev siab, ntuav nrog cov kua tsib;
• mob hnyav hauv qab ntawm cov tav thiab txoj siv tawv tawv, tej zaum ua rau hnov ​​mob hnyav nrog tsis nco qab;
• lub qhov ncauj qhuav, tsis muaj qab los noj mov;
• tus nplaig txheej, qhwv, ua ntsos;
• tsam plab thiab nro ntawm lub plab;
• kev hloov pauv ntawm daim tawv nqaij - pallor rau xiav, yellowness ntawm sclera;
• nce hws, poob phaus, zoo nkaus li tsis muaj zog.

Tus neeg mob muaj mob loj thiab yuav tsum tau mus pw hauv tsev kho mob. Qee zaum cov tsos mob tsis muaj mob, cov neeg mob zam nws yam tsis muaj kev kho mob. Qhov no muaj kev hem thawj nrog qhov ua tsis taus ntawm pancreatic muaj nuj nqi.

Tus saib pom ntev

Mob yog hnov ​​nyob rau hauv tib qho chaw - hypochondrium, yog muab rau sab nraub qaum, muaj tus cwj pwm girdling. Nrog rau qhov hnoos qeev tseem ceeb ntawm lub cev, cov kab mob ib puag ncig kuj tseem hnov ​​mob. Cov yam ntxwv los ntawm qhov txo qis hauv kev mob nrog kev hloov pauv ntawm lub cev lub cev - qhov chaw qis thiab zaum-sawv.

Exacerbations provoke kev siv dej cawv thiab khoom noj hnyav.

Cov cim ntawm tus kab mob rau tus txiv neej thiab poj niam yog tib yam. Cov tsos mob ntawm tus mob pancreatitis rau tus txiv neej feem ntau tshwm sim tom qab sib sau ua ke nrog haus cawv, cov tsos mob ntawm cov poj niam feem ntau tshwm sim tom qab sim noj zaub mov tshiab lossis yoo mov ua ntej hnub so.

Lwm yam cim:

• raws plab, raws kev raws plab, tsis tu ncua xeev siab, qee zaum ntuav;
• undigested tej daim hauv cov quav thiab ntuav;
• tsis xis nyob hauv plab, kaw, hiccups;
• nquag flatulence;
• lossi tsis xis nyob, poob ceeb thawj, tawm hws.

Kev siv tshuaj lom neeg lub cev nrog cov tshuaj lom neeg tso kua mis vim tias qhov ua haujlwm ntawm cov qog ua rau cov kua roj sai sai, ua haujlwm tsis txaus ntseeg.

Nrog kev mob hnyav rau hauv tsev, koj yuav tsum tsis kam noj zaub mov, saib lub txaj kom zoo. Mob khaub thuas tuaj yeem siv txhua 2 teev rau 10-15 feeb.

Video los ntawm Dr. Malysheva:

Teeb meem

Pancreatitis yog ib qho muaj kab mob txaus ntshai tshaj plaws, qee zaum tsis pub dhau ob lub lim tiam dhau ntawm qhov pib thiab qhov pib ntawm cov teeb meem.

Daim foos mob nrog cov mob hnyav, feem ntau ua rau mob poob siab. Cov tsos mob ntawm intoxication sai sai nce - pallor ntawm daim tawv nqaij, kev txhim kho lub raum tsis ua haujlwm, cuam tshuam patency ntawm cov hlab ntsha vim cov khoom lag luam lwj.

Ua tsis taus pa, mob hauv siab yuav tshwm sim. Cov enzymes uas tsis pom txoj kev tawm thiab thawb hauv lub qog tuaj yeem ua rau mob voos thiab foci purulent. Kab mob peritonitis muaj peev xwm ua tau. Kev tuag ntawm qhov chaw ntawm lub cev ua rau cov tsis muaj peev xwm txuas ntxiv tswj kev zom zaub mov. Nrog kev swb ntawm endocrine ib feem ntawm cov qog - cov islets ntawm Langerhans, kev tsim cov tshuaj hormones deteriorates.

Hauv cov kab mob mus ntev, pathologies ntawm cov kabmob nrog cov txiav ua tiav. Cov no yog daim siab thiab kua tsib cov kua dej, tsawg dua lub ntsws. Kab mob siab, cholecystitis, txawm tias mob ntsws tuaj yeem dhau los ua ib tus khub ntawm kev mob pancreatitis.

Kev puas tsuaj rau lub cev ua mob pancreatic ua rau nws deformation, kev tsim cov nqaij hlav, thiab qee zaum mob cancer. Feem ntau, cov ntshav tsis muaj zog txaus ua rau ntshav khov.

Qhov tseem ceeb ua rau muaj kev tuag nyob rau hauv pancreatitis yog kev txhim kho ntawm kev mob purulent thiab ntxiv rau sepsis.

Kev kuaj mob

Kev kuaj mob thawj zaug ntawm tus neeg mob muab cov duab ntawm tus kabmob. Nrog rau pancreatitis, txoj kev loj hlob ntawm kev mob ntawm tus txiav yuav tuaj yeem paub los ntawm cov xwm txheej ntawm qhov mob thiab lawv ib cheeb tsam.

Cov kev tshawb fawb:

• kev kuaj ntshav dav dav, biochemical, ntawm qhov ntsuas ntawm alpha-amylase - qhia kev o, ntshav liab, txhawm rau txhav;
• ntshav rau electrolytes - tso cai rau koj txhawm rau tshawb pom lub cev poob thiab rov muab cov khoom noj haus ntxiv;
• kuaj cov quav (coprogram) - kev txiav txim siab ntawm pancreatic elastase;
• tsom xam tso zis dav dav;
• Ultrasound - qhia tau tias qhov loj me thiab contours ntawm cov khoom hauv nruab nrog cev, kev hloov pauv ntawm cov ntaub so ntswg, kev tsis xwm yeem, nthuav dav ntawm cov leeg, hlwv;
• radiography siv los txiav txim pob zeb;
• CT, MRI - pab txhawm rau txheeb xyuas qhov kev ntsuas calcifications, hloov pauv ntawm ducts, kev mob ntawm tus txiav thiab kab mob nyob ze;
• endoscopic kev soj ntsuam ntawm lub bile ducts (ERCP) - ib qho kev kawm paub, yog tsim nyog yog tias tsim nyog.

Hauv qee qhov xwm txheej nyuaj, lawv tuaj yeem sau ntawv rau kev txiav cov nqaij mos rau qhov nqaij mus kuaj. Nws yog nqa tawm los txheeb xyuas qhov txheeb xyuas ntawm necrotic tshwm sim thiab txiav txim siab cov neeg sawv cev ua tau zoo rau kev kis mob. Tus kws kho mob gastroenterologist tau koom nrog hauv kev kuaj mob thiab kho mob. ICD 10 tus lej rau kev mob ceev yog K85, K86 yog mob ua mob pancreatitis.

Cov hau kev kho

Kev kho mob ntawm daim ntawv mob hnyav yog nqa tawm hauv tsev kho mob.

Cov tshuaj nram qab no ntawm cov tshuaj yog kws kho:

1. Cov Tawv Rog Kho Mob, Antispasmodics - Tsis-shpa, Platifillin, Baralgin, Pentazocine, Gastocepin. Nrog mob hnyav - Promedol.
2. Diuretic tshuaj kom tshem tawm cov khoom lag luam lwj thiab txo qis o - Lasix.
3. Cov tshuaj Antisecretory - Omeprazole, Cimetidine.
4. Probiotics - Bifiform los txhim kho txoj haujlwm hnyuv.
5. Cov Enzymes - Enzystal, Pancreatin.
6. Tshuaj tua kab mob - Doxycycline, Ampioks cais los yog kho kab mob.
7. Antiemetic - Cerucal los tiv thaiv lub cev qhuav dej.

Rau kev kho mob ntawm tus mob ntev, siv:

• cov ceg tawv uas muaj cov vitamins A, B, E, D, K;
• kev npaj enzyme - Festal, Digestal, Creon, Pancreatin;
• tshuaj kho mob plab - Gastocepin, Papaverine, Analgin, Ketanov;
• cov tshuaj tiv thaiv kab mob - Hypoxene, Unitiol;
• cov tshuaj tiv thaiv kab mob - Timogen, Amiksin;
• secretolytics los txo qis rau kev tso tawm ntawm cov kua txiv pancreatic - Nizatidine, Omeprazole.

Hauv kev kho cov kab mob pancreatitis ntawm ib daim ntawv twg, kev noj haus yog qhov tsim nyog. Nrog lub ntsej muag ua kom pom tus kab mob, kev tshaib plab yog qhia.

Hauv kev mob siab, kev tshaib plab nrog rau kev siv cov ntxhia dej thiab lub pas dej rosehip rau peb hnub yog qhia. Tom qab txhim kho tus mob, cereals thiab decoctions nrog cov ntsiab lus siab ntawm gluten tau ntxiv rau cov khoom noj haus.

Kev phais mob

Kev phais mob ntawm pancreatitis yog ua nyob rau hauv mob hnyav thiab mob ntev ntawm cov kab mob. Mob pob txha taub hau yuav tsum muaj kev phais mob, yog tias tsis tuaj yeem ruaj khov kho lub xeev kev siv tshuaj kho mob, yoo mov thiab noj zaub mov. Nws yog nqa nrog daim ntaub necrosis, mob qog ntawm lub qog, cholecystitis thiab peritonitis.

Nrog rau kev puas tsuaj rau lub cev, cov cheeb tsam muaj kev cuam tshuam ntau tshaj yog kev tiv thaiv kom tsis txhob muaj tus kabmob purulent txhab thiab necrosis.

Hauv kev ua haujlwm ntev ntawm tus mob ua kab mob pancreatitis, kev nqis tes ua haujlwm tau ua hauv qee kis:

• malignant neoplasms;
• pob zeb hauv cov kua tsib lub raj;
• qhov mob siab ntsws uas tsis tuaj yeem nres;
• stenosis ntawm cov kua tsib lossis pancreatic ducts;
• los ntshav.

Ntau hom kev ua haujlwm tau ua tiav, qee zaum lawv yuav tsum muaj kev sib koom ua ke.

Kev ua kom zoo thiab tshem tawm ntawm ib feem ntawm cov khoom hauv lub cev yog ua thaum necrosis tau cuam tshuam tsuas yog qee qhov ntawm lub txiav ua kab mob.

Kev tawm dag zog lub cev

Kev siv dag zog hauv lub cev yog siv nyob rau lub sijhawm ntawm kev kho kom rov zoo tom qab kev phais mob thiab hauv daim ntawv ntev dua ntawm tus kab mob hauv kev tshem tawm.

Cov txheej txheem hauv qab no yog qhia ntawm lub txiav:

• kev kho mob magnetotherapy;
• kev kho mob laser;
• electrophoresis nrog cov tshuaj;
• kev kho av nkos;
• raug ultrasound.

Cov txheej txheem txhim kho cov txheej txheem metabolic thiab muab ntshav rau lub cev, txhawb kev txhab tom qab kev phais.

Kev Tiv Thaiv

Kev tiv thaiv kev ntsuas yog lub ntsiab cai ntawm kev noj qab nyob zoo. Ntawm lawv, ib qho ntawm cov neeg tseem ceeb yog tsis lees txais haus cawv. Noj zaub mov zoo yuav pab txo qis lub nra ntawm lub txiav. Noj fractional - 5-6 zaug hauv ib hnub. Koj yuav tsum tso tseg kev siv lub lauj kaub tais diav kub thiab txias. Cov tswv yim ua noj ua haus yog hau, ncu thiab ncu.

Nqaij lauj kaub tais diav yog npaj los ntawm cov roj muaj roj tsawg, feem ntau yog minced - hauv daim ntawv ntawm pastes, cutlets, soufflé, casseroles. Txhua cov zaub mov tsis muaj rog rog ua kom tso cai. Cov cai no yog raws li kev noj haus No. 5.

Pom zoo kom haus cov tshuaj uas txo cov ntsaws rau ntawm cov txiav:

1. B vitamins - txhim kho cov txheej txheem metabolic, nce hemoglobin, ntxiv dag zog rau cov hlab ntshav.
2. Cov Enzymes - Pancreatin, Mezim, Festal - ua rau lub cev tsis muaj peev xwm hauv lub cev, pab kev zom zaub mov.
3. Antispasmodics rau kev tso plob tsis so tswj plab - Duspatalin.

Tom qab qhov kawg ntawm kev mob siab lossis nyob rau hauv kev tshem tawm, kev kho mob hauv chaw so balneological nrog bicarbonate ntxhia dej tau qhia. Ua raws li kev noj haus yuav tsum dhau los ua ib txoj kev ntawm lub neej, txwv tsis pub lub luag haujlwm ntawm tus txiav kab mob yuav ploj mus.