Nyob hauv ntau tus neeg, txiav txiav pib ua tsis tiav, nws dhau los ua mob vim muaj cov kua tsib tsis zoo. Biliary pancreatitis tshwm sim, uas feem ntau cuam tshuam rau cov neeg laus. Tus kab mob no kho tau, tab sis yuav tsum tau mus ntsib kws kho mob raws sij hawm thiab ua raws li tag nrho cov tshuaj tsim nyog. Ua tsaug rau kev kho mob pancreas tau zoo, tus neeg mob rov qab mus rau nws txoj kev ua neej li qub.
Tus yam ntxwv ntawm tus kab mob
biliary pancreatitis tshwm sim nrog cholelithiasis. Nws tshwm sim los ntawm cov kua dej reflux mus rau hauv cov ducts ntawm tus txiav, ua rau o. Cov txheej txheem no qhia txog kev ua haujlwm tsis zoo ntawm lub gallbladder.
Nyob rau hauv tus neeg noj qab haus huv, lub siab hauv cov ducts ntawm lub cev no qis dua qhov siab ntawm cov ducts ntawm lub txiav. Nws qhov kev nce ntxiv qhia tias qhov tshwm sim ntawm qhov teeb meem uas tsis tso cai rau cov kua tsib kom ua tiav nws qhov tam sim no ib txwm. Qhov no tej zaum yuav yog vim qhov txhaws ntawm cov ducts, ntau zauspob zeb xwb. Tag nrho cov no ua rau cov kua dej nkag mus rau hauv lub txiav.
Ua rau kab mob
Cov kab mob no tuaj yeem tshwm sim rau ntau yam. Xav txog qhov yooj yim tshaj plaws.
Yog tias ib tug neeg raug mob cholelithiasis, feem ntau nrog tus kab mob no, cov kua txiv hmab txiv ntoo pib stagnate vim yog txhaws ntawm cov ducts nrog pob zeb. Tag nrho cov no ua rau muaj kev nce siab hauv txoj hauv kev no, ua rau cov kua dej nkag mus rau hauv cov txiav.
Nrog cholecystitis, cov txheej txheem inflammatory tshwm sim rau ntawm lub gallbladder, tiv thaiv cov kua txiv los ntawm ib txwm.
Pab txhawb rau kev txhim kho ntawm biliary pancreatitis thiab cholangitis, uas yog qhov tsis zoo ntawm cov ducts vim muaj kev cuam tshuam ntawm cov kab mob biliary thiab kis kab mob ntawm cov zais zis.
Cov kab mob saum toj no ua ke nrog biliary pancreatitis ua rau muaj kev hloov pauv hauv qab no hauv cov txiav:
- mob thiab degeneration;
- kev loj hlob ntawm cov hlwb txuas;
- kev ua txhaum hauv nws txoj haujlwm.
Tab sis tsis yog cov ua rau muaj feem cuam tshuam rau qhov pib ntawm tus kab mob. Kev qaug dab peg feem ntau tshwm sim hauv cov neeg nyiam noj zaub mov qab. Cov zaub mov zoo li no tuaj yeem ua ib hom kev tawm tsam ntawm gallbladder spasms thiab ua rau pancreatic edema. Tsis tas li ntawd, tus kab mob pancreatitis tshwm sim vim noj ntau dhau, noj zaub mov tsis zoo lossis ua tsis zoo.
tus kab mob no zoo li cas?
Tus kab mob pancreatitis tuaj yeem mob ntev lossis mob. Kawgtshwm sim los ntawm kev siv cov khoom noj zoo li no, uas txhawb nqa tag nrho cov txheej txheem ntawm kev zom zaub mov. Nws tuaj yeem yog kib nqaij pies, dej qab zib, khoom noj txom ncauj qab, nqaij kib.
Cov zaub mov no yeej tsis suav tias yog noj qab haus huv, vim nws txhawb nqa lub zog ntawm pob zeb uas tuaj yeem thaiv cov ducts hauv lub gallbladder. Cov neeg mob uas muaj kab mob ntev ntev, saib xyuas kev noj zaub mov kom zoo, tuaj yeem tiv thaiv qhov tshwm sim ntawm biliary pancreatitis.
Cov kev kawm ntawm biliary pathology nyob ntawm qhov kev txiav txim ntawm pob zeb hauv cov kua tsib. Yog tias lawv me me thiab dhau mus zoo rau hauv duodenum, ces tus neeg mob tus mob yuav zoo dua sai. Yog hais tias kev txav ntawm pob zeb raws cov kav dej yog qhov nyuaj, qhov no koj tuaj yeem ntshai rau tus neeg mob lub neej.
Cov tsos mob ntawm biliary pancreatitis
Cov tsos mob ntawm tus kab mob no, tshwj xeeb tshaj yog tawm tsam keeb kwm ntawm cov kua tsib, muaj ntau haiv neeg, yog li cov kab mob no nyuaj heev rau kev kuaj mob.
Yog li, yog tias tus neeg mob muaj tus mob biliary pancreatitis, nws cov tsos mob yuav ua raws li hauv qab no:
- Qhov tshwm sim ntawm qhov mob hnyav thoob plaws hauv plab plab, uas tuaj yeem tawg mus rau sab nraub qaum lossis hypochondrium. Feem ntau, mob tshwm sim tom qab noj rog, kib lossis haus cov zaub mov. Nws nce tshwm sim thaum hmo ntuj lossis ob teev tom qab noj mov.
- Nyob tsw qab nyob hauv qhov ncauj.
- Ntaus, ntuav.
- Zoo, cem quav lossis flatulence.
- Lub cev kub tuaj yeem nce me ntsis.
Tus kab mob biliary pancreatitis yog tus cwj pwm los ntawm qhov mob hnyav hauv cheeb tsam hypochondrium vim yog spasms ntawm cov nqaij ntshiv uas ua rau pob zeb, thiab mob ntev - mob mob uas ua rau ntev heev.
Tsis tas li ntawd, nyob rau hauv daim ntawv mob ntev ntawm tus kab mob, cov tsos mob ntawm jaundice tuaj yeem tshwm sim, vim tias cov kab mob biliary raug cuam tshuam thiab cov kua dej digestive nkag mus rau hauv cov hlab ntsha. Nyob rau tib lub sij hawm, cov dawb ntawm lub qhov muag thiab daim tawv nqaij integuments tig daj. Hauv qhov no, kev kho mob yuav tsum tau pib tam sim ntawd, vim txhua yam tuaj yeem xaus rau tu siab heev.
Kev kuaj kab mob
Tus neeg mob yuav tsum xeem dhau qhov kuaj ntshav thiab kuaj ntshav biochemical. Hauv cov kab mob biliary pancreatitis ntev, muaj qhov nce hauv qib ntawm bilirubin, alkaline phosphatase thiab cov roj cholesterol, thiab qhov piv ntawm cov proteins yooj yim, ntawm qhov tsis sib xws, txo qis. Amylase qib nce 3-6 zaug hauv cov zis thiab ntshav.
Ultrasound ntawm pancreas thiab ultrasound ntawm cov kab mob hepatobiliary yuav tsum tau txiav txim siab muaj pob zeb hauv cov ducts, thiab cov xwm txheej ntawm cov txiav txiav kuj raug soj ntsuam.
Cov kev siv tau zoo xws li intraductal lossis endoscopic ultrasound raug tshuaj xyuas kom pom pob zeb.
Txoj kev qhia tshaj plaws yog CT ntawm lub plab hnyuv, tshwj xeeb tshaj yog tias tus neeg sawv cev sib txawv tau txhaj. MRCP thiab ERCP kuj tseem siv los kuaj xyuas cov kab mob pancreatic thiab bile ducts.
Kev kho mob ntawm pathology
Kev kho mob biliaryTus kab mob pancreatitis yog ua raws li kev tswj hwm ntawm tus kws kho mob gastroenterologist, endoscopist thiab kws phais. Yog li kom tus kab mob no tsis mus ntxiv, thiab tseem txhawm rau tiv thaiv kom tsis txhob mob hnyav, tus kab mob hauv qab tau kho.
Yog hais tias mob pathology tau dhau los ua tus mob biliary pancreatitis, kev kho mob yuav tsum tau ua hauv tsev kho mob nkaus xwb. Daim ntawv mob hnyav yog kho raws li qhov nyuaj, nrog rau kev siv tshuaj kho mob thiab kev noj zaub mov zoo.
Tus kab mob pancreatitis nyob rau theem mob tshwm sim nrog qhov mob hnyav, uas tau txo qis nrog tshuaj tua kab mob thiab tshuaj tua kab mob. Tsis tas li ntawd, kev ua haujlwm sab hauv thiab sab nraud ntawm cov txiav ua haujlwm raug kho, tshem tawm cov tshuaj lom, thiab tiv thaiv kev kis kab mob nrog kev pab ntawm cov tshuaj tua kab mob.
Nrog rau qhov exacerbation hauv thawj peb hnub, kev kho yoo mov thiab siv cov dej tsis muaj carbonated alkaline ntxhia yog tsim nyog. Tom qab kev noj zaub mov rov pib dua, nco ntsoov txwv cov rog hauv cov zaub mov, carbohydrates kuj yuav tsum tau tswj.
txhawm rau txo qhov cuam tshuam ntawm kev ua haujlwm ntawm pancreatic enzymes, sau tshuaj somatostatin, protease inhibitors, proton twj tso kua mis inhibitors. Tus kws kho mob kuj tuaj yeem sau tshuaj microspheroidal enzymes, uas pab kho cov kab mob pancreatic enzyme tsis ua haujlwm. Txhawm rau kom cov ntshav qab zib rov qab mus rau qhov qub, cov tshuaj hypoglycemic tau sau tseg.
Thaum qhov mob hnyav tau txo qis, koj tus kws kho mob yuav hais kom phais kom tshem cov pob zeb. Nws yog ua nyob rau hauv ob txoj kev:txiav rau hauv phab ntsa sab sauv ntawm lub plab (laparotomy) los yog ua ob lub me me rau hauv lub plab phab ntsa (laparoscopy).
Muaj Teeb Meem
Yog tias tus kab mob pancreatitis raug kho kom raug, tus neeg mob yuav rov qab mus rau nws txoj kev ua neej li qub. Nrog cov kab mob siab heev, pob zeb tuaj yeem txav mus rau hauv cov kua tsib. Yog tias tus kab mob tso tseg rau lub caij nyoog thiab tsis muaj dab tsi ua tiav, qhov no yuav ua rau muaj kev cuam tshuam ntawm kev ua haujlwm ntawm lub plab zom mov. Txhua zaus qhov mob tsuas yog hnyav zuj zus, tshwj xeeb tshaj yog tom qab noj zaub mov tsis zoo.
Ntxiv rau, kab mob siab heev tuaj yeem hloov mus ua parenchymal pancreatitis. Qhov no yuav hem tus neeg mob nrog cov hauv qab no:
- kev kho mob hauv tsev kho mob ntev;
- kev phais loj;
- sijhawm kho dua tshiab;
- kev noj zaub mov nruj tshaj yuav luag tag nrho kuv lub neej.
Txhawm rau tiv thaiv qhov tshwm sim ntawm biliary pancreatitis, koj yuav tsum ua raws li kev noj qab haus huv, noj kom raug thiab tso tseg cawv tag.
Kev noj haus
Yog tias muaj kab mob pancreatitis tshwm sim, kev noj zaub mov yuav tsum yog qhov tsim nyog. Thaum nruab hnub, tus neeg mob yuav tsum noj 4-5 zaug, thaum lub ntim ntawm ib qho kev pabcuam yuav tsum tsis pub ntau tshaj 250 ml. Cov zaub mov haus luam yeeb, kib thiab rog yog txwv nruj.
Thaum noj zaub mov, tus nqi ntawm cov protein yuav tsum tau nce 25%. Yog li, tus neeg mob yuav tsum noj 120 g ntawm cov khoom protein ib hnub. Tab sis qhov ntim ntawm cov rog, ntawm qhov tsis sib xws, yuav tsum tau txo los ntawm 20%, thiab thaum nruab hnubLawv noj yuav tsum tsis txhob ntau tshaj 80 g. Carbohydrate kom tsawg yuav tsum tau txo, thiab nws yuav tsum yog 350 g ib hnub twg. Tus nqi qab zib raug pom zoo kom txo los ntawm 2 npaug ntawm tus nqi xav tau.
Zoo kawg
Tus kab mob biliary pancreatitis (tshwj xeeb yog daim ntawv mob hnyav) yog ib yam kab mob hnyav heev. Nws yog ib qho tseem ceeb kom kuaj xyuas tus kab mob no kom raug thiab pib kho raws sij hawm, txij li kev tawm tsam yuav tshwm sim ntxiv, ua rau muaj kev txom nyem ntau. Tsuas yog kev phais pab kom tshem tau cov kab mob biliary pancreatitis mus tas li.
