Ib qho ntawm cov kab mob loj tshaj plaws ntawm tib neeg lub plab zom mov yog pancreatic necrosis, uas, raws li kev txheeb cais, ua rau tuag taus hauv 40-60% ntawm cov neeg mob.
Caus ntawm pancreatic necrosis
Tus mob pancreatitis, qhov teeb meem uas yog pancreatic necrosis, yog nyob rau hauv peb qhov chaw ntawm qhov tshwm sim, hla ua ntej tsuas yog mob plab hnyuv thiab cholecystitis. Raws li txoj cai, nws tshwm sim vim kev puas tsuaj rau cov cell secretory ntawm pancreas, ntau lawm ntawm pancreatic kua txiv thiab impaired outflow. Cov txheej txheem no tuaj yeem ua rau:
- mob plab;
- phais plab;
- lub cev qaug cawv (xws li cawv);
- kev tsis haum;
- kab mob gallstone;
- kab mob los yog kab mob cab;
- noj ntau dhau ntawm cov nqaij kib, tshem tawm, tsiaj rog.
Ua rau mob pancreatic necrosis ntawm pancreasmuaj ntau, tab sis feem ntau nws tshwm sim tom qab haus dej cawv ntau nrog rau cov khoom noj muaj rog. Nws tshwm sim tias tus kab mob tshwm sim yuav luag tam sim ntawd thiab qhov kev tawm tsam tuaj yeem tsim tawm tsam keeb kwm ntawm kev noj qab haus huv tag nrho. Cov neeg mob tau sau npe thaum mob pancreatic necrosis, uas qhov tshwm sim tuag tau tshwm sim nyob rau hauv ob peb teev tom qab thawj cov tsos mob tshwm sim, tsim ob peb hnub tom qab noj mov ntau.
YYuav ua li cas nrog pancreatic necrosis
Ib lub txiav noj qab haus huv tsim cov enzymes uas xav tau los rhuav tshem cov zaub mov uas nkag mus rau hauv plab. Nws yog ua tsaug rau lawv tias cov zaub mov tau tawg mus rau hauv cov ntsiab lus uas tuaj yeem nkag mus rau hauv cov hlab ntsha los ntawm lub plab hnyuv, uas xa mus rau cov ntaub so ntswg thiab lub cev. Qhov no ua rau pancreas yog ib qho tseem ceeb hauv lub cev. Kev haus dej cawv nrog cov khoom noj uas muaj roj nplua nuj ua rau cov kua txiv hmab txiv ntoo los ntawm lub txiav, thiab vim tias cov ducts tsis tuaj yeem tshem tawm tag nrho, nws pib nkag mus rau hauv lub caj pas. Qhov no ua rau kev loj hlob ntawm edema, ntxiv compression ntawm lub excretory ducts thiab lawv cov blockage tom ntej. Kev ua haujlwm ntawm pancreatic enzymes, uas nws lub luag haujlwm yog Ameslikas rhuav tshem cov protein, tawm hws los ntawm cov phab ntsa ntawm cov ducts thiab pib yaj lawv, nyob rau hauv qhov kev txiav txim ntawm cov enzymes, "kev zom" ntawm lub caj pas tus kheej cov ntaub so ntswg tshwm sim. Active enzymes thiab lwj cov khoom uas tshwm sim los ntawm qhov no nkag mus rau hauv cov hlab ntsha thiab pab mus rau lub dissolution ntawm lwm yam kabmob thiab cov ntaub so ntswg,mob hnyav heev. Yog li, pancreatic necrosis, qhov kev cia siab ntawm qhov uas nyuaj rau kev kwv yees, yog kab mob txaus ntshai heev.
Kev faib tawm ntawm pancreatic necrosis
Nyob ntawm seb qhov mob ntawm lub caj pas, me-focal, nruab nrab-focal, loj-focal, subtotal thiab tag nrho pancreatic necrosis yog qhov txawv. Tau kawg, qhov sib txawv ntawm thawj ob hom yog feem ntau arbitrary. Cov kws kho mob siv cov tswv yim no txhawm rau txiav txim siab qhov kev puas tsuaj ntawm lub cev. Nrog subtotal pancreatic necrosis, cov kev hloov necrotic cuam tshuam rau feem ntau ntawm cov qog. Yog tias lub cev raug cuam tshuam tag nrho, ces tag nrho pancreatic necrosis ntawm tus txiav tau kuaj pom. Qhov tshwm sim tuag nyob rau hauv rooj plaub no ib txwm pom.
Muaj lwm qhov kev xaiv cais. Nws faib pancreatic necrosis ua ob hom:
- Limited. Qhov no suav nrog cov txheej txheem uas foci ntawm ntau qhov sib txawv yog tsim.
- Common. Hauv qhov no, feem ntau ntawm cov qog lossis tag nrho lub cev raug cuam tshuam.
Type ntawm pancreatic necrosis
Nyob ntawm seb muaj tus kab mob hauv thaj chaw cuam tshuam, tsis muaj menyuam lossis muaj kab mob pancreatic necrosis txawv. Nyob rau tib lub sijhawm, nyob rau hauv rooj plaub ntawm tus txheej txheem muaj tus kabmob, qhov kev cia siab yog qhov tsis zoo, vim tias muaj qhov tshwm sim ntau ntawm kev tsim muaj kev sib kis-tshuaj lom, thiab nws tuaj yeem nyuaj heev kom tus neeg mob tawm ntawm lub xeev no.
Sterile pancreatic necrosis tau muab faib ua hom hauv qab no:
- rog - nws yog tus cwj pwm los ntawm qeebkev loj hlob nyob rau hauv 4-5 hnub los yog me me;
- hemorrhagic - tus cwj pwm los ntawm kev ntws nrawm thiab nquag los ntshav;
- sib xyaw - tshwm sim feem ntau, txij li pancreatic necrosis sib npaug cuam tshuam rau ob qho tib si adipose thiab pancreatic parenchyma.
Yog tias qhov kev puas tsuaj ntawm pancreatic necrosis ntawm tus txiav txiav raug kuaj pom, kev phais yog qhov yuav tsum tau zam. Tab sis feem ntau nws tsis muab qhov xav tau, thiab rov txhim kho necrotic foci yog ua tau.
Cov tsos mob thiab kuaj mob pancreatic necrosis
kho mob mob pancreatitis yog tshwm sim los ntawm qhov mob hnyav nyob rau sab laug hypochondrium lossis mob uas muaj lub cim khi. Muaj ntuav ntawm cov hnyuv, uas tsis tuaj yeem ua rau mob, raws plab. Tawm tsam keeb kwm no, lub cev qhuav dej ntawm lub cev sai sai, intoxication intensifies. Thaum kuaj xyuas, kev sau ntawm anamnesis yog qhov tseem ceeb heev. Yog tias nws muaj cov ntaub ntawv hais txog kev tsim txom ntawm cawv, khoom noj muaj roj, lossis cov ntaub ntawv hais txog cov kab mob ntawm daim siab thiab lub gallbladder, qhov no feem ntau yuav ua rau nws muaj peev xwm ua kom muaj kev kuaj mob xws li pancreatic necrosis ntawm pancreas. Qhov kev kwv yees nyob rau hauv cov ntaub ntawv no feem ntau yuav nyob ntawm seb tus kab mob theem twg tus neeg mob tau nrhiav kev pab kho mob, thiab nyob ntawm qhov chaw ntawm qhov txhab.
Raws li kev kuaj mob hauv chaw kuaj mob, ntawm no lawv ua tib zoo saib xyuas cov zis thiab ntshav, qhov twg muaj qhov tseem ceeb tshaj ntawm amylase qib. Abdominal ultrasound, CT lossis MRI kuj tseem ua tau, qhov uas koj tuaj yeem pom cov tsos mob ntawm qhov chaw necrotic.pancreatic ntaub so ntswg.
Kev kho mob
Feem ntau, pancreatic necrosis yuav tsum tau phais. Nyob rau tib lub sijhawm, txawm hais tias qhov kev tuag ntawm cov neeg tuag yog qhov siab heev, kev phais mob raws sij hawm muab txoj hauv kev zoo rau kev rov zoo. Kev saib xyuas kev kho mob suav nrog cov kauj ruam hauv qab no:
- hauv ob peb hnub tom qab qhov kev tawm tsam - ua tiav kev yoo mov, thiab nyob ntawm qhov hnyav ntawm tus kab mob, kev qhia txog cov as-ham los ntawm cov tshuaj infusions tuaj yeem txuas ntxiv mus rau lub lis piam;
- ntshav purification (hemosorption) - nqa tawm nrog kev mob hnyav heev;
- somatostatin yog ib yam tshuaj uas tuaj yeem txo cov teebmeem ntawm lub raum kev puas tsuaj uas feem ntau nrog pancreatic necrosis;
- nyob rau hauv cov ntaub ntawv kis kab mob - tshuaj tua kab mob.
Kev Noj Qab Haus Huv Pancreatitis
Txij li nws yog cov khoom noj uas feem ntau dhau los ua tus mob pancreatitis, nws yog tus uas tseem ceeb heev hauv txoj kev kho mob. Raws li tau hais los saum no, thawj hnub tom qab kuaj pom tus mob pancreatitis tau tsim, kev noj zaub mov nruj heev - ua tiav kev yoo mov. Hauv qhov xwm txheej hnyav, kev noj zaub mov ntawm niam txiv tuaj yeem txuas ntxiv rau ob peb lub lis piam.
Nyob rau hauv lub neej yav tom ntej, khoom noj khoom haus rau pancreatic necrosis ntawm pancreas implies ib tug sparing regimen, uas yog guaranteed los ntawm lub siab tshaj plaws cais tawm ntawm cov zaub mov ntawm cov rog thiab carbohydrates, raws li zoo raws li cov khoom uas ua rau kom muaj roj ntau ntxiv. Cov zaub mov yog steamed thiab finely tws. Txais los ntawm me mefeem tsib mus rau rau lub sij hawm ib hnub twg. Kev siv cov extractives thiab ntsev tsis suav nrog tag nrho. Kev noj zaub mov zoo li no, nyob ntawm qhov mob hnyav, yuav tsum kav ntev li ob peb lub hlis mus rau ib xyoos.
Tau kawg, nrog cov kab mob loj xws li pancreatic necrosis, qhov tshwm sim tuag tau tshwm sim, thiab, tau kawg, nws yog qhov zoo dua tsis coj koj lub cev mus rau qhov kev tawm tsam, tshem tawm cov xwm txheej txaus ntshai ntau li ntau tau. Tab sis yog hais tias tus kab mob no tseem tsim, ces ceev faj ua raws li cov kev noj haus yuav pab kom tsis txhob rov qab mus rau yav tom ntej.
