Zinthu zachipatala
Pali kupweteka, kutupa, ndipo nthawi zina zimakhala zowawa m'mimba. Odwala ambiri amakhudzidwa ndi nseru ndi kusanza; ena - kokha kukhumba kusanza. Pangakhale phokoso lopaka buluu kumalo ozungulirapo (chizindikiro cha Cullen) kapena cyanosis (buluu) la khungu pamakono ofanjika pamimba (chizindikiro cha Grey-Turner). Izi zikhoza kusonyeza kuperewera kwa magazi m'kati mwa mimba. Chizindikiro cha Cullen chimatsimikizira kukhalapo kwa kutuluka kwa magazi mkati, kumene ziphuphu zozungulira phokosolo zimadzazidwa ndi magazi. Kuchuluka kwa magazi m'magazi ndi zotsatira za kuphwanya njira zowononga magazi chifukwa cha kuyamwa kwa michere ya pancreatic. Nkhanzazi zili kumbuyo kwa mimba kumbuyo kwa m'mimba. Mutu wake uli pa bend wa duodenum.
Ziphuphu zimapanga:
- insulini ndi glucagon - mahomoni omwe amamasulidwa mwachindunji m'magazi ndi kuyang'anira shuga la magazi;
- madzi osokoneza bongo - ali ndi mavitamini anayi omwe amachotsa mapuloteni (trypsin, chymotrypsin), komanso mafuta (lipase) ndi wowuma (amylase). Mitsewu yotsika yopanda phokoso imalowa mumtambo wamba nthawi yomweyo isanatuluke ku duodenum.
Madzi okongoletsera, pamodzi ndi bile, amasakanizidwa ndi chakudya chochepa m'mimba, atsegulidwa ndikukwaniritsa njira zowonongeka kwa zakudya.
Zomwe zimayambitsa chiwerewere chachikulu ndi:
- matenda a khansa (45%); Mwachitsanzo, kulimbika kwa nyongolotsi m'matope a bile asanafike mu duodenum;
- kumwa mowa mopitirira muyeso (35%).
Zifukwa zina ndizo:
- Kupweteketsa kapena kupweteka kwa m'mimba, mwachitsanzo, chifukwa cha opaleshoni;
- ululu wa ululu wa duodenum;
- Matenda osokoneza bongo, monga hypercalcemia (chifukwa cha matenda a gland parathyroid ndi kudya kwa mankhwala a calcium); hypertriglyceridemia (msinkhu wa triglycerides m'magazi); impso kulephera;
- Kuchita kwa mankhwala, mwachitsanzo, kuphatikizapo zina zothandizira kulera;
- Matenda opatsirana, monga parotitis, matenda a chiwindi, HIV;
- matenda ochizira, monga khansa ya pancreatic;
- milandu yodalirika (yosadziwika kuchokera pachiyambi). Zomwe zimagwiritsidwa ntchito pazifukwazi sizinafotokozedwe, komabe, molingana ndi chimodzi mwa ziphunzitsozo, izo zimakhala mu "kudzipiritsa" kwa chidziwitso, pamene mavitamini ake amapezeka m'matumbo ake. Mwa kuwononga gland, nawonso, amachititsa mitundu ina ya michere, monga elastase (kutaya makina otsekemera a mitsempha ya magazi) ndi phospholipase.
Chifukwa cha matendawa
Zomwe zimayambitsa mapuloteni osokoneza bongo zimatha kuwononga maselo ndi kuwononga maselo, kuchititsa magazi, edema ndi necrosis wa maphala. Ndi kutaya kwakukulu kwa magazi, ziwalo zoyandikana zingathe kuonongeka, zomwe zimapangitsa chiopsezo cha mantha ndi mavuto ena. Ndi kupwetekedwa koopsa kwambiri, kutupa kumangokwanira kokha kokha. Zizindikiro zofananazi zikhoza kuwonedwa mu matenda ena ammimba (kupweteka kapena kutsekeka kwa matumbo, kutupa koopsa kwa ndulu), komanso chifuwa (chifuwa cha mtima).
Mayeso a magazi
Magazi amawerengera kuti chiwopsezo sichipezeka, koma kuyesa kwa magazi kumathandiza kuthandizira chithunzi chachipatala. Nthaŵi zambiri, kuchuluka kwa mapuloteni a pancreatic (amylase ndi lipase) m'magazi. Zizindikirozi ndizofunikira kwambiri pa matendawa, kuyambira mkati mwa sabata iwo amabwerera ku zachilendo. Mafuta akuluakulu a mafuta omwe amapangidwa ndi lipase amachititsa kuti puloteni saponification ndi kuchepa kwa kashiamu m'magazi. Mlingo wa leukocyte m'magazi mwa odwala matenda opatsirana amayamba kukwera (leukocytosis), ndipo chifukwa cha kutayika kwa madzi, hematocrit (chiŵerengero cha kuchuluka kwa erythrocytes ku chivomezi cha plasma) chikuwonjezeka.
Njira zowonetsera
Chotsatira cha matenda operewera kwa chifuwa chachikulu chimachokera pa zotsatira zokha zomwe zimapezeka mothandizidwa ndi njira zowonongeka: ultrasound ndi computed tomography. Mankhwala a tomography amawopsa kwambiri chifukwa cha vutoli. Mothandizidwa ndi njira izi nthawi zina zimatha kuzindikira chifukwa cha chifuwa chachikulu. Kuwulula chomwe chimayambitsa matendawa kumalola kuchita njira zothandizira zowonongeka, zomwe zidzakuthandizani kupeŵa mobwerezabwereza kuzunzidwa.
• Zipangizo zamtundu wofiira pa pulogalamu ya pseudocolor yopangidwa ndi microscope ya electron ndi ma lymphocytes (mtundu wa leukocytes). Mlingo wa leukocyte m'magazi mu chiwopsezo choopsa nthawi zambiri umakwera. Chiwerengerochi chikuyankhidwa pa msinkhu wa mfundo khumi ndi umodzi malinga ndi njira zoyenera, zomwe zikuphatikizapo:
- ali ndi zaka zoposa 55 pa nthawi ya kulembetsa;
- mayesero a ma laboratory (anayi ataloledwa ndipo asanu ndi limodzi pambuyo pa maola 48). Ngati pali mfundo zitatu kapena zambiri pa nthawi yolowera, mwayi wa zotsatira zoopsa ndi 1: 5; Ngati pali mfundo zisanu ndi ziwiri kapena zingapo, imatuluka.
M'masiku oyamba, imfa imapezeka chifukwa chakuti thupi likhoza kulephera. Ambiri (odwala 80%) amafa kamodzi pa sabata, kawirikawiri chifukwa cha chitukuko (abscessing) kapena mapangidwe a chinyengo. Kukula kwa matenda pamsana wa necrosis wa ziphuphu ayenera kukayikira ngati palibe mankhwala kapena mankhwala owonongeka mwadzidzidzi. Kupuma kwa zinthu zomwe zili m'mimba m'mimba polamulidwa ndi computed tomography kungathandize kuti mudziwe. Ngati chikhumbo cha zomwe zili ndi kachilombo sikuchitika nthawi, chiwerengero cha anthu omwe amamwalira chimafika 100%. Mtundu wochepa wodetsa wa chifuwa ungadutse mwadzidzidzi. Wodwalayo amapatsidwa mankhwala osokoneza bongo, kudya chakudya ndi zakumwa zimachotsedwa. Pochotseratu kunyoza ndi kusanza ndi nasogastric chubu, mimba imachotsedwa. Izi zimathandiza kupewa mantha, kuchepetsa kutaya kwa madzi. Pulojekiti imagwiritsidwanso ntchito popereka mankhwala osokoneza bongo, nthawi zina pogwiritsa ntchito chipangizo cholamulidwa ndi odwala. Izi zimapatsa wodwalayo mwayi wodzetsa kudya kwa mankhwala, malinga ndi kukula kwa ululu. Kuti mupewe kudyetsa, pali chipangizo chapadera chomwe chimapangidwa kuti chigwiritse ntchito mlingo wochepa wa mlingo kwa nthawi yayitali.
Kufufuza kozama
Mu chiwopsezo chachikulu cha matenda osokoneza bongo, chipatala ndi chofunika ku chipatala chodziwika bwino chomwe wodwala amafufuza mosamala ndi zizindikiro zoopsa zomwe zimasonyeza kuti chiopsezo chachikulu cha imfa chikuwululidwa. Chithandizochi chimayesetsa kupewa matendawa.