Clinical features
Kune urombo, kuzvimba, uye dzimwe nguva kushungurudzika kwemasimba kwemuviri mudumbu. Vakawanda vanorwara vane hanya nekushushikana uye kurutsa; vamwe-chete chido chokurutsa. Ikoko kunogona kunge kune bhuruu shoma shoma inenge yakakomberedza nhenje (chiratidzo chaCullen) kana cyanosis (buluu) rweganda pane zvisikwa zvepamusoro zvemuviri (chiratidzo cheGrey-Turner). Izvi zvinogona kuratidza kupinza kwemuviri mukati mechipfuva chemuviri. Chiratidzo cheCullen chinopupurira kuvapo kwekubuda kweropa mukati, umo maitiro anenge akapoteredza maruva aya akazara neropa. Kushandiswa kwemuviri kunokonzera kukanganisa kwekuvhara ropa maitiro semugumisiro wekudya kwepencreatic enzymes. Iyo panikresi iri kumashure kwemuviri shure kwechikamu chepasi chemukati. Musoro waro uri pa bend ye duodenum.
Ipakreas inobereka:
- insulini uye glucagon - mahomoni anonunurwa zvakananga muropa uye kudzivirira mazinga ehuga eropa;
- pancreatic juice - ine maine enzymes mana anoputsa mapuroteni (trypsin, chymotrypsin), uyewo mafuta (lipase) uye starch (amylase). Nzira yakaderera yepancreatic inopinda muitiro yakazara bile duct nguva pfupi isati yabva duodenum.
Pancreatic juice, pamwe ne bile, inosanganiswa nechingwa chakakanganwa mudumbu, yakagadzirirwa uye inopedza zvirongwa zvekugadzikana kwezvibereko.
Zvinonyanya kukonzera kukonzerwa nepacreatitis zvakanyanya ndezvi:
- chirwere chinonzi bile duct (45%); somuenzaniso, kuomesera kwematombo ematombo mumatope asina kunyangwe asati apinda mu duodenum;
- kusagadzikana kudhakwa (35%).
Zvimwe zvikonzero ndezvi:
- kushungurudza kana kupinda mukati mokurwadziwa kwepamuviri, somuenzaniso, semubairo wekuvhiyiwa;
- perforated ulcer we duodenum;
- Matambudziko emagetsi, akadai se hypercalcemia (nemhaka yehutachiona hwezvinyorwa zvepathyroid uye kudya kwemagiramuumine zvinodhaka); hypertriglyceridemia (yakakwirira ye triglycerides muropa); kidney failure;
- kupindira kumishonga, semuenzaniso, akabatanidzwa mune zvimwe zvekudzivirira pamuviri;
- Zvirwere zvinotapukira, zvakadai separotitis, hepatitis, HIV;
- zvirwere zvehupenyu, zvakadai sepancreatic cancer;
- Idiopathic matambudziko (asingazivikanwi mavambo). Iyo nzira yezviito zvezvizvi izvi haisati yajekeswa, zvisinei, maererano neimwe yemafungiro acho, inosanganisira "kuzvidya" kweglandu, apo kushandiswa kwemakemikari kunowanikwa mumatumbu ayo. Nokuparadza gland, ivo, uyewo, vanoita mamwe maantimiti, akadai se elastase (kupera kusunguka kwemitsipa yeropa) uye phospholipase.
Nzira yechirwere
Kushandiswa kwepancreatic enzymes kunogona kuparadza masero uye kukuvadza mishonga, zvichikonzera kubuda ropa, edema uye necrosis yepascreas. Nehutachiona hwakawandisa, nhengo dziri pedo dzinogonawo kukuvadzwa, izvo zvinowedzera dambudziko rekutyisidzika uye mamwe matambudziko. Nekusava nesimba kwakanyanya kwepascreatitis, kuputika kunongogumira chete kune gland pachako. Zviratidzo zvakafanana zvinogona kuonekwa mune dzimwe zvirwere zvemuviri (kuputika kana kuvhiringidzika mumatumbo, kuputika kwakanyanya kwenduru), pamwe nebhokisi (heart attack 'pneumonia).
Kuongorora ropa
Ropa rinotaura zvakananga kuti pancreatitis haisipo, asi kuongorora ropa kunobatsira kubhadhara kliniki yemifananidzo. Muzviitiko zvizhinji, kuwedzera kwemazino emakemikari (amylase uye lipase) muropa. Idzi zviratidzo ndezvekukosha kwekuongororwa pachigarire chechirwere ichi, sezvo mukati pevhiki vanozodzoka zvakare. Iyo yepamusoro yemafuta emafuta ehurukuro inoumbwa nechiito che lipase inokonzera enzymatic saponification uye inopera mumusana we calcium muropa. Nhamba yeaukocyte muropa mune varwere vane pancreatitis inowanzokwidziridzwa (leukocytosis), uye semugumisiro wekushisa kwemvura, hematocrit (chiyero chevheti yeyerythrocytes kusvika kumapulamu eplasma) inowedzera.
Nzira dzekuona
Kupedzisira kuongororwa kwepaccreatitis yakajeka kunobva chete pamigumisiro inowanikwa nekubatsira kwekuona maitiro: ultrasound uye computed tomography. Computed tomography inowanzoitwa mukutengesa kukuru uye mune zvinetso. Nekubatsira kwezvi nzira idzi dzimwe nguva zvinogoneka kuziva chinokonzera kupisa. Kuzarura chinokonzera chirwere ichi kunobvumira kuita maitiro ekurapa anogadziriswa kuparadzwa, izvo munguva yemberi zvichabatsira kudzivisa kurwiswa kudzokorora kwepachikwereti.
• Zvipfeko zvejena zvakapoteredzwa paseudocolor scan yakagadzirwa ne electron microscope ine lymphocytes (a kind of leukocytes). Uwandu hweeukocyte muropa mukutengesa kwakanyanya kunowanzokwidziridzwa. Izvo zvinotaridzirwa zvinoongororwa pane imwe nhamba yegumi neimwe-nheyo zvichienderana nemitemo yeprognostic, inosanganisira:
- ane makore anopfuura makumi mashanu panguva yekunyorwa;
- testatory laboratory (vana pakugamuchirwa uye matanhatu mushure maawa 48). Kana pane zvitatu kana kupfuura mapeji panguva yekupinda, mikana yemugumisiro unouraya i1: 5; Kana pane mairi manomwe kana kupfuura, inowedzera.
Mumazuva mashomanana okutanga, kufa kunowanikwa nekuda kwechimiro chakakundikana. Muzviitiko zvakawanda (80%) varwere vanofa mushure mevhiki, kazhinji nekuda kwekukura kwehutachiona (abscessing) kana kuumbwa kwekrisiti yenhema. Kubudirira kwehutachiona pamucheto we necrosis wepascreas kunofungidzirwa kana kusina kwechiitiko chekurapa kana kukurumidza kuora. Kupera kwezvinhu zviri mukati mechidziro chemuviri pasi pekutonga kwe computed tomography kunogona kubatsira pakuongororwa. Kana kuda kwezvinhu zvakakonzerwa nehutachiona zvisingaitiki munguva, huwandu hwekufa hunosvika 100%. Chimwe chinhu chinokanganisa chinokonzera kupisa chinogona kupfuura zvishoma. Murwere anopiwa kuvhiringidzika, kusadya kwezvokudya uye zvinodhaka hazvisi zvachose. Kuti abvise kusuruvara uye kushambidzika nehutachiva, mudumbu inodururwa. Izvi zvinobatsira kudzivisa kutyisidzika, kudzivirira kukanganiswa kwemvura. Shanduro yacho inoshandiswawo kutungamirira unesthetic, dzimwe nguva vachishandisa chirwere chinotarirwa nemurwere. Izvi zvinopa murwere mukana wekudzivirira kudya kwechirwere, zvichienderana nekukura kwemarwadzo. Kuti urege kuwedzeresa, pane chigadzirwa chakanaka chakagadzirirwa kushandisa nhamba shoma yemadhora kwehumwe nguva yakareba.
Kunyatsoongorora
Muhosha yakanyanya necrotic pancreatitis, kugadziriswa kwakakosha mune imwe nhengo yepamusoro yekuchengetedza yakawanda umo murwere anonyatsoongororwa uye zviratidzo zvinokuvadza zvinoratidza dambudziko guru rekufa rinoratidzwa. Chirapa chinangwa chekudzivirira zvinetso zvechirwere.