Kodi mukudziwa za ngozi ya necrotizing pancreatitis?

Kodi mudamvapo za vuto lalikulu lomwe gawo la kapamba limafa ? Izi ndi zomwe madokotala amati ``Necrotizing Pancreatitis''. Tangoganizirani momwe zimakhalira zoopsa kutaya gawo la chiwalo chofunikira m'thupi mwathu. Izi zimachitika pamene vuto lotchedwa ``Acute Pancreatitis '' limakhala lalikulu kwambiri . Lero, tikambirana izi mwatsatanetsatane, ngati kuti tikulankhula ndi mnzanu.

Kodi ``(Necrotizing Pancreatitis)`` ndi chiyani kwenikweni?

Mwachidule, ``Necrotizing Pancreatitis`` ndi imfa ya gawo la ``Pancreas`` yanu (Necrosis). Izi zimachitika pamene vuto la ``Pancreatitis`` lakula kwambiri. Pancreatitis ndi pamene kapamba amatupa, amafiira, komanso amapweteka chifukwa cha kuvulala kapena chinthu chonga poizoni. Ngati kutupa kumeneku kwakula kwambiri, kuyenda kwa magazi kupita ku minofu ya kapamba kumatha kusokonezeka ``Ischemia``. Kenako minofuyo silandira mpweya ndi michere yomwe imafunika ndipo imayamba kufa . Izi zimatchedwa ``Necrosis``. Ili ndi vuto loopsa kwambiri.

Ngati izi zitachitika, gulu lanu lachipatala lidzakusungani kuchipatala kwa kanthawi ndikukuyang'anirani mosamala kuti mudziwe ngati pali zovuta zina. Chofunika kwambiri chomwe muyenera kusamala nacho ndi matenda . Tangoganizirani ngati mabakiteriya ayamba kudya minofu yakufa, akhoza kufalikira mwachangu ndikufalikira m'thupi lanu lonse. Ngati zimenezo zitachitika, zingayambitse matenda aakulu monga kulephera kwa ziwalo , zomwe zingakhale zoopsa kwa moyo. Zikatero, madokotala angafunike kuchotsa minofu yakufayo opaleshoni .

Kodi vutoli ndi lofala bwanji?

Ponena za izi, pafupifupi 20% ya anthu omwe ali ndi kapamba woopsa adzadwala kapamba woyambitsa matenda. M'dziko ngati United States, akuti anthu pafupifupi mazana atatu zikwi amagonekedwa m'chipatala chaka chilichonse chifukwa cha kapamba. Ndiye kuti, 20% ndi chiwerengero chofunikira, eti?

Kodi zizindikiro za `(Necrotizing Pancreatitis)` ndi ziti?

Zizindikiro zoyamba zomwe zimawonekera ndi za pancreatitis yoopsa.

• Ululu waukulu m'mimba. Ululuwu ukhozanso kufalikira kumbuyo.
• Kutupa kapena kutupa m'mimba.
• Kusanza ndi kusanza.

Pamene pancreatitis ikukulirakulira, zizindikiro zotsatirazi zingawonekere:

• Malungo ndi kuzizira.
• Kuwonjezeka kwa kugunda kwa mtima (Tachycardia).
• Ludzu lalikulu kapena kutaya madzi m'thupi.

Kodi ndi zinthu ziti zomwe zimayambitsa "Necrotizing Pancreatitis"?

Izi zimachitika m'magawo angapo. Choyamba, kutupa kwachibadwa kwa kapamba (Acute Pancreatitis) kumakhala kwakukulu. Kenako, magazi amasokonekera (Ischemia), ndipo pamapeto pake, kufa kwa minofu (Necrosis) kumachitika. Pali zifukwa zosiyanasiyana za chilichonse mwa izi.

Kodi pancreatitis ndi yoopsa bwanji?

Choyambitsa chachikulu cha kapamba wa kapamba ndi matenda a ndulu . Izi zimachitika pamene mwala wa ndulu umakhala mu ndulu ndikutseka njira yolumikizira ndulu. Izi zimatchedwanso kuti pancreatitis ya ndulu. Choyambitsa chachikulu chachiwiri ndi kumwa mowa mopitirira muyeso .

Kutupa kwenikweni ndi njira ya thupi yochitirapo kanthu pakavulala, kuyesera kukonza kuwonongekako. Koma nthawi zina kutupa kumeneku kumakhala koopsa kwambiri moti kumayamba kuwononga.

Sizikudziwika bwino chifukwa chake kutupa kumeneku kumakhala koopsa kwambiri mwa anthu ena kuposa ena. Komabe, n'zoonekeratu kuti izi zimapangitsa kuti pakhale " chipale chofewa" mkati mwa kapamba.

Kupanikizika kwakukulu komwe kumachitika chifukwa cha kutupa kwakukulu kumayambitsa ma enzyme a kapamba mkati mwa minofu ya kapamba. Nthawi zambiri, ma enzyme amenewa amayamba kugwira ntchito chakudya chikalowa m'thupi. Koma ngati ayamba kugwira ntchito msanga, amayamba kugaya kapamba palokha. Tangoganizirani, kugaya chiwalo chanu ndi ma enzyme anu!

Kuchepa kwa magazi kumabweretsa "Ischemia" ndi kufa kwa minofu "Necrosis"

Kuwonongeka kosalekeza kwa kapamba kumapangitsa kuti kapamba achuluke kwambiri. Pamapeto pake, kutupa kwa kapamba kumapangitsa kuti mitsempha yamagazi ikule, zomwe zimachepetsa kuchuluka kwa magazi omwe amapita ku minofu.

Chinthu china chomwe chingakhudze izi ndi Systemic Inflammatory Response Syndrome (SIRS). Ichi ndi matenda otupa omwe amapezeka m'thupi lonse. Izi zingayambitse kuchepa kwa kuthamanga kwa magazi ndi kuyenda kwa magazi.

Kutaya magazi m'thupi (ischemia) kumayambitsa kufa kwa minofu (necrosis). Kugayidwa kwa kapamba ndi ma enzyme a kapamba kungathandizenso kufa kwa minofu imeneyi.

Kodi ndi mavuto ati omwe angakhalepo chifukwa cha `(Necrotizing Pancreatitis)`?

Vutoli lingayambitse mavuto osiyanasiyana nthawi yochepa komanso yayitali.

Mavuto a nthawi yochepa:

• Matenda: Ichi ndi chiopsezo choopsa kwambiri cha Necrotizing Pancreatitis. Izi zitha kuchitika mwa odwala pafupifupi 20%. Minofu yakufa imakhala ngati malo abwino odyetsera mabakiteriya omwe amayendayenda. N'zovuta kulamulira matenda mukamadwala kale. Ngati afalikira m'magazi, akhoza kukhala pachiwopsezo. Matenda m'magazi angayambitse sepsis , zomwe zingayambitse kulephera kwa ziwalo zambiri . Ichi ndiye chifukwa chachikulu cha imfa mwa anthu omwe ali ndi Necrotizing Pancreatitis.
• Kusonkhanitsa Madzi Otupa: Mu kapamba woopsa, ma enzyme a kapamba omwe amagwira ntchito amatha kutuluka mu kapamba ndikuwononga minofu yozungulira. Kapisozi ya minofu yopyapyala imapangidwa mozungulira madzi a kapamba. Ngati kapisozi iyi ili ndi minofu yakufa ndi mabakiteriya, matenda amatha kuyamba ndikufalikira mosavuta. Nthawi zina, kapisozi iyi imatha kukula ndikukankhira ziwalo zapafupi, monga m'mimba, mitsempha yamagazi, kapena ndulu.
• Kutaya magazi: Kutaya magazi m'thupi (hemorrhagic pancreatitis) sikuchitika kawirikawiri, koma kungakhale koopsa ngati kukuchitika. Kutupa kwa kapamba kumawonjezera chiopsezo cha kutuluka magazi kumeneku. Njira imodzi yomwe izi zingachitikire ndi ngati kutupa kapena madzi m'thupi la kapamba afalikira kupita ku mtsempha wapafupi, kuwononga khoma la mtsempha ndikuyambitsa kutuluka magazi. Njira ina ndi ngati ma enzyme a kapamba aphwanya khoma la mtsempha, ndikupanga pseudoaneurysm , yomwe imaphulika ndikuyambitsa kutuluka magazi.
• Matenda a m'mimba: Kutupa, kutuluka magazi, ndi madzi ena ochulukirapo omwe amabwera chifukwa cha kutupa kwa kapamba kungayambitse kuthamanga kwa magazi m'mimba. Izi zimachitika makamaka mwa odwala omwe ali ndi vuto lalikulu. Izi zingayambitse kuchepa kwa magazi kupita ku ziwalo, zomwe zingayambitse magazi kuundana , ischemia, ndi hypoxia . Izi zingayambitsenso kulephera kwa ziwalo zambiri.

Zotsatira za nthawi yayitali:

• Kusakwanira kwa Pancreatic: Ngati minofu yambiri ya kapamba yatayika, ntchito zina za kapamba zimatha kutayika. Kusakwanira kwa Pancreatic kwa Exocrine ndi pamene kapamba sapanga ma enzyme okwanira kugaya chakudya. Izi zingayambitse kusayamwa bwino chakudya komanso kusowa zakudya m'thupi . Kusakwanira kwa Pancreatic kwa Endocrine ndi pamene kapamba sapanga mahomoni okwanira omwe amalamulira kuchuluka kwa shuga m'magazi. Izi zingayambitse hyperglycemia ndi matenda a shuga .
• Matenda a Pancreatic Duct Syndrome: Kutupa kwambiri, kutuluka magazi, kufa kwa minofu, ndi mavuto ena a kapamba woyambitsa matenda a kapamba kungayambitse kuti kapamba achotsedwe pang'ono kuchokera ku kapamba kapena m'matumbo ang'onoang'ono. Izi zingayambitse kutuluka kwa ma enzyme a kapamba kosalekeza. Kutuluka kumeneku kungayambitse kudzikundikira kwa madzi kwa nthawi yayitali komanso/kapena kutupa kwa kapamba kosatha.
• Kutsekeka kwa ndulu:Kutupa kwakukulu komanso kwa nthawi yayitali kungayambitse zipsera m'mitsempha iliyonse yomwe imalumikiza kapamba ndi dongosolo logaya chakudya (pancreatic duct, bile duct, duodenum - chiyambi cha matumbo ang'onoang'ono). Zipsera izi zimapangitsa kuti duct ikhale yopapatiza kwambiri (stricture). Izi zimachepetsa kuyenda kwa ndulu, ndipo ndulu imayamba kubwerera m'mimba.
• Kutupa kwa Mitsempha ya Splanchnic: Mitsempha yanu ya splanchnic ili pansi pa kapamba wanu. Pancreatitis yoopsa ingayambitse kutupa. Izi zingayambitse magazi kuundana (thrombosis) m'mitsempha iyi. Mitsempha iyi imaphatikizapo mtsempha wa splenic, mtsempha wa mesenteric, mtsempha wa chiwindi, ndi mtsempha wa portal. Ngati magazi kuundana apanga chimodzi mwa izi, mavuto osiyanasiyana angachitike, monga portal hypertension , gastrointestinal varices, gastrointestinal bleeding, ischemic colitis, ndi mesenteric ischemia.

Kodi Necrotizing Pancreatitis imapezeka bwanji?

Madokotala amazindikira vutoli `(Necrotizing Pancreatitis)` atazindikira koyamba `(Acute Pancreatitis).` Zizindikiro zodziwikiratu za kufa kwa minofu `(Necrosis)` sizimawonekera mpaka masiku atatu kapena asanu kuchokera pamene matendawa adayamba. Ngati muli ndi zizindikiro za matenda oopsa a kapamba masiku angapo pambuyo pa kutupa koyamba, dokotala wanu adzagwiritsa ntchito CT scan ndi utoto wa fluorescent `(Contrast-enhanced CT scan)` kapena MRI.` (MRI - Magnetic Resonance Imaging)` kuti ayang'ane kufa kwa minofu iyi. Adzafufuzanso zovuta zina, monga kudzikundikira kwa madzi.

Kodi mankhwala ochizira izi ndi otani?

Chithandizo chanu chidzadalira ngati muli ndi matenda kapena mavuto ena. Ngati pancreatic necrosis ndi yopanda tizilombo ndipo palibe zizindikiro, madokotala nthawi zambiri amachichiza ndi chithandizo chothandizira . Ngati zizindikiro za matenda kapena mavuto ena abuka, madokotala amalowererapo ngati pakufunika kutero. Adzayesa kuchotsa minofu yakufa pogwiritsa ntchito njira zosavulaza kwambiri asanayambe opaleshoni.

Kasamalidwe ka Chisamaliro

Chithandizo chothandizira cha ``Sterile Necrotizing Pancreatitis`` chosapatsirana chimaphatikizapo:

• Mankhwala opha ululu.
• Madzi olowa m'mitsempha `(Madzimadzi a IV)`.
• Zakudya Zam'mimba.

Milandu yambiri yosavuta imatha pokhapokha ngati pali chithandizo chothandizira. Panthawiyi, gulu lanu lachipatala lidzayang'anira bwino vuto lanu. Adzayang'anira zizindikiro zanu zofunika , kuthamanga kwa magazi m'mimba, komanso kuchuluka kwa magazi m'thupi lanu.Adzayang'anira zinthu monga Kuchuluka kwa Maselo a Magazi Onse (CBC) ndikuyang'anira mavuto omwe angakhalepo. Ngati pali vuto monga matenda kapena kulephera kwa ziwalo, adzapereka chithandizo cha moyo kapena njira zina zothandizira ngati pakufunika kutero.

Kutulutsa Madzi ndi Kutaya Zinyalala

Mukangoyamba kuona zizindikiro za matenda, gulu lanu lachipatala lidzayamba kukupatsani mankhwala opha tizilombo toyambitsa matenda ndipo lidzakonza zochotsa minofu yakufa ngati n'kotheka. Adzayamba ndi njira yosavulaza kwambiri, kenako pang'onopang'ono adzawonjezera mphamvu ngati pakufunika kutero.

Njira izi zikuphatikizapo:

• Kutulutsa madzi m'thupi: Njira yochotsera madzi m'thupi kudzera pakhungu. Katswiri wa radiology amagwiritsa ntchito njira zojambulira (nthawi zambiri ultrasound kapena CT scans) kuti apeze malo a minofu yakufa ndikuyika chubu kudzera pakhungu lanu. Chubucho chimasiyidwa pamalo pake ndikutsukidwa ndi saline kangapo patsiku kuti chitulutse madziwo. Iyi ndiyo njira yokhayo kwa pafupifupi gawo limodzi mwa magawo atatu a odwala. Kwa ena, zimathandiza kulamulira matenda mpaka njira zina zochotsera madzi m'thupi zitha kuchitidwa bwino.
• Kuchotsa Endoscopic: Njira yotchedwa endoscopy imalola dokotala wa gastroenterologist kufika ku minofu yakufa mkati mwa thupi lanu popanda kudula khungu lanu. Iye adzadutsa endoscope, yomwe ili ndi ultrasound probe, kudzera m'mimba mwanu kuti apeze malo a kapamba. Kenako, zida zimadutsa mu endoscope kuti apange njira pakati pa minofu yakufa ndi matumbo anu. Minofu yakufa imachotsedwa kudzera munjira imeneyo.
• Kuchotsa Magazi Opaleshoni Yothandizidwa ndi Video (VARD): Iyi ndi njira yochitira opaleshoni yomwe siivuta kwenikweni. Izi zimaphatikizapo kulowetsa zida zochitira opaleshoni kudzera mu njira yomweyi yomwe muli nayo kale pakhungu lanu yotchedwa Percutaneous Drainage Portal ndikupita kumalo komwe kuli minofu yakufa. Dokotala wochita opaleshoni amagwiritsa ntchito forceps, kuthirira ndi kuyamwa kuti achotse minofu yakufa kudzera mu njira yopaleshoniyo. Ngati kuli kofunikira, njira yopaleshoniyo ingakulitsidwe ndipo chubu chokhala ndi kamera chotchedwa laparoscope chingaikidwe. Kenako minofu yotsalayo imachotsedwa pogwiritsa ntchito njira ya laparoscopic yotchedwa opaleshoni ya laparoscopic.
• Opaleshoni Yotseguka - Necrosectomy: Necrosectomy ndi kuchotsa minofu yakufa. Opaleshoni yotseguka imaphatikizapo kutsegula m'mimba ndikupeza minofu yakufa (Laparotomy). Iyi ikadali njira yachangu kwambiri yopezera ndikuchiza mavuto adzidzidzi. Ngakhale opaleshoni ili ndi zoopsa zina, ndiyo njira yomaliza yopezera zadzidzidzi komanso pamene njira zosalowerera kwambiri zalephera.

Kodi chiŵerengero cha imfa ndi chiŵerengero cha kuchira kwa `(Necrotizing Pancreatitis)` ndi chiani?

Mwayi wochira umadalira kuchuluka kwa kapamba wanu amene wafa, kaya mwadwala matenda kapena ziwalo zanu zalephera kugwira ntchito, komanso momwe mumayankhira bwino chithandizo. Ngati kapamba wanu wakhudzidwa ndi wochepera 30%, chiwerengero cha imfa chimakhala chochepera 15% . Ngati minofu yokha ndi yomwe yafa popanda matenda, palibe vuto. Koma ngati kapamba wanu wakhudzidwa ndi woposa 50%, ndipo mwadwala matenda kapena ziwalo zanu zalephera kugwira ntchito, chiwerengero cha imfa chimawonjezeka kufika pa 30% .

Musachite mantha ndi ziwerengerozi. Izi ndi nkhani wamba chabe. Gulu lachipatala lokha lomwe likukuthandizani ndi lomwe lingakuuzeni bwino za matenda anu komanso mwayi wanu wochira.

Kodi chimachitika ndi chiyani mukalandira chithandizo?

Pa nthawi yokumana ndi dokotala pambuyo pa chithandizo, dokotala wanu adzakufunsani za zizindikiro zilizonse zomwe zikupitirira kapena zatsopano. Necrotizing Pancreatitis ikhoza kukhala ndi zovuta kwa nthawi yayitali ngakhale mutalandira chithandizo. Ngati muli ndi zizindikiro, mungapemphedwe kuti muyesedwe magazi, mayeso a labu, kapena mayeso ojambula kuti muwone ngati zili bwino. Mavuto angafunike chithandizo china, chomwe chingakhale cha nthawi yochepa kapena yayitali.

Kutupa kwa kapamba ndi vuto lalikulu kwambiri la kapamba wa pachimake. Ngakhale anthu ambiri amachira ku kapamba wa pachimake pogwiritsa ntchito chithandizo chothandizira chokha, omwe ali ndi kapamba wa kapamba ndi necrosis yayikulu amafunika chisamaliro cha nthawi yayitali komanso champhamvu. Mudzafunika gulu la madokotala osiyanasiyana kuti ayang'anire vuto lanu ndi zovuta zilizonse zomwe zingachitike. Mungafunike chithandizo kapena opaleshoni, komanso chithandizo chotsatira.

Zinthu zofunika kwambiri zomwe tiyenera kukumbukira kuchokera munkhaniyi (Uthenga Wopita Nawo Kunyumba)

• Pancreatitis Yotupa ndi matenda oopsa omwe gawo lina la kapamba limafa.
• Izi nthawi zambiri zimachitika chifukwa cha kutupa kwa kapamba koopsa kwambiri. Zomwe zimayambitsa kwambiri ndi miyala ya ndulu ndi kumwa mowa mopitirira muyeso .
• Ngati muli ndi zizindikiro monga kupweteka kwambiri m'mimba, kutentha thupi, nseru, ndi kusanza, funsani upangiri wa dokotala nthawi yomweyo.
• Matenda ndi vuto lalikulu komanso loopsa kwambiri la vutoli.
• Njira zochiritsira zimasiyana malinga ndi momwe wodwalayo alili. Pali njira zosiyanasiyana zochiritsira , kuyambira chithandizo chothandizira mpaka opaleshoni .
• Ngakhale kuti vutoli ndi lalikulu, anthu ambiri amachira ndi chithandizo choyenera chamankhwala . Choncho musataye mtima.

Ngati inu kapena munthu amene mumamudziwa ali ndi zizindikiro izi, chonde pitani kwa dokotala nthawi yomweyo. Kulandira chithandizo msanga kungapulumutse miyoyo!

Pancreatitis Yoyambitsa Matenda , Pancreatitis, Imfa ya Pancreatic, Kupweteka kwa m'mimba, Matenda a Pancreatic, Pancreatitis Sinhala, Matenda a Pancreatic