Ese uzi akaga gaterwa n'indwara ya pancreatitis itera indwara?

Ese wigeze wumva indwara ikomeye aho igice cya pancreas gipfa ? Ibi ni byo mu buvuzi twita "Necrotizing Pancreatitis". Tekereza ukuntu ari bibi gutakaza igice cy'urugingo rw'ingenzi mu mubiri wacu. Ibi bibaho iyo indwara yitwa "Acute Pancreatitis " ibaye mbi cyane . Uyu munsi, tuzaganira kuri ibi birambuye, nk'aho turimo kuvugana n'inshuti.

"Necrotizing Pancreatitis" ni iki mu by'ukuri?

Mu magambo make, "Necrotizing Pancreatitis" ni urupfu rw'igice cya "Pancreas" yawe (Necrosis). Ibi bibaho iyo indwara ya "Pancreatitis" ibaye ikomeye cyane. Pancreatitis ni igihe pancreas ibyimbye, itukura, kandi ikababara bitewe n'igikomere cyangwa ikindi kintu nk'uburozi. Iyo ubu bubyimba bubaye bubi cyane, amaraso ajya mu turemangingo twa pancreas ashobora guhungabana "Ischemia". Hanyuma utwo turemangingo ntitwongere kubona ogisijeni n'intungamubiri dukeneye maze tugatangira gupfa . Ibi byitwa "Necrosis". Iyi ni indwara iteje akaga cyane.

Ibi nibibaho, itsinda ry’abaganga bawe rizagushyira mu bitaro igihe gito kandi rikurinde izindi ngorane zose. Ikintu cy’ingenzi ugomba kwitondera ni ubwandu . Tekereza ko bagiteri zitangiye kurya ingingo zapfuye, zishobora kwiyongera vuba zikagera mu mubiri wawe wose. Ibyo nibibaho, bishobora gutera indwara zikomeye nko kunanirwa kw’ingingo , bishobora gushyira ubuzima mu kaga. Muri ibyo bihe, abaganga bashobora kubaga ingingo zapfuye .

Iyi ndwara ikunze kugaragara gute?

Mu buryo bugaragara, hafi 20% by'abantu barwara pancreatitis ikabije bazarwara pancreatitis itera indwara. Mu gihugu nka Leta Zunze Ubumwe za Amerika, bivugwa ko abantu bagera ku bihumbi magana atatu barwarira mu bitaro buri mwaka kubera pancreatitis. Rero, 20% ni umubare munini, si byo se?

Ni ibihe bimenyetso bya `(Necrotizing Pancreatitis)`?

Ibimenyetso bya mbere bigaragara ni iby’indwara ya pancreatitis ikabije. Ni ibi bikurikira:

• Ububabare bukomeye mu nda yo hejuru. Ubu bubabare bushobora no kugera mu mugongo.
• Kubyimba inda cyangwa kubyimba.
• Isesemi no kuruka.

Uko pancreatitis irushaho gukomera, ibimenyetso nk'ibi bishobora no kugaragara:

• Umuriro n'ubukonje.
• Ukwiyongera k'umuvuduko w'umutima (Tachycardia).
• Inyota ikomeye cyangwa amazi ahagije.

Ni izihe mpamvu zitera "Necrotizing Pancreatitis"?

Ibi bibaho mu byiciro bitandukanye. Ubwa mbere, kubyimba gusanzwe kwa pancreatitis (Acute Pancreatitis) biba bikomeye. Hanyuma, amaraso arahagarara (Ischemia), hanyuma hagapfa ingirangingo (Necrosis). Hari impamvu zitandukanye zitera buri kimwe muri ibi.

Indwara ya pancreatitis ikabije gute?

Impamvu nyamukuru itera pancreatitis ikabije ni indwara ya gallstone . Ibi bibaho iyo agakoko gacitse mu gasabo kagafunga umuyoboro wa pancreas. Ibi kandi byitwa pancreatitis ya gallstone. Impamvu ya kabiri nyamukuru ni kunywa inzoga nyinshi .

Ububyimbirwe ni uburyo umubiri witabira ububyimbirwe, ugerageza gusana ibyangiritse. Ariko rimwe na rimwe ubu bubyimbirwe buba bukomeye cyane ku buryo butangira kwangiza.

Ntibiramenyekana neza impamvu ubu burwayi bukabije cyane kuri bamwe kurusha abandi. Ariko, biragaragara ko ibi bitera " ingaruka z'umukara wa snowball" muri pancreas.

Umuvuduko mwinshi uterwa no kubyimba gukomeye utuma enzymes za pancreas ziba mu turemangingo twa pancreas. Ubusanzwe, izi enzymes zo mu igogora zitangira gukora nyuma y’uko ibiryo byinjiriye mu igogora. Ariko iyo zitangiye gukora kare, zitangira gusya pancreas ubwayo. Tekereza, usya urugingo rwawe ukoresheje enzymes zawe!

Kugabanuka kw'amaraso bitera "Ischemia" no gupfa kw'ingingo "Necrosis"

Uku kwangirika gukomeje kwa pancreas bituma pancreas irushaho kwiyongera. Amaherezo, kubyimba kwa pancreas bituma imiyoboro y'amaraso yaguka, bigagabanya ingano y'amaraso atembera mu ngingo.

Indi mpamvu ishobora kugira ingaruka kuri ibi ni indwara yo kubyimba umubiri wose (SIRS). Iyi ni indwara yo kubyimba umubiri wose. Ibi bishobora gutuma umuvuduko w'amaraso n'amaraso bigabanuka.

Kubura amaraso atembera (ischemia) bitera gupfa kw'ingingo (necrosis). Igogorwa ry'ingirabuzimafatizo za pancreas nabyo bishobora kugira uruhare muri uru rupfu rw'ingingo.

Ni izihe ngorane zishobora guterwa na `(Necrotizing Pancreatitis)`?

Iyi ndwara ishobora gutera ingorane zitandukanye mu gihe gito no mu gihe kirekire.

Ingorane z'igihe gito:

• Kwandura: Iyi ni yo ngaruka mbi cyane zo kurwara Necrotizing Pancreatitis. Ibi bishobora kubaho ku barwayi bagera kuri 20%. Imitsi yapfuye ni nk'ahantu heza ho kugaburira bagiteri zizenguruka. Biragoye kugenzura ubwandu iyo usanzwe urwaye. Iyo bukwirakwira mu maraso, bushobora gushyira ubuzima mu kaga. Ubwandu mu maraso bushobora gutera sepsis , bishobora gutuma ingingo nyinshi zinanirwa gukora neza . Iyi ni yo mpamvu nyamukuru y'urupfu ku bantu barwaye Necrotizing Pancreatitis.
• Gukusanya amazi yo mu bwoko bwa Necrotic: Mu ndwara ikomeye ya pancreatitis, enzymes za pancreas zikora zishobora kuva mu pancreas zikangiza ingirangingo ziyikikije. Hari agace gato k’ingirangingo zikora hafi y’amazi yo mu bwoko bwa pancreas. Iyo iyi kapsule irimo ingirangingo zapfuye na bagiteri, indwara ishobora gutangira no gukwirakwira byoroshye. Ni gake cyane, iyi kapsule ishobora kwaguka no gukanda ku ngingo zegereye, nko mu gifu, imiyoboro y’amaraso, cyangwa imiyoboro y’amaraso.
• Kuva amaraso: Pancreatitis iterwa n'amaraso ikunze kugaragara, ariko ishobora gushyira ubuzima mu kaga iyo ibayeho. Pancreatitis itera amaraso yongera ibyago byo kuva amaraso. Uburyo bumwe ibi bishobora kubaho ni uko ububyimba cyangwa amazi ari muri pancreas yakwirakwira mu mitsi iri hafi aho, bikangiza urukuta rw'imitsi bigatuma amaraso ava. Ubundi buryo ni uko enzymes za pancreas zisenya urukuta rw'imitsi, bigatuma habaho pseudoaneurysm , igacika kandi igatera kuva amaraso.
• Indwara yo mu gifu: Kubyimba, kuva amaraso, n'ibindi bintu bivanze n'ikwirakwira ry'amazi bijyana no kurwara pancreatitis bishobora gutera umuvuduko mwinshi mu nda. Ibi bigaragarira cyane cyane ku barwayi barembye cyane. Ibi bishobora gutuma amaraso agabanuka mu ngingo, bigatera kubyimba kw'amaraso , kubura amaraso mu mubiri, no kubura umwuka uhagije . Ibi bishobora kandi gutuma ingingo nyinshi zinanirwa gukora neza.

Ingaruka z'igihe kirekire:

• Kubura Imisemburo ya Pancreatic: Iyo ingano nini y'udusimba twa pancreatic ibuze, imwe mu mikorere ya pancreatic ishobora kubura. Kubura Imisemburo ya Pancreatic ya Exocrine ni igihe pancreas idakora enzymes zihagije zo gusya ibiryo. Ibi bishobora gutera kubura ubushobozi bwo kubirya no kubura imirire myiza . Kubura Imisemburo ya Pancreatic ya Endocrine ni igihe pancreas idakora imisemburo ihagije igenzura urugero rw'isukari mu maraso. Ibi bishobora gutera hyperglycemia na diyabete .
• Indwara y’imiyoboro y’indurwe ya Pancreatic Disconnected: Kubyimba cyane, kuva amaraso, gupfa kw’imitsi, n’izindi ngorane ziterwa na pancreatitis itera pancreatitis bishobora gutuma umuyoboro w’indurwe ya pancreatic utandukana igice na pancreas cyangwa amara mato. Ibi bishobora gutuma imisemburo ya pancreas ikomeza kuva. Uku kuva kw’amazi bishobora gutuma amazi yiyongera igihe kirekire cyangwa pancreatitis idakira.
• Kugabanuka kw'imiyoboro y'inda:Kubyimba gukomeye kandi igihe kirekire bishobora gutera inkovu mu miyoboro iyo ari yo yose ihuza pancreas n'igogora (umuyoboro wa pancreatic, umuyoboro wa bile, duodenum - intangiriro y'amara mato). Iyi nkovu ituma umuyoboro ugabanuka ku buryo budasanzwe (stricture). Ibi bigabanya umuvuduko w'indyo, maze inyo igatangira gusubira mu nzira y'indyo.
• Splanchnic Vein Thrombosis: Imitsi yawe ya splanchnic iherereye munsi ya pancreas yawe. Pancreatitis ikomeye ishobora gutuma ibyimbirwa. Ibi bishobora gutera kubyimba kw'amaraso (thrombosis) muri iyi mitsi. Iyi mitsi irimo umutsi wa splenic, umutsi wa mesenteric, umutsi w'umwijima, n'umutsi wa portal. Iyo amaraso agize kimwe muri ibi, hashobora kubaho ingorane zitandukanye, nko kurwara umuvuduko ukabije w'amaraso , kuribwa mu nda, kuva amaraso mu nda, ischemic colitis, na ischemia ya mesenteric.

Ni gute Necrotizing Pancreatitis ipimwa?

Abaganga basuzuma iyi ndwara ya ``Necrotizing Pancreatitis`` nyuma yo gusuzuma bwa mbere ``Acute Pancreatitis``. Ibimenyetso bigaragara by'uko ingirangingo zipfa ``Necrosis`` ntibigaragara kugeza ku minsi itatu kugeza kuri itanu nyuma y'uko ingirangingo zitangiye kugaragara. Niba ufite ibimenyetso by'ingirangingo zikomeye nyuma y'iminsi mike ububyimbirwe bwa mbere butangiye, muganga wawe azakoresha CT scan hamwe n'irangi ry'urumuri ``Contrast-enhanced CT scan`` cyangwa MRI. ``Magnetic Resonance Imaging``` kugira ngo barebe ko ingirangingo zipfa. Bazashakisha kandi izindi ngorane, nko kwikusanya amazi.

Ni ubuhe buryo bwo kuvura ibi?

Uburyo bwo kuvura buzaterwa no kuba wandura indwara cyangwa izindi ngorane. Iyo indwara ya pancreas idakira kandi nta bimenyetso igaragara, abaganga bakunze kuyivura bakurikije uburyo bwo kuyivura . Iyo hagaragaye ibimenyetso by'ubwandu cyangwa izindi ngorane, abaganga bazabikora uko bikenewe. Bazagerageza gukuraho ingingo zapfuye bakoresheje uburyo budakunze kugaragara mbere yo kubagwa.

Ubuyobozi bw'Abakonserisiti

Ubuvuzi bufasha ku ndwara ya "Sterile Necrotizing Pancreatitis" idatera indwara burimo:

• Imiti igabanya ububabare.
• Ibinyobwa biva mu mitsi (IV Fluids).
• Indyo yo mu nda.

Indwara nyinshi zigoye zizakemuka hakoreshejwe ubuvuzi bufasha gusa. Muri iki gihe, itsinda ry’abaganga rizakurikirana hafi uko umerewe. Bazakurikirana ibimenyetso by’ubuzima bwawe, umuvuduko w’inda, n’umubare w’amaraso yose.Bazakurikirana ibintu nk'umubare wuzuye w'uturemangingo tw'amaraso (CBC) kandi barebe niba hari ingorane zishobora kubaho. Iyo habayeho ikintu nk'ubwandu cyangwa kunanirwa kw'ingingo, bazatanga ubufasha bw'ubuzima cyangwa ubundi buryo bwo kuvura bukenewe.

Gusukura no Gukuraho imyanda

Ukimara kubona ibimenyetso by'ubwandu, itsinda ry'abaganga rizagutangira imiti igabanya ubukana bw'udukoko kandi rizaguteganyiriza gukuraho udusimba twose twapfuye nibishoboka. Bazatangirana n'uburyo budakunze kugaragara, hanyuma bongere imbaraga buhoro buhoro nibiba ngombwa.

Ubu buryo bukubiyemo:

• Gusohora amazi mu ruhu: Uburyo bwo gusohora amazi mu ruhu. Inzobere mu by'imirasire ikoresha uburyo bwo gufata amashusho (kenshi nka ultrasound cyangwa CT scans) kugira ngo ibone agace k'inyama zapfuye hanyuma ishyiremo umuyoboro mu ruhu rwawe. Umuyoboro usigara aho uri hanyuma ugasukwaho saline inshuro nyinshi ku munsi kugira ngo amazi asohoke. Ubu ni bwo buryo bwonyine ku barwayi bagera kuri kimwe cya gatatu. Ku bandi, bifasha mu kugenzura ubwandu kugeza ubwo ubundi buryo bwo gusukura amazi bushobora gukorwa mu buryo bwizewe.
• Gukuraho Endoskopi: Uburyo bwitwa endoskopi butuma umuganga w’indwara y’igifu agera ku ngingo zapfuye ziri mu mubiri wawe adaciye uruhu rwawe. Azanyuza endoskopi, ifite probe ya ultrasound, mu gice cyo hejuru cy’igifu cyawe kugira ngo amenye agace ka pancreas. Hanyuma, ibikoresho binyuzwa muri endoskopi kugira ngo habeho umuyoboro uhuza ingingo zapfuye n’inzira y’igifu cyawe. Ingingo zapfuye zikurwamo binyuze muri uwo muyoboro.
• Gukuraho uruhu hakoreshejwe videwo (VARD): Ubu buryo kandi bwo kubaga bukoreshwa mu buryo budakoresha ikoranabuhanga. Ibi bikubiyemo gushyira ibikoresho byo kubaga ukoresheje uburyo bumwe usanzwe ufite mu ruhu rwawe bwitwa Percutaneous Drainage Portal no kujya aho ingingo zapfuye ziri. Umuganga ubaga akoresha imbaraga, kuhira no gukurura kugira ngo akureho ingingo zapfuye ukoresheje uburyo bwo gukata. Iyo bibaye ngombwa, uburyo bwo gukata bushobora kwaguka hanyuma agashyirwamo umuyoboro ufite kamera witwa laparoscope. Hanyuma ingingo zisigaye zikurwaho hakoreshejwe uburyo bwa laparoscopic bwitwa laparoscopic surgery.
• Kubaga mu buryo bwihuse - Necrosectomy: Necrosectomy ni ugukuraho ingingo zapfuye. Kubaga mu buryo bwihuse bikubiyemo gufungura umwobo w'inda no gushaka ingingo zapfuye (Laparotomy). Ubu ni bwo buryo bwihuse bwo kubona no kuvura ibibazo byihutirwa. Nubwo kubaga bifite ingaruka zimwe na zimwe, ni bwo buryo bwa nyuma bwo gukemura ibibazo byihutirwa kandi iyo uburyo budakunze kugaragara bwananiwe.

Ni ikihe gipimo cy'impfu n'igipimo cyo gukira kwa `(Necrotizing Pancreatitis)`?

Amahirwe yo gukira aterwa n'ingano y'agakoko kawe kapfuye, niba waranduye cyangwa warananiwe ingingo, ndetse n'uburyo wakira neza iyo uvuwe. Niba ari munsi ya 30% by'agakoko kawe kagizweho ingaruka, igipimo cy'urupfu kiri munsi ya 15% . Niba hari urupfu rw'ingingo gusa rudatewe n'ubwandu, nta kibazo. Ariko niba ari hejuru ya 50% by'agakoko kawe kagizweho ingaruka, kandi ukaba waranduye cyangwa warananiwe ingingo, igipimo cy'urupfu kiriyongera kigera ku kigero kirenga 30% .

Ibi bipimo ntibigutere ubwoba. Aya ni amakuru rusange gusa. Itsinda ry'abaganga bakuvura ni ryo ryonyine rishobora kukubwira neza uko umerewe n'amahirwe yawe yo gukira.

Bigenda bite nyuma yo kuvurwa?

Mu gihe cyo gukurikirana gahunda yawe nyuma yo kuvurwa, muganga wawe azakubaza ibimenyetso bikomeza cyangwa bishya. Pancreatitis yo mu bwoko bwa Necrotizing ishobora gutera ingorane z'igihe kirekire ndetse na nyuma yo kuvurwa. Niba ufite ibimenyetso, ushobora gusabwa gupimwa amaraso, gupimwa muri laboratwari, cyangwa gupimwa mu mashusho kugira ngo urebe niba ari byo koko. Ibibazo bishobora gusaba ubundi buvuzi, bushobora kuba ubw'igihe gito cyangwa kirekire.

Gutera pancreatitis ifata amaraso ni ikibazo gikomeye cyane cya pancreatitis ifata amaraso. Nubwo abantu benshi bakira pancreatitis ifata amaraso bakoresheje ubuvuzi bubafasha gusa, abarwaye pancreatitis ifata amaraso menshi na necrosis bakeneye ubuvuzi bw'igihe kirekire kandi bwimbitse. Uzakenera itsinda ry'abaganga b'inzobere zitandukanye kugira ngo bakurikirane ikibazo cyawe n'ingorane zose zishobora kuvuka. Ushobora gukenera ubufasha cyangwa kubagwa, ndetse wenda no gukurikiranwa.

Ibintu by'ingenzi tugomba kwibuka muri iyi nkuru (Ubutumwa bwo kujyana mu rugo)

• Pancreatite yo mu bwoko bwa Necrotizing ni indwara ikomeye aho igice kimwe cya pancreas gipfa.
• Ibi akenshi biterwa na pancreatitis ikomeye ikabije. Impamvu nyamukuru ni amabuye y'agahinda no kunywa inzoga nyinshi .
• Niba ufite ibimenyetso nko kubabara mu gifu cyane, umuriro, isesemi no kuruka, shaka ubufasha kwa muganga byihutirwa.
• Kwandura ni yo ngorane nyamukuru kandi iteje akaga cyane y’iyi ndwara.
• Uburyo bwo kuvura buratandukanye bitewe n'uko umurwayi amerewe. Hariho uburyo butandukanye bwo kuvura , kuva ku buvuzi bufasha kugeza ku kubagwa .
• Nubwo iyi ari indwara ikomeye, abantu benshi barakira iyo bavuwe neza kandi bakitabwaho . Bityo rero ntugacike intege.

Niba wowe cyangwa undi muntu uzi afite kimwe muri ibi bimenyetso, nyamuneka jya kwa muganga vuba. Guvurwa hakiri kare bishobora kurokora ubuzima!

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