Ngaba nawe ukhe waba ne-pancreatitis ngenxa yamatye enyongo? (I-Gallstone Pancreatitis) Makhe sithethe ngale nto!

Ngaba wakha weva ukuba amatye enyongo anokubangela ukuba i-pancreas idumbe okanye ivuvuke kakhulu? Le yinto oogqirha abayibiza ngokuba yi-`(Gallstone Pancreatitis)` okanye `(Biliary Pancreatitis)`. Oku kunokuba yimeko enzima ngokwenene. Kodwa ungakhathazeki, kuba kukho unyango olufanelekileyo loku. Namhlanje, siza kuthetha ngayo yonke into ngendlela elula onokuyiqonda.

Ngoko ke yintoni le pancreas?

Ngamafutshane, ipancreas sisitho esibalulekileyo esikwisisu sethu, ngasemva kwesisu. Sifana nomzi-mveliso omncinci emzimbeni wethu. Sivelisa ii-enzymes zokugaya ukutya ezibaluleke kakhulu ezisinceda sitye ukutya esikutyayo. Xa sisitya, kwaye ukutya kufikelela emathunjini amancinci, ipancreas ifumana umqondiso wokukhupha ezi enzymes. Ezi enzymes zihamba kwipancreas zihamba ngetyhubhu encinci (i-pancreatic duct) kwaye zijoyine ityhubhu enkulu kancinci (i-common bile duct). Kukule tyhubhu inkulu apho ii-enzymes, kunye ne-bile evela kwisibindi kunye ne-gallbladder, ziya khona kwinxalenye ephezulu yamathumbu amancinci. Kulapho inkqubo yokugaya ukutya yenzeka khona ngokwenene.

Kulungile, ke ngoko ziintoni ezi zinyongo?

Amatye enyongo akheka kwinyongo yethu. Inyongo sisingxobo esincinci esiqokelela kwaye sigcine inyongo, eyenziwa sisibindi. Le nyongo iqulethe izinto ezahlukeneyo. Ngamanye amaxesha, ukuba kukho i-cholesterol okanye i-bilirubin eninzi kule nyongo, ingaba njengodaka olusezantsi kwenyongo. Ukuba inyongo ayikhutshelwanga kakuhle, le nto ifana nodaka inokuqokelelana kwaye ngokuhamba kwexesha yenze amatye. Lawa siwabiza ngokuba ngamatye enyongo.

Ngaba i-pancreatitis ebangelwa ngamatye enyongo iyingozi?

Ewe, le yimeko enzima kakhulu . Ukuba unesifo se-pancreatitis, kubalulekile ukufuna uncedo lwezonyango ngokukhawuleza. Iimpawu zinokuba zincinci okanye zibe nzima. Nangona kunjalo, okukhona ungafumani unyango ixesha elide, kokukhona imeko iya kuba mandundu. Ingakumbi ukuba ilitye linamathele kwimibhobho yenyongo, kokukhona kunokwenzeka ukuba kubekho iingxaki. Kwiimeko ezinzima, inokuba yingozi ebomini.

Ixhaphake kangakanani le sifo?

Amatye enyongo yingxaki eqhelekileyo kubantu abaninzi. Kodwa ayinguye wonke umntu onawo. Umzekelo, eMelika, kuqikelelwa ukuba i-10% ukuya kwi-15% yabantu banamatye enyongo. Kodwa yi-0.1% kuphela yabo bantu abafumana i-pancreatitis ngenxa yamatye enyongo. I-pancreatitis ebukhali ichaphazela malunga ne-0.4% yabemi eMelika. Amatye enyongo yimbangela yamalunga ne-35% yala matyala. Isizathu sesibini esixhaphakileyo kukusetyenziswa kotywala.

Yintoni ebangela amatye enyongo?

Kunzima ukuqaphela unobangela omnye we-gallstones, kodwa zininzi izinto ezinokubangela oku:

• Ukuba amazinga e-cholesterol egazini lakho aphezulu, kusenokwenzeka ukuba kungenxa yokutya okutyayo okanye ukuphazamiseka kwendlela umzimba osebenza ngayo. Kwimeko enjalo, i-cholesterol inokuqokelelana kwinyongo yakho.
• Ukuba unesifo sesibindi, amanqanaba e-bilirubin egazini lakho nakwi-bile anokunyuka.
• Ukuba kukho ingxaki yokusebenza apho inyongo ingakhuphi kakuhle.
• I-estrogen egqithisileyo inokubangela ukuba i-gallbladder iphume kancinci. Yiyo loo nto le ngozi iphezulu ngexesha lokukhulelwa.

Amatye enyongo ayibangela njani i-pancreatitis?

Khawuthelekelele ukuba i-pancreas yakho, i-gallbladder, kunye ne-bile duct zidibene ngetyhubhu ebizwa ngokuba yi-common bile duct. Ngokwesiqhelo, i-bile evela kwi-gallbladder yakho idlula kule common bile duct iye emathunjini akho amancinci. Kodwa ukuba unama-gallstones, nawo anokuhamba ngale duct.

Nangona amatye edlula lula xa esemncinci, aya ekhula kancinci kancinci njengoko inyongo entsha idlula phezu kwawo. Ngoko ke, ilitye elalidlula lula linokunamathela kamva, ingakumbi ukuba umjelo umncinci. Ilitye lenyongo linokunamathela ngaphakathi komjelo we-pancreatic okanye linamathele ngaphandle komjelo, nto leyo ebangela i-pancreatitis.

Kukho iingcamango ezimbini malunga nendlela oku kuvinjelwa okubangela ngayo i-pancreatitis:

1. Ingcamango yokuqala kukuba xa ilitye lihlala ngaphandle komjelo wenyongo oqhelekileyo, inyongo inokugeleza ibuyele umva iye kwi-pancreas. Inyongo idlakadlaka kakhulu, nto leyo ecaphukisa i-pancreas.

2. Ingcamango yesibini kukuba ii-enzymes zepancreas zinoxanduva lokudumba. Ezi enzymes zenzelwe ukugaya iiproteni, iicarbohydrates, kunye namafutha emathunjini amancinci. Ngenxa yoko, zikwanokonakalisa kakhulu. Nangona amathumbu ethu amancinci ekhuselwe kwezi zinto yi-mucus lining etyebileyo, i-pancreas ayinalo olo khuselo.

Ngokwesiqhelo, ii-enzymes zepancreas ziyavuselelwa emva kokuba zifikelele emathunjini amancinci. Nangona kunjalo, ukuba uxinzelelo olugqithisileyo lwenzeka ngenxa yokuvaleka kwendlela yokuhambisa i-pancreatic, ii-enzymes zinovuselelwa ngaloo xinzelelo.

Nangona kunjalo, siyazi ukuba kukho ubudlelwane phakathi kwesizathu kunye nesiphumo phakathi kwamatye enyongo kunye ne-acute pancreatitis. Xa usiya esibhedlele ukuze ufumane unyango, i-pancreatitis iya kuphola xa amatye akwimibhobho yenyongo esusiwe.

Ziziphi iimpawu ze-pancreatitis ezibangelwa ngamatye enyongo?

Iimpawu eziqhelekileyo ezibonwayo zezi:

• Intlungu ebuhlungu esiswini. Usenokuziva oku kwicala eliphezulu lasekhohlo lesisu sakho, apho ipancreas yakho ikhoyo. Kusenokuvakala ngathi yimela ekuhlabayo okanye ekucinezela ngaphakathi. Le ntlungu inokuphumela esifubeni sakho, egxalabeni, okanye emqolo.
• Isicaphucaphu nokuhlanza.

Njengoko imeko iba mandundu, iimpawu ezifana nezi zinokuvela:

• Ukudumba kwesisu.
• Ukuphelelwa ngamanzi emzimbeni.
• Isantya sentliziyo siyanda.
• Ukuphefumla ngokukhawuleza okanye ubunzima bokuphefumla.
• Uxinzelelo lwegazi oluphantsi.
• Ubushushu bomzimba obuphantsi.
• Umkhuhlane kunye nokubanda.
• I-Jaundice (ukutyheli kwamehlo nolusu).

Ziziphi iingxaki ze-pancreatitis ezibangelwa ngamatye enyongo?

Ukuba ipancreas yakho iyaqhubeka nokudumba kakhulu, izicubu zayo ziya konakala kancinci kancinci kwaye ukuhanjiswa kwegazi kuya kuqala ukuncipha. Oku kunokukhokelela ekubeni ipancreas ilahlekelwe ngumsebenzi wayo. Ukudumba okuqhubekayo kunokubangela ukuba ulwelo luqokelele kwizicubu eziphakathi kwamalungu omzimba (i-peritonitis). Olu lwelo lunokusasazeka luye esifubeni, lucinezele imiphunga nentliziyo. Njengoko olu lwelo luqokelelana, umthamo wegazi lomzimba uyancipha, okubangela ukuphelelwa ngamanzi emzimbeni kakhulu. Oku kunokubangela ukuba izintso zigcine ulwelo, ekugqibeleni kukhokelela kwimeko eyingozi ebizwa ngokuba yi-hypovolemic shock.

Xa ilitye livalekile kwi-bile duct, linokubangela iingxaki kwamanye amalungu adibene nenkqubo ye-bile duct. I-bile ingabuyela esibindini nakwi-gallbladder, nto leyo ebangela i-cholecystitis kunye nesifo sesibindi. Xa uxinzelelo kwi-ducts lusanda, ulwelo lokugaya ukutya olufana ne-bile lunokuvuza egazini. Ukuvaleka kunokuvumela iibhaktheriya ezivela emathunjini amancinci ukuba zibuyele kwi-ducts, nto leyo ebangela usulelo. Ukuba olu sulelo lusasazeka luye egazini, lunokubangela usulelo oluchaphazela umzimba wonke kwaye lunokukhokelela kwimeko ebulalayo ebizwa ngokuba yi-septic shock.

Sifunyaniswa njani esi sifo?

Xa ufika esibhedlele uneempawu eziqhelekileyo, ugqirha uza kuqala enze uvavanyo lwegazi ukujonga amanqanaba eeenzyme zepancreas yakho. Baza kujonga namanqanaba eeenzyme zesibindi sakho ukubona ukuba ungakanani umonakalo owenziwe kwisibindi sakho. Emva koko, baza kwenza uvavanyo lwemifanekiso ukujonga ipancreas yakho nokufumanisa ubukhali bokudumba.

I-ultrasound yesisu ingafumanisa amatye enyongo kwimibhobho yenyongo. Ukuba kuyimfuneko, i-CT scan ingajonga i-pancreas ngokweenkcukacha. Ngamanye amaxesha, xa uza kunyangwa, ilitye lokuqala elaqala ukudumba lisenokuba lidlulile lodwa. Kodwa ukuba kukho amanye amatye ajikelezileyo, oogqirha banokufumanisa ukuba yimbangela.

Iphathwa njani i-pancreatitis ebangelwa yi-gallstones?

Ukuba imeko yakho imbi kakhulu, uza kungeniswa kwigumbi lokhathalelo oluphezulu. Kwiimeko ezininzi (malunga nama-80%) ukuba imeko yakho ayimbi kangako, unyango lokuqala lunyango oluxhasayo. Olu lolona nyango kuphela lwe-pancreatitis.

Inkathalo exhasayo

Unyango luqala ngolu hlobo lulandelayo:

• Ulwelo lwe-IV: Ngenxa yokuba abantu abaninzi bomile, umthamo wegazi kufuneka ubuyiselwe. Iqela lezonyango liza kufaka i-saline catheter emthanjeni osesandleni sakho okanye esandleni sakho lize liqhubeke nokukunika ulwelo. Olu lwelo lukwaqulathe ii-electrolytes.
• Ukuphelisa iintlungu:Abantu abaninzi banentlungu eqatha, ngoko ke kufuneka banikwe iintlungu eziqatha, nokuba zifakwe inaliti okanye nge-saline.
• Ukuphumla kwamathumbu: Kuya kufuneka uyeke ukutya de ipancreas yakho ithomalale. Oku kungenxa yokuba xa usitya, inkqubo yakho yokugaya ukutya isebenza, nto leyo enika ipancreas yakho ithuba lokukhupha ii-enzymes ezingaphezulu kwaye nesibindi sakho kunye nenyongo zikhuphe inyongo engaphezulu. Oku kunokunyusa uxinzelelo kwimibhobho yakho yenyongo, nto leyo eyenza imeko ibe mandundu.
• Inkxaso yesondlo: Ngokuxhomekeke kubunzima bemeko yakho kunye nobude bexesha lokuhlala kwakho esibhedlele, iqela lakho lezonyango linokongeza inani elincinci leglucose kwisisombululo setyuwa ukuze likunike amandla. Banokukunika nesondlo ngetyhubhu ye-nasogastric okanye isisombululo setyuwa.

Ukongeza, olu nyango lunokwenziwa:

• Iyeza lokucaphuka.
• Ukunika ioksijini.
• Ii-antibiotics ukuba kukho usulelo oluqinisekisiweyo.
• Ukufaka ityhubhu ye-nasogastric (NG) ngempumlo ukuya esiswini ukuze kususwe ulwelo esiswini.
• Ukufaka i-catheter yomchamo ukuze kususwe umchamo kwaye kulinganiswe ubungakanani bomchamo ophumayo.

Kuya kufuneka uhlale kule nkxaso de ipancreas yakho iqale ukuzola. Kwiimeko ezingembi kangako, oku kuya kuphelela kwiintsuku ezimbalwa. Inkxaso inokunceda ilitye lizidlulele lodwa ngaphambi kokuba libe yingozi ngakumbi.

Iindlela zokususa iGallstone `(Ukungenelela kweGallstone)`

Kungekudala, naziphi na iitshetshe zenyongo ezibambeke kwiipayipi zakho kuya kufuneka zisuswe. Oku kungenziwa njengotyando olungxamisekileyo, okanye emva konyango oluxhasayo. Kuxhomekeke kwimeko yakho. Nokuba ilitye lokuqala elibangele ukuvaleka liphelile, onke amanye amatye kuya kufuneka asuswe.

Kusenokufuneka wenze enye okanye zombini ezi ndlela:

• I-ERCP (i-Endoscopic retrograde cholangiopancreatography): Oku kubizwa ngokuba yi-ERCP ngamafutshane. Le yinkqubo eluhlobo lovavanyo lwangaphakathi, kwaye ikwavumela oogqirha ukuba balungise naziphi na iingxaki abadibana nazo ngelo xesha. Imibhobho yenyongo ihlolwa kusetyenziswa ii-X-ray kunye ne-endoscope (ityhubhu ende enekhamera eqhotyoshelweyo). Le endoscope ifakwa ngomqala iye esiswini, ize emva koko enye ityhubhu idluliselwe kuyo iye kwimibhobho yenyongo. Ugqirha unokubona le mibhobho esebenzisa ubuchwepheshe be-X-ray ye-fluoroscopic. Izixhobo zinokudluliselwa kwityhubhu ukususa amatye enyongo kwaye ii-stents zinokubekwa ukunciphisa ukuvaleka.
• Ukususwa kwenyongo:Ukuba amatye enyongo abangele ukuba ulaliswe esibhedlele, kusenokwenzeka ukuba uphinde ube neengxaki ngawo. Ngoko ke, unyango olulodwa lwamatye enyongo abangela iingxaki kukususa inyongo. Le yinkqubo ekhuselekileyo nesebenzayo. Oku kudla ngokwenziwa nge-laparoscopic cholecystectomy. Oku kuthetha ukuba kwenziwa imingxunya embalwa emincinci kwaye ikhamera ebizwa ngokuba yi-laparoscope ifakwa ngenye yemingxunya ukuze kususwe inyongo. Abanye abantu, kuxhomekeke kwimeko yabo, banokufuna utyando oluvulekileyo lwendabuko.

Ngaba i-pancreatitis ebangelwa ngamatye enyongo inokuthintelwa?

Ukuba ukhe waba neempawu ze-gallstones ngaphambili, olo luphawu lwesilumkiso . Ngokuqinisekileyo kufuneka uzihlole kwaye uzisuse ukuba unazo. I-biliary colic sisibane esibomvu. Yintlungu eyenzeka kwicala lasekunene lesisu sakho, ngaphantsi nje kwembambo yakho yasekunene, apho i-gallbladder yakho ikhoyo. Isenokuba mandundu emva kokutya kwaye isenokuhamba nesicaphucaphu. Ukuba le biliary colic iyafika ize ihambe, oko kuthetha ukuba kukho ukuvaleka, kodwa kungekhona ukuvaleka ngokupheleleyo, kwi-gallbladder okanye kwi-bile ducts. Le ntlungu inokuza ihambe njengoko i-gallbladder iyancipha kwaye ikhula. Inokuba yinto enzulu ngakumbi.

Kubalulekile: Iimpawu ezifana neentlungu zesisu kunye nesicaphucaphu, ingakumbi emva kokutya, zinokuba luphawu lwe-`(biliary colic)`. Ungaze uyityeshele intlungu. Funa ingcebiso kagqirha ukuze ufumane unobangela. Okukhona ufumana unyango lwe-pancreatitis ngokukhawuleza, kokukhona iziphumo zakho zokuchacha zingcono.

Le meko iza kuhlala ixesha elingakanani?

Oku akuhlali kuphelile ngokwako. Kodwa ukuba unemeko engenzima kangako, akukho nzima ukuhlala iintsuku ezimbalwa uncedwa esibhedlele. Nangona kunjalo, usenokufuna ukususwa i-splint.

Kuthatha ixesha elingakanani ukuchacha emva konyango?

Abantu abaninzi kufuneka basuswe i-cholecystectomy ukuze kususwe i-gallbladder yabo. Ixesha lokuchacha lixhomekeke kuhlobo lotyando olwenziwayo. Kuthatha malunga neeveki ezimbini ukuze uphile emva kotyando lwe-laparoscopic. Ukuba utyando oluvulekileyo, kuthatha malunga neeveki ezintandathu ukuya kwezisibhozo.

Injani imeko yokuchacha kwabantu abalaliswe esibhedlele ngenxa ye-pancreatitis ngenxa yamatye enyongo?

Ngaphandle kokuba unemeko enzima okanye enzima, ungalindela ukuba uphile ngokupheleleyo. Ukususwa kwenyongo kuthathwa njengotyando oluncinci, oluneengxaki ezimbalwa. Nokuba ngaphandle kwenyongo yakho, inkqubo yakho yokugaya ukutya inokusebenza ngokuqhelekileyo.

Malunga nama-20% amatyala anzima okanye anzima. Kwiimeko ezinjalo, kunzima ukubuyisela umva umonakalo osele wenziwe. Nokuba kunyango olunzulu, malunga nama-25% amatyala anjalo anokubulala. Abo basindileyo kufuneka bahlale esibhedlele iiveki ukuze baphile.

Ukuba awazi ukuba unee-gallstones (kwaye abantu abaninzi abanazo), unokumangaliswa kwaye ukhathazeke xa ngequbuliso uhlaselwa yi-pancreatitis ngenxa yee-gallstones. Intlungu inokuba nkulu kwaye isenokubonakala ngathi ivela ngaphandle kwesizathu. Ukuba ucinga ukuba unokuba nee-gallstones, kulungile ukuba uhlolwe kwangethuba.

Izinto ezibalulekileyo ekufuneka uzikhumbule (Umyalezo Wokuya Ekhaya)

Kulungile, nazi izinto ekufuneka uzikhumbule koko sithethe ngako:

• I-Gallstone pancreatitis yimeko enzima kakhulu. Ngoko ke ukuba ufumana iimpawu, bonana nogqirha ngokukhawuleza.
• Iimpawu eziphambili zinokuba yintlungu eqatha esiswini esingaphezulu, ingakumbi kwicala lasekhohlo, isicaphucaphu, kunye nokuhlanza .
• Okukhona unyango lulibaziseka ixesha elide, kokukhona iingxaki zinokubakho.
• Ukuba uyazi ukuba unamatshe enyongo, okanye ngaphambili ube neempawu ezifana ne-`(biliary colic)`, yazi loo nto.
• Amaxesha amaninzi, ukususa inyongo yeyona ndlela isisigxina, kwaye lutyando olukhuselekileyo.
• Ukuba ufumana iintlungu kwicala eliphezulu lasekunene lesisu sakho emva kokutya, oko kungaba luphawu lwe-gallstones. Thetha nogqirha ngayo.

Ukuba awoyiki, fumana iingcebiso zonyango ezifanelekileyo, kwaye ufumane unyango olufanelekileyo, ungaphila ngokupheleleyo kule meko. Ukuba uneminye imibuzo, ungathandabuzi ukuthetha nogqirha wakho.

Amatye enyongo , iPancreatitis, iGallstone Pancreatitis, iintlungu zesisu, ukususwa kwenyongo, i-ERCP, iPancreatitis, iBile