Ngaba uyazi ngemeko eyingozi ye-necrotizing pancreatitis?

Ngaba wakha weva ngemeko enzima apho inxalenye yepancreas ifa khona ? Le yinto esiyibiza ngokwezonyango ngokuba yi-"Necrotizing Pancreatitis". Khawuthelekelele indlela ekuyingozi ngayo ukulahlekelwa yinxalenye yelungu elibalulekileyo emzimbeni wethu. Oku kwenzeka xa imeko ebizwa ngokuba yi-"Acute Pancreatitis " iba nzima kakhulu . Namhlanje, siza kuthetha ngale nto ngokweenkcukacha, ngokungathi sithetha nomhlobo.

Yintoni kanye kanye ``(Necrotizing Pancreatitis)``?

Ngamafutshane, "I-Necrotizing Pancreatitis" kukufa kwenxalenye ye "Pancreas" yakho (iNecrosis). Oku kwenzeka xa imeko ethi "Pancreatitis" iba nzima kakhulu. I-Pancreatitis kuxa i-pancreas idumba, ibomvu, kwaye ibuhlungu ngenxa yokwenzakala okanye into efana netyhefu. Ukuba oku kuvutha kuba nzima kakhulu, ukuhamba kwegazi kwiithishu ze-pancreas kunokuphazamiseka "Ischemia". Emva koko ezo thishu azifumani ioksijini kunye nezondlo ezizidingayo kwaye ziqala ukufa . Oku kubizwa ngokuba yi "Necrosis". Le yimeko eyingozi kakhulu.

Ukuba oku kuyenzeka, iqela lakho lezonyango liza kukugcina esibhedlele okwethutyana lize likujongele phantsi naziphi na iingxaki ezingakumbi. Eyona nto ibalulekileyo ekufuneka uyilumkele kusulelo . Khawuthelekelele ukuba iintsholongwane ziqale ukutya izicwili ezifileyo, zinokuphindaphindeka ngokukhawuleza zisasazeke emzimbeni wakho wonke. Ukuba oko kuyenzeka, kunokukhokelela kwiimeko ezinzulu ezifana nokungasebenzi kakuhle kwezitho zomzimba , okunokuba yingozi ebomini. Kwiimeko ezinjalo, oogqirha banokufuna ukususa izicwili ezifileyo ngotyando .

Ixhaphake kangakanani le meko?

Xa sithetha nje, malunga nama-20% abantu abafumana i-acute pancreatitis baza kuba ne-necrotizing pancreatitis. Kwilizwe elifana ne-United States, kuqikelelwa ukuba phantse amakhulu amathathu amawaka abantu bangeniswa esibhedlele minyaka le ngenxa ye-pancreatitis. Ngoko ke, ama-20% linani elibalulekileyo, akunjalo?

Zithini iimpawu ze-`(Necrotizing Pancreatitis)`?

Iimpawu zokuqala ezibonakala zezo ze-acute pancreatitis. Nazi:

• Intlungu ebuhlungu esiswini esingaphezulu. Le ntlungu isenokuvela nasemqolo.
• Ukuvuvukala kwesisu okanye ukudumba.
• Isicaphucaphu nokuhlanza.

Njengoko i-pancreatitis iba mandundu, iimpawu ezinjalo zinokubonakala:

• Umkhuhlane kunye nokubanda.
• Ukunyuka kwesantya sentliziyo (iTachycardia).
• Ukoma kakhulu okanye ukuphelelwa ngamanzi emzimbeni.

Zithini izizathu ze-"Necrotizing Pancreatitis"?

Oku kwenzeka ngamanqanaba aliqela. Okokuqala, ukudumba okuqhelekileyo kwepancreas (i-Acute Pancreatitis) kuba nzima. Emva koko, ukuhanjiswa kwegazi kuyaphazamiseka (i-Ischemia), kwaye ekugqibeleni, ukufa kwezicubu (i-Necrosis) kwenzeka. Kukho izizathu ezahlukeneyo zesiganeko ngasinye.

Inzima kangakanani i-pancreatitis?

Eyona nto ibangela i-acute pancreatitis sisifo se -gallstone . Oku kwenzeka xa i-gallstone ingena kwi-gallbladder ize ivale umbhobho we-pancreatic. Oku kukwabizwa ngokuba yi-gallstone pancreatitis . Eyona nto ibangela i-gallstone pancreatitis kukusebenzisa utywala kakhulu .

Ukudumba yindlela umzimba osabela ngayo kwingozi, uzama ukulungisa umonakalo. Kodwa ngamanye amaxesha le mpendulo yokudumba iba nzima kangangokuba iqale ukubangela umonakalo.

Akukacaci ukuba kutheni le mpendulo yokudumba inzima kakhulu kwabanye abantu kunakwabanye. Nangona kunjalo, kuyacaca ukuba oku kudala " isiphumo sebhola yekhephu" kwi-pancreas.

Uxinzelelo oluphezulu olubangelwa kukudumba okukhulu luvuselela ii-enzymes zepancreas ngaphakathi kwizicubu zepancreas. Ngokwesiqhelo, ezi enzymes zokugaya ukutya ziyavuselelwa emva kokuba ukutya kungene kwinkqubo yokugaya ukutya. Kodwa ukuba zivuselelwe kwangethuba, ziqala ukugaya i-pancreas ngokwayo. Khawuthelekelele, ukugaya isitho sakho somzimba ngee-enzymes zakho!

Ukuncipha kokunikezelwa kwegazi kukhokelela kwi-"Ischemia" kunye nokufa kwezicubu "Necrosis"

Oku konakala okuqhubekayo kwi-pancreas kubangela ukuba i-pancreatitis ibe mandundu. Ekugqibeleni, ukudumba kwe-pancreas kubangela ukuba imithambo yegazi ivuleke, nto leyo enciphisa inani legazi elihamba liye kwizicubu.

Enye into enokuthi ichaphazele oku yiSystemic Inflammatory Response Syndrome (SIRS). Le yimeko yokuvuvukala okwenzeka emzimbeni wonke. Oku kunokubangela ukuba uxinzelelo lwegazi luphelele kunye nokuhamba kwegazi kwehle.

Ukulahleka kokuhamba kwegazi (ischemia) kubangela ukufa kwezicubu (necrosis). Ukugaywa kwepancreas yi-enzymes yepancreas nako kunokubangela ukufa kwezicubu.

Ziziphi iingxaki ezinokubakho ze-`(Necrotizing Pancreatitis)`?

Le meko inokubangela iingxaki ezahlukeneyo kwixesha elifutshane nelide.

Iingxaki zexesha elifutshane:

• Usulelo: Le yeyona ngozi iyingozi kakhulu yeNecrotizing Pancreatitis. Oku kunokwenzeka kwi-20% yezigulana. Izicubu ezifileyo zifana nendawo elungileyo yokutya iintsholongwane ezizulazula. Kunzima ukulawula usulelo xa sele ugula. Ukuba lusasazeka luye egazini, lunokuba yingozi ebomini. Usulelo olusegazini lunokubangela i-sepsis , enokubangela ukungasebenzi kakuhle kwamalungu amaninzi omzimba . Le yeyona nto ibangela ukufa kubantu abaneNecrotizing Pancreatitis.
• Ukuqokelelwa kolwelo olune-Necrotic: Kwi-pancreatitis enzima, ii-enzymes ze-pancreatic ezisebenzayo zinokuvuza kwi-pancreas kwaye zonakalise izicubu ezingqongileyo. I-capsule yezicubu ezincinci zenzeka zijikeleze ulwelo lwe-pancreas. Ukuba le capsule inezicubu ezifileyo kunye neebhaktheriya, usulelo lunokuqala kwaye lusasazeke ngokulula. Amaxesha amaninzi, le capsule inokukhula kwaye icinezele amalungu akufutshane, njengesisu, imithambo yegazi, okanye i-bile ducts.
• Ukopha: I-hemorrhagic pancreatitis ayiqhelekanga, kodwa inokuba yingozi ebomini ukuba iyenzeka. I-necrotizing pancreatitis inyusa umngcipheko wokopha. Enye indlela oku okunokwenzeka ngayo kukuba ukudumba okanye ulwelo olukwi-pancreas lusasazeka luye kumthambo okufutshane, lonakalisa udonga lomthambo kwaye lubangele ukopha. Enye indlela kukuba ii-enzymes ze-pancreas zidiliza udonga lomthambo, zidale i- pseudoaneurysm , eqhumayo kwaye ibangele ukopha.
• Isifo seGumbi lesisu: Ukudumba, ukopha, kunye nokunye ukuqokelelana kolwelo okunxulunyaniswa ne-necrotizing pancreatitis kunokubangela uxinzelelo oluphezulu ngaphakathi kwesisu. Oku kubonakala kakhulu kwizigulana ezigula kakhulu. Oku kunokukhokelela ekuncipheni kokuhamba kwegazi ukuya kwizitho zomzimba, nto leyo enokukhokelela ekuqhekekeni kwegazi , ischemia, kunye ne -hypoxia . Oku kunokukhokelela nasekungasebenzini kwamalungu amaninzi.

Iziphumo zexesha elide:

• Ukungasebenzi kakuhle kwePancreatic: Ukuba inani elikhulu lezicubu zepancreas lilahlekile, eminye yemisebenzi yepancreas inokulahleka. Ukungasebenzi kakuhle kwePancreatic ye-Exocrine kuxa ipancreas ingavelisi ii-enzymes ezaneleyo zokugaya ukutya. Oku kunokukhokelela ekungafunxweni kakuhle kunye nokungondleki kakuhle . Ukungasebenzi kakuhle kwePancreatic ye -Endocrine kuxa ipancreas ingavelisi iihomoni ezaneleyo ezilawula amanqanaba eswekile egazini. Oku kunokukhokelela kwi-hyperglycemia kunye nesifo seswekile .
• I-Disconnected Pancreatic Duct Syndrome: Ukudumba okukhulu, ukopha, ukufa kwezicubu, kunye nezinye iingxaki ze-necrotizing pancreatitis kunokubangela ukuba i-pancreatic duct ihlukane kancinci ne-pancreas okanye amathumbu amancinci. Oku kunokubangela ukuvuza okuqhubekayo kwee-enzymes ze-pancreatic. Oku kuvuza kunokukhokelela ekuqokeleleni kolwelo ixesha elide kunye/okanye i-pancreatitis engapheliyo.
• Ukuqina kweBiliary:Ukudumba okukhulu nokuhlala ixesha elide kunokubangela amanxeba kuyo nayiphi na imibhobho edibanisa ipancreas nenkqubo yokugaya ukutya (i-pancreatic duct, i-bile duct, i-duodenum - ukuqala kwamathumbu amancinci). Oku kumanxeba kubangela ukuba umbhobho ube mxinwa ngendlela engaqhelekanga (i-stricture). Oku kucothisa ukuhamba kwe-bile, kwaye i-bile iqala ukubuyela kwi-biliary system.
• I-Splanchnic Vein Thrombosis: Imithambo yakho ye-splanchnic ikwi-pancreas yakho. I-pancreatitis enzima inokubangela ukuba ivuvuke. Oku kunokukhokelela ekuqhekekeni kwegazi (thrombosis) kule mithambo. Le mithambo iquka i-splenic vein, i-mesenteric vein, i-hepatic vein, kunye ne-portal vein. Ukuba i-blood clot iyenzeka kwenye yezi, iingxaki ezahlukeneyo zinokwenzeka, ezinje nge -portal hypertension , i-gastrointestinal varices, ukopha kwegazi kwe-gastrointestinal, i-ischemic colitis, kunye ne-mesenteric ischemia.

Ifunyanwa njani iNecrotizing Pancreatitis?

Oogqirha bafumanisa le meko `(Necrotizing Pancreatitis)` emva kokuxilonga okokuqala `(Acute Pancreatitis).` Iimpawu ezicacileyo zokufa kwezicubu `(Necrosis)` azibonakali de kube ziintsuku ezintathu ukuya kwezintlanu emva kokuqala kwe-pancreatitis. Ukuba uneempawu ze-pancreatitis enzima kwiintsuku ezimbalwa emva kokudumba kokuqala, ugqirha wakho uza kusebenzisa i-CT scan enedayi ye-fluorescent `(Contrast-enhanced CT scan)` okanye i-MRI.` (MRI - Magnetic Resonance Imaging)` ukujonga ukufa kwezicubu. Baza kukhangela nezinye iingxaki, ezifana nokuqokelelwa kolwelo.

Zithini iindlela zonyango zoku?

Unyango lwakho luya kuxhomekeka ekubeni unosulelo okanye ezinye iingxaki. Ukuba i-pancreatic necrosis ayizali kwaye akukho zimpawu, oogqirha bahlala beyinyanga ngononophelo oluxhasayo . Ukuba kuvela iimpawu zosulelo okanye ezinye iingxaki, oogqirha baya kungenelela njengoko kufuneka. Baza kuzama ukususa izicwili ezifileyo besebenzisa iindlela ezingangenisi kakhulu ngaphambi kokuba basebenzise utyando.

Ulawulo lweConservative

Unyango oluxhasayo lwe-"Sterile Necrotizing Pancreatitis" olungenazo izifo luquka:

• Izibulali-ntlungu.
• Ulwelo olufakwa emthanjeni `(IV Fluids)`.
• Isondlo sangaphakathi.

Uninzi lweemeko ezilula ziya kuconjululwa ngonyango oluxhasayo lodwa. Ngeli xesha, iqela lakho lezonyango liza kujonga imeko yakho ngokusondeleyo. Liza kujonga iimpawu zakho ezibalulekileyo , uxinzelelo lwesisu, kunye nokubala kwegazi ngokupheleleyo.Baza kujonga izinto ezifana neComplete Blood Cell Count (CBC) baze bajonge iingxaki ezinokubakho. Ukuba kukho into efana nosulelo okanye ukungasebenzi kakuhle kwamalungu omzimba, baza kubonelela ngenkxaso yobomi okanye ezinye iindlela zokungenelela njengoko kufuneka.

Ukukhupha amanzi amdaka kunye nokucocwa kwamanzi

Wakuba nje uqalile ukubona iimpawu zosulelo, iqela lakho lezonyango liza kukuqalisa ngee -antibiotics kwaye licebe ukususa naziphi na izicwili ezifileyo ukuba kunokwenzeka. Baza kuqala ngendlela engeyiyo eyosulelayo kangangoko kunokwenzeka, baze bandise kancinci kancinci ukuba kuyimfuneko.

Ezi ndlela ziquka:

• Ukukhupha amanzi emzimbeni ngendlela engaphandle kwesikhumba: Indlela engaphandle kwesikhumba isebenzisa iindlela zokujonga imifanekiso (ngokuqhelekileyo i-ultrasound okanye i-CT scans) ukufumana indawo yezicubu ezifileyo kwaye ifaka ityhubhu engaphandle kwesikhumba sakho. Le tyhubhu ishiywa endaweni yayo kwaye ihlanjwe nge-saline izihlandlo ezininzi ngemini ukuze kukhutshwe ulwelo. Le yindlela kuphela malunga nesithathu sezigulane. Kwabanye, inceda ukulawula usulelo de kube kusetyenziswe ezinye iindlela zokucoca ulwelo ngokukhuselekileyo.
• Ukususwa kwe-Endoscopic: Inkqubo ebizwa ngokuba yi-endoscopy ivumela ugqirha we-gastroenterologist ukuba afikelele kwizicubu ezifileyo emzimbeni wakho ngaphandle kokuzisika ulusu lwakho. Uza kudlulisa i-endoscope, exhotyiswe nge -ultrasound probe, ngendlela yakho ephezulu yesisu ukuze afumane indawo yepancreas. Emva koko, izixhobo zidluliselwa kwi-endoscope ukuze zenze umjelo phakathi kwezicubu ezifileyo kunye nendlela yakho yesisu. Izicubu ezifileyo zisuswa ngaloo mjelo.
• Ukususwa kwe-Retroperitoneal Debridement (VARD) encediswa yividiyo: Le yindlela yotyando engaphantsi kakhulu. Oku kuquka ukufaka izixhobo zotyando nge-incision efanayo onayo eluswini lwakho ebizwa ngokuba yiPercutaneous Drainage Portal uze uye kwindawo apho kukho izicubu ezifileyo. Ugqirha usebenzisa i-forceps, ukunkcenkceshela kunye nokufunxa ukususa izicubu ezifileyo nge-incision. Ukuba kuyimfuneko, i-incision inokwandiswa kwaye ityhubhu enekhamera ebizwa ngokuba yi-laparoscope inokufakwa. Izicubu eziseleyo emva koko zisuswa kusetyenziswa inkqubo ye-laparoscopic ebizwa ngokuba yi-laparoscopic surgery.
• Utyando Oluvulekileyo - I-Necrosectomy: I-Necrosectomy kukususwa kwezicubu ezifileyo. Utyando oluvulekileyo lubandakanya ukuvula umngxuma wesisu kunye nokufumana izicubu ezifileyo (i-Laparotomy). Le iseyeyona ndlela ikhawulezayo yokufumana nokunyanga iingxaki ezingxamisekileyo. Nangona utyando lunemingcipheko ethile, luyindlela yokugqibela yokujongana neengxamiseko kwaye xa iindlela ezingangenisi kakhulu zingaphumelelanga.

Lithini izinga lokufa kunye nezinga lokuchacha kwe-`(Necrotizing Pancreatitis)`?

Ithuba lokuchacha lixhomekeke ekubeni ingakanani i-pancreas yakho efileyo, nokuba unesifo okanye ukungasebenzi kakuhle kwezitho zomzimba, kwaye usabela kakuhle kangakanani kunyango. Ukuba ingaphantsi kwama-30% ye-pancreas yakho echaphazelekileyo, izinga lokufa lingaphantsi kwe-15% . Ukuba kukho ukufa kwezicwili kuphela ngaphandle kosulelo, kulungile oko. Kodwa ukuba ingaphezulu kwama-50% ye-pancreas yakho echaphazelekileyo, kwaye uphuhliswa sisifo okanye ukungasebenzi kakuhle kwezitho zomzimba, izinga lokufa liyanda liye ngaphezulu kwama-30% .

Musa ukoyika ezi zibalo. Olu lulwazi nje oluqhelekileyo. Liqela lezonyango kuphela elinokukuxelela ngcono ngemeko yakho kunye namathuba akho okuchacha.

Kwenzeka ntoni emva konyango?

Kwintlanganiso yakho yokulandelela emva konyango, ugqirha wakho uza kukubuza ngazo naziphi na iimpawu eziqhubekayo okanye ezintsha. I-Necrotizing Pancreatitis inokuba neengxaki ezihlala ixesha elide nasemva konyango. Ukuba uneempawu, unokucelwa ukuba wenze uvavanyo lwegazi, uvavanyo lwelebhu, okanye uvavanyo lwemifanekiso ukuze uzijonge. Iingxaki zinokufuna unyango olongezelelweyo, olunokuba lolwexesha elifutshane okanye elide.

I-necrotizing pancreatitis yingxaki enkulu kakhulu ye-acute pancreatitis. Nangona uninzi lwabantu luyaphola kwi-acute pancreatitis ngoncedo oluxhasayo kuphela, abo bafumana i-pancreatitis enzima kunye ne-necrosis bafuna unyango oluqatha nolunzulu lwexesha elide. Uya kufuna iqela loogqirha abanolwazi oluninzi ukujonga imeko yakho kunye nazo naziphi na iingxaki ezinokuvela. Ungadinga ukungenelela okanye utyando, mhlawumbi nonyango olulandelayo.

Ezona zinto zibalulekileyo ekufuneka sizikhumbule kweli bali (Umyalezo Wokuya Ekhaya)

• I-Necrotizing Pancreatitis yimeko enzima apho inxalenye yepancreas ifa khona.
• Oku kudla ngokubangelwa yi-pancreatitis ebukhali kakhulu. Izizathu eziphambili zizinto ezibangela ukuba umntu atye inyongo kunye nokusela utywala kakhulu .
• Ukuba uneempawu ezifana nentlungu eqatha yesisu, umkhuhlane, isicaphucaphu, kunye nokuhlanza, funa ingcebiso kagqirha ngokukhawuleza.
• Usulelo yeyona ngxaki iphambili neyingozi kakhulu yale meko.
• Iindlela zonyango ziyahluka ngokuxhomekeke kwimeko yesigulana. Kukho iindlela ezahlukeneyo zonyango , ukusuka kunyango oluxhasayo ukuya kutyando .
• Nangona esi sisifo esibi kakhulu, abantu abaninzi bayaphila ngonyango olufanelekileyo nonyango . Ngoko ke musa ukuphelelwa lithemba.

Ukuba wena okanye umntu omaziyo unenye yezi mpawu, nceda ubone ugqirha ngokukhawuleza. Unyango lwangethuba lunokusindisa ubomi!

I- Necrotizing Pancreatitis, i-Pancreatitis, ukufa kwe-Pancreatic, iintlungu zesisu, usulelo lwe-Pancreatic, i-Pancreatitis, izifo ze-Sinhala, i-Pancreatic