Ingabe nawe uke waba ne-pancreatitis ngenxa yamatshe enyongo? (I-Gallstone Pancreatitis) Ake sixoxe ngalokhu!

Wake wezwa ukuthi amatshe enyongo angabangela ukuthi i-pancreas ivuvuke kakhulu noma ivuvuke? Yilokhu odokotela abakubiza ngokuthi `(Gallstone Pancreatitis)` noma `(Biliary Pancreatitis)`. Lokhu kungaba yisimo esibucayi ngempela. Kodwa ungakhathazeki, ngoba kunezindlela zokwelapha ezinhle zalokhu. Namuhla, sizoxoxa ngakho konke ngendlela elula ongayiqonda.

Ngakho-ke iyini le pancreas?

Kalula nje, i-pancreas iyisitho esibalulekile esitholakala ngaphakathi esiswini sethu, ngemuva kwesisu. Ifana nefektri encane emzimbeni wethu. Ikhiqiza ama-enzyme okugaya ukudla abaluleke kakhulu asiza ekugayeni ukudla esikudlayo. Uma sidla, futhi ukudla kufinyelela emathunjini amancane, i-pancreas ithola isignali yokukhulula la ma-enzyme. Lawa ma-enzyme ahamba esuka kuma-pancreas ngethubhu elincane (umsele we-pancreas) bese ejoyina ithubhu elikhulu kancane (umsele we-bile ovamile). Kukule thubhu enkulu lapho ama-enzyme, kanye ne-bile evela esibindini kanye ne-gallbladder, eya engxenyeni engenhla yamathumbu amancane. Yilapho inqubo yokugaya ukudla yenzeka khona empeleni.

Kulungile, pho-ke ziyini lezi zinhlayiya zenyongo?

Amatshe enyongo akheka enyongweni yethu. Inyongo iyisikhwama esincane esiqoqa futhi sigcine inyongo, ekhiqizwa yisibindi. Lenyongo iqukethe izinto ezahlukahlukene. Ngezinye izikhathi, uma kune-cholesterol noma i-bilirubin eningi kakhulu kulenyongo, ingaba njengodaka phansi kwenyongo. Uma inyongo ingakhishwa kahle, le nto efana nodaka inganqwabelana futhi ngokuhamba kwesikhathi yakhe amatshe. Lokhu yilokho esikubiza ngokuthi amatshe enyongo.

Ingabe i-pancreatitis ebangelwa amatshe enyongo iyingozi?

Yebo, lesi yisimo esibucayi . Uma unesifo sofuba, kubalulekile ukufuna usizo lwezokwelapha ngokushesha okukhulu. Izimpawu zingaba zincane noma zibe zimbi kakhulu. Kodwa-ke, uma ungatholi ukwelashwa isikhathi eside, isimo sizoba sibi kakhulu. Ikakhulukazi uma itshe libhajwe emigudwini yenyongo, kulapho amathuba okuba nezinkinga anda khona. Ezimweni ezimbi kakhulu, kungaba yingozi empilweni.

Sivame kangakanani lesi sifo?

Amatshe enyongo ayinkinga evamile kubantu abaningi. Kodwa akuwona wonke umuntu onawo. Isibonelo, e-United States, kulinganiselwa ukuthi abantu abayi-10% kuya ku-15% banamatshe enyongo. Kodwa yi-0.1% kuphela yalabo bantu abathola i-pancreatitis ngenxa yamatshe enyongo. I-pancreatitis ebukhali ithinta cishe u-0.4% wabantu e-United States. Amatshe enyongo ayimbangela yalezi zimo ezingaba ngu-35%. Imbangela yesibili evame kakhulu ukusetshenziswa kotshwala.

Yini ebangela amatshe enyongo?

Kunzima ukukhomba imbangela eyodwa yamatshe enyongo, kodwa kunezici eziningana ezingaba nomthelela kulokhu:

• Uma amazinga e-cholesterol egazini lakho ephezulu, kungaba ngenxa yokudla okudlayo noma ukuphazamiseka kwe-metabolic. Kuleso simo, i-cholesterol inganqwabelana nasenyongweni yakho.
• Uma unesifo sesibindi, amazinga e-bilirubin egazini lakho kanye ne-bile anganda.
• Uma kukhona ukuphazamiseka kokusebenza lapho inyongo ingakhiphi khona kahle.
• I-estrogen eningi ingalibazisa nokukhishwa kwenyongo. Yingakho le ngozi iphezulu ngesikhathi sokukhulelwa.

Amatshe enyongo ayibangela kanjani i-pancreatitis?

Cabanga ukuthi i-pancreas yakho, i-gallbladder, kanye ne-bile duct kuxhunywe komunye nomunye ngepayipi elibizwa ngokuthi i-common bile duct. Ngokuvamile, i-bile evela kwi-gallbladder yakho igeleza ngale common bile duct iye emathunjini akho amancane. Kodwa uma unama-gallstones, angahamba nakule duct.

Nakuba amatshe edlula kalula lapho esesemancane, kancane kancane aba makhulu njengoba inyongo entsha idlula phezu kwawo. Ngakho-ke, itshe elalivame ukudlula kalula linganamathela kamuva, ikakhulukazi uma umsele umncane. Itshe lenyongo linganamathela ngaphakathi komsele we-pancreatic noma linamathele ngaphandle komsele, okubangela i-pancreatitis.

Kunemibono emibili mayelana nokuthi lokhu kuvinjelwa kubangela kanjani i-pancreatitis:

1. Inkolelo-mbono yokuqala ukuthi uma itshe lihlala ngaphandle komsele we-bile ovamile, i-bile ingageleza ibuyele emuva iye ku-pancreas. I-Bile iyagqwala kakhulu, okucasula i-pancreas.

2. Inkolelo-mbono yesibili ukuthi ama-enzyme e-pancreatic abangela ukuvuvukala. Lawa ma-enzyme aklanyelwe ukugaya amaprotheni, ama-carbohydrate, namafutha emathunjini amancane. Ngakho-ke, nawo ayagqwala kakhulu. Nakuba amathumbu ethu amancane evikelwe kulokhu ngolwelwesi olukhulu lwe-mucus, i-pancreas ayinalo ukuvikelwa okunjalo.

Ngokuvamile, ama-enzyme e-pancreatic ayasebenza ngemva kokufika emathunjini amancane. Kodwa-ke, uma kudalwa ingcindezi enkulu ngenxa yokuvaleka komsele we-pancreatic, ama-enzyme angasetshenziswa yileyo ngcindezi.

Kodwa-ke, siyazi ukuthi kukhona ubudlelwano phakathi kwezimbangela nemiphumela phakathi kwamatshe enyongo kanye ne-pancreatitis ebukhali. Uma uya esibhedlela ukuze uthole ukwelashwa, i-pancreatitis izophola uma amatshe asezimbotsheni zenyongo esesusiwe.

Yiziphi izimpawu ze-pancreatitis ezibangelwa amatshe enyongo?

Izimpawu ezivame ukubonakala yilezi:

• Ubuhlungu obukhulu besisu. Ungase uzizwe lokhu engxenyeni ephezulu kwesobunxele yesisu sakho, lapho kukhona khona i-pancreas yakho. Kungase kuzwakale sengathi ummese ukugwaza noma ukukucindezela ngaphakathi. Lobuhlungu bungaphinde buphumele esifubeni sakho, ehlombe, noma emhlane.
• Isicanucanu nokuhlanza.

Njengoba isimo siba sibi kakhulu, izimpawu ezinjengalezi zingase zivele:

• Ukuqunjelwa kwesisu.
• Ukuphelelwa amanzi emzimbeni.
• Isilinganiso senhliziyo siyanda.
• Ukuphefumula okusheshayo noma ubunzima bokuphefumula.
• Umfutho wegazi ophansi.
• Ukushisa komzimba okuphansi.
• Umkhuhlane kanye nokubanda.
• I-jaundice (ukuphuzi kwamehlo nesikhumba).

Yiziphi izinkinga ze-pancreatitis ezibangelwa amatshe enyongo?

Uma i-pancreas yakho iqhubeka nokuvuvukala kakhulu, izicubu zayo zizokonakala kancane kancane futhi ukunikezwa kwegazi kuzoqala ukwehla. Lokhu kungaholela ekutheni i-pancreas ilahlekelwe umsebenzi wayo. Ukuvuvukala okuqhubekayo kungabangela uketshezi ukuthi luqoqeke ezicutshini eziphakathi kwezitho zomzimba (i-peritonitis). Lolu ketshezi lungasakazeka luye esifubeni, lucindezele amaphaphu nenhliziyo. Njengoba lolu ketshezi luqongelela, umthamo wegazi lomzimba uyancipha, okubangela ukuphelelwa amanzi emzimbeni okukhulu. Lokhu kungabangela izinso ukuthi zigcine uketshezi, ekugcineni kuholele esimweni esiyingozi esibizwa ngokuthi i-hypovolemic shock.

Uma itshe livalekile emgudwini wenyongo, kungabangela izinkinga kwezinye izitho ezixhumene naleyo nqubo yomgudu wenyongo. Inyongo ingabuyela esibindini kanye nasenyongweni yenyongo, okubangela i-cholecystitis kanye nesifo sesibindi. Lapho ingcindezi emigudwini ikhula, uketshezi lokugaya ukudla olufana nenyongo lungavuza egazini. Ukuvaleka kungavumela amabhaktheriya asemathunjini amancane ukuthi abuyele emigudwini, okubangela ukutheleleka. Uma lokhu kutheleleka kusakazekela egazini, kungabangela ukutheleleka okusemzimbeni okuthinta wonke umzimba futhi kungaholela ngisho nasesimeni esibulalayo esibizwa ngokuthi i-septic shock.

Lesi sifo sitholakala kanjani?

Uma ufika esibhedlela unezimpawu ezijwayelekile, udokotela uzoqala ngokuhlola igazi ukuze ahlole amazinga e-enzyme yakho ye-pancreatic. Bazohlola namazinga e-enzyme yakho yesibindi ukuze babone ukuthi umonakalo ongakanani owenzekile esibindini sakho. Ngemuva kwalokho, bazokwenza izivivinyo ze-imaging ukuze babheke i-pancreas yakho futhi bathole ukuthi ukuvuvukala kungakanani.

I-ultrasound yesisu ingabona amatshe enyongo emigudwini yenyongo. Uma kudingeka, i-CT scan ingabheka i-pancreas ngokuningiliziwe. Ngezinye izikhathi, ngesikhathi ufika ukuzokwelashwa, itshe lokuqala elaqala ukuvuvukala kungenzeka ukuthi selidlulile lodwa. Kodwa uma kukhona amanye amatshe azungezile, odokotela bangathola ukuthi yimbangela.

Iphathwa kanjani i-pancreatitis ebangelwa amatshe enyongo?

Uma isimo sakho sibi kakhulu, uzongeniswa egunjini lokunakekelwa okujulile. Ezimweni eziningi (cishe u-80%) uma isimo sakho singesibi kangako, ukunakekelwa okusekelayo kuyindlela yokuqala yokwelapha. Lena ukuphela kwendlela yokwelapha i-pancreatitis.

Ukunakekelwa okusekelayo

Ukwelashwa kuqala kanje:

• Uketshezi lwe-IV: Ngenxa yokuthi abantu abaningi baphelelwa amanzi emzimbeni, umthamo wegazi udinga ukubuyiselwa. Ithimba lezokwelapha lizofaka i-saline catheter emthanjeni osengalweni noma esandleni sakho bese liqhubeka nokukunikeza uketshezi. Lolu ketshezi luqukethe nama-electrolyte.
• Ukuqeda ubuhlungu:Abantu abaningi bahlushwa ubuhlungu obukhulu, ngakho-ke kufanele banikezwe amaphilisi okudambisa izinhlungu anamandla, kungaba njengomjovo noma ngosawoti.
• Ukuphumula kwamathumbu: Kuzodingeka uyeke ukudla kuze kube yilapho i-pancreas yakho ipholile. Lokhu kungenxa yokuthi uma udla, uhlelo lwakho lokugaya ukudla luba lusebenza, okubonisa ukuthi i-pancreas yakho ikhiphe ama-enzyme amaningi kanye nesibindi sakho kanye nenyongo yakho kukhiphe inyongo eyengeziwe. Lokhu kungandisa kakhulu ingcindezi emigudwini yakho yenyongo, okwenza isimo sibe sibi kakhulu.
• Ukusekelwa kokudla okunempilo: Kuye ngokuthi isimo sakho sibucayi kangakanani kanye nobude besikhathi oyohlala ngaso esibhedlela, ithimba lakho lezokwelapha lingangeza inani elincane le-glucose esixazululweni se-saline ukuze likunike amandla. Bangakunikeza nokudla okunempilo ngepayipi le-nasogastric noma isixazululo se-saline.

Ngaphezu kwalokho, lezi zindlela zokwelapha zingenziwa futhi:

• Umuthi wokucanuzela kwenhliziyo.
• Ukunikeza umoya-mpilo.
• Ama-antibiotic uma kuqinisekisiwe ukuthi unesifo.
• Ukufaka ipayipi le-nasogastric (NG) ngekhala liye esiswini ukuze kukhishwe uketshezi esiswini.
• Ukufaka i-catheter yomchamo ukuze kukhishwe umchamo futhi kulinganiswe inani lomchamo ophumayo.

Kuzodingeka ube kulolu kunakekelwa okusekelayo kuze kube yilapho i-pancreas yakho iqala ukuzola. Ezimweni ezingatheni kakhulu, lokhu kuvame ukuxazululeka ezinsukwini ezimbalwa. Ukunakekelwa okusekelayo kungasiza futhi itshe lizidlulele lodwa ngaphambi kokuba libe yingozi kakhulu.

Izindlela zokususa amatshe enyongo `(Ukungenelela kwamatshe enyongo)`

Ngokushesha noma kamuva, noma yimaphi amatshe enyongo abhajwe emigudwini yakho kuzodingeka asuswe. Lokhu kungenziwa njengokuhlinzwa okuphuthumayo, noma ngemuva kokunakekelwa okusekelayo. Kuya ngesimo sakho. Ngisho noma itshe lokuqala elibangele ukuvaleka seliphelile, wonke amanye amatshe kuzodingeka asuswe.

Kungadingeka wenze eyodwa noma zombili lezi zindlela:

• I-ERCP (i-Endoscopic retrograde cholangiopancreatography): Lokhu kubizwa ngokuthi i-ERCP ngamafuphi. Lena inqubo empeleni ewukuhlolwa kwangaphakathi, futhi ivumela odokotela ukulungisa noma yiziphi izinkinga abahlangabezana nazo ngaleso sikhathi. Amapayipi e-bile ahlolwa kusetshenziswa i-X-ray kanye ne-endoscope (ithubhu elide elinekhamera enamathiselwe). Le endoscope ifakwa ngomphimbo iye esiswini, bese kuthi elinye ithubhu lidluliselwe kuyo liye emapayipini e-bile. Udokotela angabona la mapayipi esebenzisa ubuchwepheshe be-X-ray be-fluoroscopic. Izinsimbi zingadluliselwa ngethubhu ukuze kususwe amatshe enyongo futhi ama-stents angabekwa ukuze kuncishiswe ukuvaleka.
• Ukususwa kwenyongo:Uma amatshe enyongo ebangele ukuthi ulaliswe esibhedlela, kungenzeka ukuthi uphinde ube nezinkinga ngawo. Ngakho-ke, ukwelashwa okuwukuphela kwamatshe enyongo abangela izinkinga ukususa inyongo. Lena inqubo ephephile kakhulu futhi ephumelelayo. Lokhu kuvame ukwenziwa nge-laparoscopic cholecystectomy. Lokhu kusho ukuthi kwenziwa imicu embalwa emincane bese kufakwa ikhamera ebizwa ngokuthi i-laparoscope ngenye yezicucu ukuze kususwe inyongo. Abanye abantu, kuye ngesimo sabo, bangadinga nokuhlinzwa okuvulekile kwendabuko.

Ingabe i-pancreatitis ebangelwa amatshe enyongo ingavinjelwa?

Uma uke waba nezimpawu zamatshe enyongo ngaphambili, lokho kuyisibonakaliso esiyisixwayiso . Kufanele nakanjani uzihlole futhi uzikhiphe uma unazo. I-biliary colic iyisibani esibomvu. Kuyibuhlungu obuvela ohlangothini lwesokudla lwesisu sakho, ngaphansi nje kwekheji lakho lesokudla, lapho inyongo yakho ikhona khona. Kungase kube kubi kakhulu ngemva kokudla futhi kungase kuhambisane nesicanucanu. Uma le nyongo ifika futhi ihambe, kusho ukuthi kukhona ukuvaleka, kodwa hhayi ukuvaleka okuphelele, enyongweni noma emigudwini yenyongo. Lobuhlungu bungafika buhambe njengoba inyongo incipha futhi ikhula. Bungaphenduka kalula bube yinto engathi sína kakhulu.

Okubalulekile: Izimpawu ezifana nobuhlungu besisu kanye nesicanucanu, ikakhulukazi ngemva kokudla, kungaba uphawu lwe-`(biliary colic)`. Ungalokothi ungazinaki ubuhlungu. Funa iseluleko sezokwelapha ukuze uthole imbangela. Uma uthola ukwelashwa kwe-pancreatitis ngokushesha, kulapho umphumela wakho wokululama ungcono khona.

Lesi simo sizohlala isikhathi esingakanani?

Lokhu ngokuvamile akupheli ngokwako. Kodwa uma unesifo esingenzima kangako, izinsuku ezimbalwa zokunakekelwa okusekelwe esibhedlela kulungile. Kodwa-ke, kungase kudingeke ukuthi ususwe i-balt.

Kuthatha isikhathi esingakanani ukululama ngemva kokwelashwa?

Abantu abaningi kufanele bahlinzwe i-cholecystectomy ukuze basuse inyongo yabo. Isikhathi sokululama sincike ekutheni hlobo luni lokuhlinzwa oluzokwenziwa. Kuthatha cishe amasonto amabili ukululama ngemva kokuhlinzwa kwe-laparoscopic. Uma uhlinzwa ngokuvulekile, kuthatha cishe amasonto ayisithupha kuya kwayisishiyagalombili.

Sinjani isimo sokululama kwabantu abalaliswe esibhedlela ngenxa ye-pancreatitis ngenxa yamatshe enyongo?

Ngaphandle kokuthi unesimo esibucayi noma esiyinkimbinkimbi, ungalindela ukululama ngokuphelele. Ukususwa kwenyongo kubhekwa njengokuhlinzwa okuncane, okunezinkinga ezimbalwa. Ngisho noma ungenayo inyongo yakho, uhlelo lwakho lokugaya ukudla lungasebenza kahle.

Cishe u-20% wamacala anzima noma ayinkimbinkimbi. Ezimweni ezinjalo, kunzima ukubuyisela emuva umonakalo osuvele wenziwe. Ngisho noma unakekelwa kakhulu, cishe u-25% wamacala anjalo angaba yingozi. Labo abasindayo kumele bahlale esibhedlela amasonto amaningi ukuze balulame.

Uma ungazi ukuthi unamatshe enyongo (futhi abantu abaningi abanawo), ungase umangale futhi ukhathazeke lapho uhlaselwa yi-pancreatitis ngokuzumayo ngenxa yamatshe enyongo. Ubuhlungu bungaba bukhulu futhi bungase bubonakale buvela ngaphandle kwesizathu. Uma ucabanga ukuthi ungase ube namatshe enyongo, kuwukuhlakanipha ukuhlolwa kusenesikhathi.

Izinto ezibaluleke kakhulu okufanele uzikhumbule (Umyalezo Wokuya Ekhaya)

Kulungile, ngakho-ke nazi ezinye izinto okudingeka uzikhumbule kulokho esikhulume ngakho:

• I-pancreatitis ye-Gallstone iyisimo esibi kakhulu. Ngakho-ke uma uzwa izimpawu, bona udokotela ngokushesha.
• Izimpawu eziyinhloko kungaba ubuhlungu obukhulu esiswini esingaphezulu, ikakhulukazi ohlangothini lwesobunxele, isicanucanu nokuhlanza .
• Uma ukwelashwa kubambezeleka isikhathi eside, kulapho kungase kube nezinkinga eziningi khona.
• Uma wazi ukuthi unamatshe enyongo, noma uke waba nezimpawu ezifana ne-`(biliary colic)`, qaphela lokho.
• Ngokuvamile, ukususa inyongo kuyisisombululo esihlala njalo, futhi kuyindlela yokuhlinzwa ephephile.
• Uma uzwa ubuhlungu engxenyeni ephezulu kwesokudla yesisu sakho ngemva kokudla, kungaba uphawu lwamatshe enyongo. Khuluma nodokotela ngakho.

Uma ungesabi, uthole iseluleko esifanele sezokwelapha, futhi uthole ukwelashwa okufanele, ungalulama ngokuphelele kulesi simo. Uma uneminye imibuzo, ungangabazi ukukhuluma nodokotela wakho.

Amatshe enyongo, i-pancreatitis, i-gallstone pancreatitis, ubuhlungu besisu, ukususwa kwenyongo, i-ERCP, i-pancreatitis, inyongo