Anụ a na-eme ka enzymes na-agbari, nke bụ ikekwe ihe ndị na-eme ike karịa ahụ mmadụ. Ha na - enwe ike igbari ụdị nri ọ bụla n’ihe ndị dị mfe, si otú ahụ mee ka ọ dịrị ha mfe.
Agbanyeghị, n'ihi ọrịa ụfọdụ, enwere ngabiga nke mmiri ọgwụ nri sitere na anụ ahụ, nke na-akpata mmebi nke pancreas. Nke a bụ ọnọdụ dị oke njọ nke na-eweta nnukwu ihe egwu ọ bụghị naanị maka ahụike kamakwa na ndụ mmadụ.
Ya mere, ọ dị mkpa ka ndị ọrịa niile na-efe efe na-amata ihe necrosis pancreatic bụ, ihe na-akpata ya, ihe mgbaàmà na-egosi ọrịa a, otu esi achọpụta ọrịa nke ọma. Nke a ga - enyere aka ileba anya na - achọpụta ihe ịrịba ama mbụ nke ọrịa siri ike ma chekwaa onye ọrịa ahụ site na nkwarụ na ọnwụ.
Njirimara Pancreatic
A na - enweta pancreas bụ gland kasị ukwuu n’ahụ mmadụ. Ọ na - arụ ọrụ abụọ dị mkpa n'otu oge - ọ na - ewepụta enzymes nri dị mkpa maka mgbaze nke protein, abụba na carbohydrates, ma na - egbochi homonụ nke na - akwalite glucose ma na - edozi shuga ọbara.
A na-emepụta ihe ọcụ Panụ pancreatic n'ime gland ma wụsa ya n'akụkụ nnukwu mmiri n'ime duodenum, ebe ha na-etinye aka na mgbaze nri. Enzymes ndị a na - arụ ọrụ nke ukwuu ma nwee ike ịkwatu abụba na protein nke ahịhịa na anụmanụ, yana carbohydrates dị mfe ma sie ike.
A na-akọwa Njirimara nke pancreas site na ọtụtụ enzymes zoro ezo na mkpụrụ ndụ ya. Yabụ, ndị dọkịta kwuru na ọria ahụ nwere akụkụ ahụ dị mkpa, na-enweghị nke ịrụ ọrụ nkịtị na-agaghị ekwe omume.
Ngwakọta na Njirimara nke ihe ọ pancụ pancụ pancreatic:
- Amylase - dị mkpa maka hydrolysis nke carbohydrates, akpan akpan stachi na glycogenado glucose;
- Lipase - na-agbaji ụdị abụba niile, polyunsaturated na fatụ ahụ, yana vitamin A, D, E, K;
- Pancreatic elastase bụ naanị enzyme nke nwere ike ịkụda elastin na eriri collagen na anụ ahụ jikọtara ọnụ;
- Nuclease - gụnyere ọtụtụ enzymes (exonuclease, endonuclease, ribonuclease, deoxyribonuclease, igbochi, wdg) achọrọ maka hydrolysanucleic acid, gụnyere DNA na RNA;
- Carboxypeptidase, trypsin na chymotrypsin-na-ehichapụ ụdị protein niile iji nwere amino acid n'efu.
Oge mwepu nke enzymes a na-egbu egbu n'oge a na - eso akpata ntolite nke pancreas. Sistemụ ntụpọ parasympathetic, ọmịiko na metasympathetic n'ụdị nke irighiri akwara, akwara aka nri buru ibu, celiac akwara plexus na intramural ganglia bụ ndị kpatara ya.
Ha bụ akụkụ nke sistemụ akwara autonomic, ya bụ, na-arụ ọrụ na-enweghị njide onwe ya n'akụkụ akụkụ ụbụrụ dị elu.
Nke a pụtara na mgbe ị na-eri nri, a na - emechi enzymes nke onwe ya na - eme, na - enweghị mgbamume ọ bụla nke mmadụ.
Ihe na-akpata Pancreatonecrosis
Ihe kpatara mmebi nke pancreas nwere ike ịdị iche iche, mana ọtụtụ mgbe, ọ bụ nri na-edozi ahụ na ị alcoholụbiga mmanya ókè. Ọzọkwa, necrosis na-egbu egbu nwere ike ịrịa ọrịa ọ bụghị naanị ndị na-a alcoholụ mmanya mgbe niile, kamakwa ndị na-a alcoholụ mmanya na-adịghị ahụkebe, mana n'ọtụtụ.
Ihe oriri na ihe ọ alcoholụ alcoholụ na-aba n'anya na-ebelata ihe nchebe nke pancreas, mee ka mmiri ọgwụ mmiri a na-a pancụ nke ọma, mee ka mmiri ghara ibu ibu ma mebie mmiri nke enzymes n'ime duodenum. N'ihi ya, ịgbalite enzymes nri diges na-aputa n’ime anụ ahụ, nke na-eduga n ’mbibi enzymatic kachasị akwara nke anụ ahụ na mgbaze onwe.
N’ọnọdụ a, onye ọrịa na-amalite ngwa ngwa akwara pịrịkụsọ, akwara anụ ahụ wee nwụọ. Ọzọkwa, n'ọtụtụ ndị ọrịa, a na-ahụta mmerụ vaskụla, nke ihe ọ juiceụ pancụ pancreatic na-abanye na sistemụ mgbasa ma na-agbasa ahụ niile, na-enwe mmetụta ọjọọ na ya.
Ọtụtụ mgbe, yana pancreatic necrosis, yana enzymes digestive, nje pyogenic dị ka streptococci na staphylococci abanye n'ọbara. N'ihi nke a, onye ọrịa na - etolite sepsis - nchoputa dị egwu nke ọnyị na - akpata ọgwụgwọ mberede.
Ihe na-akpata pancreatic necrosis:
- Alcoholụ mmanya na-aba n’anya n’ụba;
- Iri nri mgbe niile na nri nke abụba na nke e ghere eghe, nri-kalori dị elu, nri na-ekpo ọkụ na nri na-atọ ụtọ.
- Gallstones
- Ọnya afọ na duodenal ọnya afọ;
- Nchịkọta nke nje na-efe efe;
- Surgerywa ahụ n’ime afọ
- Certainnweta ọgwụ ụfọdụ: Azathioprine, Metronidazole, Tetracycline, Isoniazid, Aspirin na salicylates ndị ọzọ;
- Drugsakingụ ọgwụ, karịsịa amphetamine na iopiates;
- Nri nri siri ike;
- Ọrịa mmerụ ahụ.
Ọrịa
Ọtụtụ mgbe, necrosis pancreatic bụ nsogbu nke nnukwu ọrịa ma ọ bụ ọrịa na-adịghị ala ala. Yabụ, ndị ọrịa ahụ butere mbufụt nke pancreas nọ n'ihe ize ndụ pụrụ iche maka ịmalite ọrịa a dị ize ndụ.
Mmebi nke pancreas nwere usoro ato nke mmepe. N’agba nke mbụ, onye ọrịa nwere ahụ ike, nke ọ na - esokarị ị withụbiga mmanya ókè ma ọ bụ drinkingụọ mmanya. Mgbe ahụ, nsogbu ndọkụrịta, ọgbụgbọ, ọgbụgbọ, na ahụ ọkụ na-agbakwunye na ya.
Na ọkwa nke abụọ nke ọrịa ahụ, mgbe enzymes nke anụ ahụ na-emetụta ọnya gland, oke ọkụ na-etolite n'ime ahụ ya na imepụta nnukwu ego ihe. N'oge a, akụkụ anụ ahụ niile nwụrụ anwụ na-etolite na pancreas nke na-akpata mmerụ ahụ.
Agba nke atọ nke ọrịa ahụ na - egosipụta onwe ya n'ụdị ngụgụ necrosis na - ekpuchi akụkụ ahụ niile nke anụ ahụ. N'ime ọkwa a nke ọrịa, usoro mkpali na-agakarị anụ ahụ na akwara ndị gbara ya gburugburu, ọ na-emetụta akwara, duodenum na obere eriri afọ.
Nnukwu ọnya a na-elekwasị anya nwere ike ịkpasu ọtụtụ ọghọm mmadụ, nke bụ ọnọdụ na-egbu egbu ma n'ọtụtụ ọnọdụ na-eduga n'ọnwụ nke onye ọrịa ahụ. Ya mere, ọ dị mkpa ịghọta na pancreatic necrosis bụ ọrịa nke na-etinye ndụ onye ọrịa egwu ma chọọ ịmaliteghachi ngwa ngwa.
Isi ihe mgbaàmà nke mmebi anụ ahụ:
- Ọrịa siri ike na hypochondrium ekpe. Ihe dị ka 50% nke ndị ọrịa na-akọwa ya dị ka nnukwu ihe mgbu na-enweghị ike ịnagide nke enweghị ọgwụ mgbu ọ bụla. Ọ na-enyekarị azụ, ubu, n'akụkụ aka ekpe ya na mpaghara mpaghara obi. Maka nke a, necrosis pancreatic na-enwe mgbagwoju anya na infarction myocardial;
- Vom siri ike na-enweghị enyemaka. Ọ bụrụ na onye ọrịa ahụ ebutela ọnya ọbara arịa na vom, ọbara nwere ike ịdị;
- Ihe ịrịba ama nke ịba ọcha n'anya bụ vomiting nke ọnya afọ, odo na anụahụ na anya ọcha. Site na akwara na-egbu mgbu, mmebi imeju na-apụta, nke nwere ike ibute imeju;
- Ahụ ọkụ, akpata oyi, ahụ ọkụ;
- Nkpachi afọ, nke na - etopụta site na oke mmebi nke sistem;
- Nnukwu bloating na uru ahụ ike nke peritoneum;
- Ọnụ a na-akpọ nkụ siri ike, mbelata nke mmamịrị, akara nke ọdịda akwara enwere ike;
- Mbelata nke ọbara mgbali elu;
- Okpu umeji, mwakpo a na-a suụ a frequentụ ugboro ugboro, nke bụ nsonaazụ nke nnukwu ahụ;
- Formationmepụta ọnya nke agba aja aja na hypochondrium ekpe, ọdịdị nke ọnya dị n'akụkụ aka ekpe na nso otube;
- Mgbagha, nke a na-akọwa site na mmụba na shuga ọbara n'ọtụtụ.
Ọ dị mkpa icheta na necrosis pancreatic nwere ike ọ bụghị naanị na okenye, kamakwa na nwata. Na nwata, ọrịa a nwere ike itolite ngwa ngwa ma bute ọdịda, ya bụ, mbelata ọbara mgbali elu.
Nke a bụ ihe mgbagwoju anya na-egbu ndụ, ihe na-esite na ya bụ oge ezughi oke ume na ọnwụ nke onye ọrịa.
Diagnostics
Nchoputa nke pancreatic necrosis kwesiri ime ngwa ngwa o kwere mee, ebe obu na oria a na nkeji obula di oke onu. Na mgbakwunye na onye na-ahụ maka eriri afọ, dọkịta na-awa ahụ na onye na-atụgharị uche na-ekerekwa na nyocha nke onye ọrịa ahụ, bụ onye na-enyocha ogo ọnọdụ onye ọrịa ahụ ma na-eme ihe niile dị mkpa iji chekwaa ndụ ya.
Ihe kachasị dị mkpa n ’ụzọ nchọpụta niile maka ọrịa a bụ ikpebi ọkwa ọgwụ enzymes dị n’ime ọbara na mmamịrị, ọkachasị, nnwale amylase. Ọ bụrụ na achọtara nnabata nke enzyme a n'ọbara nke mmadụ, nke a na - egosi kpọmkwem mmepe nke necrosis.
Diagnozọ nchọpụta nchọpụta ọzọ dị mkpa bụ nnwale ọbara maka ọnụọgụ ọbara ọcha na ọnụego mbelata erythrocyte. Ọ bụrụ na ndị ngosi ndị a dị elu, nke a na - egosi na ha nwere nnukwu nkụda mmụọ n'ahụ ahụ onye ọrịa.
Na mgbakwunye, ọ bụrụ na a na-enyo enyocha necrosis pancreatic, a na-eziga onye ọrịa ozugbo maka nyocha nke ultrasound (ultrasound), nke na-enye gị ohere iji nyochaa ogo nke ihe mgbu pancreatic, wee hụ njiri ọkụ na-adịghị mma na nhazi nke akụkụ ahụ nke akwara nke necrosis.
N'iji mkpokoro tomography (CT) na onyonyo onyonyo (MRI), ị nwere ike nweta o doo anya nke gland ọrịa nwere karịa ultrasound. Yabụ, a na-ejikarị usoro nchọpụta a iji mata kpọmkwem ọnọdụ nke necrosis anụ ahụ, gụnyere obere nlezianya, yana ịchọpụta mgbasa nke ọrịa ahụ n'akụkụ akụkụ ahụ na akụkụ ahụ.
Angiography bụ usoro nyocha nke ga - enyere gị aka ịchọpụta mebiri obunye ọbara n'ime mpaghara nke akwara na - emetụta oke, yana ikpebi nchụpụ nke akwara ọbara dị oke mkpa, ọkachasị akwara azụ na akwara.
Ọgwụgwọ
Ihe izizi ime ya necrosis bụ inye ezumike zuru ezu. Maka nke a, a machibidoro ndị ọrịa iwu ịrụ ọrụ ọ bụla, na-eri nri ọ andụ andụ na mmiri ọ .ụ anyụ. A na-edozi nri na-edozi ahụ nke onye ọrịa.
Mgbe ọrịa a, a na-eme onye ọrịa ahụ ka ọ na-asa mmiri dị jụụ iji hichaa nsị nri. Nke a ga - enyere gị aka ịkwụsị usoro nri ma belata mmepụta enzymes.
Otu n'ime ọnọdụ kachasị mkpa maka ịgwọ ọrịa akụrụngwa bụ mwepụ nke ihe mgbu. Maka ebumnuche a, a na-eji ụdị ọgwụ mgbu dị iche iche, dị ka analgin, baralgin na amidopyrine, nke a na-enye onye ọrịa ahụ site na ntụtụ.
Ọzọkwa, maka ebumnuche nke ihe mgbu, a na-eji mmiri ntụpọ na ngwakọta glucose-novocaine na 1-2 lita. kwa ụbọchị. Site na mgbu na-anagide, a na-enye onye ọrịa mgbochi novocaine, nke na-ewepụ syndromes mgbu kachasị na-enye gị ohere ịnweta mmetụta analgesic ozugbo.
Iji belata ihe mgbu sitere na akụkụ ahụ metụtara, antispasmodics, dịka ọmụmaatụ, papaverine, nopa, platifillin, ka a na-enye mmadụ. Na mgbakwunye, a na-enye onye ọrịa ọgwụ ọgwụ ọgwụ dịka ọgwụ lasix na furosemide, na-enye aka na ntụrụndụ zuru oke nke okpu akwara.
Ihe dị oke mkpa maka ịgwọ ọrịa a dị njọ bụ iji ọgwụ nje mee ihe, na-alụ ọgụ megide usoro mkpali ma mebie nje bacteria na-eme pyogenic, nke na-abawanye mmebi ahụ. Ọzọkwa, a na-atụ aro onye ọrịa nwere pancreatic necrosis ị drinkụ ọgwụ antihistamines nke na-ewepu ọzịza anụ ahụ ngwa ngwa.
Ọgwụgwọ nke pancreatic necrosis na-agụnye ịwa ahụ mgbe niile, nke a na-eme naanị n'ụbọchị nke ise, mgbe ụlọ ọgwụ gachara n'ụlọ ọgwụ. N'oge a, ndị dọkịta jikwaa ịkwụsị usoro mkpali, gbochie mgbasa nke ọrịa ahụ na mkpụrụ ndụ nwere ike belata ihe egwu nke nsogbu ịmụ nwa.
Mgbe ị na-arụ ọrụ na akwara, ana-ewepụ onye ọrịa ahụ nwụrụ anwụ, akụkụ ahụ akpọnwụwo, anapụ ya nnabata ọbara, na-eweghachikwa ahụkarị enzymes pancreatic. N'ọnọdụ siri ike nke ọrịa ahụ, onye ọrịa ahụ nwere ike ịchọ ọtụtụ usoro ọgwụgwọ.
Ọzọkwa, n'oge a na-agwọ ọrịa pancreatic necrosis, a na-eme usoro ọgwụgwọ dị iche iche nke kwesịrị ịkwalite ọrụ nke akụkụ afọ ma na-echebe onye ọrịa n'ọtụtụ ọdịda ahụ. Usoro ọgwụgwọ niile n'ụlọ ọgwụ nwere ike were ọtụtụ ọnwa.
Ọkachamara na vidiyo dị n'isiokwu a ga-ekwu okwu banyere necrosis pancreatic.
