I ka makahiki 1930, ua hoʻohana mua ʻo Frey me ka trasilol kallikrein inactivator e hoʻomaʻamaʻa pancreatitis maʻa. ʻO ka inhibitor protease hoʻomaʻemaʻe mua ʻia i loaʻa e M. Kunitz a me J. H. Norlrop i ka makahiki 1936 mai nā pancreas o nā holoholona.

He waiwai maʻamau o nā inhibitors (ʻo ka hoʻomākaukau antienzyme) ʻo ia ka hiki ke kāohi i ka hana o nā enzymes proteolytic e ka hoʻokumu ʻana i nā ʻoihana paʻa paʻa me lākou. I kēia manawa, ua paʻi ʻia ma mua o 2,000 mau hana ma luna o ke hoʻohana ʻana i nā hoʻomākaukau antienzyme no ka mālama ʻana i ka pancreatitis maʻa, ʻelua a me ka hoʻokolohua. Eia nō naʻe, ʻaʻohe mea i ʻae ʻia ma ka hopena o ka pathogenetic o kā lākou hoʻohana, kūpono ʻana, nā pali, nā ala o ka hoʻokele. Manaʻo nā mea lapaʻau he nui ka hoʻohana ʻana o nā inhibitors ke hāʻawi i ka hopena, e pili ana i ka mea kūpono no ka hoʻomākaukau ʻana o nā antiferment, ʻoiai me nā koina nui, ʻaʻole i hoʻokaʻawale i ka hana necrotic i ka lula a me ka lailua para-pancreatic. Me nā ʻano edematous o ka pancreatitis, ʻaʻole i hoʻāpono ʻia ka hoʻohana ʻana o ka trasilol a me nā hoʻomākaukau hou antienzyme mai nā lāʻau lapaʻau a mai kahi kūpono pae o ka ʻike. Eia nō naʻe, ʻaʻole pono e haʻalele ʻia ka hoʻohana ʻana o nā inhibitor protease.

Hōʻike ka ʻike i nā kauka home a me nā haole e hoʻōla ʻia ka proteolysis inhibitors i ka hoʻokumu ʻana o ka kinin a me ka autolysis ma ka pale ʻana i ka trypsin, kallikrein, chymotrypsin a me ka plasmin. Kuhi mākou me ke kōkua o nā mea pale i hiki ke hoʻokaʻawale i nā mea maʻi mai ka hoʻomākeʻaka, ka maʻiemia, ka hoʻomaikaʻi ʻana i ke ʻano maʻamau a hoʻoponopono i kekahi mau ʻōhua biochemical. Eia kekahi, ua ʻike ʻia e hoʻomākaukau ʻia ka hoʻomākaukau ʻana o nā aniani i ka esterase, ka proteolytic a me kininogenase hana o ka plasma a me ka pancreatic kallikrein.

Ma hope o ka hoʻoponopono ʻana i kahi hoʻomākaukau antienzyme i ka mea maʻi no 5 mau minuke, kahi ʻano lōkuhi-pale eneini (Werle, 1963). 60 mau minuke ma hope o ka infusion, ua hōʻemi nui ʻia nā mea inhibitor i loko o ke koko, ʻoiai kēia manawa ke loaʻa o nā keiki i ka liʻiliʻi o ka 50% o ka inhibitor i pale ʻia. Hoʻomaʻamaʻa piha ʻia ka enzyme i ka ʻike wale ʻana i ka nui o ka mea pale.

Ua hoʻokolohua ʻia a hiki i ka 98% o nā antienzymes i ke ʻano o kahi paʻakikī o ka hoʻopiʻe ʻia ʻana mai ke kino e nā keiki. Manaʻo ia ka trasilol a me nā mea hoʻohālikelike e hoʻokaʻawale i ka fibrinolysis, hoʻoneʻe i ka hana o kininogenin (kallikrein) i ka huapalapa, hoʻomaʻamaʻa i ka hana metabola kūloko o ka parenchyma kelima, hoʻopili ikaika i ka microcirculation a me ka hoʻokaʻa o ka oxygen o nā kiko, ka hoʻokaʻawale ʻana i ka elastase, chymotrypsin i ka pancreas. ʻO ka hapalua o ke ola o ka trasilol, kontrikal a me nā proteases mai ka koko he 2 mau hola. No laila, pono e lawelawe pinepine ʻia nā hoʻomākaukau antienzyme. Pono nā laha ma waena o nā ʻoihana eʻoi aku ma mua o 3 mau hola, a ʻoi aku ka kiʻekiʻe o ka inactivator e kiʻekiʻe aʻe ma mua o ke kiʻekiʻe o nā enzyme proteolytic. I kēia mea, ke nānā ʻole nei ka hoʻomohala ʻana o ka manawa lōʻihi o nā papa liʻiliʻi o nā inhibitors me ka maikaʻi ʻole. Pono ka hoʻoholo ʻana o kēlā me kēia lā o ka inhibitors i ka mālama ʻana i ka hapalua o ko lākou ola mai ke koko (2 mau hola). ʻO ka nui o nā mākaukau antienzyme e lawe ʻia ma ka lā mua o ka maʻi.

Wahi a kā mākou ʻikepili (Meiat B.C. et al., 1976), e pili ana i kahi loiloi o nā hopena o ka mālama ʻana o nā mea maʻi o 107, ʻo ka puʻuwai a pau o nā hoʻomākaukau antienzyme a i loko o nā pololi nui ʻaʻole i pau ka hoʻomaka ʻana o ka necrosis pancreatic. He mea nui ia e hoʻomaopopo i ka hopena o ka inhibitors ke hoʻoholo e ka nui o ka manawa i hala mai ka hoʻomaka ʻana o ka maʻi a hiki i ka manawa o kā lākou hoʻohana a me ka hopena o ka lāʻau lapaʻau e mālama ʻia ai. Wahi a nā kauka he nui, pono e hoʻolako ʻia nā hoʻomākaukau antienzyme i nā hola 6 i hala mai ka hoʻomaka ʻana o ka maʻi. Loaʻa nā hopena hoʻopiʻi hou aku me ka hoʻopuka o nā inhibitor i ka ʻōpala celiac. Paule B.C. (1983) kono aku i ka hoʻokele fractional o nā hoʻomākaukau antienzyme ma nā hola 3-4-hola.

G.P. Ua loaʻa ʻo Titova (1989) i ka inhibitor ʻo protease i ka pancreatitis hoʻokolohua, ʻaʻole i palena i ka nui o ka luku ʻana i ka puhipuhi a ʻaʻole kāpae i ka maʻi hemorheological kūloko.

Ma nā hana lapaʻau, ʻo ka maʻi o ka inhibitor protease e pili ana nui: Contrical, Trasilol (Germany), Gordox (Hungary), Pantripin (Russia), Tsalol (Italia).

ʻO ka hoʻohālikelike he lāʻau hoʻokaʻawale i ka māmā o nā bipi. Mālama ia i ka hana o trypsin, kallikrein, plasmin. Hoʻohana ʻia ia me ka hana i loko o nā ʻāpana antitrypsin (1 unahi i hana ʻole ʻia 6 μg o trypsin). ʻO kahi pākahi hoʻokahi no ka maʻi pancreatitis mahele he 20,000 mau ʻāpana, i kēlā me kēia lā - 60,000 mau ʻāpana. ʻO ka papa o ka mālamaʻana he 500,000-700,000 hui. Hiki i ka lāʻau lapaʻau ke hoʻohana i ka topically ma ke kāʻei i ka serat parapancreatic.

Loaʻa ʻia ka Trasilol mai nā kumulāʻau hanima o nā holoholona. Hoʻomaʻa ka lāʻau i ka hana o plasmin, kallikrein, trypsin a me nā enzymes proteolytic. Eia kekahi, pili ia i ka trypsin ikaika i nā manawa 4 mauwaliwali ma mua o ka hana a kallikrein. ʻO ka hapa hapalua o kona kaila i loko o ke koko he 150 mau minuke. Hoʻohana ʻia ia ma kahi ʻāpana: 50,000-75,000 mau ʻāpana, ma nā hihia koʻikoʻi - a hiki i 100000 mau ʻāpana, e lawelawe ʻia me ka hoʻololi ma 250-500 ml o 5% hoʻopiko glucose. No ka papa o ka mālama - 400000-500000 hui. ʻO ke papa o ka papa antienzyme maʻamau e hoʻopau i ka lā 7-10th.

ʻO Gordox, e like me ka trasilol, ua loaʻa mai i nā kumulima o nā holoholona ʻalani. E hoʻopili paʻa. E like me ka ʻōmai mua, pono e lawelawe lōlō ʻia nā ʻāpana 500,000, a laila 50,000 mau ʻāpana i kēlā me kēia hola. I nā lā aʻe ma hope o ka holomua, hiki ke hoʻohaʻahaʻa ʻia ka nui o ka lā i ka 300,000-500,000 mau ʻāpana.

Loaʻa ka Pantripin mai ka pancreas o nā holoholona. Hoʻokahi kikowaena o ia e pili ana i 800 IU o trasilol. ʻO kahi mahele o kēlā me kēia lā he 300 mau waihona, ma nā ʻano he nui - a hiki i 400-500 mau ʻāpana i ka manawa.

Loaʻa ka Tsalol mai nā holoholona hānai parotid. ʻO kahi kiko hoʻokahi - 25,000 mau ʻāpana, i kēlā me kēia lā - 50,000 hui. E komo ma ka hoʻopihapiha. ʻO ka papa o ka mālamaʻana he 300000-400000 hui.

Hiki ke hoʻokomo ʻia nā mea pale i loko o ka peke kālaʻa, retroperitoneally i ka wā o ke kaʻina.

Loaʻa nā hopena me ka hoʻohana ʻana i nā mea pale o ka protease. Aia kekahi mau kuhikuhi e pili ana i ka hopena anaphylactic a me ke kino, ke hoʻomohala ʻana o ka thrombophlebitis ma waena o nā veins. Mākaʻi ʻo P. Kyrle (1962) i ka hoʻomohala ʻana o nā pseudocysts a me nā mea hoʻokipa.

Ke koho ʻana i ka mālama antifina no ka poʻe maʻi me ka pancreatitisʻeha, e pono nā mea e pili ana i kēia mau mea: 1) ka noʻonoʻo ʻana i ke ʻano o ka manawa (ʻo ke kaulike ʻana, ka mālama ʻana a mālama ʻia) nā ʻano hana o ka hoʻomehana ʻana (Savelyev BC et al., 1976).

ʻO ka huakaʻi intravenous o ka hoʻokele o ka pale o ka protease, ʻaʻole e ʻae i ke kāohi nui o lākou i ka pancreas. I mea e hoʻomaikaʻi ai i nā hopena hopena o ka B.C. pancreatitis Saveliev (1976), Yu.A. Nesterenko et al. (1978) paipai i ka hana ʻana o ka protease inhibitors intra-aortic a i ʻole ka mea koho catheterization o ka celiac artery e like me Seldinger-Edman. I loko o ka haukapila, ua noi mua kēia ʻano e K.N. Grozinger lāua ʻo Wenz (1965). ʻAʻole kaulana.

B.C. Briskin et al. (1989) hana i ka maʻi intra-aortic ma 92 nā mea maʻi me ka pancreatitis koʻikoʻi. Catheterized pahu celiac a i ʻole mesenteric artery maikaʻi, ʻoi aku ka nui o nā lāʻau maʻamau. ʻO ka hui pū ʻana o ka hui ʻana o nā lāʻau lapaʻau i komo pū ʻia: gelatin, polyglucin, albumin, a me kahi no-spa, papaverine, hana, antibiotics, gordox (600 000-800 000 unahi i ka lā). ʻO ka nui o ka infusion i hilinaʻi ma ka BCC a iā lākou mai 2000 a 3500 ml i kēlā me kēia lā. Inā makemake, kahi nui o nā waiila a me nā lāʻau lapaʻau i mālama ʻia ma ka intravenously. Manaʻo nā mea kākau e hoʻomanee i ka hoʻomālamalama o ke kaʻina hana i ka kiko retroperitoneal e ka hoʻokuʻu ʻia o nā wai a me nā lāʻau lapaʻau i ka manawa like i loko o ʻelua mau lāʻau.

V.P. Grigoriev (1978) no ka hoʻolauna ʻana i ka inhibitors catheterized ka pono gastro-omental gland. ʻO ka pōmaikaʻi o ka hoʻokele hōʻailona o nā protease inhibitors ʻo ia, i ka hoʻohui ʻana i ka hana pololei a ka pancreas, hiki iā ia ke haʻalele i nā kānana kūlohelohe kūlohelohe - nā puʻuwai a me nā māmā.

Ma ka hana pilikino, ʻaʻole i hoʻohana nui ʻia nā inhibitor protease no nā kumu waiwai, a ma muli o ka hiki ʻole o ka pnankis pancreatic. Eia naʻe, me nā toxemia koʻikoʻi, hui pū kekahi me ka cytostatics a me ka protease inhibitors i ʻōlelo ʻia, e hiki ai iā ʻoe ke hoʻopihapiha pono i ke kaʻina hana a me ke kelepona ponoʻī a hoʻowalewale i nā huila o ka lōloʻi i loko o ke koko, nymph, a me nā kiko.

ʻO ka lāʻau lapaʻau pancreatitis

Pono e noʻonoʻo i ka pancreatitis mahele e pili ana i nā kūlana wikiwiki, a e mālama ʻia ana ka mālama ʻana ma kahi hale haukapila ma kahi o nā mea maʻi, i ka hapanui o nā maʻi, e hoʻolōʻihi ʻia ka maʻi e kahi hui ʻokoʻa. I nā hihia koʻikoʻi, aia ka 20-25% o nā maʻi, hiki ke ʻike ʻia kahi ʻano kokoke i ka pīhoihoi hōʻeha o ka ʻōpū, a inā i ʻike nui ʻia ka nui o ka wai ma muli o ka luaʻi, a me ka hypovolemia.

No laila, ʻo nā lāʻau lapaʻau no ka maʻi pancreatitis, ma ka mua, pono e hōʻoluʻolu i ka ʻehaʻeha, hui pū ʻia e ka luaʻi, hoʻopukaʻi, hoʻonui ʻia ʻana o ka puʻukui a me kahi hāʻule o ke kahe koko, a hoʻihoʻi hou i ka pale wai-electrolyte i loko o ke kino. Ua hōʻoluʻolu ʻia ka ʻeha e ka hoʻokele makua o nā analgesics (Novocaine me ka glucose, Analgin, Ketanov) a i ʻole antispasmodics: No-shpa, Papaverine hydrochloride, Platifillin hydroartate, Metacin a i ʻole Ganglefen hydrochloride.

I ka manawa like, ke lawe ʻia nei ka hoʻihoʻi hou ʻana a me ka hoʻokaumaha hemodynamic: e hoʻokomo hou ʻia kahi pahu wai no ka pancreatitis - me ka paʻakai, ka glucose a me nā ʻāpana ʻē aʻe e kākoʻo ana i ka hana o nā ʻōnaehana like ʻole a me nā hui. Syndrome o kahi pane hoʻonā systemic, sepsis a me ka hoʻonanea ʻana o nā mea maʻi i ulu i nā mea maʻi me ka pancreatitis koʻikoʻi ma muli o ka mea i hoʻōla i nā enzyme pancreatic e hoʻokaʻawale i nā membranes o kāna mau kelepona ponoʻī.

No laila, ua hui pū ʻia nā hana mālama koʻikoʻi me ka pale ʻana i ka lāhele pancreatic i hoʻopilikia ʻia a i ʻole ka hakakā ʻana me ka maʻi maʻi kano, a hoʻohana ʻia nā antibiotika i ka gastroenterology e hoʻoponopono ai i kēia pilikia (ʻoi aku ka maʻamau o kēia ʻo Amoxiclav a i ʻole cephalosporins o ka hanauna ʻekolu). ʻO nā hiʻohiʻona o kā lākou hoʻohana i ka gastroenterology pediatric, ʻike - ʻO ka pancreatitis acute i nā keiki

ʻO kekahi hana e ʻoi aku ai i ka hana huna ʻana i nā hana huna o ka hoʻopale i ʻole e kaupalena ʻia ana i kona ukana ka mea e like me ka hiki, akā e pani pū i ka luku ʻole ʻia o nā kelepona, e alakaʻi ana i ka pankreatic necrosis. No kēia, aia kekahi mau lāʻau e pale i ka hoʻopili ʻana o nā enzyme pancreatic. ʻO kā lākou inoa nui:

• ʻAnekinin (kuikui - Kontrikal, Gordoks, Traskolan),
• Octreotide (Octrid, Octretex, Sandostatin, Seraxtal).

Ma ke ʻano he kānāwai, hoʻohana wale nō lākou ʻo ka pancreatitis hoʻonāukiuki i nā pākeke. ^ E Ha yM. Heluhelu hou e pili ana iā lākou ma lalo nei.

Ke ʻano o nā lāʻau lapaʻau no ka maʻi pancreatitis

ʻO ka mea nui nui, ka mea e hui pū ai i ka lāʻau mālama lapaʻau no ka pancreatitis me nā lāʻau lapaʻau, ʻo ia ka hoʻokaʻawale i ka hana hana o ke pancreas, ʻo ia hoʻi, e hōʻemi i ka hana o kāna enzymes. Hōʻike ʻia ka maʻamau o ka huina parenchyma e nā kino o ka proteases synthesized e ia, a ua hoʻomaka ʻia ka pōʻino i loko o nā cell acinar ma hope o ka hana mua o ka intracellular activation o ka digestive enzymes.

I ka hopena maʻamau o ka maʻi, hiki i ka Pirenzepine (Gastrocepin) a i ʻo Profinia bromide (Riabal) hoʻi e hoʻemi i ka hana ʻana o nā enzyme proteolytic. Ua kuhikuhi ʻia kēia mau lāʻau lapaʻau no ka exacerbation o ka pancreatitis: inā mālama ʻia ka mea maʻi, ʻo Pirenzepine ka mea i hoʻohana ʻia i ka makua.

ʻO kahi kūlana o ka nele o nā enzyme pancreatic digestive e pili ana i ka mumū me ka aʻa ʻana a me ka hōʻino ʻana i nā ʻoihana huna o ka pancreas. E uhi e uhi iā ia, ua kuhikuhi ka gastroenterologists e hoʻomākaukau i ka hoʻomākaukau ʻana i nā enzyme e loaʻa ana nā proteases (hoʻokaʻawale i nā protein), amylase (no ka hydrolysis o nā ʻaluna paʻakikī) a me ka lipase (i hiki i ke kino ke komo i nā momona). Hoʻopili kēia ma ka Pancreatin, ka nui o nā inoa kālepa: Pancitrate, Pangrol, Pancreasim, Penzital, Mikrazim, Creon, Mezim, Gastenorm forte, Vestal, Hermitage, a me nā mea hou i ka pancreatitis, nā hōʻailona no ka hoʻohana ʻana o nā enzyme e pili ana i nā pilikia me ka pūnaehana digestive o nā ʻano etiologies, dyspepsia , māʻamaʻu, cystic fibrosis, nā hemahema o ka meaʻai.

I mea e pani ai i ka hana o ka waikila hydrochloric i loko o ka ʻōpū, ka hoʻonui nui ʻana o ka hana e hoʻāla i ka synthesis o ka pancreatic wai, i loko o ka hoʻoponopono ka maʻi pancitisitis ua hoʻolōʻihi ʻia nā lāʻau lapaʻau o ʻekolu mau hui kāmekua:

• antisecretory H2 antihistamines: Ranitidine (Ranigast, Atzilok, Zantak, etc.) a i ʻole Famotidine (Pepsidin, Kvamatel, Gastrosidin),
• nā mea paʻa o ka pūnaehana hydrogen-potassium ATPase (pump proton): Omeprzazol (Omez, Gastrozole, Promez), Rabeprazole a i Lansoprol (Lanzol, Clatinol, etc.),
• antacids me alumini a me nā konupene magnesium - Almagel (Alumag, Gastratsid, Maaloks), ka mea e hōʻemi ai i ka hoʻohuihui ma ka ʻōpū.

ʻO ka hiʻohiʻona o ka hana, ka mea e hoʻokuʻu ai, ke ʻano o ka noi a me nā ʻano a me nā ʻano lāʻau lapaʻau like ʻole o nā lāʻau lapaʻau o kēia mau hui ʻekolu i wehewehe pono ʻia i ka mahele - ʻO nā ʻōpū ulkine ʻōpū

E pili ana i nā mea e pono ai nā lāʻau lapaʻau no ka pancreatitis i nā keiki, a e pili ana i nā hiʻohiʻona o kā lākou hoʻohana i ka wā kamaliʻi, e heluhelu i ka paʻi - Ka hoʻomaʻamaʻa ʻana o ka pancreatitis kūloko

A ʻo nā lāʻau lapaʻau no ka maʻi pancreatitis, ka mea e pale ai i ka hana ʻana o nā enzyme pancreatic (Aprotinin, Octreotide, Pirenzepine, Prifiny bromide) a hana i kā lākou nāwaliwali i kū mai ma hope (Pancreatin), i kūkākūkā ma nā kikoʻī ma lalo nei.

ʻO ka hoʻohanaʻana i ka inhibitor protease no ka mālamaʻana o pancreas

I ka pancreatitis, ʻo ka hoʻolaʻaʻana o nā proteases e alakaʻi i ka maʻi o ke kino a me ka hoʻomohala ʻana o nā pūnaewele necrotic.

I mea e pale ai i nā kaʻina holokeʻo, ua kuhikuhi ka poʻe loea i nā Contrical, Trasilol, Gordoks a me Antagozan. ʻO ka hoʻohana ʻana i kēia mau lāʻau lapaʻau no ka hoʻokō intravenous mea nui loa i ka lā mua o ke pancreatitis akamai.

Nā ʻano o Enzymes pancreatic

ʻO ka hana nui o ka pancreas ke hana i ka hana endocrine (i loko) a me nā exocrine (waho). Hoʻokomo ka hana Endocrine i ka hana o nā hormone - insulin, e hoʻohaʻahaʻa i ka glucose, a me ka glucagon, kahi i hāʻawi aku i ka hoʻohemo o ka glucose i loko o ka ate.

ʻO ka hana exocrine o ka pancreas e hana i nā enzyme kūikawā (enzymes) no ka hoʻihoʻi ʻana i ka meaʻai. Pono e hoʻokaʻawale i nā pūʻulu - lipolytic, amylolytic a me proteolytic enzim. E noʻonoʻo pono i kā mākou kikoʻī o kēlā me kēia mahele.

Nā ʻōmaʻomaʻo lipolytic. No kēia hui ke kuleana no ka ʻoki ʻana i nā momona i nā momona momona a me nā glycerol. ʻO Prolipase kahi enzyme lipase kaheʻe ʻole, i ka wā e komo ai i ka duodenum, hui pū me ka colipase.

Hoʻohana ʻia ka lipase me ka nui o nā paʻakai bile a me ka trypsin. Hoʻomoeʻia ka hoʻopauʻana o nā māhele lipolytic i nā hola 7-14. Kuhi ka glomeruli Renal no kā lākou kānana: hoʻolaha lākou i ka hoʻopili ʻana o ka lipase i ka hoʻopili ʻana o nā mea kiko, no laila ʻaʻole i loaʻa ka hapa o nā māhele lipolytic i ka urine. Hoʻololi ʻia nā mea like like me ka lipase e ka ʻāʻī, nā ʻōpū a me nā ʻāpana.

Nā ʻōmole Amylolytic. Nui nā ʻanoʻokoʻa - alpha, beta a me gamma amylase.Ua kapa ʻia kēia ʻano o nā enzyme i ke ʻano aliʻi. I loko o ke kaʻina hana ʻana, hoʻopili wale ʻia ʻo alpha-amylase.

Hoʻokuʻu ʻia kekahi i nā mea liʻiliʻi na nā kalepona salivary, ʻoi loa ke kipi ʻana i ka meaʻai. No laila, hoʻomaʻamaʻa mākou i kahi momona maikaʻi i ka wā e aʻamu nei i nā meaʻai starchy - laʻa a i ʻole a kalupona paha. Mahalo i amylase, ke kaʻina o ka assimilation o ke kō a me nā mea paʻakikī ʻē aʻe e lilo i maʻalahi.

Nā kinipōpō protein. ʻO ka hana nui o kēia hui ka wāwahi ʻana i nā protein. Hoʻopuka ka huina protein protein i ka uha o ka waikawa amino paʻa i loko o nā peptides a me nā protein. ʻElua ʻanoʻokoʻa o ka protease ma ka wai pancreatic:

1. ʻO Peptidase, a i ʻole exopeptidase, kuleana no ka hydrolysis o nā pulu koʻo o nā peptides.
2. ʻO ka protein, a i ʻole endopeptidase e wāwahi i ka hoʻohui kino o nā peptides.

No laila, lipase, amylase a me ka protease ka hua ʻana i ka wai pancreatic, kahi, i ka wā e komo ana i ka duodenum, e wāwahi ana i nā molekui meaʻai paʻakikī i loko o nā mea maʻalahi maʻalahi.

Nā kumu a me nā hōʻailona o ka pancreatitis

I loko o kahi kanaka olakino, hoʻōla ʻia ka hoʻonaninani o nā enzyme pancreatic i ka duodenum.

Inā he hana ia o ka amylase, hoʻomaka ka protease a me ka lipase i ka pancreas ponoʻī, hiki iā mākou ke kamaʻilio e pili ana i ka hāʻule ʻole o ka huelo.

Hoʻomaopopo ka pancreatitis me kahi paʻakikī o nā syndromes a me nā maʻi i hoʻopiʻi ʻia me ka hoʻōla o nā huina i loko o ka palaki, ka mea e alakaʻi ai i ke kaʻina o ka "pale kūʻokoʻa". I ka hopena, ʻaʻole lākou e komo i ka duodenum, a hoʻopau ʻia ka hoʻoneʻe ʻana.

Aia kekahi mau kumu e alakaʻi ai i kēlā ʻano hanana lolo.

• ka inu pinepine ana
• nele i ka hahai ʻana i ka meaʻai kūpono,
• ka nui o ka ai ole i ka ai a me ka momona.
• kaʻai ʻana i ka meaʻai maikaʻi loa ma hope o ka ʻai nui a i ka hoʻokē ʻai ʻana paha.
• lawe ʻole i ka lāʻau i loko o kekahi mau lāʻau lapaʻau
• nā hana hōʻoweliweli ʻoihana
• kalaka o kahi ʻano maʻi.

Me ka hoʻōlaʻana o nā huina i ka pancreas, kū ka huhū: ua nui ka nui, a loaʻa nā wahi necrotic. ʻAʻole hiki ke ʻano he ʻano no ka manawa like me ka manawa, aia kekahi hewaʻole o ke keʻakeʻa gastrointestinal.

Me ka nele o nā enzyme pancreatic i loko o ka duodenum a me ka mumū o nā pancreas, ʻike ʻia nā hōʻailona like ʻole:

1. ʻEha i ka hypochondrium hema, pinepine kahi ʻano shingles.
2. ʻO ka hōʻemi nui loa i ka maʻi kīnā, ka maʻi maʻamau a me ka nāwaliwali.
3. ʻO ka maʻi Dyspeptic - bloating, nausea a luaʻi paha, nele i ka makemake, ka lāʻau staired.

Hiki i nā ʻōmole o ke maʻi ke ʻano ma muli o ka nele o kekahi hāmeʻa:

• ʻO ka hapa nui o Amylase e alakaʻi i ka maʻi puhaka, ka nui o ka hōʻemi, ka nui o ke kaumaha. Loaʻa nā mīkī me ka waiū, ʻaila unigested o ka meaʻai ma loko.
• ʻAʻole ka hapa o ka lipase e wāwahi i nā momona nā kumu o ka steatorrhea - hoʻonui nui i ka nui o ka momona i ka papa. Me ka pancreatitis, lilo ka ʻeleʻele a i ʻole ʻulaʻula, ua ʻike ʻia kahi māla o ka lemus i loko o lākou.
• Me ka nele o protease, loaʻa nā ʻōmole protein kalaiwa loa i nā moena. ʻO kahi hiʻohiʻona maʻamau ka hoʻomohalaʻana i ka anemia.

Inā ʻike kekahi i kēlā mau ʻōuli, pono ʻo ia e ʻimi i ke kōkua olakino i ka hiki ke hiki. E kuhikuhi ke kauka i nā hana o nā hoʻokolohua a me nā pono kūpono.

Nā mea hoʻomaʻi Enzyme pancreatic maoli

Hoʻopuka wale ke kino i nā mea enzymatic i komo i ka hoʻopau ʻana o nā molekō paʻakikī, akā ke pale pū kekahi i ka mea paʻa pancreatic, i.e. nā mea e pale ai i ka hoʻoulu ʻana o ka wai pancreatic.

Hoʻopili ka poli o ka maikaʻi ma ka pancreatic polypeptide (PPP), YY peptide, somatostatin, pancreatic glucagon, pancreastatin a me neuropeptides.

ʻO nā mokupuni o Langerhans, i loaʻa nui loa ma ka huelo o ka pancreas, e hoʻoulu ai i kahi hormone kūikawā, ʻo PPP, ka mea e kāohi ana i ka hana o ka pancreatic wai, nā enzyme a me nā bicarbonates. Mālama pū kekahi i ka hana o acetylcholine.

Hoʻonui ʻia ka mea huna o ka PPP i kēlā mau kūlana:

1. me ka mea noʻonoʻo e ʻai nei a i ʻole ka ʻai ʻana i ka meaʻai.
2. ma hope o ka hoʻoulu ʻana o ka nerve vagus,
3. me ka hoʻoliʻiliʻi o duodenal,
4. i ka wā e kū ai i ka gastrin a me ka gastrin-hoʻokuʻu i ka peptide,
5. i ka wā e hōʻike aku ai i ka pilikino, cholecystokinin a me VIP.

Hoʻopuka ka distum ileum a me kahi ākea i ka peptide YY i ka wā e komo nā momona i ka ʻalihi. Kōkua kēia peptide i ka hoʻēmi ʻana i ka hiki o ka kelepona i nā hopena o ka cholecystokinin a me nā mea huna.

ʻO nā cell pancreatic D a me ka membrane mucous o ka digestive tract e loaʻa ana i ka somatostatin. Hoʻopili kēia hormonale i ka hana o nā enzyme a me nā bicarbonates. Hoʻokomo ka pūnaehana autonomic i ka hana o somatostatin, ma hope koke iho mai nā momona a me nā waikawa amino mai ka meaʻai.

ʻO nā inhibitoratic pancreatic kekahi e hōʻike ʻia e nā hormones like:

• ʻO ka glucagon pancreatic, kahi e kāpae ai i nā hana o nā wai, nā bicarbonates a me nā enzymes.
• ʻO Pancreastatin, ke kāohi nei i ka hoʻokuʻu ʻana o ka acetylcholine. Hana ʻia ia ma nā hopena efferent o ka wahī waha.
• ʻO ka neuropeptides, ka mea i loaʻa i ka peptide e pili ana i ka calcitonin (hoʻoulu i kahi somatostatin) a me nā enkephalins (e hōʻemi i ka hana o acetylcholine).

Me nā hana ʻino i loko o ka hoʻopīpī, hiki ke hoʻokaʻawale nā ​​mea huna o ka pancreatic enzyme no laila, no laila pono ʻoe e lawe i ka lāʻau lapaʻau.

Nā lula o ka mālamaʻana no ka maʻi pancreatitis

ʻO nā mea nui ʻelua o ka mālama ola no ka maʻi maʻi he meaʻai a me ka lāʻau lapaʻau. Hoʻokumu ʻia ka regimen lapaʻa pilikino e pili ana i ka nui o ka maʻi a me ka hana ʻino i ka pancreas.

Hoʻokumu ʻia ka meaʻai kūikawā no ka pancreatitis ma ka meaʻai No. 5 e like me ka Pevzner. Hoʻopau i ka hoʻohana nui ʻana i nā mea momona a me nā momona, a ke manaʻo nei nō hoʻi e ʻai i ka ʻai o ka protein.

Me ka hoʻomaka ʻana o ka pancreatitis kūlohelohe, ua hoʻokaʻawale ʻia nā lā 3-4 o ka hoʻokē ʻai. I kēia manawa, pono ʻoe e hōʻole loa i ka ʻai a inu i nā wai hoʻoluʻu mahana, no ka laʻana, ʻo Borjomi.

Ma hope o ka pololi me ka pancreatitis, ua hoʻokomo ʻia nā meaʻai i ka mālama ʻana i loko o ka meaʻai i lawe ʻole i ke kaomi ʻana o ka digestive. ʻO nā mea maʻi me ka pancreatitis e ʻae ʻia e hoʻohana:

• ka mea ʻai i nā ʻiʻo a me ka iʻa,
• mau mea ʻupena a inaina ʻia i ka mauʻu,
• berena o inehinei
• skim dairy huahana,
• nā huaʻai nui, nā mea kanu a me ka lau,
• nā mea ʻiʻī i hoʻolapalapa ʻia i ka wai a i ʻole momona momona.
• hua moa ma ka nui o ka nui,
• rosehip hupa, meli a iʻa paha (palena).

Me ka hoʻonāukiuki o ka pancreas, pono ia e hōʻole i ka meaʻai e hoʻonāukiuki i ke kaʻina hana ʻana:

1. Nā huahana Chocolate, nā pastries, nā kuki.
2. Nāʻaina hou.
3. Nā meaʻai iʻaʻa.
4. Mālama, puaa i nā ʻoli a me nā pickles.
5. ʻO ka mea momona a me ka iʻa.
6. ʻO nā huahana momona.
7. Nā meaʻai ʻona.
8. Nā kuʻuna.
9. ʻO nā mau momona.
10. Nui ka nui o nāʻano.
11. Kālā ikaika a me ke kofe.
12. Nā huahana Sausage.
13. ʻO ka ʻōpala a me nā kamato.

Me ka exacerbation o ka pancreatitis maʻamau, pono ia e hoʻomau i nā hoʻomaha hoʻomaha o kahi moe.

ʻO ka lāʻau lapaʻau no ka pancreas e pili ana i ka hoʻohana ʻana o:

• hoʻoweliweli enzyme e hōʻemi i ka hoʻōla o ka protere pancreatic (proteinases),
• nā mea maʻi aʻole e pale aku i nā kaʻina maʻi o ka ʻōpū o ka ʻōpū, ka hoʻomaʻemaʻe ʻana o ka ʻōpū omental bursa, ka hoʻomohala ʻana o ka necrosis pancreatic a me ka ʻololi cellulitis cellulose o ka wahi ma hope o ka peritoneum.
• H2 blockers e hōʻemi i ka hana o ka waikila hydrochloric,
• antacids e hooliui i ka acid hydrochloric i loko o nā loko,
• antispasmodics no ka hōʻoia ʻana o nā ʻūlani palupalu e pili ana i ka hana sphincter impaired i ka papa pancreatic,
• nā lāʻau anticholinergic e pale ai i nā kaʻina maʻamau i loko o ka ganglia a me ka cortex cerebral,

Hoʻopili, e hoʻohana ʻia nā mea hoʻomehana enzymatic i ka hoʻomaikaʻi ʻana i ke kaʻina hana a kāpae i ka maʻi dyspeptic.

ʻO nā lāʻau kūpono

I ka lā mua o ka hoʻonāukiuki o ka ʻano maʻamau, ʻo ka hoʻohana ʻana i nā mea pale o ka protease no ka mālama ʻana o ka pancreatitis. Ke hoʻopau nei kēia mau lāʻau i ke kumu o ka puka ʻana o ka foci me ka hoʻolaha o nā pūnaewele necrotic.

Loaʻa nā lāʻau lapaʻau mai ka parenchyma pulmonary a me nā pancreas pipi.

Ma lalo aʻe nā mea e hoʻohana pono ai ka lāʻau lapaʻau, ʻo ka nui o nā maʻi i hoʻoholo ʻia e kēlā me kēia e ke kauka. ʻAʻole lākou i loaʻa i ke ʻano o nā papa, akā ma ke ʻano o ka noʻonoʻo a me ka lyophilisate no ka infusion.

Hoʻomaopopo ʻia ka mālamaʻana o ka pancreatitis me nā mea paʻa me ka hoʻokele intravenous ma kahi kūlana wale nō. Eia kekahi, pono e mālama pono ke kahu a me ke kauka i ke ʻano o ka mea maʻi. Diet No. 5, ʻo ia ka mea i hui pū me ka lāʻau lapaʻau e pono e hōʻako i ka hoʻōla ʻana o ka mea maʻi me ke hoʻopiʻi ʻole ʻia, pono hoʻi e mālama pono.

Pehea e mālama ai i nā poʻe loea pancreatitis e haʻi i ka wikiō ma kēia ʻatikala.