ʻO nā hopena o ka pancreatitisʻeha, pancreatitis kūloko

ʻO nā ʻōmua mua o nā pancreatitis kūlohelohe (ka huhū, hemahema, retroperitoneal phlegmon, fistulas, cysts, psychosis, mediastinitis): hana, mālama.

ʻO ka pancreatitis acute kahi maʻi ma muli o ke kaʻina hana o ka necrotic a me nā kumu hana autolytic. Pancatanitis Patan а / Pancreas edema - kaheʻe ʻana, i hoʻonui ai i ka nui, ka huhū, ka mucus i ka wai, edematous interstitial tissue, hyperemia, hoʻoneʻe o ka acini. B / Hemorrhagic pancreatitis - nā mea āpau me ka edema + koko i loko o nā moku + necrosis o ka wahi interstitial i loko o ka ʻōpū hemorrhage, cell infiltrates ma ka palena o ka hemorrhages. c / Pūkuhīpiki Purulent - neutrophils, hope scarring, m. hoʻohanu. g / Necrotic pancreatitis - hoʻololi i ka necrotic i loko o ke kelepona holoʻokoʻa a ʻāpana paha.

ʻO nā hoʻololi i loko o ka maʻi pancreatitis kūlohelohe - hele aku ke kaniʻana i ka huhū, ka mea e pili ana i ka huhū o ka ʻōpū, ka make o nā sela parenchymal, endarteritis, ʻāwīwī a me ka lawe ʻana i ka lumen o nā kumulāʻau, kahi ʻōpala hoʻomohala, hōʻeha. Kahi helu: papa haʻawina: ʻeha (edema, hemorrhagic, necrosis pancreatic, purulent), ʻokoʻa (lūlū i nā manu ʻole, hoʻomaha, ʻeha, pseudotumorosis), pancreatitis cholecystic (koʻikoʻi, hoʻoheleheʻe, hoʻihoʻi-free). Hiki ke hanana me ka predominance o cholecystitis, pancreatitis. ʻEnologi: nā maʻi ʻeha, nā hōʻeha, nā trauma, nā maʻi o ka ʻōpū, nā maʻi o ka ʻōpū a me ka duodenum, nā meaʻai ʻai, ka ʻai ʻana, ka inu ʻona, nā hormone. Nā kumu pilina: ke ʻano, ka wahine, nā loli vascular, piha piha, kūloko, hoʻāʻo hou ʻana. Nā pathogenesis: ʻĀpanaHaumaka (koko, lymph, etc.). 2. ʻeha hōʻeha i nā hōʻeha o ka pancreatitis 30:30% o ka pancreatitis luku. Mālama ʻia ka hao e ka hui hoʻohui -> hōʻiliʻili ʻia -> XP. lōkohu

ʻO ka hoʻopiʻi o ka hopena o ka pancreatitis maʻa (maʻi pancreatitis, cysts, fistulas, diabetes mellitus, ʻiliʻī o ka duodenum 12).

KĀLOHE PANCREATITIS: kahi maʻi i hoʻokumu ʻia ma kahi ʻano degenerative i loko o ka hua glandular, ka hopena o ka sclerosis o ka organ parenchyma me ka nalowale o ka mea hoʻopuka exogenous a me ka endogenous. ʻO ka pancreatitis acute kahi hana luku. ʻO nā ʻōmua mua e pili ana i ka maʻi pancreatitis ma mua: 1. Bleeding. 2. Retroperitoneal phlegmon. 3. Fistulas (waho, loko). 4. Cysts (ʻoiaʻiʻo - i kona iho ponoʻī, ua hoʻopaʻa ʻia nā paia o loko me ka epithelium. Pololei - ʻaʻohe hona maoli, palena ʻole i nā ʻōpū kokoke. 5. Pleurisy 6. Mediastenitis. 7. Polokalamu maʻi. ʻO ka hopena o ka hopena o ka maʻi pancreatitis: 1.X. lōkohu 2. Cysts (pinepine ʻoiaʻiʻo) 3. Nā mea loloa (ʻaʻole luhi, akā ʻike ʻia) 4. Diabetes mellitus 5. Narrowing 12per. ʻiliʻili. Kahi papa papaʻa ʻana o ka maʻi pancreatitis (e like me ke aʻo ʻana i nā kauka) 1. ʻ -wīwīwīwī (latent), 2. Pain. 3. Hōʻike hou. 4. Pseudotumor aiʻole jaundice. 5. Cholecystopancreatitisitis. EʻIOLIʻI ʻ .lelo paukuhi: 1. Ke hoʻololi ʻana i ka maʻi kūloko i ka maʻi; a w. luhi, 3. maʻi ʻeha (hepatitis F, ate cirrhosis) 4. Nā maʻi o ka ʻōpū a me ka 12 p. KOLIKAI paukuhi: 1. I ka wā i hala o ka hoʻouka ʻana o ka maʻi pancreatitis maʻa. 2. Ke kahe ʻana o nā maʻi zh.p. zh.bubble, ʻōpū, 12 p.p. me ke ʻano o ka herpes zoster. 3. ʻohi a pale paha paha a i ʻole ʻeha e hōʻeha i ka epigastrium, ʻoi aku ka hema. 4. Radiation ʻeha no ka sternum, ma ka ʻākau a i ʻole hema paha, kelepaʻi wai. 5. Ka ʻeha ma ka palpation o ka pancreas. 6. Ka ʻeha ma ka kihi hema-vertebral kihi (hōʻailona Mayo-Robson). ʻO 7.Frenicus kahi hōʻailona.8. ʻO ka hui pūʻana o nā hōʻailona o ka pancreatitis me ka metabolism kila. 9. ʻO ka maʻi Dyspeptic (nausea, salivation, flatulence). 10. ʻO ka pohō kaumaha, lethargy, asthenia. 11. ʻO ke kūpaʻa i nā maʻi maʻi. Manaʻo noiʻi kūikawā: 1. Echolocation. 2.Computerogram. NA MANAU O KEKAHI IHE OANA 1. Conservative: a) perirenal novocaine blockade, b) polyglucin, reopoliglyukin, antienzymes, novocaine, plasma, koko, AK, c) ʻai kaiʻai (N 5), d) atomin 1t 3 mau lā i ka lā no 7-10 lā, nerobol 1t 2 mau manawa i ka lā lā 15 lā, retabolil 1t 2 mau manawa i ka hebedoma, e) pancreatin, methionine, lipolcain, festal, e) analgesia: papaverine, no-spa antispasmodic myotropic hana, baralgin, promedol, g) hoʻoili ʻana i ka hopena paʻakai me nā mea ʻai: h) X-ray therapy (UHF) therapy no ka laʻana o ka solar plexus, a me ka mālama ʻana i ka spa (Zheleznovodsk, Esntuki, Truskavets) 2. Hana. Hōʻike: - ka hana o ka mālama conservative (ma hope o kekahi mau mahina), - nā cysts o ka pancreas, fistula (waho), obstructive (mechanical) jaundice, - pseudotumor pancreatitis, - nā pōhaku pancreas. Kahi ʻano hana: A. Kaila Pancreatic: haki amputation mai ka hope, puka mai ka waena. - Hoʻomili ka Pancreato-duodenal, - Pancreatectomy, - anastomosis cervical, - Pancreato-intestinal anastomosis, int. a nar. pancreatic cyst, -Marsulinization - puka kaulike ma waho o kahi pū hala ʻole, B. Hoʻohana ma ka ʻōnaehana biliary. - ka cholecystectomy, - anastomosis biodigestive, - ʻike maka wai hiki ke kahe o ke ala, - ka ʻōpū ma luna o ka ʻōpū a me ka ʻoli i ke kaua, - gastroenteroanastomosis, - ka haʻalele ʻana o ka ʻōpū, - duodenojejunoanastomosis. B. Ka hana ma ka mea kanu NS: - ka haʻalele ʻana o ka ʻĀpela solar; - marginal neurotomy, etc. G. Fistula hoʻopiha.

Pancreatitis Kānia: wehewehe o kahi manaʻo, kumu.

ʻO ka maʻi ka hopena o ka maʻi pancreatitis a i ʻole

ulu ka hoʻomaka, hoʻomaka i kahi papa maʻi.

ʻO ka ʻieʻala: nā kumu o ke pancreatitis mau maʻi he mau maʻi o ka ʻōpū,

duodenum, ate, polohi a me ka biliary tract, i.e.

nā hui me nā pili anatomical a me nā hana pili me ka pancreas

nā kīnāʻai a me nā loli i ka momona metabolism (mau lawehala i ka meaʻai,

inu wai), ke huʻeha a me nā maʻi, ke ʻano, ka ʻoluʻolu ʻana, ka ʻono ʻana, ka hoʻololi

i ka ʻōnaehana kumukanawai o ka pancreas (nā ʻōpū mua, nā ʻoihana paʻa.

excretory duct epithelium metaplasia), nā hōʻeha pancreatic i pani.

ʻO ka pathogenesis: nui ka maʻi pancreatitis me nā pathogenesis o nā huaʻala

lōkohu. ʻO ka pilina o ka maʻi e alakaʻi i ka komo ʻana o nā mea hou a pau

nā keʻena o ka pancreas, kahi i hala ke kumu no ka hoʻololi ʻana o kahi hana

parenchyma o ka ʻili hoʻohui huina e alakaʻi ai i nā loli sclerotic i loko

ductal ʻōnaehana o ka gland a ma ka paravasal kiko kikoʻī.

Koi a pathological: hele a proliferation ma ka pancreatic tissue

hoʻopili pili, ka hopena ma ka fibrosis a me ka sclerosis. Ka mea hope loa

hiki ke lilo i peri- a i ka intralobular, i hui pū ʻia me ka atrophy like ʻole

nā kelepona pili. Ma muli o ka hoʻonui nui ʻana o ka hoʻopili pilina hao

compacted a pinepine pinepine i loko o ka leo. ʻO ka microscopically like me

kiko fibrosis, kāna infiltration inflammatory, lipomatosis,

nā loli ʻeha i nā paia o nā papa. I kekahi manawa pāhuahua

nā cysts liʻiliʻi i hana ʻia ma muli o ka nalowale o ka lumen o nā kiʻi, nā waihona waiwai

māke o ka calcium i loko o nā koina kūlala (kalima pancreatitis).

ʻO kēia ka hopena maʻi a me nā anatomical o ka pancreatitis maʻi i hoʻokaʻawale: 1)

pancreatitis induktus maʻi, 2) pseudotumor pancreatitis, 3)

ʻO ka pancreitis pseudocystic (maʻi pancreatitis me ka hopena o ka cyst), 4)

pancreatitis calculous pilikia (virgolithiasis, calcifying

ʻO ka clacy o pancreatitis kūpaʻa e hilinaʻi ana i ka papa maʻi (hōʻehaʻeha, hōʻeha, hoʻomohala, atrophic, pseudotumorous, cholecystopancreatitis).

K-k, q-k o ka pancreatitis mau pilikia.

ʻO ka maʻi maʻi a me ka maʻi maʻi: nā hōʻailona nui o ka hōʻeha, nā maʻi dyspeptic,

jaundice, hoʻemi kaumaha, ʻeha ma ka wahi o ka epigastric a me ka piʻi pinepine

Nā pancreas i ʻike ʻia e ka palpation.

Hiki i ke ʻeha ke kānana a ʻāwili i ka ʻāina epigastric,

ʻO ka ʻoka a me ka hema hema a ka hypochondria, mau kaʻi like me ke kāʻei, e kū mai ana

kua hoʻi, i ka ʻāina interscapular, pololei hypochondrium. E hoʻomau mau paha ka ʻeha

a i ʻole paroxysmal. ʻO nā hōʻeha o ka hōʻeha ʻana mai nā hola he hiki i 4-6 mau lā.

Hoʻopiʻi pinepine pinepine i nā hewa i ka papaʻai.

ʻO nā maʻi Dyspeptic - hoʻokuʻi, ka luaʻi, ka salivation, kahi paʻa ʻole

(alternating constipation me ke ʻōpū) - he mau paʻa paha a i ʻole he manawa wale nō ka manawa

ʻO Jaundice, ʻili a me ka sclera e nānā i ka hapalua o nā mea maʻi. Hiki iā lākou

e hui a mau loa. Uha huakini in

ka hapa nui o nā poʻe maʻi e hui pū ʻia me kahi acholia, ʻo ia ka hopena o ka humu o ke poʻo

pancreas, hoʻomoʻi ʻia o ka dile bile ma muli o ka inductive

kaʻina ma ka ʻōkuhi, nā cicatricial a me ke hoʻololi ʻana i nā kinipō i nā papa a me ka sphincter

ʻO Oddi, nā pōhaku i ka nui o ka papilla duodenal nui.

ʻOi ka lilo ʻana o ke kaumaha i kekahi manawa a kiʻekiʻe. ʻO nā kumu o ka hoʻonāukiuki:

ka lawa ʻole ʻana a me ka lako o nā enzyme pancreatic i

ʻO ka luodenum, nā pilikia i ke koho ʻana i kahi meaʻai, makaʻu i nā mea maʻi e lawe

ka ʻai ma muli o ke kaumaha. I nā maʻi he nui, ua ʻā mai nā hōʻeha o ka ʻeha ma hope o ka lawe ʻana

he wahi liʻiliʻi o nā meaʻai wai e loaʻa ai nā waiwai sokogonnymi.

Hōʻike pinepine kahi loiloi i ka manawa o ka exacerbation mau hōʻailona,

ʻanoʻano maʻamau o ka pancreatitis maʻa. I loko o ka manawa hakakā, i kaha pinepine ʻia

modeness soreness ma ka pancreas. I nā poʻe maʻi maʻa, mau manawa

hiki iā ʻoe ke pāpaʻi i kahi pancreas i hoʻonui ʻia.

Pono e nānā ʻia ka mea maʻi ma kahi kūlana a me kahi lālā i waiho ʻia ma lalo o ke kua

kūlana ma ka ʻaoʻao ʻākau me ka torso i kāʻili ʻia anteriorly e 45 °, e kū ana me ke kāʻei

kalaki - mua i ka hema. Me nā pseudotumor e hele mai ana me ka jaundice,

ʻIke ʻia ka Courvoisier syndrome i kekahi mau manawa, hōʻike ʻia e ka triad o nā hōʻailona:

jaundice obstructive, hoʻonuiʻia a me ke kaumaha ʻole o ka ʻili, hoʻopuka, kahi acholia.

Hoʻokumu ʻia ka maʻi pākuhi o nā maʻi pancreatitis i kumuhana a

ʻōmaʻomaʻi ʻōmaʻomaʻo o nā maʻi, ka ʻikepili mai nā hoʻokolohua o ka lab

nā hopena o nā ʻano noiʻi kūikawā. Me nā exacerbations o ke kaʻina ma

ka pancreas a me ka pilikia ʻana i ka puka ʻana o ka wai o pancreatic i loko o ke koko a me ka ʻili

hoʻonui pinepine ʻia nā mea o nā enzyme pankreatic - diastases, trypsin,

nā lehelehe. I loko o ka manawa i waena, he mea maʻamau. Ke ʻano nui o nā mea nui a pau

nā kaomi o ka lesion i nā manaʻo duodenal, ma ke ʻano, ua hoʻemi ʻia,

nā maʻi kūʻokoʻa, holoʻokoʻa lākou.

Hōʻike ka hoʻokolokolo Coprological i ka heleʻana o kekahi helu nui

nā puʻuwai hoʻonaninani (unsorrent) a me kahi hāʻule o ka momona momona

A pili me ke komo i ke kaʻina hana o ka islet appite, ʻike ʻia nā kuli

ka hyperglycemia a me ka loli o ka pihi meli maʻamau ma lalo o ke kumu o pālua

Me ka fluoroscopy panoramic o ka ʻōpū o ka ʻōpū, e hoʻoholo ʻia nā hoʻololi ʻia e kekahi mau manawa

ke ala o ka pancreas. Me ka hoʻokolokolo x-ray

duodenum i nā kūlana o kāna hypotension ("paralytic"

hiki i ka duodenography) ke ʻike i nā hōʻailona hema ʻole o ka maʻi pancreatitis:

loop i hamama ("hōihoʻi wāwae") o ka duodenum, manaʻo a hema paha

ke hoʻopiha nei i nā kumulāʻau o loko o kona ʻōpū e iho ana, e hoʻololi ana i ka hoʻomaha o nā pā

hina membrane ma ka wahi o ka papaleu duodenal a me ka deformation

ʻO ka ultrasound a me ka compute tomography e ʻae ai no ka maʻi mau

ʻO ka pancreatitis e ʻike ai i kahi hoʻonui i loko o ke kelepona a i ʻole wale ke poʻo

(pseudotumor pancreatitis), loli cystic i ka mānoanoa o ka nui o ke kīpē. He helu

mau hihia echostructures e kū ma ka ʻākau a me ka hema

ka ʻai ʻeke ma ka pae II - III o ka vertebrae lumbar, paʻa i ka ʻike o ka

ka lumen o ka epa o nā pōhaku a i nā calinates i ka mānoanoa o ka parenchyma o ka hoʻopiha.

Hōʻike nā radioisotope scan: scintigraphic depletion

ma muli o ke ʻano o ka ʻōnaehana sclerotic, defects i ka ʻohi ʻana o ka isotope, kahi

Hōʻike i kā lākou loli cystic a i ʻole ka helu ʻana o ka parenchyma

Hiki i ka Retrograde pancreatography ke ʻike i nā hōʻailona hōʻailona

ka maʻi pancreatitis: deformation o ke kumu nui a i ʻole nā kaupalena ʻē aʻe, ʻiliʻī

nā mea āpau, e hoʻopiha ana i nā hemahema ma ke kumu o ke kūkaʻi o nā pōhaku.

Hoʻomaka Angiographic (celiac a me mesentericography) i nā wā mua

hōʻike ʻo ka pancreatitis maʻi i nā wahi o ka hypervascularization, a ma hope aʻe

nā ʻōpio ma muli o nā fibrosis diffuse e hōʻemi ana i ka vascular

hoʻohālike, nā hoʻololi i kona neʻe ʻana, nā neʻe a hoʻomaha paha i nā kīʻaha koko i ka wā

ka pae ʻana i nā ʻona o ka momona.

Ka hoʻolalahi ʻē aku no ka maʻi pancreatitis kūwaho (ulia peptic a me 12PC, ʻōpū o ka ʻōpū, ke kanesa o ka pancreatic, gastritis kūloko, cholecystitis maʻi, hepatitis).

ikaika, puni a puni ka laha. epigastrium me ka irradiation ma ke poʻohiwi, nā ʻūhā poʻohiwi, hoʻohaʻahaʻa i hope

Kū mai ma muli o ka hana kīnā i ka hana o ka inehini. ʻōmaʻomaʻo

mea ʻōpala ala, calcification o ka pā o ka cyst, nodules i ka ʻōpū. ʻōmaʻomaʻo

dysproteinemia, hyponatremia, hoʻonui trypsin, hoʻonui nui ʻia amylases me ka exacerbation

ʻā ʻia, ʻoi aku ka naʻau ma luna o ka ʻōpū ʻole a i ka pō paha ma ka ʻāina

inā inā pili, ʻaʻole pili ia me ka maʻi

i ka wā e hoʻohālikelike ai: ulcer niche, hoʻopaʻa ʻia nā lula i ke kumu o ka ulia

ʻaʻohe loli nui

ʻeha o ka hoʻowalewale o ke koloka, ʻo ia ka spasmodic

i ka wā e hoʻohālikelike ana: ka ʻāʻī o ka lumen o ka ʻawa, nele i kahi haustra, barium depot a me ka ulia zone

pilikia ma ke ʻano, he pilikia ma ka hoʻopili ʻana

cramping., localized at the hypochondrium ʻākau, kukui i ka ʻkaukau ʻākau a me nā ʻūhā poʻohiwi

nā pōhaku i ka hāhi a me ke kuihue

i nā hoʻonui e nānā: bi-lirubin, ESR, alkatine phosphatase aminotransferases

Ke mālama nei ka mālama ʻana i ka maʻi pancreatitis a me nā hoʻopiʻi ʻana.

a) perirenal novocaine blockade, b) polyglucin, reopoliglukin, antiferment, novocaine, plasma, koko, AK, c) ʻaiʻai ʻai (N 5), d) atomin 1t 3 mau lā i ka lā no 7-10 lā, nerobol 1t 2 mau manawa i ka lā no 15 lā, retabolil 1t 2 mau manawa i ka hebedoma, e) pancreatin, methionine, lipolcain, festal, e) analgesia: papaverine, no-spa antispasmodic myotropic action, baralgin, promedol, g) hoʻoheheʻe ʻia o ka paʻakai me nā huaora: h) radiotherapy (UHF therapy i ka ʻāpana plexus, a me ka mālama ʻana i ka spa (Zheleznovodsk, Esntuki, Truskavets) I loko o ka manawa hoʻohui t mai kahi meaʻai ʻokoʻa kūikawā e ka mea ʻole

paʻi, kōpala, paʻakai, nā momona momona, nā kīʻaha sokogonnye. Akā, ʻo ka papaʻai

Pono ke kiʻekiʻe i nā kaloria a loaʻa kahi lawa o ka maʻalahi maʻalahi

mea huna. ʻO ka meaʻai o ka lā e pono ai he 150 g o ka palaka, 30-40 g o ka momona, 350-400 g

I ka hihia o ka palakaʻole, e aʻo ʻia e hoʻohui i ka pono o ka hoʻokomo

makua, e hoʻohana ana i nā hoʻonā waikawa amino i loko o kēia kumu

nā hoʻonā glucose. E hoʻomaʻamaʻa i ka hāhai ʻana, ʻike ʻia nā maʻi e lawe

mākaukau e pili ana i ka enzyme pancreatic (pancreatin, festal,

panzinorm). Hana i kēlā me kēia maʻi me ka antispasmodics, alkalizing

mineral wai e like me borzh.

Pono kēlā me kēia exacerbation o ke poʻo pancreatitis e haʻi i ka hoʻouka.

maʻiʻo pancreatitis. Pono e hana ʻia ka lāʻau lapaʻau i ka wā exacerbation

nā lula e pili ana i ka maʻi pancreatitis maʻa.

Nā hōʻailona no ka mālama ʻana i ka maʻi pancreatitis maʻi a me nā hoʻopiʻi ʻana.

2. Ka Hana: Ka hōʻailona: - ka hana ʻole o ka mālama conservative (ma hope o kekahi mau mahina), - nā cysts o ka pancreas, fistula (waho), obstructive (mechanical) jaundice, - pseudotumor pancreatitis, -stones pancreas. Kahi ʻano hana: A. Kaila Pancreatic: haki amputation mai ka hope, puka mai ka waena. - Hoʻomili ka Pancreato-duodenal, - Pancreatectomy, - anastomosis cervical, - Pancreato-intestinal anastomosis, int. a nar. pancreatic cyst, -Marsulinization - puka kaulike ma waho o kahi pū hala ʻole, B. Hoʻohana ma ka ʻōnaehana biliary. - ka cholecystectomy, - anastomosis biodigestive, - ʻike maka wai hiki ke kahe o ke ala, - ka ʻōpū ma luna o ka ʻōpū a me ka ʻoli i ke kaua, - gastroenteroanastomosis, - ka haʻalele ʻana o ka ʻōpū, - duodenojejunoanastomosis. B. Ka hana ma ka mea kanu NS: - ka haʻalele ʻana o ka ʻĀpela solar; - marginal neurotomy, etc. G. Fistula hoʻopiha.

Hoʻoulu pinepine ʻia ka pancreatitis maʻi e pili ana i nā maʻi o nā kino kokoke

(cholousse cholecystitis poʻo, gastric ulcer a i ʻole

duodenum), no laila, ka lāʻau lapaʻau o kēia mau maʻi

hoʻomaikaʻi i ka papa o ka maʻi pancreatitis. Ma ka haʻalele ʻana i ka palaka mai

nā papa wili, ka ʻōpū, a me ka duodenum i hiki mai paha

ka nīnau no ke komo komo pololei ma ka pancreas. Nā ʻōmaka no

e hana nei i kēia hihia: ka noho ʻana o nā pōhaku i nā kumu o ka pā o ka mea hoʻopuka, cicatricial

nā hana paʻa o nā kumulā, nā ʻano paʻakikī o ka pancreatitis ʻeha. ʻO ke kumu nui

ka hana hoʻokō - hana i nā kūlana no ka kaila holomua

pancreatic wai ma ka gastrointestinal tract.

I ka wā o ka ʻoihana, pono ke hoʻopaʻa ʻia intraoperative hoʻopaʻa loa i nā papa

pancreas, biliary tract a me duodenum. Me kēia

Hana ʻia ka pahuhopu e ka intraoperative cholegraphy, ke aʻo ʻana o ka gallbladder. I

i ka wā o ka hana, hoʻohana ʻia ka pancreatography retrograde e ka cannulation

hoʻomalu ma waena o ka papila a duodenal a puncture - ma ka puncture ma o ka ʻāpana

nā kīhāpai o nā papa hana i hoʻonui ʻia o kona māhele mamao.

Me nā lōlū liʻiliʻi lōʻihi i ka hapa hope o ka papa pancreatic

ua hōʻike ʻia kahi transduodenal papillosphincterotomy me ka transpapillary

kaomi ana o ka papa pancreatic a virsungoplasty. Ma na koi o

ka nui o nā hana paʻa o ka papa pancreatic i kēlā ʻano hana

hikiʻole, ʻo ia ka noi kūpono kūpono o ka anastomosis ma waena o kahi i komo i ka

ka lōʻihi ma ka mānoanoa o ka umauma me ke kumu o ka pancreatic a i hoʻopau ʻia ka pōpoki ma hope o ka Ru

Ke hoʻokaʻawale nei i kahi ʻāpana nui o ke kumulana ma kahi o ke poʻo a me ke kino o ka umuhi

ua paipai ia e wehe i ka mahelehele o ka lepa a ua aniani ia i ka ili

pipi ʻili pū ʻia e Ru. ʻO ke kumu o kēlā hana, ʻo ia ke hana i nā kūlana no ka kaila o ke kahe

ka wai ʻai pancreatic i ke kuhikuhi retrograde.

I nā hihia a nā mea e hana ai i ka parenchyma o ka hapa nui o ka momona ma o ka hopena o ka

make a me ke ʻano o nā helehelena he nui i ka make

hoʻohālikelike i nā loli sclerotic, a me nā hōʻailona nui o ka maʻi pancreatitis maʻi

haʻi ʻia a ʻaʻole ʻāpono i nā ʻano mālama mālama o ka mālama ʻana, hana

ka hoʻohuli ʻana o ka pancreas (ʻoi a me ke kino, subtotal pancreatectomy).

Nā ʻano o nā hana no ka maʻi pancreatitis kūlohelohe.

Hoʻoulu pinepine ʻia ka pancreatitis maʻi e pili ana i nā maʻi o nā kino kokoke

(cholousse cholecystitis poʻo, gastric ulcer a i ʻole

duodenum), no laila, ka lāʻau lapaʻau o kēia mau maʻi

hoʻomaikaʻi i ka papa o ka maʻi pancreatitis.Ma ka haʻalele ʻana i ka palaka mai

nā papa wili, ka ʻōpū, a me ka duodenum i hiki mai paha

ka nīnau no ke komo komo pololei ma ka pancreas. Nā ʻōmaka no

e hana nei i kēia hihia: ka noho ʻana o nā pōhaku i nā kumu o ka pā o ka mea hoʻopuka, cicatricial

nā hana paʻa o nā kumulā, nā ʻano paʻakikī o ka pancreatitis ʻeha. ʻO ke kumu nui

ka hana hoʻokō - hana i nā kūlana no ka kaila holomua

pancreatic wai ma ka gastrointestinal tract.

I ka wā o ka ʻoihana, pono ke hoʻopaʻa ʻia intraoperative hoʻopaʻa loa i nā papa

pancreas, biliary tract a me duodenum. Me kēia

Hana ʻia ka pahuhopu e ka intraoperative cholegraphy, ke aʻo ʻana o ka gallbladder. I

i ka wā o ka hana, hoʻohana ʻia ka pancreatography retrograde e ka cannulation

hoʻomalu ma waena o ka papila a duodenal a puncture - ma ka puncture ma o ka ʻāpana

nā kīhāpai o nā papa hana i hoʻonui ʻia o kona māhele mamao.

Me nā lōlū liʻiliʻi lōʻihi i ka hapa hope o ka papa pancreatic

ua hōʻike ʻia kahi transduodenal papillosphincterotomy me ka transpapillary

kaomi ana o ka papa pancreatic a virsungoplasty. Ma na koi o

ka nui o nā hana paʻa o ka papa pancreatic i kēlā ʻano hana

hikiʻole, ʻo ia ka noi kūpono kūpono o ka anastomosis ma waena o kahi i komo i ka

ka lōʻihi ma ka mānoanoa o ka umauma me ke kumu o ka pancreatic a i hoʻopau ʻia ka pōpoki ma hope o ka Ru

Ke hoʻokaʻawale nei i kahi ʻāpana nui o ke kumulana ma kahi o ke poʻo a me ke kino o ka umuhi

ua paipai ia e wehe i ka mahelehele o ka lepa a ua aniani ia i ka ili

pipi ʻili pū ʻia e Ru. ʻO ke kumu o kēlā hana, ʻo ia ke hana i nā kūlana no ka kaila o ke kahe

ka wai ʻai pancreatic i ke kuhikuhi retrograde.

I nā hihia a nā mea e hana ai i ka parenchyma o ka hapa nui o ka momona ma o ka hopena o ka

make a me ke ʻano o nā helehelena he nui i ka make

hoʻohālikelike i nā loli sclerotic, a me nā hōʻailona nui o ka maʻi pancreatitis maʻi

haʻi ʻia a ʻaʻole ʻāpono i nā ʻano mālama mālama o ka mālama ʻana, hana

ka hoʻohuli ʻana o ka pancreas (ʻoi a me ke kino, subtotal pancreatectomy).

Insuloma: k-ka, q-ka, maimoā.

ʻO nā ʻōpū o ka pancreatic benign kekahi pūlima,

e hele mai ana mai nā pūnaehana o ka hāmeʻa o ka pancreatic. Kekahi o lakou

hormonally active, e like me beta-cell adenomas (insulomas) a

adenomas ulcerogenic (gastrinomas).

ʻO nā adenomas Beta-cell (insulomas) e hoʻopuka i nā nui o ka insulin a

hōʻike ʻia e nā maʻi maʻi hypoglycemia. ʻO nā hōʻailona maʻamau maʻamau me

tupu kēia: hoʻonui nui loa, haʻalulu, polū nā nāwaliwali nui,

pauku wā e ʻike ʻole ai.

ʻO ka Hyperinsulinism ma muli o ka insuloma e hōʻike ʻia e ka triad o nā hōʻailona: 1)

ka loaʻa ʻana mai o nā hopena hōʻeha nui o ka hypoglycemia a hiki i kahi coma ma ke kiʻi o ka wikiwiki

a i ʻole ka hana pilikino, 2) i ka emi nui o ke kō o ke koko (ma lalo o 0,5 g / l, a i ʻole 50

mg%), 3) nā nalo o nā hōʻailona a pau o ka hypoglycemia ma hope o ke alakaʻi intravenous

ʻO ke ala nui no ka hoʻopaʻa ʻana i nā insuloma celiacography kahi koho. I ke

ʻike nani nā angiograms o insuloma a maikaʻi maikaʻi

hoʻomohala manuahi me ka diameter o 0,5 a 2-3 cm. I nā angiograms

i kekahi manawa he nui nā adenomas i loaʻa, kūloko ʻia ma ka nui

nā wahi o ka huelo a me ke kino o ka pancreas.

ʻO ka hana maʻi: ʻo ka hana ʻana wale nō, ka mea e wehe ai i ka adenoma me

kona mau kākala. Me nā adenomas he nui o ka huila a me ke kino o ka pancreas, a

ka adenomas me nā hōʻailona o ka lawenaʻa (malignant adenomas me

hele mai ka hyperinsulinism i ka 10% o ka nui o nā hihia)

hana i ka papa inoa pancreas.

ʻO Ulcerogenic adenoma (gastrinoma) e pili ana i kahi hui o nā tumors e hoʻomaka ana mai

ʻO ka hoʻohana ʻana i ka islet pancreatic i ʻole e hana ʻana i ka insulin.

ʻO kahi hiʻohiʻona ʻano o kēia mau ʻōpū, ʻo ia kā lākou mau cell

hoʻāliʻi i ka gastrin, kahi e pili ai i nā hormones nā kihi o ka mucosa

ka membrane o ka ʻōpū. Ma 60% o nā maʻi, he hōʻeha nā gastrinomas a hāʻawi

nā metastases i nā lepa lymph, nā pepona, nā māmā, peritoneum, a me ka ʻili. I 50% o nā maʻi

hui pū ʻia nā gastrinomas me ka adenomatosis o nā kelima endocrine ʻē aʻe

(ka nui o ka adenomatosis endocrine) me ka ʻaʻa ʻole a

ʻike ʻia nā loli hyperplastic i ka pituitary, parathyroid

ʻO ke kiʻi o ke kino o ka adenomatosis ulcerogenic i hōʻike ʻia e kahi maʻi maʻi

ʻO nā hoʻokolohua o ka pilikia a me ka maʻi pancreatitis lohi.