Ascend Pancreatitis: hōʻailona hōʻailona a me ka mālama ʻana no ka maʻi maʻi pancreatic maʻi

ʻO ka pancreatitis kahi maʻi maʻi ka maʻi o ka pancreas, kahi i hoʻopili ʻia ai nā enzyme e ka hoʻowalewale ʻia, ʻaʻole i hoʻolei ʻia i ka duodenum. Hiki i ka maʻi ke hōʻike iā ia iho i kēlā me kēia makahiki he ʻano kūlohelohe kūʻokoʻa, a ma luna o ke ʻano o nā maʻi ʻē aʻe o ka ʻeha gastrointestinal.

Hoʻokaʻawale ʻia ka pancreatitis e like me ke ʻano o ka lesion, ka hele ʻana o ka maʻi, nā hōʻailona morphological, a me ke ʻano hoʻi o ka maʻi.

ʻO ka pancreatitis huaido, kahi e hoʻomohala nui ai ka pathology, kahi hōʻailona i hoʻohālikelike ʻia.
ʻO ka pancreatitis mau ka huehue, kahi i ʻōlelo ʻia ai nā hōʻailona, akā hele mai kēlā me kēia manawa.
ʻO ka maʻi pancreatitis ka maʻi, i ʻole e haʻi ʻole ʻia ai nā hōʻailona, akā mau loa, e hoʻopili ʻia e nā ʻano like ʻole. Hoʻomoe ka pancreatitis maʻi i ʻelua mau manawa: exacerbation a kala ʻana.

I ka huli ʻana, ua loaʻa ka maʻi pancreatitis i nā manawa he nui:

Enima: 3-5 lā,
reactive: 6-14 lā,
hana hanahana: hoʻomaka mai ka lā 21,
hopena: 6 mau mahina a keu paha.

Ua hoʻokaʻawale ʻia ka pancreatitis maʻi ʻelua i nā ʻano ʻelua e pili ana i ke kumu o ka hanana.

ʻO ka pancreatitis mua: e hele ana me ka maʻi kūʻokoʻa.
ʻO ka pancreatitis lua: e kū ana i kahi kūmole o nā ala āpau o ka gastrointestinal, no ka laʻana, ka maʻi gallstone, nā ʻōpio duodenal.

ʻO nā kumu nui o nā maʻi ʻO nā kumu nui o ka pancreatitis o ka huehue ke inu i ka waiʻona a me ka uahi ʻana, hoʻopiʻi ka pila o ka bile ma muli o ka palaki biliary, ka hōʻea o ka cholelithiasis me kahi meaʻai hoʻokaʻawale. Akā hiki pū kekahi pathology i nā hōʻeha a me nā hana paha ma ka pancreas a me ka hoʻohana ʻana i kekahi mau lāʻau lapaʻau me ka ʻole e kūkākūkā me ke kauka.

Nā maʻi ʻeha ʻO ka neʻe i ka pancreatitis o ka maʻi ke ʻano o ke ʻano o ka papa. Nā pae kiʻekiʻe. Ma kahi maʻi pancreatitis, he emi iki ka hōʻailona a mau loa. Hiki ke hoʻomaopopo ʻia nei ka maʻi i ka loaʻa ʻana o nā maʻi kuʻuna o ka herpes zoster, hoʻopili ʻia ma hope o ka ʻai ʻana i nā mea momona aʻai, ma ka haʻi ʻana a me ka luaʻi ʻana, ka maʻi ʻaihue a me ka hoʻolilo ʻana.

ʻĀkōkō ʻO ka maʻi ʻana i ka maʻi, pono ʻoe i ke kūkākūkā kūkākūkā ākea o kahi gastroenterologist a me nā kauka. Eia, kuhikuhi nā kauka nei iā ʻoe i nā ʻano diagnostic e pono ai, e loaʻa paha:

hōʻikeʻike biochemical a me ke ʻano holoʻokoʻa
Paona o ka ʻōpū o ka ʻōpū,
CT a i ʻole MRI
Endoscopic retrograde cholangiopancreatography (ERCP): nā loiloi o nā kumu bile a me nā pancreatic.

Hoʻomaʻamaʻa maikaʻi iā-ʻO ka lapaʻau ʻana o ka maʻi pancreatitis ma ka hale ʻaʻole wale nō e hōʻino i ka olakino, akā ke alakaʻi pū ʻia hoʻi i ka make. ʻO ia ke kumu, inā ʻike ʻoe i nā hōʻailona ʻano, pono ʻoe e ʻōlelo aku i kahi gastroenterologist e kuhikuhi i ka lāʻau lapaʻau pono mua, ʻo ka mea mua, ʻo ka hoʻa ʻana ka ʻaʻa ʻana e hoʻohemo i ka lawe mai ka lepa a me ka hau a hoʻopili ʻia ma ka ʻōpū o luna e hōʻemi i ka ʻeha.

hōʻoluʻolu ke kinikini,
ʻO nā lāʻau lapaʻau pancreatic-hoʻemi haʻahaʻa
antioxidants a me nā huaora.

Hoʻomoe ʻia ka hoʻokele no ka make ʻana o ka aila (pancreatic necrosis) a i ʻole ka hoʻopiʻi ʻana o ka mālama conservative.

Nā hopena hoʻopiʻi ka naʻau o ka pancreitis necrosis, ka hoʻokumu ʻana o kahi cyst pancreatic hewa, pancreatic abscess, pancreatogenic ascites, a me nā hakahaka pulmonary.ʻO ka pancreatitis kūpaʻa, hiki mai ka pancreatic endocrine insufficiency, kahi e alakaʻi ai i ka hoʻomohala ʻana o ka maʻi mellitus.

Inā ʻaʻole ʻoe makemake e alo i ka pancreatitis, pono ʻoe e hāʻawi i ka waiʻona a me ka ulaula, e ʻai i ka paukū a me ke kaulike, a ʻōlelo aku i ke kauka inā manawa inā hopohopo ʻoe i ka maʻi gallstone, pathology o ka biliary tract.

No ke aha e hōʻiliʻili ai ka wai i loko o ke ana o ka ʻōpū?

No nā makahiki he nui, ke kūleʻa ʻole ole me ka maʻi gastritis a me nā maʻi ulia?

Ke poʻo o ka Institute: "E haʻihaʻo ʻoe i ka maʻalahi o ka hoʻopakele ʻana i nā maʻi gastritis a me nā ʻōpala me ka lawe wale ʻia i kēlā me kēia lā.

ʻO nā hōʻailona hiʻohiʻona o ka ascites he hoʻonui i loko o ke kaomi intra-abdominal, kahi hoʻonui i loko o ka ʻōpū mai ka puʻukū i hōʻuluʻulu ʻia.

No ka mālamaʻana i ka gastritis a me nā ulia, hoʻohana maikaʻi kā mākou poʻe mea heluhelu iā Monastic Tea. Ke ʻike nei i ka kaulana o kēia huahana, ua hoʻoholo mākou e hāʻawi iā i kou makemake.

ʻO nā Ascites (ka hōʻiliʻili hōʻuluʻulu o ka wai) e hoʻopau i ka hana o nā māmā a me nā lālā o ka gastrointestinal tract.

Hiki i nā kumu no ka hōʻiliʻili o nā wai ka mea like: hiki ke piʻi mai nā ascites ma muli o kekahi mau pilikia o ke kino, ka pathology organ. ʻO ke kumu maʻamau pinepine o ascites he cirrhosis.

Hoʻopilikia ʻia nā ascites me ka hoʻohana ʻana i ka ultrasound a me ka ninaninau kauka. Ma hope o ke ʻano maʻi, e loaʻa ka hopena i ka nui o ka manawa. Oe e mālama i kahi kanaka mai ascites a mai i nā maʻi i kumu i ka manawa like.

ʻO ka lōʻihi o ke kau, ke koʻikoʻi o ka maʻi, ʻo ka prognosis ʻoi aku ka hilinaʻi i ke olakino kanaka, ke kumu o ka maʻi. ʻIke mau paha ka piʻi i ka wā i hala mau mau mahina.

Hoʻomaka nā hōʻailona o ka ascites e ʻike inā ua ʻoi aku ma mua o hoʻokahi lita o ka wai i hōʻili i loko o ka ʻōpū.

Nā hōʻailona o ka hōʻemi o ka wai'ōpū ma waena:

ʻaʻano pōkole
hoʻonui i ke kaupaona a me ka nui o ka ʻōpū,
ka ʻōpū ʻana o nā wāwae
ʻālina
a ʻeha hiki i ka wā kū
ka ʻōpū ʻana o ka ʻōpū, ʻeha,
puʻuwai
edema hana (i nā kāne).

ʻO ka maʻamau, i ka manawa mua, mālama ke kanaka i nā hōʻailona e like me ka protrusion o ka pusela, hoʻonui i ka ʻōpū o ka ʻōpū - ma kahi kū, kū ka ʻōpū e like me ka pōkaʻi, a inā moe ke kanaka, hina ka ʻōpū.

I nā wahine, he hōʻailona paha nā māka keʻokeʻo - ʻo ia kekahi o nā hōʻailona o ka ascites.

Aia kekahi mau ʻōpili e pili pū me nā maʻi hou, ke kumu kumu o ka ascites.

No ka laʻana, inā ma ke ʻano he nui ʻana i ka wai o ka pehu, a laila ʻōlelo ʻia nā veins ma ka ʻōpū (mua, ʻaoʻao).

Inā pilikia nā pilikia ma nā ipu ma lalo o ka puʻu, a laila e hōʻailona ana nā hōʻailona like ʻole o ka maʻi.

Hōʻike ʻia nā ascites tuberculous e nā mea āpau o luna, a me ke poʻo, hoʻonui hopohopo, nā nawaliwali, a me ka puʻuwai wikiwiki.

Hoʻopilikia ka pilikia o nā pilikia i nā moku lymphatic i ka piʻi wikiwiki i loko o ka ʻōpū. Inā nele ka ʻiʻo o ka protein, a laila e loli ana nā hōʻailona o ka ascites i nā pihi, ʻo ka pōkole o ka hanu.

Inā pili ka maʻi i nā pilikia ma nā moku lymphatic, a laila e kuhikuhi ʻia ana kahi ultrasound o nā veins, nā kīʻaha o ka wahi pilikia. Inā kānalua ka oncology, hana ʻia kahi scan ultrasound.

Ascites maʻi pancreatic

Hōʻike pinepine ʻia nā exudation i ka lua peritoneal me OP, akā naʻe, he hanana pathological ʻano maʻamau ka pancreatic. I kekahi mau hihia, ʻaʻole i pau ka hoʻomohala ʻia ka hoʻomohala o kahi hana effusion i loko o ka ʻōpū pūpū; ʻO ke kumu, e like me ka mea i hōʻike ʻia ma luna nei, hiki ke hoʻoulu ʻia a me ka thrombosis i ka ʻōnaehana urin system. ʻO kēia ka ʻike pinepine ʻia me OP a i ʻole hōʻeha ʻia i ka hōʻeha ʻia o ka CP ma ka mea maʻi me ka cirrhosis ate - hopena o ka pancreatic ma ke ala o ka decompensation o ka cirrhosis a me nā mea e ulu nei i nā kaila o ka hypertension ʻike ʻia i ka ascites maoli.

I nā pinepine pinepine, hele aku ka pancreatic ascites i nā mea maʻi me nā pancreatic cyst e hoʻoheheʻe ʻia ana i loko o ka ʻōpū ʻeha. ʻO nā mea hou i hoʻoili ʻia i ka hoʻomohala ʻana i nā ascites pancreatic: kahi poloka o nā nūlā lymph retroperitoneal (parapancreatitis) me ka hypertension i loko o ka lakiki lymphatic thoracic, ʻoi ka nui o ka protein-pūngao ikaika e like me kwashiorkor.

Hoʻohana wehe ʻia nā ʻano ʻelua o ka papa kaukau o ka papa pancreatic. Ma ke koho mua, ma hope o ka ulu ʻana o kekahi maʻi ʻehaʻeha, hōʻiliʻili ka wai i loko o ka ʻōpū o ka ʻōpū, i kumu ʻia e ka hoʻomohala ʻana o nā pona pancreatic focal me ka hopu ʻana i kahi ʻāpana o ka ʻōnaehana pancreatic me ka hoʻokumu ʻana o ka pseudocysts e kamaʻilio pū ana me ka ʻōpū o ka ʻōpū. Hōʻike ka lua o ka lua e ka hōʻuluʻulu ʻana o ka wai me ka hoʻoweliweli ʻana i ka papa o kahi subclinical papa o CP, ka ʻike pinepine ʻia i ka wā o ka luku ʻana i kahi wahi liʻiliʻi o kahi lāʻau pancreatic maʻi.

ʻAʻole paʻakikī ke Diagnosis. Hoʻoholo ʻia nā Ascites kino, hoʻopaʻa ʻia e nā haʻawina hou (ultrasound, x-ray mode). Hoʻopili pinepine ʻia nā ascites me ka effusion a me ka pericardial effusion, aemaise i nā mea maʻi me nā genesis hui pūpū o nā ascites (portal hypertension, kwashiorkor, hypertension o ka thoracic lymphatic duct).

Ua hōʻoia ʻia ka hōʻoia ʻana e ka laparocentesis. ʻO ka nui o ka wai i loko o ka'ōpū o ka'ōpū he pinepine a hiki ke hōʻea i 10-15 lita. ʻO ka wai i loaʻa i ka wā laparocentesis he kukui melemele māmā, ʻo ka waihona o ka protein ʻaʻole iʻoi aku ma mua o 30 g / l, me ka hoʻokolokolo cytological, lymphocytes predominate. ʻO ka liʻiliʻi, nā ascites he chylous ma ke ʻano. Ua hoʻonui ʻia ka hana o nā enzyme pancreatic i ka wai ascite.

ʻO Laparocentesis me ka haʻalele loa o ka wai o ka intraperitoneal he hopena leʻa wale nō, ka hopena i loko o ka ʻōpū o ka ʻōpū e hōʻiliʻili koke. ʻAʻole pono ke ʻoluʻolu o Laparocentesis, ʻoiai kēia mea ke ʻano maʻi maʻi ʻole, ʻoiai ʻo ia ke hoʻolōʻihi i ka maikaʻi o ke kanaka maʻi. ʻO ka laparocentesis i hoʻihoʻi hou aku i ka hakahaka trophological a hiki ke hoʻonāukiuki i nā hōʻailona o ka kwashiorkor ma muli o ka nalowale nui o ka protein me ka ascitic wai.

Me ka ascites pancreatic, ʻoi aku ka lāʻau lapaʻau me ka octreotide (sandostatin) i nā maʻi maʻamau no nā 2-3 mau wiki, a laila hana ʻia ka hana hana.

No ka mea, ʻo ka pancreatic ascites kumu o nā cysts pancreatic, ʻo ka hoʻomaʻamaʻi ana ʻo ia wale nō ke ana kūpono, a me ka hoʻopuʻi ʻoi loa ka limu o ka pūpū. Ma ke ʻano he lāʻau hou, ʻike ʻia nā lāʻau lapaʻau e mālama ai i ka cirrhosis alikaʻi, kākoʻo kākoʻo a me ke hoʻoponopono ʻana i ka hypoproteinemia, me ka diuretics (spironolactone).

ʻO ka pleurisy pancreatogenic

Hoʻonui pinepine ʻia ka ʻoluʻolu i ka pancreatitis i ka ascites no ka pancreatic ascites a keu pinepine aku i ka hele ʻana o kahi pū pancreatic pili kokoke i ka diaphragm, ʻoiai ke kuhi nei, me ka hoʻokumu pū ʻana me kahi fistula pancreatic e wehe i loko o ka lua pleal. ʻO ka hoʻomohala ʻana o ka pūke ʻoliʻoli i loko o ka puʻu pleural e alakaʻi i ka hoʻomohala ʻana o ka pleurisy purulent.

He mea paʻakikī wale nō ka ʻōpū o ka pleurisy me kahi exudate liʻiliʻi, i ka wā i hōʻike ʻole ʻia ai ka nānā kino ʻana i nā hōʻailona pathognomonic pleurisy. Kūkulu ʻia ka hopena me ka hoʻohana ʻana i x-ray e ʻike ai i nā ʻōpū o nā umauma. ʻO ka waiwai diagnostic koʻikoʻi ʻoi aku ka puncture pleural, kahi e hiki ai ke hoʻomālamalama i ke ʻano o ka hopena a hoʻoholo i nā ʻano o nā hana hou. Eia kekahi, me ka effusion nui, ka mea maʻamau, maʻemaʻe, a hiki ke hoʻohana ʻia kahi puncture rongoa i hiki ke hoʻohana ʻia no nā kumu therapeutic (evacuation of exudate, elimination of compression atelectasis, the introduction of antibiotics into the pleural cavity, etc.).

Hoʻomaopopo ka ʻano maʻi pancreatogenic o ka effusion e ka hoʻoholo ʻana o ka hana a nā papa pancreatic i loko. Inā kānalua ka kamaʻilio cystic-pleural ma hope o ka puncture, ua ʻike ʻia kahi noiʻi ʻokoʻa (pleurography me ka wai hoʻoliʻi wai-hoʻokaʻa ʻia) e hoʻomaopopo i kēlā manaʻo a i ʻole ka pancreatic fistula kūloko.

Inā ua kūpaʻa ʻia ke kumu o ka hopena o ka pleural is the pancreatic cyst, ka hōʻea ʻana i ka maʻi ma luna o ka cyst pono ia (pono ʻole a i ʻole nā luawai o waho, cystectomy, hema-sided pancreatic resection, a pēlā aku). Ma ke ʻano he mālama mālama, ua hoʻohana ʻia ka octreotide (sandostatin) i kahi maʻa o 200 μg subcutaneously 3 mau manawa i kahi lā no nā pule he nui, e hoʻemi nui ana i ka hana o nā manaʻo cyst.

Nā varicose veins o ka esophagus a me nā ʻōpū

ʻO nā veic varicose non-hepatogen o ka esophagus a me ka ʻōpū e kū ana inā hoʻonāukiuki ʻia ka vepela a me kāna mau lālā e ka nui o ke poʻo pancreatic a i ʻole ka pancreatic cyst, a ma muli o kā lākou thrombosis. ʻO ka mea pōʻino loa e hoʻopiʻi ʻia ana mai nā vena varicose, nā hōʻailona nui e hele mai i ke koko a i ʻole ka lua a me ka hoʻopiʻi ʻana i ka ʻano o nā ʻano kīnā ʻele, melena, anemia posthemorrhagic, hypovolemia, a hiki i ka pīhoihoi hemorrhagic.

ʻO ka mālama ʻana i ka hoʻopiʻi ʻana o kēia hoʻopiʻi e loaʻa ana i kahi kūpono infusion-transfusion therapy, ka hoʻokele o ka etamsylate a me nā nui o ka waika ascorbic. I mea e hoʻokō ai i ka hemostasis kūloko, maikaʻi ia e hoʻohana i ka probe Blackmore, ka mea e hoʻoulu i ka poma varicose o ka maʻi esophagus a me cardia i kekahi mau hola (a i kahi lā). Inā hiki i kēia ala, ʻaʻole hiki ke hoʻokaʻawale i ke aʻeha o ka maʻi palaualelo, i ke komo ʻana i ka wawa ʻana.

Hoʻohana ʻia ka hana traumatic minimally - gastrotomy a me ka uila uila i loko o nā kohe koko i loko o ka hana gastroesophageal me ke kuʻuna mua o ka gastric hema a me ka splenic artery. Me nā varicose veins i kumu o ka hoʻopiʻi ʻana o ka vein portal a i kāna mau lālā la e ka pancreatic cyst, ka hoʻoheheʻe a lawe ʻole ʻana paha i ka cyst e alakaʻi ʻaʻole wale e hoʻokō i ke koko, akā, nā neʻe ʻana aku o nā veins varicose.

Kalihi - Weiss Syndrome

Hōʻike ʻia ka maʻi Mallory-Weiss ma kahi o 3% o nā mea maʻi i ka wā i hōʻike ʻia ai ke kaʻeha a me ka luku paha i ka pancreas e hōʻike ʻia ana me ka hoʻopiʻi pinepine ʻole a indomitable. ʻO ka morphological kumu o ke ʻano maʻi he mau rupture o ka membrane mukous a me ka layer subucosal o ka pā o ka ʻōpū ma ka wahi o ka hoʻololi gastrointestinal, ma ka ʻaoʻao ma kahi o ka pale o kahi haʻahaʻa. No ka hana ʻana i ka haki ʻana, e koi ʻia kahi kao hana koʻikoʻi i ke ʻano o ka hoʻololi ʻana o ka dystrophic i ke ʻano i ka palapala laikini me nā kīʻaha varicose, infiltration perivascular a me micronecrosis i loko o ke akea o ka ʻōpū. ʻO ke ʻano nui o nā palapala subclinical i hoʻopaʻi ʻia ʻole i hoʻoholo ʻia ʻole.

ʻO nā mea like e hoʻopiʻi i ka hoʻouka ʻana o ka pancreatitis, ka inu ʻona a me ka overeating, hoʻonāukiuki i ka hoʻomohala ʻana o ka maʻi Mallory-Weiss. I ka pathogenesis, hāʻawi ʻia ka mea nui i ka wehe ʻana o ka hana pani i ke kao cardial a me ka pyloric, kahi i hoʻonāukiuki ai ka hopena hoʻonāukiuki i ka piʻi wikiwiki i ka hoʻoikaika intragastric i ka wā o ka luaʻi. ʻO ka mea nui nui, ʻo ka prolaps o ka gastosa mucosa i loko o ka lumen o ka esophagus, a me ka hiki ke kahalulu ʻia ʻana o ka hernia liʻiliʻi o ka wehe esophageal o ka diaphragm.

ʻO nā hōʻike kino o ka maʻi Mallory-Weiss i hoʻokumu ʻia i nā hōʻailona maʻamau o ke koko o ka gastric a me nā hōʻailona o ke koko. Pono e noʻonoʻo i ka poʻe ʻōpio me ka pancreatitis edematous, ʻoiai ke koko, hiki ke piʻi ke koko kiʻekiʻe no ka manawa lōʻihi, ʻaʻole i pili ia i ka nui o ke koko.

Hoʻokumu ka diagnagnosis o Mallory-Weiss syndrome ma ka ʻikepili EGDS ulia, ke ʻae nei ʻaʻole wale e hoʻokū i ke kumu o ke koko a me ka hoʻoholo i ka hohonu o ka hakakā, akā e hoʻokau i ka hemostasis kūloko. Ke hana nei i ka endoscopy, ʻike pono ʻia ka nānā ʻana o ka esophagus, ʻōpū a me ka duodenum, no ka mea i nā mea maʻi me ka OP a me ka exacerbation o CP, hiki ke ʻike pinepine ʻia ka hopena a me nā ulia.

Hoʻomaʻamaʻa ʻia no ka maʻi Mallory-Weiss ka hoʻokomo ʻana i nā lāʻau antiemetic: metoclopramide (cerucal) intramuscularly a domperidone (motilium) sublingally i loko o kēlā me kēia lā o 40 mg. Ma ka hoʻohālike, lawe ʻia ke ʻano hemostatic a me ka infusion-transfusion therapy. Hoʻokomo ʻia ka launa ʻana no ka maʻi ma ka hoʻomaka ʻana o kahi ʻeleʻaha Blackmore (no 12 mau hola) i ke kumu o ka maʻi hemostatic. I nā kūlana o kēia wā, ua manaʻo ʻia kahi ala o ke endoscopic diathermic (bipolar) a i ʻole ka hōʻohui ʻana o ka ʻāpana mucosal i kahi ala hou. Ka manawa kauoha no PPIs (omeprazole, lansoprazole, rabeprazole), ka mea e pale ai i ka proteolysis o ka thrombus i hoʻokumu ʻia i loko o ka lumen o ka ʻōpū ma muli o ke kaʻi ʻana o ka hana pepsin,

Nā ʻeha a me nā ulcerative o ke ake o ka gastrointestinal tract

ʻO nā mea pilikia no ka hoʻomohala ʻana i ka aʻalolo a me nā ʻōpala i nā maʻi me ka pancreatitis:
• elemakule,
• paleka o ka ate me ka encephalopathy,
• ka hopena hanu me ka hypoxemia koʻikoʻi,
• hypovolemia a me ka hemodenamic e pili ana,
• maʻi o ka hepatorenal,
• nā peritonitis pancreatitogenic, nā kaʻina purulent-septic i ka pancreas a me ka serat parapancreatic,
• ka hoʻopiʻi traumatic no ka pancrotitis necrotic a i ʻole kahi maʻi pancreatic ʻē aʻe.

Hiki ke ʻike ʻia nā ʻōpūʻeha hopuna a me nā uliaative ulia o ka esophagogastroduodenal e ka hoʻokalakupua a me ka hanana ma hope o 2/3 o nā mea maʻi me OP. ʻO ka pinepine, ʻo ka ʻōpala a me nā ulia ua hoʻopaʻa ʻia i ka lalo a me ke kino o ka ʻōpū, ʻaʻole i emi pinepine i ka duodenum. ʻCers pinepine pinepine nā ʻūpihi o nā maʻi ʻehā.

I ka hoʻomohalaʻana o nā hoʻopiʻi hemorrhagic, pono ke koʻikoʻi o ka manawa - ʻike ʻia ke koko mai 3 a 20 mau lā ma hope o ka hoʻomohala ʻana o ka luku pancreatic.

ʻO ka pathogenesis o nā ʻeha ulia, ka piʻi ʻana o ka hoʻololi mua o ka necrotic ulcerative i ka membrane mucous a me ka loaʻa ʻana o ke kano maʻi ma muli o kēia mau mea i ka hopena iho: Ka haunaele o ka microcirculation ma nā ʻano like ʻole o ka ʻāpana o ke kūpaʻa, ka hōʻeuʻeu nui o ka sekela gastric me ka hoʻēmi ʻana i ka hiki ke hoʻākāka me ka hoʻōla ʻana o ka pancreatic secretion, duodenogastric reflux.

ʻO ka hopena hui o ischemia, hua a me ka lysolecithin, hypersecretion o ka hydrochloric acid a me ka hoʻonui i ka hana pepsin maoli e hoʻohuli i ka pale o ka mucosal ma mua o nā mea hoʻonāukiuki. Hoʻopili pinepine ʻia nā maʻi o ka hemostasis me ka pohō o nā mea e hoʻopiʻi ai i ke koko ma muli o ka hana ʻole o ka hana synthetic ati i loko o nā mea maʻi me ka wai ʻakaʻaka a me ka CP i paʻakikī e nā subhepatic portal hypertension, hepatoprivial syndrome, a me ka palaualohi ʻana.

I ka hapa nui o nā mea maʻi me ka pancreatitis, nā maʻi erosive a me nā uliaative ulia e like me ka asymptomatic, ua ʻike pinepine lākou i kahi maʻi hānai koko nui, e puka ana ka "kīwī kīpī" a me ka haʻalulu hemorrhagic, ʻike pinepine lākou i ka melena, e ʻike pinepine ʻia i hoʻokahi lā ma hope o ke koko. ʻO ke kumu nui o ka nā maʻi me ke nānā ʻo ka endoscopic, ʻoiai ke kahakaha hiki ke ʻeha i nā mea maʻi me ka nasogastric a i ʻole ʻelua-lumen nasointestinal probes no ka hoʻopili ololi.

He paʻakikī nā mea mālama, e komo pū ana ke kaiāulu (me ke kōkua o ka endoscopy) a me ka lāʻau hemostatic systemic, ka hoʻohana ʻana i nā mea huna huna gastric, cytoprotectors a me nā antiioxidants, e ukali ʻia e ka hoʻokumu ʻana i nā lāʻau e hoʻomaikaʻi i ka microcirculation a me ka hoʻomaikaʻi.

ʻO nā hewa pinepine i loko o nā haukapila ʻoi aku ka hoʻopau ʻana o ka ʻoihana ma hope o ke pani ʻana i ke kahe, ka hoʻohana ʻana i ka atropine, pirenzepine, ranitidine i nā pakanā maʻamau a i ʻole nā antacids me he mea blockers, ka mea i kūlike ʻole ʻia ka "era" o nā IDU. ʻO nā lāʻau lapaʻau i koho ʻia i kēia kūlana he omeprazole a me lansoprazole no ka hoʻokele makua. Me ka huhū nui, ʻoi aku ka hoʻohana ʻana o octreotide, kahi hōʻailona synthetic o somatostatin.

Hoʻomaopopo ʻia ka loiloi o nā ʻeha ulia no ka hoʻohaʻahaʻa lōʻihi a i ʻole ke kala ʻana, ʻoiai ke ʻano o ka systemic, local or endoscopic hemostasis i loaʻa i kēia waihona.

ʻO nā fistula pancreatic

ʻO Fistula o ka pancreas kekahi o nā pilikia i aʻo ʻia ʻo ka pancreatology. ʻO kēia ke kumu nui o ka hoʻopiʻi nui ʻana o kēia hoʻopiʻi (ʻoiai he nui ka hoʻonui ʻana o ka nui o nā mea maʻi me ka pancreatic fistula i kēia manawa). ʻO ka fistula pancreatic e hoʻopili mau ʻia me ka ʻōnaehana o ka pancreas, hiki ke hoʻopaʻa ʻia i ke poʻo, ke kino a i ʻole ka poʻo o ka pancreas.

Ua māhelehele ʻia nā fistulas pancreatic i:
• traumatic, post-necrotic and postoperative,
• kū i ka (kāpeka) a kū ʻole (lateral)
• kūmole (wehe i ka ʻili a i ʻole ka mana i kau ʻia i ka ʻeha o ka pā o ka ʻōpū a i ʻole ka paʻa purulent pili) a me ka ʻono (wehe i ke ana o ka pūpō pancreatic, nā ʻāpana kū kokoke a i ʻole nā ʻāpana ʻē aʻe - no ka laʻana, pleural).

No ka hōʻike ʻana i ka fistula pancreatic o waho, pono ia e hoʻoholo i nā enzyme pancreatic ma ka fistulous discharge and fistulography.

I ka loaʻa ʻana o ka fistula pancreatic, ʻo ka hōʻailona me ka hoʻokele ʻana o nā hana conservative a me nā mea hoʻokele. Hōʻailona ʻia nā fistulas inclope a me ka hoʻopiʻi maʻamau e like me ka papahana therapy CP maʻamau me ka hoʻomaʻemaʻe ʻana o ke ʻano ʻo nā fistulous a me nā ana, nā kāpae ʻana o ka maceration a puni ka papa fistulous. Ua lilo ka maikaʻi o ka mālama ʻana i ka fistula pancreatic i kūleʻa hou i ka pilina me ka hoʻomaka ʻana o ka octreotide (sandostatin) i ka pancreatology. Ke hoʻohana nei i kēia lāʻau lapaʻau, kahi hōʻemi o ka nui o ka hoʻokuʻuʻana mai ka paukū kūpono e 10 mau manawa a i ʻole ʻia i hōʻike ʻia, kahi e hiki ai iā ʻoe ke uku no ka hoʻopiʻi wai-electrolyte pono, hoʻomaʻamaʻa kūpono i ke kaʻo fistulous a kāpae i ka maceration kino. Aia kahi manaʻo e pili ana ka octreotide i kēlā me kēia lā o 100-300 μg e kōkua i ka pani i ka fistula ma mua o 70% o nā mea maʻi i loko o 6 mau lā.

ʻO ka lōʻihi o ka heleʻana o nā fistulas pancreatic e alakaʻi i nā ʻano hoʻopiʻi: malabsorption ma muli o ka nalowale o ka enzymes, insufficiency trophological ma muli o ka malabsorption a me ka nalowale mau o ka protein, nā wai a me nā meaʻeha mai ka hala o ka fistulous, komplication komplulent (suppuration of fistula, abscesses of the omental bursa, retroperitoneal phlegmon) nā maʻi ʻeha āpau e puni ana i ke kahe kūpono (ulcerative dermatitis, eczema), ka hoʻopuka koko.

No ka hoʻoholo ʻana i nā hōʻailona no ka mālama ʻana i ka lāʻau lapaʻau, ʻo ia hoʻi no ka manawa lōʻihi (4-6 mau pule) a me ka lapaʻau conservative hiki ʻole, pono ia e hana i ka fistulography, kahi hiki ke hoʻomaopopo i ka pili ʻana o ke ʻano o nā hana fistulous me GLP, ka hele ʻana o nā corectic, cystic formations. Ke hoʻonui nei i ka lōʻihi o ka mālama conservative ma nā maʻi me ka pancreatic fistula i hoʻopilikia i nā hopena koke o ka lilo ʻana o ka mea maʻi. Me nā fistulas pancreatic kūwaho waho a kūpaʻa ʻole i ka pharmacotherapy, he ala hou aʻe no ka lilo ʻana o ka hōʻiliʻili maʻi ʻana. "Hoʻopiha" i ka fistula a me nā ʻāpana o ka ʻōnaehana pancreatic me nā mea polymeric.

ʻO Gelatoprivial syndrome, ka hemaocellular insufficiency a me ka hepatic encephalopathy

ʻO ke kinipona Gelatoprivial kahi hopena hoʻopiʻi o nā maʻi, nā maʻi pancreatic koʻikoʻi. Nā kumu o ka maʻi hepatoprivial:
• nā hopena pili i ka ate me ka pancreatic, hemorrhagic a i nā traumatic shock, i hui pū ʻia me ka hōʻeha o ka pancreatic (kahi i kapa ʻia ʻo ka haʻalulu haʻalulu),
• ka pancreatitis luku kino, ka hana ʻana me ka endotoxemia koʻikoʻi me ka hoʻomaʻemaʻe ʻole ʻana (ʻo ka maʻi i kapa ʻia ʻo pancreatic-hepatic),
• ka mea hoʻomaloka microbial i ka hopena o ka hoʻopiʻi nui a i nā maʻi ākea ma ka hana o ka hoʻopiʻi purulent o OP (ka mea i kapa ʻia ka maʻi lēʻalopona i hōʻoli ʻia, a me ka piwa septic paha).
• nā pua thrombosis vekort,
• ka hōʻiliʻili manuahi ma ka pancreas (hōʻeha a hoʻolālā paha) me ka nui o ka trauma a me ka hikiʻole o ka pale anesthetic, e kū'ē loa i ke ʻano o ka mau hana koʻikoʻi o ka ate ma mua o ka hoʻomaʻemaʻe ʻana,
• ka wō a me ka lōʻihi o ka cholestasis, inā kū i ke kūpaʻa o ka hypoxic a me nā pōʻino o ka ate ma muli o ka hōʻino ʻana, OP, hōʻano i nā hōʻailona, he overdose o ka lāʻau hepatotoxic, etc.

ʻO ka hōʻeha o ka hepatitis B syndrome e hōʻike ʻia e nā ʻano hohonu o nā loli nui i ka protein synthesizing function o ka ate, ma mua, nā loli i loko o nā kiko o nā protein serum (albumin, transferrin, serum cholinesterase), a me ka ʻike o nā māka o ka cytolysis a me nā cholesstasis.

Hoʻomaʻamaʻa piha - etiotropic, pathogenetic a me nā hōʻailona. He ʻokoʻa nā hoʻokele Etiological a ke kuhikuhi mai nei i ka hoʻoponopono koke ʻana i kahi kumu maʻamau. Ka hoʻohana ʻana o ka hepatoprotectors (heptral, ursofalk, forte koʻikoʻi), antioxidants (ascorbic acid, oligogai-Se, unitiol, etc.), glucocorticoids (prednisolone, methylprednisolone), therapy detoxification a me ke kākoʻo e pono ai ka ʻoluʻolu e pathogenetically. ʻAʻole komo ʻo Detoxification i ka maʻi infusion wale nō, akā hiki ke hoʻopihapiha i nā hana hemocorrection extracorporeal (plasmapheresis, hemosorption). ʻO ka lawelawe oral i ka enterosorbents (enterosgel, polyphane) he maikaʻi nō hoʻi, a he kūpono loa ka lactulose (dufalac).

ʻO ka Hepatocellular insufficiency kahi hopena hemo o ka hepatoprivial syndrome e hiki ke hele pū me nā ʻano ʻino o ka OP, ka lōʻihi o ka cholestasis e pili ana i ke kāwili ʻana o kahi mahele o ka intrapancreatic o ka umauma bile maʻamau, ʻo ka biliary-hilinaʻi me kahi paʻa lōʻihi o ka calculus bile duct maʻamau. ʻO ka hoʻomohala ʻana o ka maʻi hepatopellular i nā mea maʻi me ka pancreatitis ka ʻoluʻolu o ka lau, like me ka fulminant viral a i ʻole hepatitis lāʻau, ʻoi aku ka ulu pinepine ʻana e like me kahi ʻano protracted, e pili ana i kekahi hopena hepatostabilizing o kekahi mau māhele o ka mālama koʻikoʻi.

ʻO ka hōʻike kino maʻamau o ka lawa o ka hepatocellular he hepatic encephalopathy. Hoʻomaopopo ʻia ka huaʻōlelo hepatic encephalopathy ka hopena o ka hoʻopulapula o ka maʻi cerebral e ulu ana ma ke ʻano o ka hōʻeha a i ʻole ka maʻi aʻa. He ʻano neʻe, a hiki i ka nānā ʻana i nā hōʻuluʻulu like ʻana, e hiki ai ke hoʻākāka i nā pae (hōʻeha) o ka hepatic encephalopathy.

He hana paʻakikī ka mālama ʻana i ka encephalopathy hepatic, no ka mea, ʻoi aku ka hopena o ka etiological o ka maʻi ma mua o ka manawa mau loa, a ʻo nā mea kolaila therapeutic i kēia manawa he multicomponent a ʻaʻole i hoʻohālikelike ʻia. Kuhi ka hapanui o nā gastroenterologists i ka hoʻohana ʻana i ka ʻai o ka waiora o ka wai haʻahaʻa, ka hoʻohana ʻana o ka laxatives a me nā ʻano like ʻole o ka hoʻomaʻemaʻe ʻana o nā ʻōpū o ka ʻawaʻawa, ka hoʻohana ʻana i nā antibiotics no ke kumu o ka decontamination intestinal, intermitate metabolites o ka urea cycle, branched chain amino acid, antagonists o benzodiazepine receptors a me nā lāʻau lapaʻau ʻē aʻe.

I mea e hōʻemi ai i ka hoʻokumu ʻana i ka hauoli i loko o ka ʻōpū, hoʻoneʻe ʻia ka lactulose (duphalac) - kahi disaccharide synthetic e wāwahi ana i ka colon ke lilo i ka lactic a me ka acetic acid, hoʻohaʻahaʻa i ka pH i ka ʻōpū o ka ʻōpū, pale i ka hana o nā mea kūmole ammonia, a hoʻoemi ʻia i ka hoʻopio ʻana o ka ammonia. Koho ʻia ka make o ka lāʻau lapaʻau ʻokoʻa (mai 30 a i 120 ml / lā). Inā ʻaʻole hiki ke hoʻohana i ka lāʻau lapaʻau, ua kuhikuhi ʻia i loko o kahi enema (300 ml kāpena i ka 700 ml o ka wai 2 mau manawa i ka lā).

ʻO ka mana nui o ka hyperammonemia i loko o ka pathogenesis o ka hepatic encephalopathy, ʻo ia ke kumu no ka koho ʻana i nā lāʻau lapaʻau e hoʻonui ai i ka kūaloli ʻana o ka ammonia i loko o ka puʻuwai. ʻO ka maʻamau maʻamau ʻo L-ornithine-L-aspartate.

ʻO ka hoʻomaka ʻana o ka maʻi hepatocellular me ka hemorrhagic syndrome e hiki nō - aia ke ihu a me ka ʻōpū o ka ʻōpū, ka ʻūhaka ʻana o nā wahi o ka maʻi a me nā kahua cannulation o nā veins, nā ʻōpū ʻōpala subutaneus ma luna o nā wāwae, ma nā wahi i hōʻike ʻia i ke kaumaha, nui ka ʻalaʻawa o ke koko gastrointestinal.

ʻO nā koina laboratory no ka lawa ʻole o ka hepatocellular i ka hihia o ka cholestasis mua e hōʻike ʻia e ka hyperbilirubinemia, a aia kahi "hoʻololi o ke alakaʻi" - ka nui o ka piʻi ʻana o ka bilirubin unconjugated. Me ka pōʻino o ka pūpū pīhoihoi, maʻi hepatorenal postoperative me ka hopena i ka encephalopathy, hiki i ka maʻi hyperbilirubinemia. Nalo nā Hypercholesterolemia, ke hele kokoke nei ke kukuna o ka kolamu nui i ka serum o ke koko i ka palena haʻahaʻa o ka maʻamau (3.5 mmol / L), ua hōʻemi maoli ʻia nā ʻike o ka māhele unesterified kolesterol. ʻO ka nui o ka albumin me ka emi iki loa (a hiki i 20 g / l), ʻoiai ke kahe o ke kaumaha catabolism, kūlohelohe ka hewa o ke ana o ka urea a me ke kōkua plastik kūpono me ke kōkua o ka meaʻai maoli.

Hoʻohui pinepine ʻia ka hypoalbuminemia hope loa me ka hyperazotemia. ʻO ka hapa nui o ka nitrous slag kahi nitrogen polypeptides e kū ʻole ʻia e ka ate. ʻO ka hana o ka serse pseudocholinesterase a me ka paʻa ʻana o ceruloplasmin, ka hoʻoneʻeneʻo transferrin i ke kahiki, e hōʻike ana i nā pilikia hohonu o ka protein synthesizing function o ka puʻuwai. Hōʻike ʻia kahi ʻano pale o ka hepatocellular insufficiency e ka hoʻomohala ʻana i ka maʻi edema, me ka ascites, kahi kuleana nui i ka hoʻomohala ʻana e hoʻokani wale nei ʻaʻole e ka hypoproteinemia holomua a me ka hoʻonui ʻana i ke kaomi venous portal, akā ke hoʻolilo nei hoʻi i ka hoʻoneʻe ʻana i ka ate ma o ka aldosterone.

ʻO nā hoʻololi nui i ka coagulogram he mau ʻano o ka hepatocellular insufficiency: kahi holomua holomua i ka huaʻōlelo prothrombin (i ka 60% a i lalo), proconvertin (ma lalo o 40%), kahi hōʻemi haʻahaʻa o ka neʻe o ka fibrinogen, ʻoiai me ka noho ʻana ma kekahi o nā poʻe maʻi o kahi hana purulent-inflammatory hoʻoikaika, ka mea e hāʻawi pinepine i ka hypercoagulation. I ka manawa like, hoʻonui ka hana o nā fibrinolysis a me ka proteolysis.

Hōʻike ʻia ka sindrom laboratorium cytolytic i kēlā mau maʻi me nā hōʻailona e hoʻonui i ka hiki ke hoʻonui i ka aspartylaminotransferase a me ka hoʻoweliweli maoli ʻana o ka coefficient de de Ritis. ʻO ka hana nui a ka γ-glutamyl transpeptidase e waiho mau, akā ma nā hihia koʻikoʻi e hoʻemi ana. Ke noʻonoʻo nei i ka emi nui o ka hana o nā mea pale anti antioxidant kūlohelohe, ʻo ia ka nui o ka hoʻonui ʻana i ka lipid peroxidation (i hoʻoholo ʻia e ka neʻe ʻana o ka malondialdehyde a me nā konene diene) he hopena maikaʻi loa i ke kino o ka mea maʻi me ka maʻi hepatopriva a hiki ke kumu i ka hoʻonui ʻana i ka maʻi hepatocellular.

Hiki ke mālama maikaʻi ʻia nā maʻi hepatocellular i ke kahua o ka precoma. Ka Hoʻohuli i ke hoʻololi, ka mea e hiki ai iā ʻoe ke mālama i ka lako o ka ikehu a me nā pae o nā procoagulants (nā plasma kūwaho me nā nui o nā waiven), ʻaʻole ia i hāʻawi i ka hopena kūpaʻa. Ke hoʻohana nei i nā substrates ikaika (glucose), pono e hoʻomanaʻo e pili i kekahi i ka hoʻohaʻahaʻa ʻana i ka insulin exogenous me ka hiki o kahi kūlana hypoglyxmic.

Hoʻonui ka infusion i ka hapa o ka albumin me ka hoʻohana ʻana i nā saluretics (me nā mea pōʻino liʻiliʻi) hiki ke hōʻemi i ka hōʻeha o ka edematous-ascitic syndrome. E kāohi i ka nui o ka ulu ʻana i ka nui o nā maʻi bacterial, hoʻākāka ʻia nā antibiotics like ʻole e like me kanamycin (a hiki i 4 g / lā), tobramycin, polymyxin, etc.

E hoʻohana i nā antioxidants pololei (ka huaʻalima E a i ka 600-800 mg / lā intramuscularly, dibunol i loko), a me nā lāʻau lapaʻau e hoʻomau i nā ʻōnaehana pale anti-antiogenous (5 ml unitiol 2-3 mau manawa i ka lā). ʻO ka hoʻohana ʻana o ka hepatoprotectors (heptral, pono forte, etc.) he mea ʻole paha i ka wā e mālama ana i nā mea pathological i alakaʻi i ka maʻi hepatocellular.

ʻO ka emi ʻana o ka hōʻeha o ka hyperbilirubinemia me ka hoʻonui ʻana i ka ʻike o nā huahana procoagulants a me kahi hoʻēmi ʻana i ka hana fibrinolytic i ke koko, he mau ka mana o ka ʻike o ka maʻi o ka serum, ceruloplasmin (a ma hope o ka hana serum cholinesterase), he hōʻemi i ka hōʻike o nā huahana lipid peroxidation i loko o ke koko me ka hoʻōla mau i ka hoʻoikaika ʻana o ka naʻau.

No ke aha i kū ai ke ʻano?

Nā kumu o ka hōʻuluʻulu ʻana o ka wai:

oncology (hana hoʻomālamalama)
cirrhosis o ke ake (ʻike ʻia ma 75% o ka poʻe)
puʻuwai paʻakikī
nā maʻi āpau like ʻole
piʻi
mahuahua
mai nā maʻi gynecological (ma nā wahine),
lōkohu

ʻO kekahi o nā pilikia paʻakikī, ʻo ka hele ʻana o ka oncology. ʻO ka mea maʻi i loaʻa ka hoʻomaopopo i ka pōʻino a me nā hōʻailona exacerbated e kuhikuhi i ka hoʻokō.

Hiki pū i nā pēpē hou mai nā ascites. ʻO nā kumu maʻamau ke kumu i ka hoʻomohala ʻia o ka maʻi i ka hoʻoweliweli ʻana i kahi keiki, nā ʻano edema congenital.

ʻO kaʻoiaʻiʻo, i kēia hihia, nā kumu nui o nā pathology he mau maʻi like ʻole a ʻino paha o ka makuahine nāna e lawe nei i ke keiki.

Hiki i ka wai ehu ke kumu o ka loaʻa ʻole o ka protein i ka meaʻai a ke pēpē. I kekahi manawa ke kānalua ka kaila o ka ascites no nā pēpē hou

Ke hoʻomaopopo pono i ke kumu e hoʻomaka ai ka nui o ka wai e hōʻuluʻulu i loko o ke kino, pono ʻoe e kipa i ka loea a hoʻomaʻamaʻa i nā maʻi diagnostics.

ʻO ka huakaʻi hōʻuluʻulu o ka lohi a me nā diagnostics

ʻO ka hoʻomohala ʻana i ka maʻi ma kēlā me kēia kanaka e pili ana i nā ʻano like ʻole. E nānā pono i ke kino kanaka i ʻike maopopo i ke ʻano o kēia hana ʻana.

I loko ʻo ia ka lamuna serous (membrane) e uhi ana i nā kino. I uhi ai i kekahi holoʻokoʻa loa, hoʻopili ʻia kekahi. Hoʻopili i nā hui kokoke, e hana ka membrane i ka wai.

I ka lā, ua hūnā ʻia a paheʻe, ʻae ʻia i nā ʻōpū e hana maʻamau a ʻaʻole e pili pū. Inā hōʻeha ʻia kahi kanaka i ka wai o ka wai nui, a laila hana hewa ka hana o kāna hana.

ʻO ke kaʻina hoʻohuli hana e kū nei, hana i kahi ʻāina maikaʻi no nā toxins. I kēia mea, ʻike pū kekahi mau hiʻohiʻona.

Inā maʻi kekahi kanaka me ka cirrhosis o ka ate, a laila hōʻiliʻili ka lolo i kekahi ala ʻē aʻe.

ʻEhā mau ʻaoʻao o ka ascites form:

Me ka cirrhosis o ke ake, ke piʻi nei ka puʻuwai, ma muli o ke kiʻi ʻana o ka hōʻuluʻulu o ka wai ma loko o ka ʻōpū,
Ke hoʻāʻo nei ke kino e hōʻemi i ka kaumaha o nā veins ma ka holo lymphatic. Hoʻokumu ʻia ka Lymphatic hypertension (ʻaʻole hiki i ke kino ke hoʻokūkū me ka ukana), ke kahe mai ke kahe mai loko o nā moku i ka ʻōpū o ka ʻōpū. No kekahi manawa, makemake ʻo ia i loko o ka wai, a laila hoʻole ka launa,
Me ka cirrhosis o nā ate, ua emi ka nui o nā huina o nā ate, he emi ka protein, ua haʻalele ke kahe i nā ipu, haʻalele ka peritoneum i ʻole.
E like me ka hoʻopili ʻana o ke kahe i loko o ka ʻōpū o ka ʻōpū, puka ana ke kahe o ke kahe mai ke koko. A laila ma hope o ka emi o ka nui o ka urine i hoʻokuʻu ʻia, piʻi mai ke koko.

Ma hope o ke kī ʻehā, ʻoi aku ka wikiwiki o ka hōʻuluʻulu ʻana a me ka hoʻonui. ʻO nā hoʻopiʻi hou ma muli o ka oncology (inā paha) inā paha.

Inā ʻeha ka ʻeha o ka puʻuwai, a laila kaʻe ʻana o ke ake i loko o ke akea, ma muli o ke kahe e kahe a ka wai mai kona mau moku.

ʻO ke kaʻina ʻeha o ka peritoneum e hoʻonāuki i ka hoʻōla nui o ka wai o ka nui, ʻaʻole hiki ke hoʻokuʻi, ma kahi hopena e komo ai i ka peritoneum.

Hoʻohana pinepine nā kauka i ka ultrasound, nāna e kōkua i ka piʻi ascites. Me kēia, ua ʻike ʻia kahi pāpālua no ka cirrhosis.

Hoʻolālā ʻia hoʻi ka ʻōnika i ka ʻike i ke ʻano o ka puʻuwai, nā ʻōpū o ka mea maʻi, kahi o ka hōʻiliʻili ʻana o ka wai.

Hiki iā ʻoe ke hana i kahi hoʻokolokolo me ka ʻole ka ultrasound - e hana i kahi palpation o ka ʻōpū o ka mea maʻi. Inā manaʻo ʻia nā lūlū o ka wai, a laila e ʻike ʻia ka ascites.

ʻO nā ʻenehana hou a me ka ultrasound e hiki ai iā ʻoe ke noʻonoʻo i kahi kahe me ka nui o ka hapalua o ka hapalua.

E hoʻopili i ka hepatoscintigraphy (kahi analog o ka ultrasound) e hoʻokumu i ke kūlana o ka ate, ka pae o ka cirrhosis.

ʻO ka hōʻailona o ke cirrhosis, ke hoʻomohala ʻia kona hoʻomohala e kahi coagulometer - kahi mea e kōkua ai e hoʻoholo i ka coagulation koko.

Lawe nā kauka i nā hoʻokololi koko venous no ka α-fetoprotein, ka mea e ʻike ai i ke kanikola o nā ate e hoʻolilo i ka nui o ka wai.

Kōkua kekahi X-hihi o nā kino i ke ʻano maʻi. No kahi laʻana, he X-ray o ka māmā ke kōkua i ke kuhikuhi ʻana i ke kiʻekiʻe o ka maʻi pākōkē, ka nui o nā wai, ke kumu o ka hōʻiliʻili o ka wai.

Aia kahi angiography - kahi hōʻike o nā pili koko (kahi analog o ka ultrasound), e kōkua ana i ke ʻike i nā kumu o nā ascites (ascites o vascular origin).

Hiki i kahi loiloi biopsy o ka peritoneum a me nā leʻaleʻa. I kekahi manawa hana nā kauka i kahi hoʻokolohua wai wai, ma hope o ka hana noiʻi. Hiki ke kau ʻia ka mea maʻi i kahi ʻano o ka urea, sodium, creatinine, pāhare.

Nā lāʻau no ka mālamaʻana i ka maʻi

I kēia manawa he mau ala e hoʻomaʻamaʻa ai i nā ascites. Hoʻopili pinepine ʻia kēia maʻi me ka mau hewa ʻana o ka gastrointestinal tract, ate.

Hāʻawi i kēia mea maoli, hōʻike pinepine nā kauka i ka ʻai me nā mea kaumaha, nā meaʻai maikaʻi, i ka wai ʻona, a me ka paʻakai.

Hoʻokomo ʻia nāʻaina liʻiliʻi nāu, nā mea momona i kuke ʻia i ka moa, ʻono ʻia ka veal. Pono e hoʻololi i ka pani i kahi nati.

ʻO nā mea maʻi me ka ascites e pono e hele pono e hele i kahi papaʻai, inā ʻaʻole i loaʻa ka hopena o nā hoʻopiʻi a i ʻole hoʻi i ka maʻi.

ʻAʻole hiki iā ʻoe ke ʻai i ka pulisa, ke kāleka, nā niki, nā kālai, ka ʻūhū, ka ʻōpala, nā turnips, nā ʻano hua like ʻole. ʻO ka waiū skim pono a me nā huahana waiahi paha e ʻai ʻia.

ʻAʻole hiki iā ʻoe ke ʻai i ka palaoa, paʻakai, uala. ʻAi ʻia nā ʻano ʻai manuahi, sausages, ʻoki ʻole ʻia. ʻO ka pīpī mai ka palaoa, hiki ʻole kekahi kīnē ka mea hiki ʻole.

Eia naʻe, ʻaʻole ka hopena o ka meaʻai no kēia maʻi i ka hoʻokaʻawale ʻana i ka nui o ka ʻai kanaka. Pono ka mea maʻi e hoʻopau i nā inu ʻoluʻolu.

Pono ke kanakolu o ka pākeke o ka ʻohi ʻaina ke ʻā. Hiki ke hoʻomāwahi ʻia ka palaoa. Kūkulu ʻia nāʻaila momona. Hiki iā ʻoe ke kuke i ka paila ʻaʻohe millet.

Hiki ke hoʻopau ʻia nā hua manu ma ke ʻano he omelet, hoʻokahi a ʻelua paha ma ka pule. No nā mea ʻala, hiki iā ʻoe keʻai i ka aniani, marshmallows.

ʻO ka pahuhopu nui o ka hoʻomaʻamaʻa ʻana ke hoʻokō i ka momona kaumaha o ka mea maʻi. Ma hope o hoʻokahi pule, e lilo ke kanaka i ka liʻiliʻi o ʻelua kilona.

Inā ʻaʻole hana kēia, a laila hoʻouna ʻia ʻo ia i ka haukapila, diuretics i kuhikuhi ʻia. Hoʻomaʻamaʻa pinepine ka mea maʻi no nā electrolytes i ke koko.

Ma hope o ka hana ʻana i kēlā papa o ka mālama ʻana, hiki ke hoʻomaikaʻi ʻia ka hoʻomaʻamaʻa ʻana o kahi kūlana no kahi kanaka e loaʻa ana i ka ascites.

Hoʻolaha ʻia ka hana i nā hihia koʻikoʻi nui, inā ʻaʻole e kōkua ka mālama ʻana me ka mea ʻai me nā lāʻau lapaʻau. E like me ke kānāwai, me ka hoʻoholo ʻana i ka manaʻo o ka prognosis o nā ascites he mea maikaʻiʻole.

He mea maʻamau paha ia i kēlā mea maʻi i kekahi mau manawa o ka oncology. ʻO nā hōʻailona o ka ascites a me nā mīkini noiʻi noiʻi e kōkua e hoʻoholo i kēia ma kahi kikoʻī.

Eia nā mea hana no kēia hana no ka mālama ʻana i nā ascites.

hoʻonohonoho ʻia o kahi shit peritoneovenous,
paracentesis, puncture o ka paia o ka ʻōpū (transudate ua lawe ʻia ma hope o ka puncture),
heleʻe kōpili.

ʻO ka hana maʻamau e hoʻopau ai i ka ascites he puncture o ka ʻōpū o ka ʻōpū, ma ke ʻano ʻuʻuku o ka manu kaomi.

ʻO nā ʻano ʻē aʻe ʻē aʻe e koi i nā kūlana kūikawā - anesthesia, nānā kokoke. No ka mea hoʻohālikelike, hana ʻia kahi neʻe hāpū me nā pae ʻokoʻa o ka oncology.

Inā i kau ʻia ka mea maʻi ma ka paracentesis, hana ʻia kahi kūloko kūloko - ʻāpana o ka lula. Ma hope o kēia, ua lawe ʻia ka hana ʻana o hoʻokahi kenimeter i ka lōʻihi, e hoʻomaka ana e hoʻomaʻū ana i ka wai o ka nui.

E pili ana kēia hana i kahi noho noho o ka mea maʻi.

Pono e hoʻomanaʻo ʻia he mau contraindications kekahi hana. Aia kekahi makehewa o ka hepatic coma, kūlohelohe o loko.

ʻO nā maʻi me nā maʻi lēpaʻa, ua hoʻohālikelike kēia ʻano hana. I kekahi mau manawa ka Paracentesis e hoʻopiʻi ai i nā hoʻopiʻi - ka emphysema, ka hemorrhage ma ka ʻōpū o ka ʻōpū, a me nā hana hewa.

I kekahi manawa ke hana nei ka hana me ka hoʻohana ʻana i ka ultrasound. Ma hope o ka hōʻea ʻana, hiki i ka wai neʻe i hōʻiliʻili ʻia mai waho o ke kino o ka mea maʻi no ka manawa lōʻihi, e kōkua ana i ka wehe ʻana i ka maʻi.

Hiki i ka poʻe makemake e wehe i nā ascites ke hoʻohana i nā ala lāʻau lapaʻau e hoʻoneʻe i nā hōʻailona o ka maʻi.

Hana ʻia nā lāʻau lapaʻau no nā mea he "haʻahaʻa" i nā hōʻailona o ka hōʻuluʻulu ʻana o ka wai, kahi hoʻomaʻamaʻa hoʻohiki, a ʻaʻohe kānalua o nā ʻanoʻokoʻa o ka oncology.

Hiki ke kōkua i ka paukena i ka hana pono me ka maikaʻi. No ka mālamaʻana i nā ascites (hōʻiliʻili i ka wai), hiki iā ʻoe ke hana i nā pākōkō, nā pākō i kū ʻia.

Hoʻohana pinepine ʻia ka ʻili parsley i mea he diuretic. Hoʻopili ʻia ʻelua mau punetola o ka pālia i loko o kahi ipu wai o ka wai wela.

Pono ka pani ʻia o ka mana, pono ke hoʻopaʻa ʻia i nā hola ʻelua. Pono ʻoe e inu i hoʻokahi haneri milila o ka infusion ʻelima mau manawa i ka lā.

Hiki i nā Parsley i pīpī ʻia i ka waiū. Pono ʻoe e lawe i hoʻokahi oho pālio, waiwai i loko o ka lita o ka waiū wela, waiho i loko o ka wai ʻauʻau. E hoʻomoʻa i ka hapalua hola. Pono ka inu i loko o ka nui o luna.

Kuhi pinepine nā kauka i nā diuretics. Hiki ke hoʻomākaukau ʻia kekahi ʻano lāʻau like ʻole ma ka home. No ka laʻana, hiki iā ʻoe ke hana i kahi decoction o bean pods.

Pono e ʻokiʻoki ʻia nā ʻōpala - pono ʻoe e ʻelua mau punetēpē o kēlā ʻano lei. I hope, pono ʻoe e hoʻolapalapa i ka pauka i ka wai (ʻelua lita) no nā ʻumikumamālima mau minuke.

I mea e lanakila ai nā ascites, pono ʻoe e inu i ʻekolu manawa i hoʻokahi haneli mililiter i ka lā.

1 ʻO ke kumu no ka hoʻomohala ʻana o nā pathology

Me ascites, he hōʻuluʻulu ʻana o nā ʻano wai i loko o ka ʻōpū o ka ʻōpū, ʻaʻohe ona huakaʻi. I ka nui o nā hihia, hoʻopili nā kauka i kēia pathology me ka uaki ʻole o ka wai-paʻakai a me ka edema. He paʻakikī ke kuhi hewa e piʻi aʻe kahi kanaka. Ke hoʻomau nei ke kanaka e like me ka maʻamau a hiki i ka neʻe ʻana mai o nā maʻi koʻikoʻi mua, a hiki i ka hoʻomakaʻana o nā patology e hoʻopilikia maikaʻi i ka pono o ka mea maʻi.

Hiki i nā ascites oncological ke hōʻeha i kahiʻano o nā maʻi koʻikoʻi, inā ʻaʻole hiki i kekahi o nā mea ʻokoʻa ke kū i nā kaumaha i kau ʻia ma luna. ʻO ka hōʻiliʻili o ka wai puna i ka peritoneum e ʻike pū me ka maʻi kano o ka puʻuwai, ka puʻuwai a me nā pūpū. Hoʻokomo kēia mau mea i ka hoʻoili ʻana o ka wai ma loko o ke kino. Inā pilikia nā pilikia mai ka ʻōnaehana cardiovascular, a laila maʻi ʻia lākou e nā maʻi valve, myocarditis.

ʻO ka hoʻopiʻi ʻana o nā maʻi ma muli o ka hypoplasia, ke maʻi pākī, ke kanesa, ka hoʻohuihui ʻokoʻa o ke kino ke kumu ʻana o ka hōʻuluʻulu ʻana o ka ʻōpū ma loko o ka ʻōpū. ʻO ka Hepatitis a me ka cirrhosis e hoʻonāukiuki i ka hoʻomohala o ka pathology.

Hiki i ke kumu o ke ala hiki i ka oncology. Ke hoʻomāhuahua ka nui o nā maʻi kanesa, pili lākou i ka hana o nā kola he nui a me nā ʻōnaehana, ʻoiai inā i hele mai nā maʻi kūwaho i loko o kēia mau papa nā iwi kanesa i komo i ke kino me ke koko. Hoʻomaʻa ka ʻenehana i ka hana ma kāna ʻano maʻamau, a ma muli o ka hopena - ka hōʻemi o ka nui o nā wai i nā mea nui.

2 Pūʻano

He mau hiʻohiʻona hiʻohiʻona ʻo ka Ascites wale nō o. Eia kahi mea, inā aia ke kanaka ma kona kua, a laila hoʻomaka ka ʻōpū i nā ʻaoʻao ma nā ʻaoʻao. ʻO kēia ke kumu o ka hāʻawiʻana o ke kaila. ʻO kekahi hōʻailona ʻē aʻe he pihi ʻōpū. Inā e kīlī ʻoe i kou lima ma ka ʻōpū, kani ke kani ʻana ma muli o ka wai i hōʻuluʻulu ʻia. Hiki i ka maʻi ke hele pū me nā pilikia kiʻekiʻe o ke koko a me nā pilikia hanu. Ma kahi kūlana i haʻalele ʻole ʻia, hiki mai paha ka prolaps o ka rectum.

Hoʻokumu ka mālama ʻana i nā ascites i ke kumu o kona hoʻokumu ʻana. E hoʻoneʻe i ka wai i hōʻuluʻulu ʻia, hoʻomanawanui ka mea maʻi i ka laparocentesis, ke kumu o ke kuke ʻana i ka wai ma hope o ke kū ʻana i ka ʻōpū.

Me nā pae kiʻekiʻe o ka maʻi maʻi, piʻi mau ka ascites e ka protrusion o nā paia o ka ʻōpū. Hoʻopalā nui ʻia nā veins e hele ana ma kēia wahi. Hiki ke hōʻuluʻulu ka Fluid i nā wahi noi. Me ka maʻi kanesa, ʻo ka hopena o ka ulu ʻana i nā ascites, e like me nā kauka, he 10%.

Akā ʻaʻole hiki i kēlā me kēia kanesa ke hele pū me nā ascites. Loaʻa ka hoʻomohala o ka pathology inā ka mea maʻi:

colectal maʻi ʻaʻai
ʻōpū o ka ʻōpū a i ʻole ka ʻōpū
nā moʻi maʻi ʻino o nā molmary manuahi a ovaries.

3 Ke kali nei ke ola

Me ka hanaʻino i ka pancreas, hiki i ka manawa ke kūkulu i nā ascites e liʻiliʻi. ʻO lākou ka mea kiʻekiʻe loa ma ka maʻi kanesa ovary, a hiki i 50%. ʻAʻole make ka make me kēia neia mai ka maʻi maʻi, ʻo ia hoʻi mai ascites. He aha ka mea e hōʻuluʻulu ai ka wai i loko o ka ʻōpū o ka ʻōpū?

Ke piʻi ka naʻau, i ka neʻe ʻana o ka diaphragm. E neʻe i loko o ka puʻu umauma. Ua kūlohelohe ka hana o ka hanu a me ka hana o ka puʻuwai.

I ke kūlana olakino, aia ka wai me ka kahe ma ka ʻōpū. Heʻuʻuku ʻia kona mau kikoʻī, pono ke kūpono. Kāohi ia i ka hoʻopaʻa ʻana o nā ʻōpū kūloko a pale iā lākou mai ke kahaki ʻana aku i kekahi i kekahi.

ʻO ka nui o ka wai i loko o ka'ōpū o ka ʻōpū e hoʻoponopono mau ʻia. Hoʻohālikelike ʻia ka hana. Me ka oncology, pau loa kēia hana. Loaʻa paha ka hoʻomohala ʻana i nā hanana ma nā ʻaoʻao ʻelua. I ka hihia mua, hoʻopili ʻia ka nui o ka wai, ma ka lua ʻaʻole hiki ke hoʻopili piha ʻia. ʻO ka hopena, loaʻa nā ascites. Noho ka pūnaewele āpau e ka miki. Kuhi ʻia kahi kūlana i ka wā o ka nui o ka pulu ʻia i ka wai, he 25 lita.

Hiki i nā cell cancer ke komo i ka peritoneum, e hoʻopau ana i kāna hana absorption, ka nui o ka nui o ka wai e hoʻonui.

ʻAʻole hiki ka Ascites i ka manawa i hala. Hoʻomaka a pau ʻia - mai he mau hebedoma a i he mau mahina, no laila ke ʻike ʻia ka hana mua. Ke hoʻonui nei ka paʻakikī. Hiki i kona paʻakikī ke hana i nā hana maʻalahi.

Uaʻike nui ʻia ka ʻaoʻao o ka maʻi e ka maka mua - ʻo ka maʻi kanesa. ʻOi aku ka pilikia o ke kūlana, ʻoi aku ka nui o ka hoʻomaka ʻana o ke kahua kō. I ka hoʻomaka, ʻaʻole e pili ka ascites i ke kūlana o ka mea maʻi, a laila, me ka hōʻuluʻulu o ka wai, ʻike ʻia nā hōʻailona e like me like me ka appendicitis.

Inā ʻoe i loko o ka manawa a hoʻomaka i ka mālama ʻana, e ʻoluʻolu paha ka hopena. No ka hana i kēia, e hoʻolei i ka nui o ka wai me ka hahai i kahi meaʻaiʻai. I nā manawa he nui, kau ka ola o ka mea maʻi ma ka papa o ka maʻi lalo, ka makahiki a me ke ʻano o ke kino.

Nui nā mea e hāpai i ka manaʻolana me ka hōʻuluʻulu ʻana o ka wai: inā paha i hoʻokō ʻia ke mālama ʻana, pehea ka maikaʻi, pehea e ulu ai ka ʻōkuhi malignant. Inā he hopena koʻikoʻi ke kūlana o ka mea maʻi, a he nui ka maʻi o ka maʻi ma ke alapine me ka metastases, a hoʻomau ka piʻi a piʻi i nā ala, e piʻi nui nā hōʻailona o ka maʻi, a ʻaʻole nā mea mālama i nā hopena maikaʻi. I kēia hihia, hiki i nā maʻi ke noho mai nā hebedoma a hala i mau mahina.

Inā hōʻoluʻolu a maʻalahi ke kūlana, a e pono ka mālama ʻana, a laila hiki i nā mea maʻi ke noho lōʻihi. Ma kēia hihia, hiki i ka mea ke manaʻolana i ka hoʻokau kūleʻa e alakaʻi i ka hoʻokō o nā kala piha a i ʻole ma kahi ʻāpana o ke kala a me ka ascites. Akā e pono ke hahai i nā ʻōlelo aʻoaʻo a pau o ka loea, e mālama mau i ka nānā ʻana a hōʻike i nā loli liʻiliʻi i loko o ke kino i ke kauka e hele mai ana.

ʻO nā hiʻohiʻona o nā meaʻai no nā maʻi me ka pancreatitis a me ka gastritis

Ka ʻai ʻaina - ʻaila semi-wai i loko o ka wai a i ka waiū paha (ka laʻu, oatmeal, ʻīpala, semolina i ka ʻoli), ʻūlū ʻai ʻūlū, ʻū palupalu, kuki ʻia ka pīpī.
ʻAi awakea a ʻaina awakea - omelet mai ʻelua hua ʻole i ʻole yolks, wai wai hoʻoheheʻe ʻia.
ʻAina awakea - kākā kuke, kalima stroganoff mai ka ʻiʻo mua i kau ʻia, ka lau maʻa keʻokeʻo, kālua ʻia i nā lau ʻai ʻia a me nā huaʻai, nā ʻuala kuke, compote.
Snack - ʻaina kekāhi, kaʻaā o ka rose rose.
ʻAiina - iʻa ʻia a i ʻole iʻa iʻa iʻa, nā meaʻai hoʻāla, kaʻaila me ka waiū.
Ma mua o ka hele ʻana e hiamoe, he waiū a i ʻole kefir ka mea e pono ai.

ʻO ka hoʻohana ʻana i ka waiū a i ʻole nā mea i hoʻopaʻa ʻia i nā ʻōmole i nā ʻōkuhi pono e hoʻopili ʻia me ke ʻano o ka gastritis i hoʻokumu ʻia - me ka hoʻohaʻahaʻa haʻahaʻa, ua hoʻololi ʻia ka waiū āpau i ka wai a i kefir. ʻO ka nui o ke kō, e hāʻawi ʻia i nā kumuwaiwai kūlohelohe i nā huaʻai a me nā mea kanu, ʻaʻole pono e ʻoi aku ma mua o 40 g i hoʻokahi lā a me 15 g i ka manawa.

Nā manaʻo ʻōlelo huakaʻi

Inā ʻoe e ʻimi i kahi mau kānāwai o ka ʻai ʻana, hiki i kahi ʻona maʻi ke hanu nei, me ka ʻole e hōʻehaʻeha iā ia iho, nui o nā mea maʻi e hāʻawi. I mea e pale ai i ka hoʻomohala ʻana o nā maʻi maʻi o ka pēpē o ka gastrointestinal, ʻo kahi moʻomeheu meaʻai ka mea ʻole i ʻoi aku ka nui o ka maikaʻi o ka ʻai, a no ka poʻe i maʻi me ka gastritis a me ka pancreatitis, pono ke kiaʻi ʻana. Kūlana nui:

1. Hōʻalo i ka inu nui. ʻO ka nui o ka ʻai me ka hoʻonāukiuki ʻana i nā paia o ka ʻōpū, hana i nā ʻano no ka ʻoi a me nā ʻūhā, ʻoi aku ka naʻau, ke kāʻei a me ka hōʻino o ka meaʻai hiki ke hele, i mea e hoʻopiʻi ai i ka pancreas.

2. Pono eʻai mau nā meaʻai. I loko o ka wā o ka hōʻoluʻolu, pono ia e ʻai i nā manawa 6 i ka lā, ma hope o ka hebedoma - 5, no nā maʻi maʻi - ka liʻiliʻi 4 mau manawa. ʻO ka hana ʻana o ka meaʻai paʻa mai ka ʻōpū a i nā ʻōpū hoʻi he 3-6 hola, ʻo ka papa kuhikuhi no kēlā me kēia lā i hōʻuluʻulu ʻia i nā hola he 3-4 ma hope o ka pāʻina kahi liʻiliʻi liʻiliʻi.

3. Pono ka kakahiaka kakahiaka nui e like me ka hiki, a me kahi pāʻina māmā - ʻaʻole ma mua o 3 mau hola ma mua o ka hiamoe. Inā hiamoe ke kanaka a aia i ke kūlana pahū, hoʻōla ka hana ʻana i loko o ka ʻōpū e hoʻomaʻamaʻa, a hiki ke pohō.

4. I ka wā nui ka pancreatitis e hoʻomaʻamaʻa i ka meaʻai. Pale kēia i ka hoʻowalewale mechanical, wikiwiki i ka hoʻowalewale ʻana, hōʻemi i ka kaumaha ma ka pancreas. Ke hoʻomoe nei i kahi hamburger nui i kēlā me kēia lā i ka hoʻomaha mau ʻelima mau minuke ke ala maikaʻi loa e hele aku i ka haukapila ma ke ʻano he 25-30 mau makahiki.

5. Pono ʻoe e pale i ke kaumaha ma ka wā ʻai, e hoʻokolo i ka ʻai. ʻO ka nānā ʻana i kahi meaʻai no ka maʻi gastritis me ka hoʻohaʻahaʻa haʻahaʻa a me ka pancreatitis, ʻo ia ka mea nui loa ka hūnā ʻia mai nā mea āpau a kau ma luna o ke ʻano ʻono a me nā ʻono kīʻaha - e kōkua kēia i ka hoʻowalewale ʻana.

6. Pono e hōʻalo i nā hana maikaʻi ʻole - ʻo ka waiʻona me ka pancreatitis hiki iā ia ke pepehi maoli, a ʻo ka ulaula e hoʻowalewale mau ana i nā membrane a me nā mea ʻino o nā kino.

Ke hoʻolālā nei i kahi papaʻai meaʻai no ka maʻi pancreatitis a me gastritis, e noʻonoʻo e noʻonoʻo pono ʻoe e hahai iā ia no ke koena o kou ola. Hiki i ke koho ʻoluʻolu, nā ʻano like ʻole a me nā kaupaona ʻana e hōʻoluʻolu maoli i ke ala o ka maʻi a hoʻopaʻa i ke kali ʻana i ke ola holoʻokoʻa, akā ʻo nā mea āpau ma waho aʻe o ke ʻano he mea e pōhoihoi koke ai ka make, ʻoiai hoʻi i ka wā ʻelemakule.

Hoike ʻike

ʻO ka Ascites a i ʻole ka ʻōpū o ka ʻōpū e hiki ke hele i ka papa o nā maʻi ma ka gastroenterology, gynecology, oncology, urology, cardiology, endocrinology, rheumatology, a me lymphology. ʻO ka hōʻiliʻili o ka waiu peritoneal i ascites me ka hoʻonui ʻia ʻana o ke kaomi intra-abdominal, kaomi ʻana i ka pahu o ka diaphragm i loko o ka lua o ka umauma. I ka manawa like, ua pau ka palena o ka hanu ʻana i ka māmā o ka māmā, ka hana cardiac, ka holo ʻana o ke koko a me ka hana o nā ʻōpū o ka ʻōpū. Hiki i nā ascites nui ke hele pū me ka nalowale nui o ka protein a me nā abnormalities electrolyte. No laila, me ka ascites, ka hanu a me ka puʻuwai puʻuwai, e hiki ke ulu i ka hana hōʻiliʻili metabolic, ka mea e hopohopo nei i ka māhuahua o ka maʻi lalo.

ʻO nā kumu o nā ascites

ʻIke pinepine ʻia nā Ascites i loko o ka wā hou i ka maʻi hemolytic o ka pēpē, i nā keiki ʻōpio - me ka maʻi palupalu, enteropathy exudative, congenital nephrotic syndrome. Hiki i ka ulu ʻana o nā ascites ke hoʻopili i nā leʻaleʻa like ʻole o ka peritoneum: hoʻokaʻawale i ka peritonitis kūʻokoʻa, ka maʻi tuberkulosis, kaʻi ʻana, ka lolo parasit, ka perotoneal mesothelioma, pseudomyxoma, ka carcinosis peritoneal ma muli o ke kanesa o ka ʻōpū, ka ʻōpū nui, ka ʻōpū, nā ovaries, endometrium.

Hiki i ka Ascites ke lawelawe i kahi hōʻike o ka polyserositis (pericarditis pū kekahi, pleurisy a me ka dropsy o ka ʻōpū o ka ʻōpū), e loaʻa ana me ka rheumatism, systemus lupus erythematosus, rheumatoid arthritis, uremia, a me ka maʻi Meigs (komo pū ka fibroma ovarian, ascites a me hydrothorax).

ʻO nā kumu maʻamau o ka ascites he mau maʻi e kū mai me ka hypertension portal - he piʻi nui o ka neʻe ʻana i loko o nā pūnaehana o ka wahī (portal vein a me kāna mau nā kaila). Hiki ke ulu i ka maʻi hypertension a me ka ascites ma muli o ka cirrhosis, sarcoidosis, hepatosis, hepatitis alikaʻi, heʻumeu hepatic i hoʻāhu ʻia e ka maʻi paleka, hypernephroma, nā maʻi koko, thrombophlebitis maʻamau, a laila, stenosis (thrombosis) o ka waihona a i ʻole vena cava, stousosis stasis. me ka maikaʻi ʻole o ka ventricular.

ʻO ka hapa o ka protein, maʻi o ka ʻōpū (nephrotic syndrome, glomerulonephritis kroni), hōʻeha puʻuwai, myxedema, gastrointestinal tract disease (pancreatitis, maʻi a Crohn, ʻeha paʻa), lymphostasis pili me ka hoʻopiʻi ʻana o ka limu lymphatic thoracic, lymphangiectasia a me ka hana ʻana i ka lymphatic tract e predisposite e pili ana. . ^ E Ha yM.

ʻO ka maʻamau, ʻo ka uhi o ka pale o ka ʻōpū o ka ʻōpū - ua hana ka peritoneum i ka nui o nā wai o ka wai e pono ai no ka neʻe ʻana o nā pono o nā ʻōpū a me ka pale ʻana o ka ʻaila o nā ʻōpū. Hoʻomomo ʻia kēia exudate e ka peritoneum like like. Me nā maʻi he nui, ka hoʻokaʻawale ʻana o ka mea huna, ka resorptive a me nā hana pā o ka peritoneum, e alakaʻi ana i nā hiʻohiʻona o ka ascites.

No laila, hiki ke hoʻomoe ʻia nā pathogenesis o ka ascites i kahi paʻakikī o ka maʻi o ka maʻi, ka hemodynamic, hydrostatic, ka wai-electrolyte, ka huʻina o ka metabola, ma kahi o ka ea interstitial e hōʻoluʻolu nei a hōʻuluʻulu i loko o ka ʻōpū o ka ʻōpū.

Nā hōʻailona o nā ascites

Kūlike i nā kumu, hiki i ka pathology ke ulu wikiwiki a palau paha, e hoʻonui ana i nā mahina he nui. ʻO ka maʻamau, mālama ka mea maʻi i ka hoʻololi ʻana i ka nui o nā lole a me ka hiki ʻole ke paʻa i ke kāʻei, loaʻa ka nui. Hōʻike ʻia nā hōʻike maʻi o ka ascites e nā manaʻo piha o ka ʻōpū, ka kaumaha, nā ʻōpū o ka ʻōpū, ke kīwī, nā puʻuwai a me ka belching, ka lua.

Ke piʻi nei ka nui o nā wai, e piʻi ana ka ʻōpū i loko o ka leo, nā protrudes navel. Ma ka manawa like, ma ke kū ke ku, kū ka ʻōpū o ka ʻōpū, a i ka kūlana o ka paia maʻa ʻia ia, ʻāwili i nā keʻena hope ("frog abdomen"). Me kahi nui o ka effusion peritoneal, pōkole ka hanu e kū mai ana, e kaʻe ana i nā wāwae, nā neʻe, ʻili nui a huli hoʻi i nā tilts o ke kino. ʻO ka hoʻonui nui loa o ke kaomi intra-abdominal i loko o ka ascites hiki ke alakaʻi i ka hoʻomohala ʻana i ka umbilical a i ʻole femoral hernias, varicocele, hemorrhoids, a me ka prolaps o ka rectum.

ʻO ka ascites i loko o ka peritonitis tuberculous ma muli o ka maʻi kūlohelohe o ka peritoneum ma muli o nā maʻi o ka maʻi tuberculosis a i ʻole a nā maʻi ʻōpala. No nā ascites o ka etiology tuberculous, ka nui o ke kaumaha, ke kuni, a me ka hoʻohālikelike maʻamau he ʻano maʻamau nō ia. I loko o ka ʻōpū o ka ʻōpū, i hoʻohui ʻia i nā kaʻe ascitic, hoʻonui ʻia nā hua lymph ma ka mesentery o ka ʻōpū. ʻO ka exudate i loaʻa me ka ascites tuberculous aia kahi>> 1616, kahi kiko o ka protein o ka 40-60 g / l, he hopena Rivalt maikaʻi, a me kahi neʻe o nā limahana, nā erythrocytes, nā huina endothelial, he mycobacterium tuberculosis.

Hoʻomau ka piʻi me ka carcinosis peritoneal me nā nū lymph nui i hoʻonui ʻia i nā pā ʻōpū o ka ʻōpū. ʻO ka hoʻopiʻi ʻana i nā hoʻopiʻi me kēia ʻano piʻi. Hoʻokomo ʻia ka effusion peritoneal i ka hemorrhagic mau loa i ke kūlohelohe, i kekahi manawa ke loaʻa nā cell atypical i ka sediment.

Me Meigs syndrome, ua loaʻa ka fibroma ovarian (i nā manawa nā maʻi ovarian malignant), ascites a me hydrothorax i ʻike ʻia i nā mea maʻi. Hōʻano ʻia e ka ʻeha o ka ʻōpū, paʻa loa o ka hanu. Hōʻike ʻia ka hemahema ventricular kūpono e piʻi me ascites e ka acrocyanosis, ke kahe ʻana o nā wāwae a me nā wāwae, hepatomegaly, ʻeha i ka hypochondrium kūpono, hydrothorax. I ka hana ʻole, ua hui pū ʻia nā ascites me ka ʻāʻī ʻana o ka ʻili o ka ʻili a me ka kiko o ka subcutaneous - anasarca.

ʻO ka Ascites, e hoʻomohala nei e pili ana i ke ʻano o ka portal trombosis portal, hoʻomau ʻia, i hele pū ʻia me ka ʻeha ʻeha, splenomegaly, a me ka hepatomegaly liʻiliʻi. Ma muli o ka hikiʻana o ka alahaka collateral, hele pinepine ka huhū mai ka ʻōpū o ka hemorrhoids a i ʻole nā varicose veins o ka esophagus. Anemia, leukopenia, thrombocytopenia ʻike ʻia i ke koko peripheral.

ʻO ka Ascites pū kekahi me ka portal hypertension intrahepatic hele pū me ka dystrophy muscular, hepatomegaly modular. I ka manawa like, ua hoʻonui ʻia ka hoʻonui ʻia o ka pūnaewele venous i ke ʻano o ke "anele ulu" ma luna o ka ʻili o ka ʻōpū. Ma ka hipertension portal posthepatic, hoʻohui ʻia nā ascites hoʻomau me ka jaundice, i hōʻike ʻia e hepatomegaly, ʻaloha a me ka luaʻi.

ʻO nā Ascites i loko o nā koina o ka protein ka liʻiliʻi ma ka liʻiliʻi, ua nānā ʻia ka peripheral edema a me ka hoʻopiʻi ʻana i nā pleural. Hōʻike ʻia ka polyserositis i nā maʻi rheumatic e nā ʻano ʻili o ke kino, ascites, ka ʻike ʻana i ka wai i loko o ka lua pericardial and pleura, glomerulopathy, arthralgia. Me kahi wai lymphatic kahaha (chylous ascites), hiki i ka nui ke hoʻonui i ka nui. He waiu waiu ka ascitic, he ʻano pasty maʻamau, a ma kahi noiʻi noiʻi, ʻike ʻia nā momona a me nā lipoids. ʻO ka nui o ka wai i loko o ka kahe peritoneal me nā ascites hiki ke piʻi i 5-10, a i kekahi manawa 20 lita.

Nā huapau

I ka wā o ka nānā ʻana, ʻaʻole i loaʻa i ka gastroenterologist nā kumu ʻē aʻe o ka hoʻonui ʻana i ka nui o ka ʻōpū - obesity, ovarian cyst, hapai, ʻeha o ka ʻōpū o ka ʻōpū, a me nā mea e hoʻowalewale ai i nā ascites a me nā kumu, percussion a me palpation o ka ʻōpū, ka ultrasound o ka ʻōpū, ka ultrasound o nā moku welo a lymphatic, MSCT ʻōpū o ka ʻōpū, pūpū scintigraphy, laparoscopy diagnostic, ascites fluid examination.

ʻO ka kamaʻilio ʻana o ka ʻōpū me nā ascites e hōʻike ʻia e ka ʻūhā o ke kani, kahi lihi i ka palena o ka ʻūhā me nā loli i ke kūlana o ke kino. Ke kau nei i kou pā palau ma ka ʻaoʻao o ka ʻōpū e hiki ai iā ʻoe ke noʻonoʻo i ka hiʻi (kahi hōʻailona o nā fluctuations) i ke kāʻī ʻana i kou mau manamana lima ma ka pā o ka ʻōpū. Hōʻike ka radiology o ka ʻōpū o ka ʻōpū e hiki ai iā ʻoe ke hoʻomaopopo i ka ascites me ka nui o ka wai o ka wai o ka ʻona ma mua o 0,5 lita.

Mai nā hoʻokolohua hōʻoia no ka ascites, kahi coagulogram, nā tauira biochemical o ka pepi, nā pae o IgA, IgM, IgG, urinalysis e nānā ʻia ai. I nā maʻi me ka portal hypertension, hōʻike ʻia ka endoscopy e ʻike i nā varicose veins o ka esophagus a i ʻole ʻōpū. Me ka fluoroscopy umauma, ʻike ʻia ke kahe i nā puʻu pleural, ke kū kiʻekiʻe o ke kahe o ka diaphragm, ka palena o ka hopena o ka hanu o nā kipa.

I ka wā o ka ultrasound o nā ʻōpū o ka ʻōpū me ka ascites, ʻo ia ka nui, ke ʻano o ka meʻa o ke ana o ka ʻā a me ka spleen e aʻo ʻia, nā hana ʻeha a me nā loiloi o ka peritoneum. Hiki iā Dopplerography iā ʻoe e loiloi i ke kahe koko ma nā moku o ka wahī. Hoʻolālā ʻia ʻo Hepatoscintigraphy e hoʻoholo i ka hana o ka absorption-excretory o ke ate, i kona nui a me nā pae, a me ka loiloi i ka paʻakikī o nā loli cirrhotic. I mea e nānā ai i ke kūlana o ka moe splenoportal, hana ka angiography koho - portographic (splenoportography).

ʻO ka maʻi āpau me nā ascites i ʻike ʻia no ka manawa mua e hana i ka laparocentesis diagnostic e hōʻiliʻili a hoʻopaʻa ʻia i ke ʻano o ka asc asc fluid: e hoʻoholo ana i ka hana, cellular form, ka nui o ka protein, a me ka moʻomeheu bacteriological. Ma nā pilikia paʻakikī e pili ana i ka ascites, hōʻike ʻia ka laparoscopy diagnostic a laparotomy me ka huaʻai peritoneal biopsy.

Hoʻohana ʻia ascites

Pono ka hoʻomaʻamaʻa pathogenetic i ke kumu o ka hōʻuluʻulu ʻana o ka wai, i.e., pathology mua. No ka hoʻēmi ʻana i nā hōʻike o ka ascites, he paʻakai paʻakai ʻole, ka palena o ka hoʻohuihui, ka diuretics (spironolactone, furosemide ma lalo o ka uhi ʻana o ka hoʻomākaukau ʻana i ka paʻakai) e kuhikuhi ʻia, ua hana ʻia ka maʻi pākana me ka hoʻokaʻawale ʻia o ka wai me ka hoʻoneʻe ʻia o ka maʻi hypertension me ke kōkua o ka angiotensin II receptor antagonists a me ACE inhibitors. I ka manawa like, ua hōʻike ʻia ke hoʻohana ʻana o nā hepatoprotectors, ka hoʻolālā intravenous o ka hoʻomākaukau ʻana o ka protein (ka plasma kūlohelohe, ka hoʻonā albumin).

Ke kūpaʻa ka ascites i ka hoʻomau i ka lāʻau lapaʻau huakaʻi, a laila hele lākou ma ka maʻi paracentesis o ka ʻōpū (laparocentesis) - ka wehe ʻana i ka wai o ke kahe mai ka ʻōpū o ka ʻōpū. No kahi pākahi hoʻokahi, pono ia e haʻalele i nā mea hou aku ma o ka 4 mau lita o ka wai ascite ma muli o ka hopena o ka hemo. Hoʻokumu pinepine nā mau hana maʻamau i ka neʻe i ka maʻi o ka peritoneum, ka hūnū ʻana o nā adhesions a hoʻonui i ka hopena o nā hoʻonāukiuki o nā hui ma hope o ka laparocentesis. No laila, me ka nui o nā ascites no kahi hoʻokuʻu lōʻihi o ka kahe, ua kau kahi paʻa catitter peritoneal.

Hōʻalo ka hāʻawi ʻana i nā kūlana no nā ala o ka kahe o ka kahe o ka wai peritoneal e pili ana i ka pu a peritoneovenous a me ka wehe ʻana o kahi o nā pā o ka pūpū. Hoʻololi kūleʻa ʻo ia no nā ascites i nā hana e hōʻemi i ka neʻe ʻana i ka ʻōnaehana o ka wahī. Hoʻopili kēia me ka noi ʻana o nā anastomoses portocaval (opococrat bypass surgery, transjugular intrahepatic portosystemic bypass surgery, ka hoʻemi ʻana o ke kahe koko splenic), lymphovenous anastomosis. I kekahi mau manawa, me nā mea e hoʻohālikelike ana, e hana ʻia kahi splenectomy. Me nā ascites kūleʻa, hiki ke kuhikuhi ʻia ke hoʻololi i ka ate.

ʻO ka wānana a me ke kālai

ʻO ka heleʻana i ascites nui e hoʻopiha i ka papa o ka maʻi ma lalo o ka maʻi a me ka hoʻopilikia i ka hoʻomaʻamaʻa ʻana. ʻO nā ʻōmole o ka ascites hiki i ka peritonitis bacterial spontan, hepatic encephalopathy, hepatorenal syndrome, pehu. Hoʻokomo ka poʻe prognostic hopena i nā mea maʻi me ka ascites i ʻoi aku ka makahiki i ʻoi aku ma mua o 60 mau makahiki, hypotension (ma lalo o 80 mm Hg), hōʻea o ka renaloma, hepatocellular carcinoma, maʻi mellitus, cirrhosis, ʻāleʻa o ka huinaʻi o nā selula, a me nā mea ʻē aʻe. ascites ola kokoke 50%.

He aha ka ascites i loko o ka maʻi pancreatitis

Ma keʻano holoʻokoʻa, me ka ascites, hele a exudate i nā ducts i loko o ka lua retroperitoneal a hōʻuluʻulu i loko ona i nā wahi liʻiliʻi. I kēia hihia, hoʻopau pinepine iā ia ma hope o ka pau ʻana o ka maʻi o ka pancreas hala, a he nui ka pōpilikia.

Me kahi papa lōʻihi o ka maʻi, hōʻiliʻili ke ʻano a noho mau i ka ana i kahi lōʻihi. Hiki i kēia ke kumu i ka necrosis kiko a alakaʻi i kahi kūlike o ka hilinaʻi.

Hoʻohui mau ʻia ka wai, akā hoʻopau ka hana ma ke ʻano o ka phlegmon a i nā pseudocysts paha.

Inā nui ka nui o ka poʻe me ka pancreatogen ascites he nui i ka nui o ka amylase i loko o ko lākou koko, he lahui nā halekupapaʻu a hiki ke ʻike wale ʻia me ka hana.

E like me ka slankish pancreatitis, me ka nui o ke kāwili ʻana o ka amylase i hoʻemi nui ʻia, hōʻiliʻili ʻia ke ʻano a wehe ʻia e ka helu ʻana i ka puʻe o ka ʻōpū.

ʻO ka prognosis ma hope o ia mau mea he nui ka maikaʻi, a i ʻole e ʻike ʻia ka ascites i kēia manawa.

ʻO ke kumu nui e hele mai ai nā ascre pancreatic

ʻO nā kumu maʻamau loa o nā ascites pancreatic:

ʻO ka heleʻana o ka piso pancreatic,
Hoʻopili ʻana i nā nū lymph ma nā ana o ka retroperitoneal,
Hypertension o nā kumuhana lymphatic thoracic,
ʻO ka hapa o Protein.

Pono e ʻōlelo ʻia ʻaʻole nā maopopo loa ka pathogenesis o nā ascites. Aia no ka papa lāʻau o ka maʻi, hiki ke hoʻokaʻawale i nā ʻano ʻelua. I ka embodiment mua, ʻike ka nui o ka rhinestone i ka ʻeha, ua komo koke ke kahe i ke ana o ka ʻōpū a hōʻuluʻulu i loko. Hoʻokumu ka'ōpū pancreatic i kahi mahele o nā kumu o nā pancreas, kahi pseudo-cyst i hoʻokumu ʻia i ka wa retroperitoneal.

Me ka lua o ka lua, ʻaʻole i ʻōlelo ʻia ka haukapila. Hoʻākoakoa pinepine ʻia ka wai i loko o kahi papa o nā kaʻina luku e kū mai ana i kahi wahi liʻiliʻi o ka pūke. ʻIke ʻia ka maʻi i ka wā o ka hōʻike x-ray a ma hope o ka laparocentesis.

ʻO ka nui o ka exudate e komo ana i loko o ka pūhaka ʻōpū me nā ascites e hiki ke piʻi a ʻumi lita. ʻO Laparocentesis i kēia hihia ke kōkua nei e wehe i ka wai, akā ʻaʻohe ona hopena. Ma hope o ka manawa pōkole, hōʻiliʻili hou ia, a ʻo kēlā me kēia laparocentesis ma hope e alakaʻi i kahi nui o ka protein. No laila, hāʻawi ʻo nā kauka i ka makemake i ka hōʻiliʻili o ka hōʻemi ma hope o ʻelua pule o ka lāʻau lapaʻau. ʻO ka mālama ʻana i nā ascites e pili ana i ka paʻakai paʻakai, aʻai ʻole i ka protein.

Ua kauka nā kauka i nā diuretics, antibiotics, nā lāʻau lapaʻau e hōʻemi i ke kaomi ma ka vein portal (inā hoʻāla ʻia).

ʻO nā pilikia o ka ascites a me kona kāohi

Nā ʻāpana o nā ascites ʻokoʻa. Hiki i ke kumu o ka hoʻolālā ʻana o ka peritonitis, ka hemahema o ka hanu, ke kuhi ʻana i nā kino o nā kino a me nā ala ʻē aʻe i hoʻoulu ʻia e ka hoʻonui ʻana o ka nui o ka puna i ka peritoneum a me ka hoʻopiʻi ʻana i ka diaphragm, ate, ʻōpū. Me ka laparocentesis pinepine, e ʻike pinepine ʻia nā adhesions e hoʻopilikia nei i ka hana piha o ka ʻōnaehana kaʻai.

ʻO kēia ke kumu o ka hoʻomaʻemaʻe ʻole ʻole a nānā ʻole. Pono nā hana e piʻi ai nā lāʻau lapaʻau, inā ʻaʻole e holomua a alakaʻi i nā hopena hoʻi ʻole. No laila, i ka hoʻomaka mua o kahi maʻi, pono koke ʻoe e ʻimi i ke kōkua mai nā poʻe loea.

E hoʻokaʻawale i ka maʻi, he mea nui ia e hoʻomaʻamaʻa pinepine i ka nānā pale a hiki i ka manawa me ka mālama ʻana o ka maʻi pancreatic. Mai ka meaʻai, pono ke kāpae i ka kō, paʻakai, nā momona momona, e kaupalena i ka ʻai ʻana i ke kofe, nā inu kōkeke aʻa, kaʻaila ikaika. Pono ʻoe e haʻalele iki i nā hana maikaʻi, hoʻopau i ka manawa e hiki ai i ka ea hou a hoʻāʻo e hopohopo no kekahi kumu. Me ka pancreatitis a me ka ascites, nui ka hoʻoikaika kino kino, a laila ʻo ka poʻe e pili ana i nā haʻuki e hoʻokō maikaʻi ʻia me nā hoʻomaʻamaʻa māmā.

ʻO nā mea ascites i wehewehe ʻia i ke wikiō ma kēia ʻatikala.