He kani o ka pancreas

Hoʻopilikia pinepine ʻia ka pancreatitis e nā maʻi hou. ʻO kekahi o lākou, he puehu pancreatic, ʻo ka mālama ʻia e paʻakikī ai i nā pilikia o ke kuʻuna o ke kino (a me ke kino holoʻokoʻa). Ua hoʻonui ʻia ka nui o nā neʻe i ka hiki ʻana mai o nā hana diagnostic hou (magnetic resonance imaging a me ka tomography compute, ultrasound).

He paʻakikī ka pancreatitis e nā capsules me kahi wai ma loko o 18%, ʻo nā hihia i koe e loaʻa i nā hōʻeha e pono ai ka hana. Hoʻolima ʻia ka hapalima o nā mea maʻi e nā ala ʻē aʻe a i ʻole nā ​​ʻano. ʻAʻohe ʻoluʻolu o nā mea maʻi i kahi pūnō pancreatic, ka hana ʻo ia i manaʻo ʻia he hoʻokahi wale nō hana (ka wai holo). Ua manaʻo ʻia ka hana ʻino, ua hoʻoweliweli ʻia me ka peritonitis, i ʻole o ka lua o ka ʻōpū, ka manaʻo, ke koko.

Hōʻalo i ka cyst Pancreatic

I nā makahiki he kanawalu, kaukaʻi nā kauka i ka lawe ʻana o ka cy pancreatic, e ʻōlelo ana i nā hopena hiki. ʻO ka paʻakikī o ka liloʻole o nā mea maʻi i ka hana mālama i alakaʻi ai i nā ala hou. ʻO ka huina kekahi he mau ala e pono ai e wehe i ka ʻili (hana):

  • huki ʻia ma ka ʻāʻī o ka pūnao - pono pū me ka hoʻokaʻawale o ke kino me ka hoʻohana ʻana i ka ultrasound (a i ʻole nā ​​kiʻi ʻehā-X
  • puncture ma o ka ʻili me ka minamina - i hana ʻia me ka lāʻau pono ma lalo o ka nānā ʻana i ka ultrasound

I nā kūlana ʻelua, kahi anesthesia kūloko, hoʻopiʻi ka pahu i kahi pūma 1,7 mm. ʻO ka bougie ka puncture, kahi wai ʻekolu-milimita ka waiho ʻia. ʻO ka hūnā ʻole o kēia ke ʻano, ʻo ia ka pilikia o ka hōʻeha ʻana i nā ʻāpana palena, ka kamaʻilio ʻana o ka retroperitoneal a me ka pā o loko. Hoʻowalewale i ka hemahema ma o ka hoʻohālikelike ʻana i ka mea maʻi i inu i ke aniani o ka maile o sulfate, kahi mea e hiki ai ke wehewehe pono i nā ʻāpana pili.

Hoʻomaʻamaʻi maikaʻi loa ʻo Cyst

ʻO ke kālai ʻole ʻana o nā cysts ma luna o ka pancreas, ʻaʻole mau loa, no laila, ʻōlelo ʻo gastroenterologists i nā decoctions a me nā infusions o nā mea kanu. Hoʻohana pinepine lākou i kahi moena, mullein, yarrow, clover, burdock. Ua lawe ʻia lākou a pau ma mua o ka ʻai ʻana, e paʻa ʻia nā decoction, hoʻohana ʻia. ʻO kahi Dosage kahi papa. Ke hoʻohana nei kahi ʻano loea i kahi ʻano kuʻuna o nā kānaka:

  • celandine, calendula, yarrow ma nā ʻāpana like e koi ana i nā minuke 120 mau (ʻo kahi o ka lapaʻau ʻo 50 g i ka lā)
  • ma hope o ka pau ʻana o ka mālama ʻana i ka mua, hoʻomaka koke lākou i kahi hou - calendula, plantain (pua), tansy e like me ka ʻōlelo mua, akā, no ka hapalua makahiki i ka lālani

Hoʻowalewale i ka ulu ʻana o nā capsules wai me kahi infusion o bean pods, stigmas o ka palaoa, nā lau o nā strawberry, blueberries a me nā lingonberries. Hoʻokomo ka papa hana no ka hapalua malama no kēlā me kēia makahiki, ʻo ka wā hoʻomaha he mea like ia me ka lōʻihi o ka hoʻāʻo ʻana, ka mea i mau ʻia i nā manawa pinepine.

ʻO ka wā maʻi kāpena pancreatic

I ka hikiʻana i ka weheʻana i kahi pōpō pancreatic, ʻo ka mea mua e pono ai ʻoe e koho ʻo ia ke ʻano o ka lāʻau lapaʻau. Aia ia i kona nui, a me kahi i kau ʻia. Hoʻohana ʻia kahi hana ʻoluʻolu a me ke ʻā ʻana no ka pancreas. Hiki iā ia ke mālama ma kēia ala, i hoʻolako ʻia heʻuʻuku ka neoplasm a he liʻiliʻi a he maoli nō i loko o ke ʻano. I kēia hihia, pono nā wahi o ka ʻaʻa i loko o nā keʻena o ka pancreas, i kapa ʻia ka mamao.

Inā ʻike ʻia ka neoplasm he pseudocyst, ʻaʻole hiki ke hoʻokipa ʻia kēia hōʻiliʻili maʻi, no ka mea, ʻo ka ʻaoʻao o ia ʻano hana i hoʻohālikelike ʻia e nā ʻāpana kūloko. Hoʻohana ʻia nā hana o ke ʻano wai wai i nā hihia o kahi kālai kūikawā o ke kolo - pseudocysts. Inā aia ma ka wahi o caudal o ke kino, a laila hana kekahi cystogastrostomy. I nā hihia o nā hiʻohiʻona o nā maʻi liʻiliʻi, lawe ʻia ka mālama ʻana o ka pehu pancreatic i ka cystoduodenostomy transduodenal. Hoʻopau ʻia ia me ka hoʻokumu ʻana o kahi hupa paʻa i loko o ke poʻo o ka puna. Inā he kapoka a aia kahi hopena o ka peritonitis purulent, hana ʻia ka marsupialization. Hoʻopoka kēia mea me ke kōkua o kona hemming i ka peritoneum. ʻO ka ʻano hana o kēia ʻano hana i maʻamau.

ʻO ka cyst pancreatic kahi kūlana no ke ana o nā kahe i hoʻopiha ʻia me ka huna huna pancreatic a me ka kiko detritus kikoʻī ma ka papa parinhematous o ke kino. I loko o nā kahe cystic, nā hua pili o ka pancreas necrotic (make), i hoʻololi ʻia e nā ʻiʻo fibrous. Ua waiho ka Cysts i kahi pōpilikia olakino koʻikoʻi ma muli o ka hopena o ka degeneration i loko o nā hana palaka, hiki ke hoʻopiʻi i ka kāne a me nā wahine, ʻaʻole nā ​​keiki.

Ke mīkini a me nā kumu kumu o ka hoʻomohala ʻana o ka pathology

ʻO ka pancreas kahi hana koʻikoʻi i ka uhaʻi ʻana a me ka hoʻoliʻi ʻana o ka protein, hōʻoki i nā momona, nā momona. Loaʻa i ka okana ka hoʻolālā alveolar e wehe ana i ke ʻano o nā cysts. ʻAʻole ke ʻano o ke ʻano loina o nā cystic i loko o ka aahu.

Hoʻokumu ʻia ka mīkini o ka hanana i ka luku ʻia ʻana o nā io ponoʻī. Ma lalo o ka mana o nā hopena maikaʻiʻole, nā ʻōpala o nā ʻano make make ma ka papa parinhematous o ka papa pancreas, hoʻokaʻawale ke kino i ke wahi pathological mai nā mea olakino - he kāpili i kahi kāpili mai nā huakaʻi hoʻohui a i ʻole fibrous. Hoʻopiha iki ʻia nā kapuni i nā mea kikoo a me ka mea huna - pehea kēia e ʻike ʻia ai kahi cyst.

Nā kumu maʻamau o ka nānā ʻana i nā patology:

  • pōpilikia hanenital o nā kaupalena o ka lepa,
  • ka hiki ana o na pohaku
  • pancreatitis - akeʻeha, kūloko, ka waiʻona,
  • ʻOnawa papaʻaila,
  • ʻeha nā iwi hōʻeha
  • nā maʻi Endocrine - heʻano nui, ka maʻi maʻi,
  • maʻi maʻi parasitō.

Hoʻoikaika papa

Ua helu ʻia ka Cysts i ka:

  • ʻOiaʻiʻo (congenital) - loaʻa i ka hana ʻino i ka lālani ke hānau ʻia mai ka hānau ʻana mai, ua waiho ʻia ke ʻano hana hoʻomohala i ka wā prenatal. ʻAʻole hoʻonui ka nui o nā pūpale kongenital i ka nui, kūwaho ka nui o nā pūpū squamous. ʻO ke ʻano o nā cysts maoli ma muli o ke kaohi ʻana o nā kumuʻai pancreatic e alakaʻi i ka maʻi me ka hoʻokumu ʻana i nā iwi fibrous - ua kapa ʻia kēia pathology "cystic fibrosis", a i ʻole polycystic.
  • Luku (pseudocysts) - nā hana hoʻopili i kū i ka wā o ke kaʻina o nā keʻena i nā pancreas, nā hōʻeha a me nā mea ʻē aʻe o ke ʻano lua.

Hiki i nā lua o ke kuʻuna ke hana i nā ʻāpana like ʻole o ka pancreas - ma ke poʻo, ke kino a me ka huelo. Wahi a nā heluʻepekema, ʻike pinepine ʻia ka poʻo ke kani, ma 15% o nā hihia a pau, he 85% ka mea i hōʻā ʻia e ka cystic lesion o ke kino a me ka huelo o nā mea. Ma kahi kokoke o 90% o nā hihia, he lua ke kūlohelohe ʻana o nā cyst a kū i ke kūkaʻi o ka pancreatitis i hoʻohuli. ʻO 10% o nā hihia e pili pū ana me ka trauma organika.

Kuhi ʻia ka Atlanta i nā puka cystic i ʻike ʻia ma hope o ka maʻi pancreatitis.

  • ka hopena o nā ʻōpala huehue - hele koke mai, ʻaʻohe pā kūpono i nā mākeke, nā kolo o ke kelepona, nā ʻāpana o ka parinhematous a i ʻole like me ka lua.
  • subacute (lahilahi) - ulu mai kahi akuhiʻi e like me nā paia o nā puʻupuʻu mai nā fibrous a me ka granulation tissues.
  • abses - ka maʻi ʻaole purulent o ke ʻano, hoʻopiha ʻia ke ana me nā mea ʻeha.

Mai ka hoʻomakaʻana o ka papa o nā kulekele, ʻo nā cysts:

  • paʻakikī e nā fistulas, ke koko, pus a perforation paha,
  • unformawa.

Nā kiʻi haukapila

ʻAʻole ʻike mau ʻia nā ʻōuli o kahi pihi pancreatic. ʻO nā hōʻike kulana ma muli o ka nui o nā ana, kā lākou kūloko, kahi kumu. I mua o nā puka cystic hoʻokahi i ka hoʻopiha a i ka 50 mm i ka nui, ʻaʻohe mau hōʻailona ʻike - ʻaʻole kuʻe ka pūpili i nā kumu lāʻau a me nā ʻīpī e pili kokoke ana, ʻaʻole ia e hoʻopololi i ka hopena o ka nerve - ʻaʻole iʻike ka mea maʻi i ka ʻeha.

ʻO ka hele ʻana o nā pūhaka iʻike pinepine ʻia e hōʻike nei i kahi mau maʻi ma ke ʻano he maʻi ākea. Hiki i ke ʻano o ke ʻeha ke hoʻoholo i ke kiʻekiʻe o ka lesst cystic:

  • i ka wā e kūpaʻa ai nā pōkole hoʻopunipuni i ka pancreatitis, he ikaika a ʻeha ka ʻeha, e uhi ana i ka lumbar a me ka ʻaoʻao hema.
  • nā puʻuwai ākea e ʻike koke ʻia i kahi hōʻeha a mālama paha paha i ka lua, ʻoiai inā he maʻi ka mea maʻi;
  • ke kuana ʻana o kahi popiki e piʻi ana i ka plexus o ka lā ua ʻike ʻo ia iā ia iho me kahi ʻeha ʻā e ʻā ana i ka kua.

Eia kekahi i nā ʻeha, hōʻike ʻia ka pathology e nā maʻi ʻē aʻe:

  • ninaki a me ka luaʻi
  • ʻO ka maʻi a pau, me ka steatorrhea (nā pūmole o ka momona i ka papa)
  • Kāwili ʻole, hoʻowalewale maikaʻi ʻana o nā mea momona a me nā mea kaumaha.
  • hoʻemi i ka momona
  • hoke i nā helu subfebrile.

Nā hopena

Pilikia nui ka maʻi pancreatic no ka hiki ʻana o ka degeneration i loko o ke kao maʻi. Ma ke hoʻonohonohoʻana, hiki i nā lua cystic ke maleign a me ka hōʻino. He maʻi hōʻeha nui ka maʻi maʻi pancreatic, kahi hoʻohālikelike o ke ʻano wikiwiki me ka metastasis ākea. ʻO nā pōpoki Benign ʻaʻole liʻiliʻi liʻiliʻi loa ma muli o ka loaʻa o ka wāwahi a me ka hoʻomohala ʻana o ka peritonitis ma hope.

ʻO ka hana fistula kekahi mea hoʻopiʻi hou. Me ka hoʻonaninani ʻana i nā hana cystic, hoʻopiha piha a me ka piha ʻole. Hoʻonui ka maikaʻi o nā fistulas i ka hopena o ka maʻi a me ka hoʻomohala ʻana i ke kaʻina o nā maʻi bacterial.

Hoʻokomo nui nā pūpū nui i nā moku a me nā kumu mua o ka hoʻopapa a me nā ʻāpana pili i loko o ka ʻōpū o ka ʻōpū, ma muli o nā hopena maikaʻi ʻole.

  • ka hoʻomohala ʻana o ka jaundice obstrate me ka hoʻokae ʻana o nā cyst i ke poʻo,
  • ka ʻaʻuhū ʻana i nā wāwae i ka wā e huki ai i ka vein portal.
  • disuric disorders me ka hoʻokaumaha ʻia o ka urinary tract,
  • ka wahī i ka wā a ka ʻū ʻana i ka lumen i loko o nā kīʻaha o ka ʻōpū (kahi kūlana i loaʻa ʻole i ka hele ʻana o nā cysts pancreatic nui).

ʻIke ʻike

ʻO kahi kauka i nānā a mālama i nā poʻe me ka maʻi pancreatic i manaʻo ʻia he gastroenterologist. I ka hoʻomaʻamaʻi mua ʻana, e koi ʻia kahi anamnesis, e hoʻomaʻemaʻe i nā hoʻopiʻi a me ka nānā ʻana me ka palpation. Me kahi hōʻike manual o ka ʻōpū o ka ʻōpū, hiki ke ʻike ʻia kahi protrusion me nā palena palena. ʻO kahi hoʻokolohua piha me ka hui pū ʻana o nā hana a me nā ʻina hana.

ʻO ka papa inoa o nā hoʻokolohua hōʻoia pili i nā hoʻokolohua o ke koko, e komo pū ana i ka biochemistry. Ma mua o ka heleʻana o ka pathology, e ʻike ʻia ka loli i loko o ka hōʻike ESR a me ka bilirubin (hoʻonui), leukocytosis, hoʻonui ʻia ka hana o ka phosphatase alkaline. Hiki i kahi urinalysis ke kūkaʻi hōʻike i nā hōʻailona o ke kuni ʻana i nā maʻi paʻakikī - nā pūpū maʻamau a me nā keʻokeʻo ke keʻokeʻo ke ʻike i ka urine.

ʻIke ʻia ka ʻike ʻike ʻoiaʻiʻo i ka wā e hōʻoia ʻia ana ka holomua ma o nā mea kōkua.

  • Hāʻawi ka Ultrasound iā ʻoe e hoʻoholo i ka nui o nā kahe cystic, ko lākou helu, ka hele ʻana o nā hoʻopiʻi,
  • ʻO ka MRI ka mea e hoʻoholo maʻalahi a kuhikuhi i ka nui, ka pilina o nā hana cystic me nā kumu o nā kuʻekuʻe,
  • Hoʻohana ʻia ka scintigraphy (ka hana a ka radionuclide) i mea hoʻohana hou e hoʻomālamalama ai i ka wahi o ka lua o ka pathological i loko o ka parinham o ka huila.
  • ʻO endogropika retrograde cholangiopancretography ma ke ʻano he kumu kiʻekiʻe ka hāʻawi ʻana i nā kikoʻī kikoʻī e pili ana i ka hoʻopili ana i ka lua, kona ʻano a me nā pilina me nā panina, akā lawe pū i ka hopena kiʻekiʻe o ka maʻi i ka wā o ka hoʻokolokolo.
  • Hoʻohana ʻia kahi radior panoramic o ka ʻōpū ʻōpū e hoʻomaopopo i nā palena o nā lua.

Inā maopopo ʻole ke ʻano o ke kime o ka papale o nā cystic formations, he biopsy o ka pancreatic tissue i mea e hōʻoia a hōʻoia i nā hōʻino ʻana. Hana ʻia kahi biopsy ma lalo o ka mākaʻi o kahi ʻike ultrasound a i ʻole ma ka nānā ʻana i kahi CT. ʻO ka ʻokoʻa ʻokoʻa i ka wā biopsy ka ʻimi o ka nānā ʻana i ka oncology a pale i ka ulu ʻana o nā nui o ke kanesa.

Hoʻohana ʻia ka hoʻomaʻamaʻa ʻana o nā cysts pancreatic ma o ke komo ʻana i ka holo ʻana. ʻAʻohe maikaʻi loa ka lāʻau lapaʻau me nā cysts lehulehu. ʻAʻole i kuhikuhi ʻia ka hana no nā mea liʻiliʻi (a hiki i ka 30-50 mm cysts) nā cysts, inā ʻaʻole lākou e hoʻopilikia i nā ʻāpana pili a ʻaʻole e kumu i nā hōʻailona maikaʻi ʻole. ʻO ka wehe ʻana o kahi cyst malignant, ʻoiai me nā liʻiliʻi liʻiliʻi, pono e pale i ka metastasis.

I loko o kahi gastroenterology bedah, ua hoʻohana ʻia nā 3 ala e pale aku ai i ka cysti pancreatic:

  • ka wehe ʻana i ke kumuhana patological - resection,
  • kahe uila
  • laparoscopy

Ke hoʻihoʻi ʻia, hoʻokaʻawale ʻia ke kino cyst a me nā ʻaoʻao pili i luna o ka pancreas. Loaʻa ka nui o ka hauʻoli i ka nui o ka lua, ka moku'āina o ka ʻāpana o ka parinhematous o ka umauma - hana lākou i kahi hana o ke poʻo, kahi mamao, pancreatoduodenal.

Hoʻomaka ka wai kūloko o ka pūpono ma o ka anastomosis ma waena o ke kino ʻoi a me ka ʻōpū, duodenum a i ʻole peʻa liʻiliʻi. ʻO ka pākuhi o loko o kahi mea palekana a me nā ala physiological e hoʻomaikaʻi ai i ke kūlana o ka mea maʻi - ke hōʻoiaʻiʻo ʻia nei ke ʻano o nā manaʻo o ke ana, hoʻopau ʻia ka ʻeha, hōʻemi ka hopena o ke kahe ʻana.

Ke lawe ʻia nei ka honu o waho o ka cyst me kahi papa paʻakikī o nā patology.

  • ka ʻohi ʻana o ka exudate purulent,
  • mekameka
  • hoʻonui vascularization (ka hoʻokumu ʻana o nā moku hou) i loko o nā paia o ka pua,
  • ʻano kūlana koʻikoʻi.

Me ka wai o waho, hiki i nā hopena maikaʻi ke hopena i ka hoʻopiha ʻana i ka fistula formal, hoʻonui ʻia o nā cyst i ka nui, ka ulu ʻana o nā puka hou. I kekahi manawa, ulu ka sepsis. I kēlā me kēia hihia, lawe ʻia nā ka ʻaoʻao o waho a me loko o ka pae kino wale nō.

ʻO Laparoscopy kahi ʻano maʻalahi, ʻo kona pono o ka loaʻa ʻole o nā hana hoʻokipa ākea loa a me ka wikiwiki wikiwiki o ka mea maʻi. He kūpono ʻo Laparoscopy no ka wehe ʻana i kahi nui, hoʻokahi cystic hanganga. ʻO ka manaʻo nui o kēia hana hōʻiliʻili minimally ʻo ka hoʻomaka ʻana o ka lāʻau puncture i loko o ka foci pilikia me ka suction o nā ʻike.

Hoʻokomo ʻia ka hopena me nā lāʻau lapaʻau i ka hoʻoponopono ʻana i ka maʻi lalo. Ma mua o ka pancreatitis, pono ke koho ʻana i nā huina e hōʻoia i ka hoʻowalewale 'ana a lawe mai ka pancreas. E hōʻoluʻolu i ka ʻeha, ua hoʻohana ʻia nā antispasmodics a me nā analgesics. Kahi ʻia ka paila kaulua o ke koko, inā e hoʻopilikia ʻia, e kuhikuhi ʻia nā lāʻau kūpono.

Kūkulu ʻia no nā lesi cystic i kau ʻoi loa i ka nui o ka pancreatic sparing. ʻO ka mālama kūpono e hiki ke hōʻemi i ka hoʻoneʻe ʻana i ka maʻi a kākoʻo i ka hiki ke ʻōnaehana o ka enzymatic. ʻO nā loina o ka meaʻai me ke aniani pancreatic:

  • hualuae pōʻaiʻai i ka manawa like (3-4 hola),
  • holoi ʻia nā meaʻai a pau, a ʻuwala.
  • ʻano hana
  • hōʻole no ka momona a me ka palaoa,
  • he mea ʻoki i ka berena a me ka hūnā,
  • ʻO ke kumu o ka meaʻai, ʻo ka ʻai ʻai protein (ʻaʻole pono nā mea kanu i kanu ʻia i luna o 30% o ka nui o kēlā me kēia lā).

ʻAi paʻa ka mea maʻi e ʻai i ka ʻiʻo momona, nā huaʻai, nā pīni. ʻO nā huahana e pono ai ka wai momona me ka haʻahaʻa haʻahaʻa haʻahaʻa, moa a me ka palaoa turki, hua manu kuke, nā lau ʻai ma hope o ka mālama wela. Mai nā mea inu, ʻai momona, kīleʻa a me ka hua stewed. Diet - kahi ola lōʻihi, ʻo ka hoʻomaha iki loa e hiki ai ke hoʻonāukiuki i kahi ʻino.

ʻO ka mākona o ke ola e pili ana i nā kumu kumu o ka pathology, papa a me ka lawa o ka ʻoihana. Hōʻike ʻia ka maʻi e ka kiʻekiʻe o nā hoʻopiʻi - i ka 10-50% o nā maʻi, ka hele ʻana o ka maʻi me ka oncology, maʻi a me ka hemorrhages i loko. Ma hope o ke kau ʻana, aia kahi manawa hou e ulu nui ana.Ma ke kumuhana e pili ana i nā kauka, ʻo ka mālama pinepine ʻana a me ka lawe ʻana i nā enzymes, aia ka manawa e mālama ai i ka kali ʻana o ke ola maʻamau.

I mea e pale ai i ka hūnā a mālama i kahi kūlana paʻa, pono nā maʻi:

  • e pae i ka meaʻai
  • hāʻawi pio i nā waiʻona
  • pane manawa kūpono i nā pilikia me ka gastrointestinal tract.

ʻO ka lesi Cystic o ka pancreas he maʻi maʻamau, ma ke ʻano o ka mālama ʻana i nā kūpono kūpono, he mauʻu nā hopena. Hiki i ka hopena o ka lāʻau lapaʻau hou ke kūleʻa i ka maʻi a hiki i ka poʻe maʻi ke ola holoʻokoʻa. ʻO ka mea nui he ma mua o ke ʻano me ke ʻano koho maikaʻi o ka wehe ʻana i nā cysts.

ʻO ka ʻōkō pancreatic kahi papa hoʻopiha i nā mea ʻalemai. ʻO nā kumu nui o kāna hōʻino ʻia ka pōʻino ma muli o ka trauma a i ʻole ka mumū.

Hoʻokumu nā hōʻailona i kahi a me ka nui o ka hoʻokumu. Pākuʻi ʻia ʻo ka maʻi ultrasound, CT, MRI. Ma hope o ka hoʻoholo ʻia, hoʻokaʻawale ʻia a me ka hana ʻoihana.

ʻO nā ʻano a me nā ʻokoʻa o ka hoʻokumu ʻana

ʻO ka helu ʻana o nā cysts ma ka pancreas e lawe e like me ke ʻano o ka papa, localization a me nā ʻano kūloko. Hiki ke nānā ʻia ko lākou hiʻohiʻona ma nā wahi like o ke kino, ma ka pili me kēia he ʻekolu ʻano ʻano:

  • ʻO Cyst o ke poʻo. ʻOi aku ka liʻiliʻi ma mua o nā poʻe ʻē aʻe, i hoʻokumu ʻia i loko o ka lua o ka ʻeke lole. ʻO kahi hoʻopiʻi paha e paʻi paha i ka duodenum.
  • Aia ka cyst o ka huelo ma ka palena ʻākau o ka pancreas. ʻAʻohe pānaʻi i ka hoʻokaʻawale ʻana o nā ʻenehana retroperitoneal i pili i nā kolo pili pili.
  • ʻO kahi tumio i hoʻopaʻa ʻia ma ke kino o kahi ʻāpana kekahi o nā ʻano maʻamau maʻamau o kēia ʻano. ʻO ka hele ʻana o ia kahiʻahe e piʻihue me ka loli ma ke kūlana o ka ʻōpū a me ke koloka.

He kumuhana ka hoʻonaʻauao hoʻonaʻauao pili me nā kumu o kona ʻano. He ʻokoʻa ka ʻano:

  • He popo hoʻopunipuni e kū ʻia ma hope o kahi maʻi. ʻAʻohe o kahi papa lula o ka epithelium.
  • ʻO kahi pūpō maoli e kū mai i ke kahua o ka hoʻonā kino ʻana i loko o ka ʻōpū. Loaʻa pinepine ʻia nā maʻi hoʻokalakupua, loaʻa ka māka epithelial.

Inā he hopena ka hopena i ka pancreatitis, a laila e like me ke ʻano o ke ʻano, e like me ka papa ʻana i ka Atlanta, hoʻokaʻawale lākou iā lākou:

  • Kāwiki. ʻO ka wīkī o kēia hihia, ʻaʻohe pā o ka pā.
  • ʻO Subacute, ka mea i kaupalena ʻia e kona mau pānaʻi fibrous a i ole ʻia.
  • ʻO kahi pohō i hōʻike ʻia e ka heleʻana o ka exudate purulent i ka lua.

ʻO ke kumu nui o ka hoʻomohala ʻana i ka ʻōpū

ʻO ke ʻano maoli o ka hoʻonaʻauao kahi ʻano maʻamau o nā ala nui o ka intrauterine. Hoʻohālikelike ʻia e kona nui o ka nui o ka hoʻopiʻi ʻana, ka hala ʻana o nā hoʻopiʻi, ka ʻāpana epithelial i loko o ke ʻano. Hiki iā ʻoe ke ʻike i kēlā me ke wā i kahi scan ultrasound.

I kekahi manawa hiki ke hele hewa i kahi ʻano maoli. Kēia ʻia kēia i ka wā e puka ʻia ai ka pūlima mua i ke kīpona ʻia nā kaupalena i ka ʻōpū. Kūkulu ʻia kahi ʻāpana hoʻokaʻawale, e hoʻonāukiuki i ka ʻehaʻeha. I kēlā mau kūlana, nā ʻōhua kiko o ka fibrous, ua kapa ʻia kēia kaʻina hana he cystic fibrosis.

ʻO nā kumu o ke ʻano o ka pseudocysts he poʻokela o nā hana o ke kino.

  • ʻO nā kaʻina hoʻomakeʻe, ʻo ia ka laʻana, ka pancreatitis, ka necrosis pancreatic. ʻO nā huaʻai i nā mea maʻamau maʻamau, ʻoi aku ma mua o ka 80% o nā hihia o nā hoʻopunipuni pololei e kū ana ma hope o ke ʻano o ka pancreatitis.
  • ʻO Pancreolithiasis, ke pani ka lāʻau i nā pan.
  • ʻEha hōʻeha Hoʻokumu 14% o nā cysts waha no kēia kumu. ʻO kēia, ua hōʻiliʻili ka 85% i ke kino a me ka huelo o ka umu, a hāʻule ka 15% i ke poʻo.
  • ʻAʻohe meaʻai kūpono. ʻO ka hōʻinoʻana i nā momona momona, ke alakaʻi nei i ka momona, e hoʻonāukiuki i ka hana a lipid metabolism.
  • ʻO ke ola kino maikaʻi ʻole, ʻo ia hoʻi ka hoʻohui ʻana i ka waiʻona.
  • ʻO nā Tumors ma ke kiko.
  • ʻO ka heleʻana o ka maʻi helminth, ma muli, cysticercosis a me echinococcosis.
  • Hoʻopilikia i kahi hana hōʻemi ma luna o nā mea āpau o ka pāpaʻi gastrointestinal.
  • Naʻi maʻi mellitus.

ʻO nā hōʻailona o ka helehelena o kahi cyst

Hiki ke hōʻike ʻia nā ʻōuli ma ke ʻano o ka ʻoluʻolu a i ʻole ke hōʻeha ʻeha, hilinaʻi ia i ka nui a me kahi o ka hoʻokumu. ʻAʻole ma kahi pūpiki liʻiliʻi i nā pilikia koʻikoʻi, no ka mea, ʻaʻole lākou e hoʻopuʻi i nā ʻōpū, ʻo nā mea ʻē aʻe he mau ʻano.

Inā nui ka nui o ka hakahaka, a laila ua manaʻo ka mea maʻi:

  • ʻO kahi hoʻouka ʻana o ka pancreatitis i kahi kūlana koʻikoʻi. Hoʻonui ka ʻeha ʻo Paroxysmal i ka hōʻeha ma hope o ka ʻai ʻana a i ʻole ka inu ʻona, a me ka lawe ʻana i nā antispasmodics a me nā NSAID ʻaʻole ia e hoʻomaha. Hoʻomau, pīpī, hiki i ka ʻeha ke hui pū me kēia ʻano. Ma hope o hoʻokahi mahina, e lilo i ka mea maʻi ma mua o ka hoʻi ʻana.
  • ʻOkoʻa ka piliki a me ke ʻano lōʻihi.
  • Kāhāhā, e ala aʻe ka mahana o ke kino.
  • ʻO ka nāwaliwali ākea, keʻano i ka luhi, ka lethargy.
  • Ke hele nei ka maʻa nui, ma ka maʻamau he hypochondrium hema.
  • Ke loli ka ʻili o ka maka, ka loaʻa ʻana o ka lau melemele.
  • Hoʻonui pinepine ʻia ka urination, nā makewai ʻana.

Loaʻa i nā hōʻailona ke hōʻike ʻike.. ^ E Ha yM. I kēia hihia, ʻike ʻia kahi protrusion o ka pā ma lalo o ke sternum. I ka hapanui pinepine, hōʻike kēia i kahi hoʻokumu nui i waiho ʻia ma ke poʻo o ka pihi.

Hiki i ke ʻano o nā hōʻailona ke hōʻike i ka ʻōlala o ka hoʻonaʻauao. Inā aia ma ke poʻo o ke kino a kuʻi i ka lolo, a laila ka mea i hoʻomāino ʻia e ka mea maʻi i ka ʻāhaʻi a me ka luaʻi, kahi ʻaha o ka integument.

Ke komo nei i ke kaʻina hana o ke kumua nui o ka nui o ka nui o ka hoʻopā, hele mai ka huehue o ke aʻa, ʻeha, maʻi ʻeha. ʻO ka nāwaliwali me ke kuni ʻole e hōʻike ai i ke kūkulu ʻana i kahi kakena ma muli o ka maʻi.

Nā huapau

Hoʻopili i nā hōʻiliʻili ʻana i kahi anamnesis a me nā hōʻike hoʻokolohua, ua ʻike ʻia kahi hōʻike ʻana e ʻike ai i ka pathology, kahi e:

  • Paona o ka ʻōpū. Hiki i kēia ala ke koho i ka hele ʻana o kahi cyst, kona nui, kahi a me nā ʻano. Hōʻike ʻia kahi pancreas maikaʻi e ka poperous echogenic form black form. Hiki ke hoʻoholo ʻia ka hele ʻana o kahi pūʻai e kahi mākeke lihilihi pōkole ma luna o ke kino o ke aʻa. Inā loaʻa kona mau paia i ka hoʻokumu, a laila hoʻokaʻawale ʻia lākou e ke ʻano kikoo me nā kihi maikaʻi.
  • Hāʻawi ka MRI i ka hoʻokaʻawale ʻana i kahi cyst mai nā ala ʻē aʻe me nā hōʻailona e pili ana.
  • CT
  • Hiki iā ERCP iā ʻoe e nānā i nā paia o nā pā ma o ka endoscope kūikawā a hoʻopaʻa i kahi puncture no ka nānā ʻana i ka biochemical, microbiological a me ka cytological analysis. ʻOiai ʻo ke olakino ʻana iā ia, ʻaʻole loaʻa pinepine kēia ʻano maʻi, no ka mea, he koʻikoʻi loa ka maʻi o ka mea maʻi.

ʻAʻole hōʻike nā haʻawina laboratory i nā ikepili pathological, akā kōkua ke hoʻoholo i ke koko huna i ka wahi o ka cyst.

ʻO ke ʻano hana lapaʻau maʻamau

Hāʻawi ka gastroenterologist i kahi kūlana kali a ʻike i ka hihia o:

  • ʻO ka hanana kū hoʻokahi o nā cysts.
  • ʻO kahi liʻiliʻi o ka hoʻonaʻauao (a hiki i 2-3 cm).
  • Hoʻopaʻa paʻa loa i ka ana.
  • ʻO ka hala ʻana o nā hoʻopiʻi a me nā hopena ma luna o nā mea pili.

I kēia hihia, nā ʻōlelo a ke kauka e pili ana i ka meaʻai a me nā lāʻau lapaʻau:

  1. Pono nā huakaʻi Antibacterial e pale ai i ka maʻi o ka wahi i hoʻopilikia ʻia. Hoʻohana nui ʻia ka hoʻomākaukau ʻana ʻo Tetracycline a me cephalosporin.
  2. Hoʻokomo nā pale pale proton e hōʻoluʻolu i ka ʻeha a hoʻemi i ka ʻōlelo huna enzim. ʻO ia ʻo Omeprazole, Omez, Rabeprazole
  3. No ka hoʻomaikaʻi ʻana i ka hoʻoneʻe ʻana, hoʻohana ʻia nā stimulants enzymatic, no ka laʻana, ʻo Creon, Pancreatin.

Ma hope o hoʻokahi mahina o ka lawe ʻana i nā lāʻau lapaʻau, ʻike hou lākou.

Inā ʻaʻole e hoʻonui ka hoʻonaʻauao i ka nui a e manaʻo ka mea maʻi i ka holomua, a laila koho ka gastroenterologist i kahi kipa ma hope o ke kipa ʻana i ka ultrasound i nā mahina eono. Ke lawe ʻole nei ka lāʻau i ka hopena e makemake ai a hoʻomau ka ʻōhumu, ua kuhikuhi ʻia kahi hana maʻa.

Pili pinepine nā maʻi i ka hoʻonaʻauao kū ʻana iā ia iho. Aia nā wā i hala, ma hope o 3-5 mau mahina, me kaʻai kūpono kūpono a me ka lawe ʻana i nā lāʻau kūpono, ua nalo aku ka ʻōpala. Akā pili ka pili nui i nā cysts wahaʻa, ka hopena o ka pancreatitis. I loko o ka papa maʻamau o ka maʻi, kahi holomua i hoʻolālā i ke kaʻina he ʻano.

I ka manawa e pono ai ka hana?

Me ka hana ʻole o ka mālama conservative, hōʻike ʻia ka hoʻokele. ʻIke ʻia kekahi mau ala o ka hōʻiliʻili o ka hoʻomaʻamaʻa ʻana, me nā kaʻina minimally invasive.

Hōʻike ka Percutaneous i ka cyst e ka hopena haʻahaʻa o nā hoʻopiʻi. He maikaʻi ia ke ʻano o ke kau ʻana i kahi hoʻoili hoʻokahi ma ke kino a i ʻole ka poʻo o kahi ʻōpala.. ^ E Ha yM. I ka wā o ka hana, ua hoʻopaʻa ʻia ka wahi i hoʻopili ʻia, ma hope o kahi mea i makemake ʻia kahi aspirator a i kahi lāʻau pana paha i hoʻokomo ʻia i kahi ulu liʻiliʻi i loko o ka wahi o epigastric.

Hoʻomaka ʻia i ke ʻano o ke kaʻina hana, hiki i ka lāʻau lapaʻau ke hana:

  • ʻO ka sclerosis o kahi pūpika i ke kau ʻia ʻana o kahi mākaʻikaʻi kino i loko o kahi lua i hoʻomaʻemaʻe ʻia. I kēia hihia, pani ʻia ka cyst e nā hono pili.
  • Pāʻuku i ka paila, kahi i ka hoʻomaʻemaʻe ʻana i ka ana a kau i kahi pahu hāmeʻa no ka ka puka o ka exudate. Hoʻopau i ka hana hoʻoheheʻe ma hope o ka pau ʻana o ka hemo. ʻO kahi contraindication e pili ana i kēia kaʻina hana ka nui nui o ka cyst a i ʻole ke pani ʻana o ka duct.

Inā ʻaʻole hiki ke hoʻokalakia percutaneous, hoʻokō ka hana maʻi ma waena o ka hoʻomaʻemaʻe laparoscopic. No kēia, 2 mau kuhi i hana ʻia ma loko o kahi e hoʻokomo ʻia ai nā mea hana endoscopic.

Hiki iā ʻoe ke hana i kēia:

  • ʻO ka hoihoi a me nā kulekele me ka wehe a me ka ʻūhū o ka lua a me nā hana suturing e hiki mai ana. Hōʻike ʻia ia me kahi hoʻonohonoho super o ka hoʻonaʻauao.
  • ʻO ka hoʻonāʻana o ka ʻāpana i hoʻopili ʻia i ka hua o ka nui. Hoʻoholo ʻia ia ma ke alo o kahi hoʻonaʻauao nui. Hoʻokuʻu ʻia kahi kahua pūnaewele i ka wahi i hoʻopuni ʻia.
  • Ka Hoʻolā Hou. Hōʻikeʻia ia no nā mea maʻi me ka hoʻonui hou ʻana o ka duct. I ka wā o ka hana ʻana, ua hoʻopili ʻia ke kāpili o ka hapa i loko o ka ʻāpana liʻiliʻi.

ʻO ka meaʻinoʻole o ka pauna laparoscopic he hopena nui loa ia o nā hoʻopiʻi. I ka hala ʻole o ka hiki ke hoʻohana i kēia mau ʻenehana, hana ʻia kahi hana laparotomy.

He hana maʻamau ia, kahi e pili ai i kahi manawa hoʻoponopono hou.

I kēia hihia, hiki iā ʻoe ke hoʻolimalima:

  • ʻO ka hoihoi a me ka luawai o waho o ka cyst.
  • E wehe i ka papa hana piha a me ka mahele o ke kīpapa.
  • Marsupialization. I kēia hihia, hoʻomaʻamaʻa ʻia ka autopsy a me ka hoʻomaʻemaʻe ʻana o ka lua, a laila hoʻomaʻemaʻe i nā kihi o ka incision a me nā paia o ka cyst. ʻO nā hemahema o kēia hana kaanalike ka hopena o nā pauku fistulous.

Hoʻopili hou a me kā lākou hoʻohana ʻana i ka mālama ʻana

ʻO nā hoʻoponopono āpau a pau e hoʻohana ʻia e ka mea maʻi e ʻae ʻia me kahi gastroenterologist. Kūkulu, ke hana ʻia ana ka hana me ka hoʻomākaukau ʻana i nā lāʻau laʻau, e kōkua ana e hōʻoluʻolu i ke kuni a hoʻihoʻi i nā kiko o ka hui:

  • Lawe ʻia nā calendula, celandine a me yarrow i nā kūlike like. 1 punetēple o ka hui ʻana e ninini ʻia i loko o ka 250 ml o ka wai paʻū a hoʻomoe ʻia no 2 mau hola, ma hope o ka lawe ʻia ʻana ma mua o ka ʻai i ka 60 ml.
  • E lawe i 2 mau wahi o ka tansy a me calendula, 1 ʻāpana o nā pua o ka mea kanu, koho i kahi aniani o ka wai i hoʻolapalapa a hoʻokahe i 2 mau hola. Ke kū nei, inu lākou i ka ml 60 ml i kēlā me kēia lā no 1 mahina.
  • Hana ʻia ka infusion mai nā ʻāpana like o nā lau o nā strawberry, lingonberry, blueberries, bean leaf, stigmas mais. I 1 tbsp. Hoʻohui ʻia ka 250 ml wai o ka wai kuke i ka puna o ka wili a ʻae ʻia e hoʻopō i ka pō i ka pō. Ke loaʻa nei, inu i ka ml ml 125 ml i kēlā me kēia lā no 2 mau pule. Ma hope o ka hoʻomaha ʻana o ka lā 7 mau lā, ua hoʻomau hou ʻia ke papa.

He mea nui o ka pono kūpono

ʻO kaʻai ʻana ma ke alo o kahi cyst e waiho ʻole i ka hoʻohana ʻana i nā momona, ka meaʻai aʻa a me ka kaona o nā kaū waʻa. Pono ke kuhi ʻia i ka ʻaihue ʻia ʻana i ka wai paha. Pono e hoʻohui a nā lāʻau a me nā meaʻai i ka meaʻai.

ʻAʻole ʻai a ʻeleʻele paha ka meaʻai āu e ʻai ai.. ^ E Ha yM. No ka lohi o ke ʻano o ka mālama ʻana, ʻaʻole i papa ʻia ke komo ʻana i ka wai inu ʻona. Pono ka mea hānai o ka mea maʻi e hoʻokomo i nā meaʻai 5-6 i kēlā me kēia lā, ma nā wahi liʻiliʻi.

I ka hōʻea ʻana o ka cyst i ka nui nui a pā i ke kūlana o ka mea maʻi, ʻōlelo ʻia kahi hana i hoʻonohonoho ʻia. No ka hoʻomākaukau no ka hāʻawi ʻana i nā maʻi maʻi, ua hōʻike ʻia ka mea maʻi e nānā i kahi kaʻai i mālama ʻia, e kōkua kahi mea hoʻomaʻemaʻe ʻano e hana i kahi papa kuhikuhi, no ka mea e loaʻa ai kahi ʻano kiʻekiʻe.

  • ʻO ka Proteins, ka hapalua o lākou e pili pono i nā huahana o nā ʻano holoholona.
  • ʻO nā ʻalemona, ʻo ia mau pūʻulu B, A a me C.
  • ʻO nā huahana huahana Lipotropic.

Pono hoʻi e hoʻokaʻawale i nā momona, nā pale a me nā meaʻai me nā kolamu kiʻekiʻe.

Nā hopena cyst

Hiki maikaʻi ʻia ka prognosis me nā maʻi manawa kūpono o ka pathology. Hoʻomaopopo nā hoʻokolohua ma ke ʻano o ka suppuration, ka huhū o loko, a me ke ʻano o nā fistulas. I nā hihia maikaʻi loa, hiki ke hopena i nā hopena: hiki i ka pohā keʻa a i ʻole ka hōʻemi ke kumu.

ʻO ka loli nui o ka hoʻi hou ʻana ma hope o ka hoʻomaʻemaʻe ʻana.

Nā hana kūpono

Hoʻomaopopo i ka pilikia o kahi cycrre pancreatic, pono ʻoe e nānā i kou olakino a pili i kekahi mau kānāwai:

  • E hōʻole i nā hewa maikaʻi: inu ʻole, inu i ka wai inu.
  • Alakaʻi i kahi ʻano hana.
  • E hahai i ka meaʻai, inā he nui ke kaumaha, a laila pono ʻoe e hōʻalo i nā kilokikina pono ʻole me ke kōkua o ka ʻai kūpono a me kahi hoʻonohonoho hana.
  • Hana i nā papa maʻi gastrointestinal āpau.
  • Lawe i nā lāʻau lapaʻau ma lalo o ka mākaʻi o ke kauka a ʻaʻole lōʻihi ma mua o ka manawa i ʻōlelo ʻia.

Pilikia ka pancreatic cyst no kona hoʻomohala wikiwiki ʻana a me ka hoʻokaumaha ʻana i nā mea pili pili. Pono maikaʻi ka mālama ʻana i ka mālama ʻana, ʻoi aku hoʻi i mua o nā puka nui. No laila, ma hope o ka hoʻomohala ʻana, ua noi ʻia nā mea ʻai, a me ka loaʻa ʻana o ka ultrasound. Hoʻopiʻi kahi hana hoʻolālā i ka holo ʻana o ka lua i ke alo o nā cysts nui a i ʻole exulate purulent.

Nā Cystadenomas

ʻO ka neoplasm benign maʻamau e ulu nei mai ka ditli epithelium o ka pancreas. Loaʻa ia ma ka 10-15% o nā leona cystic āpau o nā pancreas a ma nā 1.5-4% o kāna mau maʻi hōʻeha. ʻOi aku ka lehulehu i ka ʻili a i ʻole ke kino o ka nui. Hoʻopilikia ka hapa nui o nā wahine.

E like me ka papa helu moʻolelo kahiko o kēia o ka WHO (J. Kloppel et al., 1996), 3 mau ʻanoʻokoʻa o ka nui o ke tumiki a benign pancreatic e hoʻokaʻawale: serous, cystadenoma mucinous a me intraductal papillary-mucinous tumor.

ʻO cystadenoma kakou

ʻO kēia ʻano o ka cystadenoma pancreatic i ka nui o nā hihia he ʻano kahe ʻāpana, i loko o kahi wai wai wai paʻa. ʻO ka etiology o serstad cystadenoma i maopopo ʻole, ʻoiai ka manaʻo ia e hiki ke hoʻomohala ʻia mai nā huina epithelial o ka acini pancreatic ma muli o ke hoʻololi ʻana i ka chromosome Zp25.

ʻO kahi hiʻohiʻona hiʻona o ka hana macroscopic o ka cystic tumors o ka pancreas ma ke komo ʻana i ko lākou ana o nā mea kikoʻī hou aku - septa a i ʻole nā ​​papaha paʻa (Fig. 58-11).

Kuhi. 58-11. ʻO ka cystadenoma huelo pancreatic koʻikoʻi: a - hoʻomākaukau i ka ʻāpana, b - ka imaging magnetic resonance.

Ka hōʻike ʻana o nā moʻolelo o nā paia o ka cystadenoma serous e hōʻike ana i ka lula epithelial i loko, aia nō i nā selika cubic-layer, a i ka wā o ka puni ʻana o ka histochemical, ʻike ʻia nā granule me glycogen i loko o kēia mau cell epithelial.

Me ka cystadenoma serous, hoʻokaʻawale ka septum i ka tumuni cystic i loko o nā koena liʻiliʻi he nui, e like hoʻi me ka meli. ʻO kēia ʻano ʻano o ke ʻano o ka cystadenoma i kapa ʻia ʻo ka microcystic a ua manaʻo ʻia ia ʻano ʻano wale nō no ka maʻi serous cystic o ka pancreas. Eia nō naʻe, aia kekahi ʻano ʻē aʻe o ka hana macroscopic o ka maʻi cystic serous, i ka manawa i kū ʻia ai kahi pūnaehana unisexual, a me nā ʻāpana kūwī i loko ona. ʻO kēia ʻano ʻokoʻa o ka cystadenoma serous i kapa ʻia macrocystic, a i ʻole oligocystic. He mea paʻakikī e hoʻokaʻawale me nā pseudo-cysts.

Ke holomua nui nei ka maʻi, a me ka nānā ʻana i ka lōʻihi o ka nānā ʻana i ka piʻi ʻana o ka nui o ka cystadenoma serous. ʻO nā hihia o kāna hoʻololi kino i ka cystadenocarcinoma serous he casuistic.

ʻO ka nui o ia ʻano cystic maʻamau ʻaʻole eʻoi aku ma mua o 5-7 cm.ʻO ka maʻi pinepine e ʻike ʻia i ka wā pale. Kahi hoʻohua ʻia nā maʻi maʻi, nonspecific, ʻoi pinepine ka maʻi maʻamau i loko o ka wahi o ka epigastric. Ma nā maʻi diagnostics, nona ka waiwai nui Papaki ʻōnaehana, CT a MRIAHUIaoiaʻe Endosonography. ^ E Ha yM. No ka maʻi maʻi ʻana me ka pseudocysts, hiki iā ʻoe ke hoʻohana puncture pono-pono punthure me ka minamina a me nā ʻike ʻike ma ka hana a amylase a ʻo ka hana pū.

ʻO ka hui pū ʻana o nā hiʻohiʻona i kau inoa ʻia o kēlā me kēia ʻoi ʻana o ka tumunā cystic e pale aku i ka hoʻopiʻi ʻana i ke kaʻina hana hōʻeuʻeu a kau i nā hōʻike ʻana i kēia makahiki no nā mea maʻi. Hōʻike ʻia ka hana no ka hoʻonui ʻana i nā hōʻailona a me ka hoʻonui ʻana i ka nui o ka cyst ma luna o 5-6 cm. Lae maikaʻi ʻo ka neʻe ʻana ma waena o nā ʻoihana o ka hoʻomaʻemaʻe ʻana, a me ke ʻano wale o ka pūlio i ka ʻoihana hānai i ka maʻi o kēia pancreas e ʻae ʻia. ʻAʻole paʻa ʻia ka hana ʻana o ka ʻauahi kūwaho a i ʻole. ʻO ka mea nui o ka hoʻokolohua moʻolelo kūpilikiʻi o ka pā cyst, me ka ʻole o ke kaila ʻē aʻe o ka koho ʻana i kahi ala kūpono ʻole a i ʻole ka nui o ka hoʻomaʻamaʻa ʻana, ʻoi aku hoʻi i nā kūlana ākea me ka hoʻohana ʻana i nā hana minimally invasive.

Melania cystadenoma

Hōʻike ʻia ka cystadenoma Mucinous e kahi polymorphism o ke ʻano. I ka nui o nā hihia, ʻo ia kahi nui kīkē lehulehu. (Fig. 58-12), i hoʻopiha ʻia i nā lemus viscous aiʻole hemorrhagic me kahi pā paʻa.

Kuhi. 58-12. ʻO ka cystadenoma mucusous pancreatic: a - hoʻomākaukau i ka māhele, b - tomogram compute me ka hoʻonui ʻokoʻa.

ʻO ka pinepine, aia ka hoʻolālā o kahi cystise unisexual me ka ʻole o nā kulu i loko (macrocystic oligocystic form). Wahi a kekahi o nā hypotheses maʻamau, ʻike ʻia kahi ulu kūpū cystic e ulu mai mai ka ovarian tissue, nā mea i waiho i loko o ka puke o ka pancreas i loko o ka wā o ka hoʻomohala mua ʻana i ka hana intrauterine. ʻO ka iwi puha o ka pā a me ka septum o ka cystadenoma mucinous e like me like me ka stromal tissue o ka ovary, ʻo ia ke kumu o ka toʻa like ovarian-like stroma. Hoʻomaopopo ʻia kēia o kekahi o nā hiʻohiʻona kūʻokoʻa o ka hoʻolālā o ka tumuna cystic mucinous. Hōʻike ʻia ka pae histological o ka paia o ka miki cystic o ka mucinous i kahi lula epithelial e pili ana i ka epithelium prismatic e loaʻa ana i ka mucin. ʻO ka hoʻomau ʻana o ka histochemical no ka glycogen ma kēia hihia ke hāʻawi i kahi hopena maikaʻi ʻole.

E holomua wikiwiki ka cystadenoma Mucinous, a ma o ka manawa i ʻike ʻia ai, e maʻamau ana ke ana a hiki i ka 10-15 cm ke anawaena. No laila, kahi maʻi hōʻeha akā kūpaʻa maʻamau, kahi makaʻu ʻole i ka epigastrium e ʻano paha o ia mea. Ua hōʻike ʻia nā ʻike ʻōiwi o ka hoʻoulu ʻana a i ʻole hōʻino i kēia ʻanoʻano o ka umauma bile maʻamau, duodenum, a me nā kumu nui o ka pancreatic. ʻO ka hiʻohiʻona nui o ia maʻi cystic ikaika ākea loa ka hoʻololi ʻana i ka malignant transformation.

Ua hōʻike ʻia nā noiʻi he nui i kekahi keaka cystic mucinous, ma hope o ke manawa, ʻike ʻia nā wahi o ka dysplasia epithelial koʻikoʻi, e hele ana i loko o ka carcinoma ma laila, a laila i loko o ka cystadenocarcinoma pancreatic.

Wahi a ka ultrasound a me ka CT, ma kahi o 20-30% o nā hihia, ʻike ʻia ka calcification o kona pā o waho. I kekahi mau kūlana, i ka wā e hoʻokele nei i ka CT me ka hoʻonui ʻana i ka bolus intravenous, hiki ke ʻike ke ʻike i ka hōʻiliʻili ʻana o ka ʻokoʻa ʻē aʻe i nā ʻāpana a me ka pā o ka pūlohi cystic (ʻike i ka Fig. 58-12). Hiki ke ʻike ʻia ka kahe o ke kolamu ma loko o ke kaʻi cystic me ka ultrasound i ka mode scan duplex, ma muli o ke kahe o ke kīʻaha koko ma nā hana intracavitary a me ka pā o ka maʻi cystic.

ʻO ke kūlana o ke koena o ka parenchyma pancreas o kekahi mea nui no ka mālamaʻana i kahi maʻi cystic. He mea nui ia e noʻonoʻo me nā nūpepa like ʻole i kū ʻole ʻia i nā loli hanana. I ka manawa like, me kahi pseudocyst o ka pancreas, sclerosis, atrophy, ka hoʻopili ʻana o nā kalima, a me ka hoʻonui ʻana i ke kumu nui o nā pancreas e loaʻa pinepine i kona parenchyma. ʻO ka cystadenoma mucinous e like me ka cystadenocarcinoma pancreatic. Akā e like me CT a i ʻole Papaki ʻōnaehana wale nō me nā cystadenocarcinoma hiki i nā hōʻailona o ke komo ʻana i ka ʻōpū o nā pale i nā ʻaoʻao a puni, kahi ulu o nā nūlā lymph regional, a ʻike ʻia paha nā metastases i nā ʻokoʻa ʻē aʻe. E hoʻokaʻawale i waena o lākou, pono e hōʻike i nā hōʻailona hōʻoki (CEA a me CA-19-9).

Loaʻa nā manawa maikaʻi loa no ka maʻi maʻi o ka maʻi cystic o ka pancreas MRIAHUI. ^ E Ha yM. ʻAʻole ia e hoʻoili a hoʻoili i ke kiʻi o nā huelo, akā e hōʻike like i kekahi mau ʻano pilikino o nā ʻano bi3 i loko o ka hoʻopaʻa ʻana o nā kiʻi T1 a me T2. Hiki i kēia mau ʻikepili i ka hopena maʻi o ka serous mai ka mucstous cystic tumor. I ka cystadenoma serous, ʻike ʻia ka wai o ka intracavitary e kahi neʻe haʻahaʻa haʻahaʻa i ka T1 - a kiʻekiʻe - i ke kiʻi T2. ʻO ka hōʻailona mai nā ʻike kūloko o ka maʻi cystic mucinous e ʻoi aku ka maʻa o ke kiʻi ʻo T1.

No nā pseudocysts o ka pancreas, e like me ka serous cystadenoma, kahi haʻahaʻa kaha haʻahaʻa i kahi kiʻi T1-paona a kiʻekiʻe i ke kiʻi T2-kaumaha ke ʻano. Eia nō naʻe, hiki ke hoʻololi i nā clots koko a manuahi paha i loko o ka pseudocyst i nā hiʻohiʻona o ka hōʻailona i loaʻa.

Hoʻololi Magnetic Resonance Pancreaticocholangiography hiki iā ʻoe ke hoʻokumu i ka pilina ma waena o ka cyst a me ke kumu nui o ka pancreas. Me nā puʻu cystic serous a me mucinous, ʻaʻole i pili kēia pilina. A me kahi māloʻi papillary-mucinous intraductal, ma kahi ʻē aʻe, kahi kohu kumu nui i hoʻokaʻawale ʻia e ka pūpana o ka cyst kekahi o kāna mau hiʻohiʻona ka hoʻokaʻawale.
Eia naʻe, ke ʻano o ka ultrasound a me ka CT ma ke ʻano o nā maʻi cystic ʻaʻole iʻoi aku i ka 50-60%. ʻO ka nui nui o nā hopena hemahema e kū mai me ka variig oligocystic o ke kaina o ka tumahā cystic.

I nā kānalua kānalua, i ka wā e kūleʻa ʻole ai ke ʻano o ke cystic lesion o ka pancreas, pono e hoʻohana ʻia. percebutan TAB nā cysts i ukuhi ʻia e nā hōʻike ʻana biochemical a me cytological. ʻO kekahi o nā ala hoʻohiki no ka nānā ʻana i nā kaʻina pathological i loko o ka pancreas ʻo ke ʻano ʻO ka ultrasound endoscopici hoʻoholo kiʻekiʻe.

Hoʻokomo ʻia nā hana hoʻokolohua kūpono i ke mālama ʻana i ka cystadenoma mucinous e pili ana i kona nui, ʻo ia nō ka kiʻekiʻe o ke kolohe ʻana o kēia ʻano o ka cyst. Ma waena o nā mea lapaʻau hana lapaʻau, ʻo ka pau ʻana o ka wehe ʻana i ka maʻamau ke ʻae ʻia, ka maʻamau me ka haʻalele ʻana i nā pancreas e pili ana ma hope o ka hoʻopiʻi ʻana, biopsy, cytological a me ka hōʻoia mōʻaukala.

Pono e noʻonoʻo i ka paia o ka pūliki o ka cystic i pinepine i nā wahi i loaʻa ʻole ka lula epithelial i loko. Hoʻokomo ʻia kekahi mau hāpana o ka pā cyst i ka hoʻokolokolo ʻana, aia i ka hapa nui o nā wahi kahi i loaʻa ai kahi ulu ulu intracavitary aiʻole septa.

Pākuʻi papillary Intraductal-mucinous

He luhi a paʻakikī kēia e hoʻoponopono ai i ka ʻaila. Loaʻa ia i kekahi makahiki. Hoʻokumu ʻia ia mai ka prismatic, mucin-epithelium o nā kumu nui a i ʻole lateral o ka pancreas a hoʻopaʻa ʻia iā ia ma kāna poʻo a me kāna kīhāpai ʻano pane. Hāʻawi ʻia kēlā mau maʻi i ke ʻano o ka ulu ʻana o ka epithelial papillary, hana i ka ʻalupelo mānoanoa a hoʻopili ʻia me nā mea hoʻolalima koʻikoʻi o nā kumu nui a hope paha o ka pancreas. I kekahi mau hihia, aia paha kahi lōnaʻi mea nui paha o kekahi ʻāpana o ka huina. ʻO kēia ʻano ʻano maʻi i loaʻa kahi hopena o ke kolohe.

Ma muli o kēia, ʻaʻole kekahi o nā ala o ka noiʻi noiʻi, koe wale i ka morphological, hiki ke hoʻoholo i nā palena maoli o ka hoʻolaha ʻana o ka ʻūhā ma nā kipa, ʻo ke ala nui ka maʻi lapaʻau ka pancreatectomy. I kekahi mau hihia, ʻae ʻia ka wehe ʻana o ka lula i loko o nā palena o nā loli i ʻike ʻia me ka hoʻokolohua ʻana i ka histological huli i nā ʻāpana.

Hoʻololi hou i ka hana maʻi paleki ma ka pancreas

ʻO ka pancreas kekahi o nā kaila nui loa o ka pūpū o ka ʻōpū, e hana ana i nā hana o ke kāpili ʻana o nā hormones a me nā enzymes e pono ai e hōʻoia i ke kaʻina o ka kūwī ʻana a me ka assimilation o nā meaʻai. Ke hoʻokō nei i ka pancreas ma o ka hōʻiliʻili ʻana, pono ka hana ʻana i ka plastik hou reconstructive e hoʻihoʻi hou i ka hana o ke keʻa o ka digestive, kahi e pono ai ka ʻoihana akamai.

Aia nā kaona liʻiliʻi me nā ona. Hiki i nā maʻi hoʻoneʻe a me ke benign ke hoʻohālikelike mai i nā hana glandular, me ka hoʻomohala ʻana o nā kaʻina o nā maʻi, nā cysts a me nā abscesses e hiki ke hele i loko o ka ʻōwili, a hana ʻia nā pōhaku ma kāna kumu No ka mālamaʻana i kēia mau maʻi, nā ʻano like ʻole ka hana maʻi pancreatic:

  • piʻo pancreatic - hana pili i ka hoʻokaʻawale ʻana o kēia ʻano mai nā ʻili o ke kino me ka hoʻopili piha ʻana o nā kīʻaha koko,
  • Nā pōhaku pancreas - ke hana ʻia nei ka hana ma nā hihia koʻikoʻi o ka maʻi a kau i kahi pae o nā hana e hana ai i kahi kahe mai o ka wai pancreatic. E hoʻoneʻe i nā pōhaku hoʻokahi, hana ʻia ka pancreatotomy - ka ʻae ʻana mai o ka iʻa ma luna o ka pōhaku a me kona hoʻoneʻe ʻana. Me nā pōhaku he nui, wehe ka wai mai ka huelo o ka gland,
  • hana hoʻopau pancreas - hana hōʻike ʻia no nā pōʻino kino nui ma muli o ka trauma, ka maʻi maʻi, ka necrosis pancreatic.

Me ka hoʻomohala ʻana o nā kaʻina hana hōʻino i ke kino, ʻo ka hana ma ke ʻano wale nō ka maʻi. Hiki i ka ho'ōla kūpono hiki ke hoʻopau wale i ka metastasis i nā kino ʻē aʻe.

Inā loaʻa ka lolo i ke poʻo o ka pala, makemake ʻia ke ala pylorus, ka mea, e like me ka hana ʻo Whipple maʻamau, i hiki ai iā ʻoe ke hoʻopakele i kahi ʻāpana o ka ʻōpū. Hoʻomaikaʻi kēia i ke ola o ka mea maʻi, ʻoiai ʻaʻole pono ia e pili i nā hopena o ka hoʻopukapuka ʻana o ka gastric (no ka laʻana, hemo hoʻomake syndrome).

Hana ia no ka pancreatic - ʻĀLOHE

Hiki i ka pancreatectomy ke hana i ʻelua ala. Ke hoʻāla ʻia ka hūpō ma ke poʻo o ke kīpē, ua noi ʻia ka hana ʻana o Whipple, ka mea e lawe ai i ka poʻo a me nā ʻāpana o ka duodenum, me ka ʻāpana hoʻi o ka ʻōpū, ka ʻōpū o ka puhaka, nā pōpoki bile a me nā nū lymph. I ka pae aʻe, hoʻihoʻi ʻia ka māhele o ka meaʻai ma loko o nā ʻōpū me ka plastik o ka duodenum a me nā papa lepo.

Ma kēia hana, i ka wehe ʻana i ka pancreas a me nā ʻili e hoʻopuni ana, kahi hana koʻikoʻi nui i ka ʻāina o ka hōʻoki ʻana ke ʻano o ka hana hou ʻana a me ka hana ʻana o ka puhipuhi o ka huna ʻana o ka pancreatic a me ka bile mai ka ʻōpala. I ka wā hana, ʻo kēia ʻāpana o ka digestive tract "reassembles" hou me ka hoʻokumu ʻana o ka anastomoses e hiki mai ana:

  • ka hopena o ka ʻōpū a me ka jejunum,
  • kinohi o ka moʻo pancreatic a me ka puʻuwai,
  • ka umauma bile maʻamau me ka pākia.

ʻO ka Anastomosis kahi pūpū hoʻonaninani (loakino mai ka ʻawaʻawa, ligament of the loop o nā ʻāpana a me nā dile bile), kahi e hiki ai iā ʻoe ke mālama i ke kahe o nā ʻōpū ma luna o ka huelo.

Hiki ke hoʻohana ʻia i ke ʻano o ka hoʻopihapiha o ke kaʻi pancreatic i loko o ka ʻōpū, a ʻaʻole i loko o ka ʻōpū (pancreatogastroanastomosis). Pono kēia mau pae āpau e hana i ka hana hoʻopihapiha hou hou hou e hoʻihoʻi i ka hana o ke kaomi kūwili, kahi e pono ai ka loea.

KAHIKI NO KA HOOLAHA ANA O KA NUI ANA NUI-KAULANUI-MAUI

Ua nui ka nui o nā koho a me nā kaʻina hana no ka hoʻopaʻa hou ʻana o ka pūnao. ʻO ka koho maʻamau e pili ana i ka anastomosing i ka ʻaʻa o ka lipopa me ka ʻōpū a me ka jejunum. Hoʻokumu ʻia ka pancreatic-gastric a i ʻole pancreatic-intestinal anastomosis e nā ʻano ʻelua:

ka hoʻohana ʻana i ka implantation a i intussusception paha, i hōʻike ʻia no ka pancreas palupalu me kahi ʻōmū palupalu a me kahi ʻōmole maʻamau o ka papa pancreatic,

pauku mucosaal mucosa, ka mea e pili ana i ka anastomosing o ka papa pancreatic a me ka membrane mucous o ka ʻōpū a me ka jejunum. Hoʻohana ʻia kēia ʻano hana no ka hoʻonui nui ʻana o ka pankre pancreatic a me ka hoʻonui nui ʻana o ka parenchyma o ka aila ma muli o ka maʻi pancreatitis.

KA PILE ʻIAI POTOPANUI

ʻO ka hoʻomaʻamaʻa ʻana o ka pancreas e pono ai ka digestive enzymes me ka meaʻai.

Hōʻike pū ʻia nā hōʻike koko no ke kō, no ka mea, ʻoi aku ka hoʻoulu ʻia o ka pancreatic i ka ʻōpū o ka maʻi diabetes Lawe ʻia ka ʻike pālua i ʻelua mau makahiki i ka nānā ʻana i kēlā me kēia lā i ka nānā ʻana i ka ʻike kukuna o ke koko. Eia kekahi, hoʻokō ʻia ka hoʻokolohua hoʻonaninani waha. Inā loaʻa iā ʻoe nā pilikia kūpono, pono ʻoe eʻai i ka ʻai.

He ola ma hope o ka maʻi pancreatic: he aha nā hopena?

Wikiō (kaomi ke pāʻani).

I ʻōlelo ʻo Great Pirogov penei: "He hana hilahila ka hana maʻi no ka lāʻau lapaʻau." Pono e hoʻohui i kēia - no ka mea maʻi pū kekahi.

ʻO ko mākou makemake ʻole e mālama i nā maʻi hoʻomaka, ka manaʻo ka hala ia o ka manawa, a ʻo ka haʻalele ʻana i nā ʻano maʻamau o ke ʻano maikaʻi e alakaʻi iā mākou i ka papa hana. ʻAʻole kūpono loa.

ʻO kekahi hana koʻikoʻi loa ke kino. ʻO ka hōʻeha maʻi pancreatic i 25% o nā hihia e alakaʻi i ka make, a ma 100% i kahi kīnā. ʻO ka kaliʻana o ke ola o nā mea maʻi ma hope o ka lawenaʻa liʻiliʻi.

Nā ʻano o nā maʻi lapaʻau hou loa i ka pancreas

Wikiō (kaomi ke pāʻani).

I kēia lā, hana i nā hana ma ka pancreas me ka hoʻohana ʻana i kēia mau ʻano:

I ka wā o ka hana, kū mai nā pilikia he nui ma muli o kona kāpili, kahi a me nā ʻano.

ʻO ka hao he kikoʻi momona. He paʻakikī koʻikoʻi ʻo Stitching, hiki ke hōʻino ʻia e ka pā maʻalahi me ka manamana lima.

He mea ʻole ʻole kēia, pili nā lula ma ka ʻaoʻao o ke akepaʻa, ma ka ʻaoʻao o laila he mau nāhelehe nui, ka aorta ʻōpū, nā aʻalolo, nā alapaʻi, nā kuʻi, a me ka duodenum he kaila kaila holoʻokoʻa. ʻO ka manawa pinepine e hoʻokaʻawale i kahi ʻāpana o ka kelepona, pono ʻoe e hoʻokaʻawale i ka duodenum. ʻO ka hiki ʻana i kēia ʻaha me ka hōʻino ʻole ʻana i ka kaila a puni ʻoi aku ka paʻakikī.

Ma muli o ka hana nui o nā kinina e hua ana ka hao, i ka wā hikiʻole, hiki i nā enzymes ke hōʻalo i ka hao ʻoi iho, ʻaʻole ma ka meaʻai. Inā i ka wā o ka hana e komo ai ka enzyme i ke kahe wai, a laila hiki mai koke nui ka pīhoihoi nui.

Ma muli o nā hiʻohiʻona hiʻohiʻona o kēia kiko, ka mākū a me nā pū, cysts, abscesses, a me nā pōhaku i hiki i loko o kāna mau sela. Hiki ke ho'ōla ʻia kēia mea ma o nā maʻi wale nō.

ʻAʻole maʻamau ka lawena pancreatic ma muli o kona paʻakikī nui a me nā makeʻe kiʻekiʻe. ʻO kahi palena o nā kumu ke kumu no ko lākou hoʻokō ʻana:

  • ʻOnawa papaʻaila,
  • ʻōpū, ʻeha a palepoke,
  • ʻeha me ka hōʻeha i ka hapa nui o nā kumulā,
  • hoʻoiho cyst
  • nā hānau hānau
  • peritonitis
  • pōhaku i loko o nā kumu i kālai ʻia
  • nā kāʻei a me nā fistulas.

Hana pinepine ʻia nā hana i loko o kekahi mau hana, ʻoiai ʻaʻole hiki ke mālama pono i ka hana holoʻokoʻa i hoʻokahi manawa.

Eia ke ʻano o ka maʻi o ka pancreas i kāna maʻi, ʻaʻole maopopo. Aia ke kūleʻa nui e pili ana i ka mālama ʻana o ka nui o nā maʻi.

I kēia mau lā, hiki i kahi hana hōʻola gland ke ola, akāʻo ka mea maʻi ma ka awelika e ola ma hope o kēia hana no ʻekolu mau makahiki. ʻAʻole i ae ʻia i ka hao ʻo ke kahe ʻana o ke koko no ka hapalua hola. Ke aniani, hiki ke hoʻohana ʻia, ʻaʻole iʻoi aʻe ma mua o ʻelima mau hola. Ke hoʻoili ʻia, ʻaʻole i kau ʻia ma kona wahi, akā ma ka peritoneum.

ʻO ka hoʻololi ʻana ka pancreas i ke ʻano nui o ka unplplants.

Ma muli o nā pilikia koʻikoʻi, ʻaʻole i hanaʻia ka hana gland transplant. Ke hoʻomau ʻia nei ka huli ʻana no nā hana hou o ka hoʻouka ʻana, hana ʻia ka noiʻi ma ke ʻano o ka hana ʻana i kahi kūlohelohe.

ʻOkoʻa nā kumu no nā mea hana, ua nui ka nui o nā kaʻina hana ma ke ʻano he ʻumikumamālima:

  • aloha limahana pancreatic lesi,
  • ʻaʻamai
  • hihihihihihihihihi,
  • Marsunialization o ka cyst
  • haʻalele-hema hema,
  • papillotomy a me nā mea ʻē aʻe.

Hoʻohana ʻia nā hana e nā mea maʻi loea i nā ʻoi loa e pono ai.

ʻO ka lōʻihi o ka mālamaʻana i ka mea maʻi ma hope o ka hana ʻana ma muli o ke kūlana o kona olakino ma mua o ia a ma ke ʻano o ka hana i koho ʻia e ka mea maʻi.

ʻO ka maʻi i koi ai i ka hōʻiliʻili o ka maʻi, ma hope o ka hoʻomau ʻana i ka maʻi o ka mea maʻi, e hoʻoholo i nā hana o nā hana pale a me ke ʻano o ke kanaka maʻi.

ʻAʻole hiki ke hoʻihoʻi hou i nā ʻāpana i lawe ʻia i ka wai; Ma hope o ka hōʻemi ʻana, ʻeha ka noho ʻana o ke kanaka a me ka huina o ka enzyme i ka ʻāpana i lawe ʻia o ka ʻai;

I ka wā o ke hoʻolaʻa hou ʻana ma hope o kahi hana ma ka pancreas, ua noho ka mea maʻi i ka ʻoihana hoʻoponopono hou o ka haukapila i kahi lōʻihi. Aia nā ʻokoʻa nā ʻōlelo hoʻopiʻi like ʻole:

  • peritonitis
  • kahe koko
  • huina o ka maʻi diabetes
  • nā mālamalama maikaʻi ʻole
  • kaʻe lele ʻana.

Pono ke kūleʻa i ke kikowaena olakino a hiki i ʻelua mau hale o ka haukapila, pono ke ʻano o ka digestive tract i nā ʻano hana i hoʻololi ʻia.

Ma hope o ka hoʻomaʻemaʻe ʻana, ua hoʻohuli ʻia kahi kanaka i kahiʻai intravenous artial. ʻO ka lōʻihi loa o ka manawa hana pilikino he hopena koʻikoʻi i ka hoʻōla. Lawe ʻia nā mea kanu intravenous mai 5 a 10 mau lā. Ke hoʻokō nei i kēlā kīʻai ʻole hiki i ka mea hōʻemi i nā hoʻopiʻi ma hope o ka hana ʻana.

Nā ʻano hana postoperative o ka hoʻomanawanui hou ʻana ka meakanalima:

  • kaiʻai paʻa loa
  • hana maʻamau
  • ka hoʻohana ʻana o ka insulin e hoʻoponopono i ke kō,
  • ka hoʻohana ʻana o nā enzymes no ka hoʻokaʻawale ʻana i ka meaʻai.

ʻO ka nānā mau ʻana i ka lāʻau lapaʻau mau ke ʻano o ka mea maʻi e pale aku i nā hoʻopiʻi hiki.

I loko oʻelua mau pule ma hope o ka haʻalele ʻana mai ka haukapila, ua kuhikuhi ʻia ka mea maʻi i ka hoʻomaha hoʻomaha a me ka hoʻomaha o kahi moe.

E hele ana, e heluhelu ana i nā puke a me nā hana kino e hiki ke hoʻolako ʻia i ka papa o ka mea maʻi e like me kona ola ʻana, he mea hiki ʻole ke hana.

Hoʻolālā ʻia ka hoʻolālā e ke ʻano kauka ma hope o ka ʻike ma ka mōʻaukala olakino, hoʻohālikelike o nā hoʻokolohua ma mua a ma hope o ka hana.

I ka ʻai, e pono ke hoʻokaʻawale ʻia ka hoʻohana ʻana i nā mea inu, momona, momona a me ka momona.

ʻOiai ʻo ka mokuʻāina o ke olakino o ke kanaka ma hope o ke kaʻina e hilinaʻi nei i ke ʻano o kāna hoʻokō, ʻo ke ʻano o nā kaʻina olakino ma hope o ia, ua kiʻekiʻe loa ka makeʻe ma hope o ka hana.

Hoʻokomo ʻia ka hoʻomaʻamaʻa pancreatic (pancreatectomy) no ka mālama maʻi ʻana. I ka wā o ka hana, hiki iā lākou ke hoʻokaʻawale i nā mea āpau a ʻāpana paha o ke kīwī. Hiki iā lākou ke wehe i nā nū o nā ʻaoʻao ʻē aʻe, e like me:

  • - spleen a he ʻulaʻula,
  • - ʻōpū lymph,
  • - hapa ʻāpana o ka ʻōpū liʻiliʻi a i ʻole ka ʻōpū.

ʻO ka prognosis ma hope o ke kaʻina hana ma ka pancreas e hilinaʻi nei i nā mea he nui:

  • - ke ʻano o ka hana,
  • - he aha ke kūlana preoperative o ka mea maʻi,
  • - ka maikaʻi o nā ʻenehana a me ka therapeutic,
  • - nā meaʻai kūpono a me ka mālama koʻikoʻi o ka mea maʻi.

ʻO ka hoʻohemo ʻana o nā cysts, ka pancreatitis hoʻonāukiuki, nā pōhaku i ka pancreas a me nā kūlana pathological kahi i hoʻokō ʻia ai nā hana a i kahi i hoʻoiho ʻia ai ke ola holoʻokoʻa a i ʻole ʻāpana wale o nā mea i hoʻopau ʻole i ka hoʻopilikia ʻana i ke kūlana maʻamau o ka mea maʻi a me ka ʻike maʻamau.

No ka mea, he hana me ka maʻi ʻeha e hoʻoweliweli i ka hoʻomohala ʻana o nā relapses. No kēia kumu, ʻaʻole maopopo ka kiʻekiʻe o ka pōpilikia o ke ola ma hope o kēlā ʻano hana. No ka poʻe maʻi maʻi maʻi, ma hope o ka hōʻeha ʻana, inā i loaʻa kekahi mau mea leʻaleʻa, ua hōʻike ʻia nā hōʻike hoʻokūkū kūikawā e hoʻoholo ai i ka hoʻomohala ʻana o ka huakaʻi maʻi a me ka hoʻomohala ʻana o nā metastases i ka manawa.

Ma ka nahele uluhia o kahi wahi i hoʻopaʻa ʻia ʻole o ka maʻi a me ka hōʻoki ʻana ka pancreatic, aia kahi hihiʻi i ka mana i hāʻawi ʻia e nā kauka naturopathic iā mākou.

Ua kākau aku nei ka mea nāna i hōʻike maikaʻi ʻia e Arnold Eret ma ka hoʻomaka ʻana o ka kenekulia 20: "ʻO nā maʻi āpau, me ka ʻole o ka ʻokoʻa, ke hele mai a me nā meaʻai kūlohelohe a a mai kēlā me kēia pā o nā meaʻai nui." E noʻonoʻo e pili ana i ka lilo ʻana o ka meaʻai ʻano ʻano maʻamau i ka hoʻomaka o ke kenekulia 21.

No ka hoʻokuʻu ʻana i nā maʻi, ʻaʻole pono ʻoe e lilo i ka ʻai mākaʻi a i ʻole he mea lāʻau iʻa, pono wale ʻoe e hahai i nā kuʻina o ke ʻano palekana, kahi a Eret i kuhikuhi mai iā mākou ma ka puke o ka inoa hoʻokahi.

Ke nānā nei nā kānaka i nā kumu o nā maʻi i nā mea āpau - i nā maʻi, nā hokai koke o nā kino, nā kīnā hānau, akā ʻaʻole i ka meaʻai. No laila, he mea pohihihi a hiki ʻole nā ​​kumu o nā maʻi he nui. Heluhelu i nā kumu o nā maʻi i loko o ke ʻano lapaʻau o ka lāʻau lapaʻau - aneane ʻike pinepine ʻia.

He ʻumi mau wahi keu ma mua o ka pono o ke kino, a no ka hapa nui o ka ʻai, ʻo ke keʻakeʻa ʻana me ke kanaka.

ʻO kekahi maʻi ka ʻano o ke ʻano o nā mea ʻē aʻe, ʻo ia hoʻi, nā mea hoʻopau i nā kino o ke kanaka. ʻO ka hoʻopauʻana iā lākou he mea maʻalahi a paʻakikī hoʻi i ka manawa like.

Ke kūleʻa ʻia nei ka maʻalahi i nā loiloi kaulana: hoʻēmi i ka nui o ka meaʻai e hoʻomaʻemaʻe i ke kino. Pono kaʻai kūlohelohe a kūlohelohe. Hoʻonui ka hoʻomaʻamaʻa i ke ʻano o ka hoʻomaʻemaʻe i ke kino. Hoʻohana nui nā ʻauʻau wela i ka mālama ʻana i ke kino. ʻAʻole emi ʻole ka ʻauʻau kai ma mua o nā ʻauʻau wai, no ka mea he ʻoi aku ka nui o ka ea no ke kino ma mua o ka mea ʻai.

Ma hope o ka hele ʻana ma ka pancreas

ʻO kahi wahi koʻikoʻi ma hope o ka paleʻana ma ka pancreas i manaʻo ʻia he meaʻaiʻai, me ka hāʻawi pono ʻana i ka ʻai. Ma hope o ka hoʻopiliʻana, ʻaʻole hiki ke hana i ka hui ʻana me ka piha. ʻO ka hoʻohana ʻana i ka papaʻaina e hōʻemi ana i ka ukana ma luna o lākou. ʻO ka papaʻai meaʻai a me kona wā e kuhikuhi kūʻokoʻa ana e ke kauka.

ʻO ka maʻamau, me nā maʻi a me nā palaka, pono nā poʻe maʻi e haʻalele i kekahi huahana e hoʻonui i ka hana o nā enzyme e hāʻawi ana i ka hōʻemi ʻana o ka meaʻai. Ma hope o ka hoʻomaʻamaʻa ʻana ma ka pancreas, pono e uku ʻia kāna hana e nā lāʻau lapaʻau. Hiki i kāu kauka ke kuhikuhi i nā inikini insulin e hoʻomaʻamaʻa i kāu koko koko. Eia kekahi, kauka pinepine nā kauka i ka vitamina A, E, K, D, a me B12.

ʻO ka ʻōpiopio olakino postoperative ka mea maʻamau:

1) Nūlā huaʻai:

- ka hoʻohana ʻana i kahi ʻauʻau,

2) Ke ʻano pilikino kūlohelohe.

Ma hope o ka hoʻomaʻamaʻa, ʻike maikaʻi nā mea kanu lāʻau.

Hoʻopili i ka lāʻau mālama manawa i kēia manawa.

Manaʻo 1st. ʻO nā mea ʻai makua wale no 7-12 mau lā. ʻO ka lōʻihi o ke kaʻina e pili ana i ka paʻakikī o ka hana.

Manaʻo 2nd. ʻO kēia kahala he hoʻololi i ka kai kūlohelohe a ma laila lākou e hoʻohana ai i ka pono makua pelika.

Manaʻo 3. Ua kuhikuhi ʻia ka mea maʻi i kahi meaʻai kūlohelohe maoli. Pono pono e hoʻonui lohi i nā kaumaha i nā mea lawe o ka poʻe maʻi:

- ka mua, ka pule mua, e kau ʻia ana nā mea maʻi i ka ʻaina 0.

- ma hope iho, no ka pule ʻelua, ʻae lākou i ka papa ʻaina No. 1a,

-, laila, ua ʻōlelo ʻia i kahi hebedoma ʻē aʻe e huli i ka ʻai i ke ʻauhau ʻokoʻa 1b.

- ka papa manawa hou aʻe a hiki i ʻelua mau mahina e koho i ka papa mua o ka meaʻai No.5p,

- a laila no ka manawa ʻeono mahina i ka makahiki, ua kuhikuhi ʻia ka lua o kaʻai ʻana No ka nui o 5p.

Ma hope o ka hoʻokuʻu ʻana i ka mea maʻi mai ka haukapila, pono ia e kāpae i ka komo ʻana o nā huahana penei.

- nā meaʻala a me nā kau,

- ka meaʻai me ka māhu poli.

Pono ka ʻai o ka mea maʻi e pono me ka piha o ka protein, a me ka minimally i nā momona, nā kō a me nā haʻalulu.

ʻO ka manawa postoperative holoʻokoʻa, pono ka mea maʻi ma lalo o ka mālama koʻikoʻi lāʻau e pale i ka hoʻomohala ʻana o nā ʻano ʻano like ʻole.

Waiho I Kou ManaʻO HoʻOpuka