Mob necrosis ntawm lub txiav. Cov tsos mob, kev kho mob

Cov txiav dag qab lub peritoneum nyob rau theem kuv-II lumbar vertebral feem. Qhov no lub cev yog muab kev koom tes nyob rau hauv lub tseem ceeb tshaj plaws dab nyob rau hauv lub cev. Tom ntej no, peb yuav tsum to taub, ib yam li nws kev tso cai, yog dab tsi yuav ua tau irregularities nyob rau hauv nws cov hauj lwm. Nyob rau hauv kev, peb xav manifested mob pancreatic necrosis.

Txheej txheem cej luam

Txiav (qub loj: 15-10 cm - qhov ntev ntawm 2-3 cm - dav) yog suav tias yog loj txaus lub cev. Nws yuag rau cov neeg laus - txog 100 g ntawm yug nws hnyav tsis muaj ntau tshaj peb grams. Nyob rau hauv tib neeg, lub cev ua ob yam tseem ceeb cai. Cia peb xav txog lawv nyob rau hauv ntau yam rau hauv qab.

hloov khoom nruab nrog muaj nuj nqi

Exocrine txiav yog ib qho tseem ceeb mus rau lub duodenum - sawv tawm nyob rau hauv nws pancreatic kua txiv. Nws muaj enzymes: amylase, lactase, maltase, lipase, trypsin thiab lwm yam. Vim pancreatic kua txiv yog neutralized acidic pais plab txheem thiab zom zaub mov. Chiv, enzymes yog ua nyob rau hauv ib tug tsis nquag daim ntawv, tom qab activating lub 12-duodenum. Lawv txiav txim no yog raws kev coj kom lub neej puas carbohydrates, cov rog, cov nqaijrog rau ntawm lub ntsiab Cheebtsam. Ua kom cov enzymes yog los ntawm enterokinase bile. Internal pa yog zus tau tej cov tseem ceeb tebchaw. Cov no muaj xws, nyob rau hauv particular, xws li lipokain, glucagon thiab insulin. Lub ob yog antagonistic rau txhua lwm yam. Lawv muab kev koom tes nyob rau hauv cov kev cai ntawm cov ntshav qab zib concentration, carbohydrate metabolism. Vim lipokaina tsim tshwm sim nyob rau hauv lub siab phospholipids. Qhov no, nyob rau hauv lem, muaj ib tug nyhuv lig rau hauv lub oxidation ntawm fatty acids. Thaum tsis muaj peev xwm lipokaina tej zaum fatty siab.

ducts

Hauv lub caj pas kis tus channel qhib mus rau hauv lub duodenum. Cov hom kua tsib thiab pancreatic ducts, nyob rau hauv feem ntau tsim nyob rau minyuam lam fwj. Raws li ib tug tshwm sim, lawv qhib ib tug loj lub txiv mis 12 duodenal rwj. Lub pancreatic ducts qub siab yuav tsum muaj ntau tshaj nyob rau hauv cov kua tsib ciav. Qhov no yog vim qhov yuav tsum tau los mus tiv thaiv qhov uas qhia tawm ntawm lub plab hnyuv txheem thiab lub tsib lub zais zis.

Kev ua txhaum ntawm lub cev ua ub no

Thaum hloov nyob rau hauv lub siab sib txawv nyob rau hauv lub pancreatic ciav zoo nkaus li kub siab. Nws yog txuam nrog qhov teeb meem ntawm outflow ntawm pancreatic kua txiv, tso tus txheem ntawm lub tsib lub zais zis los yog plob tsis so tswj. Tawm tsam tom qab zuj zus siab ntawm lawv tus kheej pancreatic hlwb pib yuav puas ntsoog. Ntawm cov enzymes yog tso tawm thiab xa cov kev twb kev txuas. Lawv txeem mus rau hauv lub parenchyma, roj thiab connective cov ntaub so ntswg ntawm lub prostate. Cov no ib tug chain reaction. Los ntawm ib tug enzyme tso ob leeg. Qhov no provokes ib inflammatory txheej txheem uas ua rau yus muaj zog ntshav txaus, thiab tom qab - mus rau ib tug stagnation ntawm cov ntshav. Qhov no muaj txhawb rau thrombosis nyob rau hauv lub caj pas. Raws li ib tug tshwm sim, ntshav teeb meem tshwm sim pancreatitis, feem ntau provoking pancreatic necrosis.

Ua rau mob ntawm lub

Pathological mob feem ntau tshwm raws li ib tug tshwm sim ntawm tej kev txom nyem ib zaug xwb los pheej rov qab ua bouts ntawm pancreatitis. Cov mob daim ntawv no yog ncaj qha mus txuas nrog cholelithiasis. Raws li precipitating yam protrudes ulcers (plab los yog duodenum 12) npuas paug, kab mob siab, alcoholism.

ntaub ntawv tseem ceeb

Raws li hais saum toj no, yog ib lub zog ntawm endocrine qog xws li zus tau tej cov tshuaj hormones. Nyob rau hauv nqa tawm no ua hauj lwm muab kev koom tes rau hauv lub islets ntawm Langerhans. Nyob rau hauv cov ntaub ntawv ntawm lawv cov swb rau hauv lub keeb kwm yav dhau ntawm pathologies, xws li mob pancreatitis tsis pub dhau, tsim fatty degeneration ntawm daim siab thiab ntshav qab zib (mob ntshav qab zib). Cov txiav yog tau rau nws tus kheej kho mus rau lub hom zaub mov. Nws tag nrho cov nyob rau cov khoom noj kom tsawg. Thaum koj tau txais ib tug loj npaum li cas ntawm carbohydrate yog tshuab txais ntau tshaj li splitting lawv enzymes. Yog hais tias lub predominant zaub mov, nws tsim tawm ntau lipase, thiab yog hais tias lub protein - trypsin. Txawm li cas los, cov kev tsim txom cov nta yuav tsum tsis txhob yuav. Qhov tseeb yog hais tias tus txiav yog tsis tshua muaj muab Pib ntsais koj teeb txog ib tug ua tau overload. Feem ntau nws manifests nws tus kheej ib tug heev tsausmuag cov tshuaj tiv thaiv, uas ua tim khawv tsis mus rau lub thawj zaug rau theem ntawm tus kab mob, thiab nws tag nrho tawg.

Lub txim ntawm tsis saib tsis xyuas cov kab mob

Disdain rau lub xeev ntawm lub pancreas yuav ua rau ntau yam teeb meem. Qhov kev nyab xeeb yog lus dag mas nyob rau hauv lub fact tias ib sab ntawm nws muaj lwm lub koom haum uas yog tsis muaj tsis tseem ceeb rau lub cev. Qhov no, nyob rau hauv particular, tus po, daim siab, lub plab. Nws tsis tsis nyob twj ywm aloof thiab lub plawv. Thaum ua txhaum hauv cov kev ua ntawm lub pancreas thiab lub cev yog nyuab siab. Cov kev hloov nyob rau hauv lub system tshwm sim sai sai heev. Rau cov pancreatic mob cancer tej zaum cia li ob peb teev.

Mob necrosis ntawm lub pancreas

Qhov no tus txheej txheem yog cov ntaub so ntswg kev puas tsuaj lub cev. Nws txoj kev loj hlob muaj feem xyuam rau ntau yam puas yam. Hauv plawv ntawm lawv cov lus dag hloov khoom nruab nrog o. Mob necrosis ntawm lub pancreas muaj nyob rau hauv cov ntaub ntawv ntawm ib tug zawm ntawm nws cov kev soj ntsuam thiab kev kho mob. Thaum lub sij hawm lub active kev koom tes ntawm lawv tus kheej lub cev enzymes. Los ntawm lawv txoj kev ua digesting lub pancreas. Thaum tshuab txais interstitial enzymes progressing pathological dab. Raws li ib tug tshwm sim, lawv tsim foci ntawm roj necrosis.

Hauj lwm ntawm tus txheej txheem

Raws li ib tug tshwm sim ntawm lub splitting ntawm fatty acids tshwm sim pH hloov. Qhov no activates intracellular tripsogen. Tom qab, nws yog hloov mus rau hauv trypsin. Qhov no compound, nyob rau hauv lem, activates proteases uas tsim kev proteolytic hnab ris. Enzymes pib corrode lub vascular phab ntsa thiab lub connective nqaij. Puas txheej txheem extends tshaj lub pancreas. Lub cev rov qab nyob rau hauv cov ntaub ntawv no yog tsis yooj yim sua. Thaum lub manifestation ntawm cuab kev pom tuag tej zaum yuav tam sim ntawd.

thab plaub yam

Necrosis ntawm lub pancreas, cov tsos mob uas yuav tau los sib tham li hauv qab no, yog feem ntau qhov tshwm sim ntawm ntau tau ntawm dej cawv, overeating, dyskinesia nyob rau hauv lub biliary ib ntsuj av tau, enzymes outflow txawv txav vim cholangitis, calculous cholecystitis. Sib tw pathology yuav tsis yog koob tshuaj noj tshuaj, txhaj koob tshuaj txhaum thiab daim ntawv thov Circuit Court. Mob pancreatic necrosis yuav tsum tshwm sim los ntawm heev kis kab mob stresses.

pathology rau

Nyob rau hauv lub loj hlob, mob pancreatic necrosis tej zaum yuav kim heev thiab focal. Cov txheej txheem yuav vam meej sai heev los yog haum sluggish txaus. Nyob rau hauv raws li cov hom pathological kawg pancreatic sib cais rau hauv tug, haumxeeb, hemostatic, hemorrhagic thiab edematous. Cov yav tas yog suav tias yog lub feem ntau me me daim ntawv. Vim nce o lub pancreas uas nkoos ib qho kev nce nyob rau hauv siab rau pankreotsity thiab tsis meej ntawm microcirculation. Kev kho mob ntawm edematous theem, feem ntau yog ntse. Nrog kev siv rau untimely txawj pathology yuav siv sij hawm ib tug khiav hom. Nyob rau hauv kev, necrotic txheej txheem muab outflow ntawm pancreatic mob cancer ntawm digestive enzymes. Raws li ib tug tshwm sim ntawm kev zom pib los ntawm tsis pub dhau lub cev. Nyob rau hauv lub chav kawm ntawm lub txheej txheem pib infiltration ntawm kua paug rau hauv lub plab kab noj hniav. Raws li ib tug tshwm sim ntawm peritonitis npaj nyob rau hauv ib tug mob daim ntawv. Qhov no inevitably phais. Txwv tsis pub pib sepsis, ua rau txoj kev tuag.

soj ntsuam daim duab

Yuav ua li cas yog cov tsos mob ntawm pancreatic necrosis? Cov tsos mob ntawm tus kab mob muaj zog txaus. Nyob rau hauv lub sab laug sab sauv quadrant mob ntawm herpes zoster muaj cim. Nws kis thoob plaws lub cev hauv qab no lub ribs. Mob nyob rau hauv lub xub pwg thiab muab cov hniav raws li ib tug lub plawv nres. Dab yog nrog profuse ntuav, tsam plab, flatulence. Cov neeg mob muaj ib tug kub taub hau, daim tawv nqaij puv daj ntseg los yog reddens. Lub ntsiab seb mob dab tsi ntawm ib tug pathological mob yog pom tias yuav tau muaj cov tsos mob ntawm Grey-Turner. Nws manifests nws tus kheej nyob rau hauv daim ntawv ntawm xiavlus me ntsis rau ntawm sab ntawm lub plab mog. Palpation phab ntsa cim mob, nro. Mob yog nqa tawm raws li nyob rau hauv nrig txog kev pom kev xeem, ua siab ntev tsis txaus siab, raws li tau zoo raws li los ntawm cov kev tshwm sim ntawm instrumental thiab kuaj kev tshawb fawb. Yuav kom ntsuam xyuas lub parenchymal echogenicity tsa los ntawm ultrasound. CT thiab MRI soj, angiography thiab laparoscopy tso cai rau koj mus muab lub caij nyoog pib ntawm tus kab mob.

kho ntsuas

Kev kho mob ntawm mob necrosis yuav tsum yog phais los yog conservative. Cov kev xaiv nyob ntawm seb pathological kev hloov nyob rau hauv lub cev. Drug raug yog muab ib lub zuj zus. Ntawm cov tshuaj pom zoo rau kev txais tos, - spasmolytics (txhais tau tias "Tsis muaj-spa", piv txwv li), thiab antifermental cytotoxic tshuaj rau enzyme synthesis. Ntawm phais hom kev kawm uas siv los ntawm laparotomy thiab laparoscopy. Txawm li cas los, nyob rau hauv lub chav kawm ntawm lub lag luam nws tsis yog ib txwm tau mus tshem tawm kiag lub pathology. Nyob rau hauv Feem ntau, kev kho mob ntawm cov neeg mob nyob rau hauv lub tsev kho mob chaw yog ua.