Acute vs Chronic Pancreatitis | Tus mob pancreatitis vs Mob pancreatitis Etiology, Pathological hloov pauv, kho cov yam ntxwv, teeb meem, kev tswj hwm thiab kev kuaj mob
Txawm hais tias mob pancreatitis mob thiab mob ntev zoo li lub sijhawm luv thiab ntev mus rau qhov tshwm sim ntawm tib tus kab mob, lawv tsis yog. Lub pathology yog txawv kiag li nyob rau hauv ob yam mob. Mob pancreatitis yog ib qho kev kho mob, uas tshwm sim los ntawm kev khiav tawm ntawm cov kab mob pancreatic digestive enzymes los ntawm cov hlab ntsha mus rau hauv parenchyma ua rau muaj kev puas tsuaj ntau ntawm cov txiav thiab cov nqaij peripancreatic. Hauv kev sib piv, tus kab mob pancreatitis ntev yog tus cwj pwm los ntawm kev puas tsuaj ntawm cov ntaub so ntswg pancreatic parenchymal nrog mob ntev, fibrosis, stenosis thiab dilatation ntawm cov kav dej thiab thaum kawg ua rau kev puas tsuaj ntawm pancreatic functions. Tsab ntawv xov xwm no qhia txog qhov sib txawv ntawm tus mob pancreatitis mob ntev txog lawv cov etiology, kev hloov pauv ntawm cov kab mob, cov yam ntxwv kho mob, teeb meem, kev tswj hwm thiab kev kuaj mob.
mob pancreatitis
Tus mob pancreatitis, uas yog qhov pib zom zaub mov ntawm txiav txiav los ntawm cov enzymes qhib, yog qhov xwm txheej ceev. Hauv 25% ntawm cov neeg mob, etiology tsis paub, tab sis qee qhov cuam tshuam tau raug txheeb xyuas. Biliary tract calculi tau pom los ua lub luag haujlwm tseem ceeb. Mob pancreatitis feem ntau tshwm sim tom qab kev sib tw ntawm kev haus dej ntau, uas pom tau tias nws cov tshuaj lom rau ntawm pancreatic acinar hlwb. Lwm qhov ua rau yog hypercalcemia pom hauv thawj hyperparathyroidism, Hyperlipidemias, poob siab, hypothermia, tshuaj thiab hluav taws xob.
Thaum xav txog cov kab mob ntawm tus mob pancreatitis tso tawm cov enzymes ua rau kev puas tsuaj ntawm pancreatic thiab peripancreatic cov ntaub so ntswg ua rau mob o, thrombosis, hemorrhage, vascular raug mob thiab rog necrosis. Depletion ntawm intra vascular ntim tuaj yeem ua rau poob siab. Kev nthuav dav necrosis ntawm cov ntaub so ntswg thiab hemorrhage tau pom. Rog necrosis tshwm li chalky dawb foci uas yuav raug calcified. Hauv cov xwm txheej hnyav, pancreatic abscess tuaj yeem tsim vim liquefactive necrosis loj heev. Neutrophils yog cov kab mob inflammatory tshaj plaws.
kho mob pancreatitis tshwm sim raws li kev kho mob xwm txheej ceev. Tus neeg mob tuaj yeem tsim mob epigastric mob hnyav, nquag xa mus rau nraub qaum, txo qis los ntawm leaning rau pem hauv ntej, nrog ntuav thiab poob siab. Muaj qhov nce siab tam sim ntawm cov ntshav amylase, feem ntau 10-20 npaug ntawm qhov kev txwv sab saud thiab rov zoo li qub hauv 2-3 hnub. Tom qab 72 teev, ntshav lipase pib nce.
Feem ntau cov neeg mob uas mob pancreatitis rov zoo los ntawm qhov mob hnyav nrog kev saib xyuas kom raug. Hauv cov xwm txheej hnyav, cov teeb meem loj tuaj yeem tshwm sim xws li pancreatic abscess, hemorrhage hnyav, poob siab, DIC lossis mob ua pa nyuaj, uas tuaj yeem ua rau tuag taus.
Tus mob pancreatitis
Nws yog qhov raug mob mus tas li rau tus txiav ua haujlwm uas exocrine thiab endocrine ua haujlwm thiab morphological txawv txav tshwm sim hauv qog. Hauv feem ntau ntawm cov xwm txheej, tej zaum yuav tsis muaj qhov pom tseeb qhov tseeb. Lwm yam ua rau muaj xws li kev haus dej cawv ntev ntev, kab mob biliary calculi, noj zaub mov zoo thiab mob pancreatitis.
Thaum xav txog cov kab mob ntawm tus kab mob pancreatitis ntev; Tom qab rov qab tawm tsam ntawm tus mob pancreatitis, txiav txiav ua atrophic thiab fibrotic. Lub pancreatic duct tau stenosed nrog proximal dilatation nrog poob ntawm parenchyma thiab hloov nrog caws pliav nqaij. Exocrine thiab endocrine kev ua haujlwm tsis zoo. Diffuse calcifications muab lub pob zeb-nyuaj sib xws rau lub caj pas. Microscopically variable lymphocytic infiltration yog tam sim no.
Tus neeg mob hauv tsev kho mob muaj mob plab, mob nraub qaum, jaundice, yam ntxwv ntawm pancreatic tsis ua haujlwm xws li kev poob phaus, anorexia, anemia, steatorrhoea thiab ntshav qab zib.
Ntawm no, X-ray ntawm lub plab mog tuaj yeem ua rau pom kev ua rau pancreatic calcifications. Ultrasound thiab CT scan ntawm lub plab, kuaj pancreatic functions, Endoscopic retrograde cholangiopancreatography, angiography thiab pancreatic biopsy yog lwm yam kev ntsuam xyuas tseem ceeb hauv kev mob pancreatitis.
Kev kho mob muaj kev tswj hwm qhov mob los ntawm kev siv tshuaj lossis kev phais mob, malabsorption los ntawm kev noj zaub mov thiab ntshav qab zib los ntawm kev muab tshuaj insulin yog tias tsim nyog. Cov teeb meem ntawm ntshav qab zib sawv cev rau kev hem thawj rau lub neej. Narcotic dependence yog lwm qhov teeb meem.
Dab tsi yog qhov txawv ntawm tus mob pancreatitis thiab mob pancreatitis ntev?
• Mob pancreatitis yog mob xwm txheej ceev.
• Etiologies thiab pathogenesis txawv ntawm ob yam mob.
• Nyob rau hauv mob pancreatitis, cov xwm txheej yuav ua rau lub neej tshwm sim xws li hemorrhage thiab poob siab, uas tuaj yeem ua rau mob hnyav txaus ua rau tuag, tab sis tus kab mob pancreatitis ntev, yog tus kab mob qeeb zuj zus.
• Cov qib ntshav siab amylase tau pom nyob rau hauv tus mob pancreatitis hauv 1-2 hnub ntawm kev tawm tsam.
• Pancreatic calcifications thiab kev hloov pauv hauv cov qauv tshwm sim nyob rau hauv mob pancreatitis, tab sis mob pancreatitis morphological hloov pauv tau rov qab nrog kev saib xyuas zoo.
• Mob ntshav qab zib mellitus tas li yuav luag tsis ua raws li ib qho kev tawm tsam ntawm tus mob pancreatitis, tab sis tus mob pancreatitis ntev ua rau mob ntshav qab zib mellitus qhov twg tus neeg mob yuav tsum nyob ntawm insulin.
