12 duodenum: isakhiwo, umsebenzi, izifo ezinokwenzeka kwaye unyango. I-Duodenal ulcer: iimpawu

Umzimba womntu ulungele izifo ezahlukahlukeneyo. Izifo ziyakuchukumisa nayiphi na ilungu langaphakathi. I-duodenum ye-12 ayikho. Isifo esidume kakhulu sale nxalenye yenkqubo yokugaya isilonda sesilonda. Abantu abaninzi banxulumanisa nesisu, kodwa eqinisweni akuxhomekeke kuphela. Kwinkqubo ye-pathological often is involved in duodenum. Yintoni le nto yokugula? Ziziphi ezinye izifo ezinokuchaphazela i-duodenum? Ngaphambi kokukhangela iimpendulo kule mibuzo, kukufanelekile ukuqwalasela isakhiwo segama elibizwa ngokuba liSebe lenkqubo yokutya.

Isakhiwo se-duodenum

Inkqubo yokugaya abantu iyinkimbinkimbi. Elinye lalo candelo liyi-12 duodenum. Kuqwalaselwa njengesebe lokuqala kumathumbu amancinci. I-duodenum ivela kwi- pylorus kwaye iphela nge-crood-duodenum-jejunal ewela kwicandelo elilandelayo lomathumbu omncinci (kwi-jejunum).

Kwi-duodenum, amanqaku amaninzi ayahluka:

• Ingxenye ephezulu, ubude bayo buvela kwi-5 ukuya kwi-6 cm;
• Inxalenye ehlayo, eyi-7-12 cm ubude;
• Icandelo elincinci, elide ubude li-6-8 cm;
• Inxalenye ephakanyanayo ilingana nobude ukuya ku-4-5 cm.

Imisebenzi ye-duodenum

Imisebenzi emininzi ebalulekileyo eyenziwa yi-duodenum:

1. Iqala inkqubo yokugonywa kwamathumbu emathumbu. Ukutya okuvela esiswini kuziswa apha kwi-pH ye-alk, engacasuli ezinye iindawo zamathumbu.
2. I-duodenum ilawula ukuveliswa kwe-bile ne-pancreatic enzymes, ngokuxhomekeke kwi-chemical composition kunye ne-acidity yokutya esiswini.
3. Isebe lokuqala lomathumbu omncinci lenza umsebenzi wokukhupha. Ukusuka kuyo, ukutya kwe-gruel, ephuma kwisisu, ithunyelwa kwezinye iindawo zamathumbu.

Ezinye izifo ezinokudityaniswa ne duodenum

Esinye sezifo ezivela kwi duodenum yi-duodenitis. Eli gama libhekisela kwiinguqu ezinokutsha-zitshintsho kwiimbrane. Zivela ngenxa yempembelelo emzimbeni wezinto ezinobungozi: ukutyhelwa kokutya, izinto ezinobuthi obangela ubuthi xa ungena kwinkqubo yokutya, ukutya okunzulu, iziyobisi, izidumbu zangaphandle. Xa i-duodenitis, intlungu kwisigodi se-epigastric ibonakala, i-nausea, ukuhlanza, ubuthathaka, ukushisa komzimba kuphakama.

Izifo ze-duodenum zihlala ziquka ukukhutshwa okungapheliyo kwe-duodenal. Le yinkqubo ekhokelela ekuchaseni kwinqanaba le-duodenum, okokuthi umoto kunye nokukhutshwa komsebenzi kule nxalenye yenkqubo yokutya iphazamiseka. Isifo senzeke kwiintlobo ezahlukeneyo zezizathu (umzekelo, ubukho beentlungu, ukungabikho komzimba, njl njl). Iimpawu zixhomekeke kwizimbangela ezibangele ukuphazamiseka okungapheliyo kwe-duodenal, ukusuka kwinqanaba lesi sifo kunye nokususelwa kwimizuzu eyi-12-duodenum. Izibonakaliso zabantu abagulayo ziphawula ngokwabo njengokungahambi kakuhle kunye nobunzima kwisigodi se-epigastric, ukutshabalalisa, ukuphazamiseka kwesondlo, ukumbombozela, ukumbombozela kunye nokuxutywa kwamanzi.

Unyango lwe-duodenitis kunye nesithintelo esingapheliyo

Ukunyangwa kwezifo kufuneka kuqeshwe ugqirha. Ukuze i-duodenitis ye-duodenum ibuyiselwe imisebenzi yayo, ezi zilandelayo ziyimfuneko:

• Ulambile iintsuku ezili-1 okanye ezimbini;
• Ukugcoba isisu;
• Ukutyunjwa kokutya okhethekileyo (№ 1, 1а, 1б);
• Ukutyunjwa kwe-astringent, enveloping, antacid, spasmolytic, anticholinergic, i-ganglion-blocking agents, iivithamini;
• Kwezinye iimeko, kufuneka unyango kunye neyeza-antibiotics.

Ngenxa yokuphazamiseka okungapheliyo, unyango lwe-duodenum lufuna umntu. Ukuba eso sifo sichaphazela umqobo, utyando lwenziwa. Kwezinye iimeko iprokinetics inokumiselwa. Ezi zi yobisi zinomphumela oshukumisayo kwimisipha yesondlo sesisu, ukwandisa umsebenzi wesivumelwano, isisu sesisu kunye ne-duodenum, yenza ukukhutshwa ngokukhawuleza kokuqukethwe kwesisu.

Kuthetha ukuthini isilonda sesilonda?

Ukuqwalasela izifo ze-duodenum, ingqwalasela ekhethekileyo kufuneka ihlawulwe kwisilonda se-peptic. Eli gama libhekisela kwisifo esibalulekileyo esenzeka kwifomu engapheliyo kunye nexesha lokutshintshwa kunye nokunyanzeliswa. I-etiology yesi sifo ayizange ifundwe kakuhle. Ngaphambili, kwakukholelwa ukuba isilonda se-peptic esibangelwa izinto ezifana ne-pepsin ne-hydrochloric acid, eziveliswa kwinkqubo yokutya. Nangona kunjalo, uphando lubonise ukuba indima ebalulekileyo edlalwa ngama-microorganisms uHelicobacter pylori.

Izibalo zibonisa ukuba ukusabalalisa kwesilonda se-duodenal ku-6 ukuya kwi-15%. Akunakutsholwa ukuba ummeli wesondo uyagula kaninzi okanye kaninzi. Amadoda nabasetyhini banokungathinteka kwesi sifo.

Iimpawu zezilonda ze-duodenal

Izilonda zimela umonakalo kwi-duodenum. Ziyakulinganiswa nokukhukhula. Nangona kunjalo, ezi zimbini iintlobo zomonakalo zineenkalo ezibalulekileyo. Ukunyuka kwe-Erosion kuthinta kuphela i-membrane ye-mucous eyenza i-duodenum. Isilonda sifinyelela kwiingqungquthela ze-submucosal and muscular.

Izifundo zibonisa ukuba izilonda kwiimeko ezininzi zikwinqanaba eliphezulu. Zifumaneka kufuphi ne-pylorus. Ububanzi bomonakalo bunokuhluka. Izilonda eziqhelekileyo, apho le parameter ayidluli kwi-1 cm. Kwezinye iimeko, iilonda ezinkulu zifumaneka. Oogqirha kwizenzo zabo bahlangabezane nomonakalo kwi-duodenum, ebudeni befikelela kwi-3-6 cm.

Ukubonakaliswa kwezonyango zezilonda zesilonda

Kwabanye abantu, isifo siqhubeka singenakuqonda, ngelixa kwezinye iimpawu ezisolisayo zesilonda se-duodenal zibonakalisa ngokwazo. Iimpawu zivame ukugcinwa ngolu hlobo lulandelayo:

• Iintlungu eziqhelekileyo ezihlala kwindawo esiswini;
• Iingxaki zokugaya;
• Ukuhlaselwa komntu ogulayo kunye nokulahlekelwa kwesisindo;
• Izitishi zokulinda;
• Ukuhlamba ngenxa yokugcoba iisisindo zesisu seendonga zegazi;
• Ubuhlungu emva (zivela ngenxa yokukhula kwesilonda kwi-pancreas);
• Intlungu ebuhlungu esiswini (ziyabonwa ngexesha lokugqithiswa kwesilonda, ukuphuhliswa kwe-peritonitis).

Kule ndawo, eyona nto ixhaphakileyo. Ngokwemvelo yayo ingaba yinto eyahlukileyo - isantya, esitshisayo, esiqhayisayo, esingapheliyo, esingapheliyo. Ubuhlungu, njengomthetho, buvela kwisisu esingenalutho (kusasa emva kokuvuswa). Zingavela kwakhona emva kokutya malunga nee-1.5-3 iiyure. Imvakalelo engathandekiyo imisiwe kunye ne-antacids, ukutya kunye neglasi yobisi okanye amanzi afudumeleyo. Inyaniso kukuba ukutya kunye neziyobisi, xa zitsalwa, zinciphisa ngokuthe ngqo umphumo we-hydrochloric acid. Nangona kunjalo, emva kwexesha elifutshane, intlungu iqala kwakhona.

Inkqubo yokuxilonga i-peptic isifo sesilonda

Ukuxilongwa kwe "ulonda wesibini" akunakwenziwa kuphela kumqondiso omnye kunye nokuhlolwa kwangaphandle komntu ogula, kuba iziganeko ezingentla zibalawuli bezifo ezininzi. Ezi zimpawu zifihla isilonda esisodwa se-duodenal, kodwa kunye ne-cholelithiasis, umdlavuza wesisu, i- pancreatitis, i-tumor tumors, njl.

Indlela efanelekileyo nefanelekileyo yokuxilonga isilonda se-peptic yi-fibrogastroduodenoscopy. Ngethuba le sifundo, isisombululo esikhethekileyo esinomthombo wokukhanya kunye nekhamera efakwe emlonyeni kwisisu ukuze uhlolisise i-membrane ye-digestive system. Umfanekiso wenziwa kweso sondlo. Ugqirha uhlola isisu kunye ne-12-duodenum. Izifo zifunyaniswa ngenguqu ebonakalayo yentsholongwane. Ukuba kuyimfuneko, oyingcali ithatha isampuli yelummbrane ye-mucous ukulungiselela uviwo lwezinto ezincinci ezivusa ukuvela kwesilonda se-peptic.

Unyango lwonyango lwezilonda ze-duodenal

Isilonda se-peptic singaphathwa ngamayeza okanye ngokuhlinzwa. Kwiindlela zokuqala kubagulane abagulayo banikeze izidakamizwa ezidambisa i-hydrochloric acid. Zibizwa ngokuba yi-antacids. Kwakhona, iziyobisi ezikunceda ukucima imveliso ye-hydrochloric acid emzimbeni womntu unceda ngezifo. Ngokomzekelo, i-omeprazole inokumiselwa.

Ukuba kukho i-diagnostic i-microorganisms i-Helicobacter pylori ifunyenwe, ngoko kusetyenziswe unyango oluthathu lwezonyango. "I-Omeprazole" okanye "i-Ranitidine" imiselwe ngokudibanisa ne-antibiotics ("Amoxicillin" kunye ne "Clarithromycin").

Uphando lwe-peptic isifo sesilonda

Xa ixesha elidlulileyo lifumanisa ukuba "nesilonda se-duodenal", unyango lubekwe unyango. Iqhutyelwa phantsi kweendlela ezithile:

• Nge-perforation yezilonda okanye isisu esinamandla;
• Ukuqhutyelwa kanzima kwesifo esenzekayo nangona unyango oluqhubekayo;
• Ukunciphisa imveliso yesisu, eyayibangelwa ukukhubazeka kwe-duodenum;
• Ukuvuvukala okungapheliyo, okungaziboleki kwonyango oluqhubekayo.

Ingundoqo yonyango lokunyangwa kukususa inxalenye yesisu. Ekusebenzeni, inxalenye yelungu langaphakathi elinoxanduva lokukhutshwa kwe-gastrin emzimbeni. Le nkunkuma ikhuthaza ukuveliswa kwe-hydrochloric acid.

Ekugqibeleni, ku funeka kuqatshelwe ukuba xa kukho iimpawu ezisolisayo ezibonakalisa izilonda ze-duodenal, kuyafaneleka ukucela uncedo kwiklinikhi ukuya kwiingcali. Ukuzivocavoca ngezifo akunakulungelekanga, kuba unyango olungekho mthethweni, ukungabikho kwayo okanye izilwanyana ezingekho mfuneko zingenza umonakalo omkhulu emzimbeni wakho, ukonakalise impilo yakho.