Malabsorption - yintoni na le nto? Ukuhlelwa kunye ubangela

emathunjini amancinci - enye emathunjini. Iqhuba iintlobo ngeentlobo zemisebenzi, kudlala indima enkulu ukwetyisa kokutya kunye nokufunxwa kwezondlo. Ngophuhliso kwezifo ezithile aphazamisa eli sebe - kuyabonakala malabsorption syndrome, apho emfutshane njengoko koMmandla weNqila yeKapa. Yintoni na apho eli gama? Esi sifo sibangelwa yintoni izizathu?

imiqondo kokuhlaziya

Kule ncwadi lonyango, ungenza ibinzana ukufumana ezifana "malabsorption". Eli gama lisetyenziswa ukubhekisela malabsorption isifo wamathumbu inamacandelo ukutya. Kukwakho ibinzana ezifana "maldigestion". Le nkqubo ukuguqulwa ukungathobeli amanqatha, iiproteins kunye carbohydrate ukwetyisa iimveliso absorbable.

Iingcali zizidibanise zombini kwekota ngentla ( "malabsorption" yaye "maldigestion"), xa uthetha malabsorption syndrome. Ibhekisa wabonakala entsonkothileyo lwezonyango, okungenxa kwephulwa kwisisu, udonga, inwebu yokwetyiswa kunye nezothutho emathunjini amancinci. Ngenxa ezenzeka emzimbeni womntu ngenxa ukuvela malabsorption syndrome, kuvela iingxaki yokucolwa. Abantu baqale kusithuthumbisa iimpawu ezingemnandi.

Ubangelwa sma

malabsorption syndrome waphawula kuzo izifo ezininzi sofuzo kwaye iziphene apho kuphazanyiswa nokufunxwa kwezinto, kunciphise umsebenzi enzyme. Ngokomzekelo, abanesigulo esinganyangekiyo. Kulo sifo, i AGR iphuhlisa ngenxa ukuya kwabancinane umsebenzi enzyme kunye pancreatic ukuphazamiseka amahlebo viscosity.

Ukuze ludala izifo syndrome malabsorption ezibangelwa zizifo ezidala, emithanjeni engaqhelekanga kunye neenkqubo kwegazi. CMA nayo wazibona xa kukho umonakalo emathunjini amancinci kunye nokunciphisa indawo yokufunxa (ekuthiwa utshintsho emzimbeni, ukuba imzisele ukuphazamiseka kakhulu iintlobo ezininzi kokutshintshiselana, ngokwasemzimbeni kunye wazivalela engqondweni).

Ngenxa yoko, malabsorption - iseti iimpawu ezibi kunokubangela ezininzi yezizathu ezahlukeneyo. Baya zinokudityaniswa ngolu hlobo lulandelayo:

1. Preenteralnaya qela. Ezi ziquka izifo biliary phecana, isibindi, isisu, abanesigulo esinganyangekiyo.
2. Postenteralnaya qela. Oku kuquka iingxaki nkovu kunye nokuhamba kwegazi ethunjini elide, nto leyo ifumaneka phakathi esiswini kunye colon, enteropathy exudative, lymphosarcoma, isifo Hodgkin kaThixo.
3. iqela Enteral izizathu. Ezi ziquka galactose malabsorption, isifo celiac, ukusilela disaccharidase, giardiasis, dermatitis herpetiformis.

Iimpawu ezithile ku sma

Ngaphandle kwento yokuba syndrome malabsorption ezendeleyo zizifo ezahlukahlukeneyo, kunokuba eliphum features uphawu ngaye. Xa CMA isicaphucaphu, ukugabha. Xa izigulane yehle onombilini. ezi mpawu nazo kubonwa ukuqunjelwa, utshintsho isitulo (sorhudo kaninzi kwenzeka). Yonke le miqondiso kuthiwa dyspeptic syndrome. Yena ulahlekisa wabonakala kwezonyango sma.

ingqalelo ekhethekileyo kufuneka sibe kwesitulo. Ukuhlola ngeempawu endleni, iingcali kufumana inkcazelo ebalulekileyo evumela ukuba ukubeka uxilongo echanekileyo:

• kunye isitulo angqindilli ulwelo kunye ivumba asidi - luphawu olunokuba ezendeleyo ezimbi ezifana glucose-galactose malabsorption, intswelo disaccharidase;
• isitulo kutyetyiswa na pancreatitis ezingapheliyo, abanesigulo esinganyangekiyo, dermatitis herpetiformis, exudative enteropathy syndrome Pearson, dysbacteriosis emathunjini;
• ilindle kutyetyiswa kakhulu iqatshelwe abanesigulo esinganyangekiyo, iziphene lipase ngxaki;
• utyatyazo utwa - luphawu ukuba kwenzeka xa usuleleko engena umzimba, enterocolitis asakhasayo, malabsorption glucose kunye galactose.

Xa MCA maxa wambi kukho iintlungu. Kakhulu, bona bangenwe amathumbu kunye uhlaselo. Iintlungu syndrome kunokwenzeka emva kokudla iimveliso zobisi. Wahlanganisa ne isitulo foamy kunye livumba ezimuncu, flatulence ibonisa ukuhluleka yelactose. neentlungu esiswini ngexesha yeKapa kunye allergies ukutya, ukungaqheleki isisu, isifo Whipple kaThixo, sisilonda sikabhobhosi, isifo Crohn kaThixo. Ezi mpawu zilandelayo kuvandlakanywa naxa malabsorption syndrome:

• ufunga kwesikhumba;
• nokudinwa;
• imvakalelo yobuthathaka;
• ukuqumba;
• anorexia.

Malabsorption kubantwana abahamba syndromes awukho. Zaphazanyiswa ngokomzimba. Oku kubonakala ukuncitshiswa ubunzima bomzimba, uphuhliso ukungondleki, ukukhula kwamathuba emfundo. On vitamin okubangelwa ibonisa imo esikhumbeni. Isikhumba uba owomileyo luqala amaxolo off. On kubonakale namabala amnyama. Hair olindelwe kwaye uqale ukuyeka. Izikhonkwane babe isandi buthuntu kwaye exfoliate. Xa calcium imibala zenzeka amahlaba, iintlungu izihlunu kunye namathambo. Ukunqongophala ngentsimbi, ubhedu nezinki ikhokelela ukubonakala yabangxamayo eluswini, yentsimbi-imibala anemia, nande lobushushu emzimbeni.

ngezigaba ekhoyo

malabsorption syndrome kuquka izifo ezahlukeneyo ezingaphezu kwama-70. Kulo mba, iingcali ziye nazo iingxaki abanye ukuhlelwa yokulungiselela. Le yimpumelelo kakhulu ukwahlulwa of syndromes malabsorption amafa ozifumeneyo:

1. Eyokuqala kwezi ibanjiwe ngo-10% yamatyala. Ilifa sma uphume abazali umntwana. Naye ngenxa zofuzo.
2. malabsorption Acquired syndrome - isiphumo ukuphazamiseka amathumbu kunye extraintestinal (umz nangezilonda, immunodeficiencies, isibindi kunye pancreas).

Kukho kwakhona kudidi osekelwe phezu ubuzaza malabsorption syndrome:

• Grade I (ifom onomoya) - abantwana kuncitshiswa kancinane ubunzima bomzimba, kuvela iimpawu ukusilela anikezela ngezakhi ebona uphuhliso ngokomzimba disharmonious;
• II degree (average imilo) - isigulane enobunzima umzimba intsilelo (ukutenxa kumgaqo mkhulu kwe-10%) liyasetyenziswa lag kuphuhliso ngokwasemzimbeni, wabona iimpawu sho electrolyte ukushiyeka, insufficiency afikelelekayo;
• Grade III (elimandundu) - abantwana ngokwaneleyo emzimbeni, umzimba intsilelo ngobuninzi kune-20%, kwezinye izigulane kukho ukulibaziseka kuphuhliso lengqondo.

iintlobo malabsorption

Ngowe-1977 eyayibanjelwe VIII World Congress of Gastroenterology. iingcali It ziye zachongwa iintlobo ezininzi malabsorption, kuxhomekeke kubangelwa:

• intracavitary;
• posttsellyulyarnaya;
• enterotsellyulyarnaya.

Ukunqongophala inyongo secreted yi-injeke kunye izinto ochaphazela ukwetyisa ingontsi kwaye ebangela umonakalo, - uhlobo malabsorption intracavitary. Abantwana baya kuvela ngenxa abanesigulo esinganyangekiyo, hypoplasia naso zepancreas. Xa abantwana abadala imbonakalo malabsorption intracavitary syndrome bandiqumbisayo izifo ezifana kwesibindi, pancreatitis esinganyangekiyo.

Uhlobo lwesibini sma - malabsorption posttsellyulyarnaya. Esi sifo, nto leyo luphawulwa ilahleko leeprothini plasma eludongeni emathunjini. Yena yabonakala mgaqweni zeenkqubo igazi kunye emithanjeni. Enye zifo - an lymphangiectasia idiopathic emathunjini. Yena ezendeleyo ilahleko lunzima calcium, lipids kunye neeproteni kwisiqwenga zesisu.

uhlobo Enterotsellyulyarny idibanisa ezo meko apho inwebu ukugaywa eyaphukileyo okanye nokufunxwa ngenxa yesiphako iinkqubo enzyme kweeseli emathunjini epithelial. Oko kungenzeka abantwana abaselula ngenxa yezifo ilifa ezinxulumene umthetho:

• sokufunxa;
• ndizayo ukugaywa;
• yokwetyiswa ukufunxeka.

Abantwana uhlobo omdala ubudala enterotsellyulyarny of malabsorption syndrome kwenzeka ngenxa yomonakalo amathumbu kunye iseli ukufa ngenxa yempembelelo zizifo okanye yezinambuzane, isifo sephepha, nangezilonda ze emathunjini amancinci, isifo Crohn kaThixo.

Imizekelo malabsorption intracavitary

Nale hlobo AGR becala yaphazamiseka ukugaywa ngamanqatha. haydrolisis yazo ikhutshwa phandle lipase pancreatic, nto leyo owenziwe inyongo. Ngenxa yokunqongophala kwezi zinto ivela uphawu ezifana steatorrhea. Le ukheto nge endleni ngamanqatha kwemfuneko. Oku kakhulu ngokucacileyo wabonakalaliswa engapheliyo pancreatitis steatorrhea. Lula oku luphawu in wesibindi phecana biliary.

Phakathi ezibangela malabsorption intracavitary, kufuneka bacinge hypoplasia naso zepancreas (hypoplasia). Iimpawu kuvela kwiintsuku zokuqala okanye iiveki yobomi. Kukho osisityebi isitulo ngokukhawuleza ayenechaphothi ulwelo elibi kwaye kutyetyiswa. Amafutha Unga rhoqo avuze ziphume ngezantsi.

Imizekelo malabsorption posttsellyulyarnoy

Posttsellyulyarnaya malabsorption isisu kwenzeka enteropathy xa exudative. Esi sifo apho plasma iproteni ilahlekileyo ngokusebenzisa isifo. Unobangela enteropathy exudative inokuba phambi malformation naso iimpahla yesisu emithanjeni. Amaninzi isifo syndrome Whipple kaThixo, isifo Crohn kaThixo, nangezilonda yesisu encinane, nokwaliwa ukutya.

maxa wambi enteropathy Exudative lwenzeka ngaphandle obubonakala ezikwekwayo clinical. Ngamana nazo iimpawu ezifana norhudo kunye steatorrhea. Izigulane zibonakala nokudumba peripheral, yenzelwe phezu kobuso, emva, perineum, amalungu omzimba.

Imizekelo enterotsellyulyarnoy malabsorption

Enterotsellyulyarny uhlobo AGR malabsorption ibe ngenxa ngezifo ezifana glucose-galactose malabsorption. Esi sisifo ilifa apho izithuthi esebenzayo glucose kunye galactose kwaphulwa isifo emathunjini amancinci. Yokugula kwiintsuku zokuqala yobomi kuboniswa ukurhuda. Gciwane yabelwe ukusuka izihlandlo ezili-10 ukuya ku-20 ngosuku. Ba anzongonzongo, efana umchamo. Umntwana kuphakamisa ubushushu bomzimba, ukugabha kwenzeka. Ukuba ukurhoxisa ubonelelo ubisi iimpawu. ukunyamezelana Poor iilekese kunye nobisi ihleli yobomi.

Omnye umzekelo enterotsellyulyarnogo yeKapa - fructose malabsorption. Le malabsorption yemfuza ezinqabileyo. Iimpawu kwenzeka emva kokusetyenziswa iziqhamo kunye incindi, equlethe kubume bayo isixa esikhulu fructose. Le-apile kunye orenji, namaqunube kunye cherry. Loo fructose akukho zifunxwe ngumzimba izakhamzimba, ebangela flatulence, utyatyazo anzongonzongo, iintlungu abanabantwana esiswini. Kwezinye iimeko, ngohlangothi apho. Ubuzaza Iimpawu kuxhomekeke kubungakanani fructose wangena umzimba.

Eyona ixhaphakileyo Isizathu enterotsellyulyarnoy malabsorption kunye kakuhle inwebu ekugayeni - oko disaccharidase intswelo. Ukuba disaccharides leyo gqiphu ngokupheleleyo. Oko kwelifunekayo xa ungena emathunjini distal bathole Ukubila iintsholongwane kunye ngendaleko hydrogen. Kukho ezikwenza kwesisu isisu, ukuqunjelwa, urhudo, sinciphise ukutya, ukugabha, ukugabha.

Enterotsellyulyarnaya isisu malabsorption malabsorption kunye ukwetyisa lunokwenzeka izifo celiac. Sisifo esingapheliyo yemfuza zonakaliswe apho villi ye emathunjini amancinci yi ukutya okuthile. isifo Celiac esibonakaliswa abantwana kwiinyanga ezimbalwa emva kokuba ukuqaliswa kwemveliso catering glyutensoderzhaschih. Xa esi sifo:

• defecation frequency kukuphinda-2 ukuya ku-5 ngemini;
• isitulo na mushy, maxa wambi amagwebu, kuba sizalwa ivumba enukayo, kukhanya;
• kwandisa isisu;
• kukho azonelanga ubunzima inzuzo (emva kwexesha elithile ukuya intsilelo ngobuninzi ajoyine deficiency nokukhula).

Yenza uxilongo ne malabsorption syndrome

Uxilongo malabsorption akwenziwanga. Iingcali ekuchongeni iimpawu sma emiselweyo utshintsho zovavanyo ezizodwa ukuba izigulane zabo aze ahlalutye ukuqinisekisa indlela enye okanye enye ngezifo ekucingelwa nomsindo Absorption kakuhle okanye ekugayeni.

Xa wenza uxilongo, oogqirha ekhokelwa yi-algorithm ingezantsi eyenziwe yi-World Zesisu Umbutho:

• kuqala kwenziwe imbali ngokucokisekileyo, iqokelele ingcaciso malunga namayeza azenzileyo kutshanje ukuhamba, ukusetyenziswa kokutya neziselo engafakwanga ekutyeni eqhelekileyo;
• imbali yosapho wafunda;
• ngokuyincina emzimbeni iimpawu malabsorption;
• wafunda isitulo, kuthathelwa ingqalelo iimpawu zabo;
• laboratory yenziwa ukuze ufumane inkcazelo engakumbi.

Further isifo malabsorption syndrome iquka uphando ukwenza ukuba isifo celiac kurhanelwa, ubukho Giardia, iintsholongwane kunye irhorho emzimbeni. Ulwazi sokuxilonga kuvumela ukufumana ultrasound amalungu angaphakathi kwisisu. Ngenxa ultrasound kunokwenzeka ukuqikelela imeko kwiindawo isibindi, injeke, inyongo isinyi, nkovu.

Ngaphandle okanye uqinisekise i gastritis samathambo, isifo celiac, isifo Crohn kufuneka esophagogastroduodenoscopy kunye biopsy esiswini kunye duodenum. Ukuze uqinisekise ukuba ukunqongophala umsebenzi pancreatic izifundo exocrine zabanjwa isitulo, ikhompyutha kunye nemagnethi livakale Itomography, cholangiopancreatography retrograde ngengqondo imibhobho. Ukuze ufunde ngale ubukho okanye ukungabikho izitshanguba le ileum, iingcali amisiweyo ileokolonoskopiyu kunye biopsy balo mmandla uphononongwayo kwaye ikholoni.

Unyango lwe malabsorption syndrome

Emva ekuxilongweni oonobangela malabsorption oogqirha etiotropic ukumisela unyango ezijolise ekujonganeni sifo ezichongiweyo. Umzekelo:

• Ukuba isifo celiac wabonakala, yingcali icebisa umguli ukutya ubomi gluten-free;
• ukuba uchonge malabsorption wekhabohayidreyiti nobandlululo ukutya, ngoko ke wacelwa ukuba An ukupheliswa okanye imingcele eqinile ekudleni i engqinelanayo;
• iinkqubo esosulelayo eboniswe antibiotics;
• yezifo pathways ezidalwe kufuna unyango eyaneleyo pathogenetic.

Xa wavakalisa syndrome sotyatyazo ebangela malabsorption, unyango ukuze babe etiologic, kunye lingaze pathogenetic. Patogenetichekaya unyango etiological kwaye kubekho ukutya kwezi ndlela zilandelayo:

• ezifo sorhudo amagciwane;
• "Metronidazole" kunye amebiasis;
• iziyobisi anthelmintic helminthiasis;
• glucocorticoids, cytostatics, "infliximab" kwi isifo wamathumbu arhabaxa;
• "Tetracycline", "Ceftriaxone", "Co-trimoxazole" isifo Whipple kaThixo;
• "Octreotide" nangezilonda yonyango lwe iphecana zesisu.

unyango lingaze kuquka ukufumana probiotics, opiates, "Loperamide" arhente izifunxi (bismuth amalungiselelo "Diosmektita").

To self-ayinakwenzeka xa kuthe iimpawu sma. It ayiniki iziphumo ezihle. Ukongeza, malabsorption - nto ibonakalisa izifo enkulu yingozi. Ukuba ngaba wehlelwa iimpawu sma kucetyiswa ukuba udibane nogqirha. Kuphela ingcali ekunokuthiwa isizathu sokuba le syndrome kwaye akhethe kunyango ngokukuko lokuphelisa esi sifo.