This may be due to reduction in the synthesis of insulin in defeat pancreatic ostravkov (Langergansa islets), and increased his antagonist - glukina rate which increases the flow driven liver glycogen. Patients hidden diabetes changes can be expressed so that clinically manifested as giperglikemical coma. Total pankreonekros can also cause and gipoglikemii that develops against the backdrop of pechenern-pochecna failure. The destruction of the liver depends on the previous changes in the disease biliary tract, alcoholism, obesity, diabetes. Pankreonekros accompanied by violations also exchange protein, which manifests itself as gipoproteinemia dizproteinemia and at the expense of the albuminates and some increase in the number α1-, α2- and γ-globulinov (grubodispersne factions). These changes caused by proteolytic enzymes and immunological violations in the body. The destructive form of pancreatitis in the blood can be found metgemoglobin that result from the compounds albumin and solanokislogo hematite-product of red. In acute pankreatite and pankreonekrose violations and hemostasis system, which are directly dependent on the severity of the pathological process. Thus, in the form of otecna Pancreatitis is giperkoagulyatsia that can be of a temporary nature and is not clinically apparent in the face of a successful conservative therapy. In steatonekrose and gemorragicescom pankreonekrose development changes that may occur in the handling -sindroma. Diagnosis and treatment in Dvs-sindroma pankreonekrose is 0248, as its development of the arts in kallickrein-kininova system. In the same can be divergent views on the appropriateness of heparin for the prevention and treatment of the Dvs-sindroma pankreonekrose. Apparently, the treatment failure geparinom even in combination with dry plasma containing antitrombin III, can be explained by the fact that it is not blocking the protease, which are scattered multiple vnutrisosudistoe tromboobrazovanie. One of the worst manifestations of toxemia, acute respiratory distress, clinical manifestations were varied. Those patients with peritonitis and intestinal infection developed dyspnoea, with a gradual increase hypoxia as a result of a breach of ventilation, blood flow and the balance in the lungs, as well as the diffusion of gases through alveoljarnuu disc, which is typical of the syndrome "shock lung." Others lung damage in the form of bilateral plevrita, atelektazov, pneumonia prevails picture diseases, and acute pancreatitis diagnosis only after a comprehensive survey. Often in the face of growing Dvs-sindroma thrombosis end branches pulmonary artery, which can be one of "shock lung." The development of acute pancreatitis is divided into several stages. B. C. Maat (1978) defines these stages as intersticialny swelling, necrotic changes (fat, hemorrhagic) and carbon, festering cancer. B. C. Saveliev and B. Buyanov M. (1979) between the three periods : 1) gemodinamicakih disorders, in which dominated volemicakie violations; 2) functional deficiency, or toxic malnutrition parenchymatous organs; 3) local abdomen and decaying septic complications. Stages of the process, the nature of local changes, the general disorder and clinical forms of acute pancreatitis are in the table. Stage nature of the local changes Preferential a common disorder Clinical form Acute Pancreatitis swelling, destruction Fermentativaya toxaemia, the micro light, moderate, severe (pankreonekros) Stage inflammatory changes Asepticescoe inflammation, fermentativei autoliz Inflammatory complications destructive changes bodies. Localized, unless Stage local aseptic and grand complications Carbon, purulent inflammation, flegmona. Purulent intoxication, sepsis. Infiltrata, carbon, in the view of most local surgeons, anaesthetists and anaesthetists, in intensive care in the intensive-care patients require : 1) to pankreaticski shock events acute abdomen; 2) with acute respiratory distress, in the face of pancreatitis; 3) with severe mental disorders of the toxemia; 4), with acute renal or pochern-pechenocna deficiency as a result of progression of pancreatitis and peritonitis; 5) with a dynamic intestinal infection in the face of toxaemia and peritonitis. Preoperative preparation for a pre requires the following clinical and laboratory research : 1. Study hemodynamics : definition DVD handling by the central vein (right outside jugular vein or podklucicna wrists). 2. Measuring changes in blood pressure and the ECG (monithornoe observation). 3. The diureza hour, which must be put in the bladder catheter permanent. 4. 1) haemoglobin blood cells, leikozita EMAS, diastaza urine, Bilirubin blood sugar blood coagulability time, the time for the bleeding ex index protrombina, KHS, the content of potassium and sodium in the plasma osmolarity of blood and urine; 2) research (BCC and its components, koagulogramma residual nitrogen, urea, creatinine plasma electrolytes plasma and urine in the dynamics, basic PHOSPHATASE, amylase blood CD4, Asat). 5. Income Study chest and review your abdomen.
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