Indwara ya esophage ya esophal (gerd) nindwara imwe nimwe mu ishami rishinzwe gusya. Ibyuma byayo no kwigaragaza bigoye bigira ingaruka zikomeye ku mibereho yabarwayi. Kandi gutwika karande bya Esofagus bifite ibyago byo gutera kanseri ya Esophaphage. Nigute ushobora gusuzuma neza no gutunganya nibyibandwaho.
02 Imyidagaduro ya Gerd
Gerd irashobora kugabanywamo muburyo budasubirwaho (nerd), esophagis (re) na barreta esophage (be) ukurikije endoscopi.
Nerd: Esofphagus ya Barrett hamwe na Mucosa ya Esophageal yangiritse mubisobanuro bya gerd ariko endoscopi yangiritse.
Re: Endoscopy irashobora kubona igifu-cya esophageal mucosa ihujwe na esofagus cyangwa hejuru. Mucous Membrane yangiritse rimwe na rimwe.
Ba: Esophadic-esophadial epithelial igice cya esofagus cyanze esofagus cya esofagus kuri endoscopi yasimbuwe na epithelium ya silindrike.
02 Imyidagaduro ya Gerd
Usibye gutwika umutima no kunyeganyega, ibimenyetso nko kubabara mu gatuza, ububabare bwo munda bwo mu gituza, ububabare bwo munda, kandi mu buryo bw'igitangaza, kandi mu buryo bw'igitangaza, kandi mu buryo bw'igitangaza, kandi mu buryo bw'igitangaza, kandi igitangaza, asthma, asima n'ibindi bimenyetso bya byayo byanze bikunze.
Twabibutsa ko abarwayi bafite abarwayi bakuru bageze mu zabukuru bafite umutima muto cyane. INTEGO Z'IBIMENYETSO MU GIHE CY'UBURYORIKA. Ibimenyetso ntabwo bisanzwe, cyangwa ndetse nibisobanuro. Uburemere bwibimenyetso ntabwo busa nuburemere bwindwara. Uruganda Guiyuri yaringaniye, akiri umuganga, yatejwe imbere muri Guangli.
03 dibd
Ishusho. Ibimenyetso bisanzwe bya gerd hamwe na Atypical Shost Shost Ibimenyetso byanditseho bikaba bivuye kuri Gerd Gukuramo Inkomoko: Ihuriro ryubuvuzi
Ikizamini cyo gusuzuma Umukozi wa ACID
Kubarwayi bakekwa (bakoreshwa na PPI isanzwe), Dosage isanzwe izamara ibyumweru 2 (abafite ibimenyetso hanze yumuyoboro ukeneye kubyumweru). Niba ibimenyetso biruhutse rwose cyangwa ibimenyetso bimwe gusa byoroheje byagaragaye ko bifite akamaro.
2) Endoscopic
-Re -los Angeles igabanijwemo amanota (reba ishusho hepfo):
Icyiciro A: Ibyangiritse bya Esophageal Mucosal, uburebure bwangiritse ≤5 mm;
Icyiciro B: 1 cyangwa byinshi byangiritse bya Esophageal, uburebure bwangiritse> 5 mm, mucous membrane ibyangiritse kandi nta guswera;
Icyiciro C: Nibura 2 Mucosa 2 ya Esophageal yangiritse, kandi umucowo wangiritse uvanze.
Icyiciro D: bivuga kwangirika no kwishyira hamwe kwa mugenzi wawe, kandi urwego rwa Fusion ni 75% bya Esofagus.
-Benga ingamba za biopsy: Birasabwa ko hari aho biopsy nyinshi kandi bikiri biopsy, kandi biopsy habonetse inteko ya 1cm izenguruka amashyiga. Ingano yurwego rufitanye isano nibyago bya kanseri, kandi ibyago bya kanseri biriyongera kandi byongera urugero rwa 3cm.
3) gupima byinshi -Bylephadaal gupima
Abarwayi bafite gerd bakunze kwigaragaza nkimbaraga zidafite ubuzima: igipimo cya 70% cyangwa ibipimo byateganijwe bya 70% cyangwa peristalsis ni ≥50%.
Gukurikirana irwanya -ukuri
Nigisanzwe cyo gusuzuma CEDD. Ninzira ya zahabu yo gusuzuma Gerd, harimo no gukurikirana igenzura rya esofagus nh agaciro ka esophageal yang anti -nh Gukurikirana agaciro ka esofafu Nh agaciro na Esophagetang Gukurikirana Anti -nh. Ijanisha rya PH <4 (Igihe cya Acide, Aet)> 4% muri 24h, bifatwa nkaho hari aside pathox.
04 imiti ya gerd
Igishushanyo .ger
Inkomoko: ISHYAKA RY'UBUSHUZI
INTEGO:
-Ppi na P-cab ni yo guhitamo kwambere kwivuza kwambere no gufata neza abarwayi bafite umubiri. Kubanjirije kwivuza kwa PPI ni ibyumweru 8 kandi kuvura p-cab ni ibyumweru byinshi.
-Ku barwayi bafite amakimbirane nijoro (mugihe ufata PPI, PH <4 IGIHE> 1h nijoro ryabanditsi) Igice cya kabiri cya PPI.
-Umukozi wo kurwanya -acid na gastrointestastinal arashobora gukoreshwa mugihe gito -Tari kugirango uhitemo ibimenyetso byamahirwe nko gutwika umutima no kugarura.
-Ibimenyetso bya Endoscopic: Umuti wa Gerd urasobanutse, ucide ntangarugero, udashaka gufata imiti igihe kirekire, cyangwa ingaruka mbi zijyanye nibiyobyabwenge, kandi ntishobora kwihanganira ibiyobyabwenge, kandi ntashobora kwihanganira.
-Ibimenyetso byo kwivuza byo kubaga: Hariho ibimenyetso bisanzwe bya gerd, kuvura ppi ntibyemewe; Endoscopy ibona hernia ya esophageal, be, re, amanota ya los angeles cyangwa hejuru; X-DIPRAS YATANZE KO HARI HOSOFHAAL HOLE HOLENIA.
Igihe cya nyuma: Werurwe-21-2024