Intangiriro
Akalaziya ya cardia (AC) ni indwaraindwara y'ibanze yo kugenda k'umuyoboro w'amaraso.Bitewe no kutagira uburyo bwo kuruhuka neza kw'umuyoboro wo hasi w'ibiryo (LES) no kutagira uburyo bwo kuruhuka mu muyoboro w'ibiryo, ibiryo bigumanaKudakora neza kw'umubiri no kugira icyo ukora. Ibimenyetso by'uburwayi nko kuva amaraso, kubabara mu gituza no kugabanya ibiro.Ikwirakwizwa ry’abanduye ni hafi 32.58/100.000.
ItsindakuvurwaIndwara ya achalasia ikubiyemo cyane cyane kuvura indwara zitari ukubaga, kwagura imiterere y'umubiri no kubaga.
01Ubuvuzi bw'Ubuvuzi
Uburyo bwo kuvura imiti ni ukugabanya umuvuduko wa LES mu gihe gito.Nta kimenyetso kigaragara kigaragaza ko imiti ishobora gukomeza kandi neza kongerera ibimenyetso bya AC.Imiti ikoreshwa cyane muri iki gihe irimo nitrate, calcium channel blockers, na β-receptor agonists.
(1)Nitrates, nka nitroglycerin, amyl nitrate, na isosorbide dinitrate
(2)Ibikoresho bifunga imiyoboro ya kalisiyumu, nka nifedipine, verapamil, na diltiazem
(3)agonisti za β-receptor, nka cabuterol
02 Inshinge y'uburozi bwa Botulinum (BTI) yo mu bwoko bwa Endoscopic
Inshinge ya endoscopic botulinum toxin (BTl) ishobora gukoreshwa mu kuvura AC,ariko ishobora gutanga ingaruka z'igihe gito gusa kandi ishobora gukoreshwa ku barwayi bageze mu za bukuru bafite ibyago byinshi byo kubagwa no gusinziriza.
1) Ibimenyetso:abarwayi bari mu kigero cyo hagati n'abageze mu zabukuru (barengeje imyaka 40); abadashobora kwihanganira kuvurwa hakoreshejwe uburyo bwa endoscopic balloon dilation (PD) cyangwa kubagwa; abavurwa kenshi na PD cyangwa ubuvuzi bubi bwo kubagwa; abatobowe mu mfuruka mu gihe cyo kuvurwa na PD Ku bafite ibyago byinshi, ishobora no gukoreshwa hamwe na PD; ishobora gukoreshwa nk'inzira yo kubagwa cyangwa kuvura PD.
(2) Ibibujijwe:Ntibyemewe kuvura indwara ya AC ku barwayi bakiri bato (≤imyaka 40).
03 Ukwaguka kw'ibaluni yo mu minota (PD)
Kwaguka kw'amabaluni bigira ingaruka zimwe na zimwe kuri AC, ariko bisaba kuvurwa kenshi kandi bishobora guteza ingorane zikomeye.
(1) Ibimenyetso:Abarwayi ba AC badafite ikibazo cy'umutima n'ibihaha, ubumuga bwo kuvura amaraso, nibindi; abagabo barengeje imyaka 50 n'abagore barengeje imyaka 35; abarwayi bananiwe kubagwa. Bushobora gukoreshwa nk'uburyo bwa mbere bwo kuvura.
(2) Ibibujijwe:Kunanirwa cyane kw'umutima n'ibihaha, kudakora neza kw'imitsi ndetse n'ibyago byinshi byo gutobora umwobo w'igifu.
04 Indwara yo mu kanwa (Peroscopic Myotomy)
Mu myaka ya vuba aha, hamwe n’ishyirwa mu bikorwa ryagutse rya peroral endoscopic myotomy (POEM), igipimo cy’intsinzi mu kuvura AC cyariyongereye cyane.Uburyo bwo kuvura indwara ya AC mu buryo bw’ubusizi bujyanye cyane n’igitekerezo cya "kubaga mu buryo buciriritse cyane", ni ukuvuga ko ibisebe gusa ari byo bikurwaho/bikurwaho mu gihe cyo kuvurwa, kandi ingingo ntizikurwaho.Ubuziranenge n'imikorere y'imiterere y'umubiri birakomeza, kandi ubuzima bw'umurwayi nyuma yo kubagwa ntabwo bugira ingaruka. Kugaragara kwa POEM byatumye ubuvuzi bwa AC bugabanuka cyane.
Igishushanyo: Intambwe zo kubaga POEM
Ingufu za POEM zo hagati n'igihe kirekire mu kuvura AC zirahuye n'iza laparoscopic Heller myotomy (LHM)ishobora gukoreshwa nk'uburyo bwa mbere bwo kuvura.Bamwe mu barwayi bashobora kugira ibimenyetso byo kugaruka k'umuyoboro w'amaraso nyuma yo kubagwa POEM
(1) Ibimenyetso byuzuye:AC idafite imiterere ikomeye ya submucosal, ikibazo cyo gusohora ubusa mu gifu ndetse na diverticulum nini.
(2) Ibimenyetso bifitanye isano:Kurwara indwara zo mu ruhu, indwara zo mu ruhu n'izindi ndwara zo mu ruhu, abarwayi bananiwe kubagwa POEM cyangwa Heller, hamwe na AC ifite uduce duto tw'umuyoboro w'amaraso.
(3) Ibibujijwe:Abarwayi bafite ikibazo gikomeye cyo kuvura amaraso, indwara zikomeye z'umutima n'ibihaha, indwara mbi muri rusange, n'ibindi badashobora kwihanganira kubagwa.
05Laparoscopic Heller Myotomy (LHM)
LHM ifite imikorere myiza mu gihe kirekire mu kuvura AC, kandi yasimbuwe na POEM ahantu imiterere y’umubiri ibyemera.
06 Kubaga Esophagectomy yo Kubaga
Iyo AC ihujwe n'inkovu zo mu kibuno cyo hasi, ibibyimba, nibindi, hashobora kwitabwaho kubagwa isofa.
Twebwe, Jiangxi Zhuoruihua Medical Instrument Co., Ltd., ni uruganda rukora ibikoresho byo mu Bushinwa byihariye mu gukoresha ibikoresho byo mu nda, nkaforceps za biopsy, hemoklip, umutego wa polyp, urushinge rwo kuvura sclerotherapy, katheteri itera umuti, uburoso bwa cytology, insinga y'ubuyobozi, agasanduku ko gukurura amabuye, katheteri itwara amazi mu mazurun'ibindi bikoreshwa cyane muriEMR, ESD,ERCPIbicuruzwa byacu bifite icyemezo cya CE, naho inganda zacu zifite icyemezo cya ISO. Ibicuruzwa byacu byoherejwe mu Burayi, Amerika ya Ruguru, Uburasirazuba bwo Hagati no mu gice kimwe cya Aziya, kandi birushaho kumenyekana no gushimwa n'abakiriya!
Igihe cyo kohereza: Nyakanga-09-2024