He mate noa te mate reflux esophageal puku (GerD) i roto i te tari nakunaku. He pānga nui tōna horapa me ngā āhuatanga haumanu uaua ki te kounga o te oranga o ngā tūroro. Ā, ko te mumura mau tonu o te esophagus he mōrearea ki te mate pukupuku esophageal. Ko te arotahi o ngā mahi haumanu ko te pehea te tautuhi tika me te whakataurite i te maimoatanga.
02 Ngā āhuatanga haumanu o te GERD
E ai ki te endoscopy, ka taea te wehewehe i te GERD ki te reflux kore-eroded (NERD), te reflux esophagitis (RE) me te Barreta esophageal (BE).
NERD: Kua pakaru te korokoro o Barrett me te kiriuhi korokoro mārama i roto i te whakamāramatanga o Gerd engari kua pakaru te endoscopy.
Re: Ka taea e te endoscope te kite i te kiriuhi mucous o te puku-esophageal e hono ana ki te esophagus, ki runga ake rānei. Ka pakaru te kiriuhi mucous i ētahi wā.
BE: I te wā o te endoscopy, ka whakakapia te wāhanga epithelial squamous gastric-esophageal o te epithelium rite ki te esophagus e te hononga esophagus ki te epithelium porotaka.
02 Ngā āhuatanga haumanu o te GERD
Haunga te ngenge o te ngākau me te reflux, ka puta pea ngā tohu pēnei i te mamae o te uma, te mamae o te puku o runga, me te esophagus whakamiharo, te mare, te huango me ētahi atu tohu esophageal.
Me mōhio he iti noa te auau o te ngākau me te reflux i roto i ngā tūroro kua kaumātua e pāngia ana e ngā tūroro GerD. He nui te auau o ngā tohu i roto i te ngongo tango. Kāore ngā tohu i te āhua noa, kāore hoki i te whakaatu i ngā tohu. Kāore te kaha o ngā tohu i te rite ki te kaha o te mate. He papatahi a Factory Guiyu, ā, i a ia e tākuta ana, i whakawhanakehia ia ki Guangli.
03 Te tātaritanga o te GERD
Pikitia. Ko ngā tohumate GerD noa me ngā tohumate ara kai o runga kāore i te noa ka pāngia e te tūtohi tātaritanga GERD Puna: Chinese Medical Association
Whakamātautau tātaritanga o te kaihoko pehi waikawa
Mō ngā tūroro e whakapaetia ana he mate gerd (te PPI e whakamahia whānuitia ana), ka rua wiki te roa o te horopeta paerewa (me neke atu i te 4 wiki te roa o te hunga he tohu kei waho o te ngongo). Mena kua tino memeha ngā tohu, kotahi noa iho rānei ngā tohu ngawari kua kitea he whai hua.
2) Endoscopic
-Mō -Kua wehea a Los Angeles ki ngā taumata (tirohia te ahua i raro nei):
Akomanga A: 1, neke atu rānei ngā pakaru o te kiriuhi korokoro, ko te roa o te pakaru he ≤5 mm;
Taumata B: 1, neke atu rānei ngā pakaru o te kiriuhi esophageal, te roa o te pakaru > 5 mm, te pakaru o te kiriuhi mucous, ā, kāore he hononga;
Akomanga C: Neke atu i te rua ngā kiriuhi esophagus kua pakaru, ā, kua pakaru te kiriuhi esophagus i te mea kua konatunatua tetahi ki tetahi.
Akomanga D: E pā ana ki te pakaru o te kiriuhi mucous me te hononga o tetahi ki tetahi, ā, ko te awhe hanumi he 75% o te korokoro.
-Rautaki koiora BE: E taunakihia ana kia maha ngā wā koiora me ngā wā poto, ā, me tango te koiora mā te 1cm te tawhiti huri noa i te oumu. E pā ana te rahi o te awhe ki te mōrearea o te mate pukupuku, ā, kei te piki haere te mōrearea o te mate pukupuku, ā, kei te piki haere te awhe ki te 3cm.
3) Ine i te korokoro teitei-taumira
He maha ngā wā ka puta te mana koretake o te korokoro o ngā tūroro e pangia ana e te GerD: ko te ōwehenga o te 70%, te ōwehenga rānei o te korenga o te peristalsis o te 70%, te peristalsis rānei, he ≥50%.
Te aroturuki i te aukati-auau
Koinei te paerewa mō te tautuhi i te CEDD. Koinei te paerewa koura mō te tautuhi i te GERD, tae atu ki te aroturuki i te uara NH o te esophagus me te aroturuki i te uara anti-NH o te esophagus o te uara NH o te paipa esophagus me te aroturuki i te uara anti-NH o te esophagus. Ko te ōrau o te pH <4 (te wā whakapūtanga waikawa, AET)> 4% i roto i te 24H, e kiia ana he mate huka.
04 Te rongoā mō te GERD
Pikitia. Te tūtohi rere o te maimoatanga a Gerd
Puna: Te Rōpū Hauora Hainamana
Ngā Whakatūpato:
-Ko te PPI me te P-CAB ngā whiringa tuatahi mō te maimoatanga tuatahi me te pupuri i ngā tūroro e pāngia ana e te mate Gard. Ko te maimoatanga tuatahi o te maimoatanga PPI he 8 wiki, ā, ko te maimoatanga P-CAB he ≥4 wiki.
-Mō ngā tūroro he pakarukaru i te pō (ina tangohia te PPI, ko te pH <4 wā> 1H i te pō o te pō), ka taea e koe te whakamahi i ngā aukati i te kaiwhakawhiwhi H2 i mua i te moe i runga i te maimoatanga PPI, ka taea rānei te huri ki te P-CAB me te maimoatanga PPI roa. Haurua-ora.
-Ka taea te whakamahi i ngā rongoā ārai-waikawa me ngā rongoā hohe o te puku mō te wā poto hei whakamama wawe i ngā tohu o te mamae pērā i te wera o te ngākau me te reflux.
-Ko te tohu maimoatanga endoscopic: He mārama te tātaritanga GERD, kāore e tika te maimoatanga waikawa, kāore e pai ki te tango rongoā mō te wā roa, he pānga kino rānei e pā ana ki ngā rongoā, ā, kāore e taea te aro atu.
-Tohu maimoatanga pokanga: he tohu noa iho a GerD, kāore te maimoatanga PPI i te whai hua; ka kitea e te tirotiro endoscopic te hernia esophageal, BE, RE, Los Angeles ngā taumata teitei ake rānei; i kitea e te whakamātautau X-ray he hernia poka esophageal.
Wā tuku: Maehe-21-2024