Ọrịa reflux esophageal nke afọ (GerD) bụ ọrịa a na-ahụkarị na ngalaba nri nri.Ọgbasa ya na ngosipụta ụlọ ọgwụ dị mgbagwoju anya nwere mmetụta dị ukwuu na ndụ ndị ọrịa.Na mbufụt na-adịghị ala ala nke esophagus nwere ihe ize ndụ nke ịkpata ọrịa cancer esophageal.Otu esi achọpụta n'ụzọ ziri ezi na ịhazi ọgwụgwọ bụ isi ọrụ ụlọ ọgwụ na-elekwasị anya.
02 Ngosipụta ụlọ ọgwụ GERD
Enwere ike kewaa GERD n'ime reflux na-abụghị eroded (NERD), reflux esophagitis (RE) na Barreta esophageal (BE) dị ka endoscopy si kwuo.
NERD: Barrett esophagus na ọcha esophageal mucosa mebiri na nkọwa nke Gerd ma endoscopy mebiri emebi.
Re: Endoscopy nwere ike ịhụ mucosa afọ-esophageal nke jikọtara na esophagus ma ọ bụ n'elu.A na-emebi akpụkpọ ahụ mucous na obere oge.
BE: A na-eji cylindrical epithelium dochie akụkụ eriri afọ-esophageal squamous epithelial nke esophagus-dị ka epithelium nke njikọ esophagus na endoscopy.
02 Ngosipụta ụlọ ọgwụ GERD
Na mgbakwunye na ọkụ obi na reflux, ihe mgbaàmà dị ka mgbu obi, ihe mgbu nke elu afọ, na esophagus dị ebube, ụkwara, ụkwara ume ọkụ na mgbaàmà esophageal ndị ọzọ nwere ike ime.
Ekwesiri iburu n'uche na ndị ọrịa nwere ndị ọrịa GerD meworo agadi nwere mmetụta dị ala nke obi na reflux.Mmetụta nke mgbaàmà na tube extractive dị elu.Mgbaàmà anaghị ahụkarị, ma ọ bụ ọbụna asymptomatic.Ogo nke mgbaàmà adịghị ejikọta na oke ọrịa ahụ.Ụlọ ọrụ Guiyu dị larịị, ma mgbe ọ bụ dọkịta, e mepụtara ya na Guangli.
03 Nyocha GERD
Onyonyo.Ihe mgbaàmà GerD a na-ahụkarị na mgbaama traktị nri nri nri dị elu na-ata ahụhụ site na GERD diagnostic flowchart Source: Medical Association China
Nnwale nyocha nke onye na-egbochi acid
Maka ndị ọrịa gerd na-enyo enyo (nke a na-ejikarị PPI), usoro onunu ogwu ga-adịru izu 2 (ndị nwere akara na mpụga tube kwesịrị ịdịru ≥4 izu).Ọ bụrụ na mgbaàmà ahụ kwụsịrị kpamkpam ma ọ bụ naanị otu mgbaàmà dị nro ka egosipụtara na ọ dị irè.
2) Endoscopic
-Re -Los Angeles na-ekewa n'ime akara ule (lee foto dị n'okpuru):
Klas A: 1 ma ọ bụ karịa mmebi mucosal esophageal, mmebi ogologo ≤5 mm;
Ọkwa B: 1 ma ọ bụ karịa mmebi mucosal esophageal, mmebi ogologo> 5 mm, mmebi akpụkpọ anụ mucous na enweghị njikọ;
Klas C: Ọ dịkarịa ala 2 mucosa esophageal mebiri emebi, na akpụkpọ anụ mucous na-ejikọta ya na ibe ya.
Klas D: Na-ezo aka na mmebi nke mucosa na ntinye nke ibe ya, na ngwakọta ngwakọta bụ 75% nke esophagus.
-BE usoro biopsy: A na-atụ aro ka enwere biopsy nkenke na nkenke, a na-enwetakwa biopsy site na nkeji 1cm n'akụkụ stovu ahụ.Ogo nke oke ahụ metụtara ihe ize ndụ nke ọrịa cancer, na ihe ize ndụ nke ọrịa cancer na-abawanye ma na-abawanye oke nke 3cm.
3) Ntụle esophageal dị elu
Ndị ọrịa nwere GerD na-egosipụtakarị dị ka ike esophageal adịghị arụ ọrụ: oke nke 70% ma ọ bụ ọdịda peristalsis nke 70% ma ọ bụ peristalsis bụ ≥50%.
Anti-ugbu a nlekota oru
Ọ bụ ọkọlọtọ maka nyocha nke CEDD.Ọ bụ ọkọlọtọ ọla edo nke nchoputa nke GERD, gụnyere nlekota nke uru NH esophagus na esophageal yang anti-NH uru nlekota nke esophagus pipe NH uru na esophageal yang anti-NH uru nlekota oru.Onu ogugu pH <4 (oge ikpughe acid, AET)> 4% na 24H, a na-ewere ya na enwere reflux acid pathological.
04 ọgwụgwọ GERD
Ọgụgụ .Ụdị usoro ọgwụgwọ Gerd
Isi mmalite: Òtù Na-ahụ Maka Ọgwụ nke China
Mkpachapụ anya:
-PPI na P-CAB bụ nhọrọ mbụ maka ọgwụgwọ mbụ na nlekọta nke ndị ọrịa nwere Gard.Ọgwụgwọ mbụ nke ọgwụgwọ PPI bụ izu 8 yana ọgwụgwọ P-CAB bụ ≥4 izu.
-N'ihi na ndị ọrịa nwere ọganihu n'abalị (mgbe ị na-ewere PPI, pH <4 oge> 1H n'abalị nke abalị), ị nwere ike iji H2 receptor blockers tupu ị lakpuo ụra na ndabere nke PPI ọgwụgwọ, ma ọ bụ gbanwee P-CAB. na ogologo.Ọgwụgwọ PPI ọkara ndụ.
-Enwere ike iji ọgwụ mgbochi acid na eriri afọ na-arụ ọrụ maka ngwa ngwa ngwa ngwa iji belata mgbaàmà nke ahụ erughị ala dịka ọkụ obi na reflux.
Ihe ngosi ọgwụgwọ endoscopic: Nchọpụta GERD doro anya, ọgwụgwọ acidic adịghị mma, na-achọghị ịṅụ ọgwụ ruo ogologo oge, ma ọ bụ mmeghachi omume ọjọọ metụtara ọgwụ ọjọọ, na enweghị ike ịnagide ya.
-Ngosipụta ọgwụgwọ ịwa ahụ nke ịwa ahụ: enwere ụdị mgbaàmà GerD, ọgwụgwọ PPI adịghị mma;endoscopy na-achọpụta hernia esophageal, BE, RE, Los Angeles akara ule ma ọ bụ karịa;Nnyocha X-ray chọpụtara na e nwere hernia oghere esophageal.
Oge nzipu: Mar-21-2024