Okwu Mmalite
Achalasia nke obi (AC) bụnsogbu ngagharị nke esophageal nke mbụ.N'ihi na sphincter esophageal dị ala (LES) na-ebelata nke ọma na enweghị peristalsis esophageal, nri na-ejide onwe ya na-ebute nsogbu.nsogbu na mmeghachi omume. Mgbaàmà ahụike dịka ọbara ọgbụgba, mgbu obi na mbelata ibu.Ọnụọgụ ndị a dị ihe dịka 32.58/100,000.
Iheọgwụgwọnke achalasia gụnyerekarị ọgwụgwọ na-abụghị ịwa ahụ, ọgwụgwọ mgbasa na ọgwụgwọ ịwa ahụ.
01 Ọgwụgwọ Ahụike
Usoro ọgwụgwọ ọgwụ bụ ibelata nrụgide LES n'oge dị mkpirikpi.Enweghị ihe akaebe doro anya na ọgwụ nwere ike imeziwanye ihe mgbaàmà nke AC n'oge niile ma n'ụzọ dị irè.Ọgwụ ndị a na-ejikarị eme ihe ugbu a gụnyere nitrates, calcium channel blockers, na β-receptor agonists.
(1)Nitratesdịka nitroglycerin, amyl nitrate, na isosorbide dinitrate
(2)Ndị na-egbochi ọwa calciumdịka nifedipine, verapamil, na diltiazem
(3)ndị na-anabata β-receptor, dịka ọmụmaatụ, cabuterol
02 Ọgwụ Endoscopic Botulinum Toxin (BTI)
Enwere ike iji ọgwụ ntụtụ botulinum toxin (BTl) gwọọ AC,mana ọ nwere ike inye naanị mmetụta dị mkpirikpi ma enwere ike iji ya mee ihe n'ime ndị agadi nwere nnukwu ihe egwu nke ịwa ahụ na nkụchi obi.
1) Ihe ngosi:Ndị ọrịa dị n'etiti na ndị agadi (karịa afọ 40); ndị na-enweghị ike ịnabata endoscopic balloon dilation (PD) ma ọ bụ ọgwụgwọ ịwa ahụ; ndị nwere ọtụtụ ọgwụgwọ PD ma ọ bụ nsonaazụ ọgwụgwọ na-adịghị mma; ndị nwere oghere esophagus n'oge ọgwụgwọ PD. Maka ndị nwere nnukwu ihe egwu, enwere ike iji ya na njikọta PD; enwere ike iji ya dị ka mgbanwe gaa na ịwa ahụ ma ọ bụ ọgwụgwọ PD.
(2) Ihe ndị na-egbochi ya:A naghị atụ aro ya maka ọgwụgwọ mbụ nke AC na ndị ọrịa na-eto eto (ihe dị ka afọ 40).
03 Mgbasa Balloon Endoscopic (PD)
Mgbasa balloon nwere mmetụta ụfọdụ na AC, mana ọ chọrọ ọtụtụ ọgwụgwọ ma nwee ihe egwu nke nnukwu nsogbu.
(1) Ihe ngosi:Ndị ọrịa AC na-enweghị nsogbu obi, nsogbu coagulation, wdg; ndị ikom karịrị afọ 50 na ụmụ nwanyị karịrị afọ 35; ndị ọrịa dara ịwa ahụ. Enwere ike iji ya dị ka ụzọ ọgwụgwọ mbụ.
(2) Ihe ndị na-egbochi ya:Nsogbu obi na akpa ume nke ukwuu, nsogbu coagulation na nnukwu ihe ize ndụ nke mgbawa esophagus.
04 Myotomy Endoscopic Peroral (POEM)
N'afọ ndị na-adịbeghị anya, site na nnukwu mmejuputa nke peroral endoscopic myotomy (POEM), ọnụego ọganihu nke ọgwụgwọ ụlọ ọgwụ nke AC amụbaala nke ukwuu.Ọgwụgwọ POEM nke AC kwekọrọ nnọọ na echiche nke "ịwa ahụ nke na-adịghị oke njọ", ya bụ, naanị ọnya ka a na-ewepụ/ewepụ n'oge usoro ọgwụgwọ, a naghịkwa ewepụ akụkụ ahụ.A na-ejigide iguzosi ike n'ezi ihe na ọrụ nke usoro ahụ ji arụ ọrụ, ndụ onye ọrịa mgbe a wachara ya ahụ anaghị emetụta ya. Mmalite nke POEM emeela ka ọgwụgwọ AC bụrụ ihe na-adịghị emerụ ahụ nke ukwuu.
Foto: Usoro ịwa ahụ POEM
Mmetụta etiti na ogologo oge nke POEM n'ọgwụgwọ AC kwekọrọ na nke laparoscopic Heller myotomy (LHM)enwere ike iji ya dị ka nhọrọ ọgwụgwọ mbụ.Ụfọdụ ndị ọrịa nwere ike inwe mgbaàmà reflux gastroesophageal mgbe a wachara ha ahụ POEM
(1) Ihe ngosi zuru oke:AC na-enweghị njikọ siri ike nke submucosal, nsogbu nke afọ na-enweghị ihe ọ bụla na-eme ka afọ gbapụ na nnukwu diverticulum.
(2) Ihe ngosi ndị metụtara ya:Ọrịa esophageal gbasaa, ọrịa nutcracker esophageal na ọrịa ndị ọzọ na-agagharị na esophageal, ndị ọrịa nwere POEM ma ọ bụ Heller ịwa ahụ dara ada, na AC nwere ụfọdụ njikọ submucosal esophageal.
(3) Ihe ndị na-egbochi ya:Ndị ọrịa nwere nsogbu ọbara ọgbụgba dị oke njọ, ọrịa obi na akpa ume siri ike, nsogbu izugbe na-adịghị mma, wdg. ndị na-enweghị ike ịnabata ịwa ahụ.
05 Laparoscopic Heller Myotomy (LHM)
LHM nwere ezigbo irè ogologo oge n'ịgwọ AC, a na-ejikwa POEM dochie ya n'ebe ọnọdụ dị iche iche kwere.
06 Ịwa Ahụ Esophagus
Ọ bụrụ na ejikọtara AC na obere ọnya esophageal, etuto ahụ, wdg, a pụrụ ịtụle ịwa ahụ esophageal.
Anyị, Jiangxi Zhuoruihua Medical Instrument Co., Ltd., bụ ụlọ ọrụ mmepụta ihe na China nke ọkachamara n'ihe gbasara ihe ndị a na-eji eme ihe na endoscopic, dịkaike biops, hemoklip, ọnyà polyp, agịga sclerotherapy, katetị ịgbasa, ahịhịa cytology, waya nduzi, nkata mwepụta nkume, katita drainage biliary imiwdg. nke a na-ejikarị eme ihe naEMR, ESD,ERCPNgwaahịa anyị nwere asambodo CE, ebe osisi anyị nwere asambodo ISO. Ebupụla ngwa ahịa anyị na Yuropu, North America, Middle East na akụkụ Eshia, ma na-eme ka ndị ahịa nweta otuto na otuto nke ukwuu!
Oge ozi: Julaị-09-2024