Ọkachamara n'otu edemede: Ọgwụgwọ Achalasia

Okwu mmalite
Achalasia nke obi obi (AC) bụ ambụ ọrịa motility esophageal.N'ihi nkwụsịtụ na-adịghị mma nke sphincter esophageal dị ala (LES) na enweghị peristalsis esophageal, njigide nri na-ebute ụzọ.dysphagia na mmeghachi omume. Mgbaàmà ụlọ ọgwụ dị ka ọbara ọgbụgba, mgbu obi na mbelata ibu.Ọnụnọ ya dị ihe dịka 32.58/100,000.
Nkeọgwụgwọnke achalasia tumadi gụnyere ọgwụgwọ na-abụghị nke ịwa ahụ, ọgwụgwọ dilation na ọgwụgwọ ịwa ahụ.

01 Ọgwụgwọ ahụike
Usoro ọgwụgwọ ọgwụ bụ iji belata nrụgide LES na obere oge.Enweghị ihe akaebe doro anya na ọgwụ nwere ike na-aga n'ihu na-emeziwanye ihe mgbaàmà nke AC.Ọgwụ ndị a na-ejikarị eme ihe ugbu a gụnyere nitrates, ndị na-egbochi ọwa calcium, na agonists β-receptor.
(1)Nitrates, dị ka nitroglycerin, amyl nitrate, na isosorbide dinitrate
(2)Calcium ọwa blockers, dị ka nifedipine, verapamil, na diltiazem
(3)agonists β-anabata, dị ka cabuterol

02Endoscopic Botulinum Toxin Injection (BTI)
Endoscopic botulinum toxin injection (BTl) nwere ike iji gwọọ AC,ma ọ nwere ike inye naanị mmetụta dị mkpirikpi ma nwee ike iji ya mee ihe na ndị ọrịa agadi nwere nnukwu ihe ize ndụ nke ịwa ahụ na nkwụsị.

1) Ngosipụta:ndị agadi na ndị agadi (> 40 afọ); ndị na-enweghị ike anabata endoscopic balloon dilation (PD) ma ọ bụ ọgwụgwọ ịwa ahụ; ndị nwere ọtụtụ ọgwụgwọ PD ma ọ bụ nsonaazụ ọgwụgwọ ịwa ahụ na-adịghị mma; ndị nwere perforation esophageal n'oge ọgwụgwọ PD Maka ndị nwere nnukwu ihe ize ndụ, a pụkwara iji ya mee ihe na PD; enwere ike iji ya dị ka mgbanwe na ịwa ahụ ma ọ bụ ọgwụgwọ PD.
(2) Ihe mgbochi:A naghị atụ aro ya maka ọgwụgwọ mbụ nke AC na ndị ọrịa na-eto eto (≤40 afọ).

03Endoscopic Balloon Dilation (PD)
Mgbasa balloon nwere mmetụta ụfọdụ na AC, mana ọ chọrọ ọgwụgwọ ọtụtụ ma na-ebu ihe egwu nke nnukwu nsogbu.
(1) Ngosipụta:Ndị ọrịa AC na-enweghị ụkọ cardiopulmonary, arụ ọrụ coagulation, wdg; ndị nwoke karịrị afọ 50 na ndị inyom karịrị afọ 35; ndị ọrịa dara ịwa ahụ. Enwere ike iji ya dị ka usoro ọgwụgwọ mbụ nhọrọ.
(2) Ihe mgbochi:Ọrịa obi siri ike nke obi, adịghị arụ ọrụ coagulation na nnukwu ihe ize ndụ nke perforation esophageal.

04 Peroral Endoscopic Myotomy (POEM)
N'ime afọ ndị na-adịbeghị anya, site na nnukwu mmejuputa iwu nke peroral endoscopic myotomy (POEM), ọganihu nke ọgwụgwọ ọgwụgwọ AC abawanyela nke ukwuu.Ọgwụgwọ POEM nke AC dabara nke ọma n'echiche nke "ịwa ahụ nke pere mpe", ya bụ, ọ bụ naanị ọnya na-ewepụ / wepụ ya n'oge usoro ọgwụgwọ, anaghị ewepụ akụkụ ahụ.A na-edobe iguzosi ike n'ezi ihe na ịrụ ọrụ nke usoro ahụ, na ụdị ndụ onye ọrịa gachara n'ọrụ anaghị emetụta ya. Mpụta nke POEM emewo ka ọgwụgwọ AC dị ntakịrị ihe mkpasu iwe.