Isifo se-gustric schegegeal bhala (i-gerd) sisifo esiqhelekileyo kwisebe lokugaya. Ukuxhaphaka kwayo kunye nokuboniswa kwayo kweklinikhi kunefuthe elibi kumgangatho wobomi babaguli. Kwaye ukuvuvukala okungapheliyo kwe-esophagus inomngcipheko wokubangela umhlaza wentyatyambo. Indlela yokuqonda ngokuchanekileyo kunye nokuhamba ngomgangatho kugxilwe kumsebenzi wekliniki.
I-02 yeKlinikhi yeKlinikhi yeKlinikhi
I-gerd inokwahlulwa ibe yi-hlengahlengi (i-nerd), i-reaphax yephagitis (re) kunye neBarreta Esophagetal (i) ngokwe-Endoscopy.
I-Nerd: I-Barrett Esophagus kunye ne-Esophageal Mucosa yonakaliswe kwinkcazo ye-gerd kodwa i-endoscopy yonakalisiwe.
Re: I-Endoscopy inokubona i-sus-esophageal mucosa isaxhunyiwe kwi-esophagus okanye ngaphezulu. I-membrane ye-mucous yonakalisiwe ithutyana.
Yiba: Inxalenye ye-guricric-scaphageal scauplial ye-esophagus-njenge-epitisus ye-esophagus kwi-endoscopy ithathelwe indawo yi-cylindrium.
I-02 yeKlinikhi yeKlinikhi yeKlinikhi
Ukongeza kwintliziyo evuthayo kunye ne-Reflux, iimpawu ezinjengeentlungu zesifuba, isisu esisesisu, kunye ne-Esophagus Esophagus, ukukhohlela, isifuba, isifuba kunye nezinye iimpawu zeSophage.
Kufuneka kuqatshelwe ukuba abaguli abaneegulana ezikhulileyo ze-geds banesimo sentliziyo esiphantsi kunye ne-reliux. Imeko yeempawu kwityhubhu ekhutshiweyo iphezulu. Iimpawu aziqhelekanga, okanye i-asymptomatic. Ubungqingqwa beempawu azifaniyo nobukhulu besi sifo. I-fekyu yayisicaba, kwaye xa wayengugqirha, waphuhliswa eGungli.
I-03 ye-Gerd's Discunosis
Inani. Iimpawu eziqhelekileyo ze-gerd kunye ne-acypical topy ract thect thect zinengxaki yokuqhutywa kwe-gerdnolost: Umbutho wezonyango waseTshayina
Uvavanyo lokuqonda isifo seArhente yokuTshintsha
Kwiziguli ze-gerds ezikrokrelayo (i-PPI esetyenziswayo i-PPI), idosi esemgangathweni iya kuhlala iiveki ezi-2 (ezo zineempawu ezingaphandle kwetyhubhu kufuneka zihlale iiveki zokugqibela ze-≥4. Ukuba iimpawu zikhululwe ngokupheleleyo okanye inye kuphela iimpawu ezinobulali zingqineke zisebenza kakuhle.
2) endoscopic
-I-Angeles yahlulahlulwe yangamabanga (jonga eli ngezantsi):
Iklasi A: 1 okanye ngaphezulu komonakalo we-mucosal mucosal, ubude bomonakalo ≤5 mm;
IBAKALA B: 1 okanye nangaphezulu ukonakaliswa kwe-mucossal mucosal, ubude boMoya> 5 mm, umonakalo we-mucous kwaye akukho ntlungu;
Iklasi C: Ubuncinci i-2 i-isphageal mucosa yonakalisiwe, kwaye i-membrane ye-mucous yona yonakele idityaniswa kunye.
Iklasi D: ibhekisa kuMonakalo we-MUCOSA kunye nokudityaniswa, kunye noluhlu lwe-fusion ngama-75% e-Esophagus.
-Benqanaba le-biopsy: Kucetyiswa ukuba kukho i-biessops ende nefutshane kwaye imfutshane ifunyanwa yi-1cm yentengo ejikeleze isitovu. Ubungakanani boluhlu luhambelana nomngcipheko womhlaza, kwaye umngcipheko womhlaza uyanda kwaye ukwandisa uluhlu lwe-3cm.
3) Umlinganiso wephaphageal we-Esophagegel
Izigulana ezine-gerd zihlala zibonisa amandla eSophagegeal ye-Esophagetal: Inxalenye ye-70% okanye i-peristasis yokungaphumeleli i-70% okanye i-peristals yi-≥50% yi-≥50%.
Ukubeka iliso kwiliso
Ngumgangatho wokufumanisa isifo se-CEDD. Ngumgangatho wegolide wokufunxa jikelele, kubandakanya nokubekwa esweni kwe-Esophagus NH kunye ne-Esophagebal Yang Andli -Nh Ixabiso le-Esophagus Pipe kunye ne-Esophagebal Yang Anti -Nh yexabiso lokujonga. Ipesenti ye-PH <4
Unyango lwe-Gedd
Umzobo .gerd flowchart
Umthombo: Umbutho wezonyango waseTshayina
Ukulumkela:
-I -pi kunye ne-P-CAB lukhetho lokuqala kunyango lokuqala kunye nokugcinwa kwezigulana ngegazi. Unyango lokuqala lonyango lwe-PPI ziiveki ezi-8 kwaye unyango lwe-P-CAB ziiveki ezingama -4.
-Bezigulana ezivuthayo ebusuku (xa uthatha i-PPI, i-PH <ixesha le-1> I-1h ngobusuku bobusuku), ungasebenzisa i-Bloctor yasebusuku, okanye ukutshintshela kwi-P-CAB kwaye ixesha elide. Isiqingatha-nyango lwe-PPI.
I-Anti -Acid Arhente ye-Anti-Arhente ye-Antid kunye namachiza e-gestrointenal anokusetyenziselwa isicelo sokufumana isicelo ngokukhawuleza ukuze sinciphise iimpawu zokungonwabisi njengentliziyo evuthayo kunye ne-guqulox.
-I-Endoscopic yoNyango lwe-Endoscopic: Unyango lwe-gerd lucacile, unyango lwe-acidic aluvumelekanga, ukungafuni ukuthatha amayeza ixesha elide, okanye ukungabi nakuphendule okunxulumene neziyobisi, kwaye akunakukwazi ukunyamezelana.
-Isalathiso sonyango lonyango: Kukho iimpawu eziqhelekileyo ze-gerd, unyango lwe-PPI alusebenzi; I-Endoscopy ifumana i-esophageal hernia, yiba, iBanga le-Los Angeles okanye ngaphezulu; I-X -RAY Ifunyenwe ukuba kukho umngxunya we-esophagebal Hole.
IXESHA LOKUQALA: UMar-21 ukuya ku-4024