I-Peptic ulcer ibhekiselele kwisilonda esingapheliyo esenzeka esiswini kunye nebhalbhu ye-duodenal.Kuthiwa ngenxa yokuba ukubunjwa kwesilonda kuhambelana nokucolwa kwe-asidi yesisu kunye ne-pepsin, ebangela malunga ne-99% yesilonda se-peptic.
I-Peptic ulcer sisifo esixhaphakileyo esiyingozi esisasazeka kwihlabathi jikelele.Ngokwezibalo, izilonda ze-duodenal zivame ukwenzeka kubantu abadala abancinci, kwaye ubudala bokuqala kwezilonda zesisu mva, ngokomndilili, malunga neminyaka eyi-10 kamva kunokuba izilonda ze-duodenal.Iziganeko zezilonda ze-duodenal malunga namaxesha e-3 kwizilonda zesisu..Ngokuqhelekileyo kukholelwa ukuba ezinye izilonda zesisu ziya kuba ngumhlaza, ngelixa izilonda ze-duodenal ngokubanzi azinjalo.
Umfanekiso 1-1 Umfanekiso wegastroscopic womhlaza wekhephu wokuqala Umfanekiso 1-2 Umfanekiso we-gastroscopic yomhlaza ophezulu.
1. Uninzi lwezilonda zesilonda ziyanyangeka
Kwizigulane ezine-peptic ulcer, uninzi lwazo zinokunyangwa: malunga ne-10% -15% yazo ayinazimpawu, ngelixa uninzi lwezigulana zineempawu zeklinikhi eziqhelekileyo, ezizezi: ezingapheliyo, isingqisho sokuqala ngexesha lekwindla nasebusika nasebusika nasentwasahlobo. isisu esibuhlungu.
Izilonda zeDuodenal zihlala zibonakala ngeentlungu zokuzila ukutya, ngelixa izilonda zesisu zihlala zibonakalisa iintlungu zasemva kokutya.Ezinye izigulana zihlala zingenazo izibonakaliso zeklinikhi eziqhelekileyo, kwaye iimpawu zazo zokuqala kukuphuma kwegazi kunye nokubhoboza okubukhali.
I-angiography ye-gastrointestinal okanye i-gastroscopy kaninzi inokuqinisekisa ukuxilongwa, kunye nonyango oludityanisiweyo lwezonyango kunye ne-acid suppressants, i-gastric mucosal protective agents, kunye ne-antibiotics zingenza izigulane ezininzi zilulame.
2.Izilonda zesisu eziphindaphindiweyo zithathwa njengezilonda ezinobungozi
Izilonda zesisu zinezinga elithile lomhlaza.Iyenzeka ikakhulu kubudala obuphakathi nangaphezulu, indoda, izilonda eziphindaphindiweyo ezingenako ukunyangeka ixesha elide.Enyanisweni, i-pathological biopsy kufuneka iqhutywe kuzo zonke izilonda zesisu ekusebenzeni kweklinikhi, ngakumbi izilonda ezikhankanywe ngasentla.Unyango oluchasene nezilonda lunokwenziwa kuphela emva kokuba umhlaza kufuneka ungabandakanywa, ukwenzela ukuthintela ukuxilongwa kakubi kunye nokulibaziseka kwesi sifo.Ngaphezu koko, emva kokunyangwa kwesilonda esiswini, kufuneka kuphinde kuhlolwe kwakhona ukuze kubonwe utshintsho ekuphulukisweni kwesilonda kunye nokulungelelanisa amanyathelo onyango.
Izilonda zeDuodenal azifane zibe ngumhlaza, kodwa izilonda zesisu eziphindaphindayo ngoku zigqalwa ziingcali ezininzi njengesilonda esingaphambi komhlaza.
Ngokutsho kweengxelo zoncwadi lwaseTshayina, malunga ne-5% yezilonda zesisu zinokuba ngumhlaza, kwaye eli nani ngoku liyanda.Ngokweenkcukacha-manani, ukuya kuthi ga kwi-29.4% yomhlaza wesisu ziphuma kwizilonda zesisu.
Uphononongo lufumene ukuba izigulane zomhlaza wesilonda esiswini ziba malunga ne-5% -10% yezehlo zesilonda esiswini.Ngokuqhelekileyo, izigulane ezininzi ezinomhlaza wesilonda esiswini zinembali ende yesilonda esiswini.Ukutshatyalaliswa ngokuphindaphindiweyo kweeseli ze-epithelial ekupheleni kwesilonda kunye nokulungiswa kwe-mucosal kunye nokuvuselelwa, i-metaplasia, kunye ne-atypical hyperplasia kwandisa amathuba okuba nomhlaza ngokuhamba kwexesha.
Umhlaza ngokuqhelekileyo uvela kwi-mucosa ejikelezileyo yezilonda.I-mucosa yale nxalenye iyancipha xa isilonda sisebenza, kwaye sinokuba sibi emva kokutshatyalaliswa ngokuphindaphindiweyo kunye nokuvuselelwa.Kwiminyaka yakutshanje, ngenxa yenkqubela phambili yokuxilongwa kunye neendlela zoviwo, kuye kwafunyaniswa ukuba umhlaza wesisu sokuqala ovalelwe kwi-mucosa unokukhukuliseka kwaye ube nesilonda, kwaye umphezulu we-tissue ungatshintshwa zizilonda zesibini ze-peptic.Ezi zilonda zomhlaza zinokulungiswa njengezilonda ezinobungozi.kunye nokulungiswa kunokuphinda, kwaye ikhosi yesifo inokwandiswa kwiinyanga eziliqela okanye nangaphezulu, ngoko izilonda zesisu kufuneka zihlawulwe ingqwalasela enkulu.
3. Ziziphi iimpawu zenguqu enobungozi yezilonda zesisu?
1. Utshintsho kubume kunye nokuqheleka kweentlungu:
Intlungu yesilonda esiswini ibonakala njengentlungu ebuhlungu kwisisu esiphezulu, esivuthayo okanye esibuhlungu, kwaye ukuqala kwentlungu kuhambelana nokutya.Ukuba iintlungu ziphulukene nale meko ikhankanywe ngasentla, ibe luhlaselo olungaqhelekanga, okanye iba ziintlungu ezingapheliyo ezibuhlungu, okanye uhlobo lweentlungu lutshintshe kakhulu xa luthelekiswa nexesha elidlulileyo, kufuneka lulumke kwisazisi somhlaza.
2. Ayisebenzi ngamachiza okuthomalalisa isilonda:
Nangona izilonda zesisu zivame ukuhlaselwa rhoqo, iimpawu zikhululeka emva kokuthatha amachiza okulwa nezilonda.
3. Izigulana eziqhubela phambili zokwehla kobunzima:
Ngexesha elifutshane, ukulahlekelwa ngumdla, isicaphucaphu, ukuhlanza, umkhuhlane kunye nokuncipha kwesisindo esiqhubekayo, ukulahleka kwesisindo, amathuba okuba nomhlaza uphezulu kakhulu.
4. I-Hematemesis kunye ne-melena ibonakala:
Ukugabha rhoqo kwesigulana kwegazi okanye ilindle elihlala lihleli, iziphumo zovavanyo lwegazi lobugqi, kunye neanemia eqatha zibonisa ukuba izilonda zesisu zinokujika zibe ngumhlaza.
5. Ubunzima buvela esiswini:
Izigulana ezinezilonda zesisu ngokuqhelekileyo azenzi ubunzima besisu, kodwa ukuba ziba ngumhlaza, izilonda ziya kuba zikhulu kwaye zibe lukhuni, kwaye izigulana eziphambili zinokubuva ubunzima kwisisu esiphezulu sasekhohlo.Ubunzima bobunzima buhlala bulukhuni, bunamaqhuqhuva kwaye abugudi.
6.Abo bangaphezu kweminyaka engama-45 ubudala, banembali yesilonda kwixesha elidlulileyo, kwaye ibe neempawu eziphindaphindiweyo kutshanje, ezifana ne-hiccups, i-belching, intlungu yesisu, kwaye ihamba kunye nokulahlekelwa kwesisindo.
7. Igazi lemimoya elimdaka elilungileyo:
Uphinda-phinda ukuba une-positive, qiniseka ukuba uye esibhedlele ukuze uxilongwe ngokupheleleyo.
8. Abanye:
Ngaphezulu kweminyaka emi-5 emva kotyando lwesisu, kukho iimpawu zokungagayeki, ukwehla kobunzima bomzimba, i-anemia kunye nokopha kwesisu, kunye nokungacaciswanga kwesisu esingaphezulu, ukubetha, ukungonwabi, ukudinwa, ukunciphisa umzimba, njl.
4,Unobangela wesilonda esiswini
I-etiology yesilonda se-peptic ayikaqondwa ngokupheleleyo, kodwa kuye kwacaciswa ukuba usulelo lwe-Helicobacter pylori, ukuthatha iziyobisi ezingekho-steroidal ezichasayo kunye neziyobisi ze-antithrombotic, kunye nokukhutshwa kwe-asidi yesisu, imiba yemfuza, ukuguquguquka kwengqondo kunye neemvakalelo, kunye ukutya okungaqhelekanga Ukwabelana ngesondo, ukutya amashwamshwam, ukutshaya, ukusela, imo engqongileyo yejografi kunye nemozulu, izifo ezingapheliyo ezifana ne-emphysema kunye ne-hepatitis B nazo zinxulumene neziganeko zesilonda se-peptic.
1. Usulelo lwe-Helicobacter pylori (HP):
UMarshall noWarren baphumelele iBhaso leNobel kuNyango ngo-2005 ngokukhulisa ngempumelelo iHelicobacter pylori ngo-1983 kwaye becebisa ukuba usulelo lwayo ludlala indima kwipathogenesis yezilonda zepeptic.Inani elikhulu lophononongo lubonakalise ngokupheleleyo ukuba usulelo lwe-Helicobacter pylori ngoyena nobangela wesilonda se-peptic.
2. Amachiza kunye nemiba yokutya:
Ukusetyenziswa kwexesha elide kweziyobisi ezifana ne-aspirin kunye ne-corticosteroids kulungele ukubangela esi sifo.Ukongezelela, ukutshaya ixesha elide, ukusela ixesha elide, nokusela iti eyomeleleyo nekofu kubonakala kunxulumene.
(1) Amalungiselelo ahlukeneyo e-aspirin: Ukusetyenziswa kwexesha elide okanye i-dose ephezulu kunokubangela intlungu yesisu kunye nokungahambi kakuhle.Kwiimeko ezinzima, i-hematemesis, i-melena, njl., inokufumaneka kwi-gastric mucosal ukuvuvukala, ukuguguleka kunye nokubunjwa kwesilonda.
(2) Amachiza athatha indawo yeHormone:
Iziyobisi ezifana ne-indomethacin kunye ne-phenylbutazone ziziyobisi ezithatha indawo yehomoni, ezinomonakalo othe ngqo kwi-gastric mucosa kwaye inokukhokelela kwizilonda ezibukhali zesisu.
(3) Iipilisi zokuthomalalisa iintlungu:
Njenge-A.PC, i-paracetamol, iipilisi zokukhulula iintlungu kunye namayeza abandayo afana ne-Ganmaotong.
3. Iasidi yesisu kunye ne-pepsin:
Ukubunjwa kokugqibela kwezilonda ze-peptic kubangelwa ukuzicoca kwe-asidi yesisu / i-pepsin, eyona nto ibalulekileyo ekuveleni kwezilonda.Oku kubizwa ngokuba "izilonda ezingenayo i-asidi".
4. Izinto ezibangela uxinzelelo lwengqondo:
Uxinzelelo olubukhali lunokubangela izilonda zoxinzelelo.Abantu abanoxinezeleko olungapheliyo, ukuxhalaba, okanye ukuguquguquka kweemvakalelo badla ngokuba nezilonda zepeptic
isilonda.
5. Imiba yemfuzo:
Kwezinye i-syndromes ezinqabileyo zofuzo, ezifana ne-multiple endocrine adenoma uhlobo I, i-systemic mastocytosis, njl., isilonda se-peptic siyinxalenye yezibonakaliso zayo zeklinikhi.
6. Ukuhamba kwesisu esingaqhelekanga:
Ezinye izigulana zezilonda zesisu zineengxaki ze-gastric motility, ezifana nokunyuka kwe-asidi ye-gastric secretion ebangelwa ukulibaziseka kwesisu kunye ne-duodenal-gastric reflux ebangelwa yi-bile, ijusi ye-pancreatic kunye nomonakalo we-lysolecithin kwi-mucosa.
7. Eminye imiba:
Njengosulelo lwendawo lwe-herpes simplex virus uhlobo ndinganxulumana.Usulelo lwe-Cytomegalovirus lunokuthi lubandakanyeke kwi-renal transplants okanye izigulane ezingenakuzivikela.
Ukuququmbela, izilonda zinokuthintelwa ngokufanelekileyo ngokuphucula ngokusebenzayo iindlela zokuphila, ukuthatha iziyobisi ngokufanelekileyo, ukuphelisa i-Helicobacter pylori, kunye nokuthatha i-gastroscopy njengento yokuhlola umzimba rhoqo;
Emva kokuba isilonda senzeke, kuyimfuneko ukulawula ngokusebenzayo unyango kwaye uqhube ukuhlaziywa rhoqo kwe-gastroscopy (nokuba isilonda sinyangwa), ukwenzela ukukhusela ngokufanelekileyo ukwenzeka komhlaza.
“Ukubaluleka kwe-gastroscopy ngokuqhelekileyo kunokusetyenziswa ukuqonda ukuba ummizo wesigulana, isisu kunye ne-duodenum zinamanqanaba ahlukeneyo okudumba, izilonda, iipolyps zethumba kunye nezinye izilonda.I-Gastroscopy ikwayindlela yokuhlola ngokuthe ngqo engenakubuyiselwa, kwaye amanye amazwe athathe uvavanyo lwe-gastroscopic.Njengento yokuhlola impilo, uviwo kufuneka luqhutywe kabini ngonyaka, kuba iziganeko zomhlaza wesisu zakwamanye amazwe ziphezulu ngokwentelekiso.Ke ngoko, emva kokufunyanwa kwangoko kunye nonyango lwangethuba, umphumo wonyango nawo uyabonakala. ”
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Ixesha lokuposa: Aug-15-2022