Isilonda sePeptic sibhekisa kakhulu kwisilonda esingapheliyo esenzeka esiswini nakwi-duodenal bulb. Sibizwa ngokuba kukwakheka kwesilonda kunxulumene nokugaywa kwe-asidi yesisu kunye ne-pepsin, ebangela malunga ne-99% yesilonda sePeptic.
Isilonda sesisu sisifo esiqhelekileyo esingenabungozi nesisasazeka kwihlabathi liphela. Ngokwezibalo, izilonda zesisu zivame ukwenzeka kubantu abadala abancinci, kwaye ubudala bokuqala kwezilonda zesisu buya emva kwexesha, ngokomndilili, malunga neminyaka eli-10 emva kobo bezilonda zesisu. Ukwanda kwezilonda zesisu kuphindwe kathathu kunezilonda zesisu. . Ngokuqhelekileyo kukholelwa ukuba ezinye izilonda zesisu ziya kuba ngumhlaza, ngelixa izilonda zesisu ngokubanzi azibi njalo.
Umfanekiso 1-1 Umfanekiso wesisu somhlaza wekhephu wasekuqaleni Umfanekiso 1-2 Umfanekiso wesisu somhlaza ophucukileyo.
1. Uninzi lwezilonda zesisu ziyanyangeka
Kwizigulane ezinesilonda sesisu, uninzi lwazo lunokunyangeka: malunga ne-10%-15% yazo azinazo iimpawu, ngelixa uninzi lwezigulane luneempawu eziqhelekileyo zeklinikhi, ezizezi: ukuqala okungapheliyo, okunesigqi kokuqala rhoqo ekwindla nasebusika nasebusika nasentwasahlobo iintlungu zesisu.
Izilonda ze-duodenal zihlala zineentlungu zokuzila ukutya ezihambelanayo, ngelixa izilonda zesisu zihlala zineentlungu emva kokutya. Ezinye izigulana zihlala zingenazo iimpawu eziqhelekileyo zeklinikhi, kwaye iimpawu zazo zokuqala kukuphuma kwegazi kunye nokugqobhoka ngokukhawuleza.
I-angiography yesisu esiphezulu okanye i-gastroscopy idla ngokuqinisekisa ukuxilongwa, kwaye unyango oludibeneyo olune-acid suppressants, ii-gastric mucosal protective agents, kunye nee-antibiotics zinokwenza uninzi lwezigulane luphile.
2. Izilonda zesisu eziphindaphindayo zithathwa njengezilonda ezingaphambi komhlaza
Izilonda zesisu zinezinga elithile lomhlaza.Ixhaphake kakhulu kubantu abaneminyaka ephakathi nangaphezulu, amadoda, izilonda eziphindaphindayo ezingenakunyangwa ixesha elide. Enyanisweni, kufuneka kwenziwe i-biopsy ye-pathological kuzo zonke izilonda zesisu kwiklinikhi, ingakumbi izilonda ezikhankanyiweyo apha ngasentla. Unyango lokulwa nezilonda lunokwenziwa kuphela emva kokuba umhlaza kufuneka ungafakwanga, ukuze kuthintelwe ukuxilongwa okungafanelekanga kunye nokulibaziseka kwesifo. Ngaphezu koko, emva konyango lwezilonda zesisu, kufuneka kuhlolwe kwakhona ukuze kubonwe utshintsho ekupholeni kwezilonda kunye nokulungisa amanyathelo onyango.
Izilonda zeDuodenal azifane zibe ngumhlaza, kodwa izilonda zesisu eziphindaphindayo ngoku zithathwa ziingcali ezininzi njengesilonda esingaphambi komhlaza.
Ngokweengxelo zeencwadi zaseTshayina, malunga ne-5% yezilonda zesisu zinokuba ngumhlaza, kwaye eli nani liyanda okwangoku. Ngokwezibalo, ukuya kuthi ga kwi-29.4% yezigulane zesisu zivela kwizilonda zesisu.
Izifundo zifumanise ukuba izigulane ezinomhlaza wesisu zimalunga ne-5%-10% yeziganeko zezilonda zesisu. Ngokubanzi, uninzi lwezigulane ezine-gastric ulcer zinembali ende ye-gastric ulcer ezingapheliyo. Ukutshatyalaliswa okuphindaphindiweyo kweeseli ze-epithelial kumphetho wesilonda kunye nokulungiswa kunye nokuvuselelwa kwe-mucosal, i-metaplasia, kunye ne-atypical hyperplasia kwandisa amathuba okuba nomhlaza ngokuhamba kwexesha.
Umhlaza udla ngokuvela kwi-mucosa ejikelezileyo yezilonda. I-mucosa yala malungu iyabola xa isilonda sisebenza, kwaye inokuba yingozi emva kokutshatyalaliswa okuphindaphindiweyo kunye nokuvuselelwa. Kwiminyaka yakutshanje, ngenxa yenkqubela phambili yeendlela zokuxilonga kunye nokuhlolwa, kufunyenwe ukuba umhlaza wesisu wokuqala ovaleleke kwi-mucosa unokubola kwaye ube nezilonda, kwaye umphezulu wezicubu zawo unokutshintshwa zizilonda zesisu zesibini. Ezi zilonda zomhlaza zinokulungiswa njengezilonda ezingengobungozi. kwaye ukulungiswa kunokuphinda, kwaye inkqubela yesifo inokwandiswa kangangeenyanga ezininzi okanye nangaphezulu, ngoko ke izilonda zesisu kufuneka ziqwalaselwe kakhulu.
3. Zithini iimpawu zotshintsho olubi lwesilonda esiswini?
1. Utshintsho kwindlela ezibuhlungu ngayo kunye nokuqheleka kwazo:
Intlungu yesilonda esiswini ibonakaliswa kakhulu njengentlungu engathandekiyo esiswini esingaphezulu, esitshisayo okanye esingenamsebenzi, kwaye ukuqala kwentlungu kunxulumene nokutya. Ukuba intlungu ilahlekelwa yimeko ekhankanyiweyo apha ngasentla, iba luhlaselo olungaqhelekanga, okanye iba yintlungu engapheliyo engathandekiyo, okanye uhlobo lwentlungu lutshintshe kakhulu xa kuthelekiswa nexesha elidlulileyo, kufuneka uqaphele uphawu lomhlaza.
2. Ayisebenzi kakuhle ngamayeza okulwa nezilonda:
Nangona izilonda zesisu zidla ngokuhlaselwa rhoqo, iimpawu zihlala zilula emva kokuthatha amayeza okulwa nezilonda.
3. Izigulana ezinciphisa ubunzima obuqhubekayo:
Ngexesha elifutshane, ukuphelelwa ngumdla wokutya, isicaphucaphu, ukuhlanza, umkhuhlane kunye nokuncipha kobunzima okuqhubekayo, ukwehla kobunzima, amathuba okuba nomhlaza aphezulu kakhulu.
4. I-Hematemesis kunye ne-melena ibonakala:
Ukuhlanza rhoqo kwegazi okanye indle ehlala ihleli kwesigulana, iziphumo zovavanyo lwegazi oluhlala luhleli olubonisa ukuba kukho igazi elimdaka emzimbeni, kunye ne-anemia enzima zibonisa ukuba izilonda zesisu zinokuba ngumhlaza.
5. Kuvela izixa zesisu:
Izigulane ezinezilonda zesisu azihlali zineengxangxasi zesisu, kodwa ukuba ziba nomhlaza, izilonda ziya kuba zikhulu kwaye ziqine, kwaye izigulane ezikhulileyo zinokuziva ubunzima kwisisu esingaphezulu ngasekhohlo. Ubunzima bobunzima buhlala buqinile, bunamaqhuqhuva kwaye abugudi.
6. Abo baneminyaka engaphezu kwama-45 ubudala, banembali yesilonda ngaphambili, kwaye kutshanje ndineempawu eziphindaphindiweyo, ezinje ngee-hiccups, i-belching, iintlungu zesisu, kwaye zihamba nokunciphisa umzimba.
7. Igazi elicocekileyo lendle:
Ukuba uphinda ufumanise ukuba une-HIV, qiniseka ukuba uye esibhedlele ukuze uhlolwe ngokupheleleyo.
8. Abanye:
Emva kweminyaka engaphezu kwemi-5 emva kotyando lwesisu, kukho iimpawu zokungagayi kakuhle ukutya, ukwehla kobunzima, i-anemia kunye nokopha esiswini, kunye nokudumba kwesisu okungachazwanga, ukubhoboza, ukungonwabi, ukudinwa, ukwehla kobunzima, njl.njl.
4, Unobangela wesilonda esiswini
Isizathu sokubakho kwesilonda sesisu asikaqondwa ngokupheleleyo, kodwa kucacisiwe ukuba usulelo lweHelicobacter pylori, ukuthatha amayeza angengo-steroidal okulwa nokuvuvukala kunye namayeza okulwa nokuphazamiseka kwegazi, kunye nokukhupha i-asidi yesisu ngokugqithisileyo, izinto zemfuza, ukuguquguquka kwengqondo kunye neemvakalelo, kunye nokutya okungacwangciswanga. Isondo, ukutya izimuncumuncu, ukutshaya, ukusela, imeko-bume yendawo kunye nemozulu, izifo ezingapheliyo ezifana ne-emphysema kunye ne-hepatitis B nazo zinxulumene nokwanda kwesilonda sesisu.
1. Usulelo lweHelicobacter pylori (HP):
UMarshall noWarren baphumelele iMbasa yeNobel kwiMedicine ngo-2005 ngokukhulisa ngempumelelo iHelicobacter pylori ngo-1983 kwaye bathi usulelo lwayo ludlala indima ekubangeleni izilonda zesisu. Inani elikhulu lezifundo liye labonisa ngokupheleleyo ukuba usulelo lweHelicobacter pylori lolona lubangela isilonda sesisu.
2. Izinto ezichaphazela amayeza kunye nokutya:
Ukusetyenziswa ixesha elide kweziyobisi ezifana ne-aspirin kunye ne-corticosteroids kunokubangela esi sifo. Ukongeza, ukutshaya ixesha elide, ukusela utywala ixesha elide, kunye nokusela iti nekofu enamandla kubonakala ngathi kunxulumene.
(1) Iintlobo ngeentlobo ze-aspirin: Ukusetyenziswa ixesha elide okanye ngomthamo ophezulu kunokubangela iintlungu zesisu kunye nokungonwabi. Kwiimeko ezinzima, i-hematemesis, i-melena, njl.njl., zinokufumaneka ekuvuvukeni kwesisu, ukukhukuliseka kunye nokwakheka kwezilonda.
(2) Amayeza okutshintsha iihomoni:
Amayeza afana ne-indomethacin kunye ne-phenylbutazone ngamayeza okutshintsha iihomoni, anomonakalo ngqo kwi-mucosa yesisu kwaye angakhokelela kwizilonda zesisu ezibukhali.
(3) Ii-antipyretic painkillers:
Ezifana ne-A.PC, i-paracetamol, iipilisi zokunciphisa iintlungu kunye namayeza omkhuhlane afana ne-Ganmaotong.
3. I-asidi yesisu kunye ne-pepsin:
Ukwakheka kokugqibela kwezilonda zesisu kubangelwa kukuzigaya ngokwakho i-asidi yesisu/i-pepsin, nto leyo ebangela ukuba kubekho izilonda. Ezibizwa ngokuba “zii-ulcers ezingena-asidi”.
4. Izinto ezibangela uxinezeleko engqondweni:
Uxinzelelo olukhawulezileyo lunokubangela izilonda zoxinzelelo. Abantu abanoxinzelelo olungapheliyo, ixhala, okanye utshintsho lweemvakalelo banokuba nezilonda zesisu.
isilonda.
5. Izinto ezibangela ufuzo:
Kwezinye izifo ezingaqhelekanga zemfuza, ezifana ne-multiple endocrine adenoma type I, i-systemic mastocytosis, njl.njl., isilonda se-peptic siyinxalenye yeempawu zaso zonyango.
6. Ukunyakaza okungaqhelekanga kwesisu:
Abanye abaguli abanezilonda zesisu baneengxaki zokunyakaza kwesisu, ezifana nokukhupha i-asidi yesisu okwandisiweyo okubangelwa kukuphuma kancinci kwesisu kunye ne-duodenal-gastric reflux okubangelwa yi-bile, ijusi yepancreatic kunye nomonakalo we-lysolecithin kwi-mucosa.
7. Ezinye izinto:
Njengosulelo lwasekuhlaleni lwentsholongwane ye-herpes simplex uhlobo I olunokuthi luhlobene. Usulelo lwe-Cytomegalovirus lunokubandakanyeka ekufakelweni kwezintso okanye kwizigulana ezine-immunocompromised.
Ukuqukumbela, izilonda zinokuthintelwa ngempumelelo ngokuphucula indlela yokuphila, ukusebenzisa amayeza ngendlela enengqondo, ukuphelisa iHelicobacter pylori, kunye nokuthatha i-gastroscopy njengento eqhelekileyo yokuhlolwa komzimba;
Xa kuvela isilonda, kuyimfuneko ukulawula unyango rhoqo nokwenza uphononongo lwe-gastoscopy rhoqo (nokuba isilonda sinyangiwe), ukuze kuthintelwe ngempumelelo ukwenzeka komhlaza.
"Ukubaluleka kwe-gastroscopy ngokubanzi kunokusetyenziswa ukuqonda ukuba ingaba umphimbo, isisu kunye ne-duodenum yesigulane zinamanqanaba ahlukeneyo okudumba, izilonda, ii-polyps ze-tumor kunye nezinye izilonda. I-Gastroscopy ikwayindlela yokuhlola ngokuthe ngqo engenakutshintshwa, kwaye amanye amazwe amkele uvavanyo lwe-gastroscopy. Njengento yokujonga impilo, uviwo kufuneka lwenziwe kabini ngonyaka, kuba ukwanda komhlaza wesisu kwangoko kwamanye amazwe kuphezulu. Ke ngoko, emva kokufunyanwa kwangoko kunye nonyango ngexesha elifanelekileyo, isiphumo sonyango siyabonakala."
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Ixesha lokuthumela: Agasti-15-2022