ʻO Gorstric esoplac reflux reflux reflux (Ged) he maʻi maʻamau ma ke keʻena Digestive. ʻO kāna mau lanakila a me kāna mau mea hoʻomaʻamaʻa nui e loaʻa ana i kahi hopena koʻikoʻi i ka maikaʻi o ke ola o nā maʻi maʻi. Aʻo ka hōʻinoʻana o ka maʻi maʻi o ka esophagus ka hopena o ka pilikia o ka maʻi maʻi esophageal. Pehea e hoʻoponopono ai i ka diagnose a me ka hoʻonohonohoʻana i ka mālamaʻana i ka hana o ka hana lapaʻau.
02ʻO nā hōʻikeʻike GRD's Clinical
Hiki ke hoʻokaʻawaleʻiaʻo Gedes i kahi ret -Eroded reflux (nerd), ret)
NEDD: Ua hoʻopauʻiaʻo Barrett esopart a me Clelathigeal Mucosap
Re: Hiki i ka Deposcopy keʻike i ka mucosal obosal-esophageal e pili ana i ka Esophagus a i luna paha. Ua hōʻinoʻia ka membus membrane.
E:ʻO ka huiʻana o Gastric-Esophagetal i ka'āpana o ka Esophagus-like Epithamlim o ka pilina Esophagus ma ka hopena cylindrical.
02ʻO nā hōʻikeʻike GRD's Clinical
Ma kahi o ka puhiʻana i ka puʻuwai a me ka retlux
Pono e hoʻomaopopoʻia e loaʻa nā mea maʻi me nā mea maʻi maʻi he nui o nā maʻi he haʻahaʻa haʻahaʻa a me ka retlux. ʻO ka uluʻana o nā hōʻailona i ka nui o ka'ōpala. ʻAʻole maʻamau nā hōʻailona, a iʻole asympomatic. ʻO ka paʻakikī o nā hōʻailonaʻaʻole i hoʻohālikelikeʻia i ka paʻakikī o ka maʻi. ʻO Gairika kahi papahele, aʻo ia i ke kauka, ua hoʻomohalaʻo ia i ka lāʻau hū.
03 GED's DIAGNISIS
Kiʻi. ʻO nā hōʻailona o Gerd Gerd a me Anypical Direditive Striestive Stuff
ʻO Diagnostic Export o Acid Hoʻohālikelike Manaho
No nā mea maʻi GRD SEDD (hoʻohana pinepineʻia ka PPI) Inā hōʻoluʻoluʻia nā hōʻailona a iʻole nā hōʻailona o nā hōʻailona'ē aʻe e hōʻoiaʻia e pono ai.
2) Endoscopic
-ʻO nā Angles -los i hoʻokaʻawaleʻia i nā helu (ʻike i ke kiʻi ma lalo):
Helu A: 1 a iʻole aʻoi aku paha i ka pōʻino esophagel i hōʻinoʻia, ka maikaʻi o ka maikaʻi ≤5 mm;
Palapala B: 1 a iʻole aʻoi aku paha esophagel Mucosal District
Palapala C: Ma ka liʻiliʻiʻo 2 esopareal Mucosa i hoʻopauʻia, a ua hōʻinoʻia ka membrane membrane me kēlā me kēia.
Palapala D: E pili ana i ka pōʻino o ka mucosa a me ka hoʻohuiʻana o kēlā me kēia, aʻo ka mea e pili ana i ka fusion i 75% o ka esophagus.
-Be biopsy hoʻolālā: ua manaʻoʻia he nui ka nui o ka biopy a me ka pōkole o ka biopy, a loaʻa i ka biopsy ma kahi o 1cm e hoʻopuni ana i ka stove. ʻO ka nui o nāʻano e pili ana i ka hopena o ka maʻi kanesa, aʻo ka hopena o ka maʻi maʻi e hoʻonui ana a hoʻonui i ka nui o 3CM.
3) kiʻekiʻe-dedituarle esophigal
ʻO nā mea maʻi me nā hōʻike pinepineʻo Ged e like me ka mana o ka nui o ka mana: ka hapa nui o ka 70% a iʻole ka peristial.
Anti -current nānā
ʻO ia keʻano no ka maʻi maʻi cedd. ʻO ia keʻano gula o ka maʻi maʻi o Gerd, me ka nānāʻana o ka Esophagus NH ʻO ka hapaʻumi o ka PH <4 (acid Exposure Time, Anet)> 4% ma 24H, ua manaʻoʻia he mea moʻo pathological Acid.
04ʻO ke Hana Kūlana
Kiʻi kiʻi .GRDRD OFFT FLOCHART
Kumuhana:ʻO ka hui lāʻau lapaʻau Kina
Precations:
-PPI a me P-CAB ka koho mua no ka mālama muaʻana a me ka mālamaʻana i nā maʻi me ka nui o ka māla. ʻO ka hoʻomaʻamaʻa muaʻana o ka mālamaʻana o ka PPI i ka 8 mau pule aʻo ka mālama P-CAB he ≥4 mau pule.
-ʻO nā mea maʻi me ka wā hoʻomaha ma ka pō (ke laweʻana i ka PPI, ka PH <4 manawa> 1H Half -life PPifine.
-ʻO ka anti -Tid Agent Agent a me GAstroinTinar e hoʻohana i nā lāʻau lapaʻau e hiki ke hoʻohanaʻia no ka noi pōkole e hōʻoluʻolu i nā hōʻailona e like me ka naʻau
-ʻO ka hōʻikeʻana o ka mālamaʻana i ka hana
-Surgical sesgical sesgical siggical: aia nā hōʻailona ged ged ged,ʻaʻole kūpono ka maʻi PPI; Loaʻaʻo Cendoscopy i ka Esophageal Hernia, B, L, Los Angeles ʻO X -Y ka mea hoʻokolokolo ma laila e loaʻa ana i kahi esophagal hole tounia.
POST manawa: Mar-21-2024