He maʻi maʻamau ka maʻi maʻi o ka esophageal reflux (GerD).He hopena koʻikoʻi kona prevalence a me nā hōʻike lapaʻau paʻakikī i ka maikaʻi o ke ola o nā maʻi.A ʻo ka ʻeha mau o ka esophagus ka pilikia o ka maʻi maʻi esophageal.ʻO ke ʻano o ka hoʻomaʻamaʻa pono ʻana a me ka hoʻomaʻamaʻa ʻana i ka mālama ʻana ke kumu o ka hana lapaʻau.
02 ʻO nā hōʻike maʻi o GERD
Hiki ke hoʻokaʻawale ʻia ʻo GERD i non-eroded reflux (NERD), reflux esophagitis (RE) a me Barreta esophageal (BE) e like me ka endoscopy.
NERD: Ua poino ka esophagus Barrett a me ka mucosa esophageal ma ka wehewehe o Gerd akā ua poino ka endoscopy.
Re: Hiki i ka Endoscopy ke ʻike i ka ʻōpū o ka ʻōpū-esophageal mucosa e pili ana i ka esophagus a i luna paha.Ua poino ka mucous membrane i kekahi manawa.
BE: Hoʻololi ʻia ka ʻāpana ʻāʻī-esophageal squamous epithelial o ka epithelium like esophagus o ka pilina esophagus ma ka endoscopy e ka epithelium cylindrical.
02 ʻO nā hōʻike maʻi o GERD
Ma waho aʻe o ka puʻuwai a me ka reflux, hiki mai nā hōʻailona e like me ka ʻeha o ka umauma, ka ʻeha o ka ʻōpū o luna, a me ka esophagus kupanaha, ka ʻū, ka hānō a me nā hōʻailona esophageal ʻē aʻe.
Pono e hoʻomaopopo ʻia ʻo ka poʻe maʻi me nā maʻi maʻi GerD kahiko he haʻahaʻa haʻahaʻa o ka puʻuwai a me ka reflux.He kiʻekiʻe ka loaʻa ʻana o nā hōʻailona ma ka paipu extractive.ʻAʻole maʻamau nā hōʻailona, a i ʻole asymptomatic.ʻAʻole like ka paʻakikī o nā hōʻailona me ka nui o ka maʻi.ʻO Factory Guiyu he palahalaha, a i kona wā he kauka, ua kūkulu ʻia ʻo ia ma Guangli.
03 ʻO ka maʻi o GERD
Kiʻi.Loaʻa nā hōʻailona GerD maʻamau a me nā hōʻailona atypical o ka digestive tract i ka GERD diagnostic flowchart Source: Chinese Medical Association
ʻO ka hoʻāʻo diagnostic o ka mea hoʻopau ʻakika
No nā poʻe maʻi maʻi maʻamau (PPI i hoʻohana mau ʻia), e mau ke ʻano maʻamau no 2 pule (ʻo ka poʻe me nā hōʻailona ma waho o ka paipu e pono ke mau ≥4 pule).Inā hoʻomaha loa nā hōʻailona a i ʻole hoʻokahi wale nō hōʻailona maʻalahi i hōʻoia ʻia i ka maikaʻi.
2) Endoscopic
-Re -Los Angeles ua mahele ʻia i nā māka (e nānā i ke kiʻi ma lalo):
Papa A: 1 a ʻoi aku ka pōʻino o ka esophageal mucosal, ka lōʻihi o ka pōʻino ≤5 mm;
Papa B: 1 a ʻoi aʻe paha ka pōʻino o ka esophageal mucosal, ka lōʻihi o ka pōʻino> 5 mm, ka pōʻino o ka mucous membrane a ʻaʻohe hui;
Papa C: Ma kahi o 2 esophageal mucosa i poino, a ua poino ka mucous membrane i hui pu ia me kekahi.
Papa D: E pili ana i ka pōʻino o ka mucosa a me ka hoʻohui ʻana o kekahi i kekahi, a ʻo 75% o ka esophagus ka laulā hui.
ʻO ka hoʻolālā biopsy BE: Manaʻo ʻia he nui a pōkole ka manawa biopsy, a loaʻa ka biopsy ma ka 1cm manawa a puni ka umu.ʻO ka nui o ka laulā e pili ana i ka pilikia o ka maʻi kanesa, a ke piʻi nei ka nui o ka maʻi kanesa a hoʻonui i ka laulā o 3cm.
3)Ana esophageal kiʻekiʻe
ʻO ka poʻe maʻi me GerD ke hōʻike pinepine nei i ka mana esophageal pono ʻole: ʻo ka hapa o 70% a i ʻole peristalsis hemahema ratio o 70% a i ʻole peristalsis ʻo ≥50%.
Ka nānā ʻana i kēia manawa
ʻO ia ka maʻamau no ka hōʻoia ʻana o CEDD.ʻO ia ke kūlana gula o ka maʻi o GERD, me ka nānā ʻana i ka waiwai esophagus NH a me ka esophageal yang anti -NH waiwai ka nānā ʻana o ka esophagus pipe NH waiwai a me ka esophageal yang anti -NH waiwai nānā.ʻO ka pākēneka o ka pH <4 (ka manawa hoʻolaha wai, AET)> 4% i ka 24H, ua manaʻo ʻia aia he pathological acid reflux.
04 Lapaʻau GERD
Kiʻi .Gerd's treatment flowchart
Puna: Hui Lapaau Kina
Nā mea e mālama ai:
-ʻO PPI a me P-CAB ka koho mua no ka mālama mua ʻana a me ka mālama ʻana i nā maʻi me Gard.ʻO ka mālama mua ʻana o ka mālama PPI he 8 mau pule a ʻo ka mālama P-CAB ʻo ≥4 mau pule.
-No nā poʻe maʻi me nā pōʻino i ka pō (i ka wā e lawe ai i ka PPI, ka pH <4 manawa> 1H i ka pō o ka pō), hiki iā ʻoe ke hoʻohana i ka H2 receptor blockers ma mua o ka moe ʻana ma ke kumu o ka mālama ʻana i ka PPI, a i ʻole e hoʻololi iā P-CAB a lōʻihi.ʻO ka mālama PPI hapalua ola.
- Hiki ke hoʻohana ʻia ka lāʻau anti-acid a me nā lāʻau lapaʻau gastrointestinal no ka noi pōkole e hoʻopau koke i nā hōʻailona o ka ʻehaʻeha e like me ka puʻuwai a me ka reflux.
-Ka hōʻailona lapaʻau endoscopic: Ua maopopo ka maʻi GERD, ʻaʻole kūpono ka mālama ʻana i ka waikawa, makemake ʻole e lawe i ka lāʻau no ka manawa lōʻihi, a i ʻole nā hopena ʻino e pili ana i nā lāʻau lapaʻau, a ʻaʻole hiki ke ʻae.
- Hōʻike hōʻailona hōʻailona hōʻailona: aia nā hōʻailona GerD maʻamau, pono ʻole ka mālama PPI;loaʻa ka endoscopy i ka hernia esophageal, BE, RE, Los Angeles māka a i ʻole;Ua ʻike ʻia ka nānā ʻana i ka X-ray he hernia hole esophageal.
Ka manawa hoʻouna: Mar-21-2024