Matenda a Barrett Ndi Ovuta Kwambiri Kufufuza
Mitsempha ya Barrett ndi yachilendo kwambiri pamene chimbudzi cha mmimba chimasinthidwa ndi matumbo a m'mimba. Kusintha kwa maselo anu enieni ochepa kwambiri kumaganiziridwa kuti kumachitika chifukwa cha kuwonetsa kosatha kwa zakudya zamkati za m'mimba zomwe zimachokera ku matenda a reflux a gastroesophageal (GERD). Pamene asidi amaletsa maselo oyenera a m'mimba yanu, mukhoza kuyamba kukula mtundu wina wa selo umene umatchedwa columnar epithelium .
Mtundu uwu unkawonekera poyambirira ndi Norman Barrett, dokotala wa opaleshoni wa ku Australia, mu 1950. Chigawo cha Barrett chingakhale chithunzithunzi cha khansa yododometsa ndipo alibe zizindikiritso zosiyana; Choncho ndizovuta kudziwa. Popeza zimapezeka kawirikawiri kwa odwala omwe ali kale ndi GERD, madokotala amalimbikitsa kuti anthu ena omwe apezeka ndi GERD amadziwika ndi esophagogastroduodenoscopy (EGD) kuti ayang'ane pazithunzi za Barrett.
Kukula ndi Kuzindikiritsa kwa Barrett's Esophagus
Ngati muli ndi zilonda zokhazokha kamodzi pa sabata, mumangokhala mwayi wa 5% wokhala ndi mayendedwe a Barrett. Komabe, chiwerengero cha zipsinjo za mtima zomwe muli nazo sizikuwonjezera chiopsezo chanu chokhala ndi mayendedwe a Barrett. Kusanthula mayendedwe a Barrett kungatheke pokhapokha pogwiritsira ntchito ndondomeko yowunikira magawo awiri. Choyamba, dokotala yemwe amachititsa mapulogalamu otchedwa endoscopy amadziwa ngati pali magulu ochepa omwe ali pamtunda wa m'munsi, pafupi ndi m'mimba.
Ngati azindikiranso, sitepe yachiwiri ndikutenga malo owona kuti maselo ali ndi zizindikiro zomwe anasintha kuchokera ku mtundu umodzi wa selo.
Ngakhale kuti matendawa alibe zizindikiro, pafupifupi 1% mwa odwala omwe ali ndi mayina a Barrett amapanga khansa yoopsa yotchedwa adenocarcinoma .
Pa chifukwa chimenechi, muyenera kuyang'anitsitsa dysplasia (kusintha kosasunthika m'maselo omwe angakhale chonchi kwa khansa) kudzera mu mapulogalamu osungirako mankhwala komanso mapiritsi ena a mthupi ngati muli ndi vuto la Barrett.
Kuchiza kafukufuku wa Barrett
Ngati dysplasia imapezeka m'thupi lanu, maselo angawonongeke pogwiritsa ntchito opaleshoni kapena njira zoperekera. Chithandizo chimodzi cha mtundu wa Barrett chimatchedwa photodynamic therapy (PDT) . Mankhwalawa amagwiritsa ntchito mankhwala otchedwa Photofrin, omwe amachititsa minofu kukhala yovuta kwambiri. Maola makumi asanu ndi atatu mphambu asanu ndi atatu kuchokera pamene Photofrin imapatsidwa kwa wodwalayo, dokotala akhoza kudutsa laser chubu (kudzera pa endoscope ) kupita kumalo osokoneza bongo ndikuwononga maonekedwe a Barrett osalongosoka.
Barrx, njira ina yowonongeratu dysplasia yapamwamba, ingagwiritsidwe ntchito ngati dokotala sakuwona kuti ndiwe wodziteteza wabwino. Njira imeneyi imagwiritsa ntchito kathethala ya Barrx imene imayikidwa mu endoscope ndipo imalola kuti pakhale mavitamini osalimba. Imeneyi ndi njira yochepa yopanda opaleshoni yoononga minofu ya Barrett.
Njira ina yothandizira dysplasia m'thupi la Barrett imatchedwa endoscopic mucosal resection (EMR) . EMR ikhoza kugwiritsidwa ntchito kwa mayendedwe a Barrett kapena khansa yowopsya.
Mwa njirayi, chinthu chimayikidwa pansi pa chikhomo cha minofu ya Barrett isanachotsedwe kudzera ku endoscope. Ngati mankhwalawa akugwiritsidwa ntchito pa khansa yochepa kwambiri, ndiye kuti masentimita apamwamba okha amachotsedwa. Chifukwa chaichi, chingagwiritsidwe ntchito kwa dysplasia kapena khansara yoyambirira kwambiri.
Kwa anthu omwe ali ndi matenda oopsa a dysplasia kapena odwala kwambiri komanso ali ndi thanzi labwino loti azitha kugonana ndi anesthesia, opaleshoni imakhalabe njira yoyamba yopangira chithandizo cha Barrett ndi dysplasia yapamwamba kapena khansa. Njira zambiri zochititsira opaleshoni zimagwiritsidwa ntchito malinga ndi zosowa za wodwalayo komanso malo a chotupacho.
Ngakhale kuti tizilombo ta Barrett ndi matenda osadziwika bwino ndipo pali mwayi wapang'ono woti tizilombo toyambitsa matenda tizilombo toyambitsa matenda tizilombo toyambitsa matenda tizilombo toyambitsa matenda, adenocarcinoma ya epopu imakhala yosauka kwambiri pamene imapezeka pamsinkhu wopita patsogolo. Pachifukwa ichi, nkofunika kuti ngati mukudwala ndi GERD, mumasamala bwino mankhwala omwe amatsutsana ndi reflux monga Prilosec kapena Dexilant . Ngati mwapezeka ndi matenda a Barrett, onetsetsani kuti mupeze ENT kapena gastroenterologist wabwino kukuthandizani kuyendetsa bwino ndikutsata.
> Chitsime
> Del Genio, G, Del Genio, F, Schettino, P, Limongelli, P, Tolone, S, Brusciano, L. (2015). Papapoma ya Esophageal: Flexible Endoscopic Ablation ndi Radiofrequency. World J Gastrointest Endosc. 7 (3): 290-4. do: 10.4253 / wjge.v7.i3.290.
> National Digestive Disease Clearing House. Zovuta za Barrett.
> Spechler, SJ & Souza, RF. (2016). Matenda a Sleisenger ndi Fordtran ndi Matenda a Chiwindi. 10 th . (Kulembetsa Kuyenera Kuyenera)