Kutambasula Zamagetsi Poletsa Kutsekula Kwavuta
Kusungunulira kwapadera ndi mankhwala omwe amathandiza kutambasula, kapena kuchepetsa, zoperewera zachilendo zomwe zimapezeka m'mimba. Kuphatikizidwa kumeneku kumatchedwa kugwiritsidwa ntchito komanso kungayambitse matenda osiyanasiyana. Dokotala wanu angakutumizireni kwa otolaryngologist (dokotala, khutu ndi mphuno dokotala) kapena gastroenterologist (mmimba ndi matenda a m'magazi) kuti izi zitheke.
Amagwiritsira ntchito njira zitatu zosiyanitsira:
- Mphuno yowonongeka - mpweya wotsekemera womwe umakhala wodzaza ndi mercury (Maloney) kapena wodzazidwa ndi tungsten (Wopweteka)
- Wothandizira waya - waya wolowetsamo amaikidwa poyamba ndiyeno polyvinyl dilator (Savary-Gilliard kapena American) amaikidwa pamwamba pa waya wotsogolera
- Baloon dilator - imayikidwa mpaka pamtanda, pamapeto pake (kugwiritsa ntchito vidiyo endoscope) kapena fluoroscopy (pogwiritsa ntchito x-ray)
Nchifukwa chiyani Esophageal Dilation Yachitidwa?
M'kupita kwa nthawi, mavuto osiyanasiyana azaumoyo angayambitse mitsempha yotentha yomwe imayambitsa mimba. Izi zimakhala zovuta kuzimeza ndipo mumakhala ndikumverera kwa chakudya kumalowa m'chifuwa chanu. Maganizowa ndi chifukwa chakudya chili ndi nthawi yovuta kudutsa pamtunda. Kawirikawiri, izi zimakhala chifukwa cha kusungunuka kwa fibrous kapena collagen.
Pano pali mndandanda wa mavuto omwe angapindule pogwiritsa ntchito kuchepetsa kuchepa:
- Achalasia
- Kuvulala kwa mankhwala (mankhwala)
- Ososinophilic esophagitis
- Khansara ya Esophageal
- GERD - yofala kwambiri
- Jackhammer oophagus
- Kuchita opaleshoni isanayambe
- Kuchiza ma ARV
- Mzere wa Schatzki
- Sclerotherapy kwa masewera olimbitsa thupi
Kusungunulira kwapadera si mankhwala a mavuto aliwonsewa pamwamba ndipo zizindikiro zidzatha.
Ngakhale kuchepetsa kutaya thupi kungakhale njira yothandiza kuthetsa zizindikiro zokhudzana ndi kumeza mavuto.
Ngozi Zowonjezera Kutha kwa Esophageal
Muyenera kukhala ndi vuto lokhalitsa loperekedwa ndi wothandizira ophunzitsidwa. Ngakhale kuti kuchepetsa kuchepa kwa thupi kumakhala kotetezeka, palinso zoopsa zomwe muyenera kuzidziwa. Ngakhale kuti zoopsazo zimawoneka zoopsya, kuchepetsa kuchepa kwazinthu kumakhala kosavuta kuchitapo mthupi ndipo sikuyenera kuchitidwa kuchipatala.
Kupuma ndi kukhumba kungathe kuchitika ndi njira iliyonse yokhudzana ndi msewu wa pamsewu. Dokotala wanu adziwonera zovuta izi panthawi yonseyi. Muyenera kupita kuchipatala mukaona zotsatirazi:
- kupuma kupuma
- malungo
- kupweteka pachifuwa
- zamagazi kapena zakuda
Kuwopsa koopsa kwambiri ndi chiopsezo cha phokoso, kapena dzenje pamphuno. Izi zikhoza kuchitika pafupifupi nthawi zonse mphambu zisanu ndi zitatu kuchokera pa kupitirira 1,000. Ngati phokoso limatha, opaleshoni angafunikire mwamsanga. Mavuto anu ndi apamwamba chifukwa cha vutoli ngati mankhwala anu ali okhudzana ndi mankhwala opatsirana. Mavuto anu ndi apamwamba ngati muli ndi dokotala yemwe sanachite opaleshoni kawirikawiri, kotero akupangitsani kuti mukhale ndi vuto la kuchepa kwa otolaryngologist kapena gastroenterologist.
Zimene Tingayembekezere Ndi Kutaya Kwambiri
Musanayambe kuchepetsa kuchepa kwa zakudya, muyenera kudya (osakhala ndi chakudya kapena madzi) kwa maola 6 osachepera. Muyenera kutsata ndondomeko ya dokotala wanu potsata ndondomeko yoyenera yosala kudya. Kawirikawiri izi zidzakhala zofulumira pakati pausiku chisanachitike.
Ngati muli ndi mankhwala omwe amachititsa kuti magazi anu asapitirire (aspirin, warfarin, etc.) muyenera kudziwitsa dokotala wanu. Mungafunikire kuchotsedwa kumwa mankhwala, komabe dokotala wanu angasinthe mlingo wanu kapena atcheru. Kusamuuza dokotala wanu za mankhwalawa kungapangitse chiopsezo chanu chokhala ndi vuto la magazi.
Mwinanso mungapangidwe mankhwala opha tizilombo musanayambe ndondomeko ngati muli ndi mbiri ya matenda ena. Ngati mutenga antibiotics ndi ntchito yamazinyo, muyenera kutsimikiza kukambirana za antibiotics ndi dokotala wanu.
Panthawiyi, dokotala wanu akhoza kugwiritsa ntchito sedation kuti akuthandizeni kuti muzitha kupumula komanso musakumbukire njira. Ngati njirayi ikugwiritsidwa ntchito, mungafunike wina kuti akuyendetseni kunyumba, monga mankhwala omwe anthu ambiri amagwiritsa ntchito ndi awa: fentanyl, odziwa, kapena propofol. Mankhwala onsewa amafuna kuti musayendetse maola 24. Mwinanso, dokotala angagwiritse ntchito mankhwala osokoneza bongo kuti asokoneze khosi kuti achite zomwe mukuchita. Ngati njirayi ikugwiritsidwa ntchito, mudzakhala maso mokwanira kuti mutha kuyenda. Anthu ambiri amasankha kugwiritsa ntchito sedation, chifukwa lingaliro la fodya wautali loponyedwa m'khosi mwako mpaka m'mimba mwako lingakhale lowopsya, makamaka ngati iwe uli pafupi ndi claustrophobia.
Pambuyo pa ndondomekoyi, mudzapatsidwa malangizo pa nthawi yomwe mungathe kudya ndi kumwa. Kumwa kudzapitirira mpaka zotsatira zowonongeka zilizonse zatha. Izi ndizakuti musakhale ndi mpweya m'mapapu anu mmalo mwa mimba yanu, popeza kuti mankhwalawa amalepheretsa ntchito zowononga. Mwinanso mumakhala ndi zilonda zowawa pakhosi pamasiku angapo mutatha.
Kodi Ndiyenera Kuposa Zambiri Zochepa?
N'chizoloŵezi kuti zizindikiro zimabwereranso pambuyo poyerekeza. Zimatengera nthawi yaitali bwanji kuti zizindikiro zikhale zosasintha komanso zimadalira pazinthu zambiri kuphatikizapo kuuma komanso chifukwa cha zizindikiro. Nthaŵi zambiri, kasamalidwe ka zakudya , kugwiritsa ntchito proton pump inhibitors (PPIs), ndi zina zamankhwala zothandizira kuchepetsa ngati sichiteteza kufunikira kwa kuchepa kosayembekezereka m'tsogolo. Kugwira ntchito mwakhama ndikutsata ndondomeko yanu yothandizira chithandizo kungakuthandizeni kusunga zizindikiro nthawi yayitali. Kutsekula kwapadera ndi mankhwala osati mankhwala, komabe kupuma kwa chidziwitso kudzapangitsa njirayi kukhala yothandiza kwambiri kuti mukhale ndi moyo wabwino.
Zotsatira:
American Society for Masitolo Endoscopy. (nd). Kumvetsa Kusokonezeka Kwambiri. Idapezeka pa January 31, 2016 kuchokera ku http://www.asge.org/patients/patients.aspx?id=392
Dellon, ES, Gibbs, WB, Rubinas, TC, Fritchie, KJ, Madanick, RD, Woosley, JT & Shaheen, NJ (2010). Kuthamangitsidwa kwapadera m'maganizo osakanikirana: kutetezeka ndi kutsogolo kwa zomwe zimachitika ndi matenda. Gastrointest Endosc. 71 (4): 706-12. Mayi: 10.1016 / j.gie.2009.10.047.
Kochman, ML (2007). Kuchepetsa zoopsa za kuchepa kwa thupi. Kachilombo kovuta Kwambiri Pachipatala N Am. 17 (1): 47-58, vi.
Makhalidwe a Komiti, Egan JV, Baron TH, Adler DG, Davila R., Faigel DO, ... Fanelli RD. (2006). Malangizo: Kusokonezeka Kwambiri. Gastrointest Endosc. 63 (6): 755-60.