Manometry yosawerengeka ndi mayeso omwe amagwiritsidwa ntchito kawirikawiri kuti athandizidwe kugwiritsira ntchito mankhwala osokoneza bongo. Mayesowa amathandiza dokotala wanu kufufuza zovuta m'mimba yanu, peristalsis (kupanikizana mosagwiritsidwa ntchito ndi kupumula mu malo anu), ndi kuyenda kwa chakudya kudzera m'mimba yanu. Zowoneka bwino zomwe dokotala angakulimbikitseni kuti mayeso ochepa a manometry ndi awa:
- vuto lomeza (dysphagia)
- kupweteka pachifuwa osati mtima wamtima (mtima)
- acid reflux
- pamaso opaleshoni ya anti-reflux
Mwinanso mungalimbikitsidwe pofuna kuyesa zotsatirazi:
- achalasia (kuvutika kudutsa chakudya m'mimba)
- scleroderma
- GERD popanda phindu pakatha milungu 8 yogwiritsira ntchito proton-pump inhibitor (PPI)
- jackhammer oophagus
- maosopopitis
Masewero Anu
Mankhwalawa ndi autali kwambiri omwe amachokera pamtima pako kupita kumimba mwako ndipo nthawi zina amatchedwa "gullet". Pali sphincter, kapena mphete yamtundu yomwe imatsegula ndi kutseka, pamwamba ndi pansi pa malo anu. Izi ndizomwe zimatchulidwa kuti supopugeal sphincter ndi otsika osakaniza sphincter . Zitsulozi zimatseguka ndi kutseka mwachibadwa pamene zikumeza chakudya kapena zakumwa.
Mpweya wanu wamakono wotchedwa sphincter (UES) umatumikira 2 zolinga zazikulu:
- imatseka panthawi ya kudzoza kuti mupewe kudzaza mimba yanu ndi mpweya
- Tseka kuteteza asidi-reflux kuti musalowe m'mapapu anu
Cholinga chanu chochepa cha aspirgeal sphincter's (LES) ndicho kuteteza mimba ya asidi kuti musalowe muyeso lanu. Pofuna kupewa izi, kutsika kwanu kochepa kumakhala kosatsekedwa mpaka kukumeza chakudya panthawi yomwe imakambirananso kuti chakudya chimachokera m'mimba mwako.
Palinso mpumulo wafupipafupi wa otsika otchedwa sophageal sphincter pamene iwe ukuwombera.
Kukonzekera Mayeso a Manometry A Esophageal
Kukonzekera mayesero a manometry omwe amatha kupezeka kumaphatikizapo chitetezo kuteteza aspiration (kupweteka kwa m'mimba mwake) ndi kukhathamiritsa zotsatira za mayesero. Pofuna kuonetsetsa kuti mimba yanu ilibe kanthu, dokotala wanu angakulimbikitseni kuti mukhale osachepera maola asanu musanayambe njira yanu. Ngati mudya nthawi isanafike, dokotala wanu akhoza kuletsa kapena kuchepetsa kuyesedwa kwanu.
Mankhwala ambiri angakhudze vuto lanu ndipo choncho dokotala wanu angakufunseni kuti musamamwe mankhwala ena. Mankhwala ena sangathe kulephereka choncho muyenera kukambirana za mankhwala anu ndi dokotala wanu musanayambe. Mankhwala aliwonse omwe amatengedwa "monga momwe akufunira" sayenera kutengedwa musanachitike.
Mitundu yambiri ya mankhwala omwe ingakhudze zotsatira za mayeso ochepa omwe amapezeka ndi manometry ndi awa:
- nitrates - nitroglycerin, isosorbide, Viagra, Cialis
- calcium-channel blockers - Norvasc, Cardizem
- anticholinergics - Cogentin, Spiriva, Atrovent, Ditropan
- Otsatsa malonda - Reglan, Zelnorm
- zosangalatsa - Zolemba, Ativan, Fentanyl
Ndikofunika kukambirana za mankhwala ndi dokotala wanu musanayambe chilichonse chimene mumatenga nthawi zonse.
Zimene Tingayembekezere M'kuyesedwa kwa Manometry Test Esophageal
Nthawi zambiri sedation sizingagwiritsidwe ntchito poika catheter yosungira motility. Ngakhale kuti njira zochepetsetsa zochepetsetsa zochepa zomwe zimagwiritsidwa ntchito poyerekeza zingagwiritsidwe ntchito popititsa patsogolo chitonthozo, zowonjezereka zingakhudze kuyesa kochepa, choncho zimapewa ngati zingatheke.
Pofuna kulimbikitsa chitonthozo chanu, mumapatsidwa mwayi wosankha dokotala kuti aike catheter. Njira yamphongo imasankhidwa chifukwa imayambitsa kuchepa kochepa ndipo imakhala yovuta kwambiri kamodzi m'malo mosiyana ndi pakamwa pako. Dokotala wanu amaphunzitsidwa bwino pakuchita izi, choncho khulupirirani ndipo yesetsani kumasuka.
Ngati mumamva ululu waukulu, kambiranani nawo.
Asanayambe, muyenera kuchotsa magalasi ndi chilichonse chomwe chili m'kamwa mwanu chomwe chingachotsedwe mosavuta. Muyenera kuchotsa zinthu izi chifukwa kugwedeza n'kwachilendo panthawi ya catheter.
Pano pali zomwe zidzachitike nthawi zonse:
- Asanalowetse catheter ya motility yochepa kwambiri, nsonga ya catheter idzagwiritsidwa ntchito ndi mankhwala otsegula m'mimba. Ngati kulemba sikuli kovuta, akhoza kukupangitsani kuwombera pang'ono kapena kupukusira chisa chanu ndi nsalu yokutidwa ndi mankhwala osokoneza bongo.
Mfundo yaikulu kwambiri yotsutsa imapezeka pamene catheter imatha kumbuyo kwa misomali yanu ndipo imalowa m'khosi mwako chifukwa cha bendu yomwe imafunika kupanga. Pa gawoli, mutha kupempha mutu wanu pansi, ndikuyika chinkhoswe chanu pachifuwa chanu kuti muthe kutembenuka ndi catheter. - Kuti muthe kusuntha catheter kupyola sophageal sphincter, mudzapemphedwa kuti mudzamwe madzi kudzera mu udzu. Ngati mutayamba chifuwa mobwerezabwereza ndipo mumakhala ndi vuto loyankhula, zikhoza kutanthauza kuti chubuyo inalowa mumtundu wanu m'malo moyambira. Izi zimachitika nthawi zina ndipo wodwala akuchita izi amachotsa kathete pang'ono ndikuyesanso mutakhala ndi mpumulo wotsitsimula ndikugwira mpweya wanu.
- Katheta ikatha kudutsa mpweya wanu wam'mimba, catheter ikhoza kutsogolo mwamsanga. Catheter yosungunuka ya motility idzagwedezeka kumphuno mwakachetechete pomwepo. Mudzafunsidwa kuti mugone pansi pamene catheter imadziwika bwino kuti muyesedwe. Pomwe mukulimbitsa, muyenera kupewa kumeza kuti mulole kuti muyambe kuyendetsa bwino.
- Kuyezetsa kumayamba ndi masewera awiri otsiriza omwe ali m'mimba. Mudzafunsidwa kuti mutenge mpweya wambiri kuti mutsimikizire malo oyenerera m'mimba mwanu. Kamodzi kokhazikika, catheter yosungunuka ya motility catheter mayeso imayikidwa ku zero. Ngakhale kupanikizika kwenikweni sikuli zero, mimba imadziwika kuti zero kuti ikhale ngati maziko oyenerera kuti muyese kupanikizika pazomwe mumadzipiritsa otsika.
- Pambuyo poyeza miyeso ya m'mimba, kathete yosungunuka ya motility imachokera kumtunda wochepa kwambiri wa sophageal sphincter. Mukakhala bwino, mudzapatsidwa sips zingapo za kutentha kwa madzi (pafupifupi 5 mL kapena pang'ono kuposa supuni imodzi). Adzakhala akuyesa kupanikizika komwe kulipo (sphincter) ndipo pamene sphincter imatsitsimula pakamwa madzi.
Pamene sphincter imatsitsimutsa, nthawi zambiri imayenera kufika pafupi ndi vuto la m'mimba lomwe linayesedwa kale kumayeso. Pakati pa mayesero, mudzapemphedwa kuti mupume mwakachetechete pamtunda wozama kuti mulole muyeso woyenera. - Ndi mapulogalamu otsiriza omwe ali m'madera othamanga kwambiri omwe ali otsika kwambiri, amathanso kuyeza pakamwa kwa madzi momwe mchere wako umayendera kuti umame. Mlonda wanu ayenera kusonyeza kupanikizika kochulukirapo kumayambiriro kwa malo anu ndipo ayenera kusamala kuwonjezeka kwa catheter yosungunuka mofulumira ngati madzi akuyenda kupita kumimba mwako.
Kuwonjezeka kumeneku kwawonjezeka ndi chifukwa cha kuwonongeka, kapena kupachikidwa kwadzidzidzi kwa mitsempha yotupa kuti mutuluke m'mimba mwanu. Monga momwe tanenera kale, pamene madzi ali pamlingo wapamwamba kwambiri, msinkhuwu uyenera kuyandikira zero. - Poyesera sphincter yanu yapamwamba kwambiri, mudzafunsidwa kukhala pansi. Catheter yosungunuka ya motility idzayendetsedwa pang'onopang'ono ndi malo pomwe angadziwe malo otetezeka kwambiri a sphincter wanu apamwamba. Kupsyinjika kwa sphincter kudzafanizidwa ndi kukakamizidwa koyambira maziko mu gawo lalikulu la malo anu. Mukangokhalira kupanikizika, kapena kutsekedwa, kupanikizidwa pa nthawi yomeza kudzayesedwa. Panthawiyi, ndi malo abwino, mayeserowa angathenso kuzindikira kuyanjana pakati pa mmero ndi mpweya wanu wam'mwamba.
Zovuta Zilipo
Dziwani kuti zovuta zokhudzana ndi kuyerekezera kwa manometry ndizosowa. Komabe, mavuto alionsewa angakhalepo:
- ziphuphu zopanda pake
- aspiration (mankhwala a asidi kapena m'mimba akuyenderera m'mimba ndi mapapu anu)
- kupotoza (kuvundula) kwa malo anu
- chubu mumapapu mmalo mwa mitsempha - yowonongeka mosavuta powonjezera
Zambiri mwazi zimapewa mwa kutsatira malangizo operekedwa ndi dokotala wanu musanayambe.
Njira Zina Zoperekera Kuyesedwa kwa Manometry
Manophythrayi ndi njira yabwino kwambiri yowunika kusokonekera kulikonse ndi vuto lokhalira motility. Komabe, kugwiritsidwa ntchito kwa barium kungagwiritsidwe ntchito poyesa ntchito ya ntchito yanu yofooka ya sphincter.
Palinso njira yowonjezera yowonjezereka ya manometry yotchedwa high-resolution manometry. M'malo mogwiritsa ntchito masensa asanu ndi atatu m'kati mwa catheter ya motility yosakanikirana, catheter yopambana kwambiri imagwiritsa ntchito masensa 36. Njira yogwiritsira ntchitoyi ndi yofanana. Komabe, pokhapokha catheter itayikidwa bwino, palibe kuchotsedwa kwa catheter. Zimaperekanso mapu a mapulogalamu atatu omwe amachititsa kuti anthu asamagwiritse ntchito mankhwala omwe angakhale othandiza kuti athetse vuto linalake lopanda matenda.
Mawu Ochokera
Ngati mukuchita mantha kapena kukhumudwa pamene dokotala akuyesa kuyerekezera mayeso a manometry, dziwani kuti njirayi ndi yosavuta ndipo sichimayambitsa mavuto, makamaka mukatsatira malangizo. Kudziwa zomwe mungayembekezere kungathandize kuthetsa mantha ena, ndipo ngati mudakali ndi mantha pazochitika zina, dokotala wanu adziwe. Iye akhoza kukhala ndi malingaliro othandiza.
> Zotsatira:
> Kuthamanga kwakukulu > manometry. Tsambulani webusaitiyi. https://www.uptodate.com (Kulembetsa Kufunikira). Kusinthidwa Jul 10, 2017.
> Kuchuluka kwa mimba kuyesedwa kwa motility. Tsambulani webusaitiyi. https://www.uptodate.com (Kulembetsa Kufunikira). Kusinthidwa Sep 12, 2016.
Richter, JE & Castell, DO. (2012). The Esophagus. 5 th . Wiley-Blackwell. mas. 163-181.
> Kumvetsetsa Masewera a Manopha. American Society for Masitolo Endoscopy webusaitiyi. https://www.asge.org/home/for-patients/patient-information/understanding-esophageal-manometry.