I-Barrett Isifo Sekunzima Ukuyijonga
Isisu sikaBarrett sisimo esingavumelekanga apho umgca we-esophagus utshintshwa ngamathumbu omzimba wamathumbu. Ukutshintshwa kweeseli zakho eziqhelekileyo zokuqhathaniswa nokucatshulwa kucinga ukuba zenzeke ngenxa yesifo esingenasiphelo kwi-gastric contents of gluroesophageal reflux (GERD). Njengoko i-asidi ibonakalisa iiseli eziqhelekileyo zesifo sakho, unokukwazi ukukhupha uhlobo oluthile lweseli ebizwa ngokuba yi- columnar epithelium .
Olu hlobo lweselula luye lwabonwa okokuqala kwi-oophagus nguNorman Barrett, udokotela ogqirha wase-Australia, ngo-1950. I-barrett isifo se- anti-cancer esingenasisombululo kwaye asinayo impawu ebonakalayo; Ngoko kunzima ukuxilonga. Ekubeni kudla ngokuphindaphindiweyo kwizigulane esele zifumene i-GERD, oogqirha bancomela ukuba abantu abathile abaye bafumana i-GERD bafumana i- esophagogroduodenoscopy (EGD) kwisikrini se-Barrett's oopopus.
Ubuninzi kunye nokuxilongwa kwe-Barrett's Esophagus
Ukuba uneziqwenga zokubhukuda okungenani kanye ngeveki, umane ubeke ithuba eli-5% lokuphuhlisa isisu sikaBarrett. Nangona kunjalo, inani leentlungu ezithintekayo ezingenako ukwandisa umngcipheko wokuba ne-Barrett's oopopus. Ukuchonga isisu sikaBarrett singenziwa kuphela nge-endoscopy usebenzisa inkqubo yokuchongwa kwamanyathelo amabini. Okokuqala, ugqirha owenza i-endoscopy uya kugqiba ukuba ngaba akukho iiseli ze-epithelial columnar kwi-distal (engezantsi) inxalenye yesigxina sakho, kufuphi nesisu.
Ukuba zichongiwe, inyathelo lesibini kukuthatha i- biopsy yendawo ukuze ubone ukuba iiseli zinemiqondiso yokuba zatshintshile ukusuka kwelinye uhlobo lwesellu olunye.
Nangona isifo ngokwazo asikho iimpawu, malunga ne-1% yezigulane ezine-barrett's epopus zihlakulela uhlobo olunobungozi lomhlaza wesifo sokuqhaqhaza okuthiwa i- adenocarcinoma .
Ngenxa yesi sizathu, kufuneka uhlolwe i-dysplasia (utshintsho olungaqhelekanga kwiiseli ezinokuba ngumlandeleli womhlaza) ngokusebenzisa i-endoscopy kunye ne-biopsies ezongezelelweyo zezifo xa ufumanisa ukuba unesifo se-Barrett.
Ukunyangwa kwe-Barrett's Esophagus
Ukuba i-dysplasia ifunyenwe kwi-oophagus yakho, iiseli zingatshatyalaliswa usebenzisa utyando okanye iinkqubo ze-endoscopic. Olunye unyango lwe-Barrett's esophagus lubizwa ngokuba yi- photodynamic therapy (PDT) . Olu unyango lusebenzisa imichiza ebizwa ngokuthi i-Photofrin, eyenza izicubu zivelele ngakumbi ekukhanyeni. Iiyure ezimashumi mane anesibhozo emva kwe-Photofrin inikezelwa isigulane, ugqirha unako ukudlula ityhubhu ye-laser (nge- endoscope ) ukuya kwisigxina kunye nokutshabalalisa izicubu zeBarrett ezingavamile.
I-Barrx, enye indlela yokubhubhisa i-dysplasia ephakamileyo, ingasetyenziswa ukuba ugqirha wakho akavakalelwa kukuba ungumviwa ogqityiweyo. Le ndlela isebenzisa i-catheter ye-Barrx efakwe kwi-endoscope kwaye ivumela ukukhishwa kwe-radiofrequency (kubhujiswa) kweethambo ezingaqhelekanga. Le ndlela yindlela engaphangeliyo yokubhubhisa isisindo seBarrett kwisigxina sakho.
Olunye unyango lwe-dysplasia kwisifo seBarrett lubizwa ngokuba yi- endoscopic resection mucosal (EMR) . I-EMR ingasetyenziselwa isifo seBarrett okanye isifo somhlaza wesisu.
Kule nkqubo, inkunkuma ifakwe phantsi kwembombo yeethambo zikaBarrett ngaphambi kokuba isuswe nge-endoscope. Ukuba unyango lisetyenziselwa umhlaza wesifo somhlaza, kuphela uluhlu oluphezulu lweeseli luya kususwa. Ngenxa yoko, inokusetyenziswa kuphela kwi-dysplasia enamandla okanye umhlaza wesantya.
Kubantu abanomdla obunzima okanye umdlavuza ogqithiseleyo kwaye banempilo ngokwaneleyo yokuba bahlalise i-anesthesia jikelele, utyando luhlala luyonyango lokuqala lokunyanga kweBarrett ene-high-grade dysplasia okanye umdlavuza. Kusetyenziswa iindlela ezininzi zokuhlinzwa ngokuxhomekeka kwisigulane somntu ngamnye kunye nesimo se-tumor.
Nangona isifo sikaBarrett sisifo esingaqhelekanga kwaye kunethuba elincinane kakhulu lokuba nomhlaza wesifo sengqondo kuye, i-adenocarcinoma yesigxina sinesifo esichengileyo xa sisifumene kwisigaba esiphambili. Ngenxa yoko, kubalulekile ukuba ukuba uhlupheke kwi-GERD, uthatha unonophelo olufanelekileyo kumachiza anxamnye ne-reflux njenge- Prilosec okanye Dexilant . Ukuba ufumene ukuba unesifo se-Barrett, qiniseka ukuba ufumane i-ENT enhle okanye u-gastroenterologist ekuncedeni ukulawula ukulandelwa kwakho kunye nokunyanga.
> Umthombo
> Del Genio, G, Del Genio, F, Schettino, P, Limongelli, P, Tolone, S, Brusciano, L ... i-Docimo, L. (2015). I-Papilloma ye-Esophageal: I-Flexible Endoscopic Ablation ngo-Radiofrequency. Ihlabathi J Gastrointest Endosc. 7 (3): 290-4. i-doi: 10.4253 / wjge.v7.i3.290.
> I-National Digestive Disease Clearing House. I-Barrett's Esophagus.
> Spechler, SJ & Souza, RF. (2016). I-Sleisenger kunye ne-Fordtran's Gastrointestinal and Liver Disease. 10 th . (Ubhaliso lufunekayo)