Ukubethelela i-Esophagus ukukhusela ubunzima bokulahla
Ukuhluthwa kwe-Esophageal yonyango ukunceda ukunweba, okanye ukuphucula, ukungqinelana okungaqhelekanga kufumaneka kwi-esophagus. Ezi ncitshiso zibizwa ngokuba yimigangatho kwaye zinokuvela kwiintlobo zeengxaki zempilo. Ugqirha wakho uya kukuthumela kwi-otolaryngologist (ugqirha, impumlo kunye nomgudu wengqondo) okanye igastroenterologist (isisu kunye nesifo sengxaki yesifo somzimba) ukwenzela ukuba le nkqubo iqhutywe.
Ngokubanzi baya kusebenzisa iindlela ezahlukeneyo ezahlukeneyo ezintathu zokwenza ukunyuka kwe-esophageal:
- I-bougie enobunzima - i-dilator ye-push-type eyenziwa yi-mercury-full (Maloney) okanye i-tungsten-egcweleyo (i-Hurst)
- I-dilator ekhokelwa yi-Wire - ifowuni-fowuni ifakwe kuqala kwaye i-dilator ye-polyvinyl (i-Savary-Gilliard okanye i-Amerika) ifakwe kwi-wire-guide
- I-Baloon dilator - ifakwe kwiqondo lokugcina, ngaphantsi kwe-endoscopy (usebenzisa i-endoscope yevidiyo) okanye i-fluoroscopy (usebenzisa i-ray-ray), ize iphazamise ibhaluni
Kutheni i-Esophageal Dilation eyenziwe?
Kwixesha elide, iingxaki ezahlukeneyo zempilo zingenza ukuba izithintelo zenzeke kwisigxu esibangela ukunciphisa isifo. Ezi zithintelo zinokukwenza kube nzima ukugwinya kwaye unokuba uvakalelo lokutya luhlangene esifubeni sakho. Esi sivakalelo kukuba ukutya kunzima ixesha elidlulileyo. Kwiimeko ezininzi, ezi ziqhamo zibangelwa ukuqokelela kwe-fibrous okanye i-collagen accumulation.
Nalu uluhlu lweengxaki eziza kuxhamla ekusebenziseni ukuhluthwa kwe-esophageal:
- Achalasia
- Ukulimala kweCaustic (chemical)
- Eosinophilic esophagitis
- Umhlaza we-Esophageal
- GERD - ixhaphakileyo
- I-Jackhammer isophagus
- Ukuhlinzwa kwangaphambili
- Ukunyanga kwamayeza
- Isalathiso sikaSchatzki
- I-Sclerotherapy ye-varophageal varices
Ukuhluthwa kwe-Esophageal akuyiyo yonyango kuyo nayiphi na ingxaki ezilapha ngasentla kwaye iimpawu ziya kubuyela kwakhona.
Nangona kunjalo ukuhluthwa kwe-esophageal kungaba yindlela efanelekileyo ekunciphiseni iimpawu ezinxulumene nobunzima bokugwinya.
Izingozi ezibandakanyeka nokuxilongwa kwe-Esophageal
Kufuneka ube ne-dilutional dilational eyenziwa ngumboneleli oqeqeshiwe. Nangona ukuhluthwa kwe-esophageal ngokuqhelekileyo yinkqubo ekhuselekileyo, kukho iingozi ezifanele uziqaphele. Nangona izingozi ezivakalayo zivakalayo, ukuhluthwa kwe-esophageal ngokubanzi kuphephile ukwenza kwisilathiso sokugula kwaye akufuneki kwenziwe esibhedlele.
Ukuhluthwa kunye nokuthandwa kuya kwenzeka malunga naluphi na umgaqo obandakanya indlela yokuhamba nomoya okanye i-oopopus. Ugqirha wakho uya kujonga ezi ngxaki kuzo zonke iinkqubo. Kufuneka ufune unyango xa ubona nawaphi na oku okulandelayo emva kokuhluthwa kwe-esophageal:
- ukuphefumula
- umkhuhlane
- iintlungu zesifuba
- ukunyakaza kwamanzi okanye amnyama
Ingxaki enobungozi kakhulu yingozi yobunzima, okanye umgodi kwindawo. Oku kunokwenzeka malunga namaxesha onke ama-1-4 kwi-dilesi ye-1,000. Ukuba kuqhutyelwa i-perforation, utyando lungafuneka ngokukhawuleza. Umngcipheko wakho uphezulu kule nkcenkceshe ukuba uvavanyo lwakho luhambelana nokunyanga kwamayeza. Umngcipheko wakho uphakeme nangakumbi ukuba unogqirha ongenakwenza utyando rhoqo, ngoko kuphakanyisiwe ukuba uhlalutyo lwe-oophogeal olwenziwa yi-otolaryngologist okanye i-gastroenterologist.
Yintoni enokuyilindela ngoxilongo lwe-Esophageal
Ngaphambi kokuhluthwa kwe-esophageal kuyakufuneka ukhawuleze (ungenayo ukutya okanye amanzi) ubuncinci beeyure ezingama-6. Kufuneka ulandele umyalelo wakho wangaphambili wegqirha ngokuphathelele ixesha lokuzila ukudla. Amaxesha amaninzi oku kuza kuba ukuqala ngokukhawuleza phakathi kobusuku ngaphambi komsebenzi.
Ukuba ukhona nawaphi na amayeza anesondlo segazi lakho (aspirin, warfarin, njl ...) kufuneka uxelele ugqirha wakho. Akunakudingi ukuba ususwe kumachiza, nangona ugqirha wakho unokuthi alungele umthamo wakho okanye uthathe amanyathelo okukhusela. Awuxeleli ugqirha wakho malunga nala mayeza anokwandisa umngcipheko wokuba unengxaki yegazi.
Unokumiselwa kwakhona iintsholongwane ngaphambi kokuba inqubo ukuba unembali yezifo ezithile zeentliziyo. Ukuba uthatha i-antibiotics ngomsebenzi wamazinyo, kufuneka uqiniseke ukuba uxoxe ngamagciwane ngamayeza.
Ngethuba le nkqubo, ugqirha wakho unokusebenzisa i-sedation ukuze akuncede uphumule kwaye ungakhumbuli inkqubo. Ukuba le ndlela isetyenziswe, uya kufuna umntu ukuba akuqhube ekhaya, njengoko amayeza aqhelekileyo asetyenziswa kule nkqubo abandakanya: i-fentanyl, eyaziwayo, okanye ipropofol. Zonke ezi zonyango zifuna ukuba ungaqhubi iiyure ezingama-24. Ngaphandle koko, ugqirha wakho unokusebenzisa i-anesthetic ye-spray ukuze anqande umqala wakho ukuba enze inkqubo yakho. Ukuba le ndlela isetyenzisiweyo, uya kuvuleka ngokupheleleyo kwinkqubo kwaye uza kukwazi ukuqhuba. Nangona kunjalo abantu abaninzi banqwenela ukusebenzisa i-sedation, kuba ingcamango yesikhuni eside ifakwe entanyeni yakho ukuya kwisisu sakho inokuba yingozi, ingakumbi ukuba unyanzelekile ukuba uqhathanise ne-claustrophobia.
Emva kwenkqubo, uya kunikwa imiyalelo xa ungadla kwaye uphuze. Ukusela kuya kubanjelwa kude kube nayiphi na imiphumo ye-anesthetic. Oku kungenjalo ukuba ungenawo umbane ungena emaphaphini endaweni yesisu sakho, kuba i-anesthetic inqanda imisebenzi evamile yokugwinya. Mhlawumbi uya kuba nesifo somqala somqala emininzi emva kwenkqubo.
Ngaba Ngaba Ndiza Kufuna Uninzi Oluthile?
Kuqhelekile ukuba iimpawu zigqitywe ekugqibeleni zibuye emva kokunyuka kwe-esophageal. Kuthatha ixesha elide ukwenzela ukuba iimpawu zibuye ziguquke kwaye zixhomekeka kwizinto ezininzi ezibandakanya ubunzima kunye nesibalo sobunzima. Kwiimeko ezininzi, ukuphathwa kokutya , ukusetyenziswa kweproton pump inhibitors (PPIs), kunye nezinye iindlela zokwelapha kunokuncedisa ukulibaziseka ukuba akunakuthintela imfuneko yokunyuka kwexesha elizayo. Ukusebenza ngokusondeleyo nokulandela isicwangciso sakho sokonyango kunokunceda ugcine iimpawu ezilawulwayo ixesha elide. Ukuxilongwa kwe-Esophageal yonyango kwaye ayiyiyo yonyango, nangona uncedo lweempawu luya kunceda le nkqubo ibencede kakhulu ukuphucula umgangatho wobomi.
Imithombo:
I-American Society ye-Gastrointestinal Endoscopy. (nd). Ukuqonda ukuxilwa kwe-Esophageal. Kufumaneka ngoJanuwari 31, 2016 ukusuka http://www.asge.org/patients/patients.aspx?id=392
Dellon, ES, Gibbs, WB, Rubinas, TC, Fritchie, KJ, Madanick, RD, Woosley, JT & Shaheen, NJ (2010). Ukuxilongwa kwe-esophageal kwi-eosinophilic esophagitis: ukhuseleko kunye nokuqikelelwa kweempendulo zonyango kunye neengxaki. I-Gastrointest Endosc. 71 (4): 706-12. I-Doi: 10.1016 / j.gie.2009.10.047.
Kochman, ML (2007). Ukuncitshiswa kweengozi zokuxilwa kwamanzi. I-Clinic Endosc Clinic N Am. 17 (1): 47-58, vi.
IKomiti yeMigangatho yokuSebenza, u-Egan JV, uBaron TH, u-Adler DG, uDavid R., Faigel DO, ... Fanelli RD. (2006). Isikhokelo: Ukuxubusha kwe-Esophageal. I-Gastrointest Endosc. 63 (6): 755-60.