I-manometry yesisophageal isilingo esisetyenziswa ngokuqhelekileyo ukukunceda ukucacisa ukusetyenziswa kwemoto engasebenzi. Olu vavanyo lunceda ugqirha wakho ukuvavanya iingcinezelo ngaphakathi kwe-oophagus, peristalsis (ukukhankanya ngokungenakuzikhethela kunye nokuphumla kwisigxina sakho), kunye nokuhamba kokutya ngokusebenzisa isifo sakho. Izizathu eziqhelekileyo ugqirha wakho unokuncoma ukuba uvavanyo lwe-manometry lugxininisa lubandakanya:
- ubunzima bokugwinya (dysphagia)
- intlungu yesifuba esingenayo intliziyo (i-heart)
- i-acid reflux
- phambi kokutyunjwa kwe-anti-reflux
Kusenokwenzeka ukuba unokucetyiswa kule mvavanyo ukukunceda ukuvavanya ezi zinto zilandelayo:
- i-achalasia (ubunzima bokudlulisa ukutya kwisisu)
- scleroderma
- I-GERD ngaphandle kwenzuzo emva kweiveki ezi-8 zokusebenzisa i-proton-pump inhibitor (PPI)
- jackhammer esophagus
- eosinophilic esophagitis
I-Esophagus yakho
I-esophagus ityhubhu ende ye-muscular ephuma emqaleni wakho ukuya esiswini sakho kwaye ngezinye izihlandlo ibizwa ngokuba yi "gullet" yakho. Kukho i-sphincter, okanye isalathisi se-muscular evula kwaye ivale, phezulu kunye nezantsi kwegama lakho. Ezi zilandelwa ngokulandelanayo njenge- sphincter ephezulu ye-esophageal kunye ne- infhgeer esophageal sphincter . Ezi zitshizi zivula kwaye zivale ngokwemvelo ngelixa ziginya ukutya okanye ziselo.
I- sphincter yakho ye- esophageal esophageal (UES) ikhonza iinjongo ezi-2 eziphambili:
- ivala ngexesha lokuphefumlelwa ukuphepha ukuzalisa isisu sakho emoyeni
- ivala ukukhusela i-asidi-reflux yokungena kwimiphunga yakho
Injongo yakho ephambili ye-sphincter (LES) yenzelwe ukukhusela i-acid yesisu ukungena kwisigxina sakho. Ukuthintela oku, i-sphincter yakho esezantsi ihlala ivalwe kuze kube yinkomfa yokutya ngexesha apho ihlaziya ngokukhawuleza ukuvumela ukuhamba kwesidlo sakho kwisisu sakho.
Kukho kwakhona ukuphumula okufutshane kwe-sphincter engezantsi xa ubhinqa.
Ukulungiselela uvavanyo lweManometry lwe-Esophageal
Ukulungiselela uvavanyo lwe-manometry oluxhasayo luquka iindlela zokukhusela ukukhusela ukufunwa (ukukhulelwa kwesisu) kunye nokuphuculwa kweziphumo zovavanyo. Ukuze uqinisekise ukuba isisu sakho asinalutho, ugqirha wakho uya kucetyiswa ukuba ukhawuleze ubuncinane kwiiyure ezintandathu ngaphambi kokuba wenze inkqubo yakho. Ukuba uyadla ngaphambi kwesi sikhathi, ugqirha wakho unokurhoxisa okanye ulibazise ukuvavanywa kwakho.
Uninzi lwamachiza lunokuphazamisa isifo sakho kwaye ngoko ugqirha wakho unokucela ukuba unqabe okwethutyana ukuthatha imithi ethile. Amanye amayeza angenakukwazi ukumiswa kwaye ngoko kufuneka uxoxe ngamachiza wakho kunye nodokotela wakho ngaphambi kwenkqubo. Nawaphi na amayeza athathwe kuphela "njengoko kuyimfuneko" akufanele athathwe ngaphambi kwenkqubo.
Iindidi eziqhelekileyo zonyango ezinokuchaphazela iziphumo zolu vavanyo lwe-manometry lwe-esophageal ziquka:
- nitrate - nitroglycerin, isosorbide, Viagra, Cialis
- i-calcium-channel blockers - i-Norvasc, iCardizem
- anticholinergics - uCogentin, Spiriva, Atrovent, Ditropan
- i-Agent, i-Zelnorm
- izidalwa - i-Versed, i-Ativan, i-Fentanyl
Kubalulekile ukuxoxa ngamachiza kunye nodokotela wakho ngaphambi kokuyeka nayiphi na into oyithatha rhoqo.
Yintoni enokuyilindela ngexesha lovavanyo lwe-Manometry Test Esophageal
Uninzi lwexesha lokuditywa kwexesha alinakusetyenziswa ngelixa ufaka i-catheter ye-motility ye-esophageal. Nangona iidalative ezinomdaka ezinjengezilwanyana eziphantsi ze-Versed zingasetyenziselwa ukuphucula induduzo, izidalwa ezinokuthi zitshintshe ziyakuchukumisa ukuhlolwa kwexesha elide, ngoko kuya kugwenywa xa kunokwenzeka.
Ukuze ukomeleze intuthuzelo yakho, uya kuthi unikwe ukhetho lwamayeza ongafuna ugqirha ukuba afake i-catheter. Umzila wamanzi ukhethwa njengokuba kudala ukubangeleka kwaye kungakhathazeki ngokukhawuleza ukuhamba nomlomo wakho. Ugqirha wakho uqeqeshe kakhulu ukwenza le nkqubo, ngoko themba uze uzame ukuphumla.
Ukuba uziva ukhululekile, qhagamshelana nabo.
Ngaphambi kokuqala, kufuneka ususe iiglasi kunye nantoni emlonyeni wakho ongasuswa kalula. Kufuneka ususe ezi zinto kuba ukugubha kuqhelekileyo ngexesha lokufakwa kwecatheter.
Nantsi into eya kwenzeka kuyo yonke inkqubo:
- Ngaphambi kokufaka i-catheter ye-motility ye-esophageal, i-tip of catheter iya kubhalwa nge-anesthetic. Ukuba ukufakela akukhathazi kakhulu, banokukufakela umncinci okanye uhlambe i-nostril yakho nge-swab eboshwe nge-antichetic.
Ingongoma enkulu yokuchasana kwenzeka xa i-catheter ifinyelela emva kweempawu zakho kwaye ingena emqaleni wakho ngenxa yokuguqa okufuneka iyenze. Ngethuba le nxalenye yenkqubo, uya kucelwa ukuba ujikezele intloko yakho phantsi, ubeke i-chin yakho kwisifuba sakho ukuze uncede wenze i-turn by cathter. - Ukuze uncede ukuhambisa ikhenta idlule i-sphincter yakho ephezulu, uya kucelwa ukuba uphuze amanzi ngamanzi. Ukuba uqala ukukhwehlela ngokuphindaphindiweyo kwaye ube nobunzima bokuthetha, kusenokuthetha ukuba ityhubhu yaya kwi-trachea yakho endaweni yesigxina sakho. Oku kwenzeka njalo kwaye ugqirha owenza inkqubo iya kuhoxisa i-catheter kancane kwaye uzame kwakhona emva kokuba ube nethuba lokuphumla kwaye ubambe umoya wakho.
- Emva kokuba i-catheter idlule i-sphincter yakho ye-esophageal, i-catheter ingaqhubekela phambili ngokukhawuleza phantsi kwe-oopopus yakho. I-catheter ye-moop ye-esophageal iya kuhlonyelwa ekhaleni lakho emva kokuba ubunzulu obufanelekileyo sele bufikeleleke. Emva koko uyacelwa ukuba ulale phantsi ngelixa i-catheter ichanekile ngokufanelekileyo ukuvavanya. Ngexesha lokulinganiswa, kufuneka ubaleke ukugwinya ukuvumela ukulinganisa okufanelekileyo.
- Ukuvavanya kuqala ngeentloko ezimbini zokugqibela ezisesisu. Uyakucelwa ukuba uthathe umoya ophezulu ukuze uncede uqinisekise ukubeka ngokufanelekileyo ngaphakathi kwesisu sakho. Emva kokumiselwa, umlinganiselo wecathterter motility catheter isilinganiselo isetyenziswe kwi-zero. Nangona uxinzelelo lwangempela aluyiyo yonke into, isisu sagqithwa njenge-zero ukwenza njengesiseko sokulinganisa uxinzelelo kwi-sphincter yakho engaphantsi.
- Emva kokuba imilinganiselo yesiseko yesisu isungulwe, i-catheter ye-motility e-esophageal ihoxiswa kwi-sphincter esezantsi. Xa sele ubekwe ngokufanelekileyo, uya kunikwa iipasiti ezininzi zamanzi okushisa kumgangatho (malunga ne-5 mL okanye ngaphantsi kweyisipuni esisodwa). Baya kukulinganisa uxinzelelo olukhoyo ekuphumleni (i-sphincter kwindawo evuliwe) kwaye xa i-sphincter ihlaziya ngexesha lokugwinya kwamanzi.
Xa i-sphincter ihlaziya, kufuneka ngokuqhelekileyo isondele kwinqanaba lexinzelelo yesisu esisetyenziselwe ukuqala. Ngethuba lovavanyo, uya kucelwa ukuba uphefumle ngokuzithe ngqinqa kwisiseko esiqhelekileyo ukuze uvumele umlinganiselo ofanelekileyo. - Ngezixhobo zokugqibela ezikwindawo ephezulu yokuxinzelela kwe-sphincter yakho engaphantsi, baya kuthatha amanyathelo ngexesha lokugwinya kwamanzi ngendlela i-esophagus yakho isabela ngayo ukugwinya. I-oophagus yakho kufuneka ibonise uxinzelelo olunyuliweyo oluqala kwinxalenye ephezulu yesifo sakho kwaye kufuneka ligcine ukunyuka kwexinzelelo phantsi kwe-catheter ye-motility njengamanzi ehla ukuya kwisisu sakho.
Olu lugxininiso lokunyuka kwengcinezelo lubangelwa yi-peristalsis, okanye ukunyanzeliswa kokuzibandakanya komzimba we-osophogeal ukuhambisa izinto ngaphakathi kwisisu sakho. Njengoko kwinqanaba elidlulileyo, xa amanzi ephezulu kwinqanaba le-sphincter yakho ephezulu, umgangatho woxinzelelo kufuneka ungene kwi-zero. - Xa uvavanya i-sphincter yakho ephezulu, uya kucelwa ukuba uhlale. I-catheter ye-esophageal motility iya kutshukunyiswa ngokukhawuleza kwaye ibekwe apho iyakwazi ukuchonga indawo ephezulu yokuxinzelela kwi-sphincter yakho ephezulu. Uxinzelelo kwi-sphincter iya kufaniswa nexinzelelo olusisiseko olusisiseko kwisigxina esinqununu sakho. Xa uxinzelelo luphumlile, okanye kwindawo evuliwe, uxinzelelo ngexesha lokugwinya liya kulinganiswa. Kule ngongoma, ngokumiswa okufanelekileyo, uvavanyo luyakwazi ukubona ukunxibelelana phakathi komqala wakho kunye ne-sphincter yakho ephezulu.
Iingxaki ezinokwenzeka
Yazi ukuba iingxaki ezinxulumene nokuhlolwa kwe-manometry ezingapheliyo ziqabile. Nangona kunjalo, kukho naziphi na iingxaki ezilandelayo:
- iintliziyo ezingavumelekanga
- Iinjongo (i-asidi okanye isisu esisuka ejikeleza i-esophagus kunye nemiphunga yakho)
- ukugqithwa (ukubhubhisa) kwesigxina sakho
- ityhubhu ibekwe kumphunga esikhundleni se-esophagus - ilungiswe ngokukhawuleza ngexesha lokufakwa
Uninzi lwazo luyakhuselwa ngokulandela imiyalelo enikezelwa ngugqirha wakho phambi kwenkqubo.
Ezinye iindlela zokuvavanywa kweManometry Testing
I-manometry ye-Esophageal yindlela efanelekileyo yokuvavanya nayiphi na into engeyiyo yokusebenza kunye ne-esophageal motility. Nangona kunjalo, isifundo somngxube we- barium singasetyenziselwa ukuvavanya ukusebenza komsebenzi wakho we-sphincter esophageal.
Kukho intsha entsha yeenguqu ye-manometry ebizwa ngokuthi yi-manometry ephezulu. Esikhundleni sokusebenzisa iisenti ezisibhozo kwi-catheter ye-motility e-esophageal, i-catheter esiphezulu isebenzisa ama-36. Inkqubo esetyenziselwa ukulinganisa iyafana. Nangona kunjalo, xa i-catheter isetyenziswe kakuhle, akukho kukhishwa kwecatheter kuyadingeka. Ikwavumela kwakhona imephu ye-3-dimensional map (e-dimensional map map pressure) ebizwa ngokuba yi-oophageal imprapography engasiluncedo ekunqumeni iziphazamiso ezithile kunye nokungasebenzi kwe-sphincter engasebenzi.
ILizwi
Ukuba ukhathazekile okanye ugxininiswe xa ugqirha wakho uncoma ukuhlolwa kwe-manometry, qaphela ukuba le nkqubo ilula kwaye ayibangele iimeko ezinzima, ngakumbi xa ulandela imiyalelo. Ukwazi oko unokulindela kunokunceda ukukhulula ukwesaba, kwaye ukuba usenomdla malunga nesinyathelo esithile kwinkqubo, vumela ugqirha wakho wazi. Unako ukufumana iingcebiso ezifanelekileyo.
> Imithombo:
> Isisombululo esiphezulu > i-manometry. KwiWebhu yeToDate. https://www.uptodate.com (Ubhaliso olufunekayo). Ukuhlaziywa ngoJulayi 10, 2017.
> Ubume bokuvavanywa kwezilwanyana zesilingo. KwiWebhu yeToDate. https://www.uptodate.com (Ubhaliso olufunekayo). Ukuhlaziywa kweSept 12, 2016.
> Richter, JE & Castell, DO. (2012). I-Esophagus. 5 th . Wiley-Blackwell. iphe 163-181.
> Ukuqonda i-Esophageal Manometry. Umbutho waseMelika wewebhusayithi yeGastrointestinal Endoscopy. https://www.asge.org/home/for-patients/patient-nformation/understanding-esophageal-manometry.