Lub hauv paus rau phau ntawv
Anshalasia ntawm cardia (AC) yog aThawj Esophageal Motility tsis zoo.Vim tias tsis zoo so kom txaus ntawm qhov qis dua esophageal sphincter (les) thiab tsis muaj tshuaj esophageal peristalsis, cov zaub mov kom muaj peev xwm ua tau nyob hauvdysphagia thiab cov tshuaj tiv thaiv. Cov mob kho mob xws li los ntshav, mob hauv siab thiab poob phaus.Qhov kev sib cav sib ceg yog kwv yees li 32.58 / 100,000.
Tuskev khoNtawm Achalasia tsuas yog suav nrog kev kho mob tsis yog phais neeg, dilation kho thiab phais mob.
01medical Kho
Lub tshuab ntawm kev kho yeeb tshuaj yog txo cov les siab hauv lub sijhawm luv luv.Tsis muaj pov thawj tseeb tias cov tshuaj muaj peev xwm txuas ntxiv thiab txhim kho cov tsos mob ntawm AC.Tam sim no feem ntau siv cov tshuaj suav nrog nitrates, calcium cov thaiv, thiab β-receptor agonists.
(1)Nitrates, xws li nitroglycerin, amyl nitrate, thiab isosorbide dinitrate
(2)Calcium channel blockers, xws li nifedipine, verapamil, thiab diltiazem
(3)β-receptor agonists, xws li cabuterol
02endoscopic botulinum toxin txhaj tshuaj (BTI)
Kev Txhaj Tshuaj Endoscopic Botulinum Toxin Kev Txhaj Tshuaj (BTL) tuaj yeem siv los kho AC,Tab sis nws tsuas tuaj yeem muab cov teebmeem luv luv thiab tuaj yeem siv rau cov neeg mob laus uas muaj kev pheej hmoo ntawm kev phais mob thiab tshuaj loog.
1) Qhia tias:cov neeg mob nruab nrab thiab laus (> 40 xyoo); Cov neeg uas tsis tuaj yeem zam lub siab endoscopic dilation (pd) lossis phais mob; cov uas muaj ntau txoj kev kho pd lossis kev kho tsis zoo; Cov uas muaj lub ntsej muag zoo nkauj thaum muaj kev pheej hmoo rau cov uas muaj kev pheej hmoo siab, nws kuj tuaj yeem siv ua ke nrog PD; Nws tuaj yeem siv los ua kev hloov pauv mus phais lossis kho PD.
(2) contraindications:Nws tsis pom zoo rau kev kho cov kab ua ntej ntawm AC hauv cov neeg mob hluas (≤40 xyoo).
03endoscopic zais pa dilation (pd)
Kev zais pa tawm muaj qee qhov teebmeem ntawm AC, tab sis yuav tsum muaj ntau txoj kev kho thiab nqa qhov kev pheej hmoo ntawm kev phom sij hnyav.
(1) Qhia tias:AC cov neeg mob tsis muaj daim cardiopulmonary tsis txaus, sib cais ua tsis tau, thiab lwm yam.; cov txiv neej muaj 50 xyoos thiab poj niam muaj hnub nyoog tshaj 35 xyoos; Cov neeg mob uas tau phais tsis tiav. Nws tuaj yeem siv ua thawj txoj kev xaiv.
(2) contraindications:Kev mob plawv mob hnyav tsis txaus, ua tsis tau zoo thiab kev pheej hmoo ntawm ESOPHAGAL PICIFATION.
04peroral Endoscopic Myotomy (Paj Huam)
Nyob rau hauv xyoo tsis ntev los no, nrog rau qhov loj-teev siv ntawm peroral endoscopic myotomy myotomy myotomy (paj huam), kev ua tiav ntawm kev kho mob ntawm AC muaj nce ntau.Paj huam kho mob ntawm AC yog heev sib xws nrog lub tswv yim ntawm "super tsis tshua muaj kev phais", tsuas yog tshem tawm / tshem tawm thaum lub sijhawm kho mob, thiab cov kabmob tsis raug tshem tawm.Kev ncaj ncees thiab kev ua haujlwm ntawm cov qauv anatomical yog tswj, thiab tus neeg mob postoperative zoo ntawm lub neej yeej tsis cuam tshuam. Qhov tshwm sim ntawm paj huam tau ua cov kev kho mob ntawm AC super tsawg heev kev phem.
Daim duab: POEM phais cov kauj ruam
Qhov nruab nrab- thiab ntev-sim kev ua tau zoo ntawm cov paj huam hauv kev kho mob ntawm AC yog xwm yeem nrog ntawm laparoscopic hellomy (LHM)tuaj yeem siv ua ntej-kab kev xaiv.Qee tus neeg mob tuaj yeem tsim cov tsos mob reflues
(1) Kev Qhia Txog Txog:Ac yam tsis muaj kev ua tiav submucosal loj, cov plab hnyuv ua haujlwm tsis haum thiab kev cuam tshuam loj dua.
(2) Cov kwv yees kwv yees:Diffuse Esophageal ESOPHAG, Nutopracker ESOPHAGUS THIAB LWM YAM ESOPHAGAL MERATILY, cov neeg mob phais, thiab AC nrog qee qhov Esophageal Shigucosal Adhesions.
(3) contraindications:Cov neeg mob uas muaj dej sib thooj loj, cov kab mob plawv, tsis zoo rau kev phais, thiab tsis tuaj yeem tiv taus kev phais.
05Laparoscopic heller myotomy (lhm)
LHM muaj kev ua tau zoo ntev rau kev kho AC, thiab tau hloov tau los ntawm paj huam uas cov neeg mob tso cai.
06Surgical Esophagvy
Yog tias AC ua ke nrog qis dua esophageal caws pliav stenosis, qog, thiab lwm yam, kev phais mob esophagagects yuav suav tau.
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Lub Sijhawm Post: Jul-09-2024