Taw qhia
Achalasia ntawm cardia (AC) yog athawj esophageal motility tsis meej.Vim tsis muaj kev so tsis zoo ntawm qhov qis esophageal sphincter (LES) thiab tsis muaj esophageal peristalsis, cov khoom noj khaws cia tau ua raudysphagia thiab tshuaj tiv thaiv. Cov tsos mob xws li los ntshav, mob hauv siab thiab poob phaus.Qhov tshwm sim yog kwv yees li 32.58 / 100,000.
Covkev kho mobntawm achalasia feem ntau suav nrog kev kho tsis yog phais, kho dilation thiab kev kho phais.
01 Kev Kho Mob
Cov txheej txheem ntawm kev kho tshuaj yog txo qis LES siab hauv lub sijhawm luv.Tsis muaj pov thawj pom tseeb tias cov tshuaj tuaj yeem ua haujlwm tsis tu ncua thiab txhim kho cov tsos mob ntawm AC.Tam sim no feem ntau siv tshuaj muaj xws li nitrates, calcium channel blockers, 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
02 Endoscopic Botulinum Toxin Txhaj Tshuaj (BTI)
Endoscopic botulinum toxin txhaj (BTl) tuaj yeem siv los kho AC,tab sis nws tsuas tuaj yeem muab cov teebmeem luv luv thiab siv tau rau cov neeg laus laus uas muaj kev pheej hmoo siab ntawm kev phais thiab tshuaj loog.
1) Cov lus qhia:cov neeg mob hnub nyoog nruab nrab thiab cov neeg laus (> 40 xyoo); cov neeg uas tsis tuaj yeem ua rau lub ntsej muag endoscopic balloon dilation (PD) lossis kev kho mob phais; cov neeg uas muaj ntau yam kev kho PD lossis kev kho mob tsis zoo; cov neeg uas muaj esophageal perforation thaum lub sij hawm kho PD Rau cov neeg uas muaj kev pheej hmoo siab, nws kuj siv tau nrog PD; nws tuaj yeem siv los ua kev hloov pauv mus rau kev phais lossis kev kho PD.
(2) Contraindications:Nws tsis pom zoo rau kev kho thawj kab ntawm AC hauv cov neeg mob hluas (≤40 xyoo).
03 Endoscopic Balloon Dilation (PD)
Balloon dilatation muaj qee yam cuam tshuam rau AC, tab sis yuav tsum tau kho ntau yam thiab ua rau muaj kev pheej hmoo ntawm cov teeb meem loj.
(1) Cov lus qhia:AC cov neeg mob uas tsis muaj cardiopulmonary insufficiency, coagulation dysfunction, thiab lwm yam.; cov txiv neej hnub nyoog tshaj 50 xyoo thiab cov poj niam tshaj 35 xyoo; cov neeg mob uas ua tsis tau tejyam phais. Nws tuaj yeem siv los ua thawj txoj kev kho mob.
(2) Contraindications:Mob hnyav cardiopulmonary insufficiency, coagulation dysfunction thiab muaj kev pheej hmoo ntawm esophageal perforation.
04 Peroral Endoscopic Myotomy (POEM)
Nyob rau hauv xyoo tas los no, nrog rau kev siv loj ntawm peroral endoscopic myotomy (POEM), qhov ua tiav ntawm kev kho mob ntawm AC tau nce ntau.POEM kev kho mob ntawm AC yog zoo ib yam nrog lub tswv yim ntawm "super minimally invasive phais", uas yog, tsuas yog qhov txhab raug tshem tawm / tshem tawm thaum lub sij hawm kev kho mob, thiab lub cev tsis raug tshem tawm.Kev ncaj ncees thiab kev ua haujlwm ntawm cov qauv anatomical yog khaws cia, thiab tus neeg mob lub neej tom qab kev ua haujlwm zoo yog qhov pib tsis cuam tshuam. Qhov tshwm sim ntawm POEM tau ua rau kev kho mob ntawm AC super minimally invasive.
Daim duab: POEM phais cov kauj ruam
Qhov nruab nrab- thiab mus sij hawm ntev ntawm POEM hauv kev kho mob ntawm AC yog zoo ib yam nrog cov laparoscopic Heller myotomy (LHM)tuaj yeem siv ua thawj kab kev xaiv.Qee tus neeg mob tuaj yeem tsim cov tsos mob gastroesophageal reflux tom qab POEM phais
(1) Cov lus qhia meej:AC tsis muaj qhov ua rau submucosal adhesion loj, gastric functional emptying disorder thiab loj diverticulum.
(2) txheeb ze indications:Diffuse esophageal spasm, nutcracker esophagus thiab lwm yam kab mob esophageal motility, cov neeg mob uas ua tsis tau tejyam POEM los yog Heller phais, thiab AC nrog ib co esophageal submucosal adhesions.
(3) Contraindications:Cov neeg mob uas muaj kev coagulation hnyav, mob plawv mob hnyav, mob tsis zoo, thiab lwm yam uas tsis tuaj yeem ua rau phais.
05 Laparoscopic Heller Myotomy (LHM)
LHM muaj kev ua tau zoo mus sij hawm ntev hauv kev kho AC, thiab tau hloov pauv los ntawm POEM hauv cov chaw uas muaj kev tso cai.
06 Kev phais esophagectomy
Yog hais tias AC yog ua ke nrog qis esophageal caws pliav stenosis, qog, thiab lwm yam, kev phais esophagectomy yuav raug txiav txim siab.
Peb, Jiangxi Zhuoruihua Medical Instrument Co., Ltd., yog cov chaw tsim khoom hauv Suav teb tshwj xeeb hauv cov khoom siv endoscopic, xws libiopsy forceps, hemoclip, polyp nuv, koob sclerotherapy, tshuaj tsuag catheter, cytology txhuam, phau ntawv qhia, pob zeb retrieval pob tawb, qhov ntswg biliary kua catheteretc. uas yog dav siv nyob rau hauvEMR, ESD,ERCP. Peb cov khoom muaj ntawv pov thawj CE, thiab peb cov nroj tsuag tau ntawv pov thawj ISO. Peb cov khoom tau raug xa tawm mus rau Tebchaws Europe, North America, Middle East thiab ib feem ntawm Asia, thiab tau txais cov neeg siv khoom ntawm kev lees paub thiab qhuas!
Lub sij hawm xa tuaj: Plaub Hlis-09-2024