Kev Taw Qhia
Achalasia ntawm cardia (AC) yog ib qhokev tsis taus ntawm txoj hlab pas thawj zaug.Vim yog qhov tsis zoo ntawm lub sphincter qis esophageal (LES) thiab tsis muaj esophageal peristalsis, cov khoom noj khaws cia ua raudysphagia thiab kev ua xua. Cov tsos mob xws li los ntshav, mob hauv siab thiab poob phaus.Qhov feem pua ntawm kev pheej hmoo yog kwv yees li 32.58 / 100,000.
Lubkev kho mobKev kho mob achalasia feem ntau suav nrog kev kho mob tsis yog phais, kev kho mob dilation thiab kev kho mob phais.
01Kev Kho Mob
Lub tshuab ntawm kev kho mob tshuaj yog kom txo qhov siab ntawm LES hauv lub sijhawm luv luv.Tsis muaj pov thawj tseeb tias cov tshuaj tuaj yeem txhim kho cov tsos mob ntawm AC tau zoo tas mus li.Cov tshuaj siv niaj hnub no suav nrog nitrates, calcium channel blockers, thiab β-receptor agonists.
(1)Cov Nitratescov tshuaj xws li nitroglycerin, amyl nitrate, thiab isosorbide dinitrate
(2)Cov tshuaj calcium channel blockerscov tshuaj xws li nifedipine, verapamil, thiab diltiazem
(3)Cov tshuaj agonist β-receptorxws li cabuterol
02 Kev Txhaj Tshuaj Botulinum Toxin Endoscopic (BTI)
Kev txhaj tshuaj botulinum toxin endoscopic (BTl) siv tau los kho AC,tab sis nws tsuas yog muab cov teebmeem luv luv xwb thiab siv tau rau cov neeg laus uas muaj kev pheej hmoo siab ntawm kev phais thiab kev siv tshuaj loog.
1) Cov cim qhia:cov neeg mob hnub nyoog nruab nrab thiab cov neeg laus (>40 xyoo); cov neeg uas tsis tuaj yeem ua siab ntev rau kev siv lub tshuab endoscopic balloon dilation (PD) lossis kev phais mob; cov neeg uas tau kho ntau yam PD lossis cov txiaj ntsig kho mob phais mob tsis zoo; cov neeg uas muaj qhov ncauj plab thaum kho PD Rau cov neeg uas muaj kev pheej hmoo siab, nws kuj tseem siv tau ua ke nrog PD; nws tuaj yeem siv ua kev hloov pauv mus rau kev phais mob lossis kev kho mob PD.
(2) Cov Kev Txwv Tsis Pub Siv:Tsis pom zoo kom siv cov tshuaj AC thawj zaug rau cov neeg mob hluas (≤40 xyoo).
03 Kev Siv Lub Tshuab Nqus Pa Endoscopic (PD)
Kev nthuav dav ntawm lub zais pa muaj qee yam teebmeem rau AC, tab sis xav tau ntau txoj kev kho mob thiab muaj kev pheej hmoo ntawm cov teeb meem loj.
(1) Cov cim qhia:Cov neeg mob AC uas tsis muaj mob plawv thiab lub ntsws tsis ua haujlwm zoo, ntshav khov tsis ua haujlwm zoo, thiab lwm yam; cov txiv neej hnub nyoog tshaj 50 xyoo thiab cov poj niam hnub nyoog tshaj 35 xyoo; cov neeg mob uas tsis tau phais. Nws tuaj yeem siv ua txoj kev kho mob thawj zaug.
(2) Cov Kev Txwv Tsis Pub Siv:Mob plawv tsis ua haujlwm zoo, ntshav coagulation tsis zoo, thiab muaj feem yuav mob esophageal perforation.
04 Kev Siv Tshuaj Endoscopic Myotomy (POEM)
Nyob rau xyoo tas los no, nrog rau kev siv loj ntawm peroral endoscopic myotomy (POEM), qhov kev vam meej ntawm kev kho mob AC tau nce ntxiv ntau heev.Kev kho mob POEM ntawm AC yog sib xws nrog lub tswv yim ntawm "kev phais mob tsawg kawg nkaus", uas yog, tsuas yog cov qhov txhab raug tshem tawm / tshem tawm thaum lub sijhawm kho mob, thiab cov kabmob tsis raug tshem tawm.Qhov kev ncaj ncees thiab kev ua haujlwm ntawm cov qauv anatomical raug tswj hwm, thiab tus neeg mob lub neej zoo tom qab phais tsis raug cuam tshuam. Kev tshwm sim ntawm POEM tau ua rau kev kho mob ntawm AC super minimally invasive.
Daim Duab: Cov kauj ruam phais POEM
Qhov ua tau zoo ntawm POEM hauv kev kho mob AC nruab nrab thiab ntev yog sib xws nrog laparoscopic Heller myotomy (LHM)siv tau ua thawj txoj kev kho mob.Qee tus neeg mob yuav muaj cov tsos mob ntawm gastroesophageal reflux tom qab phais POEM
(1) Cov cim qhia meej:AC tsis muaj kev sib txuas submucosal loj heev, kev ua haujlwm ntawm lub plab zom mov tsis zoo thiab diverticulum loj heev.
(2) Cov cim qhia txog kev sib piv:Diffuse esophageal spasm, nutcracker esophagus thiab lwm yam kab mob esophageal motility, cov neeg mob uas tsis ua tiav POEM lossis Heller phais, thiab AC nrog qee qhov esophageal submucosal adhesions.
(3) Cov Kev Txwv Tsis Pub Siv:Cov neeg mob uas muaj teeb meem ntshav khov loj heev, muaj kab mob plawv thiab ntsws loj heev, mob nkeeg, thiab lwm yam uas tsis tuaj yeem zam kev phais.
05 Laparoscopic Heller Myotomy (LHM)
LHM muaj txiaj ntsig zoo rau kev kho AC mus sij hawm ntev, thiab feem ntau tau hloov los ntawm POEM hauv cov chaw uas muaj xwm txheej tso cai.
06Kev phais mob plab
Yog tias AC raug ua ke nrog qhov caws pliav qis dua ntawm txoj hlab pas, qog nqaij hlav, thiab lwm yam, kev phais mob esophagectomy yuav raug txiav txim siab.
Peb, Jiangxi Zhuoruihua Medical Instrument Co., Ltd., yog lub chaw tsim khoom hauv Suav teb tshwj xeeb hauv cov khoom siv endoscopic, xws licov forceps biopsy, hemoclip, polyp snare, koob txhaj tshuaj sclerotherapy, tshuaj tsuag catheter, cov txhuam cytology, txoj hlua qhia, pob zeb rov qab tau pob zeb, lub raj xa dej ntawm lub qhov ntswgthiab lwm yam uas siv dav hauvEMR, ESD,ERCPPeb cov khoom muaj daim ntawv pov thawj CE, thiab peb cov nroj tsuag muaj daim 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 kev lees paub thiab qhuas los ntawm cov neeg siv khoom!
Lub sijhawm tshaj tawm: Lub Xya Hli-09-2024