Peptic ulcer feem ntau yog hais txog cov kab mob ntev uas tshwm sim hauv plab thiab duodenal qhov muag.Nws yog lub npe vim tias kev tsim cov kab mob muaj feem cuam tshuam nrog kev zom zaub mov ntawm gastric acid thiab pepsin, uas suav txog li 99% ntawm cov kab mob peptic.
Peptic ulcer yog ib hom kab mob benign uas muaj thoob plaws ntiaj teb.Raws li kev txheeb cais, duodenal ulcers yuav tshwm sim nyob rau hauv cov tub ntxhais hluas, thiab lub hnub nyoog ntawm pib ntawm gastric ulcer yog tom qab, nyob rau hauv nruab nrab, li ntawm 10 xyoo tom qab ntawm lub duodenal ulcers.Qhov tshwm sim ntawm duodenal ulcers yog kwv yees li 3 npaug ntawm lub plab rwj..Nws feem ntau ntseeg tias qee qhov mob plab yuav ua mob qog noj ntshav, thaum cov kab mob duodenal feem ntau tsis ua.
Daim duab 1-1 Daim duab gastroscopic ntawm cov mob qog noj ntshav thaum ntxov daim duab 1-2 Cov duab gastroscopic ntawm cov mob qog noj ntshav siab.
1. Feem ntau cov kab mob peptic yog kho tau
Hauv cov neeg mob uas muaj kab mob peptic, feem ntau ntawm lawv tuaj yeem kho tau: kwv yees li 10% -15% ntawm lawv tsis muaj tsos mob, thaum cov neeg mob feem ntau muaj cov tsos mob tshwm sim, xws li: mob ntev, lub sijhawm pib ntawm lub caij nplooj zeeg thiab lub caij ntuj no thiab lub caij ntuj no thiab caij nplooj ntoos hlav. mob plab.
Duodenal ulcers feem ntau tshwm sim nrog kev mob nrawm nrawm, thaum lub plab rwj feem ntau tshwm sim nrog mob tom qab.Qee cov neeg mob feem ntau tsis muaj qhov tshwm sim hauv chaw kho mob, thiab lawv thawj cov tsos mob yog hemorrhage thiab mob perforation.
Upper gastrointestinal angiography lossis gastroscopy feem ntau tuaj yeem lees paub qhov kev kuaj mob, thiab kev kho mob nrog cov kua qaub, cov tshuaj tiv thaiv kab mob plab, thiab tshuaj tua kab mob tuaj yeem ua rau cov neeg mob feem ntau zoo.
2.Recurrent plab ulcers yog suav hais tias precancerous lesions
Gastric ulcers muaj qee yam mob qog noj ntshav.Nws feem ntau tshwm sim nyob rau hauv nruab nrab-hnub nyoog thiab laus dua, txiv neej, rov tshwm sim rwj uas tsis tuaj yeem kho tau ntev.Qhov tseeb, pathological biopsy yuav tsum tau nqa tawm rau tag nrho cov plab hnyuv siab raum hauv kev kho mob, tshwj xeeb tshaj yog cov kab mob saum toj no.Kev tiv thaiv kab mob tsuas tuaj yeem ua tiav tom qab kev mob qog noj ntshav yuav tsum raug cais tawm, txhawm rau tiv thaiv kev kuaj mob tsis raug thiab ncua ntawm tus kab mob.Tsis tas li ntawd, tom qab kev kho mob plab hnyuv, rov kuaj xyuas yuav tsum tau ua kom pom cov kev hloov pauv hauv kev kho mob thiab kho kev kho mob.
Duodenal ulcers tsis tshua muaj mob cancer, tab sis cov kab mob plab rov qab tam sim no tau txiav txim siab los ntawm ntau tus kws tshaj lij los ua qhov mob ua ntej.
Raws li Suav cov ntaub ntawv tshaj tawm, kwv yees li 5% ntawm cov kab mob plab tuaj yeem ua rau mob qog noj ntshav, thiab tam sim no tus lej no nce ntxiv.Raws li kev txheeb cais, txog li 29.4% ntawm cov qog nqaij hlav plab los ntawm plab hnyuv.
Cov kev tshawb fawb tau pom tias cov neeg mob qog nqaij hlav hauv plab muaj txog li 5% -10% ntawm qhov mob plab.Feem ntau hais lus, feem ntau cov neeg mob uas mob plab ulceration muaj keeb kwm ntev ntawm kev mob plab hnyuv.Rov ua dua kev puas tsuaj ntawm cov hlwb epithelial ntawm ntug ntawm lub qhov txhab thiab cov mucosal kho thiab rov tsim dua tshiab, metaplasia, thiab atypical hyperplasia ua rau muaj kev mob qog noj ntshav thaum lub sijhawm.
Mob qog noj ntshav feem ntau tshwm sim nyob rau hauv ib puag ncig mucosa ntawm ulcers.Cov mucosa ntawm cov khoom no erodes thaum lub rwj yog rwj, thiab tuaj yeem ua malignant tom qab kev puas tsuaj thiab rov tsim dua tshiab.Nyob rau hauv xyoo tas los no, vim muaj kev vam meej ntawm kev kuaj mob thiab kev kuaj mob, nws tau pom tias mob qog noj ntshav thaum ntxov uas nyob rau hauv cov mucosa tuaj yeem raug eroded thiab ulcerated, thiab nws cov ntaub so ntswg tuaj yeem hloov pauv los ntawm cov kab mob peptic thib ob.Cov kab mob qog noj ntshav no tuaj yeem kho tau zoo li benign ulcers.thiab kho tuaj yeem rov ua dua, thiab cov txheej txheem ntawm tus kab mob tuaj yeem txuas ntxiv rau ob peb lub hlis lossis ntev dua, yog li kev mob plab hnyuv yuav tsum tau them nyiaj zoo.
3. Dab tsi yog cov cim qhia ntawm kev hloov pauv ntawm lub plab zom mov?
1. Kev hloov pauv ntawm qhov xwm txheej thiab tsis tu ncua ntawm qhov mob:
Qhov mob ntawm plab rwj feem ntau tshwm sim raws li qhov mob npub ntawm lub plab sab sauv, uas yog kub hnyiab lossis npub, thiab qhov pib ntawm qhov mob yog cuam tshuam nrog kev noj mov.Yog tias qhov mob poob qhov tsis tu ncua ntawm cov lus hais saum toj no, dhau los ua qhov tsis sib xws, lossis dhau los ua qhov mob tsis tu ncua, lossis qhov xwm txheej ntawm qhov mob tau hloov pauv ntau piv nrog yav dhau los, nws yuav tsum ceeb toom rau harbinger ntawm mob qog noj ntshav.
2. Tsis siv tshuaj tiv thaiv kab mob:
Txawm hais tias mob plab ulcers feem ntau yuav rov tshwm sim dua, cov tsos mob feem ntau zoo dua tom qab noj tshuaj tiv thaiv kab mob.
3. Cov neeg mob hnyav zuj zus:
Nyob rau hauv lub sij hawm luv luv, tsis qab los noj mov, xeev siab, ntuav, kub taub hau thiab hnyav poob, poob phaus, muaj peev xwm ntawm mob qog noj ntshav yog siab heev.
4. Hematemesis thiab melena tshwm:
Tus neeg mob tsis ntev los no ntuav ntshav los yog cov quav tso quav, tsis tu ncua kev kuaj ntshav fecal occult, thiab mob ntshav qab zib hnyav qhia tias cov kab mob plab tuaj yeem hloov mus ua mob qog noj ntshav.
5. Masses tshwm hauv plab:
Cov neeg mob plab rwj feem ntau tsis tsim cov plab hnyuv, tab sis yog tias lawv ua mob qog noj ntshav, cov rwj yuav loj dua thiab tawv, thiab cov neeg mob siab heev tuaj yeem hnov qhov loj ntawm sab laug sab plab plab.Qhov loj ntawm qhov loj yog feem ntau nyuaj, nodular thiab tsis du.
6.Cov neeg uas muaj hnub nyoog tshaj 45 xyoos, muaj keeb kwm mob plab yav dhau los, thiab tau rov ua cov tsos mob tsis ntev los no, xws li hiccups, belching, mob plab, thiab nrog rau kev poob phaus.
7. Positive fecal occult ntshav:
Rov ua dua qhov zoo, nco ntsoov mus rau hauv tsev kho mob kom paub meej.
8. Lwm tus:
Ntau tshaj 5 xyoos tom qab phais plab, muaj cov tsos mob ntawm plab zom mov, poob phaus, anemia thiab gastric los ntshav, thiab tsis tau piav qhia txog plab plab, belching, tsis xis nyob, qaug zog, poob phaus, thiab lwm yam.
4, Qhov ua rau mob plab
Lub etiology ntawm peptic ulcer tseem tsis tau to taub tag nrho, tab sis nws tau qhia meej tias tus kab mob Helicobacter pylori, noj cov tshuaj uas tsis yog steroidal anti-inflammatory thiab tshuaj antithrombotic, nrog rau ntau dhau ntawm gastric acid secretion, genetic yam, kev puas siab puas ntsws thiab kev xav hloov, thiab. Kev noj zaub mov tsis tu ncua Kev sib deev, noj khoom txom ncauj, haus luam yeeb, haus dej haus, thaj chaw ib puag ncig thiab kev nyab xeeb, cov kab mob ntev xws li emphysema thiab kab mob siab B kuj muaj feem cuam tshuam rau qhov tshwm sim ntawm peptic ulcer.
1. Helicobacter pylori (HP) kab mob:
Marshall thiab Warren yeej 2005 Nobel nqi zog hauv Tshuaj rau kev ua tiav kev loj hlob ntawm Helicobacter pylori hauv 1983 thiab qhia tias nws tus kab mob ua lub luag haujlwm hauv cov kab mob peptic ulcers.Ntau cov kev tshawb fawb tau ua pov thawj tag nrho tias tus kab mob Helicobacter pylori yog qhov ua rau mob plab peptic.
2. Yam tshuaj thiab kev noj haus:
Kev siv tshuaj ntev ntev xws li tshuaj aspirin thiab corticosteroids feem ntau ua rau tus kab mob no.Tsis tas li ntawd, kev haus luam yeeb ntev ntev, haus dej mus ntev, thiab haus cov tshuaj yej muaj zog thiab kas fes zoo li muaj feem cuam tshuam.
(1) Kev npaj ntau yam tshuaj aspirin: kev siv ntev lossis ntau npaum li cas tuaj yeem ua rau mob plab thiab tsis xis nyob.Nyob rau hauv cov xwm txheej hnyav, hematemesis, melena, thiab lwm yam, tuaj yeem pom nyob rau hauv lub plab mucosal o, erosion thiab rwj tsim.
(2) Cov tshuaj hloov tshuaj hormones:
Cov tshuaj xws li indomethacin thiab phenylbutazone yog cov tshuaj hloov tshuaj hormones, uas muaj kev puas tsuaj rau lub plab hnyuv thiab tuaj yeem ua rau mob plab hnyuv.
(3) Antipyretic analgesics:
Xws li A.PC, paracetamol, tshuaj kho mob thiab tshuaj txias xws li Ganmaotong.
3. plab acid thiab pepsin:
Qhov kawg tsim ntawm peptic ulcers yog vim nws tus kheej-gestion ntawm gastric acid / pepsin, uas yog txiav txim siab qhov tshwm sim ntawm ulcers.Qhov thiaj li hu ua "acid-free ulcers".
4. Kev nyuaj siab ntxhov plawv:
Kev ntxhov siab tuaj yeem ua rau muaj kev ntxhov siab.Cov neeg uas muaj kev ntxhov siab ntev, ntxhov siab, lossis lub siab hloov pauv yog qhov ua rau mob plab
mob plab.
5. Cov yam ntxwv ntawm caj ces:
Hauv qee cov kab mob tsis tshua muaj caj ces, xws li ntau yam endocrine adenoma type I, systemic mastocytosis, thiab lwm yam, peptic ulcer yog ib feem ntawm nws qhov kev kho mob tshwm sim.
6. Kab mob plab tsis zoo:
Qee cov neeg mob plab rwj muaj cov kab mob hauv plab, xws li cov kua qaub ntau ntxiv uas tshwm sim los ntawm kev ua rau lub plab zom mov qeeb thiab duodenal-gastric reflux los ntawm cov kua tsib, kua txiv pancreatic thiab lysolecithin kev puas tsuaj rau cov mucosa.
7. Lwm yam tseem ceeb:
Xws li tus kab mob hauv zos ntawm tus kab mob herpes simplex hom kuv yuav muaj feem cuam tshuam.Kev kis kab mob cytomegalovirus kuj tseem tuaj yeem koom nrog hauv kev hloov lub raum lossis cov neeg mob tiv thaiv kab mob.
Hauv kev xaus, cov kab mob tuaj yeem tiv thaiv tau zoo los ntawm kev txhim kho txoj kev ua neej, noj tshuaj rationally, tshem tawm Helicobacter pylori, thiab noj gastroscopy raws li niaj hnub tshuaj xyuas lub cev;
Thaum muaj qhov txhab tshwm sim, nws yog ib qho tsim nyog yuav tsum ua tib zoo tswj cov kev kho mob thiab ua cov tshuaj gastroscopy tsis tu ncua (txawm tias qhov txhab kho tau zoo), txhawm rau tiv thaiv qhov tshwm sim ntawm qog noj ntshav.
"Qhov tseem ceeb ntawm gastroscopy feem ntau tuaj yeem siv los nkag siab seb tus neeg mob lub plab, plab thiab duodenum muaj qhov sib txawv ntawm qhov mob, mob, qog nqaij hlav thiab lwm yam kab mob.Gastroscopy kuj yog ib qho kev tshuaj xyuas ncaj qha uas tsis tuaj yeem hloov tau, thiab qee lub tebchaws tau txais kev kuaj mob plab.Raws li cov khoom kuaj xyuas kev noj qab haus huv, kev kuaj mob yuav tsum tau ua ob zaug hauv ib xyoos, vim tias qhov tshwm sim ntawm kev mob qog noj ntshav thaum ntxov hauv qee lub tebchaws yog qhov siab.Yog li ntawd, tom qab kuaj pom ntxov thiab kho raws sijhawm, kev kho mob kuj pom tseeb. "
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!
Post lub sij hawm: Aug-15-2022