Isingeniso
I-Achalasia ye-cardia (AC) iyisifo esingapheliisifo sokuqala sokuhamba komphimbo.Ngenxa yokungaphumuli kahle kwe-sphincter engezansi ye-esophageal (LES) kanye nokuntuleka kwe-esophageal peristalsis, ukugcinwa kokudla kuholelaIzimpawu zomtholampilo ezifana nokopha, ubuhlungu besifuba kanye nokwehla kwesisindo.Ukusabalala cishe kungama-32.58/100,000.
IukwelashwaI-achalasia ihlanganisa kakhulu ukwelashwa okungadingi ukuhlinzwa, ukwelashwa kokukhulisa kanye nokwelashwa kokuhlinzwa.
01 Ukwelashwa Kwezokwelapha
Indlela yokwelapha ngemithi ukunciphisa ingcindezi ye-LES esikhathini esifushane.Akukho bufakazi obucacile bokuthi izidakamizwa zingathuthukisa njalo futhi ngempumelelo izimpawu ze-AC.Imithi esetshenziswa kakhulu njengamanje ihlanganisa ama-nitrate, ama-calcium channel blockers, kanye nama-β-receptor agonists.
(1)Ama-nitrate, njenge-nitroglycerin, i-amyl nitrate, kanye ne-isosorbide dinitrate
(2)Ama-blocker eziteshi ze-calcium, njenge-nifedipine, i-verapamil, ne-diltiazem
(3)ama-agonist e-β-receptor, njenge-cabuterol
02 Umjovo We-Endoscopic Botulinum Toxin (BTI)
Umjovo we-botulinum toxin (BTl) we-endoscopic ungasetshenziswa ukwelapha i-AC,kodwa inganikeza imiphumela yesikhashana kuphela futhi ingasetshenziswa ezigulini ezindala ezinezingozi eziphezulu zokuhlinzwa kanye ne-anesthesia.
1) Izinkomba:iziguli ezineminyaka ephakathi nendawo kanye nasebekhulile (abangaphezu kweminyaka engama-40 ubudala); labo abangakwazi ukubekezelela i-endoscopic balloon dilation (PD) noma ukwelashwa ngokuhlinzwa; labo abanezindlela eziningi zokwelapha i-PD noma imiphumela emibi yokwelashwa ngokuhlinzwa; labo abanezimbobo zomqala ngesikhathi sokwelashwa kwe-PD Kulabo abanengozi enkulu, ingasetshenziswa futhi kanye ne-PD; ingasetshenziswa njengoshintsho ekuhlinzeni noma ekwelashweni kwe-PD.
(2) Izimo ezingahambisani nalokhu:Akukhuthazwa ukwelashwa kokuqala kwe-AC ezigulini ezisencane (ezineminyaka engu-≤40 ubudala).
03 Ukwanda Kwebhaluni Le-Endoscopic (PD)
Ukwanda kwebhaluni kunemiphumela ethile ku-AC, kodwa kudinga ukwelashwa okuningi futhi kuthwala ingozi yezinkinga ezinkulu.
(1) Izinkomba:Iziguli ze-AC ezingenakho ukungasebenzi kahle kwenhliziyo namaphaphu, ukungasebenzi kahle kokujikeleza kwegazi, njll.; amadoda angaphezu kweminyaka engama-50 ubudala nabesifazane abangaphezu kweminyaka engama-35 ubudala; iziguli ezihlulekile ukuhlinzwa. Ingasetshenziswa njengendlela yokwelapha yokuqala yokukhetha.
(2) Izimo ezingahambisani nalokhu:Ukwehluleka okukhulu kwenhliziyo namaphaphu, ukungasebenzi kahle kokugaya ukudla kanye nengozi ephezulu yokubhoboka komphimbo.
04 I-Peroscopic Endoscopic Myotomy (INKONDLO)
Eminyakeni yamuva nje, ngokusetshenziswa okukhulu kwe-peroral endoscopic myotomy (POEM), izinga lempumelelo yokwelashwa kwe-AC emtholampilo likhuphuke kakhulu.Ukwelashwa kwe-AC nge-POEM kuhambisana kakhulu nomqondo "wokuhlinzwa okuncane kakhulu", okungukuthi, izilonda kuphela ezisuswayo/ezisuswayo ngesikhathi senqubo yokwelashwa, futhi izitho zomzimba azisuswa.Ubuqotho kanye nokusebenza kwesakhiwo somzimba kuyagcinwa, futhi ikhwalithi yokuphila kwesiguli ngemva kokuhlinzwa ayithinteki. Ukuvela kwe-POEM kwenze ukwelashwa kwe-AC kwaba yinto encane kakhulu.
Isithombe: Izinyathelo zokuhlinzwa ze-POEM
Ukusebenza kahle kwe-POEM phakathi nesikhathi eside ekwelapheni i-AC kuhambisana nokusebenza kwe-laparoscopic Heller myotomy (LHM)ingasetshenziswa njengendlela yokwelashwa yokuqala.Ezinye iziguli zingase zibe nezimpawu ze-reflux ye-gastroesophageal ngemva kokuhlinzwa kwe-POEM
(1) Izinkomba eziphelele:I-AC engenakho ukunamathela okukhulu kwe-submucosal, ukuphazamiseka kokusebenza kwesisu kanye ne-diverticulum enkulu.
(2) Izinkomba ezihlobene:Ukwanda kwe-spasm ye-esophageal, i-nutcracker esophagus nezinye izifo zokunyakaza kwe-esophageal, iziguli ezine-POEM noma ukuhlinzwa kwe-Heller okuhlulekile, kanye ne-AC ene-submucosal adhesions ethile ye-esophageal.
(3) Izimo ezingahambisani nalokhu:Iziguli ezinenkinga enkulu yokungasebenzi kahle kokugaya ukudla, isifo senhliziyo namaphaphu, isimo esibi jikelele, njll. ezingakwazi ukubekezelela ukuhlinzwa.
05 I-Laparoscopic Heller Myotomy (LHM)
I-LHM inamandla amahle ekwelapheni i-AC, futhi ngokuyisisekelo ithathelwe indawo yi-POEM ezindaweni lapho izimo zivuma khona.
06 Ukuhlinzwa Kokuhlinza Umlomo
Uma i-AC ihlanganiswa ne-stenosis yesibazi esiphansi somqala, izimila, njll., ukuhlinzwa kwe-esophagectomy kungacatshangelwa.
Thina, iJiangxi Zhuoruihua Medical Instrument Co.,Ltd., singumkhiqizi eShayina ogxile ezintweni ezisetshenziswayo ze-endoscopic, njengei-biopsy forceps, i-hemoclip, ugibe lwe-polyp, inaliti ye-sclerotherapy, i-catheter yokufafaza, amabhulashi e-cytology, ucingo lokuqondisa, ubhasikidi wokuthola amatshe, i-catheter yokukhipha amanzi ekhaleninjll. ezisetshenziswa kabanzi ku-I-EMR, I-ESD,I-ERCPImikhiqizo yethu inesitifiketi se-CE, kanti izitshalo zethu zinesitifiketi se-ISO. Izimpahla zethu zithunyelwe eYurophu, eNyakatho Melika, eMpumalanga Ephakathi kanye nengxenye ye-Asia, futhi zithola ukuqashelwa nokunconywa kakhulu ngamakhasimende!
Isikhathi sokuthunyelwe: Julayi-09-2024