I-Peptic ulcer ibhekisela kakhulu esilonda esingapheli esenzeka esiswini kanye ne-duodenal bulb.Iqanjwe ngoba ukwakheka kwesilonda kuhlobene nokugaya kwe-gastric acid kanye ne-pepsin, okubalelwa ku-99% wesilonda se-peptic.
I-Peptic ulcer yisifo esivamile esiyingozi esisakazwa emhlabeni wonke.Ngokwezibalo, izilonda ze-duodenal zivame ukwenzeka kubantu abadala, futhi iminyaka yokuqala yezilonda zesisu kamuva, ngokwesilinganiso, cishe eminyakeni eyi-10 kamuva kunaleyo yezilonda ze-duodenal.Isigameko sezilonda ze-duodenal cishe izikhathi ezi-3 kunezilonda zesisu..Ngokuvamile kunenkolelo yokuthi ezinye izilonda zesisu zizoba nomdlavuza, kuyilapho izilonda ze-duodenal ngokuvamile azikwenzi.
Umfanekiso 1-1 Isithombe se-gastroscopic somdlavuza weqhwa wangaphambi kwesikhathi Umfanekiso 1-2 Isithombe se-gastroscopic somdlavuza osezingeni eliphezulu.
1. Izilonda eziningi ze-peptic ziyelapheka
Ezigulini ezine-peptic ulcer, iningi lazo lingelapheka: cishe u-10% -15% wazo awunazo izimpawu, kuyilapho iziguli eziningi zinezimpawu zomtholampilo ezijwayelekile, okungukuthi: ukuqala okungapheli, okunesigqi kokuqala ngezikhathi ezithile ekwindla nasebusika nasebusika nasentwasahlobo. isisu esibuhlungu.
Izilonda ze-Duodenal zivame ukuba nobuhlungu bokuzila ukudla okunesigqi, kuyilapho izilonda zesisu zivame ukuba nobuhlungu be-postprandial.Ezinye iziguli ngokuvamile azinazo izimpawu zomtholampilo ezivamile, futhi izimpawu zazo zokuqala ukopha nokubhobozwa kakhulu.
I-angiography ye-gastrointestinal engenhla noma i-gastroscopy ngokuvamile ingaqinisekisa ukuxilongwa, futhi ukwelashwa okuhlangene okuhlangene nama-acids, ama-agent okuvikela ama-mucosal esiswini, kanye nama-antibiotics angenza iziguli eziningi zilulame.
2.Izilonda zesisu eziphindelelayo zithathwa njengezilonda ezidala umdlavuza
Izilonda zesisu zinezinga elithile lomdlavuza.Ivela kakhulu eminyakeni yobudala ephakathi nangaphezulu, owesilisa, izilonda eziphindelelayo ezingenakwelashwa isikhathi eside.Eqinisweni, i-pathological biopsy kufanele yenziwe kuzo zonke izilonda zesisu emisebenzini yomtholampilo, ikakhulukazi izilonda ezibalwe ngenhla.Ukwelashwa kwe-anti-ulcer kungenziwa kuphela ngemuva kokuthi umdlavuza kufanele ukhishwe, ukuze kuvinjwe ukutholakala okungalungile nokubambezeleka kwesifo.Ngaphezu kwalokho, ngemva kokwelashwa kwesilonda esiswini, ukuhlolwa kabusha kufanele kwenziwe ukuze kubonwe izinguquko ekuphulukisweni kwesilonda futhi kulungiswe izindlela zokwelashwa.
Izilonda ze-Duodenal azivamile ukuba nomdlavuza, kodwa izilonda zesisu eziphindelelayo manje sezibhekwa ochwepheshe abaningi njengesilonda esiyingozi.
Ngokwemibiko yezincwadi zaseShayina, cishe amaphesenti angu-5 ezilonda zesisu angaba nomdlavuza, futhi lesi sibalo siyanda okwamanje.Ngokwezibalo, kufike ku-29.4% womdlavuza wesisu uqhamuka ezilonda zesisu.
Ucwaningo luthole ukuthi iziguli ezinomdlavuza wesisu zenza cishe u-5% -10% wezigameko zezilonda zesisu.Ngokuvamile, iziguli eziningi ezinomdlavuza wezilonda zesisu zinomlando omude wezilonda zesisu ezingapheli.Ukubhujiswa okuphindaphindiwe kwamangqamuzana e-epithelial emaphethelweni ezilonda kanye nokulungiswa kwe-mucosal nokuvuselelwa, i-metaplasia, ne-atypical hyperplasia kwandisa amathuba okuba nomdlavuza ngokuhamba kwesikhathi.
Umdlavuza uvame ukuvela ku-mucosa ezungezile yezilonda.I-mucosa yalezi zingxenye iguguleka lapho isilonda sisebenza, futhi singaba yingozi ngemva kokubhujiswa okuphindaphindiwe nokuvuselelwa.Eminyakeni yamuva, ngenxa yenqubekelaphambili yokuxilongwa kanye nezindlela zokuhlola, kutholakale ukuthi umdlavuza wesisu wasekuqaleni ovalelwe ku-mucosa ungaguguleka futhi ube nezilonda, futhi indawo yawo yezicubu ingashintshwa yizilonda zesibili ze-peptic.Lezi zilonda ezinomdlavuza zingalungiseka njengezilonda eziyingozi.futhi ukulungiswa kungaphinda kuphindwe, futhi inkambo yesifo inganwetshwa izinyanga ezimbalwa noma ngisho nangaphezulu, ngakho izilonda zesisu kufanele zinakwe kakhulu.
3. Yiziphi izimpawu zokuguquka okubi kwesilonda esiswini?
1. Izinguquko emvelweni nokujwayelekile kobuhlungu:
Ubuhlungu be-gastric ulcer bubonakala kakhulu njengobuhlungu obuthuntu esiswini esingaphezulu, esivuthayo noma esibuhlungu, futhi ukuqala kobuhlungu kuhlobene nokudla.Uma ubuhlungu bulahlekelwa ukujwayelekile okukhulunywe ngenhla, buba ukuhlasela okungajwayelekile, noma buba yizinhlungu ezingapheli eziqhubekayo, noma uhlobo lobuhlungu selushintshe kakhulu uma luqhathaniswa nesikhathi esedlule, kufanele luqaphele inkomba yomdlavuza.
2. Ayisebenzi ngemithi elwa nesilonda:
Nakuba izilonda zesisu zivame ukuhlaselwa okuphindelelayo, izimpawu ngokuvamile ziyakhululeka ngemva kokuphuza izidakamizwa ezilwa nezilonda.
3. Iziguli zokuncipha kwesisindo eziqhubekayo:
Esikhathini esifushane, ukulahlekelwa ukudla, isicanucanu, ukuhlanza, umkhuhlane kanye nokuncipha kwesisindo okuqhubekayo, ukuncipha kwesisindo, amathuba okuba nomdlavuza kuphezulu kakhulu.
4. I-Hematemesis ne-melena ivela:
Ukuhlanza njalo kwesiguli kwegazi noma indle, imiphumela yokuhlolwa kwegazi le-fecal eqhubekayo, kanye ne-anemia enzima iphakamisa ukuthi izilonda zesisu zingase ziphenduke zibe umdlavuza.
5. Ubuningi buvela esiswini:
Iziguli ezinezilonda zesisu ngokuvamile azikhiqizi isisu, kodwa uma ziba nomdlavuza, izilonda zizoba zikhudlwana futhi zibe lukhuni, futhi iziguli esezikhulile zingakwazi ukuzwa isisindo kwesokunxele esiphezulu sesisu.Ubuningi besisindo ngokuvamile buqinile, bunama-nodular futhi abushelelezi.
6.Labo abaneminyaka engaphezu kuka-45 ubudala, banomlando wezilonda esikhathini esidlule, futhi babe nezimpawu eziphindaphindiwe muva nje, njengokuhiccups, ukubhodla, ubuhlungu besisu, futhi kuhambisana nokuncipha kwesisindo.
7. Igazi lemilingo elihle lendle:
Uma une-positive ephindaphindiwe, qiniseka ukuthi uya esibhedlela ukuze uyohlolwa ngokugcwele.
8. Abanye:
Eminyakeni engaphezu kwengu-5 ngemva kokuhlinzwa kwesisu, kunezimpawu zokungagayeki kahle kokudla, ukwehla kwesisindo somzimba, i-anemia nokopha kwesisu, nokungachazeki kwesisu esingenhla, ukubhodla, ukungakhululeki, ukukhathala, ukuncipha, njll.
4,Imbangela yesilonda esiswini
I-etiology yesilonda se-peptic ayikaqondwa ngokugcwele, kodwa kuye kwacaciswa ukuthi ukutheleleka kwe-Helicobacter pylori, ukuthatha izidakamizwa ezingezona ukuvuvukala kanye nezidakamizwa ze-antithrombotic, kanye nokuphuma ngokweqile kwe-acid esiswini, izici zofuzo, ukushintshashintsha kwengqondo nangokomzwelo, kanye ukudla okungajwayelekile Ucansi, ukudla okulula, ukubhema, ukuphuza, indawo ezungezile nesimo sezulu, izifo ezingelapheki njenge-emphysema kanye ne-hepatitis B nazo zihlobene nokuba khona kwesilonda se-peptic.
1. Ukutheleleka nge-Helicobacter pylori (HP):
UMarshall noWarren bawine uMklomelo KaNobel Kwezokwelapha ngo-2005 ngokuhlakulela ngempumelelo i-Helicobacter pylori ngo-1983 futhi baphakamisa ukuthi ukutheleleka kwayo kunendima ekubangeleni izilonda ze-peptic.Ucwaningo oluningi luye lwafakazela ngokugcwele ukuthi ukutheleleka kwe-Helicobacter pylori kuyimbangela eyinhloko yesilonda se-peptic.
2. Izici zezidakamizwa nezokudla:
Ukusetshenziswa isikhathi eside kwezidakamizwa ezifana ne-aspirin ne-corticosteroids kujwayele ukudala lesi sifo.Ngaphezu kwalokho, ukubhema isikhathi eside, ukuphuza isikhathi eside, nokuphuza itiye elinamandla nekhofi kubonakala kuhlobene.
(1) Amalungiselelo ahlukahlukene e-aspirin: Ukusebenzisa isikhathi eside noma umthamo omkhulu kungabangela ubuhlungu besisu nokungakhululeki.Ezimweni ezinzima, i-hematemesis, i-melena, njll, ingatholakala ekuvuvukeni kwe-gastric mucosal, ukuguguleka nokubunjwa kwesilonda.
(2) Izidakamizwa ezishintsha ama-hormone:
Izidakamizwa ezifana ne-indomethacin ne-phenylbutazone yizidakamizwa ezishintsha ama-hormone, ezinomonakalo oqondile ku-mucosa yesisu futhi zingaholela ezilonda zesisu esibi.
(3) Ama-analgesics e-Antipyretic:
Njenge-A.PC, i-paracetamol, amaphilisi okudambisa izinhlungu kanye nemithi ebandayo efana ne-Ganmaotong.
3. I-asidi yesisu kanye ne-pepsin:
Ukwakheka kokugcina kwezilonda ze-peptic kungenxa yokuzigayeka kwe-gastric acid/pepsin, okuyisici esinqumayo ekuveleni kwezilonda.Okubizwa ngokuthi "izilonda ezingenayo i-asidi".
4. Izici zengqondo ezicindezelayo:
Ukucindezeleka okukhulu kungabangela izilonda zokucindezeleka.Abantu abanokucindezeleka okungapheli, ukukhathazeka, noma ukushintshashintsha kwemizwelo bathambekele ekubeni nezilonda ze-peptic
isilonda.
5. Izici zofuzo:
Kwezinye izifo zofuzo ezingavamile, njenge-multiple endocrine adenoma type I, i-systemic mastocytosis, njll., isilonda se-peptic siyingxenye yokubonakaliswa kwaso komtholampilo.
6. I-gastric motility engavamile:
Ezinye iziguli zezilonda zesisu zinezinkinga ze-gastric motility, ezifana nokukhuphuka kwe-asidi yesisu okubangelwa ukubambezeleka kokukhipha isisu kanye ne-duodenal-gastric reflux ebangelwa i-bile, ijusi ye-pancreatic kanye nokulimala kwe-lysolecithin ku-mucosa.
7. Ezinye izici:
Njengokutheleleka kwasendaweni kwe-herpes simplex virus hlobo I ingase ihlobane.Ukutheleleka kwe-Cytomegalovirus kungase futhi kuhileleke ekufakweni kwezinso noma iziguli ezingenayo i-immunocompromised.
Ekuphetheni, izilonda zingavinjelwa ngokuphumelelayo ngokuthuthukisa ngenkuthalo izindlela zokuphila, ukuthatha izidakamizwa ngokunengqondo, ukuqeda i-Helicobacter pylori, nokuthatha i-gastroscopy njengento evamile yokuhlola ngokomzimba;
Uma isilonda sivela, kuyadingeka ukulawula ngenkuthalo ukwelashwa futhi uqhube ukubuyekezwa okuvamile kwe-gastroscopy (ngisho noma isilonda selashwa), ukuze kuvinjwe ngempumelelo ukuvela komdlavuza.
“Ukubaluleka kwe-gastroscopy ngokuvamile kungasetshenziswa ukuqonda ukuthi umphimbo wesiguli, isisu kanye ne-duodenum kunamazinga ahlukene okuvuvukala, izilonda, ama-polyps nezinye izilonda.I-Gastroscopy nayo iyindlela yokuhlola engenakuthathelwa indawo, futhi amanye amazwe asebenzise ukuhlolwa kwe-gastroscopic.Njengento yokuhlola impilo, ukuhlolwa kufanele kwenziwe kabili ngonyaka, ngoba izinga lomdlavuza wesisu osanda kuzalwa kwamanye amazwe liphezulu uma kuqhathaniswa.Ngakho-ke, ngemva kokutholwa kusenesikhathi nokwelashwa kusenesikhathi, umphumela wokwelapha nawo uyabonakala.”
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Isikhathi sokuthumela: Aug-15-2022