Isilonda se-peptic ikakhulukazi sibhekisela esilonda esingamahlalakhona esenzeka esiswini nase-duodenal bulb. Siqanjwe ngokuthi ukwakheka kwesilonda kuhlobene nokugaya i-asidi yesisu kanye ne-pepsin, okubangela cishe u-99% wesilonda se-peptic.
Isilonda se-Peptic yisifo esivamile esingenabungozi esisakazeka emhlabeni wonke. Ngokwezibalo, izilonda ze-duodenal zivame ukwenzeka kubantu abadala abasebasha, futhi ubudala bokuqala kwezilonda ze-gastric bufika kamuva, ngokwesilinganiso, eminyakeni engaba yi-10 kamuva kunezilonda ze-duodenal. Ukwanda kwezilonda ze-duodenal cishe kuphindwe kathathu kunezilonda ze-gastric. . Ngokuvamile kukholelwa ukuthi ezinye izilonda ze-gastric zizoba nomdlavuza, kanti izilonda ze-duodenal ngokuvamile azibi njalo.
Isithombe 1-1 Isithombe sesisu somdlavuza weqhwa lokuqala Isithombe 1-2 Isithombe sesisu somdlavuza othuthukile.
1. Izilonda eziningi zesisu ziyalapheka
Ezigulini ezinesilonda sesisu, iningi lazo lingelapheka: cishe u-10%-15% wazo awunazo izimpawu, kuyilapho iziguli eziningi zinezimpawu ezivamile zemitholampilo, okungukuthi: ukuqala okungapheli, okunesigqi kokuqala ngezikhathi ezithile ekwindla nasebusika kanye nobuhlungu besisu ebusika nasentwasahlobo.
Izilonda ze-duodenal zivame ukuba nobuhlungu bokuzila ukudla obuhambisana nomjikelezo, kuyilapho izilonda zesisu zivame ukuba nobuhlungu ngemva kokudla. Ezinye iziguli ngokuvamile azinazo izimpawu ezivamile zemitholampilo, futhi izimpawu zazo zokuqala ukopha kanye nokubhoboka okukhulu.
I-angiography ephezulu yamathumbu noma i-gastroscopy ingaqinisekisa ukuxilongwa, futhi ukwelashwa okuhlangene nezidakamizwa zokucindezela i-asidi, izinto zokuvikela ulwelwesi lwesisu, kanye nama-antibiotic kungenza iziguli eziningi zilulame.
2. Izilonda zesisu eziphindaphindayo zibhekwa njengezilonda ezingaphambi komdlavuza
Izilonda zesisu zinezinga elithile lomdlavuza.Kwenzeka kakhulu kubantu asebekhulile nabaphakathi, abesilisa, izilonda eziphindaphindayo ezingelapheki isikhathi eside. Eqinisweni, kufanele kwenziwe i-biopsy ye-pathological kuzo zonke izilonda zesisu emtholampilo, ikakhulukazi izilonda ezishiwo ngenhla. Ukwelashwa okulwa nezilonda kungenziwa kuphela ngemva kokuba umdlavuza ukhishwe, ukuze kuvinjelwe ukuhlonza okungalungile kanye nokubambezeleka kwesifo. Ngaphezu kwalokho, ngemva kokwelashwa kwezilonda zesisu, kufanele kuhlolwe kabusha ukuze kubonwe izinguquko ekwelapheni kwezilonda futhi kulungiswe izindlela zokwelapha.
Izilonda ze-duodenal azivamile ukuba umdlavuza, kodwa izilonda zesisu eziphindaphindayo manje sezibhekwa ochwepheshe abaningi njengesilonda esingaphambi komdlavuza.
Ngokusho kwemibiko yezincwadi zesiShayina, cishe u-5% wezilonda zesisu zingaba umdlavuza, futhi leli nani liyanda njengamanje. Ngokwezibalo, kufika ku-29.4% womdlavuza wesisu uvela ezilondeni zesisu.
Izifundo zithole ukuthi iziguli ezinomdlavuza wezilonda zesisu zibanga cishe u-5%-10% wezifo zesisu. Ngokuvamile, iziguli eziningi ezinomdlavuza wezilonda zesisu zinomlando omude wezilonda zesisu ezingamahlalakhona. Ukubhujiswa okuphindaphindiwe kwamaseli e-epithelial emaphethelweni esilonda kanye nokulungiswa nokuvuselelwa kwe-mucosal, i-metaplasia, kanye ne-hyperplasia engavamile kwandisa amathuba okuba nomdlavuza ngokuhamba kwesikhathi.
Umdlavuza uvame ukwenzeka kulwelwesi oluzungezile lwezilonda. Ilwelwesi lwalezi zingxenye luyawohloka lapho isilonda sisebenza, futhi lungaba yingozi ngemva kokubhujiswa okuphindaphindiwe nokuvuselelwa. Eminyakeni yamuva nje, ngenxa yentuthuko yezindlela zokuxilongwa nokuhlolwa, kutholakale ukuthi umdlavuza wesisu wokuqala ovalelwe kulwelwesi ungawohloka futhi ube nezilonda, futhi ubuso bawo bezicubu bungashintshwa yizilonda zesibili zesisu. Lezi zilonda zomdlavuza zingalungiswa njengezilonda ezingengozini. futhi ukulungiswa kungaphindwa, futhi inkambo yesifo ingandiswa izinyanga eziningana noma ngaphezulu, ngakho-ke izilonda zesisu kufanele zinakwe kakhulu.
3. Yiziphi izimpawu zokuguquka kwesilonda esiswini okubangela umonakalo?
1. Izinguquko esimweni kanye nokujwayelekile kobuhlungu:
Ubuhlungu besilonda esiswini bubonakala kakhulu njengobuhlungu obungazwakali esiswini esingaphezulu, obusha noma obungazwakali, futhi ukuqala kobuhlungu kuhlobene nokudla. Uma ubuhlungu bulahlekelwa ukuvama okukhulunywe ngakho ngenhla, buba ukuhlaselwa okungajwayelekile, noma bube ubuhlungu obungapheli obungazwakali, noma uhlobo lobuhlungu lushintshe kakhulu uma luqhathaniswa nesikhathi esidlule, kufanele uqaphele uphawu lomdlavuza.
2. Ayisebenzi kahle ngemithi yokulwa nezilonda:
Nakuba izilonda zesisu zivame ukuhlaselwa njalo, izimpawu ngokuvamile ziyaphela ngemva kokuthatha imithi yokulwa nezilonda.
3. Iziguli ezinciphisa isisindo ngendlela eqhubekayo:
Esikhathini esifushane, ukulahlekelwa yisifiso sokudla, isicanucanu, ukuhlanza, umkhuhlane kanye nokwehla kwesisindo okuqhubekayo, ukwehla kwesisindo, amathuba okuba nomdlavuza aphezulu kakhulu.
4. I-Hematemesis ne-melena ivela:
Ukuhlanza igazi noma indle ehlala isikhathi eside kwesiguli muva nje, imiphumela yokuhlolwa kwegazi elingabonakali elihlala likhona, kanye nokuntuleka kwegazi emzimbeni okukhulu kusikisela ukuthi izilonda zesisu zingase zibe umdlavuza.
5. Kuvela izinqwaba esiswini:
Iziguli ezinezilonda zesisu ngokuvamile azikhi izinqwaba zesisu, kodwa uma ziba nomdlavuza, izilonda zizoba zinkulu futhi ziqine, futhi iziguli esezikhulile zingazizwa izinqwaba esiswini esingaphezulu kwesobunxele. Isisindo sesisindo sivame ukuba nzima, sibe namaqhubu futhi singasheleli.
6. Labo abaneminyaka engaphezu kwengu-45 ubudala, banomlando wesilonda esikhathini esidlule, futhi ube nezimpawu eziphindaphindayo muva nje, njengokuqunjelwa, ukubhoboza, ubuhlungu besisu, futhi kuhambisana nokwehla kwesisindo.
7. Igazi elingcolile lendle:
Uma uphinda uveze ukuthi unegciwane, qiniseka ukuthi uya esibhedlela ukuze uhlolwe ngokuphelele.
8. Abanye:
Ngemva kweminyaka engaphezu kwemi-5 yokuhlinzwa kwesisu, kuba nezimpawu zokungagayi kahle ukudla, ukwehla kwesisindo, ukuntuleka kwegazi kanye nokopha esiswini, kanye nokuvuvukala kwesisu okungaphezulu okungachazeki, ukubhoboza, ukungakhululeki, ukukhathala, ukwehla kwesisindo, njll.
4, Imbangela yesilonda esiswini
Izimbangela zesilonda se-peptic azikaqondakali ngokugcwele, kodwa sekucacisiwe ukuthi ukutheleleka kwe-Helicobacter pylori, ukuthatha imithi yokulwa nokuvuvukala engeyona i-steroidal kanye nemithi yokulwa nokuvuvukala, kanye nokukhiqizwa ngokweqile kwe-asidi yesisu, izici zofuzo, ukuguquguquka kwengqondo kanye nemizwelo, kanye nokudla okungajwayelekile Ubulili, ukudla ukudla okulula, ukubhema, ukuphuza, indawo kanye nesimo sezulu, izifo ezingamahlalakhona ezifana ne-emphysema kanye ne-hepatitis B nazo zihlobene nokwanda kwesilonda se-peptic.
1. Ukutheleleka kwe-Helicobacter pylori (HP):
UMarshall noWarren bawine umklomelo weNobel Prize in Medicine ka-2005 ngokukhulisa ngempumelelo iHelicobacter pylori ngo-1983 futhi basikisela ukuthi ukutheleleka kwayo kudlala indima ekubangeleni izilonda zesisu. Ucwaningo oluningi luye lwafakazela ngokugcwele ukuthi ukutheleleka kweHelicobacter pylori kuyimbangela eyinhloko yesilonda sesisu.
2. Izici zemithi kanye nokudla:
Ukusetshenziswa isikhathi eside kwezidakamizwa ezifana ne-aspirin kanye ne-corticosteroids kuthambekele ekubangeleni lesi sifo. Ngaphezu kwalokho, ukubhema isikhathi eside, ukuphuza isikhathi eside, kanye nokuphuza itiye nekhofi elinamandla kubonakala kuhlobene.
(1) Amalungiselelo ahlukahlukene e-aspirin: Ukusetshenziswa isikhathi eside noma ngomthamo ophezulu kungabangela ubuhlungu besisu kanye nokungakhululeki. Ezimweni ezimbi kakhulu, i-hematemesis, i-melena, njll., ingatholakala ekuvuvukeni kwe-mucosal yesisu, ukuguguleka kanye nokwakheka kwezilonda.
(2) Imithi yokubuyisela ama-hormone:
Izidakamizwa ezifana ne-indomethacin kanye ne-phenylbutazone ziyizidakamizwa zokufaka esikhundleni sama-hormone, ezinomonakalo oqondile ku-mucosa yesisu futhi zingaholela ezilondeni zesisu ezibukhali.
(3) Imithi yokunciphisa ubuhlungu elwa nokuvuvukala:
Njenge-A.PC, i-paracetamol, amaphilisi okuqeda ubuhlungu kanye nemithi yomkhuhlane efana ne-Ganmaotong.
3. I-asidi yesisu kanye ne-pepsin:
Ukwakheka kokugcina kwezilonda zesisu kungenxa yokuzigaya kwe-asidi yesisu/i-pepsin, okuyisici esiyinhloko ekuveleni kwezilonda. Lokho okubizwa ngokuthi “izilonda ezingenayo i-asidi”.
4. Izici zengqondo ezicindezelayo:
Ukucindezeleka okukhulu kungabangela izilonda zokucindezeleka. Abantu abanokucindezeleka okungapheli, ukukhathazeka, noma ukushintshashintsha kwemizwa bathambekele ekubeni nezilonda zesisu
isilonda.
5. Izici zofuzo:
Kwezinye izifo ezingavamile zofuzo, njenge-multiple endocrine adenoma uhlobo I, i-systemic mastocytosis, njll., isilonda se-peptic siyingxenye yezibonakaliso zaso zezokwelapha.
6. Ukunyakaza kwesisu okungavamile:
Ezinye iziguli ezinezilonda zesisu zinezinkinga zokunyakaza kwesisu, njengokwanda kokukhiqizwa kwe-asidi yesisu okubangelwa ukuphuza kwesisu okuphuzile kanye ne-duodenal-gastric reflux okubangelwa yi-bile, ijusi ye-pancreatic kanye nomonakalo we-lysolecithin ku-mucosa.
7. Ezinye izici:
Njengokutheleleka kwendawo kwegciwane le-herpes simplex uhlobo I okungenzeka ukuthi kuhlobene. Ukutheleleka kwe-Cytomegalovirus kungase kuhileleke nasekufakelweni kwezinso noma ezigulini ezine-immune ebuthakathaka.
Ekuphetheni, izilonda zingavinjelwa ngempumelelo ngokuthuthukisa indlela yokuphila ngenkuthalo, ukuthatha izidakamizwa ngendlela enengqondo, ukuqeda i-Helicobacter pylori, kanye nokuthatha i-gastoscopy njengento ejwayelekile yokuhlola umzimba;
Uma isilonda sivele, kubalulekile ukulawula ukwelashwa ngenkuthalo futhi wenze ukuhlolwa kwesisu njalo (ngisho noma isilonda selaphekile), ukuze kuvinjelwe ngempumelelo ukwenzeka komdlavuza.
"Ukubaluleka kwe-gastroscopy ngokuvamile kungasetshenziswa ukuqonda ukuthi ngabe umphimbo, isisu kanye ne-duodenum yesiguli zinamazinga ahlukene okuvuvukala, izilonda, ama-polyp esimila kanye nezinye izilonda. I-gastroscopy nayo iyindlela yokuhlola eqondile engenakuphikwa, futhi amanye amazwe asebenzise ukuhlolwa kwe-gastroscopy. Njengento yokuhlola impilo, ukuhlolwa kudingeka kwenziwe kabili ngonyaka, ngoba ukwanda komdlavuza wesisu kusenesikhathi kwamanye amazwe kuphakeme kakhulu. Ngakho-ke, ngemva kokutholwa kusenesikhathi kanye nokwelashwa ngesikhathi esifanele, umphumela wokwelashwa nawo usobala."
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Isikhathi sokuthunyelwe: Agasti-15-2022