I-Barrett's Isophagus Ayinzima Ukuzihlola
Isisu sikaBarrett yisimo esingavamile lapho uhlaka lwesigxathu lufakwa khona ngamathumbu omzimba wamathumbu. Ukuguqulwa kwamaseli akho ajwayelekile okuxilonga okucatshangelwayo kubonakala sengathi kubangelwa ukuvezwa okungapheli kokuqukethwe kwe-glucid refluxed kusuka kwesifo se-reflux ye-gastroesophageal (GERD). Njengoba i-asidi ilimaza amangqamuzana avamile we-oophagus, ungaba namandla okukhula uhlobo oluthile lweseli okubizwa ngokuthi i- columnar epithelium .
Lolu hlobo lwamaseli luqale lwabonwa ku-Norman Barrett, udokotela ohlinzayo wase-Australia, ngo-1950. I-Barrett isifo somdlavuza singaba yisandulela somdlavuza we-esophageal futhi ayikho izimpawu ezihlukaniswayo; ngakho-ke kunzima ukuxilonga. Njengoba kwenzeka njalo kaningi ezigulini ezitholakale zikhona ngeGERD, odokotela batusa ukuthi abantu abathile abatholwe benesifo se-GERD bahlelwe esophagogroduodenoscopy (EGD) esibukweni se-Barrett's esophagus.
Ukuqhathaniswa nokuxilongwa kwe-Barrett's Esophagus
Uma uneziqephu zokubhukuda okungenani kanye ngesonto, umane ubeke amathuba okuba ngu-5% wokuthuthukisa isifo sikaBarrett. Kodwa-ke, inani leziqephu ze-heartburn onayo azikhulise ingozi yokuba ne-Barrett's esophagus. Ukubona isifo sikaBarrett kungenziwa kuphela ngokuthi i-endoscopy isebenze ngezinqubo ezimbili zokuhlonza izinyathelo. Okokuqala, udokotela owenza i-endoscopy uzobona ukuthi kukhona noma ngabe kukhona amangqamuzana e-columnar epithelial engxenyeni ye-distal (engezansi) yesigcawu sakho, eduze kwesisu.
Uma kukhonjisiwe, isinyathelo sesibili ukuthatha i- biopsy yendawo ukuze ubone ukuthi amaseli anezibonakaliso zokuthi ashintshe kusuka kolunye uhlobo lweseli kwenye.
Ngisho noma lesi sifo ngokwazo singenayo izimpawu, cishe 1% weziguli ezine-britt's esophagus zihlakulela uhlobo oluyingozi lomdlavuza we-esophageal okuthiwa i- adenocarcinoma .
Ngenxa yalesi sizathu, kufanele uqaphelwe i-dysplasia (ukuguqulwa okungavamile kumaseli angaba yisandulela komdlavuza) ngokusebenzisa i-endoscopy kanye nezinye izicubu ze-biopsies uma uthola ukuthi unesisindo se-Barrett.
Ukwelapha isisindo sikaBarrett
Uma i-dysplasia itholakele endaweni yakho, amangqamuzana angabhubhisa besebenzisa ukuhlinzwa noma izinqubo zokugcina. Ukwelashwa okulodwa kokubhekwa kukaBarrett kuthiwa yi- photodynamic therapy (PDT) . Le therapy isebenzisa ikhemikhali okuthiwa i-Photofrin, eyenza izicubu zizwele ukukhanya. Amahora angamashumi amane nesishiyagalolunye ngemuva kokuthi i-Photofrin inikezwe isiguli, udokotela angadlulisa ithubhu ye-laser (nge- endoscope ) ibe yi- endoscope futhi abulale izicubu ezingavamile zikaBarrett.
I-Barrx, enye indlela yokubhubhisa i-dysplasia ephezulu, ingahle isetshenziswe uma udokotela wakho engazizwa ukuthi ungumfundi ohlinzayo omuhle. Le nqubo isebenzisa i-catheter ye-Barrx efakwe ku-endoscope iphinde ivumele ukukhishwa kwe-radiofrequency (abhubhise) izicubu ezingavamile. Lena indlela engeyona engavamile yokubhubhisa izicubu ze-Barrett kuleso simo.
Omunye ukwelashwa kwe-dysplasia ku-britt's epopus ubizwa ngokuthi ukuthengiswa kwe-mucosal endoscopic (EMR) . I-EMR ingasetshenziselwa isisindo sikaBarrett noma umdlavuza we-esophageal.
Kule nqubo, into ejojowe ngaphansi kwendwangu yamathambo kaBarrett ngaphambi kokuthi isuswe nge-endoscope. Uma ukwelashwa kusetshenziselwa umdlavuza we-esophageal, ungqimba oluphezulu lwamaseli kuphela oluzosuswa. Ngenxa yalokhu, ingasetshenziselwa kuphela i-dysplasia eqinile noma umdlavuza wesigaba sokuqala.
Kulabo bantu abane-dysplasia eyingozi kakhulu noma umdlavuza ophakeme futhi abanempilo ngokwanele yokuba banesifo esiphezulu se-anesthhesia, ukuhlinza kuyisiguli sokuqala sokukhetha isifo sikaBarrett nge-high-grade dysplasia noma umdlavuza. Kusetshenziswa izinqubo ezimbalwa zokuhlinzwa kuye ngezidingo zomuntu ngamunye wesiguli kanye nendawo yesikhumba.
Nakuba isifo sikaBarrett sisifo esingavamile futhi kunethuba elincanyana kakhulu lokuthuthukisa umdlavuza we-esophageal, i-adenocarcinoma yesifo sinomqondo ophansi kakhulu uma utholakala esiteji esithuthukile. Ngenxa yalesi sizathu, kubalulekile ukuthi uma uhlushwa yi-GERD, uthatha ukunakekelwa okufanele ngemithi yokulwa ne-reflux njenge- Prilosec noma i- Dexilant . Uma uthola ukuthi unesisindo se-Barrett, qiniseka ukuthola i-ENT enhle noma i-gastroenterologist ekusizeni ukuphatha ukulandelwa kwakho kanye nokwelapha.
> Umthombo
> Del Genio, G, Del Genio, F, Schettino, P, Limongelli, P, Tolone, S, Brusciano, L ... Docimo, L. (2015). I-Papilloma Esophageal: I-Flexible Endoscopic Ablation nge-Radiofrequency. I-World J Gastrointest Endosc. 7 (3): 290-4. doi: 10.4253 / wjge.v7.i3.290.
> I-National Digestive Disease Clearing House. I-Esophagus kaBarrett.
> Spechler, SJ & Souza, RF. (2016). Isifo Sengculazi nesifo se-Sleisenger kanye ne-Fordtran. 10 th ed. (Okubhaliselwe Kudingekile)