Ukwehlisa i-Esophagus Ukuvimbela Ukunciphisa Ukunciphisa
Ukunwetshwa kwe-esophageal yindlela yokwelashwa ekusizeni ukwelula, noma ukuphucula, ukungezwani okungavamile okutholakala kulesi sigameko. Lezi zingqinamba zibizwa ngokuthi iziqu futhi zingavela ezinhlobonhlobo zezinkinga zempilo. Udokotela wakho cishe uzokuthumela ku-otolaryngologist (udokotela, indlebe nephunga) noma i-gastroenterologist (isisu nesifo sezinhlungu) ukuze kwenziwe le nqubo.
Ngokujwayelekile bazosebenzisa izindlela ezihlukene ezintathu zokwenyuka kwe-esophageal:
- I-candle ye-weighted - i-pusher type dilator okungaba yi-mercury-igcwele (Maloney) noma i-tungsten-egcwele (i-Hurst)
- I-dilator eqondiswe nge-wire - ifoni yokuqondisa ifakwe kuqala bese dilator ye-polyvinyl (i-Savary-Gilliard noma i-American) efakwe phezu kwe-wire guide
- I-Baloon dilator - efakiwe kuze kube seqophelweni lokunquma, ngaphansi kwe-endoscopy (usebenzisa i-endoscope yevidiyo) noma i-fluoroscopy (usebenzisa i-ray-ray), bese igxilisa ibhaluni
Kungani i-Esophageal Dilation eyenziwe?
Ngokuhamba kwesikhathi, izinkinga ezehlukene zezempilo zingabangela ukuqina okumele kwenziwe ekugxileni okubangela ukugxilwa kwesimo. Lezi zingqinamba zingenza kube nzima ukugwinya futhi ungase ube nomuzwa wokudla obanjwe esifubeni sakho. Lo mzwa wukuthi ukudla kunenkathi enzima ehamba phambili kudlulile. Ezimweni eziningi, lezi zinsika ziwumphumela wokuqoqwa kwe-fibrous noma i-collagen.
Nasi uhlu lwezinkinga ezingase zizuze ekusebenziseni ukuxilongwa kwe-esophageal:
- I-Achalasia
- Ukulimala kwe-Caustic (chemical)
- I-eosinophilic esophagitis
- Umdlavuza we-Esophageal
- I-GERD - evame kakhulu
- I-Jackhammer esophagus
- Ukuhlinzwa kokuqala kokuqapha
- Ukwelashwa kwamafutha
- Indandatho kaSchatzki
- I-Sclerotherapy ye-varophageal varices
Ukwehlisa isisindo akuyona ikhambi nganoma yiziphi izinkinga ezingenhla futhi izimpawu zizophinde zibuyele.
Kodwa ukuxubha kwe-esophageal kungaba yindlela ewusizo ekunciphiseni izimpawu ezihambisana nokugwinya izinkinga.
Izingozi Ezihlobene Nokuhlukunyezwa Kwe-Esophageal
Kumele ube nokuhlanjululwa okulinganiselwe okwenziwa ngumhlinzeki wokunakekelwa oqeqeshiwe. Ngenkathi ukunyuka kwe-esophageal ngokuvamile kuyindlela ephephile, kunezingozi ezithile okufanele uziqaphele. Ngisho noma izingozi zizwakala ziyingozi, ukuxilongwa kokulingana ngokuvamile kuphephile ukwenza isilungiselelo sokugula futhi akudingeki kwenziwe esibhedlela.
Ukweqa nokuzifisa kungenzeka cishe noma iyiphi inqubo ehilela ukuhamba kwezindiza noma i-oophagus. Udokotela wakho uzoqaphela lezi zinkinga kulo lonke uhlelo. Kufanele ufune usizo lwezokwelapha uma ubona noma yikuphi kwalokhu okulandelayo emva kokunciphisa kwe-esophageal:
- ubunzima bokuphefumula
- umkhuhlane
- ubuhlungu besifuba
- ukunyakaza kwamagazi noma abamnyama
Ingcindezi eyingozi kunazo zonke ingozi yokukhwabanisa, noma umgodi osesiswini. Lokhu kungahle kwenzeke cishe njalo izikhathi ezingu-1-4 ngaphandle kokunciphisa okungu-1,000. Uma kwenzeka i-perforation, ukuhlinzwa kungadingeka ngokushesha. Ingozi yakho iphakeme kule nkinga uma ukulinganisa kwakho kuhlobene nokuthelela imishanguzo. Ingozi yakho iphinde ibe ngaphezulu uma unodokotela ongazange enze lo msebenzi njalo, ngakho-ke kuphakanyiswa ukuba uhlaziye ngokweqile okwenziwa i-otolaryngologist noma i-gastroenterologist.
Yini Ongayilindela Ngokwehluleka Kwama-Esophageal
Ngaphambi kokunciphisa okuyisidingo uzodinga ukuzila ukudlala (kungabi nokudla noma amanzi) okungenani amahora ayisithupha. Kumele ulandele imiyalelo ye-pre-procedure yodokotela wakho mayelana nesikhathi esifanele sokuzila ukudla. Izikhathi eziningi lokhu kuzoba ukuqala ngokushesha phakathi kwamabili ngaphambi kwenkambiso.
Uma ngabe kunoma imiphi imithi ephuca igazi lakho (i-aspirin, i-warfarin, njll ...) kufanele uzise udokotela wakho. Kungase kungadingeki ukuthi ususwe imithi, kodwa udokotela wakho angase alungise umthamo wakho noma uthathe izinyathelo ezingaphezulu zokuqapha. Ukutshela udokotela wakho mayelana nale mithi kungakwandisa ingozi yokuba nenkinga yokuphuma kwegazi.
Ungase uphinde wabike ama-antibiotics ngaphambi kwenqubo uma unomlando wezifo ezithile zenhliziyo. Uma uthatha ama-antibiotics ngomsebenzi wamazinyo, kufanele uqiniseke ukuthi uzoxoxa ngama-antibiotics nodokotela wakho.
Phakathi nenqubo, udokotela wakho angasebenzisa i-sedation ukuze akusize uphumule futhi ungakhumbuli inqubo. Uma le ndlela isetshenzisiwe, uzodinga ukuthi omunye umuntu akushayele ekhaya, njengoba imithi ejwayelekile esetshenziswe kule nqubo ibandakanya: i-fentanyl, eyaziwayo, noma i-propofol. Yonke le mithi idinga ukuthi ungadlulisi amahora angu-24. Ngaphandle kwalokho, udokotela wakho angasebenzisa i-anesthetic ye-spray ukuze anqine umphimbo wakho ukuze enze inqubo yakho. Uma le ndlela isetshenziswa, uzobe uphapheme ngokuphelele ngenqubo futhi uzokwazi ukushayela. Kodwa abantu abaningi bakhetha ukusebenzisa i-sedation, ngoba umcabango wesikhumbi eside ufakwa emqaleni wakho kuya esiswini sakho kungesabeka, ikakhulukazi uma ulungele u-claustrophobia.
Emva kwenqubo, uzonikezwa imiyalo lapho ungadla uphinde uphuze. Ukuphuza kuzothathwa kuze kube yilapho noma yikuphi ukulimala kokugula okuphelile. Lokhu kungukuthi ungenawo amanzi angena emaphashini akho esikhundleni sesisu sakho, ngoba ukuhlinzeka ngokweqile kukuvimbela imisebenzi evamile yokugwinya. Mhlawumbe nawe uzoba nomkhuhlane omnene izinsuku ezimbalwa emva kwenqubo.
Ingabe Ngidinga Okungaphezu Kokulingana Okulinganayo?
Kuvamile ukuthi izimpawu zibuye zibuyele emva kokuhlenga kwe-esophageal. Kuthatha isikhathi esingakanani ukuthi izimpawu ziphinde ziguquke futhi zixhomeke ezintweni eziningi ezibandakanya ubunzima kanye nesibangela sokuqina. Ezimweni eziningi, ukuphathwa kokudla , ukusebenzisa i- proton pump inhibitors (i-PPIs), nezinye izindlela zokwelashwa kungasiza ukulibaziseka uma kungavimbeli isidingo sokungenwa kwamandla esikhathini esizayo. Ukusebenza eduze nokulandela uhlelo lwakho lwezokwelapha olulodwa kungasiza ukugcina izimpawu ezilawulwa isikhathi eside. Ukuhlunga ngokweqile kuyindlela yokwelapha hhayi ukwelashwa, kodwa ukukhululeka kwezibonakaliso kuzokwenza le nqubo ibe usizo kakhulu ekuthuthukiseni izinga lakho lokuphila.
Imithombo:
I-American Society Ye-Endoscopy Yokugubha. (nd). Ukuqonda ukuxilongwa kwe-Esophageal. Kufinyelelwe ngoJanuwari 31, 2016 kusuka ku-http: //www.asge.org/patients/patients.aspx?id=392
Dellon, ES, Gibbs, WB, Rubinas, TC, Fritchie, KJ, Madanick, RD, Woosley, JT & Shaheen, NJ (2010). Ukunciphisa ngokweqile ku-eosinophilic esophagitis: ukuphepha nokubikezela kwempendulo yemitholampilo kanye nezinkinga. I-Gastrointest Endosc. 71 (4): 706-12. I-Doi: 10.1016 / j.gie.2009.10.047.
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