Lapho Ukuphazamiseka Kubuyisa
I-term refractory reflux isifo se-gluroesophageal (GERD esinqabile) ichaza labo abagulayo abaqhubeka beba nezimpawu ze-reflux ye-gastroesophageal naphezu kokwelashwa okuvamile neproton pump inhibitors (PPIs).
Iziguli ezithola i-GERD engabonakali ngokuvamile ziwela kwelinye lamaqembu amabili:
- Labo abadinga ukwelashwa okungaphezu kolaka
- Labo abanezinye izimbangela zezimpawu zabo ze-reflux
Ukwelashwa Okudlulele Kakhudlwana kwe-GERD ye-Refractory
Ukwelashwa ukwelashwa okunye okwedlulele akusho ukuthi ukhetho olulodwa kulaba baguli lungukuhlinzwa. Eqinisweni, labo abanemiphumela emihle evela ekuhlinzekeni okuphikisana no-reflux yilabo ababesabela ngaphambi kwemithi. Iziguli eziphikisayo aziphenduli kahle nokuhlinzwa okulwa no-reflux. Lokhu, kodwa, akusho ukuthi ukuhlinzwa, njengokuxhaswa kwezimali, ngeke kube inketho. Udokotela uzolinganisa izingozi kanye nezinkinga zokuhlinzwa ngokumelene nezinzuzo ezingenzeka bese uxoxisana nesiguli ukuthi ngabe ukuhlinzwa kuyindlela enhle.
Ezinye iziguli aziphenduli kahle emithwalweni yendabuko yama-PPIs, kanti udokotela angase acabangele ukwandisa umthamo, kanye nokuba neziguli zibuyele kokuphindwe kabili kwansuku zonke kunalokho okujwayelekile uma kwenzeka ngosuku.
Kubalulekile ukulawula i-reflux yama-asidi ebusuku. Ukuthatha i- block ye-H2 ngaphambi kokulala isikhathi kuboniswe ukusiza ngezimpawu.
Ezinye izindlela zokulawula i-reflux yasebusuku zihlanganisa:
- Ukulala nekhanda namahlombe kuphakanyisiwe
- Ukulala ngakwesokunxele
- Ilinde amahora amabili noma amathathu emva kokudla ukuze alale
- Ukugqoka izingubo zokulala ezifanelekile
Odokotela bangase babeke nokusetshenziswa kwe-agent yokukhuphula, njenge-Reglan, ngaphambi kokudla nangaphambi kokulala ukuze kusize ukunciphisa ingozi ye-acid reflux.
Ezinye izimbangela zezimpawu ze-Reflux
Uma isiguli singaphenduli emithi yokwelashwa, ikakhulukazi ngemuva kokwelashwa okunonya okunye, ezinye izinkinga ngaphandle kweGERD zingase zisondele.
Ngenkathi i-GERD iyimbangela evamile kakhulu yezimpawu ze-reflux, akuyona imbangela kuphela. Okunye ukuphazamiseka kokugaya okungabangela i-reflux kufaka phakathi ama- hernias we- hiatal nokukhathazeka kwe-motility .
Izivivinyo udokotela angasebenzisa ukuqinisekisa ukuxilongwa yizi:
- Isivivinyo se-PH
- Endoscopy ephezulu
- I-Manometry Esophageal
Imiphumela yalezi zivivinyo izosiza udokotela ukuba anqume ngesiphakamiso esifanele sokwelashwa.
I-GERD engenalutho ayivamile. Uma okuhlangenwe nakho kwesiguli kuqhubeka nezimpawu ze-reflux naphezu kokwelashwa, udokotela kufanele axoxwe. Ukuxoxa ngohlobo lwezimpawu ezitholakalayo, ukuvama kwabo, kanye nokulandelela ukuthi kungenzeka yini ukuvuselela i-reflux kuzosiza ekutholeni uhlelo lokuphatha olufanele.
Imithombo:
> Kenneth R. DeVault MD, FACG, uDonald O. Castell MD, MACG > "Imihlahlandlela Ebuyekeziwe Yokuthola Ukuxilongwa Nokuphathwa Kwezifo Zesifo Se- Reflux Gastroesophageal." i-doi: 10.1111 / j.1572-0241.2005.41247.x. I-American College of Gastroenterology. 5 Dec 2007.
> Ikuo Hirano, MD, 1 uJoel E. Richter, MD, "Izikhombandlela ze-ACG Practice: Ukuhlolwa kwe-Reflux Esophageal." i-doi: 10.1111 / j.1572-0241.2006.00936.x. I-American College of Gastroenterology. 5 Dec 2007.