I-manometry yokulinganisa iyisivivinyo esivame ukusetshenziswa kakhulu ukusiza ukucacisa ukungasebenzi kwamandla kagesi. Lokhu kuhlolwa kusiza udokotela wakho ukuba ahlole ukucindezeleka ngaphakathi kwesifo sakho, i-peristalsis (ukuvinjelwa okungenasidingo nokuphumula endaweni yakho), nokuhamba kokudla ngokusebenzisa isifo sakho. Izizathu ezivame kakhulu udokotela wakho angase ancome ukuthi ukuhlolwa kwe-manometry okulinganayo kuhlanganisa:
- ubunzima bokugwinya (dysphagia)
- ubuhlungu besifuba akuyona inhliziyo ehlobene nenhliziyo
- i-reflux ye-asidi
- ngaphambi kokuhlinzwa okulwa no-reflux
Kungenzeka futhi ukuthi unconywa kuloluhlolo ukuze usize ukuhlola lezi zifo ezilandelayo:
- i-achalasia (ubunzima bokudlulisa ukudla esiswini)
- i-scleroderma
- I-GERD ngaphandle kokuzuzwa ngemva kwamasonto angu-8 wokusebenzisa i-proton-pump inhibitor (PPI)
- jackhammer esophagus
- i-eosinophilic esophagitis
I-Esophagus yakho
I-hoop is a tube long muscular ephuma emqaleni wakho kuya esiswini sakho futhi ngezinye izikhathi ibizwa ngokuthi "gullet" yakho. Kukhona i-sphincter, noma indandatho ye-muscular evula futhi ivale, phezulu nangaphansi kwesimo sakho. Lezi zibizwa ngokulandelana ngokuthi i- sphincter ephezulu ye-esophageal kanye ne- infhgeer esophageal sphincter . Lezi zitshalo zivulekile futhi zivame ngokwemvelo ngenkathi zigwinya ukudla noma iziphuzo.
I- sphincter yakho ephezulu ye-esophageal (UES) ikhonza izinhloso ezimbili eziyinhloko:
- ivala ngesikhathi sokuphefumulelwa ukuze ugweme ukugcwalisa isisu sakho emoyeni
- ivala ukuvimbela i-acid-reflux ukungena emaphashini akho
Injongo yakho eyinhloko ye-sphincter's (LES) esezansi ephansi ukuvimbela isisu esiswini ukungena endaweni yakho. Ukuze uvimbele lokhu, i-sphincter yakho engezansi ehlala igcinwe ivaliwe kuze kugweme ukudla lapho ihlehlisa khona kancane ukuvumela ukuhamba kokudla okuvela esiswini sakho kuya esiswini sakho.
Kubuye kube nokuphumula okuncane kwe-sphincter engaphansi kwe-esophageal uma ubamba.
Ukulungiselela Ukuhlolwa Kwemanometerry Esophageal
Ukulungiselela ukuhlolwa kwe-manometry okulinganayo kufaka phakathi izinyathelo zokuphepha ukuvimbela ukufisa (ukungenwa kwesisu) nokusebenza kahle kwemiphumela yokuhlolwa. Ukuze uqinisekise ukuthi isisu sakho asinalutho, udokotela wakho uzokutusa ukuba uzilale okungenani amahora ayisithupha ngaphambi kwenqubo yakho. Uma udla ngaphambi kwalesi sikhathi, udokotela wakho angakwazi ukukhansela noma ukubambezela ukuhlolwa kwakho.
Imithi eminingi ingathinta isifo sakho futhi ngakho-ke udokotela wakho angakucela ukuba uyeke okwesikhashana ukuthatha imithi ethile. Eminye imithi ingase ingakwazi ukumiswa ngakho-ke kufanele uxoxe ngemithi yakho nodokotela wakho ngaphambi kwenqubo. Noma imiphi imithi ethathwa kuphela "njengoba kudingeka" akufanele ithathwe ngaphambi kwenqubo.
Izinhlobo ezijwayelekile zemithi ezingase zithinte imiphumela yokuhlolwa kwe-manometry okulinganayo zihlanganisa:
- nitrate - nitroglycerin, isosorbide, i-Viagra, i-Cialis
- abakhi be-calcium-channel - uNorvasc, uCardizem
- anticholinergics - Cogentin, Spiriva, Atrovent, Ditropan
- ama-promotional agents - Reglan, iZelnorm
- izidakamizwa - Okubhekiselweyo, Ativan, Fentanyl
Kubalulekile ukuxoxa ngemithi nodokotela wakho ngaphambi kokuyeka noma yini oyithathayo njalo.
Yini Ongayilindela Ngesikhathi Sokuhlolwa Kwemanometer Yokulinganisa
Iningi le-sedation lesikhathi ngeke lisetshenziswe ngenkathi lifaka isikhala se-motility esophageal. Ngesikhathi izidakamizwa ezincane ezinjengamazinga aphansi we-Versed zingasetshenziswa ukuthuthukisa induduzo, izidakamizwa zingathinta ukuhlolwa okujwayelekile, ngakho zigwetshwa uma kungenzeka.
Ukuze uthuthukise induduzo yakho, cishe uzonikezwa ukukhetha ukuthi iyiphi induna ongayithanda udokotela ukuba afake le catheter. Umzila wamasalula ukhethwa ngoba uvame ukubangela ukunciphisa okuncane futhi kungakhathazeki ngokukodwa ngokuphambene nokuphuma emlonyeni wakho. Udokotela wakho uqeqeshwe kakhulu ekwenzeni le nqubo, ngakho-ke thembela futhi uzame ukuphumula.
Uma uzizwa unzima kakhulu, khuluma nabo.
Ngaphambi kokuqala, kufanele ususe izibuko nakho konke okusemlonyeni wakho okungasuswa kalula. Kufanele ususe lezi zinto ngoba ukuguga kuyinto evamile ngenkathi kufakwa i-catheter.
Nakhu okuzokwenzeka kuzo zonke izinqubo:
- Ngaphambi kokufaka i-catheter ye-motility esophageal, iphoyinti le-catheter lizogcoba nge-anesthetic ye-topical. Uma ukungeniswa kungakhululekile, bangakwazi futhi ukufiphaza inani elincane noma ukugcoba i-nostril yakho nge-swab eboshwe nge-antichetic.
Iphuzu elikhulu lokumelana lenzeke lapho i-catheter ifinyelela emuva kwezinyosi zakho bese ingena emphinjeni wakho ngenxa yebhande okufanele iyenze. Ngalesi sigaba senqubo, uzocelwa ukuba uhlehlise ikhanda lakho, ubeke isikhumba sakho esifubeni sakho ukuze usize wenze ijika ngekhamera. - Ukuze usize ukuhambisa i-catheter esedlule i-sphincter yakho engaphezulu, uzocelwa ukuba uphuze amanzi ngamanhlamvu. Uma uqala ukukhwehlela ngokuphindaphindiwe futhi ube nobunzima bokukhuluma, kungase kusho ukuthi ithubhu yangena emthonjeni wakho esikhundleni sakho. Lokhu kwenzeka njalo kanti umtholampilo owenza inqubo uzohoxisa u-catheter kancane bese uzama futhi emva kokuba ube nethuba lokuphumula nokubamba umoya wakho.
- Uma i-catheter isidlulile isiphincter sakho esiphezulu, i-catheter ingaqhubekela phambili ngokushesha. I-catheter ye-motility ye-esophageal izobe ikhethwe ekhaleni lakho uma ukujula okufanele kutholakale. Khona-ke uzocelwa ukuba ulale phansi ngenkathi i-catheter iqondiswa kahle ukuze ihlolwe. Ngesikhathi sokulinganiswa, kufanele ugweme ukugwinya ukuvumela ukulinganisa okulungile.
- Ukuhlolwa kuqala ngezinzwa ezimbili zokugcina ezisesiswini. Uzocelwa ukuba uthathe umoya ojulile ukusiza ukufaka ukubekwa kahle ngaphakathi kwesisu sakho. Uma isungulwe, isisindo somswakama we-motility catheter isilinganiso sokucindezela sisethelwe ku-zero. Ngenkathi ingcindezi yangempela ingeyona ngempela i-zero, isisu simakwe njenge-zero ukwenza njengesisekelo sokulinganisa ukucindezelwa kwesiphincter sakho esingaphansi kwe-sphincter.
- Ngemuva kokulinganiswa kwesisu esiswini, i-catheter ye-motility esophageal ihoxiswa ku-sphincter esezansi. Uma ubeke kahle, uzonikezwa ama-sips amaningana amanzi okushisa kwamakamelo (cishe ama-5 ml noma ngaphezulu kwepisipuni eyodwa). Zizobe zilinganisa ukucindezela okukhona ekuphumuleni (sphincter endaweni evaliwe) futhi uma i-sphincter ixosha ngesikhathi sokugwinya kwamanzi.
Lapho i-sphincter ixosha, kufanele ivame ukufika eduze nesilinganiso sokucindezeleka kwesisu esisethelwe ku-zero ngaphambili kokuhlolwa. Ngesikhathi sokuhlolwa, uzocelwa ukuthi uphefumule ngokuthula ngokujula okujwayelekile ukuze uvumele isilinganiso esifanele. - Ngama-sensor wokugcina endaweni ephezulu yokucindezela ye-sphincter yakho engaphansi, uzophinde athathe isilinganiso ngesikhathi sokugwinya kwamanzi ukuthi isisindo sakho sithinta kanjani ukugwinya. I-esophagus yakho kufanele ibonise ukucindezela okwenyuka okuvela engxenyeni ephezulu yendawo yakho futhi kufanele ibone ukukhushulwa kwengcindezi phansi kwe-catheter yokuzamazama komhlaba njengoba amanzi ewela phansi esiswini sakho.
Le nkinga yokunyuka kwengcindezi ingenxa ye-peristalsis, noma ukuvinjelwa okungazibandakanyi komzimba osindayo ukuhambisa okuqukethwe kwisisu sakho. Njengasesiteji sangaphambilini, lapho amanzi esesimweni se-sphincter yakho esiphezulu, izinga lokucindezela kufanele lifinyelele ku-zero. - Uma uhlola i-sphincter yakho engaphezulu, uzocelwa ukuba uhlale. I-catheter ye-motility esophageal izothuthukiswa kancane futhi ibe khona lapho ingakwazi ukukhomba indawo ephezulu yokucindezela ye-sphincter yakho engaphezulu. Umfutho we-sphincter uzoqhathaniswa nengcindezi esisekelo esisekelo esengxenyeni eyinhloko yesimo sakho. Uma ukucindezelwa sekuphumula, noma endaweni evaliwe, ingcindezi ngesikhathi sokugwinya izokala. Kuleli phuzu, ngokubeka kahle, ukuhlolwa kungabuye kubone ukuxhumana phakathi komphimbo wakho kanye ne-sphincter yakho ephezulu.
Izinkinga ezingenzeka
Yazi ukuthi izixazululo ezihlobene nokuhlolwa kwe-manometry esingajwayelekile. Noma kunjalo, noma yikuphi ukucindezeleka okulandelayo okungenzeka kwenzeke:
- izinhliziyo ezingavamile
- isifiso (okuqukethwe kwe-asidi noma isisu egeleza uphuzu kanye namaphaphu akho)
- i-perforation (ukubhubhisa) ye-esophagus yakho
- i-tube ibekwe emaphashini esikhundleni se-esophagus - iqondiswe kalula ngesikhathi sokufaka
Eziningi zazo ziyakugwema ngokulandela imiyalelo ehlinzekwe udokotela wakho ngaphambi kwenqubo.
Ezinye izindlela zokuhlola ukulinganisa kwe-Manometry
I-manometry yokulinganisa iyindlela engcono kakhulu yokuhlola noma yikuphi ukungasebenzi kahle nge-motility esophageal. Noma kunjalo, isifundo sokugwinya se- barium singasetshenziselwa ukuhlola umsebenzi we-spopincter function yakho.
Kukhona inguqulo entsha emisha yokwenza i-manometry engalingani ebizwa ngokuthi i-manometry ephezulu yokuxazululwa. Esikhundleni sokusebenzisa izinzwa eziyisishiyagalombili emgodini we-motility catheter, i-catheter ephezulu yokusebenzisa isebenzisa izinzwa ezingu-36. Inqubo esetshenziselwa ukulinganisa iyafana. Kodwa-ke, uma i-catheter ifakwe kahle, akukho ukuhoxiswa kwe-catheter okudingekayo. Ibuye ivumeleke imephu ye-3-dimensional imephu ebizwa ngokuthi i-esophageal pressurepography engase iwusizo ekunqumeni ukukhathazeka okuthile nge-asymmetrical sphincter ukungasebenzi.
Izwi elivela
Uma uzwa ukhathazekile noma uphazamiseke lapho udokotela wakho uncoma ukuhlolwa kwe-manometry esesisindo, yazi ukuthi inqubo ilula futhi ayibangele ukudala izinkinga, ikakhulukazi uma ulandela imiyalelo. Ukukwazi ukuthi yini ongayilindela kungasiza ekudambiseni ukwesaba okuthile, futhi uma usesaba ngesinyathelo esithile senqubo, vumela udokotela wakho azi. Angase abe nezincomo eziwusizo.
> Imithombo:
> Isinqumo esiphezulu > i-manometry. Iwebhusayithi ye-UpToDate. https://www.uptodate.com (Okubhaliselwe Kudingeka). Kubuyekezwe u-Julayi 10, 2017.
> Sibutsetelo sokuhlolwa kwamathumbu emathunjini. Iwebhusayithi ye-UpToDate. https://www.uptodate.com (Okubhaliselwe Kudingeka). Kubuyekezwe Sep 12, 2016.
> Richter, JE & Castell, DO. (2012). I-Esophagus. 5 th . Wiley-Blackwell. iphe 163-181.
> Ukuqonda i-Manophytic Esophageal. I-American Society ye-website yezinsipho ze-Endoscopy. https://www.asge.org/home/for-patients/patient-information/understanding-esophageal-manometry.