hnoos tuaj yeem muaj ntau yam ua rau - los ntawm tus mob khaub thuas mus rau tuberculosis. Nws tsis yog ib txwm cuam tshuam nrog cov kab mob ua pa, pathology tuaj yeem tshwm sim thaum lub suab ntawm cov leeg ntawm lub plab thiab txoj hlab pas cuam tshuam. Tus kab mob no hu ua gastroesophageal reflux disease (GERD). hnoos hauv qhov no, cov neeg mob yuav tsis meej pem nrog laryngitis, bronchitis lossis pharyngitis, yog li kev kho tus kheej tsis muaj qhov xav tau.
Keeb kwm ntawm hnoos
Qhov rov qab txav ntawm cov zaub mov uas muaj kua txiv kab ntxwv yog hu ua reflux. Cov zaub mov me me dhau los ntawm lub plab mus rau hauv txoj hlab pas vim qhov kaw tsis tiav ntawm qhov qis esophageal sphincter (LES) ntawm cov kabmob no lossis, yooj yim dua, lub valve.
Muaj ntau yam laj thawj vim li cas lub valve tsis muaj zog:
- Cov khoom muaj txiaj ntsig uas ua rau muaj kev nce siab hauv lub plab kab noj hniav (cev xeeb tub, flatulence, muaj zog plab hnyuv txhaws, loj neoplasms, tsub zuj zuj hauvCov kua dej ntau hauv plab).
- Ntxias lub plab phab ntsa (hnav nruj txoj siv, nruj ris, los yog khoov dua sharply).
- Nyob ntawm LES cov leeg pob txha vim muaj hnub nyoog.
- Ntau lub siab hauv plab (overeating, gas accumulating, quav quav).
- Siv dej cawv, khoom noj khoom haus thiab qee yam tshuaj.
- Ntau tshaj, tshwj xeeb tshaj yog tias koj muaj plab loj.
Tsis tu ncua reflux surges, nrog rau lub siab kub hnyiab, ib qho kev xav ntawm hnyav nyob rau hauv lub plab los yog tom qab lub sternum, qhia txog kev loj hlob ntawm GERD.
Cas thiab tshwm sim ntawm hnoos tsis tu ncua
hnoos fits hauv GERD tshem tawm cov hnoos qeev thiab cov khoom txawv teb chaws los ntawm txoj kev ua pa. Cov laj thawj tseem ceeb ntawm qhov kev tshwm sim no hu ua:
- kab mob ua xua;
- ua rau lub cev los ntawm cov kab mob;
- kab mob thiab qog ntawm txoj hlab pa;
- ua txhaum ntawm plab hnyuv microflora;
- Aortic aneurysm cuam tshuam rau ntawm lub bronchi;
- mob plab lossis mob plab;
- tshuaj lom neeg sab nraud ntawm lub bronchi;
- qhov quav pathology;
- kab mob siab;
- kev lom zem.
Kev noj zaub mov tsis zoo, kev ua neej nyob tsis muaj zog, noj zaub mov tsis zoo, tus cwj pwm tsis zoo tuaj yeem ua rau GERD.
hnoos tshwm sim los ntawm ntau yam laj thawj thiab kav ntev, ua rau muaj ntshav siab, tsis muaj ntshav ncig hauv siab thiab lub plawv dhia qisabbreviations.
daim duab kho mob
Gastroesophageal reflux txawv rau txhua tus, nws txhua tus nyob ntawm qhov ua rau khaus. Kev sib xyaw ua ke ntawm hnoos thiab gastroenterological pathologies pab kom paub qhov txawv reflux los ntawm lwm yam kab mob:
- angina;
- ARVI;
- caws;
- hnoos nrog lub plawv tsis ua hauj lwm.
Kev kho mob nrog homolytic cov neeg ua rau hnoos plab tsis ua rau cov txiaj ntsig xav tau, thiab qhov xav kom hnoos yog pom los ntawm cov neeg mob tsuas yog tom qab noj mov. Cia peb kawm seb hom hnoos li cas nrog GERD tshwm sim thiab nrog lub cev twg nws cuam tshuam:
- kis kab mob hauv plab (debilitating, hnoos qhuav tas li);
- plab rwj, mob plab (zoo li ob peb teev tom qab noj mov, hnov lub suab du, zoo li tus neeg choke);
- worming (hnoos nrog rau kev ua pa tsis ua haujlwm);
- kab mob enterovirus (nyuaj thiab mob plab zom mov, hnoos qhuav, malaise thiab mob plab).
Feem ntau, thaum hmo ntuj, nyob rau hauv txoj kab rov tav ntawm tus neeg mob, kev tawm tsam tuaj yeem ua kom hnyav dua thiab ntuav.
Lub luag haujlwm tiv thaiv ntawm cov kev tawm tsam no yog tias hauv GERD hnoos nrog cov hnoos qeev thiab cov khoom txawv teb chaws uas tau nkag mus rau hauv txoj hlab pa tshem tawm cov hnoos ntau dhau.
Pathology entails general malaise, irritability, nkees, mob hauv siab.
Kev mob tshwm sim
Hauv cov neeg laus, cov tsos mob hnoos GERD tshwm sim nrogqee qhov tsis xis nyob:
- Mob siab. Qhov sib txawv tseem ceeb ntawm tus kab mob yog qhov tshwm sim hauv 1-2 teev tom qab noj mov thiab hmo ntuj. Tsis xis nyob nce yog tias koj haus cov dej qab zib thiab kas fes. Kev tawm dag zog lub cev thiab noj ntau dhau cuam tshuam.
- Belching cua los yog kua txiv qaub. Qhov laj thawj yog kev noj cov ntsiab lus ntawm lub plab mus rau hauv txoj hlab pas, thiab tom qab ntawd mus rau hauv qhov ncauj kab noj hniav. Li no thiaj li pom qaub saj thiab mob qa.
- Teeb meem thaum nqos zaub mov. Muaj kev khaus ntawm lub larynx thiab o ntawm phab ntsa ntawm txoj hlab pas, xeev siab thiab ntuav.
- Hlub. Khawv koob ntawm phrenic paj hlwb thiab contraction ntawm lub diaphragm.
- Dysphonia. Lub suab nrov nrov thiab nyuaj rau hais nrov nrov.
- Ua pa tshwm sim. Ua tsis taus pa thiab hnoos tshwm sim thaum lub cev txav.
Nyob rau hauv cov menyuam yug tshiab, lub cev nqaij daim tawv gastroesophageal reflux muaj ntau, tab sis qhov no yog vim lub peculiarities ntawm sphincter thiab lub plab me me. Rau thawj peb lub hlis, cov menyuam mos ntuav ntuav, qee zaum lawv tuaj yeem ntuav, tab sis qhov no yog qhov qub. Thaum loj hlob tuaj, cov kev tshwm sim no ploj mus.
Tab sis nws tshwm sim tias tus kab mob gastroesophageal reflux tsis ploj mus, tab sis mus ntxiv. Cov menyuam yaus yws txog cov tsos mob hauv qab no:
- mob thaum nqos mov;
- mob qa;
- xav ib pob hauv siab.
Ib lub tswb tswb yog hnoos hauv tus menyuam uas muaj GERD, nrog rau kev kuaj pom thaum sawv ntxov ntawm lub hauv ncoodawb-xim impurities, uas tuaj yeem hu ua qhov taw qhia ntawm nquag belching thaum pw tsaug zog. Cov tsos mob ntxiv ntawm tus kab mob hauv cov menyuam yaus yog tib yam li cov neeg laus.
Spawn time
Cov neeg mob feem ntau tsis hnoos thaum noj mov. Feem ntau, kev tawm tsam pib tom qab noj mov tom qab 30 feeb, vim tias cov khoom noj zom tau zoo nyob rau lub sijhawm no. Ib qho tsis xws luag nyob rau hauv qis sphincter tsim reflux ntawm lub plab thiab txoj hlab pas, ua rau hnoos.
Ua ke nrog hnoos hnoos, cov tsos mob hauv qab no tuaj yeem ua tau:
- tsis xis nyob saum plab;
- siab kub;
- ua tsis taus pa;
Yog tus neeg mob tsis noj zaub mov ntau tshaj 3 teev thiab xav tias tshaib plab, ces cov ntxhiab tsw ntawm cov zaub mov yuav thawb tsim cov hydrochloric acid nyob rau hauv lub plab, uas yuav ua rau mob hnyav ntawm cov phab ntsa ntawm lub cev thiab lub cev. reflux ntawm digestive kua txiv mus rau hauv lub esophagus. Qhov tshwm sim yuav yog ib qho haum ntawm hnoos thiab khaus rumbling hauv plab.
Diagnosis
Nws yog qhov zoo dua rau tus neeg mob tsis yog kho tus kheej, tab sis tig mus rau tus kws kho mob plab. Tus kws kho mob tshwj xeeb yuav kuaj:
- yuav hais tsis txaus siab rau hauv tus account;
- xeem tus neeg mob;
- yuav teem sijhawm kuaj kuaj.
Tus kws kho mob yuav mloog tus neeg mob lub ntsws thiab lub hauv siab, kawm txog qhov hnoos. Feem ntau nrog GERD, hnoos qhuav uas ua rau tus neeg mob tas mus li. Nws yog ib qho tseem ceeb uas yuav tsum tau ua tib zoo saib yuav ua li cas lub suab hloov txhua hnub. Cov hauv qab no feem ntau yog siv los kuaj mob gastroesophageal reflux:
- X-ray ntawm lub ntsws- tiv thaiv kab mob ntsws los yog tuberculosis.
- Esophageal endoscopy - txhawm rau txheeb xyuas qhov mob, yaig thiab rwj.
- Kev ntsuas txhua hnub ntawm acidity (pH) hauv qab ntawm txoj hlab pas. Cov qauv ntawm pH ntsuas yuav tsum nyob ntawm 4 txog 7. Kev hloov pauv ntawm cov ntaub ntawv tiag tiag yuav qhia txog kev txhim kho ntawm cov kab mob.
- X-ray kuaj ntawm txoj hlab pas yuav pab kom tsis suav nrog lwm hom kab mob.
- txhawm rau ntsuas lub suab ntawm cov hlab ntsha hauv plab, kev tshawb nrhiav manometric tau ua.
- Kev kuaj ntshav ntawm txoj hlab pas tau ua tiav thaum Barrett tus hlab pas xav tias.
Rau qhov kev kuaj mob kom raug, nws yog ib qho tseem ceeb kom paub qhov txawv seb nws yog hnoos nrog GERD los yog qhov tshwm sim ntawm lwm yam kab mob.
kab mob daim ntawv
Txawm li cas los xij, nyob ntawm seb qhov kev puas tsuaj rau cov hlab ntsha ntawm lub plab, tus kab mob muaj ob hom:
- Tsis yog erosive. Qhov no yog hom kab mob feem ntau ntawm pathology. Nws tshwm sim yam tsis muaj kev hloov pauv hauv mucosa (endoscopically negative - NERB).
- Nyob zoo. Nrog rau daim ntawv no, kuaj pom qhov tsis xws luag ntawm qhov sib txawv.
Cov teeb meem ntawm GERD suav nrog cov mob ua ntej xws li Barrett's esophagus. Nyob rau hauv cov ntaub ntawv no, lub hlwb ntawm stratified epithelium ntawm lub mucosa yog hloov los ntawm lwm tus, piv txwv li, hlwb rau cov hnyuv me los yog loj.
Lub cev noj qab nyob zoo muaj peev xwm rov qab tau cov zaub mov gruel rov qab rau hauv plab. Nyob rau tib lub sijhawm, cov kua txiv hmab txiv ntoo tau ua kom tsis zoo los ntawm qaub ncaug bicarbonate, uas tiv thaiv cov mucosa los ntawm kev sib tsoo.
Dab tsi yuav pab txo qis reflux
Tom qab txheeb xyuas qhov ua rau hnoos plab kom txo tau qhov tshwm sim tsis zooCov lus qhia txog kev noj haus los ntawm cov kws tshaj lij:
- tshem tawm cawv thiab dej qab zib;
- normalize lub cev hnyav, uas yuav txo qhov siab hauv kab noj hniav thiab txo qhov tshwm sim ntawm reflux;
- tsis txhob noj ntau dhau, ib pluas noj yuav tsum tsis pub tshaj 300-500 ml;
- zaub mov zoo dua los ua noj;
- noj me me 4-5 zaug ib hnub;
- txo cov zaub mov muaj roj;
- txwv cov khoom noj ntsev thiab ntsim vim lawv ua rau plab acid thiab enzyme ntau lawm;
- tom qab noj mov, txwv tsis pub ua txoj haujlwm kab rov tav, reflux tuaj yeem ua raws hauv txoj hlab pas, thiab tsis txhob khoov;
- hmo ntuj pw yuav tsum nyob rau hauv ib lub taub hau tsa me ntsis ntawm lub txaj, kwv yees li ntawm 15-20 cm.
GERD hnoos puas kho tau? Yog tias koj ua raws li cov lus pom zoo no, ces qhov yuav nce ntxiv, tab sis tsis tas li. Thaum pathology siv ib daim ntawv loj, kev txwv hnyav dua yuav tsum tau siv rau kev noj haus. Muaj ntau yam zaub mov tsis suav nrog, zaub mov tsuas yog siv rau hauv daim ntawv grated, noj mov kawg yuav tsum yog 4 teev ua ntej yuav mus pw.
kev pab kho mob
hnoos hauv GERD tshwm sim vim muaj cov ntsiab lus ntawm lub plab. Thiab kev kho mob yuav tsum tau ua tiag tiag kom ua tiav cov txiaj ntsig xav tau.
Thaum lub sijhawm kho tshuaj, cov tshuaj hauv qab no tau sau tseg:
- proton twj tso kua mis inhibitors (Omeprazole, Rabeprazole) thiab lwm yam tshuaj tua kab mob;
- prokinetics txhawm rau txhim kho plab hnyuv thiab plab motility ("Cerukal", "Motilium");
- antacids ("Maalox", "Phosphalugel");
- vitamins los kho cov mucous ntawm txoj hlab pas.
Omnitus ua pov thawj tias yog qhov zoo rau qhov hnoos qhuav tsis tu ncua nrog GERD. Cov tshuaj muaj kev cuam tshuam ncaj qha rau ntawm qhov chaw hnoos. Zoo heev expectorant thiab anti-inflammatory agent.
Ntau tus neeg sim tshem tus kab mob ntawm lawv tus kheej, siv cov tinctures thiab decoctions. Ua ntej pib kho, koj yuav tsum xyuas kom meej tias qhov kev kuaj mob yog lawm. Txwv tsis pub, kev kho mob yuav tsis muaj txiaj ntsig. Mob khaub thuas hnoos thiab GERD tawm tsam tsis yooj yim kom paub qhov txawv.
kho mob phais
Yam tsawg kawg yuav tsum tau kho yog tias tus kab mob tsis haum rau kev kho tshuaj. Muaj ntau hom kev phais:
- Txoj kev Endoscopic (suturing the cardiac sphincter).
- Radiofrequency (kev puas tsuaj rau lub plawv sphincter txheej).
- Gastrocardiopexy (kev kho mob ntawm hernias uas tau tshwm sim hauv txoj hlab pas, nrog ntxiv dag zog ntawm ligamentous apparatus).
- Laparoscopic (thaum lub sijhawm ua haujlwm, hauv qab ntawm lub cev tau qhwv ib ncig ntawm txoj hlab pas).
Txhua yam kev phais mob yog ib qho kev ntsuas yuam kev thiab feem ntau cuam tshuam cov kev mob tshwm sim.
Nkauj hmoob kho siab
Ib qho hnoos nrog GERD puas tuaj yeem kho nrog pej xeem txoj kev? Cov kws kho mob dab thiab cov kws kho mob tau qhia qee cov zaub mov txawv los daws cov tsos mob tsis zoo:
Yuav xav tauflax noob. Ib teaspoon ntawm cov noob yog poured rau hauv ib lub tais (tsuas yog tsis yog hlau), ncuav nrog ib khob ntawm boiling dej thiab simmered tshaj tsawg tshav kub rau 5 feeb. Cov tais diav tau muab tso tseg thiab qhwv rau ib nrab ib teev. Tom qab lub sijhawm dhau los, lim los ntawm cheesecloth. Haus dej sov 1/3 khob 3 zaug hauv ib hnub.
- Kho hnoos rau GERD tuaj yeem ua nrog hiav txwv buckthorn lossis rosehip roj. Koj yuav tsum noj peb zaug ib hnub rau ib teaspoon.
- Khau los ntawm tshuaj ntsuab. Koj xav tau 4 pinches ntawm St. John's wort, 2 pinches ntawm calendula, licorice keeb kwm, plantain, calamus, ib qho ntawm tansy paj thiab peppermint. Cov nyom yog poured rau hauv ib lub tais enamel, txhua yam yog tov. Cov sau yog nchuav nrog ib khob ntawm boiled dej, npog, qhwv thiab insisted rau 30 feeb. Tom qab straining, sov 1/3 khob 3 zaug ib hnub twg.
Qhov tshwm sim ntawm qhov tsis muaj kev kho mob
Yog tias tsis quav ntsej GERD cov tsos mob thiab hnoos, kev kho mob yuav ntev dua vim muaj teeb meem. Feem ntau yog:
- kev tsis haum;
- pathology ntawm kev ua pa;
- aneurysms;
- chronic bronchitis;
- pneumonia;
- pulmonary fibrosis;
- qog nqaij hlav hauv lub ntsws.
Nrog rau lub sijhawm ntev ntawm kev mob lossis kab mob hauv daim ntawv ntev, lub siab hauv siab nce ntxiv. Muaj kev ua tsis tiav hauv cov ntshav ncig thiab kev ua haujlwm ntawm lub plawv txo qis. Ib qho spasm tas li ua rau tsis muaj zog ntawm elasticity ntawm lub ntsws cov ntaub so ntswg, uas ua rau emphysema.
hnoos haum nrog GERD tuaj yeemua rau pw tsaug zog apnea, uas txo qis qhov cua ntawm lub ntsws. Tus neeg mob tsis tau txais cua rau lub alveoli rau ib lub sijhawm.
Kev kho tus kab mob yuav tsum yog qhov zoo. Nws yuav tsum tau kho tus kab mob nws tus kheej thiab cov tsos mob thiab cov tsos mob.
