Y Gastroesophageal reflux kab mob yog ib qho pathology uas cov ntsiab lus ntawm lub plab tuaj yeem rov qab mus rau hauv txoj hlab pas. Nyob rau hauv cov ntaub ntawv no, lub mucous daim nyias nyias yog puas, uas yog vim li cas cov tsos mob tshwm sim. Xws li ib tug pathology tsis nyob ntawm kev noj zaub mov, tshwm sim systematically, feem ntau txhawj xeeb thaum hmo ntuj nyob rau hauv txoj hauj lwm kab rov tav.
Kev tshwm sim
Kab mob gastroesophageal reflux feem ntau yog tshwm sim los ntawm kev noj zaub mov tsis txaus, muaj roj ntau hauv cov zaub mov, nqos tau huab cua ntau. Cov laj thawj hauv qab no tuaj yeem ua rau muaj kab mob:
- Kev ua haujlwm tsis raug lossis tsis txaus ntawm lub sphincter qis uas cais cov hlab pas thiab lub plab. Qhov no tej zaum yuav yog vim lub cev tsis zoo ntawm lub plab zom mov lossis ib qho kev kis kab mob.
- Diaphragmatic hernia.
- Kev kho mob ntawm esophageal clearance. Khoom noj khoom hauslingers nyob rau hauv lub plab thiab, tsub kom, provokes lub reflux ntawm hydrochloric acid rov qab.
- noj zaub mov uas ua rau khaus khaus.
- Npaj plab siab. Nws feem ntau tshwm sim vim kev puas tsuaj rau cov kabmob hauv nruab nrog cev lossis cov khoom ntim ntawm cov kua dej ntau hauv.
- Zoo plab plab ulcer.
- Kev ntxhov siab.
- Ntau tshaj.
- Kev siv qee cov tshuaj. Qee cov tshuaj pab txo cov suab nrov ntawm cov hlab pas esophageal sphincter.
Cov tsos mob ntawm tus kab mob gastroesophageal reflux yog txhawb nqa los ntawm tus cwj pwm phem: haus luam yeeb, haus cawv. Tus mob no feem ntau tshwm sim hauv cov poj niam cev xeeb tub vim muaj kev ntxhov siab ntau hauv plab.
YKev faib tawm ntawm pathology
Kev faib tawm ntawm tus kab mob gastroesophageal reflux yog raws li hauv qab no:
- Sour form. Ntawm no cov acidity theem yog 4 units. Muaj ib qho tseem ceeb ntawm hydrochloric acid nyob rau hauv lub plab, uas tshaj li tus qauv.
- Siab me ntsis acidic. Cov ntsuas ntsuas hloov hauv 4-7 units.
- Alkaline.
Tsis tas li, tus kab mob gastroesophageal reflux (GERD) tsis yog erosive (cov tsos mob tsis zoo yog mob me, cov txheej txheem inflammatory tsis tsim), ulcerative-erosive (qhov txhab, rwj tshwm sim ntawm lub plab mucosa, kev pheej hmoo ntawm los ntshav nce). Cov kab mob uas nyuaj tshaj plaws yog Barrett's esophagus - qhov no yog ib qho mob ua ntej.
Symptomatics
Ua rau thiab cov tsos mobTus kab mob gastroesophageal reflux yuav tsum paub rau cov neeg uas muaj caj ces predisposition rau kab mob ntawm lub plab zom mov. Qhov no pathology yog tus yam ntxwv los ntawm xws manifestations.
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Ntau tus neeg mob muaj mob tom qab sternum, uas kis mus rau lwm qhov ntawm lub cev: caj dab, nraub qaum, xub pwg, caj npab.
Thawj cov tsos mob ntawm tus kab mob gastroesophageal reflux yuav tsis mob heev, tab sis lawv tshwm sim ntau zaus, yog li koj yuav tsum tsis txhob yig mus ntsib kws kho mob. Cov kev tshwm sim tau tshwm sim ntau dua tom qab kev tawm dag zog lub cev, noj ntau dhau ntawm cov khoom noj qab zib, khoom noj hnyav, hmo ntuj.
Kev kuaj mob nta
Gastroesophageal reflux disease (GERD) cov tsos mob tsis yog tshwj xeeb. Los ntawmTus neeg mob qhov tsos mob tsis tuaj yeem kuaj tau, yog li nws yuav tsum tau kuaj xyuas, suav nrog:
- Proton twj tso kua mis inhibitor kuaj. Nws lub sijhawm yog 14 hnub.
- Sphincter manometry. Nws yuav pab koj kawm txog lawv txoj haujlwm.
- Kev txiav txim siab ntawm lub cev muaj zog ntawm txoj hlab pas.
- Saib xyuas pH ntawm kua txiv plab. Nws yog nqa tawm txhua hnub. Ua tsaug rau txoj kev tshawb no, nws muaj peev xwm tsim tau qhov zaus ntawm reflux, nrog rau tus nqi deacidification.
- YFibroesophagogastroduodenoscopy. Txoj kev tshawb no ua rau nws muaj peev xwm sib txawv GERD los ntawm kev mob qog noj ntshav.
- Helicobacter test.
- Chromoendoscopic kuaj ntawm txoj hlab pas. Xws li kev kuaj mob yog tsim nyog rau cov neeg mob uas nquag tawm tsam ntawm GERD, thiab tus kab mob nws tus kheej muaj kev kawm ntev.
- Ultrasound ntawm lub cev sab hauv ntawm lub plab kab noj hniav thiab lub plawv.
- Electrocardiogram kom sib txawv angina pectoris.
- X-ray ntawm txoj hlab pas nrog qhov sib piv nruab nrab.
Kev kuaj mob endoscopic yog siv los kho thiab kuaj mob. Nws tso cai rau koj los txiav txim siab qhov kev puas tsuaj rau txoj hlab pas:
- Zero. Tseem tsis tau muaj ntaub so ntswg puas lawm.
- Thawj. Kev yaig me me tshwm sim ntawm cov mucosa, tab sis lawv tsis sib koom ua ke.
- Second. Nyob rau theem no, qhov txhab cuam tshuam rau thaj tsam loj thiab pib ua ke. Txawm li cas los xij, qhov qis thib peb ntawm cov mucosa tseem tsis zoo.
- Thib peb. Nyob rau theem no, erosion npog yuav luag tag nrho qis ntawm txoj hlab pas (distaldepartment).
- Plaub. Cov theem no yog qhov nyuaj tshaj plaws, vim nws suav tias yog ib qho mob precancerous. Conservative kho nyob rau hauv cov ntaub ntawv no tej zaum yuav siv tsis tau.
Tsis tas li ntawd, tus neeg mob tau raug kuaj kuaj ntshav, quav. Txhawm rau kuaj xyuas qhov tseeb, koj yuav tau hu rau tus kws kho mob pulmonologist, kws kho plawv, ENT, thiab tus kws phais.
GERD in me nyuam
Cov tsos mob ntawm tus kab mob gastroesophageal reflux (GERD) hauv cov menyuam yaus yog:
- Ntxawm hmo.
- -nquag thiab profuse regurgitation.
- poob qab los, poob phaus.
- Poob tsis nco qab.
- Ntshai chim siab heev, quaj quaj.
- poob teeb meem.
- Headache.
Kev kho mob gastroesophageal reflux hauv cov menyuam yaus suav nrog kev siv tshuaj, suav nrog qhov hnyav ntawm cov kab mob, qhov hnyav ntawm cov tsos mob, thiab cov yam ntxwv ntawm lub cev. Feem ntau, cov menyuam mos yog cov tshuaj uas ua kom lub plab zom mov kom ruaj khov: Domperidone, Metoclopramide.
Tom qab noj cov nyiaj no, lub plab tso tawm sai dua, thiab lub suab ntawm cov hlab ntsha hauv lub cev nce ntxiv. Lub sijhawm ntawm kev kho yog 10-14 hnub. Txhua yam tshuaj nyob rau hauv me nyuam yaus raug sau nrog ceev faj heev.
kho mob thiab phais
Tshuaj rau tus kab mob gastroesophageal reflux yuav tsum tau xaiv los ntawm kws kho mob, nyob ntawm seb tus neeg mob, qhov kev hem thawj ntawm cov teeb meem, hom kab mob. GERD yuav tsum tsis yog kho xwb, nws yog ib qho tsim nyog los tiv thaiv kev rov qab los. Ib tug neeg yuav raug muab tshuaj raws li nram no:
- Antacids: Gaviscon, Maalox. Cov nyiaj no neutralize cov nyhuv ntawm hydrochloric acid, txhawb kev tsim cov bicarbonates, uas tsim cov nyhuv cytoprotective. Lub suab ntawm qhov qis sphincter yog nce. Lawv tsuas yog siv rau lub sij hawm luv luv tshem tawm ntawm qhov tsis pom kev. Lawv tau siv los ua kev kho mob ntxiv, txawm li cas los xij, lawv tsis kav ntev. Hom kev kho no yuav tsum tau siv tom qab ib teev ntawm kev noj mov, nrog rau ua ntej yuav mus pw. Nws yog qhov zoo dua los siv cov khoom siv thib 3.
- Prokinetics: "Motilium". Lawv pab txhim kho lub suab ntawm sphincter. Lub plab zom mov yog tawm sai sai los ntawm cov zaub mov digested. Prokinetics tuaj yeem txo tus naj npawb ntawm refluxes. Nyob rau hauv thawj theem ntawm txoj kev loj hlob ntawm pathology, tshuaj ntawm hom no tau tso cai rau siv nyob rau hauv monotherapy. Nws yog ib qho tseem ceeb uas yuav tsum nco ntsoov tias qee cov tshuaj hauv pab pawg no ua rau qaug zog, pw tsis tsaug zog, tsis muaj zog, yog li lawv tau muab tshuaj rau hauv cov chav kawm luv luv.
- Proton twj tso kua mis inhibitors: "Omeprazole". Lawv stabilize lub acidity thiab tswj nws nyob rau hauv ib txwm theem rau tsawg kawg yog 16 teev. Cov chav kawm ntawm kev kho mob nrog xws li txhais tau tias yog 6-8 lub lis piam. Cov tshuaj no suav hais tias yog qhov zoo tshaj plaws thiab muaj zog. Lawv qhov txiaj ntsig yog qhov tsawg tsawg ntawm cov kev mob tshwm sim.
- tshuaj tiv thaiv kab mob: "Famotidine". Cov tshuaj no txo qis cov kua qaub, nrog rau nws cov teebmeem tsis zoo.
- Cytoprotectors: "Preductal". Nrog rau cov tshuaj no, nws muaj peev xwm txo tauacidity ntawm cov kua txiv hmab txiv ntoo hauv plab, txhim kho kev tsim cov bicarbonates, ua kom muaj kev tiv thaiv ntawm hnoos qeev. Cov ntshav ntws hauv cov mucosa ntawm txoj hlab pas tau qhib.
- Reparants: "Dalargin", hiav txwv buckthorn roj. Cov nyiaj no ua rau kev kho kom zoo dua qub.
Thaum lub sijhawm kho, nws tseem yuav tsum tau saib xyuas koj tus kheej qhov hnyav, tso tseg cov khaub ncaws nruj. Koj yuav tsum haus 2-2.5 litres dej ib hnub.
Kev kho tus kab mob gastroesophageal reflux, tshuaj tsuas yog kws kho mob tau sau tseg, thiab yog tias tus neeg mob tau noj tshuaj ua ntej, lawv yuav tsum tau tso tseg.
Yog tias kev kho mob ntawm cov kab mob pathology tsis zoo, tus neeg mob yuav raug txiav txim. Muaj ntau hom txheej txheem:
- YEndoscopic phais.
- Laparoscopy. Ua tsaug rau cov txheej txheem no, lub kaum sab xis ntawm lub plab thiab txoj hlab pas tuaj yeem rov qab los.
- Radiofrequency ablation ntawm txoj hlab pas.
- Argon plasma coagulation.
Zoo nyob ntawm kev cuam tshuam, lub sijhawm rov qab siv sijhawm ntau lub lis piam.
Kev Kho Mob Neeg
Yog tias ib tus neeg raug kuaj pom tias muaj kab mob gastroesophageal reflux, kev kho mob nrog cov tshuaj pej xeem tuaj yeem ua tau zoo. Tab sis nws yuav tsum tau siv ua ke nrog tshuaj. Ua ntej siv cov tshuaj pej xeem tshuaj, koj yuav tsum sab laj nrog koj tus kws kho mob. Cov cuab yeej hauv qab no yuav pab tau:
- Decoction of flax noob. Rau kev ua noj, noj 4 tbsp. l. raw cov ntaub ntawv thiabncuav 2 khob dej kub boiled. Nws yuav siv li ib nrab teev mus rau ib teev los hais. Tom qab txias, lub decoction yuav tsum tau lim thiab noj thaum sawv ntxov, 5 sips. Lub sijhawm kho yog 5-6 lub lis piam. Cov cuab yeej pab tiv thaiv txoj hlab pas los ntawm kev puas tsuaj los ntawm hydrochloric acid, ua rau nws tsis kam.
- Muaj. Nws muaj cov nyhuv enveloping. Koj tuaj yeem haus nws tom qab noj mov, nrog rau ua ntej ib hmo so.
- qos yaj ywm nyoos. Nws yuav tsum xub muab ntxuav thiab txiav mus rau hauv me me pieces. Tsis tas li ntawd, lawv yuav tsum tau zom maj mam. Qhov kev kho no yuav pab nrog kub siab. Kua txiv qos kuj suav hais tias muaj txiaj ntsig. Haus 1/4 khob 3 zaug ib hnub.
- Birch bark. Nws yuav tsum xub muab av rau hauv hmoov. Cov khoom siv raw yog siv txhua hnub rau 1 tsp. Cov hmoov yuav tsum tau ntxuav nrog dej kom ntau.
- Decoction ntawm marshmallow cag. Nws yuav siv 6 g ntawm cov khoom ua ntej crushed, nrog rau ib khob dej sov, qhov sib tov yuav tsum tau boiled nyob rau hauv ib da dej. Lub sijhawm ntawm cov txheej txheem yog 30 feeb. Tom qab straining, lub decoction yuav tsum tau txias thiab noj 0.5 khob mus rau 3 zaug ib hnub twg.
- Kua txiv celery cag. Nws soothes siab kub hnyiab, pab tshem tawm lwm cov tsos mob. Tus neeg mob yuav tsum tau siv 3 tbsp. l. dej peb zaug ib hnub twg.
- noob taub dag. Lawv kuj pab kom soothe mob thiab kub siab. Nws txaus tsuas yog noj me me ntawm cov khoom ib hnub xwb.
- Herbal collection. Nws yog tsim nyog los sib tov 1 tbsp. l. elecampane paus, aloe, ntxiv rau cov muaj pes tsawg leeg ntawm 2 tbsp. l. grapes, 4 tbsp. l. hypericum paj. Txhua yam khoom siv rawyuav tsum tau crushed ua ntej. Cov sib tov yog poured nrog freshly boiled dej thiab boiled rau 20 feeb tshaj tsawg tshav kub. Tom qab cov kua tau txias lawm, nws yuav tsum tau lim thiab haus 125 ml mus txog 5 zaug ib hnub.
- Decoction of plantain. Koj xav tau 6 tbsp. l. finely tws nplooj ntawm cov nroj tsuag ua ke nrog 1 tbsp. l. chamomile paj thiab 4 tbsp. l. St. John lub wort, thiab ces ncuav 1 liter ntawm boiling dej. Tsis tas li ntawd, koj yuav tsum tau boil lub broth tshaj tsawg tshav kub (20 feeb). Cov kua yuav tsum tau infused rau ib nrab ib teev. Siv ib tug decoction yuav tsum yog 1 tbsp. l. peb zaug ib hnub.
- Gold centaury. Yuav tsum tau 1 tbsp. l. raw cov ntaub ntawv rau chav 0.5 liv ntawm boiling dej. Nws yog qhov zoo dua rau ncuav cov nyom hauv ib lub thermos, raws li nws yuav tsum tau infused rau ib nrab ib teev. Koj yuav tsum haus dej ib nrab khob thaum sawv ntxov thiab yav tsaus ntuj.
tshuaj kho neeg pej xeem tsis yog panacea thiab tshem tsis tau txhua yam kab mob. Tab sis kev muaj peev xwm siv cov ntawv sau ua ke nrog cov tshuaj yuav ua rau cov kab mob tswj hwm thiab tiv thaiv kev txhim kho ntawm cov teeb meem. Ua ntej siv cov tshuaj pej xeem, nws yuav tsum tau mus ntsib kws kho mob gastroenterologist.
Txoj Cai Noj Mov
Kev noj zaub mov rau tus kab mob gastroesophageal reflux yog lub hauv paus ntawm kev kho kom raug. Yog tsis muaj nws, kev kho mob yuav tsis ua haujlwm, thiab kev rov ua dua tshiab yuav tshwm sim. Ib tug neeg yuav tau ua raws li cov cai no:
- Khoom noj yuav tsum tau noj ntau zaus, tab sis nyob rau hauv feem. Koj yuav tau noj 6 zaug hauv ib hnub.
- Khoom noj yuav tsum tsis txhob kub lossis txias dhau.
- Tom qab noj movTsis txhob pw tam sim ntawd, khoov lossis ua kev kawm lub cev.
- Nws yog ib qho tseem ceeb kom txwv tsis pub noj cov zaub mov uas tsim cov hydrochloric acid sai dua, thiab lub suab ntawm cov hlab ntsha ntawm cov hlab ntsha txo qis. Nws yog qhov zoo dua kom tso tseg cawv, legumes, ntsim thiab kib, cov khoom noj uas muaj roj ntau.
- Thaum muaj tus kab mob gastroesophageal reflux, cov ntawv qhia zaub mov yuav tsum muaj zaub thiab txiv hmab txiv ntoo, cov khoom noj uas muaj cov vitamins E thiab A. Ua tsaug rau lawv, kev rov ua dua ntawm lub plab hnyuv sai dua.
- Cov ntawv qhia zaub mov yuav tsum muaj ntau haiv neeg. Tom qab tus kab mob nkag mus rau hauv kev zam txim, nws raug tso cai rau diversify. Tab sis ntawm no nws yog ib qho tseem ceeb kom coj mus rau hauv tus account tus yam ntxwv ntawm lub cev.
- Nws yog txwv tsis pub kom dhau lub plab nrog zaub mov. Nyob rau hauv tas li ntawd, nws motility slows down thiab nws cov ntsiab lus yog muab pov rau hauv lub sab esophagus.
Tus neeg mob raug txwv nruj kom tshaib plab, vim qhov no tsuas ua rau qhov xwm txheej hnyav dua. Kev siv tshuaj yej thiab kas fes yuav tsum txwv. Ntsev thiab txuj lom raug tshem tawm ntawm kev noj haus. Noj mov kawg yog ob peb teev ua ntej yuav mus pw.
Lub hauv paus ntawm kev noj zaub mov yog cereals, boiled thiab stewed zaub, zaub roj.
Muaj Teeb Meem
Vim nws yog ib qho tseem ceeb los kho tus kab mob gastroesophageal reflux, nws yuav tsum mus ntsib kws kho mob txawm tias mob me me tab sis tsis xis nyob. Thaum tsis kho, cov teeb meem hauv qab no tuaj yeem ua tau:
- peptic ulcers lossis erosions ntawm mucous membranes.
- Zooqhov hauv phab ntsa ntawm txoj hlab pas.
- Internal los ntshav.
- Stenosis ntawm esophagus vim caws pliav.
- ntsws abscess.
- Relapse of chronic bronchitis.
- txheej txheem mob hauv nasopharynx.
Qhov teeb meem loj tshaj plaws yog mob precancerous.
tiv thaiv kab mob
Yog li, cov tsos mob, kev kho mob gastroesophageal reflux yog qhov tseeb. Tab sis nws yog qhov zoo dua tsis tso cai rau cov tsos mob ntawm tus kab mob no txhua. Yog hais tias pathology twb tau tsim, ces nws yog tsim nyog los txo qhov zaus ntawm relapses. Txhawm rau ua qhov no, koj yuav tsum ua raws li kev tiv thaiv hauv qab no:
- Cia li haus cawv thiab haus cawv.
- Hnav khaub ncaws zoo uas yuav tsis ua rau koj lub plab.
- Nyob zoo.
- Cia li haus luam yeeb. Nicotine cuam tshuam tsis tau tsuas yog cov hlab ntsha thiab lub ntsws, tab sis kuj rau lub plab zom mov.
- Puag saum lub hauv ncoo siab.
- Tsis txhob rog. Yog hais tias ib tug neeg muaj qhov hnyav heev, ces nws yuav tsum tau normalized. Rau lub hom phiaj no, nws yuav tsum tau ua lub cev qoj ib ce, tab sis tsuas yog 2-3 teev tom qab noj mov.
- txwv tsis pub nqa qhov hnyav tshaj 10 kg.
- Txhua yam tshuaj tau noj zoo tshaj plaws nrog kev tso cai los ntawm kws kho mob, tshwj xeeb tshaj yog tias lawv ua rau lub plab sphincter so.
Kab mob gastroesophageal yog ib qho kev tsis txaus siab uas tuaj yeem ua rau mob qog noj ntshav. Txhawm rau tiv thaiv qhov no tshwm sim, nws yog ib qho tsim nyog yuav tau pib kho thaum tsis muaj zog, tab sis cov tsos mob mus tas li tshwm sim.tsos mob. Kev ua raws li kev tiv thaiv kev tiv thaiv yuav txo kev pheej hmoo ntawm kev mob.
