Tshem tawm ntawm polyp hauv plab: npaj rau kev phais thiab kho dua tshiab

Cov txheej txheem:

Tshem tawm ntawm polyp hauv plab: npaj rau kev phais thiab kho dua tshiab
Tshem tawm ntawm polyp hauv plab: npaj rau kev phais thiab kho dua tshiab

Video: Tshem tawm ntawm polyp hauv plab: npaj rau kev phais thiab kho dua tshiab

Video: Tshem tawm ntawm polyp hauv plab: npaj rau kev phais thiab kho dua tshiab
Video: Tshuaj theem vim li cas thiaj tau nqi ?/ Siv kho mob dab tsi?/paris polyphylla use for? 2024, Kaum ib hlis
Anonim

A lub plab polyp (ICD-10 code: D13.1) yog lub foob ntawm ib qho loj, uas yog hais txog benign neoplasms. Nws loj hlob los ntawm cov ntaub so ntswg ntawm cov mucosa thiab tuaj yeem ncav cuag qhov loj me, tshwj xeeb tshaj yog tias tsis kho raws sijhawm.

Ntxhais kab mob

Lub neej zoo ntawm tib neeg feem ntau nyob ntawm lub xeev ntawm cov kabmob sab hauv. Lub plab ua lub luag haujlwm tseem ceeb hauv lub plab zom mov thiab tsis tas yuav ua rau qhov tshwm sim tsis xis nyob, txawm tias muaj kab mob hnyav. Txawm li cas los xij, qhov tsis txaus ntseeg ntawm qhov xwm txheej no nyob hauv qhov tseeb tias thaum tsis muaj cov tsos mob hnyav, pathologies tuaj yeem txhim kho sai thiab ua rau muaj teeb meem. Cov txheej txheem no suav nrog neoplasms hauv cov mucous ntawm lub plab zom mov.

tshem tawm polyp hauv plab
tshem tawm polyp hauv plab

Raws li ICD-10 code, gastric polyp yog tsim los ntawm D 13.1 thiab yog kev tswj tsis tau ntawm cov hlwb ntawm cov mucosa. Xws li ib tug neoplasm tuaj yeem yog puag ncig, oval lossis nceb-puab. Nws yog benign nyob rau hauv cov xwm thiab muaj cov ntaub so ntswg epithelial, txawm li cas los xij, nrog kev kho tsis raug, kev noj zaub mov tsis zoo, haus cawv, thiabkuj muaj lwm yam provoking yam, tuaj yeem degenerate mus rau hauv daim ntawv malignant.

Kev faib tawm

Kev faib tawm ntawm polyps feem ntau nyob ntawm seb cov ntaub so ntswg twg tau koom nrog lawv tsim. Lawv subdivided raws li kev hem thawj ntawm rebirth, nrog rau qhov chaw ntawm localization. Yog li, raws li qhov chaw nyob, cov neoplasms hauv qab no yog qhov txawv:

  • hyperplastic;
  • inflammatory;
  • hypertrophic;
  • hyperplasiogenic.

Polyps tuaj yeem ua adenomatous lossis glandular.

Hom hyperplastic yog cov qog ntawm lub hauv paus dav, uas tshwm sim los ntawm cov txheej txheem inflammatory thiab kis kab mob hauv lub cev. Qhov no yog hom kab mob uas tshwm sim ntau tshaj plaws thiab yuav luag tsis tau tsim mus rau hauv cov qog nqaij hlav.

polyp ntawm lub plab code rau mcd 10
polyp ntawm lub plab code rau mcd 10

Adenomatous hom txawv nyob rau hauv uas nws feem ntau ua malignant, yog li ntawd, nws yog ib qho tseem ceeb rau kev ua hauj lwm raws sij hawm. Kev tsis haum tshuaj hormonal, noj zaub mov tsis zoo, thiab noj qee yam tshuaj tuaj yeem ua rau muaj qhov tshwm sim ntawm neoplasm.

Glandular polyp yog qhov tsawg heev, tsis tshwm sim nws tus kheej rau lub sijhawm ntev thiab kev ua haujlwm ntawm lub plab zom mov tsis hloov hlo li. Tab sis txawm tias tsis muaj cov tsos mob, cov neoplasm tuaj yeem loj hlob sai heev rau hauv cov qog nqaij hlav.

Kev tshwm sim

Qhov ua rau polyps hauv plab tsis nkag siab tag nrho, thiab yog li ntawd lawv yog qhov txaus ntshai tshwj xeeb. Cov kws kho mob paub tus lejyam cuam tshuam rau qhov tshwm sim ntawm neoplasms:

  • cov txheej txheem mob;
  • muaj cov kab mob Helicobacter pylori;
  • kev hloov pauv.

Ntxiv rau, qee yam tshuaj, qhov xwm txheej ntxhov siab tas li thiab kev noj zaub mov tsis txaus tuaj yeem ua rau muaj qhov tshwm sim ntawm cov txheej txheem pathological.

Cov tsos mob tseem ceeb

Cov tsos mob thiab kev kho mob ntawm polyps hauv plab tuaj yeem sib txawv heev - txhua yam nyob ntawm tus yam ntxwv ntawm cov kab mob. Nyob rau hauv nws cov theem pib, cov tsos mob tsis tau hais tawm heev, uas ua rau nyuaj rau kev kuaj mob. Thiab qee zaum, tej yam tshwm sim yuav tshwm sim:

  • mob plab pancreas;
  • kev digestibility ntawm zaub mov;
  • mob plab;
  • ua pa tsis zoo;
  • pom ntshav hauv quav;
  • hloov raws plab thiab cem quav.

Vim qhov tseeb tias cov tsos mob thiab kev kho mob ntawm polyps hauv plab feem ntau yog nyob ntawm theem ntawm cov kab mob, nws yog qhov txaus ntshai heev uas tos kom pom thawj zaug tshwm sim, txij li qhov tshwm sim tuaj yeem tshwm sim. tu siab.

Diagnostics

Hom kev kuaj mob polyp suav nrog kev nug tus neeg mob txog qhov muaj cov kab mob tshwm sim thiab kev tsis txaus siab, kev tshuaj xyuas endoscopic ntawm cov kab mob hauv nruab nrog cev, kev tshawb fawb hauv chav kuaj. Raws li cov txiaj ntsig tau, qhov ua rau tus kab mob raug tsim.

polyps hauv plab cov tsos mob thiab kev kho mob
polyps hauv plab cov tsos mob thiab kev kho mob

Ib yam uas tsis muaj teeb meem thiab kev nyab xeeb tshaj plawsKev tshawb fawb yog suav tias yog endoscopy, thiab yog tias tsim nyog, ultrasound yog ntxiv rau. Txoj kev tshawb fawb no yuav pab txiav txim siab qhov tob ntawm polyp germination nyob rau hauv lub plab mucosa. Nws qhov zoo dua yog qhov muaj peev xwm pom qhov txawv ntawm qhov zoo thiab qhov tsis zoo neoplasms.

Thaum yuav tsum tau tshem tawm

Qee lub sij hawm, thaum neoplasms tshwm sim, pom cov duab zoo nkauj heev. Yog li, thaum nws yog pinched, tej zaum yuav muaj ib tug ntse mob nyob rau hauv lub epigastric cheeb tsam, radiating mus rau lwm yam departments. Hauv qhov no, yuav tsum tau kuaj xyuas sai thiab xaiv kev kho mob zoo.

Raws li cov txiaj ntsig ntawm kev tshawb fawb, qhov teeb meem ntawm kev tshem tawm polyp hauv plab yog txiav txim siab. Muaj qee qhov qhia txog kev phais:

  • yog tias tsis muaj kev kho mob tshwm sim, cov polyp yog hyperplastic;
  • nyob rau hauv qhov tsis muaj kev kho mob tshwm sim, lub neoplasm yog adenomatous;
  • muaj cov tsos mob hnyav;
  • muaj kev loj hlob sai ntawm neoplasm, nrog rau kev hloov pauv ntawm nws cov duab.

Qhov yuav tsum tau tshem tawm polyps hauv plab yog txiav txim siab nruj me ntsis rau txhua tus neeg mob. Hauv qhov no, nws yuav tsum tau coj mus rau hauv tus account tus yam ntxwv ntawm neoplasms thiab kev noj qab haus huv ntawm tus neeg mob.

Kev tshem tawm

Qhov phom sij ntawm neoplasm yog, raws li twb tau hais lawm, uas dhau sijhawm nws tuaj yeem loj hlob mus rau cov qog nqaij hlav. Yog vim li cas thiaj li kuaj tau raws sijhawm, kev kho mob lossis kev tshem tawm polyp hauv plab yog xav tau.

noj zaub mov tom qab tshem tawm polypplab
noj zaub mov tom qab tshem tawm polypplab

Txoj kev kho mob ntawm kev kho yog pib siv. Nws txhais tau hais tias siv cov tshuaj uas ntim cov phab ntsa ntawm lub plab, nrog rau cov khoom noj uas pab txhawb kev zom zaub mov. Tsis tas li ntawd, yuav tsum siv cov tshuaj uas yuav pab tshem tawm cov txheej txheem inflammatory.

Yog tias kev kho tshuaj mus ntev tsis tau ua tiav, ces cov polyp hauv plab yuav raug tshem tawm. Nws yog nqa tawm siv ob lub thev naus laus zis:

  • endoscopic;
  • kev cuam tshuam kev phais tag nrho.

Thawj yog siv yog tias tsim nyog tshem tawm ib qho neoplasms thiab thaum qhov kev puas tsuaj rau cov mucosa tsis tseem ceeb. Hauv tshwj xeeb yog mob hnyav, qhib kev phais raug sau tseg, nrog rau kev txiav tawm ntawm ob peb lub plab.

Endoscopic tshem tawm

Kev ua haujlwm kom tshem tawm cov polyps hauv plab yog ua los ntawm cov txheej txheem endoscopic, uas suav nrog:

  • endoscopic excision;
  • hluav taws xob coagulation;
  • polypectomy.

Endoscopic excision yog siv lub voj los tuav lub qog ntawm nws lub hauv paus thiab tom qab ntawd hla cov hluav taws xob los ntawm nws. Tom qab ntawd ib qho kev txiav thiab cauterization yog ua. Yog tias cov neoplasm loj txaus, cov txheej txheem no tsis siv lossis cov polyp raug tshem tawm ntau qhov chaw.

tshem tawm polyp hauv plab
tshem tawm polyp hauv plab

Hluav taws xob coagulation suav nrog kev siv tam sim no. Rau neoplasmtshwj xeeb tongs raug coj thiab tam sim no txuas nrog. Cov ntaub so ntswg yog rhuab thiab maj mam evaporated. Txoj kev no yog tsim los tshem tawm cov neoplasms me me uas tsawg dua 1 cm inch.

Polypectomy yog hais txog kev tshem tawm cov qog. Rau qhov no, ib lub voj thiab lwm yam cuab yeej siv. Kev phom sij ntawm cov txheej txheem nyob rau hauv qhov tseeb tias muaj kev pheej hmoo ntawm hemorrhage, txij li cov ntaub so ntswg cauterization tsis tau ua.

Qhov txiaj ntsig loj ntawm cov tswv yim no yog kev yooj yim, kev npaj tsawg kawg rau kev tshem tawm ntawm plab hnyuv, tsis muaj tshuaj loog, thiab tsawg kawg ntawm kev pheej hmoo ntawm cov teeb meem. Tom qab kev tswj hwm, tus neeg mob siv sijhawm tsis pub dhau 2 teev hauv tsev kho mob.

YLaser tshem tawm

Tshem tawm cov polyps hauv plab nrog lub laser yog suav tias yog txoj kev nyab xeeb tshaj plaws thiab maj mam. Nws yog siv los excise txhua hom benign neoplasms. Lub ntsiab lus laser muab tso rau hauv qhov endoscope, thiab tom qab ntawd cov polyp yog evaporated hauv txheej.

Kev kho mob nruj me ntsis tswj qhov tob ntawm kev kho laser, ua rau muaj txiaj ntsig zoo heev. Tom qab ntawd, cov hlab ntsha raug kaw, uas tiv thaiv hemorrhage. Qhov kawg rov qab los tom qab li ntawm 10 hnub.

Qhov tsis zoo tsuas yog tus nqi siab ntawm kev tshem tawm polyp hauv plab nrog lub laser. Tus nqi ntawm cov txheej txheem yog kwv yees li 7000 rubles. Tsis tas li ntawd, yuav tsum muaj cov txheej txheem tshwj xeeb thiab kws kho mob cov txuj ci.

Surgery

Nyob rau hauv muaj cov neoplasms tseem ceeb lossis thaum twgteeb meem, qhib kev phais yog ua. Qhov kev ua haujlwm zoo li no tuaj yeem ua rau muaj kev cuam tshuam ntau yam thiab tsuas yog sau rau hauv qhov xwm txheej hnyav tshaj plaws.

Ntau tus neeg txhawj xeeb txog ntev npaum li cas qhov kev tshem tawm ntawm lub plab polyp yuav siv sij hawm ntev npaum li cas thiab cov txiaj ntsig yuav tshwm sim thaum lub sijhawm phais. Raws li lub sijhawm, kev ua haujlwm tuaj yeem siv sijhawm li 1-1.5 teev.

phais tshem tawm polyps hauv plab
phais tshem tawm polyps hauv plab

Yog tias muaj kev puas tsuaj loj rau lub plab, kev txiav tawm ntawm qee qhov ntawm lub cev no tau ua nrog rau kev tsim polyposis. Txoj kev no yog muab tshuaj nrog kev loj hlob ntawm polyps, lawv pinching, los yog thaum lub neoplasm dhau mus rau theem ntawm cov qog malignant. Nyob rau hauv tas li ntawd, resection yog tib txoj kev los cawm tus neeg mob txoj sia.

Txoj kev xaiv rau kev tshem tawm cov polyps nyob ntawm tsis yog tsuas yog ntawm lawv qhov loj, tab sis kuj nyob ntawm tus lej, nrog rau hom ob txhais ceg uas lawv txuas nrog. Tsis muaj qhov tseem ceeb me me yog qhov peculiarity ntawm kev hloov pauv hauv plab hnyuv thiab muaj cov kab mob sib xyaw ua ke.

Thaum xav tau kev kuaj ntshav

Thaum lub sijhawm endoscopy, cov qauv ntaub so ntswg yuav tsum raug coj los tshuaj xyuas. Qhov no yog qhov yuav tsum tau rau kev kuaj ntshav biopsy, uas yog ib qho tseem ceeb heev kev kuaj mob.

Raws li cov txiaj ntsig tau txais, nws tuaj yeem txiav txim siab los ntawm txheej txheej ntawm lub plab mucosa cov ntaub so ntswg proliferation. Yog tias pom cov hlwb epithelial, ces cov polyp belongs rau hom hyperplastic, yog benign neoplasm, thiab kev tshem tawm tsis tuaj yeem ua, tab sissiv kev kho mob.

Yog tias pom cov qog nqaij hlav qog nqaij hlav, ces nyob rau hauv txhua rooj plaub, yuav tsum tau tshem tawm, vim degeneration mus rau hauv cov qog nqaij hlav cancer.

Nyob rau hauv kev noj haus tom qab kev kho mob

Lub luag haujlwm tseem ceeb hauv kev rov qab sai ntawm lub plab hnyuv muaj khoom noj khoom haus. Qhov no yuav pab kom yooj yim rau kev ua haujlwm ntawm lub plab zom mov. Kev noj zaub mov tom qab tshem tawm ntawm polyp hauv plab txhais tau tias tus neeg mob tsuas yog noj zaub mov sov thiab nyiam dua. Cov khoom noj uas kub dhau los yog txias tuaj yeem ua rau cov kab mob ua paug thiab ua rau muaj qhov hnyav ntxiv.

tshem tawm polyps hauv plab nrog lub laser
tshem tawm polyps hauv plab nrog lub laser

Nco ntsoov ua raws li cov cai ntawm cov khoom noj khoom haus fractional. Noj yuav tsum tsis tu ncua txhua hnub kom tsis txhob muaj kev tshaib kev nqhis. Lub sijhawm nruab nrab ntawm cov zaub mov yuav tsum yog kwv yees li 3-4 teev. Tsis tas li ntawd, koj yuav tsum tau txo qhov loj me, vim qhov no yuav tso cai rau koj kom tsis txhob overload lub plab zom mov.

Tom qab excising polyps, koj yuav tsum tau noj cov zaub mov protein, vim tias lawv muaj ntau cov amino acids uas yuav tsum tau tsim cov ntaub so ntswg thiab hlwb, nrog rau kev kho lub cev. Nws yog ib qho tsim nyog yuav tsum tsis txhob haus kas fes, haus dej cawv, nrog rau cov khoom uas ua rau lub qhov txhab ua paug. Tsis tas li ntawd, koj yuav tsum tsis txhob haus cov khoom noj uas ua rau muaj kev ua haujlwm ntawm lub plab zom mov.

Txoj kev kho mob

Nrog ua tiav kev txiav tawm ntawm neoplasms, qhov kev kuaj mob tau zoo heev, tab sis muaj qhov tshwm sim ntau ntawm cov qog. Tej zaum yuav muaj qhov tshwm sim tsis zoo ntawm kev tshem tawm.polyp hauv plab.

Yog li, yog tias siv tshuaj loog thaum lub sijhawm txiav, tej zaum yuav muaj teeb meem cuam tshuam nrog kev ua pa. Tsis tshua muaj, los ntshav tshwm sim, uas yog pom thaum lub sij hawm endoscopic tshem tawm ntawm polyps. Tej zaum kuj yuav muaj qhov kub thiab txias thiab muaj qhov mob. Nrog rau qhov tsis zoo ntawm kev noj qab haus huv, koj yuav tsum sab laj nrog kws kho mob tam sim.

Pom zoo: