Peptic rwj yog ib yam kab mob txaus ntshai heev uas tib neeg ntsib tsis hais poj niam los txiv neej thiab hnub nyoog. Tus kab mob yog nrog los ntawm cov kab mob ntawm lub plab mucosa, tsim ntawm ulcers thiab loj digestive teeb meem. Yog tias tsis kho, pathology ua rau muaj teeb meem txaus ntshai, mus txog rau kev ua txhaum ntawm cov phab ntsa ntawm lub plab zom mov.
Tau kawg, ntau tus neeg tab tom nrhiav cov ntaub ntawv ntxiv txog kab mob. Vim li cas ulcers tshwm? Cov tsos mob dab tsi yuav tsum tau saib xyuas? Cov kev kho mob twg niaj hnub no tuaj yeem muab tau? Kev phais puas tsim nyog rau kev mob plab? Cov lus teb rau cov lus nug no txaus siab rau ntau tus nyeem.
Cov lus qhia dav dav txog tus kabmob
Peptic ulcer ntawm lub plab yog ib qho pathology uas yog nrog los ntawm kev ua txhaum ntawm trophism ntawm mucous daim nyias nyias ntawm lub cev thiab tsim ntxiv ntawm cov rwj me me. Thaum xub thawj, kev puas tsuaj tsuas yog npog cov txheej txheej saum npoo, tab sisTom qab ntawd cov txheej txheem pathological kis mus rau cov ntaub so ntswg sib sib zog nqus - yog tias tsis kho, tus kab mob tuaj yeem ua rau los ntshav loj heev thiab lub plab perforation.
Raws li kev txheeb cais, 70% ntawm cov neeg mob yog cov txiv neej hnub nyoog 20 txog 50 xyoo. Tsawg zaus, tus kab mob manifests nws tus kheej nyob rau hauv lub hnub nyoog laus. Tau kawg, cov poj niam tsis tiv thaiv los ntawm cov kab mob no.
Nws tsim nyog sau cia tias kab mob peptic yog ib txoj kev mob ntev, uas, raws li txoj cai, ua rau lub caij nplooj zeeg thiab caij nplooj ntoos hlav.
Qhov laj thawj tseem ceeb ntawm pathology
Raws li kev txheeb cais, hauv 75% ntawm cov neeg mob, mob plab yog tshwm sim los ntawm kev nkag mus rau hauv lub cev ntawm Helicobacter pylori. Qhov no yog cov kab mob kauv uas tiv taus qhov hnyav ib puag ncig ntawm lub plab thiab tuaj yeem cuam tshuam cov teebmeem ntawm hydrochloric acid. Kev ua haujlwm ntawm cov kab mob pathogenic no ua rau muaj kev puas tsuaj rau cov hlwb ntawm lub plab hnyuv, thiab tom qab ntawd mus rau kev tsim cov kab mob. Tus kab mob kis tau los ntawm kev sib cuag nrog tus neeg nqa khoom, nrog rau cov zaub mov, dej, tais diav, khoom siv kho mob, thiab lwm yam.
Ntxiv mus, muaj lwm yam ua rau mob plab.
- Ua ntej tshaj, nws tsim nyog hais txog kev noj tshuaj. Cov pab pawg ntawm cov tshuaj uas muaj peev xwm txaus ntshai suav nrog cov tshuaj uas tsis yog-steroidal anti-inflammatory, cytostatics, antihypertensive agents thiab potassium npaj. Tau kawg, nyob rau hauv cov ntaub ntawv no peb tab tom tham txog kev siv lub sij hawm ntev ntawm cov tshuaj loj ntawm cov tshuaj no. Qhov kev pheej hmoo ntawm rwj nce nrogyog tus neeg mob tshaj 65.
- Peptic ulcer tej zaum yuav tshwm sim los ntawm lwm yam pathologies. Piv txwv li, tus kab mob no feem ntau tshwm sim tawm tsam keeb kwm ntawm ntshav qab zib mellitus, pancreatitis, kab mob siab, kab mob ntsws, cirrhosis ntawm daim siab, syphilis.
- Cov npe ua rau muaj ntau yam kev raug mob ntawm lub plab, kub hnyiab lossis frostbite ntawm qhov loj ntawm lub cev, kev poob siab.
- Tseem muaj noob caj noob ces.
- Nws tau raug pov thawj tias qhov kev pheej hmoo ntawm kev kis tus kab mob no ntau dua rau cov neeg mob thawj hom ntshav.
Rau ib qho laj thawj lossis lwm qhov, cov txheej txheem tiv thaiv ntawm lub plab tsis muaj zog, vim tias qhov ua rau lub plab zom mov succumbs mus rau qhov hnyav ntawm cov kua txiv hmab txiv ntoo.
Nyob rau hauv tus txheej txheem ntawm kev kuaj mob, nws yog ib qho tseem ceeb heev uas yuav tau txiav txim seb qhov tshwm sim ntawm qhov kev loj hlob ntawm tus kab mob - txoj kev vam meej ntawm kev kho mob feem ntau nyob ntawm qhov no.
Peptic ulcer: pheej hmoo yam
Cov kws kho mob tseem hais txog qhov muaj feem cuam tshuam, qhov cuam tshuam ntawm qhov ua rau muaj kev puas tsuaj rau cov mucous daim nyias nyias ntawm txoj hnyuv.
- Ua ntej tshaj, nws tsim nyog hais txog kev haus luam yeeb. Los ntawm txoj kev, tsis tsuas yog luam yeeb zoo tib yam muaj peev xwm txaus ntshai, tab sis kuj yog luam yeeb thiab hookah sib xyaw.
- Cawv kuj ua rau lub plab ua paug - haus dej cawv txaus ntshai.
- Cov xwm txheej tseem ceeb kuj suav nrog kev tsim txom ntawm cov dej qab zib thiab dej qab zib uas muaj caffeine (qhov no tsis yog kas fes xwb, tab sis kuj muaj ntau yam dej qab zib).
- noj tsis tu ncua, kev noj zaub mov zoo, noj kub dhau lossis,ntawm qhov tsis sib xws, cov khoom noj txias, khoom qab zib, buns, khoom qab zib - tag nrho cov no cuam tshuam rau sab hauv phab ntsa ntawm lub plab.
- Cov xwm txheej pheej hmoo suav nrog kev ntxhov siab ntau zaus, kev nyuaj siab, vim txhua yam no cuam tshuam rau kev ua haujlwm ntawm cov qog endocrine.
Cov tsos mob tseem ceeb ntawm pathology
Cov tsos mob ntawm plab rwj ncaj qha nyob ntawm theem ntawm kev loj hlob. Muaj ob peb yam cim qhia ntawm tus kab mob.
- Feem ntau, thawj cov tsos mob ntawm plab rwj yog mob. Nws feem ntau yog nyob rau hauv lub plab mog. Kev mob yuav hnyav zuj zus thaum lub cev tawm dag zog, nrog rau tom qab haus cawv, noj zaub mov ntsim, lossis plab khoob.
- Daim ntawv teev npe muaj xws li kub siab. Nws yog txuam nrog ingress ntawm gastric kua txiv rau hauv lub lumen ntawm txoj hlab pas. Raws li txoj cai, qhov tsis hnov tsw tsw qab tshwm sim 1-2 teev tom qab noj mov.
- Vim qhov tsim ntawm qhov txhab, cov txheej txheem digestion cuam tshuam, nrog rau lub plab zom mov. Yog li ntawd, cov neeg mob txhawj xeeb txog xeev siab, uas tshwm sim ob peb teev tom qab noj mov. Feem ntau, kev tawm tsam ntawm xeev siab xaus nrog ntuav - qhov no ua rau cov neeg mob zoo heev, yog li cov neeg mob feem ntau ua rau ntuav ntawm lawv tus kheej.
- Cov tsos mob kuj muaj xws li tsis qab los noj mov thiab belching, nrog los ntawm qaub los yog iab saj nyob rau hauv lub qhov ncauj.
- Thaum noj mov, qhov kev xav puv sai sai. Tom qab noj mov, cov neeg mob qhia qhov kev xav ntawm hnyav hauvplab.
- Cov neeg mob kuj raug cem quav tas li thiab nce roj ntau ntxiv.
Qhov tsos mob li no yog vim li cas mus ntsib kws kho mob. Nws tsis tuaj yeem tsis quav ntsej cov tsos mob, vim tias cov txheej txheem ulcerative tau nce mus tas li.
theem ntawm kev txhim kho kab mob
Nyob rau hauv cov tshuaj niaj hnub no, muaj ob peb theem ntawm gastric ulcer, txhua yam uas yog yus muaj los ntawm tej yam tshwm sim.
- Thawj theem yog suav tias yog hom kab mob ua ntej ulcerative. Cov cheeb tsam me me ntawm kev yaig tshwm sim ntawm cov mucous membrane, tab sis cov neeg mob hnov zoo li qub. Cov tsos mob ntawm tus kab mob peptic ulcer yog mob me heev. Kev mob ntshav qab zib tshwm sim txhua 2-7 xyoo.
- Thib Ob - ntawm no peb tab tom tham txog cov kab mob nruab nrab thiab hnyav ntawm peptic ulcer.
- Cov teeb meem twb tshwm sim nyob rau theem peb, suav nrog los ntshav thiab perforation.
- theem plaub yog hais tias tus neeg mob tau rov qab ua dua tom qab ua tiav kev phais kom raug.
Kev mob vim tus kab mob
mob plab rwj tuaj yeem txaus ntshai heev.
- Qee zaum, tawm tsam keeb kwm ntawm tus kab mob, kev nkag mus tau zoo. Maj mam, cov phab ntsa ntawm lub plab raug rhuav tshem, raws li qhov tshwm sim ntawm cov hauv qab ntawm lub plab ua rau lub cev nyob ze, piv txwv li, lub gallbladder, pancreas, tsawg dua omentum. Gastric kua txiv rhuav tshem cov ntaub so ntswg ntawm lub cev. Piv txwv li, yog tias peb tham txog kab mob pancreatic, ces cov neeg mob tsim kev puas tsuaj rau pancreatitis.
- YogCov txheej txheem ulcerative txuas mus rau cov txheej txheem tob, ces perforation ntawm lub plab yuav tshwm sim. Yog li ntawd, tag nrho cov ntsiab lus ntawm lub cev tau nchuav rau hauv lub plab kab noj hniav.
- plab hnyuv los ntshav yog suav tias yog ib qho teeb meem tshwm sim - kwv yees li 20% ntawm cov neeg mob uas muaj qhov kev kuaj mob no nrog ntshav poob. Pathology yog nrog los ntawm qhov mob ntawm lub plab mog. Qhov ntuav zoo li kas fes hauv av. Kuj tseem muaj cov ntshav nyob hauv cov quav. Thaum tsis muaj kev pab raws sijhawm, tus mob no xaus rau ntawm tus neeg mob tuag.
- Muaj qhov muaj peev xwm ntawm malignant degeneration ntawm cov ntaub so ntswg tiv thaiv keeb kwm ntawm cov kab mob ulcerative. Raws li kev txheeb cais, tus kab mob no xaus nrog mob plab hauv 3% ntawm cov neeg mob.
- Pyloric stenosis kuj yog ib qho teeb meem txaus ntshai. Qhov no pathology yog nrog los ntawm ib tug nqaim ntawm lub pyloric ib feem ntawm lub plab, vim hais tias ntawm cov zaub mov tsis tuaj yeem txav mus rau hauv cov hnyuv.
Yog vim li cas nws tseem ceeb heev kom mus ntsib kws kho mob thaum thawj cov tsos mob tshwm sim. Cov teeb meem ntawm plab rwj yuav tsum tau saib xyuas xwm txheej ceev.
ntsuas ntsuas
Kev kuaj mob plab hnyuv suav nrog ob peb kauj ruam tseem ceeb. Nws yog ib qho tseem ceeb heev los txiav txim seb qhov ua rau ntawm kev loj hlob ntawm tus kab mob, thaj tsam ntawm lub mucosal lesion, muaj teeb meem.
- Ua ntej tshaj plaws, tus neeg mob yuav kuaj ntshav thiab zis los tshuaj xyuas. Cov quav kuj tau tshuaj xyuas cov ntshav occult.
- Yuav tsum tau ua yog fibrogastroduodenoscopy. Nrog kev pab los ntawm ib tug tshwj xeebCov khoom siv kho qhov muag, tus kws kho mob ua tib zoo tshuaj xyuas cov mucous ntawm txoj hlab pas, plab thiab duodenum. Yog tias tsim nyog, cov ntaub so ntswg biopsy tau ua thaum lub sijhawm ua haujlwm - cov qauv tom qab raug xa mus rau kev kuaj xyuas.
- Ultrasound ntawm plab, siab, gallbladder thiab pancreas kuj ua.
- Cov ntaub ntawv yog hluav taws xob siv hluav taws xob sib piv.
- Qee zaum ntxiv kev saib xyuas pH ntawm cov kua txiv hmab txiv ntoo ua tiav. Qhov no yog ib qho kev kawm nyuaj heev, uas, txawm li cas los xij, pab ntsuas cov kua qaub ntawm lub plab thiab qhov kev hloov ntawm qhov ntsuas no thaum nruab hnub.
- Tsis tas li ntawd, cov qauv ntawm cov quav thiab plab hnyuv (kwv yees thaum kuaj ntshav) raug kuaj xyuas seb muaj tus kab mob Helicobacter pylori. Kev kuaj ntshav kuaj ntshav kuj tseem ua los txiav txim seb muaj cov tshuaj tiv thaiv kab mob rau tus kab mob no.
Txoj kev kho mob plab rwj
Nyob ntawm cov ntaub ntawv tau txais thaum lub sijhawm kuaj mob, tus kws kho mob yuav kos cov txheej txheem kho mob. Txog niaj hnub no, ntau yam tshuaj siv. Nrog rau plab rwj, nws yog ib qho tsim nyog los tshem tawm cov kab mob, kho cov qauv ntawm cov mucous membrane, thiab tshem tawm cov ua rau kev loj hlob ntawm tus kab mob.
- Ua ntej tshaj, kev kho tshuaj tua kab mob yog ua los pab tshem tawm Helicobacter pylori. Feem ntau, cov tshuaj tua kab mob ntawm pab pawg penicillin ("Amoxicillin"), macrolides ("Clarithromycin"), tetracyclines, thiab nitromidazole derivatives yog siv.
- Kev kho mob peptic ulcerkab mob plab yuav tsum suav nrog kev tiv thaiv sab hauv ntawm lub cev. Cov tshuaj xws li De-nol thiab Sucralfate pab tsim cov yeeb yaj kiab tiv thaiv tshwj xeeb rau ntawm daim tawv nqaij.
- Tsis tas li, cov neeg mob tau sau npe Enprostil, Biogastron, Ventroxol. Cov nyiaj no txhawb cov txheej txheem ntawm kev rov tsim dua ntawm cov mucous membranes, ua kom cov ntaub so ntswg zoo.
- Kev kho mob plab yuav tsum suav nrog kev noj tshuaj tiv thaiv kab mob. Proton twj blockers tau nkag mus rau hauv txoj kev kho mob, tshwj xeeb, Rabelok, Nexium thiab Omez. Cov tshuaj no inhibit qhov tso tawm ntawm hydrochloric acid.
- Antacids, tshwj xeeb tshaj yog Antareyt, Almagel, pab cuam tshuam cov teebmeem ntawm cov kua qaub, muaj lub hnab ntim thiab cov khoom tiv thaiv.
- Cov tshuaj xws li Cytotec thiab Misoprostol txo qis hydrochloric acid tso tawm thiab tseem ua kom cov hnoos qeev los tiv thaiv lub plab hauv ob sab phlu.
- Cov neeg mob kuj raug pom zoo kom noj cov tshuaj prokinetics - cov tshuaj no ua kom lub zog ntawm lub plab zom mov. Cov tshuaj xws li Domperidone thiab Mltilium raug suav hais tias yog siv tau.
- Anspasmodics, xws li Drotaverine thiab No-shpa, pab txo qis ntawm lub plab phab ntsa thiab tiv thaiv qhov mob.
- Probiotics kuj tseem siv los pab kho qhov qub microflora ntawm lub plab zom mov.
- Yog tias tsim nyog, cov neeg mob tau ntxiv tshuaj sedatives thiab tshuaj tiv thaiv kev nyuaj siab.
Cov kev kho mob yuav kav li ntawm 14 hnub mus rau 1.5-2 lub hlis nyob ntawm qhov muajQee cov tsos mob, qhov kev puas tsuaj rau lub plab.
Kev noj haus raws li ib feem ntawm kev kho
Kev noj zaub mov rau plab yog qhov tseem ceeb heev. Lub cev yuav tsum tau saturated nrog cov khoom muaj txiaj ntsig thiab lub zog substrates, thaum zam kev ua xua ntxiv ntawm cov mucous ntawm lub plab zom mov.
Ua ntej, cia peb tham txog qee txoj cai yooj yim. Cov neeg mob tau pom zoo noj cov zaub mov feem ntau - noj tsawg kawg 5 zaug hauv ib hnub, tab sis qee qhov me me (qhov no koj tuaj yeem tsis txhob ncab lub plab). Zaub mov yuav tsum tsis txhob txias los yog kub. Cov khoom yog qhov zoo tshaj plaws boiled los yog steamed. Kev noj zaub mov rau plab rwj yog siv cov khoom hauv qab no:
- qe qe;
- slimy soups los ntawm mov, oats, cereals;
- kua porridge (mashed);
- nqaij ntshiv (shredded);
- jelly;
- tsev cheese thiab qab zib tsawg.
Cov zaub mov hauv qab no yuav tsum raug cais tawm ntawm kev noj haus:
- fried and fatty foods, smoked nqaij;
- khoom muaj dyes thiab preservatives;
- -cov kua mis, cov txuj lom, ntsim seasonings;
- KhCov nqaij muaj roj, broths;
- khob cij, khoom noj khoom haus;
- txiv hmab txiv ntoo thiab zaub uas ua rau mob plab hauv plab, tshwj xeeb tshaj yog legumes, txiv lws suav, gooseberries, citrus txiv hmab txiv ntoo, legumes, hnub, radishes.
Thaum twg yuav tsum tau phais?
Hmoov tsis zoo, qee zaum kev kho mob plab plab tsis ua rau qhov xav tau. Ntxiv mus, mobqee zaum ua rau kev txhim kho cov teeb meem txaus ntshai uas yuav tsum tau muaj kev cuam tshuam kev phais xwm txheej ceev. Cov lus qhia rau kev ua haujlwm yog raws li hauv qab no:
- gastric los ntshav;
- perforation ntawm gastric phab ntsa;
- pronounced stenosis;
- malignant degeneration ntawm cov ntaub so ntswg (pib mob qog noj ntshav);
- txheej txheem nkag;
- muaj qhov txhab uas tsis kho tau ntev txawm tias tom qab kho;
- ntau zaus ntawm tus kab mob;
- pob txha tsim ntawm phab ntsa ntawm lub plab nrog ntxiv deformation ntawm lub cev;
- Tshuaj tsis muaj txiaj ntsig txawm tias tom qab 2-3 xyoos ntawm kev kho tshuaj.
Muaj ntau txoj hauv kev kho mob ntawm tus kab mob no. Piv txwv li, qee zaum nws yog ib qho tsim nyog yuav tsum kaw qhov chaw ntawm lub plab perforation, thiab qee zaum ua tiav los yog ib feem ntawm lub cev yog qhov tsim nyog. Qee zaum, nws raug nquahu kom ua lub vagotomy - lub ntsiab lus ntawm txoj kev yog txiav lub cev ntawm lub paj hlwb lossis nws cov ceg ntoo.
ntsuas kev tiv thaiv
Muaj ntau tus kab mob uas tuaj yeem ua rau muaj kab mob plab. Los ntshav, perforation ntawm phab ntsa ntawm lub plab zom mov - tag nrho cov no yog cov teeb meem txaus ntshai. Nws yog qhov yooj yim dua los sim tiv thaiv kev txhim kho ntawm tus kab mob no. Kev tiv thaiv hauv qhov no yog qhov yooj yim heev.
- Nws tsim nyog ua kom tsis txhob nkag mus ntawm Helicobacter pylori rau hauv lub cev. Txog rau qhov kawg no, tib neeg raug qhia kom siv cov tais diav ntawm tus kheej thiab cutlery, ua raws li cov cai ntawm tus kheejkev tu cev.
- Nws yog ib qho tseem ceeb uas yuav tsum tsis suav nrog kev pheej hmoo, tshwj xeeb, tso cawv, txiav luam yeeb.
- Cov kws kho mob pom zoo noj kom raug. Nws yog qhov zoo dua los noj hauv me me, tso cov txuj lom, ntsim, rog thiab kib.
- Koj yuav tsum tsis txhob arbitrarily noj tshuaj uas ua rau cov tsos ntawm erosions thiab rwj ntawm lub mucous daim nyias nyias ntawm lub plab thiab hnyuv (piv txwv li, non-steroidal anti-inflammatory tshuaj). Yog tias tseem xav tau siv cov tshuaj, qhov ntau npaum li cas thiab lub sijhawm ntawm kev tswj hwm yuav tsum raug txiav txim los ntawm tus kws kho mob nkaus xwb.
- Kev ntim khoom, kev tawm dag zog lub cev, kev ua si sab nraum zoov txhua tus pab txhawb kev tiv thaiv kab mob.
- Cov kws kho mob kuj pom zoo kom tsis txhob muaj kev ntxhov siab, vim nws tau nrog kev cuam tshuam ntawm hormonal, uas qee zaum ua rau cov mucous puas.
- Tsis txhob hnov qab txog kev so zoo, sijhawm ua haujlwm kom raug, pw tsaug zog zoo.
- Txhua yam kab mob uas nyob rau hauv txoj kev xav tuaj yeem ua rau kev txhim kho plab hnyuv thiab plab plab yuav tsum tau kho raws sijhawm - lawv yuav tsum tsis txhob ignored nyob rau hauv txhua rooj plaub.
Yog tias tus neeg mob twb mob plab lawm, ces nws yuav tsum mus ntsib kws kho mob tsis tu ncua, kuaj thiab kuaj - qhov no koj tuaj yeem kuaj pom qhov rov tshwm sim hauv lub sijhawm. Tau kawg, koj yuav tsum ua raws li kev noj zaub mov kom tsim nyog thiab tso tseg cov cwj pwm phem. Lawv hais txog kev zam txim yog tias tus kab mob hnyav dua tsis tau pom nyob hauv tus neeg mob tau peb xyoos.
Kev mob tshwm sim feem ntau yog qhov zoo, tshwj xeeb tshaj yog tias tus neeg mob tig mustus kws kho mob kom pab.
