Cov kab mob thiab kab mob ntawm lub plab zom mov yog nrog los ntawm qhov mob lossis tsis xis nyob hauv plab, xeev siab thiab belching, ntuav, saj tsis zoo hauv qhov ncauj lossis nqos nyuaj. Qee yam ntawm cov tsos mob no tshwm sim los ntawm kev ua yuam kev hauv kev noj haus, thaum lwm tus yog cov cim qhia ntawm tus kab mob. Qhov kev tshaj tawm no yuav pab kom nkag siab lub ntsiab lus ntawm cov tsos mob thiab cov tswv yim ntawm tus neeg mob uas hnov lawv.
Qhia rau cov neeg mob
Keeb kwm zoo, lub hom phiaj thiab ncaj ncees yog lub ntsiab lus ntawm kev kuaj mob kom raug. Kev kuaj mob ntawm cov kab mob ntawm lub plab zom mov thiab dyspepsia yuav tsum muaj kev ntsuam xyuas txaus ntawm cov tsos mob. Nws yog tsis tsim nyog mus ntsib ib tug kws kho mob thiab tsuas yog yws txog qee yam kev ua txhaum cai, yuam tus kws kho mob kom rub tawm ntawm tus neeg mob nrog pincers tag nrho cov yam ntxwv ntawm cov tsos mob. Thiab txawm tias phem dua, thaum cov neeg mob, vim lawv tsis kam nkag siab thiab vim tias muaj peev xwm hloov txoj haujlwm no mus rau tus kws kho mob, tsis txhob thab kom nco txog qhov xwm txheej ntawm lawv qhov kev tsis txaus siab. Tag nrho cov sijhawm no nyuaj rau kev ua haujlwm ntawm tus kws kho mob thiabncua kev kho tus neeg mob.
Terminology
Txhawm rau sib txawv cov kab mob ntawm lub plab zom mov thiab txhais lub ntsiab lus ntawm xeev siab thiab belching, nws yog ib qho tsim nyog yuav tsum ua kom nkag siab meej txog cov ntsiab lus no. Kev xeev siab yog ib qho kev xav ntawm qhov hnyav hauv thaj tsam epigastric thiab hauv siab, tsis xis nyob hauv lub qhov ncauj thiab caj pas nrog kev xav ntawm lub siab los ntawm hauv qab thiab dov nyob rau hauv lub plab mog, qee zaum nrog cov qaub ncaug, belching thiab hiccups, feem ntau ua ntej ntuav.
Belching yog ib qho mob ntawm kev sib cais ntawm cov pa los yog ib feem me me ntawm plab hnyuv tawm ntawm lub qhov ncauj, nrog rau qhov tsis kaj siab tom qab.
ntuav yog kev sib cais ntawm cov ntsiab lus ntawm lub plab lossis duodenum mus rau hauv txoj hlab pas thiab qhov ncauj kab noj hniav vim yog qhov rov qab peristalsis.
Dysphagia - Teeb meem nqos lossis nqos cov zaub mov, qhov xav tias nyuaj txav zaub mov hauv caj pas lossis hauv siab, mob, kub hnyiab, hiccups lossis xeev siab thaum nqos.
Kev pom zoo ntawm cov tsos mob
Kev xav xeev siab thiab belching, ntuav, dysphagia lossis mob plab tsis thab koj txhua lub sijhawm, tab sis tshwm sim hauv qee yam mob. Lawv yuav tsum tau hais meej meej thaum hu rau tus kws kho mob, tab sis, qhov tseem ceeb tshaj, lawv yuav tsum tau taug qab txawm tias ua ntej mus ntsib kws kho mob tshwj xeeb. Txwv tsis pub, nco ntsoov thiab sim xav txog qhov xwm txheej ntawm qhov pib ntawm cov tsos mob, koj tuaj yeem ua rau tus kws kho mob yuam kev thiab xa nws mus rau qhov tsis raug. Yog li, cov xwm txheej uas cov tsos mob xws li xeev siab thiab belching yuav tsum tau saib xyuas los ntawm tus neeg mob.
Yuav tsum tigsaib xyuas lub sijhawm ntawm qhov tshwm sim ntawm qhov tsis txaus siab: ua ntej noj mov hauv qhov xwm txheej ntawm kev tshaib kev nqhis, thaum noj mov lossis qee lub sijhawm tom qab noj mov. Qhov xwm ntawm cov tsos mob yog ib qho tseem ceeb, uas yog, nws yog tas li los yog paroxysmal, manifests nws tus kheej nyob rau hauv txhua txoj hauj lwm los yog tsis nyob ntawm seb lub cev txoj hauj lwm, mus deb ntawm nws tus kheej los yog yuav tsum tau noj tej yam kev ntsuas. Thaum ntuav, yuav tsum nco ntsoov tias qhov ntuav yog xim dab tsi, muaj pes tsawg zaus tshwm sim, thiab cov paug tawm ntau npaum li cas nrog txhua ntu.
Belching, zoo li tag nrho lwm cov tsos mob, kuj xav tau kev nthuav dav tob. Nws yog ib qho tsim nyog los taug qab cov xwm txheej hauv qab uas nws tsim, qhov no tshwm sim nrog lub plab ib txwm muaj thaum tuav lub siab tsis tiav saturation lossis thaum nws overfilled. Nws yog ib qho tsim nyog yuav tsum tau ceeb toom seb qhov belching yog nrog los ntawm hiccups thiab mob hauv plab, qhov hnov qab ntawm lub qhov ncauj los yog qhov reflux ntawm cov ntsiab lus mus rau hauv lub qhov ncauj kab noj hniav, nyob rau lub sij hawm ntawm noj dab tsi tshwm sim.
Keeb kwm ntawm huab cua belching
Cov tsos mob xws li xeev siab thiab belching feem ntau nrog ib leeg, txawm hais tias tus neeg mob yuav muaj kev cuam tshuam los ntawm belching. Tab sis ntau tus tsis tig mus rau tus kws kho mob tshwj xeeb vim yog burping nrog huab cua, txawm tias nws ua rau tsis xis nyob. Yog vim li cas yog tias cov tsos mob no feem ntau tshwm sim nws tus kheej tom qab haus dej cawv, thiab cov neeg mob zoo li no, vim lawv tus cwj pwm tshwj xeeb rau kev noj qab haus huv, yuav tsis mus ntsib kws kho mob vim li no. Txawm tias cov tsos mob ntawm ntuav tsis ceeb rau lawv, raws li lawv tau siv rau nws thiab txawm tias feem ntau ua rau nws tuaj yeem ua rau kom haus ntau dua.cawv.
Qhov thib ob ua rau mob me me yog noj nrawm thiab thaum lub sijhawm sib tham, haus dej haus carbonated, overeating nrog lub plab tag. Tsis tas li ntawd, kev nqos ntawm huab cua thaum noj mov feem ntau pom, uas tau yooj yim los ntawm qhov muaj cov hniav cuam tshuam los yog poob, thaum zom yog nqa tawm feem ntau ntawm ib sab, thiab ib feem ntawm cov cua yog maj mam nqus mus rau hauv lub qhov ncauj kab noj hniav los ntawm lub ces kaum ntawm lub qhov ncauj. qhov ncauj. Sib tov nrog cov zaub mov, nws nqos nrog zaub mov, thiab thaum cov chyme kis hauv plab, nws tawm, ua rau belching.
Cardia tsis ua haujlwm
Qav thiab belching tuaj yeem tshwm sim los ntawm qhov tsis txaus ntawm lub plawv esophageal sphincter. Qhov no yog ib qho mob ntawm qhov tsis tiav kaw ntawm cov leeg annular uas cais cov hlab ntsha ntawm lub plab, uas tuaj yeem ua rau muaj kab mob reflux. Cardia insufficiency yuav tsum tswj lub cev upright txoj hauj lwm rau 1 teev tom qab noj mov. Nws yog ib qho tsim nyog kom tshem tawm lub cev ua haujlwm thiab khoov rau pem hauv ntej tam sim tom qab noj mov. Qhov no tsuas yog tsim nyog los tiv thaiv GERD, txawm hais tias burping nws tus kheej yuav tsis pab. Tsis kam tham thaum noj mov, nqos kom zom cov zaub mov hauv me me, cov hniav tuaj yeem pab tshem tawm lossis txo qhov tsis xis nyob.
Nyob zoo ib tsoom niam txiv kwv tij neej tsas sawv daws
Qhov laj thawj rau kev tsim cov ntsiab lus tseem nyob hauv qhov tsis txaus ntawm lub plawv qhib. Txawm li cas los xij, nyob rau hauv rooj plaub no, tsis tsuas yog huab cua sib cais, tab sis kuj muaj qee yam ntawm cov ntsiab lus ntawm plab.los yog 12 duodenal rwj. Cov paug tawm, feem ntau yog kua los yog mushy, nkag mus rau hauv txoj hlab pas thiab mus rau hauv lub qhov ncauj kab noj hniav yam tsis muaj kev tawm tsam ntawm xeev siab. Qhov no tshwm sim tom qab hiccups los yog khoov rau pem hauv ntej, nias ntawm lub plab tom qab noj mov. Qhov paug tawm muaj qhov tsis txaus siab, nyob ntawm seb hom zaub mov noj hnub ua ntej thiab lub sijhawm noj mov.
Yog tias belching tshwm thaum noj mov lossis 5-15 feeb tom qab nws, ces nws yuav tsis muaj qab zib. Qee zaum yuav muaj belching thiab xeev siab tom qab haus dej cawv, tab sis qhov no yog ib qho cim ntawm episodic dyspepsia, tsis yog kab mob. Cov qaub saj ntawm qhov tso tawm yog pom tom qab nws kho nrog kua txiv gastric. Nws muab pov rau hauv txoj hlab pas thiab qhov ncauj kab noj hniav tom qab noj nrog cardia insufficiency. Cov tsos mob no yuav tsum tau kho raws li qhov tshwm sim yog muaj kev pheej hmoo ntawm GERD thiab esophagitis.
Ntshav qab zib thiab iab iab yog ib qho tsos mob tshwj xeeb uas muaj qhov nthuav dav ntawm qhov tshwm sim. Nws tshwm sim vim qhov reflux ntawm cov ntsiab lus ntawm duodenum rau hauv lub plab, thiab los ntawm nws mus rau hauv txoj hlab pas thiab qhov ncauj kab noj hniav. Qhov kev xav ntawm iab nyob rau hauv lub qhov ncauj yog tsim los ntawm cov kua tsib, uas yog pov mus rau hauv ib tug tsawg kawg nkaus tus nqi, ua ntej vim duodenogastric reflux, thiab ces gastroesophageal. Kev xeev siab nyob rau hauv cov ntaub ntawv no yog pom vim khaus ntawm lub plab los ntawm cov ntsiab lus ntawm duodenum 12. Qhov no yog kho los ntawm kev txo qhov so ntawm cov pluas noj mus rau 4-6 teev. Noj mov me me 6-8 zaug ib hnub.
YPyloric stenosis
Nyob rau saum toj nokab mob, cov tsos mob tseem ceeb yog xeev siab thiab belching tom qab noj mov, kev kho mob uas yuav tsum tsis txhob siv tshuaj thiab kev ua haujlwm, tab sis kev qhuab qhia ntawm kev noj haus. Ntawm cov kab mob uas tuaj yeem ua rau cov tsos mob tshwm sim, nws yuav tsum raug sau tseg tias yog kab mob reflux, cardia insufficiency thiab GERD, gastritis. Tib lub sijhawm, nws ntuav uas pom tsis tshua muaj thiab tsis tas li tom qab noj mov.
Tawm tsam lawv keeb kwm yav dhau, pyloric stenosis yog ib qho mob hnyav heev. Nws tshwm sim vim qhov nqaim ntawm qhov hluav taws xob ntawm lub plab thiab txwv nws txoj kev nkag mus. Qhov no yog pom nyob rau hauv cov neeg mob postoperative los yog raws li ib tug tshwm sim ntawm ib tug ulcer ntawm lub pyloric cheeb tsam. Cov tsos mob zoo sib xws tuaj yeem ua rau cicatricial nqaim ntawm duodenal rwj. Nrog rau cov kab mob no, xeev siab thiab belching, hiccups thiab ntuav yog cuam tshuam.
Tus yam ntxwv ntawm cov tsos mob ntawm pyloric stenosis
Nrog stenosis ntawm pyloric ib feem ntawm lub plab, nws nyuaj rau cov zaub mov nkag mus rau hauv duodenum vim cicatricial nqaim. Yog li ntawd, cov ntsiab lus ua tiav los ntawm cov kua txiv hmab txiv ntoo tau qeeb thiab feem ntau cuam tshuam rov qab rau hauv txoj hlab pas. Qhov no tuaj yeem tshwm sim ntawm lub sijhawm sib txawv tom qab noj mov. Thiab tom qab los ntawm nws, ntau tshaj tawm cov tsos mob. Piv txwv li, belching ntawm cov qe lwj thiab xeev siab nrog ntuav yog cov cim qhia ntawm pyloric stenosis.
Nyob rau hauv thawj qib ntawm stenosis, muaj belching thiab tsis xis nyob hauv plab rau thawj ob peb teev tom qab noj mov. Cov paib no tsis tshua muaj suab lossis yuav luag tsis tuaj nrog noj mov ntau zaus. Nrog rau qib thib ob ntawm stenosis, thaum zaub mov nyob hauv lub plab ntev, nrog rau belching nrog cua thiab qaub,hnyav hauv plab, tsis xis nyob, qee zaum xeev siab thiab hiccups. ntuav tsis tshua muaj, txawm hais tias nws yuav tshwm sim nrog kev noj ntau dhau.
Nrog rau qib peb ntawm stenosis, lub sijhawm ntawm cov khoom noj hauv lub plab twb tawm 6-8 teev, thiab lub sijhawm no nws yuav lwj. Ntawm cov kev tsis txaus siab, cov neeg mob feem ntau qhia xeev siab thiab belching ntawm huab cua nrog ib tug tsis hnov tsw, belching ntawm cov ntsiab lus nrog ib tug putrid saj. Muaj yuav luag tas li ntuav: nws tshwm sim tom qab noj mov tom qab 4-8 teev tom qab noj mov. Nyob rau hauv ntuav, ua cov zaub mov nrog ib tug putrid thiab tej zaum fecal tsw. Qib plaub ntawm pyloric stenosis nyob rau hauv cov nqe lus ntawm cov tsos mob yuav luag tib yam li peb. Kev kho mob yuav tsum muaj kev phais, thiab thawj zaug thiab feem ntau hauv qib thib ob los kho cov zaub mov feem ntau hauv cov me me.
Dysphagia
Esophageal, los yog oropharyngeal, dysphagia yog ib pawg ntawm kev nqos cov kab mob uas nws nyuaj rau kis tsuas yog cov khoom lossis cov khoom noj los ntawm txoj hlab pas thiab pharynx. Qhov no tshwm sim vim muaj cov kab mob neurological, piv txwv li, tom qab raug kev txom nyem los ntawm cerebral infarction nrog kev nqhis dej. Qhov ua rau yuav tsum yog stenosis ntawm txoj hlab pas tom qab phais, tshuaj tua kab mob, lossis kev loj hlob neoplasm.
Nyob rau hauv tag nrho cov no, muaj belching ntawm zaub mov thiab xeev siab, txawm hais tias tom kawg cov tsos mob tsis tshua muaj. Raws li txoj cai, xeev siab tseem tsis tau muaj sij hawm los tsim, raws li thaum chewed zaub mov nkag mus rau hauv txoj hlab pas los yog pharynx, hiccups thiab ntuav tshwm. Pab kom noj mov yooj yim duahaus dej los yog sib tsoo zaub mov nrog kua. Nws yuav tsum tau nqos me me.
YEsophageal dysphagia
Nrog rau qhov mob hnyav ntawm txoj hlab pas, tus neeg mob tsis kam noj mov vim xeev siab thiab belching thaum nqos. Tsuas yog ib feem me me ntawm cov zaub mov, uas nws yuav nqos tau, yuav ncav cuag lub plab thiab digested. Hauv qhov no, ib qho ntawm cov tsos mob tseem ceeb yog poob phaus sai vim qhov tsis tuaj yeem ntawm cov khoom noj kom txaus. Feem ntau, thaum muaj cov qog nqaim ntawm txoj hlab pas, cov ntshav tuaj yeem tshwm sim hauv ntuav vim kev raug mob rau lub cev neoplasm.
mob xeev siab thiab belching tom qab noj mov, cuam tshuam nrog kev tsis tuaj yeem nqos lossis nyuaj rau kev hla zaub mov mus rau hauv lub plab, cov no yog cov tsos mob hnyav tshaj plaws uas tsis tuaj yeem tsis quav ntsej vim qhov loj hlob sai ntawm cov qog epithelial. Qhov no tuaj yeem ua rau muaj qhov xwm txheej uas tus kab mob kuaj tau raug kho tsis tuaj yeem kho vim kev kho mob lig.
Recommendations
Txhua tus tsos mob saum toj no yuav tsum tau saib xyuas los ntawm tus neeg mob ua ntej, thiab tom qab ntawd tus kws kho mob. Thiab nws yog ib qho tseem ceeb tshwj xeeb uas yuav tsum tau xyuam xim rau lawv thaum lawv rov ua dua. Kev ntuav tom qab noj mov lossis xeev siab tom qab noj mov yog cov tsos mob uas ua rau cov kab mob qog nqaij hlav ntawm lub pharynx, esophagus, lossis plab. Thiab txawm hais tias lawv tsis yog qhov yooj yim, nws yog qhov tsis tsim nyog los tas li tso ntuav thiab siv rau nws, tsis paub txog nws keeb kwm. Txhawm rau kom paub qhov ua rau ntawm cov tsos mob no yuav tso cai rau kev kuaj mob endoscopic ntawm lub plab nrog rau biopsy ntawm mucous daim nyias nyias. NwsCov txiaj ntsig kev kuaj mob yog qhov siab heev, yog li FEGDS yuav tsum tau ua kom ntxov li sai tau.
