Gastric dysplasia yog ib qho kab mob ntev uas cov squamous epithelium ntawm lub plab mucosa pib proliferate, nws cov hlwb mutate. Tom qab ntawd lawv hloov cov hlwb noj qab haus huv, qhov no twb hu ua metaplasia. Dysplasia yog hloov ntawm ib cov ntaub so ntswg los ntawm lwm tus raws li kev hloov pauv. Cov txheej txheem tuaj yeem tshwm sim hauv yuav luag txhua lub cev. Lub plab tsis muaj qhov zam.
Lo lus nws tus kheej txhais tau tias kev txhim kho tsis raug. Kev kuaj mob ntawm "dysplasia" tsis yog tsim yam tsis muaj qhov qhia meej ntawm lub cev, cov ntaub so ntswg lossis lub cev nyob qhov twg nws pom. Lub squamous epithelium ntawm CO (mucous daim nyias nyias) hloov nws cov qauv thiaj li pom tau hais tias nws kiag li tso tseg tsis pub leejtwg paub, yog li ua txhaum lub general secretion ntawm lub plab. Lub neej ntev ntawm cov hlwb epithelial lawv tus kheej nrog dysplasia ntawm lub epithelium ntawm lub plab yog txo.
Qhov tseem ceeb! Nws yog qhov ua tsis tau zoo uas ua rau kev tuag ntawm tes.
Mechanism for change
Lub epithelium hloov nws cov qauv histological thiab tinctorial zog (muaj peev xwm stain). Pav calub epithelium pib hloov thiab hloov los ntawm atypical hlwb.
Secretion nyob rau hauv dysplasia ntawm lub epithelium ntawm lub plab txo qis - parietal thiab lub ntsiab hlwb lub luag hauj lwm rau zus tau tej cov gastric kua txiv pib ua hauj lwm tsis muaj zog thiab raug thawb mus rau lub periphery. Lawv pib tuag sai sai.
Dysplasia yog ib qho kev hloov pauv ntawm cov txheej txheem hyperplastic thiab mob qog noj ntshav. Qhov no yog lub hauv paus ntawm nws txoj kev txaus ntshai. Qhov tshwm sim ntawm malignancy yog 75%.
Cov txheej txheem ib txwm ua tiav, thiab thawj zaug focal gastric dysplasia pib nquag ntes cov chaw tshiab, cov txheej txheem dhau los ua dav dav. Lub plab yog cuam tshuam tsis tsuas yog nyob rau hauv dav, tab sis kuj nyob rau hauv qhov tob. Tsis tas li ntawd, dysplasia, pib los ntawm cov qog hlwb, nkag mus rau hauv cov khaubncaws sab nraud povtseg ntawm daim siab, cov qog mammary, qhov chaw mos, thiab lwm yam. Ces dysplasia tshwm sim nyob rau hauv cov cheeb tsam no.
Vim txoj kev loj hlob
Raws li ntau yam kev tshawb fawb, nws tau raug pov thawj tias kev txhim kho ntawm plab hnyuv dysplasia ncaj qha nyob ntawm kev noj haus thiab ecology.
Cov xwm txheej-provocateurs tau ua ke ua 2 pawg loj: sab nraud thiab sab hauv.
External ua rau:
- tus ua txhaum loj tshaj yog haus luam yeeb thiab cawv;
- ua raws li kev noj zaub mov tsis txaus thiab cov vitamins los ntawm cov zaub mov;
- noj zaub mov tsis txaus nrog qhov tseem ceeb ntawm txhua yam khoom noj carcinogenic thiab yooj yim carbohydrates;
- kev mob siab rau ntsev thiab nqaij liab;
- ntsim, qaub, haus luam yeeb, kaus poom;
- junk zaub mov hauv daim ntawv ntawm cov khoom noj yooj yim, khoom noj ceev, chips, mayonnaise, thiab lwm yam;
- noj tsis txaus - khoom noj txom ncauj thaum mus, noj ntau dhau, zaub mov qhuav, noj zaub mov zoo ib hnub ib zaug thaum yav tsaus ntuj.
Fact! Cov khoom tsim kev puas tsuaj tshaj plaws yog vinegar - ib tug ncaj provocateur ntawm dysplasia. Qhov no yog qhov tseeb tshwj xeeb ntawm txoj hnyuv.
Qhov chaw ua lag luam yog kev haus luam yeeb, nws ua rau muaj kev hloov pauv tsis yog hauv cov hlwb ntawm lub plab, tab sis kuj nyob rau hauv lwm yam hauv nruab nrog cev hauv 99% ntawm cov neeg mob, piv txwv li, dysplasia yog kab mob ntawm cov neeg haus luam yeeb.
Kev siv cawv ua rau muaj kev ua txhaum ntawm morphology thiab cov qauv ntawm cov hlwb ntawm qib gene. Qhov no kuj muaj xws li ecology tsis zoo, ua hauj lwm hauv kev lag luam uas muaj kev phom sij, raug hluav taws xob, lom nrog tshuaj lom neeg, alkalis thiab acids.
Lwm yam ntawm kev puas tsuaj kuj suav nrog kev siv tshuaj mus ntev - tshuaj tiv thaiv kab mob hauv qhov ncauj, tshuaj hormones, tshuaj tsis-steroidal anti-inflammatory, plawv glycosides, cytostatics, aspirin, thiab lwm yam.
Internal ua rau:
- kev nqus tsis zoo ntawm cov kab mob muaj txiaj ntsig vim muaj kab mob plab ntev;
- lawv tsis noj;
- txo qis kev tiv thaiv thiab kev tawm tsam ntawm lub cev los ntawm cov kab mob thiab kab mob;
- hereditary predisposition rau kab mob ntawm txoj hnyuv, yog li cov me nyuam los ntawm cov tsev neeg tam sim ntawd poob rau hauv pawg neeg muaj kev pheej hmoo;
- noob caj noob ces mutations;
- immunodeficiency xeev;
- endocrinopathy - ntshav qab zib, pancreatitis, hypothyroidism, thyretoxicosis;
- nce ntau ntawm hydrochloric acid los ntawm lub plab;
- dysbacteriosis ntawm plab hnyuv;
- kis kab mob - helicobacteriosis, dysentery, salmonella, plab hnyuvwand.
Qhov tseem ceeb! Qhov laj thawj tseem ceeb yog kev noj zaub mov tsis zoo thiab kev ua neej tsis zoo.
Degrees ntawm qhov hnyav ntawm dysplasia
Txhua txheej txheem dysplastic hauv ib lub cev ib txwm muaj 3 lub ntsiab lus, lossis lawv tuaj yeem hu ua cov yam ntxwv: kev tsis sib xws ntawm cov qauv ntawm cov mucous membrane (SO), cell atypia thiab impaired differentiation.
Dysplasia ntawm lub plab mucosa tuaj yeem ua rau hyper- thiab hyposecretory los ntawm qhov kev hloov pauv hauv kev zais cia.
Nrog hypersecretory dysplasia hauv glandular epithelium, cov granules nce, cov hlwb puas tau pib nyob sib nrug.
Hypersecretion raws li qib ntawm qhov tshwm sim tuaj yeem yog me, nruab nrab lossis hnyav.
Hauv pathology, muaj peb theem lossis theem ntawm kev loj hlob:
- І degree ntawm plab dysplasia - hyperchromatosis tshwm (chromatin nce hauv cov nucleus, thiab cov nucleus ua xim xim). Cov tub ntxhais nws tus kheej kuj nce thiab thawb lub plasma mus rau qhov chaw ib puag ncig, kev tsim cov mucosa txo. Xws li cov epithelium pib metaplase, hloov los ntawm txoj hnyuv.
- II degree - cov txheej txheem txuas ntxiv mus, cov hlwb pib faib ntau dua thiab nrawm dua. Tawm tsam keeb kwm no, tus naj npawb ntawm Paneth hlwb thiab goblet hlwb txo qis. Goblet hlwb yog nyob rau hauv lub plab, lawv tsim cov mucus, Paneth hlwb nyob rau hauv cov hnyuv. Yog li, kev faib ua kom nce hauv cov hlwb ntawm cov hnyuv. Cov tsos mob tshwm sim tau tshwm sim ntau dua.
- III degree ntawm gastric dysplasia - txheej txheem ntawm kev loj hlobgeneralized, tsis pub leejtwg paub yog tam sim no tsis tsim nyob rau hauv tag nrho. Atrophic gastritis tsim - ib tug mob precancerous. Tej zaum yuav muaj daim duab ntawm peptic ulcer. Qhov pib ntawm dysplasia yog kho tau zoo nrog txoj kev khaws cia. Nws yeej ib txwm thim rov qab. 3rd theem - tuaj yeem ua ke nrog atrophic gastritis thiab gastric polyps. Kev pheej hmoo ntawm kev yug dua tshiab yog 75%.
Hyposecretory dysplasia yog cov txheej txheem rov qab, tab sis tsis muaj tsawg insidious. Cov granules nyob rau hauv lub hlwb ua me me, qhov zais cia ib yam nkaus. Kev txheeb xyuas qhov nruab nrab ntawm lub plab dysplasia, thiab tseem tshaj tawm, yog cov cim ntawm kev pheej hmoo ntawm oncology.
Ntawm hom mob qog noj ntshav, nruab nrab thiab zoo sib txawv adenocarcinomas feem ntau tsim.
Tshuaj plab metaplasia ntawm plab
Cov plab hnyuv dysplasia ntawm lub plab, lossis metaplasia, yog qhov hloov pauv ntawm cov cellular theem ntawm lub plab glandular epithelium rau hauv txoj hnyuv. Kev tsim cov hydrochloric acid los ntawm parietal hlwb nres kiag li.
Muaj 2 hom kab mob xws li kab mob hauv plab. Yog hais tias mutated plab hlwb hloov los ntawm cov hlwb nyob rau hauv cov hnyuv, qhov no yog txaus ntshai, tab sis kho tau. Yog tias cov qog nqaij hlav hauv lawv qhov chaw, ces muaj kev pheej hmoo mob qog noj ntshav ntau dua, kev kho mob ua tau, tab sis nws tsis tuaj yeem kwv yees qhov tshwm sim.
Tubular adenoma ntawm plab
Adenoma ntawm lub plab, los yog polyps, yog benign neoplasms. Txawm li cas los xij, lawv ib txwm xav tau kev kho mob sai.
Muaj 3 hom, feem ntau thiab ua ke nrog dysplasia tubular adenoma ntawm lub plab. Nws nyob rau hauv microscopymuaj cov contours meej, xim crimson thiab muaj peev xwm loj hlob mus tas li. Nws qhov teeb meem yog kev cuam tshuam ntawm lub plab zom mov.
Tubular adenoma ntawm lub plab thiab dysplasia muaj kev cuam tshuam zoo heev, vim lawv cuam tshuam rau cov kab mob mucosal. Lawv ua khub ntau zaus.
Feem ntau, adenoma tuaj yeem tshwm sim ntawm 2-3rd theem ntawm gastric dysplasia. Kev ua haujlwm ntawm lub plab nrog adenoma tsis cuam tshuam. Kuj tsis muaj tsos mob rau lub sijhawm ntev. Yog tias muaj cov ntshav sib xyaw hauv cov quav, qhov adenoma tuaj yeem kuaj tau thaum kuaj tus neeg mob. Nrog nws txoj kev loj hlob hnyav, tus neeg mob hnyav tom qab noj mov, qab los noj mov thiab xeev siab tshwm.
daim duab kho mob
Cov theem pib lossis qib ntawm plab plab feem ntau tsis muaj cov tsos mob, qhov no yog qhov nyuaj ntawm kev kuaj mob ntxov, yog li txoj hauv kev zoo tshaj plaws yog tshuaj xyuas cov neeg mob uas muaj kev pheej hmoo thiab muaj qhov tshwm sim. Tus neeg mob tej zaum yuav pom qhov tsis xis nyob hauv plab, hnyav tom qab noj mov, ua rau qaug zog ntxiv.
Nrog rau qib 2 dysplasia, cov tsos mob ntawm kev tsis xis nyob yuav tshwm sim:
- Mob hauv lub epigastrium ua ntau zaus, thiab tom qab ntawd mus tas li; tej zaum lawv yuav los sis tsis cuam tshuam txog zaub mov.
- Hav hauv plab tam sim no tas li.
- Nausea - tshwj xeeb tshaj yog tshwm sim sai thaum noj zaub mov tsis zoo.
- Heartburn - qhia txog qhov sib ntxiv ntawm kab mob gastroesophageal reflux (GERD).
- Belching cua lossis plab cov ntsiab lus nrog qaub saj. Lub plab yuav o nrog roj.
qib 3 dysplasia:
- Lub plab zom mov nrawmtxo. Mob, mob plab thiab tsis xis nyob yog mob hnyav thiab tas li.
- Slimming.
- Cov tsos mob ntawm qhov tsis muaj zog thiab qaug zog.
- ntshav qab zib thiab folic acid deficiency.
- Daim tawv nqaij qhuav, tsis muaj zog, txawm tias qhuav nws tus kheej tsis qhia dysplasia.
- Dyspeptic disorders - raws plab, raws li cem quav.
- Cov teeb meem tuaj yeem tshwm sim hauv daim ntawv ntawm cov ntshav los ntawm lub plab lossis cov hnyuv. Lawv ntuav thiab cov quav dub.
Ib yam ntawm cov cim no xav tau kev kho mob tam sim.
ntsuas ntsuas
Kev siv tshuaj ntsuam xyuas:
- YUltrasound.
- Helicobacter pylori tests.
- Tshawb nrhiav pH-metry, kua txiv plab.
- Kev kuaj mob endoscopic.
- Biopsy ntawm thaj chaw cuam tshuam ntawm lub plab - ua thaum lub sijhawm endoscopy, cov txheej txheem tsis mob.
- kuaj Fecal thiab tso zis.
Txoj kev tshawb fawb ntxiv suav nrog fluoroscopy, kuaj ntshav biochemical.
Kev cuam tshuam kho mob
Kev kho mob plab dysplasia yuav zoo tsuas yog tias nws nyuaj. Tus neeg mob tus cwj pwm yuav tsum yog rau kev kho mob mus ntev. Txhua qhov kev kho mob suav nrog:
- tshuaj;
- khoom noj;
- qee zaum radical kho.
Qhov tseem ceeb! Lwm txoj hauv kev rau dysplasia yog qhov tsis muaj txiaj ntsig thiab muaj kev phom sij, vim tias lub sijhawm muaj txiaj ntsig yog nkim rau lawv.
Radical method - endoscopic resection lossis cryodestruction, kuj ua endoscopically.
Kev txiav txim siab yog ua rau qhov xwm txheej hnyav, tsis tas yuav npaj tshwj xeeb rau tus neeg mob. Nws tshem tawm qhov cuam tshuam ntawm lub plab thiab ua haujlwm tiav.
Dysplasia tsis kho hauv ib hlis, yuav tsum ua siab ntev rau ntau xyoo. Kev pab hauv kev kho mob tuaj yeem yog kev tshuaj xyuas koj cov zaub mov. Nws kuj yog ib qho kev tsis lees paub tus cwj pwm tsis zoo, tsis suav nrog cov khoom noj carcinogenic, nws raug nquahu kom tsis txhob noj nqaij liab, zaub mov kaus poom, tsis suav cov kua mis, thiab lwm yam.
Drug therapy
Kev kho mob plab dysplasia yog qhov ua tau zoo tshaj plaws nyob rau hauv daim ntawv focal ntawm qhov txhab. Daim ntawv no tawm tsis muaj teeb meem tom qab. Theem 3 ciam teb ntawm oncology thiab yuav tsum tau kho sai los ntawm oncologist.
Kev kho mob nrog 3 qhov txuas tseem ceeb ntawm cov tshuaj:
- tshuaj tua kab mob;
- PPIs - proton twj tso kua mis inhibitors;
- bismuth npaj.
Metabolics, cov tsos mob kuj siv tau.
Txhob Cia Siab
Proton twj tso kua mis inhibitors txo qis kev tsim cov hydrochloric acid hauv parietal hlwb ntawm lub plab - Zulbex, Rabelok, Pariet, Ontime, Lanzap, Omez, Omeprazole, Emanera, thiab lwm yam. Cov menyuam yaus hnub nyoog qis dua 12 xyoos tsis raug tshuaj.
Thaum kuaj pom Helicobacter pylori, txoj haujlwm ntawm kev kho mob dhau los ua kev puas tsuaj tag.
Tshuaj tua kab mob tuaCov kab mob Helicobacter pylori yog Amoxiclav, Clarithromycin, Azithromycin. Kev teem sijhawm tsuas yog ua los ntawm kws kho mob xwb. Tsis suav tshuaj rau tus kheej.
Bismuth npaj tiv thaiv kab mob plab, suav tias yog gastroprotectors. Cov npe nrov tshaj plaws yog De-Nol, ua raws li Ulcavis, Gastronorm, Vikalin, Vikair, thiab lwm yam. Cov tshuaj no yuav tsum tsis txhob noj ntev dua 8 lub lis piam.
Kev kho mob yog cov tsos mob: rau qhov mob, tshuaj tua kab mob tuaj yeem pom zoo, ntuav - Cerucal, kub hnyiab - Maalox, Rennie, Almagel, thiab lwm yam.
Qhov tseem ceeb! Cov tshuaj tua kab mob rau lub plab dysplasia muab cov nyhuv rau cov neeg mob hnub nyoog qis dua 18 xyoo, lawv tsis cuam tshuam rau cov mucosa.
khoom noj kom zoo hauv kev kho tus kab mob
Txhua yam kev kho mob ib txwm pib nrog kev kho cov khoom noj khoom haus thiab kev ua haujlwm txhua hnub. Hauv kev noj zaub mov, lawv txwv cov carbohydrates, rog, thiab tsom mus rau cov protein. Kev kho zaub mov yog qhov tseem ceeb txij thaum pib.
Txhua theem ntawm tus kabmob, yuav tsum muaj cov kua dej txaus nkag rau hauv lub cev.
Nws yog qhov zoo tshwj xeeb yog siv cov kua txiv hmab txiv ntoo tshiab (xws li tsis yog khw muag khoom). Dos, qej thiab radish, uas cov kws tshawb fawb Suav tau tawm tswv yim ntau, tuaj yeem ua tus tiv thaiv tsuas yog thaum tsis muaj hyperacid gastritis thiab ulcerative lesions. Rau tib lub hom phiaj, citrus txiv hmab txiv ntoo yog contraindicated. Kev noj ntsev yuav tsum khaws cia kom tsawg.
tsev cheese thiab kefir muaj txiaj ntsig. Qhov piv ntawm BJU yuav tsum raug: feem ntau yuav tsum tau nyob ntawm cov protein, tsawg dua los ntawm cov rog thiab carbohydrates.
kho cua sov -Ua tiav kev cais ntawm kib, steaming nkaus xwb, stewing thiab boiling yog ua tau. Kev noj zaub mov ntau zaus yog 5-6 zaug hauv qhov me me. Kev tshaib kev nqhis rau kev poob phaus thiab kev noj zaub mov hnyav tsis suav nrog. Tom qab noj mov, nws raug nquahu kom taug kev luv luv los txhawb txoj kev zom zaub mov.
Qhia qhov tseeb ntawm kev noj haus yog kev txhim kho hauv cov metabolism thiab qhov hnyav nce. Cov qauv tseem ceeb ntawm kev xaiv cov khoom yuav tsum yog nws qhov txiaj ntsig zoo rau lub plab. Noj cov zaub mov uas tiv thaiv kab mob ntau dua.
Kev Tiv Thaiv
Yuav tsum ua kom noj qab nyob zoo, noj zaub mov kom zoo. Fiber, zaub tshiab thiab txiv hmab txiv ntoo, zaub ntsuab yuav tsum tau nkag rau hauv kev noj haus.
Yuav tsum tau teem sijhawm kuaj xyuas nrog kws kho mob txhua rau lub hlis, tshwj xeeb tshaj yog rau menyuam yaus.
Koj yuav tsum tsis txhob haus luam yeeb thiab haus dej. Kev tawm dag zog lub cev yuav pab tau.
Nws yog qhov tsim nyog los ntxiv dag zog rau lub cev - lactobacilli txhawb nws zoo - "Linex", "Acipol", Omega-3 acids, antioxidants - vitamin C thiab selenium.
Poj niam nug ntau yam. Kev txiav txim siab los ntawm kev txheeb xyuas, ntau tus tsis txawm xav tias tsis yog lawv muaj teeb meem xwb, tab sis feem ntau hais txog qhov muaj xws li pathology. Tab sis qhov kev tsis sib haum xeeb ntawm kev tshuaj xyuas yog tias kev kho mob ib txwm nyob ntev, nws yog qhov tsim nyog los pib nws sai li sai tau.
