Ib tug kab mob hauv menyuam yaus hu ua kab mob peptic hauv cov ntaub ntawv kawm. Qhov no yog ib yam kab mob uas tshwm sim nrog relapses, yog qhia los ntawm lub xub ntiag ntawm lub rwj nyob rau hauv lub mucous daim nyias nyias ntawm lub plab thiab / los yog duodenum.
Yog vim li cas
Raws li kev tshawb fawb tsis ntev los no, tshuaj saib ntawm qhov ua rau duodenal rwj hauv cov menyuam yaus tau hloov pauv ntau. Txog niaj hnub no, cov laj thawj hauv qab no tau suav tias yog qhov yuav tsum tau ua ntej tshaj plaws rau kev mob plab hauv menyuam yaus:
- Yog tias pom muaj kab mob Helicobacter Pylori hauv plab. Tom qab kis tus kab mob no, cov txheej txheem pathological, kev puas tsuaj pib hauv plab, uas ua rau pom cov kab mob ntawm cov phab ntsa ntawm lub plab thiab duodenum.
- Ntau dhau ntawm plab acid thiab pepsins tuaj yeem ua rau peptic ulcers.
- Ua kom tsis muaj zog tiv thaiv kab mob ntawm lub plab thiab ua rau mob plab hnyuv tuaj yeem noj cov tshuaj tiv thaiv uas tsis yog tshuaj steroidal. Lub insidiousness ntawm cov tshuaj no nyob rau hauv qhov tseeb hais tias lawv muaj nyob rau hauv feem ntau seemingly nkag tau thiabCov tshuaj tua kab mob nrov thiab cov tshuaj tiv thaiv kab mob (Ibuprofen, Aspirin) thaum muaj kev phiv xws li cuam tshuam cov hnoos qeev hauv plab, ua rau cov ntshav tsis zoo thiab rov ua kom lub plab zom mov.
- kev noj zaub mov tsis zoo ntawm tus menyuam tuaj yeem ua rau mob plab (ntau dhau ntawm cov khoom kib, rog thiab ntsim, noj ntau dhau, so ntev ntawm pluas noj); kev ntxhov siab, kev puas siab puas ntsws thiab lub cev (kev raug mob) tuaj yeem ua rau mob plab hauv tus menyuam.
Cov tsos mob tseem ceeb
Yeej, cov tsos mob ntawm peptic ulcer hauv cov menyuam yaus feem ntau tshwm sim qhov mob hauv plab. Raws li txoj cai, qhov no yog lub sab sauv ntawm nws. Qee zaum qhov mob kis mus rau sab nraub qaum, hauv qab lub xub pwg hniav lossis mus rau thaj tsam lumbar.
Peptic ulcer kuj nrog rau kev tawm tsam thaum tsaus ntuj thiab tshaib plab. Lawv feem ntau poob qis tom qab noj mov, tab sis tom qab ib ntus lawv rov pib dua, tshwj xeeb tshaj yog tom qab kev tawm dag zog lub cev.
Signs
Nrog cov yam ntxwv ntawm peptic ulcer hauv cov menyuam yaus kuj yog:
- nausea;
- ntua;
- kho siab tas li;
- kev pw tsaug zog;
- bloating;
- nrawm cem quav;
- kev tshaib plab;
- belching nrog tsis kaj siab, feem ntau yog cua qaub.
Kev tshwm sim ntev ntawm cov tsos mob ua rau poob phaus, kev puas siab puas ntsws, nrog rau kev nyuaj siab thiab tshwm sim ntawm ntau yam phobias hauv tus menyuam.
Lusua densely furred, jams tshwm nyob rau hauv lub ces kaum ntawm lub qhov ncauj. Cov tawv nqaij thiab plaub hau ua tsis muaj zog thiab qhuav, rau tes ua nkig. Feem ntau cov tsos mob ntawm tus kab mob peptic tuaj yeem tsis meej pem nrog qhov tshwm sim ntawm kev mob plab ntev, vim tias nws qhov kev kuaj mob yuav tsum tau ua tib zoo saib xyuas thiab kho kom tsim nyog tam sim.
Diagnosis
Kev kho mob peptic ulcer rau ntau qhov laj thawj yog qhov sib txawv, yog li kev kuaj xyuas tus kab mob kom raws sijhawm yog qhov tseem ceeb heev. Cov txheej txheem tseem ceeb ntawm kev kuaj mob, ntxiv rau kev kuaj lub cev thiab kev sau ntawm anamnesis ntawm heredity, suav nrog cov haujlwm hauv qab no:
- Kev txiav txim siab muaj cov kab mob Helicobacter Pylori hauv plab. Hauv cov chaw kho mob niaj hnub no, kev sim ua pa yog siv, tab sis, ntxiv rau, kab mob plab tuaj yeem kuaj pom los ntawm kev kuaj xyuas cov ntaub so ntswg thaum lub sij hawm endoscopy, kev kawm txog kev kuaj ntshav rau qhov muaj cov tshuaj tiv thaiv kab mob no, thiab kev kuaj ntshav. Kev tshawb nrhiav quav rau ib qho antigen rau H. Pylori.
- X-ray ntawm lub plab hnyuv sab sauv. Noj cov kua tshwj xeeb (barium suspension) tso cai rau koj los txiav txim siab txog thaj tsam ntawm lub cev thiab thaij duab zoo.
- Kev kuaj Endoscopic ua rau muaj kev nyuaj rau kev ua, tab sis muab cov duab tseeb tshaj plaws ntawm lub plab. Lub raj nyias nyias nrog lub koob yees duab me me ntawm qhov kawg yog ntxig los ntawm qhov ncauj kab noj hniav, qhov no tso cai rau koj los tshuaj xyuas kom meej tag nrho cov kev hloov pauv pathological ntawm cov phab ntsa ntawm lub plab. Tsis tas li ntawd, thaum lub sij hawmendoscopy, nws muaj peev xwm nqa ib daim ntawm cov ntaub so ntswg puas rau biopsy (kev tsom xam cov qauv).
Kev kuaj mob raws sij hawm yuav tiv thaiv cov kab mob peptic hauv cov menyuam yaus thiab tiv thaiv qhov tshwm sim.
Non-pharmacological kev kho mob
Muaj ob txoj hauv kev los kho tus menyuam mob los ntawm kab mob peptic: tshuaj thiab tsis yog tshuaj.
Kev kho tsis yog tshuaj kho mob muaj xws li:
- personal psychotherapy;
- yog qhov no ua tau, ces kev kho mob yog los ntawm kev tsis lees paub cov tshuaj ulcerogenic.
Cov txheej txheem rau kev rov qab los ntawm cov kab mob peptic hauv cov menyuam yaus raug pom zoo kom pib noj zaub mov yooj yim. Ua ntej noj, tag nrho cov zaub mov yog grated los yog ua nyob rau hauv daim ntawv ntawm ib tug dej los yog ib tug me ntsis tuab sib tov, lawv yuav tsum tau boiled nyob rau hauv dej los yog steamed.
Yog tus kab mob no yooj yim heev, tsis muaj mob plawv lossis mob, ces qhov kev noj haus no yuav ua haujlwm yam tsis muaj kev kho mob ntxiv. Thaum lub qhov txhab pib maj mam ploj mus, nws yuav tsum tau saib xyuas cov khoom noj thiab noj kom txaus, suav cov carbohydrates, cov rog thiab cov protein uas tau noj, thiab tseem noj cov vitamins tsim nyog kom txaus.
Tsis suav cov khoom haus luam yeeb, cov kaus poom (cov nqaij thiab ntses), koj tsis tuaj yeem noj zaub ntau, uas suav nrog cov roj thiab fiber ntau ntxiv, piv txwv li, radish.
tshuaj kho mob
Kev kho mob peptic ulcer hauv cov menyuam yaus (duodenum thiab plab) los ntawm kev siv tshuajmuaj ntau yam txheej txheem, laj thawj, nrog rau kev siv cov txheej txheem antisecretory. Kev kho tus kab mob yog txiav txim siab tsis yog los ntawm lub sijhawm, tab sis kuj los ntawm kev muaj peev xwm khaws cov pH ntawm intragastric saum toj peb rau ib lub sijhawm, qhov tseeb, qhov no ua rau kev kho mob ntawm qhov txhab.
Ntawm tag nrho cov tshuaj tua kab mob, H2 blockers yog qhov zoo tshaj plaws, lawv ncua kev tsim cov pepsin thiab hydrochloric acid hauv parietal hlwb. Famotidine yog cov tshuaj siv ntau tshaj plaws hauv kev kho menyuam yaus vim qhov muaj feem cuam tshuam tsawg tshaj plaws uas tuaj yeem tshwm sim los ntawm kev siv ranitidine. Nws tau noj ib zaug hauv kaum yim teev, tsis pub ntau tshaj plaub caug milligrams ib hnub twg. Kev kho mob yuav kav tsis ntev tshaj yim lub hlis thiab tsis pub tsawg tshaj plaub.
Tam sim no ib qho ntawm cov khoom muaj zog tshaj plaws antisecretory yog cov twj tso kua mis proton, lawv lav kev thauj H +, suav nrog K + hlwb, mus rau hauv lub xovtooj, yog li ntawd, lawv koom nrog kev ua haujlwm ntawm cov twj tso kua mis proton, raws. thiab parietal hlwb ntawm lub plab, uas muab cov kev kho mob muaj zog tshaj plaws ntawm gastric secretion rau hnub tim. Txhua tus inhibitors tau lees paub ntev, nruab hnub thiab hmo ntuj, thaum H2 qhia tau zoo rau kev kho mob ntawm qhov txhab, peb tsis suav nrog cov tshuaj uas ua haujlwm zoo rau tus kab mob Helicobacter pylori.
Cov kev mob tshwm sim tsis suav nrog hauv daim ntawv:
- malaise;
- nquag hloov ntawm raws plab mus rau cem quav;
- mob taub hau;
- pob raudaim tawv nqaij.
Yog li ntawd, cov tshuaj xaiv yuav tsum siv tsis pub ntev tshaj li ob lub hlis, thiab tsis pub ntau tshaj ib hnub ib zaug. Smoother agents xws li omeprazole yog qhov zoo tshaj plaws pom zoo.
Thaum siv lansoprazole lossis rabeprazole, cov nyhuv yuav muaj zog dua, tab sis qhov tshwm sim ntawm cov kev mob tshwm sim hauv cov menyuam yaus ntau dua. Nrog kev txhawb nqa ntawm histamine H2 receptor blockers, koj tuaj yeem tshem tawm tag nrho cov teeb meem ntawm tus kab mob, tshwj tsis yog rau ib qho, lawv tsis lav qhov kev cais tawm ntawm qhov muaj peev xwm rov qab los.
Colloidal bismuth subcitrate tuaj yeem siv los ua cov khoom lag luam rau lub sijhawm ntev, nws muaj cov nyhuv antacid thiab txhawb nqa cov tsos ntawm colloidal pawg hauv daim duab ntawm zaj duab xis. Cov khoom lag luam muaj txiaj ntsig zoo ntawm cov khoom muaj txiaj ntsig thiab cov khoom zoo ntawm lub plab hnyuv, txo qis zog ntawm pepsin, thiab cuam tshuam rau Helicobacter pylori. Koj yuav tsum tau siv nws ib zaug ib teev ua ntej noj mov, tsis pub ntau tshaj peb zaug hauv ib hnub. Lub sijhawm kawm tsis pub tsawg tshaj plaub thiab tsis tshaj yim lub hlis. Koj yuav tsum tau npaj rau qhov tshwm sim tsis zoo nyob rau hauv daim ntawv ntawm lightheadedness, xeev siab, cov quav yuav ua tsaus rau hauv cov xim, nws yog undesirable siv nyob rau hauv cov ntaub ntawv ntawm lub raum kab mob.
Nws yog ib qho tsim nyog yuav tsum tau coj mus rau hauv tus account lub luag haujlwm ntawm Hp, nws qhov kev tshem tawm yog qhov tseem ceeb, qhov tseeb, uas txo tus naj npawb ntawm cov kab mob rov qab. Cov cai tseem ceeb ntawm txoj kev kho no yog kom tshem tawm Hp hauv kev tswj xyuas. Qhov txiaj ntsig zoo tshaj plaws tuaj yeem ua tiav yog tias chav kawm kav ntev li xya thiab tsis pub ntau tshaj kaum plaub hnub (ua raws li tus nqi ntawm cov tshuaj thiab nws txoj kev nyab xeeb).
Txoj Kev Kho Mob
Tam sim no yog qhov zoo tshaj plawssiv cov tshuaj sib xyaw ntawm peb lossis plaub yam tshuaj, txawm tias tsis yog tshuaj xwb, tab sis kuj tseem muaj cov tshuaj tiv thaiv Helicobacter.
Muaj peev xwm kho tau:
- Kev sib xyaw ntawm colloidal bismuth subcitrate, flemoxin, solyutab thiab furazolidone.
- Colloidal bismuth subcitrate, Solutab thiab Flemoxin.
- Kev sib xyaw ntawm colloidal bismuth subcitrate, furazolidone thiab clarithromycin.
- Quad therapy muaj omeprazole, Solutab thiab bismuth subcitrate.
Muab lub luag haujlwm tseem ceeb ntawm kev txawv txav hauv kev txav ntawm lub plab zom mov, qhov chaw tseem ceeb hauv kev kho yog muab rau prokinetics - cov no yog cov tshuaj uas txhim kho kev txav mus los, tsis yog siv cov blockers uas muaj kev phiv loj heev, domperidone yog tam sim no feem ntau siv, nws raug suav hais tias yog ib qho peripheral blocker, nws tshem tawm cov kev mob tshwm sim hauv nruab nrab, nrog rau cisapride, nws pib tso tawm acetylcholine hauv cov plexuses ntawm txoj hnyuv, vim nws txuas cov neuronal plexuses siv HT-4 receptors.
Cov txheej txheem ntawm kev kho mob muab lub sijhawm rau kev kho mob ntawm peptic ulcer, tshem tawm cov exacerbations thiab tiv thaiv kev rov tshwm sim ntawm tus kab mob. Cov nqi zoo tshaj plaws ntawm kev kho mob nrog ntau yam tshuaj tseem nyob nrog cov kws kho mob uas cuam tshuam nrog cov mob hnyav tshaj plaws. Nyob rau hauv cov ntaub ntawv no, lawv cia siab rau ib tug me ntsis nrov kev phais, uas muaj nyob rau hauv txwv tsis pub lub plab los ntshav nrog kev txhawb nqa ntawm feem ntau.paub txoj kev endoscopic. Ua raws li kev kho mob yooj yim ntawm peptic rwj, tsuas yog nyob rau hauv cov ntaub ntawv ntawm cov refractoriness kiag li mus rau kev kho mob, lawv mus rau kev siv laparoscopic heev xaiv vagotomy.
Kev Tiv Thaiv
Qhov tseem ceeb ntawm tus kab mob peptic ulcer yog kis kab mob Helicobacter pylori. Yog vim li cas qhov kev ntsuas tseem ceeb rau kev tiv thaiv kab mob peptic hauv cov menyuam yaus (lub plab thiab duodenum) yog kev tu cev.
Nws yog ib qho tseem ceeb uas yuav tsum nco ntsoov tias cov kab mob kis tau los ntawm cov qaub ncaug, yog li txhua tus neeg hauv tsev neeg yuav tsum muaj cov txhuam hniav thiab cov phuam so cais, qhov no yuav tsum tau ua tib zoo saib xyuas thaum tus menyuam nyob hauv tsev kawm ntawv lossis qib kindergarten. Kev hnia ntawm tsev neeg thiab cov neeg paub yuav tsum txwv.
txheej xwm ntxiv
Kev ntsuas ntxiv los tiv thaiv kab mob peptic muaj xws li hauv qab no:
- Kev kho hniav ntawm thawj cov tsos mob ntawm caries lossis mob hniav, vim tias cov khoom zom zom tsis zoo tsis tuaj yeem ua kom muaj kev zom zaub mov zoo, uas ua rau muaj acidity hauv plab.
- Kev noj zaub mov kom raug, uas yog, kib, haus luam yeeb thiab cov kaus poom, ntau cov hmoov nplej thiab dej qab zib yuav tsum raug cais tawm ntawm cov ntawv qhia txhua hnub.
- Cov khoom yuav tsum tau ua raws li kev kho cua sov, nyiam yuav tsum tau muab rau steaming, boiling los yog ci nyob rau hauv qhov cub ntawm qhov kub thiab txias es tsis txhob haus luam yeeb los yogkib.
- Tsis muaj kev ntxhov siab, kev ua neej nyob ntsiag to thiab ntsuas kev ua haujlwm txhua hnub.
Kev noj haus
Hauv thawj ob peb hnub txij li pib kho mob plab hauv cov menyuam yaus, raws li kev pom zoo ntawm kws kho mob, tsuas yog steamed lossis boiled, muab zaub mov kom huv si. Cov khoom uas ua rau kom cov secretory muaj nuj nqi ntawm lub plab yog kiag li tshem tawm los ntawm cov khoom noj. Cov pluas noj tsis qab ntsev.
Ib tug me nyuam yuav tsum noj 6-8 zaug ib hnub twg hauv me me li ntawm 200 gr. Qhov ntau ntawm cov khoom tso cai suav nrog:
- whole milk;
- butter and cream;
- qe qe;
- jelly thiab kissels los ntawm tshiab, finely grated berries;
- nqaij qaib thiab zaub broths;
Lean nqaij soufflé: nqaij nyuj, nqaij nyug, luav, qaib ntxhw, nqaij qaib thiab nqaij npuas. Cream soups ntawm zaub thiab nqaij nrog mov los yog semolina.
Raws li dej qab zib, nyiam yog muab rau rosehip thiab chamomile kua zaub, nrog rau cov txiv hmab txiv ntoo qab zib thiab cov kua txiv hmab txiv ntoo diluted nyob rau hauv ib nrab nrog mov broth.
Qhov kub ntawm cov khoom noj yuav tsum nyob nruab nrab ntawm 38-40 degrees. Tag nrho cov khoom bakery thiab hmoov nplej, nrog rau cov nplej zom thiab crackers, raug tshem tawm tag nrho los ntawm kev noj zaub mov, vim tias lawv ua rau muaj kev zais ntawm lub plab thiab tuaj yeem ua rau muaj tus kab mob exacerbation. Tib yam siv rau khoom qab zib.
Tab sis cov zaub mov saum toj no tsis tuaj yeem ua tau raws li tag nrho cov kev xav tau ntawm lub cev ntawm tus menyuam, yog li ntawd, nyob rau hnub 3-4 ntawm kev kho mob, daim ntawv teev npeCov zaub mov tau qhia:
- khob cij dawb (nws yuav tsum tau qhuav me ntsis hauv qhov cub);
- cereals thiab soups with milk;
- -nqaij thiab ntses chav txiav, quaenelles, meatballs thiab meatballs;
- thaum tsis muaj kev fab tshuaj, zib ntab yog siv los ua ib qho tshuaj ntxiv, vim nws normalizes lub plab zom mov thiab txhawb kev kho mob me me hauv nws.
Raws li kev soj ntsuam cov txheej txheem rau peptic rwj hauv cov menyuam yaus, cov dej ntxhia uas tau kub txog 45 degrees tuaj yeem suav nrog haus, noj ib teev ua ntej noj mov.
