Gastric Esophageal Reflux chirwere (hutachiona) chirwere chakajairika mudhipatimendi rekugaya. Kukurira kwayo uye kuomarara kwekiriniki kunokanganisa zvakanyanya hupenyu hwevarwere. Uye kuzvimba kusingaperi kweshungu kune njodzi yekukonzera kenza yemagetsi. Maitiro ekuongorora nenzira yakakodzera uye kurapwa kurapwa ndiko kutarisisa kwekiriniki basa.
02 Gerd's Clinical Kuratidzwa
GERD can be divided into non -eroded reflux (NERD), reflux esophagitis (RE) and Barreta esophageal (BE) according to endoscopy.
Nerd: barrett esophagus uye yakajeka esophageal mucosa inokuvadzwa mune tsanangudzo yehutachiona asi iyo endoscopy yakakuvadzwa.
Re: endoscopy inogona kuona dumbu-esophageal mucosa iro rakabatana neiyo esophagus kana pamusoro. Iyo mucous membrane inokuvadzwa nguva nenguva.
Iva: Iyo Gastric-Esophageal Squamous Epithelial Chikamu cheEsophagus-Sesa Esopelium of the Esipolium of the Esipolium of the Esopolius yekubatanidza neEsphagus yekubatanidza pane endoscopy inotsiviwa neCylindrical epithelium.
02 Gerd's Clinical Kuratidzwa
Kuwedzera kumoyo unopisa uye Reflux, zviratidzo zvakadai sekurwadziwa kwepamita, kurwadziwa kwepamhepo, uye zvishamiso zvesvomhu, kukosora, sthma uye zvimwe zviratidzo zvemagetsi zvinogona kuitika.
Izvo zvinofanirwa kucherechedzwa kuti varwere vane varwere veGerd vane huwandu hwakaderera hwemoyo uye Reflux. Iko kuitika kwezviratidzo mune yekutsvaira tube yakakwira. Zviratidzo hazvisi zvakajairika, kana kunyange asymptomatic. Kuomarara kwezviratidzo hakuna kufanana nekuomarara kwechirwere. Factory Guiyu rakanga rakapetana, uye paaive chiremba, akagadziridzwa muGuwarli.
03 Gerd's Diagnosis
Nhamba. Chaizvoizvo Gerd Zviratidzo uye Atypical Uptop Dightsive Turakiti Zviratidzo zvinotambura kubva kuGerd Diagnostic Flowchart Sourcew: Chinese Medical Association
Kuongororwa kweDignostic kweAcid SubicsVession Mumiriri
Kune vanofungidzira varwere veGerd (vanowanzo shandiswa PPI), iyo standard dosage ichagara kwemavhiki maviri (avo vane zviratidzo kunze kwehubhu vanoda vekupedzisira ± vhiki). Kana zviratidzo zvacho zvakazadziswa zvakakwana kana chete zviratidzo zvinyoro zvinyoro zvinoratidzwa kuti zvibudirire.
2) endoscopic
-Re -los Angeles yakakamurwa kuita mamakisi (ona nhamba pazasi):
Kirasi A: 1 kana more esophageal kukuvara kwemuchadenga, urefu hwekukuvara ≤5 mm;
Giredhi B: 1 kana more esophageal kukuvara kwemukuru, kukuvara kwehurefu> 5 mm, mucous memrane kukuvara uye hapana fusion;
Kirasi C: kanokwana 2 Esophageal Mucosa akakuvadzwa, uye mucous membrane inokuvara pamwe chete.
Kirasi D: inoreva iyo mucosa kukuvara uye kuunganidzwa kweumwe neumwe, uye iyo fiusion huwandu ndeye 75% yeiyo esophagus.
-Be biopsy zano: Zvinokurudzirwa kuti pane akawanda uye pfupi kupindirana kweiopsy, uye biopsy inowanikwa ne 1cm nguva yakatenderedza chitofu. Saizi yerudzi ine chekuita nenjodzi yekenza, uye njodzi yekanza iri kuwedzera uye kuwedzera huwandu hwe3cm.
3) Yakakwira -Soluolution Esophageal Chiyero
Varwere vane gerd vanowanzo kuratidzira seisina basa eresogeal Simba: Iyo chikamu che70% kana peristalsis kukundikana huwandu hwe 70% kana peristalsis iri ≥50%.
Anti -currrent yekutarisa
Iyo ndiyo mwero wekuongororwa kweCEDD. Iyo ndiyo mwero wegoridhe wekuongororwa kwehutachiona, kusanganisira kuongorora kweiyo Esophagus nh kukosha kweiyo esophagus pombi nh kukosha uye Esophagel yang anti -Nh kukoshesa kutarisa. Iyo perenti yePH <4 (acid Exposure nguva, AET)> 4% muna 24h, inoonekwa kuti pane pathological acid contix.
04 GERD kurapwa
Mufananidzo
Kwayaka: Chinese Medical Association
Zvekungwaririra:
-Pi uye P-kabhaki ndiyo yekutanga sarudzo yekutakura kurapwa uye kuchengetedza varwere vane gard. Kurapa kwekutanga kwePpi kurapwa kune mavhiki masere uye iyo PP-CABE kurapwa kwemavhiki ≥4.
-For patients with breakthroughs at night (when taking PPI, the pH <4 time> 1H in the night of the night), you can use H2 receptor blockers before going to bed on the basis of PPI treatment, or switch to P-CAB and long. Hafu -life ppi kurapwa.
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-Iye endoscopic kurapwa zvinoratidza: kurapwa kwehurongwa
-Surgical kuvhiya kurapwa kwezviratidzo: Kune yakajairwa gerd zviratidzo, ppi kurapwa hazvibvumirwe; Endoscopy anowana Esophageal hernia, iva, res, los Angeles mamakisi kana pamusoro; X -ray bvunzo dzakawana kuti kune Esophageal Hole Hernia.
Kutumira Nguva: Mar-21-2024