Nhanganyaya
Acheraliya yeCardia (AC) ndeyeyekutanga esophageal motider disorder.Nekuda kwekuzorora kwakashata kweiyo yepazasi esopophaal sphincter (les) uye kushaya kwesphageal peristalis, kuchengetwa kwechikafu kunogumaDysphagia uye maitiro. Zviratidzo zvechiratidzo zvakadai sekubuda ropa, kurwadziwa kwechipfuva uye uremu.Iko kuwanda kweanenge 32,58 / 100,000.
The thekurapwayaChalasia inonyanya kusanganisira kusiri kwekuvhiya, kurapa kwekurapa uye kurapwa kwekuvhiya.
01Medical Tratement
Iyo Mechanism yeKutrira kwezvinodhaka ndeyekuderedza les kudzvanywa mune pfupi pfupi.Iko hakuna humbowo hwuri pachena kuti mishonga inogona kuramba ichinyatsoenderana nezviratidzo zve ac.Parizvino zvinowanzo shandiswa zvinodhaka zvinosanganisira nitrates, calcium chiteshi blockers, uye β-recptor vagonists.
(1)Nitrates, senge nitroglycerin, amyl nitrate, uye isosorbide ditrate
(2)Calcium Channel Blockers, senge nifrepine, verapamil, uye diltiazem
(3)β-recptor agonists, senge butilerol
02endoscopic Botulinum toxin jekiseni (bti)
Endoscopic botulinum toxin jekiseni (btl) inogona kushandiswa kurapa ac,Asi inogona kungopa zvipfupi-pfupi mhedzisiro uye inogona kushandiswa mune varwere vakwegura vane njodzi dzakakwirira dzekuvhiya uye anesthesia.
1) Zviratidzo:Varwere vepakati uye vakwegura (> makumi mana emakore); avo vasingagoni kushivirira endoscopic balloon diloon (PD) kana kurapwa kwekuvhiya; avo vane akawanda maPD kurapwa kana kurapwa kwakashata kurapwa kwemhedzisiro; Vaya vane maEsophageal kutsungirira panguva yePd kurapwa kwevaya vane njodzi huru, inogona kushandiswawo musanganiswa nePD; Inogona kushandiswa sechishanduko yekuvhiya kana pd kurapwa.
(2) kukanganisa:Izvo hazvikurudzirwe kuti urege-mutsara kurapwa kwe AC muvarwere vechidiki (č40 makore).
03endoscopic Balloon Dilation (PD)
Balloon Dilatation ine zvimwe mhedzisiro pane ac, asi inoda kurapwa kwakawanda uye inotakura njodzi yezvakakura matambudziko.
(1) Zviratidzo:AC Varwere vasina Cardiopulmonary issquienscy, coagulation dysfunction, etc.; varume vanopfuura makore makumi mashanu uye vakadzi vanopfuura makore 35; Varwere vakakundikana kuvhiyiwa. Inogona kushandiswa seyekutanga sarudzo yekurapa nzira.
(2) kukanganisa:Yakanyanya Cardiopulmonary issquienscy, coagulation deysfunction uye yakanyanya njodzi yesphageal perforation.
04perereral endoscopic myototomy (nhetembo)
Mumakore achangopfuura, neakakura-chiyero chekusazvibata chePereral endoscopic myotoscopic myotokoryPoem kurapwa kwe AC inoenderana zvakanyanya neiyo pfungwa ye "Super zvishoma Invasive Surgery", kureva kuti, zvasara zvasara panguva yekurapa, uye nhengo dzisina kubviswa.Kuvimbika uye kushanda kweiyo chiratidzo chechimiro chinochengetwa, uye mhando yemurwere yehupenyu haina kukanganiswa. Iko kubuda kwenhetembo kwakaita kurapwa kweAc Super zvishoma zvinosangana.
Mufananidzo: nhetembo dzinovhiya matanho
Pakati-uye kwenguva refu kushanda kwetsvimbo mukurapa kweiyo ac inoenderana neiyo yeLaparoscopic Heatery (LHM)inogona kushandiswa seyekutanga-mutsara kurapwa sarudzo.Vamwe varwere vanogona kukudziridza gastroesophagal Reflux zviratidzo mushure mekuvhiyiwa nhetembo
(1) Chaizvoizvo Zviratidzo:AC isina submere submucosal adhishsion, gastric inoshanda kudurura kusagadzikana uye yakakura divorticulum.
(2) Zvinyorwa zvehama:Diffuse Esophageal Spasm, Nutcracker Esophagus uye zvimwe Zvirwere zveEsophagel Motilous, varwere vane dzimba dzakundikana, uye accery nedzimwe esophageal submucosal adesucosal.
(3) kukanganisa:Varwere vane kakawanda kanzuru sysfunction, chirwere chakasimba chemwoyo, murombo mamiriro, etc. ndiani asingakwanise kuvhiyiwa.
05laparoscopic Heller Myotoksory (LHM)
LHM ine yakanaka yekubudirira-nguva yekubatira mukurapa ac, uye yave yakatsiviwa nedetembo munzvimbo dzinobvumirwa nemamiriro ezvinhu.
06surgical Esophagectomy
Kana AC ikasanganiswa neyakaderera Esophageal Scen Stenosis, tumors, etc., Kuvhiya Esophagegectomy inogona kutariswa.
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Kutumira Nguva: Jul-09-2024