Barrett's Esophagus Isingadi Kuongorora
Bhurett yaBarrett inowanzosawanzoita iyo iyo yakagadzika yeeophagus inotsiviwa nemukati-mhando dzemuviri. Kudzorerwa kwemasero ako akaenzana eesophageal inofungidzirwa kuti inoitika semugumisiro wekusagadzikana kusingaperi kune zvakagadziriswa gastric zviri mukati kubva gastroesophageal reflux chirwere (GERD). Sezvo asidi ichikuvadza masero ezvakakosha emuviri wako, iwe unogona kuwedzerwa kukura rudzi rwakasiyana rweesero iyo inonzi inonzi columnar epithelium .
Iyi sero yekisi yakatanga kuonekwa mune imwe nharaunda naNorman Barrett, chiremba wokuvhiya wokuAustralia, muna 1950. Bhurett yaBarrett inogona kuva inopedzisira yechirwere chekusangana uye haina chero zviratidzo zvinopesana; saka zvakaoma kufungidzira. Sezvo inowanzoitika kakawanda muvarwere vagara vaongororwa neGERD, vanachiremba vanokurudzira kuti vamwe vanhu vakaonekwa kuti vane GERD vanoita esophagogastroduodenoscopy (EGD) kuti vatarise sarudzo yaBarrett.
Kuwandisa uye Kuongororwa kwaBarrett's Esophagus
Kana uine zvikamu zvekurwadza kamwechete pavhiki, iwe unongomira mukana we5% wekuvandudza sopu yaBarrett. Zvisinei, nhamba yekushungurudzika kwezviitiko zvinenge uine hazviwedzeri njodzi yako yekuve nechepopus yaBarrett. Kuongorora hutachiona hwaBarrett kunogona kuitwa chete nekugadzirisa nekushandisa hurongwa hwekutora matanho maviri. Chokutanga, chiremba anoita endoscopy achaona kana kana kwete pane zvinyorwa zve epithelial mashesi ari pasi (pasi) chikamu chemukati mako, pedyo nechemukati.
Kana zvakaratidzwa, danho rechipiri nderokutora biopsy yenharaunda kuti uone kana masero ane zviratidzo zvaakashandura kubva kune imwe sero-rudzi kune imwe.
Kunyange zvazvo chirwere chacho pachacho chisina zviratidzo, inenge 1 muzana yevarwere vane chirwere cheBarrett vanokura mungozi yekenza yekushaya simba inonzi adenocarcinoma .
Nokuda kwechikonzero ichi, unofanirwa kuongororwa nekuda kwedysplasia (kuchinja kusina kuitika mumasero anogona kuva mutsva wekenza) kuburikidza nekugumira uye mamwe maitiro ezvinyorwa kana iwe uine chirwere cheBarrett's esophagus.
Kurapa Esperhagus ya Barrett
Kana dysplasia inowanikwa mukati mako, masero anogona kuparadzwa achishandisa chirwere kana endoscopic nzira. Imwe mushonga weBopret's's hoophagus inonzi photodynamic therapy (PDT) . Iyi inorapwa inoshandisa ikemikari inonzi Photofrin, iyo inoita kuti mishonga inzwisise chiedza. Maawa makumi mana nemasere mushure me Photofrin anopiwa murwere, chiremba anogona kudarika laser tube (kuburikidza ne endoscope ) kupinda mudenga uye kuparadza zvisikwa zvisina kufanira zveBarrett.
Barrx, imwe nzira yekuparadza yakakwirira-grade dysplasia, inogona kushandiswa kana chiremba wako asinganzwi kuti uri mukana wokuvhiya akanaka. Nzira iyi inoshandisa Bhats Catheter iyo inowanikwa mu endoscope uye inobvumira kuperesa kwemafuro (kubviswa) kwemavara asina kunaka. Iyi ndiyo nzira isina kuvhara isingasviki yekuparadza kupisa kwaBarrett mumuviri wako.
Imwe mushonga weDysplasia muBarrett's esophagus inonzi endoscopic mucosal resection (EMR) . EMR inogona kushandiswa pakutsvaga kwaBarrett kana kuti kenza yekusaphageal.
Muchiitiko ichi, chinhu chinoshandiswa pasi pechigadziko chemuviri weBarrett zvisati zvabviswa ne endoscope. Kana kurapwa kunoshandiswa kwekenza yekushaya simba, chete iyo yakakwirira masero ichabviswa. Nemhaka yeizvi, inogona kushandiswa chete kune dysplasia yakaoma kana kenza yemukomana.
Kune vanhu vane dysplasia yakaoma kana kenza yakawanda uye vane utano hwakakwana kuti vawane anesthesia, chirwere chinoramba chichirongwa chekutanga chokutarisa kwaBarrett neyepamusoro-grade dysplasia kana kenza. Mishonga yakawanda inoshandiswa inoshandiswa zvichienderana nezvinodiwa nemurwere mumwe nomumwe uye nzvimbo yechipfuva.
Kunyange zvazvo chirwere chaBarrett chirwere chisingawanzoziviki uye pane mukana muduku kwazvo wekuita kenza yeesophageal kubva mairi, adenocarcinoma yeeophagus ine urombo husinganzwisisiki huwandu hunofanirwa hunoonekwa mune imwe nzvimbo yakakwirira. Nokuda kwechikonzero ichi, zvakakosha kuti kana iwe uri kutambura neGERD, iwe unotarisira zvakakodzera nemishonga inorwisa-reflux sePolosec kana Dexilant . Kana iwe uine chirwere cheshuga chaBarrett, iva nechokwadi chokuti uwane ENT yakanaka kana gastroenterologist ichikubatsira kuti uchengetedze kutevera nekurapa kwako.
> Source
> Del Genio, G, Del Genio, F, Schettino, P, Limongelli, P, Tolone, S, Brusciano, L ... (2015). Esophageal Papilloma: Flexible Endoscopic Ablation neRadioofrequency. World J Gastrointest Endosc. 7 (3): 290-4. doi: 10.4253 / wjge.v7.i3.290.
> National Digestive Disease Clearing House. Barrett's Esophagus.
> Spechler, SJ & Souza, RF. (2016). Sleisenger uye Fordtran's Gastrointestinal and Liver Disease. 10 th ed. (Kubhadhara Kunodikanwa)