Gabatarwa
Achalasia na zuciya (AC).rashin motsa jiki na farko na esophageal.Saboda rashin kwanciyar hankali na ƙananan ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar kuma da kuma rashin jin daɗin ci abinci yana haifar da ci gaba da cin abinci.dysphagia da amsawa. Alamomin asibiti kamar zub da jini, ciwon kirji da asarar nauyi.Yaduwar kusan 32.58/100,000.
Themaganina achalasia yafi hada da marasa tiyata, maganin dilation da maganin tiyata.
01 Magani
Hanyar maganin miyagun ƙwayoyi shine don rage karfin LES a cikin gajeren lokaci.Babu wata bayyananniyar shaida cewa kwayoyi na iya ci gaba da inganta alamun AC yadda ya kamata.A halin yanzu magungunan da aka saba amfani da su sun haɗa da nitrates, masu hana tashar calcium, da agonists β-receptor.
(1)Nitrates, irin su nitroglycerin, amyl nitrate, da isosorbide dinitrate
(2)Calcium tashar blockers, irin su nifedipine, verapamil, da diltiazem
(3)β-receptor agonists, irin su cabuterol
02 Endoscopic Botulinum Toxin Allurar (BTI)
Endoscopic botulinum toxin injection (BTl) za a iya amfani dashi don magance AC,amma zai iya samar da sakamako na ɗan gajeren lokaci kuma ana iya amfani dashi a cikin tsofaffi marasa lafiya tare da babban haɗari na tiyata da maganin sa barci.
1) Alamu:marasa lafiya masu matsakaici da tsofaffi (> shekaru 40); wadanda ba za su iya jure wa endoscopic balloon dilation (PD) ko magani na tiyata; waɗanda ke da jiyya na PD da yawa ko rashin sakamakon maganin tiyata; wadanda ke da ciwon ciki a lokacin jiyya na PD Ga wadanda ke da haɗari mai yawa, ana iya amfani da shi tare da PD; ana iya amfani dashi azaman canji zuwa tiyata ko maganin PD.
(2) Contraindications:Ba a ba da shawarar maganin farko na AC a cikin matasa marasa lafiya (≤40 shekaru).
03 Endoscopic Balloon Dilation (PD)
Faɗawar balloon yana da wasu tasiri akan AC, amma yana buƙatar jiyya da yawa kuma yana ɗaukar haɗarin haɗari masu tsanani.
(1) Alamu:Marasa lafiya AC ba tare da gazawar zuciya ba, rashin aikin coagulation, da sauransu; maza fiye da shekaru 50 da mata masu shekaru 35; marasa lafiya da suka kasa aikin tiyata. Ana iya amfani dashi azaman hanyar jiyya ta farko.
(2) Contraindications:Matsanancin rashin wadatar zuciya, rashin aiki na coagulation da babban haɗari na perforation na esophageal.
04Peroral Endoscopic Myotomy (POEM)
A cikin 'yan shekarun nan, tare da aiwatar da babban tsarin aiwatarwa na peroral endoscopic myotomy (POEM), nasarar nasarar maganin asibiti na AC ya karu sosai.Maganin WAKI na AC ya yi daidai da manufar "super minimally invasive tiyata", wato, raunuka kawai ana cirewa / cirewa yayin aikin jiyya, kuma ba a cire gabobin.Ana kiyaye mutunci da aiki na tsarin jikin mutum, kuma ingancin rayuwar majiyyaci bayan tiyata ba shi da tasiri. Fitowar waƙar ya sanya maganin AC ya zama mafi ƙaranci.
Hoto: Matakan aikin waƙa
Tsakanin da na dogon lokaci ingancin WAKAR a cikin maganin AC ya yi daidai da na laparoscopic Heller myotomy (LHM)za a iya amfani da shi azaman zaɓin jiyya na farko.Wasu marasa lafiya na iya haifar da alamun reflux gastroesophageal bayan tiyata na POEM
(1) Cikakkun alamomi:AC ba tare da mannewar submucosal mai tsanani ba, rashin aikin aikin ciki da babban diverticulum.
(2) Alamun dangi:Yaduwa spasm na esophageal, nutcracker esophagus da sauran cututtuka motsi na esophageal, marasa lafiya da gazawar POEM ko Heller tiyata, da AC tare da wasu adhesions submucosal esophageal.
(3) Contraindications:Marasa lafiya tare da rashin aiki mai tsanani na coagulation, cututtukan zuciya mai tsanani, rashin lafiyar gaba ɗaya, da sauransu waɗanda ba za su iya jure wa tiyata ba.
05 Laparoscopic Heller Myotomy (LHM)
LHM yana da inganci na dogon lokaci a cikin kula da AC, kuma an maye gurbinsa da asali da WAKAR a wuraren da yanayi ya yarda.
06 tiyata Esophagectomy
Idan AC ta haɗu tare da ƙananan tabo na esophageal, ciwace-ciwacen ƙwayoyi, da dai sauransu, ana iya la'akari da esophagectomy na tiyata.
Mu, Jiangxi Zhuoruihua Medical Instrument Co., Ltd., wani manufacturer ne a kasar Sin ƙware a cikin endoscopic consumables, kamarbiopsy forceps, hemoclip, polyp tarko, allurar sclerotherapy, fesa catheter, cytology goge, jagora, kwandon dawo da dutse, hanci biliary drainage catheterda sauransu wadanda ake amfani da su sosai a cikiEMR, ESD,ERCP. Samfuran mu suna da takardar shedar CE, kuma tsire-tsire namu suna da takaddun ISO. An fitar da kayanmu zuwa Turai, Arewacin Amurka, Gabas ta Tsakiya da wani yanki na Asiya, kuma suna samun abokin ciniki yabo da yabo!
Lokacin aikawa: Jul-09-2024