Yog koj xav tias koj muaj ntshav los sab hauv, nrhiav kev kho mob tam sim. Thaum koj muaj cov ntshav GI siab dua, thawj kauj ruam hauv kev kho mob yog kom ruaj khov koj cov cim tseem ceeb. Qhov no yog vim tias, thaum muaj ntshav hnyav, koj muaj feem yuav ua rau poob siab los ntawm kev poob ntshav tseem ceeb. Thaum koj tau ruaj khov lawm, koj tus kws kho mob yuav ua qhov kev kuaj mob txhawm rau txheeb xyuas qhov laj thawj tshwj xeeb ntawm koj cov ntshav GI sab saud, yog li qhov laj thawj tuaj yeem kho tau zoo. Feem ntau, kev kho mob yog ua tiav endoscopically.
Cov kauj ruam
Ntu 1 ntawm 3: Paub Txog Tus Cwj Pwm Stabilizing Cov Cim Tseem Ceeb
Kauj Ruam 1. Paub cov cim thiab tsos mob ntawm lub plab zom mov
Cov cim qhia txog ntshav GI sab saud tuaj yeem txaus ntshai - ib qho ntawm qhov ntsuas ntau tshaj yog ntuav ntshav. Tsis txhob ntshai - hu rau koj tus kws kho mob thiab tau txais kev saib xyuas tam sim yog tias koj tau ntsib cov hauv qab no:
- Cov ntshav ntuav, uas yuav zoo li thaj chaw kas fes
- Cov quav dub nrog tsw ntxhiab tsw
- Cov ntshav tshiab hla lub qhov quav, feem ntau pom nrog cov quav (qhov no feem ntau yuav qhia tau tias qis dua GI los ntshav, tab sis tseem tseem tuaj yeem nrog ntshav GI sab saud)
- Hnov tsaus muag thiab lub ntsej muag tsis muaj zog, tsis muaj zog
- Mob hauv lub plab sab saud, nyob hauv qab kab tav
- Mob plab los yog plab zom mov
Kauj Ruam 2. Kuaj koj cov cim tseem ceeb
Nyob ntawm seb cov ntshav los ntshav ntau npaum li cas, cov ntshav GI siab tuaj yeem, qee zaum, ua rau muaj kev phom sij rau lub neej. Yog tias koj tab tom poob ntshav sai, cov ntshav tshuav kom ntws los ntawm koj lub cev poob qis, uas tuaj yeem ua rau pom kev tsis pom kev, tsis pom kev, tsaus muag, thiab thaum kawg pom tias poob siab los ntawm ntshav poob. Koj tus kws kho mob tuaj yeem kuaj koj cov cim tseem ceeb kom tau txais lub tswv yim tias koj tau poob ntshav ntau npaum li cas. Cov cim taw qhia rau kev poob ntshav hnyav dua suav nrog:
- Lub plawv dhia ceev heev
- Ntshav siab tsis txawv txav
- Ua pa ntau ntxiv
- Ib theem qis ntawm kev nco qab
Kauj Ruam 3. Tau txais kev kuaj ntshav thiab ntsuas ntshav tsis txaus
Ib qho tseem ceeb los ntsuas hauv GI ntshav yog qib ntshav poob. Thaum muaj ntshav poob ntau, qhov tseem ceeb yuav yog los hloov cov ntshav uas ploj lawm thiab ua kom koj muaj kev kho mob ruaj khov ua ntej txav mus rau kev kuaj mob tshwj xeeb thiab xaiv kev kho mob. Yog tias koj tsuas yog poob ntshav tsawg, txawm li cas los xij, koj tus kws kho mob tuaj yeem ua ncaj ncaj rau kev kuaj mob thiab kho mob.
- Txoj hauv kev zoo tshaj los ntsuas qib ntshav poob, yog tias nws tsis paub tseeb (piv txwv li piv txwv tias koj tsis poob siab lossis qhia lwm yam kev qhia paub txog ntshav poob), yog los ntawm kev kuaj ntshav.
- Kev kuaj ntshav yuav tshuaj xyuas koj cov qib hemoglobin, uas yog cov qauv hauv koj cov ntshav uas yog lub luag haujlwm nqa cov pa oxygen.
- Tsawg hemoglobin yog kuaj mob ntawm "ntshav tsis txaus," thiab qhov hnyav ntawm cov ntshav tsis sib xws cuam tshuam nrog qib ntshav poob los ntawm GI ntshav.
Kauj Ruam 4. Tau txais cov kua los yog tso ntshav, yog xav tau
Tom qab txiav txim siab koj cov ntshav poob (los ntawm kev sib koom ua ke ntawm cov tsos mob thiab kuaj ntshav rau ntshav tsis txaus), koj tus kws kho mob yuav muab koj cov kua IV thiab/lossis tso ntshav yog tias nws txiav txim siab tias koj cov ntshav muaj tsawg txaus thiab xav tau yuav tsum tau ntxiv.
- Cov kua dej IV raug muab rau thaum muaj ntshav tsawg dua. Lawv txhawb koj cov ntshav (cov dej ntws hauv koj lub cev ncig), tab sis tsis ncaj qha nce cov hemoglobin (lossis muaj peev xwm nqa cov pa oxygen) ntawm koj cov ntshav.
- Yog tias koj cov hemoglobin tau poob qis (piv txwv li yog tias koj muaj ntshav tsis txaus ua rau muaj kev cuam tshuam zoo ntawm koj li kev ua haujlwm ntawm lub plawv), koj yuav xav tau kev tso ntshav.
Ntu 2 ntawm 3: Tshawb Nrhiav Ntxiv
Kauj Ruam 1. Nug koj tus kws kho mob rau PPIs (proton pump inhibitors)
PPIs yog cov tshuaj uas tuaj yeem pab txo qis qhov hnyav ntawm GI sab saud. Txawm tias ua ntej qhov ua rau pom ntshav los, nws raug nquahu kom tau txais PPIs vim tias muaj lawv hauv koj lub cev txo qis txoj hauv kev uas koj yuav xav tau kho lub tsev kho mob, thaum pom qhov chaw los ntshav.
Kauj Ruam 2. Xaiv lub plab zom mov
Ua ntej yuav tau txais kev kuaj lub cev, qee zaum nws tau txais txiaj ntsig kom tau txais "lub plab zom mov." Nov yog qhov uas cov ntsiab lus ntawm lub plab - suav nrog cov ntshav tuaj yeem ua ke - tau raug ntxuav kom tso cai kom pom meej dua ntawm lub plab phab ntsa ntawm kev kuaj mob endoscopic.
- Qhov no tso cai rau kom yooj yim txheeb xyuas qhov chaw ntawm cov ntshav GI sab saud.
- Nws tseem tso cai kom pom meej dua los pab kho GI ntshav (uas yog nyob ntawm qhov pom los txheeb xyuas qhov chaw ntawm cov ntshav).
Kauj Ruam 3. Tau txais qhov ntsuas GI sab saud
Thaum koj tau txais kev kho mob ruaj khov, yog xav tau (piv txwv li yog tias koj lub cim tseem ceeb tau cuam tshuam lossis koj qib ntawm cov ntshav tsis txaus txaus los lav cov kua dej thiab/lossis hloov ntshav), cov kauj ruam tom ntej yuav yog rau koj tus kws kho mob txhawm rau txiav txim siab qhov pib mob - uas yog, qhov ua rau koj cov ntshav GI. Kev txiav txim siab qhov ua rau yuav yog dab tsi hais txog qhov phiaj xwm kho mob kawg.
- GI endoscopy sab saud feem ntau pom zoo ua qhov ntsuas ntsuas hauv thawj 24 teev ntawm cov ntshav (yog tias ua tau).
- Kev ntsuas GI sab saud yog thaum lub raj nrog lub koob yees duab ntawm qhov kawg tso rau hauv koj lub caj pas, hla koj txoj hlab pas, thiab thaum kawg nqes mus rau koj lub plab.
- Lub hom phiaj yog txhawm rau ntsuas qhov muag (ntawm lub koob yees duab) rau qhov chaw ntawm GI los ntshav.
- Kev kho kuj tseem tuaj yeem muab tshuaj endoscopically yog thiab thaum twg los xij ntawm qhov los ntshav.
Kauj Ruam 4. Txheeb xyuas qhov ua rau los ntshav
Feem ntau ua rau cov ntshav GI sab saud yog mob plab (mob plab hauv plab). Cov no suav txog 60% ntawm cov ntshav GI sab saud. Lawv muaj ntau dua nyob hauv cov tib neeg uas muaj tus kab mob H. Pylori nyob hauv lawv lub plab, yog li muab tshuaj tua kab mob rau cov kab mob no tuaj yeem yog ib feem ntawm txoj kev npaj qhia kho mob. Dab tsi suav rau lwm 40% ntawm cov ntshav GI sab saud? Yog tias koj tsis tau kuaj pom tias muaj mob plab (peptic ulcer), koj tus kws kho mob yuav txiav txim siab txog cov hauv qab no ntawm qhov ua tau los ntshav GI siab dua:
- Mallory -Weiss kua muag - cov no yog kua muag hauv koj txoj hlab pas, feem ntau tshwm sim los ntawm kev quab yuam hnyav xws li quab yuam rub los yog ntuav ua rau cov hlab ntsha tawg.
- Qhov txawv txav ntawm txoj hlab pas - cov no yog cov hlab ntsha me me hauv txoj hlab pas uas tuaj yeem tawg thiab los ntshav.
- Arteriovenous malformations - cov no yog kev txawv txav hauv caj ces ntawm cov hlab ntshav ua rau ib tus neeg los ntshav hauv thaj tsam ntawm qhov tsis zoo.
- Mob qog noj ntshav (xws li mob plab/esophageal/mob plab hnyuv) - cov hlab ntshav me me ntawm kev loj hlob ntawm cov qog nqaij hlav tuaj yeem ua rau muaj ntshav ntau.
- Mob plab - qhov no yog qhov txawv txav thiab ua rau khaus ntawm lub plab, uas tuaj yeem ua rau ntshav poob.
- Duodenitis - qhov no yog qhov txawv txav thiab ua rau khaus ntawm duodenum hauv txoj hnyuv me, uas tseem tuaj yeem ua rau ntshav poob.
Ntu 3 ntawm 3: Kho Tus Mob Ua Ntej Ua Ntej Ntawm Cov Ntshav
Kauj Ruam 1. Muaj lub hauv paus los ntshav los kho qhov kawg
Thaum lub siab GI endoscope tso rau txhawm rau nrhiav qhov chaw los ntshav, nws kuj tseem tuaj yeem siv los tswj kev kho mob ntawm qhov chaw los ntshav thaum pom qhov chaw ntawd. Hom kev kho mob uas tuaj yeem muab endoscopically suav nrog:
- Txhaj tshuaj epinephrine
- Thermocoagulation
- Banding
- Kev thov ntawm cov yeeb yaj kiab
- Cov kev tshawb fawb tau pom tias kev sib xyaw ntawm kev txhaj tshuaj epinephrine nrog lwm hom kev kho mob rau cov ntshav yog qhov ua tau zoo tshaj plaws ntawm kev txwv tsis pub ntshav thiab tiv thaiv kev rov tshwm sim.
Kauj Ruam 2. Nthuav cov tshuaj uas yuav ua rau GI ntshav ntau ntxiv
Thaum kev kho mob tsis yog lub hauv paus tseem ceeb ntawm kev kho tus mob GI sab saud, tshem tawm cov tshuaj uas koj tuaj yeem siv tau uas tuaj yeem ua rau qhov xwm txheej tsis zoo yog qhov tseem ceeb. Cov tshuaj uas tuaj yeem ua rau hnyav dua (lossis ua rau koj xav tau) GI los ntshav suav nrog:
- Cov ntshav ua kom ntshav tsawg xws li Warfarin (Coumadin) lossis lwm tus, uas cuam tshuam rau koj cov ntshav khov ib txwm thiab yog li ua rau tsis muaj ntshav ntxiv lawm. Tham nrog koj tus kws kho mob txog kev tso tseg cov tshuaj no ib ntus kom txog thaum koj cov ntshav GI tau raug daws lossis yog tias koj xav tau tso tseg lawv mus tas li.
- NSAIDs xws li Ibuprofen (Advil, Motrin), vim tias feem ntau cov no ua rau cov ntshav qis dua. Yog li, yog tias koj noj ib txwm, txiav txim siab tso tseg nws thiab/lossis hloov nws nrog lwm yam tshuaj.
- Tshuaj aspirin, uas cuam tshuam cov platelet sib sau ua ke thiab yog li ua rau muaj cov ntshav uas twb muaj lawm. Tham nrog koj tus kws kho mob txog kev tso tseg cov tshuaj no ib ntus kom txog thaum koj cov ntshav GI raug daws.
Kauj Ruam 3. Kho cov ntshav GI rov qab raws li xav tau
Nws yog ib qho tseem ceeb kom nkag siab tias 10-20% ntawm kev kho mob sab saud GI los ntshav rov tshwm sim. Ntawd yog, kev kho mob tsis kav ntev. Thaum muaj xwm txheej rov tshwm sim, cov kws kho mob tau qhia kom sim ua zaum thib ob ntawm tib txoj kev kho endoscopic tau sim thawj zaug. Yog tias qhov no tsis ua tiav, thiab cov ntshav rov tshwm sim dua zaum thib peb, cov kws kho mob tau qhia kom ua haujlwm nrog "cov hlab ntshav nrog embolization," lossis nrog kev phais.
