Muaj ntau txoj hauv kev los ntsuas rau lub plab zom mov (GI) los ntshav. Cov no suav nrog: nrhiav ntshav hauv koj ntuav, tau kuaj ntshav txhawm rau ntsuas qhov ua rau muaj ntshav tsis txaus, thiab ntsuas ntshav hauv koj cov quav, ntawm lwm yam. Yog tias koj tus kws kho mob pom tias koj tab tom poob ntshav thiab xav tias muaj ntshav GI siab dua, nws yog qhov tseem ceeb los tshuaj xyuas kev noj qab haus huv txhawm rau txiav txim siab qhov los ntshav. Thaum qhov chaw tau txheeb xyuas, koj tuaj yeem tau txais kev kho mob raws li xav tau. Nco ntsoov tias yog tias koj tab tom muaj ntshav poob sai, nws yog qhov tseem ceeb uas yuav tsum tau mus rau chav kho mob xwm txheej tam sim ntawd.
Cov kauj ruam
Ntu 1 ntawm 3: Kev Xeem Kom Muaj Ntshav
Kauj Ruam 1. Txheeb xyuas seb puas muaj ntshav nyob hauv qhov ntuav
Yog tias koj tau ntuav, sau tseg yog tias nws yog xim liab lossis xim liab tsaus. Qhov no tuaj yeem qhia pom tias muaj cov ntshav hauv koj ntuav, uas tuaj yeem yog ib qho cim ntawm cov ntshav GI sab saud. Yog tias koj ntuav ntshav, nws yog qhov tseem ceeb mus ntsib kws kho mob tam sim.
Kauj Ruam 2. Kom kuaj ntshav rau ntshav tsis txaus
Lwm txoj hauv kev los qhia yog tias koj poob ntshav yog kom kuaj ntshav txhawm rau ntsuas koj qib hemoglobin. Yog tias koj cov hemoglobin qis, nws hu ua "anemia," thiab nws txhais tau tias koj yuav poob ntshav uas tuaj yeem ua rau suav qis hemoglobin.
Thaum ntshav tsis txaus (hemoglobin qis) tsis tas yuav cuam tshuam nrog cov ntshav GI sab saud, nws yog qhov tsis txaus ntseeg ntawm plab zom mov
Kauj Ruam 3. Kuaj seb puas muaj ntshav hauv koj cov quav
Ntshav los ntawm GI sab saud feem ntau nthuav tawm li tsaus ntuj (feem ntau dub) quav quav quav quav. Ntshav hauv cov quav tuaj yeem xav tias yog qhov pom ntawm koj cov quav. Nws kuj tseem tuaj yeem raug tshuaj xyuas ncaj qha los ntawm kev sim tshuaj.
- Hauv qhov kev sim tshuaj (hu ua FOBT - quav quav quav ntshav, lossis kuaj FIT uas yog qhov tshiab dua) koj xa tus qauv ntawm cov quav mus rau chav kuaj.
- Cov quav yog tom qab saib hauv qab lub tsom iav kom pom tias muaj hemoglobin.
- Yog tias nws ntsuas tau zoo rau hemoglobin, qhov no cuam tshuam nrog kom muaj ntshav hauv cov quav uas yuav zoo heev los ntawm kev mob ntshav siab GI.
Kauj Ruam 4. Txheeb xyuas seb puas muaj cov kev pheej hmoo mob plab hnyuv
Peptic ulcers yog tus naj npawb ib qho feem ntau ntawm cov ntshav GI sab saud (lav txog 62%). Yog li, yog tias koj tab tom sim ntsuas lossis kuaj mob ntshav GI sab saud, paub txog qhov muaj feem pheej hmoo thiab muaj peev xwm ua rau mob plab yuav ua rau koj pom zoo qhov twg los saib ua thawj qhov chaw muaj ntshav. Cov teeb meem pheej hmoo uas qhia tias mob plab tuaj yeem yog lub hauv paus ntshav suav nrog:
- Kuaj qhov zoo rau qhov muaj tus kab mob H. Pylori hauv koj lub plab.
- Noj cov tshuaj NSAID (cov tshuaj tsis-steroidal anti-inflammatory xws li Ibuprofen), uas yog lub hom phiaj rau kev tsim ntawm mob plab.
Ntu 2 ntawm 3: Kev Txiav Txim Siab Los ntawm Upper GI Bleed
Kauj Ruam 1. Xaiv qhov ntsuas GI sab saud
GI endoscopy sab saud yog qhov muab lub raj tso rau hauv koj txoj hlab pas, hla koj lub plab, thiab mus rau sab saud ntawm koj txoj hnyuv me. Muaj lub koob yees duab kawg ntawm nws, tso cai rau tus kws kho mob tshuaj xyuas ntau yam ntawm koj li kab mob GI sab saud.
Yog tias thiab thaum lub hauv paus ntawm koj cov ntshav GI sab saud nyob, nws tseem tuaj yeem raug tso tseg los ntawm kev ntsuas GI sab saud vim tias kev kho me me tuaj yeem ua los ntawm lub raj
Kauj Ruam 2. Muaj "plab zom mov
Vim tias lub plab (lossis lwm qhov chaw ntawm txoj hlab GI sab saud) tuaj yeem pib tso ntshav nrog cov ntshav GI sab saud, nws yuav ua rau nws nyuaj rau pom thiab txiav txim siab qhov los ntshav los ntawm kev siv GI siab kawg. Yog tias qhov pom tsis pom los ntawm cov ntshav ua ke, yuav tsum tau ntxuav lub plab.
Qhov tseem ceeb no "ntxuav" lossis "ntxuav" cov ntshav tawm ntawm lub plab thiab GI txoj hlab ntshav kom pom tau zoo dua thiab pom qhov chaw los ntshav
Kauj Ruam 3. Ceev faj txog qhov ua tau ua rau muaj ntshav GI sab saud
Feem ntau ua rau cov ntshav GI sab saud yog mob plab, uas suav txog 62% ntawm cov neeg mob. Nco ntsoov tias kev noj NSAIDs (cov tshuaj tsis-steroidal anti-inflammatory, xws li Ibuprofen) yog ib qho tseem ceeb txaus ntshai rau kev mob plab hnyuv los ntshav. Yog tias koj tau kuaj pom tias muaj mob plab, koj yuav zoo li yuav tsum tau txiav tawm ib qho tshuaj NSAID uas koj yuav tau noj thiab hloov lawv nrog lwm txoj kev kho mob. Lwm qhov laj thawj ua rau muaj ntshav GI sab saud suav nrog:
- Los ntshav ntawm cov hlab ntsha txawv txav hauv txoj hlab pas (hu ua "esophageal varices")
- Tearing ntawm cov hlab ntsha hauv txoj hlab pas vim qhov quab yuam xws li qaug zog (hu ua "Mallory-Weiss kua muag")
- Mob plab, txoj hlab pas, lossis mob qog noj ntshav
- Kev ua xua lossis ua rau lub plab (hu ua "gastritis")
- Kev ua xua lossis ua rau khaus ntawm sab saud ntawm txoj hnyuv (hu ua "duodenitis")
- Ib txoj hlab pas
Ntu 3 ntawm 3: Kho Upper GI Bleed
Kauj Ruam 1. Ua kom ntseeg tau tias koj cov cim tseem ceeb ruaj khov ua ntej
Yog tias koj tau kuaj pom tus mob GI sab saud, thawj qhov uas koj tus kws kho mob xav ua yog kom ntseeg tau tias koj ruaj khov. Hauv lwm lo lus, nws lossis nws yuav xav kom ntseeg tau tias qib ntshav poob tsis ua rau koj cov ntshav siab poob, koj lub plawv dhia nce ntxiv, thiab koj cov cim tseem ceeb kom suav nrog tag nrho vim koj tseem poob ntshav ntau thiab ntau ntxiv.
- Koj tus kws kho mob yuav ntsuas koj cov cim tseem ceeb suav nrog lub plawv dhia, ntshav siab, ua pa pa, thiab oxygen txaus.
- Yog tias nws lossis nws txhawj xeeb txog tus nqi uas koj poob ntshav, thiab/lossis koj qib ntshav poob, koj yuav raug xa mus rau tsev kho mob qhov chaw koj tuaj yeem ruaj khov thiab/lossis rov ua haujlwm yog xav tau.
Kauj Ruam 2. Xaiv qhov tso ntshav yog xav tau
Nyob ntawm koj qhov kev poob ntshav, koj yuav xav tau kev tso ntshav kom koj ruaj khov thaum cov kws kho mob ua haujlwm los daws qhov laj thawj ntawm koj li GI ntshav. Kev tso ntshav tuaj yeem ua hauv tsev kho mob, yog tias koj tus mob hnyav txaus los lav nws.
Kauj Ruam 3. Kho qhov chaw ntawm cov ntshav GI sab saud
Qhov tseem ceeb los kho tus ntshav GI sab saud yog txhawm rau txheeb xyuas qhov chaw, thiab ua kom tsis txhob los ntshav. Feem ntau, thaum pom qhov chaw los ntshav los ntawm lub siab GI endoscopy thiab ua tau lub plab los txhawm rau txhim kho lub koob yees duab saib, cov kws kho mob yuav ua raws ob peb kauj ruam rau kev kho mob. Cov no yog:
- Kev txhaj tshuaj epinephrine ntawm qhov chaw los ntshav. Epinephrine txwv cov hlab ntshav, yog li ua rau cov ntshav ntws mus rau thaj chaw thiab txo qis cov ntshav, yog tias tsis yog ib ntus nres cov ntshav tag nrho.
- Ib pab pawg, lossis clip, lossis lwm hom "ligation" ntawm qhov chaw ntshav (hauv lwm lo lus, txheej txheem kaw cov ntshav hauv txoj hauv kev ruaj khov dua li uas tau muab los ntawm kev txhaj tshuaj epinephrine yooj yim). Qhov no tuaj yeem ua tiav nyob rau tib lub sijhawm raws li kev ntsuas GI sab saud, siv lub koob yees duab los saib nws thiab cov cuab yeej me me los ua tus txheej txheem.
Kauj Ruam 4. Noj tshuaj PPI
Cov tshuaj PPI (cov tshuaj tiv thaiv kab mob proton) tau pom tias txo qis ntshav tag nrho thiab txhawm rau txhim kho qhov kev cia siab nrog cov ntshav GI sab saud. Thaum lawv lub tswv yim ntawm kev nqis tes ua tsis nkag siab, koj tus kws kho mob feem ntau yuav muab cov tshuaj no rau koj rau ib ntus lossis tsis tu ncua, nyob ntawm qhov xwm txheej (thiab qhov chaw) ntawm koj cov ntshav.
- Yog tias qhov chaw ntawm koj cov ntshav yog mob plab, PPIs yuav raug pom zoo mus sij hawm ntev kom txo qis txoj kev pheej hmoo ntawm kev mob plab tom ntej.
- Tsis tas li, yog tias koj tau kuaj pom tias mob plab thiab kuaj pom tus kab mob H. Pylori, koj tuaj yeem tau txais tshuaj tua kab mob kom tshem tawm cov kab mob hauv koj lub plab.
Kauj Ruam 5. Tau txais kev tshuaj xyuas raws li qhov xav tau
Thaum kawg, nws yog ib qho tseem ceeb kom nkag siab tias feem pua ntawm cov tib neeg muaj ntshav rov qab los tom qab kho tas. Hauv lwm lo lus, kev kho (xws li banding, clipping, thiab lwm yam) tsis ib txwm muaj txiaj ntsig ntawm kev daws cov ntshav hauv lub sijhawm ntev. Koj tus kws kho mob yuav cia koj nyob hauv tsev kho mob li ob peb hnub los tshuaj xyuas qhov ua tau zoo ntawm kev kho mob. Xwb, nws lossis nws yuav qhia tias koj rov qab los ob peb hnub tom qab rau kev tshuaj xyuas tom qab kom ntseeg tau tias tsis muaj cov cim qhia ntxiv lossis ntshav ntxiv.
