Selelekela
Achalasia ea pelo (AC) kebothata bo ka sehloohong ba ho tsamaea ha esophageal.Ka lebaka la khatholoho e mpe ea esophageal sphincter (LES) le ho haella ha esophageal peristalsis, ho boloka lijo ho fella kadysphagia le karabelo. Matšoao a kliniki a kang ho tsoa mali, bohloko ba sefuba le ho lahleheloa ke boima ba 'mele.Ho ata hoo e ka bang 32.58/100,000.
Thephekoloea achalasia haholo-holo e kenyelletsa phekolo e sa buuoeng, phekolo ea ho atolosa le phekolo ea ho buuoa.
01Kalafo ea Bongaka
Mokhoa oa phekolo ea lithethefatsi ke ho fokotsa khatello ea LES ka nako e khutšoanyane.Ha ho na bopaki bo totobetseng ba hore lithethefatsi li ka tsoela pele le ka katleho ho ntlafatsa matšoao a AC.Lithethefatsi tse sebelisoang hajoale li kenyelletsa li-nitrate, calcium channel blockers, le β-receptor agonists.
(1)Nitrate, joalo ka nitroglycerin, amyl nitrate, le isosorbide dinitrate
(2)Li-block blockers tsa calcium, joalo ka nifedipine, verapamil, le diltiazem
(3)β-receptor agonists, joalo ka cabuterol
02Endoscopic Botulinum Toxin Enjection (BTI)
Endoscopic botulinum toxin injection(BTl) e ka sebelisoa ho phekola AC,empa e ka fana ka liphello tsa nako e khutšoanyane feela 'me e ka sebelisoa ho bakuli ba tsofetseng ba nang le likotsi tse kholo tsa ho buuoa le anesthesia.
1) Lipontšo:bakuli ba lilemo tse mahareng le ba tsofetseng (> lilemo tse 40); ba sa khoneng ho mamella endoscopic balloon dilation (PD) kapa kalafo ea ho buuoa; ba nang le mekhoa e mengata ea phekolo ea PD kapa liphello tse mpe tsa phekolo ea ho buuoa; ba nang le phallo ea 'metso nakong ea phekolo ea PD Bakeng sa ba nang le kotsi e kholo, e ka boela ea sebelisoa hammoho le PD; e ka sebelisoa e le phetoho ea ho buuoa kapa kalafo ea PD.
(2) Contraindications:Ha e khothalletsoe bakeng sa kalafo ea pele ea AC ho bakuli ba banyenyane (≤40 ba lilemo li).
03Endoscopic Balloon Dilation (PD)
Ho atolosoa ha balune ho na le litlamorao tse itseng ho AC, empa ho hloka liphekolo tse ngata 'me ho jara kotsi ea mathata a tebileng.
(1) Lipontšo:Bakuli ba AC ntle le ho haella ha pelo, ho se sebetse ha coagulation, joalo-joalo; banna ba ka holimo ho lilemo tse 50 le basali ba ka holimo ho lilemo tse 35; bakuli ba hlolehileng ho buuoa. E ka sebelisoa e le mokhoa oa pele oa phekolo.
(2) Contraindications:Ho haella ho hoholo ha pelo, ho se sebetse hantle ha coagulation le kotsi e kholo ea ho phatloha ha esophageal.
04Peroral Endoscopic Myotomy (POEM)
Lilemong tsa morao tjena, ka ts'ebetsong e kholo ea peroral endoscopic myotomy (POEM), tekanyo ea katleho ea phekolo ea meriana ea AC e eketsehile haholo.Kalafo ea POEM ea AC e lumellana haholo le khopolo ea "opereishene e fokolang haholo", ke hore, maqeba feela a tlosoa / a tlosoa nakong ea phekolo, 'me litho tsa 'mele ha li tlosoe.Botšepehi le ts'ebetso ea sebopeho sa anatomical li bolokiloe, 'me boleng ba bophelo ba mokuli ka mor'a ts'ebetso ha e le hantle ha bo amehe. Ho hlaha ha POEM ho entse hore phekolo ea AC e be e fokolang haholo.
Setšoantšo: Mehato ea opereishene ea POEM
Matla a mahareng le a nako e telele a POEM kalafong ea AC e lumellana le ea laparoscopic Heller myotomy (LHM)e ka sebelisoa e le khetho ea pele ea kalafo.Bakuli ba bang ba ka ba le matšoao a reflux a gastroesophageal ka mor'a ho buuoa ka POEM
(1) Lipontšo tse phethahetseng:AC ntle le ho khomarela ho matla ha submucosal, bothata ba ho ntša mpa ka mpeng le diverticulum e kholo.
(2) Matšoao a amanang:Ho hasanya spasm ea esophageal, nutcracker esophagus le mafu a mang a esophageal motility, bakuli ba hlōlehileng POEM kapa opereishene ea Heller, le AC e nang le li-adhesions tse ling tsa esophageal submucosal.
(3) Contraindications:Bakuli ba nang le ts'ebetso e matla ea coagulation, lefu le matla la pelo ea pelo, boemo bo bobe ka kakaretso, joalo-joalo ba ke keng ba mamella ho buuoa.
05Laparoscopic Heller Myotomy (LHM)
LHM e na le ts'ebetso e ntle ea nako e telele ea ho phekola AC, 'me e nketsoe sebaka ke POEM libakeng tseo maemo a lumellang.
06 Ho buuoa ka Esophagectomy
Haeba AC e kopantsoe le stenosis e tlase ea esophageal scar stenosis, lihlahala, joalo-joalo, ho ka nahanoa ka ho buuoa ka esophagectomy.
We, Jiangxi Zhuoruihua Medical Instrument Co., Ltd., ke moetsi oa China ea sebetsanang le lisebelisoa tsa endoscopic, joalo kabiopsy forceps, hemoclips, polyp leraba, sclerotherapy nale, fafatsa catheter, borashe ba cytology, guidewire, seroto sa ho khutlisa lejoe, nasal biliary drainage catheterjoalo-joalo tse sebelisoang haholo hoEMR, ESD,ERCP. Lihlahisoa tsa rona li netefalitsoe ke CE, 'me limela tsa rona li netefalitsoe ke ISO. Thepa ea rona e rometsoe Europe, Amerika Leboea, Bochabela bo Hare le karolo ea Asia, 'me e fumana ho pharaletseng moreki oa kananelo le thoriso!
Nako ea poso: Jul-09-2024