Hypercontractile Peristalsis
Motsoako oa Jackhammer, kapa hypercontractile peristalsis, ke lefu la motility la esophageal le khetholloang ke li-spasms tse fokolang tse amang tsohle kapa boholo ba mesifa ea setopo. Li-spasms li matla haholo 'me li atisa ho nka nako e telele, ho etsa lebitso la boloetse, jackhammer eophagus, tlhaloso e lekaneng ea hore motho ea nang le lefu lena a ka' na a ikutloa joang.
Lisosa
Lisosa tsa motheo tsa jackhammer eophagus ha li utloisisoe hantle empa boemo bo ka bakoa ke maemo a sa tloaelehang litseleng tse nang le methapo ea kutlo tse laolang bothata kapa keketseho ea bongata ba acetylcholine. Ba bang ba litsebi tsa bophelo bo botle ba lumela hore jackhammer eophagus e bakoa ke GERD .
Boemo bona bo bonahala bo atile haholo ho batho ba nang le mafu a kelello 'me boemo ba ka linako tse ling bo atleha ka ho phekoloa ka tricyclic ea ho tepella maikutlo. Sena ha se bolele hore maloetse a mafu a kelello a baka jackhammer eophagus kapa hore motho ea nang le lefu la jackhammer le eena o na le boloetse ba kelello, feela hore ho bonahala ho na le setsoalle se pakeng tsa maemo ana a mabeli. Motsoako oa Jackhammer o boetse oa tloaelehile ho:
- Macaucasia ho feta ba merabe e meng
- ho ka etsahala hore e ama basali ho feta banna
- ho ka etsahala hore e ama batho ba baholo ho feta bana.
Ha ho tsejoe hore na ho na le tšebetso efe ea jackhammer eophagus, ho ka 'na ha etsahala hore maemong a mangata ha a tsebe hore na matšoao a bonolo hakae' me hangata boemo bo sa hlalosoe e le reflux ea acid kapa boemo bo bong bo bakang matšoao a tšoanang.
Matšoao
Matšoao a jackhammer e phahame ka matla 'me a kopana le mathata a mangata a mangata a kenyeletsang GERD, eosinophilic esophagitis le achalasia . Ntle le li-spasms tse ling tsa 'mele, matšoao a mang a ka kenyelletsa:
- bohloko ba sefuba
- ikutloa joaloka ho na le lesapo molaleng oa hau
- ho thata ho e metsa
- ho tsosolosa
- ho otloa ke pelo
Bohloko ba lefuba hangata bo amahanngoa le bothata ba jackhammer bo ka ba boima 'me bo etsa hore u ikutloe eka u na le lefu la pelo. E ka 'na ea phatloha mokokotlong oa hau. U ka hlokomela hore matšoao a mpefala ha o ja kapa a le matla haholo ka mor'a ho ja lijo tse itseng.
Tsejoa
Ho lemoha bothata ba jackhammer ho ka ba boima 'me joalokaha ho boleloa ka holimo boemo boo hangata bo sa tsejoe e le boloetse bo bong bo bakang matšoao a tšoanang. Ngaka ea hau e tla hlahloba histori ea bophelo bo botle, matšoao a tlalehiloeng, 'me mohlomong e sebetse tlhahlobo ea' mele. Leha ho le joalo, hangata liteko tse peli li hlokahala bakeng sa ho fumana hore na jackhammer eophagus e hokae, e leng boko ba barium kapa manometry ea ho qetela . Manometry ea ho itšireletsa, teko e lekanyang li-contraction tse nkiloeng ka bongata, e nkoa e le teko e ntle ka ho fetisisa ea ho hlahlojoa sekhahla sa jackhammer. Liteko tse ling li ka 'na tsa sebelisoa ho laola maemo a tlatlapuoang empa liphello tsa liteko tseo ha li qetelle li bontša tšebetso ea jackhammer.
Litlhare
Tlhokomelo ea lijo
Ho laola acid reflux ho ka thusa ho fokotsa mahlaba a amanang le jackhammer eophagus. Le ha ho na lijo tse tobileng tseo hona joale li khothalletsoang ho ka ba tsa bohlokoa ho:
- Qoba ho ja bosiu
- Lula hole le lijo tse atisang ho baka, (tse kang lino tse nang le carbonate)
- Boloka koranta ea lijo ho tseba lijo tse ka 'nang tsa mpefatsa matšoao a hau
Meriana
Matšoao a jackhammer eophagus ka linako tse ling a ka sebelisoa ka meriana. Meriana e ka 'nang ea e-ba ea bohlokoa e kenyeletsa:
- Tricyclic ho loantšana ha maikutlo (joaloka imipramine) ke e 'ngoe ea meriana e atlehang haholo e sebelisoang.
- Proton pump inhibitors (joaloka Dexilant kapa Nexium) e fokotsang bongata ba acid e ka mpeng le ka popelong
- Calcium channel blockers (joaloka Verapamil)
- Smooth muscle relaxers (joaloka Viagra)
- Nitrate (joaloka nitroglycerin kapa isosorbide mononitrate) ka linako tse ling e thusa ho fokotsa bohloko ba sefubeng
- Bothata bo entsoeng ke chefo e entsoeng ke endoscopy ho sophageal sphincter e atlehile ho fokotsa matšoao a nakoana
Mekhoa e meng
Ka linako tse ling ho lekanngoa ha li-Esophageal hoa thusa haeba ho le thata ho emisa kapa ho ikutloa eka ho na le ntho e khomaretsoeng molaleng ke bothata. Sena se etsoa ka endoscope tlas'a sedation, hangata e le mokhoa o ts'oanang le letsatsi.
Bakeng sa lits'ebetso tse ling tse sa atleheng ho laola matšoao a mokhoa oa ho buuoa, mokhoa oa ho buuoa o bitsoa Per Oral Endoscopic Myotomy (POEM) e ka sebelisoa, ho seng joalo myotomy e tloaelehileng (mokhoa oa ho buuoa oa ho fokotsa mesifa ea 'mele) e ka sebelisoa. E le khetho ea ho qetela ea esophagectomy e ka etsoa empa e boloketsoe ba nang le matšoao a matla a khathetse ka mekhoa e meng ea phekolo.
Lisebelisoa:
Medscape. Esophageal Spasm. E fihletsoe: la 24 March, 2014 ho tloha ho http://emedicine.medscape.com/article/174975-overview#a0199
Litaba tsa bongaka. Mekhoa e mecha ea tlhaho ea ho thibela tšebetso ea jackhammer. E fumaneha: la 24 March, 2014 ho tloha ho http://www.news-medical.net/news/20140304/New-minimally-invasive-procedure-to-treat-jackhammer-esophagus.aspx