Polyps hauv txoj hnyuv - ua rau, tsos mob, kho thiab tshem tawm cov polyps hauv cov hnyuv

Cov txheej txheem:

Polyps hauv txoj hnyuv - ua rau, tsos mob, kho thiab tshem tawm cov polyps hauv cov hnyuv
Polyps hauv txoj hnyuv - ua rau, tsos mob, kho thiab tshem tawm cov polyps hauv cov hnyuv
Anonim

Ua rau thiab cov tsos mob ntawm polyps hauv cov hnyuv, kho thiab tshem tawm

Polyps nyob rau hauv cov hnyuv
Polyps nyob rau hauv cov hnyuv

Polyps nyob rau hauv cov hnyuv yog benign neoplasms, feem ntau nyob rau hauv nws cov phab ntsa sab hauv, xws li nyob rau hauv lwm yam hollow kab mob. Zoo sib xws outgrowths yog tsim los ntawm glandular epithelium thiab protrude mus rau hauv lub lumen ntawm txoj hnyuv, qee zaum lawv tau tuav ntawm ib tug stalk, thiab qee zaum nws tsis tuaj, thiab ces lawv tham txog polyps ntawm ib tug dav puag.

plab hnyuv polyps raug cais raws li cov kab mob ua ntej, vim lawv feem ntau raug hloov pauv tsis zoo (tshwj xeeb tshaj yog nyob rau hauv daim ntawv ntawm cov kab mob polyposis). Yog li ntawd, thaum lawv pom nyob rau hauv cov hnyuv, cov kws kho mob unambiguously pom zoo kom tshem tawm phais. Qhov nyuaj ntawm kev kuaj mob yog nyob rau hauv qhov tseeb tias polyps muab cov tsos mob me me, txawm hais tias qee zaum nws tuaj yeem xav tias lawv muaj los ntawm ntau cov tsos mob (xws li, cem quav, khaus, thiab hnov qab lub cev txawv teb chaws hauv qhov quav).

Qhov sib xws ntawm cov formations yog mos, raws li rau cov duab, nws muaj peev xwm yuav varied: spherical, branched, nceb-puab. Feem ntau, kev loj hlob hauv qhov quav los yog hauv txoj hnyuv loj. Hauv qhov siab dua ntawm txoj hnyuv, polyps yog qhov tsawg heev. Piv txwv li, tsuas yog hauv 0.15% ntawm cov neeg mob tau kuaj pom hauv duodenum. Lawv cov xim txawv, nws tuaj yeem yog xim liab, liab doog grey, nrog daj tinge. Qee zaum cov hnoos qeev tau pom nyob rau saum npoo ntawm polyps.

Raws li kev txheeb cais, plab hnyuv polyposis yog ib yam kab mob. Kwv yees li 10% ntawm cov neeg muaj hnub nyoog tshaj 40 xyoo muaj cov qog nqaij hlav hauv cov hnyuv. Ntxiv mus, hauv cov txiv neej lawv tau tsim 1.5 npaug ntau zaus. Thaum kuaj pom pathology sai dua, qhov muaj feem ntau ntawm kev tiv thaiv nws cov malignancy. Feem ntau qhov no yuav pab ua kom muaj kev tshawb fawb ntawm fecal masses rau occult ntshav. Thaum ua haujlwm kom tshem tawm cov polyps ntawm txoj hnyuv tau ua raws sijhawm, hauv 90% ntawm cov neeg mob nws dhau los ua tus yuam sij rau tib neeg txoj sia.

Cov tsos mob ntawm polyps hauv plab hnyuv

Nws feem ntau tsis tuaj yeem xav tias muaj tus kab mob polyp los ntawm qee cov tsos mob, vim tias tsis muaj cov tsos mob tshwj xeeb ntawm pathology. Cov qib ntawm lawv qhov hnyav nyob ntawm qhov loj ntawm qhov tsim, qhov twg raws nraim hauv txoj hnyuv lawv nyob, thiab tseem nyob ntawm seb lawv qhov mob qog noj ntshav tau tshwm sim los yog tsis.

Ntawm cov tsos mob tshwm sim ntawm txoj hnyuv polyps:

  • Kev cais tawm ntawm cov hnoos qeev thiab cov ntshav, uas feem ntau pom nyob rau hauv lub xub ntiag ntawm villous adenomas;
  • Yog tias cov polyps muaj qhov loj me, ces tus neeg mob yws ntawm qhov mob rov tshwm sim uas yog cramping. Lawv tshwm sim nyob rau hauv lub plab mog. Tsis tas li ntawd, cov hnoos qeev thiab ntshav tau pom, nrog rau cem quav tshwm sim nyob rau hauv daim ntawv ntawm plab hnyuv. Feem ntau nrog polyps loj, ib tug neeg muaj kev hnov ntawm lub cev txawv teb chaws hauv qhov quav;
  • Nyob rau tib lub sijhawm nrog polyps, tus neeg mob feem ntau muaj lwm yam pathologies ntawm lub plab zom mov, uas yuam nws mus kuaj tag nrho, thaum lub sijhawm kuaj pom neoplasm yuam kev;
  • Kev loj hlob ntawm cov qog nqaij hlav hauv plab tshwm sim 5-15 xyoo tom qab tsim cov villous adenomatous polyp. Malignancy tshwm sim hauv 90% ntawm cov neeg mob;
  • Cov tsos mob pom tseeb ntawm polyps yog kev ua txhaum cai tas li ntawm peristalsis. Nws tuaj yeem ua raws plab thiab cem quav. Qhov loj dua qhov tsim, feem ntau constipation tshwm sim, raws li txoj hnyuv lumen nqaim. Raws li qhov tshwm sim, ib feem ntawm plab hnyuv obstruction raug tsim;
  • Tus neeg mob yuav hnov mob hauv plab, raug kev belching thiab xeev siab;
  • Thaum mob tshwm sim hauv plab hnyuv, qhov pib ntawm cov txheej txheem inflammatory tuaj yeem xav tias;
  • Qhov laj thawj xwm txheej ceev mus ntsib kws kho mob yog qhov pib los ntshav ntawm qhov quav. Qhov no yog cov tsos mob hnyav heev thiab yuav qhia tau tias muaj cov txheej txheem malignant hauv txoj hnyuv;
  • Yog hais tias tus polyp muaj ib tug ntev stalk, ces nws yuav protrude los ntawm lub qhov quav, tab sis qhov no yog heev tsawg;
  • Hypokalemia yog tshwm sim los ntawm kev ua haujlwm tsis zoo ntawm txoj hnyuv vim muaj cov polyps loj nrog cov txheej txheem ntiv tes hauv nws. Lawv tso cov ntsev thiab dej ntau ntau, yog li txhawb kev ua kom raws plab. Qhov no ua rau txo qis ntawm cov poov tshuaj hauv cov ntshav.

Ua rau polyps hauv plab hnyuv

Polyps nyob rau hauv cov hnyuv
Polyps nyob rau hauv cov hnyuv

Cov tshuaj niaj hnub no tsis muaj cov ntaub ntawv tsis meej ntawm etiology ntawm plab hnyuv polyposis.

Txawm li cas los xij, muaj qee qhov kev xav uas qhia txog kev txhim kho tus kabmob:

  • Cov kab mob hauv plab hnyuv. Nws tau raug tsim los tias polyps tsis tuaj yeem pib tsim hauv cov ntaub so ntswg noj qab haus huv. Yog li ntawd, xws li kev xav txog qhov ua rau ntawm lawv qhov tshwm sim zoo li yog qhov pom tseeb tshaj plaws. Cov txheej txheem o tshwm sim hauv cov mucous daim nyias nyias ua rau cov epithelium rov tsim dua sai dua, thiab qhov no tuaj yeem ua rau tsis muaj kev loj hlob. Tsis tas li ntawd, cov kws tshawb fawb taw qhia txog kev sib txuas ntawm kev tsim cov plab hnyuv polyps thiab cov kab mob xws li mob plab, mob plab, mob plab, mob plab, enteritis, proctosigmoiditis. Lub hauv paus rau qhov kev xav no yog qhov ploj ntawm kev rov qab los ntawm polyposis tom qab tshem tawm cov kab mob no. Tsis tas li ntawd, cem quav thiab plab hnyuv dyskinesia muaj peev xwm ua rau kev loj hlob ntawm polyps. Nws muab tawm tias kev loj hlob polyposis feem ntau pom nyob rau hauv qhov chaw ntawm txoj hnyuv uas muaj stagnation ntawm cov quav thiab muaj microtraumas;
  • Cov teeb meem kev noj qab haus huv thoob ntiaj teb rau feem coob ntawm cov pej xeem cuam tshuam nrog kev tsis zoo ntawm ib puag ncig. Nws yog qhov nyuaj heev kom tsis txhob hnov qab txog kev noj qab haus huv ntawm cov neeg niaj hnub no. Ua ntej tshaj plaws, qhov no siv rau cov menyuam yaus. Tus naj npawb ntawm cov menyuam mos uas muaj mob hnyav congenital pathologies yog tas li nce. Ntau tus menyuam raug kev txom nyem los ntawm cov kab mob uas yav tas los tus yam ntxwv ntawm tib neeg tsuas yog thaum muaj hnub nyoog laus heev. Cov txheej txheem ntawm kev tsim cov polyps kuj cuam tshuam los ntawm cov khoom xws li noj zaub mov nrog cov tshuaj, lub cev tsis ua haujlwm, tsis muaj huab cua ntshiab hauv nroog, kev haus dej cawv, haus luam yeeb, noj zaub mov tsis zoo;
  • Pathologies ntawm lub plab zom mov thiab cov hlab ntsha. Lub xeev ntawm cov hnyuv mucosa feem ntau nyob ntawm cov hlab ntsha. Varicose thiab diverticular kab mob, atherosclerosis muaj qhov tsis zoo. Cov kab mob ntawm lub plab zom mov (mob plab, gastritis, pancreatitis, cholecystitis thiab lwm yam) tsis tuaj yeem cuam tshuam kev noj qab haus huv ntawm cov hnyuv;
  • Genetics. Nws ntseeg tau tias lub nra hnyav muaj feem cuam tshuam rau kev loj hlob ntawm tus kab mob. Qhov no tau lees paub los ntawm qhov tseeb tias txawm tias tawm tsam keeb kwm ntawm kev noj qab haus huv, kev loj hlob polyposis muaj nyob hauv qee cov menyuam yaus. Cov kws tshawb fawb piav qhia qhov tseeb no los ntawm kev pab cuam caj ces uas ua rau qee ntu ntawm txoj hnyuv ua haujlwm sib txawv;
  • Embryonic theory. Cov kws tshawb fawb tau tso tawm qhov kev xav tias cov cheeb tsam ntawm txoj hnyuv uas tsim cov polyps raug tsim tsis raug thaum lub sijhawm yug menyuam. Cov tsos mob ntawm tus kab mob pib tshwm sim me ntsis tom qab los ntawm kev cuam tshuam ntawm lwm yam tsis zoo;
  • Food allergy, gluten intolerance. Yog tias ob peb xyoos dhau los gluten intolerance yog ib qho teeb meem tsis tshua muaj, tam sim no ntau thiab ntau tus me nyuam raug kev txom nyem los ntawm cov zaub mov no. Thaum cov khoom uas muaj cov protein no nkag mus rau hauv lub cev, lub cev tiv thaiv kab mob pib ua phem rau nws. Nws pom gluten ua tus neeg sawv cev txawv teb chaws, uas ua rau muaj kev puas tsuaj rau cov mucous membrane hauv cov hnyuv. Yog tias tsis quav ntsej txog kev tiv thaiv kab mob tsis txaus, ib tus neeg ntsib teeb meem kev noj qab haus huv, suav nrog kev mob plab hnyuv thiab kev txhim kho pob txha.

Ntxiv rau qhov tseeb tias muaj ntau yam ua rau kev loj hlob ntawm polyps hauv txoj hnyuv, feem ntau yuav ua rau lawv tsim nyob rau hauv ntau lub tuam tsev, piv txwv li:

  • Tsis tshua muaj kev loj hlob polyposis hauv duodenum feem ntau tshwm sim los ntawm gastritis nrog acidity siab, cholecystitis lossis cholelithiasis. Lub hnub nyoog ntawm tus kab mob sib txawv ntawm 30 txog 60 xyoo;
  • Txawm tias tsawg zaus, kev tsim tau raug kuaj pom hauv kab noj hniav ntawm txoj hnyuv. Nyob rau tib lub sijhawm, lawv tau ua ke nrog polyps hauv lwm qhov ntawm txoj hnyuv thiab hauv plab, thiab feem ntau kuaj pom hauv cov poj niam hnub nyoog 20 txog 60 xyoo. Cov tsos mob ntawm kev loj hlob tuaj yeem tshwm sim los ntawm ntau yam, ntawm cov txheej txheem inflammatory yog nyob rau hauv cov hlau lead;
  • Kev pom muaj nyob hauv txoj hnyuv feem ntau yog qhov tshwm sim ntawm qhov tsis zoo.

Qhov tshwm sim ntawm polyp degenerating rau hauv plab hnyuv yog dab tsi?

Polyps nyob rau hauv cov hnyuv
Polyps nyob rau hauv cov hnyuv

Txog 75% ntawm tag nrho cov kab mob polyposis pom nyob rau hauv txoj hnyuv muaj peev xwm ua rau malignancy. Cov kev loj hlob zoo li no hu ua adenomatous. Txhawm rau txiav txim siab qhov subtype ntawm adenomatous polyp, nws yog ib qho tsim nyog yuav tsum tau kuaj xyuas nws hauv lub tshuab tsom. Polyps tuaj yeem yog tubular, glandular-villous, lossis tsuas yog villous. Qhov zoo tshaj plaws prognosis nyob rau hauv cov nqe lus ntawm malignancy yog muab los ntawm tubular formations. Villous polyps yog qhov txaus ntshai tshaj plaws thiab feem ntau degenerate mus rau hauv mob qog noj ntshav.

Txawm tias tus polyp raug hem nrog malignancy ntxiv cuam tshuam los ntawm qhov loj ntawm kev tsim. Qhov loj dua, qhov kev pheej hmoo siab dua. Thaum loj hlob nyob rau hauv ntim ntau tshaj 20 hli, qhov kev hem thawj yog aggravated los ntawm 20%. Vim qhov tseeb tias txawm tias cov polyps me tshaj plaws yuav nce tsis tu ncua, lawv yuav tsum raug tshem tawm tam sim tom qab kuaj pom.

Tseem muaj ntau yam ntawm polyps uas tsis raug hem los ntawm malignancy - cov no yog hyperplastic, inflammatory thiab hamartoma formations.

  • Adenomatous formations yog qhov txaus ntshai tshaj plaws. Lawv muaj peev xwm phem heev.
  • pob ntau ntau yuav ua rau mob phem.

Yuav tsum kuaj xyuas ib txwm

Colonoscopy, sigmoidoscopy thiab sigmoidoscopy yog cov txheej txheem kuaj mob uas yuav tsum tau ua kom tsis tu ncua rau cov neeg muaj hnub nyoog 50 xyoo uas muaj kev phom sij txaus ntshai. Yog tias qhov kev loj hlob tsis pom, tom qab ntawd lub sijhawm tom ntej tuaj rau hauv tsev kho mob tau pom zoo hauv ob xyoos;

Tom qab tshem tawm ntawm kev tsim adenomatous, ib tus neeg raug kuaj xyuas kom pom cov polyps tshiab hauv txoj hnyuv;

Cov tshuaj niaj hnub no muaj cov kev sim tshwj xeeb los kuaj xyuas cov kab mob qog nqaij hlav hauv plab. Cov txheej txheem no ua rau nws muaj peev xwm ua tau raws sijhawm los tiv thaiv oncological degeneration ntawm polyps.

Diagnosis

theem pib ntawm tus kab mob tsis ua rau pom cov tsos mob zoo, yog li cov tebchaws tsim kho feem ntau tau qhia txog qhov yuav tsum tau kuaj cov quav txhua xyoo txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau pom cov ntshav hauv nws. Qhov kev tshuaj ntsuam no tso cai rau koj los txheeb xyuas cov ntshav tsis pom txawm tias tawm nrog cov quav thaum lub plab zom mov. Txawm li cas los xij, txawm tias qhov ntsuas tsis zoo tsis tuaj yeem qhia tau tias tsis muaj polyp hauv txoj hnyuv.

Techniques xws li MRI thiab CT tuaj yeem kuaj pom kev loj hlob hauv qee qhov ntawm txoj hnyuv. Txhawm rau kuaj xyuas lawv hauv qhov quav thiab cov hnyuv sigmoid, nws yog qhov tsim nyog yuav tsum tau kuaj xyuas sigmoidoscopy siv lub proctoscope. Cov cuab yeej no ua rau nws tuaj yeem pom cov phab ntsa ntawm cov hnyuv hauv qhov nthuav dav ntxiv. Tsis tas li ntawd, proctologists pom zoo kom prophylactic sigmoidoscopy txhua 5 xyoos. Qhov no yog qhov yuav tsum tau rau txhua tus neeg tshaj 50.

Kev tshuaj ntsuam digital yog lwm txoj hauv kev los kuaj pom kev loj hlob ntawm polyposis, fissures, qog, cysts thiab hemorrhoids nyob rau hauv lub qhov quav thiab qhov quav.

Irrigoscopy tso cai rau pom cov duab loj dua 10 hli. Nws yog ua los ntawm kev txhaj tshuaj zoo ib yam rau hauv cov hnyuv loj thiab noj x-rays.

Txawm li cas los xij, txoj hauv kev niaj hnub tshaj plaws thiab paub txog kev kuaj mob polyposis yog colonoscopy. Nws ua rau nws muaj peev xwm tau txais cov ntaub ntawv hais txog txhua yam pathologies ntawm txoj hnyuv, thiab yog tias pom muaj polyp, koj tuaj yeem kho nws tam sim ntawd. Cov txiaj ntsig biopsy raug xa mus rau kev kuaj histological thiab cytological.

Nws yog ib qho tseem ceeb rau tus kws kho mob tsis txhob yuam kev polyp rau lwm tus, kev kawm zoo sib xws:

  • Angioma. Qhov no yog qog nqaij hlav uas muaj ntau lub hlab ntsha thiab feem ntau tshwm sim los ntawm cov ntshav hnyav;
  • Lipoma yog qog me me feem ntau nyob ntawm sab xis ntawm txoj hnyuv;
  • Myoma ua rau mob plab hnyuv tsis tshua kuaj pom;
  • Ib kab mob uas tsis yog epithelial uas tsis muaj stalk thiab tib lub sijhawm nce mus txog qhov loj;
  • Crohn tus kab mob tuaj yeem ua rau pseudopolyposis, uas pom nyob rau hauv txoj hnyuv loj;
  • Actinomycosis cuam tshuam rau cecum.

Differentiate hom kev kawm pab feem ntau histology.

Cov Lus Nug thiab Lus Teb

  • Kuv puas yuav tsum tshem cov polyps hauv cov hnyuv? Cov lus teb rau lo lus nug no yog tiag tiag. Txhua tus polyp raug tshem tawm, nws txoj kev kho mob tsis yooj yim sua.
  • Puas mob plab nrog polyps hauv txoj hnyuv? Nyob rau tib lub sijhawm, lub plab plab thiab cheeb tsam iliac raug mob. Tsis tas li ntawd, mob plab yuav tshwm sim tawm tsam keeb kwm ntawm qhov mob.
  • Pob txoj hnyuv loj raug tshem tawm thaum lub sij hawm rectoscopy? Thaum lub sij hawm kev tshawb nrhiav no, cov khoom me me, qhov chaw zoo tuaj yeem raug tshem tawm. Hauv txhua qhov xwm txheej, yuav tsum tau phais.

Kev kho mob polyps hauv plab hnyuv

Tom qab cov polyp tau raug sib txawv, tus kws kho mob txiav txim siab txog txoj kev tshem tawm. Raws li kev kho tshuaj, nws tsis yog siv, vim nws tsis muaj peev xwm cawm tus neeg mob los ntawm kev loj hlob. Qee zaum, cov tshuaj tau qhia, tab sis qhov kev ntsuas no yog ib ntus thiab tso cai rau koj los npaj tus neeg mob rau kev ua haujlwm tom ntej. Qhov no muaj tseeb tshwj xeeb rau cov neeg mob uas muaj lub cev tsis muaj zog thiab cov neeg laus.

Txhawm rau txo qhov tsam plab, tshuaj los ntawm pab pawg tshuaj tiv thaiv kab mob, piv txwv li, Simethicone, raug tshuaj. Thaum muaj mob hnyav, nws raug nquahu kom noj cov tshuaj antispasmodics, piv txwv li, No-shpy.

Tshem tawm cov polyps hauv cov hnyuv

Polyps nyob rau hauv cov hnyuv
Polyps nyob rau hauv cov hnyuv

Txawm hais tias qhov loj npaum li cas ntawm kev tsim, txhua tus ntawm lawv yuav tsum raug tshem tawm. Tom qab cov txheej txheem no, kev tshuaj xyuas microscopic yog ua rau muaj cov hlwb atypical.

Txoj kev nrov tshaj plaws los tshem tawm cov hnyuv hauv plab yog:

Transrectal polyp excision

Cov txheej txheem yog ua nrog txiab lossis scalpel. Nyob rau hauv txoj kev no, tsuas yog polyps nyob ze ntawm lub qhov quav tuaj yeem raug tshem tawm ntawm lub cev. Lawv yuav tsum tsis pub tshaj 10 cm txij thaum pib ntawm lub qhov quav, txawm hais tias qhov deb ntawm 6 cm yog suav tias yog qhov zoo tshaj plaws rau kev ua haujlwm zoo li no.

Tus neeg mob tau txais tshuaj loog hauv zos. Feem ntau, Novocain 0.25% yog siv rau qhov no. Cov tshuaj loog tsis tshua siv. Tom qab pib tshuaj loog, tus kws kho mob, siv daim iav tshwj xeeb, thawb lub qhov quav ntawm lub qhov quav thiab tshem tawm cov polyp.

Thaum qhov tsim muaj qia, Billroth clamp yog siv los clamp lub qia. Qhov tsis xws luag tsim nyob rau hauv lub mucous membrane yog raug rau suturing. Rau qhov no, qhov siab tshaj plaws ntawm 3 knots ua nrog catgut suture yog txaus. Nws tsis tas yuav tshem tawm thiab daws tag nrho tom qab ib hlis. Yog hais tias lub polyp txuas rau ntawm lub hauv paus dav, ces qhov kev tshem tawm yog ua los ntawm kev txiav tawm cov neoplasm los ntawm thaj tsam ntawm cov mucous membrane noj qab haus huv siv ib qho oval incision.

Nyob rau hauv rooj plaub thaum cov kev loj hlob nyob rau hauv ntau tshaj 6 cm, tab sis ze tshaj li 10 cm los ntawm qhov nkag mus rau lub qhov quav, lub tshuab ntawm lub lag luam yog me ntsis hloov. Nrog kev pab los ntawm daim iav qhov quav, qhov qhov qhov qhov qhov qhov qhov qhov qhov qhov qhov qhov qhov qhov qhov qhov qhov qhov qhov qhov qhov qhov qhov qhov qhov qhov qhov qhov qhov qhov qhov qhov qhov qhov qhov qhov qhov qhov qhov qhov qhov qhov qhov qhov qhov qhov qhov qhov qhov qhov qhov qhov qhov qhov cua Tom qab ntawd, qhov loj dua yog muab tso rau hauv lub plab hnyuv phab ntsa kom tshem tawm yam tsis muaj polyp. Tom qab ntawd ib daim iav luv yog ntxig, thiab tus neeg mob yuav tsum tau thawb. Qhov no tso cai rau kev tsim kom tau los ze zog thiab muab sijhawm rau tus kws kho mob kom ntes nws nrog ib qho elongated Billroth forceps lossis fenestrated forceps. Tus kws kho mob tshem tawm qhov luv luv, txhaj tshuaj loog ntxiv ntawm lub hauv paus ntawm polyp, thiab tom qab ntawd tshem nws.

YEndoscopic polypectomy

Txoj kev tshem tawm cov polyp no yog pom zoo siv yog tias cov formations nyob rau hauv nruab nrab (proximal) seem ntawm txoj hnyuv. Xws li kev phais yog hu ua minimally invasive surgical txoj kev uas yuav siv tau nyob rau hauv ib lub xeev ntawm cov tshuaj induced pw tsaug zog ntawm tus neeg mob. Thaum lub sij hawm tus txheej txheem, ib qho endoscope yog muab tso rau hauv lub qhov quav, uas pom cov polyp. Tom qab nws kuaj pom, neoplasm raug tshem tawm siv cov cuab yeej endoscopic. Tom qab ntawd tus kws kho mob ua kom paub tseeb tias tsis muaj los ntshav thiab, yog tias tsim nyog, rov ua coagulation. Cov polyp raug tshem tawm ntawm tus neeg mob lub cev siv qhov endoscope.

Yog tias qhov kev loj hlob loj, ces nws yuav tsum raug tshem tawm tsis yog tag nrho, tab sis nyob rau hauv qhov chaw. Cov txheej txheem no hu ua lumping. Qhov no yog cov txheej txheem nyuaj heev, thaum lub sij hawm tawg ntawm cov plab hnyuv gases tuaj yeem tshwm sim, nrog rau perforation ntawm txoj hnyuv phab ntsa yog qhov kub hnyiab heev. Yog li ntawd, tsuas yog ib tus kws kho mob tshwj xeeb uas tau kawm proctologist lossis endoscopist tuaj yeem ua haujlwm li no. Tom qab tshem tawm cov polyp loj tshaj 20 hli, tus neeg mob xav tau qhov kev kuaj xyuas thib ob tom qab ib xyoos. Ib tug neeg tsis raug tshem tawm ntawm daim ntawv teev npe ntawm tus kws kho mob thiab txhua 3 xyoos yuav tsum tau ua cov txheej txheem no txhawm rau txheeb xyuas qhov muaj peev xwm rov muaj tus kab mob.

Electro excision

Ib tus proctoscope tau muab tso rau hauv lub qhov quav. Lub voj hluav taws xob yog nqa tawm raws nws mus rau polyp. Nws pounces ntawm lub polyp, ib tug tam sim no hla nws. Qhov kub ntawm lub voj nce, cov ntaub so ntswg epithelial heats li. Yog li ntawd, cov qog tau txais cov thermal hlawv thiab tuag. Thaum lub voj yog nruj, qhov tsim raug txiav tawm thiab coj tawm.

Txoj kev no muaj ntau qhov zoo, ua ntej ntawm tag nrho, nws tso cai rau koj los tiv thaiv kev loj hlob ntawm cov ntshav, vim tias muaj kev coagulation ntawm cov hlab ntsha.

Colotomy lossis plob tsis so tswj

Kev ua haujlwm yog qhia rau kev tshawb pom ntawm polyps nyob rau hauv cov hnyuv sigmoid, nrog rau kev kuaj mob ntawm cov kab mob fleecy nrog lub hauv paus dav. Cov txheej txheem yuav tsum tau siv tshuaj loog. Tom qab ntawd tus kws kho mob ua ib qho kev phais nyob rau hauv sab laug iliac cheeb tsam thiab cov hnyuv raug tshem tawm mus rau hauv lub resulting lumen. Lub cheeb tsam polypous yog palpated thiab qhib. Yav dhau los, txwv tsis pub mos pulp yog siv rau thaj chaw noj qab haus huv. Cov qog thiab ib feem ntawm cov mucous membrane uas nws nyob yog excised, ces sutures yog siv rau qhov chaw no. Cov hnyuv nws tus kheej yog sutured nyob rau hauv ob kab, thiab lub anterior plab phab ntsa nyob rau hauv txheej.

Enterotomy

Kev phais mob txhawm rau tshem tawm cov polyps uas me me thiab txuas rau ceg. Nyob ntawm seb qhov twg ntawm txoj hnyuv tau dhau los ntawm kev loj hlob ntawm cov kab mob, duodenotomy (duodenum), ileotomy (ileum), jejunotomy (jejunum) yog qhov txawv. Qhov tsim nyog ntawm txoj hnyuv me yog txiav nrog rab riam lossis rab riam, lub polyp raug tshem tawm, thiab qhov tshwm sim yog sutured. Kev ua haujlwm feem ntau tsis ua rau muaj teeb meem, txij li lub lumen nqaim me ntsis nrog tus qauv enterotomy.

Segmental resection ntawm txoj hnyuv me

Kev ua haujlwm yog qhia thaum pom cov polyps loj hauv cov hnyuv, lossis yog tias lawv lub hauv paus dav. Tag nrho cov cheeb tsam uas qhov kev loj hlob yog localized yog excised. Qhov kawg ntawm txoj hnyuv tuaj ua ke, thiab ib qho kev sib txuam ntawm plab hnyuv anastomosis yog tsim. Feem ntau qhov kev cuam tshuam no dhau los ua qhov ua rau mob plab zom mov yav tom ntej, vim tias tus neeg mob raug kev txom nyem los ntawm "mob plab plab."

Raws li qhov kev cia siab rau kev rov zoo, nws yog qhov zoo yog tias qhov tsim tau raug kuaj pom thaum ntxov thiab tshem tawm sai ntawm lub cev. Qhov ntev ntawm cov polyps nyob rau hauv txoj hnyuv thiab qhov loj ntawm lawv qhov loj thiab tus naj npawb, qhov kev pheej hmoo siab dua uas lawv yuav degenerate mus rau hauv cov qog malignant. Qhov tshwm sim ntawm kev rov tshwm sim yog qhov siab heev txawm tias tom qab tshem tawm cov qog ua tiav, nws yog txog 30%. Yog li ntawd, kev soj ntsuam ntawm tus neeg mob thiab kev kuaj mob tsis tu ncua yog qhov tseem ceeb heev.

Kev noj zaub mov tom qab tshem tawm cov polyps hauv cov hnyuv

Polyps nyob rau hauv cov hnyuv
Polyps nyob rau hauv cov hnyuv

Kev kho tus neeg mob tom qab ua haujlwm feem ntau yog nyob ntawm kev noj haus. Kev rov qab muaj ob peb theem thiab yuav tsum ua raws qee cov cai.

  1. Tom qab ua haujlwm, thawj theem ntawm kev noj zaub mov pib. Nws kav li 3 hnub tom qab kev cuam tshuam. Tus neeg mob tsis pub haus lossis noj mov hauv thawj 24 teev. Thaum lub sij hawm no tas lawm, ib tug neeg tuaj yeem quench nws nqhis dej. Qhov siab tshaj plaws ntawm cov kua noj ib zaug yuav tsum tsis txhob ntau tshaj 50 ml. Tsis tas li ntawd, tus neeg mob tuaj yeem haus cov kua txiv hmab txiv ntoo, lossis compote raws li cov txiv hmab txiv ntoo uas tsis muaj qab zib. Tom qab lwm 12 teev, dej mov, tsis muaj zog nqaij broth los yog jelly tau tso cai. Koj tseem tuaj yeem faib cov zaub mov nruj ntawm tus neeg mob tom qab kev ua haujlwm nrog decoction ntawm qus sawv. Cov kev txwv no yog vim lub fact tias nws yog tsim nyog los tshem tawm cov hnyuv motility ntau npaum li sai tau thiab txo nws excretory muaj nuj nqi. Cov kua tsib thiab cov enzymes digestive tuaj yeem cuam tshuam rau qhov mob ntawm cov hlab ntsha thiab cov ntaub so ntswg puas.
  2. theem thib ob ntawm kev noj zaub mov pib peb hnub tom qab tom qab kev cuam tshuam. Yog tias tus neeg mob xav tias txaus siab, ces nws cov khoom noj tuaj yeem nthuav dav nrog kev qhia txog cov khoom noj ua kua, nqaij soufflé (los ntawm cov nqaij ntshiv), cov kua zaub thiab cov qe mos. Raws li rau cereals, nyiam yuav tsum tau muab rau millet, oatmeal thiab mov. Thaum cov khoom tshiab tau nthuav tawm, nws yuav tsum ua tib zoo saib xyuas kev noj qab haus huv ntawm tus neeg mob. Yog tias, tom qab noj cov zaub mov tshwj xeeb, muaj cov pa roj ntau ntxiv, lossis cov tsos mob tshwm sim, ces nws tseem ceeb heev uas yuav tsum tsis kam noj zaub mov. Qhov thib ob theem ntawm kev noj haus yog tsom mus tas li nce lub nra ntawm cov hnyuv ua haujlwm. Lub sijhawm no, tus neeg mob yuav tsum normalize cov quav. Koj yuav tsum ua raws li kev noj haus kom txog thaum koj tawm hauv tsev kho mob.
  3. theem thib peb tshwm sim ob lub lis piam tom qab ua haujlwm. Lub sijhawm plaub lub hlis tom ntej no, tus neeg mob yuav tsum ua raws li kev noj zaub mov tsis zoo.

Tus kws kho mob yuav tsum paub tus neeg mob nrog cov cai yooj yim ntawm kev noj haus:

  • Nws yog ib qho tseem ceeb uas yuav tsum ua raws li txoj cai. Yog tias koj noj tib lub sijhawm, qhov no yuav tso cai rau cov enzymes pib tsim ua ntej. Hauv qhov no, cov txheej txheem ntawm kev zom zaub mov yuav tsis nyuaj rau txoj hnyuv rov qab;
  • Yuav tsum muaj cov khoom noj khoom haus fractional. Qhov no yuav txhim kho txoj hnyuv ua haujlwm, txo cov load ntawm nws. Cov zaub mov yuav tsum tsis txhob tsawg dua 6, tab sis yuav tsum tau noj me me;
  • Nws yog ib qho tseem ceeb los tiv thaiv cov txheej txheem fermentation hauv cov hnyuv, vim tias lawv tuaj yeem ua rau kev loj hlob ntawm peritonitis. Ua li no, koj yuav tsum tsis kam suav cov legumes hauv kev noj haus. Ceev, asparagus thiab nceb yog txwv;
  • Txhawm rau tiv thaiv cem quav, tus neeg mob yuav tsum tau txais cov kua dej txaus. Nws ntim nyob ntawm tus neeg mob lub cev hnyav thiab qhov nruab nrab 3 litres. Nco ntsoov suav nrog thawj cov kev kawm ntawm cov ntawv qhia zaub mov;
  • Cov zaub mov ntau dua, cov kua tsib ntau zais cia. Nws cov ntsiab lus ntau dhau cuam tshuam rau cov txheej txheem ntawm kev tsim cov ntaub so ntswg hauv plab;
  • Nws yog ib qho tseem ceeb kom tsis txhob noj cov zaub mov ntxhib heev uas ua rau mob plab hnyuv. Cov zaub mov yuav tsum tau boil kom huv si los yog ci;
  • Koj yuav tsum ntxiv mis nyuj, qe thiab nqaij ntshiv rau koj cov zaub mov. Lawv txhua tus muaj cov protein, uas txhawb kev kho cov ntaub so ntswg sai;
  • Siab, ntsim thiab kib yog txwv tsis pub tag nrho. Qhov no yog vim lawv muaj peev xwm ua rau mob plab hnyuv.

Cov ntawv qhia zaub mov yuav tsum tau tsim thiab tsim raws li nws ua tau raws li qhov xav tau ntawm tus neeg ntawm kev kho. Qhov no tseem ceeb heev uas yuav tau ua txawm tias muaj kev txwv tam sim no. Lub plab hnyuv motility yog tus yuam sij rau cov quav tsis tu ncua. Qhov no pab txhawb kev tiv thaiv ntawm dysbacteriosis thiab cem quav, thiab yog li ntawd, rau qee qhov, txo qhov kev pheej hmoo ntawm kev rov tsim ntawm polyps.

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