Kev phais los tiv thaiv mob - menyuam yaus

Kev tiv thaiv kom tsis txhob rov qab yog phais mob txhaws kom nruj rau cov leeg hauv qab txoj hlab pas (lub raj uas nqa zaub mov tawm ntawm lub qhov ncauj mus rau lub plab). Teeb meem nrog cov leeg no tuaj yeem ua rau lub plab zom mov (GERD).

Qhov kev phais no tseem tuaj yeem ua tau thaum kho hiatal hernia.

Kab lus no yuav tham txog kev kho mob phais thim rov qab rau hauv cov menyuam yaus.

Qhov feem ntau ntawm txoj kev los tiv thaiv phais neeg mob hu ua fundoplication. Qhov kev phais no feem ntau siv 2 rau 3 teev.

Koj tus menyuam yuav raug tso tshuaj kom tsaug zog ua ntej kev phais mob. Qhov ntawd txhais tau hais tias tus menyuam yuav tsaug zog thiab tsis tuaj yeem hnov ​​tus mob thaum ua haujlwm.

Tus kws phais mob yuav siv hlua khi los qhwv sab saud ntawm koj tus menyuam lub plab ib puag ncig ntawm txoj hlab nqos mov. Qhov no pab tiv thaiv lub plab thiab zaub mov kom ntws rov qab.

Yuav tso tau txoj hlab ntsws (g-tube) yog tias koj tus menyuam tau nqos lossis noj teebmeem. Txoj yas no pab nrog pub mis thiab tso cua los ntawm koj tus menyuam lub plab.

Lwm txoj kev phais, hu ua pyloroplasty kuj tseem yuav ua tiav. Qhov kev phais no qhib lub qhov ncauj ntawm txoj hnyuv thiab plab hnyuv kom lub plab tuaj yeem khoob sai dua.

Txoj kev phais no yuav raug ua los ntawm ntau txoj kev, suav nrog:

• Txoj kev qhib kho - tus kws phais yuav txiav ntau qhov chaw hauv plab hauv plab (hauv plab).
• Txoj kev kho laparoscopic - Tus kws phais yuav ua 3 txog 5 qhov me me hauv plab. Ib qho xaim nyias, khoob khoob nrog lub koob yees duab me me ntawm qhov kawg (daim duab laparoscope) tau tso los ntawm ib qho ntawm cov kev txiav no. Lwm cov cuab yeej tau hla dhau los ntawm lwm txoj kev phais mob.

Tus kws phais yuav xav hloov mus rau qhov qhib kev yog tias muaj ntshav, muaj caws pliav ntau heev los ntawm kev phais mob ua ntej, lossis yog tias tus menyuam rog dhau heev.

Endoluminal fundoplication zoo ib yam li kev kho laparoscopic, tab sis tus kws phais neeg ncav cuag lub plab mus los ntawm lub qhov ncauj. Cov ntawv me me yog siv los txhawm rau kev txuas ntawm lub plab thiab txoj hlab pas.

Kev phais mob rov qab zoo feem ntau yog ua txhawm rau kho GERD hauv cov menyuam yaus tsuas yog tom qab cov tshuaj tsis ua haujlwm lossis teeb meem loj tuaj. Koj tus menyuam tus kws kho mob tej zaum yuav hais qhia kom rov zoo qhov phais thaum:

• Koj tus me nyuam muaj cov tsos mob kub siab tau zoo dua nrog cov tshuaj, tab sis koj tsis xav kom koj tus menyuam noj cov tshuaj no txuas ntxiv.
• Cov tsos mob ntawm lub siab kub nyhiab yog hlawv hauv lawv lub plab, caj pas, lossis hauv siab, faus lossis roj npuas, lossis teeb meem nqos khoom noj lossis dej haus.
• Ib feem ntawm koj tus menyuam lub plab tau daig hauv siab lossis ntxeev ncig nws tus kheej.
• Koj tus menyuam muaj txoj hlab nqaim nqaim (hu ua nruj) los ntshav hauv txoj hlab pas.
• Koj tus menyuam tsis loj hlob zoo los yog nws tuaj tsis dhau.
• Koj tus menyuam tau mob ntsws los ntawm kev ua pa ntawm lub plab mus rau hauv lub ntsws (hu ua mob ntsws.
• GERD ua rau koj tus menyuam hnoos lossis txhaws qa.

Kev phom sij rau kev phais mob suav nrog:

• Ntshav
• Kab mob

Kev phom sij rau cov tshuaj loog muaj xws li:

• Kev tshuaj tiv thaiv
• Ua tsis taus pa teeb meem, suav nrog mob ntsws
• Lub plawv muaj teeb meem

Kev phais mob rov zoo tuaj yeem suav nrog:

• Kev puas tsuaj rau lub plab, txoj hlab pas, daim siab, lossis lub plab hnyuv. Qhov no yog qhov tsawg kawg.
• Roj thiab bloating uas ua rau nws nyuaj rau tawg lossis pov. Feem ntau, cov tsos mob no maj mam zoo zuj zus.
• Gagging.
• Kev mob hnyav, nqos nyuaj, hu ua dysphagia. Rau feem ntau cov menyuam yaus, qhov no ploj mus hauv thawj 3 lub hlis tom qab kev phais mob.
• Tsis tshua muaj teeb meem ua pa, mob ntsws lossis ntsws, xws li lub ntsws tsaus muag.

Nco ntsoov xyuas kom koj tus kws saib xyuas kev noj qab haus huv paub txog txhua yam tshuaj thiab cov tshuaj ntxiv uas koj tus menyuam tau noj, suav nrog cov uas koj yuav yam tsis muaj daim ntawv yuav tshuaj.

Ib lim piam ua ntej kev phais mob, tej zaum yuav kom koj tsum tsis txhob muab koj cov menyuam cov khoom uas cuam tshuam rau cov ntshav txhaws. Qhov no suav nrog cov tshuaj aspirin, ibuprofen (Advil, Motrin), vitamin E, thiab warfarin (Coumadin).

Luag yuav qhia rau koj paub thaum mus txog hauv tsev kho mob.

• Tus menyuam yuav tsum tsis txhob noj lossis haus ib yam dab tsi tom qab ib tag hmo ua ntej kev phais mob.
• Koj tus menyuam tuaj yeem mus da dej lossis da dej hmo ntuj ua ntej lossis thaum sawv ntxov ntawm kev phais mob.
• Hnub ua kev phais mob, tus me nyuam yuav tsum noj yam tshuaj uas tus kws kho mob hais kom coj nrog lub me pas dej.

Koj tus menyuam nyob hauv tsev khomob ntev npaum li cas yog nyob ntawm seb qhov kev phais ua tiav li cas.

• Cov menyuam yaus uas muaj lub laparoscopic los tiv thaiv kev phais mob feem ntau yuav nyob hauv tsev kho mob li 2 rau 3 hnub.
• Cov menyuam uas qhib phais yuav siv li 2 mus rau 6 hnub nyob hauv tsev kho mob.

Koj tus menyuam tuaj yeem pib noj ntxiv li ntawm 1 mus rau 2 hnub tom qab phais mob. Cov tshuaj ua kua feem ntau yog muab ua ntej.

Qee tus menyuam yaus tau muab g-raj tso tawm thaum phais. Cov raj no siv tau rau kev pub noj kua, los yog tso cov pa roj tawm ntawm lub plab.

Yog tias koj tus me nyuam tsis tso g-tube, tso cov raj rau hauv qhov ntswg mus rau lub plab kom pab tso pa tawm. Txoj yas no tau muab tshem tawm thaum koj tus menyuam pib noj mov dua.

Koj tus menyuam yuav tau rov mus tsev thaum lawv noj mov, muaj plob tsis so plab thiab mloog zoo dua.

Kev kub siab thiab cov tsos mob ntsig txog yuav tsum txhim kho tom qab phais mob tawm tsam. Txawm li cas los xij, koj tus menyuam tseem yuav tsum tau noj tshuaj rau lub siab tom qab phais mob.

Qee tus menyuam yuav tsum tau khiav lag luam lawm yav tom ntej txhawm rau txhawm rau kho tus mob hnyav ntxiv lossis teeb meem nqos dej. Qhov no tuaj yeem tshwm sim yog tias lub plab tau qhwv ntawm txoj hlab pas kom nruj heev lossis nws xoob.

Kev phais mob kuj yuav tsis tiav yog tias qhov kev kho me me dhau xoob.

Fundoplication - cov menyuam yaus; Nissen fundoplication - cov menyuam yaus; Belsey (Cim IV) kev ua haujlwm fundoplication - menyuam yaus; Toupet fundoplication - menyuam yaus; Thal fundoplication - menyuam yaus; Kho Hiatal hernia - menyuam yaus; Endoluminal fundoplication - menyuam yaus

• Kev txiav tawm tsam tsis tuaj yeem rov qab - cov menyuam yaus - tso tawm
• Anti-reflux phais - tawm
• Gastroesophageal reflux - tso tawm
• Kev mob siab rau lub ntsws - yuav nug koj tus kws kho mob li cas

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Khan S, Matta SKR. Gastroesophageal reflux tus kab mob. Hauv: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Phau Ntawv ntawm PediatricsCov. 21st ed. Philadelphia, PA: Elsevier; 2020: chau 349.

Kane TD, Xim av MF, Chen MK; Cov Tswv Cuab ntawm APSA Tshiab Technology Committee. Daim ntawv qhia txog cov haujlwm laparoscopic antireflux kev ua haujlwm ntawm menyuam yaus thiab menyuam yaus rau kev mob lub plab kem plab. Koom Haum Pediatric American Kev Koom Tes. J Pediatr SurgCov. 2009; 44 (5): 1034-1040. PMID: 19433194 www.ncbi.nlm.nih.gov/pubmed/19433194.

Yates RB, Oelschlager BK, Pellegrini CA. Gastroesophageal reflux tus kab mob thiab hiatal hernia. Hauv: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Phau Ntawv Txog Kev Kho MobCov. 20 tus ed. Philadelphia, PA: Elsevier; 2017: cha 42.