Functional dyspepsia: Izimpawu kanye Ukwelashwa

Ngaphansi zokwelapha elithi "dyspepsia" elivame ukuqondwa ngayo njengoba inombolo enkulu izimpawu ezahlukene yangaphandle ezihlobene nezinkinga pheshana emathunjini, okuyinto zibangelwa ukuhlukumeza inqubo ukugaya ukudla. Yingakho igama, phela ukuqunjelwa lihunyushwe kwelesiHeberu lesiGreki lisho "ukuqunjelwa".

zinhlobo Hlukanisa yezifo eziyinkimbinkimbi dyspepsia sokusebenza. Izimpawu zayo: zibuthuntu noma evutha ubuhlungu endaweni besisu (okubizwa ngokuthi unxantathu epigastric). Ngaphezu ukungakhululeki, isiguli sibe umuzwa wobukhulu, futhi zichichima besisu. Futhi, kungase kube ukuqumba, isicanucanu, isilungulela nokubhamuka. Ngo inqubo ukuxilongwa awayiboni iyiphi pathologies organic (akukho izizathu morphological noma kwamakhemikhali).

Yilokho ezahlukene ukwelashwa dyspepsia obusebenzayo ukuthi inezici ezithile.

Cabangela le mibuzo kabanzi.

izibalo isifo

ukuqunjelwa - omunye iziyaluyalu ezivamile nazo pheshana emathunjini. Phakathi izindlela ezahlukene kwezibalo, kwatholakala ukuthi inani eliphelele iziguli efuna usizo gastroenterologist, inani labantu okwatholakala obusebenzayo dyspepsia, esiswini, imayelana 70%. Emazweni European, inani imiphakathi obala izifo kuchaziwe, kuze kube u-40%, kanye e-United Afrika - ezingaphezu kuka-60%.

Naphezu kweqiniso lokuthi ukusebenza dyspepsia, izimpawu okuyizinto ngempela ezingemnandi, kuletha ukungakhululeki abalulekile ukuze umuntu usizo kuphela ingxenye yesine izisulu uphendukela onguchwepheshe yezokwelapha. Ngo iningi amacala okutholakala ukuthi banesifo sochoko ke ukusebenza, kunokuba uhlobo organic izifo.

Ngo isimo owesifazane efanayo kwenzeka cishe isikhathi esisodwa nohafu maningi amathuba.

Isilinganiso sobudala kweziguli le nkinga - abaneminyaka engu-20 kuya ku-45. Ngo abadala, lesi ukungasebenzi kwekhono pheshana emathunjini lingandile kangako. Kunalokho, lapho mabi kakhulu izifo wokugaya ukudla uhlelo, okuyinto nokho babe nezimpawu ezifanayo.

nohlobo lodlame

Functional dyspepsia esiswini, njengoba usuvele waqonda, akulona uhlobo kuphela zokugula. Kukhona inguqulo organic yalo. Ake sicabangele ngokuningiliziwe oluningi ezicini ehlukile ngamunye wabo.

1. Organic. Lo ukuphazamiseka ngenxa isilonda, futhi izifo ezihlukahlukene kwamanyikwe, nenyongo sesinye, kanye nezinye pathologies organic.
2. Functional. Ivela uma wawuhamba ungqimba kwemisipha isisu duodenum 12 (hhayi yizifo), okuyinto ukudlulisa izinyanga 3 phakathi nonyaka. Lokhu akufanele ihlonzwe isixhumanisi kokuvela ubuhlungu kanye ukungasebenzi kwekhono pheshana emathunjini.

Ukwahlukanisa isifo non-yemvelo

Ngokwe Yiqiniso basemtholampilo neziyaluyalu, dyspepsia kokusebenza, isisu zingahlukaniswa zibe zenyathi ezintathu:

• Yazvennopodobnom - libhekene ubuhlungu esifundeni epigastric.
• Dyskinetic - isiguli uzizwa kabi lapho esiswini, ongenakwenziwa ephelezelwa ubuhlungu oyingozi.
• Non-ethize - isithombe emtholampilo ngamandla kwalesi sifo has izimpawu ezinhlobonhlobo (babe isicanucanu, isilungulela, belching).

izici ngodlame

Ngokungafani izinhlobo begazi, ukucabangela lapho akulona Injongo yale ncwajana, dyspepsia ukusebenza abadala nezingane ethiwa izizathu eziqondile elandelayo.

1. Izinkinga umsebenzi peristaltic ka kwezintambo zesivikelo sesifuba kwemisipha yesisu futhi duodenum. Lezi zihlanganisa:
   
   - ukungabi zokuzilibazisa ezithile esiswini emva yokushayiswa ukudla (okuthiwa yokuhlala);
   - ukuhlukumeza komjikelezo kwemisipha Kufinyeta umzimba;
   - nezinkinga nge motor umsebenzi UMnyango anal kapopopo;
   - ukwehluleka antroduodenalnoy ukubambisana.
   
   
2. Propensity anda yokwelula odongeni esiswini ngenkathi bedla.
3. Ukudla okungenamsoco, ukuphuza inqwaba itiye, ikhofi kanye nophuzo oludakayo.
4. Ukubhema.
5. Ukwelashwa nge ezihlukahlukene izidakamizwa zemithi (ama-NSAID).
6. ukucindezeleka kwengqondo.

Abanye ochwepheshe bezokwelapha baphawula kutsi syndrome of dyspepsia obusebenzayo lihlotshaniswa ukukhululwa esiningi hydrochloric acid e pheshana emathunjini, kodwa manje ubufakazi onokwethenjelwa lo mbono alikho.

Amafomu zokugula nesenzakalo

Cabangela izici zangaphandle kanye emizweni yangaphakathi isiguli ayisibonelo salezi iziyaluyalu kuchazwe.

Yazvenopodobnaya dyspepsia obusebenzayo, ngokuyinhloko libhekene ahlekise nehlala njalo, okuyinto avele esifundeni epigastric. Bona angamukela liphinyiselwe ebusuku noma lapho umuntu uzizwa yindlala. Ongaqeda kabi usebenzisa izidakamizwa ezifanele - antacids. Ubuhlungu iba babubukhulu ngokwengeziwe, uma isiguli bacindezelekile psycho-ngokomzwelo, kungenzeka wayesaba khona isifo esithile esibi.

ifomu Dyskinetic sokwephulwa kwe-(non-isilonda dyspepsia obusebenzayo) kuhambisana izimpawu ezifana satiety ekuseni, ukugcwala pheshana emathunjini, ukuvuvukala esiswini nesicanucanu.

Ngokuphathelene dyspepsia non-ethize, kukhona ukuze uhlukanise izikhalazo ngezizathu ezihlukahlukene indoda nzima. Lolu hlobo isifo kungase kuhambisane nezimpawu ezithile kwezinye izifo ezithile ezihambisana ne pheshana emathunjini. A isibonelo esifanayo kuba nzima ukuhlonza isimo ezifana obusebenzayo dyspepsia esiswini. Ukwelashwa siyefana esimisiwe yayo.

ukuhlola

Umsebenzi wokuqala zibheke ezempilo - ukuhlukanisa phakathi dyspepsia begazi futhi zisebenza kahle. Njengomthetho, lona wamuva senzeka esimweni lapho izimpawu avele isiguli akukho izizathu zangaphandle ebonakalayo.

Ukuze ukhulume ngokuzethemba mayelana nenqubekela phambili isiguli ukuphazamiseka kokusebenza, kubalulekile ukuba ukusungula khona ngemibandela ezintathu eziyinhloko:

• Kukhona njalo (yansukuzonke) dyspepsia - kufakazelwa ubuhlungu epigastric, okuyinto ukudlulisa isikhathi ingqikithi izinyanga 3 phakathi nonyaka.
• Akutholakali iminonjana iziyaluyalu organic - kuyasiza ukusungula ultrasound, Endoscopy noma ezinye izinqubo zokwelapha kanye kwamakhemikhali.
• izimpawu Kubhekiwe musa zinyamalale ngemva kokusebenzisa indlu yangasese, ngemva kwalokho angene endleni sezinyawo imvamisa futhi ukungaguquguquki musa ukushintsha - ivumela ukuhlukanisa phakathi dyspepsia futhi engaphathekile wamathumbu syndrome.

izindlela zocwaningo

Ngaphezu kwalokho, kubalulekile ukuba siqambe ezinye izifo kanye nezimpawu ezifana nalezo ezihambisana obusebenzayo dyspepsia esiswini. Yokwelapha lezi pathologies kungaba ngokuphelele ezahlukene.

Lemisebenti lelandzelako abazenzi le njongo.

1. Anamnesis. Lapho ngochwepheshe ingxoxo eyinhloko kumelwe athole ukuthi isiguli uhlushwa iziyaluyalu ephelezelwa izimpawu of dyspepsia. Kuyadingeka ukusungula uhlobo ukugeleza futhi ufunde umuzwa umuntu (kungakhathaliseki distension besisu kuyinto, ukubhodla, isilungulela noma ubuhlungu). Kubalulekile ukwazi ukuthi ukuthatha ukudla abantu phezu izinsuku ezedlule, futhi kungakhathaliseki ukuthi sekubekwe phansi iyiphi indlela yokwelapha.
2. Ukuhlolwa. Ngesikhathi kubalulekile ukuvala amathuba okuvela ukwephulwa pheshana emathunjini, esimiso senhliziyo nemithambo yegazi, neziyaluyalu zokuphefumula.
3. iqoqo Specimen. Ngokuvamile, udinga:

• ukuhlaziywa Jikelele indle;
• Ukutadisha indle ngoba khona iminonjana igazi kuzo;
• ukuhlolwa kwegazi;
• ukuzimisela khona kwezinhlobo ezithile izifo.

4. Ucwaningo nezinsimbi ezihlukahlukene zezokwelapha:

• esophagogastroduodenoscopy (igama uzobajayela - gastroscopy);
• Ukutadisha esiswini ngosizo umshini-X-ray,
• ultrasound izitho kubekwe phakathi komgodi ongaphakathi kwamathumbu;
• nezinye izinqubo ezidingekayo.

inhlolovo uhlelo

Ukuze dyspepsia ukusebenza nezingane kanye nabantu abadala kuye kwatholakala ngokunembe ngangokunokwenzeka, udokotela kufanele alandele ukulandelana ethile yezenzo.

Sidinga ukuqala ukuhlolwa imisebenzi kwegazi, kanye ekusunguleni iminonjana yayo indle. Lokhu kuzoveza ukopha afihlekile pheshana emathunjini.

Uma kukhona ngeziphambeko isifundo laboratory inikezwe kufanele kwenzeke ukuqinisekisa noma ukuphikisa uphethwe usebenzisa amathuluzi (isib Endoscopy). Uma iziguli abaneminyaka engama 50, efakwe izimpawu eziyingozi (ukuhlanza igazi, umbala obomvu we wamathumbu ukunyakaza, imfiva, ukuntuleka kwegazi emzimbeni, ezinzima kwesisindo), enifeza gastroscopy esiphuthumayo kunesidingo.

Kungenjalo (lapho izimpawu eziyingozi kungukuthi waphawula) ukuqoka okuthiwa yokwelapha empiric usebenzisa izidakamizwa isinyathelo antisecretory futhi prokinetic. Kuphela ngemuva kokungadlali Dynamics omuhle kumele kusetshenziswe izindlela wezinsimbi.

Nokho, le ndlela, kukhona ingozi ezifihliwe. Iqiniso lokuthi ejenti eziningi kwemithi nethonya elihle futhi ukunciphisa izimpawu nezinye pathologies sina abaningi (isib, umdlavuza). Lokhu inkimbinkimbi kakhulu uphethwe ngesikhathi esifanele.

ukwelashwa

Phakathi uphethwe kungenziwa esisungulwe dyspepsia organic noma sokusebenza. Ukwelashwa lokuqala sihlose izimbangela ukuthi kuvusa isifo. Endabeni le zokwelapha zakamuva achazwayo ngamunye, ziyabhekelelwa izici of isithombe emtholampilo.

I imigomo eyinhloko yokwelashwa:

• ukunciphisa ukungakhululeki;
• ukuqedwa izimpawu;
• zokuvimbela kokushelela.

Izidakamizwa-imiphumela

Izindlela ezilandelayo zisetshenziselwa ukuqeda izimpawu dyspepsia.

1. Ukudla. Omunye akufanele abanamathela tincomo esiqinile, umane kujwayeleke amandla. Kungcono ukulishiya ngokuphelele imikhiqizo ukuthi kungukuthi kusetshenzwe kalula amathumbu, kanye roughage. Kungcono ukuba adle njalo, kodwa udle kancane. It is hhayi Kunconywa ukuba ngibheme, ungaphuzi utshwala, baphuze ikhofi.
2. Ukwenqabela ngokuphuza imithi ethile. Kuyinto ikakhulukazi umbuzo izidakamizwa nonsteroidal antiinflammatory, okuyinto abe negalelo elinamandla ekusebenzeni kahle pheshana emathunjini.
3. ithonya Psychotherapeutic. ezingaphezu kwesigamu iziguli Isimanga siwukuthi, ukuqeda izimpawu ezihambisana dyspepsia obusebenzayo, uma lisetshenziswe ekwelapheni placebo. Ngakho, ngezindlela ezifanayo ekubhekaneni Ukwephulwa hhayi kuphela kungenzeka, kodwa futhi ngokuphindaphindiwe efakazelwe ekulenzeni libe namandla.

izidakamizwa

ezithile ejenti kwemithi esetshenziselwa isiguli naye etholakele dyspepsia obusebenzayo, bazimisele ngamunye kucatshangelwa izimpawu aqine.

Ngokuvamile isicelo yokwelapha enokwehla, eyenzelwe elilodwa noma amabili ezinyangeni i-reception.

Noma yimuphi izindlela ezikhethekile emzabalazweni nalesi sifo futhi zokuvimbela yayo ayikasekeli khona. izinhlobo ezaziwa elandelayo kwemithi:

• izidakamizwa antisecretory;
• antacids;
• izindlela umswakama;
• amaphilisi prokinetic;
• elwa namagciwane.

Kwezinye izimo, antidepressant ziboniswa, okuyinto bayakwazi ukuqeda izimpawu ze-non-begazi dyspepsia.

Uma kutholakale ukuthi une-dyspepsia ukusebenza nezingane, ukwelashwa kufanele kwenziwe ikhumbula izici umzimba ezikhulayo.

ukulwa amaqhinga

Isikhathi esiningi izindlela nge ukuhlupheka isayensi yezokwelapha zesimanje engakaze athuthukile.

Ngezinye lokubuya kwesifo iziyaluyalu kungcono ukusebenzisa izidakamizwa ukuthi uke efakazelwe ngempumelelo e ukususa izimpawu dyspepsia.

Lapho ukusetshenziswa eside kwanoma iyiphi amaphilisi akusho inciphe ukungakhululeki nesineke, kutuswa ukuba ukwelashwa nge okunye ejenti kwemithi.

isiphetho

Functional (kwezinto eziphilayo) dyspepsia - esinye sezifo ezivamile. Naphezu entula kalula khona izimpawu, kakhulu ziyancipha izinga lempilo. Ngoba kubalulekile ukuthatha izinyathelo ezihlose zokuvimbela. Ukuze wenze lokhu, kudingeka nje bagcine ukudla lesifanele, ukukhipha umthelela ukucindezeleka emzimbeni futhi uphumule ngokugcwele.

Hlala uphilile!