I-Ulcer ye-bulb duodenal: incazelo, izimbangela, izimpawu kanye nezici zokwelashwa

Ukuqothulwa kwe-bulb ye-duodenum (i-ICD 10: K26) yisifo esivamile, esitholakale sezinyathelo eziphambili. Lokhu kungenxa yokuthi abantu bajwayele ukuzwa okungenakukhathazeka esiswini okushiwo ukudla okuyisidlo noma ukwephulwa kokudla. Umuntu uzwa ubuhlungu, uphonsa imithi yakhe, kanti okwamanje isifo siyaqhubeka. Kudokotela, umuntu ogulayo kanjalo uyowa lapho enganaki umzimba wakhe futhi engabekezeleleki.

Epidemiology

Ukuqothulwa kwe-bulb ye-duodenum, njengombuso, kuyiseceleni kwesilonda se-mucosa esiswini. Ngakho-ke, ukuxilongwa ngokuvamile kubhalwe "isisu ne-duodenal ulcer", ngaphandle kokukhomba indawo yangakini.

Cishe u-5% wabo bonke abantu eMhlabeni bane-pathology. Emadodeni, kwenzeka kaningi kaningi ngaphezu kobulili obuhle. Futhi isilinganiso samadolobhana nezakhamuzi zasezindaweni zasemaphandleni cishe ku-2 kuya ku-1. Kungenzeka ukuthi lokhu kungenxa yezinga lokudla, imikhuba yokudla kanye nemisebenzi yomsebenzi wezakhamuzi ezindaweni ezihlala ezindaweni ezihlala emadolobheni.

Izimbangela

Ukuqotshwa kwe-bulb ye-duodenum kubangelwa isenzo esibucayi se-hydrochloric acid (okuyingxenye yejusi lokugaya) emcimbini wamathumbu amancane. Kunezizathu eziningana zokwanda kwama-asidi:

• Ukukhululwa ngokweqile kwe-gastrin (ihomoni eqondisa ukugaya);

• Umdlandla wokudla okunzima, okubabayo, okusawoti, okumuncu, okuthosiwe namafutha;

• Ukudla okunganele okwanele emini nokudla ngokudliwayo kusihlwa;

• Ukusebenzisa isikhathi eside izidakamizwa ze-hormonal noma ezilwa nokuvuvukala;

• Ukuvezwa njalo ekucindezelekeni;

• Ukubhema nokuphuza utshwala, ikakhulukazi esiswini esingenalutho.

Ezimweni ezingavamile, ukubonakala kwezidakamizwa nezilonda ku-duodenum kungase kuhlotshaniswe nokwanda kwezinga le-calcium emzimbeni, ukwehla kwesibindi nesifo sezinso, nezifo ezingavamile zokuphefumula.

I-Pathogenesis

Ukwehliswa kwe-bulb ye-duodenum kuboniswa inkambo efana ne-wave-wave ne-alternation of remission and exaceration. Izigaba ezintathu zihlukaniswa ngokujwayelekile:

• Inkambo enhle (izimpawu zibizwa, zikhona izilonda kanye nezimo ezithinta ulwelwesi);

• Ukunqunywa kwenqubo (akukho izikhalo, izilonda ziyabonakala);

• Ukuthethelelwa (izimpawu azikho, izibazi zihlukaniswe nge-epithelialized).

Indima eyinhloko ekubukeni kwesilonda ukuphulwa kwe-asidi-base balance ngaphakathi mucosa emathunjini. Uma i-hydrochloric acid ikhiwa ngaphezu kwe-alkali, ayinciphisi ngokuphelele futhi ilimaze izicubu ezizungezile. Amaseli awela phansi, akhipha ama-enzyme futhi akhulise umonakalo. Le ndawo ye-mucosa ifaka ukuvuvukala, okukhulunywa ngengxenye ngayinye entsha ye-chyme. Ngaphezu kwalokho, i-peristalsis eyandisiwe kanye nokwanda kwenani lamaseli angasese ngaphakathi esiswini kuvumela ukufihla kwe-asidi ngaphandle kokudla kokudla.

Izimpawu

Isilonda se-bulb ye-duodenum sibonakala kanjani? Izimpawu kanye nokwelashwa kwazo zihlobene kakhulu, ngakho kubalulekile ukuqonda ukuthi iyiphi i-syndrome ekhona. Izimo zomtholampilo zikhulu kakhulu futhi zenza isiguli sibe nenkinga enkulu.

Isibonakaliso sokuqala nesinhloko ubuhlungu esifundeni sendawo. Kungaba kokubili okunzima futhi okuphazamisayo, konke kuxhomeke ekutheni futhi izinga lokudla. Ngaphezu kwalokho, okokuqala kulula ukuyiqeda ngokuphuza ama-antacids. Ngezinye izikhathi ubuhlungu bungabuya ebusuku futhi bubuhlungu emuva.

Zonke izilonda ziyazi: ukukhipha isicanucanu, ukubopha noma ubuhlungu obudinga nje isidlo. Kuyinto efiselekayo into efana ne-kissel. Kodwa le mpendulo ayiyona yonke into, ngoba ukuhlanza kungabuya ngemva kokudla, "ukuletha" ngokwakho njengendlela yokuphuza ukukhwabanisa "nesibindi" nokuzizwa kunzima. Ngezikhathi ezithile, laba bantu bahlushwa yizinkinga zesitokisi ngendlela yokuqothulwa nokulala.

Izinkinga

Isilonda esibucayi se-bulb ye-duodenum yisifo esongela ukuphila nesongela impilo. Ezimweni ezinzima, ukuphuma kwegazi okukhulu, ukuguqulwa kwamadwala emathumbu kanye nokubunjwa kwe-sepsis kunokwenzeka.

Isilonda asikwazi nje ukususa udonga lwesitho esingenalutho, kodwa futhi singena esakhiweni esiseduze. Isibonelo, kusukela ku-bulb ye-duodenum, inqubo ye-pathological idlula kuma-pancreas, enza ama-fistula nama-abscesses.

Izinkinga ezingapheli zihlanganisa stenosis (narrowing) yegciwane lomathumbu. Lokhu kwenza kube nzima ukudlulisa ukudla, kuphazamise ukulimala kwakhe nokubola ngaphakathi esiswini. Kubantu, lokhu kubonakala ngomuzwa wokuhlupheka, ubuthakathaka, ubuhlungu, ukukhathala, ukuntuleka kwesifiso. Kwezinye izimo, kungase kube nokuhlanza ngezicucu zokudla okungaxhunyiwe, kudliwe ezinsukwini ezimbalwa ezedlule.

Izifo

Ama-ulcers we-bulb duodenal abhekwa kalula, enikezwe ukuthi iziguli zifuna usizo kudokotela oselekhulile, uma ukungazizwa kuvimbela ukuba bangahlali ngokujwayelekile.

Okokuqala, udokotela uqoqa i-anamnesis futhi uqhuba ucwaningo. Yiqiniso, i-palpation yesisu ayinikezi ulwazi oluphakeme, kodwa kungenzeka ukuthi umsola, ngezinga eliphezulu kakhulu, inqubo yokulonda isifo kungenzeka. Khona-ke isiguli siyahamba ukuhlolwa kwegazi, izimpawu ze-biochemical, ukuhlaziywa kwesikhumba segazi elilindile, futhi futhi kunqume izinga le-gastrin nomsebenzi we-Helicobacter pylori.

Inqubo ejwayelekile kakhulu yokuxilongwa yi-esophagogroroodenoscopy, noma, ngokulula nje, i-EGDS. Ivumela ukuhlola i-membrane yamangqamuzana ye-tube digestive, ukuze ihlukanise zonke izilonda ezivezile, ukuthatha izicubu namanzi okuhlolisisa ukuhlolwa. Ulwazi olunemininingwane lubuye lubuyele emabalazweni. Ezithombeni ngokuphambene, izilonda kanye nesimo sesisu nesisu se-duodenal sizobonakala ngokucacile.

Ukwelashwa kwezilonda ze-duodenal bulb

Okokuqala, kudingeka uzilungiselele ukuthi le nqubo ende futhi inzima, ehlanganisa ukudla, physiotherapy nokuthatha imithi. Ungesabi, konke lokhu akumele kwenziwe ngesikhathi esifanayo, kodwa ngokuvumelana nenhlelo ehlelwe kahle futhi uxhumane nodokotela.

Okokuqala, i-gastroenterologist inquma imbangela eyabangela isilonda futhi iqondisa zonke izinyathelo zokuyiqeda. Kulokhu, kukhona ukwelashwa kwezidakamizwa. Lezi zihlanganisa ama-antacids, prokinetics, proton pump inhibitors, nezinye izimangaliso eziningi zemithi. Ngaphezu kwalokho, izidakamizwa ezikhanyayo kanye ne-hypnotics zingasiza ekulwa nesilonda sokucindezeleka, kodwa kufanele zisetshenziswe ngokucophelela. Ngokumelene neHelicobacter pylori uchungechunge oluhle kakhulu lwe-antiictic penicillin kanye nama-macrolides.

Esikhathini sokuqabuleka ukuze silondoloze amandla omzimba, isiguli siboniswa izinqubo ze-balneological, novocaine electrophoresis nokufudumala.

Amakhambi omphakathi

Ukwelashwa kwezilonda ze-bulb ye-duodenum nezokwelapha zomuntu kunemiphumela emibi kakhulu yezempilo. Ngakho-ke, ngaphambi kokuqala lolu hlobo lokuhlola, tshela udokotela wakho. Uzokubonga ngalokhu.

E-intanethi, kanye nogogo bethu banezindlela zokupheka eziningi zokwelapha izilonda. Ukuze unciphise ama-asidi futhi ukwandise ukumelana kwe-mucosa, abantu baphuza ijusi yamazambane omusha, ingxube yobusi nebhotela noma bamane bachithe uju emanzini afudumele bese bedla ngaphambi kokudla. Kukhona nezinye zokupheka ezingavamile, isibonelo, ukusetshenziswa kwamafutha kusuka emathanjeni olwandle olunamapunyukunsawoti ku isipuni ngaphambi kokudla.

Zonke lezi zindlela zingasusa izenzakalo ezingakhululekile, ezinye zize zifaka isandla ekuphulukiseni izilonda, kodwa namanje okumele kwenziwe kunikezwe izindlela zokwelapha zendabuko.

Yidla ngesilonda se-bulb ye-duodenum

Ngezikhathi zokwehliswa kwesifo, iziguli kufanele zihambisane nokudla okunomsoco okwanele, okuzosiza ukunciphisa ubukhulu bezinhlungu, futhi ukusheshisa ukutakula. Amanye amathiphu wokudla okufanayo:

1. Ukudla okuyizinhlangothi zonke amahora amathathu ezinxenyeni ezincane.

2. Yidla kancane, ufune ukudla ngokucophelela.

3. Ukudla kufanele kufudumele, ukuze kungabisusi isibeletho esivele sibhekene naso.

4. Imikhiqizo ekhethiwe akufanele ivuse ukukhiqizwa okwengeziwe kwe-hydrochloric acid, ngakho-ke akukho okuthosiwe, okubabayo, okusawoti, okufakwe emanzini anosawoti futhi okubabayo.

Kusuka kwezinye izicathulo nama-pickle, kungase kudingeke ulahlekelwe impilo. Kodwa ubisi, izithelo, amazambane ahlambulukile kanye ne-kissels, imifino enamafutha kanye namaqanda kungadliwa ngobuningi obungenamkhawulo.