Zina mwazinthu zodziwika bwino za khansa yoyambirira yam'mimba yoyambirira, pali zinthu zina zosowa matenda zomwe zimafunikira chisamaliro chapadera ndi kuphunzira. Mmodzi wa iwo ndi khansa yosavuta ya m'mimba. Lingaliro la "Matenda a Epitheal Epithelial" tsopano ndi otchuka kwambiri. Padzakhala malingaliro osiyanasiyana pa dzina. Chiphunzitso chofananirachi chimatengera zomwe zili zokhudzana ndi magazini "m'mimba ndi matumbo", ndipo dzinalo limagwiritsanso ntchito khansa yam'mimba ".
Zotupa zamtunduwu zimakhala ndi zomwe zimakhala zochepa kwambiri, zovuta zomwe zimavuta kuzindikirika, chidziwitso cholongosoka, komanso njira yosavuta ya mesda siyigwira ntchito. Kuphunzira chidziwitsochi kumafunikira zovuta.
1. Chidziwitso choyambirira cha HP-chosavuta champhamvu cha m'mimba
Mbiri yazakale
M'mbuyomu, amakhulupirira kuti munthu amene akudwala khansa yam'mimba anali ndi matenda a HP, motero mtundu wapamwamba kwambiri. Mtundu wapamwamba nthawi zonse umadziwika kwambiri, wovomerezeka ndikukhulupirira. Zotupa zimayamba limodzi pamaziko a matrophy komanso mothandizidwa ndi HP, chifukwa chake khansa imamera m'matumbo am'madzi komanso ochepa atrosic mucosa.
Pambuyo pake, madokotala ena adazindikira kuti khansa ya chapamimba imatha kuchitika ngakhale pakalibe matenda a HP. Ngakhale kuti kuchita zinthu motsimikizika kuli kochepa kwambiri, nkotheka. Khansa yamtunduwu yotchedwa HP-yosasangalatsa ya m'mimba.
Pomvetsetsa mwachidule matenda amtunduwu, mwakuya mawonekedwe apadera ndi zidule zayamba, ndipo mayina amasintha mosalekeza. Panali nkhani mu 2012 yotchedwa "chapamtima am'mimba pambuyo potsatira", nkhani mu 2014 idatchedwa "HP-nkhani mu 2020 yotchedwa" HP-ing'onoting'ono tokha. Dzinalo limasintha limawonetsa kumvetsetsa kokulirapo komanso kokwanira.
Mitundu yolimba ndi mawonekedwe okwera
Pali mitundu iwiri yayikulu ya funds ndi ma pyloric tinthu m'mimba:
Zida za ndalama (zotupa za oxyntic) zimagawidwa mu fundus, thupi, ngodya, etc. za m'mimba. Ndi mizere yozungulira ya tubular. Amakhala ndi ma cell a mucous, maselo akulu, maselo a parita ndi endocrine, iliyonse yomwe imagwira ntchito zawo. Pakati pawo, maselo a wamkulu ali ndi malo okhala ndi muc6 anali olimbikitsa, ndipo ma cell a parieonal anali ndi chiyembekezo cha hydrochloric acid ndi nkhani;
Tizilombo ta pyloric zili pamalo am'mimba ndipo imapangidwa ndi maselo a mucos ndi endocrine. Maselo a mucos ndi muc6 wabwino, ndipo ma endocrine amaphatikiza g, d maselo ndi ma cell a endochromaffin. Ma cell a Seckrete Gastrin, ma cell a D ntchentche amatchedwa Somatostatin, ndi entechromafin cells Seckrete 5-ht.
Ma cell am'mimba am'mimba ndi zotupa zotupa zimayala mitundu yosiyanasiyana ya mapuloteni a ntchos, omwe amagawika "chapamimba", "matumbo" komanso "mitundu" ya mucos. Kuwonetsedwa kwa micyrin mucin kumatchedwa genotype osati malo ena a anatomical m'mimba ndi matumbo.
Pali ma chenotype anayi otupa am'mimba: chapamimba, m'mimbakulu osakanikirana, m'mimba yosakanikirana, komanso matumbo okwanira. Zotupa zomwe zimachitika pamaziko a matumbo metaplalasia makamaka kwambiri m'mimba yosakanikirana kwambiri. Zosakaniza zosiyanitsidwa makamaka zimawonetsa mtundu wa matumbo (muc2 +), ndipo makeke osokoneza bongo makamaka amawonetsa gestric mtundu (muc5ac +, muc6 +).
Kusankha HP kuyenera kuphatikiza kwina kwa njira zingapo zodziwika kuti mutsimikizire kuti mwatsimikiza mtima. HP-yosasangalatsa yam'mimba ndi stewililization khansa yam'mimba ndi malingaliro awiri osiyana. Kuti mumve zambiri pa khansa ya X-ray ya khansa yosavuta ya m'mimba, chonde onani gawo loyenerera la "m'mimba ndi matumbo".
2.
Kuzindikira kwa endoscopic ndiye gawo la khansa ya m'mimba. Amaphatikizaponso mtundu wa fundric khansa yam'mimba, fund and Muctos khansa yam'mimba, rasipiberi mphete ya epinoma, etc. Nkhani iyi imayang'ana pa khansa ya endoscopic.
1) Fund Guat Mtundu wa Cestric Cacker
-Kudzutsa zotupa
Fund Guat Mtundu wa Cestric Cark
Bwana 1: White, wokweza zovala
Kufotokozera:Mitu yam'mimba yopindika kwambiri ya mtima, 10 mm, yoyera, o-ngongole (SMT), wopanda matrophy metapria kumbuyo. Zombo zamagazi zingathe kuwoneka pamwamba (NBI ndi kukulitsa pang'ono)
Kuzindikira (kuphatikiza ndi matenda):Iwe, o-1la, 9m, Gundic, PT1B / SM2 (600μm), ly0, VMO, VMO
-Mawu otupa
Fund Guat Mtundu wa Cestric Cark
Bwana 2: White, lathyathyathya / wokhumudwa
Kufotokozera:Khoma lakunja lam'mimba la pestic fornix-distia yayikulu kwambiri, 14 mm, yoyera, yoyera, yopanda matumba, ndi mitsempha yamagazi yomwe imawonekera pamtunda. (NBi ndi makulidwe achidule)
Kuzindikira (kuphatikiza ndi matenda):U, 0-Ilc, 14mm, Gundic Eya Ceck Cacc, PT1B / SM2 (700μm), ly0, VMO, VMO
-Zotupa zokwezedwa
Fund Guat Mtundu wa Cestric Cark
Bwana 3: Red ndikukweza zotupa
Kufotokozera:Khoma loyandama la mtima ndi 12 mm, mwachiwonekere, mtundu 0-1, wopanda matope a metaplais
Kuzindikira (kuphatikiza ndi matenda):U, 0-1, 12mm, Guand Gund Chovala Cacc, PT1B / SM1 (200μm), Ulo, LOO, VMO, VMO
-Ded, lathyathyathya, wopiriras
Fund Guat Mtundu wa Cestric Cark
Bwana 4: Red, lathyathyathya / zotupa
Kufotokozera:Khoma ladzidzidzi la kupindika kwakukulu kwa chapamwamba thupi, 18mm, ofiira, o-1
Kuzindikira (kuphatikiza ndi matenda):U, o-1lc, 19mm, Gund Gund Cenge Cacc, PT1B / SM1 (400μm), Ulo, VOO, VMO, VMO
kambilanani
Amuna omwe ali ndi matendawa ndi achikulire kuposa akazi, omwe ali ndi zaka pafupifupi 67.7. Chifukwa cha mawonekedwe a utomatane ndi herurochrony, odwala omwe adapezeka kuti ali ndi fund fund mtundu wa castric amayenera kuwunikiridwa kamodzi pachaka. Tsamba lofala kwambiri ndi malo owonera topic mu pakati ndi kumtunda kwa m'mimba (fundus ndi gawo lapakati ndi kumtunda kwa thupi lam'mimba). Zovala zoyera zoyera zimakhala ngati zofala zoyera. Chithandizo chachikulu ndikuzindikira ESR / ESD.
Palibe mawu a lymphatic kapena kuwonekera kwa mavosi akuwoneka mpaka pano. Pambuyo mankhwala, ndikofunikira kudziwa ngati mungachite opaleshoni yowonjezera ndikuwunika ubale pakati pa zoyipa ndi HP. Sikuti ndalama zonse zamphongo zomwe zimapangitsa kuti zikhale bwino.
1) Fund Gund Mucoal Cacker Cluck
Fund Gust Mucosal Cacker Cluck
◆ Bwana 1
Kufotokozera:Atsambawo amaleredwa pang'ono, ndipo alk omwe sakhala atrophic mucosa akhoza kuwoneka mozungulira. Kusintha mofulumira microstssessinsssssssss kuti iwoneke mu gawo la ine-nbi, ndipo DL itha kuwoneka.
Kuzindikira (kuphatikiza ndi matenda):Pind Gigh Mucoal Cacker khansa yam'mimba, mdera, 0-1la, 47 * 32m, nt1a, ly0, vemo
Fund Gust Mucosal Cacker Cluck
◆ Bwana 2
Kaonekeswe: Zotupa zathyathyathya pa khoma la ocheperako la mtima, wokhala ndi kusungunuka kosakanikirana ndi redness, mitsempha yamagazi imatha kuwoneka pamtunda, ndipo zotupa zimaleredwa pang'ono.
Kuzindikira (kuphatikizidwa ndi matenda): Pind Gind Mucoal Cackerc, 0-Lla, PT1a / M, Ulo, LOV0, HMO, VMO
kambilanani
Dzinalo la "gastric gland Mucoas adenocarcinoma" ndizovuta kwambiri kunena, ndipo kuchuluka kwake kumakhala kochepa kwambiri. Pamafunika kuyesetsa kwambiri kuzindikira ndi kumvetsetsa. Thupic Git Mucoas adenocarcinoma ali ndi mawonekedwe a chitupa chachikulu.
Pali mikhalidwe inayi yayikulu ya kuwala koyera koyera: ① zotupa zowopsa; Otupa ang'onoang'ono; ③ mitsempha yam'magazi yolimba; ④ Micraparctartics mic. Ine magwiridwe antchito: DL (+) imvp (+) imsp (+) ya mce imafanana ndi IP ndikuwonjezeka. Pogwiritsa ntchito njira yolimbikitsidwa ya Mesda-g, 90% ya Fund Mucoal inhalerric Melers amakwaniritsa njira yodziwira.
3) chapamimba adenoma (pyloric gland adenoma pga)
chapamimba adenoma
◆ Bwana 1
Kufotokozera:Misozi yoyera yakuyalidwa idawoneka pakhoma lam'mimba lam'mimba wokhala ndi malire. Carmine ya Carmine Kupanda malire sikunafotokozedwe zomveka, ndipo mawonekedwe a Lst-G
Kuzindikira (kuphatikiza ndi matenda):Anypia carcinoma, o-1la, 47 * 32 * 32m, wosiyana kwambiri wabulularcinoma, pt1a / m, ly0, ly0, vemo
chapamimba adenoma
◆ Bwana 2
Kaonekeswe: Zotupa zokwezedwa ndi maudzu pakhoma la pansi pa gawo la pakati la m'gulu la chapamimba. Gastritis yogwira ikhoza kuwoneka kumbuyo. Carmine carmine amatha kuwoneka ngati malire. (NBi ndi kukula pang'ono)
Zochitika: Mawu a muc5ac adawoneka mu epithelium epithelium, ndipo muc6 amawoneka mu epithelium yapamwamba kwambiri. Kuzindikira komaliza kunali PGA.
kambilanani
Pasticric adenomas ndidera kwambiri m'matauni a mucinous amalowa mu mtangawo ndikuphimbidwa ndi Fovelolar Epithelium. Chifukwa cha kuchuluka kwa chiwonetsero cha g-hemispherical kapena nodelar, chapamimba a ma adnomas owoneka ndi kuwala koyera koyera ndi koronar. Ndikofunikira kulabadira kalasi 4 ya Jiu Ming pansi pa mayeso a endoscopic. Me-NBI imatha kuwona mawonekedwe a papillary / mawonekedwe a PGA. PGA siabwino kwambiri komanso osakhala atrophic, ndipo ali ndi chiopsezo choletsa. Kuzindikira koyambirira komanso chithandizo choyambirira kumapangidwira, ndipo nditapeza njira yofananira ndi yowonjezera ya BloC ndikuphunzira mwatsatanetsatane ndikulimbikitsidwa.
4) (rasipiberi-ngati) foveolar epitlial khansa ya m'mimba
rasipiberi foveolar epithelial khansa ya m'mimba
◆ Bwana 2
Kufotokozera:(adasiyidwa)
Kuzindikira (kuphatikizidwa ndi matenda): epiolar epitlial cacc khansa ya m'mimba
rasipiberi foveolar epithelial khansa ya m'mimba
Ngati 3
Kufotokozera:(adasiyidwa)
Kuzindikira (kuphatikiza ndi matenda):Foveolar Epithelial Cacker
kambilanani
Rasipiberi, wotchedwa "Tubai'or" Wamkati mwa kwawo, ndi chipatso chamtchire m'mbali mwa msewu pamene tinali ana. Glandular echitheum ndi tizilombo timalumikizidwa, koma sizofanana. Ndikofunikira kumvetsetsa mawonekedwe a kukula ndi chitukuko cha maselo epithelial. Rasipiberi epithelial khansa ya m'mimba ndi yofanana kwambiri ndi polysi polyps kapena kusokonekera mosavuta chifukwa cha m'mimba. Chiwonetsero cha Havekor Epithelium ndiye mawu odziwika bwino a muc5ac. Chifukwa chake foveolar epithelial carcinoma ndiye nthawi yonse ya mtundu uwu. Itha kukhalapo mu HP koyipa, zabwino, kapena pambuyo. Maonekedwe a endoscopic: ofiira ofiira owala ngati sitiroberi owala, nthawi zambiri amakhala ndi malire.
5) siginet mphete ya cell carcinoma
Signet Ring Cell Carcinoma: mawonekedwe oyera oyera
Signet Ring Cell Carcinoma: mawonekedwe oyera oyera
Signet Ring Cell Carcinoma
◆ Bwana 1
Kufotokozera:Zotupa zathyathyathya pa khoma la m'mimba, 10 mm, zozimiririka, loi-1 00
Kuzindikira (kuphatikiza ndi matenda):Malingaliro a ESD amagwiritsidwa ntchito kuti azindikire ku Signet mphete ya cell carcinoma.
Mawonetseredwe azatha
Signet Ring Cell carcinoma ndiye mtundu woipa kwambiri. Malinga ndi gulu la Lauren, rignet signet rignet cell carcinoma limadziwika kuti ndi mtundu wa carcinoma ndipo ndi mtundu wa carcinoma wopanda mphamvu. Nthawi zambiri zimachitika mthupi la m'mimba, ndipo ndizofala kwambiri mu zotupa komanso zotupa ndi ma toni osungunuka. Zotupa ndizosowa kwambiri ndipo zitha kuonekera ngati kukokoloka kapena zilonda zam'mimba. Ndikosavuta kudziwa nthawi ya endotoscopic m'zinthu zoyambirira. Chithandizo chitha kukhala chofanizira monga endoscopic esd, ndi kutsatira kokhazikika ndi kuwunika ngati mungachite opaleshoni yowonjezera. Pulogalamu yosakhala yodziwika iyenera kufunikira opaleshoni yowonjezera, ndipo njira yochita opaleshoni imasankhidwa ndi dokotala.
Malingaliro omwe ali pamwambapa ndi zithunzi zimachokera ku "m'mimba ndi matumbo"
Kuphatikiza apo, chidwi chiyeneranso kuperekedwa kwa ESOPHAGOGL Vutive, khansa ya Cardia, komanso adnocarcinoma yemwe ali ndi vuto lalikulu.
3. Chidule
Lero ndidaphunzira chidziwitso choyenera komanso chiwonetsero cha endoscopic cha khansa ya HP-chosalimbikitsa. Zimaphatikizapo: Thupi la Fund Cent Custic khansa yam'mimba, fund fund mucosal mucosas khansa ya chapamimba, rassiber, (rasipiberi) kutulutsa epithelial epinoma.
Matenda a khansa ya HP-coucker omwe ali ndi chipatala ndi ochepa, ndizovuta kuweruza, ndipo ndikosavuta kuphonya kuzindikira. Chovuta kwambiri ndi chiwonetsero cha endoscopic cha matenda ovuta komanso osowa. Tiyeneranso kumvedwanso kuchokera ku endoscopic mawonekedwe a endoscopic, makamaka chidziwitso cham'munsi pa icho.
Ngati mungayang'ane pa m'mimba, kukokoloka, ndi madera ofiira ndi oyera, muyenera kuganizira kuthekera kwa khansa ya HP-yoyipa. Chiweruzo cha HP chikuyenera kutsatira miyezo, ndipo chidwi chiyenera kulipidwa chifukwa cha zonama zomwe zimayambitsidwa chifukwa cha kudalirika kwa zotsatira zoyeserera. Maso odziwa matondo amadalira maso awo. Kukumana ndi Chinsinsi Chatsatanetsatane cha HP-chosalimbikitsa cha mtima, tiyenera kupitilizabe kuphunzira, kumvetsetsa ndi kuchita maphunziro.
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Post Nthawi: Jul-12-2024