ʻOki kino Anti-reflux

ʻO kahi ʻoki anti-reflux kahi lapaʻau no ka reflux acid, i ʻike ʻia ʻo GERD (gastroesophageal reflux disease). ʻO GERD kahi ʻano i hoʻi mai ai ka ʻai a i ʻole ka waikawa ʻōpū mai kou ʻōpū i ka esophagus. ʻO ka esophagus ka paipu mai kou waha a i ka ʻōpū.

Hana pinepine ʻia ʻo Reflux inā ʻaʻole pili paʻa nā mākala kahi e hui ai ka esophagus me ka ʻōpū. Hiki i kahi hernia hiatal ke hōʻino i nā hōʻailona GERD. Hana ʻia ia i ka ʻōpū mai o ka ʻōpū ma o kēia hāmama i loko o kou umauma.

Ke puhi nei nā ʻōuli o ka reflux a i ʻole ka puʻuwai puʻuwai i loko o ka ʻōpū e ʻike paha ʻoe i kou puʻu a i ʻole ka umauma, ʻūpū a i ʻole nā ​​ʻōpala kinoea, a i ʻole ka pilikia e ale i nā meaʻai a wai paha.

ʻO ke kaʻina hana maʻamau o kēia ʻano i kapa ʻia he fundoplication. I kēia ʻoki ʻana, na kāu kauka lāʻau:

• E hoʻomaikaʻi mua i ka hernia hiatal, inā aia kekahi. Hoʻopili kēia i ka wehe ʻana i kāu diaphragm me nā humuhumu e mālama i kou ʻōpū mai ka piʻi ʻana i luna ma o ka puka i ka paia o ka mākala. Hoʻonoho kekahi poʻe kauka lapaʻau i ʻāpana o ka ʻupena i ka wahi i hoʻoponopono ʻia e paʻa pono ai ia.
• Hoʻopili i ka ʻaoʻao i luna o kou ʻōpū a puni ka hopena o kou esophagus me nā humuhumu. Hoʻokumu nā humuhumu i ke kaomi ma ka hopena o kāu esophagus, kahi e kōkua ai i ka pale ʻana i ka waikawa ʻōpū a me ka meaʻai e kahe ana mai ka ʻōpū i loko o ka esophagus.

Hana ʻia ka ʻokiʻoki ʻoiai ʻoe ma lalo o ka anesthesia ākea, no laila ke hiamoe nei ʻoe a ʻaʻohe ʻeha. Lawe pinepine ke ʻoki kino i 2 a 3 mau hola. Koho paha kāu kauka lāʻau mai nā ʻano hana like ʻole.

WEHE HOU

• E ʻokiʻoki kāu kaukipona i kahi ʻoki lāʻau nui i kou ʻōpū.
• Hoʻokomo ʻia kahi paipu i loko o kou ʻōpū ma o ka ʻōpū e paʻa ai ka paia o ka ʻōpū. E lawe ʻia aku kēia paipu ma kahi o hoʻokahi pule.

LAPAROSCOPIC REPAIR

• E ʻoki ana kāu kaukipoki i 3 a 5 mau ʻoki liʻiliʻi i kou ʻōpū. Hoʻokomo ʻia kahi ʻōmole lahilahi me kahi kāmela liʻiliʻi ma ka hopena ma o kekahi o kēia mau ʻoki.
• Hoʻokomo ʻia nā mea hana ʻokiʻoki ma o nā ʻoki ʻē aʻe. Pili ka laparoscope i kahi nānā wikiō i ka lumi hana.
• Hoʻoponopono kāu mea lapaʻau i ka nānā ʻana i loko o kou ʻōpū ma ka monitor.
• Pono paha ke kauka e kuapo i kahi hana hāmama i nā pilikia.

KA HUAKAI MAKAHIKI MAKAHIKI

• He hana hou kēia e hiki ke hana ʻia me ka ʻole o ka ʻoki ʻana. ʻO kahi kāmela kūikawā ma kahi mea hana maʻalahi (endoscope) i hoʻoili ʻia i loko o kou waha a i loko o kou esophagus.
• Ke hoʻohana nei i kēia mea hana, e hoʻokau ke kauka i nā kaha liʻiliʻi ma kahi e kū ai ka esophagus i ka ʻōpū. Kōkua kēia mau pakalōlō i ka pale ʻana i ka meaʻai a i ʻole ka waikawa ʻōpū.

Ma mua o ka noʻonoʻo ʻana i ke kaha, e hoʻāʻo kāu kauka olakino iā ʻoe:

• Nā lāʻau e like me H2 blockers a i ʻole PPI (proton pump pump)
• Hoʻololi ka nohona

ʻO ke ʻoki lāʻau e mālama ai i kou puʻuwai puʻuwai a i ʻole nā ​​hōʻailona reflux paha e koi ʻia i ka wā:

• ʻAʻole maikaʻi maikaʻi kāu mau ʻōuli ke hoʻohana ʻoe i nā lāʻau.
• ʻAʻole ʻoe makemake e hoʻomau i ka lawe ʻana i kēia mau lāʻau.
• Loaʻa iā ʻoe nā pilikia ʻoi aku ka nui i kāu esophagus, e like me ka scarring a i ʻole ka hoʻopili ʻana, ulcer, a i ʻole ke kahe ʻana o ke kahe.
• Loaʻa iā ʻoe ka maʻi reflux e hoʻokumu nei i ka pulumona aspiration, kahi maʻi kūmau, a me nā hoarseness.

Hoʻohana ʻia ke kīʻaha anti-reflux e mālama i kahi pilikia ma kahi o kou ʻōpū e paʻa nei i kou umauma a i wili ʻia paha. Kapa ʻia kēia he para-esophageal hernia.

Nā pilikia o kekahi anesthesia a me ke kahakaha ʻana ma:

• Nā hopena i nā lāʻau
• Nā pilikia hanu
• Kahe ʻana o ke kahe, ke koko, a i ʻole nā ​​maʻi

ʻO nā pilikia o kēia ʻoki kino:

• Hoʻopōʻino i ka ʻōpū, esophagus, ate, a i ʻole ka ʻōpū liʻiliʻi. Kākaʻikahi loa kēia.
• Pahu ʻōpala. ʻO kēia ka wā e hoʻopiha ai ka ʻōpū i ka ea a me ka meaʻai a ʻaʻole hiki iā ʻoe ke hoʻomaha i ke kaomi e ke kanu ʻana a i ʻole ka luaʻi. Hoʻonui mālie kēia mau ʻōuli no ka hapa nui o ka poʻe.
• Ka ʻeha a me ka paʻakikī ke moni ʻoe. Kapa ʻia kēia ʻo dysphagia. I ka hapa nui o nā poʻe, hele kēia i loko o nā mahina 3 mua ma hope o ke kaha ʻana.
• Hoʻi o ka hiatal hernia a i ʻole reflux.

Pono ʻoe i kēia mau hoʻāʻo:

• Nā hoʻāʻo koko (helu piha i ke koko, electrolytes, a i ʻole nā ​​hoʻāʻo ate).
• ʻO ka manometry esophageal (e ana i nā kaomi i ka esophagus) a i ʻole ka nānā ʻana ʻo pH (e ʻike i ka nui o ka waikawa ʻōpū e hoʻi mai nei i kāu esophagus).
• Palapala hope kiʻekiʻe. ʻAneʻane pau ka poʻe i loaʻa i kēia ʻoki anti-reflux i kēia hōʻike. Inā ʻaʻole i loaʻa kēia hōʻike iā ʻoe, pono ʻoe e hana.
• X-kukuna o ka esophagus.

E haʻi mau i kāu mea hāʻawi inā:

• Hiki iā ʻoe ke hāpai.
• Ke lawe nei ʻoe i nā lāʻau, a i ʻole nā ​​mea hoʻopihapiha a me nā mea kanu āu i kūʻai ai me ka ʻole o ka lāʻau.

Ma mua o kou ʻoki kino:

• Pono paha ʻoe e haʻalele i ka lawe ʻana i ka aspirin, ibuprofen (Advil, Motrin), wikamina E, clopidogrel (Plavix), warfarin (Coumadin), a me nā lāʻau ʻē aʻe a i ʻole nā ​​mea hoʻopihapiha e hoʻopili ai i ke kāpili ʻana o ke koko i kekahi mau lā ma mua o ke ʻoki ʻana. E noi i kāu kaukukō i kāu mea e hana ai.
• E nīnau i kāu mea hāʻawi i nā lāʻau e pono ai e lawe i ka lā o kou ʻoki ʻana.

I ka lā o kou ʻoki kino:

• E hāhai i nā ʻōlelo aʻoaʻo a kāu mea hoʻolako e pili ana i ka manawa e hōʻoki ai i ka ʻai ʻana a me ka inu ʻana.
• E lawe i nā lāʻau a kāu kauka i haʻi aku ai iā ʻoe e lawe me kahi wahi wai ʻuʻuku.
• E hāhai i nā ʻōkuhi no ka ʻauʻau ʻana ma mua o ke kaha ʻana.

E haʻi aku kāu mea lawelawe iā ʻoe i ka wā e hōʻea ai i ka haukapila. E hōʻea pono i ka manawa.

ʻO ka hapa nui o ka poʻe i loaʻa i ka ʻoki laparoscopic hiki ke haʻalele i ka haukapila ma waena o 1 a 3 mau lā ma hope o ke kaʻina hana. Pono ʻoe i kahi noho haukapila o 2 a 6 mau lā inā he ʻoki ākea kāu. Hiki i ka hapa nui o ka poʻe ke hoʻi i nā hana maʻamau i 4 a 6 mau pule.

Pono e hoʻomaikaʻi i ka ʻāʻī a me nā ʻōuli ʻē aʻe ma hope o ke kaha ʻana. Pono kekahi mau kānaka e inu i nā lāʻau no ka puʻuwai ma hope o ka ʻoki ʻana.

Pono paha ʻoe i kahi ʻoki hou i ka wā e hiki mai ana inā e hoʻomohala ʻoe i nā hōʻailona reflux hou a i ʻole ka ale ʻana i nā pilikia. Hiki paha kēia inā ua ʻōwili ʻia ka ʻōpū a puni ka esophagus, paʻa loa ka wahī, a ulu paha kahi hernia hiatal hou.

Fundoplication; Nissen waihona kālā; Belsey (Mark IV) waihona kālā; Pūnaewele funduplication; Thal waihona kālā; Hoʻomaikaʻi hou ʻo Hiatal hernia; Endoluminal waihona kālā; Reflux Gastroesophageal - ke kahakaha; GERD - ʻoki kino; Reflux - ʻoki kino; Hānnia hernia - ʻoki kino

• ʻOki kino Anti-reflux - hoʻokuʻu
• Reflux Gastroesophageal - hoʻokuʻu
• Heartburn - he aha e nīnau aku ai i kāu kauka
• Mālama ʻeha ʻeha - wehe

• Hoʻoponopono ʻo hernia hernia - moʻo
• Hānnia hernia - x-ray

Katz PO, Gerson LB, Vela MF. Nā ʻōkuhi no ka ʻike a me ka mālama ʻana i ka maʻi reflux gastroesophageal. ʻO Am J Gastroenterol. 2013; 108 (3): 308-328. PMID: 23419381 www.ncbi.nlm.nih.gov/pubmed/23419381.

Mazer LM, Azagury DE. Hoʻoponopono ʻoki kino o ka maʻi reflux gastroesophageal. I: Cameron AM, Cameron JL, eds. ʻO ke kaʻoki lāʻau lapaʻau o kēia manawa. 13th ed. Piladelapia, PA: Elsevier; 2020: 8-15.

Richter JE, Friedenberg FK. ʻO ka maʻi reflux Gastroesophageal. I: Feldman M, Friedman LS, Brandt LJ, eds. ʻO Sleisenger a me Fordtran's Gastrointestinal a me ka maʻi Liver: Pathophysiology / Diagnosis / Management. 10 o ka lā. Piladelapia, PA: Elsevier Saunders; 2016: chap 44.

ʻO Yates RB, ʻOelschlager BK, Pellegrini CA. ʻO ka maʻi reflux Gastroesophageal a me ka hernia hernia. I: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. ʻO Sabiston Textbook of Surgery. 20 ouk. Piladelapia, PA: Elsevier; 2017: chap 42.