Barrett's Cawaaqibta Way adag tahay in la Ogaado
Astaamaha 'barrett' waa xaalad naadir ah taas oo xuubka hungurigu uu ku beddelay unugyada nooca mindhicirka. Beddelidda unugyada caadiga ah ee maskaxda ee caadiga ah waxaa loo maleynayaa inay dhacaan sababtoo ah soo-gaadhis raagay oo soo noqnoqda oo ku saabsan waxyaabaha la xajiyey ee gastrics-ka ee ka yimaada cudurka gawracatada 'gastroesophageal reflux (GERD). Maaddaama ay acidku waxyeello u geysato unugyada caadiga ah ee hungurigaaga, waxaad noqon kartaa mid u nugul inaad sii kordhiso nooc kale oo unugyo ah oo loo yaqaan ' epithelium column' .
Nooca unugyada noocan ah ayaa markii ugu horraysay lagu ogaadey borotiinka by Norman Barrett, dhakhtar Australian ah, 1950. Nafaqada Barrett waxay noqon kartaa mid hor leh ee kansarka uur-maskaxda oo aan lahayn calaamado kala duwan; Sidaa darteed way adag tahay in la ogaado. Maaddaama ay badanaa ku dhacdo bukaannada hore loo sheegay GERD, dhakhaatiirtu waxay ku talinayaan in shakhsiyaadka qaarkood laga helay GERD ay marin habaabin uurqaadis ah (EGD) si ay ugu soo bandhigaan cunaha Barrett.
Maqnaanshaha iyo baaritaanka Calaamadaha Barrett
Haddii aad qabto qandho jilicsan ugu yaraan hal mar asbuucii, waxaad ku taagan tahay 5% fursad ah inaad ku horumariso hunguriga Barrett. Si kastaba ha noqotee, tirada qandhada qoorta ah ee aad qabtid ma kordhinayso khatarta aad u leedahay barrett ee hunguriga. Calaamadaha barrett ee hunguriga ayaa kaliya lagu sameyn karaa endoscopy iyadoo la adeegsanayo habka aqoonsiga laba-tallaabo. Ugu horreyn, dhakhtarka qabatey endoscopy wuxuu go'aan ka gaari doonaa haddii uu jiro unugyo xasaasiyadeed oo dheeri ah qaybta hoose ee hoose ee hungurigaaga, oo u dhow caloosha.
Haddii la ogaado, tallaabada labaad waa in la qaado cad ka qaadista aagga si loo arko haddii unugyada ay calaamado muujiyaan in ay ka bedeleen hal unug oo nooc kale ah.
Inkasta oo cudurku uusan lahayn calaamado, qiyaastii 1% bukaanka qaba barrett ee hunguriga ayaa horumarinaya qaab khatar ah oo kansar naaso ah oo loo yaqaanno adenocarcinoma .
Sababtan awgeed, waa in lagugu ilaaliyaa dysplasia (isbeddel aan caadi ahayn ee unugyada kuwaas oo noqon kara hormoon u ah kansarka) iyada oo loo marayo endoscopy iyo dheecaan dheeraad ah oo dheecaan ah haddii lagugu ogaado cunaha Barrett.
Daweynta Barrett ee Calaamka
Haddii dysplasia lagu arko hungurigaaga, unugyada ayaa la burburin karaa iyada oo la adeegsanayo qalliin ama nidaamyo endoscopic. Hal daaweyn loogu talagalay barrett ee hunguriga ayaa loo yaqaan ' therodynamic therapy' (PDT) . Daaweyntu waxay isticmaashaa kiimiko la yiraahdo Photofrin, taas oo ka dhigaysa unug aad xasaasi u ah iftiinka. Laba iyo siddeed saacadood ka dib markii uu bukaan-socodka Fotofrin la siiyo bukaanka, dhakhtarku wuxuu ku dhejin karaa tuubo leysar ah (iyada oo loo maro endoscope ) xagga hunguriga iyo burburinta unugyada Barrett ee aan caadiga ahayn.
Barrx, hab kale oo lagu baabi'inayo dysplasia-da, waa la isticmaali karaa haddii dhakhtarkaaga uusan dareemin inaad tahay musharax qalliin oo wanaagsan. Farsamadani waxay isticmaashaa tuubo Barrx ah oo loo geliyo qulqulka endoscope waxaana ay u ogolaaneysaa in abuurta shucaaca ay ka mid tahay unugyada aan caadiga ahayn. Tani waa hab aan habooneyn oo aan qalliinka ahayn ee lagu burburinayo nudaha Barrett ee hungurigaaga.
Daaweeynta kale ee dysplasia ee Barrett ee hunguriga ayaa loo yaqaan ' endoscopic mucosal resection (EMR)' . EMR waxaa loo isticmaali karaa barrett ama hunguriga maskaxda.
Nidaamkan, walax waa la isku duraa oo hoosta ka soo duuduubtay nudaha Barrett ka hor inta aan laga qaadin dhamaadka baaritaanka. Haddii daaweynta loo isticmaalo kansarka maskaxda, kaliya lakabka sare ee unugyada ayaa laga saari doonaa. Sababtaas awgeed, waxaa loo isticmaali karaa oo kaliya kaliya xuubka daran ama kansarka marxaladda hore.
Shakhsiyaadka qaba dysplasia daran ama kansar badan oo caafimaad qaba oo ku filan si looga qaado suuxdinta guud, qaliinka ayaa ah doorka ugu horreeya ee daaweynta hunguriga Barrett ee leh dysplasia ama kansar heer sare ah. Qaar ka mid ah qalliinnada qaliinka waxaa loo isticmaalaa iyadoo ku xiran baahida qofka bukaanka ah iyo goobta burka.
Inkasta oo hunguriga Barrett uu yahay mid aad u dhif ah, haddana waxaa jira fursado aad u yar oo lagu kobcin karo kansarka maskaxda, adenocarcinoma ee hunguriga ayaa leh saameyn guud oo liita marka la ogaado heer heer sare ah. Sababtan awgeed, waxaa muhiim ah in haddii aad qabto GERD, waxaad qaadataa daryeel ku haboon daawooyinka anti-reflux sida Prilosec ama Dexilant . Haddii lagugu ogaado cunaha Barrett, hubso inaad hesho ENT ama dhakhtarka gaasta kaa caawiya sidii aad u maareyn lahayd dabagalkaaga iyo daaweyntaada.
> Isha
> Del Genio, G, Del Genio, F, Schettino, P, Limongelli, P, Tolone, S, Brusciano, L ... Docimo, L. (2015). Esophageal Papilloma: Abbaaska Cudurka Dabeecadda Cudurka ah ee loo yaqaan 'Endoscopic Ablation by Radiofrequency. World J Gafunkest Endosc. 7 (3): 290-4. doi: 10.4253 / wjge.v7.i3.290.
> Cudurka Shuban ee Diidmada Qaranka. Barrett ee "casiraad".
> Spechler, SJ & Souza, RF. (2016). Sleisenger iyo Fordtran ee Cudurka Gaagaaban iyo Cudurka beerka. 10 th ed. (Loo Baahan Yahay)