Mob qog noj ntshav plab muaj qhov tshwm sim ntau tshaj plaws ntawm tag nrho cov kab mob plab hnyuv thoob ntiaj teb.Txawm li cas los xij, nws yog ib qho kev tiv thaiv thiab kho tau.Los ntawm kev coj noj coj ua hauv kev noj qab haus huv, kev kuaj xyuas tsis tu ncua, thiab nrhiav kev kuaj mob ntxov thiab kho, peb tuaj yeem tiv thaiv tus kab mob no tau zoo.Cia peb tam sim no muab cov lus qhia meej rau koj txog cuaj nqe lus nug tseem ceeb los pab koj kom nkag siab txog mob qog noj ntshav plab.
1. Puas yog mob qog noj ntshav txawv ntawm haiv neeg, cheeb tsam, thiab hnub nyoog?
Raws li cov ntaub ntawv kho mob qog noj ntshav thoob ntiaj teb tshiab xyoo 2020, Tuam Tshoj tau tshaj tawm txog 4.57 lab tus neeg mob qog noj ntshav tshiab, nrog rau mob qog noj ntshav hauv plab.kwv yees li 480,000 tus neeg mob, lossis 10.8%, qeb ntawm peb sab saum toj.Mob qog noj ntshav qhia meej meej qhov txawv ntawm haiv neeg thiab cheeb tsam.Cov cheeb tsam East Asian yog thaj chaw muaj kev pheej hmoo siab rau mob qog noj ntshav, nrog Tuam Tshoj, Nyiv, thiab Kaus Lim Qab Teb suav txog li 70% ntawm tag nrho cov neeg mob thoob ntiaj teb.Qhov no yog vim muaj yam xws li caj ces predisposition, noj cov zaub mov grilled thiab pickled, thiab cov neeg haus luam yeeb siab hauv cheeb tsam.Hauv Suav teb av loj, mob qog noj ntshav tau tshwm sim nyob rau thaj tsam ntug dej hiav txwv nrog cov khoom noj ntsev ntau, nrog rau nruab nrab thiab qis qis ntawm tus dej Yangtze thiab cov cheeb tsam txom nyem.
Hais txog lub hnub nyoog, qhov nruab nrab qhov pib mob qog noj ntshav yog nyob nruab nrab ntawm 55 thiab 60 xyoo.Ntau xyoo dhau los, qhov tshwm sim ntawm mob qog noj ntshav hauv Suav teb tau nyob ruaj khov, nrog kev nce me ntsis.Txawm li cas los xij, qhov tshwm sim ntawm cov tub ntxhais hluas tau nce ntawm tus nqi nrawm dua, tshaj qhov nruab nrab hauv lub tebchaws.Tsis tas li ntawd, cov mob no feem ntau raug kuaj pom tias yog mob qog noj ntshav hauv plab, uas ua rau muaj teeb meem kev kho mob.
2. Puas yog mob qog noj ntshav puas muaj cov kab mob precancerous?Cov tsos mob tseem ceeb yog dab tsi?
Gastric polyps, mob atrophic gastritis, thiab lub plab seem yog qhov muaj feem pheej hmoo rau mob qog noj ntshav.Txoj kev loj hlob ntawm mob qog noj ntshav plab yog ib qho txheej txheem multifactorial, multilevel, thiab multistage txheej txheem.Nyob rau theem pib mob qog noj ntshav,Cov neeg mob feem ntau tsis pom cov tsos mob pom tseeb, lossis lawv tsuas yog muaj qhov tsis xis nyob hauv lub plab sab sauv,atypical mob plab plab, poob qab los noj mov, tsam plab, belching, thiab qee zaum, cov quav dub los yog ntuav ntshav.Thaum cov tsos mob tshwm sim ntau,qhia qhov nruab nrab mus rau theem siab ntawm mob qog noj ntshav, cov neeg mob tuaj yeem ua rau poob phaus tsis tau piav qhia, ntshav ntshav,hypoalbuminemia (cov protein tsawg hauv cov ntshav), edema,mob plab tas li, ntuav ntshav, thiabcov quav dub, ntawm lwm tus.
3. Yuav ua li cas thiaj kuaj tau cov neeg mob qog noj ntshav siab thaum ntxov?
Tsev neeg keeb kwm ntawm cov qog: Yog tias muaj cov qog nqaij hlav hauv plab lossis lwm cov qog hauv ob lossis peb tiam neeg ntawm cov txheeb ze, qhov yuav ua rau mob qog noj ntshav siab dua.Txoj hauv kev pom zoo yog mus kuaj mob qog nqaij hlav tsawg kawg 10-15 xyoo ua ntej tshaj hnub nyoog yau tshaj ntawm ib tsev neeg uas muaj mob qog noj ntshav.Rau mob qog noj ntshav plab, kev kuaj mob gastroscopy yuav tsum tau ua txhua peb xyoos, raws li kws kho mob qhia.Piv txwv li, yog tias hnub nyoog yau tshaj plaws ntawm cov neeg hauv tsev neeg uas muaj mob qog noj ntshav yog hnub nyoog 55 xyoo, thawj qhov kev kuaj mob gastroscopy yuav tsum tau ua thaum muaj hnub nyoog 40 xyoo.
Cov tib neeg uas muaj keeb kwm ntev ntawm kev haus luam yeeb, haus cawv, nyiam cov zaub mov kub, pickled, thiab grilled, thiab noj ntau cov zaub mov ntsev yuav tsum tau kho cov cwj pwm tsis zoo, vim lawv tuaj yeem ua rau lub plab puas tsuaj.
Cov neeg mob gastric ulcers, gastritis ntev, thiab lwm yam kab mob plab yuav tsum nquag nrhiav kev kho mob los tiv thaiv kev kis kab mob thiab mus kuaj xyuas hauv tsev kho mob tsis tu ncua.
4. Cov kab mob gastritis ntev thiab mob plab puas tuaj yeem ua rau mob qog noj ntshav?
Qee cov kab mob plab yog qhov ua rau mob qog noj ntshav siab thiab yuav tsum tau ua tib zoo saib xyuas.Txawm li cas los xij, muaj kab mob plab tsis tas txhais tau tias ib tus yuav tsim mob plab.Gastric ulcers qhia meej meej nrog kev pheej hmoo ntawm kev mob qog noj ntshav.Ntev mus ntev thiab mob hnyav heev, tshwj xeeb tshaj yog tias nws pom cov tsos mob ntawm atrophy, plab hnyuv metaplasia, lossis atypical hyperplasia, yuav tsum tau saib xyuas ze.Nws yog ib qho tseem ceeb kom tam sim txiav cov cwj pwm tsis zoo xws linres haus luam yeeb, txwv tsis pub haus cawv, thiab zam cov zaub mov kib thiab ntsev.Tsis tas li ntawd, nws raug nquahu kom kuaj xyuas txhua xyoo nrog tus kws kho mob plab hnyuv siab raum los ntsuas qhov xwm txheej tshwj xeeb thiab xav txog cov lus pom zoo xws li gastroscopy lossis tshuaj.
5. Puas muaj kev sib raug zoo ntawm Helicobacter pylori thiab mob qog noj ntshav?
Helicobacter pylori yog cov kab mob uas feem ntau pom nyob rau hauv lub plab, thiab nws muaj feem xyuam nrog qee yam mob qog noj ntshav hauv plab.Yog tias ib tug neeg kuaj tau tus kab mob Helicobacter pylori thiab tseem muaj cov kab mob hauv plab ntev xws li gastritis los yog mob plab, lawv txoj kev pheej hmoo ntawm kev mob qog noj ntshav hauv plab yuav nce ntxiv.Nrhiav kev kho mob raws sij hawm yog qhov tseem ceeb rau cov xwm txheej zoo li no.Ntxiv nrog rau cov neeg uas tau txais kev kho mob, cov neeg hauv tsev neeg yuav tsum tau kuaj xyuas thiab xav txog kev kho mob yog tias tsim nyog.
6. Puas muaj qhov mob tsawg dua rau kev kuaj mob plab?
Tseeb tiag, kev kuaj mob gastroscopy yam tsis muaj kev ntsuas mob tuaj yeem ua rau tsis xis nyob.Txawm li cas los xij, thaum nws los kuaj pom mob qog noj ntshav thaum ntxov, gastroscopy tam sim no yog txoj hauv kev zoo tshaj plaws.Lwm txoj kev kuaj mob yuav tsis pom mob qog noj ntshav thaum ntxov, uas tuaj yeem cuam tshuam rau txoj hauv kev ntawm kev kho mob zoo.
Qhov kom zoo dua ntawm gastroscopy yog tias nws tso cai rau cov kws kho mob kom pom lub plab ncaj qha los ntawm kev ntxig lub raj nyias nyias los ntawm txoj hlab pas thiab siv lub koob yees duab me me zoo li kev sojntsuam.Qhov no ua rau lawv muaj qhov pom tseeb ntawm lub plab thiab tsis nco cov kev hloov pauv hloov maj mam.Cov tsos mob thaum ntxov ntawm lub plab tuaj yeem hloov maj mam, zoo ib yam li ib thaj me me ntawm peb txhais tes uas peb yuav saib tsis taus, tab sis tej zaum yuav muaj kev hloov me ntsis ntawm cov xim ntawm lub plab.Thaum CT scans thiab cov neeg ua haujlwm sib txawv tuaj yeem txheeb xyuas qee qhov kev txawv txav hauv plab, lawv yuav tsis ntes cov kev hloov pauv hloov maj mam.Yog li ntawd, rau cov neeg uas tau pom zoo kom kuaj mob gastroscopy, nws yog ib qho tseem ceeb tsis txhob yig.
7. Dab tsi yog tus qauv kub rau kev kuaj mob qog noj ntshav?
Gastroscopy thiab pathological biopsy yog tus qauv kub rau kev kuaj mob plab.Qhov no muab ib qho kev kuaj mob zoo, ua raws li theem pib.Kev phais, kev kho hluav taws xob, tshuaj khomob, thiab kev txhawb nqa yog cov kev kho mob tseem ceeb rau mob qog noj ntshav.Kev phais yog thawj txoj kev kho mob rau cov mob qog noj ntshav thaum ntxov, thiab kev kho mob ntau yam tam sim no suav tias yog txoj hauv kev kho mob siab tshaj plaws rau mob qog noj ntshav.Raws li tus neeg mob lub cev lub cev, kev loj hlob ntawm tus kab mob, thiab lwm yam, ib pab pawg kws tshaj lij sib koom ua ke tsim cov phiaj xwm kho tus kheej rau tus neeg mob, tshwj xeeb tshaj yog tsim nyog rau cov neeg mob uas muaj teeb meem nyuaj.Yog tias qhov kev mob tshwm sim thiab kev kuaj mob ntawm tus neeg mob tau meej, kev kho mob tuaj yeem ua tau raws li cov lus qhia cuam tshuam rau mob qog noj ntshav plab.
8. Yuav ua li cas thiaj nrhiav tau kev kho mob rau mob qog noj ntshav ntawm lub plab raws li kev tshawb fawb?
Kev kho mob tsis tu ncua tuaj yeem txhawb kev loj hlob ntawm cov qog hlwb thiab ua rau muaj kev nyuaj ntawm kev kho mob tom ntej.Thawj qhov kev kuaj mob thiab kev kho mob yog qhov tseem ceeb rau cov neeg mob uas muaj mob qog noj ntshav, yog li nws yog ib qho tseem ceeb kom nrhiav kev kho mob los ntawm lub tuam tsev tshwj xeeb oncology.Tom qab kev ntsuam xyuas zoo, tus kws kho mob yuav ntsuas tus neeg mob tus mob thiab muab cov lus pom zoo kho mob, uas yuav tsum tau tham nrog tus neeg mob thiab lawv tsev neeg ua ntej txiav txim siab.Ntau tus neeg mob xav tias ntxhov siab thiab xav tau kev kuaj mob tam sim hnub no thiab kev phais tag kis.Lawv tos tsis tau rau hauv kab rau kev kuaj mob lossis mus pw hauv tsev kho mob.Txawm li cas los xij, txhawm rau kom tau txais kev kho mob sai, mus rau cov tsev kho mob uas tsis yog tshwj xeeb thiab tsis muaj kev paub txog kev kho mob tsis tu ncua tuaj yeem ua rau muaj kev pheej hmoo rau kev tswj hwm tus kab mob tom ntej.
Thaum kuaj pom mob qog noj ntshav, feem ntau nws muaj nyob rau qee lub sijhawm.Tshwj tsis yog tias muaj teeb meem loj xws li perforation, los ntshav, lossis kev cuam tshuam, tsis tas yuav txhawj xeeb tias ncua kev phais tam sim ntawd yuav ua rau cov qog nqaij hlav sai.Qhov tseeb, tso cai rau lub sijhawm txaus rau cov kws kho mob kom nkag siab zoo txog tus neeg mob tus mob, ntsuas lawv lub cev ntev, thiab tshuaj xyuas cov yam ntxwv ntawm cov qog yog qhov tseem ceeb rau kev kho mob zoo dua.
9. Peb yuav tsum saib cov lus hais tias “ib feem peb ntawm cov neeg mob ntshai tuag” li cas?
Cov lus no yog overly exaggerated.Qhov tseeb, mob qog noj ntshav tsis txaus ntshai li peb xav.Ntau tus neeg nyob nrog mob qog noj ntshav thiab ua rau lub neej ua tiav.Tom qab kuaj mob qog noj ntshav, nws yog ib qho tseem ceeb uas yuav tau kho ib tus neeg lub siab thiab koom nrog kev sib txuas lus zoo nrog cov neeg mob zoo.Rau cov tib neeg uas nyob rau theem rov qab los tom qab kev kho mob qog noj ntshav hauv plab, cov neeg hauv tsev neeg thiab cov npoj yaig yuav tsum tsis txhob ua rau lawv tsis yooj yim, txwv tsis pub lawv ua dab tsi.Txoj hauv kev no tuaj yeem ua rau cov neeg mob xav tias lawv tus nqi tsis raug lees paub.
Txoj kev kho mob ntawm plab hnyuv
Kev kho tus nqi kho mob plab hauv Suav teb yog kwv yees li 30%, uas tsis yog tshwj xeeb tsawg piv rau lwm hom mob qog noj ntshav.Rau kev mob qog noj ntshav thaum ntxov, qhov kev kho mob feem ntau yog nyob ib ncig ntawm 80% txog 90%.Rau theem II, nws yog feem ntau nyob ib ncig ntawm 70% mus rau 80%.Txawm li cas los xij, los ntawm theem III, uas suav tias yog qib siab, tus nqi kho tau poob mus rau ib puag ncig 30%, thiab rau theem IV, nws tsawg dua 10%.
Nyob rau hauv cov nqe lus ntawm qhov chaw, mob qog nqaij hlav plab distal muaj kev kho mob ntau dua piv rau cov mob qog nqaij hlav hauv plab.Distal mob qog noj ntshav yog hais txog mob qog noj ntshav nyob ze rau ntawm pylorus, thaum mob plab proximal yog hais txog mob qog noj ntshav nyob ze rau cardia lossis lub plab zom mov.Signet nplhaib cell carcinoma yog qhov nyuaj dua los kuaj xyuas thiab nyhav rau metastasize, ua rau txo qis tus nqi kho.
Yog li ntawd, nws yog ib qho tseem ceeb uas yuav tsum tau ua tib zoo saib xyuas txhua qhov kev hloov pauv hauv lub cev, mus ntsib kws kho mob tsis tu ncua, thiab nrhiav kev kho mob sai yog tias muaj kev mob plab tsis zoo.Yog tias tsim nyog, gastroscopy yuav tsum tau ua.Cov neeg mob uas tau txais kev kho mob endoscopic yav dhau los yuav tsum tau teem sij hawm mus ntsib kws kho mob tsis tu ncua thiab ua raws li cov lus qhia kho mob rau kev kuaj mob raws sij hawm.
Post lub sij hawm: Aug-10-2023