Kab mob qog noj ntshav hauv plab muaj feem ntau tshaj plaws ntawm cov qog nqaij hlav hauv txoj hnyuv thoob ntiaj teb. Txawm li cas los xij, nws yog ib qho mob uas tiv thaiv tau thiab kho tau. Los ntawm kev ua neej noj qab haus huv, mus kuaj mob tsis tu ncua, thiab nrhiav kev kuaj mob thiab kho mob thaum ntxov, peb tuaj yeem tawm tsam tus kab mob no tau zoo. Cia peb tam sim no muab cov lus qhia meej rau koj txog cuaj lo lus nug tseem ceeb los pab koj nkag siab zoo dua txog kab mob qog noj ntshav hauv plab.
1. Mob qog noj ntshav hauv plab puas txawv ntawm haiv neeg, cheeb tsam, thiab hnub nyoog?
Raws li cov ntaub ntawv mob qog noj ntshav thoob ntiaj teb tshiab xyoo 2020, Tuam Tshoj tau tshaj tawm txog li 4.57 lab tus neeg mob qog noj ntshav tshiab, nrog rau mob qog noj ntshav hauv plab suav nrogkwv yees li ntawm 480,000 rooj plaub, lossis 10.8%, qeb duas ntawm peb sab saum toj.Kab mob qog noj ntshav hauv plab qhia tau tias muaj ntau yam sib txawv ntawm haiv neeg thiab thaj chaw. Thaj chaw Es Xias sab hnub tuaj yog thaj chaw muaj kev pheej hmoo siab rau kab mob qog noj ntshav hauv plab, nrog rau Tuam Tshoj, Nyiv Pooj, thiab Kaus Lim Qab Teb suav txog li 70% ntawm tag nrho cov neeg mob thoob ntiaj teb. Qhov no yog vim muaj tej yam xws li kev xeeb tub, kev noj zaub mov ci thiab pickled, thiab kev haus luam yeeb ntau hauv thaj chaw. Hauv Suav teb, kab mob qog noj ntshav hauv plab feem ntau tshwm sim hauv cov cheeb tsam ntug dej hiav txwv uas muaj zaub mov ntsev ntau, nrog rau nruab nrab thiab qis dua ntawm tus dej Yangtze thiab thaj chaw txom nyem.
Hais txog hnub nyoog, qhov nruab nrab ntawm cov neeg mob qog noj ntshav hauv plab yog nyob nruab nrab ntawm 55 thiab 60 xyoo. Tau kaum xyoo dhau los, tus nqi ntawm cov neeg mob qog noj ntshav hauv plab hauv Suav teb tseem ruaj khov, nrog rau kev nce me ntsis. Txawm li cas los xij, tus nqi ntawm kev tshwm sim ntawm cov tub ntxhais hluas tau nce siab dua, dhau qhov nruab nrab hauv tebchaws. Tsis tas li ntawd, cov neeg mob no feem ntau raug kuaj pom tias yog mob qog noj ntshav hauv plab uas sib kis, uas ua rau muaj kev cov nyom rau kev kho mob.
2. Mob qog noj ntshav hauv plab puas muaj cov qhov txhab ua ntej mob qog noj ntshav? Cov tsos mob tseem ceeb yog dab tsi?
Cov polyps hauv plab, mob gastritis atrophic chronic, thiab mob plab seem yog cov yam ua rau muaj mob qog noj ntshav hauv plab.Kev loj hlob ntawm mob qog noj ntshav hauv plab yog ntau yam, ntau theem, thiab ntau theem txheej txheem.Thaum pib mob qog noj ntshav hauv plab,cov neeg mob feem ntau tsis pom cov tsos mob pom tseeb, lossis lawv tsuas yog hnov mob me ntsis hauv plab sab saud,mob plab sab saud uas tsis zoo li qub, tsis xav noj mov, o, ntuav, thiab qee zaum, quav dub lossis ntuav ntshav. Thaum cov tsos mob tshwm sim ntau dua,qhia txog theem nruab nrab mus rau theem siab ntawm mob qog noj ntshav hauv plab, cov neeg mob yuav muaj qhov hnyav poob yam tsis paub meej, ntshav tsis txaus,hypoalbuminemia (cov protein tsawg hauv cov ntshav), o,mob plab tas li, ntuav ntshav, thiabcov quav dub, ntawm lwm tus.
3. Yuav ua li cas thiaj nrhiav tau cov neeg uas muaj feem yuav mob qog noj ntshav hauv plab thaum ntxov?
Keeb kwm tsev neeg ntawm cov qog nqaij hlav: Yog tias muaj cov qog nqaij hlav hauv lub plab lossis lwm yam qog nqaij hlav hauv ob lossis peb tiam neeg ntawm cov txheeb ze, qhov muaj feem yuav mob qog nqaij hlav hauv plab ntau dua. Txoj hauv kev pom zoo yog kom kuaj mob qog nqaij hlav tsawg kawg 10-15 xyoo ua ntej hnub nyoog yau tshaj plaws ntawm ib tus tswv cuab hauv tsev neeg uas muaj mob qog nqaij hlav. Rau mob qog nqaij hlav hauv plab, yuav tsum tau kuaj gastroscopy txhua peb xyoos, raws li tus kws kho mob qhia. Piv txwv li, yog tias hnub nyoog yau tshaj plaws ntawm ib tus tswv cuab hauv tsev neeg uas muaj mob qog nqaij hlav yog 55 xyoo, thawj qhov kev kuaj 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 khoom noj kub, cov khoom qab zib, thiab cov khoom ci, thiab noj cov khoom qab ntsev ntau yuav tsum hloov kho cov cwj pwm tsis zoo no sai li sai tau, vim tias lawv tuaj yeem ua rau lub plab puas tsuaj loj heev.
Cov neeg mob uas muaj mob qog hauv plab, mob plab hnyuv ntev ntev, thiab lwm yam kab mob hauv plab yuav tsum nrhiav kev kho mob kom tiv thaiv kev loj hlob ntawm tus kab mob thiab mus kuaj mob tsis tu ncua ntawm tsev kho mob.
4. Mob plab zom mov tsis zoo thiab mob qog hauv plab puas tuaj yeem ua rau mob qog noj ntshav hauv plab?
Qee cov kab mob hauv plab yog cov yam ua rau muaj mob qog noj ntshav hauv plab thiab yuav tsum tau saib xyuas kom zoo. Txawm li cas los xij, kev muaj mob qog noj ntshav hauv plab tsis tas txhais tau tias ib tus neeg yuav muaj mob qog noj ntshav hauv plab. Cov kab mob qog noj ntshav hauv plab yog qhov muaj feem cuam tshuam nrog kev pheej hmoo ntawm kev mob qog noj ntshav. Mob qog noj ntshav ntev thiab hnyav, tshwj xeeb tshaj yog tias nws qhia txog cov cim ntawm atrophy, plab hnyuv metaplasia, lossis atypical hyperplasia, yuav tsum tau saib xyuas ze. Nws yog ib qho tseem ceeb kom tso tseg cov cwj pwm tsis zoo tam sim ntawd xws linres haus luam yeeb, txwv kev haus cawv, thiab tsis txhob noj cov khoom noj kib thiab cov khoom noj ntsev ntauTsis tas li ntawd xwb, nws raug qhia kom mus kuaj mob txhua xyoo nrog kws kho mob plab hnyuv kom paub txog qhov teeb meem tshwj xeeb thiab xav txog cov lus qhia xws li kev kuaj plab hnyuv lossis tshuaj.
5. Puas muaj kev sib raug zoo ntawm Helicobacter pylori thiab mob qog noj ntshav hauv plab?
Helicobacter pylori yog ib hom kab mob uas feem ntau pom muaj nyob rau hauv lub plab, thiab nws cuam tshuam nrog ib hom mob qog noj ntshav hauv plab. Yog tias ib tug neeg kuaj pom tias muaj Helicobacter pylori thiab kuj muaj cov kab mob plab ntev xws li mob plab hnyuv lossis mob qog hauv plab, lawv txoj kev pheej hmoo ntawm kev mob qog noj ntshav hauv plab yuav nce ntxiv. Kev nrhiav kev kho mob raws sijhawm yog qhov tseem ceeb heev rau cov xwm txheej zoo li no. Ntxiv nrog rau tus neeg mob uas tau txais kev kho mob, cov tswv cuab hauv tsev neeg kuj yuav tsum tau kuaj mob thiab xav txog kev kho mob sib xws yog tias tsim nyog.
6. Puas muaj lwm txoj kev xaiv uas tsis mob npaum li kev kuaj gastroscopy?
Tseeb tiag, kev ua gastroscopy yam tsis muaj kev ntsuas kom txo qhov mob tuaj yeem ua rau tsis xis nyob.Txawm li cas los xij, thaum nws los txog rau kev kuaj pom mob qog noj ntshav hauv plab theem thaum ntxov, gastroscopy tam sim no yog txoj hauv kev zoo tshaj plaws.Lwm txoj kev kuaj mob tej zaum yuav tsis pom muaj mob qog noj ntshav hauv plab thaum ntxov, uas tuaj yeem cuam tshuam loj heev rau txoj kev kho mob kom zoo.
Qhov zoo ntawm kev siv gastroscopy yog tias nws tso cai rau cov kws kho mob kom pom lub plab ncaj qha los ntawm kev ntxig ib lub raj nyias nyias, yoog tau los ntawm txoj hlab pas thiab siv lub koob yees duab me me zoo li lub koob yees duab. Qhov no ua rau lawv pom lub plab meej thiab tsis nco qab qee qhov kev hloov pauv me me. Cov cim qhia thaum ntxov ntawm mob qog noj ntshav hauv plab tuaj yeem tsis pom tseeb heev, zoo ib yam li ib daim me me ntawm peb txhais tes uas peb yuav tsis quav ntsej, tab sis tej zaum yuav muaj kev hloov pauv me ntsis ntawm cov xim ntawm daim ntaub hauv plab. Txawm hais tias CT scans thiab cov tshuaj contrast tuaj yeem txheeb xyuas qee qhov teeb meem loj dua ntawm lub plab, lawv yuav tsis ntes tau cov kev hloov pauv me me no. Yog li ntawd, rau cov neeg uas tau pom zoo kom ua gastroscopy, nws yog ib qho tseem ceeb kom tsis txhob yig.
7. Tus qauv kub rau kev kuaj mob qog noj ntshav hauv plab yog dab tsi?
Kev kuaj mob plab thiab kev kuaj mob qog nqaij hlav yog tus qauv kub rau kev kuaj mob qog nqaij hlav hauv plab. Qhov no muab kev kuaj mob zoo, tom qab ntawd yog kev txiav txim siab theem. Kev phais mob, kev kho mob hluav taws xob, kev siv tshuaj kho mob qog nqaij hlav, thiab kev saib xyuas txhawb nqa yog cov kev kho mob tseem ceeb rau qog nqaij hlav hauv plab. Kev phais mob yog kev kho mob tseem ceeb rau qog nqaij hlav hauv plab theem thaum ntxov, thiab kev kho mob ntau yam kev kawm tam sim no suav hais tias yog txoj hauv kev kho mob siab tshaj plaws rau qog nqaij hlav hauv plab. Raws li tus neeg mob lub cev, kev loj hlob ntawm tus kab mob, thiab lwm yam, pab pawg kws tshaj lij ntau yam kev kawm sib koom tes tsim ib txoj kev npaj kho mob rau tus neeg mob, uas yog qhov tsim nyog tshwj xeeb rau cov neeg mob uas muaj mob nyuaj. Yog tias qib thiab kev kuaj mob ntawm tus neeg mob meej, kev kho mob tuaj yeem ua tiav raws li cov lus qhia rau qog nqaij hlav hauv plab.
8. Yuav tsum nrhiav kev kho mob rau mob qog noj ntshav hauv plab li cas raws li kev tshawb fawb?
Kev kho mob tsis tu ncua yuav ua rau cov qog nqaij hlav loj hlob thiab ua rau muaj kev nyuaj rau kev kho mob tom qab. Kev kuaj mob thawj zaug thiab kev kho mob yog qhov tseem ceeb rau cov neeg mob uas muaj mob qog nqaij hlav hauv plab, yog li nws yog ib qho tseem ceeb uas yuav tsum nrhiav kev kho mob los ntawm lub chaw kho mob tshwj xeeb. Tom qab kev kuaj mob kom zoo, tus kws kho mob yuav soj ntsuam tus neeg mob tus mob thiab muab cov lus qhia txog kev 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 ntawd hnub no thiab phais tag kis. Lawv tsis tuaj yeem tos kab rau kev kuaj mob lossis rau lub txaj pw hauv tsev kho mob. Txawm li cas los xij, txhawm rau kom tau txais kev kho mob sai, kev mus rau cov tsev kho mob tsis tshwj xeeb thiab tsis yog kws tshaj lij rau kev kho mob tsis tu ncua tuaj yeem ua rau muaj kev pheej hmoo rau kev tswj hwm tus kab mob tom qab.
Thaum kuaj pom tias muaj mob qog noj ntshav hauv plab, feem ntau nws tau muaj nyob rau ib lub sijhawm. Tsuas yog tias tsis muaj teeb meem loj xws li lub qhov, los ntshav, lossis kev thaiv, tsis tas yuav txhawj xeeb tias kev ncua kev phais tam sim ntawd yuav ua rau mob qog noj ntshav loj hlob sai dua. Qhov tseeb, kev cia sijhawm txaus rau cov kws kho mob kom nkag siab txog tus neeg mob tus mob, ntsuas lawv lub cev ua haujlwm tau zoo, thiab tshuaj xyuas cov yam ntxwv ntawm mob qog noj ntshav yog qhov tseem ceeb rau kev kho mob zoo dua.
9. Peb yuav tsum xav li cas txog cov lus hais tias "ib feem peb ntawm cov neeg mob ntshai tuag"?
Cov lus no yog hais ntau dhau lawm. Qhov tseeb, mob qog noj ntshav tsis yog qhov txaus ntshai li peb xav. Muaj ntau tus neeg nyob nrog mob qog noj ntshav thiab ua lub neej zoo siab. Tom qab kuaj pom tias muaj mob qog noj ntshav, nws yog ib qho tseem ceeb uas yuav tsum kho tus kheej lub siab thiab sib txuas lus zoo nrog cov neeg mob uas muaj kev cia siab. Rau cov tib neeg uas nyob rau theem rov zoo tom qab kev kho mob qog noj ntshav hauv plab, cov tswv cuab hauv tsev neeg thiab cov npoj yaig tsis tas yuav kho lawv zoo li cov neeg tsis muaj zog, txwv tsis pub lawv ua dab tsi. Txoj hauv kev no tuaj yeem ua rau cov neeg mob xav tias lawv tus nqi tsis tau lees paub.
Tus nqi kho mob qog noj ntshav hauv plab
Tus nqi kho mob qog noj ntshav hauv Suav teb yog kwv yees li 30%, uas tsis qis heev piv rau lwm hom qog noj ntshav. Rau qog noj ntshav hauv plab theem pib, tus nqi kho mob feem ntau yog li ntawm 80% txog 90%. Rau theem II, nws feem ntau yog li ntawm 70% txog 80%. Txawm li cas los xij, los ntawm theem III, uas suav tias yog theem siab heev, tus nqi kho mob poob qis mus rau li ntawm 30%, thiab rau theem IV, nws tsawg dua 10%.
Hais txog qhov chaw mob, mob qog nqaij hlav hauv plab distal muaj feem kho tau zoo dua li mob qog nqaij hlav proximal. Mob qog nqaij hlav hauv plab distal yog hais txog mob qog nqaij hlav uas nyob ze rau lub pylorus, thaum mob qog nqaij hlav proximal yog hais txog mob qog nqaij hlav uas nyob ze rau lub cardia lossis lub plab zom mov. Signet ring cell carcinoma nyuaj rau nrhiav pom dua thiab feem ntau kis mus rau lwm qhov, ua rau tus nqi kho mob qis dua.
Yog li ntawd, nws yog ib qho tseem ceeb heev uas yuav tsum tau ua tib zoo saib xyuas txhua qhov kev hloov pauv hauv lub cev, mus kuaj mob tsis tu ncua, thiab nrhiav kev kho mob sai sai yog tias muaj kev tsis xis nyob hauv plab. Yog tias tsim nyog, yuav tsum tau ua gastroscopy. Cov neeg mob uas tau kho mob endoscopic yav dhau los kuj yuav tsum tau teem sijhawm nrog tus kws kho mob plab thiab ua raws li cov lus qhia kho mob rau kev kuaj mob gastroscopy tsis tu ncua.
Lub sijhawm tshaj tawm: Lub Yim Hli-10-2023