Yav dhau los , gastric ulcer yog txuam nrog kev noj qab haus huv thiab haus cawv, thaum tseem ceeb tshaj plaws ua rau tus kab mob yog tus kab mob Helicobacter pylori. Eradication therapy yog ib txheej txheem ntawm cov tswv yim tsim los ua kom muaj kev tua kab tsuag thiab ua kom lub cev ua haujlwm ntawm lub plab zom mov.
Scheme ntawm kev kho kev puas siab puas ntsws Maastricht
Muaj ntau ntawm cov kev cai raug muab nthuav tawm rau cov txheej txheem kev kho mob:
- kev khwv nyiaj txiag;
- kev kho ntawm kev tshem tawm ntawm theem siab tas li;
- yooj yim thiab simplicity;
- tsis muaj kev tiv thaiv kab mob ntawm cov kab mob ntawm cov kab mob ntawm txoj kev kho;
- tsis tshua muaj pes tsawg tus phiv;
- lub xub ntiag ntawm ib qho kev cuam tshuam ntawm kev mob lub rwj.
Yuav ua kom tiav cov hom phiaj no, cov tswv yim tsim kho tau zoo dua thiab kho raws li cov kev txiav txim siab hauv International Medical Conferences of Maastricht.
Txog rau hnub tim, muaj peb qho kev tivthaiv thiab quadrotherapy, peb yuav xav txog lawv hauv ntau yam.
Kev tiv thaiv peb-tivthaiv Helikobakter Pilori
Tus txheej txheem peb lub hom phiaj yog ob hom: raws li kev npaj bismuth thiab ua rau lub hauv paus ntawm cov twj proton ntawm cov hlwb parietal.
Nyob rau hauv rooj plaub thawj zaug, txoj kev kho ntawm peptic eradication nrog rau:
- Bismuth (120 mg) ua ib qho colloidal subcitrate los yog gallate los yog subalicylate.
- Tinidazole lossis Metronidazole. Txhua qhov kev pab yog 250 mg.
- Tetracycline yog nruj me ntsis 0.5 g.
Tag nrho cov tshuaj yuav tsum tau noj 4 zaug ib hnub twg ntawm cov tshuaj noj. Txoj kev kho mob yog 1 lub lim tiam.
Nyob rau hauv rooj plaub thib ob, lub tswv yim zoo li no:
- Omeprazole (20 mg) nrog Metronidazole (0.4 g 3 zaug ib hnub) thiab lwm yam tshuaj tua kab mob - Clarithromycin (250 mg ob zaug hauv 24 teev).
- Pantoprazole 0.04 g (40mg) nrog Amoxicillin 1 g (1000 mg) 2 zaug ib hnub, thiab Clarithromycin 0.5 g zoo li 2 zaug ib hnub twg.
Proton twj yuav tsum muab 2 zaug txhua txhua 24 teev.
Nyob rau hauv rooj plaub tom kawg, Pantoprazole yuav hloov nrog Lanoprazole ntawm ntau npaum li ntawm 30 mg ob zaug ib hnub.
Lub sijhawm ntev li cov lus piav qhia yog 7 hnub.
Nws yog ib qho tseem ceeb uas yuav tsum nco ntsoov tias kev tshem tawm ntawm 80% yog qhov kev vam meej, tab sis qhov no tsis txhais tau tias cov kab mob puas tag. Vim yog siv cov tshuaj tua kab mob, cov kab mob kis tau sai thiab txo qis thiab thaum lub sij hawm kev ntsuam xyuas lawv tsis tuaj yeem pom. Thaum kawg ntawm qhov kev kawm no yuav rov qab kho dua tshiab thiab yuav tau kho tom ntej no.
Kev tiv thaiv plaub feem ntawm kev kho mob Helicobacter pylori
Lub tswvyim nug tau yog thaum muaj kev sib tw tsis tau tom qab peb txoj kev kho mob ntawm ob qho tib si ntawm hom kab sau saum toj no. Nws muaj cov tshuaj xws li:
- Kev npaj ntawm bismuth yog 120 mg 4 zaug ib hnub twg.
- Muab tshuaj tua kab mob - Tetracycline (4 zaug hauv ib hnub rau 500 mg) nrog Metronidazole (250 mg 4 zaug hauv 24 teev) lossis Tinidazole (4 zaug ib hnub rau 250 mg).
- Cov tshuaj tiv thaiv proton tshuaj (ib ntawm peb) yog Omeprazole (0.02 grams) los yog Lansoprazole (0.03 grams) lossis Pantoprazole (0.04 grams) ib hnub ob zaug.
Tag nrho ntev ntawm txoj kev kho yog tsis pub dhau 1 lub lim tiam.
Thaum xaiv cov tshuaj tua kab mob, nws tseem ceeb rau kev suav cov kab mob hu ua Helicobacter pylori cov kab mob rau cov neeg ua haujlwm no. Nws paub zoo tias cov kab mob me me tiv taus Amocycillin thiab Tetracycline. Muaj qee zaum muaj kev tiv thaiv tsis tshua muaj siab rau Clarithromycin (li 14%). Qhov kev tiv thaiv kab mob siab tshaj plaws yog pom rau Metronidazole (li 55%).
Cov kev tshawb xyuas kev kho mob tsis ntev los no tau pom tias kev ua kom tau zoo eradication nws yog ib qho tsim nyog siv cov tshuaj tua kab mob tshiab, piv txwv li, Rifabutin thiab Levofloxacin. Yuav kom accelerate qhov kho ntawm ulcers on qhov mucous saum npoo ntawm lub plab, nws yog pom zoo kom ntxiv rau Sophalcon thiab Cetraxate.