Ngā Mōhiotanga Whānui mō te Mate Pukupuku o te Esophagus
Ko te mate pukupuku korokoro he mate e puta ai ngā pūtau kino (matepukupuku) i roto i ngā kiko o te korokoro.
Ko te korokoro he ngongo kikokore, he uaua e neke ana i te kai me te wai mai i te korokoro ki te puku. He maha ngā paparanga kiko o te pakitara o te korokoro, tae atu ki te kiriuhi mucous (te arai o roto), te uaua, me te kiko honohono. Ka tīmata te mate pukupuku korokoro i te arai o roto o te korokoro, ā, ka horapa ki waho mā roto i ngā paparanga kē atu i a ia e tipu ana.
Ko ngā momo matepukupuku korokoro e rua e tino kitea ana, e whakaingoatia ana mō te momo pūtau ka huri hei mate kino (matepukupuku):
- Te mate pukupuku pūtau-pūtau:He mate pukupuku e puta mai ana i roto i ngā pūtau angiangi, papatahi e whakarārangi ana i te taha o roto o te korokoro. Ko te nuinga o te wā ka kitea tēnei mate pukupuku i te wāhanga o runga me waenganui o te korokoro engari ka puta pea i ngā wāhi katoa o te korokoro. Ka kiia hoki tēnei ko te mate pukupuku epidermoid.
- Te mate pukupuku adenoma:Ko te mate pukupuku e tīmata ana i roto i ngā pūtau repe. Ko ngā pūtau repe i roto i te arai o te korokoro ka whakaputa me te tuku i ngā wai pērā i te hūpē. Ko te Adenocarcinoma ka tīmata i te wāhanga o raro o te korokoro, e tata ana ki te puku.
He nui ake te kitea o te mate pukupuku korokoro i roto i ngā tāne.
E toru ngā wā ka nui ake te tūponotanga o te pāngia o ngā tāne e te mate pukupuku korokoro i ngā wāhine. Ka piki ake te tūponotanga o te pāngia e te mate pukupuku korokoro i te pakeketanga. He nui ake te kitea o te mate pukupuku pūtau-pūtau o te korokoro i roto i ngā tāngata mangu i ngā tāngata mā.
Te Ārai i te Mate Pukupuku o te Esophagus
Mā te karo i ngā āhuatanga mōrearea me te whakanui ake i ngā āhuatanga tiaki ka āwhina pea ki te ārai i te mate pukupuku.
Mā te karo i ngā āhuatanga mōrearea o te mate pukupuku ka āwhina pea ki te ārai i ētahi mate pukupuku. Ko ngā āhuatanga mōrearea ko te momi hikareti, te taumaha rawa, me te kore e nui te whakakori tinana. Mā te whakanui ake i ngā āhuatanga tiaki pērā i te whakamutu momi hikareti me te whakakori tinana ka āwhina pea ki te ārai i ētahi mate pukupuku. Kōrero ki tō tākuta, ki tētahi atu tohunga hauora rānei mō te whakaiti i tō mōrearea ki te mate pukupuku.
Kāore i te ōrite ngā āhuatanga mōrearea me ngā āhuatanga tiaki mō te mate pukupuku pūtau squamous o te esophagus me te adenocarcinoma o te esophagus.
Ko ngā āhuatanga mōrearea e whai ake nei ka whakanui ake i te mōrearea o te mate pukupuku pūtau squamous o te esophagus:
1. Te momi hikareti me te inu waipiro
Kua whakaatuhia e ngā rangahau ka piki ake te mōrearea o te mate pukupuku pūtau squamous o te esophagus i roto i te hunga e momi hikareti ana, e inu nui ana rānei.
Mā ēnei āhuatanga tiaki e whai ake nei ka whakaiti i te mōrearea o te mate pukupuku pūtau-pūtau o te korokoro:
1. Te karo i te kai tupeka me te waipiro
Kua whakaatuhia e ngā rangahau he iti ake te mōrearea o te mate pukupuku pūtau squamous o te korokoro i roto i te hunga kāore e whakamahi tupeka, e whakamahi waipiro rānei.
2. Te ārai i te mate pukupuku me ngā rongoā anti-mumura kore-steroidal
Ko te ārai matepukupuku ko te whakamahinga o ngā rongoā, ngā huaora, ētahi atu rongoā rānei hei whakaiti i te mōrearea o te mate pukupuku. Kei roto i ngā rongoā anti-inflammatory kore-steroidal (NSAID) te aspirin me ētahi atu rongoā hei whakaiti i te pupuhi me te mamae.
Kua whakaatuhia e ētahi rangahau mā te whakamahi i ngā NSAID ka whakaiti i te mōrearea o te mate pukupuku pūtau squamous o te korokoro. Heoi, mā te whakamahi i ngā NSAID ka piki ake te mōrearea o te mate ngakau, te ngoikore o te ngakau, te whiu, te toto i roto i te puku me ngā whekau, me te kino o te whatukuhu.
Ko ngā āhuatanga mōrearea e whai ake nei ka whakanui ake i te mōrearea o te adenocarcinoma o te esophagus:
1. Te rerenga puku
He hononga kaha te adenocarcinoma o te esophagus ki te mate reflux gastroesophageal (GERD), inā koa ka roa te GERD, ā, ka puta ngā tohu kino i ia rā. Ko te GERD he āhuatanga e rere ana ngā ihirangi o te puku, tae atu ki te waikawa o te puku, ki te wāhanga o raro o te esophagus. Ka whakapataritari tēnei i te roto o te esophagus, ā, i roto i te wā, ka pā pea ki ngā pūtau e whakarārangi ana i te wāhanga o raro o te esophagus. Ka kiia tēnei āhuatanga ko te Barrett esophagus. I roto i te wā, ka whakakapia ngā pūtau e pāngia ana e ngā pūtau rerekē, ā, ka huri pea hei adenocarcinoma o te esophagus i muri mai. Ko te momona me te GERD ka piki ake te mōrearea o te adenocarcinoma o te esophagus.
Mā te whakamahi i ngā rongoā e whakangāwari ana i te uaua o raro o te esophagus ka piki ake te tūponotanga o te whakawhanake i te GERD. Ina whakangāwaritia te uaua o raro o te esophagus, ka rere pea te waikawa o te puku ki te wāhanga o raro o te esophagus.
Kāore i te mōhiotia mēnā ka whakaitihia te mōrearea o te adenocarcinoma o te esophagus e te pokanga, e ētahi atu maimoatanga hauora rānei hei aukati i te reflux puku. Kei te whakahaerehia ngā whakamātautau haumanu hei tirotiro mēnā ka taea e te pokanga, e ngā maimoatanga hauora rānei te aukati i te Barrett esophagus.
Mā ēnei āhuatanga tiaki e whai ake nei ka whakaiti i te mōrearea o te adenocarcinoma o te esophagus:
1. Te ārai i te mate pukupuku me ngā rongoā anti-mumura kore-steroidal
Ko te ārai matepukupuku ko te whakamahinga o ngā rongoā, ngā huaora, ētahi atu rongoā rānei hei whakaiti i te mōrearea o te mate pukupuku. Kei roto i ngā rongoā anti-inflammatory kore-steroidal (NSAID) te aspirin me ētahi atu rongoā hei whakaiti i te pupuhi me te mamae.
Kua whakaatuhia e ētahi rangahau mā te whakamahi i ngā NSAID ka whakaiti i te mōrearea o te adenocarcinoma o te esophagus. Heoi, mā te whakamahi i ngā NSAID ka piki ake te mōrearea o te mate ngakau, te ngoikore o te ngakau, te whiu, te toto i roto i te puku me ngā whekau, me te kino o te whatukuhu.
2. Te tango i te auau irirangi o te korokoro
Ko ngā tūroro e pangia ana e te Barrett esophagus he pūtau rerekē kei te taha raro o te esophagus ka taea te rongoā mā te radiofrequency ablation. Ka whakamahia e tēnei tikanga ngā ngaru reo irirangi hei whakamahana me te whakangaro i ngā pūtau rerekē, ka huri pea hei mate pukupuku. Ko ngā mōrearea o te whakamahi i te radiofrequency ablation ko te whaiti o te esophagus me te toto i roto i te esophagus, te puku, te whekau rānei.
I roto i tētahi rangahau mō ngā tūroro he Barrett esophagus me ngā pūtau rerekē i roto i te esophagus, i whakaritea ngā tūroro i whiwhi i te radiofrequency ablation ki ngā tūroro kāore. Ko ngā tūroro i whiwhi i te radiofrequency ablation he iti ake te tūponotanga kia kitea he mate pukupuku esophageal ngā tūroro i whiwhi i te radiofrequency ablation. Me nui ake ngā rangahau hei mōhio mēnā ka whakaitihia e te radiofrequency ablation te mōrearea o te adenocarcinoma o te esophagus i roto i ngā tūroro e pāngia ana e ēnei āhuatanga.
Wā tuku: Hepetema-04-2023