��θʳ�ܷ�� Barrett ʳ��̫��ʶ

z****y · �� 2016-7-7 20:40

��ע�ᣬ�ύ��ѣ��ø��๦�ܣ��ת��

��Ҫ��¼�ſ��ػ�鿴��û��ʺţ�ע��

x

�� 2008 ��̫��θʳ�ܷ��GORD��ʶ��ڸ��˺ܶ��µĿ�ѧ��չ��ʶ��Ҫ��ӱ��Ƽ��θʳ�ܷ�� Barrett ʳ�ܷ��о��չ��˸��¡�

��¼��ҽԺ�� Kwong Ming Fock ��Σ�� 3 ��ͬ��С��Ƽ��ݣ��ֱ��ǣ�1. ��ͷ��ϣ�2. ��ӱ��Ƽ��Է��3. Barrett ʳ�ܡ�

��ݺ��ָ��ίԱ��ͶƱ�ͻ��۵ķ��һ��ۣ��֧��֤�ݡ��ѭ�¶��ʶ��̽��У�� 70% Ϊ��ͬ��ֵ�� GRADE ��֤�ݵ��Ƽ��ǿ�Ƚ��з��ࡣ�ù�ʶ�� 2016 �� 6 �µ� Gut ��־�ϡ�

�ù�ʶ��Ҫָ��θʳ�ܷ��ķ��޳��ƣ��Է��Է��Ϊ��غͷ��Ҫԭ��ӱ��Ƽ��Է��Ϊ�� PPI ��ҩ��θʳ�ܷ��˾��·��ھ��ʳ�ܹ��ܼ��е�Ӧ�ü�ֵ��

�� Barrett ʳ�ܵĶ��޶��ڶ��ǿ��˲��θʳ�ܽ��С�ĳ��ȷ�ΧΪ 1 cm��ڳ��Ƥ��ٱ��Ҫ��ڹ�ʶ�л��Ƽ��ñ�׼��ھ��鱨��Լ��ȷ��Ĳ��簩��ھ��Ƶ�ѡ��

��ʶ��Ҫ��ݲ��ʴ��ʽ��£�

�� GORD ��

1. ��ȷ GORD �ķ��ʣ�

��֢״��ʾ��˽�֢״�� GORD �ķ��Լ��ھ��ʳ��׺� GORD ��ز��֢��ǿ��Բ��õ�ɸ�鷽��

2. ��̫��Ժͷ�� GORD �ķ��кθı䣿

��1��GORD �ķ��̫��2��Է��ʳ�� GORD ��Ҫ��ͣ��3��θʳ�ܷ��ߵĲ��̶�Ϊ��ȣ��ɼ�ּ� A ��ռ 50-90%��

3. ��̫�� GORD ��ʱ仯��ҪӰ��ʲô��

��Ⱥ�ͷ��Ⱥ�ı�� GORD ��ߵ��ݸ˾��Ⱦ��½�� GORD �ķ��ʲ��Ӱ�졣

4. �� GORD ��ߴ��ʳ��֢״�ı��ж�ߣ�

��һ��ȱ��Ӧ��֤ʵ��ʳ��ֵ��

5. �� Barrett ʳ�ܵ��ǻ��ھ��±��ּ��ɣ��Ҫ��ϣ�

Barrett ʳ�ܾ��±��Ϊʳ��Զ�˵�θճĤ��״��Ƥ��ʳ��ճĤ��״��Ƥ��ƣ��Ȼ��Ҫ��֯��̬ѧ��ϣ��ݲ��϶��Σ�ճ̶Ƚ��зּ��ڳ��Ƥ��ϵı�Ҫ��

6. �� Barrett ʳ�ܵķ��ʽ��

Barrett ʳ�ܵķ��Ҫ��ڽ��Ⱥ��ھ�ɸ��Ľ��Լ��Գ��֢״��Ⱥ�ļ�顣

7. ��ڴ��ڷ��Դ��ʹ��NCCP��Ļ��ߣ��Ƿ��Ҫ��ǰ��ھ��ʳ�� pH ��⣿

��ھ��ĵ��Ժ�ʳ�� pH ��Ӧ��ޣ�ʹ�� PPI ��ƶ��ڻ�� GORD ��صķ��Դ��ʹ��ʵ��е��Ʒ��

8. ��ڷ��Ժ��׵��Ƿ��Ե��ļ��

��ں��ʷ��֢��ϲ��ɿ��Ƽ��ϡ�

9. ��ʳ��ֵ� GORD ��壿

��Ⱥ��ڴ��ʳ��ֵ� GORD ��߲��÷��ޣ��Բ��Ƽ��ڳ��顣

�� GORD

1. ��޹�� GORD �Ķ��

�ڳ�� PPI �� 8 �ܷ��֢״��޻�� GORD ��Զ��Ϊ�� PPI ��ܵ�θʳ�ܷ��

2. �� GORD �ķ��Σ�

��޷��θʳ�ܷ��ж� PPI ��ܵ��Ϊ��

3. �� GORD ��ߵ�֢״��Ӱ��

�� GORD ��֢״��Ӱ�쵽��ߵ��˯�ߺ͹��

4. �� GORD ��߶� PPI ��ܵ�ԭ��ʲô��

�� GORD ��Ҫ��1��޷��Ч��θ��ڣ��2��ᣨ��ԣ��Ĵ��ڣ��3�� GORD Ӱ��صĴ��ڣ��θ��⡢��ϸ��ʳ��ס��ġ��볦�׼��ۺ��֢״��ص��ȣ��4��ԡ�

�� 1 ��Է��֢״��ϵĿ��

�� GORD ��	θ�ſ��ӳ١�ʳ�ܶ��ң�ʧ�ٻ��Է��֢��ۻ��ϸ��ʳ��׵�
��/��Է��	��ܴ��ƺ��е��ش��µ�θ��Է��ʳ��ѿ��
��Ч��	��ء��ҩ��ԡ�׿��ۺ��PPI ��ҩ��
��	��Լ��Ⱦ��»��߶�֢״��

5. ��ޣ��ʳ�� GORD ��ԭ��

��ޣ��ʳ��ײ�� GORD �ĳ��

6. �� GORD ��Ҫ��һ��Щ��飿

��ȷ��Ƿ��ڷ�ҩ��Ե�Ӱ��Խ��н�һ��ļ��Ը��õ��˽��صĲ��ѧ��ƣ��ڿ��飨��Ҫʱ��ϷŴ��ھ��Ⱦɫ�ھ��Լ� NBI �ھ��24 Сʱʳ�ܶ�̬ pH ��Լ�ʳ��ѹ��ⶨ��

7. �� PPI ��ҩ�� GORD ��ʹ��ʲôҩ��ƣ�

��֢״��Ļ��߶��ԣ�PPI ��ƻ��Կ�� PPI �ļ��߸��һ�� PPI ��ơ�Ҳ��Կ��ʹ�� PPI �� H2 ��׿��ν��ơ�

8. �� PPI ��ҩ�� GORD��Ƿ��һ�ֿ��ѡ��Ʒ�ʽ��

��ҩ��ʧ�ܶ��͹۴��θʳ�ܷ�� GORD ��߿��Կ��ѡ��ǻ��θ��۵��ơ�

9. ��ڹ��ƣ�

��ʹ�ð��࿹��ҩ��ѡ�� 5 ��ɫ��ȡ��Ƽ��ڵĿ��ҩ��ƣ��Ч��Ⱥ�в��һ�¡�

10. �� GORD ��ʽ�а��

��ڳ��ػ��ֵĻ��ߣ��֢״��ƣ��ȱ��ϵ�֧�֡�

11. ��ڴ��ڳ��ʳ��֢״�ġ�PPI ��Ч��ѵ� GORD ��ߣ��Ƿ��Ҫ�ڽ��ھ��̬ʳ�� pH ��ǰ��ȶԷ� GORD ��м�飿

��ڴ��ڼٶ�ʳ��֢״�Ļ��ߣ��ʹ�� PPI ��Ч��Ӧ��ڽ��ھ��Լ��ǰ��Ƚ��з� GORD ��صĲ��顣

�� GORD �Ĺ��·��

��¼/ע��ɿ��ͼ

ͼ 1 ʳ�ܹ��Լ��޵�� GORD ��·��

��¼/ע��ɿ��ͼ

ͼ 2 ��ʳ�ܹ��Լ�� GORD ��·��HRM Ϊ�߷ֱ��ʲ�ѹ��

�й� Barrett ʳ�ܣ�BO��

1. BO ��ϱ�׼��ʲô��

BO ��ϱ�׼��ʳ��Զ��״��Ƥ��״��Ƥ��ȡ��ò��ھ��θʳ�ܽ��紦�� 1 cm��Ҿ��ɲ��֯��̬ѧ��֤ʵ��

2. �� 6 �� BO ��޵ķ��Σ�

BO �ķ��̫��ʽ��ƣ��Ҵ��Ϊ�̽׶��͡�

3. ��ޣ�BO ��Σ��Щ��

BO ��Σ��岻ͬ��в��졣һ��䡢��ԡ��֢״��ʱ�䳤��ͷ��ֺ��Ϊ��Σ��ء�

4. ��ھ�� BO ��п͹۱�׼��淶�кμ�ֵ��

��ò�� C&M ��׼��ھ�� BO ��б�׼��淶��ˮƽ��׼ȷ�ԣ��ǿ�ھ��Ŷȣ�Ҳ��ٴ�ҽ��֮��໥��

5. BO ��߷�չΪʳ��ٰ��Σ��Щ��

��Ի��ߡ��ʷ��ͷ��֡��ˡ��Ŵ��ء��׶β��䡢��ڳ��Ƥ��ʹ��ڲ��

6. ��޽�� BO ɸ��壿

�� BO ��޷��ʽϵͣ��Խ��Ⱥ�н��ɸ��档

7. ��֤��ᳫ��ҩ��Ԥ�� BO ��

��֤��֤ʵ PPI Ӧ�ÿ��Խ�� BO ��չΪ��PPI Ӧ�õļ�ֵ��ڻ��֢״��ٽ�ճĤ��ϣ��Ԥ��

8. �ھ��¼�� BO ��չ��

��о�֤ʵ�ھ��¶��޲��ڵ� BO ��м��ʹ��߻��档

9. �Ƚ��ھ�� NBI խ��ھ�� BO ��ϲ��簩��

�Ƚ��ھ��ڸ��Ŀ��ԵĽ��л��ȡ��ʹ�û��Ϊ��ȷ��߲��ʡ��С�̶��ϣ��ھ��Ӧ��ʹ�ø߷ֱ��ʵ� NBI խ��⸨��׹��ھ��顣

10. ��ɸ��ƻ��У��ڵͼ�� BO ��Ӧ�ü��೤ʱ��һ��ھ��أ�

��Բ��ڲ��Ĳ��м�⣬Ӧ��ѭ��׼��̵��ھ��ǰ��£�ø 3��5 ��һ��ھ��鲢��л�졣

11. ��ϲ��еͼ�� BO ��ߣ�

��Ѿ��ȷ��ϵĴ��ڵͼ�� BO ��ߣ�Ӧ�ÿ��ǽ��м��һ��ơ�

ѡ��һ��ƵĻ��ھ��¿��ϲ��䷶Χ�ɿ��ھ��½��ճĤ�г��ԵĲ��ɿ��ǽ��Ƶ��

��ѡ��ÿ 6 ��½��һ�α�׼��ھ��顣

12. ��ڴ��ڸ߼�� BO ��ƣ�

�ھ��²��Ϊ��Եģ��ڸ߶Ȳ��ԭλ��ɿ��ǽ��ھ��ճĤ�г��

�� BO ��Ƽ��Ƶ��ƿɼ�⵽��δ��⵽��ͬʱ�Բ����Ԥ��ʱ�Բ��ķ�չ��Ϊ��ѡ��Ʒ��ϻ��Ƶ��ڣ��

�༭��ѵ

[�����]������θʳ�ܷ������� Barrett ʳ����̫��ʶ

����ע�ᣬ�ύ������ѣ����ø��๦�ܣ�����������ת������

[��]��θʳ�ܷ�� Barrett ʳ��̫��ʶ

��ע�ᣬ�ύ��ѣ��ø��๦�ܣ��ת��