Bệnh viêm loét bờ cong nhỏ dạ dày

Benh Viem loct

b6 cong nho da day e PGS.TS. BUI KHAC HAU

Da ddy la ndi chfla thfle an, nddc ufl'ng trUdc

khi xufl'ng rupt, trong do cfl th i ed ca vi

khudn, hda chd't, hfla ddpc, vi vdy, da ddy

rd't dl hi tan cflng, nlu sflc de khdng kem thi cfl thi

mac benh.

Lodt da ddy, ddng ldu y nhdt la lodt bd cong nho,

tiln mfln vi hodc mfln vi, bdi vi d cdc vi tri nay ty Id

bi ung thd hda cao hcfn rat nhilu so vdi cdc vi tri khac.

Vi 1^ do ndy md bdc si npi soi khuyen ngfldi benh

can dilu tri thdt tich cflc, nlu khflng se nguy hilm.

Ve nguygn nhdn, trddc ddy, thudng dUa theo gid

thuyet do than kinh, nhUng ngdy nay, benh viem loet

da ddy, trong dfl cd bd cong nhd cd thi do dung thufl'c

(corticoid, khdng viem khdng steroid,...), do chl do an

uing vd do vi khudn Helicobacter pylori (HP) chilm

ty le eao hdn ca (trgn 90%). Mflt sfl' ngUdi bgnh do

dung mflt sfl' loai thud'c de dieu tri benh roi loan tien

dinh (Tanganyl, Betasec,..) cung cfl thi ldm cho da

day ldm bgnh.

Mdt so ngfl&i an qua nhilu chat cay (dt, mu tat,.,.),

uong nhilu rUdu, hodc an qua chua, ne'u bi nhiem

thgm vi khuan HP thi rdt dl mac benh da day. Vi

khudn HP gdy bgnh da day dd dupc phdt Men tfl nam

1983, gdy bgnh da ddy chiem ty lg rdt cao vd nlu mac

benh da day do HP thi lay lan theo dddng dn uo'ng

md trong y hoc gpi Id dfldng phdn - midng. Cfl nghia

Id vi khudn gay benh d da ddy, theo phan ra ngoai,

ne'u quan ly phdn khflng tfl't, khdng dam bdo ve sinh

moi trddng, vd vg sinh an todn thdc phdm thi ngddi

lanh rdt de mdc bgnh.

Ngoai ra, cfl mflt so' ye'u t l thudn ldi khdc cung

cdn lflu y, quan tdm Id thfle khuya, bi nhieu tdc dflng

tam ly, edng thang than kinh lien tuc (stress), nlu

thfle dn, nflde ufl'ng bi nhiim vi khudn HP thi benh

cang dl xua't hidn.

Tri^u chflng diln hinh cua vidm loet b& cong nhd

Id dau thddng vi, cfl trfldng hdp dau lan len ca vung

xddng flc Idm cho ngfldi bdnh nham tfldng benh phoi

hoac benh tim mach. Dau cd the lan ra sau liflig.

Dau efl luc dm i nhdng cfl luc dfl dpi phai ngoi gap

ngddi mdi dd chut it. Luc mdi mac bgnh (viem) thi

thfl&ng an vdo dau (dau luc no) nhflng khi da loet

thi no ddi deu dau. Ngodi ra, eo the buon ndn, hodc

nfln. Khi vigm, loet bd cong nhd thi mua ndo cung

THUOC & SLfC KHOE so 509 (1.10.2014)

Ndi soi da diy de xie dinh ton thuang

dau, nhung thay dli thdi tig't dot ngflt, ve dem thi

cdn dau xua't hien hoac dau tdng hdn. Dau, met moi

lam cho ngddi bgnh khflng mud'n dn, hodc dn vao

ndn, da phdn la chdn an, mdt ngu triln mien cho

nen ngUdi gdy, da xanh, kem linh hoat, hay cdu gat,

lddi suy nghi vd thddng cfl mflt bp mdt huln (bfl mat

cua ngddi dau da day).

De chan doan vidm loet bd cong nhd cd thi chup

da ddy vdi thufl'c cd can quang luc ddi. Ngdy nay, ky

thuat ndi soi da day dUdc dp dung khd rdng rai. Tfl't

nhdt Id xdc dinh vi khudn HP bdng ky thuat sinh hpc

phdn tfl (PCR) tfl mdnh sinh thilt da ddy thdng qua

npi soi. Day Id mot ky thudt hign dai, cd dp chinh

xac rd't cao (gan 100%), hcfn nfla ne'u trong manh sinh

thie't (qua nfli soi da day) vi khuan it hoac tham chi

vi khudn dd chit van xdc dinh dddc.

Ne'u cfl mdc cdc benh vl khdp, hen suygn, rfl'i loan

tiln dinh, benh thgn thi cdn cho bdc si khdm bgnh

bilt de Ida chon thufl'c va trdnh dung cac thulc cfl

anh hddng dg'n da day.

Ngn dn chin, ud'ng chin, cdc dung cu dung trong

che big'n vd dn ud'ng can dfldc vfl trung (rfla sach

bang xd phdng, nhung vao nflde sdi,..), nhdm tranh

vi khudn HP rat dl Idy lan tfl ngfldi b^nh sang ngddi

lanh trong gia dinh. 1$