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消化性溃疡

ID: ANH11057chis
医学动画文字记录:消化性溃疡是指发生在食管下部或胃或小肠的任何部位的溃疡。发生在食管的消化性溃疡称为食管溃疡。发生在胃的溃疡称为胃溃疡。当溃疡发生在小肠的起始部分,也就是十二指肠时,称为十二指肠溃疡。当你吃东西的时候,胃会产生高酸性的消化液,也就是胃酸,来帮助分解食物。然后,食物进入十二指肠进行进一步的消化,再被血液吸收。胃和十二指肠的内壁上覆盖着一层黏膜以保护器官免受胃酸的腐蚀。当保护性黏膜层被破坏时,胃酸就会渗入胃或十二指肠,导致溃疡。大多数消化性溃疡是由幽门螺杆菌引起的。科学家认为,这些细菌可能通过被污染的食物或水或与感染者密切接触而进入人体内。一旦进入体内,它们就会停留在胃或十二指肠的黏膜层。随着细菌的生长,它们会破坏黏膜层,胃酸就会渗入到胃或十二指肠内壁。细菌和胃酸一起导致溃疡。一些消化性溃疡与大量使用非甾体抗炎药有关,包括阿司匹林和布洛芬。这些药物会降低胃和十二指肠保护自身免受胃酸破坏的能力。医生可能会给你开一种或多种药物来治疗消化性溃疡。如果溃疡是由幽门螺杆菌引起的,可以服用抗生素来杀死细菌。如果溃疡是由非甾体抗炎药引起的,医生会建议你停止或限制使用这些药物。对于胃溃疡,可以服用质子泵抑制剂(PPI),以减少胃酸的分泌。对于十二指肠溃疡,可以服用2型组胺受体阻滞剂,通常被称为H2受体阻滞剂,以减少胃酸的分泌。此外,医生可能会建议使用药物来覆盖和保护胃和十二指肠内壁,直到溃疡愈合。这些药物包括硫糖盐、米索前列醇和亚水杨酸铋(俗称Pepto Bismol)。以下情况需要手术治疗:药物不能治愈的溃疡、复发性溃疡、溃疡出血、溃疡穿破胃壁或十二指肠(溃疡穿孔)、溃疡阻碍食物从胃排出(幽门梗阻)。如果你有一种或多种这样的并发症,医生可能会建议以下三种手术方法之一——迷走神经切断术、胃窦切除术或幽门成形术。在迷走神经切开术中,医生会切除一部分迷走神经。迷走神经可通过大脑调节胃酸分泌。切断神经后,胃酸分泌会减少。在胃窦切除术中,医生会切除胃的下部,也就是胃窦。胃窦可向胃发出分泌胃酸的信号。一旦被切除,胃酸分泌就会减少。如果溃疡阻碍了食物从胃的出口排出,医生可能会做幽门成形术。在手术中,医生会扩大幽门,也就是胃和十二指肠之间的开口,让食物更容易通过。治疗溃疡的过程中,你应该避免饮酒和吸烟,因为它们会减缓愈合过程,并可能使溃疡恶化。治疗几周后,医生可能会给你做内镜检查,该检查通过探查上消化道以明确溃疡是否已经治愈。

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