Esikhathini esidlule , isilonda esiswini sangasese sasihlanganiswa kuphela nokuphazamiseka kokudla nokusetshenziswa kabi kotshwala, kuyilapho isici esiyinhloko esibangela lesi sifo yi-Helicobacter pylori bacterium. Ukuqeda ukwelashwa kuyisethi esimisiwe yamasu oklanyelwe ukubhubhisa le ncane yezinyoni nokuqinisekisa ukusebenza okuvamile kwesistimu yokugaya.
I-Scheme yokuqeda ukwelapha i-Maastricht
Eziningana zezidingo zihanjiswa eziyinkimbinkimbi zokwelapha:
- umnotho;
- ukugcinwa kokuqedwa ezingeni eliphezulu;
- lula nokulula;
- ukungabi khona kwethonya lamagciwane omelana nemibandela yezokwelapha;
- inombolo ephansi yemiphumela emibi;
- ukutholakala komthelela ohlelweni lwezilonda.
Ukufeza lezi zinhloso, ama-scheme aqhubeka ethuthukiswa futhi ahlelwe ngokuvumelana nezinqumo ezithathwe kwi-International Medical Conferences zamaMaastricht.
Kuze kube manje, kunezinqubo ezintathu kanye ne-quadrotherapy, sizozicubungula ngokuningiliziwe.
Ukwelashwa kokukhipha izingxenye ezintathu uHelikobakter Pilori
Inqubo yesithathu inezinhlobo ezimbili: ngesisekelo samalungiselelo e-bismuth futhi ngesisekelo se-inhibitors yepompo ye-proton yama-parietal cells.
Esikhathini sokuqala, ukwelashwa kokuqedwa kwesilonda se-peptic kuhlanganisa:
- I-Bismuth (120 mg) njenge-subcitrate yama-colloidal noma i-gallate noma i-subalicylate.
- Tinidazole noma i-Metronidazole. Ukukhonza ngamunye ngu 250 mg.
- I-Tetracycline i-0.5 g kuphela.
Yonke imithi kufanele ithathwe izikhathi ezine ngosuku emithini ebonisiwe. Inkambo yokwelapha isonto eli-1.
Esikhathini sesibili, uhlelo lubukeka kanje:
- I-Omeprazole (20 mg) ne-Metronidazole (0.4 g izikhathi ezintathu ngosuku) kanye neminye imithi elwa namagciwane - Clarithromycin (250 mg kabili emahoreni angu-24).
- I-pantoprazole 0.04 g (40 mg) ne-Amoxicillin 1 g (1000 mg) izikhathi ezimbili ngosuku, no-Clarithromycin 0.5 g kanye nezikhathi ezingu-2 ngosuku.
I-proton pump inhibitors kufanele ithathwe izikhathi ezingu-2 njalo ngamahora angu-24.
Esikhathini esilandelayo, i-Pantoprazole ingashintshwa yi-Lanoprazole ngesilinganiso sika-30 mg kabili ngosuku.
Ubude be-therapy echazwe yizinsuku ezingu-7.
Kubalulekile ukuthi uqaphele ukuthi ukuqothula kusukela ku-80% kubhekwa njengempumelelo, nakuba lokhu akusho ukuthi ibhethri yabhujiswa ngokuphelele. Ngenxa yokusetshenziswa kwezidakamizwa zokulwa ne-antibacterial, inani lezinyunyana ezincane liyancishiswa ngokushesha futhi ngesikhathi sokuhlaziywa abangase bangabonisi. Ekupheleni kwenkambiso ikoloni izobuyiselwa futhi iklayenti yokwelashwa elilandelayo liyodingeka.
I-helicobacter pylori yezokwelapha zokuqeda izingxenye ezine
Uhlelo olubuzwayo lunikezwe uma kwenzeka imiphumela engaphumeleli ngemuva kokwelashwa kwamakhemikhali amathathu kokubili okuchazwe ngenhla. Kuhlanganisa imithi enjalo:
- Ukulungiswa kwe-bismuth kuyi-120 mg izikhathi ezine ngosuku.
- Inhlanganisela yama-antibiotics - iTetracycline (izikhathi ezine ngosuku 500 mg) nge-Metronidazole (250 mg izikhathi ezine emahoreni angu-24) noma i-Tinidazole (izikhathi ezine ngosuku 250 mg).
- I-proton pump inhibitor izidakamizwa (enye yezintathu) yi-Omeprazole (0.02 amagremu) noma i-Lansoprazole (0.03 amagremu) noma i-Pantoprazole (0.04 amagremu) kabili ngosuku.
Ubude besikhathi sokwelapha abudluli isonto elilodwa.
Uma ukhetha imithi yokulwa ne-antibacterial, kubalulekile ukucabangela ukumelana kwama-bacterium e-Helicobacter pylori kuma-agent anjalo. Kuyaziwa ukuthi ama-microorganisms amancane awaphikisana no-Amocycillin no-Tetracycline. Kunezimo zokuthuthukiswa kokungajwayelekile okungajwayelekile kuClaithithromycin (cishe u-14%). I-immununity ephakeme ibonakala kuMetronidazole (cishe 55%).
Ucwaningo lwamuva lwezokwelapha luye lwabonisa ukuthi ukuze kuqedwe ngempumelelo kuphakanyiswa ukusebenzisa izidakamizwa ezintsha ze-antibiotic, isibonelo, uRifabutin neLevofloxacin. Ukuze kuphuthumise ukuphulukiswa kwezilonda emcimbini wesisu, kunconywa ukuba ukhethe ngokungeziwe ukuthi i-Sophalcon ne-Cetraxate.