Iimpawu zokuqala zomhlaza esophageal. umhlaza Esophageal: eyokuqala imiqondiso, unyango, abantu abane

umhlaza esophageal kuluhlu sezifo iqhelekileyo owesixhenxe. Kungenxa yoko le nto kweli nqaku ufuna sihlolisise kwesi sifo. Ngaloo ndlela, injongo yalo inqaku - kangangoko kunokwenzeka ukuze bafunde yintoni na umhlaza esophageal: iimpawu, unyango, iimpawu, ebangela le ngxaki.

parenthesis

Ekuqaleni, kufuneka kuthathwe amanyathelo kwabo iingqiqo, eza ngokubonakalayo kusetyenziswa kweli nqaku. Ngoko ke, lo kuvuleke iminxunya - lelona candelo ibalulekileyo lebhokisi isisu oluntu kunye kwisisu ngomlomo. Kulo mzekelo, i kuvuleke iminxunya "akayithandi" eshushu okanye ebandayo, ezibukhali kakhulu okanye eqhotsiweyo. Ngenxa yezi zinto ke, inwebu kwiinwebu umzimba ube asha, ehamba ezifana ithumba ukuba ukuvela ingxaki. Ukuba ne ebubonisayo amayeza namhlanje uyakwazi ukuphatha nangezilonda amabi zinika isoyikiso nje kuphela impilo kunye nobomi isigulane. Le ngxaki kwakhona nzima sisifo kunzima kakhulu ukuchonga nisaqala livela (ukungabikho kweempawu).

malunga ukugula

Iyafuna esithi xa nisaqala kakhulu zomhlaza kuvuleke iminxunya ukufumanisa sifo phantse akunakwenzeka. Bonke ngokuba kuya kuba ndingekho ngokupheleleyo naziphi na iimpawu onokukuxela umntu ukuba umzimba ukuba kukho into engalunganga. Kwaba kuphela emva kokuba ukudumba linciphise emphinjeni phantse isiqingatha, munhu a nga va ezinye kabi. Iyafuna esithi ukuba umhlaza esophageal ixhaphake kakhulu kubantu ngokuphindwe 4 kuneentombi. Iqela ubungozi - Abantu abaminyaka yobudala eyi-50-60. Ukuba umntu ithumba, iya wabetha umzimba edyokhweni. Ngoko ke, inxalenye engentla kuvuleke iminxunya mandibethwe yi malunga ne-10%, i-avareji - 40%, kwaye ephantsi - malunga nama-50%.

oonobangela

Eyona njongo iphambili yale nqaku - ukufunda iimpawu kunye noonobangela somhlaza we emphinjeni. Ngoko ke, ezi zinto zilandelayo bungabonakala phakathi ngoonobangela esi sifo:

1. Power. Unobangela yokuqala zomhlaza kuvuleke iminxunya uba ukusetyenziswa rhoqo ukutya okuvuthiweyo kwakunye utywala kunye kweziqu yayo. Kufuneka kwakhona mabangezi ekutyeni izitya okuneziqholo kakhulu.
2. Into geographical. Oosonzuluwazi baqaphela ukuba kuloo ndawo ahlala kuyo isigulane kuchaphazela kokuvela esi sifo. Kodwa bonke kwakhona zehla ukuba inkcubeko ukutya. Ngoko ke, iziganeko carcinoma iphezulu kwezinye iindawo China, Iran, kunye Central Asia. Kwaye bonke ngenxa yokuba kukho ukudla zifakwa, ngumngundo kunye izitya ezishushu kakhulu.
3. Ukuswela iivithamini. Ukunqongophala iivithamini A kunye C kungakhokelela kuphuhliso umhlaza esophageal.
4. Malunga kathathu umngcipheko wokosuleleka SISIFO uphakame ngabo abatshayayo, kunye nangaphezulu 12 amaxesha abo kakubi utywala.
5. Ukwanda umngcipheko umhlaza kuvuleke iminxunya, ukuba umzimba itshile kwealkali. Nkqu apho emva isiganeko, sele kudlule iminyaka emininzi.
6. Kakade ke, ezinye izifo kunokubangela uphuhliso yamathumba amabi. umhlaza Esophageal inokuba ngenxa achalasia esophageal, okanye-kuthiwa kuvuleke iminxunya Barrett kaThixo.

Uphawu 1. Dysphagia

Ekuqaleni, kufuneka siqwalasele iimpawu zokuqala zomhlaza kuvuleke iminxunya. Enkosi kubo, uyakwazi ukubona sifo. Ngoko ke, kuqala kwiinto zonke, isigulana siya kufumana ubunzima ukuginya ukutya. Umntu uya kuvakalelwa kukuba emqaleni wakhe ukuba nokuthintela sicatshulwa eqhelekileyo ukutya, ukuba ukutya kuqhubeka jamming. Ukuthintela kuyaphela umntu kufuneka ngenyameko yonke ihlafuna. Ukuba isifo eseleyo lunganyangwa yaye ukubaleka, ngoko emva kwexesha, nkqu ulwelo akayi kuba intshukumo nako ngokuqhelekileyo emzimbeni. Kwinqanaba lokugqibela sifo umntu akakwazi ukuginya ngokuqhelekileyo nokuba amathe yakhe. Phantse zonke izigaba esi sifo (ngaphandle kuqala) zihamba yi ubuhlungu.

izigaba dysphagia

Ukufunda imiqondiso yokuqala zomhlaza kuvuleke iminxunya, oko kukuthi ukuba ubunzima yokuginya ekuqaleni kwesi sifo kwenzeka qho, kuba akukho rhoqo umntu akhathazeke. Kungenxa yoko le nto sifo kunzima ukumisela. Ngapha koko, ukuba umntu ungazihluphi, akukho ingqiqo ukuze uqhagamshelane nogqirha. Le dysphagia efanayo uqobo amanyathelo amane:

1. Inxaxheba kwinqanaba lokuqala umntu kunzima yokuginya iziqwenga ezinkulu ukutya, kwakunye sicatshulwa ukutya ezinezikhondo (inyama, isonka, imifuno kunye neziqhamo).
2. Kulo lesibini inqanaba ogulayo kunzima yokuginya isidudu ubukhulu kunye ezicujiweyo.
3. Isigaba sesithathu sibandakanya dysphagia ubunzima odlulayo ulwelo nge emphinjeni.
4. Yinkalo yokugqibela - a isithintelo ngokupheleleyo emphinjeni.

2. Pain uphawu

Yintoni enye luphawulwa umhlaza kuvuleke iminxunya? Imiqondiso yokuqala - ukuba intlungu. Baya kuza phantse zonke izigulane kumanqanaba ahlukeneyo sifo. Uhlobo neentlungu nomahluko - kungaba zombini oyingozi futhi obtuse. ntoni xa oku kwenzeke kabi emqaleni kunye entanyeni, phakathi iincakuba zamagxa kwaye emhlathini asezantsi.

3. Reflux uphawu

Ziziphi ezinye iimpawu ezisaqalayo zomhlaza kuvuleke iminxunya? Ngoko ke, oogqirha bathi ukuba ubungqina sifo kwakhona Kunjani (okanye ulwimi lenzululwazi - reflux). Nakuba kunjalo, ukuba oko kwenzeka emva izidlo enzima okanye emva kokutya kunye abafane etsolo - oku ke kuqhelekile. Ukuba regurgitation kwenzeka kungakhathaliseki isidlo nangaliphi na ixesha emini okanye ebusuku - kunokuba yentsimbi ukuba ukuba kufuneka ngokukhawuleza ukuba axilongwe ngugqirha.

Uphawu 3. Uyakhupha, isicaphucaphu

Xa Ithumba ikhula, isigulane kusenokuvela isicaphucaphu nje kuphela, yaye ukugabha. Alarm kufuneka enze kube lula ubumdaka in vomitus.

Uphawu 4. Igazi

Sihlola Iimpawu zokuqala zomhlaza kuvuleke iminxunya. Njengoko sele kukhankanyiwe ngasentla, kusenokubakho igazi linganihlanzi lomguli. Oku kwenzeka ngenxa yokuba inkangeleko amanxeba kunye nezilonda kuvuleke iminxunya (oku kukhokelela ekukhuleni yamathumba). Inxalenye yegazi ingaphuma ngumhlanzo, abanye kweyela esiswini. Kungenxa yoko le nto admixture wegazi nayo kubulongwe yesigulane.

izinkcwe uphawu 5. Ukwandisa

Ukuba umntu umhlaza kuvuleke iminxunya, imiqondiso yokuqala - hiccup kunye izinkcwe kakhulu. Hiccup kwenzeka ngenxa yokuba utrudnennogo umoya nokuwela emphinjeni. Kwaye izinkcwe kakhulu - nolwalusisiphumo sokuqala ithumba ukwanda kunye neengxaki yokuginya nezinkcwe zabo. Ulwelo naphi uhambe, oko oluhlala emlonyeni kwaye izisa umntu engonwabanga.

Uphawu 6. Ukukhathala, umzimba

Okulandelayo, iimpawu zomhlaza kuvuleke iminxunya. Ngaloo ndlela, umntu abe kukungabikho amandla, ukwehla kobunzima, kunokwandisa lobushushu. Bonke ngenxa yeengxaki yokuginya isigulane nje siyayeka ukudla (ukuze uphephe intlungu). Oku kuthetha inani elingonelanga iivithamini kunye neeminerali, nto leyo ebangela iimpawu ezifanayo. Ukwenziwa buthathaka umzimba ukuba isigulane nga 'anamathele' ezahlukahlukeneyo zizifo zamaphaphu, nto leyo eya kubangela ukuba ukunyuka kwamaqondo obushushu.

Uphawu 7. Tshintsha izwi, ukhohlokhohlo

Eyona engundoqo kunye iimpawu zokuqala zomhlaza kuvuleke iminxunya - a ukukhohlela rhoqo kunye notshintsho ilizwi lomntu. Konke oku kwenzeka ngenxa ukwanda metastases kwingqula, bronchi. Le hoarseness ilizwi ukuze babonakale ngathi sisifo oluqhelekileyo zemiphunga. Amaxesha amaninzi umntu intlungu imisipha.

Uphawu 8. ungqinisiso

Kaloku, xa sifo ayisekho kwinqanaba lokuqala, isigulane kubonakale embi umoya. Kwakhona kungandisa kwiindawo nkovu, nto leyo ingabonisa ukuba kukho 'ilungiswe' metastases. Ukubola umlomo ivumba na ngenxa ukwanda umhlaza.

ukungaphili

Kokuqwalasela iimpawu zokuqala zomhlaza kuvuleke iminxunya, oko kukuthi ukuba ukubola somhlaza alandelayo iingxaki kungenzeka isigulana:

1. ukopha Esophageal. Isenokuba ikhatshwe nokugabha igazi, isicaphucaphu, ilahleko lokuqonda. Zinde opha isigulana ithumba angavela isitulo emnyama. Le meko ifuna ungenelelo yezonyango engxamisekileyo.
2. Perforation iqhuma. Isigulane nazo zibe umngxuma kuvuleke iminxunya, zikhokelela kuphuhliso ukudumba kwi mediastinum. Oku kuya onke ikhatshwe iintlungu, umkhuhlane kunye ukunxila.

ekuxilongweni

Siqwalasela izifo ezinye ezifana umhlaza kuvuleke iminxunya. Iimpawu kunye nemiqondiso - ukujongana nalo. Ngubani ofuna ukuthetha ngayo, oko iindlela kunye neenkqubo bangenza ukuxilongwa. Ngenxa yoko, omnye kuphela kuhlolwe kuvuleke iminxunya awunakunqamla thina, oko akuthethi ukunika umfanekiso opheleleyo sifo. Ezi zifundo zilandelayo ziya kufuneka wenze isifo:

1. X-ray. Le nkqubo yenza kube lula ukufumanisa iimpawu komzimba le ithumba, kwakunye ukwazi indawo yayo ngqo.
2. Bronchoscopy ukunceda isigqibo iqondo ithumba lokuhlasela emphinjeni, kwakunye baqonde ukuba Ukudlulela wabonakala.
3. Kwahlula imida thumba ze ukunyenyisa sase- elizayo kuya kunceda esophagogastroscopy.
4. Ultrasound and CT - yesiqhelo ezincinane ukuba zinceda ekucaciseni uxilongo, ukufumanisa ubukhulu kanye phambi metastases ithumba.
5. uphando igazi Laboratory lunika ithuba ukugqiba oncomarkers.

unyango

A lot of iingxaki lokukhulula umhlaza esophageal. Iimpawu nemiqondiso, yeqonga, unyango, abantu abane - konke oku kubalulekile kakhulu kwaye kufuneka ukuba kuxoxwe kunye nogqirha wakho. Ngoko ke, kweli banga bekuya kuba kunqweneleka ukuba siqwalasele ngokweenkcukacha zonke zonyango olunokubaluleka kule meko.

1. Radiation therapy.
2. Surgery. Kulo mzekelo, isigulana siya kususwa kuvuleke iminxunya. Kwakhona efunekayo esiswini zeplastiki okanye wamathumbu.
3. indlela Ludityanisiwe: unyango radiation ngokusebenzisana uqhaqho.

Ngokubhekiselele ichemotherapy, ngoko indlela ozimeleyo nokungaphumeleli kwawo.

Oyise inxalenye asezantsi nalawo aphakathi kwe emphinjeni. Kulo mzekelo, ngempumelelo utyando ilandelwe kwimitha kunye nechemotherapy. Ukuba akunakwenzeka ukuba asuse ithumba, unyango kwemitha uyasetyenziswa.

Ukuba isigulane wambetha yesithathu ophezulu kuvuleke iminxunya, kwimeko apho umhla kuya kuba radiotherapy.

Ukuba sifo iqalwa kakhulu, nebakala yokugqibela dysphagia lomguli (ukungakwazi ukondla kakuhle) - angabi gastrostomy. Olu tyando, phantsi zomzimba zasekuhlaleni xa isisu isigulane bukaThixo sutured eludongeni esiswini, ngoko ukondla ityhubhu yaziswa kuyo.

Outlook

Xa siqwalasela imiqondiso yokuqala kunye iimpawu umhlaza esophageal, unyango kunye ALS - yiloo nto ke kubalulekile ukumxelela. Ukuba unyango sele bathi, ngexesha ukwazi uqikelelo ukwenzela ubomi izigulane nesi sifo. Okokuqala ndifuna ukuthi konke oko kuxhomekeke kumlinganiselo uphuhliso izifo, ubudala yomguli kunye neminye imiba eyahlukeneyo. Oko kukuthi, naliphi na ityala kufuneka kuqwalaselwe ngamnye. Noko ke, unako ukunika kwaye amanani ewonke:

1. Xa umhlaza esophageal sele singanyangwa, ALS kulo mzekelo asiyiyo kuFeliks. I-avareji Ixesha wobomi yezigulane ukususela ekufumanekeni sifo - malunga 6-8 iinyanga. Ukuba uphethwe kwi zigaba yokuqala, ngaphandle unyango, ezinye izigulane wayephila 5 iminyaka.
2. Ukuba isicelo unyango radiation, ukusinda nomonde uyandiswa kakhulu.
3. Xa unyango ezidityanisiweyo emva utyando olukhulu, malunga nesiqingatha izigulane ubomi iminyaka engaphezu kwemihlanu.
4. Xa unyango entsonkothileyo (ukuba naziphi metastases) yi malunga ne-57% ezigulane ubomi iminyaka engaphezu kwemihlanu.