Stenosis esophageal: Oonobangela, Iimpawu, Treatment

stenosis nowomqala - imeko apho sikhatshwa i exineneyo engaqhelekanga le mithambo tube esophageal. Le anomaly inokuba iziphene okanye sibonakala abadala ngakumbi. Isifo kunokubangela ezininzi iingxaki. Ngaphezu koko, iingxaki yokuginya indlela yokutya esiswini kuba nefuthe elibi kwi imeko yempilo yomguli kunye yonke eziphilayo. Ngoko kutheni na kukho oku ngezifo, kwaye nokuba kunokwenzeka ukuthintela ukukhula kwawo? Oko yayingako imiqondiso kufuneka sinikele ingqalelo kuyo? Ingaba kukho naluphi na unyango olusebenzayo ngokwenene?

stenosis esophageal: ntoni na?

Yinto eyaziwayo ukuba kuvuleke iminxunya - ityhubhu umngxuma lebhokisi umqala kunye nesisu. avareji ubude wayo Ngokuqhelekileyo-25 cm, lo ubukhulu ityhubhu ayikho iyunifom -. kuvuleke iminxunya na isithintelo ezintathu komzimba zona zicwangciswe kummandla intlala cricoid, bifurcation tracheal kunye imbobo.

Xa Gastroenterology mihla ngezifo eqhelekileyo ebizwa ngokuba stenosis esophageal. Yintoni na? Le ngezifo ihamba ucutheko uncharacteristic tube esophageal. Ekubeni kukho unxulumano olusondeleyo phakathi le yinxalenye wokugaya kunye nezinye izigqeba (umzekelo, uqhoqhoqho, aorta, pericardium, eli bronchus ngasekhohlo, isiqu le luvo vagus, duct thoracic, inxalenye pleura), kunye nokuhluthwa umsebenzi wakhe kubandakanya ngobuninzi iingxaki.

Eyona eziphambili ezibangela wophuhliso izifo

Ingaba kukho naziphi na izinto umngcipheko engabangela isifo onjalo? stenosis esophageal kunokuba oonobangela ezahlukeneyo. Xa kufikwa iintlobo iziphene zesi sifo, ukuba zinxulunyaniswa nophuhliso kakuhle ngeempawu ezalatha into, oko kukhokelele hypertrophy bokugcinwa udonga yesihlunu le kuvuleke iminxunya, ukuvela amakhonkco ezinezikhondo okanye cartilaginous.

Ke ukuba stenosis ababeyiqwebile, izizathu ezininzi ezahlukahlukeneyo ngakumbi:

• Umzekelo, i inwebu yangaphakathi zingamoshakala ngenxa bahlale okubhalwe emuncu esiswini. Loo iqatshelwe reflux esophagitis, izilonda Peptic, gastritis esinganyangekiyo, Ithemba hiatal , okanye nkqu toxemia eqatha zokukhulelwa, ngaphandle kokuba oko kukhatshwa ukugabha rhoqo.
• Kubalulekile ukukhankanya yokulimala. Le stenosis ngokuqatha emphinjeni waphawula ukutsha iikhemikhali arhente ndlongondlongo, kwakunye kubangele umonakalo eludongeni umzimba amazwe. Ndenzakale ungenza ngexesha iinkqubo ezahlukeneyo zokuxilonga, kuquka ekumfakeni esiswini.
• Valiweyo okanye ukuvalwa nokuba epheleleyo mithambo ngenxa umhlaza kuvuleke iminxunya okanye imbonakalo yamathumba ebubonisayo.
• stenosis nowomqala esinxulunyaniswa kunye nezifo ezosulelayo kuquka usulelo fungal, ifiva nebomvu, negcushuwa, isifo sephepha, ukubola komqala.
• Kwezinye iimeko, licuthe ityhubhu, yaye zonke ezimbi ezinxulumene amalungu ezingqongileyo. Umzekelo, ukuba kuvuleke iminxunya ukuba zixinaniswe iinqanawa anomalously zazibekwe okanye banzi iindawo nkovu. Izizathu ziquka yamathumba le mediastinum kunye kwemithambo aortic.

ISeva yeeFom ze stenoses kunye neempawu zazo

Kukho iindlela ezininzi kule ulwahlulo sifo. Umzekelo, stenosis esophageal inokuba iziphene okanye lufundiwe. Hi ndlela leyi, ngo-90% yamatyala oko kwenzeka uhlobo naso esi sifo.

Kuxhomekeka inani kwiindawo ezichaphazelekayo emajukujukwini stenosis single (sayo iingqameko le kuvuleke iminxunya kwindawo enye kuphela) kunye ezininzi (kukho amaziko ezininzi izilonda). Thatha ingqalelo constriction kwasendaweni kukukhethwa stenosis ngezifo eliphezulu (eyendawo emqolo wesibeleko), eliphakathi (isahlulo iingqameko imi kwinqanaba bifurcation tracheal kunye arch aortic), libya (leengxaki seziko zibekwe kwisebe intliziyo) nezidibeneyo.

Kukho kwakhona qheke ngenxa yezizathu esi sifo. Umzekelo, stenosis cicatricial le kuvuleke iminxunya uphawuleka umonakalo mucosal kunye maleko maxa wambi dystrophy tube. Xa isayithi ye yokuvelisa amalungu ubonakala ngcembe kwizicwili - ngoko luqokelelane kukuqulungana. Isizathu edla gastro-esophageal reflux ezigulo ezondeleyo. Ngamanye amaxesha isithintelo ngenxa ekubeni kusekwe kwaye ukukhula yamathumba leyo isenokuba mhlawumbi ingozi okanye amabi. Kwenzeka kunye nefomu ebuhlungu yokugula. Xa nawuphi na umcimbi, amisele ngqo uhlobo lwesifo kunye neempawu kuphela emva kokuxilongwa ngenyameko.

Inqanaba yophuhliso sifo

Xa yesilungu, ukwahlula degrees ezine stenosis esophageal:

• Inxaxheba kwinqanaba lokuqala sisifo kunye licuthe le mithambo ukuya 9-11 mm ubukhulu. Ngelo xesha ngalo kusenokwenzeka ukuba ukuqalisa naphakathi mbhobho wokuhlola.
• Kwi inyathelo lesibini, bathi xa kuthe ubukhulu be mithambo le kuvuleke iminxunya kwisiza stenosis liye lancitshiswa 6-8 mm. Kodwa ngalo sisenako ukungena fibrobronzoskop.
• Xa inyathelo wesithathu tube esophageal na iingqameko apha layo lingaphantsi kwe-5.3 mm. Ngokusebenzisa le sayithi ugqirha angangena kuphela, fiberscope ekhethekileyo ultra-obhityileyo.
• Isigaba sesine kwesi sifo luphawulwa exineneyo enabileyo kwinkqubela-mafutha, netoti nto 1-2 mm. Kwezinye izigulane kukho ukuvaleka ngokupheleleyo kuvuleke iminxunya, nto leyo eyingozi kakhulu.

Stenosis Esophageal: Iimpawu

Ke ukusuka kwangethuba sifo kwafunyaniswa, kamsinyane isigulane ufumana unyango olufanelekileyo. Ngoko ke oko yayingako imiqondiso kunye stenosis le kuvuleke iminxunya? Iimpawu kuxhomekeka kakhulu kwifom kunye ibakala sifo.

Xa kuziwa ezingaqhelekanga iziphene, i "iminxeba alarm" yokuqala kubonakala kwangoko. Emva ukondla umntwana rhoqo vomits ubisi nestvorozhennym. Uyakwazi ubone yencindi ezinamandla iivesi ngeempumlo, kunye izinkcwe kakhulu.

Kwimeko yokuba umntwana ngamnye sibi stenosis awazalwa enaso, iingxaki ziqala kunye nokuqaliswa ukutya oluncedisanayo phakathi ezityiwa ukutya yokuqala okanye okuqinileyo.

pathology Acquired eyenzeke kancinci. Njengomgaqo, izigulane kunye nobunzima baginye zenzeke. Umzekelo, iintlungu kunokwenzeka ngexesha sicatshulwa ukutya ngokusebenzisa kuvuleke iminxunya kunye nesifuba iintlungu imbonakalo. Kumanqanaba okuqala dysphagia waphawula kusetyenziso ukutya okuqinileyo, kodwa ubuncinane ukuvala ityhubhu esophageal, umntu uba nzima ukuba ndiginye nokuba ukutya ulwelo. Ngamanye amaxesha sifo iba kakhulu kangangokuba isigulana ayikwazi ukuginya amanzi okanye amathe.

Ukuba stenosis ise kwingingqi wesibeleko, kodwa uyiselayo engamanzi, okanye amaqhekeza ukutya ukungena uqhoqhoqho, nto leyo igcwele oluqinileyo ukukhohlela, laringospazmom, ukutsarhwa. Kumatyala ngokuqatha stenosis kukhokelela kuphuhliso yokulangazelela pneumonia.

Amaxesha amaninzi, iziqwenga esiluqilima kwaye elikhulu yokudla ukuba yande kwi constriction, nto leyo ekhokelela isicaphucaphu rhoqo kunye nokugabha, imbonakalo intlungu kakhulu. iziphumo eziyingozi stenosis ziquka komsipha yezizwe eludongeni umphimbo.

iindlela Modern loxilongo

Emva kokuba incoko ugqirha yomguli ukuze aveze ukukrokrelana malunga phambi stenosis. Kakade ke, kwixesha elizayo uphando efunekayo. Into yokuqala ukwenza oesophagoscopy, nge apho kunokwenzeka khona ukuba ukubona licuthe le mithambo kuvuleke iminxunya nokulinganisa ububanzi bayo, kwaye kananjalo ukuba ayikhangele isifo. Phambi yamathumba, okanye nezilonda isenokuba biopsy endoscopic ubukho iiseli amabi.

Okubaluleke ngokulinganayo indlela une ray usebenzisa arhente umahluko (iityuwa idla barium zisetyenziswa). Le nkqubo inceda ukuphonononga ngokuma kunye iikhonto ke kuvuleke iminxunya, kwakunye ukufunda peristalsis yayo.

Yintoni unyango inikela iyeza namhlanje?

Scheme therapy kuxhomekeke kwizinto ezininzi, kuquka ukuma ngezifo, isigaba yayo yophuhliso, imeko yomguli, kwaye ibangela stenosis. Okokuqala kufuneka ukutshintsha yokudla - ezityiwa kufuneka iqulunqwe ukutya semi-esingamanzi ukuba kugqitha constriction ye emphinjeni. Xa kufikwa dysphagia kakhulu kumlinganiselo sesine xa isigulane abakwazi ukuthatha undirhabulise amanzi, ukutya ibanjelwe yegazi.

Kukho iindlela ezininzi ukususa isithintelo. Kwiimeko onomoya wenziwe usebenzisa i bougies ibhaloni dilatation. Kodwa ukuba stenosis ayikho efanele ezo indlela ulwandiso wenza zingaxhomekekanga asike endoscopic. Kwimeko apho kukho ucinezelo le kuvuleke iminxunya (umzekelo, nokunciphisa Sondeza ithumba olukhulayo), ngaphakathi ke le mithambo le stent bufakwe ezizodwa, eziya ukugcina imilinganiselo efunekayo ye emphinjeni.

Maxa wambi kuyenzeka ukuba indlela ngasentla ayiniki oko akufunayo, stenosis uyaqhubeka inkqubela. Ugqirha ingenza isigqibo malunga isisombululo olukhulu ngakumbi - ukususwa inxalenye uchaphazelekayo womGaqo-kuvuleke iminxunya, kunye recovery ezilandelayo.

Nokuba kunyango iindlela kunokwenzeka zemveli?

amayeza emveli - kwishishini ikunikeza inani elikhulu amakhambi. Ngaba kunokwenzeka ukuba bahlukane nabo ngoncedo izifo ezifana stenosis le kuvuleke iminxunya? Abantu abahlala zokulungisa unyango kule meko ayamkelekanga. Kusenokwenzeka ukuba ugqirha isiphakamiso yokudla echanekileyo okanye ukunika nayiphi na imiyalelo. therapy Ekhaya kule ityala ngokupheleleyo contraindicated.

Ingaba kukho amanyathelo oluphumelelayo lokunqanda?

Ngelishwa, izixhobo ezisebenza ngokwenene lokunqanda ikhona. Njengoko le fom enaso, unina kubalulekile ukuba esweni nemeko yobume bempilo yakhe. Phambi ubungozi (transferred ngexesha usulelo lokukhulelwa, njalo njalo. D.) Ukuhlolwa kufuneka ukuchitha iintsuku ezimbalwa zokuqala emva kokuzalwa ukuze akwazi ukulungisa ukutya kunye nexesha ukuthatha amanyathelo okhuseleko.

Ebudaleni, izigulane bayacetyiswa ukuba balandele yokudla, kwakunye nexesha ukunyanga izifo phecana wokudla, ukuvimbela sicatshulwa yabo olunzima ngakumbi okanye engapheliyo.

I-ALS izigulana stenosis esophageal

Xa ushiye stenosis alunyangwanga esophageal kunokukhokelela ubunzima iingxaki. Noko ke, utyando nga ukuphelisa umthetho. Kakade ke, kukho unyango olongezelelweyo phambi izifo ezihamba. Noko ke, abantu abane ukuba isigulana kakhulu intle. A iphinde kunokwenzeka, kodwa, Ngokwezibalo, iimeko ezinjalo ngaphandle kwaye zibhalwe kunqabile kakhulu.