Ukuphuka kwe-Esophageal: izizathu, iimpawu, unyango

Ukugqithiswa, okanye kunoko ukuphazamiseka kwesisu - kukuphulwa kwentembeko yesigxina, kwenzeka ngokusuka kwimvelaphi yentlekele okanye ngokukhawuleza. Kulo rhulumente, uncedo olulodwa oluphuthumayo, kuba isithuba sisongelo lokwenene ebomini. Ukuphelisa ingxaki kuphela xa kunokwenzeka ukuhlinzwa ngokukhawuleza. Kwimeko enzima, ukuba isigulane sisesibhedlele, kwaye izikhewu zincinci, ngoko mhlawumbi unyango olulondolozayo.

Izibalo

Olu hlobo lentsholongwane aluqhelekanga, li-1% yazo zonke izigulana eziwela kwi- thoracic isebe. I-Perforation ivela kathathu ngokuphindaphindiweyo kwizigulane zesilisa. Esi sifo siqhelekileyo kubantu abaneminyaka engama-50 ubudala nangaphezulu. Ukuphulukana ngokukhawuleza kwesifo, okanye i-Burkhawe syndrome, malunga ne-15% yazo zonke izigulane ezineempembelelo.

Ukuhlulwa kwesifo

I-pathology yahlula ngokwemigaqo yokuvela:

• Isifo se-neological esizimeleyo, kuquka ne-Burkhawe syndrome;
• Inkxalabo emva kwesinye isifo, intlungu okanye izizathu ze-iatrogenic.

Endaweni yendawo:

• Ukugqitywa kokugqitywa kwe-esophagus, oko kukuthi, i-perforation iyindawo ekufutshane kuyo yonke ububanzi bodonga;
• I-perforation engagqibekanga, oko kukuthi, ikhona kwindawo enye okanye iibloksi ezininzi ze-mucosa esophageal;
• Ukuphulwa kwangaphakathi okanye kuvaliwe, ukuhlaliswa kwendawo yangaphakathi ngaphakathi kwesigxina;
• Ukugqithiswa kwangaphandle okuvulekileyo kunye nesayithi sokuhlala kwiindonga zangaphandle zesigxina.

Nangona kuzo zombini iintlobo zokuphuka, uphawu lokubonakalisa isifo lufana.

I-Mallory-Weiss Syndrome, okanye i-esophagus crack

Ukugqithwa kwendawo yesifo kune-pathology efanayo, njengokonakala kwisisu okanye isisu. Imichila ingaba yedwa, kodwa inokufumaneka kwi-mucosa yesigxina. I-Mallory-Weiss syndrome ayinalo umonakalo owenziwe kwizicubu. Njengamaqhekeza, ukuqhekeka kuyimpawu kwizigulane ezineminyaka engama-50 ubudala, indoda kunye nokusetyenziswa kakubi kotywala.

Izizathu

Ukuqhekeka kwe-Esophagus kudla kwenzeka ngokumalunga nemvelaphi ye:

• Iimviwo zokugqibela zexesha elide ;
• Ukutshisa kweekhemikhali;
• Izigqeba zamazwe angaphandle, ikakhulukazi ezinzima;
• Ukulimala kunye namanxeba angenayo;
• Ngaphandle kokungakhathali ukwenza imisebenzi eyahlukeneyo, kwaye ngenxa yentlekele yesifo.

Kwiimeko ezinqabileyo, ukuhlanza rhoqo okanye ukukhwehlela olude kunye nexesha elide kunokukhokelela ekugqibeleni. Imisebenzi yesiGrike, okanye ngokuthe ngqo, iinzame ezinamandla zingabangela izifo. Ngokuchasene nemvelaphi yokuhlaselwa kwesibetho, kunokuhle kube nokuphuka.

Iqela leengozi

Eli qela liquka abantu abanezifo ezilandelayo:

• I-Esophagitis;
• Ulcer ye-esophagus enokuhlanza okukhulu.

Abantu abane-syndrome yokutya okungalawulwa ngokungalawulwayo nabo basengozini. Esi sifo singakhokelela ekusebenziseni umzimba ngokugqithiseleyo okanye ngokugqithiseleyo ngexesha lokuxhatshazwa. Esemngciphekweni yeso siqingatha sesintu esivela kwiminyaka engama-50.

Iimpawu zokubonakalisa kwesi sifo

Kwiimeko ezininzi, umfanekiso weklinikhi ubonakaliswa ngokubonakala ngokukhawuleza kweempawu kwaye ubonakalise kwifom:

• Intlungu ebuhlungu kwisifuba kunye nommandla we-epigastric;
• Ubungqina bemilenze;
• Ubuhlungu kwisifuba;
• I-Pallor yolusu kuwo wonke umzimba;
• Umkhuhlane omile owenzeka kwi "level level";
• Ukunyuka kwamanani;
• Tachycardia, dyspnea;
• Ukuhlanza okungenakulungelelaniswa kunye nokufakelwa kwegazi, emva kokuhlanza kwexesha kunokubonakala ngathi kunezizathu zekhofi;
• Ubunzima nokuphefumula okunzima;
• Ukukhupha
• Ukutshitshiswa malunga nemvelaphi yentlungu;
• Kukho imiqondiso yokuxiliswa komzimba;
• Iimpawu kunye nobuso zingabhakabhaka, kwaye i-cyanosis ikhula;
• Ukuqhekeka kwingingqi ye-thorac kungabonakaliswa yi-mediastinitis;
• Ukuba kukho ukuphuka eduze kwesisu, kunokubakho i-peritonitis;
• I-Emphysema, igcwele umoya, ebusweni, entanyeni.

Ubungqina beempawu zokuphuka kwesisu kufuna ukunakekelwa kwangoko kunyango. Kubuhlungu, kodwa kwi-50% yamatyala okugqithiswa, izigulane ziyafa ngenxa yokungenakwenzeka ukunceda.

Ingxaki ilele kwinqanaba leemeko zokugqithwa nazo ziyimpawu kwezinye izifo kwaye ingaba yimbangela ye-pleurisy okanye isifo senhliziyo. Ngenxa yoko, ngaphandle kokuxilongwa okwaneleyo kunye nokonyango, umntu unokufa.

Amanyathelo okuchonga

Ukuba kukho ukukhankanywa kokuqhaqha isisu, amanyathelo okuxilonga athatyathwa kwimeko engxamisekileyo. Ukuqala, ukuhlolwa komzimba kwenziwa, i-anamnesis ibonakala. Emva koko igazi lithathwa ukuba luhlalutyo lwezinto eziphilayo. Ukuhlolwa kwe-X kunye ne-ultrasound kwenziwa. Ngokuxhomekeke kwimeko yentlungu, ukuhlolwa kwe-x-ray yesifuba kwenziwa. Ukuxilongwa kwakhona kubandakanya i-mediastinoscopy kunye ne-pharyngoscopy.

Uvavanyo lwe-X lujoliswe ekuboneni iifomsile ezichanekileyo kunye nomoya kwi-pleura nangesisu esiswini. Ukucacisa indawo yesifo, ukuhlukana kwamanzi okuqhaqhaqhaqhaqho kufakwe kwi-oophagus, okuthi, ukufuduka, kwenza ukuba kube lula ukucacisa indawo kunye nobukhulu be-oopopus.

I-Endoscopy iyenziwa ngokusebenzisa i-endoscope eqinile ukuze ingagcini i-esophagus emoyeni.

Amanyathelo okuphilisa

Ukunyangwa kwe-esophagus rupture kubandakanya ukungenelela ngophengululo.

Kunqabile kakhulu, kodwa kusetyenziswa unyango olulondolozayo. Amanyathelo anjalo anokwenzeka ukuba i-mucosa ibonakaliswe ngokungabi ngaphezu kwe-1.5 cm. Oku kungabangela umonakalo kwisifo seentlanzi okanye inaliti ye-biopsy, imeko esemgangathweni kukuba akukho monakalo kwizitho zamalungu omzimba. Ukongezelela, isigulane akufanele sibe neempawu ezihambelanayo, oko kukubonisa ukungenelela ngoncedo. Kule meko, kusetyenziswe unyango lwe-antibiotic esebenzayo. Ukutya nokusela ngelixesha lonyango alubandakanyi ukuqaliswa kokutya ngomlomo. I-antibiotics ilawulwa kwisigulana ngamaxesha amaninzi ngemini kwaye ifake ukulala okupheleleyo. Ukuba yonke imilinganiselo ayizange ibe nempembelelo emihle, kuya kufuneka usebenze.

Nangona kunjalo, ngokuqhelekileyo "banokuwunqoba" eso sifo kwaye bagweme umphumo obulalayo kunokwenzeka kuphela ngokuthatha inxaxheba kwonyango. Imisebenzi ephambili yokusebenza ijoliswe ku:

• Ukuvala ngokukhawuleza kwendawo;
• Utywala lwezilonda xa zifumaneka ukukhusela ukuphuhliswa kwe-peritonitis;
• Ukukhutshwa kwexeshana kweso sophelo kwinkqubo jikelele yokutya.

Emva kokusebenza, ubuncinane iintsuku ezimbini kufuneka ungadli ngomlomo. Ukutya kuhanjiswa kwi-gastrostomy. Oogqirha badla isisombululo esikhethekileyo sesondlo.

Ukuba imeko yesigulane ivumela, ukuqaliswa kokutya ngendlela eqhelekileyo kuqala ngomhla we-3, kodwa itafile yokutya isetyenziswe. Ezi zinto zilandelayo zivunyelwe ukusetyenziswa:

• Imifuno neziqhamo kwifom ebhaka;
• Porridge;
• Iifatata ezinomsila;
• Jelly kunye neenkomfa;
• Inyama neentlanzi, kuphela iintlobo zeefama ezincinci, ziyabhaka okanye zitshisa;
• Iimfumba ze-kottage shizi kunye nenyama.

Awunakuyidla imveliso yomgubo, kuquka isonka. Akuvumelekile ukuba udle ukutya okuthosiweyo kunye namafutha, ukugcinwa, ukutya okunomsoco ongakuchukumisa umlenze we-mucous. Imveliso equkethe idayi.

Zonke iimveliso ezinokusetyenziswa emva kokusebenza kufuneka zibe ne-puree-like consistency okanye zichithwe, ngaphambi kokufunyanwa kuyimfuneko ukuba zizise kwindawo efudumele kwaye zizisebenzise kwiincinci ezincinci.

Iingxaki ezinokwenzeka

Imiphumo yokuphuka kwesisu ingaba nzima. Ifomu elalihoywa yeso sifo ingakhokelela ekuphuhlisweni kwenkqubo yokuhlutha kunye nokuvuvukala, okuya kubangela umonakalo kwi-cellulose. Ukukhawuleza kwonyango isiqinisekiso sokungabandakanyi umngcipheko wokuphuhliswa kwemiphumo engozi kunye nokuqala kokufa.

Ukuxela kunye nokukhusela

Njengokuba kukho ububanzi be-epopus, i-Mallory-Weiss syndrome, ukugxekwa ukubuyiswa ngokuxhomekeka kuxhomekeke kwixesha eliphakathi kokuqala kokonyango kunye nexesha lokulimala kwi-esophagus. Indima ebalulekileyo idlalwe yiinkxalabo ezihamba kunye neengxaki zokugula, indawo yokuhlala kunye nobukhulu bokuphuka, imeko epheleleyo yesigulane kunye nezifo ezingapheliyo.

Amanyathelo okukhusela kweli phepha adlala indima yesibini. Nangona kunjalo, ukukhutshwa kwezinto ezithile kuya kuthintela ukuphuhliswa kwesi sifo. Kufuneka ugweme umonakalo we-atrogenic, ungavumeli umzimba wakho ukuba ube ngumqathango we-bulimia, ufike ngexesha lokuhlolwa kwezokwelapha.

Eminye imimiselo kufuneka ilandelwe ukunciphisa umngcipheko wokugqithisa. Fundisa abantwana ukuba bahlale besidla ngaphandle kokukhawuleza. Ngokuqhelekileyo i-perforation ivela kwimvelaphi yokugwinya i-chunk enkulu yokutya. Ungalilibali ilizwi elithi "xa ndidla, andisithulu kwaye ndisisithulu." Ufanele ukuyeka ukunyamekela ngokomzimba, ukuphakamisa izisindo. Ukutya kufuneka kube nokulinganisela kunye nokuchanekileyo, ungasebenzisi kakubi utywala.