Esophageal Disease: Iimpawu and Treatment

umsebenzi kuvuleke iminxunya mhlawumbi eyaziwa bonke. Ngokwale elula, xa uqala, umzimba waginya lihamba nokutya kwabantu kungena esiswini. Kwathi kanti, isifo esophageal, iimpawu eza kuxutyushwa kweli nqaku zintsonkothe kakhulu kwaye zahlukene, njengoko ngokulula iba asha and sensitive zonke iziphoso ekutyeni kwethu.

Okubangel 'umdla kukuba, loo mntu, ethe wafumana imiqondiso yesifo ebizwa ngokuba umzimba, kaninzi kubangelwa ukuba iingxaki kunye isisu, intliziyo okanye ngomqolo izifo, kunye nokuphucula imeko, zama ukuqhelana nabo.

Yintoni dysphagia?

Okokuqala, makhe sijonge elilapha phantse zonke izifo zonke iimpawu umphimbo.

Eyokuqala kuzo - dysphagia. Oku lunyhasho iinkqubo kunokubangela iingxaki ezisebenzayo okanye imiqobo organic yintshukumo ukutya ngokusebenzisa kuvuleke iminxunya ukuginya.

Le ukuhlukunyezwa luphawu imvakalelo ukuba ukutya wanamathela ngexesha kukuginya okanye sicatshulwa esiswini. Ngendlela, kufuneka zingahlukaniswa Afaq, Nguwo lowo umqondiso kwimiqobo kuye ngokupheleleyo kuvuleke iminxunya kwaye kufuna unyango olungxamisekileyo.

heartburn

Olunye uphawu sifo esiswini kunye kuvuleke iminxunya na imvakalelo elivuthayo retrosternal ukuba kuye kwanwenwa entanyeni, kwaye ngamanye amaxesha ezandleni. Ngokuqhelekileyo, heartburn sikhatshwe yi regurgitation (ejection) lweziqulatho esiswini, kwakunye imvakalelo uqengqa ukuya emqaleni wave efudumeleyo.

Heartburn sibi kakhulu emva kokutya, xa isigulane asondele, kuthatha ifoto okanye ngepali emzimbeni. Kwaye ngegalelo lako kungancitshiswa xa ukuginyile nje ngamathe, ukwenza ndandirhabula ezimbalwa amanzi okanye uthathe esesiwini (zehydrochloric acid lwaze action) ithetha.

I-njalo kakhulu heartburn - ngumqondiso oqinisekileyo iingxaki kunye nokusebenza emphinjeni, umzekelo, inyongo reflux okanye zehydrochloric acid, ubuchule ukuphazamiseka komzimba olule kunye nokudumba yayo mucosal (oesophagitis).

odynophagia

Bomzimba isenzo ligwinya okwenzeka emva breastbone, - odynophagia, unobangela woko idla ngokuba sisilonda esidumbileyoesingaphakathi mucosal phezu emphinjeni. Kufuneka zingahlukaniswa iintlungu esifubeni yiSpasticity ezinxulumene ne ukutyhala mali nzima ukutya. Odynophagia - luphawu non-ngqo, njalo njalo kunzima ukumisela ukuba uhlobo leengxaki emzimbeni ochazwa unobangela intlungu.

Kuba reflux esophagitis elikhankanyiweyo uphawu na aziqhelekanga, kodwa kungabonwa kwi esophagitis esosulelayo (ingakumbi xa iintlobo Candida, kunye herpes). Ukuba imichiza abatshileyo, isilonda kunye neentlungu umhlaza kananjalo iqatshelwe kuvuleke iminxunya - izizathu iimpawu ezifanayo kwezi meko eziphezu.

buhlungu isifuba Nedlac

ubuhlungu Nedlac wahlukile ukusuka heartburn okanye odynophagia. Ngokungafaniyo yokugqibela, ngasendleleni, lingakwazi kuthi kunye reflux esophagitis, kwakunye kwiimeko ukuphazamiseka motility esophageal, ezifana esophagospasm. Le uphawu ivela ngexesha izidlo, yaye zide.

ubuhlungu kwaye ndityiwa kwi kuvuleke iminxunya, oonobangela apho siza kuxubusha kamva, oko kube ngumqondiso umhlaza okanye izilonda esophageal. Kwenzeka, kwelinye kwaye isigulane efanayo ukuze abe umlinganiswa eyahlukileyo, ngamanye amaxesha izigulane nokuba bakufumanisa kunzima ukuchaza iimvakalelo zabo.

Kwezinye iimeko, iintlungu esifubeni esinxulunyaniswa naziphi na izinto ezazinokuphazamisa Nedlac kwi motility esophageal. Kulo mzekelo, izigulane zinokuba neengxaki ezininzi zokuziphatha, ukudakumba, uvalo nezigulo zengqondo lwesenzi ukukhathazeka.

regurgitation

Le uphawu sele ikhankanyiwe apha inkcazo heartburn, njengoko ngumqondiso yeqabane lakhe. Reguritatsiya ngokuqhelekileyo kwenzeka ngaphandle isicaphucaphu kunye uvalo ucutheko idla kunye ezininzi izifo kuvuleke iminxunya emathunjini.

Iimpawu ukungahoywa imixholo esiswini emlonyeni ihambe ezimbi ezifana stricture esophageal okanye diverticulum. A reflux gastro-esophageal reguritatsii uzibandakanya ukuya kwenye ukubonakala emlonyeni incasa krakra okanye ubumuncu oko kungenxa ekungaphumelelini sphincter esophageal.

Uphawu echazwe yingozi imixholo popadenii esiswini kwinkqubo yokuphefumla kwaye kungabangela kuphela ukukhohlela, kodwa ukomiwa. Ngamanye amaxesha regurgitation kungabangela mgomo inyumoniya.

wenza njani isifo engundoqo achalasia esophageal

Iimpawu ze lead esophageal sifo kwintlungu nobukhali kwentamo, imbonakalo regurgitation, reflux, iingxaki igwinya, isicaphucaphu, heartburn, ungqinisiso ngenxa ukubola ukutya kuvuleke iminxunya, asenokubonisa okuvela achalasia.

Esi sifo eyaziwa ngokuba yi "cardiospasm" kwaye zoxilongo neuromuscular ukuba ihamba ukuhlukunyezwa yokuvulwa sphincter, ibekwe inxalenye esezantsi kuvuleke iminxunya kwaye sibizwa inhliziyo. Ngenxa yoko, ukutya awukwazi ukungena esiswini, ebangela mpawu zidweliswe ngasentla.

Ubangelwa sifo ayaziwa. Kwaye kwezinye iimeko, imbonakalo yawo ngequbuliso, yaye abanye - yenzeka kancinci. Le ibonisa isigulane kudla wayethimb achalasia, ukunciphisa izinga kwabo isixa esikhulu samanzi, ukuzilolonga zemithambo, njl

Kodwa ke uphuhliso oluqhubekayo ngezifo kufuna impendulo esizimiseleyo umbuzo lokuba ziphathwa njani emphinjeni. Ukuze wenze oku, sebenzisa iindlela ezijolise ekususeni imiqobo wawo ukuya kuvala ingxingwa ukutya - cardiodiosis (ibhaloni komlomo le sphincter) okanye kardiomiotomiyu (liqatywe zoqhaqho esihlunwini sphincter). unyango Drug nayo idla umlinganiswa nkarhinyana.

Iimpawu kunye nonyango lwe spasm esophageal

Izifo umphimbo, esinokucinga iimpawu nazo ekusebenzeni yesiqhelo sphincter. Xa oku kusenzeka kule spasm omzimba, edla ngenxa yezifo kwenkqubo zokwetyisa okanye ukuphazamiseka luvo.

Kule sifo isigulane ikhalazela iintlungu nezilwanyana ezohlukeneyo amandla ngexesha sicatshulwa ukutya ngokusebenzisa kuvuleke iminxunya nokuginya iingxaki. Hi ndlela leyi, ngamanye amaxesha iintlungu kwenzeka phakathi izidlo bandule ke lula mazingabhidaniswa iimpawu ze angina.

Uviwo lwe kuvuleke iminxunya kwesi sifo baye bajongwe deformation yayo ngenxa aqaqambayo. Ezi zifo zifuna unyango lwe kuvuleke iminxunya, elondoloza ngokubanzi, kwaye, ngaphezu koko, kufuneka babe ukuqeshwa ukutya umxakatho neziyobisi antispasmodic, kunye nitrofuran kunye arhente umthomalalisi. Kwimeko ukuphazamiseka gqolo isigulane kufuneka ibhaloni dilatation okanye uqhaqho.

Yintoni reflux esophagitis?

Isifo ukwabizwa ngokuba esophagitis Peptic kwaye luphawulwa ngokuyilahlela imixholo esiswini emphinjeni. Isizathu soku ziyenzeka ukungaphumeleli sphincter asezantsi. isenzo elide juice esiswini kunye inyongo ine banqande kwaye ikhokelela nangokurhala, izilonda na isifo, apho loloyiko kwenzeka licuthe emphinjeni.

Njengoko umthetho, esi sifo kwenzeka kancinane kwaye kaninzi kubonwa kwiintsana.

Kulo sifo iimpawu emphinjeni lidla wabonakalaliswa ngokohlobo heartburn kunye nokushisa kwindawo retrosternal, ezinokuthi zenzeke okanye mandundu ngokugoba phambili, ulele phantsi, ngexesha ukutshaya okanye usela utywala.

Esophagitis kungenziwa nzima ukopha (rhoqo efihliweyo) utshintsho, ukunqwenela inyumoniya kunye kukuqulungana kwi emphinjeni.

Ukuxilonga le ngezifo ezofagogasteroskopiyu lwenziwa kunye X-ray barium. A unyango ejoliswe Ngokuphelisa izinto eziphambili esophagitis (pylorospasm, xa Ithemba piloroduodenalnyh hiatal okanye stenosis). Isigulane kwakhona emiselweyo iziyobisi zokunciphisa iasidi ( "Ranitidine" yaye "Famotidine"), asidi kunye antispasmodics. Diet for zezifo engashiyi kuvuleke iminxunya namandla iqhezu.

Ithemba diaphragmatic

Ngamanye amaxesha ngokusebenzisa bekhubazekile kwaye abazifumene uvalo kwi lweHo- esifubeni ukuhambisa amalungu esiswini - lizwe luchazwa Ithemba diaphragmatic. Amaninzi uqala kwi esophageal lokuvula. Njengoko kukhankanyiwe ngasentla, iliphawu esi sifo wakhetha reflux esophagitis, kwakunye ukopha efihliweyo kunye nemeko anemia.

Indlela yokuphatha i kuvuleke iminxunya kulo mzekelo elisombulula uxilongo ngokuchanekileyo usebenzisa X-ray kunye endoscopy. Ngokuqhelekileyo, unyango na elondoloza, ejolise ekunciphiseni reflux. Kwiimeko ze licuthe le kuvuleke iminxunya okanye ukopha, ungenelelo yotyando.

isifo umphimbo Barrett kaThixo

Xa intlungu umqala, emva kwentamo, waziphosa imixholo isisu emlonyeni, heartburn, incasa asidi emlonyeni, ukhohlokhohlo ezingapheliyo kunye hoarseness sithethe isifo umphimbo, leyo kuthiwa metaplasia Barrett kaThixo.

Isizathu, nto leyo evusa uphuhliso esi sifo iye ayasekwa, kodwa wafumanisa ukuba kuvela kakhulu kwingxaki enkulu ngenxa gastro-nowomqala reflux esophagitis (uyibambe). Ngaphezu koko, le ngezifo kusenokuba negalelo kuphuhliso somhlaza.

metaplasia Barrett kaThixo ikhatshwe esenza le mucosal kumphezulu weeseli ze - iiseli ngakwimida le kuvuleke iminxunya athathelwa indawo kwiiseli ze isifo emathunjini. Phela, oko kuthathwa imeko precancerous, kungakhathaliseki ukuba umhlaza kuvuleke iminxunya - isifo esinqabileyo.

Barrett kaThixo metaplasia: isifo kwaye afumane unyango lwesifo esophageal

Iimpawu, unyango leyo ifuna ukuxilongwa, kunye metaplasia Barrett xa ngokuyimfuneko iqinisekiswa luphando olongezelelweyo njengoko endoscopy kunye biopsy.

Kuba emqaleni le yesigulane ukufaka ityhubhu ekhethekileyo ubhityile apho emphinjeni unako kuhlolwa, kwaye ke ngaphandle isampuli inyama uhlalutyo elandelayo iiseli ndibuthabathe.

Xa unyango lwe kuvuleke iminxunya Barrett kaThixo kujoliswe kuvamise on eyahluthwa unyango ingqondo metaplasia, kwakunye nokuthintela somhlaza. Therapy unawo isimilo ngokufanayo unyango lwe ulibambe (asidi kunye namayeza antireflux), kodwa kakhulu ngakumbi. Ukuba kunjalo, kunye nonyango ukudla engazisi isiqabu, kwakunye kwiimeko impazamo Ithemba, umguli, ungenelelo ngotyando kuthiwa fundoplication (ukuyilwa kwivelufa sokwenziwa).

Umhlaza kuvuleke iminxunya

Izifo kuvuleke iminxunya, iimpawu zazo kuxoxwa ngazo kwinqaku - sisifo enzima, kodwa ngezifo zimandundu ngokungathandabuzekiyo umhlaza.

Kuphuhliso yamathumba umhlaza kwi kuvuleke iminxunya zidlala indima ebalulekileyo ukudumba ezingapheliyo emzimbeni okubangelwa lwekhemikhali, thermal okanye ukuvuselela ngoomatshini. A ukutshaya nokusebenzisa kakubi utywala kwandisa umngcipheko umhlaza nesifo yi izihlandlo ezili-12!

Ngokuqhelekileyo, ekuqaleni esi sifo nazimpawu, yaye le nkqubo ingathatha ukuya kwiminyaka emi-2. Xa Ithumba ikhula kangangokuba ngenxa yoko linciphise le mithambo le kuvuleke iminxunya, ogulayo iimpawu iingxaki kunye sicatshulwa ukutya ngokusebenzisa umzimba igama. Yandisa dysphagia - luphawu uphawu lomhlaza. Ukuba ekuqaleni yokugula kwakhe, kubonakala kuphela xa ukuginyile okanye zingaqondwa ehlafuna ukutya okuqinileyo, ngoko kamva isigulane Banokusebenzisa iimveliso ngendlela lulwelo okanye eziphantse-ulwelo.

ezibonisa Data Masiziqwebele kukwehla imeko jikelele: silale, ukungabi namdla, ukwehla kobunzima bomzimba. Xa ukuvala elibukhali le mithambo manqanaba kwi kuvuleke iminxunya kwakhona izinkcwe kakhulu.

Kwezinye izigulane uphuhliso yamathumba kwaye lukhatshwa ubuhlungu ngasemva okanye emva breastbone. Ngokuqhelekileyo, ukuba kwenzeka ngexesha yokufakwa emva kwethutyana shwaka. Ayifane ubuhlungu ezinjalo lusaqhubeka.

Unyango zomhlaza kuvuleke iminxunya

Unyango lwezifo ze kuvuleke iminxunya, ngumhlaza ochaphazelekayo yangempela utyando, kwimitha kunye nechemotherapy. Kwimeko yokuqala isigulana ngokupheleleyo okanye inxalenye kuvuleke iminxunya onomzi. Oku kuxhomekeke ikakhulu kwindlela eqhelekileyo yinkqubo. Ukongezelela, iindawo nkovu zisuswe kwi imimandla Ukudlulela imbonakalo. Nangona kunjalo, le ndlela ngonyango contraindicated kwezinye izigulane (umzekelo, isifo sentliziyo okanye ukuphazamiseka kwemisebenzi isixokelelwano sokuphefumla).

Radiation therapy - indlela kuphela enokusetyenziswa ukunyanga uninzi lwezigulane kunye nomhlaza esophageal (40% amatyala xi nga hi pfuna ku ukuphelisa wabonakala kakhulu kwezonyango sifo). Chemotherapy esisetyenziselwa uhlobo esezantsi-grade lomhlaza.

Kukho kwakhona unyango indibaniselwano apho uthomalaliso radiation phambi utyando ukunciphisa impembelelo ebalulekileyo ukuphinda zasekuhlaleni kwaye kunciphisa ukukhula nethumba.

ngamathumba ebubonisayo

Phakathi nangezilonda nabungozi kwi kuvuleke iminxunya ziquka nangezilonda epithelial and non-epithelial. Esi sisifo noko esingaqhelekanga, kwaye inkalo babo likhondo kancinane esi sifo kunye nokungabikho iimpawu kakhulu.

Ngokuqhelekileyo, ezi nangezilonda iphuhlisa eludongeni kuvuleke iminxunya kwaye ngamanye amaxesha kweyela mithambo. Avamise kakhulu phakathi zazo leiomyoma, nendawo lwesibini neoplasms esinganyangekiyo.

Iimpawu eziphambili phambi yamathumba ebubonisayo liyenyuka kancinane dysphagia, kwaye (ngexesha kuphuhliso polyp) uza kokuba nomzimba amazwe, nto leyo ebangela isicaphucaphu nokugabha.

Inkoliso yezi yamathumba ezifunyenweyo ngengozi ngethuba loviwo radiology.

Njengoninzi sisifo esophageal, unyango yamathumba ebubonisayo, kwanciphisa ukususwa zabo ngotyando, ukwenzela ukuthintela iingxaki kunokwenzeka ezinxulumene nokukhula ithumba. Ngokuqhelekileyo, ukususwa lwenzeka ngaphandle ngumonakalo isifo esophageal kwaye abantu abane kakuhle.

UMallory-Weiss syndrome

Xa isifo emphinjeni kunye nesisu iimpawu bavame ngokwabo ukubuyisa okanye gagging naye. Ngamanye amaxesha isigulane ngeli xesha kukho bekhefu inwebu kwiinwebu le esophageal-esiswini kuhlangana khona. Le leengxaki amayeza kuthiwa syndrome UMallory-Weiss.

Ngokuqhelekileyo, oko njengokubonisa buhlungu kakhulu kwi esifubeni, kwaye egazini emhlanzweni ibonakala. Nangona uninzi amaxhoba ukopha iyeka ngokwayo, isigulane kufuneka balaliswe esibhedlele ngokukhawuleza ukuthintela iingxaki ezinzulu.

Njengoko zitofwe sokuphatha Syndrome wasebenzisa vasoconstrictors, kananjalo, ukuba kuyimfuneko, electrocoagulation.

Malformations le kuvuleke iminxunya

Ngamanye amaxesha isifo kwingqula kunye kuvuleke iminxunya ezinxulumene ngqo ne ezingaqhelekanga kuphuhliso owokugqibela - ukuya yokungaphuhliseki ukumila kwayo, ubungakanani okanye indawo engalunganga.

Ngokuqhelekileyo, ezifana leengxaki ebonakaliswa licuthe le kuvuleke iminxunya, ubukho naso tracheal fistulae esophageal, kwaye ngamanye amaxesha xa engekho lilonke umzimba ezichazwe. Ngelishwa, uphuhliso leengxaki esophageal nga olo nkqu olusandul yindlala, ngoko kotyando kufuneka ukuba bahlukane kubo.