Esophageal Disease: Zizindikiro ndi Chithandizo

ntchito ya kholingo mwina kudziwika kwa aliyense. Malinga ndi yosavuta imeneyi, pa Koyamba, thupi kumeza chakudya chimachititsanso anthu mu m'mimba. Mwamwayi, matenda esophageal, zizindikiro amene ayankhidwa m'nkhaniyi ndi zovuta kwambiri ndiponso zosiyanasiyana, monga mosavuta amakhala chofuna ndi tcheru ku zolakwa zonse zakudya zathu.

N'zochititsa chidwi, mwamunayo, kudzindikira zizindikiro za matenda otchedwa thupi, nthawi zambiri zimachitika kuti mavuto ndi m'mimba, mtima kapena msana matenda, ndi bwino, kuyesera kuzidziwa.

dysphagia ndi chiyani?

Choyamba, tiyeni tione pansiyi pafupifupi nthenda iliyonse ya zizindikiro ndi kum'mero.

The oyamba - dysphagia. Izi ndi kuphwanya Pomeza zomwe mavuto zinchito kapena zopinga organic kuti kayendedwe ka chakudya kudzera kholingo.

kuphwanya Izi amadziwika ndi kukhudzidwa kuti chakudya munakhala pa nthawi ya Pomeza kapena ndime m'mimba. Mwa njira, iwo ali kulekanitsidwa kwa Afaq, komwe ndi chizindikiro cha kutsekeka lathunthu la kholingo ndipo amafuna chithandizo mwadzidzidzi.

kutentha

Wina chizindikiro cha matenda mimba ndi kum'mero ndi retrosternal woyaka kumva kufalikira kwa khosi, ndipo nthawizina manja. Kawirikawiri, kutentha limodzi ndi regurgitation (ejection) ya nkhani chapamimba, komanso kuona kuti ipitirirabe mpaka kukhosi funde ofunda.

Kutentha ndi woipa atatha kudya, pamene wodwala amatsamira patsogolo, akutenga malo yopingasa kapena mwathupi yofinyira. Ndi mphamvu yake kuchepetsedwa ngati chabe kuwameza malovu, kupanga sips ochepa a madzi kapena kutenga mankhwala ochotsa asidi (hydrochloric asidi neutralizing kanthu) amatanthauza.

The pafupipafupi ndi aakulu kutentha - chizindikiro cha mavuto ndi kugwira ntchito kwa kholingo Mwachitsanzo, ya ndulu Reflux kapena acid amathiridwa, luso matenda thupi kutambasula ndi kutupa ake mucosal (oesophagitis).

odynophagia

Soreness mchitidwe wa kumeza amenewa amapezeka kumbuyo breastbone wa, - odynophagia, kawirikawiri chifukwa cha chotupa mucosal padziko kholingo. Kuyenera siyanitsa chonsechi ululu pachifuwa kugwirizana ndi kukankhira molimbika mtanda chakudya. Odynophagia - chizindikiro si yeniyeni, ndi zina zotero n'zovuta kudziwa zimene mtundu wa kudwala mu thupi anafotokoza chifukwa cha ululu.

Pakuti Reflux esophagitis mwachindunji chizindikiro si lililonse, koma angathe kuonedwa pa esophagitis opatsirana (makamaka pamene candida mitundu, ndi nsungu). Ngati mankhwala lamoto, chilonda ndi ululu khansa ndi anatinso mu kholingo - zifukwa zizindikiro zofanana mu milandu ali padziko.

Atypical ululu pachifuwa

ululu atypical chosiyana ndi kutentha kapena odynophagia. Mosiyana otsiriza, ndi momwe, zikhoza kumachitika ndi Reflux esophagitis, komanso milandu matenda esophageal motility, monga esophagospasm. chizindikiro Zikuoneka kuti pa chakudya, ndipo zokha.

Zonse ndi woopsa ululu kholingo, zimayambitsa amene tikambirana kenako, kungakhale chizindikiro cha khansa kapena zilonda esophageal. Zodabwitsa ndizakuti, pa umodzi ndi mtima yomweyo amakhala ndi khalidwe losiyana, nthawi zina odwala ngakhale zimawavuta kufotokoza maganizo awo.

Nthawi zina, kupweteka m'chifuwa likhoza kulumikizidwa ndi chisokonezo atypical mu motility esophageal. Pankhaniyi, odwala kuthyola ndi khalidwe matenda, maganizo, mantha ndi matenda obwera chifukwa choganiza kwambiri ndi maganizo nkhawa.

regurgitation

Chizindikiro chimenechi tanenera chikunena za kutentha, monga chizindikiro cha mnzake. Reguritatsiya zambiri amapezeka popanda kunyansidwa ndi zakulera chidule ndipo kawirikawiri limodzi ndi ambiri za matenda a kum'mero ndi m'mimba.

Zizindikiro kusiyidwa ya nkhani chapamimba m'kamwa atsagane pathologies monga stricture esophageal kapena diverticulum. A gastro-esophageal Reflux reguritatsii akulowa wina ndi maonekedwe m'kamwa zowawa kapena wowawasa kukoma kuti ndi chifukwa cholephera wa sphincter esophageal.

The anafotokoza chizindikiro oopsa popadenii muzituluka nkhani mu dongosolo kupuma ndipo zikhoza osati chifuwa, komanso kutsamwa. Nthawi zina regurgitation zingachititse kukhumba chibayo.

Kodi matenda waukulu achalasia esophageal

Zizindikiro za matenda esophageal patsogolo kwa ululu kwakukulu ndi sternum ndi maonekedwe regurgitation, Reflux, mavuto ndi kumeza, nseru, kutentha, halitosis chifukwa lawola chakudya mu kholingo, zingasonyeze pakutchulidwa wa achalasia.

matenda imatchedwanso "cardiospasm" ndipo ndi kudwala neuromuscular kuti umabweretsa kuphwanya kutsegula kwa sphincter ndi ili mmunsi mwa kholingo ndipo amatchedwa mtima. Chifukwa cha zimenezi, chakudya sangathe kulowa m'mimba, kuchititsa zizindikiro tatchulazi.

Zimayambitsa matenda omwe sakudziwika. Ndipo nthawi zina, chikuoneka chodzidzimutsa, ndipo ena - akufotokozera pang'onopang'ono. The kusonyezedwa mtima zambiri Amasintha kuti achalasia, kuchepetsa kadyedwe awo a wambirimbiri madzi, gymnastic kokoka, etc.

Koma pofuna kukwaniritsa kudwala amafuna kuyankha kwambiri ndi funso la mmene tiyenera kuchitira ndi kum'mero. Kuchita izi, ntchito njira umalimbana kuchotsa zotchinga kuti ndimeyi chakudya - cardiodiosis (zibaluni dilation wa sphincter a) kapena kardiomiotomiyu (opaleshoni ang'ambe thupilo a minofu sphincter). mankhwala ndi zambiri makhalidwe wothandiza.

Zizindikiro ndi mankhwala a kuphipha esophageal

Matenda a kum'mero, zomwe tikambirane zizindikiro ya khateyo mu kugwira ntchito za masiku onse sphincter lapansi. Pamene izi zimachitika mu kuphipha izi limba, zomwe kawirikawiri chifukwa cha matenda a dongosolo m'mimba kapena matenda mantha.

Pa matenda a mtima anadandaula ululu wa kusinthasintha mphamvu mu nthawi ya ndime ya chakudya kudzera kum'mero ndi Pomeza mavuto. Mwa njira, nthawi zina ululu kumachitika pakati pa chakudya kenako mosavuta kusokonezedwa ndi zizindikiro za angina.

Kuphunzira kum'mero ku matenda zambiri zimachitika mapindikidwe ake chifukwa spasms minofu. matenda amenewa amafuna chithandizo cha kholingo, zambiri ndiwofatsa, ndipo, kuwonjezera, ayenera kuikidwa kwa yosalekerera zakudya ndi mankhwala antispasmodic, ndi nitrofuran ndi wothandizila sedative. Pankhani ya chisokonezo kulimbikira mtima chofunika zibaluni dilatation kapena opaleshoni.

Kodi Reflux esophagitis?

Matendawa amatchedwanso zilonda esophagitis ndipo amakhala ndi kuponya zili m'mimba mwa kholingo. Chifukwa zodabwitsazi Kulephera kwa sphincter m'munsi. Yaitali kanthu madzi muzituluka ndi ya ndulu ali ndi chikhalidwe mwamakani ndipo kumayambitsa kutupa ndi ulceration wa mucosa, imene ndi amamuyambitsa timabala amapezeka kuchepetsa wa kholingo.

Monga ulamuliro, matenda kumachitika pang'onopang'ono zimachitika mu makanda.

Mu matenda zizindikiro za kholingo nthawi anawonetseredwa mu mawonekedwe a kutentha ndi kugirigisha moto m'dera retrosternal, omwe angagwe kapena kukula chifukwa kupinda patsogolo, kugona pansi, pa nthawi ya kusuta kapena kumwa mowa.

Esophagitis akhoza kumva ndi magazi (nthawi zambiri zobisika), kukhumba chibayo ndi chilonda kusintha kholingo.

Matenda izi kudwala ezofagogasteroskopiyu anachita ndi X-ray barium. A mankhwala umalimbana ndi kuthetsa zimene zimayambitsa waukulu esophagitis (pylorospasm, mu chophukacho hiatal piloroduodenalnyh kapena stenosis). Wodwalayo anali Kwalamulidwa mankhwala amene amachepetsa acidity ( "Ranitidine" ndi "Famotidine"), Mankhwalawa ayenera kumwedwa ndi MANKHWALA OLETSA VUTOLI. Kudya matenda a yosalekerera kum'mero ndi mphamvu fractional.

diaphragmatic chophukacho

Nthawi zina mwa olumala ndipo anagula mu zakulera mu chifuwa M'mimbamo kusuntha ziwalo m'mimba - okhumudwa limanenedwa ngati chophukacho diaphragmatic. Nthawi zambiri akufotokozera mu esophageal kutsegula. Monga tanena chizindikiro cha matenda ndi mokomera Reflux esophagitis, komanso magazi zobisika ndi chikhalidwe magazi m'thupi.

Kodi azisamalila kum'mero Pankhaniyi zochimwazo kumathetsa matenda zolondola ntchito X-ray ndi endoscopy. Childs, mankhwala ndi ndiwofatsa, umalimbana kuchepetsa Reflux. Nthawi ya kuchepetsa wa kum'mero kapena magazi, alowererepo pa opaleshoni.

matenda Barrett ndi kum'mero

Pamene ululu mu mmero, kumbuyo sternum, anaponyera zili m'mimba m'kamwa, kutentha, kukoma asidi pa kamwa, aakulu chifuwa ndi hoarseness tinganene matenda kum'mero, wotchedwa metaplasia Barrett a.

Chifukwa, amene amakwiya chitukuko cha matenda sikuti zakhazikitsidwa, koma anapezeka kuti si vuto lalikulu n'lakuti chifukwa cha gastro-oesophageal Reflux esophagitis (katengedwe). Komanso, ndi kudwala imeneyi kungakhale kutsogolera kwa chitukuko cha khansa.

metaplasia Barrett ndi limodzi mwa alibe wa mucosal pamwamba pa maselo - maselo kumalumikiza la kholingo m'malo mwa maselo a mucosa matumbo. Zodabwitsa ndizakuti, amaona chikhalidwe precancerous, kaya chakuti khansa ya kum'mero - matenda osowa.

Barrett a metaplasia: matenda ndi mankhwala a matenda esophageal

zizindikiro, mankhwalawa chimene chimafuna matenda zolondola, ndi metaplasia Barrett a kwenikweni anatsimikizira ndi kafukufuku zina monga endoscopy ndi biopsy.

Pakuti pakhosi mtima limeneli amaika wapadera woonda chubu mwa zomwe kum'mero akhoza anayendera, ndiyeno nkutenga kunja kwa minofu chitsanzo kwa kusanthula wotsatira maselo.

Mankhwalawa kum'mero Barrett ndi cholinga ndi zambiri pa chithandizo katengedwe n'zothandiza metaplasia, komanso kupewa matenda a khansa. Therapy ali ndi khalidwe mofanana zochizira imagwira (Mankhwalawa ayenera kumwedwa ndi mankhwala antireflux), koma ndi kwambiri. Ngati izo ziri, pamodzi ndi zakudya mankhwala wosatenga mpumulo, komanso milandu siudzalandilidwa ngathi lamulo la chophukacho, wodwala, alowererepo opaleshoni amatchedwa fundoplication (mapangidwe ndi valavu yokumba).

Khansa ya kholingo

Matenda a kholingo, zizindikiro za zimene m'nkhani - ndi matenda ovuta, koma kudwala lalikulu kwambiri Mosakayika khansa.

Mu chitukuko cha zotupa khansa mu kholingo mbali yofunika kutupa aakulu mu thupi chifukwa cha mankhwala, matenthedwe kapena kukondoweza makina. A kusuta, kumwa mowa mwauchidakwa azitaya khansa ndi nthawi 12!

Kawirikawiri, pa chiyambi cha matenda ndi asymptomatic, ndi ndondomeko akhoza kutenga zaka 2. Pamene chotupa limakula kumlingo kuti chifukwa cha itsekeke pang'ono ndi lumen wa kholingo, wodwalayo zizindikiro za mavuto ndi ndimeyi chakudya m'thupi dzina lake. Kuonjezera dysphagia - chizindikiro khalidwe la khansa. Ndipo ngati pa chiyambi cha matenda ake, iye imapezeka ngati kuwameza kapena bwino fodya ameneyu amatafunidwa chakudya chotafuna, kenako wodwala yekha ntchito mankhwala mu madzi kapena theka-madzi mawonekedwe.

Data zikuonetsa accrue kuwonongeka kwa chikhalidwe ambiri: mphwayi, kusowa chilakolako kuwonda. Mu kuchepetsa lakuthwa wa lumen wa magawo mu kholingo limapezekanso salivation kwambiri.

Odwala ena chitukuko cha zotupa ndi limodzi ndi zomverera chowawa mmbuyo kapena kumbuyo breastbone lapansi. Childs, iwo zidzachitika pa nthawi ya ingestion ndipo patapita kanthawi kutha. Kawirikawiri ululu wotere ali kupitirirabe.

Chithandizo khansa ya kholingo

Chithandizo cha matenda a kholingo, khansa ya akhudzidwa inali opaleshoni, cheza ndi mankhwala amphamvu. Mbali yoyamba wodwalayo kwathunthu kapena pang'ono pochotsa kum'mero. Izi zimadalira kwenikweni mmene wamba ndondomeko. Komanso, lymph mfundo amachotsedwa mu mabacteria wa metastasis maonekedwe. Komabe, njira imeneyi mankhwala akhoza contraindicated odwala ena (mwachitsanzo, matenda a mtima kapena matenda a ntchito kupuma dongosolo).

Cheza mankhwala - njira yokhayo zomwe zingagwiritsidwe ntchito pofuna kuchiza ambiri odwala khansa esophageal (40% milandu kungakuthandizeni kuthetsa ovuta matenda kuwonekera kwa matenda). Morning zimagwiritsa ntchito mawonekedwe otsika kalasi ya khansa.

Palinso osakaniza mankhwala amene cheza mankhwala pamaso opaleshoni kuti muchepetse chapadera cha zisadzachitikenso m'deralo ndipo kumachepetsa kukula chotupa.

chosaopsa zotupa

Pakati pa zotupa chosaopsa mu kholingo monga zaminyewa ndipo sanali zaminyewa zotupa. Izi ndi matenda mwachilungamo yosowa ndi mbali zawo ndi njira pang'onopang'ono cha matenda ndi kusowa kwa matenda.

Monga ulamuliro, zotupa awa kukhala ku linga la kholingo ndipo nthawi zina amagwa lumen wa. Ambiri mwa iwo leiomyoma, ndipo lachiwiri ndi enaake neoplasms.

Zizindikiro zazikulu pamaso pa zotupa chosaopsa zikuchulukirachulukira pang'onopang'ono dysphagia, ndipo (pa chitukuko cha tizilombo ting'onoting'ono) Timatha kukhala ndi thupi achilendo, zomwe zimabweretsa kunyansidwa ndi kusanza.

Ambiri a zotupa awa agwidwa ndi mwayi pa Kupenda radiological.

Ngati ambiri a matenda esophageal, mankhwala a zotupa chosaopsa yafupika kuchotsa awo opaleshoni, pofuna kupewa mavuto amene angakumane nawo pa kukula chotupa. Childs, kuchotsa chikuchitika popanda kuwonongeka kwa mucosa esophageal ndipo ali ndi madokotala ananena zawo zabwino.

syndrome Mallory-weiss, wopangidwa

Pamene matenda a kum'mero ndi m'mimba zizindikiro zambiri zimapezeka kusanza kapena gagging ake. Nthawi zina wodwala pa nthawi iyi pali yopuma nembanemba mucous ya Mphambano esophageal-muzituluka. kudwala Izi mankhwala amatchedwa matenda Mallory-weiss, wopangidwa.

Monga ulamuliro, ndi chiwonetsero cha ululu mu chifuwa, ndi mwazi masanzi akuwonekera. Ngakhale ambiri mwa anthu magazi mabasi lokha, monga wodwala ayenera kuchipatala mwachangu kupewa mavuto aakulu.

Monga katemela zochepetsera Syndrome ntchito vasoconstrictors, ndiponso, ngati n'kofunika, electrocoagulation.

Malformations la kholingo

Nthawi zina matenda a m'phuno ndi kum'mero mwachindunji ndi kuvutika mu chitukuko cha iwowa - kwa underdevelopment wa mawonekedwe ake, kukula kapena malo olakwika.

Childs, kudwala ngati akuwonetseredwa mu kuchepetsa wa kholingo, pamaso pa kobadwa nako tracheal esophageal fistulae, ndipo nthawi zina sitili okwana thupi anafotokoza. Mwatsoka, chitukuko cha kudwala esophageal akhoza kuwonongeka ngakhale wakhanda njala, choncho opaleshoni chofunika kuti tichotse iwo.