Esophageal stenosis: Zoyambitsa, Zizindikiro, Chithandizo

oesophageal stenosis - chikhalidwe amene anatsagana ndi kuchepetsa nthenda ya lumen wa chubu esophageal. anomaly Izi zikhoza kukhala kobadwa nako kapena kuoneka mu wamkulu kwambiri. Matendawa zingachititse kwambiri matendawo. Komanso, mavuto ndi kumeza ndi ndime ya chakudya mmimba kungasokoneze pa ukupeza a wodwalayo komanso lonse chamoyo. Choncho n'chifukwa chiyani kudwala izi, ndipo ngati n'zotheka kupewa chitukuko? Kodi zizindikiro muyenera kulabadira? Kodi pali mankhwala kwenikweni ogwira?

esophageal stenosis: ndichiyani?

Amadziwika kuti kum'mero - chubu dzenje kuti zikugwirizana pakhosi ndi m'mimba. M'litali avareji masentimita 25 Mwachibadwa, m'mimba mwake chubu si yunifolomu -. kum'mero atatu thupi chiletso yomwe imakonzedwa mu dera la cricoid chichereŵechereŵe, tracheal bifurcation ndi kabowo.

Mu gastroenterology ano wamba kudwala otchedwa esophageal stenosis. Ndi chiyani icho? kudwala Izi limodzi ndi chidule uncharacteristic esophageal chubu. Popeza pali ubwenzi pakati pa gawo ili la kapepala m'mimba ndi ziwalo zina (mwachitsanzo, trachea, msempha, pericardium, ndi bronchus kumanzere, thunthu la mitsempha vagus, thoracic ritsa, gawo la pleura), ndipo kuphwanya cha ntchito kumaphatikizapo misa matendawo.

Zimayambitsa chachikulu cha chitukuko matenda

Kodi pali zinthu aliyense chiopsezo amene amayambitsa matenda amenewa? esophageal stenosis akhoza kukhala zimayambitsa osiyana. Pankhani mitundu kobadwa nako matendawa, iwo ali oyanjana ndi chitukuko mkhutu yoopsa, chifukwa mu hypertrophy anati kwa minofu linga la kholingo, maonekedwe a mphete fibrous kapena cartilaginous.

Koma anapeza stenosis, chifukwa awo mochuluka osiyanasiyana:

• Mwachitsanzo, nembanemba mucous zikhoza kuonongeka chifukwa cha kukhudzana zonse ndi nkhani acidic chapamimba. Chotero anati mu Reflux esophagitis, zilonda zilonda, gastritis aakulu, hiatal chophukacho , kapena toxemia choopsa cha mimba, kupatula limodzi ndi kusanza pafupipafupi.
• M'pofunikanso kutchula kuvulala. The stenosis chachikulu kwambiri kum'mero anaona amayaka mankhwala wothandizila aukali, komanso chifukwa mu kuwonongeka kwa mpanda wa thupi lina. Mungavulale mukhoza pa njira zosiyanasiyana matenda, kuphatikizapo intubation muzituluka.
• Kuchepetsa kapena kutsekedwa ngakhale wathunthu wa lumen ndi chifukwa cha khansa ya kholingo kapena maonekedwe a zotupa chosaopsa.
• oesophageal stenosis likhoza kulumikizidwa ndi matenda opatsirana kuphatikizapo matenda a mafangasi, fever, chindoko, TB diphtheria.
• Mu zina, kuchepetsa a chubu, ndi pathologies onse obwera ndi ziwalo ozungulira. Mwachitsanzo, kum'mero akhoza wothinikizidwa ziwiya anomalously pabwino kapena anawonjezera lymph mfundo. zimayambitsa monga zotupa za mediastinum ndi kung'ambika aneurysm.

Ndipamene stenoses ndi zizindikiro zawo

Pali kachitidwe zambiri izi classifications matenda. Mwachitsanzo, esophageal stenosis kungakhale kobadwa nako kapena kugula. Mwa njira, 90% milandu kumachitika mawonekedwe kobadwa nako matendawa.

Malinga ndi kuchuluka kwa madera akhudzidwa akutali stenosis umodzi (mwapang'ono lumen wa kum'mero mu malo amodzi okha) ndi angapo (pali malo angapo zotupa). Ganizirani kutanthauzira constriction kulekanitsa mkulu kudwala stenosis (isanafalikire mu msana khomo lachiberekero), sing'anga (gawo mwapang'ono ili pa mlingo wa tracheal bifurcation ndi Chipilala kung'ambika), otsika (kudwala moto anaika mu dipatimenti mtima) ndipo pamodzi.

Palinso kugawanika chifukwa cha matenda. Mwachitsanzo, cicatricial stenosis la kholingo amakhala ndi kuwonongeka mucosal ndipo nthawi zina akulu wosanjikiza chubu. Pamalo a minofu zowonongeka pang'onopang'ono limapezeka minofu connective - kotero chilonda aumbike. chifukwa kawirikawiri ndi aakulu gastro-esophageal Reflux. Nthawi zina chiletso chifukwa mapangidwe ndi kukula kwa zotupa yomwe ikhoza kukhala chosaopsa kapena zilonda. Zimachitika ndi mawonekedwe zoopsa matenda. Mulimonse, kudziwa chimodzimodzi mtundu wa matenda ndi makhalidwe pokhapokha matenda mosamala.

Siteji ya chitukuko cha matenda

Mu mankhwala amakono, kusiyanitsa madigiri anayi stenosis esophageal:

• Mu gawo loyamba matenda limodzi ndi kuchepetsa wa lumen kuti 9-11 mm m'mimba mwake. Pa nthawi yomweyo kudzera zikuoneka kuti atchule sing'anga-kakulidwe endoscope.
• Pa sitepe yachiwiri, kuti kukachitika kuti m'mimba mwake wa lumen wa kum'mero pa malo stenosis yafupika 6-8 mm. Koma kupyolera zikadali n'zotheka kulowa fibrobronzoskop.
• Mu ndime yachitatu esophageal chubu ndi mwapang'ono ndi awiri ake ndi zosakwana 5.3 mm. Kudzera pamalowo dokotala akhoza kulowa yapadera, kopitilira muyeso-woonda fiberscope.
• Mbali chachinayi cha matenda yodziwika ndi kuchepetsa kwambiri lumen, ndi awiri a ndi 1-2 mm. Odwala ena pali wathunthu blockage wa kum'mero, amene ndi oopsa kwambiri.

Esophageal Stenosis: Zizindikiro

The kale matenda ndi matenda mwamsanga wodwala amalandira mankhwalawa. Choncho zizindikiro limodzi ndi stenosis la kholingo? Zizindikiro zimadalira kwambiri pa mawonekedwe ndi gawo la matenda.

Pankhani kuvutika kobadwa nako, woyamba "Alamu kuyitana" Tingaone pafupifupi nthawi yomweyo. Pambuyo kudyetsa mwana zambiri akusanza mkaka nestvorozhennym. Mukhozanso muzindikire ntchofu kwambiri ndi ndime m'mphuno, ndipo salivation kwambiri.

Mu chochitika kuti mwana umakhala ofatsa a stenosis kobadwa nako, mavuto kuyamba ndi oyamba zakudya Kugwirizana mu zakudya za chakudya woyamba kapena olimba.

Kuthi kudwala akufotokozera pang'onopang'ono. Monga ulamuliro, odwala ndi mavuto Pomeza zimachitika. Mwachitsanzo, ululu zotheka pa ndime ya chakudya kudzera kum'mero ndi chifuwa ululu maonekedwe. Mu masiteji koyamba dysphagia anamuona pa ntchito ya chakudya chotafuna, koma osachepera kuchepetsa chubu esophageal, munthu amakhala lovuta kulitsatira chakudya madzi. Nthawi zina matendawa amakhala kwambiri kuti wodwalayo sangathe kumeza madzi kapena malovu.

Ngati stenosis ndi ili mu dera khomo lachiberekero, koma atamwa madzi, kapena ngakhale zidutswa za chakudya angakhoze kulowamo trachea, ndilo zinadzala ndi amphamvu chifuwa, laringospazmom, suffocation. Mu Zikavuta kwambiri stenosis kumabweretsa chitukuko cha chibayo chiyembekezo.

Nthawi zambiri, zidutswa olimba ndi lalikulu linayamba kudziunjikira mu constriction, ndi imbaenda nseru pafupipafupi ndi kusanza, maonekedwe a ululu. zotsatira zowawa za stenosis monga chophukacho mowiriza a linga kum'mero.

njira zamakono za matenda

Pambuyo pokambirana ndi dokotala wodwalayo anganene kukayikira pamaso pa stenosis. Kumene, m'tsogolo kafukufuku pakufunika zambiri. Chinthu choyamba kunyamula oesophagoscopy, kudzera zomwe n'zotheka kudziwa ndi kuchepetsa wa lumen kum'mero nuyese awiri ake, ndi kuyendera mucosa. Mu kukhalapo kwa zotupa, kapena zilonda akhoza kuchitidwa endoscopic biopsy pamaso pa maselo zilonda.

Ofunika ndi njira matenda a radiography ntchito mosiyana wothandizila (salt zambiri barium ntchito). Ndondomeko amathandiza kufufuza mtunda ndi contours a kholingo, komanso kuphunzira peristalsis ake.

ndi mankhwala zimene amapereka mankhwala amakono?

Chiwembu mankhwala kumatengera zifukwa zambiri, monga mawonekedwe a kudwala, mbali yake chitukuko, chikhalidwe cha wodwalayo, ndipo kumachititsanso stenosis. Choyamba tiyenera kusintha zakudya - zakudya ayenera zigwirizana wa chakudya theka-zamadzimadzi kuti akhoza kudutsa constriction la kholingo. Pankhani digiri dysphagia aakulu chachinayi pamene wodwala ngakhale kutenga ndimweko madzi, chakudya unachitikira m'nsinga.

Pali njira zingapo kuchotsa chiletso. Nthawi bata ikuchitika ntchito zibaluni dilatation bougies. Koma ngati stenosis si amenable njira zimenezi ukugwirizana anachita endoscopic kung'ambika strictures. Kukachitika kuti pali psinjika wa kum'mero (mwachitsanzo, kuchepetsa pafupi chotupa kukula), mkati mwa lumen wa stent akhoza anaikapo wapadera, zomwe kusunga mbali yofunika ya kholingo.

Nthawi zina zimachitika kuti njira pamwamba sapereka chifukwa akufuna, stenosis akupitiriza kupita patsogolo. adokotala akhoza kugamula zambiri kwakukulu njira - kuchotsa mbali akhudzidwa la kholingo, ndi kuchira wotsatira.

Kaya chithandizo n'zotheka miyambo njira?

Traditional mankhwala - makampani kuti amapereka nambala yaikulu njira zina. Kodi n'zotheka kuti tichotse iwo mothandizidwa ndi matenda monga stenosis la kholingo? wowerengeka azitsamba chithandizo mu nkhani iyi si yoyenera. N'zotheka kuti dokotala khalidwe zakudya zolondola kapena malangizo ena alionse. mankhwala Home Pankhaniyi mwamtheradi contraindicated.

Kodi pali miyeso ogwira njira?

Mwatsoka, kwenikweni ogwira zipangizo zodzitetezera alipo. Koma mawonekedwe kobadwa nako, mayi ndi wofunika kuti aziona ukupeza. Pamaso pa mfundo zoopsa (anasamutsa pa matenda mimba, ndi zina zotero. D.) kasamalidwe muyenera kucheza woyamba masiku angapo pambuyo pa kubadwa kwa kuzolowera zakudya ndi nthawi kukhwimitsa chitetezo.

Mu akula, odwala akulangizidwa kutsatira zakudya, komanso nthawi pofuna kuchiza matenda pa mundawo m'mimba, kuteteza ndimeyi awo mu kwambiri kapena yokhalitsa.

Kuti madokotala ananena zawo odwala ndi stenosis esophageal

Pamene sanalandire chithandizo esophageal stenosis kungayambitse mavuto kulemera. Komabe, opaleshoni akhoza kuthetsa kuphwanya lapansi. Kumene, ndi mankhwala owonjezera pamaso pa matenda concomitant. Komabe, madokotala ananena zawo wodwalayo bwino ndithu. muyambirenso A n'zotheka, koma, malinga ndi ziwerengero Zikatero ndi mwapadera opezeka kwambiri kawirikawiri.