Zamiya hiatal hernia: cututtuka da kuma magani

Hiatal hernia (photo Pathology da aka gabatar a kasa a cikin labarin) da kuma reflux esophagitis ne quite hatsari cututtuka. Kan bango na wadannan jihohi da aka alama mikewa da wasu gastrointestinal segments. A musamman, canje-canje da faruwa a cikin jijiyoyin cewa goyi bayan ciki da kuma esophagus, wani photo na wanda aka kuma gabatar a cikin labarin. A sakamakon haka, tashin hankali da aka canja. A musamman, da na sama na ciki da ke shiga cikin akwati yankin. A sakamakon gaji da damuwa da aiki na sphincter haɗa da ciki da kuma esophagus (hoto misalta wannan sashe).

m hadarin

Idan ka canza kwana na tsaki da kuma take hakkin ayyuka esophageal (kasa) na sphincter auku jefa acid abinda ke ciki na ciki, ko kuma bile cikin esophagus na 12 duodenal miki. A tsari yana tare da ci gaban da kumburi mucous rearrangement. Wannan ƙwarai qara kasadar ciwon daji. Na musamman muhimmancin a cikin ci gaban da cutar ne a zamiya hiatal hernia. Surgery ne kawai hanyar samuwa da ya kawar da take hakkin. Duk da haka, m baki na da nuances. Bugu da ari, bincika daki-daki, abin da ya ƙunshi wani hiatal hernia. Har, iri da kuma bayyananen ma aka bayyana a cikin labarin.

Overview

Hernia a esophageal bude, yawanci tasowa a tare da gastroesophageal cuta. Kwace tare da hadaddun cardiac, na huhu da kuma dyspeptic cuta. Sun bayyana yafi saboda hernia da gastroesophageal reflux. Bisa ga American da Turai da ƙungiyoyi a gaban HH da mutum ga 5-12 shekaru yiwuwar ciwon daji shekaru biyar baya tsiro zuwa 270%, da kuma 12 - by 350-490% (dangane da shekaru).

Yaduwar Pathology

HH, bisa ga dama mawallafa, an dauke a matsayin fiye kamu da cutar, kamar cholecystitis ko esophageal ulcers. A cewar ta dauko daga wadannan cututtuka ne manyan gastrointestinal cututtuka. HH kamar yadda esophageal miki, an dauke isasshe m cuta bukata farkon ganewar asali da kuma hankali da lura.

rarrabuwa

Akwai uku main Categories HH. Wadannan sun hada da:

• Axial hiatal hernia. Wannan Pathology yana da wani sunan. The kowa sunan - zamiya hiatal hernia. Wannan irin Pathology da aka gano a cikin kusan 90% na marasa lafiya. Jihar halin da ya faru na esophageal achalasia sama da rami. A wannan batun, shi ya kasance mai kaifi warwarewarsu rufe aiki.
• Paraesophageal hernia. Wannan siffar da aka samu a kusan 5% da marasa lafiya. Domin irin wannan Pathology ne halin da akai matsayi na cardia da wani gagarumin curvature na ciki.
• Short esophagus. Matsayin mai zaman kanta, wannan Pathology da aka yi fama sosai da wuya. A cuta ne abnormality a ci gaba. Matsayin mai mulkin, wannan ciwo yana tare da wani zamiya hiatal hernia. Ga shi kuma an halin da kumburi da kuma scarring tafiyar matakai.

zamiya hernia

Wannan nau'i na cutar halin da wasu peculiarities. A general zamiya hernia ne protrusion, cikinsa da daya bango ne partially rufi peritoneum jiki. Yana za a iya kara dauke a cikin labarin rabo, mafitsara, suna hawa da sauka ciwon, da sauransu. A wannan yanayin, da hernia jakar kwai ba zai iya zama. Diverticulum, a cikin wannan yanayin dimbin yawa jiki yankunan ba ta rufe peritoneum.

Ginshikai na aukuwa

A daidai da wannan siffa da aka ware:

• Nakasar hernias. A wannan yanayin da hukumomi domin wani dalili daya ko wasu sassan, ba rufaffiyar peritoneum hankali sauka zuwa wani yanki na ciki ƙofar retroperitoneal kitse. A lõkacin da suka zo daga cikin kogo. Wannan tsari na iya fara a farkon zamanin tayi zai kare. A sakamakon haka, sassan an biya diyya bangaren protrusion ba tare da hernia jakar kwai.
• An samo cuta. Hernias na da irin wannan suna kafa ta a inji ƙanƙancewa na cikin mafitsara ko hanji segments. Su suna hana serous murfin kuma m ga peritoneum.

Inguinal hernia zamiya a cikin manyan hanji, yawanci manyan protrusions tare da fadi da ƙofar. Bincikar lafiya, yawanci a cikin tsofaffi. Gano yin amfani da X-ray dabaru na manyan hanji jarrabawa. Zamiya hernia na mafitsara bayyana dysuric cuta. Marasa lafiya alama biyu urination. Da farko draining ne da za'ayi kamar yadda ya saba, sa'an nan, a lokacin da latsa a kan protrusion, akwai wani tura da haƙuri urinates sake. Lokacin da ganewar asali aka yi catheterization da cystography. A cikin shakka daga cikin wadannan hanyoyin saukar da siffar da size da hernia, babu ko gaban mafitsara duwatsu.

Axial hiatal hernia

Wannan Pathology ne hijirar na ciki ko wasu na ciki gabobin a cikin kirji kogo. Cutar da ake bincikar lafiya a 5% na yawan balagaggun jama'a. Duk da haka, game da rabin da marasa lafiya ba lura da wani bayyanar cututtuka. Irin wannan kwarara Pathology saboda zamiya hiatal hernia ya share ãyõyi hankula siffar saboda protrusion an zubar da cikin jiki da kuma karkashin al'ada Viewing ba za a iya gano. Haka kuma cutar rinjayar mata fiye da sau da yawa fiye da maza. Katafaren Pathology ne mafi yawa m.

siffofin da cutar

Zamiya hiatal hernia ne zuwa kashi:

• Kardiofundalnuyu.
• Total na ciki.
• Cardiac.
• Subtotal ciki.

Paraesophageal hernias suna kasu:

• Gastrointestinal.
• Shaƙewa.
• Hanji.
• Antral.
• Fundus.

pathological mataki

Zamiya hiatal hernia iya classified daidai da ƙara na ciki iya shiga cikin akwati rami:

• A mataki na farko. A wannan yanayin, thoracic rami da diaphragm aka located a kan na ciki rabo daga esophagus. A ciki ne sai a wani dagagge matsayi. Shi ne kai tsaye dab da diaphragm. Kuma shi ne located a cardia.
• A mataki na biyu. A thoracic kogo ne na ciki rabo daga esophagus, ciki aka raba kai tsaye a cikin yankin na phrenic rami.
• The uku mataki. Sama da diaphragm ne cardia, na ciki da jiki da kuma kasa (wani lokacin antral rabo) na ciki esophageal rabu.

asibiti hoto

Alamun cutar suna kama da bayyanar cututtuka na cututtuka na narkewa kamar fili hade tare da mai illa aiki. Kan bango na tabarbarewar a aiki na esophageal (m) sphincter alama catarrhal reflux (baya Jefo ciki abinda ke ciki). A kan lokaci saboda da m rinjayar da taro a cikin ƙananan rabo daga esophagus tasowa kumburi tsari. A haƙuri fara koka ƙwannafi bayan da abinci da kuma kara da jiki danniya ko a kwance matsayi. Sau da yawa akwai wani ji daga wani curi a makogwaro. Bayan da abinci, da zafi iya bayyana. Su ne daban-daban a yanayi. A soreness iya yada wa kafada ruwa, ba a cikin wuyansa, bayan da sternum, a kusa da zuciya ko ƙananan muƙamuƙi. Wadannan cututtuka su ne kama da bayyanar cututtuka na angina, wanda yana da za'ayi bambanci ganewar asali. A wasu lokuta da zafi bayyana a wani wuri na jiki. M kira ga haƙuri da babba ciki distension, sakankancẽwa gaban kasashen waje jiki.

effects

More tsanani lokuta ana halin da yawan rikitarwa. Daya daga cikin su an zubar da jini daga esophageal tasoshin. Matsayin mai mulkin, yana daukan wuri a cikin wani latent tsari, da kuma bayyana a matsayin m anemia. Zub da jini zai iya zama na kullum, kuma m. A wasu lokuta, ko da gano ƙeta protrusions a esophageal bude da kuma esophageal perforation. Mafi na kowa sakamakon cuta ne reflux esophagitis. Yana za a iya canza kama zuwa wani peptic miki a cikin esophagus. A lokacin m magani tsokani wannan yanayin mafi tsanani wahala - cicatricial stenosis (takaita) na jiki.

bincikowa da

Pathology ganewa ne da za'ayi ta hanyoyin da dama. An ambaci yana daga cikin manyan: esophagogastroduodenoscopy, X-haskoki na ciki da kuma esophagus, intraesophageal PH-mita. Amfani da duban dan tayi, lissafta tomography, ezofagometriya.

cuta magani

Za'ayi ayyuka daban-daban da nufin alleviating da bayyananen cewa bi da zamiya hiatal hernia: rage cin abinci, magunguna. Conservative hanyoyin da ake da nufin kawar da cutar bayyanar cututtuka: zafi taimako, ƙwannafi, tashin zuciya. A wannan yanayin, nada kwayoyi da rage ciki acidity. By irin wannan nufin, misali, hada da shirye-shiryen "Kvamatel". Daya daga cikin yanayi na tasiri lura da marasa lafiya bincikar lafiya tare da hiatal hernia - a rage cin abinci. A rage cin abinci da aka iyakance ga gaban m, yaji, soyayyen abinci, barasa, cakulan, kofi, kayayyakin da inganta samar da ciki ruwan 'ya'yan itace. Cin ya zama kananan abinci sau da yawa. Don hana reflux barci haƙuri an rika da tashe babba jiki yankin, da kuma kauce wa nauyi dagawa.

Surgery: general bayanai

Ya kamata a ce cewa sama da ayyuka ba kawar da dalilin da akwai wani zamiya hiatal hernia. Operation - kadai hanyar dawo da anatomic dangantaka tsakanin GI sassa. A kan aiwatar da baki halitta wani antireflux inji cewa hana baya da ya jefa ciki abinda ke ciki. Lokacin aiki hernial shafe ta da suturing kara girman budewa al'ada size.

Used m dabaru

Yau, masana amfani da hanyoyi guda biyu da na sa baki:

• Open damar. A wannan yanayin, zai iya yiwuwa a dauki Nissen fundoplication ko roba da Tope. A cikin farko case, wani babban hadarin da bunkasa rikitarwa na sa. Saboda roba ne fin so ga Tope.
• Laparoscopic m. Wannan ne kalla traumatic Hanyar baki. Bayan da aiki a cikin wannan hanya da mãsu haƙuri recovers sauri da kuma sauki.

Ba dole ne a ce cewa a laparoscopic hernia esophageal rami ne sau da yawa da za'ayi tare da yadda ake gudanar da sauran gabobin a cikin kogon ciki. Alal misali, holetsistomiya yi a lokacin da calculous cholecystitis a kullum mataki, zabe proximal vagotomy - miki a duodenum.