Atsamwira pakati yegurokuro: Zvinokonzera, Zviratidzo, Treatment

Perforation, kana pane atsamwira kuti yegurokuro - kutyora kuvimbika yegurokuro, kwakaitika pamusoro mamiriro pfungwa kana nomuzvarirwo. Vagumirwe inosimbisa ndiyo imwe - amburenzi, sezvo pakakoromoka chiine ngozi chaiyo upenyu murwere. Kugadzira dambudziko iri zvinogona chete kuva zvashata kuvhiya kupindira. Muzviitiko, kana murwere ari muchipatara, uye pakakoromorwa zvidiki, zvinokwanisika kuti kuchinja kurapwa.

nhamba

Izvi Chirwere kushoma chaizvo, ndiye anenge 1% wevarwere vose kuwira thoracal Department. Perforation kunoitika katatu kakawanda varwere makono. The chirwere zvikuru nevakawanda vanhu makore makore 50 uye vakwegura. Boerhaave urwere kana chirwere Boerhaven anenge 15% wevarwere vose perforation.

kupatsanura zvirwere

Zvokurwara inogona kupatsanurwa maererano nheyo panowanikwa:

• rakazvimirira nosological chirwere kusanganisira Boerhaven urwere;
• kuomesa chimwe chirwere, kunotevera, kana iatrogenic zvinokonzera.

Panzvimbo localization:

• atsamwira rakazara yegurokuro, i.e. vemunyika perforation mhiri rusvingo ukobvu;
• kukwana perforation, kuti vemunyika mumwe kana kupfuura membranes lining pamusoro yegurokuro;
• zvemukati kana up gwanza, localization mukati perforation pakati yegurokuro;
• Outdoor rakavhurika perforation pamwe localization kuchivanze masvingo yegurokuro.

Kunyange zvazvo zviratidzo chirwere kuratidzwa akafanana vaviri mhando discontinuity.

Mallory-Trappers Syndrome, esophageal kana mutswe

esophageal atsamwira ndiko zvokurwara zvakadai, uyewo kutsemuka mudumbu kana yegurokuro. Makatsemuka inogona kuroorwa uye unogona kurongwa mhiri mucosa pakati yegurokuro. For Mallory-Trappers chirwere haisi kwese kunoitika connective kukuvara tishu. Sezvo pakakoromorwa, makatsemuka vari yo varwere vane makore makore 50, vanhurume, uye kudhakwa.

zvikonzero

esophageal atsamwira kazhinji inoitika necheseri;

• kakawanda endoscopic bvunzo ;
• makemikari Unopisa;
• mitumbi vatorwa, kunyanya chenjera;
• kunotevera uye rakapinza kukuvara;
• ne hanya maitiro siyana remapazi, uye somunhu mugumisiro esophageal kukuvara.

Mune zvisingawanzoitiki Muzviitiko, misodzi anogona kazhinji kukurutsai kana kuva simba uye inogara kwenguva refu chikosoro. Labor, kana pane simba kuedza zvinogona kukonzera zvirwere. Tikafunga tsviyo nepfari zvingaitikawo pakakoromoka.

boka nengozi

boka iri zvinosanganisira vanhu nemashoko anotevera pathologies:

• esophagitis;
• esophageal urikanwi pamwe hune kurutsa.

Vanhu vane kushapira nokudya chirwere zviri pangozi. By chirwere kunogona kukonzera zvakakomba chaiko kushushikana kana overexertion panguva defecation. Pangozi uyewo vari hono hafu vanhu kubva pamakore 50.

Zviratidzo zvirwere kuratidzwa

Kazhinji, ari kurapwa mufananidzo kunoratidzwa pakarepo kutanga zviratidzo, uye kunoratidzwa dziri:

• marwadzo ari epigastric nharaunda uye retrosternal;
• chiveve;
• bhokisi marwadzo;
• paleness ganda rose pamusoro muviri;
• yakaoma chikosoro kuti inoitika "nzvimbo isina yakaenzana";
• zvakawedzera salivation;
• tachycardia, kupfupika mweya;
• anacatharsis pamwe splashes ropa, pamusoro kwenguva, nemarutsi chingaratidzika akafanana kofi nhandare;
• kupfupika mweya uye rinorema;
• kunonyengedza vangadikitira;
• kuvhundutsa pamusoro yaitwa kurwadziwa;
• kuratidza zviratidzo kudhaka;
• makumbo uye chiso azvidzore zvitema, uye anovandudza cyanosis;
• mukaha mumarudzi thorax zvinogona kuzivikanwa mediastinitis;
• kana pakakoromoka kumativi mudumbu, zvingakonzera peritonitis;
• emphysema, vakazadzwa mhepo, kumeso uye mutsipa.

Kuvapo esophageal atsamwira zviratidzo zvinoda kurapwa nokukurumidza. Zvinosuruvarisa asi muna 50% nyaya, perforation varwere kufa nokuda pokumbononotswa kutsvaka kutarisirwa.

The dambudziko zvakare iri ndege kuti pakakoromoka zviratidzo zvakafanana kuti zvimwe zvirwere uye anogona kukonzera pleuritis kana infarction. Somugumisiro, asina zvakakwana chirwere uye kurapwa munhu anogona chete kufa.

chirwere matanho

Kana uchifungidzira aparadzanisa pakati yegurokuro chirwere mabasa kuitwa pamusoro zvashata hwaro. Chokutanga, kuitwa ongororo mumuviri, zvinoitika kare. Ropa vakatorwa pamusoro nemakemikari uye zvayo kuongorora. Kuitwa X-ray kuongororwa uye Ultrasound. Zvichienderana nzvimbo kurwadziwa, akaita chipfuva X-ray. Chirwere kunosanganisirawo mediastinoscopy uye pharyngoscope.

X-ray kudzidza zvainanga kuona mvura Kamudzira uye mhepo iri pleural uye abdominal in. Kuti tizive localization chirwere kare chakaunzwa yegurokuro soluble kusiyana iyo dzichitama, kuona nzvimbo uye kukura esophageal kukuvara.

Endoscopy rinoitwa kushandisa yakaoma endoscope, kwete kuti kudza mhepo yegurokuro.

kurapa kungaitwa pane kwakajairika

esophageal atsamwira kurapwa kunosanganisira kuvhiyiwa.

Very kashoma, asi akangoshandisa kuchinja kurapwa. Zviitiko zvakadai zvinogoneka kana kukuvaradzwa mucosa hakuna masendimita anopfuura 1,5 Zvinogona kukuvara yegurokuro kana hove mapfupa biopsy tsono, mukuru mugariro -. Mediastinal kutadzirwa. Mukuwedzera, murwere haafaniri kuva kuuyawo zviratidzo, iyo kunoratidza kuti kuvhiya kupindira. Panyaya iyi, zvinoshingaira asingaurayiwi. Food uye zvokunwa panguva kurapwa hakudi pakatanga zvokudya achishandisa muromo. Mishonga inorwisa utachiona raitongwa murwere kakawanda pazuva uye akaisa mubhedha zvizere zororo. Kana chiitiko haripi kunobatsirawo, zvakakodzera kuitisa oparesheni.

Zvisinei, kazhinji "kukurira" chirwere uye kudzivirira rufu zvinogoneka chete chete chikamu ari chiremba. Huru operative mabasa chinangwa:

• mangwanani kuvhara zviri pakakoromoka;
• abudise kuti abscesses, kana iripo, kudzivirira kukura peritonitis;
• pfupi achisiya yegurokuro kubva zvinonakisa zvomudumbu hurongwa.

Pashure pokuvhiyiwa, dzinenge 2 mazuva havadyi nomuromo. Power akasungwa kuburikidza gastrostomy. Doctors raitongwa chaiyo inotonhorera mhinduro.

Kana murwere nemamiriro anosiya, pazuva 3 rinotanga pakatanga zvokudya nenzira inozivikanwa, asi akaisa Mishonga tafura. Kushandisa anotevera zvinhu vanobvumirwa:

• miriwo nemichero zvimedu chimiro;
• bota;
• soups;
• mondo uye muchero zvinwiwa;
• nyama uye hove, asi pasi-mafuta marudzi, iva nechokwadi kuti zvakabikwa kana steamed;
• Pudding kuti chizi uye nyama.

Zvichava hazviiti kushandisa furawa zvigadzirwa, kusanganisira chingwa. Zvinonzi rambidzwa kudya fried uye mafuta zvokudya, Kuchengetedzwa, acidic zvokudya anogona kugumbura mucous membrane. Products chine madhayi.

zvinogadzirwa zvose zvinogona kushandiswa pashure pokuvhiyiwa, vanofanira kuva kwemashoko puree kana kuva peretortom chimiro, asati ndichivatakura inofanira kuiswa ushamwari pakusava, uye kudya migove diki.

zvinogoneka yematambudziko

Migumisiro atsamwira pakati yegurokuro ingarwadza. Advanced siyana hosha anogona kukura pus uye kuzvimba, zvichiguma kukuvadza tishu. Early kurapwa - njodzi kunzvenga Guarantee zvinokuvadza zvinokonzerwa uye kutanga rufu.

Kufembera uye kudzivirira

Sezvo kuvapo esophageal atsamwira, Mallory-Trappers urwere, asi fungidziro hwokuponesa kunonyanya novimba nguva penguva pakati pakutanga nguva kurapwa uye esophageal kukuvara. Kuita basa rinokosha, uye zvakaoma kunzwisisa kuti pematanho zvokurwara, nzvimbo localization uye kukura pakakoromoka, mukuru ezvinhu omurwere, nezvirwere.

Matanho munyaya ino, kuridza yechipiri basa. Zvisinei, achisiya zvimwe zvinhu kuchaita kuti kukura chirwere. Kuti tidzivise iatrogenic kukuvara, usarega muviri wako ezvinhu bulimia, nenguva kuongorora zvokurapa.

Zvakakosha kuchengeta zvimwe mitemo kuti kuderedza mukana perforation. Dzidzisai vana kuti nguva dzose kudya zvokudya zvishoma nezvishoma, kutsenga kwazvo. perforation rinowanzoberekera tikafunga pakuparadza guru zvimedu zvokudya. Musakanganwa shoko "kana ini ndidye, ndiri matsi uye mbeveve." Zvakakosha kuramba kubva simba mumuviri nesimba, kubva uremu vachisimudza. Meals vanofanira kuva pakati nepakati uye zvakarurama, regai kushandisa doro.