Esophageal stenosis: Zvinokonzera, Zviratidzo, Treatment

oesophageal stenosis - mamiriro icho pamwe vanokara aienda pamusoro lumen ari esophageal chubhu. anomaly Izvi zvingava vachiberekwa kana kuoneka mune zvimwe munhu akura. The chirwere kungaita zvakawanda yematambudziko. Uyezve, nezvinetso kumedza uye ndima zvokudya mudumbu vane inokanganisa mamiriro utano murwere uye yose muviri. Saka nei paine zvokurwara ichi, uye kana zvichiita kudzivirira kukura kwayo? Ndezvipi zviratidzo unofanira kuteerera? Pane mishonga here inobudirira?

esophageal stenosis: chii?

Zvinozivikanwa kuti yegurokuro - negomba chubhu unobatanidza huro uye mudumbu. Its avhareji kureba masendimita 25 Sezvinotarisirwa, chubhu dhayamita haisi yunifomu -. Yegurokuro ane nhatu akavarambidza vasiri izvo kurongwa kunzvimbo cricoid shwashwa, tracheal bifurcation uye aperture.

In gastroenterology ano zvakafanana zvokurwara inonzi esophageal stenosis. Chii? zvokurwara Izvi pamwe marwadzo uncharacteristic esophageal chubhu. Sezvo pane pedyo ukama pakati chikamu ichi zvomudumbu turakiti uye dzimwe nhengo (semuenzaniso, trachea, yeropa, pericardium, kuruboshwe bronchus, hunde yacho vagus etsinga, thoracal mutsinga dzinofamba nemukaka, chikamu pleura), uye kutyorwa basa rake rinosanganisira boka guru yematambudziko.

The kukonzera chirwere kukura

Pane zvinokonzera njodzi kuti pave nekukurukurirana chirwere chakadai? esophageal stenosis kunokonzerwa zvakasiyana. Kana totaura vachiberekwa siyana chirwere, izvo chokuita havachanyatsogoni fetus, zvichiguma vakachengeta hypertrophy pamusoro tsandanyama rusvingo yegurokuro, pakuonekwa fibrous kana cartilaginous zvindori.

Kana vawana stenosis, zvikonzero zvavo zvikuru siyana:

• Somuenzaniso, mashoko mucous Kamudzira inogona zvakakuvadza somugumisiro kugara vachionana acidic gastric mukati. Kwakadaro kuchengetwa reflux esophagitis, peptic maronda, chisingaperi gastritis, hiatal heniya , kana kunyange zvakakomba toxemia pamuviri, kunze kwokunge pamwe kakawanda kurutsa.
• Zvakakodzera kuzotaura makuvaro. Wakakura zvikuru stenosis pakati yegurokuro vakachengeta kutsva mishonga hasha vamiririri, uyewo zvichiguma kukuvadzwa rusvingo muviri yokumwe. Get vakakuvara unogona panguva dzakasiyana-siyana chirwere dzokuvhiya, kusanganisira gastric intubation.
• Kuderedza kana kuvhara zviri lumen kunyange kwakakwana uri mugumisiro kenza yegurokuro kana chitarisiko benign anomera.
• oesophageal stenosis anogona chokuita nezvirwere kusanganisira fungal zvirwere, nezvitsvuku fivha, njovhera, tibhii, diphtheria.
• Mune zvimwe zviitiko, aienda pamusoro chubhu, uye zvose pathologies chokuita yakapoteredza nhengo. Somuenzaniso, yegurokuro inogona compressed anomalously papi midziyo kana awanda node nodes. The zvinokonzera zvinosanganisira mapundu pamusoro mediastinum uye kutsemuka aneurysm.

Unoumba stenoses uye mamiriro avo

Kune vazhinji mugadziriro ino chirwere classifications. Somuenzaniso, esophageal stenosis kungava vachiberekwa kana vawana. Panzira, muna 90% kubva kacho zvinoitika vachiberekwa chimiro chirwere.

Zvichienderana nhamba ane nzvimbo voga vasina stenosis (kujekesa lumen pakati yegurokuro panzvimbo imwe chete) uye vakawanda (pane zvakawanda nzvimbo maronda). Kufungawo localization constriction anoparadzanisa yakakwirira zvokurwara stenosis (vemunyika mune remuromo nomuzongoza), svikiro (mugove kujekesa riri ufanane tracheal bifurcation uye kutsemuka chematenga), pasi (zvokurwara pachoto muNzvimbo cardiac dhipatimendi) uye zvabatanidzwa.

Panewo weboka kwezvikonzero chirwere. Somuenzaniso, cicatricial stenosis pakati yegurokuro kunoratidzwa mucosal zvakakanganisika uye dzimwe nguva tsandanyama rukoko yacho chubhu. At nzvimbo tagovera zvinyama zvishoma nezvishoma anooneka connective zvinyama - saka vanga aumbwa. Chikonzero Kazhinji chirwere gastro-esophageal reflux. Dzimwe nguva Kurambidzwa nokuda paumbwe uye kukura anomera izvo vangava benign kana akaipa. Kuitika uye dzechimwe chimiro nechirwere. Chero zvazvingava, kuziva zvirwere uye unhu imwe mhando chete pashure kungwarira kuongorora chirwere.

Stage okukura chirwere

In mushonga ano, kusiyanisa madhigirii mana esophageal stenosis:

• In wokutanga Danho chirwere kubatana aienda pamusoro lumen kuti 9-11 mm mu dhayamita. Panguva iyoyo kuburikidza ingangodaro yokusuma svikiro kadikidiki endoscope.
• On danho rechipiri, vanoti chiitiko kuti dhayamita yacho lumen pakati yegurokuro pa nzvimbo stenosis ipfupi kuti 6-8 mm. Asi kuburikidza zvichiri zvinogoneka kupinda fibrobronzoskop.
• In danho rechitatu esophageal chubhu iri kujekesa wayo dhayamita idukusa 5.3 mm. Kuburikidza nzvimbo iyi chiremba anogona chete kupinda chaiwo, Ultra-mutete fiberscope.
• Danho rechina chirwere inozivikanwa kwakakura aienda pamusoro lumen, iyo dhayamita ihwo 1-2 mm. Mune dzimwe varwere pane blockage pakati yegurokuro, inova ngozi chaizvo wakakwana.

Esophageal Stenosis: Zviratidzo

Kwokutanga chirwere kunokwanisa kuonekwa, nokukurumidza murwere anogamuchira kurapwa. Saka chii zviratidzo aine stenosis pakati yegurokuro? Zviratidzo kuvimba zvikuru pamusoro chimiro uye pavaipfuura chirwere.

Kana totaura vachiberekwa abnormalities, wokutanga "aramu zvinoda" anogona kuonekwa panenge pakarepo. Mushure zvokudya mwana kazhinji vomits nestvorozhennym mukaka. Unogonawo kuona simba madzihwa kubva nasal ndima, uye kunyanya salivation.

Kuri kuti mwana ane munyoro chimiro vachiberekwa stenosis, matambudziko kutanga pakatanga nopindirana zvokudya mumba zvokudya wokutanga kana chikafu chikukutu.

Vawana zvokurwara hwapedyo zvishoma nezvishoma. Kazhinji, varwere pakuparadza matambudziko kuitika. Somuenzaniso, zvimwe marwadzo panguva ndima zvokudya kuburikidza yegurokuro uye chipfuva marwadzo chitarisiko. In kwokutanga nzendo dysphagia kwakacherechedzwa pakushandisa zvokudya zvikukutu, asi kanenge kuderedza esophageal chubhu, munhu anova nesimba kumedza kunyange mvura nezvokudya. Dzimwe nguva chirwere zvinova kwazvo zvokuti murwere haakwanisi kumedza mvura kana mate.

Kana stenosis iri munzvimbo remuromo nharaunda, asi ndikanwa mvura, kana kunyange zvidimbu zvokudya anogona kupinda trachea, iyo hwakazara rakasimba chikosoro, laringospazmom, kutadza kufema. In wakakura zvikuru zviitiko stenosis kunotungamirira kukura chido nemabayo.

Kazhinji, yakasimba uye hombe zvidimbu zvokudya kutanga kuunganidza ari constriction, iyo inotungamira kakawanda kuda kurutsa uye kurutsa, pakuonekwa kwazvo kurwadziwa. Ngozi migumisiro stenosis zvinosanganisira kwatangwa atsamwira pakati yegurokuro rusvingo.

Modern nzira nechirwere

Mushure kutaura chiremba murwere anogona kutaura kufungirana pamusoro pamberi stenosis. Zvechokwadi, mune ramangwana zvakawanda tsvakurudzo chinodiwa. Chinhu chokutanga kutakura oesophagoscopy, vachishandisa izvo zviri vakwanise kuona aienda pamusoro yegurokuro lumen uyere dhayamita wayo, uye kuti aongorore mucosa. In pamberi namamota, kana nemaronda igotakurwa endoscopic biopsy kuvapo masero nyanyisa.

Zvinokoshawo ndezvokuti ndiyo nzira nechirwere kuti radiography kushandisa musiyano mumiririri (kazhinji barium munyu anoshandiswa). nzira iyi zvinobatsira kuongorora mamiriro enzvimbo uye contours pakati yegurokuro, uyewo kudzidza peristalsis kwayo.

Ndezvipi kurapa anopa mushonga ano?

Scheme kurapa anoenderana zvinhu zvakawanda, kusanganisira pezvakaita zvokurwara, ayo padanho kukura, ezvinhu omurwere, uye chinokonzera stenosis. Tinofanira kutanga kuchinja zvokudya - zvokudya kunofanira kuva Semi-mvura zvokudya anogona napakati constriction pakati yegurokuro. Kana totaura zvikuru dysphagia chechina dhigirii kana murwere anogona kunyange kutora sveta mvura, zvokudya yakaitwa nomutsinga.

Pane nzira dzakawanda kubvisa kumanikana. In munyoro Muzviitiko kunze uchishandisa chibharuma dilatation bougies. Asi kana stenosis hakusi amenable zvakadaro kuwedzera nzira akaita endoscopic kwetsinga strictures. Kuri kuti pane compression pakati yegurokuro (semuenzaniso, kuderedza nayo pedyo kukura bundu a), mukati lumen yacho stent anogona rakapinzwa chaiyo, iyo kuchengeta zvakakodzera kukura yegurokuro.

Dzimwe nguva zvinoitika kuti nzira pamusoro Haapi kutsvakwa mugumisiro, stenosis anoramba mberi. Chiremba anogona kusarudza okunyanyisa mhinduro - kubviswa njodzi chikamu yegurokuro, pamwe tevera kupora.

Kana kurapa zvinogoneka nemakwenzi?

Traditional mushonga - imwe indasitiri kuti inopa akawandisa kurapa kungaitwa pane kwakajairika. Zvinoita ndeyokubvisa pavo tichibatsirwa zvirwere zvakadai stenosis pakati yegurokuro? pevairwara mishonga kurapwa hazvisi isingagamuchiriki. Zvinogoneka kuti chiremba achaita kutokurudzira yakarurama kudya kana kupa chero mirayiridzo. Home mushonga uyu nyaya iri zvachose contraindicated.

Pane inoshanda matanho?

Sezvineiwo, chaizvoizvo inobudirira yokudzivisa Ezvemutauro ariko. Kana vachiberekwa chimiro, amai zvakakosha kuongorora mamiriro utano. In pamberi zvinokonzera njodzi (Kutamiswa panguva pamuviri utachiona, uye zvichingodaro. D.) Inspection kupedza mazuva okutanga mashoma pashure kunobereka kukwanisa kuchinja zvokudya uye nguva kutora kuchengeteka matanho.

Vakura, varwere vari zano kutevera zvokudya, uyewo nguva kubata zvirwere zvomudumbu turakiti, kudzivisa ndima yavo zvikuru kana chirwere.

The fungidziro varwere vane esophageal stenosis

Kana akasiya untreated esophageal stenosis kungatungamirira matambudziko uremu. Zvisinei, Kuvhiya anogona kubvisa kukanganisa. Chokwadi, chimwezve kurapa pamberi concomitant zvirwere. Zvisinei, fungidziro nokuti murwere iwayo zvakanaka. A kuitazve zvichiita, asi, maererano nenhamba, nyaya dzakadaro kunze uye zvakanyorwa chaizvo kashoma.