Esophageal Disease: Zviratidzo neMarapirwo

kushanda yegurokuro zvimwe anozivikanwa wose. Maererano nyore ichi, Pakutanga, muviri yakamedza zvokudya kwevanhu inofamba mudumbu. Somugumisiro, esophageal chirwere, zviratidzo izvo dzichakurukurwa munyaya ino chaizvo kunzwisisa uye yakasiyana-siyana, sezvo zviri nyore zvinova zvomoto uye kunzwisisa zvose zvikanganiso kwedu kudya.

Sezvineiwo, murume, kuziva zviratidzo chirwere yainzi muviri, kazhinji raibva kuti matambudziko mudumbu, mwoyo kana musana chirwere, uye kugadzirisa dambudziko, edza kuzivana navo.

Chii dysphagia?

Chokutanga, ngationei kuti Sezviri anenge ose hosha yegurokuro zviratidzo.

Wokutanga wavo - dysphagia. Izvi kutyora pakuparadza pezvakaitwa kuti kukonzera matambudziko dzichipfekeka kana makemikari vhiringidza kufamba kwezvokudya kuburikidza yegurokuro.

kutyora iyi inechirevo manzwiro kuti zvokudya varamba panguva pakuparadza kana ndima mudumbu. Nenzira, chinofanira kusiyaniswa kubva Afaq, ndiro chiratidzo chakakwana mhingaidzo pakati yegurokuro uye kunoda nechimbichimbi kurapwa.

chirungurira

Chimwe chiratidzo chirwere chichizobuda uye yegurokuro riri retrosternal rinopfuta manzwiro kuti anopararira pamutsipa, uye dzimwe nguva maoko. Kazhinji, chirungurira achiperekedzwa regurgitation (ejection) pamusoro gastric mukati, uyewo manzwiro akakungurutsa kusvika pahuro inodziya wave.

Chirungurira kwakaipa pashure pokudya, kana murwere anozendama mberi, zvinotora chinjikira nechinzvimbo kana mumuviri munomimina. Uye kuchinyanya kwayo zvingaderedzwa kana kungoziva ikamedza nemate, kuti sips shoma remvura kana kutora antacid (hydrochloric iine acid neutralizing chiito) rinoreva.

The kakawanda uye zvakakomba chirungurira - yakasimba chiratidzo matambudziko pamwe nokushanda kwenhengo yegurokuro, somuenzaniso, bile reflux kana hydrochloric acid, zvirwere muviri anogona ruoko uye ayo mucosal kuzvimba (oesophagitis).

odynophagia

Soreness Chiito kumedza anowanika seri breastbone, - odynophagia, kazhinji kunokonzerwa lesion mucosal pechiso yegurokuro. Zvinofanira kusiyaniswa kubva spastic bhokisi marwadzo chokuita kufurira zvakaoma bundu zvokudya. Odynophagia - asiri yakananga chiratidzo, uye zvichingodaro zvakaoma kuona kworudzii zvokurwara ari zvinorondedzerwa muviri yaiva mhaka marwadzo.

Nokuti reflux esophagitis yakanatsa chiratidzo hakusi chaiwo, asi dzinogona kuonekwa pagungano kutapuriranwa esophagitis (kunyanya kana Candida marudzi, uye herpes). Kana makemikari kokutsva, urikanwi uye kurwadziwa kenza iri kuchengetwa yegurokuro - zvikonzero zvakafanana zviratidzo muzviitiko izvi zviri panyika.

Atypical bhokisi marwadzo

Atypical marwadzo rakasiyana chirungurira kana odynophagia. Kusiyana ekupedzisira, nenzira, zvinogonawo kuitika pamwe reflux esophagitis, uyewo vanenge esophageal motility zvirwere, zvakadai esophagospasm. chiratidzo ichi rinowanikwa sezvo panguva zvokudya, uye nomuzvarirwo.

Constant uye marwadzo zviri yegurokuro, zvinokonzera izvo tichakurukura gare gare, kungava chiratidzo kenza kana esophageal maronda. Sezvineiwo, pane imwe chete murwere zvinogona kuva zvakasiyana hunhu, dzimwe nguva varwere kunyange zvakaoma kutsanangura manzwiro avo.

Mune zvimwe zviitiko, kurwadziwa muchipfuva vangava chokuita atypical kuvhiringidzika esophageal motility. Muchiitiko chino, varwere vanogona zvakawanda uye maitiro zvinetso, kuora mwoyo, kutya uye psychosomatic zvirwere uye mwoyo kumunetsawo.

regurgitation

chiratidzo ichi kwave anotaurwa tsananguro chirungurira, sezvazvakaita chiratidzo shamwari yake. Reguritatsiya Kazhinji kunoitika pasina svoto uye diaphragm marwadzo uye kazhinji pamwe vazhinji zvirwere yegurokuro uye mudumbu.

Zviratidzo Kuramba kwakaita gastric zviri mumuromo kuperekedza pathologies zvakadai esophageal stricture kana diverticulum. A gastro-esophageal reflux reguritatsii anobatana mumwe uye chitarisiko mumuromo shungu kana anovava kunaka kuti imhaka kukundikana esophageal sphincter.

The zvinorondedzerwa Chiratidzo ngozi popadenii gastric zviri munzvimbo kufema maitiro uye zvingakonzera kwete chete chikosoro, asi kudzipwa. Dzimwe nguva regurgitation anogona kukonzera chido nemabayo.

huru chirwere esophageal achalasia sei

Zviratidzo esophageal chirwere kutungamirira kuti marwadzo uye kukuvadza ari sternum, chitarisiko regurgitation, reflux, nezvinetso kumedza, kuda kurutsa, chirungurira, halitosis nokuda kuorera mazviri kwezvokudya ari yegurokuro, zvingaratidza panowanikwa achalasia.

chirwere ichi inonziwo "cardiospasm" uye ndiyo imwe neuromuscular zvokurwara kuti kuitwawo kutyora hwomukova sphincter, riri yepazasi chikamu yegurokuro uye inonzi cardiac. Somugumisiro, zvokudya haagoni kupinda mudumbu, achiita zviratidzo pamusoro apa.

Zvinokonzera chirwere vasingazivikanwi. Uye mune zvimwe zviitiko, chakaonekwa kuti nokukurumidza, uye vamwe - inokudziridza zvishoma nezvishoma. Murwere Matafura kazhinji zvinoenderana kuti achalasia, kuderedza kudya kwavo yakawanda mvura, gymnastic muviri, etc.

Asi pakuzadzisa ari zvokurwara kunoda chakakomba mukupindura mubvunzo sei kurapa yegurokuro. Kuti aite izvi, kushandisa nzira zvainanga achibvisa zvipingamupinyi kuti ndima zvokudya - cardiodiosis (chibharuma dilation pamusoro sphincter) kana kardiomiotomiyu (kuvhiya incision pamusoro sphincter tsandanyama). Drug kurapwa kuri kazhinji webetsero hunhu.

Zviratidzo uye vabatwe esophageal spasm

Zvirwere yegurokuro, izvo isu funga zvingaratidza munguva dzose kushanda sphincter. Kana izvi zvaitika izvi nhengo spasm, izvo kazhinji ndiyo nemhaka zvirwere zvomudumbu ino kana huta zvirwere.

Panguva chirwere ichi murwere anonyunyuta kurwadziwa kunosiyana simba panguva ndima zvokudya kuburikidza yegurokuro uye pakuparadza matambudziko. Panzira, dzimwe nguva kurwadza kunoitika pakati zvokudya uye ipapo vanogona nyore kuvhiringidzwa zviratidzo angina.

Kuongorora yegurokuro mune chirwere ichi zvinowanzochengetwa deformation yayo nokuda kwetsandanyama. zvirwere izvi zvinoda kurapwa pakati yegurokuro, kazhinji kuchinja, uye, mukuwedzera, zvinofanira kuva kugadzwa kuva neusimbe zvokudya, uye zvinodhaka antispasmodic, uye nitrofuran uye kunyaradza nevamiririri. Kana tichinzwa nenyonganiso murwere zvaida chibharuma dilatation kana kuvhiyiwa.

Chii reflux esophagitis?

The chirwere chinonzi peptic esophagitis uye kunoratidzwa nokukanda zviri dumbu mukati yegurokuro. Chikonzero chinoita iri kukundikana rezasi sphincter. Mazhinji kuitwa gastric muto uye bile ane nechisimba hunhu uye zvinotungamirira kuzvimba uye ulceration pamusoro mucosa, umo scarring kunoitika aienda pamusoro yegurokuro.

Kazhinji, chirwere kunoitika zvishoma nezvishoma uye kazhinji kuonekwa vacheche.

In chirwere ichi zviratidzo yegurokuro kakawanda richiratidzwa muchimiro chirungurira uye kutekenyedzwa ichipfuta ari retrosternal nharaunda, izvo zvinogona kuitika kana kuti kuwedzerwa vachikotama mberi, avete pasi, panguva kusvuta kana kunwa doro.

Esophagitis anogona kuva kwakaoma nekudeura ropa (kazhinji zvakavanzika), chido nemabayo uye vanga kuchinja yegurokuro.

Rokuongorora ichi zvokurwara ezofagogasteroskopiyu rinoitwa uye X-ray barium. A kurapwa zvainanga kubvisa huru zvinokonzera esophagitis (pylorospasm, mu heniya hiatal piloroduodenalnyh kana stenosis). Murwere rainge ushandiswe mishonga kuti kuderedza acidity ( "Ranitidine" uye "Famotidine"), antacids uye antispasmodics. Diet nokuti zvirwere yegurokuro neusimbe uye fractional simba.

diaphragmatic heniya

Dzimwe nguva achishandisa vachiberekwa uye vawana kuremara ari diaphragm mubhokisi mhango kufambisa abdominal zvomukati - ezvinhu akadaro Inonzi diaphragmatic heniya. Kakawanda inokudziridza iri esophageal yokutanga. Sezvataurwa pamusoro apa, munhu chiratidzo chirwere ichi chiri vachida reflux esophagitis, uyewo ropa zvakavanzika uye kupererwa neropa ezvinhu.

Sei kubata yegurokuro mune iyi anodzidudzira yakarurama zvokuongorora uchishandisa X-ray uye endoscopy. Kazhinji, kurapa iri kuchinja, zvainanga nokuderedza reflux. Muzviitiko aienda pamusoro yegurokuro kana ropa, kuvhiya kupindira.

Barrett kwakaita yegurokuro chirwere

Kana kurwadziwa huro, seri sternum, akakanda dumbu zviri mumuromo, chirungurira, iine acid kuravira mumuromo, chisingaperi chikosoro uye hoarseness anogona kutaura yegurokuro chirwere, unonzi Barrett kuti metaplasia.

The chikonzero, izvo chinokurwadzai kukura chirwere ichi haina yatangwa, asi akawana kuti zviri zvikuru chakakomba kuomesa zvauya nokuda gastro-oesophageal reflux esophagitis (tora). Uyezve, zviri zvokurwara ichi kunogona kuva riwedzere kuti kukura kenza.

metaplasia Barrett kuti aine degeneration pamusoro mucosal pose masero - masero lining pakati yegurokuro inotsiviwa masero ari intestinal mucosa. Sezvineiwo, zviri sechinhu precancerous mamiriro, pasinei chokwadi kuti kenza yegurokuro - isingawanzowanikwi chirwere.

Barrett kuti metaplasia: chirwere uye vabatwe esophageal chirwere

Zviratidzo, mishonga izvo zvinoda kuongororwa zvakarurama, pamwe Barrett kwakaita metaplasia hazvo kwakaitika zvokuwedzera sezvo endoscopy uye biopsy.

Nokuti huro ichi murwere kuti pinza inokosha dzakaonda chubhu kuburikidza iyo yegurokuro inogona iongororwe, uye ipapo utore kubva zvinyama yokuenzanisira kuti unozotevera kuongorora masero.

In pakurapa Barrett kuti yegurokuro pfungwa iri kazhinji pamusoro kurapwa tora afunge metaplasia, uyewo kudzivirira kenza. Zvipatara ane chimiro zvakafanana pakurapa akadzvinya (antacids uye antireflux mishonga), asi zvikuru kwazvo. Kana, pamwe zvokudya kurapa haiunzi zororo, uyewo vanenge kukanganisa pamusoro heniya, murwere, kuvhiya kupindira inonzi fundoplication (paumbwe rakagadzirwa nevanhu vharafu).

Kenza yegurokuro

Zvirwere yegurokuro, zviratidzo izvo dzinokurukurwa munyaya - chirwere yakaoma, asi zvakakura zvokurwara hadzina kenza.

Kukura namamota kenza mu yegurokuro zvinoita basa rinokosha echirwere kuzvimba mumuviri kunokonzerwa nemakemikari, chafariz kana zvokuimba dzishande. A kusvuta uye kudhakwa nedoro nokuwedzera nechirwere kubudikidza ka12!

Kazhinji, pakutanga hosha iri asymptomatic, uye izvi zvinogona kutora kusvika 2 years. Kana bundu inokura kuti zvokuti nokuda nhete ari lumen pakati yegurokuro, murwere ane zviratidzo matambudziko nokufamba zvokudya nomuviri ainzi. Kuwedzera dysphagia - anozivikanwa chiratidzo kenza. Uye kana kana pakutanga chirwere chake, agozviratidza chete akamedza kana taita rikamunya muchindwi zvokudya zvikukutu, Ndokuzofungisisa murwere chete vanogona kushandisa zvigadzirwa mune mvura kana Semi-mvura fomu.

Data zvinoratidza -bereka Kushatiswa mukuru ezvinhu: lethargy, kurasikirwa kudya, uremu. Kusiyana aienda pamusoro lumen rematanho mu yegurokuro rinowanikawo kunyanya salivation.

Mune dzimwe varwere pave namamota uye achabatsirwa kurwadza nezvekufadza ari shure kana seri breastbone. Kazhinji, zvaitika panguva ingestion uye pashure penguva yakati apere. Kashoma kurwadziwa kwakadaro mberi.

Mabatirwo kenza yegurokuro

Mabatirwo zvirwere yegurokuro, kenza njodzi mamota pasi kuvhiyiwa, nemwaranzi uye mishonga. Muchiitiko chokutanga murwere ari zvachose kana ubatanidzwewo avabvisa yegurokuro. Izvi kunonyanya sei wakajairika muitiro. Uyezve, node nodes vanobviswa mukati dzinodengenyeka ose metastasis chitarisiko. Zvisinei, nzira iyi yokurapa anogona contraindicated vamwe varwere (somuenzaniso, zvemwoyo chirwere kana nyonganyonga yacho kufema ezvinhu mabasa).

Radiation mushonga - nzira chete inogona kushandiswa kurapa ruzhinji varwere esophageal kenza (40% nyaya rinogona kubatsira kubvisa zvakakomba zvekuchipatara zvinoratidza chirwere). Mishonga dzinowanzotsigi- rakashandiswa muchimiro kenza yakaderera-mugiredhi.

Panewo mubatanidzwa kurapa umo nemwaranzi mishonga asati avhiyiwa kuderedza chinokosha kwechirwere omunzvimbo dzokororo uye kunoderedza bundu kukura.

benign anomera

Pakati benign anomera munzvimbo yegurokuro zvinosanganisira epithelial uye non-epithelial anomera. Uyu zvakanaka isingawanzowanikwi chirwere, uye avo inoti ndiyo anononoka weboka chirwere uye kushaikwa kwazvo zviratidzo.

Kazhinji, mapundu aya kuva parusvingo yegurokuro uye dzimwe nguva kuwira lumen. Rakajairika pakati pavo vari leiomyoma, uye nzvimbo yechipiri ndiwo cystic neoplasms.

The huru Zviratidzo pamberi benign anomera iri kuwedzera zvishoma nezvishoma dysphagia, uye (mumazuva pokumuka polyps) manzwiro ndine muviri wokumwe, hunokonzera svoto uye kurutsa.

Most anomera izvi zvakwakafukurwa netsaona munguva radiological kuzviongorora.

Kufanana vazhinji esophageal chirwere, pakurapa benign yamamota akaderedza dzavo kuvhiya kubviswa, kuitira kuti tidzivise matambudziko chokuita bundu kukura. Kazhinji, kubviswa kunoitika pasina kuvadza esophageal mucosa uye ane zvakanaka fungidziro.

Mallory-Trappers urwere

Kana hosha yegurokuro uye mudumbu zviratidzo kazhinji kuratidza pachavo nokuda kurutsa kana gagging naye. Dzimwe murwere panguva ino hapana yokumbozorora mucous Kamudzira iri esophageal-gastric Junction. zvokurwara ichi mu mushonga chinonzi chirwere Mallory-Trappers.

Kazhinji, icho chinoratidza kurwadziwa muchipfuva, uye mumarutsi ropa rinooneka. Kunyange zvazvo vakawanda vanobatwa kubuda ropa rinomira pamusoro wayo, murwere chakadaro chinofanira muchipatara nokukurumidza kudzivisa zvakakomba matambudziko.

Sezvo inoculated chokubata Syndrome akashandisa vasoconstrictors, uye zvakare, kana zvakakodzera, electrocoagulation.

Malformations pakati yegurokuro

Dzimwe nguva chirwere ari dokeriro uye yegurokuro nechokuita zvakananga abnormalities kukura yokupedzisira - kusvikira underdevelopment waro chimiro, ukuru kana isiri nzvimbo.

Kazhinji, zvokurwara kwakadaro richiratidzwa aienda pamusoro yegurokuro, kuvapo vachiberekwa tracheal esophageal fistulae, uye dzimwe nguva ari zvachose pasina zvinorondedzerwa muviri. Zvinosuruvarisa kuvandudzwa esophageal zvokurwara anogona chatichaita achangoberekwa nenzara kunyange, saka kuvhiya kunodiwa ndeyokubvisa pavo.