HH - yintoni na? Iimpawu kunye nonyango lwe HH

Masiqalise nesibakala sokuba asinguye wonke umntu isifinyezo aqhelekileyo HH. Yintoni na?

Ithemba Hiatal (HH kuyafana omfutshane), okanye Ithemba hiatal, - nto ngaphezu sisifo luphawulwa ukubana yeziko (ise kwisisu) ngokusebenzisa ukutya umngxuma uvalo ukuya kwisisu thoracic. Le umzimba phantse lonk 'isisu.

Ithemba nowomqala unokuba uhlobo naso okanye lufundiwe kwaye zomlomo kubonakaliswa onyango. Ithemba azalwa lingaphantsi eqhelekileyo kunokuba ezifunyenwe. HH lunokwenzeka ngenxa yezizathu ezininzi.

Kweli nqaku siza kujonga ntoni na HH, iimpawu, unyango kunye nexesha post-operative kwesi sifo.

iimpawu Jikelele sifo

Imbobo (ngayo kusabalulekile ngqo HH) ngokumila hlulo angqukuva entlantlu iindidi ezimbini amalaphu: izihlunu kunye nokuqina. Le ulwahlulo eyohlula kwisisu ukusuka esifubeni. Besusa kwi esihlunwini uvalo ukwenza umngxuma encinane apho emphinjeni. Kwaye mhlawumbi sele ukuqonda ukuba kutheni le nto ibizwa ngokuba lokuvula esophageal.

Ukubuyela Ithemba hiatal (HH). Yintoni na? Oku abunjwe ngenxa ukubana umzimba kwisisu kwizikhongozelo ngokusebenzisa hiatal kakhulu. Kwaye kwenzeka ngenxa buthathaka yayo.

Ithemba Hiatal - sisifo eqhelekileyo ukwenzela ukuba ungakhuphisana ngempumelelo cholecystitis, pancreatitis okanye izilonda duodenal. Noko ke, ngokutsho ukubaluleka kwayo, kuya kwenza ukuba bakhuphisane.

ubudala Relative ze isigulane kunokuthiwa kaninzi sifo senzeka kubantu abadala ngaphezu kweminyaka engama-60. Ngokumalunga nesini - nabafazi badla ubunzima kwesi sifo kunamadoda.

ngezigaba

Ithemba nowomqala zahlelwa ngohlobo iimpawu zazo. Yaba Iintlobo ezifana:

• Incopho okanye Ithemba fixed (Ithemba ngenxa yezihlunu kunye paraesophageal kuphela). Ngokukodwa, Ithemba paraesophageal - oku xa umfanekiso inxalenye nesisu ngqo ecaleni kuvuleke iminxunya ngaphezu uvalo. Kwaye ke cardia esiswini ngezantsi uvalo nendawo. Yezihlunu HH - esophageal, igazi, okanye totalnozheludochnaya losuku. A umahluko nangoku sliding Ithemba, ingakumbi apho ezikhandelwa ngendlela sac hernial enjalo lwenziwa kunye peritoneum. Yohluka ukusuka into yezihlunu ukuba ingxowa yokugqibela apho. Yezihlunu Ithemba Ungasa ngokukhululekileyo usebenzisa iintshukumo zomzimba.
• Ithemba Paraesophageal (fundic okanye antral).
• Ithemba azalwa, zibangelwa yi kuvuleke iminxunya elifutshane kunye anomaly kuphuhliso.
• Hernias lolunye uhlobo (ama, seals njalo njalo. P.).

Esi sifo nayo zihlelwe kuxhomekeke kubungakanani:

- Ithemba Esophageal isidanga sokuqala. Ungachazwa ukuba cardia ye nesisu kwinqanaba uvalo, nesisu esinyusiweyo kancinane kuthinteleke unamathele kuye uvalo. emphinjeni besisu ise kwisisu thoracic nangoko ngaphezu uvalo.

- Ithemba Esophageal isidanga sesibini. Lo mfanekiso yinto ngolu hlobo lulandelayo: kuvuleke iminxunya esiswini kwi Isifuba, kunye nokuvulwa esophageal sele yinxalenye esiswini.

- Ithemba Esophageal isidanga wesithathu. Umgama kunawo, luphawulwa ziziphumo kuvuleke iminxunya, cardia, kwaye maxa wambi nkqu umzimba kunye fundus esiswini ngentla uvalo.

Izizathu Ithemba esophageal

Sele ekhankanywe ukuba izizathu kufuneka Ithemba hiatal kakhulu kunene. Noko ke, amaxesha amaninzi ezi zinto zilandelayo:

• Thinning of the nemisipha nokuqina okubangelwa utshintsho ezinxulumene-yobudala okanye ukhuthazelwe naziphi ezinye iinkqubo.
• Ngendlela okanye inqanaba libe linye-chronic ukwanda koxinzelelo kwi kwisisu ngokwayo. Kubangela ukwanda kontanga kungaba ukuqhina ezingapheliyo, umthambo enzima (ezifana uphakamisa into enzima), umothuko esiswini buthuntu nangaphezulu.
• izifo ezondeleyo ezinxulumene ngqo inkqubo yokucola ukutya yaye eziphazamisana umsebenzi lwemoto le inyongo isinyi, isisu, okanye duodenum.
• Ukuphazamiseka kwamadlala yonyango (endocrinopathy).
• imikhwa emibi (ukutshaya, ukusela), umntu omdala.

HH: Iimpawu

Kuxhomekeka ezibonisa kwezonyango sifo ezi fom zilandelayo Ithemba hiatal:

- HH engenazimpawu;

- HH, ngokuba ngezifo ngexesha apho sifo sibangelwa ekungaphumelelini cardia;

- HH, alupheleli bubukho esiswini cardia insufficiency syndrome;

- HH, leyo kuvela ingxaki nezinye iintlobo zezifo emathunjini (okanye ukuphuhlisa ngokulula imvelaphi yabo);

- paraesophageal HH;

- HH ukuzalwa, iphawulwa kuvuleke iminxunya elifutshane.

Iyafuna ingqalelo uhlobo ngalunye HH (uhlobo ngalunye iimpawu) ngokwahlukeneyo:

• hernias nazimpawu. Njengoko usazi igama le fomu yesi sifo, naziphi na iimpawu HH kwezi meko, akukho. Oku kubhekisela Ithemba kwentliziyo okanye esophageal, oko kukuthi ngokobuninzi ezincinane ubukhulu. Fumana olu hlobo Ithemba random ngokupheleleyo, ngokufuthi - ngethuba uviwo olupheleleyo, yaye ngamanye amaxesha abantu nakubona ukuba unalo HH - iimpawu (unyango kuxoxwa ngezantsi) kuba akukho Ithemba.
• HH ukusilela syndrome cardia. Ezi mpawu zixhaphakileyo zokuma HH - heartburn kunye neentlungu, postprandial, kwaye xa utshintsho elibukhali isikhundla yomzimba yesigulane. Kufuneka kuqatshelwe ukuba ezi mpawu akholisa ukubakho ebusuku, kunokwenzeka ukuba achaze iimpawu ukunyusa isandi le luvo vagus, kwakunye ukunyenyiswa le sphincter esezantsi esophageal.

Ngokuphathelele amandla heartburn, nina nithi ukuba kube lula (kulo mzekelo, lunokunyangwa kunye asidi), kwaye kakhulu buhlungu (kangangokuba bade ogqwetha intsebenzo oluntu). nokuqina kwayo ogqitywe oluntsonkothileyo izinto ezahlukeneyo, kwaye, kuqala, ezi ziquka esiti-Peptic, nto leyo eziziimpawu ijusi esiswini. Kwakhona, oko kusenokuba nefuthe distension esophageal ulilahle imixholo duodenal (kakhulu inyongo).

Kakhulu phawu Iliso-ukulotywa Ithemba hiatal, Kakade ke, iintlungu. Kubalulekile ukuphawula ukuba kuxhomekeke unobangela heartburn. Ngokomthetho kubonakala ngenxa yezizathu ezifanayo. Iintlungu yenzelwe ubukhulu becala kummandla kwentamo, kwaye ziyanyuswa xa isigulane kuthatha indawo ilele. Ukongeza kule meko zingenza ezinamathele iqolo naphambili. Uhlobo kuye inokuba nomahluko, amaxesha amaninzi oko ngokuhlaba, usika okanye avuthayo ukushukumisa.

Regurgitation lweziqulatho esiswini - nazo uphawu kakhulu rhoqo ka HH. Yintoni na? Le yinkqubo bephosa imixholo isisu emlonyeni. phenomenon zingambi kakhulu, kwaye imixholo esiswini unako ukungena uqhoqhoqho okanye bronchi.

Kwakhona, isibini yamagama malunga intlungu. ubuhlungu Real uziva isiqingatha kuphela izigulane kunye-25% of iimeko psevdokoronarnaya iintlungu, nto leyo yenzelwe entliziyweni. Kuwo ungenza ngokulula balahle yokusebenzisa nitroglycerin. Ukongeza kule ntlungu, izigulane va kabi kwimimandla interscapular, hepatopancreatoduodenal, ngokunjalo kwi-Chauffard Minkowski, njl

Kwakhona, malunga nama-70% ezigulane kunye Ithemba hiatal (ingakumbi ukuba kwentliziyo HH) lijongene luphawu efana belching. Amaninzi yenzeka imixholo isisu, kwaye ezihlangwini zayo kuyabuya ezingemnandi lifana nenzaliseko kummandla epigastric, nto leyo ebonisa aerophagia. Izisa i incasa elibi ekrakra. Kunye antispasmodics kunye analgesics kulo mzekelo, ukususa ezi mvakalelo abakwazi.

Kwakhona, 40% ezigulane kunzima badlula ukutya ecaleni kuvuleke iminxunya, kwanaxa ukuthatha ukutya ulwelo. Nangona kunjalo kufuneka kuqatshelwe ukuba ukutya okuqinileyo udlula ngokulula ngokwaneleyo. Abantu abanengxaki kule nomphumela, amaxesha amaninzi athe wabonakala yi isininzi kushushu kakhulu okanye vice, ukutya kubanda kakhulu. Ngoko ke, ukuba Ithemba Kucetyiswa ukuba utye ukutya kuphela eye teperatura umzimba.

Malunga ne-4% ezigulane abanengxaki HH hiccups kwisiqalo kwefom yezihlunu of Ithemba. Kuphela akukho ncam le hiccups njengesiqhelo. osemqoka yayo kungathathwa lonke ebalulekileyo (ungatsala iiveki okanye iinyanga). ukuba balahle nto kakhulu nje, kwaye kunceda sisiganeko ube uchwepheshe ofanelekayo kuphela.

Ezinye izigulane ikwafumana glossalgia (ulwimi kunene) kunye hoarseness, nto leyo ngenxa ukutsha ukusuka imixholo Peptic esiswini ekhutshwa ngexesha regurgitation.

Ukongeza zonke ngasentla, siya ungongeza ukuba iimpawu Ithemba ixhomekeke kubungakanani bayo.

• HH kungekho zimpawu insufficiency le cardia. Kwiimeko ezinjalo, iimpawu kwezifo ezinamathuba ucaca ngakumbi, hayi Ithemba. Iimpawu yale fomu uya pericardial Ithemba, epigastric okanye intlungu retrosternal ezenzeka ngoko nangoko emva kwesidlo okanye emva nokuphakamisa.

Aqikelele abanjalo iintsuku eziliqela. Ukuze yokungenelela kuzo ungasebenzisa analgesics non-ezidakumbisayo (ngaphandle validol ngenxa yoko akukho isiphumo) okanye nitroglycerin. Kwakhona, iintlungu siyeka xa uthatha ukutya okanye ulwelo.

• HH, leyo kuvela ingxaki okanye ukuphuhlisa ngokulula imvelaphi ezinye iintlobo zezifo zesisu. ngezifo ezifana kakhulu amaninzi esiswini okanye isilonda duodenal. Kule fomu ye HH iimpawu eziphambili zesi sifo, hayi Ithemba.
• Paraesophageal HH. Olu hlobo Ithemba luphawulwa kungekho naziphi na iimpawu nemiqondiso. Amaninzi isifo Ithemba paraesophageal kwenzeka ngokungenamkhethe ngexesha uphando ngokubanzi. Kodwa xa Ithemba banzi, kukho ucinezelo esophageal (ngamanye amazwi, licuthe le kuvuleke iminxunya). Kwiimeko ezinqabe kakhulu, ukuphuhlisa spasm esophageal (a isifo kuphazanyiswa apho peristalsis esophageal).

Ukuba ulwaphulo-mthetho hernias paraezafagealnyh kukho intlungu kwentamo okanye epigastric.

• Azalwa HH luphawulwa umphimbo elifutshane. Xa olu hlobo Ithemba kuvuleke iminxunya kunokuba iinketho ezimbini. Xa wokuqala kuwo ukuphuhlisa into efana "esiswini thoracic", nto leyo zibandakanya ezi fom zilandelayo:

- indawo esifubeni;

- kwasendaweni esiswini intrathoracic.

Kwimeko yokugqibela, uxilongo kunzima kakhulu, oku kudla ngokwenzeka ngexesha utyando okanye kwesidumbu.

iingxaki kunokwenzeka

Ithemba Hiatal kungabangela ezahlukahlukeneyo iingxaki. Amaninzi wabonakalaliswa ngolu hlobo lulandelayo:

- gastritis okanye isilonda esiswini ukuba yinxalenye apho Ithemba (livela malunga-8% amatyala);

- ukopha, igazi (kukho-20% amatyala);

- ukuqaliswa kuvuleke iminxunya esezantsi kwi sac hernial;

- kokunciphisa emphinjeni (idla kuphela iifomu kardiaezofagealnymi);

- prolapse le isifo esiswini kwi kuvuleke iminxunya (okt ilahleko retrograde);

- Ithemba strangulated (i ingxaki nto inzima kuzo zonke ngasentla).

lokufunyaniswa kwesifo

Ngokuqhelekileyo, iingcaphephe ukuqhuba iimvavanyo ezininzi ngokwesiseko apho iziphumo sele unesifo "HH." Loluphi uhlobo lweemvavanyo:

• Fibrogastroscopy. Unga sebenzisa oku ukuba aqonde imeko kuvuleke iminxunya emathunjini. Iimpawu Endoscopic of HH sichaza yena ugqirha, esekelwe kuyo ungenza isifo kwaye zibeka unyango.
• iimviwo X-reyi yesifuba, olusekelwe barium umahluko. Ngokusebenzisa le saveyi, unako ukuba ungafumana herniation umfanekiso, nto leyo uphawu ngenxa HH-degree nganye.
• pH-metry. Olu vavanyo lwenziwa ukuqinisekisa inqanaba asidi esiswini. Kuyimfuneko ukuba abele ngokuchanekileyo unyango lwe Ithemba.

HH Treatment umphimbo

Ngokubanzi, unyango Ithemba hiatal udlula iziyobisi, kodwa kwezinye iimeko (ingakumbi xa iingxaki) ifuna ungenelelo yotyando.

Ngokumalunga unyango ngamayeza, ngayo ukunciphisa le asidi esiswini (usebenzisa asidi), kunye nokuncitshiswa secretion esiswini. Le - umsebenzi wokuqala. Kwakhona, ukuba unyango kuyimfuneko ukukhusela isifo esiswini, nayo obonelela isicelo iziyobisi ezithile.

Xa unyango inikwa ukutya engqongqo, ekufuneka ilandelwe ngokupheleleyo. Ngokusisiseko, besidla ukudla phantse ngokufanayo gastritis: akukho nenqatha, akukho okuneziqholo, ezimuncu, enetyuwa. Kuphela ukutya okunempilo, ezifana nemifuno, iziqhamo, okuziinkozo, isuphu yokutya kunye broths, inyama ezinqinileyo.

Ngoko ke, ukuze kupheliswe heartburn nokunciphisa secretion esiswini singathatha ichiza "Maalox". Kube lula kakhulu, nto ifumaneka iipilisi nje kuphela, kodwa ke uhlobo babe-, iipilisi, ukumiswa. uhlobo ngalinye oku kuthetha imiyalelo ezahlukeneyo ukusetyenziswa, leyo icaciswe nayiphi ekhemesti lomzi wakho.

Kungenzeka kwakhona ukuba basebenzise iindlela ezifana "Rennie" okanye "Gastal". Ukuze ukuphelisa heartburn sele kubonakala ukuba ngokwaneleyo ukuba athathe ipilisi enye, kunye nokuthintela - tablets 4 ngosuku (iyure enye emva kwesidlo). Nangona kunjalo, khumbula ukuba la machiza ukususa iimpawu kuphela.

Yona kotyando, ngayo ukususa ukwakheka Ithemba.

Ngokuba iinjongo afunyaniswe isifo kwaye afumane unyango oluchanekileyo ngakumbi kuyimfuneko ukuba isicelo kugqirha (ugqirha okanye gastroenterologist).

Unyango amayeza intsomi

HH Treatment amayeza intsomi ayiyi kunika iziphumo ezinqwenelekayo, njengoko kwiimeko ezininzi umntu ogulayo kufuna amayeza kakhulu okanye uqhaqho.

Oko kukuthi, akukho Ithemba ngokwayo akanako ukususa imali abantu. Isizathu kuphela zisetyenziswe - kuphele iintlungu.

Ezinye iti eengcambu kunokunceda ukunciphisa intlungu. Nazi ezinye amayeza abanam kuya kunceda ekulweni ne Ithemba:

- A decoction of marshmallow ingcambu. Galela nama-20 g ye nakhandiweyo ingcambu Althea imagi ngamanzi abilayo agunyazise utywala.

- Xuba amathontsi 30 utshwala propolis tincture kunye ml-50 zobisi. Thatha amaxesha 2 ngosuku.

- flatulence kakuhle kunceda decoction ka rimbewu yeeminqathe. Zalisa enye imbewu negram iikomityi ezi-2 zamanzi ashushu uze uvumele umxube ukuba asile iyure yonke. Kufuneka sisele kunye imbewu.

Khumbula ukuba ngaphambi kokuba nantoni (ingakumbi amayeza intsomi) kuyafuneka ukuba udibane nogqirha wakho.

Kwakhona, ngokusebenzisa amayeza nabantu, ungafumana azisusi heartburn, hiccups, kunye nezinye iimpawu HH. Kodwa khumbula ukuba oku yoko yethutyana nje kuphela, kunye nemfuneko ukunyanga unobangela kwesifo kunokuba iimpawu.

Ithemba nowomqala emva kotyando

Njengoko kukhankanyiwe ngasentla, kwezinye iimeko, Ithemba hiatal kufuneka uqhaqho. HH-operation, ncomo apho ingacaci, ndingekawuboni ukusindisa ubomi kwiimeko oluphambili kakhulu.

Kodwa yintoni ofanele uyenze xa unikwa umsebenzi sele yenziwe? Indlela ukuthobela imo post-operative? Njani kungekudala unako ukubuyela ubomi obuqhelekileyo?

HH emva kotyando ngokuyimfuneko kufuna inkathalo ezintsonkothileyo unyango kunye nothintelo.

Ngosuku lokuqala emva kotyando, izigulane kufuneka ukuba uviwo therapist electrocardiography. Ngemini yesibini yaba esifubeni X-ray. Ngomhla wesithathu - itotali epheleleyo wegazi kunye nezifundo kwemichiza ngazo ufundo sonography emiselweyo.

Kabini ngosuku, izigulane kufuneka enze imisebenzi elula uphefumla imithambo kunye nonyango ngokwasemzimbeni.

Njengoko zazo kunyango ngamachiza uthi oku kulandelayo. It sikuko ukuqaliswa saline butofelwe kwi levolyum 1800 ml ngosuku. Zonke izigulane emva kotyando uthathe antibiotics.

amanxeba Trocar babacukucezela kotywala ebotshelelwe ngosuku.

Nje kosuku olunye emva kotyando ogulayo ukuba usele amanzi, kodwa ukususela kusuku lwesibini - ukuthatha ukutya ulwelo. Ithuba postoperative yi kweenyanga ezi-3.

wenza njani HH-operation (reviews of ezahlukileyo, ngokuxhomekeke nobungozi besi sifo), sele sitshilo ngentla. Kuyinto ukususa Ithemba kakhulu.

isiphelo

Ngoko ke uya kuba na ukoyika, ukuba ethile uya kubona basisishunqulelo HH. Yintoni na yaye oko kubonakala njani ngokwayo, wena uyazi.

Kuhleli kuphela ukuba bashwankathele, ukuba esi sifo kuyingozi kakhulu. Self-amayeza, ingakumbi unyango amayeza intsomi, oko kuyingozi ngokwaneleyo kwaye kunokubangela iingxaki ezinzulu.

Kodwa ke, yeha, kwiingxaki akukho mntu ugonyiwe, ekubeni iintlobo ezithile HH nazimpawu. Indlela kuphela phandle - thatha zoviwo ezipheleleyo esibhedlele ubuncinane kanye ngonyaka. Ngoko ungenza nje ukufumana esi sifo krakra.