Diaphragmatic heniya - chii nechikonzero panowanikwa?

Kutaurwa "diaphragmatic heniya" wokutanga anoreva remakore rechi16. Nderake rinozivikanwa murapi nguva - Ambroise Paré. Izvi izwi zvinofanira kunzwisiswa infiltration zvimwe zvomukati kuburikidza zvakakanganisika iri diaphragm.

Unofanira kuziva kuti pasi dzimwe hadzina kufambiswa zvakanaka kunobva matambudziko ari embryo kukura ari mudumbu, pangava kukwana kana kwakakwana diaphragm urema vachangoberekwa. Pakadaro, kana kutyorwa izvi zviri kuitika kusvikira paumbwe diaphragm, kuti heniya achava asina heniya zai. Kana zvarakasiya kukura kwakaitika pashure paumbwe diaphragm Kamudzira iri rakapinda mafirimu rinoumbwa serous hernial zai kuburikidza hernial rin'i ine hapana tsandanyama.

Area kubatana mbabvu kuti sternum, inova isina tsandanyama, ndiyo nzvimbo yechizvarirwo kuti sterno-costal heniya. Zvikasadaro, dzinonzi sternokostalnymi hernias. munjodzi iyi inonzi, triangle sternokostalnym Larrey vake, uye heniya akaita ikoko, inonziwo Triangle Larrey kuti heniya.

Diaphragmatic heniya zvinogona kukonzerwa nezvimwewo zvikonzero. Toti, chirwere yakatorwa semhosva Petrovsky, sezvinotevera:

1. heniya akagamuchira somugumisiro kukuvara (dzechimwe heniya):

- venhema;

- wechokwadi.

2. non-randakambosangana naro heniya:

- vachiberekwa venhema;

- simba kwechokwadi heniya aperture mapazi;

- Diaphragmatic heniya orifices:

- heniya wechokwadi atypical localization;

3. heniya esophageal yokutanga;

4. isingawanzowanikwi heniya orifices.

Kana diaphragmatic heniya, zviratidzo izvo chokuita kukuvara kana kukuvara, akaparadzanisa chete wenhema uye chechokwadi zvakananga, asiri dzechimwe heniya vane zvimwewo kupatsanura. The chete chenhema vachiberekwa heniya kuti kunoitika nokuda diaphragm zvikanganiso (mumukaha abdominal uye thoracal in).

Nokuti heniya wechokwadi simba diaphragm heniya munyika dzine dzinosanganisira sternum-costal Triangle. Munharaunda iyi, iyo thorax anosiiwa ari peritoneum bwendefa connective zvinyama yaiva pakati peritoneum uye pleura.

Retrostenalnye heniya dzinoratidzwa underdeveloped sternum diaphragm nharaunda.

Apo neapo heniya vena cava, aimunzwira tsitsi etsinga pakakoromoka uye yeropa. The inonyanya mhando (anenge 98% vose nyaya) zviri diaphragmatic hiatus heniya.

Ane anatomical kwayo zvinhu. Kune mhando wandei chirwere ichi. heniya ava: kukwira, pamwe kuchinja yegurokuro (pamwe kupfupikisa, pasina vachigurisira); cardiac; subtotal; kardiofundalnaya; vanosvika.

Huripo paraesophageal hernias akakamurwa: intestinal, stuffing, fundic, gastrointestinal.

Nyanzvi kusiyanisa:

1. vachiberekwa "mupfupi yegurokuro";

2. paraesophageal heniya, umo chikamu mudumbu iri makhiriniki parutivi yegurokuro;

3. hiatal heniya zvishoma nezvishoma mumatope, panguva iyo cardiac yegurokuro nomudumbu inogona retracted kupinda zamu mhango.

Paraesophageal heniya, sezvo zvishoma nezvishoma mumatope kungava vachiberekwa kana akawana, asi zviri zvikuru kashoma kupfuura akawana pamwe vachiberekwa heniya. In vanhu vanenge zvasvika makore 40, zviri zvikuru zvinozivikanwa vawana heniya. Zvikuru zera involution munyama, zvichitungamirira kuwedzera uye kwakaderera ari esophageal hwomukova linkages diaphragm uye yegurokuro.

The inonyanya kukonzera herniation vane zviviri. Chimwe chinhu -pulsatsionny, sezvamakaropafadzwa heniya achiumbwa nokuda kuwedzera intra-abdominal kumanikidzwa (rinorema muviri, flatulence, nokudyisa, pamuviri, kugara akapfeka mabhandi zvakasimba). Chimwe chinhu - the traction inobatanidzwa gipermotorikoy yegurokuro kunokonzerwa kakawanda kurutsa.

A inokosha pakuita Pakusarudza chirwere chinoita X-ray kuzviongorora. Diaphragmatic heniya akakamurwa dhayamita diki (3 cm), svikiro (3 kusvika 8 cm) uye guru (vanopfuura 8 cm).

Diaphragmatic heniya kubatwa kuchinja nzira vanogona kubereka zvinodiwa mugumisiro, zvinonzi zvakanaka kurapwa surgically.