HH - chii here? Zviratidzo uye vabatwe HH

Ngatitange nepfungwa yokuti haasi munhu wose anoziva chidimbu HH. Chii?

Hiatal heniya (HH ndiro kuti pfupi), kana munhu hiatal heniya, - hapana kupfuura chirwere inozivikanwa ne misha ane nhengo (riri abdominal mhango) kuburikidza nokudya buri diaphragm kusvika thoracal mhango. muviri Izvi inenge nguva mudumbu.

Oesophageal heniya anogona kuva vachiberekwa kana vawana zvakasikwa uye akavimbisa zvekuchipatara kuratidzwa. Vachiberekwa heniya iri ishoma pane yakawanikwa. HH anogona kuitikira zvakawanda.

Munyaya ino tichakurukura zvinhu HH, zviratidzo, kurapwa uye post-kushanda nguva chirwere ichi.

General zvechadenga chirwere

Aperture (icho chine zvakananga kushanda HH) ane chimiro domed partition kuti rine marudzi maviri machira: tsandanyama uye connective. Ndiyo partition Anopatsanura abdominal mhango kubva pachipfuva. The tufts ari diaphragm tsandanyama kuumba duku buri kuburikidza iyo yegurokuro. Uye iwe pamwe kare kunzwisisa nei inonzi esophageal buri.

Tichidzokera hiatal heniya (HH). Chii? It achiumbwa somugumisiro misha muviri kubva abdominal mhango mubhokisi kuburikidza hiatal chaizvo. Zvoitika nokuda kutinetesa.

Hiatal heniya - vakawanda chirwere kuitira kuti kukwikwidzana zvinobudirira cholecystitis, pfungwa nomuviri zvemwana asati kana duodenal maronda. Zvisinei, namarudzi kuipa, zvichaita zvakare vave kwikwidza.

Hama makore murwere anogona kunzi kazhinji hosha ikabuda vanhu vakura kupfuura makore 60. Panyaya vakadzi - Vakadzi vangangowedzera vanotambura nechirwere ichi pane vanhu.

kupatsanura

oesophageal heniya Classified maererano unhu hwavo. Govera marudzi akadaro:

• Zvinoyangarara kana yakamisirwa heniya (heniya nokuda axial uye paraesophageal chete). Zvikurukuru, paraesophageal heniya - ndiwo kana mufananidzo chikamu mudumbu iri zvakananga parutivi yegurokuro pamusoro diaphragm. Zvino Cardia mudumbu pazasi diaphragm hwokungotsvaka. Axial HH - esophageal, cardiac, kana subtotal totalnozheludochnaya. A mutsauko achiri zvishoma nezvishoma mumatope heniya, kunyanya apo kuti achiumbwa yakadaro hernial zai mudungwe pamwe peritoneum. Zvakasiyana kubva axial yokuti yokupedzisira bhegi ikoko. Axial heniya anogona kufamba takasununguka kufamba muviri.
• Paraesophageal heniya (fundic kana antral).
• Vachiberekwa heniya, kwakakonzerwa pfupi yegurokuro ane anomaly kukura.
• Hernias imwe mhando (enteric, zvisimbiso zvichingodaro. P.).

chirwere ichi inogona Classified maererano dhigirii:

- Esophageal heniya wokutanga dhigirii. Dzinoratidzwa pakuti Cardia mudumbu iri ufanane diaphragm, dumbu kwakasimudzirwa zvishoma uye zvakasimba adherent kuti diaphragm. Abdominal yegurokuro iri mune thoracal mhango pakarepo pamusoro diaphragm.

- Esophageal heniya dhigirii wechipiri. The kunotoda mufananidzo uri sezvinotevera: abdominal yegurokuro ari thorax, uye mune esophageal yokutanga ndiyo yatova chikamu mudumbu.

- Esophageal heniya dhigirii rechitatu. Wakakura zvikuru dhigirii, kunoratidzwa ne kuwanikwa yegurokuro, Cardia, uye dzimwe nguva kunyange muviri uye fundus mudumbu pamusoro diaphragm.

Zvikonzero esophageal heniya

Takatodzidza kutaurwa kuti zvikonzero vane hiatal heniya kwazvo. Zvisinei, kazhinji ndivo zvinhu zvinotevera:

• Rive dete of connective nemarunda anokonzerwa zera-kufanana kuchinja kana kunyengedzwa nedzimwe chero kwendangariro.
• Enderana kana mumwe-Danho chisingaperi kuwedzera nevezera ari abdominal mhango pachayo. Inokonzera kuwedzera chingavabvisa seisingaperi kupatira, rinorema muviri (akadai kusimudza zvinhu), kungopotsera abdominal kunotevera uye zvakawanda.
• Zvirwere kuti zvine chokuita zvakananga zvomudumbu maitiro uye kuti anogona kuvhiringidza gwenya kushanda nduru dundira, dumbu, kana duodenum.
• Zvirwere zviri kwemakemikari anobudiswa mumasero (endocrinopathy).
• Bad tsika (fodya, kunwa), vakwegura munhu.

HH: Zviratidzo

Zvichienderana zvekuchipatara zvinoratidza chirwere ndedzinotevera mhando hiatal heniya:

- HH asymptomatic;

- HH, nokuti zvokurwara panguva iyo chirwere kunokonzerwa kukundikana Cardia;

- HH, haisi dzinoratidzwa pamberi gastric Cardia insufficiency chirwere;

- HH, anoonekwa somunhu kuomesa vamwe mhando gastrointestinal zvirwere (kana kungoita kuva pamusoro dzavaigara);

- paraesophageal HH;

- HH nokuberekwa, dzinoratidzwa pfupi yegurokuro.

Zvakakodzera kufunga mumwe mhando HH (neimwe mhando zviratidzo) yoga:

• Asymptomatic hernias. Sezvaunoziva zita chimiro ichi chirwere, chero zviratidzo HH muna muzviitiko izvi, kwete. Izvi Rinoreva cardiac kana esophageal heniya, kureva vaduku kukura idzodzo. Discover chimiro ichi heniya zvachose asingashumbi, kazhinji - panguva kuongororwa yakazara, uye dzimwe nguva vanhu havambozivi kuti ane HH - zviratidzo (kurapwa inokurukurwa pazasi) nekuti hapana heniya.
• HH chirwere Cardia kukundikana. Vakawanda zviratidzo cardiac HH - chirungurira uye marwadzo, postprandial, uye panguva unopinza kuchinja chinzvimbo muviri murwere. Zvinofanira kucherechedzwa kuti zviratidzo izvi zvinowanzoitika usiku, zvinokwanisika kutsanangura zvaidiwa kuwedzera mataurire yacho vagus etsinga, uyewo kutandara repasi esophageal sphincter.

Achitaura kusimba chirungurira, unogona kutaura kuti zvinogona nyore (iyi, unogona kubatwa antacids), uye zvikuru kurwadza (zvokuti kunyange kuwana mabasa evanhu). kuchinyanya Its vagara vandifungira kuzvivako dzakasiyana zvinhu, uye, pakutanga, izvi zvinosanganisira asidhi-peptic, inova inoitika kune gastric muto. Uyewo, zvimwe kufurira esophageal distension uikande duodenal mukati (zvikurukuru bile).

Zvikuru ziso-nokukwezva kuchiitwa hiatal heniya Chokwadi, marwadzo. Zvinokosha kucherechedza kuti kunoenderana chinokonzera chirungurira. Kumboda zvikaonekwa kuti dzakafanana zvikonzero. Marwadzo ari vemunyika kunyanya munzvimbo yacho sternum, uye yakakura kana murwere anotora renhema chinzvimbo. Kuwedzera kune izvi anokonzerawo marwadzo mutumbi nokuku. Hunhu wake angava akasiyana, kazhinji zviri zvinokubaya, achicheka kana unopfuta nezvekufadza.

Regurgitation pamusoro gastric Mukati - vari zvikuru kakawanda chiratidzo HH. Chii? Ndiwo muitiro zvokukanda mudumbu zviri mumuromo. Very kusingafadzi Fani, uye nokudaro zviri mudumbu anogona kupinda trachea kana principales.

Zvakare, mumwe murume nomudzimai mashoko pamusoro marwadzo. marwadzo Real anonzwa chete hafu varwere uye muna 25% kacho psevdokoronarnaya marwadzo, riri vemunyika mumwoyo. Pairi unogona kuwana nyore kubvisa kushandisa nitroglycerin. Kuwedzera marwadzo ichi, varwere vangafunga kusagadzikana mune interscapular, hepatopancreatoduodenal nzvimbo, uyewo-Chauffard Minkowski, etc.

Uyewo, vanenge 70% varwere ine hiatal heniya (kunyanya kana cardiac HH) akatarisana zvakadai chiratidzo sezvo belching. Kakawanda zvinoitika mudumbu zviri, uye nowakautangira ndiyo risingafadzi manzwiro chairwo pakuzara ari epigastric, nharaunda iyo chinoratidza aerophagia. Kunoita risingafadzi zvinovava kuravira. Uye antispasmodics uye analgesics iyi, kubvisa manzwiro aya asingagoni.

Uyewo, 40% wevarwere vachinetseka anopfuura zvokudya pamwe yegurokuro, kunyange kana achitora mura chikafu. Kunyange zvazvo zvinofanira kucherechedzwa kuti zvokudya zvikukutu uchipfuura nyore zvakakwana. Vanhu vanenge chiratidzo ichi, kazhinji zviri kwakaratidzwa rinopisa zvikuru kana ndiEzekieri, zvokudya chando chaizvo. Naizvozvo, kana munhu heniya inokurudzirwa kudya zvokudya chete kuti ane teperatura muviri.

About 4% wevarwere kutambura kubva HH hiccups pamusoro pakanyorwa axial muchimiro heniya. Chete hazvina zvikuru senguva hiccups. Its chikuru chinhu kunogona kunzi chinokosha nguva (agare mavhiki kana kunyange mwedzi). kwete kuchiparadza zvakare nyore, uye kubatsira vari chiitiko kuti chete anogona kuva vakakodzera mukoti.

Vamwe varwere uyewo kuona glossalgia (kwazvo rurimi) uye hoarseness, ndiro migumisiro kutsva kubva peptic gastric mukati chaibwinya panguva regurgitation.

Kuwedzera ose apa, tinogona kuwedzera kuti zviratidzo zvechirwere heniya kunoenderana ukuru hwaro.

• HH pasina zviratidzo insufficiency yacho Cardia. Muzviitiko zvakadaro, zviratidzo mikana zvirwere zvakawanda raidudzwa, kwete heniya. Zviratidzo chimiro ichi pericardial heniya, epigastric kana retrosternal marwadzo yokuvamba pakarepo pashure kudya kana pashure nokusimudza.

Tora vakadaro marwadzo zvinogona kwemazuva anoverengeka. To neutralize navo unogona kushandisa non-marwadzo analgesics (kunze validol nokuda kwayo hakuna maturo) kana nitroglycerin. Uyewo, kurwadziwa rinomira kana kutora zvokudya kana mvura.

• HH, anoonekwa somunhu kuomesa kana kungoti kuva pamusoro mamiriro vezvimwe gastrointestinal zvirwere. zvirwere zvakadai vanowanzobatwa gastric kana duodenal urikanwi. In chimiro ichi HH chikuru zviratidzo hosha, kwete heniya.
• Paraesophageal HH. chimiro ichi heniya kunoratidzwa kusavapo chero zviratidzo uye zviratidzo. Kakawanda chirwere pamusoro paraesophageal heniya kunoitika randomly weruzhinji ongororo. Asi kana heniya Achiparadzira, ipapo esophageal compression (nemamwe mazwi, kuderedza pamusoro yegurokuro). Mune zvisingawanzoitiki Muzviitiko, kuva esophageal spasm (chirwere umo vachanetseka esophageal peristalsis).

Kana kukanganisa paraezafagealnyh hernias pane kurwadziwa sternum kana epigastric.

• Vachiberekwa HH dzinoratidzwa pfupi yegurokuro. In chimiro ichi yegurokuro heniya kunogona maviri zvokusarudza. In wokutanga wavo anogona kuva chinhu chakadai "thoracal dumbu", iro kunoratidzwa anotevera siyana:

- nzvimbo pechipfuva;

- localization of intrathoracic mudumbu.

Mukupera nyaya, chirwere ari zvakaoma chaizvo kuti zvinowanzoitika pakuvhiya kana panguva kuvhuya chitunha.

zvinogoneka yematambudziko

Hiatal heniya kungakonzera zvakasiyana siyana yematambudziko. Most kazhinji kwakaratidzwa sezvinotevera:

- gastritis kana gastric urikanwi kuti chikamu umo heniya (rinowanika pana anenge 8% nyaya);

- ropa, kupererwa neropa (pane 20% nyaya);

- kutanga rezasi yegurokuro iri hernial zai;

- kupfupikisa yegurokuro (kazhinji kuwanikwa chete kardiaezofagealnymi siyana);

- prolapse of gastric mucosa mu yegurokuro (kureva retrograde kurasikirwa);

- strangulated heniya (yakaomesesa kuomesa ose ari pamusoro).

chirwere chirwere

Kazhinji, vanachiremba vanoita nemiedzo inoverengeka pahwaro iyo zvabuda dzinogona kutowanikwa chirwere "HH." Imhandoi miedzo:

• Fibrogastroscopy. Unogona kurishandisa kunzwisisa mamiriro yegurokuro uye mudumbu. Endoscopic zviratidzo HH rinorondedzera pachake chiremba, kunobva izvo zvinogona kuita chirwere uye taurira kurapwa.
• X-ray ongororo, iyo yakavakirwa barium musiyano. Kuburikidza neongororo iyi, unogona kuwana mufananidzo herniation, izvo maitire nomumwe HH-dhigirii.
• ph-metry. bvunzo ichi chinoitwa kuona padanho acidity mudumbu. Zvakakodzera nemazvo basa Mabatirwo heniya.

HH yegurokuro Treatment

Kazhinji, kurapwa hiatal heniya ichipfuura zvinodhaka, asi mune zvimwe zviitiko (kunyanya kana matambudziko) zvinoda kuvhiya kupindira.

Panyaya kurapwa pamwe mishonga, ndiko kuti kuderedza acidity mudumbu (kushandisa antacids), uye achidzikisa gastric secretion. Ichi - wokutanga basa. Uyewo, kana kurapa zvakafanira kudzivirira gastric mucosa, iyo anopa kushanda zvimwe zvinodhaka.

Kana marapirwo anopiwa kunyatsoteerera kudya, izvo zvinofanira zvakakwana vakatevera. Zvikurukuru, Kudya iri rinenge zvakafanana gastritis: hapana mafuta, hapana Beans, yakashapa, wakawanda. chikafu chete utano, zvakadai miriwo, michero, bota, Mishonga soups uye broths, dzakaonda nyama.

Saka, kubvisa chirungurira uye kuderedza gastric secretion anogona kutora zvinodhaka "Maalox". Ndezvipi zviri nyore chaizvo, ichiwanika kwete chete pamahwendefa, asi chimiro gels, mapiritsi, suspensions. Mumwe mufananidzo uyu zvinoreva kuzvitsaurira mirayiridzo kushandiswa, iyo inogona raanotaura chero chemishonga reguta renyu.

Zvinogonekawo kuti kushandisa nzira dzakadai se "Rennie" kana "Gastal". Kubvisa chirungurira akatooneka kuti zvakakwana kutora rimwe hwendefa, uye nokuda kudzivirira - 4 mahwendefa ane zuva (awa rimwe pashure kudya). Zvisinei, yeuka kuti zvinodhaka izvi chete kubvisa zviratidzo.

Kana vavhiyiwa, ndiko kubvisa heniya inotungamirwa.

Kuti uwane yakarurama chirwere uye kurapwa zvinangwa zvinokosha kushandisa kuti chiremba (chiremba kana gastroenterologist).

Mabatirwo zvavo mishonga

HH Treatment chevarwere mishonga hauzobudisi zvinodiwa zvabuda, sezvo kakawanda vanorwara munhu zvinoda mishonga chakakomba kana kunyange kuvhiya.

Kureva, hapana heniya pachayo haina kukwanisa kubvisa mari nevanhu. The chete chikonzero vanogona kushandiswa - kuderedza marwadzo.

Vamwe mishonga teas kunogona kubatsira kuderedza marwadzo. Heano mamwe mishonga chevarwere zvichakubatsira mukurwa ane heniya:

- A decoction kuti marshmallow mudzi. Dururirai anenge 20 g yakapwanyika mudzi Althea mug of kufashaira mvura uye ngaiparadzanise yokubika.

- Mix 30 samadonhwe doro namo tincture uye 50 ml mukaka. Tora 2 kanomwe pazuva.

- flatulence zvakanaka kunobatsira decoction mbeu makerotsi. Zadza rimwe giremu mbeu 2 mikombe mvura inopisa uye kubvumira musanganiswa yokubika kweinenge awa. Unofanira kunwa pamwe mbeu.

Yeuka kuti asati chinhu (kunyanya chevarwere mishonga) zvakakodzera kubvunza chiremba wako.

Uyewo, achishandisa chevarwere mishonga, unogona kubvisa chirungurira, hiccups, uye zvimwe zviratidzo HH. Asi yeuka kuti izvi chete kwenguva pfupi pamusana, uye kudiwa kubata mhaka chirwere pane zviratidzo.

oesophageal heniya pashure pokuvhiyiwa

Sezvataurwa pamusoro apa, mune zvimwe zviitiko, hiatal heniya kunoda kuvhiyiwa. HH-mashandiro, wongororo izvo zvakawanda, unogona chaizvoizvo kuponesa upenyu akura zvikuru zviitiko.

Asi zvokuita kana kuvhiyiwa kuri kare? Sei zvinoenderana post-kushanda nzira? unogona kudzokera nokukurumidza sei kurarama?

HH pashure vavhiyiwa hazvo zvinoda zvakaoma kutarisira uye kurapwa uye kudzivirira.

Pazuva rokutanga pashure pokuvhiyiwa, varwere vanoda chiremba kuzviongorora uye electrocardiography. Pazuva rechipiri raiva chipfuva X-ray. On wechitatu - yose izere neropa count uye nokukanganisika zveBhaibheri izvo KUVERENGWA ramakanzi sonography.

Kaviri pazuva, varwere vanofanira kutakura kubuda nyore muviri kufema kurovedza muviri kurapa.

Kana mushonga mushonga unogona kutaura zvinotevera. It kunoratidzwa okutanga yesaline nomutsinga mune vhoriyamu 1800 Rine mamiririta pazuva. Varwere All pashure pokuvhiyiwa kutora mishonga inorwisa mabhakitiriya.

Trocar maronda vari kubatwa ne doro uye yakasungirirwa pazuva.

Just rimwe zuva avhiyiwa murwere ane kunwa mvura, asi kubvira pazuva rechipiri - kutora mvura chikafu. The postoperative kumwedzi anenge 3 months.

Sei iye HH-kushanda (wongororo izvo zvakasiyana, zvichienderana kwokuomerwa hosha), hatina kare ataurwa pamusoro. Zviri kubvisa zvikuru heniya.

mhedziso

Saka zvino imi haangatyi, kana pane imwe nzvimbo muchaona chidimbu HH. Chii uye sei chinoratidza pacharo, imi munoziva.

Zvazvinosarira chete muchidimbu, kuti hosha iri zvakakura chaizvo. Self-mishonga, kunyanya Mabatirwo chevarwere mishonga, hazvina ngozi zvakakwana uye zvinogona kukonzera zvakakomba matambudziko.

Asi, nhamo, kubva yematambudziko hapana angati, sezvo mamwe HH asymptomatic. The chete nzira yokubuda - kutora kuongorora zvizere muchipatara kanenge kamwe pagore. Saka unogona chete kuwana chirwere ichi hachifadzi.