Kwa zaka zambiri, panalibe mgwirizano m'mabuku opezeka pafupipafupi a nthawi yochepa ngati chitukuko chokhazikika chachitukuko. Chothandizira kwambiri pa maphunziro a etiology, pathogenesis, data-morphological data, matenda ndi chithandizo cha mphindi zochepa zapachiyambi zinapangidwa ndi B. Barret (1959). Matendawa akufotokozedwa m'mabuku omwe ali ndi mayina osiyanasiyana: brachiozophagus, mimba pachifuwa, osalowetsa m'mimba, m'mimba mwapadera.
Kuwoneka kwa khungu kochepa kumatanthauzidwa ndi kuphwanya mapangidwe a kapangidwe ka zakudya m'mimba yoyambirira ya embroni, pamene mimbayo inali ndi epithelium yamakono. Kutengera kwa epithelium iyi, kuyambira pakati pa magawo atatu a chiwonongeko, kumasokonezeka, chifukwa chachitali chachitatu cha izo chikugwirizana ndi chapamimba epithelium. Momwemonso pali dystopia ya m'mimba mucosa m'munsi mwa chigawo (ndi malo oyenera a cardia).
Kutsimikiza kwa lingaliro ili ndilokuti gawo la supra-diaphragmatic la chomwe chimatchedwa kuti chosadulidwa mmimba, kupatulapo mu mucous nembanemba, imapangidwa ngati nthenda ndipo ilibe chivundikiro cha serous. Mu gawo lomwelo, zigawo zozungulira ndi zam'mbuyo zamkati zimakhala zosiyana, ndipo magazi amaperekedwa, monga mwachizolowezi, kuchokera ku aorta.
Zizindikiro za kuchipatala
Mphuno yochepa ya congenital imaperekedwanso, monga lamulo, ndi reflux ya gastroesophageal, yomwe imakhala yovuta kwambiri ndi matenda a shuga komanso kuyambira kwa stenosis.
Mphuno yaching'ono ya congenital ikuwululidwa kwa ana a zaka zitatu zoyambirira za moyo, chifukwa ali ndi matenda ofanana a reflux. Mu anamnesis, odwala amenewa nthawi zambiri amatsuka posachedwa atabadwa. Kawirikawiri pali zizindikiro za matenda opatsirana kawirikawiri: bronchitis, chibayo (mu 30%). M'tsogolomu, mawonetseredwe a kachipatala amadalira mapangidwe a stenosis yachiwiri. Ngati stenosis siinapangidwe, chizindikiro chachikulu ndicho kusanza ndi zinthu zamkati. Kutupa kumapwetekedwa ndi kulira, ndi malo osakanikirana a thupi, ndi kupweteka pang'ono kwa thupi kumene kumayambitsa kuwonjezeka kwa mtima wa m'mimba. Masanzi a magazi amapezeka mu masanzi; kusanza khofi kawirikawiri. Ndi kuponderezedwa kwachiwiri kwa mimba chifukwa cha chiwindi chachikulu cha ulcerative anopharyngitis, zizindikiro za kuphwanya zofooka zazitsulo zimakhala: dysphagia, kusanza kwa chakudya.
Ana oposa zaka zisanu ndi zitatu akudandaula za zowawa pambuyo pa sternum, kutuluka kumene kuli chifukwa cha todisagia ndi ulcerative esophagitis. Kawirikawiri, ana amayesa kumwa pishchuk. Chifukwa cha magazi omwe amachokera nthawi zonse m'magazi, amatsimikiziridwa ndi kusakaniza magazi m'magazi a masanzi komanso njira zabwino zowonjezera magazi m'magazi, magazi amayamba. Matenda a anemic amapezeka mu 1/3 mwa odwala. Ana omwe ali ndi matenda ochepa omwe amatha msinkhu amatha kusamba.
Kuti mudziwe za matenda ochepa omwe amachititsa kuti thupi likhale lochepa, kugwiritsidwa ntchito kwa X-ray kumagwiritsidwa ntchito, mothandizidwa ndi, omwe poyamba, chifuwa cha reflux chimapezeka. M'njira ya Trendelenburg, wodwala wa refopuline odwala matenda otupa amadzimadzi amatsimikiza kuponyera mankhwala osiyana a ovary m'mimba. Gawo la distal, monga lamulo, likufutukuka pansi ngati mawonekedwe kapena belu. X-ray zithunzi mu distal mayopoti longitudinal kupukuta, khalidwe la mucous nembanemba m'mimba. Chigawo cha mthendayi poyesa wodwalayo poima chilili. Pogwiritsa ntchito stenosis yachilendo, chizoloŵezi chosiyanitsa chosemphanacho chimalephereka, ndipo kusemphana kwa chigawocho kumatsimikiziridwa pamwamba pa zovuta zowonjezereka. Chithunzi chojambulidwa ndi chithunzithunzi ndi chiwonetsero cha dera la chisokonezo ndi kusungidwa kwa chipinda chokwanira chikufuna kusiyanitsa ndi chivundikiro cha kutsekemera kotsekemera kwa chingwe ndi diverticula.
Amagwiritsidwa ntchito kwambiri kuti apeze matenda a esophagofibroscopy. Chizindikiro chofunika kwambiri chotchedwa endoscopic ndicho kusintha kwasintha kwa mucosal yophimba mu mimba mu chapamimba mucosa, i.е. pamwamba pa chiwonetsero cha chidutswa cha diaphragmatic. Popanda stenosis m'mimba ya distal, catarrhal kapena ulcerative fibrinous epopitisiti imapezeka. Ndi chitukuko cha stenosis, monga lamulo, chiri pamalire a mucous membrane ya m'mimba ndi mimba.
Pogwirizana ndi mfundo yakuti odwala omwe ali ndi mpweya wochepa wobadwa nawo amakhala ndi malo otchedwa reflux gastroesophageal, mtengo wotsimikizira uli ndi intraepithelial pH-metry.
Anthu okhala ndi makanda amakhala ndi matenda osiyana siyana ndi pyloric stenosis, pilorospasm, herniation ya phokoso la diaphragm, chalasia, congenital ndi stenoses yomwe imapezedwa.
Chithandizo
Opaleshoni nthawi zambiri amagwira opaleshoni, pofuna kuthetsa opaleshoni ya gastroesophageal. Kuchita opaleshoni yodalirika kwambiri ndi ntchito ya NN Kanshin mu kusinthidwa kwa YF Isakova et al., Kuchokera pa chifuwa chachikulu cha valve. Pamene malo ochepa omwe amakhala ochepa amakhala ovuta chifukwa cha peptic stenosis , opaleshoni yoyamba imaphatikizidwa ndi kuikidwa kwa gastrostomy. M'tsogolomu, imadulidwa ndi bougie.
Kuchokera kwa odwala omwe akuganiza kuti mimba yayamba kukhala yopanda kupweteka m'mimba, m'pofunika kuchita chithandizo chokhalitsa cha nthawi yayitali (pamene mwana akukula).
Chithandizo chodziŵika bwino chimapereka malo okwera nthawi zonse pamtunda wapamwamba wa thunthu, kudyetsa mwana nthawi zonse m'magawo ang'onoang'ono a zakudya zomwe zimakhala zosasinthasintha. Khalani ndi chithandizo chachikulu chobwezeretsa ndi chachizindikiro.
Kukula!