HH - he aha te mea te reira? Tohu me te maimoatanga o HH

Kia tīmata a ki te meka e kore katoa he whakarāpopototanga maheni HH. He aha te mea te reira?

whaturama Hiatal (HH ko te taua hoki poto), ranei he whaturama hiatal, - kahore neke atu i te mate āhuatanga e te displacement o te okana (kei roto i te kōhao puku) i roto i te kai i te poka i roto i te HWM ki te kōhao rei. Ko te tata tonu tenei tinana te puku.

whaturama Oesophageal taea whai natula congenital riro ranei me kua korerotia faaiteraa haumanu. Ko iti noa whaturama congenital atu riro. Ka taea e HH puta mō ngā take maha.

I roto i tēnei tuhinga ka titiro tatou ki te mea ko HH, tohu, maimoatanga me te wā pou-operative o tenei mate.

āhuatanga General o te mate

Pūare (ki nei he hāngaitanga HH) he arai domed āhua e ngā o rua ngā momo o ngā papanga; uaua, me te tūhonohono. Ko tenei te arai e wehe te kōhao puku i te pouaka. Ko te putiki i roto i te uaua HWM ki te hanga i te poka iti i roto i nei te pū kai. A koe pea kua matau he aha huaina te mea te whakatuwheratanga esophageal.

Hoki mai ki te whaturama hiatal (HH). He aha te mea te reira? Kei te hanga e te reira i rite ki te hua o te displacement o te tinana i te kōhao puku ki te pouaka i roto i te tino hiatal. A tupu te reira no te mea o tona he vaivai.

whaturama Hiatal - he mate noa kia taea whakataetae reira pai ki cholecystitis, pancreatitis tuwhenua duodenal ranei. Heoi, kia rite ki tona kaumatua, ka meinga ano a reira whakataetae ratou.

Ka taea te mea tau whanaunga o te manawanui e maha whakawhanake te mate i roto i te iwi pakeke atu i te 60 tau. Ki te whakaaro ki te ira tangata - he nui ake pea ki te mamae i tenei mate atu i nga tangata wahine.

whakarōpū

whaturama oesophageal whakarōpūtia rite ki o ratou āhuatanga. Tohatoha taua momo:

• Māngi whaturama pūmau (whaturama mō axial me paraesophageal anake) ranei. I roto i ngā, whaturama paraesophageal - ko tenei, ka he tika te ahua o te wahi o te puku i te taha o te pū kai i runga i te HWM. Na fakatefito te cardia o te kopu i raro te HWM te. Axial HH - esophageal, cardiac, totalnozheludochnaya tapekeroto ranei. Kei te retireti tonu te puta ke whaturama, ngā wahi i hanga e te i roto i te taua pūwhera hernial kapi katoa ki te peritoneum. rere ke te reira i te meka axial e putea whakamutunga reira. Ka taea e Axial whaturama neke noa ki nekehanga tinana.
• whaturama Paraesophageal (fundic antral ranei).
• whaturama congenital, meinga e te pū kai poto ki te Pākatokato i roto i te whanaketanga.
• Hernias o tētahi atu momo (enteric, hiri, me te pera i runga i. P.).

taea hoki te whakarōpūtia tenei mate rite ki te tohu:

- whaturama Esophageal tohu tuatahi. Āhuatanga i roto i taua i te cardia o te kopu ko i runga i te taumata o te HWM, puku paku piki me piri piri ki te HWM. Kei pū kai puku i roto i te kōhao rei tonu i runga i te HWM.

- whaturama Esophageal tohu tuarua. Ko te pikitia haumanu ko e whai ake: pū kai puku i roto i te ãpoko, a i roto i te whatitoka esophageal ko kē wahi o te puku.

- whaturama Esophageal toru tohu. Ko te tohu tino nui, kei te āhuatanga e te kitenga o te pū kai, cardia, a ētahi wā noa te tinana, me te fundus o te puku i runga i te HWM.

Ngā take mō te whaturama esophageal

Kua tatou whakahuatia kē e te take i whaturama hiatal rawa nui. Heoi, te nuinga o maha ko nga āhuatanga e whai ake nei:

• Thinning o nga mea tuhonohono tūhonohono meinga e huringa e pā ana-tau piri ranei e tetahi atu tukanga.
• hua nahanaha ranei kotahi-wā ma'i i roto i te pēhanga i roto i te kōhao puku iho. Ai hua i roto i te pēhanga e taea e kōroke ma'i, mahi taimaha (pērā i ara taonga taimaha), puhuki whētuki puku me te ake.
• mate mau e kua pā hāngai ki te pūnaha kūnatu me e taea whakapōrearea i nekeneke mahi o te au tōngāmimi, puku, duodenum ranei.
• Disorders o te repe endocrine (endocrinopathy).
• peu kino (paowa, inu), tangata kaumātua.

HH: Tohu

Tei runga i te faaiteraa haumanu o te mate e te whai ake puka whaturama hiatal:

- HH asymptomatic;

- HH, mo te māuiuitanga i roto i i meinga te syndrome e kore o te cardia;

- HH, e kore e āhuatanga e te aroaro o pekitīlia syndrome cardia iti hoki;

- HH, e puta rite te pōauautanga o te tahi atu momo o mate gastrointestinal (ranei whakawhanake noa i runga i to ratou papamuri);

- paraesophageal HH;

- HH whanau, āhuatanga e te pū kai poto.

Ko reira utu whakaaro ia momo HH (ia momo o tohu) motuhake:

• hernias Asymptomatic. Ka rite ki matau koutou te ingoa o tenei ahua o te mate, i tetahi tohu o HH i enei take, e kore. E pā fele tenei ki whaturama cardiac esophageal ranei, arā, te ngā rahi iti. Ite i tenei puka o te whaturama rawa tupurangi, maha - i roto i te whakamātautau tonu, a te tahi mau taime e kore e te iwi ara ite e kua e ia he HH - tohumate (maimoatanga kōrero i raro nei) no te mea kahore he whaturama.
• HH cardia syndrome kore. Ko te tohu tino noa o cardiac HH - tokopā me te mamae, postprandial, me i huringa koi o te tūranga o te tinana o te manawanui. Me mahara hoki käore te reira e tupu pinepine enei tohu i te po, he mea ka taea ki te whakamārama i te āhuatanga o te whakanui ake i te āhua o te karere vagus, me te te whakangā o te sphincter esophageal raro.

No nia i te kaha o te tokopā, ka taea e koe te mea e taea e te reira ngāwari (i roto i tenei take, e taea te tukinotia reira ki waikawa), a tino mamae (kia nui kia ara whakaputa mahi tangata). i whakarite ona kaha e te matatini o ngā āhuatanga rerekē, me, te tuatahi, me te tuatahi, ngā waikawa-keté, i te mea moku, ki te wai pekitīlia enei. Hoki, kia whakaawe reira distension esophageal ka maka ai tirotiro duodenal (matua bile).

Ko te āhuatanga kanohi-hopu te nuinga o whaturama hiatal, o te akoranga, te mamae. E tano ia tapao e tei te reira i runga i te take o te tokopā. Fele puta reira no te mau tumu ōrite. paetata mamae e te nuinga i roto i te rohe o te whaturei, a kua rahi roa'tu, ina e te manawanui he tūranga te teka. I tua atu ki tenei āhuatanga meinga hoki te mamae utumu hoki a waho. kia rerekē te āhua o ia, te nuinga o maha te ngau a te reira, tapahi tahu sensations ranei.

Regurgitation o tirotiro pekitīlia - he hoki tohu tino auau o HH. He aha te mea te reira? Ko te tukanga o e maka ana i te tirotiro puku ki te mangai tenei. tītohunga Tino kino, a ko te kupu i te tirotiro o te kopu e taea te tiki ki te pukorokoro bronchi ranei.

Ano, o kupu e pā ana ki te mamae tetahi tokorua. mamae Real mana'o hawhe anake o nga tūroro me i te 25% o te wā psevdokoronarnaya reira mamae, paetata nei i roto i te ngakau. Mai i reira ka taea e ngāwari te tiki e koe te maka o te whakamahi i nitroglycerin. I tua atu i tenei mamae ki, kia whawha tūroro hūhi i roto i te interscapular, ngā wāhi hepatopancreatoduodenal, me te i roto i-Chauffard Minkowski, me ētahi atu

Hoki, e pā ana ki 70% o tūroro ki te whaturama hiatal (ina koa, ki te reira cardiac HH) fehangahangai ki te tohu pēnei i te paowa. Nuinga o ngā wā tupu te reira i te tirotiro kopu, me tona mua ko te sensation kino angamaheni o tini i roto i te rohe epigastric, e tohu aerophagia. hopoi mai te reira i te reka kawa kino. Na antispasmodics me Pë i roto i tenei take, ki te tango kore e taea enei mau mana'o.

Ano, 40% o tūroro i fifi haere kai me te pū kai, ara ka tango kai wai. Ahakoa kia tuhia te reira e haere i te kai maro ngāwari nui. Iwi e mate ana i tenei tohu, tino maha e whakakitea ai e te hurihia rawa wera tumuaki tuarua ranei, kai rawa matao. Na reira, ki te tūtohutia he whaturama te ki te kai te kai anake e kua teperatura tinana.

Mō 4% o tūroro mate i hiccups HH i te papamuri o te puka axial o whaturama. Anake te reira e kore rawa te hiccups mua. Ka taea te whakaaro Ko tōna āhuatanga matua te roanga nui (kia muri wiki ranei ara marama). kore too atu o reira noa rawa, a ki te āwhina i roto i te takahanga e taea anake e te kaitoi tohu.

wheako hoki ētahi tūroro glossalgia (nui arero) me te whango, i te mea he putanga o ngiha i tirotiro pekitīlia keté tukuna i roto i regurgitation.

I tua atu ki te katoa i runga, ka taea e tatou te tāpiri e nga tohu o te whaturama tei runga i tona rahi.

• HH kahore tohu iti hoki o te cardia. I roto i ngā take pēnei, ko te tohu o mate kapo ko atu korerotia, e kore te whaturama. Ka pericardial tohu o tenei puka whaturama, epigastric mamae retrosternal puta tonu i muri i te kai i muri i ara ranei ranei.

Tangohia taua mamae kēne hoki te maha nga ra. Hei e haamou i ratou e taea e koe te whakamahi i Pë kore-whakapōauau (anake validol no o reira kahore he pānga) nitroglycerin ranei. Ano, mutu te mamae, ka tango kai wai ranei.

• HH, e puta rite te pōauautanga ranei whakawhanake noa i runga i te whakamārama o ētahi atu momo o mate gastrointestinal. Ko te nuinga o maha pekitīlia whewhe duodenal ranei taua mate. I roto i tenei ahua o HH nga tohu matua o te mate, e kore te whaturama.
• Paraesophageal HH. āhuatanga tēnei puka o te whaturama e te ngaro o tetahi tohumate me tohu. Nuinga o ngā wā puta matapōkeretia tātaritanga o whaturama paraesophageal i roto i rangahau whānui. Otira ka whakanui te whaturama, kōpeketanga esophageal reira (i roto i te kupu atu, whāiti o te pū kai). I roto i te wā onge, te whakawhanake spasm esophageal (he mate i roto i i ohorere ioio esophageal).

Ki te nga hernias paraezafagealnyh hara i reira he mamae i roto i te whaturei epigastric ranei.

• Congenital HH āhuatanga e pū kai poto. I roto i tenei ahua o te whaturama pū kai e taea e rua ngā kōwhiringa. I roto i te tuatahi o ratou e taea te whakawhanake i tētahi mea pērā i "puku rei", āhuatanga nei i te te puka e whai ake nei:

- te wāhi o te pouaka;

- localization o te puku intrathoracic.

I roto i te take whakamutunga, kei te tino uaua, reira te tikanga tupu te tātaritanga i roto i te pokanga ranei i tūpāpaku.

pōauautanga taea

Ka taea e whaturama Hiatal whakapataritari i te momo o pōauautanga. Nuinga o ngā wā whakakitea e whai ake:

- gastritis whewhe pekitīlia ranei e wahi i roto i nei te whaturama (puta i pā ana ki 8% o ngā take);

- toto, anemia (i reira e 20% o ngā take);

- te whakataki o te pū kai raro i roto i te pūwhera hernial;

- shortening o te pū kai (te nuinga kitea anake ki ngā puka kardiaezofagealnymi);

- prolapse o te mucosa pekitīlia i roto i te pū kai (ie retrograde ngaronga);

- whaturama strangulated (te pōauautanga uaua tino o katoa o te runga ake).

tātaritanga o te mate

Tikanga, tohunga kawe i te maha whakamātautau i runga i te pūtake o e taea kua te pāngia nga hua "HH." He aha te momo o whakamātautau:

• Fibrogastroscopy. Ka taea e koe te whakamahi i te reira ki te mahino te huru o te pū kai, me te puku. tohu Endoscopic o HH tautuhi ia he tākuta, e hāngai ana i runga i nei e taea e hanga i taua he tātaritanga, me te whakahau maimoatanga.
• whakamātautau X-ray, e hāngai ana nei i runga i te rerekē pārana. Na roto i tenei rangahau, ka taea e te tiki e koe he herniation pikitia, i te mea ulungāanga mo ia HH-tohu.
• pH-metry. hanga ana tēnei whakamātautau te ki te whakatau i te taumata o te kawatanga i te kopu. He mea tika ki te tautapa tika maimoatanga o te whaturama.

HH te Treatment pū kai

Ko te tikanga, haere maimoatanga whaturama hiatal roto i taero, engari i roto i ētahi wā (tautautefito ki he taimi pōauautanga) rapu wawaotanga hāparapara.

Ki te whakaaro ki te maimoatanga ki rongoa, he reira ki te whakaiti i te kawatanga o te puku (te whakamahi i patu waikawa), me te whakaiti secretion pekitīlia. Tenei - ko te mahi tuatahi. Hoki, ki te mea he tika maimoatanga ki te tiaki i te mucosa pekitīlia, e whakarato ana hoki mo te tono o etahi raau taero.

A, no te homai maimoatanga te he kai tino, e me kakato aru. Fele, Ko tata tenei kai te rite mo te gastritis: e kore ngako, kahore raukikini, kawa, tote. kai hauora anake, pērā i huawhenua, hua, pata, hupa kai me broths, kai hiroki.

Na, ki te whakakore i tokopā me ki te whakaiti i secretion pekitīlia taea te tango i te tarukino "Maalox". I te mea te tino watea, he reira e wātea ana papa kore anake, engari ano hoki i roto i te puka o hāpiapia, pire, te aukati. Ia ahua o tenei tikanga te motuhake tohutohu mo te whakamahi, e taea te tohua i roto i tetahi rongoā o koutou pa.

Ko reira taea hoki ki te tango i taua tikanga rite "Rennie" ranei "Gastal". Hei whakakore i tokopā kē puta ki te kia nui ki te tango tetahi papa, me mo te ārai o - 4 papa he ra (kotahi te haora i muri i te kai). Heoi, mahara e enei taero anake tango i te tohu.

Ka rite ki hoki pokanga, he reira ki te tango i te hanganga whaturama.

Hoki te tātaritanga me te maimoatanga tika atu mau opuaraa he tika ki te tono ki te tākuta (faitafá gastroenterologist ranei).

Maimoatanga o rongoā iwi

e kore e rongoā iwi HH Treatment hoatu te hua e hiahiatia ana, pera i roto i nuinga o te wā i te tangata e mate ana titau rongoā nui ranei ara pokanga.

E ko, e kore e taea ki te tango moni o te iwi, kahore whaturama iho. Ko te take anake e taea te whakamahi ratou - ki te atawhai mamae.

Ka taea e ētahi teas otaota te āwhina whakaiti mamae. Here te tahi rongoā iwi e ka āwhina i roto i te whawhai ki te whaturama:

- He decoction o marshmallow pakiaka. Ringihia āhua 20 go o mongamonga pakiaka Althea maka o te wai kohua, a kia silica reira.

- Whāranu 30 pata o tincture propolis waipiro, me te 50 ml o te waiu. Tangohia 2 nga wa i te ra.

- E tauturu te flatulence pai decoction o nga purapura o kāreti. Whakakiia tetahi uri karamu 2 kapu o te wai wera, me te tuku i te ranunga ki te silica hoki e pā ana ki te haora. Me koe ki te inu me purapura.

Kia mahara e i mua i te tango tetahi (rawa rongoā iwi) he reira e tika ana ki te kōrero ki tō tākuta.

Hoki, mā te whakamahi i rongoā iwi, ka taea e te tiki e koe te maka o te tokopā, hiccups, me ētahi atu tohu o HH. Engari kia mahara e te mea noa he hua rangitahi, me te hiahia ki te hamani i te take o te mate, kaua ki te te tohu tenei.

whaturama oesophageal i muri i te pokanga

Ka rite ki whakahuatia i runga ake, i roto i ētahi wā, titau pokanga whaturama hiatal. HH-mahi, arotake o e rangirua, ka taea e mau whakaora i te ora i roto i te wā tino matatau.

Ko te aha ki te mahi ina te kua mahi he mahi? Me pēhea te ki te ū ki te aratau pou-mahi? I peheatia i hohoro taea e koe te hoki ki te ora noa?

HH muri pokanga rapu tika tiaki matatini me te maimoatanga me te ārai.

I te ra tuatahi i muri i te pokanga, Me tūroro he whakamātautau kaihaumanu me electrocardiography. I te rua o nga ra, ko te pouaka X-ray. I runga i te tuatoru - te katoa tatau toto tonu me rangahau matüora o e pānuitanga sonography tikanga.

Rua te ra, kia kawe tūroro i mahi kuware te kupukupu mahi me te therapy tinana.

Ko therapy raau e taea te mea i te whai. Kei a ia i roto i te whakataki o te otinga saline pâmuhia i roto i te rōrahi ki te 1800 ml ia ra. tūroro katoa i muri i te pokanga tango paturopi.

E tukinotia patunga Trocar ki waipiro me e herea i roto i te ra.

kotahi ra noa i muri i te mahi kua i te manawanui ki te inu i te wai, engari i te rua o nga ra - tango kai wai. Ko te wā postoperative ko e pā ana ki 3 marama.

Nahea ia HH-mahi (arotake o e he rerekē, i runga i te pakeke o te mate rānei), kua kua matou whakahuatia i runga ake. Ko reira ki te tango i te whaturama te nuinga.

mutunga

Heoi inaianei e kore e waiho e koe e wehi, ki te wahi e kite koe i te whakarāpopototanga HH. He aha te mea a pehea faaite te reira iho, e matau ana koe.

tonu te reira anake ki te whakarāpopoto, e ko te tino nui te mate. Whaiaro-rongoā, rawa maimoatanga o rongoā iwi, he mōrearea nui reira a taea meinga pōauautanga nui.

Ko, Aue, i pōauautanga kahore tetahi he ārai, mai i etahi momo o HH asymptomatic. Ko te ara anake i roto i - tangohia te whakamātautau tonu i roto i te hōhipera i te iti rawa kotahi te tau. Na e taea kitea noa e koe i tenei mate kino.