Retireti whaturama hiatal: tohumate me te maimoatanga

whaturama Hiatal (aroaro māuiuitanga whakaahua e raro i roto i te tuhinga), me te Reflux esophagitis he mate tino kino. Ki te whakamārama o enei āhua e tohua totoro o etahi wāhanga gastrointestinal. I roto i ngā, huringa puta i roto i te here e tautoko i te puku, me te pū kai, kei te aroaro ano hoki he whakaahua o nei i roto i te tuhinga. Ka rite ki te hua, neke mānukanuka te. I roto i ngā te wahi o runga o te kopu, haere ki te wāhi pouaka. Ka rite ki te hua ohorere mahi o te sphincter honotanga te puku, me te pū kai (pikitia whakaatu tenei wāhanga).

mōrea pea

Ki te huri koe i te koki o hi me ngā mahi takahi esophageal (raro) o te sphincter puta maka te tirotiro waikawa o te puku ate ranei ki te pū kai o te 12 whewhe duodenal. tahi ana te tukanga e te whanaketanga o te mumura o te whakatikatika mucous. Tenei nui faarahi te mōrea o te mate pukupuku. O te faufaa ngā i roto i te whanaketanga o te mate ko te whaturama hiatal retireti. Pokanga Ko anake te tikanga e wātea ana ki te whakakore i te tūkino. Heoi, he ona ake onäianei wawaotanga hāparapara. tātari I tua atu i roto i te taipitopito, he aha te tikanga i te whaturama hiatal. E whakaahuatia hoki whānuitanga, momo me mau faaiteraa i roto i te tuhinga.

Overview

Whaturama i roto i te kuwaha esophageal, te tikanga whanake i roto i te taha ki te mate gastroesophageal. Grab tahi e cardiac matatini, pūkahukahu me disorders dyspeptic. whakatika ratou te nuinga no te mea o te whaturama me Reflux gastroesophageal. E ai ki nga feohi Amerika me te Pākehā i roto i te aroaro o HH te tangata mō te 5-12 tau te tūponotanga o te mate pukupuku e rima tau i muri mai tupu ki runga ki te 270%, me te 12 - e 350-490% (i runga i tau).

nuinga o te māuiuitanga

HH, kia rite ki te maha kaituhi, kua whakaaro te reira rite te mate nuitia pāngia, pērā i cholecystitis mariao esophageal ranei. E ai ki tona nuinga o enei mate ko te mate gastrointestinal ārahi. HH rite whewhe esophageal, kua whakaaro te reira fe'unga mate kino tono tātaritanga wawe, me te kitea te tupato.

whakarōpū

E toru ngā wāhanga matua o HH. Ko ētahi o ēnei:

• Axial whaturama hiatal. He ingoa tetahi tenei māuiuitanga. Ko te ingoa noa - retireti whaturama hiatal. kitea tēnei momo o te māuiuitanga e i roto i te tata 90% o tūroro. āhuatanga State e takanga o achalasia esophageal runga ake te poka. I roto i tenei whakaaro, kua reira he mahi koi pakaru kati.
• whaturama Paraesophageal. kitea ana tēnei āhua i roto i te āhua 5% o tūroro. Hoki tenei momo o te māuiuitanga āhuatanga e te tūranga tamau o te cardia me te curvature nui o te puku.
• pū kai Poto. Ka rite ki te motuhake, pāngia tenei māuiuitanga te rawa uaua. Ko te mate, ko te he pīari i te whanaketanga. Ka rite ki te tikanga, haere tahi tenei syndrome e te whaturama hiatal retireti. Hoki reira Kei te hoki āhuatanga e tukanga mumura me te scarring.

retireti whaturama

Ko tēnei puka o te mate āhuatanga e te tahi mau taa. I roto i te whaturama retireti whānui ko te protrusion, he tinana peritoneum wāhanga Uwhi ai te taiepa kotahi. Ka taea te atu whakaaro te reira i roto i te tuhinga wahi, tōngāmimi, e piki ana, e heke kopirua, a na i runga i. I roto i tenei take, e kore e taea e te pūwhera whaturama kia. Diverticulum, i roto i tenei take āhua wāhi tinana kore hipokina e te peritoneum.

Ko te tikanga o te takanga

I roto i runga ki tenei āhuatanga taratahi te:

• hernias congenital. I roto i tenei take i te mana mo tetahi take kotahi atu tari ranei, e kore peritoneum kati āta heke ki te wahi o te kuwaha i roto o te ngako retroperitoneal. A, no te roto o te kōhao mai ratou. Ka taea e tēnei tukanga tīmata rite wawe rite te wā embryonic. Ka rite ki te hua, e wāhikē tari protrusion wae kahore whaturama pūwhera.
• disorders riro. Hernias o tenei momo e hanga e e te hukihuki pūkaha o te tōngāmimi whēkau ranei wāhanga. E tangohia ratou o taupoki serous me tata ki te peritoneum.

whaturama Inguinal retireti i roto i te kōpiro nui, te tikanga he protrusions nui ki te kuwaha whanui. Pāngia, te tikanga i roto i te paari. Kitea whakamahi i ngā tikanga X-ray o te whakamātautau whēkau nui. Retireti whaturama o te tōngāmimi puta disorders dysuric. Tūroro tohua urination rua. I te tīmatanga te kawea riringi ano i rite mua, a ka, ka pēhi i runga i te protrusion, i reira he tetahi hiahia me tamaiti tane ano te manawanui. A, no te whakamana te tātaritanga te catheterization me cystography. I roto i te akoranga o enei ngā tukanga whakakitea te āhua me te rahi o te whaturama, te ngaro aroaro o kohatu tōngāmimi ranei.

whaturama hiatal Axial

Tenei māuiuitanga Ko te displacement o te puku atu whekau puku ranei ki te kōhao pouaka. pāngia te mate i roto i te 5% o te taupori pakeke. Heoi, e pā ana ki te hawhe o tūroro e kore e kite i tetahi tohumate. māuiuitanga rere pērā hoki te retireti whaturama hiatal kua murua tohu āhua angamaheni no nga tikanga te protrusion i roto i te tinana, me te i raro i te tirohanga noa e kore e taea te kitea i te reira. pā te mate wahine atu pinepine atu i te tangata. Ko te nuinga tumu māuiuitanga pediatric.

momo o te mate

Retireti whaturama hiatal te wehea ki:

• Kardiofundalnuyu.
• pekitīlia Tapeke.
• Cardiac.
• puku Tapekeroto.

E whakarōpūtia hernias Paraesophageal ki:

• Gastrointestinal.
• Hau.
• Intestinal.
• Antral.
• Fundus.

atamira pathological

Retireti whaturama hiatal kia whakarōpūtia i runga i te rōrahi o te puku hohonu ki te kōhao pouaka:

• Ko te wāhanga tuatahi. I roto i tenei take, te kōhao rei kei te HWM te i runga i te wahi puku o te pū kai. Ko Na te kopu i roto i te tūranga teitei. Ko te tika pātata ki te HWM ia. A kua Kei reira i te cardia.
• Ko te wāhanga tuarua. Ko te kōhao rei ko te wahi puku o te pū kai, wehea te kopu e tika i roto i te rohe o te poka phrenic.
• Ko te atamira tuatoru. Runga ake i te HWM he cardia, tinana pekitīlia me raro (i ētahi wā wahi antral) esophageal puku wehea.

pikitia haumanu

He tino rite ki te tohu o mate o te wahi kūnatu e pā ana ki te mahi waimaero Tohu o mate. Ki te whakamārama o te ino i roto i te mahi o te esophageal (raro) sphincter tohua Reflux catarrhal (whakamuri whakaitinga o tirotiro pekitīlia). Neke atu i te wa e tika ana ki te mana pukuriri o te papatipu i roto i te wahi o raro o te pū kai whakawhanake tukanga inflammatory. tīmata te manawanui ki te amuamu o te tokopā i muri i ngā kai, me te whakanui ake i te ahotea tinana ranei i roto i te tūnga whakapae. E mea pinepine i reira ko te mana'o o te puranga i korokoro te. I muri i te kai, kia puta te mamae. He rerekē i roto i te āhua ratou. kia horahia te tetahi raru ki te peke, kia hoatu i roto i te kaki, i muri i te whaturei, huri noa te ngakau te kauae raro ranei. He rite ki te tohu o te angina, kawea nei i roto i pārōnaki tātaritanga ēnei tohumate. I roto i ētahi wā puta te mamae i te tetahi tūnga o te tinana. Pea ki te karanga ki te distension puku o runga o te manawanui, ite i te aroaro o te tinana ke.

pānga

Kei te āhuatanga e te maha o pōauautanga take atu kino. Ko tētahi o ratou ko toto i oko esophageal. Ka rite ki te tikanga, e te reira wahi i roto i te puka moe, a ka faaite rite anemia ahu whakamua. kia ma'i, me te whakapeka toto. I roto i ētahi wā, ara kitea protrusions hara i te kuwaha esophageal me perforation esophageal. Ko te putanga tino noa o te mate ko te Reflux esophagitis. Ka taea te puta te reira ki te whewhe keté i roto i te pū kai. I roto i te maimoatanga tonu whakaoho tenei huru pōauautanga atu kino - stenosis cicatricial (whāiti) o te tinana.

tātaringa

kawea Pathology Haurapa te roto e maha ngā tikanga. Kei te whakahuatia te reira i roto i te nui: esophagogastroduodenoscopy, X-hihi o te puku , me te pū kai, intraesophageal PH-mita. Whakamahia rite ultrasound, tomography computed, ezofagometriya.

maimoatanga mate

Kawea atu ngā mahi e hāngai ana ki tamarыraa i te mau faaiteraa e haere tahi i te whaturama hiatal retireti: kai, rongoa. E hāngai tikanga tūpato i te whakakore i nga tohu mate: mamae te tauturu, tokopā, whakapairuaki. I roto i tenei take, i whakaritea taero e whakaiti kawatanga pekitīlia. Na roto i taua tikanga, hei tauira, ngā te faaineineraa "Kvamatel". Ko tētahi o nga tikanga mo te maimoatanga whai hua o tūroro pāngia ki te whaturama hiatal - he kai. iti te kai kei te ki te aroaro o te fatty, raukikini, parai kai, waipiro, tiakarete, kawhe, hua e whakatairanga te hanga o te wai pekitīlia. kia kai kai iti maha. Kia kore ai tohutohu Reflux moe manawanui e ki whakaarahia rohe tinana o runga, a ka karo toronga taimaha.

Pokanga: mōhiohio whānui

kia mea te reira e kore te mahi i runga ake e faaore i te take hoki i reira te mea he whaturama hiatal retireti. Mahi - anake te ara ki te whakahoki i te hononga anatomic i waenganui i nga wahi GI. I roto i te tukanga o te wawaotanga hanga he tikanga antireflux aukati atu whakamuri kua maka e nga tirotiro puku. I roto i te mahi hernial whakakorea e suturing piata whakanui ki te rahi noa.

tikanga hāparapara whakamahia

I teie mahana, te whakamahi i ngā tohunga e rua tikanga o te wawaotanga:

• Open uru. I roto i tenei take, kia kawea ai reira Nissen fundoplication kirihou ranei e Tope. I roto i te take tuatahi, he mōrea tiketike o te whakawhanake pōauautanga o te huinga. No te mea he pai mo Tope kirihou.
• huarahi Laparoscopic. Ko te tikanga pāmamae iti rawa o te wawaotanga tenei. I muri i te mahi i roto i tenei ara ora tere me te māmā te manawanui.

Me mea te reira e te maha i te poka whaturama esophageal laparoscopic kawea i roto i tahi me te ngā mahi o ētahi atu whēkau i roto i te kōhao puku. Hei tauira, i mahi holetsistomiya ina cholecystitis calculous i roto i te wā tonu, whiriwhiri vagotomy proximal - whewhe i roto i te duodenum.