Lub plab yog ib qho tseem ceeb ntawm lub cev, kev noj qab haus huv uas cuam tshuam ncaj qha rau kev nplij siab thiab kev ua haujlwm tag nrho ntawm tus neeg. Qhov tsos ntawm zawv zawg hernia tuaj yeem muaj qhov cuam tshuam tsis zoo rau lub cev. Nws yog tsis yooj yim sua kom tsis quav ntsej txog qhov teeb meem no, yog li nws yog ib qho tseem ceeb kom paub koj tus kheej nrog cov tsos mob ntawm pathology thiab txoj kev kho mob.
Hiatal hernia
Tus kab mob no tuaj yeem txhais tau tias yog pathology, qhov tseem ceeb ntawm qhov uas yog kev hloov pauv ntawm ib lossis ntau lub cev nyob hauv lub peritoneum. Lub zog nws tus kheej yog nqa tawm los ntawm kev qhib ntawm txoj hlab pas hauv lub diaphragm nyob rau hauv cov kev taw qhia ntawm lub hauv siab kab noj hniav. Yog li ntawd, cov khoom nruab nrog cev uas yuav tsum nyob rau hauv lub plab kab noj hniav mus rau hauv lub hauv siab cheeb tsam thiab protrude noticeably.
Hiatal hernia (lub npe thib ob ntawm tus kab mob) tuaj yeem ua rau ib feem ntawm lub plab, uas nws thiaj li xaus rau hauv lub hauv siab.
Tus mob no qee zaum provokes kev txhim kho cov kua qaub reflux hauv tus neeg mob, uas yog, cov kua qaub tawm hauv plab mus rau hauv txoj hlab pas. Feem ntau ntawm cov noKev kuaj mob yog tsim nyob rau hauv cov neeg mob hnub nyoog tshaj 50 xyoo. Nyob rau tib lub sijhawm, nws yuav tsum tau muab sau tseg tias cov poj niam raug kev txom nyem los ntawm qhov teeb meem xws li axial hernia, ntau dua li cov neeg sawv cev ntawm kev sib deev muaj zog.
Kev tshwm sim
Kev tshem tawm ntawm lub cev sab hauv tuaj yeem yog qhov tshwm sim ntawm ntau yam uas yuav tsum tau coj mus rau hauv tus account. Nov yog cov laj thawj rau qhov tshwm sim ntawm qhov pathology:
- hnyav dhau ua rau muaj kev cuam tshuam ntawm peritoneum;
- hnoos ntev;
- rog dhau;
- pathology ntawm txoj kev loj hlob ntawm lub diaphragm ntawm txoj hlab pas, uas yog congenital xwm;
- kev hloov pauv cuam tshuam nrog cov txheej txheem kev laus;
- cem quav tas li;
- pom qhov nce siab hauv lub peritoneum;
- kev ua haujlwm thiab ntau yam kev raug mob;
- Qee zaum, hiatal hernia tuaj yeem yog vim cev xeeb tub lossis yug menyuam nyuaj.
Nws yooj yim pom tias qhov mob hnyav yog tshwm sim los ntawm kev nruj heev hauv lub peritoneum, uas tshwm nyob rau hauv kev cuam tshuam ntawm ntau yam.
Hom thiab qib kab mob
Kev xyaum kho mob niaj hnub tso cai rau peb txheeb xyuas ntau yam tseem ceeb ntawm qhov teeb meem no:
- Paraesophageal. Peb tab tom tham txog kev hloov pauv tsuas yog ib feem ntawm lub plab yam tsis muaj kev koom tes ntawm lwm cov kabmob hauv cov txheej txheem.
- zawv zawg hernia, nws kuj yog axial. Nyob rau hauv rooj plaub no, nws cov cardial feem kuj tau muab tso rau hauv lub hauv siab kab noj hniav.
- Mix. Cov no yog cov yam ntxwv ntawm thawj ob hom, uastshwm sim ib txhij.
- Kev yug los. Xws li kev kuaj mob yog tsim thaum kuaj pom hernia, qhov tsim ntawm qhov tshwm sim tawm tsam keeb kwm ntawm cov hlab pas me me, nyob rau hauv daim ntawv ntawm "thoracic ventricle". Qhov xwm txheej no tsis zoo.
Nws yog ib qho tseem ceeb kom nco ntsoov qhov tseeb tias zawv zawg hernia yog ib qho kab mob uas tuaj yeem muaj ntau qib, txhua tus ntawm lawv muaj nws tus yam ntxwv thiab tsim nyog mloog:
1. Lub plab nyob hauv qab ntawm lub diaphragm, lub cardia yog nyob rau theem nrog nws, thiab lub plab ntu ntawm txoj hlab pas yog siab dua qib ntawm lub diaphragm.
2. Hiatal hernia ntawm 2nd degree txawv nyob rau hauv uas txoj hlab pas yog sib npaug zos compressed, thiab lub cardinal ib feem ntawm lub plab protrudes mus rau hauv lub mediastinum.
3. Muaj cov lus hais tawm ntawm txoj hlab pas, thiab tag nrho lub plab lossis nws cov khoom protrudes mus rau hauv mediastinum.
Kev kuaj mob li cas
Muaj ntau txoj hauv kev uas tus axial hernia lossis lwm hom kab mob no tuaj yeem kuaj pom.
Ua ntej tshaj plaws, nws tsim nyog rau kev kuaj X-ray, uas yuav ua raws li qhov sib txawv ntawm barium. Yog tias cov txheej txheem tau ua tiav lawm, yog li ntawd, qhov tshwm sim pom tau pom hauv daim duab.
Kev mloog kuj yuav tsum tau them rau cov txheej txheem xws li pH-metry. Nrog nws pab txiav txim lub acidity ntawm lub plab. Cov ntaub ntawv no tseem ceeb heev rau kev teem caij kho kom zoo.
Fibrogastroscopy plays nws lub luag haujlwm hauv kev txheeb xyuas tus neeg mob tus mob. Kev siv cov txheej txheem no ua rau nws muaj peev xwm los ntsuas lub xeev uas nyob rau hauv txoj hlab pas thiab lub plabzuag qhia tag nrho.
Yog tsis muaj kev ntsuas ntsuas, xws li pathology yuav luag tsis paub meej nyob rau theem pib. Yog li ntawd, nws tsim nyog paub koj tus kheej nrog cov tsos mob txhawm rau txhawm rau paub txog qhov cuam tshuam ntawm tus mob hnyav rau lub sijhawm.
Kev tshwm sim ntawm tus kab mob
Mob tuaj yeem txheeb xyuas tau raws li cov tsos mob tseem ceeb, tshwm sim nrog ntau zaus thiab siv. Txawm li cas los xij, lawv tuaj yeem ua tsis ncaj thiab hlawv.
Qee zaum qhov mob kis mus rau thaj tsam plawv, ua rau cov neeg mob xav tias lub plawv tsis ua haujlwm. Qee zaum, hiatal hernia tuaj yeem ua rau mob hauv cheeb tsam interscapular.
Yog tias tus kab mob no tshwm sim los ntawm qhov teeb meem hauv lub cev xws li lub plab tsis txaus, ces cov tsos mob yuav zoo li cov kab mob axial hernia. Peb tab tom tham txog kev kub ntxhov uas tshwm sim tom qab noj mov, mob hauv siab, hnyav rau hauv txoj kab rov tav, thiab mob lwm qhov ntawm lub cev.
Feem ntau, pathology tshwm sim nws tus kheej raws li hauv qab no:
- nyuaj rau nqos zaub mov;
- kub siab tom qab kev tawm dag zog lossis noj mov;
- mob hauv siab;
- Cov tsos mob ntawm hiatal hernia tuaj yeem ua rau lub plab lossis plab.
Cov tsos mob no qee zaum tsis nkag siab los ntawm cov neeg mob. Raws li kev tshuaj xyuas qhia, tib neeg xav tias cov no yog cov cim qhia ntawm lwm yam kab mob, lawv tus kheej noj tshuaj. Txawm li cas los xij, nrog kev tsis txaus siab ntawm hernia ntawm hom no, koj yuav tsum tau mus ntsib kws kho mob tam sim ntawd. Qhov no yuav tso caipib kho raws sij hawm thiab tiv thaiv qhov teeb meem.
Txoj Kev Kho Mob
Yog tias koj yuav tsum tau ntsib teeb meem xws li hiatal hernia, ces muaj ob txoj hauv kev tawm ntawm qhov xwm txheej: kev phais lossis kev kho mob.
Raws li lub luag haujlwm tseem ceeb ntawm cov txheej txheem classical, ib tus tuaj yeem txhais tsis yog tshem tawm hernia nws tus kheej, tab sis txo qis cov tsos mob ntawm reflux esophagitis thiab neutralization ntawm gastroesophageal reflux. Qhov ntawd yog, cov kws kho mob nrhiav kev tshem tawm qhov mob thiab tiv thaiv kev mob tshwm sim. Cov hom phiaj no tau ua tiav los ntawm kev teem caij noj zaub mov raws li cov khoom noj feem ntau thiab nquag noj. Thaum lub sij hawm ntawm kev kho mob zoo li no, koj yuav tsum tso tseg qee yam khoom. Peb tab tom tham txog chocolate, dej qab zib, kas fes, tsiaj rog, qhob cij tshiab thiab lwm yam khoom siv hmoov nplej. Tsis tas li, cov kws kho mob tsis qhia nrog cov kev kho mob zoo li no kom so nyob rau hauv ib qho chaw xis nyob rau 3 teev tom qab noj mov.
tus cwj pwm phem tuaj yeem ua rau cov txheej txheem sib ntaus sib tua, yog li lawv yuav tsum tau tso tseg. Tej zaum kuj muaj cov tshuaj pharmacological. Cov no tuaj yeem yog proton twj tso kua mis inhibitors, prokinetics, antacids, thiab lwm yam.
Raws li kev cuam tshuam kev phais, nws tsuas yog cuam tshuam yog tias kev kho mob tsis tau muab cov txiaj ntsig xav tau. Cov txheej txheem laparoscopic feem ntau siv.
Muaj Teeb Meem
Yog tias tus mob hiatal hernia tau kuaj pom, yog tias tsis muaj sijhawm kho thiab tsim nyog, tus neeg mob yuav mob hnyav dua.
Qhov tseeb ntawm qhov teeb meem tuaj yeem qhia los ntawmntau yam txheej txheem:
- ua txhaum ntawm hernia;
- esophageal los ntshav;
- peptic stricture ntawm txoj hlab pas;
- reflux esophagitis;
- esophageal perforation;
- prolapse ntawm gastric mucosa rau hauv txoj hlab pas;
- peptic ulcers.
Yog tias phais tau ua tiav lawm, muaj kev pheej hmoo ntawm plab hnyuv, megaesophagus thiab gastroesophageal reflux. Tsis txhob cais qhov muaj peev xwm ntawm kev rov tshwm sim ntawm hernia. Aspiration pneumonia tuaj yeem ua rau muaj teeb meem. Txhawm rau tshem tawm nws, kev siv tshuaj tua kab mob parenteral yog siv.
Results
Kev tso tseg qhov tseeb ntawm hiatal hernia yog qhov yuam kev loj. Yog tias qhov kev kuaj mob zoo li no, ces cov txheej txheem kev kho mob yuav tsum tau ua raws li qhov ua tau. Txwv tsis pub, tus mob yuav hnyav zuj zus.
