A cikin shekarun da yawa, babu wata yarjejeniya a cikin wallafe-wallafe a kan ɗan gajeren lokaci na asophagus a matsayin mai zaman kanta mai zaman kanta. Mafi kyawun gudunmawa ga ilimin ilimin ilimin halitta, ilimin lissafi, ilimin binciken kwayoyin halitta, ganewar asali da kuma maganin bishiyocin ɗan gajeren lokaci na B. Barret (1959). An bayyana wannan cututtukan a cikin wallafe-wallafe a ƙarƙashin sunayen daban: brachiozophagus, ƙwaƙwalwar ciki, rashin ciki na ciki, m kirji ciki.
Ana bayyana bayanin bayyanar da ke tattare da ɓacin tsinkayyi ta hanyar cin zarafi na gwargwadon ƙwayar narkewa a farkon lokacin amfrayo, lokacin da aka haɗin gwiwar bishiyar tare da epithelium na cylindrical. Sauyawa na wannan epithelium, wanda ya fara da tsakiyar na uku na esophagus, yana damuwa, saboda sakamakon haka an haɗa shi da kashi uku na uku tare da epithelium na ciki. Saboda haka akwai dystopia na mucosa na ciki a cikin ƙananan ɓangaren esophagus (tare da yanayin yanayin cardia).
Tabbatar da wannan zato shi ne gaskiyar cewa ɓangaren supra-diaphragmatic na abin da ake kira ciwon ciki ba tare da jin dadi ba, banda gambar mucous membrane, an kafa shi ne a matsayin ɓoye da ba tare da rufe murfin ba. A wannan bangare, an rarraba maɓallin ƙwayar tsoka da tsohuwar ƙwayar tsohuwar jiki, siffar haɗin gwiwar, kuma ana aiwatar da jini, kamar yadda ya saba, daga aorta.
Clinical bayyanar cututtuka
Kwayar esophagus ta yanayi ne tare da shi, a matsayin mai mulkin, ta hanyar maye gurbin gastroesophageal, wanda yake da rikitarwa ta hanyar esophagitis da kuma farawa na cututtuka na kwakwalwa.
An gabatar da esophagus a cikin yara a farkon shekaru uku na rayuwa, saboda suna da ciwon kwanciyar hankali. A cikin magunguna, irin wannan marasa lafiya sukan fuskanci zubar da ciki bayan da aka haifa. Sau da yawa akwai alamomi na cututtuka na numfashi na numfashi: mashako, ciwon huhu (cikin 30% na lokuta). A nan gaba, bayyanuwar ta asibiti ya dogara ne akan kafawar ɓarkewa na biyu. Idan ba a kafa stenosis ba, babban alamar alama tana cike da abun ciki na ciki. Ana shawo kan ruwan zafi ta hanyar kuka, ta hanyar matsayi na jiki, da kuma wani nau'i na jiki wanda zai haifar da karuwa a cikin matsa lamba na ciki. An sami vomit jini a cikin zubar; Ƙananan lalata ruwan kofi. Tare da raguwa ta tsakiya na esophagus saboda cututtuka na maganin anopharyngitis, bayyanar cututtuka na cin zarafin haɗuwa da cututtuka ya fi yawa: dysphagia, vomiting na abinci.
Yaran da suka tsufa shekaru takwas sun yi kuka akan ciwon sternum, wanda aka haifar da shi da kuma haɓakawa. Sau da yawa, yara suna kokarin shan pishchuk. Saboda jinin zub da jini daga jikin mucous dystopic, kamar yadda yake nunawa ta hanyar yayyafa jinin a cikin kwayar zubar da jini da kuma amsa mai kyau ga jini mai yatsuwa a cikin feces, anemia tasowa. An ji ciwon ciwo na anmic a cikin 1/3 na marasa lafiya. Yara da ƙananan esophagus marasa galihu a baya a ci gaban jiki.
Don tantance gwagwarmaya na ɓangaren ƙwayar ɗan gajeren lokaci, an yi amfani da jarrabawar X-ray, tare da taimakonsa, na farko, an gano reflux na ciki. A matsayi na Trendelenburg, mai haɗin gwiwar sophageal reflux an ƙaddara ya jefa jigilar bambanci na ovary zuwa cikin esophagus. Tsakanin ɓangare na esophagus, a matsayin mai mulkin, an fadada shi a ƙasa a cikin hanyar motsi ko kararrawa. Hotuna X-ray a cikin kwakwalwa ta tsakiya suna nuna nuni na tsawon lokaci, halayyar mucous membrane na ciki. Tsarin esophagus a lokacin jarrabawar masu haƙuri a matsayinsu na tsaye ne. Tare da ƙuƙwalwa na biyu, maɓallin bambancin matsakaici ne ya raguwa, kuma ƙaddamarwa daga cikin esophagus an ƙaddara a sama da rikice-rikicen da ake ciki.
Ana amfani dashi don ganewar asali na esophagofibroscopy. Alamar magungunan endoscopic mafi muhimmanci shi ne haɓakar ƙwayar mucosal na esophagus a cikin mucosa na ciki, i.a. sama da ƙaddamar da zane-zane na diaphragmatic. Idan ba tare da ɓarna a cikin distal esophagus ba, catarrhal ko ulcerative fibrinous esophagitis na faruwa. Tare da ci gaban stenosis, a matsayin mai mulkin, yana a kan iyakar mucous membrane na ciki da kuma esophagus.
Dangane da gaskiyar cewa a marasa lafiya tare da ƙananan esophagus marasa lafiya ko da yaushe suna da wuri na reflux na gastroesophageal, wani ƙididdigar ganowar yana da intraepithelial pH-metry.
Mazauna da jarirai suna gudanar da ganewar asali tare da pyloric stenosis, pilorospasm, labarun kwayoyin halitta na diaphragm, hotuna, rashin rayuwa da kuma samun stenoses na distal esophagus.
Jiyya
Aiki ne sau da yawa muni, nufin kawar da gastroesophageal reflux Lafiyar maganin rigakafi mafi aminci shine aikin NN Kanshin a gyare-gyaren YF Isakova et al., Bisa ga gastroplication na bawul. A cikin lokuta inda ɓangaren ƙananan esophagus ya zama rikitarwa ta hanyar tsinkar fata. , aikin tiyata ne ya dace da shigar da gastrostomy. A nan gaba, ana kwantar da shi ta hanyar bougie.
Daga ra'ayi na likitoci suna la'akari da gajeren ɓangaren ƙananan esophagus kamar yadda ba a kawar da ciki ba, dole ne a gudanar da farfadowa na tsawon lokaci na mazan jiya a cikin lissafin ƙaddamar da hankali na ciki (kamar yarinyar yake tasowa).
Mahimmancin magani yana bayar da matsayi mai girma na babban rabi na gangar jikin, ciyar da yarinyar a cikin ƙananan abinci na lokacin daidaito. Har ila yau, halayen mahimmanci ne da magunguna.
Girma!