Kwiminyaka emininzi, kwakungekho nziswano kwiincwadi ezithatyathwe kwixesha elifutshane eliqhelekileyo njengophuhliso oluzimeleyo lokuphuhlisa. Igalelo elikhulu kwi-etiology, i-pathogenesis, i-clinico-morphological data, ukuxilongwa kunye nokunyangwa kwe-epenital short-oophagusti eyenziwe nguBarret (1959). Esi sifo sichazwa kwincwadi phantsi kwamagama ahlukeneyo: i-brachiozophagus, isisu sesisu, ukungenwa kwesisu, isisu esifubeni esiswini.
Ukubonakala kokuphakanyiswa kwexesha elifutshane kuchazwe ngokuphulwa kwendlela yokugaya inyama ngexesha lokuqala lokubambela, xa i-esophagus idibene ne-epithelium ye-cylindrical. Ukutshintshwa kwale epithelium, ngokuqala kwinqanaba elinesithathu le-esophagus, liphazamiseka, ngenxa yoko isithathu esezantsi sine-epithelium yesisu. Ngaloo ndlela kukho i-dystopia ye-mucosa yesisu kwisigxina esingaphantsi kwesisu (kunye neendawo eziqhelekileyo ze-cardia).
Ukuqinisekiswa kwezi ngcamango kukuba inxalenye ye-supra-diaphragatic ye-so-called engavumelekanga isisu, ngaphandle kweyombrane enamaqabunga, isakhiwe njenge-esophagus kwaye ingenayo i-serous cover. Kwinqanaba elifanayo, iindawo zomzimba zomzimba ezihamba ngapha nangasemva, ezibonakalayo, ziyahlukahlukana, kwaye ukunikezelwa kwegazi kwenziwa, njengesiqhelo, ukusuka kwi-aorta.
Izimpawu zonyango
Isisu esifutshane sihamba kunye, ngokusemthethweni, ngo-reflux ye-gastroesophageal, eyinkimbinkimbi yi-esophagitis kunye nokuqala kwe-stenosis ye-peptic esophageal stenosis.
Isisu esifutshane somntwana sibonakaliswa kubantwana bokuqala kweminyaka emithathu yobomi, kuba bane-reflux syndrome. Kwi-anamnesis, izigulane ezinjalo zihlala zihlanza ngokukhawuleza emva kokuzalwa. Ngokuqhelekileyo kukho izibonakaliso zezifo zokuphefumula rhoqo: i-bronchitis, i-pneumonia (kwi-30% yamatyala). Kwixesha elizayo, ukubonakaliswa kwekliniki kuxhomekeke ekubunjweni kwe-stenosis yesibini. Ukuba i-stenosis ayilwanga, uphawu oluphambili luyilo lokuhlanza kunye nokuqukethwe kwesisu. Ukuvuthwa kukucaphukisa ngokukhala, ngesimo esinqamlekileyo somzimba, kunye nobunzima obuthathaka obumzimba obangela ukwanda kweengcinezelo ze-intra-esiswini. Ukuhlanza kwegazi kufunyanwa kumhlanzi; ukuhlanza ikhofi. Ngokunciphisa isondlo ngenxa ye-peptic ulcerative yopharyngitis, iimpawu zokuphulwa kwe-oesophageal obstruction zibangelwa: i-dysphagia, ukuhlanza kokutya.
Abantwana abaneminyaka engaphezu kwe-sibhozo bayakhalaza ngenxa yeentlungu emva kwe-sternum, ukuvela kwe-due disagia kunye ne-ulcerative esophagitis. Ngokuqhelekileyo, abantwana bazama ukusela ipishchuk. Ngenxa yokuphuma kwegazi kwi-membrane ye-dystopic, njengoko kubonakaliswe ukuxutywa kwegazi kumaninzi okuhlanza kunye nokuphendula okulungileyo kwigazi elilindileyo emanzini, i-anemia iyaqhubeka. I-anemic syndrome ibonwa kwi-1/3 yezigulane. Abantwana abanesifo esincinci esiswini emva kokukhula ngokwenyama.
Ukuxilongwa kwesifo esifutshane somntwana, uvavanyo lwe-X-ray lusetyenziswa, ngoncedo lwaloo nto, okokuqala, i-reflux yesisu ifunyenwe. Esikhundleni seTellelenburg, isigulane se-reflux esophageal esophageal esophageal sigqitywe ukuphonsa into ehlukileyo ye-ovary kwisigxu. Icandelo elikude le-esophagus, njengomyalo, liyancipha ngaphantsi kwefomu okanye i-bell. Imizobo ye-X kwi-distal esophagus ibonisa ukunyumba kwexesha elide, uphawu lwesibonda somzimba esiswini. Ingqamlezo yesigxina ngexesha lokuhlolwa kwesigulane kwindawo yokuma ihambelana. Nge-Stenosis yesibini, ubuchule bendawo yokungafaniyo buyekezelwa, kwaye ukugqithiswa kwe-oophagus kugqityiwe ngaphezu kwesithintelo. Umfanekiso owenziwe nge-radiological kunye nokuguqulwa kwendawo yokumisa kunye nokugcinwa ngokugqithiseleyo kwimbane kufuna ukubahluko phakathi kwendlela yokuvulwa kwe-sophageal kunye ne-diverticula ye-esophagus.
Kusetyenziswa ngokubanzi ukuxilongwa kwe-esophagofibroscopy. Uphawu olubaluleke kakhulu lwe-endoscopic lugqithiso oluphezulu lwe-mucosal lining of the emophagus kwi-mucosa yesisu, i.e. ngaphezu kwendlela yokuqhafaza. Ukungabikho kwe-stenosis kwi-distal esophagus, i-catarrhal okanye i-ulcerative fibrinous isophagitis eyenzekayo. Ngokuphuhliswa kwe-stenosis, njengomthetho, usekwe kumda we-membrane ye-mucous yesisu nesisu.
Ngokubhekiselele kwinto yokuba kwizigulane ezinomsoco omfutshane onentsholongwane zihlala zihlala kwindawo ye-reflux ye-gastroesophageal, ixabiso elithile lokuxilonga linalo i-intraepithelial pH-metry.
Abahlali kunye neentsana zenza ukuxilongwa ngokungafaniyo kunye ne-pyloric stenosis, pilorospasm, i-herniation ye-esophagus ye-diaphragm, i-chalasia, i-stenosis kunye ne-stenoses efunyenwe yecala le-distal.
Unyango
Uphulo luvame ukutyalwa, lujoliswe ekupheliseni i-reflux ye-gastroesophageal. Ukuhlinzwa ngonyameko kwe-antiretflux kukusebenza kukaNN Kanshin ekuguqulweni kwe-YF Isakova et al., Ngokusekelwe kwisigxalaba se-valve. Kwiimeko apho i-epenital shortopopus ilukhuni yi-peptic stenosis , utyando lwe-antireflux luzaliswa ngokumiselwa kwe-gastrostomy. Kwixesha elizayo, lugqitywa yi-bougie.
Ukususela kwimbono yabakliniki bacinga ukuba isifo esifanelekileyo sesisu sisingaziphazamisi isisu, kuyimfuneko ukuqhuba unyango olulondolozo lwexesha elide ekubaleni ukuthotywa kwesisu (njengoko umntwana ekhula).
Unyango olulondolozo lwentliziyo lubonelela ngesimo esiphakamileyo sesigxina sesigxina, ukondla rhoqo umntwana kumacandelo amancinci okutya okulinganayo. Ukuziphatha kubuye kuhlaziywe ngokubanzi kunye nokunyangwa kwamachiza.
Ukukhula!