Zenker kuti diverticulum sei pachena, kurapwa, kuvhiya

Zenker kwakaita diverticulum haiwanzowaniki chaizvo mhando zvokurwara pamusoro zvomudumbu turakiti. Mugove zvirwere zvakadai pamusana 3-5% vose nyaya. Externally bhegi-protrusion zvokurwara akaratidza mucosa pakati yegurokuro uye pahuro angava akasiyana chimiro uye kukura. Kuremara zvomudumbu turakiti kunoitika pakutanga panguva rwaro shure, uye ipapo anouya kurutivi. Pharyngoesophageal diverticulum ndiye zvose vachiberekwa uye akava chirwere, kukura pane mashandiro izvo kazhinji pulsionny, sezvo pane simba nzvimbo mumuviri nokuda yakawedzera kuomesa wayo lumen.

Zvakakurukurwa chirwere

Zenker kwakaita diverticulum hwapedyo zvishoma nezvishoma. miganhu yacho inogona dzaisiyana, richisvika mune zvimwe zviitiko kukosha achangozvarwa musoro. Diverticulum ane mutsipa uye muviri, akafukidza mucous epithelium. In yaro mvura mhango angava vhoriyamu izvo anokwanisa yekuwana 1.5 litres.

It riri shure paumbwe yegurokuro uye rworuboshwe, vakananga yokumusoro mediastinum. Very kashoma kuva intramural muchimiro zvokurwara, kana kupinda diverticulum rikaitika nzvimbo pakati pamadziro yegurokuro netsandanyama.

Kusvika makuru hukuru, dzidzo ichi anotanga angatidzvinyirira nezviremera, izvo zviri pedyo. Diverticula hadzina fused uye regai kukonzera kuzvimba iri dzakapoteredza nyama bedzi havasi nounhu peridivertikulit.

The kukonzera chirwere

Mumazuva chakaipa kuita kumedza rinowanikwa rutapudzo ari pharynx tsandanyama fibers cricopharyngeal tsandanyama dzinotanga kuzorora, uye muromo yegurokuro chakaziviswa. Kana zvaipesana tsandanyama basa kunoitika diverticulum.

Huru zvikonzero paumbwe pathologies ndiwo:

• nemagene kubatwa;
• esophageal mucosal zvinokuvadza;
• vachiberekwa zvirwere tsandanyama tishu;
• sclerosis calcification kuti shwashwa;
• kutyora fetus;
• tsandanyama tishu kuremara;
• musana zvinokuvadza;
• anogumbura zvirwere yegurokuro nepahuro.

Clinical Kuratidza chirwere

mumwe diverticulum akadaro sei? It zvinoenderana ukuru hwaro. kuremara diki (2 cm) hakuiti unooneka uye netsaona pachena apo X-ray kana fluoroscopic kuzviongorora.

Kana paiva Zenker diverticula, zviratidzo chirwere ichi vakakamurwa maererano nzendo chirwere.

Features wokutanga Danho

Nokuti Danho rokutanga noruzhinji nonspecific zviratidzo. Idzi dzinosanganisira: scratchy huro, kunonyengedza salivation, kana ndiEzekieri, kuoma ari nomumukanwa mucosa. Varwere kutevera zvisingafadzi Rinofembedza (kuorera mazviri, tuhlosti, rehydrogen sulfide). Zvingava isingawanzowanikwi chikosoro kana chinetso kumedza. Panguva kudya pane kuwedzera matauriro, achiperekedzwa kusungika kwemitsipa tsandanyama, zvichiita kuti murwere anonzwa sezvo zvichipomerwa boka kuti huro bundu. Kwapera nguva, murwere nezvechinhu chimwe nzira youpenyu, umo haana kuona munhu kuramba chikosoro uye burp pashure kudya ndichipfeka kushandiswa kakaridza.

Features kwechikuva rechipiri uye rechitatu

Sei munhu diverticulum rechipiri danho? Nguva iyi dzinoratidzwa kurega kunotanga kubva madzihwa, zvokudya, mhepo kuwanda, asi kunopindirana utano haisi vasingadzoreki. On kuongororwa, chiremba rinozivisa asymmetry kwemitsipa nokuda mumwe-mativi protrusion. Kuna chingakubata dzamutswa pamusoro palpation anonyangarika, uye panguva kudya zvakare yakawedzera kukura. Panguva tapping musimboti thickening Urume pashure kudya ikoko chiratidzo kurovera, uye kurutivi kudzvanya akacherechedza kutinhira.

In wechitatu pavaipfuura chirwere akacherekedza decompensation. Kutanga zviratidzo kuva raidudzwa, kunopindirana utano zvakatoipa, murwere anotanga nokukurumidza uremu.

Chirwere kushoma kuitika mhango diverticulum, zvinotungamirira siyana matambudziko: nemabayo, asphyxia, abscesses, stasis venous ropa, esophageal perforation masvingo, mediastinitis uye kwaita malignancies.

Diagnostics

Huru Nzira rokuongorora Zenker kuti diverticulum, - X-ray inoitwa ndege siyana. Special gadziriro akasvibiswa mhango inotungamirwa, saka kuti zvinokwanisika kuziva kwete chete chaiyo nzvimbo, asiwo saizi yayo, chimiro, mutsipa urefu, anokotama pamwe kureba kwayo, mamiriro pedyo nadzo uye anatomical ezvirevo. Kana zvokuudzwa diverticulum barium slurry anotanga hakunonoki, inoratidza kukura diverticulitis.

Kurapa chirwere ne kuchinja

Kana nechirwere Zenker kwakaita diverticulum, kurapwa zvose kuchinja uye kuvhiya unyanzvi. Asi kana kuvhiyiwa anogona mumutsetse wokutanga zvokurwara zvikaramba rubatsiro. By kuchinja kurapa kuita chete muzviitiko apo pane zvakakomba contraindications kuti kuvhiyiwa. Panyaya iyi, murwere unofanira kuomerera vaitofanira chikafu hwechiFascist, nyoro kudya, kwazvo dög zvokudya. Murwere rinoitwa mushure ingestion abudise diverticulum, nokuti chinangwa ichi chinofanira kuva imwe nzvimbo. Uyezve, inotungamirwa kwakadaro unotakurwa lavage, uye murwere vanofanira kutora muriwo kana mafuta Paraffin kuti lubrication masvingo aro.

kuvhiya kurapwa

Most Zvinowanzobatsira mune chirwere akadai Zenker kuti diverticulum, kuvhiya kunhaka riri kuratidzwa panguva rechipiri nerechitatu nzendo chirwere, achiperekedzwa matambudziko. maawa 48 risati kuvhiyiwa, murwere ushandiswe imvura kudya, akashamba kwazvo ane dzidzo kuburikidza esophagoscope kana anobudisa mushonga zvishoma nezvishoma.

Apo Zenker kwakaita diverticulum maonero hwokushanda vachava divertikulektomiya-danho randinogara mukubvisa jira bhegi ichi kuburikidza mutswe inotungamirwa. Asati avhiyiwa murwere chinotarisirwa gobvu vachiongorora kupinda yegurokuro, nokudaro kufambisa kuvhiyiwa. Isolated kubva akapoteredza munyama diverticulum piringisha nechepasi uye vari vasonanidza kana knotted chinopfuurira suture. Dzadzimwa pathological inotungamirwa kushandisa stapler, iro rinoshandiswa chawo.

Ipapo vachiongorora rinoitwa pamusoro inputted ekstramukoznuyu esophagomyotomy kureba masendimita anoverengeka. Kana diverticula zviduku saizi, zvakakwana chete chete cricopharyngeal myotomy, pashure izvo vari anombotwasanudza, uye pamwe chete mucous Kamudzira ari zvomudumbu turakiti vanoumba mumwe Flat rusvingo.

Recently vamwe makiriniki vakatanga kuita kuvhiyiwa endoscopic nenzira, kureva. E. Not kuita incision pamutsipa. Chaizvoizvo Its ndechokuti chekawo kuburikidza vanhuwo rusvingo pakati yegurokuro uye diverticulum, uye achiedza endoscopic stapler chiitwe myotomy. Mushure akadaro kuvhiyiwa, murwere anonaya nokukurumidza uye kuderera uwandu yematambudziko.

The postoperative nguva pashure nokubviswa diverticulum Zenker

Features ino nguva ndechokuti murwere maawa 48, havadyi. Vamwe vanachiremba siya kwemazuva 3-4 vachiongorora zvokudya murwere mushonga kudya. Shure kwokunge abvisa kwemazuva 5-6 kare kupa Semi-mvura chikafu, zvishoma nezvishoma kuwedzera zvokudya.

Kana musingadi kubata chirwere, asi fungidziro murombo chaizvo. Various yematambudziko kukonzera rufu muna 23-33% nyaya.

mhedziso

Saka, Zenker kwakaita diverticulum - a achinyengera chaizvo chirwere. Pasina kuratidza pacharwo pakutanga chaipo waro kukura, mushure menguva nayo yekudyidzana kunokanganisa utano mamiriro. Itirawo zvinofanira kuva mutemo unoti, kureva. A. A mukuru mukana norufu zvakasiyana siyana yematambudziko.