Diverticulum Zenker kanjani sobala, ukwelashwa, ukuhlinzwa

diverticulum Zenker sika uhlobo ezingavamile kakhulu zokugula we ipheshana wokugaya ukudla. I share kwezifo ezifana akhawunti 3-5% azo zonke izimo. Ngaphandle le zokugula isikhwama-protrusion wabonakaliswa mucosa we emphinjeni kanye umphimbo ungase ube ukuma ezahlukene kanye nosayizi. Isici ipheshana yesisu kwenzeka ekuqaleni ngesikhathi udonga lwaso ezingemuva, bese kuza ohlangothini. diverticulum Pharyngoesophageal kokubili azalwa naso futhi wathola isifo, ukuthuthukiswa indlela okuvame pulsionny, njengoba kukhona indawo ababuthakathaka emzimbeni ngenxa yokucindezeleka okwandayo e inesikhala yayo.

Izici lesi sifo

diverticulum Zenker siyogcizelela kancane kakhulu. Ubukhulu balo kungaba nhlobonhlobo, ukufinyelela kwezinye izimo ukubaluleka ikhanda kuzalwa. Diverticulum kokuba entanyeni nasemzimbeni, embozwe epithelium lwamafinyila. Ngo ingaphakathi layo uketshezi kungenzeka ngevolumu olukwaziyo ekufezeni 1.5 amalitha.

Itholakala ngemuva kumiswa emphinjeni kanye kwesokunxele ke, ekufezeni mediastinum engenhla. Kakhulu akuvamile ukuthuthukisa ifomu intramural zokugula, lapho Ukungena diverticulum kwenzeka esikhaleni phakathi kwezindonga kwemisipha emphinjeni.

Ukufinyelela namasayizi amakhulu, lokhu imfundo iqala asicindezele neziphathimandla, okuyinto eseduze. Diverticula kungukuthi tho futhi akavumi ukuba ukuvuvukala emisipheni ezizungezile nje ngeke ukuthuthukisa peridivertikulit.

Ziyini izimbangela eziyinhloko zalokhu lesi sifo

Ngokuhamba evamile ukugwinya kwenzeka ukuncipha pharynx imisipha Imicu yotshani cricopharyngeal imisipha uqale uphumule, nomlomo emphinjeni kwembulwe. Endabeni ka ukwephulwa of ukunyakaza kwemisipha kwenzeka diverticulum.

Izizathu eziyinhloko for kumiswa pathologies yilezi:

• yofuzo;
• ngomphimbo ukulimala mucosal;
• izifo azalwa naso kwemisipha izicubu;
• ukuqina kwamathishu futhi calcification cartilage;
• ukwephulwa wokukhula kwengane esiswini;
• kwemisipha izicubu ukukhubazeka;
• Ukulimala umgogodla;
• Izifo ukuvuvukala we emphinjeni kanye umphimbo.

ukubonakaliswa Clinical yesifo

Kanjani a diverticulum enjalo? It kuncike lingakanani. ukukhubazeka encane (2 cm) akusho ukuzibonakalisa futhi ngephutha wathola lapho-X-ray noma luhlolo fluoroscopic.

Uma kwakuba khona Zenker diverticula, izimpawu zalesi sifo ahlukaniswe ngokuvumelana izigaba zesifo.

Izici esigabeni sokuqala

Esigabeni sokuqala izimpawu nobuntu nonspecific. Lezi zihlanganisa: emphinjeni okulumayo, amathe kakhulu, noma okuphambene nalokho, kome le mucosa ngomlomo. Iziguli siphishekele iphunga elibi (abolile, tuhlosti, hydrogen sulfide ne-). Kungaba ezingavamile ukukhwehlela noma nobunzima ukugwinya. Phakathi nesidlo lapho kuwukwanda ithoni, ephelezelwa ukungezwani we Imisipha yentamo, okubangela isiguli uzizwa njengoBaba ngemoto kuya yinhlama emphinjeni. Ngemva kwesikhathi esithile, isiguli eba indlela yokuphila, lapho akusho ukuqaphela uhlale ukhwehlela futhi ukubhodla emva kokudla futhi ukujwayelana ukuhahaza.

Izici kwesiteji wesibili nowesithathu

Kanjani a diverticulum esigabeni sesibili? Le nkathi elinesimo yokujama tsi ka isikhwehlela, ukudla, umoya ekuqongeleleni, kodwa impilo jikelele is hhayi kahle. On udokotela wembula asymmetry entanyeni ngenxa protrusion eyodwa emaceleni. Ukuze touch kuba soft ku palpation esenyamalala, ngesikhathi sakusihlwa futhi anda ubukhulu. Phakathi ngokushaya isikhungo oketshezi ukuqina emva kokudla kukhona uphawu ethi awafike, futhi ohlangothini ngokucindezela waphawula kwentaba.

In esigabeni sesithathu lesi sifo imakwe decompensation. Lapho kuqala izimpawu ziba evelele, impilo jikelele zimbi kakhulu, isiguli uqala ngokushesha ukunciphisa umzimba.

Okungalapheki ukuvuvukala okwenzeka diverticulum ingaphakathi, kuholela yezinkinga ezihlukahlukene: i-pneumonia, asphyxia, abscesses, stasis emithambo yegazi igazi, ngomphimbo perforation izindonga, mediastinitis futhi ukuvela komdlavuza.

ukuhlola

Indlela eyinhloko ukuxilonga diverticulum Zenker sika, --X-ray olwenziwa e izindiza ezahlukene. amalungiselelo Special ingcoliswe ingaphakathi ekwakhekeni, ukuze kungenzeka ukunquma hhayi kuphela indawo ngqo, kodwa futhi lingakanani, ukuma, intamo obuphelele, egoba kanye ubude bayo, isimo kwezitho ezisondele kanye izakhiwo yokwakheka. Uma ngomlomo diverticulum barium yombala slurry iqala ukulibala, kubonisa ukuthuthukiswa diverticulitis.

Ukwelashwa kwezifo ngu olandelanayo

Uma kutholakale ukuthi une-diverticulum Zenker sika, kwelashwa kokubili inqubo ngoludala futhi kuhlinzwa. Kodwa uma ukusebenza can esimweni sokuqala zokugula iqhubeka usizo. Ngu yokwelapha olandelanayo is yakhetha kuphela ezimweni lapho kukhona Izimo sina leso siguli. Kulokhu, isiguli kufanele ihambisane a esiqinile ukudla umbuso, Ukudla elithambile, ukuhlafuna olunzulu ukudla. Isiguli Kwenziwa emva kokungenisa amanzi diverticulum, le njongo kumele kube endaweni ethile. Ngaphezu kwalokho, ukwakheka enjalo yenziwa lavage, kanti isiguli kumelwe futhi uthathe yemifino noma uwoyela upharafini Lubrication kwezingange zawo.

ukwelashwa kuhlinzwa

Iningi ngokuvamile eziwusizo e isifo esinjengo diverticulum Zenker sika, ukuhlinzwa eliyifa okuyinto siboniswa izigaba zesifo wesibili nowesithathu, ephelezelwa ukuxakeka. amahora angu-48 ngaphambi kokuhlinzwa, isiguli ezinqunyiwe ukudla okuwuketshezi, futhi kahle wageza ofundile ngokusebenzisa esophagoscope noma ipayipi.

Lapho Zenker sika diverticulum Ngenxa ukusebenza kuyoba divertikulektomiya-esiteji, esakhiwa ekususeni lokhu isikhwama Indwangu ngokusebenzisa kumiswa umqhewu. Ngaphambi kokuba ahlinzwe isiguli iqondiswa uphenyo obukhulu emphinjeni, ngaleyo ndlela kube lula ukusebenza. Gqwa evela ezizungezile kwezicubu diverticulum aphambana ngasesinqeni futhi ithungwe noma ifindo suture okuqhubekayo. Ezisusiwe kumiswa sokugembula usebenzisa stapler, okuyinto lisetshenziswa isisekelo sayo.

Khona-ke uphenyo wenziwa phezu esifakiwe ekstramukoznuyu esophagomyotomy ubude ngamasentimitha ambalwa. Uma diverticula owayemude encane, ngokwanele nje eyodwa cricopharyngeal myotomy, okwathi ngemva kwalokho kuthiwa waqonda, futhi kanye ulwelwesi lwamafinyila yaleli pheshana wokugaya ukudla zimumethe udonga flat.

Okusanda eminye imitholampilo waqala ukufeza eyohlinzwa endoscopic ngendlela, isb. E. Hhayi okwenza imbobo entanyeni. essence yayo wukuthi Imi ogangeni ezivamile phakathi emphinjeni futhi diverticulum, futhi usebenzisa i stapler endoscopic wenziwa myotomy. Ngemva kokuhlinzwa esinjalo, isiguli silulama ngokushesha futhi wehlise inombolo ukuxakeka.

Isikhathi nasezinkingeni ezilandela ngemva kokuhlinzwa emva kokususwa diverticulum Zenker

Izici kwalesi nkathi ngokuthi isiguli amahora angu-48, ungadli. Abanye odokotela abahlinzayo ngibambe 3-4 izinsuku Uphenyo ukondla nesineke ukudla okuwuketshezi. Ngemva kokususa izinsuku 5-6 kakade ukunikeza ukudla-semi ketshezi, kancane kancane kwanda ekudleni.

Uma ungenawo aphathe lesi sifo, onalesi sifo ayiyinhle kakhulu. yezinkinga ezihlukahlukene ekufeni e 23-33% of amacala.

isiphetho

Ngakho, diverticulum Zenker sika - isifo esikhohlisayo kakhulu. Ngaphandle kokukubonisa uqobo ekuqaleni sokuthuthuka, emva kwesikhashana ke kakhulu kuthuntubeza ikhono lomuntu zempilo esifundazweni. Phatha ke kufanele kube impoqo, isb. A. awokuthi nekufa ezihlukahlukene izinkinga.