Diverticulum Zenker kaThixo kubonakala njani, unyango, uqhaqho

diverticulum Zenker kukuba uhlobo inqabile kakhulu ngezifo le lokugaya. Isabelo kwezifo ezifana akhawunti ngenxa 3-5% kuzo zonke iimeko. Ngaphandle kokuba ngezifo ingxowa-Buze wabonakalisa isifo le kuvuleke iminxunya nasemqaleni unokuba imilo eyahlukeneyo kunye nobukhulu. Siphene wokugaya kwenzeka ekuqaleni udonga kwayo nangasemva, uze emva koko uza ecaleni. diverticulum Pharyngoesophageal liyathandeka iziphene kwaye ziyafikelelwa izifo, uphuhliso kwendlela leyo edla pulsionny, njengoko kukho ibala uswele amandla emzimbeni ngenxa yoxinzelelo kwanda mithambo yayo.

Iimpawu zesi sifo

diverticulum Zenker kaThixo uvela kancinane kakhulu. imilinganiso yayo zinokohluka, ukuya kwezinye iimeko ixabiso kwentloko yeentsana. Diverticulum ukuba intamo kunye nomzimba, Bathiwe wambu epithelium yangaphakathi. Xa kwisisu yayo engamanzi isenokuba umthamo ezinako ekufezekiseni iilitha 1.5.

Le esemva lokusekwa kuvuleke iminxunya nasekholo kwayo, ukuya mediastinum eliphezulu. kunqabile kakhulu ukuphuhlisa uhlobo intramural kwezimilo, xa umthondo diverticulum kwenzeka kwisithuba phakathi kweendonga izihlunu umphimbo.

Ukufikelela ubukhulu ezinkulu, le imfundo uqala ukufaka uxinzelelo phezu abasemagunyeni, leyo apha. Diverticula nje edidekile, kwaye musa ukuba ukudumba emzimbeni ezingqonge logama nje akayi ukuphuhlisa peridivertikulit.

Eyona eziphambili ezibangela isifo

Xa zesiqhelo ligwinya lwenzeka ukwehliswa pharynx Imicu izihlunu cricopharyngeal izihlunu ziqala ukuba bakhululeke, yaye emlonyeni kuvuleke iminxunya kutyhilwa. Kwimeko zokugxojwa kwemisipha lwenzeka diverticulum.

Izizathu eziphambili ezibangela ukuyilwa ezimbi zezi:

• yofuzo;
• Ukwenzakala mucosal esophageal;
• izifo bekhubazekile esiqwini imisipha;
• sclerosis kunye calcification of intlala;
• kophulwa umthetho Palsy;
• iziphene kwemisipha inyama;
• ukulimala spinal;
• izifo yokukrala kuvuleke iminxunya nomqala.

obubonakala Clinical zezifo

njani a diverticulum onjalo? Oku kuxhomekeke kubungakanani bayo. ukukhubazeka ezincinane (2 cm) akuthethi ukuzibonakalisa kwaye ngempazamo bafumanisa xa X-ray okanye uviwo fluoroscopic.

Ukuba kwakukho Zenker diverticula, iimpawu zesi sifo yahlulwe ngokwezi zigaba zesi sifo.

Iimpawu kweqonga yokuqala

Kuba kwinqanaba lokuqala iimpawu nonspecific isici. Ezi ziquka: umqala scratchy, ukuvuza izinkcwe lweenkcukacha, okanye ngokugqwethekileyo, kome na isifo ngomlomo. Izigulane balandele iphunga elibi (anokungenwa, tuhlosti, emanzini). Kusenokuba iseliswelekile ukukhohlela okanye ubunzima ligwinya. Ngexesha sidlo kukho ukwanda ithoni, ekhatshwa ukuqina izihlunu entanyeni, ebangela isigulane uvakalelwa njengoko ngemoto kusolwa ukuba esisixa umqala. Emva kwexesha elithile, isigulana kuphuhlisa indlela yobomi, apho yena uqaphele Ukhohlokhohlo olutsho kwaye Kunjani emva kokutya ukuze siqhelane gargle.

Iimpawu kweqonga yesibini neyesithathu

wenza njani diverticulum sesibini isigaba? Eli xesha lubonakala ngokuba yokunqaphela yencindi, ukutya, ulwandiso umoya, kodwa impilo ngokubanzi nje kakuhle. Ngosuku loviwo, ugqirha utyhila asymmetry entanyeni ngenxa Buze elinye macala. Xa uyibamba oku ethambileyo oma Ngokucofa, kwaye ngexesha isidlo kwakhona akhula ukusuka kwisayizi. Ngeli evunyelwe embindini ulwelo ukuqina emva kokutya apho iliphawu lindanda, kunye icala ngokucinezela waphawula kwentaba.

Xa Isigaba sesithathu sifo ophawulwe decompensation. Ukuqala iimpawu zibe ucaca ngakumbi, impilo jikelele mbi kakhulu, isigulane uqalisa ukuphulukana ngokukhawuleza ubunzima.

inkqubo Chronic ukudumba ibakho kwi diverticulum kwisisu, kukhokelela kubunzima ezahlukeneyo: inyumoniya, zizalwa, amathumba, stasis lwemithambo yegazi, iindonga perforation esophageal, mediastinitis kunye ukuvela umhlaza.

ekuxilongweni

Indlela ephambili ngoxilongo diverticulum Zenker kaThixo, - X-ray olwenziwe iinqwelomoya ezahlukeneyo. amalungiselelo eziZodwa zidyojwe kwisisu Ukwakheka, ukuze ukuba kunokwenzeka ukufumanisa kuphela indawo ngqo, kodwa ke ubukhulu balo, imilo, ubude intamo, egobile ecaleni ubude bayo, urhulumente amalungu ezisecaleni nezakhiwo yokwakheka. Ukuba diverticulum barium oluludaka somlomo iqala nakuzilazila, libonisa uphuhliso diverticulitis.

Unyango isifo ngokonga

Ukuba unesifo diverticulum Zenker kaThixo, unyango zombini ubuchule endala kunye yotyando. Ke ukuba lo msebenzi ungenziwa kwimeko yokuqala ngezifo liqhubeka uncedo. Ngu therapy elondoloza na babhenela kuphela kwiimeko apho kukho Izimo kakhulu ukuba uqhaqho. Kulo mzekelo, isigulane kufuneka ngqo ulawulo ukutya engqongqo, ukutya ethambileyo, ukuhlafuna olunzulu ukutya. Isigulane lwenziwa emva yokungenisa semibhobho diverticulum, ngenxa yale njongo kufuneka ibe kwindawo ethile. Ukongeza, ukubunjwa loo iqhutywa lavage, kwaye isigulane kufuneka uthathe zemifuno okanye ioli iparafini ukuthambisa ajikeleze kweendonga zayo.

unyango ngotyando

Kaninzi eluncedo izifo ezifana diverticulum Zenker kaThixo, zime utyando oboniswe kumanqanaba yesibini neyesithathu zesi sifo, kunye iingxaki. iiyure ezingama-48 phambi kotyando, isigulane emiselweyo ukutya elulwelo, wabahlamba kakuhle imfundo ngokusebenzisa esophagoscope okanye catheter.

Xa Zenker kaThixo diverticulum Ngenxa msebenzi iya kuba divertikulektomiya-eqongeni, nezibabandakanya ekumfuduseni le bhegi ngelaphu ngokuthi kwakhiwe noqhoqhoqho. Ngaphambi kokuba ahlinzwe isigulane ilawulwa olumayelana elinzima emphinjeni, ngaloo ndlela kube lula ukusebenza. Uyazimela ezingqonge izicwili diverticulum yendlela yokwenza imigca iwela emazantsi yaye athungwe okanye igqibe suture oluqhubekayo. Ususe ukubunjwa yezifo usebenzisa stapler, olusetyenziswa kwisiseko sayo.

Ngoko ke probe lwenziwa kwi ekstramukoznuyu inputted esophagomyotomy ubude ngeesentimitha eziliqela. Ukuba diverticula ngobukhulu encinane, ngokwaneleyo kuphela omnye cricopharyngeal myotomy, emva kokuba ayinakolulwa, yaye kunye inwebu kwiinwebu wokugaya ziquka udonga flat.

Kutshanje kwezinye iikliniki baqalisa ukwenza utyando endoscopic ngendlela, okt. E. Hayi enze liqatywe kwi entanyeni. umongo wayo kukuba eso basinqumla eludongeni eqhelekileyo phakathi kuvuleke iminxunya kunye diverticulum, kwaye usebenzisa i stapler endoscopic wenziwa myotomy. Emva msebenzi, isigulana kwakhona ngokukhawuleza kwaye kuncitshiswe inani iingxaki.

Ithuba postoperative emva kususwa diverticulum Zenker

Iimpawu lweli thuba ukuba isigulana iiyure ezingama-48, musani ukudla. Abanye oogqirha ushiye probe iintsuku 3-4 ukondla isigulane isidlo ulwelo. Emva kokususa iintsuku 5-6 sele ukunika ukutya semi-elulwelo, ngokuthe ngcembe kwandiswa yokudla.

Ukuba awunalo igama ukunyanga esi sifo, i-ALS ulihlwempu kakhulu. iingxaki ezahlukeneyo kukhokelela ekufeni 23-33% yamatyala.

isiphelo

Ngaloo ndlela, Zenker kaThixo diverticulum - isifo singanyangekiyo kakhulu. Ngaphandle kokubonisa ngokwawo kwasekuqaleni wophuhliso lwawo, emva komzuzwana kokuba ngokonakalisa kakhulu imeko yempilo. Ngayo kufuneka inyanzelekile, okt. A. A high amathuba okuba abulawe ezahlukeneyo iingxaki.