HH - He aha Ua It? Symptoms a me ka lapaʻau o HH

E ka hoʻomaka me ka mea i ole a pau i nā hua h ÷ ailona HH. He aha ka mea?

Hiatal hernia (HH o ka ia no ka pōkole), a he hiatal hernia, - aole e oi ma mua o ka maʻi wehewehe aku ma ka pohupani hale o ka hui, (aia i loko o ka abdominal lua) ma kaʻaiʻana o ka puka i loko o ka diaphragm i ka thoracic lua. Keia kino Ua kokoke mau ka'ōpū.

Oesophageal hernia hiki i congenital a loaa ano, a mai ka hai lapaʻau hoike ana. Congenital hernia Ua emi, he pono ole ma mua o loaa. HH ke'ākoʻakoʻa no na kumu.

Ma kēia 'atikala, e nana aku kakou, i ka mea HH, symptoms, lapaau a me ka lāʻau kū-operative wā o kēia maʻi.

General ano o ka maʻi

Puka (i i mea pololei pilina HH) mai ka shape na¯ haʻawina paku e he a mauʻano o nā fabrics: Muscle a me ka connective. 'O kēia ka paku hoʻokaʻawale ka abdominal lua mai o ka pahu. Nā tufts ma ka diaphragm Muscle e hana i kekahi meaʻuʻuku puka ma i ka esophagus. A oe paha ike ano ke kumu ka mea, ua kapaia ka esophageal puka.

Hoi mai i ka hiatal hernia (HH). He aha ka mea? Ua Ua hana like me ka hopena o pohupani hale o ke kino, mai ka abdominal lua i loko o ka pahu ma ka loa hiatal. A i ka hana no o kona mea hoʻonāwaliwali maoli nō.

Hiatal hernia - he na maʻi no laila, i ka mea hiki ke paʻi ana me ka cholecystitis, pancreatitis a duodenal ulcers. Eia naʻe, e like me kona koʻikoʻio, ka mea e hoi e ia paʻi.

I pili makahiki o ka hoʻomanawanui hiki e mai la oia ia pinepine i ka maʻi e hoʻomōhala ana i loko o kanaka mua o 60 makahiki. Me ka pili ana i ka hoohanau - na wahine i oi paha e ae aku, mai keia maʻi ma mua o nā kānaka.

Mea Maluna

oesophageal hernia hoʻolaha e like me ko lakou mau ano. Līkaia no ia ano:

• Lana ole paʻa hernia (hernia no ka iho a me ka paraesophageal wale). Ma kekahi, paraesophageal hernia - keia mea, i ka wa i ke kiʻi o kekahi hapa o ka'ōpū mea pololei ma kaʻaoʻao o ka esophagus ma luna o ka diaphragm. A me ka cardia o ka'ōpū ma lalo o ka diaphragm ua e pili ana. Iho HH - esophageal, cardiac, a subtotal totalnozheludochnaya. A hoʻokaʻawale ua nō ka hāʻuleʻana hernia, i nā hiʻona i hanaʻia i loko o ia ka hernial sac hoalaala ia me ka peritoneum. Ka mea, i kekahi, mai ka iho nui, e hoike ana hope eke malaila. Iho hernia hiki ke neʻe ke alalai ole me ka neʻe 'ana o ke kino.
• Paraesophageal hernia (fundic ole antral).
• Congenital hernia, kena ae la ia e ka pōkole esophagus me ka anomaly i loko o ka ulu ana.
• Hernias o kekahi 'ano (enteric, sila, a no laila, ma luna o. P.).

Kēia maʻi hiki e hoʻolaha no hoi e like me ka degere:

- Esophageal hernia mua loa. Wehewehe aku i loko i ka cardia o ka'ōpū mea ma luna o ka iliwai o ka diaphragm,'ōpū iki ke kiekie, a paa i adherent i ka diaphragm. Abdominal esophagus ua aia i loko o ka thoracic lua, pono ma luna o ka diaphragm.

- Esophageal hernia lua o degere. Ka lapaʻau kiʻi Ua like penei: abdominal esophagus i loko o ka thorax, a ma ka esophageal puka mea, ua mahele o ka'ōpū.

- Esophageal hernia kolu o degere. Ka loa loa degere, ua wehewehe aku ma ka mea i hoʻoholo 'ana o ka esophagus, cardia, a me kekahi manawa, a hiki i ke kino a me ka fundus o ka'ōpū ma luna o ka diaphragm.

Kumu no ka esophageal hernia

Mākou i olelo mua ia na kumu i hiatal hernia he nui loa. Eia naʻe, ka hapanui pinepine nō ke kēia kumumea:

• Thinning o ka connective ligaments, kena ae la ma ka makahiki-pili loli paha e poloʻai pule e kekahi'ē aʻe keʻano o ka hanaʻana.
• Kahua hoʻonohonohoʻana a hoʻokahi-ke kahua maʻi mahuahua ma ka puʻe i loko o ka abdominal lua iho. Ke kumu no mahuahua ma ka puʻe hiki e maʻi constipation, kaumaha hoounauna (e like me ka mea, hoaka mea kaumaha i), kūmūmū abdominal trauma a oi.
• Maʻi maʻi i mea pololei e pili ana i ka digestive'ōnaehana a me ka mea hiki loko Hawaii hana o ka make bladder, opu, a me ka duodenum.
• Kāna hana o ka endocrine glands (endocrinopathy).
• Hewaʻano (uiki, inu), kūpuna kanaka.

HH: Symptoms

Ke kaumaha ma muli o ka lapaʻau hoike ana mai o ka maʻi i ke kēia mau pepa hiatal hernia:

- HH asymptomatic;

- HH, no ka pathology manawa a ka maʻi pale ua kena ae la ma ka hoʻokō 'ole' ana o ka cardia;

- HH, ua i wehewehe aku ma ke alo o gastric cardia insufficiency maʻi pale;

- HH, i like me ka complication o nāʻano o gastrointestinal maʻi (ole wale hoʻomōhala ma luna o lākou kāʻei kua);

- paraesophageal HH;

- HH hanau, wehewehe aku ma ka pōkole esophagus.

E noʻonoʻo kēlā me kēia 'ano HH (kela mea keia mea e like symptoms) kaawale:

• Asymptomatic hernias. E like me oe i ka inoa o keia palapala o ka maʻi, i kekahi hoailona o HH i loko o kēia mau hoopii, aole. Ua holo nōhie pili i cardiac paha esophageal hernia, oa ka poe uuku a me ka ho okumu nui. Wehe aʻe i kēia palapala o ka hernia loa huikau, pinepine - ma ka piha hookolokolo, a me kekahi manawa kanaka e ole e ike ana ia mea he HH - symptoms (lapaau ana ma lalo nei), no ka mea, aohe hernia.
• HH maʻi pale cardia ole. Ka loa e like me ka hoailona o ka cardiac HH - heartburn a me ka eha, postprandial, a maʻoi loli o ke kulana o ka hoʻomanawanui ka kino. It E e kaulana no hoi ia mau symptoms pinepine i hoʻomaka ai i ka po, ia mea hiki ke wehewehe i nā hiʻona o ka hoʻoulu i ka leo o ka vagus nā aʻalolo, e like me ka hoʻomaha o ka lalo esophageal sphincter.

E pili ana i ka nui o ka heartburn, e hiki ke olelo i ka mea hiki e oluolu (i loko o keia hihia, ka mea hiki ke hana ia me antacids), a he ola (nei, ua nui no laila, ua hiki hoonele kanaka hana). Kona pinepine 'ua nānā' ia e ka luna 'o ka okoa aʻe, a me ka, mua a me ka mea i hele mamua, i kēia mau nāʻakika-peptic, i mea nona i ka gastric wai. No hoi, ka mea e loli i ke esophagus hohola ana a me ka hoolei ia duodenal Contents kuhikuhi (bile).

Ka hapanui maka-lālau hiʻona o hiatal hernia, o ka papa, eha. Ua mea waiwai 'ana i kumumanaʻo i mea hilinaʻi nui ma luna o ke kumu o ka heartburn. Holo nōhie eia kahi mea akaka no'ālike kumu. Pain ua IIeEeAIEUIeXAIIUEʻano nui i loko o ka wahi o ka sternum, a ua listen ka wā o ka hoʻomanawanui i ka moe kūlana. Ma waho aʻeo i keia kulana hoi i eha torso hoʻi a me ka mai. Ke ano o ia i ia okoa, loa pinepine ka mea, ua walania iho la, a oki paha kuni ka waiʻona ma ke.

Regurgitation o gastric Contents - i kekahi lā pinepine hoailona o HH. He aha ka mea? 'O kēia ke kaʻina hana o ka hoolei ana i ka'ōpū Contents i loko o ka waha. Loa kaʻawaʻawa loa kŰia, a pela i kahi o ka'ōpū ke komo i loko o ka trachea paha bronchi.

Hou, he mau olelo e pili ana i ka eha. Realʻeha Kahalaopuna wale hapalua o ka hoʻomanawanuiʻana, a ma ka 25% o ka hihia e psevdokoronarnaya eha, a ua IIeEeAIEUIeXAIIUE i loko o ka naʻau. Mai ia oe hiki wale kiʻi pohaku uinihepa, a me ka hoʻohana 'nitroglycerin. Ma waho aʻeo ia keia eha, nā mea maʻi i haha discomfort i loko o ka interscapular, hepatopancreatoduodenal mau mea, e like me ia ma-Chauffard Minkowski, etc.

No hoi, ma kahi o 70% o nā mea maʻi me ka hiatal hernia (oi loa aku hoi ina mea cardiac HH)ʻalo me ka ka symptom me belching. Loa pinepine ka mea hana i ka opu Contents, a me kona hoʻokomo o kaʻawaʻawa loa ka waiʻona ma typical o ka pono nui i loko o ka epigastric aina, i Hōʻike aerophagia. Ua lawe mai i kaʻawaʻawa loa awaawaʻaiʻana. A me antispasmodics a me analgesics ma keia hihia, e wehe i kēia mau manaʻo e hiki ole.

Nō hoʻi, 40% o nā mea maʻi i pilikia hele ae ai ma ka esophagus, a hiki i ka wā e lawe wai a ka ai. ʻOiai ka mea, e e hoʻomaopopo i ka mea paa ai hele hoopuni lawa. People loaa mai keia symptom oi pinepine eia kahi mea akaka ma ka mea ku ole loa wela ole loa anuanu ai. Nolaila, ina he hernia ua? Aeiiaiaoaony eʻai wale nōʻai i loaʻa teperatura kino.

About 4% o nā mea maʻi e loaa ana mai o HH hiccups ma ke kāʻei kua o ka iho helehelena o ka hernia. Wale ka mea, 'o ole o kona kulana i ka mau hiccups. Kona papa kuhikuhiE hiʻona hiki ke noʻonoʻo i ka nui lōʻihi like 'ole (e mau pule a mahina). ʻaʻole kiʻi pohaku uinihepa, no ka mea, nui na mea, a kōkua ma ka hanana i wale e hiki i ka palapala hōʻoia no technician.

Kekahi hoʻomanawanui iki mai i ka mahina glossalgia (eha loa elelo) a me ka hoarseness, i mea heʻilihune o ka'ā mai peptic gastric Contents kinoea i regurgitation.

Ma waho aʻeo ia a pau nā luna, ua hiki ke hui aku i ka symptoms o ka hernia hilinaʻi nui ma luna o kona nui.

• HH me symptoms insufficiency o ka cardia. Ma na hihia a pau, na symptoms o opportunistic maʻi Ua oi haʻi,ʻaʻole ka hernia. Na hoailona o keia palapala, e pericardial hernia, epigastric a retrosternalʻeha ike koke ma hope o kaʻai a ma hope, ua leha aku.

Lawe ia ana na eha, hiki i kekahi mau lā. E neutralize ia oe ke hoʻohana 'ole-narcotic analgesics (koe nae validol no ka mea, he mea ole keia) a nitroglycerin. Nō hoʻi, ka eha aɃe ka wā ka lalau ana i ka ai a me ka wai.

• HH, i like me ka complication paha wale hoʻomōhala ma ke kāʻei kua o nā ano o gastrointestinal ka maʻi. Oia maʻi i loa pinepine gastric a duodenal ulcer. Ma keia palapala o HH ke kumu nui symptoms o ka maʻi, i ka hernia.
• Paraesophageal HH. Keia ano o ka hernia ua wehewehe aku ma ka wa e kaawale aku o kekahi symptoms a me na hoailona. Loa pinepineʻike, o paraesophageal hernia ia lŘlŘ randomly i mau manaʻo. Akā, i ka wa a ka hernia hoonee aku, he esophageal mīkini'opihia (i loko o nā hua'ōlelo, hou o ka esophagus). Ma pohihihi keia hoopii, hoʻomōhala esophageal spasm (i ka maʻi i loko o i ko lakou kupikipikio esophageal peristalsis).

Inā kaʻaihue paraezafagealnyh hernias he mea eha ma ka sternum a epigastric.

• Congenital HH wehewehe aku ma ka pōkole esophagus. Ma keia palapala o ka esophagus hernia hiki ia mau koho. Ma ka mua o ia ke kūkulu i ka i kekahi mea e like me "thoracic opu", a ua wehewehe aku ma ka kēia pepa.

- o ka wahi o ka pahu;

- IIeEeAIEUAA o ka intrathoracic'ōpū.

Ma ka hope hihia, ai kaʻike, ua loa paʻakikī, ia IeAUPIIe, IAa IO ka hana i ka manawa eʻoki kino a ma autopsy.

hiki complications

Hiatal hernia hiki hoʻonāukiuki i keʻano o nā complications. Loa pinepine hoikeia like penei:

- gastritis a gastric ulcer i ka loa ma ka a ka hernia (akaka ma kahi o 8% o ka hihia);

- kahe ana ke koko, anaemia (loaʻa he 20% o ka hihia);

- i ka hoʻokomo 'ia' ana o ka lalo esophagus i loko o ka hernial sac;

- hua'ōleloʻo o ka esophagus (ana i loaʻa wale nō me kardiaezofagealnymi 'ano apau loa);

- prolapse o ka gastric mucosa i loko o ka esophagus ( 'o ia hoʻi retrograde lilo);

- strangulated hernia (ka loa paʻakikī o nā mea a pau i ka helu 'ia ma complication).

ʻike, no ka maʻi

Nō kāu, hoʻomalu lawe aku no hoi mai kekahi mau ho'āʻo ma ma ke kumu o ka a na hualoaʻa ke ano e diagnosed "HH." He aha ke ano o ka ho'āʻo ma:

• Fibrogastroscopy. Hiki nō ke hoʻohana mea i maopopo i ke ano o ka esophagus a me ka'ōpū. Endoscopic hoailona o HH Ho'ākāka 'ia ia iho i ke kauka, ma muli ia i ka mea hiki ke hana i kaʻike, a me ka hoakaka lapaau.
• X-Ray keia hookolokolo ana, a ua nānā 'ana i barium Akä naÿe. Ma keia ana manaʻo, e hiki ke kiʻi i kekahi kiʻi herniation, i mea ano no kela a me keia HH-loa.
• pH-metry. Kēia hōʻike ua i, e hooholo i ka nui o kaʻakika i loko o ka'ōpū. He mea pono i ka pono hāʻawi aku lapaau o hernia.

HH ka esophagus lapaʻau

Nui, lapaʻau hiatal hernia hele Via ai ', akā, i loko o kekahi hihia (oi loa aku hoi, i ka wa complications) noi aku iʻoki lāʻau lapaʻau' uao.

Me ka pili ana i ka lapaʻau me ka laau lapaau, ia mea e emi i kaʻakika o ka'ōpū (hoʻohana antacids), a me ka hoemi gastric secretion. Kēia - ka mua hana. No hoi, ina lapaʻau mea pono e hoʻopale ai i ka gastric mucosa, i kekahi hoakaka no ka noi ana o kekahi mau ai '.

I ka ua hāʻawiʻia lapaʻau i ka ikaikaʻai, a pono e implicitly hahai. Holo nōhie, i kēiaʻai mea kokoke i ka ia me ka gastritis:ʻaʻohe kaikea,ʻaʻohe spicy, huawaina, palemo iho. Wale ola ai, e like me ka lau, hua, kiliala, dietary Nā Kopa a me nā kai, waiho ihola, wīwī ai.

No laila, e hoʻopau heartburn, a no ka emi gastric secretion hiki ke lawe i ka lāʻau "Maalox". I ka loa i ka pono, ka mea i loaʻa i wale na papa, akā, i loko o ka palapala o gels, huaale, Wehe 'ia mai. Kēlā me kēiaʻano o kēia 'o ia hoʻi he olelo okoa no ka hana, i hiki ke hoakaka ia i loko o kekahi hale kūʻai lāʻau lapaʻau o kou kulanakauhale.

Ua mea i hiki, e apono i na mea e like "Rennie" a me "Gastal". E hoʻopau heartburn ua ikeia oia e e lawa, e lawe i kekahi papa, a no ka Kāohiʻana o - 4 papa i ka lā (hoʻokahi hola ma hope o kaʻai). Eia naʻe, e hoomanao i mau ai 'wale wehe i na symptoms.

Like no kaʻoki kino, ka mea, o ka wehe i ka hernia ho okumu.

No ka hou pololeiʻike, a me ka lapaʻau hooko mea pono e pili ana i ke kauka (surgeon ole gastroenterologist).

Iapaau ana o ke kanaka laau

HH iapaau ana hoolaʻi laau e ole e haawi mai ka mea i makemake i nā hualoaʻa, e like me ia ma ka hapanui o na hihia i ka maʻi kanaka koi ka lapaʻauʻia nui aʻoki kino.

Oia hoi, i hernia iho mea i hiki ke wehe i na kanaka ka kala. Ke wale kumu ka mea, hiki ke hoʻohana '- e höʻike aku ka eha.

Kekahi lāʻau lapaʻau kī ke kōkua ho'ēmi i ka eha. Eia nō kekahi poʻe Kids mea e kōkua ana ma ke kaua me ka hernia:

- A decoction o marshmallow kumu. Ninini aku au i ka hola 20 g. O ka pepe iho la ka mole Althea Mug o nā kapuahi e ka wai, a e ia brew.

- Mix 30 paka ua o kanakaʻona mau propolis tincture a me 50 ml o ka waiu. E 2 manawa i ka lā.

- flatulence pono kōkua decoction o na anoano o carrots. E hoʻopiha i kekahi gram hua 2 na kiaha o ka wai wela, a ae i ka läÿau, e brew no e pili ana i ka hora. E Pono e inu pu ai me na anoano.

E hoomanao i ma mua ka lawe i kekahi mea (oi hoolaʻi Kids) ia mea pono e kukakuka me kou kauka.

Nō hoʻi, ka hoʻohana 'ana hoolaʻi Kids, e hiki ke kiʻi pohaku uinihepa, o ka heartburn, hiccups, a me nā symptoms o HH. Akā, e hoomanao i keia mea he pokole result wale, a me ka mea e pono i ke kumu o ka maʻi ma mua o nā symptoms e pono ai.

oesophageal hernia ma hope oʻoki kino

E like me ka olelo ma luna, ma kekahi hihia, hiatal hernia ponoʻoki kino. HH-hana, hōʻike manaʻo o i kekahi henua, hiki nae ho'ōla he ola i loko o loa holomua hihia.

Akā, i ka mea e hana ka wā i hanaʻia ua hanaʻia? Pehea e hoʻokō i nā kia-operative pololei me? Pehea koke 'oe e hoʻi i ka maʻamau ke ola?

HH ma hope oʻoki kino pono koi eiiieaena malama a me ka lapaau a me ka Kāohiʻana.

Ma ka lā mua ma hope oʻoki kino, e hoomanawanui i pono i ka kino hookolokolo a me ka electrocardiography. Ma ka lua o ka lā ua i ka pahu X-Ray. Ma ke kolu - ka huina piha koko helu a me ka biochemical haʻawina o i kāuʻikepili kuhikuhi sonography.

ʻelua manawa o ka lā, nā mea maʻi e lawe mai na mea kino ha kino a me physical Inc.

Like no ka lāʻau Inc ke olelo aku i ka eia. Ua oia ma ka hoike o ka Saline pāʻoihana intravenously i loko o ka buke a hiki i 1800 ml no ka lā. A pau nā mea maʻi ma hope oʻoki kino lawe antibiotics.

Trocar eha i ia me ka waiʻona, a i nakinakiʻia i loko o ka lā.

Just kekahi lā ma hope o ka hana i ka hoʻomanawanui, e inu i ka wai, akā, mai ka lua o ka lā - e lawe wai a ka ai. Post-operative wā mea e pili ana 3 mahina.

Pehea e holo ai ia HH-hana (hōʻike manaʻo o i mea okoa, ke kaumaha ma muli o ka oolea o ka maʻi), ua ua ua kau aʻela ma luna. Ua mea e wehe i ka hapanui hernia.

ka hopena

No ia manawa oe e ole e makau, ina kahi e oe e ike i ka hua h ÷ ailona HH. He aha ia mea, a pehea e hoike mai ai ia ia, e ike.

Ka mea, koe wale no ka hōʻuluʻulu manaʻo, i ka maʻi ka mea nui. Pakiko-lapaʻau, ka oi hana maikaʻiʻole o ka poʻe kānaka Kids,ʻano pilikia loa, a hiki i complications nui.

Akā, auwe, mai complications i kekahi mea'ōnaehana paleʻea, mai kekahi mau ano o HH asymptomatic. Ke wale ala mai - lawe i ka piha ninaninau i loko o ka haukapila ma ka liʻiliʻi loa, pakahi i ka makahiki. No laila, e hiki wale loaʻa i kēia kaʻawaʻawa maʻi.