Izimpawu kanye nokwelashwa biliary Reflux kolwelwesi

pathologies wokugaya ukudla ezivamile phakathi kwabantu. izifo evamile ehambisana Reflux. Yiziphi izici?

Reflux esophagitis

Lesi sifo singumbulali ukuvuvukala njalo emphinjeni, okuyinto kubangelwa contact njalo ke okuqukethwe isisu asidi. I zokugula ezihambisana ne ukwehluleka aphansi sphincter ngomphimbo, okuyinto evamile ivikela emphinjeni kusukela Ukungena we juice esiswini.

Acute biliary Reflux kolwelwesi

Leli fomu libhekene ukuthuthukiswa ukuvuvukala acute e ulwelwesi lwamafinyila ngenxa yokuchayeka Bile lichaza ekwakheni ukudla bolus. ezahlukeneyo eziningana elikhethiwe yokudleka kolwelwesi lwesisu oyingozi:

1. ukubonakaliswa Esogastritis main kuyinto hyperemia okuncane nokuvuvukala odongeni esiswini. It sikhula futhi embozwe ungqimba isikhwehlela obukhulu. Ulwelwesi lwamafinyila has a nokopha encane petechial nokuguguleka kwenhlabathi.
2. kolwelwesi Fibrinous, lapho udonga kwakhiwa EPITHELIAL necrosis esishintshashintshayo ngesinyenyela fibrinopurulent ubovu exudate. Ukubonakaliswa lesi simanga - fibrin ifilimu elincanyana phezu ezindaweni ezithintekile we mucosa. kolwelwesi okukha phezulu ebonakala Looseness of the ifilimu, futhi uma ukuvuvukala ezijulile tho nge epithelium.
3. Necrotizing kolwelwesi, lapho ngaphezu nezinye kuthinta EPITHELIAL mucosa izingqimba. Ngaphansi necrosis baqonde yokufa kwamangqamuzana engokwemvelo ngaphansi kwethonya izici nolaka.
4. Ubovu kolwelwesi - ifomu olunzima ukuvuvukala. Inqubo kungabanga zonke zamatshe esiswini, okubeka engcupheni kuya perforation. Ukubonakaliswa le samuntu - khona exudate, kodwa futhi kokuziphatha okukhulu mucosal leukocyte.

Okungalapheki biliary Reflux kolwelwesi

Lolu hlobo libhekene inhlanganisela imihlola ukuvuvukala futhi esiwohlozayo. Avamile ekungeneni Bile kanye enzyme pancreatic zingene esiswini kuholela ukuthuthukiswa ukuvuvukala ezingamahlalakhona. Futhi, leli fomu kungenzeka umphumela yokudleka kolwelwesi lwesisu oyingozi. Ngenxa ayinayo ku mucosa anda amanani ka histamine, okwenza kube edematous futhi erythematous.

pathogenesis

Phakathi esiswini, antrum yakhe kanye duodenum has a sphincter, okwakubizwa ngokuthi i "umlindisango". Umsebenzi lokhu imisipha iqondiswe Move chyme (bolus) kusukela esiswini emathunjini for kokudla esiswini okwengeziwe futhi ukumuncwa okwalandela izakhamzimba. Ukuphazamiseka sphincter kungaholela ukuthi kwakuyoba ukuthuthukisa Reflux biliary, kolwelwesi, ekwelapheni edinga inhlanganisela yemithi nokudla. Ukuze lokhu Imiphumela isifo ukuvulwa okungazelele we sphincter, lapho yinhlama ukudla lapho ijoyina Bile ekhiqizwa isibindi emuva zingene esiswini. Ukwakheka Bile kuba nomthelela ongemuhle isimo mucosa yayo. Iqukethe nosawoti, acid kanye enzyme zibizwa ubudlova izici.

omsakazo

Izimbangela biliary Reflux kolwelwesi ephathelene ne-ukungasebenzi sphincter - umlindisango. Ukuze lokhu kungabangela kokungenela kuhlinzwa esithinta motility pheshana emathunjini. Futhi phakathi izici etiologic bungabonakala izifo ezifana ne-hepatitis, cholecystitis chronic duodenitis. Ubuthakathaka we imisipha sphincter futhi kwandise ingcindezi yokufuna emathunjini ngokuvamile siyimbangela kolwelwesi, futhi lokhu kungaholela eziningi pathologies yokusetshenziswa pheshana emathunjini. Indima ebalulekile ungalokothi uphuze izinto. Ngokwesibonelo, ukucindezeleka njalo kuyehla izakhiwo mucosal avikelayo, futhi-ke omelana buthaka isinyathelo ezizihluphayo. Kungokufanayo -non-steroidal izidakamizwa eqeda ukuvuvukala ukuthi kwandisa ingozi yokungenwa kolwelwesi izikhathi eziningana. Le mithi nomthelela prostaglandin zamagama, futhi ukwenza umsebenzi obalulekile - ukuze sikhuthaze kumiswa isikhwehlela amangqamuzana goblet, okwandisa izakhiwo okuvimbelayo le mucosa. izidakamizwa eqeda ukuvuvukala zivimbela cyclooxygenase enzyme, futhi ngaleyo ndlela kunciphisa inani prostaglandin, futhi kungakho inani isikhwehlela.

Ngu kumiswa Reflux esophagitis okuholela ascites, okuholela yokucindezeleka okwandayo esikhathini constriction besisu imbobo pyloroduodenal. izici engeziwe angenza ukudla okungenamsoco, Friend izingubo, imithi, ukucindezeleka futhi ukubhema. Lesi simo esiyingqayizivele sibangelwa kungenzeka ngesikhathi sokukhulelwa, khona-ke ongakaphathelani egunjini lokuhlolwa kwezifo.

Biliary Reflux kolwelwesi futhi Reflux esophagitis: Izimpawu

Izimpawu eyinhloko Reflux esophagitis kukhona isilungulela eructation acid, okuyinto zivamise ukwenzeka ngemva kokudla, futhi lapho esitshekile phambili. Iphelelisane lena kabi esifundeni epigastric.

umtholampilo acebile kuyahluka biliary Reflux kolwelwesi. Izimpawu zalesi sifo zihlanganisa ubuhlungu kanye nezinye izifo. Ngokuvamile iziguli ayinandaba umuzwa ukugcwala futhi ukuvuvukala, kanye kobukhulu epigastric. Ubuhlungu ngokuvamile bavele esiswini esingenalutho, futhi ufake umfutho owengeziwe yabo ingase ibe khona ehlukile - acute ezinzima ukuze ezidabukile. Ngokuvamile kukhona ukuhlanza.

ukuhlola

Ukuxilongwa biliary Reflux kolwelwesi wenziwa emva ekufezeni ucwaningo akhethekile anamnesis. Ezinye izikhalazo azanele, zisiza nje ukuthi nokwami ukuthuthukiswa lesi sifo. Okokuqala, isiguli siqondiswe ukulethwa endleni, lapho ochwepheshe ukubona igazi noma ukusebenzelana nemimoya. Futhi kumelwe nakanjani ukuba ukuqhuba EGD esisiza ukuba zibukeke ukuhlola isimo ulwelwesi lwamafinyila, ukuthola foci onesifo. Ukwandisa ukugandeleleka duodenum kungenziwa kunqunywa manometry.

Reflux esophagitis kutholakala ukuthi uphethwe yini advantageously indlela radiographic usebenzisa i-ejenti ukuze kuvele umehluko. Le ndlela ikuvumela ukulandelela ngesikhathi Ukuxoshwa okuqukethwe isisu emphinjeni. It is ibuye Kunconywa ukuba afeze Endoscopy, okuzokwenza ukuhlola isimo mucosa futhi ukuthatha izinto eziphilayo azithathe ukuqhuba izifundo.

ukwelashwa

Biliary Reflux kolwelwesi futhi Reflux esophagitis zidinga ukwelashwa ngokushesha. Lokhu kuzosiza ukuthuthukisa isimo lesiguli kanye ligweme izinkinga ezingase zivele kungenzeka. Phezu ukuthola esophagitis kufanele uhlukane nale mikhuba emibi, kanye umsebenzi okukhulu endaweni besisu.

ukwelashwa kusekelwe ukuqashwa kukaNksz antacids ukuthi kuncishiswe ithonya nolaka of juice esiswini kwi mucosa ngomphimbo. Phakathi kwazo kunabafundi "Almagel", "Maalox" isicelo izinga. Bona lisibekele ezindongeni isisu asidi aphansi.

Ngaphezu kwalokho, kutuswa ukuba asebenzise izidakamizwa ukuthi ukunciphisa uketshezi of juice esiswini ( "omeprazole"). Prokinetics angathuthukisa ithoni sphincter, okuyinto ukuvikelwa ngokuphonswa kwawo acid. "Motilium" ungakwazi ukuhlukanisa phakathi kwemithi enjalo futhi "Motilak". Uma impatho olandelanayo ehluleka, ukuhlinzwa kungadingeka, okuyinto eyenziwa ngosizo imishini endoscopic.

Kangakanani ukwelapha izifo ezifana biliary Reflux kolwelwesi? Izimpawu kanye nokwelashwa yalesi sifo atehlukaniseki. Iziguli zidinga kwemithi eziyinkimbinkimbi futhi izinyathelo ze-non-izidakamizwa, okuzokwenza ngcono isimo, balahle ukubonakaliswa emtholampilo. Okokuqala kubalulekile kulesetayelekile ukuphila - ngokuyeka imikhuba ezimbi, umsoco ofanele. Phakathi amalungiselelo okwelapha ngokuvamile zinikwa histamine yokwamukela blocker okuyinto ukunciphisa uketshezi. Gastroprotectives ngeke akwenze ngaphandle - bona kusheshiswe sokuphulukiswa lwamafinyila ulwelwesi izilonda. Ngaphezu kwalokho, kubalulekile esibophezelayo Bile acid, ezenza usebenzisa ursodeoxycholic acid. Ukuvikela phezu chyme esiswini ukusiza izidakamizwa ezifana "Domperidone" futhi "metoclopramide".

zokuvimbela

Vimbela kumiswa biliary Reflux kolwelwesi futhi esophagitis ukusiza umsoco ofanele kanye ukuxilongwa esifike izinqubo sokugembula. Kunconywa ukuvimbela ukuziphatha njalo izivivinyo endoscopic, ozokusiza ukuba bahlonze izifo ngendlela efanele usaqala. Lokhu kuzokhulisa ukuphumelela ukwelashwa ngoludala ukugwema ukuhlinzwa kanye nesenzakalo yezinkinga ezinzima.

Ngaphezu kwalokho, kufanele ukuthuthukisa izakhiwo okuvimbelayo le mucosa. Kunconywa ukuba bangayeki imikhuba emibi (noma ukunciphisa ukuba ubuncane), zama ukuba badle ukudla okunempilo futhi ugweme izimo ezibangela ukucindezeleka.

Futhi ungalokothi uphuze isici ukusetshenziswa njalo izidakamizwa nonsteroidal eqeda ukuvuvukala okuyinto ukunciphisa ukukhiqizwa isikhwehlela esiswini, kuphumele mucosa kuba sengozini. I indima ebalulekile eyadlalwa nokwelashwa ekuseni izifo concomitant.

Inkinga okuvela biliary Reflux kolwelwesi futhi esophagitis lubalulekile, njengoba lezi izimo kungenzeka kuphela isimo sibe sibi ngezimo zesiguli, kodwa futhi kubangele izinkinga. Imiphumela yaloku kuhlola okungenhla Esifike Ngesikhathi ivumela ukuphathwa ukuqala ngesikhathi.