Cov tsos mob, mob thiab kev kho mob ntawm esophageal dysphagia

A phenomenon nyob rau hauv uas ib tug neeg muaj kev tsis xis nyob thaum nqos ua los yog tsis nqos ib yam dab tsi (khoom noj khoom haus, cov dej, cov qaub ncaug) yog hu ua dysphagia. Tib manifestation ntawm lub xeev no yuav ceeb toom cov neeg, thiab yog hais tias xws li ib tug tshwm sim tau raug cai muaj ntau zaus, nws yog tsim nyog los tham ib tug kws kho mob thiab kho dysphagia.

Tsis txhob xav yuam kev rau qhov tseeb dysphagia thiab psevdodisfagiyu. Thaum qhov tseeb nyob rau hauv cov hlab pas los yog qab lub breastbone muaj "pob", thiab lub nqos txheej txheem yog li qub. Cov tshwm sim ntawm dysphagia feem ntau nrog reversible puas siab puas ntsws ua cuam tshuam, nrog tsaus ntuj nti lub siab lub ntsws tshua (nrov tis, kua muag, quaj), clouding nco qab, qaug dab peg, raws li zoo li cov thyroid thiab kab mob plawv.

Cov tsos mob ntawm esophageal dysphagia

Kev kho mob peb xav txog nyob rau hauv kom meej hauv qab no. Thiab thaum peb piav qhia txog cov tsos mob ntawm tus kab mob.

Kev ua txhaum ntawm lub nce qib ntawm ib tug pob ntawm cov khoom noj los ntawm lub qhov ncauj mus rau hauv cov hlab pas, los yog, raws li peb twb xa mus rau phenomenon - ib tug yeej muaj tseeb dysphagia tshwm sim vim kev puas tsuaj ntawm lub paj chaw uas tswj nqos, uas leads mus rau ib Unbalance ntawm no complex txheej txheem. Raws li ib tug tshwm sim, thaum koj sim mus nqos lub bolus thiab nws txheem mus rau hauv lub ntsws huam (qhov ntswg, caj pas, lub raj cua) thiab tsis nyob rau hauv cov hlab pas. Qhov no ua rau ib tug spasm ntawm cov hlab pas, mob hawb pob thiab ib tug muaj zog hnoos reflex.

Mob ntawm lub paj hlwb xws li txob taus los yog tshee ntshawv siab, yuav ua tau tej qhov dysphagia. Nws cov tsos mob tshwm sim sporadically, cov neeg mob nyob qib qub lawv nrog tus txais tos ntawm ib tug tej yam ntawm cov zaub mov (e.g., nyuaj, ntse, kua thiab thiaj li nyob). Cov pa ib ntsuj av tau tsis tau cov zaub mov, tab sis nqos yog yooj yim, thiab cov qib ntawm cov hlab pas txuam nrog mob thiab tsis kaj siab ncus. Cov kev kho mob ntawm dysphagia yuav tsum kev.

Cov ua rau dysphagia

Tus txheej txheem ntawm nqos tau muab faib mus rau hauv peb theem:

• qhov ncauj (arbitrary) thaum ib tug neeg ntawm lwm yam uas ib tug pas ntawm lawv tus kheej;
• pharyngeal (sai tsis), thaum muaj uncontrolled txiv neej ceev pas;
• esophageal (tsis tuaj yeem qeeb) nrog ib tug qeeb uncontrolled nce qib ntawm cov zaub mov los ntawm cov hlab pas.

Thaum tshee dysphagia kev kho mob yog aimed ntawm kev kho cov tib neeg psyche. Txoj cai ntawm nqos nrog esophageal dysphagia yog tsis tawg, tab sis kev kawm rau nws ua rau mob nyob rau lub sab saum toj ntawm lub plab, kub siab, belching. Tsis tas li ntawd, muaj yog regurgitation, thaum tus txheem ntawm lub plab yog muab pov rau hauv lub caj pas thiab lub qhov ncauj, ua rau ib tug unpleasant saj nyob rau hauv lub qhov ncauj. Ntxiv dag zog rau regurgitation zaum yuav tshwm sim nyob rau hauv oblique txoj hauj lwm ntawm lub cev, xws li thaum lub sij hawm pw tsaug zog, yog tias noj hmo yog tsawg tshaj li ob teev ua ntej hmo ntuj so.

Dysphagia can tau nrog los ntawm cov tsos mob xws li txhaws qa, siab slyunoobrazovanie chim thiab qa ntom. Esophageal dysphagia yog feem ntau provokes nqaij muaj zog. Cov neeg mob qhia tias yog yooj yim los mus nqos thaum zapivaniya dej los yog txais tos pasty los yog kua zaub mov. Txawm hais tias muaj neeg mob qhov twg lub kua zaub mov los dysphagia, cov tsos mob thiab kev kho mob yog paramount tseem ceeb.

ntaub ntawv ntawm tus kab mob

Nyob rau hauv tus txheej txheem khiav qhov chaw cais dysphagia nram qab no ntaub ntawv:

• oropharyngeal (nyuaj zog ntawm cov zaub mov mus rau hauv cov hlab pas, nqos lawm arbitrary theem);
• pharyngoesophageal (nyuab los ntawm tus me nyuam mus rau lub txoj hlab nqos mov khoom noj khoom haus lawm sai tsis haus theem);
• oesophageal (gullet yog nyuab los ntawm cov zaj uas lub khoom noj khoom haus, tawg, qeeb theem ntawm involuntary nqos).

Dysphagia yog tseem subdivided rau hauv:

• organic (nws ua yog cov sab sauv qhov chaw ntawm lub digestive ib ntsuj av tau pathology);
• haumxeeb. Cai nyob rau hauv cov ntaub ntawv ntawm central lub paj hlwb kev ntshawv siab, muab hais tias tsis muaj cov neeg kho tshuab obstacles rau cov zaj uas tsis muaj khoom noj khoom haus.

Kev kho mob ntawm haumxeeb dysphagia tuas ib tug psychotherapist los yog ib tug neurologist nrog ib tug gastroenterologist.

Ua rau pathological mob

Feem ntau cov kev loj hlob ntawm dysphagia yog ib cov tsos mob ntawm cov kab mob ntawm cov hlab pas. Ntawm lawv yog cov:

• Esophagitis - o ntawm lub sab hauv ntawm cov hlab pas.
• Gastroesophageal reflux kab mob (GERD). Nyob rau hauv no kab mob, lub plab txheem rau hauv cov hlab pas nchuav, irritating nws cov phab ntsa.
• Protrusion esophageal phab ntsa (diverticula).
• Cicatricial narrowing ntawm cov hlab pas, uas sawv tom qab kho tshuaj kub nyhiab tshwm sim los ntawm haus ntawm acid los yog alkali. Tom qab xws li ib tug tej yam elastic cov ntaub so ntswg ntawm cov hlab pas yog hloov los ntawm connective, phem stretches thiab tsis nrog txhawb nqa rau kev siv ntawm cov khoom noj los ntawm cov hlab pas.
• Phem hlav ntawm cov hlab pas thiab lub plab. Raws li ib tug txoj cai, nws yog fast-loj hlob, ntoo nyob rau lub nyob ib sab nruab nrog cev mob.
• Achalasia. Ntxhov zaub mov bolus dua los ntawm cov hlab pas mus rau hauv lub plab, yog vim li cas cov lus dag nyob rau hauv ib tug mob neuromuscular kab mob ntawm cov hlab pas.

Dysphagia kuj los muaj kev nyob rau hauv cov tom qab:

• mob ntawm lub venous outflow ntawm cov ntshav los ntawm lub siab (portal tawg), esophageal varices thiab hepatic insufficiency (daim siab tsis tu tsis tseg rau cov ua haujlwm vim mob los yog mob kev puas tsuaj txheej txheem ntawm nws cov hlwb);
• esophageal raug mob (kev puas tsuaj rau cov hlab pas ntawm lub sab hauv, rau Piv txwv li, yog hais tias nqos yam khoom ntse ntse, los yog ib tug gunshot qhov txhab hniav hauv siab, thiab lwm yam);
• lwm narrowing ntawm cov hlab pas, uas yuav tsum tau tshwm sim los ntawm ib tug aneurysm ntawm lub aorta (aortic extension), ib tug loj me ntsis cov lub plawv, mediastinal hlav - Department ntawm lub hauv siab, rau sab laug thiab txoj cai ntawm lub tsawg lub teeb, nyob rau hauv pem hauv ntej ntawm lub kaus siab, thiab tom qab cov nqaj qaum. Nyob rau hauv nws yog cov hlab pas, lub raj cua, yog lub plawv thiab lub thymus (tiv thaiv kab mob hauv nrog cev).

Feem ntau yuav tsum tau kev kho mob ntawm dysphagia tom qab mob stroke.

Tsis tas li ntawd, dysphagia yuav ua pathological txhab ntawm lub oropharynx:

• o;
• angioedema (tsis haum cov tshuaj tiv thaiv rau cov ua cim ntawm txoj kev loj hlob uas nws kim heev edema ntawm lub suab thiab lub caj pas);
• tonsillitis (tonsillitis);
• txawv teb chaws lub cev (pob zeb, pieces ntawm khoom noj khoom haus, thiab lwm yam);
• tuag tes tuag taw ntawm lub pharyngeal leeg. Nws tshwm sim feem ntau yog tom qab cerebrovascular xwm txheej (stroke), tsim nyob rau hauv lub keeb kwm yav dhau ntawm atherosclerosis (clogging cerebrovascular atherosclerotic plaques). Nws tej zaum yuav ib tug txim ntawm lub hlwb hlav, raws li zoo raws li lub tsev me nyuam nqaj qaum raug mob. Tag nrho cov no ua rau esophageal dysphagia. Kev Kho Mob thiab nws kawm tau zoo nyob rau hauv ib lub tseeb mob.

txoj kev mob

Mob ntawm tus kab mob no muaj xws li cov nram qab no ua ub no:

• Sau los ntawm kev tsis txaus siab thiab kev kho mob yav dhau los nrog rau cov nram qab no ntaub ntawv: lub sij yawm ntawm pib ntawm cov tsos mob, tag nrho cov sij hawm tau ua txhaum nqos, mob yog tias nqos, seb puas nyob rau hauv lub hauv siab tsis xis nyob thaum noj mov, nrog uas tus neeg mob txuas lawv cov keeb kwm, tej teeb meem ces yuav tsum nyob rau hauv nqos xwb cov khoom noj, thiab tam sim no kua los yog lwm yam.
• Analysis ntawm lub keeb kwm ntawm lub neej: zoo li cas tus kab mob ntawm tus neeg mob muaj, yog muas tau esophageal kub, o ntawm lub plab (gastritis), cov kab mob ntawm tus mob huam.
• Analysis raws roj ntsha keeb kwm (cai seb cov tsev neeg cov kab mob ntawm tus mob huam, tshwj xeeb yog esophageal mob).
• Soj ntsuam ntawm tus neeg mob, ceev faj soj ntsuam ntawm lub qhov ncauj kab noj hniav, cov lawm (palpation) rau cov qog ntshav hauv nyob rau hauv lub caj dab tebchaws dysphagia syndrome. Kuaj thiab kev kho mob ntawm tus kab mob no yuav tsum yog raws sij hawm.
• General thiab biochemical kev kuaj ntshav - kev txiav txim rau cov theem ntawm hemoglobin (lub protein xa cov pa oxygen), ntshav liab, ntshav dawb (lawv nce qhia lub xub ntiag ntawm lub inflammatory kev) zoo li raws li kev tswj ntawm lub raum, pancreas thiab daim siab.
• Coprogram - me me tsom xam ntawm cov quav (nyob rau hauv txoj kev tshawb no kuaj tawg tsam ntawm undigested zaub mov, crude fiber, roj).
• Laryngoscopy: siv ib tug endoscope kev soj ntsuam yog ua rov qab ntawm lub caj pas.
• Upper endoscopy (EGD) - kev xeem los ntawm lub apparatus gastroscope duodenum, plab thiab txoj hlab nqos mov, nyob rau hauv txoj kev tshawb no lub sijhawm los saib ib daim ntawm mucosal me.
• Ultrasonography (US). Yuav kom ntsuam xyuas qhov mob ntawm lub plab nrog cev (hnyuv, gallbladder, raum, biliary ib ntsuj av tau, mob plab, pancreas) thiab paub qhov ua tau ua ntawm dysphagia.
• X-ray kev soj ntsuam ntawm cov hlab pas. Tsis tas li ntawd nws yuav ua rau nws tau mus ntes tej yam kab mob los yog tej yam kev mob uas yuav ua rau muaj teeb meem nyob rau hauv nqos.
• Barium enema - X-ray kev soj ntsuam ntawm cov hlab pas nrog cov kev taw qhia ntawm ib tug zoo ib tus neeg saib xyuas, kom meej meej reflected nyob rau hauv daim duab. Ntes constriction los yog rhuav txhua ntawm cov hlab pas tshuaj.
• MRI (magnetic resonance imaging) ntawm lub paj hlwb thiab hlwb electroencephalography ua mus ntes pathologies ntawm poob siab system, yog tias kev soj ntsuam ntawm tus neeg mob nrog dysphagia twb pom tsis muaj cov neeg kho tshuab chaw khuam siab rau advancement bolus oropharynx thiab txoj hlab nqos mov.

Cov neeg mob uas muaj teeb meem nqos tas yuav mus tham cov kws kho mob: otolaryngologist, neurologist, gastroenterologist.

Tshuaj kho mob ntawm dysphagia

Tshuaj kho (siv tshuaj) yog ib tug tshuaj. Feem ntau cov feem ntau muab inhibitors uas txo lub acidity ntawm lub plab txheem yog tias qhov no yog qhov ua rau ntawm dysphagia. Tsis tas li ntawd yuav tau tshuaj tua kab mob kev kho mob ntawm o ntawm lub caj pas thiab txoj hlab nqos mov, uas coj mus rau qhov tau ua txhaum ntawm nqos. Npaj rau kev kho mob ntawm dysphagia yuav tsum appoint ib tug kws kho mob.

phais kho mob

Nws yuav tsum tau surgically tshem los txoj hlab nqos mov kub nyhiab los ntawm nws cov contraction, o, hlav. Lwm txoj hau kev los mus tshem tawm cov teeb meem uas ua txhaum cov txheej txheem ntawm nqos, tsis txhob nyob ua ib ke.

Yog hais tias tus neeg mob thaum lub sij hawm rov qab nram qab no stroke tsis pub rau cov kev phais kho mob ntawm dysphagia mus tshem tawm qhov ua (e.g., esophageal hlav), lub sij hawm cov kev tshwm sim yog nqa tawm mus pab txhawb rau tus neeg mob kom loj hlob zoo.

Yog nws tau nrog dysphagia kev kho mob ntawm pej xeem cov tshuaj? Nyob rau qhov no tom qab.

Tsoos txoj kev kho mob

Yuav kom tiv nrog tsis kaj lub siab tsos mob ntawm dysphagia nrog herbal tshuaj yuav pab tau. Ua ntej noj mov yuav tsum haus dej haus ib decoction ntawm tshuaj ntsuab, uas muaj ib tug calming nyhuv:

• Hop cones - '25
• Peppermint yoojyim - nyob rau hauv '25
• Rosemary yoojyim - '20
• Valerian paus - '30
• Cov tshuaj ntsuab St John lub Wort - 20 g
• Txiv qaub tshuaj yoojyim - '25

Collection yuav tsum tau tov meej, 1 tablespoon rau daus thiab ncuav 1 khob boiling dej, infuse rau ob lub sij hawm. Ces Txoj kev lis ntshav ntawm lim yog yuav tsum tau. Siv ib tug peb lub hlis twg khob peb zaug ib hnub twg rau ib nrab ib teev ua ntej noj mov.

Antispasmodic vaj tse muaj belladonna tincture (belladonna). Yuav tsum tau coj 5 dauv peb lub sij hawm ib hnub twg rau 5 feeb ua ntej noj mov.

Yog lwm khwv nrog zoo xws li cov zog:

• Hauv paus thiab rhizome ragwort latifolia, '15
• Cov tshuaj ntsuab ephedra, '20
• Motherwort tshuaj ntsuab, '20

As them nyiaj ncuav liter dej txias rau plaub teev, ces rhuab nyob rau hluav taws rau ob tug nas this, txias, lim. Ob dia ntawm qhov uas ua muaj pes tsawg leeg yog yuav tsum tau coj kaum feeb ua ntej noj mov.

Thaum dysphagia lub teb chaws kev kho mob tsis yeej ib txwm pab, li ntawd, yuav nco ntsoov sab laj ib tug tshwj xeeb.

Yuav ua li cas yog muaj nyob rau hauv cov khoom noj?

dysphagia kev kho mob yog complex, li ntawd, nyob rau hauv thiaj li yuav pab txhawb rau lub cev mob ntawm tej yam zog yuav tsum tau ua raws li cov kev cai.

• Fractional tau ntawm cov khoom noj nyob rau hauv me me.
• Ceev faj crushing los yog zom zaub mov.
• Ua lub ntim ntawm cov kua ntim.
• Tsis kam ntawm cov khoom noj uas thab plaub hauv txheej membrane ntawm cov hlab pas (ntse, qab ntsev, ntsim, ib yam nkaus thiab txias los yog kub kub), noj mov cov zaub mov txias, zoo kas fes thiab tshuaj yej, cov dej qab zib fizzy thiab dej caw.

Tej zaum yuav tsum tau bougienage - rov extension ntawm cov hlab pas lumen buzhom, tshwj xeeb extenders. Hais tias yog dab tsi yog cov kev kho mob ntawm dysphagia.

Yuav mob

• Pheej ua pa tsis ua hauj lwm tej zaum kuj mus rau ib tug ua tiav standstill, tshwm sim los ntawm ib tug nqaij hlav ntawm cov hlab pas, compressing lub raj cua (lub cev uas ua huab cua mus rau hauv lub ntsws).
• o ntawm cov hlab pas (esophagitis).
• Phem hlav (loj hlob sai thiab kis tus kab mob thoob hauv lub cev) ntawm cov hlab pas los yog thawj zaug feem ntawm lub plab.
• Aspiration mob ntsws, thaum nyob rau hauv kev ua txhaum ntawm lub nqos nuj nqi ntawm tus txheem ntawm lub oropharynx yog pov los ntawm lub qhov ntswg mus rau hauv lub ntsws thiab lub raj cua, thiab cov qhov tso zis yog ib tug kev loj hlob ntawm mob ntsws, mob rau hauv cov ntsws.
• Mob ntsws ua paug (surrounded los ntawm ib tug tiv thaiv cov tshuaj ntsiav ulcers) uas tshwm sim thaum lub plab txheem ces muab pov tseg rau hauv lub pa ib ntsuj av tau thiab yeej txhawb o.
• Koj muaj teebmeem kev fibrosis yog ib tug ua txhaum ntawm cov qauv ntawm cov mob ntsws cov ntaub so ntswg kev puas tsuaj vim nws plab txheem (uas yog acidic) uas tau txais muaj tom qab casting vim impaired nqos.
• Poob vim lub me me muaj pes tsawg tus ntawm cov khoom as-ham.
• Poob ntawm lub cev dej ntawm tus neeg mob los yog lub cev qhuav dej.

Peb tau pom tias ib tug kab mob, xws li dysphagia. Mob, cov tsos mob, kev kho mob, piav nyob rau hauv kom meej nyob rau hauv no tsab xov xwm.