Popeza kuti nthendayi zambiri sizimayambitsa zizindikiro, nthawi zambiri zimapezeka m'kati mwa chifuwa cha X-ray chifukwa chosiyana. Nthaŵi zina, amatha kudandaula kuti anthu omwe ali ndi asidi amphamvu a reflux amalephera kuyankha antacids kapena mankhwala ena. Pazochitika zoterezi, pali mayesero angapo omwe madokotala angagwiritse ntchito kutsimikizira kuti akudwala matendawa, kuphatikizapo X-rays, endoscopy, ndi manometry ochepa kwambiri.
Kujambula
Matenda aang'ono omwe amawoneka kuti ndi ovuta nthawi zambiri amawoneka ovuta pa X-ray nthawi zonse ndipo amawoneka ngati gasi wodzaza ndi mpweya mu chifuwa. Pofuna kutanthauzira bwino, zoyezetsa zojambula monga GI Barium Study kapena computed tomography (CT) scan ingathenso kulamulidwa.
Barium Phunziro
Njira yodziŵika bwino ya nthendayi yotchedwa hiatal ndi matenda apamwamba a m'mimba (GI). Kawirikawiri amatchedwa " Barium swallow" , kuyesa kumafuna kumwa makapu amodzi ndi theka a madzi otentha omwe ali ndi barium sulphate ndipo, pafupi maminiti 30 kenako, amatha kujambula ma X-ray. Chitsulocho chimavala malaya ndi mimba, zomwe zimathandiza kuti azidzipatula m'maganizo.
Ngati mutayesedwa, yang'anani kuti mupangidwe pa tebulo pamene mukuchita X-rays. Phunziroli, tebulo imasokonezeka pamene mumamwa bokosilo.
Ngakhale kuti ndondomekoyi imakhala yotetezeka, ikhoza kuyambitsa kudzimbidwa ndipo, kawirikawiri, zimakhala zovuta.
Ngati simungathe kukhala ndi kambuku masiku awiri kapena atatu mutatha, pitani dokotala wanu.
CT Scan
Kafukufuku wa barium nthawi zambiri amatha kudziwitsa bwinobwino. Ngati simungathe kuchita zimenezi, pulogalamu ya tomography (CT) ingayambe. Izi zikhoza kukhala zofunikira kwa anthu omwe ali ovuta kwambiri kapena atachita opaleshoni ya m'mimba yapitayo.
Kansalu ya CT ingakhale yofunika kwambiri pavuto ladzidzidzi, monga gastric volvulus (vuto lalikulu limene m'mimba limapotoza madigiri oposa 180) kapena strangulation (kumene kuponderezedwa kapena kupotoza kwa herniation kumadula magazi).
Ndondomeko ndi Mayesero
Dokotala wanu angafune kuyang'anitsitsa kuti apange matenda, kapena kufuna zotsatira zina kuti atsimikizire chimodzi kapena kuzindikira kukula kwa chikhalidwe chanu. Pazochitikazi, zotsatirazi zingaganizidwe:
Pamwamba GI Endoscopy
Nthenda yowonongeka ingapezekenso ndi njira yomwe imadziwika kuti pamwamba ya GI endoscopy . Imeneyi ndi njira yowoneka bwino yomwe imakhala yotetezeka, yotchedwa endoscope, imayikidwa m'kamwa mwanu kuti mupeze zithunzi zamoyo za mimba, m'mimba, ndi duodenum (gawo loyamba la matumbo aang'ono).
Njirayi idzafuna kuti musiye kudya kapena kumwa maola anayi kapena asanu musanayese kuyesedwa. Musanayambe ndondomekoyi, mumapatsidwa chiopsezo chotere pofuna kukuthandizani. Mphuno yopweteka pamtima pako ikhoza kugwiritsidwanso ntchito. Njirayi imatenga pakati pa 10 ndi 20 mphindi, ndi ola lina lofunika kuti libwezeretse ku sedation.
Endoscopy nthawi zina imayambitsa kuphulika, mpweya, kupweteka, ndi pakhosi. Itanani dokotala wanu ngati muli ndi malungo, zilonda, ululu m'mimba, kapena kutuluka m'mphuno.
Esophageal Manometry
Manophythra yokhayokha ndi njira yatsopano yomwe imayesa momwe minofu ya mimba ndi esophageal sphincter (valve) ikugwirira ntchito. Zingathandize dokotala kudziwa mavuto omwe amagwira ntchito, monga dysphagia (zovuta kumeza), komanso momwe hernia ingakhale ikuwathandizira.
Ndondomekoyi imachitidwa poyambitsanso chingwe ndi mafuta onunkhira. Thupi lochepa kwambiri, lokhala ndi masensa, limadyetsedwa kudzera mumphuno mwanu mpaka pansi. Kujambula kwa digito kumapangitsa wogwira ntchito kuti ayang'ane ndi kusindikiza kusintha pampanipani pamene mukudya.
Chotsatira cha manometry chingathandize dokotala kudziwa njira yoyenera yothandizira.
Pakhosi ndi phokoso la mphuno ndizo zotsatira zofala kwambiri.
Kusaka Esophageal pH
Kuwunika kwapopugeal pH ndiyeso yogwiritsira ntchito kusintha kusintha kwa acidity kwa nthawi yanu (monga kuyesedwa ndi pH ). Zimaphatikizanso kuyika kwa sensa yotengera phukusi kudzera mumphuno yomwe imagwirizanitsidwa ndi chovala chimene mumavalira pa lamba wanu. Pa maola 24 otsatirawa, mawonekedwewa amalembetsa nthawi iliyonse yomwe mumakhala ndi asidi reflux ndikulemba kusintha kosiyanasiyana pa ma pH.
Kulemba
Kamodzi kokha kafukufuku kameneka kamapezeka kuti kamasankhidwa ndi mtundu, chomwe chingathandize chithandizo choyenera komanso / kapena kugwiritsidwa ntchito kuyang'anira kusintha kulikonse mu chikhalidwe chanu. Mitunduyi imasankhidwa ndi kukula ndi makhalidwe a hernia:
- Mtundu 1 umadziwika ngati chiphuphu chotsitsa; mimba imakhalabe mwachizoloŵezi chake pamene gawo la herniated limalowa mkati mwa hiatus (dzenje mu mzere umene umatuluka).
- Mtundu Wachiwiri ndi chithumwa cha pharaeophageal, chimene sichidutsa mkati ndi kunja kwa hiatus koma chimakhala chokhazikika pafupi ndi chigawocho.
- Mtundu wachitatu umachitika pamene mgwirizano wa gastroesophageal (mgwirizano pakati pa mimba ndi m'mimba) umayamba kuphulika kudzera mu hiatus.
- Mtundu wa 4 umachitika pamene herniation imalola mimba ndi ziwalo zina, monga colon kapena chiwindi, kuti alowe mkati mwa chifuwa.
Kusanthula Kusiyanasiyana
Zizindikiro za reflux zamadzimadzi si zachilendo kwa anthu omwe ali ndi vuto lachiberekero. Mankhwala akuluakulu amachititsa zizindikiro zina, zozama kwambiri monga kupweteka pachifuwa, kusanza, kubwezera, ndi aspiration chibayo (chifukwa chokakamira chakudya m'mapapo).
Ngakhalenso ngati chitsimikizo cholera chitsimikizirika chimatsimikiziridwa, zingakhale zofunikira kuti munthu asapatsidwe matenda osiyanasiyana kuti asatuluke zina, makamaka ngati hernia ndi yaing'ono komanso yosagwirizana ndi kuopsa kwa zizindikiro. Zina mwazifukwa zina zowonjezera ndizo:
- Angina , yomwe ingathe kusiyanitsidwa pamayesero a mtima wa mtima
- Chibayo , zomwe zimayambitsa zikhoza kusiyanitsidwa ndi chifuwa cha X-ray ndi mayeso a magazi
- Matenda a reflux a Gastroesophageal (GERD) , omwe amatha kusiyanitsidwa ndi chikhalidwe choopsa cha zizindikiro, komanso zizindikiro za kuchepa kwa dzino kapena mano
- Kutsekemera kwa m'mimba, zomwe zingathe kusiyanitsidwa ndi kuwonongeka kwa pylorus (kutsegula kuchokera mmimba kupita ku duodenum) osati hiatus
> Zotsatira:
> Roman, S. "Kuzindikira ndi kusamalira chikhalidwe cha hiatus." BMJ. 2014; 349: g6154. DOI: 10.1136 / bmj.g6154.
> Bungwe la Amayi Am'mimba a American and Endoscopic Opaleshoni (SAGES). "Malangizo Othandizira Kulamulira kwa Hernia ya Hiatal." Los Angeles, California; yakutuluka mu April 2013.