Hernia Diaphragmatic - yisiphi isizathu okuyisona nesenzakalo?

Lapho kukhulunywa ngaye okokuqala "hernia diaphragmatic" libhekisela ngekhulu le-16. It kungokwalabo umelaphi owaziwa wesikhathi - Ambroise Pare. Leli gama kufanele kuvisiswe kokuziphatha ezinye izitho zangaphakathi ngokusebenzisa isici diaphragm.

Kufanele uqaphele ukuthi ngaphansi semfene ezithile ezivukayo emirarweni kule ukuthuthukiswa embryonic umbungu, kungase kube ngokwengxenye noma ngokuphelele diaphragm yokulimala izinsana. Kuleso simo, uma lokho kwephula olwenziwa kuze kumiswa diaphragm, lo umbhunu ngeke ibe sac umbhunu. Uma ngeziphambeko ukuthuthukiswa okwenzeka ngemva kokuba ama kumiswa ulwelwesi diaphragm is lwangena amafilimu ehlanganisa serous sac hernial ngokusebenzisa indandatho hernial eliqukethe akukho imisipha.

Area uxhumano izimbambo kuya sternum, okuyinto elingenalo imisipha, iyona kwazalelwa hernia sterno-costal. Kungenjalo, bebizwa hernias sternokostalnymi. Lokhu sengozini ibizwa ngokuthi unxantathu sternokostalnym Larrey, futhi umbhunu okubangelwa khona, nayo ibizwa ngokuthi unxantathu hernia Larrey sika.

hernia Diaphragmatic kungadalwa izizathu ezahlukene. Ake sithi, lesi sifo ukuthi oluthathwa Petrovsky, njengoba kulandela:

1. hernia wathola ngenxa yokulimala (hernia kuhlasimulise):

- amanga;

- kweqiniso.

2. hernia-non-kuhlasimulise:

- amanga azalwa naso;

- ababuthakathaka kweqiniso hernia beso zone;

- Diaphragmatic hernia orifices:

- hernia kweqiniso kwasendaweni atypical;

3. hernia ngomphimbo ukuvulwa;

4. ezingavamile hernia orifices.

Uma hernia diaphragmatic, izimpawu zazo kuhlobane ngokuqondile ukulimala noma ukulimala, ihlukaniswe kuphela yamanga weqiniso, hernia-non-kuhlasimulise abe ngezigaba ebanzi. I zamanga kuphela hernia azalwa naso ukuthi kwenzeka ngenxa yokulimala ekwakhiweni diaphragm (emfantwini besisu kanye izimbotshana thoracic).

Ukuze umbhunu diaphragm kweqiniso ababuthakathaka hernia esishintshashintshayo zihlanganisa unxantathu sternum-costal. Kule ndawo, ama-thorax ahlukaniswa peritoneum ipuleti ezondile ezicutshini elise phakathi peritoneum futhi pleura.

Retrostenalnye hernia libhekene ampofu sternum diaphragm ndawo.

Akuvamile kakhulu hernia vena cava, nonozwela ezinzwa igebe aorta. Uhlobo oluvame kakhulu (cishe ngo-98% azo zonke izimo) kuyinto diaphragmatic hiatus umbhunu.

It has yayo izici yokwakheka. Kunezinhlobo eziningana yalesi sifo. Lezi hernia yilezi: ekhuphuka, nge ushintsho emphinjeni (nge kokunciphisa, ngaphandle kunciphisa); inhliziyo; subtotal; kardiofundalnaya; Imininingwane.

Ekhona paraesophageal hernias zihlukaniswe: emathunjini, ukugxusha, fundic, emathunjini.

Ochwepheshe ukuhlukanisa phakathi:

1. azalwa naso "mfushane emphinjeni";

2. paraesophageal umbhunu, lapho ingxenye isisu ngokuvamile itholakala ohlangothini emphinjeni;

3. hernia hiatal beya, lapho inhliziyo emphinjeni endaweni esiswini kungenziwa kubuyiswe phakathi komgodi webele.

hernia Paraesophageal, njengoba beya kungenzeka azalwa naso noma bathenga, kodwa ezingavamile kakhulu ukwedlula aluthola hernia azalwa nako. Ngo abantu Usufike iminyaka engu-40, kuvamile kakhulu hernia kuluthola. Lokubaluleke kakhulu iminyaka involution kwezicubu, okuholela ukuwathuthukisa buthakathaka ukuvulwa ngomphimbo ukuxhumana diaphragm kanye kuqhoqhoqho.

Imbangela ezivame kakhulu herniation yizici ezimbili. Esinye isizathu singaba ukuhlonipha -pulsatsionny, lapho kumiswa hernia is ngenxa ukwanda ingcindezi naphakathi-besisu (umsebenzi esindayo, ukubuyisa, ukudla, ukukhulelwa, njalo amabhande egqoke Friend). Esinye isici - the traction lihlotshaniswa gipermotorikoy emphinjeni kubangelwa ukuhlanza njalo.

A indima ebalulekile ekunqumeni uphethwe udlala-X-ray luhlolo. hernia Diaphragmatic ihlukaniswe ubukhulu ezincane (3 cm), eliphakathi (3 kuya kwezingu-8 cm) futhi ezinkulu (ngaphezu kuka-8 cm).

hernia Diaphragmatic baphathwe izindlela olandelanayo kungenzeka nemiphumela ebesiyilindele, kungcono kakhulu iphathwa surgically.