He aha ia Zenker's Diverticulum a pehea e mālama ʻia ai?

Anter

• Nā anuu
• He aha nā hōʻailona?
• He aha ke kumu o kēia?
• Pehea ia ʻike?
• 'Kali a ʻike' kokoke
• Lapaʻau ʻoki kino
• Nā kaʻina hana Endoscopic
• ʻOki kino wehe
• He aha nā pilikia?
• Outlook

He aha ka divertikulum a Zenker?

ʻO Divertikulum kahi huaʻōlelo olakino e pili ana i kahi ʻano like ʻole o ka ʻeke. Hiki ke hana ʻo Diverticula ma kahi o nā wahi āpau o ka tract digestive.

Ke kū nei kahi ʻeke ma ka huina o ka pharynx a me ka esophagus, ua kapa ʻia ʻo Zenker's divertikulum. Aia ka pharynx ma ka hope o kou puʻu, ma hope o kou ihu a me kou waha.

Hōʻike maʻamau ʻo Zenker's diverticulum i ka hypopharynx. ʻO kēia ka hapa ʻōmole o ka pharynx, kahi e hoʻopili ai i ka paipu (esophagus) e alakaʻi ai i ka ʻōpū. Hōʻike maʻamau ʻo Zenker's diverticulum ma kahi i ʻike ʻia ʻo Killian's triangle.

Kākaʻikahi ka hoʻohuli ʻana o Zenker, e hoʻololi nei ma waena o ka heluna kanaka. Kū ʻia ia i waena o ka ʻelemakule a me nā mākua makua, ʻo ka poʻe hoʻi i ko lākou 70 a me 80. Kākaʻikahi ka hoʻohuli a Zenker ma waena o ka poʻe ma lalo o 40. Hoʻololi ia i nā kāne ma mua o ka wahine.

Kapa ʻia ia ma ke ʻano he divertikulum pharyngoesophageal, diophic hypopharyngeal, a i ʻole ʻeke pharyngeal.

Nā anuu

Nui a hewahewa nā ʻōnaehana no ka hoʻokaʻawale ʻana i kā Zenker divertikulum:

He aha nā hōʻailona?

ʻO ka ale ʻana i ka paʻakikī, ka mea i ʻike ʻia ʻo dysphagia, ka ʻōuli maʻamau o ka divertikulum a Zenker. Hōʻike ʻia ma kahi o 80 a 90 paha ka pākēneka o ka poʻe me kā Zenker divertikulum.

ʻO nā ʻōuli ʻē aʻe a me nā ʻōuli o kā Zenker divertikulum e komo pū ana:

• regurgitating ka meaʻai a i ʻole ka lāʻau waha
• hanu maikaʻi ʻole (halitosis)
• leo uō
• ʻū mau
• ale ʻana i nā wai a i ʻole nā ​​mea ʻai “iho i ka paipu kūpono ʻole” (aspiration)
• ʻike i ka puʻupuʻu i kou puʻu

Inā haʻalele ʻole ʻia, hiki i nā ʻōuli o kā Zenker divertikulum ke hōʻino ma mua o ka manawa.

He aha ke kumu o kēia?

ʻO ka ale ʻana kahi hana paʻakikī e koi ai i ka hoʻohui ʻana o nā mākala ma ka waha, pharynx, a me esophagus. Ke ale ʻoe, wehe ʻia kahi mākala puni i kapa ʻia ka sphincter esophageal luna e ʻae i nā mea ʻai nau. Ma hope o kou moni ʻana, pani ka sphincter esophageal o luna e pale i ka ea hanu mai ke komo ʻana i ka esophagus.

ʻO ka hoʻokumu ʻana o kā Zenker divertikulum e pili ana i ka hana ʻana o ka sphincter esophageal luna. Ke wehe ʻole ka sphincter esophageal o luna i nā ala āpau, kau ʻia kaomi ma kahi o ka paia pharynx. ʻO kēia kaomi nui e hoʻolei i ka mea i waho i waho, e hana iā ia i diverticulum.

Manaʻo ʻia ʻo Gastroesophageal reflux disease (GERD) a me nā loli pili i ka makahiki i ka haku mele a me nā leo o nā mākala e hana i kēia hana.

Pehea ia ʻike?

E kamaʻilio me kāu kauka inā ʻoe a i ʻole kekahi mea āu e mālama nei e ʻike nei i nā ʻōuli o kā Zenker divertikulum.

ʻIke ʻia ka diverticulum a Zenker me ka hoʻohana ʻana i kahi hoʻokolohua i kapa ʻia ʻo barium telow. ʻO kahi barium moni kahi X-ray kūikawā e hōʻike i ka loko o kou waha, pharynx, a me ka esophagus. Hāʻawi kahi barium i ka fluoroscopy i kāu kauka e ʻike pehea ʻoe e ale ai i ka neʻe.

I kekahi manawa, aia nā kūlana ʻē aʻe ma ka ʻaoʻao o kā Zenker divertikulum. Hōʻike paha kāu kauka i nā hoʻokolohua hou aku e ʻike ai a kāpae paha i nā kūlana ʻē aʻe. ʻO kahi endoscopy luna kahi hana e pili ana i ka hoʻohana ʻana i kahi laulā lahilahi, i lako pono ʻia me ka pahupaʻi e nānā i ka ʻāʻī a me ka esophagus. ʻO ka manometry esophageal kahi hōʻike e ana i ke kaomi i loko o ka esophagus.

'Kali a ʻike' kokoke

ʻAʻole koi ʻia nā hihia akahai o kā Zenker divertikulum i ka lāʻau koke. Kaukaʻi ʻia i kāu mau ʻōuli a me ka nui o ka divertikulum, e ʻōlelo paha kāu kauka i kahi ala "kali a ʻike".

ʻO ka hoʻololi ʻana i kāu ʻano ʻai hiki i kekahi manawa ke kōkua i ka hoʻomaikaʻi ʻana i nā ʻōuli. E hoʻāʻo e ʻai i nā mea ʻai liʻiliʻi i loko o ka noho hoʻokahi, e nau pono ʻana, a me ka inu ʻana ma waena o nā nahu.

Lapaʻau ʻoki kino

ʻO ke kūlana kaulike i nā hihia koʻikoʻi o kā Zenker divertikulum e koi pinepine ai i ke ʻoki. Aia kekahi mau koho ʻoki. Hiki i kāu kauka ke kōkua iā ʻoe e hoʻomaopopo i kahi koho kūpono loa nāu.

Nā kaʻina hana Endoscopic

I ka manawa o ka endoscopy, hoʻokomo kahi kauka lāʻau i ka mea lahilahi, e like me ka paipu i kapa ʻia he endoscope i loko o kou waha. Hoʻokomo ʻia ka endoscope me ke kukui a me ka pahu paʻi kiʻi. Hiki ke hoʻohana ʻia e hana i kahi ʻoki i loko o ka paia e hoʻokaʻawale i ka diverticulum mai ka uhi o ka esophagus.

Hiki ke paʻakikī a maʻalahi ʻole nā ​​endoscopies no kā Zenker's divertikulum. Hoʻohana kahi endoscopy ʻoʻoleʻa i kahi endoscope undendable a koi i ka anesthesia ākea. Pono nā endoscopies ʻoʻoleʻa i ka hoʻonui ʻana o ka ʻāʻī nui.

Ma muli o ka makaʻu o nā pilikia, ʻaʻole koi ʻia kēia kaʻina hana no ka poʻe i loaʻa iā:

• he divertikulum liʻiliʻi
• he papa kuhikuhi kino nui
• paʻakikī e hoʻonui i ko lākou ʻāʻī

Hoʻohana kahi endoscopy maʻalahi i endoscope bendable a hiki ke hoʻokō ʻia me ka ʻole o ka anesthetic laulā. ʻO ia ka koho ʻoki kino loa i loaʻa no ka mālama ʻana i ka divertikulum o Zenker. ʻO ka maʻa mau kahi kaʻina hana i waho e lawe i kahi haʻahaʻa haʻahaʻa o nā pilikia.

ʻOiai hiki i nā endoscopies maʻalahi ke maʻalahi i nā ʻōuli o kā Zenker divertikulum, hiki ke kiʻekiʻe i nā helu hou. Hiki ke hoʻohana ʻia i nā kaʻina hana endoscopy lehulehu hiki ke hoʻoponopono i nā ʻōuli hou.

ʻOki kino wehe

Ke hiki ʻole kahi endoscopy a nui paha ka divertikulum, ʻo ke kaha hāmama ke koho aʻe. Hana ʻia ka ʻoki lāʻau no ka divertikulum o Zenker ma lalo o ka anesthetic laulā.

E hana kahi mea lapaʻau i kahi ʻoki liʻiliʻi i kou ʻāʻī i mea e hoʻokō ai i kahi divertikulomi. Hoʻopili kēia i ka hoʻokaʻawale ʻana i ka diverticulum mai kou paia esophageal. I nā hihia ʻē aʻe, hana ka lāʻau lapaʻau i divertikopexy a i ʻole i ka hoʻohuli diverticular. Pili kēia mau kaʻina hana i ka hoʻololi ʻana i ke kūlana o ka diverticulum a humuhumu iā ia i kahi.

Loaʻa i kahi kahakaha ke kiʻekiʻe o ka helu o ke kūleʻa, me nā ʻōuli e ʻike ʻole ʻia i ka wā lōʻihi. Eia nō naʻe, koi ʻia kahi noho haukapila i kekahi mau lā a i kekahi manawa, hoʻi i ka haukapila e wehe i nā humuhumu. Pono paha ʻoe e hoʻohana i kahi paipu hānai no hoʻokahi pule a ʻoi paha e pili ana i ke kaʻina hana. E ʻōlelo paha kāu kauka e pili ana i ka papaʻai kūikawā ke hoʻōla ʻoe.

He aha nā pilikia?

Inā haʻalele ʻole ʻia, hiki i kā Zenker divertikulum ke hoʻonui i ka nui, e hoʻonui ana i kāu mau ʻōuli. I ka hala ʻana o ka manawa, hiki i nā ʻōuli koʻikoʻi e like me ka paʻakikī ke ale ʻana a me ka regurgitation hiki ke paʻakikī i ka noho olakino ʻana. Hiki paha iā ʻoe ke ʻike i ka hōʻino kino.

ʻO Aspiration kahi hōʻailona o kā Zenker divertikulum. Hana ʻia ia i ka wā e hanu ai ʻoe i ka meaʻai a i ʻole nā ​​mea ʻē aʻe i loko o nā ake māmā ma kahi o ka ale ʻana iā ia i loko o ka esophagus. ʻO nā pilikia o ka ʻiʻini e komo pū me ka pulumonia aspiration, kahi maʻi i hiki ke hoʻopaʻa ʻia ka meaʻai, lawai, a me nā mea ʻē aʻe i loko o kou mau ake māmā.

ʻO nā pilikia paʻakikī ʻē aʻe o kā Zenker divertikulum e komo pū ana:

• āpana esophageal (choking)
• hemorrhage (kahe ana ke koko)
• lolo uila
• carcinoma sele uila
• fistulas

Ma kahi o 10 a 30 paha ka pākēneka o ka poʻe e hana ana i ke kīʻaha hāmama no ka loaʻa ʻana o nā pilikia ma waena o Zenker. ʻO nā pilikia i hiki ke hoʻopili ʻia:

• pulumonia
• mediastinitis
• ʻino nā hōʻino (palsy)
• hemorrhage (kahe ana ke koko)
• hoʻokumu fistula
• maʻi maʻi
• stenosis

E kamaʻilio i kāu kauka e pili ana i nā pilikia o ke kīpē hāmama no kā Zenker divertikulum.

Outlook

ʻO kahi diverticulum a Zenker kahi ʻano maʻamau e pili pinepine i nā ʻelemākule. Hana ʻia ia i ka wā e hoʻopaʻa ai kahi ʻeke o nā kiko kahi e hui ai ka pharynx me ka esophagus.

ʻAʻole koi ʻia nā ʻano akahai o kā Zenker divertikulum i ka lāʻau. ʻO ka hoʻomaʻamaʻa ʻana no nā ʻano kaulike a paʻakikī hoʻi o kā Zenker's divertikulum maʻa mau i ke ʻoki.

ʻO ka nānā manawa lōʻihi no ka divertikulum o Zenker maikaʻi. Me ka lapaʻau, ʻike ka hapanui o ka poʻe i kahi hoʻomaikaʻi o nā hōʻailona.