I-fistula ebangelwa yi-congenital ye-inophagus ezinganeni

I-fistula ekhulile ingahlukaniswa noma ihlangene, ngokuvamile ihlanganiswe ne-atresia ye-esophagus. Ama-fistula yizintambo ezingenalutho ezixhuma isibani se-esophagus noma i-anastomosis nge-tube yokuphefumula (i-trachea, i-bronchi) noma imvelo yangaphandle ngokusebenzisa umgodi wesikhumba (i-fistula yangaphandle ye-esophagus). I-fistula engama-fentu ebusweni ebusweni ihlukaniswa njengento engavamile yezinkinga zezingxenye zalesi sigaba sokugaya. I-fistula eyaziwa kakhulu futhi eyaziwa kakhulu yi-fostula esophageal-tracheal ne-esophageal-bronchial, enezinhlobonhlobo ezihlukahlukene ze-esophagus ne-airways: i-esophagus ne-trachea inodonga oluvamile, inkambo ye-fistulous iyinde futhi imincane, inkambo ye-fistulous iyifushane futhi ibanzi. I-fistula yendawo, njengombuso, ezingeni lama-vertibrae angu-1-2. Ucwaningo olwengeziwe lwe-fistula morphology lwanikezelwa emisebenzini ye-AP Biesin (1964), GA Bairov, NS Mankina (1977).

I-fistula ebangelwa yilezi zinyama zivela ngenxa yokungaqedi okuphelele kwe-tube yomzimba emathunjini emathunjini.

Izimpawu zomtholampilo

Izimpawu zomtholampilo zivela emahoreni ambalwa emva kokuzalwa komntwana ekudleni kokuqala. Zinqunywe ngokuhlukahluka kokungafani kokulinganisa. Ezimweni zodonga oluvamile lwesigcawu kanye ne-trachea, kanye nenkambo emfushane neyinkimbinkimbi ngokushesha ngemva kokudla kokubili, okubangela ukuphazamiseka okukhulu kokuphefumula, ukulandelana kwe-sequentially, ne-hypoxia. I-Cyanosis ivela. Esikhathini esilandelayo kukhona ukuzila ukudla kanye ne-pneumonia. Ukukhwehlela kwe-paroxysmal kuncane uma kudlalwa nge-probe. Ngesikhathi esifanayo, ukudla akukwazi ukufinyelela ezindleleni ezihamba emoyeni.

Ezimweni zenkambo ende futhi emincane efana nezingane ezinamaviki okuqala okuphila, ukukhwehlela nakuba kubonakala, kodwa kuboniswe kancane. Ukuhlambalaza akuvamile. Nokho, ekupheleni kokuphela, ngisho nokudla okuncane okuwela emgodini wokuphefumula, ngenxa yokuthi ukuhlaselwa ukukhwehlela kuyaba nzima kakhulu, ukuhluleka kokuphefumula kwanda, futhi kuphunyuleka isibhamu.

Okufundiswa kakhulu ekuhloleni i-fistula ye-esophagus isophagoscopy kanye ne-itraheobronchoscopy. Ngosizo lwe-esophagoscopy, umuntu angabona umgodi wokungena we-oviposition nokubonakala kwamabhulebhu emoyeni esifundeni salo mgodi, kanye ne-mucus frothy. Ngosizo lwe-tracheobronchoscopy, ukungenisa (ukuvuza) ngokusebenzisa i-fistula ekuphefumuleni kokudla okuncane okutholakala, ukucasuka kwekhanda elimangcwaba le-trachea noma i-bronchus endaweni yokuphuma ye-fistula. Indlela ebalabala nayo isetshenziselwa ukubona ukuxhumana kwesiguli ngenqubo yokuphefumula ngokusebenzisa inkambo ye-fistulous. Ukuze wenze lokhu, tint i-liquid esetshenziselwa umntwana ukuphuza, i-methylene eluhlaza okwesibhakabhaka. Ukubonakala kwepende emphefumulweni wokuphefumula kuqinisekisa ukutholakala kwe-fistula.

Kokubili i-esophagoscopy ne-tracheobronchoscopy yenziwa ngaphansi kwe-anesthesia jikelele.

Ngokuqondene nokuxilongwa nge-radiological of fistula esophageal, kubalulekile ukuhlolisisa izihlobo. Okokuqala, ngoba isifundo esisebenzisa i-medium medium esangena emgodini, bese singena e-fistula ngokusebenzisa ukungena, kuholela ekwakhiweni kwesifiso esinamandla se-pneumonia (phambi kwe-pneumonia, ukuhlolwa okungafani kuyaphikisana). Okwesibili, ukutadisha ngaphandle kwe-agent ehlukileko akuvezi ukuveza i-fistula. Kukhona indlela engafanele yokuthola ukuphefumula kwesifo sokuphefumula, okuwukuqhathaniswa kwezimpawu zomtholampilo zokuhluleka ukuphefumula kanye nesimo samaphaphu. Ukuze wenze lokhu, ukuhlolwa kwe-X-ray yamaphaphu. Uma kungekho izibonakaliso zokuguquka kokuvuvukala emathunjini emaphaphu uma kwenzeka kukhwehlela, ukuthuthukiswa kokuhluleka ukuphefumula ezinganeni ezincane, umuntu angacabanga ngokukhona kwesifo se-fistula. Uma ingane isivele ihlakulele i-aspiration pneumonia, ke, le ndlela yokuxilonga ayinandaba ngempela. Ngakho-ke, ukuhlolwa kwe-X kufanele kwenziwe ngokucophelela, kukhumbula engenhla.

Ukwelapha

Ukwelashwa kwesiguli kuyinto yokuhlinzwa. Ukwelashwa okufike ngesikhathi kuphulukisa isiguli. Ngokwelashwa kokusebenza kokuphela kwesikhathi, ukubikezela kunqunywa umlingiswa kanye nobude bezinkinga ze-bronchopulmonary.

Khula enempilo!