Ukuhlaziywa kobunzima

Okuqukethwe okuqinisekisiwe

Umfantu wendundu ukudabuka okuwumngcingo nokungashoni noma izilonda kufinyila lomsele womgudu wokugaya ukudla emngceleni we-rectum ne-anus). I-fissure ibangelwa ukucindezeleka okukhulu ekugcineni komsele we-anal ngesikhathi sokuzikhandla ngokomzimba noma ukuqunjelwa. Lesi sifo sivela kubantu bayo yonke iminyaka, abesilisa nabesifazane.

I-anal fissure - incazelo

I-anal fissure ibangelwa ukungezwani okuphezulu ekugcineni komsele wangemuva (ngenxa yokuzivocavoca, ukuqunjelwa okungapheli kanye / noma ukungezwani okwandayo kwe-anal sphincters). Ibonakala ngokubunjwa kwesilonda somugqa we-anal canal mucosa, ngokuvamile etholakala engxenyeni engemuva noma emaphakathi yomsele. Lesi sifo singase futhi sibonakale ngenxa yokutheleleka noma i-mucosa ischemia endaweni ye-mucosa. I-anal fissure ingenzeka kubantu babo bonke ubudala, kokubili amadoda nabesifazane. Esimweni sokugcina, inani eliphezulu lokukhulelwa nokubonisana kwandisa ingozi yesifo.

Izimbangela zokwakheka kwe-fissure anal

Sales iyisiqephu esiqinile, esifushane (3-6 cm) kanye nesiphetho somgudu wokugaya ukudla esizungezwe imisipha ye-anal sphincter: yangaphakathi nangaphandle. I-anal fissure ekuseni emseleni we-anal okwenzeka lapho ungqimba lwangaphakathi lwe-anus luqhuma. Ngokuvamile kwenzeka ngemva kokuxoshwa kwesihlalo esiqinile (khona-ke kukhona ukuhlukumezeka komshini kanye nokwelula kakhulu kwe-anus nokuphuka kwesendlalelo sayo sangaphakathi).

Esinye isizathu sokuqhekeka kwendunu kungase kube indle exegayo, ekhishwa yisisu. Bese kuba khona ukucasuka kwamakhemikhali ngamajusi okugaya ukudla, angena ngokushesha endaweni yendunu futhi acasule indawo esengozini yokuhlukumezeka, okungukuthi imifantu ngaphakathi. Lokhu kudala inxeba engxenyeni engaphakathi yedidi ebizwa ngokuthi i-anal fissure. Ihamba ngobude eduze kwe-eksisi ende ye-anal canal futhi itholakala kaningi (ngama-85% amacala) ukusuka phezulu (kusuka ngemuva), kancane kancane (10%) ukusuka phansi (kusuka esithweni sangasese kwabesifazane, kusukela i-scrotum emadodeni), kuyaqabukela kakhulu kwamanye ama-periphery of anus. Kwesinye isikhathi kuba namanxeba angaphezu kwelilodwa (imifantu).

Ezinye izici ezithonya ukwakheka kwe-anal fissure zihlanganisa:

1. izilonda emathunjini,
2. Isifo sikaCrohn,
3. ucansi lwendunu (okuvamile),
4. ukutheleleka kwezindlala ze-anal,
5. ukuzikhulula ngendlela yendle eqinile nehlangene,
6. ukuqunjelwa isikhathi eside
7. ukubeletha isikhathi eside, lapho umntwana ezalwa enesisindo esikhulu sokuzalwa (khona-ke udokotela kufanele asebenzise izitho ezisizayo),

Ukuhlukaniswa komfantu we-anal

I-fissure yangemuva ingaba;

1. i-acute - khona-ke inohlobo lomonakalo omusha ku-mucosa yomsele we-anal,
2. okungapheli - njengesici ku-mucosa ye-rectal engakapholi phakathi namasonto ayisithupha okuqala kwezimpawu.

Kuphi umfantu wendundu?

1. Umugqa ongemuva wangemuva womsele wangemuva - ovame kakhulu.

2. Umugqa wangaphambili omaphakathi womsele wendunu.

3. Ingemuva eliphakathi nendawo nomsele wangaphambili wangemuva.

4. I-Lateral rectal quadrants (ikakhulukazi ezigulini ezinesifo sikaCrohn, umdlavuza, i-leukemia noma isifo sofuba).

Izimpawu ze-anal fissure

Izimpawu zomfantu wendundu ziyefana nalezo ze-hemorrhoids noma i-fistula yangemuva. Isici esibaluleke kakhulu ubuhlungu, ukopha kanye nokuvutha ngesikhathi sokuzikhulula. Ubuhlungu buvame ukuzwakala njengoba indle idlula edidi kanye nemizuzu embalwa ngemva kokuyidlulisa, ngemva kwalokho ngokuvamile iyazixazulula ngokwayo. Kunezimo lapho ubuhlungu bungahlala nesiguli isikhathi eside, okuvimbela ukusebenza okuvamile. Kungaba noma kulume, futhi kungaba namandla noma kungabonakali. Ukwengeza, ukulunywa, ukushisa noma ukungakhululeki ku-anus ne-perineum kungase kube khona.

Ukopha cishe njalo kwenzeka lapho udlula indle. Ngokuvamile, igazi libonakala ephepheni lapho lisulwa, endishini yasendlini yangasese, noma njengebala esitulweni. Kwesinye isikhathi ukopha kukhulu, kuhlale isikhathi eside kunomzuzu wokuzikhulula, futhi izimpawu ziyabonakala engutsheni yangaphansi. Ngaphezu kwalokho, kungase kube nokukhishwa okumanzi emaphethelweni e-anus. Olunye uphawu lwe-anal fissure umuzwa wokucindezela okukhulu esitulweni.

I-anal fissure - ukuxilongwa kwesifo

Izimpawu zomtholampilo, ezivezwa ngesikhathi sokuxoxisana kwezokwelapha nesiguli, zidlala indima eyinhloko futhi ngesikhathi esifanayo isisekelo sokuxilongwa. Ngokulandelayo, ukuze kuqinisekiswe okokugcina kwezinsolo, kuyadingeka ukwenza ukuhlolwa kwe-proctological. Lolu hlobo lokufunda:

1. endaweni entsha ye-anal fissure kuveza ukuba khona kokugqashuka komugqa we-mucosa ye-anal canal kanye nobuhlungu,
2. izigaxana ze-sentinel zembulwa ku-fissure engapheli yangemuva; imicu eqinile yemisipha ye-sphincter yangaphakathi yangaphakathi phansi kwe-fissure; ukukhubazeka kwe-mucosa ngendlela yesilonda se-longitudinal esinamaphethelo aqinile; ingono ye-perianal ekhule ngokweqile.

Abanye abantu bangase bakuthole kunzima ukwenza ukuhlolwa kwe-proctological noma i-anoscopy ngenxa yobuhlungu obuhambisana nakho. I-anoscopy ihlanganisa ukuhlola i-anus kanye ne-rectal fragment ngaphezu kwayo (8-15 cm). Okunye ukuhlolwa kokuxilonga i-signoidoscopy (ikakhulukazi ezigulini ezingaphansi kweminyaka engama-50, ezingenamlando womdlavuza). Kodwa-ke, kwabanye abantu abane-co-occurring rectal blood, kunconywa i-colonoscopy. Kubandakanya ukuhlola wonke amathumbu amakhulu nazo zonke izingxenye zawo: i-rectum, ikholoni ye-sigmoid, ikholoni eyehlayo, ikholomu eguquguqukayo, ikholoni ekhuphukayo kanye ne-cecum - usebenzisa i-speculum eguquguqukayo (kufika ku-130 cm). Ngesikhathi sokusebenza kwabo, kungenzeka ukuthatha isampula endaweni enesifo, susa isilonda, isb i-polyp.

Ukwehluka

Kungaba iphutha ukwelapha i-anal fissure ethatha amasonto, ngezinye izikhathi izinyanga, ngaphandle kokukhipha ngaphambili isifo esibi kakhulu esenzeka phezulu emathunjini. Lokhu kuyiqiniso ikakhulukazi kubantu abangaphezu kweminyaka engama-50 noma ezigulini ezinomlando womndeni womdlavuza we-colorectal. Isitatimende sokuthi isiguli ngokuqinisekile sinomfambo wendundu futhi sopha kuso asikushiyi ngaphandle ukuthi singase sibe nezinye izifo (isb. Angase ophe nge-colonic diverticula, ama-polyps, ama-hemorrhoids, umdlavuza wamathumbu, ngenxa yezifo ezivuthayo zamathumbu, ukukhubazeka kwemithambo yegazi. amathumbu amakhulu). Ukuze ungabakhiphi, kudingeka ukuhlolwa kwe-endoscopic yamathumbu amakhulu, okungukuthi i-rectoscopy ne-colonoscopy.

Ukwelashwa kwe-anal fissure

Ukwelashwa kokubhoboza indunu kungase kube okokugcina (ukudla okunothe nge-fiber, izinto ezithambisa indle, izidakamizwa ezilwa nokuvuvukala kanye nezidakamizwa ezidambisa i-sphincter). Ukwelashwa ngokuhlinzwa kuyasetshenziswa futhi ezimeni ezifanele (isb ekubuyeni). Inhloso yokwelashwa ukunciphisa ukungezwani kwe-anal sphincter yangaphakathi, okuthuthukisa ukunikezwa kwegazi ku-anoderm ye-anal canal futhi uphulukise amaphutha ku-mucosa.

Endabeni yokuqhekeka okunamandla kanye nezimpawu zesikhashana, ukwelashwa okulondolozayo kuvame ukwanele, okuhlala amasonto ambalwa noma ambalwa futhi kuhlanganisa:

1. ukudla okufanele okukuvumela ukuthi ukhiphe indle njalo futhi udlule indle ethambile,

2.ukuhlanzeka okufanele kwendunu,

3. ukusetshenziswa kwe-ointment enomuthi okhulula imisipha ye-anal sphincter. okwenza i-anal sphincter ikhululeke.

Uma umfantu obuhlungu wendundu uhluleka ukuphola noma ungapheli, isinyathelo esilandelayo sokwelashwa wukujova ngendlela ubuthi be-botulinum A (Botox) kuya kumsipha we-sphincter. Le ndlela ihloselwe ukuyikhulula, ehlala izinyanga ezingu-2-4, inikeze ithuba lokuphola kwe-fissure. Impumelelo ifinyelelwa ngemva kwale nqubo ku-90% ezimweni zokuqhekeka okunamandla kanye no-60-70% ezimweni zokwelashwa okungapheli.

Enye indlela ukuhlinzwa okuhilela ukuhlangana kwe-internal anal sphincter (ingxenye ethile yayo), ngokusikwa kanyekanye komkeko ngokwawo futhi kuthungwe isilonda esiwumphumela. Ukusebenza kokwelashwa kungu-90-95%.

Ukuhlinzwa idume kakhulu ngezinga eliphezulu lokuxaka. Ukungalawuleki kwe-fecal noma ukuntuleka kokulawula ukugeleza komoya kungase kwenzeke ngamaphesenti ambalwa ngemva kokuhlinzwa kwe-anal fissure. Amaphesenti ambalwa ezinkinga ezinesilinganiso sokwelapha esingama-95% ambalwa, kodwa ukungakwazi ukuzibamba kwe-fecal kubi kakhulu. Izinkinga zangemva kokuhlinzwa zivame kakhulu kwabesifazane abamiphumela yabo idlulela nokulimala okungakahlonzwa kwe-perineal ngesikhathi sokubeletha noma sokukhulelwa. Ukuhlinzwa kubuye kuhlotshaniswe nokucindezeleka, ubuhlungu kanye nokukhishwa isikhashana emsebenzini.

Kubalulekile ukuhlolwa ngezikhathi ezithile ukuze kuqashwe ukuqhubeka kokwelashwa kanye noshintsho olungase lube khona lapho kungekho ntuthuko enjalo. Isikhathi sokwelashwa okungasebenzi esinezelwa esikhathini sokugula ngaphambi kokuba siqale kubangela ukuqhekeka kube “ndala” futhi izinga lokwelapha lendlela ngayinye liyehla, futhi isikhathi esidingekayo sokuphulukiswa siyandiswa.

I-anal fissure - izinkinga

Inkinga ye-anal fissure (imvamisa uma kwenzeka i-fissure enganakwa noma engelashwa) ingaba izifo ezimbi kakhulu ze-anus ezisongela umsebenzi wemisipha ye-anal sphincter:

1. i-perianal fistula;
2. ithumba perianal.

Ngakho-ke, kubaluleke kakhulu ukubonana nochwepheshe ngokushesha ngangokunokwenzeka futhi uqale ukwelashwa kusenesikhathi, okuyinto elula, ephumelelayo futhi ikuvumela ukuba ugweme izinkinga nezinkinga. Ukuhlehlisa ukuvakashela udokotela, ukuhlehlisa isikhathi, ukuzelapha, ukusetshenziswa kwemithi ngokungafanele, amafutha okugcoba, ama-suppositories, uma kungekho ukuxilongwa okufanele nokulawulwa kwezokwelapha, kuyingozi empilweni futhi kungase kubangele ukuhlupheka okungadingekile, ngisho nokukhubazeka, futhi kubeke engozini impilo yesiguli kanye nempilo.

Umbhalo: SzB

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I-proctologist endaweni yangakini - yenza isikhathi sokubonana