I-paraproctitis

Incazelo jikelele yalesi sifo

Lokhu ukuvuvukala okukhulu kwezicubu zeseli zeparaleal. Cishe i-30% yazo zonke izifo zamangqamuzana zibangelwa yiyo. Ezimweni eziningi, i-paraproctitis ibangelwa izimbali ze-polymicrobial. Ngesikhathi sokufakwa kokuqukethwe kwe-purulent, kutholakala i-staphylococci, i-Escherichia coli, i-gram-positive ne-Gram-negative bacilli. Njengomthetho, lesi sifo siqala ngokuzumayo, futhi sihambisana nezimpawu ezishiwo, ukungakhululeki, nobuhlungu obukhulu. Kudinga ukwelashwa okuphuthumayo nokusheshayo.

Izizathu ezicasula ukuqala kwe-paraproctitis

Imbangela ye-paraproctitis yisifo esingena ezicutshini ezithambile ezizungeze ingquza, okudala ukuvuvukala namathumba. Ukutheleleka kungena ngamanxeba abangelwa uhudo noma ukuqunjelwa, ama-hemorrhoids, ukuhlukumezeka endunu. Ngezinye izikhathi imbangela eqondile yokuqala kwesifo kumuntu othile kunzima ukusungula. Ngisho ithambo eligwinywe ngengozi noma isikhafu seqanda, eliphuma nendle, lingalimaza amathumbu.

Phakathi kwezinye izimbangela ezijwayelekile zeparaproctitis, odokotela babiza nokulandelayo:

• ukunweba nokuvuvukala kwemithambo ye-hemorrhoidal;
• ukuqhuma kwezindunu;
• izifo ezivuthayo ze-rectum nezinye izingxenye zamathumbu;
• iziyaluyalu (isifo sohudo, ukuqunjelwa);
• ukungasebenzi komzimba;
• ukuvuvukala okungapheli kunoma yiluphi uhlelo lomzimba.

Izinhlobo ze-paraproctitis

Ngokuya ngendawo, kunezigaba eziningana zalesi sifo.

1. 1 I-paraproctitis engaphansi… Ithumba livela ngqo ngaphansi kwesikhumba, izimpawu zesifo ziyabonakala ngisho nasekuhlolweni, lolu uhlobo lwesifo oluvame kakhulu.
2. 2 I-paraproctitis engathandeki… I-purulent paraproctitis yenzeka engxenyeni engaphansi kolwelwesi lwamafinyila.
3. 3 I-Ischiorectal… Ukuvuvukala kuya emsipheni ophakamisa ingquza.
4. 4 I-Pelviorectal… Ukuvuvukala kusakazekela emisipheni yokuphakanyiswa kwendunu bese kusebenza ngayo ezicutshini zokhalo. Ngenxa yokuvela kwayo kabanzi, lolu hlobo lweparaproctitis luyingozi kakhulu.

Ngaphezu kwalokho, ukuvuvukala kungaba deep or ngokuyisisekelo.

Izimpawu ze-paraproctitis

Lesi sifo siqala ngokuzumayo futhi sibonakala ngokuboniswa komtholampilo okunobudlova. Nazi izimpawu ezijwayelekile ezingabonakala emahoreni okuqala ngemuva kokuqala kwesifo:

• ubuhlungu obuzungeze i-rectum ne-anus. Ubuhlungu bungangena ngaphakathi kwe-groin ne-perineum, kanye nasemgodini wesisu; ngesikhathi sokuhamba kwamathumbu, kuyanda.
• ukuthambekela kaningi nangamanga kokuzikhulula, kepha ukuqunjelwa kungenzeka.
• ukuchama okubuhlungu;
• izimpawu zokudakwa ezifana nomkhuhlane, ubuthakathaka, i-pallor, ukulahleka kwesifiso nesiyezi, izinga lokushisa lingakhuphukela kuma-39 degrees.

Lezi zimpawu ziboniswa kuzo zonke izinhlobo ze-paraproctitis futhi azixhomeki endaweni yayo. Kodwa-ke, uhlobo ngalunye lwe-pathology luba nezimpawu zalo ezijwayelekile ezisiza ukunquma ngqo ukuthi ukuvuvukala kwavelaphi.

RџS•Rё paraproctitis engaphansilapho ithumba litholakala eduze kwendunu engaphansi kwesikhumba, izimpawu zibonakala kakhulu: ukuvuvukala okubuhlungu endunu, nokubomvu kwesikhumba ngaphezulu kwaso. Izinhlungu ziyakhula kancane kancane, zithola umlingiswa oshisayo, oletha ukungakhululeki okukhulu lapho uhleli, uzikhulula. Lezi zinqubo zihambisana nobuhlungu obukhulu. Leli fomu le-abscess livame kakhulu.

Ithumba le-submucosal etholakala ngaphansi kwe-mucosa engunxande. Izimpawu zalolu hlobo lwendawo zifana nethumba elingaphansi, kepha ubuhlungu nezinguquko zesikhumba azibonakali kangako.

I-RџSЂRё ischeorectal abscess purulent focus isendaweni engenhla kwemisipha ephakamisa indunu. Ngenxa yethumba elijulile, izimpawu zasendaweni azicaci kakhulu: izinhlungu zokuqaqamba komzimba esifundeni se-pelvic kanye ne-rectal, esanda ngesikhathi sokuhamba kwamathumbu. Ukubomvu kwesikhumba, ukuvuvukala kwenzeka ezinsukwini ezingama-5-6 ngemuva kokuqala kobuhlungu. Umuzwa ojwayelekile usinda: izinga lokushisa lingakhuphukela kuma-degree angama-38, ukudakwa okunzima kuyabonakala.

Okunzima kakhulu kubhekwa ithumba le-pelviorectal… Lena indlela engavamile yethumba elibukhali, lapho ukugxila komgogodla kutholakala phezu kwezicubu ezakha iphansi le-pelvic, kwehlukaniswa nomgodi wesisu ngongqimba oluncane lwe-peritoneum. Ukuqala kwalesi sifo kuhambisana nomkhuhlane omkhulu, amakhaza nobuhlungu bamalunga. Izimpawu zendawo: ubuhlungu bejoyini le-hip kanye nesisu esiswini. Ngemuva kwezinsuku eziyi-10-12, ubuhlungu buyaqina, ukugcinwa kwendle nokuchama kwenzeka.

Abanye abantu batholakala benayo i-necrotizing paraproctitis eyedwa… Leli fomu libonakala ngokusabalala okusheshayo kwethumba, okuhambisana necrosis enkulu yezicubu ezithambile futhi ezidinga ukususwa kwazo, ngemuva kwalokho kuhlala izibazi ezinkulu, ezidinga ukungenela kukadokotela ohlinzayo wepulasitiki.

I-paraproctitis ezinganeni

Imvamisa, i-paraproctitis ivela kubantu abaneminyaka engaphezu kwengu-20 ubudala, kepha izingane nazo zisengozini. Izimpawu ezinganeni ziyefana nasezigulini zabantu abadala, kodwa-ke, kunzima kakhulu ukuthola isifo, ngoba izingane azikwazi ukuchaza njalo ukuthi yini ezikhathaza njalo.

Abazali kufanele banake kakhulu umkhuhlane, ukukhala njalo kosana, ikakhulukazi ngesikhathi sokuhamba kwamathumbu, nokuqunjelwa. Njengomthetho, izingane zihlushwa i-paraproctitis engaphansi kwesikhumba, ngakho-ke, isikhumba esizungeze i-anus sibomvu futhi siyavuvukala.

Izizathu zokwakheka kwe-paraproctitis ezinganeni:

• ukungajwayelekile kwezindlala ku-rectum;
• amasosha omzimba aphansi;
• ukuvuvukala kwamathumbu kanye nesistimu yokuphefumula;
• i-dysbiosis yamathumbu.

Izinkinga nge-paraproctitis

Uma i-purulent paraproctitis ingaphumi ngesikhathi, kungavela izinkinga eziyingozi:

• ukwakheka kwe-purulent kungalimaza izindonga zamathumbu nezindonga zesifazane kwabesifazane;
• nge-subcutaneous localization, ukubhujiswa kwethumba kungaba kwangaphandle, okuholela ekutheleleni okwengeziwe;
• ukulimala kwezicubu ezinamafutha esifundeni se-pelvic;
• ukulimala kwe-urethra okubangelwa ukungena kwayo ngo-purulent;
• i-peritonitis ngenxa yokwanda okusheshayo kokuvuvukala emgodini wesisu;

Isikhathi sangemva kokuhlinzwa nakho kungaba yinselele. Ngisho noma udokotela ohlinzayo enamathela kuyo yonke imithetho yokungenelela kokuhlinzwa, ukuphuma kwegazi, izinkinga ezithathelwanayo nezinye izinkinga zangemva kokuhlinzwa kungavela.

Ukuvimbela i-paraproctitis

Azikho izindlela ezikhethekile zokuvimbela lesi sifo. Kuyadingeka ukwelapha ngesikhathi esifanele nangokufanelekile konke ukuphazamiseka kwamangqamuzana. Ukutheleleka okungapheli kwezinye izinhlelo zomzimba akufanele kunganakwa. Inhlanzeko esondelene kahle ibaluleke kakhulu. Kuyadingeka ukuthi uvakashele njalo udokotela ukuhlolwa kokuvikela, futhi ungalibali uhambo lokuya kochwepheshe lapho umzimba uqala ukunikeza izimpawu ezethusayo: ubuhlungu, ukungakhululeki, ubuthakathaka, njll.

Diagnostics

Ukuxilongwa kwe- "paraproctitis", njengomthetho, kwenziwa ngesisekelo sesifundo sesithombe somtholampilo, kanye nangemva kokuhlolwa kwedijithali kwe-rectum. Phakathi nalokhu kuhlolwa, udokotela ogqoke amagilavu ​​akhethekile ufaka umunwe endunu futhi uzizwe kalula izindonga ze-rectum. Kulokhu, isiguli singalala ngohlangothi noma ngomhlane, esihlalweni sabesifazane. Lokhu kaningi kwanele.

Ezimweni ezingavamile, ikakhulukazi ngezindlela zesifo esithuthuke kakhulu noma eziyinkimbinkimbi, kunikezwa ukuhlolwa kwensimbi ama-rectoscopy (ukuhlolwa kwe-endoscopic) noma siningi (ukufaka iphenyo ye-ultrasound ku-rectum).

Ukwelashwa kwe-paraproctitis emithini esemthethweni

I-acute paraproctitis yisimo esiphuthumayo sezokwelapha futhi sidinga ukwelashwa ngokuhlinzwa.

I-Anesthesia idlala indima ebaluleke kakhulu ekwelapheni i-acute paraproctitis. Ukuhlinzwa kwenziwa ngaphansi kwe-anesthesia ejwayelekile, futhi odokotela kufanele bakhulule imisipha yesiguli ngangokunokwenzeka. Ukuhlinzwa nge-paraproctitis kudinga ukuhambisana neminye imithetho ebalulekile ukususa ukuvuvukala komhluzi:

• ukuqunjelwa kwethumba;
• amanzi ithumba;
• ukutholwa kwendawo ethintekile yamathumbu nokususwa kwawo.

Kwesinye isikhathi odokotela abangenalwazi benza kuphela ukusika kanye nokukhipha ithumba ukwelapha i-paraproctitis, okungaholela ekubuyeleni emuva noma kwe-anal fistula.

Ngesikhathi sokuhlinzwa, isiguli kufanele sithathe ama-antibiotic ukuvimbela ukuphindaphinda kwe-paraproctitis. Futhi zivimbela ezinye izinhlelo zomzimba ukuthi zingatheleleki kanye nasezinkingeni ezifana ne-sepsis noma i-peritonitis.

Ngesikhathi sokululama, kubaluleke kakhulu ukugcina inhlanzeko efanelekile. Indawo engunxande igezwa kabili ngosuku ekuseni nakusihlwa nangemva kokunyakaza kwamathumbu ngakunye ukuvimbela ukutheleleka kwesilonda sangemva kokuhlinzwa.

Qaphela!

Abaphathi abanacala nganoma yimuphi umzamo wokusebenzisa imininingwane oyinikiwe, futhi akuqinisekisi ukuthi ngeke ikulimaze wena uqobo. Izinto zokwakha azinakusetshenziselwa ukunquma ukwelashwa nokwenza ukuxilongwa. Njalo thintana nodokotela wakho onguchwepheshe!