I-fistula ye-rectum

I-fistula ye- rectum iyingozi, ekhona ngaphansi kwesikhumba endaweni yangaphambili. Uhlanganisa isikhumba esithintekayo nesikhumba eduze kwe-anus. Izimbangela zokuthuthukiswa kwenqubo engavamile yokuvuvukala eholela ekubunjweni kwe-fistula kungaba ukungenelela okuhlinzekwa, ukuthengiswa kwamagciwane, ukuhlukumezeka, ukuqhuma kule ndawo kanye namacala angu-95% - i-paraproctitis enzima.

Akuzona zonke iziguli ezine-paraproctitis ezinzima eziqala i-fistula ye-rectum. Kodwa uma i-abscess ivuliwe, idliwe, kepha ingasuswa ngokuphelele ngesango langaphandle lokutheleleka ukutheleleka, lokhu kuzoholela ekuqukethwe okune-purulent egijima njalo ku-lumen ye-fistula. Konke lokhu kuzoholela ekwakhiweni kokungena emagqumeni kanye namapulangwe ane-pus, izindonga zangaphandle zenkambo ye-fistulous ziqala ukuphefumula, futhi izindonga zangaphakathi zimbozwa izicubu ze-granulation.

Ekuqaleni, i-gland evuthayo ivuvuka, i-pus form ifuna ukuphuma nge-fiber evulekile ibe yi-rectum nangesikhumba sangaphandle endaweni yokuvula. Ngakho-ke, kwakhiwa ama-famtula angaphakathi nangaphandle. Ukuhlukanisa ngemithi:

• Ukuqeda (kwangaphandle) i-fistula kuhambisana nokushisa okuqhubekayo, ukuguqulwa nokuqhuma ngesikhathi sokukhukhumeza nokuzizwa kabi, ukuphazamiseka ngesikhathi sokuhlukunyezwa ngenxa yokuqina kwesikhumba ngesikhathi sokuxoxwa;
• I-fistula engaphelele (yangaphakathi) ye-rectum, izimpawu zaso ukuthi phakathi nenkathi yokuxoxwa akubanga imbangi futhi cishe ayibonakali ngokwayo, kodwa uma isimo sesidlulile, isimo sesiguli sihla kakhulu.

Lesi sifo siqhubeka sichitha. Ukucindezeleka kubonakala lapho amavesi evinjiwe, lapho isiguli sikhathazekile ngobuhlungu obuse-anus, obukhushulwa yi-defecation. Umkhuhlane wesifo, ikhanda, ubuthongo kanye ne-potency ihlupheka, ukugcoba nesifo sokuphazamiseka ngezikhathi ezithile kuphazanyisa. Kukhona ukucasuka okuqinile kwesikhumba, ukushisa nokushaywa, ngakho isiguli sidinga ukugeza njalo kanye nokushintsha kwamagesi.

Ngemuva kokuvula izikhala, inhlalakahle ithuthuka kakhulu, ukuvuvukala kunciphisa, ukukhishwa kuyinto engavamile, amandla okusebenza abuyiselwa. Izinqubo zokuvuvukala isikhathi eside emathisini afanelekayo ziholela ezinkingeni ze-fistula. Kungase kuvele ukuguqulwa komsele wamanzi kanye nobunzima bemisipha ye-sphincter ephazamisa ukusebenza okujwayelekile futhi kuholele ekutheni ukungabi khona kwe-sphincter yesilwane. Ezimweni ezinzima kakhulu futhi ezinzima, ukuwohloka okubi kwe-fistula kungenzeka.

Ukuxilongwa "i-fistula ye-rectum" kwenziwa ngumtholampilo - ochwepheshe owenza ukuhlolwa komunwe emaceleni esihlalweni sobuhlalo endaweni yokugulisa iziguli. Ngemuva kokulungiswa okuthile kwesiguli, ukuhlolwa kokugcina kwe- intestine enkulu kwenziwa ukulungisa ukuxilongwa - sigmoidoscopy. Kulesi simo, ungabuka ukubona i-mucosa, uthathe izicubu ze-biopsy, wenze ukuhlonza ukuhlukana uma usola isisu.

Uma kudingekile, i-fistula yangaphandle isetshenziswa, futhi ukuhlolwa kwe-ultrasound - i-ultrasonography - kwenziwa ukuze kunqume indawo ye-fistulous site. Ukunquma ukuqondiswa kwemivimbo, ukutholakala kwe-fistula yangaphakathi kubhekene ne-fistulography. Lezi zifundo zisiza ukuqinisekisa ukuthi isiguli sine-fistula ye-rectum, noma ukukhipha lokhu okuxilongwa.

Imithi yokwelashwa ayiyona ingasebenzi futhi isetshenziswa njenge-prophylaxis yokuphindaphinda esikhathini esilandelayo. Ukungenelela kokusebenza kwenziwa ngabachwepheshe esibhedlela, ngaphansi kwe-anesthesia jikelele noma ngaphansi kwe-anesthesia ye-epidural. Uhlobo lokusebenza lusekelwe endaweni ye-fistula maqondana ne-sphincter, ngezinga lezinsalela zomzimba, ebukhosini nasenqwaba yezigqoko ezihlanzekile ku-cellulose. Kodwa kunoma yikuphi, lapho isiguli sinesifo se-fistula se-rectum, ukusebenza akunakugwemeka.

Okuhle kunazo zonke yisikhathi se-postoperative ne-intrasfincter fistula. Kulukhuni kakhulu ukwenza ngokusemthethweni ukusebenza kwezehlakalo ze-transfinctorial kanye ne-extra-inflexional. Kunzima kakhulu ukuhlanganiswa okunzima kwezigatshana, uma kubalulekile ukukhipha izicubu ezithatha iqhaza ekwenzeni i-fistula futhi ukwandise umsebenzi we-sphincter.

Esikhathini se-postoperative, isiguli kumele senze ama-bandages nge-levomycol, okugeza ngama-manganese, kamuva ne-chamomile noma i-calendula. Inqubo yokuphulukiswa okuphelele iphela cishe ngenyanga.