Anal crack

Proven content

Kutsemuka kwetsvina kutsemuka kudiki uye kusina kudzika kana maronda ari mucosa yemugero wetsvina (kumucheto mupfupi wegumbo rekudya pamuganhu we rectum uye anus). Iyo fissure inokonzerwa nekukakavadzana kwakanyanya pamagumo emugero wekumashure panguva yekushanda kwemuviri kana kuvimbiswa. Chirwere ichi chinoitika muvanhu vemazera ese, varume nevakadzi.

Anal fissure - tsanangudzo

Anal fissure inokonzerwa nekushushikana kwakanyanya mumagumo emugero weanal (nekuda kwekuita maekisesaizi, kuramba kuvharwa uye / kana kuwedzera tension yeanal sphincters). Iyo inoratidzirwa nekuumbwa kwemutsara weronda remugero wegomarara, kazhinji inowanikwa mumashure kana chikamu chepakati chemugero. Chirwere chacho chinogonawo kuoneka semugumisiro wehutachiona kana mucosa ischemia munzvimbo ye mucosa. A anal fissure inogona kuitika muvanhu veese mazera, vese varume nevakadzi. Muchiitiko chekupedzisira, kuwanda kwepamuviri uye kubvunzurudza kunowedzera dambudziko rechirwere.

Zvikonzero zvekuumbwa kweanotsemuka

Sales iyo yakasimba, ipfupi (3-6 cm) uye chikamu chekupedzisira chechikamu chekudya chakakomberedzwa nemhasuru dzeanal sphincter: mukati nekunze. Kutsemuka kwetsvina ndiyo mangwanani mumugero wetsvina unoitika kana mukati menyumbu inoputika. Inowanzoitika mushure mekudzingwa kwechitubu chakaoma (ipapo kune mechanical trauma uye yakanyanyisa kutambanudza anus uye kuputika kwemukati wayo wemukati).

Chimwe chikonzero chekutsemuka kwemashure kungave kwakasununguka, marara emanyoka. Zvadaro, kune kemikari inogumburwa nemajisi ekudya, ayo anopinda munzvimbo yekumashure nekukasira uye anotsamwisa nzvimbo inova inotapukirwa nekukuvara, kureva kutsemuka mukati. Izvi zvinogadzira ronda kuchikamu chemukati che anus chinonzi anal fissure. Inomhanya kureba ichitevedza axis yakareba yeanora uye inowanikwa kazhinji (mu85% yezviitiko) kubva kumusoro (kubva kumashure), zvishoma kazhinji (10%) kubva pasi (kubva kumukadzi muvakadzi, kubva scrotum muvarume), kunyanya kashoma mune imwe nzvimbo yeanus. Dzimwe nguva kune maronda anopfuura rimwe (fissures).

Zvimwe zvikonzero zvinopesvedzera kuumbwa kweanal fissure zvinosanganisira:

1. intestinal ulcers,
2. Chirwere cheCrohn,
3. bonde rekumashure (zvakajairwa),
4. kutapukira kweanal glands,
5. kuita defecation muchimiro chekuoma uye compact stool,
6. kuvimbiswa kwenguva refu
7. kubereka kwenguva refu, panguva iyo mwana anoberekwa ane uremu hukuru (zvino chiremba anofanira kushandisa nhengo dzekubatsira),

Kupatsanurwa kwegomba rekumashure

Kutsemuka kwemusana kungave;

1. acute - ipapo ine chimiro chekukuvadza kutsva kune anal canal mucosa,
2. chisingaperi - sechirema mu rectal mucosa iyo isina kupora mukati memavhiki matanhatu ekutanga kwezviratidzo.

Kupiko kunonzi fissure?

1. Posterior midline yemugero wetsvina - yakajairika.

2. Mutsara wepakati wepamberi wenzira yekumashure.

3. Posterior midline uye anterior anal canal.

4. Lateral rectal quadrants (kunyanya kune varwere vane chirwere cheCrohn, kenza, leukemia kana tuberculosis).

Zviratidzo zvekubuda netsvina

Zviratidzo zvekutsemuka netsvina zvakafanana nezvehemorrhoids kana kuti anal fistula. Chinonyanya hunhu marwadzo, kubuda ropa uye kupisa panguva yetsvina. Marwadzo anowanzonzwa sezvo chigaro chinopfuura nepa anus uye maminetsi mashomanana mushure mokupfuura, mushure mokunge inowanzogadzirisa pachayo. Pane zviitiko apo marwadzo anogona kugara nemurwere kwenguva yakareba, izvo zvinotadzisa kushanda zvakanaka. Inogona kuva kana kuruma, uye inogona kuva yakasimba kana kuti isingaoneki. Mukuwedzera, kuchenesa, kupisa kana kusagadzikana mu anus uye perineum inogona kuvapo.

Kubuda ropa kunenge nguva dzose kunoitika paunopfuura marara. Kazhinji kazhinji, ropa rinoonekwa pabepa kana rapukutwa, pandiro yechimbuzi, kana setsvina pachituru. Dzimwe nguva kubuda ropa kwakakura, kunogara kwenguva yakati rebei kupfuura nguva yetsvina, uye mavanga anooneka pachipfeko chemukati. Mukuwedzera, panogonawo kuva nekunyorova kunoyerera kumativi emucheto we anus. Chimwe chiratidzo chekubuda kweanal fissure kunzwa kwekumanikidzwa kwakawanda pachituru.

Anal fissure - kuongororwa kwechirwere

Zviratidzo zvekliniki, izvo zvinoratidzwa panguva yekubvunzurudzwa kwechiremba nemurwere, zvinotamba basa guru uye panguva imwechete hwaro hwekuongororwa. Uyezve, kuitira kusimbiswa kwekupedzisira kwekufungira, zvakakosha kuita proctological kuongorora. Rudzi urwu rwekudzidza:

1. mune nyowani yekumashure fissure inoratidza kuvepo kwemutsara kuputika kweanal canal mucosa uye kurwadziwa,
2. sentinel nodules inoratidzwa mune chisingaperi chisingaperi fissure; michina yakaoma yemhasuru yemukati anal sphincter pazasi pefissure; kukanganisa kwemucosa muchimiro chelongitudinal ulcer ine mitsetse yakaoma; zamu yakawedzera perianal.

Vamwe vanhu vanogona kuwana zvakaoma kuita proctological ongororo kana anoscopy nekuda kwemarwadzo anouya nawo. Anoscopy inosanganisira kuongorora anus uye rectal fragment pamusoro payo (8-15 cm). Imwe bvunzo yekuongorora ndeye signoidoscopy (kunyanya kune varwere vari pasi pemakore makumi mashanu, vasina nhoroondo yegomarara). Zvisinei, mune vamwe vanhu vane co-inoitika rectal kubuda ropa, colonoscopy inokurudzirwa. Inosanganisira kuongorora ura hwose hombe uye zvikamu zvayo zvose: rectum, sigmoid colon, inodzika colon, transverse column, inokwira colon uye cecum - uchishandisa flexible speculum (kusvika 50 cm). Panguva yekushanda kwavo, zvinokwanisika kutora sampuli kubva munzvimbo ine chirwere, kubvisa chironda, semuenzaniso polyp.

Kusiyanisa

Zvingava kukanganisa kurapa kuputika kwemashure kunotora mavhiki, dzimwe nguva mwedzi, pasina kutonga kunze kwekare chirwere chakakomba chinoitika kumusoro mumatumbo. Izvi ndezvechokwadi kunyanya kune vanhu vanopfuura makumi mashanu kana kune varwere vane nhoroondo yemhuri yegomarara remukati. Chirevo chekuti murwere ane chitseko chekumashure uye ari kubuda ropa kubva mairi hachirevi kuti angave ane zvimwe zvirwere (semuenzaniso anogona kubuda ropa kubva mucolonic diverticula, polyps, hemorrhoids, kenza yemudumbu, nekuda kwezvirwere zvebowel, vascular malformations. ura hombe). Kuti varege kuvabvisa, kuongororwa kwe endoscopic yedumbu guru, kureva rectoscopy uye colonoscopy.

Kurapwa kwekutsemuka

Kurapa kwekutsemuka kwetsvina kunogona kuve kwakachengetedza (kudya kwakapfuma mufiber, zvinyoro zvinyoro, anti-inflammatory drugs uye sphincter-relieving drugs). Kurapa kwekuvhiya kunoshandiswawo muzviitiko zvinoruramiswa (semuenzaniso mukudzokazve). Chinangwa chekurapa ndechekuderedza tension yemukati anal sphincter, iyo inovandudza kugoverwa kweropa kune anoderm yemugero wemvura uye inoporesa kukanganisa mucosa.

Muchiitiko cheacute fissure uye zviratidzo zvenguva pfupi, kurapwa kwekuchengetedza kunowanzo kukwana, iyo inotora mavhiki mashoma kana akati wandei uye inosanganisira:

1. kudya kwakaringana kunoita kuti ugare uchiita tsvina nekupfuudza tsvina dzakapfava,

2.hutsanana hwakakodzera hwe anus,

3. kushandisa chizoro chine mushonga unonyevenutsa tsandanyama dzenal sphincter. zvichiita kuti anal sphincter isununguke.

Kana acute anal fissure ikatadza kupora kana kusingaperi, danho rinotevera rekurapa ndere kubaya jekiseni nenzira ye chepfu botulinum A (Botox) kune sphincter tsandanyama. Iyi nzira inotarisirwa kuisunungura, iyo inotora mwedzi 2-4, ichipa mukana wekuti fissure apore. Kubudirira kunowanikwa mushure mekuita uku mu90% mumatambudziko ekuputika kwakanyanya uye 60-70% mumatambudziko ekurapa kusingaperi kwefissure.

Imwe nzira ndeyekuvhiya kunosanganisira mharadzano yemukati anal sphincter (chimwe chikamu chayo), nekuchekwa panguva imwe chete yekuchekwa kwayo uye kusona ronda rinoguma. Kubudirira kwekurapa ndeye 90-95%.

Surgery inofarirwa zvakanyanya neiyo yepamusoro complication rate. Fecal incontinence kana kushaya simba pamusoro pekuyerera kwemhepo kunogona kuitika mune zvishoma kubva muzana mushure mekuvhiyiwa kweanal fissure. Zvishoma kubva muzana zvematambudziko ane 95% kurapa chiyero mashoma, asi incontinence yefecal yakanyanya. Zvinetso zvepashure zvinowanzoitika muvakadzi vane mhedzisiro inopindirana nekukuvara kusingazivikanwe perineal panguva yekusununguka kana nhumbu. Kuvhiyiwa kwacho kunobatanidzwawo nekushushikana, kurwadziwa uye kubviswa pabasa kwenguva pfupi.

Zvakakosha kuongororwa nguva nenguva kutarisa kufambira mberi kwekurapa uye kuchinja kunobvira mukusavapo kwekufambira mberi kwakadaro. Nguva yekurapa kusingabatsiri yakawedzerwa kunguva yechirwere chisati chatangwa inokonzera kutsemuka kuve "kwakwegura" uye kurapa kwemaitiro ega ega kunoderera, uye nguva inodiwa kuporesa inowedzera.

Anal fissure - matambudziko

Chinetso chekuputika kwemashure (kazhinji kana pane kusaregererwa kana kusagadziriswa fissure) inogona kunge yakatonyanya kurwara zvirwere zve anus zvinotyisidzira basa rezvipembenene zvemakumbo:

1. perianal fistula;
2. perianal abscess.

Nokudaro, zvakakosha zvikuru kuona nyanzvi nokukurumidza sezvinobvira uye kutanga kurapwa nokukurumidza, izvo zvinobva zvave nyore, zvinobudirira uye zvinokubvumira kuti udzivise matambudziko uye matambudziko. Kumisa kushanya kwachiremba, kuverengera, kuzvirapa, kushandisa zvisina tsarukano kwemishonga, mafuta ekuzora, suppositories, pasina kuongororwa kwakakodzera uye kutonga kwekurapa, kune njodzi kuhutano uye zvinogona kukonzera kutambura kusingakoshi, uye kuremara, uye kuisa mungozi hutano nehupenyu hwemurwere.

Chinyorwa: SzB

Zviri mukati meedTvoiLokony webhusaiti inoitirwa kuvandudza, kwete kutsiva, kusangana pakati peWebhusaiti Mushandisi nachiremba wavo. Iyo webhusaiti yakagadzirirwa ruzivo uye zvinangwa zvekudzidzisa chete. Usati watevera ruzivo rwenyanzvi, kunyanya zano rekurapa, riri paWebhusaiti yedu, unofanirwa kubvunza chiremba. Iyo Administrator haina mhedzisiro inokonzerwa nekushandiswa kweruzivo rwuri paWebhusaiti.

A proctologist munharaunda yako - ita musangano