Māhele anal

Maikaʻi i hōʻoia ʻia

ʻO ka māwae anal he haʻihaʻi haiki a pāpaʻu paha i loko o ka mucosa o ke kahawai anal (ka hopena pōkole o ka ʻāpana digestive ma ka palena o ka rectum a me ka anus). Hoʻokumu ʻia ka māwae ma muli o ka haʻalulu nui loa ma ka hope o ke kahawai anal i ka wā o ka hoʻoikaika kino a i ʻole ka constipation. Loaʻa ka maʻi i nā kānaka o nā makahiki āpau, nā kāne a me nā wahine.

Anal fissure - wehewehe

Hoʻokumu ʻia ka māwae anal ma muli o ka haʻalulu kiʻekiʻe ma ka hope o ke kahawai anal (ma muli o ka hoʻoikaika kino, ka paʻa mau ʻana a me / a i ʻole ka piʻi ʻana o ka naʻau o nā sphincters anal). Hōʻike ʻia ia e ka hoʻokumu ʻana o kahi ulceration linear o ka mucosa canal anal, maʻamau ma ka hope a i ʻole ka waena waena o ka anal canal. Hiki ke ʻike ʻia ka maʻi ma muli o nā maʻi a i ʻole mucosa ischemia ma kahi o ka mucosa. Hiki ke loaʻa kahi māwae anal i nā kānaka o nā makahiki āpau, nā kāne a me nā wahine. I ka hihia hope, nui ka nui o nā hāpai a me nā kūkākūkā e hoʻonui i ka pilikia o ka maʻi.

ʻO nā kumu o ka hoʻokumu ʻana i kahi māwae anal

kuai he ʻāpana paʻa, pōkole (3-6 knm) a me ka pauku hope o ka ʻāpana digestive i hoʻopuni ʻia e nā ʻiʻo o ka sphincter anal: loko a me waho. ʻO ka māwae anal ke kakahiaka i loko o ke kahawai anal i ka wā e pohā ai ka papa o loko o ka anus. He mea maʻamau ia ma hope o ka hoʻokuke ʻia ʻana o ka waihona paʻa (a laila aia kahi ʻeha mechanical a me ka hohola nui ʻana o ka anus a me ka haki ʻana o kona papa i loko).

ʻO ke kumu ʻē aʻe o ka māwae anal, ʻo ia hoʻi, ʻo ka maʻi diarrheal. A laila, aia kahi hoʻonāukiuki kemika e nā wai hoʻoheheʻe, e komo koke ana i ka ʻāpana anal a hoʻonāukiuki i kahi i hiki ke loaʻa i ka trauma, ʻo ia hoʻi nā māwae o loko. Hoʻokumu kēia i kahi ʻeha i ka papa o loko o ka anus i kapa ʻia he anal fissure. Holo lōʻihi ia ma ke koʻi lōʻihi o ka canal anal a loaʻa pinepine (ma 85% o nā hihia) mai luna (mai ke kua), emi pinepine (10%) mai lalo (mai ka ʻōpū o nā wahine, mai ka scrotum i nā kāne), ʻoi aku ka kakaikahi ma nā ʻaoʻao ʻē aʻe o ka anus. I kekahi manawa, ʻoi aku ma mua o hoʻokahi mau ʻeha (fissures).

ʻO nā kumu ʻē aʻe e pili ana i ka hoʻokumu ʻana o kahi māwae anal penei:

1. nā ʻeha ʻōpū,
2. ʻO ka maʻi o Crohn,
3. moe anal (maʻamau),
4. ka maʻi o ka anal glands,
5. defecation ma ke ʻano o ka ʻōpala paʻa a paʻa,
6. paʻa lōʻihi
7. hānau hānau lōʻihi, kahi i hānau ʻia ai ke keiki me ke kaumaha o ka hānau ʻana (a laila pono ke kauka e hoʻohana i nā ʻāpana kōkua),

Māhele o ka māwae anal

He māwae anal paha;

1. acute - a laila loaʻa ke ʻano o kahi pōʻino hou i ka mucosa canal anal,
2. maʻi maʻi - ma ke ʻano he kīnā i ka mucosa rectal i ho'ōla ʻole i loko o ʻeono pule ma hope o ka hoʻomaka ʻana o nā hōʻailona.

Aia ma hea kahi māwae anal?

1. Ma hope o ka laina waena o ka anal canal - ka mea maʻamau.

2. Laina mua waena o ka auwai anal.

3. ʻO ka laina waena o hope a me ke kahawai anal mua.

4. Lateral rectal quadrants (ʻoi loa i nā poʻe maʻi me ka maʻi o Crohn, ka maʻi kanesa, ka maʻi leukemia a i ʻole ka maʻi maʻi maʻi).

Nā hōʻailona o ka māwae anal

ʻO nā hōʻailona o kahi māwae anal ua like ia me ka hemorrhoids a i ʻole ka anal fistula. ʻO ka mea nui loa ka ʻeha, ke koko a me ke ahi i ka wā defecation. ʻIke pinepine ʻia ka ʻeha i ka hele ʻana o ka ʻōpū ma ka anus a he mau minuke ma hope o ka hele ʻana, a ma hope o ka hoʻoholo ʻana ma kāna iho. Aia kekahi mau hihia i hiki ai i ka ʻeha ke noho me ka mea maʻi no ka lōʻihi o ka lōʻihi, kahi e pale ai i ka hana maʻamau. Hiki ke ʻeha a i ʻole ke kuʻi ʻana, a ikaika a ʻike ʻole paha. Eia kekahi, hiki ke loaʻa ka ʻili, ka wela a i ʻole ka ʻeha i ka anus a me ka perineum.

ʻaneʻane hiki ke koko ke hele ʻoe i ka ʻili. ʻO ka pinepine, ʻike ʻia ke koko ma ka pepa i ka wā e holoi ʻia ai, ma ke kīʻaha kīʻaha, a i ʻole ma ke ʻano he ʻeleʻele ma ka waihona. I kekahi manawa ʻoi aku ka nui o ke koko, ʻoi aku ka lōʻihi ma mua o ka manawa o ka defecation, a ʻike ʻia nā māka ma ke kapa komo. Eia kekahi, hiki ke hoʻokuʻu ʻia ma ka ʻaoʻao o ka anus. ʻO kekahi hōʻailona ʻē aʻe o kahi māwae anal ʻo ia ka manaʻo o ka nui o ke kaomi ʻana i ka waihona.

Anal fissure - hōʻoia o ka maʻi

ʻO nā hōʻailona hōʻailona, ​​​​i hōʻikeʻia i ka wā o ka hālāwai ninaninau me ka mea maʻi, e pāʻani i ka hana nui a ma ka manawa like ke kumu no ka hōʻailona. I ka huli ʻana, no ka hōʻoia hope loa o nā kānalua, pono ia e hana i kahi hoʻokolokolo proctological. ʻO kēia ʻano haʻawina:

1. i loko o kahi māwae anal hou e hōʻike ana i ka hele ʻana o kahi laina laina o ka mucosa anal canal a me ka ʻeha,
2. ʻike ʻia nā nodules sentinel i kahi māwae anal mau loa; nā lālā paʻakikī o ka ʻiʻo o ka sphincter anal kūloko ma lalo o ka māwae; ka hemahema o ka mucosa ma ke ʻano o ka ʻeha longitudinal me nā ʻaoʻao paʻakikī; he nipple perianal ulu nui.

Paʻakikī paha kekahi poʻe e hana i kahi hoʻokolokolo proctological a i ʻole kahi anoscopy ma muli o ka ʻeha e hiki mai ana. ʻO ka anoscopy ka nānā ʻana i ka anus a me ka ʻāpana rectal ma luna o ia (8-15 knm). ʻO kekahi hoʻāʻo diagnostic ʻo ka signoidoscopy (ʻoi loa i nā poʻe maʻi ma lalo o 50, ʻaʻohe moʻolelo o ka maʻi kanesa). Eia nō naʻe, i nā poʻe ʻē aʻe me ka hoʻoheheʻe ʻana i ke koko, ua ʻōlelo ʻia kahi colonoscopy. Aia ia i ka nānā ʻana i ka ʻōpū nui a me kona mau ʻāpana a pau: rectum, sigmoid colon, descending colon, transverse column, ascending colon and cecum - me ka hoʻohana ʻana i kahi speculum flexible (a hiki i 130 knm). I ka wā o kā lākou hana, hiki ke lawe i kahi laʻana mai kahi maʻi, wehe i kahi lesion, e laʻa i ka polyp.

ʻOkoʻa

He kuhi hewa paha ka mālama ʻana i kahi māwae anal e lawe ana i nā pule, i kekahi manawa he mau mahina, me ka ʻole o ka hoʻoholo mua ʻana he maʻi koʻikoʻi e piʻi aʻe ana i loko o ka ʻōpū. He ʻoiaʻiʻo loa kēia no ka poʻe ma luna o 50 a i ʻole no nā poʻe maʻi i loaʻa i ka moʻolelo ʻohana o ka maʻi maʻi colorectal. ʻO ka ʻōlelo i loaʻa i ka mea maʻi he māwae anal a e kahe ana ke koko mai ia mea, ʻaʻole ia e kāpae i kona loaʻa ʻana i nā maʻi ʻē aʻe (e laʻa, hiki ke kahe mai ke koko mai ka colonic diverticula, polyps, hemorrhoids, intestinal cancer, ma muli o nā maʻi ʻeha o ka ʻōpū, nā malformations vascular o ka maʻi. ʻōpū nui). No ka wehe ʻana iā lākou, pono nā hoʻokolohua endoscopic o ka ʻōpū nui, ʻo ia hoʻi ka rectoscopy a me ka colonoscopy.

Ka lapaʻau ʻana i kahi māwae anal

ʻO ka mālama ʻana i kahi māwae anal he conservative (he meaʻai momona i ka fiber, mea hoʻomaʻemaʻe ʻili, nā lāʻau anti-inflammatory a me nā lāʻau hoʻomaha sphincter). Hoʻohana pū ʻia ka lāʻau lapaʻau i nā hihia kūpono (e laʻa me ka relapses). ʻO ka pahuhopu o ka lāʻau lapaʻau ʻo ia ka hoʻemi ʻana i ka ʻāʻī o ka sphincter anal i loko, kahi e hoʻomaikaʻi ai i ka hāʻawi koko i ka anoderm o ka canal anal a hoʻōla i nā hemahema o ka mucosa.

I ka hihia o ka maʻi maʻi a me nā hōʻailona pōkole, lawa ka mālama conservative, e mau ana i kekahi mau pule a i ʻole he mau pule a me:

1. kahi meaʻai kūpono e hiki ai iā ʻoe ke hoʻoheheʻe mau a hele i nā ʻōpala palupalu,

2. kūpono ka maʻemaʻe o ka anus,

3. ka hoʻohana ʻana i ka hamo me ka lāʻau e hoʻomaha ai i nā ʻiʻo o ka sphincter anal. e hoʻomaha ai ka sphincter anal.

Inā ʻaʻole hiki ke hoʻōla a maʻi paha ka maʻi maʻi anal acute, ʻo ka hana lapaʻau aʻe e hoʻokō i kahi injection ma ke ʻano o lāʻau make botulinum A (Botox) i ka ʻiʻo sphincter. Kuhi ʻia kēia ʻano i ka wehe ʻana iā ia, ʻo ia ka 2-4 mau mahina, e hāʻawi ana i kahi manawa e hoʻōla ai ka fissure. Loaʻa ka lanakila ma hope o kēia kaʻina hana ma 90% i nā hihia o ka fissure acute a me 60-70% i nā hihia o ka mālama ʻana i nā fissure mau.

ʻO kekahi ala ʻē aʻe he hana e pili ana ka huina o ka sphincter anal kūloko (kahi hapa o ia mea), me ka ʻoki like ʻana o ka ʻāʻī ponoʻī a humuhumu i ka ʻeha i hopena. ʻO ka hopena o ka mālama ʻana he 90-95%.

Ho'āla kaulana loa ia me ka helu hoʻopiʻi kiʻekiʻe loa. Hiki i ka fecal incontinence a i ʻole ka mana ʻole o ke kahe ʻana o ka makani i loko o kekahi mau pākēneka ma hope o ke kaʻe ʻana i ka anal fissure. He liʻiliʻi ka liʻiliʻi o ka nui o nā pilikia me ka 95% maʻi, akā paʻakikī ka fecal incontinence. ʻOi aku ka maʻamau o nā hoʻopiʻi postoperative i nā wahine nona nā hopena i uhi ʻia me nā ʻeha perineal i ʻike ʻole ʻia i ka wā o ka hānau ʻana a i ʻole ka hāpai ʻana. Hoʻopili pū ʻia ke kaʻina hana me ke koʻikoʻi, ka ʻeha a me ka haʻalele ʻana i ka hana.

He mea nui e hana i nā hoʻokolohua manawa e nānā i ka holomua o ka mālama ʻana a me ka hiki ke hoʻololi i ka loaʻa ʻole o ia holomua. ʻO ka manawa o ka lāʻau lapaʻau ʻole i hoʻohui ʻia i ka lōʻihi o ka maʻi ma mua o ka hoʻomaka ʻana e lilo ai ka māwae i "ʻelemakule" a emi ka lāʻau lapaʻau no kēlā me kēia ʻano, a hoʻolōʻihi ʻia ka manawa e pono ai e ho'ōla.

Anal fissure - complications

ʻO ka hoʻopiʻi ʻana o kahi māwae anal (ʻoi aku ka nui o ka wā i mālama ʻole ʻia a mālama ʻole ʻia paha) he mau maʻi koʻikoʻi o ka anus e hoʻoweliweli i ka hana o nā ʻiʻo sphincter anal:

1. fistula perianal;
2. ʻaʻaʻa perianal.

No laila, he mea nui e ʻike i kahi loea i ka wā hiki a hoʻomaka i ka mālama ʻana, a laila ʻoi aku ka maʻalahi, ʻoi aku ka maikaʻi a hiki iā ʻoe ke pale i nā pilikia a me nā pilikia. Hoʻopanee i ke kipa ʻana i ke kauka, hoʻopaneʻe, mālama ponoʻī, hoʻohana pono ʻole i nā lāʻau lapaʻau, ʻaila, suppositories, me ka ʻole o ka maʻi kūpono a me ka hoʻokele olakino, he pōʻino i ke olakino a hiki ke alakaʻi i ka ʻeha pono ʻole, a me ke kīnā ʻole, a hoʻoweliweli i ka ke olakino a me ke ola o ka mea maʻi.

kikokikona: SzB

ʻO ka ʻike o ka pūnaewele medTvoiLokony i manaʻo ʻia e hoʻomaikaʻi, ʻaʻole e hoʻololi i ka pilina ma waena o ka mea hoʻohana pūnaewele a me kā lākou kauka. Hoʻolālā ʻia ka pūnaewele no ka ʻike a me ka hoʻonaʻauao wale nō. Ma mua o ka hahai ʻana i ka ʻike loea, i ka ʻōlelo aʻoaʻo olakino, aia ma kā mākou Pūnaewele, pono ʻoe e nīnau i ke kauka. ʻAʻole lawe ka Luna Hoʻokele i nā hopena ma muli o ka hoʻohana ʻana i ka ʻike i loaʻa ma ka Pūnaewele.

He proctologist ma kou wahi - e hana i kahi manawa