I-anal / perianal fistula: kuyini, izimpawu nokuthi uzohlinzwa nini

-Delile

• Izimpawu eziyinhloko
• Yelashwa kanjani
• Lulama kanjani
• Uzoya nini kudokotela

I-anal fistula, noma i-perianal, uhlobo lwesilonda, esivela engxenyeni yokugcina yamathumbu kuya esikhumbeni sendunu, kwakheka umhubhe omncane odala izimpawu ezifana nobuhlungu, ububomvu nokuphuma kwegazi endunu.

Imvamisa, i-fistula ivela ngemuva kwethumba ku-anus, noma kunjalo, ingabangelwa nezifo zamathumbu ezivuthayo, njengesifo sikaCrohn noma i-diverticulitis, isibonelo.

Ukwelashwa cishe kwenziwa njalo ngokuhlinzwa, ngakho-ke noma nini lapho kusolwa khona i-fistula, ikakhulukazi uma ngabe unethumba, kunconywa ukuthi uthintane nodokotela we-proctologist ukuqinisekisa ukuxilongwa bese uqala ukwelashwa.

Bona ukuthi yiziphi ezinye izimbangela ezivamile zobuhlungu ku-anus noma ukulunywa esifundeni.

Izimpawu eziyinhloko

Izimpawu eziyinhloko ze-anal fistula zifaka:

• Ukubomvu noma ukuvuvukala kwesikhumba sendunu;
• Ubuhlungu obuhlala njalo, ikakhulukazi lapho uhleli noma uhamba;
• Ukuphuma kobomvu noma kwegazi nge-anus;

Ngaphezu kwalezi zimpawu, ubuhlungu besisu, isifo sohudo, ukulahlekelwa isifiso sokudla, ukwehla kwesisindo somzimba kanye nesicanucanu nakho kungenzeka uma ukutheleleka noma ukuvuvukala kwe-fistula kwenzeka.

Kulezi zimo, kunconywa ukuthi uthintane nodokotela we-proctologist ukuthola inkinga, ngokubheka isayithi noma i-magnetic resonance imaging, ngokwesibonelo, bese uqala ukwelashwa okufanele.

Yelashwa kanjani

Ukwelapha i-fistula yangemuva, nokugwema izinkinga ezifana nokutheleleka noma ukungavumelani kwendle, udinga ukuhlinzwa, okubizwa nge-anal fistulectomy, lapho udokotela:

1. Yenza ukusika ku-fistula ukuveza wonke umhubhe phakathi kwamathumbu nesikhumba;
2. Isusa izicubu ezilimele ngaphakathi kwe-fistula;
3. Faka ucingo olukhethekile ngaphakathi kwe-fistula ukuthuthukisa ukuphulukiswa kwayo;
4. Inika amaphuzu khona lapho ukuvala inxeba.

Ukugwema ubuhlungu, ukuhlinzwa kuvame ukwenziwa nge-anesthesia ejwayelekile noma ye-epidural futhi, ngaphambi kokuqala inqubo, udokotela usebenzisa iphenyi ukuhlola i-fistula nokuhlola ukuthi ngabe kukhona umhubhe owodwa kuphela noma ngabe i-fistula eyinkimbinkimbi, lapho kukhona khona imigudu. Kulokhu, kungadingeka ukwenza ukuhlinzwa okungaphezu kokukodwa ukuvala umhubhe owodwa ngasikhathi.

Ngaphezu kwe-anal fistulectomy, kunezinye izindlela zokwelapha i-fistula ngokuhlinzwa, njengama-graft, plugs kanye nama-suture akhethekile, abizwa ngokuthi ama-seton, kepha lezi zindlela zincike ohlotsheni lwe-fistula kanye nesifo esasibanga, njengesifo sikaCrohn, okudingeka ukuthi usebenzise imishanguzo, njenge-Infliximab ngaphambi kwanoma yikuphi ukuhlinzwa.

Lulama kanjani

Ngemuva kokuhlinzwa, imvamisa kuyadingeka ukuhlala esibhedlela okungenani amahora angama-24 ukuqinisekisa ukuthi umphumela we-anesthesia unyamalele nokuthi azikho izinkinga, njengokuphuma kwegazi noma ukutheleleka.

Ngemuva kwalokho kungenzeka ukubuyela ekhaya, kepha kunconywa ukuphumula izinsuku ezi-2 kuye kwezi-3, ngaphambi kokubuyela emsebenzini. Ngalesi sikhathi, kungahle kudingeke ukuthi uphuze ama-antibiotic, njenge-Amoxicillin ne-Clavulonate, noma imishanguzo yokulwa nokuvuvukala, njenge-Ibuprofen, ebekwe ngudokotela, ukudambisa izinhlungu nokuqinisekisa ukuthi isifo asiveli. Ukunciphisa ubungozi bokutheleleka, inhlanzeko yesifunda nayo kufanele igcinwe ngamanzi nensipho ye-pH engathathi hlangothi, ngaphezu kokushintshwa kokugqoka, ukusebenzisa amafutha okugcoba izinhlungu okungenani izikhathi eziyisithupha ngosuku.

Ngesikhathi sangemva kokuhlinzwa kujwayelekile ukuthi inxeba liphume kancane, ikakhulukazi lapho kusulwa iphepha langasese esifundeni, noma kunjalo, uma ukuphuma kwegazi kusinda noma uma kukhona uhlobo oluthile lobuhlungu obunzima, kubalulekile ukubuyela kudokotela.

Ngaphezu kwalokho, ngesonto lokuqala kubalulekile futhi ukulandela indlela yokudla ukuze ugweme ukuqunjelwa, ngoba ukuqoqwa kwendle kungakhuphula ingcindezi ezindongeni zendunu futhi kuvimbele ukuphulukiswa. Bona ukuthi ungalwenza kanjani lolu hlobo lokondla.

Uzoya nini kudokotela

Kunconywa ukuthi uthintane ne-proctologist ngokushesha lapho kuvela:

• Ukopha egazini endunu;
• Ukwanda kobuhlungu, ububomvu noma ukuvuvukala;
• Imfiva engaphezu kuka-38ºC;
• Kunzima ukuchama.

Ngaphezu kwalokho, kubalulekile futhi ukuya kudokotela uma kwenzeka ukuqunjelwa okunganyamalali ngemuva kwezinsuku ezi-3, noma ngabe usebenzisa laxatives.