Hemorrhoids yog ib yam kab mob uas ntau tus muab kev kho mob. Nws yog ib tug pathology uas tsim nyob rau hauv cov hlab ntsha ntawm lub qhov quav. Raws li qhov xwm txheej ntawm cov dej ntws, cov kws kho mob paub qhov txawv ntawm sab nraud prolapse ntawm nodes thiab sab hauv hemorrhoids.
Nodular formations nyob rau hauv lub qhov quav mucosa. Hauv qhov mob hnyav, mob hnyav, lawv qhov kev poob qis thiab qis qis tuaj yeem ua tau.
mus ntsib kws kho mob tsis tu ncua tuaj yeem ua rau muaj kev phom sij txaus ntshai. Txhawm rau kom tsis txhob muaj qhov tshwm sim tsis zoo, koj yuav tsum nkag siab qhov tseeb tias cov tsos mob ntawm hemorrhoids sab hauv yog dab tsi thiab yuav ua li cas tus kab mob tshwm sim hauv thawj theem. Kev kho mob zoo tshaj plaws yuav yog nrog kev sib koom ua ke.
Ua rau kab mob tsim
Internal hemorrhoids (ICD-10) muab code - I84. Tus kab mob no yog cais raws li o thiab loj expansion ntawm internal varicose leeg. Qhov no yog ib yam kab mob sib haum xeeb ntawm cov neeg laus. Nws tshwm sim feem ntau hauv cov poj niam. ATFeem ntau tshwm sim hauv hemorrhoids tom qab yug me nyuam. Thiab nrog rov qab xeeb tub, qhov kev pheej hmoo ntawm kev kis kab mob varicose nce ntxiv. Qhov laj thawj tiag tiag ntawm kev tsim cov hemorrhoids sab hauv tseem tsis tau tsim kom tiav, txawm li cas los xij, muaj ntau yam ua rau muaj kev tsim cov kab mob no, tshwj xeeb, xws li:
- kev ua lub cev tsis txaus;
- hnyav nce;
- cev xeeb tub thiab yug me nyuam, tshwj xeeb tshaj yog ntau yam;
- malnutrition;
- cem quav;
- nqa hnyav;
- kev ua neej tsis ncaj ncees.
Qhov tshwm sim ntawm keeb kwm thiab muaj cov kab mob sib kis, tshwj xeeb, xws li mob plab hnyuv lossis mob plab hauv plab, yog qhov tseem ceeb hauv kev txhim kho cov txheej txheem pathological.
Cov tsos mob tseem ceeb
Cov tsos mob thiab kev kho mob hemorrhoids sab hauv tuaj yeem sib txawv heev, txhua yam nyob ntawm tus yam ntxwv ntawm cov kab mob no. Thawj qhov tsis xis nyob cuam tshuam nrog kev ua ntawm defecation. Lawv manifest lawv tus kheej nyob rau hauv daim ntawv ntawm tsis xis nyob thiab ib tug zoo siab ntawm tag nrho cov nyob rau hauv lub qhov quav. Tsis tas li ntawd, tej zaum yuav muaj khaus thiab kub hnyiab hauv qhov quav, qhov kev xav ntawm lub cev txawv teb chaws, nrog rau kev ua tsis tiav ntawm txoj hnyuv tom qab mus rau chav dej.
Lawv tuaj yeem nrog mob hauv plab plab. Thaum cov hemorrhoids los ntshav, koj tuaj yeem pom cov tee ntshav ntawm daim ntawv tso zis tso quav thiab pom hauv cov quav.
Qee zaum, thaum lub sijhawm tso quav, tej zaum yuav muaj qhov tshwm sim ntawm qhov chawhauv nodes. Nyob rau hauv rooj plaub no, tsis xis nyob yuav tsis muaj ib txwm muaj, thiab qhov mob yuav tsis txaus hais. Thaum tus kab mob dhau mus rau theem tom ntej, muaj hypertrophy ntawm cov nodes thiab nthuav dav ntawm cov leeg ntawm qhov quav. Xws li kev tshwm sim tuaj yeem ua rau qhov nqaim ntawm nws lub lumen.
Cov kab mob zoo li no cuam tshuam cov paug tawm, uas ua rau cem quav ntev. Raws li qhov tshwm sim, kev hnov mob raug pom, uas ua rau muaj kev khaus khaus ntawm cov mucosa vim qhov siab tas li thiab kev sib cuag nrog cov quav. Tsis tas li ntawd, tej zaum yuav muaj ntshav los ntawm qhov quav, thiab qhov no tshwm sim tom qab txhua lub plab zom mov. Qhov no yog ib qho kev ntxhov siab heev uas ua rau tus neeg tig mus rau tus kws kho mob.
Flow Stages
Nyob ntawm qhov mob hnyav ntawm cov tsos mob thiab cov kab mob, muaj 4 theem. Thaum xub thawj, qhov tsim ntawm dilated venous plexuses nyob rau hauv cov hlab ntsha ntawm lub qhov quav yog pom. Nyob rau theem no, tus neeg mob tsis thab dab tsi los yog tsis xis nyob me ntsis.
Cov hemorrhoids sab hauv ntawm 2nd degree manifest lawv tus kheej nyob rau hauv daim ntawv ntawm varicose leeg, uas me ntsis nyuaj rau cov txheej txheem ntawm defecation. Cov theem no yog tus cwj pwm los ntawm cov chav kawm undulating, tshwj xeeb tshaj yog, cov cim qhia tau raug hloov los ntawm lub sijhawm zam txim. Txawm li cas los xij, txawm tias muaj kev txhim kho hauv kev noj qab haus huv, tus neeg mob yuav muaj kev tsis xis nyob thaum tso zis.
Nyob rau theem 3, muaj kev hloov pauv ntawm hemorrhoids mus rau theem ntev, thaum lub sijhawm txhim kho kev noj qab haus huv tsawg duancua ntev, thiab varicose expansions loj tuaj. Tom qab ib ntus, cov tsos mob ua kom ci dua thiab hnyav dua. Nyob rau theem no, tus kab mob manifests nws tus kheej nyob rau hauv daim ntawv ntawm me me spotting thaum lub sij hawm tso quav tso. Hauv qhov no, lub pob yuav poob tawm. Tom qab ntawd, cov pob txha yuav poob tawm thaum txham thiab nqa qhov hnyav. Nyob rau theem no, lawv twb zoo palpable. Tom qab ua qhov defecation, cov pob caus poob yuav tsum tau rov qab los ntawm tes.
Nyob rau theem 4, cov teeb meem txaus ntshai tshwm sim, uas yog vim li cas thiaj li yuav tsum tau kho sai. Hauv qhov no, kev ua haujlwm tau tshwm sim.
Cov hemorrhoids sab hauv tuaj yeem tshwm sim hauv qhov mob hnyav thiab mob ntev. Thaum lub sij hawm mob hnyav, cov tsos mob yuav ci ntsa iab thiab nce sai heev. Thaum lub sij hawm tus txheej txheem inflammatory nyob rau hauv cov neeg mob, qhov chaw ntawm lub qhov quav yuav mob heev.
Diagnostics
Raws li cov tsos mob ntawm cov hemorrhoids sab hauv, kev kho mob yog xaiv rau tus neeg mob ib leeg xwb, tab sis ua ntej koj yuav tsum tau ua qhov kev kuaj mob dav dav. Txhawm rau txiav txim siab qib ntawm cov kab mob, palpation ntawm hemorrhoids yuav tsum tau ua. Los ntawm kev ua cov kev kuaj mob, lawv qhov ntau thiab tsawg tuaj yeem qhia tau.
Rau qhov no, kev siv cov cuab yeej xws li anoscopy thiab sigmoidoscopy yog qhia. Anoscopy yog ib qho kev kuaj mob ntawm lub qhov quav mucosa. Sigmoidoscopy - kev siv qhov endoscope los tshuaj xyuas qhov quav.
Txhua txoj kev tshawb fawb ua los ntawm tus kws kho mob pom zoopreliminary cleansing enema. Yog tias qhov txheej txheem no tsis tau ua tiav raws sijhawm, kev kuaj xyuas yuav tsis muab cov txiaj ntsig raug vim yog cov dej ntws ntawm qhov quav nrog quav.
Txhua txoj kev kuaj mob tuaj yeem ua rau mob hnyav rau tus neeg mob, tshwj xeeb tshaj yog tias muaj teeb meem. Thaum yws qhov mob, tus kws kho mob ua tshuaj loog hauv zos.
Txoj kev kho mob
Kev kho mob ntawm cov hemorrhoids sab hauv tsuas yog muab nrog kev sib koom ua ke. Koj tuaj yeem tshem tau tus kab mob no mus tas li los ntawm kev siv cov txheej txheem kev saib xyuas, tswj kev noj qab haus huv thiab kev phais mob.
Ua ke nrog cov tshuaj, nws tsim nyog ua cov kev kho mob tshwj xeeb, nrog rau kev kho lub neej thiab kev noj haus. Kev kho tshuaj muaj xws li kev siv xws li:
- Yanti-inflammatory;
- laxatives;
- phlebotonics;
- tshuaj tiv thaiv kab mob.
Kev phais yog qhia yog tias txoj kev khaws cia tsis ua rau qhov xav tau lossis muaj teeb meem loj tshwm sim.
kev kho mob
Tsis muaj universal kho rau sab hauv hemorrhoids. Conservative therapy yog siv nyob rau hauv thawj theem ntawm kev loj hlob ntawm hemorrhoids los yog raws li ib tug complex kev kho mob thaum lub sij hawm phais. Qhov teeb meem tseem ceeb yog lub sijhawm no tsis muaj cov tsos mob pom tseeb thiab tus neeg mob yuav tsis paub txog qhov muajkab mob. Kev kho mob thawj theem ntawm hemorrhoids suav nrog kev siv xws li:
- phlebotonics - Ginkor Forte, Venoruton, Detralex, Phlebodia 600;
- laxatives - Microlax, Guttalax, Duphalac;
- lub qhov quav - Hepazolon, Prostopin, Ekonika.
Nyob rau theem thib ob, thawj cov cim qhia ntawm tus kab mob twb tshwm sim lawm. Rau kev kho mob ntawm sab hauv hemorrhoids hauv tsev, qhov quav suppositories feem ntau yog siv. Feem ntau lawv muaj cov nyhuv ua ke, uas yog:
- painkillers;
- Yanti-inflammatory;
- moo zoo;
- venotonic;
- anticoagulant.
Rau kev npaj cov teebmeem nyuaj tuaj yeem raug ntaus nqi xws li "Anuzol", "Procto-Glivenol", "Betiol". Tus nqi ntawm kev loj hlob ntawm tus kab mob no feem ntau cuam tshuam los ntawm cov txheej txheem kho. Nyob rau theem thib peb, hemorrhoids poob tawm txhua lub sijhawm, uas ua rau lawv raug mob, thiab los ntshav. Tias yog vim li cas kev kho mob phais lossis cov txheej txheem minimally invasive tau qhia. Cov tshuaj no yog siv los tshem tawm qhov mob.
Thaum theem 4 pib mus, cov tsos mob tshwm sim ntau dua. Prolapse ntawm hemorrhoids ua ntev yam tsis muaj kev txo qis tom qab. Kev kho tshuaj yog tsom los txo cov tsos mob uas twb muaj lawm thiab siv rau:
- pab mob;
- tshem tawmmob;
- tso tseg.
Kev xaiv cov tshuaj rau cov hemorrhoids sab hauv tsis yog nyob ntawm qhov chaw kho mob ntawm tus kab mob, tab sis kuj muaj ntau yam ntxiv. Ntau yam tshuaj raug txwv thaum cev xeeb tub thiab pub niam mis. tswm ciab, uas muaj xws li heparin, nruj me ntsis contraindicated nyob rau hauv los ntshav. Nrog rau kev kho kom raug thiab raws sijhawm, koj tuaj yeem tshem tawm cov kab mob uas twb muaj lawm, thiab tiv thaiv kev txhim kho ntawm cov teeb meem loj.
tshuaj ntsuab
tshuaj ntsuab tau pov thawj nws tus kheej zoo. Tshwj xeeb, tswm ciab thiab tshuaj pleev rau sab hauv hemorrhoids yog dav siv rau kev kho mob, uas tuaj yeem npaj los ntawm cov khoom xyaw ntuj.
Nws yog qhov ua tau kom tswm ciab hauv tsev los ntawm beets, qos yaj ywm, lard, aloe, quince. Cov tshuaj pov thawj pej xeem yog gauze swabs soaked nyob rau hauv hiav txwv buckthorn roj, zib mu los yog birch tar. Xws li cov kev kho mob sai sai tshem tawm qhov mob thiab tu thaj chaw cuam tshuam nrog cov vitamins uas yuav tsum tau ua. Tsis tas li ntawd, lawv pab kho cov phab ntsa ntawm cov hlab ntsha uas cuam tshuam.
Kev kho mob hemorrhoids hauv tsev yog siv cov microclysters. Txoj kev no muaj ntau qhov zoo, txij li cov tshuaj yog absorbed sai heev thiab pab tshem tawm cov tsos mob ntawm tus kab mob. Feem ntau, decoctions ntawm cov tshuaj ntsuab siv, tshwj xeeb, xws li chamomile, calendula, wormwood. Koj tseem tuaj yeem siv kua txiv beetrootlos yog qos yaj ywm, tshuaj propolis. Cov tshuaj no muaj cov nyhuv tonic ntawm cov hlab ntsha, thiab tseem muaj cov tshuaj tiv thaiv kab mob. Zoo pab kho hemorrhoids roj enemas. Koj tuaj yeem siv cov roj txiv roj lossis roj sunflower.
Koj tuaj yeem siv tshuaj ntsuab rau kev siv sab hauv. Kev sau tshuaj npaj los ntawm calendula, strawberry nplooj, linden paj, plantain, Rose petals tuaj yeem ua tau zoo heev. Rau kev siv sab hauv, jam ua los ntawm dogwood berries yog zoo suited.
Surgery
Txoj kev kho mob yooj yim tshaj plaws yuav yog kev phais. Kev tshem tawm ntawm hemorrhoids yog nyob rau theem 3-4th ntawm txoj kev loj hlob ntawm tus kab mob, nrog rau kev muaj teeb meem thiab thaj chaw necrotic. Muaj ob txoj hauv kev tseem ceeb rau kev tshem tawm cov chaw cuam tshuam, tshwj xeeb yog hemorrhoidectomy thiab transanal resection. Ob hom kev phais yog ua raws li kev siv tshuaj loog thiab yuav tsum tau ua tib zoo saib xyuas tom qab phais.
Hemorrhoidectomy yog ua los ntawm kev nthuav lub qhov quav thiab tom qab ntawd rub lub pob hauv sab hauv nrog lub clamp. Tom qab ntawd, lub pob caus yog excised, thiab lub qhov txhab yog sutured. Nyob rau hauv lub xub ntiag ntawm los ntshav, electrocoagulation ntawm lub qhov txhab yog ua nrog ib tug laser. Kev ua haujlwm tuaj yeem ua rau muaj kev cuam tshuam, uas yog vim li cas thiaj li yuav tsum muaj lub sijhawm kho dua tshiab.
Transanal resection yog ib feem ntawm qhov chaw me me ntawm lub qhov quav, uas ua rau nws tuaj yeem ua kom nruj cov hemorrhoids. Hom kev phais no suav hais tias tsis tshua muaj mob, thiab cov neeg mobua siab ntev nws zoo dua. Tsis tas li ntawd, nws tsim nyog sau cia lub sijhawm luv luv tom qab ua haujlwm thiab rov zoo sai.
Nws tsim nyog sau cia tias kev cuam tshuam kev phais muaj ntau yam contraindications, uas yuav tsum tau coj mus rau hauv tus account. Qhov kev ua haujlwm yog tshwj xeeb los ntawm tus kws kho mob uas tuaj koom, tom qab kev tshuaj ntsuam xyuas.
Lwm yam kev kho mob
Cov txheej txheem cuam tshuam tsawg kawg yog siv thaum pib ntawm tus kab mob. Lawv tau ua los ntawm tus neeg mob sab nraud thiab xyaum tsis mob, tab sis nws tsim nyog sau cia tias cov txiaj ntsig ntawm lawv yog luv luv. Ntawm cov tswv yim tseem ceeb, ib tus tuaj yeem paub qhov txawv xws li:
- sclerotherapy;
- bipolar coagulation;
- laser coagulation;
- suture ligation;
- latex nplhaib ligation.
Txoj kev ntawm sclerotherapy yog raws li kev qhia txog cov khoom tshwj xeeb rau hauv cov hlab ntsha dilated, uas provokes kev cais tawm ntawm cov hlab ntsha cuam tshuam los ntawm cov hlab ntsha. Rau qhov no, siv tshuaj xws li Fibro-Wayne, Thrombovar.
Infrared coagulation yog siv thaum muaj los ntshav. Rau nws qhov kev siv, ib qho cuab yeej tshwj xeeb yog siv, hluav taws xob hluav taws xob hluav taws xob uas nkag mus tob rau hauv cov ntaub so ntswg ntawm qhov chaw, qhov twg nws hloov mus rau hauv thermal zog. Qhov no pab kom tsis txhob los ntshav.
Suture ligation txhais tau hais tias nrog kev pab los ntawm ultrasound sensor qhov chaw ntawm cov hlab ntsha uas cov ntshav nkag mus rau hemorrhoid yog txiav txim siab. Lub nkoj no ces muab khi.
Kev ua neej
Ua ntej kev kho mob nyuajNws yog ib qho tsim nyog yuav tsum tau ua qee yam kev ntsuas uas yuav pab tshem tawm cov kab mob uas twb muaj lawm ntau dua thiab ua tau zoo. Muaj qee cov lus pom zoo uas yuav pab tshem tawm cov kab mob uas twb muaj lawm, tshwj xeeb, xws li:
- txhim kho cov txheej txheem defecation;
- ua raws li kev noj zaub mov zoo;
- siv tshuaj laxative;
- kev ua neej noj qab nyob zoo;
- no exercise.
Nws yog ib qho tseem ceeb saib qhov hnyav thiab tsis pub nws nce. Tsis tas li ntawd, koj yuav tsum tau mus taug kev hauv huab cua ntshiab kom ntau li ntau tau, tso tus cwj pwm phem, thiab koom nrog kev ua kis las nruab nrab.
Muaj Teeb Meem
Nyob rau hauv cov kab mob ntev, cov teeb meem thiab exacerbation ntawm sab hauv hemorrhoids feem ntau tshwm sim. Qee qhov kev tshwm sim tuaj yeem ua rau tus neeg mob lub neej. Cov chav kawm ntawm pathology tuaj yeem ua rau muaj teeb meem xws li:
- ntshav qab zib;
- pinched nodes thiab lawv cov necrosis tom ntej;
- poob ntshav tseem ceeb;
- kab mob;
- thrombosis;
- malignant qog;
- fistula formation.
Thaum twg muaj qhov tshwm sim no tshwm sim, yuav tsum muaj kev kho mob sai sai, uas feem ntau ua phais. Txawm hais tias muaj kev pheej hmoo siab ntawm kev tsim cov teeb meem loj, nws yog qhov ua tau kom tshem tawm cov hemorrhoids tag nrho, qhov tseem ceeb tshaj plaws yog kev kho mob kom raws sijhawm.
