Acute purulent paraproctitis yog ib yam kab mob uas tshwm sim los ntawm o ntawm cov ntaub so ntswg adipose uas nyob ib puag ncig lub qhov quav. Cov txiv neej feem ntau raug kev txom nyem los ntawm nws - cov qauv ntawm lawv cov cellular chaw nyob ze ntawm qhov quav qhov quav predisposes rau qhov no.
Vim li cas tus kab mob no tshwm sim? Cov tsos mob dab tsi qhia tias nws muaj? Thiab tus kab mob no kho tau li cas? Zoo, lub ncauj lus no tsim nyog saib xyuas tshwj xeeb.
Kev faib tawm
Thawj kauj ruam yog xa mus rau cov ntaub ntawv qhia hauv ICD-10. Paraproctitis, raws li kev faib tawm thoob ntiaj teb ntawm cov kab mob, belongs rau cov npe ntawm cov kab mob raws li txoj cai K61. Chav kawm no yog Abscess ntawm Anus thiab Rectum.
Lo lus abscessus yog txhais los ntawm Latin li "abscess". Abscess yog purulent o ntawm cov ntaub so ntswg. Thiab raws li ICD-10, paraproctitis yog cov hauv qab no:
- Anal (qhov quav) - K61.0.
- Rectal - K61.1.
- Anorectal - K61.2.
- Ishiorectal - K61. Z.
- Intrasphincteric - K61.4.
Cov kev faib cov ntawv sau tseg tias tus kab mob tuaj yeem ua tau ob qho tib si nrog lub fistula (ib txoj kab nruab nrab ntawm txoj kab thiab lub qhov quav),thiab tsis muaj nws.
Yog vim li cas
Raws li txoj cai, mob purulent paraproctitis tshwm sim los ntawm tib neeg kev kis kab mob nrog cov kab mob ntawm cov kab mob pathogenic.
Feem ntau nws yog E. coli. Nws nkag mus yuav luag unhindered rau hauv cov ntaub so ntswg fatty los ntawm lub qhov quav los yog los ntawm ulcers thiab qhov txhab. Tsis tas li, tus kab mob tuaj yeem tshwm sim vim yog kis kab mob nrog clostridium, enterococci, kab mob anaerobic thiab staphylococci.
Nws yuav tsum tau muab sau tseg tias cov kab mob tuaj yeem nkag mus yuav luag txhua feem ntawm cov rog subcutaneous. Tab sis raws li txoj cai, lawv cuam tshuam rau txheej lossis thaj chaw pelvic-rectal.
Nyob tsis tshua muaj, qhov ua rau mob purulent paraproctitis yog o ntawm prostate caj pas ntawm cov kab mob.
Yog tias peb tham txog cov pab pawg muaj kev pheej hmoo, cov txiv neej uas muaj ntshav qab zib mellitus, hemorrhoids lossis kab mob atherosclerotic vascular feem ntau raug rau tus kab mob no. Tsis tas li ntawd, cov xwm txheej tshwm sim muaj xws li kev sib deev ntawm qhov quav, ua rau tawg, nrog rau kev tiv thaiv tsis muaj zog.
Subcutaneous paraproctitis
daim ntawv no tus kab mob no yog tus yam ntxwv ntawm qhov chaw ntawm purulent tsom nyob rau hauv cov ntaub so ntswg rog ncaj qha rau ntawm daim tawv nqaij.
Thaum pom pom ib ncig ntawm lub qhov quav, qhov o ntawm cov xim liab yog pom tau. Txhua qhov kov, nrog rau kev sim zaum los yog defecate, ua rau mob hnyav ntawm qhov xwm txheej. Tsis tas li ntawd, tus neeg mob yws txogCov tsos mob ntawm kev qaug cawv, uas yog:
- Kub ncav cuag 39 ° C.
- Nyob zoo ib tsoom phooj ywg.
- xav tsis zoo.
- Kev tsis qab los noj mov.
- Mob hauv cov leeg, pob qij txha thiab pob txha.
Vim qhov teeb meem no ua rau muaj qhov tsis xis nyob thiab cuam tshuam rau lub neej ib txwm muaj, feem ntau cov txiv neej tam sim ntawd mus ntsib kws kho mob. Kev kuaj mob tsis ua rau muaj teeb meem - kev soj ntsuam, kuaj pom thiab palpation txaus.
Ishiorectal paraproctitis
Tus kab mob ntawm daim ntawv no tau kuaj pom yog tias qhov ua kom pom tseeb ntawm qhov mob yog nyob hauv ischiorectal fossa.
Qhov tshwj xeeb ntawm tus kab mob nyob rau hauv qhov tseeb tias cov txheej txheem pathological hauv qhov no kuj cuam tshuam rau cov leeg uas nce qhov quav. Yog li ntawd, tus neeg mob tau kov yeej los ntawm qhov mob ntawm lub plab me me thaum sim tso quav, hnoos lossis txham.
Yog tias koj tsis tig mus rau tus kws kho mob tam sim ntawd, ischiorectal paraproctitis yuav pib nce ntxiv. Tom qab ob peb hnub, lub qhov quav yuav o thiab hyperemic, thiab cov tsos mob hauv qab no tseem yuav tshwm sim:
- Kub 37.5-38 ° C, tab sis qee zaum siab dua.
- Ua pa yooj yim.
- Npaj siab lub plawv dhia.
- Paj hauv qhov quav.
- Nyob ib leeg pob tw.
- Smoothness ntawm qhov quav quav ntawm qhov cuam tshuam.
Hauv qhov no, koj yuav xav tau kev kuaj digital ntawm lub qhov quav, uas yuav pab txiav txim siab qhov mob ntawm phab ntsa thiab txiav txim siab qhov tseeb ntawm qhov nkag mus.
YPelviorectal paraproctitis
Nov yog ib rooj plaub tshwj xeeb,txij li cov txheej txheem pathological tsis tsuas yog txuas mus rau qhov chaw pelvic-rectal - nws cuam tshuam rau ciam teb ntawm lub plab kab noj hniav. Mob purulent paraproctitis ntawm daim ntawv no yog txaus ntshai vim nws xyaum tsis tshwm sim nws tus kheej nyob rau hauv txhua txoj kev, txij li thaum lub tsom xam nyob rau hauv tob.
Cov tsos mob kuj tsis yog tshwj xeeb. Nov yog yam uas ib tug neeg txhawj xeeb:
- Headache.
- ua npaws thiab ua daus no.
- Symptoms of pronounced intoxication.
- cem quav, dysuria.
- mob plab plab ntawm qhov tsis zoo. Sij hawm dhau mus, cov kev xav tau nyob hauv ib cheeb tsam, thiab tus neeg mob pib hnov lawv hauv qhov quav thiab hauv thaj chaw pelvic.
txhawm rau kuaj mob pelviorectal mob purulent paraproctitis, kev kuaj digital ntawm lub qhov quav yog qhov tsim nyog. Tab sis kom paub meej qhov kev kuaj mob, tus kws kho mob feem ntau xa tus neeg mob mus rau sigmoidoscopy thiab ultrasound.
YSubmucosal paraproctitis
Koj tuaj yeem twv qhov tshwj xeeb ntawm daim ntawv no los ntawm lub npe. Nyob rau hauv cov ntaub ntawv no, cov txheej txheem purulent yog nyob rau hauv lub mucous daim nyias nyias ntawm cov hnyuv distal. Yog li ntawd, cov neeg mob yws ntawm qhov mob hauv qhov quav.
Nyob rau hauv tus txheej txheem ntawm palpation, tus kws kho mob pom ib cheeb tsam nrog lub foob. Kev kov me ntsis tsis yog tsuas yog ua rau mob hnyav, tab sis kuj feem ntau provokes ib qho kev ua kom pom tseeb. Yog tias qhov no tshwm sim, ces nws cov ntsiab lus nkag mus rau hauv txoj hnyuv lumen, thiab tom qab ntawd nws raug tso tawm los ntawm qhov quav.
YRetrorectal paraproctitis
Cov ntaub ntawv no kuj nyuaj, vim tias qhov tsom ntawm kev kis mob tshwm sim tom qab lub qhov quav. Nws tsis tshwm hauvntev. Tej zaum tsuas muaj cov tsos mob ntawm intoxication. Qee cov neeg mob yws yws ntawm qhov mob ntawm lub paj hlwb sciatic. Nyob rau hauv tas li ntawd, daim duab kho mob muaj cov tsos mob ntawm neurological.
Los ntawm cov cim tshwj xeeb, nws tuaj yeem sau tseg tias nrog tus kab mob no, qhov mob kis mus rau perineum thiab ncej puab. Tseem muaj qee zaum los ntshav me ntsis ntawm cov mucous hauv thaj tsam ntawm ampoule thiab hyperemia.
Nws yuav tsum tau muab sau tseg tias tsuas yog 1.5-2.5% ntawm cov neeg mob uas muaj mob purulent paraproctitis muaj daim ntawv rov qab los hauv lawv cov keeb kwm kho mob. Qhov no yeej yog ib rooj plaub tsawg heev. Tab sis kiag li kho. Tom qab kuaj digital thiab sigmoidoscopy, tus kws kho mob tau sau ntawv kho mob uas yuav pab koj kho sai sai.
Drug therapy
Tam sim no koj tuaj yeem tham luv luv txog kev kho tus kab mob paraproctitis. Raws li txoj cai, tus kws kho mob proctologist tau sau cov tshuaj hauv qab no:
Vishnevsky tshuaj pleev. Ib qho tshuaj ua ke uas tua kab mob, tshem tawm qhov mob, thiab tseem txhawb kev tsim kho ntawm thaj chaw puas
- Y "Proctosedyl". Tshuaj pleev nrog corticosteroid cov tshuaj hormones. Nws thaiv cov txheej txheem inflammatory, muaj cov nyhuv analgesic thiab anti-edematous.
- "Locacorten-N". Cov tshuaj tiv thaiv kab mob nrog glucocorticosteroids sai sai txo qhov mob, tiv thaiv kev txhim kho ntawm kev kis kab mob thiab saturates daim tawv nqaij nrog cov khoom muaj txiaj ntsig, rov ua kom nws elasticity.
- "Posterized". Siab heevzoo suppositories uas muaj ib tug immunostimulating thiab anti-inflammatory nyhuv. Lawv txo exudation thaum lub sij hawm o, khaus, o thiab hyperemia, txhim kho lub suab ntawm cov hlab ntsha, thiab tseem txhawb kev tsim dua tshiab.
Thiab tau kawg, thaum tham txog yuav ua li cas kho tus kab mob paraproctitis, ib tus tsis tuaj yeem hais txog cov tshuaj suppositories nrog propolis. Nws yog ib qho tshuaj homeopathic ntawm lub hauv paus chiv keeb, uas muaj cov tshuaj tua kab mob thiab kho cov nyhuv.
Kab mob hauv me nyuam
Nws yuav tsum tau muab sau tseg tias paraproctitis muaj ntau heev hauv cov menyuam mos (hnub nyoog qis dua 6 hli). Yog vim li cas yog tib yam - nkag mus ntawm pathogenic microbes rau hauv lub cev. Cov menyuam mos muaj lub cev tsis muaj zog, yog li lawv yuav kis tau ntau dua li cov neeg laus kaum npaug.
Paraproctitis hauv cov menyuam mos yog qhov nyuaj rau pom. Ua ntej, ib daim ntawv me me, uas tom qab ntawd txhim kho mus rau hauv qhov txhab. Feem ntau nws tawm los thiab tawg. Yog tias nws tseem nyob hauv, cov txheej txheem ntawm kev tsim fistula pib (tsis yog nyob rau hauv txhua rooj plaub, tab sis feem ntau). Qhov no yog qhov txaus ntshai - yog cov kua paug nkag mus rau hauv lub plab kab noj hniav, peritonitis yog ua tau.
Yog li ntawd, nws tseem ceeb heev uas yuav tsum tau kuaj xyuas tas li. Cov tsos mob ceeb toom yog kub taub hau, tsis xis nyob ntawm tus me nyuam, kev tsis kam ntawm tus me nyuam noj, lethargy thiab deterioration ntawm cov tshuaj tiv thaiv, raws li zoo raws li nrog rau lub plab zom mov nrog quaj.
Kev ua haujlwm
Qhov kev ua haujlwm tsuas yog qhia yog tias pom muaj fistulous hauv tus neeg mob thaum kuaj. Kev phaiskev cuam tshuam yog tsom meej rau nws qhov kev tshem tawm.
Lub fistula tuaj yeem raug tshem tawm ntau txoj hauv kev - incision, excision, ligature method, yas phais, laser obliteration los yog collagen thread.
Kev tshem tawm ntawm lub hollow channel yog tsim nyog. Yog tias muaj fistula, ces kab mob yuav nkag mus rau hauv nws. Thiab qhov no yog fraught nrog tsis tu ncua relapses ntawm o. Hauv cov ntsiab lus yooj yim, paraproctitis yuav dhau mus ntev. Thiab kev tsis xis nyob yuav nrog ib tug neeg mus tas li.
Tom qab ua haujlwm, paraproctitis yuav rov zoo. Tab sis nws yuav siv sij hawm ntev kom rov zoo. Tus neeg mob yuav tsum tau noj tshuaj tua kab mob thiab tshuaj tua kab mob, hnav khaub ncaws txhua hnub, thiab ua raws li kev noj zaub mov tsis muaj slag - noj mov thiab semolina porridge rau hauv dej, boiled ntses, steamed meatballs thiab omelettes. Koj tseem yuav tau tuav quav 2-3 hnub.
Lub qhov txhab zoo nyob hauv 3-4 lub lis piam. Tab sis kev kho kom rov zoo tag nrho yuav siv sij hawm 2-3 lub hlis.
