I-anal thrombosis - i-thrombosis ye-anal vein
Iyini i-perianal thrombosis?
I-Perianal thromboses yizigaxa ezibuhlungu ku-rectum ezibangelwa ukwakheka kwamahlule emithanjeni ye-perianal.
Amahlule egazi angase akheke emithanjeni ye-perianal - eyaziwa nangokuthi "ama-hemorrhoids angaphandle" noma "i-varicose veins of the rectum" - okubangela isigaxa esibuhlungu - i-anal thrombosis - ku-anus. I-perianal thrombosis ingaba yincane noma ilingane neplamu futhi ingavala ingxenye yengxenye ye-rectum. I-Anal thrombosis ingenzeka ngokuzumayo, njengokuthatha uhambo olude noma ukuhlala isikhathi eside. I-Perianal thrombosis ingazwakala emaphethelweni e-anal, kodwa i-thrombosis ingase yenzeke endaweni engaphakathi yomsele we-anal. Inhlanganisela ye-thrombosis yangaphakathi nangaphandle ibuhlungu kakhulu, iholela ekuvuvukeni okukhulu, i-prolapse, ukwakheka kwama-node aqinile ngisho nokuvuvukala nokuvuvukala. I-Perianal thrombosis iyenzeka lapho amahlule akheka eduze kwe-rectum endaweni engaphandle. Isigaxa singaba sincane, kodwa ngezinye izikhathi sibe yiplamu, esithatha ingxenye eyodwa kuphela ye-rectum. I-Anal thrombosis ivela ngokuzumayo, ngezinye izikhathi phakathi nohambo olude noma lapho ihlezi isikhathi eside. Kodwa amahlule angakheka nangaphakathi, ama-hemorrhoids eqiniso. I-thrombosis ehlanganisiwe yama-hemorrhoids yangaphakathi nangaphandle ibuhlungu kakhulu, iholela ekuvuvukeni okukhulu, i-prolapse, ukwakheka kwama-nodule aqinile ngisho nokuvuvukala nokuvuvukala.
Izimpawu ze-perianal thrombosis
I-Anal thrombosis ibangela izimpawu ezilandelayo:
- Iqhubu elizwakalayo, elibuhlungu emaphethelweni endunu
- Ukuvuvukala (kufika kusayizi weplamu)
- Ubuhlungu obungase bube nzima kakhulu ekuqaleni
- Kunzima, ukuhlala kubuhlungu
- Ezinye izikhalo: umuzwa wokucindezela, ukushaya, ukuhlaba, ukushisa, ukulunywa
- Igazi elimnyama ephepheni lasendlini yangasese lapho i-thrombotized node iqhuma
I-Anal thrombosis ngaphambi nangemva kwezithombe
Ingabe i-anal thrombosis iyingozi?
I-anal thrombosis ngokwayo ayikwazi ukubangela i-pulmonary embolism. Lokhu kwehluka ku-thrombosis ye-leg vein. Kodwa-ke, ama-thromboses amakhulu e-perianal abuhlungu, avuvukele, angaqhuma bese opha. Nakuba ukopha ngokwako kungekukhulu, kusathusa futhi kufanele kumiswe. Ukuqhuma kwe-thrombosis ku-anus, okungase kuvutha. Uma ingelashwa, iqhubu lihlala, elibonakala njengethegi yesikhumba ku-rectum. Amathegi esikhumba abe esephazamisa ukuhlanzeka, futhi inhlanzeko ye-rectum ngokuvamile ayifiseleki ngokombono wobuhle.
Ukuhlolwa kwe-proctologist
Odokotela bezwe kanye nodokotela abajwayelekile babona kuphela i-thrombosis ngokusebenzisa ukuxilongwa okubonakalayo ngoba isigaxa esibuhlungu esiphambi kwe-rectum sibonakala ngokucacile. I-proctologist yesimanje manje ingakwazi ukubona ngeso lengqondo ukujula kwe-pelvic floor isebenzisa i-ultrasound futhi inikeze isithombe esiqondile sobukhulu be-thrombosis, ukubandakanyeka nokuthuthukiswa kwama-hemorrhoids angaphakathi kanye nokunye okungenzeka, izifo ezikhona ngesikhathi esifanayo ze-anal and perianal (fistula, amathumba. , I-Prolapse, izimila, ama-polyps, izitho ezishintshayo ezingomakhelwane) futhi ngaleyo ndlela wenze ukuxilongwa okuphelele ngaphandle kobuhlungu futhi ngaphandle komzamo omkhulu ngokuthwebula isithombe phezu kwayo yonke i-pelvis encane kuhlanganise naphezu kwe-hemorrhoid pad. Ukuxilongwa okuphelele nokuhlukanisayo kubalulekile ukuze kungabikho ezinye izifo ezibalulekile ezinganakwa, isibonelo. Uhlelo lokwelapha lulungile kuphela uma zonke izifo endaweni zicatshangelwa.
Ukwelashwa kwe-anal thrombosis
Ukwelashwa nge-Laser
Izicubu ezigulayo, ama-hemorrhoids kanye ne-thrombosis zingasuswa ngokushesha futhi ngobumnene nge-laser beam ye-1470 nm diode laser, ngaphandle kokusikeka futhi ngaphandle kobuhlungu. Izicubu, i-thrombosis, i-vaporized, okungukuthi, ishisa futhi iguqulwa ibe yi-steam. Okusele kuwuhlobo nje “lomlotha”, okungukuthi izinsalela zezicubu ezigayiwe. Le mpushana yezicubu ingamuncwa ekupheleni kwenqubo ye-laser, ukuze kusele umthungo omncane kuphela ku-thrombosis node, ebukeka iphulukisa ngakusasa futhi ibuhlungu neze. Kubalulekile ukuthi i-laser ingasetshenziswa futhi ukwelapha nokuvala eminye imithambo ye-perianal engakavaleki, kanye nama-hemorrhoids namathegi esikhumba. Lokhu kubaluleke kakhulu ngoba i-perianal thrombosis akusona isifo esizimele futhi akusona isifo esithinta iphuzu elilodwa kuphela emnyango we-anal. Njengomthetho, kuneminye imithambo ye-perianal eguge kakhulu emaphethelweni endunu, ehlelelwe i-thrombosis yakamuva. Ngaphezu kwalokho, imithambo ye-perianal kuphela "i-tip of the iceberg" futhi ibonakala njengokuqhubeka kwama-hemorrhoids angaphakathi. Bona isithombe esingenhla. Lokho kusho ukuthi: ama-hemorrhoids angaphakathi yiwo abangela ukuthi imithambo ye-perianal, "i-varicose veins" ye-anal edge, ivele kuqala. Ithishu ye-ano-rectal erectile ngokombono we-Stelzner, evuvukala lapho impontshwa isuka esiswini yimithambo eqinile, elandelwa ingxenye yomkhumbi we-venous emaphethelweni endunu, okukhulunywa ngayo emazweni abakhuluma isiNgisi. "yangaphandle - yangaphandle - ama-hemorrhoids". Ngaphandle kwama-hemorrhoids (angaphakathi), awekho ama-hemorrhoids "angaphandle", awekho ama-perianal veins kanye ne-thrombosis yawo. Ngakho-ke, ukwelashwa okufanele okunengqondo yilokho kuphela okuhlanganisa zonke izingxenye ze-vascular bundle, i-anal corpora cavernosa: ama-hemorrhoids angaphakathi + angaphandle, hhayi kuphela ama-hemorrhoids angaphandle asevele esesigabeni se-thrombosis, kodwa futhi nemithambo ye-perianal kanye nama-hemorrhoids. abakatholi i-thrombosis kodwa cishe izobangela ezinye izinkinga nezinkinga esikhathini esizayo. Ngesikhathi somhlangano we I-Laser Hemorrhoid Plastic Surgery (LHPC) Ngakho-ke zonke izingxenye ezingenzeka ze-hemorrhoid kanye nesifo se-thrombosis ziyasuswa, njengokungathi "suliwe" nayo yonke imiphumela emibi engabonakali noma ubuhlungu ngaphandle komthwalo owengeziwe obonakalayo esigulini.
Nge-LHPC, kokubili ama-hemorrhoids kanye ne-anal thrombosis kuyaqedwa ngesikhathi esisodwa. Nokho, ngemva kwenqubo, labo abalashwayo bangahlala, bahambe futhi baqhubeke nemisebenzi yabo evamile ngokushesha. Ayikho enye inqubo eyaziwa ku-proctology, lapho kokubili i-thrombosis kanye neminye i-pathologically egugile emithanjeni ye-perianal nokuningi. konke Ama-hemorrhoids angasuswa ngeseshini eyodwa ye-laser ngaphandle kokusikwa futhi kamuva ngaphandle kwesilonda, ngaphandle kobuhlungu noma okunye ukuhlupheka. Le nkonzo eyingqayizivele yenzeka ngaphandle kokuhlala esibhedlela, ukuhlinzwa nje kwehora elingu-1-1,5. kuhlanganise ne-anesthesia encane yesiguli. Izithombe zethu zangaphambi nangemuva ze-hemorrhoid laser plastic surgery (LHPC) kanye nokuhlinzwa kwe-laser perianal thrombosis emtholampilo wethu kubonisa impumelelo enkulu ngaphandle kwemiphumela emibi emikhulu.
Ukugwazwa
I-thrombosis entsha ye-anal ingabhobozwa ngaphansi kwe-anesthesia yendawo futhi ihlule liphushelwe ngaphandle. Ukukhululwa kulandela ngokushesha. Esikhathini esidlule, odokotela bezwe kanye nodokotela abajwayelekile babephatha yonke i-thrombosis ngokubhoboza. Kodwa-ke, kunengozi yokutheleleka ngenxa yokuthi isilonda sihlala sivulekile. Inxeba lokubhoboza elivulekile liyagobhoza futhi ligcobe igazi futhi lingatheleleka. Ukuphulukiswa kuthatha cishe izinsuku ezingu-7-10 ngobuhlungu obuthile. Kodwa-ke, lokhu kwelashwa kusebenza kuphela ku-thrombosis encane - kuze kufike kusayizi we-pea. Ngawo wonke amanye, ama-thromboses amakhulu, uthola ukulimala kwenxeba futhi kamuva kube nesigaxa esihlala njalo emnyango wendunu uma i-thrombosis enkulu ibhoboze futhi ikhishwe kancane.
Ukucwecwa kwepulasitiki yokuhlinzwa
Le ndlela ivamile kithi ngoba, ngesipiliyoni seminyaka engu-40, singanikeza ukuxebuka kwepulasitiki okungavamisile okuncane, ngisho nasezimeni ze-thrombosis enkulu kakhulu, enemiphumela engemihle emincane kanye nokungakhululeki. Isiguli sinquma ukuthi sisebenzise i-anesthesia yendawo noma i-twilight i-anesthesia yokulala njengoba sithanda. Kunoma yikuphi, singakwazi ukwenza i-anesthesia yendawo ngaphandle kobuhlungu obuningi ukuze inqubo ngokwayo ingabi nabuhlungu ngokuphelele. Inzuzo yokucwecwa kwepulasitiki yokuhlinzwa ukususwa okuphelele kwazo zonke izicubu ezivuvukele ezilinyazwe yi-thrombosis. Kusele izicubu ezinempilo kuphela, lapho umnyango we-anal wakhiwe kabusha ngokuphelele kusuka endaweni encane yokufinyelela kusetshenziswa ama-plastic sutures acwile, angabonakali. Abukho ubuhlungu ngemva kwalokho, okungenani izinsuku ezingu-1-2, ezingalawuleka kalula ngama-analgesics amancane. Ukuphulukiswa kwamanxeba ngokuvamile kuqhubeka kangcono kakhulu futhi ngokushesha kunangemva kokubhoboza i-thrombosis. Uma ama-hemorrhoids ane-prolapse noma i-prolapse ekhona, ukwelashwa kokuxhunyaniswa okuncane kanye kanye ne-HAL, i-RAR noma i-ligation excision kungenzeka. Lokhu kusindisa isiguli okunye ukuhlinzwa kwe-hemorrhoid ngoba ama-hemorrhoids abangela imithambo ye-perianal kanye ne-thrombosis nawo ayasuswa. Ekusebenzeni kwethu, okugxile kakhulu ku-proctology, ukucwecwa kwepulasitiki okuhlinza kukodwa noma okuhlanganiswe ne-laser vaporization kufakazele ukuthi kuyindlela efakazelwe kahle yayo yonke i-anal thrombosis.
Ukwelashwa ngamafutha e-hemorrhoid?
Ama-thromboses amancane endunu kanye ne-perianal angaxazululeka, kuyilapho ama-thromboses amakhulu abe eseqhuma ngemva kwezinsuku ezimbalwa ezibuhlungu. Ukunciphisa ukuvuvukala kwama-hemorrhoids amancane, amafutha afana ne-Faktu-Akut noma i-cortisone kanye namafutha e-lidocaine ayasiza esikhathini esifushane. Amafutha e-Heparin anganciphisa ukusakazeka kwe-thrombosis. Kodwa-ke, ngisho nangemva kokuba ukuvuvukala sekuphelile, isigaxa noma ithegi yesikhumba cishe ihlala njalo. Wonke umuntu manje kufanele azinqumele ukuthi kufanele achithe impilo yakhe yonke namathegi esikhumba anganda futhi aphazamise inhlanzeko ngokuhamba kwesikhathi. I-Anal thrombosis ene-throbbing, ubuhlungu obandayo nokuvuvukala kudinga ukunakekelwa okuphuthumayo kwezokwelapha, ngokufanelekile okuvela ku-proctologist, ongakwazi futhi ukwenza izinqubo ezincane ngokushesha esigulini esingaphandle.
Ukwelashwa ngemuva kokususwa kwe-thrombosis ye-anal
Ngemuva kwe-laser anal thrombosis ngokwelashwa nge-laser hemorrhoid noma ngaphandle kwayo, ukuphulukiswa kuyashesha kakhulu. Kukhona kuphela inxeba lokubhoboza elincane elingu-3-5 mm endaweni yokungena endunu, lapho “umpuphu” wawumuncwa khona ngemva kokuhwamuka kwe-thrombosis. Uma kungenjalo alikho nhlobo inxeba, noma ku-rectum noma i-perianally emaphethelweni e-anal. Uma kungesona isilonda, akukho ukuphazamiseka kokuphola kwesilonda. Kodwa-ke, i-laser beam ngezikhathi ezithile iba nemiphumela yayo engemihle ngoba ukuhwamuka kwenzeka ngokushisisa, “ngokushisa” izicubu ze-hemorrhoidal. Ubuciko be-LHPC laser therapy buseqinisweni lokuthi ulwelwesi lwamafinyila olubucayi lushiywa lungalimele, kuyilapho ama-hemorrhoids kanye ne-thrombosis ngaphansi kushile ngokuphelele, ukuze kungabikho mkhondo wokucekelwa phansi okukhulu kwangaphakathi kwe-thrombosis kanye nama-hemorrhoids angabonwa noma wezwa. Inhlanganisela yokuvikelwa kwezicubu nokusebenza ngempumelelo kwapheleliswa inqubo ye-LHPC: leyo eyasungulwa uDkt. U-Haffner uthuthukise inqubo ye-LHP, esebenza ngezimiso ezahlukene kanye negayidi yokukhanya ye-laser ehlukile kanye nezindlela zokuhlinza ezihlukile kunezokuqala ze-LHP. Izithombe zangaphambi nangemuva zokwelashwa nge-laser ye-hemorrhoid, ukwelashwa nge-laser kwe-thrombosis ye-anal vein, kanye nesigaba sokuphulukisa esisheshayo nesiphansi kufakazela ukusebenza kahle okuphezulu nokuvikelwa kwezicubu okuthuthukisiwe kwenqubo ye-LHPC.
Isigaba sokuphulukisa ngemva kokususwa kokuhlinzwa kwepulasitiki kwe-thrombosis siyizinsuku ezimbalwa ubude, kodwa ngokuvamile asiba buhlungu. Kodwa-ke, ukuxetshulwa kwepulasitiki kwe-anal vein thrombosis kuhlala kwenziwa uma kukhulunywa ngama-thromboses amakhulu - amakhulu kuneplamu - athatha ingxenye ye-rectum futhi ngenxa yalokho adinga udokotela ohlinzayo onolwazi olunzulu oqeqeshelwe ukuhlinzwa kwepulasitiki. Kodwa-ke, ezandleni zabanolwazi, ngisho nokutholakele okukhulu okunjalo kujwayelekile futhi kungenziwa njengomsebenzi ojwayelekile ngaphandle kwezinkinga. Isigaba sokuphulukisa manje sithatha cishe izinsuku ezingu-7-10 ezimweni ezinkulu, kodwa ukungaphatheki kahle okuncane kuphela okulindelekile.
Ukuvimbela thrombosis perianal
Ukuvimbela kusebenza kuphela uma uqaphela imbangela ye-perianal thrombosis, okungukuthi: ama-hemorrhoids, ukuminyana kwendawo ephezulu yokucindezela okubangelwa ama-hemorrhoids, ukusabalala kwe-perinal "varicose veins", okungukuthi i-dammed-up hemorrhoids yangaphandle.
Ngamanye amazwi: uma i-proctologist - noma udokotela womndeni - ebona imithambo ye-perianal ngesikhathi sokuhlolwa kwe-proctological, kufanele futhi acabange ngama-hemorrhoids futhi aqinisekise ukususwa kwawo kokuqala, okuvimbelayo. Ngokunjalo, imithambo ye-perianal ebonakalayo egcwele kakhulu, ebukeka njengemithambo ye-varicose, kufanele isuswe njengesexwayiso - ngaphambi kokuthi kwenzeke i-thrombosis. Le filosofi yintsha futhi iyindawo yokuthengisa eyingqayizivele ye-HeumarktClinic. Ngokwezimfundiso nemihlahlandlela yakudala ye-proctology, esasebenza nanamuhla, awudingi ukwenza lutho ngemithambo ye-perianal noma kuphela uma i-thrombosis yenzekile lapho. Ngokusho kwefilosofi yethu entsha, wonke umuntu kufanele acabange ngempilo yakhe njengendlela yokuzivikela futhi abe nezandulela ze-thrombosis, i-perianal "varicose veins" isuswe njengesinyathelo sokuqapha ngaphambi kokuqala kwe-thrombosis, kanye nama-hemorrhoids aqalayo. Ukulungiswa kwalokhu kwelashwa okusha kokuvimbela ama-hemorrhoids kanye nemithambo ye-perianal kuvela ekwethulweni kokwelashwa nge-laser kanye nenqubo ye-LHPC kaDkt. Haffner. Ukuhlinzwa okuqinile kokuvimbela ngaphakathi nangaphandle kwe-rectum kusetshenziswa izindlela ezindala kusetshenziswa imimese nesikele kuvinjiwe futhi akukho mbuzo ngoba kungahlukumeza kakhulu.
Ukwelashwa nge-laser kwenza kube nokwenzeka ukuvimbela izinkinga zesifo se-hemorrhoid - kuhlanganise ne-anal thrombosis - ngokuvimbela i-laser.
Inqubo esebenzayo: Uma udokotela ethola imithambo ye-perianal noma ama-hemorrhoids kusukela esiteji sesi-2 kuye phambili, bese enza i-laser sclerotherapy yokuvimbela yakho kokubili ama-hemorrhoids nayo yonke imithambo ye-perinal. Lokhu kuvimbela i-thrombosis nokuqhubekela phambili kwesifo se-hemorrhoid, kukusindisa ukuvakashela kudokotela, ukuhlinzwa okukhulu ngisho nasesibhedlela, ubuye ulondoloze izindleko, futhi uzivikele ngokumelene ne-thrombosis yesikhathi esizayo, izinyembezi, i-rectum evuzayo, i-eczema, ukulunywa, ukushisa kanye nokungasebenzi kahle kwe-anal. ngokugcoba indle.
Ngokombono wethu ngamunye, iziguli akufanele zizilahle esiphethweni sokuwohloka futhi kufanele zilinde ukuthi i-thrombosis yakheke futhi ziye kudokotela kuphela lapho i-thrombosis isivele iphoqa. Ngokushesha kungcono, ngokushesha kuba lula.
Die Ukwelashwa nge-laser nge-LHPC yenza kube nokwenzeka ukuvimbela i-thrombosis nama-hemorrhoids ngaphandle kwemiphumela emibi ebalulekile.