Ama-Hemorrhoids - Ama-Hemorrhoids - Ama-Hemorrhoids

Ama-hemorrhoids yisifo esisabalele, kepha akekho okhuluma ngaso.

Ingabe uSind Hämorrhoiden? 

Ama-hemorrhoids - ama-hemorrhoids - ama-nodular dilations emithanjeni yegazi e-rectum, ehlinzekwa ngumthambo ophakathi onomfutho wegazi ophezulu. Ama-hemorrhoids awawona imikhumbi evamile ye-anal, ehlinzeka nge-cushioning yokulawulwa kwendle. Ama-hemorrhoids asevele agugile imikhumbi ye-rectal, engaholela ekuqhumeni kwamathumbu futhi kuholele ekuvuzeni nasekuphumeni kwamafinyila. Ngenxa yalokho, ama-hemorrhoids adala izimpawu ezinjengokuphuma, ukucasuka kwesikhumba, ukusha, ukulunywa futhi ngezinye izikhathi ukopha. Ngolimi lobuchwepheshe, ama-hemorrhoids angaphandle abizwa ngokuthi "i-perinal veins". I-Perianal thrombosis noma i-anal vein thrombosis iyiqhubu elizumayo, elibuhlungu ku-rectum elidinga ukunakekelwa kwezokwelapha ngokushesha.

Izinkinga zama-hemorrhoids

Izimbangela eziqondile ze-hemorrhoids aziqondi ngokugcwele. Isizathu esiyinhloko sibonakala kuwukuphila ngokuzihlalela kanye nokungadli imicu eyanele. Ukudla okunothe nge-fiber okufana ne-cereal, isaladi, i-oatmeal kanye ne-wheat bran kuyingxenye yokudla okunempilo, kodwa akubona bonke abantu abakulandelayo. Ngaphezu kwalokho, izakhi zofuzo nazo zingadlala indima ekuthuthukiseni ama-hemorrhoids.

Ama-hemorrhoids - ngaphambi nangemva kwezithombe

Funda kabanzi ngezithombe kanye nangaphambi nangemuva kwezithombe mayelana ama-hemorrhoids,  imithambo perianal, ngaphambi nangemva kwezithombe mayelana nokuhlinzwa kwe-laser hemorrhoid (LHPC)  futhi ukwelashwa kwe-laser hemorrhoid, kanye Ukwelashwa kwe-laser ye-Perianal vein futhi Ukwelashwa kwe-laser ye-Perianal thrombosis e-HeumarktClinic Cologne noDkt. Haffner.  

Izimpawu zama-hemorrhoids?

Ama-hemorrhoids nganoma yiluphi uhlobo ngokuvamile angabangela ukopha nokuluma endaweni ye-anal. Kubuye kube nezinkinga ngokuphuma kwamathumbu. Iziguli ezine-hemorrhoids ngokuvamile kufanele ziye endlini yangasese izikhathi eziningana zilandelana futhi azikwazi ukuthulula yonke into ngesikhathi esisodwa. Ukuqunjelwa, ingcindezi nobuhlungu nakho kuyizimpawu ezivamile. Ukugcotshwa kwendle nakho kungase kwenzeke, kodwa lokhu kuhlukile ekungalawuleni indle. Ngama-hemorrhoids, ukuhluleka kwe-fecal kweqiniso akwenzeki ngoba i-reflexively tense deep sphincter ayivimbeli nje kuphela i-hemorrhoid ekuqhumeni, kodwa futhi ivikela ekungangeni kwe-fecal. Kodwa-ke, lokhu kuvikelwa kwemisipha okuhlinzekwa yimisipha ejulile ye-pelvic floor akukwazi ukuvimbela inkinga ye-continence enhle emaphethelweni e-anal. Ukungasebenzi kahle kwendunu ekungeneni kwendunu bese kuholela ezimpahleni ezijwayelekile ze-hemorrhoid njengokuphuma, ukulunywa, ukushiswa nokugcotshwa. "Imithambo ye-perianal" egcwele, ebonwa ngokuthi "imithambo ye-varicose ye-rectum" noma i-hemorrhoids yangaphandle, idala inkinga ngoba ingaholela ekuvuthweni kwe-perianal noma i-anal vein thrombosis noma ibangele izinyembezi ezincane ezopha futhi ezibuhlungu futhi ngenxa yesifo se-Hemorrhoid. kunzima ukuphulukisa.

Ukopha nge-rectum

Ngokweziqondiso ze-S3, ukubonakaliswa okuvame kakhulu kwama-hemorrhoids ukopha ku-rectum. Ngokweziqondiso, imvamisa kanye nokuqina kokopha akulandeli ukwakheka kwama-hemorrhoids okukhulunywe ngenhla. Ukopha ku-rectum kungenzeka ngisho nama-hemorrhoids amancane futhi kuxwayise ngokufanelekile iziguli ezigabeni zokuqala zesifo se-hemorrhoid. Njengoba kungekho muntu ofuna ukuphila ngokuphuma kwegazi ku-rectum, ukwelashwa, isib. B. ngokuhlinzwa okwenziwe nge-laser, sekuvele kukhonjisiwe kuma-hemorrhoids amancane uma kubangela ukopha noma ezinye izimpawu. Ukopha okuvela kuma-arterial vascular conglomerates akha ama-hemorrhoids ngokuvamile kubabomvu ngokugqamile. Ukopha kungaba kuncane, kodwa futhi kungaba nzima kakhulu futhi kuholele ekuweni. Njengoba umzimba womuntu ungahlala uvala i-rectum ngenxa yemisipha eqinile ye-sphincter, igazi liqala ukuqoqa ku-ampulla ye-rectum. Khona-ke ingadluliswa ngamanani amakhulu njengendle emnyama ebomvu. Imithambo ye-Perianal eyopha ngezinyembezi zendundu nayo ingase yophe ngokubomvu okumnyama. Kubalulekile ukwazi ukuthi izimpawu zokuqala ze-colon kanye nama-rectal tumors ngokuvamile ukopha. Ngakho-ke, uma wopha ku-rectum, kuyadingeka ngokushesha ukuthi uvakashele i-proctologist e-Cologne futhi uthole ukuxilongwa okusheshayo okwenziwa ngaphandle kwamalungiselelo ayinkimbinkimbi. Konke okudingekayo ukunyakaza kwamathumbu okuvamile ekhaya ngaphambi kokuhlolwa nokuhlanza okuhlanzekile.

I-Perianal eczema - ukuvuvukala kwe-perianal

Ukuvuvukala kwesikhumba okungapheli, okucasulayo futhi okunobuthi ku-anus kubizwa ngokuthi i-perianal eczema. I-proctologist eqaphile izobona isikhumba esimhlophe-bomvu esinamanxeba amancane kuya kwamakhulu kanye nemifantu. Isikhumba se-perianal sivuvukele, sibonisa ukwanda kokushwabana kanye namathegi esikhumba abizwa ngokuthi amathegi esikhumba. Ukuxilongwa kungenziwa ngisho nodokotela womndeni ngokusihlola ngaphandle kokuhlolwa okwengeziwe: Udokotela oqaphile ubona isikhumba esimhlophe-esibomvu futhi esimboziwe, esibuhlungu nesishwabene endaweni ecishe ibe ngu-2-6 cm ezungeze i-rectum. Lapho umsele wangemuva ubhebhetheka, amafinyila, umswakama, noma ngezinye izikhathi kungase kubonakale ukukhishwa kwendle. Ezinye iziguli zisebenzisa ukhilimu njalo. Uma isiguli nge creamtem Lapho i-rectum ifika ku-proctologist, lokhu kakade kubonisa isifo esithuthukisiwe se-hemorrhoid.

Ukuluma kwendunu, ukulunywa kanye nokusha ku-rectum

Izimpawu zama-hemorrhoids, njengokuluma, ukushisa, ubuhlungu nokuluma ku-rectum, zivela ngenxa yokungasebenzi kahle kwe-anal lapho i-rectum ingakwazi ukuvala ngokuphelele futhi yomile. Lokhu kubangela ukucasuka kwesikhumba, okufana nomkhuhlane omkhulu, lapho ikhala eligijima licasula kakhulu isikhumba esinempilo futhi esomile ngaphambili. Ngisho noma i-rectum ingavalwanga ngokuphelele ngenxa yama-hemorrhoids, kwanele ukuthi i-mucus encane ephuma emgodini we-anal, embozwe ulwelwesi lwamafinyila, ihlale ingena esikhumbeni sokuqala esomile futhi isigcobe. Isikhumba esomile, esinempilo emnyango wendunu siyahlaselwa, sonakaliswe, sivuvukele futhi sivuvukele, okuholela ekulunyweni nasekushiseni. Ngakho-ke akudingekile ukuthi "i-stool incontinence" yenzeke ukuze uzwe ukulunywa nokusha ku-rectum. Ngisho noma i-rectum ikwazi ukubamba indle emagebhugebhu, isentimitha lokugcina endaweni yokungena endunu ingase ivaleke ngendlela efanele uma ukuvala ngokuphelele kungenakwenzeka ngenxa yokuvuvukala kwama-hemorrhoids. Lokhu kubangela ukuba amafinyila kanye nomswakama kuphume kulwelwesi oluvamile lwamafinyila, okuholela ekulunyweni kwesikhumba esivamile sangaphandle, esingakwazi ukubekezelela i-mucus esikhathini eside.

Ukuvuvukala kwama-hemorrhoids

Isigaba sikaGoligher sama-hemorrhoids siphakamisa ngokungalungile ukuthi ama-hemorrhoids abangela inkinga eyodwa kuphela, i-prolapse. Lesi sigaba esiphelelwe yisikhathi sinika umbono wokuthi ubulukhuni besifo sokoma kanye nezimpawu ezihambisana nakho kuhlobene kuphela nezinga lokuqubuka kwe-hemorrhoid yangaphakathi. Ama-hemorrhoids angaphandle akhuphukayo, i-thrombosis yama-hemorrhoids angaphandle, ukungasebenzi kahle kwendunu, ukuphazamiseka kwe-continence, ukopha, umswakama nokuluma kanye ne-eczema yesikhumba akunakwa. Ngisho nomhlahlandlela we-S3 eJalimane usamukele lesi sigaba esiphelelwe yisikhathi futhi uphakamisa izinkomba zokuhlinzwa ngokusekelwe kulesi sigaba esiphelelwe yisikhathi sama-hemorrhoids. I-Goligher's staging of hemorrhoids icabangela kuphela ukuqhuma kwama-hemorrhoids angaphakathi. Kodwa-ke, emitholampilo ye-proctology, iziguli zivame ukuba khona ngokunyuka okuhlangene kwama-hemorrhoids angaphakathi nangaphandle kanye namathegi esikhumba, azwakala njengeqhubu elizwakalayo ku-anus futhi aphazamise ukuhlanzeka kwendunu nokukhipha. Lapho i-thrombosis yama-hemorrhoids angaphandle noma ukucasuka njalo kwesikhumba ekugcineni kwe-prolapse kwenzeka, iziguli zivame ukufisa ukususwa okuthambile nokungenabuhlungu, kungakhathaliseki ukuthi ama-hemorrhoids angaphakathi asesiteji II noma III. Cishe u-90-95% weziguli zifuna usizo ngenxa yesigaxa esiphuphumayo ku-rectum, esibonakala njengomthambo oshayayo. Cishe u-10% kuphela weziguli ezifuna usizo nge-prolapsed hemorrhoids, okufanele ngezikhathi ezithile ihlehliswe ngomunwe. Izimpawu zesikhumba njengezigaxa ku-anus ziyisizathu esivamile sokuvakashela i-proctologist, futhi iziguli eziningi zifuna ukwelashwa ngaphandle kokuhlinzwa, isb. B. ngokwelashwa nge-laser.

Ukuqhekeka kwe-anal

Izinyembezi ze-anal zingenzeka ngenxa yokwelula okukhulu noma ngaphandle kokulimala kwangaphandle ngenxa yesikhumba esithambile nesivuvukele se-perianal kanye nolwelwesi lwamafinyila. Imifantu ingenzeka kokubili emnyango wendunu njengemifantu yakudala noma njengemifantu emincane namanxeba azungeze i-rectum. Isikhumba esivuvukele, imifantu namanxeba kubuhlungu kakhulu ngokuzenzakalelayo nangokuthinta kancane. Ngenxa yokuminyana kwegazi kuma-hemorrhoids kanye nemithambo ye-perianal, ulwelwesi lwamafinyila luvuvukala njengebhaluni. Khona-ke ulwelwesi lwamafinyila olukhukhumele lukhala njengebhaluni lapho indle iklwebha. Isikhumba esivuvukele futhi esine-eczematous perianal asikwazi ukuqina kunesikhumba esinempilo. Ngakho-ke, ama-hemorrhoids angaholela ekuqhekekeni kwe-anal ngenxa yokulimala kwesikhumba kanye nesikhumba esincane se-anal kanye nolwelwesi lwamafinyila. E-HeumarktClinic Proctology e-Cologne, azikho izinqubo ezilimazayo ezenziwayo ezinciphisa i-sphincter futhi, ngokusho kwamashidi olwazi lwe-proctology anconywe kulo lonke elaseJalimane, ingaba yingxenye yohlelo lokuhlinza lwama-proctologists angcono kakhulu e-Cologne. Njengoba ukukhala kwendunu kungesona isifo esizimele ngomqondo wangempela, kodwa kunalokho kuwumphumela wama-hemorrhoids, kufanele kuphathwe njengengxenye yesifo esiwumsuka we-hemorrhoid. Futhi lokho ngaphandle kokusikeka, imimese noma isikelo, kodwa nge-laser irradiation ku-HeumarktClinic Proctology e-Cologne. Ikakhulukazi, ukusika noma ukusika i-sphincter kanye nokusika izinyembezi njengoba kunconyiwe eshidini lolwazi akunconywa.

Ubuhlungu ku-anus kanye ne-rectum

Ama-hemorrhoids ngokwawo awabangeli ubuhlungu! Iziguli zivame ukuza ekubonisaneni kwethu kwangasese kwe-proctology e-Cologne ezimangala lapho i-proctologist ibatshela ukuthi banama-hemorrhoids e-prolapsed, okubangela umswakama, ukuvuvukala, ukulunywa nokuvutha futhi kudinga ukwelashwa okuhlaselayo ngokushesha. Ngenxa yokuthi ama-hemorrhoids awabangeli buhlungu, ngokuvamile ayabekezelelwa, ngisho noma eqhumile ngesikhathi sokukhishwa kwamathumbu futhi ngezinye izikhathi adinga ukuphindiselwa emuva. Iziguli zijwayele ukujwayela isimo se-rectum yazo, njengoba isimo sishintsha kancane kancane eminyakeni eminingi futhi singanxeshezelwa kakhulu yimisipha eqinile ye-sphincter. Kuyamangaza ku-proctologist ukuthi iziguli eziningi aziboni i-eczema nokuvuvukala kwesikhumba se-perianal. Abantu abaningi babonakala bengenandaba nokuthi kuyaluma ngezinye izikhathi kodwa kuphuma "amafutha amahle e-hemorrhoid". Abanye ababoni nokuthi ukuvuvukala kudlulela nini ethanjeni lomsila noma ngaphambili kwescrotum kwabesilisa noma ekuvulekeni kwesitho sangasese kwabesifazane. Abantu abaningi abakuboni ukuncika kwabo kumafutha e-hemorrhoid njengesifo futhi bacabanga ukuthi yisikhumba nje esinwaya kancane.

Ama-Marisques

Amathegi esikhumba noma ama-flap amathegi esikhumba emnyango wangaphandle wangemuva, endaweni ye-anus. Ngokuphambene nama-appendages we-mucosal noma ama-polyps emathunjini noma e-anal canal, amathegi esikhumba ayizicubu zesikhumba. Ukwakhiwa kwamathegi esikhumba kungabangelwa izici eziningana, okuhlanganisa ukukhuphuka kolwelwesi lwamafinyila, i-micro thrombosis yemithambo ye-perianal, noma inhlanganisela yazo zombili izici. Ukucasuka kwesikhumba ngenxa yomswakama kanye nokuphazamiseka kwe-continence enhle nakho kunomthelela ekwakhiweni kwamathegi esikhumba. Amathegi esikhumba angahlupha abantu abaningi, ikakhulukazi ngenxa yezizathu zobuhle, ngisho noma angabangeli ubuhlungu. Lapho isiguli sifika ku-proctology e-Cologne ngenxa yobuhlungu obunzima, i-90% yalabo abathintekile sebevele benemifantu ebuhlungu kakhulu endunu. Njengoba sekushiwo kakade, ukuqhekeka akwenzeki ngaphandle kwesizathu, kodwa kubangelwa imithambo ye-perianal edabukile ebangelwa ukungezwani okuphezulu noma okonakele, isikhumba esivuvukele sendundu lapho kwenzeka khona ukungakwazi ukusebenza kahle kwendunu kanye nama-hemorrhoids. Ubuhlungu obuzumayo kanye nokuba khona kweqhubu le-hemorrhoidal elizwakalayo ku-rectum kuphakamisa i-thrombosis yama-hemorrhoids noma i-perinal veins.

I-anal spasm kanye ne-continence disorder

I-Lord's anal spasm kuwuphawu lwakudala lwama-hemorrhoids olwalashwa nge-dilator anal ngesikhathi somsunguli. Ngisho nanamuhla, ama-anal dilators asasetshenziswa lapho i-rectum inzima kangangokuthi ngakolunye uhlangothi ibangela ubuhlungu obukhulu, ngezinye izikhathi obubizwa ngokuthi "i-proctalgia fugax", futhi ngakolunye uhlangothi iholela ekuphazamisekeni kokukhipha i-rectal. Ngamafuphi, i-rectum ayikwazi ukuvuleka kahle ngakho ayikwazi ukuthulula ngokuphelele. Umuntu angase abuze ukuthi kungani kokubili i-anal spasm kanye nokuvuza kwendunu kubhekwa njengezimpawu zama-hemorrhoids. Ingabe imisipha yama-rectal ibuthakathaka futhi ayanele noma iqine kakhulu? Incazelo yalokhu imi kanje: Ku-proctology e-Cologne asikhulumi nge-sphincter, kodwa ngama-sphincters. Ama-sphincters angahlukaniswa ngamaqembu amabili amakhulu emisipha anemisebenzi ehlukene nemisebenzi ehlobene nezwekazi:

I-A/ I-continence enhle: Isibopho = imisipha ye-sphincter yangaphandle (i-sphincter yangaphandle, i-sphincter yangaphakathi)

Endabeni yama-hemorrhoids, ubuthakathaka bemisipha yangemuva yangaphandle bungabonwa nge-manometry ye-anal. Isizathu salokhu ukuthi ama-hemorrhoids angena emgodini we-anal, oshiya i-anal canal ivulekile kancane futhi imisipha ayikwazi ukugcina ukucindezela kwama-hemorrhoids. Lokhu kuholela ekuphazamisekeni kwe-continence enhle, ebonakala ngokuswakama, ukugcotshwa nokulunywa. Uma ama-hemorrhoids abe esesuswa kusetshenziswa i-laser, i-HAL, i-RAR, njll. ngaphandle kokusikwa, unqenqema lwendunu lungaphinda luvaleke kangcono futhi umswakama nokuluma kungayeka. Ngezinye izikhathi ukuqeqeshwa kwe-endo-anal biofeedback yemisipha ye-anal nakho kuyadingeka, okwenziwa ngokuzivocavoca kwe-pelvic floor noma ngosizo lwedivayisi yamanje yokuvuselela.

B/ Izwekazi Eliphelele: Isibopho = ama-sphincters ajulile (M. Puborectalis, Levator ani)

Ama-sphincters ajulile aqinisekisa ukuthi ingxenye engaphezulu ye-rectum ivaleka ngendlela eguqukayo lapho ama-hemorrhoids enyuka. Ngokusho kuka-Lord, i-cramp engapheli kanye ne-spasm ye-sphincters ejulile enenkinga yokukhishwa kwesisu ngenxa yokuvaleka kokuvulwa kwendunu kuphakathi kwezimpawu zakudala zama-hemorrhoids athuthukile, kungakhathaliseki ukuthi ama-hemorrhoids angahlehliswa ngomunwe noma cha. Esimeni sesifo se-hemorrhoidal esithuthukisiwe esine-anal spasm, ngakho-ke ukwelashwa kuhlanganisa ukwelula imisipha ejulile ye-basal (i-levator ne-puborectalis) nokukhipha ama-hemorrhoids njengengxenye yenqubo ye-hemorrhoid. Uma lokhu kungalethi noma iyiphi intuthuko esikhathini eside, i-HeumarktClinic Proctology e-Cologne inikeza umjovo okhethekile, olawulwa yi-ultrasound, ohlosiwe wemisipha ejulile ye-pelvic floor ene-muscular relaxant ukuze ukhulule i-cramp okungenani izinyanga ezingu-6 futhi unike amandla ukuphuma okuvamile. .

ukuntula indunu

Ukungasebenzi kahle kwe-anal kusho ukuphazamiseka kokungakwazi ukuzibamba kahle. Ngokusho komhlahlandlela we-S3 wemiphakathi yobungcweti baseJalimane ye-proctology kanye ne-colon-proctology, ama-hemorrhoids akhuphukayo aholela ekuphumeni okumanzi futhi kwesinye isikhathi ngisho nokuphuma kwendle, okungase kubonakale njengokuphumayo, kodwa kamuva njengokugcotshwa kwendle futhi ekugcineni kungaholela ekungcolisweni kwezingubo zangaphansi ezingcolile. Umswakama oqhubekayo ucasula isikhumba se-perianal unomphela. Kuyinto engaqondakali ukuthi inhlanzeko eyomile nengagcobisi endunu ayinikeziwe nokuthi abantu abaningi abayiboni imikhondo yendle engutsheni yabo yangaphansi njengenkomba yokuthi kukhona okungahambi kahle nge-rectum. Igama elithi "ukungasebenzi kahle kwendunu" - i-fine continence disorder - igama elingaziwa emphakathini jikelele, okusho ukuthi "akungithinti" ngoba "ngisengakwazi ukulawula indle yami".

I-Perianal thrombosis - i-anal thrombosis

I-Perianal thrombosis noma i-anal vein thrombosis kwenzeka lapho igazi elinqwabelene emithanjeni enwetshiwe emaphethelweni endunu lihlangana ndawonye. Iqhubu elibuhlungu lakheka emaphethelweni endunu. Ukuhlala nokuzikhulula kubuhlungu. I-Perianal thromboses ivame ukuqhuma futhi kungenzeka ukopha. Ubuhlungu, izigaxa ezizwakalayo nokopha kwenza iziguli zifune usizo lwezempilo ngokushesha. Kubalulekile ukwazi ukuthi i-thromboses emaphethelweni e-anal yizimpawu ezibonakalayo zangaphandle ze-hemorrhoids yangaphakathi. Emazweni akhuluma isiNgisi, kwenziwa umehluko phakathi kwama-hemorrhoids angaphandle nangaphakathi, amele izingxenye ezimbili zesifo se-hemorrhoidal. Ngaphandle kwama-hemorrhoids angaphakathi, ama-hemorrhoids angaphandle awakhi futhi i-thrombosis yemithambo ye-perianal endaweni ye-anal ayenzeki. Kwesinye isikhathi kwenzeka i-thrombosis yama-hemorrhoids angaphakathi nangaphandle, okungaba buhlungu kakhulu futhi kudinga ukwelashwa okuphuthumayo kwe-proctological.

Yini okufanele uyenze uma unama-hemorrhoids? 

Uma unezimpawu ezinjengokulunywa, ukushiswa, ukuzigcoba noma ukopha endaweni yendunu, kufanele uvakashele uchwepheshe we-proctology e-Cologne ukuze ahlolwe i-rectum yakho futhi kwenziwe ukuxilonga okuyisisekelo kanye nokuhlolwa komdlavuza. Ngemva kokuhlolwa, ungathola iseluleko ngezindlela ezihlukahlukene zokwelapha, okuhlanganisa izindlela ezilondolozayo ezifana ne-rubber band ligation, i-sclerotherapy, iqhwa, kanye nezindlela zokuhlinza ezifana nendlela ye-HAL, iTHD, indlela ye-RAR, i-submucosal ligation kanye ne-ligature excision. Emsebenzini wethu we-proctology e-Cologne, siqala incazelo yezindlela zokwelapha ezingase zibe khona nge-laser therapy ngoba siyaqiniseka ukuthi i-laser iyindlela engcono kakhulu. Ngosizo lobuchwepheshe be-laser, ukwelashwa kokuvalwa okucishe okungenabuhlungu kwama-hemorrhoids kungenziwa ngaphandle kokusikwa okukhulu kokuhlinzwa.

I-LHPC – I-Laser Hemorrhoid Plastic Surgery

Cishe eminyakeni emithathu edlule saqala ukuhlinzwa kweplastiki ye-laser hemorrhoid ngemva kokuba uDkt. (H) U-Haffner wayeqede izifundo zokuhlinza nge-laser e-Bio-Litec. Ekuqaleni, senza indlela ngokuvumelana nezincomo kuwebhusayithi ye-Bio-Litec LHP. Kodwa-ke, phakathi nokwelashwa kwaba sobala ukuthi i-laser beam ingakwazi futhi kufanele isetshenziswe ngezindlela ezihlukene ukuze kuzuzwe imiphumela engcono kakhulu. Siguqule indlela namathuluzi ngokufanele. Indlela entsha yasungulwa ngaphansi kwegama lomkhiqizo i-Laser Hemorrhoid Plastic Surgery (LHPC). Isisekelo se-LHPC sathuthukiswa ngokwesayensi ngocwaningo lokuhlolwa kwezilwane ngokubambisana ne-Experimental Surgical Institute eNyuvesi yaseSemmelweis. Yakhiwa kanje indlela entsha ye-laser yokuhlinzwa kwe-hemorrhoid njenge-LHPC, i-laser hemorrhoid plastic surgery e-Cologne, osekuphenduke indlela yokwelapha ejwayelekile yazo zonke izinhlobo nezigaba zama-hemorrhoids ekusebenzeni kwethu.

Izinzuzo ze-LHPC:

- Akukho ukusikeka - azikho izinkinga zokuphola kwesilonda - abukho ubuhlungu
- Ukuqinisa kunokuwenza buthaka i-sphincter
- Ukunyakaza kwamathumbu okuthuthukisiwe uma kuqhathaniswa nangaphambili
- I-continence engcono uma iqhathaniswa nangaphambili
- Ukubamba iqhaza komphakathi ngokushesha

Ngaphambi kokuqokwa kwe-LHPC, ukuhlolwa kokuqala kwe-ultrasound kwenziwa, lapho yonke inethiwekhi yemithambo yegazi nemithambo iboniswa futhi izikhalazo zakho ezithile ziyacaciswa. Ukuhlinzwa kwepulasitiki ye-laser hemorrhoid kwenziwa ngaphandle kwesiguli esilaliswa ngaphandle ngaphansi kwe-anesthesia evamile noma ukulala kwe-twilight. I-anesthesia yendawo isebenzisa indlela ye-tumescent yanele kuphela ama-hemorrhoids amancane.

I-LHP laser hemorrhoidoplasty

I-LHP Laser Hemorrhoidoplasty**** yasekuqaleni, isekelwe ekuvaleni imithambo ehlinzeka ngama-hemorrhoids ngethemba lokuthi lokhu kuzoholela ekuhlehleni kwama-hemorrhoids. Eyodwa ukuhlolwa komtholampilo ku-LHP e-USA I-ClinicalTrials.gov  enombolweni I-NCT03322527 EN PARADES Vincent, MD ngo-2018 yenziwe, kodwa ayikho imiphumela etholakalayo okwamanje. Nokho, okunye okushicilelwe nge-LHP kushicilelwe kwaba nemiphumela emihle. Imihlahlandlela yaseJalimane S3, njengoba kushiwo kuyi-Ärzteblatt, isatusa ukuhlinzwa okuvamile ngemibese nezikelo zokwelashwa kwama-hemorrhoids athuthukile, njengoba kusenezincwadi ezimbalwa kanye nezifundo ezilawulwayo ngezindlela zamagagasi e-laser nomsakazo, nakuba izincwadi nababhali ngabanye babika imiphumela emihle. 

Izindlela ze-HAL, THD kanye ne-RAR

I-HAL, i-THD ne-RAR izindlela zokwelapha ze-proctological ezisekelwe kumasu okuthunga akhethekile. Umqondo oyisisekelo wazo zonke izindlela ukunciphisa ama-hemorrhoids ngokunqamula ukutholakala kwegazi. Ngendlela ye-HAL, umthambo owodwa utholakala ne-Doppler ultrasound probe futhi uboshwe nge-ligature. Ngendlela ye-THD, yonke imithambo eyinhloko yama-hemorrhoids iboshelwe ngomsele oyindilinga eduze kwe-rectum. Umgomo wendlela ye-THD, njengoba negama liphakamisa, ukuqeda ama-hemorrhoids ngokumisa yonke imithambo yegazi ebalulekile. Ngendlela ye-RAR, ama-hemorrhoids aqala ukuvinjelwa, njengangendlela ye-HAL. Kodwa-ke, ngemva kokuxhunyaniswa komthambo oyinhloko, inqubo iyaqhubeka ngokubopha inqwaba ye-hemorrhoid nge-ligatures eyengeziwe nokuqinisa ulwelwesi lwamafinyila. I-RAR ligation kanye nokuqinisa ngokuvamile kuhilela imicu emine emikhulu yama-hemorrhoids. E-HeumarktClinic Proctology e-Cologne, zonke lezi zindlela zokuthunga zisetshenziswa ngesipiliyoni seminyaka eminingi nempumelelo. Okuhlangenwe nakho kwethu kubonise ukuthi ukuhlanganisa lezi zindlela ne-laser irradiation ye-hemorrhoid mass kuphumelela kakhulu. Kafushane, kungashiwo ukuthi i-HAL-RAR-THD ihlanganiswe ne-laser iyindlela yokwelapha ephumelela kakhulu nemnene ku-proctology. Akukho kusika okwenziwayo, okunciphisa ubungozi bezinkinga.

Incithakalo, eboshwe ngamabhande enjoloba kanye noqweqwe

kuyindlela yokwelapha esetshenziswa kakhulu ezigulini zangaphandle kuma-hemorrhoids ku-proctology, kokubili ngama-proctologists kanye nama-proctologists e-Cologne. Lezi zindlela zokwelapha zilula futhi ngokuvamile azibuhlungu. I-sclerotherapy ihilela ukujova i-agent ye-sclerotherapy esicutshini se-hemorrhoid, okubangela ukuthi inciphe. Kodwa-ke, kuma-hemorrhoids anzima kakhulu, le ndlela ayigculisi futhi kungenzeka ukuthi ibuyele emuva. I-Rubber band ligation ihlanganisa ukubopha iphuzu elilodwa kuphela le-hemorrhoid, kodwa lokhu kuvame ukuphumelela. Ku-proctology e-HeumarktClinic e-Cologne, inhlanganisela yalezi zindlela isetshenziselwa ukwandisa impumelelo nokunciphisa imiphumela emibi. Ifindo elilodwa kuphela eliboshiwe ngesikhathi futhi i-sclerotherapy ijovwa engxenyeni eboshiwe kuphela ukuze kugwenywe imiphumela engemihle efana nezibazi noma ukuqina kodonga lwamathumbu anempilo. Ifindo eliphathwayo libe selifakwe uqhwa ngepensela elibandayo eqhweni. Ngale nhlanganisela, iziguli ze-HeumarktClinic Proctology e-Cologne azinazinhlungu phakathi nangemuva kokwelashwa kanye nemiphumela engemihle kuphela efana nokopha kwesibili okuncane nokungavamile kakhulu. Izinkinga ezinjengamathumba noma i-fistula, eziye zabikwa ezinye izazi ze-proctologists, azikaze zenzeke nathi ngemva kwalokhu kwelashwa.

Imaphi amafutha angcono kakhulu ama-hemorrhoids

I-ointment engcono kakhulu ye-hemorrhoids iyahlukahluka kuye ngokuthi izimpawu zomuntu ngamunye kanye nesimo sendawo ye-anal. Amafutha amahle e-hemorrhoid kufanele abe nomphumela wokudambisa izinhlungu, ukupholisa kanye nokwehlisa umoya. Ingase iqukethe izinto zemvelo ezithuthukisa ukunwebeka kwesikhumba sangemuva futhi zikhuthaze ukuphulukiswa kwesilonda. I-ointment enhle kufanele futhi isebenze njenge-lubricant ngesikhathi sokunyakaza kwamathumbu ngaphandle kokunamathela ezingutsheni zangaphansi. Kubalulekile ukuthi i-ointment ingabangeli ukungezwani komzimba futhi ayithathi hlangothi.

Umkhiqizi uvame ukuhlinzeka ngesisetshenziswa esingasetshenziswa ukufaka isigcobo ngobumnene emseleni wangemuva. Ukukhetha phakathi kwejeli, ama-suppositories noma amafutha okugcoba kuncike ezimpawu zomuntu ngamunye, njengobuhlungu, ukopha, ukulunywa noma ukushiswa, kanye nesimo sendawo ye-anal. Awekho amafutha okugcoba angcono kakhulu emhlabeni wonke kulo lonke uhlobo nesigaba sama-hemorrhoids. Kunconywa ukuthi ufune iseluleko nokuhlolwa ku-proctologist. Amafutha afaneleka kuphela ekudambiseni izimpawu futhi awakwazi ukwelapha ama-hemorrhoids. Yingakho isiqubulo sokukhangisa esithi "Laser ingcono kakhulu yokugcoba i-hemorrhoid" yadalwa, njengoba ukwelashwa nge-laser kunganciphisa ngempumelelo ama-hemorrhoids futhi ngaleyo ndlela kunciphise izimpawu ezivamile.

Kafushane: Amafutha okugcoba ayasiza, kodwa ukwelashwa nge-laser kuyaphilisa.

Kuboniswa nini ukuhlinzwa kwe-hemorrhoid? 

Ukuhlelwa kwama-hemorrhoids ngokusho kukaGoligher kusukela ngo-1980, okwakusetshenziswa phambilini ukucacisa inkomba yokuhlinzwa, sekuphelelwe yisikhathi. Lesi sigaba asizicabangeli zonke izimpawu kanye namazinga obunzima besifo se-hemorrhoidal. Kusatuswa ukwenza ukuhlinzwa kuphela ezimweni ezithuthukisiwe zesigaba III noma IV lapho ama-hemorrhoids ehla futhi edinga ukuphindiselwa emuva ngomunwe. Lokhu kuhlukaniswa okuqinile kwakufaneleka esikhathini esidlule lapho ukuhlinzwa okungathi sína kwenziwa ngemibese futhi i-anesthesia iyingozi kakhulu.

Nokho, namuhla, izindlela ezithambile nezisebenza ngempumelelo njengokwelashwa nge-laser ziyatholakala. E-HeumarktClinic Proctology e-Cologne, kugxilwe ekuhluphekeni nezimpawu zesiguli. Ukwelashwa kuhlose ukukhulula izimpawu, kungakhathaliseki ukuthi isiteji sama-hemorrhoids. Isigaba esidala sika-Goligher asihambelani nezimpawu nokuhlupheka kweziguli. Izigaba ezintsha kanye nezinye izindlela zokwelapha zicabangela izimpawu ezihlukahlukene ezifana nokopha, ukuphuma kwegazi, i-thrombosis kanye nezinkinga zesikhumba (ukuluma, ukuvutha, ukuphuma, i-eczema) kanye ne-thrombosis yemithambo yangaphandle ye-perianal. 

Ngenxa yokuthi imihlahlandlela emidala kanye nezigaba zokuqina kwe-hemorrhoid azifaki izimpawu abantu abahlangabezana nazo, kufanele kuqalwe isigaba esisha sobunzima be-hemorrhoid (4,5,6,7). Izigaba ezintsha zobunzima be-hemorrhoid azisebenzi kuphela ekwelapheni ama-hemorrhoids angaphakathi, kodwa futhi ekwelapheni ama-hemorrhoids "angaphandle" kanye nezimpawu ezivamile. Isibonelo, umlando wokopha uyacatshangelwa kusigaba "se-PNR-Bleed" lapho ulinganisa ubunzima (7). Ngesiteji se-BRST ngokusho kukaSobrado (4), ezinye izindlela zokwelapha ezintsha kanye nezimpawu ezibalulekile zama-hemorrhoids asethuthukile ziyacatshangelwa lapho kunqunywa izinkomba zokuhlinzwa, ngale ndlela elandelayo: ukopha (B), i-prolapse (P), izinkinga zesikhumba (S) kanye imiphumela ye-thrombosis (T) ama-hemorrhoids angaphandle.

Ukwelashwa kwe-laser kungaphatha ngempumelelo kokubili ama-hemorrhoids angaphakathi nangaphandle futhi kuvimbele izinkinga. Sekuyisikhathi sokuthi i-proctology igxile ekuhlukaniseni okusha nezindlela zokwelashwa ezithambile ezifana nokusetshenziswa kwama-lasers.

Inkomba yokusebenza yokuphila kwansuku zonke

ukopha, ama-prolapse amakhulu noma ama-rectal strictures. Ukungasebenzi kahle kwendunu, ukugcotshwa kwendle, ukukhala, ukuvutha, i-eczema ye-perianal, ubuhlungu, imifantu yendunu noma i-thrombosis nakho kuyimiphumela yesifo se-hemorrhoid. Le miphumela engathi sína ifinyezwa “njengesifo se-hemorrhoid esithuthukisiwe” futhi iyinkomba ephelele yokuhlinzwa. Kodwa-ke, inhloso yalolu hlelo lokusebenza namuhla kumele ihlasele kancane. Uma ama-hemorrhoids angasuswa kancane kancane futhi ngaphandle kwezingozi ezinkulu kusetshenziswa i-laser noma enye inqubo, khona-ke ezinye, izindlela zangaphambili azisadingeki.

Kungenjalo, kufanele

I-Sclerotherapy noma i-rubber band ligatures yama-hemorrhoids

kufanele kucatshangelwe, kodwa imiphumela yawo ayifinyeleli ekusebenzeni kokuhlinzwa kwe-hemorrhoid ngakho-ke ayanele ekwelapheni kokugcina kwesifo esinzima, esithuthukile se-hemorrhoid. Ngokusho kwezincwadi, izindlela ezingahlinzeki nazo zinemiphumela emibi kakhulu.

Ama-hemorrhoids kanye ne-thrombosis ngesikhathi sokukhulelwa

Isizathu sikhona ama-hemorrhoids angaphakathi, angaphansi kwengcindezi ephezulu yokuminyana ngesikhathi sokukhulelwa. Imiphumela yi-prolapse kanye ne-thrombosis. Ukwelashwa kwe-thrombosis yokukhulelwa kuhlale kumuntu ngamunye futhi kuncike ekutheni ngubani owelapha owesifazane okhulelwe, isiphi isipiliyoni i-proctologist enaso nokuthi zingaki izinsuku kuze kufike usuku olunqunyiwe. Ama-anesthetics ngokuvamile awavunyelwe futhi awekho amaphilisi ezinhlungu e-narcotic angase anikezwe. Kufanele isuswe kanjani i-thrombosis ebuhlungu kakhulu? Ukuze siphendule lo mbuzo onzima, singabelana kuphela ngohlelo lwethu lokwelapha nolwazi: Ama-thromboses ngokuvamile abangela ukuhlupheka okukhulu ngesikhathi sokukhulelwa futhi kungaba kokubili ukuphazamisa kakhulu futhi kube buhlungu ngesikhathi sokuzalwa. Ngakho-ke sizama ukusiza owesifazane okhulelwe ngokuhlinzwa okuthambile, okungavamisile. Lokhu kudinga ikhono lokuhlinzeka ngezinzwa zendawo ezingenabuhlungu ngaphandle kwezibulala-zinhlungu. Okwesibili, akufanele kube khona ukopha, kungabikho ukopha kwesibili kanye nobuhlungu obuncane ngangokunokwenzeka ngemva kokuhlinzwa. Ngale njongo, sinikeza ukususwa okusizwa nge-laser kwe-thrombosis yokukhulelwa kusukela ekusikeni okuncane, okubangela kuphela ubuhlungu obuncane bangemva kokuhlinzwa, okuhlangenwe nakho okubonise ukuthi kuyabekezeleleka. Izinkinga azilindelekile. Kodwa-ke, seluleka ngokumelene nezinqubo ezinkulu ze-hemorrhoid; lokhu kufanele kwenziwe ngemva kokuzalwa.

Yini okufanele uyenze uma unama-hemorrhoids angaphandle?

Ama-hemorrhoids angaphandle ama-hemorrhoids Imithambo ngaphandle kwe-anus kuthinta, yingakho ama-hemorrhoids angaphandle abizwa ngokuthi i-pianal veins. Lezi hemorrhoids zingakwazi Ukopha, imifantu futhi ukulunywa futhi ngaphezu kwakho konke kaningi i-perianal thrombosis / i-anal vein thrombosis imbangela. Ama-hemorrhoids angaphandle awakwazi ukuqedwa noma ukuboshwa ngoba aholela ku-acute complication - thrombosis. Ama-hemorrhoids angaphandle angasikwa kancane kuphela, athinte imisebe emincane yama-hemorrhoids angaphandle/imithambo ye-perinal. Nokho, lokhu kubuhlungu kakhulu. Ukususwa okungcono kakhulu, okuphelele nokungunaphakade kwemithambo ye-perianal - ama-hemorrhoids angaphandle - kwenzeka ngelaser e-HeumarktClinic. I-HeumarktClinic igxile ekukhishweni nge-laser kwama-hemorrhoids angaphandle nangaphakathi ngaphandle kokusikeka noma ubuhlungu obukhulu. Endabeni ye-thrombosis yama-hemorrhoids angaphandle / i-perinal veins, indlela ye-laser nayo iyona engcono kakhulu uma ufuna ukukhipha imithambo ye-perianal ngokuphelele. Kodwa-ke, ama-thromboses amancane nawo angaxazululeka ngokuzenzakalelayo kodwa angaphinde avele uma imithambo ye-perianal/ama-hemorrhoids angaphandle engasuswa. Abantu abathintekile babe sebephelezelwa kukho konke ukuphila kwabo ngokuphindaphindeka kwe-perianal thrombosis emithanjeni ye-perianal engakasuswa.

Izindleko Zokwelashwa Kwe-Hemorrhoid

Zonke izivivinyo nemithi yokwelapha yenziwa emnyangweni we-proctology we-HeumarktClinic e-Cologne ngokweshejuli yemali. Ngeshwa, ayikho inombolo eqondile echazayo yokuhlinzwa kwe-laser ye-hemorrhoid etafuleni lenkokhelo. Ngakho-ke, lo mkhuba usebenzisa inombolo engu-2886 nezindleko zayo ezengeziwe, okusohlelweni lwenkokhelo yezinsizakalo ezifanayo zokwelashwa nge-laser kwezicubu ezifanayo zemithambo yegazi futhi, ngokusho kwesitatimende se-German Medical Association, ilungile nge-laser irradiation yemithambo yegazi. Ukungakanani kwalokhu okukhava yinkampani yomshuwalense wezempilo kuyahlukahluka esimweni ngasinye. Sizokunikeza isilinganiso sezindleko zokuhlinzwa kwe-laser ye-hemorrhoid, ongaxoxa ngayo nenkampani yakho yomshwalense futhi uthole isiqinisekiso sezindleko. Umthethosivivinywa we-GOÄ ukhokhwa abantu abazikhokhayo noma abafuna abantu abanomshwalense osemthethweni; Kulabo abanomshwalense wangasese, okuningi kwalokhu kubuyiselwa umshwalense wezempilo ozimele.

Thola okwengeziwe futhi uhlele isikhathi sokubonisana ngocingo ku: 0221 257 2976 noma nge Ukubhukha i-aphoyintimenti eku-inthanethi - ngisho namahora okusebenza angaphandle. Xhumana nge-imeyili lapha.

Izincwadi:

1. Goligher JC. Ama-hemorrhoids noma ama-piles. Ku: Goligher JC, Duthie HL, Nixon HH, abahleli. Ukuhlinzwa kwe-anus, i-rectum ne-colon.Umhleli wesi-4. London: Baillière Tindall; 1980. p. 96. [-Google Scholar]

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3. Gerjy R, Lindhoff-Larson A, Nystrom PO. Ibanga le-prolapse kanye nezimpawu zama-hemorrhoids azihlobene kabi: umphumela we-algorithm yokuhlukanisa ezigulini ezingama-270. I-Colorectal Dis. 2008;10:694–700. [I-PubMed] [-Google Scholar]

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5. I-Rubbini M, i-Ascanelli S, i-Fabbian F. Isifo se-Hemorrhoidal: ingabe yisikhathi sokuhlukaniswa okusha? I-Int J Colorectal Dis. 2018;33:831–3. [I-PubMed] [-Google Scholar]

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8. UMurie JA, Sim AJ, Mackenzie I: Ukubaluleka kobuhlungu, pruritus kanye nokungcoliswa njengezimpawu zama-hemorrhoids kanye nokusabela kwabo ku-hemorrhoidectomy noma i-rubber band ligation. Br J Surg 1981; 68(4): 247–9.

 

 

Imigomo:

* Indlela ye-HAL= I-Hemorrhoidal artery ligation ngokusho kukaMorinaga 

** Indlela ye-THD= I-Transanal hemorrhoidal arteries ligation - inqubo enwetshiwe ye-Morinaga

*** Indlela ye-RAR =I-Clinical.Trials.gov Isivivinyo Somtholampilo No  I-NCT01301209, 

****LHP  = I-Laser Hemorrhoidoplasty : https://clinicaltrials.gov/ct2/show/NCT03322527 Study by DE PARADES Vincent, MD for Stage 2 and 3 Hemorrhoids 

*****LHPC = Ukuhlinzwa Kwepulasitiki Ye-Laser Hemorrhoids - UDkt. (H) U-Haffner (Cologne) usebenzise izinqubo eziguquliwe ze-laser skeletal for hemorrhoids kuzo zonke izigaba. Ukuhlolwa kwezilwane kanye nedatha yomtholampilo iyatholakala. Isetshenziswa ngemiphumela emihle ekuhlinzweni kwama-hemorrhoid angaphezu kuka-500 ngenani eliphansi lezinkinga, kuziguli ezilaliswayo futhi ngaphandle kobuhlungu.