Fistula anal / perianal: he aha ia, nā ʻōuli a me ka wā hea e ʻoki ai

Anter

• Nā hōʻailona nui
• Pehea e hana ai i ka lāʻau
• Pehea ke ola ʻana
• I ka manawa e hele ai i ke kauka

ʻO ka anal fistula, a i ʻole perianal, kahi ʻano ʻeha, ka mea i hana ʻia mai ka ʻāpana hope o ka ʻōpū i ka ʻili o ka anus, e hana ana i kahi ʻalalā liʻiliʻi e kumu i nā ʻōuli e like me ka ʻeha, ʻulaʻula a me ke kahe o ke anus.

ʻO ka maʻamau, kū ka fistula ma hope o kahi abscess i loko o ke anus, akā naʻe, hiki ke kumu ʻia e nā maʻi ʻōpala, e like me ka maʻi o Crohn a i ʻole diverticulitis, no ka laʻana.

ʻAneʻane hana mau ʻia ka lapaʻau me ke ʻoki, no laila ke kānalua ʻia kahi fistula, keu hoʻi inā ua loaʻa iā ʻoe kahi abscess, ua ʻōlelo ʻia e nīnau i kahi proctologist e hōʻoia i ka hōʻailona a hoʻomaka i ka lāʻau.

E ʻike i nā kumu maʻamau ʻē aʻe o ka ʻeha ma ka anus a i ʻole ka aniani ma ka ʻāina.

Nā hōʻailona nui

ʻO nā ʻōuli nui o ka fistula anal me:

• ʻO kaʻulaʻula a pehu paha o ka ʻili o ka anus;
• ʻEha mau, ʻoiai ke noho a hele wāwae paha;
• Ke puka o ka pā a i ʻole ke koko ma o ka anus;

Ma waho aʻe o kēia mau ʻōuli, ʻeha ka ʻōpū, diarrhea, nalo o ka makemake ʻole, hoʻoliʻiliʻi ke kaumaha o ke kino a me ka nausea ke hiki mai ka maʻi a me ka mumū o ka fistula.

I kēia mau hihia, paipai ʻia e nīnau i kahi proctologist e kuhikuhi pono i ka pilikia, me ka nānā ʻana i ka pūnaewele a i ʻole ke kiʻi magnetic resonance, no ka laʻana, a hoʻomaka i ka lāʻau kūpono.

Pehea e hana ai i ka lāʻau

E mālama i kahi anal fistula, a pale i nā pilikia e like me ka maʻi a me ka incontinence fecal, pono ʻoe e ʻoki ʻia, i kapa ʻia he anal fistulectomy, kahi a ke kauka.

1. E hana i kahi ʻoki ma ka fistula e hōʻike i ka tunnel holoʻokoʻa ma waena o ka ʻōpū a me ka ʻili;
2. Wehe i nā mea ʻeha i loko o ka fistula;
3. E kau i kahi uea kūikawā i loko o ka fistula e hāpai i kona hoʻōla;
4. Hāʻawi i nā kiko ma kahi e pani i ka ʻeha.

I mea e hōʻeha ai i ka ʻeha, hana pinepine ʻia ke kaha me ka anesthesia ākea a epidural paha, a ma mua o ka hoʻomaka ʻana i ke kaʻina hana, hoʻohana ka kauka i kahi ʻimi e ʻimi i ka fistula a loiloi inā aia wale nō kahi alawai a i ʻole inā he fistula paʻakikī, kahi i nui ai tunnels. I kēia hihia, pono pono paha e hana i nā mea ʻoi aku ma mua o hoʻokahi e hoʻopau ai i hoʻokahi tunnel i ka manawa.

Ma waho aʻe o ka anal fistulectomy, aia kekahi mau ʻano hana ʻē aʻe o ka mālama ʻana i nā fistula ma o ke kaha ʻana, e like me nā grafts, plugs a me nā sutures kūikawā, i kapa ʻia he setons, akā pili kēia mau ʻano i ke ʻano o ka fistula a me nā maʻi nāna i hana, e like me ka maʻi o Crohn, i ka mea pono e hoʻohana i nā lāʻau, e like me Infliximab ma mua o kekahi ʻoki kino.

Pehea ke ola ʻana

Ma hope o ke kaha ʻana, pono ia e noho i ka haukapila ma kahi o 24 mau hola e hōʻoia i ka nalo ʻana o ka hopena o ka anesthesia a ʻaʻohe pilikia, e like me ke kahe ʻana o ke kahe a me ka maʻi.

Ma hope o kēlā hiki ke hoʻi i ka home, akā makemake ʻia e hoʻomaha no 2 a 3 mau lā, ma mua o ka hoʻi ʻana i ka hana. I loko o kēia wā, pono paha e lawe i nā lāʻau ʻaloʻalo, e like me Amoxicillin me Clavulonate, a i ʻole lāʻau anti-inflammatory, e like me Ibuprofen, i kuhikuhi ʻia e ke kauka, e hōʻoluʻolu i ka ʻeha a e hōʻoia ʻole e ala aʻe kahi maʻi. I mea e hōʻemi ai i ka maʻi o ka maʻi, pono e mālama ʻia ka maʻemaʻe o ka ʻāina me ka wai a me kahi kopa pH kūpaʻa ʻole, ma kahi o ka hoʻololi ʻana i nā lole, me ka hoʻopili ʻana i nā hamo me nā mea ʻeha ma kahi o 6 mau manawa i ka lā.

I ka wā postoperative he mea maʻamau ia no ka hōʻeha ʻana o ka ʻeha ma kahi liʻiliʻi, keu hoʻi i ka holoi ʻana i ka pepa lua i ka ʻāina, akā naʻe, inā kaumaha ke kahe a inā loaʻa kekahi ʻano ʻeha ʻeha, nui ia e hoʻi i ke kauka.

Eia hou, i ka hebedoma mua he mea nui nō hoʻi e ukali i ka papaʻai e hōʻalo ai i ka paʻa paʻa ʻana, ʻoiai ka hōʻiliʻili o nā feces hiki ke hoʻonui i ke kaomi ma nā paia o ka anus a pale i ka hoʻōla. E ʻike pehea e hana ai i kēia ʻano hānai.

I ka manawa e hele ai i ke kauka

Paipai ʻia e nīnau koke i ka proctologist ke ʻikea.

• Hemorrhage i loko o ka anus;
• Hoʻonui i ka ʻeha, ʻulaʻula a huʻu paha;
• Fiva ma luna o 38ºC;
• Huakaʻi paʻakikī.

Eia hou, he mea nui e hele i ke kauka i ka hihia o ka constipation ʻaʻole e nalo ma hope o 3 mau lā, ʻoiai me ka hoʻohana ʻana i nā laxatives.