Yuav Kho Li Cas Fistula (nrog Duab)

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Yuav Kho Li Cas Fistula (nrog Duab)
Yuav Kho Li Cas Fistula (nrog Duab)

Video: Yuav Kho Li Cas Fistula (nrog Duab)

Video: Yuav Kho Li Cas Fistula (nrog Duab)
Video: For Which Cancer to Avoid taking Supplement Cassia Fistula 2024, Lub peb hlis ntuj
Anonim

Lub fistula yog txoj kab nruab nrab ntawm qhov qhib lossis tubular qhib thiab lwm lub cev nqaij daim tawv lossis ntawm 2 lub cev hauv nruab nrog cev. Fistulas tuaj yeem tsim qhov chaw sib txawv thiab kev hloov pauv hauv lub cev, tab sis qhov mob hauv plab yog qhov feem ntau. Kev phais yuav tsim nyog los kho lub qhov txhab, tab sis qee qhov kev hloov hauv lub neej kuj yuav ua rau muaj qhov sib txawv, ib yam.

Cov kauj ruam

Ntu 1 ntawm 3: Hloov Txoj Kev Ua Neej

Kho qhov Fistula Kauj Ruam 1
Kho qhov Fistula Kauj Ruam 1

Kauj Ruam 1. Noj zaub mov kom zoo

Kev saib xyuas koj cov zaub mov noj yuav ua rau muaj kev mob plab thiab zom zaub mov. Tsuas yog zam cov zaub mov ntsim, zaub mov tsis zoo thiab zaub mov muaj roj yuav ua rau koj muaj kev zom zaub mov zoo uas tsis muaj teeb meem tsawg. Xaiv rau ntau cov nplej tag nrho, cov nplooj zaub ntsuab, txiv hmab txiv ntoo, thiab nqaij ntshiv.

  • Ntxiv cov fiber thiab cov zaub mov rau koj cov zaub mov yuav pab tiv thaiv cem quav, uas tuaj yeem ua rau khaus khaus.
  • Sim saib seb hom zaub mov twg koj ua xua lossis ua rau koj lub plab chim. Nco ntsoov tias nws tsis yog txoj cai nruj - txhua tus neeg sib txawv.
  • Cov rog pov tseg tuaj yeem ua rau muaj peev xwm thaiv lub qhov quav qhov quav thiab yog li tuaj yeem tsim kev tsim cov perianal abscess, qhov ua rau muaj mob loj rau tib neeg kev txom nyem los ntawm fistulas.
Kho qhov Fistula Kauj Ruam 2
Kho qhov Fistula Kauj Ruam 2

Kauj Ruam 2. Haus dej ntau dua

Nws raug nquahu kom haus ib thiab ib nrab litres dej ib hnub tshwj tsis yog koj tus kws kho mob hais lwm yam. Txhob haus cawv thiab dej qab zib; es tsis txhob haus dej ntau dua thiab kua txiv hmab txiv ntoo. Qhov no yuav pab tiv thaiv ib qho tuaj yeem tshwm sim ntawm cem quav, uas tso siab rau koj lub qhov muag.

  • Cov dej ntau dhau yuav ua rau pov tseg softer thiab yuav pab ntxuav cov hnyuv; qhov no yog vim li cas yog tias koj haus dej ntau dhau koj yuav xav tias yuav tsum tau nkag mus tso quav ntau zaus.
  • Dej kuj tiv thaiv cov hnyuv los ntawm kev thaiv tshwj xeeb hauv cov neeg mob uas muaj qee yam kab mob zom zaub mov zoo li Crohn tus kab mob, tshuaj lom megacolon, thiab lwm yam.
Kho qhov Fistula Kauj Ruam 3
Kho qhov Fistula Kauj Ruam 3

Kauj Ruam 3. Siv hauv ncoo

Yog tias koj txoj haujlwm ua rau koj zaum ntau teev, zam kev tso siab ntxiv rau koj nraub qaum, taub qab, thiab txhais ceg, tshwj xeeb tshaj yog tias koj muaj qhov quav qhov quav. Qhov no tuaj yeem ua tiav los ntawm kev zaum ntawm lub hauv ncoo lossis "lub tog hauv ncoo" hloov lub rooj zaum ib txwm muaj.

Ua yam koj ua tau kom xis nyob. Sim zam qhov xwm txheej uas koj tuaj yeem pom ua ntej tsis xis nyob lossis nqa hauv ncoo lossis lwm yam kev pab nrog koj

Kho qhov Fistula Kauj Ruam 4
Kho qhov Fistula Kauj Ruam 4

Kauj Ruam 4. Siv cov ntaub nqus dej

Yog tias koj lub qhov txhab ua rau muaj hmoov tsis zoo los ntawm qhov ntawd, hnav cov ntaub mos muag, cov ntaub nqus dej yuav ua rau koj tsis txhob txhawj xeeb txog kev xau cov ntshav, pus los yog kua dej tawm ntawm koj lub qhov quav, vim cov pawm yuav ua raws li qhov nqus dej.

  • Cov pawm neeg laus ua haujlwm, ib yam nkaus, lawv tsuas yog me ntsis hnyav dua thiab ntau yam kev thuam. Pads yog nyias thiab yooj yim dua los daws nrog.
  • Hloov cov ntaub qhwv ntau zaus ib yam nkaus vim tias qhov tso tawm yuav muaj ntxhiab tsw.
Kho qhov Fistula Kauj Ruam 5
Kho qhov Fistula Kauj Ruam 5

Kauj Ruam 5. Saib xyuas tus kheej kom zoo

Nco ntsoov ntxuav koj tus kheej tom qab txhua lub plab zom mov lossis mus tso quav. Tsis txhob muaj kab mob uas seem ntawm koj cov tawv nqaij yog thawj kauj ruam kom tsis txhob kis kab mob. Qhov no mus ob zaug hauv chav dej pej xeem thiab thaum koj tab tom ntsib kev xau.

  • Yog tias koj nyob sab nraud thiab tsis tuaj yeem ua qhov no, nco ntsoov khaws cov ntaub so nrog koj kom siv tau kom txog thaum koj tuaj yeem rov los tsev. Koj txhais tes tau pom muaj feem kis tau cov kab mob thiab yog li ntawd yuav tsum nyob huv.
  • Hloov koj cov ris tsho hauv qab raws li xav tau txhua hnub yog tias lub fistula tau xau. Hloov cov phuam da dej txhua zaus koj da dej, ib yam nkaus. Ob qho ntawm no tiv thaiv kev kis tus kab mob thiab kev loj hlob ntawm cov kab mob uas tuaj yeem txo qis perianal voos thiab yog li yuav pab tshem tawm cov tsos mob uas ua rau cov neeg mob fistula raug kev txom nyem.
Kho qhov Fistula Kauj Ruam 6
Kho qhov Fistula Kauj Ruam 6

Kauj Ruam 6. Siv tshuaj pleev

Anorectal fistulas feem ntau nrog mob uas tsis tu ncua, throbbing thiab uas ua rau hnyav dua thaum koj zaum. Txhawm rau daws qhov no, tham nrog koj tus kws kho mob txog yam tshuaj kho mob thiab hom tshuaj twg yog qhov zoo rau koj. Ibuprofen, cov tshuaj tsis-steroid anti-inflammatory (NSAID), yuav pab tau rau kev kho mob qhov txhab, lossis koj yuav xav tau tshuaj noj.

  • Qhov mob yuav yog qhov teeb meem ntawm fistula. Lub qhov av thaiv yuav ua kom puv es tsis txhob tso kua paug tawm - cov txheej txheem uas tuaj yeem ua rau muaj qhov tsim tawm ntawm lub qhov quav, lossis lub hnab ntim pus ze ntawm daim tawv nqaij.
  • Qhov mob kuj tuaj yeem ua ke nrog qhov ua rau khaus khaus thiab liab uas zoo ib yam rau ntawm daim pawj nyob ib ncig ntawm daim tawv nqaij perianal vim tias muaj cov kua paug.
Kho qhov Fistula Kauj Ruam 7
Kho qhov Fistula Kauj Ruam 7

Kauj Ruam 7. Txhim kho koj lub cev tiv thaiv kab mob

Tswj kev noj zaub mov zoo thiab noj zaub mov nplua nuj nyob hauv omega-3s, omega-6s, thiab vitamin C, zoo li ntses, txiv ntseej roj thiab txiv hmab txiv ntoo citrus yuav pab ntxiv dag zog rau lub cev tiv thaiv kab mob thiab txo qis kev mob koj yuav raug kev txom nyem vim yog lub fistula. Koj kuj tseem tuaj yeem noj tshuaj ntxiv yog tias koj tus kws kho mob xav tias nws txawj ntse.

Kev tawm dag zog, haus dej ntau, pw tsaug zog zoo, thiab nyob huv si kuj yog cov kauj ruam zoo uas koj tuaj yeem ua rau koj muaj kev noj qab haus huv dua. Thiab yog tias koj muaj tus cwj pwm tsis zoo - nyiam haus luam yeeb - txiav txim siab qhov laj thawj no kom txiav luam yeeb

Kho qhov Fistula Kauj Ruam 8
Kho qhov Fistula Kauj Ruam 8

Kauj Ruam 8. Nyob twj ywm

Yog tias koj qhov xwm txheej tso cai rau ua kom yooj yim, ua rau lub cev qoj ib ce xws li taug kev qeeb, ua li ntawd rau koj kev noj qab haus huv thiab pab tshem tawm kev ntxhov siab. Kev nyuab siab tuaj yeem cuam tshuam koj li kev xav thiab tuaj yeem ua teeb meem thiab ua rau koj lub plab tsis txaus. Qhov no cuam tshuam rau koj lub plab zom mov thiab koj tus cwj pwm noj zaub mov noj tag nrho, uas tsim lub voj voog phem.

  • Ib txwm nres thiab ntes koj cov pa ib pliag yog tias koj hnov mob lossis tsis muaj peev xwm txuas mus ntxiv. Nov yog koj lub cev qhia rau koj tias nws tsis tuaj yeem tswj hwm qhov koj tab tom tso rau hauv.
  • Nug koj tus kws kho mob rau txhua yam kev ua kis las lossis ua si uas koj tuaj yeem ua tau. Txawm nyob hauv tsev, yoga tau qhia los ntawm ntau tus kws kho mob kom qhia meej koj lub siab, tshem kev ntxhov siab, thiab tawm tsam kev nyuaj siab. Nws tseem txhim kho koj txoj kev xav thiab kev noj qab haus huv feem ntau.

Ntu 2 ntawm 3: Tau Txais Kev Kho Mob

Kho qhov Fistula Kauj Ruam 9
Kho qhov Fistula Kauj Ruam 9

Kauj Ruam 1. Mus ntsib koj tus kws kho mob

Kev kuaj mob yog los ntawm kev tshuaj xyuas qhov muag. Ib qho sigmoidoscopy yuav tsum ib txwm ua raws qhov kev kuaj pom kom txiav tawm Crohn tus kab mob, mob qog noj ntshav, thiab lwm yam mob hnyav. Txawm li cas los xij, kom paub qhov nkag thiab tawm ntawm koj rooj plaub, koj tus kws kho mob tuaj yeem ua 1 lossis ntau dua ntawm cov kev ntsuas hauv qab no, ib yam nkaus:

  • Computerized Tomography (CT scan). Tshwj xeeb tshaj yog hauv cov neeg mob Crohn tus kab mob, CT scan qhia txog theem mob ua ntej tuaj yeem tsim lub fistula, ntxiv rau qhia pom kab noj hniav ntawm qhov mob txhawm rau txiav txim siab yog xav tau kev phais mob.
  • Sib Nqus Resonance Imaging (MRI). Qhov no yog txoj hauv kev muaj txiaj ntsig los txiav txim siab ib qho fistulas nkag los ntawm kev qhia pom qhov hloov pauv lossis ua kom cov kua hauv lub raj fistula.
  • Fistulography. Qhov no yog X-ray txoj hauv kev uas cov xov xwm sib piv tau txhaj rau ntawm qhov chaw sab nraud ntawm lub qhov muag kom pom meej txog txoj kev fistula thiab tob npaum li cas nws yog los ntawm cov ntaub so ntswg uas yuav pab xaiv kev kho mob.
  • Kev kuaj mob ultrasound. Qhov no ua ke nrog kev tshuaj xyuas lub cev tuaj yeem siv los txheeb xyuas qhov muaj nyob ntawm cov dej hauv lub cev lossis cov kua dej ntau uas tuaj yeem nyob hauv lub raj fistula.
  • Cystoscopy. Qhov no muaj txiaj ntsig zoo rau "enterovesical fistula" uas txuas cov hnyuv nrog lub zais zis.
  • Kev kuaj kab mob microbiological. Txhawm rau qhia ib qho cim ntawm kev kis mob, tshwj xeeb tshaj yog thaum muaj mob hauv lub cev, yuav tsum tau tso zis tso zis thaum muaj colisssical fistulas.
Kho qhov Fistula Kauj Ruam 10
Kho qhov Fistula Kauj Ruam 10

Kauj Ruam 2. Raug phais

Qhov kev kho mob feem ntau ntawm fistulas yog kev phais mob, uas hu ua "fistulotomy." Cov txheej txheem no yuav tshem lub qhov quav thiab cov pus lossis cov kua dej sib sau ua ke.

  • Hauv fistulotomy rau qhov quav fistulas, tus txheej txheem hu ua nrov plig plawg yuav siv. Nov yog qhov uas cov ntaub so ntswg noj qab haus huv nyob ib puag ncig tau muab tso rau hauv lub qhov txhab kab noj hniav kom ntseeg tau tias kev tiv thaiv nws cov quav los ntawm cov quav thaum kis tau tus kab mob rov tshwm sim.
  • Cov xaum xaum xaum (hla txoj hlua mus rau hauv lub qhov txhab txhawm rau kom nws kaw thaum lub qhov dej ntws) kuj tau tshaj tawm tias yuav siv rau hauv fistulotomy. Qhov no, txawm li cas los xij, feem ntau siv sijhawm mus ntsib koj tus kws kho mob kom txog thaum rov zoo thiab thaum kawg cov kab xaws tau tawg. Muaj "Kev Txiav Txim Kho Mob" hu ua "Kshar Sutra Therapy," uas muaj qhov ua tiav tau zoo.
Kho qhov Fistula Kauj Ruam 11
Kho qhov Fistula Kauj Ruam 11

Kauj Ruam 3. Ua tib zoo ceeb toom yog tias koj muaj lub qhov txhab ze koj lub plab

Fistulas nruab nrab ntawm txoj hlab pas thiab tsob ntoo trachea-bronchial tau suav tias yog kev phom sij rau lub neej thiab xav tau kev kho tam sim thiab txuas ntxiv mus. Yog tias tsis kho lawv tuaj yeem ua rau mob ntsws ntev thiab ua rau mob ntsws tuag taus. Kev kho mob yog muab los ntawm tus txheej txheem kho mob xws li:

  • Esophageal dilation. Qhov no yuav nyob ntev rau lub hlis lossis ntau xyoo nyob rau qee tus neeg mob.
  • Saj zawg zog-hlau mesh stents. Cov no yog qhov ua tau zoo tshaj plaws hauv kev tswj hwm txoj hlab pas thiab tus qauv.
  • Yas coated mesh stents. Cov no kuj tseem tuaj yeem siv txhawm rau txhawm rau txhaws qhov nqaj nqaj-esophageal fistulas; qee qhov tau siv nrog lub valve uas tiv thaiv kev rov qab thaum lub fistula nyob ze ntawm txoj hlab pas.
Kho qhov Fistula Kauj Ruam 12
Kho qhov Fistula Kauj Ruam 12

Kauj Ruam 4. Ua raws koj tus kws kho mob

Nws yog ib qho tseem ceeb heev uas koj ua raws koj tus kws kho mob tom qab phais, tshwj xeeb tshaj yog tias koj muaj tus kab mob ua mob ntev, xws li Crohn tus kab mob lossis lwm yam mob. Hauv cov xwm txheej no, fistulas tsuas yog qhov tshwm sim tshwm sim thiab qhov ua rau xav tau tiag tiag yuav tsum tau hais daws.

  • Muaj lwm yam teeb meem uas cuam tshuam ncaj qha rau lub plab fistulas uas tus neeg mob cuam tshuam yuav tsum taug qab thiab paub txog, ib yam. Lawv yuav tsum zam kev sepsis los ntawm kev kho ib qho tsos mob ntawm kev kis mob, xws li mob hauv cov ntaub so ntswg nyob ib puag ncig lub qhov txhab, tswj kev tso dej ntawm lub qhov quav thiab ua tib zoo saib xyuas ntawm daim tawv nqaij kom tswj tau cov nqaij nyob ze hauv lub xeev noj qab nyob zoo.
  • Ib txoj hlab pas yuav tsum tau pub rau ib tus neeg nrog txoj hlab pas. Qhov no mus los ntawm phab ntsa hauv plab thiab ncaj qha mus rau hauv plab. Yog xav tau, lub raj yuav muab tso rau thaum tus neeg mob nyob rau hauv tshuaj loog kom lawv yuav tsis mob.
Kho qhov Fistula Kauj Ruam 13
Kho qhov Fistula Kauj Ruam 13

Kauj Ruam 5. Tham nrog koj tus kws kho mob txog kev noj tshuaj tua kab mob

Tshuaj tua kab mob tuaj yeem txo qis txoj hauv kev los tsim kev kis mob ntawm qhov chaw fistula, tshwj xeeb tshaj yog rau cov hom nkag. Qib siab ntawm cov qe ntshav dawb qhia pom tias muaj tus kab mob uas yuav xav tau kho nrog cov tshuaj tua kab mob tsim nyog.

Fistulas tuaj yeem kho thawj zaug nrog kev kho mob sib xyaw ntawm metronidazole thiab ciprofloxacin lossis vancomycin. Metronidazole yuav yog 250-500mg txhua 8 teev; Vancomycin yog 125-250 mg txhua 6 teev, lossis peb zaug ib hnub ib teev tom qab noj mov

Ntu 3 ntawm 3: Nkag Siab Fistulas

Kho qhov Fistula Kauj Ruam 14
Kho qhov Fistula Kauj Ruam 14

Kauj Ruam 1. Paub qhov ua rau thiab muaj feem cuam tshuam

Feem ntau yog muaj feem cuam tshuam nrog mob hnyav xws li Crohn tus kab mob thiab tuberculosis. Lwm tus tuaj yeem tshwm sim los ntawm diverticulitis, qog, lossis raug mob ntev. Kev phais lossis kev raug mob tuaj yeem ua rau tsim cov fistula, ib yam nkaus, zoo li ntawm cov kua tsib los yog cov hlab ntshav loj.

  • Recto-vaginal fistulas yuav yog theem thib ob rau Crohn tus kab mob, kev raug mob ntawm cev xeeb tub vim yug los, kho hluav taws xob lossis mob qog noj ntshav.
  • Fistulas hauv menyuam yaus lossis menyuam mos liab feem ntau muaj menyuam hauv plab cuam tshuam rau tub ntau dua li ntxhais.
Kho qhov Fistula Kauj Ruam 15
Kho qhov Fistula Kauj Ruam 15

Kauj Ruam 2. Paub cov cim thiab tsos mob

Ib qho fistula feem ntau tuaj nrog cov tsos mob no:

  • Kev tso tawm tas li (pus)
  • Mob (ntsig txog kev kis kab mob)
  • Los ntshav
  • Mob hauv plab
  • Raws plab
  • Tsis qab los noj mov
  • Poob phaus
  • Xeev siab thiab ntuav
Kho qhov Fistula Kauj Ruam 16
Kho qhov Fistula Kauj Ruam 16

Kauj Ruam 3. Paub ntau hom fistulas

Lub qhov quav, los ntawm kev txhais, yog lub raj zoo li lub qhov nrog 2 qhov qhib: 1 qhov qhib thawj coj mus rau lwm qhov qhib sab nrauv hu ua qhib thib ob. Ntau hom fistulas tau paub, tab sis 90% ntawm tag nrho cov fistulas yog qhov quav fistulas. Lub cev, lawv tuaj yeem ua raws li cov hauv qab no:

  • Dig muag Fistula: Qhov sib txuas ntawm ob sab; ib kawg tau kaw thiab lwm qhov qhib. Qhov no tuaj yeem dhau mus ua qhov fistula tiav yog tias tsis kho.
  • Tsis tiav Fistula: Qhov txuas tsuas muaj ib qho qhib sab nraud xwb.
  • Ua kom tiav Fistula: Kev sib txuas ntawm qhov qhib sab hauv thiab qhib sab nraud.
  • Horseshoe Fistula: Kev sib txuas hauv U duab, nruab nrab ntawm ob sab qhib sab nraud ncig lub qhov quav.
Kho qhov Fistula Kauj Ruam 17
Kho qhov Fistula Kauj Ruam 17

Kauj Ruam 4. Paub qhov teeb meem ntawm lub qhov quav

Hmoov tsis zoo, fistula cov tsos mob tsis yog qhov teeb meem nres - nws tseem tuaj yeem ua rau nws tus kheej muaj teeb meem. Lawv yog cov hauv qab no:

  • Cov zais zis uas ua rau mob ib ncig ntawm qhov quav
  • Cov qog nqaij hlav ntawm qhov quav
  • Kab mob Radial fungus (tsawg heev)
  • Raug raug mob hnyav
  • Cov kab nrib pleb nyob ib ncig ntawm qhov quav
  • Cov kab mob ntawm txoj hnyuv

    Vim li no, nws tau qhia paub tias koj ntxuav qhov quav kom zoo tom qab siv chav dej, saib cov cai ntawm kev nyab xeeb rau pej xeem thiab kev tu tus kheej, thiab siv ntaub so tom qab siv chav dej thiab muab pov tseg tom qab siv tas

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