Pilonidal chotupa: zimayambitsa, zizindikiro, kupewa ndi kuchiza

Nthawi zina munthu angakhale theka moyo mosazindikira kuti thupi lake akhoza zimayambitsa kumuopseza chobisika, monga teratoma, impso malformation kapena chotupa cha coccyx. Yotsirizira alibe kuonekera mpaka nthawi inayake, ndipo madokotala sangakhoze kunena chimodzimodzi chimene chinayambitsa maonekedwe zizindikiro matenda. Panthawi ina maphunziro izi zikuyamba chofuna, mafinya aumbike, woyenga a zimakhala zofewa, ndi vuto zimaonekera.

tanthauzo

Pilonidal chotupa - ndi anomaly wa khungu m'dera sacrococcygeal. N'chimodzimodzi ndi matenda awa pilonidal nkusani kapena zaminyewa coccygeal Inde. Mmodzi kukhulupirira za matenda pamaso pa khungu Anabweza mu mezhyagodichnoy crease. Pambuyo ululu wa coccyx kapena yozizira m'dera amakhala chofuna fistula ndi abscesses. Patapita nthawi, iye mwanjira anatsegula, kupanga timapepala zina ndi mipata. Ngati sachita zaumoyo, matenda ndi kobwereza m'chilengedwe.

Pilonidal chotupa (ICD-10)

Mu gulu mayiko a Matenda younikanso chakhumi cha gawo mu kalata L, imene, mwa zina, lili khungu ndi subcutaneous minofu. Pilonidal chotupa ndi encrypted pansi malamulo L05, kumaphatikizapo fistula ndi coccygeal pilonidal nkusani. Kuzindikiritsidwa subgroups awiri:
- L05.0 - chotupa ndi abscess;
- L05.9 - chotupa popanda abscess.

Chigawo chimenechi mulinso ng'ombe, dermatitis, chikanga, urticaria, matenda a pakhungu ndi zokhudzana ena.

Zimayambitsa chotupa mapangidwe

Monga amadziwika, Ndisanaumbidwe akudutsa pa kukula siteji ya kusanduka. Iye ali mutu waukulu, mtima atatu chambered, ndipo ngakhale Kakhungu mchira. madokotala ambiri ndi pathologists amakhulupirira kuti pilonidal cysts coccyx ndi chilema kobadwa nako wa kunja wosanjikiza nyongolosi. Ichi ndi chifukwa kuti mapeto a minofu kuchepetsedwa ndi Mitsemphayi mchira limeneli, lomwe limapezeka mu masabata oyambirira angapo a gestation, ndipo kodi phompho pambuyo sabata chitatu.

Pali maganizo osiyanasiyana pa nkhani imeneyi. Akatswiri ena amakhulupirira kuti matenda kumachitika chifukwa cha tsitsi ingrown mu mafuta subcutaneous. Otsatira mfundo imeneyi chiphunzitso kukhalapo kwa ndime zaminyewa pakati pa zala pa hairdressers ndi mwambo wa nthambi udulidwe, m'dera underarm.

Kuposa zaka zana zapitazo, asayansi anali wapampando wa bungwe la chiphunzitso monga amene zaminyewa coccygeal Inde aumbike mwa ndondomeko involution cha mapeto a zigawo msana. mafotokozedwe ina momwe anapanga pilonidal chotupa, conformable ndi yapita: coccygeal vertebrae zomwe zimapanga nyama mchira, resorbed ndi achikalekale mtolo amakhalabe malo ake. Ngati ndondomeko izi kulembedwa mu zonse, pa malo awa anapanga kusuntha akhungu, amene akhoza kukhala chofuna.

zizindikiro

Avereji odwala ndi matenda a "pilonidal chotupa" - kuchokera sikisitini kwa zaka twente-faifi. Nthawi zambiri chimakhudza anthu a mafuko kum'mwera. matenda ndi pafupifupi wamba mu akuda. Ambiri amadwala amuna amene amapita kwambiri ndi galimoto kapena nezi yaitali, monga asilikali kapena truckers.

Inde zaminyewa ili pa midline mu mezhyagodichnoy crease, iye mwachimbulimbuli kuthera mu adipose minofu ndi kutsegula chilonda pakhungu. Kumbali ya yopapatiza kutalika chubu kuti masentimita atatu kapena anayi. Mkati, izo wodzaza ndi epithelium, amene amatulutsa ntchofu. mwakayakaya aliyense makina kapena matenda kungayambitse kuchedwa kwa outflow zaminyewa katulutsidwe ndi kutupa. Pilonidal chotupa kanthu kena kuposa nkusani chofuna, amene ndi Mwina mkulu tikhoza kupita abscess ndi. Nthawi zapamwamba akafika mtengo ndithu, ndipo mukhoza zokha chinatseguka kusungunuka khungu. Iyi ndi ndondomeko zopweteka kwambiri kuti akhoza kusokoneza moyo.

Kusiyanitsa wopepuka ndi zovuta zaminyewa Inde coccygeal. Mbali yoyamba, monga ulamuliro, pali kudandaula ayi. Nthawi zina pali yosamveka ululu coccyx ndi, mbwenye nkhabe vuto la wodwalayo ndipo kudzachitika pokhapo ndi msonkhano kapena m'mapapo kuvulala yaitali. Kawirikawiri pilonidal chotupa limodzi ndi kuyabwa ndi kumaliseche mu mezhyagodichnoy crease.

Ngati matenda zovuta, ndiye pali pachimake kapena aakulu kutupa kwa zaminyewa sitiroko, malungo, kupweteka kwambiri m'dera la abscess, pali amamuyambitsa timabala pa malo a fistula machiritso. Izi zambiri akusokoneza odwala ndi kukakamiza iwo kukaonana ndi dokotala.

diagnostics

Doctor ndipo ndikofunika bwino kusonkhanitsa mbiri zambiri zachipatala. Nthawi zambiri, odwala ankachitira pambuyo pa choipa kapena ululu pamene kulitchula. Pamaso pa mabowo dera mezhyagodichnoy, kutupa pa malo pachilonda, okhazikika abscesses kobwereza kupanga matenda mosavuta zokwanira.

Pofuna kudziwa momwe mabowo ambiri pali ndi mmene sikuti fistula, dokotala injects utoto mu izo, ambiri a methylene buluu, ndiye kuonera kuwona kumene utuluke madzimadzi. Njira imeneyi zimathandiza inu kuti muzione milozo onse a mafinya ndi kwathunthu kuwachotsa pa ntchito.

wopepuka chotupa chithandizo

Pilonidal chotupa popanda abscess kumafuna wopita opaleshoni chithandizo, nthawi ndi mmene amene akhoza anasankha munthu mmodzi wodwala aliyense. The Tinganene ndi chimodzi chokha: kusokonezedwa ayenera pochitika chikhululukiro cha matenda. ntchito kwakukulu ndi zofunika pa nkhani ya kutsegula kunja anaonekera mafinya. Dokotalayo akuchita excision wa khungu kumezanitsa ndi minofu subcutaneous mpaka fascia sacrococcygeal. Kuti atsogolere mwayi, zaminyewa chimachititsanso wodetsedwa ndi ayodini, fukortsinom kapena methylene buluu. chilonda anali sutured mu zigawo kapena mwamphamvu (ndi zotupa kwambiri kapena yaikulu) anachita suturing bala m'mbali kuti pansi pake. Stitches amachotsedwa Patatha milungu iwiri kwambiri zodzikongoletsera zopindika pa malo ang'ambe thupilo si anati. Mosamala mosamala nthendayo anachiritsa kotheratu.

zovuta chotupa chithandizo

Pilonidal chotupa ndi abscess amafuna njira ina pang'ono mankhwala. Ngati kutupa Kodi asapitirire makutu mezhyagodichnoy, alibe oposa atatu masentimita ndi mosamalitsa ndawala njira, n'zotheka kuchititsa kamodzi kwakukulu alowererepo ndi kwathunthu kuchotsa cholinga cha kutupa awiri. Pankhani ya kafalitsidwe adzalowerera asanachite opareshoni zofunika odana ndi yotupa mankhwala.

Pamene abscess mapangidwe (i.e. mowiriza yojambula zili abscess) ndi bwino woyamba agwire odana ndi yotupa mankhwala kuti mezhyagodichnoy dera anali kupezeka kwa ntchito komanso kuchepetsa chiopsezo cha matenda oyamba postoperative. Mtsogolo kwakukulu siteji angapo ubwino:
- ndalama ang'ambe thupilo pakhungu;
- pazipita mgwirizano wa m'mbali bala.

Ngakhale adzalowerera chimafikira m'mbali, chinthu chachikulu ndicho pilonidal chotupa coccyx. opaleshoni amachitidwa pa midline wa abscess lapansi. Pambuyo kupeza dokotalayo akuchita ndi kafukufuku wa bala kuchotsa zonse necrotic minofu misa ndi yopuma jumper, ngati aliyense. Kuyambiranso kupewa ndi bwinobwino za kuthengo opaleshoni, kuchotsa detritus onse necrotic, excision mavesi ndi milozo. Mobwerezabwereza kutupa angayambe ngati opaleshoni sanali kwakukulu zokwanira, zotsala za zaminyewa sitiroko anasunga tsitsi kapena chilonda machiritso kwathunthu.

Ntchito yausilikali

Pa ndime ya kusodza ntchito dokotala ndikupeza pafupi Anabweza wa chotulukira banga ndi tsitsi kumutulutsira za izo. DOKOTALA A chikuyambitsa ndi nkhawa, kotero mnyamata kufunsa mafunso kutsogolera: Kodi izo itch kazivutitsa ngati mafinya zilipo ngati kutupa anali. Ngati yankho ndi zoipa, dokotalayo malangizo thanzi ndipo ananena kuti msilikali ali woyenera utumiki.

Koma ngati imodzi mwa mafunso yankho ndi inde, pamafunika opaleshoni, chifukwa cha mankhwala ndiwofatsa kulibe. alowererepo The ikuchitika m'njira wopita, ngati palibe zizindikiro kuchitapo kanthu mwamsanga.

Malangizo kwa odwala

Pilonidal chotupa amafuna wosakhwima chisamaliro postoperative, choncho ndi zofunika kusunga odwala ndi malangizo awa:
- masabata atatu opaleshoni kukhala ndi kunyamula zitsulo sikuloledwa;
- azitenga kusamba tsiku ndi ofunda ukhondo kutsuka mezhyagodichnoy m'dera;
- mkati iwiri iliyonse Patangotha miyezi isanu ndi opareshoni, muyenera kuchotsa tsitsi m'dera la ang'ambe thupilo la;
- atavala zofewa, kugona tulo kabudula, popanda seams yotundumukira kunja kwa mpanda.

Njira yolondola kuti kupewa zisadzachitikenso ya matenda ndiponso ntchito yonyamula katundu kunja kwa audits m'tsogolo.

zosokonezeka

Monga ulamuliro, pilonidal chotupa, mankhwala yomwe ikuchitika mofulumira yekha, ali ndi madokotala ananena zawo zabwino, zimadza kuchira bwino. Mwatsoka, zosokonezeka zina n'kotheka, monga:

- abscesses kobwereza (ngati kafukufuku sichinayambe ikuchitika zonse);
- zisadzachitikenso wa matenda (ngati wodwala safuna kutsatira malangizo kwa kasamalidwe mode pambuyo ntchito);
- sepsis ndi pyosepticemia (pamene anagwirizana ndi matenda sekondale bakiteriya);
- kusinthika kwa zimakhala zaminyewa kuwasandutsa carcinoma squamous selo.

The Vuto yamasika yosowa kwambiri, koma madokotala ngati mukulimbana mu nkhani iyi, ndi minofu kuchotsedwa akutumizidwa kufufuza histological, kuti mupewe matenda a khansa.