Ligature fistula postoperative caws pliav - cov tsos mob thiab kev kho mob

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Ligature fistula postoperative caws pliav - cov tsos mob thiab kev kho mob
Ligature fistula postoperative caws pliav - cov tsos mob thiab kev kho mob
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Ligature fistula postoperative caws pliav

Ligature fistula
Ligature fistula

Qhov tshwm sim ntawm kev ua haujlwm, tsis cuam tshuam nrog kev kho mob ntawm lub qhov txhab purulent, yog kev kaw ntawm qhov chaw phais los ntawm kev suturing. Yog hais tias cov ntaub so ntswg kis tau tus kab mob, tus kws phais yuav tsim ib lub sij hawm los tshem tawm cov kua paug thiab txo qhov ntim ntawm infiltration. Cov khoom siv suture siv hauv kev phais tej zaum yuav yog los ntawm ntuj los yog hluavtaws. Ligature sutures yuav yaj ib ntus tom qab kev phais, lossis xav tau kev kho mob kom tshem tawm lawv.

Yog tias cov kua dej ntawm cov xim cherry tsaus lossis purulent tso tawm ntawm qhov chaw suture, qhov no yog ib qho cim ntawm kev tsim cov txheej txheem inflammatory thiab tsim cov ligature fistula. Cov tsos mob ntawm cov tsos mob no yog ib qho cim ntawm ligature rejection thiab yog vim li cas rau resuming kev kho mob. Lub fistula uas tshwm sim tom qab phais tsis tuaj yeem suav tias yog qhov tshwm sim ib txwm muaj, kev kho mob ceev yuav tsum tau ua raws li kev taw qhia ntawm tus kws phais.

Causes of ligature fistula:

  • Kab mob hauv qhov txhab vim tsis quav ntsej cov cai ntawm cov tshuaj tua kab mob;
  • Kev tsis haum rau kev phais.

Features of ligature fistulas:

  • Ua nyob qhov twg hauv lub cev;
  • Muaj nyob rau txhua hom ntaub so ntswg ntawm tib neeg lub cev (epidermis, nqaij nqaij, fascia);
  • Muaj tshwm sim tom qab txhua lub sijhawm (lub lim tiam, hli, xyoo) tom qab ua haujlwm;
  • Lawv muaj qhov sib txawv ntawm qhov chaw kho mob daim duab (sutures tuaj yeem tsis lees paub los ntawm lub cev nrog kev kho qhov txhab ntxiv, lossis lawv tuaj yeem ua rau mob hnyav nrog suppuration ntawm qhov txhab thiab tsis kho);
  • Lawv tshwm sim txawm hais tias cov khoom siv ntawm cov hlua khi.

Risk factors

Muaj ntau yam uas ua rau muaj qhov tshwm sim tom qab fistula:

  • Hnub nyoog ntawm tus neeg mob;
  • Immune reactivity (feem ntau siab dua hauv cov neeg hluas);
  • Kev kis tus kab mob ntev;
  • Tsev kho mob kis tau zoo ntawm cov tsev kho mob phais thiab kho mob;
  • Kev noj cov staphylococcus thiab streptococcus, feem ntau ib txwm pom ntawm tib neeg daim tawv nqaij, rau hauv qhov txhab;
  • Localization thiab hom kev cuam tshuam ntawm kev phais (caj dab, phais rau paraproctitis, thiab lwm yam);
  • Protein malnutrition in cancer;
  • Tsis muaj cov vitamins thiab minerals;
  • YMetabolic Disorders (mob ntshav qab zib, rog rog, metabolic ntshawv siab).

Symptoms of ligature fistula

Cov tsos mob ntawm ligature fistula
Cov tsos mob ntawm ligature fistula

Kev txhim kho ntawm kev ua haujlwm tom qab fistula tshwm sim raws li cov xwm txheej hauv qab no:

  • Tsis pub dhau ob peb hnub tom qab ua haujlwm, thaj chaw qhov txhab ua kom tuab, o me ntsis, thiab mob heev. Cov tawv nqaij ib ncig ntawm nws tig liab, ua kub rau qhov kov dua li lwm qhov chaw.
  • Tom qab 6-7 hnub, thaum nias, cov kua dej thiab cov kua paug tawm hauv qab seam.
  • Lub cev kub kub nce mus rau qhov muaj nuj nqis subfebrile (37, 5-38 °).
  • Lub fistulous tract tej zaum yuav spontaneously kaw, tom qab rov qhib.
  • Kev rov qab tuaj yeem ua tau tom qab ua haujlwm thib ob.

Teeb meem tshwm sim vim kev ua haujlwm tom qab fistula

  • Abscess - kab noj hniav uas muaj cov paug;
  • Phlegmon - suav nrog hauv cov txheej txheem inflammatory ntawm subcutaneous rog;
  • Eventration - prolapse ntawm cov kabmob sab hauv vim yog purulent fusion ntawm cov ntaub so ntswg;
  • Sepsis - kis ntawm cov ntsiab lus purulent nyob rau hauv kab noj hniav ntawm lub hauv siab, pob txha taub hau, hauv plab kab noj hniav;
  • Toxic-resorptive fever - hnyav hyperthermia, raws li cov tshuaj tiv thaiv ntawm lub cev.

Diagnosis

Kev kuaj mob
Kev kuaj mob

Kev kuaj mob tseem ceeb ntawm lub caj dab fistula yog nqa tawm hauv chav hnav khaub ncaws thaum lub sijhawm kuaj pom qhov txhab los ntawm tus kws phais. Txhawm rau kom paub meej qhov chaw ntawm lub fistula, muaj lossis tsis muaj teeb meem (abscess, purulent streaks), ultrasound ntawm lub qhov txhab phais yog ua.

Yog tias lub fistula nyob rau hauv cov ntaub so ntswg tuab, thiab nws qhov kev kuaj mob nyuaj, siv fistulography. Thaum kuaj xyuas, tus neeg sawv cev sib txawv yog txhaj rau hauv qhov chaw fistulous thiab radiography yog ua. Raws li qhov tshwm sim ntawm kev tswj hwm, qhov fistulous ib puag ncig yuav pom meej meej ntawm x-ray.

Kev kho mob ligature fistula

Feem ntau ntawm cov mob ligature fistula tsuas yog daws tau los ntawm kev phais. Lub sijhawm ntev tom qab kev phais fistula, qhov nyuaj dua nws yog kho. Kev kho mob nyuaj nrog kev siv tshuaj yog siv los kho.

Cov tshuaj siv los kho fistula:

  • tshuaj tua kab mob hauv zos;
  • YAntibacterial agents;
  • Enzymes rau kev rhuav tshem cov ntaub so ntswg tuag.

Kev kho lub cev yog siv ntxiv rau kev phais thiab kev kho mob:

  • Quartzation ntawm qhov txhab ntawm qhov txhab. Quartzation muaj kev cuam tshuam rau cov kab mob pathogenic, pab txhawb kom ruaj khov ntawm cov txheej txheem, txawm hais tias tsis tau lees paub qhov rov ua tiav.
  • UHF txoj kev kho. microcirculation ntawm cov ntshav thiab lymph txhim kho, uas ua rau txo qis hauv edema thiab xaus rau kev sib kis.

"tus qauv kub" rau kev kho mob ligature fistula yog kev ua haujlwm uas tso cai rau koj tshem tawm qhov teeb meem tag nrho. Tom qab ua haujlwm, tus neeg mob xav tau kev hnav khaub ncaws, ntxuav cov kua dej. Yog tias tsis kho qhov paug tawm, qhov ntws tawm raug tshem tawm.

Kev kho hauv zos ntawm cov ntaub so ntswg uas muaj qhov txhab dav ntawm fistula yog ib hom kev kho mob ntawm kev phais tom qab lub fistula. Feem ntau cov kev tawm tsam me me tsis zoo hauv kev kho qhov teeb meem no.

Kev kho tus kheej ntawm qhov caws pliav yuav tsis coj rov qab, vim tias tsuas yog kev phais thiab kev huv ntawm lub qhov txhab tuaj yeem cawm tus neeg mob los ntawm cov teeb meem. Sim kho tus kheej yuav nkim sij hawm muaj nuj nqis.

Huab cua thiab tiv thaiv

Nyob rau hauv rooj plaub ntawm kev tsis lees paub los ntawm lub cev ntawm kev phais xov los ntawm cov khoom siv, qhov kev cia siab ntawm kev ua haujlwm tsis zoo. Ib yam yog qhov tseeb nrog kev kho tus kheej - qhov kev kwv yees hauv qhov no nyuaj ua rau.

Kev tiv thaiv rau qhov pom ntawm fistula tsis tuaj yeem siv, txij li txawm tias nrog kev saib xyuas nruj ntawm cov tshuaj tua kab mob, tus kab mob tuaj yeem nkag mus rau hauv qhov txhab phais thiab tsis lees txais cov khoom siv suture.

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