Mafupa amapezeka makamaka pakati pa anthu okalamba, ngakhale kuti akufotokozedwa kuti ali ndi chitukuko cha ana komanso okalamba. Amuna amadwala kawirikawiri kuposa akazi.
Etiology ndi pathogenesis.
Njira zothandizira tizilombo toyambitsa matenda zimafotokozedwa m'njira zosiyanasiyana. Zina mwa zinthu zomwe zimapangitsa kuti thupi lizikhalanso ndi ziwalo zikuluzikulu: 1) zizindikiro za maonekedwe a chiwombankhanga cha dera lachilombo ndi 2) zovuta zogwirizana ndi zosakwanira. Mwazinthu zambiri zomwe zikufotokozedwa kuti zifotokoze kupanga mapangidwe a ziwalo, zotsatirazi zikuyenera kusamalidwa: 1) lingaliro lopangidwa; 2) opatsirana komanso 3) chiphunzitso cha congenital anomalies ya mitsempha ya malo osadziwika.
Mankhwala amatsenga amafotokoza kuchitika kwa ziwalo za m'mimba mwa mphamvu ya zinthu zomwe zimayambitsa kupatsirana magazi ndi kuwonjezeka kwa mpweya wochokera m'mimba. Izi zimaphatikizapo kuthamanga kwambiri panthawi ya thupi, kuima kwa nthawi yayitali kapena kukhala pansi, kuyenda motalika chifukwa cha ntchito yopanga mankhwala, kudzimbidwa kwanthawi yaitali, mimba, kutupa ndi ziwalo za thupi. Pogwiritsa ntchito zinthu izi, pali kufooka kwa khoma lamatumbo, pang'onopang'ono kumawonjezeka mitsempha, kupuma kwa magazi mwa iwo.
Malingaliro opatsirana amafotokoza kukula kwa ziwalo zotsegula m'mimba ndi chitukuko chosatha chotchedwa endophlebitis, chochokera ku mitundu yosiyanasiyana yotupa m'dera lachilombo.
Otsatira ambiri a chiphunzitso cha congenital anomalies of the system of the anorectal chigawo amakhulupirira kuti chiyambi cha ziwalo zotupa zimayang'aniridwa ndi zinthu zosawerengeka za kapangidwe ka khoma la pakhosi ndi lavine.
Malinga ndi zomwe zimapangitsa kuti munthu asamangodziwa, ziwalo zimagawidwa kukhala congenital kapena cholowa (mwa ana), ndipo anapeza. Mafupa omwe amapezeka amatha kukhala apamwamba ndi apamwamba kapena owonetsa. Kukhazikitsa malo kumasiyanitsa pakati, mkati mwachinsinsi, kunja ndi kumbali, kumene zigawozo zili pansi pa phwando lapakati, chomwe chimatchedwa Hilton mzere. Ndi kuthamanga, magawo aakulu ndi ovuta a ziwalo zotsekemera amakhala olekanitsa.
Chithunzi chachipatala.
Zimadalira kukula kwake kwa ziwalo za m'mimba komanso kukhalapo kwa mavuto. Kwa nthawi yaitali, ziwalo zowononga zimatha kukhala zozizwitsa popanda kusokoneza wodwalayo. Ndiye palinso kumverera pang'ono kosautsa, chithunzithunzi mu anus. Kawirikawiri, zozizwitsazi zimachitika pamene akuphwanya matumbo, atatha kumwa mowa.
Kachipatala ka chitukuko cha matendawa chimadalira kumidzi, kukhalapo ndi kuuma kwa mavuto oopsa. Kawirikawiri chizindikiro choyamba chimachotsa magazi, chomwe chimachitika makamaka pa nthawi yachisokonezo. Kutaya magazi kumachitika, monga lamulo, ndi ziwalo zamkati zamkati, zakunja zopanda magazi. Wodwala amapeza magazi pa zinyama, pa pepala la chimbudzi nthawi zina magazi amathyoka pambuyo pa kutayika kuchokera ku anus. Kutsekemera kumawoneka nthawi ndi nthawi, magazi amapezeka mwatsopano, madzi. Ichi ndicho kusiyana kwa magazi omwe amatuluka m'magazi omwe ali ndi khansa yodetsa nkhaŵa kapena kudwala matenda osokoneza bongo omwe amachititsa kuti magazi asinthidwe nthawi iliyonse.
Kwa odwala ambiri, zotupa zimatuluka ndi zovuta nthawi zina, kutupa, kupweteka komanso kusokonezeka kwa magazi. Muzigawo zoyamba za kuwonjezereka pali kutupa kowawa kwa nodes, kumverera kwa raspiraniya mu anus, kumverera kosavuta pamene akuyenda. Pa malo otchulidwa kwambiri, node zikuwonjezeka kukula, pali ululu waukulu, edema wa dera lonse la anus amawonedwa. Kutetezedwa kumakhala kowawa kwambiri.
Zovuta zomwe zimapezeka nthawi zambiri ndi ziwalo za m'mimba zimaphatikizapo ziboliboli za anal, kuyabwa kwala, kupweteka kwambiri kwa piratum ndi fistula ya rectum, ndi proctalgia.
Kuphatikiza pa zomwe zimatchulidwa m'magazi, wachiwiri chimadziwika, chomwe chiri chizindikiro cha matenda ena. Zitha kuchitika ndi chibwibwi cha chiwindi, ndi zotupa za malo otchedwa retroperitoneal, ndi kuperewera kwa mtima.
Chithandizo.
Njira zonse zothandizira mavitamini zimagawidwa m'magulu atatu: 1) osamala; 2) jekeseni ndi 3) ntchito. Malingana ndi malo, kukula kwa ziwalo zotsekemera, kukhalapo kwa mavuto kumagwiritsira ntchito izi kapena mtundu umenewo wa chithandizo.
Matenda onse osavuta omwe amachotsa kunja ndi omwe amapezeka m'magazi ndi osowa magazi ochepa amatha kuchiritsidwa. Wodwala amatsutsana ndi kutenga zakudya zamadzimadzi, zokometsera, kumwa mowa. Chakudya chiyenera kukhala ndi zowonjezera zowonjezera (masamba, zipatso, mkate wakuda), zomwe zimapewa kudzimbidwa. Ndi kudzimbidwa kosalekeza, osatetezedwa ku zakudya, mavitamini a laxative amasonyezedwa. M'pofunikanso kutsatila ukhondo, kutsukidwa pambuyo pa chitetezo chilichonse.
Mwa njira za physiotherapeutic zothandizira mafinya ammimba, nthawi zambiri amalimbikitsidwa kuti azigwiritsa ntchito madzi ozizira okwera komanso okwera.
Pamene magazi amapezeka, kutentha kwa nodes kumagwiritsa ntchito mankhwala osiyanasiyana. Mwazi wodwala, wodwalayo wagona pabedi, amalephera kudya zakudya. Mu njira yotupa, anti-inflammatory suppositories amalembedwa.
Zizindikiro za chithandizo cha opaleshoni kwa mafupa ndi:
- Kuthamanga kwa magazi kosalekeza, osatetezedwa kuti azisamalidwa;
- Matenda a m'mitsempha, kuphatikizapo kugwedezeka mobwerezabwereza, kuphwanya, kutupa kwa nodes ndi kutuluka magazi;
- Kuchenjeza kwa ziwalo zotsegula m'mimba, zomwe zingayambitse kukhala chotupa chachikulu;
- Matenda akuluakulu, omwe amatsutsana ndi zochita za defecation.