النّاسور الشرجي
Abstract
شملت هذه الدراسة 61 مريضاً بنواسير شرجيّة, قبلوا وعولجوا في قسم الجراحة بمشفى الأسد الجامعي في اللاذقيّة خلال الفترة بين عام 2003 حتّى 31/8/2009, منهم 55 ذكراً (90.16%), و6 إناث (9.84%). تمّ تصنيف النّواسير حسب باركس إلى: نواسير بين المصرّتين عند (46) مريضاً (75.41%), نواسير عبر المصرّتين عند (12) مريضاً (19.67%), نواسير ما فوق المصرّتين عند مريضين (3.28%), ونواسير خارج المصرّتين عند مريض واحد (1.64%).
كانت الأسباب المرضيّة لحدوثها هي الخرّاجات الشرجيّة المستقيميّة المهملة, أمّا أهمّ المظاهر السريريّة فكانت خروج القيح عبر الشرج (85.25%), وأكثر طرائق التشخيص إتّباعاً هي زرق أزرق الميثيلين (88.52%). تمّ إتّباع تقنيّتين جراحيّتين هما: تقنيّة فتح الموقع (75.41%), وتقنيّة وضع الخزامة (24.59%). بلغت نسبة المضاعفات القريبة (26.23%), ونسبة المضاعفات البعيدة في تقنيّة فتح الموقع (17.39%), وفي تقنيّة وضع الخزامة (66.66%).
This study included 61 patients (55 males (90.16%) and 6 females (9.84%) with anal fistulas, admitted and treated in the Department of Surgery at Al-Assad University Hospital in Lattakia from 2003 to 31/8/2009. According to Parks, Fistulas were classified into: intersphincteric fistulas (46) patients (75.41%), transsphincteric fistulas (12) patients (19.67%), suprasphincteric fistulas (2) patients (3.28%), and extrasphincteric fistulas (1) patient (1.64%). The causes of these fistulas were neglected anorectal abscesses. The most important clinical features were draining pus from anus (85.25%). Injection of methylene blue was the most executed investigating method (88.52%). Two surgical techniques were performed: Lay-open technique (75.41%) and seton placement (24.59%). Incidence of early complications accounted for (26.23%), while later complications accounted for (17.39%) with lay-open technique and (66.66%) with seton placement.
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