Description
LAP LAMBERT Academic Publishing Patologicheskaya fiziologiya funktsionalnogo zapora 2012 Edition by Levin Mikhail
Funktsional'nyy zapor nachinaetsya v detstve. On vsegda nosit obstruktivnyy kharakter. So vremenem razvivaetsya megarektum i megakolon. Udlinyaetsya sigmovidnaya kishka.Zastoy v pryamoy kishke kalovykh mass rastyagivaet ee stenku, snizhaya ee chuvstvitel'nost'. Neobkhodimy bol'shie, chem v normy ob"emy kala, chtoby vyzvat' refleks defekatsii.Na pervom etape voznikaet gipertrofiya puborektal'noy myshtsy. V posleduyushchem mnogokratnoe buzhirovanie anal'nogo kanala shirokimi kalovymi massami privodit k rastyazheniyu i slabosti etoy myshtsy vplot' do polnoy nesostoyatel'nosti. Eto proyavlyaetsya nederzhaniem kala. Iz-za rigidnosti myshts v distal'noy chasti anal'nogo kanala voznikaet nesootvetstvie mezhdu shirinoy kalovykh mass i propusknoy sposobnost'yu anal'nogo kanala.Pri etom vsegda nastupaet zamedlenie passazha po tolstoy kishke. U detey starshego vozrasta i u vzroslykh zabolevanie prodolzhaetsya po dvum stsenariyam. V odnikh sluchayakh obstruktivnyy zapor oslozhnyaetsya invaginatsiey i rektotselle. U drugikh bol'nykh voznikaet diskineziya tolstoy kishki s povysheniem ee tonusa. Shirina stula umen'shaetsya. Na fone oblegcheniya zapora poyavlyaetsya khronicheskaya bol' v zhivote. Predlagaetsya prostoy i effektivnyy metod diagnostiki.