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هل سأعود لحالتي الطبيعية بعد عملية الناسور؟

السؤال:
أعاني من مرض الناسور، وقال لي الطبيب: إن علي إجراء عملية جراحية، فأنا لا أستطيع الجلوس لفترة طويلة, هل سأعود لحالتي الطبيعية بعد العملية؟ علما بأني مقبل على الزواج؟
الإجابــة:
بسم الله الرحمن الرحيم
الأخ الفاضل/ فهد حفظه الله.
السلام عليكم ورحمة الله وبركاته وبعد،،،

لم تذكر -يا أخ فهد- إن كنت تعاني من ناسور عصعصي أي كيس شعر، أو ناسور شرجي، فالناسور الشرجي هو فتحة غير طبيعية بين الشرج والجلد، ويخرج منها الريح والبراز دون تحكم، وهي تكون نتيجة التهابات وخراجات في منطقة الشرج.

إلا أنه على الأكثر أن ما تعنيه هو الناسور العصعصي، لأنني رأيت استشارة لك أخرى تسأل فيها عن زيادة الشعر في الجسم، فالناسور العصعصي هو عبارة عن كيس، أو قناة تحتوي على شعر متساقط، ويظهر في الغالب عند العقد الثاني من العمر، وموقعه أسفل الظهر، ويعاني المريض من آلام وإفرازات دموية بصورة مزمنة، أو يظهر بصورة مفاجئة على شكل خراج مسبباً آلام حادة، وتورما أسفل الظهر.

وهو ينجم عن دخول الشعر الزائد، والمتساقط من الظهر إلى منطقة العصعص، وهذا المرض يصيب عادة الرجال المشعرين، ويكون في السن ما بين 20 و30 عاما، فعند الجلوس يتم تحميل وزن الجسم كله على الأرداف.

والشعر الذي يقع من الجسم نتيجة احتكاك الملابس يسقط في ما بين الأرداف.. (ومما يساعد أيضا على حدوث ذلك كثرة الجلوس – استخدام المناديل الورقية للتنشيف – كثرة القيادة للسيارات)، وبذلك تدخل الشعرة إلى داخل الغدد العرقية التي في جلد هذه المنطقة التي تكون نشطة أثناء هذه الفترة عند الرجال، وبمجرد دخول الشعر يبدأ تكون الناسور، وعند تكون الناسور يصير الضغط داخله أقل من الخارج، ويبدأ بابتلاع الشعر ويكبر.

وهناك عوامل مساعدة على حدوث المرض منها:

– السمنة.

– الخمول والكسل.

– التعرق الشديد.

– الجسد المشعر.

– أصحاب المهن التي تستلزم الجلوس لوقت طويل (مثل: القيادة المتواصلة لفترة طويلة).

– عدم الاهتمام بالنظافة الشخصية.

– استخدام المناديل الورقية للتنشيف فقط من دون الماء.

وتكون الإعراض بشكل تورم واحمرار يترافق مع ألم شديد في منطقة أسفل الظهر بين الآليتين، وينتشر بدرجة كبيرة بين الأشخاص الذين يكثر لديهم شعر الجسم، وخاصة منطقة أسفل الظهر، كذلك ممن لديهم نشاط زائد في الغدد العرقية، ولاسيما إذا ما كانوا يجلسون لفترات طويلة بسبب طبيعة أعمالهم.

ويبدأ تكون كيس الشعر على شكل فتحات صغيرة في هذه المنطقة، يتسرب إليها الشعر الذي يتساقط من الجسم، وهو غالباً ملوث، فيبدأ حدوث الالتهاب، وتكون الصديد، ويتجمع الشعر الملوث داخل هذه الفتحات فيما يشبه الكيس، مما يزيد من الشعور بالألم.

ويكون هناك على الجلد بالفحص الطبي فتحة، أو فتحات في أسفل منتصف الظهر، وهناك بعض الإفرازات منها، وقد تكون قيحا أو دما.

إذا لم يكن هناك تجمع صديدي، فإن العلاج يكون بالتالي:

1- رفع وإزالة كل الشعيرات السائبة من فتحة أو فتحات الغدد العرقية.

2- استخدام المضاد الحيوي إذا كان هناك التهاب حاد في هذه الغدد العرقية في المنطقة.

3- الاهتمام بالنظافة الشخصية، وحلاقة الشعر والاستحمام أكثر من مرة، وعدم الجلوس فترات طويلة والجلوس في الوضع الصحيح.

وقرار الطبيب بالتدخل الجراحي يعتمد على درجة الناسور العصعصي، ففي حالة الالتهاب البسيط يتم إجراء جراحة لاستئصال الخلايا الالتهابية، وتصريف الصديد، وتنظيف الجرح، وإزالة الشعر، ثم الخياطة، ولا تستغرق مدة الشفاء في الحالات البسيطة أكثر من عدة أيام، لكن في حالة تكرار الالتهاب يفتح الجرح وينظف، ويترك مفتوحاً، ويتم عمل الغيار والغسيل المستمر حتى يشفى.

وفي الحالات الالتهابية الحادة حيث يتم فتح الكيس، وتصريف الصديد واستئصال الخلايا الالتهابية، وإزالة الشعر الميت، وفي هذه الحالة لا يتم خياطة الجرح ويترك مفتوحاً مع الحرص على نظافته حتى يتم الشفاء، والذي يستغرق فترة تستمر من ستة إلى عشرة أسابيع يغلق خلالها الجرح تماماً، وهذه تعطي أفضل النتائج إن كان قد حصل أيضا تكرر في حدوث الالتهابات الشديدة مع تشكل صديد، لذا ينصح بالجراحة إن كانت الالتهابات متكررة وهناك تجمع صديدي.

والله الموفق.

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  2. The new Zune browser is surprisingly good, but not as good as the iPod’s. It works well, but isn’t as fast as Safari, and has a clunkier interface. If you occasionally plan on using the web browser that’s not an issue, but if you’re planning to browse the web alot from your PMP then the iPod’s larger screen and better browser may be important.

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  5. The Zune concentrates on being a Portable Media Player. Not a web browser. Not a game machine. Maybe in the future it’ll do even better in those areas, but for now it’s a fantastic way to organize and listen to your music and videos, and is without peer in that regard. The iPod’s strengths are its web browsing and apps. If those sound more compelling, perhaps it is your best choice.

  6. Apple now has Rhapsody as an app, which is a great start, but it is currently hampered by the inability to store locally on your iPod, and has a dismal 64kbps bit rate. If this changes, then it will somewhat negate this advantage for the Zune, but the 10 songs per month will still be a big plus in Zune Pass’ favor.

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  8. The new Zune browser is surprisingly good, but not as good as the iPod’s. It works well, but isn’t as fast as Safari, and has a clunkier interface. If you occasionally plan on using the web browser that’s not an issue, but if you’re planning to browse the web alot from your PMP then the iPod’s larger screen and better browser may be important.

  9. Apple now has Rhapsody as an app, which is a great start, but it is currently hampered by the inability to store locally on your iPod, and has a dismal 64kbps bit rate. If this changes, then it will somewhat negate this advantage for the Zune, but the 10 songs per month will still be a big plus in Zune Pass’ favor.

  10. The Zune concentrates on being a Portable Media Player. Not a web browser. Not a game machine. Maybe in the future it’ll do even better in those areas, but for now it’s a fantastic way to organize and listen to your music and videos, and is without peer in that regard. The iPod’s strengths are its web browsing and apps. If those sound more compelling, perhaps it is your best choice.

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  13. The Zune concentrates on being a Portable Media Player. Not a web browser. Not a game machine. Maybe in the future it’ll do even better in those areas, but for now it’s a fantastic way to organize and listen to your music and videos, and is without peer in that regard. The iPod’s strengths are its web browsing and apps. If those sound more compelling, perhaps it is your best choice.

  14. Hands down, Apple’s app store wins by a mile. It’s a huge selection of all sorts of apps vs a rather sad selection of a handful for Zune. Microsoft has plans, especially in the realm of games, but I’m not sure I’d want to bet on the future if this aspect is important to you. The iPod is a much better choice in that case.

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  23. If you’re still on the fence: grab your favorite earphones, head down to a Best Buy and ask to plug them into a Zune then an iPod and see which one sounds better to you, and which interface makes you smile more. Then you’ll know which is right for you.

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  25. I’ll gear this review to 2 types of people: current Zune owners who are considering an upgrade, and people trying to decide between a Zune and an iPod. (There are other players worth considering out there, like the Sony Walkman X, but I hope this gives you enough info to make an informed decision of the Zune vs players other than the iPod line as well.)

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  29. If you’re still on the fence: grab your favorite earphones, head down to a Best Buy and ask to plug them into a Zune then an iPod and see which one sounds better to you, and which interface makes you smile more. Then you’ll know which is right for you.

  30. Zune and iPod: Most people compare the Zune to the Touch, but after seeing how slim and surprisingly small and light it is, I consider it to be a rather unique hybrid that combines qualities of both the Touch and the Nano. It’s very colorful and lovely OLED screen is slightly smaller than the touch screen, but the player itself feels quite a bit smaller and lighter. It weighs about 2/3 as much, and is noticeably smaller in width and height, while being just a hair thicker.

  31. I’ll gear this review to 2 types of people: current Zune owners who are considering an upgrade, and people trying to decide between a Zune and an iPod. (There are other players worth considering out there, like the Sony Walkman X, but I hope this gives you enough info to make an informed decision of the Zune vs players other than the iPod line as well.)

  32. Apple now has Rhapsody as an app, which is a great start, but it is currently hampered by the inability to store locally on your iPod, and has a dismal 64kbps bit rate. If this changes, then it will somewhat negate this advantage for the Zune, but the 10 songs per month will still be a big plus in Zune Pass’ favor.

  33. Apple now has Rhapsody as an app, which is a great start, but it is currently hampered by the inability to store locally on your iPod, and has a dismal 64kbps bit rate. If this changes, then it will somewhat negate this advantage for the Zune, but the 10 songs per month will still be a big plus in Zune Pass’ favor.

  34. Between me and my husband we’ve owned more MP3 players over the years than I can count, including Sansas, iRivers, iPods (classic & touch), the Ibiza Rhapsody, etc. But, the last few years I’ve settled down to one line of players. Why? Because I was happy to discover how well-designed and fun to use the underappreciated (and widely mocked) Zunes are.

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