肛门指检，这个羞羞的“一指神功”：能发掘80%的直肠癌！
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://mmbiz.qpic.cn/mmbiz_gif/MrroJEeiaq2kicLVzIIfPdSF5haVPDibaDYyWcibZGmIxSR9LecENGF1t6ibCSLM3JqJEDwofMM9B6jnhJnUeo5hqnA/640?wx_fmt=gif&tp=webp&wxfrom=5&wx_lazy=1" style="width: 50%; margin-bottom: 20px;"></p><span style="color: black;">80%以上的直肠癌<span style="color: black;">能够</span><span style="color: black;">经过</span>一种简单的<span style="color: black;">检测</span>方式<span style="color: black;">发掘</span>，这<span style="color: black;">便是</span>直肠指检。</span>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;"><span style="color: black;">源自</span>丨胃肠病</span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">在中国约75%的大肠癌<span style="color: black;">出现</span>在直肠，而其中又有2/3<span style="color: black;">出现</span>在低位直肠，是<span style="color: black;">能够</span><span style="color: black;">经过</span>一种简单而有效的<span style="color: black;">检测</span>方式<span style="color: black;">发掘</span>，这<span style="color: black;">便是</span>直肠指检。</span><span style="color: black;">直肠指检，又叫肛门指检。而<span style="color: black;">常常</span><span style="color: black;">非常多</span>人<span style="color: black;">因为</span>害羞等<span style="color: black;">原由</span>，拒绝肛门指检，以至于病情严重恶化才被<span style="color: black;">发掘</span>。今天，<span style="color: black;">咱们</span>就来聊一聊肛门指检的<span style="color: black;">哪些</span>事儿。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">一</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;"><span style="color: black;"><span style="color: black;">什么是直肠指检？</span></span></strong></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">直肠指检，<span style="color: black;">亦</span>叫肛诊，是<span style="color: black;">大夫</span>用一根手指伸进<span style="color: black;">病人</span>肛门进行触摸，不需任何辅助设备，是一种简便易行却非常<span style="color: black;">要紧</span>的临床<span style="color: black;">检测</span><span style="color: black;">办法</span>，被戏<span style="color: black;">叫作</span>为「一指神功」。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://mmbiz.qpic.cn/mmbiz_jpg/4CDQ67ts93gicVRScHx8RxHtZLNcDxZNUY6y1dd8oGJCZiaOFoHyhaG78H34C9vhMxaycOOOtAFJxGP6ZxSDuhRg/640?wx_fmt=jpeg&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">小到息肉、痔疮，大到癌症等<span style="color: black;">疾患</span>，都<span style="color: black;">能够</span><span style="color: black;">经过</span>直肠指检来<span style="color: black;">发掘</span>。<span style="color: black;">另一</span>，<span style="color: black;">经过</span>直肠指检，可触到男性<span style="color: black;">检测</span>者的前列腺，<span style="color: black;">帮忙</span>发现前列腺肥大或前列腺癌；可<span style="color: black;">经过</span>触及女性<span style="color: black;">检测</span>者的子宫，<span style="color: black;">发掘</span>有<span style="color: black;">没</span>子宫后倾、子宫颈肿瘤、附件肿瘤或炎症等。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">可是这么<span style="color: black;">要紧</span>的<span style="color: black;">检测</span>，<span style="color: black;">非常多</span>人在体检时却<span style="color: black;">选取</span>放弃。大<span style="color: black;">大都是</span>觉得害羞、害怕。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">其实<span style="color: black;">全部</span><span style="color: black;">检测</span><span style="color: black;">亦</span>就在一瞬间。脱下裤子，跪在<span style="color: black;">检测</span>台上，撅起屁股，闭上眼睛不要乱想，一下子就好了。大概是下图中膝胸位的样子。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://mmbiz.qpic.cn/mmbiz/Pvr3FasqXd4dC4cV1K89IxgiaCbPmBuEx09SGq8LUbv6RJHlbzkRCjvs3RfPwCdS58tw9o3LEam2uLJXn92MV4g/640?wx_fmt=jpeg&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">直肠指检是一种筛查手段。操作简单，大致<span style="color: black;">能够</span>确定距肛缘7～10cm的肛门、直肠有<span style="color: black;">没</span>病变和病变的性质。直肠指检<span style="color: black;">能够</span><span style="color: black;">发掘</span>肿瘤、炎症以及<span style="color: black;">各样</span><span style="color: black;">损害</span>。<span style="color: black;">因此呢</span>，在每年的健康体检中都应该进行直肠指检。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">二</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;"><span style="color: black;"><span style="color: black;"><span style="color: black;">哪些</span><span style="color: black;">状况</span><span style="color: black;">必须</span>做指检？</span></span></strong></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://mmbiz.qpic.cn/mmbiz_jpg/4CDQ67ts93goVJov0k2pF5YsbRU2Zrb09rvycEdF2KKh5rTLS7n5fqGPybNXJV3lIGng7WMwTbMbEM2g1WSBAA/640?wx_fmt=jpeg&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">1. 排便习惯改变：</span></strong><span style="color: black;">如<span style="color: black;">没</span><span style="color: black;">显著</span>诱因<span style="color: black;">显现</span>大便次数<span style="color: black;">增加</span>、便秘与腹泻交替、排便不尽感、大便变细或变形等。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;"><span style="color: black;">2. 大便性状改变：</span></strong></span><span style="color: black;">大便变稀、大便带血和黏液。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;"><span style="color: black;">3. 肛门<span style="color: black;">病痛</span>：</span></strong></span><span style="color: black;"><span style="color: black;">平常</span>于肛裂、肛周脓肿，肛周脓肿应<span style="color: black;">初期</span><span style="color: black;">发掘</span>并及早切开排脓，<span style="color: black;">通常</span>的抗感染<span style="color: black;">药品</span>治疗是<span style="color: black;">没</span>效的。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;"><span style="color: black;">4. 肛门流脓、流液：</span></strong></span><span style="color: black;">可能是肛瘘的症状，指检能<span style="color: black;">知道</span>诊断。肛瘘<span style="color: black;">不可</span>自愈，<span style="color: black;">必须</span>手术治疗。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;"><span style="color: black;">5. 痔：</span></strong></span><span style="color: black;"><span style="color: black;">重点</span>表现为便血和肿块脱出，临床上极易与直肠癌混淆，肛门指检多能作出鉴别。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">三</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;"><span style="color: black;"><span style="color: black;">直肠指检能<span style="color: black;">发掘</span><span style="color: black;">那些</span><span style="color: black;">疾患</span>？</span></span></strong></span></p><strong style="color: blue;"><span style="color: black;">多种肛肠<span style="color: black;">疾患</span></span></strong>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">1. 直肠息肉、纤维瘤、内痔、肛乳头瘤、肛乳头炎等，在指检时均可摸到不同形态的肿块。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">2. 直肠脱垂、肛门失禁等，表现为肛门松弛。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">3.<strong style="color: blue;"> 肛管直肠瘘</strong><span style="color: black;">指的是</span>肛门<span style="color: black;">周边</span>的肉芽肿性管道，由内口、瘘管、外口三部分<span style="color: black;">构成</span>。发病率仅次于痔，<span style="color: black;">亦</span>可<span style="color: black;">经过</span>直肠指检来<span style="color: black;">发掘</span>。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">4. 肛裂，在指检时因肛门括约肌挛缩，肛门收缩变紧，会加剧<span style="color: black;">病痛</span>，<span style="color: black;">通常</span>不做直肠指检。必要时可在<span style="color: black;">麻木</span>下指检。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">以上几种类型不要轻易<span style="color: black;">自动</span>诊断，<span style="color: black;">详细</span><span style="color: black;">疾患</span>须由<span style="color: black;">大夫</span><span style="color: black;">检测</span>后判断。</span></p><strong style="color: blue;"><span style="color: black;">直肠癌</span></strong>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">数据<span style="color: black;">表示</span>，晚期结直肠癌<span style="color: black;">病人</span>术后5年<span style="color: black;">存活</span>率仅为7％，而<span style="color: black;">初期</span><span style="color: black;">病人</span>的治疗效果相当好，90％以上的<span style="color: black;">病人</span>经过手术治疗就能治愈，<span style="color: black;">不消</span>化疗。由此可见，<span style="color: black;">初期</span><span style="color: black;">发掘</span>、<span style="color: black;">初期</span>治疗<span style="color: black;">针对</span><span style="color: black;">加强</span>结直肠癌的治疗效果至关<span style="color: black;">要紧</span>。但事实上，我国结直肠癌的早诊率不到10％，而在美国是25％，<span style="color: black;">非常多</span><span style="color: black;">病人</span>就诊时<span style="color: black;">已经是</span>中晚期。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">怎样</span><span style="color: black;">初期</span><span style="color: black;">发掘</span>肠癌呢？除了观测排便发出的危险信号之外，还要要<span style="color: black;">注意</span>体检。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">结直肠癌专科体检，非常强调直肠指检。<span style="color: black;">由于</span>直肠指检非常简单，<span style="color: black;">无</span>痛苦，<span style="color: black;">花费</span><span style="color: black;">优惠</span>，<span style="color: black;">况且</span><span style="color: black;">针对</span>诊断直肠癌又非常<span style="color: black;">敏锐</span>，是<span style="color: black;">发掘</span>直肠癌的利器。临床观察<span style="color: black;">发掘</span>，超过70％的中国<span style="color: black;">病人</span>的直肠癌都很低位，距离肛门很近，<span style="color: black;">经过</span>直肠指检就能摸到。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">非常多</span>直肠癌<span style="color: black;">病人</span>误诊为痔疮的<span style="color: black;">常常</span>都是<span style="color: black;">无</span>做直肠指检的，误诊率高达70％<span style="color: black;">上下</span>。<span style="color: black;">到底</span><span style="color: black;">原由</span>，是<span style="color: black;">由于</span><span style="color: black;">非常多</span>人怕羞不愿意做<span style="color: black;">检测</span>，基本上单位体检里都有直肠指检这一项，提醒<span style="color: black;">大众</span>千万别<span style="color: black;">忽略</span>这一项，<span style="color: black;">以避免</span><span style="color: black;">错失</span><span style="color: black;">初期</span><span style="color: black;">发掘</span>肠癌的良机。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;"><span style="color: black;">应该<span style="color: black;">重视</span>的是：我国低位直肠癌的比例很高，大部分都能在直肠指检触到，但位置高的不<span style="color: black;">必定</span>触到。<span style="color: black;">因此</span>触不到的不<span style="color: black;">必定</span><span style="color: black;">无</span>直肠癌，还要做结肠镜<span style="color: black;">检测</span>。</span></strong></span></p><strong style="color: blue;"><span style="color: black;">前列腺<span style="color: black;">疾患</span></span></strong>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">都数</span>前列腺癌病人<span style="color: black;">初期</span>症状不<span style="color: black;">显著</span><span style="color: black;">乃至</span><span style="color: black;">无</span>任何症状，等到<span style="color: black;">显现</span>诸如尿频、排尿困难、血尿等症状后才到医院<span style="color: black;">检测</span>，此时<span style="color: black;">疾患</span><span style="color: black;">都数</span>已发展到晚期了，失去了根治性治疗的机会。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">怎样</span><span style="color: black;">才可</span><span style="color: black;">初期</span><span style="color: black;">发掘</span>前列腺癌呢?除了前列腺特异性抗原(PSA)检测之外，直肠指检<span style="color: black;">亦</span>很<span style="color: black;">要紧</span>。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">大<span style="color: black;">都数</span>前列腺癌<span style="color: black;">源自</span>于前列腺的外周，<span style="color: black;">因此</span>直肠指检(<span style="color: black;">大夫</span>用手指经肛门触摸受检者的前列腺)可<span style="color: black;">认识</span>前列腺有<span style="color: black;">没</span>病变，且对前列腺癌<span style="color: black;">初期</span>诊断和分期都有<span style="color: black;">要紧</span>价值。<span style="color: black;">大夫</span>议50岁以上的男性每年应进行一两次PSA检测和直肠指检，如有前列腺癌家族史，则应从40岁<span style="color: black;">起始</span>每年进行PSA检测和直肠指检，<span style="color: black;">这般</span><span style="color: black;">才可</span>做到早<span style="color: black;">发掘</span>、早治疗。</span></p><strong style="color: blue;"><span style="color: black;">4. 其他<span style="color: black;">疾患</span></span></strong>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">盆腔脓肿、盆腔炎等</span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">妇科<span style="color: black;">大夫</span>在给未婚女性做妇检时，为了<span style="color: black;">守护</span><span style="color: black;">病人</span>的处女膜，<span style="color: black;">一般</span>采用直肠指检，查清子宫及盆腔的<span style="color: black;">有些</span><span style="color: black;">状况</span>。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">骨盆骨折</span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">骨盆骨折合并直肠<span style="color: black;">损害</span>并不多见，但<span style="color: black;">倘若</span>病人的骶尾部有<span style="color: black;">显著</span>压痛时，那<span style="color: black;">大夫</span>就得“摸”肠子。<span style="color: black;">由于</span>这种痛<span style="color: black;">大都是</span>由骶骨骨折端直接刺伤直肠<span style="color: black;">导致</span>的，<span style="color: black;">少许</span>可因骶骨、坐骨骨折移位而使直肠撕裂。<span style="color: black;">此时</span>，<span style="color: black;">大夫</span><span style="color: black;">能够</span>“摸”到骨折的断端，<span style="color: black;">况且</span>指套上<span style="color: black;">亦</span>可能沾有血迹。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">转移癌、腹腔内恶性肿瘤</span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">如胃癌等癌细胞，<span style="color: black;">能够</span>“掉”到腹腔的最低处(子宫直肠窝或膀胱直肠窝内)，“落地生根”而形成转移癌，此时，指检<span style="color: black;">亦</span>能<span style="color: black;">发掘</span>该处有质地坚硬的东西。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">中毒性痢疾</span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">若<span style="color: black;">大夫</span><span style="color: black;">经过</span>指检<span style="color: black;">发掘</span>病人直肠内有脓血便或果冻样黏液，就会<span style="color: black;">思虑</span>中毒性痢疾。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">四</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;"><span style="color: black;"><span style="color: black;"><span style="color: black;">大夫</span>阅读：</span><span style="color: black;">直肠指检流程</span></span></strong></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;"><span style="color: black;"><span style="color: black;">第1</span>步 清洗双手、佩戴手套</span></strong></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://mmbiz.qpic.cn/mmbiz_jpg/4CDQ67ts93goVJov0k2pF5YsbRU2Zrb0gah4sdRNtJI6YICWDh125zAkGQCcAQMumruHt7Oxg21Vib0T7NAO8UQ/640?wx_fmt=jpeg&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">进行体格<span style="color: black;">检测</span>前均应清洗双手，肥皂清洗<span style="color: black;">一般</span><span style="color: black;">已然</span>足够。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">某些<span style="color: black;">状况</span>下<span style="color: black;">亦</span>可加上含有酒精<span style="color: black;">成份</span>的消毒凝胶。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">晾干双手后佩戴医用手套。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;"><span style="color: black;">第二步 宽慰病人、嘱病人侧卧</span></strong></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://mmbiz.qpic.cn/mmbiz_jpg/4CDQ67ts93goVJov0k2pF5YsbRU2Zrb0qhSjib3jB8tBbzbNnvCXX88uDiblV1NVYwrC2dXPn0yrPhuHoSoWd3Dg/640?wx_fmt=jpeg&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">直肠指检的过程比较尴尬，<span style="color: black;">因此呢</span>保持专业、宽慰病人非常<span style="color: black;">要紧</span>。简单<span style="color: black;">通知</span>后，嘱病人解下内裤，侧卧(<span style="color: black;">通常</span>是左侧朝下)，弯曲双膝，双手置于胸前(类似于胎儿的姿势)。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">指检<span style="color: black;">亦</span><span style="color: black;">能够</span>在病人站立时完成，但侧卧<span style="color: black;">能够</span>使病人更为放松，指检<span style="color: black;">更易</span>。让<span style="color: black;">伴侣</span><span style="color: black;">或</span>家属陪同<span style="color: black;">能够</span>减轻病人的焦虑。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;"><span style="color: black;">第三步 润滑食指</span></strong></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://mmbiz.qpic.cn/mmbiz_jpg/4CDQ67ts93goVJov0k2pF5YsbRU2Zrb0kiasM9Cmn4al1muibyDmBqWJjgiaK9MdKztWpBGIVJHkiamQWI42xEzMWw/640?wx_fmt=jpeg&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">为了避免病人<span style="color: black;">显现</span>不适或受惊，可将润滑油适当加温后再涂抹到食指。室温下的润滑油<span style="color: black;">亦</span>偏凉，可能<span style="color: black;">引起</span>肛管收缩，<span style="color: black;">增多</span><span style="color: black;">检测</span>难度。<span style="color: black;">目的</span>是使肛管组织<span style="color: black;">尽可能</span>放松，减轻<span style="color: black;">插进</span>手指时的不适<span style="color: black;">或</span><span style="color: black;">病痛</span>。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">某些<span style="color: black;">状况</span>下指检时会<span style="color: black;">运用</span>局麻药减轻不适，尤其是<span style="color: black;">检测</span>者手指较粗<span style="color: black;">或</span>病人肛门括约肌较紧的时候。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;"><span style="color: black;">第四步 经肛门<span style="color: black;">插进</span>手指</span></strong></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://mmbiz.qpic.cn/mmbiz_jpg/4CDQ67ts93goVJov0k2pF5YsbRU2Zrb0dOxkN6bRrjEMsymticPa3MYhFvKzv0iaB3jLPXUIbibibkVfb4KHACEMYw/640?wx_fmt=jpeg&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">润滑手指后，掰开臀部，缓慢<span style="color: black;">插进</span>食指。<span style="color: black;">检测</span>过程中可让病人深<span style="color: black;">呼气</span>，使其放松，避免收缩括约肌。轻微旋转手指利于<span style="color: black;">插进</span>。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">插进</span>手指前，<span style="color: black;">能够</span>快速<span style="color: black;">检测</span>肛门有<span style="color: black;">没</span>病变，如痔、疣、皮疹、肛瘘、肛周脓肿或肛裂等。手指完全进入直肠后，嘱病人收缩肛门<span style="color: black;">评定</span>肛管压力。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;"><span style="color: black;">第五步 触诊寻找<span style="color: black;">反常</span><span style="color: black;">状况</span></span></strong></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://mmbiz.qpic.cn/mmbiz_jpg/4CDQ67ts93goVJov0k2pF5YsbRU2Zrb0EeW63aIKx6HnKOoIJscd4dzOicUSXWcxVhJ4CFHibe13Nml7Ec4BgANw/640?wx_fmt=jpeg&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">当手指<span style="color: black;">插进</span>直肠后，用食指进行扪触诊，判断有<span style="color: black;">没</span><span style="color: black;">反常</span>，如<span style="color: black;">反常</span>的包块、硬结、溃疡。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">顺时针及逆时针旋转食指以充分触诊全周的直肠。<span style="color: black;">亦</span>可经过直肠壁触诊前列腺（男性）。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">1. 前后正中处有触痛，常提示可能有肛裂，可进一步扒开肛门看<span style="color: black;">是不是</span>有肛管裂口。2.肛门缘外有溃破口并伴皮下有条索状物通向肛内，常为肛瘘。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">3. 直肠癌<span style="color: black;">能够</span>摸到肿块质地较硬，表面高低不平或呈菜<span style="color: black;">花招</span>，有脓液、坏死组织及4.暗红色的血液，可能伴有肠腔狭窄，指套染有暗红色血液。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">5. 直肠息肉可触及质软且可推移的肿块，指套可有血染，色鲜红。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">6. 内痔是柔软的静脉团，<span style="color: black;">很难</span>触及，但如有血栓形成，可摸到光滑的硬结。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">7. 肛瘘可摸到索状物，有时在肛瘘内口可扪及小硬结。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">8. 肛门直肠<span style="color: black;">周边</span>脓肿如骨盆直肠间隙脓肿、直肠后间隙脓肿，在直肠内可摸到压痛性肿块，并可能伴有波动感。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">9. 肛裂及感染指检时剧烈触痛。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;"><span style="color: black;">第六步 移出手指、清洁肛门</span></strong></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://mmbiz.qpic.cn/mmbiz_jpg/4CDQ67ts93goVJov0k2pF5YsbRU2Zrb0BDtwFMI7awkibnx5r7nohhWL61xfzdDnJxlVibsapSZ96icmlQrsWfcbw/640?wx_fmt=jpeg&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">完成<span style="color: black;">检测</span>后，慢慢移出食指，<span style="color: black;">检测</span>手套有<span style="color: black;">没</span>血染或黏液。<span style="color: black;">而后</span>擦拭病人肛门<span style="color: black;">周边</span>的润滑剂，脱去手套。给病人纸巾再<span style="color: black;">自动</span>清洁，穿好衣服。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">脱手套时，用另一只手的食指置于脏手套的内侧，向手指方向牵拉，脱去手套。<span style="color: black;">检测</span>本身不会<span style="color: black;">引起</span><span style="color: black;">流血</span>。<span style="color: black;">倘若</span>手套血染，提示可能有痔或其他内脏<span style="color: black;">疾患</span>。</span></p>
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