Ukusebenza kwesistimu ye-urinary kuncike ekutheni ukuchithwa okulungile kwe-fluid. Uma ukuphuma kwayo kuphazamiseka, ukuqhuma kwenzeka, ngenxa yalokho i-renal pelvis ne-calyx zanda. Lokhu kuholela ekutheni ama-tissu aqhubekile atrophy kanye nomzimba ukufa.
I-Hydronephrosis yezinso - iyini?
Uma umchamo ubambezelekile ohlelweni lwe-excretory, ivolumu yayo ikhula njalo. Inqwaba yezikhukhula ezinomsoco ezisezintweni zezinso kanye ne-pathologies ehambisanayo, echaza ukuthi yi-hydronephrosis:
- ukucindezela okwenyukayo;
- ukuwohloka kokuhlunga kwe-glomerular;
- ukuphazanyiswa kwamanje, ukulandelana kwemicabango kanye nokulandelana kwemicabango;
- ukunciphisa ukuguqulwa kwamathambo;
- i-atrophy yezicubu zomzimba, i-parenchyma;
- ukufa kwama-nephron.
Iyini i-hydronephrosis eyingozi?
Ukugula okuqhubekayo kubangela ukufa kancane kwezingxenye zesakhiwo sezinso. Okokuqala, isifo se-hydronephrosis sihambisana nokuphulwa okuncane kwemisebenzi yelungu futhi akuthinti ngokucacile isimo sohlelo lwe-urinary. Kamuva, kukhona ukwehluleka okuncane, okungahle kwenzeke ngokuphindaphindiwe okungajwayelekile. Uma kungekho ukwelashwa okuphumelelayo, i-kidney hydronephrosis yezinso ezifanele izowela esigabeni esinzima ngokuphazanyiswa ngokuphelele noma ukukhubaza kwemisebenzi yomzimba. Lokhu kugcwele ukungakwazi ukusebenza okuphelele kanye nobuthi obugcwele nemikhiqizo ebalulekile.
I-Hydronephrosis yezinso - izimbangela
Ama-urologists abiza ukuthi atholakele futhi abhekene nezinkinga zokuzalwa ezingakapheli ekuthuthukiseni izifo ezichazwe. I-Hydronephrosis - izimbangela zeqembu lokuqala:
- i-tumor ekhulayo ngokushesha, icindezeleke kuma-ureters;
- Ukwehliswa kwe-tubules emva kokuthungatha noma kokuthutha emva kokubunjwa kwezicubu ezibomvu;
- ukumbumbana komkhumbi;
- ukulimala komgogodla;
- umdlavuza wezinso, kwesobunxele noma izinsana;
- ukutholakala kwamatshe, isanti;
- i-endometriosis ;
- i-cyst ovarian;
- izifo ezivuvukalayo zesistimu ye-genitourinary;
- isifo sofuba;
- izibalo zokunye nokunye.
Conghenital hydronephrosis
Ngezinye izikhathi ukuphuma komchamo kuphazamisekile ngemuva kwesizinda sezimpawu ezihlukile ezakhiweni zamapheshana aphumayo. I-Hydronephrosis ngakwesokudla nangakwesobunxele itholakale enezinkinga zokubeletha ezilandelayo:
- ukuvinjelwa kwezigulane zamanzi;
- izakhiwo ezengeziwe, i-septa nama-valve emaphethweni omchamo;
- i-diverticula;
- izivimbela ezenziwe ngamathambo ezikulesi sambatho, i-urethra, udonga kanye ne-ureteral lumen, i-pelvis;
- i-dyskinesia ne-distension;
- ureterocele.
I-Hydronephrosis yezinso ezilungile ngokuvamile ivela ngesakhiwo esingalungile se-artery systemic noma amagatsha awo amakhulu. Isitsha segazi esakhiwe ngendlela engavamile sinobunzima bendandatho ehlanganiswa yi-ureter. Lokhu "ukuphoqa" kuvimbela okwamanje okujwayelekile nokukhishwa kwamanzi abizayo, kuholela ekunwetsheni kwezinkomishi kanye ne-lohanok kwesokunxele noma kwesinney kwesokudla.
Hydronephrosis ekukhulelweni
Inkinga ecatshangelwe ibhekwa njengento ejwayelekile ngesikhathi sokukhulelwa, ikakhulukazi kusukela ku-2 trimester. I-Hydronephrosis yezinso ngesikhathi sokukhulelwa iqala ngenxa yokwanda okwenziwe ngobukhulu besibeletho. Izindonga zalo ziqala ukuphuma endaweni ye-peritoneal bese ucindezela. Uma welula isisu, uketshezi oluthe xaxa kugcinwa ezinso.
Ama-degree of hydronephrosis
Ngokuya ngobukhulu be-pathology kanye nobukhulu bezimpawu zalo, izigaba ezintathu zenkambo yesifo ziyahlukahluka:
- I-Hydronephrosis 1 degree (ihlawuliswa) ibonakala ngokulondolozwa okuphelele kwemisebenzi yezinso ezifanele. Esikhathini samapulangwe inani elincane lomchamo liqoqa, ngakho izindonga kanye ne-calyx yelungu akulula.
- I-Hydronephrosis yezinga lesibili (ehlawulwa kancane) ihambisana nokuguqulwa kwezicubu zezinso ezimele futhi kunciphise emisebenzini yayo ngo-40-45%. Ukuze uhlelo lwe-excretory lusebenze ngendlela evamile, umsebenzi wegciwane elihlanganisiwe elinempilo landa.
- I-Hydronephrosis ye-3 degrees (ukuphela) ukuhluleka kwezinso ezifanele. Ngenxa yomthwalo osebenza ngokweqile, umzimba onempilo awukwazi ukubhekana nokukhipha umchamo okwedlulele, nokuntuleka okukhulu okuqhubekayo. Uma kungekho ukwelashwa, kungenzeka ukuthi imiphumela ebulalayo kungenzeka.
I-Hydronephrosis yezimpawu zezinso
I-pathology echazwe kakhulu ayihambisani neze nezimpawu ezibalulekile zomtholampilo. Ubukhulu kanye nokucacile kwezimpawu kuxhomeke esiteji se-hydronephrosis, izimbangela kanye nobude bokuqhubeka kwayo, ukutholakala kwendawo yokuvinjelwa komgudu wamanzi. Esikhathini sokuqala, cishe akunakwenzeka ukubona lesi sifo, azikho izimpawu zokuphazamiseka kwesistimu ye-excretory nezinso ezifanele.
I-Hydronephrosis - izimpawu zesifo esibi kakhulu:
- ukunganaki emhlane ophansi;
- ukukhathala okungapheli;
- ukucindezeleka komzimba;
- kunciphise ikhono lokusebenza;
- isicasuli;
- i-renal colic;
- umkhuhlane;
- ukuhlanza;
- izikhukhula;
- ukuvuthwa okungavamile nokuncane kakhulu;
- ubuhlungu emhlane nangemuva;
- ukuvuvukala;
- i-anemia.
I-Hydronephrosis - Ukuxilongwa
Ukusola ukuthi ukugula okucatshangelwayo i-urologist ingahlolwa ekuziphatheni ngokomzimba, ngesikhathi sokulunywa, ukuxubha, ukuhlaziya. Ukuze kuqinisekiswe i-hydronephrosis yezinso ezilungile noma ezisele, kuningi lwezinhlolo zokuhlolwa kwelabhorethri ezidingekayo:
- igazi (i-biochemistry, electrolytes);
- umchamo (jikelele, oveziwe, obhaka);
- Amasampula avela eNechiporenko, Reberga, Zimnitskiy, Addis-Kakovsky.
Okokugcina, ukusungula ukuxilongwa kwe "hydronephrosis yezinso ezifanele"
- imaging resonance magnetic noma tomography computed;
- ukubuyisela emuva ukurekhoda;
- urography ;
- ukuhlolwa kwe-ultrasound;
- i-dopplerography;
- i-Echography endoluminal;
- i-chromocystoscopy;
- Renoangiography;
- i-percutaneous antegrade pyelography;
- i-radioisotope nephroscintigraphy enamandla nezinye.
Ukwelashwa kwe-kidney hydronephrosis
Ukwelashwa kwe-pathology ezethuliwe kuthuthukiswa ngamunye ngesiguli ngasinye. Izindlela zokuphatha i-hydronephrosis zikhethwe yi-urologist ngokuhambisana nesimo sesifo, ukuqina kwezimpawu, imbangela yokuqoqa umchamo. Imisebenzi esemqoka yezinyathelo zokwelapha:
- ukuqeda uketshezi okweqile kusuka ohlelweni lwe-urinary;
- ukuvimbela ukunwetshwa kwezinso ezifanele kanye ne-atrophy yamathambo alo;
- ukuvame ukuphuma komchamo;
- ukuqedwa kwezinto eziphazamisa ukukhwabanisa kwemisebenzi yezinkunzi.
Hydronephrosis - ukwelashwa ngaphandle kokuhlinzwa
Ukwelapha okugcinwa yi-Conservative kwenziwa kuphela ezinyathelweni zokuqala zesifo, lapho umsebenzi we-urinary system usaphoselwa. Isifo sezinso "hydronephrosis" sihilela ukusetshenziswa kwemithi ebonisa ukuthi kukhona amaqembu amaningana:
- anti-inflammatory - ketoprofen, Ibuprofen, Tenoxicam;
- i-anesthetics - Ketorolac, Naproxen , Indomethacin ;
- ama-antibiotics - ama- sumamed , i-Flemoxin Solutab, i-Clindamycin;
- hypotensive - Metoprolol, Physiotens, Albarel nabanye.
Ukusetshenziswa kwama-pharmacy agents akuyona indlela ephumelelayo yokwelapha izinso ezifanele. Imithi ivame ukushiwo ngesikhathi sokuhlinzwa ukuqinisa isimo, ukuthuthukisa inhlalakahle yesiguli nokuvimbela ukutheleleka kohlelo lokugaya. Ngaphandle kwezinqubo zokuhlinzwa, ukukhubazeka kuzoqhubeka.
I-Hydronephrosis - ukusebenza
Ukukhetha indlela yokwelashwa okunamandla kwenziwa kuphela ngemuva kokuxilongwa ngokucophelela. Okokuqala, kubalulekile ukuthola ukuthi kungani i-hydronephrosis yenzekile - ukwelashwa kuthuthukiswa kuye ngokuthi kunesimo esicasulayo. Lapho kukhona amatshe noma isanti ezimpileni ezifanele, ukucutshungulwa kwabo okude (lithotripsy) kunconywa. Ukuxhaphazwa kwenziwa ngokusebenzisa amathonya we-ultrasonic ne-radio wave.
Uma i-hydronephrosis yezinso (kwesobunxele) kwesokudla (i-kwesokunxele) ibangelwa yisisu, isinqumo senziwa ekuthengiseni izifo. Ngaphezu kwalokho, imishanguzo nemithi yamakhemikhali ingenziwa. Ngokuvamile, akunakwenzeka ukususa kuphela i-tumor kanye ne-metastase, ngakho-ke udokotela ohlinzayo uncoma ukukhethwa okuyingxenye noma okuphelele kwesitho lapho ukukhula kutholakala khona, kanye nokugeleza okufanayo ngesikhathi sezinso.
Nge-anomalies yangasese ekuthuthukiseni uhlelo lwe-urinary, i-plastic yenziwa. Imisebenzi enjalo ihlose ukubuyiselwa kwamanje evamile ketshezi. Ezimweni ezimbi, uma i-hydronephrosis iholela ekunqandeni ngokuphelele izinso ezilungile, kunengozi yezinkinga ngendlela yokudakwa okunamandla nemikhiqizo yokuqubuka komchamo, isitho kumele sisuswe (nephrectomy).