Esinye sezifo ezivame kakhulu ohlelweni lwamagciwane kwabesifazane yi-pyelonephritis, izimpawu kanye nokwelashwa okudinga ukunakekelwa okwandisiwe, ngoba cishe cishe ngesiguli, kungaholela ekuthuthukiseni izinkinga eziyingozi.
I-Pyelonephritis - Izimbangela
Ngalesi sifo, izinso zibandakanya inqubo yokuvuvukala - isitsha sayo-izinsimbi zomzimba kanye ne-parenchyma, okungukuthi, izakhi eziyisisekelo zomsebenzi zesitho. Ngokuvamile, i-lesion esiswini esisodwa ibangelwa ukungena kokutheleleka okungangena emzimbeni ngenye yezindlela ezilandelayo:
- ukhuphuka - kusuka ezingxenyeni eziseduze (isisindo, i-urethra, njll);
- i-hematogenous - ngegazi kusukela ekugxilweni okubhebhethekayo okutholakala kunoma yiziphi izitho (indlu yesilonda, indlebe ephakathi, izoni maxillary njalonjalo);
- I-lymphogenous - ngokusebenzisa izitsha ze-lymph ngokumelene nesizinda samagciwane omathumbu .
I-renal pyelonephritis, ngenxa yezici zayo ezibonakalayo, iningi isifo sezinsikazi, ngoba umsele ongagudluzwa umchamo ungcono kunamadoda, futhi umzila wesigcawu kanye ne-rectum siseduze. Ngaphezu kwalokho, umzimba wesifazane uhambelana nezinguquko ze-hormone ezenza ukwehla kokuzivikela komzimba nokwephulwa kokubunjwa kwe-microflora. Ama-microorganisms alandelayo abhekwa njengama-pathogens ajwayelekile kakhulu ekutheleleni kwesifo (eziningi zazo zingabameleli be-microflora evamile yomzimba):
- E. coli ;
- Pseudomonas aeruginosa ;
- i-enterococci;
- Klebsiella;
- streptococci;
- i-staphylococci;
- Amaprotheni;
- Abafundi.
Izimo ezimbi ezingase zithuthukise ukuthuthukiswa kwezinso yizi:
- ukungasebenzi kwesikhumba ("isisindo se-neurogenic");
- nephrolithiasis;
- izicubu ze-urinary;
- reflux vesical-pelvic-ureteral;
- ukuqina okukhulu kwezinso;
- indawo engavamile yesimo sezinso;
- ukuphazamiseka kwamagciwane okuhlobene nosawoti okweqile emzimbeni (phosphates, urates, njll);
- isifo sikashukela mellitus;
- i-instrumental ukuhlolwa kwepheshana lomchamo;
- ukuthatha imithi ethile (i-sulfonamides, i-cytostatics, njll);
- ukuvezwa kwemisebe;
- ukudakwa komzimba;
- i-supercooling;
- ukuhluleka kwe-hormone ;
- ukucindezeleka;
- ukuhlanzeka okuhlanzekile kwezitho zangasese.
I-pyelonephritis elula
Esikhathini esiyinkimbinkimbi se-pyelonephritis kubesifazane sibonakala ngokuzumayo kokuqala kanye nesithombe esitholakala emtholampilo ngokukhuphuka kwezimpawu. Ngokuvamile lena yinkqubo eyinhloko yokutheleleka, engakaze yandulele umonakalo wendikimba ngaphambili, ehilela enye yezinso. Ubude baleli fomu lesifo luyizinsuku ezingaba ngu-10-20 (ngelashwa kahle).
I-pyelonephritis engapheli
I-pyelonephritis engapheli kwabesifazane, abanezimpawu kanye nokwelashwa okuhlukile kakhulu kulabo abasenkonzweni ephawulekayo, kubonakala ukuhamba kancane nokuphindaphinda ngezikhathi ezithile. Kancane kancane, ngale ndlela yokukhubazeka, izicubu ezivamile zelungu ziyashintshwa yizicubu ezixhunyiwe ezingasebenzi. Ngokuvamile, ukugula okungapheli kungumphumela we-pyelonephritis engaphelele. Ezimweni eziningi, i-pyelonephritis engapheli iyatholakala ngesikhathi sokukhulelwa, okuyinto phakathi nalesi sikhathi idinga ukukhushulwa.
Iyini ingozi ye-pyelonephritis?
Uma kungabikho ukwelashwa ngesikhathi esifanele futhi kufanelekile, lesi sifo sibangela ingozi enkulu yezempilo. Ngenxa yenkambo eqhubekayo yalesi sifo, izinso zingase zilahlekelwe ngokuphelele amandla ayo okusebenza, okuyinto, ngokulimala kokubili, okudala ukungaphumeleli kwengqamuzana okungapheli nesidingo se-hemodialysis. Ngaphezu kwalokho, izinkinga ezinjalo zingathuthuka:
- ukungakwazi ukusebenza kwama-renal;
- i-paranephritis;
- ukwanda okuqhubekayo e-blood pressure;
- i-papillitis ye-necrotic;
- i-abscess yezinso ;
- urosepsis;
- ukuphazamiseka kwamagciwane.
Ngokuhlukile kufanele kuqaphele ukuthi iyiphi ingozi ebizwa yi-pyelonephritis ye-gestational - egeleza ngesikhathi sokubeletha kwengane. Ukukhubazeka kungathuthuka ngisho nakubesifazane abakhulelwe abanempilo abanezinso ezisebenzayo ngokujwayelekile, ngaphandle kokushintsha kwesakhiwo emgqeni we-urinary. Kulesi simo, ngokuvamile lesi sifo sihlasela abesifazane abaqala ukukhulelwa, e-trimester yesibili futhi bangabangela ukwephulwa kwenkambo yokukhulelwa, ukubeletha nokutholwa ngemuva kokubeletha. Imiphumela emibi yilezi:
- ukulethwa ngaphambi kwesikhathi;
- i-gestosis;
- i-hypotrophy yesisu;
- ukungaqiniseki kwamapulangwe okungapheli;
- ukutheleleka kwe-intrauterine ye-fetus;
- Ukukhipha isisu kokukhulelwa.
I-Pyelonephritis - izimpawu kubesifazane
Izimpawu ze-pyelonephritis, ezenzeka ngendlela elula, ngokuvamile zilandelayo:
- ukushisa komzimba okwandisiwe;
- izikhukhula, isimo se-febrile;
- ukujuluka okukhulu;
- ubuhlungu obunzima esifundeni se-lumbar kusukela ohlangothini lwesilonda, esingabuyiselwa emuva, indawo engaphansi komhlaba, isifunda esingumgogodla, sichithwa;
- isicanucanu, ukuhlanza;
- ukuvuthwa okubuhlungu njalo futhi ukusikhuthaza;
- ukuvuvukala emlenzeni;
- ubuthakathaka jikelele;
- ikhanda, ubuhlungu besisu.
I-pyelonephritis engapheli, izimpawu ezitholwa iziguli eziningi, zivame ukungazinaki. Kuphawulwe ukuthi:
- ukhathala okwandayo;
- ubuthakathaka, ubuqili;
- ukulala;
- ubuhlungu bokuziphatha okungazinzile okuvela ekuhlangothini kokunqotshwa;
- i-malaise nobuhlungu obukhulu ngemva kwe-hypothermia, esimweni sezulu esimanzi;
- ukudla okumbi;
- ikhanda eliphindaphindiwe;
- ukuvuthwa njalo.
Ukushisa nge-pyelonephritis
Ifomu eliyinkimbinkimbi yalesi sifo nokukhushulwa kwe-pyelonephritis kuhambisana nokwanda kwezinkomba zokushisa, ezingafinyelela ku-38-40 ° C. Ngokuvamile amazinga okushisa aqhuma ngokuphawulekayo, ehambisana nokujuluka okukhulu, ukushisa nokushisa, ukuqina obuthakathaka. Lokhu kubonisa ukudakwa komzimba ngemikhiqizo yokuhlukaniswa kwezifo ezifuywayo, okwenyusa inqubo yokutheleleka. Ngemuva kokuqala ukwelashwa, izinga lokushisa liwehla, lihlale isikhathi esingaphansi kwe-37-37.5 ° C.
I-urine ne-pyelonephritis
Uma owesifazane eqala i-pyelonephritis, umchamo uguqula imingcele evamile, iba yi-turbid, ngezinye izikhathi - emnyama, ithola iphunga elibi elibi. Ngokuvamile nge-iso iso, lembula ukungena kwegazi, izidakamizwa. Ngesikhathi sokuvuthwa, okuphawulekayo, okuvuthayo, okukhathazekayo, iziguli eziningi zibika lezi zibonakaliso zesifo njengokungavumelani kwamagciwane, izifiso ezivamile nezamanga zokuthutha.
I-Pyelonephritis - ukuxilongwa
Ukuqinisekisa ukutholakala kwe "pyelonephritis" kwabesifazane, lapho kubonakala khona izimpawu futhi ukwelashwa kuyadingeka ngokushesha, kutholakala ukuxilongwa kwe-ultrasound. Udokotela owaziwa yi-uuzist uzothola ngokushesha izibonakaliso ze-pathological: ukungahambisani okungafani kwesigungu, ukwandisa usayizi, i-asymmetry, ukuqhubekela phambili kokuhamba, ukukhula kwe-echogenicity ye-parenchyma,
Okubonisa lesi sifo yizivivinyo zebhobhothri, eziveza izinkomba ezinjalo:
- ukuhlolwa kwegazi okuvamile - ukwanda kwe-ESR, i- leukocytosis ;
- Ukuhlaziywa komchamo jikelele - ukutholakala kwamaprotheni nama-bacterium;
- Ukuhlaziywa kwe-bacteriological umchamo - ukuzimisela kwenombolo kanye nohlobo lwezilwanyana eziphilayo.
Enye indlela yokuxilonga esetshenziswa kakhulu yindlela yokuhlaziya. Lokhu kuhlolisiswa kwe-X-ray, okuyinto, ngenqubo enzima, ayinikezi izibonakaliso ezicacile zesifo, kodwa ngesifundo esingapheli sinikeza isithombe sezinguquko esakhiweni sezinso. Uma i-pyelonephritis icatshangwa kwabesifazane abakhulelwe, ukuhlolwa kwe-X akukwenziwa ngenxa yengozi yokuvezwa kwemisebe kumntwana. Ezinye izindlela zokuxilonga zingahle zibekwe njalo njalo:
- CT, i-MRI;
- i-kidney biopsy;
- i-pyelography;
- i-renal angiography, njll.
I-Pyelonephritis - ukwelashwa
Indlela yokuphatha i-pyelonephritis, i-urologist noma i-nephrologist izothatha emva kokufeza zonke izicwaningi ezidingekayo eziveza izimpawu zokugula. Ezimweni ezimbi, ukuhlinzeka esibhedlela kwenziwa. Ngokuvamile ukwelapha okunamandla kwe-pyelonephritis kuyisimo esiqinile, esekelwe ekwelapheni kwezokwelapha. Ezimweni eziningi, ukwelashwa okungapheli kwe-pyelonephritis kufana, kodwa kudinga isikhathi eside.
Ukwelashwa kwe-pyelonephritis - izidakamizwa
Yenza ukwelashwa kwe-pyelonephritis ngama-antibiotics, okuyisisekelo sokwelapha. Kuyinto enhle ukunquma ukuzwela kwezifo ezihlasela i-causative kwizidakamizwa ezithile ze-antibacterial. Ngaphambi kokwamukela imiphumela yokuhlaziywa, ama-antibiotics we-pyelonephritis asemthethweni, futhi ngokuvamile aqale ngezidakamizwa ezivela eqenjini le-fluoroquinolones (i-Levofloxacin, i-Ofloxacin). Ukwengeza, ama-antibiotics angabekwa ukwelashwa:
- Aminopenicillins (Amoxicillin, i-Penicillin);
- cephalosporins (Cefalexin, Cefepime);
- aminoglycosides (Gentamicin, Amikacin);
- i-carbopenems (imipenem, i-Meropenem);
- i-sulfonamide (i-Co-trimoxazole).
Ukuzikhethela, isikhathi sokwelashwa, umzila wokuphatha izidakamizwa ukhethwe ngamunye. Futhi, i-pyelonephritis yabesifazane, izimpawu kanye nokwelashwa okudinga isimo sengqondo esinokwethenjelwa, siphathwa ngokusebenzisa izidakamizwa ezivela kwamanye amaqembu:
- i-diuretics (i-Furosemide);
- izidakamizwa ezingekho-steroidal anti-inflammatory (Voltaren, Movalis);
- ama-anticoagulants (i-Heparin, i-Troxevasin);
- amavithamini, amaminerali (amavithamini A, E, C, β-carotene, selenium, njll).
I-Pyelonephritis - amakhambi abantu
Ngaphandle kokwelashwa, kuvame ukuphakanyiswa ukuthi i-phytotherapy - ukusetshenziswa kwamagilebhisi nezithelo ezine-antimicrobial, anti-inflammatory and diuretic effects. Ukwelashwa kwe-pyelonephritis kwabesifazane kungenziwa ngosizo lwezinhlobo zezitshalo ezinjalo:
- i-bearberry;
- i-yarrow;
- i-cranberry;
- wavuka ezinqulwini;
- i-cranberries;
- i-chamomile;
- i-calendula;
- i-mint;
- iqabunga le-birch njalonjalo.
Yidla nge-pyelonephritis
Iziguli kufanele zikwazi ukuthi i-pyelonephritis ingasetshenziselwa imikhiqizo ethile evela ekudleni okujwayelekile okusetshenziswe ngaphambili. Ezinye izitsha emva kwe-pyelonephritis kuzodingeka zishiywe:
- izinongo, ukushisa iziqholo;
- ukubhema;
- ukukhethwa;
- ukupheka;
- ukudla okunamafutha;
- ukudla okuthosiwe;
- i-broths ecebile.
Sincoma ukudla ubisi lwemifino ngokufaka amaqanda, inyama enomfutho nenhlanzi. Imifino nezithelo ezilandelayo ziyasiza:
- amazambane;
- amabhontshisi;
- i-zucchini;
- ukhukhamba;
- amakhabe;
- ama-apula;
- ama-strawberries;
- ikhabe;
- amabhomu, nabanye.