Nephroptosis ya impso: zizindikiro ndi chithandizo. Kodi chakudya cha odwala ndi impso nephroptosis n'chiyani?

Ziwalo zonse zaumunthu zili paubwenzi wapamtima. Izi zimapereka homeostasis (nthawi zonse zowonongeka kwa thupi), choncho ndizofunika kuti maselo onse azigwira bwino ntchito. Choyamba, machitidwe omwe amathandiza miyeso yofunika kwambiri (acidity, kutentha, kusungunuka kwa mitundu yambiri ya mankhwala) imaphatikizapo mtima ndi zamitsempha. Popeza woyamba mwa iwo amapereka magazi, chimbudzi chachikulu, ndi chachiwiri - kugawidwa kwa metabolites, zamadzimadzi ndi poizoni zosafunikira.

Udindo wa impso m'thupi

Poyang'ana koyambirira, dongosolo la mkodzo likuoneka ngati losafunika kwambiri kuposa, kunena, kupuma kapena mtima. Ndipotu, anthu okwanira amakhala mwamtendere komanso ali ndi impso imodzi, pamene kusapsa kwa m'mapapo kapena mtima umodzi kumakhudza kwambiri mkhalidwe wa wodwalayo. Komabe, izi zimangokhala zopanda pake, chifukwa chiwongolero cha impso munthu amamwalira mofulumira ngati kupuma kwa mtima kapena kupweteka kwa mtima. Ndipo izi zimakhala chifukwa cha mphezi-kuthamanga kwambiri kwa toxinemia, chifukwa ziwalo ziwiri ndizo "zowonongeka" za thupi lathu, ndipo tsiku ndi tsiku iwo amapopera makumi ambiri malita mwa magazi okha, kuthetsa zinthu zoopsa ndikuwamasula ku chilengedwe.

Ntchito zamagetsi

Kuwonjezera apo , impso zimapitirizabe kuthamanga kwa magazi nthawi zonse komanso zimataya magazi, ndipo ndizo zomwe zimayambitsa chizindikirochi - rain-angiotensin-aldosterone system (RAAS). Komanso, chifukwa chosungunuka kwa ma capillaries mu parenchyma ya chida ichi, kuchuluka kwa electrolytes osiyanasiyana ndi osmotic zigawo mu magazi ndi ziphuphu zimaperekedwa: sodium, potaziyamu, calcium, magnesium, shuga, mapuloteni, acids ndi ena ambiri. Amagwirizananso ndi erythropoiesis, chifukwa chakuti iwo ali ndi mankhwala apadera erythropoietin, omwe amachititsa kuti maselo ofiira a m'magazi aphungu apangidwe.

Matenda a impso

Ziwalozi zimagwirizanitsidwa ndipo zili m'dera la lumbar pambali pamphepete mwa msana. Zili ndi mawonekedwe a nyemba ndipo zimatembenuzidwa ndi zigawo za concave, ndipo izi zimatchedwa "zipata", zimalowa mu mitsempha ndi mitsempha, mitsempha, mitsempha ndi mitsempha yotuluka m'mimba. Mapangidwe ameneŵa amangotulutsa mphamvu zamagetsi, koma amagwiranso ntchito monga mbali yothandizira. Mkati mwazi, ziwalozi zimakhala ndi zovuta zambiri: chirichonse chimayambira ndi nephron, capillary glomerulus yomwe, makamaka, mwazi umasankhidwa. Ali ndi mamiliyoni ambiri mu impso, kenako amatha kulowa m'magazi, komwe kumakhala magazi ambiri, kubwezeretsedwa kwa madzi, amino acid, shuga ndi salt, zomwe zimachititsa mkodzo wachiwiri wokonzeka.

Mathirakiti a m'mitengo

Kuwonjezera apo, zimapita kutali, kupita kuzing'ono, kenako makapu akulu ndi mapepala a ntchentche, ndipo pomalizira pake zimakhala zothamanga ndi chikhodzodzo ndipo potsiriza, kudzera mu urethra, zimatulutsidwa kunja. Choncho, dipatimenti iliyonse ya urinary dongosolo ili ndi ntchito yake, ndipo mulimonse mwazo zolakwika zina zingabwere, zomwe zimapangitsa kukanika. Mwachitsanzo, matendawa a nephroptosis kapena hydronephrosis, pyelonephritis, glomerulonephritis, urolithiasis, stenital strictures, urethritis, cystitis ndi ena. M'nkhani ino tidzakhalabe pa matenda oyamba makamaka, tisanayambe kuiganizira, tikufunika kuphunzira zina za mawonekedwe a chiwalochi.

Kukonzekera kwa impso

Iwo ali mu malo otchedwa retroperitoneal, choncho ali ndi zipangizo zodzikonzera zokha kuti azikhalabe pamlingo wofanana (kuchokera ku thoracic 12 mpaka 2nd lumbar vertebrae). Izi zimaphatikizapo peritoneal folds (impso zolondola - chifukwa cha mitsempha ya duodenum-hepatic ndi renal-hepatic, ndi lamanzere - chifukwa cha chithunzithunzi), bedi lawo lapadera, zotengera (zomwe tanena kale), zida zamtengo wapatali Zigawo za mitambo yamakono ndi zidutswa zitatu zomwe zimapanga "chotowa chofewa" palimodzi ndi chithandizo champhamvu) ndi kupanikizika kwa m'mimba, komwe kumaperekedwa ndi kupweteka kwa minofu ya makoma a m'mimba. Kotero, ziwalo izi zimakhazikitsidwa molimba mu dera la lumbar. Panthawi imodzimodziyo, impso zolondola zimakhala zochepa kwambiri kusiyana ndi kumanzere, ndipo zimakhalabe zogwira ntchito: pochita zinthu zowuma, zimatha kutsika ndikukwera ndi 1-2 cm, koma zowonongeka pamtundawu zimapitirira 2 cm, kenako zimasiya Pansi pa malire abwino, vutoli limatchedwa nephroptosis ya impso.

Etiology ndi zifukwa zoopsa

Matenda okhudzana ndi matenda a abambo amapezeka kwambiri mwa amayi, chifukwa amadziwika kuti ali ndi mphamvu zambiri kuposa amuna, ndipo amatha kuchoka ku zifukwa zosiyanasiyana zomwe zimayambitsa zofooka za zipangizo zokonzekera. Makamaka a nephroptosis a nsomba angayambitse:

• Kutaya thupi kwakukulu, chifukwa cha capsule yamtundu wa thupi yowonda, ndipo imakhala yochuluka kwambiri;
• Zoopsa ku dera la lumbar kapena mimba, kusokoneza umphumphu wa fascia kapena kuwononga ubongo wa impso, mwachitsanzo chitsanzo cha impso nephroptosis nthawi zambiri chimayenda ndi retroperitoneal post-traumatic hematomas;
• Kuwonjezereka mwadzidzidzi kwa maseŵera kapena masewera olimbitsa thupi, omwe amachititsa kuti minofu ikhale yolimba komanso kuwonjezeka kwa mimba ya m'mimba, koma nthawi zonse zimakhudza zida zogwiritsira ntchito, motsogoleredwa ndi impso pamalo otsika;
• Kufooka kwa zipangizo zamagulu, m'malo mwake, kumachepetsa kupanikizika, ndipo ntchito yokonzanso imagwa, ndiye chifukwa cha nephroptosis ndi mimba kapena moyo wokhudzana ndi thupi laumunthu nthawi zambiri zimayenda mbali;
• Kuwonjezera pa zomwe tazitchula pamwambapa, kuwonjezeka kwa minofu yowonjezera kungakhalenso chifukwa cha kuikidwa kwa thupi, mwachitsanzo, mu matenda a minofu.

Zizindikiro za matendawa

Zochitika zachipatala za nephroptosis zingagawidwe mu magawo. Choncho, ndi yoyamba, impso zowonongeka zimagwera pa masentimita 4-6 ndi mawonekedwe a wodwalayo ndipo zimabwerera pokhapokha ngati zikupita patsogolo. Panthawiyi, wodwalayo akhoza kuvutika maganizo ndi ululu wojambula kuchokera kumbali yomwe imakhudzidwa ndi chiuno pamene akukweza zolemera, ndikuyesera mwamphamvu. Ntheptosisiti ya impso za kumanzere sizodziwika kwambiri kuposa impso zolondola, popeza ndi physiologically yomwe ili pamwamba, kotero zizindikiro zambiri zimawoneka bwino. Ngati pakadali pano matendawa atayika, ndiye kuti ikupita, ndipo gulu lokhudzidwa likhoza kutsika kumtunda. Izi zikuwonetseredwa mu gawo lachiwiri la impso zolondola za nephroptosis, zizindikiro zake ndi izi: thupi lokha silisamaliridwenso, nkofunikira kuti mutha kupita pamgedi. Ululu pa siteji iyi umakula ndi kufalikira pafupifupi mimba yonse ndipo imatha pamene impso imasinthidwa ndi malo osasunthika atengedwa.

Kuthamanga

Choopsya kwambiri ndi nephroptosis ya impso ziwiri, zomwe zingayambe kale pamsinkhu uwu, monga lamulo, chifukwa cha choloŵa choloŵa cholowa. Kuchuluka kwake ndiko kuchepa kwa chiwalo mpaka pang'onopang'ono, ndiye ululu umakhala wokhazikika, ngakhale umakhala m'malo osapumula ndipo usadwale mu malo osakanikirana, chifukwa chonyalanyaza matendawa, impso sungabwererenso kuntchito yowonongeka. Izi zimawopseza mavuto aakulu, monga hydronephrosis, matenda oopsa a m'magazi, colic renal chifukwa cha urolithiasis, ndipo gulu lokhudzidwa limakhala losavuta kuti liwonongeke, zomwe zimawoneka ngati pyelonephritis.

Kuzindikira matendawa

Ngati wodwala ali ndi thupi labwino, dokotala akhozabe kukayikira kuti impso sizigwa chifukwa cha madandaulo, mbiri ndi malingaliro a impso zomwe zimasonkhanitsidwa pamtanda wamkati.

Komabe, izi zimakhala zosatheka kwa odwala omwe ali ndi kunenepa kwambiri kapena ndi minofu yotukuka ya mimba. Kenaka, pogwiritsa ntchito zizindikiro za nephroptosis, wodwala amatumizidwa ku gawo loyambalo la kafukufuku - kafukufuku wa radiography kapena fluoroscopy, kotero kuti matenda a impso okhudzidwa angathe kuwonetsedwa. Ngati kale ali derali adokotala amatsutsa matenda alionse (urolithiasis, congenital anomalies of chitukuko, hydronephrosis, impso yachiwiri yakhate pambuyo pa atherosclerosis kapena matenda oopsa), ndiye kuti excretory urography ndi intravenous contrast agent administration ndi kotheka. Njira iyi ili ndi ubwino wambiri, mwachitsanzo, imangowonetsera mosavuta momwe zimakhalire ndi mkodzo ndi malire awo, miyala kapena nephroptosis ya impso. Chithandizo pa gawo ili chimayambira kumayambiriro, choyamba muyenera kuyesa ultrasound kuyesa ziwalo za m'mimba, magazi ndi mkodzo, komanso chikhalidwe cha mabakiteriya kuti athe kutsimikizira kapena kukana matenda a matendawa.

Zovuta zakutali

Choncho, tatsimikiza mwatsatanetsatane zomwe nephroptosis ya impso ndi momwe angapewere matendawa. Tiyeneranso kutchulidwa kuti zovuta za matendawa siziwonetsedwanso osati mu njira yokha. Choncho, ngati palibe chithandizo chokwanira kapena mwachitsanzo, ngati wodwala sakutsatira zakudya za nephroptosis ya impso, ndiye kuti vuto la m'mimba (kuvomereza / kutsegula m'mimba, kutsekula m'mimba, kupweteketsa mtima), amavutika kwambiri ndi vutoli, zomwe zimayambitsa neurasthenia Ndipo gawo labwino la mkodzo limasokonezeka, limaphatikizapo ziwalo zozungulira, mitsempha ndi zitsulo. Izi zimawonjezera chiopsezo cha matenda oopsa kwambiri ndi matenda kapena matenda a impso, kuperewera kwamtunda, zomwe zimayambitsa imfa ya wodwalayo.

Thandizo

Momwe mungachiritse nephroptosis ya impso pachigawo choyamba? Ili ndi funso lokhazikika. Kuti muchite izi, ndizofunika kwambiri kuti musamavutike, kuvala zomangira zapadera, makamaka pa nthawi ya mimba. Mankhwala ogwira ntchito payekha amatchulidwanso, omwe cholinga chake ndi kulimbitsa minofu ya m'chiuno. Wodwala akulangizidwa kuti alimbikitse zakudya zake, kulemera kwake, ndithudi, mopanda malire. Chofunika kwambiri ndi zakudya zamakono zokhala ndi nthenda yokhala ndi mchere №7 ndi kuchepetsa kuchuluka kwa mchere (chingasinthidwe ndi chitowe kapena madzi a mandimu), mitsempha, zakudya zopsereza, kusuta fodya, zakudya za mafuta, maswiti ndi nyemba. Ngati matendawa amapita ku magawo awiri ndi atatu ndikupeza zovuta zowonjezereka, njira yokhayo ikakhalabe ya nephropexy, njira yopaleshoni imene impso imabweretsedwera ku bedi lake. Ndipo ndi chitukuko cha nthendayi, wodwalayo amaikidwa pa hemodialysis nthawi zonse kuyeretsedwa kwa magazi kuchokera ku poizoni ndi metabolites kuti impso zomwe zimakhala bwino nthawi zambiri zimagwira bwino kwambiri.