Vesicoureteral Reflux ana ndi akulu omwe. Zizindikiro, Matendawa, Chithandizo

Mu urology inapeza matenda monga vesicoureteral Reflux (PMR). Ndi matenda kawirikawiri amapezeka nthawi zambiri ana. Komabe, kudwala angathe kuonedwa mu alionse akuluakulu. Tiyeni tione zimene tingachite TMR kuposa ndi ngozi ndi njira kulimbana nacho.

pathography

Kuti timvetsetse zimene kudwala amatchedwa vesicoureteral Reflux, muyenera pang'ono zambiri za thunthu la umunthu.

Chikhodzodzo - m'dzenje akulu limba. Bukuli lakonzedwa kuti kudzikundikira mkodzo mpaka nthawi monga panalibe mchitidwe wa pokodza. Kuwira ali mipata atatu. Awiri a iwo olumikiza ureters lapansi. Kupyolera mu njira izi mkodzo uyenda kuchokela impso ndi chikhodzodzo. Una lachitatu ndi kutaya. Izi pawiri malo mkodzo ndi kuwira.

The ureters ndi machubu nyuzi woboola pakati. Iwo anabwera mu kuwira pa makona pachimake. The ureters ndi njira ya vavu dongosolo yeniyeni. Kuti chindiletsa n'zosiyana kayendedwe ka mkodzo mu ureter ndi mu impso ndi. Choncho wathanzi kugwira ntchito dongosolo.

Ngati munthu wodwala matenda vesicoureteral Reflux, limagwirira oteteza thupi ku mkodzo n'zosiyana kayendedwe si ntchito. Motero, mkodzo ikuyenda malangizo ena. Choncho, chifukwa cha kulemala outflow ya mkodzo madzi amasonkhana chikhodzodzo, kenako anaponyedwa ureters lapansi. Zimenezi zimabweretsa mavuto, mavuto otsiriza. M'njira choopsa cha Reflux mkodzo ndi kukwaniritsa ngakhale impso.

kudwala Zoyambitsa

Magwero a matenda si bwino. Madokotala zimachitika vesicoureteral Reflux ana ndi kobadwa nako nthenda chitukuko cha gawo ili. Choncho, nthaŵi zambiri matenda kudwala chachikulu. matenda, amene anaonekera mu maziko a anomalies kobadwa nako.

Vesicoureteral Reflux akuluakulu nthawi zambiri sekondale. chitukuko matenda ali malinga ndi mikhalidwe alipo.

Iwo zifukwa chachikulu ichi:

• zosayenera kutanthauzira kwa ureteral orifice;
• chikhodzodzo diverticulum;
• chosakhwima smykatelnyh makina pakamwa;
• zowononga submucosal mumphangayo intramural ureter;
• pathological mawonekedwe a pakamwa;
• ndi anawaonjezera kuwirikiza kawiri wa ureter, ndi kuchititsa kuti njira ili kunja kwa makona kuwira.

Mfundo yachiwiri wopita ku chitukuko cha matenda, imene akusokoneza otaya yachibadwa ya mkodzo, monga matenda otsatirawa:

• chikhodzodzo kubwereketsa kutsekeka;
• BPH;
• Chikhodzodzo khosi ofoola ziwalo;
• cystitis pakamwa pa m'dera;
• stenosis kapena stricture ya mkodzo ndi;
• matenda opatsirana mavavu mkodzo;
• chikhodzodzo kukanika.

gulu la matenda

Kudwala lagawidwa mitundu itatu:

1. Yogwira PMR. chikuoneka malinga potsatira kuchita pokodza.
2. Chabe. Timakusonyeza pa kudzazidwa chikhodzodzo.
3. Losakanizika yogwira kapena kungokhala chete. Inati matenda yodziwika ndi osakaniza pamwamba.

Komanso, mosiyana olekanitsidwa kudwala monga mwa Reflux likukulira. Matendawa kumaonekera monga pyelonephritis ndi kobwereza.

mlingo wa kudwala

Matendawa akhoza yodziwika ndi njira zosiyana yokoka.

Malinga ndi kutayikira ndi mlingo kutsatira Reflux vesicoureteral:

1. mtundu wofanana ndi Reflux ya mkodzo mu ureter zone m'chiuno. Mu digiri yoyamba patsogolo njira kumachitika.
2. N'zosiyana outflow chimakwirira ureter lonse. Komanso, pali osewera a mkodzo mu chikho, mafupa a chiuno. Komabe, ngakhale njira kapena zigawo impso si kukodzedwa.
3. Pamlingo ili yodziwika ndi kuponya mkodzo dongosolo pyelocaliceal impso. Last kwambiri kukodzedwa. Koma ureter ndi sanasinthe. awiri wake ndi zolondola.
4. Pakuti stepi ino, yodziwika ndi kuwonjezeka ndi zida pyelocaliceal, ndi ureter chifukwa cha mkodzo kuponyera zambiri.
5. Ndi digiri ichi cha ntchito yafupika impso. chipatala Izi malinga ndi kupatulira a dipatimenti popanga mkodzo.

zizindikiro

Mwatsoka, zovuta kudziwa pa siteji oyambirira Reflux vesicoureteral. Zizindikiro za matenda kawirikawiri ankavala. N'chifukwa chake matenda ambiri amangoti matenda pamene kale zosokonezeka.

Komabe, pali gulu la zizindikiro izi amaganiziridwa chitukuko cha matenda ana:

• sikelo mwana thupi pobadwa;
• akuchedwa kukula;
• kusokonezeka kwa ntchito kwa chikhodzodzo.

Akuluakulu, pang'ono mosiyana akuwonetseredwa vesicoureteral Reflux. Zizindikiro zomwe matenda, monga ulamuliro, izi:

• mwamsanga ndipo nthawi zambiri amakhala ndi chilakolako chofuna kukodza;
• ululu kusapeza pamimba kapena mafupa a chiuno;
• yaing'ono kuchuluka kwa mkodzo;
• mkodzo mitambo, ndi fungo loipa;
• pa pokodza limapezeka woyaka zotengeka;
• otaya mkodzo;
• magazi mu mkodzo;
• pafupipafupi nocturnal awakenings kupita ku chimbudzi;
• malungo, kuzizira;
• ululu kumbuyo, mbali m'mbali.

mavuto a matenda

Vesicoureteral Reflux angakhale ndi zotsatira zoipa kwambiri. kudwala Izi zimayambitsa zotupa sekondale impso. Ziwalo kufota, pakhala akuchuluka ntchito yaikulu - zosefera.

Chifukwa cha Reflux ndi kuphwanya kuchotsa yachibadwa ya mkodzo. Mkodzo munali zomera tizilombo tating'onoting'ono, likulowerera momasuka mu ureters ndi impso. Choncho, pali nthawi zonse chilli ndi kutupa mu ziwalo.

Komanso, pa ukuwonjezeka pokodza kuthamanga m'dera mafupa a chiuno. Zimenezi zimabweretsa zina kuwononga kwa minofu impso.

Makwinya impso ndi ofoola ziwalo izo chimayambitsa matenda oopsa sekondale. kudwala Izi ndi zovuta kuchiza. Pamene chikhalidwe ichi kawirikawiri amakhala ndi kuchotsa impso ndi ureter lapansi.

matenda a matenda

Pamene kulimbikira pyelonephritis ndi achifwamba vesicoureteral Reflux. Matendawa zikuphatikizapo angapo Kafukufuku:

1. US.
2. Analysis magazi ndi mkodzo.
3. CT.
4. Cystourethrography. Kudzera catheter mu chikhodzodzo madzimadzi umayamba. Kamodzi ndi full, kuchita mndandanda wa akatemera. X-ray anachita pa pokodza.
5. Mtsempha pyelogram. Mu kafukufuku ameneyu, kuonekera madzimadzi pa x-ray ndi kutumikiridwa m'nsinga. Pankhaniyi, muyenera kudikira mpaka thunthu la magazi amapita ku impso ndi chikhodzodzo.
6. Nyukiliya chindodo. A zosiyanasiyana zipangizo nyukiliya ntchito kafukufukuyu. Iwo akhoza kutumikiridwa mwachindunji mu chikhodzodzo kapena mtsempha. kafukufuku ntchito kudziwa kugwira ntchito dongosolo mkodzo.

mankhwala mankhwala

Only dokotala angathe kudziwa njira ya kulimbana kudwala ichi monga Reflux vesicoureteral. Chithandizo umalimbana ndi kuthetsa zimene zimayambitsa matenda ndi kuteteza zosokonezeka.

Chotsatira ovuta kwambiri kuti angathe pa maziko a matenda, - ndi Reflux nephropathy. The kudwala ndi yotupa zowononga ndondomeko kunachitika ndi parenchyma impso.

chithandizo strategy zimadalira zimayambitsa matenda ndi ukulu wake.

chithandizo ndiwofatsa

Msampha umenewu ndi othandiza kwambiri mu magawo oyambirira a matenda. Makamaka bwinobwino ankachitira vesicoureteral Reflux ana. Odwala wamkulu, mu 70% ya onse kuyamba kusintha.

Ntchito yaikulu ya mankhwala ndiwofatsa ndi yake matenda, kuphimba dongosolo mkodzo.

Chithandizo ikukhudza mbali zotsatirazi:

1. Physiotherapy. Events akhoza kuthetsa kuvutika kagayidwe kachakudya kuti zimachitika chikhodzodzo.
2. Kusankha mankhwala antibacterial. Iwo wachotsedwa odwala amene amapezeka matenda kapepala kakuti mkodzo.
3. Kudya pang'ono. Odwala mwamphamvu analangiza kupereka uphungu. Zakudya zikutanthauza kuletsa ntchito zomanga thupi ndi mchere.
4. Catheterization a chikhodzodzo.
5. Kugwiritsa ntchito mankhwala antihypertensive. Amaperekera mankhwala kukachitika vuto la mtima ndi chinawonjezeka chifukwa cha PMR.
6. Analimbikitsa zonse pokodza. kukhwimitsa ayenera akuyendera mawola 2, osayang'ana akugwiritsira ntchito chimbudzi.

Ngati amaganiziridwa vesicoureteral Reflux ana, mankhwala ayenera kukhala mu chipatala. Poyamba, mwana mwafufuza. Pambuyo kudziwa chifukwa cha matenda, mankhwala chithandizo choyenera kuthetsa gwero la matenda.

Pankhani ya chitsimikiziro cha anomalies kobadwa nako kwa ana analimbikitsa opaleshoni.

opaleshoni endoscopic

phukusi analimbikitsa ngati mankhwala ndiwofatsa sapereka chifukwa anakhumba mwina kuvutika kobadwa nako ana. Komabe Endoscopic kuwukonza Reflux vesicoureteral ikuchitika yekha pa 1, 2, 3-TH digiri ya matenda. Ndipo mwina mwake, ngati anasunga contractile ntchito za pakamwa.

Opaleshoni imeneyi ndi opaleshoni asang'ambe. Amakhala mu izi. Mu pakamwa m'munsi semicircle akabweretsa analili wapadera. Timatha inu yolumikizana mlomo pamwamba ndi pansi. Chifukwa cha zimenezi, mbali chabe kumatheka antireflux limagwirira.

chithandizo opaleshoni

Kutsegula ntchito ayamba milandu zotsatirazi:

• ngati kapena ndiwofatsa kapena endoscopic chithandizo sanapatsidwe zotsatira anakhumba;
• pathologies 4 TH, 5 TH digiri;
• zinachitikira anomalies kobadwa nako ana amene sangathe kuchotsedwa endoscopically.

Kuwukonza Reflux vesicoureteral ikuchitika nthawi zambiri lotseguka kuwira. Cholinga chachikulu cha opaleshoni - ndi mapangidwe Kakhungu mucous a chikhodzodzo kumene ureter isanafalikire, ndime chofunika.

Pambuyo ntchito ngati amalenga chotchinga ena omwe amamuteteza ureter ndi chikhodzodzo ku kuwonjezapo mkodzo kwa iwo.

Opaleshoni mankhwala amapereka zotsatira zabwino, malingana ndi kuwerengera, 75-98% milandu onse. Komabe, opaleshoni si popanda kuipa.

The downside ndi ndondomeko:

• mankhwala ochititsa dzanzi yaitali;
• yaitali konzanso nthawi;
• ngati zisadzachitikenso reoperation ndi mmene zovuta.

zodzitetezera

Kaya Reflux kutha maganizo awo? Ngati chosayenerera ndi matenda mwana pa siteji atumwi, zikhoza kwenikweni kupita ndi chitukuko ndi kukula kwa mwana. Komabe, ayenera kusunga nyenyeswa ku exacerbations ndi matenda. Ngati zinthu izi zimapezeka, pafupifupi 10-50% ya ana kudwala chikuchitika paokha. Koma akhoza kusiya mu minofu amamuyambitsa timabala.

Pamene TMR 3 digiri kapena apamwamba sayenera kudalira kudziletsa ikutha. ana awa amene amafunika chithandizo chokwanira, zotchulidwa dokotala.

Pofuna kupewa chitukuko ndi kupitilira kwa PMR, muyenera:

1. Nthawi kuchiza matenda onse yotupa a dongosolo mkodzo.
2. Aliyense kuphwanya pokodza amafuna ulendo kuvomerezedwa kuti dokotala.
3. Amayi oyembekezera ayenera kuonetsetsa kukaonana ndi adokotala anu. Komanso, mkazi akuyembekezera mwana ayenera kutsata moyo wathanzi ndi oyenera, chakudya chopatsa thanzi.

PMR - ichi ndi kudwala kwambiri. matenda ayenera kuti asagwidwe mwa magawo oyambirira, kuteteza kupitilira ake. Choncho, kwenikweni, zinkanenedwa pokamba za luso.