Ukwazisa okuningi kwezindlela eziningi zokuxilonga kusengakapheli, ngakho-ke kwezinye izimo udokotela kufanele athathe isigwebo. I-biopsy yinsiza yendawo encane yezinso besebenzisa izinsimbi zokuhlinza. Isampula esilandelayo ithunyelwa ngokushesha ukuze ihlolwe ngokucophelela kanye ne-histological.
I-Renal biopsy - izinkomba nokuphikisana
Ubuchwepheshe obuchazwe busiza udokotela ukuba acacise ukuxilongwa okulindelekile, ukuthola ukuqina nokubangela izifo ezitholakalayo nokuthuthukisa uhlelo olusebenzayo lokwelapha. Ngaphezu kwalokho, isetshenziselwa ukwehlukanisa izifo. I-biopsy yezinso nge glomerulonephritis iqinisekisa ukuhlukaniswa kwayo nomunye umonakalo womzimba:
- amyloidosis ;
- Isifo sikaBergger;
- i-pyelonephritis;
- ukungezwani kwesifo sikashukela ;
- i-interstitial, i-nephritis yesiguli noma engenasifo.
Uhlobo luni lwesifo sezinso luyi-biopsy?
Ukudla kwangaphakathi kwezicubu akukwenziwanga kwisicelo sesiguli, kuphela uchwepheshe ongasikhuthaza kuphela uma kunezizathu ezinhle zenqubo. I-bialsy Renal: ukufundwa:
- i-glomerular ephilayo noma i-proteinuria e-tubular;
- i-hematuria yamazwe amabili;
- i-nephrotic syndrome;
- ukwehluleka kwenqunu, i-glomerulonephritis ngokuqhubekayo okusheshayo;
- i-tubulopathy yemvelaphi engaqondakali;
- i-neoplasm ecatshangelwayo;
- ukusebenza okungalungile kwesitho esitshalwe kabusha.
I-biopsy yezinso zokwelapha yenziwa ngezinhloso ezilandelayo:
- ukukhethwa kokwelashwa okwanele;
- lawula ukusebenza kwenkambo ekhethiwe;
- ukuqapha isimo sokufakelwa.
I-biopsy biopsy - ukuphikisana
Kunezifo kanye nezimo zokugula lapho lokhu kuqhutshwa kungenzeki khona:
- ukungezwani kwemithi ene-novocaine;
- izinso eyodwa kuphela zisebenza;
- ukuphazamiseka kwegazi okwephutha;
- i-hydronephrosis;
- i-aneurysm ye-artery ye-renal;
- ukwehluleka kwe-ventricular;
- isifo sofuba;
- i-thrombosis ye-veins ye-renal;
- i-perinephritis ye-purulent;
- isisu;
- i-psychosis;
- i-dementia;
- uhlale e-coma.
Kwezinye izimo, ukugcoba i-biopsy yezinso kuvunyelwe, kodwa kufanele kwenziwe ngokuqapha okukhulu:
- ukungafinyeleli ngokweqile esigabeni esinzima;
- i-nodular periarteritis;
- i-diastolic hypertension nge-indices ngaphezu kwe-110 mm Hg;
- i-myeloma;
- izinga eliphakeme lomzimba we-atherosclerosis;
- ukuhamba kwezilwane ezisezingeni eliphezulu;
- I-Nephroptosis.
Izinso zezinso - izinzuzo nezingozi
Inqubo okucatshangelwayo ihambisana nezinkinga eziyingozi, ngakho umbuzo wokusebenza kwawo unqunywa udokotela oqeqeshiwe. Ukuphumula kunganikezela inani eliphakeme lemininingwane mayelana nezimbangela, uhlobo lwemfundo nokuqina kwesi sifo, kusiza ukusungula ukutholakala okunembile nokungenaphutha. Ngesikhathi esifanayo, iyakwazi ukukhipha imiphumela emibi, ikakhulukazi uma kwenziwa phambi kwezingqinamba.
Ngokuhlukile, izazi ze-nephrologists zixoxa nge-biopsy ye-tumor yezinso. Ukutholakala kwezidumbu kulesi sitho nakho kutholakala ngezinye izindlela ngaphandle kwesidingo sokwakheka. Cishe konke okutholakala ukukhula kuyasuswa, okuhlinzeka ngokufinyelela okuphezulu kwezingxube zezinso, kanye ne-tumor ngokwayo. Mayelana nalokhu, ochwepheshe abaqaphele kakhulu ukuchazela ukuphathwa okungahleliwe okuhlosiwe kokucubungula ama-neoplasms.
Ingabe kubuhlungu ukwenza i-biopsy yezinso?
Inqubo ehlinzekwayo yenziwa ngaphansi kwesenzo sezinzwa zomzimba zendawo (ukuphindaphindiwe okuncane kakhulu noma i-anesthesia jikelele). Ngisho nokwazi nge-anesthesia, ezinye iziguli ziqhubeka nokuthola ukuthi i-biopsy yezinso ayijabuli kanjani-kungakhathaliseki ukuthi iyabuhlungu noma ayiqondile ngqo ngesikhathi nangemva kweseshini. Uma inqubo eyenziwa ngumchwepheshe onolwazi, kubangele ukukhathazeka okuncane. Ukusetshenziswa kahle kwe-anesthetic kuqinisekisa ukuhlukunyezwa okuncane.
Kungani i-biopsy yezinso iyingozi?
Ukuhlukunyezwa okuvamile (kweziguli ezingama-20-30%) zokuxhaphaza kuphuma okuncane, okuyeka ukuphela kungakapheli izinsuku ezimbili. Ngezinye izikhathi i-biopsy yezinso inzima kakhulu - imiphumela ingabonakaliswa kanje:
- i-pneumothorax ;
- ukutheleleka kwezicubu zomzimba;
- ukulimala kwezitho zangaphakathi eziseduze;
- ukulimaza okukhulu;
- i-renal colic;
- umkhuhlane;
- ukuphazamiseka kwesigungu;
- ubuhlungu obukhulu;
- ukuphuka kwesigxobo esiphansi sezinso;
- ukubonakala kwe-hematoma ye-perirenal;
- ukunciphisa ukucindezelwa kwegazi;
- i-paranephritis ekhuthazayo;
- ukwakheka kwe-fistula yangaphakathi.
Ngokuvamile kakhulu (ngaphansi kwezingu-0.2% zamacala) i-biopsy yezinso iphetha ngomusa. Izinkinga eziyingozi kunazo zonke zenqubo:
- ukuyeka ukusebenza komzimba;
- isidingo se-nephrectomy;
- umphumela obulalayo.
Yini engayenza esikhundleni se-biopsy yezinso?
I-full-fledged, kodwa engaphansi kokungabonakali nokuhlukumezayo, izilinganiso zezifundo ezichazwe ngobuchwepheshe azange zakhiwe. I-biopsy yezinso njengendlela yokuxilonga ibhekwa nokuqwashisa okukhulu nokuchithwa. Ezinye izindlela zokubona izifo ze-urinary system azikho ithemba futhi zinganikeza imiphumela yamanga. Njengokunye kwalokhu ukuxhaphaza, i-ultrasound ivame ukusetshenziswa, kodwa emitholampilo ephakeme, i-kidney biopsy ithathelwa ubuchwepheshe obunamuhla:
- i-tomography ehlanganisiwe;
- ukwenziwa komzimba ;
- i-radioisotope i-renography;
- i-veno- ne-arteriography;
- i-angiography;
- i-radiography ye-panoramic ngokuphambene.
I-biopsy yezinso isenziwe kanjani?
Ukuhluka okuvamile kokugqama kwenziwa ngendlela evaliwe. Ukusebenzisa ama-ultrasound noma ama-X-rays, indawo yezinso ibonakala. Ngokusho kwakhe, udokotela wethula inaliti ekhethekile ngqo ngenhla engaphansi kokuhlolwa, engena ngaphakathi esikhunjeni esasikhululwe ngamanxeba kanye nesisindo somzimba. Uma usufinyelele umgomo, idivayisi yokukhishwa yenza isampuli ngokuzenzakalelayo. Ngezinye izikhathi, ukuze uthole isifundo esifanele, udinga izinto eziningi eziphilayo, futhi kufanele ujobe inaliti izikhathi eziningana (ngokusebenzisa umgodi owodwa).
Kunezinye izindlela, njenge-biopsy yezinso:
- Sula. Amasampula we-tishu nokuhlaziywa kwawo okulandelayo kwenziwa ngesikhathi sokuhlinzwa ngaphansi kwe-anesthesia jikelele.
- With ukufinyelela ngokusebenzisa vein jugular. Le nqubo ingcono kakhulu kuneziguli ezinokukhubazeka kwegazi, ukwehluleka ukuphefumula, noma ukungasebenzi okubangelwa ukuzalwa kwesifo sezinso.
- Urethroscopy nge-puncture. Le ndlela inqunywe phambi kwamatshe emagqumeni kanye nesiguli, izitho ezifakelwe kabusha, kunconywa abesifazane nabakhulelwe abakhulelwe.
Yini ebangela ukushisa ngemuva kwe-biopsy yezinso?
Izinguquko zesimo somlilo noma izinguquko ezincane ku-thermoregulation zivame ukugcinwa emva kwamahora amaningana noma izinsuku kusukela ekugqibeleni. Ukushisa ngemuva kwe-biopsy yezinso kungenzeka ngezizathu ezilandelayo:
- izinqubo zokuvuvukala ezakhiweni zomzimba noma emisipha;
- ukutheleleka kwesikhumba esikhungweni sokuqothula;
- pathologies purulent;
- umonakalo ezakhiweni eziseduze.
Inkinga evamile ehlobene ne-biopsy yezinso iyancipha futhi ichithe ukuphuma kwangaphakathi ngaphakathi kwefayibha ehamba phambili futhi ngaphansi kwe-capsule yelungu (perirenal hematoma). Lapho imiphumela yale ngozi iphela, futhi ukuqoqwa kwe-fluidled fluid fluid kuyaqedwa, umkhuhlane kungenzeka. Akufanele uzame ukuthola izimbangela zakho ngokwakho, kungcono ukuthi uthole ngokushesha ukungena kwangaphakathi ku-nephrologist.
I-Hematoma ngemuva kwe-biopsy yezinso
Ukuphikisana okuchazwe ngenqubo kungavamile, kubangelwa amacala angaphansi kwama-1.5%. Amathuba okushisa okukhulu kwangaphakathi nokubunjwa kwe-hematoma enkulu kuncike ekutheni i-biopsy yezinso zenziwa kahle kanjani-ukuthi lokhu kwenziwa kanjani (ukukhetha indlela), ukuthi ngabe i-anesthesia yokuqala kanye nokwelapha okulwa nesifo sofuba kwenziwa kahle.
I-hematoma ye-Periorenal ayibheki emiphumeleni emibi yokuxilongwa futhi ayidingi ukungenelela okuhlinzekwa, kodwa ihlale ihambisana nokukhula kokushisa komzimba kanye nezimpawu ezingezinhle:
- ukunciphisa ukucindezelwa kwegazi;
- ukusika, ubuhlungu obunzima emhlane ophansi;
- ukubonakala kwegazi emcintweni noma ushintsho embala walo kuya obomvu, obomvu;
- ukunciphisa ukuhlushwa kwe-hemoglobin ekuhlolweni kwegazi;
- ubuthakathaka, ukulala;
- ukungabi nesifiso sokudla;
- ukuphazamiseka kokuvuthwa.