Phakathi kwezifo ezihlukahlukene zesistimu ye-genitourinary, i-reflux ye-vesicoureteral ezinganeni kuyinkinga enkulu emithi yesimanje. Lesi sifo sinikeza ukukhathazeka okukhulu kwabagulayo futhi ngaphandle kokwelashwa okwanele kungaholela ekukhubazekeni.
Ukuxilongwa kwe-DMR enganeni - kuyini?
I-refrex ye-refrax yesigqebhezana noma i-PMR efingqiwe yinkqubo lapho umchamo ongena e-urea kungenxa yesizathu esithile ubuyela emuva kwe-renal pelvis noma uhlale ukhona. Isimo esinjalo sihlehlisela ukutheleleka ngendlela ye-pyelonephritis, futhi esimweni esibucayi kakhulu, ukuphikisana kwezinso. Kwezinye izimo, i-reflux ye-vesicoureteral ezinganeni ingadlula ngokwayo, nakuba ngalesi sikhathi ezinso izinqubo ezilimazayo. Ezimweni eziningi, kuyadingeka ukwelashwa okwesikhathi eside noma ukwelashwa.
I-reflux ye-swell-ureteral - izimbangela
Isifo esingahambi kahle se-reflux ye-vesicoureteral, izimbangela zazo zingabombele futhi zitholakale, zibhekene nokuphulwa kwesistimu yama-valve esesithombeni. Izifo kuma-70% wamacala atholakele ezinganeni ezingaphansi konyaka ongu-1. Ukungahambisani kwe-valve ku-ureter kungaba kokubili kokuzalwa - i-PMR eyinhloko, futhi ithole - i-PMR yesibili. Esimweni sesibili, izimbangela ziyi- cystitis (okungapheliyo), okuholela ekukhuleni komlomo esifundeni se-valve nokunciphisa amandla okugcina ngenxa yenqubo yokuvutha njalo.
I-degree ye-reflux ye-vesicoureteral ezinganeni
Lesi sifo yi-reflux ye-vesicoureteral, i-degree ebaluleke kakhulu, eyayizosiza kakhulu ukwelashwa kuye ngesiteji. Izicubu ezincane ezimbalwa ezithintekayo kwi-reflux ye-vesicoureteral ezinganeni ezithintekile, amathuba amaningi okuthola ingane. Ukuhlukanisa:
- I degree - umchamo uwela kuphela engxenyeni ye-pelvic ye-ureter, ngaphandle kokugeleza phambili.
- I-II degree - ukuphuma komchamo kubonakala kulo lonke ureter futhi kancane kancane i-pelvis ye-renal.
- I-III degree - lesi sigaba sibonakala ngokunyuka kwesikhumba, lapho umchamo ukhipha khona, ngaphandle kokwandiswa kwe-ureter.
- I-IV degree - i-pelvis ne-ureter enezinguquko ezibalulekile ngendlela yokwandisa.
- I-V degree - ukunciphisa izindonga zezinso ngenxa yokukhipha umchamo futhi ngenxa yalokho - ukuphikisana nokucindezelwa kwemisebenzi.
Ngaphezu kwalokho, ukuqina kwesifo kuhlushwa ngokunciphisa ukusebenza kwezinso. Ukuhlukanisa:
- reflux vesicoureteral yezinga eli-1 - lapho izinguquko zingaphansi futhi umsebenzi wezinso awuthintekile;
- I-reflux ye-2-degree vesicoureteral ezinganeni ibonakala ngokunciphisa ukusebenza komzimba ohlanganyelwe ngo-30%
- Reflux 3-degree vesicoureteral - lapho izinso zisebenza ngamandla angu-60%;
- I-reflux ye-4-degree isifo esibi kakhulu, ngoba umsebenzi wezinso wehliswe ngamaphesenti angu-60%.
Irereter ye-vestiment reflux ezinganeni - izimpawu
I-reflux ye-ureteral ezinganeni inezibonakaliso zezici zalesi sifo, okuyinto ngezinye izikhathi ezithathwa ukuze zibonwe nge-symptomatology ye- pyelonephritis . Ukuze ngokushesha ngangokunokwenzeka ukuze unciphise isimo senyane eligulayo, udinga ukufaka isicelo sokuxilonga odokotela abaqeqeshiwe. Abazali kufanele baxwayiswe uma ingane ikhononda ngalokhu:
- ikhanda;
- ukuvuvukala;
- ukuzwa ukoma;
- i-raspiree esifundeni sesinqe;
- umfutho wegazi ophezulu;
- ukukhula kwezinga lokushisa elide;
- ubuhlungu ngemva kokuvuthwa
- kwashintsha umbala we-urine (turbidity, frothiness).
Isisindo nesiguli se-reflux - ukuxilongwa
Ukuze uhlolisise i-MTCT enganeni, kufanele uthole umtholampilo omuhle onguchwepheshe be-urology yabantwana. Odokotela baqhuba ukuhlolwa okunzima okunjalo ukuze banqume izinga lesifo:
- ukuhlolwa okuyisisekelo ngudokotela we-urologist nokwenza i-anamnesis;
- ukuhlaziywa okujwayelekile komchamo ;
- Ukuhlaziywa kwe-bacteriological umchamo (bakopsev);
- I-Ultrasonography yezinso nezitho eziseduze esebenzisa iDoppler;
- ukuskena kwesistimu ye-genitourinary;
- i-cystoscopy;
- urethrocystography;
- i-radiography.
I-reflux ye-vesicoureteral iphathwa kanjani?
Isifo esinjalo njenge-reflux ye-vesicoureteral ezinganeni, okwelashwa okungagcina isikhathi eside, kunezinhlobo ezimbili - esebenzayo futhi engenzi lutho. Esikhathini sokuqala, ukuchithwa okuqhubekayo komchamo kwenzeka kuphela ngokuvuthwa, futhi okwesibili, le nqubo ayixhomeki kwizimbangela zangaphandle. I-reflux ye-Vesicoureteral iphathwa ngokuphumelelayo ezinganeni, ikakhulukazi esemncane. Ukwelapha cishe ngu-100%. Kunezinhlobo ezimbili zokwelashwa - okulondolozayo nokuhlinzeka. Ezilungiselelweni eziphuthumayo:
- ukwelashwa kokudla;
- ukubeka izidakamizwa ukunciphisa ukucindezelwa;
- ukuthatha ama-antibiotics;
- i-phytotherapy;
- i-acupuncture;
- Ukwelashwa ngehora ngeso lesikhumba;
- i-electrophoresis.
Ukungenelela kokuhlinzekwa kuboniswa uma:
- ezinye izindlela zokwelashwa azisebenzi;
- Ngaphandle kwe-reflux, kunezimo ezingavamile zesakhiwo se-urinary tract;
- ukuphindaphinda kwezifo ezingamanzi ezingaphenduli ukwelashwa kwama-antibacterial.
Isambiso nesiguli se-reflux ezinganeni - izincomo zomtholampilo
Ngenxa yokuthi ukungaboni kahle kwezingane kubhekwa njengenkinga enkulu yokwelapha kanye nombuso, ubuchwepheshe bwanamuhla bokuphathwa kwawo buyaqhubeka nokuthuthukiswa. I-II ne-II degree yalesi sifo uphathwa ngaphandle kokuhlinzekwa, okwenzeka ngamaphesenti angama-65% anika amandla ezinamandla. Kodwa uma inqubo yokuvuvukala ayikwazi ukumiswa, ngisho nakulezi zigaba kunconywa ukwenza umsebenzi ophansi othukuthele ozokhohlwa kuze kube phakade ngenkinga.
Ukulungiswa kwe-endoscopic ye-reflux ye-vesicoureteral ezinganeni
Indlela yesimanje kakhulu futhi ephumelelayo, enekhono lokunciphisa i-reflux ye-97% i-operation ebizwa ngokuthi "endoscopy". Ngenaye, i-endoscope yedivayisi ekhethekile, ukungenelela okuphansi okuthungatha, okugcina imizuzu engu-15 kuphela. Yonke inqubo ingaphansi kwe-mask anesthesia futhi ngezinsuku ezingu-3-4 isiguli esincane sesivele sinqunyelwe ukubhekelwa ekhaya.