Reflux Vesicoureteral abantwana kunye nabantu abadala. Iimpawu, diagnosis, Treatment

In nomchamo ziphuma izifo ezifana reflux vesicoureteral (pmr). Sisifo inqabile yenzeka amaninzi ebantwaneni. Nangona kunjalo, lo ngezifo sivakala kubantu abadala. Makhe sijonge ukuba yintoni eyenza TMR kunokuba kuyingozi kwaye iindlela ukulwa nayo.

pathography

Ukuze uqonde ukuba yintoni na ngezifo kuthiwa reflux vesicoureteral, kufuneka nzulu kancinci phakathi kwendlela ezakhiwe ngayo abantu.

Lwesinye - ilungu umngxuma dystrophy. It yenzelwe ukuqokelelana umchamo kude kube lelo xesha njengoko kwakungekho isenzo ukuchama. Iqamza somongi ezintathu. Ababini kubo udityanisiwe kwi ureters. Ngokusebenzisa ezi amajelo umchamo ophuma izintso ukuya lwesinye. Umngxuma yesithathu kukuba ngenxa yoko. Le compound indawo urethra ne kwiqamza.

Ezi ureters ezi wesizalo ifanele-ezimile. Baya kuza kwiqamza kwi-engile yayiyazi. Le ureters babe inkqubo vana indlela enye ngqo. Ukuba singabi intshukumo reverse umchamo ukuya ureter kwaye kungena kwizintso. Ngoko ke inkqubo esebenza esempilweni.

Xa umntu ene reflux vesicoureteral, indlela ekhusela umzimba ukusuka intshukumo umchamo umva into engasebenziyo. Ngako oko, umchamo Ungasa kwelinye icala. Ngenxa yoko, ngenxa lokuphuma kakuhle umchamo ulwelo oluhlala esinyini, uze uphoswe ureters. Oku kukhokelela kwempixano, uhlobo lokugqibela. Xa iintlobo okunzima reflux umchamo unako ukufikelela nkqu nezintso.

Kubanga zokugula

Imithombo esi sifo ayiqondwa ngokupheleleyo. Oogqirha bathi reflux vesicoureteral ebantwaneni kunye nophuhliso bekhubazekile okungaqhelekanga yale ingxenye. Ngenxa yoko, baye rhoqo kwafunyaniswa ngezifo ephambili. Esi sifo, owayebonakele ngasemva mgceni bekhubazekile.

reflux Vesicoureteral abadala kwiimeko ezininzi zamabanga aphakamileyo. Uphuhliso sifo lilawulwe iimeko ezikhoyo.

Zezona izizathu eziphambili kulo:

• kwasendaweni ngokungafanelekanga of ureteral orifice;
• isinye diverticulum;
• Ukungakhuli smykatelnyh koomatshini emlonyeni;
• okunciphisa submucosal itonela ureter intramural;
• uhlobo yezifo emlonyeni;
• ukuphinda le ureter, ebangela ijelo elisetyenziswa ibekwe ngaphandle kwiqamza nxantathu.

Imiba yesibini ekhokelela kuphuhliso sifo, kungaphazamiseka ngo apho ukugeleza umchamo, zibandakanya ezi zifo zilandelayo:

• lwesinye kugesi kokuphazamiseka;
• BPH;
• Lwesinye entanyeni sclerosis;
• Ngokuzimela emlonyeni kule ndawo;
• stenosis okanye stricture le urethra;
• Izifo ezosulelayo mbobo urethra;
• lwesinye kwekhono.

nokubekwa kwezifo

Pathology ke zohlulwa ngokwendidi ezintathu:

1. Pmr Active. Ukubonakala kwaso isuke kuphela xa isenzo ukuchama.
2. Kwisixando sokwenziwa. Ebonakalisa ngexesha lwesinye ukugcwaliswa.
3. Icandelo elinezakhiwo-osebenzayo okanye kwisixando sokwenziwa. Isifo States iphawulwa zidityaniswe ngasentla.

Ngaphezu koko, ngokwahlukileyo zodwa kwizifo ezifana of reflux uveza. Isifo kubonakala nje pyelonephritis nezolo.

ngezinga leengxaki

Isifo kubalulwa iintlobo ezahlukeneyo womxhuzulane.

Ngokutsho ukuvuza ke iqondo ilandelayo reflux vesicoureteral:

1. Olu hlobo luphawulwa reflux umchamo kulo ureter zone zangasese. Kwandise yokuqala isidanga umjelo kwenzeka.
2. ephuma Reverse lugubungela yonke ureter. Ukongeza, kukho cast of umchamo ngesitya, isinqe. Nangona kunjalo, akukho lijelo okanye amacandelo zezintso hayi-qhinga.
3. Ukuza kuthi ga ebonakala inkqubo pyelocaliceal kidney lokuphosa umchamo. Last landiswa kakhulu. Kodwa ureter akawatshintshi. ububanzi bayo ichanekile.
4. Kuba eli nyathelo, esibonakala ukwandiswa kunye nezixhobo pyelocaliceal, kwaye ureter ngenxa ephuphumayo umchamo eyahlulayo.
5. Ekubeni esi sidanga umsebenzi kwezintso lifinyele. Le ekliniki ibinyanzeliswa ukuxozwa zesebe, ukuvelisa umchamo.

iimpawu

Ngelishwa, kunzima kakhulu ukuba ukubona kwibakala okuqala reflux vesicoureteral. Iimpawu sifo zidla zonakele. Kungenxa yoko le nto sifo kakhulu ngokuqhelekileyo ukuxilongwa sele xa kwavela iingxaki.

Nakuba kunjalo, kukho iqela iimpawu, ezinokuthi kurhanelwa uphuhliso sifo ebantwaneni:

• baby belula ukuba umzimba ekuzalweni;
• alibazise ngokomzimba;
• ukuphazamiseka ukusebenza lwesinye.

Xa abadala, ngokwahlukileyo kancinci wabonakalaliswa reflux vesicoureteral. Iimpawu ziimpawu sifo, njengoko umthetho, oku kulandelayo:

• ngokungxamisekileyo kwaye zisoloko ndiyazibamba ukuchama;
• ubuhlungu kabi esiswini okanye isinqe;
• imali encinane umchamo;
• umchamo welifu, kunye livumba embi;
• ngexesha echama ubonakala nokushisa;
• flow umchamo;
• igazi umchamo;
• eke rhoqo ebusuku ukuya yangasese;
• fever, kuthibaza;
• intlungu emva, kwicala nemithungo.

iingxaki sifo

reflux Vesicoureteral kungakhokelela neziphumo ezibi kakhulu. Le ngezifo sisoloko sisenza amanxeba zesekondari kidney. Amalungu ziyabuna, kubekho zisiba kwimisebenzi yazo engundoqo - lokuhluza.

Ngenxa reflux kukwaphula yokususwa eqhelekileyo umchamo. Umchamo equlathe flora ngeentsholongwane, ungena lula ukuya ureters kunye nezintso. Ngoko ke, kukho usoloko kukho usuleleko kunye nokudumba kwindawo amalungu.

Ukongeza, ngexesha ukunyuka koxinzelelo ukuchama kule ndawo isinqe. Oku kukhokelela umonakalo ngokubhekele ijwabu zezintso.

Imibimbi izintso kunye sclerosis oko kunokubangela wegazi eziziisekondari. Le ngezifo kunzima kakhulu ukunyanga. Xa le meko badla kufuneka asuse kidney kunye ureter.

lokufunyaniswa kwesifo

Xa pyelonephritis ucingisise kurhanelwa reflux vesicoureteral. Uxilongo iquka uphando:

1. US.
2. Uhlalutyo igazi nomchamo.
3. CT.
4. Cystourethrography. Ngokusebenzisa i catheter kulwelo esinyini lokuQala. Xa luzele, ukwenza uthotho kuqhume. -X-reyi eyenziwa ngexesha ukuchama.
5. pyelogram efakwa. Kolu phando, kuyabonakala unamanzi-x-reyi zoshwankathelo zilawulwe yegazi. Kulo mzekelo, kufuneka alinde de ubuncwane igazi liya izintso isinye.
6. ayisuse Nuclear. Iintlobo radioactive materials asetyenziswa phando. Basenokuba ezilawulwa ngqo kwi esinyini okanye umfanekiso. Le saveyi isetyenziselwa ukufumanisa ukusebenza kwenkqubo womchamo.

Imithi

ugqirha kuphela kumisela qhinga yokulwa le ngezifo njengoko reflux vesicoureteral. Unyango ijonge ukuphelisa izinto ezibangela isifo kwaye ukuthintela iingxaki.

Isiphumo kakhulu kakhulu ukuba bakwazi ukuphuhlisa kwisiqalo esi sifo, - a nephropathy reflux. Le ngezifo yinkqubo arhabaxa etshabalalisayo ibakho kule parenchyma zezintso.

qhinga unyango kuxhomekeke ngoonobangela sifo kunye namandla aso.

unyango elondoloza

Eli cebo lusebenza kakhulu kwi zigaba zokuqala zesi sifo. Ingakumbi baphathwe ngempumelelo reflux vesicoureteral ebantwaneni. Xa izigulane abadala, ngo-70% yabo bonke uqale ukuphucula.

Umsebenzi ophambili we nothomalaliso endala kokulawula usuleleko ngexesha, equka inkqubo womchamo.

Unyango kubandakanya le miba ilandelayo:

1. Ukuyifundisa. Iziganeko nga ukuphelisa izinto ezingaqhelekanga pathways ukuba kwenzeka lwesinye.
2. Ukuqeshwa amachiza antibacterial. Yokuba izigulane lingatshajiswanga abafunyenwe usulelo kwi womchamo.
3. Sokudla. Kucetyiswa Izigulane ngamandla ukuba unikeze ulungiso. Ukudla kuthetha nomqathango wokusetyenziswa protein netyuwa.
4. Catheterization lwesinye.
5. Ukusetyenziswa kweziyobisi umfutho. Ezifanelekayo imithi apho uxinzelelo isigulane luyanda njengoba ngenxa pmr.
6. Kucetyiswa echama rhoqo. Amanyathelo anjalo kufuneka luphunyezwe zonke iiyure ezi-2, nokuba siyanibongoza ukuba usebenzisa indlu yangasese.

Ukuba kurhanelwa reflux vesicoureteral ebantwaneni, unyango kufuneka ube esibhedlele. Ekuqaleni, lo mntwana axilongwe. Emva kokuba izigqibo unobangela izifo, amisele unyango olufanelekileyo ukuphelisa umthombo sifo.

Kwimeko isiqinisekiso mgceni iziphene abantwana kucetyiswa uqhaqho.

utyando endoscopic

Olu ngenelelo ngoncedo kuyacetyiswa ukuba unyango endala ayiniki isiphumo oyifunayo mhlawumbi abanala makhwiniba bekhubazekile ebantwaneni. Noko Endoscopic Ukulungiswa reflux vesicoureteral yenziwa kuphela kwi-1, 2, isidanga-3-th kwesi sifo. Kwaye kwenzeka, ukuba walondoloza umsebenzi contractile emlonyeni.

Lo msebenzi usebenzela kancinane wesibeleko esigqibeleleyo. It iqulathe kule ilandelayo. Phantsi emlonyeni esezantsi kwisangqa elingangenisa uyofaka okhethekileyo. It ikuvumela ukuba ziqhagamshelane umlebe phezulu nasezantsi. Ngenxa yoko, eli candelo isixando zinokukhuliswa indlela antireflux.

unyango ngotyando

Ukuvula imisebenzi aze asebenzise kwezi meko zilandelayo:

• ukuba akukho unyango endala okanye endoscopic akazange anikwe iziphumo ezinqwenelekayo;
• ezimbi th 4, 5 th degree;
• kwimeko mgaqweni iziphene ebantwaneni abangakwaziyo zisuswe endoscopically.

Ukulungiswa reflux vesicoureteral oluqhutywa kwiimeko ezininzi, kwiqamza evulekileyo. Eyona njongo ephambili zotyando - lo ukuyilwa inwebu kwiinwebu esinyini apho ureter yenzelwe, esi sicatshulwa efunekayo.

Emva msebenzi kudala umqobo ethile ekhusela ureter kunye esinyini ukusuka nezongezelelo umchamo kubo.

unyango Surgical inika iziphumo ezigqwesileyo, Ngokwezibalo, 75-98% yazo zonke iimeko. Noko ke, utyando ayikho ngaphandle nezingalunganga.

Zisasuka le nkqubo:

• Ukubulawa elide;
• ixesha kwimo elide;
• xa kwimeko yokuphinda reoperation kuba kakhulu nzima ngakumbi.

amanyathelo othintelo

Nokuba reflux iyanyamalala ngendlela yabo? Ukuba nemvelo olufunyanwa umntwana kusekwangoko, oku ngokwenene ukuya ngophuhliso kunye nokukhula wosana. Nangona kunjalo, kufuneka ukuba eziwa exacerbations kunye nezifo. Ukuba le meko ziyafikeleleka, phantse 10-50% yabantwana ngezifo kwenzeka ngokuzimeleyo. Kodwa uyakwazi ukushiya ngasemva loloyiko kwithishyu.

Xa degree TMR 3 okanye ngaphezulu kufuneka ungenakuxhomekeka self-eziphilayo. Ezi abantwana abadinga unyango olufanelekileyo, amiselwe ngugqirha.

Ukuthintela uphuhliso kunye progression of the pmr, kufuneka:

1. Ixesha ukunyanga zonke izifo yokukrala kwenkqubo womchamo.
2. Nakuphi na ukwaphulwa ukuchama kufuna utyelelo mandatory ukuya kugqirha.
3. abafazi abakhulelweyo kufuneka uqiniseke ukuba ukutyelela ugqirha wakho. Ukongeza, umfazi elindele ukuba umntwana kumele ukuba zichithe i yokuphila esempilweni kwaye efanelekileyo, ukutya okunesondlo.

Pmr - le ngezifo embi kakhulu. Esi sifo kufuneka ziphathwe sisaqala, ukuvimbela progression yayo. Ngoko ke, ngokuyimfuneko, jonga kwabo zezakhono.