Cystinuria

Cystinuria ndizosowa pomwe miyala yopangidwa ndi amino acid yotchedwa cysteine ​​imapanga impso, ureter, ndi chikhodzodzo. Cystine amapangidwa mamolekyulu awiri amino acid otchedwa cysteine ​​amangidwa pamodzi. Vutoli limaperekedwa kudzera m'mabanja.

Kuti mukhale ndi zizindikilo za cystinuria, muyenera kulandira cholakwika kuchokera kwa makolo onse awiri. Ana ako adzalandira cholowa chofananira kuchokera kwa iwe.

Cystinuria imayambitsidwa ndi cystine wambiri mkodzo. Nthawi zambiri, cystine yambiri imasungunuka ndikubwerera m'magazi atalowa impso. Anthu omwe ali ndi cystinuria ali ndi vuto la chibadwa lomwe limasokoneza izi. Zotsatira zake, cystine imakula mumkodzo ndikupanga makhiristo kapena miyala. Makristali amatha kulowa mu impso, ureters, kapena chikhodzodzo.

Pafupifupi m'modzi mwa anthu 7000 ali ndi cystinuria. Miyala ya cystine imafala kwambiri kwa achinyamata ochepera zaka 40. Pansi pa 3% mwa miyala yamagazi ndimiyala ya cystine.

Zizindikiro zake ndi izi:

• Magazi mkodzo
• Kumva kupweteka m'mbali kapena kumbuyo kapena kumbuyo. Ululu nthawi zambiri umakhala mbali imodzi. Simamveka kawirikawiri mbali zonse. Ululu nthawi zambiri umakhala waukulu. Zitha kuwonjezeka pakapita masiku. Muthanso kumva kupweteka m'chiuno, kubuula, kumaliseche, kapena pakati pamimba kumtunda ndi kumbuyo.

Matendawa amapezeka nthawi zambiri atakhala ndi impso. Kuyesa miyala itachotsedwa kumawonetsa kuti amapangidwa ndi cystine.

Mosiyana ndi miyala yokhala ndi calcium, miyala ya cystine samawoneka bwino pama X-ray.

Kuyesa komwe kungachitike kuti mupeze miyala iyi ndikuzindikira vutoli ndi monga:

• Kutola mkodzo kwa maola 24
• M'mimba mwa CT scan, kapena ultrasound
• Mitsempha yotchedwa pyelogram (IVP)
• Kupenda kwamadzi

Cholinga cha chithandizo ndikuthandizira kuthetsa vutoli ndikuletsa miyala yambiri kuti isapangidwe. Munthu amene ali ndi zizindikiro zoyipa angafunike kupita kuchipatala.

Kuchiza kumaphatikizapo kumwa madzi ambiri, makamaka madzi, kuti apange mkodzo wambiri. Muyenera kumwa magalasi osachepera 6 mpaka 8 patsiku. Muyeneranso kumwa madzi usiku kotero kuti mumadzuka usiku kamodzi kuti mupite mkodzo.

Nthawi zina, madzi amafunika kuperekedwa kudzera mumitsempha (ya IV).

Kupanga mkodzo kukhala wamchere kwambiri kumatha kuthandizira kusungunula makhiristo. Izi zitha kuchitika pogwiritsa ntchito potaziyamu citrate kapena sodium bicarbonate. Kudya mchere wochepa kumathandizanso kuchepa kwa cystine ndikupanga miyala.

Mungafunike kuchepetsa ululu kuti muchepetse kupweteka kwa impso kapena chikhodzodzo mukadutsa miyala. Miyala yaying'ono (ya 5 mm kapena yochepera 5 mm) nthawi zambiri imadutsa mkodzo paokha. Miyala ikuluikulu (yopitilira 5 mm) imafunikira chithandizo chowonjezera. Mwala wina waukulu ungafunike kuchotsedwa pogwiritsa ntchito njira monga:

• Extracorporeal shock wave lithotripsy (ESWL): Mafunde amawu amapita mthupi ndipo amayang'ana kwambiri miyala kuti idutse tizidutswa tating'ono. ESWL mwina singagwire bwino ntchito miyala ya cystine chifukwa ndi yolimba kwambiri poyerekeza ndi mitundu ina yamiyala.
• Percutaneous nephrostolithotomy kapena nephrolithotomy: Kachubu kakang'ono kamaikidwa m'mbali mwa impso. Telescope kenako imadutsa mu chubu kuti idule mwalawo mosawonekera.
• Ureteroscopy ndi laser lithotripsy: Laser imagwiritsidwa ntchito kuthyola miyala ndipo itha kugwiritsidwa ntchito pochiza miyala yomwe siikulu kwambiri.

Cystinuria ndiwosakhalitsa, wamoyo wonse. Miyala imabweranso. Komabe, vutoli limabweretsa impso. Sizimakhudza ziwalo zina.

Zovuta zingaphatikizepo:

• Kuvulaza chikhodzodzo pamwala
• Impso kuvulala ndi mwala
• Matenda a impso
• Matenda a impso
• Kutsekeka kwamtundu
• Matenda a mkodzo

Itanani omwe akukuthandizani ngati muli ndi zizindikiro zamiyala yamikodzo.

Pali mankhwala omwe amatha kumwa kuti cystine samapanga mwala. Funsani omwe akukuthandizani za mankhwalawa ndi zotsatirapo zake.

Munthu aliyense yemwe ali ndi mbiri yodziwika bwino yamiyala mumikodzo ayenera kumwa madzi ambiri kuti azipanga mkodzo pafupipafupi. Izi zimalola miyala ndi timibulu kuti tisiye thupi tisanakhale lokulirapo kuti zitheke. Kuchepetsa kumwa mchere kapena sodium kudzathandizanso.

Miyala - chotupa; Miyala ya cystine

• Impso miyala ndi lithotripsy - kumaliseche
• Impso miyala - kudzisamalira
• Impso miyala - zomwe mungafunse dokotala wanu
• Njira zowongolera kwamikodzo - zotulutsa

• Thirakiti lachikazi
• Njira yamkodzo wamwamuna
• Cystinuria
• Nephrolithiasis

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Lipkin ME, Ferrandino MN, Woyambitsa GM. Kuwunika ndikuwongolera zamankhwala a lithiasis kwamikodzo. Mu: Wein AJ, Kavoussi LR, Partin AW, Peters CA, olemba. Urology wa Campbell-Walsh. 11th ed. Philadelphia, PA: Elsevier; 2016: chap 52.

Sakhaee K, Moe OW. Urolithiasis. Mu: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal MW, olemba. Brenner ndi Rector a Impso. 11th ed. Philadelphia, PA: Elsevier; 2020: chap 38.