Miyala ya impso

Mwala wa impso ndi wolimba wopangidwa ndi timibulu tating'onoting'ono. Mwala umodzi kapena yambiri imatha kukhala mu impso kapena ureter nthawi yomweyo.

Miyala ya impso ndi yofala. Mitundu ina imayendetsedwa m'mabanja. Nthawi zambiri zimachitika makanda asanakwane.

Pali mitundu yosiyanasiyana ya miyala ya impso. Choyambitsa vutoli chimadalira mtundu wamwala.

Miyala imatha kupanga pamene mkodzo uli ndi zinthu zambiri zomwe zimapanga timibulu. Makandulo amenewa amatha kukhala miyala pakadutsa milungu kapena miyezi.

• Miyala ya calcium ndiyofala kwambiri. Amakonda kupezeka mwa amuna azaka zapakati pa 20 mpaka 30. Calcium imatha kuphatikiza ndi zinthu zina kupanga mwalawo.
• Oxalate ndiofala kwambiri mwa awa. Oxalate amapezeka mu zakudya zina monga sipinachi. Amapezekanso mu zowonjezera mavitamini C. Matenda am'mimba ang'onoang'ono amachulukitsa chiopsezo cha miyala iyi.

Miyala ya calcium imatha kupangidwanso chifukwa chophatikizana ndi phosphate kapena carbonate.

Mitundu ina yamiyala ndi iyi:

• Miyala ya cystine imatha kupangidwa mwa anthu omwe ali ndi cystinuria. Matendawa amapezeka m'mabanja. Zimakhudza amuna ndi akazi.
• Miyala ya Struvite imapezeka mwa amuna kapena akazi omwe amabwereza matenda amkodzo. Miyala iyi imatha kukula kwambiri ndipo imatha kulepheretsa impso, ureter, kapena chikhodzodzo.
• Miyala ya asidi a Uric imakonda kwambiri amuna kuposa akazi. Zitha kuchitika ndi gout kapena chemotherapy.
• Zinthu zina, monga mankhwala ena, amathanso kupanga miyala.

Choopsa chachikulu pamiyala ya impso kusamwa madzi okwanira. Miyala ya impso imatha kupezeka ngati mupanga mkodzo wochepera lita imodzi patsiku.

Simungakhale ndi zizindikilo mpaka miyala itasunthira m'machubu (ureters) momwe mkodzo umalowerera m'chikhodzodzo. Izi zikachitika, miyala imatha kuletsa mkodzo kutuluka mu impso.

Chizindikiro chachikulu ndikumva kuwawa komwe kumayamba ndikusiya mwadzidzidzi:

• Ululu ukhoza kumvekera m'mimba kapena kumbuyo kwa msana.
• Ululu umatha kusunthira kumalo am'mimba (kupweteka kwa kubuula), machende (kupweteka kwa machende) mwa amuna, ndi labia (ululu wamaliseche) mwa akazi.

Zizindikiro zina zitha kuphatikiza:

• Mtundu wosadziwika wa mkodzo
• Magazi mkodzo
• Kuzizira
• Malungo
• Nseru ndi kusanza

Wothandizira zaumoyo adzayesa. Malo am'mimba (pamimba) kapena kumbuyo kumatha kumva kuwawa.

Mayeso omwe angachitike ndi awa:

• Kuyesa magazi kuti muwone calcium, phosphorus, uric acid, ndi ma electrolyte
• Ntchito ya impso
• Kuthira urinal kuwona makhiristo ndikuyang'ana maselo ofiira mumkodzo
• Kupenda mwala kuti mudziwe mtundu wake

Miyala kapena kutseka kumawoneka pa:

• M'mimba mwa CT scan
• Mimba x-ray
• Mitsempha yotchedwa pyelogram (IVP)
• Impso ultrasound
• Kubwezeretsanso piyama

Chithandizo chimadalira mtundu wamwala komanso kuopsa kwa zizindikilo zanu.

Miyala ya impso yomwe imakhala yaying'ono nthawi zambiri imadutsa pamakina anu.

• Mkodzo wanu uyenera kusokonekera kuti mwalawo usungidwe ndikuyesedwa.
• Imwani madzi osachepera 6 kapena 8 patsiku kuti mupange mkodzo wambiri. Izi zidzathandiza mwalawo kudutsa.
• Ululu ukhoza kukhala woipa kwambiri. Mankhwala opweteka kwambiri (mwachitsanzo, ibuprofen ndi naproxen), kaya okha kapena pamodzi ndi mankhwala osokoneza bongo, akhoza kukhala othandiza kwambiri.

Anthu ena omwe akumva kuwawa kwambiri chifukwa cha miyala ya impso amafunika kukhala mchipatala. Mungafunike kupeza madzi kudzera mu IV mumitsempha yanu.

Kwa mitundu ina yamiyala, omwe amakupatsani akhoza kukupatsani mankhwala kuti miyala isapangidwe kapena kuthandizira kuwononga ndikuchotsa zomwe zikuyambitsa mwalawo. Mankhwalawa atha kuphatikiza:

• Allopurinol (ya miyala ya uric acid)
• Maantibayotiki (amiyala ya struvite)
• Odzetsa (mapiritsi amadzi)
• Mankhwala mankwala
• Sodium bicarbonate kapena sodium citrate
• Mapiritsi amadzi (thiazide diuretics)
• Tamsulosin kumasula ureter ndikuthandizira mwala kudutsa

Nthawi zambiri opaleshoni imafunika ngati:

• Mwalawo ndi waukulu kwambiri kuti ungadutse wokha.
• Mwalawo ukukula.
• Mwalawo umatseka mkodzo kutuluka ndikupangitsa matenda kapena kuwonongeka kwa impso.
• Ululu sungalamuliridwe.

Masiku ano, mankhwala ambiri ndiocheperako kuposa kale.

• Lithotripsy imagwiritsidwa ntchito kuchotsa miyala yaying'ono pang'ono kuposa theka la inchi (1.25 sentimita) yomwe ili mu impso kapena ureter. Zimagwiritsa ntchito phokoso kapena mafunde kuti ziphwanye miyala kukhala zidutswa tating'onoting'ono. Kenako, zidutswa zamwala zimasiya thupi mkodzo. Amatchedwanso extracorporeal shock-wave lithotripsy kapena ESWL.
• Ndondomeko zomwe zimachitika podutsa chida chapadera kudzera pakadulira kakang'ono pakhungu lanu kumbuyo kwanu ndi impso zanu kapena ureters amagwiritsidwa ntchito pamiyala yayikulu, kapena impso kapena madera oyandikana nawo sanapangidwe molondola. Mwalawo umachotsedwa ndi chubu (endoscope).
• Ureteroscopy itha kugwiritsidwa ntchito pamiyala yam'munsi. Laser imagwiritsidwa ntchito kuphwanya mwalawo.
• Kawirikawiri, opaleshoni yotseguka (nephrolithotomy) ingakhale yofunikira ngati njira zina sizigwira ntchito kapena sizingatheke.

Lankhulani ndi omwe akukuthandizani pazomwe mungasankhe.

Muyenera kudzisamalira. Ndi njira ziti zomwe mumatenga zimadalira mtundu wamwala womwe muli nawo, koma atha kukhala:

• Kumwa madzi owonjezera ndi zakumwa zina
• Kudya zakudya zambiri ndikuchepetsa zakudya zina
• Kutenga mankhwala othandiza kupewa miyala
• Kutenga mankhwala okuthandizani kupititsa mwala (mankhwala oletsa kutupa, alpha-blockers)

Miyala ya impso ndi yopweteka, koma nthawi zambiri imatha kuchotsedwa mthupi popanda kuwononga mpaka kalekale.

Miyala ya impso nthawi zambiri imabwerera. Izi zimachitika kawirikawiri ngati chifukwa chake sichipezeka ndikuchiritsidwa.

Muli pachiwopsezo cha:

• Matenda a mkodzo
• Kuwonongeka kwa impso kapena kupweteka ngati mankhwala akuchedwa kwa nthawi yayitali

Kuphatikizika kwa miyala ya impso kungaphatikizepo kutsekeka kwa ureter (pachimake unilateral obstructive uropathy).

Itanani omwe akukuthandizani ngati muli ndi zizindikiro za mwala wa impso:

• Kupweteka kwakukulu kumbuyo kwanu kapena mbali yomwe sikudzatha
• Magazi mkodzo wanu
• Malungo ndi kuzizira
• Kusanza
• Mkodzo womwe umanunkha kapena wowoneka ngati mitambo
• Kumva koyaka mukakodza

Ngati mwapezeka kuti mwatsekedwa ndi mwala, ndimeyi iyenera kutsimikiziridwa mwina pogwidwa mu strainer mukakodza kapena potsatira x-ray. Kukhala wopanda ululu sikutsimikizira kuti mwalawo wadutsa.

Ngati muli ndi mbiri yamiyala:

• Imwani madzi ambiri (magalasi 6 mpaka 8 amadzi patsiku) kuti mupange mkodzo wokwanira.
• Mungafunike kumwa mankhwala kapena kusintha kadyedwe kanu pamitundu ina yamwala.
• Wothandizira anu angafune kuyesa magazi ndi mkodzo kuti athandizire kupeza njira zoyenera zopewera.

Aimpso calculi; Nephrolithiasis; Miyala - impso; Calcium oxalate - miyala; Mpweya - miyala; Struvite - miyala; Uric acid - miyala; Lithiasis yamikodzo

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

• Matenda a impso
• Impso - kutuluka magazi ndi mkodzo
• Nephrolithiasis
• Mitsempha yotchedwa pyelogram (IVP)
• Ndondomeko ya Lithotripsy

Tsamba la American Urological Association. Kusamalira zamankhwala amwala a impso (2019). www.auanet.org/guidelines/kidney-stones-medical-mangement-guideline. Inapezeka pa Feb 13, 2020.

Tsamba la American Urological Association. Kusamalira opangira miyala: AUA / Endourology Society malangizo (2016) www.auanet.org/guidelines/kidney-stones-surgical-management-guideline. Inapezeka pa Feb 13, 2020.

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Fink HA, Kodi TJ, Eidman KE, et al. Recurrent nephrolithiasis mwa akulu: kuyerekezera magwiridwe antchito a njira zodzitetezera. (Adasankhidwa) Rockville, MD. Agency for Healthcare Research and Quality (US) 2012; Lipoti Na. 12-EHC049-EF. PMID: 22896859 adasankhidwa.ncbi.nlm.nih.gov/22896859/.

Miller NL, Borofsky MS. Kuwunika ndikuwongolera zamankhwala a lithiasis kwamikodzo. Mu: Partin AW, Dmochowski RR, Kavoussi LR, Peters CA, olemba. Campbell-Walsh-Wein Urology. Wolemba 12. Philadelphia, PA: Elsevier; 2021: mutu 92.

Qaseem A, Dallas P, Forciea MA, Starkey M, Denberg TD; Clinical Guidelines Committee ya American College of Physicians. Zakudya ndi mankhwala kusamalira kupewa nephrolithiasis mwa akulu: malangizo achipatala ochokera ku American College of Physicians. Ann Intern Med. 2014; 161 (9): 659-667. PMID: 25364887 pubed.ncbi.nlm.nih.gov/25364887/.

Ziemba JB, Matlaga BR. Malangizo owongolera: miyala ya impso. BJU Int. 2015; 116 (2): 184-189. PMID: 25684222. [Adasankhidwa] [Cross Ref] PMB.