Mgwirizano wa hydronephrosis

Bilateral hydronephrosis ndikukulitsa kwa ziwalo za impso zomwe zimasonkhanitsa mkodzo. Mgwirizano amatanthauza mbali zonse ziwiri.

Mgwirizano wa hydronephrosis umachitika pamene mkodzo sungathe kutuluka kuchokera ku impso kupita m'chikhodzodzo. Hydronephrosis siyokha matenda. Zimachitika chifukwa cha vuto lomwe limalepheretsa mkodzo kutulutsa impso, ureters, ndi chikhodzodzo.

Zovuta zomwe zimalumikizidwa ndi ma hydronephrosis amtunduwu ndi monga:

• Pachimake amgwirizano obstructive uropathy - impso kutsekeka mwadzidzidzi
• Kutsekereza kwa chikhodzodzo - kutseka kwa chikhodzodzo, komwe sikulola ngalande
• Matenda osachiritsika am'magazi - kutsekeka kwa impso pang'ono nthawi zambiri kumachitika chifukwa chodziletsa chimodzimodzi
• Chikhodzodzo cha neurogenic - chikhodzodzo chosagwira bwino ntchito
• Mavavu opitilira urethral - amawombera mkodzo womwe umayambitsa kutaya kwa chikhodzodzo (mwa anyamata)
• Prune mimba yam'mimba - chosatulutsa chikhodzodzo chomwe chimayambitsa kusungunuka kwa m'mimba
• Retroperitoneal fibrosis - minofu yowonjezeka yowonjezereka yomwe imatsekereza ureters
• Ureteropelvic mphambano kutsekeka - kutsekeka kwa impso pomwe ureter umalowa mu impso
• Reflux ya Vesicoureteric - kusunga mkodzo kuchokera mu chikhodzodzo mpaka impso
• Chiberekero chimawonjezeka - chikhodzodzo chikamatsika ndikudina m'thupi. Izi zimapangitsa kink mu urethra, yomwe imalepheretsa mkodzo kutuluka mu chikhodzodzo.

Kwa mwana, zizindikilo za vuto nthawi zambiri zimapezeka asanabadwe panthawi yomwe ali ndi pakati pa ultrasound.

Matenda amkodzo m'mwana wakhanda amatha kuwonetsa impso. Mwana wachikulire yemwe amabwerezanso matenda opitilira mkodzo ayeneranso kuyang'anitsitsa kutseka.

Matenda opitilira kwamkodzo nthawi zambiri amakhala chizindikiro chokhacho chavutoli.

Zizindikiro zodziwika bwino kwa akulu zimaphatikizapo:

• Ululu wammbuyo
• Nseru, kusanza
• Malungo
• Muyenera kukodza pafupipafupi
• Kuchepetsa mkodzo
• Magazi mkodzo
• Kusadziletsa kwamikodzo

Mayeso otsatirawa atha kuwonetsa hydronephrosis yamayiko awiri:

• CT scan pamimba kapena impso
• IVP (imagwiritsidwa ntchito pafupipafupi)
• Mimba (fetal) ultrasound
• Kujambula kwatsopano
• Ultrasound pamimba kapena impso

Kuyika chubu mu chikhodzodzo (Foley catheter) kungatsegule kutsekeka. Mankhwala ena ndi awa:

• Kutulutsa chikhodzodzo
• Kuchepetsa kupanikizika poyika machubu mu impso kudzera pakhungu
• Kuyika chubu (stent) kudzera mu ureter kulola mkodzo kutuluka kuchokera ku impso kupita ku chikhodzodzo

Zomwe zimayambitsa kutsekeka ziyenera kupezeka ndikuchiritsidwa mkodzo utatha.

Kuchita opaleshoni mwana ali m'mimba kapena atangobadwa kumene kumatha kukhala ndi zotsatira zabwino pakukweza impso.

Kubwereranso kwa ntchito yaimpso kumatha kusiyanasiyana, kutengera kutsekeka kwake kulipo.

Kuwonongeka kosasintha kwa impso kumatha kubwera chifukwa cha zomwe zimayambitsa hydronephrosis.

Vutoli nthawi zambiri limapezeka ndi wothandizira zaumoyo.

Ultrasound panthawi yoyembekezera imatha kuwonetsa kutsekeka kwamitsempha ya mwana. Izi zimapangitsa kuti vutoli lichiritsidwe ndi opaleshoni yoyambirira.

Zina zomwe zimayambitsa kutsekeka, monga miyala ya impso, imatha kuzindikiridwa msanga ngati anthu azindikira zizindikiro za vuto la impso.

Nkofunika kulabadira mavuto ambiri ndi pokodza.

Hydronephrosis - wapawiri

• Thirakiti lachikazi
• Njira yamkodzo wamwamuna

Mkulu JS. Kutsekedwa kwa thirakiti. Mu: Kliegman RM, Stanton BF, St. Geme JW, Schor NF, olemba. Nelson Textbook of Pediatrics. Wolemba 20th. Philadelphia, PA: Elsevier; 2016: chap 540.

Frøkiaer J. Kutsekeka kwa kwamikodzo. Mu: Skorecki K, Chertow GM, Marsden PA, Taal MW, Yu ASL, olemba. Brenner ndi Rector a Impso. 10th ed. Philadelphia, PA: Elsevier; 2016: chap 38.

Gallagher KM, Hughes J. Kutsekeka kwa thirakiti. Mu: Feehally J, Floege J, Tonelli M, Johnson RJ, olemba. Chachikulu Chachipatala Nephrology. Lachisanu ndi chimodzi. Philadelphia, PA: Elsevier; 2019: chap 58.

Nakada SY, SL Yabwino Kwambiri. Kuwongolera kutsekemera kwapamwamba kwamikodzo. Mu: Wein AJ, Kavoussi LR, Partin AW, Peters CA, olemba. Urology wa Campbell-Walsh. 11th ed. Philadelphia, PA: Elsevier; 2016: chap 49.