Ukulimala - izinso ne-ureter

Ukulimala ezinso nase-ureter kulimaza izitho zomgudu ongaphezulu womchamo.

Izinso zitholakala ohlangothini ngalunye lomgogodla. Uhlangothi lungemuva kwesisu esingenhla. Zivikelwe umgogodla, ubambo olungaphansi, nemisipha eqinile yangemuva. Le ndawo ivikela izinso emandleni amaningi angaphandle. Izinso nazo zizungezwe ungqimba lwamafutha. Amafutha ayasiza ukuwaqinisa.

Izinso zinegazi elikhulu. Noma yikuphi ukulimala kubo, kungaholela ekopheni kakhulu. Izendlalelo eziningi ze-padding zisiza ukuvimbela ukulimala kwezinso.

Izinso zingalimala ngokulimala emithanjeni yegazi eyiphakelayo noma eyihlanzayo, kufaka phakathi:

• I-Aneurysm
• Ukuvinjelwa kwemithambo
• I-arteriovenous fistula
• I-renal vein thrombosis (ukuqina)
• Ukuhlukumezeka

Ukulimala kwezinso nakho kungabangelwa:

• I-Angiomyolipoma, isimila esingadli umdlavuza, uma isimila sikhulu kakhulu
• Ukuphazamiseka okuzenzakalelayo
• Isithintelo esidayisa isinye
• Umdlavuza wezinso, izitho zangasese (amaqanda noma isibeletho kwabesifazane), noma ikholoni
• Isifo sikashukela
• Ukwakhiwa kwemikhiqizo kadoti womzimba efana ne-uric acid (engenzeka nge-gout noma ukwelashwa komnkantsha wethambo, i-lymph node, noma ezinye izinkinga)
• Ukuvezwa kwezinto ezinobuthi ezinjengomthofu, imikhiqizo yokuhlanza, izincibilikisi, izibaseli, ama-antibiotic athile, noma ukusetshenziswa kwesikhathi eside kwemithi yezinhlungu ezisezingeni eliphakeme (i-analgesic nephropathy)
• Umfutho wegazi ophakeme nezinye izimo zezokwelapha ezithinta izinso
• Ukuvuvukala okubangelwa ukuphendula kwamagciwane emithini, ukutheleleka, noma ezinye izifo
• Izinqubo zokwelashwa ezinjengezinso biopsy, noma ukubekwa kwe-nephrostomy tube
• Ukuvinjelwa kokuhlangana kwe-Ureteropelvic
• Ukuvinjelwa kwesibeletho
• Amatshe ezinso

Ama-ureters yimibhobho ethwala umchamo kusuka ezinso kuya esinyeni. Ukulimala kwangaphakathi kungabangelwa:

• Izinkinga ezivela ezinkambisweni zezokwelapha
• Izifo ezinjenge-retroperitoneal fibrosis, i-retroperitoneal sarcomas, noma umdlavuza osakazekela kuma-lymph node eduze ne-ureters
• Isifo samatshe ezinso
• Imisebe eya endaweni yesisu
• Ukuhlukumezeka

Izimpawu zezimo eziphuthumayo zingafaka:

• Ubuhlungu besisu nokuvuvukala
• Ubuhlungu obukhulu bomgogodla nobuhlungu bomhlane
• Igazi emchameni
• Ukozela, ukwehlisa ukuqapha, kufaka phakathi ikhoma
• Ukwehla kokukhishwa komchamo noma ukungakwazi ukuchama
• Imfiva
• Ukunyuka kwenhliziyo
• Isicanucanu, ukuhlanza
• Isikhumba esiphaphathekile noma esipholile ukusithinta
• Ukujuluka

Izimpawu zesikhathi eside (ezingapheli) zingafaka:

• Ukungondleki
• Umfutho wegazi ophezulu
• Ukuhluleka kwezinso

Uma ngabe inso elilodwa kuphela elithintekile kanti elinye izinso liphilile, ungahle ungabi nazimpawu.

Umhlinzeki wezokunakekelwa kwempilo uzokuhlola. Bazise nganoma yisiphi isifo sakamuva noma uma uhlangane nezinto ezinobuthi.

Ukuhlolwa kungakhombisa:

• Ukopha ngokweqile (ukopha)
• Ubumnene obukhulu ngaphezu kwezinso
• Ukushaqeka, kufaka phakathi ukushaya kwenhliziyo okusheshayo noma umfutho wegazi owayo
• Izimpawu zokuhluleka kwezinso

Ukuhlolwa okungenziwa kufaka phakathi:

• Iskena se-CT esiswini
• I-MRI yesisu
• I-ultrasound yesisu
• I-angiography yomthambo wezinso noma umthambo
• Ama-electrolyte egazi
• Ukuhlolwa kwegazi ukubheka izinto ezinobuthi
• Qedela ukubalwa kwegazi (CBC)
• I-pyelogram efakwa emithanjeni (IVP)
• Ukuhlolwa kokusebenza kwezinso
• Phinda wenze kabusha i-pyelogram
• X-ray yezinso
• Ukuskena kabusha
• Ukuhlolwa komchamo
• Ucwaningo lwe-Urodynamic
• Ukuvala i-cystourethrogram

Izinhloso ukuphatha izimpawu eziphuthumayo nokuvikela noma ukwelapha izinkinga. Ungadinga ukuhlala esibhedlela.

Ukwelashwa kokulimala kwezinso kungafaka:

• Ukuphumula kombhede isonto elilodwa kuya kwelesibili noma kuze kwehle ukopha
• Vala ukubuka nokwelashwa kwezimpawu zokuhluleka kwezinso
• Izinguquko zokudla
• Imithi yokwelapha umonakalo odalwe yizinto ezinobuthi noma ukugula (ngokwesibonelo, ukwelashwa kwe-chelation for poisoning lead noma i-allopurinol ukwehlisa i-uric acid egazini ngenxa yegciwane)
• Imithi yezinhlungu
• Ukuqeda imithi noma ukuvezwa ezintweni okungenzeka zilimaze izinso
• Izidakamizwa ezinjenge-corticosteroids noma ama-immunosuppressants uma ukulimala kubangelwa ukuvuvukala
• Ukwelashwa kokuhluleka okukhulu kwezinso

Kwesinye isikhathi, kudingeka ukuhlinzwa. Lokhu kungafaka:

• Ukulungisa "izinso eziphukile" noma ezidabukile, imithambo yegazi edabukile, i-ureter edabukile, noma ukulimala okufanayo
• Ukususa yonke inso (nephrectomy), ukukhipha indawo ezungeze izinso, noma ukumisa ukopha nge-arterial catheterization (angioembolization)
• Ukubeka i-stent
• Ukususa ukuvinjelwa noma ukunciphisa ukuvinjelwa

Ukwenza kahle kangakanani kuya ngesizathu nobukhulu bokulimala.

Kwesinye isikhathi, izinso ziqala ukusebenza kahle futhi. Kwesinye isikhathi, ukwehluleka kwezinso kwenzeka.

Izinkinga zingafaka:

• Ukuhluleka kwezinso ngokungazelelwe, eyodwa noma zombili izinso
• Ukopha (kungaba kuncane noma kube nzima)
• Ukuqhuma kwezinso
• Ukwehluleka kwezinso okungamahlalakhona, eyodwa noma zombili izinso
• Ukutheleleka (peritonitis, sepsis)
• Ubuhlungu
• I-renal artery stenosis
• Umfutho wegazi ophezulu we-renal
• Ukushaqeka
• Ukutheleleka ngomgudu womchamo

Shayela umhlinzeki wakho uma unezimpawu zokulimala ezinso noma kwi-ureter. Shayela umhlinzeki uma unomlando we:

• Ukuchayeka ezintweni ezinobuthi
• Ukugula
• Ukutheleleka
• Ukulimala ngokomzimba

Iya egumbini lezimo eziphuthumayo noma ushayele inombolo yendawo ephuthumayo (efana ne-911) uma wehlise ukuphuma komchamo ngemuva kokulimala kwezinso. Lokhu kungaba uphawu lokuhluleka kwezinso.

Ungasiza ukuvimbela ukulimala ezinso nase-ureter ngokuthatha lezi zinyathelo:

• Qaphela izinto ezingadala ubuthi bomthofu. Lokhu kufaka phakathi upende wakudala, umhwamuko osebenza ngensimbi efakwe umthofu, notshwala obufakwe kuma-radiator ezimoto asetshenzisiwe.
• Thatha yonke imithi yakho ngokufanele, kufaka phakathi leyo oyithenga ngaphandle kokuyalelwa ngudokotela (ngaphezulu kwekhawunta).
• Ukwelapha i-gout nezinye izifo njengokuyalelwa ngumhlinzeki wakho.
• Sebenzisa imishini yokuphepha ngesikhathi somsebenzi nokudlala.
• Sebenzisa imikhiqizo yokuhlanza, izincibilikisi, namafutha njengoba kuqondisiwe. Qiniseka ukuthi indawo inomoya ongcono, ngoba nomusi ungaba nobuthi.
• Bopha amabhande bese ushayela ngokuphepha.

Ukulimala kwezinso; Ukulimala okunobuthi kwezinso; Ukulimala kwezinso; Ukulimala okubuhlungu kwezinso; Izinso eziqhekekile; Ukulimala okuvuvukalayo kwezinso; Izinso ezilinyaziwe; Ukulimala kwesibeletho; Ukwehluleka kwangaphambi kwezinso - ukulimala; Ukwehluleka kwangemva kwezinso - ukulimala; Ukuvinjelwa kwezinso - ukulimala

• Ukwakheka kwezinso
• Izinso - ukugeleza kwegazi nomchamo

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U-Okusa MD, uPortilla D. Pathophysiology wokulimala kanzima kwezinso. Ku: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal MW, ama-eds. IBrenner neRector's The Kidney. Umhla ka-11. IPhiladelphia, PA: Elsevier; 2020: isahluko 28.

Shewakramani SN. Uhlelo lweGenitourinary. Ku: Walls RM, Hockberger RS, Gausche-Hill M, ama-eds. Imithi Ephuthumayo yaseRosen: Imiqondo kanye Nokuzijwayeza Komtholampilo. Umhlaka 9. IPhiladelphia, PA: Elsevier; 2018: isahluko 40.