Vesicoureteral reflux mune vana nevakuru. Zviratidzo, nechirwere, Treatment

In urology Hauwanikwi zvirwere zvakadai vesicoureteral reflux (PMR). Zviri isingawanzowanikwi chirwere kuti anowanika kakawanda muvana. Zvisinei, zvokurwara anogona kuonekwa munzvimbo yevagari vemo vakura. Ngatitarisei chii chinoumba TMR pane zviri ngozi uye chii nzira kurwa naro.

pathography

Kuti tinzwisise zvinodzidziswa zvokurwara inonzi vesicoureteral reflux, unofanira zvishoma zvakadzama kupinda anatomi womunhu.

Dundira - negomba tsandanyama nenyere. It rakagadzirirwa kuunganidza weti kusvikira nguva kwakadaro kwakanga kusina chiito weti. The dhudhumira ane mawindo matatu. Vaviri vavo zvakabatanidzwa kune ureters. Kuburikidza Mipata iyi weti runoyerera kubva itsvo kusvika dundira. Chechitatu Buri ndechokuti nokuisa. Izvi nzvimbo urethra remubatanidzwa pamwe sefuro.

The ureters vari fanera serin'i sepombi. Vakasvika pane sefuro panguva imwe rikwanise akachinjikana. The ureters vane imwe-nzira vharafu mugadziriro chaicho. Kuti rinovatadzisa neizvi kufambira weti kupinda ureter uye kupinda itsvo. Saka hwakanaka kushanda hurongwa.

Kana munhu akanzi vesicoureteral reflux, kuti mashandiro chinodzivirira muviri kubva weti neizvi kufamba haisi kushanda. Nokudaro, weti anogona kufamba mune zvimwe. Saka, somugumisiro vasingadzoreki water drainage emura weti rinoungana iri dundira, uye ipapo wokandirwa ureters. Izvi zvinotungamirira nokunetseka, wokupedzisira epfungwa. In kwazvo siyana reflux weti anokwanisa kusvika kunyange neitsvo.

zvokurwara Zvinokonzera

The manyuko hosha haina aizvinzwisisa. Doctors raibva vesicoureteral reflux muvana vane vachiberekwa zvemamiriro kukura chidimbu ichi. Saka, havana kakawanda chirwere chikuru zvokurwara. chirwere ichi, yakabuda pakanyorwa vachiberekwa anomalies.

Vesicoureteral reflux nedzevakuru kakawanda yechipiri. budiriro chirwere ari zvinosiyana ezvinhu aripo.

Ndivo chikuru zvikonzero ichi:

• localization zvisina kufanira ureteral orifice;
• dundira diverticulum;
• umbishi smykatelnyh muromo michina;
• vachigurisira submucosal tanera intramural ureter;
• pathological chimiro muromo;
• mumwe doubling of ureter, kukonzera gwara iri kunze Triangle sefuro.

The yechipiri zvinoita inotisvitsa kukura chirwere, umo kwakakanganiswa kunowanzoitika chokubuda weti, zvinosanganisira zvinotevera zvirwere:

• dundira nzira yokubudisa mhingaidzo;
• BPH;
• kuoma dzimwe nhengo dzomuviri dundira mutsipa;
• cystitis mumiromo nzvimbo;
• stenosis kana stricture of urethra;
• zvirwere mavharuvhu urethra;
• dundira dysfunction.

kupatsanura zvirwere

Zvokurwara rakakamurwa zvitatu mhando:

1. Active PMR. chitarisiko chawo ari anopinywa chete nokuda kuita weti.
2. Pusa. It akaratidza panguva zvinodiwa dundira.
3. Mixed-basa kana pusa. Nokuti chirwere inoti dzinoratidzwa ibatanidzo apa.

Uyezve, wakaparadzaniswa nevamwe zvokurwara sekwewakaberekwa inoratidza reflux. The chirwere kunoratidza pacharo sezvo idzokororo pyelonephritis.

ukuru zvokurwara

The chirwere anogona dzinoratidzwa zvakasiyana siyana regiravhiti.

Maererano vhinza ndivo zvinotevera mwero vesicoureteral reflux:

1. Izvi mhando kunoratidzwa ne reflux kuti weti kupinda ureter pelvic mapazi. In wokutanga dhigirii pakuwedzera mugero kunoitika.
2. Reverse water drainage anofukidza ureter yose. Uyezve, pane chakakandirwa kuti weti iri mukapu, chiuno. Zvisinei, kana kushandiswa kana itsvo zvikamu zvisina kuwedzerwa.
3. Kusvikira pamwero uyu dzinoratidzwa rikaposherwa weti pyelocaliceal itsvo hurongwa. Last akawedzera zvikuru. Asi ureter hakuna kushanduka. dhayamita Its akarurama.
4. Danho iri, vaine kuwedzera uye pyelocaliceal midziyo, uye ureter somugumisiro zvakawanda weti Kudzingwa.
5. With dhigirii uku kuderedzwa itsvo chaitika. kiriniki Izvi zvinosiyana ari rive dete wedhipatimendi, ichibereka weti.

zviratidzo

Sezvineiwo, zvakaoma chaizvo kuziva vachiri padanho vesicoureteral reflux. Zviratidzo chirwere anowanzoshandurwa kumbopfeka. Ndokusaka chirwere anowanzodanwa chirwere kana kare dzakabudirira matambudziko.

Zvisinei, pane boka zviratidzo, izvo zvingazivikanwa vanofungidzirwa pakukura hosha muvana:

• underweight kwomwana muviri pakuzvarwa;
• kunonoka kwomuviri;
• nokuvhiringidzirwa kushanda dundira.

In vakuru, zvishoma zvakasiyana hwakaratidzwa vesicoureteral reflux. Zviratidzo izvo zvaizobatsira kuti chirwere, sezvo mutemo, zvinotevera:

• nokukurumidza uye kazhinji uchida urinate;
• marwadzo kusagadzikana mudumbu kana chiuno;
• zvizhinji duku weti;
• weti ramakore, ane munhuwi yakaipa;
• panguva weti anooneka inopisa chishamiso;
• aibuda weti;
• ropa iri weti;
• kakawanda usiku awakenings kuenda chimbuzi;
• fivhiri, chills;
• marwadzo ari shure, divi kumicheto.

yematambudziko chirwere

Vesicoureteral reflux kungaita kuti zvikuru nemigumisiro yakaipa. zvokurwara ichi kunowanzokonzera yechipiri maronda itsvo. Nhengo shrivel, kwave kune kuwedzera zvavo chikuru mashandiro - mupise.

Somugumisiro reflux kutyora kunowanzoitika kubviswa weti. Weti ine microbial kasvisto, chinopinda pachena kunyika ureters neitsvo. Naizvozvo, pane nguva dzose utachiona uye kuzvimba ari nhengo.

Uyezve, panguva weti nevezera kunowedzera ari chiuno munharaunda. Izvi zvinotungamirira mberi kukuvadza kuti itsvo tishu.

Kuunyana itsvo kuoma dzimwe nhengo dzomuviri nayo kukonzera neBP yechipiri. zvokurwara Izvi zvakaoma zvikuru kurapa. Kana ichi chirwere kazhinji kubvisa itsvo pamwe ureter.

chirwere chirwere

Kana Kuramba pyelonephritis iri vanofungidzirwa vesicoureteral reflux. Chirwere rinosanganisira anoverengeka kuongorora:

1. US.
2. Analysis ropa uye weti.
3. CT.
4. Cystourethrography. Kuburikidza anobudisa mushonga zvishoma nezvishoma vari dundira Urume kutaurwa. Kamwe izere, ita yaitevedzana kwepfuti. Maekisirei anoitwa panguva weti.
5. Intravenous pyelogram. In ongororo iyi, Urume kuoneka pane x-mwaranzi vari kutarisirwa nomutsinga. Muchiitiko chino, unofanira kumirira kusvikira pafuma ropa anoenda itsvo dundira.
6. Nuclear kushanda pakuvheneka. A-siyana radioactive zvinhu zvinoshandiswa kuti ongororo. Vanogona kupiwa zvakananga kupinda dundira kana tsinga. The Ongororo inoshandiswa kuona kushanda nezvezvimwe zvinetso zvedundira.

kurapa kungaitwa pane kwakajairika

chiremba chete anogona kusarudza nzira kuti tikunde zvokurwara ichi sezvo vesicoureteral reflux. Treatment nechinangwa Achabvisa zvinokonzera chirwere uye kudzivirira matambudziko.

Wakakura zvikuru mugumisiro kuti anogona kuva pamusoro pakanyorwa chirwere, - a reflux nephropathy. The zvokurwara chinhu anogumbura anoparadza kwacho kuitika ari itsvo parenchyma.

kurapwa zano kunobva zvinokonzera chirwere chacho kukuvadza.

kuchinja mabatiro

Nzira iyi ndiyo inoshanda chaizvo mukutanga nzendo chirwere. Kunyanya zvinobudirira zvakaipa vesicoureteral reflux vana. In varwere mukuru, muna 70% vose vanotanga kuvandudza.

The chikuru basa ari kuchinja mishonga yakakodzera chirwere kuzvidzora, kufukidza nezvezvimwe zvinetso zvedundira.

Treatment kunosanganisira zvinotevera:

1. Physiotherapy. Events anogona kubvisa metabolic abnormalities kuti kuitika dundira.
2. Kudomwa antibacterial zvinodhaka. Ndivo varwere pauri vari panoonekwa zvirwere zviri Urinary turakiti.
3. Kudhayeta. Varwere vari zano zvakasimba kupa kururamiswa. Diet chinoreva Kurambidzwa wokushandiswa mapuroteni uye munyu.
4. Catheterization of dundira.
5. Kushandiswa antihypertensive zvinodhaka. Ivo vanoita nemishonga iri chiitiko kuti murwere kumanikidzwa ichiwedzerwa somugumisiro wacho PMR.
6. Ndakarumbidzwa dzose weti. matanho akadaro anofanira chinozoiswa ose 2 maawa, pasinei kapfungwa kushandisa chimbuzi.

Kana vanofungidzirwa vesicoureteral reflux nevana, kurapwa kunofanira muchipatara. Pakutanga, mwana aongororwe. Mushure Pakusarudza chinokonzera chirwere, akarayira zvakakodzera kurapwa kubvisa anokonzera chirwere.

Kana nokusimbisa vachiberekwa anomalies kuvana inokurudzirwa kuvhiyiwa.

endoscopic kuvhiya

kupindira ichi inokurudzirwa kana kuchinja kurapwa Haapi aida mugumisiro zvokungokubatai vachiberekwa abnormalities vana. Zvisinei Endoscopic nokururamiswa vesicoureteral reflux rinoitwa chete pana 1, 2, 3-fung mwero chirwere. Uye akarurama kana, kana akachengetedzwa contractile basa pamuromo.

oparesheni uyu zvishoma invasive kuvhiyiwa. It kunoratidzwa zvinotevera. Under rezasi denderedzwagama muromo yokusuma rinokosha kudyara. Kunoitawo kuti kubatanidza kukwira kumusoro uye pasi muromo. Somugumisiro, mashoko pusa zvinoriumba kunosimudzirwa antireflux mashandiro.

kuvhiya kurapwa

Kuti usvinudze akavhiyiwa kuti akarwawo anotevera nyaya:

• kana kunyange kuchinja kana endoscopic kurapwa haana kupiwa unodikanwa zvabuda;
• pathologies 4 th, 5 fung dhigirii;
• kune vachiberekwa anomalies muvana vasingakwanisi kubviswa endoscopically.

Nokururamiswa vesicoureteral reflux rinoitwa kakawanda, hayo sefuro. The chinangwa chikuru wokuvhiya - ndiyo paumbwe imwe mucous Kamudzira pakati dundira apo ureter iri mupasi, runodiwa ndima.

Avhiyiwa kwakadaro kunoita imwe chipingamupinyi chinodzivirira ureter uye dundira kubva weti kuwedzera kwavari.

Kuvhiya kurapwa inopa nemigumisiro yakanaka, maererano nenhamba, 75-98% vose nyaya. Zvisinei, Kuvhiya hakusi pasina payakaipira.

The marapirwo ndiyo nzira;

• refu yokutindivadza;
• refu vapore kumwedzi;
• pakuparwa dzokororo reoperation iri zvakati kupfuura kuoma.

matanho

Pasinei reflux inonyangarika panzira yavo? Kana abnormality kunokwanisa kuonekwa mune mwana achiri Danho, chaizvoizvo unogona kuenda kukura uye kukura kwemwana. Zvisinei, anofanira kuchengeta mafufu kubva exacerbations uye zvirwere. Kana izvi zvinhu zviri akasangana, anenge 10-50% vana zvokurwara kunoitika pasina. Asi anogona kusiya ari tishu scarring.

Apo TMR 3rd dhigirii kana kwakakwirira haafaniri kuvimba kuzvipira kutsakatika. Vana ava vanoda zvakakwana kurapa, ushandiswe nachiremba.

Kudzivirira kukura uye kufambira mberi kwemashoko PMR, unofanira:

1. Time kubata zvose anogumbura zvirwere nezvezvimwe zvinetso zvedundira.
2. Chero zvaipesana weti kunoda fanira kushanyira chiremba.
3. Vakadzi vane pamuviri vanofanira kuva nechokwadi kushanyira chiremba wako. Uyezve, mukadzi kumirira mwana anofanira kuomerera mararamiro utano uye zvakakodzera, zvokudya zvinovaka muviri.

PMR - ichi chinhu chakakura zvikuru zvokurwara. chirwere ichi vanofanira kubatwa tanga, kudzivisa kunoita kwayo. Saka, hazvo, kureva vaya unyanzvi.