Phakathi kwezifo ze-urinary system, reflux vesicoureteral kwenzeka njalo. I-pathology ithinta kakhulu izingane kanye nabantu asebekhulile. Ukutholakala kwezifo kuyinkimbinkimbi ngokungabikho kwezimpawu ezibonakalayo ezigabeni zokuqala zokugula.
Yini i-reflux ye-vesicoureteral?
I-reflux ye-vestiva ebizwa ngokuthi i-vestide ngokuvamile ibhekwa njengesiyaluyalu lapho i-current reverse yomchamo eyenzeka khona. I-Reflux ye-urine, ukudluliselwa ku-ureter nezinso zenziwa ngaphansi kwengcindezi, okuphazamisa ukusebenza kwe-valve ye-vesicle ye-ureter. Lokhu kwenzeka njalo lapho isikhumba siphuphuma, ngenxa yokuthi, ngokuhamba kwesikhathi, kungase kube khona ushintsho emandleni alo mzimba.
Ngokuvamile, ukucindezela okwandayo esiqandisini njengoba kugcwaliswa kufanele kubangele ukuthi ivalve ivaliwe. Kodwa-ke, nge-reflux, lokhu kwakhiwa kubonakalisiwe noma kunobuthakathaka, okubangela ukutholakala kwamaminithi okuqhubekayo. Ukukhipha umchamo kungenziwa kokubili ngesikhathi sokuvuthwa nangesikhathi sokugcwalisa isisu. Lesi sifo isikhathi eside asibonisi ngokwaso futhi siyatholakala lapho sihlola izitho zesikhumba esincane.
I-reflux ye-vesicoureteral esebenzayo
Ngalolu hlobo lwe-pathology, i-reflux yomchamo ivele kuphela ngesikhathi sokuchama. Imisipha yesikhumba isondela emoyeni, ngenxa yalokho, umchamo uchithelwa emaqenjini futhi uqhubeke nezinso. Ngesikhathi esifanayo, kubelwe ngaphandle. Ngakho-ke lo muntu uzizwa engakhululekile emkhakheni wokuhamba, ezinhlangothini. Leli fomu lokukhubazeka lingenxa yokungafaneleki kwe-valve esesithombeni se-ureter, esivezwe ngesikhathi sokuhlolwa okuphelele.
Reflux ye-vesicoureteral encane
I-reflux encane ibhekisela ekudluliseni umchamo kusuka kwesinye isilwane kuya ku-ureters, okwenzeka ngesikhathi sokugcwalisa isitho somchamo. Ngalolu hlobo lwe-pathology, ukungakwazi ukusebenza kwe-valve kubonakala kakhulu, ngakho ukungena komchamo ku-ureters nezinso kwenzeka njalo. Umthamo we-urine ubuyela emuva ungenxa yezinga lokukhubazeka, isivumelwano sokwelashwa kwesibindi, nesimo se-valve uqobo.
I-reflux yesikhumba / i-ureter idala
Ngokuya ngesikhathi sokuthuthukiswa kwalesi sifo, reflux ye-vesicoureteral eyinhloko neyesibili ayodwa. Indlela oyinhloko yokwelapha isho ukuthi lesi sifo siwumphumela we-anomalies engavamile futhi sakhiwe esiteji sokuthuthukiswa kwe-intrauterine - reflux ye-vesicoureteral ye-congenital. Ukucindezela okwandayo esiqandisini ngokulondoloza okwanele kwe-orifice eholela ekuphukeni, okwenza umchamo reflux, izimbangela zazo zingaba kanje:
- ukuphindaphindiwe kokubili;
- i-dystopia emlonyeni;
- ukuphuza komlomo;
- umhubhe omfushane we-submucosal we-intravesical ureter.
Ifomu lesibili le-reflux ye-vesicoureteral ivela ngokumelene nesizinda sezinye izimo ze-pathological ohlelweni lwe-urinary. Phakathi kwezizathu ezivamile:
- isakhiwo se-urethra;
- stenosis entanyeni yesisu;
- i-adenoma ye-prostate;
- i-cystitis ;
- ukugwinya kwesisindo;
- umonakalo ku-orifice ye-ureteric ngesikhathi sokuhlinzwa.
Izimpawu ze-reflux zomshoshaphansi
I-symptomatology yesifo ivame ukufihlwa. Kulezi zibonakaliso ezingenzeka, kodwa hhayi ezigunyazayo zesifo, odokotela banikeza ubuhlungu obunzima, obubuhlungu emhlane ongezansi, obonakala ngokushesha ngemva kokuba isilazi sikhishwe. Izingane zingabhekisela ebuhlungu emathunjini aphansi, ubuhlungu.
Izimpawu zalesi sifo zibangelwa isigaba senqubo yokwelapha. Ngokuvamile, konke kuncike kwisiteji sokuthuthukiswa kwe-reflux ye-vesicoureteral, izinga laso lingaba kanje:
- I-degree eli-1 - umchamo ubuyela emuva, awufinyeleli esikhwameni;
- 2 degree - reflux ifinyelela izinso;
- I-3 degree - i-dilates i-ureter;
- I-degree 4 - i-geometry yepheshana lomchamo iphazamiseka, i-crimp ivela;
- I-degree 5 - i-parenchyma yamaphoyinti i-thinned, zonke izinguquko ezingenhla zikhona.
Izikhalo ezivela ezigulini odokotela zivame ukuzwa njalo ngokuthuthukiswa kwe-pyelonephritis. Kulokhu, kubonakala:
- ukushisa komzimba okwandisiwe;
- ubuhlungu besisu;
- ukuwohloka kwenhlalakahle jikelele;
- i-clouding yomchamo.
Ezimweni eziningi, i-PMR itholakale kuphela esigabeni sokuthuthukiswa kwezinkinga nezinye izinkinga, phakathi kwazo:
- i-cystitis ephindaphindiwe (ukuphuthuma ngokushesha kwe-urinary ezinxenyeni ezincane);
- i- pyelonephritis engapheli (ukukhwabanisa, isitayela esingenalutho esifundeni se-lumbar, izinga lokushisa alikho ngaphezu kwama-degree angu-38);
- enuresis.
Isisindo nesiguli se-reflux - ukuxilongwa
Esikhathini esingenakuqhathaniswa sokuxilongwa kwe-reflux ye-vesicoureteral, i-ultrasound yezinso kufanele isetshenziswe. Ucwaningo lungenziwa ngisho nangaphambi kokubonakala komntwana (reflux eyinhloko). Isiboniso sokuhlolwa okuphelele kwe-urological kungase kube ukukhulisa kwe-pelvis (esilinganisweni esingaphezu kwe-5 mm). Ukuhlolwa okuphelele uma kunezinsolo zokugula kufanele kufaka izifundo ezilandelayo:
- izindlela zokubhubhisa: ukuhlaziywa komchamo jikelele, ukuhlolwa kwegazi, isiko lesibhaktheriya;
- i-radioisotope i-renography;
- nephroscintigraphy enamandla;
- uroflowmetry;
- urography ;
- Mikrotsionnaya cystourethrography;
- i-cystoscopy.
I-reflux yama-chlamydial - ukwelashwa
Ukukhipha i-reflux ye-vesicoureteral, ukwelashwa kuqondiswa ekuqedeni izici ezimbili ezilimazayo:
- umthelela we-hydrodynamic ngenxa yomsindo okhuphukisiwe esilwaneni;
- izifo eziphindaphindiwe ze-urinary.
Noma ngabe yikuphi ukuphazanyiswa, ukungenelela kokwelashwa kuqala ngezindlela zokuzimela ezihlanganisa:
- Ukulungiswa kwezinkinga zemetabilesi esiqandisini kanye ne-ureter (Pikamilon, Elkar).
- Ukuvimbela nokwelashwa kokutheleleka kohlelo lwe-genitourinary - uroseptics , antibiotics, phytotherapy (iTetracycline, Metronidazole, Ciprofloxacin).
- Ukuqedwa kwe-urodynamics.
I-reflux ye-swell-ureteral - izincomo zomtholampilo
Uma ukubuya komchamo kungenxa ye-pathology ye-orifice ye-ureteral, indlela yodwa yokuphatha ngayo ukuhlinzwa. Esikhathini sayo, ukubuyiselwa komsebenzi we-valve we-ureter kwenziwa ngokufakelwa kabusha izicubu futhi ukwakha i-valve ngendlela yokufakelwa. Nge-MTCT yesibili, ukwelashwa okulungile kwezifo ezibangele ukukhubazeka (ukutheleleka kwamagciwane omgogodla kanye nomchamo, ukukhubazeka kwesibindi) kuyadingeka. Amathuba okunyamalala kwesifo emva kokuqedwa kwezimbangela zingase zifinyelele ku-70%.
Ukulungiswa kwe-endoscopic ye-reflux ye-vesicoureteral
Uma kungabikho umphumela wokwelashwa okulondolozayo, lapho kungenakwenzeka ukuqeda reflux vesicoureteral, lo msebenzi iba yindlela yokwelapha kuphela. Ngokuvamile, indlela endoscopic isetshenziswa. Nge-lumen of the ureters, ngaphandle kokucubungula esikhumbeni, ukufakelwa kwe-gel kufakwe endaweni engasetshenzisiwe ye-ureter. Yakha i-tubercle, eyenza njenge-valve, ukuvimbela ukudluliswa komugqa emuva kwesibhanzana ibe ngumbhalo.