Yog tias peb tig mus rau WHO cov txheeb cais, peb tuaj yeem pom tias ntawm tag nrho cov kab mob raum, pyelonephritis nyob hauv txoj haujlwm tseem ceeb. Yuav luag txhua tus neeg thib ob tau kuaj pom tias muaj mob pyelonephritis latent. Qhov txaus ntshai ntawm tus kab mob no yog tias nws tuaj yeem ua rau lub raum tsis ua haujlwm. Qhov kawg no txo qis lub neej zoo thiab qee zaum ua rau tuag.
Nyob rau hauv tsab xov xwm peb yuav nthuav qhia qhov kev faib tawm tseem ceeb ntawm pyelonephritis tau txais los ntawm WHO (World He alth Organization). Xav txog cov yam ntxwv ntawm tus kab mob, cov ntaub ntawv txheeb cais. Cia peb piav qhia txog cov kab mob sib txawv hauv kev faib tawm.
Qhov no yog dab tsi?
Ua ntej xav txog kev faib tawm ntawm pyelonephritis, cia peb nthuav qhia txog tus kab mob no. Qhov no yog lub npe ntawm cov txheej txheem inflammatory ntawm tus kab mob uas tshwm sim nyob rau hauv cov ntaub so ntswg interstitial thiab tubules ntawm ob lub raum. Tib lub sijhawm lossis tom qab ntawd, nws tuaj yeem cuam tshuam rau parenchyma thiab pelvis ntawm lub raum. Thaum nws kawg theem, tus kab mobtxuas mus rau glomeruli thiab cov hlab ntsha ntawm lub cev.
Pyelonephritis feem ntau kuj yog hu ua kab mob ntau yam ntawm interstitial nephritis.
Cov ntaub ntawv txheeb cais
Tom ntej no, peb yuav nthuav qhia WHO kev faib tawm ntawm pyelonephritis. Tab sis ua ntej, cia peb tshaj tawm cov txheeb cais ntawm World He alth Organization txog tus kab mob no:
- Cov kab mob raum uas muaj ntau tshaj plaws hauv txhua pab pawg hnub nyoog. Raws li rau cov menyuam yaus, pyelonephritis nyob ntawm qhov chaw thib 2-3 nyob rau hauv cov nqe lus ntawm kev nthuav dav, thib ob tsuas yog rau cov kab mob ua pa.
- Ntawm cov neeg laus, pyelonephritis tau kuaj pom hauv 100 ntawm 100 txhiab tus neeg. Ntawm cov menyuam yaus - 480-560 tus neeg ntawm 100 txhiab.
- 60-75% ntawm cov neeg mob yog cov hluas, cov hnub nyoog nruab nrab (30-40 xyoo). Tus kab mob feem ntau tshwm sim hauv lawv tom qab defloration, cev xeeb tub, tom qab yug me nyuam.
- Hauv cov menyuam yaus, qhov tshwm sim ntawm pyelonephritis tshwm sim thaum muaj hnub nyoog 2-3 xyoos.
- Raws li "poj niam txiv neej" ntawm tus kab mob, feem ntau yog poj niam. Pyelonephritis tau kuaj pom ntau zaus hauv cov ntxhais dua li cov tub. Cov qauv no txuas ntxiv nrog lub hnub nyoog. Cov poj niam hluas raug tus kab mob 4-5 zaug ntau dua li cov txiv neej. Qhov no tau piav qhia los ntawm cov yam ntxwv anatomical ntawm lub genitourinary system.
- Provokes pyelonephritis feem ntau urolithiasis, urethral nruj, mob prostatitis, txawv txav ntawm lub raum thiab cov zis. Raws li rau cov txiv neej laus, tus kab mob tuaj yeem ua rau cov qog prostate loj hauv lawv, uas ua rau nws nyuaj rau cov zis tawm ntawm ob lub raum thiab cov zis.kub.
International Classifier of Diseases
Yog tias peb tig mus rau kev faib tawm ntawm pyelonephritis hauv ICD-10, peb yuav pom tias tus kab mob no tsis tau sau tseg hauv phau ntawv siv raws li tus kab mob sib cais. Nws belongs rau subclass ntawm pathologies ntawm tubulointerstitial raum apparatus. Pyelonephritis hauv ICD-10 tuaj yeem pom nyob rau hauv cov lej N10-N13.
Cia li xav txog tej xwm txheej tshwj xeeb:
- N10. Tubulointerstitial mob nephritis. Muaj kab mob sib kis nephritis, pyelonephritis thiab pyelitis.
- N11. Tubulointerstitial chronic nephritis. Cov qeb muaj xws li tib yam interstitial nephritis, pyelonephritis thiab pyelitis. Muaj ntau pawg ntxiv ntawm cov kab mob uas tau teev tseg: N11.0 - cov keeb kwm tsis muaj kev cuam tshuam, cuam tshuam nrog reflux, N11.1 - obstructive forms (tshwj tsis yog pyelonephritis, uas cuam tshuam nrog urolithiasis), N11.2 - lwm hom kab mob, N11. 3 - Cov ntaub ntawv loj ua rau cov kab mob ntev.
- N12. Tubulointerstitial kab mob, nyob rau hauv cov ntaub ntawv twg nws yog tsis yooj yim sua kom qhia nws daim ntawv - mob los yog ntev.
- N13. Ntau tus kab mob obstructive, uas obstructive pyelonephritis thiab urolithiasis sawv.
Kev faib tawm ntawm pyelonephritis
Tus kab mob no yog tus yam ntxwv los ntawm ntau txoj hauv kev kis tus kab mob, cov ntaub ntawv, xwm txheej ntawm chav kawm thiab lwm yam tseem ceeb rau cov kws kho mob tshwj xeeb. Yog li ntawd, nephrologists txiav txim siab los qhia ib qho gradation. Nws tau tshaj tawm nyob rau xyoo 1974 ntawm Thawj Pawg Thawj Tswj Hwm All-Union ntawm Nephrologists.
Qhov no yog kev faib tawm ntawm pyelonephritis raws li Lopatkin N. A., Rodman V. E. Cov hom kab mob hauv qab no yog qhov txawv:
- ib leeg ib sab thiab ob sab.
- mob thiab mob ntev.
- Pib thiab theem nrab.
- Kuv muaj ib tug heev thiab purulent.
- YHematogenous thiab urinogenic.
- Kev tsis sib haum xeeb thiab tsis muaj kev cuam tshuam.
Muaj cais cais ntawm tus mob pyelonephritis:
- Pib acute.
- Secondary acute.
- mob pyelonephritis hauv cov poj niam cev xeeb tub.
- YApostematous pyelonephritis.
- Kidney carbuncle.
- Kidney abscess.
Kev faib tawm ntawm tus mob pyelonephritis muaj raws li hauv qab no:
- Ua tau daim ntawv mob ntev.
- YPyonephrosis.
- Paranephritis.
- Necrosis ntawm lub raum papilla.
Cia peb paub txog cov kab mob uas nthuav dav.
Ntau lub raum cuam tshuam
Raws li tus naj npawb ntawm lub raum cuam tshuam, kev faib tawm ntawm pyelonephritis yog raws li hauv qab no:
- ib leeg ib sab.
- ob leeg.
Hauv thawj kis, ib lub raum raug cuam tshuam, hauv qhov thib ob - ob. Qhov kev gradation no yog ib yam rau ob qho tib si mob thiab mob ntev ntawm pyelonephritis.
Tau kawg, nrog rau qhov kev tsis sib haum xeeb ntawm tus kab mob, nws qhov kev cia siab yog qhov zoo dua, vim tias ib lub raum noj qab haus huv muaj peev xwm muab kev ua kom zoo ntawm lub cev ntawm cov co toxins thaum muaj mob. Txwv tsis pub, pyelonephritis feem ntau yoghloov mus ua teeb meem.
Muaj xwm txheej tshwm sim
Kev faib tawm ntawm pyelonephritis raws li cov xwm txheej tshwm sim:
- Pib.
- Secondary.
Nyob rau hauv thawj daim ntawv, cov kab mob pathogenic muaj kev cuam tshuam tsis zoo rau lub raum tam sim ntawd tom qab nws nkag mus rau hauv lub cev. Nyob rau hauv cov ntaub ntawv ntawm ob pyelonephritis, ib tug kab mob inflammatory txheej txheem twb tsim nyob rau hauv tej qhov chaw ntawm lub cev. Yog li ntawd, cov kab mob los ntawm nws, los ntawm kev tsiv teb tsaws, nkag mus rau hauv lub raum noj qab nyob zoo, ua rau lawv o.
txoj kev kis kab mob
Raws li kev faib tawm no, txoj hauv kev ntawm kev kis tus kab mob ua rau pyelonephritis tuaj yeem ua raws li hauv qab no:
- YUrinogenic.
Nyob zoo ib tsoom phooj ywg.
Nws yog ib qho tseem ceeb uas yuav tsum nco ntsoov tias homogeneous (los ntawm cov ntshav) txoj kev kis kab mob yog cov yam ntxwv ntawm tus mob pyelonephritis. Nyob rau hauv cov ntaub ntawv no, cov txheej txheem inflammatory yuav nyob rau hauv lub cortex, nyob ib ncig ntawm lub intralobular hlab ntsha.
Urinogenic (los ntawm cov zis) kab mob yog ib yam, feem, rau mob pyelonephritis. Pathogenic microflora tsiv ntawm no los ntawm cov zis qis, txav mus raws phab ntsa lossis lumen ntawm lub ureter.
Nyob rau hauv rooj plaub no, qhov chaw ntawm qhov mob yuav ua rau kiv cua. Lawv zoo li wedges, nyob rau hauv lub taub hau ntawm lub plab mog, thiab lub hauv paus - mus rau sab nrauv ntawm lub raum. Feem ntau, nrog rau urinogenic pyelonephritis, nws yog ua ntej los ntawm cystitis lossis urethritis.
Us dej patency
Ntawm no tus kab mob no kuj yogsawv cev hauv kev faib ua ob hom:
- Kev tsis sib haum.
- Tsis muaj kev cuam tshuam.
Feem ntau, kev cuam tshuam (kev thaiv) raug kuaj pom thaum cov kab mob kis tau mus rau hauv lub raum raws cov phab ntsa ntawm lub ureter. Qhov no ua rau qhov mob ntawm qhov kawg, uas ua rau cov phab ntsa nqaim, txo qis hauv lumen ntawm lub ureter.
Raws li, nyob rau hauv daim ntawv obstructive, pyelonephritis loj hlob sai thiab hnyav dua. Tus kab mob no tuaj yeem ua rau muaj kev lom zem ntau ntawm lub cev, vim tias cov zis tso zis tsis yooj yim. Nws yuav tsum tau hais tias urostasis (stagnation ntawm cov zis) tsim cov kev mob zoo rau kev loj hlob ntawm pathogenic microflora. Thiab lom lub cev nrog cov khoom lag luam metabolic ua rau lub cev tsis muaj zog.
Ib yam mob
Muaj ob hom pyelonephritis hauv pawg no:
- Serous.
- Purulent. Hom no suav nrog daim ntawv apostematous, lub raum abscesses thiab carbuncles.
Raws li kev txheeb cais, thawj qeb ntawm tus kabmob yog suav tias ntau dua. Serous pyelonephritis - 70% ntawm tag nrho cov mob, purulent - 30%. Nrog serous o, muaj ib tug thickening, o ntawm lub raum. Lub cev yog pom kev nruj. Nyob rau hauv parenchyma, foci ntawm infiltration nyob ib ncig ntawm cov hlab ntsha. Nws yog ib qho tseem ceeb uas yuav tsum nco ntsoov tias daim ntawv serous tuaj yeem hloov mus ua purulent ib zaug.
Purulent pyelonephritis yog tus cwj pwm los ntawm kev ua tsis ncaj ncees, uas muaj ntau yam suppurations tsim. Leukocytes tau sau tseg hauv infiltrates,neutrophils, cell tuag. Cov kab mob pathological no compresses lub raum tubules.
Carbuncle ntawm no yog ib qho ntawm ntau yam ntawm apostematous pyelonephritis. Ntau precisely, qhov no yog nws lub ntuj kawg theem. Nws yog ib tug loj purulent tsom. Txawm hais tias tus neeg mob rov qab ua tiav, qhov degree ntawm pyelonephritis yog fraught nrog qhov tshwm sim tsis zoo, vim tias lub raum tuag tau hloov los ntawm cov ntaub so ntswg. Thiab qhov no ua rau lub raum tsis ua haujlwm ntxiv.
Kev faib tawm ntawm daim ntawv mob hnyav
Kev faib cov kab mob pyelonephritis nyob rau hauv cov neeg laus, peb yuav nthuav qhia ntxiv. Tam sim no xav txog qhov gradation ntawm tus kab mob hnyav:
- Pib ntsim. Yog li nyob rau hauv kev kho mob ib puag ncig lawv hu ua pyelonephritis, uas tsim tsis muaj ib tug yav dhau los kab mob ntawm lub raum los yog genitourinary system. Nrog rau daim ntawv no ntawm tus kab mob, cov kab mob microflora nkag mus rau hauv lub raum los ntawm txoj kev hematogenous (hauv lwm lo lus, los ntawm cov ntshav) los ntawm cov kab mob thiab cov kab mob inflammatory foci nyob hauv lub cev.
- Secondary acute. Daim ntawv ntawm pyelonephritis no tuaj yeem ua ntej los ntawm cov hauv qab no: urinary kab mob txawv txav, zais zis pob zeb, cev xeeb tub, nruj ntawm ob lub kwj dej thiab ureter, prostate o. Hauv cov menyuam yaus, cov kab mob hemodynamic ntxiv tau muab faib.
- mob pyelonephritis hauv cov poj niam cev xeeb tub. Nws loj hlob kwv yees li ntawm ib nrab thib ob ntawm lub sijhawm cev xeeb tub. Tus kab mob provokes siab ntawm lub tsev menyuam loj hlob nyob rau hauv lub ureters, asymptomatic bacteriuria, txo suab nrov ntawm lub urinary ib ntsuj av, raws li ib tug tshwm sim ntawm neurohumoral.hloov hauv lub cev.
- Apostematous form. Qhov no yog ib qho mob ntawm ib tug purulent xwm. Ntau pustules yog tsim nyob rau hauv lub raum cortex. Qhov no yog theem lossis teeb meem ntawm tus mob pyelonephritis theem nrab. Qhov tshwm sim ntawm tus kab mob metastatic (kis) nrog tus kab mob pyogenic.
- raum kab mob. Purulent-necrotic lesion ntawm lub cev. Ib qho txwv infiltrate yog tsim nyob rau hauv lub raum cortex. Nws kuj tseem yuav yog tus kab mob tseem ceeb, qhov tshwm sim ntawm cov kab mob loj heev tsiv teb tsaws los ntawm kev ua kom pom kev mob.
- Kidney abscess. Ib daim ntawv tsis tshua muaj.
Kev faib tawm ntawm daim ntawv mob ntev
Cia peb xav txog qhov kev faib tawm ntawm cov kab mob pyelonephritis ntev:
- Ua tau daim ntawv ntev. Qhov tshwm sim ntawm mob pyelonephritis. Qhov no yog ua kom yooj yim los ntawm qhov ua rau muaj kev cuam tshuam rau cov zis tawm ntawm cov zis uas tsis tau muab tshem tawm hauv lub sijhawm, tsis tsim nyog, kev kho mob tsis txaus ntawm daim ntawv mob hnyav, kev tiv thaiv kab mob, kab mob loj, kab mob nrog cov kab mob uas tiv taus kev kho mob, nyob hauv. ib daim ntawv uas tsis ua haujlwm.
- YPyonephrosis. Thermal theem ntawm purulent-destructive daim ntawv ntawm tus kab mob, ob qho tib si tshwj xeeb thiab nonspecific.
- Paranephritis. Kev kis tus kab mob mus rau cov ntaub so ntswg perirenal.
- Necrosis ntawm lub raum papillae. Qhov tshwm sim ntawm exacerbation ntawm mob pyelonephritis. Qhov tshwm sim ntawm ob qho embolism ntawm cov hlab ntsha los ntawm pathogenic microflora, los yog qhov tshwm sim ntawm compression ntawm cov hlab ntsha los ntawm infiltrate.
theem ntawm tus kab mob
Koj paub txog WHO kev faib tawm ntawm pyelonephritis ntev. Nyob rau hauv nws cov chav kawm, tus kab mob no tshwm sim nyob rau hauvpeb theem:
- Spicy.
- Lub sijhawm latent mob.
- Remission (tej zaum yuav ua tiav lossis tsis tiav).
theem ntawm tus kab mob tau lees paub tias mob hnyav raws li kev soj ntsuam ntawm tus neeg mob cov ntshav thiab zis, kuaj pom cov tsos mob. Raws li rau theem latent, thaum nws txuas ntxiv, tus kab mob tsis tshwm sim nws tus kheej hauv txhua txoj kev. Cov tsos mob hauv tsev kho mob tsis tau hais tawm, uas ua rau nws tuaj yeem txiav txim siab cov txheej txheem inflammatory sluggish.
Cov kev xaiv kom xaus tus kab mob yog raws li hauv qab no:
- Nyob zoo tus neeg mob.
- Kev hloov ntawm daim ntawv mob mus rau ib tus mob ntev.
- Kev txhim kho ntawm theem nrab nephropathy.
- Kev kuaj mob raum qis qis.
Yuav tshwm sim ntawm tus kab mob muaj raws li hauv qab no:
- YUrosepsis.
- mob raum tsis ua haujlwm.
- mob raum tsis ua haujlwm.
Kev faib rau menyuam yaus
Tsis muaj qhov sib txawv ntawm no. Kev faib tawm ntawm pyelonephritis hauv cov menyuam yaus zoo ib yam li cov neeg laus. Tus kab mob no tau muab faib ua ib pawg:
- Pib thiab theem nrab.
- mob thiab mob ntev.
- Kev tsis sib haum xeeb thiab tsis muaj kev cuam tshuam.
Koj twb paub txog cov yam ntxwv ntawm cov npe ntawm cov kab mob pyelonephritis.
YPyelonephritis yog ib hom kab mob raum loj heev. Koj paub nws lub ntsiab ntau yam, uas muaj lawv tus yam ntxwv.
