Ib lub raum pob zeb hauv tus menyuam yaus yog qhov tshwm sim tsis tshua muaj piv rau qhov tsim zoo sib xws hauv cov zis ntawm tus neeg laus. Txawm li cas los xij, cov menyuam yaus tuaj yeem tau pob zeb raum, tseem hu ua urolithiasis lossis nephrolithiasis.
Thiab lub pob zeb nws tus kheej, zoo li hauv cov neeg laus, yog ib qho tsim muaj qee cov ntsev thiab cov organic tebchaw uas muaj nyob hauv cov zis. Cov kab mob no feem ntau tshwm sim los ntawm cov kab mob metabolic, tab sis lawv tuaj yeem yog qhov sib txawv heev.
Vim kev kawm
Nws ntseeg tias yog muaj pob zeb hauv lub raum hauv cov menyuam yaus, yog vim li cas yog congenital anomalies nyob rau hauv cov qauv ntawm ob lub raum thiab urinary tract.
Qhov tseeb, kev tshawb fawb tau pom tias cov kev tsis txaus ntseeg no yog qhov ua rau urolithiasis hauv tsuas yog 48% ntawm cov neeg mob. Tib lub sijhawm, yam xws li:
- genetic predisposition rau tus kab mob no;
- yam khoom ua ntej;
- qhov cuam tshuam ntawm ntau yam teeb meem ntawm niam lub cev thaum cev xeeb tub thiab ua ntej nws (qhov no tsis tas yuav haus luam yeeb, tej zaum ua haujlwmhauv chemical industries);
- cev xeeb tub nrog cov teeb meem, mob hnyav toxicosis lossis preeclampsia.
Nws yog qhov nthuav tias kev pub niam mis lossis, qhov sib txawv, kev pub mis nrog cov khoom sib xyaw ua ke tsis cuam tshuam rau cov txheej txheem ntawm kev tsim pob zeb. Thaum tus menyuam loj hlob tuaj, cov zaub mov tsis tu ncua tseem ua lub luag haujlwm tsis zoo, nrog rau kev tsim txom cov khoom noj ceev thiab khoom noj yooj yim.
Tshwj xeeb tom qab hnub nyoog, cov kab mob enzymatic, hyperthyroidism, thiab kab mob raum tuaj yeem ua lub luag haujlwm tsis zoo. Nws yuav tsum raug sau tseg tias urolithiasis feem ntau ua ke nrog pyelonephritis ntev, tab sis nws tsis yog lub hauv paus ua rau nws txoj kev loj hlob.
pob zeb raum rau menyuam yaus hnub nyoog 2 xyoos pom tsis tshua muaj. Feem ntau, thawj cov cim qhia ntawm urolithiasis yog kho tom qab, tshwj tsis yog nws txoj kev loj hlob tiag tiag cuam tshuam nrog congenital anomalies ntawm lub hauv nruab nrog cev los yog nrog ib tug genetic predisposition.
Muaj ib txoj kev xav tias thaum menyuam yaus, thawj qhov ua rau pob zeb tsim tuaj yeem yog kab mob urinary, uas yuav siv sijhawm ntev. Hauv kwv yees li 62-65% ntawm cov neeg mob, cov pob zeb hauv lub raum tau pom hauv tus menyuam hnub nyoog 3 xyoos lossis laus dua me ntsis.
Cov tsos mob ntawm lub raum pob zeb hauv cov menyuam yaus
Cov tsos mob tseem ceeb ntawm urolithiasis yog mob. Muaj ntau txoj hauv kev, cov cim qhia ntawm lub raum pob zeb hauv cov menyuam yaus coincide nrog cov duab kho mob ntawm tus kab mob no hauv cov neeg laus. Txawm li cas los xij, muaj qhov sib txawv tseem ceeb. Yog tias cov neeg laus muaj feem ntau yuav muaj lub raum colic, cov menyuam yaus hnov mob qhov mob uas muaj qhov sib txawv, thiab qhov no yuavNws cuam tshuam qhov kev kuaj mob ntawm urolithiasis hauv menyuam yaus. Tsis tas li ntawd, feem ntau tus me nyuam tsis tuaj yeem qhia qhov tseeb tias nws mob qhov twg.
Nyob rau hauv cov neeg laus, feem ntau, qhov mob yog feem ntau nyob rau hauv qis rov qab, thaum nyob rau hauv cov me nyuam nws muaj peev xwm muab rau lub plab. Yog li ntawd, cov niam txiv feem ntau xav tias muaj zaub mov lom, kab mob appendicitis lossis kev tawm tsam ntawm gastritis hauv qhov xwm txheej zoo li no. Tab sis yog tias qhov ntsuas qis qis, ces tus me nyuam tuaj yeem ua rau mob ceg. Cov menyuam yaus yuav muaj mob caj pas.
Yog tias muaj pob zeb raum, cov tsos mob ntawm tus menyuam yaus kuj yuav yog tus yam ntxwv. Txawm hais tias tus me nyuam tseem tsis tau qhia tias nws mob, qhov mob yuav tshwm sim los ntawm kev quaj thiab kev ntxhov siab.
Ntxiv nta
Cov tsos mob xws li:
- cim ntawm kev qaug dab peg (tsis muaj zog, qaug zog, tsis qab los);
- fever, qee zaum ua npaws;
- dysuria, uas yog, ncua lossis tsis tso zis;
- hematuria - cov tsos mob ntawm cov ntshav nyob rau hauv cov zis, cov tsos mob no qhia tau hais tias lub pob zeb tiv thaiv cov zis tawm los yog tswj kom puas cov mucous daim nyias nyias ntawm lub ureters;
- xeev siab thiab ntuav.
Daim duab kho mob no yog vim qhov tseeb tias thaum muaj hnub nyoog ntxov, urolithiasis feem ntau yog nrog los ntawm kev kis kab mob ntawm cov kab mob genitourinary. Kev hla ntawm pob zeb me me daws nrog cov tsos mob tsawg dua, thiab feem ntau pom tshwm sim.
Asymptomatic
Qee zaumtus kab mob no yuav luag asymptomatic. Yam tsawg kawg nkaus sab nraud, nws tsis tshwm sim nws tus kheej hauv txhua txoj kev yog tias lub pob zeb me me thiab tsis cuam tshuam nrog cov zis tawm.
Nws tsuas tuaj yeem kuaj pom thaum lub raum ultrasound. Qhov no yog qhov tseeb tias urolithiasis hauv cov menyuam yaus yog qhov txaus ntshai rau, txij li cov niam txiv tsis paub dab tsi txog nws (tus menyuam tsis muaj mob, tsis muaj lwm yam tshwm sim), thiab tom qab qee lub sijhawm rau lub raum tsis ua haujlwm. Txhawm rau tiv thaiv qhov no tshwm sim, koj yuav tsum mus ntsib kws kho mob tsis tu ncua.
Ntxim qab kawg, cov pob zeb calcium uas muaj ntau tshaj rau cov menyuam yaus. Tab sis lawv lwm hom - urate pob zeb thiab struvite - tau kuaj pom tsawg dua.
Kev kuaj mob raum pob zeb hauv cov menyuam yaus
Vim qhov tseeb tias qhov tshwm sim ntawm urolithiasis hauv cov menyuam yaus tuaj yeem zoo ib yam li cov tsos mob ntawm pyelonephritis, mob plab hnyuv, cystitis, mob raum thiab lwm yam pathologies, yuav tsum muaj kev kuaj mob ntxiv. Qhov no txhais tau hais tias kev sim kuaj thiab kuaj ultrasound ntawm lub raum tau ua tiav. X-ray diagnostic txoj kev yog siv. Ntawm cov no, excretory urography yog suav hais tias yog kev tshawb fawb tshaj plaws. Daim duab qhia txog tag nrho cov zis tau raug coj mus.
Yog tias qhov tso tawm ntawm lub laij lej tshwm sim, nws raug nquahu kom ua cov tshuaj muaj pes tsawg leeg ntawm pob zeb (kev tshuaj xyuas spectral, kho qhov muag crystallography ua tiav).
Kev kho mob rau urolithiasis
Yog tias lub raum pob zeb tau pom hauv cov menyuam yaus, kev kho mob tuaj yeem ua tauconservative thiab phais. Kev saib xyuas kev kho mob suav nrog ntau qhov chaw ib zaug, feem ntau yog kev kho mob ntawm qhov mob, nrog rau kev tshem tawm ntawm qhov mob thiab kev tawg ntawm pob zeb (uas yog ua tau rau cov lej me me xwb).
Thaum muaj kev tawm tsam, nws raug nquahu kom tso tseg qhov mob thawj zaug, rau qhov no, siv cov tshuaj uas tsis yog steroidal anti-inflammatory, uas suav nrog, piv txwv li, Nurofen. Cov tshuaj no tsis tsuas yog txo qhov mob xwb, tab sis kuj tiv thaiv kev loj hlob ntawm kev tawm tsam thib ob. Cov tshuaj no yuav tsum tau siv nrog ceev faj hauv cov neeg mob lub raum tsis ua haujlwm, vim tias lawv tuaj yeem ua rau tus kab mob hnyav dua. Tab sis tib lub sijhawm, lawv tsis cuam tshuam rau lub raum noj qab haus huv.
Raws li kev tawg ntawm pob zeb, kev xaiv tshuaj nyob ntawm lawv cov tshuaj muaj pes tsawg leeg. Piv txwv li, yog tias cov no yog cov pob zeb calcium, ces Lidaza, methylene xiav, thiab Furosemide yog tshuaj diuretic. Yog tias peb tab tom tham txog kev sib cais ntawm oxalate pob zeb, ces cov tshuaj fitin thiab vitamin B6. Nrog ib hom pob zeb sib xyaw, ib qho extract ntawm madder dye yog sau nyob rau hauv ntsiav tshuaj, Fitolizin (nws yog tsim nyob rau hauv cov hlab), Nieron, Cystenal, thiab lwm yam tshuaj.
Anti-inflammatory, analgesic thiab diuretic nyhuv yog muaj los ntawm xws li tshuaj ntsuab ua ke xws li Cyston, Cystenal thiab Canephron N.
Yog tias tag nrho cov txheej txheem kev saib xyuas tsis tau muab cov txiaj ntsig xav tau, ces cov pob zeb hauv lub raum raug crushed rau cov menyuam yaus lossis lwm cov txheej txheem phais siv.txoj hauv kev raws li WHO cov lus pom zoo.
Kev kho mob raum pob zeb
Kev cuam tshuam kev phais tsuas yog tso cai yog tias muaj qee yam qhia, uas suav nrog:
- mob tas li txawm hais tias tus menyuam tau noj tshuaj kho mob;
- mob raum ua haujlwm tsis zoo;
- pob zeb loj hlob tuaj;
- kev txhim kho ntawm tus kab mob thib ob;
- hematuria, uas yog, pom cov ntshav hauv cov zis, uas qhia txog kev puas tsuaj rau cov phab ntsa ntawm cov kabmob ntawm cov zis.
Ob lub hnub nyoog ntawm tus menyuam thiab "hnub nyoog" ntawm lub raum pob zeb tseem ceeb. Yog lawv tau txheeb pom 2-3 xyoos dhau los no, thiab lub sijhawm no lawv tsis tuaj yeem tawg, ces lawv yuav tsum tau ua nrog ntau txoj hauv kev.
Txoj kev phais ntau yam siv.
External lithotripsy
Nyob rau hauv xyoo tas los no, tej thaj chaw deb lithotripsy, uas yog, kev tshem tawm ntawm lub pob zeb los ntawm crushing, tau dhau mus. Nws tsis pom zoo rau txhua tus neeg mob, tab sis tsuas yog rau cov neeg thaum lub cheeb ntawm lub laij lej tsis tshaj 2.0 cm, thiab qhov kev tsim no nws tus kheej muaj qhov ntom ntom.
Nyob rau hauv lub teb chaws tsim, urological ntxhuav yog siv rau qhov no, nyob rau hauv uas niaj hnub lithotripters twb ua nyob rau hauv.
Kev cuam tshuam ntawm pob zeb nyob rau hauv rooj plaub no yog ua los ntawm kev siv cov kev kho yoj yoj, thaum nthwv dej ntawm hom no raug coj los ntawm lub pob zeb, cuam tshuam nrog qee zaus. Lub hwj chim ntawm lub nthwv dej no, nws cov yam ntxwv, tus naj npawb ntawm kev rov ua dua - tag nrho cov no yog txiav txim los ntawm tus kws kho mob tuaj koom.
Sab nrauv lithotripsy yog contraindicated nyob rau hauv hemorrhagic diathesis, nyob rau hauv lub xub ntiag ntawm ib tug tsis kho urinary tract kab mob, thiab kuj nyob rau hauv cov ntaub ntawv uas muaj loj deformities ntawm musculoskeletal system, los yog thaum ib tug me me neeg mob rog.
Hu rau lithotripsy
Yog tias nws yog ib qho kev suav loj, ces hu rau lithotripsy txoj kev siv. Ib qho ntawm feem ntau yog percutaneous nephrolithotripsy.
Nws yog siv thaum txoj kab uas hla ntawm lub laij lej siab dua 2 centimeters, lossis thaum kuaj pom tias muaj ntau lub raum pob zeb. Qee lub sij hawm nws tau ua nyob rau hauv rooj plaub uas cov txheej txheem tej thaj chaw deb tsis muab qhov xav tau.
Tab sis hom kev ua haujlwm no kuj tseem muaj contraindicated nyob rau hauv cov ntaub ntawv ntawm urinary system kab mob, nrog rau cov qog nqaij hlav ntawm tej keeb kwm.
Kev phais qhib tam sim no tsis tshua muaj tshwm sim vim lawv koom nrog kev cuam tshuam ntau tshaj plaws.
Zoo kawg
Nephrolithiasis yog ib yam kab mob loj uas yuav tsum tau txais kev kho mob tsim nyog. Kev kho tus kheej, tshwj xeeb tshaj yog cov tshuaj siv tshuaj, raws li ntau cov lus qhia, tsis tsuas yog yuav tsis tshem tawm qhov teeb meem, tab sis tuaj yeem ua rau qhov xwm txheej hnyav dua.
