Tus txiv neej niaj hnub no tsis quav ntsej txog nws txoj kev noj qab haus huv. Yog tias muaj mob nraub qaum, ces qhov no feem ntau yuav ua haujlwm dhau ntawm txoj haujlwm sedentary. Kub nce? Kab mob khaub thuas thiab mob ua pa hnyav tshwm sim txhua lub sijhawm ntawm lub xyoo. Ntshai thiab ntuav? Noj ib yam dab tsi stale. Thiab txhua yam zoo li ntawd. Tib neeg qee zaum tsis kam lees qhov pom tseeb: lub cev tuaj yeem ua tsis tiav, thiab qee zaum koj yuav tsum tau mus ntsib kws kho mob kom txiav txim siab koj tus kheej.
Definition
Npaj ntawm lub raum yog ib qho mob hnyav ntawm pyelonephritis, uas yog nrog los ntawm purulent fusion ntawm lub raum cov ntaub so ntswg. Kev tsom xam loj yog tsim nyob rau hauv tus txheej txheem ntawm confluence ntawm me me inflammatory ntsiab, raws li zoo raws li thaum lub sij hawm tsim ntawm ib tug carbuncle. Ib qho tshwj xeeb ntawm cov txheej txheem no yog muaj cov tshuaj ntsiav. Nws tiv thaiv cov ntaub so ntswg noj qab haus huv los ntawm cov enzymes uas ua kom yaj txhua yam uas tau poob rau hauv thaj tsam abscess.
Raws li kev txheeb cais, ua ntej lub sijhawm ntawm cov tshuaj tua kab mob, lub ntsiab ua rau tus kab mob yog hematogenous kab mob ntawm lub cev, tab sis hnub no nws tau ploj mus rau hauv keeb kwm yav dhau. Lub luag haujlwm tseem ceeb hauv qhov saum toj no yog nyob los ntawm kev ua txhaum ntawm cov zis tawm los ntawm cov khoom siv pyelocaliceal ntawm lub raum. Cov kua dej stagnates, kis tau thiab suppurates,Cov kab mob kis mus rau parenchyma ntawm ob lub raum, qhov twg lub hom phiaj ntawm fusion yog tsim. Nrog hematogenous kis, abscesses tshwm sim nyob rau hauv ob lub raum, thiab nyob rau hauv cov ntaub ntawv ntawm impaired tso zis tawm, tsuas yog nyob rau hauv ib tug.
Yog vim li cas
Ntau tus txheej txheem pathological tuaj yeem ua rau lub raum abscess. Qhov ua rau feem ntau yog txuam nrog kev kis kab mob ntawm lub cev. Lub xub ntiag ntawm carbuncle nyob rau hauv nruab nrab ntawm pyelonephritis los yog blockage ntawm lub lumen ntawm lub ureter nrog ib lub pob zeb tsim ib tug zoo tej yam kev mob rau kev loj hlob ntawm cov kab mob. Thiab zoo li txhua yam muaj sia nyob, lawv xav tau ib yam dab tsi noj, yog li lawv "tshem" lub parenchyma ntawm lub cev. Qee qhov xwm txheej, cov kws phais mob tau sau tseg lub raum abscess tom qab phais rau urolithiasis. Nyob rau tib lub sijhawm, cov kws tshaj lij nco txog qhov ntev ntawm lub sijhawm rov qab los, tsim cov fistulas ntawm lub ureter thiab lub plab kab noj hniav.
Qee lub sij hawm, yog tias qhov abscess tsuas yog nyob ntawm ib tus ncej ntawm lub raum, kev sib cais ntawm thaj chaw no tshwm sim. Qhov no ua rau irreversible morphological hloov nyob rau hauv lub cev thiab cuam tshuam ntawm nws cov dej num. Nyob rau hauv cov ntaub ntawv kho mob, cov xwm txheej ntawm kev loj hlob ntawm lub raum abscess tom qab lub qhov txhab stab tau piav qhia. Tab sis nyob rau hauv tej rooj plaub, qhov chaw ntawm tus kab mob yog nyob rau hauv lub ntsws los yog lub plawv.
Ib qho uas twb tsim lub raum abscess muaj ob peb txoj kev loj hlob:
- Spontaneous qhib rau hauv cov ntaub so ntswg perirenal nrog tsim cov perirenal abscess.
- Tau rau hauv lub raum pelvis lossis calyx thiab ntws los ntawm ureter.
- Qhib rau hauv plab kab noj hniav thiab kev loj hlob ntawm purulent peritonitis.
- Kev hloov pauv ntawm theem mob mus raumob.
Risk factors
Rau txhua tus kab mob, muaj cov xwm txheej hauv qab no uas muaj qhov muaj feem ntau ntawm kev tsim cov txheej txheem pathological. Rau lub raum abscess, qhov no yog keeb kwm ntawm ntshav qab zib mellitus, vim qhov no endocrine pathology aggravates tag nrho cov kab mob thiab txhawb cov kab mob loj hlob. Thiab nrog ntshav qab zib hauv cov neeg mob, kev tsim cov zis ntau, uas tseem ua rau muaj kab mob hauv lub raum.
Kev cev xeeb tub, raws li kev hloov pauv ntawm lub cev lub cev, tuaj yeem ua rau kis kab mob raum cov ntaub so ntswg. Cov poj niam thaum lub sij hawm no yog qhov tshwj xeeb tshaj yog muaj kev cuam tshuam vim txo qis kev tiv thaiv. Tsis tas li ntawd, lawv tau tso zis ntau zaus, uas ua rau nws yooj yim dua rau cov kab mob pathogenic nkag mus.
Qhov thib peb - pyelonephritis. Nws hem dab tsi? Ntev, ntws nrog cov teeb meem, pyelonephritis tuaj yeem ua rau lub raum abscess. Kev cuam tshuam ntawm cov zis provokes suppuration ntawm cov ntsiab lus ntawm lub cev thiab tsim ntawm foci ntawm o. Thiab nyob rau hauv qhov chaw muaj koob meej thib plaub - thawj lossis theem nrab immunodeficiency. Tab sis qhov tshwm sim ntawm ntau qhov mob purulent yog ib qho xwm txheej zoo li no.
Symptoms
Yuav ua li cas thiaj kuaj pom lub raum abscess? Cov tsos mob thaum xub thawj zoo li mob pyelonephritis, uas tuaj yeem ua rau tus kws kho mob yuam kev. Hmoov tsis zoo, tsuas yog hauv ib feem peb ntawm cov neeg mob qhov kev kuaj mob raug ua ntej kev phais. Tus kab mob pib nrog qhov kub thiab txias mus rau tus lej febrile, ua pa thiab lub plawv dhia ntau zaus, qhov mob tshwm sim.cheeb tsam lumbar. Tab sis qhov no yog yog tias qhov patency ntawm cov zis tsis cuam tshuam, thiab lub cev tseem ua haujlwm.
Yog tias lub raum abscess tau tsim los ntawm kev cuam tshuam ntawm cov ureters, ces cov neeg mob ua npaws (tsawg dua plaub caug degrees), ua daus no, tachycardia thiab ua tsis taus pa nquag, nqhis dej, mob taub hau, tsis muaj zog thiab mob ntawm lub raum projection. Nrog rau kev txhim kho ntawm cov txheej txheem ob sab, cov neeg mob ntsib cov tsos mob ntawm lub raum tsis ua haujlwm thiab mob hnyav heev.
Diagnosis
Muaj cov txheej txheem uas lub raum abscess tuaj yeem kuaj tau. Ultrasound yog suav tias yog ib txoj kev tshawb fawb zoo tshaj plaws rau kev pom cov kab mob hauv plab. Tus kws tshaj lij sau tseg cov kev hloov pauv hauv qab no:
- cheeb tsam ntawm qhov txo qis loj dua ib centimeter;
- tsis sib xws ntawm lub raum;
- txo qis tso zis;
- kev txo qis hauv cov ntaub so ntswg ceev.
Ntxiv rau, koj tuaj yeem pom cov ntshav ntws hauv cov hlab ntsha ntawm lub raum thiab ua rau qhov sib txawv ascending urography. Tab sis txoj kev tom kawg tsis zoo li ultrasound, vim tias cov neeg mob feem ntau muaj kev tsis haum rau tus neeg sawv cev sib txawv. Hauv kev kuaj ntshav kuaj ntshav, cov tshuaj tiv thaiv kab mob ua rau muaj zog: nce erythrocyte sedimentation tus nqi (ESR), nce ntawm cov leukocytes thiab neutrophils. Cov zis muaj cov kua paug thiab cov ntshav, nrog rau cov kab mob uas tuaj yeem pom hauv microscopy.
Kev kho mob
Tom qab tag nrho cov kev tshawb fawb, tus kws kho mob yuav tsum txiav txim siab yuav ua li cas tshem tawm cov abscesslub raum. Kev kho mob feem ntau yog phais. Tam sim ntawd tom qab kuaj pom, tus neeg mob raug coj mus rau hauv chav ua haujlwm, qhov chaw kho mob sai sai qhib, nws cov kab noj hniav tau kho nrog cov tshuaj tua kab mob thiab cov kua dej tso rau hauv nws. Feem ntau thaj chaw pathological yog nyob hauv qab lub raum tshuaj ntsiav, yog li lub suab pom tau zoo.
Cov ntsiab lus ntawm lub raum abscess raug xa mus rau kev kuaj mob histological thiab bacteriological kom raug txheeb xyuas cov kab mob thiab txiav txim siab nws qhov rhiab heev rau cov tshuaj tua kab mob. Yog tias qhov zis tawm ntawm cov zis raug cuam tshuam, ces tus kws phais yuav tsim nephrostomy. Tom qab ua haujlwm, tus neeg mob tseem tau txais kev kho tshuaj tua kab mob zoo dua thiab ua kom tshem tawm cov tshuaj lom.
Tsis ntev los no, lub tsev kawm ntawv tshiab ntawm kws phais neeg tau hais qhia tias cov pob khaus uas nyob ze rau ntawm lub raum tau ntws los ntawm kev sib tsoo, yaug cov kab noj hniav nrog cov tshuaj tua kab mob, thiab teeb tsa cov dej ntws. Tab sis tsis muaj cov ntaub ntawv kho mob txhim khu kev qha txog kev ua tau zoo ntawm txoj kev no.
Huab cua
Kidney abscess yog ib yam kab mob loj ntawm lub cev tseem ceeb, yog li txawm tias qeeb me ntsis hauv kev kho mob tuaj yeem ua rau tuag taus. Nrog kev saib xyuas kev kho mob, yuav luag xya caum feem pua ntawm cov neeg mob tuag taus.
Kev cuam tshuam raws sijhawm thiab txaus tuaj yeem cawm tus neeg mob txoj sia thiab kev noj qab haus huv. Hauv cov xwm txheej zoo li no, lawv raug coj los ntawm cov tsos mob thiab qhov xaus ntawm ultrasound, tag nrho lwm yam kev ntsuam xyuas raug coj mus rau hauv chav ua haujlwm.
Kev Tiv Thaiv
Tiv thaiv lub raum abscesstuaj yeem kho raws sijhawm tag nrho ntawm pyelonephritis, tshwj xeeb tshaj yog tias nws nyuaj los ntawm obstructive syndrome. Kev muaj peev xwm immunoprophylaxis, ua raws li cov lus pom zoo ntawm tus kws kho mob thiab kev tiv thaiv kev tiv thaiv hauv tsev thiab hauv tsev kho mob yuav pab kom tsis txhob muaj tus kab mob txaus ntshai no.
