Pathology nyob rau hauv lub genitourinary system txuam nrog kev nqaim ntawm cov kwj dej tso zis yog heev muaj. Qhov teeb meem no hu ua ureteral stricture. Cov txheej txheem pathological tuaj yeem cuam tshuam rau lub cev ob qho tag nrho thiab ib nrab. Vim muaj kev ua txhaum ntawm kev ua haujlwm ntawm cov zis, cov zis tsis tawm txhua, lossis nws tshwm sim maj mam. Tau txais thiab congenital strictures tshwm sim.
Kev piav qhia ntawm pathology
Lub ureter yog ib qho khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob khoob.
Nws pib los ntawm qhov chaw nqaim ntawm lub raum pelvis, qhov twg cov zis tsim hauv lub raum ntws. Nws excretory kawg xaus rau hauv lub zais zis phab ntsa.
Rau tus neeg noj qab haus huv, nqaim ntawm lub ureter ntawm ib qho anatomical lossis physiological xwm raug suav hais tias yog ib qho kev pom zoo. Ib qho tshwm sim zoo sib xws tshwm sim vim qhov elasticity ntawm nws phab ntsa. Txawm li cas los xij, nyob rau hauv cov xwm txheej ntawm stenosis los yog nruj, cov kev hloov pauv pib kom tau ib daim ntawv fibrous-sclerotic. Raws li qhov tshwm sim ntawm cov txheej txheem pathological no, muaj kev ua txhaum ntawm submucosa, nrog rau cov leeg nqaij thiab sab nrauv ntawm lub ureter. Nyob rau tib lub sijhawm, qee cov leeg nqaij tuag thiab raug hloov los ntawm cov caws pliav, uas tsis tuaj yeem ua haujlwm, vim nws yog atrophied.
Kev cuam tshuam ntawm lub cev ua haujlwm
Lub lumen ntawm cov ducts ntawm qhov chaw ntawm qhov tshwm sim ntawm ureteral stricture yog txo, uas cuam tshuam kev ua haujlwm ntawm lub cev hauv lub cev. Cov zis tsis tuaj yeem raug tshem tawm tag nrho los ntawm lub cev thiab pib nkag mus rau hauv lub zais zis, dhau sijhawm ua rau muaj zog ntxiv ntawm cov ureter. Nyob rau hauv lub neej yav tom ntej, nws yog stretched thiab elongated. Qee qhov xwm txheej, nws los txog curvature ntawm ureter. Thaum tsis muaj kev kho kom raug, cov kab mob pathology cuam tshuam rau lub raum.
Ureteral nruj nreem tuaj yeem txhim kho hauv txhua qhov chaw ntawm lub cev. Feem ntau, pathology yog nyob rau hauv qhov sib txawv ntawm lub zais zis thiab lub ureter. Tsis tas li ntawd, muaj cov xwm txheej ntawm kev kuaj xyuas qhov nruj ntawm lub ureter thiab lub plab mog.
Ntau yam kev txwv
Nqaim ntawm cov ureter tuaj yeem ua rau ntau hom nyob ntawm thaj chaw ntawm thaj chaw ntawm cov kab mob, nrog rau qhov xwm txheej ntawm tus kab mob. Ua ntej ntawm tag nrho cov, muaj tau thiab congenital stenosis. Qhov kawg tshwm sim nyob rau hauv tus txheej txheem ntawm intrauterine kev loj hlob ntawm tus me nyuam hauv plab.
Ib txheej txheem pathological yuav tshwm sim vim qhov tuab ntawm phab ntsa hauv qee yamqhov chaw. Congenital ureteral strictures tshwm sim los ntawm qee qhov txawv txav hauv kev loj hlob ntawm tus menyuam hauv plab, uas yog:
- Kinking vim qhov nkhaus ntawm lub ureter.
- Qhov tshwm sim ntawm daim nyias nyias ntawm lub valve ntawm lub ureter, uas ua rau muaj cov zis ntau ntxiv hauv lub zais zis.
- Ureterocele. Tus kab mob no tshwm sim los ntawm qhov nqaim ntawm lumen nyob rau hauv qis qis, thaum lub ureter nthuav dav, thiab qee zaum poob rau hauv lub zais zis.
- Squeezing hlab ntsha.
- Kev tsim ntawm diverticula, uas ua rau protrusion ntawm qis qis ntawm cov ureter.
Tau txais daim ntawv ntawm qhov nqaim ntawm lub ureter tuaj yeem tshwm sim nyob rau hauv kev cuam tshuam ntawm ntau yam, nyob ntawm lub xeev ntawm tib neeg kev noj qab haus huv. Nyob ntawm thaj chaw uas qhov kev nruj nruj tau nyob hauv ib cheeb tsam, txoj cai-sab thiab sab laug-stenosis yog qhov txawv. Nws kuj tshwm sim tias ob sab ntawm lub ureter raug cuam tshuam. Tsis tas li ntawd, stenosis tuaj yeem nyob hauv ob qho tib si nyob rau sab sauv ntawm lub ureter thiab hauv nws qhov qis, qhov chaw hloov mus rau lub raum pelvis tshwm sim. Yog tias cov txheej txheem pathological tsim nyob rau hauv nruab nrab ntu, ces ob qho tib si sab sauv thiab sab qis ntawm lub cev raug cuam tshuam.
Yog vim li cas
Muaj ntau yam uas ua rau kev nqaim ntawm lumen ntawm ureter. Cov no yog cov kab mob kev loj hlob ntawm cov noob caj noob ces nyob rau hauv cov ntaub ntawv ntawm ib tug congenital daim ntawv ntawm pathology, uas ua rau cov tsim ntawm caws pliav nqaij es tsis txhob ntawm cov leeg nqaij. Daim ntawv kis tau tus kab mob tuaj yeem ua rau ntau yam laj thawj, tab sis feem ntau yog ib qho tseem ceebtxaus ntshai yog raug mob.
Txhob Cia Siab
Yam uas tuaj yeem ua rau kev loj hlob ntawm ureteral nruj yog:
- Kev tsim cov pob zeb raum. Qhov no belongs rau qeb ntawm kev raug mob sab hauv. Urolithiasis ua rau mob, thiab mucous daim nyias nyias yog yooj yim puas los ntawm pob zeb, uas ua rau caws pliav.
- Kev raug mob sab nraud hauv lumbar qaum. Raws li qhov tshwm sim, hematoma tshwm tom qab peritoneum, uas tom qab ntawd yog lub hauv paus rau kev nruj.
- Kev raug mob thaum lub sijhawm phais.
- Kev kho hluav taws xob, nrog rau kev puas tsuaj hluav taws xob.
- Tuberculosis, mob hauv lub ureter.
Ureteric nruj yuav tsum tau soj ntsuam los ntawm kws kho mob.
Ntxiv rau, qee qhov xwm txheej, kab mob tshwm sim vim tau txais cov phom los yog pob qhov txhab. Tsis tas li ntawd, kev kho tus kheej ntawm cov kab mob sib deev tuaj yeem ua rau raug mob rau lub ureter. Cov txiv neej feem ntau raug mob thiab ua rau lub cev ntau dhau, yog li lawv muaj feem yuav muaj kev nruj. Yog tias ib qho ntawm cov xwm txheej teev tseg tsis suav nrog, ces tus kws kho mob txiav txim siab tias tus kab mob no yog los ntawm.
ICD-10 code rau ureteral nruj - N13.5.
Symptoms
Raws li txoj cai, cov tsos mob thiab qhov mob hnyav nrog rau ob sab stenosis. Unilateral stenosis, ntawm qhov tsis sib xws, feem ntau tshwm sim hauv daim ntawv latent. Vim li no, nws yuav luag tsis tuaj yeem kuaj pom tus kab mob thaum ntxov ntawm nws txoj kev loj hlob. Nrog ob sab lesions, cov hauv qab no tau pomCov tsos mob:
- Nyob rau hauv cov hlab ntsha.
- mob hauv cheeb tsam lumbar.
- Ntaus thiab ntuav.
- Convulsive Syndrome.
- tso zis me me.
- Paj thaum tso zis.
- nce hauv lub cev kub, qhia txog cov txheej txheem inflammatory hauv lub cev.
- Kev muaj ntshav hauv cov zis.
Cov tsos mob ntawm lub cev nqaij daim tawv tsis xis nyob heev.
Thaum tsis muaj kev kho kom raug, cov txheej txheem pathological tuaj yeem ua tiav thiab kis mus rau cov kabmob uas nyob ib sab, suav nrog raum. Vim tias cov zis tsis tiav ntawm lub cev, qhov kev pheej hmoo ntawm stagnation nce ntxiv, uas yuav ua rau urolithiasis, pyelonephritis, hydronephrosis, thiab raum tsis ua haujlwm nyob rau hauv daim ntawv ntev. Nws yog ib qho tseem ceeb los txheeb xyuas cov kab mob raws sij hawm thiab tau txais kev kho mob tsim nyog.
Txoj kev kuaj mob
Txhawm rau kom tau txais daim duab kho mob tiav, nws yuav tsum tau teem sijhawm kuaj xyuas tus neeg mob kom ntxaws. Cov txheej txheem kuaj ntshav muaj xws li kuaj ntshav thiab zis, ultrasound ntawm lub genitourinary system. Tsis tas li ntawd, tus neeg mob tau txais kev suav tomography thiab magnetic resonance imaging. Endoscopy yog contraindicated yog hais tias tus neeg mob muaj ib tug inflammatory txheej txheem nyob rau hauv qhov chaw mos, uterus, urethra los yog prostate caj pas.
Urethrography yog suav tias yog cov ntaub ntawv tshaj plaws thiab kev tshawb fawb ntau tshaj plaws rau kev nruj ureteral. Cov txheej txheem yog x-raykev kawm sib txawv. Cov txheej txheem no ua rau nws muaj peev xwm txheeb xyuas cov cheeb tsam uas muaj stagnation, nrog rau kev txheeb xyuas qhov muaj thiab qhov chaw ntawm cov chaw nqaim. Qhov sib txawv yog txhaj ncaj qha mus rau hauv cov zis los yog tso rau hauv cov hlab ntsha.
Kev npaj rau urography
Urography yog suav tias yog txoj kev kuaj mob zoo, nyab xeeb. Txoj kev tshawb no tau sau tseg yog tias muaj qhov tsis txaus ntseeg ntawm lub raum pathology, kab mob zais zis, teeb meem nrog kev pom thiab tso zis tso zis.
Cov cai yooj yim rau kev npaj rau urography yuav ua raws li hauv qab no:
- 3 hnub ua ntej tus txheej txheem, tus neeg mob yuav tsum tsis kam noj zaub mov uas ua rau muaj roj ntau dhau.
- Ib qho tshuaj tiv thaiv kab mob radiopaque yuav tsum ua yam tsis tau ua tsis tiav.
- Cov zaub mov yuav tsum tsis pub dhau 8 teev ua ntej kawm, tsis txhob haus dej ntau dhau ib hnub.
- Tsis txhob noj sawv ntxov.
- Hauv chaw ua haujlwm, koj yuav tsum tshem cov khoom hlau, cov hniav nyiaj hniav kub, khoob koj lub zais zis raws li tus kws kho mob qhia.
- Yog tias muaj kev ntxhov siab sai ua ntej urography, koj tuaj yeem haus cov tshuaj sedative (sedative) kho.
Kev kho mob
Tom qab kev tshuaj xyuas kom meej thiab qhia meej txog qhov kev kuaj mob, tus neeg mob tau txais kev kho mob tsim nyog. Lub hom phiaj tseem ceeb ntawm kev kho yog normalization ntawm cov zis tso zis. Txoj kev kho mob raug xaiv raws li cov txiaj ntsig ntawm kev tshawb fawb. Nws tseem yog ib qho tseem ceeb uas yuav tau xav txog qhov xwm txheej ntawm lub raum thiab cov kab mob genitourinary. Lwm qhov tseem ceeb ntawm kev xaiv kev kho mob yognruj me ntsis.
Txoj kev txwv ntawm cov ureter tsis tuaj yeem kho tau hauv tsev, nrog rau cov txheej txheem ntawm cov tshuaj ib txwm siv. Raws li kev ntseeg nrov, ua kom sov rau thaj tsam cuam tshuam yuav tsum tsis txhob ua, vim qhov mob ntawm qhov no tuaj yeem ua rau mob hnyav dua.
Ib qho ntawm txoj kev kho mob zoo yog kev phais yas hauv cov chaw urology. Qhov no yog ib txoj kev nyuaj heev, nrog rau lub sij hawm ntev rehabilitation, yog li nws tsuas yog muab raws li qhov chaw kawg. Kev ua haujlwm tsis haum rau txhua tus neeg mob, vim nws muaj ntau yam contraindications.
Lwm txoj kev kho mob yog ureteral bougienage. Cov txheej txheem yog ua los ntawm ib tug hlau pas nrig uas tau muab tso rau hauv lub ureter thiab nthuav nws. Cov txheej txheem yog mob heev, thiab cov nyhuv ntawm nws yog luv luv. Bougienage tsis tshua siv.
Plastic replacement method
Txoj kev hloov cov yas kuj tseem siv rau hauv cov chaw urology. Txoj kev no yog tsim rau kev kho mob ntawm me me strictures, qhov loj ntawm uas tsis pub tshaj 20 mm. Kev ua haujlwm yog ua qhov kev txiav thiab hloov cov nti nrog cov ntaub so ntswg los ntawm tus neeg mob. Tsis tas li ntawd, kho qhov muag urethrotomy siv lub cystoscope. Txhua qhov kev cuam tshuam los kho tus mob stenosis yuav tsum tau pom zoo nrog tus kws kho mob tuaj koom thiab ua raws li kev saib xyuas ntawm tus kws phais neeg tsim nyog.
Pathology yog qhov hnyav heev, tsis kho nrog tshuaj lossis pej xeem txoj kev. Yog tias tsis phais, muaj teeb meem tshwm sim uas cuam tshuam rau lub raum thiab lwm yam kabmob.
Stenosis loj hlob sai, tshwj xeeb tshaj yog thaum raug mob ua ntej nws. Ib daim ntawv hematoma nyob rau hauv cheeb tsam cuam tshuam, uas yuav tsum tau kuaj thiab ntws. Nrog kev pabcuam thawj zaug kom raug, kev tsim cov kev txwv tsis suav nrog. Txawm li cas los xij, txawm tias muaj kev raug mob me me rau sab nraub qaum yuav tsum tau xa mus rau tus kws kho mob tshwj xeeb rau kev kuaj thiab kuaj. Nws yog ib qho tseem ceeb kom tsis txhob raug mob rau thaj tsam plab thaum ua si. Nws yog ib qho tseem ceeb uas yuav tau siv cov ntaub thaiv npog tshwj xeeb uas tuaj yeem ua rau lub tshuab ua kom mos.
Kev phais sai dua tom qab kuaj pom qhov nruj, qhov zoo dua rau tus neeg mob thiab qhov tsis zoo yuav tshwm sim. Tsis tas li ntawd, qhov no yuav txo lub sijhawm rov qab los, thiab kev ua haujlwm nws tus kheej yuav tsis mob heev. Lub ntsiab lus tseem ceeb ntawm kev kho kom zoo yog ua raws li tag nrho cov tshuaj ntawm tus kws kho mob tuaj koom.
Kev nyuaj siab
Yog tias tsis pom cov xwm txheej saum toj no, cov teeb meem tshwm sim uas tuaj yeem cuam tshuam rau kev ua haujlwm ntawm cov kab mob genitourinary thiab lwm yam kabmob. Kev phais kuj tuaj yeem ua rau muaj qhov tshwm sim yog tias tus neeg mob cov ntaub so ntswg tsis tau loj hlob ua ke kom raug lossis tsis tau muab cov cag kiag li.
Tsis kho tuaj yeem ua rau muaj kev txhim kho ntawm cov kab mob xws li cyst lossis lub raum tsis ua haujlwm, nrog rau hydronephrosis, thaum lub raum plab hnyuv loj. Qee zaum, cystitis tshwm sim tawm tsam keeb kwm ntawm kev nruj, nrog rau lub raum pob zeb.
