Kidney infarction, zoo li lwm yam kab mob, overtakes ib tug neeg mam li nco dheev. Ib tug txiv neej los yog poj niam tej zaum yuav tsis txawm xav tias ib tug ntshav txhaws tau matured nyob rau hauv cov hlab ntsha ntawm ceg, uas yuav sai sai no tawm thiab nkag mus rau lub raum hlab ntsha. Qhov no yuav ua rau mob plawv tsis zoo thiab necrosis ntawm qhov chaw parenchyma. Tab sis nws yuav yog tom qab, thiab lub sijhawm no tus neeg zaum, dag lossis mus ua haujlwm thiab xav tias zoo heev. Los tsis yog?
Definition
Kidney infarction yog ib yam kab mob uas tsis tshua muaj urological, uas yog nrog los ntawm kev tuag ntawm cov kab mob hauv nruab nrog cev los ntawm cov ntshav ncig hauv lub raum hlab ntsha lossis nws cov ceg. Feem ntau, qhov no pathology tshwm sim nyob rau hauv cov neeg laus thiab cov laus. Pathophysiologists ntaus nqi qhov no rau qhov tseeb tias cov kab mob sib kis uas tshwm sim hauv tus neeg muaj hnub nyoog tsim cov xwm txheej zoo rau kev loj hlob ntawm lub plawv nres.
Yog tias cov hlab ntsha yuav luag txhaws ntawm ob sab, ces tus neeg mob yuav tsum tuag. Nws tuaj yeem tshwm sim ob qho tib si los ntawm kev mob hnyav nrog cov khoom lag luam metabolic, thiab los ntawm kev lom nrog cov co toxins uas nkag mus rau hauv cov hlab ntsha los ntawm lub cev tuag. Txoj kev pheej hmoo ntawm kev tuag kuj tseem muaj nyob rau hauv qhov mob unilateral yog tias tus neeg mob muaj kab mob raum ua ke.
Nyob raum infarction
Hauv cov neeg laus, hemorrhagic thiab ischemic raum infarction raug cais. Nws cov tsos nyob ntawm seb lub tshuab ntawm necrosis tsim.
Cov tsos mob ntawm hemorrhagic infarction yog txuam nrog kev ua haujlwm tsis zoo ntawm lub venous network. Kev thaiv ntawm cov hlab ntsha no ua rau stagnation ntawm cov ntshav hauv lub cev saum toj ntawm qhov chaw raug mob. Cells uas tsis tau txais kev noj haus sai sai tuag, thiab cov ntshav venous txuas ntxiv mus ntxiv thiab permeate cov ntaub so ntswg ntawm lub raum. Qhov chaw no ntawm parenchyma yuav stained ntshav-liab. Xws li kev txhim kho ntawm cov txheej txheem pathological tsis zoo rau lub raum, tab sis qee zaum nws tshwm sim.
Ischemic infarction ntawm lub raum tshwm sim thaum lub txaj hlab ntsha raug thaiv. Lub parenchyma ntawm lub raum tsis tau muab cov ntshav, nws cov ischemia tshwm sim. Qhov chaw uas ua necrotic ua daj ntseg mus rau dawb.
Cov yam ntxwv ntawm cov ntshav ntws cuam tshuam rau hom mob infarction. Raws li txoj cai, qhov chaw tuag yog lub khob hliav qab nrog nws lub apex tig mus rau hilum ntawm lub raum, txij li nws nyob ntawd lub raum cov hlab ntsha faib rau hauv nws cov ceg. Nyob ib ncig ntawm thaj chaw dawb muaj ntau cov hemorrhages me me. Qhov no yog vim lub fact tias cov capillaries thawj spasm thiab ces nthuav heev.
raum mob raum rau menyuam
Cov tsos mob ntawm lub raum mob kuj tshwm sim rau cov menyuam yaus. Lawv feem ntau tshwm sim hauv cov menyuam mos uas muaj lub plawv tsis xws luag lossis thaum lub valvular apparatus puas vim rheumatism. Tsis tas li ntawd, lawv muaj ib qho mob xws li uric acidraum infarction.
Uric acid infarction tshwm sim tshwj xeeb hauv cov menyuam yug tshiab, yog li nws yog, feem ntau, kev txhawj xeeb ntawm neonatologists. Tom qab yug me nyuam, tus me nyuam yuav tsum tau hloov mus rau qhov muaj nyob sab nraum leej niam lub cev, uas tsis tas yuav dhau mus yam tsis muaj ib txoj hauv kev rau nws. Txij li thaum cov kab mob tsis zoo ntawm cov ntshav tseem tsis tau zoo tag nrho, thiab qee qhov ntawm cov zis me dhau, cov ntsev ntawm uric acid yuav poob rau hauv lub raum parenchyma.
Thaum koj loj hlob tuaj, cov teebmeem ntawm lub plawv nres no ploj mus, thiab lawv tsis ua rau muaj kev phom sij ntxiv lawm. Lub plawv nres uas kav ntev tshaj li kaum hnub ntawm tus menyuam lub neej tuaj yeem suav hais tias yog kab mob.
Ua rau kab mob
Txiv li nws zoo li, tus neeg laus kuj tuaj yeem kuaj pom tias muaj uric acid raum infarction. Qhov ua rau ntawm tus mob no yog txuam nrog cov kab mob xws li gout lossis oncological txheej txheem.
Clogging ntawm lub raum hlab ntsha tshwm sim vim kev ncig ntawm emboli hauv cov hlab ntsha. Lawv tshwm sim hauv plawv pathologies: atrial fibrillation, mitral defects, atherosclerosis, periarteritis nodosa, myocardial infarction, aortic thrombosis thiab kab mob endocarditis.
Tsis tas li, lub raum infarction tuaj yeem tshwm sim hauv cov neeg uas tau txais kev phais ntawm lub raum cov hlab ntsha. Hauv obstetrics thiab traumatology, xws li pathology li DIC kuj raug txiav txim siab. Hauv cov ntsiab lus yooj yim, qhov no yog qhov pom ntawm ntau cov ntshav me me tawm tsam keeb kwm ntawm hypocoagulation. Rau cov neeg mob nyob rau hauv cov ntaub ntawv no, necrosis yog yam ntxwv, nyob rau hauv uas lub cheeb tsam cuam tshuam yog lub cortical txheej.
Clinic
Cov tsos mob ntawm lub raum mob nyob ntawm seb muaj pes tsawg tus nephrons tau tuag. Yog tias necrosis tsis tshaj li ob peb millimeters hauv ntim, ces ib tus neeg yuav tsis txawm kwv yees txog nws. Tab sis nrog cov kab mob loj, qhov pib ntawm cov tsos mob yuav tsis ntev tom ntej.
Ua ntej tshaj plaws, muaj qhov mob ntawm sab nraub qaum. Tom qab ntawd qhov kub nce mus rau peb caug-yim degrees hauv cov neeg mob. Qhov no yog li cas qhov mob tshwm sim nws tus kheej, uas tshwm sim hauv thaj tsam necrosis nyob rau hnub thib ob lossis thib peb tom qab kev txhim kho ischemia. Tus neeg mob yws yws ntawm qhov txias, qaug zog, tsaug zog, xeev siab. Hauv cov zis, cov ntshav txhaws yuav pom ntawm qhov muag liab qab. Lub xeev no yuav txuas ntxiv mus txog tsib hnub ntxiv. Hauv kev teb rau qhov txo qis hauv cov ntshav khiav hauv ob lub raum vim kev ua haujlwm ntawm cov txheej txheem them nyiaj, ntshav siab yuav nce ntxiv.
Cov tsos mob zoo li no tshwm sim hauv ischemic necrosis, tab sis hemorrhagic ischemia hnyav dua. Cov tsos mob yuav tsis pom thaum xub thawj, tab sis maj mam nce mus rau 39-40 degrees, qaug zog, ntxhov siab vim thiab insomnia koom nrog qhov no. Kev dag ntawm koj nraub qaum yog yuav luag tsis yooj yim sua. Cov ntshav nyob rau hauv cov zis yog li hais tias cov kua zoo li cov nqaij slops, thiab nws cov hlab ntsha tuaj yeem thaiv cov urethra. Tus nqi ntawm cov zis poob qis mus rau 150 milliliters ib hnub. Qhov no qhia tau hais tias lub cev txuas ntxiv tshuaj lom nws tus kheej nrog cov khoom metabolic.
Nyob rau hauv cov me nyuam mos, cov kev mob dav dav tsis raug kev txom nyem, tab sis cov xim ntawm cov zis hloov ntawm daj mus rau cib. Qhov no ib txwm ua rau niam txiv ntshai.
Kev nyuaj siab
Nws tsis yog lub raum mob plawv uas txaus ntshai. Cov tsos mob, ntawm chav kawm, tsis qab ntxiag, tab sis tib lub sijhawm, nrog kev kho kom zoo, tag nrho cov haujlwm ploj tuaj yeem rov qab los. Nws yog qhov txaus ntshai dua thaum cov kab mob tsis tau kuaj pom hauv lub sijhawm lossis qhov ntim ntawm qhov txhab loj heev uas cov ntaub so ntswg ua haujlwm tsis tuaj yeem tiv nrog cov co toxins.
Tom qab lub plawv nres, qhov chaw puas yog sclerosed thiab hloov los ntawm cov ntaub so ntswg. Qhov no ua rau txo qis hauv lub raum ua haujlwm thiab, yog li ntawd, ua rau mob hnyav lossis mob raum tsis ua haujlwm. Cov neeg zoo li no raug yuam mus rau kev lim ntshav peb zaug hauv ib lub lis piam, thiab lawv lub neej raug txuas mus rau qhov chaw kho mob uas muaj cov cuab yeej tsim nyog.
Diagnosis
Kidney infarction yog ib yam kab mob uas tsis tshua muaj nrog cov tsos mob ntawm qhov muag tsis pom, yog li nws nyuaj heev los txheeb xyuas nws. Txhawm rau txhawm rau kuaj mob, tus kws kho mob sau cov keeb kwm ntxaws ntxaws. Nug tus neeg mob txog tshuaj, phais, thiab lwm yam ntsiab lus.
Nws yog ib qho tseem ceeb qhia rau koj tus kws kho mob yog tias koj muaj mob rheumatism, endocarditis, lossis mob plawv, vim tias cov no tuaj yeem ua rau mob thrombosis. Kev kuaj ntshav thiab zis, nrog rau cov ntshav biochemistry, yuav pab kom nkag siab txog qib ntawm co toxins hauv lub cev. Kev nce hauv lactate dehydrogenase yog ib qho cim tshwj xeeb ntawm lub raum puas. Kev muaj ntshav hauv cov zis yog qhov qhia ncaj qha rau cystoscopy. Qhov no yog txwv tsis pub lwm qhov los ntshav, xws li los ntawm cov zis los yog zais zis.
Instrumental tshawb nrhiav pabpom lub raum infarction. Ultrasound ntawm lub plab zom mov nrog dopplerography tso cai rau koj los tshuaj xyuas thaj tsam ntawm necrosis thiab xyuas seb cov ntshav ntws hauv nws li cas. Tsis tas li ntawd, cov kab mob vascular tuaj yeem pom siv angiography. Tab sis qhov no yog ib qho kev tawm tsam uas tsis haum rau txhua tus.
Kev kho mob
Yuav ua li cas thiaj pom zoo ua tom qab kuaj pom lub raum infarction. Kev kho mob tsuas yog ua tau nyob rau hauv tsev kho mob, nyob rau hauv kev saib xyuas ntawm kws kho mob, vim hais tias tus neeg mob yuav tsum ua raws li nruj me ntsis rau lub txaj. Tus kws kho mob tseem ceeb hauv qhov no yuav yog tus kws kho mob urologist, tab sis yog tias tsim nyog, tus kws phais lossis kws kho mob tuaj yeem txuas nrog.
Kev saib xyuas kev noj qab haus huv suav nrog kev rov ua kom cov ntshav ntws los ntawm kev nthuav cov hlab ntsha lossis los ntawm kev ua kom cov embolus (yog tias ua tau). Muab thrombolytics thiab anticoagulants ntawm kev ua ncaj qha thiab tsis ncaj. Nws yog qhov zoo dua los ua qhov no kom ntxov li sai tau, kom txog thaum lub parenchyma ntawm lub cev muaj sij hawm thaum kawg tuag. Tsis tas li ntawd, qhov mob syndrome yuav tsum raug tshem tawm. Rau qhov no, tus neeg mob tau muab narcotic analgesics. Yog tias tag nrho cov hematuria loj heev, ces cov tshuaj hemostatic raug sau tseg, piv txwv li, Etamzilat. Txhawm rau tiv thaiv lub cev qhuav dej thiab kho qhov ntim ntawm cov ntshav ncig, tus neeg mob tau muab cov kua dej tso rau hauv cov hlab ntsha.
Kev kho mob phais yog qhia tsuas yog thaum thaj chaw loj ntawm necrosis. Yog hais tias lub cev tsis tau txais kev cawmdim, ces nws raug tshem tawm tag nrho, disconnecting ntawm lub vascular pedicle. Hauv lwm qhov xwm txheej, balloon angioplasty lossis thrombus extraction tuaj yeem muab faib nrog.
Hauv cov menyuam mos, uric acid infarction dawsntawm nws tus kheej thiab tsis muaj kev kho tshwj xeeb yog xav tau. Txhawm rau kom cov uric acid crystals tawm sai dua, koj tuaj yeem ntxiv dej rau tus menyuam.
Huab cua
Kidney infarction yog ib yam kab mob uas tsis tshua muaj thiab hnyav, tab sis qhov kev cia siab feem ntau yog qhov zoo. Qhov chaw ntawm necrosis yog hloov nrog cov ntaub so ntswg nyob rau lub sijhawm, thiab cov khoom seem ntawm lub cev tau nthuav dav kom them rau qhov poob hauv ntim thiab ua haujlwm. Cov zis tsis hloov pauv, tshwj xeeb tshaj yog tias lub raum ua ke noj qab haus huv.
Vim tias cov neeg mob no tseem muaj kev pheej hmoo ntawm thrombosis thiab embolism, lawv tau muab tshuaj tua kab mob rau xyoo, thiab qee zaum rau tag nrho lawv lub neej. Qhov tshwm sim ntawm lub raum infarction nyob ntawm thaj tsam ntawm qhov txhab thiab qhov ceev ntawm kev kho mob.
Kev Tiv Thaiv
Kidney infarction yog ib qho teeb meem ntawm pathology ntawm cov hlab plawv, yog li ntawd, kev tiv thaiv muaj nyob rau hauv kev kho mob raws sij hawm ntawm thawj kab mob. Nco ntsoov ua raws li tag nrho cov lus qhia ntawm tus kws kho plawv, saib xyuas lub siab thiab mus ntsib kws kho mob tsis tu ncua. Qhov tsos ntawm cov nroj tsuag loj, thickening ntawm cov leeg ntawm ob txhais ceg los yog ntawm lub plab mog yog ib qho kev ceeb toom, koj yuav tsum sab laj nrog tus kws kho mob tam sim ntawd.
