Cov kab mob raum mob ntev yog ib qho kev kuaj mob uas suav nrog txhua yam kab mob ntawm lub cev nrog kev txo qis ntawm lawv txoj haujlwm. Lub raum noj qab haus huv tshem tawm cov dej ntau dhau thiab pov tseg los ntawm cov ntshav. Lub cev no tseem koom nrog hauv kev tswj ntshav siab thiab tsim cov qe ntshav liab.
Thaum mob raum mob tshwm sim, lawv txoj haujlwm raug cuam tshuam, yog li lawv tsis tuaj yeem tshem tawm cov khoom tsis zoo. Thiab tus neeg mob tus mob yog tus cwj pwm los ntawm kev qaug zog hnyav, insomnia, qhov tsos ntawm o, nco tsis zoo. Thaum thawj cov tsos mob tshwm sim, nws yog ib qho tsim nyog yuav tsum tau kuaj xyuas thiab kho, uas tus kws kho mob yuav sau ntawv.
Tus yam ntxwv ntawm tus kab mob
kab mob raum mob (raws li ICD-10: N18) yog tus cwj pwm los ntawm kev ua haujlwm tsis zoo ntawm cov kabmob no rau ntau tshaj peb lub hlis. Lub raum ua raws li lub cev lim dej. Ob peb kaum litres cov ntshav dhau los ntawm lawv ib hnub, uas tau tshem tawm cov tshuaj lom thiab cov khoom pov tseg.
Nrog txoj kev loj hlob mus ntevkab mob raum yog ib qho kev hloov hauv lub cev ntawm cov ntaub so ntswg ua haujlwm lossis kev tuag ntawm nephrons. Cov txheej txheem pathological no ua rau muaj kev hloov pauv tsis tau hauv lub raum thiab cuam tshuam rau lawv lub peev xwm los ua tiav lawv txoj haujlwm ntawm kev lim ntshav thiab tshem tawm cov dej ntau dhau.
Tus kab mob no ua rau muaj kev puas tsuaj loj hauv lub neej zoo thiab tuaj yeem ua rau tuag taus, tsuas yog zam tau nrog kev ua haujlwm nyuaj, tshwj xeeb, xws li hemodialysis lossis hloov raum.
theem kev txhim kho
Raws li kev faib tawm, kab mob raum mob tau muab faib ua ob peb theem, nyob ntawm seb cov kab mob pathology. Cov kws kho mob paub qhov txawv 5 degrees:
- latent;
- nyiaj pab;
- nruab nrab;
- decompensated;
- terminal.
Thaum thawj theem tshwm sim, cov kab mob raum mob ntev tsis tshwm sim nws tus kheej li cas. Cov neeg mob tau xyaum tsis muaj kev tsis txaus siab, tsuas yog ua rau qaug zog ntxiv. Cov kev sim kuaj pom muaj me me ntawm cov protein hauv cov zis.
Nyob rau theem ob, cov neeg mob tseem muaj cov tsos mob zoo ib yam, tab sis lawv tshwm sim ntau zaus. Cov kev hloov pauv hauv qhov ntsuas ntsuas tau sau tseg hauv cov zis thiab ntshav. Cov zis tso zis txhua hnub txo qis.
Raws li theem thib peb pib, muaj kev poob qis hauv lub raum ua haujlwm. Hauv kev kuaj ntshav, muaj kev nce qib ntawm urea thiab creatinine. Kev noj qab haus huv dav dav zuj zus lawm.
Nyob rau theem plaub, qhov hloov tsis tau tshwm simhloov hauv lub raum ua haujlwm. Cov edema tsis tu ncua, kev ua haujlwm ntawm lub plawv cuam tshuam, tawv nqaij khaus tshwm sim, erosive hloov ntawm daim tawv nqaij thiab mucous daim nyias nyias.
Qib thib tsib ntawm qhov mob hnyav ntawm lub raum tsis ua haujlwm yog qhov tshwm sim los ntawm kev ua haujlwm ntawm lub cev. Hauv qhov no, cov ntsiab lus ntxiv ntawm urea tau pom hauv cov ntshav. Tsis tas li ntawd, electrolyte metabolism cuam tshuam thiab uremia tshwm sim. Tus neeg mob xav tau kev lim ntshav tas li.
Nyob ntawm kev faib cov kab mob raum ntev, cov tsos mob yog tus yam ntxwv rau txhua qib ntawm pathology. Cov theem ntawm qhov txhab yog txiav txim siab los ntawm cov txheej txheem xws li glomerular filtration rate thiab ntsuas cov protein hauv cov zis. Cov neeg mob feem ntau tseem tsis tau paub txog qhov muaj tus kab mob nyob rau theem pib thiab tej zaum yuav tsis quav ntsej txog cov tsos mob tshwm sim nrog kev kis tus kab mob ntxiv.
Kev tshwm sim
mob raum mob feem ntau tshwm sim hauv cov neeg uas muaj cov kab mob metabolic. Hauv particular, provoking yam muaj xws li rog, kub siab thiab ntshav qab zib mellitus. Lawv muaj kev cuam tshuam rau lub raum nephrons.
Ntxiv rau, nws ua rau mob raum mob - pyelonephritis thiab glomerulonephritis. Nws yuav tsum raug sau tseg tias cov poj niam raug kev txom nyem los ntawm cov kab mob no ntau dua li cov txiv neej. Kuj ntawm cov laj thawj yog cov hauv qab no:
- tshwm sim ntawm neoplasms;
- kab mob autoimmune;
- qhov tshwm sim ntawm kev lom;
- teeb meem tom qab raug mob;
- kev quav cawv.
Nws yog ib qho nyuaj heev los txiav txim seb qhov ua rau mob raum mob ntev, vim tias cov txheej txheem pathological yuav tsis muaj qhov tsim muaj etiology.
Cov tsos mob tseem ceeb
Cov tsos mob ntawm cov kab mob raum ntev yog cuam tshuam ncaj qha rau kev ua txhaum ntawm cov txheej txheem ntawm kev tsim thiab tso zis, nrog rau cov tsos mob ntawm intoxication. Ntawm cov tsos mob tseem ceeb ntawm tus kab mob tuaj yeem txheeb xyuas:
- kev ua txhaum txoj kev tso zis;
- hloov pauv cov zis;
- xeev siab thiab ntuav;
- lethargy thiab qaug zog;
- qhuav mucous daim nyias nyias;
- khaus ntawm daim tawv nqaij;
- poob qab los;
- nqhis dej tas li.
Los ntawm ib sab ntawm cov hlab plawv, xws li mob xws li mob hauv lub sternum, nce plawv dhia, loog ntawm cov extremities tuaj yeem raug sau tseg. Tag nrho cov tsos mob no tuaj yeem sib txawv heev, vim txhua tus neeg mob muaj keeb kwm kho mob sib txawv.
Diagnostics
Nrog kev tsis txaus siab txog kev mob raum ntawm theem 1-2, cov neeg mob tsis tshua siv. Pathology tuaj yeem kuaj pom los ntawm kev sib tsoo thaum kho cov txheej txheem inflammatory ntawm lub genitourinary system lossis nrog cov zis tsis zoo thiab kuaj ntshav. Yog tias pom muaj kev hloov pauv hauv cov zis, ces yuav tsum tau kuaj pom tus kab mob raum ntev, uas suav nrog:
- kuaj ntshav kuaj;
- urinalysis;
- ultrasound;
- tomography.
Raws li cov txiaj ntsig kev xeem, poj niam txiv neej thiab hnub nyoogTus neeg mob yog txiav txim siab los ntawm peculiarity ntawm chav kawm ntawm cov txheej txheem pathological. Tsis tas li ntawd, kev sab laj nrog lwm tus kws tshaj lij yuav xav tau. Raws li kev kuaj mob, xaiv txoj kev kho tus kab mob.
Kev kho mob
Kev kho mob raum mob feem ntau nyob ntawm theem ntawm tus kab mob. Nyob rau theem pib, kev kho mob yog tsom rau kev khaws cia ntau tshaj plaws ntawm cov hlwb ua haujlwm ntawm lub cev muaj npe. Kev kho mob yog ua los ntawm kev siv tshuaj tshwj xeeb, nrog rau kev noj zaub mov tshwj xeeb.
Nws yog ib qho tseem ceeb kom tshem tawm qhov tshwm sim uas ua rau muaj qhov tshwm sim ntawm lub raum tsis ua haujlwm. Hmoov tsis, nws yog tsis yooj yim sua kom kho nws tag nrho. Koj tsuas tuaj yeem tswj hwm kev ua haujlwm ntawm cov zis thiab txo qhov kev noj qab haus huv ntawm tus neeg mob. Cov theem tom qab yuav tsum tau hemodialysis lossis hloov lub raum.
Nrog rau kev kuaj mob raws sij hawm thiab kev kho muaj peev xwm, qhov kev kuaj mob tau zoo heev. Txawm hais tias nrog kev kho hemodialysis tas li, koj tuaj yeem ua kom lub neej ntev ntawm tus neeg mob thiab tswj nws qhov kev ua tau zoo.
Txawm li cas los xij, nws tsim nyog nco ntsoov tias tus kab mob no nyob rau theem tom ntej tuaj yeem ua rau tuag taus. Yog li ntawd, ntawm thawj kos npe ntawm nws, koj yuav tsum tau mus ntsib kws kho mob. Thaum kho tus kab mob raum ntev, cov lus qhia kho mob yuav tsum tau ua raws nruj heev.
Drug therapy
Nyob rau hauv cov txheej txheem ntawm kev kho mob, ua ntej ntawm tag nrho cov, nws yog tsim nyog los normalize lub siab, vim hais tias nws muaj ib tug tsis zoo ntxim rautxoj kev ntawm tus kab mob. Txhawm rau kho tus mob no, koj yuav tsum siv cov tshuaj hauv qab no:
- calcium channel blockers (Felodilin, Verapamil, Amlodipine);
- ACE inhibitors (Captopril, Renitek, Enalapril);
- receptor blockers (Losartan, Valsartan, Eprosartan).
Raws li ib feem ntawm txoj kev kho, nws yog ib qho tsim nyog yuav tsum tswj hwm qib phosphorus hauv cov ntshav. Tshaj ntawm cov ntsiab lus ntawm lub caij no tuaj yeem ua rau muaj qhov tshwm sim loj heev rau lub cev:
- nrawm nrawm ntawm pathology;
- nce kev pheej hmoo ntawm kev tuag;
- calcification ntawm cov ntaub so ntswg thiab cov hlab ntsha.
Rau qhov no, phosphate binders raug sau tseg, uas muaj peev xwm los thaiv cov phosphates hauv cov hnyuv. Ntawm cov tshuaj zoo tshaj plaws yog xws li Sevelamer, Renagel. Lawv ua tau zoo heev thiab tsis tshua muaj tshwm sim tshwm sim. Yog tias tsis muaj kev txhim kho hauv kev noj qab haus huv thaum siv cov tshuaj no, ces cov tshuaj vitamin D ntxiv. Nws pab kom normalize metabolism.
Nyob rau hauv cov kab mob ntev, anemia feem ntau tshwm sim. Txhawm rau nce hemoglobin, hlau gluconate, "Erythropoietin", yog siv. Hauv cov neeg mob uas muaj cov roj (cholesterol) siab, tus kab mob no tshwm sim sai dua li cov metabolism hauv ib txwm muaj. Tias yog vim li cas lawv thiaj li raug xaiv "Doppelherz Active Omega-3", raws li nws tso cai rau koj kom stabilize lipid qib.
Physiotherapy
Kev kho lub cev yog ua thaum theem 1-3 ntawm tus kab mob thiab yog heevzoo complementary kho. Nws yog tsim nyog nco ntsoov tias lawv muaj qee yam contraindications. Cov no suav nrog:
- mob hnyav ntawm lub cev;
- lub plawv tsis ua hauj lwm;
- txheej txheem kis kab mob hauv lub raum;
- hlab ntshav siab;
- kab mob sib kis nyob rau theem mob hnyav.
Cov neeg mob tau sau tseg, raws li txoj cai, electrophoresis, hydrotherapy, UHF kho. Tsis tas li ntawd, lawv tau pom cov tshuaj chloride, radon thiab sodium da dej. Cov txheej txheem no qhib rau lub raum, muaj kev tiv thaiv kab mob, thiab txhim kho kev noj qab haus huv.
Thaum lub sijhawm electrophoresis, cov khoom siv tseem ceeb nkag mus rau hauv lub cev. Cov txheej txheem no lav qhov tsis suav nrog qhov tshwm sim ntawm kev ua xua.
Kev hloov pauv
Nyob rau hauv cov kab mob siab heev, kev kho mob hloov pauv, xws li hemodialysis lossis peritoneal dialysis, tej zaum yuav xav tau. Hemodialysis yog ib txoj hauv kev los ntxuav cov ntshav ntawm cov tshuaj lom neeg ntau ntxiv. Thaum lub sij hawm tus txheej txheem, tus neeg mob cov ntshav mus rau theem ntawm filtration thiab purification. Siv cov txheej txheem zoo sib xws, koj tuaj yeem:
- tshem tawm cov tshuaj lom;
- stabilize siab;
- normalize acid-base balance.
Ntawm cov ntsiab lus tseem ceeb rau cov txheej txheem, nws yog ib qho tsim nyog los qhia txog qhov muaj cov kab mob plawv, qog nqaij hlav, mob kis kab mob.
Lub cuab yeej "lub raum cuav" tso cai rau tus neeg kom lub neej ntev. Cov txheej txheem yuav tsum tau ua 3ib zaug ib lub lim tiam. Lub sijhawm ntawm ib ntu yog 4 teev.
raum hloov
Nyob rau theem kawg, kev hloov raum tau qhia. Ib lub cev tuaj yeem hloov pauv los ntawm tus neeg muaj sia nyob lossis tus neeg tuag. Lub raum tshiab noj qab nyob zoo yog hloov mus rau hauv thaj av iliac lossis nyob rau hauv qhov chaw ntawm lub cev cuam tshuam. Qee zaum, tus neeg lub raum tshuav. Cov txheej txheem no muaj qee yam contraindications. Cov no suav nrog:
- malignant neoplasms;
- cov txheej txheem mob hnyav;
- lub plawv tsis ua hauj lwm;
- laus;
- kab mob HIV.
Ib tug neeg muaj hnub nyoog qis dua 18 xyoo tsis tuaj yeem yog tus pub raum. Lub hnub nyoog laus kuj yog ib tug contraindication. Kev ua haujlwm yog ua raws li kev siv tshuaj loog thiab siv sijhawm 2-4 teev.
Lub raum muab tso rau hauv qhov chaw npaj rau nws, ces lub cev no txuas nrog cov hlab ntsha, ureter thiab cov hlab ntsha. Lub catheter txuas nrog cov khoom ntim zis tso rau hauv lub zais zis.
Nrog rau kev hloov pauv tau zoo, qhov tseeb hauv 1-2 lub lis piam lub cev hloov pauv pib ua haujlwm li qub. Tom qab ntawd, tus neeg mob yuav tsum noj cov tshuaj tiv thaiv kab mob thoob plaws hauv nws lub neej kom tsis txhob raug tso tseg ntawm tus neeg pub khoom nruab nrog cev.
Dieting
Thaum tus kab mob tshwm sim, siv cov khoom noj tshwj xeeb. Nws yog ib qho tsim nyog yuav tsum txwv tsis pub noj cov protein, txij li thaum lawv tawg, lawv tsim cov tshuaj tshwj xeeb uas muaj co toxins. Yuav tsum taukoj yuav tsum tau txo cov roj noj hauv koj cov khoom noj txhua hnub. Tshwj xeeb, muaj cov rog tsis txaus, ntau dhau ntawm qhov ua rau muaj kev nce qib hauv cov roj cholesterol, yuav tsum txo qis.
Nws yog ib qho tsim nyog yuav tsum txo qis kom tsawg ntawm kev noj ntsev hauv cov zaub mov, ib yam li nws cov dej ntau dhau, cov kua dej ntau ntxiv hauv lub cev thiab ua rau cov txheej txheem tshem tawm cov co toxins. Nws raug nquahu kom ua zaub mov tsis muaj ntsev txhua.
Nws yog ib qho tseem ceeb kom tsis txhob haus cawv, vim nws cuam tshuam cov dej sib npaug thiab muaj kev cuam tshuam rau lub cev, yog li ua rau lub raum nce ntxiv. Cov zaub mov kib yuav tsum raug cais tawm ntawm kev noj zaub mov, vim tias txoj kev ua noj no ua rau kom muaj roj ntau ntxiv.
Nws yog ib qho tseem ceeb kom txwv tsis pub haus dej, thaum nws tus nqi txhua hnub raug xaiv tshwj xeeb los ntawm tus kws kho mob. Raws li kev haus dej haus, koj tuaj yeem siv tshuaj yej, decoction lossis infusion ntawm qus sawv, dej huv.
Kab mob hauv me nyuam
Lub raum tsis ua haujlwm yog qhov tsawg heev thaum menyuam yaus. Thiab qhov tseem ceeb, cov mob ntawm cov menyuam yaus cuam tshuam nrog qee yam pathologies:
- congenital anomalies;
- fetal development disorder;
- preterm yug;
- yug me nyuam qis.
kab mob raum tuaj yeem zais tau ntev. Lawv tshwm sim thaum muaj hnub nyoog kawm ntawv nrog kev ntxhov siab ntxiv. Feem ntau qhov no yog mob nephrotic syndrome. Tus me nyuam qhia tau hais tias muaj kev lom lom ntawm lub cev, thiab nwsxav tau kev kho tshuaj sai sai hauv tsev kho mob.
Ua ntej pib txoj kev kho, koj yuav tsum tau kawm txog cov zis thiab ntshav, nrog rau xyuas seb qhov concentration ntawm cov protein hauv lub cev. Feem ntau, kev kho tshuaj yog nqa tawm, tab sis hauv cov xwm txheej nyuaj, kev lim ntshav tau qhia. Txoj kev kho no yog txhawm rau ntxuav cov ntshav los ntawm kev siv tshuaj.
Muaj Teeb Meem
Yog tias koj tsis quav ntsej cov cim uas twb muaj lawm nyob rau theem pib ntawm tus kab mob, ces qhov kev hloov pauv tuaj yeem ua tsis tau. Kab mob raum ntev tuaj yeem ua rau cov txheej txheem pathological nyuaj hauv kev hloov pauv kev ua haujlwm ntawm ntau lub cev thiab lub cev. Ntawm cov teeb meem tseem ceeb yog cov hauv qab no:
- mob plawv, ischemia;
- malignant hypertension;
- kev muaj menyuam;
- pathology ntawm thyroid caj pas;
- mob ntshav qab zib;
- osteoporosis;
- txo qis tiv thaiv kab mob.
Qhov teeb meem yooj yim tshaj plaws yog kub siab thiab kab mob ntawm cov hlab plawv. Lawv yog cov uas ua rau tus neeg mob tuag.
prophylaxis
Kev tiv thaiv kab mob raum ntev yuav tsum pib ua ntej hnub nyoog 40 xyoo. Kev tiv thaiv yuav tsum muaj xws li:
- kom txhob haus luam yeeb thiab haus cawv;
- hnyav normalization;
- txwv kev noj ntsev, zaub mov kaus poom.
Rau lub hom phiaj tiv thaiv, nws yog ib qho tseem ceeb heev kom noj txauskua thiab nws zoo dua yog tias nws yog dej ntshiab. Koj yuav tsum tsis txhob noj cov tshuaj diuretics, tshuaj tua kab mob, cov vitamins thiab tshuaj lom neeg ntawm koj tus kheej. Koj yuav tsum sim txo qis kev sib cuag nrog cov tshuaj lom. Kev noj zaub mov nruj, hypothermia thiab kev tshaib plab tuaj yeem ua rau lub raum ua haujlwm tsis zoo.
Kev tiv thaiv kab mob cuam tshuam nrog kev npaj kho mob. Nws yog ib qho tseem ceeb uas yuav tsum tau saib xyuas cov ntshav siab, qib qab zib thiab qhov xwm txheej ntawm cov kab mob hauv nruab nrog cev.
