Cov kab mob xws li mob raum reflux, cov tsos mob uas tsis tau qhia meej meej nyob rau hauv thawj theem, yog tsawg. Feem ntau, tus kab mob no cuam tshuam rau menyuam yaus thiab cov neeg laus. Xav txog qhov ua rau tus kab mob, hom, qib kev loj hlob, cov cim qhia, nrog rau kev kuaj mob thiab kho li cas.
vesicoureteral reflux ntawm lub raum yog dab tsi?
Nquag, qhov siab ntawm lub zais zis thaum nws puv yuav tsum ua rau lub kwj dej kaw. Yog li ntawd, cov zis tawm ntawm lub urethra. Reflux, uas hauv Greek txhais tau tias "rov qab txav", yog qhov ua txhaum ntawm cov txheej txheem ntawm cov zis tawm, thaum lub sijhawm nws rov qab mus rau lub zais zis. Xws li ib tug pathology yog ua tau nrog ib tug tsis ua hauj lwm, underdeveloped los yog qaug zog valve.
Txhua lub sijhawm zais zis, ib feem ntawm cov zis rov qab los rau nws, thiab dhau sijhawm, kev hloov pauv ntawm lub cev tau pom. Tib lub sijhawm, cov zis reflux tuaj yeem tshwm sim ob qho tib si thaum mus rau hauv chav dej me me, thiab thaum nws puv.zais zis. Reflux ntawm cov zis mus rau hauv lub raum nyob rau hauv thaum ntxov theem ntawm tus kab mob tsis tshwm sim nws tus kheej. Nws tsuas tuaj yeem kuaj tau nrog kev kuaj mob plab.
Type of pathology
Urologists faib xws li pathology li vesicoureteral reflux ntawm lub raum mus rau hauv daim ntawv nquag thiab ib qho passive. Nyob rau hauv daim ntawv nquag ntawm tus kab mob, cov zis rov qab mus rau hauv lub ureter tshwm sim tsuas yog nyob rau hauv tus txheej txheem ntawm tso zis. Lub sijhawm no, cov leeg ntawm lub zais zis tuaj rau hauv lub suab, thiab ib txhij nrog tso zis tawm sab nraud, muaj cov zis tawm mus rau hauv cov ureters, thiab tom qab ntawd mus rau hauv lub raum. Thaum lub sijhawm no, tus neeg yuav hnov mob hauv qab thiab tsis xis nyob thaum mus rau chav dej. Qhov no pathology feem ntau yog tshwm sim los ntawm valve insufficiency.
Nyob rau hauv daim ntawv passive ntawm reflux, tso zis yog muab pov rov qab raws li lub cev ntim nrog zis. Nyob rau hauv tas li ntawd, lub valve insufficiency yog ntau pronounced, thiab cov zis rov los tas li. Qhov ntim hauv qhov no nyob ntawm qhov kev ua txhaum cai, qhov xwm txheej ntawm lub valve thiab lub peev xwm ntawm urea cog lus.
Kuj, kws kho mob faib cov kab mob los ntawm:
- etiological yam - nws tuaj yeem yog qhov tshwm sim lossis kis tau;
- by xwm - ib sab lossis ob sab;
- raws li tus kab mob no - tas li lossis tsis sib xws.
Nws tau sau tseg tias txawm tias muaj kev cuam tshuam me ntsis hauv kev ua haujlwm ntawm lub valve lossis lub zais zis anatomical tuaj yeem ua rau reflux thiab cuam tshuam rau kev ua haujlwm ntawm lub cev.
Degrees of disease
Muaj qhov kev lees paub feem ntau,Raws li cov kws kho mob urologist txiav txim siab qib ntawm pathology. Nws yog nyob ntawm qhov no tias yav tom ntej kev xaiv kev kho mob raum reflux nyob ntawm.
Urine reflux qib raws li kev faib tawm:
- First degree. Vim qhov tsis txaus ntawm lub valve, me me rov qab ntawm cov zis tshwm sim. Nyob rau tib lub sijhawm, cov qauv thiab ntim ntawm lub zais zis tsis hloov. Nyob rau theem no, tsis muaj cov tsos mob tshwm sim, thiab cov teeb meem, ob qho tib si kis tau thiab tsis kis, tsawg heev.
- Second degree. Cov zis tso zis yog pom nyob rau hauv tag nrho cov ureter, tab sis tsis muaj dilatation, uas yog, zis tsis mus txog rau lub raum. Nyob rau theem no, pathology tuaj yeem ua tiav, txawm hais tias pom tseeb cov cim tseem tsis tau pom. Nws tuaj yeem kuaj pom thaum lub sijhawm niaj hnub lossis kev tiv thaiv kev kuaj mob ntawm lub plab mog.
- Third degree. Cov zis nkag mus rau hauv lub raum thiab txo lawv txoj haujlwm ntawm 20%. Lub ureter nyob rau tib lub sij hawm nce qhov loj thiab muaj kev hloov kho ntawm nws cov qauv thiab cov ntaub so ntswg. Cov paib yog qhov hnyav me ntsis thiab muaj kev pheej hmoo kis tus kab mob ntau ntxiv.
- Plaub degree. Lub ureter ho nce nyob rau hauv ntim. Lub raum ua haujlwm raug txo los ntawm 50%. Ib tug neeg xav tias tsis xis nyob, lub cev kub thiab o tshwm. Yog tias txheej txheem yog ob sab, nws tuaj yeem ua rau muaj kev hem thawj rau tus neeg mob lub neej.
- tsib degree. Cov tsos mob tau hais. Lub ureter tsis tsuas yog nce loj, tab sis kuj khoov. Muaj khaus ntawm daim tawv nqaij, diuresis, xeev siab thiab ntuav. Kev pab kho mob yog qhov tseem ceeb ntawm no.
Kev tshwm sim
Zoo li cas thiab thaum lub raum reflux tsim, nws tuaj yeem yog thawj lossis theem nrab. Nyob rau hauv thawj rooj plaub, nws yog tshwm sim los ntawm congenital anomalies, uas yog, qhov tsis raug tsim ntawm lub cev tshwm sim txawm nyob rau hauv lub intrauterine txoj kev loj hlob ntawm tus me nyuam. Cov zis rov qab tuaj yeem yog vim muaj qhov sib npaug ntawm cov ureter, gaping lossis dystory ntawm lub qhov ncauj, nrog rau qhov luv submucosal qhov hauv qee qhov ntawm cov ureter.
Daim ntawv thib ob tsis tshwm sim ntawm nws tus kheej, tab sis tawm tsam keeb kwm ntawm lwm yam pathologies ntawm cov zis.
Ntawm cov laj thawj rau kev txhim kho ntawm kev mob ntshav qab zib theem nrab yog:
- stenosis ntawm caj dab ureteral;
- urethral kwj dej qauv;
- Yprostate adenoma;
- mob zais zis (cystitis);
- kev puas tsuaj rau cov duab lossis qauv ntawm cov ureter thaum phais.
Symptomatics
Cov tsos mob raum reflux yog latent rau lub sijhawm ntev. Nyob rau hauv thawj theem, tus neeg mob yuav muaj kev mob me thiab ntuav nyob rau hauv lub lumbar cheeb tsam. Lawv feem ntau tshwm sim tom qab tso zis. Cov menyuam yaus uas tseem tsis tau piav qhia qhov mob tuaj yeem yws ntawm qhov mob hauv plab, nrog rau hauv pliaj.
Qhov tshwm sim ntawm tus kab mob nyob ncaj qha rau ntawm qib ntawm pathology. Yog tias thawj theem tso zis rov qab los rau hauv me me, ces cov txheej txheem no yuav tsis muaj tsos mob nyob rau hauv ib txoj kev. Pib los ntawm qib thib peb, muaj kev nthuav dav thiab hloov kho cov qauv ntawm cov ureter. Feem ntau tus neeg mob muaj tag nrho cov tsos mobpyelonephritis, uas yog: qhov kub thiab txias, kev noj qab haus huv zuj zus, tso zis yuav tsaus thiab pos huab thiab mob tshwm sim nyob rau hauv lub plab mog.
Feem ntau, reflux tuaj yeem kuaj pom twb nyob rau theem ntawm cov teeb meem. Nws tuaj yeem tshwm sim nws tus kheej hauv daim ntawv nquag cystitis, mob pyelonephritis thiab enuresis.
Muaj Teeb Meem
Txawm hais tias yog vim li cas thiaj ua rau cov zis reflux mus rau hauv lub ureter thiab ob lub raum, reflux yog fraught nrog kev loj hlob ntawm txhua yam teeb meem. Qhov kev pheej hmoo siab yog nyob rau hauv qhov tseeb tias nyob rau hauv thawj theem ntawm pathology tsis tshwm sim nws tus kheej.
Cov teeb meem uas tshwm sim feem ntau nrog reflux:
- Ypyelonephritis;
- Yhydronephrosis;
- mob raum tsis ua haujlwm;
- raum ntshav siab.
Txawm hais tias muaj cov kab mob zoo li no, ob qho tib si ntawm cov tsos mob thiab cov kab mob sib txawv, lawv tuaj yeem ua rau muaj kev cuam tshuam los ntawm ib qho xwm txheej - tsis raug tso zis. Tsis tas li ntawd, cov urethra nyob rau hauv lub ureter yog ib qho chaw zoo rau kev loj hlob thiab kev loj hlob ntawm cov kab mob.
Diagnosis
Yog tias reflux tshwm sim thaum tso zis tso rau hauv lub raum, nws txhais tau hais tias cov kab mob tau dhau mus rau theem thib peb thiab tau pib tshwm sim nws tus kheej nrog qee cov tsos mob. Thawj thiab theem ob ntawm tus kab mob tuaj yeem pom tsuas yog los ntawm lub sijhawm ntawm kev tshuaj xyuas kev tiv thaiv thaum muaj lwm yam kev tsis txaus siab lossis kab mob hauv tus neeg mob.
Txhawm rau kuaj xyuas kom raug thiab txiav txim siab qib ntawm kev txhim kho tus kabmob, ntau cov txheej txheem kuaj mob tau ua tiav:
- musCov neeg mob keeb kwm - tus kws kho mob yuav tsum paub seb puas muaj cov kab mob pathologies cuam tshuam nrog cov zis hauv tus neeg mob yav dhau los;
- kuaj pom thiab ntsuas qhov siab, uas tsis suav lossis lees paub lub raum kub siab;
- kuaj - urinalysis (siab ESR thiab cov qe ntshav dawb qhia o hauv lub cev), ntshav chemistry pab ntsuas lub raum ua haujlwm;
- excretory urography - x-ray nrog qhov sib txawv qhia tau hais tias cov channel ntawm cov urethra dhau los ntawm kev sib xyaw kom tawm mus (puas muaj qhov tsis zoo thiab khoov ntawm cov qauv ntawm lub cev);
- Ultrasound - ua tiav ntawm lub zais zis thiab tam sim ntawd tom qab tso zis, qhov no tso cai rau koj los ntsuas seb cov urea tau ntim ntau npaum li cas thiab nws thiaj li nqus tau li cas, nrog rau txhawm rau txheeb xyuas cov qauv ntawm cov ntaub so ntswg thiab qhov tshwm sim tsis zoo hauv txoj kev loj hlob. ntawm lub cev ntawm cov zis;
- voicing cystography - kuaj xyuas seb puas muaj cov zis rov qab mus rau hauv lub ureter thiab qib twg nws yog, yog ua los ntawm kev siv tus neeg sawv cev sib txawv, uas tom qab ntawd tshwm rau ntawm cov duab.
Kev kho mob
Tus kws tshaj lij yuav qhia koj txog cov tsos mob thiab kev kho mob raum reflux. Kev kho mob feem ntau yog nyob ntawm seb qhov ua rau pathology, nyob ntawm lub hnub nyoog ntawm tus neeg mob thiab qhov hnyav ntawm tus kab mob. Nyob rau hauv thawj theem, kev kho mob yog nqa tawm. Lub sijhawm no yog tus cwj pwm los ntawm qhov mob ntawm lub ureter qis thiab tsis cuam tshuam rau lub raum, yog li koj tuaj yeem txwv koj tus kheej rau kev kho tshuaj.
Thaum hu rau tus kws kho mob urologist kom pab hauv thawj peb theem ntawm kev loj hlobQhov feem pua ntawm cov neeg mob rov qab ua tiav yog txog li 70%.
Kev saib xyuas kev noj qab haus huv yog raws li hauv qab no:
- Kev noj haus. Nws yog ib qho tseem ceeb nyob rau hauv cov ntaub ntawv ntawm pathology kom txo tau ntsev kom tsawg, tso tseg cov nqaij smoked, fatty zaub mov, hloov mus rau zaub, txiv hmab txiv ntoo thiab nplej. Taboo ntawm cawv, dej qab zib thiab kas fes muaj zog.
- Tshuaj. Cov no tuaj yeem yog tshuaj tua kab mob, tshuaj tiv thaiv kab mob, tshuaj antispasmodics, nyob ntawm seb qhov kev sib kis ntawm cov txheej txheem inflammatory thiab kab mob. Yog hais tias lub siab yog siab, cov tshuaj tau muab tshuaj kom txo nws.
- Physiotherapy. Kev kho mob da dej, magnetotherapy, electrophoresis txo cov txheej txheem inflammatory, tshem tawm spasms thiab rov kho cov physiological tam sim no ntawm cov urethra.
Kev phais rau lub raum rov qab rau cov neeg laus
Raws li txoj cai, kev kho kom zoo yog ua tiav rau rau lub hlis. Yog tias tsis muaj kev txhim kho nyob rau lub sijhawm no, ntxiv rau, cov teeb meem tshwm sim hauv daim ntawv ntawm pyelonephritis rov qab thiab txo qis hauv lub raum kev ua haujlwm, kev phais yog qhia.
Thaum thawj theem ntawm txoj kev loj hlob ntawm pathology, nrog rau qib 1 thiab qib 2 ntawm reflux, endoscopic kho yog ua. Nrog kev pab los ntawm kev txhaj tshuaj, ntim-forming implants yog nkag mus rau hauv cheeb tsam ntawm lub qhov ncauj ntawm lub ureter. Lawv ua ib qho kev txhawb zog. Cov implants yog raws li collagen, teflon los yog silicone. Cov ntaub ntawv no yog hypoallergenic, ruaj, thiab muaj kev sib raug zoo nrog tib neeg lub cev.
Rau lub raum reflux, kev phais kuj tau ua yogpathology tau nce mus rau theem siab ntawm qhov hnyav. Laparoscopic laureterocystoneostomy yog qhia rau kev nqa tawm ntawm 3rd lossis 5th degree ntawm pathology. Nyob rau theem no ntawm txoj kev loj hlob ntawm tus kab mob, cov phab ntsa ntawm lub ureter twb tau hloov loj heev, yog li ntawd, kev tshem tawm ntawm pathological cheeb tsam yog tam sim ntawd nqa tawm, nrog rau cov creation ntawm ib tug dag kev twb kev txuas ntawm lub ureter nrog lub ureter. Qhov kev ua haujlwm no tuaj yeem ua tau nrog kev txiav tawm ntawm ib feem ntawm lub ureter lossis nrog rau lub raum hloov pauv.
Huab cua thiab tiv thaiv
Nrog rau lub raum reflux, nws yog ib qho tseem ceeb rau kev kuaj mob raws sij hawm. Tsuas yog nyob rau hauv cov ntaub ntawv no, lub pathology yuav tsum tau nres los yog kho los ntawm conservative kev kho mob. Yog tias muaj teeb meem lossis mob nrog rau cov kev hloov pauv hauv lub raum, ces kev phais tsis tuaj yeem zam tau.
Tsis muaj kev tiv thaiv tshwj xeeb uas tsis yog kev tiv thaiv kev kuaj mob. Nws tsim nyog tiv thaiv lub nraub qaum thiab lub plab hauv plab los ntawm kev raug mob, hypothermia, kho cov txheej txheem inflammatory ntawm lub urinary system kom raws sijhawm thiab txo cov ntsev kom tsawg.
Zoo kawg
Kidney reflux, nyob ntawm hom (congenital lossis kis tau), nrog rau qib, yog ib tus kab mob kho tau. Feem ntau, cov kab mob pathology tuaj yeem raug tshem tawm los ntawm cov txheej txheem kev saib xyuas, tab sis yog tias tus kab mob tsis quav ntsej, kev cuam tshuam kev phais yog qhia. Nws yog ib qho tseem ceeb uas yuav tsum tau kuaj xyuas raws sij hawm, txij li tus kab mob no tshwm sim rau lub sijhawm ntev thiab tsis tshwm sim nws tus kheej hauv txhua txoj kev. Nyob rau theem pib, nws tuaj yeem pom los ntawm lub sijhawm thaum kuaj lub plab.
