Spongy (medullary) lub raum yog ib qho kev hloov pauv hauv lub raum ntawm lub raum khaws cov ducts ntawm Malpighian pyramids, uas ua rau lub raum cov ntaub so ntswg zoo li daim txhuam cev porous. Thaum muaj teeb meem (pyelonephritis thiab nephrocalcinosis), lub raum colic, pyuria, hematuria tau sau tseg. Pathology yog kuaj nrog retrograde pyelography thiab excretory urography. Kev kho mob rau cov tsos mob yog tsom rau kev tshem tawm qhov tshwm sim tsis zoo. Yog tias kev kho mob tsis zoo, pob zeb raug tshem tawm ntawm lub raum, nephrostomy, raum resection, nephrectomy.
ob sab qhov tsis zoo
Nrog rau lub raum spongy, feem ntau muaj qhov tsis xws luag hauv ob sab hauv cov tshuaj medullary, thaum cov kab mob cystic txawv txav tuaj yeem cuam tshuam rau lub raum papillae. Tsis zoo li polycystic, spongy muaj cov duab tsis tu ncua, du nto, du contours thiabqee qhov nce hauv qhov loj me piv rau hnub nyoog tus qauv. Ntawm qhov kev txiav, nws muaj qhov nthuav dav ntawm lub raum terminal tubules nrog ntau cov hlwv me me thiab kab noj hniav hauv thaj tsam ntawm cov pyramids.
Sizes
Qhov loj ntawm cov hlwv yog li ntawm 1 txog 4 hli, nce mus rau qhov chaw. Nrog rau lub raum spongy, cystic formations ntawm ob hom yog sau tseg - diverticuloid protrusions rau hauv lub lumen ntawm cov tubules, nrog ib tug cylindrical epithelium, los yog kaw kab noj hniav tsim los ntawm combining me hlwv uas yog cais los ntawm lub raum tubules thiab lined nrog squamous epithelium. Cov kab mob cystic feem ntau muaj cov kua dej daj daj (thaum tsis muaj cov txheej txheem inflammatory), calcified calculi, thiab desquamated hlwb. Vim leaching, pob zeb me me los ntawm cov tubules yuav pom nyob rau hauv lub calyces los yog lub raum pelvis.
Kev hloov lub raum cov ntaub so ntswg
Lub raum cov ntaub so ntswg hauv thaj tsam ntawm cov pyramids hauv lub raum spongy, raws li txoj cai, yog fibrous thiab ntom, thiab nrog cov pyelonephritis concomitant, nws feem ntau muaj kev hloov pauv.
Calcification ntawm lub parenchyma ntawm lub raum (nephrocalcinosis) yog suav tias yog ib qho kev mob thib ob, vim tias cov zis tsis nyob hauv cov hlab ntsha thiab cov kab noj hniav ua rau muaj cov calcium ntsev. Nrog rau lub raum spongy, lawv txoj haujlwm tau khaws cia rau lub sijhawm ntev. Thiab qhov cuam tshuam ntawm parenchyma tuaj yeem ua rau muaj kev kis kab mob, kev loj hlob ntawm cov txheej txheem pob zeb thiab kev hloov pauv hauv patency ntawm cov zis.
Vim txoj kev loj hlobkab mob
Feem ntau cov kev tshawb fawb urological tau lees paub tias ob lub raum spongy (raws li ICD-10 - Q61), raws li qhov tsis txaus ntseeg ntawm kev loj hlob hauv plab, zoo ib yam hauv cov kab mob thiab etiology rau polycystic ob lub raum. Cov kws tshawb fawb tseem ntseeg tias qhov tshwm sim ntawm cov kab mob no cuam tshuam nrog kev ua txhaum cai lig ntawm embryogenesis, thiab kev hloov pauv ntawm cov ducts ntawm lub raum kuj tuaj yeem pom nyob rau lub sijhawm tom qab yug menyuam. Cov keeb kwm ntawm tus kab mob no tau lees paub, tab sis hom qub txeeg qub teg feem ntau tsis sib xws.
Lub raum Spongy tau pom feem ntau hauv cov neeg laus thiab cov hnub nyoog nruab nrab, feem ntau - hauv cov txiv neej. Vim lub sij hawm latent ntev ntawm cov txheej txheem pathological hauv menyuam yaus, tus kab mob no pom tsis tshua muaj.
Symptoms of disease
Feem ntau, rau lub sijhawm ntev, cov kab mob pathology tsis tshwm sim hauv tsev kho mob. Cov tsos mob tshwm sim nyob rau hauv lub hnub nyoog ntawm 20 mus rau 40 xyoo nrog tshwm sim ntawm ntau yam teeb meem: tsim ntawm pob zeb nyob rau hauv lub cystic kab noj hniav, kab mob ntawm lub urinary ib ntsuj av thiab ob lub raum. Lub ntsiab kev kho mob tshwm sim ntawm lub raum nyuaj spongy yog npub los yog paroxysmal mob mob nyob rau hauv lub lumbar cheeb tsam, micro- thiab macrohematuria, pyuria.
Papillary nephrocalcinosis tau pom nyob rau hauv cov kab mob no ntau dua 62% ntawm cov neeg mob. Lub raum colic tshwm sim los ntawm kev tsiv teb tsaws ntawm pob zeb me los ntawm cov kab noj hniav mus rau hauv lub plab mog thiab calyces. Txoj kev loj hlob ntawm cov txheej txheem inflammatory vim yog nkag mus ntawm cov pob zeb me me rau hauv lub plab-calyx system thiab ua txhaum ntawm kev tawm mus.tso zis tuaj yeem tshwm sim los ntawm qhov kub thiab txias, qhov tso zis tsis zoo. Tsis tshua muaj, nyob rau hauv cov ntaub ntawv hnyav ntawm urolithiasis thiab kis tus kab mob thib ob, purulent fusion thiab tuag ntawm parenchyma tuaj yeem tshwm sim, uas tshwm sim los ntawm cov tsos mob ntawm lub raum tsis ua haujlwm.
Kev ntsuas ntsuas rau cov kab mob no
Kev kuaj mob ntawm lub raum spongy yog ua raws li cov txiaj ntsig ntawm kev kuaj urological uas nws kim heev, txoj hauv kev tseem ceeb ntawm cov tshuaj urography. Ntawm urogram, ib tus tuaj yeem pom qhov sib txawv sib txawv, kiv cua-zoo li tus thiab mosaic-puab cystic pampiniform kab noj hniav thiab nthuav dav ntawm cov ducts. Kev hloov pauv ntawm qhov xwm txheej hauv lub raum spongy feem ntau cuam tshuam rau thaj chaw medullary distal ntawm lub cev, thaum cov khoom siv cortical thiab thaj chaw cortico-medullary tseem nyob, raws li txoj cai, tsis hloov..
Nyob rau hauv cov kab noj hniav nyob rau hauv thaj chaw papillary, tus neeg sawv cev sib txawv rau x-rays nyob ntev dua li hauv khob, uas qhia tau tias tsis nyob hauv cov ducts. Kev loj hlob ntawm nephrocalcinosis yuav qhia tau los ntawm papillary calculi darkened nrog radiopaque tshuaj.
Ntau tus neeg xav paub seb puas tuaj yeem pom lub raum spongy ntawm ultrasound. Peb yuav tham txog qhov no hauv qab no.
Retrograde pyelography
Tseem tsawg zaus, retrograde pyelography yog siv los kuaj tus kab mob, vim nws tsis yog ib txwm muaj peev xwm txiav txim siab txog kev hloov pauv hauv cov hlab ntsha ntawm lub raum ntawm pyelograms. Kev kuaj X-ray ntawm lub raum yog pom zoo kom ua nrog kev sib xyaw ntawm ob lub raum nrog nephrolithiasis lossisnephrocalcinosis txhawm rau txheeb xyuas microliths thiab calcifications nyob rau hauv cov pyramids distal. Nyob rau hauv cov ntaub ntawv no, lub ntsiab lus dluab pom cov duab ntxoov ntxoo ntawm cov pob zeb me me nyob rau hauv lub papillary hlwv, ib feem los yog tag nrho coinciding nrog cov duab ntxoov ntxoo ntawm cov kab noj hniav nyob rau hauv lub excretory urogram.
Puas yog lub raum medullary spongy txiav txim los ntawm ultrasound? Kev kuaj ultrasound tsis tas yuav tso cai pom cov hlwv me me hauv cov txheej sib sib zog nqus ntawm lub raum cov ntaub so ntswg. Tsis tas li ntawd, qhov kev kuaj mob no tso cai rau koj los txiav txim seb muaj pob zeb, hematuria thiab pyuria.
Kev kuaj mob rau lub raum spongiform kuj tseem pab tshawb pom pyuria, hematuria, me me hypercalciuria, thiab proteinemia.
Kev kuaj mob sib txawv ntawm tus kab mob no yog ua tiav nrog cov kab mob uas muaj cov kab mob polycystic ntawm cov ntaub so ntswg ntawm lub raum (polycystic raum kab mob, cystic pyelitis, papillary necrosis, mob pyelonephritis), nrog rau nephrocalcinosis, nephrolithiasis, tuberculosis.
Saib hauv qab no rau daim duab ntawm lub raum spongy ntawm ultrasound.
Kev kho mob
Spongy buds - yog vim li cas thiaj txaus ntshai?
Nrog cov txheej txheem pathological tsis yooj yim thiab nws cov chav kawm asymptomatic, tsis muaj kev kho, raws li txoj cai, yog ua tiav. Hauv qhov no, tus neeg mob tau qhia txog kev tiv thaiv kev tiv thaiv kom txo tau qhov tshwm sim ntawm cov teeb meem. Nrog rau kev kho mob tshwm sim ntawm spongy ob lub raum, kev kho mob yog tsom rau kev tiv thaiv kev txhim kho ntawm cov kab mob thib ob hauv cov zis thiab cov kab mob metabolic.(tom qab tso cov calcium ntsev hauv cystic-hloov tubules ntawm ob lub raum). Yog tias pyelonephritis tshwm sim, haus dej kom ntau, noj zaub mov tsis muaj calcium, thiab siv tshuaj tua kab mob ntev.
txhawm rau tiv thaiv kev tsim cov kab mob iatrogenic, cov cuab yeej siv urological hauv cov neeg mob uas muaj lub raum spongy tau qhia tsuas yog hauv cov xwm txheej tshwj xeeb. Nephrostomy yog qhov tsim nyog thaum cov txheej txheem pathological nyuaj los ntawm pyelonephritis lossis urolithiasis, nrog rau qhov tsis muaj txiaj ntsig ntawm kev kho mob ib txwm muaj. Nrog focal cystic deformities cuam tshuam rau ib ntu ntawm ob lub raum, lawv raug kho dua.
Kev tshem tawm lub cev
Kev tshem tawm ntawm lub cev (nephrectomy) yog ua tsis tshua muaj heev thiab tsuas yog nrog ib sab qhov txhab. Kev tsiv teb tsaws ntawm cov pob zeb me me, uas cuam tshuam cov zis tawm ntawm cov zis, yuav yog ib qho qhia rau kev tshem tawm cov pob zeb los ntawm ob lub raum sai li sai tau siv nephrolithotomy, pyelolithotomy, percutaneous nephrolithotripsy, tej thaj chaw deb nephrolithotripsy. Hauv cov xwm txheej me, qhov kev kwv yees rau lub raum spongy yog qhov zoo. Txawm li cas los xij, nrog rau qhov pib thiab kev loj hlob ntawm nephrocalcinosis thiab qhov sib ntxiv ntawm kev kis tus kab mob thib ob, nws tuaj yeem ua rau lub sijhawm. Nrog rau kev kho tsis tiav ntawm cov txheej txheem nyuaj, qhov no ua rau tsim cov kua paug hauv lub raum thiab ua rau lub cev poob ntxiv.
