Kab mob uas tshwm sim los ntawm kev kis kab mob thiab cuam tshuam rau lub plab mog, calyx thiab tubules ntawm lub raum yog hu ua mob pyelonephritis. Qhov no yog cov kab mob ntau tshaj plaws uas tshwm sim hauv 65% ntawm cov neeg mob raum pathology. Cov poj niam muaj kev cuam tshuam ntau dua rau nws, uas yog vim cov qauv ntawm lawv cov urethra, vim tias nws yooj yim dua rau cov kab mob nkag mus rau hauv lub cev. Mob pyelonephritis raws li ICD-10 code muaj tus nqi N11.
Yog vim li cas
Muaj qee qhov ua rau muaj tus kabmob ntau tshaj plaws. Thawj qhov tshwm sim ntawm tus kab mob no yog suav tias yog qhov tshwm sim hauv lub cev thiab kev vam meej ntawm kev kis tus kab mob hu ua tus neeg sawv cev. Cov kws kho mob xav tias Escherichia coli yog qhov yooj yim tshaj plaws thiab nquag ua tus neeg sawv cev ntawm pyelonephritis, tab sis qhov no tsis txhais hais tias lwm yam kab mob tsis ua rau nws. Piv txwv li, kab mob uas tuaj yeem ua rau tus kab mob no muaj ntau yam staphylococci, streptococci, proteus, thiab enterococci.
Ntxiv rau cov kab mob, cov kab mob fungal kuj tuaj yeem ua rau kab mob. Kev kis ntawm cov kab mob no tshwm sim nyob rau hauv ob txoj kev:
- Urinogenic, lossis nce. Kev sib cuag nrog cov urethralub cev nce. Txoj kev sib kis ntawm cov kab mob tshwm sim hauv cov poj niam.
- Hematogenous. Txoj kev kis tau tus mob tshwm sim los ntawm cov ntshav khiav. Cov kab mob thiab cov kab mob kis tau los ntawm thaj chaw cuam tshuam mus rau hauv lub cev, uas tuaj yeem kis tau los ntawm cov hlab ntsha.
Kab mob tsis tuaj yeem tawm tsam lub cev noj qab haus huv. Hauv qhov no, muaj qee yam tseem ceeb hauv qhov muaj tus kab mob pyelonephritis tuaj yeem tshwm sim. Thawj qhov tseem ceeb yog qhov txo qis hauv kev tiv thaiv kab mob. Thiab qhov thib ob yog congenital los yog kis tsis muaj zog ntawm lub raum lossis lawv cov kab mob, uas ua rau ua txhaum ntawm cov zis tawm.
Signs of disease
Cov tsos mob ntawm pyelonephritis ntev nyob ntawm nws theem. Primary pyelonephritis muaj cov tsos mob tshwm sim ntau dua li theem ob. Nrog rau qhov exacerbation ntawm pyelonephritis ntev, cov tsos mob hauv qab no yog qhov txawv:
- nce hauv lub cev kub txog 39 degrees.
- Pom qhov mob hauv thaj chaw pelvic, suav nrog qhov mob tuaj yeem ua ib leeg lossis ob sab.
- Kev txheeb xyuas cov kab mob urinary.
- Nyob rau hauv lub cev, qaug zog.
- Tsis qab los noj.
- Tseem mob taub hau.
- mob plab nrog ntuav thiab xeev siab.
- Pom kev hloov pauv hauv lub cev, uas yog, muaj edema thiab o.
Thaum kev zam txim, kuaj tus kab mob no nyuaj dua. Cov tsos mob tshwm sim ntawm tus mob pyelonephritis ntev ntawm qhov kev kawm no yog raws li hauv qab no:
- mob me me thiab ntuav hauv cheeb tsam lumbar.
- Pajtej zaum yuav rub los yog mob.
- Cov zis tso zis tsis zoo, thiab yog tias lawv pom, ces tawm tsam cov keeb kwm yav dhau los lawv tsis yog qhov tseem ceeb rau tus neeg mob.
- Lub cev kub tseem yuav luag tsis hloov, tab sis tej zaum yuav nce me ntsis mus rau 37 degrees thaum yav tsaus ntuj.
- Ua kom qaug zog ntawm lub cev, tshwj xeeb tshaj yog tias tus kab mob tsis saib xyuas thiab kho tsis raug. Tsis tas li, cov neeg mob pib pom kev qaug zog, tsis qab los noj mov thiab mob taub hau.
- Raws li nws loj tuaj, muaj teeb meem ntxiv nrog rau tso zis, tev, tawv nqaij thiab ua kom tawv nqaij.
- Ib daim quav plaque tshwm rau ntawm qhov ncauj thiab qhov ncauj qhuav ntawm qhov ncauj tau tshwm sim.
- Tus kab mob no feem ntau nrog cov hlab ntshav siab, uas ua rau muaj kev nce siab ntxiv.
- Zoo qhov ntswg.
Nyob rau theem siab ntawm pyelonephritis, mob pob txha thiab pob qij txha raug kuaj pom. Tus kab mob no tshwm sim los ntawm kev tso zis ntau ntxiv (txog 3 litres ntawm cov zis ib hnub twg) thiab nqhis dej heev.
Stages
Tus kab mob pyelonephritis muaj plaub theem ntawm kev txhim kho ntawm o ntawm lub raum cov ntaub so ntswg.
Thawj theem yog tus cwj pwm los ntawm qhov tsis sib xws ntawm cov ducts sau (cov raj tsim los tshem cov zis). Lub glomeruli nyob rau theem no muaj kev noj qab haus huv tag nrho, cov txheej txheem pathological tsis tshwm sim hauv lawv. Kuj tseem muaj me ntsis leukocyte infiltration ntawm cov ntaub so ntswg sib txuas ntawm medulla.
theem thib ob yog tus cwj pwm los ntawm kev muaj cov ntaub so ntswg puas thiab atrophy ntawm me metus naj npawb ntawm glomeruli, tom qab uas lawv yaj. Tom qab lub glomeruli, lub raum nyob ib puag ncig cov tubules pib tuag. Qee lub nkoj tau nqaim heev, rub thiab kaw.
Nyob rau theem thib peb, lub raum noj qab nyob zoo yog hloov los ntawm cov caws pliav, lub raum ntsws me me thiab ua rau lub ntsej muag wrinkled nrog bulges thiab kev nyuaj siab.
theem plaub, nyob ntawm kev ua haujlwm ntawm qhov mob, muab faib ua cov hauv qab no:
- Active. Cov theem no muaj peev xwm txav mus rau lwm qhov.
- Latent (ntev theem siab). Muaj peev xwm txav tau ob qho tib si mus rau tom ntej thiab rov qab mus rau yav dhau los.
- Kev zam txim yog theem ntawm kev kho mob rov qab, uas yog, qhov tsis muaj cov cim qhia ntawm qhov muaj tus kab mob thiab txhim kho hauv kev tso zis.
Cov Teeb Meem thiab qhov tshwm sim
Nrog kev kho tsis raug ntawm pyelonephritis ntev, lub sijhawm ntawm exacerbation yuav tshwm sim. Nrog rau lub sij hawm ntev ntawm exacerbation, cov teeb meem tshwm sim uas tshwm sim raws li lub mechanism ntawm mob pyelonephritis. Teeb meem, nyob rau hauv tag nrho cov hom ntawm pyelonephritis ntev, siv daim ntawv ntawm lub raum tsis ua hauj lwm. Ib qho cim ntawm qhov no yog qhov nce ntawm cov zis tawm hauv ib hnub, nrog rau kev txo qis hauv nws cov concentration, nqhis dej tas li thiab qhov ncauj qhuav.
Lub raum tsis ua haujlwm muaj cov theem hauv qab no:
- Hidden (latent). Nyob rau theem no, cov tsos mob ntawm keeb kwm ntawm pyelonephritis mob ntev tsis tshwm sim.
- Nco ntsoov. Kev qaug zog sai yog pom tau nrog me ntsiskev tawm dag zog lub cev, tsis muaj zog, tshwj xeeb tshaj yog thaum yav tsaus ntuj, qhov hnyav thiab qab los noj mov.
- Cov tsos mob hnyav pib tshwm sim ntawm lub davhlau ya nyob twg lossis theem kawg nkaus xwb. Nyob rau tib lub sijhawm, qhov tsis hnov tsw ntawm ammonia los ntawm lub qhov ncauj thiab lub xub ntiag ntawm qhov mob taub hau tas li raug nthuav tawm. Cov tawv nqaij ua daj ntseg, qhuav, flabby. Kev ua haujlwm ntawm txhua lub cev lub cev yog deterioration. Nws yog ib qho nyuaj rau tshem tawm toxins los ntawm lub cev, uas ib txwm yuav tsum tau tawm hauv cov zis.
Nyob ntev ntawm cov kab mob pyelonephritis tuaj yeem ua rau muaj kev loj hlob ntawm cov kab mob xws li pedunculitis, uas yog, o hauv thaj tsam ntawm lub raum rooj vag, thiab nephrosclerosis, uas ua rau lub raum deformation.
Diagnosis
Raws li txoj cai, nws nyuaj dua los kuaj xyuas cov kab mob pyelonephritis. Kev kuaj mob yog qhov nyuaj los ntawm cov kab mob latent. Cov ntaub ntawv hais txog lwm yam kab mob tso cai rau peb kom paub meej qhov ua rau ntawm txoj kev loj hlob ntawm cov kab mob no. Ntau zaus, thaum kuaj cov kws kho mob, lawv txaus siab rau qhov muaj lossis tsis muaj qhov txawv txav hauv qab no:
- Pathology ntawm ob lub raum thiab tso zis.
- Kab mob kis ntawm poj niam cev xeeb tub.
Tus kab mob pyelonephritis feem ntau ploj mus nrog cov tsos mob me me, uas ua rau nws nyuaj rau kev tshawb nrhiav. Kev kuaj mob hauv cov xwm txheej zoo li no yog ua raws li cov txiaj ntsig ntawm kev sim thiab ntsuas cov txheej txheem tshawb fawb. Kev kuaj lub cev yuav tsis pom cov txheej txheem pathological hauv lub raum. Nws muaj nyob rau hauv lub hom phiaj kev tshuaj xyuas rau lub xub ntiag ntawm pallor ntawm daim tawv nqaij, o ntawm lub ntsej muag thiab daim tawv muag,tsis xis nyob thaum ntaus lub lumbar cheeb tsam, thiab kuj pab txheeb xyuas qhov muag intoxication.
Kev tshawb fawb txog kev mob pyelonephritis ntev (ICD-10: N 11) hauv cov neeg mob muaj raws li hauv qab no:
- Kev kuaj zis. Nrog nws, kuaj pom qhov ntsuas ntau ntawm leukocytes hauv cov ntshav.
- tso zis tsom xam los ntawm Zimnitsky txoj kev. Raws li cov txiaj ntsig tau, cov kev ua haujlwm ntawm lub raum raug tshuaj xyuas, tus nqi thiab qhov ceev ntawm cov zis tau txiav txim siab ntawm lub sijhawm sib txawv ntawm ib hnub.
- Ua tiav cov ntshav suav yog txhawm rau txiav txim siab tus nqi hemoglobin, erythrocyte sedimentation tus nqi thiab cellular muaj pes tsawg leeg ntawm cov ntshav.
- Kev kuaj ntshav biochemical, uas qhia tau tias muaj kev hloov pauv hauv cov tshuaj electrolyte ntawm cov ntshav.
ntsuas ntsuas hauv cov neeg mob yog raws li hauv qab no:
- Ultrasound ntawm lub raum tso cai rau koj los tshuaj xyuas ob sab hauv lub raum thiab nws daim nyias nyias.
- Ultrasound ntawm cov hlab ntsha nyob ib puag ncig lub raum tso cai rau peb ntsuas qhov ua txhaum ntawm cov ntshav ntws ntawm lub raum daim nyias nyias.
- X-ray kuaj (nrog rau kev suav tomography) tuaj yeem kuaj pom qhov loj ntawm lub raum thiab cov zis, xws li kev hloov pauv ntawm qhov loj lossis cov duab ntawm lub cev.
- MRI yog ua rau cov neeg mob uas muaj contraindicated nyob rau hauv kev taw qhia txog cov contrast agents rau hauv lub cev.
Tus kab mob pyelonephritis (ICD-10: N 11) zoo ib yam hauv cov yam ntxwv ntawm cov kab mob glomerulonephritis ntev, uas ua rau nyuaj rau kev kuaj mob thaum siv cov hau kev saum toj no. Yog li, kev kuaj mob sib txawv yog nyob ntawmib txheej ntawm cov ntaub ntawv anamnesis, uas tau rov ua kom zoo dua los ntawm cov txheej txheem saum toj no. Nrog rau kev kuaj mob zoo li no, kev saib xyuas ntau yog them rau txoj kev tshawb fawb ntawm cov zis tso quav, uas yog kev txiav txim siab ntawm nws cov kab mob bacteriological.
Drug therapy
Nws yuav tsum tau muab sau tseg tias yog tsis muaj tshuaj tua kab mob, mob pyelonephritis nyob rau hauv cov poj niam thiab cov txiv neej yuav kho tsis tau. Yog li ntawd, thaum kuaj pom cov theem no, lawv sim pib noj tshuaj tua kab mob tam sim ntawd. Hom tshuaj yuav nyob ntawm qhov rhiab heev ntawm cov kab mob uas ua rau lub raum mob rau cov tshuaj tua kab mob. Kev ua tau zoo ntawm kev kho mob nrog cov tshuaj zoo li no tuaj yeem poob yog tias siv tshuaj tua kab mob lig dhau los lossis kev kawm tsis tiav. Qhov no yog vim qhov tseeb tias dhau sijhawm cov kab mob yuav nce ntxiv, raws li qhov chaw cuam tshuam.
Qhov kev xav tau tseem ceeb hauv kev kho mob pyelonephritis rau cov tshuaj tua kab mob: tsawg kawg nkaus toxicity nrog kev ua haujlwm siab tshaj plaws. Tsis tas li ntawd, cov tshuaj tua kab mob yuav tsum tiv nrog cov kab mob pathogenic feem ntau.
Cov tshuaj hauv qab no yog siv los kho cov mob pyelonephritis ntev:
- penicillins ("Ampicillin", "Oxacillin", "Sultamicillin", "Amoxiclav");
- cephalosporins ("Ceporin", "Kefzol", "Cefepime", "Ceftriaxone", "Cefotaxime", "Cefixime");
- nalidixic acid ("Nevigramon", "Negram");
- aminoglycosides ("Kolimycin", "Kanamycin", "Gentamicin", "Amikacin","Tobramycin");
- fluoroquinolones ("Moxifloxacin", "Levofloxacin", "Ciprinol", "Ofloxacin");
- nitrofurans ("Furadonin", "Furazolidone");
- sulfonamides ("Etazol", "Urosulfan");
- antioxidants (tocopherol acetate, ascorbic acid, retinol, selenium).
Txawm hais tias lawv cov kev ua haujlwm siab, cov tshuaj tua kab mob muaj ntau yam kev phiv. Yog tias kuaj pom cov tshuaj tiv thaiv tsis zoo, nws yog ib qho tsim nyog yuav tau kho cov tshuaj los yog hloov cov tshuaj. Txhawm rau xaiv ib lossis lwm yam tshuaj tua kab mob, tus kws kho mob yuav tsum paub los ntawm kev tshuaj xyuas cov zis seb tus neeg mob muaj acidity li cas, vim tias kev kho mob nrog cov tshuaj no lossis cov tshuaj ntawd nyob ntawm qhov ntsuas no.
Tshuaj tua kab mob feem ntau pom zoo rau tsawg kawg 2 lub hlis. Qee lub sij hawm qhov kev ntsuas tau zoo yog qhov hloov pauv ntawm thawj cov tshuaj tua kab mob nrog qhov thib ob thaum lub sijhawm kawm rau txhua 10 hnub. Lub sijhawm ntawm kev kho tshuaj tua kab mob rau ib tus neeg mob tshwj xeeb yuav nyob ntawm cov txiaj ntsig ntawm kev tshawb fawb. Lawv nqes los tseb ib tug colony coj los ntawm lub cev uas cuam tshuam thiab kawm nws rau cov tshuaj tua kab mob rhiab heev. Yog hais tias tus kab mob yog siab heev thiab tus neeg mob qhov mob hnyav, ces muab tshuaj tua kab mob ua ke rau nws. Lawv tau noj ob qho tib si ua ntsiav tshuaj ntawm qhov ncauj thiab txhaj tshuaj.
kev kho neeg zoo
Parsley yog tus pabcuam tseem ceeb hauv kev tawm tsam pyelonephritis ntev. Nws yuav muaj ib tug detoxifying thiab antispasmodic nyhuv, ua hauj lwm raws li ib tug antiseptic, thiab tseem ceeb tshaj, nws yuav txhim khu kev ua hauj lwm ntawm lub urinary system, pab tshem tawm toxins nyob rau hauv lub cev.lub cev. Ua ke nrog parsley, nws tseem pom zoo kom siv dill, celery, dos, lovage thiab lettuce, uas yuav pab txhim kho cov nyhuv ntawm lub ntsiab tivthaiv ntawm lub raum cov ntaub so ntswg. Koj yuav tsum siv ib pawg ib zaug ib lub lim tiam tsis muaj qhob cij thiab ntsev.
Thaum kho tus mob pyelonephritis nyob rau hauv cov poj niam, koj yuav tsum tsis kam noj dej, hloov nws nrog berries, xws li:
- raspberries;
- strawberry;
- cranberries;
- lingonberries;
- Yblackberry.
Lawv yuav pab ntxiv cov dej noo uas lub cev xav tau yam tsis tsim lub nra rau lub raum.
Ib qho tseem ceeb yuav muaj tinctures. Cov tshuaj uas xav tau yuav tsum tau noj nyob rau hauv tib tus nqi, sib tov thiab ncuav nrog boiling dej nrog rau kev suav ntawm 200 milliliters dej ib 1 tablespoon ntawm raw cov ntaub ntawv. Tawm rau ob teev thiab lim. Koj yuav tsum haus ib nrab khob plaub zaug ib hnub twg peb caug feeb ua ntej noj mov. Cov tshuaj no yuav tsum tau sov.
Tus nqi tshuaj ntsuab:
- Anise txiv hmab txiv ntoo, nplooj birch, St. John's wort, tricolor violet.
- YCowberry nplooj, Ivan tshuaj yej, parsley paus, goose cinquefoil, parsley paus.
Kev noj haus
Cov neeg mob tau muab tshuaj noj nrog cov kua dej ntau hauv cov kab mob pyelonephritis. Cov lus pom zoo hauv tsev kho mob yuav tsum ua raws li nruj me ntsis, txwv tsis pub tus mob yuav hnyav dua.
Nyob rau hauv ib txwm muaj siab, cov cai niaj hnub yuav tsum muaj raws li hauv qab no: cov protein - 95-105 g, rog - 75-85 g, carbohydrates - 400 g, ntsev - 7-9 g, kua - txog 2 litres, tag nrho calorie cov ntsiab lus nyob rau tib lub sij hawm yuav tsum yog2900-3100 calorie ntau ntau. Tus naj npawb txais tos - 5 zaug.
Nrog kev kub siab, cov cai niaj hnub ntawm cov ntsiab lus yog raws li hauv qab no: cov protein - 70-80 g, rog - 55-75 g, carbohydrates - 400 g, ntsev - 3-5 g, kua - ib ncig ntawm 2 litres, tag nrho cov ntsiab lus caloric - 2400-2900 calories. Tus naj npawb txais tos - 5 zaug.
Nws yog qee zaum pom zoo kom siv sijhawm yoo mov. Piv txwv li, noj txiv hmab txiv ntoo ntau hnub no thiab zaub ntxiv tag kis.
Thaum noj zaub mov, koj yuav tsum noj cov zaub mov hauv qab no:
- qib noj nqaij, nqaij qaib, ntses, lawv raug tso cai rau boil thiab steamed;
- khoom noj;
- dawb lossis grey qhob cij;
- pasta, cereals thiab hmoov;
- zaub nyoos;
- qe;
- txiv hmab txiv ntoo thiab txiv ntoo;
- Zib ntab, Jam, Tej Christ, Tej Dej Puam, Marshmallows;
- yam tshuaj yej thiab kua txiv.
Nyob rau hauv mob pyelonephritis, cov txheej txheem kho mob rau cov zaub mov txwv tsis pub muaj raws li hauv qab no:
- khoom noj haus thiab qab ntsev;
- nceb;
- fatty broths;
- legumes;
- refractory rog;
- ncuav mog qab zib nrog nplua nuj cream;
- khoom noj ceev thiab khoom noj txom ncauj nrog ntsev ntau;
- kas fes thiab chocolate;
- cawv.
Kev Tiv Thaiv
Koj yuav tsum paub tias mob raum pyelonephritis yuav ua rau muaj kev cuam tshuam loj heev. Yog li ntawd, nws yog ib qho tseem ceeb uas yuav tsum tau siv cov kev tiv thaiv tiv thaiv tus kab mob no txhawm rau tiv thaiv nws txoj kev loj hlob. Txhawm rau kom tsis txhob muaj cov tsos mob ntawm pyelonephritis ntev, nws yog ib qho tsim nyog yuav tsum tau kho cov theem mob ntawm cov kab mob no thiab tom qab ntawd tsis tu ncua.mus ntsib kws kho mob. Kev tiv thaiv, nws yog ib qho tseem ceeb los tiv thaiv lub raum ntawm cov kab mob.
Ua li no, nws yog ib qho tsim nyog yuav tau kho cov kab mob hauv qab no kom tiav, feem ntau ua rau muaj kev mob hnyav hauv lub raum: coprostasis, mob plab, cholecystitis. Nws yog ib qho tseem ceeb los tiv thaiv pyelonephritis hauv cov poj niam cev xeeb tub. Raws li kev txheeb cais, yog tias koj tswj kom kov yeej pyelonephritis thaum cev xeeb tub, tom qab ntawd cov kab mob ntev tsis tshwm sim.
Tsis tas li ntawd, thaum tiv thaiv exacerbations ntawm pyelonephritis ntev, tsis txhob hnov qab txog kev ntsuas kev nyiam huv, khoom noj khoom haus zoo thiab sib npaug, muaj nyob hauv cov zaub mov ntawm cov khoom noj uas muaj cov vitamins. Nws yog ib qho tseem ceeb los tiv thaiv kev txhim kho ntawm lwm yam kab mob thiab tsis tu ncua kev kawm tshuaj tua kab mob txhawm rau txo cov kab mob pathogenic hauv lub cev.
Spa kho mob
Daim ntawv kho mob sanatorium coj tau qhov txiaj ntsig zoo hauv kev kho mob pyelonephritis (ICD-10 code - N11). Nyob rau hauv rooj plaub no, cov txheej txheem tshiab tshaj plaws yog siv los pab tshem tawm qhov mob, ntxuav lub raum thiab coj tus neeg mob lub cev rov qab los. Ua tsaug rau qhov kev ua haujlwm nyuaj uas lub sanatorium muab, tus neeg mob yuav rov qab mus rau lub neej zoo li qub.
Yuav ua li cas kho tus mob pyelonephritis nyob rau hauv sanatorium? Qhov no suav nrog cov haujlwm xws li:
- Kev noj haus.
- muag da dej.
- Mineral water therapy.
- Hydrotreatment.
- Kev kho cua sov.
Txhua tus txheej txheem tsuas yog ua tom qab lub sijhawm teem tsegDr.
