Mwa mitundu yosiyanasiyana ya matenda a maginito, ma reflux a vesicoureteral kwa ana ndi vuto lalikulu la mankhwala amakono. Matendawa amapweteka kwambiri kwa odwala ndipo popanda chithandizo chokwanira angapangitse kulemala.
Kupezeka kwa DMR mu mwana - ndi chiyani?
Chikhodzodzo chotchedwa reflux kapena chidule cha PMR ndi njira yomwe mkodzo umalowa mu urea ndi chifukwa china chomwe chimabwereranso ku chifuwa chachikulu. Chikhalidwe choterocho chimayambitsa matenda mu mawonekedwe a pyelonephritis, ndipo mu choipitsitsa, makwinya a impso. Nthawi zina, reflux ya vesicoureteral ana imatha kudutsa yokha, ngakhale panthawiyi mu impso pali njira zowonongeka. Nthaŵi zambiri, chithandizo chamankhwala kapena chithandizo chamakono chokhazikika n'chofunika.
Chiwonetsero cha chikhodzodzo-chimayambitsa - chimayambitsa
Matenda osalimba a reflux ya vesicoureteral, zomwe zimayambitsa zonsezi zingakhale zomwenso zimakhala zowonongeka, zimadziwika ndi kuphwanya dongosolo la ma valve omwe ali mu ureter. Matenda opitirira 70% amapezeka mwa ana osapitirira chaka chimodzi. Kusagwirizana kwa valve mu ureter kungakhale onse congenital - primary PMR, ndipo anapeza - yachiwiri PMR. Pachifukwa chachiwiri, zimayambitsa matendawa ndi cystitis (matenda), zomwe zimapangitsa kuti m'kamwa mwake zikhale zowonjezereka kwambiri komanso kuchepa kwa mphamvu yake yosungirako chifukwa cha kutupa nthawi zonse.
Mlingo wa reflux vesicoureteral kwa ana
Nthendayi ndi reflux ya vesicoureteral, digiri yomwe ili yofunika kwambiri, yothandizira kuchiza malingana ndi siteji. Mitundu yochepetsetsa yochepetsetsa yomwe imayambira mu reflux ya vesicoureteral mu ana omwe akukhudzidwa, ndi mwayi waukulu wopeza mwanayo. Kusiyanitsa:
- Mpikisano - mkodzo umagwera pang'onopang'ono chabe, popanda kupitirira.
- Kuchuluka kwa mkodzo kumawonetseredwa mu ureter lonse komanso pang'onopang'ono.
- Gawo lachitatu - gawo ili likukhudzidwa ndi kuwonjezeka kwa pakhosi, kumene mkodzo ukuponyera, popanda kukula kwa ureter.
- Mpata wa IV - mapepala a chiwerewere ndi kuphulika amakhala ndi kusintha kwakukulu mu mawonekedwe a kukulitsa.
- V digitala - kupukuta kwa mphuno za impso chifukwa chopsa mkodzo ndipo zotsatira zake - kukwinya kwake ndi kuponderezedwa kwa ntchito.
Kuonjezera apo, kuopsa kwa matendawa kumayesedwa chifukwa cha kuchepa kwa impso. Kusiyanitsa:
- reflux ya vesicoureteral ya digiri 1 - pamene kusintha kuli kochepa ndipo ntchito ya impso siidakhudzidwe;
- 2-degree reflex vesicoureteral kwa ana amadziwika ndi kuchepa mu ntchito ya gululi ndi 30%
- 3-digsi vesicoureteral reflux - pamene impso zimagwira ntchito mphamvu 60%;
- 4-degree vesicoureteral reflux ndi gawo lalikulu kwambiri la matenda, chifukwa ntchito ya impso yacheperapo ndi 60%.
Chikhodzodzo chotsitsimula cha ana - zizindikiro
Kuyeretsa kwa ana mwachisawawa kumakhala ndi zizindikiro za matendawa, omwe nthawi zina amatengedwa kuti azindikire chizindikiro cha pyelonephritis . Kuti mwamsanga kuthetsa vuto la mwana wodwala, muyenera kugwiritsa ntchito zofufuza kwa madokotala oyenerera. Makolo ayenera kuchenjezedwa ngati mwanayo akudandaula za:
- mutu;
- kupuma;
- kumva ludzu;
- raspiranie m'chigawo cha m'chiwuno;
- kuthamanga kwa magazi;
- nthawi yaitali kutentha;
- ululu mutatha kukodza
- anasintha mtundu wa mkodzo (kutopa, chisanu).
Chikhodzodzo ndi chiwerewere reflux - matenda
Pofuna kudziwa kuti MTCT ndi mwana, muyenera kupeza chipatala chabwino kwambiri pa urology ya ana. Madokotala amayesa zovuta zambiri kuti adziwe kuchuluka kwa matendawa:
- kufufuza koyamba ndi urologist ndikupanga anamnesis;
- kukonzanso kwa mkodzo ;
- tizilombo toyambitsa mkodzo (bakopsev);
- Ultrasonography ya impso ndi ziwalo zozungulira zomwe zimagwiritsa ntchito Doppler;
- kusinkhasinkha kwa dongosolo la genitourinary;
- chithunzithunzi;
- chiwonetsero;
- radiography.
Kodi zotchedwa reflux zotchedwa vesicoureteral zimatani?
Matenda otere monga reflux vesicoureteral ana, amene chithandizo chingathe kukhala nthawi yaitali, ali ndi mitundu iŵiri - yogwira ndi osasamala. Pachiyambi choyamba, kukhetsa mkodzo kumabwereka kokha ndi kukodza, ndipo m'chiwiri, izi sizidalira zifukwa zakunja. Reflux ya vesiicrereteral imathandizidwa bwino kwa ana, makamaka ali aang'ono. Chithandizo ndi pafupifupi 100%. Pali mitundu iwiri ya mankhwala - osamala komanso opaleshoni. Muzipangidwe zochokera kunja:
- mankhwala;
- kulongosola mankhwala osokoneza bongo;
- kutenga mankhwala;
- phytotherapy;
- kuchitsulo;
- Kutaya kwa ola limodzi kwa chikhodzodzo;
- electrophoresis.
Kupititsa patsogolo opaleshoni kumawonetsedwa ngati:
- mankhwala ena samagwira ntchito;
- Kuwonjezera pa reflux, pali zotsatizana ndi kapangidwe kamene kamakono kakang'ono;
- Kuchulukanso kwa matenda opatsirana m'makina omwe sagwira ntchito yothandizidwa ndi antibacterial.
Chikhodzodzo ndi urere reflux kwa ana - mankhwala othandizira
Chifukwa chakuti ana amasiye amayamba kuganiza kuti ndi vuto lalikulu la mankhwala komanso boma, makompyuta amakono amachiritsidwa ndikuwongolera. Ine ndi yachiwiri ya matendawa amachiritsidwa osati opaleshoni, yomwe mu 65% ya milandu imapereka mphamvu zabwino. Koma ngati kutupa sikungakhoze kuimitsidwa, ngakhale pazigawo izi zikulimbikitsidwa kuchita ntchito yopweteka kwambiri imene ingaiwale kwanthawizonse za vutolo.
Endoscopic kukonza reflux vesicoureteral kwa ana
Njira yamakono komanso yogwira mtima, yokwanira 97% yogonjetsa reflux ya vesicoureteral ndi opaleshoni yotchedwa "endoscopy". Ndili, chipangizo chapadera chotchedwa endoscope, chomwe chimapweteka kwambiri, chomwe chimatha mphindi 15 zokha. Njira yonseyi ili pansi pa mask anesthesia ndipo kwa masiku 3-4 wodwala wamng'ono amalembedwa kale kuti athandizidwe.