Kuziva kwedzidzo dzakawanda dzekuongorora kunenge kure kure nekukwana, saka mune dzimwe nguva chiremba anofanira kutora nguva. Bhiopsy ndiyo fence yenzvimbo duku yeputsvo uchishandisa zvigadzirwa zvokuvhiya. Shanduro inoguma inotumirwa pakarepo kuti iite zvinyorwa zvishoma uye zvidzidzo zvayo.
Renal biopsy - zviratidzo uye zvinopesana
Iyo inorondedzerwa teknolojia inobatsira chiremba kuti atsanangure zvinotarisirwa kuongororwa, ona kuti zvakasimba uye zvikonzero zvekuonekwa kwechirwere uye kukura chirongwa chinoshanda cherapi. Mukuwedzera, inoshandiswa kusiyanisa zvirwere. Tsitsi inoputirana ne glomerulonephritis inoita kuti ikwanise kuenzaniswa nedzimwe nhengo yekukuvara:
- amyloidosis ;
- Chirwere cheBerger;
- pyelonephritis;
- diabetes nephropathy ;
- kubatana, nhaka kana kusingaperi nephritis.
Iro chirwere chepfungwa chei chinonzi biopsy?
Maitiro emukati maitiro haana kuitirwa kumurwere wekukumbira, chete nyanzvi inogona kukurudzira chete kana pane zvikonzero zvakanaka zvekuita. Renal biopsy: kuverenga:
- organic glomerular kana tubular proteinuria;
- mhirizhonga hematuria;
- nephrotic syndrome;
- renal failure, glomerulonephritis nekukurumidza kufambira mberi;
- tubulopathy yekusatsanangurwa kwakabva;
- anofungidzirwa neoplasm;
- kushanda kusina kururama kwechimiro chakaiswa.
Kucherechedza kwepfungwa yemoyo inoitwa nokuda kwezvinangwa zvinotevera:
- kusarudzwa kwehutano hwakakwana;
- kudzora kubudirira kwekoro yakasarudzwa;
- kutarisa mamiriro ekutengesa.
Iropi bhiopsy - zvinopesana
Kune zvirwere uye mamiriro ekudzivirira umo kushandiswa uku hakugoni kuitwa:
- kusawirirana kwehanavocaine-ine zvinodhaka;
- Inongo imwe chete inoshanda;
- kukanganiswa kweropa kuvhara;
- hydronephrosis;
- aneurysm ye renal renter;
- kodzero yokurwisa ventricular;
- cavernous tuberculosis;
- thrombosis yemavheya emvura;
- purulent perinephritis;
- ronda;
- psychosis;
- dementia;
- kugara mu coma.
Mune zvimwe zviitiko, kuputika kwechipiro chetsvo kunobvumirwa, asi kunofanira kuitwa nekuchenjerera kwakanyanya:
- renal insufficient mumugariro wakaoma;
- nodular periarteritis;
- diastolic hypertension ine nhamba dzinopfuura 110 mm Hg;
- myeloma;
- chiyero chemaatrosclerosis;
- atypical movement of the organ;
- Nephroptosis.
Iropi bhiopsy - pros uye cons
Nzira iri pasi pekufungidzirwa inobatanidza nedambudziko rakaoma, saka mubvunzo wekubatsira kwake unosarudzwa nechiremba anokwanisa. Kuvhara kunogona kupa huwandu hwehuwandu hwemashoko, maitiro edzidzo uye kuoma kwechirwere, kunobatsira kusimbisa zvakarurama uye zvisina kukanganisa kusarudzwa. Panguva imwe chete, inogona kukanganisa migumisiro yakaipa, kunyanya kana yakaitwa pamberi pekupikisa.
Zvakasiyana, nephrologists inokurukura nezvechirwere chepfungwa yemutsvo. Kuvapo kwemakumbo muchigunhi ichi kunowanikwawo mune dzimwe nzira kunze kwekudiwa kwekuvhara. Munenge zvose zvinowanikwa kunze kwekukura zvinotarisirwa kubviswa, izvo zvinopa huwandu hwekuwana mavara epiyo, uye kumarara. Panyaya iyi, nyanzvi dzinowanzosarudzira zvinorondedzerwa kushandiswa kwekushandiswa kwekutsvaga zvinyorwa.
Zvinorwadza here kuita tsvina yeutsvo?
Izvo zvinoratidzirwa zvinowanikwa pasi pechiito chekuita anesthetic (kunowanzo kazhinji - sedation kana general anesthesia). Kunyangwe achiziva nezveanesthesia, vamwe varwere vanoenderera mberi kuziva kuti kusagadzikana kweiyo tsvina yeyipi - ingave inorwadza kana kwete panguva chaiyo uye mushure mekunge purogiramu. Kana nzira yacho inoshandiswa neunyanzvi ane ruzivo, inokonzera kusuruvara chete. Kushandiswa kwakakodzera kwekushongedzwa kwepasi kunogadzirisa kusagadzikana kwakanyanya.
Nemhaka yei kushaya tsvina kunopisa?
Kuwirirana kwakafanana (muna 20-30% yevarwere) yekunyengedza kunopa ropa shoma, iro rinomira pacharo mukati memazuva maviri. Dzimwe nguva ingwe yenyuchi inonetsa zvikuru - mhinduro inogona kuratidzirwa seyizvi:
- pneumothorax ;
- hutachiona hwemasisita mhuka;
- kukanganisa kune nhengo dzomukati dziri mukati;
- kunyanya kuora ropa;
- renal colic;
- fever;
- chikamu chechirwere;
- kurwadziwa kukuru;
- kuputika kwepasi rezasi reimpso;
- chimiro che perirenal hematoma;
- kuderedza ropa;
- suppurative paranephritis;
- kugadzirwa kwemukati arteriovenous fistula.
Hazviwanzoitiki (pasi pe2.22%). Dambudziko rakaipisisa pane iyo nzira:
- kuguma kwekushanda kwemuviri;
- chikonzero chekushaya nephrectomy;
- lethal outcome.
Chii chinogona kutora chinangwa chepisvo?
Yakakwana-refu, asi zvishoma zvisingasviki uye zvinotambudza, zvienzaniso zvezvitsvakurudzo zvesayenzi zvemakambani hazvina kuumbwa. Iropi inoputira senzira yekuongororwa inoratidzwa nepamusoro pekudzidzira uye nekururama. Zvimwe nzira dzekuziva zvirwere zvekuvhenekera hazvina kuvimbika uye zvinogona kupa mhinduro dzenhema. Sezvimwe zvinoshandiswa pakugadzirisa uku, ultrasound inowanzoshandiswa, asi mumakiriniki akare, mafungiro epiyo anotsiviwa nemichina yakawanda yemazuva ano:
- computed tomography;
- intravenous urography ;
- radioisotope renography;
- veno- uye arteriography;
- angiography;
- panoramic radiography ine kusiyana.
Bhiopsy yemutsvo yakaitwa sei?
Kusiyana kwechikoro chechigadzirwa kunoitwa nenzira yakavharwa. Uchishandisa ultrasound kana X-ray majekithara, nzvimbo yeinso inoratidzwa. Maererano naye, chiremba anotanga nheyo inokosha zvakananga pamusoro pechirongwa chiri pasi pekuongororwa, achipindira kuburikidza neganda rekare rakasvibiswa uye rinosuruvara. Sezvo wasvika pane chinangwa, chigadziro chinogadzirisa chinogadzira sampuli inotsvaga. Dzimwe nguva, pakudzidza kwakarurama, iwe unoda zvakawanda zvezvinhu zvehupenyu, uye iwe unofanirwa kuvhara nenyuchi kakawanda (kuburikidza nehomwe imwe).
Kune dzimwe nzira, seyiyo biopsy:
- Clear. Zvinyorwa zvemasumbu uye kuongororwa kwavo zvakatevera zvinowanikwa panguva yekuvhiyiwa pasi pehuwandu hweanesthesia.
- Nekusvikirwa kuburikidza nemuviri wechipfuva. Iyi nzira inoshandiswa kune vanorwara vasina kukwana ropa coagulation, kupererwa nekuputika, kana kuberekwa kwemaitiro emakumbo.
- Urethroscopy nekunyorera. Nzira yacho inorayirwa pamberi peatombo mumapapiro uye ureter, nhengo dzakatemwa, inokurudzirwa kuvakadzi vane pamuviri nevana.
Chii chinokonzera kutonhora mushure mekunzwa kwepvo?
Feverish mamiriro kana kushanduka maduku mumhepo inowanzogadziriswa inowanzochengetwa mushure memaawa akawanda kana mazuva kubva pakuvhara. Kupisa shure kwehuputi hwepvo kunogona kuitika nekuda kwezvikonzero zvinotevera:
- kuvhiringidza maitiro mumatumbu echirongwa kana masumbu;
- hutachiona hweganda pane nzvimbo yekunaya;
- purulent pathologies;
- kukanganisa kune zvivako zviri pedyo.
Chimwe chinetso chinokonzerwa nehupopu hwepsosi chakasimba uye chinoputika mukati mukati mekuyerera mukati mehutano hwepineane uye pasi pejecha capsule (perirenal hematoma). Kana migumisiro yehutachiona ichi ichinyangarika, uye kuunganidzwa kwemvura yakasvibirira inoparara, fivha inogona kuitika. Iwe haufaniri kuedza kutsvaga zvinokonzera iwe pachako, zviri nani kuti uwane pakarepo kubvuma kwemukati kune nephrologist.
Hematoma mushure moutano hwepfungwa
Iyo yakatsanangurwa kushandiswa kweitiro yacho ishoma, inobata zvishoma kune 1.5% yezviitiko. Mikana yekunze kwemazuva akawanda uye kuumbwa kwehematoma yakawanda kunofanirwa nemaitiro ehutano hwepfungwa yehupi yakaitwa nenzira yakarurama-kuti iko kushandiswa kunoitwa sei (kusarudzwa kwemuitiro), kana kutanga kweanesthesia uye kurapwa kwepiriseptic kwakaitwa zvakanaka.
Periorenal hematoma haina kureva migumisiro inokuvadza yekuzivikanwa uye haibviri kupindira, asi nguva dzose inowirirana nekuwedzera kwekushisa kwemuviri uye zvimwe zviratidzo zvisingafadzi:
- kuderedza ropa;
- kucheka, kurwadziwa kwakanyanya mumushure wezasi;
- kuonekwa kweropa mumuginho kana kuchinja mumuchero waro kune bhandi, tsvuku;
- kuderedza hemoglobin kuongororwa muropa;
- kushaya simba, hope;
- kusava nenzara;
- kushungurudzika kwekuzora.