Ukwelashwa kwama-Stones Stones
Amaphesenti angaba ngu-12 kubo bonke abantu bazoba nezinso zezinso esikhathini esithile ekuphileni kwabo. Eqinisweni, amatshe ezinso ziyisethulo sesithathu esivame ukwedlulisa izidakamizwa ngemuva kokungenwa kwe-urinary nezifo zesifo sofuba.
Amatshe ezinso zibuhlungu kakhulu futhi abuhlungu emuva, ubuhlungu be-flank noma ubuhlungu. Umlingiswa walobu buhlungu ngokuvamile buphakathi. Ezinye izimpawu ezihambisana nezinso zezinso ziwumkhuhlane, izikhukhula, isicashu, ukuhlanza, umchamo wegazi kanye nomchamo ombala.
Kubantu abaningi, ubuhlungu besitshe sezinso luphoqelela uhambo oluya ekamelweni eliphuthumayo.
Amatshe angakha isisu, ama-ureter noma izinso. Uma amatshe anjalo atholakele ezinso, angabuye abizwe ngokuthi i-calcili yama-renal noma i-nephrolithiasis. Amatshe wezinso angabavimbela noma angavimbeli. Ukuvimbela amatshe ezinso kunamakhulu (ngaphezulu kuka-7 mm) futhi uvale umzila we-urinary odinga ukwelashwa okunonya. Amatshe ezinso ezingabonakaliyo amancane futhi ngokuvamile azidlula futhi awadingi ukuhlala esibhedlela. Esikhundleni salokho, uma uletha ekamelweni eliphuthumayo ngamatshe angase adlule, uzothola imithi yobuhlungu (ama-NSAID noma ngaphandle kwama-opioids) nemiyalelo yokuzihambisa kanye nokulandelela nodokotela wakho.
Amatshe wezinso ngokuvamile akhiwa nge-calcium oxalate. Kodwa-ke, kuye ngezizathu zabo, ukubunjwa kwamatshe wezinso kuyahlukahluka futhi kungenziwa nge-calcium phosphate, struvite, cystine noma i-uric acid.
Lapho amatshe enso ewela emcimbini, angatholakala njengengqimba engasiza ekuxilongweni kwalesi simo.
Uma umuntu ebeka ekamelweni eliphuthumayo nge-diagnosis yezinso ze-kidney, i-CT yesisu ngaphandle kokuphambene ngokuvamile iyalwelwa ukubuka ngeso lengqondo noma yimaphi amatshe ezinso. Amatshe wezinso nawo angabonwa ngokusebenzisa ezinye izindlela zokuxilonga ezihlanganisa i-ultrasound, i-ray ray, i-MRI, ne-fluoroscopy.
Ukwengeza, i-urinalysis nayo iyalwe ukuba ihlolwe umchamo wamakhemikhali namaseli abomvu egazi (okukhombisa ukuphuma kwegazi).
Izinso ezinkulu zezinso ezivimbela umgudu wamanzi ungadinga ukuhlinzwa ukuze ususwe. Kodwa-ke, ukuhlinzwa kwezinso zezinso manje kuvele kungavamile. Esikhundleni salokho, ukushaqeka kwamanye ama-wave thotripsy (ESWL) kuye kwaba yindlela yokuhamba lapho kutholakala amatshe ezinso.
Nge-ESWL, amagagasi omsindo aphezulu asetshenziselwa ukuhlakaza amatshe enso eboniswa nge-ultrasound. Lezi zitshalo zezinso zezinso zingakwazi ukuhamba ngokukhululekile emaphethelweni omchamo nge-urine. Ngokuthakazelisayo, ubuchwepheshe obusetshenziselwa ukuthuthukisa i-ESWL kusekelwe kubuchwepheshe obusetshenziselwa ukuthuthukisa indiza ye-supersonic.
Kunezindlela ezimbili ukuthi i-ESWL ingasetshenziswa. Okokuqala, i-ESWL ingasetshenziswa ngamanzi okugezela lapho ugeleza ngamanzi futhi amagagasi omsindo aphezulu ahanjiswa emanzini. Ngaphandle kwalokho, lamagagasi aphezulu anamandla angaqondiswa ngesikhwama samanzi esibekelwe isikhumba sakho. Zombili izinqubo zingase zingakhululekile futhi i-anesthesia ijwayele ukuphathwa ngesikhathi senqubo. I-anesthesia ibuye ivuselele izikhathi zokuphumula ngemva kwe-ESWL.
Ngisho nokusetshenziswa kwe-anesthesia, i-ESWL ingaba nobuhlungu.
Ngokuqondile, i-ESWL iyabuhlungu kakhulu uma ubukhulu besikhulumi lapho umsindo ozwakalayo uhamba khona phakathi kwamanzi nezicubu noma izicubu namatshe. Ngakho-ke, ubuhlungu buvame ukubukeka, bujulile ezinso lapho kutholakala khona itshe.
Nakuba i-ESWL ivame ukuphepheka, akuvamile ukuthi ingabangela izifo zenhliziyo noma ukugcoba nge-pacemakers. Ukwengeza, i-ESWL ngezinye izikhathi ingangcola ngegazi futhi ikhulise ukuhluleka kwenhliziyo. Ukulimala kwamanye ama-renal nokuphuma kwegazi kujwayelekile emva kokusetshenziswa kwe-ESWL.
Ngaphezu kokuhlinzwa noma i-ESWL, ezimweni ezithile, i-ureteroscopy ne-endoscopy ingasetshenziselwa ukubona ngeso lengqondo futhi isuse amatshe wezinso.
I-ureteroscopy isetshenziselwa ukubuyisela amatshe abanjwe ku-ureters.
Amatshe ezinso zibangelwa imiphumela ehlanganisiwe yezofuzo nemvelo. Kuye ngezizathu, ngezinye izikhathi ungathatha izinyathelo ezithile zokuvimbela amatshe ezinso. Isibonelo, isici esiyingozi kakhulu ehambisana nezinso zezinso ukuphelelwa amandla kwamanzi; ngakho-ke, ukuphuza amanzi amaningi noma ngisho nokuthatha i-diuretics (amaphilisi amanzi) kungasiza ekuvimbeleni amatshe ezinso. (Udokotela wakho kufanele athole izidakamizwa.) Ngaphezu kwalokho, ukudla okunye kungasiza ekwakhiweni kwezinhlobo ezithile zamatshe ezinso. Ngokwesibonelo, isipinashi iqukethe i-oxalate, isakhi sezinso zezinso esakhiwa nge-calcium oxalate. Ngaphezu kwalokho, ukunciphisa inani lenyama ne-sodium oyidlayo nakho kungavimbela amatshe e-calcium oxalate.
Imithombo ekhethiwe
UHwang JQ, uPoffenberger C. Hwang JQ, uPoffenberger C Hwang, uJames Q., noCori McClure Poffenberger.Isigaba 10. Uhlelo lwe-Renal ne-Urinary Ultrasound. Ku: Carmody KA, Moore CL, Feller-Kopman D. Carmody KA, Moore CL, Feller-Kopman D Eds. UKristin A. Carmody, et al.eds. I-Handbook of Care Critical kanye ne-Emergency Ultrasound . ENew York, NY: McGraw-Hill; 2011. Kufinyelelwe ngoDisemba 12, 2015.
UCereda M, uKennedy S. Cereda M, uKennedy S Cereda, Maurizio, noSean Kennedy.Isigaba 61. Ukucatshangelwa kobuciko bokuhlinza ngo-Genitourinary and Renal Surgery. Ku: Longnecker DE, Brown DL, Newman MF, Zapol WM. I-Longnecker DE, i-Brown DL, iNewman MF, i-Zapol WM Eds. UDavid E. Longnecker, et al.eds. Anesthesiology, 2e . ENew York, NY: McGraw-Hill; 2012. Ukutholakala ngoDisemba 12, 2015.