Izinkinga kanye nokwelashwa kwalesi simo esingavamile sezinso
Sibutsetelo
Njengoba igama liphakamisa, izinso zamahhashi ziyisimo esingavamile lapho izinso zombili zihlangana ndawonye ukuze zenze amahhashi. Nokho, akuyona nje ukuma nesakhiwo sezinso ezingavamile. Indawo yabo ayijwayelekile futhi.
Esikhundleni sokuba khona esiswini sangaphezulu, ngaphansi kwesibambo somhlanga kanye nomgogodla wakho, izinso zamahhashi zivame ukwehla kakhulu ngaphansi kwesikhumba.
Lokhu akukhona kuphela ukungajwayelekile kwezakhi zofuzo 'izindawo' noma isakhiwo. Esinye isibonelo esivamile kukhona okuthiwa " izinso ze-ectopic ." Ngaphambi kokuba sizwisise ukuthi kungani amafomu amahhashi amafomu nezinhlobonhlobo zawo, kubalulekile ukuqonda ukubunjwa okuvamile kwezinso zomuntu phakathi nentuthuko yethu esibelethweni.
Ukuqonda Ukubunjwa Kwesolo Elivamile Lomuntu
Uma sisesiteji se-embryonic futhi sithuthuka ukuba sibe umuntu ogcwele, izinso zethu zihamba ngezinyathelo ezintathu zokuthuthukiswa ngaphambi kokuba kutholakale izinso ezigcwele nokusebenza ngokugcwele:
- I-Pronephros
- I-Mesonephros
- I-Metanephros
Cabanga isobho esikhulu samangqamuzana nezinhlaka zokuqala ezizohlangana ndawonye zibe izinso eziphethwe ngokugcwele. Isiteji se-metanephros sitholakala ngamasonto angama-6 wokubeletha. Lakhiwa ngokuthi okuthiwa "mesenchyme yemetanephric" kanye "nokuhlunga okungahambi kahle." Lezi zakhiwo zizogcina zifake izinso kanye ne-ureter.
Kungani sidinga ukuqonda le nqubo yokwakha? Uma siqonda ukuthi izinso zomuntu zithinta izinguquko ezithile zomzimba nezimo kuze kube yilapho seziqeda isimo sayo sokugcina, kuba lula ukuqonda ukungavamile okufana nezinsolo zamahhashi. Ngakho-ke kuyathakazelisa ukuphawula ukuthi isiteji esiphezulu esichazwe nge-metanephros (esandulela izinso ezithuthukile) empeleni sibeke endaweni yethu ye-pelvis, futhi akusikho lapho izinso ezivuthiwe zilele khona (isisu sangasese)!
Njengoba sivuthwa kusuka embungwini singena emntwaneni, ukukhula kwemizimba yethu kubangelwa ukuguquka esimweni esifanele salokhu kukhula kwezinso ezinjengoba sisuka esikhwameni futhi kancane kancane sikhuphukela esimweni sayo sokugcina (ngaphansi komgqa wokudoba eduze komkhola womgogodla ). Akusho nje ukuthi izinso zenyuka, empeleni zijikeleza ngaphakathi ukuze okuthiwa "i-renal pelvis" manje ibheke ikholomu yomgogodla. Le nqubo ibizwa ngokuthi ukujikeleza, kanti ukuphakama kwezinso endaweni yayo yokugcina kuthiwa ukufuduka. Le nqubo iphelele ngesikhathi umbungu ungamaviki angu-8 ubudala.
Manje njengoba sinomqondo ophelele wokubunjwa kwezinso zomuntu, singaqala ukuqaphela ukuthi noma yikuphi ukuphazanyiswa ngokushintshaniswa noma izinqubo zokufuduka kuzosho ukuthi izinso zethu ngeke zitholakale endaweni engafanele kuphela, futhi kungenzeka ukuthi zizophela fused zibe mass esisodwa, kunokuba izinso ezicacile kwesokunxele nesokunxele.
Ukufometha
Inso yamahhashi yilokho esikubiza ngokuthi "i-fusion anomaly." Njengoba igama liphakamisa, i-fusion anomaly izokwenzeka uma izinso ezinye zixhumene komunye. Lokhu kuzokwenzeka ngenxa yokuphazanyiswa ngenqubo evamile yokufuduka kwezinso zombili izinso. Into encane engavamile kuyisimo lapho ukufuduka okungajwayelekile khona kuthinta izinso ezilodwa kuphela kunezinye, okuholela kokubili izinso ezikhona kolunye uhlangothi lwesigcawu somgogodla.
Lokhu kubizwa ngokuthi "i-ectopic kidney" ehlangene.
Ngezinyosi ezijwayelekile zamahhashi, isigxobo esiphansi sezinso sizohlangana ndawonye futhi ngaleyo ndlela siphakamise isimo esijwayelekile samahhashi. Ama-tubes adonsa umchamo ezivela ezinsweni zethu (abizwa ngokuthi ama-ureters) asesekhona futhi avule eceleni ngakunye. Ingxenye ehlangene yezinso ibizwa ngokuthi "isthmus.
Lesi sakhiwo singase singabi namanga ngokulinganisa phezu komgogodla. Uma lilala kakhudlwana kolunye uhlangothi kunalunye, siyibiza ngokuthi "i-ashometric hohoe yezinso." Izicubu zezinso zomzimba zingasebenza noma zingabe zingabangeli isthmus, ngakho-ke akuyona into engavamile ukubona nje izinso ezimbili ezifakwe yi-band non fibrous tishu band.
Ukuvama
Ngokwesilinganiso, izifundo ziye zabika ukuthi kunezinsolo zamahhashi kunoma yikuphi okuvela ezigulini ezingu-0.4 kuya ku-1.6, kuzo zonke izingane eziyi-10 ezizalwa ngokuzalwa. Noma kunjalo, lokhu kungukuthi kwenzeke kuphela. Isibalo sangempela singase sibe siphakeme ngoba ukutholakala kwezinso zehhashi kuvame ukungaziwa ngesiguli esithintekile.
Izimpawu
Iningi ngeke. Eqinisweni, izinso zehhashi zivame ukulandelwa ngezifundo ezitholakala ngezinye izizathu. Kodwa-ke, uma izimpawu zikhona, ngokuvamile zihlobene nokungajwayelekile emvelweni we-urine owadala ngenxa yendawo engavamile nokuma kwezinso. Ezinye izimpawu ziyi:
- Ukuvutha ngesikhathi sokuvuthwa, ukwandisa imvamisa ye-urinary, ukuphuthuma komchamo-konke okudalwe ngenxa yokuthambekela okukhulayo kokuthuthukisa izifo zokungena kwamagciwane. Lokhu kuthambekela kubonakala ngenxa yamanzi angaphansi kwamanzi. Lokhu kuholela emaphaketheni omchamo we-static, okuyinto enhle kakhulu ukuthi amabhaktheriya akhule futhi aphumelele
- Ubuhlungu bephunga noma ubuhlungu be-pelvic ngenxa yokuvimbela ukugeleza komchamo
- Ingozi enkulu yezinso zezinso. Lezi zizobangela ubuhlungu be-flank noma ye-pelvic njengoba kuchaziwe ngenhla, kodwa kungabangela ukubonakala kwegazi emcinini. Amatshe ayedwa angabangela ukutheleleka kwamagciwane
- Ubukhona be-reflux yomchamo kusuka kwesinye isibeletho kuya ezibelethweni, okungaholela engozini enkulu yokwelashwa kwamagciwane kanye nokushaya izinso. Lokhu kubizwa ngokuthi i-VUR (reflux ye-vesicoureteral)
- I-Hydronephrosis - lokhu kubhekisela ohlelweni olubanzi oluvaliwe lokugeleza kwamanzi eminzini. Lesi sithintelo singadalwa yizinso noma amatshe okugcoba, kanye nokucindezelwa kwabangqongqoshe ngezakhiwo zangaphandle.
- Okunye okungavamile kokuzalwa ngokocansi - ngoba izinso zehhashi zingaba yingxenye ye-spectra engavamile ye-gene, nezinye izinkinga ze-urogenital tract nazo zingaqaphela. Lokhu kufaka ama-testes angahlosiwe kubafana, noma isakhiwo esibelethweni esingavamile emantombazaneni.
Izinkinga
Izinkinga eziningi zivela ezimpawu ezibalulwe ngenhla nezibonakaliso zezinso zehhashi, okuvame ukuhlotshaniswa nokuvinjelwa emgqeni we-urinary.
Kuyathakazelisa ukuthi iziguli ezinezinyosi zamahhashi zibonakala zinengozi eyengeziwe yokwehla kwesifo sezinso okuthiwa "i-Wilms tumor". Izizathu ezivela kule ngozi aziqondi kahle. Lokhu kuqale kwaqalwa yi-National Wilms Tumor Study eyayiziwa iminyaka engaba ngu-30 futhi yahlonza iziguli ezingu-41 zakwa-Wilms tumor oye waba nesifo senhliziyo yamahhashi.
Mhlawumbe ukukhathazeka okuqhubekayo ngosuku nosuku, kungukuthi izinsolo zamahhashi ziyakwazi ukulimala ngokuhlukunyezwa kwesisu. Ngokwesibonelo, endaweni yokulimala kwesibhande esasihlala ngesikhathi sengozi yemoto, isibopho sokuhlala singase siphumelele okuqukethwe kwesisu, kuhlanganise nezinsolo zamahhashi ngokubhekene nomgogodla. Izinso zomuntu ezijwayelekile ezihlala phezulu futhi azixhunyiwe ndawonye ngokuvamile azikho engozini enkulu.
Ukuxilongwa
Njengoba kuphawuliwe ngenhla, izinso zamahhashi zizovame ukutholakala emifanekisweni yomzimba yangasese. Uphenyo oluqhubekayo luvame ukudingeka uma izimpawu, izimpawu, noma izinkinga ezichazwe ngenhla ziye zaphawulwa. Isibonelo, uma uhlushwa ngezifo eziphindaphindiwe zamagciwane e-urinary , i-kidney yakho yezinso ngokuyinhloko itusa okuthile okuthiwa i-voiding cystourethrogram (i-VCUG) ukuthola ukuthi ngabe i-reflux yomchamo ikhona yini. Ezinye izivivinyo ezingase zibekwe zihlanganisa:
- Izivivinyo zomsebenzi wezinso : lezi zihlanganisa nokuhlolwa kwegazi njengezinga le-BUN nama-creinine, nokulinganisa kwe-GFR. Ukuhlolwa kwama-urine amaprotheni noma igazi nakho kuyasiza. Sicela ubone lapha ukuze uthole imininingwane.
- Ukuskena kwe-Renal ukusakaza ukuqinisekisa ukuvinjelwa
- CT Urogram
Ukwelapha
Uma kungekho izinkinga ezinkulu noma eziphathelene nezimpawu ezikhona, futhi umsebenzi wezinso uvamile, akukho ukwelashwa okuqhubekayo okudingekayo. Isigulane nokho kufanele sisalokhu sixwayiswe mayelana nezinkinga zezinso zabo ekubhekaneni nokuhlukunyezwa kwesisu. Uma kunezinkinga ezibhekwa ngenxa yokuvimbela ukugeleza komchamo, isiguli kufanele sihlolwe ngumchwepheshe (isazi se-nephrologist kanye ne-urologist) ukuze sithole inkambo ethile yokusebenza futhi sibone ukuthi ukulungiswa kokuhlinzwa kungaqeda ukuvimbela. Ezigulini eziningi, ukubikezela isikhathi eside kulungile.
Izwi elivela
Khumbula ukuthi izinso zamahhashi ziyizinto ezingajwayelekile ezingavamile zezinso 'isikhundla nesakhiwo. Ngenkathi iziguli eziningi zingenayo izimpawu futhi izinso zabo zamahhashi zizotholakala ngokuzenzekelayo ngemifanekiso, khumbula ukuthi izimpawu zingabikwa ezincane zeziguli futhi ngokuvamile zihlobene nokuvimbela ukugeleza komchamo, amatshe ezinso, noma izifo ezibangelwa umchamo.
Uma kukhona izimpawu, ukwelashwa, okufaka ukwelapha okuhlinzekwa ukwelashwa, kungase kudingekile, kodwa iziguli eziningi zingabhekwa ngokuphepha futhi akukho ukuhlolwa okunye noma ukwelashwa okudingekayo. Nakuba udinga ukukhumbula ingozi yokulimala emzimbeni kwezinsolo zamahhashi (ikakhulukazi ngenxa yokuhlukumezeka kwesisu), khumbula ukuthi ukubikezelwa kwesikhathi eside kulungile!
> Imithombo:
> Fekak H, et al. Ukuphathwa kwezinsolo zamahhashi okusekelwe ochungechungeni lwamacala angu-36. Prog Urol. 2004 Sep; 14 (4): 485-8.
> U-O'Brien J at al. Ukucabanga ngezinsolo zamahhashi nezinkinga zabo.J Med Imaging Radiat Oncol. 2008 Jun; 52 (3): 216-26. i-doi: 10.1111 / j.1440-1673.2008.01950.x.
> Pascual Samaniego M, et al. Ukuqothulwa kabuhlungu kwezinsolo zamahhashi. Ama-Actas Urol Esp. 2006 Apr; 30 (4): 424-8.
> Neville H, et al. Okwenzeka kuWilms isifo senhliziyo ngamahhashi: umbiko ovela ku-National Wilms Tumor Study Group (NWTSG) .J Pediatr Surg. 2002 Aug; 37 (8): 1134-7.