Ukungaqondi kahle okuvamile abantu abanayo kaningi ukulinganisa umkhiqizo we-urine kuze kusebenze izinso. Ngakho-ke, ukucabanga ukuthi uma "wenza umchamo," izinso zakho ziyasebenza kahle. Kodwa-ke, akukho okunye okuvela eqinisweni, futhi ukuhlola umsebenzi wezinso zakho kudinga ukuhlolwa kwelebhu kanye nokufaneka kwe-radiological ngezinye izikhathi.
Abantu abaningi bayazi ukuthi ukuhlolwa kokucindezeleka kuyindlela yokuhlola umsebenzi wenhliziyo yakho.
Kodwa uhlola kanjani umsebenzi wakho wezinso? Kungenzeka ukuthi wezwa odokotela bekhuluma amagama afana ne "creatinine" noma "GFR" uma uhlola ukuthi izinso zakho zihle kangakanani noma zimbi. Nakuba kunezindlela eziningi lapho izinso zokusebenza zingalinganiswa khona, ngizozichaza lezo ezisetshenziselwa ukujwayela emitholampilo.
Ngokubanzi, ungabheka umsebenzi wezinso ngokusebenzisa:
(2) Ukuhlolwa kwe-Urine
(3) Ukucabanga nge-radiological
Izivivinyo zegazi
Lokhu kuyindlela evame kakhulu futhi ngokuvamile indlela enokwethenjelwa kakhulu. Odokotela bazovame ukuhleleka ukuhlolwa okungaba amagama ahlukahlukene njenge "iphaneli eyisisekelo yamandla (BMP)," "ikhamera yesi-7," "iphaneli yomsebenzi we-renal," "i-GFR," njll. Ngokuyinhloko, yini abayilingayo amazinga we-electrolytes namabili amanye amakhemikhali abizwa ngegazi urea nitrogen (BUN) ne-creatinine.
I-BUN yenza inani le-nitrogen ekhona egazini lakho ngendlela ye-urea, ngakho igama elithi BUN! Ngamanye amazwi, lokho esikulingayo yizinga le-urea egazini.
Urea, njengoba kungenzeka wazi, i-nitrogen equkethe isakhi esivela emcinini wezilwane ezincelisayo futhi ngokuvamile esetshenziswa njengomanyolo. Ngaphambi kokuba uphethe ngokuthi kukhona umanyolo ogeleza egazini lakho, ake ngigcizelele ukuthi i-urea yebhrijini yezimboni esetshenziselwa umanyolo yenziwe ngokufanele. Eqinisweni, urea yiyona "yokuqala" (okungukuthi, etholakala emvelweni eziphilayo) inhlanganisela eyakhiwe ngobuciko ebhokisatri lapho usosayensi waseJalimane uFriedrich Wohler enza isakhi se-ammonium cyanate ngo-1828.
BUN: Isivivinyo esingaphelele
Ngakho kungani sikala izinga le-urea egazini? Lokhu kungenxa yokuthi izinga le-urea legazi, (noma i-BUN!) Kuncike ekulinganiseni phakathi kwezinqubo ezandisa izinga legazi layo ngokuhambisana nezinqubo ezinciphisa izinga layo legazi. Izinto ezikhuphula izinga le-urea egazini zibandakanya ukudla kwamaprotheni okudla, ikhono lesibindi sakho sokwenza i-urea, kanye nesilinganiso sokuhlukana kwamaseli avamile (okubizwa ngezokwelapha ngokuthi "i-catabolism") okuholela ekukhiqizeni urea. Okokugcina, inqubo eyanciphisa izinga le-urea egazini ikhono lakho lezinso lokukhipha irea u-urine.
Uma ucabanga ukuthi izici ezandisa izinga le-urea lihlale lihlala njalo ngosuku, ungase uphikelele ukuthi izinga le-urea egazini lingaxhomeke kakhulu ekusebenzeni kwezinso zakho. Ngakho-ke, isifo sezinso singatholakala ngokunyuka kwezinga legazi le-urea, noma i-BUN. Kodwa-ke, sicela ukhumbule ukuthi lokhu kuyincazelo elula, futhi amazinga we-BUN, njengoba kungenzeka ukucabanga, angathonywa ukudla, i-catabolism, nokusebenza kwesibindi.
I-Creatinine iyindlela engcono
Ngakho-ke akudingeki ukuba ube ochwepheshe wezokwelapha ukuze uqaphele ukuthi i-BUN ingumvivinyo ophelele ongaphelele wezinso 'umsebenzi, ngokuya ngaphansi kwezinguquko zezinye izinto ezingezona izintambo.
Ngakho ake sikhulume ngamanye amakhemikhali engiwakhulume ngenhla: i-creatinine.
Igama elithi "creatinine" livela egameni lesiGreki elisenyameni, futhi liwumkhiqizo wokuphazamiseka kwemizimba. Njengoba ubuhlungu bemisipha yakho engashintshi nsuku zonke, izinga lokukhiqizwa kwe-creatinine nalo lihlale lihlala njalo. Njengoba izinga le-creatinine egazini liyakhula (kusuka ekuphukeni kwemisipha), izinso zenza umsebenzi omkhulu wokuyihlunga ohlelweni lwakho. (I-smallest, futhi ngokuvamile engadingekile (ngokungafani ne-urea!) Inani le-creatinine liphinde lenziwe kabusha nezinso, ezingase zithinte izinga layo legazi, kodwa kube lula, masingayinaki okwamanje).
Ngakho-ke, ucabangela ukuqina komzimba, izinga le-creatinine egazini kufanele lithonywe kuphela ikhono lezinso lokulihlunga. Ngakho-ke, ukwanda kwezinga legazi le-creatinine kusho ukuthi umsebenzi wezinso obi kakhulu.
Iveli le-creatinine yegazi yingxenye yedatha ewusizo engasiza odokotela ukuba balinganise izinga lapho izinso zihlunga igazi zisebenzisa amafomula nezibalo eziqinisekisiwe (ukuthi kusobala ukuthi akudingeki sikhathazeke ngalokhu). Leli nani libizwa ngokuthi iG Glomerular Filtration Rate noma i-GFR; igama ongase uzwe odokotela bephonsa nxazonke lapho bekhuluma ngomsebenzi wakho wezinso. Kubantu abaningi abalinganiselwe, i-GFR evamile yayizolala phakathi kuka-60 kuya ku-120 ml / min.
Okuvamile kuvamile abantu abavamile!
Ukulinganisela kwe-GFR kusekelwe kumfomula owawenzelwe abantu abavamile abajwayelekile. Njengoba ukubalwa kuncike ezingeni legazi le-creatinine, elibuye lithembeke emzimbeni we-muscle, kungenzeka ukuthi lingabasebenzisi kubantu abaneminyaka yobudala obunzima (izingane, abantu abangaphezu kuka-70 yonyaka), noma ubukhulu bemisipha (abantu abanesisindo sokulahleka, ukwehluleka kwesibindi , njll). Ngamanye amazwi, izinga le-creatinine le-1.2 (elibhekwa ngokuthi "elivamile" njengamabanga amaningi ebhodi) kungenzeka kube yinto enomuntu ofundayo njengo-Arnold Schwarzenegger kodwa angabonisa isifo esibalulekile sensizwa owesifazane oneminyaka engu-90 ubudala. Njengezinga le-BUN, udokotela wezokwelapha kufanele akwazi ukutshela ukuthi kufanele acabangele amazinga e-creatinine namaGFR engavamile.
Ukuhlolwa kwe-Urine
Ukuhlola umchamo ukufuna amaprotheni noma igazi, futhi ukwakheka kwawo kwamakhemikhali kungasiza ekuboniseni ukutholakala kwezinso zezinso. Amaprotheni noma igazi ngokuvamile akumele kubonakale emcinini futhi kungabonakali izimpawu zesifo sezinso. Udokotela kufanele anqume ukuthi ngabe ukubhekwa okuqondile kanye / noma ukudluliselwa kumuntu wezinkanyezi kuyadingeka.
I-Radiological Imaging
Lezi zindlela zihlanganisa ukuthatha izithombe zezinso ngokusebenzisa izindlela ezahlukene ezifana ne-ultrasound, i-CT scan, noma i-MRI. Lokhu kungasiza ekunqumeni ukuma nobukhulu bezinso. Izinso ziyizitho ezibushelelezi zezinyosi ezingaba ngu-8-14 cm (amasentimitha angu-3-5,5) ngobukhulu (kuye ngokuthi usayizi womuntu). Izifo eziningi ezingenasifo zengqondo, okunye okuhlukile, zivame ukuhlanekezela izinso 'izakhiwo futhi lokhu kungathathwa kalula kwi-imaging. Omunye angase futhi abe nokukhetha izimbangela eziqondile zezifo zezinso / ukungasebenzi njengamatshe, izivimbela, i-hydronephrosis, isifo sezinso ze-polycystic, njll.
> Umthombo:
> Hall JE, Guyton AC. (2011). I-Guyton neHholo incwadi yezobuchwepheshe bezokwelapha . Philadelphia, PA: Saunders Elsevier.