Kulinganiselwa ukuthi amaphesenti angama-50 kuya kwangu-80 kubo bonke abesifazane ahlakulela ukutheleleka kwamagciwane (UTI) ngesikhathi esithile ekuphileni kwabo. (Ngokuvamile, abesifazane banamathuba amaningi kakhulu kunamadoda ukuthuthukisa i-UTIs.) I-term tract urinary tract is infected and is referring to an infection which is caused by bacteria that occurs at any level of urinary tract: urethra, swelling, ureters, or kidneys.
I-Spectrum Yokutheleleka
Ukutheleleka kwamagciwane e-Urinary kukhona kwi-spectrum. Ngesinye isikhathi sokuphela kwe-spectrum yi- bacteriuria enamandla, lapho amabhaktheriya atholakele emcinini kodwa akukho izimpawu zomtholampilo zokutheleleka ezikhona. Njengoba kunamacala amaningi we-bacteriuria engenamaphutha, akukho ukwelashwa okudingekayo.
Ngakolunye uhlangothi lomkhakha ukhuluma nge- pyelonephritis noma ukutheleleka kwezinso, okuyinto engathà sina nakakhulu nesihloko salesi sihloko. Phakathi kwe-spectrum yi-bacteriuria ephawulekayo noma i- cystitis , yilokho abantu abaningi abakucabangelayo lapho bexoxa nge-UTIs. Izimpawu ze-cystitis zihlanganisa ubuhlungu ekuchama, ukugcoba umchamo, nokuphuthuma.
Nge-pyelonephritis, amabhaktheriya ahamba esuka e-urethra ehamba ngesisindo bese ehamba futhi efika ezinso. Ngenhlanhla, i-pyelonephritis ehilela kokubili izinso ayivamile.
Izimpawu
Nazi ezinye izimpawu ezivamile ze-pyelonephritis:
- ubuhlungu be-flank
- i-costovertebral angle tenderness
- izintuthwane ezithinta izinso ezinzulu
- isiyaluyalu
- ukuhlanza
- umkhuhlane
- izikhukhula
- ukuhlukumezeka
Ukuxilongwa
Ukuxilongwa ngemitholampilo ye-pyelonephritis kusekelwe kumlando kanye nokuhlolwa kokuhlolwa komzimba kanye nokutholakala kwelabhoratri ezivivinyweni zokuxilonga ezifana ne-urinalysis kanye namasiko omchamo. Ngokungafani ne-cystitis engavamile, ukusola kwe-pyelonephritis kuvumela isiko lomchamo.
Ukucabangela ukuxilonga akudingeki ukuxilonga amacala amaningi e-pyelonephritis. Noma kunjalo, i-ultrasound ne-CT ingasetshenziselwa ukubona ngeso lengqondo i-pyelonephritis.
Izingozi Zezingozi
Izinto eziyingozi ze-pyelonephritis zifana nezici zobungozi kuzo zonke izinhlobo ze-UTI futhi zibandakanya abalingani abaningi bezocansi, ukwandisa umsebenzi wobulili, umlingani omusha ocansini kanye nomlando we-UTIs ophindaphindiwe.
Ukwelapha
Ukwelashwa kwe-pyelonephritis kufana nokuphathwa kwe-cystitis enamandla. Kodwa-ke, i-pyelonephritis inamathuba amaningi kune-cystitis eyingozi ukuthi ibangelwa amagciwane aphikisana namagciwane ahlanganisa ama-E. coli angamelana ne-Bactrim (TMP-SMX). Ngakho-ke, ukwelashwa kwe-pyelonephritis kuvame ukuqala nge-antibiotic ebanzi njenge-ciprofloxacin, futhi, ngokuya ngokuthi ama-bacteria ayingozi kanjani okwenza ukutheleleka, angabandakanya inhlanganisela yama-antibiotic noma ama-antibiotic amaningi (ama-big-gun) anjenge-carbapenem.
Iningi labantu abakhona nge-pyelonephritis engaqondakali bangelashwa emtholampilo (okuphulukisiwe). leli gama eliyinkimbinkimbi lisho ukuthi isiguli asikhombisi okungajwayelekile kwe-anatroic tract, ayikho insimbi endaweni efana nendawo yokuhlala emanzini futhi ayikhulelwe. Abantu baphathwa emtholampilo nge-pyelonephritis engaqondakali kumele bakwazi ukubekezelela uketshezi nokuphuza imithi.
Abantu abane-pyelonephritis eyinkimbinkimbi, i-pyelonephritis ephindaphindiwe noma i-comorbidities, njengesifo sikashukela noma isifo se-sickle cell, iphathwa kahle esibhedlela. Ngesikhathi esesibhedlela, laba bantu bathola ama-antibiotic emithi.
Ngaphezu kwemithi elwa namagciwane, umuntu one-pyelonephritis angabuye athole ama-analgesics (cabanga ngama-opioids) ngobuhlungu nokugqugquzela ukuhlanza izinhlanzi nokuhlanza.
Ukwelashwa kwe-pyelonephritis engazinzile kuhlala cishe izinsuku eziyisikhombisa. Amacala anzima noma ngaphezulu kakhulu we-pyelonephritis aphathwa cishe izinsuku ezingu-14.
I-Pyelonephritis iningi kakhulu kune-cystitis eyingozi, futhi amaphesenti angama-20 kuya kwangu-30 abantu abane-pyelonephritis futhi ahlakulela ukutheleleka kwegazi, futhi.
Ezinye izinkinga ze-pyelonephritis zihlanganisa i-cortical necrosis kanye ne-emphysematous pyelonephritis, lapho izinso zilimazekile futhi igesi lwakhiwa ezinso, zombili lezi zinkinga zingabangela ukwehluleka kwezinso.
Ukuvimbela
Encwadini yokugcina, nansi izinyathelo ezithile ongayithatha (owesifazane) ukuvimbela i-pyelonephritis ne-UTIs:
- baphuze amanzi amaningi
- vala isisu ngemuva kocansi
- Sula kusukela phambili ukuya emuva ukuze ugweme ukusungulwa kwamabhaktheriya ngaphakathi kwesifazane
- vula njalo
- ugweme imikhiqizo yokuhlanzeka yabesifazane esetshenziselwa indawo yesisu njengama-douches kanye ne-sprays
Imithombo:
I-Gupta K, i-Trautner BW. Izifo Zama-Urinary Tract, i-Pyelonephritis, ne-Prostatitis. Ku: Kasper D, Fauci A, Hauser S, Longo D, Jameson J, Loscalzo J. eds. I-Harrison's Principals of Internal Medicine, 19e . ENew York, NY: McGraw-Hill; 2015.
I-DS, i-Bogner MP. Isahluko 94. Izifo Zama-Urinary Tract kanye ne-Hematuria. Ku: Tintinalli JE, Stapczynski J, Ma O, Cline DM, Cydulka RK, Meckler GD, T. eds. Umuthi Ophuthumayo We-Tintinalli: Umhlahlandlela Wokufunda Ophelele, 7e . ENew York, NY: McGraw-Hill; 2011.