Urolithiasis yog tus cwj pwm ntawm lub pob zeb (kev sib tw) nyob rau hauv cov kabmob ntawm qhov mob ntawm lub cev. Lwm lub npe rau tus kab mob pathology yog urolithiasis. Raws li kev txheeb cais, tus kab mob no muaj coob heev uas nws cuam tshuam rau ib qho degree lossis lwm tus neeg laus thib tsib.
Urolithiasis - ua rau
Pob zeb zoo li formations nyob rau hauv lub raum, txoj hnyuv, los yog zais zis pib feem ntau ntawm cov neeg muaj hnub nyoog 20-45 xyoo, tab sis qee zaus - thiab thaum yau. Cov mechanism ntawm lawv cov kev tsim muaj ntau haiv neeg, yog li ntawd nws yog ib qho yooj yim rau ib qho tawm ntawm ib qho kev cuam tshuam dab tsi. Feem ntau, qhov ua rau urolithiasis raug txuam nrog kev ua txhaum ntawm cov txheej txheem metabolic hauv lub cev, nrog rau kev tsim cov kab mob urinary ntawm crystallizing compounds.
Predisposing yam tseem ceeb rau kev loj hlob ntawm tus kab mob yog:
- heredity;
- siv cov dej uas muaj ntau tus minerals;
- kev haus tsis txaus;
- sedentary txoj kev ua neej;
- kis kab mob thiab kis mob ntawm cov kab mob urinary;
- mob cov kab mob hauv lub plab;
- prevalence ntawm cov kua qaub, acidic, salty khoom noj hauv kev noj haus;
- siv ntau yam khoom siv (tshuaj ntsuab, nqaij, khoom noj siv mis, muaj zog tshuaj yej, thiab lwm yam);
- kev mob hauv lub cev los sis kev mob ntawm ob lub raum, cov hlab ntsha (constrictions, ntxiv hlab ntsha);
- kev mob kabmob metabolic ( gout , hyperparathyroidism );
- noj cov tshuaj, thiab lwm yam.
Urolithiasis - hom pob zeb
Urolithiasis tuaj yeem kuaj tau nrog ib lossis ntau lub pob zeb, muaj qhov txawv me me - ntawm 1 hli mus rau 10 cm los yog ntau dua. Thaum muaj ntau lub pob zeb me me lawv hu ua xuab zeb. Raws li daim ntawv, lub pob zeb urinary tuaj yeem ca, sib npaug, nrog cov npoo ntse thiab kab qaum. Ib qho kev sib koom tes yog hu ua coral, yog tias nws muaj nyob rau hauv lub raum thiab nws yuav luag tag nrho cov kab noj hniav ntawm nws, sib sau ua "pwm" ntawm lub calyx-pelvis system.
Lub pob zeb yog cov ntsev ntawm cov zis urinary, ua txhua yam nrog cov protein ntau sib txuas. Ntau ntawm lawv muaj kev sib xyaw cov tshuaj muaj sib xyaw, tab sis feem ntau lawv yeej muaj los ntawm cov tshuaj txuas. Urolithiasis (urolithiasis) nyob rau hauv cov qauv siv tshuaj ntawm cov kab sib txawv muab faib rau cov nram qab no:
- oxalate;
- ntxub;
- phosphate;
- struvite.
Oxalate Urolithiasis
Kev faib tawm ntawm pob zeb hauv urolithiasis yog ib qho tseem ceeb rau kev kho kom tsim nyog. Hauv ntau tus neeg mob (li thaj tsam 70%) oxalate formations uas muaj cov calcium oxalate thiab oxalate ammonium ntsev. Lawv cov nta muaj qhov siab ceev, tsis tshua muaj solubility, spiny nto. Thaum tsiv, cov pob zeb zoo li no ua rau cov nqaij ntawm cov kaus naus zis, thiab cov ntshav ua kom pab tau lawv nyob hauv ib qho xim dub, xim dub.
Ib qho ntawm cov laj thawj ntawm kev tsim ntawm kev sib tw ntawm hom no yog khoom noj khoom haus nyob hauv ascorbic acid, oxalic acid yog nyob rau hauv loj nyiaj, muaj ib qho tsis muaj peev xwm ntawm magnesium thiab vitamin B6. Tsis tas li ntawd, lawv provoked los ntawm cov tsos ntawm inflammatory kab mob ntawm ob lub raum, ua hauj lwm nyob rau hauv gastrointestinal ib ntsuj av, endocrine kawg.
Phosphate urolithiasis
Piav txog cov pob zeb yog thaum muaj urolithiasis, cov kws qhia ntawv nco tias phosphate pob zeb muaj ntau heev, thiab feem ntau - rau cov poj niam. Lawv muaj cov phosphoric acid thiab calcium ntsev thiab muaj muag, ntxeem formations ntawm grayish los yog whitish hue. Cov pob zeb zoo li no tuaj yeem sai sai, ua kom tag nrho cov kab noj qab haus huv, i.e. tsim cov qauv kev coral.
Feem ntau, kev ua mob hauv kev zis, ua rau alkalinization ntawm cov zis, ua qhov pib taw rau kev txhim kho phosphates. Lwm hom ua yog qhov hyperfunction ntawm parathyroid qog, uas ua rau kev cuam tshuam ntawm cov phosphate metabolism. Cov cwj pwm noj zaub mov ua si, uas yog cov uas muaj zog ntawm cov tshuaj yej thiab cov kas fes muaj zog, vitamin A, E, D deficiency yog cai.
Struvitous urolithiasis
Struvitic pob zeb nyob hauv urolithiasis yog kuaj txog 15% ntawm cov neeg mob. Cov pob zeb no muaj kev ntxhib los mos, lawv tuaj yeem loj hlob sai. Nyob rau hauv nyob tus yeees, cov tebchaw no yog ammonium thiab magnesium phosphate, zoo li carbonate apatite. Ib qho tseem ceeb tshaj plaws rau lawv cov tsos mob yog tus kab mob ntawm tus kab mob urogenital, cov neeg ua hauj lwm hauv cov tshuaj uas muaj cov tshuaj enzymatically cleavable urea. Pathogens muaj nyob ntawm lub pob zeb lawv tus kheej.
Feem ntau, qhov tsim ntawm kev ua si tawm hauv kev sib raug zoo yog los ntawm kev tsis tshua muaj neeg, qhov tsis tiav ntawm lub zais zis, ua rau cov zis stagnation. Nyob rau hauv qhov kev pheej hmoo - cov neeg mob uas muaj ntshav qab zib mellitus thiab mob pelvic cheeb tsam nrog yuam lub sij hawm ntev immobilization. Cov khoom noj muaj peev xwm ua tau rau kev noj cov zaub mov muaj protein ntau hauv kev noj haus (tsuas yog nqaij).
Urartic urolithiasis
Txog li ib feem peb ntawm cov neeg mob uas muaj urolithiasis daim ntawv qog zeb - xim daj-xim av los yog cib xim av-pob zeb nrog lub zog tawv-xoob thiab ib tus me nyuam qhuav. Los ntawm tshuaj lom neeg muaj pes tsawg leeg yog ntsev ntawm uric acid. Cov kev ua no tuaj yeem tsim nyob rau hauv ob lub raum, zais zis, cov hlab ntsha.
Hauv cov poj niam, daim ntawv no ntawm urolithiasis yog kuaj tau me ntsis, feem ntau yog vim li cas ib qho ntawm nws lub ntsiab lus tseem ceeb - nquag noj khoom noj khoom haus nplua nuj hauv purines. Cov tshuaj no muaj nyob rau hauv cov dej loj ntawm cov tsiaj me, hauv cov hlwv, txias, legumes, thiab lwm yam ntxiv. Tus kab mob no tuaj yeem tsim los ntawm cov kab mob metabolic uas muaj qhov nce ntxiv ntawm cov tshuaj uric acid hauv lub cev.
Urolithiasis - cov tsos mob
Cov kab mob cwj pwm tshaj plaws ntawm urolithiasis yog:
- Periodic mob hauv cheeb tsam hauv cheeb tsam (ntawm ib sab tes, ntawm ob sab) los yog hauv thaj tsam groin ntawm kev mob nyhav thiab tawg, rub tus cwj pwm;
- nquag hu kom tso zis ;
- mob, kub nyhiab thaum tso zis;
- qhov muag tsis pom kev, qhov pom ntawm cov ntshav hauv nws;
- o ntawm lub ntsej muag, ceg tawv.
Feem ntau, lub sij hawm ntev loo tsis ua rau nws tus kheej hnov, thiab cov tsos mob ntawm urolithiasis thawj zaug yuav tuaj yeem paub nws tus kheej hauv lub ntsws pob , thaum lub pob zeb nkag mus rau hauv cov hlwv thiab ua rau nws khoob. Hauv qhov no, cov tsos mob nram qab no tshwm sim:
- qhov ntse ntse ntawm qhov mob siab heev ntxeem rau hauv cheeb tsam chaw lumbar;
- tshwm sim ntawm kev nquag nquag tuaj tso zis, tom qab uas tau pom qhov anuria;
- ntxiv zog kub cev;
- ua daus no;
- xeev siab;
- txias hws;
- blanching, lwm yam.
Urolithiasis - mob
Urolithiasis yuav txiav txim tau los ntawm ultrasound ntawm ob lub raum, zis thiab cov hlab ntsha. Cov ntaub ntawv ntawm computed tomography thiab radiocontrast diagnostics ua kom tau ntau dua qhov tseeb, qhov loj thiab qhov ceev ntawm lub pob zeb, los tshawb xyuas cov zis txaus, txhawm rau txiav txim qhov ua rau cov kab mob urinary. Yog xav tias urolithiasis xav tias, tso zis thiab tso ntshav kuaj yuav pab tsim kho qhov teeb meem ntawm cov kab mob metabolic thiab qhia cov khoom uas yog cov khoom tsim ua qauv.
Urolithiasis - kev kho mob
Muaj ntau txoj hauv kev los kho cov neeg mob uas muaj pob zeb nyob hauv txoj kev ua zis, nyob ntawm qhov chaw ntawm lub pob zeb, lawv qhov kev ua neej, qhov loj me, cov kev mob tshwm sim ntawm tus kab mob, qhov teeb meem tsis zoo ntawm lub plab mob, thiab lwm yam. Ntxiv nrog rau kev tshem cov kab mob pathological los ntawm lub cev, kev kho ntawm cov xwm txheej metabolic, uas tau ua haujlwm li causal, yog yuav tsum tau ua.
Kev kho mob ntawm urolithiasis nrog pob zeb me me yog feem ntau ua los ntawm ib txoj hauv kev noj qab haus huv nrog kev noj qab haus huv. Hauv nruab nrab thiab loj formations, muaj ib qho kev xav tau rau lawv txoj kev tawg (lithotripsy) lossis rau kev tshem tawm sai. Ua raws li cov nram qab no uas tsis yog-ntxeem hom ntawm crushing ntawm pob zeb:
- Chaw taws teeb lithotripsy - kev sib tsoo pob zeb los ntawm kev siv lub tshuab hluav taws xob tsis muaj zog, nkag los ntawm sab nraud, ua raws li lub ntuj ntim nrog lub ziag ntawm zis.
- Hu rau lithotripsy yog ib txoj kev ua tau los ntawm inserting endoscope mus rau hauv lub zais zis, cov hauv siab los yog lub plab hauv lub plab, uas tsis muaj ultrasonic tsis, pneumatic impulses lossis laser radiation yog siv los rhuav tshem lub pob zeb nrog ntxiv kev khiav tawm ntawm aspiration los yog siv endoscopic loops thiab forceps.
Urolithiasis - kev kho mob (tshuaj)
Yuav kom txo qhov mob thaum lub sijhawm qaug dab peg, tsis siv tshuaj (anti-inflammatory drugs) (Diclofenac, Indomethacin ) thiab spasmolytics ( Tsis muaj-shpa , Atropine, Nifedipine). Spasmolytics yog tsim nyog los txo lub suab ntawm cov leeg ntawm cov kab mob ntawm txoj hlab zis thiab pab txhawb kev tshem tawm cov pob zeb me me. Tsis tas li ntawd, muaj ntau yam tshuaj ntsuab npaj uas muaj antispasmodic thiab anti-inflammatory teebmeem (Kanefron, Cystenal, Olimetin).
Cov tshuaj rau urolithiasis, uas muaj cov nyom zeb-rhuav tshem los ntawm kev hloov cov acidity ntawm cov zis, tuaj yeem siv rau txhua hom pob zeb, tshwj tsis yog tsis muaj kab. Rau qhov no, cov tshuaj nram qab no kuj yuav raug nquahu:
- nrog oxalate urolithiasis - Piroxidine, Thiamin ntxiv rau Asparcum, Magnesium oxide;
- ntawm phosphate pob zeb - Aluminium hydroxide, Tsiston;
- nrog rau cov qaub ncaug - Blemaren, Soluran, Magurlit, Allopurinol.
Yog hais tias urolithiasis yog nrog los ntawm kev tsim cov pob zeb tawv ncauj, tshuaj tua kab mob yog qhia, rau cov tshuaj xws li:
- Cefepime;
- Ofloxacin;
- Meropenem thiab lwm tus.
Urolithiasis - kev kho nrog pej xeem tshuaj
Yuav ua li cas kom kho cov urolithiasis, pej xeem tshuaj paub ntau. Hauv qhov no, tsis muaj ib qho txhais tau tias yuav siv tsis tau ntawm nws tus kheej, tsis muaj kev pom zoo nrog tus kws kho mob, tk. nws tuaj yeem yog ib qho txaus ntshai. Nyob rau hauv dav dav, ntau yam tshuaj ntsuab npaj yog siv, hom uas xaiv nyob ntawm seb cov tshuaj muaj pes tsawg leeg, qhov loj thiab qhov chaw ntawm lub pob zeb. Cov nqi ntawm cov nqi lam tshuaj suav nrog cov nroj tsuag nram qab no:
- pob kws stigmas;
- burdock hauv paus;
- Rose hips;
- peb-xim violet;
- dandelion keeb kwm;
- nplooj ntawm cov txiv hmab;
- currant nplooj, thiab lwm yam
Kev noj haus nrog urolithiasis
Nyob ntawm seb hom tshuaj urinary thiab qhia metabolic mob, tus kws kho mob qhia txog kev noj haus rau urolithiasis. Feem ntau, nrog ntau hom kev mob nkeeg, kev noj haus nrog urolithiasis muab rau:
- nce nyob rau hauv dej kom tsawg (tsawg 2 liters hauv ib hnub);
- txo qis hauv qhov ntim ntawm cov khoom;
- nce nyob rau hauv kev noj haus nplua nuj nyob rau hauv fiber;
- txwv ntsev, ntsev;
- txwv kev siv khoom noj thiab dej qab zib nrog cov qauv ntawm pob zeb (tsiaj cov protein, purines, oxalic acid, thiab lwm yam).
Ua haujlwm nrog urolithiasis
Yog tias cov hlab ntsha urolithiasis lossis cov plhaws loj loj tau kuaj pom, nws tau siv cov tshuaj lithotripsy percutaneous - pob zeb los ntawm ultrasound, uas yog pub los ntawm qhov ntswg ntawm daim tawv nqaij thiab qhov ntsaws qhov kawg. Qee zaum, ib tug ua tsis tau qe phais - nrog qhov tsis ntev ntawm qhov kev txuam ntawm kev txhom kho kev kho mob, cov kev khaus ntawm qhov mob txeeb zis, kev ua mob loj, thiab lwm yam zoo li no.
- pyelolithotomy;
- nephrolithotomy;
- ureterolithotomy.
Kev tiv thaiv ntawm urolithiasis
Kev tiv thaiv thawj ob thiab theem nrab ntawm urolithiasis muaj xws li cov lus qhia nram qab no:
- txaus haus dej cawv;
- ib hom zaub mov zoo noj qab haus huv;
- thim txoj kev coj tsis zoo;
- kev ua kom lub cev loj dua;
- kev kho mob raws sij hawm;
- kuaj mob tsis tu ncua.