Ua loaʻa iā ʻoe nā pōhaku ʻano 'staghorn' i loko o kou mau puʻupaʻa? E aʻo kākou e pili ana i ka Staghorn Calculus!

Ua lohe paha ʻoe i nā pōhaku puʻupaʻa? He pilikia maʻamau kēia no kekahi poʻe. Akā i kēia lā e kamaʻilio mākou e pili ana i kahi ʻano kūikawā o ka pōhaku puʻupaʻa. ʻO Staghorn Calculus kēia i kapa ʻia. He mea ʻē iki ke kani ʻana o ka inoa, ʻeā? ʻO "Staghorn" ke ʻano o nā pepeiaohao o ka dia. Loaʻa i kēia mau pōhaku ko lākou inoa no ka mea ua lālā lākou a pālahalaha i loko o ka puʻupaʻa e like me nā pepeiaohao dia. Hiki iā ʻoe ke noʻonoʻo iā lākou he mau ʻāpapa koʻa i ke kai.

He aha ka helu Staghorn?

I ka ʻōlelo maʻalahi, he ʻano pōhaku puʻupaʻa ka staghorn calculus (ʻo ke ʻano o ka calculus he pōhaku). Akā, ʻaʻole like kēia me nā pōhaku liʻiliʻi maʻamau ʻē aʻe. Hiki iā ia ke ulu nui, lālā i waho, a laha ma ke kahawai nui (pelvis renal) a me ka ʻōnaehana kahawai liʻiliʻi (calyces) e hōʻiliʻili ana i ka mimi i loko o ka puʻupaʻa . E noʻonoʻo inā like ka puʻupaʻa me kahi hale hana e hana ana i ka mimi, e like kēia pōhaku me kahi mea paʻa nui i loko o ka pipeline o kēlā hale hana.

ʻO ke kumu nui o kēia mau pōhaku, ʻo ia nā maʻi pinepine o ke ala mimi (UTI) . ʻO nā pōhaku i hana ʻia ma muli o ia mau maʻi, ua hana pinepine ʻia me kahi kemika i kapa ʻia ʻo struvite . He hui pū ʻia kēia o ka magnesium, phosphate, a me ka ammonium. I kekahi manawa, hiki i kahi pōhaku liʻiliʻi ke ulu i ka hala ʻana o ka manawa a lālā a lilo i pōhaku staghorn e like me kēia. Ke hana ʻia kēlā, hiki iā lākou ke hana i ka wā e hui pū ʻia ai ka struvite me ka calcium phosphate, calcium oxalate , a i ʻole calcium carbonate apatite.

ʻO ka maʻamau, hoʻokumu ʻia kēia ʻano pōhaku i hoʻokahi wale nō puʻupaʻa. Eia naʻe, he mea kākaʻikahi loa, hiki ke loaʻa kēia ʻano maʻi i nā puʻupaʻa ʻelua. Hiki i kēia mau pōhaku ke hoʻopilikia nui i ka hana a nā puʻupaʻa, a hiki ke alakaʻi i ka hāʻule ʻana o nā puʻupaʻa .

ʻO wai ka mea hiki ke ulu i ka hapa nui o kēia mau 'pōhaku pepeiaohao dia'?

ʻOi aku ka nui o ka pilikia o kekahi poʻe i ka loaʻa ʻana o kēia mau pōhaku staghorn. E nānā kākou iā lākou:

• No nā wāhine: ʻOi aku ka maʻamau o kēia ʻano i nā wāhine ma mua o nā kāne.
• No ka poʻe i loaʻa pinepine i nā maʻi ʻōpū mimi (UTI): E like me ka mea i ʻōlelo ʻia ma mua, he kumu nui kēia.
• No ka poʻe me ke ʻano ʻē a i ʻole nā ​​​​loli i loko o ka ʻōnaehana mimi: Inā he nāwaliwali i ke kahe ʻana o ka mimi, ʻoi aku ka maʻalahi o ka hana ʻana o nā pōhaku.
• No ka poʻe me nā ʻeha o ke kaula kuamoʻo.
• No ka poʻe me ka ʻōpū mimi neurogenic: Pili kēia i ka poʻe i hoʻopilikia ʻia kā lākou hana ʻōpū mimi ma muli o ka hōʻino ʻia o nā aʻalolo.

Pehea ka hopena o nā pōhaku staghorn i ko mākou kino?

Hiki i kēia mau pōhaku staghorn ke hana i ka paʻa piha a hapa paha o nā puʻupaʻa. E noʻonoʻo iā ia e like me kahi mea nui e paʻa ana i kahi paipu wai. Hoʻonui nā lālā o kēia pōhaku i loko o ka pelvis renal , kahi ʻāpana like me ka funnel o ka puʻupaʻa e hōʻiliʻili ana i ka mimi. Mai laila mai, mimi,Hele ia i ka ʻōpū mimi ma o ʻelua mau ʻōmole lahilahi i kapa ʻia ʻo ureters. No laila, inā paʻa ka pelvis renal a i ʻole ka ureter, hoʻomaka ka puʻupaʻa e pehu.

Eia kekahi, hiki i kēia mau pōhaku ke ālai i nā calyces o ka puʻupaʻa, kahi e hōʻiliʻili mua ai ka mimi. Inā pehu nā calyces ma muli o ka wai keu, ua kapa ʻia ʻo caliectasis . Inā ʻaʻole mālama pono ʻia kēia, hiki i nā puʻupaʻa ke hāʻule.

He aha nā hōʻailona o kēia?

Inā he pōhaku staghorn i loko o kou puʻupaʻa, hiki iā ʻoe ke ʻike i nā hōʻailona e like me:

• Kuni.
• ʻEha ʻaoʻao ma waena o nā iwi ʻaoʻao a me ka ʻūhā. Hiki i kēia ke like me ka ʻeha kua.
• Koko i loko o ka mimi (hematuria). Hiki i ka mimi ke lilo i ʻulaʻula a ʻeleʻele paha.
• Pu me ka mimi (pyuria). Hiki ke noe ka mimi, waiū, a he ʻala pilau paha.
• Manaʻo luhi loa.

I kekahi manawa aia paha kēia mau pōhaku nui akā ʻaʻohe hōʻailona . ʻO ia ka mea weliweli loa. Hiki ke loaʻa kēia mau pōhaku me ka ulia pōpilikia i ka wā o kahi hoʻāʻo i hana ʻia no kekahi kumu ʻē aʻe.

No ke aha i hana ʻia ai nā pōhaku e like me kēia? He aha nā kumu?

E like me ka mea i ʻōlelo ʻia ma mua, ʻo nā maʻi pinepine o ke ala mimi (UTI) kekahi kumu nui. ʻO kekahi ʻano bacteria e hoʻoulu ai i nā maʻi e hana i kahi enzyme i kapa ʻia ʻo urease . No ka laʻana, ʻo ka bacteria Proteus mirabilis . Hoʻohaʻahaʻa kēia enzyme i ka acidity (pH) o kāu mimi, ʻo ia hoʻi ke lilo ia i alkaline. A laila, hana ʻia nā kristal, e hui pū ana a hoʻomaka e hana i nā pōhaku puʻupaʻa.

Aia kekahi mau kumu ʻē aʻe:

• ʻOkoʻa anatomika: ʻOi aku ka maʻalahi o kekahi poʻe i ka hoʻomohala ʻana i nā pōhaku ma muli o kekahi mau ʻokoʻa hānau i loko o kā lākou ʻōnaehana mimi.
• Ka ālai ʻana o ke ala mimi.
• Ke hoʻohana nei i kahi catheter urinary no ka manawa lōʻihi.
• Inā ua loaʻa iā ʻoe kahi kaʻina hana hoʻohuli urinary ma mua.
• Ke kūlana o ka ʻōpū mimi neurogenic.
• Loaʻa nā pōhaku puʻupaʻa i mālama ʻole ʻia no ka manawa lōʻihi. Hiki i nā pōhaku liʻiliʻi ke ulu nui aʻe a hoʻoulu i kēia maʻi.

Pehea e ʻike ai nā kauka i kēia?

Inā loaʻa iā ʻoe nā hōʻailona, ​​e nīnau mua ke kauka iā ʻoe i nā nīnau a hana i kahi hoʻokolokolo kino. A laila e kauoha paha lākou i nā hoʻokolohua e like me:

• Nānā ʻana i nā puʻupaʻa me ke kukuna X: ʻO ka maʻamau, he ʻano radiopaque nā pōhaku Staghorn. ʻO ke ʻano kēia, ʻaʻole moakaka kēia mau pōhaku i nā kukuna X a no laila e ʻike maopopo ʻia ma kahi kiʻi kukuna X.
• Hoʻāʻo CT Scan (Computed Tomography - CT scan):ʻAe kēia iā mākou e ʻike maopopo i ka nui, ke ʻano, a me kahi o ka pōhaku. I ka manawa pinepine, hana ʻia kahi scan CT inā kānalua ʻia he pōhaku staghorn.
• Nā hoʻāʻo mimi: E nānā no ka maʻi, ke koko, a i ʻole ka pus.

Pehea e mālama ʻia ai?

ʻO ka mālama ʻana i nā pōhaku staghorn e pili ana i ke ʻoki kino . Pono e wehe loa ʻia ka pōhaku, ʻaʻole naʻe i nā ʻāpana liʻiliʻi. A i ʻole, hiki i kēlā mau ʻāpana liʻiliʻi ke hoʻoulu i ka maʻi a me nā pōhaku hou e hana ʻia.

He mea nui: ʻO nā pōhaku Staghorn kahi maʻi e hiki ai ke hōʻino i nā puʻupaʻa, no laila inā ʻōlelo ke kauka i ka lāʻau lapaʻau, ʻoi aku ka maikaʻi o ka hana koke ʻana.

Aia kekahi mau ʻano lapaʻau nui i hoʻohana ʻia:

1. ʻO ka Nephrolithotomy Percutaneous (PCNL)

ʻO kēia ke kaʻina hana ʻoki maʻamau i hoʻohana ʻia e wehe i nā pōhaku staghorn. ʻO ka PCNL kahi kaʻina hana e wehe ai i nā pōhaku nui i loko o ka puʻupaʻa, nā pōhaku nui loa e hele ma o ka mimi.

• Pehea e hana ʻia ai?: Hana ke kauka lapaʻau i kahi ʻoki liʻiliʻi ma kou kua, kokoke i kou puʻupaʻa. Hoʻokomo ʻia kahi ʻōmole liʻiliʻi no kekahi manawa ma o ka ʻoki i loko o kou puʻupaʻa. A laila, hoʻokomo ʻia kahi mea hana kūikawā me ke kāmela i kapa ʻia he nephroscope ma o ka ʻōmole e ʻimi i ka pōhaku a wāwahi iā ia i mau ʻāpana a wehe loa paha.
• Anesthesia: Hana ʻia kēia ʻoki ma lalo o ka anesthesia laulā .
• Noho ma ka haukapila: E noho mau ʻoe ma ka haukapila no hoʻokahi a ʻelua paha lā. I kekahi manawa, hiki ke waiho ʻia kahi paipu hoʻokahe liʻiliʻi no kekahi mau lā a hiki i ka ho'ōla ʻana o ka puʻupaʻa. Eia naʻe, ʻo ka hapa nui, ua kau ʻia kahi ureteral stent , kahi paipu liʻiliʻi e noho ana i loko o ke kino.

2. He aha ka stent ureteral?

Ua lohe paha ʻoe i ka "ʻoki ʻana i nā ʻōpū ʻole," ʻo ia hoʻi, ua waiho ʻia kahi ʻōmole hoʻokahe wai ma ke kua ma hope o ke kaʻina hana PCNL. Eia nō naʻe, hiki ke waiho ʻia kahi stent i loko.

He ʻōmole palaki liʻiliʻi ka ureteral stent i waiho ʻia no kekahi manawa i loko o ka ureter , ʻo ia ka ʻōmole e lawe ana i ka mimi mai ka puʻupaʻa a i ka ʻōpū mimi. Ua kau ʻia:

• Inā ua ālai ʻia kou puʻupaʻa, inā paha ma muli o ka pōhaku a i ʻole kekahi mea ālai ʻē aʻe, e kōkua i ka wehe ʻana.
• Ma hope o ke ʻoki ʻana, pono e wehe ʻia ka ureter e kōkua i ke kahe pono ʻana o ka mimi.

Hoʻopau pinepine ʻia kēia stent i loko o kekahi mau pule.

3. Lapaʻau ʻana o ka ureteroscopy

ʻO ka ureteroscopy kahi hana e komo ai ke kauka ʻoki i loko o nā ureters , nā ʻōmole e hoʻopili ai i nā puʻupaʻa i ka ʻōpū mimi. Hoʻohana pū kēia i nā mea hana liʻiliʻi loa. Ua kapa ʻia kēia he ureterorenoscopy.Hiki paha iā ʻoe ke lohe i ka URS a i ʻole U-scope .

ʻO kahi ʻano kūikawā o kēia ka ureteroscopy flexible , i ʻike ʻia hoʻi ʻo ke ʻoki intrarenal retrograde (RIRS) . Pili kēia i ke komo ʻana i nā mea hana ma o ka urethra me ka ʻole o nā ʻoki a i loko o ka puʻupaʻa e mālama i nā pōhaku. Hoʻohana pinepine ʻia kēia kaʻina hana no nā pōhaku liʻiliʻi a i ʻole no nā ʻāpana liʻiliʻi i waiho ʻia ma hope o PCNL. ʻO PCNL ke kumu nui no nā pōhaku staghorn.

4. Nā ʻAno Lithotripsy ʻē aʻe

Aia kekahi mau ʻano hana ʻē aʻe no ka wāwahi ʻana i nā pōhaku. No ka laʻana, hiki ke hoʻohana ʻia nā ʻano hana laser e like me ka Holmium laser lithotripsy a i ʻole Thulium fiber laser lithotripsy e wāwahi i nā pōhaku. Hiki ke hoʻohana ʻia kēia mau mea me ka PCNL a i ʻole Ureteroscopy.

5. Hoʻohuihui hui ʻana

I kekahi manawa, ʻaʻole hiki i hoʻokahi ʻano lapaʻau ke wehe loa i ka pōhaku. I kēlā hihia, pono e hoʻohana pū ʻia kekahi mau lapaʻau.

ʻIke: Loaʻa i nā lāʻau lapaʻau āpau kekahi mau pilikia. Hiki ke waiho ʻia nā ʻāpana pōhaku liʻiliʻi. Aia paha kekahi kahe koko. Ma hope o ke ʻoki ʻana, e hāʻawi kāu kauka iā ʻoe i nā lāʻau antibiotic a me nā mea hōʻeha ʻeha. Aia kekahi pilikia o ka maʻi no ka mea ʻaʻole maʻemaʻe ka mimi.

Pehea e hiki ai iaʻu ke hōʻemi i ka pilikia o ka hoʻi hou ʻana o kēia mau pōhaku ma hope o ka mālama ʻana?

Ma hope o ka wehe ʻia ʻana o kahi pōhaku, hiki iā ʻoe ke hoʻāʻo e pale i kona hana hou ʻana. Hiki i kēia mau mea ke kōkua:

• Ma hope o nā ʻōlelo aʻoaʻo kikoʻī a kāu kauka: E haʻi aku kāu kauka iā ʻoe i ka mea e ʻai ai a me ka mea ʻaʻole e ʻai ma muli o ke ʻano o ka pōhaku. Eia kekahi laʻana, e haʻi paha lākou iā ʻoe e inu i ka wai he nui.
• ʻO ka lawe ʻana i nā lāʻau lapaʻau urease inhibitor e like me ka acetohydroxamic acid : ʻAʻole hāʻawi pinepine ʻia kēia mau mea, ʻoi aku hoʻi i ka poʻe e hoʻomohala ana i nā pōhaku struvite, e ālai i ka enzyme urease.
• ʻO ka lawe ʻana i nā lāʻau antibiotics e pale aku i nā maʻi: Inā loaʻa pinepine iā ʻoe nā maʻi urinary tract, hiki i kāu kauka ke ʻōlelo aku e hoʻomau ʻoe i ka lawe ʻana i nā lāʻau antibiotics ma kahi haʻahaʻa haʻahaʻa.

He aha ka mea e hana ai inā loaʻa iā ʻoe kahi pōhaku staghorn? He aha inā ʻaʻole ia e mālama ʻia?

Inā loaʻa iā ʻoe kahi pōhaku staghorn a ua mālama pono ʻia , hiki iā ʻoe ke mimi maʻamau a e nalowale ka ʻeha. Loaʻa paha iā ʻoe a ʻaʻole paha. ʻOkoʻa ia mai kēlā kanaka a i kēia kanaka.

Eia nō naʻe, inā waiho ʻole ʻia ka pōhaku staghorn me ka mālama ʻole ʻia , hiki iā ia ke alakaʻi i nā kūlana weliweli e like me:

• ʻO ka pyelonephritis Xanthogranulomatous: He maʻi koʻikoʻi kēia o nā puʻupaʻa. Hiki iā ia ke hana i ka sepsis.Hiki i kahi maʻi hoʻoweliweli ke laha i loko o ke kino holoʻokoʻa.
• Caliectasis: Ka pehu ʻana o nā calyces o ka puʻupaʻa ma muli o ka paʻa ʻana o ka wai.
• Ka hāʻule ʻana o ka puʻupaʻa: Ua nalowale ka hiki i nā puʻupaʻa ke kānana i nā huahana ʻōpala. Hiki i kēia ke make.
• Urosepsis: He maʻi koʻikoʻi o ka ʻōnaehana mimi. Hiki i kēia ke make.

Eia nō naʻe, inā aia kekahi poʻe i loko o ke kūlana kahi hiki ʻole ai ke ʻoki kino (ma muli o ka makahiki a i ʻole nā ​​maʻi ʻē aʻe), hiki iā lākou ke ola me ka lāʻau lapaʻau ʻoki kino ʻole (hoʻokele conservative) ma lalo o ka nānā mau ʻana a ke kauka.

ʻEhia ka lōʻihi e ho'ōla ai?

ʻOkoʻa ka manawa hoʻōla ma muli o ka lāʻau lapaʻau. Inā loaʻa iā ʻoe kahi ʻoki kino nui, e lōʻihi ka manawa e hoʻōla ai. Eia nō naʻe, me nā kaʻina hana minimally invasive e like me PCNL, hiki paha iā ʻoe ke hoʻi i ka home i ka lā hoʻokahi. E haʻi aku kāu kauka iā ʻoe i ka wā e hiki ai iā ʻoe ke hoʻi i ka hana, ke kula, a me nā hana hāpai kaumaha.

Āhea ʻoe e ʻike ai i ke kauka?

Ma hope o ka mālama ʻana i kahi pōhaku staghorn, e ʻike i ke kauka a i ʻole e hele koke i ka haukapila inā loaʻa iā ʻoe kekahi o kēia mau hōʻailona:

• Inā loaʻa iā ʻoe ke kuni ma luna o 100 degere Fahrenheit (ma kahi o 37.8 Celsius).
• Inā ʻoe e anu a haʻalulu (anuanu/haʻalulu).
• Inā ʻaʻole e pau a hoʻonui paha ke kahe ʻana o ke koko.
• Inā ʻaʻole e emi a hoʻonui paha ka ʻeha.
• Inā ʻaʻole hiki iā ʻoe ke mimi.

ʻO ka mea hope loa, nā mea e hoʻomanaʻo ai

Hiki i nā pōhaku Staghorn, e like me nā pōhaku puʻupaʻa ʻē aʻe, ke hoʻonāukiuki iki a ʻeha. Akā, mai hopohopo. Hiki i kāu kauka ke nānā iā ʻoe a hāʻawi iā ʻoe i ka hopena maikaʻi loa. I ka hapanui o nā hihia, ʻo ia hopena paha he ʻoki kino. He mea nui e mālama i nā pōhaku staghorn inā hiki ke pale aku i ka hāʻule ʻana o ka puʻupaʻa.

E hahai pono i ka ʻai a kāu kauka, ka hoʻoikaika kino, a me nā ʻōlelo aʻoaʻo ʻē aʻe. A laila hiki iā ʻoe ke hoʻōla koke a noho olakino. Ua maopopo iā ʻoe? Inā he mau nīnau kāu, mai makaʻu e nīnau i kāu kauka.

Nā pōhaku puʻupaʻa, nā calculi staghorn, nā maʻi ʻaʻai mimi, PCNL, ʻoki puʻupaʻa, maʻi puʻupaʻa, ʻōnaehana mimi