I fa te hian zun lama harsatna a nei fo em? Hei hi Vesicoureteral Reflux (VUR) a ni thei!

Moms and dads, in fate hian urinary tract infection (UTI) a nei fo em? A nih loh leh zun a harsat em , a nih loh leh khawsik a nei em? A chang chuan hei hi a chhan hi kan sawi vak loh condition a ni thei a, mahse hriat a phu hle. Vawiin hian he natna hi Vesicoureteral Reflux , a tawi zawngin VUR an tih hi han sawi ila. Lungngai suh, hei hi a hun taka hriatthiam leh enkawl a nih chuan a tam zawkah chuan a dam kim vek thei a ni.

Vesicoureteral Reflux (VUR) hi eng nge ni? A awlsam zawngin i hrethiam ang u.

A awlsam zawngin VUR tih awmzia chu kan zun , chu chu zun chu kawng dik lo lamah a luang tihna a ni. Hetiang hian ngaihtuah teh, a nih tur angin. Kan taksa zun kawng hian kawng khata kal ang maiin hna a thawk a.

Hetiang hian a thleng thin:

• Kan kal (kidney) hian zun a siam chhuak thin. Kidney pahnih kan nei tlangpui.
• Tichuan, he zun hi ureters an tih tube te tak te pahnih hnuaiah a kal a, bladder-ah a khawl khawm ta a ni . Bladder hi balloon ang mai a ni a , chu chu zun khawlkhawm turin a inzar pharh a ni .
• Kan zun hian bladder a zun khawlkhawm chu tube dang urethra an tih hmangin taksa atangin a chhuak thin .

Tunah hian i hrethiam em? Hei hi tui dahna atanga tui pipe atanga lo chhuak leh tap atanga lo chhuak ang a ni. A pawimawh ber chu ureters, bladder nena an inzawmna hmun chu one-way valve angin an thawk a ni . Chu chu, zun chu zunthlum (bladder) a thlen chuan a chho leh thei tawh lo tihna a ni a, chu chu zun kawng zawhin kal (kidney) thlengin a kal leh thei lo tihna a ni.

Mahse, VUR nei mi pakhatah chuan he process-ah hian harsatna tlem a awm. Chu valve chuan hna a thawk tha lo a, bladder chhunga zun chu a luang leh a, ureter pakhat emaw pahnih emaw ah a luang lut a, a chang chuan kidney thlengin a luang lut leh thin. Hei hi reflux kan tih chu a ni .

He natna hi nau piang thar, nausen thla engemaw zat mi, leh naupang kum hnih vel thlenga awmte zingah a tam ber a ni . Mahse, naupang kum upa zawkah pawh a awm thei a, a tlem hle a, puitlingah pawh a awm thei bawk.

A pawimawh ber chu hetiang hian zun hnunglam a luang chuan bladder chhunga bacteria te chu kal lamah an kal thei a, kal natna a thlen thei a ni . Heng kal infection te hi uluk taka enkawl a nih loh chuan kal a tichhe vek thei a ni. Chuvang chuan VUR hi fimkhur a pawimawh hle.

Mahse, lungngai suh. VUR enkawl dan tur a awm. Enkawlna chu naupang kum, a natna lan chhuah dan leh VUR nasat danah a innghat a ni. Mild case thenkhat chuan enkawl an ngai lo va, naupang a lo puitlin chuan anmahni chauhin an dam leh ang. Mahse naupang thenkhat chuan an kal chhiatna tihtawp nan damdawi emaw, zai emaw an mamawh mai thei.

VUR chi hrang hrang a awm em?

Ni e, VUR hi chi hnih lian tak a awm.

• Primary VUR: Hei hi a tam ber chi a ni. A tam zawkah chuan urethra leh kidney sir khat chauh a nghawng a (hei hi unilateral reflux an ti a ni ). Primary VUR-ah chuan pian tirh atanga urethra leh bladder inzawmna hmunah hian chhiatna te tak te a awm a. Kan sawi tawh valve kha a khar tha tawk lo va, zun chu hnunglam hawiin a luang chhuak thin.
• Secondary VUR: Hei hi zun kawng khawi emaw laiah a block vang a ni. Entirnan, zun kawng (urethra) a block chuan zun chu hnunglam hawiin a luang lut thei a, chu chuan bladder chhungah pressure a siam thei a ni. A nih loh leh, bladder chhunga nerve-a harsatna awm vang a ni thei a, chu chuan a inzawm tha thei lo va, zun hnunglam a luang chhuak thei bawk. Secondary VUR nei naupangte hian ureter leh kidney pahnih a nghawng fo thin (hei hi bilateral reflux an ti a ni ).

Engtin nge VUR nasat dan (stage) hi an hriat theih? (VUR zirlai) 1.1.

VUR nasat zia hi stage, a nih loh leh grade panga a awm a. Pawl 1 hi a na lo ber a, pawl 5 hi a na ber a ni. He grade hian:

• Urinary system-ah hian eng chen nge zun a luang chho leh chhoh dan.
• Urethra hi engtiang chiahin nge a zau emaw, a hring emaw.

Chu stage pangate chu hetiang hi a ni:

• Grade 1: Zun chu hnunglam hawiin zunthlum chhungah a luang lut a, mahse zun kawng chu a zau zawng pangngai a ni.
• Grade 2: Urine chu ureter zawhin hnunglam hawiin a luang a, chu chu kidney hmun hmasa ber, zun a khawlkhawmna hmun (kidney pelvis) a thlen thlengin a luang chhuak a ni. Mahse, ureter emaw, chu kal lai emaw chu a lian lo.
• Grade 3: Ureters, kidney pelvis, leh calyces (bladder-a zun a awm tanna hmun) te chu zun hnunglam hawiin a lian deuh a ni
• Grade 4: Ureters hi a twisted a, a dilated deuh a, a chhan chu zun tam tak hnunglam hawiin a luang chhuak thin. Chutiang hmunte chu kal (kidney) pawh a zau deuh bawk.
• Grade 5: Zun hnunglam a luang lutuk avangin ureters chu a chhe nasa hle a, a lian hle bawk . Kal (kidney) khawlkhawmna kawng (collecting ducts) pawh a lian hle bawk.

VUR hi engtiang chiahin nge a awm?

Khawvel hmun hrang hrang i thlir chuan, .Naupang 1% leh 3% inkar velin VUR an nei nia chhut a ni. Chubakah, VUR vei naupang zinga 75% chauh chu hmeichhia an ni .

VUR natna lan chhuah dante chu engte nge ni?

A tam zawkah chuan VUR nei naupang hian symptom a nei lovang. Mahse, a lan chhuah dan a awm a nih chuan a lan chhuah tam ber chu zun kawng (UTI) a ni . Report thenkhat chuan naupang UTI vei zinga 30% leh 50% inkar velin VUR an nei thei tih an sawi!

Naupangin UTI a neih chuan heng ang symptoms hi zawng rawh:

• Zun tam a tulna .
• Zun chhuah laiin kang leh natna .
• Flank pain chu pum chhunga natna emaw, hnungzang hnuai lam (side of the abdomen) a na a ni.
• Zun tlemte chauh .
• Zun rawng a danglam a, a dum a, rimchhia a nei bawk.
• Taksa chu a lum a, a khawsik a lo awm ta.

Mahse, nausen hnute pein UTI a nei em tih hriat a harsa deuh thei. An tap nasa mai thei a, zu an in lo mai thei a, an rilru a buai mai thei bawk.

VUR hi a hrehawm em?

Ni lo, VUR ngei pawh hi a pawi lo. Mahse, VUR hian UTI a thlen a nih chuan zun chhuah laiin natna i nei thei a , kal/ pum na.

VUR hi eng thilin nge a thlen?

A hmaa kan sawi tawh VUR chi hnih, primary VUR leh secondary VUR te hian chhan hrang hrang an nei a.

• Primary VUR: Hei hi ureter leh bladder inkar valve-a pianpui chhiatna avanga lo awm a ni. A khar tha lo va, zun chu hnunglam hawiin kidney-ah a luang lut thei a ni. Thu lawmawm tak chu naupang a lo puitlin chuan, taksa pengte a puitlin chuan he valve hi a khar tha tan ang a, primary VUR hi a tlangpuiin a mah chauhin a tha thei a ni.
• Secondary VUR: Hei hi a chhan ber chu bladder neck emaw urethra emaw blockage emaw narrowing emaw vang a ni. He harsatna hian zun chu chhuak lovin hnunglam hawiin urinary tract chung lamah a luang chhuak thin. A nih loh leh, bladder control tu nerve te hian hna an thawk tha lo thei bawk. He harsatna hian bladder a tikhawlo a, a ti hahdam a, zun a chhuak thei lo. Secondary VUR-ah chuan bilateral VUR hi a tam zawk.

Hetiang dinhmun hi engte nge ni?

VUR lo awm dan tur tichhe thei risk factor thenkhat a awm a:

• Genetics: VUR hi chhungkuaah a kal tlangpui. Chhungkaw zinga naupang pakhatin VUR a neih chuan unaupa emaw unaunu emaw pawhin VUR a vei theihna chance chu pali zinga pakhat aia tlem a ni. Nu leh pa zinga pakhatin naupan laiin VUR a neih chuan naupang pawhin VUR a vei theihna chance chu pathum zinga pakhat vel a ni.
• Nau piangsualna: 1.1.Naupang pianpui kidney emaw urinary system lama harsatna nei te chuan VUR an vei tam zawk.
• Bladder leh bowel dysfunction (BBD): BBD vei naupangte hian zun leh ekna mumal takin harsatna an nei thin. Hei hi taksa ruh emaw, nerve emaw lama harsatna avanga lo awm a ni fo.
• Hnam leh mipat hmeichhiatna: Naupang var, hmeichhia te hian VUR an vei tam zawk nia sawi a ni (mahse naupang tu chungah pawh a thleng thei).

VUR avanga harsatna awm thei te chu engte nge ni?

VUR vei naupangte hian harsatna an nei thei a, chungte chu:

• Urinary tract infection (UTIs): Bladder infection, kal natna te pawh a tel.
• Bladder lama harsatna: zun control theih lohna (urinary incontinence), khumah hnim hring, zun chhuah vek theih lohna ( urinary retention).
• Thisen sang a sang.
• Kidney scarring, kidney chhiatna (e.g., nephrotic syndrome), leh a tlem berah chuan, chronic kidney failure.

Mahse, VUR vei naupang tam zawk hi chu hun rei tak chhung harsatna nei lovin an dam leh thin tih hre reng ang che. Chuvangin hlauthawng lo leh doctor thupek zawm a pawimawh.

Puitlingah engtin nge VUR hi a lo awm? (Hei hi naupang tê tê tan chauh a ni lo)

A tlem hle nachungin puitling pawhin VUR an nei thei bawk. A chhan awm thei te chu:

• Prostate gland lian zawk (`Benign prostate hyperplasia` - mipa tan) .
• Nerve chhiatna avanga bladder hnathawh that loh (`Neurogenic bladder`) .
• Ureter-ah surgery an nei a.

VUR hian kal (kidney stone) a thlen thei em?

Ni e, VUR hian kal (kidney stone) a thlen thei. Tin, zun kawng hmun dang, zunthlum (bladder)-ah pawh lung a siam thei bawk.

VUR hian nunna a tichhe thei em?

VUR ngei pawh hi nunna atana hlauhawm a ni lo. Mahse, VUR hian zun kawng infection (UTI) a thlen fo thei a, chu chuan kal a tichhe thei a, hun kal zelah kal natna hian thisen sang (renal hypertension) leh kal natna a thlen thei bawk. End-stage kidney disease i neih chuan dialysis emaw kidney transplant emaw i mamawh mai thei. Chuvang chuan VUR hi i ngaihtuah tur a ni.

Engtin nge VUR i nei tih i hriat theih ang? (Diagnosis) tih a ni.

I fain VUR a vei nia rinhlelh a nih chuan i naupang enkawltu doctor chuan pediatric nephrologist emaw pediatric urologist emaw hnenah a refer ang che .

VUR i neih leh neih loh dik taka hriat theih nan a hnuaia test te hi i ti thei ang:

• Voiding Cystourethrogram (VCUG): Hei hi X-ray test a ni. Tube te tak te, te tak te (catheter) chu naupang zunthlum chhungah dahin, a zun chhungah dye bik an theh lut thin. Tichuan, naupang zun laiin X-ray lak a ni a , zun hma leh zun hnuah . Heng X-ray te hian zun chu bladder atanga urethra ah a luang leh em tih a tarlang a. Hei hi doctor office-ah emaw, outpatient clinic-ah emaw, damdawi inah emaw tih theih a ni. Anesthesia hi a ngai lova, mahse naupang thenkhat chu an hahdam theih nan damdawi pek an ni mai thei.
• Ultrasound scan: Hei hi test na lo, him lo tak a ni. Sound wave hmangin i naute zun kawng zawng zawng (kidney leh bladder te pawh tel) thlalak a la thin. Hei hi doctor office-ah emaw, outpatient department-ah emaw, damdawi inah emaw pawh tih a ni. X-ray emaw radioactive material emaw nena inhriat loh i duh chuan VCUG hmain ultrasound neih hmasak phawt a ngai mai thei. Naupai laiin a chang chuan ultrasound scan hian i naute hian VUR (kidney hring ang chi) a nei thei tih chhinchhiahna a lang thei tih hre reng ang che.
• Dimercaptosuccinic acid (DMSA) scan: Hei hian naupang kal (kidney) chu UTI vangin a chhiat em tih enfiah a ni.
• Radionuclide cystogram (RNC): Hei hi nuclear scan chi khat a ni bawk. Radioactive material tlemte chu naupang bladder-ah dah a ni. Tichuan, naupangin a zun lai emaw, a zun a chhuah hnuah emaw, scanner hmangin radioactive material chu a zawng chhuak thin. Hei hi technician bik training neiin a ti bawk a, radiologist chuan thlalakte chu a zirchiang thin. Hei pawh hian anesthesia a ngai lo va, mahse naupang thenkhat chu an chawlh hahdam theih nan damdawi pek an ni thei bawk. RNC hi VCUG aiin a sensitive zawk a, mahse bladder structure chungchang erawh a sawi tam lo hle.

VUR nei naupangte tan eng test dang nge tih tur?

I fain VUR a vei tih finfiah a nih chuan heng test te hi tih fo tur a ni:

• Thisen sang endik: Naupang kal lama harsatna nei te hian thisen sang an nei tam zawk.
• Thisen test: Thisenah protein emaw creatinine emaw a tam chuan kal (kidney) a chhiatzia chhinchhiahna a ni.
• Zun test leh culture: Zun chhunga protein awm hi kal a chhiatzia tilangtu a ni. Zun chhunga bacteria awm hi natna hrik kai theihna chhinchhiahna a ni.

I fa doctor chuan bladder leh bowel dysfunction (BBD) a awm leh awm loh a enfiah bawk ang. BBD natna lan chhuah dan chu:

• Vawi tam tak, hmanhmawh taka zun chhuah a ngai .
• I rarely go to urinate , a rei tawh bawk.
• Nitin hnim hring .
• Constipation - kar khatah vawi thum aia tlem lo chhuak.
• Stool control theih lohna (Fecal incontinence).

Naupang VUR ruala BBD symptom nei te chu infection avanga kal a chhiat theihna a sang hle.

VUR hi engtin nge enkawl a nih?

VUR enkawl nan hian doctor puihna a ngai a ni. Enkawlna chu i fa kum, a natna lan chhuah dan, VUR chi hrang hrang leh a nasat danah a innghat a ni. Enkawlna kawng hrang hrangah antibiotics leh damdawi dang, soluble filler injection, hun rei lote chhunga catheterization, leh surgery te a ni. Nang leh i naupang enkawltu doctor leh specialist dangte chuan heng enkawlna kawng hrang hrangte hi in sawiho ang a, i fate tana tha ber tur chu i thlang ang.

Primary VUR enkawl dan tur

Primary VUR hi naupang a lo upat deuh deuh chuan a mah chauhin a tha thei (a tlangpuiin kum 5 vel a ni). A châng chuan "nghah leh en" tih hi a hlawhtling ṭhin. Mahse hun dangah chuan surgery emaw damdawi emaw a ngai thin.

Damdawi chi hrang hrang

Primary VUR hi i fa a lo upat deuh deuh a, an urinary system a puitlin chuan a tha chho fo thin. Chumi hma chuan i doctor chuan UTI a lo awm loh nan emaw, a lo awm a nih chuan enkawl nan emaw antibiotic a pe ang.

UTI venna atana antibiotics hun rei tak pek chungchangah ngaihdan hrang hrang a awm. Hei hi a chhan chu hun rei tak chhung antibiotics hman hian bacteria-ah antibiotic resistance a thlen thei a ni. American Academy of Pediatrics (AAP) chuan VUR grade sang zawk nei naupangte chauh (an tar atanga an VUR lo thang lian tur an nghah laiin) preventive antibiotics pek tur a rawt a ni.

Inzai

Doctor-te chuan primary VUR enkawlna atan hian surgical procedure hrang hrang an hmang a. Surgery tum ber chu bladder leh urethra inzawmna hmuna one-way valve (the one-way valve) siamthat a ni a, chu chuan zun hnunglam a luang lo thei lo.

• Ureteral reimplantation: Hei hi VUR tan surgery atana "gold standard" anga ngaih a ni. A tum ber chu ureter chu bladder wall kal tlanga tunnel sei tawk tak kal tlanga a kal theih nan a dah leh a, chu chuan zun hnunglam a luang lo tur valve siam a ni. I fa surgeon chuan he surgery hi open surgery angin (i fa pum chhunga incision hmangin) emaw, laparoscopically (incision tenau tlemte chauh hmangin) emaw a ti thei a ni. I surgeon chuan a hman dan tinte thatna leh that lohna te, a side effect awm thei te a sawifiah ang. Surgery atan hian general anesthesia , damdawi inah ni engemaw zat awm a ngai mai thei.

• Injectable bulking agent: Primary VUR enkawlna dang chuGel ang chi tui hyaluronic acid/dextranomer (Deflux®) tih hmanga . I fa doctor chuan hei hi a tlem berah i fate zunthlum bang, urethra luhna bulah a inject ang. Injection hian chuta tissue chu a ti hring a, valve angin a thawk a, zun chu a luang leh thei lo. Hei hi outpatient basis-a tih a ni (i fa chu ni khatah a haw thei), mahse general anesthesia a ngai bawk. I doctor chuan he enkawlna thatna leh that lohna a sawipui ang che.

Secondary VUR enkawl dan tur

Secondary VUR hi a blockage tihbo emaw, bladder empty dan siam that emaw hmanga enkawl a ni. Enkawlna hrang hrangte chu:

• Obstruction tihbo emaw, bladder emaw urethra pianzia mumal lo siamthat emaw tur surgery.
• UTI venna emaw enkawlna atana antibiotics pek.
• Intermittent catheterization: Hei hian urethra kaltlangin bladder chhungah tube te tak te dahin bladder chu a hring chhuak thin.
• Bladder muscle te tan damdawi.

Ka fain VUR a neih chuan eng nge thleng ang?

I fa chu VUR a vei tih hmuhchhuah a nih chuan, i chhungkaw tana tha tur enkawlna ruahmanna siam turin i medical team te nen thawhhona tha tak nei rawh. VUR ang dinhmun enkawl hi nangmah leh i enkawltu dangte tan chuan a buaithlak thei hle. I fate medical team nen i ngaihtuahna leh zawhnate chu sawipui rawh. Thu lawmawm tak chu VUR hi a tam zawkah chuan enkawl theih a ni a, naupang tam zawk tan chuan hun rei tak chhung nghawng a nei lo.

VUR hi eng chen nge a daih? / Kum upat danah VUR a tlahniam em?

I fa hian kum khat aia rei lo VUR a nei thei a, mahse hun bituk dik tak erawh a awm lo, naupang dinhmun a zirin a danglam thin. A châng chuan i doctor chuan "watchful waiting" approach a rawt ang a, test-naah VUR nasa tak emaw, kal a chhiat emaw a nih chuan surgery neih a rawt bawk ang.

Ni e, i fa chu VUR atang hian a thang chhuak thei a, a bik takin a tir lama VUR chu grade hniam (grade khat emaw pahnih emaw) a nih chuan. Hetiang natna nei naupangte hian kum tlemte chhungin anmahni chauhin an dam leh thei tlangpui.

VUR nei naupang chu sikul a kal thei ang em?

I fate symptoms nasat danah a innghat a ni. VUR ngei pawh hi i fate nitin nunah harsatna a ni lova, UTI a lo awm chuan harsatna a ni thei tih hre reng ang che. I fa chu natna, chaw ei kham, a nih loh leh insum theih lohna a nei thei a ni . I fa sikul kaltir emaw, ṭhiante nena inkhelh emaw chungchangah i doctor nen sawiho rawh.

VUR ven dan tur a awm em?

VUR laka inven dan tur hriat a ni lo - ei leh in, nunphung thlak danglam, damdawi hmang pawh ni lovin. Mahse, i fate taUrinary system pumpui hriselna tha tak neih theih nan thil tih theih i nei a:

• Naupang chu tui in tur tling pek .
• Naupangin a zun emaw, a zun emaw a chhuah hnua diaper thlak vat .
• Naupang chu "holding it in" ni lovin, zun tam turin fuih.
• Constipation, incontinence, incontinence ang chi harsatna te chu a rang thei ang bera enkawlna zawng rawh.

Tin, exercise lak hi fuih a pawimawh bawk a, i fate hrisel taka a awm theih nan chaw inthlau tak, ei tur tha tak tak pek a pawimawh bawk.

VUR chungchangah engtikah nge doctor ka hmuh ang?

UTI (VUR chhinchhiahna hmasa ber a ni fo) i rinhlelh chuan i fa naupang doctor pan nghal rawh. Urinary incontinence, sawifiah theih loh khawsik, leh zun laiin natna ang chi symptoms te pawhin VUR a tilang thei bawk. I pediatrician chuan VUR a rinhlelh chuan specialist hnenah a refer ang che.

Doctor hnenah eng zawhna nge i zawh tur?

VUR chungchanga zawhna i neih apiang chhanna dawng turin i fa doctor nen inbia ang che. Zawhna i zawh theih ṭhenkhat chu hetiang hi a ni:

• Ka fa primary VUR hi enkawl loh chuan a dam leh ang em?
• Ka fa pawhin kal (kidney) lama harsatna a nei em?
• Specialist ka hmuh tur em ni?
• Ka fa VUR hi engtin nge i enkawl?
• VUR enkawl loha awmtir chuan eng nge a rah chhuah theih?
• Ka fate dinhmun a ṭhat theih nan in lamah eng nge ka tih theih ang?
• Hetiang dinhmun hian ka fa chu a ti na dawn em ni?
• VUR hian taksa peng dang emaw taksa hnathawhna emaw a nghawng em tih engtin nge ka hriat theih ang?
• Engtin nge zun kawng infection i ven theih ang?
• Ka fa dangte hi VUR test an ni tur em ni?

A tawp berah chuan hriat reng tur (Take-Home Message) .

VUR hi a tlangpuiin a na lo va, nunna atana hlauhawm a ni lo. A enkawl theih a, enkawlna pawh a hlawhtling fo bawk. Inven dan tur a awm loh laiin, i fate chu an hriselna zawng zawng vawng reng turin tui a tam theih nan, exercise la tur leh ei tur tha tak tak ei turin i pui thei a ni. I doctor thiamna ring rawh. I fa VUR hriatchhuah leh enkawl danah an pui thei che a ni. I zawhna leh ngaihtuahnate chu sawipui hreh suh. I fate natna lan chhuah dan chu sawi harsa tak pawh ni se, inhawng tak leh rinawm takin sawi rawh. I hriatna leh i doctor thurawn zawm hi i fate a dam theih nan a tha ber a ni.

` Vesicoureteral reflux, VUR, zun kawng infection, naupang zun kawng natna, zun kawng infection, UTI, kal infection, naupang hriselna