Kua puta he kōhatu āhua 'staghorn' i roto i ō whatukuhu? Me ako tātou mō te Staghorn Calculus!

Kua rongo koe i ngā kōhatu whatukuhu? He raruraru noa tēnei mō ētahi tāngata. Engari i tēnei rā ka kōrero tātou mō tētahi momo kōhatu whatukuhu motuhake. Ko te ingoa o tēnei ko te Staghorn Calculus . He ahua rerekē te ingoa, kāore? Ko te tikanga o "Staghorn" ko ngā haona o te tia. I tapaina ēnei kōhatu nā te mea ka peka atu, ka horapa ki roto i te whatukuhu, pērā i ngā haona tia. Ka taea hoki te whakaaro he toka korara i te moana.

He aha te Tātaitai Staghorn?

Ki te kī māmā noa, he momo kōhatu tākihi te staghorn calculus (ko te tikanga o te calculus he kōhatu). Engari kāore tēnei i rite ki ētahi atu kōhatu ririki noa. Ka taea e ia te tipu nui, te manga, me te horapa puta noa i te awa matua (renal pelvis) me te pūnaha awa iti (calyces) e kohi ana i te mimi i roto i te tākihi . Whakaarohia mēnā he rite te tākihi ki tētahi wheketere e hanga mimi ana, ka rite tēnei kōhatu ki tētahi aukati nui i roto i te paipa o taua wheketere.

Ko te tino take o ēnei kōhatu ko ngā mate mimi auau (UTI) . Ko ngā kōhatu e puta mai ana i ēnei mate he mea hanga i te matū e kiia nei ko te struvite . He ranunga tēnei o te konupūmā, te phosphate, me te ammonium. I ētahi wā, ka tipu te kōhatu iti i roto i te wā, ka peka atu hei kōhatu staghorn pēnei i tēnei. Ina tupu tēnā, ka puta mai i te wā e konatunatua ai te struvite ki te konupūmā phosphate, te konupūmā oxalate , te konupūmā carbonate apatite rānei.

I te nuinga o te wā, ka puta tēnei momo kōhatu i roto i te whatukuhu kotahi anake. Heoi, he tino onge, ka puta tēnei āhuatanga i roto i ngā whatukuhu e rua. Ka taea e ēnei kōhatu te whakararuraru nui i te mahi a te whatukuhu, ā, ka arahi pea ki te ngoikore o te whatukuhu .

Ko wai ka taea te whakatipu i te nuinga o ēnei 'kōhatu haona tia'?

He nui ake te mōrearea o ētahi tāngata ki te pāngia e ēnei kōhatu staghorn. Me titiro tātou ko wai rātou:

• Mō ngā wāhine: He nui ake te kitea o tēnei mate i roto i ngā wāhine i ngā tāne.
• Mō te hunga e pāngia pinepine ana e ngā mate mimi (UTI): E ai ki te kōrero i mua ake nei, koinei tētahi o ngā tino take.
• Mō te hunga he āhua rerekē, he panoni rānei kei roto i te pūnaha mimi: Mena he ngoikore te rere o te mimi, ka māmā ake te hanga kōhatu.
• Mō te hunga kua whara te taurakira.
• Mō te hunga he pūkahukahu neurogenic: E pā ana tēnei ki te hunga kua ngoikore te mahi a te pūkahukahu nā te kino o te io.

He aha ngā pānga o ngā kōhatu staghorn ki ō tātou tinana?

Ka taea e ēnei kōhatu staghorn te aukati katoa, te aukati wāhanga rānei i ngā whatukuhu. Whakaarohia he rite ki tētahi mea nui e aukati ana i tētahi paipa wai. Ka toro atu ngā manga o tēnei kōhatu ki roto i te pelvis whatukuhu , he wāhanga rite ki te awaawa o te whatukuhu e kohi ana i te mimi. Mai i reira, ka puta te mimi,Ka haere ki te pūkahukahu mā roto i ngā ngongo angiangi e rua e kīia ana ko ngā ureter. Nō reira, ki te aukatia te pelvis whatukuhu, te ureter rānei, ka tīmata te pupuhi o te whatukuhu.

Waihoki, ka taea e ēnei kōhatu te aukati i ngā anga o te whatukuhu, te wāhi tuatahi e kohia ai te mimi. Mēnā ka pupuhi ngā anga nā te wai tāpiri, ka kiia ko te caliectasis . Mēnā kāore tēnei e rongoatia tika, ka ngoikore pea ngā whatukuhu.

He aha ngā tohu o tēnei?

Mena he kōhatu staghorn kei roto i tō whatukuhu, ka pāngia pea koe e ngā tohu penei:

• Te kirika.
• Te mamae o te taha i waenganui i ngā rara me te hope. Ka rite anō hoki ki te mamae o te tuara.
• Toto i roto i te mimi (hematuria). Ka huri pea te mimi ki te whero, ki te parauri pouri rānei.
• He pūkahukahu me te mimi (pyuria). Tērā pea he kapua te mimi, he miraka, ā, he haunga kino pea.
• Tino ngenge te ngenge.

I ētahi wā, tera pea ka kitea ēnei kōhatu nunui engari kāore he tohu . Koinei te mea tino morearea. Tērā pea ka kitea noatia ēnei kōhatu i te wā o te whakamātautau mō tētahi atu take.

He aha i puta ai ngā kōhatu pēnei? He aha ngā take?

E ai ki te kōrero i mua ake nei, ko ngā mate pūkahukahu auau (UTI) tētahi o ngā tino take. Ina koa, ko ētahi momo huakita e puta ai ngā mate ka whakaputa i tētahi whākōkī e kiia nei ko te urease . Hei tauira, ko te huakita Proteus mirabilis . Ka whakaitihia e tēnei whākōkī te waikawa (pH) o tō mimi, ko te tikanga ka nui ake te kawakore. Kātahi ka puta he tioata, ka huihui ngātahi, ka tīmata te hanga kohatu tākihi.

Tērā atu anō ētahi take:

• Ngā rerekētanga hanganga tinana: Ko ētahi tāngata he nui ake te tūponotanga ki te whakawhanake i ngā kōhatu nā runga i ētahi rerekētanga whānau mai i roto i ō rātou pūnaha mimi.
• Te aukati i te ara mimi.
• Te whakamahi i te catheter mimi mō te wā roa.
• Mena kua whai pokanga whakawhiti mimi koe i mua.
• Te āhua o te pūkahukahu neurogenic.
• He kōhatu tākihi tō te tinana kāore anō kia rongoatia mō te wā roa. Ka taea e ngā kōhatu iti te tipu nui ake, ā, ka puta ai tēnei āhuatanga.

Me pēhea te kite a ngā tākuta i tēnei?

Mena kei a koe ngā tohu, ka pātai tuatahi te tākuta ki a koe, ā, ka tirotirohia e ia tōna tinana. Kātahi ka tonoa pea e ia ētahi whakamātautau pēnei i:

• Whakamātautau hihi-X o ngā whatukuhu: He maha ngā wā ka kitea ngā kōhatu Staghorn i roto i te kiri mā te hihi-X. Ko te tikanga, kāore ēnei kōhatu e mārama ki ngā hihi-X, nō reira ka kitea mārama i runga i te whakaahua hihi-X.
• Whakamātautau Matawai CT (Tomography Rorohiko - matawai CT):Mā tēnei ka taea e tātou te kite mārama i te rahi, te āhua, me te wāhi o te kōhatu. He maha ngā wā, ka mahia he matawai CT mēnā e whakapaetia ana he kōhatu staghorn.
• Ngā whakamātautau mimi: Tirohia mēnā he mate urutā, he toto, he pūkahukahu rānei.

Me pēhea te rongoā?

Ko te rongoā i ngā kōhatu staghorn he tikanga pokanga . Me tango katoa te kōhatu, ahakoa ngā wahi iti. Ki te kore, ka pā mai te mate i aua wahi iti, ā, ka puta mai he kōhatu hou.

He mea nui: He mate kino ngā kōhatu staghorn ki ngā whatukuhu, nō reira, ki te tūtohu te tākuta i tētahi maimoatanga, he pai ake te mahi wawe tonu.

He maha ngā tikanga matua e whakamahia ana mō te maimoatanga:

1. Te Nephrolithotomy Percutaneous (PCNL)

Koinei te tikanga pokanga tino noa e whakamahia ana hei tango i ngā kōhatu staghorn. Ko te PCNL he tikanga e tango ana i ngā kōhatu nunui i roto i te whatukuhu, arā, ngā kōhatu nunui rawa kāore e taea te puta mā te mimi.

• Me pēhea te mahi?: Ka tapahia e te taote pokanga he kōhatu iti ki tō tuara, e tata ana ki tō whatukuhu. Ka whakaurua he ngongo iti mā roto i te tapahi ki roto i tō whatukuhu mō tētahi wā poto. Kātahi ka whakaurua he taputapu motuhake kei roto he kāmera e kiia nei ko te nephroscope mā roto i te ngongo hei kimi i te kōhatu, hei wawahi rānei, hei tango katoa rānei.
• Whakamoemiti: Ka mahia tēnei pokanga i raro i te whakamoemiti whānui .
• Noho hōhipera: I te nuinga o te wā ka noho koe ki te hōhipera mō te rā kotahi, e rua rānei. I ētahi wā, ka waiho pea he ngongo wai iti ki tōna tūranga mō ētahi rā tae noa ki te wā e ora ai te whatukuhu. Heoi, i te nuinga o te wā, ka whakanohoia he stent ureteral , he ngongo iti e noho ana i roto i te tinana.

2. He aha te stent ureteral?

Kua rongo pea koe i te "pokanga kore ngongo," arā, ka waiho he ngongo waikeri ki te tuara i muri i te tikanga PCNL. Heoi, ka taea tonu te whakauru i te stent ki roto.

He ngongo kirihou iti te stent ureteral e whakanohoia ana ki roto i te ureter mō te wā poto, arā, te ngongo e kawe ana i te mimi mai i te whatukuhu ki te pūkahukahu. Ka whakanohoia:

• Mena kua āraihia tō whatukuhu, nā te kōhatu, nā tētahi atu ārai rānei, me āwhina ki te tango.
• I muri i te pokanga, me waiho kia tuwhera te ureter kia pai ai te rere o te mimi.

I te nuinga o te wā ka tangohia tēnei stent i roto i ētahi wiki.

3. Maimoatanga ureteroscopy

He tikanga te ureteroscopy e whakaurua ai e te taote pokanga ngā ureters , arā, ngā ngongo e hono ana i ngā whatukuhu ki te pūkahukahu. Ka whakamahia hoki ngā taputapu iti rawa. Ka kiia tēnei he ureterorenoscopy.Tērā pea ka rangona e koe te URS , te U-scope rānei.

Ko tētahi momo motuhake o tēnei ko te ureteroscopy ngāwari , e mōhiotia ana ko te retrograde intrarenal surgery (RIRS) . Ko te whakauru i ngā taputapu mā roto i te urethra, kāore he tapahi, ka uru ki roto i te whatukuhu hei rongoā i ngā kōhatu. He tikanga tēnei e whakamahia ana mō ngā kōhatu iti, mō ngā kongakonga iti rānei e toe ana i muri i te PCNL. Ko te PCNL te kaupapa matua mō ngā kōhatu staghorn.

4. Ētahi atu Tikanga Lithotripsy

Tērā atu anō ngā tikanga mō te kuru kōhatu. Hei tauira, ka taea te whakamahi i ngā tikanga taiaho pērā i te Holmium laser lithotripsy , te Thulium fiber laser lithotripsy rānei hei wawahi i ngā kōhatu. Ka taea te whakamahi tahi me te PCNL, te Ureteroscopy rānei.

5. Whakaora whakakotahi

I ētahi wā, kāore e taea e te kotahi tikanga maimoatanga te tango katoa i te kōhatu. Mēnā koinei te āhua, me whakamahi ngātahi ētahi maimoatanga.

Kia mōhio: He tūponotanga kei ia maimoatanga. Tērā pea ka toe tonu ngā kōhatu ririki. Tērā pea ka puta he toto. I muri i te pokanga, ka hoatu e tō tākuta he rongoā paturopi me ngā rongoā whakamamae ki a koe. Tērā anō hoki te tūponotanga o te mate pāwera nā te mea kāore i te ma te mimi.

Me pēhea te whakaiti i te mōrearea o te hokinga mai o ēnei kōhatu i muri i te maimoatanga?

I muri i te tango i te kōhatu, ka taea e koe te ngana ki te aukati i tōna hanganga anō. Ka taea e ēnei mea te āwhina:

• Te whai i ngā tohutohu kai motuhake a tō tākuta: Ka tohutohu tō tākuta i ngā mea hei kai me ngā mea kāore e kai, i runga i te momo kōhatu. Hei tauira, ka kī atu pea rātou kia nui te wai hei inu māu.
• Te tango i ngā rongoā aukati urease pēnei i te waikawa acetohydroxamic : Kāore i te tino hoatu ēnei, inā koa ki te hunga e whakawhanake ana i ngā kōhatu struvite, hei aukati i te whākōkī urease.
• Te tango i ngā paturopi hei ārai i ngā mate urutā: Mena he maha ngā mate urutā o te ara mimi kei a koe, ka tūtohu pea tō tākuta kia haere tonu te tango i ngā paturopi i te horopeta iti.

He aha te mea ka tupu mēnā he kōhatu staghorn tōu? Me pēhea mēnā kāore e rongoatia?

Mena he kōhatu staghorn tōu, ā, kua tika te rongoā , ka taea e koe te mimi i te āhua noa, ā, ka ngaro te mamae. Tērā pea ka pā mai anō he kōhatu ki a koe, kāore rānei. He rerekē i ia tangata, i ia tangata.

Heoi, ki te kore e rongoatia te kōhatu staghorn , ka arahi pea ki ngā āhuatanga kino pēnei i:

• Pyelonephritis Xanthogranulomatous: He mate kino tēnei o ngā whatukuhu. Ka taea e ia te mate pāwera.Ka horapa pea tētahi mate morearea puta noa i te tinana.
• Caliectasis: Te pupuhi o ngā kapu o te whatukuhu nā te mea e mau ana te wai.
• Te ngoikore o te whatukuhu: Ka ngaro te kaha o ngā whatukuhu ki te tātari i ngā para. Ka mate pea tēnei.
• Urosepsis: He mate kino o te pūnaha mimi. Ka mate pea hoki.

Heoi, ki te mea kei roto ētahi tāngata i tētahi āhuatanga kāore e taea te pokanga (nā te koroheketanga, nā ētahi atu mate rānei), ka taea e rātou te ora me te maimoatanga kore-pokanga (whakahaere ā-pūmau) i raro i te tirotiro tonu a te tākuta.

Kia pēhea te roa o te wā e ora ai?

Ka rerekē te roa o te whakaoranga i runga i te maimoatanga. Mena ka pokanga nui koe, ka roa ake te wā e ora ai. Heoi, mā ngā tikanga iti rawa te whakaekenga pēnei i te PCNL, ka taea pea e koe te hoki ki te kāinga i taua rā anō. Ma tō tākuta koe e kī atu āhea koe ka taea te hoki ki te mahi, ki te kura, me ngā mahi amo taumaha.

Āhea koe me toro atu ki te tākuta?

I muri i te rongoā i te kōhatu staghorn, me toro atu ki te tākuta, me haere rānei ki te hōhipera tonu mēnā kei a koe ētahi o ēnei tohu:

• Mena he kirika tōu neke atu i te 100 nekehanga Fahrenheit (tata ki te 37.8 Celsius).
• Ki te mātao koe, me te wiriwiri hoki (te makariri/te wiriwiri).
• Ki te kore te toto e mutu, e piki rānei.
• Ki te kore te mamae e whakaiti, e whakanui rānei.
• Ki te kore e taea e koe te mimi.

Hei whakamutunga, ngā mea hei maumahara

Pērā i ngā kōhatu whatukuhu katoa, ka ahua whakarihariha, ka mamae hoki. Kaua e manukanuka. Ka taea e tō tākuta te tirotiro i a koe, ā, ka hoatu ki a koe te otinga pai rawa atu. I te nuinga o te wā, ko te pokanga pea te otinga. He mea nui kia rongoāhia ngā kōhatu whatukuhu mēnā ka taea hei ārai i te ngoikore o te whatukuhu.

Kia tika te whai i te kai a tō tākuta, te whakakori tinana, me ētahi atu tohutohu. Kātahi ka taea e koe te ora wawe, me te noho hauora tonu. Kei te mārama koe? Ki te mea he pātai āu, kaua e wehi ki te pātai ki tō tākuta.

` Ngā kōhatu whatukuhu, ngā papaku o te whatukuhu, ngā mate mimi, PCNL, pokanga whatukuhu, mate whatukuhu, pūnaha mimi