Kodi impso yanu yatsekedwa ndi kutsekeka kwa ureter? (Ureteropelvic Junction - UPJ Obstruction) Tiyeni tikambirane za izi!

Nthawi zina mwana wathu amamva ngati chotupa chaching'ono m'mimba mwake, kapena amadwala matenda amkodzo pafupipafupi, sichoncho? Mwina ndi malungo. Chifukwa chimodzi cha zinthuzi chingakhale kutsekeka kwa malo omwe mkodzo umayambira ku impso. Lero, tikambirana mwatsatanetsatane, mwachidule, za vuto ili lotchedwa `(Ureteropelvic Junction Obstruction)` kapena `(UPJ Obstruction)`.

Kodi 'kutsekeka kwa ureteropelvic junction' kumeneku n'chiyani?

Mwachidule, pali malo ofanana ndi funnel pamwamba pa impso zanu zonse ziwiri, omwe timawatcha `(Renal Pelvis)` . Mkodzo womwe umatuluka kuchokera ku impso umasonkhana mu `(Renal Pelvis)` iyi. Kenako mkodzo uwu umatsikira mu chubu chotchedwa `(Ureter)` ndikusonkhana mu chikhodzodzo. Malo olumikizirana omwe `(Renal Pelvis)` ndi `(Ureter)` amakumana amatchedwa `(Ureteropelvic Junction - UPJ)`. Ngati pali kutsekeka, ndiko kuti, kutsekeka, pa malo olumikizirana pazifukwa zina, mkodzo sutsika bwino. Izi ndi zomwe timatcha `(UPJ Obstruction)`.

Kawirikawiri, impso iliyonse imakhala ndi `(Ureter)` imodzi yokha. Impso zathu zimasefa zinyalala ndi madzi ochulukirapo ochokera m'magazi ndikupanga mkodzo. Mkodzo womwe umapangidwa mwanjira imeneyi umasonkhana mu `(Renal Pelvis)`, umadutsa mu `(UPJ)`, ndikuyenda mu `(Ureter)` kupita ku chikhodzodzo. Pakakhala `(UPJ Obstruction)`, kuyenda kwa mkodzo kumeneku kumakhala kochedwa kwambiri, ndipo nthawi zina kumatha kutha kwathunthu. Izi zimawonjezera chiopsezo cha kuwonongeka kwa impso.

Nthawi zambiri, vutoli lotchedwa `(UPJ Obstruction)` ndi chinthu chomwe chimapezeka pobadwa (ndiko kuti, `(Congenital urinary abnormality)`). Ndipo nthawi zambiri limakhudza impso imodzi yokha. Mayina ena a izi ndi `(UP junction obstruction)`, `(Obstruction of the ureteropelvic junction)`, kapena `(UPJO)` mwachidule.

Kodi `(UPJ Obstruction)` iyi ndi vuto lalikulu?

Inde, UPJ Obstruction ndi vuto lalikulu. Ngati silinalandire chithandizo choyenera, lingayambitse kulephera kwa impso . Ndicho chifukwa chake ndikofunikira kudziwa za izi ndikuchitapo kanthu kofunikira. Palibe chodetsa nkhawa, koma muyenera kusamala.

Kodi vutoli ndi lofala bwanji?

Malinga ndi ziwerengero, pafupifupi mwana m'modzi mwa ana 1,500 aliwonse obadwa ali ndi vutoli (UPJ Obstruction). Izi zikutanthauza kuti, ngakhale kuti si lachilendo, lingachitike kwa aliyense.

Kodi zizindikiro za `(Ureteropelvic Junction Obstruction)` ndi ziti?

Pali zizindikiro zingapo zodziwika bwino zomwe zingawonekere mu vutoli. Komabe, nthawi zina, makamaka mwa makanda aang'ono, sipangakhale zizindikiro zakunja.

• Kumva ngati chotupa m'mimba, makamaka m'mbali mwa mimba. Izi zimachitika chifukwa impso zimatupa chifukwa cha kutsekeka kwa mkodzo. Zimamveka ngati buluni yamadzi.
• Matenda opatsirana m'mitsempha ya mkodzo pafupipafupi (UTIs), limodzi ndi kutentha thupi. Ngati mwana wamng'ono amatenga matenda a UTI nthawi zambiri, izi ndi zinthu zofunika kuziganizira.
• Kupweteka kwa m'mbali mwa impso. Uwu ndi ululu womwe umamveka kumbuyo kwa impso. Nthawi zina ululuwu umabwera ndikutha.
• Miyala ya impso. Miyala ya impso imapezeka mosavuta mkodzo ukatsekedwa.
• Magazi mu mkodzo (`(Hematuria)`) .
• Kusanza ndi kusanza.
• Kuchedwa kukula kapena kuchepa thupi mwa mwana . Nthawi zina mavuto amenewa amathanso kuoneka.

Kodi chifukwa chachikulu cha UPJ Obstruction ndi chiyani?

Ndanena kale kuti matenda ambiri a UPJ Obstruction ndi obadwa nawo . Izi zikutanthauza kuti mwana akakhala m'mimba, ziwalo zina za mkodzo, makamaka ureter kapena impso, sizimapangidwa bwino. Nthawi zina, kutsekeka kumeneku kungayambitsidwenso ndi kupsinjika kwa mtsempha wamagazi womwe umadutsa mu UPJ. Izi nthawi zambiri zimachitika mwangozi. Komabe, ngati wina m'banja mwanu wakhala ndi vutoli, inunso mungakhale pachiwopsezo chochepa chotenga matendawa.

Ndikosowa kwambiri kuti akuluakulu akhale ndi ``UPJ Obstruction``. Komabe, izi zitha kuchitika mwa akuluakulu chifukwa cha zifukwa zotsatirazi:

• Chifukwa cha miyala ya impso .
• Chifukwa cha matenda m'njira ya mkodzo yapamwamba ('Upper UTIs') .
• Pambuyo pa opaleshoni m'dera limenelo.
• Chifukwa cha kutupa (`(Kutupa)`) kumtunda kwa dongosolo la mkodzo .

Ndani amene akukhudzidwa kwambiri ndi vutoli?

Malinga ndi zomwe zapezeka pano, amuna ali ndi mwayi wochuluka wopeza UPJ Obstruction kuposa akazi. Kafukufuku wapezanso kuti vutoli ndi lowirikiza kawiri kuposa impso yakumanja.

Kodi ndi mavuto ati omwe angayambitse UPJ Obstruction?

Ngati vutoli (UPJ Obstruction) silinachiritsidwe bwino, mavuto osiyanasiyana angachitike.

• Matenda obwerezabwereza a mkodzo (UTIs) . Nthawi zina, minofu yamafuta yozungulira impso imatha kutupa (kutsekeka kwa perinephric).
• Ululu wosatha ukhoza kuchitika m'dera lomwe lakhudzidwa .
• Miyala yowonjezera ya impso (``miyala yachiwiri ya impso``) ingapangidwe.

Chofunika kwambiri ndichakuti ngati sichikuchiritsidwa kwa nthawi yayitali, `(UPJ Obstruction)` iyi ikhoza kuwononga impso ndipo pamapeto pake ingayambitse kulephera kwa impso . Ndicho chifukwa chake ndikofunikira kuzindikira ndi kuchiza msanga.

Kodi mungazindikire bwanji vuto la `(UPJ Obstruction)`?

Nthawi zambiri,Madokotala amatha kuzindikira UPJ Obstruction panthawi yowunikira mwana ali m'mimba. Izi zili choncho chifukwa kutsekeka kwa mkodzo kumaika mphamvu kumbuyo kwa impso, zomwe zimapangitsa kuti itupa kwambiri kuposa momwe zimakhalira. Izi zimatchedwa hydronephrosis . Izi zitha kuwoneka bwino pa ultrasound.

Ngakhale mwana atabadwa, madokotala amatha kuyitanitsa mayeso osiyanasiyana kuti aone momwe impso zimapangidwira komanso momwe mkodzo ukutulutsidwira. Izi zikuphatikizapo:

• Mayeso a magazi ndi mkodzo (`(Mayeso a magazi ndi kusanthula mkodzo)`). Mayeso monga `(Blood Urea Nitrogen - BUN)` ndi `(Creatinine Clearance)` angasonyeze momwe impso zikusefera magazi.
• Kuyezetsa komwe kumatchedwa ``Intravenous Pyelogram - IVP'' kumaphatikizapo kubaya utoto wapadera mu mtsempha womwe uli m'dzanja lanu ndikujambula zithunzi za ``X-ray''. Utotowo umatha kuwoneka pamene ukuyenda mu impso, ``Renal Pelvis'', ndi ``Ureter'' kuti mudziwe ngati pali kutsekeka.
• Kujambula Impso. Mu mayesowa, mankhwala ochepa a radioactive amalowetsedwa mumtsempha ndipo kamera yapadera imagwiritsidwa ntchito kuwona momwe imadutsa mumpso. Izi zingapereke lingaliro labwino la momwe impso zikugwira ntchito komanso kuchuluka kwa kutsekeka kwa impso.
• Ultrasound, CT scan, ndi MRI. Mayeso awa amatha kuona bwino kapangidwe ka impso, ureter, ndi chikhodzodzo, komanso zotchinga zilizonse mu impso.

Kodi `(UPJ Obstruction)` imachiritsidwa bwanji?

Izi zimadalira kwambiri momwe zinthu zilili. Ngati mwana wanu ali ndi UPJ Obstruction, nthawi zina amatha kuchira yekha mkati mwa miyezi 18 yoyambirira ya moyo wake. Panthawiyi, dokotala wa mwana wanu adzamuyang'ana pafupipafupi ndi mayeso ena kuti atsimikizire kuti kutsekekako sikukuyambitsa vuto lililonse.

Komabe, ngati mwanayo sakutha kukodza patatha miyezi 18, zomwe zikutanthauza kuti kutsekekako kudakalipo, mwina angafunike kuchitidwa opaleshoni yotchedwa ``Open Pyeloplasty'' . Pachifukwa ichi, dokotala wa urologist wa ana amapanga kucheka kwakukulu, kuchotsa gawo lotsekeka, ndikulumikizanso ``Ureter'' ku impso, ndikupanga kuwonekera pang'ono. ``Open Pyeloplasty'' nthawi zambiri imatenga maola angapo, ndipo imakhala ndi chiwopsezo cha kupambana cha pafupifupi 95%.

Nthawi zina, dokotala wa opaleshoni amatha kuchita opaleshoniyi pogwiritsa ntchito njira yotchedwa `(Minimally invasive pyeloplasty)`, yomwe ndi njira ya robotic (`(surgical robot)`) . Kenako, kudula pang'ono kumapangidwa ndipo `(Laparoscope)` ndi zida zina zochitira opaleshoni zimayendetsedwa kudzera mu loboti. Kupambana kwa njira iyi kuli kofanana ndi kwa `(Open Pyeloplasty). Komabe, izi zimafuna luso laukadaulo la dokotala wa opaleshoni. Zimatengeranso zaka ndi kukula kwa mwana.

Njira ina ndi njira yotchedwa ``Endopyelotomy''.Mu izi, dokotala wa opaleshoni amadutsa chida chotchedwa ``Endoscope`` (chubu chopyapyala chokhala ndi kamera) kudzera mu urethra (``Urethra``), motsatira ``Ureter``, ndikuyang'ana kutsekeka. Kenako, waya umadutsa mu ngalande mu ``Endoscope``, kudula kutsekekako, ndipo ``drain```, kutanthauza chubu, imayikidwa pamenepo. ``drain``` iyi imasiyidwa pamalo ake kwa milungu ingapo mpaka itatha. Mu ``Endopyelotomy``, sipafunika kudula, ndipo ndikosavuta kuposa maopaleshoni ena awiri. Komabe, kupambana kwake kumakhala kochepa pang'ono. Nthawi zina izi zingafunike kuchitidwa kangapo.

Kodi ndidzamva bwino msanga bwanji nditalandira chithandizo?

Zimadalira chithandizo chomwe mudalandira pa UPJ Obstruction yanu. Anthu ambiri amachira mkati mwa milungu iwiri kapena inayi. Komabe, thupi lanu ndi losiyana, kotero nthawi yanu yochira ingasiyane. Dokotala wanu adzakupatsani lingaliro labwino kwambiri la izi.

Kodi UPJ Obstruction ingapewedwe?

Ofufuza zachipatala sanapezebe mgwirizano pakati pa chakudya ndi zakudya panthawi ya mimba komanso kukula kwa UPJ Obstruction m'mwana wosabadwayo. Izi zikutanthauza kuti palibe chomwe tingachite kuti tipewe UPJ Obstruction ichitike pobadwa.

Komabe, kwa akuluakulu omwe sanabadwe ndi UPJ Obstruction, kupewa zinthu zotsatirazi kungathandize kuchepetsa chiopsezochi:

• Kuletsa kupangika kwa miyala ya impso .
• Kuteteza matenda a mkodzo (UTIs) .
• Kupewa kuvulala kwa impso zanu .

Kodi chiyembekezo cha vutoli ndi chiyani (UPJ Obstruction)?

Ngati atapezeka msanga ndikulandira chithandizo choyenera, chiyembekezo cha UPJ Obstruction chimakhala chabwino kwambiri. Ana ambiri samakhala ndi mavuto a nthawi yayitali. Komanso, ngati atapezeka asanabadwe, nthawi zina amatha popanda chithandizo chilichonse.

Komabe, ngati mutapezeka ndi UPJ Obstruction mtsogolo, muli pachiwopsezo chachikulu cha kuwonongeka kwa impso. Pa milandu yoopsa, ngati simulandira chithandizo, UPJ Obstruction ingayambitse kulephera kwa impso komanso imfa. Ichi ndichifukwa chake kuzindikira msanga ndi chithandizo ndikofunikira kwambiri.

Kodi muyenera kupita kwa dokotala liti?

Ngati inu kapena mwana wanu muli ndi zizindikiro izi, pitani kwa dokotala nthawi yomweyo:

• Ngati pali magazi mu mkodzo (`(Hematuria)`) .
• Ngati ikugwira m'dzanja lako ngati chotupa m'mimba mwako.
• Ngati muli ndi ululu m'mimba kapena msana (`(Kupweteka kwa m'mbali)`) .
• Ngati muli ndi malungo.
• Ngati kukula kwa mwana kwachedwa (`(Kukula kulephera / kulephera kukula)`) .

Kodi ndi liti pamene muyenera kupita ku Chipinda Chothandizira Anthu Odwala Mwadzidzidzi (ETU) ?

Ngati simungathe kukodza, pitani ku chipinda chapafupi chapafupi nthawi yomweyo.Ichi si chinthu chochedwetsa.

Ndi mafunso ati omwe muyenera kufunsa dokotala?

Mungathe kufunsa dokotala mafunso monga awa:

• Kodi mumazindikira bwanji vutoli `(Ureteropelvic Junction Obstruction)`?
• Kodi mukuganiza kuti UPJ Obstruction ya mwana wanga idzakhala bwino popanda chithandizo?
• Kodi njira zochiritsira ndi ziti?
• Ngati opaleshoni ndi yofunika, mumalimbikitsa njira iti?
• Kodi mwayi woti UPJ Obstruction ibwererenso ndi wotani?

Kodi kusiyana pakati pa `(Ureterovesical Junction Obstruction)` ndi `(Ureterovesical Junction - UVJ) Obstruction` ndi kotani?

Mwachidule, kutsekeka kwa Ureteropelvic Junction (UPJ) ndi Ureterovesical Junction (UVJ) kumachitika kumapeto kwa mkodzo wanu (ureter). UVJ ndi komwe mkodzo wanu umalumikizana ndi chikhodzodzo chanu. Kutsekeka kwa UVJ kumachitika pamenepo. Koma kutsekeka kwa UPJ kumachitika ku Renal Pelvis, komwe mkodzo umalumikizana ndi impso yanu.

Ndiye, kodi uthenga wotani umene tiyenera kuutenga kuchokera ku zonsezi?

Ndizachibadwa kuchita mantha mukamva kuti mwana wanu akhoza kukhala ndi vutoli, kaya ndi panthawi yowunikira mwana wanu ali m'mimba kapena atabadwa. Mungamve ngati mukufuna kudziimba mlandu, ndikudabwa kuti, 'Kodi ndinachita cholakwika? Kodi pali chilichonse chomwe ndikanachita kuti izi zisachitike?' Koma zoona zake n'zakuti, vutoli lotchedwa `(Ureteropelvic Junction Obstruction)` ndi chinthu chomwe nthawi zina chimachitika. Ngakhale madokotala sanganene chomwe chimayambitsa vutoli.

Chofunika kwambiri ndichakuti anthu ambiri achire ku vuto la `(UPJ Obstruction)` ili. Choncho, musaope kupita kwa dokotala ndikulankhula naye. Amamvetsetsa mafunso onse ndi mantha omwe muli nawo. Adzakuthandizani mwanjira iliyonse yomwe angathe ndikuyankha mafunso anu onse. Kuzindikira msanga ndi chithandizo choyenera ndi zinthu zofunika kwambiri pano.

Impso , Njira ya Mkodzo, Kutsekeka kwa UPJ, Madokotala a Ana, Dongosolo la Mkodzo, Opaleshoni, Kutsekeka kwa Mgwirizano wa Ureteropelvic