Ese impyiko zawe zarazibye mu muyoboro w'inkari? (Ureteropelvic Junction - UPJ Obstruction) Reka tuvuge kuri ibi!

Hari igihe umwana wacu yumva ameze nk'ikibyimba gito mu nda ye, cyangwa akunda kwandura indwara zo mu nkari, si byo se? Wenda afite umuriro. Impamvu imwe y'ibi bintu ishobora kuba kuziba ahantu inkari zitangirira mu mpyiko. Uyu munsi, turaganira mu buryo burambuye, mu buryo bworoshye, kuri iki kibazo cyitwa `(Ureteropelvic Junction Obstruction)` cyangwa `(UPJ Obstruction)`.

Iyi 'guhagarika inzira y'imiyoboro y'ubura' ni iki?

Mu magambo make, hari agace kameze nk'umuyoboro hejuru y'impyiko zawe zombi, twita `(Renal Pelvis)` . Inkari zituruka mu mpyiko ziteranira muri iyi `(Renal Pelvis)`. Hanyuma izi nkari zimanuka mu muyoboro witwa `(Ureter)` zikinjira mu ruhago. Aho `(Renal Pelvis)` na `(Ureter)` bihurira byitwa `(Ureteropelvic Junction - UPJ)`. Iyo hari kuziba, ni ukuvuga kuziba, kuri iyi ihuriro ku mpamvu runaka, inkari ntizimanuka neza. Ibi nibyo twita `(UPJ Obstruction)`.

Ubusanzwe, buri mpyiko ifite `(Ureter)` imwe gusa. Impyiko zacu ziyungurura imyanda n'amazi menshi ava mu maraso zigakora inkari. Inkari zikorwa muri ubu buryo ziteranira muri `(Renal Pelvis)`, zigaca muri `(UPJ)`, hanyuma zikagenda muri `(Ureter)` zijya mu ruhago. Iyo habayeho `(UPJ Obstruction)`, iyi nkari itembera buhoro cyane, kandi rimwe na rimwe ishobora guhagarara burundu. Ibi byongera ibyago byo kwangirika kw'impyiko.

Akenshi, iyi ndwara yitwa `(UPJ Obstruction)` ni ikintu kibaho igihe umuntu avuka (ni ukuvuga `(Congenital inkari abnormality)`). Kandi akenshi ifata impyiko imwe gusa. Andi mazina ni `(UP junction obstruction)`, `(Obstruction of the ureteropelvic junction)`, cyangwa `(UPJO)` mu magambo ahinnye.

Ese iyi `(UPJ Obstruction)` ni indwara ikomeye?

Yego, UPJ Obstruction ni indwara ikomeye. Iyo idavuwe neza, ishobora no gutera impyiko kudakora neza . Niyo mpamvu ari ngombwa kubimenya no gufata ingamba zikenewe. Nta kintu na kimwe cyo guhangayikishwa nacyo, ariko ugomba kwitonda.

Iki kibazo gikunze kugaragara gute?

Mu mibare, hafi umwana umwe muri buri mwana 1.500 uvuka afite iyi ndwara (UPJ Obstruction). Ibi bivuze ko nubwo idakunze kubaho cyane, ishobora no kuba kuri buri wese.

Ni ibihe bimenyetso by'indwara yo kugabanya ururenda rw'imbere mu kanwa (Ureteropelvic Junction Obstruction)?

Hariho ibimenyetso byinshi bisanzwe bishobora kugaragara muri iki kibazo. Ariko, rimwe na rimwe, cyane cyane ku bana bato, bishobora kutagira ibimenyetso byo hanze.

• Kumva nk'ikibyimba mu nda, cyane cyane ku ruhande rw'inda. Ibi biterwa n'uko impyiko zibyimba bitewe no kuziba kw'inkari. Bimera nk'aho ari ibara ry'amazi.
• Indwara zikunze kugaragara mu nzira y'inkari (UTIs), hamwe n'umuriro. Niba umwana muto akunze kurwara UTIs, iki ni ikintu cyo kuzirikana.
• Ububabare bwo mu gituza. Ubu bubabare bugaragara mu gice cy'inyuma cy'impyiko. Hari igihe ubu bubabare buza bugashira.
• Amabuye mu mpyiko. Amabuye mu mpyiko ashobora kwibasirwa cyane iyo inkari zifunze.
• Amaraso mu nkari (`(Hematuria)`) .
• Isesemi no kuruka.
• Gutinda mu mikurire y'umwana cyangwa kugabanya ibiro . Hari igihe ibi bibazo bishobora kugaragara.

Ni iyihe mpamvu nyamukuru itera UPJ Obstruction?

Namaze kuvuga ko indwara nyinshi za UPJ zo kutagira icyo zikora ziba ari indwara yo kuvukana . Ibi bivuze ko iyo umwana ari mu nda, ibice by'inkari, cyane cyane ureter cyangwa impyiko, biba bitarakora neza. Hari igihe, uku kuziba kw'inkari bishobora guterwa no gukanda imitsi y'amaraso inyura muri UPJ. Ibi akenshi biba ari ibintu bitunguranye. Ariko, niba hari umuntu wo mu muryango wawe wagize iyi ndwara, nawe ushobora kuba uri mu kaga gato ko kuyirwara.

Ni gake cyane ku bantu bakuru bagira ``UPJ Obstruction``. Ariko, ishobora kubaho ku bantu bakuru bitewe n'impamvu zikurikira:

• Kubera amabuye yo mu mpyiko .
• Bitewe n'indwara zo mu gice cyo hejuru cy'inkari (`UTI zo hejuru`) .
• Nyuma yo kubagwa muri ako gace.
• Bitewe no kubyimba (`(Kubyimba)`) mu gice cyo hejuru cy'inkari .

Ni nde ugerwaho n'iki kibazo cyane?

Dukurikije amakuru ariho ubu, abagabo bafite amahirwe akubye kabiri yo kurwara UPJ Obstruction kurusha abagore. Ubushakashatsi bwagaragaje kandi ko iyi ndwara ifite amahirwe akubye kabiri yo kurwara impyiko y'ibumoso ugereranyije n'iy'iburyo.

Ni izihe ngorane zishobora guterwa na UPJ Obstruction?

Iyo iyi ndwara (UPJ Obstruction) idavuwe neza, hashobora kubaho ingorane zitandukanye.

• Indwara zisubira mu nzira y'inkari (UTIs) . Hari igihe ibinure bikikije impyiko bishobora kubyimba (perinephric stranding).
• Ububabare budakira bushobora kugaragara mu gace kagize ikibazo .
• Amabuye y'inyongera mu mpyiko (``amabuye y'inyongera``) ashobora kuvuka.

Igikomeye cyane ni uko iyo idavuwe igihe kirekire, iyi "(UPJ Obstruction)" ishobora kwangiza impyiko ndetse igatuma impyiko zinanirwa gukora neza . Niyo mpamvu ari ngombwa kuyisuzuma no kuyivura hakiri kare.

Ni gute wasuzuma indwara ya `(UPJ Obstruction)`?

Mu bihe byinshi,Abaganga bashobora gusuzuma UPJ Obstruction mu gihe cyo gupima umwana akiri mu nda. Ibi biterwa nuko kuziba kw'inkari bitera igitutu inyuma y'impyiko, bigatuma ibyimba birenze ibisanzwe. Ibi byitwa hydronephrosis . Ibi bigaragara neza kuri ultrasound.

Ndetse na nyuma yo kuvuka k'umwana, abaganga bashobora gutumiza ibizamini bitandukanye kugira ngo barebe uburyo impyiko zikora kandi zisohora inkari neza. Ibi birimo:

• Ibipimo by'amaraso n'inkari (`(Ibipimo by'amaraso n'isesengura ry'inkari)`). Ibipimo nka `(Blood Urea Azote - BUN)` na `(Creatinine Clearance)` bishobora kwerekana uburyo impyiko ziyungurura amaraso.
• Ikizamini cyitwa "Intravenous Pyelogram - IVP" kigamije gutera irangi ryihariye mu mitsi iri mu kuboko kwawe no gufata amashusho ya "X-ray". Iryo bara rishobora kugaragara uko rinyura mu mpyiko, "Renal Pelvis", na "Ureter" kugira ngo hamenyekane niba hari ikibazo cyo kuziba.
• Gupima Impyiko. Muri iki kizamini, hashyirwamo ibintu bike bya radiyo mu mitsi, hanyuma hagakoreshwa kamera idasanzwe kugira ngo irebe uko inyura mu mpyiko. Ibi bishobora gutanga igitekerezo cyiza cy'uburyo impyiko zikora neza n'urugero rw'aho zifunga.
• Ultrasound, CT scan, na MRI. Ibi bizamini byo gupima bishobora kwerekana neza imiterere y'impyiko, ureter, n'uruhago, ndetse n'imbogamizi iyo ari yo yose mu mpyiko.

Ni gute `(UPJ Obstruction)` ivurwa?

Ibi biterwa cyane n'imimerere. Niba umwana wawe afite UPJ Obstruction, rimwe na rimwe ashobora gukira wenyine mu mezi 18 ya mbere y'ubuzima bwe. Muri iki gihe, muganga w'umwana wawe azakora isuzuma rya ultrasound buri gihe n'ibindi bizamini kugira ngo arebe neza ko kuziba kw'umwana nta ngaruka byagize.

Ariko, niba umwana atarabasha kunyara nyuma y'amezi 18, bivuze ko kuziba kw'inkari kugihari, ashobora kubazwa yiswe "Open Pyeloplasty" . Muri ibi, umuganga w'inzobere mu by'imiti y'abana akora icyuho kinini, agakuraho igice cyari cyazibye, hanyuma agahuza "Ureter" n'impyiko, bigatuma habaho umwanya munini. "Open Pyeloplasty" akenshi bifata amasaha make, kandi ifite igipimo cyo gutsinda kingana na 95%.

Mu bihe bimwe na bimwe, umuganga w’inzobere ashobora gukora ubu buryo bwitwa `(Minimally invasive pyeloplasty)`, ari bwo buryo bwa roboti (`(surgical robot)`) . Hanyuma, hagakorwa icyuho gito hanyuma `(Laparoscope)` n'ibindi bikoresho byo kubaga bikorerwa hifashishijwe roboti. Kugira ngo ubu buryo bugende neza bisa n'ibya `(Open Pyeloplasty). Ariko, ibi bisaba ubuhanga bwinshi ku ruhande rw'umuganga w’inzobere. Biterwa kandi n'imyaka n'ingano y'umwana.

Ubundi buryo ni uburyo bwitwa "Endopyelotomy".Muri ibi, umuganga w’inzobere mu kubaga anyuza igikoresho cyitwa "Endoscope" (umuyoboro muto ufite kamera) anyuze mu muyoboro w’inkari ("Urethra"), anyuze muri "Ureter", akareba aho ifunganye. Hanyuma, insinga inyuzwa mu muyoboro uri muri "Endoscope", igakata ifunganye, hanyuma "agace k’inzobere", ni ukuvuga umuyoboro, igashyirwamo. Iyi "gace k’inzobere" isigara aho iherereye mu gihe cy’ibyumweru byinshi kugeza ikize. Muri "Endopyelotomy", nta gukata intera bisaba, kandi biroroshye kurusha ubundi bubagwa bubiri. Ariko, igipimo cyo gutsinda kiba kiri hasi gato. Hari igihe ibi bishobora gukorwa inshuro zirenze imwe.

Nzumva meze neza vuba gute nyuma yo kuvurwa?

Biterwa n'ubuvuzi wahawe kuri UPJ Obstruction yawe. Abantu benshi barakira mu byumweru bibiri kugeza kuri bine. Ariko, umubiri wawe uratandukanye, bityo igihe cyo gukira gishobora gutandukana. Muganga wawe azaguha igitekerezo cyiza kuri ibi.

Ese UPJ ishobora kwirindwa kubangamira imikorere y'umubiri?

Abashakashatsi mu by'ubuvuzi ntibarabona isano iri hagati y'ibiribwa n'imirire mu gihe cyo gutwita n'iterambere rya UPJ Obstruction mu mwana uri mu nda. Ibi bivuze ko nta kintu na kimwe twakora ngo tuburize UPJ Obstruction kubaho mu gihe cyo kuvuka.

Ariko, ku bantu bakuru batavukanye UPJ Obstruction, kwirinda ibi bikurikira bishobora kugabanya iyi ngaruka:

• Kurinda ikorwa ry'amabuye mu mpyiko .
• Kurinda indwara zo mu nzira y'inkari (UTIs) .
• Kwirinda gukomeretsa impyiko zawe .

Ni iki giteganijwe kuri iyo ndwara `(UPJ Obstruction)`?

Iyo isanzwe igaragaye hakiri kare kandi ikavurwa neza, icyizere cyo kubyara UPJ Obstruction ni cyiza cyane. Abana benshi ntibagira ibibazo by'igihe kirekire. Nanone, iyo igaragaye mbere yo kuvuka, rimwe na rimwe ishobora gukemuka nta buvuzi.

Ariko, iyo ugaragaye ko ufite UPJ Obstruction mu myaka yashize, uba ufite ibyago byinshi byo kwangirika kw'impyiko. Mu bihe bikomeye, iyo bitavuwe, UPJ Obstruction ishobora gutera impyiko kudakora neza ndetse no gupfa. Niyo mpamvu gusuzuma no kuvura hakiri kare ari ingenzi cyane.

Ni ryari ukwiye kujya kwa muganga?

Niba wowe cyangwa umwana wawe mufite kimwe muri ibi bimenyetso, hita ubonana na muganga:

• Iyo hari amaraso mu nkari (`(Hematuria)`) .
• Niba ifata mu ntoki zawe nk'ikibyimba mu nda yawe.
• Niba ubabara mu nda yo hejuru cyangwa mu mugongo (`(Ububabare bwo mu gifu)`) .
• Niba ufite umuriro.
• Iyo imikurire y'umwana idakomeye (`(Imikurire iragabanuka / kunanirwa gutera imbere)`) .

Ni ryari ugomba kujya mu Ishami ry’Ubuvuzi bw’Ingoboka (ETU) ?

Niba udashobora kunyara, jya mu cyumba cy’ubutabazi kiri hafi yawe vuba.Iki si ikintu cyo gutinza.

Ni ibihe bibazo ugomba kubaza muganga?

Ushobora kubaza muganga ibibazo nk'ibi:

• Ni gute wasuzuma iyi ndwara `(Ureteropelvic Junction Obstruction)`?
• Ese utekereza ko UPJ Obstruction y'umwana wanjye izakira nta kuvurwa?
• Ni ubuhe buryo bwo kuvura?
• Niba kubagwa ari ngombwa, ni ubuhe buryo wangira inama?
• Ni amahirwe angahe yo kongera kubangamira UPJ?

Ni irihe tandukaniro riri hagati ya `(Ureteropelvic Junction Obstruction)` na `(Ureterovesical Junction - UVJ) Obstruction`?

Muri make, kuziba k'uruhago rw'imbere mu gitsina (UPJ) na Ureterovesical Junction (UVJ) biba ku mpera z'umuyoboro w'inkari (ureter). UVJ niho ureter yawe ihurira n'uruhago rwawe. Kuziba k'uruhago rw'imbere mu gitsina (UVJ) bibaho. Ariko kuziba k'uruhago rw'impyiko (Renal Pelvis), aho ureter ihurira n'impyiko zawe.

None se, ni ubuhe butumwa dukwiye kujyana mu byo twavuze byose?

Ni ibisanzwe kumva ufite ubwoba iyo wumvise ko umwana wawe ashobora kugira iki kibazo, byaba ari mu gihe cyo gupimwa umwana akiri mu nda cyangwa nyuma yo kuvuka. Ushobora kumva ushaka kwiyagiriza, ukibaza uti 'Ese hari ikintu nakoze nabi? Hari icyo nashoboraga gukora kugira ngo mburize ibi?' Ariko mu by'ukuri, iyi ndwara yitwa '(Ureteropelvic Junction Obstruction)' ni ikintu rimwe na rimwe kibaho gusa. Ndetse n'abaganga ntibashobora kuvuga neza icyabiteye.

Igikomeye cyane ni uko abantu benshi bashobora gukira iyi ndwara ya `(UPJ Obstruction)`. Rero, ntutinye kujya kwa muganga no kumuganiriza. Basobanukiwe ibibazo byose n'ubwoba ufite mu mutwe. Bazagufasha mu buryo bwose bushoboka kandi basubize ibibazo byawe byose. Gusuzuma hakiri kare no kuvurwa neza ni byo bintu by'ingenzi hano.

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