Ingaba izintso zakho zivaliwe kukuvaleka kwe-ureter? (Ureteropelvic Junction - UPJ Obstruction) Masithethe ngale nto!

Ngamanye amaxesha umntwana wethu omncinci uziva ngathi uneqhuma elincinci esiswini sakhe, okanye ufumana usulelo oluqhelekileyo lwendlela yomchamo, akunjalo? Mhlawumbi ngenxa yomkhuhlane. Esinye sezizathu zezi zinto kukuvaleka kwendawo apho umchamo uqala khona kwizintso. Namhlanje, siza kuthetha ngokweenkcukacha, ngokulula, ngale meko ibizwa ngokuba yi-`(Ureteropelvic Junction Obstruction)` okanye `(UPJ Obstruction)`.

Yintoni le 'ingxaki yokungena kwe-ureteropelvic junction'?

Ngamafutshane, kukho indawo efana ne-funnel phezulu kwezintso zakho zombini, esiyibiza ngokuba yi -`(Renal Pelvis)` . Umchamo ophuma kwizintso uqokelelana kule `(Renal Pelvis)`. Emva koko lo mchamo wehla ngetyhubhu ebizwa ngokuba yi -`(Ureter)` uze uqokelele kwisinyi. Indawo apho `(Renal Pelvis)` kunye ne-`(Ureter)` zidibana khona ibizwa ngokuba yi-`(Ureteropelvic Junction - UPJ)`. Ukuba kukho indawo evalekileyo, oko kukuthi, indawo evalekileyo, kule ndawo evalekileyo ngesizathu esithile, umchamo awuhli kakuhle. Oku sikubiza ngokuba yi-`(UPJ Obstruction)`.

Ngokwesiqhelo, intso nganye ine-`(Ureter)` enye kuphela. Izintso zethu zihluza inkunkuma kunye nolwelo olugqithisileyo egazini kwaye zivelise umchamo. Umchamo oveliswa ngale ndlela uqokelelana kwi-`(Renal Pelvis)`, udlule kwi-`(UPJ)`, uze uhambe nge-`(Ureter)` uye kwisinyi. Xa kukho i-`(UPJ Obstruction)`, olu hambo lomchamo luhamba kancinci kakhulu, kwaye ngamanye amaxesha lunokuyeka ngokupheleleyo. Oku kwandisa umngcipheko wokonakala kwezintso.

Ixesha elininzi, le meko ibizwa ngokuba yi-`(UPJ Obstruction)` yinto ekhoyo xa kuzalwa (oko kukuthi, `(Congenital urinary abnormality)`). Kwaye idla ngokuchaphazela izintso enye kuphela. Amanye amagama ale meko ngala `(UP junction obstruction)`, `(Obstruction of the ureteropelvic junction)`, okanye `(UPJO)` ngamafutshane.

Ingaba le `(UPJ Obstruction)` yimeko enzulu?

Ewe, i-UPJ Obstruction yimeko enzima kakhulu. Ukuba ayinyangwa kakuhle, inokukhokelela ekungasebenzini kwezintso . Yiyo loo nto kubalulekile ukuba uyiqaphele kwaye uthathe amanyathelo afunekayo. Akukho nto inokubangela ukukhathazeka ngayo, kodwa kufuneka uqaphele.

Ixhaphake kangakanani le meko?

Ngokwezibalo, malunga nesinye kwi-1,500 yeentsana ezizalwayo sinale meko (i-UPJ Obstruction). Oku kuthetha ukuba, nangona ingaqhelekanga kangako, inokwenzeka nakubani na.

Zithini iimpawu ze-`(Ureteropelvic Junction Obstruction)`?

Kukho iimpawu ezininzi eziqhelekileyo ezinokubonakala kule meko. Nangona kunjalo, ngamanye amaxesha, ingakumbi kwiintsana ezincinci, kusenokungabikho zimpawu zangaphandle.

• Ukuziva ngathi liqhuma esiswini, ingakumbi ecaleni kwesisu. Oku kubangelwa kukudumba kwezintso ngenxa yokuvaleka komchamo. Kuvakala ngathi yibhaluni yamanzi.
• Usulelo oluqhelekileyo lwendlela yomchamo (UTIs), kunye nomkhuhlane. Ukuba umntwana omncinci ufumana ii-UTI rhoqo, le yinto ekufuneka iqwalaselwe.
• Intlungu emqolo. Le yintlungu evakala ngasemva kwezintso. Ngamanye amaxesha le ntlungu iyafika ize iphele.
• Amatye ezintso. Amatye ezintso anokwenzeka ngakumbi xa umchamo uvaliwe.
• Igazi kumchamo (`(Hematuria)`) .
• Isicaphucaphu nokuhlanza.
• Ukulibaziseka kokukhula okanye ukwehla kobunzima emntwaneni . Ngamanye amaxesha ezi meko zinokubonwa.

Yintoni eyona nto ibangela i-UPJ Obstruction?

Sele nditshilo ukuba uninzi lweemeko zokuvaleka kwe-UPJ zizalwa nazo . Oku kuthetha ukuba xa umntwana esesibelekweni, iindawo ezithile zenkqubo yomchamo, ingakumbi i-ureter okanye izintso, azakhekanga kakuhle. Ngamanye amaxesha, oku kuvaleka kunokubangelwa kukucinezelwa komthambo wegazi odlula kwi-UPJ. Ezi zihlala ziziganeko ezingacwangciswanga. Nangona kunjalo, ukuba kukho umntu kusapho lwakho oye waba nale meko, nawe unokuba sengozini encinci yokuba nayo.

Kunqabile kakhulu ukuba abantu abadala babe ne-"UPJ Obstruction". Nangona kunjalo, inokwenzeka kubantu abadala ngenxa yezi zizathu zilandelayo:

• Ngenxa yamatye ezintso .
• Ngenxa yosulelo olukwindlela ephezulu yomchamo (`Upper UTIs`) .
• Emva kotyando kuloo ndawo.
• Ngenxa yokudumba (`(Ukudumba)`) kwinxalenye ephezulu yenkqubo yomchamo .

Ngubani ochaphazeleka kakhulu yile meko?

Ngokwedatha yangoku, amadoda anamathuba aphindwe kabini okufumana i-UPJ Obstruction kunabasetyhini. Uphando lukwafumanise ukuba le meko inamathuba aphindwe kabini okwenzeka kwizintso zasekhohlo kunezintso zasekunene.

Ziziphi iingxaki ezinokubakho ze-UPJ Obstruction?

Ukuba le meko (i-UPJ Obstruction) ayinyangwanga kakuhle, iingxaki ezahlukeneyo zinokwenzeka.

• Usulelo oluphindaphindayo lwendlela yomchamo (UTIs) . Ngamanye amaxesha, izicubu ezinamafutha ezijikeleze izintso zinokudumba (ukuxinana kwe-perinephric).
• Iintlungu ezingapheliyo zinokwenzeka kwindawo echaphazelekayo .
• Amatye ezintso ongezelelweyo (``amatye ezintso esibini``) angenzeka.

Eyona nto ibalulekileyo kukuba ukuba ayinyangwa ixesha elide, le `(UPJ Obstruction)` inokonakalisa izintso kwaye ekugqibeleni ikhokelele ekungasebenzini kwezintso . Yiyo loo nto kubalulekile ukuyixilonga nokunyanga kwangethuba.

Ungayixilonga njani imeko ye-`(UPJ Obstruction)`?

Kwiimeko ezininzi,Oogqirha banokuxilonga i-UPJ Obstruction ngexesha lokuhlolwa kwe-ultrasound ngelixa umntwana esesesibelekweni. Oku kungenxa yokuba ukuvaleka komchamo kubeka uxinzelelo kumqolo wezintso, nto leyo ebangela ukuba zidumbe ngaphezu kwesiqhelo. Oku kubizwa ngokuba yi -hydronephrosis . Oku kunokubonwa ngokucacileyo kwi-ultrasound.

Kwanasemva kokuba umntwana ezelwe, oogqirha banokuyalela iimvavanyo ezahlukeneyo ukuze babone ukuba izintso zivelisa kwaye zikhupha umchamo kakuhle kangakanani na. Ezi ziquka:

• Uvavanyo lwegazi nomchamo (`(Uvavanyo lwegazi kunye nohlalutyo lomchamo)`). Uvavanyo olufana ne` (Blood Urea Nitrogen - BUN)` kunye ne` (Creatinine Clearance)` lunokubonisa indlela izintso ezihluza ngayo igazi.
• Uvavanyo olubizwa ngokuba yi-"Intravenous Pyelogram - IVP" lubandakanya ukufaka idayi ekhethekileyo emthanjeni osengalweni yakho uze uthathe imifanekiso ye-"X-ray". Emva koko idayi inokubonwa njengoko ihamba kwizintso, kwi-"Renal Pelvis", nakwi-"Ureter" ukuze kubonwe ukuba kukho ukuvaleka na.
• I-Renal Scan. Kolu vavanyo, kufakwa isixa esincinci se-radioactive emthanjeni kwaye kusetyenziswa ikhamera ekhethekileyo ukuyijonga idlula kwizintso. Oku kunokunika umbono olungileyo wokuba izintso zisebenza kakuhle kangakanani kunye nobungakanani bokuvaleka.
• I-Ultrasound, i-CT scan, kunye ne-MRI. Olu vavanyo lwemifanekiso lunokubona ngokucacileyo ulwakhiwo lwezintso, ii-ureters, kunye nesinyi, kunye nazo naziphi na iingxaki kwizintso.

Inyangwa njani i-`(UPJ Obstruction)`?

Oku kuxhomekeke kakhulu kwimeko. Ukuba umntwana wakho une-UPJ Obstruction, ngamanye amaxesha unokuphila yedwa kwiinyanga ezili-18 zokuqala zobomi. Ngeli xesha, ugqirha womntwana wakho uya kwenza ii-ultrasound scans rhoqo kunye nezinye iimvavanyo ukuqinisekisa ukuba ukuvaleka akubangeli monakalo.

Nangona kunjalo, ukuba umntwana akakwazi ukuchama emva kweenyanga ezili-18, oko kuthetha ukuba ukuvaleka kusekhona, kuya kufuneka ukuba enze utyando olubizwa ngokuba yi-"Open Pyeloplasty" . Kule meko, ugqirha wezifo zomchamo wabantwana wenza utyando olukhulu, asuse indawo evalekileyo, aze adibanise i-"Ureter" nezintso, nto leyo eyenza ukuba kubekho umngxuma obanzi kancinci. I-"Open Pyeloplasty" idla ngokuthatha iiyure ezimbalwa, kwaye inezinga lempumelelo elimalunga nama-95%.

Kwezinye iimeko, ugqirha otyandayo angenza olu tyando esebenzisa indlela ebizwa ngokuba yi-`(Minimally invasive pyeloplasty)`, eyinkqubo yerobhothi (`(surgical robot)`) . Emva koko, kwenziwa ukusika okuncinci kwaye i-`(Laparoscope)` kunye nezinye izixhobo zotyando zisebenza ngerobhothi. Impumelelo yale ndlela ifana neye-`(Open Pyeloplasty). Nangona kunjalo, oku kufuna ubuchule obungaphezulu bobuchwephesha kwicala logqirha otyandayo. Kukwaxhomekeke kubudala kunye nobukhulu bomntwana.

Enye indlela yinkqubo ebizwa ngokuba yi-"Endopyelotomy".Kule meko, ugqirha otyandayo udlulisa isixhobo esibizwa ngokuba yi-``Endoscope`` (ityhubhu encinci enekhamera) nge-urethra (``Urethra``), ecaleni kwe-``Ureter``, aze ajonge ukuvaleka. Emva koko, ucingo ludluliselwa kumjelo kwi-``Endoscope```, lunqumle ukuvaleka ngalo, kwaye ``drain```, oko kukuthi, ityhubhu, ibekwa apho. Le ``drain``` ishiywa endaweni yayo kangangeeveki ezininzi ide iphole. Kwi-``Endopyelotomy```, akukho kusikwa kufunekayo, kwaye kulula kunezinye iindlela ezimbini zotyando. Nangona kunjalo, izinga lempumelelo liphantsi kancinci. Ngamanye amaxesha oku kunokufuneka kwenziwe ngaphezu kwesinye.

Ndiza kuziva ngcono ngokukhawuleza kangakanani emva konyango?

Kuxhomekeke kunyango olufumeneyo kwi-UPJ Obstruction yakho. Uninzi lwabantu luyaphola kwiiveki ezimbini ukuya kwezine. Nangona kunjalo, umzimba wakho wahlukile, ngoko ke ixesha lakho lokuphola linokwahluka. Ugqirha wakho uya kukunika umbono ongcono ngalo mba.

Ngaba ukuthintelwa kwe-UPJ Obstruction kunokuthintelwa?

Abaphandi bezonyango abakafumani nxibelelwano phakathi kokutya kunye nesondlo ngexesha lokukhulelwa kunye nophuhliso lwe-UPJ Obstruction kwimveku. Oku kuthetha ukuba akukho nto sinokuyenza ukuthintela i-UPJ Obstruction ukuba ingenzeki xa umntwana ezalwa.

Nangona kunjalo, kubantu abadala abangazalwanga bene-UPJ Obstruction, ukuphepha ezi zinto zilandelayo kunokunceda ukunciphisa le ngozi:

• Ukuthintela ukwakheka kwamatye ezintso .
• Ukukhusela izifo zomchamo (UTIs) .
• Ukuphepha ukwenzakala kwizintso zakho .

Iyintoni imbonakalo yemeko ethi `(UPJ Obstruction)`?

Ukuba ifunyenwe kwangethuba kwaye inyangwa ngokufanelekileyo, ikamva le-UPJ Obstruction lihle kakhulu. Uninzi lwabantwana alubi neengxaki ezihlala ixesha elide. Kwakhona, ukuba ifunyenwe ngaphambi kokuzalwa, ngamanye amaxesha inokuphela ngaphandle konyango.

Nangona kunjalo, ukuba ufunyaniswa une-UPJ Obstruction kamva ebomini, usemngciphekweni omkhulu wokwenzakala kwezintso. Kwiimeko ezinzima, ukuba azinyangwa, i-UPJ Obstruction inokukhokelela ekungasebenzini kwezintso kwanokufa. Yiyo loo nto ukuxilongwa kwangethuba kunye nonyango kubaluleke kangaka.

Ufanele uye nini kugqirha?

Ukuba wena okanye umntwana wakho ninayo nayiphi na kwezi mpawu, bonana nogqirha ngokukhawuleza:

• Ukuba kukho igazi kumchamo (`(Hematuria)`) .
• Ukuba ibamba esandleni sakho njengethumba esiswini sakho.
• Ukuba unentlungu esiswini esingaphezulu okanye emqolo (`(Intlungu emqolo)`) .
• Ukuba unomkhuhlane.
• Ukuba ukukhula komntwana kuphazamisekile (`(Ukukhula kuyadodobala / ukungaphumeleli ukukhula)`) .

Kunini apho kufuneka uye kwiYunithi yoNyango oluNgxamisekileyo (i-ETU) ?

Ukuba awukwazi ukuchama, yiya kwigumbi likaxakeka elikufutshane ngokukhawuleza.Asikuko oku okumele kubambezelwe.

Yeyiphi imibuzo omele uyibuze ugqirha?

Ungabuza ugqirha imibuzo efana nale:

• Uyifumanisa njani le meko `(Ureteropelvic Junction Obstruction)`?
• Ucinga ukuba i-UPJ Obstruction yomntwana wam iya kuba bhetele ngaphandle konyango?
• Ziziphi iindlela zonyango?
• Ukuba utyando luyimfuneko, yeyiphi indlela oyicebisayo?
• Lithini ithuba lokuba i-UPJ Obstruction iphinde ivele?

Yintoni umahluko phakathi kwe-`(Ureterovesical Junction Obstruction)` kunye ne-`(Ureterovesical Junction - UVJ) Obstruction`?

Ngamafutshane, zombini izithintelo ze-Ureteropelvic Junction (UPJ) kunye ne-Ureterovesical Junction (UVJ) zenzeka eziphelweni ze-urethra yakho (ureter). I-UVJ yindawo apho i-ureter yakho iqhagamshela khona kwisinyi sakho. Kuvela isithintelo se-UVJ apho. Kodwa isithintelo se-UPJ senzeka kwi-Renal Pelvis, apho i-ureter iqhagamshela khona nezintso zakho.

Ngoko ke, sithini isigidimi esifanele sisithathe ekhaya kuko konke oku?

Kuqhelekile ukuziva usoyika xa usiva ukuba umntwana wakho usenokuba nale ngxaki, nokuba kungexesha lokuhlolwa kwesisu ngelixa umntwana wakho esesesibelekweni okanye emva kokuzalwa. Usenokuziva ufuna ukuzigxeka, uzibuze, 'Ngaba ndenze into engalunganga? Ngaba kukho into ebendinokuyenza ukuthintela oku ukuba kungenzeki?' Kodwa eneneni, le meko ibizwa ngokuba yi-'(Ureteropelvic Junction Obstruction)' yinto eyenzeka nje ngamanye amaxesha. Kwanoogqirha abanakutsho ukuba yintoni kanye kanye ebangela loo nto.

Eyona nto ibalulekileyo kukuba abantu abaninzi banokuphila kwesi simo `(UPJ Obstruction)`. Ngoko ke, ungoyiki ukubona ugqirha uze uthethe naye. Bayayiqonda yonke imibuzo kunye noloyiko onalo engqondweni. Baza kukunceda nangayiphi na indlela abanokukunceda ngayo kwaye baphendule yonke imibuzo yakho. Ukuxilongwa kwangoko kunye nonyango olufanelekileyo zezona zinto zibalulekileyo apha.

Izintso , Indlela Yokuchama, Ukuvalwa kwe-UPJ, Unyango lwabantwana, Inkqubo Yokuchama, Utyando, Ukuvalwa kwe-Ureteropelvic Junction