Ingabe usuvele wakha amatshe amise okwe-'staghorn' ezinso zakho? Ake sifunde nge-Staghorn Calculus!

Wake wezwa ngamatshe ezinso? Lena inkinga evamile kwabanye abantu. Kodwa namuhla sizokhuluma ngohlobo olukhethekile lwetshe lezinso. Lokhu kubizwa ngokuthi i-Staghorn Calculus . Leli gama lizwakala lingavamile, akunjalo? Igama elithi "Staghorn" lisho izimpondo zenyamazane. Lawa matshe athola igama lawo ngoba ahluma futhi asakazeke ngaphakathi kwezinso njengezimpondo zezinyamazane. Ungawacabanga futhi njengemifula yamakhorali olwandle.

Kuyini i-Staghorn Calculus?

Kalula nje, i-staghorn calculus uhlobo lwetshe lezinso (i-calculus isho itshe). Kodwa leli alifani namanye amatshe amancane avamile. Lingakhula libe likhulu, lihlume, futhi lisakazeke kulo lonke ipayipi elikhulu (i-renal pelvis) kanye nesistimu encane yepayipi (ama-calyces) aqoqa umchamo ezinso . Cabanga ukuthi ukube inso ibifana nefektri eyenza umchamo, leli tshe beliyoba njengokuvimba okukhulu endleleni yalelo fektri.

Imbangela eyinhloko yala matshe ukutheleleka okuvamile komgudu womchamo (UTIs) . Amatshe akheka ngenxa yokutheleleka okunjalo avame ukwenziwa ngekhemikhali ebizwa ngokuthi i-struvite . Lokhu kuyinhlanganisela ye-magnesium, i-phosphate, ne-ammonium. Ngezinye izikhathi, itshe elincane lingakhula ngokuhamba kwesikhathi bese likhula libe yitshe le-staghorn njengaleli. Uma lokho kwenzeka, angakheka lapho i-struvite ixutshwa ne -calcium phosphate, i-calcium oxalate , noma i-calcium carbonate apatite.

Ngokuvamile, lolu hlobo lwetshe lwakha enso eyodwa kuphela. Kodwa-ke, akuvamile kakhulu, lesi simo singavela kuzo zombili izinso. Lawa matshe angabangela ukuphazamiseka okukhulu ekusebenzeni kwezinso, futhi angaholela nasekuhlulekeni kwezinso .

Ubani ongakhulisa kakhulu lawa 'matshe ezimpondo zenyamazane'?

Abanye abantu basengozini enkulu yokuthola la matshe e-staghorn. Ake sibheke ukuthi bangobani:

• Kwabesifazane: Lesi simo sivame kakhulu kwabesifazane kunakwabesilisa.
• Kulabo abathola izifo zomgudu womchamo njalo (UTIs): Njengoba kushiwo ngaphambili, lokhu kuyimbangela enkulu.
• Kulabo abanesimo esingavamile noma izinguquko ohlelweni lomchamo: Uma kukhona ubuthakathaka ekugelezeni komchamo, kulula ukwakha amatshe.
• Kulabo abalimele emgogodleni.
• Kulabo abane-neurogenic bladder: Lokhu kubhekisela kulabo abangasebenzi kahle kwe-bladder ngenxa yomonakalo we-nerve.

Amatshe e-staghorn ayithinta kanjani imizimba yethu?

La matshe e-staghorn angabangela ukuvaleka okuphelele noma okuyingxenye kwezinso. Cabanga ngakho njengento enkulu evimba ipayipi lamanzi. Amagatsha aleli tshe adlulela e -renal pelvis , ingxenye efana ne-funnel yezinso eqoqa umchamo. Ukusuka lapho, umchamo,Iya esinyini ngemibhobho emibili emincane ebizwa ngokuthi ama-ureter. Ngakho-ke uma i-renal pelvis noma i-ureter ivalekile, izinso ziqala ukuvuvukala.

Futhi, la matshe angavimba ama-calyces ezinso, lapho umchamo uqoqana khona kuqala. Uma ama-calyces evuvukala ngenxa yoketshezi olwengeziwe, kubizwa ngokuthi i-caliectasis . Uma lokhu kungelashwa kahle, izinso zingase zingasebenzi kahle.

Ziyini izimpawu zalokhu?

Uma une-staghorn stone ezinso zakho, ungase ube nezimpawu ezifana nalezi:

• Imfiva.
• Ubuhlungu obuseceleni phakathi kwezimbambo kanye nesinqe. Lokhu kungazwakala njengobuhlungu emhlane.
• Igazi emchameni (i-hematuria). Umchamo ungase ube bomvu noma ube nsundu ngokumnyama.
• Ubomvu nomchamo (pyuria). Umchamo ungase ube namafu, ube njengobisi, futhi ube nephunga elibi.
• Ukuzizwa ukhathele kakhulu.

Ngezinye izikhathi la matshe amakhulu angase abe khona kodwa angabi nazimpawu . Yilokho okuyingozi kakhulu. La matshe angatholakala ngengozi ngesikhathi sokuhlolwa okwenziwe ngesinye isizathu.

Kungani amatshe ethanda lokhu? Ziyini izimbangela?

Njengoba kushiwo ngaphambili, ukutheleleka okuvamile komgudu womchamo (ama-UTI) kuyimbangela enkulu. Ikakhulukazi, ezinye izinhlobo zamabhaktheriya abangela ukutheleleka zikhiqiza i-enzyme ebizwa ngokuthi i-urease . Isibonelo, amagciwane i-Proteus mirabilis . Le enzyme yehlisa i-acidity (pH) yomchamo wakho, okusho ukuthi uba yi-alkaline kakhulu. Ngemuva kwalokho, kwakheka amakristalu, ahlangana ndawonye bese eqala ukwakha amatshe ezinso.

Kunezinye izizathu futhi:

• Umehluko wokwakheka: Abanye abantu bathambekele kakhulu ekukhuleni kwamatshe ngenxa yomehluko othile wokuzalwa ohlelweni lwabo lomchamo.
• Ukuvaleka komgudu womchamo.
• Ukusebenzisa i-catheter yomchamo isikhathi eside.
• Uma uke waphathwa inqubo yokuchelela umchamo ngaphambilini.
• Isimo sesinye esibangelwa yi-neurogenic.
• Ukuba namatshe ezinso angelashwa isikhathi eside. Amatshe amancane angakhula abe makhulu futhi abangele lesi simo.

Odokotela bakuthola kanjani lokhu?

Uma unezimpawu, udokotela uzoqala ngokukubuza imibuzo bese ekwenza ukuhlolwa ngokomzimba. Bangase ba-ode ukuhlolwa okufana nalokhu:

• Ukuhlolwa kwe-X-ray kwezinso: Amatshe e-Staghorn ngokuvamile abizwa ngokuthi ama-radiopaque . Lokhu kusho ukuthi la matshe awabonakali kuma-X-ray ngakho-ke abonakala ngokucacile esithombeni se-X-ray.
• Ukuhlolwa kwe-CT Scan (i-Computed Tomography - i-CT scan):Lokhu kusenza sibone ubukhulu, ukuma, kanye nendawo yetshe ngokucacile. Ngokuvamile, kwenziwa i-CT scan uma kusolwa itshe le-staghorn.
• Ukuhlolwa komchamo: Hlola ukutheleleka, igazi, noma ubomvu.

Iphathwa kanjani?

Ukwelapha amatshe e-staghorn ngokuvamile kuhilela ukuhlinzwa . Itshe kumele lisuswe ngokuphelele, hhayi ngisho nezingcezu ezincane. Ngaphandle kwalokho, lezo zingcezu ezincane zingabangela ukutheleleka futhi kwakheke amatshe amasha.

Okubalulekile: Amatshe e-Staghorn ayisimo esingalimaza izinso, ngakho-ke uma udokotela encoma ukwelashwa, kungcono ukukwenza ngokushesha.

Kunezindlela eziningana zokwelapha eziyinhloko ezisetshenziswayo:

1. I-Percutaneous Nephrolithotomy (PCNL)

Lena inqubo yokuhlinzwa evame kakhulu esetshenziswa ukususa amatshe e-staghorn. I-PCNL inqubo esusa amatshe amakhulu ezinso, amatshe amakhulu kakhulu ukuba angadlula emchameni.

• Kwenziwa kanjani?: Udokotela ohlinzayo wenza ukusika okuncane emhlane wakho, eduze kwezinso zakho. Ithubhu elincane lifakwa okwesikhashana ngokusika okungene ezinso zakho. Ngemuva kwalokho, ithuluzi elikhethekile elifakwe ikhamera elibizwa ngokuthi i-nephroscope lifakwa ngethubhu ukuthola itshe bese liliphula libe yizicucu noma lisuswe ngokuphelele.
• I-Anesthesia: Lokhu kuhlinzwa kwenziwa ngaphansi kwe-anesthesia ejwayelekile .
• Ukuhlala esibhedlela: Ngokuvamile uzohlala esibhedlela usuku olulodwa noma ezimbili. Ngezinye izikhathi, ipayipi elincane lokukhipha amanzi lingashiywa endaweni yalo izinsuku ezimbalwa kuze kube yilapho izinso ziphola. Kodwa-ke, ngokuvamile, kufakwa i- ureteral stent , ipayipi elincane elihlala emzimbeni, esikhundleni salokho.

2. Iyini i-stent ye-ureteral?

Kungenzeka ukuthi uke wezwa "ngokuhlinzwa okungenamapayipi," okusho ukuthi ipayipi lokukhipha amanzi lishiywa ngemuva ngemva kwenqubo ye-PCNL. Kodwa-ke, i-stent isengafakwa ngaphakathi.

I-ureteral stent iyipayipi elincane lepulasitiki elifakwa okwesikhashana ngaphakathi kwe-ureter , ipayipi elithwala umchamo lisuka ezinso liye esinyeni. Lifakwa:

• Uma izinso zakho zivaliwe, kungakhathaliseki ukuthi ngenxa yetshe noma okunye ukuvimbeka, siza ukuzisusa.
• Ngemva kokuhlinzwa, i-ureter kufanele igcinwe ivulekile ukuze kusize umchamo ukuthi ugeleze kahle.

Le stent ivame ukususwa emavikini ambalwa.

3. Ukwelashwa kwe-Ureteroscopy

I-ureteroscopy inqubo lapho udokotela ohlinzayo engena khona kuma-ureter , amapayipi axhumanisa izinso nesinye. Lokhu kusebenzisa nezinsimbi ezincane kakhulu. Lokhu kubizwa ngokuthi i-ureterorenoscopy.Ungase futhi uzwe i-URS noma i-U-scope .

Uhlobo olukhethekile lwalokhu yi- flexible ureteroscopy , eyaziwa nangokuthi ukuhlinzwa kwe-retrograde intrarenal (RIRS) . Lokhu kuhilela ukufaka amathuluzi nge-urethra ngaphandle kokusikwa bese kungena ezinso ukuze kwelashwe amatshe. Le nqubo ivame ukusetshenziselwa amatshe amancane noma izingcezu ezincane ezisele ngemuva kwe-PCNL. I-PCNL iyisisekelo samatshe e-staghorn.

4. Ezinye Izindlela ze-Lithotripsy

Kunezinye izindlela zokuchoboza amatshe. Isibonelo, izindlela ze-laser ezifana ne -Holmium laser lithotripsy noma i-Thulium fiber laser lithotripsy zingasetshenziswa ukuphula amatshe. Lezi zingasetshenziswa kanye ne-PCNL noma i-Ureteroscopy.

5. Ukwelashwa okuhlanganisiwe

Ngezinye izikhathi, indlela eyodwa yokwelapha ingase ingakwazi ukususa itshe ngokuphelele. Kuleso simo, kungase kudingeke ukuthi kusetshenziswe izindlela eziningana zokwelapha ndawonye.

Yazi: Zonke izindlela zokwelapha zinezingozi ezithile. Izingcezu ezincane zamatshe zingase zisale. Kungase kube nokopha okuthile. Ngemva kokuhlinzwa, udokotela wakho uzokunikeza ama-antibiotic kanye nemithi yokubulala izinhlungu. Kukhona futhi nengozi yokutheleleka ngoba umchamo awuhlanzekile.

Ngingayinciphisa kanjani ingozi yokuthi la matshe aphinde avele ngemva kokwelashwa?

Ngemva kokususwa kwetshe, ungazama ukulivimbela ukuthi lingaphinde lakheke. Izinto ezilandelayo zingasiza:

• Ukulandela izincomo zokudla ezithile ezivela kudokotela wakho: Udokotela wakho uzokutshela ukuthi yini okufanele uyidle nokuthi yini ongayidli kuye ngohlobo lwetshe. Isibonelo, angakutshela ukuthi uphuze amanzi amaningi.
• Ukuthatha imithi yokuvimbela i-urease njenge- acetohydroxamic acid : Lokhu akuvamile ukunikezwa, ikakhulukazi kubantu abakha amatshe e-struvite, ukuvimba i-enzyme ye-urease.
• Ukuthatha ama-antibiotic ukuvimbela ukutheleleka: Uma uvame ukutheleleka ngomchamo, udokotela wakho angase akuncome ukuthi uqhubeke nokuthatha ama-antibiotic ngomthamo ophansi.

Kwenzekani uma une-staghorn stone? Kuthiwani uma ingelashwa?

Uma une-staghorn stone futhi welashwa kahle , uzokwazi ukuchama ngendlela evamile futhi ubuhlungu buzophela. Ungase uthole itshe futhi noma ungalitholi. Liyahlukahluka kuye ngomuntu nomuntu.

Kodwa-ke, uma itshe le-staghorn lingelashwa , lingaholela ezimweni eziyingozi ezifana nalezi:

• I-Xanthogranulomatous pyelonephritis: Lokhu ukutheleleka okukhulu kwezinso. Kungabangela i-sepsis.Ukutheleleka okusongela ukuphila kungasakazeka emzimbeni wonke.
• I-Caliectasis: Ukuvuvukala kwama-calyces ezinso ngenxa yokugcinwa koketshezi.
• Ukwehluleka kwezinso: Izinso zilahlekelwa ikhono lazo lokuhlunga imfucuza. Lokhu kungaba yingozi.
• I-Urosepsis: Ukutheleleka okukhulu kohlelo lomchamo. Lokhu kungabulala futhi.

Kodwa-ke, uma abanye abantu besesimweni lapho ukuhlinzwa kungenzeki khona (ngenxa yokuguga noma ezinye izifo), bangaphila ngokwelashwa okungadingi ukuhlinzwa (ukuphathwa kokulondoloza) ngaphansi kokuqondisa njalo kukadokotela.

Kuthatha isikhathi esingakanani ukuphulukiswa?

Isikhathi sokululama siyahlukahluka kuye ngokwelashwa. Uma uhlinzwa kakhulu, kuzothatha isikhathi eside ukululama. Kodwa-ke, ngezinqubo ezingangenisi kakhulu njenge-PCNL, ungase ukwazi ukuya ekhaya ngalolo suku. Udokotela wakho uzokutshela ukuthi ungabuyela nini emsebenzini, esikoleni, kanye nemisebenzi yokuthwala isisindo.

Kufanele ubonane nini nodokotela?

Ngemva kokwelapha itshe le-staghorn, bona udokotela noma uye esibhedlela ngokushesha uma unezinye zalezi zimpawu:

• Uma umkhuhlane ungaphezu kwama-degree Fahrenheit ayi-100 (cishe ama-degree Celsius angu-37.8).
• Uma uzizwa ubanda futhi uqhaqhazela (ukubanda/ukuthuthumela).
• Uma ukopha kungayeki noma kukhuphuka.
• Uma ubuhlungu bungehli noma bungenyuki.
• Uma ungakwazi ukuchama.

Okokugcina, izinto okufanele uzikhumbule

Amatshe e-staghorn, njengamanye amatshe ezinso, angaba yinto ecasulayo futhi ebuhlungu kancane. Kodwa ungakhathazeki. Udokotela wakho angakuhlola futhi akunike ikhambi elingcono kakhulu. Ezimweni eziningi, leso sixazululo singaba ukuhlinzwa. Kubalulekile ukwelapha amatshe e-staghorn uma kungenzeka ukuze kuvinjelwe ukwehluleka kwezinso.

Landela ukudla kukadokotela wakho, ukuzivocavoca, kanye neminye imiyalelo njengoba injalo. Khona-ke ungalulama ngokushesha futhi uhlale uphilile. Uyaqonda? Uma unemibuzo, ungesabi ukubuza udokotela wakho.

Amatshe ezinso , i-staghorn calculi, izifo zomgudu womchamo, i-PCNL, ukuhlinzwa kwezinso, isifo sezinso, uhlelo lomchamo