N'ime ọrịa nke usoro urinary, reflux vesicoureteral na-apụtaghị. Ọrịa a na-emetụta ụmụaka na ndị agadi. Ihe nchoputa bu ihe mgbagwoju anya site na enwegh ihe puru iche nke oma na nmalite nke oria.
Kedu ihe reflux vesicoureteral?
A na-akpọkarị reflux nke na-emepụta bladder-ureter ka ọ bụrụ nsogbu na-eme ka mmamịrị ahụ na-eme ugbu a. A na-emegharị ihe na-esi ísì ụtọ nke mmamịrị, na-agafe na ureter na akụrụ, nke na-emebi ọrụ nke valvụ nke mmiri nke ureter. Nke a na-eme mgbe ọ bụla eriri afo ahụ na-asọba, n'ihi nke, ka oge na-aga, enwere ike ịgbanwe na ike nke ngwa a.
N'ikpeazụ, nrụgide na-arịwanye elu na eriri afo ahụ ka ọ na-ejuputa ya kwesịrị ime ka valvụ ahụ mechie. Otú ọ dị, site na reflux, e mebiri ma ọ bụ belata ntụzi a, nke na-eme ka ọkpụkpụ mbelata dị ugbu a. Ntugharị nke mmamịrị nwere ike ime ma n'oge urination na n'oge njuputa nke eriri afo. Ogologo oge a adịghị egosipụta onwe ya ma chọpụta ya mgbe ị na-enyocha akụkụ ahụ nke obere pelvis.
Reflux vesicoureteral ọrụ
N'iji ụdị ụdị ọgwụgwọ a, mmịnye reflux na-eme nanị n'oge urination. Mkpụrụ ahụ nke eriri afo ahụ na-abịa ụda, n'ihi ya, a na-awụnye mmamịrị ahụ n'ime ureters ma tinyekwuo n'ime akụrụ. N'otu oge, a na-ekenye ya n'èzí. Ya mere, onye ahụ na-enwe nchekasị n'ọhịa nke ala, n'akụkụ. Ụdị ọgwụgwọ a bụ n'ihi na ekwesighi ka valvụ dị na mmiri ahụ dị ọcha, bụ nke a na-ekpughe n'oge nyocha zuru ezu.
Ntughari reflux vesicoureteral
Reflux passive na-ezo aka nyefe mmamịrị site na eriri afo ahụ gaa na ureters, nke na-eme n'oge a na-ejupụta ngwa ngwa urine ahụ. N'iji ụdị ọgwụgwọ a, ekwenyeghị na valve ahụ, ya mere, ịbanye n'ime urine n'ime ureters na akụrụ na-eme mgbe niile. Olu nke urine na-alaghachi azụ bụ n'ihi ogo nke ntụpọ, nkwekọrịta nke eriri afo, na ọnọdụ nke valvụ n'onwe ya.
Ntụ ụrọ / ureter reflux kpatara
Dabere na oge mmepe nke ọrịa ahụ, reflux dị na primrị na nke abụọ dịpụrụ adịpụ. A na-ekwu ụdị ọgwụgwọ bụ isi mgbe ọrịa ahụ sitere na ọrịa mberede na-etolite na ogbo nke intrauterine mmepe - congenital vesicoureteral reflux. Nrụgide dị ukwuu na eriri afo na nkwụsịtụ nke orifice na-eduga ná mmebi, na-eme ka mpi reflux, ihe kpatara ya nwere ike ịdị ka ndị a:
- okpukpu abụọ nke onye na-eme mmehie;
- dystopia nke ọnụ;
- ngbaghari anya;
- oghere obere submucosal nke eriri nke na-egbuke egbuke.
Ụdị reflux nke vesicoureteral dị iche iche na-ebili megide ọdịdị nke ọnọdụ ndị ọzọ nke usoro urinary. Otu n'ime ihe kpatara ya:
- usoro nke urethra;
- nkwụsị nke n'olu nke eriri afo;
- adenoma nke prostate;
- cystitis ;
- na-asọ oyi nke eriri afo;
- emebi orifice orure mgbe ịwa ahụ.
Chlamydial reflux mgbaàmà
A na-ezochi ihe mgbaàmà nke ọrịa ahụ. Nke o kwere omume, ma ọ bụghị ihe ịrịba ama nke ọrịa ahụ, ndị dọkịta na-enye aka nhụjuanya, nhụjuanya na-egbu mgbu na ala dị ala, nke pụtara ozugbo ahụ ka eriri afọ ahụ. Ụmụaka nwere ike ịsị na ihe mgbu dị na ụbụrụ ala.
Ihe omuma nke oria a sitere na onodu nke usoro ihe omuma. Ọtụtụ mgbe, ihe niile na-adabere na ogbo nke mmepe nke reflux vesicoureteral, ogo nke nwere ike ịbụ dị ka ndị a:
- 1 ogo - urine na-alaghachi na ureter, adịghị eru pelvis;
- 2 ogo - reflux rutere akụrụ;
- 3 ogo - ureter dilates;
- 4 ogo - geometry nke urinary tract na-akpaghasị, gbanwee pụtara;
- 5 ogo - parenchyma nke isi ihe dị mkpa, ihe niile dị n'elu dị ugbu a.
Mkpesa site n'aka ndị dọkịta na-agwọ ọrịa mgbe mgbe na-anụkarị mgbe mmepe nke pyelonephritis. N'okwu a, a na-ahụ:
- okpukpu nke igwe;
- abdominal mgbu;
- nsogbu nke ọdịmma ọha na eze;
- igwe ojii nke mmamịrị.
N'ọtụtụ ọnọdụ, a hụrụ PMR naanị na ogbo nke mmepe nsogbu na nsogbu ndị ọzọ, nke gụnyere:
- cystitis na-aga n'ihu (ngwa ngwa urinary excretion na obere akụkụ);
- ọrịa na-egbuke egbuke (ọrịa na-egbuke egbuke, àgwà ọjọọ na mpaghara lumbar, okpomọkụ adịghị elu karịa ogo 38);
- enuresis.
Bladder na ureter reflux - nyocha
Na usoro nke asymptomatic maka nchoputa nke reflux vesicourete, ultrasound nke akụrụ kwesịrị iji. Enwere ike iduzi ọmụmụ ihe ọbụna tupu nwa ahụ apụta (reflux bụ isi). Ihe ngosi maka nyocha nke urological zuru oke nwere ike ibu nbawanye nke pelvis (nke dị n'akụkụ nke ọzọ karịa 5 mm). Nnyocha zuru ezu ma ọ bụrụ na e nwere nrubeisi nke ụdị ọrịa kwesịrị ịgụnye ihe ọmụmụ ndị a:
- usoro nyocha: nchịkọta urine n'ozuzu, ule ọbara, omenala nje;
- redioototope renography;
- ike nephroscintigraphy;
- uroflowmetry;
- urography ;
- Mikrosionnaya cystourethrography;
- cystoscopy.
Chlamydial reflux - ọgwụgwọ
Iji wepu reflux vesicoureteral, a na-agwọ ọgwụgwọ maka iwepụ ihe abụọ na-emebi emebi:
- mmetụta nke hydrodynamic n'ihi nrụgide dị ukwuu na eriri afo;
- na-ebute ọrịa urinary ugboro ugboro.
Site na nkwụsịtụ nke ọ bụla, usoro ọgwụgwọ na-amalite site na ụzọ mgbanwe nke gụnyere:
- Ndozi nsogbu nke metabolic na eriri afo na ureter (Pikamilon, Elkar).
- Mgbochi na ọgwụgwọ ọrịa nke usoro genitourinary - uroseptics , ọgwụ nje, phytotherapy (Tetracycline, Metronidazole, Ciprofloxacin).
- Mwepu nke imebi urodynamics.
Ntucha-ureteral reflux - nlekọta ahụike
Ọ bụrụ na nloghachi nke mmamịrị bụ n'ihi ọdịdị nke orifice, ọ bụ ụzọ a ga-esi agwọ ya bụ ịwa ahụ. N'ime ya, mweghachi nke ọrụ valve nke ureter na-eme site na ịmịnye anụ ahụ na ịmepụta valvụ ahụ site na usoro usoro. Na MTCT nke abụọ, a na-achọta ọgwụgwọ nke ọrịa ndị kpatara ọrịa ahụ (ọrịa urinary na urinary tract, na-egbu egbu). Ihe gbasara nke puru ime ka oria a daa mgbe mkpochapu ihe kpatara ya nwere ike iru 70%.
Ọgwụgwụ endoscopic nke reflux vesicoureteral
Na enweghị mmetụta nke usoro ọgwụgwọ na-agbanwe agbanwe, ọ bụrụ na ọ gaghị ekwe omume iwepụ reflux vesicoureteral, ọrụ ahụ bụ nanị usoro ọgwụgwọ. Ọtụtụ mgbe, a na-eji usoro endoscopic mee ihe. Site na lumen nke ureters, na-enweghị ihe mgbochi na akpụkpọ ahụ, a na-etinye gel implant ịbanye n'ime ureteral mpaghara nke ureter. Ọ na-emepụta tubercle, nke na-eme dị ka valvụ, na-egbochi mbufe mmamịrị site na eriri afo ahụ n'ime onye na-edozi ahụ.