Isifo Sikashukela Sikashukela

I-nephropathy yesifo sikashukela ivela emiphumeleni emibi yesifo sikashukela ekusebenzeni kwezinso. Le ncazelo ichaza ukuhlukaniswa okujwayelekile kokwehluleka kwezinso futhi kungenye yezinkinga ezingezinhle kakhulu zesifo sikashukela, esinquma ukuqhubekisela phambili kwesinye isiguli.

Uhlobo lokuvela

Akunamaqiniso ngqo mayelana nezimbangela ze-nephropathy yesifo sikashukela kulesi sigaba ekuthuthukiseni umuthi. Ngaphandle kokuthi izinkinga zezinso azihlobene ngqo namazinga kashukela egazini, iningi leziguli ezinesifo sikashukela ezisisohlwini lokulinda ukuhanjiswa kwezinso. Kwezinye izimo, isifo sikashukela asizikhulisi lezo zimo, ngakho-ke kunemibono eminingana yokuvela kwe-nephropathy yesifo sikashukela.

Imibono yesayensi yokwakhiwa kwalesi sifo:

• Umbono wozalo. Abantu abanokuphambuka okuthile kofuzo ngaphansi kwethonya lokuphazamiseka kwe-hemodynamic kanye ne-metabolic sici soshukela mellitus bahlakulela i-pathologies yezinso.
• Umbono we-Metabolic. Ukwehla okungapheli noma isikhathi eside ushukela wegazi ojwayelekile (hyperglycemia) kuvusa ukuphazamiseka kwamakhemikhali kuma-capillaries. Lokhu kuholela ezinqubweni ezingenakuguqulwa emzimbeni, ikakhulukazi, kulimaze izicubu zezinso.
• Umbono weHemodynamic. Ku-mellitus yesifo sikashukela, ukuphuma kwegazi ezinso kuphazamisekile, okuholela ekwakhekeni kwe-intertacavial hypertension. Esigabeni sokuqala, i-hyperfiltration iyakhiwa (ukwakheka komchamo), kepha lesi simo sishintshwa ngokushesha ngenxa yokungasebenzi ngenxa yokuthi izindima zivinjelwa izicubu ezithintekayo.

Ukuthuthukiswa kwe-pathology kwenziwa kakhulu yi-hyperglycemia yesikhathi eside, umuthi ongalawulwa, ukubhema neminye imikhuba emibi, kanye namaphutha wokudla okunempilo, izinqubo zokukhuluphisa nokuvuvukala kwizitho eziseduze (ngokwesibonelo, ukutheleleka kohlelo lwe-genitourinary system).

Kuyaziwa futhi ukuthi abantu besilisa kungenzeka ukuthi bakhe lolu hlobo lwe-pathology kunabesifazane. Lokhu kungachazwa ngesakhiwo se-anatomical sohlelo lwezitho zofuzo, kanye nokwenza okungahambi kahle kwesincomo kudokotela ekunikezelweni kwalesi sifo.

Isigaba Sikashukela Nephropathy

Lesi sifo sibonisa ngokuhamba kancane kancane. Ezimweni ezingavamile, i-pathology yathuthuka izinyanga ezimbalwa emva kokuxilongwa kwesifo sikashukela futhi ngokuvamile izinkinga ezengeziwe zesifo zifaka isandla kulokhu. Imvamisa, lokhu kuthatha iminyaka, lapho izimpawu zanda khona kancane, ngokuvamile iziguli azikwazi nakancane ukubona ukungakhululeki okuvelile. Ukwazi ngqo ukuthi lesi sifo sikhula kanjani, kufanele nakanjani uhlolwe igazi ngezikhathi ezithile kanye nomchamo.

Kunezigaba eziningana zokukhula kwalesi sifo:

• Isigaba se-asymptomatic, lapho izinkomba zaso zesifo zingekho ngokuphelele. Ukuphela kwencazelo ukwanda kokuhlunga kwe-renal. Kulesi sigaba, izinga le-microalbuminuria alidluli ku-30 ​​mg / ngosuku.
• Isigaba sokuqala se-pathology. Ngalesi sikhathi, i-microalbuminuria ihlala ikuleveli eyedlule (ingabi ngaphezu kwama-30 mg / usuku), kepha kuvela izinguquko ezingenakuguqulwa esimweni sezitho zomzimba. Ikakhulu, izindonga zama-capillaries ziyaqina, nemicu yokuxhuma yezinso, ebhekele ukunikezwa kwegazi esitho, iyakhula.
• Isigaba i-microalbuminuria noma i-prenephrotic iba phakathi kweminyaka emihlanu. Ngalesi sikhathi, isiguli asikhathazeki nganoma yiziphi izimpawu, ngaphandle kokuthi ukwanda okuncane kwengcindezi yegazi ngemuva kokuzivocavoca. Ukuphela kwendlela yokuthola lesi sifo kuzoba ukuhlolwa komchamo, okungakhombisa ukwanda kwe-albhamuinuria kusuka ku-20 kuye ku-200 mg / ml engxenyeni yomchamo wasekuseni.
• Isigaba se-nephrotic sibuye sikhula kancane. I-Proteinuria (amaprotheni omchamo) ibhekwa njalo, izicucu zegazi zivela ngezikhathi ezithile. Umfutho wegazi ophakeme futhi uba njalo, ngokuvuvukala kanye ne-anemia. Ukubalwa komchamo ngalesi sikhathi kuqopha ukwanda kwe-ESR, cholesterol, alpha-2 ne-beta-globulins, beta lipoproteins. Izikhathi ezithile, amazinga we-urea ne-creatinine esiguli ayakhuphuka.
• Isigaba esibulalayo sibonakaliswa ukuthuthukiswa kokungasebenzi kahle kwe-renal. Umsebenzi wokuhlunga nokuhlushwa kwezinso uncishiswe kakhulu, obangela ushintsho lwe-pathological esitho. Emchamweni, kuyatholakala amaprotheni, igazi kanye namasilinda, okukhombisa ngokusobala ukungasebenzi kohlelo lwe-excretory.

Imvamisa, ukwanda kwesifo kuya esigabeni esibulalayo kuthatha iminyaka emihlanu kuya kwengamashumi amabili. Uma kuthathwa izinyathelo ezifika ngesikhathi ukuze kugcinwe izinso, kungagwenywa izimo ezibucayi. Ukuxilongwa nokwelashwa kwalesi sifo kunzima kakhulu ukuqala kwe-asymptomatic, ngoba ngezigaba zokuqala ze-nephropathy yesifo sikashukela kunqunywa ngengozi kakhulu. Kungakho, ngokuxilongwa kwesifo sikashukela, kuyadingeka ukubheka ukubalwa komchamo futhi njalo kuthathwe izivivinyo ezidingekayo.

Izici Zobungozi ze-Diabetesic Nephropathy

Naphezu kweqiniso lokuthi izimbangela eziyinhloko zokubonakaliswa kwalesi sifo kufanele zifunwe emsebenzini wezinhlelo zangaphakathi, ezinye izinto zingandisa ubungozi bokuthola i-pathology enjalo. Lapho belawula iziguli ezinesifo sikashukela, odokotela abaningi ngaphandle kokungcebeleka batusa ukuthi baqaphele isimo sohlelo lwezitho zofuzo futhi baqhube izivivinyo ngochwepheshe abancane (nephrologist, urologist, nabanye).

Izici ezifaka isandla ekuthuthukiseni lesi sifo:

• Ushukela wegazi ojwayelekile futhi ongalawulwa;
• I-anemia engaholi ngisho nezinkinga ezengeziwe (izinga le-hemoglobin elingaphansi kwe-130 kwiziguli zabantu abadala);
• Umfutho wegazi ophakeme, ukubanjwa ngamandla kwegazi;
• Ukwanda kwe-cholesterol ne-triglycerides egazini;
• Ukubhema kanye nokusebenzisa kabi utshwala (izidakamizwa ze-narcotic).

Indlela yokuphila enempilo nokudla, kanye nokwelashwa okuxhasayo ukwenza amazinga kashukela abe nawo ngokwejwayelekile, kuzosiza ukunciphisa umthelela omubi.

Izimpawu zesifo

Ukuchazwa kokugula ekuqaleni kwesikhathi kuzosiza ukuqhuba ukwelashwa ngokuphepha, kepha inkinga ukuqala kwesifo. Ngaphezu kwalokho, ezinye izinkomba zingakhombisa ezinye izinkinga zempilo. Ikakhulu, izimpawu ze-nephropathy zesifo sikashukela zifana kakhulu nezifo ezifana ne-pyelonephritis engapheli, i-glomerulonephritis, noma isifo sofuba sezinso. Zonke lezi zifo zingahlukaniswa ngokuthi ama-renal pathologies, ngakho-ke, ukuthola ukuxilongwa okunembile, ukuhlolwa okuphelele kuyadingeka.

Izimpawu zesifo:

• Ukwanda okungapheli kwengcindezi yegazi - umfutho wegazi ophakeme;
• Ukungajabuli nobuhlungu emhlane ophansi;
• I-anemia yama-degree ahlukahlukene, kwesinye isikhathi ngendlela ye-latent;
• Ukuphazamiseka kokugaya ukudla, isicanucanu nokuphelelwa yisifiso sokudla;
• Ukukhathala, ukozela nobuthakathaka obujwayelekile;
• Ukuvuvukala kwemilenze nobuso, ikakhulukazi ngasekupheleni kosuku;
• Iziguli eziningi zikhononda ngesikhumba esomile, ukulunywa nokugqekeza ebusweni nasemzimbeni.

Kwezinye izimo, izimpawu zingase zifane nalezi zesifo sikashukela, ngakho-ke iziguli azibanaki. Kumele kuqashelwe ukuthi bonke abantu abanesifo sikashukela kumele babe nokuhlolwa ngezikhathi ezithile okukhombisa ukuba khona kwamaprotheni negazi emchameni wabo. Lezi zinkomba futhi ziyizimpawu ezibonakalayo zokuthuthuka kokuwohloka kwezinso, okuzosiza ekuboneni lesi sifo ngokushesha ngangokunokwenzeka.

Ukuxilongwa kwe-nephropathy yesifo sikashukela

Ukuthola lesi sifo kusenesikhathi kuzosiza ukuthintana nodokotela onguchwepheshe onguchwepheshe - nephrologist. Ngaphezu kwezifundo zaselebhu ezisiza ukunquma imingcele yomchamo negazi ezigulini, izifundo ezikhethekile zezinsizakusebenza nezinsizakalo zemisipha yesitho esithintekile zisetshenziswa kabanzi. Ukuqinisekisa ukuthi une-diagnostic enembile, kungadingeka ukuthi wenze izinqubo eziningana, ukuhluka nokufanele kwazo okunqunywe ngudokotela.

Okuzosiza ukukhomba lesi sifo:

• Ukuhlolwa kwe-Ultrasound kwezinso. Uhlobo lokuhlolwa olungenabuhlungu futhi olufundisayo. I-Ultrasound ikhombisa ama-pathologies angaba khona okuthuthuka kwesitho, ushintsho ngosayizi, ukwakheka kanye nesimo sezinsi.
• I-Dopplerography yemikhumbi yezinso. Kwenziwa ukunquma i-patency kanye nokuhlonza ama-pathologies okungenzeka nezinqubo zokuvuvukala.
• I-biopsy yezicubu zezinso. Kwenziwa ngaphansi kwe-anesthesia yendawo, imininingwane ihlolwa ngaphansi kwesibonakhulu ukubona ukutholakala kwama-pathologies.

Izinga lokuhlunga le-glomerular linqunywa nakanjani (ekuqaleni kwesifo, liyanda, bese liyeka ngokuphelele), kanye nenkomba ye-albhamuinuria. Ukubalwa kwenani elijwayelekile kwenziwa ngokwemibandela ekhethekile (ngokwesibonelo, kubantu abadala i-CKD-EPI, i-MDRD, i-Cockcroft-Gault, ezinganeni ifomula yeSchwartz). Amakhemisi amaningi anezivivinyo zasekhaya zokuthola ukubalwa okujwayelekile komchamo. Ngaphandle kokuthi ukusebenza kwabo akukuphakeme kakhulu, ngisho nokuhlaziywa okunjalo kuzosiza ekuboneni izinkinga ezingase zivele, emva kwalokho ungahamba nokuhlolwa kobuchwepheshe elabhorethri.

Ukwelashwa Kwe-Diabetesic Nephropathy

Imisebenzi esemqoka ihloselwe ukuguqula ushukela wegazi kanye nokulungiswa okujwayelekile komzimba. Izinqubo eziningi ze-metabolic ku-mellitus yesifo sikashukela zenzeka ngokuhlukile, okuholela ekulimazelweni okubukwayo, ukulimala kwemithambo nezinye izinkinga zesimo. Esikhathini sokuqala kwesifo, kunethuba langempela lokulungisa lesi simo ngokudla nokunxephezela sikashukela.

Izindlela zokuvimbela ukuthuthukiswa kwe-nephropathy yesifo sikashukela:

• Umfutho wegazi;
• Ukulawulwa kwamazinga kashukela;
• Ukudla okungenasawoti nokudla;
• Yehlisa i-cholesterol yegazi;
• Ukwenqaba imikhuba emibi;
• Ukusebenza komzimba okungenzeka;
• Ukwenqaba ukuthatha izidakamizwa ezithinta ukusebenza kwezinso;
• Ukuvakashela njalo kwi-nephrologist nokuhlolwa.

Lapho kuvela izimpawu zobuntu, izindlela zokuzivikela zodwa ngeke zanele, ngakho-ke kufanele uthintane nodokotela wakho mayelana nezidakamizwa ezifanele. Ngaphezu kwalokho, kuyadingeka ukuqapha ukubalwa komchamo kanye negazi ukuqinisekisa ukusebenza kahle kwezindlela zokwelapha.

Imithi ifaka phakathi:

• Ukuthatha ama-angiotensin aguqula ama-enzyme (ACE) inhibitors. Lokhu kufaka phakathi izidakamizwa ezifana no-Enalapril, uRamipril kanye no-Thrandolapril.
• Abaphikisi abakhethekile be-receptor be-angiotensin (ARA). Phakathi kokuthandwa kakhulu: i-Irbesartan, iValsartan, neLosartan.
• Ukugcina uhlelo lwethambo nenhliziyo, ama-ejenti asetshenziswa enza ukujwayeza ukufana kwe-lipid ekwakhekeni kwegazi.
• Ngomonakalo omkhulu wezinso, kunconywa ukuthatha izidakamizwa ezi-detoxifying, sorbyts kanye nama-anti-azotemic agents.
• Ukhuphula izinga le-hemoglobin, kusetshenziswa izidakamizwa ezikhethekile, kanye nezinye izindlela. Ukusetshenziswa kadokotela kumele kuvunyelwane nodokotela wakho.
• Ama-diuretics azosiza ekulweni ne-puffiness, kanye nokwehlisa inani lamanzi aphuzile.

Lezi zimali zenza ngokwejwayelekile i-hypertension ye-systemic ne-intracranial, kwehlise umfutho wegazi futhi kunciphise ukuqhubeka kwesifo. Uma ukwelashwa okwodwa kukodwa akwanele, impikiswano yezindlela eziningi eziyinhloko zokusekelwa kwezinso iyalungiswa.

Ukwelashwa Kwasemuva

Izimpawu ezijwayelekile zokuhluleka kwe-reculised incipient akuzona nje kuphela izinto ezonakalayo zokuhlolwa kwelebhu, kodwa futhi nesimo sesiguli. Ezigabeni zokugcina ze-nephropathy yesifo sikashukela, ukusebenza kwezinso kubuthaka kakhulu, ngakho-ke ezinye izixazululo zenkinga zidinga ukucatshangelwa.

Izindlela zika-Cardinal yilezi:

• Hemodialysis noma izinso zokwenziwa. Isiza ukususa imikhiqizo yokubola emzimbeni. Inqubo iphindwa ngemuva cishe kosuku, ukwelashwa okunjalo okusekayo kusiza isiguli ukuba siphile nalokhu kutholwa isikhathi eside.
• I-Peritoneal dialysis. Umgomo ohluke kakhulu kune-hemodialysis yehadi. Inqubo enjalo yenziwa kancane kancane (cishe njalo ezinsukwini ezintathu kuya kwezinhlanu) futhi ayidingi imishini yezokwelapha eyinkimbinkimbi.
• Ukufakwa kwezinso. Ukudluliselwa kwesitho esinikelayo kube yisiguli. Ukusebenza okusebenzayo, ngeshwa, akukakabonakali kakhulu ezweni lethu.

Ezigabeni zakamuva zesifo, iziguli zinesidingo esinciphile se-insulin. Lokhu kuwuphawu olwesabekayo lokuthuthuka kwezifo. Kungakho kubaluleke kakhulu ukugcina amazinga evamile kashukela. Kulesi sigaba, ngisho neziguli ezinganciki i-insulin zidluliselwa ekwelashweni okufanele.

Ukuqashelwa kwe-nephropathy yesifo sikashukela

Ngaphandle kokungenelela okuklanyelwe ngokukhethekile ukuvimbela kanye nokwelashwa kwe-nephropathy yesifo sikashukela, abanesifo sikashukela abaningi babhekana nemiphumela ebuhlungu yalokhu kugula. Kwezinye izimo, okuwukuphela kwendlela yokusindisa impilo yesiguli ukufaka ukuthunyelwa kwezinso kwabaxhasi. Imisebenzi enjalo inezici eziningi, isikhathi eside sokuvuselela kanye nezindleko eziphakeme. Ngaphezu kwalokho, ingozi yokuvuselelwa kabusha kwe-nephropathy iphezulu impela, ngakho-ke kungcono ukungavumeli ukuguqulwa kwesifo kube esigabeni esithuthukile.

Ukwelashwa kweziguli ezine-nephropathy yesifo sikashukela kuyinto enhle impela. Lesi sifo sikhula kancane, futhi uma ulandela izincomo zikadokotela futhi ulawula ushukela wegazi, iziguli kungenzeka zingazi ngisho nezinkinga ezinjalo.

I-Nephropathy ku-mellitus yesifo sikashukela ivela kaningi, kuyilapho kungekho muntu owazi ukunqunywa okuqondile kwezimbangela ze-pathology enjalo. Kuyaziwa ukuthi ngamazinga kashukela egazi aphakeme, ukwehluleka kwezinso kukhula kaningi, futhi izizathu ezengeziwe ezethusayo zinomthelela kulokhu. Ukuze ungafaki ukuthuthukiswa kokwehluleka okukhulu kwezinso kanye nengozi yokufa, kuyadingeka ukubheka imingcele yomchamo, kanye nokusebenzisa ukwelashwa kokulungiswa ukwenza ushukela wegazi ube ngakweli.