Nephrostomy: icho chiri, opaleshoni, chisamaliro, kupewa ndi zotsatira

Impso ayenera kupereka imodzi mwa ntchito zofunika kwambiri - kusankha mankhwala kuwombola ku thupi. Ngati sanachite, munthuyo akhoza kufa kwa kuledzera metabolites mwini.

Nthawi zina, ntchito aimpso amavutika chifukwa limati zosiyanasiyana pathological. Pakati pawo - mapangidwe khansa, urolithiasis. Mu nkhani iyi, magazi kusefera ndi mayamwidwe zinthu mchere chikuchitika, koma chomaliza mankhwala si linanena bungwe. Ndipo kukhazikitsa ndondomeko, anakhazikitsa nephrostomy.

Kodi izo ndi pamene chofunika? Nephrostomy ndi chitoliro (kuda) olumikizidwa kwa mafupa a chiuno impso ndi anadziŵa kunja. M'pofunika kuonetsetsa otaya mkodzo ndi kuteteza kuledzera.

Nephrostomy - ndichiyani? ntchito

Monga amadziwika, mu nkhani ya khansa, opaleshoni amakani ndi kusunga limba ntchito sikuti ntchito. Nthawi zina minofu zinkakhala pa malo lalikulu ziyenera kuchotsedwa kwathunthu kuti kupewa kufalikira kwa matenda a khansa. Nthawi zina, m'malo mwake, ntchito kwakukulu sizingatheke chifukwa matenda a kutchulidwa kwa thupi. Chifukwa chaichi, izo kupangidwa opaleshoni palliative. Iwo sikumachititsa kuti amuchiritse, koma amathandiza kuti kubwezeretsa ntchito thupi. ntchito Palliative akutsatiridwa m'minda yonse ya Oncology, imadalira ndi chisamaliro Urological.

Kuti akhazikitse ntchito excretory thupi ndi kupulumutsa munthu ku amkati kuledzera, kuchititsa nephrostomy. Iwo imatsogoleredwa ndi ngalande chubu mu dongosolo pyelocaliceal impso. The ufulu mapeto a nephrostomy akatulutsidwa kunja, ndiye pamwamba pa khungu. Kuti izi zalumikizana chidebe wapadera ndi outflow Zotulukapo za kagayidwe anachita anyalanyaza ndi chikhodzodzo, mkodzo ndi ducts.

Opaleshoni imeneyi imagwira ntchito kwa mtundu wa chisamaliro palliative, kotero dokotala ayenera bwino kuona ngati wodwala makamaka ayenera nephrostomy. Ndichiyani ndi posamalira, iye ifotokoza kwa wodwala asanachite opareshoni. Ndipo unsembe wa impso ngalande imagwiridwa okha ndi chilolezo olembedwa wodwala kapena achibale ake. M'pofunika kuti aone mkhalidwe wonse wa mtima ndi kuona ngati kuchita opareshoni monga zotheka.

Zikuonetsa yobereka nephrostomy

Mofanana ndi opangidwa ndi bere, nephrostomy mu impso amagwira ntchito yofunika kwambiri. Nthawi zambiri, izo amayikidwa mu khansa ya dongosolo genitourinary. Osachepera - mu pathologies ina yaikulu Urological. Pali zizindikiro zenizeni malinga ndi zomwe anakhazikitsa nephrostomy. opaleshoni imagwiridwa, ngati nephrostomy ali ndi zizindikiro zotsatirazi:

1. Khansa ya impso kapena ziwalo zina za dongosolo mkodzo.
2. Hydronephrosis.
3. Urolithiasis ndi predominance a miyala ikuluikulu.
4. Metastasis chotupa cha kutanthauzira kulikonse, kufinya ziwalo m'chiuno.
5. Ureteral kutsekeka chifukwa psinjika a kunja kwake kapena strictures.

Nephrostomy zimathandiza kuti abwezeretse outflow wa madzimadzi m'thupi, komanso kuteteza zosayembekezereka kutupa. Motero, kupewa impso kulephera aakulu ndi pachimake.

Opaleshoni imeneyi sikuti amatanthauza kuti ngalande yokumba adzakhala thupi kalekale. Nthawi zina, pambuyo chithandizo chapadera (opaleshoni, mankhwala amphamvu) nephrostomy atachotsedwa. Nthawi zina m'pofunika kuti abwezeretse otaya mkodzo pa nthawi ya kuchita njira yodziwira (stenting).

Contraindications nephrostomy

Ngakhale kukufunikira opaleshoni nephrostomy izo Sizotheka kuchita. Contraindications monga limati ngati:

• magazi matenda;
• kusalankhula oopsa;
• anticoagulation.

Matenda amene magazi coagulation anawawidwa limakhudza amapatsira mwana wake, hemorrhagic vasculitis, thrombocytopenic purpura ndi zina zotero. D. Mu pathologies izi iliyonse phukusi ntchito yoopsa moyo. N'chimodzimodzinso ndi kulandira anticoagulants wa - mankhwala, thinners magazi. Nephrostomy sipakhala ndi kuthamanga kwa magazi omwe si amenable kukonza mankhwala. opaleshoni khalidwe mu chikhalidwe ichi ndi contraindicated chifukwa cha kufala kwa matenda opha ziwalo cardiogenic mantha.

Kukonzekera atakhala nephrostomy

Nthawi ya kuyan'anila za outflow ya mkodzo, amene sakhoza inathetsedwa ndi thandizo la mankhwala, muyenera nephrostomy mu impso ndi. opaleshoni kukhazikitsa, monga ulamuliro, satenga nthawi, amafuna kukhala kuchipatala.

Akuyendera kuti ndondomeko opaleshoni, m'pofunika kuchita mayesero matenda. Pakati pawo - mayesero ambiri ndi amuzolengedwa magazi, urinalysis, coagulation. Ngati chifukwa cha anuria (kuyan'anila za outflow ya mkodzo) si bwino, mayeso malangizo zifunika. Zikuphatikizapo excretory urography, ultrasonography a impso, CT.

Njira ya nephrostomy

Odwala, inde, akufuna kudziwa zimene zikufunika nephrostomy icho chiri ndi mmene anapereka. Tikumbukenso kuti linanena bungwe la kuda chubu kwa impso ndi pamwamba khungu kwa madokotala anakumana ankaona ntchito yosavuta. Iye anachita zonse pogonekedwa ndi mankhwala ambiri ndi thandizo la mankhwala oletsa ululu pamalopo. Nephrostomy anachita mwamsanga, mkati mphindi 15-20. Komabe, pambuyo opaleshoni wodwala ayenera kuyang'aniridwa. M'pofunika kuti aone ayambe mkodzo outflow. Pali mitundu 3 nephrostomy. Pakati pawo:

1. Akuphedwa opaleshoni lotseguka.
2. Laparoscopic ngalande unsembe.
3. Percutaneous nephrostomy.

Nthawi zambiri anachita njira lomaliza. Khazikitsa nephrostomy puncture kudzera pakhungu ndipo zakuya minofu ndi bwino analekerera ndi odwala. Komanso, opaleshoni percutaneous ndi chochepa zoopsa kuposa opaleshoni lotseguka. Iye anachita pansi ultrasound kapena X-ray.

Njira ya opaleshoni zikuphatikizapo puncture wa khungu, mafuta, minofu ndi impso parenchyma ntchito puncture singano. Pa kuphedwa kwa nephrostomy dokotala Woyang'ana polojekiti. Izi ndi zofunika kwambiri, monga muyenera kupita mu dongosolo pyelocaliceal popanda kuwononga minofu ozungulira. Pambuyo mayikidwe a singano anapereka ngalande chubu, mbali ufulu chimene Ufumuyo thumba mkodzo deta.

Mukamafinya kupanga nephrostomy?

Ngati opaleshoni ikuchitika kukhazikitsa chithandizo achire (Morning, aimpso mtima stenting), pambuyo kuchepetsa kuchotsedwa nephrostomy thupi mkodzo outflow.

Nthawi zina kuda chubu anapereka kwa nthawi yosatha. Nthawi zambiri khansa ndi woopsa. Pa nthawi yomweyo lifunika m'malo nthawi nephrostomy. Izo ziyenera kuchitidwa mu chipinda cha opareshoni. Mosiyana ndi opaleshoni koyamba, minofu puncture si chofunika, kuyambira anapanga fistula kutsegula.

Kuchira pambuyo opaleshoni

Kuchira pambuyo nephrostomy mofulumira. Kale pa tsiku loyamba wodwala muziyendayenda kuchipatala ndi chubu ngalande. Tengani mankhwala pambuyo opaleshoni ayenera kukhala masiku 5-7 chifukwa kupewa matenda. Patangotha masiku 2-3 magazi kuti alowe mu thumba. Ichi ndi chifukwa ziwiya zoopsa aimpso. Patapita masiku 3, magazi mabasi. Kulamulira otaya mkodzo opangidwa ultrasound.

Nephrostomy: chisamaliro yekha kunyumba

Popeza ngalande thupi zakunja kwa thupi, pa nthawi iliyonse n'zotheka matenda. Izi akuchenjeza za wodwala aliyense, amene anapereka nephrostomy. Catheter kusamala ikuchitika mosalekeza. Mwa njira zopewera matenda monga:

1. Kusamba ndi ngalande chubu ndi saline ndi antiseptics. Chifukwa chaichi yokonzekera "Chlorhexidine" kapena "Furatsilinom".
2. Yadzaoneni bandeji wosabala pa dera bala opaleshoni.
3. Panthawi yake Ndikudzikhuthula kwa urinal lapansi.
4. Kuunikira ndi dokotala pa masabata 2.

Odwala amene nephrostomy, mukhoza asachite, zolemera. The Kukweza mawu a chubu ngalande angachotsedwe mavuto, kotero catheter ayenera kukhala malo amodzi.

Madokotala za nephrostomy

Malinga urologists, nephrostomy - ndi muyeso zofunika, popanda imene sitingathe kuchita. Ngakhale pali mavuto akuwuka kuchokera ku opareshoni, ndipo kufunika kwa chithandizo zonse ngalande, unsembe odwala catheter muyenera kuti awapulumutse ku kuledzera oopsa komanso matenda.