He aha ka Ureteral Obstruction? Nā Hōʻailona, Nā Kumu, a me ka Lapaʻau

Ke pilikia nei ka ureteral obstruction i ka wā e ālai ʻia ai ke kahe ʻana o ka mimi ma o kekahi a i ʻole nā ​​ureters ʻelua. ʻO kēia nā paipu ʻāpana e lawe i ka mimi mai kou mau puʻupaʻa i kou ʻeke mimi.

E noʻonoʻo i kou mau ureters e like me nā hose māla e hoʻohui ana i kou mau puʻupaʻa i kou ʻeke mimi. I ka wā e ālai ʻia ai lākou, e hoʻi hope ka mimi i loko o kou puʻupaʻa, hiki ke hoʻoulu i ka ʻeha a hiki ke hoʻopōʻino i kou puʻupaʻa inā waiho ʻole ʻia. ʻO ka ʻoiaʻiʻo maikaʻi, hiki ke mālama pono ʻia ka hapa nui o nā hihia ma hope o ka ʻike ʻana o nā kauka i ke kumu o ka ālai ʻana.

He aha nā hōʻailona o ka ureteral obstruction?

ʻO ka hōʻailona maʻamau loa ka ʻeha koke, nui ma kou kua a i ʻole ʻaoʻao e hele mai ana i nā nalu. Hoʻomaka pinepine kēia ʻeha ma kou wahi flank a hiki ke neʻe i kou groin i ka hala ʻana o ka manawa.

Eia nā hōʻailona āu e ʻike ai, mai ka maʻamau loa a hiki i nā mea liʻiliʻi:

• ʻEha ʻoi, cramping ma kou kua, ʻaoʻao, a i ʻole lalo ʻōpū
• Ke koko i loko o kou mimi, e hana ana i ka poni, ʻulaʻula, a i ʻole brown
• Nausea a me ka luaʻi
• Ka mimi pinepine a i ʻole ka manaʻo e pono ai ʻoe e mimi koke
• Ka puhi ʻana i ka wā e mimi ai
• Fever a me nā chills inā hoʻomohala ʻia ka maʻi
• Ka emi ʻana o ka mimi
• Ka pehu ʻana i kou mau wāwae a i ʻole a puni kou mau maka

ʻAʻole pinepine, ʻike kekahi poʻe i ke koko kiʻekiʻe a i ʻole ka hiki ʻole ke mimi inā ālai ʻia nā ureters ʻelua. Hoʻokumu pinepine ka ikaika o kou mau hōʻailona i ka wikiwiki o ka hoʻomohala ʻana o ka ālai ʻana a inā he hapa a piha paha.

He aha nā ʻano o ka ureteral obstruction?

Hoʻokaʻawale ʻia nā ureteral obstructions ma muli o kahi e kū ai a me ke kumu o lākou. Ke kōkua nei ka hoʻomaopopo ʻana i kēia mau ʻano i nā kauka e koho i ke ala lapaʻau maikaʻi loa no kou kūlana kikoʻī.

Ma muli o ka wahi, hiki i nā ālai ke kū ma ʻekolu mau kiko nui:

• Ka ālai ʻana o ka ureter kiʻekiʻe kokoke i kahi e hoʻohui ai i kou puʻupaʻa
• Ka ālai ʻana o ka ureter waena ma kahi ala o ka paipu ma o kou pelvis
• Ka ālai ʻana o ka ureter haʻahaʻa kokoke i kahi e komo ai i kou ʻeke mimi

Hoʻokaʻawale pū nā kauka i nā ālai ma ke ʻano he intrinsic (i hana ʻia e kekahi mea i loko o ka ureter) a i ʻole extrinsic (i hana ʻia e ka puʻe ʻana mai nā ʻano o waho). ʻO nā kumu intrinsic e komo pū ana i nā pōhaku puʻupaʻa a i ʻole nā ​​tumors i loko o ka ureter ponoʻī, ʻoiai nā kumu extrinsic e pili ana i nā ʻōnaehana a i ʻole nā ​​pūnaewele kokoke e kaomi ana i ka ureter.

He aha ke kumu o ka ureteral obstruction?

ʻO nā pōhaku puʻupaʻa ke kumu maʻamau loa o ka ureteral obstruction, e helu ana ma kahi o 80% o nā hihia. Hoʻokumu ʻia kēia mau wai wai paʻakikī i loko o kou mau puʻupaʻa a hiki ke paʻa i ka wā e ho'āʻo ai lākou e hele ma o ka ureter ʻāpana.

Eia nā kumu nui, e hoʻomaka ana me ka mea pinepine loa:

• Nā pōhaku puʻupaʻa o nā nui a me nā ʻano like ʻole
• Nā tumors i ka ureter, ʻeke mimi, a i ʻole nā ​​ʻōnaehana kokoke
• Ka ʻili ʻili mai nā hana ʻoki mua a i ʻole nā ​​maʻi
• Nā clots koko i hana ʻia ma hope o ka hōʻeha a i ʻole ka hana ʻoki
• Nā lymph nodes nui e kaomi ana i ka ureter
• Ke hapai ʻana, ʻoiai hiki i ka ʻōpū e ulu ana ke komo i nā ureters
• Nā hemahema congenital i loaʻa mai ka hānau ʻana

ʻO nā kumu maʻamau ʻole e komo pū ana i ka mumū nui mai nā kūlana e like me ka retroperitoneal fibrosis, kahi e hoʻomohala ai ka ʻili ʻili a puni kou mau ureters. I kekahi manawa, hiki i kekahi mau lāʻau a i ʻole nā ​​kaʻina hana lapaʻau ke alakaʻi i ka ālai manawa pōkole, ʻoiai ʻaʻole pinepine kēia.

I ka wā e ʻike ai i ke kauka no ka ureteral obstruction?

Pono ʻoe e ʻimi i ka mālama ola kino koke inā ʻike ʻoe i ka ʻeha nui o ke kua a i ʻole ka ʻaoʻao e hele mai ana i nā nalu, ʻoiai inā pili pū ia me ka nausea, ka luaʻi, a i ʻole ke koko i loko o kou mimi. Hōʻike pinepine kēia mau hōʻailona i ka ālai koʻikoʻi e pono ai ka mālama koke.

E kāhea koke i kāu kauka inā loaʻa iā ʻoe ka maʻi a me nā chills me nā hōʻailona mimi, ʻoiai hiki i kēia ke hōʻailona i ka maʻi weliweli. E ʻimi pū i ka mālama wikiwiki inā ʻaʻole hiki iā ʻoe ke mimi a i ʻole ʻike ʻoe i ka emi nui ʻana o kāu mimi i loko o kekahi mau hola.

ʻO nā hōʻailona palupalu e like me ka ʻeha mau o ke kua haʻahaʻa, nā loli i nā ʻano mimi, a i ʻole ka mimi mālie e pono ai ka hele ʻana i ke kauka i loko o hoʻokahi a ʻelua lā. Hiki i ka mālama mua ke pale aku i nā pilikia a mālama i kāu hana puʻupaʻa.

He aha nā pilikia no ka ureteral obstruction?

Inā waiho ʻole ʻia, hiki i ka ureteral obstruction ke alakaʻi i nā pilikia koʻikoʻi e hoʻopilikia i kāu hana puʻupaʻa a me kou olakino holoʻokoʻa. Hoʻokumu ka nui i ka lōʻihi o ka ālai ʻana a inā he hapa a piha paha.

ʻO nā pilikia maʻamau e komo pū ana:

• Ka maʻi puʻupaʻa (pyelonephritis), hiki ke lilo i mea weliweli i ke ola
• Ka hōʻino ʻana o ka puʻupaʻa mai ke kaomi lōʻihi a me ka hoʻi ʻana o ka mimi
• Nā pōhaku puʻupaʻa e ulu nui ana i ka wā i paʻa ai
• Ka maʻi puʻupaʻa maʻi inā mau ka ālai ʻana
• Ke koko kiʻekiʻe mai ka hana ʻole o ka puʻupaʻa
• Sepsis, kahi maʻi koʻikoʻi e pālahalaha ana i kou kino

I nā hihia maʻamau ʻole, hiki i ka ālai bilateral piha (ālai ʻia nā ureters ʻelua) ke hoʻoulu i ka hāʻule koke ʻana o ka puʻupaʻa, e pono ai ka dialysis pilikia. ʻO ka ʻoiaʻiʻo maikaʻi, hiki ke pale ʻia ka hapa nui o nā pilikia me ka ʻike koke ʻana a me ka mālama kūpono.

Pehea e hiki ai ke pale ʻia ka ureteral obstruction?

ʻOiai ʻaʻole hiki iā ʻoe ke pale aku i nā kumu āpau o ka ureteral obstruction, hiki iā ʻoe ke hoʻemi nui i kou pilikia ma ka nānā ʻana i ka pale ʻana i ka pōhaku puʻupaʻa. ʻO ka hapa nui o nā ālai i hana ʻia e nā pōhaku, no laila ʻo ka pale ʻana iā lākou kāu pale maikaʻi loa.

Eia nā hoʻolālā pale maikaʻi:

• E inu i ka wai nui i ka lā holoʻokoʻa e mālama i ka mimi diluted
• E kaupalena i ka sodium e hoʻemi i ka calcium i loko o kou mimi
• E ʻai i ka calcium lawa mai nā kumu meaʻai, ʻaʻole nā ​​hopena
• E hoʻemi i nā meaʻai kiʻekiʻe oxalate e like me ka spinach, nā nati, a me ka chocolate inā pili ʻoe i nā pōhaku calcium oxalate
• E mālama i ka kaumaha olakino ma o ka ʻai kaulike a me ka hoʻoikaika kino
• E hahai i ka ʻōlelo a kāu kauka no ka mālama ʻana i nā kūlana underlying e like me ka maʻi diabetes a i ʻole gout

Inā loaʻa iā ʻoe nā pōhaku puʻupaʻa ma mua, hiki i kāu kauka ke ʻōlelo i nā loli meaʻai kikoʻī a i ʻole nā ​​lāʻau lapaʻau ma muli o ke ʻano o nā pōhaku āu i hana ai. Hiki i nā hālāwai hoʻomau mau ke kōkua i ka hopu ʻana i nā pilikia hiki ke loaʻa koke.

Pehea ka hōʻoia ʻana o ka ureteral obstruction?

E hoʻomaka kāu kauka ma ka nīnau ʻana e pili ana i kou mau hōʻailona a me ka mōʻaukala ola kino, a laila e hana i kahi hoʻokolokolo kino. E kaomi paha lākou ma kou ʻōpū a me ke kua e nānā i ka palupalu a i ʻole ka pehu.

Ke kōkua nei kekahi mau hoʻokolohua e hōʻoia i ka hōʻoia a me ka ʻimi ʻana i ka ālai ʻana:

• Nā hoʻokolohua mimi e nānā i ke koko, ka maʻi, a i ʻole nā ​​kristala
• Nā hoʻokolohua koko e loiloi i ka hana puʻupaʻa a e nānā i nā hōʻailona o ka maʻi
• CT scan me ka ʻole o ka contrast, ʻo ia ka mea kūpono loa no ka ʻike ʻana i nā pōhaku
• Ultrasound e ʻike inā pehu kou puʻupaʻa mai ka mimi i hoʻi hope
• Intravenous pyelogram (IVP) e ʻike i ke kahe ʻana o ka mimi
• MRI i nā hihia kūikawā a i ʻole i ka wā ʻaʻole hōʻoia nā hoʻokolohua ʻē aʻe

ʻO ka CT scan ka hoʻokolohua maikaʻi loa ma muli o ka hiki ke hōʻike i ka wahi a me ka nui o nā pōhaku, a me ka nui o ka hoʻopilikia ʻana o kou puʻupaʻa. Hiki i kāu kauka ke kauoha i nā hoʻokolohua hou aku inā manaʻo lākou i nā kumu ʻē aʻe ma mua o nā pōhaku puʻupaʻa.

He aha ka lapaʻau no ka ureteral obstruction?

Hoʻokumu ka lapaʻau i ke kumu, ka nui, a me ka wahi o kāu ālai ʻana. ʻO nā pahuhopu nui ka hoʻokuʻu ʻana i ka ālai ʻana, ka mālama ʻana i ka hana puʻupaʻa, a me ka pale ʻana i nā pilikia.

No nā pōhaku puʻupaʻa, nā koho lapaʻau e komo pū ana:

• Ke kali akahele no nā pōhaku liʻiliʻi e hiki ke hele maoli
• Ka lāʻau ʻeha a me ka hoʻonui ʻana i ka wai e kōkua i nā pōhaku e hele
• Nā lāʻau lapaʻau e like me nā alpha-blockers e hoʻomaha i nā ʻiʻo ureter
• Shock wave lithotripsy e wāwahi i nā pōhaku me nā nalu kani
• Ureteroscopy e wehe a i ʻole e wāwahi i nā pōhaku me kahi scope lahilahi
• Percutaneous nephrolithotomy no nā pōhaku puʻupaʻa nui loa

Inā loaʻa iā ʻoe ka ālai koʻikoʻi a i ʻole ka maʻi, hiki i kāu kauka ke kau mua i kahi stent (paipu liʻiliʻi) i loko o kāu ureter e hoʻihoʻi koke i ke kahe ʻana o ka mimi. Ke hoʻomaha nei kēia hana manawa pōkole i ke kaomi ma kou puʻupaʻa i ka wā e hoʻolālā ai i ka lapaʻau hoʻoholo.

No nā kumu ʻaʻole pōhaku e like me nā tumors a i ʻole ka ʻili ʻili, hiki i ka lapaʻau ke komo pū me ka hana ʻoki, ka radiation therapy, a i ʻole nā ​​kaʻina hana kūikawā ʻē aʻe ma muli o ke kūlana underlying.

Pehea e mālama ai i nā hōʻailona ma ka home i ka wā o ka ureteral obstruction?

ʻOiai ʻoe e kali ana e ʻike i kāu kauka a i waena o nā lapaʻau, aia nā ala palekana e mālama ai i kou ʻoluʻolu ʻole. Eia naʻe, e hoʻomanaʻo ʻaʻole e pani ka mālama home i ka mālama ola kino ʻoihana.

Eia nā mea āu e hiki ke hana ai e ʻoluʻolu hou aku:

• E hoʻopili i ka wela i kou kua a i ʻole ʻaoʻao me ka hoʻohana ʻana i kahi pā wela ma ka hoʻonohonoho haʻahaʻa
• E lawe i nā mea hoʻoemi ʻeha ma luna o ka counter e like me ka ibuprofen a i ʻole acetaminophen e like me ke kuhikuhi ʻia
• E inu i ka wai nui e kōkua i ka holoi ʻana i kāu ʻōnaehana
• E ho'āʻo i ka neʻe mālie e like me ka hele ʻana, hiki ke kōkua i nā pōhaku e neʻe
• E hoʻomaha i nā kūlana e ʻoluʻolu loa
• E pale i nā meaʻai kiʻekiʻe i nā oxalates inā pili ʻoe i nā pōhaku calcium oxalate

Mai hoʻowahāwahā i nā hōʻailona e hoʻopilikia ana a i ʻole ka hoʻokaʻulua ʻana i ka ʻimi ʻana i ka mālama ola kino. Inā lilo kou ʻeha i mea hiki ʻole ke hoʻomanawanui, e loaʻa iā ʻoe ka maʻi, a i ʻole ʻaʻole hiki iā ʻoe ke mimi, he mau hōʻailona kēia e pono ai ʻoe i ka mālama ola kino koke.

Pehea ʻoe e hoʻomākaukau ai no kāu hālāwai kauka?

Ke hoʻomākaukau maikaʻi ʻia no kāu hālāwai e kōkua i kāu kauka e hana i kahi hōʻoia pololei a hoʻomohala i ka papahana lapaʻau maikaʻi loa no ʻoe. Hiki i ka hoʻomākaukau maikaʻi ke kōkua iā ʻoe e ʻike i ka hilinaʻi a me ka hopohopo ʻole.

Ma mua o kāu kipa, e hōʻiliʻili i kēia ʻike koʻikoʻi:

• E kākau i kou mau hōʻailona āpau, me ka wā i hoʻomaka ai lākou a me ka nui o ko lākou koʻikoʻi
• E papa inoa i nā lāʻau lapaʻau, nā hopena, a me nā huaora āu e lawe nei
• E hoʻomaopopo i ka mōʻaukala ʻohana o nā pōhaku puʻupaʻa a i ʻole nā ​​pilikia mimi
• E lawe mai i nā hopena hoʻokolohua mua a i ʻole nā ​​hoʻokolohua kiʻi inā loaʻa iā ʻoe
• E hoʻomākaukau i nā nīnau e pili ana i kou kūlana a me nā koho lapaʻau
• E noʻonoʻo e lawe mai i kahi hoaaloha a i ʻole ʻohana hilinaʻi no ke kākoʻo

Mai kānalua e noi i kāu kauka e wehewehe i kekahi mea āu i ʻike ʻole ai. He mea nui ia e ʻoluʻolu ʻoe me kāu papahana lapaʻau a ʻike i ka mea e manaʻo ai i ka wā hoʻōla.

He aha ka mea nui e pili ana i ka ureteral obstruction?

ʻO ka ureteral obstruction kahi kūlana hiki ke mālama ʻia e pono ai ka mālama ola kino koke e pale aku i nā pilikia. ʻO ka hapa nui o nā hihia i hana ʻia e nā pōhaku puʻupaʻa, hiki ke mālama pono ʻia me nā lapaʻau hou.

ʻO ka mea nui loa e hoʻomanaʻo ai ʻaʻole e hoʻowahāwahā i nā hōʻailona e like me ka ʻeha nui o ke kua, ke koko i loko o ka mimi, a i ʻole nā ​​loli i nā ʻano mimi. Hiki i ka ʻike koke ʻana a me ka mālama ʻana ke mālama i kāu hana puʻupaʻa a pale aku i nā pilikia koʻikoʻi.

Me ka mālama ola kino kūpono a me nā hana pale, hoʻōla piha ka hapa nui o nā kānaka me ka ureteral obstruction a hiki ke lawe i nā hana e hoʻemi ai i ko lākou pilikia o nā hanana e hiki mai ana. E noho hydrated, e hahai i nā ʻōlelo a kāu kauka, a mai kānalua e ʻimi i ke kōkua i ka wā e pono ai.

Nā nīnau pinepine e pili ana i ka ureteral obstruction

Q.1 Pehea ka lōʻihi e pono ai no ka pōhaku puʻupaʻa e hele ma o ka ureter?

ʻO ka hapa nui o nā pōhaku puʻupaʻa liʻiliʻi (ma lalo o 4mm) e hele maoli i loko o 1-3 mau wiki. Hiki i nā pōhaku nui ke lōʻihi a i ʻole e pono ai ka hoʻopili ʻana i ka lāʻau lapaʻau. Hiki i kāu kauka ke kuhikuhi i ka manawa ma muli o ka nui o ka pōhaku a me ka wahi ma nā hoʻokolohua kiʻi.

Q.2 Hiki i ka ureteral obstruction ke hoʻoulu i ka hōʻino mau ʻana o ka puʻupaʻa?

ʻAe, hiki i ka ālai lōʻihi ke hoʻoulu i ka hōʻino mau ʻana o ka puʻupaʻa, akā maʻamau kēia e lawe i nā wiki a hiki i nā mahina e hoʻomohala ai. Me ka mālama koke ʻana, hoʻōla ka hapa nui o nā kānaka i ka hana puʻupaʻa piha. ʻO ke kī ka ʻimi koke ʻana i ka mālama ola kino i ka wā e ʻike ʻia ai nā hōʻailona.

Q.3 He mea pono mau anei ka hana ʻoki no ka ureteral obstruction?

ʻAʻole, ʻaʻole pono mau ka hana ʻoki. Hele maoli nā pōhaku puʻupaʻa liʻiliʻi me ka mālama mālama. Eia naʻe, nā pōhaku nui, nā ālai piha, a i ʻole nā ​​hihia me ka maʻi e pono ai ka hoʻopili ʻana i ka hana ʻoki e like me ka ureteroscopy a i ʻole ka stent placement.

Q.4 Hiki i ke hapai ke hoʻoulu i ka ureteral obstruction?

ʻAe, hiki i ke hapai ke hoʻoulu i ka ureteral obstruction, ʻoi aku hoʻi i ka lua a me ke kolu o nā trimester. Hiki i ka ʻōpū e ulu ana ke komo i nā ureters, ʻoi aku hoʻi ma ka ʻaoʻao ʻākau. Hoʻopau pinepine kēia ma hope o ka hānau ʻana, akā i kekahi manawa e pono ai ka nānā a i ʻole ka mālama ʻana i ka wā hapai.

Q.5 He aha nā meaʻai āu e pale aku ai inā pili ʻoe i nā pōhaku puʻupaʻa?

ʻO nā meaʻai e pale aku ai e hilinaʻi ana i kāu ʻano pōhaku. No nā pōhaku calcium oxalate (maʻamau loa), e kaupalena i nā meaʻai kiʻekiʻe oxalate e like me ka spinach, nā nati, ka chocolate, a me ke kī. No nā pōhaku uric acid, e hoʻemi i nā meaʻai purine-rich e like me nā ʻiʻo ʻōnaehana a me nā shellfish. Hiki i kāu kauka ke hāʻawi i ka kuhikuhi meaʻai kikoʻī ma muli o kāu loiloi pōhaku.