Vesicoureteral Reflux
Incamake
Vesicoureteral (ves-ih-koe-yoo-REE-tur-ul) reflux ni umusubizo utari mwiza w'inkari uva mu kibuno ujya mu myanya (ureters) ihuza impyiko na kibuno. Ubusanzwe, inkari ziva mu mpyiko zinyura mu myanya y'inkari zijya mu kibuno. Ntizigomba gusubira inyuma.
Vesicoureteral reflux isanzwe iboneka mu bana bato n'abana. Indwara yongera ibyago by'indwara z'inzira z'inkari, iyo itabonye ubuvuzi, ishobora gutera ibibazo ku mpyiko.
Abana bashobora gukira vesicoureteral reflux y'ibanze. Ubuvuzi, burimo imiti cyangwa kubaga, bugamije gukumira ibibazo ku mpyiko.
Ibimenyetso
Ibironda by'umuhanda w'imyanda bisanzwe bibera mu bantu bafite vesicoureteral reflux. Icyorezo cy'umuhanda w'imyanda (UTI) ntibigaragaza ibimenyetso n'ibimenyetso bisobanutse, nubwo abantu benshi bafite bimwe. Ibi bimenyetso n'ibimenyetso birashobora kuba harimo: Icyifuzo cyinshi, cyihutirwa cyo kwituma Icyuma cyo gushyuha igihe utuma Icyifuzo cyo gutuma amashereka make kenshi Icyuma cy'umwuka Umuriro Ububabare mu ruhande rwawe (flank) cyangwa mu nda UTI irashobora kuba inyongera mu bana, bashobora kuba bafite ibimenyetso n'ibimenyetso bitari ibisobanutse. Ibimenyetso n'ibimenyetso mu bana bato bafite UTI birashobora no kuba harimo: Umuriro utaravuzwe Guta icyifuzo cyo kurya Kugira umutima mubi Nk'uko umwana wawe akura, vesicoureteral reflux itaravuzwe irashobora gutuma: Kwituma mu buriri Icyuma cyo gutuma cyangwa kugira ubushobozi bwo gutuma amashereka Umutwaro mwinshi w'amaraso Icyuma mu myanda Ikindi kimenyetso cya vesicoureteral reflux, gishobora kuba cyagaragaye mbere y'uko umwana yavuka n'isonogram, ni ugukura kwa ro n'imyanda y'umwuka y'umwana, byatumye amaraso y'umwana yinjira mu ro. Koresha umuganga wawe kare cyane niba umwana wawe yagaragaje ibimenyetso cyangwa ibimenyetso bya UTI, nka: Icyifuzo cyinshi, cyihutirwa cyo kwituma Icyuma cyo gushyuha igihe utuma Ububabare mu nda cyangwa mu ruhande Hamagara umuganga wawe kuri umuriro niba umwana wawe: Ari munsi y'amezi 3 kandi afite ubushyuhe bwa rectal bwa 100.4 F (38 C) cyangwa hejuru Ari amezi 3 cyangwa kirenze kandi afite umuriro wa 100.4 F (38 C) cyangwa hejuru kandi asa nk'ari murwayi Anashobora no kurya neza cyangwa yahindutse mu mibereho ye.
Igihe cyo kubona umuganga
Hamagara muganga wawe ako kanya niba umwana wawe agaragaza ibimenyetso byose cyangwa ibimenyetso by'indwara y'inkari, nka:
- Ubushake bukomeye kandi buhoraho bwo kwinjira
- Umuriro mwinshi mugihe cyo kwinjira
- Kubabara mu nda cyangwa mu kibuno
Hamagara muganga wawe kubyerekeye umuriro niba umwana wawe:
- Afite munsi y'amezi atatu kandi afite ubushyuhe bw'umubiri bwa dogere 38 C cyangwa hejuru
- Afite amezi atatu cyangwa arengejeho kandi afite umuriro wa dogere 38 C cyangwa hejuru kandi asa n'urwaye
- Nanone ararya nabi cyangwa yagize impinduka zikomeye mu mimerere
Impamvu
Sisitemu yawe y'imihingurire irimo impyiko, ibyondo, umukaya n'umuyoboro w'inkari. Byose bigira uruhare mu gukuraho ibintu bidakenewe mu mubiri wawe binyuze mu nkari.
Vesicoureteral reflux ishobora kuza mu bwoko bubiri, ubw'ibanze n'ubw'inyongera:
- Vesicoureteral reflux y'ibanze. Abana bafite vesicoureteral reflux y'ibanze bavukana ikosa mu muyoboro usanzwe ubuza inkari gusubira inyuma kuva mu mukaya ujya mu byondo. Vesicoureteral reflux y'ibanze ni yo yiganje.
Uko umwana wawe akura, ibyondo biratamba kandi bigasubira mu buryo, ibyo bishobora kunoza imikorere y'umuyoboro kandi bigakemura reflux amaherezo. Ubu bwoko bwa vesicoureteral reflux busanzwe buri mu miryango, ibyo bigaragaza ko bishobora kuba ari indwara isanzwe iri mu muryango, ariko icyateye ikosa nyakuri nticyamenyekanye.
- Vesicoureteral reflux y'inyongera. Intandaro y'ubu bwoko bwa reflux akenshi iterwa no kunanirwa kw'umukaya gusuka neza, kubera inzitizi cyangwa kunanirwa kw'imitsi y'umukaya cyangwa kwangirika kw'imitsi igenzura gusuka kw'umukaya neza.
Vesicoureteral reflux y'ibanze. Abana bafite vesicoureteral reflux y'ibanze bavukana ikosa mu muyoboro usanzwe ubuza inkari gusubira inyuma kuva mu mukaya ujya mu byondo. Vesicoureteral reflux y'ibanze ni yo yiganje.
Uko umwana wawe akura, ibyondo biratamba kandi bigasubira mu buryo, ibyo bishobora kunoza imikorere y'umuyoboro kandi bigakemura reflux amaherezo. Ubu bwoko bwa vesicoureteral reflux busanzwe buri mu miryango, ibyo bigaragaza ko bishobora kuba ari indwara isanzwe iri mu muryango, ariko icyateye ikosa nyakuri nticyamenyekanye.
Ingaruka zishobora guteza
Ibintu byongera ibyago byo kwisubira inyuma kwa vesicoureteral birimo:
- Uburwayi bw'umwijima n'amara (BBD). Abana bafite BBD bafata inkari n'amatagatifu kandi bagira indwara zikunze kugaragara mu nzira y'inkari, ibyo bishobora gutera kwisubira inyuma kwa vesicoureteral.
- Ubwoko. Abana b'abazungu basa n'abafite ibyago byinshi byo kwisubira inyuma kwa vesicoureteral.
- Ibitsina. Muri rusange, abakobwa bafite ibyago byinshi byo kugira iyi ndwara kurusha abahungu. Icyo kintu kidasanzwe ni uko kwisubira inyuma kwa vesicoureteral kibaho kuva ku ivuka, bikaba byinshi mu bahungu.
- Imyaka. Abana bato n'abana bari munsi y'imyaka 2 bafite ibyago byinshi byo kwisubira inyuma kwa vesicoureteral kurusha abana bakuru.
- Amateka y'umuryango. Kwivura inyuma kwa vesicoureteral bisanzwe bikunze kugaragara mu miryango. Abana bafite ababyeyi bagize iyo ndwara bafite ibyago byinshi byo kuyirwara. Abavandimwe b'abana bafite iyo ndwara nabo bafite ibyago byinshi, bityo muganga wawe ashobora kugutegeka gusuzuma abavandimwe b'umwana ufite kwisubira inyuma kwa vesicoureteral.
Ingaruka
Ibyangiritse by'impyiko ni byo bibangamira cyane iyo umusemburo w'inkari usubira inyuma. Uko ubwo busubira inyuma ari bukabije, ni ko ingaruka zikomeye zishobora kuba nyinshi.
Ingaruka zishobora kubaho zirimo:
- Gucika intege kw'impyiko. Ibikomere bishobora gutera igihombo mu gikorwa cyo gushungura mu gice cy'impyiko. Ibi bishobora gutera gucika intege kw'impyiko, bishobora kuba vuba (gucika intege kw'impyiko mu buryo bukabije) cyangwa bishobora gutinda (indwara y'impyiko ikaze).
Kupima
Ibizamini by'inkari bishobora kugaragaza niba umwana wawe afite indwara y'inzira z'umusemburo (UTI). Hari ibindi bipimo bishobora kuba bikenewe, birimo:
- Ubuganga bw'impyiko n'umwijima. Ubu buryo bw'amashusho bukoresha ingufu z'amajwi zikomeye kugira ngo bukore amashusho y'impyiko n'umwijima. Ubuganga bw'amajwi bushobora kugaragaza ibibazo by'imiterere.
- Ubu buryo bw'ikoranabuhanga, bukunze gukoreshwa mu gihe cyo gutwita kugira ngo hagenzurwe iterambere ry'umwana, bushobora kandi kugaragaza impyiko zifunitse mu mwana, ikimenyetso cy'indwara ya vesicoureteral reflux.
- X-ray yihariye y'inzira z'umusemburo. Iki kizamini gikoresha X-ray y'umwijima iyo yuzuye n'iyo urimo gusuka kugira ngo hagaragazwe ibibazo. Umuyoboro muto, woroshye (catheter) winjizwa mu muyoboro w'inkari no mu mwijima mu gihe umwana wawe aryamye ku mugongo ku meza ya X-ray. Nyuma yo gushyiramo umunyu wa kontrasito mu mwijima binyuze muri catheter, umwijima w'umwana wawe ufatwa amafoto ya X-ray mu myanya itandukanye. Hanyuma catheter ikurwaho kugira ngo umwana wawe ashobore kwinjira, kandi amafoto ya X-ray afatwa ku mwijima no ku muyoboro w'inkari mu gihe cyo kwinjira kugira ngo harebwe niba inzira z'umusemburo zikora neza. Ibyago bifitanye isano n'iki kizamini birimo kubabara biterwa na catheter cyangwa kugira umwijima wuzuye n'amahirwe yo kwandura izindi ndwara z'inzira z'umusemburo.
- Ubuganga bwa Nuclear. Iki kizamini gikoresha umunyu witwa radioisotope. Scanner igaragaza umunyu kandi igaragaza niba inzira z'umusemburo zikora neza. Ibyago birimo kubabara biterwa na catheter no kubabara mu gihe cyo kwinjira.
Kugabanya ubukana bw'indwara Nyuma yo gupima, abaganga bagabanya urwego rwa reflux. Mu bihe byoroheje, inkari zisubira inyuma gusa ku muyoboro w'inkari (igice cya I). Ibihe bikomeye cyane birimo kubyimbagira kw'impyiko (hydronephrosis) no guhinduka kw'umuyoboro w'inkari (igice cya V).
Kwitaho muri Mayo Clinic Itsinda ryacu ryita ku barwayi rya Mayo Clinic ribasha kubafasha mu bibazo byanyu by'ubuzima bifitanye isano na vesicoureteral reflux Tangira hano Ibindi bisobanuro Kwitaho kwa vesicoureteral reflux muri Mayo Clinic Isuzuma ry'inkari
Uburyo bwo kuvura
Uburyo bwo kuvura reflux ya vesicoureteral biterwa n'uburemere bw'uburwayi. Abana bafite reflux ya vesicoureteral yoroheje bashobora kuzarwara iyo ndwara. Muri uru rubanza, muganga wawe ashobora kugutegeka gutegereza no kureba.
Kuri reflux ya vesicoureteral ikomeye, uburyo bwo kuvura harimo:
UTIs isaba kuvurwa vuba na antibiyotike kugira ngo kwandura kudakwirakwira mu mpyiko. Kugira ngo wirinde UTIs, abaganga bashobora kandi kwandika antibiyotike ku gipimo kiri hasi ugereranije no kuvura indwara.
Umwana uvurwa imiti agomba kugenzurwa igihe cyose afata antibiyotike. Ibi birimo ibizamini by'umubiri buri gihe n'ibizamini by'inkari kugira ngo hamenyekane indwara zidasanzwe - UTIs zibaho nubwo hari kuvurwa kwa antibiyotike - no gusuzuma inshuro rimwe na rimwe amashusho y'umwijima w'umwijima n'impyiko kugira ngo umenye niba umwana wawe yararenze reflux ya vesicoureteral.
Ubuganga bwa reflux ya vesicoureteral burakosora ikosa mu mukanwa uri hagati y'umwijima na buri ureter yanduye. Ikosa mu mukanwa rikumira gufunga no kubuza inkari gutaha inyuma.
Uburyo bwo kuvura ubuganga harimo:
- Ubuganga bufunguye. Bukorwa hakoreshejwe anesthésie rusange, ubu buganga busaba igice mu nda yo hasi aho umuganga akosora ikibazo. Ubwo bwoko bw'ubuganga busaba iminsi mike mu bitaro, aho catheter isigara aho kugira ngo isukure umwijima w'umwana wawe. Reflux ya vesicoureteral ishobora gukomeza mu mubare muto w'abana, ariko muri rusange ikemuka ubwayo nta gukenera indi mvura.
- Ubuganga bwa laparoscopic bufashwa na robot. Kimwe no kuvura gufunguye, ubu buryo burimo gukosora umukanwa uri hagati ya ureter n'umwijima, ariko bukorwa hakoreshejwe ibice bito. Ibyiza birimo ibice bito kandi bishoboka ko hari ibibazo bike by'umwijima kuruta ubuganga bufunguye.
Ariko, ibyavuye mu bushakashatsi byerekana ko ubuganga bwa laparoscopic bufashwa na robot bushobora kutagera ku gipimo cyiza cyo gutsinda nk'ubuganga bufunguye. Ubu buryo bwari bufite igihe kirekire cyo gukora, ariko igihe gito cyo kurwarira mu bitaro.
- Ubuganga bwa endoscopic. Muri ubu buryo, muganga ashyiramo umuyoboro w'umucyo (cystoscope) binyuze muri urethra kugira ngo abone imbere y'umwijima w'umwana wawe, hanyuma ashyiremo igipimo cy'ibintu hafi y'umunwa wa ureter yanduye kugira ngo agerageze gukomeza ubushobozi bw'umukanwa gufunga neza.
Ubu buryo buke butera ubuganga ugereranije no kuvura gufunguye kandi bugira ibyago bike, nubwo bishobora kuba bidafite akamaro. Ubu buryo kandi busaba anesthésie rusange, ariko muri rusange bushobora gukorwa nk'ubuganga bwo hanze.
Kwitegura guhura na muganga
Abaganga basanzwe basanga reflux ya vesicoureteral mu bipimo byo gukurikirana iyo umwana muto cyangwa umwana muto aherutse kuvurwa indwara y’inzira y’umusemburo. Niba umwana wawe afite ibimenyetso n’ibibonwa, nko kubabara cyangwa gutwika mu gihe cyo kumuha, cyangwa umuriro udasobanutse uhoraho, hamagara muganga w’umwana wawe. Nyuma yo gusuzuma, umwana wawe ashobora koherezwa kwa muganga w’inzobere mu ndwara z’inzira y’umusemburo (urologue) cyangwa muganga w’inzobere mu ndwara z’impyiko (nephrologue). Dore amakuru azagufasha kwitegura, n’icyo utegereje ku muganga w’umwana wawe. Icyo ushobora gukora Mbere y’aho uganira na muganga, igihe cyo kwandika amakuru y’ingenzi, harimo: Ibimenyetso n’ibibonwa umwana wawe amaze igihe afite, n’igihe byamaze Amakuru yerekeye amateka y’ubuzima bw’umwana wawe, harimo n’ibindi bibazo by’ubuzima byaherukireho Amakuru yerekeye amateka y’ubuzima bw’umuryango wawe, harimo niba hari umwe mu muryango wa hafi w’umwana wawe — nko mubyeyi cyangwa umuvandimwe — yavuwe reflux ya vesicoureteral Amazina n’umubare w’imiti y’amabwiriza n’imiti idasaba amabwiriza umwana wawe afata Ibibazo byo kubabaza muganga Ku bijyanye na reflux ya vesicoureteral, ibibazo by’ibanze byo kubabaza muganga w’umwana wawe birimo: Ni iki gishobora kuba cyarateye ibimenyetso n’ibibonwa by’umwana wanjye? Hari ibindi bintu bishobora kuba byarateye, nko kwandura mu gifu cyangwa mu mpyiko? Ni izihe binyabuzima umwana wanjye akeneye? Ni iki gishobora kuba cyarateye uburwayi bw’umwana wanjye bugakira nta kuvurwa? Ni iyihe inyungu n’ingaruka z’ubuvuzi busabwa mu gihe cy’umwana wanjye? Ese umwana wanjye afite ibyago byo kugira ingaruka z’ubwo burwayi? Uzagenzura ubuzima bw’umwana wanjye gute uko iminsi igenda? Ni ayahe ntambwe nakora kugira ngo ngabanye ibyago by’umwana wanjye byo kwandura mu nzira y’umusemburo mu gihe kizaza? Abandi bana banjye bafite ibyago byinshi by’ubwo burwayi? Uratekereza ko umwana wanjye akwiye kubonana n’inzobere? Ntugatinye kubabaza ibindi bibazo byagushikiye mu gihe cyo kuvura umwana wawe. Uburyo bwiza bwo kuvura reflux ya vesicoureteral — bushobora kuva ku gutegereza gusa ku kubaga — akenshi ntibumvikana neza. Kugira ngo utore uburyo bw’ubuvuzi bukubereye wowe n’umwana wawe, ni ngombwa ko wumva uburwayi bw’umwana wawe n’inyungu n’ingaruka za buri muti uriho. Icyo utegereje ku muganga wawe Muganga w’umwana wawe azakora isuzuma ry’umubiri w’umwana wawe. Ashobora kukubaza ibibazo byinshi. Kwitoza kubisubiza bishobora kugufasha kugira igihe cyo kuvuga ku bintu ushaka kumaraho igihe kinini. Muganga wawe ashobora kukubaza: Ni ryari wabonye bwa mbere ko umwana wawe afite ibimenyetso? Ibyo bimenyetso byari bikomeye cyangwa byazaga bikagenda? Ibimenyetso by’umwana wawe byari bikaze gute? Hari ikintu cyari kigabanya ibyo bimenyetso? Hari ikintu cyari kigabanya ibyo bimenyetso? Hari umuntu mu muryango wawe ufite amateka ya reflux ya vesicoureteral? Ese umwana wawe yagize ibibazo by’ubukure? Ni ayahe moko y’antibiyotike umwana wawe yafashe ku zindi ndwara, nko kwandura amatwi? Na Mayo Clinic Staff
Umuhakana: Kanama ni urubuga rw'amakuru y'ubuzima kandi ibisubizo byayo ntibigize inama z'ubuvuzi. Jya ubona umuganga ufite uruhushya rwo gukorera hafi yawe mbere yo gukora impinduka izo ari zo zose.