Vesicoureteral Reflux

Kudzoka kwemukaka kubva muchiuno (vesicoureteral reflux) kuyerera kwemukaka kunobva muchiuno kuchidzokera kumashure mune zvibatanidza (ureters) zvinobatanidza itsvo nechiuno. Kazhinji, mukaka unoyerera kubva kuitsvo uchipfuura neureters uchienda kuchiuno. Hauifanire kudzokera kumashure.

Kudzoka kwemukaka kubva muchiuno kunowanzoonekwa muvana vaduku nevana. Dambudziko iri rinowedzera njodzi yekutapukirwa kwema urinary tract, izvo, kana zvisina kurapwa, zvinogona kukonzera kukuvara kweitsvo.

Vana vanogona kukura kubva pakudzoka kwemukaka kubva muchiuno. Kurapa, kunosanganisira mishonga kana kuvhiya, kunangidzirwa pakudzivirira kukuvara kweitsvo.

'Kuvhunduka kweitsvo kunowanzoitika kune vanhu vane vesicoureteral reflux. Kuvhunduka kweitsvo (UTI) hakusi nguva dzose kunokonzera zviratidzo zvinoonekwa, kunyange zvazvo vanhu vakawanda vane zvimwe. Izvi zviratidzo zvinogona kusanganisira: Chido chakasimba, chinogara chekuenda kunzvimbo yekushambidza\nKunzwa kwekupisa pakuenda kunzvimbo yekushambidza\nKuoda kupfuura huwandu hudiki hwemvura kakawanda\nMvura yakasviba\nFevha\nKurwadziwa padivi (flank) kana mudumbu UTI inogona kunge yakaoma kuongororwa muvana, vanogona kungova nezviratidzo zvisinganyanyi kujeka. Zviratidzo muvana vaduku vane UTI zvinogona kusanganisirawo: Fevha isinganzwisisiki\nKushayikwa kwechido chekudya\nKushatirwa Mwana wako paanokura, vesicoureteral reflux isina kurapwa inogona kutungamira ku: Kuchema mubhedha\nKutopwa kana kurasikirwa nekuzvidzora kwematumbu\nKuvhunduka kweropa\nProtein mumvura Chimwe chiratidzo chevesicoureteral reflux, chinogona kuonekwa usati wazvarwa ne ultrasound, kuzvimba kweitsvo kana zvikamu zvinounganidza mvura yeimwe kana ese ari maviri itsvo (hydronephrosis) mumuviri, zvinokonzerwa nekumashure kwemvura kuenda kuitsvo. Taura nachiremba wako nekukurumidza kana mwana wako akawana chero zviratidzo zveUTI, zvakadai se: Chido chakasimba, chinogara chekuenda kunzvimbo yekushambidza\nKunzwa kwekupisa pakuenda kunzvimbo yekushambidza\nKurwadziwa mudumbu kana flank Fonera chiremba wako nezvefevha kana mwana wako: Ane makore asina kusvika matatu uye ane tembiricha ye rectum ye100.4 F (38 C) kana kupfuura\nAne makore matatu kana kupfuura uye ane fevha ye100.4 F (38 C) kana kupfuura uye anoita kunge ari kurwara\nAnowanzodya zvishoma kana aine shanduko huru mumafungiro'

Taura nachiremba wako pakarepo kana mwana wako akaita chero chimwe chezviratidzo zveUTI, zvakadai se:

• Chido chakasimba, chinogara chekuenda kunzvimbo yekushambidza
• Kunzwa kwekupisa pakuenda kunzvimbo yekushambidza
• Kurwadziwa mudumbu kana kumativi

Fona nachiremba wako nezvefivha kana mwana wako:

• Ane makore asingasviki matatu uye ane tembiricha ye rectum ye100.4 F (38 C) kana kupfuura
• Ane makore matatu kana kupfuura uye ane fivha ye100.4 F (38 C) kana kupfuura uye anoita kunge ari kurwara
• Anodya zvishoma kana kuti achinja mafungiro zvakanyanya

Sisitimu yako yekubuda kwemukomana inosanganisira itsvo dzako, ureters, bladder neurethra. Zvose zvinotora basa mukubvisa zvinhu zvisina basa kubva mumuviri wako kuburikidza newee.

Vesicoureteral reflux inogona kukura mumhando mbiri, huru neyechipiri:

• Vesicoureteral reflux huru. Vana vane vesicoureteral reflux huru vanoberekwa vane chikanganiso muvharavhara rinowanzo kudzivirira wee kubva kukwira shure kubva kubladder kuenda ku ureters. Vesicoureteral reflux huru ndiyo yakajairika.

  Sezvo mwana wako achikura, ureters inorebesa uye inotwasuka, izvo zvinogona kuvandudza basa revharavhara uye pakupedzisira kugadzirisa reflux. Mhando iyi yevesicoureteral reflux inowanzoitika mumhuri, izvo zvinoratidza kuti zvinogona kuva zvemagariro, asi chikonzero chaicho chekukanganisa hachizivikanwi.

• Vesicoureteral reflux yechipiri. Chikonzero cheiyi reflux kazhinji chinobva pakukundikana kwe bladder kubuda zvakakwana, nekuda kwekuvhara kana kukundikana kwemhasuru ye bladder kana kukuvara kwenhevedzano dzinoongorora kubuda kwakajairwa kwe bladder.

Vesicoureteral reflux huru. Vana vane vesicoureteral reflux huru vanoberekwa vane chikanganiso muvharavhara rinowanzo kudzivirira wee kubva kukwira shure kubva kubladder kuenda ku ureters. Vesicoureteral reflux huru ndiyo yakajairika.

Sezvo mwana wako achikura, ureters inorebesa uye inotwasuka, izvo zvinogona kuvandudza basa revharavhara uye pakupedzisira kugadzirisa reflux. Mhando iyi yevesicoureteral reflux inowanzoitika mumhuri, izvo zvinoratidza kuti zvinogona kuva zvemagariro, asi chikonzero chaicho chekukanganisa hachizivikanwi.

Zvinokonzera njodzi dzevesicoureteral reflux zvinosanganisira:

• Kusashanda zvakanaka kwematumbu nemarunda (BBD). Vana vane BBD vanoramba vachibata wee nemanyowa avo uye vanorwara kazhinji nezvirwere zveitsvo, izvo zvinogona kukonzera vesicoureteral reflux.
• Rudzi. Vana vachena vanoita sekunge vane njodzi yakakura yekuwana vesicoureteral reflux.
• Bonde. Kazhinji, vasikana vane njodzi yakakura yekuwana chirwere ichi kupfuura vakomana. Asi kana vesicoureteral reflux iripo kubva pakuzvarwa, inowanzoitika muvakomana.
• Zera. Mwana mucheche nevana kusvika pazera remakore maviri vane mukana mukuru wekuwana vesicoureteral reflux kupfuura vana vakura.
• Nhoroondo yemhuri. Vesicoureteral reflux huru inowanzoitika mumhuri. Vana vane vabereki vakambova nechirwere ichi vane njodzi yakakura yekuchiwanazve. Vana vemunun'una kana hanzvadzi yemwana ane chirwere ichi vane njodzi yakakurawo, saka chiremba wenyu angakurudzira kuongororwa kwevana vemunun'una kana hanzvadzi yemwana ane vesicoureteral reflux huru.

Kukuvadzwa kweitsvo ndicho chinonyanya kunetseka nevesicoureteral reflux. Reflux yakanyanya kukomba, zvakanyanya zvakaoma matambudziko anogona kuitika. Matambudziko anogona kusanganisira:

• Kukundikana kweitsvo. Kukuvara kunogona kukonzera kurasikirwa nebasa mune chikamu chekuchera cheitsvo. Izvi zvinogona kutungamira pakukundikana kweitsvo, izvo zvinogona kuitika nekukurumidza (kukundikana kweitsvo kwenguva pfupi) kana kuti zvinogona kukura nekufamba kwenguva (chirwere cheitsvo chekare).

Kuongorora weewee kunogona kuratidza kana mwana wako ane UTI. Kuongorora kwakawanda kunogona kudiwa, kusanganisira: Ultrasound yeitsvo nevesikuru. Nzira iyi yekuona mifananidzo inoshandisa mafungu esainzi ane simba rakakwirira kugadzira mifananidzo yeitsvo nevesikuru. Ultrasound inogona kuona zvinhu zvisina kujairika. Tekinoroji iyi imwechete, inowanzoshandiswa panguva yekuzvitakura kutarisa kukura kwemwana, inogonawo kuratidza itsvo dzakazvimba mwana, chiratidzo chevesicoureteral reflux huru. X-ray chaiyo yetsvo. Kuongorora uku kunoshandisa X-rays yevesikuru kana yakazara uye kana iri kubuda kuti ione zvinhu zvisina kujairika. Chubhu chidiki, chinopindika (catheter) chinopinzwa kuburikidza neurethra uye kuenda kuvesikuru apo mwana wako ari kurara pamusana pake patafura ye-X-ray. Mushure mekunge dye yekuona ichipinza muvesikuru kuburikidza ne catheter, vesikuru yemwana wako inotorwa X-ray munzvimbo dzakasiyana. Zvadaro catheter inobviswa kuitira kuti mwana wako agone kuenda kunzvimbo, uye X-rays dzakawanda dzinotorwa yevesikuru neurethra panguva yekubuda kuti aone kana tsvina iri kushanda zvakanaka. Njodzi dzine chekuita nekuongorora uku dzinosanganisira kusagadzikana kubva ku catheter kana kubva pakukuvadzwa nevesikuru yakazara uye mukana wekutama kwehutachiona hutsva hwetsvina. Kuongorora kwe nyukliya. Kuongorora uku kunoshandisa tracer inonzi radioisotope. Scanner inowana tracer uye inoratidza kana tsvina iri kushanda zvakanaka. Njodzi dzinosanganisira kusagadzikana kubva ku catheter uye kusagadzikana panguva yekubuda. Kuenzanisa mamiriro Mushure mekuongorora, vanachiremba vanoenzanisa huwandu hwe reflux. Muzviitiko zvishoma, weewee inodzokera kumashure kuenda ku ureter (grade I). Zviitiko zvakanyanya zvinosanganisira kuzvimba kwakanyanya kweitsvo (hydronephrosis) uye kukotama kwe ureter (grade V). Kutarisirwa paMayo Clinic Chikwata chedu chine hanya chevanachiremba veMayo Clinic chinogona kukubatsira nezvinetso zvako zveutano zvine chekuita nevesicoureteral reflux Tanga pano Rumwe ruzivo Kutarisirwa kwevesicoureteral reflux paMayo Clinic Kuongorora weewee

Sarudzo dzekurapa reflux yevesicoureteral zvinoenderana nekuoma kwechirwere ichi. Vana vane zvirwere zvishoma zveprimary vesicoureteral reflux vanogona kupfuura chirwere ichi. Muchiitiko ichi, chiremba wenyu anogona kukurudzira nzira yekumirira-uye-kuona.

Kune vesicoureteral reflux yakakomba, sarudzo dzekurapa dzinosanganisira:

UTIs inoda kurapwa nekukurumidza neantibiotics kuchengetedza hutachiona husapinda kumakumbo. Kuti udzivise UTIs, vanachiremba vanogonawo kunyora antibiotics pane dose yakaderera kupfuura kurapa hutachiona.

Mwana ari kurapwa nemishonga anofanira kutarisirwa chero nguva ari kutora antibiotics. Izvi zvinosanganisira bvunzo dzehutano nguva nenguva uye bvunzo dzemukaka kuona hutachiona hwakapfuura - UTIs inoitika kunyange nekurapa kweantibiotic - uye scans dze radiographic dzebladder nemakumbo kuona kana mwana wako apfuura vesicoureteral reflux.

Kuvhiya kwevesicoureteral reflux kunogadzirisa kukanganisa muvharuvhu pakati pebhadha ne ureter imwe neimwe yakabatwa. Kukanganisa muvharuvhu kunoita kuti isavharwe uye kudzivirira mvura kubva kukwira kumashure.

Nzira dzekugadzirisa kuvhiya dzinosanganisira:

• Kuvhiya kwakavhurika. Kuita uchishandisa anesthesia yakajairika, kuvhiya uku kunoda kucheka mudumbu repasi umo chiremba anogadzirisa dambudziko. Rudzi urwu rwekuvhiya kazhinji runoda mazuva mashoma ekugara muchipatara, umo catheter inochengetwa panzvimbo yekudonha bladder yemwana wako. Vesicoureteral reflux inogona kuramba iripo muhuwandu hudiki hwemwana, asi kazhinji inozvigadzirisa isina kudiwa kurapwa kwakawanda.
• Robotic-assisted laparoscopic surgery. Kufanana nekuvhiya kwakavhurika, nzira iyi inosanganisira kugadzirisa vharuvhu pakati pe ureter ne bladder, asi inoitirwa uchishandisa kucheka duku. Zvakanakira zvinosanganisira kucheka duku uye zvichida spasms shoma dzebladder kupfuura kuvhiya kwakavhurika.

Asi, zviwanikwa zvepakutanga zvinoratidza kuti robotic-assisted laparoscopic surgery ingave isina mwero wakakwira wekubudirira sekushanda kwakavhurika. Nzira iyi yakabatanawo nenguva yakareba yekushanda, asi nguva pfupi yekugara muchipatara.

• Endoscopic surgery. Munzira iyi, chiremba anopinda chubhu yakavhenekerwa (cystoscope) kuburikidza ne urethra kuona mukati me bladder yemwana wako, uye wobva wapinza bulking agent kutenderera kuvhurwa kwe ureter yakabatwa kuyedza kusimbisa simba revharuvhu rekudzima zvakakwana.

Nzira iyi haina kukanganisa zvakanyanya kana ichienzaniswa nekuvhiya kwakavhurika uye ine njodzi shoma, kunyange zvazvo isingave yakakosha. Nzira iyi inodawo anesthesia yakajairika, asi kazhinji inogona kuitwa sekurapwa kwekunze.

Robotic-assisted laparoscopic surgery. Kufanana nekuvhiya kwakavhurika, nzira iyi inosanganisira kugadzirisa vharuvhu pakati pe ureter ne bladder, asi inoitirwa uchishandisa kucheka duku. Zvakanakira zvinosanganisira kucheka duku uye zvichida spasms shoma dzebladder kupfuura kuvhiya kwakavhurika.

Asi, zviwanikwa zvepakutanga zvinoratidza kuti robotic-assisted laparoscopic surgery ingave isina mwero wakakwira wekubudirira sekushanda kwakavhurika. Nzira iyi yakabatanawo nenguva yakareba yekushanda, asi nguva pfupi yekugara muchipatara.

Endoscopic surgery. Munzira iyi, chiremba anopinda chubhu yakavhenekerwa (cystoscope) kuburikidza ne urethra kuona mukati me bladder yemwana wako, uye wobva wapinza bulking agent kutenderera kuvhurwa kwe ureter yakabatwa kuyedza kusimbisa simba revharuvhu rekudzima zvakakwana.

Nzira iyi haina kukanganisa zvakanyanya kana ichienzaniswa nekuvhiya kwakavhurika uye ine njodzi shoma, kunyange zvazvo isingave yakakosha. Nzira iyi inodawo anesthesia yakajairika, asi kazhinji inogona kuitwa sekurapwa kwekunze.