Yini i-Kidney Biopsy? Inhloso, Inqubo & Imiphumela

I-kidney biopsy iyinqubo yezokwelapha lapho udokotela wakho esusa ucezu oluncane lwesicubu sezinso ukuze aluhlolisise ngaphansi kwe-microscope. Lesi sibonelo esincane sisiza odokotela ukuthi bathole izifo zezinso futhi banqume uhlelo olungcono kakhulu lokwelapha wena. Cabanga ngakho njengokuthola ukubuka okuningiliziwe kokwenzekayo ngaphakathi kwezinso zakho lapho ukuhlolwa kwegazi nokucabanga okungenakutshela yonke indaba.

Yini i-kidney biopsy?

I-kidney biopsy ihlanganisa ukuthatha isampula elincane lesicubu ezinso zakho usebenzisa inaliti encane. Le nqubo yenziwa uchwepheshe obizwa nge-nephrologist noma i-radiologist osebenzisa isiqondiso sokucabanga ukuze afinyelele ezinso ngokuphepha. Lesi sampula lesicubu sithunyelwa elabhorethri lapho ochwepheshe balihlolisisa ngokucophelela ukuze bathole noma yisiphi isifo noma umonakalo.

Isampula ngokwalo sincane kakhulu, cishe ngosayizi wethiphu yepensela, kodwa liqukethe izinkulungwane zezakhiwo ezincane ezingadalula imininingwane ebalulekile ngempilo yakho yezinso. Izinso zakho zizoqhubeka nokusebenza ngokujwayelekile ngemva kwe-biopsy njengoba kususwa inani elincane lesicubu.

Kungani kwenziwa i-kidney biopsy?

Udokotela wakho uncoma i-kidney biopsy lapho edinga ulwazi oluningiliziwe mayelana nokuthi yini ethinta izinso zakho. Ukuhlolwa kwegazi nokuhlolwa komchamo kungakhombisa ukuthi okuthile akulungile, kodwa akukwazi ngaso sonke isikhathi ukukhomba ngqo inkinga noma ukuthi ibucayi kangakanani.

Nazi izizathu eziyinhloko ezingase zidingeke ukuthi ube nale nqubo. Lezi zimo zivame ukuthuthuka kancane kancane, futhi udokotela wakho uzobe eqaphe ukusebenza kwezinso zakho ngaphambi kokusikisela i-biopsy:

• Igazi noma amaprotheni avela emchamweni wakho ngaphandle kwembangela ecacile
• Ukusebenza kwezinso kwehla ngokungalindelekile noma ngokushesha
• Ukucatshangelwa kwe-glomerulonephritis (ukuqubuka kwamathambo ezinso)
• Ukuvuvukala okungachazeki emilenzeni yakho, ebusweni, noma esiswini
• Umfutho wegazi ophezulu okunzima ukuwulawula
• Ukuqapha ukwenqatshwa ngemuva kokufakelwa izinso
• Ukunquma izinga lokulimala kwezinso ezivela ezifweni ezinjenge-lupus noma isifo sikashukela

Udokotela wakho uzoncoma i-biopsy kuphela uma imiphumela izoshintsha uhlelo lwakho lokwelashwa. Ulwazi olutholiwe lubasiza ukuthi bakhethe imithi esebenza kahle kakhulu futhi baqaphe ukuthi ukwelashwa kusebenza kahle kangakanani.

Yini inqubo ye-biopsy yezinso?

Inqubo ye-biopsy yezinso ngokuvamile ithatha imizuzu engaba ngu-30 kuya ku-60 futhi ivame ukwenziwa njengenqubo yeziguli eziphuthumayo. Uzobe uvukile ngesikhathi senqubo, kodwa uzothola i-anesthesia yendawo ukuze uqede indawo futhi mhlawumbe ukuthuliswa okuncane ukukusiza uphumule.

Nakhu okwenzekayo ngesikhathi se-biopsy yakho, isinyathelo ngesinyathelo. Ingxenye ngayinye ihlelwe ngokucophelela ukuqinisekisa ukuphepha kwakho nokunethezeka kwakho:

1. Uzolala ubuso bukhangele phansi etafuleni lokuhlolwa ngomcamelo ngaphansi kwesifuba sakho
2. Udokotela uzohlanza futhi aqede isikhumba ngaphezu kwezinso zakho nge-anesthetic yendawo
3. Esebenzisa i-ultrasound noma i-CT imaging, bazothola indawo engcono kakhulu yokufaka inaliti
4. Inaliti ye-biopsy encane ifakwa esikhumbeni sakho bese ingena ezinso
5. Uzocelwa ukuthi ubambe umoya wakho imizuzwana embalwa ngenkathi isampula lithathwa
6. Inaliti isuswa ngokushesha, futhi ingcindezi isetshenziswa ukuvimbela ukopha
7. Ngokuvamile, amasampula amancane angu-2-3 aqoqwa ukuqinisekisa izicubu ezanele

Ungase uzwe umsindo wokuchofoza lapho inaliti ye-biopsy idubula, okujwayelekile ngokuphelele. Abantu abaningi bachaza ukuzwa njengokufana nokucindezela okuqinile noma ingcindezi kunobuhlungu obukhulu.

Ungalungiselela kanjani i-biopsy yakho yezinso?

Ukulungiselela i-biopsy yakho yezinso kuhilela izinyathelo eziningana ezibalulekile ukuqinisekisa ukuthi inqubo ihamba kahle futhi iphephile. Ithimba lakho lokunakekelwa kwezempilo lizokunikeza imiyalelo ethile ngokusekelwe esimweni sakho sempilo kanye nanoma yimiphi imithi oyithathayo.

Udokotela wakho uzokunikeza imiyalelo enemininingwane yokulungiselela, evame ukuhlanganisa lezi zinyathelo ezibalulekile:

• Yeka ukuthatha imithi yokunciphisa igazi efana ne-aspirin, i-warfarin, noma i-NSAIDs izinsuku eziyi-7-10 ngaphambi kwenqubo
• Lungiselela othile ukuthi akuqhubele ekhaya ngemva kwalokho
• Ungadli noma uphuze lutho amahora angu-8 ngaphambi kwenqubo
• Tshela udokotela wakho ngayo yonke imithi, izithasiselo, kanye nemithi yezitshalo oyithathayo
• Tshela ithimba lakho lokunakekelwa kwezempilo uma unezifo zokungezwani komzimba noma izifo zokuphuma kwegazi
• Qedela noma yiziphi izivivinyo zegazi ezidingekayo ukuze uhlole ikhono lakho lokujiya kwegazi
• Hlela ukuhlala esibhedlela ukuze ubukwe amahora angu-4-6 ngemva kwenqubo

Uma uthatha imithi yesifo sikashukela noma umfutho wegazi ophezulu, udokotela wakho uzokunikeza imiyalelo ethile mayelana nokuthi uzoyithatha nini. Ungayeki le mithi ngaphandle uma utshelwe ngokuqondile ukuthi wenze njalo.

Ungazifunda kanjani imiphumela yakho ye-biopsy yezinso?

Imiphumela yakho ye-biopsy yezinso izotholakala phakathi kwezinsuku ezi-3-7, nakuba ezinye izivivinyo ezikhethekile zingathatha isikhathi eside. I-pathologist, udokotela onguchwepheshe ekuhloleni izicubu, uzofunda isampula lakho ngaphansi kwezinhlobo ezahlukene zama-microscopes futhi angase asebenzise amabala akhethekile ukuze agqamise izici ezithile.

Umbiko uzochaza lokho i-pathologist ekubonayo esicutshini sakho sezinso. Kungase kuhlanganise ulwazi mayelana nokuvuvukala, ukulimala, ukufakwa kwamaprotheni, noma ezinye izinguquko ezibonisa izifo ezithile. Udokotela wakho uzokuchaza ukuthi lokhu okutholakele kusho ukuthini ngesimo sakho esithile.

Okutholakele okuvamile emibikweni ye-biopsy yezinso kufaka imininingwane mayelana ne-glomeruli (izihlungi ezincane ezinso zakho), ama-tubules (amashubhu amancane acubungula umchamo), kanye nezicubu ezizungezile. Udokotela wezifo uzobhala ukuthi lezi zakhiwo zibonakala zivamile noma zikhombisa izimpawu zesifo noma ukulimala.

Udokotela wakho uzohlela i-aphoyintimenti yokulandela ukuze axoxe ngemiphumela yakho ngemininingwane futhi achaze ukuthi isho ukuthini ngohlelo lwakho lokwelapha. Le ngxoxo ibaluleke njenge-biopsy uqobo, ngakho unganqikazi ukubuza imibuzo nganoma yini ongayiqondi.

Yiziphi izici eziyingozi zokudinga i-biopsy yezinso?

Ezinye izimo nezici zenza kube nokwenzeka ukuthi uzodinga i-biopsy yezinso ngesinye isikhathi. Ukuqonda lezi zici eziyingozi kungakusiza ukuthi usebenze nodokotela wakho ukuze uqaphele impilo yakho yezinso ngokusondela.

Izimo eziningana zezokwelapha zikhuphula amathuba akho okuthuthukisa izinkinga zezinso ezingase zidinge i-biopsy. Lezi zimo zingathinta izinso zakho ngezindlela ezahlukene:

• Isifo sikashukela, ikakhulukazi uma usunesikhathi eside unaso
• Umfutho wegazi ophezulu ongazange ulawulwe kahle
• Izifo ze-Autoimmune ezifana ne-lupus, vasculitis, noma i-Goodpasture's syndrome
• Umlando womndeni wesifo sezinso
• Izifo zezinso zangaphambilini noma amatshe ezinso
• Imithi ethile engathinta ukusebenza kwezinso
• Ukuthola ukufakelwa kwezinso

Ubudala bungadlala indima futhi, njengoba ukusebenza kwezinso kwehla ngokwemvelo ngokuhamba kwesikhathi. Kodwa-ke, ukuba nalezi zici eziyingozi akusho ukuthi ngokuqinisekile uzodinga i-biopsy. Ukuqapha njalo nokuphathwa okuhle kwezimo eziyisisekelo kuvame ukuvimbela isidingo sale nqubo.

Yiziphi izinkinga ezingaba khona ze-biopsy yezinso?

Nakuba ukuhlolwa kwezinso ngokuvamile kuyizinqubo eziphephile, njenganoma iyiphi inqubo yezokwelapha, zithwala ezinye izingozi. Izindaba ezinhle ukuthi izinkinga ezingathi sína azivamile, zenzeka ngaphansi kuka-1% wamacala, futhi ithimba lakho lezokwelapha lilungele kahle ukubhekana nanoma yiziphi izinkinga ezingase zivele.

Nawa amaphutha angase abe khona okufanele uwazi, kusukela ezinkingeni ezivamile ezingashoni kuya ezinkingeni ezingavamile kodwa ezingathi sína:

• Ukuphuma igazi eduze kwesinso (okuvamile kakhulu, ngokuvamile okuncane futhi kuyazimisela)
• Igazi emchameni izinsuku ezimbalwa ngemva kwenqubo
• Ubuhlungu noma ubuhlungu endaweni yokuhlolwa
• Ukutheleleka endaweni yokufakwa kwenelidi (akavamile kakhulu)
• Ukuphuma igazi okukhulu okudinga ukumpontshwa kwegazi (akavamile, ngaphansi kwecala elingu-1 kwangu-100)
• Umonakalo ezithweni eziseduze (akavamile kakhulu)
• Ukwakheka kokuxhumana phakathi kwemithambo yegazi kanye nohlelo lomchamo (akavamile kakhulu)

Ithimba lakho lezempilo lizokuqapha ngemva kwenqubo ukuze libheke noma yiziphi izimpawu zezinkinga. Abantu abaningi bathola ukuqina okuncane kuphela futhi babuyela emisebenzini ejwayelekile ezinsukwini ezimbalwa.

Kufanele ngibone nini udokotela ngemva kokuhlolwa kwami kwesinso?

Ngemva kokuhlolwa kwakho kwesinso, kubalulekile ukwazi ukuthi ungathintana nini nethimba lakho lezempilo. Nakuba ukungakhululeki okuncane kujwayelekile, ezinye izimpawu zidinga ukunakekelwa kwezokwelapha ngokushesha ukuze kuqinisekiswe ukuphepha kwakho nokuphulukiswa okufanele.

Xhumana nodokotela wakho ngokushesha uma uhlangabezana nanoma yiziphi lezi zimpawu zokuxwayisa ngemva kokuhlolwa kwakho:

• Ubuhlungu obukhulu obungathuthuki ngemithi ebhalwe ngudokotela yobuhlungu
• Ukuphuma igazi eliningi endaweni yokuhlolwa
• Inani elikhulu legazi emchameni wakho elinganciphi ngokuhamba kwesikhathi
• Umkhuhlane ongaphezu kuka-100.4°F (38°C)
• Isiyezi, ubuthakathaka, noma ukuquleka
• Ubunzima bokuchama noma ukungakwazi ukuchama
• Izimpawu zokutheleleka njengokwanda kobubomvu, ukufudumala, noma ukukhipha endaweni yokuhlolwa

Udktela wakho uzophinda ahlele ukuqokwa okulandelayo ukuze axoxe ngemiphumela yakho ye-biopsy futhi ahlele ukwelashwa kwakho. Lokhu kuvame ukwenzeka phakathi nesonto elilodwa noma amabili ngemva kwenqubo yakho, kunikeze isikhathi esanele ku-pathologist ukuqedela ukuhlaziya kwabo.

Imibuzo evame ukubuzwa mayelana ne-biopsy yezinso

Umbuzo 1. Ingabe ukuhlolwa kwe-biopsy yezinso kulungile ekuxilongeni isifo sezinso?

Yebo, i-biopsy yezinso ithathwa njengezinga legolide lokuxilonga izifo eziningi zezinso. Inikeza imininingwane enemininingwane futhi enembile mayelana nokwenzekayo ezinso zakho ezingeni leselula. Ngenkathi ukuhlolwa kwegazi nokucabanga kungase kusikisela izinkinga zezinso, i-biopsy kuphela engakwazi ukukhomba ngokuqinisekile uhlobo oluthile lwesifo sezinso futhi inqume ukuthi sithuthuke kangakanani.

I-biopsy isiza udokotela wakho ukuthi ahlukanise phakathi kwezinhlobo ezahlukene zezifo zezinso ezingase zibangele izimpawu ezifanayo. Lokhu kuxilongwa okunembile kubalulekile ngoba izifo zezinso ezihlukene zidinga ukwelashwa okuhlukene, futhi okusebenzayo kwesinye isimo kungenzeka kungasebenzi kwenye.

Umbuzo 2. Ingabe i-biopsy yezinso ibuhlungu?

Abantu abaningi bathola ukuqina okuncane kuya kokulingene ngesikhathi se-biopsy yezinso. I-anesthetic yendawo idambisa indawo lapho inaliti ingena khona, ngakho akufanele uzwe ubuhlungu obukhulu ngesikhathi senqubo yangempela. Ungase uzwe ukucindezela okuthile noma umuzwa wokucindezela okufushane lapho inaliti ye-biopsy ifakwa.

Ngemva kwenqubo, ungase ube nobuhlungu obuthile noma ubuhlungu emhlane wakho noma ohlangothini lwakho izinsuku ezimbalwa, okufana nokulimala okujulile. Udokotela wakho uzokunikeza imithi yokudambisa ubuhlungu ukuze uzizwe ukhululekile ngesikhathi sokululama. Abantu abaningi bathola ukuthi ukuqina kulawuleka futhi kuthuthuka nsuku zonke.

Umbuzo 3. Kuthatha isikhathi esingakanani ukululama ku-biopsy yezinso?

Ukwelulama ngemva kokuhlolwa kwezinso ngokuvamile kuyashesha kubantu abaningi. Kuzodingeka uhlale esibhedlela ukuze ubhekwe amahora angu-4-6 ngemva kwenqubo ukuze uqiniseke ukuthi akukho ukopha noma ezinye izinkinga. Abantu abaningi bangabuyela emisebenzini elula phakathi kwama-24-48 amahora.

Kuzodingeka ukuthi ugweme ukuphakamisa izinto ezisindayo, ukuzivocavoca okunzima, nemisebenzi engase inyakazise umzimba wakho cishe isonto elilodwa. Udokotela wakho uzokunikeza imihlahlandlela ethile mayelana nokuthi ungalibuyela nini emsebenzini nasemisebenzini ejwayelekile ngokusekelwe emsebenzini wakho nasempilweni yakho yonke.

Q.4 Ingabe ukuhlolwa kwezinso kungayilimaza izinso zami?

Ingozi yokulimala unomphela kwezinso ngenxa yokuhlolwa iphansi kakhulu. Isampula elithathiwe lincane uma liqhathaniswa nosayizi wezinso zakho, futhi ukusebenza kwezinso zakho ngeke kuthinteke ngokususwa kwalesi sithako esincane. Izinso zakho zinamandla amangalisayo okuphola futhi zizoqhubeka nokusebenza ngokujwayelekile ngemva kwenqubo.

Ngenkathi ukopha okwesikhashana eduze kwezinso kungenzeka, lokhu ngokuvamile kulungiswa ngokwako ngaphandle kokubangela umonakalo ohlala njalo. Ithimba lakho lezokwelapha lisebenzisa izithombe ezithuthukisiwe ukuze liqondise inaliti ngokunembile, linciphisa noma iyiphi ingozi ezicutshini eziqashwe izinso.

Q.5 Kwenzekani uma imiphumela yokuhlolwa kwezinso yami ingajwayelekile?

Uma imiphumela yakho yokuhlolwa ikhombisa isifo sezinso, udokotela wakho uzosebenza nawe ukuthuthukisa uhlelo lokwelashwa olwenzelwe isimo sakho esithile. Uhlobo lokwelashwa luxhomekeke kulokho okudalulwa ukuhlolwa, kodwa izinketho zingabandakanya imithi yokunciphisa ukuvuvukala, ukulawula umfutho wegazi, noma ukucindezela umsebenzi wesistimu yokuzivikela komzimba.

Ukuba nemiphumela engajwayelekile akusho ukuthi isimo sakho asithembi. Izifo eziningi zezinso zingalawulwa ngempumelelo noma zibuyiswe ngokwelashwa okufanele. Udokotela wakho uzoqapha intuthuko yakho ngokucophelela futhi alungise ukwelashwa kwakho njengoba kudingeka ukuze uvikele ukusebenza kwezinso zakho nempilo yakho yonke.