Ka hōʻeha - kidney and ureter

ʻO ka hōʻeha i ka puʻupaʻa a me ka ureter ka mea e hōʻino i nā ʻāpana o ke ake urinary tract.

Aia nā puʻupaʻa i ka pale ma nā ʻaoʻao a ʻelua o ka iwi kuamoʻo. ʻO ka pale ka hope o ka ʻōpū luna. Pale ʻia lākou e ka iwi kuamoʻo, nā iwi ʻaoʻao i lalo, a me nā mākala ikaika o ke kua. Pale kēia wahi i nā puʻupaʻa mai nā mana waho he nui. Hoʻopuni pū ʻia nā puʻupaʻa e kahi papa momona. Kōkua ka momona i ka cushion iā lākou.

Loaʻa i nā puʻupaʻa kahi lako koko. ʻO kēlā me kēia ʻeha iā lākou, hiki i ke kahe koko nui. ʻO nā papa he nui e pale i ka hōʻeha ʻana o ka hakuʻala.

ʻEha paha nā hakuʻala e ka hōʻino ʻia o nā kīʻaha koko e hāʻawi a hoʻokahe paha iā lākou, e like me:

• ʻO Aneurysm
• Pahu ʻaʻa
• Fistula Arteriovenous
• ʻO ka thrombosis o ke aʻa koko (kāpili)
• Trauma

Hoʻokumu pū ʻia nā ʻeha puʻupaʻa e:

• ʻO Angiomyolipoma, kahi tumo noncancerous, inā nui loa ka tumo
• Nā maʻi Autoimmune
• ʻO ka pale ʻana i ka puka waho
• Ka maʻi ʻaʻai o ka puʻupaʻa, nā pelvic organ (ovaries a i ʻole uterus i nā wahine), a i ʻole kolona
• Diabetes
• ʻO ke kūkulu ʻana i nā huahana neoneo o ke kino e like me ka uric acid (hiki ke hana me ka gout a i ʻole ke mālama ʻana i ka iwi iwi, lymph node, a i ʻole nā ​​maʻi ʻē aʻe)
• Hōʻike i nā mea ʻona e like me ke kēpau, nā huahana hoʻomaʻemaʻe, nā mea hoʻoheheʻe, nā wahie, kekahi mau antibiotic, a hoʻohana lōʻihi paha o nā lāʻau ʻehaʻeha kiʻekiʻe (analgesic nephropathy)
• ʻO ke koko kiʻekiʻe a me nā ʻano olakino ʻē aʻe e hoʻopili i nā puʻupaʻa
• Hoʻopilikia ʻia e nā pane pale i nā lāʻau, maʻi, a i ʻole nā ​​maʻi ʻē aʻe
• ʻO nā kaʻina hana olakino e like me ka biopsy kidney, a i ʻole ka nephrostomy Tube kau
• ʻO ke keʻakeʻa ʻo Ureteropelvic
• Pākana Ureteral
• Pohaku hakuʻala

ʻO nā ureter nā paipu e halihali i ka mimi mai nā puʻupaʻa i ka pūpū. Hoʻokumu ʻia nā ʻeha ureteral e:

• Nā pilikia mai nā kaʻina hana olakino
• Nā maʻi e like me retroperitoneal fibrosis, retroperitoneal sarcomas, a i ʻole kanesa e pālahalaha aku i nā lymph node kokoke i nā ureter
• Maʻi pōhaku hakuʻala
• ʻO ka uila i ka ʻōpū
• Trauma

Pākuʻi ʻia paha nā ʻōuli pilikia:

• ʻEha o ka ʻōpū a me ka pehu
• ʻO kaʻeha flank koʻikoʻi a me kaʻeha hope
• Koko i ka mimi
• Hiamoe, hoʻēmi i ka makaʻala, me ke koma
• Hoemi i ka puka mimi a i ʻole hiki ʻole ke mimī
• Fiva
• Hoʻonui i ka helu o ka puʻuwai
• Nualea, luaʻi
• ʻĀkala o ka ʻili a ʻoluʻolu paha e hoʻopā
• Hoʻoulu

ʻO nā ʻōuli lōʻihi (mau) hiki ke hoʻopili ʻia:

• Kaʻai pono ʻole
• Piʻi koko kiʻekiʻe
• Hewa ʻole nā ​​hakuʻala

Inā hoʻokahi lākiō e loli a olakino nā kīʻaha ʻē aʻe, ʻaʻohe ou mau ʻōuli.

E nānā ka mea mālama ola iā ʻoe. E hoʻomaopopo iā lākou e pili ana i nā maʻi o kēia manawa a i ʻole inā ua ʻike ʻoe i nā lāʻau ʻona.

Hōʻike paha ka hōʻike:

• ʻO ke kahe nui ʻana (hemorrhage)
• Ka palupalu loa ma luna o ka puʻupaʻa
• Pākuʻi, me ka wikiwiki o ka puʻuwai a i ʻole ke hāʻule ʻana o ke koko
• Nā ʻōuli o ke kīnā ʻole o ke kō

ʻO nā hoʻāʻo e hana ʻia ana paha:

• Scanner CT ʻōpū
• ʻO MRI ʻōpū
• ʻO ke ultrasound ʻōpū
• Angiography o ke aʻa aʻa aʻaʻa paha
• Nā uila electrolytes
• Nānā ke koko e nānā no nā mea ʻona
• Helu piha koko (CBC)
• ʻO ka pyelogram Intravenous (IVP)
• Nā hoʻāʻo hana hakuʻala
• Retrograde pyelogram
• Pāhawewe x-ray
• Mīkini hōʻeuʻeu
• Urinalysis
• Ke aʻo Urodynamic
• Voiding cystourethrogram

ʻO nā pahuhopu ka mālama ʻana i nā ʻōuli pilikia a pale a mālama ʻana i nā pilikia. Pono ʻoe e noho i kahi haukapila.

ʻO nā mālama ʻana no ka ʻeha puʻuwai e komo pū paha:

• Hoʻomaha hoʻomaha moe no 1 a 2 mau pule a i ʻole e hoʻoliʻiliʻi ke kahe ʻana o ke kahe
• Pani ka nānā ʻana a me ka mālama ʻana i nā ʻōuli o ke kō ʻole o ka hakuʻala
• Hoʻololi nā meaʻai
• Nā lāʻau lapaʻau e mālama ai i ka poino i hoʻokumu ʻia e nā mea ʻona a i ʻole nā ​​maʻi (ʻo kahi laʻana, chelapy therapy no ka lāʻau make kēpau a i ʻole allopurinol e hoʻohaʻahaʻa i ka uric acid i ke koko ma muli o ka gout)
• Nā lāʻau ʻeha
• Ka hoʻopau ʻana i nā lāʻau a i ʻole ke hōʻike ʻana i nā mea i hōʻeha paha i ka puʻupaʻa
• Nā lāʻau e like me corticosteroids a i ʻole immunosuppressants inā hōʻeha ka hopena
• Iapaau ana o huʻi hakuʻala ole

I kekahi manawa, pono ke ʻoki. Hoʻopili paha kēia:

• Hoʻoponopono i kahi "haʻihaʻi" a i nāhaʻi haehae ʻia, nā kīʻaha koko i haehae ʻia, ureter weluwelu, a i ʻole ʻeha like
• Ke wehe nei i ka hakuʻala holoʻokoʻa (nephrectomy), hoʻokahe i ke ākea a puni ka puʻupaʻa, a i ʻole ke kū ʻana i ke kahe ʻana ma o ka catheterization arterial (angioembolization)
• Ke kau nei i kahi stent
• Ke lawe nei i ka palaka a me ka hoʻomaha ʻana i ka ālai

Maikaʻi kāu hana ma muli o ke kumu a me ke koʻikoʻi o ka ʻeha.

I kekahi manawa, hoʻomaka hou ka hakuʻala e hana hou. I kekahi manawa, kū ʻole ka hakuʻala.

Komo pū nā pilikia:

• Hewa kōpaʻa hiki ʻole, hoʻokahi a i ʻole nā ​​konāhua ʻelua
• ʻO ke kahe ʻana (ʻemi a koʻikoʻi paha)
• ʻEha o ka hakuʻala
• Hewa ʻōniʻoniʻo maʻi, hoʻokahi a i ʻole nā ​​konāhua ʻelua
• Maʻiʻaʻai (peritonitis, sepsis)
• ʻEha
• Stenosis
• Hypertension Renal
• Pāhaʻi
• Maʻi ʻaʻai Urinary

Kāhea i kāu mea hāʻawi inā loaʻa iā ʻoe nā ʻōuli o kahi ʻeha i ka puʻupaʻa a i ʻole ureter. Kāhea i ka mea hāʻawi inā loaʻa iā ʻoe ka mōʻaukala o:

• Hōʻike i nā mea ʻona
• Maʻi
• Maʻi kīnā
• ʻEha kino

E hele i ka lumi pilikia a kāhea paha i ka helu kūloko kūloko (e like me 911) inā ua hōʻemi ʻoe i ka puka mimi ma hope o ka hōʻeha ʻana o ka hakuʻala. He hōʻailona paha kēia o ke kīnā ʻole o ka hakuʻala.

Hiki iā ʻoe ke pale i ka hōʻeha i nā puʻupaʻa a me ka ureter ma ka lawe ʻana i kēia mau hana:

• E makaʻala i nā mea i hiki ke hoʻonā i ka lāʻau make kēpau. Hoʻopili kēia i nā pena kahiko, nā mahu mai ka hana ʻana me nā metala i uhi ʻia i ke kēpau, a me ka waiʻona i hoʻomaʻemaʻe ʻia i nā radiator kaʻa hana hou.
• Lawe pono i kāu mau lāʻau āpau, e like me nā mea āu e kūʻai ai me ka ʻole o ka kuhikuhi (over-the-counter).
• Mālama i ka gout a me nā maʻi ʻē aʻe e like me ke kauoha a kāu mea hāʻawi.
• E hoʻohana i nā pono palekana i ka wā o ka hana a me ka pāʻani.
• E hoʻohana i nā huahana hoʻomaʻemaʻe, nā mea hoʻoheheʻe, a me nā wahie e like me ke kuhikuhi. E nānā pono i ka hoʻoliʻiliʻi maikaʻi o ka wahi, no ka mea, ʻona pū kekahi paha ka uahi.
• E komo i nā kāʻei noho a hoʻokele palekana.

Poino hakuʻala; ʻEha ʻino o ka hakuʻala; ʻEha ʻino. ʻO ka hōʻeha hōʻeha o ka puʻupaʻa; ʻOiwi puʻupuʻu; ʻO ka hōʻeha hōʻeha o ka hakuʻala; ʻEha puʻupuʻu; ʻEha Ureteral; Hewa kōpaʻa mua - hōʻeha; Hoka hope-hōʻeha - hōʻeha; Pāpale hakuʻala - hōʻeha

• Anatomia hakuʻala
• ʻO Kidney - ke kahe o ke koko a me ka mimi

ʻO Brandes SB, Eswara JR. ʻO ka trauma urinary tract luna. I: Partin AW, Dmochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Piladelapia, PA: Elsevier; 2021: chap 90.

ʻO Okusa MD, Portilla D. Pathophysiology o ka ʻeha puʻuwai koʻikoʻi. I: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal MW, eds. ʻO Brenner a me Rector's The Kidney. 11th hua. Piladelapia, PA: Elsevier; 2020: chap 28.

ʻO Shewakramani SN. ʻŌnaehana genitourinary. I: Nā paia RM, Hockberger RS, Gausche-Hill M, nā ʻaoʻao. ʻO Rosen's Emergency Medicine: Nā Manaʻo Manaʻo a me ka hana lapaʻau. 9th ed. Piladelapia, PA: Elsevier; 2018: chap 40.