Iingxaki kunye nokunyangwa kwesi sifo esingaqhelekanga sezintso
Sibanzi
Njengoko igama libonisa, iinjongo zamahashe yinto engavumelekanga apho izintso zombini zidibanisa ndawonye ukuze zenze ihashe. Nangona kunjalo, akukhona nje ukuma kunye nesakhiwo sezintso ezingaqhelekanga. Indawo yabo ayiqhelekanga ngokunjalo.
Kunokuba ube khona kwisisu esiphezulu, ngaphantsi kwembambo yentambo kunye nomqolo wakho, iinjongo zehashe zibonakala ziphantsi kakhulu kwi-pelvis.
Oku akusiyo kuphela imfuza engafaniyo yezintso 'indawo okanye isakhiwo. Omnye umzekelo oqhelekileyo yinto ethiwa " intso ye-ectopic ." Ngaphambi kokuba siqonde ukuba kutheni iifom zehashe kunye neempembelelo zayo, kubalulekile ukuqonda ukubunjwa okuqhelekileyo kweentliziyo zabantu ngexesha lophuhliso lwethu kwisibeleko.
Ukuqonda ukuQalwa koLuntu lweNtliziyo
Xa sisesigxina se-embryonic kwaye sihlakulela ekubeni ngumntu ogcweleyo, iintso zethu zihamba kwiinqanaba ezintathu zokuphuhlisa ngaphambi kokuba kuqhutywe iinjongo ezisebenzayo kwaye zivuthiwe:
- Pronephros
- Mesonephros
- Metanephros
Cinga isobho esikhulu kakhulu seeseli kunye nezakhiwo zokuqala eziza kubumbana kunye neengxaki eziqhutywe ngokupheleleyo. Isigaba se-metanephros sifumaneka kwiiveki ezi-6 zesigxina. Ihlanganiswe yinto ebizwa ngokuba yi-mesenchyme yemetanephric kunye ne "bud bud". Ezi zakhiwo ziya kugqityha iifom kunye ne-ureter.
Kutheni sifuna ukuqonda le nkqubo yokwenza izinto? Ewe, xa sinokuqonda ukuba iinjongo zabantu zijongene neenguqu ezithile zengqungquthela kunye neemeko ezize zifikelele ekugqibeleni kwindlela yazo yokugqibela, kuba lula ukuqonda ukungaqhelekanga njengentliziyo yamahhashi. Ngoko kunomdla ukuqaphela ukuba isiteji esichazwe ngentla esichazwe ngasentla (esandulela intsholongwane eqhutywayo) empeleni ibekwe kwi-pelvis yethu, kwaye kungekhona apho iphoso elivuthiweyo likhona (isisu esisisigxina)!
Njengoko sivuthiwe sisuka kumbungu singena kumntwana, ukukhula kwemizimba yethu kubangela ukutshintsha kwisimo esifanelekileyo sale ntliziyo ekhulayo njengokuba isuka kwi-pelvis kwaye ngokukhawuleza iphakama kwindawo yayo yokugqibela (ngaphantsi kwembambo yentambo kunye nomqolo wesigxina ). Ngokutsho nje, izintso ziya kunyuka, ngokutsho, zijikeleza ngaphakathi ukuze oko kuthiwa "i-pelal pelvis" ngoku ibhekane nomqolo wamagxa. Le nqubo ibizwa ngokuba yijikelezo, ngelixa ukuphakama kweentso kwindawo yayo yokugqibela kuthiwa ukufuduka. Le nkqubo izaliswe ngethuba le-embryo li-8 iiveki ubudala.
Ngoku ukuba sinokujonga ngokubanzi ukubunjwa kweentso zabantu, sinokuqala ukuqaphela ukuba nayiphi na ukuphazamiseka nokujikeleza okanye ukunyuka kweenkqubo kuya kuthetha ukuba kungekhona nje ukuba iintso zethu zifumaneke kwindawo engafanelekanga, kwaye mhlawumbi zinokuphela yaxhamla kwisisombululo esisodwa, kunokuba iincinci ezilungileyo kunye nekhohlo zihluke.
Uqeqesho
Iinjongo zamahashe yinto esiyibiza ngokuthi "i-fusion anomaly". Njengoko igama libonisa, i-fusion anomaly iya kwenzeka xa intso enye ixhomekeke kwenye. Oku kuya kwenzeka ngenxa yokuphazamiseka kwinkqubo yokufuduka kweentlobo zombini. Into encinane engabonakaliyo yinto apho ukufuduka okungavumelekanga kuthintela intso enye kuphela kunye, ekhokelela kwiintlobo zombini ezikhoyo kwicala lomgcini.
Oku kuthethwa ngokuthi "intso e-ectopic edibeneyo."
Kwiintliziyo eziqhelekileyo zeengxoworha, isigxina sezantsi sezintso siya kufakwa kunye kunye nokuveliswa kwimoya efana nehashe. Iibhubhu ezivutha umchamo kwizintso zethu (ezibizwa ngokuba yi-ureters) zikhoyo kwaye zixhamla kwicala ngalinye. Ingxenye ephihliweyo yeentso ibizwa ngokuba yi "isthmus.
Esi sithintelo sinakho okanye asikwazi ukulala ngokulinganayo phezu komgudu. Ukuba ilala ngaphaya kwelinye icala, siyibiza ngokuthi "i-kidney horsehoe kidney". Iifom zezintso ezisebenzayo zinokuthi okanye zingabi yiyo isthmus, kwaye ngoko akuqhelekanga ukubona nje iiintso ezibini eziqhotyoshelwe ngumbumba ongasebenzi.
Ukukhula
Ngokomyinge, uphando luchaze ubukho beentliziyo zamahhashi kunoma yiphi indawo ukusuka kwizigulane ezingama-0.4 ukuya kwezi-1.6, kuzo zonke iifama eziyi-10 ezizalwayo. Nangona kunjalo, oku kungenxa yeziganeko kuphela. Iziganeko zangempela zinokuba ziphakamileyo kuba ukufumaneka kweentliziyo zamahhashi kudla ukungaziwa kwisigulane esichaphazelekayo.
Iimpawu
Uninzi luya kuthi. Enyanisweni, iinjongo zehashe zivame ukuba zifunyenwe kwizifundo zengcamango ezenzelwe ezinye izizathu. Nangona kunjalo, xa izibonakaliso zikhona, zihlala zihambelana nokungaqhelekanga kumgca womchamo owadalwa ngenxa yendawo engavumelekanga kunye nokuqhelaniswa kwezintso. Ezinye zeempawu zi:
- Ukuvutha ngexesha lokuvuthwa, ukwanda kwamaxesha okuvota, ukunyanzeliswa kwe-urinary-konke okudalwe ngenxa yokunyuka kobutyebi bokuphucula izifo. Olu tyekelo luyabonakala ngenxa yamanzi amaninzi asemanzini. Oku kukhokelela kwizikhonkwane zomchamo we-static, owona mgangatho ogqwesileyo ukuba ibhaktheriya ikhule kwaye ikhule
- Iplank okanye intlungu ye-pelvic ngenxa yokuphazamiseka ekuqhubeni komchamo
- Umngcipheko wokwanda kwamatye. Ezi zinto ziza kubangela ubuhlungu befenki okanye i-pelvic njengoko kuchaziwe ngasentla, kodwa kunokubangela ukubonakala kwegazi kumchamo. Amatye ngokwawo angakhokelela kwizifo zokungena kumanzi
- Ubukho be-urlu reflux kwi-bladder kwi-ureters, ezinokubangela umngcipheko wokwanda kwezifo zokuvuthwa kwamanzi kunye nokutshabalalisa izintso. Oku kubizwa ngokuba yi-VUR (reflux vesicoureteral)
- I-Hydronephrosis - oku kubhekisela kwinkqubo ephakanyisiweyo yokukhupha umchamo kwintliziyo. Lo mqobo ungadalwa yimpso okanye amatye angama-ureteral, kwakunye nokunyanzeliswa kwezigqeba zangaphandle.
- Olunye uhlobo olungavumelekanga ngokobulili-kuba iinjongo zehashe ziyinxalenye yecala eliqhelekileyo lokuvelisa izakhi zofuzo, ezinye iingxaki ze-urrogenital tract nazo zingaqatshelwa. Ezi zibandakanya iimvavanyo ezingabonakaliyo kumakhwenkwe, okanye kwisakhiwo esingaqhelekanga sesisu kumantombazana.
Iingxaki
Uninzi lweengxaki zivela kwiimpawu ezikhankanywe ngasentla kunye nemiqondiso yezintso zehashe, ezihlala zibandakanya ukukhutshwa kwindlela yokucoca.
Kuyathakazelisa ukuba izigulane ezinentliziyo yehashe zibonakala zinomngcipheko ophezulu wolu hlobo lwesifo seengso esibizwa ngokuba yi "Wilms tumor". Izizathu ezibangelwa le mngcipheko aziqondi kakuhle. Le nto yaqala ngokusekwa yiSizwe soLwazi lweNtsholongwane kaWil Wilms esaziwayo esadlulayo kangangeminyaka engama-30 kwaye safumanisa izigulane ezingama-41 kunye ne-Wilms toror eyabakho nokuba neentso zehashe.
Mhlawumbi inkxalabo ebalulekileyo kwimihla ngemihla, kukuba iinjongo zehashe ziyakwazi ukulimala ngenxa yokuxhatshazwa kwesisu. Ngokomzekelo, kwimeko yokulimala kwebhanti egcinwe ngexesha leengozi yemoto, ibhinti elisezantsi liyakunqumla isisu esiswini, kubandakanywa nezintso zehashe malunga nomgudu. Izintso zomntu eziqhelekileyo ezihlala phezulu kwaye ezingaxhunyiwe kunye ngokuqhelekileyo azikho mngcipheko omkhulu.
Ukuxilongwa
Njengoko kuchazwe ngasentla, iinjongo zehashe ziya kubonakala ngokubonakalayo kumfanekiso wesisu esisemthethweni. Uphando oluthe gqolo ludingeka ukuba ngaba iimpawu, imiqondiso okanye iingxaki ezichazwe ngasentla ziphawulwe. Ngokomzekelo, ukuba uye waxhatshazwa ngokuphindaphindiweyo kwezigulane zamagciwane kwisimo sezintso zehashe, ugqirha wakho wezintso uya kunconywa into ebizwa ngokuba yi-vostourethrogram (voCourethrogram) ye-void ukukhetha ukuba ngaba umlambo we-urlu reflux ukhona. Ezinye iimvavanyo ezinokuyalelwa ziquka:
- Imivavanyo yesenzo sezintso : ezi ziquka iimvavanyo zegazi ezifana ne-BUN namazinga okudala, kunye nokulinganisela kwe-GFR. Uvavanyo lwe-Urine lweprotheni okanye igazi nalo luncedo. Nceda ubone apha iinkcukacha.
- Ukukhangela kwe-Renal flow for confirming obstruction
- CT Urogram
Unyango
Ukuba akukho zinkathazo ezinkulu okanye malunga neempawu ezikhoyo, kwaye umsebenzi wezintso uqhelekileyo, akukho mfuneko yonyango efunekayo. Isigulane ke sifanele sasixwayiswe malunga neengxaki zabo zeentso ezibangelwa sisifo esibuhlungu esiswini. Ukuba kukho iingxaki eziphawulwayo ngenxa yokuphazamiseka ekuqhubeni umchamo, isiguli kufuneka sihlolwe ngutitshala (i-nephrologist kunye ne-urologist) ukugqiba inkqubo yesenzo esithile kwaye ubone ukuba ukulungiswa kocwangco kungakunciphisa umqobo. Kwizigulane ezininzi, ukuxela kwexesha elide kulungile.
ILizwi
Khumbula ukuba intliziyo yamahhashi yinto engavumelekanga ngokungaqhelekiyo yeentso 'isikhundla kunye nesakhiwo. Nangona ezininzi izigulane zingenayo impawu kwaye iifom zabo zamahashe ziza kufumaneka ngeso lengqondo kwi-imaging, khumbula ukuba iimpawu zingabikwa kwiqela elincinci yezigulane kwaye zihlala zihambelana nokukhutshwa komkhuhlane, umgudu wamatye okanye izifo zogcino.
Ukuba kukho izibonakaliso, unyango, kubandakanywa unyango wokuphelisa ukukhutshwa, kunokufuneka, kodwa ezininzi izigulane zingabonwa ngokukhuselekileyo kwaye akukho mvavanyo okanye unyango oluyimfuneko. Nangona kufuneka ukhumbule ingozi yokuzilimaza ngokwenyama kwiintso zehashe (ngokukodwa ukusuka kwintlungu engumzimba), khumbula ukuba ukuxela kwangaphambili ixesha elide!
> Imithombo:
> Fekak H, et al. Ulawulo lwezintso zehhashi ezisekelwe kwimiba engama-36. Prog Urol. 2004 Sep; 14 (4): 485-8.
> O'Brien J kwi-al. Ukucingwa kweenqwelo zamahhashi kunye neengxaki zabo.J Med Imaging Radiat Oncol. 2008 Juni; 52 (3): 216-26. i-doi: 10.1111 / j.1440-1673.2008.01950.x.
> Pascual Samaniego M, et al. Ukuqhaqhaqhaqha ngokugqithisileyo kwezintso zehashe. Actas Urol Esp. 2006 Matshi; 30 (4): 424-8.
> Neville H, et al. Isiganeko se-Wilms i-tumor kwiintshontsho zamahashe: ingxelo evela kwiQela leNkcazo yeSizwe ye-Wilms Tumor (NWTSG) .J Pediatr Surg. 2002 Aug; 37 (8): 1134-7.