Lesi sihloko sinikezelwe kubo bonke abanikazi bezilwane ezifuywayo abaphatha izilwane zabo ngesineke nangokucophelela. Noma behamba bazoluzwa uthando lwakho.

01 inani lezilwane ezifuywayo ezinokwehluleka kwezinso liyakhula unyaka nonyaka

Ukuhluleka kwe-renal acute kuyahlehla kancane, kodwa ukwehluleka kwezinso okungapheli akunakulungiseka ngokuphelele. Abanikazi bezilwane ezifuywayo bangenza izinto ezintathu kuphela:

1: Yenza umsebenzi omuhle kuyo yonke imininingwane yempilo, futhi uzame ukungavumeli izilwane ezifuywayo zibe nokwehluleka kwezinso ngaphandle kwezingozi;

2: Ukuhluleka kwe-renal acute, ukuhlolwa kusenesikhathi, ukwelashwa kusenesikhathi, ungangabazi, ungalibali;

3: Uma kusheshe kutholakale futhi kwelashwe ukwehluleka kwezinso okungamahlalakhona, isikhathi sokuphila siba side;

02 Kungani ukwehluleka kwezinso kunzima ukululama

Kunezizathu ezimbili eziyinhloko zokuthi kungani ukwehluleka kwezinso kube kubi futhi kube nzima ukukwelapha:

1: Njengoba kushiwo ngaphambili, ngaphandle kokuthi ukwehluleka okukhulu kwezinso okubangelwa ubuthi kanye ne-ischemia yendawo kungase kushintshwe, okunye akulungiseki. Uma ukulimala komsebenzi wezinso kwangempela kunzima ukululama, futhi awukho umuthi wangempela wokwehluleka kwezinso ezifuywayo emhlabeni, konke okuyizakhi kanye nezithako;

2: Siyazi sonke ukuthi izinso iyisitho esigodliwe somzimba wethu, okungukuthi, sinezinso ezimbili. Uma umuntu elimele, umzimba usengakwazi ukusebenza ngendlela evamile, futhi ngeke sizwe isifo. Izinso zibonisa izimpawu kuphela lapho cishe u-75% womsebenzi wayo ulahlekile, yingakho ukwehluleka kwezinso kuba sekwephuzile kakhulu noma kuncane uma kutholakala, futhi zimbalwa izindlela zokwelapha ezitholakalayo.

Uma umsebenzi wezinso ulahlekile ngo-50%, indawo yangaphakathi isalokhu izinzile, futhi cishe akunakwenzeka ukubona izinkinga; Ukulahlekelwa umsebenzi wezinso ngu-50-67%, umthamo wokuhlushwa ulahlekile, inani le-biochemical ngeke lishintshe, futhi umzimba ngeke ubonise ukusebenza, kodwa ezinye izivivinyo ezingenzeka, njenge-SDMA, zizokhula; Ukulahlekelwa komsebenzi wezinso kwakuyi-67-75%, futhi kwakungekho ukusebenza okusobala emzimbeni, kodwa i-biochemical urea nitrogen ne-creatinine yaqala ukuphakama; Ngaphezu kwama-75% wokulahleka kokusebenza kwezinso kuchazwa njengokuhluleka kwezinso kanye ne-uremia ethuthukisiwe.

Ukubonakaliswa okusobala kakhulu kokwehluleka kwezinso okukhulu ukuncipha ngokushesha komchamo wesilwane esifuywayo, yingakho ngidinga ukuthi wonke umnikazi wesilwane abheke umthamo womchamo wesilwane sakhe esifuywayo nsuku zonke. Lokhu kunzima kakhulu kubanikazi bezilwane ezifuywayo abavame ukuvumela amakati nezinja ukuba ziphume ngokukhululeka, ngakho ngokuvamile kuba umzuzu wokugcina ukuthi lezi zilwane ezifuywayo zigule.

03 ezinye iziguli ezinokwehluleka kakhulu kwezinso zingase zilulame

Nakuba ukwehluleka okukhulu kwe-renal ekuhlulekeni kwe-renal kunokuqala okusheshayo nezimpawu ezibucayi, kusengenzeka ukululama, ngakho-ke kubaluleke kakhulu ukugwema ukuvela kokuhluleka kwe-renal acute futhi uthole imbangela yalesi sifo. Ukwehluleka okukhulu kwezinso kubangelwa kakhulu yi-ischemia yendawo, ukuvinjelwa kohlelo lomchamo kanye nobuthi.

Isibonelo, u-20% wegazi elinikezwa inhliziyo yinso, kuyilapho u-90% wegazi lezinso udlula ku-renal cortex, ngakho-ke le ngxenye isengozini enkulu ye-ischemia kanye nomonakalo obangelwa ubuthi. Ngakho-ke, sivame ukuthola ukuthi izifo zezinso nenhliziyo zivame ukuhlobana. Uma omunye umubi, esinye isitho siba sengozini futhi sithambekele ezifweni. Izimbangela ezivamile zokwehluleka kwezinso okubangelwa yi-ischemia zihlanganisa ukuphelelwa amanzi emzimbeni, ukopha okukhulu kanye nokusha.

Uma ukuphelelwa amanzi emzimbeni, ukopha nokusha kungelula ukwenzeka, into evame kakhulu ukwehluleka kwezinso okukhulu ekuphileni kwansuku zonke ukwehluleka okukhulu kwezinso okubangelwa ukuvaleka kwesistimu yomchamo. Ngokuvamile kuba amatshe esinyeni kanye ne-urethral, ​​ukuvinjelwa kwekristalu, i-urethritis, ukuvuvukala nokuvinjelwa kwe-catheter yomchamo. Ukuvinjelwa kubangela ukunqwabelana komgudu womchamo, kuvinjwe ukucwengwa kwe-glomerular, kwandise i-nitrogen engeyona amaprotheni egazini, okuholela ku-glomerular basement necrosis. Lesi simo kulula ukusehlulela. Uma nje umchamo uvaliwe isikhathi esingaphezu kwamahora angu-24, kufanele sihlole i-biochemistry ukuze siqinisekise ukuthi abukho ukwehluleka kwezinso. Lolu hlobo lokwehluleka kwezinso luwukuphela kokungasebenzi kahle kwezinso okungalulama ngokuphelele ezinsukwini ezimbalwa, kodwa uma kubambezeleka, kungase kubhebhethekise isifo noma kuphenduke ukwehluleka kwezinso okungapheli ezinsukwini ezimbalwa.

Izinhlobo ezingaphansi ezengeziwe zokwehluleka kwezinso okukhulu zibangelwa ubuthi. Ukudla amagilebhisi nsuku zonke kukodwa, futhi okukhulu ukusetshenziswa okungalungile kwezidakamizwa. Emanzini kanye ne-electrolyte yoketshezi lwe-glomerular filtration fluid, amangqamuzana e-renal tubular epithelial avezwa ekugxilweni okukhulayo koshevu. Ukukhishwa noma ukumuncwa kabusha koshevu ngamaseli e-renal tubular epithelial kungase kwenze ubuthi buqongelele ekugxiliseni okuphezulu kumaseli. Kwezinye izimo, ubuthi be-metabolite bunamandla kunalowo wama-precursor compounds. Umuthi oyinhloko lapha yi-"gentamicin". I-Gentamicin iyisidakamizwa esilwa nokuvuvukala emathunjini, kodwa sinephrotoxicity enkulu. Ezimweni eziningi, ngisho nasesibhedlela, uma ukuxilongwa nokwelashwa kungalungile, kulula ukubangela ukwehluleka okunamandla kwezinso okubangelwa ubuthi.

Ngincoma kakhulu ukuthi abanikazi bezilwane ezifuywayo bazame ukungazijovi i-gentamicin lapho bekhetha. Ngaphezu kwalokho, izilwane ezifuywayo ezinezinso ezimbi zidinga ukunaka imithi. Imithi eminingi elwa nokuvuvukala izokhombisa ukungasebenzi kahle kwezinso kuma-contraindication. Sebenzisa ngokuqapha, i-cephalosporins, i-tetracyclines, i-antipyretics, i-analgesics, njll.

04 ukwehluleka kwezinso okungapheli kudinga ukunakekelwa kwesiguli

Okuhlukile ekuhlulekeni okukhulu kwezinso, ukwehluleka kwezinso okungapheli cishe kunzima ukukuthola, futhi azikho izimpawu ezicacile esigabeni sokuqala sokuqala. Mhlawumbe kuzoba nomchamo omningi kunokuvamile, kodwa asikwazi ukwahlulela ekuphileni kwethu kwansuku zonke ukuthi kungenxa yokwanda komthamo womchamo obangelwa isimo sezulu esishisayo, imisebenzi eminingi nokudla okomile. Ngaphezu kwalokho, kunzima ukucacisa imbangela yokwehluleka kwe-renal okungapheli. Njengamanje, okungasetshenziswa njengesithenjwa yizifo ze-glomerular, njenge-nephritis, i-nephropathy ye-genetic innate, ukuvinjelwa kwe-urethral, ​​noma ukwehluleka kwezinso okungapheli ngaphandle kokwelashwa okufika ngesikhathi.

Uma ukwehluleka kwezinso okukhulu nakho kungasheshisa ukululama ngokwandisa ukuhlinzekwa kwamanzi okuphuza, umjovo wamanzi ongaphansi kwesikhumba, i-dialysis nezinye izindlela zokugaya ubuthi nokunciphisa umthwalo ezinso. Ayikho indlela yokubuyisela ukusebenza kwezinso ekuhlulekeni okungapheli kwezinso. Okuwukuphela kwento esingayenza ukunciphisa ijubane lokulimala kwezinso nokwandisa ukuphila kwezilwane ezifuywayo ngokudla kwesayensi nezinye izakhamzimba, ezifana ne-calcium supplement, ukusetshenziswa kwe-erythropoietin, ukudla ukudla okunikezwa udokotela kanye nokunciphisa ukudla kwamaprotheni. Enye into okufanele uyiqaphele ukuthi ukwehluleka okuningi kwezinso kuzohambisana nokuncipha kokusebenza kwe-pancreatic, kanye ne-pancreatitis, nayo edinga ukunakwa.

Indlela engcono kakhulu yokubhekana nokuhluleka kwezinso okungamahlalakhona ukukuthola kusenesikhathi. Uma itholakala kusenesikhathi, isimo sokuphila singagcinwa singcono. Emakati, lapho ukuhlolwa kwe-biochemical ye-urea nitrogen, i-creatinine ne-phosphorus kuyinto evamile, i-SDMA ingahlolwa njalo kanye ngonyaka ukuze kutholakale ukuthi kukhona yini ukwehluleka kwezinso okungapheli. Nokho, lokhu kuhlolwa akulona iqiniso ezinjeni. Kwaze kwafika ngo-2016 e-United States lapho saqala khona ukufunda ukuthi lokhu kuhlolwa kungasetshenziswa yini ezinjeni. Ngenxa yokuthi inani lokuhlola lihluke kakhulu kulelo lamakati, alikwazi ukusetshenziswa njengenkomba yokuxilonga yezinja esigabeni sokuqala sokuhluleka kwezinso okungapheli. Isibonelo, i-25 ukuphela kwesigaba sesi-2 noma ngisho nokuqala kwesigaba sesi-3 sokuhluleka kwezinso okungapheli kwamakati, Ezinjeni, ezinye izazi zikholelwa ukuthi ngisho nangaphakathi kwebanga lezempilo.

Ukwehluleka kwezinso okungapheli kwamakati nezinja akusho ukufa, ngakho abanikazi bezilwane ezifuywayo kufanele bazinakekele ngesineke nangokucophelela ngesimo sengqondo esinokuthula. Okunye kuncike esiphethweni sabo. Ikati engalinika ozakwethu phambilini kwatholakala ukuthi linokwehluleka kwezinso okungapheli lapho ngineminyaka engu-13 ubudala. Lalidliswa ngokwesayensi ngezidakamizwa ngesikhathi. Lapho ngineminyaka engu-19, ngaphandle kokuguga okuthile kwamathambo namathumbu nesisu, ezinye zihle kakhulu.

Lapho bebhekene nokwehluleka kwezinso zezilwane ezifuywayo, abanikazi bezilwane banezinketho ezimbalwa okufanele bazenze, inqobo nje uma bephatha ngenkuthalo, bekhulisa futhi badle ngokwesayensi ngokwamandla abo, kunzima kakhulu, kunzima kakhulu noma cishe akunakwenzeka ukubuyisela ngokuphelele inani elijwayelekile. Kuhle ukuba ne-creatinine ne-urea nitrogen ebangeni elijwayelekile nangaphezulu kancane. Kuyisibusiso sabo ukululama, Uma ekugcineni uhamba, umnikazi wesilwane uzozama konke okusemandleni akhe. Ukuphila kuhlale kuzalwa kabusha. Mhlawumbe bazobuyela kuwe futhi maduze nje, inqobo nje uma uzimisele ukukholwa.