Itsvo matombo

Dombo reitsvo rakasimba rakaumbwa nemakristasi madiki. Rimwe kana mamwe mabwe anogona kunge ari muitsvo kana ureter panguva imwe chete.

Itsvo matombo zvakajairika. Dzimwe mhando dzinomhanya mumhuri. Zvinowanzoitika muvacheche vasati vasvika.

Kune mhando dzakasiyana dzeitsvo matombo. Chinokonzera dambudziko rinoenderana nerudzi rwebwe.

Matombo anogona kuumba kana weti iine yakawanda kwazvo yezvimwe zvinhu zvinogadzira makristasi. Aya makristasi anogona kukura kuita matombo kwemavhiki kana mwedzi.

• Matombo eCalcium anowanzoitika. Dzinonyanya kuitika kuvarume vari pakati pemakore makumi maviri kusvika makumi matatu. Karusiyamu inogona kusangana nezvimwe zvinhu kugadzira dombo.
• Oxalate ndiyo yakajairika pane izvi. Oxalate inowanikwa mune zvimwe zvekudya senge sipinashi. Inowanikwawo muvhitamini C zvinowedzera. Zvirwere zvemukati mudumbu zvinowedzera njodzi pamatombo aya.

Matombo eCalcium anogona zvakare kuumba kubva mukubatanidza ne phosphate kana carbonate.

Mamwe marudzi ematombo anosanganisira:

• Cystine mabwe anogona kuumbwa mukati mevanhu vane cystinuria. Dambudziko iri rinofamba mumhuri. Inobata vese varume nevakadzi.
• Struvite matombo anowanzo kuwanikwa mune varume kana vakadzi vakadzokorora weti turakiti hutachiona. Matombo aya anogona kukura zvikuru uye anogona kuvhara itsvo, ureter, kana dundira.
• Uric acid matombo anowanzoonekwa mune varume kupfuura vakadzi. Zvinogona kuitika ne gout kana chemotherapy.
• Zvimwe zvinhu, semimwe mishonga, zvakare inogona kugadzira matombo.

Iyo yakanyanya njodzi yekukonzera itsvo matombo haisi kunwa zvinwiwa zvakakwana. Itsvo matombo anowanzoitika kana iwe ukaita isingasviki 1 litre (32 maunzi) weti pazuva.

Unogona kunge usina zviratidzo kudzamara matombo achifamba pasi machubhu (ureters) kuburikidza nawo weti inodururira mudundira rako. Kana izvi zvikaitika, matombo anogona kuvharisa kubuda kwerini kubva muitsvo.

Chiratidzo chikuru kurwadziwa kwakanyanya kunotanga nekumira nekukasira:

• Marwadzo anogona kunzwika mudumbu nzvimbo kana kudivi rekuseri.
• Marwadzo anogona kufamba achienda kunzvimbo yekugomera (kurwadziwa kwehuswa), machende (kurwadziwa kwepachende) muvarume, uye labia (kurwadziwa kwepamuviri) muvakadzi.

Zvimwe zviratidzo zvinogona kusanganisira:

• Wakajairika weti weti
• Ropa mune weti
• Kutonhora
• Kupindwa nechando
• Kusvotwa uye kurutsa

Anopa hutano anoita bvunzo dzepanyama. Nzvimbo yedumbu (dumbu) kana musana unganzwa uchirwadza.

Miedzo inogona kuitwa inosanganisira:

• Ropa bvunzo kutarisa calcium, phosphorus, uric acid, uye electrolyte mazinga
• Itsvo basa rekuyedza
• Urinalysis kuona makristasi uye kutsvaga masero matsvuku eropa mumurini
• Kuongorora kwebwe kuona mhando

Matombo kana kuvhara kunogona kuonekwa pa:

• Abdominal CT scan
• Abdominal x-ray
• Intravenous pyelogram (IVP)
• Itsvo Ultrasound
• Dzorerazve pyelogram

Kurapa kunoenderana nerudzi rwebwe uye nekuomarara kwezviratidzo zvako.

Itsvo matombo ayo madiki kazhinji anopfuura nepano system yako ega.

• Weti yako inofanira kumanikidzwa kuitira kuti dombo rigone kuponeswa uye kuyedzwa.
• Inwa angosvika magirazi matanhatu kusvika kumasere emvura pazuva kuti ubudise huwandu hwakawanda weti. Izvi zvichabatsira dombo kupfuura.
• Marwadzo anogona kunge akaipa kwazvo. Over-the-counter pain pain (semuenzaniso, ibuprofen uye naproxen), ingave yega kana pamwe chete nema narcotic, inogona kushanda zvakanyanya.

Vamwe vanhu vane marwadzo akakomba kubva kumatombo eitsvo vanofanirwa kugara muchipatara. Ungangoda kuwana zvinwiwa kuburikidza neIV kupinda mutsinga yako.

Kune mamwe marudzi ematombo, mupi wako anogona kupa mishonga yekudzivirira matombo kubva pakuumba kana kubatsira kuputsa nekubvisa izvo zviri kukonzera iro dombo. Iyi mishonga inogona kusanganisira:

• Allopurinol (yeuric acid mabwe)
• Mishonga inorwisa mabhakitiriya (yemabwe struvite)
• Diuretics (mapiritsi emvura)
• Phosphate mhinduro
• Sodium bicarbonate kana sodium citrate
• Mapiritsi emvura (thiazide diuretics)
• Tamsulosin yekuzorodza iyo ureter uye kubatsira dombo kupfuura

Kuvhiya kunowanzo kudikanwa kana:

• Dombo iri rakanyanya kukura kuti rikwanise kupfuudza roga.
• Dombo riri kukura.
• Dombo iri kuvhara weti kuyerera uye zvichikonzera hutachiona kana kukuvara kweitsvo.
• Marwadzo haagoni kudzorwa.

Nhasi, kurapa kwakawanda kuri kushoma zvakanyanya kupfuura munguva yakapfuura.

• Lithotripsy inoshandiswa kubvisa matombo zvishoma zvishoma pane imwe hafu yehafu (1.25 masentimita) ayo ari muitsvo kana ureter. Inoshandisa ruzha kana kuvhundutsa mafungu kuputsa matombo kuita zvidimbu zvidiki. Ipapo, zvidimbu zvematombo zvinosiya muviri mune weti. Iyo inonziwo extracorporeal kuvhunduka-wave lithotripsy kana ESWL.
• Maitiro anoitwa nekupfuudza chakakosha chishandiso kuburikidza nekacheka kekuvhiya kari paganda rako kumusana uye mukati meitsvo kana ureters anoshandiswa pamatombo makuru, kana kana itsvo kana nzvimbo dzakakomberedza zvisina kuumbwa zvakanaka. Dombo rinobviswa nehubhu (endoscope).
• Ureteroscopy inogona kushandiswa kumatombo mune yepasi weti turakiti. Laser inoshandiswa kuputsa dombo.
• Kazhinji, kuvhiya kwakavhurika (nephrolithotomy) kunogona kudikanwa kana dzimwe nzira dzisingashande kana zvisingaite.

Taura nemupi wako nezvekuti ndeapi marapirwo aungashandira.

Iwe unozofanirwa kutora matanho ekuzvichengeta. Matanho api aunotora anoenderana nerudzi rwebwe rauinaro, asi izvo zvinogona kusanganisira:

• Kunwa mvura yekuwedzera uye zvimwe zvinwiwa
• Kudya zvimwe zvekudya uye kucheka pane zvimwe zvekudya
• Kutora mishonga inobatsira kudzivirira matombo
• Kutora mishonga kuti ikubatsire kupfuudza dombo (anti-anogumbura zvinodhaka, alpha-blockers)

Itsvo matombo anorwadza, asi kazhinji nguva yacho inogona kubviswa mumuviri pasina kukonzera kukuvara kusingaperi.

Itsvo matombo anowanzo dzoka. Izvi zvinoitika kazhinji kana chikonzero chisingawanikwe uye kurapwa.

Iwe uri panjodzi ye:

• Urinary turakiti hutachiona
• Kukuvara kweitsvo kana kupora kana kurapwa kuchinonoka kwenguva refu

Kusanganiswa kwematombo eitsvo kunogona kusanganisira iko kuvharidzira ureter (acute unilateral obstructive uropathy).

Fonera mupiki wako kana iwe uine zviratidzo zveibwe reitsvo:

• Kurwadziwa kwakanyanya kumusana kana parutivi uko kusingaendi
• Ropa mune yako weti
• Fivha uye kutonhora
• Kusvipa
• Weti inonhuwa zvakaipa kana inotaridzika kunge makore
• Kunzwa kupisa kana uchiita weti

Kana iwe ukabatwa uine blockage kubva padombo, ndima inofanirwa kusimbiswa kungave nekubatwa mune strainer panguva yekuita weti kana nekutevera x-ray. Kuva nekurwadziwa pasina kunosimbisa kuti dombo rapfuura.

Kana iwe uine nhoroondo yematombo:

• Inwa mvura zhinji (magirazi matanhatu kusvika kumasere emvura pazuva) kuti ubudise weti yakakwana.
• Iwe ungangoda kutora mushonga kana kuita shanduko pane chako chikafu kune mamwe marudzi ematombo.
• Wako mupi angangoda kuita kuongororwa kweropa uye neweti kuti abatsire kuona matanho akakodzera ekudzivirira.

Renal calculi; Nephrolithiasis; Matombo - itsvo; Calcium oxalate - mabwe; Cystine - mabwe; Struvite - mabwe; Uric acid - matombo; Urinary lithiasis

• Hypercalcemia - kubuda
• Itsvo matombo uye lithotripsy - buditsa
• Itsvo matombo - kuzvitarisira
• Itsvo mabwe - chii kubvunza chiremba wako
• Percutaneous weti maitiro - kubuda

• Itsvo anatomi
• Itsvo - kuyerera kweropa uye weti
• Nephrolithiasis
• Intravenous pyelogram (IVP)
• Lithotripsy maitiro

American Urological Association webhusaiti. Kurapa manejimendi eitsvo matombo (2019). www.auanet.org/guidelines/kidney-stones-medical-mangement-guideline. Yakasvika Feb 13, 2020.

American Urological Association webhusaiti. Kuvhiya manejimendi ematombo: AUA / Endourology Society nhungamiro (2016) www.auanet.org/guidelines/kidney-stones-surgical-management-guideline. Yakasvika Feb 13, 2020.

Bushinsky DA. Nephrolithiasis. Mune: Goldman L, Schafer AI, eds. Goldman-Cecil Mushonga. 26th ed. Philadelphia, PA: Elsevier; 2020: chits. 117.

Fink HA, Unoda TJ, Eidman KE, et al. Dzokororo nephrolithiasis muvakuru: kuenzanisa kushanda kweanodzivirira ekurapa nzira. Rockville, MD. Sangano reHutano Hwekutsvagisa uye Hwakanaka (US) 2012; Chirevo Nha. 12-EHC049-EF. PMID: 22896859 pubmed.ncbi.nlm.nih.gov/22896859/.

Miller NL, Borofsky MS. Kuongorora uye kurapwa kwekurapa kweiyo weti lithiasis. Mune: Partin AW, Dmochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021: chits. 92.

Qaseem A, Dallas P, Forciea MA, Starkey M, Denberg TD; Clinical Guidelines Committee yeAmerican College yeVanachiremba. Kudya uye pharmacologic manejimendi yekudzorerazve nephrolithiasis muvakuru: kiriniki yekudzidzira nhungamiro kubva kuAmerican College yeVarapi. Ann Mukati Med. 2014; 161 (9): 659-667. PMID: 25364887 pubmed.ncbi.nlm.nih.gov/25364887/.

Ziemba JB, Matlaga BR. Nongedzo yenhungamiro: itsvo matombo. BJU Int. 2015; 116 (2): 184-189. PMID: 25684222. pubmed.ncbi.nlm.nih.gov/25684222/.