UPJ kuvharidzira

Ureteropelvic junction (UPJ) kuvharidzira idziviriro panguva iyo chikamu cheitsvo chinonamira kune imwe yemachubhu kudundira (ureters). Izvi zvinodzivirira kubuda kwerini kubva muitsvo.

UPJ kudzivirirwa kunowanzoitika muvana. Zvinowanzoitika kana mwana achiri kukura mudumbu. Izvi zvinonzi kuberekwa mamiriro (aripo kubva pakuzvarwa).

Kuvharirwa kunokonzerwa kana paine:

• Kuderera kwenzvimbo pakati peureter uye chikamu cheitsvo chinonzi renal pelvis
• Ropa risina kujairika reropa rinoyambuka pamusoro peureter

Nekuda kweizvozvo, weti inovaka uye inokuvadza itsvo.

Muvana vakura nevakuru, dambudziko rinogona kunge rakakonzerwa nemavanga enyama, hutachiona, kurapwa kwekutanga kwekuvharika, kana matombo eitsvo.

UPJ kuvharirwa ndicho chikonzero chakanyanya kukonzereswa nekuvharidzirwa kwehuropi muvana. Ikozvino inowanzo kuwanikwa usati waberekwa uine bvunzo dze ultrasound. Mune zvimwe zviitiko, mamiriro acho anogona kutadza kusvika mushure mekuzvarwa. Kuvhiya kunogona kudikanwa pakutanga kwehupenyu kana dambudziko rakanyanya. Kazhinji yenguva, kuvhiyiwa hakudiwe kusvika gare gare. Zvimwe zviitiko hazvidi kuvhiyiwa zvachose.

Panogona kunge pasina zviratidzo. Kana zviratidzo zvikaitika, zvinogona kusanganisira:

• Kudzoka kana kurwadziwa kumucheto kunyanya kana uchinwa diuretics senge doro kana caffeine
• Uropa weti (hematuria)
• Bundu mudumbu (dumbu uremu)
• Utachiona hweitsvo
• Kukura kwakashata muvacheche (kutadza kubudirira)
• Urinary turakiti hutachiona, kazhinji nefivha
• Kusvipa

Iyo ultrasound panguva yekuzvitakura inogona kuratidza matambudziko eitsvo mumwana asati aberekwa.

Miedzo mushure mekuzvarwa inogona kusanganisira:

• BUN
• Chibvumirano cheCreatinine
• CT scan
• Electrolyte
• IVP - isinganyanyo shandiswa
• CT urogram - scan yeitsvo mbiri uye ureters ane IV mutsauko
• Nyukireya scan itsvo
• Kuongorora cystourethrogram
• Ultrasound

Kuvhiya kugadzirisa iko kuvhara kunotendera weti kuyerera zvakajairika. Kazhinji yenguva, yakavhurika (isina kuvhiya) kuvhiya kunoitwa mune vacheche. Vakuru vanogona kurapwa nemaitiro mashoma-anoparadza. Maitiro aya anosanganisira kucheka kwekuvhiya kudiki pane kuvhiya kwakavhurika, uye kunogona kusanganisira:

• Endoscopic (retrograde) matekiniki haidi kubviswa kwekuvhiya paganda. Panzvimbo iyoyo, chishandiso chidiki chinoiswa mukati meiyo urethra uye dundira uye mune yakakanganiswa ureter. Izvi zvinobvumira chiremba anovhura kuvharira kubva mukati.
• Percutaneous (antegrade) hunyanzvi hunosanganisira kucheka kwekuvhiya kudivi remuviri pakati pembabvu nehudyu.
• Pyeloplasty inobvisa zvinyama zvitsvuku kubva munzvimbo yakavharidzirwa uye ichibatanidza zvakare chikamu chine hutano cheitsvo kune iyo ureter ine hutano.

Laparoscopy yakashandiswawo kurapa kudzivirirwa kweUJJ muvana nevakuru vasina kubudirira nedzimwe nzira.

Chubhu inonzi stent inogona kuiswa kudhonza weti kubva kuitsvo kusvikira kuvhiya kwapora. Iyo nephrostomy tube, inoiswa parutivi rwemuviri kudhonza weti, inogona zvakare kudiwa kwenguva pfupi mushure mekuvhiyiwa. Mhando iyi yehubhu inogona zvakare kushandiswa kurapa hutachiona hwakaipa usati wavhiyiwa.

Kuona nekurapa dambudziko nekukurumidza kunogona kubatsira kudzivirira kukuvara kwetsvo mune ramangwana. UPJ kuvharirwa kunoonekwa usati waberekwa kana kutanga mushure mekuberekwa kunogona kunyatso kuvandudza pachayo.

Vazhinji vana vanoita zvakanaka uye havana matambudziko enguva refu. Kukuvara kwakakomba kunogona kuitika kune vanhu vanoonekwa mushure mehupenyu.

Yakareba-mhedzisiro mhedzisiro yakanaka neazvino kurapwa. Pyeloplasty ine yakanakisa kwenguva refu budiriro.

Kana ikasarapwa, kudzivirirwa kweUJJ kunogona kukonzera kurasikirwa zvachose kweitsvo basa (itsvo kutadza).

Itsvo mabwe kana hutachiona hunogona kuitika mune dzakakanganiswa itsvo, kunyangwe mushure mekurapwa.

Fonera mupi wehutano kana mwana wako ane:

• Uropa weti
• Kupindwa nechando
• Bundu mudumbu
• Zviratidzo zvekurwadziwa kumashure kana kurwadziwa kumakumbo (iyo nharaunda yakatarisana nemativi emuviri pakati pembabvu uye chiuno)

Ureteropelvic junction kuvharidzira; UP junction kuvharidzira; Kuvhiringidzwa kweiyo ureteropelvic junction

• Itsvo anatomi

Mukuru JS. Kuvhiringidzwa kweiyo weti turakiti. Mune: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Chinyorwa chePediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020: chap 555.

Frøkiaer J. Urinary nzira yekuvharika. Mune: Skorecki K, Chertow GM, Marsden PA, Taal MW, Yu ASL, eds. Brenner uye Rector Iyo Itsvo. 10th ed. Philadelphia, PA: Elsevier; 2016: chitsiko 38.

Meldrum KK. Pathophysiology yekuvharirwa kweurineti. Mune: Wein AJ, Kavoussi LR, Partin AW, Peters CA, eds. Campbell-Walsh Urology. 11th ed. Philadelphia, PA: Elsevier; 2016: chitsiko 48.

Nakada SY, Yakanakisa SL. Manejimendi yepamusoro yekuvharira nzira. Mune: Wein AJ, Kavoussi LR, Partin AW, Peters CA, eds. Campbell-Walsh Urology. 11th ed. Philadelphia, PA: Elsevier; 2016: chits. 49.

Stephany HA, Ost MC. Urologic kusagadzikana. Mune: Zitelli BJ, McIntire SC, Nowalk AJ, eds. Zitelli naDavis 'Atlas yePediatric Panyama Kuongorora. 7th ed. Philadelphia, PA: Elsevier; 2018: chits. 15.