Ichi chinyorwa chakatsaurirwa kune vese varidzi vezvipfuyo vanobata mhuka dzavo nemoyo murefu uye nekungwarira. Kunyange vakasiya, vachanzwa rudo rwako.

01 nhamba yemhuka dzinovaraidza dzine kutadza kwetsvo dziri kuwedzera gore negore

Acute renal kufoira kunodzokororwa zvishoma, asi kutadza kwerenal kusinga gadziriswe zvachose. Varidzi vezvipfuyo vanogona kuita zvinhu zvitatu chete:

1: Ita basa rakanaka mune zvese zvehupenyu, uye edza kusarega mhuka dzinovaraidza dzichitadza kutadza kushanda kunze kwetsaona;

2: Acute renal kukundikana, kuongororwa kwekutanga, kurapwa kwekutanga, usazeza, usanonoka;

3: Iyo yekutanga kutadza kwetsvo kunowanikwa uye kurapwa, iyo nguva yekurarama yakareba;

02 Sei kutadza kwetsvo kuchinetsa kupora

Pane zvikonzero zviviri zvikuru nei kutadza kwetsvo kuchityisa uye kuchinetsa kurapa:

1: Sezvambotaurwa, kunze kwekuti kutadza kwerenal kwakanyanya kunokonzerwa nehupfu uye ischemia yemunharaunda inogona kudzoserwa shure, zvimwe zvese hazvigoneke. Kamwe chaiyo renal basa kukuvara kwakaoma kupora, uye hapana chaiyo mushonga wemhuka dzinovaraidza renal kukundikana munyika, izvo zvose zvinovaka muviri uye zvokuwedzera;

2: Tese tinoziva kuti itsvo inhengo yakachengetedzwa yemuviri wedu, kureva kuti, tine itsvo mbiri. Kana imwe ikakuvadzwa, muviri unogona kuramba uchishanda zvakajairika, uye hatizonzwe chirwere. Itsvo inongoratidza zviratidzo kana inenge 75% yebasa rayo yarasika, ndosaka kutadza kwetsvo kunonoka kana kunonoka kana yawanikwa, uye kune mashoma ekurapa maitiro aripo.

Kana renal basa rakarasika ne50%, nharaunda yemukati ichiri kugadzikana, uye zvinenge zvisingakwanisi kuona matambudziko; Kurasikirwa kwerenal basa ndeye 50-67%, simba rekugadzirisa rinorasika, kukosha kwebiochemical hakuzoshanduki, uye muviri hauzoratidzi kushanda, asi mamwe maitiro anotarisirwa, akadai seSDMA, achawedzera; Kurasikirwa kwerenal basa kwaiva 67-75%, uye kwakanga kusina kushanda kwakajeka mumuviri, asi biochemical urea nitrogen uye creatinine yakatanga kusimuka; Kupfuura 75% yerenal basa kurasikirwa kunotsanangurwa sekutadza kwerenal uye advanced uremia.

Chiratidzo chiri pachena chekutadza kutadza kwerenal ndiko kukurumidza kudzikiswa kweweti yemhuka, ndosaka ini ndichida kuti muridzi wese wemhuka atarise huwandu hweweti yechipfuyo chake mazuva ese. Izvi zvakaomera varidzi vezvipfuyo vanowanzorega katsi nembwa dzichibuda zvakasununguka, saka kazhinji kacho kanguva kekupedzisira kuti zvipfuyo izvi zvirware.

03 vamwe varwere vane acute renal kukundikana vanogona kupora

Kunyange zvazvo kukundikana kwerenal kukundikana mune renal kukundikana kune kukurumidza kutanga uye zviratidzo zvakakomba, zvichiri zvinogoneka kupora, saka zvakakosha zvikuru kudzivisa kuitika kwekukundikana kwerenal uye kuwana chikonzero chechirwere. Acute renal failure inonyanya kukonzerwa ne local ischemia, urinary system blockage uye chepfu.

Semuenzaniso, 20% yeropa rinouya kumoyo kune itsvo, nepo 90% yeropa reitsvo inopfuura nepakati renal cortex, saka chikamu ichi chinonyanya kushungurudzwa ne ischemia uye chepfu inokonzerwa nekukuvara. Nokudaro, tinowanzoona kuti zvirwere zveitsvo nemwoyo zvinowanzobatana. Kana imwe yakashata, imwe mutezo inova isina ngozi uye isingatani kurwara. Zvikonzero zvinowanzoitika zvekukundikana kwetsvo kunokonzerwa ne ischemia zvinosanganisira kupera simba kwemvura, kubuda ropa kukuru uye kutsva.

Kana kupera mvura mumuviri, kubuda ropa uye kutsva kusiri nyore kuitika, chinonyanya kukonzera kutadza kwerenal kukundikana muhupenyu hwezuva nezuva kutadza kwerenal kunokonzerwa nekuvharika kweurinary system. Kazhinji dundira uye urethral matombo, crystal blockage, urethritis, kuzvimba uye kuvharika kweurinary catheter. Kuvharika kunokonzera weti kuunganidzwa, kuvharika glomerular kusefa, kuwedzera isiri protein nitrogen muropa, zvichikonzera glomerular basement membrane necrosis. Mamiriro ezvinhu aya ari nyore kutonga. Chero bedzi weti yakavharwa kweanopfuura maawa makumi maviri nemana, tinofanira kuedza biochemistry kuti tive nechokwadi chokuti hapana kuitika kwekukundikana kwetsvo. Rudzi urwu rwekutadza kwetsvo ndirwo chete kukundikana kwetsvo kunogona kupora zvachose mumazuva mashoma, asi kana ikanonoka, inogona kuwedzera chirwere ichi kana kushanduka kuita kutadza kwerenal kusingaperi mumazuva mashoma.

Mamwe masubspecies eacute renal failure anokonzerwa nehupfu. Kudya mazambiringa zuva rega rega ndechimwe, uye chinonyanya kushandiswa kwezvinodhaka zvisina kunaka. Mumvura uye electrolyte yeabsorbed glomerular filtration fluid, renal tubular epithelial masero anoratidzirwa kuwedzera kuwanda kwechepfu. Kuvanza kana kudzoreredzwa kwechepfu nerenal tubular epithelial masero kunogona kuita kuti chepfu iunganidze kusvika pakakwirira mumasero. Mune zvimwe zviitiko, huturu hwemetabolites hwakasimba kupfuura hwemakomboni anotangira. Mushonga unokosha pano "gentamicin". Gentamicin inowanzoshandiswa gastrointestinal anti-inflammatory drug, asi ine nephrotoxicity yakakura. Muzviitiko zvakawanda, kunyange muchipatara, kana kuongororwa uye kurapwa kusina kunaka, zviri nyore kukonzera chepfu inokonzerwa nekushaya renal kukundikana.

Ndinokurudzira zvakasimba kuti varidzi vezvipfuyo vaedze kusabaya gentamicin kana vaine sarudzo. Mukuwedzera, mhuka dzinovaraidza dzine itsvo dzakaipa dzinoda kubhadhara mishonga. Mishonga yakawanda inopesana nekuputika icharatidza kusakwana kwerenal mune contraindications. Shandisa nekuchenjerera, cephalosporins, tetracyclines, antipyretics, analgesics, nezvimwewo.

04 kutadza kushaya renal kunoda kutarisirwa nemurwere

Kusiyana neacute renal kukundikana, kusingaperi renal kukundikana kunenge kwakaoma kuwana, uye hapana zviratidzo zviri pachena mukutanga kwekutanga. Zvichida pachava newaini yakawanda kupfuura yakajairika, asi isu hatigoni kutonga muupenyu hwedu hwezuva nezuva kuti imhaka yekuwedzera kwehuwandu hwemvura hunokonzerwa nekupisa kwemamiriro okunze, mamwe mabasa uye zvokudya zvakaoma. Mukuwedzera, zvakaoma kuziva chikonzero chekusingaperi renal kukundikana. Parizvino, chinogona kushandiswa sereferensi chirwere cheglomerular, senge nephritis, innate genetic nephropathy, urethral obstruction, kana kutadza kusingaperi renal pasina kurapwa nenguva.

Kana acute renal kukundikana kunogonawo kukurumidzira kupora nekuwedzera kupihwa kwemvura yekunwa, subcutaneous jekiseni remvura, dialysis uye dzimwe nzira dzemetabolize chepfu uye kuderedza mutoro paitsvo. Iko hakuna nzira yekudzorera renal basa mukusingaperi renal kukundikana. Chinhu chimwe chete chatinogona kuita ndechekuderedza kukurumidza kwekukuvara kwerenal uye kuwedzera hupenyu hwemhuka dzinovaraidza kuburikidza nekudya kwesayenzi uye zvimwe zvinovaka muviri, zvakadai se calcium supplement, erythropoietin kushandiswa, kudya zvokudya zvemishonga uye kuderedza kudya kweprotein. Chimwe chinhu chekucherechedza ndechekuti kutadza kwetsvo kwakawanda kunoperekedzwa nekuderera kwepancreatic basa, uye kunyangwe pancreatitis, inodawo kutarisirwa.

Nzira yakanakisa yekubata nechirwere chetsvo chisingaperi ndechekuchiwana nekukurumidza. Iyo yekutanga inowanikwa, zviri nani mamiriro ekugara anogona kuchengetedzwa. Kune katsi, kana biochemical test ye urea nitrogen, creatinine uye phosphorus zvakajairika, SDMA inogona kuongororwa nguva dzose kamwe chete pagore kuti ione kana pane kwekutanga kutadza kwetsvo. Zvisinei, muedzo uyu hauna kururama kune imbwa. Muna 2016 kuUnited States ndipo patakatanga kudzidza kuti bvunzo iyi inogona kushandiswa pambwa here. Nemhaka yekuti chiyero chekuedza chakasiyana zvikuru nechekiti, haigoni kushandiswa sechiratidzo chekuongorora kune imbwa mukutanga kwechirwere chisingaperi chekushaya renal. Semuyenzaniso, 25 ndiko kuguma kwechikamu chechipiri kana kunyange kutanga kwechikamu chechitatu chekusingaperi renal kukundikana kwekatsi, Kune imbwa, dzimwe nyanzvi dzinotenda kuti kunyange mukati mehutano hwehutano.

Kusakwana kwerenal kutadza kwekatsi nembwa hazvirevi kufa, saka varidzi vezvipfuyo vanofanirwa kuzvitarisira nekushivirira uye nekungwarira nemafungiro ane rugare. Zvimwe zvacho zvinoenderana neramangwana ravo. Katsi yandakapa kune vandinoshanda navo kare yakawanikwa iine kusingaperi renal kukundikana pazera remakore 13. Yakadyiswa nesayenzi nemishonga panguva. Pakazosvika makore gumi nemapfumbamwe, kunze kwekumwe kuchembera kwemapfupa nematumbu uye nemudumbu, mamwe ese akanaka kwazvo.

Pamberi pekutadza kweitsvo dzemhuka, varidzi vezvipfuyo vane sarudzo shoma dzekuita, chero bedzi ivo vachishingairira kubata, kusimudza uye kudya nesainzi mukati mekugona kwavo, zvakanyanya, zvakanyanya kuoma kana kunyange zvisingaite kudzoreredza kukosha kwakajairika. Zvakanaka kuve ne creatinine uye urea nitrogen mune yakajairika uye yakakwirira zvishoma. Chikomborero chavo kupora, Kana ukazoenda, muridzi wemhuka anoedza nepaanogona napo. Upenyu hunogara huchiberekwazve. Zvichida vachadzoka kwauri zvakare nokukurumidza, chero bedzi iwe uchida kutenda.