Ingcindezi kwezinso. Izimpawu kanye Yiqiniso emitholampilo ye isifo

ingcindezi kwezinso, izimpawu zazo akhiwa a sebuningini izici kusala a kwezinso parenchymal isifo nomfutho wegazi ophezulu olubangelwa noma izitsha kwezinso. 30-35% of abantu abaphethwe nomfutho wegazi ophezulu kufanele concomitant isifo sezinso, ngenxa okuyinto kukhona nengcindezi enamandla futhi yanda, ngoba ingcindezi nezinso ngokuvamile kuhlobene.

nomfutho wegazi ophezulu Nephrogenic ihlukaniswe ezimbili izinhlobo: renovascular futhi parenchymal bobabili kuthinte ingcindezi kwezinso. Izimpawu zalesi kungaba ezingacacile kakhulu futhi bavame iphutha ngoba ezinye izifo. nomfutho wegazi ophezulu Renovascular eba ngenxa stenosis sohlangothi olulodwa noma zamazwe amabili noma occlusion we Umthambo kwezinso amagatsha awo. nomfutho wegazi ophezulu Renovascular kungaba kokubili uhlamvu abeyizuzile futhi isegazini. Parenchymal umfutho wegazi ophakeme, ezimweni eziningi, kubangelwa zamazwe amabili pyelonephritis esingamahlalakhona noma ezinye izifo izinso, nephrolithiasis enjalo (ezinso), isifo sofuba, isimila izinqubo, izinhlumba, hydronephrosis, polycystic nezinye izifo eziningana.

Ngokwesilinganiso, umfutho ophakeme wegazi renovascular kwenzeka 5-12% wabantu abaphethwe nomfutho wegazi ophezulu. Kunezinhlobo eziningana izimbangela eziyinhloko azalwa naso nomfutho wegazi ophezulu renovascular, ezinye zazo yilezi: useshonile, dysplasia nezinye anomalies sokugembula kwemithambo yegazi kwezinso, fistula arteriovenous. Phakathi zezizathu kumafomu atholwe nomfutho wegazi ophezulu renovascular yilezi: kwezinso Umthambo stenosis ngenxa isifo sokuqina kwemithambo yegazi, eshintsha imithambo kwezinso ngenxa lesichubekako Nephroptosis, embolism noma thrombosis kwemithambo yegazi kwezinso noma amagatsha zabo, panarteriit, kokucindezelwa we Umthambo ngaphandle izinso (izimila, izinhlumba nokunye okunjalo. d.).

Izimpawu kanye ukubonakaliswa basemtholampilo nomfutho wegazi ophezulu renovascular

nomfutho wegazi ophezulu Renovascular kwenzeka phakathi bobudala kodwa ivame kakhulu kubantu abangaphansi kweminyaka engu-50 ubudala (93% kuzo zonke izimo). I izilonda ezivamile we Umthambo kwezinso kuyinto sclerosis atherosclerotic. Lolu hlobo isifo zitholakala ngokuyinhloko kwabesilisa abaneminyaka engu-35 kuya kwengu-40 ubudala. Ngo abesifazane, i-main isici etiological kakhulu ekuthuthukeni lesi sifo singumbulali fibromuscular kwezinso Umthambo stenosis futhi owawuvamile amantombazane asemancane.

ingcindezi kwezinso, izimpawu izimpawu ukuqala okuzumayo okusheshayo (ngokuvamile ebulalayo, e 18-30% of amacala) ukugeleza. Kwegazi kuhambisana amazinga aphezulu kakhulu ingcindezi diastolic (110-125 mm HG noma ngaphezulu); akuvamile kungadala esibucayi. nomfutho wegazi ophezulu Renovascular saziwa kaningi ngengozi.

ukuhlola

Ukuze ukuthola ubukhona nomfutho wegazi ophezulu renovascular kufanele ibhekane izinkathi ezintathu cwaningo. Isigaba sokuqala kunqunywa aortography isidingo. Ukuze wenze lokhu, ukuqoqa nemlandvo wetekwelashwa kwakhe okuningiliziwe, ukusetshenziswa emitholampilo jikelele ezinye izindlela. Umlando ngokuvamile imakwe ukungabi ubunjalo lezinceku isifo, okuvela nomfutho wegazi ophezulu ngemva kokudamba esifundeni lumbar. ingcindezi kwezinso, izimpawu zazo anyakaza, kunzima kakhulu lapho ethola ukuthi unesifo futhi zidinga ukwelashwa ngokushesha udokotela izimpawu zokuqala.

Isigaba sesibili kuhilela kokwenza aortography futhi arteriography we nezinso, uma uqaphela izinguquko izinso, igazi ethathwa emithanjeni kwezinso. Igazi wahlola ngomsebenzi plasma renin esinyathelweni zokuxilonga esilandelayo.

Esigabeni yokugcina inhlolovo ukuzama ukusungula ubuhlobo nomfutho wegazi ophezulu kusukela izilonda ekhonjwe Umthambo kwezinso. Ukuze afakazele lokhu umbono nezindlela ezisetshenziswayo IKhompyuthaYami renografii, eksretornoy urography nocwaningo umsebenzi renin. Ngo 8-10% eziguli ukuthuthukisa eseduze kwegazi eqinile, okuyinto ivala isikhala ukungakhuli nemisebenzi yokusetshenziswa izinso abathintekayo.

ukwelashwa

Kwezinso ukwelashwa ingcindezi amakhambi abantu okungase kuholele eziyingozi, kumele wakhuzwa wangenela kuhlinzwa, okuhloswe ngalo ukubuyisela igazi ukugeleza imithambo main kwezinso.