Nephritis Tubulointerstitial, amafomu oyingozi futhi ezingalapheki: Izimpawu, Izimbangela Nezingozi Ukwelashwa

nephritis Tubulointerstitial basonta ezivamile isifo sezinso futhi izilonda iziteshi okuholela Ukuwohloka isitho umsebenzi. Lesi sifo libhekene izinguquko eziningi ohlelweni isakhiwo interstitial izicubu izinso. Zimbili izinhlobo zesifo - oyingozi futhi ezingalapheki. Ngo ukulaya imithi eminingi ticale emzimbeni womuntu, it is okukhulunywa ukuthi izidakamizwa iqedwe nge nezinso. Futhi imithi ngokungacabangi engalawuliwe reception zisenza sibe isifo ngenxa yokungezwani komzimba emithini ethile noma ukwelashwa ngamakhambi. Ukugula futhi kwenzeka njengoba phetho wathutha ukutheleleka.

Ukukhomba nephritis tubulointerstitial, nokusebenzisa izindlela nocwaningo lwanamuhla yomzimba, okungukuthi, ukwenza i-ultrasound, umchamo kanye nokuhlolwa kwegazi, umlando wezempilo iqoqo idatha, biopsy izinso. Isiphetho mayelana reversibility lesi sifo kusekelwe kobukhulu ukulimala kanye isikhathi nokufuna usizo lwezokwelashwa.

Izimbangela isifo

Ngezinye izikhathi reception kwamaphilisi noma ezinye izidakamizwa eqeda ukuvuvukala sisalokhu isikhathi eside. Nokulimala kwezinso kwenzeka ngemva eqinile chemical ubuthi, izinsimbi ezisindayo. elilimaza kakhulu izifo Ethanol ububi ngentukuthelo. nephritis Tubulointerstitial singenzeka ngenxa yezizathu eziningi:

• ngemva othola igciwane lohlobo lwe - 46% of amacala;
• ukubonakaliswa anobuthi avuse isifo nomzimba 28,3%;
• iziyaluyalu umzimba emzimbeni ukukhuthaza nesenzakalo lesi sifo 13.9%;
• iziyaluyalu kwegazi imisebenzi ureters - 8.8%;
• izakhi zofuzo ezibangela futhi mzimba - 0.9% lesi sifo;
• yezizathu eziningana ngesikhathi esisodwa ebonwe 2.5% amacala.

amafomu Okungalapheki lesi sifo zibangelwa nokwephula yobuqotho cytomembranes, kwezinso dysplasia izicubu umzimba izinguquko, anomalies azalwa naso futhi ureters kuluthola.

uphethwe

It olwenziwa eziningi izifundo uhlamvu ngokomzimba futhi laboratory. Futhi kuphela ke uphethwe linembile. nephritis Tubulointerstitial kulindeleke e isiguli ukuvela izimpawu ekhululekile uxilongwe ahlukene omzimba manifestations.

ubunjalo njalo lesi sifo umphumela kokuziphatha futhi yoma iziteshi emzimbeni womuntu isikhathi eside. isitho umsebenzi engasenamahloni kancane kancane - eminyakeni eminingana. Isiguli uya kudokotela uma kukhona izimpawu ezingathandeki ezifana ubuhlungu izinso, ukuqubuka, kanye nabanye. Bayinikeza kuye ukungakhululeki abalulekile. Izifo kuthinta umonakalo nje emibili noma izinso kuphela.

Ocwaningweni i-laboratory, umchamo uric kwenze kuyabonakala nge wokuqukethwe lelisetulu erythrocyte futhi leukocyte. Ngesikhathi esifanayo kukhona ukungabi oluphelele uhlobo erythrocyte dismorfnogo kuphela wawubonakalisa elincane hematuria. Ukuba khona eosinophils umchamo akuyona libhekene khona lesi sifo, njengoba 50% kuphela amacala zingabantu umphumela we isifo. Uma abekho nhlobo, khona-ke lokhu kusikisela ukuthi isifo engekho. Proteinuria Kutholwe ukusebenza okungenani, kodwa uma umzimba iye yasungula kakade zokugula glomerular kubangelwa ukusetshenziswa kwemithi elwa namagciwane, kuyilapho leli nani ufinyelela kulelo nephrotic.

Ekuhlaziyeni wegazi acute nephritis tubulointerstitial kuzibonakalisa hypercalcemia. Ukwephula umsebenzi isiteshi kuholele lactic umzimba. Lapho ultrasound is kakhulu ukhulise isilinganiso echogenicity ngenxa umzimba ukuvuvukala kanye inqubo kokuziphatha. US ubonisa ukwanda ngobukhulu izinso ukwanda index gallium enemisebe futhi leukocyte bhalisiwe ngesikhathi radionuclides. A omuhle Chile scan kubonisa nephritis tubulointerstitial. Diagnostics, wembula yi ezingezinhle, ezinye izindlela kufanele inikezwe.

symptomatology lesi sifo

Esikhathini kusaqalwa isifo azinazo izimpawu zokugula. Ezinye iziguli abawazi the zokugula asathuthuka. Izigaba kamuva inkambo isifo nomthelela izici imizwa:

• ukuqubuka avele kancane noma kubo bonke ubuso komzimba sithwele ukulunywa uhlamvu;
• inyuka elincane lokushisa ububanzi, izimo ezinzima zibonakala umkhuhlane;
• ubuhlungu kwezinso esiyitholayo ukuhlaselwa njalo noma njalo odlulayo;
• ukukhathala yanda, isiguli uzizwa imiqulu ukuwozela;
• umfutho okhuphuka ngokungazelelwe zenzeka ngaphandle kwesizathu;
• kukhona polyuria.

ukubonakaliswa eziningi ezihlukahlukene imakwe nephritis tubulointerstitial. Izimpawu waphawula ngesimo umkhuhlane ukuqubuka, kodwa ezinye zalezi zinguquko emzimbeni alanele uphethwe. Ukuqubuka kwenzeka ngenyanga eyodwa emva isenzo ubuthi noma izinsuku 3-6. Lokhu kuncike isimo umzimba impendulo yayo kuya allergen. Emakiwe kwesisindo, ubuhlungu esiswini kanye emhlane ngenhla ezinqeni.

Lesi sifo, ophasiswe esigabeni okungamahlalakhona, ezahlukene enkathini unezimpawu ezikahle, kuqinisa nge sikhathi. Abanye abantu ukuthuthukisa polyuria futhi nocturia. Umfutho wegazi ophezulu kanye ukuvuvukala nasemilenzeni kuyagcinwa inqobo uze ukwehluleka kwezinso. Izimpawu ezichazwe ohlwini, kukhona isici esigabeni acute lesi sifo.

brightism

Lesi sifo kuba amahlala khona ngemva Yiqiniso oyingozi. Kodwa ezimweni ezinjalo awavamile. Ngokuvamile, nephritis ezingamahlalakhona ukuthuthukisa ngemva othola ukutheleleka, ophikelelayo iziyaluyalu umzimba emzimbeni, imithi ejwayelekile ukudakwa. Tubuloinsterstitsialnye nephritis ezingamahlalakhona ku ultrasound yabonisa glomeruli zisesimweni evamile noma ubhujiswe. Tubules bengekho ngokuphelele noma zikhubazekile. Amanothi izikhala ezahlukene iziteshi - kusukela yayizovela ku-ulwelwesi ezibanzi eyohlobo.

izicubu kwezinso uchayeke cystic nokuvuvukala. Uma cystic eminingi engekho, nayo parenchyma ibukeka cishe enempilo. izinso Atrophied ube usayizi amancane izimpawu asymmetry. Izimpawu of nephritis ezingamahlalakhona zifana etholakala esigabeni oyingozi, kodwa abe ukubonakaliswa kancane egqamile. Leukocytosis futhi erythrocyte anda awavamile. Yiqiniso Okungalapheki lesi sifo kuyingozi kakhulu, ngakho kudingeka ngokucophelela ulalele izimpawu kusaqalwa lesi sifo. Ukubambezeleka ekwelashweni kuholele nokwehluleka ukusebenza kwezinso, okuyinto igcwele asemrarweni.

Inkambo okukhulu lesi sifo

Ngokuvamile kwenzeka ngenxa okungafanele zokuzelapha ngaphandle kokubonisana udokotela wakho. Ukungakwazi we nezinso ukusebenza, ukubukeka izinqubo acute ukuvuvukala avele emva eside ukusetshenziswa isikhathi ekwelapheni kwamaphilisi beta-laktamidnyh.

nephropathy olunamandla libhekene khona edema neuropathy kokuziphatha ukuvuvukala. Bona asidlulisela nezicubu kwezinso. Ngezinye izikhathi kuthatha amasonto ambalwa ngaphambi ukubonakala izimpawu okungazelelwe. Khona-ke ukuthuthukisa ukwehluleka oyingozi so-renal, okuyinto senziwa yokuqalisa ngaphambi kwesikhathi yokwelashwa kanye ukuchayeka okuqhubekayo ecasulayo.

izingane jades

Ikhono ukugwema ukuthuthukiswa sifo ebuntwaneni iba ukuvakashelwa esifike udokotela uma zonke izifo, ezisukela imikhuhlane. Ukuzithiba kungenzeki, isazi sezifo zezingane kuphela abaqhuba ayoyikhetha imithi ungawoni umntwana usuke engakabi kwakhiwa kwesimiso somzimba sokuzivikela ezifweni.

nephritis Tubulointerstitial ezinganeni iphathwa ngaphansi kokuqondisa onguchwepheshe. Kanyekanye babelwe Ukudla zokwelapha, ngaphandle okuyinto imiphumela emihle siyithola nzima. Endabeni egijima nephritis izinso ukutheleleka kunokwelapha akunakwenzeka ke yakhetha isitho ukufakelwa. Ukuze ezingane Yiqiniso isici inamagquma lesi sifo nge isikhathi ukubambezeleka eside.

Izibikezelo

Lapho umsebenzi izinso kahle ngenxa ukusetshenziswa kwezidakamizwa, nephritis tubulointerstitial kwenzeka. Ukwelashwa ezimweni omnene kuyadingeka. Uyeka ukuphuza umuthi, kanye efihlekile ziqala ukusebenza evamile e izinyanga 2-2.5. Ngezinye izikhathi lo mkhuba asalile kuba phambi nezibazi. Lapho lesi sifo lomunye omsakazo imbangela, kodwa lesi sifo emuva. Ezimweni ezimbi kakhulu kukhona ukwehluleka kwezinso futhi cystic.

Ukubikezela amafomu njalo nephritis incike ijubane bangabonwa futhi ukunciphisa zokugula phambi uyomenzela cystic engelapheki. Uma ungakwazi ukulungisa izinguquko zofuzo, ezinobuthi futhi umzimba, isifo ingena ezishisayo ukwehluleka kwezinso.

ukuphathwa isifo

Lapho izimpawu zokuqala zesifo kudingeka ukuba aye kudokotela. Kuphela ziyoyizwa ukuphathwa ilungile futhi abanekhono. Ukwelashwa esigulini ngasinye singumuntu. Kodwa, isibonelo, ukusheshisa yokutakula kusukela esigabeni oyingozi ukugula, futhi ngezinye izikhathi ezingamahlalakhona glucocorticoid ukusetshenziswa. inqubo reception kuvimbela angiotensin inhibitor.

A biopsy izinso

Inqubo iphathelene ukungenelela zokuxilonga ukuhlonza isifo sezinso. Kuyinto ukususwa izicubu tincetu luhlolo ezincane. Ngokusebenzisa mncane isipetu inaliti uya esincane impahla kwezinso. Lolu cwaningo uyasiza ekuboneni kahle ukwakheka kwamakhemikhali izicubu kanye choice ukwelashwa elilungile.

Izinkomba ngoba inqubo biopsy

Indlela ucwaningo biopsy inikezwa kulezi zimo ezilandelayo:

• Kuze kube sekupheleni behluleka ukuthola imbangela izifo ezingelapheki noma oyingozi.
• Ingabe nephritis okusolwayo.
• Ngokushesha okuqhubekayo ukwehluleka kwezinso.
• Kukhona aetiology eziyinkimbinkimbi ezithathelwanayo.
• Ngo-laboratory izifundo umchamo luthole admixture wegazi kanye amaprotheni.
• Igazi ukuhlolwa kubonisa yesithakazelo esikhulu uric acid, creatinine, urea.
• Oncology okusolwayo.
• Utshalwe izinso izinkinga umsebenzi.
• Kukhona isidingo kutholakale umsuka wendaba yesihluku umonakalo.
• Ukuze siqaphele intuthuko ukwelashwa.

izinhlobonhlobo biopsy

Inqubo kwenziwa ngokusebenzisa isikhumba. It Kwenziwa umjovo we nezinso ilawulwa-X ray noma ultrasound. Ukuze iwenze ube lula indawo emzimbeni ufakwa vein yalokho kuqhathanisa ngombala izidakamizwa hlangothi. Vula inqubo biopsy libhekene kocingo esincane kwezicubu ngqo phakathi nokuhlinzwa. Ngokwesibonelo, ngenkathi kususwa maqembu neoplasms Cancer. Kubonisa ukuthi labo abaye ukopha noma kukhona eyodwa kuphela izinso isebenza. Lokhu kwenziwa ukuze unciphise ingozi ukuchayeka kuso.

cystoscopy ezikanye biopsy wenziwa uma khona amatshe e-ureter noma ukhalo kwezinso. Kuye kwenziwa egumbini lokuhlinza Sinikeza isingeniso we tube nezimo ukuhlolwa sangaphakathi ureter. Transjugular umbono biopsy kuyinto ukwethulwa ipayipi ku ezikhethiwe vein kwezinso. Isetshenziselwa in iziguli ukukhuluphala nesifo esingamahlalakhona zokuphefumula futhi ngimpofu igazi ekunqandeni lapho ayikho izindlela ngenhla eyenziwa ngenxa usongo ekuphileni futhi awayiboni nephritis tubulointerstitial.

Ekuphetheni, kufanele kusho ukuthi isifo ezibonakala asymptomatic, hhayi kokuphazamisa isiguli empeleni idinga isikhathi ukukhomba. Futhi eziyinkimbinkimbi nge nephritis ingelashwa kahle nabantu izinso umsebenzi futhi abangele imiphumela engelapheki.