Genitourinary tiibhii: zviratidzo, chirwere, nzira chirwere

Zvirwere nezvezvimwe zvinetso zvedundira chaizvo nevakawanda. Vanogona zvazvinoita itsvo, Urinary turakiti, dundira. Zvose zvirwere zviri kupa uye funga genitourinary tiibhii. About chirwere ichi, unofanira kuziva munhu wose, nokuti chirwere hapana angati.

Verenga zvakawanda pamusoro tibhii, vachipidigura Urinary hurongwa

kwete zvimwe munhu akadaro, uyo asina kunzwa pamusoro tibhii. It vanowanzochema chirwere umo utachiona anonzi bacillus, zvazvinoita mumapapu. Zvisinei, kwete chete nhengo idzi angararama tusingaoneki kunzi. Vaya nyanzvi anozivikanwa extrapulmonary siyana chirwere. First pakati izvi ndizvo genitourinary tibhii.

Sei chirwere ichi? Nezvezvimwe zvinetso zvedundira Koch bacillus kuwira hematogenous nzira. On hwaro ichi, tinogona kugumisa kuti munhu wokutanga utachiwana kubva zvatinosiita murwere neTB, kusunungura kupinda hwaiitwa utachiona. Gare gare Koch bacillus kupinda Urinary hurongwa kusvika ropa rukova. Saka, nzira chirwere - kutanga kuenda neherikoputa uye ipapo hematogenous.

Tiibhii of urogenital wemuTesitamende varume nevakadzi rinotanga kukuvara itsvo. Izvi, kuti kutapuriranwa muitiro iri kuparadzirwa ne renal tubules, midziyo ropa renal chiuno. Zvadaro kunokanganisa ureters, Urinary dundira. Foci kuti tibhii rwakavapo vose netsvo, asi, panzvimbo tsika, kufambira mberi pathological kwacho chete rimwe peya zvomukati.

Sezvo chirwere hwapedyo? bacillus Koch kana yakarohwa mu itsvo sei cortex uye medulla. Mumuviri pane anorovera. Zvishoma nezvishoma ulcerate, ipapo kuora cheesy. Somugumisiro, in vari aumba. Around vari kukura anogumbura urongwa, pane anorovera. izvi zvose zvinogona kukonzera zvachose itsvo kuti kuumba pyonephrosis.

With pakuzadzisa genitourinary tiibhii pakati pavakadzi nevarume inobata fibrotic uye adipose Kamudzira dzakawanda nenyere. The anorovera uye maronda aonekwa renal chiuno, ureter. Wall nokuda kwayo thicken, Vachikwegura infiltrated, edematous. Maronda zarubtsovyvayutsya dzakwidzwa kuumbwa mamiriro mukudzivirira ane water drainage kuti weti.

Pasina zvakakwana kurapwa nokuti chirwere inopfuura kubva itsvo kusvika dundira. The pathological kwacho kukatanga munzvimbo umo ureters vanoda. In dzomunyika nhengo mucosa kuitika tubercles. Vari pasi mamwe disintegration. Munzvimbo dzavo vakaumba maronda, mavanga. Naizvozvo dundira inofambidzana rakawunyana nokuti kuti dzomunyika rusvingo sei nhengo chakatsiva sclerotic tishu.

Tiibhii of genitourinary ezvinhu: pfupi kupatsanura zvirwere

Nyanzvi mune tsika kushandisa kupatsanura chinosiyanisa panguva dzakawanda zvokukura chirwere:

• Nokuti Danho rokutanga chirwere kunoratidzwa infiltrative tiibhii itsvo, t. E. Non-dzinoparadza.
• In danho rechipiri kwokutanga kudzikisirana iri kuchengetwa, kureva. E. Single mhango sevaduku. In dhayamita, vane asingasviki 1 sendimita.
• Munguva Danho rechitatu pane kuparadzwa shoma. Mune rimwe zvikamu etsvo kuonekwa bako guru kana polikavernozny tibhii.
• Nokuti Danho chechina kunoratidzwa kuparadzwa zvachose kana subtotal.

The kunotoda Mufananidzo chirwere

Genitourinary tiibhii anogona kuoneka nenzira dzakasiyana. Ndosaka chirwere ichi muna mabhuku ezvokurapa somumwe yakajairika "mystifies" pakati zvirwere dundira, itsvo uye Urinary turakiti. On the kuratidzwa tibhii kazhinji matambudziko kukanganisa akabatanidzwa. Izvi zvingava pyelonephritis, chirwere renal kukundikana.

Zviratidzo renal tiibhii akakamurwa 2 mapoka:

• zvakafanana zviratidzo zvinoitika kana iwe kushandura mukuru mamiriro ezvinhu munhu anorwara;
• zviratidzo vemunzvimbo, dziya zvinozoita pamusoro kuzviitira (avo vanonzwa vachirwara) uye chinangwa (dzakaonekwa nenyanzvi ari kuongorora).

Common Zviratidzo tibhii nezvezvimwe zvinetso zvedundira

Apo chirwere muna 20-30% yevanhu yakawedzera muviri tembiricha. Kazhinji anoda kubatsira kubva 37-38 inegumi. Mune dzimwe varwere Zvimwe zvirwere, matambudziko kuchengetwa tembiricha akaenzana 38-39 madhigirii, chills anooneka.

Inenge kumboona neBP (BP) muna 5-18% vanhu vanorwara. Kare, nyanzvi vaidavira kuti chiratidzo ichi chinhu mugumisiro acceding pyelonephritis. Zvino zvakaratidza kuti BP - chiratidzo chokuti zvingaratidza itsvo tibhii. Zvinofanira kucherechedzwa kuti kuitika chiratidzo ichi kunobva yezvakaita chirwere. Somuenzaniso:

• tiibhii renal parenchymal neBP inobata anenge 1,1% yevanhu vanorwara;
• tiibhii renal papilla - 3.2%;
• tuberculous pyonephrosis polikavernoznom uye TB - 18.3%.

Local kuzviitira zviratidzo

Kazhinji vanhu vanobvunza, "zviratidzo, kana pane genitourinary tibhii, chii?" Kunzwa kuti anogona kuitika - kunoshungurudza uye kuita weti kakawanda. Nyanzvi mune 50-60-ies wekupedzisira remakore kwakaratidza unhu iyi vanhu vose. Zvadaro akatanga katsika vasanyanye kakawanda zviratidzo. Mugore 60-70-ies, 48 chete% yevanhu vakagunun'una pamusoro zvaipesana weti uye mumakore 80 - 43 chete% wevarwere. Mumakore achangopfuura, chiratidzo iri ishoma. kuderera kwakadaro rinotsanagurwa kakawanda maronda ari mucous Kamudzira yacho dundira.

Kazhinji kune zviratidzo - a kurwadziwa lumbar nharaunda anomuka kana kunotangira kukudziridza genitourinary tibhii. Zviratidzo izvi dzinotaura panguva inenge hafu varwere dzevanhu. Kurwadza kazhinji munhu mumwe chete angoramba. About zvisingafadzi nezvekufadza vemunyika kumativi ose, muriparidzire 15-20 chete% vanhu vanorwara.

By pezvawakaita, kurwadziwa iri rikwanise, rakafanana renal colic. It unovapo nokuda kutyora excretory basa nokuda blockage rimwe ureter ropa clots, purulent koko, kuzvimba mucous membrane. Renal colic - chiratidzo kuti kuchengetwa kwete chete tibhii nezvezvimwe zvinetso zvedundira. Ndiye chairwo, uye zvimwe zvirwere. Mumwe wavo - urolithiasis. Nokuti kuongororwa zvakarurama rinoitwa Urological kuzviongorora.

Local vavariro uchapupu

The-vataurwa pamusoro features, iro rine tibhii of genitourinary ino - zviratidzo vari kuzviitira. Chinangwa zviratidzo zvinosanganisira pyuria. Izwi rinoreva chichiwedzera nhamba leukocytes mu weti. Leucocyturia - tanga chiratidzo zvirwere. Muchiitiko chino, hazvisi fanira. Kana nzira iri kuongorora weti chena ropa masero asina kuona, hazvina vaiona uchapupu kushaya chirwere.

Zviratidzo TB zvinosanganisira eritrotsiturii urogenital hurongwa. Mukurapa, ichi izwi rinoreva anotoita masero matsvuku eropa ari weti. Mumakore achangopfuura, unhu ichi kunoratidzwa kazhinji - anenge 70-75% vanhu vanorwara. Kuitika matsvuku eropa chokuita kukura rokuparadza kwacho itsvo.

Early Chinangwa chiratidzo tibhii - proteinuria (mapuroteni kuonekwa mune weti kuongorora). Zvinonzi chirwere muna 85-95% vanhu vanorwara. On panowanikwa proteinuria vane pfungwa shoma:

1. Dzimwe nyanzvi dzinodavira kuti haisi chokuita tibhii nezvezvimwe zvinetso zvedundira. kunobva mapuroteni, avo maonero, ndivo masero matsvuku eropa.
2. Vamwe vatsvakurudzi vanotaura kuti protoinuriya kunokonzerwa chinopedza kuchinja tubules uye glomeruli etsvo.

Gore negore, vakawanda vanachiremba anowana chimwe chiratidzo tibhii. Zviri pamusoro nonspecific bacteriuria. The chirwere vangazivikanwa mumatanho ose chirwere. Kazhinji kacho here kuratidza pane cavernous siyana. Utachiona nonspecific Urinary chirwere zvakasiyana. Vanozivikanwa uye Escherichia coli coli, uye anonzi Staphylococcus, uye Streptococcus, uye netsvimbo yebhuruu-nyoro pus. Kazhinji ndiwo neveMamwe kasvisto.

The akavimbika kupfuura chiratidzo chirwere - ari kuziva Koch tumiti iri weti. Zvisinei, nyanzvi havasi kutarisira kuwana chikuru causative mutumwa chirwere. Kunyange ano nzira bacteriological miedzo havana kubatsira. Chokwadi chokuti vamwe vanhu kutora mishonga ushandiswe nachiremba kubva huripo zvirwere kana kunwa zvinodhaka izvi, vachiita kuzvidzora medicate. Somugumisiro, Mycobacterium tibhii vanorasikirwa kugona kwavo zvichiberekana uye kukura. Mushure pakudyara, ivo, chokwadi, nokuti chikonzero ichi hazvigoni kuonekwa. Zvakaoma kuziva nayo utachiona mumuviri munhu anorwara.

Kunyanya tiibhii nezvezvimwe zvinetso zvedundira muvana uye vakwegura

chirwere ichi chinobata vanhu vakuru kunyanya. In vana, ndoda akaonekwa mune genitourinary tibhii. Kakawanda uye mangwanani chiratidzo kunobva kwavari - ndiko polyuria, kureva kuwedzera weti vhoriyamu ... Pane zvimwe zviratidzo, asi ivo zvinowanzobatanidzwa nezvimwe zvirwere. Chimwe chinokosha TB muvana ndechokuti vasikana anonyanya chimiro chirwere haisi dzinoparadza, uye vakomana - zvinoparadza.

Tiibhii nezvezvimwe zvinetso zvedundira inobata vakura vanhu vazhinji. Izvi imhaka vasanyanye masoja azvidzivirire, kwaita siyana zvirwere. On zviratidzo TB kukanganisa kutsigira uye Urological zvirwere. Idzi dzinosanganisira: .. BP, zvirwere nemudumbu, itsvo mabwe chirwere, nonspecific pyelonephritis, etc. Nokuda kwaizvozvi, tiibhii nezvezvimwe zvinetso zvedundira haisi nguva dzose dzakaonekwa. Zviratidzo ayo Masked kubudikidza nezviratidzo zviri pamusoro zvirwere.

Features ane kuitika zvirwere zviri varume nevakadzi

Kubvira pauriri napo sei pachena genitourinary tibhii. Vakadzi, zviratidzo zvinosanganisira zvishoma kurwadziwa. In varume, vanondikurira nesimba. Ivowo vanowanzoguma kutanga tibhii, sikarudzi. Nhamba dzinoratidza kuti kunoita ichi vakadzi rinowanikwa chete muna 7% nyaya, vanhu - 31%.

Kufunga genitourinary tiibhii nevanhu, zviratidzo chirwere ichi, zvinokosha kuziva kuti rokutanga Koch bacillus yarova prostate (yeprostate). Mugore pathological muitiro dzinobatanidzwa uye ipapo dzimwe nhengo dzokubereka nadzo mamiriro: seminal vesicle, testis, epididymis. Mune zvisingawanzoitiki zviitiko, kwakakanganisa mboro. Rinooneka urikanwi chirwere chinobata peripheral node nodes. zviratidzo zvakadai akacherechedza panhengo yemukomana, dzinoda differential chirwere nekenza.

Genitourinary tiibhii: kuongorora chirwere

Apo chirwere kunotoda kurapwa unyanzvi vanotanga kushandiswa. Havadi kubvumira kuti yakavimbika kuona munhu ane TB kana kwete. Zvisinei, nyanzvi aiona kufungira zviratidzo kuonga kwavari. Clinical tsvakurudzo nzira anosanganisira kuongorora munhu anorwara, kuita rokuongorora, palpation chezvinhu zvinorwadza akakwirira.

Basa rinokosha nechirwere kuti kutamba rabhoritari nzira:

1. Varwere zvakaitika kuongororwa ropa. Haana kuzivisa chaiwo zvinhu kuri mumashoko tibhii nezvezvimwe zvinetso zvedundira, asi anogona kuratidza leukocytosis uye kuwedzera erythrocyte sedimentation unodiwa. Izvi zvichaita dzinoratidza pamberi kuzvimba pamuviri.
2. NeMutungamiriri weti. Ndiyo nzira mikuru nechirwere ose tibhii murabhoritari. Mune weti paurwere akawana Koch bacillus, zvimwe zvirwere (kana, kana kukura yematambudziko). Assays ngaakuitireiwo proteinuria, pyuria, eritrotsiturii.

Nyanzvi dzinotaura kukosha kushandisa zvinogoneka nzira dzose kuferefeta, avo anofambidzana uye vakawanda kushandiswa.

The mazita chirwere nzira inosanganisira tuberculin. Chaizvoizvo Its uvete subcutaneous yaitonga chaiwo thickened svikiro. Zvakanyorwa kunzi tuberculin. Tuberculin Tine zvinoratidza uye contraindications. By zvinoratidza zvinosanganisira: kuva nokufungirana pakati tibhii of genitourinary ino, zvakamubaya kuongororwa kunoitwa marapiro, muitiro kudzora basa. Contraindications anoita idiosyncrasy.

Apo chirwere kuti tibhii anogona kushandisa endoscopic nzira kuongorora:

1. Mumwe wavo - a cystoscopy. In nzira iyi, imwe endoscope, inova anobudisa mushonga zvishoma nezvishoma ane okuvhenekesa Manyiminya enyika, iri akaiswa kuburikidza urethra kupinda dundira. Nonspecific zviratidzo tibhii makabuda diffuse kana zvatichiri hyperemia vaiona munhu womukati nhego mucosa. Dzinenge zviratidzo zvikaita cystoscopy - tubercles, mavanga, nemaronda yakaumbwa pakarepo.
2. Mune zvimwe zviitiko, kana hazvibviri kuti kuongororwa zvakarurama uye pane chokwadi, akabata endovezikalnaya biopsy. Kana akaita fenzi zvinhu yokutsvakurudza. Zvinogona kusimbisa pamberi tibhii uye dundira kenza. With zvakaipa mugumisiro hazvirevi siya tibhii.

Ebetsero tsvakurudzo dzakashandiswa pachena radiography uye tomography. With Nzira idzi kuferefeta nenyanzvi vachadzidza itsvo parameters, mamiriro perinephric mafuta, zvinoratidza calcifications uye Ossificação em nzvimbo nezvezvimwe zvinetso zvedundira zvomukati, node nodes, retroperitoneal nzvimbo. Waishanda panguva imwe tiibhii renal angiography. Naro kuisa kuchinja rokuparadza nenzira itsvo, renal vascular mavakirwo kudzidza, kuziva kugona kuita dzokuchengetedza kuvhiyiwa uye itsvo rinenge vhoriyamu kuti resected.

Dzimwe nguva basa ne Ultrasound scan. Izvi nzira dzisiri invasive kuferefeta. Ultrassom kuongorora pyelocaliceal hurongwa, mangwanani kuziva miedzo itsvo mabwe, sclerotic kuchinja, calcifications muhomwe, in, cysts. Panguva iyoyowo Ehostruktura maronda hazviiti kuti kuongororwa zvakarurama. Kuongorora zvabuda Ultrasound anogona chete zvinoratidza kuvapo tibhii.

Treatment regimens chirwere

Mabatirwo tibhii pamusoro genitourinary gadziriro iri basa zvichienderana pachikuva:

• In kwokutanga nzendo mishonga takanyorera. Varwere vari basa mishonga tuberculostatic akabatana macrolides uye fluoroquinolones, immunomodulators, proteolytic makemikari. Pakusarudza zvinodhaka vanachiremba, kufungisisa nehanya kuti vasabatwa pakati M. tibhii uye matambudziko ari kuiswa mishonga.
• Panguva III chirwere zvinodhaka kurapwa pamwe kukudzivirirai kuvhiyiwa. Murwere kana kukwana nephrectomy kavernotomiya anogona kupiwa (hwomukova mhango).
• Pakupedzisira pavaipfuura chirwere ndiye akatakura mishonga uye nephrectomy (nokubviswa kwakakanganisa itsvo).

Nephrectomy pakati TB nyaya Urinary kwava zvakanaka kazhinji. Izvi imhaka kunonoka nezve unyanzvi dzokurapa kusingadzoreki mwero kurapwa. Mushure nephrectomy, postoperative matambudziko zvinogoneka, asi ivo vari apo neapo. Izvi zvinosanganisira hematoma, pute subcutaneous mafuta, pus, uye kwenguva refu kuporesa fistulas, hernias.

Tiibhii of urogenital ino nevanhu, kureva sikarudzi, zvakawanda zvakaoma kurapa. Iye kuipa amenable kuti kuchinja kurapa. Kunorapwa vanogadzwa maduramazwi Anti-TB zvinodhaka zviri zvakafanana chipimo chemushonga sezvinoitwa tibhii nezvezvimwe zvinetso zvedundira. Uyezve, kana hosha anoratidzwa immobilization Via scrotal zvakasimba pedyo rinopisa chikumbiro novocaine blockades spermatic tambo (pachiimbwa streptomycin yakawanikwa). Tiibhii ngakuite urogenital gadziriro ikarapwa nokuda 2 kana 3 months. Kana zvabuda hazvisi dzinogutsa, zvino rinoitwa resection pakati epididymis kana epididymectomy. Kana nhamba kukundwa pamusoro testis kuitwa kuvhiyiwa kuti arubvise. Kana TB inokanganisa kweprostate gland uye seminal vesicles, ipapo aisirwe kuchinja kurapwa.

In mhedziso, zvinokosha kuziva kuti genitourinary tiibhii ikabuda anenge 10-15 makore kutanga pulmonary kana osteoarticular tibhii. Kana zviratidzo inokurudzirwa kutsvaka kubatsirwa unyanzvi uye kwete kunonoka kushanya, nekuti nokuda kuchiita nehosha mune ramangwana kungada kubviswa neitsvo. Mukutanga zvokukura wakadaro nei kunogona kudziviswa.