Eli nqaku linikezelwe kubo bonke abanikazi bezilwanyana ezifuywayo abaphatha izilwanyana zabo ngomonde nangenyameko. Nokuba bayahamba, baya kuva uthando lwakho.

01 inani lezilwanyana zasekhaya ezinengxaki yezintso liyakhula unyaka nonyaka

Ukungaphumeleli kwezintso okuqatha kunokubuyiselwa umva ngokuyinxenye, kodwa ukungaphumeleli kwezintso okungapheliyo akunakulungiseka ngokupheleleyo. Abanini bezilwanyana banokwenza izinto ezintathu kuphela:

1: Yenza umsebenzi olungileyo kuzo zonke iinkcukacha zobomi, kwaye uzame ukungavumeli izilwanyana zasekhaya zibe nokusilela kwezintso ngaphandle kweengozi;

I-2: Ukungaphumeleli kwe-renal acute, ukuhlolwa kwangaphambili, unyango lwangethuba, unganqikazi, ungalibali;

3: Ngaphambili ukusilela kwe-renal okungapheliyo kufunyenwe kwaye kunyangwa, ixesha lokuphila lide;

02 Kutheni ukusilela kwezintso kunzima ukuchacha

Kukho izizathu ezibini eziphambili zokuba kutheni ukungaphumeleli kwezintso kubi kwaye kunzima ukunyanga:

I-1: Njengoko kukhankanyiwe ngaphambili, ngaphandle kokuba ukungaphumeleli kwe-renal acute okubangelwa yi-poisoning kunye ne-ischemia yendawo kunokuguqulwa, ezinye azinakubuyela umva. Xa umsebenzi wezintso wokwenyani ukwenzakala kunzima ukuchacha, kwaye akukho chiza lokwenyani lokungaphumeleli kwezintso zesilwanyana emhlabeni, zonke ezo zizondlo kunye nezongezo;

2: Siyazi sonke ukuba intso lilungu eligciniweyo lomzimba wethu, oko kukuthi, sinezintso ezimbini. Ukuba umntu wonakele, umzimba usenokusebenza ngokuqhelekileyo, kwaye asiyi kuva sisifo. Izintso zibonisa kuphela iimpawu xa phantse i-75% yomsebenzi wayo ilahlekile, yiyo loo nto ukusilela kwezintso kudlula kade xa kufunyenwe, kwaye kukho iindlela ezimbalwa zonyango ezikhoyo.

Xa umsebenzi wezintso ulahlekile nge-50%, indawo yangaphakathi isazinzile, kwaye phantse akunakwenzeka ukufumanisa iingxaki; Ukulahlekelwa ngumsebenzi wezintso ngu-50-67%, umthamo woxinaniso ulahlekile, ixabiso le-biochemical aliyi kutshintsha, kwaye umzimba awuyi kubonisa ukusebenza, kodwa ezinye iimvavanyo ezizayo, ezifana ne-SDMA, ziya kwanda; Ukulahleka komsebenzi wezintso kwakungama-67-75%, kwaye kwakungekho ntsebenzo ecacileyo emzimbeni, kodwa i-biochemical urea nitrogen kunye ne-creatinine yaqala ukunyuka; Ngaphezulu kwe-75% yokulahleka komsebenzi wezintso kuchazwa njengokungaphumeleli kwezintso kunye ne-uremia ephezulu.

Olona phawu lucacileyo lokungaphumeleli kwezintso kukuncipha ngokukhawuleza komchamo wesilwanyana sasekhaya, yiyo loo nto ndifuna ukuba wonke umnini wesilwanyana ajonge umthamo womchamo wesilwanyana sakhe yonke imihla. Oku kunzima kakhulu kubanini bezilwanyana zasekhaya abasoloko bevumela iikati kunye nezinja ziphume ngokukhululekileyo, ngoko ke idla ngokuba ngumzuzu wokugqibela wokuba ezi zilwanyana zasekhaya zigule.

03 ezinye izigulane ezinokusilela okubukhali kwezintso zinokuchacha

Nangona ukungaphumeleli kwe-renal kwi-renal kuye kwaqala ngokukhawuleza kunye neempawu ezibukhali, kusenokwenzeka ukuba ululame, ngoko kubaluleke kakhulu ukuphepha ukwenzeka kokungaphumeleli kwe-renal kwaye ufumane unobangela wesifo. Ukungaphumeleli okubukhali kwezintso ikakhulu kubangelwa yi-ischemia yendawo, ukuvaleka kwenkqubo yomchamo kunye netyhefu.

Umzekelo, i-20% yonikezelo lwegazi entliziyweni yizintso, ngelixa i-90% yegazi lentso idlula kwi-cortex ye-renal, ngoko ke le ndawo isengozini kakhulu kwi-ischemia kunye nomonakalo owenziwe yityhefu. Ke ngoko, sihlala sifumanisa ukuba izifo zezintso kunye nentliziyo zihlala zinxibelelana. Xa elinye libi, elinye ilungu liya kuba sesichengeni kwaye libe sengozini yezifo. Oonobangela abaqhelekileyo bokungaphumeleli kwezintso okubangelwa yi-ischemia kubandakanya ukuphelelwa ngamandla kwamanzi emzimbeni, ukopha okukhulu kunye nokutshisa.

Ukuba ukuphelelwa ngamanzi emzimbeni, ukopha kunye nokutshisa akukho lula ukwenzeka, eyona nto ixhaphakileyo yokusilela kwezintso kubomi bemihla ngemihla kukusilela okubukhali kwezintso okubangelwa kukuvaleka kwenkqubo yomchamo. Kudla ngokuba ngamatye esinyi kunye ne-urethral, ​​ukuvaleka kwekristale, urethritis, ukudumba kunye nokuvaleka kwecatheter yomchamo. Ukuvaleka kubangela ukufumba komjelo womchamo, kuthintelwe ukuhluzwa kweglomerular, ukwanda okungeyoproteni yenitrogen egazini, okukhokelela kwi-glomerular basement membrane necrosis. Le meko kulula ukuyigweba. Ngethuba nje umchamo uvaliwe ngaphezu kweeyure ezingama-24, kufuneka sivavanye i-biochemistry ukuqinisekisa ukuba akukho nto iyenzekayo yokungaphumeleli kwezintso. Olu hlobo lokungaphumeleli kwezintso lukwakuphela kokungaphumeleli kwezintso okunokuchacha ngokupheleleyo kwiintsuku ezimbalwa, kodwa ukuba kulityaziswa, kusenokwenzeka ukuba sibe mandundu esi sifo okanye sijike sibe kukungaphumeleli kwezintso ngeentsuku ezimbalwa.

Iintlobo ezininzi zokusilela kwezintso zibangelwa yityhefu. Ukutya iidiliya yonke imihla yinto enye, kwaye eyona nto kukusetyenziswa kakubi kweziyobisi. Emanzini nakwi-electrolyte yolwelo lokuhluzwa kwakhona kweglomerular, iiseli ze-renal tubular epithelial zisesichengeni sokuxinana kweetyhefu. Ukukhuselwa okanye ukufunxwa kwakhona kweetyhefu ngeeseli ze-renal tubular epithelial kunokwenza iityhefu ziqokelele ukuya kuxinaniso oluphezulu kwiiseli. Kwezinye iimeko, i-toxicity ye-metabolites yomelele kunaleyo ye-precursor compounds. Ichiza eliphambili apha yi "gentamicin". IGentamicin sisiyobisi esichasene nokudumba kwesisu esisetyenziswa ngokuqhelekileyo, kodwa sinephrotoxicity enkulu. Kwiimeko ezininzi, nasesibhedlele, ukuba ukuxilongwa kunye nonyango alufanelekanga, kulula ukubangela ukusilela kwe-renal okubangelwa yityhefu.

Ndincoma kakhulu ukuba abanikazi bezilwanyana bazame ukungazitoli i-gentamicin xa benokuzikhethela. Ukongezelela, izilwanyana ezifuywayo ezinezintso ezimbi kufuneka zihlawule ingqalelo kumayeza. Uninzi lweziyobisi ezichasayo ziya kubonisa ukungaphumeleli kwezintso kwii-contraindications. Sebenzisa ngokuqaphela, i-cephalosporins, i-tetracyclines, i-antipyretics, i-analgesics, njl.

04 Ukusilela kwezintso okungapheliyo kufuna ukhathalelo lwesigulana

Ngokwahlukileyo kwi-acute renal failure, ukusilela kwe-renal okungapheliyo kunzima ukukufumana, kwaye akukho zimpawu zicacileyo kwinqanaba lokuqala. Mhlawumbi kuya kubakho umchamo ngaphezu kwesiqhelo, kodwa asikwazi ukugweba kubomi bethu bemihla ngemihla ngenxa yokunyuka komthamo womchamo obangelwa yimozulu eshushu, imisebenzi emininzi kunye nokutya okomileyo. Ukongezelela, kunzima ukufumanisa isizathu sokungaphumeleli kwezintso ezingapheliyo. Okwangoku, into enokuthi isetyenziswe njengereferensi zizifo ze-glomerular, ezifana ne-nephritis, i-nephropathy ye-innate genetic, i-urethral obstruction, okanye ukungaphumeleli kwe-renal engapheliyo ngaphandle konyango olufike ngexesha.

Ukuba ukusilela okubukhali kwezintso nako kunokukhawulezisa ukuchacha ngokwandisa unikezelo lwamanzi okusela, inaliti engaphantsi kwesikhumba yamanzi, i-dialysis kunye nezinye iindlela zokusebenzisa i-toxins kunye nokunciphisa umthwalo kwizintso. Akukho ndlela yokubuyisela umsebenzi we-renal kwi-renal engapheliyo. Into kuphela esinokuyenza ukunciphisa isantya sokulimala kwezintso kunye nokwandisa ubomi bezilwanyana ezifuywayo ngokutya kwesayensi kunye nezinye izondlo, ezifana ne-calcium supplement, ukusetyenziswa kwe-erythropoietin, ukutya ukutya okumiselweyo kunye nokunciphisa iprotheni. Enye into ekufuneka uyiqaphele kukuba ukungaphumeleli kwezintso ezininzi kuya kuhamba kunye nokuncipha komsebenzi we-pancreatic, kunye ne-pancreatitis, ekwafuna ingqwalasela.

Eyona ndlela ingcono yokujongana nokusilela kwezintso okungapheliyo kukuyifumana kwangoko. Okukhona ifunyenwe kwangethuba, kokukhona imeko ephilayo inokugcinwa ngcono. Kwiikati, xa iimvavanyo ze-biochemical ye-urea nitrogen, i-creatinine kunye ne-phosphorus ziqhelekileyo, i-SDMA inokujongwa rhoqo kanye ngonyaka ukufumanisa ukuba kukho ukungaphumeleli kokuqala okungapheliyo. Nangona kunjalo, olu vavanyo aluchanekanga kwizinja. Kwaba ngo-2016 eUnited States apho saqala ukufunda ukuba olu vavanyo lunokusetyenziswa kwizinja. Ngenxa yokuba ixabiso lokuvavanya lihluke kakhulu kwiikati, alinakusetyenziswa njengesalathisi sokuxilonga kwizinja kwinqanaba lokuqala lokungaphumeleli kwezintso. Umzekelo, i-25 kukuphela kwesigaba sesi-2 okanye ukuqala kwesigaba sesi-3 sokungaphumeleli kwezintso ezingapheliyo kwiikati, Kwizinja, abanye abaphengululi bakholelwa ukuba nangaphakathi kuluhlu lwezempilo.

Ukungaphumeleli kwezintso okungapheliyo kweekati kunye nezinja akuthethi ukufa, ngoko ke abanikazi bezilwanyana kufuneka banakekele ngomonde nangononophelo ngesimo sengqondo soxolo. Okunye kuxhomekeke kwikamva labo. Ikati endayinika oogxa bam ngaphambili yafunyaniswa inokusilela kwezintso okungapheliyo kwiminyaka eyi-13. Yondliwa ngokwesayensi ngamachiza kwangexesha. Ngeminyaka eyi-19, ngaphandle kokuguga kwamathambo kunye namathumbu kunye nesisu, ezinye zilungile kakhulu.

Xa bejongene nokungaphumeleli kwezintso, abanikazi bezilwanyana baneendlela ezimbalwa abanokukhetha ukuzenza, ukuba nje benyanga, bakhulise kwaye batye ngokwesayensi ngokwesakhono sabo, kunzima kakhulu okanye akunakwenzeka ukubuyisela ngokupheleleyo ixabiso eliqhelekileyo. Kulungile ukuba ne-creatinine kunye ne-urea nitrogen kuluhlu oluqhelekileyo kwaye ngaphezulu kancinci. Kuyintsikelelo yabo ukuchacha, Ukuba uyahamba ekugqibeleni, umnini wesilwanyana uya kuzama kangangoko anako. Ubomi buhlala buvela ngokutsha. Mhlawumbi baya kubuyela kuwe kwakhona ngokukhawuleza, ukuba nje uzimisele ukukholwa.