Nephrostomy: nws yog dab tsi, kev phais, kev kho mob, kev tiv thaiv thiab kev rau txim

Ob lub raum yuav tsum tau muab ib yam ntawm cov tseem ceeb tshaj plaws zog - xaiv ntawm cov kev pauv khoom los ntawm lub cev. Yog hais tias qhov no yog tsis ua li cas, tus neeg muaj peev xwm tuag los ntawm intoxication tus kheej metabolites.

Nyob rau hauv ib co piv txwv, lub raum ua hauj lwm yog hampered vim muaj ntau yam pathological lub xeev. Cov lawv - lub tsim ntawm cancer, urolithiasis. Nyob rau hauv cov ntaub ntawv no, cov ntshav pom thiab haum ntawm mineral ntsiab yuav siv sij hawm qhov chaw, tab sis qhov kawg khoom no tsis yog tso zis. Thiab tsim kom muaj cov txheej txheem, tsim nephrostomy.

Yuav ua li cas yog nws thiab thaum nws yuav tsum tau? Nephrostomy yog ib cov yeeb nkab (ntws) kev cob cog rua rau lub raum plab mog thiab deduced outwardly. Nws yog tsim nyog los xyuas kom meej cov ndlwg ntawm cov zis thiab tiv thaiv kom intoxication.

Nephrostomy - yog dab tsi? zog

Raws li yog lub npe hu, nyob rau hauv cov ntaub ntawv ntawm cancer, ib tug radical lag luam thiab khaws cia nruab nrog cev muaj nuj nqi tsis yeej ib txwm ua hauj lwm. Tej zaum cov cov nqaij mos tshaj ib tug loj cheeb tsam yuav tsum tau muab tshem tawm kiag li nyob rau hauv kom tsis txhob kis mob cancer. Nyob rau hauv lwm yam mob, on qhov tsis tooj, cov radical lag luam yog tsis tau vim lub pronounced mob ntawm lub cev. Rau lub hom phiaj no, nws yog invented palliative phais. Lawv tsis ua rau ib tug kho, tab sis pab mus rau kho ntawm muaj sia muaj zog. Palliative hauj lwm yog nqa tawm nyob rau hauv tag nrho cov teb ntawm Oncology, yog tsis muaj exception thiab urological kho mob.

Yog li ntawd raws li mus tsim kom muaj lub excretory muaj nuj nqi ntawm lub cev thiab cawm txiv neej los ntawm endogenous intoxication, kev nephrostomy. Nws yog los ntawm ib kua raj nyob rau hauv pyelocaliceal raum system. Cov dawb kawg ntawm nephrostomy tawm rau sab nraum, hais tias yog, qhov chaw ntawm daim tawv nqaij. Yuav kom qhov no yog kev cob cog rua ib tug tshwj xeeb lub thawv thiab lub outflow kawg khoom ntawm metabolism ua bypassing lub zais zis, zis thiab ducts.

Qhov no lub lag luam muaj feem rau cov hom ntawm palliative kho mob, ces tus kws kho mob yuav tsum zoo xav txog seb ib tug neeg mob xav tau kev nephrostomy. Yuav ua li cas yog nws thiab yuav ua li cas tu rau nws, nws yuav piav qhia rau tus neeg mob ua ntej phais. Thiab lub installation ntawm raum kua yog ua tau tsuas yog nrog daim ntawv sau tso cai los ntawm tus neeg mob los yog nws cov txheeb ze. Nws yog tsim nyog rau kev ntsuam xyuas tag nrho cov kev mob ntawm tus neeg mob thiab txiav txim seb puas yuav nqa tawm xws li ib lub lag luam raws li sai tau.

Indications rau tus me nyuam nephrostomy

Raws li nrog rau tej tug txiv neej-ua drains, nephrostomy nyob rau hauv lub ob lub raum ua ib tug tseem ceeb heev muaj nuj nqi. Feem ntau cov feem ntau, nws yog teev nyob rau hauv cancer ntawm lub genitourinary system. Yam tsawg kawg - nyob rau hauv lwm yam loj urological pathologies. Muaj tej indications raws li uas tsim nephrostomy. Lub lag luam yog ua, Yog hais tias nephrostomy muaj cov nram qab indications:

1. Cancer ntawm lub raum los yog lwm yam kabmob ntawm lub urinary system.
2. Hydronephrosis.
3. Urolithiasis nrog ib tug predominance ntawm pob zeb loj loj.
4. Metastasis mob ntawm tej chaw, cia li muab lub pelvic kabmob.
5. Ureteral rhuav txhua vim compression ntawm nws cov sab nraum los yog strictures.

Nephrostomy tsis tau tsuas yog yuav pab tau rov qab kho cov outflow ntawm kua los ntawm lub cev, tab sis kuj yuav tiv thaiv tau cov tshwm sim ntawm o. Raws li ib tug tshwm sim, zam mob thiab mob raum tsis ua hauj lwm.

Qhov no lub lag luam no tsis yog yuav hais tias cov dag kua yuav tsum nyob rau hauv lub cev tas mus li. Nyob rau hauv tej rooj plaub, tom qab ib tug tshwj xeeb kev kho mob (phais, kws khomob) nephrostomy yog muab tshem tawm. Tej zaum nws yog tsim nyog los cov ndlwg ntawm cov zis thaum lub sij hawm ntawm kev ua tau diagnostic cov txheej txheem (stenting).

Contraindications rau nephrostomy

Dua li ntawm qhov ceev yuav tsum tau mus phais nephrostomy nws tsis yog ib txwm tau mus ua. Contraindications xws li tej lub xeev:

• los ntshav;
• uncontrolled tawg;
• anticoagulation.

Rau cov kab mob nyob rau hauv uas cov ntshav coagulation yog ntxhov nws koom hemophilia, hemorrhagic vasculitis, thrombocytopenic purpura thiab cov zoo li. D. Nyob rau hauv cov pathologies tej hauj lwm kev pab txaus ntshai rau lub neej. Tib yam siv rau lub txais anticoagulants - tshuaj, ntshav nyias. Nephrostomy tsis teev thiab ntshav siab uas yog tsis amenable mus tshuaj kho. Coj phais nyob rau hauv tus mob no yog txhob vim hais tias ntawm txoj kev pheej hmoo ntawm stroke thiab cardiogenic poob siab.

Npaj rau qhov chaw kawm nephrostomy

Nyob rau hauv tus neeg mob ntawm kev ua txhaum ntawm lub outflow ntawm cov zis, uas yuav tsis raug tshem tawm nrog rau cov kev pab los ntawm cov tshuaj, yuav tsum nephrostomy nyob rau hauv lub raum. Lub lag luam rau nruab nws, raws li ib tug txoj cai, tsis siv sij hawm ntev, txawm li cas los, yuav tsum tau ib tug lub tsev kho mob nyob.

Ua ntej cov tswv yim mus rau lub kev phais, nws yog tsim nyog los ua diagnostic tests. Cov lawv - lub dav dav thiab biochemical kev kuaj ntshav, urinalysis, coagulation. Yog hais tias qhov ua rau ntawm anuria (kev ua txhaum ntawm lub outflow ntawm cov zis) tsis yog tseeb, instrumental muaj xeem yuav tsum tau. Cov no muaj xws excretory urography, ultrasonography ntawm ob lub raum, i.

Txheej txheem ntawm nephrostomy

Cov neeg mob, ntawm chav kawm, xav paub dab tsi yog yuav tsum tau nephrostomy nws yog dab tsi thiab yuav ua li cas nws yog teem. Nws yuav tsum tau muab sau tseg tias tso zis ntawm lub ntws raj ntawm lub raum rau ntawm daim tawv nqaij nto rau tej cov neeg phais xam tau tias yog tej yam yooj yim lub lag luam. Nws ua ob nyob rau hauv kev tshuaj loog thiab nrog rau cov kev pab los ntawm lub zos tshuaj loog. Nephrostomy ua sai sai, tsis pub dhau 15-20 feeb. Txawm li cas los, tom qab lub lag luam tus neeg mob yuav tsum tau saib xyuas. Nws yog tsim nyog rau kev ntsuam xyuas cov rov qab los ntawm cov zis outflow. Muaj 3 hom nephrostomy. Cov lawv:

1. Tiav ntawm qhib phais.
2. Laparoscopic kua installation.
3. Percutaneous nephrostomy.

Feem ntau cov feem ntau ua kev xaiv kawg nkaus. Txhim kho nephrostomy tej ntawm daim tawv nqaij thiab lwm cov ntaub so ntswg yog zoo dua zam los ntawm cov neeg mob. Nyob rau hauv tas li ntawd, percutaneous phais yog suav tias yog tsawg puas tshaj qhib phais. Nws ua nyob rau hauv ultrasound los yog X-ray.

Txheej txheem ntawm lub lag luam muaj xws li cov tej ntawm daim tawv nqaij, roj, nqaij thiab raum parenchyma siv tej koob. Thaum lub sij hawm tua ntawm nephrostomy tus kws kho mob saib cov saib. Qhov no yog qho tseem ceeb heev, raws li koj yuav tsum tau mus nyob rau hauv pyelocaliceal system tsis ua kom cov nyob ib ncig cov ntaub so ntswg. Tom qab zoo ntawm lub koob teem kua raj, cov dawb sab ntawm uas yog txuas mus rau ib tug zis sau lub hnab.

Thaum tshem ua nephrostomy?

Yog hais tias lub lag luam yog nqa tawm mus siv lub tshuaj kho mob (kws khomob, lub raum vascular stenting), tom qab yuav txo tau muab tshem tawm nephrostomy physiological zis outflow.

Tej zaum lub ntws raj teem rau ib tug tas mus li lub sij hawm. Feem ntau cov feem ntau ua rau mob cancer thiab mob. Nyob rau tib lub sij hawm nws yuav tsum tau hloov tsis tseg nephrostomy. Nws yuav tsum tau ua nyob rau hauv lub khiav hauj lwm chav tsev. Tsis zoo li cov thawj zaug phais, ntaub so ntswg tej yog tsis yuav tsum tau, txij thaum lub tsim fistula qhib.

Rov qab tom qab phais

Rov qab tom qab nephrostomy yog ceev ceev. Twb tau nyob rau thawj hnub tus neeg mob yuav tsiv mus nyob ib ncig ntawm lub pawg ntseeg uas muaj kua raj. Siv tshuaj tua kab mob tom qab phais yuav tsum rau 5-7 hnub rau kev tiv thaiv kab mob. Tsis pub dhau 2-3 hnub cov ntshav yuav ua tau rau hauv lub hnab. Qhov no yog vim kev puas raum hlab ntsha. Tom qab 3 hnub, lub los ntshav nres. Yuav kom tswj cov ndlwg ntawm cov zis ua ultrasound.

Nephrostomy: tsev kho mob nyob ib leeg

Txij li thaum kua yog ib tug txawv teb chaws lub cev rau lub cev, ntawm txhua lub sij hawm nws yog ua tau rau kab mob. Qhov no ceeb toom ntawm txhua tus neeg mob, uas yog teem nephrostomy. Catheter kho mob yuav tsum tau nqa tawm tsis tu ncua. Los ntawm txoj kev tiv thaiv kab mob muaj xws li:

1. Ntxuav nrog ib tug kua raj nrog saline thiab antiseptics. Rau lub hom phiaj no yog ib tug npaj "Chlorhexidine" los yog "Furatsilinom".
2. Imposing ib tug menyuam tsis taus ntaub qhwv nyob rau cheeb tsam uas qhov phais mob.
3. Raws sij hawm muab nchuav ntawm lub urinal.
4. Xyuas los ntawm ib tug kws kho mob txhua txhua 2 lub lis piam.

Cov neeg mob uas muaj ib tug nephrostomy, koj yuav tsis txhob siv, nqa tes taw hnyav li. Lub inflection ntawm lub kua raj tej zaum yuav raug nyob rau hauv cov teeb meem, yog li lub catheter yuav tsum nyob rau hauv ib tug txoj hauj lwm.

Cov kws kho mob hais txog nephrostomy

Raws li urologists, nephrostomy - yog ib tug tsim nyog ntsuas, yam uas yog yog tsis yooj yim sua ua li cas. Txawm tias cov teeb meem tshwm sim los ntawm cov lag luam, thiab qhov yuav tsum tau rau qhov kev kho mob ntawm kua, installation ntawm catheter cov neeg mob yuav tsum txuag lawv los ntawm txoj kev qaug cawv thiab kab mob.