Apostematozny pyelonephritis: mea, lalau mai, symptoms,ʻike, lapaʻau

Ka maʻi o kekahi o kaʻanuʻu o ka huʻi pyelonephritis. I ka apostematoznom pyelonephritis ana hoʻoʻino keʻano o ka hanaʻana i loko o i mau liʻiliʻi abscess pus (apostemy) e hana. O ka papa kuhikuhiE wahi o ko lākou IIeEeAIEUAA o ka wauke o nā puʻupaʻa.

Ka iniiaiie palapala

Loa pinepine apostematozny pyelonephritis hoʻomaka e hoʻomōhala ka wā ureteral iaʻi, ma ka liʻiliʻi loa - me kōna urinary outflow.

I hakuʻala uuku pustules i hanaʻia i loko o ka penei: he glomerular capillary loop i loko o nā ipu maʻi koko, a me ka hakuʻala ma peritubular capillaries loaa microorganisms. Ma ka ia mea koʻohune clots i hana, ka mea, a laila e mālama aku i ke kumu o pustules. Ka mea, i aia ma luna o ka ili o kaʻaʻa puʻuwai cortex, e like me ka fibrous mea hōʻikeʻikeʻuʻuku i loko o nui mea. I ka nana aku la au, mai ko lakou maopopo i nanaia. Apostemy i ka yellowish kala like 'ole, ka nui mai i ka 2 mm o, e ke hoonohonoho i ka pūʻulu paha singly.

I ka apostematoznom pyelonephritis hakuʻala, piʻi pū me ka nui, i ke kamako iki ulaula waihoʻoluʻu. Hakuʻala'aʻaʻa mea edema, ai hanaʻia naʻe o ka fibrous mea hōʻikeʻikeʻuʻuku ia lŘlŘ. ʻaʻa puʻuwai mahele i nanaia pustules, ke huai ae ia i loko o ka medulla.

Apostematozny pyelonephritis, bacteremia a me abscess o ka hakuʻala

I ka lua o ka palapala o ka maʻi - he paea hakuʻala. Ua lŘlŘ purulent necrotic hui, kēia pōʻino, hakuʻala abscess. Ma ka cortex e hana foci o necrosis. Bacteremia kānāwai ka wā i ke alanui hematogenous laha o ka maʻiʻaʻai. Ma na hihia ke kumu pyelonephritis apostematoznogo lilo pustular maʻi, bareka, furunculosis, mastitis, felon. Keʻano papa hana o ka ho okumu ana o paea nei:

• Mea koʻohune thrombus komo kaʻaʻa puʻuwai artery mai ka distal keena pus no laila, bacteremia ia lŘlŘ i loko o kekahi o nā cii o ka arterial koko lako mau lala a uuku arterial lālā.

• Bacteremia e hana ana i mīkini'opihia o kekahi moku nui intrarenal hoʻoʻino infiltrate a mai ka hui 'ana me ke kumu o ka li nui i loko o ka vascular paia.

Ka loa, he pono ole kumu ulu paea microorganisms, e like me keʻokeʻo, a Staphylococcus aureus, Proteus a me E. coli.

ʻaʻa puʻuwai paea mahele ike i ua hoʻokōʻia bulging o necrotic'aʻaʻa, ka mea, ua permeated ma pustules uuku fused, e waiho aukaʻoi parenchyma.

Huʻi pyelonephritis apostematozny pinepine hiehie paea hakuʻala a me ka apostematozny pyelonephritis. Ka lapaʻau hoike ana mai o ka mea nui like 'aʻole mālama.

Ka lapaʻau kiʻi apostematoznogo pyelonephritis

Symptoms apostematoznogo pyelonephritis a me ka paea hilinaʻi nui ma luna ana o Nyos i ke kahe o ka mimi, mai ka hakuʻala.

Loa pinepine, i ka iniiaiie ano o ka pyelonephritis ia lŘlŘ koke, IeAUPIIe, IAa IO hope intercurrent maʻiʻaʻai. Akaka ole, kuni (mai i ka 40 degere) me ka kaumaha hou. Hectic ano ua Kīwala'ō e kuni (wela ala, oia ke ala e haule iho). Maikaʻi ole hiki ī hope mai i kekahi hora, oi paha, e ana ma ka piko o ka mahana ala. Ma hope o ole sweating hoomaka ma ke ana wela hoole mai oia. Mau symptoms i ka mea mua ekolu lā hoʻohikiʻia weakly.

Next, hoʻomaka e ulu hoʻi kaʻeha. I ka hakuʻala palpation mea maopopo ola, e mahuahua. Loli ma ka mimi ana ma ka lima o ka lā, he mea bacteriuria, proteinuria, leucocyturia.

E Picture i ke koko wehewehe aku ma ka leukocytosis, ka palaoa i loko o keʻokeʻo koko keena, mahuahua erythrocyte sedimentation ana, anaemia.

Me ka e holumua ai kaʻina e ulu sepsis, purulent ka metastatic foci o ka li nui i loko o ke akepaa, akemāmā, lolo.

Ke Kalinika hakuʻala paea

Inā ma ka hakuʻala, ma he paea, i nee ka pele o ka mimi, he lapaʻau kiʻi i like i ka huʻi infectious kaʻina. Piʻi ka mehana i 40 degere, wehewehe aku e ole nani loa a me ka ninini ipu. Ka Uluwehi o ka nawaliwali, hanu e hoola ae, ke hele mai nausea a me ka luaʻi, tachycardia.

I ke kakahiaka nui lā pinepine ole eha, aole hoi he bacteriuria, leucocyturia, dizuricheskie kāna hana. ʻike, Ua paʻakikī. E hoomanawanui i ke kiʻi no ka lapaʻau i ka pākōlea, infectious,ʻoki lāʻau lapaʻau oihana. Ke kauka ke kuhihewa diagnosing pneumonia, huʻi cholecystitis, typhoid kuni, a me ka mea e like. Wale i kekahi mau lā ma hope, i ka wa a na symptoms hoʻomaka e hōʻike kūloko (eha, symptom Pasternatskogo, no ka palupalu), ke kauka e kālele ana ma luna o nā puʻupaʻa.

Apostematozny pyelonephritisʻike,

ʻike, o ka mea maʻi ua ma muli o ka kēia nā hoailona:

• febrile manawa mau no ka oi aku i nā lāʻekolu;
• mahuahua hakuʻala eha i ka palpation;
• Keʻena hoʻokolohua haʻawina: bacteriuria, leucocyturia, koko - leukocyte haʻalele naeaeaa, leukocytosis, CRP, ESR mea ulu;
• excretory Voiding - hoemiia hakuʻala hana, mahuahua ma kaʻaoʻao maikaʻiʻole ia ma;
• US - kaupalena 'ka hoʻoneʻe, hoomahuahua i ka nui o nā loko, ai hanaʻia naʻe oi ma mua o 2cm parenchyma, kona' ole-ʻaʻahu paʻapū; wai perinephric makahiki pyelocaliceal'ōnaehana Hoʻonui i ka pono ureteral iaʻi;
• MSCT, MRI, HI - mahuahua ma ka hakuʻala nui, ai hanaʻia naʻe o ka parenchyma, kona heterogeneity a me outbreaks o purulent suppuration;
• hōʻeuʻeu a kūpaʻa nefrostsintigrafiya - mahuahua ma ka hakuʻala nui i loko o ka parenchyma haoʻa hoʻomāhuahua kālaiōewe.

Purulent suppuration'aʻaʻa maopopo i hoikeia ma ka paea. Ma US foci i loko o ka parenchyma o kiʻekiʻe paʻapū i maopopo i nanaia, e like me kā lākou mau hui 'ole. Maopopo hiki ma kēia kiʻi a me MRI, HI. ʻoni iho HI me ka Akä naÿe holomuaʻo ia ka mea e hiki ai e ike i ka 'aʻe ka wā e loaa i ka Akä naÿe, e necrosis.

Pilikia ma ke kālailaiʻana

Hihia i loko o ke kālailaiʻana i ka hoʻomanawanui i ka ke ano hiki ke'ākoʻakoʻa, inā ma mua o ke komoʻana i ka urology nā mea maʻi undergoing antibiotic Inc me ke kālā no antibiotics no kekahi - mau pule. Oia lapaʻau hiki i laumania 'ia apostematoznogo pyelonephritis, akā, he kumu hou e ole ana. Kino wela ua ua hoʻemi, emi eha, ole kākaʻikahi i hoʻomaka ai, i ko lakou ano emi haʻi a me ka lōʻihi-ka loihi. Ka hoemiia ka helu o ke koko leukocytes, akā, leukocyte haʻalele naeaeaa nō pilikia like anaemia, a mahuahua ESR. Ma nā hua'ōlelo, ka maʻi hoike mai ai ia ia iho me he flaccid sepsis. Kēia "hou" - i ke kumu no ka hana ana i ka hewa hoʻomanawanui. E pale aku i ka ulu ana o ka loa sepsis ma ke alo o ka hakuʻala hoomanawanui ipu ahi luku mea pono ke hana.

palena pauʻike,

Ma nä apostematoznogo pyelonephritis, pono e differentiated i ka maʻi, mai nā nā mea palahēhē. Me ka huʻi pancreatitis a me ka cholecystitis me subdiaphragmatic abscess, huʻi appendicitis, huʻi cholangitis, huʻi adnexitis a me ka huʻi pleurisy.

hakuʻala Kurbunkul differentiated me ka mea festering hakuʻala cyst,ʻeho parenchyma, me ka huʻi maʻi o abdominal lua.

He aha differentiates apestomatozny pyelonephritis a me kaʻaʻa puʻuwai paea?

• Pyuria. Bacteriuria.
• Low hoʻi eha.
• ʻaʻa puʻuwai dysfunction.
• Ai hanaʻia naʻe o ka parenchyma. Hoʻololi 'ana i loko o kona pa apŘ.
• Ola palpation me ka hoomahuahua i loko o nā puʻupaʻa.
• Ke anoe o kaʻaʻa puʻuwai pelvis nenoaiu.

Ke ultrasound, MRI, HI ae e hoomaopopo apostematozny pyelonephritis o kekahi mau huʻi maʻi o ka peritoneum.

lapaʻau

Lapaau apostematoznogo pyelonephritis a me ka paea, lawe mai nō ma kaʻoki kino. Loa pinepine, i ka hana ua hana ma luna o kekahi ulia pōpilikia manawa. Ka mua pōkole preoperative e hoʻomākaukau ai, me ka komo Anesthetist mau i oi aku, elua no hora. Ke aʻo nā:

• Pelvis catheterization, intravenous hooko ana o ka antibiotic.
• Transfusion o ka monakō koko a me electrolytes.
• Noaaeeecaoee o ke koko,.
• E like me ka hoike ana - cardiotonic.

I ka papa kuhikuhiE manao o ka hana - e ole sepsis. E olaʻi ola.

A haumāna Pahuhopu - i ka hoola ana o nā puʻupaʻa.

No ka anesthesia hoʻohana endotracheal anesthesia.

Iloko o ka hana maʻiʻo pa paka abscesses a me pelvis e e kekahi mea kanu, e hooholo microflora no hou paa o ka pā lonoaʻili i ka antibiotics. Nā hualoaʻa, e hoʻokūpaʻa i ka purulent pyelonephritis, a e hooholo hou lapaʻau ka hoʻolālā.

Ka postoperative manawa

Ma hope o kaʻoki kino, i ka hoʻomanawanui hookipa mai i ka iapaau ana me ka nānā 'ana ma inhibition o kaʻaʻa puʻuwai kuleana pili i a me ka intokikatsii. Ke hoomanawanui Ua häʻawi mai:

• 10% monakō koko pāʻoihana - 500 ml, 10 U insulina intravenously;
• pāʻoihana o 9% paʻakai koloriside - 1000 ml;
• gemodez - 400 ml;
• cocarboxylase - 200 mg;
• Wikamina B6 - 2 ml;
• wikamina C - 500 mg;
• Korglikon pāʻoihana o 0,06% i 1.0 ml;
• 15% mannitol pāʻoihana a me 50 ml;
• Lasix i 60 mg;
• Hou paʻahau (maoli) wai koko - 250 ml;
• Clexane a Fragmin, haawiia mai na mea kiko'î o coagulation;
• piha ula koko keena no ka anaemia (HB emi o 70).

Wā hoʻohana purulent intoxication extracorporal detoxification (plasmapheresis, hemosorbtion, plazmasorbtsiya).

Koi antibiotic Inc me nā antibiotics o ke ākea pae o ka hana.

ka loa kēia i kūpono (MRI, HI, ultrasound) e hoʻohana 'ia i loko o ka auhau ana o ka parenchyma. Kēia i mea e hiki ai i ka pono Loiloi i ka pilikia, a koho i ka buke loa pono o ka hana.