Ukwaziswa kweziindlela ezininzi zokuxilonga kusekude kugqibelele, ngoko kwezinye iimeko ugqirha kufuneka athathe isigwebo. I-biopsy yintambo yendawo encinci yeentso esebenzisa izixhobo zokugada. Isampula esiphumela sithunyelwa ngokukhawuleza ukuze kuhlolwe i-microscopic kunye ne-hertological examination.
Iingubo ze-Renal biopsy - izibonakaliso kunye nokuchasene
I-teknoloji echazweyo inceda ugqirha ukuba acacise ukuxilongwa okulindelekileyo, ukufumanisa ubunzima kunye nezimbangela ze-pathology ezifunyenweyo nokuphuhlisa isicwangciso socwangciso olusebenzayo. Ukongezelela, isetyenziselwa ukwahlula izifo. I-kidney biopsy ne-glomerulonephritis iqinisekisa ukuhlukana kwayo kunye nomnye umonakalo komzimba:
- amyloidosis ;
- Sesifo sikaBergger;
- pyelonephritis;
- nephropathy ;
- i-interphitial, ifa okanye i-nephritis engapheliyo.
Ziziphi iintlobo zesifo seengtso zi-biopsy?
I-intake ye-tissue intake ayiyenzi kwisicelo somguli, kuphela ingcali inokuyincoma kuphela ukuba kukho izizathu ezifanelekileyo zenkqubo. I-Renal biopsy: ukufunda:
- i-glomerular okanye i-proteinuria ye-tubular;
- hematuria;
- nephrotic syndrome;
- Ukungaphumeleli kwe-renal, glomerulonephritis ngokuqhubela phambili ngokukhawuleza;
- i-tubulapathy yeemvelaphi ezingachazwanga;
- krokrela i-neoplasm;
- Ukusebenza okungalunganga kwilungu elitshintshiwe.
Iinjongo zeengqondo zonyango zenziwa ngeenjongo ezilandelayo:
- ukhetho lwonyango olwaneleyo;
- lawula ukusebenza kwekhosi ekhethiweyo;
- ukubeka esweni imeko yokufakelwa.
Iinjongo ze-biopsy - iingqinisiso
Kukho izifo kunye neemeko zesifo apho oku kuqhutyelwa khona:
- ukunganyanzelwanga kwezidakamizwa ezine-novocaine;
- intliziyo enye isebenza;
- ukuphazamiseka kwegazi;
- hydronephrosis;
- ne-aneurysm ye-artery;
- ukuhluleka kwesiseko sokungena;
- isifo sofuba;
- i-thrombosis yeemvini ze-renal;
- i-purinent perinephritis;
- isisu;
- kwengqondo;
- ngqondweni;
- kuhlala e coma.
Kwezinye iimeko, ukugqithisa i-biopsy yeentso kuvumelekile, kodwa kufuneka kwenziwe ngokuqaphela okukhulu:
- ukungafihli komzimba kwisigaba esinzima;
- periarteritis;
- i-diastolic ingozi yegazi kunye neendleko ezingaphezu kwe-110 mm Hg;
- myeloma;
- iqondo lokuthi i-atherosclerosis;
- ukuhamba kwamathambo e-organism;
- Nephroptosis.
Iinjongo ze-biopsy-pros and cons
Inkqubo ekuthethwa ngayo idibene neengxaki eziyingozi, ngoko umbuzo wokusebenza kwawo ugqitywe ngugqirha ofanelekileyo. Ukukhawuleza kunokunika ubungakanani obuninzi beenkcukacha ngezizathu, ubunjani bekhosi kunye nobunzima besifo, kunceda ukusekwa ngokuchanekileyo nokungafumani ngephutha. Ngexesha elifanayo, liyakwazi ukuphazamisa imiphumo emibi, ingakumbi xa yenziwa phambi kobungqina.
Ngokwahlukileyo, izazi ze-nephrologists zixubusha i-biopsy ye-tumor tumors. Ubukho beemvumbo kulo mzimba bufumaneka kwakhona ngezinye iindlela ngaphandle kwesidingo sokutshatyalaliswa. Phantse zonke ukukhula okufunyenweyo zixhomekeke ekususwe, okubonelela ngokubanzi ukufikelela kwiifom zeentso, kunye ne-tumor ngokwayo. Kule nkalo, iingcali zinqabile ukuba zichazwe ngokuchanekileyo ukunyanzelisa ukuqhutyelwa kweengxaki zokufunda.
Ngaba kubuhlungu ukwenza i-kidney biopsy?
Inkqubo eyenziweyo iyenziwa phantsi kwezenzo zengqondo ye-anesthetic yangaphakathi (i-sedation okanye i-anesthesia jikelele). Nangona ukwazi malunga ne-anesthesia, ezinye izigulane ziyaqhubeka zifumanisa ukuba i-kidney biopsy ayiyibuhlungu - ingaba ibuhlungu okanye ingabi ngqo ngexesha nangemva kweshoni. Ukuba inqubo eyenziwa ngumcebisi onamava, kubangelwa ukuphazamiseka kancinci. Ukusetyenziswa ngokufanelekileyo kwe-anesthetic kuqinisekisa ukuphathwa kabuhlungu.
Kutheni i-kidney biopsy iyingozi?
Inkxalabo eqhelekileyo (kwi-20-30% yezigulane) zokuxhaphaza kuphaphaza okulula, okuyekelela kwiintsuku ezimbini kwiintsuku ezimbini. Ngamanye amaxesha i-kidney biopsy inzima kakhulu - iziphumo zingabonakaliswa ngolu hlobo:
- pneumothorax ;
- usulelo lwezicubu zomzimba;
- umonakalo kwizitho zangaphakathi ezikufutshane;
- ukubola kwamanzi;
- colic renal;
- umkhuhlane;
- ukuphazamiseka kwesigqeba;
- buhlungu;
- ukuphuka kwesigxina sezantsi seentso;
- ukubonakala kwe-hematoma ye-perirenal;
- ukunciphisa uxinzelelo lwegazi;
- paranephritis
- ukubunjwa kwe-fistula yangaphakathi.
Inqabile kakhulu (ngaphantsi kwe-0.2% yamatyala) i-kidney biopsy iphetha ngomsindo. Iingxaki eziyingozi kakhulu kwinkqubo:
- ukuyeka ukusebenza komzimba;
- imfuno ye-nephrectomy;
- iziphumo ezibulalayo.
Yintoni enokuthi ithathe indawo yentsholongwane yeentso?
I-full-fledged, kodwa i-analogs engaphantsi kunye neyobuhlungu, i-analogs yezifundo ezichazwe kwi-teknoloji azange zenziwe. Iinjongo ze-biopsy njengendlela yokuxilonga ibonakaliswe ngokubanzi ukuqonda nokuchaneka. Ezinye iindlela zokuchonga i-pathologies ye-urinary system ayithembekanga kwaye inganika iziphumo ezingamanga. Njengenye indlela yokusetyenziswa, i-ultrasound isetyenziswa rhoqo, kodwa kwiikliniki eziphambili, i-kidney biopsy ithathelwa indawo yobuchwepheshe bwanamhlanje.
- tomography;
- utywala ;
- i-radiosotope i-renography;
- veno- kunye ne-arteriography;
- i-angiography;
- i-radioric radiography ngokuchaseneyo.
Iphi i-biopsy yeentso yenziwe njani?
Uhlobo oluthile lwe-classical of puncture lwenziwa ngendlela evaliweyo. Ukusebenzisa i-ultrasound okanye i-X-ray zixhobo, indawo yeentso iboniswa. Ngokutsho kwakhe, ugqirha uzisa inaliti ekhethekileyo ngaphantsi kwilungu ngaphantsi kokuhlolwa, ukungena ngaphakathi kwesikhumba esasilunxwemeni kunye nesisundu se-muscle. Xa sele ufikelele ekujoliswe kuyo, ifowuni yokuqhawula isenza isampuli ngokuzenzekelayo. Ngamanye amaxesha, ekufundeni oluchanekileyo, kufuneka uninzi lwezinto eziphilayo, kwaye kufuneka ujobe inaliti ngezihlandlo eziliqela (ngomgca omnye).
Kukho ezinye iindlela, njengeengxaki zeengso:
- Sula. Iisampulu zamathambo kunye nohlalutyo lwabo olulandelayo lwenziwa ngexesha lotyando phantsi kwe-anesthesia jikelele.
- Ngokufikelela kwi-vein jugular. Le ndlela ikhethwayo kwizigulane ezinokukhubazeka kwegazi, ukuphefumula ukuphefumula, okanye ukungabikho kokuzalwa komzimba kwesakhiwo sezintso.
- Urethroscopy nge-puncture. Le ndlela imiselwe phambi kwamatye kwi-pelvis kunye ne-ureter, izitho ezifakwe kwi-intlanzi, ikhuthazwa ngabafazi abakhulelweyo nabantwana.
Yintoni ebangela ukushisa emva kwentsholongwane yeentso?
Umoya omlilo okanye utshintsho oluncinane kwi-thermoregulation kaninzi lubonwa emva kweeyure eziliqela okanye iintsuku ukusuka ekugqibeleni. Ukushisa emva kokuba i-biopsy yeentso ingenzeka ngenxa yezi zizathu zilandelayo:
- iinkqubo ezivuthayo kwiiscuphe zelungu okanye imisipha;
- ukusuleleka kwesikhumba kwisiza sokuhamba;
- pathologies purulent;
- umonakalo kwizakhiwo eziseduze.
Ingxaki eqhelekileyo enxulumene ne-biopsy yezintso iyancipha kwaye ikhupha ukuphuma kwangaphakathi kwi-fiber ephaseneyo kunye ne-capsule yelungu (perirenal hematoma). Xa imiphumo yale ntsholongwane iyanyamalala, kwaye ukuqokelelwa kwe-biological fluid iyaqhaqhazeka, i-fever iyakwenzeka. Akufanele uzame ukufumana izizathu zalo, kungcono ukuba ufumane ngokukhawuleza ukungena kwangaphakathi kwi-nephrologist.
I-Hematoma emva kwe-kidney biopsy
Inkcazo echazwe yinkqubo ayifumanekanga, ibingaphantsi kwe-1.5% yamatyala. Ubunzima bokungena kwi-hemorrhage yangaphakathi kunye nokubunjwa kwe-hematoma enkulu kuxhomekeke kwindlela i-kidney biopsy eyenziwe ngayo ngokuchanekileyo-indlela oku kuqhutyelwa ngayo (ukukhethwa kwendlela), nokuba i-anesthesia yokuqala kunye nokunyangwa kwe-antiseptic yaqhutywa kakuhle.
I-hematoma ye-Periorenal ayibhekiseli kwimiphumo engozi yecandelo lokuxilongwa kwaye ayifuni ukungenelela ngoncedo, kodwa ihlala ihamba kunye nokunyuka kwamaqondo okushisa komzimba kunye nezinye iimpawu ezingathandekiyo:
- ukunciphisa uxinzelelo lwegazi;
- ukusika, intlungu enzima kumqolo osezantsi;
- ukubonakala kwegazi kumchamo okanye utshintsho kumbala wayo kwi-pinki, ebomvu;
- ukunciphisa i-hemoglobin concentration kwiimvavanyo zegazi;
- ubuthathaka, ukulala;
- ukungabi nesidlo;
- ukuphazamiseka kokuhamba.