I-neurogenic bladder: ibangela
Ukungasebenzi kwe-neurogenic bladder kubantwana yinkinga eqhelekileyo, ngokuqhelekileyo iyenzeka kwi-10% yabantwana. Le ngxaki ichaphazela kakhulu ukuphuhliswa kwezifo ezahlukahlukeneyo ze-urinary system, ezifana ne-pyelonephritis, i-cystitis engapheliyo, ukungaphumeleli kwe-renal.
I-neurogenic bladder kubantwana ayibonakalise isoyiko elisemngciphekweni ebomini, kodwa kuluntu le nto yingxaki ebalulekileyo enokubangela iingxaki ezininzi ngokulungelelanisa kunye nentlalo yomntwana, echaphazela umsebenzi wokuthetha kwakhe kunye noontanga nokuzithemba.
Enyanisweni, i-neurogenic bladder kubantwana (i-NRM) ngumbono odibeneyo odibanisa iqela elikhulu leengxaki zokukhutshwa kwayo kunye nemisebenzi yamanzi. Ezi ngxaki ziphuhliswa ngenxa yomonakalo kwimisipha ehlaziyileyo ye-bladder, iziphazamiso zenkqubo yesantya zamanqanaba ahlukeneyo kunye nobunzulu okanye utshintsho kwisakhiwo se-uroepithelium.
I-neurogenic bladder: iimpawu
I-neurogenic bladder ibonakalisa kwiintlobo ezimbini zokuphazamiseka komchamo:
- ukugcina umchamo;
- ukungahambisi kwamanzi.
Imiqondiso ye-neurogenic bladder ihluke ngokuxhomekeke kwinqanaba kunye nobunzulu be-system ye-nervous.
Abantwana abakwazi ukulawula ngokukhawuleza ukuhamba ngokuqhelekileyo ukuya kwi-2-2.5 iminyaka. Kuze kube le minyaka, ukukhutshwa kwayo kulawulwa yi-refronron, intambo yomgca we-sacral. Ukuba ukuguquka kwe-reflex kuphawulwa ekukhuleni, sinokuthetha ngokungahambanga kwimizuzu emanzini. I-bladder ikhutshwe ngaphandle kwemimiselo, ngokuzenzekelayo.
Njengomthetho, ukungabikho kwamanzi okungcola kubantwana (i-neurogenic hyperreflex urinary bladder) yahlula kwiindidi ezilandelayo:
- imfuneko (inzwa kunye nemoto);
- xineka;
- reflex;
- kuphuma.
Abazali abaye baqaphela ukungabikho kokungcola komntwana, kuyafaneleka ukuthobela ingqalelo ezi zinto zilandelayo:
- Ixesha apho ukungabikho kwe-incontinence kwenzeka.
- Ukuphindaphinda kunye nokuphindaphindiweyo kokuphindaphindiweyo kweziganeko zokungabikho.
- Izinto ezihambelanayo.
I-Bedwetting kubantwana ivela kwi-pathology ehlukeneyo - i-enuresis yasebusuku.
Ngokwahlukileyo, kuyafaneleka ukubeka ingqalelo kwimbonakalo yokungabikho kwabantwana ababenokukwazi ukulawula ukuhamba ngokugqithiseleyo kwaye babengenalo ukulimala kwentloko nokubuya. Oku kungabonakalisa ukungathandeki okukhulu kumsebenzi we-system ye-nervous.
I-neurogenic bladder: unyango
Zonke iindlela zonyango zokwenza i-bladder dysfunction zingahlula kumaqela alandelayo:
- ukunganyangeki kweziyobisi (ukuqeqeshwa kwesikhumba, ukusetyenziswa kwemisipha ye-pelvic, iindlela zephysotherapy, njl.);
- i-pharmacotherapy;
- unyango.
Naliphi na icebo lonyango lwe-NRM luqala ngokutyunjwa kwezinto ezininzi ezingenasicathulo kunye neendlela ezilula zokwenza unyango, ukunikela nje ngeempembelelo ezinobungozi. Sincoma urhulumente wokukhusela kunye nobuncinci beengxaki, amava, ngaphandle kweemeko zengqondo. Ukubonisa kwakhona ukulahla kweemidlalo ezisebenzayo ngaphambi kokulala, uhamba emoyeni omtsha.
Makhe siqwalasele ngokungakumbi iinkcukacha zokuphatha i-neurogenic bladder ngoncedo lwamachiza. Iziyobisi ezichanekileyo zala maqela:
- iivithamini (ngokukodwa, iqela B, PP, A, E) kumanani afana nesigulo seminyaka;
- i-anticholinergics (i-bellataminal 0,5-1 tablet 2 imihla ngemihla, i-melipramine 0,02-0,05 g ubusuku bonke, i-atropine i-0,05-0,5 mg nge-1-2 ngokuphindaphindiweyo ngosuku-enye yeziyobisi ngokukhetha);
- Iindlela zokuqhelanisa iinkqubo ze-metabolic kwinkqubo ye-nervous central (amino acid, nootropics, sedatives).
Ingcali kufuneka imisele ukuxilongwa nokucacisa unyango, ngenxa yokuba ukhetho lwezonyango luxhomekeke ngokupheleleyo kumxinano wokungasebenzi, uhlobo lwalo, imeko yesigulane, ukusetyenziswa kweendlela zokusetyenziswa zonyango ngaphambili, ubukho bezifo ezidibeneyo,