Uxinzelelo kwezintso. Iimpawu kunye ikhondo kwezonyango sifo

uxinzelelo kwezintso, iimpawu apho ukusekwa kukho ezininzi izinto ngokuyimfuneko isifo parenchymal sezintso lwegazi-olubangelwa okanye izitya sezintso. 30-35% yabantu abanengxaki lwegazi babe ezihamba isifo sezintso, ngenxa apho kukho uxinzelelo eyomeleleyo kunye nokwandisa, kuba uxinzelelo nezintso zidla zihlobene.

lwegazi Nephrogenic yahlulwe iintlobo ezimbini: renovascular kunye parenchymal bobabini kuchaphazela xi kwezintso. Iimpawu oku kunokuba engacacanga kakhulu kwaye ngokuphosakeleyo nezinye izifo rhoqo. lwegazi Renovascular iphuhlise ngenxa stenosis ngomoya omnye okanye amabini okanye occlusion kwemithambo kwezintso kunye amasebe awo. lwegazi Renovascular kunokuba zombini umlinganiswa ezifunyenwe kwaye isegazini. Parenchymal lwegazi, kwiimeko ezininzi, okubangelwa pyelonephritis mazwe ezinganyangekiyo okanye ezinye izifo zezintso, nephrolithiasis onjalo (amatye kwizintso), isifo sephepha, iinkqubo ithumba, cysts, hydronephrosis, polycystic kunye nezinye izifo ezininzi.

Kwi-avareji, hypertension renovascular kwenzeka ngo-5-12% abantu abanengxaki lwegazi. Kukho izizathu ezininzi ezinkulu iziphene nomfutho renovascular, eziquka: kwemithambo, dysplasia kunye nezinye mgaqweni zophendlo lwezifo kwemithambo kwezintso, fistula arteriovenous. Phakathi izizathu ezithile kwiifom ezifunyenwe lwegazi renovascular zezi: sezintso kwimithambo stenosis ngenxa yegazi, utshintsha imithambo sezintso ngenxa inkqubela Nephroptosis, Embolism okanye thrombosis kwemithambo kwezintso okanye amasebe awo, panarteriit, ucinezelo kwemithambo ngaphandle kwizintso (nangezilonda, cysts kunye like. d.).

Iimpawu kunye obubonakala kwezonyango wegazi renovascular

lwegazi Renovascular kwenzeka phakathi onke amaqela ubudala bungakanani na kodwa ixhaphake kakhulu kubantu abangaphantsi kweminyaka engama-50 ubudala (93% yazo zonke iimeko). Ezitshangubeni zixhaphakileyo kwemithambo sezintso nto sclerosis atherosclerotic. Olu hlobo sifo ikakhulu kuni yonke into eyindoda abaneminyaka eyi-35 ukuya kuma-40 ubudala. Kwabasetyhini, eyona etiological abaphambili kuphuhliso sifo a kwemithambo sezintso fibromuscular stenosis kwaye eqhelekileyo phakathi amantombazana.

uxinzelelo kwezintso, iimpawu obubonakala ngokuba isiqalo ngesiquphe kwaye okukhawulezayo (ngokufuthi yingozi, ngo-18-30% yamatyala) kwemali. Lwegazi lukhatshwa kumanqanaba aphezulu kakhulu kuxinzelelo ukuzala (110-125 mm HG okanye ngaphezulu); kunqabile kunokubangela i ingxaki. lwegazi Renovascular ibonwa rhoqo ngengozi.

ekuxilongweni

Ukuze ukubona ubukho lwegazi renovascular kufuneka bangenele izigaba ezithathu zeso sifundo. Inqanaba lokuqala yabonakaliswa yimfuneko aortography. Ukuze wenze oku, ukuqokelela imbali yezonyango oluneenkcukacha, jikelele ukusetyenziswa lwezonyango ezinye iindlela. Imbali laziwa ngokuba kungekho uhlobo ilifa zesi sifo, ukwenzeka nomfutho emva intlungu kummandla empontshwa. uxinzelelo kwezintso, iimpawu zazo ifiphale, kunzima kakhulu ukuba unesifo kwaye kufuna unyango ngoko nangoko kugqirha kwimiqondiso yokuqala.

Inqanaba lesibini kubandakanya ukulandelwa aortography kunye arteriography kwe izintso, xa uphawula naluphi na utshintsho izintso, igazi lithatyathwe yegazi sezintso. Igazi kuvavanywa umsebenzi plasma renin kwi inyathelo elilandelayo diagnostic.

Yinkalo yokugqibela yale saveyi ukuzama ukuseka ubudlelwane nomfutho evela izitshanguba ezichongiweyo kwi kwemithambo kwezintso. Ukungqina lo mbono iindlela ezisetyenzisiweyo Isotope renografii, eksretornoy urography kunye nomsebenzi nophando renin. Ngowe-8-10% ezigulane ukuphuhlisa Kusasazwa akananto eyomeleleyo, leyo kuvala lomonakalo olusebenzayo kidney ochaphazelekayo.

unyango

Sezintso unyango xi intsomi izisombulubo ezinokukhokelela kuphela iingxaki ezinzulu, kufuneka mazilungiswe ngohlobo yokungenelela ngotyando, nejonge ukubuyisela igazi flow kwemithambo eziphambili sezintso.