Gbasara akụrụ nsogbu. Mgbaàmà na-adakarị N'ezie nke ọrịa

Gbasara akụrụ nsogbu, mgbaàmà nke na-kpụrụ nke a plurality ihe bụ nnoo a ọbara mgbali na-akpata gbasara akụrụ parenchymal ọrịa ma ọ bụ gbasara akụrụ arịa. 30-35% nke ndị mmadụ na-ata ahụhụ site na ọbara mgbali nwere concomitant ọrịa akụrụ, n'ihi na nke bụ nke a siri ike ma na-amụba nsogbu, n'ihi na nsogbu na akụrụ na-emekarị oyiri.

Nephrogenic ọbara mgbali na-kewara abụọ na ụdị: renovascular na parenchymal na ha ma emetụta gbasara akụrụ nsogbu. Mgbaàmà nke a pụrụ ịbụ nnọọ na-edochaghị anya ma na-abụkarị ndị na-ezighị maka ọrịa ndị ọzọ. Renovascular ọbara mgbali amalite n'ihi unilateral ma ọ bụ bilateral stenosis ma ọ bụ occlusion nke gbasara akụrụ akwara na alaka ya. Renovascular ọbara mgbali nwere ike ịbụ ma enwetara na ebum pụta ụwa agwa. Parenchymal ọbara mgbali elu, ọtụtụ mgbe, mere site bilateral-adịghị ala ala pyelonephritis ma ọ bụ ndị ọzọ akụrụ ọrịa, ndị dị otú ahụ nephrolithiasis (akụrụ nkume), ụkwara nta, akpụ Filiks, cysts, hydronephrosis, polycystic na ọtụtụ ọrịa ndị ọzọ.

On nkezi, renovascular ọbara mgbali n'akparamagwa 5-12% nke ndị mmadụ na-ata ahụhụ site na ọbara mgbali. E nwere ọtụtụ ihe isi congenital akpata renovascular ọbara mgbali elu, nke na-agụnye: aneurysm, dysplasia na ndị ọzọ na-enweghị nchịkwa na anomalies nke gbasara akụrụ akwara, arteriovenous fistula. Otu n'ime ihe ndị mere kpọmkwem ka enwetara forms renovascular ọbara mgbali bụ: gbasara akụrụ akwara stenosis dị ka a N'ihi ya nke atherosclerosis, na-agbanwe gbasara akụrụ akwara n'ihi-aga n'ihu Nephroptosis, embolism ma ọ bụ thrombosis nke gbasara akụrụ akwara ma ọ bụ ha na alaka, panarteriit, mkpakọ nke akwara n'èzí akụrụ (etuto ahụ, cysts na dị ka. d.).

Mgbaàmà na-adakarị ngosipụta nke renovascular ọbara mgbali

Renovascular ọbara mgbali emee n'etiti niile afọ iche iche ma na-kasị nkịtị na ndị mmadụ n'okpuru 50 afọ (93% niile ikpe). Kacha nkịtị ọnya nke gbasara akụrụ akwara bụ atherosclerotic sclerosis. Nke a na ụdị ọrịa a na-tumadi n'etiti ụmụ nwoke noo 35 na afọ 40. Nwanyi, isi etiological ihe na mmepe nke ọrịa a fibromuscular gbasara akụrụ akwara stenosis na-ahụkarị n'etiti ụmụ agbọghọ.

Gbasara akụrụ nsogbu, ihe mgbaàmà nke nke na-ji na mberede mmalite na ngwa ngwa (mgbe oké njọ, na 18-30% nke ikpe) eruba. Ọbara mgbali na-esonyere nnọọ elu etoju nke diastolic mgbali (110-125 mm HG ma ọ bụ karịa); adịkarịghị nwere ike ime ka a nsogbu. Renovascular ọbara mgbali na-ghọtara ọzọ mgbe site na mberede.

nchọpụta nsogbu

Iji chọpụta ọnụnọ nke renovascular ọbara mgbali kwesịrị ịbịa atọ n'ụzọ nke ọmụmụ. The akpa ogbo kpebisiri ike site mkpa aortography. Iji mee nke a, na-anakọta zuru ezu ọgwụ akụkọ ihe mere eme, n'ozuzu adakarị eji ụzọ ndị ọzọ. The akụkọ ihe mere eme a na-akara na-anọghị nke-eketa ọdịdị nke ọrịa, omume nke ọbara mgbali mgbe mgbu na lumbar mpaghara. Gbasara akụrụ nsogbu, mgbaàmà nke na-ahụ inyoghi inyoghi, ọ bụ nnọọ ike na-chọpụtara na-achọ ozugbo ọgwụgwọ na nke dọkịta na mbu ihe ịrịba ama.

Agba nke abụọ na-agụnye na-arụ aortography na arteriography nke akụrụ na, ọ bụrụ na ị na-achọpụta ihe ọ bụla mgbanwe na akụrụ, ọbara na-e si gbasara akụrụ veins. Blood-enyocha maka plasma renin ọrụ na-esonụ na-achọpụta ọrịa nzọụkwụ.

The ikpeazụ ogbo nke nnyocha e mere bụ na-agbalị igosi na mmekọrịta nke ọbara mgbali si mata ọnya na gbasara akụrụ akwara. Iji gosi na nke a echiche bụ na usoro ahụ isotope renografii, eksretornoy urography na nnyocha ọrụ nke renin. Na 8-10% nke ọrịa ịzụlite a ike nnochianya mgbasa, nke ụgwọ ọtọ impairment nke emetụta akụrụ.

ọgwụgwọ

Gbasara akụrụ mgbali ọgwụgwọ ndiife ịgba akwụkwọ nke nwere ike na-ịkpata oké nsogbu, ga-gbazie site ịwa ahụ aka, nke na-aduak iweghachi ọbara nke isi gbasara akụrụ akwara.