Neurogenic eriri afo na ụmụ. Neurogenic eriri afo: akpatara, Diagnosis na Ọgwụgwọ

Neurogenic eriri afo dysfunction bụ a-emeghasịkwa nke nkịtị ahụ eme. Pathology bụ nnọọ ebe nile. Na Urology na Ọrịa Ụmụaka Pediatrics banyere 10% nke ọrịa nile nke urinary usoro na-ewe nke a karịsịa ọrịa. N'otu oge ahụ na ụba n'ihe ize ndụ nke mgbanwe akụkụ dị ka nke abụọ usoro. Dysuria kpatara ọrịa nke ụjọ ụkpụrụ na elu ma ọ bụ Central larịị. Ọzọ, tụlee ihe a neurogenic eriri afo dysfunction na a-eto eto afọ.

Isi

Neurogenic eriri afo na ndị inyom mere ka oké nwa, ịwa ahụ na gynecological na-adịghị ala ala pelvic pathologies. The ọrịa nwere ike na-egosi na mberede ma ọ bụ nwayọọ nwayọọ na-enwe ọganihu. Neurogenic eriri afo na ụmụ nwoke na-abụkarị megide backdrop nke BPH, nakwa dị ka mgbe ogologo oge ọrụ metụtara na arọ ígwè. Na daa ọrịa nke mmadụ na-ekwu, mmamịrị dobe site na dobe na enweghi ike ime ya ka na-akpata nrụgide. Neurogenic eriri afo, a na nwa nwere ike a bụ isi ụdị. Na nke a, na butere n'aka nural ọrịa eme omume dị ka a-akpali agụụ mmekọahụ na-akpata. Dysuria na a tọrọ afọ nwere ike ịbụ nke abụọ. Na nke a daa ọrịa guzobere emee n'okpuru nduzi nke exogenous ma ọ bụ endogenous ihe.

guzobere mpiaji

Nwa ahụ na-kpam kpam na-achịkwa tozuru okè voiding mode a kpụrụ site 3-4 afọ. The usoro na-aga ebe ọtụtụ nkebi nke development - si spinal unconditioned omume ka a random omume mpiaji. The ụkpụrụ nke orùrù nke mmiri mmiri abuana subcortical na cortical ụbụrụ emmepe, spinal innervation zones na lumbosacral ọgidigi azụ na elu akwara plexus. Neurogenic eriri afo na a na nwa na-esonyere disturbances nke innervation na idobere-vakuatornyh Filiks. Pathology nwere ike ime ka a ọnụ ọgụgụ nke oké njọ nke ọrịa. A na-agụnye, akpan akpan, na-agụnye-adịghị ala ala gbasara akụrụ odida, pyelonephritis, cystitis, hydronephrosis, megauretru, vesicoureteral reflux.

ịmụba ihe

Neurogenic eriri afo dysfunction eto ka a n'ihi nke dị iche iche na akwara ozi ọrịa. Ha na-eduga na a ọnụ ke nchikota nke ọrụ nke mpụga sphincter ma ọ bụ detrusor na mkpọchi na oke nke mmiri mmiri. Neurogenic eriri afo, a na nwa nwere ike ịzụlite na ndabere nke CNS organic okike. Ha, n'aka, nwere ike triggered site trauma, mkpali na degenerative na akpụ daa ọrịa nke ọkpụkpụ azụ, congenital ntụpọ, ọrịa nke ọgidigi azụ na ụbụrụ. Site nsogbu megide nke na-emepe emepe neurogenic eriri afo na a na nwa na-agụnye spinal hainia, ọmụmụ trauma, na gonadal agenesis nke sacrum na coccyx, ọrịa ụbụrụ na ndị ọzọ. Ha na-eduga na a zuru ezu ma ọ bụ ele mmadụ anya n'ihu dissociation nke ọkpụkpụ azụ na supraspinal ụjọ emmepe na ngwa. Ọtụtụ mgbe, ndị daa ọrịa a hụrụ na ụmụ agbọghọ. Ọ e mere site na ụba estrogen saturation, ime uche nke detrusor anabata.

nhazi ọkwa

Na dị na vesical mpiaji mgbanwe, mata ọtụtụ ụdị nke daa ọrịa. Mgbe giperreflektornom eriri afo spastic ọnọdụ pụtara na ogbo nke ìgwè nke mmiri mmiri. Giporeflektorny ụdị daa ọrịa na-esonyere hypotension detrusor oke-adọ. Ọ e ji ọdịdị nke mpiaji na urinate na ọtọ eriri afo olu, budata ukwuu karịa chọrọ maka nkịtị afọ. Mgbe mmeghachi omume a na-kwuru hyperreflexia anya ogologo oge tupu Mkpokota tọrọ ukwu nke mmiri mmiri. Areflektorny ụdị daa ọrịa a na-ewere na-kasị oké. Ọ na-esonyere enweghi ike onwe-belata njubiga ókè nke mmadụ na a zuru eriri afo, na ịsụ omume nke nsị. Pathology na-nkewa dị na ogo nke ime mgbanwe nke detrusor na-amụba olu nke ọmụmụ. N'ihi ya, neurogenic eriri afo nwere ike ịbụ unadapted (sọrọ) na-emegharị. Ọzọkwa, e nwere ọtụtụ iche-iche nke ọrịa. Karịsịa, ndị nwayọọ ụdị spontaneously na a ọrịa na nchegbu urinary eriri afo bupụrụ. Mgbaàmà ndị siri ike mmepe nke Hinman syndrome - detrusor-sphincter dissenergii, Ochoa - urofatsialnoy daa ọrịa. Mgbe agafeghị oke iche nke akwusighi akara ngwa ọrụ.

The adakarị foto nke hyperreflexia

Gịnị na-eme mgbe eriri afo aghọ ejighị n'aka? Mgbaàmà nke ọrịa na-egosipụta imebi nke omume nke nsị. Ogo na ugboro ole nke omume na-ekpebisi ike dị na ogo mmebi akwara. Neurogenic hyperactivity emekarị nkwenkwe-eto eto ụmụ. Na nke a, e nwere ndị ọzọ Ugboro nsị (ruo asatọ ugboro n'ụbọchị) ala olu, oké mkpa (Ngwa Ngwa) ịdị ngwa, enuresis, incontinence. Postural neurogenic eriri afo mgbaàmà nke na-egosi mgbe na-agbanwe agbanwe ahụ kwụ ọnọdụ akwụ ọtọ, pollakiuria so kwa ụbọchị ma na-adị n'otu, ìgwè mmamịrị n'abalị na a nkịtị olu ụtụtụ òkè. Nchegbu incontinence egosipụta upuskaniem obere ego nke mmiri mmiri. Ndị dị otú ahụ a onu nwere ike ime n'oge omumu. Against ndabere nke detrusor-sphincter dissenergii hụrụ zuru oge ma ọ bụ na-ezughị ezu nsị, na miktsii (urination) n'oge straining.

ngosipụta hyporeflexia

Against ndabere nke ụdị daa ọrịa bụ obere ma ọ bụ abiaghi urination jupụtara ma ọ bụ zuru eriri afo. Nsị nwekwara ike ịdị umengwụ, na a voltaji nke peritoneal mgbidi. Ọtụtụ mgbe, e nwere mmetụta nke na-ezughị ezu ntọhapụ nke mmamịrị. Nke a bụ n'ihi na nnukwu ibu nke fọduru (400 ml). Ụfọdụ ụmụaka na-abụ paradoxical ischuria so site na-achịkwaghị achịkwa mmamịrị mmepụta. Nke a bụ n'ihi dehiscence nke mpụga sphincter, nke a na-agbatị n'okpuru nrụgide nke ihe mmadụ karịrị akarị n'ahụ. Mgbe a umengwụ eriri afo bụ obere urination, jikọtara na urinary, tract-efe efe, afọ ntachi. Na elu nkebi nke ọrịa na e nwere ihe ize ndụ nke mbufụt, isi ọbara na akụrụ, parenchymal n'ichihịa na e guzobere a abụọ ụdị gbasara akụrụ n'ichihịa, adịghị ala ala insufficiency na gbasara akụrụ n'ichihịa.

nchọpụta nsogbu

Mgbe urination ọrịa dị mkpa iji na-eduzi a mbara nnyocha e mere. Ọ ga-aka dibịa Bekee dị ka pediatrician, bụ ọkà n'akparamàgwà mmadụ, ọkà mmụta ọrịa akwara, nephrologist, urologist. Diagnosis agụnye a ọgwụ ihe mere eme. Egosi a na ezinụlọ pụrụ ịrịa ọrịa, ma unan bụ, ọrịa na nke ụjọ usoro , na na. ihe instrumental na laabu ọmụmụ na-inyocha. Iji mata ọrịa na gbasara akụrụ ọtọ abnormalities ruru daa ọrịa omume Biochemical analysis nke ọbara na mmamịrị sample maka Nechiporenko, Zemnitsky na bacteriological analysis. Urological research agụnye ultrasound. Na-enyocha akụrụ na eriri afo na mkpebi siri ike nke ihe mmapụta olu. -Esịne ke nnyocha e mere nke X-ray achọpụta ọrịa usoro. Igosi ihe excretory urography na nlegharị anya, voiding tsitografiyu. Ọ ẹkenịmde dị ka CT na MRI gbasara akụrụ usoro, endoscopy, radionuclide ịgụ isiokwu. Assessment nke afụ a rụrụ kwa ụbọchị site nlekota olu na ọnụego nke n'amaghi urination na nkịtị okpomọkụ ma na-aṅụ ihe ọṅụṅụ Usoro. High-achọpụta ọrịa pụtara na ịchọputa ọrịa nwere urodynamic ule usoro ọtọ ala nke ala nkewa Uroflowmetry, nrụgide n'ihe na eke na ndochi, electromyography, profilometry, cystometry (retrograde). Echo-EG, Lee, MRI nke ụbụrụ na okpokoro isi X-ray nke ọkpụkpụ azụ na-eme na ikpe nke-enyo enyo neurogenic eriri afo na ụmụ. Komorowski na otu nke ya isiokwu nkọwa zuru ezu banyere adakarị analysis (OAM).

ọgwụgwọ jikoro

Ha na-ekenye dị na ụdị, ogo ọrịa metụtara ọnọdụ. Dị ka a n'ozuzu na-achị, itinye a differentiated atụmatụ. Ọtụtụ ndị ọkachamara na nye iwu homeopathic ịgba akwụkwọ. Otú ọ dị, e nwere ụfọdụ ndị dọkịta na-adịghị atụkwasị obi ndị a ego. Dị ka ihe atụ, adịghị ike ikwu homeopathic ịgba akwụkwọ, ma ọ bụrụ na kpughere neurogenic eriri afo na ụmụ, Komorowski. Ọ ga-kwuru na dọkịta na niile obi abụọ banyere nke a ụdị ọgwụgwọ. Otú ọ dị, dị nnọọ ọtụtụ nke ikpe na omume, mgbe homeopathy bụ nnọọ irè. Bịara n'Ezi Oge nchoputa na idozi eme nke ọgwụ na-enye ohere ngwa ngwa iji kpochapụ daa ọrịa.

Drug mmetụta

Iji kpochapụ hyper ọrịa họpụtara ndị M-holinoblokatory. A na-agụnye ọgwụ ndị dị otú ahụ dị ka "Atropine", "Oxybutynin" (n'ihi na ọrịa na afọ ise). Ọzọkwa gosiri tritsiklichieskie antidepressants (eg, pụtara "Melipraminum") na-akụ ọkpọ, Ca + (nke a na-agụnye ọgwụ "Nifedipine", "Terodilin"), nootropics (gụnyere ọgwụ "Pikamilon", "Pantogam"). Tincture nke motherwort na valerian na-atụ aro, ma ọ bụrụ na chọpụtara na neurogenic eriri afo na ụmụ. ndiife ịgba akwụkwọ ọgwụgwọ ike welie irè nke isi ọgwụ, na na ọ dịghị ihe ọzọ n'ihe ize ndụ belata ọnọdụ n'ihi na o nwere a kacha nta nke mmetụta. Na ọnụnọ nke nocturnal enuresis na ọrịa na afọ ise nwere ike kenyere analọg nke antidiuretic steroid neurohypophysis - desmopressin. N'ihi mgbochi nke ọrịa na-arịa ọrịa obere doses uroseptikov na-atụ aro. Ndị a na-agụnye, akpan akpan, na-agụnye nitrofurans (pụtara "Furagin") oksihinolony (ngwaahịa "5-NOC"), fluoroquinolones (to-ta nalidixic) na nkà mmụta ọgwụ "Kanefron" immunnokorregiruyuschee mmetụta (ọgwụ "Taktivin", "Levamisole") .

Ọzọkwa

Iji ikwado steeti a họpụtara nwoke na a oge 2-3 awa. Ọzọkwa gosiri na mgbe catheterization, ngwa cholinomimetics, anticholinesterase ọgwụ ọjọọ, adaptogens. Na-atụ aro bath na-agwọ oké osimiri nnu.

arụmọrụ ụzọ

Mgbe neurogenic eriri afo endoscopic usoro na-rụrụ. Karịsịa, rụrụ transurethral resection nke n'olu nke ahụ, collagen implants na ọnụ ọnụ nke urethra na intraurethral vnutridetruzernye ntụtụ Nsí botulinum. Ọzọkwa ekenịmde adọ na akwara ganglia, nke na-ahụ maka urination. Site nsia cystoplasty rụrụ abawanye eriri afo olu.