Inofungidzirwa kuti 50 kusvika ku80 kubva muzana yevakadzi vose vanoita urinary tract infection (UTI) pane imwe nguva muupenyu hwavo. (Kazhinji, vakadzi vanonyanya kupfurikidza nevarume kukudziridza UTIs.) Izwi rokuti urinary tract infection rinopararira uye rinoreva chirwere chinowanzokonzerwa nemaabhakitiriya anowanikwa pane imwe nhamba yechiratidzo chekuvhenekera: urethra, chiraya, ureters, kana zvinso.
The Infection Spectrum
Urinary tract tract infections iripo pane imwe nzvimbo. Pamugumo mumwechete weiyo inonzi bacymiauria , iyo mabhakitiriya anowanikwa mumuginho asi hapana kliniki zviratidzo zvehutachiona huripo. Nezviitiko zvakawanda zveAymptomatic bacteriuria, hapana kurapwa kunodiwa.
Pane rumwe rutivi rwemitambo inoratidzira pyelonephritis kana utachiona hwepfungwa, iyo inonyanya kukosha uye nyaya yenyaya ino. Pakati pezviitiko zvinonzi bacteriuria zviratidzo kana cystitis , ndizvo zvinofungidzirwa nevanhu vakawanda pavanenge vachikurukura nezveTI. Zviratidzo zve cystitis zvinosanganisira marwadzo ekuzorora, mafupa emvura, uye kukurumidza.
Ne pyelonephritis, bhakitiriya inofamba ichibva pachirwere ichikwira kuburikidza nechikanda uye ichiita uroyi uye ichipinda muinso. Nenzira yakanaka, pyelonephritis inosanganisira zvipi zviviri zviri nyore.
Zviratidzo
Heano zvimwe zviratidzo zvinoratidza zviratidzo zve pyelonephritis:
- flank flank
- costovertebral angle tenderness
- the kidney tenderness on deep palpation
- nausea
- kurutsa
- fever
- chills
- kunyengera
Kuziva
Chirwere chekuongorora chirwere che pyelonephritis chakavakirwa pane zvakaitika kare uye kuongorora kwepanyama kunowanikwa pamwe chete neongorori dzinowanikwa kubva kuongororwa kwezvirwere zvakadai seyuninalysis uye urine tsika. Kusiyana nehuwandu husina kuoma cystitis, kunyunyuta kwe pyelonephritis inopa urine tsika.
Kufungidzira kufungidzira hakudi kujekesa maitiro akawanda epielonephritis. Kunyange zvakadaro, ultrasound uye CT zvinogona kushandiswa kufungidzira pyelonephritis.
Risk Factors
Zvinokonzera njodzi ye pyelonephritis zvakafanana nematambudziko emhando dzose dze UTI uye dzinosanganisira vakawanda vanoita zvepabonde, kuwedzerwa zvepabonde, hutsva hwepabonde uye nhoroondo yeTI inowanzoitika.
Kurapa
Kurapa kwepyelonephritis kwakafanana nekurapa kwechiropa cystitis. Zvisinei, pyelonephritis inowanikwa kupfuura acute cystitis inokonzerwa nemaabhakitiriya asingagadziki anosanganisira kushungurudzwa kweE E. coli kusinganzwisisi naBactrim (TMP-SMX). Nokudaro, kurapwa kwe pyelonephritis kunowanzotanga nemishonga inorwisa mabhakitiriya yakafanana ne ciprofloxacin, uye, zvichienderana nekunakidza kwebhakitiriya ndiko kuri kukonzera utachiona, kunogona kusanganisira kusanganiswa kwemishonga inorwisa mabhakitiriya kana kuti yakawanda (guru-gun) mishonga inorwisa mabhakitiriya yakafanana neyo carbapenem.
Vanhu vazhinji vanouya neepelonephritis isina kuoma vanogona kurapwa mumakirini (kunze kwepakati). shoko iri risina kuoma rinoreva kuti murwere anoratidza maitiro easomic asingakanganisi ehurogenital tract, haana chiridzwa munzvimbo yakadai sekugara mukati mekugadzira catheter uye kwete pamuviri. Vanhu vanorapwa mumakiriniki kuti vasakanganise pyelonephritis vanofanira kukwanisa kushivirira mvura uye mishonga yemuromo.
Vanhu vane pyelonephritis yakaoma, pyelonephritis inowanzoshandiswa kana kuti zvinokonzera, zvakadai sechirwere chetachiona kana kuti sickle cell chirwere, inobatwa zvakanaka muchipatara. Pavanenge vari muchipatara, vanhu ava vanowanzogamuchira mishonga inorwisa mabhakitiriya.
Mukuwedzera kune mishonga inorwisa mabhakitiriya, munhu ane pyelonephritis anogonawo kugamuchira analgesics (funga opioids) yekutambudzika uye promethazine nokuda kwekushungurudza uye kurutsa.
Kurapa kwekusagadzikana kwepyelonephritis kunosvika mazuva manomwe. Zvimwe zvakaoma kana zvakanyanya zvakanyanya zvepyelonephritis zvinorapwa kwemazuva anenge 14.
Pyelonephritis inonyanya kuparadza kupfuura acute cystitis, uye pakati pe20 ne30 muzana yevanhu vane pyelonephritis vanoitawo zvirwere zveropa, zvakare.
Zvimwe zvinetso zve pyelonephritis zvinosanganisira cortical necrosis uye emphysematous pyelonephritis, uko itsvo dzichikuvadza uye gasi inovakwa muinso, Zvose izvi zvinokonzera zvinogona kuita kuti hosha kusakundikana.
Kudzivirira
Pamusoro pekupedzisira, apa pane mamwe matanho ayo iwe (mukadzi) anogona kutora kudzivirira pyelonephritis uye UTIs:
- inwa mvura zhinji
- asiri bhiza shure kwepabonde
- Pukuta kubva mberi kuenda kumashure kuitira kuti urege kudzivisa mabhakitiriya mumudzimai
- shanya kakawanda
- kudzivisa zvigadzirwa zvehutano zvevakadzi zvinoshandiswa kumudzimai wechipatara semabhedha uye mapiritsi
Sources:
Gupta K, Trautner BW. Urinary Tract Infections, Pyelonephritis, uye Prostatitis. Muna: Kasper D, Fauci A, Hauser S, Longo D, Jameson J, Loscalzo J. eds. Harrison's Principles of Internal Medicine, 19e . New York, NY: McGraw-Hill; 2015.
Ndeipi DS, Bogner MP. Chitsauko 94. Urinary Tract Infections neHematuria. Muna: Tintinalli JE, Stapczynski J, Ma O, Cline DM, Cydulka RK, Meckler GD, T. eds. Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 7e . New York, NY: McGraw-Hill; 2011.