Interstitial cystitis: chii ichocho?

La interstitial cystitis ndiwo chirwere chedundira hazviwanzo asi zvinoremadza izvo zvachinja zita rayo. Ikozvino yava kunzi painful bladder syndrome. Iyo inoratidzirwa nekurwadziwa mudumbu rezasi uye kazhinji kuda kuita weti, masikati nousiku. Marwadzo aya uye izvi zvinokurudzira kuita weti kazhinji zvakanyanya, dzimwe nguva zvisingatsungiririki, zvekuti interstitial cystitis inogona kuita hurema hwemagariro, kudzivirira vanhu kubva mudzimba dzavo. Marwadzo anogona zvakare kukanganisa urethra (mugero unotakura weti kubva dundira kuenda kunze) uye, muvakadzi, chibereko (ona mufananidzo). Kuita weti (the weti) zvishoma kana zvachose kubvisa marwadzo aya. Interstitial cystitis inokanganisa kunyanya vakadzi. Inogona kuziviswa pazera ripi neripi kubva pamakore gumi nemasere. Parizvino, hapana mushonga wechirwere ichi, icho chinonzi chiri tora nguva refu.

Chenjera kuti usavhiringa interstitial cystitis et cystitis : "classic" cystitis chirwere cheurinary tract chinokonzerwa nebhakitiriya; interstitial cystitis haisi kwete utachiona uye chikonzero chacho hachizivikanwi.

Kuwanda

Maererano neInterstitial Cystitis Association yeQuebec, vangangosvika zana nemakumi mashanu vekuCanada vanobatwa nechirwere ichi. Zvinoita sekuti interstitial cystitis haina kuwanda muEurope kupfuura muNorth America. Zvisinei, zvakaoma kuwana fungidziro yakarurama yenhamba yevanhu vanobatwa nechirwere ichi, sezvo chirwere chacho chinenge chisingatarisirwi. Inofungidzirwa kuti kune pakati pe1 uye 7 vanhu vane interstitial cystitis pa10 vanhu muEurope. MuUnited States, chirwere ichi chinowanzobata munhu mumwe mu000.

Interstitial cystitis inokanganisa kanenge kashanu kusvika ka5 vakadzi vakawanda kupfuura varume. Inowanzoonekwa pakati pemakore makumi matatu kusvika makumi mana, uye 10% yeavo vanobatwa vari pasi pemakore makumi matatu.

Zvinokonzera

Mu interstitial cystitis, madziro emukati medundira ndiyo nzvimbo yezvinooneka zvinoputika zvisiri izvo. Maronda madiki ari pamadziro emukati medundira anogona kubuda ropa shoma uye kukonzera marwadzo uye kuda kubuda mudundira weti ine acid.

Kwakabva kuzvimba kwakaonekwa mu interstitial cystitis hazvizivikanwe zvechokwadi. Vamwe vanhu vanobatanidza kutanga kwayo nokuvhiyiwa, kubereka mwana, kana kuti hosha yakakomba yedundira, asi kazhinji kazhinji inoratidzika kuva inoitika pasina chinonyandura. Interstitial cystitis ingangodaro a multifactorial chirwere, zvinosanganisira zvikonzero zvakawanda.

zhinji kufungidzira dziri kutariswa. Vatsvakurudzi vanomutsa izvo zvekusawirirana, maitiro autoimmune kana dambudziko retsinga mumadziro edundira. Hazvisi kubviswa kuti zvinhu zvinogarwa nhaka zvinopawo pazviri.

Heano makwara anonyanya kutaurwa:

• Kushandurwa kwemadziro edundira. Nokuda kwechimwe chikonzero, chidziviriro chemukati chemukati chedundira (masero nemapuroteni) chinokanganisa muvanhu vakawanda vane interstitial cystitis. Iri layer rinowanzo dzivirira zvinovava muweti kubva pakusangana nemadziro edundira.
• Ishoma inoshanda intravesical inodzivirira layer. Mune vanhu vane interstitial cystitis, iyi yekudzivirira yaizoshanda zvishoma. Weti nokudaro inogona kushatirisa dundira uye kukonzera kuzvimba uye kunzwa kupisa, sepaya kana doro rinoiswa paronda.
• Chinhu chinonzi AFP kana antiproliferative factor inowanikwa muweti yevanhu vane interstitial cystitis. Inogona kunge iri mhosva, nokuti inoita seinodzivisa kuvandudzwa kwechisikigo uye nguva dzose yemasero akavhara mukati medundira.
• Autoimmune chirwere. Kuzvimba dundira kunogona kukonzerwa nekuvapo kwemasoja ekudzivirira chirwere anokuvadza pamadziro edundira (autoimmune reaction). Masoja ekudzivirira chirwere akadai akawanikwa mune vamwe vanhu vane interstitial cystitis, pasina kuzivikanwa kuti ndiwo here honzeri kana mhedzisiro yechirwere ichi.
• Hypersensitivity yetsinga dziri mudundira. Marwadzo anowanikwa nevanhu vane interstitial cystitis anogona kunge ari "neuropathic" kurwadziwa, ndiko kuti, kurwadziwa kunokonzerwa nekusashanda zvakanaka kwetsinga dzedundira. Nokudaro, weti shoma shoma yaizova yakakwana "kufadza" tsinga uye kukonzera zviratidzo zvinorwadza pane kungonzwa kumanikidzwa.

kushanduka

Syndrome inofambira mberi zvakasiyana kubva kumunhu kuenda kumunhu. Pakutanga, the zviratidzo vanowanzoonekwa vobva vanyangarika vega. Nguva dze kuregererwa inogona kugara kwemwedzi inoverengeka. Zviratidzo zvinowanzowedzera kuipa nekufamba kwemakore. Muchiitiko ichi, kurwadziwa kunowedzera uye chido chekuita weti chinowedzera.

Muzviitiko zvakanyanya kuoma, the kuda kuita weti inogona kuitika kusvika ka60 mumaawa makumi maviri nemana. Upenyu hwemunhu uye hwemagariro evanhu hunokanganiswa zvikuru. Marwadzo dzimwe nguva akanyanya zvokuti kuora mwoyo uye kuora mwoyo kunogona kutungamirira vamwe vanhu kuora mwoyo, uye kunyange kuora mwoyo. kuzvisungirira. Tsigiro inobva kune vadiwa inokosha zvikuru.

chirwere

Maererano neMayo Clinic muUnited States, vanhu vane interstitial cystitis gamuchira kuongororwa kwavo paavhareji 4 makore mushure mekutanga kwechirwere. MuFrance, ongororo yakaitwa muna 2009 yakaratidza kuti kunonoka kwekuongorora kwaive kwakareba uye kwaienderana ne7,5 makore.²¹. Izvi hazvishamise sezvo interstitial cystitis inogona kuvhiringika nyore nemamwe matambudziko ehutano: weti turakiti kutapukira, endometriosis, chlamydial utachiona, chirwere cheitsvo, dundira "rakawandisa", nezvimwe.

Le chirwere yakaoma kumisa uye inogona kusimbiswa chete mushure mekunge zvimwe zvikonzero zvese zvinobvira zvabviswa. Uyezve, rudo zvakare kusazivikanwa vanachiremba. Zvichiri kuitika kuti inokodzera se "dambudziko repfungwa" kana kufungidzira navanachiremba vakati wandei chirwere chisati chaitwa, nepo mukati meiyo dundira yekuzvimba ichinyanya kutaura.

Heano maitiro akajairika anoitwa kuti aongorore interstitial cystitis:

• Kuongorora weti. Tsika uye kuongororwa kwemuenzaniso weti zvinogona kuona kana paine UTI. Kana zvasvika kune interstitial cystitis, hapana hutachiona, weti haina mbereko. Asi panogona kuva neropa muweti (hematuria) dzimwe nguva kunyange shoma zvikuru (microscopic hematuria apo tinoona masero matsvuku eropa pasi pemaikorosikopu, asi pasina ropa neziso rakashama). Ne interstitial cystitis, masero machena eropa anogonawo kuwanikwa muweti.

• Cystoscopy ne hydrodistension yedundira. Uyu muyedzo wekutarisa kumadziro edundira. Kuongorora uku kunoitwa pasi peanesthesia. Dundira rinotanga razadzwa nemvura kuitira kuti madziro aende. Zvadaro, catheter ine kamera inopinzwa muurethra. Chiremba anoongorora mucosa nekuona pascreen. Anotarisa kuvepo kwekutsemuka kwakanaka kana kudiki hemorrhages. Kudanwa glomerulations, aya madiki ekubuda ropa anonyanya kuratidza interstitial cystitis uye aripo mu95% yezviitiko. Mune zvimwe zviitiko zvishoma, pane kunyange maronda chaiwo anonzi Zvironda zvemuvhimi. Dzimwe nguva chiremba anoita biopsy. Iyo nyama yakabviswa inozoonekwa pasi pe microscope kuti iwedzere kuongororwa.
• Iyo urodynamic assessment inosanganisira ukuita cystometry uye urodynamic kuongorora inogonawo kuitwa, asi bvunzo idzi hadzina kunyanya kuitwa, nekuti hadzina kunyanya kujeka uye nekudaro hadzina kunyanya kubatsira uye dzinowanzo rwadza. Panyaya ye interstitial cystitis, tinoona nebvunzo idzi kuti volumetric simba redundira rakadzikira uye kuti kuda kuita weti uye kurwadziwa kunoonekwa kwevhoriyamu yakaderera pane mumunhu asiri kurwara neinterstitial cystitis. Ongororo idzi zvisinei dzinoita kuti zvikwanise kuona hyperactivities yedundira (overactive bladder) chimwe chirwere chinoshanda chinokonzerawo kuda kuita weti.
• Potassium senitivity test. Zvishoma uye zvishoma zvinoitwa, nekuti hazvina kunyatsojeka ne25% yenhema negatives (bvunzo inoratidza kuti munhu haana interstitial cystitis nepo mu25% yezviitiko zviri!) Uye 4% yemanyepo (bvunzo inoratidza kuti munhu ane interstitial cystitis kana vasingaiti).

Kushandisa catheter yakaiswa muurethra, dundira rinozadzwa nemvura. Zvadaro, inodururwa uye izere ne potassium chloride solution. (Lidocaine gel rinotanga kuiswa pakavhurika buri rerethra kuderedza marwadzo ekuisa catheter.) Pachiyero che 0 kusvika ku5, munhu wacho anoratidza kuti anonzwa kukurumidza sei. kuita weti uye kusimba kwemarwadzo. Kana zviratidzo zvichiwedzerwa pakuedzwa ne potassium chloride solution, inogona kuva chiratidzo che interstitial cystitis. Kazhinji, hapana musiyano unofanirwa kunzwika pakati pemhinduro iyi nemvura.