Oliguria inoreva kugadzirwa kwakaderera kweweti nemuviri, kureva kuti 24-awa diuresis isingasviki 500 ml mumunhu mukuru. Normal diuresis, kana kuwanda kwekubuda kweweti (inonziwo urinary flow), iri pakati pe800 ne1 ml pamaawa mazana mashanu. Zvimwe zvirwere zvinogona kuperekedzwa neabnormality yekuyerera kweweti iyi. Oligo-anuria inokodzera diuresis isingasviki 500 ml pamaawa zana. Izvi zvinodzikira mukubuda kweweti zvinogona kunge zvakabatanidzwa nekutadza kweitsvo, asi zvinogonawo kunge zvichikonzerwa nezvimwe zvikonzero, kunyanya zvemuviri.

Oliguria, chii ichocho?

Oliguria ivhoriyamu yakaderera kwazvo yeweti inogadzirwa nemuviri. Avhareji yakajairika weti inobuda mumunhu mukuru, kana huwandu hweweti inogadzirwa, iri pakati pe800 milliliters uye 1 milliliters mumaawa mazana mashanu. Kana iyi diuresis isingasviki 500 milliliters, murwere ari mumamiriro ezvinhu e oliguria. Tichazotaurawo nezve oligo-anuria apo diuresis inowira pasi pe24 milliliters pamaawa zana.

Nzira yekuziva sei oliguria?

Oliguria inogona kuzivikanwa nehuwandu hweweti inogadzirwa, kana iri pasi pe500 milliliters.

Iwe unofanirwa kuchenjerera, nekuti murwere asina kuita weti kwemaawa makumi maviri nemana hazvireve kuti anuric, inogona zvakare kuve kuvharika kweweti, nekuda kwekuchengetedza weti. Muchiitiko ichi, weti inobuda iripo, asi hapana weti iri kubuda.

Kuongororwa kwekliniki saka kwakakosha munharaunda iri pamusoro pepubis, nekuputika, mukutsvaga bhora redundira: izvi zvakakosha, nokuti anuric kana oliguric murwere achabatwa munharaunda yenephrological. , saka nekuda kwedambudziko rine chekuita neitsvo, nepo murwere ane weti yekuchengetedza acharapwa mudhipatimendi reurological, kureva zvine chekuita nedambudziko reurinary tract. 

Zvinhu zvinotyisa

Oliguria chiitiko chinowanzoitika muvarwere vari muchipatara, umo kushaya mvura mumuviri kusingaite. Oliguria inogona kunge iri njodzi yekukura kweacute renal kutadza. Kuwedzera kwakanyanya kwekuoma kwe oliguria kuri zvakare panjodzi huru yekufa muchipatara.

Short oliguria yakajairika, zvisinei, uye haizotungamiri mukukura kwekutadza kweitsvo.

Glomerular filtration defect

Kukurumidza kudzikiswa kwechiyero chekubuda kweweti kunogona kuratidza kuderera kwakanyanya kweglomerular filtration rate. Saka, oliguria ndeimwe yekare biomarkers yekukuvara kwetsvo. Itsvo inhengo dzinoita kusefa kuburikidza neglomeruli yadzo, dzichibvisa zvinhu zvine muchetura zvinogadzirwa nemuviri uye zvinotakurwa neropa: zvinhu izvi, zvisingabatsiri kumuviri, zvine chepfu kana zvikasabviswa, kuburikidza weti. Kana itsvo dzavo dzakundikana, munhu ane itsvo.

Tsanangudzo ye oliguria seyakabatanidzwa neacute renal failure yakatsanangurwa kwemakore anopfuura 200, nachiremba weChirungu Heberden. Uyezve, kuburitsa weti isingasviki 0,5 ml / kg / h kweanopfuura maawa matanhatu ndiyo imwe nzira yekuwedzera serum creatinine level mukuongororwa kwengozi, kukuvara, kurasikirwa kana kutadza kushanda kweitsvo.

Nokudaro, nhungamiro dzepasi rose dzemazuva ano dzinofunga nezvemaitiro maviri aya, oliguria uye yakakwirira ye serum creatinine, yakakosha yakaenzana mukuongororwa kwekukundikana kwetsvo. Nekudaro, nepo creatinine ichinyatso kuratidza glomerular filtration rate, kushomeka mukubuda kweweti kunogona kuve kwakabatana nezvimwe zvikonzero zvemuviri.

Oliguria: mhinduro yepanyama

Oliguria, kana inoenderana nemhinduro yemuviri, inosanganiswa ne-anti-diuresis nekuda kwe hypovolemia, kana kuderera kukuru kwekutenderera kweropa. Iyi physiological mhinduro yakabatana nekuburitswa kweanti-diuretic hormone (ADH), iyo inogona kuzotungamira mukudzikira kwekubuda kweweti muvanhu vane hutano. Saka Oliguria inogonawo kuratidza yakajairika physiological mhinduro, kana kuratidza kukanganisa kwechinguvana kwekuyerera kweropa. Iyo inorwisa-diuresis inogona kuwedzerwa nekukurudzira kweanonzwira tsitsi tsinga system, kunyanya, ndiko kuti zvimiro zvetsinga zvinogadzirisa otomatiki chiitiko che visceral nhengo.

Zvimwe zvikonzero zve oliguria

• Oliguria inogonawo kukonzerwa nekusunungurwa kwehomoni inorwisa-diuretic inokonzerwa nekurwadziwa, kushungurudzika, kushungurudza, kusagadzikana kwehemodynamics (kuyerera kweropa mumidziyo) kana kuvhiyiwa, kunyange kushungurudzika.
• Mukuwedzera, kuongororwa kwepelvic kunogona kubatsira kutarisa benign prostatic hyperplasia. Kana prostate yakazvimba, inomanikidza urethra, iyo haibvumire weti kupfuura.
• Ongororo yeradiological, iyo inosanganisira ultrasound yeurinary turakiti inogonawo kusimbisa chinogona kuvharika, saka chipingamupinyi pachiyero cheiyo ureters.
• Pamusoro pezvo, kuvharika kweiyo renal artery kana tsinga kunogonawo kukanganisa kushanda kweitsvo, uye kukonzera oliguria kana kunyange anuria.

Imwe yematambudziko makuru e oliguria kukura kwekutadza kweitsvo. Muchiitiko chakadaro, zvichave zvakafanira kushandisa dialysis, iyo huru kurapa kwetsvo kukundikana, iyo inosanganisira kusefa ropa nemuchina.

Muedzo unokosha wekutsanangura maitiro e oliguria ndeye "Furosemide stress test" (FST), kune varwere vane oliguria: inobvumira kuziva kana renal basa rakasimba.

• Kana kupfuura 200 ml weti inogadzirwa mukati maawa maviri mushure mekuedzwa kweFurosemide, kushanda kwetsvo kwakasimba;
• Kana paine isingasviki 200 ml inogadzirwa mukati memaawa maviri, kushanda kweitsvo kwakakuvadzwa, uye kusashanda kweitsvo uku kungada dialysis, inova ndiyo inonyanya kurapa kutadza kweitsvo.

The biological assessment inoitawo kuti zvikwanise kuongorora renal filtration rate, iyo inoyerwa nekucheneswa kwecreatinine, kunoitwa nekuongororwa ropa kana neawa makumi maviri nemana kuongorora weti. 

Mhinduro kubvunzo yeFST muoliguria inogona kuita kuti zvikwanise kusarura pakati pevarwere vanouya nehurongwa hwekunetsekana mhinduro zvichikonzera anti-diuresis, kubva mukutadza kushanda kwetsvo chaiyo.

Mukuwedzera, chidzidzo chakaitwa muvana vakavhiyiwa mwoyo, uye naizvozvo kunyanya vari pangozi yekushaya renal kukundikana, kwakaratidza kuti kurapwa neaminophylline kunowedzera kubuda kweweti uye kunovandudza migumisiro yemashure. kuvhiyiwa kweitsvo. Mune varwere ava, kurapwa neFurosemide kunovandudzawo kubuda kweweti, asi boka revatsvakurudzi veAmerica rakaratidza hukuru hweaminophylline pamusoro peFurosemide mukudzivirira kutadza kwetsvo kune chokuita nekuvhiyiwa kwemoyo.

Chekupedzisira, zvinofanirwa kurangarirwa kuti yekutanga kudzivirira kwekutanga kudzivirira njodzi ye oliguria, uye zvakare yehutachiona hweurinary tract, kuve nekunaya kwakanaka kwemvura: iyo inokurudzirwa hydration mazinga evakuru i1,5. , 1,9 litres pazuva kuvakadzi, uye XNUMX malita pazuva kuvarume. Vana vazhinji vakaderera mu hydration, saka zvakakosha kuyeuka kukosha kwekunwa nguva dzose uye mvura yakakwana.