Itsvo (kubva kuLatin ren, renis) nhengo dziri chikamu cheurinary system. Vanovimbisa kusefa kweropa nekubvisa tsvina mariri kuburikidza nekugadzirwa kweweti. Vanochengetedza zvakare mvura yemuviri uye zvicherwa.

Izvo zvisina, zviviri munhamba, zviri muchikamu chekumashure chedumbu pamwero wembabvu mbiri dzekupedzisira, kune rumwe rutivi rwemusana. Itsvo yakarurama, iri pasi pechiropa, yakaderera zvishoma kudarika kuruboshwe, iyo iri pasi pespleen.

Itsvo imwe neimwe, yakaita sebhinzi, inoyera paavhareji 12 cm kureba, 6 cm muupamhi uye 3 cm muukobvu. Vanokwiridzirwa neadrenal gland, nhengo ye endocrine system uye isingabatanidzi mukuita weti. Imwe neimwe yakakomberedzwa neganda rekunze rekudzivirira, iyo fibrous capsule.

Iyo mukati meitsvo yakakamurwa kuita zvikamu zvitatu (kubva kunze kusvika mukati):

• Iyo cortex, chikamu chekunze. Pale muruvara uye anenge 1 cm mukobvu, inovhara medulla.
• Iyo medula, iri pakati, ine dzvuku dzvuku muruvara. Iine mamiriyoni emasefa ezvikamu, manephron. Aya maumbirwo ane glomerulus, nharaunda diki umo kusefa kweropa uye kugadzirwa weti kunoitika. Izvo zvakare zvinosanganisira tubules zvakanangana nekuchinja kuumbwa kweweti.
• The calyces uye pelvis uri weti inounganidza maburi. Macalyce anogamuchira weti kubva kune nephrons iyo inozodirwa muchiuno. Weti yacho inobva yayerera nemuma ureters ichienda kutundira, kwainozochengetwa isati yaburitswa.

Mupendero wemukati weitsvo unoratidzwa nenotch, renal hilum apo tsinga dzeropa renal uye tsinga pamwe chete neureters inopera. Ropa "rakashandiswa" rinosvika kuitsvo kuburikidza nerenal artery, iyo ibazi re abdominal aorta. Iyi tsinga yetsvo inobva yapatsanuka mukati meitsvo. Ropa rinobuda rinotumirwa kune inferior vena cava kuburikidza nerenal vein. Itsvo inogamuchira 1,2 litita eropa paminiti, inova chikamu chechina chehuwandu hweropa.

Pakaitika pathologies, itsvo imwe chete inogona kuita renal mabasa.

Itsvo dzine mabasa mana makuru:

• Kukura kweweti kubva pakusefa kweropa. Ropa parinosvika kuitsvo kuburikidza netsinga yetsvo, rinopfuura nepakati pemanephron apo rinobviswa zvimwe zvinhu. Zvigadzirwa zvinoraswa (urea, uric acid kana creatinine uye zvisaririra zvezvinodhaka) uye zvinhu zvakawandisa zvinoburitswa muweti. Iyi filtration inoita kuti zvikwanise panguva imwe chete kudzora mvura uye ion content (sodium, potassium, calcium, etc.) muropa uye kuichengetedza. Mumaawa makumi maviri nemana, 24 kusvika 150 litres eplasma yeropa anosefa kuti abudise 180 litre kusvika 1 litres weti. Weti pakupedzisira inoumbwa nemvura uye solutes (sodium, potassium, urea, creatinine, nezvimwewo). Zvimwe zvinhu hazvisi, mumurwere ane hutano, zviripo muweti (glucose, mapuroteni, masero matsvuku eropa, masero machena eropa, bile).
• Secretion ye renin, enzyme inobatsira kudzora BP.
• Kugadzirwa kwe erythropoietin (EPO), hormone inokurudzira kuumbwa kwemasero matsvuku eropa mumwongo wemapfupa.
• Shanduko yevhitamini D kuita fomu yayo inoshanda.

Itsvo matombo (itsvo mabwe) : inowanzonzi "matombo eitsvo", aya makristasi akaoma anoumba muitsvo uye anogona kukonzera kurwadziwa kwakanyanya. Muinenge 90% yezviitiko, urinary matombo anoumba mukati meitsvo. Kukura kwavo kwakasiyana-siyana, kubva pamamirimita mashoma kusvika kumasendimita akawanda mudhayamita. Dombo rakaumbwa muitsvo uye richienda kutundira rinogona kuvharira ureter zviri nyore uye kukonzera kurwadziwa kwakanyanya. Izvi zvinonzi renal colic.

Malformations :

Renal malrotation : congenital anomaly inogona kukanganisa itsvo imwe chete kana zvese. Munguva yekukura kwe embryonic, itsvo inokwira kumusoro kwekoramu kunzvimbo yayo yekupedzisira uye inotenderera. Muchiitiko chechirwere ichi, kutenderera hakuna kuitwa nemazvo. Somugumisiro, chiuno, chinowanzowanikwa pamucheto wemukati wechinhu, chinowanikwa pachiso chayo chepamberi. Iyo inomaly kuva benign, iyo renal basa iri intact.

Renal duplicity : isingawanzo congenital anomaly, inoenderana nekuvapo kweitsvo yekuwedzera kune rumwe rutivi rwemuviri. Iyi itsvo inozvimiririra, ine vascularity yayo uye ureter yayo inotungamira zvakananga kudura kana kujoinha ureter yeitsvo kune rimwe divi.

Hydronéphrose : iko kuri kucheneruka kwemboro nemboro. Uku kuwedzera kwehuwandu hwema cavities aya kunokonzerwa nekudzikira kana kuvharika kweureter (malformation, lithiasis ...) inodzivirira weti kuyerera.

Horseshoe itsvo : kukanganisa kunokonzerwa nekubatana kweitsvo mbiri, kazhinji nedanda radzo rezasi. Iyi itsvo inowanikwa pasi peitsvo dzemazuva ose uye ureters haikanganisi. Iyi mamiriro haatungamiri kune chero mhedzisiro yehutachiona, inowanzoratidzwa nemukana panguva yekuongororwa kweX-ray.

Renal function abnormality :

Acute uye chisingaperi renal kukundikana : kuderera zvishoma nezvishoma uye kusinga gadziriswe kweitsvo 'kusefa ropa uye kuburitsa mamwe mahormone. Zvigadzirwa zvemetabolism uye yakawandisa mvura inopfuura zvishoma uye zvishoma muweti uye inoungana mumuviri. Chirwere cheitsvo chisingaperi chinokonzerwa nedambudziko rechirwere cheshuga, high blood pressure, kana zvimwe zvirwere. Acute itsvo kukundikana, kune rumwe rutivi, kunouya kamwe kamwe. Inowanzoitika semugumisiro wekugadzirisa kuderera kwekuyerera kweropa renal (kupera mvura, utachiona hwakanyanya, nezvimwewo). Varwere vanogona kubatsirwa nehemodialysis vachishandisa itsvo yakagadzirwa.

Glomerulonephritis : kuzvimba kana kukanganisa kune glomeruli yeitsvo. Kusefa kweropa hakuchashandi zvakanaka, mapuroteni nemasero matsvuku eropa anobva awanikwa muweti. Isu tinosiyanisa pakati pekutanga glomerulonephritis (chete hapana chinokanganiswa) kubva yechipiri glomerulonephritis (mhedzisiro yechimwe chirwere). Kazhinji yechikonzero chisingazivikanwe, zvakaratidzwa kuti glomerulonephritis inogona, semuenzaniso, kuoneka ichitevera utachiona, kutorwa kwemamwe madhiragi (semuenzaniso: non-steroidal anti-inflammatory drugs senge ibuprofen) kana genetic predisposition.

zvirwere

Pyelonephritis : utachiona hweitsvo neutachiona. Muzviitiko zvakawanda, izvi ndizvocoli Coli, inokonzera 75 kusvika 90% ye cystitis (urinary tract infection), iyo inowedzera mudundira uye inokwira kuitsvo kuburikidza neureters (8). Madzimai, kunyanya madzimai akazvitakura, ndivo vari panjodzi huru. Zviratidzo zvakafanana nezve cystitis inobatanidza nefivha uye kurwadziwa kwepashure. Kurapa kunoitwa nekutora mishonga inorwisa mabhakitiriya.

Benign mapundu

Cyst : Tsvo cyst ihomwe yemvura inoumba muitsvo. Anonyanya kuzivikanwa ari nyore (kana ari oga) cysts. Havakonzeri chero matambudziko kana zviratidzo. Ruzhinji haruna kenza, asi mamwe anogona kukanganisa kushanda kwenhengo uye kukonzera kurwadziwa.

Polycystic chirwere : chirwere chenhaka chinoratidzwa nekuvandudzwa kwehuwandu hwezvipembenene zvetsvo. Chirwere ichi chinogona kukonzera BP neitsvo.

Mamota akaipa 

Chirwere chepyiyo : inomiririra inenge 3% yekenza uye inobata kaviri varume vakawanda kupfuura vakadzi (9). Gomarara rinoitika apo mamwe masero ari muitsvo anoshanduka, owanda nenzira yakanyanyisa uye isingadzoreki, oita bundu rinouraya. Muzviitiko zvakawanda, kenza yeitsvo inoonekwa sezvinei panguva yekuongororwa kwedumbu.

dziviriro. Kuchengetedza itsvo dzako kwakakosha. Kunyange zvazvo zvimwe zvirwere zvisingagoni kudzivirirwa zvachose, mararamiro ane utano anogona kuderedza ngozi. Kazhinji, kugara uine hydrated (inenge 2 malita pazuva) uye kudzora kunwa kwako munyu (kuburikidza nekudya uye mutambo) kunobatsira pakushanda kweitsvo.

Mamwe matanho chaiwo anokurudzirwa kuderedza njodzi kana kudzivirira kudzokorora kwematombo eitsvo.

Panyaya yeitsvo, zvikonzero zviviri zvikuru ishuga (type 1 ne2) pamwe neBP. Kudzora kwakanaka kwezvirwere izvi kunoderedza zvakanyanya njodzi yekufambira mberi kune imwe nyaya yekusakwana. Mamwe maitiro, akadai sokudzivisa doro, kushandisa zvinodhaka nemishonga, anogona kudzivirira chirwere.

Chirwere chepyiyo. Zvinonyanya kukonzera njodzi kusvuta, kuwandisa kana kufutisa, uye kusaita dialysis kweanopfuura makore matatu. Aya mamiriro anogona kukurudzira kukura kwegomarara (10).

Bvunzo dzeLabhoritari : Kutsunga kwezvimwe zvinhu muropa uye weti kunobvumira kushanda kwetsvo kuongororwa. Izvi ndizvo, semuenzaniso, kune creatinine, urea uye mapuroteni. Muchiitiko che pyelonephritis, kuongorora kwe cytobacteriological weti (ECBU) kunotarirwa kuti ione utachiona hunobatanidzwa muhutachiona uye nokudaro kugadzirisa kurapwa.

Biopsy: bvunzo dzinosanganisira kutora sampuli yeitsvo uchishandisa tsono. Icho chidimbu chakabviswa chinoiswa pasi pekuongororwa microscopic uye / kana biochemical ongororo kuti ione kana iine cancer.

MAPOSTER 

Ultrasound: nzira yekufungidzira inotsamira pakushandiswa kweiyo ultrasound kuona chimiro chemukati chenhengo. Ultrasound yeurinary system inobvumira kuona itsvo asiwo ureters uye dundira. Inoshandiswa kuratidza, pakati pezvimwe zvinhu, renal malformation, kusakwana, pyelonephritis (inosanganiswa neECBU) kana dombo retsvo.

Uroscanner: nzira yekufungidzira iyo inosanganisira "kuvheneka" nzvimbo yakapihwa yemuviri kuitira kugadzira mifananidzo yakachinjika, nekuda kwekushandiswa kwe X-ray danda. Zvinoita kuti zvikwanise kuona mudziyo wose weti turakiti (itsvo, excretory turakiti, dundira, prostate) muchiitiko renal pathology (gomarara, lithiasis, hydronephrosis, etc.). Iri kuwedzera kutsiva intravenous urography.

MRI (magnetic resonance imaging): kuongororwa kwekurapa kwezvinangwa zvekuongorora kunoitwa pachishandiswa cylindrical yakakura mudziyo umo magineti uye masaisai eredhiyo anogadzirwa. Inoita kuti zvikwanise kuwana mifananidzo yakanyatsojeka mumativi ose eurinary tract munyaya yeMRI ye abdomino-pelvic area. Inoshandiswa kunyanya kuratidza bundu kana kuita chirwere chegomarara.

Intravenous urography: Kuongororwa kweX-ray kunoita kuti zvikwanise kuona hurongwa hwese hweweti (itsvo, dundira, ureter uye urethra) mushure mejekiseni rechigadzirwa chisina kujeka kuX-rays inonangana muweti. Iyi nzira inogona kushandiswa kunyanya muchiitiko che lithiasis kana kuenzanisa kushanda kwetsvo.

Kidney scintigraphy: iyi inyanzvi yekufungidzira inosanganisira kuisa radioactive tracer kumurwere, iyo inopararira kuburikidza neitsvo. Kuongorora uku kunoshandiswa kunyanya kuyera basa renal renal yeitsvo, kuona morphology kana kuongorora sequelae yepyelonephritis.

Mumushonga weChinese, imwe neimwe yeashanu akakosha manzwiro akabatana kune imwe kana akawanda nhengo. Kutya kunobatanidza zvakananga neitsvo.