Cadaadiska kelyaha. Calaamadaha iyo dabcan caafimaad ee cudurka

cadaadiska kelyaha, calaamadaha kuwaas oo loo sameeyay ee hannaanka arrimood muhiimad waa cudur hypertension-laaluusheen kelyaha parenchymal amase weelal kelyaha. 30-35% ka mid ah dadka ka cabanaya hypertension leeyihiin saameen cudur kalyaha ah, sababtoo ah taas oo ay jirto cadaadis xoog leh oo ku sii kordhaya, sababtoo ah cadaadis iyo kelyihii waxaa inta badan wada xiriira.

hypertension Nephrogenic waxaa loo qaybiyaa laba nooc: renovascular iyo parenchymal oo labadooduba way saameyn cadaadiska kelyaha. Calaamadaha waxa ay noqon kartaa mid aad u caddayn iyo caadi ahaan lagu qaldo cudurada kale. hypertension Renovascular yeesho sabab u stenosis geesood ama laba geesood ama qabsamin ee halbowlaha kelyaha iyo laamihiisa. hypertension Renovascular noqon kartaa helay iyo dhalin qof labadaba. hypertension parenchymal, kiisaska intooda badan, ay keento baylonfiritis laba geesoodka ah ee joogtada ah ama cudurrada kale ee kelyaha, nephrolithiasis sida (dhagxaan kellida), qaaxada, geedi socodka buro, fiix, hydronephrosis, polycystic iyo cudurada kale oo dhowr ah.

Celcelis ahaan, hypertension renovascular dhacdaa 5-12% ka mid ah dadka ka cabanaya hypertension. Waxaa jira dhowr sababood ee ugu waaweyn ee lagu dhasho ee hypertension renovascular, taasoo ka mid ah: aneurysm, Kobac la'aanta iyo cillado kale bahal ah oo ka mid ah xididdada kelyaha, fistula arteriovenous. Ka mid ah sababaha ay u gaar ah si ay u foomamka helay hypertension renovascular waa: stenosis halbowlaha kelyaha sida natiijo ah oo atherosclerosis, badala halbowlayaasha kelyaha ay sabab u tahay horumar Nephroptosis, lungemboli ama thrombosis oo ka mid ah xididdada kelyaha ama laamihiisa, panarteriit, riixo ee halbowlaha ka baxsan kelyaha (burooyinka, fiix iyo wixii la mid. d.).

Calaamadaha iyo daliilka caafimaad ee hypertension renovascular

hypertension Renovascular dhacdaa ka mid ah kooxaha da'da oo dhan, laakiin waxay ku badan tahay dadka ka yar 50 sano jir (93% ee kiisaska oo dhan). The lesions ugu badan ee halbowlaha kelyaha waa sclerosis atherosclerotic. Noocan cudur inta badan ka mid ah oo lab ah oo da'doodu tahay 35 ilaa 40 sano jir ah laga helay. In haweenka, factor ugu weyn etiological horumarinta cudurka waa stenosis a fibromuscular kelyaha halbowlaha ah iyo waxa ka mid ah gabdhaha dhallinyarada ah.

cadaadiska kelyaha, calaamadaha, kuwaas oo loo gartaa bilawga kedis ah oo degdeg ah (inta badan malignant, in 18-30% ee kiisaska) socodka. Hypertension waxaa la socda heerka aad u sarreeya ee cadaadiska diastolic (110-125 mm Hg ama in ka badan); dhif ah waxay keeni kartaa dhibaato. hypertension Renovascular la aqoonsan yahay oo intaa ka badan by shil.

Baadhista xanuunada

Si lagu ogaado jiritaanka hypertension renovascular tahay in uu maro saddex weji oo daraasadda. Wejiga kowaad waxaa lagu go'aamiyaa aortography baahida loo qabo. Si arrintan loo sameeyo, u ururiyaan taariikhdaada caafimaad faahfaahsan, guud isticmaalka caafimaad oo hababka kale. Taariikhda waxaa inta badan lagu calaamadeeyay by maqan yahay nooca la iska dhaxlo ee cudurka, dhacdo ee hypertension xanuunka ee gobolka lumbar ka dib. cadaadiska kelyaha, calaamadaha oo waxaa saarmay caad, waxaa aad u adag in la ogaadaa iyo waxay u baahan tahay daaweyn deg deg ah dhakhtarka at calaamadaha ugu horreeya.

Heerka labaad ku lug leedahay fulinta aortography iyo arteriography of kelyaha iyo, haddii aad ku aragto wixii isbeddel ah ee kelyaha, dhiigga waxa laga soo qaatay xididdada kelyaha. Dhiig baaro hawl renin plasma in tallaabada xigta ogaanayo.

Marxaladda ugu danbeysay ee sahanka waa in ay isku dayaan in la dhiso xiriirka of hypertension ka lesions lagu tilmaamay halbowlaha kelyaha. Si aad u cadeeyo dhibic this view of hababka loo isticmaalay renografii isotope, urography eksretornoy iyo hawlaha cilmi baarista ee renin. In 8-10% bukaannada horumarinta wareegga a rahaamad xoog leh, kaas oo magdhow ah naafada ah ee kelyaha saameeyeen.

daaweynta

dawayn lahaa dad daaweyn cadaadis Kelyaha taas oo keeni karta oo kaliya in ay dhibaatooyin daran, waa in la saxo oo macneheedu yahay qalliin, taas oo loogu talagalay in lagu soo celiyo socodka dhiigga ee xidida kelyaha.