U-Oliguria ubhekisele ekukhiqizeni umchamo ngomzimba ophansi ngokungajwayelekile, okusho ukuthi i-diuresis yamahora angama-24 engaphansi kwama-500 ml kumuntu omdala. I-diuresis ejwayelekile, noma ivolumu yokukhishwa kwe-urinary (ebizwa nangokuthi ukugeleza komchamo), iphakathi kuka-800 no-1 ml ngamahora angu-500. Izifo ezithile zingahambisana nokungajwayelekile kwalokhu kugeleza komchamo. I-Oligo-anuria ifanelekela i-diuresis ngaphansi kwama-24 ml ngamahora ayi-100. Lokhu kwehla kwemfihlo yomchamo kungaxhunyaniswa nokwehluleka kwezinso, kepha futhi kungabangelwa ezinye izimbangela, ikakhulukazi ezomzimba.

Oliguria, kuyini?

I-Oliguria ivolumu ephansi kakhulu yomchamo okhiqizwa ngumzimba. Isilinganiso esivamile sokukhipha umchamo kumuntu omdala, noma umthamo womchamo okhiqizwayo, uphakathi kwamamililitha angu-800 no-1 mililitha emahoreni angu-500. Lapho le diuresis ingaphansi kwamamililitha angama-24, isiguli sisesimweni se-oliguria. Sizokhuluma futhi nge-oligo-anuria lapho i-diuresis iwela ngaphansi kwamamililitha angama-500 ngamahora ayi-100.

Ungayibona kanjani i-oliguria?

I-Oliguria ingabonwa ngevolumu yomchamo okhiqizwayo, lapho ingaphansi kwamamililitha angama-500.

Kufanele uqaphele, ngoba isiguli esingachami amahora angama-24 akuyona i-anuric, futhi kungaba ukuvimba ukuchama, ngenxa yokugcina umchamo. Kulokhu, kukhishwa umchamo, kepha awukho umchamo ophumayo.

Ukuhlolwa komtholampilo ngakho-ke kuyadingeka esifundeni esitholakala ngenhla kwe-pubis, ngokushaywa, ngokufuna ibhola lesinye: lokhu kubalulekile, ngoba isiguli se-anuric noma se-oliguric sizokwelashwa endaweni ye-nephrological. , ngakho-ke ngenxa yenkinga ehlobene nezinso, kuyilapho isiguli esinomchamo obambekayo sizolashwa emnyangweni we-urological, okusho ukuthi okuhlobene nenkinga yomgudu womchamo. 

Izici zengozi

I-Oliguria yinto ejwayelekile ezigulini ezibhedlela, okungenakwenzeka ukuthi ukuphelelwa amanzi emzimbeni. I-Oliguria ingaba yingozi enkulu ekuthuthukiseni ukwehluleka kwe-renal acute. Ukwanda okukhulu kobunzima be-oliguria nakho kusengozini enkulu yokushona esibhedlela.

I-oliguria emfushane ivamile, noma kunjalo, futhi ngeke iholele ekuthuthukisweni kokuhluleka kwezinso okukhulu.

Isici sokuhlunga kwe-Glomerular

Ukwehliswa okusheshayo kwezinga lokuphuma komchamo kungase kubonise ukwehla okukhulu kwezinga lokuhlunga kwe-glomerular. Ngakho-ke, i-oliguria ingenye yezimpawu zakudala zokulimala kwezinso. Izinso yizitho ezihluza nge-glomeruli yazo, zisusa imikhiqizo enobuthi ekhiqizwa umzimba futhi ithuthwe ngegazi: lezi zinto, ezingenalusizo entweni ephilayo, zinobuthi uma zingaqedwa, ngomchamo. Uma izinso zingasebenzi, umuntu uba nenkinga yezinso.

Incazelo ye-oliguria njengoba ihlotshaniswa nokwehluleka okukhulu kwezinso ichazwe iminyaka engaphezu kwengu-200, ngudokotela oyiNgisi u-Heberden. Ngaphezu kwalokho, uketshezi lomchamo olungaphansi kuka-0,5 ml / kg / h isikhathi esingaphezu kwamahora ayisi-6 kungenye inkomba yokwenyuka kwezinga le-serum creatinine ekuhloleni ubungozi, ukulimala, ukulahleka noma ukwehluleka kokusebenza kwezinso.

Ngakho, imihlahlandlela yakamuva yamazwe ngamazwe ibheka lezi zindlela ezimbili, i-oliguria nezinga eliphezulu le-serum creatinine, ngokubaluleka okulinganayo ekuxilongeni ukwehluleka kwezinso. Nokho, nakuba i-creatinine ilibonisa ngokunembile izinga lokuhlunga kwe-glomerular, ukushoda kokuphuma komchamo kungase kuhlotshaniswe nezinye izimbangela zomzimba.

I-Oliguria: impendulo yomzimba

I-Oliguria, uma ihambelana nempendulo yomzimba, ixhunywe ne-anti-diuresis ngenxa ye-hypovolemia, noma ukwehla okuphawulekayo kokujikeleza ivolumu yegazi. Le mpendulo yomzimba ixhunyaniswe nokukhishwa kwe-anti-diuretic hormone (ADH), engaholela ekunciphiseni uketshezi lomchamo kubantu abaphilile. I-Oliguria ngakho-ke ingakhombisa nempendulo ejwayelekile yomzimba, noma ikhombise ukuphazamiseka kwesikhashana kokugeleza kwegazi. I-anti-diuresis ingakhuphuka ngokuvuselelwa kohlelo lwezinzwa oluzwelayo, ikakhulukazi, okungukuthi izakhiwo zezinzwa ezilawula umsebenzi othomathikhi wezitho ze-visceral.

Ezinye izimbangela ze-oliguria

• I-Oliguria nayo ingabangelwa ukukhishwa kwe-hormone elwa nokuhluthwa okubangelwa ubuhlungu, ingcindezi, isicanucanu, ukungazinzi kwe-hemodynamics (ukugeleza kwegazi ezitsheni) noma ukuhlinzwa, ngisho nokuhlukumezeka.
• Ngaphezu kwalokho, ukuhlolwa kwe-pelvic kungasiza ukuhlola i-benign prostatic hyperplasia. Uma i-prostate ivuvukile, icindezela i-urethra, engavumeli ukuthi umchamo udlule.
• Ukuhlolwa kwemisebe, okuqukethe i-ultrasound yomgudu womchamo nakho kungagqamisa ukuvinjelwa okungenzeka, ngakho-ke isithiyo ezingeni lama-ureters.
• Ngaphezu kwalokho, ukuvaleka okunamandla komthambo wezinso noma umthambo kungalimaza nokusebenza kwezinso, futhi kubangele i-oliguria noma i-anuria.

Enye yezinkinga ezinkulu ze-oliguria ukuthuthukiswa kokuhluleka okukhulu kwezinso. Esimweni esinjalo, kuzodingeka ukuthi usebenzise i-dialysis, ukwelashwa okuyinhloko kokuhluleka kwezinso, okubandakanya ukuhlunga igazi ngomshini.

Ukuhlolwa okubalulekile kokuchaza izici ze-oliguria "ukuhlolwa kokucindezeleka kwe-Furosemide" (FST), ezigulini ezine-oliguria: kuvumela ukunquma ukuthi umsebenzi wezinso uphelele yini.

• Uma kukhiqizwa ngaphezu kwama-200 ml womchamo kungakapheli amahora amabili ngemuva kovivinyo lweFurosemide, ukusebenza kwezinso kusasebenza;
• Uma kukhona ngaphansi kuka-200 ml okhiqizwe kungakapheli amahora amabili, ukusebenza kwezinso kuyalimala, futhi lokhu kungasebenzi kahle kwezinso kungadinga i-dialysis, nokuyindlela yokwelashwa enkulu yokwehluleka kwezinso.

Ukuhlolwa kwebhayoloji futhi kwenza kube nokwenzeka ukuhlaziya izinga lokuhlunga kwezinso, elikalwa ngokususwa kwe-creatinine, okwenziwa ngokuhlolwa kwegazi noma ngokuhlaziywa komchamo wamahora angama-24. 

Impendulo esivivinyweni se-FST e-oliguria ingenza kube nokwenzeka ukubandlulula phakathi kweziguli ezethula ukuphendula kokucindezeleka okuhleliwe okuholele ku-anti-diuresis, kusuka ekusebenzeni kwangempela kwezinso.

Ngaphezu kwalokho, ucwaningo olwenziwe ezinganeni ezihlinzwe inhliziyo, ngakho-ke ikakhulukazi ezisengozini yokuhluleka okukhulu kwezinso, lukhombisile ukuthi ukwelashwa nge-aminophylline kwandisa uketshezi lomchamo futhi kuthuthukisa imiphumela yokwelashwa ngemuva. ukuhlinzwa kwezinso. Kulezi ziguli, ukwelashwa ngeFurosemide nakho kuthuthukisa uketshezi lomchamo, kepha iqembu labaphenyi baseMelika likhombisile ukuphakama kwe-aminophylline ngaphezu kweFurosemide ekuvimbeleni ukwehluleka kwezinso okuhambisana nokuhlinzwa kwenhliziyo.

Okokugcina, kufanele kukhunjulwe ukuthi ukuvimbela kokuqala okuyinhloko ukugwema ubungozi be-oliguria, kanye nokutheleleka ngomgudu womchamo, ukuthola i-hydration enhle: amazinga we-hydration anconyelwe abantu abadala ayi-1,5. , amalitha ayi-1,9 ngosuku kwabesifazane, namalitha angama-XNUMX ngosuku kwabesilisa. Iningi lezingane liphansi kakhulu ku-hydration, ngakho-ke kubalulekile ukukhumbula ukubaluleka kokuphuza njalo namanzi anele.