KIDNEY TRANSPLANTATION - KEV NPAJ TEEB MEEM POSTOPERATIVE
Jun 25, 2023
TSAB NTAWV
1. Taw qhia
Lub raum hloov pauv yog ib txoj kev phais uas tsim los rau kev kho mob raum tsis ua haujlwm kawg uas tau txais txiaj ntsig mus ntev. Txawm tias muaj kev vam meej tas mus li thiab kev loj hlob ntawm transplantology, ob peb postoperative phais thiab urological teeb meem tseem tshwm sim niaj hnub no, uas tuaj yeem cuam tshuam qhov ua tiav ntawm txoj kev ua haujlwm no.
2. Lub hom phiaj
Tag nrho cov teeb meem kev phais thiab urological hauv thawj 60 hnub tom qab hloov lub raum tau ua raws.
Cov ntaub ntawv thiab cov txheej txheem
Txoj kev tshawb no yog ua raws li kev soj ntsuam rov qab ntawm cov kab mob keeb kwm ntawm 35 cov neeg mob uas tau hloov lub raum ntawm Lub Tsev Kho Mob Urology ntawm UMHAT "Alexandrovska" rau lub sijhawm txij 02.2018 txog 12.2019. Cov txiaj ntsig: Cov teeb meem tshwm sim thaum ntxov tau pom hauv 46 feem pua ntawm cov neeg mob hloov pauv. Cov teeb meem urological tau pom hauv 26 feem pua ntawm lawv.
3. Kev sib tham
Qhov tshwm sim ntawm cov kab mob tso zis hauv cov neeg mob hloov pauv yog 26 feem pua. Thaum lub sij hawm rov qab los, tsis muaj qhov tshwm sim ntawm kev tso zis, nruj ntawm lub ureter, lossis urinoma hauv pawg neeg mob. Qhov tshwm sim ntawm kev phais mob hauv cov neeg mob hloov pauv yog 29 feem pua. Qhov tshwm sim ntawm postoperative hematomas yog 23 feem pua. Postoperative lymphocele tau kuaj pom hauv ib tus neeg mob, uas qhia tau tias muaj teeb meem ntawm 3 feem pua rau qhov kev kuaj mob no. Qhov tshwm sim ntawm kev phais mob kis kab mob hauv cov neeg mob hloov pauv thaum lub sijhawm ua raws yog 3 feem pua.
4. Cov lus xaus
Peb cov txiaj ntsig tau pom tias qhov sib txawv ntawm qhov sib txawv thaum ntxov postoperative urological thiab phais teeb meem sib raug rau cov ntaub ntawv cov ntaub ntawv los ntawm lwm lub chaw hloov pauv. Lawv qhia tau hais tias kev hloov pauv kev ua ub no hauv Clinic of Urology hauv UMHAT "Alexandrovska" sib haum nrog cov qauv hauv ntiaj teb.
5. Cov ntsiab lus
urological, phais, teeb meem, transplantation, pub
Nyem qhov no kom paub qhov cuam tshuam ntawm Cistanche thiab yuav Cistanche ntxiv
Taw qhia
1. Cov ntaub ntawv keeb kwm luv luv ntawm kev hloov lub raum
Xyoo 1902, Austrian kws phais H. Ullman los ntawm Vienna tau ua thawj lub raum hloov ntawm tus dev, uas tau soj ntsuam raws li kev ua tiav. Nws muab lub raum tso rau hauv tus dev lub caj dab, anastomosing lub ureter ntawm daim tawv nqaij kom nws thiaj li saib xyuas diuresis - lub raum tso zis rau tsib hnub. Xyoo 1906, thawj zaug kev sim hloov raum los ntawm cov tsiaj mus rau tib neeg tau ua los ntawm Dr. Mathieu Jaboulay los ntawm Lyon, tab sis cov haujlwm no ua pov thawj tsis tiav. Hauv xyoo 1933, thawj lub raum hloov pauv tau ua los ntawm lub cev nqaij daim tawv los ntawm Dr. Yu Yu Voronoy los ntawm Kyiv. Tus neeg tau txais kev nyob tau 4 hnub, thiab lub raum hloov pauv tsis tau ua haujlwm. Xyoo 1952, thawj lub raum hloov pauv los ntawm tus neeg pub dawb (niam ntawm tus menyuam) tau ua los ntawm Prof. Hamburger hauv Paris. Hmoov tsis zoo, nws muaj lub sijhawm luv luv ntawm kev ua tiav. Thaum Lub Kaum Ob Hlis 23, 1954, Dr. Joseph Murray los ntawm Boston tau ua thawj zaug kev hloov lub raum zoo. Kev hloov pauv tau ua ntawm cov menyuam ntxaib zoo ib yam - yog kev hloov pauv. Oscar Creech thiab Keith Reemtsma hloov lub raum thiab lub siab los ntawm chimpanzee rau tib neeg. Kev ciaj sia ntawm ob peb tus neeg mob rau lub hlis qhia tau hais tias nyob rau hauv lub xub ntiag ntawm zoo immunosuppressive txoj kev kho, hloov lub cev ntawm ntau hom (xenotransplantation) yog ua tau. Thomas Starzl sim hloov lub raum los ntawm ib tug baboon mus rau ib tug neeg mob nyob rau hauv ib tug mob hnyav heev, tab sis lub lag luam tsis ua tiav.
Thawj lub raum hloov pauv hauv Bulgaria tau ua nyob rau xyoo 1968 hauv Pirogov Tsev Kho Mob los ntawm Prof. Minkov li al. Tus neeg tau txais kev pab yog tus menyuam uas nws lub raum ib leeg raug tshem tawm tom qab raug mob. Tus neeg mob tau hloov pauv ob lub raum tso rau hauv lub plab mog. Thaum Lub Ob Hlis 1, 1969, Prof. N. Atanasov thiab Prof. St. Lambrev tau ua thawj qhov kev hloov pauv hauv lub cev hauv Alexandrovska Tsev Kho Mob - tus poj niam muaj hnub nyoog 42- xyoo raug mob los ntawm endemic nephropathy tau txais kev hloov hauv lub raum. Lub Tsev Kho Mob ntawm Urology ntawm UMHAT "Alexandrovska" dhau los ua lub chaw tseem ceeb hauv lub tebchaws rau kev hloov lub raum.
Cistanche extract
2. Kev hloov lub raum niaj hnub no
Niaj hnub no, kev hloov lub raum yog ib txoj kev phais uas tsim los kho qhov kawg ntawm lub raum tsis ua haujlwm nrog rau cov txiaj ntsig mus ntev. Piv nrog rau kev lim ntshav, kev hloov hauv lub raum ua tau zoo txhim kho lub neej zoo ntawm cov neeg mob, thiab lawv lub cev endurance txhawb kev sib raug zoo thiab txo cov xwm txheej ntawm cov kab mob dialysis ntev. Los ntawm qhov kev xav ntawm kev lag luam, kev hloov lub raum ua rau txo qis ntawm cov nqi kho mob rau cov neeg mob uas muaj lub raum tsis ua haujlwm kawg. Kev hloov lub raum ua tiav, suav nrog kev soj ntsuam ntawm tus neeg mob thaum thawj xyoo, raug nqi ntau npaum li ob xyoos ntawm kev lim ntshav. Lub sijhawm nruab nrab ntawm kev hloov lub raum ua haujlwm tom qab hloov pauv yog 9 xyoo. Muaj cov xwm txheej uas muaj txiaj ntsig zoo tau pom tom qab 20 xyoo lossis ntau dua. Lub neej expectancy nyob rau hauv cov neeg mob transplanted yog ntev dua li cov neeg mob dialysis.
3. Postoperative teeb meem ntawm lub raum hloov
Txawm hais tias muaj kev vam meej tas mus li thiab kev loj hlob ntawm kev cog qoob loo, ntau qhov kev phais tom qab phais thiab urological teeb meem tseem tshwm sim niaj hnub no. Kev phais mob tom qab phais muaj xws li cov teeb meem vascular xws li venous thiab arterial thrombosis ntawm graft, lub raum hlab ntsha stenosis, lymphocele, thiab lwm yam. Lwm yam teeb meem muaj feem xyuam rau lub qhov txhab phais - kab mob, dehiscence, thiab hernias. Cov teeb meem hemorrhagic muaj xws li diffuse cov ntaub so ntswg los ntshav thiab los ntshav los ntawm vascular anastomoses. Cov teeb meem tshwm sim feem ntau yog cuam tshuam nrog lub qhov txhab ua haujlwm (nruab nrab ntawm 12- 36} feem pua ), ua raws li hematomas (nruab nrab ntawm 2 thiab 25 feem pua), thiab qhov tsawg tshaj plaws yog cov teeb meem vascular (nruab nrab ntawm 1 thiab 12 feem pua). Cov teeb meem urological tseem cuam tshuam rau lub sijhawm postoperative hauv lub raum hloov pauv. Cov no suav nrog cov zis tso tawm los ntawm vesico-ureteroneostomy, urinoma, ureteral obstruction, urinary tract infections, vesicoureteral reflux, thiab urolithiasis. Lawv qhov zaus yog nyob nruab nrab ntawm 2-37 feem pua .
Kev kuaj mob raws sij hawm thiab kev kho mob tsim nyog ntawm kev phais thiab kev mob urological yog qhov tseem ceeb heev. Muaj ntau ntau, feem ntau cov kev tshawb fawb rov qab hauv cov ntaub ntawv ntawm qhov zaus ntawm kev phais thiab cov teeb meem urological tom qab hloov lub raum thiab lawv cov teeb meem cuam tshuam. Feem ntau cov ntawv tsom mus rau ib qho kev phais lossis urological teeb meem. Cov kev tshawb fawb uas qhia txog tag nrho cov teeb meem tshwm sim yog qhov tsawg kawg nkaus.
Cistanche capsules
Lub Hom Phiaj thiab TASKS
Peb lub hom phiaj thiab cov dej num yog los hloov kho peb cov kev paub hauv kev txhais lus, kom paub txog cov ntaub ntawv tshawb fawb tam sim no ntawm qhov teeb meem no, thiab nthuav qhia peb cov ntaub ntawv ntawm cov teeb meem tom qab phais urological thiab phais tom qab hloov lub raum. Peb kuj tau teeb tsa peb tus kheej lub hom phiaj los ntsuas peb cov txiaj ntsig thiab sib piv nrog cov ntaub ntawv muaj nyob rau hauv cov ntaub ntawv kho mob niaj hnub ntawm lub ncauj lus no.
MATERIAL THIAB MUAB
Txoj kev tshawb no yog ua raws li kev soj ntsuam rov qab ntawm cov kab mob keeb kwm ntawm 35 cov neeg mob uas tau hloov lub raum hauv Clinic of Urology, UMHAT "Alexandrovska" rau lub sijhawm txij 02.2018 txog 12.2019. Cov pab pawg neeg mob muaj 28 tus txiv neej thiab 7 tus poj niam. Lub hnub nyoog nruab nrab ntawm cov neeg mob yog 43 xyoo (qhov nruab nrab 42 xyoo). Qhov nruab nrab hnub nyoog ntawm cov poj niam thiab cov txiv neej yog 41 thiab 44 xyoo, feem. Ib tug ntawm cov txiv neej tau txais ib lub raum hloov mus rau ib tug thib ob lub sij hawm. Txoj kev tshawb no suav nrog cov neeg mob hloov pauv los ntawm tus neeg nyob thiab cadaveric pub. Hauv peb txoj kev tshawb fawb, tus naj npawb ntawm kev hloov lub raum los ntawm tus neeg pub muaj sia nyob yog 3, thiab cov neeg los ntawm tus neeg pub dawb - yog 22. Lub sijhawm rov qab los rau cov teeb meem tom qab ntxov yog 60 hnub tom qab kev phais.
Kev sib tham
Ib qho kev txo qis hauv qhov tshwm sim ntawm urological thiab kev phais mob tom qab phais mob tau ua tiav ntau xyoo nrog kev txhim kho ntawm kev hloov pauv thiab cov txheej txheem sib txawv me me. Qhov no yog qhov tseem ceeb heev vim tias qhov tshwm sim ntawm cov teeb meem zoo li no tom qab hloov lub raum tuaj yeem ua rau muaj kev mob hnyav ntxiv thiab kev tuag ntawm cov neeg mob hloov pauv.
Cistanche hmoov
SUMMARY THIAB CONCLUSIONS
Thaum ntxov postoperative teeb meem tau pom nyob rau hauv 46 feem pua ntawm cov neeg mob hloov. Urological teeb meem tsim nyob rau hauv 26 feem pua ntawm lawv. Qhov tshwm sim ntawm cov kab mob tso zis hauv cov neeg mob hloov pauv yog 26 feem pua. Peb tsis soj ntsuam ib qho kev tso zis, nruj ntawm lub ureter, lossis urinoma thaum lub sijhawm ua raws.
Qhov tshwm sim ntawm kev phais mob hauv cov neeg mob hloov pauv yog 29 feem pua. Ib tus neeg mob hauv peb pab pawg tau tsim cov qog ntshav qog ntshav qab zib, uas qhia tau tias muaj teeb meem ntawm 3 feem pua. Kev phais mob tau pom nyob rau hauv 3 feem pua. Tsis muaj cov tsos mob ntawm venous lossis arterial thrombosis thiab hernia nyob rau hauv qhov chaw ntawm lub qhov txhab ua haujlwm raug soj ntsuam thaum lub sijhawm ua haujlwm.
1. Peb cov qhabnias qhia tau hais tias qhov zaus ntawm tus neeg thaum ntxov postoperative urological thiab phais teeb meem sib raug rau cov ntaub ntawv ntaub ntawv los ntawm lwm lub chaw hloov.
2. Lub sijhawm nruab nrab ntawm kev nyob hauv tsev kho mob hauv Clinic of Urology, UMHAT "Alexandrovska" rau cov neeg mob hloov pauv tuaj yeem nyob ntawm qee yam ntawm cov kev kho mob hauv lub tebchaws.
3. Peb cov txiaj ntsig tau qhia tias Lub Tsev Kho Mob Urology, UMHAT "Alexandrovska" ua cov haujlwm hloov pauv uas tsim nyog rau lub ntiaj teb cov qauv hauv kev hloov lub raum.
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Vladislav Mladenov1, Ivan Lilianov1, Boris Botev1, Valeria Hadjiiska2, Andrian Tonev1
1) Clinic of Urology, UMHAT "Alexandrovska", Medical University - Sofia, Bulgaria.
2) Clinic of Nuclear Medicine, UMHAT "Alexandrovska", Medical University - Sofia, Bulgaria.
