Ukukhipha Umchamo Ophansi

Ukukhipha umchamo omncane noma i-oliguria yisimo sezempilo esivame ukuhlotshaniswa nokugula okuvamile kanye nesifo sohudo noma ukuhlanza lapho iziguli zilahlekelwa uketshezi oluningi lomzimba ngenxa yendle noma ngokuhlanza. Kungase futhi kwenzeke ngenxa yokungakwazi ukuzithiba okubangelwa izifo ezithathelwana ngocansi noma ukuvinjelwa indlela yomchamo. Kukhona izindlela zokwelapha ezehlukene ezitholakalayo zezimbangela ezahlukene zokuphuma komchamo omncane, futhi ngokuvamile uyelapheka ngaphandle kwezinkinga.

Kuyini Ukuphuma Komchamo Ophansi?

Ukukhipha umchamo okuphansi noma i-oliguria kwenzeka lapho umchamo ungaphansi kuka-400 ml ngosuku. Kungase kubangelwa ukuphelelwa amanzi emzimbeni noma ukuphuza inani eliphansi loketshezi noma lingase libangelwe yinoma yisiphi isimo sezempilo esicashile. Ngokuvamile kuyinkinga yesikhashana kubantu abanemizimba enempilo ngenye indlela. 

Uma umuntu eba nezinye izimpawu ngaphezu kokubona ukuphuma komchamo omncane izinsuku ezimbalwa zilandelana, kubalulekile ukufuna usizo lwezokwelapha. Ukwenza kanjalo kuzosiza ekunqumeni ukuthi kungenzeka kube nenkinga yezempilo engathi sína.

Uyini umehluko phakathi kwe-oliguria, i-anuria, ne-polyuria?

Lawa magama axhumene futhi achaza amazinga okukhiqiza umchamo. I-Oliguria ibhekisela ekuphumeni komchamo omncane, kuyilapho i-anuria ibonisa ukuthi awukho nhlobo umchamo. Ngakolunye uhlangothi, i-polyuria ibonisa ukukhiqizwa komchamo ngokweqile.

Ukuhlola umchamo kuye kwaba umkhuba wezokwelapha amakhulu eminyaka. Abahlinzeki bezempilo bahlola inani lomchamo okhiqizwayo, noma yiziphi izinto ezikhona (njengegazi noma amaprotheni), kanye nombala womchamo. Ngokuqapha ukuphuma komchamo nezici, bobabili abahlinzeki bezempilo neziguli bangathola imininingwane ebalulekile ngezempilo.

Ngubani othintwa yi-oliguria?

Ukukhipha umchamo omncane kungenzeka kunoma ubani, kodwa kuvame kakhulu kubantu abanezifo ezithile zezinso ezingase ziholele ekulimaleni okunamandla kwezinso (AKI), okubuye kwaziwe njengokuhluleka kwezinso okukhulu.

Lesi simo sivame kakhulu kulabo ababhekene nakho dialysis noma vele usesibhedlela. Futhi, abantu abadala asebekhulile bangase babe nengozi enkulu yokuthuthukisa i-oliguria.

Izimpawu Zokuphuma Komchamo Ophansi

Umuntu ophile kahle uchama izikhathi eziyisithupha ngosuku. Abantu abadala kanye nezingane ezichama ngaphansi kuka-400 ml woketshezi ngosuku bangase babe nokukhishwa komchamo omncane noma i-oliguria. Izinsana zichama noma yikuphi phakathi kwehora nehora izikhathi ezingu-6 ngosuku. Ngaphansi kwalokho kungase kube uphawu lokukhipha umchamo omncane. Ukuphuma komchamo omncane nakho kungabangela izimpawu, njenge ubuhlungu besisu, ihlangothi, umuzwa oshisayo esiswini kanye nama-ureters, njll. Ukuziba ukuphuma komchamo omncane kungaholela ezinkingeni ezinkulu ezifana ukuhluleka kwezinso, okungase kubeke ukuphila engozini.

Ukukhipha umchamo okuphansi, noma i-oliguria, kungabonakala ngezimpawu ezihlukahlukene ezingase zibonise inkinga eyisisekelo ngohlelo lomchamo, izinso, noma impilo iyonke. Kubalulekile ukuqaphela ukuthi ukuba nenkinga eyodwa noma eziningi zalezi zimpawu akusho ngempela ukuthi kunenkinga engathi sína, kodwa izimpawu ezingapheli noma ezinzima kufanele zenze ukuhlolwa kwezokwelapha. Nazi ezinye izimpawu ezijwayelekile ezihlobene nokuphuma komchamo omncane:

• Imvamisa Eyehlisiwe Yokuchama: Esinye sezibonakaliso ezisobala kakhulu ukwehla kwenani lezikhathi lapho umuntu ekhipha umchamo. Uma kukhona ukuncipha okukhulu kwemvamisa yokuchama uma kuqhathaniswa namaphethini avamile, kungase kubonise ukukhishwa komchamo okuphansi.
• Umchamo Onemibala Emnyama: Umchamo ophuzi ngokumnyama noma onombala o-amber ungase uphakamise umchamo ogxilile, obonisa uketshezi olwanele noma izinkinga ezingase zibe khona ngokusebenza kwezinso. Imvamisa, abantu abanamanzi amaningi banomchamo ophuzi ophaphathekile.
• Izimpawu zokuphelelwa amanzi emzimbeni: Ukuphuma komchamo okuphansi kuvame ukuhlotshaniswa ne kwamanzi emzimbeni. Izimpawu zokuphelelwa amanzi emzimbeni zihlanganisa umlomo owomile, ukoma okwandayo, isiyezi, nomchamo omnyama ophuzi.
• Ubuhlungu Besisu: Ukungakhululeki noma ubuhlungu esifundeni sesisu, ikakhulukazi endaweni yezinso (ubuhlungu be-flank), kungase kube uphawu lwenkinga ecashile ethinta ukusebenza kwezinso.
• Ukuzwa ukushisa ngesikhathi sokuchama: Ukuzwa ukushisa noma okubuhlungu lapho uchama kungase kube inkomba yokutheleleka nge-urinary tract infection (UTI) noma ezinye izimo ezithinta isimiso somchamo.
• I-Edema (ukuvuvukala): Ukukhipha umchamo okwanele kungaholela ekugcinweni koketshezi emzimbeni, okuholela ekuvuvukeni, ikakhulukazi emaqakaleni, emilenzeni naseduze kwamehlo.
• Izinguquko Kumfutho Wegazi: Ukukhipha umchamo okuphansi kungase kuthinte ukushaya kwegazi. Ukuqapha umfutho wegazi nokubona noma yiziphi izinguquko ezibalulekile kubalulekile, njengoba ukusebenza kwezinso kudlala indima ebalulekile ekulawuleni umfutho wegazi.
• Ukukhathala nobuthakathaka: Izinso zinomthwalo wemfanelo wokuhlunga udoti egazini. Uma zingasebenzi kahle, ukunqwabelana kwemfucuza emzimbeni kungaholela ekukhathaleni nasebuthakathakeni.
• Isicanucanu nokuhlanza: Ukuncipha kokuphuma komchamo kungaba nomthelela ekuqongeleleni udoti egazini, okungase kubangele isicanucanu nokuhlanza.
• Ukuphelelwa umoya: Ukugcina uketshezi nokungalingani kwe-electrolyte okubangelwa ukuphuma komchamo omncane kungaba nomthelela ohlelweni lokuphefumula, okuholela ekuphefumuleni.

Yini Ebangela Ukukhipha Umchamo Ophansi?

Kungaba nezimbangela eziningi zokuphuma komchamo omncane; kungaba yindaba yesikhashana nje, ngenxa yesimo sezulu esishisayo futhi ingase ixazulule ngokwayo. Kodwa-ke, ukuphikelela kokuphuma komchamo ophansi kungase kube inkomba yezimo zempilo ezibucayi ezingase zidinge ukuxilongwa okuvela kuchwepheshe onolwazi. 

• Ukuphelelwa amanzi emzimbeni: Imbangela evame kakhulu neyesikhashana yokuphuma komchamo omncane yi kwamanzi emzimbeni, ikakhulukazi ezindaweni ezishisayo. Kungase futhi kubangelwe ukuhlanza kanye nesifo sohudo lapho uketshezi oluphuma emzimbeni lulahleka ngokushesha. 
• ukutheleleka: Impela izifo ze-urinary tract infections (UTIs) kungabangela ukuphuma komchamo omncane okuholela umzimba kumodi yokushaqeka. Lena inkinga yezempilo engathi sína futhi idinga ukungenelela kwezokwelapha ngokushesha.
• Ukuhlukumezeka: Ukulimala ezithweni zangaphakathi zomchamo kungaholela ekuphumeni okuncane komchamo. Kungaba yingozi uma kungelashwa.
• Isithiyo: Ukuvaleka ngokomzimba nokusebenza emgudwini womchamo kungaba yimbangela yokukhishwa komchamo omncane. Lolu hlobo lokuvinjelwa luvame ukuhambisana nezinye izimpawu, njenge ubuhlungu obuphansi besisu. Izizathu zifaka:
  • Amatshe ezinso
  • Okudidayo kokuzalwa noma okuhlobene nokuhlinzwa emgudwini womchamo
  • Ukwandisa kahle kwe-prostate gland
  • Ama-clots egazi emgudwini womchamo
  • Ukulimala kwezinzwa kuleyo mizwa elawula ukusebenza kwesinye.
  • Umdlavuza womlomo wesibeletho, wendlala yesinye, wekholoni nowesinye
• Imithi: Imithi ethile efana nama-diuretics, ama-antibiotic athile, ama-NSAID, umfutho wegazi ophakeme imithi, njll., itholwe iyimbangela yokuphuma komchamo omncane. Ukumisa ukusetshenziswa kwemithi enqunyelwe ezinye izimo zezempilo ezingase zidale ukuphuma komchamo omncane njengomphumela ongemuhle akufanelekile. Ukufuna iseluleko sezokwelapha kudokotela wezinso onolwazi kungasiza ekuxazululeni noma yikuphi ukungabaza nezinkinga, ngisho nangokuphathelene nemithi nemithamo enqunyiwe.
• Shock: Izimo ezibangela ukushaqeka, njengokulahlekelwa igazi kakhulu, zingaholela ekugelezeni kwegazi okwanele ezinso, okuholela ekuphumeni komchamo omncane.
• Izinkinga Zokukhulelwa: Izimo ezifana ne-preeclampsia noma i-eclampsia ngesikhathi sokukhulelwa zingaphazamisa ukusebenza kwezinso futhi ziholele ekunciphiseni ukuphuma komchamo.
• AmaCancer athile: Umdlavuza othinta isimiso somchamo noma izitho eziseduze zingaholela ekuvinjweni noma ekulimaleni okuqondile, kube nomthelela ekukhiqizweni komchamo.
• I-Neurological Disorders: Izimo ezithile zemizwa, njengokulimala komgogodla noma ukuphazamiseka okuthinta amasignali ezinzwa esinyeni, kungaba nomthelela ekuphumeni komchamo omncane.
• Ukwehluleka Okukhulu Kwezinso noma Ukulimala: Izinkinga ezihlobene nezinkinga zezinso, njengokwehluleka noma ukulimala, zingaholela ekuphumeni komchamo omncane.

Amazinga Okukhipha Umchamo: Okujwayelekile vs. Oliguria

Uyombona Nini Udokotela?

Ukuphuma komchamo omncane kungaba imbangela yokukhathazeka uma kwenzeka ngokuzenzakalelayo futhi kuqhubeka. Ukuhileleka ekuzivivinyeni okukhandlayo okungase kubangele ukushaqeka kwe-septic kudinga ukunakekelwa kwezokwelapha, ukuxhumana nodokotela ukuze axilonge futhi alaphe inkinga kubalulekile kuleso simo. 

Ukuzwa ubuhlungu ngenkathi uchama noma ubuhlungu obuzenzakalela esiswini kungaba izimpawu zezinkinga ezihlobene nezinso noma izitho zomchamo. Ukuxilongwa okufanele kwezokwelapha kungasiza ukwelapha inkinga ngendlela efanele. 

Uma ukwehla kokukhishwa komchamo kuhambisana nezimpawu ezilandelayo, kufanele kufunelwe usizo lwezokwelapha ngokushesha:

• isiyezi
• Ukushaya kwenhliziyo okwandisiwe
• Ukukhanya okukhanyayo

Ukuxilongwa Kokukhipha Umchamo Ophansi

Noma ubani onenkinga yokuphuma komchamo omncane njalo onezimpawu ezengeziwe kufanele afune usizo lwezokwelapha. Ibambezeleka ekufuneni ukunakekelwa kochwepheshe ingabhebhethekisa inkinga, ngezinye izikhathi iholele ekufeni. 

Udokotela ohambelayo angase enze ukuhlolwa kwegazi ukuze akhiphe izinkinga ezivamile zomchamo njenge isifo sohudo. Ukuhlolwa kwesithombe njengama-Ultrasound kanye/noma ama-CT Scans kungenziwa ukuze kutholwe ukuvinjwa okusolekayo. Ukwelashwa ngokushesha nokunakekelwa kuyadingeka ukuze kuvinjwe inkinga ukuthi ibe nkulu.

Ukuhlonza imbangela yokuphuma komchamo omncane kuhilela ukuhlolwa okuphelele kwezokwelapha futhi kungase kudinge inhlanganisela yokuhlolwa komtholampilo, ukuhlolwa kwaselabhorethri, nezifundo zezithombe. Nakhu ukubuka konke kwenqubo yokuxilonga yokuphuma komchamo omncane:

• Umlando Wezokwelapha Nokuhlolwa Komzimba: Umhlinzeki wezempilo uzoqala ngokuthatha umlando wezokwelapha onemininingwane eminingi, okuhlanganisa ulwazi mayelana nempilo yesiguli iyonke, imithi, izifo zakamuva, nanoma yiziphi izimpawu ezihlobene nokuphuma komchamo omncane. Ukuhlolwa komzimba kungase futhi kwenziwe ukuze kutholakale izimpawu zokuphelelwa amanzi emzimbeni, ukuthamba kwesisu, noma okunye okutholakele okufanelekile.
• Ukuhlaziywa kokuchama: I-urinalysis ukuhlolwa kokuqala okuvamile okubandakanya ukuhlaziya isampula yomchamo. Inganikeza ulwazi olubalulekile mayelana nombala, ukucaca, nokwakheka komchamo. Ukungajwayelekile njengegazi, amaprotheni, noma ukuba khona kokutheleleka kungabonakala ngokuhlaziywa komchamo.
• Ukuhlolwa kwegazi: Ukuhlolwa kwegazi zibalulekile ekuhloleni ukusebenza kwezinso. Amazinga e-serum creatinine kanye ne-blood urea nitrogen (BUN) avamise ukukalwa ukuze kuhlolwe ukuthi izinso ziyihluza kahle kangakanani imikhiqizo engcolile egazini.
• Ukuhlola Ibhalansi Yamanzi: Ukuqapha umthamo nokukhishwayo koketshezi, kanye nezici zokuhlola ezinjengokushintsha kwesisindo nomfutho wegazi, kusiza ukunquma ibhalansi yoketshezi lonke emzimbeni.
• Izifundo ze-Imaging: Ukuhlolwa kwezithombe, okufana ne-ultrasound, i-CT scan, noma i-MRIs, kungenziwa ukuze kubonakale izinso nomgudu womchamo. Lokhu kungasiza ekuboneni ukungahambi kahle kwesakhiwo, ukuvinjelwa, noma ezinye izinkinga ezithinta ukugeleza komchamo.
• Ukuskena Isinye noma Ukukala Okusele Kwangemva Kokungabikho: Ukuhlola ukuthi ingabe kunobuphi ubunzima bokuthulula isinye ngokuphelele, ukuskena esinyeni noma ukukala kwensalela yangemuva kokungabi nalutho kungase kwenziwe. Lokhu kuhlanganisa ukukala inani lomchamo osele esinyeni ngemva kokuchama.
• Izifundo ze-Urodynamic: Kwezinye izimo, izifundo ze-urodynamic zinganconywa ukuhlola umsebenzi wesinye kanye ne-urethra. Lezi zifundo zihlola ukuthi uhlelo lokuchama luwugcina kanjani futhi luwukhiphe kahle umchamo.
• Ukuhlolwa Okukhethekile: Ngokuya ngesizathu esisolekayo sokuphuma komchamo omncane, ukuhlolwa okukhethekile okwengeziwe kungase ku-odwe. Isibonelo, ukuhlolwa kwezinkinga ze-autoimmune, izifo zezinso, noma izimo ezithile ze-metabolic zingenziwa.
• Ukubonisana Nochwepheshe: I-Nephrologists (ochwepheshe bezinso) kanye abelaphi (ongoti emgudwini womchamo) kungase kuxhunyanwe nabo ukuze banikeze ulwazi lokuhlola nokulawula izimo ezithinta izinso nohlelo lomchamo.
• I-Biopsy (kwezinye izimo): Ezimweni ezithile, i-biopsy yezinso ingase inconywe ukuze kutholwe isampula yethishu encane ukuze ihlolwe eduze. Ngokuvamile lokhu kwenziwa lapho kudingeka ulwazi oluningiliziwe mayelana nokwakheka nokusebenza kwezinso.

Ukwelashwa Kokuphuma Komchamo Ophansi

Uma ukukhishwa komchamo omncane kungenxa yokuphelelwa amanzi emzimbeni, ukuphuza njalo uketshezi ukuze ubuyisele uketshezi lomzimba olulahlekile kungasiza ukuthuthukisa impilo yonke kanye nenkinga ehlosiwe. Uma kunezimo ezibucayi, iseluleko sikadokotela siyadingeka ukuze uthole ukwelashwa okunembile, okusheshayo, futhi okuphumelelayo kwesimo esingaphansi.

Uma imithi evamile ibangela inkinga, udokotela owelaphayo angase atuse umthamo ohlukile kanye nezinguquko zokudla ukuze ulungise umthamo oshintshiwe. Uma ukukhishwa komchamo okuphansi kubangelwa ngenxa yokuvinjelwa, ukungenelela kokuhlinzwa kungase kudingeke, lapho udokotela ezoxoxa ngohlelo olufanele lokwelapha ngaphambi kokuqhubeka nokwelashwa okufanele.

Ukuvimbela Ukuphuma Komchamo Ophansi

• Into ebaluleke kakhulu ongayenza ukuhlala unamanzi futhi udle uketshezi oluningi nama-electrolyte. 
• Gwema ukudla okuholela esihudo noma ukuhlanza. 
• Uma kungenzeka, kunconywa ukugwema imisebenzi enzima engabangela ukuhlukumezeka emzimbeni, ikakhulukazi izinso. 
• Uma kunokungabaza mayelana nokuphuma komchamo omncane, ukufuna iseluleko sezokwelapha ukuze ukhiphe amathuba okuba nenkinga enkulu.

Isiphetho

Ukuphuma komchamo omncane ngokuvamile akuyona into engathi sína okumelwe sikhathazeke ngayo inqobo nje uma kungokwesikhashana noma inkinga ehambisana nezifo ezivamile. Uma kubangela ukukhathazeka, ukuthintana nomeluleki wezokwelapha onguchwepheshe kungasiza ekuxilongweni nasekulashweni ngokushesha kwanoma yisiphi isimo sezempilo esicashile ukuvimbela izimo ezibulalayo noma ezingenakulungiseka.

Imibuzo Evame Ukubuzwa

1. Ngingayivimbela kanjani i-oliguria?

Ukugcina i-hydration kuyisihluthulelo sokuvimbela i-oliguria. Ukugwema ukuhamba nokusebenza ezindaweni ezishisayo, nokuba nezixazululo ze-electrolyte ezitholakala kalula, kungasiza ekulawuleni isimo ngempumelelo.

2. Kuthiwani uma umchamo wami ophumayo uphansi?

Kungaba nezimbangela eziningi zokuphuma komchamo omncane. Kungaba lula njengokuqeda amanzi emzimbeni noma kubonise ukuvaleka komgudu womchamo. Ukuze kutholwe inkinga ewumsuka ngokunembile, kunconywa ukuhlolwa nguchwepheshe wezokwelapha.

3. Umchamo uphansi uwuphawu lwani?

Ukuphuma komchamo omncane kungaba inkinga yesikhashana ekhombisa ukuphelelwa amanzi emzimbeni. Kungaba futhi inkomba yezinye izimo eziningi zempilo ezingaphansi.

4. Ungahamba isikhathi esingakanani ungachami?

Abantu abadala bangahamba cishe amahora ama-4 bengachami. Uma uchama izikhathi ezingaphansi kweziyisithupha, kungase kube uphawu lokuphuma komchamo omncane.

5. Ingabe ukuphuma komchamo omncane kusho ukuhluleka kwezinso?

Ukuphuma komchamo omncane akubonisi izinkinga zezinso. Kungase futhi kube umphumela wezinto ezinjengokuncipha koketshezi noma ukuphelelwa amanzi emzimbeni okubangelwa izimo ezifana nesifo sohudo. Ukuqinisekisa ukuqonda okunembile kwempilo iyonke, ukufuna usizo lwezokwelapha kuyancomeka.

6. Kwenzekani uma umchamo uphuma kancane?

Ukukhipha umchamo omncane kungaholela ekwakhekeni kwemfucuza emzimbeni wakho, kubangele ukuvuvukala, futhi kubonise izinkinga ngezinso zakho noma ukuphelelwa amanzi emzimbeni.

7. Indlela yokwandisa ukuphuma komchamo?

Phuza uketshezi oluningi, ikakhulukazi amanzi, futhi ugweme ukudla okunosawoti. Ngezinye izikhathi, imithi ingase idingeke uma udokotela eyiyala.

8. Ingabe ukuphelelwa amanzi emzimbeni kungabangela ukuphuma komchamo omncane?

Yebo, ukuphelelwa amanzi emzimbeni kuyimbangela evamile yokuphuma komchamo omncane ngoba umzimba wakho uzama ukonga amanzi.

9. Ingabe i-UTI ingabanga ukuphuma komchamo omncane?

Yebo, a pheshana urinary ukutheleleka (I-UTI) ingabangela ukuphuma komchamo omncane, ikakhulukazi uma kukhona ukuvuvukala noma ukuvaleka.

10. Ingabe ukuqunjelwa kungabangela ukuphuma komchamo omncane?

Ukuqunjelwa ngokwakho ngokuvamile akubangeli ukuphuma komchamo omncane, kodwa izimo ezinzima zingafaka ingcindezi esinyeni futhi kuthinte ukuchama.

11. Kungani nginomchamo omncane ophumayo ngemva kokuhlinzwa?

Ngemva kokuhlinzwa, ukuphuma komchamo omncane kungase kube ngenxa yokuphelelwa amanzi emzimbeni, imithi, noma izinguquko zesikhashana ekusebenzeni kwezinso.

12. Ingabe ukuphuma komchamo omncane kungabangela ukuvuvukala komlenze?

Yebo, ukuphuma komchamo omncane kungaholela ekwakhekeni koketshezi emzimbeni, okungabangela ukuvuvukala emilenzeni nakwezinye izindawo.

13. Yimaphi amakhambi asekhaya akhulisa ukugeleza komchamo?

Ukuphuza amanzi amaningi, ukudla ukudla okukhipha isisu njengekhabe nokhukhamba, nokugwema ukudla okunosawoti omningi kungasiza ukwandisa ukugeleza komchamo.

14. Ingabe amanzi okuphuza angakulungisa ukugcwala komchamo?

Ukuphuza amanzi kungasiza uma ukuphelelwa amanzi emzimbeni kubangela ukugcina umchamo, kodwa uma kunokuvinjelwa noma enye inkinga yezokwelapha, uzodinga ukubonana nodokotela.

15. Kunini lapho ukuphuma komchamo omncane kuwukukhathazeka?

Kuyakhathaza uma kuthatha isikhathi esingaphezu kosuku, kuhambisana nobuhlungu, ukuvuvukala, noma ezinye izimpawu, noma uma ungakwazi ukuchama nhlobo. Thola usizo lwezempilo uma lokhu kwenzeka.

CARE Medical Team

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