Hoʻolaʻa ʻia kēia ʻatikala i nā mea mālama holoholona āpau e mālama i kā lākou mau puaʻa me ka hoʻomanawanui a me ke akahele. ʻOiai lākou e haʻalele, e ʻike lākou i kou aloha.

01 ke hoʻonui nei ka nui o nā holoholona me ka hana ʻole o ka renal i kēlā me kēia makahiki

ʻAʻole hiki ke hoʻihoʻi ʻia ka hemahema renal acute, akā ʻaʻole hiki ke hoʻihoʻi ʻia ka hana ʻole o ka renal. Hiki i nā mea mālama holoholona ke hana i ʻekolu mau mea:

1: E hana maikaʻi i nā kikoʻī āpau o ke ola, a e hoʻāʻo ʻaʻole e hoʻokuʻu i nā holoholona ʻaʻole i loaʻa i ka maʻi renal koe wale nō nā ulia;

2: Acute renal hemahema, hoʻokolokolo mua, lapaʻau mua, mai kānalua, mai kali;

3: ʻO ka maʻi ma mua o ka loaʻa ʻana a mālama ʻia o ka maʻi renal maʻi, ʻoi aku ka lōʻihi o ka manawa ola;

02 No ke aha e paʻakikī ai ka hoʻihoʻi ʻana i ka maʻi renal

ʻElua kumu nui no ke kumu he weliweli a paʻakikī hoʻi ka hana ʻana o ka renal:

1: E like me ka mea i ʻōlelo ʻia ma mua, koe wale nō ka hiki ke hoʻohuli ʻia ka hemahema renal ma muli o ka make a me ka ischemia kūloko, ʻaʻole hiki ke hoʻololi ʻia ke koena. I ka manawa e paʻakikī ai ka hoʻihoʻi ʻana i ka ʻeha maoli o ka renal, a ʻaʻohe lāʻau lapaʻau maoli no ka hōʻino ʻole ʻana o nā holoholona holoholona ma ka honua, ʻo ia mau mea āpau a me nā mea hoʻohui;

2: Ua ʻike mākou a pau ʻo ka puʻupaʻa he mea mālama ʻia o ko mākou kino, ʻo ia hoʻi, ʻelua kā mākou puʻupaʻa. Inā pōʻino kekahi, hiki ke hana maʻamau ke kino, ʻaʻole mākou e ʻike i ka maʻi. Hōʻike wale ka puʻupaʻa i nā hōʻailona ke nalowale ka 75% o kāna hana, ʻo ia ke kumu i ʻoi aku ai ka lohi a i ʻole ka liʻiliʻi o ka renal i ka wā i loaʻa ai, a he liʻiliʻi nā koho lapaʻau i loaʻa.

Ke nalowale ka hana renal e 50%, paʻa mau ke kaiapuni o loko, a aneane hiki ʻole ke ʻike i nā pilikia; ʻO ka nalowale o ka hana renal he 50-67%, nalowale ka mana o ka ʻike, ʻaʻole e loli ka waiwai biochemical, a ʻaʻole e hōʻike ke kino i ka hana, akā e hoʻonui ʻia kekahi mau hoʻokolohua e like me SDMA; ʻO ka nalowale o ka hana renal he 67-75%, a ʻaʻohe mea i ʻike ʻia i ke kino, akā hoʻomaka ka piʻi ʻana o ka biochemical urea nitrogen a me ka creatinine; ʻOi aku ma mua o 75% o ka pau ʻana o ka hana renal i wehewehe ʻia e like me ka hiki ʻole o ka renal a me ka uremia kiʻekiʻe.

ʻO ka hōʻike ʻoi loa o ka hiki ʻole o ka renal acute ka hoʻemi wikiwiki ʻana o ka mimi holoholona, ​​​​ʻo ia ke kumu e koi aku ai au i kēlā me kēia mea holoholona e nānā i ka nui o ka mimi o kāna holoholona i kēlā me kēia lā. He mea paʻakikī loa kēia no ka poʻe mālama holoholona e hoʻokuʻu pinepine i nā pōpoki a me nā ʻīlio i waho, no laila ʻo ia ka manawa hope loa e maʻi ai kēia mau holoholona.

03 hiki ke ola hou kekahi mau ma'i me ka hiki ole o ka renal

ʻOiai ʻo ka hōʻino ʻana o ka renal acute i ka renal ka hoʻomaka wikiwiki a me nā hōʻailona koʻikoʻi, hiki nō ke hoʻōla, no laila he mea nui loa e pale aku i ka hiki ʻana mai o ka hōʻeha renal a ʻike i ke kumu o ka maʻi. ʻO ka hapa nui o ka hōʻino renal ma muli o ka ischemia kūloko, ka paʻa ʻana o ka ʻōnaehana urinary a me ka make.

No ka laʻana, ʻo 20% o ka hāʻawi ʻana i ke koko i ka puʻuwai i ka puʻupaʻa, ʻoiai ʻo 90% o ke koko o ka puʻupaʻa e hele i loko o ka cortex renal, no laila ʻoi aku ka maʻalahi o kēia ʻāpana i ka ischemia a me ka pōʻino i hoʻoiho ʻia. No laila, ʻike pinepine mākou i ka pili pinepine ʻana o nā maʻi puʻuwai a me ka puʻuwai. Ke ʻino kekahi, e maʻalahi ke kino a hiki i ka maʻi. ʻO nā kumu maʻamau o ka hiki ʻole o ka renal i hoʻokumu ʻia e ka ischemia ʻo ia ka dehydration koʻikoʻi, ke koko nui a me ke ahi.

Inā ʻaʻole maʻalahi ka maloʻo, ke koko a me ke kuni ʻana, ʻo ka hoʻoulu pinepine ʻana o ka hōʻino ʻole o ka renal i kēlā me kēia lā, ʻo ia ka hōʻino ʻole o ka renal ma muli o ka paʻa ʻana o ka ʻōnaehana urinary. ʻO ka maʻi maʻamau a me nā pōhaku urethral, ​​blockage crystal, urethritis, pehu a blockage o ka catheter mimi. ʻO ka hoʻopaʻa ʻana ke kumu o ka hōʻiliʻili ʻana o ka urinary tract, hoʻopaʻa ʻia ka kānana glomerular, hoʻonui i ka nitrogen non-protein i loko o ke koko, e hopena i ka glomerular basement membrane necrosis. He mea maʻalahi kēia kūlana. Ke pani ʻia ka mimi ma mua o 24 mau hola, pono mākou e hoʻāʻo i ka biochemistry i mea e hōʻoia ai ʻaʻole loaʻa kahi hōʻeha o ka renal. ʻO kēia ʻano hōʻeha renal ʻo ia wale nō ka hiki ke hoʻōla hou i nā lā liʻiliʻi, akā inā lohi ʻia, e hoʻonui paha ia i ka maʻi a i ʻole e lilo i ka maʻi renal maʻi i kekahi mau lā.

ʻOi aku ka nui o nā subspecies o ka hiki ʻole o ka renal ma muli o ka make ʻana. ʻO ka ʻai ʻana i nā hua waina i kēlā me kēia lā he hoʻokahi, a ʻo ka hapa nui o ka hoʻohana hewa ʻana i nā lāʻau lapaʻau. I loko o ka wai a me ka electrolyte o ka reabsorbed glomerular filtration fluid, renal tubular epithelial cell i hōʻike ʻia i ka piʻi ʻana o ka nui o nā mea make. ʻO ka huna ʻana a i ʻole ka reabsorption o nā mea ʻawaʻawa e ka renal tubular epithelial cell e hiki ke hōʻiliʻili i nā mea ʻawaʻawa i kahi kiʻekiʻe i loko o nā cell. I kekahi mau hihia, ʻoi aku ka ikaika o ka ʻona o nā metabolites ma mua o nā pūhui precursor. ʻO ka lāʻau lapaʻau nui ma aneʻi ʻo "gentamicin". ʻO Gentamicin kahi lāʻau anti-inflammatory maʻamau i hoʻohana ʻia, akā he nephrotoxicity nui. I ka hapanui o nā hihia, ʻoiai i loko o ka haukapila, inā ʻaʻole kūpono ka maʻi a me ka mālama ʻana, maʻalahi ke kumu o ka hiki ʻole o ka renal acute induce toxic.

Paipai ikaika wau i nā mea mālama holoholona e hoʻāʻo ʻaʻole e hoʻokomo i ka gentamicin ke loaʻa iā lākou kahi koho. Eia kekahi, pono e hoʻolohe nā holoholona me nā puʻupaʻa maikaʻi ʻole i ka lāʻau lapaʻau. ʻO ka hapa nui o nā lāʻau anti-inflammatory e hōʻike i ka lawa ʻole o ka renal i nā contraindications. E hoʻohana me ka akahele, cephalosporins, tetracyclines, antipyretics, analgesics, etc.

04 pono ka ho'oma'i 'ole o ka ma'i

ʻOkoʻa mai ka hōʻino renal acute, ʻaʻole paʻakikī loa ka loaʻa ʻana o ka maʻi renal maʻi, a ʻaʻohe hōʻailona maopopo i ka wā mua o ka hoʻomaka ʻana. Malia paha e ʻoi aku ka nui o ka mimi ma mua o ka maʻamau, akā ʻaʻole hiki iā mākou ke noʻonoʻo i ko mākou ola i kēlā me kēia lā ma muli o ka piʻi ʻana o ka nui o ka mimi ma muli o ka mahana wela, ka nui o nā hana a me nā meaʻai maloʻo. Eia kekahi, paʻakikī ka hoʻoholo ʻana i ke kumu o ka hiki ʻole o ka renal. I kēia manawa, ʻo ka mea hiki ke hoʻohana ʻia ma ke ʻano he kuhikuhi ʻo nā maʻi glomerular, e like me ka nephritis, innate genetic nephropathy, urethral obstruction, a i ʻole ka maʻi renal maʻi me ka mālama ʻole ʻana i ka manawa.

Inā hiki i ka hiki ʻole o ka renal ke hoʻolalelale i ka hoʻihoʻi ʻana ma o ka hoʻonui ʻana i ka hāʻawi ʻana i ka wai inu, subcutaneous injection o ka wai, dialysis a me nā ʻano hana ʻē aʻe e metabolize i nā toxins a hōʻemi i ke kaumaha o ka puʻupaʻa. ʻAʻohe ala e hoʻihoʻi i ka hana renal i ka hana ʻole o ka renal. ʻO ka mea wale nō e hiki iā mākou ke hana, ʻo ia ka hoʻemi ʻana i ka wikiwiki o ka hōʻeha renal a hoʻolōʻihi i ke ola o nā holoholona ma o ka hānai ʻana i ka ʻepekema a me kekahi mau meaʻai, e like me ka hoʻonui calcium, ka hoʻohana ʻana i ka erythropoietin, ka ʻai ʻana i ka meaʻai a me ka hoʻemi ʻana i ka ʻai protein. ʻO kahi mea ʻē aʻe e hoʻomaopopo ai, ʻo ka nui o ka hemahema o ka renal e hui pū ʻia me ka emi ʻana o ka hana pancreatic, a ʻo ka pancreatitis hoʻi, pono e nānā.

ʻO ke ala maikaʻi loa e hoʻoponopono ai i ka hiki ʻole o ka renal ka loaʻa koke. ʻO ka mua o ka loaʻa ʻana, ʻoi aku ka maikaʻi o ka mālama ʻana i ke kūlana ola. No nā pōpoki, i ka wā maʻamau ka hoʻāʻo biochemical o ka urea nitrogen, creatinine a me ka phosphorus, hiki ke nānā mau ʻia ka SDMA i hoʻokahi makahiki i ka makahiki e hoʻoholo ai inā loaʻa ka maʻi maʻi maʻi mua. Eia naʻe, ʻaʻole pololei kēia hoʻokolohua no nā ʻīlio. ʻAʻole hiki i ka 2016 ma United States i hoʻomaka ai mākou e aʻo inā hiki ke hoʻohana ʻia kēia hoʻāʻo i nā ʻīlio. No ka mea ʻokoʻa loa ka waiwai hoʻāʻo mai nā pōpoki, ʻaʻole hiki ke hoʻohana ʻia ma ke ʻano he helu diagnostic no nā ʻīlio i ka wā mua o ka hiki ʻole o ka renal. No ka laʻana, ʻo 25 ka hopena o ka pae 2 a i ʻole ka hoʻomaka ʻana o ka pae 3 o ka hōʻino ʻole o ka renal no nā pōpoki, No nā ʻīlio, manaʻo kekahi poʻe loea i loko o ka laulā o ke olakino.

ʻAʻole ʻo ka make ʻana o nā pōpoki a me nā ʻīlio ʻaʻole ia he make, no laila e mālama pono nā mea mālama iā lākou me ka hoʻomanawanui a me ke akahele me kahi ʻano maluhia. ʻO ke koena e pili ana i ko lākou hopena. Ua ʻike ʻia kahi pōpoki aʻu i hāʻawi aku ai i kaʻu mau hoa hana ma mua o ka loaʻa ʻana o ka maʻi maʻi maʻi maʻi i ka makahiki 13. Ua hānai ʻia ia me nā lāʻau lapaʻau i ka manawa. Ma ka makahiki 19, koe wale no ka elemakule o ka iwi a me ka opu a me ka opu, maikai loa ke koena.

I mua o ka hemahema o nā puʻupaʻa puaʻa, he liʻiliʻi nā koho e hana ai ka poʻe nona nā holoholona, ​​no laila ʻoiai lākou e mālama ikaika, hānai a ʻai ʻepekema i loko o ko lākou hiki, he paʻakikī loa a ʻaneʻane hiki ʻole ke hoʻihoʻi hou i ka waiwai maʻamau. Maikaʻi ka loaʻa ʻana o ka creatinine a me ka urea nitrogen i ka pae maʻamau a ʻoi aku ka kiʻekiʻe. ʻO kā lākou pōmaikaʻi ke ola hou, Inā haʻalele ʻoe, e hoʻāʻo ka mea mālama holoholona i kāna mea maikaʻi loa. Ke ola hou nei ke ola. Malia paha e hoʻi hou mai lākou iā ʻoe, inā lōʻihi kou makemake e manaʻoʻiʻo.