March 23, 2012
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- Treatment of pyelonephritis
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The prevalence of the disease among women and girls is due primarily to the fact that the urethra of the female is shorter than that of men. Very often, the symptoms of pyelonephritis occur in people who have problems with the immune system, have Diabetics . The disease is often seen in children of preschool age. Often there is a pyelonephritis in pregnant women, and those who have survived childbirth or starting sexual life. In men, a factor that provokes the development of pyelonephritis kidney, often becomes adenoma prostate . Because of problems with the flow of urine in a person's body creates a favorable environment for the development of bacteria. Suffer well as patients with pyelonephritis kidney stones . Such formations are often a refuge for certain bacteria, which then trigger inflammation.
Pyelonephritis kidney usually divided into sharp and chronic . There is also a primary and secondary disease.
Acute pyelonephritis
Acute pyelonephritis It occurs in a patient due to the impact on his body endogenous or exogenous Microorganisms that penetrate into the kidneys. In this case, crucial in the development of disease has a number of factors: disturbance due to obstruction of the passage of urine stone and other reasons; violation of the outflow of urine due adenoma . prostate cancer . phimosis et al. Furthermore, the occurrence of pyelonephritis determines the general condition of the human body. On the resistance of the body adversely affects the wrong approach to nutrition, hypothermia, overwork . gipovitaminoz Frequent colds, illnesses of a number of body systems.
Depending on the stage of the disease, its complications of having symptoms of pyelonephritis. Definition of stages of the disease occurs after the study of morphological changes in the kidney.
At the initial stage of the disease a person suffers from serous pyelonephritis That can last from six to thirty six hours. Further, the disease moves to the next stage, which is characterized by the presence of purulent, destructive changes. As a rule, these changes have a clear sequence. First seen apostematozny pyelonephritis Further - carbuncle kidney . kidney abscess And ends the process of change purulent paranephritis .
In step apostematoznogo pyelonephritis a person appear small multiple pustules on the surface of the kidney and its cortex. If these pustules in the development process begin to merge, or microbial embolus is in the final renal arteries, a person manifests carbuncle kidney. For this condition characterized by the development necrotizing . Ischemic . pyoinflammatory processes.
Because of purulent fusion parenchyma appears kidney abscess . Abscess Which appeared in the hearth carbuncle kidney or merger certificates issued, sometimes it emptied into the perirenal fat. After that develops paranephric abscess Sometimes also occurs retroperitoneal abscess.
The most common form of purulent pyelonephritis occur as a result of obstruction of the upper urinary tract.
Secondary acute pyelonephritis It begins with symptoms of renal colic. After that manifested fever, high fever against the backdrop of a sharp rise in body temperature, which can rise to 41 ° C. Next, the patient developed symptoms similar to symptoms of a secondary pyelonephritis. Once the temperature drops to normal or subnormal performance, the person begins to sweat. He feels some improvement, back pain becomes less intense. However, in this case there is a seeming improvement which the doctor can not be regarded as a recovery of the patient. Indeed, in the case of obstruction of the upper urinary tract pain and chills attack resumed after a few hours.
If a patient develops purulent form of pyelonephritis , The symptoms become more pronounced. This back pain from paroxysmal becomes permanent, it is accompanied by fever and Hectic fever . On the side where there is defeat, tense muscles anterior abdominal wall and lumbar area. Kidney painful on palpation is determined by its increase. The body grows intoxication , Whereby the human condition becomes worse. Ppostepenno exacerbated condition of dehydration, so appreciably sharpened human facial features, the state becomes difficult, and in some cases accompanied by euphoria . However, the described symptoms of pyelonephritis renal suppurative destructive changes in the kidney is not always expressed. If a person is weakened, sick, the clinical condition may appear distorted.
Chronic pyelonephritis
Chronic pyelonephritis is quite widespread disease. However, this diagnosis is quite difficult to establish because of the very few expressed general clinical symptoms. In most cases, chronic pyelonephritis is the continuation pieolonefrita acute. Most often the disease occurs in those patients in whom there is a violation of the upper urinary tract passage of urine. This phenomenon provoked stones in the ureters and kidneys, chronic urinary retention and other phenomena.
Approximately one third of patients suffering from chronic pyelonephritis in childhood: the disease develops as a non-specific inflammation of the parenchyma sluggish pyelocaliceal system and kidneys. In most cases the disease is detected after many years after it occurs. Chronic pyelonephritis affects how one or two buds.
For this disease is characterized by polymorphism and focal changes in kidney tissue. Gradually the inflammation involved in the following sections of kidney tissue, thus the tissue dies slowly and manifests chronic renal failure .
In the subsequent progression of the disease a person complains of attacks hypertension . After ten or fifteen years from the onset of the disease in the patient develops chronic renal failure .
Diagnosis pyelonephritis
To properly diagnose the patient's kidney pyelonephritis, doctor, first of all examines the patient, paying special attention to the condition of his skin, noting whether there is moisture and pale skin. Also, the doctor notes dry, coated tongue, detects the presence of tachycardia . hypotension .
While laboratory studies of blood found leukocytosis Acceleration ESR . If there are purulent forms of the disease, the patient has Dysproteinemia . anemia , High levels of urea and creatinine serum. It is also in the process of diagnosing a mandatory urine test is conducted. It is important to bacteriological examination, and to determine the sensitivity of microorganisms to antibiotic drugs influence. Laboratory testing is required to provide bacteriological urine culture.
As additional diagnostic methods often administered ultrasound diagnosis of kidneys. If this survey there is limited mobility of the kidney, such a sign can be seen as an additional criterion in the diagnosis of acute pyelonephritis. Through ultrasound can not only diagnose the disease, but also to determine the reasons that led to its appearance - the presence of kidney stones, urinary tract defects.
Also pinpoint destructive forms pieolonefrita in children and adults is possible by CT or MRI.
In the absence of being able to perform ultrasound diagnosis to differentiate primary and secondary pyelonephritis it can be based on the results cystochromoscopy and excretory urography. In acute pyelonephritis is important to make a differential diagnosis of infectious diseases, acute illnesses genital and abdominal organs.
It is very difficult to diagnose in human chronic pyelonephritis, because this form of the disease has a long latency period. In view of this it is important to carefully examine the results of laboratory tests, even if the visible external signs of the disease are absent.
During the ultrasound the only feature that is characteristic of the chronic form of the disease is the presence of renal scarring . In this state, the kidney is reduced, there is unevenness of its circuit
For this condition is also characterized by a decrease of the secretory function of the kidney.
Treatment of pyelonephritis
Once the urine flow has been restored, as well as the primary pathogenetic treatment of pyelonephritis is used, the main point of which is the use of antimicrobials . It is important to prescribe antibiotics at the same time having a broad spectrum of activity and affect the gram-negative flora.
Preparations for the treatment of pyelonephritis administered parenterally, using the maximum therapeutic dose. In the course of complex treatment of pyelonephritis well appointed and other drugs: non-steroidal anti-inflammatory drugs, drugs that stimulate blood circulation, also apply methods intoxication therapy. If the right approach to treatment over half a day there is no effect of improving, the doctor concludes that there is a progressive purulent-destructive process in the kidney. This is a direct indication for open surgery.
The operation was carried out with the purpose of the suspension of purulent-inflammatory process or to prevent complications, provide improved blood and lymph circulation in the kidney. To this end, a decapsulation kidney. This method helps to reduce intraurethral pressure expansion vessel lumen. If purulent-destructive process involves 2/3 of the renal parenchyma and more, it is possible to perform nephrectomy during operation.
As a restorative treatment after surgery the therapy antibacterial . anti-inflammatory . detoxication means.
Early treatment of chronic pyelonephritis is important to find out what the cause of violations of passage of urine and circulatory disorders. Given the results of bacteriological examinations, the doctor prescribes anti-bacterial agents. To do this, use multiple courses of treatment, each time using a different view of the rapid emergence of drug resistant strains of microbes. In addition, used for the treatment of pyelonephritis sulfa preparations of vegetable origin, complex vitamins . Immunocorrecting facilities. Treatment of chronic pyelonephritis lasts at least two months. If chronic pyelonephritis no cure, the patient should be carried out nephrectomy.
There are also a number of traditional methods, which are further used in the treatment of pyelonephritis. As a rule, herbal teas, which include blackberry leaves, bearberry, flax seed, birch leaf, nettle, horsetail herb. Broth it takes the form of heat in a few times a day.
Complications of pyelonephritis
The most serious complication of acute pyelonephritis is bacteriotoxic shock, as a result of which died between 45 and 55% of patients. This disease is manifested in the appointment of antibacterial agents when nevostanovlennom outflow of urine.
Under this condition a person falls sharply arterial pressure to critical indicators decreased return of blood to the heart are destroyed erythrocyte and Platelet . As a result, there are processes that lead to the development of multiple organ failure.
In chronic pyelonephritis as complications arise Renal hypertension and chronic renal failure .
Pyelonephritis in pregnant women
Pyelonephritis in pregnancy often occurs as a consequence of the intensive growth of the uterus, which is increasing presses on the ureters and impedes the flow of urine. In addition, pyelonephritis in pregnant women manifested most notable because of hormonal changes in women. Due to the intense hormonal changes ureteral peristalsis can significantly hindered.
In addition, for the proper functioning of the system mochevydelnoy important daily activity, which is not always typical for a woman to bear a child.
The most common pyelonephritis manifested in those pregnant women who previously transferred cystitis or pyelonephritis .
It is important to bear in mind that pyelonephritis adversely affect the course of pregnancy and the fetus. This disease can cause anemia, late toxemia and even abortion. Therefore, show symptoms of pyelonephritis woman who bears a child, it is important to immediately seek medical help.
All women who have had pyelonephritis during pregnancy, are under the supervision of a doctor, and then after birth.
Diet with pyelonephritis
In the first days of illness it is important to drink at least two liters of fluid - weak tea, herbal teas, fruit juices, diluted with water. It is recommended to use fruit drinks from cranberries and cranberry.
Salt-free diet with pyelonephritis is not required, but you need to limit salt intake to 6 grams per day. It is important to eat foods rich in vitamins.
At the same time, the disease is chronic pyelonephritis does not involve special diet . However, it is important to follow the principles of a healthy diet, drink plenty of fluids, not to limit salt intake. For the recovery of the body periodically can arrange fasting days.
Prevention of pyelonephritis
For prevention of pyelonephritis it follows primarily special attention paid to the treatment of those diseases that cause this disease. It stones in the kidneys . prostate adenoma . You also need a sound approach to the treatment of cystitis, an infection sometimes becomes inflamed kidneys of mochevika. To prevent pyelonephritis in pregnant women, it shows urine tested regularly throughout the life pregnancy .
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