Qhov Tseem Ceeb - Cystitis vs Pyelonephritis
Kab mob uas muaj rau lub raum, ureter, zais zis, thiab urethra yog hu ua urinary tract infections (UTI). Cov kab mob no yog tshwm sim los ntawm ntau yam microbes uas nkag mus rau hauv cov zis los ntawm ntau txoj kev. Raws li thaj tsam anatomical ntawm txoj hlab zis cuam tshuam UTIs tau muab faib ua ob pawg dav xws li, kab mob hauv qab thiab kab mob sab sauv. Pyelonephritis, uas yog tus kab mob thiab mob o ntawm lub raum, poob rau hauv cov kab mob urinary sab sauv. Ntawm qhov tod tes, tus kab mob ntawm lub zais zis uas hu ua cystitis yog cais nyob rau hauv cov kab mob hauv qab qis. Qhov no yog qhov sib txawv tseem ceeb ntawm cystitis thiab pyelonephritis. Ob qho xwm txheej no sib txawv ntawm ntau yam xws li qhov chaw anatomical koom nrog, etiology, pathogenesis, thiab kev tswj hwm.
YPyelonephritis yog dab tsi?
Pyelonephritis yog qhov mob suppurative ntawm lub raum thiab lub raum pelvis uas yog tshwm sim los ntawm kab mob. Enteric gram negative bacilli yog cov kab mob tseem ceeb ntawm pyelonephritis. Ntawm lawv, E. coli yog cov kab mob sib cais feem ntau. Proteus, Klebsiella, Enterobacter, thiab Pseudomonas yog lwm yam kab mob tseem ceeb uas paub tias ua rau pyelonephritis. Staphylococcus thiab Streptococcus faecalis kuj tuaj yeem ua rau muaj tus mob no.
Pathogenesis
Kev nkag ntawm cov kab mob mus rau hauv lub raum parenchyma tuaj yeem tshwm sim hauv ob txoj hauv kev.
Nyob rau hauv urinary kab mob raws li ib tug ascending kab mob
Ntawm no yog txoj hauv kev uas ua raws cov kab mob nkag mus rau lub raum. Thaum ncav lub urinary ib ntsuj av lawv adheres rau lub mucosal nto thiab tau colonized nyob rau hauv lub distal urethra. Tom qab ntawd lawv maj mam nce thiab ua rau lub raum. Kev kis kab mob xws li fimbriae, aerobactin, hemolysin, thiab flagella ua lub luag haujlwm tseem ceeb hauv cov txheej txheem no.
Via ntshav
Hematogenous kis ntawm cov kab mob mus rau hauv lub raum feem ntau cuam tshuam nrog septicemia thiab kab mob endocarditis.
Qhov ze ntawm cov urethra rau lub qhov quav ua rau cov poj niam muaj kab mob pyelonephritis. Lub xub ntiag ntawm cov urethra luv luv thiab kev puas tsuaj rau cov txheej mucosal thaum sib deev yog lwm yam uas ua rau muaj qhov tsis zoo no.
Pyelonephritis kuj muaj tshwm sim ntawm cov neeg mob uas muaj cov kab mob urinary ob leeg vim yog cov zis tso zis uas pab cov kab mob hauv lub zais zis.
Daim duab 01: raum
Morphology
- Lub raum cuam tshuam feem ntau yog loj.
- Ib los yog ob lub raum tuaj yeem cuam tshuam.
- Discrete, yellowish, tsa abscesses muaj nyob rau ntawm lub raum.
- Liquefactive necrosis nrog abscess tsim yog pom nyob rau hauv lub raum parenchyma.
- Kev sib sau ntawm cov neutrophils hauv cov ducts sib sau ua rau cov cell dawb uas pom hauv cov zis.
- papillary necrosis tuaj yeem tshwm sim.
Cov tsos mob thiab cov tsos mob
Cov tsos mob: mob plab, kub taub hau nrog ua daus no thiab ntuav
Cov Cim: Lub raum lub kaum ntse ntse thiab thaj tsam lumbar rhiab
Predisposing Factors
- Urinary tract obstruction
- YVesicoureteric reflux
- Instrumentation
- poj niam txiv neej thiab laus
- Kev cev xeeb tub
- Pre-existing renal lesions
- Immunosuppression
Diagnosis
Tsis nyuaj pyelonephritis tuaj yeem kuaj tau hauv tsev kho mob.
Feem ntau, Daim Ntawv Qhia Txog Cov Ntshav Qab Zib (UFR) raug coj mus. Kev lees paub ntawm qhov kev kuaj mob yog nyob ntawm qhov muaj cov qog nqaij hlav, RBC lossis cov kua paug tawm hauv cov zis. Cov kab mob tso zis tuaj yeem ua tau los txheeb xyuas cov kab mob colonizing. Lub xub ntiag ntawm kev loj hlob ntshiab ntawm ntau tshaj 10 5thaj tsam ib milliliter ntawm cov zis tshiab yog suav tias yog qhov tseem ceeb. Kev kuaj tshuaj tua kab mob rhiab heev yuav tsum tau ua txhawm rau xaiv cov tshuaj tua kab mob uas tsim nyog.
Lwm qhov kev tshawb nrhiav uas feem ntau ua tiav hauv qhov chaw kho mob yog;
- Full Blood Count (FBC)
- ntshav urea
- YSerum electrolyte
- Ntshav kab lis kev cai thiab ABST
- FBS
Kev kho mob
tshuaj tua kab mob hauv cov hlab ntsha - Ciprofloxacin
YCeftazidime/Ceftriaxone
Ampicillin + Clavulinic acid
YCystitis yog dab tsi?
YCystitis yog qhov mob ntawm lub zais zis. Cov kab mob kab mob yog qhov ua rau mob cystitis. Tus mob no tuaj yeem mob thiab tuaj yeem ua rau muaj ntau yam teeb meem loj yog tias tus kab mob kis mus rau lub raum. Qhov hnyav thiab tus kab mob no nyob ntawm tus kab mob virulence.
Cov poj niam feem ntau tau mob cystitis tsis zoo tom qab kev sib deev thawj zaug. Hauv cov tshuaj, tus mob no tau muab lub npe peculiar raws li "zaum zib mu cystitis".
Cov lus pom ntawm lub plab zom mov yog cov neeg ua txhaum cai rau feem ntau cov kab mob cystitis. Lawv nkag mus rau hauv cov zis los ntawm cheeb tsam perianal thiab tau colonized nyob rau hauv lub zais zis ua rau cov kev kho mob tshwm sim
Ntev cystitis yog txuam nrog hypertrophy ntawm lub zais zis thiab trabeculation ntawm lub zais zis phab ntsa.
Daim duab 02: Lub zais zis
Cov tsos mob thiab cov tsos mob
Cov tsos mob: Dysuria, nce zaus ntawm micturition, mob supra pubic
Cov Cim: Supra pubic tenderness
Diagnosis
Feem ntau ntawm kev kuaj mob cystitis yog nyob ntawm cov tsos mob thiab cov tsos mob. Kev lees paub ntawm tus kab mob tuaj yeem ua tau los ntawm UFR lossis dipstick. Yog tias tsim nyog, cov zis kab lis kev cai tuaj yeem ua tiav txhawm rau txheeb xyuas cov kab mob colonized.
Kev kho mob
Cov tshuaj tua kab mob hauv qhov ncauj tuaj yeem muab tau 5-7 hnub. Quinolones (norfloxacin, ciprofloxacin) thiab co-amoxiclav yog cov tshuaj tua kab mob uas feem ntau tau sau tseg. Cov kab mob tso zis yuav tsum rov ua dua 2-3 hnub tom qab cov tshuaj tua kab mob.
Dab tsi zoo sib xws ntawm Cystitis thiab Pyelonephritis?
- Ob leeg cystitis thiab pyelonephritis yog ob hom kab mob urinary.
- Cov lus pom ntawm lub plab zom mov yog cov kab mob ua rau ntau tshaj plaws ntawm ob qho xwm txheej.
Qhov txawv ntawm Cystitis thiab Pyelonephritis yog dab tsi?
YCystitis vs Pyelonephritis |
|
| Pyelonephritis yog qhov mob suppurative ntawm lub raum thiab lub raum pelvis. | YCystitis yog qhov mob ntawm lub zais zis. |
| Yam kab mob tso zis | |
| YPyelonephritis yog ib qho kab mob urinary sab sauv. | Cystitis yog ib qho kab mob urinary qis. |
| Kev mob hnyav | |
| YPyelonephritis yog ib qho mob hnyav heev. | Cystitis tsis mob hnyav yog tias nws kis mus rau ob lub raum. |
Summary – Cystitis vs Pyelonephritis
Txhua tus kws kho mob yuav tsum muaj kev nkag siab zoo txog cov tsos mob thiab cov tsos mob ntawm ob yam mob uas tau tham hauv no txhawm rau txheeb xyuas qhov sib txawv ntawm cystitis thiab pyelonephritis. Yog tias xav tias pyelonephritis, nws yog ib qho tseem ceeb kom paub meej qhov kev kuaj mob los ntawm kev soj ntsuam ntxiv thiab pib kho sai li sai tau.
Download PDF Version of Cystitis vs Pyelonephritis
Koj tuaj yeem rub tawm PDF version ntawm kab lus no thiab siv nws rau offline hom phiaj raws li cov ntawv sau tseg. Thov download PDF version ntawm no Qhov txawv Ntawm Cystitis thiab Pyelonephritis.
