URINARY TRACT OBSTRUCTION-精品医学课件

Renal pelvic pressure increase
Glomerular filtration stop
"Safety valve" open
"Four ways" reflux
Glomerular filtration recovery
Decompensation, loss of renal function
Different age and gender have certain difference
children Congenital malformations
adult
Stone, injury,
cancer or tuberculosis
woman
Pelvic disease
Old man
Giant hydronephrosis
儿子患肾积水急需动手术 打工父亲…
1. clinical feature
Its clinical feature can be vary according to different etiology, location, extent and duration, or completely asymptomatic.
URINARY TRACT OBSTRUCTION
Purpose and demand：
1. master the common reason and treatment of urinary tract obstruction.
2.master the clinical feature、diagnosis 、 differential diagnosis and treament of benign prostatic hyperplasia.
1.Reason and position
Upper urinary tract obstruction is often unilateral, and can also be bilateral, the renal function can be affected quickly; Lower urinary tract obstruction, due to bladder’s compensation and buffering effect, effect on renal function that occurs more slowly, but bilateral.
CT can clear the degree of hydronephrosis and obstruction, judging the renal cortical thickness
Renal function tests, laboratory examination, urodynamic examination
2. Diagnosis
Make sure the reason of hydronephrosis, the site of obstruction, whether combined infection, clear renal function impairment.
B ultrasound: first, most simple, clear the size of hydronephrosis, cortical thickness
1! Stromal hyperplasia
8-20 grams, shape chestnuts
Inverted cone
benign prostatic hyperplasia
The ancient saying Uroschesis.
ቤተ መጻሕፍቲ ባይዱ
Also known as prostate
hyperplasia or hypertrophy of the
prostate, is the most common
disease in elderly men, often
X-ray: plain film can show there are stones or not
IVP
Retrograde angiography
MRI hydrography is currently more advanced means of inspection
2. Diagnosis
The most
common benign prostatic
hyperplasia
2. pathophysiology
above the obstruction,urinary tract dilatation Initial stage ： Ureter thickness Later stage ： Ureter thinning.
Etiological treatment: remove the cause is the best choice.
３. Treatment
Nephrostomy: drainage of urine, improve renal function, select to relieve obstruction
3. be familiar with the pathophysiology change that cause by urinary tract obstruction .
4.be familiar with the treatment of urine
Teaching content：
1.the pathogeny and pathophysiology of urinary tract obstruction.
1.Reason and position
Involve many urinary system diseases. According to urinary obstruction
properties can be divided into mechanical obstruction and dynamic obstruction. According to urinary obstruction part is divided into an upper urinary tract obstruction and lower urinary tract obstruction.
80 70 60
high as 90%. therefore also
58
66
69
known as the man "the longevity
50
42
of disease."
40
30 20 10
0
40-49岁
50-59岁
60-69岁
70岁以上
年龄
1! Prostate divide into peripheral zone, central zone and transitional zone, hyperplasia occurs in only accounts for the total prostate volume 5% of the transitional zone, and peripheral zone is prostate cancer incidence area
occur after the age of 50. Data
show that, a 50 year old male
pathological examination of 50%
visible prostate hyperplastic
中重度前列腺症状的发病情况(中国)
changes, at the age of 80, as
so what's the result that cause by urinary tract obstruction?
Upper urinary tract obstruction can cause hydronephrosis and lower urinary tract obstruction can cause dysuria. Further,it also cause hydronephrosis and injury of renal function. If the bilateral obstruction, which can lead to renal function failure.
2. pathophysiology
Hydronephrosis, renal parenchymal atrophy, thinning, renal pelvis volume increases, eventually become a nonfunction water sac. Lower urinary tract occurrence of obstruction, can make the ureterovesical junction valve loss, leading to urine reflux, hydronephrosis.
2.the pathogeny、pathology、 clinical feature 、 differential diagnosis and treatment of benign prostatic hyperplasia.
3.the diagnosis and treatment of hydronephrosis.
Study independently:the pathogeny and treatment of acute urine retention.