Amaguludla Ezinso—Ukwelapha Isifo Sasendulo
CISHE wake wezwa ngothile oye wahlushwa amaguludla ezinso (kidney stones). E-United States, kulaliswa abantu abahlushwa amaguludla ezinso abangaba ngu-300 000 ezibhedlela minyaka yonke. Lobuhlungu bungaba obusikayo, obufana nobokubeletha.
Abanye bacabanga ukuthi amaguludla ezinso ayinkinga yezempilo yamuva nje, mhlawumbe ebangelwa ukudla noma indlela yokuphila kwanamuhla. Nokho, eqinisweni amaguludla emgudwini womchamo aye ahlupha isintu emakhulwini amaningi eminyaka. Aye atholwa ngisho nasezidunjini zaseGibithe esezinezinkulungwane zeminyaka zangcwatshwa.
Lamaguludla akheka lapho okusansimbi okusemchamweni kuqoqana bese kuyakhula, kunokuba kuncibilike bese kukhishwa emzimbeni. Isimo sawo sokwakheka siyahlukahluka futhi akhiwa izinto eziningi. I-Clinical Symposia ithi: “E-United States, cishe amaphesenti angu-75 awo wonke amaguludla [ezinso] akhiwa ngokuyinhloko yi-calcium oxalate, futhi amanye amaphesenti ayisihlanu akhiwa yi-calcium phosphate engaxubene nalutho.”
Ukwanda Kwawo Nezimbangela
Ngokomunye umbiko, cishe amaphesenti ayishumi amadoda namaphesenti amahlanu abesifazane eNyakatho Melika ayoba neguludla lezinso kukho konke ukuphila kwawo. Futhi izinga lokuqhubeka kwalokhu liphakeme. Umuntu oyedwa kwabahlanu oneguludla lezinso uyoba nelinye phakathi neminyaka emihlanu.
Sekuyiminyaka eminingi kuxaka odokotela ukuthi kungani abanye abantu beba namaguludla ezinso futhi abanye bangabi nawo. Ukwakheka kwalamaguludla kungavela ngenxa yezizathu eziningi. Zihlanganisa ukuphazamiseka kwenqubo yokwakheka kwamangqamuzana omzimba, ukungenwa yigciwane, izifo ezizuzwe ngofuzo, ukuntuleka kwamanzi njalo emzimbeni, nokudla.
Amaphesenti angaba ngu-80 amaguludla ezinso aqedwa ngokuzenzekelayo lapho umuntu echama. Ukuze zisize ekuwakhipheni, iziguli zikhuthazwa ukuba ziphuze amanzi amaningi. Nakuba lamaguludla emancanyana, ngokuvamile engabonakali, ubuhlungu bungase bube bukhulu. Uma umgudu womchamo uvaleka noma iguludla lilikhulu kakhulu ukuba lingadlula (angase abe makhulu ngangebhola legalofu), ukwelashwa kudingekile ukuze kulondolozwe impilo yesiguli.
Izindlela Ezintsha Zokwelapha
Kuze kube cishe ngo-1980, kwakudingeka ukuhlinzwa okukhulu ukuze kususwe amaguludla ezinso ayengenakuzidlulela ngokwawo. Ukuze kufinyelelwe iguludla elibhajwe ensweni noma emgudwini womchamo, kwakwenziwa ukuhlinza okubuhlungu, okwakungaba amasentimitha angu-30 ohlangothini. Ngokuvamile lokhu kuhlinzwa kwakulandelwa isikhathi samasonto amabili sokululama esibhedlela bese kuba cishe izinyanga ezimbili zokudanjiswa kwezinhlungu ekhaya. Kodwa “ngentuthuko yamuva nje yezobuchwepheshe,” incwadi yezokwelapha ethi Conn’s Current Therapy (ka-1989) iphawula ukuthi “isidingo sokususwa kwamaguludla ngokuhlinza asisavamile.”
Manje, amaguludla ayinkinga angase asuswe ngenqubo esebenzisa ukuhlinzwa okuncane kuphela. Enye inqubo esetshenziswa ngokuvame kakhulu namuhla, okuthiwa yi-extracorporeal shock wave lithotripsy (ESWL), ayikudingi nakancane ukuhlinzwa. Ibhekisela kulezinqubo ezintsha zokwelapha, i-Conn’s Current Therapy ithi ukuhlinza okukhulu “cishe namuhla kusetshenziselwa ukususwa kwephesenti elilodwa nje kuphela lawo wonke [amaguludla ezinso].”
Inqubo Esebenzisa Ukuhlinza Okuncane
Inqubo esebenzisa ukuhlinza okuncane kuphela ngezinye izikhathi ibizwa ngokuthi yi-percutaneous ultrasonic lithotripsy. Elithi “percutaneous” lisho ukuthi “ngokudlula esikhunjeni,” futhi elithi “lithotripsy” ngokwezwi nezwi lisho “ukugaya.” Okuwukuphela kokuhlinza okudingekayo ukusika ingxenye engangesentimitha elilodwa ohlangothini. Kulembobo kufakwa ithuluzi elinjenge-cystoscope elibizwa ngokuthi yi-nephroscope. Ngalesipopolo kungase kubonwe ingaphakathi lenso neguludla elikhathazayo.
Uma leliguludla lilikhulu kakhulu ukuba lingase likhishwe nge-nephroscope, kudluliswa isipopolo esincane ngombhobho osesipopolweni futhi ngaleyondlela sifakwe ensweni. Khona-ke, ukuze kucutshwe iguludla noma amaguludla, lesipopolo esinembobo sixhunywa kuyi-generator enomsindo omcane kakhulu ebangela ukuba lesisipopolo sinyakaze izikhathi ezingaba ngu-23 000 kuya kwezingu-25 000 ngo-mzuzwana. Lamaza ama-ncane enza ukuba lesisipopolo sisebenze njengesando, siphihlize wonke amaguludla esihlangana nawo ngaphandle kwalawo aqinile.
Ukumunca okuqhubekayo ngalesipopolo kukukhipha ngokoqobo konke okuphakathi ensweni, kanjalo kukhipha amaguludla amancane. Lenqubo yokuphihliza nokumunca iqhubeka kuze kube yilapho ukuhlolisisa ngokucophelela kwembula ukuthi zonke izigaxana zeguludla sezisusiwe ngesipopolo.
Nokho, ngezinye izikhathi kuba nezingcezu zalamaguludla ezingafuni ukuphela. Kulesosimo, udokotela angase afake ipayipi elincane nge-nephroscope elinesimiso esisebenza ngezindlawu ezincane ezinanyathiselwe kulo. Khona-ke udokotela angase avule lezindlawu, abambe leliguludla, futhi alikhiphe.
Njengoba inqubo yokuhlinza nge-percutaneous yayithuthukiswa, kwazanywa izindlela eziningi. Eminyakeni embalwa edlule, i-Urologic Clinics of North America yathi: “Izindlela ezintsha zokukhipha amaguludla nge-percutaneous zibonakala zivela emaphephabhukwini ezokwelapha amasha aphuma nyanga zonke.” Leliphephabhuku laphawula ukuthi ithuba lokuphumelela kwalenqubo “lihambisana nobukhulu beguludla nendawo elikuyona.” Leliphebhabhuku lachaza ukuthi kodwa isici esibaluleke kakhulu “ikhono nokuhlangenwe nakho komhlinzi.”
Ngisho nakuba kuphehlwa amandla anele okuphihliza lamaguludla, lenqubo ilondekile ngandlela-thile. I-Clinical Symposia ithi: “Ukopha akukabi inkinga ephawulekayo.” Nokho, omunye umbiko uyasho ukuthi kuye kwaba nokopha okukhulu kumaphesenti angaba mane eziguli.
Izinzuzo zalenqubo zihlanganisa ukungaphatheki kahle okuncane nesikhathi sokululama esifushane. Ezimweni eziningi kuchithwa kuphela izinsuku ezinhlanu noma eziyisithupha umuntu esesibhedlela, ezinye iziguli ziphindela ekhaya ngemva nje kwezinsuku ezintathu. Lenzuzo iphawuleka ikakhulukazi kubantu abasebenzayo, abangase bakulungele ukubuyela emsebenzini ngokushesha lapho bephuma esibhedlela.
Ukwelashwa Ngaphandle Kokuhlinzwa
Indlela entsha yokwelapha ephawulekayo eyaqaliswa eMunich, eJalimane, ngo-1980, ibizwa ngokuthi yi-extracorporeal shock wave lithotripsy. Isebenzisa amaza anamandla kakhulu okuphihliza amaguludla ngaphandle kokwenza noma yikuphi ukuhlinza.
Isiguli sifakwa ethangini lensimbi elifakwe ingxenye yamanzi afudumele. Sihlaliswa ngokucophelela ukuze inso eyelashwayo iqondane nendawo yamaza okuphihliza aphehlwa amandla omfutho angaphansi kwamanzi. Lamaza adlula kalula ezicutshini ezithambile zomuntu futhi afinyelele eguludleni ngaphandle kokulahlekelwa ngisho namancane amandla awo. Ayaqhubeka eshaya iguludla lize liphihlizeke. Khona-ke iziguli eziningi zikhiphela ngaphandle lezigaxana ezicubuzekile zamaguludla kalula.
Ngo-1990, i-ESWL yasetshenziswa cishe emaphesentini angu-80 okukhishwa kwawo wonke amaguludla. Ngonyaka odlule i-Australian Family Physician yabika ukuthi selokhu kwaqala ukusetshenziswa kwalenqubo, “kuye kwelashwa iziguli ezingaphezu kwezigidi ezintathu emhlabeni wonke ngemishini engaphezu kuka-1100, kusetshenziswa imishini ephehla ugesi enhlobonhlobo esebenza ngamaza ukuze kuphihlizwe amaguludla ezinso.”
Nakuba i-ESWL ibangela ukungaphatheki kahle okuthile endaweni yezinso, i-Australian Family Physician iyachaza: “Ayivamile ukulimaza izitho ezingomakhelwane njengobende, isibindi, amanyikwe namathumbu. Lokungaphatheki kahle kwesikhashana kubekezeleleka kalula ngokulimala okuncane kakhulu ezigulini futhi iziguli eziningi zikhala kuphela [ngobuhlungu bezicubu namathambo] obuncane olwelwesini lwesisu ne[gazi elincane emchamweni] amahora angu-24 kuya kwangu-48 ngemva kokwelashwa.” Ngisho nezingane ziye zelashwa ngokuphumelelayo. Leliphephabhuku lase-Australia laphetha: “Ngemva kweminyaka eyishumi yokuhlolisisa i-ESWL ibonakala iyindlela yokwelapha elondeke kakhulu.”
Ngempela, lendlela yokwelapha iphumelela kakhulu kangangokuthi i-Conn’s Current Therapy yangonyaka odlule yachaza: “I-(ESWL) iye yenza ukuba amaguludla ayinkinga asuswe kalula kakhulu nangobuhlungu obuncane kangangokuthi iziguli nodokotela baye bathambisa ingalo kancane ekwelashweni kwesifo samaguludla sesimiso somchamo.”
Nokho, amaguludla ezinso ayisifo esibuhlungu leso ngokuqinisekile ongasifuni. Yini ongayenza ukuze uwavimbele?
Indlela Yokuwavimbela
Njengoba ngokuvamile amaguludla ezinso ephindelela, uma ake akuphatha, ngokuhlakanipha uyolalela umyalo wokuphuza amanzi amaningi. Kutuswa ukukhipha umchamo ongamalitha angaphezu kwamabili ngosuku, futhi lokho kusho ukuphuza amanzi amaningi!
Ngaphezu kwalokho, kuwukuhlakanipha ukushintsha imikhuba yakho yokudla. Odokotela basikisela ukulinganisela indlela odla ngayo inyama ebomvu, usawoti, nokudla okune-oxalate eningi, okukholelwa ukuthi kuyasiza ekwakheni amaguludla. Lokhu kudla kuhlanganisa amantongomane, ushokoledi, upelepele omnyama, nemifino eluhlaza esamacembe, njengesipinashi. Odokotela bake batusa futhi ukwehlisa izinga umuntu adla ngalo i-calcium, kodwa ukucwaninga kwamuva nje kubonisa ukuthi kunalokho ukwandisa izinga le-calcium ekudleni kuvame ukunciphisa ukuthambekela kokwakheka kwalamaguludla.
Nokho, naphezu kokuthatha kwakho zonke izixwayiso, uma kwenzeka uba nelinye iguludla lezinso, kungase kube induduzo ngalendlela-thile ukwazi ukuthi kunezindlela ezithuthukisiwe zokuwelapha.
[Isithombe ekhasini 21]
Ukwelashwa kwamaguludla ezinso ngaphandle kokuhlinza kusetshenziswa umshini okuthiwa yi-“lithotripter”
[Umthombo]
S.I.U./Science Source/PR
[Umthombo Wesithombe ekhasini 20]
Leonardo On The Human Body/Dover Publications, Inc.