Dutse na koda

Dutse na koda wani abu ne mai ɗorewa wanda aka yi shi da ƙananan lu'ulu'u. Daya ko fiye da duwatsu na iya zama a cikin koda ko kuma fitsarin a lokaci guda.

Dutse na koda na kowa ne. Wasu nau'ikan suna gudana a cikin dangi. Sau da yawa suna faruwa ne a cikin yara da ba a haifa ba.

Akwai duwatsun koda daban. Dalilin matsalar ya dogara da nau'in dutse.

Duwatsu na iya samuwa lokacin da fitsari ya kunshi wasu abubuwa da yawa wadanda ke samar da lu'ulu'u. Wadannan lu'ulu'u na iya haɓaka cikin duwatsu sama da makonni ko watanni.

• Duwatsun alli sunfi yawa. Suna iya faruwa a cikin maza tsakanin shekaru 20 zuwa 30. Calcium na iya haɗuwa da wasu abubuwa su zama dutsen.
• Oxalate shine mafi yawan waɗannan. Oxalate yana nan a wasu abinci kamar alayyafo. Hakanan ana samunsa a cikin abubuwan bitamin C. Cututtukan ƙananan hanji suna ƙara haɗarinku ga waɗannan duwatsu.

Hakanan ana iya samun duwatsun Calcium daga haɗuwa da phosphate ko kuma carbonate.

Sauran nau'ikan duwatsu sun haɗa da:

• Duwatsu na Cystine na iya samuwa a cikin mutanen da ke da cystinuria. Wannan cuta tana gudana ne a cikin dangi. Yana shafar maza da mata.
• Galibi ana samun duwatsu masu ƙarfi a cikin maza ko mata waɗanda suka maimaita cututtukan fitsari. Wadannan duwatsu na iya yin girma sosai kuma suna iya toshe koda, mafitsara, ko mafitsara.
• Duwatsun Uric acid sun fi yawa ga maza fiye da mata. Suna iya faruwa tare da gout ko chemotherapy.
• Sauran abubuwa, kamar wasu magunguna, suma suna iya ƙirƙirar duwatsu.

Babban mawuyacin halin haɗarin duwatsu na koda bai sha isasshen ruwa ba. Wataƙila duwatsun koda na faruwa idan kun yi fitsari ƙasa da lita 1 (inci 32) a rana.

Kila ba ka da alamun bayyanar har sai duwatsun sun motsa ƙasan bututun (ureters) ta inda fitsari ke zubowa cikin mafitsara. Idan hakan ta faru, duwatsun na iya toshe magudanar fitsari daga cikin koda.

Babban alama shine ciwo mai tsanani wanda ke farawa da tsayawa kwatsam:

• Za a iya jin zafi a yankin ciki ko gefen baya.
• Ciwo na iya motsawa zuwa yankin makwancin gwaiwa (zafin ciki), ƙwaraji (zafi na zina) a cikin maza, da kuma ɓarna (ciwon mara) a cikin mata.

Sauran cututtuka na iya haɗawa da:

• Launin fitsari mara kyau
• Jini a cikin fitsari
• Jin sanyi
• Zazzaɓi
• Tashin zuciya da amai

Mai ba da sabis na kiwon lafiya zai yi gwajin jiki. Yankin ciki (ciki) ko baya na iya jin ciwo.

Gwajin da za a iya yi sun hada da:

• Gwajin jini don bincika alli, phosphorus, uric acid, da matakan electrolyte
• Gwajin aikin koda
• Yin fitsari don ganin lu'ulu'u da kuma neman jan jajayen jini a fitsari
• Binciken dutse don ƙayyade nau'in

Ana iya ganin duwatsu ko toshewa akan:

• CT scan na ciki
• Rigunan ciki na ciki
• Pyelogram na jijiyoyin jini (IVP)
• Koda duban dan tayi
• Sake fasalin pyelogram

Jiyya ya dogara da nau'in dutse da kuma tsananin alamun alamunku.

Duwatsun koda waɗanda kanana ne galibi sukan ratsa tsarin ku da kansu.

• Fitsarinku ya kamata ya baci don haka dutse ya sami tsira kuma a gwada shi.
• Sha aƙalla gilashin ruwa 6 zuwa 8 kowace rana don samar da fitsari mai yawa. Wannan zai taimaka dutse ya wuce.
• Jin zafi na iya zama mummunan. Magunguna masu ciwo na kan-kan-kan (misali, ibuprofen da naproxen), ko dai su kaɗai ko kuma tare da magungunan ƙwayoyi, na iya zama da tasiri sosai.

Wasu mutanen da ke fama da tsananin ciwo daga duwatsun koda suna buƙatar zama a asibiti. Kila iya buƙatar samun ruwa ta hanyar IV a cikin jijiyar ku.

Ga wasu nau'ikan duwatsu, mai ba da sabis ɗinku na iya ba da magani don hana duwatsu daga samuwa ko taimakawa fasawa da cire kayan da ke haifar da dutsen. Wadannan magunguna na iya haɗawa da:

• Allopurinol (don duwatsun uric acid)
• Magungunan rigakafi (don duwatsu masu ƙarfi)
• Diuretics (kwayoyi na ruwa)
• Magungunan fosfat
• Sodium bicarbonate ko sodium citrate
• Kwayoyin ruwa (thiazide diuretics)
• Tamsulosin ya shakata da fitsarin kuma ya taimaka wa dutsen ya wuce

Ana buƙatar tiyata sau da yawa idan:

• Dutse ya yi girma da yawa don ya wuce da kansa.
• Dutse yana girma.
• Dutse yana toshe magudanar fitsari kuma yana haifar da cuta ko cutar koda.
• Ba za a iya magance ciwo ba.

A yau, yawancin jiyya ba su da matsala fiye da da.

• Ana amfani da Lithotripsy don cire duwatsu kadan kaɗan da rabi inci (santimita 1.25) waɗanda suke a cikin koda ko ureter. Yana amfani da sauti ko raƙuman ruwa don rarraba duwatsu zuwa ƙananan gutsure. Bayan haka, gutsutsuren duwatsu suna barin jiki a cikin fitsari. Hakanan ana kiranta extracorporeal shock-wave lithotripsy ko ESWL.
• Hanyoyin da ake bi ta hanyar wucewa ta kayan aiki na musamman ta hanyar karamin tiyatar da aka yanke a fatar ku a bayan ku kuma a cikin koda ko ureters ana amfani dasu don manyan duwatsu, ko kuma lokacin da kodan ko wuraren da ke kewaye ba su da kyau. An cire dutse tare da bututu (endoscope).
• Ana iya amfani da ureteroscopy don duwatsu a cikin ƙananan urinary tract. Ana amfani da laser don fasa dutsen.
• Ba da daɗewa ba, ana iya buƙatar aikin tiyata (nephrolithotomy) idan wasu hanyoyin ba su aiki ba ko ba su yiwuwa.

Yi magana da mai ba ka sabis game da waɗanne zaɓuɓɓukan magani na iya aiki a gare ka.

Kuna buƙatar ɗaukar matakan kula da kanku. Waɗanne matakai kuke ɗauka ya dogara da nau'in dutsen da kuke da shi, amma ƙila za su haɗa da:

• Shan karin ruwa da sauran ruwa
• Yawan cin wasu abinci da rage cin abinci
• Shan magunguna don taimakawa wajen hana duwatsu
• Shan magunguna don taimaka muku wuce dutse (magungunan anti-inflammatory, alpha-blockers)

Duwatsun koda suna da zafi, amma mafi yawan lokuta ana iya cire su daga jiki ba tare da haifar da lahani mai ɗorewa ba.

Sau da yawa duwatsun koda suna dawowa. Wannan yana faruwa sau da yawa idan ba a samo dalilin ba kuma ba a magance shi ba.

Kuna cikin haɗari don:

• Hanyar kamuwa da fitsari
• Lalacewar koda ko tabo idan an jinkirta jiyya na dogon lokaci

Rikicin duwatsun koda na iya haɗawa da toshewar mafitsara (uropathy mai ɓarkewa ta gefe ɗaya).

Kira mai ba ku sabis idan kuna da alamun cututtukan ƙwayar koda:

• Tsanani mai zafi a bayan ka ko gefen ka wanda ba zai tafi ba
• Jini a cikin fitsarinku
• Zazzabi da sanyi
• Amai
• Fitsarin da ke wari mara kyau ko kama da girgije
• Jin zafi idan kayi fitsari

Idan an gano ku tare da toshewa daga dutse, dole ne a tabbatar da hanyar ta hanyar kamawa a cikin matsi yayin yin fitsari ko kuma ta hanyar daukar hoto. Kasancewa mara jin zafi ba ya tabbatar da cewa dutsen ya wuce.

Idan kuna da tarihin duwatsu:

• Sha ruwa mai yawa (gilashin ruwa 6 zuwa 8 kowace rana) don samar da isasshen fitsari.
• Kuna iya buƙatar shan magani ko yin canje-canje ga abincinku don wasu nau'ikan duwatsu.
• Mai ba ku sabis na iya son yin gwaje-gwajen jini da na fitsari don taimakawa wajen sanin matakan rigakafin da ya dace.

Enalirƙirar ƙugu; Nephrolithiasis; Duwatsu - koda; Calcium oxalate - duwatsu; Cystine - duwatsu; Struvite - duwatsu; Uric acid - duwatsu; Littafin fitsari

• Hypercalcemia - fitarwa
• Dutse na koda da lithotripsy - fitarwa
• Koda duwatsu - kula da kai
• Dutse na koda - abin da za a tambayi likita
• Hanyoyin yin fitsari mai tsafta - fitarwa

• Ciwon jikin koda
• Koda - jini da fitsari suna gudana
• Nephrolithiasis
• Pyelogram na jijiyoyin jini (IVP)
• Tsarin Lithotripsy

Yanar gizo Associationungiyar Urological American. Kula da lafiyar duwatsun koda (2019). www.auanet.org/guidelines/kidney-stones-medical-mangement-guideline. An shiga Feb 13, 2020.

Yanar gizo Associationungiyar Urological American. Gudanar da tiyata na duwatsu: Jagorar kungiyar AUA / Endourology Society (2016) www.auanet.org/guidelines/kidney-stones-surgical-management-guideline. An shiga Feb 13, 2020.

Bushinsky DA. Nephrolithiasis. A cikin: Goldman L, Schafer AI, eds. Magungunan Goldman-Cecil. 26th ed. Philadelphia, PA: Elsevier; 2020: babi na 117.

Fink HA, Wilt TJ, Eidman KE, et al. Maimaita nephrolithiasis a cikin manya: kwatankwacin tasiri na dabarun rigakafin rigakafi. Rockville, MD. Hukumar Kula da Lafiya da Inganci (US) 2012; Rahoton A'a. 12-EHC049-EF. PMID: 22896859 pubmed.ncbi.nlm.nih.gov/22896859/.

Miller NL, Borofsky MS. Kimantawa da kula da lafiyar lithiasis na fitsari. A cikin: Partin AW, Dmochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021: babi na 92.

Qaseem A, Dallas P, Forciea MA, Starkey M, Denberg TD; Kwamitin Bayanai na Clinical na Kwalejin likitocin Amurka. Gudanar da abinci da magani don hana ciwan nephrolithiasis a cikin manya: jagorar aikin likita daga Kwalejin likitocin Amurka. Ann Intern Med. 2014; 161 (9): 659-667. PMID: 25364887 pubmed.ncbi.nlm.nih.gov/25364887/.

Ziemba JB, Matlaga BR. Jagororin jagororin: duwatsun koda. BJU Int. 2015; 116 (2): 184-189. PMID: 25684222. pubmed.ncbi.nlm.nih.gov/25684222/.