Kurapa kenza yeitsvo

nullmamota ese eitsvo anoonekwa pasina nguva, aine yakarongeka ultrasound nekushayikwa kwakakwana kwezviratidzo.Zviratidzo zvechirwere zvino zvave kushomeka.    1. Ropa mune urini (hematuria). Kutaridzika kwake kunogona kungoerekana kwaitika uye ndokufungidzira.     2. Kurwadziwa mumashure uye kuderera kumashure: izvi zvichemo zvinosanganiswa nekutumbuka kwe bundu mumidziyo yepedyo kana kuvharika kwe ureter.     3. Kuisa chisimbiso mudumbu (palpation palpates bundu).     4. Kuwedzera kwekushisa uye kudzvinyirira kweropa (iyo yekupedzisira inogona kukonzerwa nekumanikidza kwemitsipa kana kugadzirwa kwe renin tumor).5. Varicocele.     6. Kupererwa nehuremu, kushaya simba kwakawanda, kushomoka kwemhepo, sweats husiku, uye kuneta zvakanyanya.Nehurombo, kazhinji zviratidzo zvegomarara re itsvo hazviwoneki pakarepo, chirwere chinobuda muchimiro cheasymptomatic kwenguva yakareba. Ndokusaka zvichikosha kuti uongororwe kudzivirira nguva dzose, ita bvunzo dzehutachiona uye utore ropa uye urini kuongororwa.Kuongororwa kwegomarara re itsvoKuongororwa chirwere chegomarara re itsvo kunosanganisira huwandu hwese hwakasiyana hwezvinyoro, izvo zvinokutendera kuti utange kuongororwa kwakanyatsorongeka.   1. Inonyanya kubhadhara nzira yekuziva nzira ndeye ultrasound.    2. Iyo yegoridhe chiyero chekuongororwa kweanowanikwa tumors itsvo komputatomography nemusiyano. Yakatungamirwa tomography inopa mufananidzo wakakwana wechinzvimbo che tumor, kukura kwayo, nhanho yekiriniki uye kukura kwe tumorume mumitezo yepedyo.   3. A urinalysis inoratidza kuvapo kwekusachena kweropa mumhino.   4. Kuongororwa ropa kunokubvumidza kuti uone zvisina kujeka zviratidzo zvechirwere: anemia, yakakwirira manhamba ealkaline phosphatase, urea muropa, nezvimwewo.   5. MRI yekuongororwa kwematumbu eitsvo anoshandiswa kushoma kazhinji kupfuura CT, chiratidzo chikuru chekuita MRI kukanganisa kuita CT.   6. A biopsy yemapundu etsvo inoitirwa kusimbisa chirwere ichi.uye kusarudza imwezve nzira yekurapa. Nehurombo, mune dzimwe nguva, biopsy yehosha yeitsvo haisi-inopinda, nekuda kweichi, chidzidzo ichi chaitwa zvino kashoma.  7. Kuti uone metastases mumapapu nemapfupa ematehwe, chest x-ray uye osteoscintigraphy anoshandiswa.  8. Renal angiography - kuongororwa kweX-ray kune mumiririri akasiyana.Zvichienderana nezviratidziro zvegomarara re itsvo, mamiriro emurwere uye nemhedzisiro yekuongororwa kwekutanga, chiremba anosarudza dzimwe nzira dzekuti aongorore chirwere chegomarara re itsvo kuti iite mufananidzo wakanyanya.Matanho ekenza yemenoKune mana matanho ekenza yemazino ane hunhu hwakasiyana siyananullkana bundu rinopararira kune renal vein / vena cava.     4. Itsvo kenza yemazamu grade 4. Bundu rinosuka muchetura weitsvo.Kurapa kenza yeitsvoKurapa kenza yeitsvo kunoenderana nenzira dzinoverengeka dzinogamuchirwa dzinoshandiswa mumwe nemumwe kana zvakazara. Chiremba arikupinda, zvichienderana nerudzi rwe bundu, nhanho yekiriniki yezera remurwere uye hutano hwakanaka, zvinopesana zviripo nezvimwe zvinhu, anogona kutendeukira kunzira dzakasiyana siyana dzokurapwa. Nzira inoshanda yekurapa chirwere chegomarara ndeyekuvhiya bundu. Radical nephrectomy ndiko kubviswa kwakakwana kweuyo akanganisa itsvo, kazhinji pamwe chete neyezvinotenderera perirenal tishu, lymph node, uye dzimwe nguvaadrenal gland. Kana ukuru hwe bundu risingapfuuri 7 cm, kusarudzika kwetsvo kunoitwa. Pamwe chete neyechinyakare nzira, umo kubviswa kwe itsvo kana rese rese kwaro kuitwa kuburikidza hombe incision, pane laparoscopic imwe. Muchiitiko ichi, bundu rinobviswa kana kuiswazve uchishandisa zviridzwa zvakaiswa mukati mehudumbu kuburikidza nepadiki (2 cm) nzira laparoscopic inosanganiswa neyekudzikira kwekumanikidza. Mukuwedzera, kugadzirisa kwevarwere kunokurumidza. Imwe nzira yekurapa kweanodzora itsvo ndeye cryoablation. Iko kukosha kwenzira ndeyokusunungura bundu nerubatsiro rweyakakosha kiropidhi yakaiswa mukati mebundu. Tumorkuiswa kune imwezve kufungisa uye thawing, iyo pakupedzisira inotungamira kurufu rwekenza maseru. Iyi nzira ndiyo inoshungurudza murwere uye inoratidzwa kana kuvhiyiwa kusingaite, tumor reitsvo mbiri uye bundu reitsvo imwechete. Kurapa kwezvinodhaka (chemotherapy, hormone therapy kana immunotherapy) inodomwa kana chirwere chechipfuva chechipfuo chaonekwa (nhanho 4), kana kuvhiyiwa hakugoneki.Dziviriro Chemukenza KenzaKuti udzivise kenza yemeno, zvakakosha kurega kuputa, kudzora uremu uye kudya zvine hutano (zvine predominance yemichero nemiriwo). Saka, mararamiro ane hutano ndiyo nzira huru yekudzivirira chirwere ichi.