最新(泌尿系统疾病课件13.泌尿系梗阻教学讲义ppt.ppt

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1、(泌尿系统疾病课件）13.泌尿系梗阻UrinaryTractObstructionMedicalTherapySurgicalTherapyPerioperativeFollow-upPrognosisFutureBackgroundProblemEpidemiologyEtiologyPathophysiologyPresentationLaboratoryImagingHistologyCystoscopyUreteroscopyPEUrinaryTractObstructionBackgroundcommonproblemoccurat

2、anypointintheurinarytractdevelopssecondaryto-resultsin-urinestasisandthencalculusrenalpelvisCaRCCUPJOstrictureligationtumororpapillanephroptosiscalculusextrinsiccausesbladdertumorcalculuscalculusBPHorPCastricturestricturestricturerefluxDifferencesmaleBPHUrethralstricturefem

3、aleProlapsePregnancyMalignancychildUPJOUVJOUreteroceleMegaureterEtiologyPathophysiologyAcuteUrinaryTractObstructionIncreasedintraluminalpressureIncreasedcontractionsofsmoothmuscleandureteralwallpressure.AsthedurationoftheobstructionlengthensSmoothmusclecellscontractwithless

4、forceUreteralwalldilationincreasesRefluxofurinewhileobstructedPathophysiologyChronicUrinaryTractObstructionLeadstopermanentdamagetourinarytract.Infravesicalobstructionleadstochangesinthebladder,ultimately,detrusormuscledecompensation.Leadstoprogressivebackpressureontheurete

5、rsandkidneysandcancausehydroureterandhydronephrosis.PathophysiologyChronicUrinaryTractObstructionTheureterdilatedandtortured,thencannottoadequatelypropelurineforward.Urinarystasisincreasestheriskofstoneformationandinfection.Leadstopermanentdamagetourinarytract.ureterdilated

6、andtorturedCompanyLogoVarieswiththelocation,duration,anddegreeofobstructionUpperurinarytractobstruction-painLowerurinarytractobstruction-voidingdysfunctionPresentationCompanyLogoUrinalysisBiochemicalCompletebloodcellcountLaboratoryUltrasonographyinitialstudyImagingrenalpar

7、enchymalmasseshydronephrosisdistendedbladdercalculiprostateComputedtomographyscananatomicdetailcalculiright-sidedhydronephrosisandanobstructingrightureteropelvicjunctionstonerenalpathologyIntravenouspyelographydelayedcalycealfillingdelayedcontrastexcretionprolongednephrogra

8、phyresultsdilatationoftheurinarytractproximaltothepointofobstructionCTUrographyAco