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أحدث الطرق العلاجية لحصوة الكلى والمثانة والوقاية وفقا للتاريخ المرضي
شهد القطاع الطبي في المملكة تطورا كبيرا في العقود الأخيرة, وانتشرت الأساليب العلاجية الحديثة المسايرة لآخر المستجدات الطبية العالمية في طرق العلاج , أما عمليات التوعية فما زالت تلاحق هذه التطورات لإكساب المجتمع مفاهيم صحية جديدة, ففي حالات الإصابة بحصوة الكلى و المثانة كان علينا أن نتعرف على أسباب الإصابة بها, وأعراض المرض وطرق الوقاية منها وأساليب المعالجات المختلفة وأيها أكثر فاعلية في الحالات المرضية….
وفي هذا السياق أفاد الدكتور طلال مرداد استشاري جراحة المسالك البولية والتناسلية والعقم – عضو الجمعية الأمريكية للمسالك البولية والتناسلية – عضو الجمعية الأمريكية للخصوبة والذكورة والعقم – مدير عام مركز” مان كلينك ” بالرياض أن أغلب المشكلات الخاصة بمرضى حصوة الكلى والمثانة يتمثل في الإهمال وعدم المتابعة الطبية بصورة دورية للاطمئنان من ناحية والوقاية من ناحية أخرى, فعلى الرغم من عدم وجود سبب مؤكد لإصابة شخص دون آخر بتكوين الحصوة إلا أن العلم الحديث قد توصل إلى بعض الروافد المسببة لتكون حصوة الكلى والمثانة لبعض الحالات ومنها الجينات الوراثية كأثر واضح بنسبة 7% بالإضافة للأسلوب الغذائي الذي يعتمده البعض أوما يعرف بالتمثيل الغذائي المسبب للإصابة بها والمعروف باسم hyperoxalutia / cystinuria وما ينتج عنه من إفراز كمية كبيرة من الحامض الأميني الذي لا يذوب في البول, وبتراكمه في بعض الحالات يتسبب في تكوين الحصوة أما ارتفاع درجة الحرارة وقلة شرب الماء والسوائل فيتسبب فيما نسبته 35%, وكذلك زيادة كمية الأملاح التي تؤدي أيضا لتكوين الحصوة أما التهابات الجهاز البولي والكلى فتتسبب بنسبة 25%.
وأضاف الدكتور طلال مرداد أن أعراض الإصابة بحصوات الكلى والمثانة تتمثل في الآلام المبرحة إذا ما تحركت الحصوة في مجرى البول وما يصاحب ذلك من تقلصات عضلية على جانبي منطقة الكلية أسفل البطن ,يصاحب ذلك في بعض الأحيان القيء والغثيان , وتزداد حدة الألم كلما زاد حجم الحصوة, كما يمثل ظهور الدم في البول والشعور المستمر بالحاجة للتبول والحرقان الشديد أثناء التبول إحدى علامات الإصابة بها, وقد تصل الأعراض إلى حالة رعشة وارتفاع درجة حرارة المصاب.
وأشار الدكتور مرداد أن التطور الطبي الكبير في كافة المجالات الطبية ومنها أساليب علاج حصوات الكلى والمثانة قد فتح الباب على مصراعيه لعدد كبير من الخيارات في معالجة هذه الإصابات المرضية, ويتم تحديدها وفقا لمستوى الإصابة وحالة المريض وحجم الحصوة… وإننا بناءً على قاعدة أساسية لايمكن أن نلجأ إلى الجراحة في الكثير من الحالات التي يمكن فيها إنجاز الأساليب العلاجية بنجاح, فهناك عملية المعالجة بالعقاقير كمستوى أول لكثير من الحالات وأيضا عملية المعالجة بتفتيت الحصوة, أما عمليات الجراحة فنلجأ إليها إذا كان حجم الحصوة كبيرا, أو كانت الحصوة مسببة لانسداد عملية تدفق البول وحدوث الالتهابات المستمرة.
ونستطيع مع التطور الطبي الحديث في الفترة الحالية القيام بتفتيت الحصوات من خارج الجسم باستخدام تقنية الذبذبات المعتمدة على الأجهزة الحديثة ( ( E.S.W.L, وفي حال اللجوء إلى الجراحة لإزالة الحصوة من المثانة فتكون في الحالات المتأخرة والتي تظهر فيها الحصوة من خلال الأشعة كبيرة بصورة قد تصل في بعض الحالات إلى حجم (بيضة كبيرة) تزن (200 جرام) لمريض كان يشكو من عدم القدرة على التبول إلا وهو نائم وكان عمره 28 عاما, وهناك أشكال عديدة للحصوات التي تم استخراجها بالعمليات الجراحية والتي تزيد على (1770) عملية خلال خمسة عشر عاما.
وأكد الدكتور مرداد على أهمية الأخذ بمبدأ الوقاية في استشارة الطبيب في حال وجود تاريخ مرضي بالحصوة في العائلة أوظهور الأعراض السابق ذكرها وأن كل حالة من الحالات تحتاج إلى أسلوب خاص, وأن اكتشاف الحالات المصابة مبكرا تعطي الفرصة لتفادي تفاقم الإصابة.
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