Title Uloga medicinske sestre u dijagnostici i liječenju kongenitalne hidronefroze
Title (english) The role of the nurse in the diagnosis and treatment of congenital hydronephrosis
Author Mateo Kučar
Mentor Zoran Peršec (mentor)
Committee member Ivana Živoder (predsjednik povjerenstva)
Committee member Zoran Peršec (član povjerenstva)
Committee member Ivana Herak (član povjerenstva)
Granter University North (University centre Varaždin) (Department of Nursing) Koprivnica
Defense date and country 2020-09-18, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences Surgery
Abstract Svrha ovog rada je dati prikaz kongenitalne hidronefroze, anatomsko-patofiziološke podloge tog stanja, iznijeti dijegnostičko-terapijske mogućnosti te opisati ulogu medicinske sestre u liječenju ove bolesti. S incidencijom od 11,5/10.000 kongenitalna hidronefroza je relativno čest poremećaj, a zbog svog progresivnog tijeka i posljedica na funkciju bubrega te potencijalno i po život pacijenta, to stanje možemo smatrati ozbiljnim zdravstvenim problemom.
Rad daje prikaz najčešćih tipova opstrukcije pijeloureteričnog vrata koji mogu dovesti do hidronefroze, kao što su aberantne krvne žile, stenoze i valvule uretera, adhezije itd. te patofiziologiju akutne i kronične opstrukcije, kao i posljedice povišenog hidrostatskog tlaka u kanalnom sustavu bubrega.
Za pravilno postavljanje dijagnoze bilo je nužno prikazati i moguće kliničke prezentacije djeteta s hidronefrozom: od prenatalnog ultrazvučnog nalaza, do prezentaciju u dječjoj dobi s bolovima u lumbalnoj regiji, palpabilnom masom u abdomenu i urinoinfekcijom. Od dijegnostičkih postupaka spomenut ćemo ehosonografiju, ekskrecijsku urografiju, diuretsku infuzijsku urografiju, radioizotopnu renografiju, kompjuteriziranu tomografiju, magnetsku urografiju, perkutanu nefrostomiju i Whitakerov test markere opstrukcijske uropatije kao novu metodu koja se još istražuje.
Kongenitalnu hidronefrozu moguće je liječiti konzervativno i kirurški, a indikacije za kirurški zahvat su simptomatska opstrukcije pijeloureteričnog vrata, asimptomatska opstrukcija uz smanjenu funkciju bubrega, neuspješno konzervativno liječenje te perzistentna asimptomatska opstrukcija. Postoji više mogućnosti pristupa na bubreg i više metoda rješavanja opstrukcije, ali većina autora smatra da je najbolja metoda pijeloplastika po Anderson-Hynesu.
Uloga medicinske sestre u liječenju hidronefroze leži u preoperativnoj pripremi djeteta, postoperativnoj njezi kao i edukaciji roditelja.
Abstract (english) The purpose of this paper is to present an overview of congenital hydronephrosis, the anatomical and pathophysiological basis of this condition, to present diagnostic and therapeutic possibilities and to describe the role of the nurse in the treatment of this disease. With an incidence of 11,5 in 10.000, congenital hydronephrosis is a relatively common disorder. Due to its progressive course and severe consequences for kidney function as well as a pssibly fatal outcome, this disorder can be considered a serious health problem.
The paper presents the most common types of pyeloureteral juncture obstruction which can lead to hydronephrosis: abberant blood vessels, ureteral stenosis and valvulas, adhesion etc. The pathopysiology of both acute and chronic obstruction is also shown, as well as the conseyuences of increased hydrostatic pressure in the renal canalicular system.
Furthermore, in view of their diagnostic revalance, an overview of the possible clinical presentations of pediatric hydronephrosis is given: from prenatal ultrasound finding to the infant presentating with lumbar pain, palpable abdominal mass and signs od uroinfection. Diagnostic methods such as ultrasonography, excretion urography, diuretic infusion urography, radioisotope renography, computed tomography, magnetic urography, percutaneous nephrostomy. Whitaker`s test and obstruction uropathy markers, have also been mentioned.
Congenital hydronephrosis can be treated both by conservative and surgical managment. The indications for surgical precedure include: symptomatic pyeloureteral juncture obstruction, asymptomatic obstruction with reduced renal function, failure od conservative managment and persisting asymptomatic obstruction. There are several variants of surgical approach to the kidney and several methods of surgical removal of the obstruction, but most of the authors prefer the Anderson-Hynes pyeloplasty.
The role of the nurse in the treatment of congenital hydronephrosis lies in preoperative preparation of the child, postoperative care and education of parents.
Keywords
kongenitalna hidronefroza
pijeloplastika
dječja urologija
njega medicinske sestre
Keywords (english)
congenital hydronephrosis
pyeloplasty
pediatric urology
nursing care
Language croatian
URN:NBN urn:nbn:hr:122:321073
Study programme Title: Nursing Study programme type: professional Study level: undergraduate Academic / professional title: stručni/a prvostupnik/prvostupnica (baccalaureus/baccalaurea) sestrinstva (stručni/a prvostupnik/prvostupnica (baccalaureus/baccalaurea) sestrinstva)
Type of resource Text
File origin Born digital
Access conditions Open access
Terms of use
Created on 2020-11-12 18:19:09