{"id":12806,"date":"2023-01-31T16:16:50","date_gmt":"2023-01-31T16:16:50","guid":{"rendered":"https:\/\/healthtourismturkis.com\/?page_id=12806"},"modified":"2023-02-03T13:04:41","modified_gmt":"2023-02-03T13:04:41","slug":"bobrek-taslari","status":"publish","type":"page","link":"https:\/\/healthtourismturkis.com\/fr\/bobrek-taslari\/","title":{"rendered":"Calculs r\u00e9naux"},"content":{"rendered":"
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\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\"\"\n\t\t\t\t\t\t\t\t\n\t\t\t\t<\/div>\n\t\t\t\t
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Calculs r\u00e9naux <\/h3>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t

B\u00f6brek Ta\u015flar\u0131\n\u0130drar yolu ta\u015flar\u0131, idrarda \u00e7\u00f6z\u00fclemeyen ve at\u0131lamayan kimyasal maddelerin, zamanla kristalle\u015fmesi ve birikmesiyle, b\u00f6brekte ya da idrar yollar\u0131n\u0131n herhangi bir yerinde olu\u015fan sert cisimlerdir.\nG\u00f6r\u00fclme S\u0131kl\u0131\u011f\u0131\n\u00dcriner sistem ta\u015f hastal\u0131\u011f\u0131 t\u00fcm d\u00fcnyada %5 - %10 oran\u0131nda g\u00f6r\u00fclmektedir. S\u0131cak iklimlerde ve kurak da\u011fl\u0131k kesimlerde daha s\u0131kt\u0131r. En \u00e7ok 30-50 ya\u015flar aras\u0131nda g\u00f6r\u00fclmektedir. \u00dclkemizde 2008 y\u0131l\u0131nda yap\u0131lan \u00e7al\u0131\u015fman\u0131n sonucuna g\u00f6re toplumda 100 ki\u015fiden 11.2\u2019sinde ta\u015f hastal\u0131\u011f\u0131 mevcuttur ya da bu nedenle tedavi g\u00f6rm\u00fc\u015ft\u00fcr. En s\u0131k G\u00fcneydo\u011fu Anadolu b\u00f6lgesinde rastlan\u0131ld\u0131\u011f\u0131 g\u00f6r\u00fclmektedir. Birinci derece akrabalar\u0131nda \u00fcriner sistem ta\u015f\u0131 olanlarda, bu hastal\u0131\u011f\u0131n geli\u015fme olas\u0131l\u0131\u011f\u0131 birka\u00e7 kat artmaktad\u0131r.\nBelirtileri\nA\u011fr\u0131, en s\u0131k rastlanan belirtidir. B\u00f6brek a\u011fr\u0131s\u0131n\u0131n \u015fiddeti, baz\u0131 ki\u015filerde belli belirsiz bir s\u0131zlama \u015feklinde g\u00f6r\u00fcl\u00fcrken, baz\u0131lar\u0131nda son derece \u015fiddetli, k\u0131vrand\u0131r\u0131c\u0131 ve hastaneye yatmay\u0131 gerektirecek yo\u011funlu\u011fa kadar ula\u015fabilir. Genellikle \u201cbo\u015fluk\u201d olarak adland\u0131r\u0131lan, kaburgalar\u0131n alt\u0131ndan ba\u015flay\u0131p s\u0131rttan \u00f6ne, kas\u0131klara do\u011fru vuran \u015fiddetli a\u011fr\u0131 \u015feklindedir. Kimi zaman hastay\u0131 k\u0131vrand\u0131racak kadar \u015fiddetli olabilir. \u00c7o\u011funlukla, bulant\u0131, bazen de kusma g\u00f6r\u00fclmektedir. Baz\u0131 hastalarda idrardan kan da gelebilir. \u0130drar yaparken yanma, s\u0131zlama, s\u0131k idrara \u00e7\u0131kma, gece idrara gitmek i\u00e7in uyanma, acil idrara \u00e7\u0131kma, tuvalete gidince az idrar yapma ya da hi\u00e7 idrar yapamama gibi \u015fikayetler olabilmektedir. Belirti vermeyen b\u00f6brek ta\u015flar\u0131na da rastlanabilir. Bu ta\u015flar, ancak kontrol s\u0131ras\u0131nda ya da ba\u015fka ama\u00e7la \u00e7ekilmi\u015f filmlerde tesad\u00fcfen saptan\u0131r.\nTa\u015f hastal\u0131\u011f\u0131 tekrar edebilen bir hastal\u0131kt\u0131r. Bir defa ta\u015f olu\u015ftu ise, 5 y\u0131l i\u00e7inde %50 ihtimalle yine olu\u015facakt\u0131r. Bu y\u00fczden idrarla ilgili en ufak bir \u015fikayet oldu\u011funda, hemen bir \u00fcroloji uzman\u0131na ba\u015fvurmak gerekir.\nTan\u0131\nLaboratuvar incelemeleri hastal\u0131\u011f\u0131n tan\u0131s\u0131nda b\u00fcy\u00fck \u00f6nem ta\u015f\u0131r. \u0130drarda kan aranmas\u0131, idrar\u0131n asit derecesinin belirlenmesi, kanda kalsiyum ve \u00fcrik asit d\u00fczeylerinin \u00f6l\u00e7\u00fclmesi tan\u0131 i\u00e7in de\u011fer ta\u015f\u0131yan incelemelerdir. Ta\u015flar\u0131n tedaviye y\u00f6nelik kimyasal analizi ve idrar k\u00fclt\u00fcr\u00fc de \u00e7ok \u00f6nemlidir.\nTemel tan\u0131 y\u00f6ntemlerinden biri, radyolojik incelemedir. Ultrasonografik inceleme, hastaya zarar vermemesi ve uygulama kolayl\u0131\u011f\u0131 nedeniyle birinci tercihtir. \u015e\u00fcpheli ya da acil durumlarda, d\u00fc\u015f\u00fck doz radyasyon uygulamal\u0131 Bilgisayarl\u0131 Tomografi y\u00f6ntemi de tercih edilebilir.\nDamardan enjekte boyal\u0131 maddeler arac\u0131l\u0131\u011f\u0131yla idrar yollar\u0131n\u0131n g\u00f6r\u00fcnt\u00fclenmesi gerekebilir.\nKorunma Yollar\u0131\nTa\u015f olu\u015fumunda beslenme al\u0131\u015fkanl\u0131klar\u0131n\u0131n de rol\u00fc b\u00fcy\u00fckt\u00fcr. Beslenme d\u00fczenine dikkat ederek b\u00fcy\u00fck \u00f6l\u00e7\u00fcde ta\u015f olu\u015fumunu \u00f6nlemek m\u00fcmk\u00fcnd\u00fcr.\n\u2022\tBa\u015fl\u0131ca su olmak kayd\u0131yla, bol miktarda (g\u00fcnde 2,5 litre) s\u0131v\u0131 almak, ancak daha da \u00f6nemlisi idrar g\u00fcnl\u00fck \u00e7\u0131k\u0131\u015f\u0131n\u0131 2 litre \u00fczerinde tutmak tavsiye edilir.\n\u2022\tKola, gazoz gibi idrarda asit-baz dengesini bozan i\u00e7eceklerden ka\u00e7\u0131nmak gerekir (Sitratl\u0131 i\u00e7ecekler uygundur)\n\u2022\tGreyfurt, portakal ve elma suyu, ta\u015f hastal\u0131\u011f\u0131 riskini artt\u0131rabilir. \u00d6te yandan saf limon suyu i\u00e7erdi\u011fi sitrik asit dolay\u0131s\u0131yla kalsiyum ta\u015flar\u0131na kar\u015f\u0131 koruyucudur.\n\u2022\tS\u00fct ve s\u00fct \u00fcr\u00fcnlerinin hi\u00e7 t\u00fcketilmemesi, ta\u015f olu\u015fum riskini artt\u0131r\u0131r. Kalsiyumdan yoksun diyetler uygulanmamal\u0131d\u0131r. S\u00fct, yo\u011furt, peynir gibi besinler makul \u00f6l\u00e7\u00fclerde t\u00fcketilmelidir.\n\u2022\tBol lifli besinler t\u00fcketilmelidir.\n\u2022\tY\u00fcksek oksalat i\u00e7eren pancar, soya, kara \u00e7ay, \u00e7ikolata, kakao, kuru incir, karabiber, f\u0131nd\u0131k, maydanoz, ha\u015fha\u015f tohumu, \u0131spanak, \u00e7ilek, b\u00f6\u011f\u00fcrtlen vb. gibi besinleri a\u015f\u0131r\u0131 t\u00fcketmemek gerekir.\n\u2022\t\u00dcrik asit ta\u015flar\u0131 i\u00e7in; P\u00fcrin i\u00e7eren an\u00e7uez, sardalya, sakatat, kuru bakliyat, mantar, \u0131spanak, ku\u015fkonmaz, karn\u0131bahar ve et t\u00fcketimini k\u0131s\u0131tlamas\u0131 \u00f6nerilir.\n\u2022\tTuz kullan\u0131m\u0131n\u0131 azaltmak gerekir.\n\u2022\tBol bol hareket edip v\u00fccudu incitmeyecek \u015fekilde egzersiz yapmak tavsiye edilir.\n\u2022\tStresten uzak bir hayat \u00f6nerilir.\nGiri\u015fimsel Tedavi Y\u00f6ntemleri\nTa\u015f hastal\u0131\u011f\u0131n\u0131n ba\u015flang\u0131\u00e7 ve acil safhas\u0131nda t\u00fcm hastalar i\u00e7in benzer tedavi uygulan\u0131r. \u0130lk safhada, k\u00fc\u00e7\u00fck boyutta ta\u015f\u0131n kendili\u011finden d\u00fc\u015fmesi beklenirken, sadece a\u011fr\u0131 kesiciler ve su i\u00e7mesi \u00f6nerilir. A\u011fr\u0131 kesici ve s\u0131v\u0131 tedavisini a\u011f\u0131z yoluyla alabilen hastalar evine g\u00f6nderilerek ayaktan takip edilir. Ancak a\u011fr\u0131 \u00e7ok \u015fiddetliyse ve hasta su i\u00e7emiyorsa, hastaneye yat\u0131r\u0131lmas\u0131 gerekebilir. Ta\u015f\u0131n d\u00fc\u015f\u00fcr\u00fclemedi\u011fi durumlarda ise giri\u015fimsel tedavi y\u00f6ntemleri tercih edilir.\n1. ESWL Ta\u015f K\u0131rma (v\u00fccut d\u0131\u015f\u0131ndan \u015fok dalgalar\u0131yla ta\u015f k\u0131rma)\nBir odaktan \u00e7\u0131kan \u015fok dalgalar\u0131 ta\u015f\u0131n \u00fczerine y\u00f6nlendirilerek ta\u015f k\u0131r\u0131l\u0131r. X-ray ve ultrasonla odaklama yapan cihazlar mevcuttur. K\u0131r\u0131lan ta\u015f par\u00e7alar\u0131 idrar yoluyla v\u00fccuttan at\u0131l\u0131r. ESWL b\u00fct\u00fcn ta\u015flarda ba\u015far\u0131 sa\u011flayamaz. Ba\u015far\u0131, ta\u015f\u0131n cinsine, sertli\u011fine, b\u00fcy\u00fckl\u00fc\u011f\u00fcne ve idrar yolunda yerle\u015fti\u011fi yere g\u00f6re de\u011fi\u015fir. Tek bir seansta k\u0131r\u0131labilen ta\u015flar olabilece\u011fi gibi, tekrarlay\u0131c\u0131 seanslara da ihtiya\u00e7 duyulabilir.\nESWL seans\u0131 s\u0131ras\u0131nda rahats\u0131zl\u0131k hissi ve a\u011fr\u0131 duyulabilir. Bu nedenle tedavi \u00f6ncesi a\u011fr\u0131 kesiciler kullan\u0131l\u0131r. \u0130\u015flem sonras\u0131nda \u00e7o\u011funlukla hastanede kalmaya ihtiya\u00e7 olmaz.\n2. Ureterolitotripsi (URS)\n\u0130drar yolundan \u00f6zel bir endoskopik alet g\u00f6nderilerek ta\u015f g\u00f6r\u00fcnt\u00fclenir ve temizlenir. URS\u2019de herhangi bir kesi yap\u0131lmaz. \u0130nce ve esnek endoskopla \u00fcreter i\u00e7erisinde ilerleyerek, t\u0131kan\u0131kl\u0131\u011fa yol a\u00e7an ta\u015fa ula\u015f\u0131larak ta\u015f \u00e7\u0131kart\u0131l\u0131r. Esnek \u00f6zellikte olan endoskopik cihazlarla da b\u00f6brek i\u00e7erisinde uygun boyutta olan ta\u015flar lazer yard\u0131m\u0131yla buharla\u015ft\u0131r\u0131labilir. Hastalar\u0131n \u00e7o\u011fu ayn\u0131 g\u00fcn evlerine d\u00f6n\u00fcp, bir g\u00fcn sonra normal ya\u015famlar\u0131n\u0131 s\u00fcrd\u00fcrebilirler.\n3. Perk\u00fctan Nefrolitotomi (PCNL)\nEndoskopik b\u00f6brek ta\u015f\u0131 ameliyat\u0131nda, hastan\u0131n s\u0131rt b\u00f6lgesinde, b\u00f6brek hizas\u0131na 0,5 -1 cm boyutunda bir kesi yap\u0131l\u0131r. R\u00f6ntgen kontrol\u00fc alt\u0131nda b\u00f6bre\u011fe iki ucu a\u00e7\u0131k ince bir t\u00fcp yerle\u015ftirilir. Bu t\u00fcpten yerle\u015ftirilen optik cihaz yard\u0131m\u0131yla ta\u015f video sistemiyle monit\u00f6rde g\u00f6r\u00fcl\u00fcr ve \u00f6zel aletler yard\u0131m\u0131yla \u00e7\u0131kart\u0131l\u0131r. Perk\u00fctan ameliyat\u0131n\u0131n en \u00f6nemli \u00fcst\u00fcnl\u00fc\u011f\u00fc, v\u00fccut dokular\u0131n\u0131n normal yap\u0131s\u0131n\u0131n korunmas\u0131d\u0131r. Bunun sonucunda iyile\u015fme s\u00fcreci h\u0131zl\u0131d\u0131r. Hastalar\u0131n ameliyat sonras\u0131 d\u00f6nemi, a\u00e7\u0131k ameliyata g\u00f6re \u00e7ok daha rahat ge\u00e7mektedir. Hastalar genellikle 2-3 g\u00fcnde taburcu edilerek, g\u00fcnl\u00fck aktivitelerine h\u0131zla kavu\u015furlar. Bu s\u00fcre, a\u00e7\u0131k b\u00f6brek ta\u015f\u0131 ameliyat\u0131yla kar\u015f\u0131la\u015ft\u0131r\u0131ld\u0131\u011f\u0131nda olduk\u00e7a k\u0131sa bir s\u00fcredir.\nTakip\n\u0130lk ta\u015f olay\u0131ndan bir y\u0131l sonra, hastalar ultrason ve direkt filmle kontrol edilir. Bu d\u00f6nemde yeniden ta\u015f hastal\u0131\u011f\u0131 ya\u015famamak i\u00e7in, hastalar\u0131n \u00f6zellikle s\u0131v\u0131 al\u0131m\u0131na ve ilave tuz kullanmamaya dikkat etmesi gerekir. Uygun ila\u00e7 veya ta\u015f olu\u015fumunu engelleyen koruyucu tedavi de \u00f6nerilebilir.\n\n\n\n\n \n <\/p>\t\t\n\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\n\t\t\t\t<\/div> \t\t\t\t\t\t\t\n\t\t\t<\/div> \t\t\t\t\t\t\t\n \t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t

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\"\"\/<\/div><\/div>\n\t\t\t\t\t\t<\/div>\n\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\n\t\t\t\t<\/div> \n\t\t\t\t\t\t\t\n\t\n\t