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Gurda

pochkaGURDA (Ren, nephros), uzvi juft, ki dar qismi miyon dar nazdi devorai aqibi shikam az du tarafi sutunmuhra joygir shudaast. G. dar tanzimi muvozanati obu elektrolitho, kislotayu ishqorho va fishori osmosi, hamchunin az organizm khorij namudani mahsuli mubodilai nitrogen ishtirok mekunad. G. shakli lubiyoro doshta, bo nasji ravgani faro girifta shudaast. G.-ro az berun gilofai sufta ihota kardaast; sathi G. dar zeri gilofa hamvor buda, rangi jigari dorad. Darozii G. 10 – 12, pahniash 5 – 6 va gafsiash 3 – 4 sm meboshad; G. 120 – 200 g vazn dorad.
G. az gushahoi boloi va poyoni, kanorhoi barjastai beruni va furukhamidai daruni, sathi pesh va qafo iborat ast. Dar kanori darunii G. koma (daromadgoh) mavjud ast, ki ba javfi khurd (sinus) payvast meshavad. Dar daromadgohhoi G. arteriyai kaloni gurda va vena (varid), laghoi limfa, torhoi asab, inchunin jomchaho va havzakho, ki dar onho peshob gun meshavad, joy giriftaand. Dar mavridi ba darozi buridani G. du qabat namudor meshavad: beruni (qishri), ki rangi on siyoh ast va daruni (magz), ki rangi safed doshta, az ahromho iborat meboshad. Moddai qishri asosi ahromhoro faro girifta, fazoi bayni onhoro pur mekunad va poya (sutun)-hoi G.-ro ba vujud meorad. Qullai ahromho misli pistonak nimdoira buda, ba sinusi G. nigaronida shudaast. Dar qullai ahromho surokhi naychahoi sershumor boz meshavand, ki tavassuti onho peshob ba jomchaho meshorad. Jomchaho bevosita ba havzakho payvast meboshand. G. az 2 – 2,5 mln nefronhoi sokhtorashon yakkhela tarkib yoftaast, ki har yaki on vazifai alohida dorad.
Dar Gurda. peshob hosil meshavad.

Vazifahoi asosii Gurda: bo peshob khorij kardani mahsuli mubodilai moddaho va jismhoi begona; doimi nigoh doshtani mubodilai obu namak va muvozanati kislotayu ishqorho dar organizm, fishori osmosii mutadil dar khun va moei khoriji hujayraho.
Nuqs (anomaliya)-i G. beshtar dar zanho ba mushohida merasad; on odatan biduni yagon alomat padid meoyad. Vale baze illathoi Gurda. ba faoliyati organizm tasir rasonda, boisi paydoishi bemorihoi gunogun meshavand. YAke az nuqsonhoi Gurda aplaziya (ageneziya) ast. Dar mavridi on odam bo yak G. ba dunyo meoyad. Duchand shudani Gurda. nuqsi mamuli in uzv ast. Gurda.-i duchanda nisbat ba G.-i solim daroz meboshad. Har qismi on havzak, peshobroha va khungardishi alohida dorad. Ba nuqsoni hajmi G. gipoplaziya mansub ast; hangomi on hajmi Gurda khurd meshavad. Taqr. choryaki nuqsonhoi Gurdaro distoniya tashkil medihad. Dar asnoi on mavqei G. tahrif meyobad. Distoniya se nav – kamari, tihigohi va kosi meshavad. Bazan G. dar sanduqi sina joy megirad. Dar amaliyai kliniki khususan Gurdaii nalshakl beshtar duchor meoyad. Gardanai chunin G. ba shohragi shikam fishor ovarda, boftahoi asabi on boisi paydoishi dard va ikhtiloli faoliyati rohi medayu ruda meshavand. Displaziya, multikistoz, polikistoz va kista niz az jumlai nuqsonhoi G. meboshand.
Osebhoi Gurda pushida va kushoda meshavand. Osebi pushidai G. binobar zarb khurdani kamar va zeri qaburga ba vujud meoyad (mas., hangomi az balandi aftodan, yakbora kashish khurdani mushakho). Ba osebhoi kushodai G. zakhmi tir, kord va g. mansuband. Alomathoi asosii osebi G. dard, varami kamar (khonomos yo urogematomai mavzei gurda), khunpeshobi, hangomi osebhoi kushoda az joi zakhm shoridani peshob meboshand. Dar mavridi gumon burdan az osebi Gurda. marizro zud dar shubai jarrohi khobondan lozim ast.
Ba bemorihoi G. asosan pielonefrit, nefrit, bemorii sangi peshob, gidronefroz, omoshoi saratoniyu gayrisaratoni va sil mansub meboshand. Baze bemoriho bevosita ba ikhtiloli faoliyati G. vobastagi dorand, mas., oksaluriya (bo peshob khorij shudani namakhoi kislotai shilkha), uraturiya (bo peshob ikhroj gashtani uratho), fosfaturiya (ba tavassuti peshob khorij shudani fosfatho).
Ikhtiloli khungardishi G. metavonad sababhoi modarzodi doshta boshad; on dar zaminai ateroskleroz va nefroptoz niz ba vujud meoyad. Dard, khunpeshobi va gipertenziyai sharayoni alomathoi asosii ikhtiloli khungardishi G. meboshand; dar bemoroni giriftori saktai miokard, nuqsi dil, endokardit, bemorii gipertoniya, ufunat va g. ba mushohida merasad.
Ba bemorihoi iltihobii makhsusi G. sil va sifilis taalluq dorand. Mikobakteriyahoi sil ba G. tavassuti khun roh meyoband. G. giriftori ekhinokokkoz niz meshavad. Az bemorihoi omosi dar G. adenoma, fibroma, lipoma, gemangioma, leyomioma, papillomai havzakho duchor meoyand. Omosi mamuli G. saratoni hujayrahoi G. (adenokartsinoma) ast. Dar kudakon beshtar saratoni Vilms ba mushohida merasad. Nig. niz Uzvhoi peshob.

Ad.: Qodiri T.R., Vospalitelnoe zabolevanie mochepolovikh organov, D., 1990; Hamon muallif, Neotlojnaya urologiya i nefrologiya, Kiev, 1996; Hamon muallif, Muntakhabi darshoi peshobshinosi, D., 2000.
T.R. Qodiri.
KL

Rasmi 1. Sokhtori gurda dar burishi darozruya: 1 – moddai qishrii gurda; 2 – moddai magzi gurda; 3 – pistonakhoi gurda; 4 – tirak (poya)-i gurda; 5 – asosi ahromi gurda; 6 – maydoni galberak; 7 – jomchahoi khurdi gurda; 8 – qismi rakhshon; 9 qismi lulashakl; 10 – gilofaki lifi (fibrozi); 11 – nayi peshob; 12 – jomi kaloni gurda; 13 – havzakhoi gurda; 14 – venai gurda; 15 – arteriyai gurda.

Rasmi 2. Raghoi khunu limfai gurda (naqsha): 1 – raghoi limfa dar gilofaki lifi; 2 – muraghoi limfa dar qismi lulashakli moddai qishri; 3 – muraghoi limfa dar moddai magzi; 4 – venachai sitorashakl; 5 – raghoi limfai pardai zardobi; 6 – niyomi gurda va raghoi limfai on; 7 – raghoi khun va limfai gilofaki charbi; 8 – jismchahoi gurdai dar moddai qishrii gurdaho; 9 – raghoi khun va limfai majroi peshob; 10 – arteriyai gurda; 11 – venai gurda; 12 – limfaguddai mavzei va raghoi limfae, ki ba on vorid meshavand; 13 – venai bayni hissachaho; 14 – arteriya va venahoi kamonshakl.

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