| Abstract | Bubreg je parni organ crvenkastosmeđe boje, prosječne duljine 10 cm, širine 5 cm i debljine 3 cm. Leži retroperitonealno u visini između dvanaestog prsnog i trećeg lumbalnog kralješka. Desni je niže pozicioniran radi anatomskog položaja jetre, dok lijevi leži bliže središnjoj liniji. Bubrezi se pomiču s pokretima ošita pri disanju. Na njemu leže nadbubrežne žlijezde (1). Na bubregu se nalaze dva ruba, lateralni koji je konveksan, a medijalni konveksan blizu krajeva i konkavan u sredini. U sredini se otvara okomita pukotina, hilum renale, omeđena bubrežnim tkivom. Pukotina se zatvara u bubrežni sinus (lat. sinus renalis) kroz koji prolaze krvne žile i bubrežna zdjelica koja skuplja mokraću iz bubrega. Obavijen je vezivnom čahurom, okolo koje se nalazi sloj masnog tkiva. Rak bubrega se dijeli na rak bubrežnih stanica, rak tranzicijskih stanica, nefroblastom, tumore sabirnih kanala, renalni sarkom i bubrežni medularni rak. Najveća incidencija bubrežnih tumora je u sjevernoj i istočnoj Europi, sjevernoj Americi i Australiji. Najčešće se dijagnosticira kod muškaraca starijih od 60 godina, nešto rjeđe kod muškaraca mlađih od 40 godina. Rizični faktori koji dovode do nastanka raka bubrega su pušenje, pretilost, hipertenzija, genetska predispozicija i izloženost trikloroetilenu. Simptomi karcinoma bubrega su krv u urinu, bol i osjećaj pritiska na bočnoj strani leđa, izbočina na boku ili leđima, otekline zglobova i nogu, hipertenzija, anemija, slabost, umor, gubitak apetita i gubitak težine. Kirurško liječenje se dijeli na radikalnu nefrektomiju i djelomičnu nefrektomiju. Kao zlatni standard u liječenju raka bubrega uzima se laparaskopska i otvorena nefrektomija. Ove dvije metode nose razlike u duljini oporavka, razini boli, postoperativnim komplikacijama i gubitku krvi koje značajno variraju ovisno o veličini tumora koji se planira operativno odstraniti. Zadatak medicinske sestre je pružiti optimalne uvjete i zdravstvenu skrb za pacijenta prije, tijekom i nakon operacije tumora. Dodatna edukacija predstavlja važan faktor u unaprjeđivanju zdravstvene njege nad ovom skupinom pacijenata. (1)“ |
| Abstract (english) | The kidneys is a reddish- brown paired organ, withen average lenght of 10 cm, awidth of 5 cm, and 3 cm thick. It lies retroperitoneally at a height between the the twelfth thoracic and the third of lumbal spine. The right is positioned lower due to the anatomical position of liver, while the left lies closer to the center line. Kidneys move with the movements of the shield when breathing. The kidneys move together with the diaphragm as the patient takes a deep breath. Adrenal glands are situated above it.The kidney has two borders, the lateral and the medial one. The lateral border of the kidney, (lat. margo lateralis), is convex, while the medial one, (lat. margo medialis), is convex close to the edges and concave in the middle. In the middle, there is a deep vertical slit called renal hilum (lat. hilum renale) in the medial border which is encapsulated by kidney tissue. The slit expands into the central cavity (lat. sinus renalis) containing blood vessels and the renal pelvis (lat. pelvis renalis) that collects urine from the kidneys. The kidney is encapsulated by the connective tissue (lat. renal fascia), surrounded by a layer of adipose tissue. There are several kidney cancer (renal carcinoma) types, which are the following: renal cell cancer, transitional cell cancer, nephroblastoma (Wilms' tumor), collecting duct RCC, renal sarcoma and the renal medullary cancer.The incidence of kidney cancer is high in northern and eastern Europe, northern America and Australia. It is mostly diagnosed in men over 60, with a somewhat lower incidence rate in men under 40. Risk factors which are a common cause of kidney cancer are the following: smoking, obesity, high blood pressure (hypertension), genetics and esposure to trichloroethylene (TCE). The symptoms of kidney cancer are: hematuria, pains and feelings pressures, protursions on one side backs, swellings joint and legs, high blood pressure, iron definiency, feeling weak and tired, weight loss and appetite . Surgical treatments is divided into two categories, such as: the radical nephrectomyand the partial nephrectomy. The gold standard in the kidney cancer treatment are the laparoscopic and the open radical nephrectomy. The aforementioned methods differ in the duration of the postoperative recovery, pain severity, postoperative complications and blood loss that variate significantly depend on the sizes of tumor which should be surgically removed. The nurse duty is provide optimal conditions for the patient's recovery and an appropriate health care before, throught and after surgical treatment of the kidney cancer. Additional education represents a key factor in improving health care for the aforementioned patient group. |
