生命不能承受之"痛”——尿石症

生命不能承受之痛——泌尿系结石 结石从何而来？ How does the stone occur? 泌尿系结石又称尿石症，是泌尿系统的常见病，也是非常古老的疾病，考古学家曾在埃及木乃伊体内发现过膀胱结石。虽然结石病与人类并存了数千年，但结石的成因仍无定论。简单的说，结石是人体内的代谢产物通过泌尿道排出过程中，过饱和形成的结晶，也可能因为局部的感染继发形成结石。 Urinary stone disease, also known as urolithiasis, is a common disease of the urinary system. It is also very old disease, archaeologists have been found bladder stones in the Egyptian mummies. Although stone disease and human coexistence for thousands of years, the cause of the stone is still inconclusive. The stone is the crystallization of body's metabolites, which were supersaturated in the urinary tract. It may also due to the local infection. 如何诊断结石？ How to diagnose stones? 目前，最常见的泌尿系结石为肾或输尿管结石，即上尿路结石。大部分结石患者发病时都有下列症状：突发腰痛、血尿、恶心呕吐，甚至发烧。也有部分患者没有典型的症状，是通过体检发现的。B超是筛查结石最简单经济的方法，而螺旋CT 是诊断结石的“金标准”。 At present, the most common urinary stones are the kidney or ureteral calculi, which were called upper urinary tract stones. Most of the patients have the following symptoms : sudden back pain, hematuria, nausea，vomiting, and even fever. There are also some patients without typical symptoms, who are diagnosed through physical examinations. B-ultrasound is the most simple and economical way to screen the stones, while spiral CT is the "gold standard" for diagnosis. 得了尿石症，如何治疗？ How to treat？ 尿石症的治疗，因其位置、大小、数量、引起的症状轻重不同而有所不同。经评估，可能能够自行排出的结石，可以采用药物排石。如果无法自行排出，同时伴有明显的症状或肾脏积水，则需外科干预。体外冲击波碎石、输尿管镜碎石、经皮肾镜碎石等手术，是目前治疗上尿路结石的主要微创手段。 The treatment of urolithiasis varies with its location, size, quantity, and severity of symptoms. Patients with uncomplicated distal ureteral stones ≤10mm should be offered observation, and those with distal stones of similar size should be offered medical expulsive therapy（MET） with α-blockers and Chinese traditional medicine. If the stones are >10mm or MET is failed, the patients need surgery intervention such as extracorporeal shock wave lithotripsy, ureteroscopic lithotripsy, percutaneous nephrolithotomy, etc., which are the main minimally invasive treatments of upper urinary tract stones. 如何预防结石？ How to prevent the recurrence 结石极易复发，如不加干预，10年复发率约为50%。我们可以通过对病人的结石标本（自行排出或手术取出）进行分析，明确结石成分，从而制定预防复发的方案。而多饮水（>2000ml/天）、低盐饮食，被认为是最简单，却也是最有效的预防手段。 Stones can easily recur, with at least 50% of individuals experiencing another stone within 10 years of the first occurrence. We can analysis the patient's stone specimens (self-discharge or surgical removal) for the stone composition. And then we can  develop a program to prevent recurrence. And more water intake (> 2000ml / day), low-salt diet, is considered the most simple, but also the most effective means of prevention. 【本期语言点总结】 1.urolithiasis [jʊərəʊlɪ'θaɪəsɪs] n.尿石病，尿石形成； 石淋； Ur/o-尿；lith-石；-ia/iasis病名，病，病态 2.Hematuria [ˌhi:mə'tju:rɪə] n.血尿症，血尿； 尿血； 3.crystallization [ˌkrɪstəlaɪ'zeɪʃn] n.结晶化； Crystall-结晶 eg：crystallohydrate 晶状水合物 4.metabolites[me'tæbəlaɪts] [医]代谢产物 5.supersaturated[su:pər'sætʃəreɪtɪd]adj.过饱和的；v.使过度饱和( supersaturate的过去式和过去分词 )； 6.calculi ['kælkjʊlaɪ]n.微积分学，结石； 7.spiral[ˈspaɪrəl] CT 螺旋CT 8.extracorporeal shock wave lithotripsy ['laɪθəʊtrɪpsɪ][医]体外冲击波碎石术（ESWL） 9.ureteroscopic lithotripsy输尿管镜碎石术（URL） 10.percutaneous nephrolithotomy[nefrəʊlɪ'θɒtəmɪ]经皮肾镜取石术（PNL） （资料来源：renji clinic） Bgm-look at me now 撰稿讲解：福建医科大学 淑铉铉铉