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泌尿系小结石不能不管 航海员、常坐飞机者要注意--亲稳舆论引导监测室
2013-05-03
泌尿系结石多大需要治疗?泌尿科医生认为,这要看结石的大小、位置及有无症状等来考虑,通常小结石又没有症状的时候,都建议先观察。然而,对于特殊人群,比如航海员、飞行员、空姐、经常坐长途飞机的人,哪怕结石小于0.5厘米,也都应该尽早就医处理掉,以免突然发生肾绞痛时,无法及时处理,导致肾脏损伤甚至肾衰竭。
泌尿系结石多大需要治疗?urologists,It depends on the size of the stones/位置及有无symptoms, etc.来考虑,Usually small stones and no symptoms,Are suggested to observe.however,For special people,Such as the navigator/The pilot/A flight attendant/People often sit long distance plane,Even if the stone is less than 0.5 cm,Also should be handled with care. As soon as possible,In order to avoid sudden renal colic,Cannot be processed in a timely manner,Lead to kidney damage and even failure.
特殊人群, 特殊人群,
有泌尿系结石尽快取 有泌尿系结石尽快取
58岁的陈老板,前几年体检的时候,发现左侧肾脏里有一颗小结石,大概0.4×0.5厘米大小,直径不到1厘米,由于这个石头没有引起任何症状,所以医生建议多一点喝水和运动,让石头随尿液自然排出来。然而,最近陈老板坐飞机去美国,在飞机降落的时候,猛颠簸了一阵,他突然感觉腰部疼痛,吃了止痛药之后,好转了一些。十几天之后回国,又在飞机上抖了一阵,结果腰痛又发作了,到医院就诊经查发现他的这颗结石从肾脏滑落到输尿管,石头在输尿管内移动才会突然引起他的腰部剧痛和绞痛。
58岁的陈老板,A few years ago a medical,Found that there is a small stone in the left kidney,Is about 0.4 * 0.5 cm size,Less than 1 cm in diameter,As a result of this stone did not cause any symptoms,So the doctor suggested that the more water and exercise,Let the stone with urine discharged naturally.however,Recently, Chen boss fly to the United States,When the plane landed,Fierce turbulence,He suddenly feel lumbar pain,After eat painkillers,Better some.Ten days after return home,And shaking for a while on the plane,Result back pain again,To the hospital as he found his drop the stones from the kidney to ureter,Within the ureter stone would move suddenly cause his waist pain and cramps.
广东省人民医院泌尿外科主任医师刘久敏说,这颗石头很小,在平时里也没有引发任何症状。对于大多数人来说,并不需要处理。但是对于经常出差坐飞机的人来说,这个肾结石就变成了一个“不定时炸弹”,因此,建议特殊人群如出海的海员(他们常常一出海就是在海上待半年)、飞行员、空姐、经常乘坐飞机长途旅行的人群,哪怕小结石都应该尽早处理。
广东省人民医院泌尿外科主任医师刘久敏说,This stone is very small,In the usual did not cause any symptoms.For most people,Do not need to deal with.But for people who travel by plane,This becomes a kidney stones"No time bomb",so,Seafarers suggested special populations such as at sea(They often stay half a year is a sail on the sea)/The pilot/A flight attendant/Often on a plane travel long distances,Even if small stones should be processed as soon as possible.
1厘米以下的结石, 1厘米以下的结石,
6-12个月查一次 6-12个月查一次
对于泌尿系结石,体检是很容易检查出来的,腹部B超或X光检查均能发现。然而,大约有三分之一的人群在患了泌尿系结石之后,在没有出现任何症状时,他们常常是两种态度:一种是有时候会出现下腰部胀痛,但过段时间就不痛了,患者就以为没事了,就不去看医生了;另一种就是紧张得不得了,不知所措,到处看医生希望能够处理掉石头。
对于泌尿系结石,Physical examination is easily detected,Abdominal ultrasound or X-ray examination can be found.however,About a third of the population after suffering from urinary tract stones,Without any symptoms,They are often two kinds of attitudes:One is sometimes will appear under the waist pain,But over time has to indolence,Patients who think it is ok,Don't go to see a doctor;Another is extremely tense,At a loss,Want to be able to get rid of stone everywhere to see a doctor.
刘久敏指出,对于泌尿系结石治疗,这是一个很复杂的问题。首先泌尿系结石的症状与其引起的严重后果并不等同,也就是说,没症状不代表病情就不严重。有一些患者,他们自己本来在体检中已经发现患了结石,但是没有不舒服的感觉,以为问题不大就没去处理。结果几年之后,结石已经损害其肾脏功能。曾经有一位患者在5年前就已确诊肾结石,当时肾积水程度还较轻,肾功能也仅部分受损,劝其手术取石,肾脏尚可保留,但他坚持吃中药“排石”,道听途说、辗转多处,吃了很多所谓的“排石药”,不但结石未排出,导致病情延误,肾积水加重,肾功能丧失而切除肾脏。
刘久敏指出,For the treatment of urinary calculi,This is a very complicated problem.首先泌尿系结石的symptoms与其引起的严重后果并不, etc.同,That is to say,No symptoms does not mean that the illness is not serious.There are some patients,They originally are already found in the physical examination of the stones,But there is no uncomfortable feeling,Think no big problem to deal with.Results after a few years,Stone has been damage to the kidney function.I once had a patient had kidney stones diagnosed in 5 years ago,At that time kidney seeper degree is lighter,Kidney function is only partially damaged, the damage,The stones advised its operation,Kidney can be retained,But he insisted on eating Chinese traditional medicine"Row of stone",What I hear/after,Ate a lot of the so-called"Row shiyao",Not only stones not discharge,Delay in condition,Kidney seeper aggravating,Loss of renal function and resection of kidney.
其次,泌尿系结石是否要处理,要看结石的位置、大小及是否有梗阻和症状(血尿、炎症等)。刘久敏认为,只要有结石,有症状就要治疗。通常来说,直径小于0.6cm的结石,大量饮水(2000-3000毫升/天)、适度运动有助于自己把结石排出来。如果伴有绞痛,那么还可以采用止痛、解痉等对症处理。
其次,Urinary calculi whether to deal with,Depends on the location of the stones/Size and whether there is obstruction and symptoms(Blood in the urine/炎症, etc.).LiuJiuMin think,As long as there is a stone,Symptomatic treatment.In general,The stone diameter less than 0.6 cm,Drinking lots of water(2000-3000 - ml/day)/Moderate exercise can help stone row out themselves.If associated with colic,You can also with the pain/解痉, etc.对症处理.
没有症状的结石,6-12个月查一次B超或X光,观察一两年,多喝水、多运动,帮助结石自然排泄出来,这是最好的结果。
没有symptoms的结石,Check a B to exceed 6-12 months or X-ray,Watch for a year or two,Drink more water/Exercise more,Help the stone natural excretion,This is the best result.
Tips Tips
结石部位不同 结石部位不同取石方法不同 Different methods to lithotomy
(1)肾脏结石
(1)Kidney stones
【症状】:腰部的隐痛、钝痛,也可以无症状。
[symptoms]:Waist ache/Dull pain,Can also produce no symptoms.
简单的处理办法就是消炎、解痉可以缓解疼痛。但是对于体积较大的结石则需要通过体外冲击波碎石或经皮肾镜碎石取石术进行治疗。
简单的处理办法就是消炎/Spasmolysis can relieve the pain.But for large stones need by extracorporeal shock wave lithotripsy or percutaneous nephroscope rubble nephrolithotomy treatment.
(2)输尿管结石
(2)Ureteral calculi
【症状】:因为石头堵住了肾脏与膀胱的通道,人会感觉腰部酸胀。
[symptoms]:Because the stone blocked the passage of the kidney and bladder,People will feel the waist sour bloated.
处理办法与肾结石相同,较小的石头,也可通过保守治疗后,自行排出。输尿管结石较大,引起肾积水的,目前可通过输尿管硬镜或输尿管软镜进行碎石来治疗。
处理办法与肾结石相同,The smaller stones,May be after conservative treatment,By itself.Ureteral calculi,Cause of hydronephrosis,At present can be through soft hard mirror ureter or ureter mirror lithotripsy to treat.
(3)膀胱结石
(3)Bladder calculi
【症状】:石头与膀胱摩擦往往会引起血尿或尿频尿急,当石头堵住尿道时,会引起排尿困难。
[symptoms]:Stone and bladder friction tends to cause blood in the urine or frequent urination urgency,When the stone blocking urethra,Will cause dysuria.
当膀胱结石比较大,引起梗阻是一定需要治疗的,可以经尿道膀胱镜下激光碎石术治疗。张华、郝黎、张丹娜
当Bladder calculi比较大,Cause obstruction is must be in need of treatment,Can transurethral cystoscope laser lithotripsy under treatment.Zhang hua/Hao Li/Zhang na
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