Kidney and ureteral stones
Introduction
Introduction to kidney and ureteral stones Urinary calculi are one of the most common urological diseases, more men than women, about 3:1. In the past 30 years, the incidence of urinary tract (kidney, ureter) stones has increased significantly in China. The mechanism of stone formation has not yet been fully elucidated, and it is thought to be related to metabolism and infection factors. The main symptoms are pain and hematuria, and very few patients have no symptoms for a long time. basic knowledge The proportion of sickness: 0.4% Susceptible people: no specific population Mode of infection: non-infectious Complications: hydronephrosis anemia
Cause
Causes of kidney and ureteral stones
The mechanism of stone formation has not yet been fully elucidated, and it is thought to be related to metabolism and infection factors.
Prevention
Kidney and ureteral stone prevention
Changing lifestyle habits can prevent and reduce the growth and onset of stones. There are several types of kidney stones. Once your doctor confirms your stone type, the following methods can help reduce the chance of recurrence.
Check your stomach medicine:
Some common antacids contain high levels of calcium. If you have calcium stones and you are taking an antacid, you should check the ingredient description to determine if it contains high calcium. If it contains high calcium, it should be Switch to another medicine.
Multiple activities:
People who don't like activities tend to accumulate calcium in the blood. Exercise helps calcium to flow to the bones it belongs to. Don't wait for the formation of stones all day long. You should go outdoors or exercise.
Hot compress:
In the kidney area, hot compress, cupping, electrotherapy, can relieve pain, often take a hot bath, is also conducive to row of stones.
Avoid L-cystine:
If you have a kidney stone disease or are currently suffering from kidney stones. Blood avoids L-cystine, this accumulation of amino acids can crystallize in the kidneys, producing large stones that block the inside of the kidneys.
Complication
Renal and ureteral calculi complications Complications hydronephrosis anemia
There may be complications such as hydronephrosis, renal insufficiency, gastrointestinal symptoms, anemia, infection.
Symptom
Renal and ureteral stones symptoms common symptoms ureteral pain, cold sweat, abdominal pain, hematuria, blood pressure, high fever, pale pus, dull pain, hematuria, nausea
The main symptoms are pain and hematuria, and very few patients have no symptoms for a long time.
(A) Pain: Most patients have low back pain or abdominal pain, large stones, mostly dull or dull pain in the affected side, often aggravated after the activity; smaller stones, causing smooth muscle spasm and colic Colic often occurs suddenly, the pain is severe, such as knife cutting, lower abdomen, genital and inner thigh radiation, sometimes patients with pale, cold sweat, nausea, vomiting, severe weak and rapid pulse, blood pressure, etc. Symptoms, pain often have paroxysmal attacks, or may be abruptly terminated or relieved due to a certain action pain, leaving the waist and pain in the abdomen.
(B) hematuria: because the stone directly damages the mucosa of the kidney and ureter, often under the pain of microscopic hematuria or gross hematuria, the severity of hematuria is related to the degree of injury.
(C) pyuria: pus cells appear in the urine when the kidney and ureteral stones are infected, clinically high fever, low back pain.
(4) Others: Stone obstruction can cause hydronephrosis, renal insufficiency, and some patients may have gastrointestinal symptoms, anemia and so on.
Examine
Examination of kidney and ureteral stones
(1) Laboratory tests: routine examination of urine can show red blood cells, white blood cells or crystals. Urine pH is often acidic in patients with oxalate and urate stones; phosphate stones are often sputum, and there are more urine in the case of infection. Pus cells, when the infection is heavier, the blood routine examination shows the total number of white blood cells and neutrophils.
(2) X-ray examination: X-ray examination is an important method for diagnosing kidney and ureteral calculi. More than 95% of urinary calculi can be developed on X-ray plain film, supplemented by excretory or retrograde pyelolithopelography, which can determine stones. The location, whether there is obstruction and obstruction, whether the contralateral renal function is good, the difference comes from the calcification shadow outside the urinary tract, exclude other lesions of the upper urinary tract, determine the treatment plan and the stone parts after treatment, the size and number of comparisons, etc. Have important value.
(3) Other examinations: B-ultrasound can detect dense spots or light clusters in the stone site. When the hydronephrosis is combined, the liquid level can be detected. The isotope kidney diagram shows that the urinary tract in the affected side is obstructive. The CT scan is inferior. X plain film and urography are intuitive and expensive, and are generally not routinely examined.
Diagnosis
Diagnosis and differential diagnosis of kidney and ureteral calculi
diagnosis
Diagnosis can be based on medical history, clinical symptoms, and laboratory findings.
Differential diagnosis
(1) Kidney tuberculosis and kidney tumor
Renal tuberculosis and renal tumors may have pain and tenderness in the kidney area, and clinical symptoms such as microscopic hematuria should be differentiated from kidney and ureteral stones. The former rarely has colic, and B-ultrasound and X-ray examination can help identify.
(2) Acute appendicitis
The right lower abdomen pain in the right ureteral calculus is easily confused with appendicitis. It needs to be identified. In acute appendicitis, abdominal pain is as severe and persistent as stones, local tenderness, rebound tenderness and muscle tension, fever and white blood cell count. High, urine test can be no red blood cells, B-ultrasound and X-ray examination can be without stone shadow, can be identified with the former.
(3) cholelithiasis
Right kidney stones need to be differentiated from cholelithiasis. Gallstones are mainly right upper quadrant pain and radiate to the right shoulder and back. B-ultrasound and gallbladder angiography can find stone shadows, which can help identify.
(4) acute pyelonephritis
Acute pyelonephritis may have hematuria, which should be differentiated from kidney and ureteral stones, but the former has symptoms of fever and other poisoning. B-ultrasound and X-ray examination can help identify.
