Brief introduction of upper urinary calculi

Directory 1 pinyin 2 disease classification 3 disease overview 4 disease description 5 symptoms and signs 6 disease etiology 7 pathophysiology 8 diagnosis and examination 9 treatment plan 10 prognosis and prevention 1 special tips attachment: acupoint 1 treatment of upper urinary calculi1pinyin shàng niào lù jié shí

2 Classification of diseases Urology

3 disease overview symptoms: 1, pain? The pain caused by renal and ureteral stones is often located in the costal ridge angle, waist and abdomen, which is paroxysmal or persistent and can be manifested as dull pain or colic. Kidney calculi, the National People's Congress has little activity, so it can be painless. Small and active stones are more painful and even have renal colic. The pain is knife-shaped, located in the waist and abdomen, radiating to the lower abdomen and vulva, often accompanied by nausea and vomiting. 2, hematuria? Hematuria is another important symptom. Hematuria occurs after pain, mostly during physical activity. 3. Bladder disease? When the lower ureteral calculi are accompanied by infection, frequent urination, urgency and dysuria may occur. 4. Others? When hydronephrosis is caused by obstruction, the swollen kidney can be touched. Complete obstruction of upper urinary tract in bilateral or solitary kidneys can lead to anuria, and chronic obstruction can lead to renal insufficiency. Pathology: Most upper urinary tract stones are calcium oxalate stones. Magnesium ammonium phosphate stones are more common in bladder stones than in upper urinary tract. Although some kidney calculi have definite etiology, such as hyperparathyroidism, renal tubular acidosis, spongy kidney, gout, foreign body, long-term bed rest, obstruction, infection, etc., at present, the etiology of most calcium stones cannot be completely explained. Nucleation, stone matrix and crystal inhibitor are the three basic theories of stone formation. According to the different formation mechanism of upper urinary tract stones, some people divide them into stones related to metabolic factors and infectious stones. Metabolic calculus is caused by metabolic disorder, such as hyperparathyroidism, hypercalciuria, hyperuricemia and hyperoxaluria caused by various reasons. High concentrations of chemical components damage renal tubules, increase matrix substances in urine, precipitate salts and form stones. Infectious stones are deposited by bacteria that produce urease to decompose urea in urine to produce ammonia, which makes urine alkaline and phosphate and ammonium urate in urine relatively saturated. Bacteria, infection products and necrotic tissue are also the core of stone formation.

4 Disease Description Acute urinary retention is a common problem in clinical work. There are many reasons why things are urgent. Correct diagnosis and timely treatment are needed.

5 Symptoms and Signs 6 Etiology of the disease There are many reasons for acute urinary retention, sometimes caused by many reasons.

1. Mechanical blockage? Any obstructive lesion of bladder neck and urethra can cause acute urinary retention. Common diseases include prostatic hyperplasia, urethral injury and urethral stricture. Acute urinary retention caused by urethral stricture is often induced by local edema and pain after urethral dilatation. Stones, tumors and foreign bodies in the bladder and urethra block the bladder neck and urethra. Bladder tumor, pelvic tumor, a large number of blood clots in the bladder caused by pregnant uterus, hematocele caused by hymen atresia, and even fecal lumps in the rectum of infants may be the causes of acute urinary retention.

2. Dynamic blocking? There was no organic obstruction in bladder and urethra. Urinary retention is caused by dysuria. Such as anesthesia, postoperative urinary retention, especially after spinal anesthesia and anorectal surgery. Central and peripheral nervous system injuries, inflammation and tumors can also cause acute urinary retention. Various drugs for relaxing smooth muscle, such as atropine, propofol and 6542, occasionally cause acute urinary retention. ? Hypokalemia caused by various reasons, such as aldosteronism, diarrhea and long-term use of diuretics. , can make bladder detrusor muscle weakness, dysuria, and even urinary retention. ? Acute urinary retention is also common in patients with high fever coma, especially children and the elderly. Individual patients have urinary retention because they are not used to urinating in bed.

7 pathophysiology 1. Mechanical blockage? Any obstructive lesion of bladder neck and urethra can cause acute urinary retention. Common diseases include prostatic hyperplasia, urethral injury and urethral stricture. Acute urinary retention caused by urethral stricture is often induced by local edema and pain after urethral dilatation. Stones, tumors and foreign bodies in the bladder and urethra block the bladder neck and urethra. Bladder tumor, pelvic tumor, a large number of blood clots in the bladder caused by pregnant uterus, hematocele caused by hymen atresia, and even fecal lumps in the rectum of infants may be the causes of acute urinary retention.

2. Dynamic blocking? There was no organic obstruction in bladder and urethra. Urinary retention is caused by dysuria. Such as anesthesia, postoperative urinary retention, especially after spinal anesthesia and anorectal surgery. Central and peripheral nervous system injuries, inflammation and tumors can also cause acute urinary retention. Various drugs for relaxing smooth muscle, such as atropine, propofol and 6542, occasionally cause acute urinary retention. ? Hypokalemia caused by various reasons, such as aldosteronism, diarrhea and long-term use of diuretics. , can make bladder detrusor muscle weakness, dysuria, and even urinary retention. Acute urinary retention is also common in patients with high fever coma, especially children and the elderly. Individual patients have urinary retention because they are not used to urinating in bed.

8 diagnosis and examination 9 treatment plan The treatment principle of acute urinary retention is to relieve the cause and restore urination. But sometimes the cause is unknown or the obstruction is difficult to relieve for a while, so we can only do urine drainage first and then deal with it later. The specific method is as follows:

1. If the cause is clear, it can be relieved immediately, and the cause should be relieved immediately to resume urination. For example, if the foreskin or urethral orifice is narrow, local incision can restore urination; Another example is urethral calculi, which can be removed immediately. In the case of urinary retention or hypokalemia caused by some drugs, normal urination can be resumed after stopping the drug or supplementing potassium.

2. Urinary retention after spinal anesthesia and anorectal surgery can be treated with acupuncture. The commonly used acupoints are Zhongji, Qugu, Yinlingquan and Sanyinjiao. You can also inject neostigmine O.25mg at acupoint.

3. Catheterization is the most commonly used method for acute urinary retention. In any case, urethral catheterization should be carried out immediately when the bladder is highly inflated to avoid tension-free bladder after extreme inflation. Urine should be discharged slowly during catheterization to prevent bladder bleeding caused by rapid decrease of bladder pressure. Catheterization should follow aseptic operation to avoid bringing in bacteria. Elbow catheter is used in patients with benign prostatic hyperplasia when urethral catheterization is difficult. If it is estimated that the urination function will be difficult to recover for a while, it is necessary to keep a catheter, such as a silicone rubber catheter? The tube is ideal. During the indwelling period of catheter, the urethral orifice should be cleaned daily and the drainage system should be replaced daily.

4. If the catheter cannot be inserted, the bladder can be punctured from the upper edge of pubic bone under aseptic operation to extract urine. If long-term drainage is needed, cystostomy should be performed.

10 according to the cause of prognosis and prevention.

1 1 Special tips on dietary taboos for patients with stones:

1, don't drink milk before going to bed.

Because people's urine volume decreases after sleep, all kinds of tangible substances in urine increase. Because milk contains more calcium, the calcium concentration in urine suddenly rises in a short time, which is easy to form stones. Therefore, kidney calculi patients should not drink milk before going to bed.

2, avoid eating spinach

In food, spinach is the highest oxalate content, and calcium oxalate is the most important component in urinary calculi, so patients with urinary calculi should not eat spinach again. If patients with urinary calculi have been removed by surgery, avoiding eating spinach can prevent recurrence; Drinking more water when healthy people eat spinach can dilute urine and reduce the concentration of oxalic acid in urine.

3, should not eat more sugar

Patients with urinary calculi eat too much sugar, which not only hinders treatment, but also promotes the further formation of urinary calculi. Practice has proved that the concentration of calcium ion, oxalic acid and uric acid in urine will increase after taking sugar. Both calcium and oxalic acid can promote the formation of stones, and the simultaneous increase of the three is more likely to form stones.

Diet conditioning:

1, vitamin A and vitamin C supplementation: When the content of inorganic salts such as calcium and phosphorus in food and water is high, but the intake of vitamin A and vitamin C is too small, stones are easy to occur. Therefore, we should eat more fresh fruits and vegetables and increase the intake of vitamin A and vitamin C.

2. Low-calcium and low-phosphorus diet: provide 700 mg of calcium and below 1300 mg of phosphorus every day to avoid foods rich in calcium, such as milk, soybeans, tofu and green leafy vegetables. Foods with high phosphorus content include animal protein, animal viscera, brain marrow, etc., and should be eaten less.

3. Reasonable selection of acidic and alkaline foods: Changing the chemical composition of urine can reduce the conditions for stone formation. For example, changing the pH of urine and increasing the dissolution of salt.

4. Fasting high-purity foods: Common high-purity foods include: animal viscera such as pork, beef, pig liver, pig kidney and various gravy. Vegetables include peas, lentils and other beans, cauliflower, asparagus and mushrooms. Alcohol and alcoholic beverages, strong tea, coffee, cocoa and strong spices and condiments are inedible.

5, drinking water should be appropriate: ensuring adequate water in the body is one of the important measures to prevent urinary calculi. The amount of drinking water is generally 2500 ml per day. Drinking too much will easily increase the burden on the urinary system.

Treat upper urinary calculi, such as acupoint external contraction. Origin: Acupuncture classics A and B: Wailing, located in the upper and lower reaches of Shu Tian, is caused by the pulse qi of Foot Yangming. Explanation of acupoint names: the outside is opposite to the inside, and the mausoleum is the mountain mausoleum. ...

An important sign of bladder. Triangular area of bladder is an important sign of cystoscopy, and it is also a prone site for stones and tuberculosis. Nervous system of bladder: The nerves of bladder are ...

The ureteral catheter transits through the entrance and inner wall of the small pelvis. Stenosis is usually where stones stay. The left and right ureters terminate in the renal pelvis and are larger at the waist. ...

Three needles in the waist are the portal of kidney qi, hence the name. Located in the spinal region, on the posterior midline, at the depression of the inferior spinous process of the second lumbar vertebra. Take some from your stomach. Hierarchical anatomy: ...

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