Rincé M, Leroux-Robert C
Service de néphrologie, hôpital universitaire Dupuytren, Limoges.
Rev Prat. 1991 Oct 1;41(21):2043-9.
The presence and migration of stones in the urinary tract are the consequences of lithiasis, a pathological process whose evolutive potential determines the frequency of recurrence. The stones produce haematuria and above all obstruction which manifests itself by pain and may be complicated by infection. The most suggestive type of pain is renal colic, but other revealing manifestations may occur. Such signs require radiological exploration with plain X-ray of the abdomen, renal ultrasonography and intravenous urography. These three indispensable examinations complete each other, provide the diagnosis and in the vast majority of cases point to the appropriate treatment. The haemodynamic repercussions of urinary tract obstruction have been thoroughly documented and now form the basis of treatment of renal colic with non-steroidal anti-inflammatory drugs. Obstruction and infection are the causes of all complications of urinary stones. Their management has been facilitated by recent advances in urology and should prevent the disease from destroying the kidneys and eventually causing chronic renal insufficiency.
尿路结石的存在和移动是结石病的后果，这是一个病理过程，其发展潜力决定复发频率。结石会导致血尿，最重要的是造成梗阻，表现为疼痛，还可能并发感染。最具提示性的疼痛类型是肾绞痛，但也可能出现其他有诊断意义的表现。这些体征需要通过腹部平片、肾脏超声检查和静脉尿路造影进行影像学检查。这三项不可或缺的检查相互补充，可作出诊断，并且在绝大多数情况下指明适当的治疗方法。尿路梗阻的血流动力学影响已有充分记录，现已成为使用非甾体抗炎药治疗肾绞痛的基础。梗阻和感染是尿路结石所有并发症的原因。泌尿外科的最新进展为其治疗提供了便利，应可防止该病损害肾脏并最终导致慢性肾功能不全。
