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尿石症的预防

Metaphylaxis of urolithiasis.

作者信息

Menditto Vincenzo Giannicola, Milanese Giulio, Muzzonigro Giovanni

机构信息

Department of Urology and School of Medicine and Prevention, Polytechnic University of the Marche Region, Azienda Ospedaliero-Universitaria "Umberto I-Lancisi-Salesi", Ancona, Italy.

出版信息

Arch Ital Urol Androl. 2009 Mar;81(1):32-9.

Abstract

The urolithiasis is a growing disease because of the changes in dietary habits and in he general life style. Urolithiasis is characterized by the recurrent clinical manifestation and possible effect of structural damage of the kidneys and of the urinary tract ast well as the potential increase in systemic blood pressure. Moreover, frequent need for medical cure and invasive urological treatment exposes the patient to the complications of such procedures. The lithogenic process involves a wide number of systemic pathologies that are often undiagnosed. However, once identified they can be treated more precisely having an impact on the stone's forming process. For these reasons, prevention of new urolithiasis in patients, and in particular in those with high risk, appears to be clinically important. Metaphylaxis can be differentiated in two ways: "general metaphylaxis" in patients with lithiasis of the urinary tract, and "specific metaphylaxis" meant for patients with risk factors for recurrent calculosis. The aim of this narrative review is to present an algorithm for clinical practice for patients that have undergone one or more attacks of renal/ureteral colic from lithiasis in order to prevent further attacks. As such, this review deals with a method of secondary prevention (prophylaxis) that aims at identifying and correcting metabolic disorders (from which the term metaphylaxis comes) that favor and support the lithogenic process in the urinary tract.

摘要

由于饮食习惯和总体生活方式的改变,尿石症是一种日益常见的疾病。尿石症的特点是临床表现反复出现,可能对肾脏和尿路造成结构损伤,以及可能导致系统性血压升高。此外,频繁需要药物治疗和侵入性泌尿外科治疗会使患者面临此类治疗的并发症。结石形成过程涉及许多通常未被诊断出的全身性病理状况。然而,一旦识别出来,就可以更精确地进行治疗,从而对结石形成过程产生影响。出于这些原因,预防患者尤其是高危患者出现新的尿石症在临床上显得很重要。预防性治疗可分为两种方式:针对尿路结石患者的“一般预防性治疗”,以及针对复发性结石形成风险因素患者的“特异性预防性治疗”。本叙述性综述的目的是为经历过一次或多次肾结石/输尿管绞痛发作的患者提供一种临床实践算法,以防止进一步发作。因此,本综述探讨的是一种二级预防(预防性治疗)方法,旨在识别和纠正有利于并支持尿路结石形成过程的代谢紊乱(预防性治疗一词即源于此)。

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