Conort Pierre, Tostivint Isabelle
Service d'urologie, hôpital La Pitié-Salpêtrière, AP-HP, 75651 Paris Cedex 13.
Rev Prat. 2011 Mar;61(3):379-81.
Circumstances of diagnosis of urinary stones vary. Medical management is performed either in emergency for acute or serious symptoms, or delayed. Renal colic is the most typical clinical form. The emergency analgesic treatment is well established. After sedation of the pain, radiological study (plain film and ultrasound of the abdomen) may be supplemented by abdominal computerized tomography which is the best exam for the diagnosis of urinary stone and its impact. In complicated cases urological drainage is performed in emergency. If needed the urological treatment of the urinary stone is performed secondarily according to the French recommendations. A metabolic evaluation and dietary survey are required for each patient to identify and avoid the risk of recurrence. Some stone formers or complex patients must be followed in nephrology.
尿路结石的诊断情况各不相同。对于急性或严重症状，医疗管理可在紧急情况下进行，也可延迟进行。肾绞痛是最典型的临床症状。紧急止痛治疗方法已很成熟。在疼痛得到缓解后，放射学检查（腹部平片和超声）可辅以腹部计算机断层扫描，这是诊断尿路结石及其影响的最佳检查方法。在复杂病例中，需紧急进行泌尿外科引流。如有必要，可根据法国的建议，在后续进行尿路结石的泌尿外科治疗。每位患者都需要进行代谢评估和饮食调查，以识别并避免复发风险。一些结石形成者或复杂患者必须接受肾病科的随访。
