Frank S H, Resnick M I
Department of Family Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio.
Prim Care. 1989 Dec;16(4):967-80.
Urolithiasis is a common, multifactorial, medically manageable disease. Primary care physicians can play a prominent role in metabolic evaluation and medical treatment of patients with urolithiasis. Patients should be referred for urologic evaluation in the presence of intractable urinary tract infection, progressive renal damage, urinary obstruction, refractory pain, or presence of stones of uncertain etiology. Expectant management of symptomatic ureteral stones can be undertaken by a primary care physician in conjunction with urologic support. Interventional treatment of urinary stones has improved markedly with the availability of extracorporeal shock-wave lithotripsy, and percutaneous stone removal. In patients with certain types of urinary stones, medical treatment can greatly reduce the incidence of subsequent stone-forming episodes.
尿石症是一种常见的、多因素的、可通过医学手段控制的疾病。初级保健医生在尿石症患者的代谢评估和医学治疗中可发挥重要作用。当患者出现难治性尿路感染、进行性肾损害、尿路梗阻、顽固性疼痛或病因不明的结石时，应转诊至泌尿外科进行评估。初级保健医生可在泌尿外科支持下，对有症状的输尿管结石进行期待治疗。随着体外冲击波碎石术和经皮取石术的出现，尿路结石的介入治疗有了显著改善。对于某些类型的尿路结石患者，药物治疗可大大降低随后结石形成发作的发生率。
