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尿石症:历史、流行病学、病因学因素及处理。

Urolithiasis: History, epidemiology, aetiologic factors and management.

机构信息

Higher Institute of Nursing Professions and Health Techniques, Fez 30000, Morocco.

Euromed research center, Euromed faculty of medicine, Euromed University of Fes (UEMF), 30 030, Meknes Road, Campus UEMF, BP51, Fez, Morocco.

出版信息

Malays J Pathol. 2023 Dec;45(3):333-352.

Abstract

Urolithiasis is defined as a disease diagnosed by the presence of one or more stones in the urinary tract. It is one of the oldest and most widespread diseases known to man, their discovery and characterisation chronology began with the civilisation's history. This pathology has a multifactorial aetiology, very frequent worldwide with geographic and racial variation, their prevalence is increasing in lockstep with socioeconomic development. In fact, this disorder affects between 2 and 20% of the population, with an approximate recurrence rate of 30% to 50% in 5 years. Furthermore, calciumtype stones, which are composed of calcium oxalate (CaOx) alone or a mixture of CaOx and calcium phosphate are the most common, accounting for more than 80% of cases. The medical management of urolithiasis is done by medical treatments and/or by surgical intervention for the stones extraction by the techniques such as extracorporeal shock wave lithotripsy (ESWL), ureteroscopy (URS), percutaneous nephrolithotomy (PCNL) and open surgery. However, various therapies, including thiazide diuretics and alkaline citrate, are used in an attempt to prevent stones recurrence induced by hypercalciuria and hyperoxaluria, but the scientific evidence for their effectiveness is less convincing. On the other hand, endoscopic and ESWL methods have revolutionised the treatment of urinary lithiasis, but these costly methods, can cause acute kidney injury and decreased renal function, in addition, do not prevent the probability of new stone formation. The deepening of our knowledge on all points relating to this disease is a priority for specialists in order to find adequate solutions for this disease. This review provides an overview of urolithiasis, its history, epidemiology, clinical manifestation, diagnosis and treatment methods.

摘要

尿石症定义为一种在尿路中存在一个或多个结石的疾病。它是人类已知的最古老和最广泛的疾病之一,其发现和特征的历史可以追溯到文明的历史。这种病理学具有多因素的病因,在全球范围内非常普遍,存在地域和种族差异,其患病率随着社会经济的发展而同步增长。事实上,这种疾病影响了 2%到 20%的人口,大约 5 年内复发率为 30%到 50%。此外,钙型结石,由草酸钙(CaOx)单独或 CaOx 和磷酸钙的混合物组成,是最常见的,占病例的 80%以上。尿石症的医学治疗是通过医疗治疗和/或手术干预来进行的,通过体外冲击波碎石术(ESWL)、输尿管镜检查(URS)、经皮肾镜取石术(PCNL)和开放性手术来提取结石。然而,为了预防高钙尿症和高草酸尿症引起的结石复发,各种治疗方法,包括噻嗪类利尿剂和碱性枸橼酸盐,都被用于尝试,但它们的有效性的科学证据不太令人信服。另一方面,内镜和 ESWL 方法彻底改变了尿石症的治疗,但这些昂贵的方法会导致急性肾损伤和肾功能下降,此外,它们并不能预防新结石形成的概率。加深我们对这种疾病的所有方面的了解是专家们的首要任务,以便为这种疾病找到适当的解决方案。本综述概述了尿石症的历史、流行病学、临床表现、诊断和治疗方法。

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