Are small ureteral stones have a big impact?
Aunt Liu, 57, suddenly fell critically ill, but thanks to the timely rescue of a urologist, she was able to successfully save her from the "God of Death". However, Aunt Liu and her family never expected that what almost killed her was a small ureteral stone.
A few days ago, Aunt Liu, who lives in a small mountain village, suddenly appeared cold, afraid of cold, trembling, at home a measure of body temperature, there is 39.3 ° C, thought it was a cold and flu, so at home took cefixime and antipyretic drugs, sweating, Aunt Liu's body temperature returned to normal, did not attract attention.
Who knew that the next day, Aunt Liu was woken up by pain, not only did she have symptoms of fever and fear of cold again, but also the pain in her left waist was severe, and the whole person was groggy, lying on the bed and did not want to get up. She quickly called her son, and then her family drove her to the local municipal people's hospital for treatment.
After arriving at the hospital, a body temperature has reached 40 ° C! Doctors immediately hospitalized her and measured systolic blood pressure < 90 mmHg. The auxiliary examination suggested that Aunt Liu's white blood cells and neutrophils were significantly elevated, and the color ultrasound examination showed that her left kidney had severe hydrops, accompanied by kidney and ureteral stones. The stone gets stuck in the lower section of the left ureter, eventually causing sepsis with septic shock!
Source: Tencent Medical Dictionary Medical Illustration
How do ureteral stones occur?
Urinary stones are one of the common diseases and multiple diseases in urology, and kidney stones are one of the most common. Ureteral stones, on the other hand, are overwhelmingly "passing" the ureter when the kidney stones are discharged, just stuck in the narrow area.
The formation of urinary stones is related to the following reasons:
The physicochemical properties of human urine change, the concentration of crystalline substances in the urine is normal, but the physical and chemical properties of urine change, which can promote the formation of urinary stones; the physical and chemical properties of human urine change, and the concentration of crystal substances in the urine is too high to cause urine saturation, which is the most important reason for the formation of urinary stones;
Decreased urine output: increased concentrations of salts and organic substances;
Stones in the absence of blocked patients' ureters, mostly do not cause waist pain and discomfort, even if the ureteral stones block the ureters caused by hydronephrosis, many times it is also a slow progression process, the human body will gradually adapt to this process, there will be no severe pain attacks.
The concentration of crystal substances in the human urine increases, resulting in increased crystal excretion in the body and increased concentration of urine crystals.
Image source: Stand Cool Helo
Why is a small stone with such serious consequences?
In the beginning of Aunt Liu's story, the main problem is that her ureteral stones caused obstruction of the upper urinary tract, and the urine could not be effectively and timely discharged, resulting in hydrops in the left kidney.
Moreover, as hydronephrosis becomes more and more serious, kidney function is also seriously impaired, and metabolites in the body are difficult to excrete through the kidneys, causing bacterial infections.
Coupled with The fact that Aunt Liu suffers from coronary heart disease and diabetes, her own resistance is poor, and she is prone to urinary tract infections. Elderly patients, on the other hand, are generally indifferent to their response to the disease and always want to drag it out.
But delaying treatment is undoubtedly very dangerous, and over time, it aggravates the inflammatory response of the whole body, triggers septic shock, and leads to urinary sepsis, which can be life-threatening at any time.
Finally, the doctor uses a ureteroscope for intubation drainage, which drains the pus from the body, completely removes toxins from the body, and removes the stones. Aunt Liu finally passed the critical period of illness and has now been discharged from the hospital for recuperation at home.
Statistics show that the case fatality rate of sepsis is still as high as 30% to 70%[1], of which sepsis caused by urinary stones accounts for about 25%. Therefore, everyone must not underestimate the small urinary tract stone, which will also endanger life if it is serious.
What should I do if I get a stone?
Here also remind everyone, we must pay attention to the daily health examination, once the urinary stones are found, scientific and active treatment should be carried out, according to the requirements of professional doctors to regularly review the urinary ultrasound. If there is severe pain in the waist, accompanied by nausea, vomiting and other symptoms, be sure to go to the hospital immediately, the doctor will first prescribe painkillers for antispasmodic and analgesic treatment.
Regardless of the composition of the urinary stones, as long as they are smooth stones less than 0.4 cm in diameter, most of them can be excreted on their own.
Stones with a diameter of 0.4 to 0 .6cm, or individual stones up to 1.0 cm, if the surface is smooth, there is no symptom of hydronephrosis or urinary tract infection, can use drug stone removal therapy, clinically often choose potassium bisc citrate sodium granules and antispasmodic analgesic drugs to expand the ureter, and then through a large amount of drinking water, regular urination, it is possible to excrete the stone out of the body.
At the same time, you can also try jump rope exercises, with the body up and down frequent vibrations, ureteral stones may slowly come out along the ureter.
So, what are the conditions in which ureteral stones require surgery?
It is generally believed that stones with a diameter greater than 1.0 cm have less chance of discharging stones on their own, especially the common oxalic acid stones, which are difficult to discharge due to the surface is not smooth. Surgery should be considered if the stone-induced obstruction affects kidney function, or if non-surgical treatment is ineffective.
Regarding the prevention of urinary stones, it is recommended to drink more water in daily life, go to the toilet on time, urinate regularly, ensure that the urine output is more than 2500ml per day, and avoid overeating.
Different ingredients of stones, dietary prevention methods are also different.
Uric acid stones should be treated on a low purine diet in life, and cystine stones should be treated on a low methionine diet in life.
Fruits and vegetables can make the urine more alkaline, which is better to prevent uric acid and cystine stones.
Foods such as beef and lamb make urine acidic and are better at preventing infection.
For oxalic acid stones, it is necessary to eat as little food rich in oxalic acid as possible, such as cabbage, bamboo shoots, spinach and other vegetables.
bibliography:
[1] Yao Yongming, Sheng Zhiyong. Sepsis prevention and treatment. Science and Technology Literature Press, 2008
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