26歲猛男小光「漢草」很好,身高170公分、體重近百公斤,他說自己從來不喝水,只喝市面風行的手搖杯茶飲料,而且都是「正常甜」!真到最近因腰痛、全身冒冷汗而送急診,經超音波檢查發現有顆腎結石阻塞在輸尿管,緊急以輸尿管鏡打碎並取出大約0.7公分的石頭,才鬆了一口氣。

45歲上班族張先生平常就不愛喝水,在辦公室裡久坐處理公務,曾經發生輸尿管結石,治療後並未追蹤。日前因為腰痛、血尿而就醫,檢查後發現不但輸尿管 有一顆直徑2公分大的結石,並且因為工作繁忙、忍太久未就醫,腎臟有嚴重積水的現象,腎功能也變差,經進行輸尿管鏡碎石術治療,還在持續追蹤中。

高雄阮綜合泌尿科醫師陳育典表示,一般出現腎結石與飲食、體質有關,因為太鹹或太甜的飲食,都可能讓尿液中的鈣離子沈澱造成結石。結石若在膀胱,解尿會有阻礙、斷斷續續的症狀,尿一下突然停止、過陣子又可以繼續尿,或是小便速度變慢,膀胱結石無法做體外震波,只能做膀胱鏡碎石手術.

若是尿道結石則會完全尿不出來,或是小便滴滴答答,尿道感覺疼痛,摸到可能還有異物感,尿道結石使用內視鏡從尿道口進入將石頭夾出來;若是輸尿管結石,則會出現明顯劇烈疼痛,甚而伴隨產生血尿,輸尿管結石可考慮體外震波、輸尿管鏡碎石手術,安全性都很高。

陳育典說,腎臟內結石則不一定會引發症狀,但會因為反覆感染而導致腰部疼痛,腎結石若是造成輸尿管阻塞甚或腎積水,可能出現發燒、噁心、嘔吐和腰痛等症狀。一般腎結石小於0.5公分,多喝水有一半機率會自己排出,0.6公分以上的石頭若造成症狀或腎水腫,醫師會建議用無侵入性、較安全的體外震波將結石擊碎後排出,如果結石過大、超過2公分,體外震波可能無法處理,這時就需借助外科手術經皮腎造口手術,透過腎臟鏡進入腎臟將腎臟內石頭打碎,再從造口取出來。

有些人以為多喝啤酒可以將泌尿道結石沖出體外,陳育典說,事實上只是增加排尿量以利石頭排出而已,反倒是啤酒屬於小麥製品,含有草酸成分,攝取過多容易引發草酸鈣結石,造成了反效果,茶葉、可樂也都含有草酸。不論哪種飲料都忌諱過量、過鹹或甜,基本上還是要多喝白開水,尿液經過稀釋而不濃縮,就可以避免泌尿道結石。

每人每天要喝多少水才夠?陳育典表示,可以根據體重,每公斤每天需水約30至40cc,以一個60公斤的成年人來算,一天必需要喝水2000cc左右。第二,從尿液顏色也可判斷:顏色太深、口渴,都表示身體水分不足,導致尿液濃縮。

The 26-year-old macho Xiaoguang "Hancao" is very good. He is 170 centimeters tall and weighs nearly 100 kilograms. He said that he never drinks water, only drinks the hand-cranked cup of tea drink that is popular in the market, and they are all "normal sweet"! I was recently sent to the emergency department because of low back pain and cold sweat. After the ultrasound examination, I found a kidney stone blocked in the ureter. I was smashed with a ureteroscope and took out a stone of about 0.7 cm. I was relieved.

Mr. Zhang, a 45-year-old office worker, usually does not like to drink water. He has been sitting in the office for a long time to handle official duties. He has had ureteral stones and has not been followed after treatment. Recently, I was treated for low back pain and hematuria. After the examination, I found that not only the ureter has a stone with a diameter of 2 cm, but also because of the busy work, long-term treatment, the kidney has severe water accumulation, the kidney function is also worse, and the ureteroscope is broken. Stone surgery is still being tracked.

Kaohsiung's comprehensive urologist Chen Yudian said that kidney stones are generally associated with diet and constitution. Because a salty or too sweet diet may cause calcium ions in the urine to precipitate stones. If the stone is in the bladder, the urine will have obstruction and intermittent symptoms. The urine will suddenly stop, and the urine can continue to continue after a while, or the urinary speed will slow down. The bladder stones can not be used for extracorporeal shock waves, and only cystoscopic lithotripsy can be performed.

If it is a urethral stone, it will not be completely urinary, or the urination will answer, the urethra will feel pain, and there may be a foreign body sensation. The urethra stones will be inserted from the urethral opening with an endoscope; if it is a ureteral stone, Significant severe pain, even accompanied by hematuria, ureteral stones can be considered extracorporeal shock wave, ureteroscopic lithotripsy surgery, safety is very high.

Chen Yudian said that stones in the kidneys may not cause symptoms, but may cause pain in the lower back due to repeated infections. If the kidney stones cause ureteral obstruction or even hydronephrosis, symptoms such as fever, nausea, vomiting and low back pain may occur. Generally, the kidney stones are less than 0.5 cm. If you drink more than half of the water, you will be discharged by yourself. If the stones above 0.6 cm cause symptoms or kidney edema, the doctor will recommend that the stones be crushed and discharged after non-invasive and safe extracorporeal shock waves. If the stone is too large and exceeds 2 cm, the extracorporeal shock wave may not be able to be treated. At this time, surgical percutaneous nephrostomy should be performed. The kidney is broken into the kidney thrlaennecough the kidney mirror, and then the stone is broken from the stoma.

Some people think that drinking beer can urinate the urinary tract stones. Chen Yudian said that in fact, it only increases the amount of urine to facilitate the discharge of stones. On the contrary, beer belongs to wheat products and contains oxalic acid. If it is too much, it will cause calcium oxalate stones. The counter effect is that tea and cola also contain oxalic acid. No matter which kind of beverage is too much, too salty or sweet, basically drink more boiled water, and the urine can be diluted without concentration to avoid urinary calculi.

How much water do you need to drink per person per day? According to Chen Yudian, according to the weight, about 30 to 40 cc of water per kilogram per day is required. According to a 60 kilogram adult, it is necessary to drink about 2000 cc a day. Second, it can also be judged from the color of urine: the color is too deep and thirsty, which means that the body is insufficient in water, resulting in concentration of urine.

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