Pohaku hakuʻala

ʻO kahi pōhaku kīhāpai kahi pauma paʻa i hana ʻia i nā aniani liʻiliʻi. Hoʻokahi a ʻoi paha nā pōhaku i loko o ka puʻupaʻa a i ʻole ka ureter i ka manawa like.

Kūleʻa nā pōhaku hakuʻala. Holo kekahi ʻano i loko o nā ʻohana. Kū pinepine lākou i nā pēpē pēpē.

Aia he mau ʻano pōhaku ʻokoʻa. Aia ke kumu o ka pilikia i ka ʻano pōhaku.

Hiki i nā pōhaku ke hana i ka wā he nui ka nui o kekahi mau mea i hana i nā crystals. Hiki i kēia mau kristal ke hoʻomōhala i mau pōhaku i mau pule a i ʻole mau mahina.

• ʻO nā pōhaku kalipuna ka mea maʻamau. Kūpono ʻia lākou i nā kāne ma waena o 20 a 30 mau makahiki. Hiki i ka calcium ke hui pū me nā mea ʻē aʻe e hana i ka pōhaku.
• ʻOʻOxalate ka mea maʻamau o kēia. Aia ʻo Oxalate i kekahi mau meaʻai e like me ka milo. Loaʻa iā ia i loko o nā huaora C. ʻO nā maʻi o ka ʻōpū liʻiliʻi e hoʻonui i kou makaʻu no kēia mau pōhaku.

Hiki i nā pōhaku kalipuna ke hana mai ka hui pū ʻana me phosphate a i ʻole carbonate.

ʻO nā ʻano pōhaku ʻē aʻe:

• Hiki i nā pōhaku Cystine ke hana i nā kānaka i loaʻa ka cystinuria. Holo kēia maʻi i loko o nā ʻohana. Hoʻopili ia i nā kāne a me nā wahine.
• Loaʻa nā pōhaku Struvite i nā kāne a wahine paha i hana hou i nā maʻi urinary tract. Hiki i kēia mau pōhaku ke ulu nui loa a hiki ke ālai i ka hakuʻala, ureter, a i ʻole ka ʻaʻa.
• ʻOi aku ka nui o nā pōhaku acid acid i nā kāne ma mua o ka wahine. Hiki iā lākou ke hana me ka gout a me chemotherapy.
• ʻO nā mea ʻē aʻe, e like me kekahi mau lāʻau, hiki ke hana i nā pōhaku.

ʻO ka mea nui weliweli no nā pōhaku kōkō ʻaʻole inu i ka wai i lawa. ʻOi aku paha nā pōhaku hakuʻala inā hana ʻoe ma lalo o 1 lita (32 auneke) o ka mimi i ka lā.

ʻAʻole paha ʻoe e loaʻa ana i nā ʻōuli a hiki i ka neʻe ʻana o nā pōhaku i lalo o nā paipu (ureter) ma o kahi e hemo ai ka mimi i loko o kāu pākeke. Ke hiki kēia, hiki i nā pōhaku ke pale i ke kahe o ka mimi mai nā puʻupaʻa.

ʻO ka hōʻailona nui ka ʻehaʻeha loa e hoʻomaka a kū koke:

• ʻIke ʻia paha ka ʻeha ma ka ʻōpū a i ʻole ka ʻaoʻao o ke kua.
• Hiki ke neʻe i ka ʻeha i ka ʻehaʻeha (ʻeha ʻeha), testicle (ʻeha testicle) i nā kāne, a me labia (ʻehaʻeha) i nā wahine.

Hiki i nā ʻōuli ʻē aʻe ke hoʻopili pū me:

• Waihona mimi maʻamau
• Koko i ka mimi
• ʻO Chills
• Fiva
• ʻO Nusea a me ka luaʻi

E hana ka mea mālama ola i kahi hoʻokolohua kino. ʻIke paha ka ʻeha o ka ʻōpū (ʻōpū) a i hope paha.

ʻO nā hoʻāʻo e hana ʻia ana paha:

• Nā hoʻokolohua koko e nānā i ka pae o ka calcium, phosphorus, uric acid, a me nā pae electrolyte
• Nā hoʻāʻo hana hakuʻala
• ʻIke ʻo Urinalysis e ʻike i nā aniani a nānā i nā hunaola ʻulaʻula i ka mimi
• Ka hoʻokolokolo ʻana i ka pōhaku e hoʻoholo i ke ʻano

Hiki ke ʻike ʻia nā pōhaku a i ʻole ke ālai ʻana ma:

• Scanner CT ʻōpū
• ʻO nā kukuna x ʻōpū
• ʻO ka pyelogram Intravenous (IVP)
• Pākuʻi ultrasound
• Retrograde pyelogram

Pili ka mālama ʻana i ke ʻano o ka pōhaku a me ke koʻikoʻi o kāu mau ʻōuli.

ʻO nā pōhaku hakuʻala liʻiliʻi e hele pinepine ma waena o kāu ʻōnaehana iā lākou iho.

• Pono e kānana i kou mimi i hiki ai i ka pōhaku ke mālama a hoʻāʻo.
• Inu ma kahi o 6 a 8 mau aniani o ka wai i kēlā lā i kēia lā e hana i ka mimi he nui. E kōkua kēia i ka pōhaku e hala.
• Hiki i ka ʻeha ke hōʻino loa. ʻO nā lāʻau ʻeha o over-the-counter (e laʻa me, ibuprofen a me naproxen), hoʻokahi a i ʻole pū me nā narcotics, hiki ke lilo i maikaʻi loa.

Pono kekahi poʻe me ka ʻehaʻeha loa mai nā pōhaku konohiki e noho i ka haukapila. Pono ʻoe e kiʻi i nā wai ma o ka IV i loko o kou aa koko.

No kekahi ʻano pōhaku, hiki i kāu mea hāʻawi ke kuhikuhi i ka lāʻau e pale ai i nā pōhaku mai ke kūkulu ʻana a i ʻole kōkua kōkua i ka wāwahi a wehe i nā mea e hoʻomaka ai ka pōhaku. Hiki i kēia mau lāʻau ke komo pū:

• Allopurinol (no nā pōhaku uric acid)
• Nā Antibiotics (no nā pōhaku struvite)
• Diuretics (wai huaale)
• Nā hāʻina phosphate
• ʻO Sodium bicarbonate a i ʻole sodium citrate
• Pila wai (thiazide diuretics)
• Tamsulosin e hoʻomaha ai i ka ureter a kōkua i ka pōhaku e hele

Pono pono ke ʻoki kino inā:

• ʻOi aku ka nui o ka pōhaku i ka hala iā ia iho.
• Ke ulu nei ka pōhaku.
• Ke ālai nei ka pōhaku i ke kahe o ka mimi a hana i kahi maʻi a i ʻole nā ​​ʻino puʻuwai.
• ʻAʻole hiki ke kāohi i ka ʻeha.

I kēia lā, ʻoi aku ka nui o nā lāʻau lapaʻau ma mua o ka wā i hala.

• Hoʻohana ʻia ʻo Lithotripsy e hemo i nā pōhaku i ʻoi iki aʻe ma mua o hoʻokahi hapalua ʻīniha (1.25 kenimika) i loaʻa i ka puʻuwai a i ʻole ka ureter. Hoʻohana ia i nā nalu kani a haʻalulu paha e haki i nā pōhaku i mau ʻāpana liʻiliʻi. A laila, waiho nā ʻāpana pōhaku i ke kino i ka mimi. Kapa ʻia ia he lithotripsy shock-gelombang extracorporeal a i ʻole ESWL.
• Hana ʻia nā hana ma o ka hala ʻana i kahi mea hana kūikawā ma o kahi ʻoki ʻoki liʻiliʻi i kou ʻili ma kou kua a i loko o kou puʻupaʻa a i ʻole nā ​​ureter e hoʻohana ʻia no nā pōhaku nunui, a i ʻole ke hana hewa ʻia nā puʻupaʻa a me nā wahi e pili ana. Lawe ʻia ka pōhaku me kahi paipu (endoscope).
• Hiki ke hoʻohana ʻia ka Ureteroscopy no nā pōhaku i ke kaha urinary lalo. Hoʻohana ʻia kahi kukuna e haki ai ka pōhaku.
• Kākaʻikahi loa, pono ke kīpoki hāmama (nephrolithotomy) inā ʻaʻole holo pono nā ʻano ʻē aʻe a i ʻole hiki ʻole.

E kamaʻilio i kāu mea hoʻolako e pili ana i nā koho e hana ai iā ʻoe.

Pono ʻoe e hana i nā kaʻi mālama pilikino. ʻO nā ʻanuʻu hea ʻoe e hilinaʻi ai i ke ʻano o ka pōhaku i loaʻa iā ʻoe, akā hiki ke hoʻopili ʻia:

• Ke inu nei i ka wai keu a me nā wai ʻē aʻe
• ʻO ka ʻai ʻana i kekahi mau meaʻai aʻe a ʻoki ʻana i nā meaʻai ʻē aʻe
• Lawe i nā lāʻau e kōkua i ka pale ʻana i nā pōhaku
• Lawe i nā lāʻau e kōkua iā ʻoe e hele i kahi pōhaku (nā lāʻau anti-inflammatory, alpha-blockers)

He ʻeha nā pōhaku hakuʻala, akā hiki i ka hapanui o ka manawa ke hemo mai ke kino me ka ʻole o ka poino mau loa.

Hoʻi pinepine nā pōhaku hakuʻala. Kū pinepine kēia inā ʻaʻole i loaʻa ke kumu a mālama ʻia.

Ua makaʻu ʻoe no:

• Maʻi ʻaʻai Urinary
• ʻO ka hōʻino ʻana o ka hakuʻala a i ʻole ka scarring inā hoʻolohi ʻia ka lāʻau no ka lōʻihi loa

Komo pū ka hoʻopiʻi ʻana i nā pōhaku hakuʻala i ka ālai ʻana o ka ureter (uropathy obstructive unilateral ākea).

Kāhea i kāu mea hāʻawi inā loaʻa iā ʻoe nā ʻōuli o ka pōhaku hakuʻala:

• ʻEha ʻeha ma kou kua a ʻaoʻao paha ʻaʻole e hele
• Koko i kou mimi
• Fiva a me nā anuanu
• ʻO ka luaʻi
• Urine ʻaʻala a ʻino ke nānā ʻana
• ʻO ke ahi wela ke ʻihi ʻoe

Inā ua ʻike ʻia ʻoe me ka poloka mai kahi pōhaku mai, pono e hoʻokūpaʻa ʻia kahi ala e ka hopu ʻana i kahi kānana i ka wā o ka urination a i ʻole ka x-ray ukali. ʻAʻole hōʻoia i ka ʻehaʻeha ʻana ua hala ka pōhaku.

Inā loaʻa iā ʻoe kahi moʻolelo o nā pōhaku.

• E inu i ka nui o nā wai (6 a 8 mau aniani o ka wai i kēlā me kēia lā) e hana i ka mimi lawa.
• Pono ʻoe e ʻai i ka lāʻau a hoʻololi paha i kāu papaʻai no kekahi ʻano pōhaku.
• Makemake paha kāu mea e hana i nā hoʻokolohua koko a me ka mimi e kōkua ai i ka hoʻoholo ʻana i nā kaʻi pale pono.

Kaʻauli pūhala; Neprolithiasis; Pohaku - hakuʻala; Calcium oxalate - pōhaku; Cystine - pōhaku; Struvite - pōhaku; Uric acid - pōhaku; Lithiasis mimi

• Hypercalcemia - hoʻokuʻu
• Nā pōhaku hakuʻala a me ka lithotripsy - hoʻokuʻu
• Nā pōhaku hakuʻala - mālama pono iā ʻoe iho
• Nā pōhaku hakuʻala - he aha e nīnau aku ai i kāu kauka
• Nā hanana urinary Percutaneous - hoʻokuʻu

• Anatomia hakuʻala
• ʻO Kidney - ke kahe o ke koko a me ka mimi
• Neikolithiasis
• ʻO ka pyelogram Intravenous (IVP)
• Nā kaʻina hana Lithotripsy

Pūnaewele ʻAmelika Urological ʻAmelika. Ka mālama olakino o nā pōhaku hakuʻala (2019). www.auanet.org/guidelines/kidney-stones-medical-mangement-guideline. Loaʻa iā Feb 13, 2020.

Pūnaewele ʻAmelika Urological ʻAmelika. ʻO ka hoʻokalakupua ʻōpala: AUA / Endourology Society guideline (2016) www.auanet.org/guidelines/kidney-stones-surgical-management-guideline. Loaʻa iā Feb 13, 2020.

Bushinsky DA. Neikolithiasis. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 26th ed. Piladelapia, PA: Elsevier; 2020: chap 117.

Fink HA, Wilt TJ, Eidman KE, et al. Nā nephrolithiasis hou i nā mākua: ka hoʻohālikelike i ka hopena o nā hoʻolālā olakino pale. ʻO Rockville, MD. ʻOihana no ka ʻimi noiʻi ola kino a me ka maikaʻi (US) 2012; Hōʻike Helu 12:12-EHC049-EF. PMID: 22896859 pubmed.ncbi.nlm.nih.gov/22896859/.

Miller NL, Borofsky MS. Ka loiloi a me ka hoʻokele olakino o urinary lithiasis. I: Partin AW, Dmochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Piladelapia, PA: Elsevier; 2021: chap 92.

Qaseem A, Dallas P, Forciea MA, Starkey M, Denberg TD; ʻO ke Kōmike Alakaʻi Clinical o ke Kulanui ʻAmelika o nā Kauka. ʻO ka mālama ʻana i ka meaʻai a me ka lāʻau pharmacologic e pale aku ai i nā nephrolithiasis hou i nā mākua: kahi kulekele hana lāʻau lapaʻau mai ke Kulanui ʻAmelika o nā Kauka. ʻO Ann Intern Med. 2014; 161 (9): 659-667. PMID: 25364887 pubmed.ncbi.nlm.nih.gov/25364887/.

Ziemba JB, Matlaga BR. Kuhikuhikuhi o nā alakaʻi: nā pōhaku hakuʻala. ʻO BJU Int. 2015; 116 (2): 184-189. PMID: 25684222. pubmed.ncbi.nlm.nih.gov/25684222/.