Brief introduction of urinary calculi

Directory 1 Pinyin 2 Overview 3 kidney calculi 4 Ureteral Calculi 5 Bladder Calculi 6 Urethral Calculi 7 Precautions 1 Pinyin mü nià o Dà o Jieshí

2 Overview Urinary calculi are the most common diseases in the urinary system. X-ray plain film can often show the shadow of stones, and its development speed varies with the chemical composition, structure and size of stones. As far as X-ray density is concerned, it is assumed that the density of water is 1 and that of calcium phosphate is 22.0; Calcium carbonate15.0; Calcium oxalate10.3; Magnesium ammonium phosphate 4.1; Cystine 3.7; Uric acid salt1.38; Xanthine 1.2. According to statistics, calcium oxalate stones account for more than 1/3 of all stones in the urinary system, and their density is quite deep, with prickly edges; Stones mixed with calcium oxalate and apatite also account for about 1/3. Uric acid and cystine stones are light in density and generally smooth in outline. Deerhorn stone is a stone containing phosphoric acid and carbonate. In order to improve the development rate of stones, it is necessary to make preparations for intestinal cleaning. For small and suspicious stones, especially stones located in the renal area, tomographic scanning can be used as an auxiliary examination method. Plain film observation should include the location, quantity, size and shape of stones. Urography is an important method to diagnose stones and the changes of urinary tract morphology and function caused by them. At present, there is a special X-ray machine for renal radiography in surgery, and its special X-ray tube can be directly placed on the surface of the kidney, which can display stones with a diameter less than1mm.

Men are more common than women in kidney calculi, especially in the 20-50 age group. Most stones are located on one side or inferior calyx of renal pelvis, or on both sides. X-ray plain film shows that there are one or more circular, oval, staghorn or amorphous stone shadows (X-ray film 123) in the renal pelvis and calyceal region, which can show uniform, layered or granular structural shadows due to different components. In lateral photos, kidney calculi often overlaps with vertebral body. At the onset of symptoms, plain films often show that there is a reflective depression in the intestine adjacent to the diseased kidney area, and the spine bends slightly to the affected side. Hydronephrosis can increase the shadow of the kidney. During urography, the exposure conditions should be properly strengthened, so that the positive stones are not covered by the contrast agent, and the negative stones can be displayed as the defect areas with smooth inner edges of renal pelvis and renal calices. Urography can also show other pathological changes caused by stones, such as dilatation of renal pelvis and calyx caused by stone obstruction, and delayed development of renal pelvis and calyx suggests changes in renal secretion and excretion function. Urography is very helpful for the diagnosis of renal pelvis and calices stones, especially negative stones. Kidney calculi should be differentiated from gallbladder, pancreatic calculus, calcified costal cartilage and calcification of abdominal lymph nodes, which can be differentiated by location, shape, lateral photos and cholecystography.

Ureteral stones often migrate from kidney calculi, generally smaller, mostly on the right side. On the X-ray plain film, circular (usually stones fall from the kidney for a short time), oval, mulberry-shaped or jujube-red stone shadows can be seen, and their long axes are consistent with the ureter, which is located on the ureter beside the spine, and often occurs in the junction of ureteropelvic junction, the junction of ureter and iliac artery and the physiological narrow area at the entrance of ureter and bladder. During the attack, the plain film can show that the intestine is reflexively relaxed and the spine bends to the affected side. Intravenous urography can have different manifestations according to the location and duration of stones: stones are located at the junction of renal pelvis and ureter, mainly characterized by increased hydronephrosis and little change in renal calices; When the stone is at the lower end of ureter, it mainly shows that the calyx and cup of each small kidney are flattened, blunted and expanded, but the renal pelvis is not expanded obviously; If the stone is located in the middle of ureter, the renal pelvis and calyx have considerable changes. The ureter near the stone may have an irregular contour, which is caused by localized spasm. If the course of disease is long, the renal cortex will become thinner, atrophy and function decline due to back pressure, while the renal pelvis, renal calyx and ureter can generally expand. In retrograde pyelography, catheters and contrast media are often blocked in the ureter where stones are located.

Bladder stones are more common in male children. Most stones are positive, located above pubic symphysis in the middle and lower part of pelvis. Some have uniform density, some have different density, some have transparent core and layered periphery, and transparent and opaque alternate. Their cross-sectional shapes are like annual rings, oval or round, with smooth edges or as rough and sharp as mulberries. The number is generally one, and the position of the stone can move with * * * *. If the stone is embedded in the bladder diverticulum or ureter and enters the bladder, the stone shadow is fixed on one side of the renal pelvis, which can be dumbbell-shaped or conical. The diagnosis of rare negative stones often requires radiography to show the corresponding signs of filling defect (X-ray film 124).

Urethral calculi are often caused by stones falling into the urethra in the bladder and easily stopping in the navicular fossa, cavernous body and posterior urethra. Positive stone plain film shows circular or oval stone shadow with increased density in urethral area. Children's axial projection can also have a circular shadow with increased density at the pubic symphysis, which should not be mistaken for stones. Negative stones must be made urethrography, showing cup-shaped, round or oval defect shadows.

7 preventive measures