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肾结石是如何炼成的 – 译学馆
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肾结石是如何炼成的

What causes kidney stones? - Arash Shadman

最大的肾结石 在记录中
The biggest kidney stone on record
重量超过一公斤
weighed more than a kilogram
直径达到17厘米
and was 17 centimeters in diameter.
这并不是说 患者就真正吞下了
The patient didn’t actually swallow
椰子大小的结石
a stone the size of a coconut.
肾结石 尽管 是身体内部形成的
Kidney stones form inside the body,
但是 发作起来 却让患者痛苦不已
but unfortunately, they’re extremely painful to get out.
肾结石 是一种坚硬的结晶体
A kidney stone is a hard mass of crystals
形成于肾脏
that can form in the kidneys,
尿管
ureters,
膀胱
bladder,
尿道
or urethra.
尿液富含一些
Urine contains compounds
由钙
that consist of calcium,

sodium,

potassium,
草酸
oxalate,
尿酸
uric acid,
以及 磷酸盐组成的化合物
and phosphate.
如果 这些分子 浓度过高
If the levels of these particles get too high,
或者说 如果 尿液太过偏酸或偏碱
or if urine becomes too acidic or basic,
这些粒子 会彼此聚集 继而结晶
the particles can clump together and crystallize.
这个问题 如果不设法解决
Unless the problem is addressed,
这些结晶 就会历时几周 几个月 甚至几年 逐步变大
the crystals will gradually grow over a few weeks, months, or even years,
继而 形成可见的结石
forming a detectable stone.
这种方式形成的结晶类型中 草酸钙最为普遍
Calcium oxalate is the most common type of crystal to form in this way,
大概占到肾结石的80%
and accounts for about 80% of kidney stones.
而 磷酸钙和尿酸 形成的肾结石 则没有那么常见
Less common kidney stones are made of calcium phosphate, or uric acid.
而 矿物磷酸氨镁 形成的结石 则略有不同
A slightly different type of stone made of minerals magnesium ammonium phosphate, or struvite,
其则是由细菌感染所致
can be caused by bacterial infection.
类型更加少见的结石
And even rarer stones can result
是由遗传病 或者 某些药物 导致的
from genetic disorders or certain medications.
肾结石 在开始移动后 才能有所察觉
A kidney stone can go undetected until it starts to move.
结石穿过肾脏
When a stone travels through the kidney and
进入输尿管
into the ureter,
其锋利的边缘 会将泌尿系统管壁刮伤
its sharp edges scratch the walls of the urinary tract.
管壁的神经末梢 将极其疼痛的信号 通过神经系统传递开来
Nerve endings embedded in this tissue transmit excruciating pain signals through the nervous system.
管壁的刮伤处也会出血
And the scratches can send blood
渗入到尿液中
flowing into the urine.
这一过程 会伴随着一些症状
This can be accompanied by symptoms of
比如 恶心 呕吐
nausea, vomiting,
排尿时的灼烧感
and a burning sensation while urinating.
结石如果体积够大
If a stone gets big enough
足以阻塞尿液排出
to actually block the flow of urine,
这种情况会引发 细菌感染 尿液回流
it can create an infection, or back flow,
也会损害肾脏本身
and damage the kidneys themselves.
不过 绝大多数肾结石 不会变得这般严重
But most kidney stones don’t become this serious,
甚至也不会需要开刀治疗
or even require invasive treatment.
直径小于五毫米的结石
Masses less than five millimeters in diameter
会自行排出体外
will usually pass out of the body on their own.
医生通常会仅仅建议
A doctor will often simply recommend
大量喝水以促进排石
drinking large amounts of water to help speed the process along,
或许也会建议服用一些止痛药
and maybe taking some pain killers.
如果 结石颗粒更大一些
If the stone is slightly larger,
就需要用药物协助 比如“阿尔法神经阻断剂”
medications like alpha blockers can help
来让尿道肌肉放松
by relaxing the muscles in the ureter
以求让排石更容易
and making it easier for the stone to get through.
而另一种药物 叫做 柠檬酸钾
Another medication called potassium citrate
能够 把尿液酸性降低 来促进结石溶解
can help dissolve the stones by creating a less acidic urine.
结石颗粒大小中等
For medium-sized stones
达到了大概10毫米
up to about ten millimeters,
就要选择声波将结石震碎
one option is pulverizing them with soundwaves.
体外碎石震荡波
Extracorporeal shock wave lithotripsy
使用集中的高强度超声波能量
uses high-intensity pulses of focused ultrasonic energy
可以直接作用于肾结石
aimed directly at the stone.
这些超声脉冲 在结石本身内部 产生震荡
The pulses create vibrations inside the stone itself
形成气泡对结石造成挤压
and small bubbles jostle it.
这些共同作用的挤压力 把结石压成许多小碎块
These combined forces crush the stone into smaller pieces
排石便能更加容易
that can pass out of the body more easily.
不过 如果结石的确太大 用声波来碎石 也会不起了作用
But zapping a stone with sound doesn’t work as well if it’s simply too big.
因此 有时也需要进一步手术治疗
So sometimes, more invasive treatments are necessary.
在尿道里 把一根叫支架的硬管 伸进去
A rigid tube called a stent can be placed in the ureter to expand it.
光纤能够传递镭射脉冲 来粉碎结石
Optical fibers can deliver laser pulses to break up the stone.
结石 也可以通过手术 从患者背部或腹股沟的切口取出来
Stones can also be surgically removed through an incision in the patient’s back or groin.
如何在初期避免形成肾结石?
What about just avoiding kidney stones in the first place?
对于易得结石的患者
For people prone to them,
其医生会建议大量饮水
their doctor may recommend drinking plenty of water,
以便稀释草酸钙 以及
which dilutes the calcium oxalate and
其它最终能生成结石的化合物
other compoundsthat eventually build up into painful stones.
食物 比如薯片
Foods like potato chips,
菠菜 大黄 甜菜
spinach, rhubarb,and beets
草酸盐含量丰富
are high in oxalate,
因此 医生对这些食物 会建议限量食用
so doctors might advise limiting them.
尽管 结石通常含有钙元素
Even though calcium is often found in stones,
但是 食物和饮料中的钙 实际上却能起到帮助作用
calcium in foods and beverages can actually help
钙元素 在草酸盐吸收到肾脏之前 在消化道中 就能与草酸盐结合 (让其无法吸收)
by binding to oxalate in the digestive tract before it can be absorbed and reach the kidneys.
如果最终患上了结石 你却并不孤单
If you do end up with a kidney stone, you’re not alone.
数据显示 患结石的几率正在上升
Data suggest that rates are rising,
不过 那个结石的世界记录 大概不会在短期内被打破
but that world record probably won’t be broken any time soon.

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