КАМНИ В ПОЧКАХ.
Abstrak
Камни в почках являются распространенным заболеванием: ежегодная заболеваемость составляет восемь случаев на 1000 взрослых. В течение
При эпизоде почечной колики первоочередной задачей является исключение состояний, требующих немедленного направления к врачу.
отделение неотложной помощи, затем для облегчения боли, желательно нестероидным противовоспалительным препаратом.
Диагностическое обследование включает анализ мочи, посев мочи и визуализацию для подтверждения диагноза и
оценить состояния, требующие активного удаления камней, например, инфекцию мочевыводящих путей или камень размером более
10 мм. Консервативное лечение состоит из контроля боли, медикаментозной вытесняющей терапии альфа-препаратами.
блокатор и последующая визуализация в течение 14 дней для мониторинга положения камней и оценки гидронефроза. Бессимптомные камни в почках должны сопровождаться серийной визуализацией и удаляться в
в случае роста, симптомов, обструкции мочевыводящих путей, рецидивирующих инфекций или отсутствия доступа к медицинской помощи.
Все пациенты с камнями в почках должны быть обследованы на предмет риска рецидива камней с учетом анамнеза.
базовая лабораторная оценка и визуализация. Следует изменить образ жизни, например, увеличить потребление жидкости.
рекомендуется всем пациентам, при этом следует назначать тиазидные диуретики, аллопуринол или цитраты.
для пациентов с рецидивирующими кальциевыми камнями. Пациентов с высоким риском рецидива камней следует направлять
для дополнительной оценки метаболизма, которая может служить основой для индивидуальных профилактических мер.
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