迄今為止最大的腎結(jié)石重量超過了一公斤，直徑高達(dá)17厘米?！隘偪竦氖^”帶來的疼痛有時不亞于生孩子。成因為何？怎么治療和預(yù)防？
The biggest kidney stone on record weighed more than a kilogram and was 17 centimeters in diameter.
記載在冊最大的腎結(jié)石重量超過了一公斤，而直徑高達(dá)17厘米。
腎結(jié)石的成因
The patient didn't actually swallow a stone the size of a coconut.
這位病人并不是吞下了一塊椰子大小的石頭。
Kidney stones form inside the body, but unfortunately, they're extremely painful to get out.
腎結(jié)石是在人體內(nèi)部形成的，然而糟心的是，要把它們?nèi)〕鰜矸浅Ｍ纯唷?/p>
A kidney stone is a hard mass of crystals that can form in the kidneys, ureters, bladder, or urethra.
腎結(jié)石是一塊堅硬的結(jié)晶，在腎臟、尿管、膀胱或者尿道中形成。
Urine contains compounds that consist of calcium, sodium, potassium, oxalate, uric acid, and phosphate.
尿液中的一些物質(zhì)含有鈣、鈉、鉀、草酸鹽、尿酸、還有磷酸鹽。
If the levels of these particles get too high,
如果這些微粒的含量過高，
or if urine becomes too acidic or basic, the particles can clump together and crystallize.
或者尿液變得過酸或過堿，這些微粒就很容易聚集在一起，然后結(jié)晶。
Unless the problem is addressed,
如果不及時扼制，
the crystals will gradually grow over a few weeks months, or even years, forming a detectable stone.
隨著時間流逝，結(jié)晶將會一周周、一月月、甚至一年年繼續(xù)變大，直到慢慢形成了可檢測到的石頭。
Calcium oxalate is the most common type of crystal to form this way, and accounts for about 80% of kidney stones.
草酸鈣是這個過程中最常見的結(jié)晶，大約80%的腎結(jié)石的成分是草酸鈣。
Less common kidney stones are made of calcium phosphate, or uric acid.
由磷酸鈣或者尿酸造成的腎結(jié)石則不太常見。
A slightly different type of stone made of the minerals magnesium ammonium phosphate,
另一種稍有不同的結(jié)石是由磷酸銨鎂構(gòu)成的，
or struvite, can be caused by bacterial infection.
也叫鳥糞石，細(xì)菌感染是此類腎結(jié)石產(chǎn)生的罪魁禍?zhǔn)住?/p>
And even rarer stones can result from genetic disorders or certain medications.
除此之外，更為罕見的腎結(jié)石由遺傳疾病或是某些特殊的藥物造成。
腎結(jié)石的癥狀
A kidney stone can go undetected until it starts to move.
腎結(jié)石可能在它開始移動后才會被檢測出來。
When a stone travels through the kidney and into the ureter, its sharp edges scratch the walls of the urinary tract.
當(dāng)結(jié)石從腎臟移動到尿管里的時候，它尖利的邊緣會擦傷尿道壁。
Nerve endings embedded in this tissue transmit excruciating pain signals through the nervous system.
薄壁中包裹著的神經(jīng)末梢會通過神經(jīng)系統(tǒng)輸送劇烈疼痛的信號。
And the scratches can send blood flowing into the urine.
此外，擦傷還會導(dǎo)致血液進(jìn)入尿液。
This can be accompanied by symptoms of nausea, vomiting, and a burning sensation while urinating.
這會造成血尿并常伴隨著惡心、嘔吐、排尿有燒灼感等癥狀。
If a stone gets big enough to actually block the flow of urine,
當(dāng)結(jié)石長大到直接堵塞了尿液流通，
it can create an infection, or backflow, and damage the kidneys themselves.
就會出現(xiàn)尿路感染或者尿液倒流的癥狀，并對腎臟自身造成傷害。
腎結(jié)石的治療
But most kidney stones don't become this serious, or even require invasive treatment.
但是大多數(shù)腎結(jié)石不會變得這么嚴(yán)重，甚至到需要進(jìn)行手術(shù)的程度。
Masses less than five millimeters in diameter will usually pass out of the body on their own.
那些直徑不超過五毫米的結(jié)石通常能自行排出。
A doctor will often simply recommend drinking large amounts of water
醫(yī)生通常會建議病人多喝水
to help speed the process along, and maybe taking some pain killers.
以加快結(jié)石的排出，或服用止痛片來緩解疼痛。
If the stone is slightly larger, medications like α-blockers
如果結(jié)石稍微有點大，就需要藥物的幫助，比如α受體阻滯劑
can help by relaxing the muscles in the ureter and making it easier for the stone to get through.
它可以幫助松弛尿道輸尿管的肌肉，使結(jié)石更順利地通過。
Another medication called potassium citrate can help dissolve the stones by creating a less acidic urine.
另外一種藥物叫做檸檬酸鉀，它可以通過降低尿液酸性來幫助溶解結(jié)石。
For medium-sized stones up to about ten millimeters, one option is pulverizing them with soundwaves.
對于不超過十毫米的中等結(jié)石，可以選擇用聲波將其碾碎。
Extracorporeal shock wave lithotripsy uses high-intensity pulses of focused ultrasonic energy aimed directly at the stone.
體外震波碎石術(shù)通過超聲波產(chǎn)生高強度沖擊波聚焦后直接對準(zhǔn)體內(nèi)的結(jié)石。
The pulses create vibrations inside the stone itself and small bubbles jostleit.
沖擊波會在結(jié)石內(nèi)部產(chǎn)生震動，以及受擠壓的微氣泡。
These combined forces crush the stone into smaller pieces that can pass out of the body more easily.
這些力量合在一起能夠?qū)⒔Y(jié)石擊碎，從而更易于排出。
But zapping a stone with sound doesn't work as well if it's simply too big.
但是如果結(jié)石的尺寸過大，使用聲波碎石的方法就可能不起作用。
So sometimes, more invasive treatments are necessary.
這時候就需要進(jìn)行侵入性治療。
A rigid tube called a stent can be placed in the ureter to expand it.
比如放置硬質(zhì)管道支架來擴(kuò)張尿道。
Optical fibers can deliver laser pulses to break up the stone.
光纖可以輸送激光脈沖來打碎結(jié)石。
Stones can also be surgically removed through an incision in the patient's back or groin.
此外，還可以在病人的后背或腹股溝制造切口，伸入手術(shù)用具，使結(jié)石通過手術(shù)被取出。
如何預(yù)防
What about just avoiding kidney stones in the first place?
那么如何在腎結(jié)石產(chǎn)生前就加以預(yù)防呢？
For people prone to them, their doctor may recommend drinking plenty of water,
對容易產(chǎn)生結(jié)石的人們來說，醫(yī)生會建議他們大量喝水，
which dilutes the calcium oxalate and other compounds that eventually build up into painful stones.
稀釋體內(nèi)的草酸鈣，以及其他會產(chǎn)生痛苦的結(jié)石的物質(zhì)。
Foods like potato chips, spinach, rhubarb, and beets are high in oxalate, so doctors might advise limiting them.
有些食物，比如薯片，菠菜，大黃，還有甜菜，都是草酸含量很高的，所以醫(yī)生建議控制這類食物的攝入。
Even though calcium is often found in stones, calcium in foods and beverages can actually help
雖然鈣是結(jié)石的常見成分，但食物和飲料里的鈣其實有助于預(yù)防腎結(jié)石，
by binding to oxalate in the digestive tract before it can be absorbed and reach the kidneys.
這是因為它們會和消化道里的草酸結(jié)合，使其無法直接被吸收并進(jìn)入腎臟。
If you do end up with a kidney stone, you're not alone.
如果你已經(jīng)有了腎結(jié)石，也不要感到孤單無助。
Data suggests that rates are rising, but that world record probably won't be broken any time soon.
數(shù)據(jù)表明腎結(jié)石的發(fā)病率一直在升高，當(dāng)然，世界最大腎結(jié)石的記錄在短時間內(nèi)應(yīng)該還是不會被打破。
