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  • The biggest kidney stone on record weighed more than a kilogram

    世界記錄過的最大顆腎結石重超過一公斤

  • and was 17 centimeters in diameter.

    而且直徑有十七公分

  • The patient didn't actually swallow a stone the size of a coconut.

    病患們不是真的吞下了一顆如同椰子般的石頭

  • Kidney stones form inside the body,

    腎結石是在身體內部形成

  • but unfortunately, they're extremely painful to get out.

    不幸的是,取出的過程是相當疼痛的

  • A kidney stone is a hard mass of crystals that can form in the kidneys,

    腎結石是一個在腎臟形成的晶狀硬塊

  • ureters,

    輸尿管

  • bladder,

    膀胱

  • or urethra.

    或尿道

  • Urine contains compounds that consist of calcium,

    排出的尿液包含了鈣的成份

  • sodium,

  • potassium,

  • oxalate,

    草酸鹽

  • uric acid,

    尿酸

  • and phosphate.

    和磷酸鹽

  • If the levels of these particles get too high,

    如果這些粒子的在尿液成份太高

  • or if urine becomes too acidic or basic,

    或如果尿液變得太酸太鹼

  • the particles can clump together and crystallize.

    這些粒子會叢聚一起然後結晶化

  • Unless the problem is addressed,

    除非這個問題被處理

  • the crystals will gradually grow over a few weeks, months, or even years,

    不然晶體會隨著時間漸漸的成長

  • forming a detectable stone.

    直到形成一個可被偵測的結石

  • Calcium oxalate is the most common type of crystal to form this way,

    草酸鈣是最常見形成晶體的種類

  • and accounts for about 80% of kidney stones.

    說明大約百分之八十的腎結石

  • Less common kidney stones are made of calcium phosphate, or uric acid.

    比較不常見的腎結石由磷酸鈣或尿酸組成

  • A slightly different type of stone

    一些稍微不同種類的結石

  • made of the minerals magnesium ammonium phosphate, or struvite,

    由礦物磷酸銨鎂或鳥糞石所組成

  • can be caused by bacterial infection.

    可能是因為細菌感染而形成

  • And even rarer stones can result from genetic disorders

    甚至有一些罕見結石

  • or certain medications.

    是因遺傳疾病或特定藥物治療而產生的

  • A kidney stone can go undetected until it starts to move.

    一顆腎結石有開始移動前都可能不會被偵測到

  • When a stone travels through the kidney and into the ureter,

    當一顆石塊從腎臟到達輸尿管

  • its sharp edges scratch the walls of the urinary tract.

    它的鋒利邊緣割傷尿路的壁

  • Nerve endings embedded in this tissue transmit excruciating pain signals

    嵌入組織的神經末端透過神經系統

  • through the nervous system.

    傳送了這個難以忍受的疼痛訊號

  • And the scratches can send blood flowing into the urine.

    造成的刮痕會讓血液流入尿液中

  • This can be accompanied by symptoms of nausea,

    這可能伴隨著噁心的症狀

  • vomiting,

    或嘔吐

  • and a burning sensation while urinating.

    排尿時會有被燃燒的感覺

  • If a stone gets big enough to actually block the flow of urine,

    如果石塊大到實際上還會阻塞排尿

  • it can create an infection, or back flow,

    它會造成感染或血尿

  • and damage the kidneys themselves.

    反過來傷害腎臟

  • But most kidney stones don't become this serious,

    但大多數的腎結石不會造成這麼嚴重的情況

  • or even require invasive treatment.

    或甚至需要侵入式的處理方式

  • Masses less than five millimeters in diameter

    大小小於直徑五毫米的腎結石

  • will usually pass out of the body on their own.

    通常會自行排出體外

  • A doctor will often simply recommend drinking large amounts of water

    醫生通常僅會建議需要喝大量的水

  • to help speed the process along,

    去幫助加速排出的過程

  • and maybe taking some pain killers.

    或可能需要吃一些止痛藥

  • If the stone is slightly larger,

    如果結石稍微大一些

  • medications like alpha blockers can help by relaxing the muscles in the ureter

    藥物治療像是甲型阻斷劑,可以幫助放鬆輸尿管肌肉

  • and making it easier for the stone to get through.

    讓結石比較容易通過輸尿管

  • Another medication called potassium citrate

    另一種藥物治療叫做檸檬酸鉀

  • can help dissolve the stones by creating a less acidic urine.

    它可以藉由創造一個微酸的尿液來幫助溶解結石

  • For medium-sized stones up to about ten millimeters,

    對於大小中等,約達十公分的結石

  • one option is pulverizing them with soundwaves.

    一個選項是用音波把它們磨成粉末

  • Extracorporeal shock wave lithotripsy uses high-intensity pulses

    體外的振波碎石術使用高強度脈衝波

  • of focused ultrasonic energy aimed directly at the stone.

    集中的超音波能量直接瞄準結石

  • The pulses create vibrations inside the stone itself

    脈衝波引起結石內部發生震動

  • and small bubbles jostle it.

    和小氣泡推擠它

  • These combined forces crush the stone into smaller pieces

    結合的這兩股力量將結石打成小碎片

  • that can pass out of the body more easily.

    那可以讓結石更容易排出身體

  • But zapping a stone with sound doesn't work as well

    但是用超音波摧毀結石也有起不了作用的時候

  • if it's simply too big.

    那就是它實在太大

  • So sometimes, more invasive treatments are necessary.

    所以有時候,侵入式治療是有必要的

  • A rigid tube called a stent can be placed in the ureter to expand it.

    用一個堅固的管子放入輸尿管去擴張它,我們稱之為支架

  • Optical fibers can deliver laser pulses to break up the stone.

    光纖可以傳送雷射脈衝波去打碎結石

  • Stones can also be surgically removed through an incision

    結石也能夠透過切口被外科手術移除

  • in the patient's back or groin.

    從病患的背部或鼠蹊部

  • What about just avoiding kidney stones in the first place?

    那麼如何在起初就避免腎結石產生?

  • For people prone to them,

    對於易於發生的人們

  • their doctor may recommend drinking plenty of water,

    他們的醫生可能會建議喝大量的水

  • which dilutes the calcium oxalate and other compounds

    用來稀釋草酸鈣和其它複合物

  • that eventually build up into painful stones.

    而那些最終會產生令人疼痛的結石

  • Foods like potato chips,

    吃的食物像是馬鈴薯片

  • spinach,

    菠菜

  • rhubarb,

    大黃

  • and beets are high in oxalate,

    和甜菜都有高草酸鹽

  • so doctors might advise limiting them.

    所以醫生可能會建議少吃它們

  • Even though calcium is often found in stones,

    雖然鈣常被發現在結石中

  • calcium in foods and beverages can actually help

    但飲食中的鈣實際上會幫助

  • by binding to oxalate in the digestive tract

    消化道中黏合分散的草酸鹽

  • before it can be absorbed and reach the kidneys.

    在它可以被吸收和到達腎臟前

  • If you do end up with a kidney stone, you're not alone.

    如果你最終得了腎結石,你並不孤單

  • Data suggests that rates are rising,

    數據暗示得腎結石的比例正在升高

  • but that world record probably won't be broken any time soon.

    但是那項世界紀錄可能還不會這麼快被打破

The biggest kidney stone on record weighed more than a kilogram

世界記錄過的最大顆腎結石重超過一公斤

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B2 中高級 中文 美國腔 TED-Ed 尿液 腎臟 形成 治療 晶體

【TED-Ed】腎結石為什麼產生? (What causes kidney stones? - Arash Shadman)

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    Aming Chiang 發佈於 2017 年 08 月 15 日
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