Name: 【TED-Ed】腎結石為什麼產生？ (What causes kidney stones? - Arash Shadman)
Uploaded: 2017-08-15T21:59:58.000Z
Duration: 5 min 15 s

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

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

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

Urine contains compounds  that consist of calcium,

If the levels of these particles get too high,

如果這些粒子的在尿液成份太高

the particles can clump together and crystallize.

這些粒子會叢聚一起然後結晶化

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

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.

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

made of the minerals magnesium ammonium phosphate, or struvite,

由礦物磷酸銨鎂或鳥糞石所組成

And even rarer stones can result from genetic disorders

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,

its sharp edges scratch the walls of the urinary tract.

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

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,

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,

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

Masses less than five millimeters in diameter

will usually pass out  of the body on their own.

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

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.

Another medication called potassium citrate

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

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.

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

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

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？

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

that eventually build up into painful stones.

而那些最終會產生令人疼痛的結石

Even though calcium is often found in stones,

calcium in foods and beverages can actually help

by binding to oxalate in the digestive tract

before it can be absorbed and reach the kidneys.

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

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

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

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