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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
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and was 17 centimeters in diameter.
而且直徑有十七公分
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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
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Kidney stones form inside the body,
腎結石是在身體內部形成
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but unfortunately, they're extremely painful to get out.
不幸的是,取出的過程是相當疼痛的
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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
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ureters,
輸尿管
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bladder,
膀胱
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or urethra.
或尿道
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Urine contains compounds that consist of calcium,
排出的尿液包含了鈣的成份
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sodium,
鈉
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potassium,
鉀
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oxalate,
草酸鹽
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uric acid,
尿酸
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and phosphate.
和磷酸鹽
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If the levels of these particles get too high,
如果這些粒子的在尿液成份太高
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or if urine becomes too acidic or basic,
或如果尿液變得太酸太鹼
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the particles can clump together and crystallize.
這些粒子會叢聚一起然後結晶化
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Unless the problem is addressed,
除非這個問題被處理
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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
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forming a detectable stone.
直到形成一個可被偵測的結石
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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
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and accounts for about 80% of kidney stones.
說明大約百分之八十的腎結石
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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
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A slightly different type of stone
一些稍微不同種類的結石
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made of the minerals magnesium ammonium phosphate, or struvite,
由礦物磷酸銨鎂或鳥糞石所組成
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can be caused by bacterial infection.
可能是因為細菌感染而形成
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And even rarer stones can result from genetic disorders
甚至有一些罕見結石
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or certain medications.
是因遺傳疾病或特定藥物治療而產生的
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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
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When a stone travels through the kidney and into the ureter,
當一顆石塊從腎臟到達輸尿管
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its sharp edges scratch the walls of the urinary tract.
它的鋒利邊緣割傷尿路的壁
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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
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through the nervous system.
傳送了這個難以忍受的疼痛訊號
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And the scratches can send blood flowing into the urine.
造成的刮痕會讓血液流入尿液中
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This can be accompanied by symptoms of nausea,
這可能伴隨著噁心的症狀
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vomiting,
或嘔吐
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and a burning sensation while urinating.
排尿時會有被燃燒的感覺
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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
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it can create an infection, or back flow,
它會造成感染或血尿
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and damage the kidneys themselves.
反過來傷害腎臟
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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
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or even require invasive treatment.
或甚至需要侵入式的處理方式
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Masses less than five millimeters in diameter
大小小於直徑五毫米的腎結石
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will usually pass out of the body on their own.
通常會自行排出體外
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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
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to help speed the process along,
去幫助加速排出的過程
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and maybe taking some pain killers.
或可能需要吃一些止痛藥
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If the stone is slightly larger,
如果結石稍微大一些
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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
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and making it easier for the stone to get through.
讓結石比較容易通過輸尿管
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Another medication called potassium citrate
另一種藥物治療叫做檸檬酸鉀
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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
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For medium-sized stones up to about ten millimeters,
對於大小中等,約達十公分的結石
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one option is pulverizing them with soundwaves.
一個選項是用音波把它們磨成粉末
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Extracorporeal shock wave lithotripsy uses high-intensity pulses
體外的振波碎石術使用高強度脈衝波
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of focused ultrasonic energy aimed directly at the stone.
集中的超音波能量直接瞄準結石
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The pulses create vibrations inside the stone itself
脈衝波引起結石內部發生震動
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and small bubbles jostle it.
和小氣泡推擠它
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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
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that can pass out of the body more easily.
那可以讓結石更容易排出身體
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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
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if it's simply too big.
那就是它實在太大
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So sometimes, more invasive treatments are necessary.
所以有時候,侵入式治療是有必要的
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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
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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
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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
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in the patient's back or groin.
從病患的背部或鼠蹊部
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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?
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For people prone to them,
對於易於發生的人們
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their doctor may recommend drinking plenty of water,
他們的醫生可能會建議喝大量的水
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which dilutes the calcium oxalate and other compounds
用來稀釋草酸鈣和其它複合物
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that eventually build up into painful stones.
而那些最終會產生令人疼痛的結石
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Foods like potato chips,
吃的食物像是馬鈴薯片
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spinach,
菠菜
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rhubarb,
大黃
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and beets are high in oxalate,
和甜菜都有高草酸鹽
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so doctors might advise limiting them.
所以醫生可能會建議少吃它們
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Even though calcium is often found in stones,
雖然鈣常被發現在結石中
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calcium in foods and beverages can actually help
但飲食中的鈣實際上會幫助
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by binding to oxalate in the digestive tract
消化道中黏合分散的草酸鹽
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before it can be absorbed and reach the kidneys.
在它可以被吸收和到達腎臟前
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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
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Data suggests that rates are rising,
數據暗示得腎結石的比例正在升高
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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