最后审阅: 6 十一月 2021
最后更新: 20 一月 2021

小结

定义

病史和体格检查

关键诊断因素

  • 急性重度胁腹痛

其他诊断因素

  • 危险因素
  • 既往发生过肾结石
  • 恶心和呕吐
  • 尿频/尿急
  • 血尿
  • 睾丸痛
  • 肥胖
  • 肾结石家族史
  • 促结石形成药物
  • 腹股沟痛
  • 发热
  • 心动过速
  • 低血压
  • 肋脊角和同侧腰部压痛

危险因素

  • 脱水
  • 高盐摄入
  • 白人血统
  • 男性
  • 肥胖
  • 晶体尿
  • 职业暴露导致的脱水
  • 温暖的气候
  • 肾结石家族史
  • 促结石形成药物

诊断性检查

首要检查

  • 螺旋 CT 平扫(非妊娠成人)
  • 超声检查(孕妇或儿童)
  • 尿液分析
  • 全血细胞计数 (FBC) 和分类计数
  • 血清电解质、尿素和肌酐
  • 尿妊娠试验

需考虑的检查

  • 结石分析
  • 腹部平片 (KUB)
  • 磁共振成像 (MRI)
  • 随机尿胱氨酸测试

治疗流程

撰稿人

专家顾问

Jodi Antonelli, MD

Assistant Professor

Department of Urology

University of Texas Southwestern Medical Center

Dallas

TX

利益声明

JA is a member of the Scientific Advisory Board for Boston Scientific. JA has received a research grant from the US National Institutes of Health to study strategies to reduce recurrence of nephrolithiasis and reduce stent-associated pain.

Naim Maalouf, MD

Associate Program Director

Associate Professor

University of Texas Southwestern Medical Center

Dallas

TX

利益声明

NM has received a research grant from the US National Institutes of Health to study strategies to reduce recurrence of nephrolithiasis and reduce stent-associated pain.

同行评议者

Andrew Dickinson, MBBS, FRCS, FRCSEd, MD, FRCS(Urol)

Consultant Urologist

Derriford Hospital

University Hospitals Plymouth NHS Trust

Plymouth

UK

利益声明

AD was Chair of the NICE guidelines committee on renal and ureteric stones: assessment and management, 2017-2019.

编辑

Tannaz Aliabadi-Oglesby,

Lead Section Editor, BMJ Best Practice

利益声明

TAO declares that she has no competing interests.

Jo Haynes,

Head of Editorial, BMJ Knowledge Centre

利益声明

JH declares that she has no competing interests.

Annabel Sidwell,

Comorbidities Editor, BMJ Best Practice

利益声明

AS declares that she has no competing interests.

Adam Mitchell,

Drug Editor, BMJ Best Practice

利益声明

AM declares that he has no competing interests.

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