بررسی و درمان انواع سنگ های ادراری

بررسی و درمان انواع سنگ های ادراری
بررسی و درمان انواع سنگ های ادراری
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فهرست
چکیده
تاریخچه                                                                                                                          4
مقدمه                                                                                                                           6
فصل اول
کلیه- نمای ظاهری                                                                                                        10
کلیه- بافت شناسی                                                                                                           12
کلیه- خونرسانی                                                                                                            13
کالیس ها،لگنچه، حالب ها-آناتومی                                                                                         14
کالیس ها،لگنچه، حالب ها-ارتباطات                                                                                        14
کالیس ها،لگنچه، حالب ها-بافت شناسی                                                                                   16
کالیس ها،لگنچه، حالب ها-خونرسانی                                                                                      16
مثانه- نمای ظاهری                                                                                                                  17
مثانه- بافت شناسی                                                                                                                   18
مثانه- خونرسانی                                                                                                                      18
کارکرد های کلیه                                                                                                                      19
تشکیل ادرار                                                                                                                            19
پالایش گلومرولی                                                                                                                     20
بازجذب توبولی و ترشح توبولی                                                                                                      21
دفع فرآورده های زائد                                                                                                                 21
تنظیم دفع الکترولیت                                                                                                                 21
تنظیم دفع اسید                                                                                                                        22
تنظیم دفع آب                                                                                                                         23
اسمولالیته                                                                                                                              23
چگالی ویژه ادرار                                                                                                                      24
هورمون ضد ادراری                                                                                                                  24
خود تنظیمی فشار خون………                                                                                                   25
پاک سازی کلیوی                                                                                                                    25
سایر کارکرد های کلیه                                                                                                               26
کارکردهای حالب ،مثانه و پیشابراه                                                                                                  27
ذخیره ادرار                                                                                                                             27
دفع ادرار                                                                                                                                27
کنترل عضله                                                                                                                           27
کنترل عصبی                                                                                                                          28
درد                                                                                                                                      28
مشخات درد های ادراری                                                                                                            28
تغییرات در دفع ادرار                                                                                                                  29
نشانه های گوارشی                                                                                                                   29
معاینه فیزیکی                                                                                                                         29
برخی عوامل خطرزای اختلالات کلیوی یا ادراری                                                                              30
علایم انسداد دهانه خروجی مثانه                                                                                                  30
ادرار خونی                                                                                                                              30
بررسی آزمایشگاهی ادرار                                                                                                            32
بررسی ماکروسکوپی                                                                                                                  32
سایر تست های ادراری                                                                                                              33
تست های عملکرد کلیه                                                                                                             33
اورولیتیاز                                                                                                                                34
پاتوفیزیولوژی                                                                                                                          34
تظاهرات بالینی                                                                                                                        35
بررسی و یافته های تشخیصی                                                                                                     35
فصل دوم
سنگ های کلیوی و حالب                                                                                                          38
اتیولوژی                                                                                                                                38
تظاهرات سنگ ها                                                                                                                    40
عبور سنگ ها                                                                                                                         40
سایر سندروم ها                                                                                                                       41
فعالیت بیماری سنگ کلیه                                                                                                          41
پاتوژنز سنگ ها                                                                                                                       42
حالت فوق اشباع                                                                                                                      42
هسته سازی                                                                                                                           43
مهار کننده های تشکیل کریستال ها                                                                                             44
یون های ادراری                                                                                                                      45
انواع سنگ های کلسیمی                                                                                                           49
نفرولیتیازیس هیپرکلسیوریک جذبی                                                                                             50
نفرولیتیازیس هیپر کلسیوریک باز جذبی                                                                                         51
نفرولیتیازیس هیپرکلسیوریک کلیوی                                                                                               52
نفرولیتازیس کلسیمی هیپراوریکوزوریک                                                                                           52
نفرولیتازیس کلسیمی هیپراگزالوریک                                                                                               52
نفرولیتیاز یس کلسیمی هیپواسیتر اتوریک                                                                                         54
سنگ های غیر کلسیمی                                                                                                              54
استرووایت                                                                                                                              54
اسید اوریکی                                                                                                                          55
سیستین                                                                                                                                56
گزانتین                                                                                                                                 57
سنگ های ایندیناویر                                                                                                              58
نادر                                                                                                                                      58
جدول2-1                                                                                                                             59
علایم ونشانه ها                                                                                                                      61
درد:                                                                                                                                     61
درد کولیکی کلیه ودرد غیر کولیکی کلیه                                                                                           61
1-کالیس کلیه                                                                                                                        62
2-  لگنچه کلیه                                                                                                                      62
3- حالب فوقانی و میانی                                                                                                           65
4- حالب دیستال                                                                                                                     65
هماچوری(هماتوری)                                                                                                                 66
عفونت                                                                                                                                  66
تب همراه                                                                                                                              67
تهوع و استفراغ                                                                                                                       67
وضعیتهای ویژه                                                                                                                       68
پیوند کلیه                                                                                                                             68
حاملگی                                                                                                                                68
دیس مورفی                                                                                                                           68
چاقی                                                                                                                                   69
کلیه با مدولای اسفنجی                                                                                                            69
اسیدوزتوبولی کلیوی                                                                                                                 69

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