2024.05.20 Kidney stone

 

 

Typically, the stone will eventually move through the urinary tract (figure 1) and is passed out of the body in the urine.

 

국문	중문
여성 비뇨기계	Female urinary system
비뇨기 계통에는 신장, 요관, 방광 및 요도가 포함됩니다.	Your urinary system includes the kidneys, ureters, bladder and urethra.
비뇨기계는 소변을 통해 몸의 노폐물을 제거합니다.	The urinary system removes waste from the body through urine.
신장은 상복부 뒤쪽에 위치합니다.	The kidneys are located toward the back of the upper abdomen.
그들은 혈액에서 노폐물과 체액을 걸러내고 소변을 생성합니다.	They filter waste and fluid from the blood and produce urine.
그들은 혈액에서 노폐물과 체액을 걸러내고 소변을 생성합니다.	Urine moves from the kidneys through narrow tubes to the bladder.
이 관을 요관이라고 합니다.	These tubes are called the ureters.
방광은 소변을 볼 시간이 될 때까지 소변을 저장합니다.	The bladder stores urine until it's time to urinate.
소변은 요도라고 불리는 또 다른 작은 관을 통해 몸 밖으로 나옵니다.	Urine leaves the body through another small tube called the urethra.
신장 결석(신결석, 신결석증 또는 요로결석증이라고도 함)은 신장 내부에 형성되는 미네랄과 염분으로 이루어진 단단한 침전물입니다.	Kidney stones (also called renal calculi, nephrolithiasis or urolithiasis) are hard deposits made of minerals and salts that form inside your kidneys.
다이어트, 과체중, 일부 건강 상태, 특정 보충제 및 약물은 신장 결석의 많은 원인 중 하나입니다.	Diet, excess body weight, some medical conditions, and certain supplements and medications are among the many causes of kidney stones.
신장 결석은 신장부터 방광까지 요로의 모든 부분에 영향을 미칠 수 있습니다.	kidney stones can affect any part of your urinary tract — from your kidneys to your bladder
종종 소변이 농축되면 결석이 형성되어 미네랄이 결정화되어 서로 달라붙게 됩니다.	Often, stones form when the urine becomes concentrated, allowing minerals to crystallize and stick together.
신장 결석이 지나가는 것은 상당히 고통스러울 수 있지만, 적시에 발견되면 일반적으로 결석이 영구적인 손상을 일으키지 않습니다.	Passing kidney stones can be quite painful, but the stones usually cause no permanent damage if they're recognized in a timely fashion.
상황에 따라 신장 결석을 배출하기 위해 진통제를 복용하고 물을 많이 마시는 것 외에 다른 조치가 필요하지 않을 수도 있습니다.	Depending on your situation, you may need nothing more than to take pain medication and drink lots of water to pass a kidney stone
다른 경우, 예를 들어 결석이 요로에 박히거나 요로 감염과 관련되거나 합병증을 유발하는 경우 수술이 필요할 수 있습니다.	In other instances — for example, if stones become lodged in the urinary tract, are associated with a urinary infection or cause complications — surgery may be needed.
신장 결석이 다시 발생할 위험이 높은 경우 의사는 신장 결석 재발 위험을 줄이기 위해 예방 치료를 권장할 수 있습니다.	Your doctor may recommend preventive treatment to reduce your risk of recurrent kidney stones if you're at increased risk of developing them again.
증상	symptoms
신장 결석은 일반적으로 신장 내에서 이동하거나 요관 중 하나로 들어갈 때까지 증상을 일으키지 않습니다.	A kidney stone usually will not cause symptoms until it moves around within the kidney or passes into one of the ureters.
요관은 신장과 방광을 연결하는 관입니다.	The ureters are the tubes that connect the kidneys and bladder.
신장 결석이 요관에 걸리면 소변의 흐름을 막아 신장이 붓고 요관에 경련이 일어나 매우 고통스러울 수 있습니다.	If a kidney stone becomes lodged in the ureters, it may block the flow of urine and cause the kidney to swell and the ureter to spasm, which can be very painful.
이때 다음과 같은 증상이 나타날 수 있습니다.	At that point, you may experience these symptoms:
옆구리와 등, 갈비뼈 아래에 심하고 날카로운 통증	Severe, sharp pain in the side and back, below the ribs
하복부와 사타구니까지 방사되는 통증	Pain that radiates to the lower abdomen and groin
파도처럼 다가오고 강도가 변하는 통증	Pain that comes in waves and fluctuates in intensity
소변을 볼 때 통증이나 작열감	Pain or burning sensation while urinating
기타 징후 및 증상은 다음과 같습니다.	Other signs and symptoms may include:
분홍색, 빨간색 또는 갈색 소변	Pink, red or brown urine
탁하거나 악취가 나는 소변	Cloudy or foul-smelling urine
지속적인 소변 욕구, 평소보다 더 자주 소변을 보거나 소량의 소변을 보는 경우	A persistent need to urinate, urinating more often than usual or urinating in small amounts
메스꺼움과 구토	Nausea and vomiting
감염이 있을 경우 발열과 오한	Fever and chills if an infection is present
신장 결석으로 인한 통증은 결석이 요로를 통과하면서 변화할 수 있습니다(예: 다른 위치로 이동하거나 강도가 증가함).	Pain caused by a kidney stone may change — for instance, shifting to a different location or increasing in intensity — as the stone moves through your urinary tract.
신장 결석이 너무 커서 저절로 전달되지 않거나 출혈, 신장 손상 또는 지속적인 요로 감염을 유발하는 경우에는 더 광범위한 치료가 필요할 수 있습니다. 절차에는 다음이 포함될 수 있습니다.	Kidney stones that are too large to pass on their own or cause bleeding, kidney damage or ongoing urinary tract infections may require more-extensive treatment. Procedures may include:
원인	Causes
신장 결석은 종종 명확한 단일 원인이 없지만 여러 요인이 위험을 증가시킬 수 있습니다.	Kidney stones often have no definite, single cause, although several factors may increase your risk.
신장 결석은 소변에 칼슘, 옥살산염, 요산과 같은 결정 형성 물질이 소변 내 체액이 희석될 수 있는 것보다 더 많이 포함되어 있을 때 형성됩니다.	Kidney stones form when your urine contains more crystal-forming substances — such as calcium, oxalate and uric acid — than the fluid in your urine can dilute.
동시에, 소변에는 결정이 서로 달라붙는 것을 방지하는 물질이 부족하여 신장 결석이 형성되기 위한 이상적인 환경을 조성할 수 있습니다.	At the same time, your urine may lack substances that prevent crystals from sticking together, creating an ideal environment for kidney stones to form.
진단	Diagnosis
의사가 신장 결석이 있다고 의심하는 경우 다음과 같은 진단 검사 및 절차를 받을 수 있습니다.	If your doctor suspects that you have a kidney stone, you may have diagnostic tests and procedures, such as:
	Blood testing.
혈액 검사를 통해 혈액 내 칼슘이나 요산이 너무 많은 것으로 나타날 수 있습니다.	Blood tests may reveal too much calcium or uric acid in your blood.
혈액 검사 결과는 신장 건강을 모니터링하는 데 도움이 되며 의사가 다른 질병을 확인하도록 유도할 수도 있습니다.	Blood test results help monitor the health of your kidneys and may lead your doctor to check for other medical conditions.
소변 검사.	Urine testing.
24시간 소변 수집 테스트를 통해 결석을 형성하는 미네랄이 너무 많이 배출되거나 결석을 예방하는 물질이 너무 적게 배출되고 있음을 보여줄 수 있습니다.	The 24-hour urine collection test may show that you're excreting too many stone-forming minerals or too few stone-preventing substances.
이 검사를 위해 담당 의사는 이틀 연속으로 두 번의 소변 수집을 수행하도록 요청할 수 있습니다.	For this test, your doctor may request that you perform two urine collections over two consecutive days.
	Imaging.
영상 검사를 통해 요로에 신장 결석이 나타날 수 있습니다.	Imaging tests may show kidney stones in your urinary tract.
고속 또는 이중 에너지 컴퓨터 단층촬영(CT)을 통해 아주 작은 결석도 발견할 수 있습니다.	High-speed or dual energy computerized tomography (CT) may reveal even tiny stones.
단순 복부 X-레이는 이런 종류의 영상 검사가 작은 신장 결석을 놓칠 수 있기 때문에 덜 자주 사용됩니다.	Simple abdominal X-rays are used less frequently because this kind of imaging test can miss small kidney stones.
빠르고 쉽게 수행할 수 있는 비침습적 검사인 초음파는 신장 결석을 진단하는 또 다른 영상 옵션입니다.	Ultrasound, a noninvasive test that is quick and easy to perform, is another imaging option to diagnose kidney stones.
통과된 돌의 분석.	Analysis of passed stones.
지나가는 돌을 잡기 위해 여과기를 통해 소변을 보라는 요청을 받을 수도 있습니다	You may be asked to urinate through a strainer to catch stones that you pass.
실험실 분석을 통해 신장 결석의 구성이 밝혀집니다.	Lab analysis will reveal the makeup of your kidney stones.
의사는 이 정보를 사용하여 신장 결석의 원인을 파악하고 더 많은 신장 결석을 예방하기 위한 계획을 세웁니다.	Your doctor uses this information to determine what's causing your kidney stones and to form a plan to prevent more kidney stones.
	Treatment
신장 결석 치료는 결석의 종류와 원인에 따라 다양합니다	Treatment for kidney stones varies, depending on the type of stone and the cause.
증상이 거의 없는 작은 결석	Small stones with minimal symptoms
대부분의 작은 신장 결석은 침습적 치료가 필요하지 않습니다. 다음과 같은 방법으로 작은 돌을 지나갈 수 있습니다.	Most small kidney stones won't require invasive treatment. You may be able to pass a small stone by:
식수	Drinking water.
하루에 2~3쿼트(1.8~3.6리터) 정도 마시면 소변이 묽어지고 결석이 생기는 것을 예방할 수 있습니다.	Drinking as much as 2 to 3 quarts (1.8 to 3.6 liters) a day will keep your urine dilute and may prevent stones from forming.
의사가 달리 지시하지 않는 한, 투명하거나 거의 투명한 소변을 만들기 위해 충분한 수분(이상적으로는 대부분 물)을 섭취하십시오.	Unless your doctor tells you otherwise, drink enough fluid — ideally mostly water — to produce clear or nearly clear urine.
진통제.	Pain relievers.
작은 돌을 지나치면 약간의 불편함을 느낄 수 있습니다.	Passing a small stone can cause some discomfort.
경미한 통증을 완화하기 위해 의사는 이부프로펜(Advil, Motrin IB 등) 또는 나프록센 나트륨(Aleve)과 같은 진통제를 권장할 수 있습니다.	To relieve mild pain, your doctor may recommend pain relievers such as ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve).
의료 치료	Medical therapy.
의사는 신장 결석 통과에 도움이 되는 약을 처방할 수 있습니다.	Your doctor may give you a medication to help pass your kidney stone.
알파 차단제로 알려진 이러한 유형의 약물은 요관 근육을 이완시켜 신장 결석을 더 빠르고 덜 고통스럽게 배출하도록 돕습니다.	This type of medication, known as an alpha blocker, relaxes the muscles in your ureter, helping you pass the kidney stone more quickly and with less pain.
알파 차단제의 예로는 탐술로신(Flomax)과 약물 조합인 두타스테리드와 탐술로신(Jalyn)이 있습니다.	Examples of alpha blockers include tamsulosin (Flomax) and the drug combination dutasteride and tamsulosin (Jalyn).
음파를 사용하여 돌을 부수는 것입니다.	Using sound waves to break up stones.
특정 신장 결석의 경우 크기와 위치에 따라 의사가 체외 충격파 쇄석술(ESWL)이라는 시술을 권장할 수 있습니다.	For certain kidney stones — depending on size and location — your doctor may recommend a procedure called extracorporeal shock wave lithotripsy (ESWL).
ESWL은 음파를 사용하여 결석을 소변으로 전달할 수 있는 작은 조각으로 부수는 강한 진동(충격파)을 생성합니다.	ESWL uses sound waves to create strong vibrations (shock waves) that break the stones into tiny pieces that can be passed in your urine.
시술시간은 45~60분 정도 소요되며, 중등도의 통증이 있을 수 있으므로 편안하게 하기 위해 진정제나 가벼운 마취를 하셔도 됩니다.	The procedure lasts about 45 to 60 minutes and can cause moderate pain, so you may be under sedation or light anesthesia to make you comfortable.
ESWL은 소변에 혈액이 섞이고, 등이나 복부에 멍이 들고, 신장 및 기타 인접 기관 주변에 출혈이 생기고, 결석 조각이 요로를 통과할 때 불편함을 유발할 수 있습니다.	ESWL can cause blood in the urine, bruising on the back or abdomen, bleeding around the kidney and other adjacent organs, and discomfort as the stone fragments pass through the urinary tract.
신장의 매우 큰 결석을 제거하는 수술	Surgery to remove very large stones in the kidney
경피적 신절석술(nef-row-lih-THOT-uh-me)이라는 절차에는 등의 작은 절개를 통해 삽입된 작은 망원경과 기구를 사용하여 외과적으로 신장 결석을 제거하는 과정이 포함됩니다.	A procedure called percutaneous nephrolithotomy (nef-row-lih-THOT-uh-me) involves surgically removing a kidney stone using small telescopes and instruments inserted through a small incision in your back.
수술 중에는 전신마취를 하게 되며, 회복하는 동안 1~2일 정도 병원에 입원하게 됩니다.	You will receive general anesthesia during the surgery and be in the hospital for one to two days while you recover.
ESWL이 성공하지 못한 경우 의사는 이 수술을 권장할 수 있습니다.	Your doctor may recommend this surgery if ESWL is unsuccessful.
스코프를 사용하여 돌을 제거합니다.	Using a scope to remove stones.
요관이나 신장에 있는 작은 결석을 제거하기 위해 의사는 카메라가 장착된 얇고 조명이 달린 관(요관경)을 요도와 방광을 통해 요관으로 통과시킬 수 있습니다.	To remove a smaller stone in your ureter or kidney, your doctor may pass a thin lighted tube (ureteroscope) equipped with a camera through your urethra and bladder to your ureter.
결석을 찾으면 특수 도구를 사용하여 결석을 움켜쥐거나 조각으로 부수어 소변으로 배출할 수 있습니다.	Once the stone is located, special tools can snare the stone or break it into pieces that will pass in your urine.
그런 다음 의사는 부기를 완화하고 치유를 촉진하기 위해 요관에 작은 튜브(스텐트)를 삽입할 수 있습니다	Your doctor may then place a small tube (stent) in the ureter to relieve swelling and promote healing.
이 시술 중에는 전신 마취나 국소 마취가 필요할 수 있습니다.	You may need general or local anesthesia during this procedure.