医学英语6B-cxz课件.ppt
MaggieChenDiagnosis and Treatment of Kidney StonesUnit 6 Reading B1 Teaching objectives 1.Understand the text and its structure.1.Understand the text and its structure.2.Master special terms&vocabulary 2.Master special terms&vocabulary about kidney stones.about kidney stones.3.Acquire the translation skills of difficult 3.Acquire the translation skills of difficult medical sentences.medical sentences.4.Learn introducing related topics of 4.Learn introducing related topics of kidney stone in English.kidney stone in English.2Contents1 1Warming up2 2Structure 3 3Detailed study4 4Special terms3Warming up Watch the video and answer the following questions.1.How many types of kidney stones are there generally?2.How is key stone formed?3.What causes stone formation?14Structure StructureDiagnosisDiagnosis of of kidney stoneskidney stones(Para.1)TreatmentTreatment of of kidney stoneskidney stones(Para.2-7)AcuterenalColictreatment(Para.2)Prevention(Para.3)Stoneremoval(Para.4-7)26 Detailed Analysis3Questions&AnswersLanguagePointsEachPart7Q:What methods can be used to diagnose kidney stones?A:Urinalysis,abdominal radiology,excretory urography,retrograde urography,ultrasonography,CT scanning,MRI.PartI(para.1):diagnosis8RenalcolicatypeofabdominalpaincommonlycausedbykidneystonesColic(fromGreekkolikos,relativetothecolon)orcholicisaformofpainwhichstartsandstopsabruptly.Itoccursduetomuscularcontractionsofahollowtube(colon,ureter,gallbladder,etc.)inattempttorelievetheobstructionbyforcingcontentout.10urinalysisur-:尿、尿路、泌尿 urology 泌尿学 urolith 尿石urography 尿路造影术-graphy x线照相术、描记法、造影术pneumonography 肺x线造影术angiography 血管照影术PartI(para.1):diagnosis11Patients with kidney stones often present with acute renal colic,and the diagnosis is based on symptomatology and diagnostic tests,which include urinalysis,abdominal radiology,and excretory urography.肾结石病人经常出现急性肾绞痛急性肾绞痛，其诊断依据综合症状和诊断试验，包括尿分析、腹部放射检查、下行性尿路照影下行性尿路照影。PartI(para.1):diagnosis13pHAmeasureoftheacidityoralkalinitylklntofasolution.ApHvalueof7indicatesaneutralsolution.ThepHscalecommonlyinuserangesfrom0to14.AsolutionwithapHofmorethan7.0isalkalinelklan,onewithapHlowerthan7.0isacid.15AplainfilmAnx-raytakenwithouttheuseofacontrastmediumx线平片16DoubleContrastBariumEnema(灌肠剂灌肠剂)enm=DCBE双对比钡灌双对比钡灌肠肠18Excretoryurographyusesacontrastmediumthatisfilteredintheglomerulitovisualizethecollectingsystemofthekidneysandtheureters.下行性尿路造影术使用一种在血管小球得到过滤的造影剂，以显现肾脏的集尿系统和输尿管。（）19Part II(para.2-7):Treatment 1.Why should the urine be filtered during an attack?2.What is the basis for long term preventive measures?3.What can be done in order to prevent the occurrence of stone formation?4.What are the major methods to remove kidney stones?20Part II(para.2-7):Treatment Q:1.Why should the urine be filtered during an attack?A:In order to retrieve stone for the chemical analysis and determination of type.21Part II(para.2-7):Treatment Q:2.What is the basis for long term preventive measures?A:The information of the type of stones and stone analysis,along with a careful history and laboratory tests,affords the basis for long term preventive measures.22Part II(para.2-7):Treatment Q:4.What are the major methods to remove kidney stones?A:ureteroscopicremovalpercutaneousremovalextracorporeallithotripsyopensurgicalprocedureetc.24 supportive:acute phases of obstruction:in the hope of：支持性的，辅助性的 急性阻塞阶段期望25Para.2 supportive treatment Allurineshouldbestrainedduringanattackinthehopeofretrievingthestoneforchemicalanalysisanddeterminationofthetype.inthehopeof怀着的希望retrieve:getbackeg.Themenweretryingtoretrieveweaponsleftwhenthearmyabandonedtheisland.那些人正试图找回该军队撤离这个岛时留下的武器Translateit:在发作期间，应对所有的尿液进行过滤，以期获取结石作化学分析和测定其类型。26Calcium oxalate stonesYoumayreduceyourriskofkidneystonesifyou:1.Drinkwaterthroughouttheday.Passingabout2.6quarts(2.5liters)ofurineadayrecommended2.Eatfeweroxalate-richfoods.Restrictingfoodsrichinoxalatesincludingrhubarb,beets,okra,spinach,Swisschard,sweetpotatoes,nuts,tea,chocolateandsoyproducts.3.Chooseadietlowinsaltandanimalprotein(suchaslegumes).4.Continueeatingcalcium-richfoods,butusecalciumsupplementswithcaution.5.VitaminCrichfoodsareacceptable,butVitaminCsupplementsarenotrecommendedsinceitcanincreaseoxalateinyourbody28Calcium Phosphate StonesReducingsodiumReducinganimalproteinGettingenoughcalciumfromfoodortakingcalciumsupplementswithfood29Struvite StonesStruviteStones:Somepatientsformstonesthatarecomposedofamixtureofmagnesium,ammonium,phosphate,and calcium carbonate,which is known as struvite.Thesestones form as a result of infectionwithcertaintypesofbacteriathatcanproduceammonia(氨).AmmoniaactstoraisethepHofurinewhichmakesitalkaline（碱性）and promotes theformationofstruvite.鸟粪鸟粪石，也称石，也称为为磷酸磷酸铵镁结铵镁结石石31Cystine StonesCystineStones:Cystinestonesarerare,andtheyformonlyinp e r s o n s w i t h a n inheritedmetabolicdisorderthatcauseshighlevelsofcystine(胱氨 酸)intheurine,aconditionknownasc y s t i n u r i a.32Present situationKidney Stone typePopulationCircumstancesCalcium oxalate80%when urine is alkaline(ph5.5)Calcium phosphate5-10%when urine is alkaline(high pH)Uric acid5-10%when urine is persistently acidicStruvite10-15%infections in the kidneyCystine1-2%rare genetic disorder33hyperparathyroidismthyro-orthyroid-:prefixthyroid甲状腺e.g.thyroxine甲状腺素para-orpar-:pref.beside,near,alongsidee.g.parathyroid甲状旁腺hyper-:excessive,above,orbeyond-ism:suffixconditionof甲状旁腺功能亢进34byincreasingthefractionalabsorptionofcalcium钙的分次吸收35Para 3.PreventionIn people who lose the ability to lower the pH of or acidity their urine,there is an increase in the divalent and trivalent forms of urine phosphate that combines with calcium to form calcium phosphate stones.在失去了降低尿液在失去了降低尿液pH值或酸化尿液能力的人或酸化尿液能力的人当当中，尿中，尿内内二价和三价磷酸二价和三价磷酸盐的的数数量增加，量增加，碱与碱与钙结合合时就形成磷酸就形成磷酸钙结石。石。36The formation of uric acid stones,on the other hand,is increased in acid urine;stone formation can be reduced by raising the pH of urine to 6.0-6.5 with patassium alkali salts.另一方面，在酸性尿中尿酸另一方面，在酸性尿中尿酸结石的形成机率上升；石的形成机率上升；在在这种种情情况况下可通下可通过使用使用钾碱碱盐将将尿的尿的pH值增增加到加到6.0-6.5，从从而降低成石机率。而降低成石机率。Para 3.Prevention37Para.4-7 Removal methods What methods are available for removing kidney stones?Ureteroscopic removalPercutaneous removalExtracorporeal lithotripsy38Ureteroscopic removal39Ureteroscopic removalDuring ureteroscopy,the doctor passes a thin viewing instrument(ureteroscope)through your urethra and bladder into your ureter.40Percutaneous removal41Percutaneous removal42Percutaneous removal43extracorporeal lithotripsy44454647Extracorporeal lithotripsy48Extracorporeal lithotripsy4950The end of 6B.51
