Original title: After many years of stone treatment, it eventually destroyed the right kidney.
Guangzhou ** News (Quan** reporter Zhang Qingmei, correspondent Wei Xing, Wu Liting) As a common urinary system disease, kidney stones are often underestimated. A small kidney stone is not a big problem in the eyes of many people, but if it is not painful or itchy, it is even more ignored and ignored. However, experts warn that small stones can also lead to serious or even irreversible health problems if they are not paid enough attention. A few days ago, Mr. Zhang (pseudonym) had to have his right kidney removed because of a stone that had not been treated for many years.
Stones are left alone and cause a catastrophe.
Mr. Zhang, who is over half a hundred years old, is very confident in his health and always says that there is no problem except for the discovery of kidney stones a few years ago. However, when the doctor picked up his recent physical examination report, he was shocked to find that there was a serious problem with his urinary system: right ureteral stones, enlarged right kidney, severe fluid accumulation in the right kidney, ......The doctor said that further evaluation of kidney function is needed, and if the right kidney is completely out of function, surgery will be needed to remove it.
After completing the relevant evaluation, the doctor found that the right kidney had lost function;Eventually, Mr. Zhang underwent surgery** in desperation to remove his right kidney.
After the operation, the "real culprit" is still hidden in the body.
The loss of the right kidney was already a huge blow. Mr. Zhang thought that the problem was over, but during the follow-up visit, the doctor found that the "real murderer" was still hiding in his body!
During a follow-up examination, the doctor found that Mr. Zhang's calcium in his blood was slightly elevatedAt the same time, a review of the patient's previous examinations also revealed that there were many previous cases of slight elevation of serum calcium. At this point, the attending doctor muttered, why does the patient have so much calcium in his blood?
According to Mr. Zhang's medical history and examination results, Xu Bo, chief physician of the Department of Thyroid Surgery of Guangzhou First People's Hospital, who participated in the consultation, analyzed that the cause of his elevated blood calcium may be caused by hyperparathyroidism (hyperparathyroidism). In order to further confirm, Xu Bo gave Mr. Zhang a complete parathyroid hormone test and imaging examination, and the results were verified: primary hyperparathyroidism. Xu Bo introduced that hyperparathyroidism is not a common disease, and the disease can lead to a continuous increase in blood calcium in the patient's bodyIf it is not detected in time, Mr. Zhang is likely to have urinary stones again, and the condition of his left kidney is also in danger.
What is hyperparathyroidism?According to Dr. Feng Jianhua, Department of Thyroid Surgery, Guangzhou First People's Hospital, hyperparathyroidism is a disease caused by excessive secretion of parathyroid hormone (PTH) in the body, mainly including primary and secondary hyperparathyroidism.
Primary hyperparathyroidism is caused by a lesion of the primary parathyroid gland, often caused by parathyroid hyperplasia or parathyroid adenoma, which causes excessive secretion of parathyroid hormone and causes a series of pathophysiological changes. Secondary hyperparathyroidism, on the other hand, is hyperparathyroidism caused by lesions of other organs, most commonly in patients on dialysis with chronic renal insufficiency.
Parathyroid hormone first acts on bone tissue, causing a large amount of calcium ions to leave bone tissue, resulting in an increase in serum calcium content and an increase in urine calcium, resulting in a negative calcium balance. At the same time, the hormone acts on renal tubular epithelial cells to inhibit phosphorus reabsorption, resulting in a large loss of urinary phosphorus and a decrease in serum phosphorus, resulting in a negative balance of phosphorus. Calcium and phosphorus deficits are mainly supplemented by bone tissue;At the same time, long-term hypercalcemia and high urine calcium will increase the incidence of organ calcification and stones. Therefore, the common manifestations of the disease are urinary system (kidney, ureter, bladder) stone reversal, osteoporosis, bone and joint pain, and some can also cause various symptoms such as indigestion.
Another operation has finally resolved the crisis.
It can be said that surgery is the only way to treat both the symptoms and the root causes of hyperparathyroidism, but Mr. Zhang's blood calcium is significantly elevated, and he needs to pay close attention to the arrhythmia and confusion that may be caused by hypercalcemia during the perioperative period. In addition, imaging tests including neck ultrasound, parathyroid scintigraphy, or cervical CT are required to locate the abnormal parathyroid glands before surgerySome small lesions may be difficult to locate, and careful intraoperative exploration is required to look for the diseased parathyroid glands.
Therefore, throughout the perioperative period, it is necessary to monitor the changes of blood calcium and various biochemical indicators more closely, and the intraoperative anesthesia also strives to monitor the vital signs more closely. For the surgeon, the risk can be minimized by accurately locating and completely removing the lesion in the shortest possible time during the operation, which is also the biggest test faced by the surgeon.
After a thorough preoperative evaluation, Xu Bo performed surgery on Mr. Zhang**. During the operation, his right lower parathyroid gland was significantly enlarged, and the rest of the parathyroid glands were normal, and the operation successfully removed the enlarged right lower parathyroid gland, which was the culprit, and the final pathological diagnosis was parathyroid adenoma.
With the full cooperation of the thyroid surgeons, Mr. Zhang's postoperative process went smoothly, and the parathyroid hormone and blood calcium quickly returned to normal. The "real culprit" that had plagued Mr. Zhang for many years was finally caught, and the stone plague finally came to an end.
Reminder: Don't ignore stones to check for hyperparathyroidism.
The parathyroid glands are important endocrine organs in the neck and are responsible for the secretion of parathyroid hormone in the body. Hyperparathyroidism is not a common disease in clinical practice, and its onset is often manifested by urinary stones, bone pain and psychoneurological symptoms, so it is easy to misdiagnose and miss. Xu Bo reminded that if you usually encounter urinary stones, you must pay more attention, especially when the symptoms appear frequently, it may be really hidden in places we don't expect, such as the parathyroid glands in the neck.
*: Guangzhou**.