曼谷肾结石治疗

曼谷肾结石治疗

Advanced, minimally invasive kidney stone care — from non-invasive 3rd-generation shockwave (ESWL) and laser stone removal to long-term prevention — at Bangkok Hospital Headquarters.

Medically reviewed by Dr. Soarawee Weerasopone, MD — Board-Certified Urologist & Endourology Specialist · Research Scholar & Clinical Observer, Scott Department of Urology, Baylor College of Medicine

什么是肾结石？

肾结石（又称肾石）是当尿液浓度过高时，肾脏内部形成的坚硬矿物质沉淀物，这使得矿物质结晶并粘在一起。它们非常普遍，影响了大约 十分之一的人 在其一生中，一旦形成一个结石，形成另一个结石的风险会显著增加——这就是为什么预防与治疗同等重要。. Why do kidney stones form? →

肾结石可能在肾脏中静置多年，但当它移入输尿管时，会引起突发的剧烈疼痛（肾绞痛）、尿血、恶心，并且——如果它阻塞尿液流出或引发感染——则会引发需要紧急引流的泌尿急症。.

肾结石的常见类型

• 草酸钙 — 迄今为止最常见的；与饮食、脱水和代谢因素有关
• 尿酸 一种通常可以通过口服药物溶解的类型；与高嘌呤饮食、痛风和酸性尿液有关
• 磷酸铵镁结石（感染） — 伴有某些尿路感染，并且可能变得很大（鹿角形）
• 胱氨酸 罕见、遗传且容易从小复发

警告标志

• 腰部或侧腹剧烈绞痛，呈阵发性
• 疼痛放射到下腹部或腹股沟
• 尿中带血（粉红色、红色或棕色）
• 恶心、呕吐或尿频
• 发烧和寒战——需要紧急治疗的感染的警示信号

Fever or shaking chills alongside stone pain is the one combination that should not wait. An obstructed, infected kidney can deteriorate quickly and needs same-day hospital assessment, often for urgent drainage, rather than a routine appointment. The same applies to pain that no medication controls, persistent vomiting, or passing little or no urine.

治疗方案

正确的治疗取决于结石的大小、位置和类型——遵循国际（AUA/EAU）指南，始终优先选择最有效且微创的治疗方案。.

1 — 密切观察与药物排石疗法

小石头（通常小于 6 毫米）通常可以自行排出，只需多喝水、止痛和服用松弛输尿管的药物，以帮助结石通过。. 了解药物排石疗法

2 — 口服崩解（尿酸结石）

尿酸结石是独特的——它们通常可以通过口服药物溶解，这些药物能使尿液酸性降低，从而完全避免手术。. 阅读关于溶解尿酸结石 →

3 — 体外冲击波碎石术 (非侵入性冲击波碎石术)

聚焦冲击波将结石击碎成细小碎片，这些碎片会通过自然途径排出体外——无需手术切口，也无需将内窥镜插入体内。Soarawee 医生目前正在进行手术 第三代体外冲击波碎石术 在泰国. What to expect afterwards, and the warning signs that need same-day care →

4 — 柔性输尿管镜（RIRS）联合钬激光

A thin flexible scope is passed through the natural urinary passage to reach the stone, which is then vaporized with a Holmium laser — no incisions, high success rates, even for harder stones. Modern flexible ureteroscopy now handles stones of almost any size, and it is Dr. Soarawee’s preferred approach wherever it is feasible. 了解钬激光手术

5 — Very Large or Staghorn Stones

Guidelines list percutaneous nephrolithotomy (PCNL) as first-line for stones larger than 2 cm, but PCNL requires a tract created through the flank into the kidney and is considerably more invasive. PCNL is not performed at Bangkok Hospital Headquarters — Dr. Soarawee’s approach is to attempt RIRS with the Holmium laser wherever it is feasible, and where a stone genuinely requires PCNL, referral to a centre that offers it can be arranged.

浏览所有肾结石患者指南 →

防止结石复发

移除石头可以解决今天的问题；预防计划可以保护您的未来。根据您的代谢测试结果，我们将为您量身定制一项策略，其中可能包括：

• 补水目标 — enough fluid to keep urine pale and dilute, the single most powerful preventive step. Targets are adjusted where heart or kidney disease limits how much you should drink
• 饮食调整 — tailored sodium, oxalate, animal-protein, and citrate guidance based on your stone type. Eight habits that prevent stones →
• 靶向药物 — such as 柠檬酸钾 or others, when the metabolic profile calls for it
• 定期监控 定期影像学检查和尿液检测，以尽早发现新的结石

阅读完整的肾结石预防指南 →

常见问题解答

Q1: 肾结石的警示信号有哪些？

典型症状为背部或侧腹突然出现剧烈疼痛，呈阵发性，可放射至下腹部或腹股沟，常伴有尿血、恶心或尿频。伴有发热和寒战的这些症状提示感染，需要紧急就医。.

问2：所有的肾结石都需要手术吗？

不。许多小结石可以随着体液自然排出，可以通过止痛药和药物来缓解疼痛，尿酸结石通常也可以通过口服疗法溶解。手术或体外冲击波碎石术适用于体积过大无法自行排出、导致梗阻或感染、或者无法自行移动的结石。.

Q3：肾结石较大时，最佳治疗方法是什么？

It depends on size and location. Flexible ureteroscopy (RIRS) with Holmium laser handles many kidney and ureteric stones without incisions and now reaches stones of almost any size. Guidelines still list percutaneous nephrolithotomy (PCNL) as first-line above 2 cm; PCNL is not performed at Bangkok Hospital Headquarters, and where a stone genuinely requires it, referral can be arranged. A CT scan guides the choice.

如何才能防止肾结石复发？

预防始于保持充足水分，使尿液呈淡黄色，加上饮食调整，并在需要时根据您的结石类型和代谢检测进行靶向药物治疗。一旦出现结石，个性化的预防计划可以大大降低再次发生的几率。.

问5：体外碎石术会痛吗？多久能恢复？

体外冲击波碎石术（ESWL）是非侵入性的，在镇静或浅麻醉下进行，因此通常耐受性良好。大多数人在一两天内恢复正常活动，并在随后的几天到几周内排出结石碎片。对于较大的结石，可能需要不止一次治疗。.

Q6: When is a kidney stone an emergency?

Fever or shaking chills together with stone pain is the most important combination, because an obstructed kidney that becomes infected can deteriorate quickly and may need urgent drainage. Also seek same-day care for pain that the prescribed medication does not control, persistent vomiting that prevents keeping fluids down, or passing little or no urine.

预约您的咨询

获得肾结石的准确诊断和清晰的治疗计划。.

曼谷医院远程医疗服务适用于无法亲自就诊的患者，包括国际患者——请通过电子邮件提前向泌尿科预约： bhquro@bdms.co.th. Samitivej Sriracha is in-person only.

This page is provided for patient education only and is not medical advice. It does not create a doctor-patient relationship. Fever or chills with stone pain needs same-day medical assessment. Dr. Soarawee does not provide medical assessment, advice, diagnosis or prescriptions through personal messaging channels, direct messages or social media.