绵阳地区上尿路结石成分分析及预防指导  

Analysis of the Composition of Upper Urinary Tract Calculi and the Prevention Guideline of Urinary Tract Calculi in Mianyang

作　　者：范钰[1] 袁光亚[1] 王耀东[1] 辛宇鹏[1] 贺凯[1] 邵红刚[1] 胡海燕[1] 张天生[1] 向敏[1] 

机构地区：[1]绵阳市中心医院泌尿外科,四川绵阳621000

出　　处：《四川医学》2016年第10期1099-1103,共5页Sichuan Medical Journal

基　　金：绵阳市卫生局基金(编号:201114)

摘　　要：目的：研究绵阳地区上尿路结石成分组成特点，探讨基于结石成分分析结果而制定的预防指导方案的效用。方法纳入2011年6月至2013年10月间非肾输尿管混合部位的上尿路结石患者共374例，采用红外光谱法对结石成分进行分析，根据分析结果选择预防指导方案，随后根据患者采取的不同预防方案进行分组，随访24个月以观察比较组间结石复发率的差异。结果共检测出单一成分结石6种，混合成分结石5种，结石成分比例由高到低分别为草酸钙（78．6%）、碳酸磷灰石（51．9%）、六水磷酸胺镁（22．7%）、无水尿酸（14．4%）、尿酸铵（0．8%）和L-胱氨酸（0．3%），含钙结石的比例达91．4%。经随访发现，采取了预防方案的患者无论哪个时间段以及总的结石复发率（9．7%）均显著小于未预防患者（总复发率23%）；无论是严格预防方案还是一般预防方案均能有效预防结石复发；采取严格预防方案患者的结石复发率在0~12个月这个时间段内（1．4%）与采取一般预防方案的患者（6．2%）相比较，差异均有统计学意义（ P〈0．05）。结论绵阳地区上尿路结石成分以含钙结石为主，针对结石成分进行预防指导能有效的降低结石复发率。Objective This object was to study the composition of upper urinary tract calculi in Mianyang and discuss the effect of the prevention guideline which is made according to the outcomes of the composition analysis. Methods 374 patients who had upper urinary calculi were included from June 2011 to October 2013. The stone composition was detected by infrared spectros-copy and different stone compositions had different prevention guidelines. The patients were divided into different groups according to the prevention guidelines. A 24-month follow-up was conducted,which was to compare the difference of recurrence rate among different groups. Results 6 types of single-component stone and 5 types of mixed-component stone were detected. From high to low,the stone components were calcium oxalate（78. 6%）,carbonate apatite（51. 9%）,AmmoniumMagnesium Phosphate Hexahy-drate（22. 7%）,uricite（14. 4%）,ammonium citrate（0. 8%）,L-Cystine（0. 3%）. 91. 4% of the stone contained calcium. After the follow-up,we found that the recurrence rate（9. 7%）in the prevention groups was lower than the non-prevention groups（23%）. All the prevention guidelines could prevent the recurrence of lithiasis,but the difference between the recurrence rate（1. 4%）in patients who had strict prevention guidelines and that（6. 2%）in patients who had common guidelines during the 12 months was significant（P〈0. 05）. Conclusion The main component of the stone in Mianyang is calcium and prevention guidelines made according to the stone composition can reduce the recurrence rate effectively.

关 键 词：尿路结石 结石成分 预防 

分 类 号：R691.4[医药卫生—泌尿科学]