|
Objective To study and evaluate the urinary stones treatment and prevention strategies, the clinical characteristics of 1600 cases of urinary stones and stone components constitute were retrospectively analyzed.Methods 1.Analysis of 1600 cases of patients’sex, age, stone location, stone composition, admitted from August 2010 to February 2012 from around the Guangxi Province, Explore the clinical features and treatment of urinary stones in Guangxi region.2.Calculus specimens collected by patients over the 707 cases analyzed by infrared spectrometry analysis, to understand the characteristics of the composition of urinary calculi in Guangxi region,100 cases of upper urinary tract calculi specimens were compared with infrared spectroscopy and chemical analysis to analyze the similarities and differences in the characteristics of the stone analysis and stone composition.3. Characteristics of gender, age, stone location, stone composition, and treatment of 764 cases and 206 urinary stones composition analysis results were analyzed and compared with 10 years ago to understand the changes. Results 1.Gender:urinary tract stones among men 65%(1042/1600), women 35%(558/1600), the sex ratio of about 1.87:1 (1042/558); Age :3-13-year-old age group accounted for all cases 0.9%, 13-23-year-old age group accounted for 3.3%,23-33-year-old age group in all cases accounted for 12.7%,33-43-year-old age group in all cases accounted for 27%,43-53 years of age in all cases to account for all cases22.5%,53-63 age group accounted for 21.8%,73-83-year-old age group in all cases accounted for 0.7% of all cases; Stone location:kidney stones, accounting for 41.7%(667/1600), ureteral stones 50.9% (818/1600), bladder stones 4.9%(79/1600), urinaiy tract stones 0.2% (3/1600), the kidney with ureteral stones 2.1%(34/1600); urinary tract stones combined with other accounts for 0.1%(2/1600); Methods of treatment:55.6%(889/1600) extracorporeal shock wave lithotripsy, percutaneous nephrolithotomy 23.0%(368/1600), ureteroscopy 7.4% (118/1600), cystoscopy,4.9%(97/1600), laparoscopic 0.3%(5/1600), medication was 3.2%(51/1600), open surgery was 5.6% (90/1600).2. Stones constitute of 707 calculus specimens:Simple stones accounted for 40.7%:which accounted for 18.4% of calcium oxalate, uric acid accounted for 19.5%,2.5% apatite, cystine 0.3%; accounted for 59.3%of mixed stones:uric acid+calcium oxalate accounted for 32.8%, calcium oxalate+carbonated apatite accounted for 19.9%, Calcium oxalate+carbonated apatite+uric acid (4%),Phosphate apatite+ hexahydrate magnesium ammonium phosphate (2.5%).3. Both the infrared spectroscopy method and the chemical method have the characteristics of their own, The infrared spectroscopy is sensitive, fast, and can measure crystal structure, the simple stone is of more proportion in the results, the proportion of sampling is less, so the results vulnerable to the way of stone and stone parts;Chemical method detected slightly higher proportion of mixed stones, but the crystal structure can not be measured, mainly to the current knowledge of the composition is analyzed, the new composition of the stones can not be found, in order to arrive at a more reasonable conclusion the experimental results with the combination treatment.4. The result of 1600 cases of urinary stones compared with 764 cases in the same period a decade ago is below, Of gender:chi-square test X2= 1.341, P= 0.247, P> 0.05, two groups of sex is no statistical difference; the incidence ratio of 30-50 age group chi-square test:X2=1.700, P= 0.192, P> 0.05, constitute no significant difference; Stone incidence areas:the chi-square test x2= 1.367, P =.85010, P> 0.05, stones anatomical site differences were statistically significant; Stones treatment:chi-square test%= 464.985, P=0.000, P <0.05, statistically significant proportion of minimally invasive surgery is higher than a decade ago;707 cases of stone composition of uric acid and calcium oxalate compare with 206 cases 10 years ago in the same period: Chi-square test,%= 0.187, P=0.665, P> 0.05, uric acid and calcium oxalate constitute no statistically significant difference.Conclusions 1. Urinary stones with larger proportion of males in Guangxi region; The 33-53 age group the prevalence is relatively high; Upper urinary tract stones prevalence rate than the prevalence of lower urinary tract stones; The treatment approach to the minimally invasive treatment, supplemented by open surgery.2. Stones composed mainly of calcium oxalate, uric acid stones as the main ingredient.3.The two analysis methods have advantages and disadvantages, Qualified hospitals preferred infrared spectroscopy, comparison of two methods when necessary to do a more accurate analysis of stone composition. 4.Compared with 10 years ago, little fluctuation in gender, age, still young and middle-aged male, highest incidence of upper urinary calculi incidence increase in the proportion, the treatment tends to minimally invasive treatment.5.Prevention should be controlled oxalate, uric acid food intake, to maintain nutritional balance, increase fluid intake in the prevention, The calcium salt stones should be added to the rich the citrate fruit intake, restrict sodium and high-purine diet, Uric acid stones should raise the PH value of the urine, to reduce the formation and excretion of uric acid.
|