尿石症住院患者1100例分析

Analysis of 1100 in-patients with urolithiasis

目的 了解近年来尿石症住院患者情况的变化.方法 对1998年～2003年间的尿石症住院患者1 100例进行分析.结果 本组中,肾结石251例(22.8%)、输尿管结石742例(67.5%)、膀胱结石97例(8.8%)、尿道结石10例(0.9%).上、下尿路结石的比例为9.28∶1.高钙尿患者27例(13.0%)、高钙血症91例(9.1%)、高尿酸血症167例(17.8%).结石成分分析结果:草酸钙168例(62.7%);磷酸钙59例(22.0%);尿酸及尿酸盐25例(9.3 %);磷酸镁铵10例(3.7%);碳酸盐5例(1.7%);胱氨酸1例(0.4%).治疗:ESWL 658例(59.8%)、肾切开取石术35例、肾切除术6例、输尿管切开取石术92例(占8.4%)、输尿管镜加气压弹道碎石52例(4.7%)、膀胱切开取石53例(其中前列腺摘除术加膀胱切开取石术26例);膀胱镜加气压弹道碎石20例;前列腺电切术加气压弹道碎石7例;膀胱镜加大力钳碎石术9例.尿道切开取石术1例;经尿道镜取石术2例;尿道镜加气压弹道碎石3例.结论 本组尿石症患者以上尿路结石为主,含钙结石占绝大多数.尽管微创手术的普遍开展,ESWL仍不失为一种创伤小、效果好的治疗方法.

Objective To investigate changes of in-patients with urolithiasis in recent years. Methods Data of 1100 inpatients with urolithiasis from 1998 to 2003 in our department had been analysed. Results There were 251 cases of renal stone(22.8%), 742 cases of ureteral stone(67.5%), 97 cases of vesical stone(8.8%) and 10 cases of urethral stone (0.9%). Ratio of upper and lower urinary tract stone is 9.28∶1. There were 27 cases of hypercalcinuria(13.0%), 91 cases of hypercalcemia(9.1%), and 167 cases of hyperuricaemia (17.8%). Stone components were below: 168 cases of calcium oxalate (62.7%), 59 cases of calcium phosphate(22.0%), 25 cases of uric acid and urate(9.3 %), 10 cases of ammonium magnesium phosphate(3.7%), 5 cases of calcium carbonate (1.7%) and 1 case of cystine(0.4%). Of all, 658 (59.8%) cases had been treated by ESWL, 35 cases by pyelolithotomy, 6 cases by nephrectomy, 92 cases by ureterolithotomy, 52 cases by ureteroscopy and pneumatic lithotripsy (PL), 53 cases by cystolithotomy, 20 cases by cystoscopy and PL, 7 cases by TURP and PL, 9 cases by cystoscopy and lithotrite, 1 case by urethrolithotomy, 2 cases by urethroscopy, and 3 cases by urethroscopy and PL. Conclusion Upper urinary tract stones are primary in the urinary stone in-patients and most of them contain calcium. Although microtraumatic operation has been widely used, EWSL is still a less traumatic and more effective therapy.