尿路结石成分分析及个体化预防指导

Urinary calculi composition analysis and individualized prevention instruction

目的探讨河南地区尿路结石患者结石成分及个体化预防结石复发的临床意义。方法选取2009年8月至2010年7月在我院行体外冲击波碎石、输尿管镜取石、经皮肾镜取石的1050例患者为实验组，所有结石标本都采用布鲁克TENSOR27型红外光谱分析仪分析结石成分，责任护士根据结石成分，个性化指导预防复发。选取2008年7月至2009年7月在我院行体外冲击波碎石、输尿管镜取石、经皮。肾镜取石的1010例患者为对照组，对照组患者结石未进行成分分析，患者均接受一般性的预防指导。比较2组结石复发情况。结果实验组1050例尿路结石中单一成分结石486例占46．29％，其中单纯草酸钙结石（包括一水草酸钙和二水草酸钙）472例占44．95％；混合性结石564例占53．71％，主要为草酸钙与碳酸磷灰石的混合成分320例占30．48％。实验组复发57例，复发率5．43％，对照组复发177例，复发率17．52％。2组间复发率比较差异有统计学意义。结论尿路结石成分分析对于了解结石的成因，指导治疗及预防尿路结石的复发有着重要的临床意义。

Objective To investigate the calculi composition of patients with urinary calculi in Henan area and the clinical significance of preventing calculi recurrence with individualized method. Methods From August 2009 to July 2010, 1050 patients in our hospital underwent extracorporeal shock wave lithotripsy （ESWL） and ureteroscopy and percutaneous nephrolithotomy were set as the experimental group, all stone specimens were detected with the BRUKER TENSOR27 infrared spectroscopy for analysis of stone compo- sition, and nurse on duty gave instructions according to the stone composition to prevent recurrence. From July 2008 to July 2009 1010 patients in our hospital underwent extracorporeal shock wave lithotripsy, ureteroscope and percutaneous nephrolithotomy were set as the control group, patients in the control group were not given calculi component analysis and these patients received general prevention guidance. The cal- culi recurrence was compared between two groups. Results Among 1050 cases in the experimental group, urinary calculi with single component accounted for 46.29%, of which calcium oxalate stones ac- counted for 44.95%. Calculi with mixed components accounted for 53.71%, mainly were calcium oxalate and carbonate apatite mixture components （30.48%）. 57 cases （5.43%） occurred urinary stone recurrence in the experimental group, while 177 cases（17.52%） in the control group. The difference had statistical signif- icance. Conclusions Urinary calculi analysis has important clinical significance for understanding the causes and treatment of calculi as well as prevention of recurrence of calculi.