842例肾手术患者临床病理及流行病学研究

Retrospective study of clinical,pathological,and epidemiological characters in 842 cases of kidney operation diseases in a regional hospital

目的 研究肾病手术患者的肾病疾病谱、发病状况、临床流行病学特点,为肾脏疾病的预防、诊断和治疗提供依据.方法 采用国内外最新肾脏疾病诊疗标准指南,对2000年1月～2013年12月来自某大型医院收治的842例肾手术病例,进行了肾活检资料的分析总结.进而探讨了该地区肾脏病患者的病理类型、发病状况及流行病学特点.并对其进行了回顾性评价和统计学分析.结果 该组男女比为1.038∶1,年龄56.5±2.2（2～86）岁,51～60岁年龄段发病率最高.2006年肾手术标本所占总活检量比例最高.本组病例中肾病疾病谱涵盖近20种,肿瘤性肾脏疾病与非肿瘤性肾脏疾病之比为0.17∶1.本组病例肾积水、肾囊肿、肾脓肿、肾细胞癌、移行细胞癌、肾破裂、肾错构瘤、肾结核、肾母细胞瘤和其他肾病分别占31.03％、42.50％、2.34％、6.79％、2.46％、4.22％、4.22％、1.87％、0.35％和4.22％.肿瘤性肾脏疾病和非肿瘤性疾病均呈逐年上升趋势,但以非肿瘤性疾病增加明显.肾积水的病因中,以肾结石梗阻、肾纤维化、肾萎缩伴或不伴感染为主要原因.结论 肾积水、肾囊肿是过去10年来危害该地区群众健康的主要肾病病种,且近10年来非肿瘤性肾脏疾病发病率呈上升态势;该地区肾脏疾病患者的年龄、性别具有一定的结构特点.肾结石导致的梗阻性肾病、肾纤维化是肾手术的主要病因.

Objective To study the renal disease operation spectrum, incidence and clinical features of kidney dis- ease and provide basis for diagnosis and treatment. Methods The renal biopsy data from 842 patients with renal operation were analyzed and summarized using the latest domestic and international kidney disease diagnosis standards and guides. The pathology type, pathogenesis, and epidemiology characteristics of these patients were discussed. Retrospective eval- uation and statistical analysis were carried out. Results 20 kinds of kidney diseases in the disease spectrum were found in the 842 cases in this study. The ratio of tumorous kidney disease to non-neoplastic renal disease was 0.17： 1. Cases of hy- dronephrosis and cysts accounted for 31.03% and 42.50%, respectively. Both of the tumorous kidney disease and the non-neoplastic disease showed a rising trend year by year. Moreover, the rate of non-neoplastic diseases significantly in- creased.. The main causes of hydronephrosis were obstruction, renal fibrosis, and renal atrophy （with or without infec- tion） instigated by kidney stones. Conclusion Hydronephrosis and renal cysts were the main renal diseases that were hazardous to regional public health over the past 10 years. Furthermore, the constituent ratio of the non-neoplastic renal disease exhibited an increasing trend in the last 10 years. Obstructive nephropathy and renal fibrosis caused by asympto- matic renal calculus were the main pathogenies.