龙泉地区泌尿系结石成分构成特点及碳酸氢钠干预效果分析

Analysis of Urinary Calculi Composition and Effect of Sodium Bicarbonate Intervention in Longquan Area

目的:分析龙泉地区泌尿系结石成分构成特点及碳酸氢钠干预效果。方法:选取2021年1月1日—2022年12月31日在我院就诊的997例泌尿系结石患者,均进行结石成分分析。将结石负荷大,易复发的患者随机分入对照组和碳酸氢钠干预组,对照组给予呋塞米口服,干预组在对照组基础上予以碳酸氢钠片口服。对比两组的干预效果及复发情况。结果:997份泌尿系结石标本的成分中,以一水草酸钙、二水草酸钙、碳酸磷灰石所占比例较高。结石成分组成中以混合性成分结石为主,其中以一水草酸钙、二水草酸钙、碳酸磷灰石及一水草酸钙、碳酸磷灰石为主。女性患者(36.11%)明显少于男性患者(63.89%),其中六水磷酸铵镁在男性患者中的比例明显低于女性(P<0.05)。合并尿路感染的患者(37.31%)少于未合并患者(62.69%),其中六水磷酸铵镁在合并尿路感染患者中的比例明显高于未合并患者(P<0.05)。997例泌尿系结石患者中,以40~59岁的患病率(64.89%)最高,其次为60~69岁(16.25%)及30~39岁(12.74%)。本研究中结石负荷大、易复发的患者共有768例,随机纳入对照组(376例)和碳酸氢钠干预组(392例)。干预组患者的总有效率为94.64%,明显高于对照组的84.84%(P<0.05);术后随访中,干预组患者的复发率为7.91%,明显低于对照组的15.16%(P<0.05)。结论:龙泉地区的泌尿系结石病患者以混合性成分结石为主,其中以草酸钙及碳酸磷灰石为主,且男性患者多于女性患者,合并尿路感染者少于未合并感染者,30~69岁为结石高发年龄段。另外,采用碳酸氢钠治疗泌尿系结石具有一定的疗效,值得临床推广应用。

Objective:The characteristics of urinary calculus composition and the effect of sodium bicarbonate intervention in Longquan area were analyzed.Methods:From January 1st,2021 to December 31st,2022,997 patients with urinary calculus in our hospital were selected for stone composition analysis.Patients with high stone load and easy recurrence were randomly divided into control group and sodium bicarbonate intervention group.The control group was given furosemide orally,and the intervention group was given sodium bicarbonate tablets orally on the basis of the control group.The intervention effect and recurrence situation of the two groups were compared.Results:In 997 urinary stone samples,calcium oxalate monohydrate,calcium oxalate dihydrate and carbonate apatite accounted for a higher proportion.The composition of the stones is mainly composed of mixed components,including calcium oxalate monohydrate,calcium oxalate dihydrate,carbonate apatite,calcium oxalate monohydrate and carbonate apatite.Female patients(36.11%)were significantly less than male patients(63.89%),and the proportion of magnesium ammonium phosphate hexahydrate in male patients was significantly lower than that in female patients(P<0.05).Patients with urinary tract infection(37.31%)were less than those without urinary tract infection(62.69%),and the proportion of magnesium ammonium phosphate hexahydrate in patients with urinary tract infection was significantly higher than that in patients without urinary tract infection(P<0.05).Among the 997 patients with urinary calculi,the prevalence rate was highest in 40~59 years old(64.89%),followed by 60~69 years old(16.25%)and 30~39 years old(12.74%).In this study,a total of 768 patients with heavy stone load and easy recurrence were randomly included in the control group(376 cases)and sodium bicarbonate intervention group(392 cases).The total effective rate of the intervention group(94.64%)was significantly higher than that of the control group(84.84%)(P<0.05).The recurrence rate in the intervention group(7.91%)was significantly lower than that in the control group(15.16%)(P<0.05).Conclusion:The majority of urolithiasis patients in Longquan area have mixed component lithiasis,among which calcium oxalate and carbonate apatite are the main ones.There are more male patients than female patients with urinary tract infection than uninfected patients.The age group with high incidence of lithiasis is 30~69 years old.In addition,the use of sodium bicarbonate in the treatment of urinary calculi has a certain effect,worthy of clinical application.