山西地區(qū)腎結石復發(fā)特點及危險因素分析
發(fā)布時間：2018-07-17 04:15
【摘要】：目的:通過260例山西地區(qū)初發(fā)腎結石患者的術后隨訪及對復發(fā)腎結石成分分析,總結山西地區(qū)腎結石復發(fā)特點及影響復發(fā)的危險因素,為預防山西地區(qū)腎結石復發(fā)提供依據。方法:從2014年9月到2016年9月就診于中國人民解放軍264醫(yī)院的腎結石患者中篩選出符合標準的260例患者定期隨訪,隨訪資料包括術后相關影像學檢查及血、尿生化。根據結果將260例腎結石術后患者分為腎結石復發(fā)組與腎結石未復發(fā)組,同時對復發(fā)性患者結石性質進行結石成分分析,并回顧性分析二組患者臨床資料及隨訪結果,對資料進行統(tǒng)計分析,總結出山西地區(qū)腎結石復發(fā)的復發(fā)特點及影響復發(fā)危險因素。結果:260例初發(fā)性腎結石患者中,超重組5人,肥胖組29人,正常組226人;輕度腎臟積水者18人(先天性輸尿管狹窄者7人,前列腺增生患者10人,后尿道狹窄患者1人),共復發(fā)8人,無腎積水者242人,復發(fā)16人;血清高血鈣者10人,其中腫瘤患者6人(肺部腫瘤患者1人,膀胱腫瘤患者4人,前列腺腫瘤患者1人)、代謝綜合癥患者2人,不明原因患者2人,共復發(fā)3人,正常血鈣者250人,復發(fā)21人;男性和女性患者分別為182、78例,比例約為2.3:1;男性、女性平均腎結石初發(fā)年齡分別為42.5±12.4歲、40.8±13.2歲;左腎、右腎及雙腎結石分別為121例、115例、24例;非鹿角形、鹿角形結石分別為237例、23例;結石長軸2cm、2~3cm、3cm者分別有153人、92人、15人,結石長軸平均為1.9cm;最長隨訪30個月,最短隨訪7個月,平均隨訪16.9個月;腎結石共復發(fā)24例,1年復發(fā)率、2年復發(fā)率分別為7.8%、9.2%;復發(fā)患者復發(fā)時間最短7個月,最長25個月,平均為13.5個月;20~40歲、40~60歲、60歲以上分別有50例、190例、20例,復發(fā)人數(shù)人別為6例、10例、8例;男性復發(fā)18例,女性6例;超重組、肥胖組、正常體質組分別復發(fā)3、6、15例;初發(fā)單側、雙側腎結石患者中分別復發(fā)13例、11例;鹿角形結石23例,復發(fā)8例,非鹿角形結石237例,復發(fā)16例;初發(fā)腎臟結石小于2cm組、2~3cm組、大于3cm組復發(fā)人數(shù)分別為8人、12人、4人;高尿酸血癥者2人,2人術后2年全部復發(fā);復查兩次及以上尿路感染者9人,復發(fā)4人;復發(fā)結石全部為單側復發(fā),結石成分主要以草酸鈣結石、磷酸銨鎂結石及磷灰石多見。結論:1、山西地區(qū)腎臟結石患者復發(fā)率較高,1年、2年復發(fā)率分別為7.8%、9.2%;2、年齡與腎結石復發(fā)有相關性,60歲以上老年人更易復發(fā);性別因素對復發(fā)率影響無統(tǒng)計學意義;3、初發(fā)腎結石患者之中,雙側腎結石及鹿角形腎結石更易復發(fā);初發(fā)患者結石長軸大小與復發(fā)有相關性,大于2cm結石患者更易復發(fā);4、BMI指數(shù)與腎結石復發(fā)相關,BMI指數(shù)25者更易復發(fā);5、高血清Ca2+水平、長期腎臟積水、腎臟結石術后慢性尿路感染為腎結石復發(fā)的重要因素;6、山西地區(qū)復發(fā)結石成分以草酸鈣結石和感染性結石(磷酸銨鎂結石、磷灰石)為主。
[Abstract]:Objective: to summarize the characteristics of renal calculi recurrence and the risk factors affecting the recurrence of renal calculi in Shanxi area through the follow-up of 260 cases of primary renal calculi in Shanxi area and to provide evidence for preventing the recurrence of renal calculi in Shanxi area. Methods: from September 2014 to September 2016, 260 patients with renal calculi were selected from 264 Hospital of the Chinese people's Liberation Army (PLA) to follow up regularly. The follow-up data included postoperative imaging examination, blood and urine biochemistry. According to the results, 260 patients were divided into two groups: the recurrent group and the non-recurrent group. The stone components of the recurrent patients were analyzed, and the clinical data and follow-up results of the two groups were analyzed retrospectively. The recurrence characteristics and risk factors of renal calculi recurrence in Shanxi area were summarized by statistical analysis. Results among 260 patients with primary renal calculi, 5 were superrecombinant, 29 were obese, 226 were normal, 18 were mild hydronephrosis (7 patients with congenital ureteral stricture and 10 patients with benign prostatic hyperplasia). There were 8 patients with posterior urethral stricture, 242 patients without hydronephrosis, 16 patients with recurrence, 10 patients with high serum calcium, including 6 patients with tumor (1 patient with lung tumor and 4 patients with bladder tumor). (1 patient with prostate cancer), 2 patients with metabolic syndrome, 2 patients with unknown cause, 3 patients with recurrence, 250 patients with normal blood calcium and 21 patients with recurrence. The mean initial age of renal calculi in females was 42.5 鹵12.4 years old and 40.8 鹵13.2 years old respectively; there were 121 cases of renal calculi in the left kidney, 115 cases in the right kidney and 24 cases in both kidneys; 237 cases were non-staghorn stones and 23 cases were staghorn stones; The mean long axis of stone was 1.9 cm, the longest follow-up was 30 months, the shortest follow-up was 7 months, the average follow-up was 16.9 months, the recurrence rate of renal calculi in 24 cases, the recurrence rate of 1 year and the recurrence rate of 2 years were 7.8 and 9.2.The recurrence time of recurrent patients was 7 months and the longest was 25 months. The average age was 13.5 months, 20 / 40 years, 40 / 40 / 60 / 60 / 60 / 60 / 60 / 60 / 60 / 60 / 60 / 60 / 60 / 60 / 60 / 60 / 60 / 60 / 60 / 60 / 60 / 60 / 60, 20 / 50 / 50 / 60 / 60 / 60 / 60 / 60 / 60 / 60 / 60 / 60 / 60 / 60 / 60 / 60 / 60 / 60 / 60 / 60 / 60 / 60 / 50 / 60 / 60 / 60 / 60 / 60 / 60 / 60 / 60 / 60 / 60 / Among the patients with bilateral renal calculi, there were 13 cases of recurrence, 23 cases of staghorn calculi, 8 cases of recurrence, 237 cases of non-staghorn calculi, 16 cases of recurrence, the number of recurrence of primary renal calculi was less than 2cm in 2cm group and 4 cases were higher than that of 3cm group. In 2 patients with hyperuricemia, 2 patients all recurred 2 years after operation; 9 patients with urinary tract infection were re-examined twice or more, 4 patients recurred. All the recurrent stones were unilateral recurrence, the main components of the stones were calcium oxalate stones, magnesium ammonium phosphate stones and apatite. Conclusion the recurrence rate of renal calculi in Shanxi area is high, the recurrence rate in 1 year and 2 years is 7.8% and 9.2%, respectively. The age is related to the recurrence of renal calculi. The elderly over 60 years old are more likely to relapse. Sex factors had no significant effect on the recurrence rate. Among the patients with primary renal calculi, bilateral renal calculi and staghorn renal calculi were more likely to recur, and the long axis size of the stones was correlated with the recurrence of primary renal calculi. Patients with 2cm were more likely to recur than those with 2cm. The patients with high serum Ca 2 2 level and long term hydronephrosis were more likely to recur than 25 patients with renal calculi associated with renal calculi recurrence. Chronic urinary tract infection was an important factor for the recurrence of renal calculi. Calcium oxalate stones and infectious stones (ammonium magnesium phosphate stone, apatite) were the main components of the recurrent stones in Shanxi.
【學位授予單位】：山西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R692.4
本文編號：2128970
[Abstract]:Objective: to summarize the characteristics of renal calculi recurrence and the risk factors affecting the recurrence of renal calculi in Shanxi area through the follow-up of 260 cases of primary renal calculi in Shanxi area and to provide evidence for preventing the recurrence of renal calculi in Shanxi area. Methods: from September 2014 to September 2016, 260 patients with renal calculi were selected from 264 Hospital of the Chinese people's Liberation Army (PLA) to follow up regularly. The follow-up data included postoperative imaging examination, blood and urine biochemistry. According to the results, 260 patients were divided into two groups: the recurrent group and the non-recurrent group. The stone components of the recurrent patients were analyzed, and the clinical data and follow-up results of the two groups were analyzed retrospectively. The recurrence characteristics and risk factors of renal calculi recurrence in Shanxi area were summarized by statistical analysis. Results among 260 patients with primary renal calculi, 5 were superrecombinant, 29 were obese, 226 were normal, 18 were mild hydronephrosis (7 patients with congenital ureteral stricture and 10 patients with benign prostatic hyperplasia). There were 8 patients with posterior urethral stricture, 242 patients without hydronephrosis, 16 patients with recurrence, 10 patients with high serum calcium, including 6 patients with tumor (1 patient with lung tumor and 4 patients with bladder tumor). (1 patient with prostate cancer), 2 patients with metabolic syndrome, 2 patients with unknown cause, 3 patients with recurrence, 250 patients with normal blood calcium and 21 patients with recurrence. The mean initial age of renal calculi in females was 42.5 鹵12.4 years old and 40.8 鹵13.2 years old respectively; there were 121 cases of renal calculi in the left kidney, 115 cases in the right kidney and 24 cases in both kidneys; 237 cases were non-staghorn stones and 23 cases were staghorn stones; The mean long axis of stone was 1.9 cm, the longest follow-up was 30 months, the shortest follow-up was 7 months, the average follow-up was 16.9 months, the recurrence rate of renal calculi in 24 cases, the recurrence rate of 1 year and the recurrence rate of 2 years were 7.8 and 9.2.The recurrence time of recurrent patients was 7 months and the longest was 25 months. The average age was 13.5 months, 20 / 40 years, 40 / 40 / 60 / 60 / 60 / 60 / 60 / 60 / 60 / 60 / 60 / 60 / 60 / 60 / 60 / 60 / 60 / 60 / 60 / 60 / 60 / 60 / 60, 20 / 50 / 50 / 60 / 60 / 60 / 60 / 60 / 60 / 60 / 60 / 60 / 60 / 60 / 60 / 60 / 60 / 60 / 60 / 60 / 60 / 60 / 50 / 60 / 60 / 60 / 60 / 60 / 60 / 60 / 60 / 60 / 60 / Among the patients with bilateral renal calculi, there were 13 cases of recurrence, 23 cases of staghorn calculi, 8 cases of recurrence, 237 cases of non-staghorn calculi, 16 cases of recurrence, the number of recurrence of primary renal calculi was less than 2cm in 2cm group and 4 cases were higher than that of 3cm group. In 2 patients with hyperuricemia, 2 patients all recurred 2 years after operation; 9 patients with urinary tract infection were re-examined twice or more, 4 patients recurred. All the recurrent stones were unilateral recurrence, the main components of the stones were calcium oxalate stones, magnesium ammonium phosphate stones and apatite. Conclusion the recurrence rate of renal calculi in Shanxi area is high, the recurrence rate in 1 year and 2 years is 7.8% and 9.2%, respectively. The age is related to the recurrence of renal calculi. The elderly over 60 years old are more likely to relapse. Sex factors had no significant effect on the recurrence rate. Among the patients with primary renal calculi, bilateral renal calculi and staghorn renal calculi were more likely to recur, and the long axis size of the stones was correlated with the recurrence of primary renal calculi. Patients with 2cm were more likely to recur than those with 2cm. The patients with high serum Ca 2 2 level and long term hydronephrosis were more likely to recur than 25 patients with renal calculi associated with renal calculi recurrence. Chronic urinary tract infection was an important factor for the recurrence of renal calculi. Calcium oxalate stones and infectious stones (ammonium magnesium phosphate stone, apatite) were the main components of the recurrent stones in Shanxi.
【學位授予單位】：山西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R692.4
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