227例泌尿系巨大结石的多中心比较研究
摘要
目的探讨泌尿系巨大结石发生的相关因素。方法对来自华北、华东、华中、华南和西南地区的227份泌尿系巨大结石标本进行红外光谱分析,结合扫描电镜和X射线能谱分析将结石分为不同类型。比较患者性别、年龄、地区分布,以及结石的发生部位及成分。结果 227例泌尿系巨大结石患者按照发生部位划分,108例(47.6%)为膀胱结石,99例(43.6%)为肾结石,20例(8.8%)为输尿管结石;同时,根据成分分为5类,包括78例(34.5%)尿酸结石,69例(30.4%)草酸钙结石,26例(11.5%)磷酸钙结石,1例(0.4%)磷酸镁铵结石和53例混合型结石。多中心比较显示,华中、华南地区巨大结石以膀胱最常见,主要为尿酸结石,而西南地区巨大结石以肾结石最常见,主要为草酸钙结石。结论泌尿系巨大结石最常发生于膀胱,其次是肾脏,结石类型以尿酸结石为主,其次是草酸钙结石。不同地区结石部位和成分存在差异,华中、华南地区巨大结石以膀胱最常见,以尿酸结石为主,而西南地区巨大结石以肾结石最常见,以草酸钙结石为主。
引文
[1]JOUINI R,MAAZOUN K,SAHNOUN L,et al.Giant ureteric stones:report of two cases[J].Prog Urol,2005,15(3):505-510.
[2]KOMEYA M,SAHODA T,SUGIURA S,et al.A huge bladder calculus causing acute renal failure[J].Urolithiasis,2013,41(1):85-87.
[3]CELIK O,SUELOZGEN T,BUDAK S,et al.Post-renal acute renal failure due to a huge bladder stone[J].Arch Ital Urol Androl,2014,86(2):146-147.
[4]ESCOBAR-DEL B L,RODRIGUEZ-COLORADO S,DUEAS-GARCIA O F,et al.Giant intravesical calculus during pregnancy[J].Int Urogynecol J Pelvic Floor Dysfunct,2008,19(10):1449-1451.
[5]DONG Z,WANG H,ZUO L,et al.Female urethral diverticulum containing agiant calculus:a CARE-compliant case report[J].Medicine(Baltimore),2015,94(20):e826.
[6]MA R H,LUO X B,LI Q,et al.The systematic classification of urinary stones combine-using FTIR and SEM-EDAX[J].Int J Surg,2017,41:150-161.
[7]HEERS H,TURNEY B W.Trends in urological stone disease:a 5-year update of hospital episode statistics[J].BJU Int,2016,118(5):785-789.
[8]ZENG Q,HE Y.Age-specific prevalence of kidney stones in Chinese urban inhabitants[J].Urolithiasis,2013,41(1):91-93.
[9]JUNG J H,PARK J,KIM W T,et al.The association of benign prostatic hyperplasia with lower urinary tract stones in adult men:a retrospective multicenter study[J].Asian J Urol,2018,5(2):118-121.
[10]LI W M,CHOU Y H,LI C C,et al.Local factors compared with systemic factors in the formation of bladder uric acid stones[J].Urol Int,2009,82(1):48-52.
[11]CHILDS M A,MYNDERSE L A,RANGEL L J,et al.Pathogenesis of bladder calculi in the presence of urinary stasis[J].J Urol,2013,189(4):1347-1351.
[12]WIJAYARATHNA K S,WEERASINGHA G G,WE-LIGAMAGE A S,et al.Infrared spectroscopic analysis of staghorn calculi obtained after open renal surgery in a urology unit of Sri Lanka[J].Ceylon Med J,2016,61(2):74-76.
[13]SHAFI H,SHAHANDEH Z,HEIDARI B,et al.Bacteriological study and structural composition of staghorn stones removed by the anatrophic nephrolithotomic procedure[J].Saudi J Kidney Dis Transpl,2013,24(2):418-423.
[14]YANG Y J,DENG Y M,WANG Y X.Major geogenic factors controlling geographical clustering of urolithiasis in China[J].Sci Total Environ,2016,571:1164-1171.
[15]LI D J,WEN L,JIANG S,et al.Responses of soil nutrients and microbial communities to three restoration strategies in a karst area,southwest China[J].J Environ Manage,2018,207:456-464.
[2]KOMEYA M,SAHODA T,SUGIURA S,et al.A huge bladder calculus causing acute renal failure[J].Urolithiasis,2013,41(1):85-87.
[3]CELIK O,SUELOZGEN T,BUDAK S,et al.Post-renal acute renal failure due to a huge bladder stone[J].Arch Ital Urol Androl,2014,86(2):146-147.
[4]ESCOBAR-DEL B L,RODRIGUEZ-COLORADO S,DUEAS-GARCIA O F,et al.Giant intravesical calculus during pregnancy[J].Int Urogynecol J Pelvic Floor Dysfunct,2008,19(10):1449-1451.
[5]DONG Z,WANG H,ZUO L,et al.Female urethral diverticulum containing agiant calculus:a CARE-compliant case report[J].Medicine(Baltimore),2015,94(20):e826.
[6]MA R H,LUO X B,LI Q,et al.The systematic classification of urinary stones combine-using FTIR and SEM-EDAX[J].Int J Surg,2017,41:150-161.
[7]HEERS H,TURNEY B W.Trends in urological stone disease:a 5-year update of hospital episode statistics[J].BJU Int,2016,118(5):785-789.
[8]ZENG Q,HE Y.Age-specific prevalence of kidney stones in Chinese urban inhabitants[J].Urolithiasis,2013,41(1):91-93.
[9]JUNG J H,PARK J,KIM W T,et al.The association of benign prostatic hyperplasia with lower urinary tract stones in adult men:a retrospective multicenter study[J].Asian J Urol,2018,5(2):118-121.
[10]LI W M,CHOU Y H,LI C C,et al.Local factors compared with systemic factors in the formation of bladder uric acid stones[J].Urol Int,2009,82(1):48-52.
[11]CHILDS M A,MYNDERSE L A,RANGEL L J,et al.Pathogenesis of bladder calculi in the presence of urinary stasis[J].J Urol,2013,189(4):1347-1351.
[12]WIJAYARATHNA K S,WEERASINGHA G G,WE-LIGAMAGE A S,et al.Infrared spectroscopic analysis of staghorn calculi obtained after open renal surgery in a urology unit of Sri Lanka[J].Ceylon Med J,2016,61(2):74-76.
[13]SHAFI H,SHAHANDEH Z,HEIDARI B,et al.Bacteriological study and structural composition of staghorn stones removed by the anatrophic nephrolithotomic procedure[J].Saudi J Kidney Dis Transpl,2013,24(2):418-423.
[14]YANG Y J,DENG Y M,WANG Y X.Major geogenic factors controlling geographical clustering of urolithiasis in China[J].Sci Total Environ,2016,571:1164-1171.
[15]LI D J,WEN L,JIANG S,et al.Responses of soil nutrients and microbial communities to three restoration strategies in a karst area,southwest China[J].J Environ Manage,2018,207:456-464.