复杂性肾结石的早期诊断及预防

目的通过分析复杂性肾结石病史,结石成分等临床特点,为其诊疗及预防提供帮助。方法回顾性研究2009年8月至2010年5月于北京大学人民医院进修期间118例复杂性肾结石病例,对患者病史、既往史、结石化学成分及尿常规、肾功能等临床资料进行总结分析。结果118例患者中,7例(5.9%)接受过定期规律体检,97例(82.2%)从未曾接受过健康体检,64例(54.2%)曾有结石病史,86例(72.9%)以疼痛、血尿及发热等不适症状为主诉,92例(78.0%)伴有泌尿系感染,18例(15.3%)伴有肾功能不全,结石成分中含钙结石94例(79.7%),感染石55例(46.6%),含尿酸结石28例(23.7%)。结石以混合成分为主,其中感染石与草酸钙的混合成分所占比例最大,共51例(43.2%)。结论应通过定期规律体检提高早期诊断比例,控制结石进展,根据不同结石成分,采取有针对性的预防措施,同时必须重视抗感染治疗,以减少患者损伤,降低结石复发率。

Early detection and prevention of renal complex calculi

Objective To provide the information for early detection,treatment and prevention of renal complex calculi by analyzing on the characteristics of the patients and stone composition.Methods From January 2009 to November 2010,118 cases of renal complex calculi underwent treatment in our department.Clinical data including previous history,medical history,stone composition,urinary system infection and renal function were analyzed retrospectively.Results Of the 118 patients,7(5.9%)cases underwent regular medical examination and 64(56.2%)cases were with urinary calaculus history,86(72.9%)cases were with a chief complaint of back pain,hematuria or fever,92(78.0%)cases were with urinary system infection and 18(15.3%)cases were with renal dysfunction.Of the 118 patients,calcium oxalate stones were found in 94 cases(79.7%),infection stones in 55 cases(46.6%),uric stones in 28 cases(23.7%).The majority of stones were mixed compositions,it was most commonly found which was made of calcium mixed infection stone,51 cases(43.2%).Conclusions The renal complex calculi has a significant impact on renal function,it's crystalline composition is multiplicity,many factors are involved in its growth,and it has a close relationship with urinary tract infection.It is important to attach importance to early diagnosis,control the progression of stone by undergoing regular medical examination,and prevention calculi recur by analyzing stone composition,enhancing anti-infective therapy.