上尿路结石合并2型糖尿病患者临床特点的初步研究

摘要

目的 探讨上尿路结石(UUC)合并2型糖尿病(T2DM)患者的临床特征,为其治疗方式的选择提供相关依据.方法 回顾性分析2013年1月-2015年6月该院UUC住院患者660例,将其分为合并T2DM(病例组)172例、未合并糖尿病(DM)(对照组)488例.比较两组临床表现、各种检验检查结果及治疗方法.结果 两组住院天数、术前抗感染天数、凝血酶原时间(PT)、国际标准化比值(INR)、结石最大径、肾积水、尿培养、术前血小板计数差异及临床表现比较,差异有统计学意义(P ＜0.05);在尿路刺激症状、抗菌药物使用强度、入住重症监护室(ICU)、肾功能不全、并发脓毒血症等方面比较,差异无统计学意义(P ＜0.05).两组手术次数比较,差异有统计学意义(P ＜0.05);在多次手术原因方面比较,差异无统计学意义(P ＞0.05).结论 UUC合并T2DM患者临床症状与其病情严重程度不一致,患者出现尿路感染、肾功能受损及凝血功能改变可能性增大;手术耐受性下降,更容易发生出血等手术并发症,再次手术可能性增大.但其结石体积相对较小、肾积水相对较轻及脓毒血症的发生率未上升.%Objective To investigate the clinical characteristics of patients with upper urinary calculi complicated with type 2 diabetes mellitus and to provide the basis for the choice of treatment methods. Methods Retrospective analysis of 660 patients with upper urinary calculi including 172 cases of type 2 diabetes mellitus (case group) and 488 cases without diabetes mellitus (control group) were made. Clinical manifestations, various examination results and treatment methods were compared. Results There were statistically significant differencesin hospitalization, preoperative anti infection days, prothrombin time (PT), international standardization ratio (INR), maximum diameter of stone, hydronephrosis, urine culture, preoperative platelet count and clinical manifestations before operation (P ＜ 0.05); there were no statistically significant differences in urinary tract symptoms, use of antibacterial drugs, ICU stay, renal insufficiency and concurrent sepsis (P ＜ 0.05). There was statistically significant difference in operative times (P ＜ 0.05); but there were no significant differences in the causes of multiple surgeries (P ＞ 0.05). Conclusions The clinical symptoms of patients with UUC combined with type 2 diabetes are not consistent with the severity of the disease. The incidence of urinary tract infection, impaired renal function and coagulation function are increased. Surgical tolerance decreases, bleeding and other complications are more prone to occur, and the possibility of reoperation increases. However, the stone volume is relatively small, the hydronephrosis is relatively lighter and the incidence of sepsis does not increase.