湖南地区163例儿童泌尿系结石临床资料与结石成分分析

摘要

【目的】研究湖南地区儿童泌尿系结石的临床特点与结石成分。【方法】收集2013年6月至2014年10月在本院住院手术并取得结石标本的163例儿童资料，对结石进行红外光谱分析，对患者的临床资料进行回顾性分析。【结果】163例资料中男女比例约为3．7∶1115（70．6％）例发生上尿路结石，36例（22．1％）发生下尿路结石，12例（7．4％）合并上下尿路混合结石。左侧、右侧和双侧上尿路结石儿童分别为41例（25．2％） 、57例（35．0％）和29例（17．8％） 。 结石成分显示110例（67．5％）含有草酸钙成分，62例（38％）含有磷酸钙成分，23例（14．1％）含有感染性成分，53例（32．5％）含有尿酸成分，14例（8．6％）含有胱氨酸成分以及3例其他类结石成分。77例（47．2％）为单一成分结石，以单纯草酸钙类结石为最常见，其次为单纯尿酸类结石，86例（52．8％）为混合性结石，以草酸钙＋磷酸钙最常见，其次为草酸钙＋尿酸类。【结论】湖南地区儿童泌尿系结石各年龄阶段均有发生，在性别上主要以男性为主，发病部位主要为上尿路结石，结石成分中含草酸钙成分最多，其次为磷酸钙以及尿酸，约52．8％的儿童泌尿系结石为两种及以上混合成分结石。%Objective]To study the clinical characteristics and composition of urinary calculi in children of Hunan area .[Methods]Data of 163 cases of children underwent surgery in our hospital from June 2013 to Oc‐tober 2014 were collected ,and their stone specimens were obtained ,and infrared spectrum analysis of stone was performed .The clinical data of patients were retrospectively analyzed .[Results]The ratio of male to female was about 3 .7 :1 in 163 cases .115 (70 .6% ) patients got upper urinary calculi ,36 cases (22 .1% ) had lower u‐rinary calculi ,12 cases (7 .4% ) were complicated with upper and lower urinary tract stones .Location ratio on left ,right and bilateral upper urinary tracts were 41 cases (25 .2% ) ,57 cases (35% ) and 29 cases (17 .8% ) respectively .Stone composition showed that 110 cases (67 .5% ) contained calcium oxalate ,and 62 (38% ) con‐tained calcium carbonate ,23 cases (14 .1% ) contained with infectious components ,53 cases (32 .5% ) con‐tained uric acid ,14 (8 .6% ) contained cysteine ,and 3 had other kinds of calculus .77 cases (47 .2% ) were sin‐gle component stones ,and the calcium oxalate stone was the most common one ,followed by simple uric acid ones .86 cases (52 .8% ) were mixed stones ,while calcium oxalate + calcium carbonate took the most com‐mon ,followed by oxalic acid + uric acid .The main part of the site is in the upper urinary tract .[Conclusion]The occurrence of urinary stones in children of Hunan area covered all ages ,mainly in male .In the stone com‐ponents ,calcium oxalate is the most ,followed by calcium carbonate and uric acid .About 52 .8% of the urina‐ry calculi in children are composed of two or more ingredients of a mixture .