摘要
目的:探讨原发结石与J管沉积结石成分差异,分析结石形成与尿液理化性质的关系,为临床防治拔管困难,预防结石提供依据.方法:选择株洲市中心医院从2017年4月至2018年9月结石术后遵嘱拔管的357例患者,对其J管沉积结石、原结石标本及24 h尿生化成分进行检测.比较J管沉积结石与原结石成分,不同成分结石组的成分特点及其24 h尿成分含量.结果:J管结石成分和原发结石成分有差异.双J管结石以尿酸、尿酸铵为主,而原发性结石以草酸钙为主.草酸钙组、尿酸组、尿酸草酸混合组pH值均小于对照组,磷酸钙组和磷酸镁铵组大于对照组.除磷酸镁铵组外,余4组尿量均少于对照组.草酸钙组和尿酸草酸混合组尿钙均大于对照组,磷酸钙组尿磷低于对照组.尿酸组、磷酸镁铵组尿镁高于对照组,而草酸组低于对照组.尿酸组、草酸组及尿酸草酸混合组尿酸高于对照组.草酸钙组主要出现高钙尿,还有过度酸化尿和高尿酸尿.磷酸钙组和磷酸镁铵组也以高钙尿为主.尿酸组主要有高尿酸尿,其次是过度酸化尿.尿酸草酸混合组主要出现高尿酸尿,其次是少尿,与对照组相比具有差异性.结论:J管沉积结石形成与原发结石、相应尿液代谢变化之间有关联性.
Objective:To investigate the difference of composition between primary stones and J-tube sediments, and to analyze the relationship between stone formation and physicochemical properties of urine, and provide evidence for clinical prevention and treatment of tuberculosis difficulties and prevention of stones. Methods:A total of 357 patients who underwent extubation after calculi from April 2017 to September 2018 were enrolled in Zhuzhou Central Hospital. The J-tube sedimentary stones, original stone specimens and 24 h urine biochemical components were tested. The composition between J tube sedimentary stones and the original stone, and the composition characteristics and 24-hour urine contents of different components of stone groups were compared. Results:There were differences between the J tube stone composition and the primary stone composition. Double J tube stones are mainly uric acid and ammonium urate, while primary stones are mainly calcium oxalate. The pH values of the oxalic acid calcium group, the uric acid group and the uric acid oxalic acid mixed group were all lower than the control group, and the calcium phosphate group, the ammonium magnesium phosphate group, were larger than the control group. Except for the ammonium magnesium phosphate group, the urine volume of the remaining 4 groups was less than that of the control group. Urinary calcium was higher in the oxalic acid calcium group and uric acid oxalic acid mixed group than in the control group, and the urinary phosphorus in the calcium phosphate group was lower than the control group. The urinary magnesium in the uric acid group and the ammonium magnesium phosphate group was higher than that in the control group, while the oxalic acid group was lower than the control group. The uric acid group, oxalic acid group and uric acid mixed group had higher uric acid than the control group. The calcium oxalate group mainly developed high calcium urine, as well as excessive acidified urine and high uric aciduria. The calcium phosphate group and the magnesium ammonium phosphate group were also mainly high calcium urine. The uric acid group mainly has high uric aciduria, followed by excessive acidification of urine. The uric acid mixed group mainly developed high uric aciduria, followed by oliguria, which was different from the control group. Conclusion:There is a correlation between the formation of J-tube sedimentary stones and the changes of primary stones and corresponding urine metabolism.
作者
柳成孟
陶学庭
丁锦
陈娟
LIU Chengmeng;TAO Xueting;DING Jin;CHEN Juan(Operating Room, Zhuzhou Central Hospital, Zhuzhou Hunan 412007;Department of Urology, Hengyang Central Hospital, Hengyang Hunan 421000, China)
出处
《临床与病理杂志》
2019年第7期1508-1512,共5页
Journal of Clinical and Pathological Research
基金
湖南省自然科学基金(2017JJ4067)~~
关键词
双J管
沉积结石
原发结石
尿生化性质
double J tube
sedimentary stones
primary stones
biochemical properties of urine
