The Analysis Study Of Components And Clinical Data Of Staghorn Calculi

[Objective] Based on the clinical data of staghorn calculi patients and research of the calculus components, discuss the characteristics of staghorn calculi pathogenesis.[Methods] Combining with the research of the calculus components, Retrospectivly analyze the clinical data of 105 staghorn calculi patients who are operated in the 2nd Affiliated Hospital of Kunming Medical College from January, 2005 to December,2009. Clinical data including patient age, sex, stone type, urinary biochemistry, urine bacterial culture, serum uric acid, creatinine and surgical approach. X-ray diffraction (XRD) combined electron-beam probe microanalysis (EPMA) analysis of stone composition.[Results] In the 105 staghorn calculi patients, male-to-female ratio of 1.6:1. The average age of the male is (44.8±12.2), female (45.4±13.1).80 cases are partial staghorn calculi,25 cases are complete staghorn calculi. The ratio is 3.2:1. Left 47 (44.76%), right 40 (38.10%), bilateral in 18 cases (17.14%).Through detecting the urine and its sediment,90 patients'(85.71%) LEU and leukocyte increased. In the Culturing pyelonephritis urine bacterial cases before operation,21 cases are positive. More common in women. Escherichia coli is the main strains,.4 cases Magnesium ammonium phosphate stones are all proteus mirabilis.40 patients'urine PH less than 5.5; 10 are more than 7.0. In the 6-12 months follow-up of 15 patients who are renal insufficient before operation, no further deterioration in renal function, renal function improved in some patients. The chemical compositions of the calculus are calcium oxalate monohydrate (COM), calcium oxalate dihydrate (COD), hydroxyapatite, uric acid calcium, and magnesium ammonium phosphate. Cystine calculus was not found. In the research,90 of the 150 specimens contain calcium oxalate monohydrate (COM) (85.71%),30 contain calcium oxalate dihydrate (COD) (28.57%),95 contain hydroxyapatite (90.47%),30 contain uric acid (20.95%),4 contain ammonium magnesium phosphate (3.81%). In the 78 (74.28%) cases pure calculus which the main components in the calculus reaches 70%, calcium oxalate monohydrate accounts for 61.54%, uric acid 23.08%, hydroxyapatite 7.69%, ammonium magnesium phosphate 5.13%, calcium oxalate dihydrate 2.56%. In the 27 cases mixed stones, the mainly components are calcium oxalate monohydrate, hydroxyapatite mixed and calcium oxalate monohydrate,uric acid mixed stone.[Conclusions] Staghorn calculi mainly occurs in male, and mostly are at the age of 30-59. Stones were the main components of calcium oxalate monohydrate, uric acid, hydroxyapatite, ammonium magnesium phosphate, calcium oxalate dehydrate.20% of the stones were urine culture positive. Different from the conclusion reported by western countries that the main chemical composition of the calculus is ammonium magnesium phosphate, the main chemical compositions of the staghorn calculi in our country is calcium oxalate monohydrate.