| OBJECTIVE: To analyze the components and the epidemiological characteristics of stones in upper urinary tract and to study the clinical application value of dietary guidance based on stone component analysis in preventing stone recurrence.METHODS: A total of 307 patients with upper urinary calculi who were admitted to the Department of Urology in The First Affiliated Hospital of Zhengzhou University from September 2017 to March 2018 were enrolled.A total of 202 patients were selected from the inclusion criteria.There were 124 male and 78 female patients.The patient's age ranged from 14 to 77 years with an average age of 41.7 ± 10.4 years.All patients were followed up monthly by telephone and asked about their implementation of prevention strategies.They were divided into two groups,that is an experimental group and control group according to their specific conditions.Strict implementation of prevention strategies is divided into experimental groups,such as patients with strict implementation of prevention strategies before recurrence of stones,but not performed after recurrence,also divided into experimental groups.Those who did not follow the prevention strategy strictly after surgery were divided into the control group.RESULTS: 1.Calcium oxalate stone is the most common type of stone according to international and Chinese studies.In this study,calcium oxalate monohydrate had the highest detection rate among single-component stones in both men and women.In males,the calcium oxalate monohydrate was 19.4%(24/124),and the female was 21.8%(17/78),P=0.675>0.05.There was no significant difference in the detection rate of calcium oxalate monohydrate in men and women.There was also no significant difference in the detection rate of single component calcium oxalate dihydrate,carbonate apatite,magnesium ammonium phosphate and uric acid stone between male and female(P>0.05).2.In this study,a total of three types of mixed stones with two types of stones were detected,and no three types of stones were mixed,which may be related to sampling error.There was also no significant difference in the detection rate of calcium oxalate + calcium oxalate dihydrate,calcium oxalate monohydrate + carbonate apatite and calcium oxalate dihydrate + carbonate apatite between male and female(P>0.05).3.There were 99 males with oxalic acid-containing stones,and the detection rate was 79.8%.Women included 64 cases of oxalic acid stones,and the detection rate was 82.1%.There were 163 cases of oxalic acid-containing stones in total,and the overall detection rate of oxalic acid stones was 80.7%(163/202).Using the chi-square test,P=0.698>0.05,the difference in detection rate between men and women was not statistically significant.There were 60 males with stones containing carbonate apatite,and the detection rate was 48.4%.Women included 33 cases of carbonate apatite stones,the detection rate was 42.3%,and the overall examination rate was 46.0%(93/202).Using the chi-square test,P=0.698>0.05,the difference in detection rate between men and women was not statistically significant.4.In the experimental group,74 cases had a recurrence of stones within one year,and the recurrence rate was 6.8%.In the control group,113 patients had a recurrence of calculi in 21 cases within one year,and the recurrence rate was 18.6%.The chi-square test was used,P=0.022<0.05,and the difference between the experimental group and the control group was statistically significant.CONCLUSION: Similar to other results,the incidence of stones in Henan is higher in men than women.Among the stone components,calcium oxalate stone is the most common,with a detection rate 80.7%.Dietary guidance based on stone composition analysis can effectively reduce the stone recurrence rate,which is about 63.4% lower than conventional diet prevention strategy. |
PDF Full Text Request