Effect Of Intervention Measures Based On Clinical Data And Stone Composition On Recurre Nce Of Upper Urinary Tract Stones

Objective:Analyze the risk factors and recurrence characteristics of upper urinary tract stones,and explore the guiding role of stone prevention strategies in the recurrence of upper urinary tract stonesMethods:From April 2017 to April 2019,617 patients were diagnosed with upper urinary tract stones in our hospital.All patients underwent surgical treatments such as URL,RIRS,PCNL,LL,etc.and obtained stone specimens.The conventional components of the stones were detected by infrared spectroscopy.Inductively coupled plasma mass spectrometry analysis of the content of heavy metals in the stones.Collect clinical data of patients(including age,gender,stone location,urine routine,urine culture,blood pressure,blood sugar,blood lipids,blood routine,imaging data),the enrolled population is followed up for 1 year,and divided into experimental group(intervention group)according to the follow-up results)And the control group(non-intervention group)Results:Among the upper urinary tract stones included in this study1.There are more male patients(55.27%)than female patients(44.73%),and most of them are middle-aged patients(41-60 years old)(56.73%).The location of stones is mainly ureteral stones(52.35%),and there are relatively few patients with kidney stones(47.65%).Urinary tract infection(54.85%)is the main complication in patients with kidney stones,and renal insufficiency(60.96%)is the main complication in patients with ureteral stones2.Calcium oxalate stones(81.85%)are the most common stone composition,followed by magnesium ammonium phosphate hexahydrate stones(7.46%),anhydrous uric acid stones(7.29%),and carbonate apatite(2.76%).The proportion of uric acid stones in male patients(8.5%)was higher than that in female patients(5.8%),and the proportion of infectious stones(magnesium ammonium phosphate hexahydrate+carbonate apatite)in female patients(16.7%)was higher than that in male patients(5.4%).The stones of all age groups are mainly composed of calcium oxalate monohydrate.The ratio of magnesium ammonium phosphate hexahydrate stones(12.3%)in the age group of 16-40 is significantly higher than that of other age groups3.Patients with magnesium ammonium phosphate hexahydrate stones(78.3%)and carbonated apatite(70.6%)have the highest proportion of patients with urinary tract infections.Patients with anhydrous uric acid stones often have urinary tract infections and renal insufficiency4.In the detection of heavy metal components in recurring stones,the content of strontium in magnesium ammonium phosphate hexahydrate stones(103.1 ug/g)is relatively higher than other types of stones,and the content in anhydrous uric acid stones(5.47ug/g)is relatively low;the content of zinc is in The content in the two calcium oxalate monohydrate stones was significantly increased5.The recurrence rate of upper urinary tract stones in the intervention group(16.26%)was significantly lower than that in the non-intervention group(29.52%)Conclusion:1.Among the study cases,the upper urinary tract stones were dominated by calcium oxalate stones(81.85%),uric acid stones were more common in male patients,infectious stones were more common in women and patients aged 41-60 years,and most patients with kidney stones had urinary tract infections.See,there are more patients with ureteral stones complicated by renal insufficiency.The proportion of magnesium ammonium phosphate hexahydrate stones and carbonate apatite is higher in patients with urinary tract infection,and the proportion of anhydrous uric acid stones is higher in patients with urinary tract infection and renal insufficiency.The correlation between the content of heavy metal components and the analysis results of stone components Needs further study2.The prevention strategy based on the patient's clinical data and the analysis results of the stone composition can effectively reduce the recurrence rate of upper urinary tract stones.