目的:通过调查温州地区尿石症的发病情况,探讨尿石症在该地区的流行病学特征及性交频率等影响因素;并分析影响体外冲击波碎石的相关因素。方法:采取目的抽样方法抽取4598例常住人口为尿石症流行病学研究对象。另对2010年3月-2012年2月在我院行ESWL治疗尿石症的130例患者的临床资料作了回顾性分析。结果:在调查的4598例常住人口中,尿石症患者320例(6.98%);年龄、碱性药物史、婚姻、粉尘污染、尿路感染、油腻饮食、经常憋尿、长期卧床、吸烟、父系结石病史、性欲强且每周性交次数≥5等11个因素是尿石症的危险因素,其中碱性药物史(β=1.298,OR=3.465)、父系结石病史(β=1.245,OR=2.869)、尿路感染(β=1.193,OR=2.289)及性欲强且每周性交次数≥5次(β=1.202,OR=2.156)的影响最大。130例行ESWL,其中75例(57.7%)ESWL成功,结石完全粉碎排空;54例(41.5%)结石不完全粉碎;1例(1.0%)ESWL失败转为开放式手术;尿石症患者的年龄(β=0.931,OR=2.22)、结石直径(β=0.732,OR=1.95)与ESWL治疗效果关系密切,是危险因素。结论:尿石症是多因素综合作用的结果,碱性药物史、父系结石病史、尿路感染及性欲强且性交次数过多是主要危险因素应予以重视;ESWL治疗尿石症具有一定局限性,应给予合理评价,并积极探索其最佳适应症。
Objectives: To survey the incidence of urolithiasis in Wenzhou city, to explore the epidemiological characteristics and influencing factors of urolithiasis in the region, and to analyze the influencing factors of extracorporeal shock wave lithotripsy (ESWL). Methods: A purposeful sampling method was used for the epidemiological study of urolithiasis in a population of 4,598 residents. And 130 patients in our hospital underwent ESWL treatment of urolithiasis were retrospectively reviewed. Resuits: Age, history of basic drugs, marriage, dust pollution, urinary tract infections, the greasy diet, suppression of the urine, bedridden, smoking, paternal lithiasis history are the 11 most risky factors of urolithiasis. The greatest impact comes from the history of basic drugs ( β = 1. 298, OR = 3.465 ), paternal lithiasis history ( β= 1. 245, OR = 2. 869 ) , urinary tract infection (β=1. 193, OR = 2. 289) and sexual intercourse number ≥ 5 per week ( β = 1. 202, OR = 2. 156). 130 routine ESWL cases, of which 75 cases (57. 7% ) were cured, stone emptied completely; 54 (41.5%) cases is not completely crushed; 1 case ( 1.0% ) ESWL failed and resulted in open surgery. Urolithiasis patients' age ( β =0. 0. 931, OR =2. 22) and the stone diameter ( β= 0. 732, OR = 1.95) are risky factors that have close relationship with ESWL treatment. Conclusion : Urolithiasis is the result of multiple factors, the alkaline drug history, paternal of lithiasis history, sexual intercourse number ≥5 per week and urinary tract infection are the main risky factors that deserve careful attention; ESWL treatment of urolithiasis has certain limitations and should be given a reasonable evaluation and its best indications should be positively explored