Okuyama Mitsuhiko, Yamaguchi Satoshi, Kita Masafumi, Kato Yuji, Hashimoto Hiroshi, Kakizaki Hidehiro, Wada Naoki, Fujisawa Makoto, Niibori Daisuke
Department of Urology, Asahikawa Medical College.
Nihon Hinyokika Gakkai Zasshi. 2007 Jan;98(1):9-16. doi: 10.5980/jpnjurol1989.98.9.
Stone analysis is an important examination for treatment and prevention of recurrence in urolithiasis. A twenty-six years clinical study of patient with urinary stone formers performed stone analysis was conducted.
1,108 stone formers (male 726, female 382) who performed stone analysis from 1977 to 2002 was conducted. Location of the stone, sex, age, treatment and stone analysis was examined in this study. Phase 1 is from 1977 to 1983 mainly performed open surgery, phase 2 is from 1984 to 1992 mainly performed endoscopic surgery, and phase 3 is from 1993 to 2002 mainly performed extracorporeal shock wave lithotripsy (SWL).
Analytic numbers per year increased, especially phase 3. In the treatment of upper urinary tract (UUT) stone, open surgery, endoscopic surgery and SWL was carried out 78.4%, 72.8% and 71.4% of all cases in each phase. Many transurethral lithotripsy were performed for lower urinary tract (LUT) stone. The numbers of UUT and LUT stone were 1,007 and 101 cases. The frequency of LUT stone was higher than that found in a nationwide urolithiasis survey carried out in Japan in 1995. The male-female ratio of UUT stone was 2.35:1, 1.74:1 in phase 2 and 3. The frequency of female increased in phase 2 more than that in phase 3. The incidence of calcium oxalate stone was increased, calcium phosphate stone and infectious stone was significantly decreased in UUT and calcium containing stone in LUT was decreased. The average age for incidence of UUT stone rose in man step by step. The frequency in male was significantly higher than that in female under 50's, not significantly higher over 50's in calcium oxalate with calcium phosphate stone former (p = 0.009).
In the present study, the clinical features were as follows : important urinary stone analysis, high frequency of LUT stone, high frequency in females, tendency to aging, high frequency of calcium containing stone in LUT, resolution of the difference in male and female over 50's in calcium oxalate with calcium phosphate stone former.
结石分析对于尿路结石的治疗及预防复发是一项重要检查。开展了一项针对尿路结石患者的为期26年的临床研究并进行结石分析。
对1977年至2002年间进行结石分析的1108例结石患者（男性726例，女性382例）展开研究。本研究对结石位置、性别、年龄、治疗方法及结石分析情况进行了检查。第一阶段为1977年至1983年，主要采用开放手术；第二阶段为1984年至1992年，主要采用内镜手术；第三阶段为1993年至2002年，主要采用体外冲击波碎石术（SWL）。
每年的分析病例数有所增加，尤其是在第三阶段。在上尿路（UUT）结石治疗中，各阶段开放手术、内镜手术及SWL分别占所有病例的78.4%、72.8%和71.4%。对于下尿路（LUT）结石进行了许多经尿道碎石术。UUT结石和LUT结石病例数分别为1007例和101例。LUT结石的发生率高于1995年在日本开展 的一项全国性尿路结石调查中的结果。UUT结石的男女比例在第二阶段和第三阶段分别为2.35:1和1.74:1。女性发生率在第二阶段的增长幅度大于第三阶段。UUT中草酸钙结石的发生率上升，磷酸钙结石和感染性结石显著下降，LUT中含钙结石下降。UUT结石发病的平均年龄在男性中逐步上升。在50岁以下，草酸钙伴磷酸钙结石患者中男性发病率显著高于女性，50岁以上则无显著差异（p = 0.009）。
在本研究中，临床特征如下：重要的尿路结石分析、LUT结石发生率高、女性发生率高、有老龄化趋势、LUT中含钙结石发生率高、50岁以上草酸钙伴磷酸钙结石患者中男女差异消失。
