Lee Y H, Huang W C, Chang L S, Chen M T, Yang Y F, Huang J K
Department of Surgery, Veterans General Hospital, Kaohsiung, Taiwan, Republic of China.
J Urol. 1994 Nov;152(5 Pt 1):1386-8. doi: 10.1016/s0022-5347(17)32426-6.
We evaluated the stone recurrence rate and long-term renal function in 50 patients with a solitary kidney 60 to 84 months (mean 70.6) after unilateral nephrectomy for urinary tract stone disease. Followup evaluation included a detailed history, physical examination, blood and urine biochemistry studies, urinalysis, urine culture, excretory urography, ultrasonography of the kidney and 131iodine-ortho-iodohippurate renography. The overall stone recurrence rate in unilateral nephrectomy urolithiasis patients was 30% (15 of 50). The mean interval until stone recurrence was 31.1 months (range 6 to 74) and the mean episodes of recurrence were 2.1 times per patient (range 1 to 5). Function of the remnant kidney in most patients was unchanged during followup. However, 2 of the 15 patients with recurrent stones had anuria during the acute attack of renal colic and, thus, required percutaneous nephrostomy urinary diversion, while 1 had proteinuria (3 gm. per day) and progressive renal failure 47 months after nephrectomy. The metabolic stone patients seemed to experience recurrence more easily than metabolic stone patients seemed to experience recurrence more easily than infection stone patients (37% versus 13%) but no statistically significant difference was noted (p = 0.198).
我们评估了50例因尿路结石病行单侧肾切除术后60至84个月（平均70.6个月）的孤立肾患者的结石复发率和长期肾功能。随访评估包括详细病史、体格检查、血液和尿液生化检查、尿液分析、尿培养、排泄性尿路造影、肾脏超声检查以及131碘-邻碘马尿酸肾图检查。单侧肾切除术后尿路结石病患者的总体结石复发率为30%（50例中有15例）。结石复发的平均间隔时间为31.1个月（范围6至74个月）且每位患者的平均复发次数为2.1次（范围1至5次）。在随访期间，大多数患者的残余肾功能未发生变化。然而，15例复发性结石患者中有2例在肾绞痛急性发作时出现无尿，因此需要经皮肾造瘘进行尿液转流，而1例在肾切除术后47个月出现蛋白尿（每天3克）和进行性肾衰竭。代谢性结石患者似乎比感染性结石患者更容易复发（37%对13%），但未观察到统计学上的显著差异（p = 0.198）。
