Study On Urinary Calculi Composition And Non-surgical Intervention

ObjectiveTo analyze the characteristic of urinary calculi composition and the risk factors,study the intervention results of non-surgical way in our hospital.MethodsCollected all the 864 patients with urolithiasis accepted surgical treatment between October 2016 and September 2017 at Second Hospital of Tianjin Medical University.Lithiasis specimens underwent infrared spectroscopy composition analysis.The test group was consisted of postoperative 60 noninfective calculus patients willing to take Uralyt-U;the diet controlling group was consisted of other postoperative 60 noninfective calculus patients collected randomly and they were required to control diet strictly.Another 120 health checkers were randomly selected as the control group.Statisticced all of the patient’s composition analysis,age,gender,presence of diabetes and hyperuricemia,parsing the characteristics of the urinary stone composition,risk factors.The postoperative test group taked Uralyt-U for 2months,the postoperative diet controlling group was required to change diet for 6months.Both the groups were recorded preoperative and postintervention data,for example urine PH、urine citric acid、urine calcium、urine oxalic acid and uric acid.Dietary questionnaires were carried out on the patients and health checkers(including various food preferences,daily water quantity,etc).ResultsThe composition and proportion of urinary calculi and surrounding areas were respectively that calcium oxalate stones(78.7%),carbonate apatite(15.1%),uric acid(12.2%),silica(1.9%),the proportion of L-cystine,six water magnesium ammonium phosphate and hydroxyapatite was about 0.1%.There were 623 male patients and 241 female patients participating the test.The ratio was approximately 2.6:1.The age group of 40~60 years was the highest incidence of urolithiasis,the proportion was45.5%.The proportion of calculi was 94.1% in men,and 92.9% in women.Infectious calculi accounted for 15.0% of the total.Among them,the proportion in males was12.5%,and the ratio in women was 21.6%.Uric acid calculi ratio was 12.2% of thetotal.Among them,the proportion in men was 15.0%,and the proportion in women was 5.0%.Survey questionnaire showed that urinary calculi patients with daily drinking water volume 1000 ml or less,and the habit of drinking tea,eatting fat and animal offal,bean products(such as tofu,soy milk,shutter),sweets was significantly more than normal.There were 148 patients diagnosed with type Ⅱ diabetes,among them,43 cases checked of hyperuricemia,29.1%;There were 716 patients who were non-diabetic,and 33 cases of hyperuricemia were detected,with a proportion of 4.6%.The incidence of hyperuricemia in diabetes group was much higher than that in non-diabetic group(P<0.01).In the diabetes group,59 cases were mainly uric acid calculi,and 89 were non-uric acid calculi.In the non-diabetic group,there were 75 cases of uric acid calculi,and 641 cases were non-uric acid calculi.The proportion of uric acid calculi in patients with diabetes was significantly higher than that in non-diabetic patients(39.9% vs 10.5%,P<0.01).Considering the experimental group and diet control group,related indicators before treatment and after intervention was statistically significant different in urine PH value,urinary calcium,excretion of urine oxalic acid,excretion of urinary citrate.ConclusionsThe composition of urinary calculus in our hospital was dominated by calcium calculi,and the proportion of uric acid calculi couldnot be ignored.Urinary calculi was more likely to occur in men,especially in old age.The occurrence rate of urinary calculi was closely related to diet and lifestyle.We could control it through dietary adjustment.Uralyt-U could be choosed to prevent calculi recurrence into non-infectious calculi patients by alkalinizing urine,reducing urine calcium,reducing urine oxalate,elevating urinary citrate and effectively dissolving calculi.Factors related to urinary calculi could be improved by non-surgical treatment,thus reducing the probability of recurrence of calculi in theory.In this study,we only observed the changes of urine composition after non-surgical intervention,and further observation was needed for the recurrence rate of calculi.