Investigation And Analysis Of The Prevalence Of Urinary Calculi Among Seafarers In The Yangtze River Delta Region And Discussion Of Diagnosis And Treatment Strategies

Objective:To study the risk factors of urinary calculi in seafarers in the Yangtze River Delta region and to provide the basis for the prevention and treatment of urinary calculi,and proposal for diagnosis and treatment of urinary calculi for seafarers.Methods:An epidemiological survey was conducted among 5073 seafarers who underwent physical examination in Yuanwang Hospital of Jiangyin City from 2014 to 2018.They were divided into stone group(367 cases)and non-stone group(4706 cases)according to the criteria of stone judgment.Variance analysis and multivariate logistic regression were carried out on the research variables such as age,sex,biochemical index,incidence of hypertension,incidence of diabetes mellitus and body mass index.Regression model analysis was used to study the risk factors of urinary calculi.Results:A total of 5,073 patients were investigated in this study.Among them,367 patients with urinary calculi were found to have a urinary calculi prevalence rate of 7.2%.There were 357 males and 10 females,with a male to female ratio of 35.7:1.The median age was 32 years,the average age was 32.46 ± 6.04 years,the minimum age was 20 years,and the maximum age was 55 years.The median age of female patients with stones was 29.5 years,with an average age of 32.80±9.56 years.The median age of male patients with stones was 32 years,with an average age of 32.45±5.93.Among the patients with urinary calculi,the proportion of males was significantly higher in males or middle-aged patients than in females(P<0.001),but there was no difference in the overall prevalence between male and female seafarers(P>0.05).The overall prevalence of urinary stones in seafarers from 2014 to 2018 was 8.3%,7.3%,6.7%,7.1%,and 7.0%,respectively.There was no difference in the overall prevalence of urinary stones per year(P>0.05).The incidence of stones was the highest in the incidence of simple low back pain,reaching 61.90%;the treatment was conservative treatment(52.38%)and extracorporeal shock wave lithotripsy(45.23%).There were 38 cases(10.35%)with hypertension,7 cases(1.91%)with diabetes,98 cases(26.70%)with hyperlipidemia,77 cases(20.98%)with hyperuricemia,and 8 cases with BMI>25(2.18.%)in the urinary calculi patients.There were significant differences in the incidence of urinary stones between different departments(offshore seafarers and seafarers)(P<0.05).Logistic regression analysis of risk factors for urinary calculi found age(p<0.001,OR=1.053),distant sea(p<0.001,OR=1.716),hyperuricemia(p<0.001,OR=1.886),high Lipemia(p=0.001,OR=1.560)and hypertension(p=0.014,OR=1.621)were independent risk factors for urinary calculi in seafarers.Conclusion:The incidence of urinary calculi in seafarers is high,and the occurrence of calculi is closely related to factors such as age,blood uric acid,hyperlipidemia and hypertension,etc.It is of important application significance to provide reasonable suggestions to reduce the occurrence of seafarers’ calculi and propose effective prevention methods through the changes of indicators found in physical examination.