宜蘭県(中華民国台湾省)における尿路結石症の臨床的考察 : 日本の尿路結石症と比較して

Abstract

1987年8月よりの3年間余りに台湾省宣蘭県羅東博愛医院泌尿科で尿路結石症と診断され入院および治療を受けた546症例を対象とし, 県地域の年間有病率の推定, 性別年齢別頻度, 部位別頻度, 結石成分, 手術などについて臨床的検討を行い, あわせ日本の尿路結石症と比較した.1)年間有病率は推定人口10万対147であった.年齢別頻度は50歳代にピークがあり, 男女比は2.8:1, 上下比は6:1, また治療法は近年内視鏡手術が急激に増加し, 逆に開放性手術は減少してきている.この様な治療の変遷は, ほぼ日本と同じであった.2)結石成分に関しては日本と同様カルシウム結石が92.3%で最も多かったが, 尿酸結石, 感染結石が少なかった.また小児の結石症例, シスチン結石症例は1例もなかった

Between August 1987 and December 1990, 546 patients were admitted to the department of Urology at the Poh Ai Hospital of I-Lan, Taiwan, R.O.C. for the treatment of urinary stones. These urinary stone cases accounted for 50 to 60% of all urology patients admitted. The incidence of urolithiasis in I-Lan was estimated at 147/100, 000 population in 1990. There were 402 male patients and 144 female patients, The male to female ratio was 2.8: 1. There were 450 upper urinary tract stones (kidney, ureter) in 314 males and 136 females, and 79 lower urinary tract stones (bladder, urethra) in 72 males and 7 females. The ratio of upper to lower urinary tract stones was 6:1. Endourological treatments such as percutaneous nephrolithotripsy and transurethral ureterolithotripsy have increased rapidly in recent years. A summary of the present analysis for composition of 365 stones follows. The most frequent type was calcium-containing stone (92.3%), followed by infection stone (4.7%), then uric acid (UA) stone (3.0%). There were no UA stones found in the female patients. According to urinalysis criteria of more than 10 WBC/HPF (x 400), pyuria was found in 67 cases of 334 metabolic stones (20.1%), and 11 cases of 17 infection stones (67.7%). There were neither pediatric case of stone formation nor cystine stones.