外科血尿的常见病因及分析

Common Etiology and Analysis of Surgical Hematuria

摘要: 目的：探讨外科血尿常见病因以及比较不同病因的多因素分析。方法：分析2010年1月至2020年12月中国医科大学绍兴医院泌尿外科716例血尿住院患者。男546例，女170例，年龄(61.9 ± 17.1)岁，通过不同辅助检查分析血尿病因，通过对比分析不同病因患者的各因素差异。结果：716例血尿病因依次为结石(33.4%)、感染(22.3%)、BPH (16.5%)、泌尿系统肿瘤(15.4%)、未明确(13.5%)及其他原因(10.1%)。血尿患者中男女比例为3.2:1，女性最常见病因为感染(36.5%)，而男性最常见病因为结石(35.3%)。0~20岁血尿患者常见病因为输尿管结石和肾挫伤(各3例)，21~50岁及51~80岁血尿患者最常见病因均为结石(分别占比43.8%和33.3%)，而≥81岁血尿患者常见病因为良性前列腺增生(33.3%)，其次为泌尿系统肿瘤(27.3%)。结论：血尿患者的病因首先考虑结石，尚需结合年龄、性别等因素鉴别诊断；泌尿系统肿瘤发生率为15.4%，临床上对外科血尿患者亦应结合年龄、性别等因素警惕泌尿系统肿瘤的可能。

Abstract: Objective: The objective is to study the common etiology of surgical hematuria and to compare different etiology with multivariate analysis. Methods: From January 2010 to December 2020, clinical data of 716 patients with hematuria in Shaoxing Central Hospital of China Medical University were analyzed. There were 546 males and 170 females, and the mean age was (61.9 ± 17.1) years old. The etiology of hematuria was analyzed by different auxiliary examinations, and the differences of various factors in patients with different etiology were analyzed by contrast. Results: The causes of 716 cases were urinary stone (33.4%), infection (22.3%), benign prostatic hyperplasia (16.5%), urologic neoplasms (15.4%), unspecified (13.5%) and other causes (10.1%). The male-to-female ratio of hematuria was 3.2:1. Infection was the most common cause of hematuria in women (36.5%), while urinary stone was the most common cause of hematuria in men (35.3%). The most common causes in patients aged 0~20 years old were ureteral calculi and renal injury (3 each); urinary stone was the most common cause in patients aged 21~50 years old and 51~80 years old (43.8% and 33.3%, respectively); benign prostatic hyperplasia (33.3%) was the most common cause of hematuria in patients aged 81 years old or older, followed by urinary tract tumors (27.3%). Conclusion: The etiology of hematuria in patients is urinary stone, which needs to be differentiated by age, gender and other factors. The incidence of urologic neoplasms was 15.4%, and the possibility of tumor should be taken into consideration by age, gender and other factors in clinical treatment of hematuria patients.